bid_id	contract_year	version	cs_b0055	cs_b0056	cs_b0057	cs_b0058	cs_b0059	cs_b0060	cs_b0061	cs_b0062	cs_b0063	cs_b0064	cs_c0055	cs_c0056	cs_c0057	cs_c0058	cs_c0059	cs_c0060	cs_c0061	cs_c0062	cs_c0063	cs_c0064	cs_d0012	cs_d0055	cs_d0056	cs_d0057	cs_d0058	cs_d0059	cs_d0060	cs_d0061	cs_d0062	cs_d0063	cs_d0064	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_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_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_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_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_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_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_k0067	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_m0012	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_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	cs_n0067	cs_o0025	cs_o0026	cs_o0027	cs_o0028	cs_o0029	cs_o0030	cs_o0031	cs_o0032	cs_o0033	cs_o0034	cs_o0035	cs_o0036	cs_o0037	cs_o0038	cs_o0039	cs_o0040	cs_o0041	cs_o0042	cs_o0043	cs_o0044	cs_o0045	cs_o0046	cs_o0047	cs_o0048	cs_o0049	cs_o0050	cs_o0051	cs_o0052	cs_o0053	cs_o0054	cs_o0055	cs_o0056	cs_o0057	cs_o0058	cs_o0059	cs_o0060	cs_o0061	cs_o0062	cs_o0063	cs_o0064	cs_o0065
E5088_801_0	2009	4	e.3.	h.6.	h.7.	i.7.							DME/Prosthetics/Supplies	OP Facility - Other	OP Facility - Other	Professional							2500	Diabetic Mon Supplies	Urgent Care	PT/OT/ST/CORF/Cardiac Rehab/Pain Clinic	Outpatient Sub Abuse							A		D	V	T	Coin	Coin	V	V	Coin	V	Coin	Coin	Coin	V	V	V	V	V	V	Coin	P			V		V		V		Coin	V	V	Coin																																															0		254.3968941		1278.367005	1549.644226	126.7508813	22.24628549	4.99406409	347.9878091	411.3261428		787.3728098			0.01402455	4351.554371	4252.424012	183.6245306	1116.72131	2299.254618	989.5999144	30.0817656	50.42278283			393.182437		80.20019428		0		5.188638016	0.221634919	721.2872621	0.015907257							"$500/admit, reduced to $400/admit if prenotify (PBP #1A/1B)"		$100/admit (waived if prenotify); $0/day for 1st 15 days; $75/day for days 16 - 100 (#2)	"$20/visit, reduced to $0/visit if prenotify (#6)"	$50 copay (#10A)	15% coinsurance if under $750 or prenotified; 25% otherwise (#11A)	Prosthetics: 15% coinsurance if under $750 or prenotified; 25% 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 $20 copay (#8B)"	0% coinsurance	0% coinsurance (#12)	Partial Hospitalization: 50% coinsurance (#5)	$10/visit (#7A/7G/14C)	$20/visit (#7D/7F/7G/14C/16B)	$20/visit for individual therapy; $10/visit for group therapy (#7E/7H)	$20/visit (#7C/7I)	"$25 copay/day for MRI, MRA, PET, & SPECT; all other diagnostic radiology $0 copay; Therapeutic Radiology $20 copay (#8B)"	Chiropractic Services: $20/visit (#7B)	10% coinsurance (#15)	eyewear after cataract surgery or for Keratoconus: $20 copay (#17B)			$20/visit (#17A)		$20 copay ($10 if PCP provides exam) (#18A)		$20 copay (#14A)		"Glucose monitors: 20% coinsurance, reduced to 10% if prenotify; 10% coinsurance for test strips, lancets and all other supplies (#11C)"	$30 copay (#7A/7D/7F/7G/16B)	$20 copay (#3/9D/13D)	20% coinsurance (#9C)							432		41.8	4	50	0.159	0.04	50	75	0	4.48	0	0	0.5	10	20	19.70005999	20	2.95	20	0.1	20			20		19.49384405		20		0.1	30	20	0.2							414.4864865		40.10540541	3.837837838	47.97297297	0.152554054	0.038378378	47.97297297	71.95945946	0	4.298378378	0	0	0.47972973	9.594594595	19.18918919	18.90140891	19.18918919	2.830405405	19.18918919	0.095945946	19.18918919			19.18918919		18.70355307		19.18918919		0.095945946	28.78378378	19.18918919	0.191891892							8.787	0	4.272452249	0.495606937	0.50671805	3.39376104	0.191664081	1.39116748	2.466567241	0	0.282035522	0	0	0.006727994	3.479283337	6.800047407	0.289230195	1.78574804	0.542318558	1.582468332	2.886223456	0.080631027	0	0	0.628737681	0	0.125002383	0	0	0	0.497828783	0.000531624	1.153409811	0.003052474	0	0	0	0	0	0	41.6482	0	1.77	8.787	0	4.272452249	0.495606937	0.50671805	3.39376104	0.191664081	1.39116748	2.466567241	0	0.282035522	0	0	0.006727994	3.479283337	6.800047407	0.289230195	1.78574804	0.542318558	1.582468332	2.886223456	0.080631027	0	0	0.628737681	0	0.125002383	0	0	0	0.497828783	0.000531624	1.153409811	0.003052474	0	0	0	0	0	0	41.6482																																																																																		0			8.787	0	4.272452249	0.495606937	0.50671805	3.39376104	0.191664081	1.39116748	2.466567241	0	0.282035522	0	0	0.006727994	3.479283337	6.800047407	0.289230195	1.78574804	0.542318558	1.582468332	2.886223456	0.080631027	0	0	0.628737681	0	0.125002383	0	0	0	0.497828783	0.000531624	1.153409811	0.003052474	0	0	0	0	0	0	41.6482
E6036_801_0	2009	1																																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																																																			0																									11																	#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	#14A $0	#13B $0																																		0.259149091																																								0.259149091																	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.85064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.8506	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.85064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.8506																																																																																		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.85064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.8506
H0046_001_0	2009	6																					0											A	A	D	V	T	O	O	V	V	V	O	V	V	O	V	V	V	V	V	V	S	V	T	V	V	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	600	0	0	0	0	0	0	0	370.224	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	518.31	0	188.07	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/World Wide Coverage: $25, 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 (excl. Radiology): $0, 7F Podiatry: $0"	"7E Mental Health: $0, 7H Psychiatric: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	7D Physician Specialist (Radiology): $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: $0"	17A Routine Eye Exams: $15	17B Eye Wear: Medicare Covered: $0	18A Routine Hearing Exams: $15	18B Hearing Aids: $0	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15	0	15	0	0	0											0	0	0	0	0	0	0	25	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15	0	15	0	0	0											0	0	0	0	0	0	0	0.7713	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.6478875	0	0.2350875	0	0	0	0	0	0	0	0	0	0	0	0	0	1.6543	0	0	0	0	0	0	0	0	0	0.7713	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.6478875	0	0.2350875	0	0	0	0	0	0	0	0	0	0	0	0	0	1.6543	600	PBP: 1A IP Acute: 20% Coinsurance	1B IP Psych: 20% Coinsurance	2 SNF: 20% Coinsurance	6 Home Health: 20% Coinsurance	10A Ambulance: 20% Coinsurance	11A DME:  20% Coinsurance	"11B Prosthetic Medical Supplies: 20% Coinsurance, 11C Diabetes Monitoring Supplies: 20% Coinsurance"	"4A ER/World Wide Coverage: 20% Coinsurance, 4B Urgent Care: 20% Coinsurance"	9B ASC Services: 20% Coinsurance	8A OP C/D/T: 20% Coinsurance	8B OP X-Ray: 20% Coinsurance	9A OP Hospital: 20% Coinsurance	12 Renal Dialysis: 20% Coinsurance	"3 CORF: 20% Coinsurance, 5 Partial Hosp: 20% Coinsurance, 9C OP Substance Abuse: 20% Coinsurance, 9D Cardiac Rehab: 20% Coinsurance"	"7A PCP: 20% Coinsurance, 14B Immunizations: 20% Coinsurance, 14C Routine Physical Exams: 20% Coinsurance, 14D Pap Smears: 20% Coinsurance, 14D Pelvic Exams: 20% Coinsurance, 14E Prostate Screening: 20% Coinsurance, 14F Colorectal Screening: 20% Coinsurance, 14G Bone Mass Measurement: 20% Coinsurance, 14H Mammography: 20% Coinsurance, 14I Diabetes Monitoring: 20% Coinsurance"	"7B Chiropractic: 20% Coinsurance, 7D Physician Specialist (excl. Radiology): 20% Coinsurance, 7F Podiatry: 20% Coinsurance"	"7E Mental Health: 20% Coinsurance, 7H Psychiatric: 20% Coinsurance"	"7C Occupational Therapy: 20% Coinsurance, 7I Physical and Speech Therapy: 20% Coinsurance"	7D Physician Specialist (Radiology): 20% Coinsurance	"7G Other Health Care: 20% Coinsurance, 18A Medicare Covered Hearing Exams: 20% Coinsurance"	15 Part B Drugs: 20% Coinsurance	"13A Blood: 20% Coinsurance, 16B Medicare Covered Comprehensive Dental Services: 20% Coinsurance, 17A Medicare Covered Eye Exams: 20% Coinsurance"	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: Not Covered, Routine: Not Covered"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											0.841	0.01	0.0204	0.1695	0.0777	0.1279	0.0899	0.087	0.0604	0.0062	0.0416	0.0022	0.0004	0.0391	0.2797	0.5326	0.0068	0.0248	0.1402	0.2416	0.0118	0.0428	0	0	0	0	0	0	0	0											2.8535	100	5.2	0.841	0.010026004	0.020351291	0.169544209	0.077664117	0.127868955	0.089859927	0.858275585	0.060380484	0.006210137	0.041600432	0.002244628	0.000374105	0.039131342	0.279680605	0.532575321	0.006808704	0.024765725	0.140214407	0.241596756	0.011821706	0.042797567	0	0	0.6478875	0	0.2350875	0	0	0	0	0	0	0	0	0	0	0	0	0	4.5078
H0084_001_0	2009	9																					0											D	A	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	Coin	V	Coin	V	T	V	V	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	1150.37	5.12	605.46	0	318.98	13.57	9.65	277.74	346.04	3.76	19.82	62.62	1.21	423.32	5883.44	7676	220.13	820.98	40.16	11183.91	9.83	756.19	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $90 per admit	"1B IP Psych: $1,000 per admit"	2 SNF: $100	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	"9B ASC Services: $100, 9A OP Hospital: $100"	8A OP C/D/T: 20%	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	"9A OP Hospital: $50 (Observation), 5 Partial Hosp: $50"	12 Renal Dialysis: $25	"3 CORF: $25, 9C OP Substance Abuse Individual: $25, Group: $10, 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"	"7B Chiropractic: $25, 7D Physician Specialist: $25, 7F Podiatry: $25"	"7E Mental Health Individual: $25, Group: $10, 7H Psychiatric Individual: $25, Group: $10"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	"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: $10, 17A Medicare Covered Eye Exams: $10"	10B Transportation: $0	"16A Preventive Dental Services: $10, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $0, Routine: $0 with a $150 allowance"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											90	1000	100	0	75	0.199999877	0.024962158	48.59670915	100	0.199930319	0.200064733	50	25	25	10	25	24.25	25	0.148955739	24.04980459	0.200000326	10	0	0	0	0	0	0	0	0											87.35298835	970.5887594	97.05887594	0	72.79415696	0.194117632	0.024227989	47.16741965	97.05887594	0.19405012	0.194180581	48.52943797	24.26471899	24.26471899	9.705887594	24.26471899	23.53677742	24.26471899	0.144574766	23.34247	0.194118068	9.705887594	0	0	0	0	0	0	0	0											8.374	0.414117871	4.897105586	0	1.934990015	2.634176268	0.233800099	1.091689928	2.798854453	0.729628453	3.848659108	0.253242784	0.002446692	0.855978403	4.758667276	15.52133191	0.431762568	1.660070749	5.806122591	21.75500697	1.908180607	0.611624595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.5215	0	2.44	8.374	0.414117871	4.897105586	0	1.934990015	2.634176268	0.233800099	1.091689928	2.798854453	0.729628453	3.848659108	0.253242784	0.002446692	0.855978403	4.758667276	15.52133191	0.431762568	1.660070749	5.806122591	21.75500697	1.908180607	0.611624595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.5215	3350	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.374	0.414117871	4.897105586	0	1.934990015	2.634176268	0.233800099	1.091689928	2.798854453	0.729628453	3.848659108	0.253242784	0.002446692	0.855978403	4.758667276	15.52133191	0.431762568	1.660070749	5.806122591	21.75500697	1.908180607	0.611624595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.5215
H0087_801_0	2009	8																					0											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	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	220.1607345	1.409519913	49.61151492	3.497480921	9.413017657	12.29263137	1.885107657	21.46416813	37.59137391	3.941333885	8.04901338	0	0.038310867	27.17265642	27.5477592	73.15774738	1.02185498	0.370784169	34.96348814	60.23558764	38.71370438	0	0	0	0	0	0	0	0	0											Medicare FFS Cost Sharing 8.4%	Medicare FFS Cost Sharing 8.4%	Medicare FFS Cost Sharing 19.4%	Medicare FFS Cost Sharing 0.0%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.083747814	0.083747814	0.194021957	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.083747814	0.083747814	0.194021957	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											18.438	0.118044211	9.625723199	0	2.174407079	2.839597846	0.435459869	4.958222838	8.683607374	0.910448127	1.859322091	0	0.00884981	6.276883632	6.363532376	16.89943965	0.2360485	0.085651143	8.076565761	13.91442075	8.942865712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.8471	0	0	18.438	0.118044211	9.625723199	0	2.174407079	2.839597846	0.435459869	4.958222838	8.683607374	0.910448127	1.859322091	0	0.00884981	6.276883632	6.363532376	16.89943965	0.2360485	0.085651143	8.076565761	13.91442075	8.942865712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.8471	0																																																																																	0	0	0	18.438	0.118044211	9.625723199	0	2.174407079	2.839597846	0.435459869	4.958222838	8.683607374	0.910448127	1.859322091	0	0.00884981	6.276883632	6.363532376	16.89943965	0.2360485	0.085651143	8.076565761	13.91442075	8.942865712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.8471
H0087_802_0	2009	8																					0											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	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	252.9089173	1.619181349	56.99106406	4.017719666	10.81317297	14.12111972	2.1655112	24.65689231	43.18296674	4.527594295	9.246277559	0	0.044009482	31.21449939	31.64539748	84.0397209	1.173852536	0.425937091	40.16419163	69.19543254	44.47224016	0	0	0	0	0	0	0	0	0											Medicare FFS Cost Sharing 8.4%	Medicare FFS Cost Sharing 8.4%	Medicare FFS Cost Sharing 19.4%	Medicare FFS Cost Sharing 0.0%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.083747814	0.083747814	0.194021957	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.083747814	0.083747814	0.194021957	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											21.1806	0.135602898	11.05751776	0	2.497842956	3.261978655	0.500233087	5.695742124	9.975265317	1.045874282	2.135890116	0	0.01016619	7.21054936	7.310086818	19.41317553	0.271159936	0.098391468	9.277928266	15.98414492	10.27308748	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.3352	0	0	21.1806	0.135602898	11.05751776	0	2.497842956	3.261978655	0.500233087	5.695742124	9.975265317	1.045874282	2.135890116	0	0.01016619	7.21054936	7.310086818	19.41317553	0.271159936	0.098391468	9.277928266	15.98414492	10.27308748	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.3352	0																																																																																	0	0	0	21.1806	0.135602898	11.05751776	0	2.497842956	3.261978655	0.500233087	5.695742124	9.975265317	1.045874282	2.135890116	0	0.01016619	7.21054936	7.310086818	19.41317553	0.271159936	0.098391468	9.277928266	15.98414492	10.27308748	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.3352
H0087_803_0	2009	7																					0											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	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	258.5317452	1.655179993	59.66226546	4.207150455	11.15667933	14.56971093	2.234303854	25.88715294	45.3375896	4.753499528	9.707622449	0	0.046205344	32.77195315	32.65068938	86.70944405	1.211142775	0.439468003	41.44010344	71.39359129	46.69119158	0	0	0	0	0	0	0	0	0											Medicare FFS Cost Sharing 8.4%	Medicare FFS Cost Sharing 8.4%	Medicare FFS Cost Sharing 19.4%	Medicare FFS Cost Sharing 0.0%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.083747814	0.083747814	0.194021957	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.083747814	0.083747814	0.194021957	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											21.6515	0.138617706	11.57578948	0	2.577192925	3.365603225	0.51612419	5.97993233	10.4729832	1.098058391	2.242460786	0	0.010673435	7.570321179	7.542309246	20.02988158	0.279773981	0.101517109	9.572663894	16.49191959	10.78566525	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.003	0	0	21.6515	0.138617706	11.57578948	0	2.577192925	3.365603225	0.51612419	5.97993233	10.4729832	1.098058391	2.242460786	0	0.010673435	7.570321179	7.542309246	20.02988158	0.279773981	0.101517109	9.572663894	16.49191959	10.78566525	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.003	0																																																																																	0	0	0	21.6515	0.138617706	11.57578948	0	2.577192925	3.365603225	0.51612419	5.97993233	10.4729832	1.098058391	2.242460786	0	0.010673435	7.570321179	7.542309246	20.02988158	0.279773981	0.101517109	9.572663894	16.49191959	10.78566525	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.003
H0097_001_0	2009	6																																d	d	d	0	t	coin	coin	v	v	0	v	0	0	v	v	v	v	v	v	v	s	0	0	0	v	0	v																																																						0		1385.434104	32.14138151	1266.831015	0	249.2858175	7.684475579	13.97184967	278.6387851	482.5363241	0	965.8036002	0	0	485.7980181	4629.952175	7087.106474	221.0976507	937.1214984	196.7090105	128.5755597	11.3304664	0	0	0	194.0079507	0	0.000115863														"$150/day, 10 day max (PBP 1a)"	"$150/day, 10 day max (PBP 1b)"	"$25/day, days 1-100 (PBP 2)"		$100 copay (PBP 10a)	20% coinsurance (PBP 11a)	20% coinsurance (PBP 11b)	"$50 per visit (PBP 4a), 0-15 per Visit (PBP 4b)"	"$100/visit (PBP 9a, 9b)"		$15/visit (PBP 8b)			"$15 per visit (PBP 3, 5, 9c, and 9d)"	$0 copay	"$15 per visit (PBP 7b, 7d, and 7f)"	"$15 per visit (PBP categories 7e, 7h)"	$15 per visit (PBP categories 7c and 7i)	$15 per visit (PBP 7d)	$15 per visit (PBP 7d)	$50/script for certain covered injectibles (PBP 15)				$15/visit (PBP 17a)		$15/visit (PBP 18a)														150	150	25	0	100	0.2	0.2	50	100	0	15	0	0	15	0	15	15	15	15	15	50	0	0	0	15	0	15														150	150	25	0	100	0.2	0.2	50	100	0	15	0	0	15	0	15	15	15	15	15	50	0	0	0	15	0	15														17.3179	0.401767269	2.639231281	0	2.077381813	1.536895116	2.794369933	1.160994938	4.021136034	0	1.2072545	0	0	0.607247523	0	8.858883093	0.276372063	1.171401873	0.245886263	0.16071945	0.047210277	0	0	0	0.242509938	0	1.45E-07	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7672			17.3179	0.401767269	2.639231281	0	2.077381813	1.536895116	2.794369933	1.160994938	4.021136034	0	1.2072545	0	0	0.607247523	0	8.858883093	0.276372063	1.171401873	0.245886263	0.16071945	0.047210277	0	0	0	0.242509938	0	1.45E-07	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7672	0																																																																																	0			17.3179	0.401767269	2.639231281	0	2.077381813	1.536895116	2.794369933	1.160994938	4.021136034	0	1.2072545	0	0	0.607247523	0	8.858883093	0.276372063	1.171401873	0.245886263	0.16071945	0.047210277	0	0	0	0.242509938	0	1.45E-07	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7672
H0097_002_0	2009	8																																d	d	d		t	coin	coin	v	v		v			v	v	v	v	v	v	v	s				v		v																																																						0		1385.434104	32.14138151	1266.831015		249.2858175	7.684475579	13.97184967	278.6387851	482.5363241		965.8036002			485.7980181	4629.952175	7087.106474	221.0976507	937.1214984	196.7090105	128.5755597	11.3304664				194.0079507		0.000115863														"$150/day, 10 day max (PBP 1a)"	"$150/day, 10 day max (PBP 1b)"	"$25/day, days 1-100 (PBP 2)"		$100 copay (PBP 10a)	20% coinsurance (PBP 11a)	20% coinsurance (PBP 11b)	"$50 per visit (PBP 4a), 0-15 per Visit (PBP 4b)"	"$100/visit (PBP 9a, 9b)"		$15/visit (PBP 8b)			"$15 per visit (PBP 3, 5, 9c, and 9d)"	$0 copay	"$15 per visit (PBP 7b, 7d, and 7f)"	"$15 per visit (PBP categories 7e, 7h)"	$15 per visit (PBP categories 7c and 7i)	$15 per visit (PBP 7d)	$15 per visit (PBP 7d)	$50/script for certain covered injectibles (PBP 15)				$15/visit (PBP 17a)		$15/visit (PBP 18a)														150	150	25		100	0.2	0.2	50	100		15			15	0	15	15	15	15	15	50				15		15														150	150	25		100	0.2	0.2	50	100		15			15	0	15	15	15	15	15	50				15		15														17.3179	0.401767269	2.639231281	0	2.077381813	1.536895116	2.794369933	1.160994938	4.021136034	0	1.2072545	0	0	0.607247523	0	8.858883093	0.276372063	1.171401873	0.245886263	0.16071945	0.047210277	0	0	0	0.242509938	0	1.45E-07	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7672			17.3179	0.401767269	2.639231281	0	2.077381813	1.536895116	2.794369933	1.160994938	4.021136034	0	1.2072545	0	0	0.607247523	0	8.858883093	0.276372063	1.171401873	0.245886263	0.16071945	0.047210277	0	0	0	0.242509938	0	1.45E-07	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7672	0																																																																																	0			17.3179	0.401767269	2.639231281	0	2.077381813	1.536895116	2.794369933	1.160994938	4.021136034	0	1.2072545	0	0	0.607247523	0	8.858883093	0.276372063	1.171401873	0.245886263	0.16071945	0.047210277	0	0	0	0.242509938	0	1.45E-07	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7672
H0097_801_0	2009	6																																coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin																																																											0		250.1593719	3.518352358	18.06934884	5.155991314	3.979586285	5.763848093	7.914290757	3.516433055	27.2436979	6.906926886	18.91980242	0	0.607811994	90.64229411	16.90896676	37.0259178	2.18405042	9.195293039	21.32922773	213.8270488	4.133041211	3.053586164																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			0.0702	0.0702	0.1592	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.0702	0.0702	0.1592	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			17.5612	0.246988336	2.876640335	0	0.919284432	1.331448909	1.828201165	0.812296036	6.293294214	1.595500111	4.370474359	0	0.140404571	20.93836994	3.905971321	8.552987012	0.504515647	2.124112692	4.927051605	49.39404826	0.95473252	0.705378404	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.9829			17.5612	0.246988336	2.876640335	0	0.919284432	1.331448909	1.828201165	0.812296036	6.293294214	1.595500111	4.370474359	0	0.140404571	20.93836994	3.905971321	8.552987012	0.504515647	2.124112692	4.927051605	49.39404826	0.95473252	0.705378404	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.9829																																																																																		0			17.5612	0.246988336	2.876640335	0	0.919284432	1.331448909	1.828201165	0.812296036	6.293294214	1.595500111	4.370474359	0	0.140404571	20.93836994	3.905971321	8.552987012	0.504515647	2.124112692	4.927051605	49.39404826	0.95473252	0.705378404	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.9829
H0097_802_0	2009	6																																coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin																																																											0		250.1593719	3.518352358	18.06934884	5.155991314	3.979586285	5.763848093	7.914290757	3.516433055	27.2436979	6.906926886	18.91980242	0	0.607811994	90.64229411	16.90896676	37.0259178	2.18405042	9.195293039	21.32922773	213.8270488	4.133041211	3.053586164																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			0.0702	0.0702	0.1592	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.0702	0.0702	0.1592	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			17.5612	0.246988336	2.876640335	0	0.919284432	1.331448909	1.828201165	0.812296036	6.293294214	1.595500111	4.370474359	0	0.140404571	20.93836994	3.905971321	8.552987012	0.504515647	2.124112692	4.927051605	49.39404826	0.95473252	0.705378404	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.9829			17.5612	0.246988336	2.876640335	0	0.919284432	1.331448909	1.828201165	0.812296036	6.293294214	1.595500111	4.370474359	0	0.140404571	20.93836994	3.905971321	8.552987012	0.504515647	2.124112692	4.927051605	49.39404826	0.95473252	0.705378404	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.9829																																																																																		0			17.5612	0.246988336	2.876640335	0	0.919284432	1.331448909	1.828201165	0.812296036	6.293294214	1.595500111	4.370474359	0	0.140404571	20.93836994	3.905971321	8.552987012	0.504515647	2.124112692	4.927051605	49.39404826	0.95473252	0.705378404	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.9829
H0104_002_0	2009	8																					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	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	4500	246.1745556	11.92457948	150.2596373	5.452057931	116.4032711	9.662425577	3.560249677	315.3925349	485.669401	14.60031346	12.01585025	0	0.174360414	1000.185906	3000.892032	4143.294473	160.9768933	587.4046246	28.9024528	16.89812692	5.343735514	0	0	0	200.9658742	0	48.5015957	0	13.98699815	0											1a:  Acute - $600/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $600/$0/admit for 1-90	2:  Skilled Nursing Services - $75/$0/day for 1-30/31-100/2:  Non-Medicare Covered Stay                                                  (Remove 3 Day Hospital Stay?) - $75/$0/day for 1-30/31-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $30/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $300/visit/9b:  Ambulatory Surgical Center Services - $300/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $0/visit/8b:  Outpatient Therapeutic Radiological Services - $0/visit/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $30/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $30/day	7a:  Primary Care - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14c:  Physical Exams (Initial Exam) - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $30/visit/7f:  Podiatry Services - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $30/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $30/visit/7h:  Psychiatric Services - Individual - $30/visit/7h:  Psychiatric Services - Group - $30/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $30/visit/9c:  Outpatient Substance Abuse Svcs - Group - $30/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	$0 	17a:  Routine Eye Exams - $30/visit	17b:  Wear - $0	18a:  Routine Hearing Test (Check) - $30/visit/18a:  Fitting for Hearing Aid (Check) - $30/visit	18b:  Hearing Aids - $0/service	/14c:  Routine Exams - $30/visit	$0 											600	600	75	0	150	0.2	0.062758478	50	300	0	0	0	0.2	30	29.99634185	29.96098989	30	30	0	30	0	0	0	0	30	0	30	0	30	0											549.3968389	549.3968389	68.67460486	0	137.3492097	0.18313228	0.057465516	45.78306991	274.6984195	0	5.77E-19	0	0.18313228	27.46984195	27.46649232	27.43412189	27.46984195	27.46984195	0	27.46984195	0	0	0	0	27.46984195	0	27.46984195	0	27.46984195	0											11.2706	0.545943856	0.859918435	0	1.332324775	1.769502023	0.204591583	1.203303206	11.11771807	0	6.94E-18	0	0.03193102	2.289579063	6.868664829	9.4723038	0.368500818	1.34465935	0	0.038682406	0	0	0	0	0.460041733	0	0.111027597	0	0.032018386	0	0	0	0	0	0	0	0	0	0	0	49.3213	0	4.5428	11.2706	0.545943856	0.859918435	0	1.332324775	1.769502023	0.204591583	1.203303206	11.11771807	0	6.94E-18	0	0.03193102	2.289579063	6.868664829	9.4723038	0.368500818	1.34465935	0	0.038682406	0	0	0	0	0.460041733	0	0.111027597	0	0.032018386	0	0	0	0	0	0	0	0	0	0	0	49.3213	9000	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	10a:  Ambulance - $150/trip	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $30/visit	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services											2.9334	0.0926	0.112	0	0.6151	1.3244	0.4545	0.1527	0.7946	0.2508	0.2017	0	0.0095	0.1194	1.6774	4.9219	0.0528	0.3068	1.4228	1.0881	0.0878	0	0	0	0.0611	0.1391	0.0099	0.0071	0.0066	0											16.8421	2000	3.446384981	14.204	0.638588596	0.971904191	0	1.94738123	3.093861674	0.659084153	1.356019974	11.91232739	0.250809903	0.20173841	0	0.041395733	2.408943359	8.546100805	14.39424042	0.421349181	1.651507976	1.422763552	1.126773797	0.087796561	3.92E-05	0	0	0.521101231	0.139136446	0.120949629	0.007067545	0.038619416	0	0	0	0	0	0	0	0	0	0	0	66.1635
H0104_004_0	2009	7																					2500											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	V											0	0	0	0	0	0	0	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	249.7716789	12.0988218	187.5763637	5.372304959	118.7501866	9.883892205	3.641851854	330.1660056	517.1828981	15.25703307	12.43461981	0	0.174182368	1056.86489	3213.352032	4411.373323	169.9604867	620.1857932	29.96917568	17.84115607	5.528722679	0	0	1.14E-13	215.3736016	0	51.97879176	0	14.98975871	0											1a:  Acute - $150/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $150/$0/admit for 1-90	2:  Skilled Nursing Services - $50/$0/day for 1-50/51-100/2:  Non-Medicare Covered Stay                                                  (Remove 3 Day Hospital Stay?) - $50/$0/day for 1-50/51-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $15/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $0/visit/8b:  Outpatient Therapeutic Radiological Services - $0/visit/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $15/visit/3:  Rehab Services (CORF) - $15/day/5:  Partial Hospitalization - $15/day	7a:  Primary Care - $15/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14c:  Physical Exams (Initial Exam) - $15/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $15/visit/7b:  Chiropractic Services - $15/visit/7f:  Podiatry Services - $15/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $15/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $15/visit/7h:  Psychiatric Services - Individual - $15/visit/7h:  Psychiatric Services - Group - $15/visit	7c:  Occupational Therapy Services - $15/visit/7i:  Physical/Speech Therapy - $15/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $15/visit/9c:  Outpatient Substance Abuse Svcs - Group - $15/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	$0 	17a:  Routine Eye Exams - $15/visit	17b:  Wear - $0	18a:  Routine Hearing Test (Check) - $15/visit/18a:  Fitting for Hearing Aid (Check) - $15/visit	18b:  Hearing Aids - $0/service	/14c:  Routine Exams - $15/visit	$0 											150	150	50	0	150	0.2	0.062758476	50	100	0	0	0	0.2	15	15	15	15	15	0	15	0	0	0	0	15	0	15	0	15	0											137.9172784	137.9172784	45.97242613	0	137.9172784	0.183889705	0.057703188	45.97242613	91.94485226	0	0	0	0.183889705	13.79172784	13.79172784	13.79172784	13.79172784	13.79172784	0	13.79172784	0	0	0	0	13.79172784	0	13.79172784	0	13.79172784	0											2.8707	0.139053048	0.71861171	0	1.364808546	1.817546017	0.210146461	1.264877692	3.962692096	0	0	0	0.032030344	1.214666077	3.693139723	5.070038355	0.195337398	0.712786139	0	0.020505031	0	0	0	0	0.247531175	0	0.059739779	0	0.017227889	0	0	0	0	0	0	0	0	0	0	0	23.6114	0	2.0686	2.8707	0.139053048	0.71861171	0	1.364808546	1.817546017	0.210146461	1.264877692	3.962692096	0	0	0	0.032030344	1.214666077	3.693139723	5.070038355	0.195337398	0.712786139	0	0.020505031	0	0	0	0	0.247531175	0	0.059739779	0	0.017227889	0	0	0	0	0	0	0	0	0	0	0	23.6114	5000	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	10a:  Ambulance - $150/trip	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $15/visit	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services											3.1971	0.101	0.1221	0.0838	0.5424	1.181	0.4053	0.1452	0.7086	0.2237	0.1799	0	0.009	0.1064	1.6309	4.775	0.0505	0.2932	1.3675	1.0404	0.0783	0	0	0	0.0583	0.2917	0.0095	0.0142	0.0063	0											16.6213	2000	6.074841713	6.0678	0.240029113	0.840668092	0.08378429	1.907159377	2.998555736	0.61544431	1.410038995	4.671292148	0.223662	0.179902047	0	0.041073463	1.321110268	5.324078685	9.845032224	0.245831688	1.005966545	1.367530735	1.060941906	0.078293378	3.49E-05	0	0	0.305870846	0.291650248	0.069219845	0.01419733	0.023534884	0	0	0	0	0	0	0	0	0	0	0	40.2327
H0104_006_0	2009	5																					none											coin	coin	coin	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	326.8377477	10.32965211	67.3075103	67.48906087	343.2384573	30.43213365	10.25954669	355.9407859	52.68794217	14.56214946	14.2595706	0	0.172485689	0	0	0	1.163623884	6.316200857	32.85814254	0	6.918015488	0.002978509	0	0	0	0	0	0	0	0											1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - 0/admit for 1-90	2:  Skilled Nursing Services - 0/day for 1-1/2-100/2:  Non-Medicare Covered Stay                                                  (Remove 3 Day Hospital Stay?) - $0/day for 1-1/2-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - $0/service	11b:  Prosthetics Devices - $0/service/11b:  Medical Supplies - $0/service/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $0/visit/8b:  Outpatient Therapeutic Radiological Services - $0/visit/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $0/visit/3:  Rehab Services (CORF) - $0/day/5:  Partial Hospitalization - $0/day	7a:  Primary Care - $0/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - $0/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $0/visit/7b:  Chiropractic Services - $0/visit/7f:  Podiatry Services - $0/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $0/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $0/visit/7h:  Psychiatric Services - Individual - $0/visit/7h:  Psychiatric Services - Group - $0/visit	7c:  Occupational Therapy Services - $0/visit/7i:  Physical/Speech Therapy - $0/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $0/visit/9c:  Outpatient Substance Abuse Svcs - Group - $0/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	$0 	17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0	18a:  Routine Hearing Test (Check) - $0/visit/18a:  Fitting for Hearing Aid (Check) - $0/visit		/14c:  Routine Exams - $0/visit	$0 											-1.96E-19	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											1.91E-19	-1.68E-19	0	0	50	1.82E-18	0	50	-2.63E-19	0	2.43E-19	0	0	0	0	0	7.45E-19	5.49E-19	0	0	0	-2.84E-19	0	0	0	0	0	0	0	0											0	-1.73E-18	0	0	1.430160239	5.55E-17	0	1.483086608	-1.39E-17	0	3.47E-18	0	0	0	0	0	8.67E-19	3.47E-18	0	0	0	-8.47E-22	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.9132	0	0	0	-1.73E-18	0	0	1.430160239	5.55E-17	0	1.483086608	-1.39E-17	0	3.47E-18	0	0	0	0	0	8.67E-19	3.47E-18	0	0	0	-8.47E-22	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.9132	none	10% Coinsurance Except for Professional IP Services	10% Coinsurance Except for Professional IP Services	10% Coinsurance Except for Professional IP Services	10% Coinsurance Except for Professional IP Services	10a:  Ambulance - $50/trip	10% Coinsurance Except for Professional IP Services	10% Coinsurance Except for Professional IP Services	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50/visit	10% Coinsurance Except for Professional IP Services	10% Coinsurance Except for Professional IP Services	10% Coinsurance Except for Professional IP Services	10% Coinsurance Except for Professional IP Services	10% Coinsurance Except for Professional IP Services	10% Coinsurance Except for Professional IP Services	10% Coinsurance Except for Professional IP Services	10% Coinsurance Except for Professional IP Services	10% Coinsurance Except for Professional IP Services	10% Coinsurance Except for Professional IP Services	10% Coinsurance Except for Professional IP Services	10% Coinsurance Except for Professional IP Services	10% Coinsurance Except for Professional IP Services	10% Coinsurance Except for Professional IP Services	10% Coinsurance Except for Professional IP Services	10% Coinsurance Except for Professional IP Services	10% Coinsurance Except for Professional IP Services	10% Coinsurance Except for Professional IP Services	10% Coinsurance Except for Professional IP Services	10% Coinsurance Except for Professional IP Services	10% Coinsurance Except for Professional IP Services	10% Coinsurance Except for Professional IP Services											2.1776	0.0688	0.4483	0	0.9111	2.061	0.6996	0.1267	0.4743	0.1473	0.1185	0	0.0046	0.0709	0.887	2.5234	0.0283	0.1601	0.7428	0.5525	0.0533	0	0	0	0.0506	0.1574	0.0085	0	0.0035	0											12.4762	1500	1.932697078	2.1776	0.06882417	0.448257951	0	2.341245691	2.061046553	0.699589318	1.60978426	0.47431367	0.147298074	0.118477194	0	0.004613905	0.070907911	0.88704009	2.523417344	0.028325284	0.16007907	0.742753184	0.552539372	0.053306406	2.32E-05	0	0	0.050638592	0.157448457	0.008475085	0	0.003495249	0	0	0	0	0	0	0	0	0	0	0	15.3895
H0104_008_0	2009	6																					2500											coin	coin	coin	coin	coin	coin	coin	V	coin	coin	coin	O	coin	P	V	V	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	206.0556539	6.507904699	7.98585871	5.984625608	4.690571424	10.54259286	3.884558915	353.6487574	52.0524537	16.24205377	13.27299219	0	0.18056279	0	0	0	1.217687848	6.61201901	34.0044499	0	5.804595759	0.002499254	0	0	0	0	0	0	0	0											1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - 0/admit for 1-90	2:  Skilled Nursing Services - 0/day for 1-100/2:  Non-Medicare Covered Stay                                                  (Remove 3 Day Hospital Stay?) - $0/day for 1-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $0/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $0/visit/8b:  Outpatient Therapeutic Radiological Services - $0/visit/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $0/visit/3:  Rehab Services (CORF) - $0/day/5:  Partial Hospitalization - $0/day	7a:  Primary Care - $0/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - $0/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $0/visit/7b:  Chiropractic Services - $0/visit/7f:  Podiatry Services - $0/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $0/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $0/visit/7h:  Psychiatric Services - Individual - $0/visit/7h:  Psychiatric Services - Group - $0/visit	7c:  Occupational Therapy Services - $0/visit/7i:  Physical/Speech Therapy - $0/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $0/visit/9c:  Outpatient Substance Abuse Svcs - Group - $0/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	$0 	17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0	18a:  Routine Hearing Test (Check) - $0/visit/18a:  Fitting for Hearing Aid (Check) - $0/visit	18b:  Hearing Aids - $0/service	/14c:  Routine Exams - $0/visit	$0 											7.07E-19	0	0	0	0	0.2	0.062758475	50	0	0	0	0	0.2	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											-5.01E-19	0	0	0	0	0.2	0.062758475	50	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	2.108518573	0.243788994	1.473536489	0	0	0	0	0.036112558	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.862	0	0	0	0	0	0	0	2.108518573	0.243788994	1.473536489	0	0	0	0	0.036112558	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.862	5000	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	10a:  Ambulance - $0/trip	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $0/visit	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services	30% Coinsurance Except for Professional IP Services											3.2982	0.1042	0.1259	0.0134	0.3405	1.2183	0.4181	0.1485	0.731	0.2307	0.1856	0	0.0093	0.1098	1.6805	4.9219	0.0521	0.3024	1.4097	1.0732	0.0808	0	0	0	0.0602	0.2965	0.0098	0.0144	0.0065	0											16.8417	2000	6.316666017	3.2982	0.104167846	0.125914502	0.013411964	0.340511684	3.326859186	0.661898028	1.622079864	0.730998422	0.230731803	0.185588628	0	0.045441523	0.10980882	1.680536822	4.921935684	0.052090382	0.302447633	1.409662942	1.073215044	0.080768181	3.60E-05	0	0	0.060183748	0.296472439	0.009779724	0.01443207	0.006506354	0	0	0	0	0	0	0	0	0	0	0	20.7037
H0104_801_0	2009	4																					none											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	V											0	0	0	0	0	0	0	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	293.3224101	3.190611777	34.28164635	45.9240702	6.822161966	13.87224152	3.935634844	9.610216355	38.25762614	5.903794922	18.47172378	0	0.233214003	18.76382049	36.62872615	109.4007952	1.231552295	5.81650926	31.23942962	35.83543452	6.653975069	0.712681201	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.087503352	0.087503352	0.194264169	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.087503352	0.087503352	0.194264169	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											25.6667	0.279189225	6.659695532	0	1.575919414	3.20448779	0.909131649	2.219959978	8.837511639	1.363776627	4.266968193	0	0.053872435	4.334442532	8.46123574	25.27158368	0.28448858	1.343613639	7.216308242	8.277985374	1.537068241	0.164629357	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.9286	0	0	25.6667	0.279189225	6.659695532	0	1.575919414	3.20448779	0.909131649	2.219959978	8.837511639	1.363776627	4.266968193	0	0.053872435	4.334442532	8.46123574	25.27158368	0.28448858	1.343613639	7.216308242	8.277985374	1.537068241	0.164629357	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.9286	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.6897	0.0075	0.2678	0	0.5565	1.1346	0.3219	0.126	0.4985	0.091	0.287	0	0.0078	0.3823	1.3178	3.7881	0.0408	0.1944	1.0186	1.1856	0.1114	0.012	0	0	0	0	0	0	0	0											12.039	0	0	26.3564	0.286691052	6.927516033	0	2.132373927	4.339065599	1.23101791	2.345923743	9.336022693	1.454766179	4.553948659	0	0.061714882	4.716695538	9.77901713	29.05963722	0.325302026	1.538005082	8.23486364	9.463551995	1.648434513	0.176614066	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.9675
H0104_802_0	2009	5																					none											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	V											0	0	0	0	0	0	0	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	293.3129587	3.19050897	34.27607046	45.92566437	6.822097415	13.87217993	3.935619392	9.609519851	38.25666823	5.903085246	18.46945413	0	0.233221909	18.75805366	36.62894733	109.4010345	1.23160588	5.816753879	31.24129124	35.83622311	6.652843987	0.712559392	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.087506145	0.087506145	0.194268818	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.087506145	0.087506145	0.194268818	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											25.6667	0.279189142	6.658771701	0	1.575904503	3.204473563	0.90912808	2.219799086	8.837290362	1.363612692	4.266443903	0	0.053874261	4.333110396	8.461286834	25.27163896	0.284500958	1.343670146	7.216738277	8.278167538	1.536806961	0.164601219	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.9257	0	0	25.6667	0.279189142	6.658771701	0	1.575904503	3.204473563	0.90912808	2.219799086	8.837290362	1.363612692	4.266443903	0	0.053874261	4.333110396	8.461286834	25.27163896	0.284500958	1.343670146	7.216738277	8.278167538	1.536806961	0.164601219	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.9257	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.6897	0.0075	0.2678	0	0.5564	1.1345	0.3219	0.126	0.4985	0.091	0.287	0	0.0078	0.3822	1.3177	3.7879	0.0408	0.1944	1.0185	1.1855	0.1114	0.012	0	0	0	0	0	0	0	0											12.0385	0	0	26.3563	0.286690908	6.926586128	0	2.13233488	4.339008386	1.231002311	2.345758084	9.335783796	1.454598929	4.553414493	0	0.061716394	4.715349692	9.779019023	29.05955342	0.325313114	1.538055296	8.23525873	9.463688705	1.648169332	0.176585508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.9642
H0104_804_0	2009	5																					none											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	V											0	0	0	0	0	0	0	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	293.3132235	3.19051185	34.27622664	45.92561972	6.822099224	13.87218165	3.935619825	9.60953936	38.25669507	5.903105124	18.4695177	0	0.233221688	18.75821519	36.62894114	109.4010278	1.231604379	5.816747027	31.2412391	35.83620102	6.652875668	0.712562803	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.087506067	0.087506067	0.194268688	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.087506067	0.087506067	0.194268688	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											25.6667	0.279189144	6.658797578	0	1.575904921	3.204473962	0.90912818	2.219803592	8.837296561	1.363617284	4.266458588	0	0.05387421	4.333147709	8.461285403	25.27163741	0.284500612	1.343668563	7.216726232	8.278162436	1.536814279	0.164602008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.9258	0	0	25.6667	0.279189144	6.658797578	0	1.575904921	3.204473962	0.90912818	2.219803592	8.837296561	1.363617284	4.266458588	0	0.05387421	4.333147709	8.461285403	25.27163741	0.284500612	1.343668563	7.216726232	8.278162436	1.536814279	0.164602008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.9258	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.6897	0.0075	0.2678	0	0.5564	1.1345	0.3219	0.126	0.4985	0.091	0.287	0	0.0078	0.3822	1.3177	3.7879	0.0408	0.1944	1.0185	1.1855	0.1114	0.012	0	0	0	0	0	0	0	0											12.0385	0	0	26.3563	0.286690912	6.926612174	0	2.132335974	4.339009989	1.231002748	2.345762724	9.335790488	1.454603614	4.553429455	0	0.061716351	4.715387389	9.779018971	29.05955577	0.325312803	1.538053889	8.235247663	9.463684876	1.64817676	0.176586308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.9643
H0117_004_0	2009	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	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		1450.782721	129.891616	677.0840124	1232.188938	474.8112252	17.07965355	5.434382701	1709.301162	392.8597698	9496.775991	1736.983122	77.31288199	0.086898861	755.135394	8429.90147	19672.04937	544.8516795	2902.624856	4579.956869	2202.914477	39.30505883	34.80402843	0	434.6666667	368	118.2857143	29.6	17.76	0	6200											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	Medicare FFS Cost Sharing	Copay between $0.00 and $25.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $25.00	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $50.00, No benefit limit"	$10.00 copayment	"$10.00 copayment, $150 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	Not Covered	$0.00 copayment											62.57044071	32.79216824	35.63	4.403539827	37.07792805	0.2	0.2	21.23686883	54.19355367	0	12.14688161	26.24922505	0.2	6.086266561	2.387383175	6.985364151	18.20379949	9.962418527	15.98671245	6.809031483	0.2	0	0	50	10	10	10	10	0	0											56.61762755	29.67239398	32.24024071	3.9845968	33.55041609	0.180972443	0.180972443	19.21644016	49.03769899	0	10.99125419	23.75193191	0.180972443	5.507232639	2.160252827	6.320792075	16.47193032	9.014616091	14.46577204	6.161235307	0.180972443	0	0	50	10	10	10	10	0	0											6.845	0.321182934	1.819112628	0.409148008	1.327509514	3.090946626	0.983473513	2.737223624	1.605411595	0	1.590968585	0.153027526	0.015726299	0.346558857	1.517559874	10.36191115	0.747896575	2.180504061	5.521051	1.131056205	7.113132515	0	0	1.811111111	0.306666667	0.098571429	0.024666667	0.0148	0	0	0	0	0	0	0	0	0	0	0	0	52.0742	0	5.2379	6.845	0.321182934	1.819112628	0.409148008	1.327509514	3.090946626	0.983473513	2.737223624	1.605411595	0	1.590968585	0.153027526	0.015726299	0.346558857	1.517559874	10.36191115	0.747896575	2.180504061	5.521051	1.131056205	7.113132515	0	0	1.811111111	0.306666667	0.098571429	0.024666667	0.0148	0	0	0	0	0	0	0	0	0	0	0	0	52.0742	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.845	0.321182934	1.819112628	0.409148008	1.327509514	3.090946626	0.983473513	2.737223624	1.605411595	0	1.590968585	0.153027526	0.015726299	0.346558857	1.517559874	10.36191115	0.747896575	2.180504061	5.521051	1.131056205	7.113132515	0	0	1.811111111	0.306666667	0.098571429	0.024666667	0.0148	0	0	0	0	0	0	0	0	0	0	0	0	52.0742
H0117_005_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1306.109671	83.67052922	599.1976436	1216.800602	514.8779944	16.18857601	5.086253833	1255.90748	272.501605	8429.93422	1561.10201	96.27738202	0.103721171	748.6808254	9666.321973	18872.29069	384.9591119	2957.976065	4341.822078	2128.838913	36.19896093	19.67232475	0	434.6666667	368	118.2857143	29.6	17.76	0	6200											"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$50 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	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $25.00	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $50.00, No benefit limit"	$10.00 copayment	"$10.00 copayment, $150 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	Not Covered	$0.00 copayment											32.03674393	15.88313585	56.13	4.455528795	32.46624717	0.2	0.2	20.06130707	17.66769372	0	9.460836229	13.12461252	0.2	3.716927402	2.164174268	6.834969787	19.91791788	9.84276526	15.7426425	7.6973654	0.2	0	0	50	10	10	10	10	0	0											30.50962938	15.12602495	53.45441785	4.24314445	30.91865923	0.190466481	0.190466481	19.10503279	16.82551724	0	9.009860913	12.4989938	0.190466481	3.539750409	2.061013284	6.509163211	18.96847862	9.373584305	14.99222858	7.330450498	0.190466481	0	0	50	10	10	10	10	0	0											3.3207	0.105466876	2.669146768	0.43025506	1.326611438	3.083381102	0.968760868	1.9995128	0.382081704	0	1.172109332	0.100280867	0.019755406	0.220845272	1.660201499	10.23690169	0.60850739	2.310569835	5.424465754	1.300445689	6.8946887	0	0	1.811111111	0.306666667	0.098571429	0.024666667	0.0148	0	0	0	0	0	0	0	0	0	0	0	0	46.4905	0	2.2141	3.3207	0.105466876	2.669146768	0.43025506	1.326611438	3.083381102	0.968760868	1.9995128	0.382081704	0	1.172109332	0.100280867	0.019755406	0.220845272	1.660201499	10.23690169	0.60850739	2.310569835	5.424465754	1.300445689	6.8946887	0	0	1.811111111	0.306666667	0.098571429	0.024666667	0.0148	0	0	0	0	0	0	0	0	0	0	0	0	46.4905	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.3207	0.105466876	2.669146768	0.43025506	1.326611438	3.083381102	0.968760868	1.9995128	0.382081704	0	1.172109332	0.100280867	0.019755406	0.220845272	1.660201499	10.23690169	0.60850739	2.310569835	5.424465754	1.300445689	6.8946887	0	0	1.811111111	0.306666667	0.098571429	0.024666667	0.0148	0	0	0	0	0	0	0	0	0	0	0	0	46.4905
H0117_007_0	2009	7																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	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	0	0	0											0		444.7396126	54.77888591	1575.230822	2663.97929	22.04780213	40.42394148	7.132858822	30.41079788	19.10066512	12196.36085	22.22618892	1.960798371	1.75769723	10.02738947	8235.14683	93.41619689	10.35733994	28.27146768	19.7413617	7.771195133	24.94244503	0.350638135	4500	935.4545455	444	133.2	22.8	17.37142857	0	5822.857143											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	$0.00 copayment	"$0.00 copayment, No benefit limit"	$0.00 copayment	"$0.00 copayment, $200 benefit limit,"	$0.00 copayment	"$0.00 copayment, $350 benefit limit"	Not Covered	$0.00 copayment											775.3816813	576.3312257	65.31599271	0	0.152780507	0.17	0.17	0.120825132	0.17	0	0.17	0.17	0.17	0.17	0	0.088872163	0.17	0.17	0.169998023	0.030636962	0.17	0.169114402	0	0	0	0	0	0	0	0											775.3816813	576.3312257	65.31599271	0	0.152780507	0.17	0.17	0.120825132	0.17	0	0.17	0.17	0.17	0.17	0	0.088872163	0.17	0.17	0.169998023	0.030636962	0.17	0.169114402	0	0	0	0	0	0	0	0											28.7369	2.630898538	8.573980404	0	3.368474384	6.872070052	1.212586	3.674388675	3.24711307	0	3.778452117	0.333335723	0.298808529	1.70465621	0	8.302099474	1.76074779	4.806149505	3.355992463	0.238085812	4.240215656	0.059297959	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.1943	0	0	28.7369	2.630898538	8.573980404	0	3.368474384	6.872070052	1.212586	3.674388675	3.24711307	0	3.778452117	0.333335723	0.298808529	1.70465621	0	8.302099474	1.76074779	4.806149505	3.355992463	0.238085812	4.240215656	0.059297959	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.1943	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	28.7369	2.630898538	8.573980404	0	3.368474384	6.872070052	1.212586	3.674388675	3.24711307	0	3.778452117	0.333335723	0.298808529	1.70465621	0	8.302099474	1.76074779	4.806149505	3.355992463	0.238085812	4.240215656	0.059297959	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.1943
H0117_008_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2211.889126	596.9392606	1517.301984	2522.678339	2680.887354	42.08102509	6.802342444	3861.020317	354.9846524	12154.38908	1805.162813	182.0625076	0.009832282	989.2926915	7939.837662	21052.88669	1512.726635	7650.91081	4953.129172	1593.839847	32.12818076	8.826357985	4500	434.6666667	368	118.2857143	29.6	17.76	0	5960											"$75 days 1 - 5, $0 after day 5, unlimited coverage"	"$75 days 1 - 5, $0 after day 5, unlimited coverage"	Medicare FFS Cost Sharing	Copay between $0.00 and $10.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $10.00	Copay between $5.00 and $10.00	$10.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"Copay between $0.00 and $50.00, No benefit limit"	$10.00 copayment	"$10.00 copayment, $150 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	Not Covered	$0.00 copayment											45.5212565	26.37155065	40.51	1.524840595	22.49121953	0.2	0.2	21.28033134	35.7376197	0	7.28715961	19.68691878	0.2	3.374172464	0	2.052391887	7.079671622	3.710180373	12.05473333	6.656111234	0.2	0	0	50	10	10	10	10	0	0											30.52584165	17.68434883	27.16537152	1.022534221	15.08225956	0.134116868	0.134116868	14.2702569	23.96508804	0	4.886655102	13.2017394	0.134116868	2.262667207	0	1.376301854	4.747516907	2.487988849	8.08371537	4.463483944	0.134116868	0	0	50	10	10	10	10	0	0											5.6266	0.879706843	3.434839344	0.214960411	3.369486575	5.643775269	0.912308861	4.591479319	0.708936537	0	0.735100672	0.200295148	0.001318675	0.186536678	0	2.414593915	0.598474606	1.586281731	3.336640534	0.592839881	4.308930964	0	0	1.811111111	0.306666667	0.098571429	0.024666667	0.0148	0	0	0	0	0	0	0	0	0	0	0	0	41.599	0	19.3268	5.6266	0.879706843	3.434839344	0.214960411	3.369486575	5.643775269	0.912308861	4.591479319	0.708936537	0	0.735100672	0.200295148	0.001318675	0.186536678	0	2.414593915	0.598474606	1.586281731	3.336640534	0.592839881	4.308930964	0	0	1.811111111	0.306666667	0.098571429	0.024666667	0.0148	0	0	0	0	0	0	0	0	0	0	0	0	41.599	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	5.6266	0.879706843	3.434839344	0.214960411	3.369486575	5.643775269	0.912308861	4.591479319	0.708936537	0	0.735100672	0.200295148	0.001318675	0.186536678	0	2.414593915	0.598474606	1.586281731	3.336640534	0.592839881	4.308930964	0	0	1.811111111	0.306666667	0.098571429	0.024666667	0.0148	0	0	0	0	0	0	0	0	0	0	0	0	41.599
H0117_009_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2556.20341	596.2053495	1683.227218	2431.510432	3262.40673	39.69472934	7.394299357	3358.355058	290.2892485	12075.8595	1767.144195	138.9328721	2.830306483	913.1745198	9488.834125	22133.36783	1648.193645	7518.722611	5383.596366	1356.162088	18.43066186	16.04618509	4500	434.6666667	368	118.2857143	29.6	17.76	1664	6200											"$25 days 1 - 5, $0 after day 5, unlimited coverage"	"$25 days 1 - 5, $0 after day 5, unlimited coverage"	Medicare FFS Cost Sharing	Copay between $0.00 and $25.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $25.00	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"Copay between $0.00 and $50.00, No benefit limit"	$10.00 copayment	"$10.00 copayment, $150 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											13.66852315	6.961500041	40.51	2.897609435	20.39360211	0.2	0.2	20.2666264	17.83937998	0	8.242217619	6.562306262	0.2	4.700257184	1.768787848	4.252470243	20.11451501	9.216800567	15.38358642	7.39069713	0.2	0	0	50	10	10	10	10	0	0											8.926121929	4.546153049	26.45473805	1.892261134	13.31788205	0.130608433	0.130608433	13.23496155	11.6498673	0	5.382515626	4.285462679	0.130608433	3.069466121	1.155093043	2.777042368	13.1356264	6.018959383	10.04613056	4.826436844	0.130608433	0	0	50	10	10	10	10	0	0											1.9014	0.225870064	3.710777926	0.383421057	3.620695669	5.184466386	0.96575785	3.703975007	0.281819269	0	0.792640103	0.04961597	0.369661894	0.233579854	0.913373857	5.122108351	1.80417133	3.771240501	4.507025997	0.545452556	2.40719986	0	0	1.811111111	0.306666667	0.098571429	0.024666667	0.0148	0	0	0	0	0	0	0	0	0	0	0	0	42.7501	0	21.5144	1.9014	0.225870064	3.710777926	0.383421057	3.620695669	5.184466386	0.96575785	3.703975007	0.281819269	0	0.792640103	0.04961597	0.369661894	0.233579854	0.913373857	5.122108351	1.80417133	3.771240501	4.507025997	0.545452556	2.40719986	0	0	1.811111111	0.306666667	0.098571429	0.024666667	0.0148	0	0	0	0	0	0	0	0	0	0	0	0	42.7501	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	1.9014	0.225870064	3.710777926	0.383421057	3.620695669	5.184466386	0.96575785	3.703975007	0.281819269	0	0.792640103	0.04961597	0.369661894	0.233579854	0.913373857	5.122108351	1.80417133	3.771240501	4.507025997	0.545452556	2.40719986	0	0	1.811111111	0.306666667	0.098571429	0.024666667	0.0148	0	0	0	0	0	0	0	0	0	0	0	0	42.7501
H0133_001_0	2009	10																					1250											D	D	D	V	T	Coin	Coin	V	V	Coin	V	V	Coin	Coin	V	V	V	V	Coin	V	Coin	Coin	T	V	V	V	V	V	Coin	Coin																																																			0	0	1375.787739	5.203923804	1670.813063	1248.918122	201.0245811	8.072370309	3.432857716	777.8987292	349.9235553	27.12907717	931.8377291	44.06153093	0	41.61170557	7039.5548	11262.92092	314.8308309	741.3444862	0	170.9217502	22.98483641	0	225.118429	366.6573492	0	3.684513244	0	0	0.116376406	0											1a: $100 Days 1-5	1b: $275	2: $75 Days 4-18	6: none	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4b: $25	9b: $75	8a: 20%; 8a: $40; 8a: 20%; 8a: $40; 8a: 20%	8b: $15	5: $100	12: 20%	9a: 20%; 9a: $40; 9a: 20%; 9d: $20	7a: none	7d: $20	7e: $35; 7h: $35	7c: $20; 7i: $20		7b: $20; 7f: $20	15: 20%		10b: none	16a: $20	17a: $20	17b: $20	18a. $20	18b. $0	14a: none												42.65544754	275	22.44137756	0	149.8911821	0.200260338	0.108176648	14.6166357	53.38496105	0.099386679	5.664292499	31.95331773	0	0.14630629	0	5.697447478	35	18.3071067	0	19.80532883	0.182283185	0	0	19.61904762	0	18.24112432	0	0	0	0											41.05460596	275	14.43106063	0	109.6412194	0.160246535	0.096135845	13.63267853	52.41994378	0.092143946	5.421005445	27.0127654	0	0.068103592	0	5.687994709	35	17.03510087	0	19.80532883	0.072179936	0	0	19.61904762	0	18.24112432	0	0	0	0											4.7069	0.119256587	2.009300384	0	1.836715017	1.293569369	0.330020678	0.883736942	1.528581092	2.499780222	0.420958117	0.099185316	0	2.833906619	0	5.338619553	0.91825659	1.052406508	0	0.282096789	1.659044021	0	0	0.599455666	0	0.005600805	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.4174	0	8.5352	4.7069	0.119256587	2.009300384	0	1.836715017	1.293569369	0.330020678	0.883736942	1.528581092	2.499780222	0.420958117	0.099185316	0	2.833906619	0	5.338619553	0.91825659	1.052406508	0	0.282096789	1.659044021	0	0	0.599455666	0	0.005600805	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.4174	0																																																																																	0		0	4.7069	0.119256587	2.009300384	0	1.836715017	1.293569369	0.330020678	0.883736942	1.528581092	2.499780222	0.420958117	0.099185316	0	2.833906619	0	5.338619553	0.91825659	1.052406508	0	0.282096789	1.659044021	0	0	0.599455666	0	0.005600805	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.4174
H0141_001_0	2009	6																					0											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	349.2478094	34.551816	55.85822911	0	15.73696777	26.63546632	20.45387494	27.45309619	27.2852894	14.36034391	20.16532742	0	5.328770994	54.57438065	51.39684587	103.559327	10.77602613	4.966154744	25.0042106	32.62817911	9.862217534	0.696532011	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																			0.072465538	0.072465538	0.185966584	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.072465538	0.072465538	0.185966584	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											25.3084	2.503815931	10.38776408	0	3.635239555	6.15279272	4.724845111	6.341665221	6.302901852	3.317239443	4.658190633	0	1.2309461	12.60668193	11.8726714	23.92220455	2.489262036	1.147181746	5.775972649	7.537109375	2.27817225	0.160898895	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.354	0	0	25.3084	2.503815931	10.38776408	0	3.635239555	6.15279272	4.724845111	6.341665221	6.302901852	3.317239443	4.658190633	0	1.2309461	12.60668193	11.8726714	23.92220455	2.489262036	1.147181746	5.775972649	7.537109375	2.27817225	0.160898895	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.354	0																																																																																	0	0		25.3084	2.503815931	10.38776408	0	3.635239555	6.15279272	4.724845111	6.341665221	6.302901852	3.317239443	4.658190633	0	1.2309461	12.60668193	11.8726714	23.92220455	2.489262036	1.147181746	5.775972649	7.537109375	2.27817225	0.160898895	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.354
H0150_001_0	2009	5																					2250											D		D		T	COIN		P	P		P				V	V	V	V	V		COIN					V																																																							0		1908.157899		333.4330723		208.9752307	7.823525589		393.7182708	443.3651845		651.9621386				5270.694538	8329.513362	221.1692094	115.9554634	1660.100309		8.433816143					202.5															$150 per day for 1st 10 days		$0/day days 1-5; $95/day days 6-100		$150 per trip	20% Coinsurance		$50 per visit	$150 per visit		$25 per visit				$5 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit		20% Script					$100 limit on eyewear															150		95		150	0.2		50	150		25				5	30	30	30	30		0.2					100															145.99		92.45807664		145.9864368	0.194648582		48.6621456	145.9864368		19.46485824				5	30	30	30	30		0.194648582					100															23.2143	0	2.56904838	0	2.542295776	1.522838165	0	1.596597985	5.39377529	0	1.057529217	0	0	0	2.196122724	20.82378341	0.552923023	0.289888659	4.150250772	0	1.641630357	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.2385		1.3581	23.2143	0	2.56904838	0	2.542295776	1.522838165	0	1.596597985	5.39377529	0	1.057529217	0	0	0	2.196122724	20.82378341	0.552923023	0.289888659	4.150250772	0	1.641630357	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.2385																																																																																		0			23.2143	0	2.56904838	0	2.542295776	1.522838165	0	1.596597985	5.39377529	0	1.057529217	0	0	0	2.196122724	20.82378341	0.552923023	0.289888659	4.150250772	0	1.641630357	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.2385
H0150_007_0	2009	3																																D		D		T	COIN	COIN	P	P	P	P	P	P	P	V	V	V	V	V	V	COIN	COIN	T			V																																																							0																																										$0 Copay		$0 Copay		$0 Per Trip	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% Coinsurance	0% Coinsurance	$0 Per Trip			$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
H0150_010_0	2009	2																					2250											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			V																																																				0		1774.344	35.1936	426.8695271		222.6389763	7.823525589		419.9663132	434.8783997		651.9621386				5222.11788	8252.745507	219.1308327	114.8867753	1644.800214		8.433816143					202.5															$250 per day for 1st 10 days	$250 per day for days 1 - 6	"$0/day; days 1-5, $95/day;days 6 to 100"		$150 per trip	20% coinsurance		$50 per visit	$300 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															250	250	95		150	0.2		50	300		25				5	25	25	25	25		0.2					100															243.5282231	243.5282231	92.54072479		146.77	0.195564005		48.92	293.55		24.46				5	25	25	25	25		0.195640973					100															36.0086	0.714219573	3.291901286	0	2.723060213	1.53	0	1.71206267	10.63821285	0	1.328916159	0	0	0	2.17588245	17.19321981	0.456522568	0.239347449	3.426667113	0	1.65	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.7761		1.4242	36.0086	0.714219573	3.291901286	0	2.723060213	1.53	0	1.71206267	10.63821285	0	1.328916159	0	0	0	2.17588245	17.19321981	0.456522568	0.239347449	3.426667113	0	1.65	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.7761																																																																																		0			36.0086	0.714219573	3.291901286	0	2.723060213	1.53	0	1.71206267	10.63821285	0	1.328916159	0	0	0	2.17588245	17.19321981	0.456522568	0.239347449	3.426667113	0	1.65	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.7761
H0150_012_0	2009	5																					2250											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		1631.616099		111.5391287		183.77759	7.823525589		402.1974179	448.9241327		651.9621386				4985.153493	7878.26013	209.1873185	109.6735505	1570.164007		8.433816143					202.5															$125/day for 1st 10 days		$0/day; days 1-5; $95/day; days 6-100		$150 per trip	20% coinsurance		$50 per visit	$100 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															125		95		150	0.2		50	100		25				5	25	25	25	25		0.2					100															121.2896481		92.18013255		145.5475777	0.194063437		48.51585924	97.03171847		24.25792962				5	25	25	25	25		0.194063437					100															16.4915	0	0.856807639	0	2.229031921	1.518260265	0	1.626079443	3.629990005	0	1.317937639	0	0	0	2.077147289	16.41304194	0.435806913	0.228486564	3.271175014	0	1.636695347	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4195		0.8008	16.4915	0	0.856807639	0	2.229031921	1.518260265	0	1.626079443	3.629990005	0	1.317937639	0	0	0	2.077147289	16.41304194	0.435806913	0.228486564	3.271175014	0	1.636695347	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4195																																																																																		0			16.4915	0	0.856807639	0	2.229031921	1.518260265	0	1.626079443	3.629990005	0	1.317937639	0	0	0	2.077147289	16.41304194	0.435806913	0.228486564	3.271175014	0	1.636695347	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4195
H0150_015_0	2009	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
H0150_017_0	2009	5																					2250											D	D	D		T	COIN		P	P		P				V	V	V	V	V		COIN					V																																																							0		1849.01	35.49	333.4330723		208.9752307	7.823525589		393.7182708	443.3651845		651.9621386				5270.694538	8329.513362	221.1692094	115.9554634	1660.100309		8.433816143					202.5															$265/day for 1st 10 days	$250/day for 1st 6 days	$0/day days 1-5; $95/day days 6-100		$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															265	250	95		150	0.2		50	250		25				5	25	25	25	25		0.2					100															261.55	246.74	93.76		148.04	0.196842201		49.35	246.74		24.67				5	25	25	25	25		0.197212532					100															40.3007	0.72973355	2.605223738	0	2.578057763	1.54	0	1.619166389	9.116327134	0	1.340325497	0	0	0	2.196122724	17.35315284	0.460769186	0.241573882	3.45854231	0	1.663254236	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.8905		0.81	40.3007	0.72973355	2.605223738	0	2.578057763	1.54	0	1.619166389	9.116327134	0	1.340325497	0	0	0	2.196122724	17.35315284	0.460769186	0.241573882	3.45854231	0	1.663254236	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.8905																																																																																		0			40.3007	0.72973355	2.605223738	0	2.578057763	1.54	0	1.619166389	9.116327134	0	1.340325497	0	0	0	2.196122724	17.35315284	0.460769186	0.241573882	3.45854231	0	1.663254236	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.8905
H0150_019_0	2009	2																					2250											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		1849.02	35.49	333.4330723		208.9752307	7.823525589		393.7182708	443.3651845		651.9621386				5270.694538	8329.513362	221.1692094	115.9554634	1660.100309		8.433816143					202.5															$250/day for days 1-10	$250/day for days 1 - 6	$0 day/1-5; $95/day; days 6-100		$150 per trip	20% coinsurance		$50 per visit	$175 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															250	250	95		150	0.2		50	175		25				5	25	25	25	25		0.2					100															245.5480015	246.7413793	93.31		147.3288009	0.196438401		49.10960029	171.883601		24.55480015				5	25	25	25	25		0.196438401					100															37.8353	0.729737629	2.592719998	0	2.565672513	1.536840858	0	1.611278909	6.350600372	0	1.334066668	0	0	0	2.196122724	17.35315284	0.460769186	0.241573882	3.45854231	0	1.656725359	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.6106		1	37.8353	0.729737629	2.592719998	0	2.565672513	1.536840858	0	1.611278909	6.350600372	0	1.334066668	0	0	0	2.196122724	17.35315284	0.460769186	0.241573882	3.45854231	0	1.656725359	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.6106																																																																																		0			37.8353	0.729737629	2.592719998	0	2.565672513	1.536840858	0	1.611278909	6.350600372	0	1.334066668	0	0	0	2.196122724	17.35315284	0.460769186	0.241573882	3.45854231	0	1.656725359	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.6106
H0150_021_0	2009	4																					2250											A		D		T	COIN		P	P		P				V	V	V	V	V		COIN			COIN		V																																																							0		285.4657155		333.4330723		208.9752307	7.823525589		393.7182708	443.3651845		651.9621386				5270.694538	8329.513362	221.1692094	115.9554634	1660.100309		8.433816143			3.75		202.5															$150 per admit		$0 days 1-100		$50 per trip	20% Coinsurance		$50 per visit	$50 per visit		$25 per visit				$0 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit		20% per script			Various Coins		$100 limit on eyewear															150		0		50	0.2		50	50		25				0	25	25	25	25		0.2			0.2		100															133.8456501		0		44.61521669	0.178460867		44.61521669	44.61521669		22.30760835				0	25	25	25	25		0.178460867			0.2		100															3.184	0	0	0	0.776956267	1.396193158	0	1.463818831	1.648402815	0	1.211976337	0	0	0	0	17.35315284	0.460769186	0.241573882	3.45854231	0	1.505106139	0	0	0.75	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.138		1.3501	3.184	0	0	0	0.776956267	1.396193158	0	1.463818831	1.648402815	0	1.211976337	0	0	0	0	17.35315284	0.460769186	0.241573882	3.45854231	0	1.505106139	0	0	0.75	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.138																																																																																		0			3.184	0	0	0	0.776956267	1.396193158	0	1.463818831	1.648402815	0	1.211976337	0	0	0	0	17.35315284	0.460769186	0.241573882	3.45854231	0	1.505106139	0	0	0.75	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.138
H0150_802_0	2009	1																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																			21.98	0.45	4.88		0.25	0.9	-0.55	0.73	1.32	0.51	0.25	0.07	0.0176	0.53	2.5435	4.6403	0.1646	0.0392	1.0439		1.05																				40.819		2228.985452	45.48949901	912.2535721		7.987245294	8.310368441	2.761519948	23.64360988	42.7462031	16.68898728	7.972446151	2.118392835	0.584646051	17.1065916	82.04834107	149.6864857	5.310621483	1.262984479	33.67451387		33.98128179																				Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits																			8.91	8.91	4.831090432		0.2	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																			8.91	8.91	4.831090432		0.2	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																			1.655	0.033775953	0.367264959	0	1.597449059	1.662073688	0.55230399	4.728721976	8.549240619	3.337797455	1.59448923	0.423678567	0.11692921	3.42131832	16.40966821	29.93729715	1.062124297	0.252596896	6.734902774	0	6.796256358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.2329	40.81904016		23.635	0.483775953	5.247264959	0	1.847449059	2.562073688	0.00230399	5.458721976	9.869240619	3.847797455	1.84448923	0.493678567	0.134498026	3.95131832	18.95316679	34.57757821	1.226753562	0.291749415	7.778812704	0	7.846256358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.052																																																																																		0			23.635	0.483775953	5.247264959	0	1.847449059	2.562073688	0.00230399	5.458721976	9.869240619	3.847797455	1.84448923	0.493678567	0.134498026	3.95131832	18.95316679	34.57757821	1.226753562	0.291749415	7.778812704	0	7.846256358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.052
H0150_804_0	2009	1																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																			21.98	0.45	4.88		0.25	0.9	-0.55	0.73	1.32	0.51	0.25	0.07	0.0176	0.53	2.5435	4.6403	0.1646	0.0392	1.0439		1.05																				40.819		2228.985452	45.48949901	912.2535721		7.987245294	8.310368441	2.761519948	23.64360988	42.7462031	16.68898728	7.972446151	2.118392835	0.584646051	17.1065916	82.04834107	149.6864857	5.310621483	1.262984479	33.67451387		33.98128179																				Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits																			8.91	8.91	4.831090432		0.2	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																			8.91	8.91	4.831090432		0.2	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																			1.655	0.033775953	0.367264959	0	1.597449059	1.662073688	0.55230399	4.728721976	8.549240619	3.337797455	1.59448923	0.423678567	0.11692921	3.42131832	16.40966821	29.93729715	1.062124297	0.252596896	6.734902774	0	6.796256358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.2329	40.81904016		23.635	0.483775953	5.247264959	0	1.847449059	2.562073688	0.00230399	5.458721976	9.869240619	3.847797455	1.84448923	0.493678567	0.134498026	3.95131832	18.95316679	34.57757821	1.226753562	0.291749415	7.778812704	0	7.846256358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.052																																																																																		0			23.635	0.483775953	5.247264959	0	1.847449059	2.562073688	0.00230399	5.458721976	9.869240619	3.847797455	1.84448923	0.493678567	0.134498026	3.95131832	18.95316679	34.57757821	1.226753562	0.291749415	7.778812704	0	7.846256358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.052
H0150_805_0	2009	1																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																			21.98	0.45	4.88		0.25	0.9	-0.55	0.73	1.32	0.51	0.25	0.07	0.0176	0.53	2.5435	4.6403	0.1646	0.0392	1.0439		1.05																				40.819		2228.985452	45.48949901	912.2535721		7.987245294	8.310368441	2.761519948	23.64360988	42.7462031	16.68898728	7.972446151	2.118392835	0.584646051	17.1065916	82.04834107	149.6864857	5.310621483	1.262984479	33.67451387		33.98128179																				Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits																			8.91	8.91	4.831090432		0.2	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																			8.91	8.91	4.831090432		0.2	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																			1.655	0.033775953	0.367264959	0	1.597449059	1.662073688	0.55230399	4.728721976	8.549240619	3.337797455	1.59448923	0.423678567	0.11692921	3.42131832	16.40966821	29.93729715	1.062124297	0.252596896	6.734902774	0	6.796256358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.2329	40.82		23.635	0.483775953	5.247264959	0	1.847449059	2.562073688	0.00230399	5.458721976	9.869240619	3.847797455	1.84448923	0.493678567	0.134498026	3.95131832	18.95316679	34.57757821	1.226753562	0.291749415	7.778812704	0	7.846256358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.052																																																																																		0			23.635	0.483775953	5.247264959	0	1.847449059	2.562073688	0.00230399	5.458721976	9.869240619	3.847797455	1.84448923	0.493678567	0.134498026	3.95131832	18.95316679	34.57757821	1.226753562	0.291749415	7.778812704	0	7.846256358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.052
H0150_806_0	2009	1																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																			21.98	0.45	4.88		0.25	0.9	-0.55	0.73	1.32	0.51	0.25	0.07	0.0176	0.53	2.5435	4.6403	0.1646	0.0392	1.0439		1.05																				40.819		2228.985452	45.48949901	912.2535721		7.987245294	8.310368441	2.761519948	23.64360988	42.7462031	16.68898728	7.972446151	2.118392835	0.584646051	17.1065916	82.04834107	149.6864857	5.310621483	1.262984479	33.67451387		33.98128179																				Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits																			8.91	8.91	4.831090432		0.2	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																			8.91	8.91	4.831090432		0.2	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																			1.655	0.033775953	0.367264959	0	1.597449059	1.662073688	0.55230399	4.728721976	8.549240619	3.337797455	1.59448923	0.423678567	0.11692921	3.42131832	16.40966821	29.93729715	1.062124297	0.252596896	6.734902774	0	6.796256358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.2329	40.81904016		23.635	0.483775953	5.247264959	0	1.847449059	2.562073688	0.00230399	5.458721976	9.869240619	3.847797455	1.84448923	0.493678567	0.134498026	3.95131832	18.95316679	34.57757821	1.226753562	0.291749415	7.778812704	0	7.846256358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.052																																																																																		0			23.635	0.483775953	5.247264959	0	1.847449059	2.562073688	0.00230399	5.458721976	9.869240619	3.847797455	1.84448923	0.493678567	0.134498026	3.95131832	18.95316679	34.57757821	1.226753562	0.291749415	7.778812704	0	7.846256358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.052
H0151_001_0	2009	9																					3300											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2187.616515	131.2869531	1401.30061	1506.635695	217.5045036	18.24421126	7.481077695	511.577495	37.50933625	10952.59865	43.58881841	0	0.672264091	20.87503516	7058.079845	4665.795864	587.3449393	355.833165	0	0	37.88158422	806.2812346	750.7187628	0	230.599758	282.8436958	18.94136277	0	113.2252537	0											"$240 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$240 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$115 Days 1-25 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	15% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 15% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); 15% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											239.7635218	240	87.8078022	0	150	0.2	0.065929971	49.93502832	0.15	2.8	0.143303462	0	0.2	0.124359971	7.943295941	20	37.5	20	0	0	0.2	19.79256844	0	0	20	0	20	0	0	0											156.0118511	156.1493076	57.129698	0	97.59331727	0.130124423	0.042895497	32.48883375	0.097593317	1.821741922	0.093236401	0	0.130124423	0.081291758	7.943295941	20	37.5	13.0124423	0	0	0.130124423	19.79256844	0	0	20	0	20	0	0	0											28.4412	1.708363903	6.671323386	0	1.768915502	2.374017464	0.320904549	1.385046349	3.660660553	1.66273401	4.064064573	0	0.087477977	1.696968301	4.672034749	7.77632644	1.835452935	0.385854877	0	0	4.92931929	1.32986471	0	0	0.38433293	0	0.031568938	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1864	0	31.7499	28.4412	1.708363903	6.671323386	0	1.768915502	2.374017464	0.320904549	1.385046349	3.660660553	1.66273401	4.064064573	0	0.087477977	1.696968301	4.672034749	7.77632644	1.835452935	0.385854877	0	0	4.92931929	1.32986471	0	0	0.38433293	0	0.031568938	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1864																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	28.4412	1.708363903	6.671323386	0	1.768915502	2.374017464	0.320904549	1.385046349	3.660660553	1.66273401	4.064064573	0	0.087477977	1.696968301	4.672034749	7.77632644	1.835452935	0.385854877	0	0	4.92931929	1.32986471	0	0	0.38433293	0	0.031568938	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1864
H0151_015_0	2009	5																																D	D	D	V	T	O	O	V	V	O	O	V	O	O	V	V	V	V	V	V	S	O	T	V	P	P	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	2993.623068	93.86530013	2121.523841	1766.107795	310.2670483	2337.970871	1718.510117	886.2493972	404.1407249	11699.7509	6353.048199	0	11.12362703	679.7948889	7638.889576	6234.682274	594.810269	355.0484826	0	0	3138.023519	776.2622671	738.8396289	0	246.7565355	285.1857009	20.80077091	5.04	789.5100164	0											"$0 Days 1-999 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-999 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	$0 (11a)	"$0 (11b, 11c)"	"$0 (4a, 4a1, 4b)"	$0 (9b)	$0/$0 (8a1); $0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 5, 9a, 9d); $0/$0 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (7a1, 14b1, 14e1, 14h1)"	"$0 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$0/$0 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a8, 14a9)"	"$0 n/c (13b, 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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	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	2009	7																																Coin	Coin	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		340.451493	43.63	7651.44933	106.2893349	24.68064909	13.5786	15.51307243	10.77889212	7.5400987	30.9878635	25.6367082	0	0.096859989	5.038369211	1.212628373	140.5944355	45.27	42.21426951	0	0	9.26831642	6.945066583	1576.881712	0	191.5790143	148.7435641	0	0	0	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.085081456	0.086280783	0	0	0.2	0.2	0.2	0.066786643	0.2	0.08	0.15003742	0	0.2	0.2	0	0.19865215	0.2	0	0	0	0.2	0.022666282	0	0	0	0	0	0	0	0											0.085081456	0.086280783	0	0	0.2	0.2	0.2	0.066786643	0.2	0.08	0.15003742	0	0.2	0.2	0	0.19865215	0.2	0	0	0	0.2	0.022666282	0	0	0	0	0	0	0	0											28.9661	3.764430584	0	0	4.936129817	2.715719999	3.102614486	0.719886014	1.50801974	2.47902908	3.846465543	0	0.019371998	1.007673842	0	27.92938687	9.054	0	0	0	1.853663284	0.157418836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.0599	0	0	28.9661	3.764430584	0	0	4.936129817	2.715719999	3.102614486	0.719886014	1.50801974	2.47902908	3.846465543	0	0.019371998	1.007673842	0	27.92938687	9.054	0	0	0	1.853663284	0.157418836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.0599																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	28.9661	3.764430584	0	0	4.936129817	2.715719999	3.102614486	0.719886014	1.50801974	2.47902908	3.846465543	0	0.019371998	1.007673842	0	27.92938687	9.054	0	0	0	1.853663284	0.157418836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.0599
H0151_019_0	2009	4																					3100											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2018.753594	153.3429059	1255.519913	1268.717905	192.188908	16.9008206	6.342643915	454.580394	38.03544311	10782.35139	41.81081951	0	0.482021817	18.41479585	6871.578996	4625.90312	584.1499815	360.649101	0	0	58.32573435	822.8342133	749.1284334	0	221.2441643	273.2858586	18.89094845	0	113.0013087	0											"$250 Days 1-13 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$250 Days 1-13 (1b); $0 n/c (1b1, 1b2)"	"$115 Days 1-27 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	15% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 15% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); 15% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											249.744103	250	115	0	150	0.2	0.074818331	49.65418968	0.15	2.8	0.143417408	0	0.2	0.119892124	7.762682808	20	37.5	20	0	0	0.2	19.81394308	0	0	20	0	20	0	0	0											156.0106296	156.1514053	71.82964644	0	93.69084318	0.124921124	0.04673195	31.01428599	0.093690843	1.748895739	0.089579319	0	0.124921124	0.075346917	7.762682808	20	37.5	12.49211242	0	0	0.124921124	19.81394308	0	0	20	0	20	0	0	0											26.2456	1.995392521	7.515295954	0	1.500528403	2.111269509	0.296404117	1.174873862	3.563572736	1.571434034	3.745384742	0	0.060214707	1.387498104	4.445157345	7.709838533	1.825468692	0.375439093	0	0	7.286116307	1.358632522	0	0	0.368740274	0	0.031484914	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5683	0	35.3381	26.2456	1.995392521	7.515295954	0	1.500528403	2.111269509	0.296404117	1.174873862	3.563572736	1.571434034	3.745384742	0	0.060214707	1.387498104	4.445157345	7.709838533	1.825468692	0.375439093	0	0	7.286116307	1.358632522	0	0	0.368740274	0	0.031484914	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5683																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	26.2456	1.995392521	7.515295954	0	1.500528403	2.111269509	0.296404117	1.174873862	3.563572736	1.571434034	3.745384742	0	0.060214707	1.387498104	4.445157345	7.709838533	1.825468692	0.375439093	0	0	7.286116307	1.358632522	0	0	0.368740274	0	0.031484914	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5683
H0151_023_0	2009	6																					2650											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2011.805941	113.3084902	903.1827551	1352.467241	146.4215629	15.40697	6.531922429	371.7273498	35.14720421	10831.41068	46.86690179	0	0.356786315	29.06081429	7130.556998	4662.549741	590.7970494	485.2568554	0	0	32.01510811	791.0825856	703.5316614	0	191.4552987	227.8273516	18.87776916	5.04	463.0645005	0											"$170 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$170 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$125 Days 1-22 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$15 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											169.8349684	170	125	0	150	0.2	0.058337375	49.94672773	0.2	2.8	0.179557581	0	0.2	0.158043335	11.52441181	30	37.5	30	0	0	0.2	29.68248334	0	0	30	0	30	0	0	0											108.3445451	108.4311412	79.72878026	0	95.67453632	0.127566048	0.037209342	31.85753344	0.127566048	1.785924678	0.114527256	0	0.127566048	0.101089897	11.52441181	30	37.5	19.13490726	0	0	0.127566048	29.68248334	0	0	30	0	30	0	0	0											18.164	1.023847408	6.000804952	0	1.167401261	1.965406282	0.243048536	0.986859706	4.483589954	1.612006969	5.367537639	0	0.04551382	2.937754718	6.847956273	11.65637435	1.846240779	0.773778744	0	0	4.084040832	1.956774639	0	0	0.478638247	0	0.047194423	0	0	0	0	0	0	0	0	0	0	0	0	0	71.6888	0	27.7231	18.164	1.023847408	6.000804952	0	1.167401261	1.965406282	0.243048536	0.986859706	4.483589954	1.612006969	5.367537639	0	0.04551382	2.937754718	6.847956273	11.65637435	1.846240779	0.773778744	0	0	4.084040832	1.956774639	0	0	0.478638247	0	0.047194423	0	0	0	0	0	0	0	0	0	0	0	0	0	71.6888																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.164	1.023847408	6.000804952	0	1.167401261	1.965406282	0.243048536	0.986859706	4.483589954	1.612006969	5.367537639	0	0.04551382	2.937754718	6.847956273	11.65637435	1.846240779	0.773778744	0	0	4.084040832	1.956774639	0	0	0.478638247	0	0.047194423	0	0	0	0	0	0	0	0	0	0	0	0	0	71.6888
H0151_801_0	2009	2																					4840											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2358.43714	142.2348861	1522.735156	1457.266155	219.998295	15.5163861	6.549860544	451.4757739	38.5508971	12036.50946	42.96792426	0	0.462503097	15.81257443	7856.910541	5012.60107	605.1160234	322.257551	0	0	43.68847971	1027.942455	0	0	0	0	0	0	0	0											"$440 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$440 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-33 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											434.7518354	440	150	0	150	0.2	0.063444144	49.95201363	0.2	2.8	0.179373608	0	0.2	0.197890502	15.35922448	30	37.5	30	0	0	0.2	29.77524273	0	0	0	0	0	0	0	0											270.1880839	273.4324352	93.21560292	0	93.21560292	0.124287471	0.039426561	31.04204712	0.124287471	1.740024588	0.11146946	0	0.124287471	0.123538334	15.35922448	30	37.5	18.64312058	0	0	0.124287471	29.77524273	0	0	0	0	0	0	0	0											53.1018	3.240969273	11.8285563	0	1.708939476	1.928492381	0.258238476	1.167894354	4.791393488	1.745318535	4.789611322	0	0.05748334	1.953459098	10.05633773	12.53150267	1.890987573	0.500657199	0	0	5.429930636	2.550603009	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.5322	0	56.3305	53.1018	3.240969273	11.8285563	0	1.708939476	1.928492381	0.258238476	1.167894354	4.791393488	1.745318535	4.789611322	0	0.05748334	1.953459098	10.05633773	12.53150267	1.890987573	0.500657199	0	0	5.429930636	2.550603009	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.5322																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	53.1018	3.240969273	11.8285563	0	1.708939476	1.928492381	0.258238476	1.167894354	4.791393488	1.745318535	4.789611322	0	0.05748334	1.953459098	10.05633773	12.53150267	1.890987573	0.500657199	0	0	5.429930636	2.550603009	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.5322
H0151_804_0	2009	2																					4950											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2476.358993	149.3466302	1598.871912	1530.129461	230.9982095	16.29220536	6.877353552	474.0049616	40.47844184	12638.33492	45.11632035	0	0.485628251	16.60320311	8296.751833	5263.231116	635.3718237	338.3704281	0	0	45.87290357	1079.339576	0	0	0	0	0	0	0	0											"$450 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$450 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-33 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											444.631535	450	150	0	150	0.2	0.063444144	49.95200911	0.2	2.8	0.179373608	0	0.2	0.197890502	15.27222433	30	37.5	30	0	0	0.2	29.77524273	0	0	0	0	0	0	0	0											271.8782994	275.1432317	91.71441055	0	91.71441055	0.122285881	0.038791615	30.54212715	0.122285881	1.71200233	0.109674298	0	0.122285881	0.121572707	15.27222433	30	37.5	18.34288211	0	0	0.122285881	29.77524273	0	0	0	0	0	0	0	0											56.1057	3.424309538	12.21996624	0	1.765488718	1.992306682	0.266783652	1.20642665	4.949941911	1.803071569	4.948100775	0	0.059385478	2.018496354	10.5591546	13.15807779	1.985536949	0.517224073	0	0	5.609608415	2.678133156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.2677	0	61.5511	56.1057	3.424309538	12.21996624	0	1.765488718	1.992306682	0.266783652	1.20642665	4.949941911	1.803071569	4.948100775	0	0.059385478	2.018496354	10.5591546	13.15807779	1.985536949	0.517224073	0	0	5.609608415	2.678133156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.2677																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	56.1057	3.424309538	12.21996624	0	1.765488718	1.992306682	0.266783652	1.20642665	4.949941911	1.803071569	4.948100775	0	0.059385478	2.018496354	10.5591546	13.15807779	1.985536949	0.517224073	0	0	5.609608415	2.678133156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.2677
H0154_001_0	2009	5																					none											A	A	D	V	T	coin	coin	V	V	V	V	O	V	V	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	299.1955125	4.278410527	971.0993752	0	270.6031566	26.83551057	8.2630674	677.7646822	372.5277107	0	117.4456288	0	4.472257169	588.4736009	767.9791015	1174.160796	33.88063764	155.716594	27.49802698	3.556531023	21.65178427	0	0	0	108.6791138	0	160.8797341	0	7.86801803	0											1a:  Acute - $300/admit for 1-90/1a:  Additional Days - $300/admit for 91-999	1b:  Psych - $300/admit for 1-190	2:  Skilled Nursing Services - $85/$0/day for 1-30/31-100/2:  Non-Medicare Covered Stay - $85/$0/day for 1-30/31-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $175/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $6/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50/visit/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $225/visit/9b:  Ambulatory Surgical Center Services - $225/visit	8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $40/visit/8b:  Outpatient Therapeutic Radiological Services - $40/visit/8b:  Outpatient X-Ray Services - $0/visit		12:  Renal Dialysis - $50/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $0/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $30/day	7a:  Primary Care - $15/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - PCP -$15; SCP-$20/visit/14c:  Physical Exams (Initial Exam) - $15/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement/14h: Mammography - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - PCP -$15; SCP-$20/visit//14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement/14h: Mammography - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $30/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $30/visit/7h:  Psychiatric Services - Individual - $30/visit/7h:  Psychiatric Services - Group - $30/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $30/visit/9c:  Outpatient Substance Abuse Svcs - Group - $30/visit/7g:  Other Health Care Professional Services - $30/visit	"15:  Medicare Part B Rx Drugs - 20%, $2,500 annual out-of-pocket max on Medicare Part B chemotherapy drugs and chemotherapy support drugs"	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $20/visit		18a:  Routine Hearing Test - PCP -$15; SCP-$20/visit		14c:  Routine Exams - $15/visit												300	300	85	0	175	0.2	0.074510656	50	225	0	40	0	50	30	15.00207241	19.97052103	30	30	0	30	0.2	0	0	0	20	0	18	0	15	0											300	300	85	0	175	0.2	0.074510656	50	225	0	40	0	50	30	15.00207241	19.97052103	30	30	0	30	0.184009268	0	0	0	20	0	18	0	15	0											7.4799	0.106960263	6.878620575	0	3.946296034	5.367102114	0.615686573	2.824019509	6.984894576	0	0.391485429	0	0.018634405	1.471184002	0.960106508	1.954050239	0.084701594	0.389291485	0	0.008891328	3.984128969	0	0	0	0.181131856	0	0.241319601	0	0.009835023	0	0	0	0	0	0	0	0	0	0	0	43.8982	0	0	7.4799	0.106960263	6.878620575	0	3.946296034	5.367102114	0.615686573	2.824019509	6.984894576	0	0.391485429	0	0.018634405	1.471184002	0.960106508	1.954050239	0.084701594	0.389291485	0	0.008891328	3.984128969	0	0	0	0.181131856	0	0.241319601	0	0.009835023	0	0	0	0	0	0	0	0	0	0	0	43.8982	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	7.4799	0.106960263	6.878620575	0	3.946296034	5.367102114	0.615686573	2.824019509	6.984894576	0	0.391485429	0	0.018634405	1.471184002	0.960106508	1.954050239	0.084701594	0.389291485	0	0.008891328	3.984128969	0	0	0	0.181131856	0	0.241319601	0	0.009835023	0	0	0	0	0	0	0	0	0	0	0	43.8982
H0154_008_0	2009	5																					none											A	A	D	V	T	coin	coin	V	V	V	V	O	V	V	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	274.8331201	3.930035262	1068.634191	0	159.4492302	21.35836203	6.576568928	568.2794756	366.588867	0	111.4379209	0	4.31248762	541.0207511	761.0556924	1165.750939	32.67026579	150.1536827	26.50732592	3.429475414	8.247304238	0	0	178	87.53469999	0	141.459182	0	7.801358711	0											1a:  Acute - $250/admit for 1-90/1a:  Additional Days - $250/admit for 91-999	1b:  Psych - $250/admit for 1-190	2:  Skilled Nursing Services - $85/$0/day for 1-30/31-100/2:  Non-Medicare Covered Stay - $85/$0/day for 1-30/31-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $6/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50/visit/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $175/visit/9b:  Ambulatory Surgical Center Services - $175/visit	8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $40/visit/8b:  Outpatient Therapeutic Radiological Services - $40/visit/8b:  Outpatient X-Ray Services - $0/visit		12:  Renal Dialysis - $50/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $0/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $30/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - PCP -$10; SCP-$15/visit/14c:  Physical Exams (Initial Exam) - $10/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement/14h: Mammography - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $15/visit/7b:  Chiropractic Services - $15/visit/7f:  Podiatry Services - $15/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - PCP -$10; SCP-$15/visit//14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement/14h: Mammography - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $30/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $30/visit/7h:  Psychiatric Services - Individual - $30/visit/7h:  Psychiatric Services - Group - $30/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $30/visit/9c:  Outpatient Substance Abuse Svcs - Group - $30/visit/7g:  Other Health Care Professional Services - $30/visit	"15:  Medicare Part B Rx Drugs - 20%, $2,500 annual out-of-pocket max on Medicare Part B chemotherapy drugs and chemotherapy support drugs"	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $15/visit	17b:  Eyewear - $100/Per Year	18a:  Routine Hearing Test - PCP -$10; SCP-$15/visit		14c:  Routine Exams - $10/visit												250	250	85	0	150	0.2	0.074550964	50	175	0	40	0	50	30	10.00207483	14.97054176	30	30	0	30	0.2	0	0	0	15	0	13	0	10	0											250	250	85	0	150	0.2	0.074550964	50	175	0	40	0	50	30	10.00207483	14.97054176	30	30	0	30	0.157504886	0	0	0	15	0	13	0	10	0											5.7257	0.081875735	7.569492187	0	1.993115377	4.271672406	0.490289555	2.367831148	5.346087644	0	0.371459736	0	0.017968698	1.352551878	0.634344665	1.454326926	0.081675664	0.375384207	0	0.008573689	1.298990713	0	0	0	0.109418375	0	0.153247447	0	0.006501132	0	0	0	0	0	0	0	0	0	0	0	33.7105	0	0	5.7257	0.081875735	7.569492187	0	1.993115377	4.271672406	0.490289555	2.367831148	5.346087644	0	0.371459736	0	0.017968698	1.352551878	0.634344665	1.454326926	0.081675664	0.375384207	0	0.008573689	1.298990713	0	0	0	0.109418375	0	0.153247447	0	0.006501132	0	0	0	0	0	0	0	0	0	0	0	33.7105	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	5.7257	0.081875735	7.569492187	0	1.993115377	4.271672406	0.490289555	2.367831148	5.346087644	0	0.371459736	0	0.017968698	1.352551878	0.634344665	1.454326926	0.081675664	0.375384207	0	0.008573689	1.298990713	0	0	0	0.109418375	0	0.153247447	0	0.006501132	0	0	0	0	0	0	0	0	0	0	0	33.7105
H0154_009_0	2009	6																					none											A	A	D	V	T	coin	coin	V	V	V	V	O	V	V	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	259.6156811	3.712430223	611.9656039	0	198.5520202	18.47419371	5.688489041	603.1457876	284.125034	0	92.13292627	0	3.87291513	892.740384	651.6714536	1002.072568	29.34018084	134.848496	23.75377269	3.079908486	17.08191523	0	0	0	79.23213734	0	227.8329027	0	2958.676388	0											1a:  Acute - $300/admit for 1-90/1a:  Additional Days - $300/admit for 91-999	1b:  Psych - $300/admit for 1-190	2:  Skilled Nursing Services - $85/$0/day for 1-30/31-100/2:  Non-Medicare Covered Stay - $85/$0/day for 1-30/31-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $175/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $6/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50/visit/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $225/visit/9b:  Ambulatory Surgical Center Services - $225/visit	8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $40/visit/8b:  Outpatient Therapeutic Radiological Services - $40/visit/8b:  Outpatient X-Ray Services - $0/visit		12:  Renal Dialysis - $50/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $0/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $30/day	7a:  Primary Care - $15/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - PCP -$15; SCP-$20/visit/14c:  Physical Exams (Initial Exam) - $15/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement/14h: Mammography - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - PCP -$15; SCP-$20/visit//14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement/14h: Mammography - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $30/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $30/visit/7h:  Psychiatric Services - Individual - $30/visit/7h:  Psychiatric Services - Group - $30/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $30/visit/9c:  Outpatient Substance Abuse Svcs - Group - $30/visit/7g:  Other Health Care Professional Services - $30/visit	"15:  Medicare Part B Rx Drugs - 20%, $2,500 annual out-of-pocket max on Medicare Part B chemotherapy drugs and chemotherapy support drugs"	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $20/visit		18a:  Routine Hearing Test - PCP -$15; SCP-$20/visit		14c:  Routine Exams - $15/visit												300	300	85	0	175	0.2	0.074691648	50	225	0	40	0	50	30	15.0020724	19.97068993	30	30	0	30	0.2	0	0	0	20	0	18	0	0.033848181	0											300	300	85	0	175	0.2	0.074691648	50	225	0	40	0	50	30	15.0020724	19.97068993	30	30	0	30	0.177569107	0	0	0	20	0	18	0	0.033848181	0											6.4904	0.092810756	4.334756361	0	2.895550295	3.694838742	0.424882621	2.513107448	5.327344387	0	0.307109754	0	0.016137146	2.23185096	0.81470186	1.667673378	0.073350452	0.33712124	0	0.007699771	3.033220432	0	0	0	0.132053562	0	0.341749354	0	0.008345484	0	0	0	0	0	0	0	0	0	0	0	34.7447	0	0	6.4904	0.092810756	4.334756361	0	2.895550295	3.694838742	0.424882621	2.513107448	5.327344387	0	0.307109754	0	0.016137146	2.23185096	0.81470186	1.667673378	0.073350452	0.33712124	0	0.007699771	3.033220432	0	0	0	0.132053562	0	0.341749354	0	0.008345484	0	0	0	0	0	0	0	0	0	0	0	34.7447	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	6.4904	0.092810756	4.334756361	0	2.895550295	3.694838742	0.424882621	2.513107448	5.327344387	0	0.307109754	0	0.016137146	2.23185096	0.81470186	1.667673378	0.073350452	0.33712124	0	0.007699771	3.033220432	0	0	0	0.132053562	0	0.341749354	0	0.008345484	0	0	0	0	0	0	0	0	0	0	0	34.7447
H0154_010_0	2009	4																					none											coin	coin	coin	V	coin	coin	coin	coin	coin	V	V	O	coin	V	V	V	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	305.5012147	3.306471177	44.41913644	0	10.94669331	31.05114418	8.699263675	15.99359355	40.92329071	0	0	0	0.217033837	0	0	0	1.324186504	5.741596462	30.64178429	0	25.38313638	2.74222249	12000	2384.10596	0	0	0	0	0	0											1a:  Acute - $0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $0/admit for 1-190	2:  Skilled Nursing Services - $0/day for 1-100/2:  Non-Medicare Covered Stay - $0/day for 1-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $0/trip	11a:  Durable Medical Equipment - $0/service	11b:  Prosthetics Devices - $0/service/11b:  Medical Supplies - $0/service/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $0/visit/4b:  Urgently Needed Care / Urgent Care Centers - $0/visit/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $0/visit/8b:  Outpatient Therapeutic Radiological Services - $0/visit/8b:  Outpatient X-Ray Services - $0/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $0/visit/3:  Rehab Services (CORF) - $0/day/5:  Partial Hospitalization - $0/day	7a:  Primary Care - $0/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - PCP -$0; SCP-$0/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement/14h: Mammography - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $0/visit/7b:  Chiropractic Services - $0/visit/7f:  Podiatry Services - $0/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - PCP -$0; SCP-$0/visit//14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement/14h: Mammography - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $0/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $0/visit/7h:  Psychiatric Services - Individual - $0/visit/7h:  Psychiatric Services - Group - $0/visit	7c:  Occupational Therapy Services - $0/visit/7i:  Physical/Speech Therapy - $0/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $0/visit/9c:  Outpatient Substance Abuse Svcs - Group - $0/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - 0.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $0/visit	17b:  Eyewear - $100/Per Year	18a:  Routine Hearing Test - PCP -$0; SCP-$0/visit		14c:  Routine Exams - $0/visit												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H0154_011_0	2009	4																					none											coin	coin	coin	V	coin	coin	coin	V	coin	V	V	O	V	V	V	V	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	223.8820259	2.423098273	45.60234647	0	8.836002875	24.29172863	6.805551233	557.5857866	39.92926782	0	0	0	4.512079295	0	0	0	1.273301802	5.520963323	30.12367105	0	16.52633871	1.814042497	0	1589.403974	0	0	0	0	0	0											1a:  Acute - $0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $0/admit for 1-190	2:  Skilled Nursing Services - $0/day for 1-100/2:  Non-Medicare Covered Stay - $0/day for 1-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $0/trip	11a:  Durable Medical Equipment - $0/service	11b:  Prosthetics Devices - $0/service/11b:  Medical Supplies - $0/service/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50/visit/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $0/visit/8b:  Outpatient Therapeutic Radiological Services - $0/visit/8b:  Outpatient X-Ray Services - $0/visit		12:  Renal Dialysis - $50/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $0/visit/3:  Rehab Services (CORF) - $0/day/5:  Partial Hospitalization - $0/day	7a:  Primary Care - $0/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - PCP -$0; SCP-$0/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement/14h: Mammography - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $0/visit/7b:  Chiropractic Services - $0/visit/7f:  Podiatry Services - $0/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - PCP -$0; SCP-$0/visit//14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement/14h: Mammography - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $0/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $0/visit/7h:  Psychiatric Services - Individual - $0/visit/7h:  Psychiatric Services - Group - $0/visit	7c:  Occupational Therapy Services - $0/visit/7i:  Physical/Speech Therapy - $0/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $0/visit/9c:  Outpatient Substance Abuse Svcs - Group - $0/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - 0.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $0/visit	17b:  Eyewear - $100/Per Year	18a:  Routine Hearing Test - PCP -$0; SCP-$0/visit		14c:  Routine Exams - $0/visit												0	0	0	0	0	0	0	50	0	0	0	0	50	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	50	0	0	0	0	50	0	0	0	0	0	0	0	0.194369139	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	2.323274111	0	0	0	0	0.01880033	0	0	0	0	0	0	0	3.212210228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.5543	0	0	0	0	0	0	0	0	0	2.323274111	0	0	0	0	0.01880033	0	0	0	0	0	0	0	3.212210228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.5543	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	2.323274111	0	0	0	0	0.01880033	0	0	0	0	0	0	0	3.212210228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.5543
H0154_801_0	2009	2																					none											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	V											0	0	0	0	0	0	0	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	210.7315455	2.292230418	47.47427905	0	9.408147078	23.67890844	6.713723094	11.3463596	35.78728575	11.37163511	42.62648257	0	0.185975145	31.86385028	30.54808711	91.74068292	0.893041796	4.043090387	23.97242303	26.63071169	17.16090037	1.816617936	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																			0.087162919	0.087162919	0.194400917	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.087162919	0.087162919	0.194400917	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											18.368	0.199797494	9.229043403	0	2.173281975	5.469827849	1.550870035	2.621009069	8.266863008	2.626847712	9.846717474	0	0.042960259	7.360549416	7.056608123	21.19209775	0.206292655	0.933953879	5.537629721	6.1516944	3.964167986	0.419638743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.2178	0	0	18.368	0.199797494	9.229043403	0	2.173281975	5.469827849	1.550870035	2.621009069	8.266863008	2.626847712	9.846717474	0	0.042960259	7.360549416	7.056608123	21.19209775	0.206292655	0.933953879	5.537629721	6.1516944	3.964167986	0.419638743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.2178	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	18.368	0.199797494	9.229043403	0	2.173281975	5.469827849	1.550870035	2.621009069	8.266863008	2.626847712	9.846717474	0	0.042960259	7.360549416	7.056608123	21.19209775	0.206292655	0.933953879	5.537629721	6.1516944	3.964167986	0.419638743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.2178
H0154_802_0	2009	2																					none											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	V											0	0	0	0	0	0	0	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	210.7315455	2.292230418	47.47427905	0	9.408147078	23.67890844	6.713723094	11.3463596	35.78728575	11.37163511	42.62648257	0	0.185975145	31.86385028	30.54808711	91.74068292	0.893041796	4.043090387	23.97242303	26.63071169	17.16090037	1.816617936	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																			0.087162919	0.087162919	0.194400917	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.087162919	0.087162919	0.194400917	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											18.368	0.199797494	9.229043403	0	2.173281975	5.469827849	1.550870035	2.621009069	8.266863008	2.626847712	9.846717474	0	0.042960259	7.360549416	7.056608123	21.19209775	0.206292655	0.933953879	5.537629721	6.1516944	3.964167986	0.419638743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.2178	0	0	18.368	0.199797494	9.229043403	0	2.173281975	5.469827849	1.550870035	2.621009069	8.266863008	2.626847712	9.846717474	0	0.042960259	7.360549416	7.056608123	21.19209775	0.206292655	0.933953879	5.537629721	6.1516944	3.964167986	0.419638743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.2178	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	18.368	0.199797494	9.229043403	0	2.173281975	5.469827849	1.550870035	2.621009069	8.266863008	2.626847712	9.846717474	0	0.042960259	7.360549416	7.056608123	21.19209775	0.206292655	0.933953879	5.537629721	6.1516944	3.964167986	0.419638743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.2178
H0154_803_0	2009	2																					none											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	V											0	0	0	0	0	0	0	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	210.7315455	2.292230418	47.47427905	0	9.408147078	23.67890844	6.713723094	11.3463596	35.78728575	11.37163511	42.62648257	0	0.185975145	31.86385028	30.54808711	91.74068292	0.893041796	4.043090387	23.97242303	26.63071169	17.16090037	1.816617936	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																			0.087162919	0.087162919	0.194400917	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.087162919	0.087162919	0.194400917	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											18.368	0.199797494	9.229043403	0	2.173281975	5.469827849	1.550870035	2.621009069	8.266863008	2.626847712	9.846717474	0	0.042960259	7.360549416	7.056608123	21.19209775	0.206292655	0.933953879	5.537629721	6.1516944	3.964167986	0.419638743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.2178	0	0	18.368	0.199797494	9.229043403	0	2.173281975	5.469827849	1.550870035	2.621009069	8.266863008	2.626847712	9.846717474	0	0.042960259	7.360549416	7.056608123	21.19209775	0.206292655	0.933953879	5.537629721	6.1516944	3.964167986	0.419638743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.2178	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	18.368	0.199797494	9.229043403	0	2.173281975	5.469827849	1.550870035	2.621009069	8.266863008	2.626847712	9.846717474	0	0.042960259	7.360549416	7.056608123	21.19209775	0.206292655	0.933953879	5.537629721	6.1516944	3.964167986	0.419638743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.2178
H0245_001_0	2009	7																																D	D	D	V	P	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	Coin	T	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		1295.189942	336.9210711	859.6143861	267.4075886	157.3357048	15.77363248	4.928932272	695.6391586	2453.57842	2380.72353	634.2229815	0	0.864167149	116.9632208	3288.735262	5302.596026	706.8807238	147.5229337	1613.455887	0	15.49412265	0.389276282	8227.886166	1689.981239	491.0075246	463.2586487	15.99376897	1.476997135	3.021073818	12000											$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	$100/visit	$0 Lab / $30 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$30/visit	$15/visit	$35/visit	$35/visit	$35/visit	$35/visit	$35/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											77.33153234	77.33153234	40.66337511	0	124.2484388	0	0	46.84373331	33	0	0	0	0	0	12.02126323	17.5	34.34793939	35	0.039241334	0	0	0	0	9.332565056	0	0	0	0	0	0											56.77555321	56.77555321	40.66337511	0	124.2484388	0	0	46.84373331	33	0	0	0	0	0	12.02126323	17.5	34.34793939	35	0.039241334	0	0	0	0	9.332565056	0	0	0	0	0	0											6.1279	1.59407335	2.912901853	0	1.629059641	0	0	2.715527936	6.747340655	0	0	0	0	0	3.294562689	7.732952538	2.023324688	0.430275223	0.00527618	0	0	0	0	1.314321655	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.5275	0	0	6.1279	1.59407335	2.912901853	0	1.629059641	0	0	2.715527936	6.747340655	0	0	0	0	0	3.294562689	7.732952538	2.023324688	0.430275223	0.00527618	0	0	0	0	1.314321655	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.5275		$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	$100/visit	$0 Lab / $30 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$30/visit	$15/visit	$35/visit	$35/visit	$35/visit	$35/visit	$35/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											1.1462	0.2982	0.2086	0	2.8651	0	0	0.4786	0.5196	0	0	0	0	0	1.1226	2.635	0.6894	0.1466	0.0018	0	0	0	0	0.1099	0	0	0	0	0	0											10.2215	0	0	7.2741	1.89224166	3.121500538	0	4.494151402	0	0	3.194083648	7.266895847	0	0	0	0	0	4.417181562	10.36794822	2.71277051	0.576891066	0.007074033	0	0	0	0	1.424194008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7491
H0245_002_0	2009	7																																D	D	D	V	P	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	Coin	T	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		1644.333949	427.7447944	1091.340407	339.4925809	199.7486487	20.02572638	6.25762323	883.162421	3114.9889	3022.494537	805.1903014	0	1.097120456	148.492965	4175.278749	6732.015422	897.4343718	187.2906515	2048.39476	0	19.67086916	0.494213386	8227.886166	1961.918638	623.368292	588.139159	20.30520501	1.875150858	3.835463881	12000											$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	$100/visit	$0 Lab / $20 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$20/visit	$10/visit	$30/visit	$30/visit	$30/visit	$30/visit	$30/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											73.46495573	73.46495573	60.99506267	0	125.3164557	0.2	0.122529278	46.72576966	33	0	0	0	0	0	8.541691057	15	30	30	0	0	0.2	0	0	9.02200489	0	0	0	0	0	0											53.93677555	53.93677555	60.99506267	0	125.3164557	0.2	0.122529278	46.72576966	33	0	0	0	0	0	8.541691057	15	30	30	0	0	0.2	0	0	9.02200489	0	0	0	0	0	0											7.3908	1.922597914	5.547198042	0	2.085982724	4.005145275	0.766742057	3.438870321	8.566219475	0	0	0	0	0	2.971995096	8.415019278	2.24358593	0.468226629	0	0	3.934173831	0	0	1.475036629	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.2316	0	0	7.3908	1.922597914	5.547198042	0	2.085982724	4.005145275	0.766742057	3.438870321	8.566219475	0	0	0	0	0	2.971995096	8.415019278	2.24358593	0.468226629	0	0	3.934173831	0	0	1.475036629	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.2316		$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	$100/visit	$0 Lab / $20 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$20/visit	$10/visit	$30/visit	$30/visit	$30/visit	$30/visit	$30/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											1.3824	0.3596	0.3972	0	3.6687	0.0353	0.0959	0.606	0.6596	0	0	0	0	0	1.0127	2.8674	0.7645	0.1595	0	0	1.0158	0	0	0.1233	0	0	0	0	0	0											13.1482	0	0	8.7733	2.282216103	5.944443908	0	5.754683223	4.040482736	0.862652497	4.044900189	9.225831021	0	0	0	0	0	3.984699391	11.28242851	3.008085544	0.627774375	0	0	4.949991945	0	0	1.598344151	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3798
H0245_003_0	2009	7																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0.1846	0.5694	0.1779	0.791	1.2711	0.3826	0.3809	0	0.0312	0.0383	0.7704	2.1041	0.1854	0.0484	0.2506	0	0.5593	0.0141	0	0	0	0	0	0	0	0											7.7592		259.7142932	43.55833376	1000.97841	16.94539577	5.95432465	18.36761438	5.739497697	25.51545204	41.00378879	12.34032456	12.28658668	0	1.006279877	1.23398792	24.85222949	67.87357582	5.982221715	1.561657641	8.085129429	0	18.04213901	0.453292965	1.912983534	24.7665318	2.5765598	2.07216572	0.057935052	0.100863736	0.00347447	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	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											674.3410434	456.5508902	78.97738865	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											674.3410434	456.5508902	78.97738865	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											14.5947	1.657216338	6.587888409	0	1.19086493	3.673522875	1.147899539	5.103090408	8.200757758	2.468064912	2.457317335	0	0.201255975	0.246797584	4.970445898	13.57471516	1.196444343	0.312331528	1.617025886	0	3.608427803	0.090658593	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.8994	135	0	14.5947	1.657216338	6.587888409	0	1.375448994	4.242918921	1.325823968	5.894069421	9.47187521	2.850614974	2.838201522	0	0.232450651	0.285051209	5.740865012	15.67879602	1.381893216	0.360742915	1.867664898	0	4.167734112	0.104710675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6586		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											2.7299	0.31	0.4718	0	2.4191	0.5307	0.1658	1.0387	0.7293	0.756	0.7527	0	0.0616	0.0756	1.9562	5.3425	0.4709	0.1229	0.6364	0	1.0761	0.0288	0	0	0	0	0	0	0	0											19.6753	135	0	17.3246	1.96719542	7.05966018	0	3.794505659	4.773658323	1.491668999	6.932777421	10.20122358	3.606632004	3.590926357	0	0.294099332	0.360650184	7.697058904	21.02132975	1.852771919	0.483665695	2.504069805	0	5.243858347	0.133534044	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.3339
H0245_004_0	2009	6																																D	D	D	V	P	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	Coin	T	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		1262.496762	328.4165105	837.9160024	260.6576871	153.3642374	15.3754745	4.80451618	678.0798372	2391.645201	2320.629314	618.213927	0	0.842353844	114.0108355	3205.721017	5168.747914	689.0376428	143.7991602	1572.729039	0	15.10302005	0.379450172	8227.886166	1689.981239	478.6135142	451.5650753	15.59005431	1.439714778	2.944815882	12000											$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	$100/visit	$0 Lab / $20 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$20/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	$20/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											38.66576617	38.66576617	40.66337511	0	124.2484388	0.2	0.122529278	46.84373331	33	0	0	0	0	0	4.007087742	10	19.62739394	20	0.02242362	0	0.2	0	0	9.332565056	0	0	0	0	0	0											28.38777661	28.38777661	40.66337511	0	124.2484388	0.2	0.122529278	46.84373331	33	0	0	0	0	0	4.007087742	10	19.62739394	20	0.02242362	0	0.2	0	0	9.332565056	0	0	0	0	0	0											2.9866	0.776917878	2.839374393	0	1.587938922	3.075094899	0.588693899	2.646982588	6.577024304	0	0	0	0	0	1.070467116	4.307289929	1.127001104	0.239665267	0.002938856	0	3.020604011	0	0	1.314321655	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.1609	0	0	2.9866	0.776917878	2.839374393	0	1.587938922	3.075094899	0.588693899	2.646982588	6.577024304	0	0	0	0	0	1.070467116	4.307289929	1.127001104	0.239665267	0.002938856	0	3.020604011	0	0	1.314321655	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.1609		$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	$100/visit	$0 Lab / $20 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$20/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	$20/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											0.5586	0.1453	0.2033	0	2.7928	0.0271	0.0736	0.4665	0.5064	0	0	0	0	0	0.3648	1.4677	0.384	0.0817	0.001	0	0.7799	0	0	0.1099	0	0	0	0	0	0											7.9627	0	0	3.5453	0.922238851	3.042707632	0	4.380710046	3.102226511	0.662332602	3.113458599	7.083464885	0	0	0	0	0	1.435227693	5.774994574	1.51102558	0.321330962	0.003940269	0	3.800535046	0	0	1.424194008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.1237
H0245_801_0	2009	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																							0.2018	0.6224	0.1945	0.8647	1.3895	0.4182	0.4164	0	0.0341	0.0418	0.8422	2.3001	0.2027	0.0529	0.274	0	0.6114	0.0154																			8.482		214.1537431	24.31667759	32.00700364	18.52392524	6.508993133	20.07862904	6.274154214	27.89231556	44.82345108	13.48987376	13.43112998	0	1.100018758	1.34893869	27.16731126	74.19626321	6.539488918	1.70713212	8.838290659	0	19.72283439	0.495518967																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			0.076303299	0.076303299	0.219543392	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																			0.076303299	0.076303299	0.219543392	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																			16.3406	1.855442726	7.026926149	0	1.301798627	4.015725809	1.254830843	5.578463113	8.964690216	2.697974751	2.686225995	0	0.220003752	0.269787738	5.433462251	14.83925264	1.307897784	0.341426424	1.767658132	0	3.944566877	0.099103793	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.9459	135	0	16.3406	1.855442726	7.026926149	0	1.503577414	4.638163309	1.449329623	6.443124895	10.3542172	3.116160838	3.102591025	0	0.254104333	0.311604837	6.2756489	17.1393368	1.51062194	0.39434752	2.041645142	0	4.555974743	0.114464881	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.4279		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			3.0565	0.3471	0.5032	0	2.2895	0.5023	0.157	0.9831	0.6903	0.7155	0.7124	0	0.0583	0.0716	1.8514	5.0565	0.4457	0.1163	0.6023	0	1.0185	0.0273																			19.2048	135	0	19.3971	2.202499668	7.530138284	0	3.793102258	5.140483516	1.606294247	7.426213802	11.04451158	3.831695863	3.81501014	0	0.312451947	0.383155758	8.127095615	22.19579699	1.956286774	0.510688225	2.643972846	0	5.574476379	0.141744862	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.6327
H0245_802_0	2009	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																							0.2018	0.6224	0.1945	0.8647	1.3895	0.4182	0.4164	0	0.0341	0.0418	0.8422	2.3001	0.2027	0.0529	0.274	0	0.6114	0.0154																			8.482		214.1537431	24.31667759	32.00700364	18.52392524	6.508993133	20.07862904	6.274154214	27.89231556	44.82345108	13.48987376	13.43112998	0	1.100018758	1.34893869	27.16731126	74.19626321	6.539488918	1.70713212	8.838290659	0	19.72283439	0.495518967																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			0.076303299	0.076303299	0.219543392	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																			0.076303299	0.076303299	0.219543392	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																			16.3406	1.855442726	7.026926149	0	1.301798627	4.015725809	1.254830843	5.578463113	8.964690216	2.697974751	2.686225995	0	0.220003752	0.269787738	5.433462251	14.83925264	1.307897784	0.341426424	1.767658132	0	3.944566877	0.099103793	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.9459	135	0	16.3406	1.855442726	7.026926149	0	1.503577414	4.638163309	1.449329623	6.443124895	10.3542172	3.116160838	3.102591025	0	0.254104333	0.311604837	6.2756489	17.1393368	1.51062194	0.39434752	2.041645142	0	4.555974743	0.114464881	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.4279		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			3.0565	0.3471	0.5032	0	2.2895	0.5023	0.157	0.9831	0.6903	0.7155	0.7124	0	0.0583	0.0716	1.8514	5.0565	0.4457	0.1163	0.6023	0	1.0185	0.0273																			19.2048	135	0	19.3971	2.202499668	7.530138284	0	3.793102258	5.140483516	1.606294247	7.426213802	11.04451158	3.831695863	3.81501014	0	0.312451947	0.383155758	8.127095615	22.19579699	1.956286774	0.510688225	2.643972846	0	5.574476379	0.141744862	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.6327
H0248_001_0	2009	6	r.	s.	t.	u.	v.						Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered						2500											D	D	D	V	T	Coin	Coin	V	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						0		1220.961699	54.363712	426.133141	609.040804	121.138785	6.915335	2.497355	274.006841	297.014572	525.114626	779.383085	0	16.231133	596.221554	2918.082486	3517.490542	23.994894	758.156409			15.62983		4	10.66	2.69		0.81		0.05	0.09	1.23	1.48	0.06	2	2.7						$175/Day(Days 1-5):1a	$175/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$125/Visit:9b. $0 Surgery ASC -- Physician,9b. $125 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $125 Surgery OP -- Facility"	"$0-$45/Visit:8a. $0 Lab -- FSL,8. $45 Lab -- OP"	"$0-$125/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $125 Advanced Imaging -- FSR,8b. $20 Advanced Imaging -- Office,9a. $125 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $45 Radiology OP -- Facility"	$125/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$15-$125/Visit:9d. $15 Cardiac Rehab,8b. $125 Nuclear Medicine,9a. $50 OP Other,5. $45 Partial Hospitalization,8b. $50 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$5/Visit:7a	"$10-$20/Visit:7b. $10 Chiropractic,7f. $20 Podiatry,7d. $20 Physician Services Spec,7d. $20 Spec Cap"	"$20-$45/Visit:7h. $45 Psych -- OP,7e. $20 Psych -- Other Provider"	"$20/Visit:7d, 9a"			20% Coins:15		Transportation	"DEN 750 16a, 16b"	VIS 952		HearUSA		$0 Additional Smoking Cessation 14a	$0: Nutritional benefit 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0: Nurse hotline 14a	CAM 001	$0 Corp Health 14a						107.292849	89.438042	43.132801	0	100.000012	0.2	0.2	49.999992	125.000008	39.58082	57.893573	0	0.7822	49.795985	5.000001	18.508256	41.097743	19.999999			0.2		0	0	0		0		0	0	0	0	0	0	0						90.240475	75.223386	36.277575	0	84.10671	0.168213	0.168213	42.053343	105.133382	33.290122	48.616938	0	0.657883	41.88176	4.205336	15.566683	34.565955	16.821339			0.168213		0	0	0		0		0	0	0	0	0	0	0						9.1817	0.340785208	1.288256415	0	0.849048722	1.163249246	0.420087577	0.960241972	2.602178871	1.45676083	3.157601593	0	0.000889849	2.080900669	1.022626444	4.562971685	0.069117202	1.062767164	0	0	2.629140594	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.8483	0	6.2081	9.1817	0.340785208	1.288256415	0	0.849048722	1.163249246	0.420087577	0.960241972	2.602178871	1.45676083	3.157601593	0	0.000889849	2.080900669	1.022626444	4.562971685	0.069117202	1.062767164	0	0	2.629140594	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.8483	5000	$1000/Admit	$1000/Admit	40% Coins(Days 1-20) 40%(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		Transportation	"DEN 750 16a, 16b"	VIS 951		HearUSA		0	0	0	0	0	CAM 001	0						1.7082	0.055	0.3529	0.3346	0.566	1.475	0.5327	0.1695	1.5931	0.2052	0.8537		0.0002	0.4822	0.9668	2.2073	0.0139	0.1864			0.6588		0	0	0		0		0	0	0	0	0	0	0						12.3614	0	2.335888524	10.8899	0.395823208	1.641186415	0.334645	1.415080722	2.638222246	0.952748577	1.129696972	4.195277871	1.66198983	4.011253593	0	0.001046849	2.563075669	1.989396444	6.770222685	0.083066202	1.249142164	0	0	3.287986594	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.2097
H0248_801_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		219.34576	7.067283	426.133141	609.040804	3.503915	6.915335	2.497355	15.374832	39.521179	525.114626	21.369796	0	0.269658	12.174303	22.934763	52.362751	0.330917	4.42139			15.62983																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000008	1024.000312	43.132801	0	0.2	0.2	0.2	0.199999	0.2	0	0.2	0	0.200001	0.199999	0.2	0.199999	0.500001	0.2			0.2																				1024.000008	1024.000312	43.132801	0	0.2	0.2	0.2	0.199999	0.2	0	0.2	0	0.200001	0.199999	0.2	0.199999	0.500001	0.2			0.2																				18.7175	0.603075	1.531692998	0	0.700783	1.383067	0.499471	3.074951025	7.9042358	0	4.2739592	0	0.05393187	2.434848426	4.5869526	10.47249784	0.165458831	0.884278	0	0	3.125966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4127	0	0	18.7175	0.603075	1.531692998	0	0.700783	1.383067	0.499471	3.074951025	7.9042358	0	4.2739592	0	0.05393187	2.434848426	4.5869526	10.47249784	0.165458831	0.884278	0	0	3.125966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4127		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.0797	0.067	0.1702		0.4443	0.8768	0.3167	0.5792	1.5153		0.812		0.0102	0.4586	0.9196	2.0995	0.0332	0.1773			0.6267																				11.1861	0	0	20.7972	0.670083	1.701880998	0	1.14507	2.259913	0.816129	3.654152025	9.4195488	0	5.0859292	0	0.06409087	2.893479426	5.5065186	12.57197384	0.198629831	1.061553	0	0	3.752642	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.5988
H0248_802_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		219.34576	7.067283	426.133141	609.040804	3.503915	6.915335	2.497355	15.374832	39.521179	525.114626	21.369796	0	0.269658	12.174303	22.934763	52.362751	0.330917	4.42139			15.62983																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000008	1024.000312	43.132801	0	0.2	0.2	0.2	0.199999	0.2	0	0.2	0	0.200001	0.199999	0.2	0.199999	0.500001	0.2			0.2																				1024.000008	1024.000312	43.132801	0	0.2	0.2	0.2	0.199999	0.2	0	0.2	0	0.200001	0.199999	0.2	0.199999	0.500001	0.2			0.2																				18.7175	0.603075	1.531692998	0	0.700783	1.383067	0.499471	3.074951025	7.9042358	0	4.2739592	0	0.05393187	2.434848426	4.5869526	10.47249784	0.165458831	0.884278	0	0	3.125966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4127	0	0	18.7175	0.603075	1.531692998	0	0.700783	1.383067	0.499471	3.074951025	7.9042358	0	4.2739592	0	0.05393187	2.434848426	4.5869526	10.47249784	0.165458831	0.884278	0	0	3.125966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4127		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.0797	0.067	0.1702		0.4443	0.8768	0.3167	0.5792	1.5153		0.812		0.0102	0.4586	0.9196	2.0995	0.0332	0.1773			0.6267																				11.1861	0	0	20.7972	0.670083	1.701880998	0	1.14507	2.259913	0.816129	3.654152025	9.4195488	0	5.0859292	0	0.06409087	2.893479426	5.5065186	12.57197384	0.198629831	1.061553	0	0	3.752642	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.5988
H0248_803_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		219.34576	7.067283	426.133141	609.040804	3.503915	6.915335	2.497355	15.374832	39.521179	525.114626	21.369796	0	0.269658	12.174303	22.934763	52.362751	0.330917	4.42139			15.62983																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000008	1024.000312	43.132801	0	0.2	0.2	0.2	0.199999	0.2	0	0.2	0	0.200001	0.199999	0.2	0.199999	0.500001	0.2			0.2																				1024.000008	1024.000312	43.132801	0	0.2	0.2	0.2	0.199999	0.2	0	0.2	0	0.200001	0.199999	0.2	0.199999	0.500001	0.2			0.2																				18.7175	0.603075	1.531692998	0	0.700783	1.383067	0.499471	3.074951025	7.9042358	0	4.2739592	0	0.05393187	2.434848426	4.5869526	10.47249784	0.165458831	0.884278	0	0	3.125966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4127	0	0	18.7175	0.603075	1.531692998	0	0.700783	1.383067	0.499471	3.074951025	7.9042358	0	4.2739592	0	0.05393187	2.434848426	4.5869526	10.47249784	0.165458831	0.884278	0	0	3.125966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4127		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.0797	0.067	0.1702		0.4443	0.8768	0.3167	0.5792	1.5153		0.812		0.0102	0.4586	0.9196	2.0995	0.0332	0.1773			0.6267																				11.1861	0	0	20.7972	0.670083	1.701880998	0	1.14507	2.259913	0.816129	3.654152025	9.4195488	0	5.0859292	0	0.06409087	2.893479426	5.5065186	12.57197384	0.198629831	1.061553	0	0	3.752642	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.5988
H0248_804_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		219.34576	7.067283	426.133141	609.040804	3.503915	6.915335	2.497355	15.374832	39.521179	525.114626	21.369796	0	0.269658	12.174303	22.934763	52.362751	0.330917	4.42139			15.62983																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000008	1024.000312	43.132801	0	0.2	0.2	0.2	0.199999	0.2	0	0.2	0	0.200001	0.199999	0.2	0.199999	0.500001	0.2			0.2																				1024.000008	1024.000312	43.132801	0	0.2	0.2	0.2	0.199999	0.2	0	0.2	0	0.200001	0.199999	0.2	0.199999	0.500001	0.2			0.2																				18.7175	0.603075	1.531692998	0	0.700783	1.383067	0.499471	3.074951025	7.9042358	0	4.2739592	0	0.05393187	2.434848426	4.5869526	10.47249784	0.165458831	0.884278	0	0	3.125966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4127	0	0	18.7175	0.603075	1.531692998	0	0.700783	1.383067	0.499471	3.074951025	7.9042358	0	4.2739592	0	0.05393187	2.434848426	4.5869526	10.47249784	0.165458831	0.884278	0	0	3.125966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4127		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.0797	0.067	0.1702		0.4443	0.8768	0.3167	0.5792	1.5153		0.812		0.0102	0.4586	0.9196	2.0995	0.0332	0.1773			0.6267																				11.1861	0	0	20.7972	0.670083	1.701880998	0	1.14507	2.259913	0.816129	3.654152025	9.4195488	0	5.0859292	0	0.06409087	2.893479426	5.5065186	12.57197384	0.198629831	1.061553	0	0	3.752642	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.5988
H0251_001_0	2009	6																																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																																																			0		321.0435148	39.43025591	15.89846539		16.6748527	18.52582129	16.54896486	1274.860085	56.80928012	19.65081189	57.0000321	1.853042508	2.051255221	34.13648272	22.10303073	88.59643483	12.28156822	2.465433283			23.74805224	0.19555977																			ffs medicare (1a)	ffs medicare (1b)	$0 1-20 days; $130 21-100 days (2)	0% (6a)	20% (10a)	20% (11a)	"20% (11b, 11c)"	"$50 (4a), 20% (4b)"	20% (9b)	20% (8a)	20% (8b)	20% (incl in h.5)	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"20% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i)"	"20% (7b, 7d, 7f)"	"50% (7e, 7h)"	"20% (7c, 7i)"	20% (incl in h.2)	20% (7g)	20% (15)	"20% (13a, 14j, 16b, 17a, 18a)"	$0 n/c (10b)	$0 (16a)	$0 (17a)	$0 (17b)	$0 n/c (18a)	$0 n/c (18b)	$0 (14a)	$0 (13c)											0.079166218	0.079408659	0.214060728		0.198	0.198	0.198	51.57386747	0.198	0.198	0.198	0.198	0.198	0.198	0.198	0.198	0.495	0.198			0.198	0.198																			0.079166218	0.079408659	0.214060728		0.198	0.198	0.198	51.57386747	0.198	0.198	0.198	0.198	0.198	0.198	0.198	0.198	0.495	0.198			0.198	0.198																			25.4158	3.131103729	3.403237077	0	3.301620834	3.668112616	3.276695042	5.47912209	11.24823746	3.890860755	11.28600636	0.366902417	0.406148534	6.759023578	4.376400085	17.5420941	6.079376269	0.48815579	0	0	4.702114343	0.038720835	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.8597	0	0	25.4158	3.131103729	3.403237077	0	3.301620834	3.668112616	3.276695042	5.47912209	11.24823746	3.890860755	11.28600636	0.366902417	0.406148534	6.759023578	4.376400085	17.5420941	6.079376269	0.48815579	0	0	4.702114343	0.038720835	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.8597																																																																																		0	0	0	25.4158	3.131103729	3.403237077	0	3.301620834	3.668112616	3.276695042	5.47912209	11.24823746	3.890860755	11.28600636	0.366902417	0.406148534	6.759023578	4.376400085	17.5420941	6.079376269	0.48815579	0	0	4.702114343	0.038720835	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.8597
H0302_001_0	2009	4																																D	D	D	V	T	Coin	Coin	P	P	P	P	P	P	P	P	P	P	P	P	P	Coin	P	P	Coin	P	P	P	P	P	P																																																			0		1359.599645	93.85566455	1038.186266		173.1508133	12.55013942	9.002823403	369.0894015	172.4938353	119.9398875	913.5262444	55.13304789	24.80398248	643.9866872	4174.515878	4971.446257	219.9539671	113.2830173			6.001003315	91.33561455			596.0228077		236.8988314		50	11.93919648											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	"4a: $50, 4b, 7a: $25"	9b: $0-$150	8a: $0-$75	"8b: $0-$300, 20%"	4a: $125	12: $30	"3: $10, 5, 9c: $20, 7g: $10-$50, 9a: $0-$150"	"7a: $10 14c: $20, 14: $0-$25, 14d, 14e, 14h:  $0; 14f: $150, 14g: $25"	"7b, 7f: $30, 16b: 20%; 7d, 17a: $30, 18a: $0"	"7e, 7h: $20"	7i: $10	$0 (incl in i.2.)		15: 20%	17b: $20			17a: $20		18a: $20		14a: $50	13c:  $15											86.60497292	74.89664121	9.936989371		102.252904	0.002	0.041948453	48.1734535	150	13.15	49.84325432	125	30	12.72387645	11.77851181	21.44367437	20	10			0.2	20			20		20		50	15											86.60497292	74.89664121	9.936989371		102.252904	0.002	0.041948453	48.1734535	150	13.15	49.84325432	125	30	12.72387645	11.77851181	21.44367437	20	10			0.2	20			20		20		50	15											9.8123	0.585789503	0.859703824	0	1.475431124	0.025100279	0.377654518	1.481692593	2.156172941	0.131434127	3.794426744	0.574302582	0.062009956	0.68283392	4.097465383	8.883839556	0.366589945	0.094402514	0	0	1.200200663	0.152226024	0	0	0.993371346	0	0.394831386	0	0.208333333	0.014923996	0	0	0	0	0	0	0	0	0	0	38.4251	0	0	9.8123	0.585789503	0.859703824	0	1.475431124	0.025100279	0.377654518	1.481692593	2.156172941	0.131434127	3.794426744	0.574302582	0.062009956	0.68283392	4.097465383	8.883839556	0.366589945	0.094402514	0	0	1.200200663	0.152226024	0	0	0.993371346	0	0.394831386	0	0.208333333	0.014923996	0	0	0	0	0	0	0	0	0	0	38.4251																																																																																		0	0	0	9.8123	0.585789503	0.859703824	0	1.475431124	0.025100279	0.377654518	1.481692593	2.156172941	0.131434127	3.794426744	0.574302582	0.062009956	0.68283392	4.097465383	8.883839556	0.366589945	0.094402514	0	0	1.200200663	0.152226024	0	0	0.993371346	0	0.394831386	0	0.208333333	0.014923996	0	0	0	0	0	0	0	0	0	0	38.4251
H0302_004_0	2009	4																																D	D	D	V	T	Coin	Coin	P	P	P	P	P	P	P	P	P	P	P	P	P	Coin	P	P	Coin	P	P	P	P	P	P																																																			0		1804.164389	56.41830574	1015.360611		244.0485676	12.47044307	9.815945596	394.6761654	342.2693652	2141.615157	362.2134646	83.88637174	8.89701645	1157.300036	4816.980911	12789.07858	274.6826129	1664.999531			13.54808154	9.839149265			281.5233396		248.2650941		50	11.01704849											1a: $125 days 1-4	"1b: $125 days 1-8, $175 days 31-90"	"2: $0 days 1-20, $50 days 21-100"	6: $0	10a: $125/15%	11a: 0%-20%	"11b: 0%-20%, 11c: $0-$12"	"4a: $50, 4b: $25"	"9a, 9b: $0-$150"	8a: $0-$75	8b: $0-$300/ 20%	125	12: $30	"3: $10, 5, 9c: $20, 9d: $0-$25, 7g: $0-$50, 9a: $0-$150"	"7a: $10 14c: $20, 14d, 14e, 14h: $0"	"7b, 7f: $30; 16b: 20%; 13b, 13d, 14g: $25; 18a: $20; 7d: $10/$30; 17a: $30"	"7e, 7h: $20"	"7i, 7c: $10"	$0 (incl in i.2.)		15: 20%	17b: $20			17a: $20		18a: $20		14a: $50	13c: $15											82.29420549	83.97313303	10.95521916		123.4962785	0.002	0.046729316	46.5730628	150	15	114.4106298	125	30	12.16195264	10.52538465	18.26569175	20	10			0.2	20			20		20		50	15											82.29420549	83.97313303	10.95521916		123.4962785	0.002	0.046729316	46.5730628	150	15	114.4106298	125	30	12.16195264	10.52538465	18.26569175	20	10			0.2	20			20		20		50	15											12.3727	0.394801824	0.926958168	0	2.511590823	0.024940886	0.458692428	1.531773153	4.278367065	2.677018946	3.453422549	0.873816372	0.022242541	1.172919019	4.225048078	19.46678059	0.457804355	1.387499609	0	0	2.709616307	0.016398582	0	0	0.469205566	0	0.413775157	0	0.208333333	0.013771311	0	0	0	0	0	0	0	0	0	0	60.0675	0	0	12.3727	0.394801824	0.926958168	0	2.511590823	0.024940886	0.458692428	1.531773153	4.278367065	2.677018946	3.453422549	0.873816372	0.022242541	1.172919019	4.225048078	19.46678059	0.457804355	1.387499609	0	0	2.709616307	0.016398582	0	0	0.469205566	0	0.413775157	0	0.208333333	0.013771311	0	0	0	0	0	0	0	0	0	0	60.0675																																																																																		0	0	0	12.3727	0.394801824	0.926958168	0	2.511590823	0.024940886	0.458692428	1.531773153	4.278367065	2.677018946	3.453422549	0.873816372	0.022242541	1.172919019	4.225048078	19.46678059	0.457804355	1.387499609	0	0	2.709616307	0.016398582	0	0	0.469205566	0	0.413775157	0	0.208333333	0.013771311	0	0	0	0	0	0	0	0	0	0	60.0675
H0303_013_0	2009	6																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1393.939312	64.43759463	1089.256217	880.7888889	580.6873212	11.93949734	9.20950673	309.3024652	304.3974062	11141.92421	42.08191384	0	0.196052926	739.0040513	5915.986246	5248.510718	291.0477825	353.4954032	0	0	25.74125439	2725.117025	0	0	107.2995248	87.74900626	0	0	555.318484	0											"$180 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$180 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-14/$100 Days 15-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$150 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); $150 (9a); $40/$30 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											110.0692792	81.57532603	43.55423998	0	149.4714966	0.2	0.065830025	49.69574603	150	2.8	0.190655671	0	0.2	52.24780855	6.476141688	30	37.5	25	0	0	0.2	29.04197146	0	0	30	30	0	0	0	0											110.0692792	81.57532603	43.55423998	0	149.4714966	0.2	0.065830025	49.69574603	150	2.8	0.190655671	0	0.2	52.24780855	6.476141688	30	37.5	25	0	0	0.2	29.04197146	0	0	30	30	0	0	0	0											12.7858	0.438043149	3.953477223	0	7.233016915	2.387899469	0.606262056	1.280918063	3.804967578	2.599782315	8.023155508	0	0.039210585	3.217611849	3.192730429	13.12127679	0.90952432	0.736448757	0	0	5.148250878	6.595230906	0	0	0.268248812	0.219372516	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.5613	0	0	12.7858	0.438043149	3.953477223	0	7.233016915	2.387899469	0.606262056	1.280918063	3.804967578	2.599782315	8.023155508	0	0.039210585	3.217611849	3.192730429	13.12127679	0.90952432	0.736448757	0	0	5.148250878	6.595230906	0	0	0.268248812	0.219372516	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.5613																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.7858	0.438043149	3.953477223	0	7.233016915	2.387899469	0.606262056	1.280918063	3.804967578	2.599782315	8.023155508	0	0.039210585	3.217611849	3.192730429	13.12127679	0.90952432	0.736448757	0	0	5.148250878	6.595230906	0	0	0.268248812	0.219372516	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.5613
H0303_015_0	2009	5																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1355.671666	64.10881496	1016.623656	572.2100158	451.0243306	12.45985583	11.15066732	378.4522356	274.7782153	9705.27017	55.28691714	0	0.067988811	1165.254643	6260.035392	5974.991266	292.3915151	677.3139601	0	0	29.45472476	2647.132347	0	0	155.4352713	88.40020934	0	0	1341.515711	0											"$140 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$140 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$100 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$125 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); $125 (9a); $40/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$0 n/c (13b, 13d, 13e)"											85.60931691	63.4474758	55.10681964	0	146.5886978	0.2	0.081858092	49.93727956	125	2.8	0.190891406	0	0.2	44.2019741	10.64561951	30	37.5	25	0	0	0.2	29.21394918	0	0	30	30	0	0	0	0											85.60931691	63.4474758	55.10681964	0	146.5886978	0.2	0.081858092	49.93727956	125	2.8	0.190891406	0	0.2	44.2019741	10.64561951	30	37.5	25	0	0	0.2	29.21394918	0	0	30	30	0	0	0	0											9.6715	0.338961874	4.668574703	0	5.50958911	2.491971167	0.912772349	1.574906258	2.862273076	2.26456304	10.55379736	0	0.013597762	4.292212961	5.553496244	14.93747816	0.913723485	1.41107075	0	0	5.890944952	6.44443249	0	0	0.388588178	0.221000523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.9155	0	0	9.6715	0.338961874	4.668574703	0	5.50958911	2.491971167	0.912772349	1.574906258	2.862273076	2.26456304	10.55379736	0	0.013597762	4.292212961	5.553496244	14.93747816	0.913723485	1.41107075	0	0	5.890944952	6.44443249	0	0	0.388588178	0.221000523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.9155																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	9.6715	0.338961874	4.668574703	0	5.50958911	2.491971167	0.912772349	1.574906258	2.862273076	2.26456304	10.55379736	0	0.013597762	4.292212961	5.553496244	14.93747816	0.913723485	1.41107075	0	0	5.890944952	6.44443249	0	0	0.388588178	0.221000523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.9155
H0303_034_0	2009	7																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		359.473015	23.35564965	36.76948799	714.3390079	28.00854335	16.55759641	16.90314952	28.75708064	34.74037986	15.27043883	59.1299265	0	0.660589208	114.559499	29.93221345	175.2780704	14.59476868	3.477421083	0	0	32.48685018	17.0802413	650.1633578	0	134.7027457	80.82147106	0	0	34.53628602	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.069882047	0.070797728	0.150537129	0	0.2	0.2	0.2	0.092324038	0.2	0.08	0.17903733	0	0.2	0.2	0.000906768	0.199665932	0.2	0.2	0	0	0.2	0.002611369	0	0	0	0	0	0	0	0											0.069882047	0.070797728	0.150537129	0	0.2	0.2	0.2	0.092324038	0.2	0.08	0.17903733	0	0.2	0.2	0.000906768	0.199665932	0.2	0.2	0	0	0.2	0.002611369	0	0	0	0	0	0	0	0											25.1207	1.653526935	5.535173172	0	5.60170867	3.311519282	3.380629903	2.654969806	6.948075972	1.221635106	10.58646417	0	0.132117842	22.9118998	0.027141579	34.99705929	2.918953736	0.695484217	0	0	6.497370036	0.044602811	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.239	0	0	25.1207	1.653526935	5.535173172	0	5.60170867	3.311519282	3.380629903	2.654969806	6.948075972	1.221635106	10.58646417	0	0.132117842	22.9118998	0.027141579	34.99705929	2.918953736	0.695484217	0	0	6.497370036	0.044602811	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.239																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	25.1207	1.653526935	5.535173172	0	5.60170867	3.311519282	3.380629903	2.654969806	6.948075972	1.221635106	10.58646417	0	0.132117842	22.9118998	0.027141579	34.99705929	2.918953736	0.695484217	0	0	6.497370036	0.044602811	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.239
H0303_039_0	2009	5																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	283.3797117	7.932821959	910.4529346	525.5319708	390.5393112	12.8280763	11.65573175	362.436398	260.6227448	8587.833361	51.9224838	0	0.048775656	1043.001206	6129.281489	5690.725245	292.7625393	761.8533368	0	0	26.947795	2688.365341	0	0	132.422457	220.0435205	0	0	987.5538502	0											"$500 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$500 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$100 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$200 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); $200 (9a); $40/$30 (9c)"	"$5 (7a); $35 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$0 n/c (13b, 13d, 13e)"											481.3693784	500	55.10681964	0	150	0.2	0.080696851	49.93564429	200	2.8	0.190938695	0	0.2	70.06252402	3.597574008	34.99150306	37.5	30	0	0	0.2	34.19317735	0	0	35	30	0	0	0	0											481.3693784	500	55.10681964	0	150	0.2	0.080696851	49.93564429	200	2.8	0.190938695	0	0.2	70.06252402	3.597574008	34.99150306	37.5	30	0	0	0.2	34.19317735	0	0	35	30	0	0	0	0											11.3675	0.330534248	4.181013805	0	4.88174139	2.565615261	0.940580843	1.508207921	4.343712413	2.003827784	9.914011303	0	0.009755131	6.089608085	1.837545314	16.59391915	0.914882935	1.904633342	0	0	5.389559	7.660312739	0	0	0.386232166	0.550108801	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.3733	0	0	11.3675	0.330534248	4.181013805	0	4.88174139	2.565615261	0.940580843	1.508207921	4.343712413	2.003827784	9.914011303	0	0.009755131	6.089608085	1.837545314	16.59391915	0.914882935	1.904633342	0	0	5.389559	7.660312739	0	0	0.386232166	0.550108801	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.3733																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.3675	0.330534248	4.181013805	0	4.88174139	2.565615261	0.940580843	1.508207921	4.343712413	2.003827784	9.914011303	0	0.009755131	6.089608085	1.837545314	16.59391915	0.914882935	1.904633342	0	0	5.389559	7.660312739	0	0	0.386232166	0.550108801	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.3733
H0303_040_0	2009	4																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1332.92525	62.50154818	855.4518176	540.9320908	421.9844617	11.70616752	9.856601245	372.3522404	247.7896551	8908.340042	50.7762499	0	0.210255916	1063.938249	5940.661865	5677.008559	291.7170413	679.3259526	0	0	25.10276968	2604.775266	0	0	143.1919229	88.22263575	0	0	1338.442495	0											"$140 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$140 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$95 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$125 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); $125 (9a); $40/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$0 n/c (13b, 13d, 13e)"											85.60924135	63.4474758	52.35147866	0	150	0.2	0.089927344	49.9441633	125	2.8	0.191259716	0	0.2	44.00266675	10.61501208	30	37.5	25	0	0	0.2	29.25434891	0	0	30	30	0	0	0	0											85.60924135	63.4474758	52.35147866	0	150	0.2	0.089927344	49.9441633	125	2.8	0.191259716	0	0.2	44.00266675	10.61501208	30	37.5	25	0	0	0.2	29.25434891	0	0	30	30	0	0	0	0											9.5092	0.330463789	3.732013965	0	5.274805771	2.341233503	0.886377974	1.549735091	2.581142241	2.078612676	9.711451158	0	0.042051183	3.901343353	5.255016453	14.1925214	0.911615754	1.415262401	0	0	5.020553936	6.350083706	0	0	0.357979807	0.220556589	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.662	0	0	9.5092	0.330463789	3.732013965	0	5.274805771	2.341233503	0.886377974	1.549735091	2.581142241	2.078612676	9.711451158	0	0.042051183	3.901343353	5.255016453	14.1925214	0.911615754	1.415262401	0	0	5.020553936	6.350083706	0	0	0.357979807	0.220556589	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.662																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	9.5092	0.330463789	3.732013965	0	5.274805771	2.341233503	0.886377974	1.549735091	2.581142241	2.078612676	9.711451158	0	0.042051183	3.901343353	5.255016453	14.1925214	0.911615754	1.415262401	0	0	5.020553936	6.350083706	0	0	0.357979807	0.220556589	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.662
H0303_801_0	2009	2																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1308.062891	58.96537539	796.5982107	727.0363099	364.0507945	13.94671111	11.74120468	285.6936585	41.36071093	10932.02037	59.37654624	0	0.132395498	14.26880319	6956.383596	6229.639663	289.171965	849.2172681	0	0	33.56822758	2677.317848	0	0	0	0	0	0	0	0											"$330 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$330 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											266.5874292	222.0813665	159.8131731	0	150	0.2	0.085294818	49.83929656	0.2	2.8	0.186689425	0	0.2	0.206945823	12.95513848	40	37.5	35	0	0	0.2	38.97744352	0	0	0	0	0	0	0	0											266.5874292	222.0813665	159.8131731	0	150	0.2	0.085294818	49.83929656	0.2	2.8	0.186689425	0	0.2	0.206945823	12.95513848	40	37.5	35	0	0	0.2	38.97744352	0	0	0	0	0	0	0	0											29.0594	1.091259262	10.60890731	0	4.550634931	2.789342222	1.001463921	1.186564248	8.272142186	2.550804754	11.08497325	0	0.0264791	2.952869222	7.510076065	20.76546554	0.903662391	2.476883699	0	0	6.713645517	8.696250435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.2409	0	0	29.0594	1.091259262	10.60890731	0	4.550634931	2.789342222	1.001463921	1.186564248	8.272142186	2.550804754	11.08497325	0	0.0264791	2.952869222	7.510076065	20.76546554	0.903662391	2.476883699	0	0	6.713645517	8.696250435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.2409																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	29.0594	1.091259262	10.60890731	0	4.550634931	2.789342222	1.001463921	1.186564248	8.272142186	2.550804754	11.08497325	0	0.0264791	2.952869222	7.510076065	20.76546554	0.903662391	2.476883699	0	0	6.713645517	8.696250435	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.2409
H0303_803_0	2009	2																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1319.841026	59.49631483	803.7709863	733.5827323	367.3288017	14.19900143	11.95359829	288.218412	42.10890932	11030.4551	60.45064375	0	0.134790479	14.52692002	6750.97137	6285.732945	291.7757439	856.8638393	0	0	34.17546313	2701.425108	0	0	0	0	0	0	0	0											"$330 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$330 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											266.5874292	222.0813665	159.8131731	0	150	0.2	0.085294818	49.83926996	0.2	2.8	0.186493763	0	0.2	0.206916536	13.46952605	40	37.5	35	0	0	0.2	38.98758631	0	0	0	0	0	0	0	0											266.5874292	222.0813665	159.8131731	0	150	0.2	0.085294818	49.83926996	0.2	2.8	0.186493763	0	0.2	0.206916536	13.46952605	40	37.5	35	0	0	0.2	38.98758631	0	0	0	0	0	0	0	0											29.3211	1.101085242	10.70443264	0	4.591610021	2.839800285	1.019579995	1.197049604	8.421781865	2.573772858	11.27366804	0	0.026958096	3.005859965	7.577698726	20.95244315	0.9117992	2.499186198	0	0	6.835092626	8.776837047	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.6297	0	0	29.3211	1.101085242	10.70443264	0	4.591610021	2.839800285	1.019579995	1.197049604	8.421781865	2.573772858	11.27366804	0	0.026958096	3.005859965	7.577698726	20.95244315	0.9117992	2.499186198	0	0	6.835092626	8.776837047	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.6297																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	29.3211	1.101085242	10.70443264	0	4.591610021	2.839800285	1.019579995	1.197049604	8.421781865	2.573772858	11.27366804	0	0.026958096	3.005859965	7.577698726	20.95244315	0.9117992	2.499186198	0	0	6.835092626	8.776837047	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.6297
H0303_804_0	2009	2																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1228.711313	60.60742522	844.3410028	679.5849271	357.8359671	13.08728651	12.90912049	308.0796103	35.83198428	10353.2352	60.67259386	0	0.102023497	15.45075596	6998.356821	6237.970724	291.8457327	879.6989088	0	0	44.3154719	2669.660015	0	0	0	0	0	0	0	0											"$350 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$350 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											282.7432045	235.5408433	159.8131731	0	150	0.2	0.081235132	49.82422821	0.2	2.8	0.187057646	0	0.2	0.205792218	13.29443917	40	37.5	35	0	0	0.2	38.79430095	0	0	0	0	0	0	0	0											282.7432045	235.5408433	159.8131731	0	150	0.2	0.081235132	49.82422821	0.2	2.8	0.187057646	0	0.2	0.205792218	13.29443917	40	37.5	35	0	0	0.2	38.79430095	0	0	0	0	0	0	0	0											28.9508	1.189627004	11.24473457	0	4.472949588	2.617457301	1.048674107	1.279152401	7.166396857	2.415754881	11.34927259	0	0.020404699	3.179645347	7.753269089	20.79323575	0.912017915	2.565788484	0	0	8.863094381	8.630632836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.4529	0	0	28.9508	1.189627004	11.24473457	0	4.472949588	2.617457301	1.048674107	1.279152401	7.166396857	2.415754881	11.34927259	0	0.020404699	3.179645347	7.753269089	20.79323575	0.912017915	2.565788484	0	0	8.863094381	8.630632836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.4529																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	28.9508	1.189627004	11.24473457	0	4.472949588	2.617457301	1.048674107	1.279152401	7.166396857	2.415754881	11.34927259	0	0.020404699	3.179645347	7.753269089	20.79323575	0.912017915	2.565788484	0	0	8.863094381	8.630632836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.4529
H0303_805_0	2009	2																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1229.547581	60.64867497	844.915666	680.0474564	358.0795122	13.10510713	12.92669851	308.289291	35.88077578	10360.28167	60.75521019	0	0.10216242	15.47179486	7003.119942	6242.216322	292.0443646	880.2976369	0	0	44.37581515	2671.477	0	0	0	0	0	0	0	0											"$350 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$350 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											282.7432045	235.5408433	159.8131731	0	150	0.2	0.081235132	49.82422821	0.2	2.8	0.187043398	0	0.2	0.205785524	13.29443917	40	37.5	35	0	0	0.2	38.81295328	0	0	0	0	0	0	0	0											282.7432045	235.5408433	159.8131731	0	150	0.2	0.081235132	49.82422821	0.2	2.8	0.187043398	0	0.2	0.205785524	13.29443917	40	37.5	35	0	0	0.2	38.81295328	0	0	0	0	0	0	0	0											28.9705	1.19043667	11.2523878	0	4.475993903	2.621021426	1.05010206	1.280022999	7.176155157	2.417399057	11.36386093	0	0.020432484	3.18387141	7.758546008	20.80738774	0.912638639	2.567534774	0	0	8.87516303	8.640659333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.5641	0	0	28.9705	1.19043667	11.2523878	0	4.475993903	2.621021426	1.05010206	1.280022999	7.176155157	2.417399057	11.36386093	0	0.020432484	3.18387141	7.758546008	20.80738774	0.912638639	2.567534774	0	0	8.87516303	8.640659333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.5641																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	28.9705	1.19043667	11.2523878	0	4.475993903	2.621021426	1.05010206	1.280022999	7.176155157	2.417399057	11.36386093	0	0.020432484	3.18387141	7.758546008	20.80738774	0.912638639	2.567534774	0	0	8.87516303	8.640659333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.5641
H0307_008_0	2009	7	r.	s.	t.	u.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			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		1601.883579	130.181737	798.204397	15.07122	250.691415	3.906231	1.91019	366.995739	171.573298	102.741952	971.598925	0	14.551873	249.788548	4458.190735	3856.971769	2.50508	511.509595			27.052418				1.5				1.23	0.05	0.06	0.27	2.68	2.7							$150/Day(Days 1-7):1a	$150/Day(Days 1-7):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	"0%-20% Coins:11b. 0% Supplies,11b. 20% Prosthetics"	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $150 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$150/Visit:14h. $150 DMAM -- OP,8b. $25 Radiology -- FSR,14h. $25 SMAM -- FSR,14h. $25 SMAM -- OP,8b. $150 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $150 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$150/Visit:9a	"$0-$100/Proc:12. $0 Dialysis -- Dialysis Center,12. $100 Dialysis -- OP Hosp"	"$15-$150/Visit:9d. $15 Cardiac Rehab,8b. $150 Nuclear Medicine,9a. $150 OP Other,5. $40 Partial Hospitalization,8b. $50 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$150/Visit:7h. $150 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30/Visit:7d, 9a"			20% Coins:15				VIS 734				$0 Health Education Materials 14a	$0 Additional Smoking Cessation 14a	Other Added Benefit	MOW 001	FTP 004	Other Added Benefit							106.865399	94.510031	43.132801	0	99.999994	0.199999	0.124719	50.000002	149.999984	46.352594	57.430882	0	0	71.926916	10	30.000001	135.851948	30			0.2				0				0	0	0	0	0	0							106.865399	94.510031	43.132801	0	99.999994	0.199999	0.124719	50.000002	149.999984	46.352594	57.430882	0	0	71.926916	10	30.000001	135.851948	30			0.2				0				0	0	0	0	0	0							14.2655	1.02529	2.869065951	0	2.089095	0.781242294	0.238236987	1.529148974	2.144665996	0.396862999	4.649981934	0	0	1.497209992	3.715158946	9.642429744	0.02836	1.278773988	0	0	5.4104836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.5615	0	0	14.2655	1.02529	2.869065951	0	2.089095	0.781242294	0.238236987	1.529148974	2.144665996	0.396862999	4.649981934	0	0	1.497209992	3.715158946	9.642429744	0.02836	1.278773988	0	0	5.4104836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.5615																																																																																		0	0	0	14.2655	1.02529	2.869065951	0	2.089095	0.781242294	0.238236987	1.529148974	2.144665996	0.396862999	4.649981934	0	0	1.497209992	3.715158946	9.642429744	0.02836	1.278773988	0	0	5.4104836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.5615
H0307_009_0	2009	7	r.	s.	t.	u.	v.						OP Facility - Other	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered							Renal Dialysis										D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin	V		V		O	O	P	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		1487.099693	120.85349	741.008603	13.991283	232.727979	3.366476	1.646243	340.698448	159.279115	95.379919	901.978445	0	0	231.889805	4138.736521	3580.598244	2.325577	474.857082			23.31437			3.13	2.82		0.77		1.23	0.05	13.509151	2.68	0.06	0.27	2.7						$175/Day(Days 1-5):1a	$175/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	"0%-20% Coins:11b. 0% Supplies,11b. 20% Prosthetics"	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $150 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$150/Visit:14h. $150 DMAM -- OP,8b. $25 Radiology -- FSR,14h. $25 SMAM -- FSR,14h. $25 SMAM -- OP,8b. $150 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $150 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$150/Visit:9a	20% Coins:12	"$15-$150/Visit:9d. $15 Cardiac Rehab,8b. $150 Nuclear Medicine,9a. $150 OP Other,5. $40 Partial Hospitalization,8b. $50 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$5/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$150/Visit:7h. $150 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30/Visit:7d, 9a"			20% Coins:15			"DEN 772 16a, 16b"	VIS 741		HER 722		$0: Health Education Materials 14a	$0 Additional Smoking Cessation 14a	$0/Proc:12	$0: Membership in health club/fitness class 14a	$0: Nurse hotline 14a	$0: Nutritional benefit 14a	$0 Corp Health 14a						107.292852	89.437979	43.132794	0	100.000009	0.199999	0.124719	50.000004	150.000004	46.352524	57.430871	0	0	71.926887	5.000001	30.000001	135.852736	29.999982			0.2			0	0		0		0	0	0	0	0	0	0						107.292852	89.437979	43.132794	0	100.000009	0.199999	0.124719	50.000004	150.000004	46.352524	57.430871	0	0	71.926887	5.000001	30.000001	135.852736	29.999982			0.2			0	0		0		0	0	0	0	0	0	0						13.2963	0.900740992	2.663480952	0	1.9394	0.673291834	0.205317781	1.41957698	1.990988991	0.368424999	4.316783977	0	0	1.389925983	1.724473895	8.951495908	0.026328	1.187141993	0	0	4.662874	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.7165	0	0	13.2963	0.900740992	2.663480952	0	1.9394	0.673291834	0.205317781	1.41957698	1.990988991	0.368424999	4.316783977	0	0	1.389925983	1.724473895	8.951495908	0.026328	1.187141993	0	0	4.662874	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.7165																																																																																		0	0	0	13.2963	0.900740992	2.663480952	0	1.9394	0.673291834	0.205317781	1.41957698	1.990988991	0.368424999	4.316783977	0	0	1.389925983	1.724473895	8.951495908	0.026328	1.187141993	0	0	4.662874	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.7165
H0307_010_0	2009	7	r.	s.	t.	u.							OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered							Renal Dialysis										D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin				V				O	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		1601.883579	130.181737	798.204397	15.07122	250.691415	3.906231	1.91019	366.995739	171.573298	102.741952	971.598925	0	14.551873	249.788548	4458.190735	3856.971769	2.50508	511.509595			27.052418				0.4				1.23	0.05	0	0.06	0.27	2.68	2.7						$150/Day(Days 1-7):1a	$150/Day(Days 1-7):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	"0%-20% Coins:11b. 0% Supplies,11b. 20% Prosthetics"	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $150 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$150/Visit:14h. $150 DMAM -- OP,8b. $25 Radiology -- FSR,14h. $25 SMAM -- FSR,14h. $25 SMAM -- OP,8b. $150 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $150 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$150/Visit:9a	12. 20%	"$15-$150/Visit:9d. $15 Cardiac Rehab,8b. $150 Nuclear Medicine,9a. $150 OP Other,5. $40 Partial Hospitalization,8b. $100 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$150/Visit:7h. $150 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30/Visit:7d, 9a"			20% Coins:15				VIS 740				HAM 001	SMC 001	12. $0/proc	Other Added Benefit	MOW 001	FTP 004	Other Added Benefit						106.865399	94.510031	43.132801	0	99.999994	0.199999	0.124719	50.000002	149.999984	46.352594	57.430882	0	0	75.858994	10	30.000001	135.851948	30			0.2				0				0	0	0	0	0	0	0						106.865399	94.510031	43.132801	0	99.999994	0.199999	0.124719	50.000002	149.999984	46.352594	57.430882	0	0	75.858994	10	30.000001	135.851948	30			0.2				0				0	0	0	0	0	0	0						14.2655	1.02529	2.869065951	0	2.089095	0.781242294	0.238236987	1.529148974	2.144665996	0.396862999	4.649981934	0	0	1.579058997	3.715158946	9.642429744	0.02836	1.278773988	0	0	5.4104836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6433	0	0	14.2655	1.02529	2.869065951	0	2.089095	0.781242294	0.238236987	1.529148974	2.144665996	0.396862999	4.649981934	0	0	1.579058997	3.715158946	9.642429744	0.02836	1.278773988	0	0	5.4104836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6433																																																																																		0	0	0	14.2655	1.02529	2.869065951	0	2.089095	0.781242294	0.238236987	1.529148974	2.144665996	0.396862999	4.649981934	0	0	1.579058997	3.715158946	9.642429744	0.02836	1.278773988	0	0	5.4104836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6433
H0307_801_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		326.077621	13.119976	798.204397	15.07122	10.280684	3.906231	1.91019	31.722853	31.895414	102.741952	25.83253	0	0.50827	8.190079	45.441226	100.561065	0.132592	4.682703			27.052418																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999988	1023.999739	43.132801	0	0.2	0.199999	0.2	0.2	0.2	0	0.199999	0	0.2	0.199999	0.199999	0.2	0.5	0.199999			0.2																				1023.999988	1023.999739	43.132801	0	0.2	0.199999	0.2	0.2	0.2	0	0.199999	0	0.2	0.199999	0.199999	0.2	0.5	0.199999			0.2																				27.8253	1.119571	2.869065951	0	2.0561368	0.781242294	0.382038	6.3445706	6.3790828	0	5.166480167	0	0.101654	1.63800761	9.088199759	20.112213	0.066296	0.936535917	0	0	5.4104836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.2769	0	0	27.8253	1.119571	2.869065951	0	2.0561368	0.781242294	0.382038	6.3445706	6.3790828	0	5.166480167	0	0.101654	1.63800761	9.088199759	20.112213	0.066296	0.936535917	0	0	5.4104836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.2769																																																																																		0	0	0	27.8253	1.119571	2.869065951	0	2.0561368	0.781242294	0.382038	6.3445706	6.3790828	0	5.166480167	0	0.101654	1.63800761	9.088199759	20.112213	0.066296	0.936535917	0	0	5.4104836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.2769
H0307_802_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		326.077621	13.119976	798.204397	15.07122	10.280684	3.906231	1.91019	31.722853	31.895414	102.741952	25.83253	0	0.50827	8.190079	45.441226	100.561065	0.132592	4.682703			27.052418																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999988	1023.999739	43.132801	0	0.2	0.199999	0.2	0.2	0.2	0	0.199999	0	0.2	0.199999	0.199999	0.2	0.5	0.199999			0.2																				1023.999988	1023.999739	43.132801	0	0.2	0.199999	0.2	0.2	0.2	0	0.199999	0	0.2	0.199999	0.199999	0.2	0.5	0.199999			0.2																				27.8253	1.119571	2.869065951	0	2.0561368	0.781242294	0.382038	6.3445706	6.3790828	0	5.166480167	0	0.101654	1.63800761	9.088199759	20.112213	0.066296	0.936535917	0	0	5.4104836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.2769	0	0	27.8253	1.119571	2.869065951	0	2.0561368	0.781242294	0.382038	6.3445706	6.3790828	0	5.166480167	0	0.101654	1.63800761	9.088199759	20.112213	0.066296	0.936535917	0	0	5.4104836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.2769																																																																																		0	0	0	27.8253	1.119571	2.869065951	0	2.0561368	0.781242294	0.382038	6.3445706	6.3790828	0	5.166480167	0	0.101654	1.63800761	9.088199759	20.112213	0.066296	0.936535917	0	0	5.4104836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.2769
H0307_803_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		326.077621	13.119976	798.204397	15.07122	10.280684	3.906231	1.91019	31.722853	31.895414	102.741952	25.83253	0	0.50827	8.190079	45.441226	100.561065	0.132592	4.682703			27.052418																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999988	1023.999739	43.132801	0	0.2	0.199999	0.2	0.2	0.2	0	0.199999	0	0.2	0.199999	0.199999	0.2	0.5	0.199999			0.2																				1023.999988	1023.999739	43.132801	0	0.2	0.199999	0.2	0.2	0.2	0	0.199999	0	0.2	0.199999	0.199999	0.2	0.5	0.199999			0.2																				27.8253	1.119571	2.869065951	0	2.0561368	0.781242294	0.382038	6.3445706	6.3790828	0	5.166480167	0	0.101654	1.63800761	9.088199759	20.112213	0.066296	0.936535917	0	0	5.4104836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.2769	0	0	27.8253	1.119571	2.869065951	0	2.0561368	0.781242294	0.382038	6.3445706	6.3790828	0	5.166480167	0	0.101654	1.63800761	9.088199759	20.112213	0.066296	0.936535917	0	0	5.4104836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.2769																																																																																		0	0	0	27.8253	1.119571	2.869065951	0	2.0561368	0.781242294	0.382038	6.3445706	6.3790828	0	5.166480167	0	0.101654	1.63800761	9.088199759	20.112213	0.066296	0.936535917	0	0	5.4104836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.2769
H0307_804_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		326.077621	13.119976	798.204397	15.07122	10.280684	3.906231	1.91019	31.722853	31.895414	102.741952	25.83253	0	0.50827	8.190079	45.441226	100.561065	0.132592	4.682703			27.052418																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999988	1023.999739	43.132801	0	0.2	0.199999	0.2	0.2	0.2	0	0.199999	0	0.2	0.199999	0.199999	0.2	0.5	0.199999			0.2																				1023.999988	1023.999739	43.132801	0	0.2	0.199999	0.2	0.2	0.2	0	0.199999	0	0.2	0.199999	0.199999	0.2	0.5	0.199999			0.2																				27.8253	1.119571	2.869065951	0	2.0561368	0.781242294	0.382038	6.3445706	6.3790828	0	5.166480167	0	0.101654	1.63800761	9.088199759	20.112213	0.066296	0.936535917	0	0	5.4104836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.2769	0	0	27.8253	1.119571	2.869065951	0	2.0561368	0.781242294	0.382038	6.3445706	6.3790828	0	5.166480167	0	0.101654	1.63800761	9.088199759	20.112213	0.066296	0.936535917	0	0	5.4104836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.2769																																																																																		0	0	0	27.8253	1.119571	2.869065951	0	2.0561368	0.781242294	0.382038	6.3445706	6.3790828	0	5.166480167	0	0.101654	1.63800761	9.088199759	20.112213	0.066296	0.936535917	0	0	5.4104836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.2769
H0316_002_0	2009	5																					3250											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2033.070864	151.6765795	941.6087183	526.0499192	341.4989385	10.45718302	6.145262679	452.7957427	21.57710887	9750.767876	37.80127436	0	1.527609918	12.44303271	6668.268371	5516.566392	683.5215568	435.1573855	0	0	29.13719996	1498.223484	0	0	23.07735074	0	18.86940837	0	480.8651365	0											"$240 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$240 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											237.1623642	240	85.36789939	0	149.8445596	0.2	0.094577655	49.88276671	0.2	2.8	0.159145956	0	0.2	0.208951618	7.456129636	28.44824395	37.5	30	0	0	0.2	29.21686834	0	0	30	0	30	0	0	0											160.3065796	162.208097	57.69735209	0	101.2750035	0.135173414	0.063921923	33.71411941	0.135173414	1.892427798	0.107561511	0	0.135173414	0.141915912	7.456129636	28.44824395	37.5	20.27601212	0	0	0.135173414	29.21686834	0	0	30	0	30	0	0	0											27.1596	2.05026411	4.527360813	0	2.88210885	1.413533131	0.392817005	1.272134145	2.916651473	1.537718682	4.065962202	0	0.206492248	1.76586434	4.143289452	13.07805221	2.136004865	0.735271369	0	0	3.938574796	3.647783189	0	0	0.057693377	0	0.047173521	0	0	0	0	0	0	0	0	0	0	0	0	0	77.9743	0	26.295	27.1596	2.05026411	4.527360813	0	2.88210885	1.413533131	0.392817005	1.272134145	2.916651473	1.537718682	4.065962202	0	0.206492248	1.76586434	4.143289452	13.07805221	2.136004865	0.735271369	0	0	3.938574796	3.647783189	0	0	0.057693377	0	0.047173521	0	0	0	0	0	0	0	0	0	0	0	0	0	77.9743																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	27.1596	2.05026411	4.527360813	0	2.88210885	1.413533131	0.392817005	1.272134145	2.916651473	1.537718682	4.065962202	0	0.206492248	1.76586434	4.143289452	13.07805221	2.136004865	0.735271369	0	0	3.938574796	3.647783189	0	0	0.057693377	0	0.047173521	0	0	0	0	0	0	0	0	0	0	0	0	0	77.9743
H0316_012_0	2009	7																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		271.4678751	22.93	28.99857713	3419.775804	20.0697443	29.30819452	11.90568123	19.46550603	28.39872357	10.67305441	23.16560846	0	1.388287199	29.78763163	41.61866476	125.3505658	14.56	3.725585664	0	0	17.44180525	6.617087808	4750.259246	0	43.88480678	49.89390091	0	0	20.2	0											"6.9% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"6.9% (1b); $0 n/c (1b1, 1b2)"	16.3% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.067847078	0.0687	0.1625	0	0.2	0.2	0.2	0.150773696	0.2	0.08	0.2	0	0.2	0.2	0	0.199144664	0.2	0.2	0	0	0.2	0.015298549	0	0	0	0	0	0	0	0											0.067847078	0.0687	0.1625	0	0.2	0.2	0.2	0.150773696	0.2	0.08	0.2	0	0.2	0.2	0	0.199144664	0.2	0.2	0	0	0.2	0.015298549	0	0	0	0	0	0	0	0											18.4183	1.575291	4.712268783	0	4.01394886	5.861638904	2.381136245	2.934886297	5.679744714	0.853844353	4.633121692	0	0.27765744	5.957526325	0	24.96289634	2.912	0.745117133	0	0	3.48836105	0.101231844	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.509	0	0	18.4183	1.575291	4.712268783	0	4.01394886	5.861638904	2.381136245	2.934886297	5.679744714	0.853844353	4.633121692	0	0.27765744	5.957526325	0	24.96289634	2.912	0.745117133	0	0	3.48836105	0.101231844	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.509																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.4183	1.575291	4.712268783	0	4.01394886	5.861638904	2.381136245	2.934886297	5.679744714	0.853844353	4.633121692	0	0.27765744	5.957526325	0	24.96289634	2.912	0.745117133	0	0	3.48836105	0.101231844	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.509
H0316_013_0	2009	4																					2500											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1777.996355	264.0889438	37.95376468	48294.79814	84.0867896	19.00744527	8.403713453	343.6404546	360.2649366	5705.410446	436.3288344	0	0.813987011	1391.374549	5628.480139	4166.357203	1301.980366	248.4408055	0	0	24.42037841	1051.964907	810.5086242	0	327.7093149	349.7142857	0	0	20.2	0											"$175 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	16.3% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$75 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5, 9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											172.9	175	0.1625	0	75	0.14	0.2	49.97089982	75	4.4	64.79010385	0	0.2	70.33562265	3.249791485	25	20	20	0	0	0.2	13.67894853	0	0	0	0	0	0	0	0											121.8732596	123.3535016	0.1625	0	52.86578641	0.098682801	0.14097543	35.22334555	52.86578641	3.101459469	45.66906388	0	0.14097543	49.57797338	3.249791485	25	20	20	0	0	0.14097543	13.67894853	0	0	0	0	0	0	0	0											18.0575	2.71469133	6.16748676	0	0.370442855	1.875707945	1.184717121	1.00868054	1.587140766	1.474591605	1.660560784	0	0.114752169	5.748460863	1.524282236	8.679910841	2.169967277	0.414068009	0	0	3.442673358	1.199147819	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3948	0	16.4292	18.0575	2.71469133	6.16748676	0	0.370442855	1.875707945	1.184717121	1.00868054	1.587140766	1.474591605	1.660560784	0	0.114752169	5.748460863	1.524282236	8.679910841	2.169967277	0.414068009	0	0	3.442673358	1.199147819	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3948																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.0575	2.71469133	6.16748676	0	0.370442855	1.875707945	1.184717121	1.00868054	1.587140766	1.474591605	1.660560784	0	0.114752169	5.748460863	1.524282236	8.679910841	2.169967277	0.414068009	0	0	3.442673358	1.199147819	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3948
H0316_014_0	2009	7																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	324.7131726	13.60854184	929.4723369	537.7848936	337.0973635	10.18935526	5.98787116	442.5735515	363.1219786	9625.090368	36.83311396	0	1.488485008	1354.514852	6462.674109	5431.497498	674.7116572	429.5486481	0	0	28.39094249	1478.912902	0	0	147.9890135	292.8	0	0	775.2	0											"$400 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$400 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$100 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$200 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); $200 (9a); $40/$30 (9c)"	"$5 (7a); $35 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$0 n/c (13b, 13d, 13e)"											370.2508214	400	55.10681964	0	150	0.2	0.094577655	49.97987283	200	2.8	0.159491186	0	0.2	106.2628475	3.820637913	32.94668709	37.5	30	0	0	0.2	34.08249384	0	0	35	30	0	0	0	0											370.2508214	400	55.10681964	0	150	0.2	0.094577655	49.97987283	200	2.8	0.159491186	0	0.2	106.2628475	3.820637913	32.94668709	37.5	30	0	0	0.2	34.08249384	0	0	35	30	0	0	0	0											10.0188	0.453618061	4.26835537	0	4.213717044	2.037871052	0.566318812	1.843314152	6.052032977	2.245854419	5.874557021	0	0.297697002	11.99455042	2.057628143	14.91248738	2.108473929	1.07387162	0	0	5.678188498	4.200419991	0	0	0.431634623	0.732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.0614	0	0	10.0188	0.453618061	4.26835537	0	4.213717044	2.037871052	0.566318812	1.843314152	6.052032977	2.245854419	5.874557021	0	0.297697002	11.99455042	2.057628143	14.91248738	2.108473929	1.07387162	0	0	5.678188498	4.200419991	0	0	0.431634623	0.732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.0614																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.0188	0.453618061	4.26835537	0	4.213717044	2.037871052	0.566318812	1.843314152	6.052032977	2.245854419	5.874557021	0	0.297697002	11.99455042	2.057628143	14.91248738	2.108473929	1.07387162	0	0	5.678188498	4.200419991	0	0	0.431634623	0.732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.0614
H0316_801_0	2009	3																					4440											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2170.082172	161.8982629	1005.064963	561.5011121	364.5129991	11.34678263	6.668044317	483.2272552	23.41268807	10407.88489	41.01705425	0	1.657564723	13.50156989	6972.164767	5862.516938	729.5849697	464.4832116	0	0	31.6159212	1599.190726	0	0	0	0	0	0	0	0											"$370 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$370 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-30 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											365.5979933	370	150	0	150	0.2	0.094577655	49.88274657	0.2	2.8	0.158715168	0	0.2	0.210599206	7.611715388	32.98954491	37.5	35	0	0	0.2	34.08312577	0	0	0	0	0	0	0	0											241.4552775	244.3452017	99.05886557	0	99.05886557	0.132078487	0.062458368	32.94218858	0.132078487	1.849098824	0.104814297	0	0.132078487	0.139791753	7.611715388	32.98954491	37.5	23.1137353	0	0	0.132078487	34.08312577	0	0	0	0	0	0	0	0											43.6648	3.296588642	8.296716255	0	3.009020348	1.498665887	0.416475166	1.326546947	3.092312427	1.60376731	4.299173701	0	0.218928641	1.887408125	4.422511154	16.11681382	2.27995303	0.894661834	0	0	4.17578305	4.542118221	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.0423	0	39.9282	43.6648	3.296588642	8.296716255	0	3.009020348	1.498665887	0.416475166	1.326546947	3.092312427	1.60376731	4.299173701	0	0.218928641	1.887408125	4.422511154	16.11681382	2.27995303	0.894661834	0	0	4.17578305	4.542118221	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.0423																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	43.6648	3.296588642	8.296716255	0	3.009020348	1.498665887	0.416475166	1.326546947	3.092312427	1.60376731	4.299173701	0	0.218928641	1.887408125	4.422511154	16.11681382	2.27995303	0.894661834	0	0	4.17578305	4.542118221	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.0423
H0316_804_0	2009	3																					4440											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2170.082011	161.8982508	1005.064888	561.5010704	364.5129721	11.34678094	6.668043326	483.2272194	23.41268459	10407.88412	41.01704816	0	1.657564477	13.50156788	6972.16426	5862.516502	729.5849155	464.4831771	0	0	31.6159165	1599.190607	0	0	0	0	0	0	0	0											"$370 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$370 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-30 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											365.5979933	370	150	0	150	0.2	0.094577655	49.88274657	0.2	2.8	0.15871517	0	0.2	0.210599206	7.611715377	32.98954482	37.5	35	0	0	0.2	34.08312577	0	0	0	0	0	0	0	0											241.4552857	244.3452101	99.05886895	0	99.05886895	0.132078492	0.06245837	32.9421897	0.132078492	1.849098887	0.104814302	0	0.132078492	0.139791758	7.611715377	32.98954482	37.5	23.11373609	0	0	0.132078492	34.08312577	0	0	0	0	0	0	0	0											43.6648	3.296588509	8.296715921	0	3.009020227	1.498665715	0.416475118	1.326546894	3.092312073	1.603767245	4.299173261	0	0.218928616	1.887407912	4.422510826	16.11681257	2.279952861	0.894661798	0	0	4.175782572	4.542117883	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.0423	0	39.9282	43.6648	3.296588509	8.296715921	0	3.009020227	1.498665715	0.416475118	1.326546894	3.092312073	1.603767245	4.299173261	0	0.218928616	1.887407912	4.422510826	16.11681257	2.279952861	0.894661798	0	0	4.175782572	4.542117883	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.0423																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	43.6648	3.296588509	8.296715921	0	3.009020227	1.498665715	0.416475118	1.326546894	3.092312073	1.603767245	4.299173261	0	0.218928616	1.887407912	4.422510826	16.11681257	2.279952861	0.894661798	0	0	4.175782572	4.542117883	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.0423
H0317_001_0	2009	6	r.	s.	t.	u.	v.						OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered							Renal Dialysis										A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin	V				O	O	P	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		249.466176	8.037757	504.816495	547.744652	108.946923	7.667958	2.769153	310.427382	320.410059	587.365156	862.912723	0	0	676.413657	3485.305022	3991.453143	23.892896	720.056563			21.045627			4.8	0.35				1.23	0.05	16.194075	0.06	0.27	2.68	2.7						$300/Admit:1a	$300/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $150 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$150/Visit:8a. $0 Lab -- FSL,8. $150 Lab -- OP"	"$0-$150/Visit:14h. $150 DMAM -- OP,8b. $25 Radiology -- FSR,14h. $25 SMAM -- FSR,14h. $25 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $25 Advanced Imaging -- Office,9a. $150 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $150 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$15-$150/Visit:9d. $15 Cardiac Rehab,8b. $150 Nuclear Medicine,9a. $150 OP Other,5. $40 Partial Hospitalization,8b. $150 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$5/Visit:7a	"$25/Visit:7b, 7d, 7f"	"$25-$150/Visit:7h. $150 Psych -- OP,7e. $25 Psych -- Other Provider"	"$25-$30/Visit:9a. $30 Therapy (AT,PT,ST,OT) -- OP,7d. $25 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			"DEN 749 16a, 16b"	VIS 738				$0: Health Education Materials 14a	$0 Additional Smoking Cessation 14a	$0/Proc:12	$0: Nurse hotline 14a	$0: Nutritional benefit 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a						299.99998	300.000113	43.13279	0	99.999997	0.2	0.2	49.999983	149.999972	133.631297	90.244176	0	0	102.08235	4.999998	25.000001	132.378261	26.286784			0.2			0	0				0	0	0	0	0	0	0						299.99998	300.000113	43.13279	0	99.999997	0.2	0.2	49.999983	149.999972	133.631297	90.244176	0	0	102.08235	4.999998	25.000001	132.378261	26.286784			0.2			0	0				0	0	0	0	0	0	0						6.2367	0.200944001	1.814511989	0	0.907890998	1.5335916	0.5538306	1.293446985	4.00512499	6.540863967	6.489403971	0	0	5.754157973	1.452209845	8.315527714	0.263575002	1.577330945	0	0	4.2091254	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.1482	0	0	6.2367	0.200944001	1.814511989	0	0.907890998	1.5335916	0.5538306	1.293446985	4.00512499	6.540863967	6.489403971	0	0	5.754157973	1.452209845	8.315527714	0.263575002	1.577330945	0	0	4.2091254	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.1482		$600/Admit	$600/Admit	40% Coins(Days 1-20) 40%(Days 21-100)	40% Coins	$100/Trip	50% Coins	50% Coins	$50/Visit	15% Coins	15% Coins	15%-20% Coins		20% Coins	15% Coins	20% Coins	20% Coins	15%-20% Coins	15%-20% Coins			20% Coins			"DEN 749 16a, 16b"	VIS 738				0	0	0	0	0	0	0						1.3859	0.0447	0.5937	0.7059	0.6053	2.4307	0.8778	0.2283	1.4818	0.1965	0.8625		0.0004	0.463	1.3111	2.9515	0.0121	0.1922			0.8438			0	0				0	0	0	0	0	0	0						15.1872	0	0	7.6226	0.245598001	2.408252989	0.705896	1.513151998	3.9642846	1.4316336	1.521701985	5.48690699	6.737368967	7.351942971	0	0.000423	6.217114973	2.763316845	11.26706071	0.275674002	1.769549945	0	0	5.0529454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3354
H0317_002_0	2009	7	r.	s.	t.	u.	v.						OP Facility - Other	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered							Renal Dialysis										A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin	V				O	O	P	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		247.078656	7.960831	499.985143	542.502455	107.904245	7.51706	2.714658	307.456433	317.343571	581.743771	854.654206	0	0	669.94003	3451.94887	3953.252895	23.66423	713.165254			20.631469			3.23	0.35				0.05	0.27	16.039089	1.23	2.68	0.06	2.7						$650/Admit:1a	$650/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $150 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$150/Visit:8a. $0 Lab -- FSL,8. $150 Lab -- OP"	"$0-$150/Visit:14h. $50 DMAM -- OP,8b. $25 Radiology -- FSR,14h. $25 SMAM -- FSR,14h. $25 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $150 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $150 Radiology OP -- Facility"	$150/Visit:9a	20% Coins:12	"$15-$150/Visit:9d. $15 Cardiac Rehab,8b. $150 Nuclear Medicine,9a. $150 OP Other,5. $40 Partial Hospitalization,8b. $100 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$150/Visit:7h. $150 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30/Visit:7d, 9a"			20% Coins:15			"DEN 767 16a, 16b"	VIS 738				$0 Additional Smoking Cessation 14a	$0: Nutritional benefit 14a	$0/Proc:12	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0: Nurse hotline 14a	$0 Corp Health 14a						649.99999	650.000446	43.132809	0	99.999994	0.199999	0.2	49.999981	150.000013	133.631306	87.793485	0	0	94.733147	9.999999	30.000002	133.083393	29.999997			0.2			0	0				0	0	0	0	0	0	0						649.99999	650.000446	43.132809	0	99.999994	0.199999	0.2	49.999981	150.000013	133.631306	87.793485	0	0	94.733147	9.999999	30.000002	133.083393	29.999997			0.2			0	0				0	0	0	0	0	0	0						13.3834	0.431211975	1.797146973	0	0.899201988	1.503404483	0.5429316	1.281067984	3.966794981	6.47826499	6.252755935	0	0	5.288793945	2.876623771	9.883132896	0.262443002	1.782912957	0	0	4.1262938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.7564	0	0	13.3834	0.431211975	1.797146973	0	0.899201988	1.503404483	0.5429316	1.281067984	3.966794981	6.47826499	6.252755935	0	0	5.288793945	2.876623771	9.883132896	0.262443002	1.782912957	0	0	4.1262938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.7564		$850/Admit	$850/Admit	40% Coins(Days 1-20) 40%(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			"DEN 767 16a, 16b"	VIS 738				0	0	0	0	0	0	0						1.9446	0.0627	0.5821	0.692	0.5995	2.3829	0.8605	0.2261	1.9368	0.2569	1.0655		0.0004	0.6051	1.2853	2.8934	0.0156	0.2029			0.8272			0	0				0	0	0	0	0	0	0						16.4395	0	0	15.328	0.493866975	2.379202973	0.692005	1.498669988	3.886263483	1.4034606	1.507138984	5.903622981	6.73511499	7.318232935	0	0.000419	5.893920945	4.161929771	12.7765809	0.278043002	1.985853957	0	0	4.9535098	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.1959
H0317_004_0	2009	8	r.	s.	t.	u.	v.						OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered							Renal Dialysis										A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin	V				O	O	P	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		246.950916	7.956716	479.762954	685.689957	136.384373	8.765485	3.165506	308.491216	334.394523	591.201481	877.470198	0	0	671.257374	3285.32972	3960.174625	27.014706	853.572095			19.811482			3.23	0.35				1.23	0.05	17.987914	0.06	0.27	2.68	2.7						$600/Admit:1a	$600/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$25/Visit:9b. $0 Surgery ASC -- Physician,9b. $25 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $25 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $25 Radiology -- FSR,14h. $25 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $25 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$15-$100/Visit:9d. $15 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $25 Partial Hospitalization,8b. $100 Rad therapy,3. $25 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$25/Visit:7b, 7d, 7f"	"$25-$100/Visit:7h. $100 Psych -- OP,7e. $25 Psych -- Other Provider"	"$25/Visit:7d, 9a"			20% Coins:15			"DEN 767 16a, 16b"	VIS738				$0: Health Education Materials 14a	$0 Additional Smoking Cessation 14a	$0/Proc:12	$0: Nurse hotline 14a	$0: Nutritional benefit 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a						600.000009	600.000301	43.1328	0	99.999961	0.2	0.199999	49.999997	24.99999	87.957404	63.558192	0	0	67.820412	10	25.000003	88.293687	25.000011			0.199999			0	0				0	0	0	0	0	0	0						600.000009	600.000301	43.1328	0	99.999961	0.2	0.199999	49.999997	24.99999	87.957404	63.558192	0	0	67.820412	10	25.000003	88.293687	25.000011			0.199999			0	0				0	0	0	0	0	0	0						12.3475	0.397836	1.724459962	0	1.136535998	1.753097	0.633098034	1.28537999	0.696654978	4.333378959	4.647534943	0	0	3.793745972	2.737774767	8.250364792	0.198769	1.77827598	0	0	3.962276589	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.6767	0	0	12.3475	0.397836	1.724459962	0	1.136535998	1.753097	0.633098034	1.28537999	0.696654978	4.333378959	4.647534943	0	0	3.793745972	2.737774767	8.250364792	0.198769	1.77827598	0	0	3.962276589	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.6767		$800/Admit	$800/Admit	25% Coins(Days 1-20) 25%(Days 21-100)	25% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	25% Coins	25% Coins	25% Coins		20% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins			"DEN 767 16a, 16b"	VIS738				0	0	0	0	0	0	0						2.1565	0.0695	0.3919	0.5945	0.8932	2.6205	0.9463	0.2674	2.8303	0.3646	1.5166		0.0005	0.8566	1.7176	3.9215	0.0248	0.3311			1.1705			0	0				0	0	0	0	0	0	0						20.674	500	0	14.504	0.467317	2.116350962	0.59454	2.029750998	4.373571	1.579437034	1.55278399	3.526994978	4.697992959	6.164156943	0	0.000496	4.650389972	4.455362767	12.17182179	0.223552	2.10939498	0	0	5.132797589	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.3507
H0317_801_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		250.513361	8.071497	506.935568	550.043924	3.914552	7.725769	2.79003	20.85835	51.930733	589.830744	28.818799	0	0.327011	16.50902	32.946687	74.168744	0.399886	5.202063			21.204294																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999993	1024.00038	43.132795	0	0.199999	0.2	0.2	0.2	0.199999	0	0.2	0	0.199999	0.199999	0.199999	0.199999	0.500002	0.2			0.2																				1023.999993	1024.00038	43.132795	0	0.199999	0.2	0.2	0.2	0.199999	0	0.2	0	0.199999	0.199999	0.199999	0.199999	0.500002	0.2			0.2																				21.3771	0.688768	1.822128994	0	0.782906485	1.5451538	0.558006	4.17167	10.38609467	0	5.7637598	0	0.065401873	3.301787491	6.589304453	14.83367463	0.1999438	1.0404126	0	0	4.2408588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.367	0	0	21.3771	0.688768	1.822128994	0	0.782906485	1.5451538	0.558006	4.17167	10.38609467	0	5.7637598	0	0.065401873	3.301787491	6.589304453	14.83367463	0.1999438	1.0404126	0	0	4.2408588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.367		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3752	0.0765	0.2025		0.4964	0.9796	0.3538	0.7858	1.9906		1.0951		0.0123	0.6219	1.321	2.9738	0.0401	0.2086			0.8502																				14.3833	0	0	23.7524	0.765298	2.024587994	0	1.279261485	2.5247608	0.911775	4.957446	12.37669867	0	6.8588208	0	0.077720873	3.923716491	7.910296453	17.80745863	0.2400278	1.2489886	0	0	5.0910418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.7503
H0317_802_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		250.513361	8.071497	506.935568	550.043924	3.914552	7.725769	2.79003	20.85835	51.930733	589.830744	28.818799	0	0.327011	16.50902	32.946687	74.168744	0.399886	5.202063			21.204294																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999993	1024.00038	43.132795	0	0.199999	0.2	0.2	0.2	0.199999	0	0.2	0	0.199999	0.199999	0.199999	0.199999	0.500002	0.2			0.2																				1023.999993	1024.00038	43.132795	0	0.199999	0.2	0.2	0.2	0.199999	0	0.2	0	0.199999	0.199999	0.199999	0.199999	0.500002	0.2			0.2																				21.3771	0.688768	1.822128994	0	0.782906485	1.5451538	0.558006	4.17167	10.38609467	0	5.7637598	0	0.065401873	3.301787491	6.589304453	14.83367463	0.1999438	1.0404126	0	0	4.2408588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.367	0	0	21.3771	0.688768	1.822128994	0	0.782906485	1.5451538	0.558006	4.17167	10.38609467	0	5.7637598	0	0.065401873	3.301787491	6.589304453	14.83367463	0.1999438	1.0404126	0	0	4.2408588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.367		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3752	0.0765	0.2025		0.4964	0.9796	0.3538	0.7858	1.9906		1.0951		0.0123	0.6219	1.321	2.9738	0.0401	0.2086			0.8502																				14.3833	0	0	23.7524	0.765298	2.024587994	0	1.279261485	2.5247608	0.911775	4.957446	12.37669867	0	6.8588208	0	0.077720873	3.923716491	7.910296453	17.80745863	0.2400278	1.2489886	0	0	5.0910418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.7503
H0317_803_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		250.513361	8.071497	506.935568	550.043924	3.914552	7.725769	2.79003	20.85835	51.930733	589.830744	28.818799	0	0.327011	16.50902	32.946687	74.168744	0.399886	5.202063			21.204294																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999993	1024.00038	43.132795	0	0.199999	0.2	0.2	0.2	0.199999	0	0.2	0	0.199999	0.199999	0.199999	0.199999	0.500002	0.2			0.2																				1023.999993	1024.00038	43.132795	0	0.199999	0.2	0.2	0.2	0.199999	0	0.2	0	0.199999	0.199999	0.199999	0.199999	0.500002	0.2			0.2																				21.3771	0.688768	1.822128994	0	0.782906485	1.5451538	0.558006	4.17167	10.38609467	0	5.7637598	0	0.065401873	3.301787491	6.589304453	14.83367463	0.1999438	1.0404126	0	0	4.2408588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.367	0	0	21.3771	0.688768	1.822128994	0	0.782906485	1.5451538	0.558006	4.17167	10.38609467	0	5.7637598	0	0.065401873	3.301787491	6.589304453	14.83367463	0.1999438	1.0404126	0	0	4.2408588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.367		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3752	0.0765	0.2025		0.4964	0.9796	0.3538	0.7858	1.9906		1.0951		0.0123	0.6219	1.321	2.9738	0.0401	0.2086			0.8502																				14.3833	0	0	23.7524	0.765298	2.024587994	0	1.279261485	2.5247608	0.911775	4.957446	12.37669867	0	6.8588208	0	0.077720873	3.923716491	7.910296453	17.80745863	0.2400278	1.2489886	0	0	5.0910418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.7503
H0317_804_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		250.513361	8.071497	506.935568	550.043924	3.914552	7.725769	2.79003	20.85835	51.930733	589.830744	28.818799	0	0.327011	16.50902	32.946687	74.168744	0.399886	5.202063			21.204294																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999993	1024.00038	43.132795	0	0.199999	0.2	0.2	0.2	0.199999	0	0.2	0	0.199999	0.199999	0.199999	0.199999	0.500002	0.2			0.2																				1023.999993	1024.00038	43.132795	0	0.199999	0.2	0.2	0.2	0.199999	0	0.2	0	0.199999	0.199999	0.199999	0.199999	0.500002	0.2			0.2																				21.3771	0.688768	1.822128994	0	0.782906485	1.5451538	0.558006	4.17167	10.38609467	0	5.7637598	0	0.065401873	3.301787491	6.589304453	14.83367463	0.1999438	1.0404126	0	0	4.2408588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.367	0	0	21.3771	0.688768	1.822128994	0	0.782906485	1.5451538	0.558006	4.17167	10.38609467	0	5.7637598	0	0.065401873	3.301787491	6.589304453	14.83367463	0.1999438	1.0404126	0	0	4.2408588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.367		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3752	0.0765	0.2025		0.4964	0.9796	0.3538	0.7858	1.9906		1.0951		0.0123	0.6219	1.321	2.9738	0.0401	0.2086			0.8502																				14.3833	0	0	23.7524	0.765298	2.024587994	0	1.279261485	2.5247608	0.911775	4.957446	12.37669867	0	6.8588208	0	0.077720873	3.923716491	7.910296453	17.80745863	0.2400278	1.2489886	0	0	5.0910418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.7503
H0318_001_0	2009	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$100/day 1-5	$100/day 1-5	"$0/d 1-20, $100/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $30 Urgent Care Ctr	$100 per procedure	$0 per visit	$0 X-ray; $100 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$10 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	Not Covered	$0 per visit	$500 Every 3 Yrs	Coaching Only	0											61.28387407	61.28387407	40.33133874	0	100	0.2	0.2	48	100	0	40	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											61.28387407	61.28387407	40.33133874	0	100	0.2	0.2	48	100	0	40	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											9.9789	0	4.532899329	0	2.276793099	1.576138182	0	1.017676696	3.204079498	0	15.71449744	0	0.139220051	1.967526475	6.088949555	23.17962445	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.3953	0	0	9.9789	0	4.532899329	0	2.276793099	1.576138182	0	1.017676696	3.204079498	0	15.71449744	0	0.139220051	1.967526475	6.088949555	23.17962445	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.3953																																																																					0	0	0											0			9.9789	0	4.532899329	0	2.276793099	1.576138182	0	1.017676696	3.204079498	0	15.71449744	0	0.139220051	1.967526475	6.088949555	23.17962445	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.3953
H0318_002_0	2009	4																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$200/day 1-5	$200/day 1-5	"$0/d 1-20, $100/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$200 per procedure	$0 per visit	$25 X-ray; $165 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$10 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	Not Covered	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											122.5677481	122.5677481	40.33133874	0	100	0.2	0.2	48.5	200	0	81	35	25	35	10	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											122.5677481	122.5677481	40.33133874	0	100	0.2	0.2	48.5	200	0	81	35	25	35	10	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											19.9578	0	4.532899329	0	2.276793099	1.576138182	0	1.028277495	6.408158995	0	31.82185731	0	0.139220051	2.295447554	6.088949555	27.04289519	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.1675	0	0	19.9578	0	4.532899329	0	2.276793099	1.576138182	0	1.028277495	6.408158995	0	31.82185731	0	0.139220051	2.295447554	6.088949555	27.04289519	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.1675																																																																					0	0	0											0			19.9578	0	4.532899329	0	2.276793099	1.576138182	0	1.028277495	6.408158995	0	31.82185731	0	0.139220051	2.295447554	6.088949555	27.04289519	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.1675
H0318_801_0	2009	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																																																			0		330.3982922	0	40.79766496	6.185415341	7.295227334	9.711785537	0	8.584390268	44.36518006	15.12257327	61.64069797	0	3.3636637	12.78573948	45.16128229	196.1691137	0	5.813998446	0	0	8.773396166	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.0706	0.0706	0.1444	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.3261	0	5.89118282	0	1.685197514	2.243422459	0	1.982994152	10.24835659	3.493314426	14.23900123	0	0.777006315	2.95350582	10.43225621	45.31506527	0	1.343033641	0	0	2.026654514	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.9571			23.3261	0	5.89118282	0	1.685197514	2.243422459	0	1.982994152	10.24835659	3.493314426	14.23900123	0	0.777006315	2.95350582	10.43225621	45.31506527	0	1.343033641	0	0	2.026654514	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.9571																																																																																		0			23.3261	0	5.89118282	0	1.685197514	2.243422459	0	1.982994152	10.24835659	3.493314426	14.23900123	0	0.777006315	2.95350582	10.43225621	45.31506527	0	1.343033641	0	0	2.026654514	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.9571
H0318_802_0	2009	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																																																			0		329.7089875	0	40.71254944	6.172510808	7.280007418	9.691523994	0	8.566480791	44.27262169	15.09102329	61.51209796	0	3.356646142	12.7590648	45.06706303	195.7598492	0	5.801868794	0	0	8.75509237	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.0706	0.0706	0.1444	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.2775	0	5.878892139	0	1.681681713	2.238742043	0	1.978857063	10.22697561	3.48602638	14.20929463	0	0.775385259	2.947343968	10.41049156	45.22052517	0	1.340231692	0	0	2.022426338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.6943			23.2775	0	5.878892139	0	1.681681713	2.238742043	0	1.978857063	10.22697561	3.48602638	14.20929463	0	0.775385259	2.947343968	10.41049156	45.22052517	0	1.340231692	0	0	2.022426338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.6943																																																																																		0			23.2775	0	5.878892139	0	1.681681713	2.238742043	0	1.978857063	10.22697561	3.48602638	14.20929463	0	0.775385259	2.947343968	10.41049156	45.22052517	0	1.340231692	0	0	2.022426338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.6943
H0319_001_0	2009	5																					800											D	D	D	V	T	P	P	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2549.955768	309.7043069	10351.50725	91.8801879	934.8096825	7216.410783	459.8307672	180.4013379	101.727654	11407.63273	619.2243748	0	1.534093302	4448.676516	178.5562336	5064.784131	92.64433419	35.91113683	0	0	1732.943033	543.3931986	15754.63462	0	211.3562744	217.1581599	25.0141293	10.09585675	0	0											"$75 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $800 (13c)"	"$75 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0 (11a)	"$0 (11b, 11c)"	$50 (4a); $0 n/c (4a1); $10 (4b)	$25 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$25 (3, 5, 9a); $0 (9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $10 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$0 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a9, 14a10); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											74.3364829	75	0	0	75	0	0	49.88567092	25	0	0	0	0	24.9520407	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											44.28675723	44.68205466	0	0	44.68205466	0	0	29.71992367	14.89401822	0	0	0	0	14.86544596	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											9.4108	1.153185397	0	0	3.480768111	0	0	0.446792833	0.126261128	0	0	0	0	5.51096336	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.1287	0	13.6579	9.4108	1.153185397	0	0	3.480768111	0	0	0.446792833	0.126261128	0	0	0	0	5.51096336	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.1287		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $10 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $10 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a9, 14a10); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											2.4348	0.1548	1.0508	0.0206	0.3184	0.5356	0.0752	0.0395	0.1181	0.5155	0.1906	0	0	0.4471	0.0149	2.185	0.8642	0.007	0	0	0.1403	0.0627	0.3312	0	0.0216	0	0.0019	0	0	0											9.5296	0	0	11.8456	1.307985397	1.050770681	0.020562748	3.799180844	0.535594641	0.075248579	0.486264069	0.244344886	0.51548006	0.190630144	0	0	5.958016858	0.014875905	2.185041282	0.86415	0.007020969	0	0	0.140294231	0.06267399	0.331169448	0	0.021566193	0	0.001860754	0	0	0	0	0	0	0	0	0	0	0	0	0	29.6583
H0319_002_0	2009	5																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		533.5065919	22.2816	163.5220262	6952.27401	36.29617086	87.90179249	23.72594839	26.54346499	28.98222458	42.67320663	36.14120402	0	0.051744125	59.14556431	22.98674498	220.8734146	13.9175	4.553233839	0	0	28.50915061	3.510371568	6333.561741	0	149.0127781	169.3257028	0	0	20.2	0											"7.1% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"7.1% (1b); $0 n/c (1b1, 1b2)"	14.4% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.069715417	0.0706	0.1444	0	0.2	0.2	0.2	0.123400271	0.2	0.08	0.2	0	0.2	0.2	0	0.199609505	0.2	0.2	0	0	0.2	0.019993563	0	0	0	0	0	0	0	0											0.069715417	0.0706	0.1444	0	0.2	0.2	0.2	0.123400271	0.2	0.08	0.2	0	0.2	0.2	0	0.199609505	0.2	0.2	0	0	0.2	0.019993563	0	0	0	0	0	0	0	0											37.1936	1.57308096	23.61258058	0	7.259234172	17.5803585	4.745189679	3.275470785	5.796444916	3.413856531	7.228240804	0	0.010348825	11.82911286	0	44.088433	2.7835	0.910646768	0	0	5.701830121	0.070184836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	177.0721	0	0	37.1936	1.57308096	23.61258058	0	7.259234172	17.5803585	4.745189679	3.275470785	5.796444916	3.413856531	7.228240804	0	0.010348825	11.82911286	0	44.088433	2.7835	0.910646768	0	0	5.701830121	0.070184836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	177.0721		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											6.6688	0.2785	2.5819	0.5332	0.5731	1.3879	0.3746	0.1725	0.4576	0.6738	0.5707	0	0.0005	0.9339	0.3629	3.4875	0.2198	0.0719	0	0	0.4501	0.0546	0.0261	0	0.0155	0	0	0	0.003	0											19.8985	0	0	43.8625	1.85160096	26.19450731	0.533200717	7.832331607	18.96828154	5.119809916	3.447973684	6.254058989	4.087644004	7.798891394	0	0.0108935	12.76299019	0.362948605	47.57590797	3.00325	0.982539934	0	0	6.151974604	0.12481005	0.0261	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	196.9706
H0319_004_0	2009	4																					2500											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2447.872451	250.7182868	38.4311593	3690.316931	527.5235472	16.85838486	12.76220247	474.2359559	343.4284818	5697.605186	1102.65512	0	0.046581003	1891.006958	7158.365401	9512.323907	513.7438928	644.8256268	0	0	27.93737722	1414.525626	407.6156437	0	11.35125928	5.837790486	0	0	20.2	0											"$175 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$75 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5, 9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											173.3294247	175	0.154399695	0	75	0.14	0.07809865	49.94367056	75	4.4	40.11692344	0	0.2	73.85214517	3.558887569	25	20	20	0	0	0.2	23.94321379	0	0	0	0	0	0	0	0											110.1779263	111.2398379	0.154399695	0	47.67421625	0.08899187	0.049643892	31.74700468	47.67421625	2.796887353	25.50057178	0	0.127131243	46.94457519	3.558887569	25	20	20	0	0	0.127131243	23.94321379	0	0	0	0	0	0	0	0											22.4751	2.324155133	5.933759258	0	2.095772639	1.5002592	0.633565405	1.254630926	1.364390309	1.327963324	2.34319467	0	0.005921901	7.39770986	2.122984803	19.81734147	0.856239821	1.074709378	0	0	3.551713502	2.822357455	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.9018	0	26.5234	22.4751	2.324155133	5.933759258	0	2.095772639	1.5002592	0.633565405	1.254630926	1.364390309	1.327963324	2.34319467	0	0.005921901	7.39770986	2.122984803	19.81734147	0.856239821	1.074709378	0	0	3.551713502	2.822357455	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.9018		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											4.5195	0.2036	0.6068	0.141	0.1737	0.2662	0.2015	0.104	0.3823	0.2638	0.8136	0	0.0005	0.3672	0.6006	2.7876	0.1328	0.0842	0	0	0.4411	0.1313	0.0079	0	0.0155	0	0	0	0.003	0											12.2477	0	0	26.9946	2.527795133	6.540567037	0.141018758	2.269500991	1.766444224	0.835073865	1.358622575	1.74665352	1.591792131	3.156818983	0	0.006412227	7.764892418	2.723562663	22.60498048	0.988989821	1.158909258	0	0	3.992829984	2.953672547	0.007900572	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	91.1495
H0319_005_0	2009	3																					2500											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		3830.387789	246.8769931	140.1284751	137943.4344	215.8042542	30.90736739	9.788614401	636.3021232	356.2944383	7006.60721	466.7968727	0	0.947583042	1712.014405	6142.448038	4945.87086	1242.868229	291.0760826	0	0	28.16166887	947.9469917	352.9685741	0	0	0	0	0	20.2	963.8181818											"$175 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	14.4% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 n/c (4a1); $25 (4b)	$75 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5, 9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a7)"	"$0 n/c (13b, 13d); $0 (13e)"											172.9	175	0.1444	0	75	0.14	0.2	50	75	3.2	66.44614084	0	0.2	72.28915132	3.575953843	25	20	20	0	0	0.2	14.11409946	0	0	0	0	0	0	0	0											99.37629738	100.5832969	0.1444	0	43.10712726	0.080466638	0.114952339	28.73808484	43.10712726	1.83923743	38.19069665	0	0.114952339	41.54903527	3.575953843	25	20	20	0	0	0.114952339	14.11409946	0	0	0	0	0	0	0	0											31.7208	2.069308492	20.2345518	0	0.775225121	2.48701193	1.125224125	1.523842033	1.279902474	1.073901186	1.485608147	0	0.108926887	5.927712241	1.830425889	10.30389762	2.071447048	0.485126804	0	0	3.237249717	1.114951511	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.8551	0	39.0751	31.7208	2.069308492	20.2345518	0	0.775225121	2.48701193	1.125224125	1.523842033	1.279902474	1.073901186	1.485608147	0	0.108926887	5.927712241	1.830425889	10.30389762	2.071447048	0.485126804	0	0	3.237249717	1.114951511	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.8551		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a, 6a2); $0 n/c (6a1, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d); 30% (13e)"											6.4279	0.2005	2.2126	1.8653	0.3318	0.488	0.1546	0.1395	0.6969	0.132	0.3079	0	0.01	0.7253	0.9737	2.6515	0.1512	0.0948	0	0	0.4447	0.0854	0.0261	0	0	0	0	0	0	0.0419											18.1617	0	0	38.1488	2.269828492	22.44710667	1.865306195	1.10697607	2.975022994	1.279781194	1.663381973	1.976850933	1.205901187	1.793540949	0	0.118901446	6.653056577	2.804145298	12.95544446	2.222647048	0.579916196	0	0	3.681907647	1.200368516	0.0261	0	0	0	0	0	0	0.04185	0	0	0	0	0	0	0	0	0	0	107.0168
H0319_006_0	2009	4																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		508.2986106	22.3008	153.9431094	5595.628895	39.91736196	83.6387921	20.41755912	37.16847142	38.46902126	24.85920416	26.55061168	0	1.03277928	44.60801107	32.10436741	232.6817551	13.9175	2.734525887	0	0	24.1216677	8.951991719	3531.889186	0	151.6900502	169.0003664	0	0	20.2	0											"7.1% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"7.1% (1b); $0 n/c (1b1, 1b2)"	17.2% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.070508242	0.0714	0.1721	0	0.2	0.2	0.2	0.091751846	0.2	0.08	0.2	0	0.2	0.2	0	0.199660941	0.2	0.2	0	0	0.2	0.005588458	0	0	0	0	0	0	0	0											0.070508242	0.0714	0.1721	0	0.2	0.2	0.2	0.091751846	0.2	0.08	0.2	0	0.2	0.2	0	0.199660941	0.2	0.2	0	0	0.2	0.005588458	0	0	0	0	0	0	0	0											35.8392	1.59227712	26.49360914	0	7.983472392	16.72775842	4.083511823	3.410275863	7.693804252	1.988736333	5.310122337	0	0.206555856	8.921602213	0	46.45745827	2.7835	0.546905177	0	0	4.82433354	0.050027826	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	174.9132	0	0	35.8392	1.59227712	26.49360914	0	7.983472392	16.72775842	4.083511823	3.410275863	7.693804252	1.988736333	5.310122337	0	0.206555856	8.921602213	0	46.45745827	2.7835	0.546905177	0	0	4.82433354	0.050027826	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	174.9132		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											6.3537	0.2788	2.4307	0.6365	0.6303	1.3206	0.3224	0.1796	0.6074	0.3925	0.4192	0	0.0109	0.7043	0.5069	3.6739	0.2198	0.0432	0	0	0.3809	0.1328	0.0261	0	0.0155	0	0	0	0.003	0											19.2888	0	0	42.193	1.87103712	28.92428981	0.636467148	8.613746528	18.04837093	4.405894336	3.589873767	8.301209851	2.381250083	5.729342521	0	0.217427217	9.62593923	0.506911064	50.13138072	3.00325	0.590081902	0	0	5.205201978	0.182818349	0.0261	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	194.202
H0320_001_0	2009	9																					4750											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1461.007378	15.73499689	479.1997576	21.91542799	183.1918713	16.39722586	6.515471601	40.66614465	652.5051593	6.596739149	16.5261257	0.808050317	0.052850294	15.39909375	11285.42569	2882.989886	105.9213003	60.04661868	5423.647519	1847.493432	13.35432854	0	0	936	278.0282446	2.48647333	1.393528333	0	0	0											1a (IP Acute): 225 days 1-5	1b (IP Psych): 260 days 1-5	2a (SNF): 45 days 11-100	6a (Home Health): 15 copay	10a (Ambulance): 225 copay	11a (DME): 20% coin	11b (Medical Supplies): 35% coin	4a (ER): 50 copay	9b (OP Surg): 470 copay; 9b (OP ASC): 260 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 20% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 20% coin; 9c (OP SA): 50 copay; 3 (CORF): 50 copay; 5 (Partial Hosp): 55 copay; 9d (OP Cardiac Rehab): 25 copay	7a (PCP w/Copay): 15 copay	7b (Chiro): 18 copay; 7d (SPC w/Copay): 35 copay	7h (Psych): 55 copay; 7e (MH Non-Phys): 55 copay	7i (PT/ST): 25 copay; 7c (OT): 25 copay	7g (Prof. Other): 35 copay	7g (Prof. Other): 35 copay	15 (Part B Rx): 20% coin			16b (Comp. Dental): 35 copay	17a1 (Routine Eye Exam): 25 copay	17b1 (Non MCR Covered): 100 allowance	18a (Hearing Exam): 35 copay														126.2444562	128.0482148	24.06711531	15	225	0.2	0.35	50	468.5492269	0	0.150368857	0.2	0.2	0.197072878	14.20815452	33.13658486	55	25	35	35	0.2	0	0	35	25	0	35	0	0	0											108.0465537	109.5903039	20.59788561	12.83777803	192.5666704	0.171170374	0.299548154	42.79259343	401.0087313	0	0.128693467	0.171170374	0.171170374	0.168665191	12.1600756	28.36000807	47.07185277	21.39629671	29.9548154	29.9548154	0.171170374	0	0	29.9548154	25	0	35	0	0	0											13.1547	0.143700258	0.822541816	0.02344545	2.939720725	2.806719279	1.95169749	0.145017483	21.80502218	0	2.126804415	0.138314275	0.009046405	2.597291082	11.43596912	6.813468037	0.415492655	0.107064606	13.53869669	4.611777058	2.285865406	0	0	2.336475601	0.57922551	0	0.004064458	0	0	0	0	0	0	0	0	0	0	0	0	0	90.7922		15.1936	13.1547	0.143700258	0.822541816	0.02344545	2.939720725	2.806719279	1.95169749	0.145017483	21.80502218	0	2.126804415	0.138314275	0.009046405	2.597291082	11.43596912	6.813468037	0.415492655	0.107064606	13.53869669	4.611777058	2.285865406	0	0	2.336475601	0.57922551	0	0.004064458	0	0	0	0	0	0	0	0	0	0	0	0	0	90.7922																																																																																		0			13.1547	0.143700258	0.822541816	0.02344545	2.939720725	2.806719279	1.95169749	0.145017483	21.80502218	0	2.126804415	0.138314275	0.009046405	2.597291082	11.43596912	6.813468037	0.415492655	0.107064606	13.53869669	4.611777058	2.285865406	0	0	2.336475601	0.57922551	0	0.004064458	0	0	0	0	0	0	0	0	0	0	0	0	0	90.7922
H0320_005_0	2009	10																					4750											D	Coin	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	Coin	Coin	Coin	Coin																																																			0		1721.030313	0	343.2472681	9.739734023	222.0979066	18.6898248	5.760288884	29.54910326	738.9909426	7.646391418	30.39688493	0.165357226	0	8.152612445	11402.15927	3817.498228	37.41040912	51.49377756	4832.861931	1744.132224	13.418775	0	0	936	251.9118273	11.37202786	0	0	0	0											1a (IP Acute): 225 days 1-5	1b (IP Psych): 260 days 1-5	2a (SNF): 45 days 11-100	6a (Home Health): 15 copay	10a (Ambulance): 225 copay	11a (DME): 20% coin	11b (Medical Supplies): 35% coin	4a (ER): 50 copay	9b (OP Surg): 470 copay; 9b (OP ASC): 260 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 20% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 20% coin; 9c (OP SA): 50 copay; 3 (CORF): 50 copay; 5 (Partial Hosp): 55 copay; 9d (OP Cardiac Rehab): 25 copay	7a (PCP w/Copay): 15 copay	7b (Chiro): 18 copay; 7d (SPC w/Copay): 35 copay	7h (Psych): 55 copay; 7e (MH Non-Phys): 55 copay	7i (PT/ST): 25 copay; 7c (OT): 25 copay	7g (Prof. Other): 35 copay	7g (Prof. Other): 35 copay	15 (Part B Rx): 20% coin			16b (Comp. Dental): 35 copay	17a1 (Routine Eye Exam): 25 copay	17b1 (Non MCR Covered): 100 allowance	18a (Hearing Exam): 35 copay														140.5514439	0	24.68496122	15	225	0.2	0.35	50	469.472082	0	0.150039776	0.2	0	0.197542193	14.01200164	31.32788818	55	25	35	25.45362848	0.2	0	0	35	25	0	0	0	0	0											121.8104357	0	21.39348979	12.99991294	194.9986942	0.173332173	0.303331302	43.33304315	406.8730798	0	0.130033602	0.173332173	0	0.171202087	12.14365344	27.15065461	47.66634746	21.66652157	30.3331302	22.05966362	0.173332173	0	0	30.3331302	25	0	0	0	0	0											17.47	0	0.611938077	0.010551308	3.609066813	3.239547938	1.747275927	0.106704381	25.05629339	0	3.952616422	0.028661727	0	1.395744266	11.53865588	8.637297989	0.148601463	0.092974254	12.21631918	3.206247515	2.325905424	0	0	2.365984156	0.524816307	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.2852		15.0408	17.47	0	0.611938077	0.010551308	3.609066813	3.239547938	1.747275927	0.106704381	25.05629339	0	3.952616422	0.028661727	0	1.395744266	11.53865588	8.637297989	0.148601463	0.092974254	12.21631918	3.206247515	2.325905424	0	0	2.365984156	0.524816307	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.2852																																																																																		0			17.47	0	0.611938077	0.010551308	3.609066813	3.239547938	1.747275927	0.106704381	25.05629339	0	3.952616422	0.028661727	0	1.395744266	11.53865588	8.637297989	0.148601463	0.092974254	12.21631918	3.206247515	2.325905424	0	0	2.365984156	0.524816307	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.2852
H0320_006_0	2009	9																					4500											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1452.042157	44.00518647	443.5265712	17.79201435	232.2671364	18.38032741	5.857380526	61.7888071	695.633134	6.023770493	17.53014321	0.421932058	0.033649242	12.99605765	10522.48812	2704.307223	89.25663265	45.27368485	5775.674952	1263.041753	10.15527858	0	0	936	384.7587889	3.475823091	0.878771146	0	0	0											1a (IP Acute): 225 days 1-5	1b (IP Psych): 260 days 1-5	2a (SNF): 45 days 11-100	6a (Home Health): 15 copay	10a (Ambulance): 225 copay	11a (DME): 20% coin	11b (Medical Supplies): 35% coin	4a (ER): 50 copay	9b (OP Surg): 470 copay; 9b (OP ASC): 260 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 20% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 20% coin; 9c (OP SA): 50 copay; 3 (CORF): 50 copay; 5 (Partial Hosp): 55 copay; 9d (OP Cardiac Rehab): 25 copay	7a (PCP w/Copay): 15 copay	7b (Chiro): 18 copay; 7d (SPC w/Copay): 35 copay	7h (Psych): 55 copay; 7e (MH Non-Phys): 55 copay	7i (PT/ST): 25 copay; 7c (OT): 25 copay	7g (Prof. Other): 35 copay	7g (Prof. Other): 35 copay	15 (Part B Rx): 20% coin			16b (Comp. Dental): 35 copay	17a1 (Routine Eye Exam): 10 copay	17b1 (Non MCR Covered): 100 allowance	18a (Hearing Exam): 35 copay														133.1367394	109.5922882	24.33320778	15	225	0.2	0.35	50	469.244401	0	0.15091516	0.2	0.2	0.196140049	14.15746874	32.72304989	55	25	35	22.04418117	0.2	0	0	35	10	0	35	0	0	0											113.2332001	93.20857302	20.69546692	12.75754543	191.3631815	0.170100606	0.29767606	42.52515144	399.0937843	0	0.128353801	0.170100606	0.170100606	0.166817705	12.04097004	27.83105304	46.77766659	21.26257572	29.76760601	18.74864285	0.170100606	0	0	29.76760601	10	0	35	0	0	0											13.7016	0.341805053	0.76491579	0.018915203	3.703948182	3.126504827	1.743601958	0.218964865	23.13523833	0	2.250060509	0.071770899	0.005723756	2.167972518	10.55841368	6.271976481	0.34793475	0.080219596	14.3273347	1.973359895	1.727419039	0	0	2.321873269	0.320632324	0	0.002563083	0	0	0	0	0	0	0	0	0	0	0	0	0	89.1828		15.6193	13.7016	0.341805053	0.76491579	0.018915203	3.703948182	3.126504827	1.743601958	0.218964865	23.13523833	0	2.250060509	0.071770899	0.005723756	2.167972518	10.55841368	6.271976481	0.34793475	0.080219596	14.3273347	1.973359895	1.727419039	0	0	2.321873269	0.320632324	0	0.002563083	0	0	0	0	0	0	0	0	0	0	0	0	0	89.1828																																																																																		0			13.7016	0.341805053	0.76491579	0.018915203	3.703948182	3.126504827	1.743601958	0.218964865	23.13523833	0	2.250060509	0.071770899	0.005723756	2.167972518	10.55841368	6.271976481	0.34793475	0.080219596	14.3273347	1.973359895	1.727419039	0	0	2.321873269	0.320632324	0	0.002563083	0	0	0	0	0	0	0	0	0	0	0	0	0	89.1828
H0321_002_0	2009	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	Coin	P	P	P																																																			0		323.5460658	17.34470989	27.15250738		26.21779514	0.291888449	0.206920383	901.7762314	35.7518467	5.572095779	45.12164319	1.472961691	18.3317259	17.31683759	56.01285693	107.1130366	3.955229508	4.158291721		0.104450116	17.49718301	3.133129824																			#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%"	"20% (#7A, #14B, #14C, #14D, #14E, #14F, #14G, #14H, #14I)"	"20% (#7B, #7D, #7F)"	"50% (#7E, #7H)"	"20% (#7C, #7I)"	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	#18A1 $0	#18B $0	$0 n/c	#13C $0											0.067654111	0.067654111	0.152535788		0.22407	0.22407	0.22407	48.30044249	0.22407	0.22407	0.22407	0.22407	0.22407	0.22407	0.220092313	0.22407	0.22407	0.22407		0.22407	0.22407	0.22407																			0.067654111	0.067654111	0.152535788		0.22407	0.22407	0.22407	48.30044249	0.22407	0.22407	0.22407	0.22407	0.22407	0.22407	0.220092313	0.22407	0.22407	0.22407		0.22407	0.22407	0.22407																			21.8892	1.173440927	4.141729108	0	5.874621357	0.065403445	0.04636465	3.629682584	8.010916291	1.248539501	10.11040659	0.330046526	4.107589823	3.880183798	12.32799923	24.00081811	0.886248276	0.931748426	0	0.023404137	3.920593797	0.7020404	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.301	135	0	21.8892	1.173440927	4.141729108	0	5.874621357	0.065403445	0.04636465	3.629682584	8.010916291	1.248539501	10.11040659	0.330046526	4.107589823	3.880183798	12.32799923	24.00081811	0.886248276	0.931748426	0	0.023404137	3.920593797	0.7020404	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.301																																																																																		0	0	0	21.8892	1.173440927	4.141729108	0	5.874621357	0.065403445	0.04636465	3.629682584	8.010916291	1.248539501	10.11040659	0.330046526	4.107589823	3.880183798	12.32799923	24.00081811	0.886248276	0.931748426	0	0.023404137	3.920593797	0.7020404	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.301
H0322_002_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3000	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$100/day 1-5	$100/day 1-5	"$0/d 1-20, $100/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$100 per procedure	$0 per visit	$0 X-ray; $100 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$10 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	Not Covered	$0 per visit	$300 Every 3 Yrs	Coaching Only	0											61.28387407	61.28387407	40.33133874	0	100	0.2	0.2	48.5	100	0	40	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											61.28387407	61.28387407	40.33133874	0	100	0.2	0.2	48.5	100	0	40	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											8.7814	0	3.988951409	0	2.003577927	1.3870016	0	0.904884196	2.819589958	0	13.82875774	0	0.122513645	1.731423298	5.358275608	20.39806951	0	1.478528581	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.7172	0	0	8.7814	0	3.988951409	0	2.003577927	1.3870016	0	0.904884196	2.819589958	0	13.82875774	0	0.122513645	1.731423298	5.358275608	20.39806951	0	1.478528581	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.7172		$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$100 copay	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$50 copay	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$30 copay	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP		0	0	$500 ded; 20% coinsurance; $3000 max OOP	0	$500 ded; 20% coinsurance; $3000 max OOP	0	Not Covered												4.5026	0	0.556	0.0843	0.1668	0.1324	0	0.0964	0.6046	0.2061	0.84	0	0.0225	0.1742	0.6155	2.6734	0	0.0792	0	0	0.1196	0	0	0	0.0558	0	0.0036	0	0	0											10.9329	500	2.893288696	13.2841	0	4.544938531	0.084294316	2.17042691	1.519352991	0	1.001319181	3.424194873	0.206089147	14.66879195	0	0.144978932	1.905666272	5.973729737	23.07144557	0	1.55776126	0	0	1.033736393	0	0	0	0.055763101	0	0.003559502	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6501
H0322_006_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3000	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$200/day 1-5	$200/day 1-5	"$0/d 1-20, $100/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$200 per procedure	$0 per visit	$25 X-ray; $100 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$20 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	Not Covered	$0 per visit	$300 Every 3 Yrs	Coaching Only	0											122.5677481	122.5677481	40.33133874	0	100	0.2	0.2	48.5	200	0	55	35	25	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											122.5677481	122.5677481	40.33133874	0	100	0.2	0.2	48.5	200	0	55	35	25	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											17.5629	0	3.988951409	0	2.003577927	1.3870016	0	0.904884196	5.639179916	0	19.0145419	0	0.122513645	2.019993848	10.71655122	23.79774777	0	1.724950012	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.7969	0	0	17.5629	0	3.988951409	0	2.003577927	1.3870016	0	0.904884196	5.639179916	0	19.0145419	0	0.122513645	2.019993848	10.71655122	23.79774777	0	1.724950012	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.7969		$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$100 copay	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$50 copay	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$30 copay	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP		0	0	$500 ded; 20% coinsurance; $3000 max OOP	0	$500 ded; 20% coinsurance; $3000 max OOP	0	Not Covered												4.5026	0	0.556	0.0843	0.1668	0.1324	0	0.0964	0.6046	0.2061	0.84	0	0.0225	0.1742	0.6155	2.6734	0	0.0792	0	0	0.1196	0	0	0	0.0558	0	0.0036	0	0	0											10.9329	500	2.893288696	22.0655	0	4.544938531	0.084294316	2.17042691	1.519352991	0	1.001319181	6.243784831	0.206089147	19.85457611	0	0.144978932	2.194236822	11.33200535	26.47112383	0	1.80418269	0	0	1.033736393	0	0	0	0.055763101	0	0.003559502	0	0	0	0	0	0	0	0	0	0	0	0	0	100.7299
H0322_801_0	2009	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																																																			0		340.5608436	0	33.62801558	5.416743639	6.56003567	8.673070054	0	6.922702058	30.89049085	11.87499335	51.13264748	0	0.193673147	19.64941193	40.61555224	142.3596094	0	5.896053647	0	0	7.548467404	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.0706	0.0706	0.1444	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											24.0436	0	4.85588545	0	1.51536824	2.003479182	0	1.599144175	7.135703386	2.743123465	11.81164157	0	0.044738497	4.539014157	9.382192569	32.88506977	0	1.361988392	0	0	1.74369597	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.6646			24.0436	0	4.85588545	0	1.51536824	2.003479182	0	1.599144175	7.135703386	2.743123465	11.81164157	0	0.044738497	4.539014157	9.382192569	32.88506977	0	1.361988392	0	0	1.74369597	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.6646		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.2787	0	0.6622	0	0.2066	0.2732	0	0.2181	0.9731	0.3741	1.6107	0	0.0061	0.619	1.2794	4.4843	0	0.1857	0	0	0.2378	0	0	0	0	0	0	0	0	0											14.4088			27.3223	0	5.518051647	0	1.722009363	2.276680889	0	1.81720929	8.108753848	3.117185755	13.42231996	0	0.050839201	5.157970633	10.66158246	37.36939747	0	1.547714082	0	0	1.981472693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.0735
H0322_802_0	2009	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																																																			0		339.859057	0	33.55871903	5.405581469	6.546517543	8.65519764	0	6.908436591	30.82683547	11.8505228	51.02727951	0	0.193274049	19.6089208	40.53185663	142.0662519	0	5.883903773	0	0	7.532912436	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.0706	0.0706	0.1444	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.994	0	4.845879029	0	1.512245552	1.999350655	0	1.595848853	7.120998993	2.737470768	11.78730157	0	0.044646305	4.529660706	9.362858882	32.8173042	0	1.359181772	0	0	1.740102773	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.4469			23.994	0	4.845879029	0	1.512245552	1.999350655	0	1.595848853	7.120998993	2.737470768	11.78730157	0	0.044646305	4.529660706	9.362858882	32.8173042	0	1.359181772	0	0	1.740102773	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.4469		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.2719	0	0.6608	0	0.2062	0.2726	0	0.2176	0.971	0.3733	1.6074	0	0.0061	0.6177	1.2768	4.4751	0	0.1853	0	0	0.2373	0	0	0	0	0	0	0	0	0											14.3791			27.266	0	5.506680714	0	1.718460855	2.271989381	0	1.813464605	8.09204431	3.110762236	13.39466087	0	0.050734438	5.147341711	10.63961237	37.29239114	0	1.54452474	0	0	1.977389514	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.826
H0322_804_0	2009	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																																																			0		339.859279	0	33.55874095	5.405585	6.546521819	8.655203294	0	6.908441104	30.8268556	11.85053055	51.02731284	0	0.193274175	19.60893361	40.53188311	142.0663447	0	5.883907616	0	0	7.532917356	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.0706	0.0706	0.1444	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.9941	0	4.845882194	0	1.51224654	1.999351961	0	1.595849895	7.121003644	2.737472556	11.78730927	0	0.044646334	4.529663664	9.362864997	32.81732564	0	1.359182659	0	0	1.740103909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.447			23.9941	0	4.845882194	0	1.51224654	1.999351961	0	1.595849895	7.121003644	2.737472556	11.78730927	0	0.044646334	4.529663664	9.362864997	32.81732564	0	1.359182659	0	0	1.740103909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.447		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.2719	0	0.6608	0	0.2062	0.2726	0	0.2176	0.971	0.3733	1.6074	0	0.0061	0.6177	1.2768	4.4751	0	0.1853	0	0	0.2373	0	0	0	0	0	0	0	0	0											14.3791			27.266	0	5.506684311	0	1.718461978	2.271990865	0	1.81346579	8.092049596	3.110764268	13.39466962	0	0.050734471	5.147345073	10.63961932	37.29241549	0	1.544525749	0	0	1.977390806	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.8261
H0332_001_0	2009	6																					3350											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	O	T	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		1039.287338	21.81101555	628.8107221	1520.095625	169.7606337	3.608467219	5.241532781	162.6475444	188.9716045	1649.141873	506.8325384	0	74.51988822	434.8959662	9372.578864	16201.28372	137.8793269	527.4180038	3629.638819	7927.146958	6.241950215	665.304651	977	0	363.4328584	256.1591202	155.7569393	18.3318993	0	2741.054216											"$100 copay, days 1-1"	"$100 copay, days 1-1"	"$100 copay, days 21-100"	$0 copay	$100 copay	10% coinsurance	20% coinsurance	$50 copay	$100 copay to $150 copay	$0 copay to $6.25 copay	0% coinsurance to $31.25 copay		$25 copay	Varies	$0 copay	$0 copay	"$20 copay Group, $35 copay Individual"	$0 copay	0% coinsurance	Varies	10% coinsurance	Varies	$0 copay	$0 copay	$0 copay	$0 copay; and $150 credit covered every 2years	$0 copay	$1500 credit	Varies	Varies											18.18181818	12.34567901	28.71525426	0	100	0.1	0.2	45	133.2939728	2.53922874	6.193094977	0	25	5.103829325	0.346531537	0.283276202	33.5	0	0	0.943505354	0.1	0	0	0	0	0	0	0	0	0.014549295											18.15361021	12.34567901	28.71172826	0	100	0.099511427	0.199663648	45	133.2904468	2.53922874	6.193094977	0	25	5.103829325	0.341362559	0.274341193	33.5	0	0	0.939979358	0.1	0	0	0	0	0	0	0	0	0.014549295											1.5722	0.022439316	1.504520215	0	1.414671947	0.359083724	1.046543558	0.609928291	2.099009133	0.34896237	0.261571837	0	0.155249767	0.184969565	0.266620626	0.370389959	0.384913121	0	0	0.620946209	0.624195021	0	0	0	0	0	0	0	0	0.003323367	0	0	0	0	0	0	0	0	0	0	11.8496		0.0705	1.5722	0.022439316	1.504520215	0	1.414671947	0.359083724	1.046543558	0.609928291	2.099009133	0.34896237	0.261571837	0	0.155249767	0.184969565	0.266620626	0.370389959	0.384913121	0	0	0.620946209	0.624195021	0	0	0	0	0	0	0	0	0.003323367	0	0	0	0	0	0	0	0	0	0	11.8496																																																																																		0			1.5722	0.022439316	1.504520215	0	1.414671947	0.359083724	1.046543558	0.609928291	2.099009133	0.34896237	0.261571837	0	0.155249767	0.184969565	0.266620626	0.370389959	0.384913121	0	0	0.620946209	0.624195021	0	0	0	0	0	0	0	0	0.003323367	0	0	0	0	0	0	0	0	0	0	11.8496
H0332_002_0	2009	9																					3350											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	O	T	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		1049.78421	22.34943526	621.1789467	1511.032266	170.7048752	3.892319612	5.687680388	162.4423612	188.5960752	1618.228564	492.5438662	0	74.07861997	432.7641946	6859.294696	9366.01158	137.3826478	490.199437	3529.852847	7714.718471	6.205401861	623.8079722	977	0	338.5762149	265.41287	145.1040921	18.15097167	0	2734.943297											"$250 copay, days 1-1"	"$250 copay, days 1-1"	"$100 copay, days 21-100"	$0 copay	$100 copay	10% coinsurance	20% coinsurance	$50 copay	$100 copay to $150 copay	$0 copay to $6.25 copay	0% coinsurance to $43.75 copay		$25 copay	Varies	$0 copay	$15 copay	"$20 copay Group, $35 copay Individual"	$15 copay	0% coinsurance	Varies	10% Coinsurance	Varies	$0 copay	$0 copay	$15 copay	$0 copay	$15 copay	$1000 credit every 2 years	Varies	Varies											45.45454545	30.86419753	28.71525426	0	100	0.1	0.19375943	45	133.292775	2.572336939	8.678888657	0	25	9.135838118	2.322343527	9.41080375	33.5	15	0	1.91677526	0.1	13.39624075	0	0	15	0	15	0	0	0.014435184											45.10839929	30.86419753	28.67198599	0	100	0.09444184	0.189955747	45	133.2495067	2.572336939	8.678888657	0	25	9.135838118	2.249176386	9.310897809	33.5	15	0	1.87350699	0.1	13.39624075	0	0	15	0	15	0	0	0.014435184											3.9462	0.057483115	1.484202838	0	1.422540626	0.367597826	1.080407575	0.609158855	2.094194499	0.346885759	0.356227781	0	0.154330458	0.329471969	1.285646971	7.267164725	0.383526558	0.612749296	0	1.204464915	0.620540186	0.696390148	0	0	0.423220269	0	0.181380115	0	0	0.003289951	0	0	0	0	0	0	0	0	0	0	24.927		0.8654	3.9462	0.057483115	1.484202838	0	1.422540626	0.367597826	1.080407575	0.609158855	2.094194499	0.346885759	0.356227781	0	0.154330458	0.329471969	1.285646971	7.267164725	0.383526558	0.612749296	0	1.204464915	0.620540186	0.696390148	0	0	0.423220269	0	0.181380115	0	0	0.003289951	0	0	0	0	0	0	0	0	0	0	24.927																																																																																		0			3.9462	0.057483115	1.484202838	0	1.422540626	0.367597826	1.080407575	0.609158855	2.094194499	0.346885759	0.356227781	0	0.154330458	0.329471969	1.285646971	7.267164725	0.383526558	0.612749296	0	1.204464915	0.620540186	0.696390148	0	0	0.423220269	0	0.181380115	0	0	0.003289951	0	0	0	0	0	0	0	0	0	0	24.927
H0332_003_0	2009	6																					3350											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	O	T	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		1078.331428	25.10734282	726.7341645	1755.686589	176.2516988	3.609792147	5.240207853	187.7632687	196.3518823	1713.513762	526.533384	0	77.46204096	451.9784617	9738.731756	16838.06438	159.2092639	608.4930036	3770.189937	8230.784153	6.48854849	768.2290819	977	0	419.7418009	296.0008062	179.8893432	21.18168322	0	2794.124789											"$100 copay, days 1-1"	"$100 copay, days 1-1"	"$100 copay, days 21-100"	$0 copay	$100 copay	10% coinsurance	20% coinsurance	$50 copay	$100 copay to $150 copay	$0 copay to $6.25 copay	0% coinsurance to $31.25 copay		$25 copay	Varies	$0 copay	$0 copay	"$20 copay Group, $35 copay Individual"	$0 copay	0% coinsurance	Varies	10% Coinsurance	Varies	$0 copay	$0 copay	$0 copay	$0 copay; and $150 credit covered every 1years	$0 copay	$1500 credit	Varies	Varies											16.36363636	12.34567901	28.71525426	0	90	0.1	0.2	45	119.9646878	2.286297944	5.57256936	0	22.5	4.593099291	0.312061228	0.255039649	33.5	0	0	0.847425547	0.09	0	0	0	0	0	0	0	0	0.01649207											16.3204049	12.34567901	28.70924989	0	90	0.099168322	0.199427087	45	119.9592838	2.286297944	5.57256936	0	22.5	4.593099291	0.304140415	0.241344729	33.5	0	0	0.842021614	0.09	0	0	0	0	0	0	0	0	0.01649207											1.4666	0.0258306	1.738666061	0	1.321887741	0.35797703	1.045039386	0.704112258	1.962852598	0.326466916	0.244511984	0	0.145241327	0.172998496	0.246828493	0.338648174	0.444459195	0	0	0.577541513	0.583969364	0	0	0	0	0	0	0	0	0.003840075	0	0	0	0	0	0	0	0	0	0	11.7074		0.11	1.4666	0.0258306	1.738666061	0	1.321887741	0.35797703	1.045039386	0.704112258	1.962852598	0.326466916	0.244511984	0	0.145241327	0.172998496	0.246828493	0.338648174	0.444459195	0	0	0.577541513	0.583969364	0	0	0	0	0	0	0	0	0.003840075	0	0	0	0	0	0	0	0	0	0	11.7074		"$1000 copay, days 1-1"	Not Covered	Not Covered	Not Covered	20% coinsurance	Not Covered	Not Covered	Not Covered	$60 copay to 20% coinsurance	20% coinsurance	20% coinsurance		20% coinsurance	Varies	20% coinsurance	20% coinsurance	Not Covered	Not Covered	20% coinsurance	Varies	10% Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.8794	0.7585	1.5061	6.435	0.2021	0.9817	1.8287	2.2026	0.6424	0.4847	0.4881	0	0.0364	0.4916	1.5222	2.4191	0.506	2.1661	1.1435	0.902	0.0833	1.929	0	0	0.8853	3.4664	0.2445	0	0	0.019											35.2236			5.3459	0.784330564	3.244801959	6.435004074	1.523990405	1.339678503	2.873691054	2.906760219	2.605245088	0.81113188	0.73263587	0	0.181627289	0.66460464	1.769042001	2.757724144	0.950457986	2.166058231	1.14353907	1.479554685	0.667280274	1.928964573	0	0	0.885291582	3.466368708	0.244474434	0	0	0.0228667	0	0	0	0	0	0	0	0	0	0	46.9311
H0332_004_0	2009	9																					3350											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	O	T	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		1103.10789	26.09408056	725.2574076	1764.205548	179.3758116	3.892319612	5.687680388	189.6595601	198.1757933	1700.426316	517.5625807	0	77.84143578	454.746407	7207.711859	9841.757167	160.4010946	572.3322961	3709.151356	8106.586795	6.520604604	728.3269261	977	0	395.3046207	309.8827658	169.416266	21.19216488	0	2791.063008											"$250 copay, days 1-1"	"$250 copay, days 1-1"	"$100 copay, days 21-100"	$0 copay	$100 copay	10% coinsurance	20% coinsurance	$50 copay	$100 copay to $150 copay	$0 copay to $6.25 copay	0% coinsurance to $43.75 copay		$25 copay	Varies	$0 copay	$15 copay	"$20 copay Group, $35 copay Individual"	$15 copay	0% coinsurance	Varies	10% Coinsurance	Varies	$0 copay	$0 copay	$15 copay	$0 copay	$15 copay	$1500 credit every 2 years	Varies	Varies											40.90909091	30.86419753	28.71525426	0	90	0.1	0.19375943	45	119.9634975	2.315103245	7.810999791	0	22.5	8.222254307	2.090109174	8.469723375	33.5	15	0	1.69846776	0.09	13.39624075	0	0	15	0	15	0	0	0.016514919											40.40066036	30.86419753	28.6446389	0	90	0.090928885	0.187551684	45	119.8999437	2.315103245	7.810999791	0	22.5	8.222254307	1.982638939	8.322978336	33.5	15	0	1.634913941	0.09	13.39624075	0	0	15	0	15	0	0	0.016514919											3.7139	0.067114405	1.731228046	0	1.345318587	0.353924284	1.066734033	0.711223351	1.980105538	0.328055207	0.336890101	0	0.145952692	0.311586717	1.190857516	6.826060974	0.447786389	0.71541537	0	1.104464314	0.586854414	0.813070237	0	0	0.494130776	0	0.211770333	0	0	0.003841182	0	0	0	0	0	0	0	0	0	0	24.4862		0.8	3.7139	0.067114405	1.731228046	0	1.345318587	0.353924284	1.066734033	0.711223351	1.980105538	0.328055207	0.336890101	0	0.145952692	0.311586717	1.190857516	6.826060974	0.447786389	0.71541537	0	1.104464314	0.586854414	0.813070237	0	0	0.494130776	0	0.211770333	0	0	0.003841182	0	0	0	0	0	0	0	0	0	0	24.4862		"$1000 copay, days 1-1"	Not Covered	Not Covered	Not Covered	20% coinsurance	Not Covered	Not Covered	Not Covered	$60 copay to 20% coinsurance	20% coinsurance	20% coinsurance		20% coinsurance	Varies	20% coinsurance	20% coinsurance	Not Covered	Not Covered	20% coinsurance	Varies	10% Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.8805	0.7587	1.5066	6.4389	0.2022	0.9823	1.8297	2.2039	0.6428	0.485	0.4884	0	0.0364	0.4919	1.2958	2.0592	0.4304	1.8423	0.9779	0.7684	0.0834	1.6406	0	0	0.8858	3.4684	0.2446	0	0	0.019											33.6631			7.5944	0.825832915	3.237797904	6.438853056	1.547541287	1.336212945	2.896479477	2.91510878	2.622865989	0.813006925	0.82530595	0	0.182360418	0.803483827	2.48668113	8.885283721	0.878149352	2.557694945	0.977883938	1.872910453	0.670214505	2.453696506	0	0	1.379951879	3.468442055	0.456390995	0	0	0.022879122	0	0	0	0	0	0	0	0	0	0	58.1494
H0332_801_0	2009	7																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																			13.3567	0.1016	0	0	0.1569	0.1872	0.2172	0.3198	0.9945	0.5943	0.5298	0	0.0469	0.5875	3.4373	7.1289	0.0913	0.3254	2.2255	1.5803	0.2034	0.4936																			32.5781		1022.475448	19.99585112	890.2759078	2188.881	5.062775562	6.037128689	7.006021022	10.31529484	32.08130338	19.17079263	17.09041215	0	1.513697567	18.95189713	110.8807758	229.965197	2.944775823	10.49791906	71.79062768	50.97840068	6.561002982	15.92152681	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										12.92780205	5.028841136	87.78056943	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										12.92780205	5.028841136	87.78056943	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										1.1015	0.008379663	6.512410511	0	1.012555112	1.207425738	1.401204204	2.063058968	6.416260676	3.834158527	3.41808243	0	0.302739513	3.790379427	22.17615516	45.9930394	0.588955165	2.099583811	14.35812554	10.19568014	1.312200596	3.184305362	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.9762	Medicare Standard		14.4582	0.109987881	6.512410511	0	1.169501155	1.394576727	1.618390856	2.382833108	7.410781081	4.428453098	3.947885206	0	0.349664138	4.377888238	25.61345921	53.12196051	0.680243215	2.425019302	16.58363499	11.77601056	1.515591689	3.677872694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	163.5544																																																																																		0			14.4582	0.109987881	6.512410511	0	1.169501155	1.394576727	1.618390856	2.382833108	7.410781081	4.428453098	3.947885206	0	0.349664138	4.377888238	25.61345921	53.12196051	0.680243215	2.425019302	16.58363499	11.77601056	1.515591689	3.677872694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	163.5544
H0332_803_0	2009	5																					N/A											D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																			13.3649	0.1017	0	0	0.157	0.1873	0.2173	0.32	0.9951	0.5947	0.5301	0	0.047	0.5879	3.4394	7.1333	0.0913	0.3256	2.2269	1.5813	0.2035	0.4939																			32.5983		1022.788367	20.00202365	890.5518173	2189.559366	5.065902951	6.040871257	7.010364231	10.32168955	32.10119139	19.18262093	17.10100693	0	1.514635946	18.96358571	110.9493981	230.1075951	2.946601364	10.50442698	71.83506672	51.00991703	6.565055066	15.93138946	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										12.93180109	5.030399646	87.8077739	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										12.93180109	5.030399646	87.8077739	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										1.1022	0.008384848	6.516447719	0	1.01318059	1.208174251	1.402072846	2.06433791	6.420238278	3.836524186	3.420201385	0	0.302927189	3.792717142	22.18987963	46.02151902	0.589320273	2.100885396	14.36701334	10.20198341	1.313011013	3.186277892	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.0573	medicare standard	0	14.4671	0.11005593	6.516447719	0	1.170223582	1.39544126	1.619394137	2.384310286	7.415375211	4.431185435	3.9503326	0	0.349880904	4.380588299	25.62931097	53.15485447	0.680664915	2.426522633	16.59390041	11.78329083	1.51652772	3.680150965	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	163.6556																																																																																		0			14.4671	0.11005593	6.516447719	0	1.170223582	1.39544126	1.619394137	2.384310286	7.415375211	4.431185435	3.9503326	0	0.349880904	4.380588299	25.62931097	53.15485447	0.680664915	2.426522633	16.59390041	11.78329083	1.51652772	3.680150965	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	163.6556
H0332_804_0	2009	7																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																			13.4062	0.102	0	0	0.1575	0.1878	0.218	0.321	0.9982	0.5965	0.5318	0	0.0471	0.5897	3.4501	7.1555	0.0916	0.3266	2.2338	1.5862	0.2041	0.4954																			32.6993		1024.357646	20.03297919	891.935527	2192.96143	5.081601538	6.059658049	7.032166095	10.35378946	32.20102441	19.24199536	17.15419016	0	1.519346384	19.0222587	111.2938641	230.8223968	2.955765139	10.5370952	72.05813909	51.16812032	6.585395338	15.98089746	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										12.95185658	5.03821571	87.94420669	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										12.95185658	5.03821571	87.94420669	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										1.1056	0.008410873	6.536713528	0	1.016320308	1.21193161	1.406433219	2.070757893	6.440204881	3.848399071	3.430838031	0	0.303869277	3.804451739	22.25877281	46.16447937	0.591153028	2.107419039	14.41162782	10.23362406	1.317079068	3.196179492	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.4643	Medicare Standard		14.5118	0.110397521	6.536713528	0	1.173849955	1.399781009	1.624430368	2.391725366	7.438436638	4.444900928	3.962617926	0	0.350969015	4.394141759	25.7088826	53.31997367	0.682781747	2.434068991	16.64543013	11.81983579	1.521226323	3.691587313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	164.1635																																																																																		0			14.5118	0.110397521	6.536713528	0	1.173849955	1.399781009	1.624430368	2.391725366	7.438436638	4.444900928	3.962617926	0	0.350969015	4.394141759	25.7088826	53.31997367	0.682781747	2.434068991	16.64543013	11.81983579	1.521226323	3.691587313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	164.1635
H0332_805_0	2009	6																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																			13.4062	0.102	0	0	0.1575	0.1878	0.218	0.321	0.9982	0.5965	0.5318	0	0.0471	0.5897	3.4501	7.1555	0.0916	0.3266	2.2338	1.5862	0.2041	0.4954																			32.6993		1024.357646	20.03297919	891.935527	2192.96143	5.081601538	6.059658049	7.032166095	10.35378946	32.20102441	19.24199536	17.15419016	0	1.519346384	19.0222587	111.2938641	230.8223968	2.955765139	10.5370952	72.05813909	51.16812032	6.585395338	15.98089746	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										12.95185658	5.03821571	87.94420669	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										12.95185658	5.03821571	87.94420669	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										1.1056	0.008410873	6.536713528	0	1.016320308	1.21193161	1.406433219	2.070757893	6.440204881	3.848399071	3.430838031	0	0.303869277	3.804451739	22.25877281	46.16447937	0.591153028	2.107419039	14.41162782	10.23362406	1.317079068	3.196179492	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.4643	Medicare Standard		14.5118	0.110397521	6.536713528	0	1.173849955	1.399781009	1.624430368	2.391725366	7.438436638	4.444900928	3.962617926	0	0.350969015	4.394141759	25.7088826	53.31997367	0.682781747	2.434068991	16.64543013	11.81983579	1.521226323	3.691587313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	164.1635																																																																																		0			14.5118	0.110397521	6.536713528	0	1.173849955	1.399781009	1.624430368	2.391725366	7.438436638	4.444900928	3.962617926	0	0.350969015	4.394141759	25.7088826	53.31997367	0.682781747	2.434068991	16.64543013	11.81983579	1.521226323	3.691587313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	164.1635
H0332_806_0	2009	7																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																			13.3567	0.1016	0	0	0.1569	0.1872	0.2172	0.3198	0.9945	0.5943	0.5298	0	0.0469	0.5875	3.4373	7.1289	0.0913	0.3254	2.2255	1.5803	0.2034	0.4936																			32.5781		1022.475448	19.99585112	890.2759078	2188.881	5.062775562	6.037128689	7.006021022	10.31529484	32.08130338	19.17079263	17.09041215	0	1.513697567	18.95189713	110.8807758	229.965197	2.944775823	10.49791906	71.79062768	50.97840068	6.561002982	15.92152681	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										12.92780205	5.028841136	87.78056943	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										12.92780205	5.028841136	87.78056943	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										1.1015	0.008379663	6.512410511	0	1.012555112	1.207425738	1.401204204	2.063058968	6.416260676	3.834158527	3.41808243	0	0.302739513	3.790379427	22.17615516	45.9930394	0.588955165	2.099583811	14.35812554	10.19568014	1.312200596	3.184305362	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.9762	Medicare Standard		14.4582	0.109987881	6.512410511	0	1.169501155	1.394576727	1.618390856	2.382833108	7.410781081	4.428453098	3.947885206	0	0.349664138	4.377888238	25.61345921	53.12196051	0.680243215	2.425019302	16.58363499	11.77601056	1.515591689	3.677872694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	163.5544																																																																																		0			14.4582	0.109987881	6.512410511	0	1.169501155	1.394576727	1.618390856	2.382833108	7.410781081	4.428453098	3.947885206	0	0.349664138	4.377888238	25.61345921	53.12196051	0.680243215	2.425019302	16.58363499	11.77601056	1.515591689	3.677872694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	163.5544
H0332_807_0	2009	5																					N/A											D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																			13.4062	0.102	0	0	0.1575	0.1878	0.218	0.321	0.9982	0.5965	0.5318	0	0.0471	0.5897	3.4501	7.1555	0.0916	0.3266	2.2338	1.5862	0.2041	0.4954																			32.6993		1024.357646	20.03297919	891.935527	2192.96143	5.081601538	6.059658049	7.032166095	10.35378946	32.20102441	19.24199536	17.15419016	0	1.519346384	19.0222587	111.2938641	230.8223968	2.955765139	10.5370952	72.05813909	51.16812032	6.585395338	15.98089746	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										12.95185658	5.03821571	87.94420669	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										12.95185658	5.03821571	87.94420669	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										1.1056	0.008410873	6.536713528	0	1.016320308	1.21193161	1.406433219	2.070757893	6.440204881	3.848399071	3.430838031	0	0.303869277	3.804451739	22.25877281	46.16447937	0.591153028	2.107419039	14.41162782	10.23362406	1.317079068	3.196179492	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.4643	medicare standard	0	14.5118	0.110397521	6.536713528	0	1.173849955	1.399781009	1.624430368	2.391725366	7.438436638	4.444900928	3.962617926	0	0.350969015	4.394141759	25.7088826	53.31997367	0.682781747	2.434068991	16.64543013	11.81983579	1.521226323	3.691587313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	164.1635																																																																																		0			14.5118	0.110397521	6.536713528	0	1.173849955	1.399781009	1.624430368	2.391725366	7.438436638	4.444900928	3.962617926	0	0.350969015	4.394141759	25.7088826	53.31997367	0.682781747	2.434068991	16.64543013	11.81983579	1.521226323	3.691587313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	164.1635
H0332_808_0	2009	7																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																			13.4062	0.102	0	0	0.1575	0.1878	0.218	0.321	0.9982	0.5965	0.5318	0	0.0471	0.5897	3.4501	7.1555	0.0916	0.3266	2.2338	1.5862	0.2041	0.4954																			32.6993		1024.357646	20.03297919	891.935527	2192.96143	5.081601538	6.059658049	7.032166095	10.35378946	32.20102441	19.24199536	17.15419016	0	1.519346384	19.0222587	111.2938641	230.8223968	2.955765139	10.5370952	72.05813909	51.16812032	6.585395338	15.98089746	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										12.95185658	5.03821571	87.94420669	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										12.95185658	5.03821571	87.94420669	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										1.1056	0.008410873	6.536713528	0	1.016320308	1.21193161	1.406433219	2.070757893	6.440204881	3.848399071	3.430838031	0	0.303869277	3.804451739	22.25877281	46.16447937	0.591153028	2.107419039	14.41162782	10.23362406	1.317079068	3.196179492	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.4643	Medicare Standard		14.5118	0.110397521	6.536713528	0	1.173849955	1.399781009	1.624430368	2.391725366	7.438436638	4.444900928	3.962617926	0	0.350969015	4.394141759	25.7088826	53.31997367	0.682781747	2.434068991	16.64543013	11.81983579	1.521226323	3.691587313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	164.1635																																																																																		0			14.5118	0.110397521	6.536713528	0	1.173849955	1.399781009	1.624430368	2.391725366	7.438436638	4.444900928	3.962617926	0	0.350969015	4.394141759	25.7088826	53.31997367	0.682781747	2.434068991	16.64543013	11.81983579	1.521226323	3.691587313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	164.1635
H0332_809_0	2009	6																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																			13.4062	0.102	0	0	0.1575	0.1878	0.218	0.321	0.9982	0.5965	0.5318	0	0.0471	0.5897	3.4501	7.1555	0.0916	0.3266	2.2338	1.5862	0.2041	0.4954																			32.6993		1024.357646	20.03297919	891.935527	2192.96143	5.081601538	6.059658049	7.032166095	10.35378946	32.20102441	19.24199536	17.15419016	0	1.519346384	19.0222587	111.2938641	230.8223968	2.955765139	10.5370952	72.05813909	51.16812032	6.585395338	15.98089746	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										12.95185658	5.03821571	87.94420669	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										12.95185658	5.03821571	87.94420669	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										1.1056	0.008410873	6.536713528	0	1.016320308	1.21193161	1.406433219	2.070757893	6.440204881	3.848399071	3.430838031	0	0.303869277	3.804451739	22.25877281	46.16447937	0.591153028	2.107419039	14.41162782	10.23362406	1.317079068	3.196179492	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.4643	Medicare Standard		14.5118	0.110397521	6.536713528	0	1.173849955	1.399781009	1.624430368	2.391725366	7.438436638	4.444900928	3.962617926	0	0.350969015	4.394141759	25.7088826	53.31997367	0.682781747	2.434068991	16.64543013	11.81983579	1.521226323	3.691587313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	164.1635																																																																																		0			14.5118	0.110397521	6.536713528	0	1.173849955	1.399781009	1.624430368	2.391725366	7.438436638	4.444900928	3.962617926	0	0.350969015	4.394141759	25.7088826	53.31997367	0.682781747	2.434068991	16.64543013	11.81983579	1.521226323	3.691587313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	164.1635
H0351_014_0	2009	4																					none											D	A	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	815.7312421	4.555606918	372.7167498	12.87675725	296.0167205	2.964650877	1.761011933	360.7470931	269.4312822	5.719336234	885.4960365	0	0.697460821	390.4603687	4063.263837	5837.461948	193.7298408	383.5824099	32.97782924	20.33628163	29.62139734	0	0	0	0	0	0	0	0	10400											1a:  Acute - $175/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $1024/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$100/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $200/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $5 to $40/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $200/visit/9b:  Ambulatory Surgical Center Services - $200/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - min $125/max $200/visit/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - $25/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $40/visit/3:  Rehab Services (CORF) - $40/day/5:  Partial Hospitalization - $40/day	7a:  Primary Care - $5/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $40/visit/7b:  Chiropractic Services - $40/visit/7f:  Podiatry Services - $40/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $40/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $40/visit/7h:  Psychiatric Services - Individual - $40/visit/7h:  Psychiatric Services - Group - $40/visit	7c:  Occupational Therapy Services - $40/visit/7i:  Physical/Speech Therapy - $40/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $40/visit/9c:  Outpatient Substance Abuse Svcs - Group - $40/visit/7g:  Other Health Care Professional Services - $5 to $40/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Membership in Health Club/Fitness Classes - $0/service/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												175	1024	100	0	200	0.25	0.147375819	46.50340473	200	0	64.85640926	0	0.2	40	5.026932718	40	40	40	0	40	0.2	0	0	0	0	0	0	0	0	0											175	1024	100	0	200	0.25	0.147375819	46.50340473	200	0	64.85640926	0	0.2	40	5.026932718	40	40	40	0	40	0.2	0	0	0	0	0	0	0	0	0											11.8961	0.388745124	3.105972915	0	4.933612009	0.741162719	0.259530576	1.39799734	4.490521371	0	4.785841112	0	0.139492164	1.301534562	1.70214616	19.45820649	0.645766136	1.278608033	0	0.067787605	5.924279467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.5173	0	0	11.8961	0.388745124	3.105972915	0	4.933612009	0.741162719	0.259530576	1.39799734	4.490521371	0	4.785841112	0	0.139492164	1.301534562	1.70214616	19.45820649	0.645766136	1.278608033	0	0.067787605	5.924279467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.5173																																																																																		0			11.8961	0.388745124	3.105972915	0	4.933612009	0.741162719	0.259530576	1.39799734	4.490521371	0	4.785841112	0	0.139492164	1.301534562	1.70214616	19.45820649	0.645766136	1.278608033	0	0.067787605	5.924279467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.5173
H0351_029_0	2009	6																					none											coin	coin	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	V											0	0	0	0	0	0	0	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	311.9834053	2.800509586	453.6506156	14.56445982	1342.813526	5.020581252	3.208348599	645.9264347	39.1601103	6.238475558	17.30146952	0	4.784564153	0	0	0	219.4167352	2.775456291	38.67724902	23.03269596	39.68928833	4.479687043	1320	2616.974016	735	0	0	0	0	10400											1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $0/admit for 1-190	2:  Skilled Nursing Services - $0/$100/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $25/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $0 to $25/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - min $50/max $100/visit/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - $0/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $0/visit/3:  Rehab Services (CORF) - $0/day/5:  Partial Hospitalization - $10/day	7a:  Primary Care - $0/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - $0/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $0/visit/7b:  Chiropractic Services - $0/visit/7f:  Podiatry Services - $0/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $10/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $10/visit/7h:  Psychiatric Services - Individual - $10/visit/7h:  Psychiatric Services - Group - $10/visit	7c:  Occupational Therapy Services - $0/visit/7i:  Physical/Speech Therapy - $0/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $10/visit/9c:  Outpatient Substance Abuse Svcs - Group - $10/visit/7g:  Other Health Care Professional Services - $0 to $10/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	10b:  Transportation - $0/trip	"16a:  Preventive Dental - Various copays, limits, and coinsurance applies.  Please see supporting documentation/16b:  Comprehensive Dental  - Various copays, limits, and coinsurance applies.  Please see supporting documentation"	17a:  Routine Eye Exams - $10/visit	17b:  Wear - $0/service			14b:  Other Immunizations - $0/visit/14a:  Membership in Health Club/Fitness Classes - $0/service/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												0	0	100	0	25	0.25	0.154608232	40.82903325	0	0	0.129315808	0	0.2	0	0	0	10	0	0	10	0.2	0	0	26.31382619	5.714285714	0	0	0	0	0											0	0	100	0	25	0.25	0.154608232	40.82903325	0	0	0.129315808	0	0.2	0	0	0	10	0	0	10	0.2	0	0	26.31382619	5.714285714	0	0	0	0	0											0	0	3.780421797	0	2.79752818	1.255145313	0.496037105	2.197712656	0	0	2.237353518	0	0.956912831	0	0	0	0.182847279	0	0	0.019193913	7.937857666	0	0	5.73854995	0.35	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.9496	0	0	0	0	3.780421797	0	2.79752818	1.255145313	0.496037105	2.197712656	0	0	2.237353518	0	0.956912831	0	0	0	0.182847279	0	0	0.019193913	7.937857666	0	0	5.73854995	0.35	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.9496																																																																																		0			0	0	3.780421797	0	2.79752818	1.255145313	0.496037105	2.197712656	0	0	2.237353518	0	0.956912831	0	0	0	0.182847279	0	0	0.019193913	7.937857666	0	0	5.73854995	0.35	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.9496
H0351_030_0	2009	2																					none											D	A	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	669.9273557	4.094631433	360.1484286	10.85548142	236.8415774	3.091374267	1.424914343	288.4120308	239.7780472	3.515090897	833.9849638	0	0.297076932	374.614901	3229.878076	4865.669172	179.8574169	494.0571982	32.56815886	18.88006034	16.32079887	0	0	0	0	0	0	0	0	10400											1a:  Acute - $225/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $1024/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$100/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $10 to $40/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $200/visit/9b:  Ambulatory Surgical Center Services - $200/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - min $125/max $200/visit/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - $30/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $40/visit/3:  Rehab Services (CORF) - $40/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $40/visit/7b:  Chiropractic Services - $40/visit/7f:  Podiatry Services - $40/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $40/visit/7i:  Physical/Speech Therapy - $40/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $10 to $50/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Membership in Health Club/Fitness Classes - $0/service/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												225	1024	100	0	150	0.25	0.117748296	46.50329298	200	0	70.65131492	0	0.2	40	10.01994146	40	50	40	0	50	0.2	0	0	0	0	0	0	0	0	0											225	1024	100	0	150	0.25	0.117748296	46.50329298	200	0	70.65131492	0	0.2	40	10.01994146	40	50	40	0	50	0.2	0	0	0	0	0	0	0	0	0											12.5611	0.349408549	3.001236905	0	2.960519718	0.772843567	0.167781236	1.117675764	3.996300786	0	4.91017786	0	0.059415386	1.248716337	2.696932437	16.21889724	0.749405904	1.646857327	0	0.078666918	3.264159775	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.8001	0	0	12.5611	0.349408549	3.001236905	0	2.960519718	0.772843567	0.167781236	1.117675764	3.996300786	0	4.91017786	0	0.059415386	1.248716337	2.696932437	16.21889724	0.749405904	1.646857327	0	0.078666918	3.264159775	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.8001	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	12.5611	0.349408549	3.001236905	0	2.960519718	0.772843567	0.167781236	1.117675764	3.996300786	0	4.91017786	0	0.059415386	1.248716337	2.696932437	16.21889724	0.749405904	1.646857327	0	0.078666918	3.264159775	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.8001
H0351_032_0	2009	6																					none											D	A	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	749.5295797	4.725551108	502.4063106	14.04834522	293.5284137	3.839145928	1.636580902	403.1318751	273.4531529	5.300686683	884.3326167	0	0.506130471	431.8771791	4540.021114	6469.399545	207.6716421	450.6754047	35.74018131	21.79978563	24.54629636	0	0	2616.974016	735	0	0	0	0	10400											1a:  Acute - $225/$0/day for 1-4/5-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $1024/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$100/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $5 to $40/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $200/visit/9b:  Ambulatory Surgical Center Services - $200/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - min $125/max $200/visit/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - $25/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $40/visit/3:  Rehab Services (CORF) - $40/day/5:  Partial Hospitalization - $40/day	7a:  Primary Care - $5/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $40/visit/7b:  Chiropractic Services - $40/visit/7f:  Podiatry Services - $40/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $40/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $40/visit/7h:  Psychiatric Services - Individual - $40/visit/7h:  Psychiatric Services - Group - $40/visit	7c:  Occupational Therapy Services - $40/visit/7i:  Physical/Speech Therapy - $40/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $40/visit/9c:  Outpatient Substance Abuse Svcs - Group - $40/visit/7g:  Other Health Care Professional Services - $5 to $40/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		"16a:  Preventive Dental - Various copays, limits, and coinsurance applies.  Please see supporting documentation/16b:  Comprehensive Dental  - Various copays, limits, and coinsurance applies.  Please see supporting documentation"	17a:  Routine Eye Exams - $10/visit	17b:  Wear - $0/service			14b:  Other Immunizations - $0/visit/14a:  Membership in Health Club/Fitness Classes - $0/service/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												225	1024	100	0	150	0.25	0.107000148	46.50357627	200	0	65.11376803	0	0.2	40	5.027224312	40	40	40	0	40	0.2	0	0	2.240220716	5.714285714	0	0	0	0	0											225	1024	100	0	150	0.25	0.107000148	46.50357627	200	0	65.11376803	0	0.2	40	5.027224312	40	40	40	0	40	0.2	0	0	2.240220716	5.714285714	0	0	0	0	0											14.0537	0.403247028	4.186719255	0	3.669105172	0.959786482	0.175114399	1.562256158	4.557552548	0	4.798519072	0	0.101226094	1.439590597	1.901975377	21.56466515	0.692238807	1.502251349	0	0.072665952	4.909259273	0	0	0.48854995	0.35	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3884	0	0	14.0537	0.403247028	4.186719255	0	3.669105172	0.959786482	0.175114399	1.562256158	4.557552548	0	4.798519072	0	0.101226094	1.439590597	1.901975377	21.56466515	0.692238807	1.502251349	0	0.072665952	4.909259273	0	0	0.48854995	0.35	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3884																																																																																		0			14.0537	0.403247028	4.186719255	0	3.669105172	0.959786482	0.175114399	1.562256158	4.557552548	0	4.798519072	0	0.101226094	1.439590597	1.901975377	21.56466515	0.692238807	1.502251349	0	0.072665952	4.909259273	0	0	0.48854995	0.35	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3884
H0351_033_0	2009	6																					4500											D	A	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	770.491357	4.006672754	331.1451918	11.37965638	265.8631769	2.673656893	1.588160592	316.2485184	240.0502148	5.161808466	804.9368367	0	0.615029614	348.559168	3348.72508	5157.792097	170.7543152	338.0911865	28.99019581	17.92448613	26.41584638	0	0	0	0	0	0	0	0	10400											1a:  Acute - $225/$0/day for 1-6/7-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $1024/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$128/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$128/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $200/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $15 to $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $200/visit/9b:  Ambulatory Surgical Center Services - $200/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - min $125/max $200/visit/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - $30/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $45/visit/3:  Rehab Services (CORF) - $45/day/5:  Partial Hospitalization - $45/day	7a:  Primary Care - $15/visit/17a:  Vision Exams - $45/visit/18a:  Hearing Exams - $45/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $45/visit/7b:  Chiropractic Services - $45/visit/7f:  Podiatry Services - $45/visit/17a:  Vision Exams - $45/visit/18a:  Hearing Exams - $45/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $45/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $45/visit/7h:  Psychiatric Services - Individual - $45/visit/7h:  Psychiatric Services - Group - $45/visit	7c:  Occupational Therapy Services - $45/visit/7i:  Physical/Speech Therapy - $45/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $45/visit/9c:  Outpatient Substance Abuse Svcs - Group - $45/visit/7g:  Other Health Care Professional Services - $15 to $45/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Membership in Health Club/Fitness Classes - $0/service/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												225	1024	128	0	200	0.25	0.147375819	50	200	0	68.49455223	0	0.2	45	15.02477071	45	45	45	0	45	0.2	0	0	0	0	0	0	0	0	0											202.7603326	922.7848025	115.3481003	0	180.2314067	0.225289258	0.132808756	45.05785168	180.2314067	0	61.72434751	0	0.180231407	40.55206652	13.54003868	40.6051936	40.55206652	40.55206652	0	40.55206652	0.180231407	0	0	0	0	0	0	0	0	0											13.0188	0.30810806	3.183080733	0	3.99307453	0.602346179	0.210921632	1.18745657	3.605382325	0	4.140350086	0	0.110847653	1.177899547	3.778488927	17.45276222	0.577036696	1.14252469	0	0.060572913	4.760965153	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3106	0	6.48	13.0188	0.30810806	3.183080733	0	3.99307453	0.602346179	0.210921632	1.18745657	3.605382325	0	4.140350086	0	0.110847653	1.177899547	3.778488927	17.45276222	0.577036696	1.14252469	0	0.060572913	4.760965153	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3106																																																																																		0			13.0188	0.30810806	3.183080733	0	3.99307453	0.602346179	0.210921632	1.18745657	3.605382325	0	4.140350086	0	0.110847653	1.177899547	3.778488927	17.45276222	0.577036696	1.14252469	0	0.060572913	4.760965153	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.3106
H0351_034_0	2009	6																					4000											A	A	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	251.9551934	4.481784743	479.1087036	12.19356058	325.0991906	3.31284562	1.967840704	389.226291	266.9571965	6.544907489	1007.852998	0	0.657224453	411.7758475	3.209262137	5936.902446	189.3111074	374.8333787	31.27394663	19.87243669	30.55271259	0	0	2616.974016	735	0	177.3625654	0	0	10400											1a:  Acute - $600/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $1024/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$100/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $0 to $35/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $200/visit/9b:  Ambulatory Surgical Center Services - $200/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - min $125/max $200/visit/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - $25/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $30/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $30/day	7a:  Primary Care - $0/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $30/visit/7f:  Podiatry Services - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $30/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $30/visit/7h:  Psychiatric Services - Individual - $30/visit/7h:  Psychiatric Services - Group - $30/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $30/visit/9c:  Outpatient Substance Abuse Svcs - Group - $30/visit/7g:  Other Health Care Professional Services - $0 to $30/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		"16a:  Preventive Dental - Various copays, limits, and coinsurance applies.  Please see supporting documentation/16b:  Comprehensive Dental  - Various copays, limits, and coinsurance applies.  Please see supporting documentation"	17a:  Routine Eye Exams - $10/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $30/visit	18b:  Hearing Aids - $0/service	14b:  Other Immunizations - $0/visit/14a:  Membership in Health Club/Fitness Classes - $0/service/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												600	1024	100	0	150	0.25	0.147375819	44.66701093	200	0	64.70678636	0	0.2	30	30	30	30	30	0	30	0.2	0	0	2.240220716	5.714285714	0	30	0	0	0											536.9876751	916.4589656	89.49794586	0	134.2469188	0.223744865	0.13189833	39.97605726	178.9958917	0	57.91124462	0	0.178995892	26.84938376	26.84938376	26.84938376	26.84938376	26.84938376	0	26.84938376	0.178995892	0	0	2.240220716	5.714285714	0	26.84938376	0	0	0											11.2747	0.342280984	3.573270401	0	3.636963719	0.741232195	0.259554904	1.296644375	3.98202012	0	4.863835126	0	0.117640477	0.921327313	0.007180559	13.28351434	0.423573881	0.838670436	0	0.044463557	5.468810034	0	0	0.48854995	0.35	0	0.396839632	0	0	0	0	0	0	0	0	0	0	0	0	0	52.3111	0	6.04	11.2747	0.342280984	3.573270401	0	3.636963719	0.741232195	0.259554904	1.296644375	3.98202012	0	4.863835126	0	0.117640477	0.921327313	0.007180559	13.28351434	0.423573881	0.838670436	0	0.044463557	5.468810034	0	0	0.48854995	0.35	0	0.396839632	0	0	0	0	0	0	0	0	0	0	0	0	0	52.3111																																																																																		0			11.2747	0.342280984	3.573270401	0	3.636963719	0.741232195	0.259554904	1.296644375	3.98202012	0	4.863835126	0	0.117640477	0.921327313	0.007180559	13.28351434	0.423573881	0.838670436	0	0.044463557	5.468810034	0	0	0.48854995	0.35	0	0.396839632	0	0	0	0	0	0	0	0	0	0	0	0	0	52.3111
H0351_801_0	2009	2																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	263.945932	2.406392554	32.43824086	15.23148734	11.6994677	5.690149679	1.902005462	11.41099694	36.76015914	4.985782816	11.70930822	0	0.610091412	20.6394083	43.99430813	118.9256316	3.023694113	4.147747237	41.25937425	17449.87644	21.16270078	2.249576532	0	0	0	0	0	0	0	0											Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits											0.070621911	0.070621911	0.152992794	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.703541037	0.231	0.231	0	0	0	0	0	0	0	0											0.070621911	0.070621911	0.152992794	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.703541037	0.231	0.231	0	0	0	0	0	0	0	0											18.6404	0.169944041	4.962817107	0	2.702577039	1.314424576	0.439363262	2.635940293	8.491596761	1.151715831	2.7048502	0	0.140931116	4.767703317	10.16268518	27.4718209	0.69847334	0.958129612	9.530915451	8.293840531	4.888583881	0.519652179	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.6463	0	0	18.6404	0.169944041	4.962817107	0	2.702577039	1.314424576	0.439363262	2.635940293	8.491596761	1.151715831	2.7048502	0	0.140931116	4.767703317	10.16268518	27.4718209	0.69847334	0.958129612	9.530915451	8.293840531	4.888583881	0.519652179	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.6463	none	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined 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	18.6404	0.169944041	4.962817107	0	2.702577039	1.314424576	0.439363262	2.635940293	8.491596761	1.151715831	2.7048502	0	0.140931116	4.767703317	10.16268518	27.4718209	0.69847334	0.958129612	9.530915451	8.293840531	4.888583881	0.519652179	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.6463
H0351_803_0	2009	2																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	263.945932	2.406392554	32.43824086	15.23148734	11.6994677	5.690149679	1.902005462	11.41099694	36.76015914	4.985782816	11.70930822	0	0.610091412	20.6394083	43.99430813	118.9256316	3.023694113	4.147747237	41.25937425	17449.87644	21.16270078	2.249576532	0	0	0	0	0	0	0	0											Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits											0.070621911	0.070621911	0.152992794	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.703541037	0.231	0.231	0	0	0	0	0	0	0	0											0.070621911	0.070621911	0.152992794	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.703541037	0.231	0.231	0	0	0	0	0	0	0	0											18.6404	0.169944041	4.962817107	0	2.702577039	1.314424576	0.439363262	2.635940293	8.491596761	1.151715831	2.7048502	0	0.140931116	4.767703317	10.16268518	27.4718209	0.69847334	0.958129612	9.530915451	8.293840531	4.888583881	0.519652179	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.6463	0	0	18.6404	0.169944041	4.962817107	0	2.702577039	1.314424576	0.439363262	2.635940293	8.491596761	1.151715831	2.7048502	0	0.140931116	4.767703317	10.16268518	27.4718209	0.69847334	0.958129612	9.530915451	8.293840531	4.888583881	0.519652179	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.6463	none	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined 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	18.6404	0.169944041	4.962817107	0	2.702577039	1.314424576	0.439363262	2.635940293	8.491596761	1.151715831	2.7048502	0	0.140931116	4.767703317	10.16268518	27.4718209	0.69847334	0.958129612	9.530915451	8.293840531	4.888583881	0.519652179	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.6463
H0351_804_0	2009	2																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	263.945932	2.406392554	32.43824086	15.23148734	11.6994677	5.690149679	1.902005462	11.41099694	36.76015914	4.985782816	11.70930822	0	0.610091412	20.6394083	43.99430813	118.9256316	3.023694113	4.147747237	41.25937425	17449.87644	21.16270078	2.249576532	0	0	0	0	0	0	0	0											Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits											0.070621911	0.070621911	0.152992794	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.703541037	0.231	0.231	0	0	0	0	0	0	0	0											0.070621911	0.070621911	0.152992794	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.703541037	0.231	0.231	0	0	0	0	0	0	0	0											18.6404	0.169944041	4.962817107	0	2.702577039	1.314424576	0.439363262	2.635940293	8.491596761	1.151715831	2.7048502	0	0.140931116	4.767703317	10.16268518	27.4718209	0.69847334	0.958129612	9.530915451	8.293840531	4.888583881	0.519652179	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.6463	0	0	18.6404	0.169944041	4.962817107	0	2.702577039	1.314424576	0.439363262	2.635940293	8.491596761	1.151715831	2.7048502	0	0.140931116	4.767703317	10.16268518	27.4718209	0.69847334	0.958129612	9.530915451	8.293840531	4.888583881	0.519652179	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.6463	none	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined 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	18.6404	0.169944041	4.962817107	0	2.702577039	1.314424576	0.439363262	2.635940293	8.491596761	1.151715831	2.7048502	0	0.140931116	4.767703317	10.16268518	27.4718209	0.69847334	0.958129612	9.530915451	8.293840531	4.888583881	0.519652179	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.6463
H0351_806_0	2009	2																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	263.945932	2.406392554	32.43824086	15.23148734	11.6994677	5.690149679	1.902005462	11.41099694	36.76015914	4.985782816	11.70930822	0	0.610091412	20.6394083	43.99430813	118.9256316	3.023694113	4.147747237	41.25937425	17449.87644	21.16270078	2.249576532	0	0	0	0	0	0	0	0											Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits											0.070621911	0.070621911	0.152992794	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.703541037	0.231	0.231	0	0	0	0	0	0	0	0											0.070621911	0.070621911	0.152992794	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.703541037	0.231	0.231	0	0	0	0	0	0	0	0											18.6404	0.169944041	4.962817107	0	2.702577039	1.314424576	0.439363262	2.635940293	8.491596761	1.151715831	2.7048502	0	0.140931116	4.767703317	10.16268518	27.4718209	0.69847334	0.958129612	9.530915451	8.293840531	4.888583881	0.519652179	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.6463	0	0	18.6404	0.169944041	4.962817107	0	2.702577039	1.314424576	0.439363262	2.635940293	8.491596761	1.151715831	2.7048502	0	0.140931116	4.767703317	10.16268518	27.4718209	0.69847334	0.958129612	9.530915451	8.293840531	4.888583881	0.519652179	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.6463	none	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined 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	18.6404	0.169944041	4.962817107	0	2.702577039	1.314424576	0.439363262	2.635940293	8.491596761	1.151715831	2.7048502	0	0.140931116	4.767703317	10.16268518	27.4718209	0.69847334	0.958129612	9.530915451	8.293840531	4.888583881	0.519652179	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.6463
H0354_001_0	2009	11																					none											A	A	D	P	T	P	O	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	O	T	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	none	346.2929159	6.07223855	305.7966007	0	295.7481186	6.132029768	0	503.836093	165.8059129	552.9525444	2103.77715	0	2.696763575	557.2467993	0	0	20.75108323	32.18166513	0	8681.072772	51.50826737	0	0	0	362.1173492	0	83.60227491	0	0	168.3518324											$250/admit	MHSA - $876/admit	Contracted - $100/day; days 21-100; Non-contracted - $100/day; days 21-100	$0/visit	$100/trip	20% for high cost DME	$0/visit	"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/visit	"$30/visit in-area, $50/visit OOA"	CMG - $20/visit; Non-CMG - $30/visit	$0/visit	$0/visit	$30/visit	$30/visit	$0/visit	Primary Care - $0/visit; CMG Specialist - $20/visit; Non-CMG Specialist - $30/visit	"20% coinsurance for immunosuppressive, anti-cancer, and anti-emetics (anti-nausea) drugs obtained from CMG pharmacies, 0% otherwise"	$0/visit	$0/visit	$0/visit	CMG Routine Exam - $0/visit; CMG Medically Needed - $20/visit; Non-Medically Needed - $30/visit	$0/visit	Hearing Aid Fitting - $0/visit; CMG Routine Exam - $0/visit	$0/visit	$0/visit	CMG Podiatrist - $20/visit; CMG Nail Technician - $0/visit; Non-CMG Nail Technician - $30/visitNon-CMG Podiatrist - $30/visit											250	876	100	0	100	413.5416835	0	39.56912497	125	30	50.47023512	0	30	30	0	0	30	30	0	13.32285496	0.031989906	0	0	0	5.909851347	0	0	0	0	10.41017802											250	876	100	0	100	413.5416835	0	39.56912497	125	30	50.47023512	0	30	30	0	0	30	30	0	13.32285496	0.031989906	0	0	0	5.909851347	0	0	0	0	10.41017802											7.2144	0.443273414	2.548305006	0	2.464567655	0.211320826	0	1.661362777	1.727144926	1.382381361	8.848177285	0	0.006741909	1.393116998	0	0	0.051877708	0.080454163	0	9.638056119	1.647744606	0	0	0	0.178338309	0	0	0	0	0.146047712	0	0	0	0	0	0	0	0	0	0	39.6433		0	7.2144	0.443273414	2.548305006	0	2.464567655	0.211320826	0	1.661362777	1.727144926	1.382381361	8.848177285	0	0.006741909	1.393116998	0	0	0.051877708	0.080454163	0	9.638056119	1.647744606	0	0	0	0.178338309	0	0	0	0	0.146047712	0	0	0	0	0	0	0	0	0	0	39.6433	none																																																																																	0		0	7.2144	0.443273414	2.548305006	0	2.464567655	0.211320826	0	1.661362777	1.727144926	1.382381361	8.848177285	0	0.006741909	1.393116998	0	0	0.051877708	0.080454163	0	9.638056119	1.647744606	0	0	0	0.178338309	0	0	0	0	0.146047712	0	0	0	0	0	0	0	0	0	0	39.6433
H0354_012_0	2009	11																					none											A	A	D	P	T	P	O	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	O	T	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	none	433.8363553	7.607310806	1501.41652	0	688.1043865	11.27580737	0	1030.329401	216.1940415	712.4225154	2768.784219	0	0	967.006147	0	0	69.60845488	65.66248018	0	11491.4011	40.66908864	0	0	0	556.1344323	0	198.1768639	0	0	256.840449											$0/admit	$0/visit	$0/visit	$0/visit	$50/trip	20% for high cost DME	$0/visit	"CMG Urgent Care - $0/visit; Non-CMG Urgent Care - $0/visit in-area, $25/visit OOA; Emergency Room - $50/visit"	$0/visit	$0/visit	$0/visit	$0/visit	"$0/visit in-area, $50/visit OOA"	$0/visit	$0/visit	$0/visit	$0/visit	$0/visit	$0/visit	$0/visit	"20% coinsurance for immunosuppressive, anti-cancer, and anti-emetics (anti-nausea) drugs obtained from CMG pharmacies, 0% otherwise"	$0/visit	$0/visit	$0/visit	$0/visit	$0/visit	$0/visit	$0/visit	$0/visit	$0/visit											0	0	0	0	50	468.3605	0	28.84656197	0	0	0	0	0	0	0	0	0	0	0	5.38E-06	0.045581298	0	0	0	0.00001	0	0.000005	0	0	0.00001											0	0	0	0	50	468.3605	0	28.84656197	0	0	0	0	0	0	0	0	0	0	0	5.38E-06	0.045581298	0	0	0	0.00001	0	0.000005	0	0	0.00001											0	0	0	0	2.86710161	0.440095232	0	2.476788409	0	0	0	0	0	0	0	0	0	0	0	5.16E-06	1.853749843	0	0	0	4.63E-07	0	8.26E-08	0	0	2.14E-07	0	0	0	0	0	0	0	0	0	0	7.6377		0	0	0	0	0	2.86710161	0.440095232	0	2.476788409	0	0	0	0	0	0	0	0	0	0	0	5.16E-06	1.853749843	0	0	0	4.63E-07	0	8.26E-08	0	0	2.14E-07	0	0	0	0	0	0	0	0	0	0	7.6377	none																																																																																	0		0	0	0	0	0	2.86710161	0.440095232	0	2.476788409	0	0	0	0	0	0	0	0	0	0	0	5.16E-06	1.853749843	0	0	0	4.63E-07	0	8.26E-08	0	0	2.14E-07	0	0	0	0	0	0	0	0	0	0	7.6377
H0354_014_0	2009	11																					none											A	A	D	P	T	P	O	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	O	T	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	none	379.0238153	6.646174141	334.6998711	0	323.701627	6.711616703	0	551.4576519	181.4775493	605.21649	2302.621872	0	2.951656162	609.9166291	0	0	22.71243325	35.22341042	0	9501.590047	56.37672364	0	0	0	396.3439418	0	91.50419126	0	0	184.2641039											$250/admit	MHSA - $876/admit	Contracted - $100/day; days 21-100; Non-contracted - $100/day; days 21-100	$0/visit	$100/trip	20% for high cost DME	$0/visit	"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/visit	"$30/visit in-area, $50/visit OOA"	CMG - $20/visit; Non-CMG - $30/visit	$0/visit	$0/visit	$30/visit	$30/visit	$0/visit	Primary Care - $0/visit; CMG Specialist - $20/visit; Non-CMG Specialist - $30/visit	"20% coinsurance for immunosuppressive, anti-cancer, and anti-emetics (anti-nausea) drugs obtained from CMG pharmacies, 0% otherwise"	$0/visit	$0/visit	$0/visit	CMG Routine Exam - $0/visit; CMG Medically Needed - $20/visit; Non-Medically Needed - $30/visit	$0/visit	Hearing Aid Fitting - $0/visit; CMG Routine Exam - $0/visit	$0/visit	$0/visit	CMG Podiatrist - $20/visit; CMG Nail Technician - $0/visit; Non-CMG Nail Technician - $30/visitNon-CMG Podiatrist - $30/visit											250	876	100	0	100	413.5416835	0	39.56912497	125	30	50.47023512	0	30	30	0	0	30	30	0	13.32285496	0.031989906	0	0	0	5.909851347	0	0	0	0	10.41017802											250	876	100	0	100	413.5416835	0	39.56912497	125	30	50.47023512	0	30	30	0	0	30	30	0	13.32285496	0.031989906	0	0	0	5.909851347	0	0	0	0	10.41017802											7.8963	0.485170712	2.789165593	0	2.697513558	0.231294439	0	1.818391395	1.890391138	1.513041225	9.684488937	0	0.00737914	1.524791573	0	0	0.056781083	0.088058526	0	10.54902551	1.803486062	0	0	0	0.195194482	0	0	0	0	0.159851844	0	0	0	0	0	0	0	0	0	0	43.3904		0	7.8963	0.485170712	2.789165593	0	2.697513558	0.231294439	0	1.818391395	1.890391138	1.513041225	9.684488937	0	0.00737914	1.524791573	0	0	0.056781083	0.088058526	0	10.54902551	1.803486062	0	0	0	0.195194482	0	0	0	0	0.159851844	0	0	0	0	0	0	0	0	0	0	43.3904	none																																																																																	0		0	7.8963	0.485170712	2.789165593	0	2.697513558	0.231294439	0	1.818391395	1.890391138	1.513041225	9.684488937	0	0.00737914	1.524791573	0	0	0.056781083	0.088058526	0	10.54902551	1.803486062	0	0	0	0.195194482	0	0	0	0	0.159851844	0	0	0	0	0	0	0	0	0	0	43.3904
H0354_801_0	2009	4																					none											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	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	none	332.0488377	3.002523067	19.27419602	27.09807517	9.746882016	4.654393859	0	21.7535318	22.10602425	11.97644905	45.59378374	0	0.358220819	17.11499083	0	0	2.123517017	0.504677793	39.45453911	249.5619283	44.85982456	11.79380603	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/visit	$0/visit	$0/visit	$0/visit	$0/visit	$0/visit	$0/visit	$0/visit											0.0706	0.0706	0.1444	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0706	0.0706	0.1444	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.4426	0.211978128	2.783193907	0	2.251529746	1.075164981	0	5.025065845	5.106491603	2.76655973	10.53216404	0	0.082749009	3.953562883	0	0	0.490532431	0.11658057	9.113998533	57.64880545	10.36261947	2.724369193	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.688		0	23.4426	0.211978128	2.783193907	0	2.251529746	1.075164981	0	5.025065845	5.106491603	2.76655973	10.53216404	0	0.082749009	3.953562883	0	0	0.490532431	0.11658057	9.113998533	57.64880545	10.36261947	2.724369193	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.688	none																																																																																	0		0	23.4426	0.211978128	2.783193907	0	2.251529746	1.075164981	0	5.025065845	5.106491603	2.76655973	10.53216404	0	0.082749009	3.953562883	0	0	0.490532431	0.11658057	9.113998533	57.64880545	10.36261947	2.724369193	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.688
H0354_804_0	2009	4																					none											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	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	none	332.0488377	3.002523067	19.27419602	27.09807517	9.746882016	4.654393859	0	21.7535318	22.10602425	11.97644905	45.59378374	0	0.358220819	17.11499083	0	0	2.123517017	0.504677793	39.45453911	249.5619283	44.85982456	11.79380603	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/visit	$0/visit	$0/visit	$0/visit	$0/visit	$0/visit	$0/visit	$0/visit											0.0706	0.0706	0.1444	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0706	0.0706	0.1444	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.4426	0.211978128	2.783193905	0	2.251529746	1.075164981	0	5.025065845	5.106491603	2.76655973	10.53216404	0	0.082749009	3.953562883	0	0	0.490532431	0.11658057	9.113998533	57.64880545	10.36261947	2.724369193	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.688		0	23.4426	0.211978128	2.783193905	0	2.251529746	1.075164981	0	5.025065845	5.106491603	2.76655973	10.53216404	0	0.082749009	3.953562883	0	0	0.490532431	0.11658057	9.113998533	57.64880545	10.36261947	2.724369193	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.688	none																																																																																	0		0	23.4426	0.211978128	2.783193905	0	2.251529746	1.075164981	0	5.025065845	5.106491603	2.76655973	10.53216404	0	0.082749009	3.953562883	0	0	0.490532431	0.11658057	9.113998533	57.64880545	10.36261947	2.724369193	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.688
H0354_805_0	2009	4																					none											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	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	none	332.0488377	3.002523067	19.27419602	27.09807517	9.746882016	4.654393859	0	21.7535318	22.10602425	11.97644905	45.59378374	0	0.358220819	17.11499083	0	0	2.123517017	0.504677793	39.45453911	249.5619283	44.85982456	11.79380603	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/visit	$0/visit	$0/visit	$0/visit	$0/visit	$0/visit	$0/visit	$0/visit											0.0706	0.0706	0.1444	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0706	0.0706	0.1444	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.4426	0.211978128	2.783193906	0	2.251529746	1.075164981	0	5.025065845	5.106491603	2.76655973	10.53216404	0	0.082749009	3.953562883	0	0	0.490532431	0.11658057	9.113998533	57.64880545	10.36261947	2.724369193	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.688		0	23.4426	0.211978128	2.783193906	0	2.251529746	1.075164981	0	5.025065845	5.106491603	2.76655973	10.53216404	0	0.082749009	3.953562883	0	0	0.490532431	0.11658057	9.113998533	57.64880545	10.36261947	2.724369193	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.688	none																																																																																	0		0	23.4426	0.211978128	2.783193906	0	2.251529746	1.075164981	0	5.025065845	5.106491603	2.76655973	10.53216404	0	0.082749009	3.953562883	0	0	0.490532431	0.11658057	9.113998533	57.64880545	10.36261947	2.724369193	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.688
H0370_001_0	2009	11																					2000											D	D	D	V	T	COIN	COIN	V	V	COIN	COIN	COIN	COIN	COIN	P	P	P	P	P	P	COIN	V	T	V	V	V	V	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	5000	1166.240761	39.16480168	460.1864197	0	209.0157991	0	15.31221265	378.0558989	749.2588207	17.2919513	24.09187767	1.551378319	0.016465537	7.509981486	7553.922733	20713.49469	173.3705945	2335.067313	0	23397.59191	4.424858863	0	0	0	144.2058793	0	0	0	0	0											1a $600 per stay	1b $600 per stay	2 $75 days 7-26	6 $0	10a $150	11a 30%	11b 30%; 11c 10%	4a $50	9a $100; 9b $100	8a 20% Diagnostic	8b 20%	9a 20%	12 20%	3 $0; 4b $50; 5 $50; 9a 20%; 9d 20%; 13a $0; 14b $0	7a $10; 14d - j $0	7b $20; 7d $30; 7f $30; 7g $30; 14c $10; 14d - j $0; 17a $30	7e $30; 7h $30; 9c $30	7c $25; 7i $25	14h $0	7g $30	15 20%			16a 50%; 16b $30	17a $30	17b $0	18a $30	18b $0	14a $0	14b $0											110.1338432	110.1338432	35.68239796	0	105.7377049	0	0.113226638	50	97.40853659	0.044636798	0.196904598	0.2	0.2	0.172279358	5.655961218	8.300875666	30	25	0	0.425022009	0.246042756	0	0	0	30	0	0	0	0	0											83.288207	83.288207	26.9846476	0	79.96364785	0	0.085627119	37.81226759	73.66475301	0.033756371	0.148908187	0.15124907	0.2	0.130285464	5.655961218	7.929193763	22.68736055	18.90613379	0	0.321420919	0.18606869	0	0	0	30	0	0	0	0	0											8.0945	0.271830509	1.034830697	0	1.392805479	0	1.311140648	1.191262568	4.599497164	0.583713525	3.587477832	0.234644529	0.003293107	0.978441419	3.560391168	13.68677607	0.327776765	3.678924587	0	0.626706291	0.823327693	0	0	0	0.360514698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3479	0	9.9041	8.0945	0.271830509	1.034830697	0	1.392805479	0	1.311140648	1.191262568	4.599497164	0.583713525	3.587477832	0.234644529	0.003293107	0.978441419	3.560391168	13.68677607	0.327776765	3.678924587	0	0.626706291	0.823327693	0	0	0	0.360514698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3479	0	0.2	0.2	0.2	0.2	150	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			0.5	0.2		0.2			0.2											3.5941	0.044	0.2775	0.2109	0.1467	0	0.323	0.1608	0.7982	0.3531	0.4919	0.0317	0.0003	0.157	0.6506	1.9531	0.0347	0.1222	0.752	0.6407	0.0904	0	0	0	0.0072	0.0349	0	0	0	0.0001											10.8752	0	0.96	11.6886	0.315805664	1.312288543	0.210857727	1.539546125	0	1.634150245	1.352091411	5.397730056	0.93680982	4.079426519	0.266323194	0.003629329	1.135487638	4.211011548	15.63985632	0.362497518	3.801083747	0.752024946	1.267446177	0.913681942	0	0	0	0.367674136	0.034926297	0	0	0	9.19E-05	0	0	0	0	0	0	0	0	0	0	57.2231
H0370_002_0	2009	12																					2000											D	D	D	V	T	COIN	COIN	V	V	COIN	COIN	COIN	COIN	COIN	P	P	P	P	P	P	COIN	V	T	V	V	V	V	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	5000	1166.240761	39.16480168	460.1864197	0	209.0157991	0	15.31221265	378.0558989	749.2588207	17.2919513	24.09187767	1.551378319	0.016465537	7.509981486	0	20713.49469	173.3705945	2335.067313	0	0	4.424858863	0	0	0	144.2058793	0	0	0	0	0											1a $250 per stay	1b $250 per stay	2 $100 days 16-36	6 $0	10a $150	11a 10%	11b 10%; 11c 10%	4a $50	9a $100; 9b $100	8a 10% Diagnostic	8b 10%	9a 10%	12 10%	3 $0; 4b $50; 5 $50; 9a 10%; 9d 10%; 13a $0; 14b $0	7a $0; 14d - j $0	7b $0; 7d $0; 7f $0; 7g $0; 14c $0; 14d - j $0; 17a $10	"7e $10,7h $10; 9c $10"	"7c $10,7i $10"	14h $0	7g $0	15 10%			16a $50 ded; 16b $50 ded 50% - 80%	17a $10	17b $0	18a $10	18b $0	14a $0	14b $0											45.88910134	45.88910134	23.85204082	0	105.7377049	0	0.1	50	97.40853659	0.022318399	0.098452299	0.1	0.1	0.088832868	0	0.504405956	10	10	0	0	0.123021378	0	0	0	10	0	0	0	0	0											40.42606611	40.42606611	21.01248773	0	93.14977466	0	0.088095136	44.04756786	85.81218251	0.019661424	0.086731687	0.088095136	0.1	0.078257436	0	0.477867392	8.809513572	9.407236358	0	0	0.108550015	0	0	0	8.809513572	0	0	0	0	0											3.9289	0.131939905	0.805805125	0	1.622481215	0	1.348931451	1.387703572	5.357961223	0.339984385	2.089529184	0.136668884	0.001646554	0.587711893	0	0.82485864	0.127275884	1.830544178	0	0	0.480318495	0	0	0	0.105865304	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.1081	0	2.6537	3.9289	0.131939905	0.805805125	0	1.622481215	0	1.348931451	1.387703572	5.357961223	0.339984385	2.089529184	0.136668884	0.001646554	0.587711893	0	0.82485864	0.127275884	1.830544178	0	0	0.480318495	0	0	0	0.105865304	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.1081	0	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			16a $50 ded; 16b $50 ded 10% - 80%	0.1		0.1			0.1											1.9099	0.0366	0.1474	0.1121	0.2012	0	0.1881	0.1709	0.4242	0.1876	0.2574	0.0168	0.0002	0.0856	0.352	1.0452	0.0185	0.0649	0.3996	0.3405	0.048	0	0	0	0.0039	0.019	0	0	0	0											6.0298	0	0.13	5.8388	0.168528982	0.953247734	0.112050944	1.823700472	0	1.537063038	1.558634217	5.782146526	0.527621678	2.346907329	0.153503099	0.001829504	0.673361837	0.352033376	1.870032738	0.145726681	1.89546022	0.399630149	0.340492663	0.528333234	0	0	0	0.10976102	0.019004694	0	0	0	4.88E-05	0	0	0	0	0	0	0	0	0	0	27.1379
H0370_801_0	2009	10																					0											COIN	COIN	COIN	COIN	COIN	O	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	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	176.0124557	3.371912534	13.58775956	0	5.315115576	0	15.31221265	6.433821184	39.09133142	17.2919513	24.09187767	1.551378319	0.016465537	7.509981486	31.86240151	95.6469072	1.700356438	5.982419729	36.82842025	31.37853064	5.443522337	0	0	0	0	0	0	0	0	0											FFS Medicare 8.7%	FFS Medicare 8.7%	FFS Medicare 13.2%	FFS Medicare 0%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	0	0	0	0	0	0	0	0											0.087	0.087	0.1321	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.087	0.087	0.1321	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											15.3131	0.29335639	1.794943038	0	1.227791698	0	3.537121122	1.486212693	9.030097558	3.994440751	5.565223743	0.358368392	0.003803539	1.734805723	7.360214749	22.09443556	0.392782337	1.381938958	8.507365079	7.248440578	1.25745366	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.5819	0	0	15.3131	0.29335639	1.794943038	0	1.227791698	0	3.537121122	1.486212693	9.030097558	3.994440751	5.565223743	0.358368392	0.003803539	1.734805723	7.360214749	22.09443556	0.392782337	1.381938958	8.507365079	7.248440578	1.25745366	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.5819	0	FFS Medicare 8.7%	FFS Medicare 8.7%	FFS Medicare 13.2%	FFS Medicare 0%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	0	0	0	0	0	0	0	0											1.7015	0.0326	0.1994	0	0.1364	0	0.393	0.1651	1.0033	0.4438	0.6184	0.0398	0.0004	0.1928	0.8178	2.4549	0.0436	0.1535	0.9453	0.8054	0.1397	0	0	0	0	0	0	0	0	0											10.2869	0	0	17.0145	0.325951545	1.994381153	0	1.364212998	0	3.93013458	1.651347437	10.03344173	4.438267501	6.183581937	0.398187102	0.004226155	1.927561915	8.178016387	24.54937285	0.436424819	1.535487731	9.452627865	8.053822864	1.397170733	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.8688
H0370_802_0	2009	10																					0											COIN	COIN	COIN	COIN	COIN	O	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	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	176.0124557	3.371912534	13.58775956	0	5.315115576	0	15.31221265	6.433821184	39.09133142	17.2919513	24.09187767	1.551378319	0.016465537	7.509981486	31.86240151	95.6469072	1.700356438	5.982419729	36.82842025	31.37853064	5.443522337	0	0	0	0	0	0	0	0	0											FFS Medicare 8.7%	FFS Medicare 8.7%	FFS Medicare 13.2%	FFS Medicare 0%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	0	0	0	0	0	0	0	0											0.087	0.087	0.1321	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.087	0.087	0.1321	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											15.3131	0.29335639	1.794943038	0	1.227791698	0	3.537121122	1.486212693	9.030097558	3.994440751	5.565223743	0.358368392	0.003803539	1.734805723	7.360214749	22.09443556	0.392782337	1.381938958	8.507365079	7.248440578	1.25745366	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.5819	0	0	15.3131	0.29335639	1.794943038	0	1.227791698	0	3.537121122	1.486212693	9.030097558	3.994440751	5.565223743	0.358368392	0.003803539	1.734805723	7.360214749	22.09443556	0.392782337	1.381938958	8.507365079	7.248440578	1.25745366	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.5819	0	FFS Medicare 8.7%	FFS Medicare 8.7%	FFS Medicare 13.2%	FFS Medicare 0%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	0	0	0	0	0	0	0	0											1.7015	0.0326	0.1994	0	0.1364	0	0.393	0.1651	1.0033	0.4438	0.6184	0.0398	0.0004	0.1928	0.8178	2.4549	0.0436	0.1535	0.9453	0.8054	0.1397	0	0	0	0	0	0	0	0	0											10.2869	0	0	17.0145	0.325951545	1.994381153	0	1.364212998	0	3.93013458	1.651347437	10.03344173	4.438267501	6.183581937	0.398187102	0.004226155	1.927561915	8.178016387	24.54937285	0.436424819	1.535487731	9.452627865	8.053822864	1.397170733	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.8688
H0370_803_0	2009	10																					0											COIN	COIN	COIN	COIN	COIN	O	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	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	176.0124557	3.371912534	13.58775956	0	5.315115576	0	15.31221265	6.433821184	39.09133142	17.2919513	24.09187767	1.551378319	0.016465537	7.509981486	31.86240151	95.6469072	1.700356438	5.982419729	36.82842025	31.37853064	5.443522337	0	0	0	0	0	0	0	0	0											FFS Medicare 8.7%	FFS Medicare 8.7%	FFS Medicare 13.2%	FFS Medicare 0%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	0	0	0	0	0	0	0	0											0.087	0.087	0.1321	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.087	0.087	0.1321	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											15.3131	0.29335639	1.794943038	0	1.227791698	0	3.537121122	1.486212693	9.030097558	3.994440751	5.565223743	0.358368392	0.003803539	1.734805723	7.360214749	22.09443556	0.392782337	1.381938958	8.507365079	7.248440578	1.25745366	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.5819	0	0	15.3131	0.29335639	1.794943038	0	1.227791698	0	3.537121122	1.486212693	9.030097558	3.994440751	5.565223743	0.358368392	0.003803539	1.734805723	7.360214749	22.09443556	0.392782337	1.381938958	8.507365079	7.248440578	1.25745366	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.5819	0	FFS Medicare 8.7%	FFS Medicare 8.7%	FFS Medicare 13.2%	FFS Medicare 0%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	0	0	0	0	0	0	0	0											1.7015	0.0326	0.1994	0	0.1364	0	0.393	0.1651	1.0033	0.4438	0.6184	0.0398	0.0004	0.1928	0.8178	2.4549	0.0436	0.1535	0.9453	0.8054	0.1397	0	0	0	0	0	0	0	0	0											10.2869	0	0	17.0145	0.325951545	1.994381153	0	1.364212998	0	3.93013458	1.651347437	10.03344173	4.438267501	6.183581937	0.398187102	0.004226155	1.927561915	8.178016387	24.54937285	0.436424819	1.535487731	9.452627865	8.053822864	1.397170733	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.8688
H0401_002_0	2009	4																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1425.566053	141.9366482	609.7752513	476.9654307	86.83262765	8.979588399	4.005660129	316.9660114	196.8548299	7788.747508	30.94014077	0	0.125774172	578.947104	4131.378245	3070.896779	499.2168862	180.93432	0	0	12.81419316	667.3220036	0	0	121.3176645	0	12.99102012	0	458.0545955	0											"$160 Days 1-19 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$160 Days 1-19 (1b); $0 n/c (1b1, 1b2)"	"$80 Days 1-37 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$125 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); $125 (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											158.1381921	160	80	0	150	0.2	0.08433218	48.11087782	125	2.8	0.17840229	0	0.2	44.32794465	7.128902605	25	37.5	25	0	0	0.2	23.71163777	0	0	25	0	25	0	0	0											109.3712679	110.6385954	55.31929768	0	103.7236832	0.138298244	0.058314962	33.26824965	86.43640263	1.936175419	0.123363617	0	0.138298244	30.78539395	7.128902605	25	37.5	17.28728053	0	0	0.138298244	23.71163777	0	0	25	0	25	0	0	0											12.993	1.308639282	2.81102822	0	0.750549996	1.241861309	0.233589919	0.878742033	1.417951945	1.256698456	3.816887683	0	0.017394347	1.485259556	2.454349428	6.397701623	1.560052769	0.260655196	0	0	1.772180415	1.318608136	0	0	0.252745134	0	0.027064625	0	0	0	0	0	0	0	0	0	0	0	0	0	42.255	0	13.4808	12.993	1.308639282	2.81102822	0	0.750549996	1.241861309	0.233589919	0.878742033	1.417951945	1.256698456	3.816887683	0	0.017394347	1.485259556	2.454349428	6.397701623	1.560052769	0.260655196	0	0	1.772180415	1.318608136	0	0	0.252745134	0	0.027064625	0	0	0	0	0	0	0	0	0	0	0	0	0	42.255	2950	"$295 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$295 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-20 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											3.3278	0.329	3.5138	0.2703	0.2502	0.6209	0.277	0.2929	1.8409	0.4189	1.8709	0	0.0058	0.4822	2.8404	3.8183	0.7577	0.1564	0	0	1.1393	0.804	0	0	0.1516	0	0.0162	0	0	0											23.1846	0	6.669461989	16.3208	1.637657966	6.324813496	0.270312199	1.000733329	1.862791964	0.510577801	1.171656044	3.258871556	1.675597941	5.687785844	0	0.023192463	1.967420507	5.294715958	10.21600324	2.317792686	0.417048313	0	0	2.911439254	2.122628963	0	0	0.404392215	0	0.0433034	0	0	0	0	0	0	0	0	0	0	0	0	0	65.4396
H0401_004_0	2009	4																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		303.9086326	22.992	39.86498558	4774.89538	13.17801074	28.94643498	9.843405355	20.67854629	32.1880734	5.977587969	14.46151078	0	2.41062417	34.29107043	46.5097586	124.5348392	13.3855	5.085730965	0	0	21.39969495	6.207854778	306.3141212	0	162.4405593	183.2916658	0	0	20.2	0											"8% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"8% (1b); $0 n/c (1b1, 1b2)"	21% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.0787436	0.0797	0.2096	0	0.2	0.2	0.2	0.12478716	0.2	0.08	0.2	0	0.2	0.2	0	0.199553321	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											0.0787436	0.0797	0.2096	0	0.2	0.2	0.2	0.12478716	0.2	0.08	0.2	0	0.2	0.2	0	0.199553321	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											23.9309	1.8324624	8.355700978	0	2.635602148	5.789286995	1.968681071	2.580417067	6.437614679	0.478207037	2.892302156	0	0.482124834	6.858214086	0	24.8513408	2.6771	1.017146193	0	0	4.279938991	0.092306324	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.1593	0	0	23.9309	1.8324624	8.355700978	0	2.635602148	5.789286995	1.968681071	2.580417067	6.437614679	0.478207037	2.892302156	0	0.482124834	6.858214086	0	24.8513408	2.6771	1.017146193	0	0	4.279938991	0.092306324	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.1593		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.7989	0.2874	0.6294	0.9322	0.2081	0.457	0.1554	0.1359	0.5082	0.0944	0.2283	0	0.0254	0.5414	0.7344	1.9663	0.2114	0.0803	0	0	0.3379	0.0674	0.0261	0	0.0155	0	0	0	0.003	0											11.4443	0	0	27.7297	2.1198624	8.985148119	0.932209613	2.843676002	6.246335969	2.124103261	2.716338192	6.945847417	0.572590005	3.1206418	0	0.507499825	7.39965204	0.73436461	26.81768037	2.88845	1.097447208	0	0	4.617828911	0.159668598	0.0261	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	108.6036
H0401_005_0	2009	3																					2900											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1710.835777	258.2531322	36.16921579	46125.13447	79.90761021	18.06844946	7.988557619	326.5611947	342.3594867	5421.847073	414.6429492	0	0.701753375	1323.830501	5350.637265	3968.677409	1242.868229	236.6297661	0	0	23.21427498	1002.165824	769.983193	0	314.3760437	332.2285714	0	0	20.2	0											"$175 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	21% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$75 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5, 9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											172.9	175	0.2096	0	75	0.14	0.2	49.97090897	75	4.4	64.79010385	0	0.2	70.26839385	3.248639311	25	20	20	0	0	0.2	13.6791576	0	0	0	0	0	0	0	0											129.8389194	131.4159104	0.2096	0	56.32110444	0.105132728	0.150189612	37.52555711	56.32110444	3.30417146	48.65400274	0	0.150189612	52.76791399	3.248639311	25	20	20	0	0	0.150189612	13.6791576	0	0	0	0	0	0	0	0											18.5111	2.828214206	7.581067629	0	0.375040405	1.899585387	1.199798368	1.02119923	1.606838701	1.492892697	1.681169932	0	0.105396067	5.821314503	1.448524213	8.268077936	2.071447048	0.394382943	0	0	3.486542948	1.142398688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.935	0	13.2756	18.5111	2.828214206	7.581067629	0	0.375040405	1.899585387	1.199798368	1.02119923	1.606838701	1.492892697	1.681169932	0	0.105396067	5.821314503	1.448524213	8.268077936	2.071447048	0.394382943	0	0	3.486542948	1.142398688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.935		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.2335	0.2098	0.5711	0.4832	0.1244	0.2853	0.1261	0.0717	0.5646	0.0888	0.2394	0	0.0074	0.4501	0.6144	1.9341	0.1512	0.0664	0	0	0.3665	0.0763	0.0569	0	0.0155	0	0	0	0.003	0											9.7396	0	0	21.7445	3.037974206	8.15216051	0.483194387	0.49941115	2.184876694	1.325933488	1.092881561	2.171389568	1.581684251	1.920610461	0	0.112782945	6.271410163	2.062963271	10.20220388	2.222647048	0.460801001	0	0	3.853084132	1.218654952	0.056935837	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	70.6746
H0401_801_0	2009	3																					4500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1700.962784	169.3565555	1067.108753	667.7528941	121.5659138	12.57147238	5.607945869	443.7127311	37.27158559	10904.2676	43.31636459	0	0.176084521	26.75290549	6219.824688	4595.948222	748.8267772	271.4020049	0	0	19.22136408	1000.984941	0	0	0	0	0	0	0	0											"$305 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$305 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$140 Days 1-33 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											301.3918952	305	140	0	150	0.2	0.08433218	48.1107052	0.2	2.8	0.178402229	0	0.2	0.198417438	24.85991498	34.82536196	37.5	35	0	0	0.2	33.19629288	0	0	0	0	0	0	0	0											217.6966099	220.2844492	101.1141734	0	108.3366143	0.144448819	0.060908419	34.74767277	0.144448819	2.022283468	0.128849956	0	0.144448819	0.143608162	24.85991498	34.82536196	37.5	25.27854335	0	0	0.144448819	33.19629288	0	0	0	0	0	0	0	0											30.8578	3.108884628	8.991651624	0	1.097503293	1.81593434	0.341571118	1.284832065	5.383836525	1.837626674	5.581311688	0	0.025435201	3.841935574	12.88535941	13.33796336	2.340083679	0.571720612	0	0	2.776503343	2.769082439	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.8491	0	25.9503	30.8578	3.108884628	8.991651624	0	1.097503293	1.81593434	0.341571118	1.284832065	5.383836525	1.837626674	5.581311688	0	0.025435201	3.841935574	12.88535941	13.33796336	2.340083679	0.571720612	0	0	2.776503343	2.769082439	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.8491																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	30.8578	3.108884628	8.991651624	0	1.097503293	1.81593434	0.341571118	1.284832065	5.383836525	1.837626674	5.581311688	0	0.025435201	3.841935574	12.88535941	13.33796336	2.340083679	0.571720612	0	0	2.776503343	2.769082439	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.8491
H0401_804_0	2009	3																					4500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1700.962784	169.3565555	1067.108753	667.7528941	121.5659138	12.57147238	5.607945869	443.7127311	37.27158559	10904.2676	43.31636459	0	0.176084521	26.75290549	6219.824688	4595.948222	748.8267772	271.4020049	0	0	19.22136408	1000.984941	0	0	0	0	0	0	0	0											"$305 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$305 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$140 Days 1-33 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											301.3918952	305	140	0	150	0.2	0.08433218	48.1107052	0.2	2.8	0.178402229	0	0.2	0.198417438	24.85991498	34.82536196	37.5	35	0	0	0.2	33.19629288	0	0	0	0	0	0	0	0											217.6966099	220.2844492	101.1141734	0	108.3366143	0.144448819	0.060908419	34.74767277	0.144448819	2.022283468	0.128849956	0	0.144448819	0.143608162	24.85991498	34.82536196	37.5	25.27854335	0	0	0.144448819	33.19629288	0	0	0	0	0	0	0	0											30.8578	3.108884628	8.991651624	0	1.097503293	1.81593434	0.341571118	1.284832065	5.383836525	1.837626674	5.581311688	0	0.025435201	3.841935574	12.88535941	13.33796336	2.340083679	0.571720612	0	0	2.776503343	2.769082439	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.8491	0	25.9503	30.8578	3.108884628	8.991651624	0	1.097503293	1.81593434	0.341571118	1.284832065	5.383836525	1.837626674	5.581311688	0	0.025435201	3.841935574	12.88535941	13.33796336	2.340083679	0.571720612	0	0	2.776503343	2.769082439	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.8491																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	30.8578	3.108884628	8.991651624	0	1.097503293	1.81593434	0.341571118	1.284832065	5.383836525	1.837626674	5.581311688	0	0.025435201	3.841935574	12.88535941	13.33796336	2.340083679	0.571720612	0	0	2.776503343	2.769082439	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.8491
H0401_805_0	2009	3																					4500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1700.962784	169.3565555	1067.108753	667.7528941	121.5659138	12.57147238	5.607945869	443.7127311	37.27158559	10904.2676	43.31636459	0	0.176084521	26.75290549	6219.824688	4595.948222	748.8267772	271.4020049	0	0	19.22136408	1000.984941	0	0	0	0	0	0	0	0											"$305 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$305 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$140 Days 1-33 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											301.3918952	305	140	0	150	0.2	0.08433218	48.1107052	0.2	2.8	0.178402229	0	0.2	0.198417438	24.85991498	34.82536196	37.5	35	0	0	0.2	33.19629288	0	0	0	0	0	0	0	0											217.6966099	220.2844492	101.1141734	0	108.3366143	0.144448819	0.060908419	34.74767277	0.144448819	2.022283468	0.128849956	0	0.144448819	0.143608162	24.85991498	34.82536196	37.5	25.27854335	0	0	0.144448819	33.19629288	0	0	0	0	0	0	0	0											30.8578	3.108884628	8.991651624	0	1.097503293	1.815934339	0.341571118	1.284832065	5.383836525	1.837626674	5.581311688	0	0.025435201	3.841935574	12.88535941	13.33796336	2.340083679	0.571720612	0	0	2.776503343	2.769082439	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.8491	0	25.9503	30.8578	3.108884628	8.991651624	0	1.097503293	1.815934339	0.341571118	1.284832065	5.383836525	1.837626674	5.581311688	0	0.025435201	3.841935574	12.88535941	13.33796336	2.340083679	0.571720612	0	0	2.776503343	2.769082439	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.8491																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	30.8578	3.108884628	8.991651624	0	1.097503293	1.815934339	0.341571118	1.284832065	5.383836525	1.837626674	5.581311688	0	0.025435201	3.841935574	12.88535941	13.33796336	2.340083679	0.571720612	0	0	2.776503343	2.769082439	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.8491
H0401_806_0	2009	3																					4500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1700.962784	169.3565555	1067.108753	667.7528941	121.5659138	12.57147238	5.607945869	443.7127311	37.27158559	10904.2676	43.31636459	0	0.176084521	26.75290549	6219.824688	4595.948222	748.8267772	271.4020049	0	0	19.22136408	1000.984941	0	0	0	0	0	0	0	0											"$305 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$305 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$140 Days 1-33 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											301.3918952	305	140	0	150	0.2	0.08433218	48.1107052	0.2	2.8	0.178402229	0	0.2	0.198417438	24.85991498	34.82536196	37.5	35	0	0	0.2	33.19629288	0	0	0	0	0	0	0	0											217.6966099	220.2844492	101.1141734	0	108.3366143	0.144448819	0.060908419	34.74767277	0.144448819	2.022283468	0.128849956	0	0.144448819	0.143608162	24.85991498	34.82536196	37.5	25.27854335	0	0	0.144448819	33.19629288	0	0	0	0	0	0	0	0											30.8578	3.108884628	8.991651624	0	1.097503293	1.81593434	0.341571118	1.284832065	5.383836525	1.837626674	5.581311688	0	0.025435201	3.841935574	12.88535941	13.33796336	2.340083679	0.571720612	0	0	2.776503343	2.769082439	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.8491	0	25.9503	30.8578	3.108884628	8.991651624	0	1.097503293	1.81593434	0.341571118	1.284832065	5.383836525	1.837626674	5.581311688	0	0.025435201	3.841935574	12.88535941	13.33796336	2.340083679	0.571720612	0	0	2.776503343	2.769082439	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.8491																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	30.8578	3.108884628	8.991651624	0	1.097503293	1.81593434	0.341571118	1.284832065	5.383836525	1.837626674	5.581311688	0	0.025435201	3.841935574	12.88535941	13.33796336	2.340083679	0.571720612	0	0	2.776503343	2.769082439	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.8491
H0408_001_0	2009	5																																Coin	Coin	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		361.4017199	42.2955	7637.46695	101.8084293	23.83532445	13.11352612	14.9817419	10.40970964	7.28184653	29.9265136	24.75863806	0	0.093542486	4.864857563	1.166401574	135.7667812	43.282	40.43461633	0	0	8.951051021	6.707328765	1498.037626	0	182.0000636	141.3063859	0	0	0	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.074322446	0.075353699	0	0	0.2	0.2	0.2	0.066242846	0.2	0.08	0.15003742	0	0.2	0.2	0	0.198674011	0.2	0	0	0	0.2	0.022666282	0	0	0	0	0	0	0	0											0.074322446	0.075353699	0	0	0.2	0.2	0.2	0.066242846	0.2	0.08	0.15003742	0	0.2	0.2	0	0.198674011	0.2	0	0	0	0.2	0.022666282	0	0	0	0	0	0	0	0											26.8603	3.187122379	0	0	4.76706489	2.622705224	2.99634838	0.689568792	1.456369306	2.394121088	3.714722165	0	0.018708497	0.972971513	0	26.97333102	8.6564	0	0	0	1.790210204	0.152030203	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.2519	0	0	26.8603	3.187122379	0	0	4.76706489	2.622705224	2.99634838	0.689568792	1.456369306	2.394121088	3.714722165	0	0.018708497	0.972971513	0	26.97333102	8.6564	0	0	0	1.790210204	0.152030203	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.2519		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.78	0.3254	0.7803	0.0493	0.3763	0.2071	0.2366	0.0363	0.115	0.4725	0.3909	0	0.001	0.0768	0.0184	2.1437	0.6834	0.0046	0	0	0.1413	0.1058	0.1107	0	0.0089	0	0	0	0	0											9.0643	0	0	29.6403	3.512472379	0.780337768	0.049320165	5.143412118	2.8297609	3.2329022	0.725861886	1.57134583	2.866644987	4.105648029	0	0.019693155	1.049785053	0.018416867	29.11701704	9.3398	0.0045656	0	0	1.931542589	0.257808211	0.110719388	0	0.008933819	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.3163
H0408_002_0	2009	5																																Coin	Coin	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		322.8279586	42.87075	7218.381085	96.22196016	21.29129086	11.71387029	13.38268439	9.298642285	6.504627734	26.73234454	22.11605574	0	0.083558345	4.35169689	1.072239169	121.3719572	43.2725	38.21587335	0	0	7.995671768	5.991430405	1498.037626	0	182.0000636	141.3063859	0	0	0	0											"8.8% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"8.8% (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.086764462	0.088	0	0	0.2	0.2	0.2	0.070067353	0.2	0.08	0.15003742	0	0.2	0.2	0	0.198516748	0.2	0	0	0	0.2	0.022666282	0	0	0	0	0	0	0	0											0.086764462	0.088	0	0	0.2	0.2	0.2	0.070067353	0.2	0.08	0.15003742	0	0.2	0.2	0	0.198516748	0.2	0	0	0	0.2	0.022666282	0	0	0	0	0	0	0	0											28.01	3.772626	0	0	4.258258172	2.342774057	2.676536878	0.651531252	1.300925547	2.138587563	3.318235934	0	0.016711669	0.870339378	0	24.09436622	8.6545	0	0	0	1.599134354	0.135803449	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.8403	0	0	28.01	3.772626	0	0	4.258258172	2.342774057	2.676536878	0.651531252	1.300925547	2.138587563	3.318235934	0	0.016711669	0.870339378	0	24.09436622	8.6545	0	0	0	1.599134354	0.135803449	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.8403		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.4833	0.3298	0.697	0.0441	0.3362	0.185	0.2113	0.0343	0.1027	0.4221	0.3492	0	0.0009	0.0687	0.0169	1.9164	0.6833	0.0041	0	0	0.1262	0.0945	0.1107	0	0.0089	0	0	0	0	0											8.2255	0	0	30.4933	4.102401	0.697049391	0.044056039	4.594436449	2.527729904	2.887842421	0.68582237	1.403630195	2.560677214	3.667436814	0	0.017591231	0.939050382	0.016930092	26.01076555	9.33775	0.004078296	0	0	1.725381803	0.230291374	0.110719388	0	0.008933819	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.0659
H0410_001_0	2009	4																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1648.776327	42.0398337	2748.441665	5191.072732	272.0854819	17.54662359	9.679398524	387.5253062	394.2787301	6710.341445	493.3227821	0	7.855580179	1493.227459	7014.276467	5915.22895	241.3586028	702.6796939	0	0	1452.112815	1710.848121	2759.542995	487.4730143	205.2567597	154.1150788	49.27524142	14.09480567	932.1	115.5175384											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b); $0 n/c (7b1); $0/$20 (7d); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0.2	0.2	49.97419523	50	8	16.62123034	0	0	46.77659972	1.306126012	9.499946878	20	0	0	0	0	10.95381953	0	20	20	0	20	0	0	20											0	0	0	0	0	0.16651238	0.16651238	41.60661087	41.62809494	6.66049519	13.83820309	0	0	38.94441467	1.087430753	7.90929381	16.65123797	0	0	0	0	10.95352522	0	20	20	0	20	0	0	20											0	0	0	0	0	2.921730051	1.611739683	1.343634551	1.367756034	3.724516409	0.568891737	0	0	4.846072447	0.635628328	3.898773643	0.334909961	0	0	0	0	1.561651504	0	0.812455024	0.342094599	0	0.082125402	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	24.2445	0	4.2744	0	0	0	0	0	2.921730051	1.611739683	1.343634551	1.367756034	3.724516409	0.568891737	0	0	4.846072447	0.635628328	3.898773643	0.334909961	0	0	0	0	1.561651504	0	0.812455024	0.342094599	0	0.082125402	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	24.2445		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.5593	0.0196	0.6443	0.4218	0.0846	0.1074	0.0593	0.0329	0.2688	0.047	0.114	0	0	0.2145	0.3618	1.1151	0.0142	0.0363	0	0	0.1881	0.0823	0	0	0.0039	0.0039	0.0016	0.0006	0	0											5.3812	0	0	1.5593	0.019574811	0.644256258	0.421797053	0.084642299	3.029158359	1.671001306	1.376570377	1.636521698	3.77148972	0.68286375	0	0	5.060526158	0.997448806	5.013894165	0.349131686	0.036349051	0	0	0.188088366	1.643905261	0	0.812455024	0.346006016	0.003931507	0.083745916	0.000575298	0	0.192529231	0	0	0	0	0	0	0	0	0	0	29.6257
H0410_002_0	2009	2																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1652.084686	42.12418893	2753.956564	5201.211104	272.6314363	17.61711076	9.718281981	388.3024956	395.0698719	6723.806112	494.3126612	0	7.87134283	1496.223701	7028.201947	5749.548737	241.8429021	704.0896591	0	0	1455.026559	1714.281031	2759.542995	487.4730143	205.2567597	154.1150788	49.27524142	14.09480567	932.1	115.5175384											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b); $0 n/c (7b1); $0/$20 (7d); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0.2	0.2	49.97424688	50	8	16.62123034	0	0	46.77659972	1.306153712	9.485403286	20	0	0	0	0	10.95381953	0	20	20	0	20	0	0	20											0	0	0	0	0	0.166606261	0.166606261	41.63011213	41.65156528	6.664250445	13.84600521	0	0	38.96637193	1.088066932	7.901637884	16.66062611	0	0	0	0	10.95352605	0	20	20	0	20	0	0	20											0	0	0	0	0	2.935120956	1.619126625	1.347089703	1.371273213	3.734093989	0.57035464	0	0	4.858534104	0.637262844	3.785904343	0.335771181	0	0	0	0	1.564785161	0	0.812455024	0.342094599	0	0.082125402	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	24.1885	0	4.2482	0	0	0	0	0	2.935120956	1.619126625	1.347089703	1.371273213	3.734093989	0.57035464	0	0	4.858534104	0.637262844	3.785904343	0.335771181	0	0	0	0	1.564785161	0	0.812455024	0.342094599	0	0.082125402	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	24.1885		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.5655	0.0197	0.6468	0.4235	0.085	0.1079	0.0595	0.033	0.2698	0.0472	0.1144	0	0	0.2153	0.3633	1.1196	0.0143	0.0365	0	0	0.1919	0.0826	0	0	0.0039	0.0039	0.0016	0.0006	0	0											5.4057	0	0	1.5655	0.019653446	0.646844323	0.423491469	0.084982319	3.042980818	1.678626311	1.380091615	1.641118546	3.781255998	0.684784494	0	0	5.073849305	1.000536804	4.905481146	0.350050037	0.03649507	0	0	0.191855994	1.647369342	0	0.812455024	0.346006016	0.003931507	0.083745916	0.000575298	0	0.192529231	0	0	0	0	0	0	0	0	0	0	29.5943
H0410_003_0	2009	3																					1500											D	D	D	V	T	P	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2928.512057	63.34440287	2689.825295	89722.30272	162.3889759	3290.624424	18.02069657	463.9411777	445.9041215	8617.0577	561.4088874	0	12.59412008	1717.693268	7860.614947	6405.86597	255.6882251	293.6774893	0	0	1917.501067	1717.981395	1418.390092	487.4730143	205.2567597	154.1150788	37.56409609	10.74492219	932.1	115.5175384											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	$0 (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b); $0 n/c (7b1); $0/$20 (7d); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0	0.2	49.97844554	50	3.2	16.87836848	0	0	45.70445279	1.386181754	9.280817128	20	0	0	0	0	0.001602202	0	20	0	0	20	0	0	20											0	0	0	0	0	0	0.164568717	41.12444326	41.14217921	2.633099469	13.88825722	0	0	37.60761574	1.140610763	7.63666083	16.45687168	0	0	0	0	0.001318362	0	20	0	0	20	0	0	20											0	0	0	0	0	0	2.965642911	1.589943553	1.52878894	1.890797505	0.649749253	0	0	5.383195698	0.747158501	4.076618811	0.350652359	0	0	0	0	0.000188743	0	0.812455024	0	0	0.062606827	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	20.2503	0	4.13	0	0	0	0	0	0	2.965642911	1.589943553	1.52878894	1.890797505	0.649749253	0	0	5.383195698	0.747158501	4.076618811	0.350652359	0	0	0	0	0.000188743	0	0.812455024	0	0	0.062606827	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	20.2503		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a3); $0 (6a2)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.6842	0.0296	0.6174	0.4159	0.1038	0.171	0.1103	0.0394	0.3186	0.0587	0.1324	0	0	0.2571	0.4354	1.2985	0.0156	0.0382	0	0	0.2387	0.0864	0	0	0.0039	0.0039	0.0009	0.0004	0	0											7.0604	0	0	2.6842	0.029602698	0.617416189	0.415876957	0.103797894	0.171022848	3.075973706	1.629377327	1.84740432	1.94945493	0.782110812	0	0	5.640249057	1.18259352	5.375079056	0.36621983	0.038185828	0	0	0.23870879	0.08663817	0	0.812455024	0.003911416	0.003931507	0.063548589	0.000438568	0	0.192529231	0	0	0	0	0	0	0	0	0	0	27.3107
H0410_004_0	2009	4																					500											D	D	D	V	T	P	P	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1489.528057	53.61809026	5893.654666	78.56318443	454.4993957	361.5152026	1010.698507	128.5698544	84.15539598	9492.914446	1247.958126	0	4.676061766	204.8541134	137.1876323	6118.978475	1842.643783	31.20244798	0	0	1117.415844	714.801537	1576.881712	0	182.0000636	141.3063859	46.85749586	13.66333203	0	0											"$25 Days 1-20 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$25 Days 1-20 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$50 (10a)	$0 (11a)	"$0 (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	$0 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$0 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a9, 14a10); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											24.6793694	25	0	0	50	0	0	49.6332695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											21.79928391	22.08249688	0	0	44.16499375	0	0	43.84106075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											2.7059	0.098668443	0	0	1.672746915	0	0	0.4697199	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.947	0	0.6536	2.7059	0.098668443	0	0	1.672746915	0	0	0.4697199	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.947		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.5479	0.2885	0.6252	0.0395	0.3015	0.1659	0.1895	0.028	0.0921	0.3786	0.3132	0	0	0.0613	0.0116	1.7745	0.424	0.0038	0	0	0.1178	0.0883	0	0	0.0089	0.0093	0.004	0.0054	0	0											7.4786	0	0	5.2538	0.387118968	0.625204852	0.039515204	1.974275461	0.165892538	0.189526384	0.497708243	0.092118931	0.378585077	0.313208917	0	0	0.061272175	0.011607567	1.774475565	0.423972836	0.003804483	0	0	0.1177713	0.088250064	0	0	0.008933819	0.009296473	0.003969466	0.005393421	0	0	0	0	0	0	0	0	0	0	0	0	12.4257
H0423_001_0	2009	6																					0											Coin	Coin	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	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	456.1	42.37	0	0	0	0	0	404.1	0	0	0	0	0	262.4285949	0	11198.82883	2036.240677	876.8516472	0	1140.431331	9.73	0	0	0	0	0	0	0	0	0											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: $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 Partial Hosp: $1000, 9C OP Substance Abuse: $20, 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 Ind, $10 Group, 7H Psychiatric: $20"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	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: $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	14A Health Education/Wellness Programs: N/A	"13B Acupuncture: Not Covered, Health Related Expense Card: $0"											0.056909946	0.056909946	0	0	0	0	0	46.95	0	0	0	0	0	2.5	0	10	20	25	0	10	0.2	0	0	0	0	0	0	0	0	0											0.056909946	0.056909946	0	0	0	0	0	46.95	0	0	0	0	0	2.5	0	10	20	25	0	10	0.2	0	0	0	0	0	0	0	0	0											25.9566	2.411274416	0	0	0	0	0	1.58104125	0	0	0	0	0	0.054672624	0	9.332357355	3.393734462	1.826774265	0	0.950359443	1.946	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4528			25.9566	2.411274416	0	0	0	0	0	1.58104125	0	0	0	0	0	0.054672624	0	9.332357355	3.393734462	1.826774265	0	0.950359443	1.946	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4528	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			25.9566	2.411274416	0	0	0	0	0	1.58104125	0	0	0	0	0	0.054672624	0	9.332357355	3.393734462	1.826774265	0	0.950359443	1.946	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4528
H0423_002_0	2009	8																					0											Coin	Coin	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	COin	V	T	V	V	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	838.64	29.75	0	0	0	0	0	1123.03	0	0	0	0	0	731.1994966	0	16871.35285	4220.426338	1811.162274	0	2414.223165	28.07	0	0	0	0	0	0	0	0	0											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: $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: $1000, 9C OP Substance Abuse: $20, 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 Ind, $10 Group, 7H Psychiatric: $25"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	Included in i.2.	"7B Chiropractic: $10, 7F Podiatry: $10, 7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: 20%	"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: Not Covered"	17A Routine Eye Exams: $0	"17B Eye Wear: Medicare Covered: $0, Routine: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	14A Health Education/Wellness Programs: N/A	13B Acupuncture: Not Covered; Health Expense Reimbursement Card: $0											0.0569	0.0569	0	0	0	0	0	47.94	0	0	0	0	0	1.75	0	10	20	25	0	10	0.2	0	0	0	0	0	0	0	0	0											0.0569	0.0569	0	0	0	0	0	47.94	0	0	0	0	0	1.75	0	10	20	25	0	10	0.2	0	0	0	0	0	0	0	0	0											47.7186	1.692775	0	0	0	0	0	4.48650485	0	0	0	0	0	0.10663326	0	14.05946071	7.034043897	3.773254737	0	2.011852637	5.614	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4971	0	0	47.7186	1.692775	0	0	0	0	0	4.48650485	0	0	0	0	0	0.10663326	0	14.05946071	7.034043897	3.773254737	0	2.011852637	5.614	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4971	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	47.7186	1.692775	0	0	0	0	0	4.48650485	0	0	0	0	0	0.10663326	0	14.05946071	7.034043897	3.773254737	0	2.011852637	5.614	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4971
H0423_003_0	2009	6																					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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	404.1	0	0	0	0	0	0	0	11198.82883	2036.240677	876.8516472	0	1140.431331	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: $0	"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	14A Health Education/Wellness Programs: $0	"13B Acupuncture: Not Covered, Massage Therapy"											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	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	1.601738203	0	0	0	0	0	0	0	9.332357355	3.393734462	0.730709706	0	0.950359443	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.0089			0	0	0	0	0	0	0	1.601738203	0	0	0	0	0	0	0	9.332357355	3.393734462	0.730709706	0	0.950359443	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.0089	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			0	0	0	0	0	0	0	1.601738203	0	0	0	0	0	0	0	9.332357355	3.393734462	0.730709706	0	0.950359443	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.0089
H0427_001_0	2009	7																					1200															T	Coin	Coin	V							V	V		V			Coin						V																																																						0	1200					70.22864021	3.604907343	5.889170015	236.4363399							2666.131154	5487.175126		2096.603675			43.34470295						29.37527502																		$50 waived	20% to $500	20% to $500 Prosth and $0 copay Supplies	$50 waived - WW							$15 PCP / $15 Specialists	$15 PCP / $15 Specialists		$15 OT/PT/ST			10% Part B Rx						$15 Med-Cov/$15 routine/Aids to $250 per 2 yrs																		50	0.2	0.2	50							15	15		15			0.1						15																		48.5	0.194	0.194	48.5							14.55	14.55		14.55			0.1						14.55														0	0	0	0	0.283840754	0.699352024	1.142498983	0.955596874	0	0	0	0	0	0	3.232684024	6.653199841	0	2.542131956	0	0	4.334470295	0	0	0	0	0	0.035617521	0	0	0	0	0	0	0	0	0	0	0	0	0	19.8794		0.4808	0	0	0	0	0.283840754	0.699352024	1.142498983	0.955596874	0	0	0	0	0	0	3.232684024	6.653199841	0	2.542131956	0	0	4.334470295	0	0	0	0	0	0.035617521	0	0	0	0	0	0	0	0	0	0	0	0	0	19.8794		$0 Copay	$0 Copay	$0 (1-100)		$50 waived	20% to $500	20% to $500 Prosth and $0 copay Supplies	$50 waived - WW							$15 PCP / $15 Specialists	$15 PCP / $15 Specialists		$15 OT/PT/ST			10% Part B Rx						$15 Med-Cov/$15 routine/Aids to $250 per 2 yrs														0	0	0	0	0.0149	0.0368	0.0601	0.0503	0	0	0	0	0	0	0.1701	0.3502	0	0.1338	0	0	0.2281	0	0	0	0	0	0.0019	0	0	0											1.0463		0.032359293	0	0	0	0	0.298779741	0.736160026	1.202630508	1.005891446	0	0	0	0	0	0	3.402825288	7.003368253	0	2.675928375	0	0	4.562600311	0	0	0	0	0	0.037492127	0	0	0	0	0	0	0	0	0	0	0	0	0	20.9257
H0427_002_0	2009	7																					1200											D	D	D		T	Coin	Coin	V	V						V	V		V			Coin						V																																																						0	1200	491.5852879	54.62058754	170.1630328		70.20858304	3.603877788	5.887488079	236.3688142	105.8232702						2638.716015	5430.75192		2075.04484			43.33232379						29.07321665														$100 (1-5)	$100 (1-5)	$25 (1-100)		$50 waived	20% to $500	20% to $500 Prosth and $0 copay Supplies	$50 waived - WW	$200 ASC/ $0 OPV						$20 PCP / $20 Specialist	$20 PCP / $20 Specialist		$20 OT/PT/ST			10% Part B Rx						$20 Med-Cov/$20 routine/Aids to $250 per 2 yrs														100	100	25		50	0.2	0.2	50	200						20	20		20			0.1						20														97	97	24.25		48.5	0.194	0.194	48.5	194						19.4	19.4		19.4			0.1						19.4														3.9736	0.441516416	0.343871129	0	0.28375969	0.699152291	1.142172687	0.955323957	1.710809535	0	0	0	0	0	4.265924223	8.779715604	0	3.354655825	0	0	4.333232379	0	0	0	0	0	0.0470017	0	0	0	0	0	0	0	0	0	0	0	0	0	30.3308		0.804	3.9736	0.441516416	0.343871129	0	0.28375969	0.699152291	1.142172687	0.955323957	1.710809535	0	0	0	0	0	4.265924223	8.779715604	0	3.354655825	0	0	4.333232379	0	0	0	0	0	0.0470017	0	0	0	0	0	0	0	0	0	0	0	0	0	30.3308		$100 (1-5)	$100 (1-5)	$25 (1-100)		$50 waived	20% to $500	20% to $500 Prosth and $0 copay Supplies	$50 waived - WW	$200 ASC/ $0 OPV						$20 PCP / $20 Specialist	$20 PCP / $20 Specialist		$20 OT/PT/ST			10% Part B Rx						$20 Med-Cov/$20 routine/Aids to $250 per 2 yrs														0.2091	0.0232	0.0181	0	0.0149	0.0368	0.0601	0.0503	0.09	0	0	0	0	0	0.2245	0.4621	0	0.1766	0	0	0.2281	0	0	0	0	0	0.0025	0	0	0											1.5964		0.049371866	4.1828	0.464754122	0.361969609	0	0.29869441	0.73594978	1.202287039	1.005604166	1.800852142	0	0	0	0	0	4.490446551	9.241805899	0	3.531216658	0	0	4.561297241	0	0	0	0	0	0.049475474	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9271
H0490_001_0	2009	6																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	V	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	Coin	V	Coin	V	Coin	Coin	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	790.4981747	18.02511266	660.5174956	0	188.9705391	8.404999005	5.606349717	295.6661801	265.1010078	0	153.3561539	0	0.388473941	14.47291406	4844.028026	6205.726757	135.8707185	435.4478121	86.22943104	1510.060077	7.59967446	0	0	0	443.3035836	0	189.9872501	0	0	936.1473803											$150/Days 1-10 for IP Medical; $150/Days 1-10 for IP Surgical;	$150/Days 1-10 for IP Psych; $150/Days 1-10 for IP Substance Abuse;	$75/Days Custom for SNF	No Cost-Sharing	$100/Run 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; $35/Visit for Urgent Care;	$150/Case for OP Fac - Surgery; $150/Case for OP Fac - ASC	No Cost-Sharing	$100/Case for OP Fac - CT/MRI/PET	No Cost-Sharing	20% Coinsurance for Renal Dialysis - Fac; 20% Coinsurance for Renal Dialysis - Prof	20% 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; $30/Visit for Prof - CORF; $30/Visit for Prof - CORF;	$10/Visit for PCP - Office Visits; $10/Consult for PCP - Consults; $10/Procedure for PCP - Surgery (Office); $10/Visit for PCP - Tx Injections; $10/Visit for PCP - Allergy Testing; $10/Visit for PCP - Allergy Tx;	$30/Visit for Speclst - Office Visits; $30/Procedure for Speclst - Surgery (Office); $30/Visit for Speclst - Tx Injections; $30/Visit for Speclst - Allergy Testing; $30/Visit for Speclst - Allergy Tx; $30/Consult for Speclst - Consults;	$30/Visit for OP Psych - Non-Physician; $30/Visit for OP Psych - Psychiatrist; $30/Visit for OP Substance Abuse;	$30/Visit for PT/ST (PCP); $30/Visit for Occ Therapy (PCP); $30/Visit for PT/ST (Specialist); $30/Visit for Occ Therapy (Specialist);	$100/Visit for Prof Radiology (Office);	$30/Visit for Chiropractor; $30/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	$30/Service for Vision Exams (Refractions);	No Cost-Sharing	$30/Service for Hearing Exam;	No Cost-Sharing	No Cost-Sharing	$10/Service for Physical Exams (Routine); $30/Service for Podiatry;											150	150	75	0	100	0.2	0.2	45.46462353	150	0	100	0	0.2	0.143890116	10	29.79612222	29.99999999	30	100	30	0.2	0	0	0	30	0	30	0	0	3.34828172											145.940026	145.9400261	72.97001301	0	97.29335069	0.194586701	0.194586701	44.23405561	145.940026	0	97.29335068	0	0.194586701	0.139995515	9.729335069	28.98964568	29.1880052	29.18800521	97.29335068	29.18800521	0.194586701	0	0	0	29.18800521	0	29.1880052	0	0	3.257655475											9.6138	0.219215451	4.016497521	0	1.532131411	1.635501031	1.090921098	1.089876188	3.224070665	0	1.243377839	0	0.075591863	2.026143053	3.927430979	14.99181833	0.330482937	1.059154417	0.699129189	3.672970116	1.478795585	0	0	0	1.078262275	0	0.462112404	0	0	0.254137137	0	0	0	0	0	0	0	0	0	0	53.7214	0	1.4945	9.6138	0.219215451	4.016497521	0	1.532131411	1.635501031	1.090921098	1.089876188	3.224070665	0	1.243377839	0	0.075591863	2.026143053	3.927430979	14.99181833	0.330482937	1.059154417	0.699129189	3.672970116	1.478795585	0	0	0	1.078262275	0	0.462112404	0	0	0.254137137	0	0	0	0	0	0	0	0	0	0	53.7214	0																																																																																	0	0	0	9.6138	0.219215451	4.016497521	0	1.532131411	1.635501031	1.090921098	1.089876188	3.224070665	0	1.243377839	0	0.075591863	2.026143053	3.927430979	14.99181833	0.330482937	1.059154417	0.699129189	3.672970116	1.478795585	0	0	0	1.078262275	0	0.462112404	0	0	0.254137137	0	0	0	0	0	0	0	0	0	0	53.7214
H0490_002_0	2009	6																					1500											Coin	Coin	D	Coin	T	Coin	Coin	V	V	Coin	V	Coin	Coin	Coin	Coin	V	V	V	V	V	Coin	Coin	Coin	Coin	V	Coin	V	Coin	Coin	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	739.9861817	0	203.4044413	8.608142845	5.728179728	307.3269337	270.1101685	0	167.7289566	0	0.42502706	15.75467861	0	6415.57151	140.6418537	455.2940716	89.89757025	1595.083494	8.907135507	0	0	0	443.3035836	0	189.9872501	0	0	936.1473803											No Cost-Sharing	No Cost-Sharing	$75/Days Custom for SNF	No Cost-Sharing	$50/Run 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;	$50/Case for OP Fac - Surgery; $50/Case for OP Fac - ASC	No Cost-Sharing	$100/Case for OP Fac - CT/MRI/PET	No Cost-Sharing	20% Coinsurance for Renal Dialysis - Fac; 20% Coinsurance for Renal Dialysis - Prof	20% Coinsurance 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/Visit for Prof - CORF; $20/Visit for Prof - CORF;	No Cost-Sharing	$20/Visit for Speclst - Office Visits; $20/Procedure for Speclst - Surgery (Office); $20/Visit for Speclst - Tx Injections; $20/Visit for Speclst - Allergy Testing; $20/Visit for Speclst - Allergy Tx; $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/Visit for PT/ST (PCP); $20/Visit for Occ Therapy (PCP); $20/Visit for PT/ST (Specialist); $20/Visit for Occ Therapy (Specialist);	$100/Visit for Prof Radiology (Office);	$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/Service for Vision Exams (Refractions);	No Cost-Sharing	$20/Service for Hearing Exam;	No Cost-Sharing	No Cost-Sharing	$20/Service for Podiatry;											0	0	75	0	50	0.2	0.2	43.97958244	50	0	100	0	0.2	0.123468273	0	20	20	20	100	20	0.2	0	0	0	20	0	20	0	0	1.893944687											0	0	72.05609524	0	48.03739683	0.192149587	0.192149587	42.25329308	48.03739683	0	96.07479366	0	0.192149587	0.118621889	0	19.21495873	19.21495873	19.21495873	96.07479367	19.21495873	0.192149587	0	0	0	19.21495873	0	19.21495873	0	0	1.81960345											0	0	4.443376232	0	0.814251655	1.654051095	1.100667371	1.08213125	1.081282446	0	1.342877075	0	0.081668774	1.868849737	0	10.27291182	0.225202285	0.729038066	0.719740876	2.55412196	1.711502412	0	0	0	0.709838339	0	0.304216431	0	0	0.141951417	0	0	0	0	0	0	0	0	0	0	30.8377	0	1.2599	0	0	4.443376232	0	0.814251655	1.654051095	1.100667371	1.08213125	1.081282446	0	1.342877075	0	0.081668774	1.868849737	0	10.27291182	0.225202285	0.729038066	0.719740876	2.55412196	1.711502412	0	0	0	0.709838339	0	0.304216431	0	0	0.141951417	0	0	0	0	0	0	0	0	0	0	30.8377	0																																																																																	0	0	0	0	0	4.443376232	0	0.814251655	1.654051095	1.100667371	1.08213125	1.081282446	0	1.342877075	0	0.081668774	1.868849737	0	10.27291182	0.225202285	0.729038066	0.719740876	2.55412196	1.711502412	0	0	0	0.709838339	0	0.304216431	0	0	0.141951417	0	0	0	0	0	0	0	0	0	0	30.8377
H0490_003_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		316.7498988	22.53682964	88.84937722	0	13.92743898	23.23706541	17.4817367	22.27897599	28.77855268	8.297300919	21.96889859	0	4.249626	40.61081645	56.63223758	107.9165018	7.937880372	4.843536206	20.85803236	34.74675526	8.991092772	0.684082148	0	0	0	0	0	0	0	0											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	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing											0.075453359	0.075453359	0.180058038	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.075453359	0.075453359	0.180058038	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.8998	1.700479495	15.99804456	0	3.217238404	5.36776211	4.038281178	5.146443454	6.647845668	1.916676512	5.074815574	0	0.981663606	9.3810986	13.08204688	24.92871191	1.833650366	1.118856864	4.818205476	8.026500465	2.07694243	0.158022976	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.4131	0	0	23.8998	1.700479495	15.99804456	0	3.217238404	5.36776211	4.038281178	5.146443454	6.647845668	1.916676512	5.074815574	0	0.981663606	9.3810986	13.08204688	24.92871191	1.833650366	1.118856864	4.818205476	8.026500465	2.07694243	0.158022976	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.4131																																																																																		0	0	0	23.8998	1.700479495	15.99804456	0	3.217238404	5.36776211	4.038281178	5.146443454	6.647845668	1.916676512	5.074815574	0	0.981663606	9.3810986	13.08204688	24.92871191	1.833650366	1.118856864	4.818205476	8.026500465	2.07694243	0.158022976	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.4131
H0496_801_0	2009	4																					0											D	D	D	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	296.8450342	1.736743822	8.642312827	0	298.0650452	19.2743601	0.248021726	226.3287113	118.7825718	0	430.25342	0	0	342.6272385	2499.26594	2110.084382	67.24407226	276.7518269	0	0	0	0	0	0	0	0	0	0	0	0											1A IP Acute: $250 per day (days 1-10); 1B IP Psych: $250 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	12 ESRD: $0	3 CORF: $40; 5 Partial Hosp: $40; Part B Rx: $50	7A PCP: $20; 14A through 14J 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.	13 Blood: $0	0	0	0	0	0	0	0	0											250	0	100	0	75	0.2	0.20000145	49.52366249	250	0	73.04417243	0	0	40.98327293	20	40	40	40	0	0	0	0	0	0	0	0	0	0	0	0											250	0	100	0	75	0.2	0.20000145	49.52366249	250	0	73.04417243	0	0	40.98327293	20	40	40	40	0	0	0	0	0	0	0	0	0	0	0	0											6.1843	0	0.072019274	0	1.862906533	3.854872021	0.049604705	0.934052226	2.474636913	0	2.61895875	0	0	1.170165469	4.165443233	7.033614606	0.224146908	0.92250609	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.5672	0	0	6.1843	0	0.072019274	0	1.862906533	3.854872021	0.049604705	0.934052226	2.474636913	0	2.61895875	0	0	1.170165469	4.165443233	7.033614606	0.224146908	0.92250609	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.5672	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.1843	0	0.072019274	0	1.862906533	3.854872021	0.049604705	0.934052226	2.474636913	0	2.61895875	0	0	1.170165469	4.165443233	7.033614606	0.224146908	0.92250609	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.5672
H0496_805_0	2009	3																					0											D	D	D	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	296.8450342	1.736743822	8.642312827	0	298.0650452	19.2743601	0.248021726	226.3287113	118.7825718	0	430.25342	0	0	342.6272385	2499.26594	2110.084382	67.24407226	276.7518269	0	0	0	0	0	0	0	0	0	0	0	0											1A IP Acute: $250 per day (days 1-10); 1B IP Psych: $250 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	12 ESRD: $0	3 CORF: $40; 5 Partial Hosp: $40; Part B Rx: $50	7A PCP: $20; 14A through 14J 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.	13 Blood: $0	0	0	0	0	0	0	0	0											250	0	100	0	75	0.2	0.20000145	49.52366249	250	0	73.04417243	0	0	40.98327293	20	40	40	40	0	0	0	0	0	0	0	0	0	0	0	0											250	0	100	0	75	0.2	0.20000145	49.52366249	250	0	73.04417243	0	0	40.98327293	20	40	40	40	0	0	0	0	0	0	0	0	0	0	0	0											6.1843	0	0.072019274	0	1.862906533	3.854872021	0.049604705	0.934052226	2.474636913	0	2.61895875	0	0	1.170165469	4.165443233	7.033614606	0.224146908	0.92250609	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.5672	0	0	6.1843	0	0.072019274	0	1.862906533	3.854872021	0.049604705	0.934052226	2.474636913	0	2.61895875	0	0	1.170165469	4.165443233	7.033614606	0.224146908	0.92250609	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.5672	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.1843	0	0.072019274	0	1.862906533	3.854872021	0.049604705	0.934052226	2.474636913	0	2.61895875	0	0	1.170165469	4.165443233	7.033614606	0.224146908	0.92250609	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.5672
H0504_015_0	2009	9																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	Coin	P	P	P	V	P	P	P	Coin	O	T	V	P	P	P	P	O	O																																																			0		1145.94282	27.87404489	1076.927341	1614.935264	135.1769904	19.90388082	0.952844339	231.5692971	192.5678638	1057.958297	21.17510254	0	0.292444684	1303.943618	4974.116369	6056.596279	223.2983959	2949.574253	4091.658743	9631.763784	44.04424546	0	0	3876.212689	344.1516575	96.2758534	0	0	0	0											$0.00 copay	$900 per stay	Days 1-20 is $0 and days 21-100 is $85	$0.00 Copay	$100 Copay per trip (1-way)	20% Coinsurance of medicare-allowable	20% Coinsurance of medicare-allowable for prosthetics.  $0.00 for medical supplies	$50 Copay - waived if admited to hospital	$0.00 Copay per visit	$0.00 Copay	$0 copay for simple x-ray and lab; 20% of Medicare Allowable for complex diagnostic radiology (up to $500 cost sharing cap per service); 20% of Medicare Allowable for therapeutic radiology	$0.00 Copay	10% Coinsurance of medicare allowable + 20% coins for drugs	$0.00 Copay per visit	$0.00 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	$0.00 Copay	Not covered	Not covered	$10 Copay per Exam	$20 Copay for Frames & Lenses	$0.00 Copay.  Office visit copay may apply.	Not covered	$0.00 Copay	$0.00 Copay																																																			0	103.6866359	46.18706658	0	100	0.2	0.2	43.75	0	0	0.077682787	0	0.1	0	0	10	30	10	0	0	0.2	0	0	0	10	20	0	0	0	0											0	0.240847162	4.145009567	0	1.12647492	3.980776165	0.190568868	0.844263062	0	0	1.644940986	0	0.029244468	0	0	5.047163566	0.55824599	2.457978545	0	0	8.808849092	0	0	0	0.286793048	0.160459756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.5216			0	0.240847162	4.145009567	0	1.12647492	3.980776165	0.190568868	0.844263062	0	0	1.644940986	0	0.029244468	0	0	5.047163566	0.55824599	2.457978545	0	0	8.808849092	0	0	0	0.286793048	0.160459756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.5216																																																																																		0			0	0.240847162	4.145009567	0	1.12647492	3.980776165	0.190568868	0.844263062	0	0	1.644940986	0	0.029244468	0	0	5.047163566	0.55824599	2.457978545	0	0	8.808849092	0	0	0	0.286793048	0.160459756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.5216
H0504_017_0	2009	8																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	Coin	P	P	P	V	P	P	P	Coin	O	T		P	P	P	P																																																					0		1145.94282	27.87404489	1076.927341	1614.935264	135.1769904	19.90387913	0.952844258	231.5692971	192.5678638	1057.958297	21.17510254	0	0.29244466	1303.943618	4974.116369	6056.596279	223.2983959	2949.574253	4091.658743	9631.763784	44.04424546	0	0	0	344.1516575	96.2758534	0	0	0	0											$0.00 copay	$900 per stay	Days 1-20 is $0 and days 21-100 is $95	$0.00 Copay	$110 Copay per trip (1-way)	20% Coinsurance of medicare-allowable	20% Coinsurance of medicare-allowable for prosthetics.  $0.00 copay for medical supplies.	$50 Copay - waived if admited to hospital	$0.00 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	$0.00 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	$0.00 Copay	Not covered	Not covered	$10 Copay per Exam	$20 Copay for Frames & Lenses	$0.00 Copay.  Office visit copay may apply.	Not covered	Not covered	Not covered																																																			0	103.6866359	51.62083912	0	110	0.199863455	0.2	43.75	0	0	0.077682787	0	0.1	0	4.872185702	10	30	10	0	0	0.2	10	0	0	10	20	0	0	0	0											0	0.240847162	4.632657751	0	1.239122412	3.978058042	0.190568852	0.844263062	0	0	1.644940986	0	0.029244466	0	2.019568221	5.047163566	0.55824599	2.457978545	0	0	8.808849092	0	0	0	0.286793048	0.160459756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.1388			0	0.240847162	4.632657751	0	1.239122412	3.978058042	0.190568852	0.844263062	0	0	1.644940986	0	0.029244466	0	2.019568221	5.047163566	0.55824599	2.457978545	0	0	8.808849092	0	0	0	0.286793048	0.160459756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.1388																																																																																		0			0	0.240847162	4.632657751	0	1.239122412	3.978058042	0.190568852	0.844263062	0	0	1.644940986	0	0.029244466	0	2.019568221	5.047163566	0.55824599	2.457978545	0	0	8.808849092	0	0	0	0.286793048	0.160459756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.1388
H0504_021_0	2009	8																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	P	P	P	V	P	P	P	Coin	O	T	V	P	P	P	P	O	O																																																			0		1145.94282	27.87404489	1076.927341	1614.935264	135.1769904	19.90388082	0.952844339	231.5692971	192.5678638	1057.958297	21.17510254	0	1.595709479	1303.943618	4974.116369	6056.596279	223.2983959	2949.574253	4091.658743	9631.763784	44.04424546	0	0	3876.212689	344.1516575	96.2758534	0	0	0	0											$0.00 copay	$900 per stay	Days 1-20 is $0 and days 21-100 is $40	$0.00 Copay	"$60 Copay per trip (1-way), waived if admitted to hospital"	$0 copay for purchase or rental $0-$499; 20% of Medicare Allowable for purchase or rental $500 or more	$0.00 copay	$50 Copay - waived if admited to hospital	$0.00 Copay per visit	$0.00 Copay	$0 copay for simple x-ray and lab; 20% of Medicare Allowable for complex diagnostic radiology (up to $500 cost sharing cap per service); 20% of Medicare Allowable for therapeutic radiology	$0.00 Copay	$25.00 Copay + 20% coins for drugs	$0.00 Copay per visit	$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)	$5.00 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	103.6866359	21.73509015	0	60	0.086	0	37.5	0	0	0.077682787	0	25	0	0	0	30	0	0	0	0.2	0	0	5	10	15	0	0	0	0											0	0.240847162	1.950592737	0	0.675884952	1.711733751	0	0.723654053	0	0	1.644940986	0	0.003324395	0	0	0	0.55824599	0	0	0	8.808849092	0	0	1.61508862	0.286793048	0.120344817	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.3403			0	0.240847162	1.950592737	0	0.675884952	1.711733751	0	0.723654053	0	0	1.644940986	0	0.003324395	0	0	0	0.55824599	0	0	0	8.808849092	0	0	1.61508862	0.286793048	0.120344817	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.3403																																																																																		0			0	0.240847162	1.950592737	0	0.675884952	1.711733751	0	0.723654053	0	0	1.644940986	0	0.003324395	0	0	0	0.55824599	0	0	0	8.808849092	0	0	1.61508862	0.286793048	0.120344817	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.3403
H0504_801_0	2009	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											16.4861	0.1628	0	0	0.0642	0.1654	0.0104	0.1193	0.3579	0.155	0.1891	0	0.0034	0.2888	1.2878	4.8857	0.0832	0.2794	1.7375	0	0.9497	0	0	0	0	0	0	0	0	0											27.2258		299.7481198	2.959395614	52.52135085	43.08550488	7.807227829	20.12008795	1.267407115	14.50570478	43.53606777	18.85867977	22.99684903	0	0.410767857	35.13337293	39.75906947	150.8365931	2.570158644	8.624705419	53.64300615	0	29.32116082	0	0	0	0	0	0	0	0	0											"$1024 Deductible to days 1-60, $256 days 61-90 and $512 days 91+"	"$1024 Deductible to days 1-60, $256 days 61-90 and $512 days 91+"	$0 days 1-20 and $128/day for days 21-100	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.004234823	0.004234823	0.151045701	0	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.190602986	0.190602986	0.190602986	0.190602986	0.190602986	0.190602986	0.190602986	0.190602986	0	0	0	0	0	0	0	0											0.004234823	0.004234823	0.151045701	0	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.190602986	0.190602986	0.190602986	0.190602986	0.190602986	0.190602986	0.190602986	0.190602986	0	0	0	0	0	0	0	0											1.2694	0.012532515	7.933124257	0	1.828984837	4.713495826	0.296913123	3.398224653	10.19911415	4.417988062	5.387429328	0	0.096229827	8.230630355	7.578197373	28.74990509	0.489879913	1.643894609	10.22451717	0	5.588700813	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.0591			17.7555	0.175299274	7.933124257	0	1.893170267	4.878908765	0.307332836	3.517480159	10.55703649	4.573030608	5.576492935	0	0.099606866	8.519471762	8.866021895	33.63560956	0.573129178	1.923254948	11.96205227	0	6.538434055	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.285																																																																																		0			17.7555	0.175299274	7.933124257	0	1.893170267	4.878908765	0.307332836	3.517480159	10.55703649	4.573030608	5.576492935	0	0.099606866	8.519471762	8.866021895	33.63560956	0.573129178	1.923254948	11.96205227	0	6.538434055	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.285
H0504_803_0	2009	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											16.4861	0.1628	0	0	0.0642	0.1654	0.0104	0.1193	0.3579	0.155	0.1891	0	0.0034	0.2888	1.2878	4.8857	0.0832	0.2794	1.7375	0	0.9497	0	0	0	0	0	0	0	0	0											27.2258		299.7481198	2.959395614	52.52135085	43.08550488	7.807227829	20.12008795	1.267407115	14.50570478	43.53606777	18.85867977	22.99684903	0	0.410767857	35.13337293	39.75906947	150.8365931	2.570158644	8.624705419	53.64300615	0	29.32116082	0	0	0	0	0	0	0	0	0											"$1024 Deductible to days 1-60, $256 days 61-90 and $512 days 91+"	"$1024 Deductible to days 1-60, $256 days 61-90 and $512 days 91+"	$0 days 1-20 and $128/day for days 21-100	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.004234823	0.004234823	0.151045701	0	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.190602986	0.190602986	0.190602986	0.190602986	0.190602986	0.190602986	0.190602986	0.190602986	0	0	0	0	0	0	0	0											0.004234823	0.004234823	0.151045701	0	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.190602986	0.190602986	0.190602986	0.190602986	0.190602986	0.190602986	0.190602986	0.190602986	0	0	0	0	0	0	0	0											1.2694	0.012532515	7.933124257	0	1.828984837	4.713495826	0.296913123	3.398224653	10.19911415	4.417988062	5.387429328	0	0.096229827	8.230630355	7.578197373	28.74990509	0.489879913	1.643894609	10.22451717	0	5.588700813	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.0591			17.7555	0.175299274	7.933124257	0	1.893170267	4.878908765	0.307332836	3.517480159	10.55703649	4.573030608	5.576492935	0	0.099606866	8.519471762	8.866021895	33.63560956	0.573129178	1.923254948	11.96205227	0	6.538434055	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.285																																																																																		0			17.7555	0.175299274	7.933124257	0	1.893170267	4.878908765	0.307332836	3.517480159	10.55703649	4.573030608	5.576492935	0	0.099606866	8.519471762	8.866021895	33.63560956	0.573129178	1.923254948	11.96205227	0	6.538434055	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.285
H0504_804_0	2009	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											16.4861	0.1628	0	0	0.0642	0.1654	0.0104	0.1193	0.3579	0.155	0.1891	0	0.0034	0.2888	1.2878	4.8857	0.0832	0.2794	1.7375	0	0.9497	0	0	0	0	0	0	0	0	0											27.2258		299.7481198	2.959395614	52.52135085	43.08550488	7.807227829	20.12008795	1.267407115	14.50570478	43.53606777	18.85867977	22.99684903	0	0.410767857	35.13337293	39.75906947	150.8365931	2.570158644	8.624705419	53.64300615	0	29.32116082	0	0	0	0	0	0	0	0	0											"$1024 Deductible to days 1-60, $256 days 61-90 and $512 days 91+"	"$1024 Deductible to days 1-60, $256 days 61-90 and $512 days 91+"	$0 days 1-20 and $128/day for days 21-100	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	$135 Deductible and 20% Coins	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.004234823	0.004234823	0.151045701	0	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.190602986	0.190602986	0.190602986	0.190602986	0.190602986	0.190602986	0.190602986	0.190602986	0	0	0	0	0	0	0	0											0.004234823	0.004234823	0.151045701	0	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.234268152	0.190602986	0.190602986	0.190602986	0.190602986	0.190602986	0.190602986	0.190602986	0.190602986	0	0	0	0	0	0	0	0											1.2694	0.012532515	7.933124257	0	1.828984837	4.713495826	0.296913123	3.398224653	10.19911415	4.417988062	5.387429328	0	0.096229827	8.230630355	7.578197373	28.74990509	0.489879913	1.643894609	10.22451717	0	5.588700813	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.0591			17.7555	0.175299274	7.933124257	0	1.893170267	4.878908765	0.307332836	3.517480159	10.55703649	4.573030608	5.576492935	0	0.099606866	8.519471762	8.866021895	33.63560956	0.573129178	1.923254948	11.96205227	0	6.538434055	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.285																																																																																		0			17.7555	0.175299274	7.933124257	0	1.893170267	4.878908765	0.307332836	3.517480159	10.55703649	4.573030608	5.576492935	0	0.099606866	8.519471762	8.866021895	33.63560956	0.573129178	1.923254948	11.96205227	0	6.538434055	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.285
H0523_002_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1942.4498	0	1334.318816	1036.652771	270.5726515	8.049812533	0	252.5950127	389.2086552	1040.523826	4667.565342	0	67.51623878	793.60074	7264.865411	9291.354518	0	678.8069015	0	0	276.9433569	0	0	0	876.3166563	0	74.54373432	0	0	0											$75/day 1-5	$75/day 1-5	"$0/d 1-20, $20/d 21-100"	$0 per visit	$75 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$70 per procedure	$0 per visit	$0 X-ray; $140 Complex Radiology	$10 per visit	$10 per visit	$10 per visit	$5 PCP visit; $10 if no PCP selected	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$45 per script	0	Not Covered	0	$0 per visit	Not Covered	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											45.96290555	45.96290555	8.066267748	0	75	0.2	0.2	47.5	70	0	56	10	10	10	5	10	10	10	10	10	45	0	0	0	0	0	0	0	0	0											45.96290555	45.96290555	8.066267748	0	75	0.2	0.2	47.5	70	0	56	10	10	10	5	10	10	10	10	10	45	0	0	0	0	0	0	0	0	0											7.4401	0	0.896914403	0	1.691079072	1.609962507	0	0.999855259	2.270383822	0	21.78197159	0	0.056263532	0.66133395	3.027027254	7.742795431	0	0.565672418	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.7818	0	0	7.4401	0	0.896914403	0	1.691079072	1.609962507	0	0.999855259	2.270383822	0	21.78197159	0	0.056263532	0.66133395	3.027027254	7.742795431	0	0.565672418	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.7818																																																																					0	0	0											0			7.4401	0	0.896914403	0	1.691079072	1.609962507	0	0.999855259	2.270383822	0	21.78197159	0	0.056263532	0.66133395	3.027027254	7.742795431	0	0.565672418	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.7818
H0523_022_0	2009	7																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1942.4498	0	1334.318816	1036.652771	270.5726515	8.049812533	0	252.5950127	389.2086552	1040.523826	4667.565342	0	67.51623878	793.60074	7264.865411	9291.354518	0	678.8069015	0	0	276.9433569	0	0	0	876.3166563	0	74.54373432	0	0	0											$50/day 1-5	$50/day 1-5	"$0/d 1-20, $20/d 21-100"	$0 per visit	$75 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$50 per procedure	$0 per visit	$0 X-ray; $140 Complex Radiology	$10 per visit	$10 per visit	$10 per visit	$5 PCP visit; $10 if no PCP selected	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$45 per script	0	Not Covered	0	$0 per visit	Not Covered	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											30.64193704	30.64193704	8.066267748	0	75	0.2	0.2	47.5	50	0	56	10	10	10	5	10	10	10	10	10	45	0	0	0	0	0	0	0	0	0											30.64193704	30.64193704	8.066267748	0	75	0.2	0.2	47.5	50	0	56	10	10	10	5	10	10	10	10	10	45	0	0	0	0	0	0	0	0	0											4.96	0	0.896914403	0	1.691079072	1.609962507	0	0.999855259	1.62170273	0	21.78197159	0	0.056263532	0.66133395	3.027027254	7.742795431	0	0.565672418	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.6532	0	0	4.96	0	0.896914403	0	1.691079072	1.609962507	0	0.999855259	1.62170273	0	21.78197159	0	0.056263532	0.66133395	3.027027254	7.742795431	0	0.565672418	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.6532																																																																																		0			4.96	0	0.896914403	0	1.691079072	1.609962507	0	0.999855259	1.62170273	0	21.78197159	0	0.056263532	0.66133395	3.027027254	7.742795431	0	0.565672418	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.6532
H0523_031_0	2009	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1942.4498	0	1334.318816	1036.652771	270.5726515	8.049812533	0	252.5950127	389.2086552	1040.523826	4667.565342	0	67.51623878	793.60074	7264.865411	9291.354518	0	678.8069015	0	0	276.9433569	0	0	0	876.3166563	0	74.54373432	0	0	0											$75/day 1-5	$75/day 1-5	"$0/d 1-20, $50/d 21-100"	$0 per visit	$75 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$85 per procedure	$0 per visit	$0 X-ray; $140 Complex Radiology	$0 per visit	$0 per visit	$0 per visit	$0 PCP visit; $0 if no PCP selected	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$45 per script	0	Not Covered	0	$0 per visit	Not Covered	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											45.96290555	45.96290555	20.16566937	0	75	0.2	0.2	47.5	85	0	56	0	0	0	0	0	0	0	0	0	45	0	0	0	0	0	0	0	0	0											45.96290555	45.96290555	20.16566937	0	75	0.2	0.2	47.5	85	0	56	0	0	0	0	0	0	0	0	0	45	0	0	0	0	0	0	0	0	0											7.4401	0	2.242286006	0	1.691079072	1.609962507	0	0.999855259	2.756894641	0	21.78197159	0	0	0	0	0	0	0	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5606	0	0	7.4401	0	2.242286006	0	1.691079072	1.609962507	0	0.999855259	2.756894641	0	21.78197159	0	0	0	0	0	0	0	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5606																																																																																		0			7.4401	0	2.242286006	0	1.691079072	1.609962507	0	0.999855259	2.756894641	0	21.78197159	0	0	0	0	0	0	0	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5606
H0523_032_0	2009	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1942.4498	0	1334.318816	1036.652771	270.5726515	8.049812533	0	252.5950127	389.2086552	1040.523826	4667.565342	0	67.51623878	793.60074	7264.865411	9291.354518	0	678.8069015	0	0	276.9433569	0	0	0	876.3166563	0	74.54373432	0	0	0											$150/day 1-5	$150/day 1-5	"$0/d 1-20, $25/d 21-100"	$0 per visit	$50 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$75 per procedure	$0 per visit	$0 X-ray; $90 Complex Radiology	$15 per visit	$15 per visit	$15 per visit	$10 PCP visit; $15 if no PCP selected	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											91.92581111	91.92581111	10.08283469	0	50	0.2	0.2	47.5	75	0	36	15	15	15	10	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											91.92581111	91.92581111	10.08283469	0	50	0.2	0.2	47.5	75	0	36	15	15	15	10	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											14.8801	0	1.121143004	0	1.127386048	1.609962507	0	0.999855259	2.432554095	0	14.00269603	0	0.084395298	0.992000925	6.054054509	11.61419315	0	0.848508627	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.8054	0	0	14.8801	0	1.121143004	0	1.127386048	1.609962507	0	0.999855259	2.432554095	0	14.00269603	0	0.084395298	0.992000925	6.054054509	11.61419315	0	0.848508627	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.8054																																																																																		0			14.8801	0	1.121143004	0	1.127386048	1.609962507	0	0.999855259	2.432554095	0	14.00269603	0	0.084395298	0.992000925	6.054054509	11.61419315	0	0.848508627	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.8054
H0523_034_0	2009	4																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1942.4498	0	1334.318816	1036.652771	270.5726515	8.049812533	0	252.5950127	389.2086552	1040.523826	4667.565342	0	67.51623878	793.60074	7264.865411	9291.354518	0	678.8069015	0	0	276.9433569	0	0	0	876.3166563	0	74.54373432	0	0	0											$150/day 1-5	$150/day 1-5	"$0/d 1-20, $25/d 21-100"	$0 per visit	$50 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$75 per procedure	$0 per visit	$0 X-ray; $75 Complex Radiology	$15 per visit	$15 per visit	$15 per visit	$10 PCP visit; $15 if no PCP selected	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											91.92581111	91.92581111	10.08283469	0	50	0.2	0.2	47.5	75	0	30	15	15	15	10	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											91.92581111	91.92581111	10.08283469	0	50	0.2	0.2	47.5	75	0	30	15	15	15	10	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											14.8801	0	1.121143004	0	1.127386048	1.609962507	0	0.999855259	2.432554095	0	11.66891335	0	0.084395298	0.992000925	6.054054509	11.61419315	0	0.848508627	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.4716	0	0	14.8801	0	1.121143004	0	1.127386048	1.609962507	0	0.999855259	2.432554095	0	11.66891335	0	0.084395298	0.992000925	6.054054509	11.61419315	0	0.848508627	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.4716																																																																																		0			14.8801	0	1.121143004	0	1.127386048	1.609962507	0	0.999855259	2.432554095	0	11.66891335	0	0.084395298	0.992000925	6.054054509	11.61419315	0	0.848508627	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.4716
H0523_047_0	2009	7																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1942.4498	0	1334.318816	1036.652771	270.5726515	8.049812533	0	252.5950127	389.2086552	1040.523826	4667.565342	0	67.51623878	793.60074	7264.865411	9291.354518	0	678.8069015	0	0	276.9433569	0	0	0	876.3166563	0	74.54373432	0	0	0											$50/day 1-5	$50/day 1-5	"$0/d 1-20, $20/d 21-100"	$0 per visit	$75 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$50 per procedure	$0 per visit	$0 X-ray; $125 Complex Radiology	$10 per visit	$10 per visit	$10 per visit	$5 PCP visit; $10 if no PCP selected	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$45 per script	0	Not Covered	0	$0 per visit	Not Covered	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											30.64193704	30.64193704	8.066267748	0	75	0.2	0.2	47.5	50	0	50	10	10	10	5	10	10	10	10	10	45	0	0	0	0	0	0	0	0	0											30.64193704	30.64193704	8.066267748	0	75	0.2	0.2	47.5	50	0	50	10	10	10	5	10	10	10	10	10	45	0	0	0	0	0	0	0	0	0											4.96	0	0.896914403	0	1.691079072	1.609962507	0	0.999855259	1.62170273	0	19.44818892	0	0.056263532	0.66133395	3.027027254	7.742795431	0	0.565672418	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.3194	0	0	4.96	0	0.896914403	0	1.691079072	1.609962507	0	0.999855259	1.62170273	0	19.44818892	0	0.056263532	0.66133395	3.027027254	7.742795431	0	0.565672418	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.3194																																																																																		0			4.96	0	0.896914403	0	1.691079072	1.609962507	0	0.999855259	1.62170273	0	19.44818892	0	0.056263532	0.66133395	3.027027254	7.742795431	0	0.565672418	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.3194
H0523_048_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1942.4498	0	1334.318816	1036.652771	270.5726515	8.049812533	0	252.5950127	389.2086552	1040.523826	4667.565342	0	67.51623878	793.60074	7264.865411	9291.354518	0	678.8069015	0	0	276.9433569	0	0	0	876.3166563	0	74.54373432	0	0	0											$75/day 1-5	$75/day 1-5	"$0/d 1-20, $20/d 21-100"	$0 per visit	$75 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$70 per procedure	$0 per visit	$0 X-ray; $125 Complex Radiology	$10 per visit	$10 per visit	$10 per visit	$5 PCP visit; $10 if no PCP selected	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$45 per script	0	Not Covered	0	$0 per visit	$200 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											45.96290555	45.96290555	8.066267748	0	75	0.2	0.2	47.5	70	0	50	10	10	10	5	10	10	10	10	10	45	0	0	0	0	0	0	0	0	0											45.96290555	45.96290555	8.066267748	0	75	0.2	0.2	47.5	70	0	50	10	10	10	5	10	10	10	10	10	45	0	0	0	0	0	0	0	0	0											7.4401	0	0.896914403	0	1.691079072	1.609962507	0	0.999855259	2.270383822	0	19.44818892	0	0.056263532	0.66133395	3.027027254	7.742795431	0	0.565672418	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4481	0	0	7.4401	0	0.896914403	0	1.691079072	1.609962507	0	0.999855259	2.270383822	0	19.44818892	0	0.056263532	0.66133395	3.027027254	7.742795431	0	0.565672418	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4481																																																																																		0			7.4401	0	0.896914403	0	1.691079072	1.609962507	0	0.999855259	2.270383822	0	19.44818892	0	0.056263532	0.66133395	3.027027254	7.742795431	0	0.565672418	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4481
H0523_051_0	2009	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1942.4498	0	1334.318816	1036.652771	270.5726515	8.049812533	0	252.5950127	389.2086552	1040.523826	4667.565342	0	67.51623878	793.60074	7264.865411	9291.354518	0	678.8069015	0	0	276.9433569	0	0	0	876.3166563	0	74.54373432	0	0	0											$75/day 1-5	$75/day 1-5	"$0/d 1-20, $50/d 21-100"	$0 per visit	$75 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$85 per procedure	$0 per visit	$0 X-ray; $125 Complex Radiology	$0 per visit	$0 per visit	$0 per visit	$0 PCP visit; $0 if no PCP selected	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$45 per script	0	Not Covered	0	$0 per visit	Not Covered	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											45.96290555	45.96290555	20.16566937	0	75	0.2	0.2	47.5	85	0	50	0	0	0	0	0	0	0	0	0	45	0	0	0	0	0	0	0	0	0											45.96290555	45.96290555	20.16566937	0	75	0.2	0.2	47.5	85	0	50	0	0	0	0	0	0	0	0	0	45	0	0	0	0	0	0	0	0	0											7.4401	0	2.242286006	0	1.691079072	1.609962507	0	0.999855259	2.756894641	0	19.44818892	0	0	0	0	0	0	0	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.2269	0	0	7.4401	0	2.242286006	0	1.691079072	1.609962507	0	0.999855259	2.756894641	0	19.44818892	0	0	0	0	0	0	0	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.2269																																																																																		0			7.4401	0	2.242286006	0	1.691079072	1.609962507	0	0.999855259	2.756894641	0	19.44818892	0	0	0	0	0	0	0	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.2269
H0523_801_0	2009	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																																																			0		314.8319652	0	38.31184162	5.941334867	6.910792452	9.305775517	0	8.140867634	41.96549511	14.28014096	58.29941058	0	3.460399764	12.72702273	42.63481811	184.902481	0	5.491998341	0	0	8.335353281	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.062478981	0.062478981	0.165317857	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											19.6704	0	6.333631539	0	1.596393056	2.149634145	0	1.880540423	9.69402937	3.298712563	13.46716384	0	0.799352346	2.93994225	9.848642983	42.71247311	0	1.268651617	0	0	1.925466608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.585			19.6704	0	6.333631539	0	1.596393056	2.149634145	0	1.880540423	9.69402937	3.298712563	13.46716384	0	0.799352346	2.93994225	9.848642983	42.71247311	0	1.268651617	0	0	1.925466608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.585																																																																																		0			19.6704	0	6.333631539	0	1.596393056	2.149634145	0	1.880540423	9.69402937	3.298712563	13.46716384	0	0.799352346	2.93994225	9.848642983	42.71247311	0	1.268651617	0	0	1.925466608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.585
H0523_805_0	2009	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																																																			0		314.551868	0	38.27775665	5.936049027	6.904644113	9.297496429	0	8.133624931	41.92815958	14.26743632	58.24754322	0	3.457321143	12.71569985	42.5968871	184.7379784	0	5.487112264	0	0	8.32793755	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.062496127	0.062496127	0.16525284	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											19.6583	0	6.325507987	0	1.59497279	2.147721675	0	1.878867359	9.685404863	3.29577779	13.45518248	0	0.798641184	2.937326666	9.839880921	42.67447302	0	1.267522933	0	0	1.923753574	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.4833			19.6583	0	6.325507987	0	1.59497279	2.147721675	0	1.878867359	9.685404863	3.29577779	13.45518248	0	0.798641184	2.937326666	9.839880921	42.67447302	0	1.267522933	0	0	1.923753574	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.4833																																																																																		0			19.6583	0	6.325507987	0	1.59497279	2.147721675	0	1.878867359	9.685404863	3.29577779	13.45518248	0	0.798641184	2.937326666	9.839880921	42.67447302	0	1.267522933	0	0	1.923753574	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.4833
H0524_002_0	2009	6																					3350											D	D	D	V	T	Coin		V	P	V	V			V	V	V	V	V			S				V				V																																																				0		942.8248338	54.32806402	545.6710524	0	203.5356427	8.601111655		427.1803439	45.73714377	3273.292185	1207.141809			46.91721575	8560.729181	2.614038633	235.1392968	796.5035959			822.6577126				269.4824105				83.55513906												$125/days 1-10	$125/days 1-10	$100/days 21-100	0	$300/trip	twenty percent		"$50/ER visit,$10U/R OOA"	$050/procedure	$15/routine lab	"$15/x-ray, $50/MRI,PET, CAT Scans"			$05/visit	$05/visit	$05/visit	$05/visit	$05/visit			"$8/generic, $45/brand"				$05/visit				$05/visit												125	125	100	0	300	8.601111655		45.375	47.5	14.4	18.15			4.75	5	5	5	5			15.8172				5				4.75												97.375	97.375	17.4	0	263.7	0.2		39.884625	41.7525	12.6576	15.95385			4.17525	4.395	4.395	4.395	4.395			15.8172				4.395				4.17525												7.6506	0.440849603	0.791223026	0	4.472695749	1.720222331	0	1.419827319	0.159136675	3.452668597	1.604879946	0	0	0.016324259	3.135367062	0.000957392	0.086119767	0.291719442	0	0	1.084345131	0	0	0	0.098697933	0	0	0	0.029071966	0	0	0	0	0	0	0	0	0	0	0	26.4547	None	8.0844	7.6506	0.440849603	0.791223026	0	4.472695749	1.720222331	0	1.419827319	0.159136675	3.452668597	1.604879946	0	0	0.016324259	3.135367062	0.000957392	0.086119767	0.291719442	0	0	1.084345131	0	0	0	0.098697933	0	0	0	0.029071966	0	0	0	0	0	0	0	0	0	0	0	26.4547																																																																																		0			7.6506	0.440849603	0.791223026	0	4.472695749	1.720222331	0	1.419827319	0.159136675	3.452668597	1.604879946	0	0	0.016324259	3.135367062	0.000957392	0.086119767	0.291719442	0	0	1.084345131	0	0	0	0.098697933	0	0	0	0.029071966	0	0	0	0	0	0	0	0	0	0	0	26.4547
H0524_003_0	2009	7																					3350											D	D	D	V	T	Coin		V	P	V	V			V	V	V	V	V			S				V				V																																																				0		949.9409315	54.73811242	483.222317	0	205.4234358	8.214225494		484.5108366	58.01707962	3977.720242	1466.924472			57.01402388	10400.2338	3.175735663	285.665346	967.6539754			822.6577126				269.4824105				129.580003												$125/days 1-10	$125/days 1-10	$100/days 21-100	0	$300/trip	twenty percent		"$50/ER visit,$5U/R OOA"	$050/procedure	$15/routine lab	"$15/x-ray, $50/MRI,PET, CAT Scans"			$05/visit	$05/visit	$05/visit	$05/visit	$05/visit			"$5/generic, $35/brand"				$05/visit				$05/visit												125	125	100	0	300	8.214225494		45.375	47.5	14.4	18.15			4.75	5	5	4.85	5			11.368				5				4.75												97.375	97.375	17.4	0	263.7	0.2		39.884625	41.7525	12.6576	15.95385			4.17525	4.395	4.395	4.26315	4.395			11.368				4.395				4.17525												7.7084	0.444176975	0.70067236	0	4.514180003	1.642845099	0	1.610377752	0.201863176	4.195699311	1.950257749	0	0	0.019837317	3.809085631	0.001163113	0.101486185	0.354403268	0	0	0.779331073	0	0	0	0.098697933	0	0	0	0.045085742	0	0	0	0	0	0	0	0	0	0	0	28.1775	None	7.9657	7.7084	0.444176975	0.70067236	0	4.514180003	1.642845099	0	1.610377752	0.201863176	4.195699311	1.950257749	0	0	0.019837317	3.809085631	0.001163113	0.101486185	0.354403268	0	0	0.779331073	0	0	0	0.098697933	0	0	0	0.045085742	0	0	0	0	0	0	0	0	0	0	0	28.1775																																																																																		0			7.7084	0.444176975	0.70067236	0	4.514180003	1.642845099	0	1.610377752	0.201863176	4.195699311	1.950257749	0	0	0.019837317	3.809085631	0.001163113	0.101486185	0.354403268	0	0	0.779331073	0	0	0	0.098697933	0	0	0	0.045085742	0	0	0	0	0	0	0	0	0	0	0	28.1775
H0524_008_0	2009	9																					3350											D	D	D	V	T	Coin		V	P	V	V			V	V	V	V	V			S				V				V																																																				0		1238.453688	57.08647851	709.8494249	0	284.0319098	10.4721894		459.1786998	77.63101071	3452.851506	1217.148965			44.82744755	9293.588099	2.208761931	289.8639485	832.4993836			133.0538647				291.3317038				138.1685527												$225/days 1-7	$225/days 1-7	$100/days 21-100	0	$300/trip	twenty percent		"$50/ER visit, $25/UR OOA"	$175/procedure	$20/routine lab	"$20/x-ray, $50/MRI,PET, CAT Scans"			$25/visit	$25/visit	$25/visit	$25/visit	$25/visit			"$10/generic, $35/brand"				$25/visit				$25/visit												225	225	100	0	300	10.4721894		46.375	166.25	19.2	22.7			23.75	23.75	25	24.35	25			16.905				23.75				22.5625												150.3	150.3	13.1	0	257.1	0.2		39.743375	142.47625	16.4544	19.4539			20.35375	20.35375	21.425	20.86795	21.425			16.905				20.35375				19.3360625												15.5116	0.715008143	0.774918956	0	6.085383668	2.09443788	0	1.520775938	0.921714607	4.734549985	1.973191187	0	0	0.076033888	15.76328073	0.00394356	0.504072199	1.486358274	0	0	0.187439632	0	0	0	0.494141056	0	0	0	0.222636314	0	0	0	0	0	0	0	0	0	0	0	53.0695	none	15.9023	15.5116	0.715008143	0.774918956	0	6.085383668	2.09443788	0	1.520775938	0.921714607	4.734549985	1.973191187	0	0	0.076033888	15.76328073	0.00394356	0.504072199	1.486358274	0	0	0.187439632	0	0	0	0.494141056	0	0	0	0.222636314	0	0	0	0	0	0	0	0	0	0	0	53.0695																																																																																		0			15.5116	0.715008143	0.774918956	0	6.085383668	2.09443788	0	1.520775938	0.921714607	4.734549985	1.973191187	0	0	0.076033888	15.76328073	0.00394356	0.504072199	1.486358274	0	0	0.187439632	0	0	0	0.494141056	0	0	0	0.222636314	0	0	0	0	0	0	0	0	0	0	0	53.0695
H0524_010_0	2009	5																					3350											D	D	D	V	T	Coin		V	P	V	V			V	V	V	V	V			S				V				V																																																				0		1084.829154	50.00516109	717.1919282	0	251.9842088	7.97221343		527.8054747	99.85845108	3797.312597	1338.573376			49.29949377	8203.151389	1.949603136	255.853587	734.8204377			133.0538647				291.3317038				99.18927663												$225/days 1-7	$225/days 1-7	$100/days 21-100	0	$300/trip	twenty percent		"$50/ER visit, $25/UR OOA"	$175/procedure	$20/routine lab	"$20/x-ray, $50/MRI,PET, CAT Scans"			$25/visit	$25/visit	$25/visit	$25/visit	$25/visit			"$10/generic, $35/brand"				$25/visit				$25/visit												225	225	100	0	300	7.97221343		46.375	166.25	19.2	23.26			23.75	23.75	24.5	23.875	24.5			16.905				23.75				22.5625												150.3	150.3	13.1	0	257.1	0.2		39.743375	142.47625	16.4544	19.93382			20.35375	20.35375	20.9965	20.460875	20.9965			16.905				20.35375				19.3360625												13.5875	0.626314643	0.782934522	0	5.398761674	1.594442686	0	1.748064242	1.18562147	5.206875034	2.223573394	0	0	0.083619131	13.91374105	0.003411237	0.436249022	1.285721443	0	0	0.187439632	0	0	0	0.494141056	0	0	0	0.159827504	0	0	0	0	0	0	0	0	0	0	0	48.9182	none	14.6741	13.5875	0.626314643	0.782934522	0	5.398761674	1.594442686	0	1.748064242	1.18562147	5.206875034	2.223573394	0	0	0.083619131	13.91374105	0.003411237	0.436249022	1.285721443	0	0	0.187439632	0	0	0	0.494141056	0	0	0	0.159827504	0	0	0	0	0	0	0	0	0	0	0	48.9182																																																																																		0			13.5875	0.626314643	0.782934522	0	5.398761674	1.594442686	0	1.748064242	1.18562147	5.206875034	2.223573394	0	0	0.083619131	13.91374105	0.003411237	0.436249022	1.285721443	0	0	0.187439632	0	0	0	0.494141056	0	0	0	0.159827504	0	0	0	0	0	0	0	0	0	0	0	48.9182
H0524_013_0	2009	5																					3350											D	D	D	V	T	Coin		V	P	V	V			V	V	V	V	V			S				V				V																																																				0		1012.113663	46.65334313	724.5549441	0	261.4821457	9.663357035		616.9591175	114.0291523	3554.145912	1252.855795			46.14252573	8969.687434	2.131782033	279.7615935	803.4850674			133.0538647				291.3317038				128.7843345												$225/days 1-7	$225/days 1-7	$100/days 21-100	0	$300/trip	twenty percent		"$50/ER visit, $25/UR OOA"	$175/procedure	$20/routine lab	"$20/x-ray, $50/MRI,PET, CAT Scans"			$25/visit	$25/visit	$25/visit	$25/visit	$25/visit			"$10/generic, $35/brand"				$25/visit				$25/visit												225	225	100	0	300	9.663357035		46.375	166.25	19.2	22.7			23.75	23.75	24.5	23.875	24.5			16.905				23.75				22.5625												150.3	150.3	13.1	0	257.1	0.2		39.743375	142.47625	16.4544	19.4539			20.35375	20.35375	20.9965	20.460875	20.9965			16.905				20.35375				19.3360625												12.6767	0.584333123	0.790972481	0	5.602254971	1.932671407	0	2.043336464	1.353870501	4.873444874	2.031077612	0	0	0.078264453	15.21389797	0.003729997	0.477013916	1.405864518	0	0	0.187439632	0	0	0	0.494141056	0	0	0	0.207515162	0	0	0	0	0	0	0	0	0	0	0	49.9566	none	15.072	12.6767	0.584333123	0.790972481	0	5.602254971	1.932671407	0	2.043336464	1.353870501	4.873444874	2.031077612	0	0	0.078264453	15.21389797	0.003729997	0.477013916	1.405864518	0	0	0.187439632	0	0	0	0.494141056	0	0	0	0.207515162	0	0	0	0	0	0	0	0	0	0	0	49.9566																																																																																		0			12.6767	0.584333123	0.790972481	0	5.602254971	1.932671407	0	2.043336464	1.353870501	4.873444874	2.031077612	0	0	0.078264453	15.21389797	0.003729997	0.477013916	1.405864518	0	0	0.187439632	0	0	0	0.494141056	0	0	0	0.207515162	0	0	0	0	0	0	0	0	0	0	0	49.9566
H0524_015_0	2009	5																					3350											D	D	D	V	T	Coin		V	P	V	V			V	V	V	V	V			S				V				V																																																				0		967.4391233	55.74640458	502.5575768	0	220.9241333	8.930080618		475.9262688	66.55099419	4076.823483	1503.472284			58.43450451	9288.642064	2.836308531	255.1330286	864.2297461			822.6577126				269.4824105				109.4295489												$150/day 1-9	$150/day 1-9	$100/days 21-100	0	$300/trip	twenty percent		"$50/ER visit,$15U/R OOA"	$100/procedure	$20/routine lab	"$20/x-ray, $50/MRI,PET, CAT Scans"			$15/visit	$15/visit	$15/visit	$15/visit	$15/visit			"$10/generic, $45/brand"				$15/visit				$15/visit												150	150	100	0	300	8.930080618		45.875	95	19.2	22.7			14.25	15	15	14.6	15			17.346				15				14.25												112.35	112.35	16	0	267	0.2		40.82875	84.55	17.088	20.203			12.6825	13.35	13.35	12.994	13.35			17.346				13.35				12.6825												9.0576	0.521925713	0.670076769	0	4.915561967	1.786016124	0	1.619289554	0.468907213	5.80539664	2.531220879	0	0	0.061757967	10.3336143	0.003155393	0.276266548	0.961455592	0	0	1.189151723	0	0	0	0.299799182	0	0	0	0.115653355	0	0	0	0	0	0	0	0	0	0	0	40.6169	None	12.6349	9.0576	0.521925713	0.670076769	0	4.915561967	1.786016124	0	1.619289554	0.468907213	5.80539664	2.531220879	0	0	0.061757967	10.3336143	0.003155393	0.276266548	0.961455592	0	0	1.189151723	0	0	0	0.299799182	0	0	0	0.115653355	0	0	0	0	0	0	0	0	0	0	0	40.6169																																																																																		0			9.0576	0.521925713	0.670076769	0	4.915561967	1.786016124	0	1.619289554	0.468907213	5.80539664	2.531220879	0	0	0.061757967	10.3336143	0.003155393	0.276266548	0.961455592	0	0	1.189151723	0	0	0	0.299799182	0	0	0	0.115653355	0	0	0	0	0	0	0	0	0	0	0	40.6169
H0524_029_0	2009	5																					3350											D	D	D	V	T	Coin		V	P	V	V			V	V	V	V	V			S				V				V																																																				0		1779.615579	102.546163	837.6327193	0	484.7117378	22.93215944		923.4377139	65.53817074	4829.451825	1781.030499			69.22218379	11478.01089	3.504837412	315.2688694	1067.932037			822.6577126				269.4824105				138.3708941												0	0	0	0	0	0		0	0	0	0			0	0	0	0	0			0				0				0												0	0	0	0	0	0		0	0	0	0			0	0	0	0	0			0				0				0												0	0	0	0	0	0		0	0	0	0			0	0	0	0	0			0				0				0												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H0524_030_0	2009	5																					3350											D	D	D	V	T	Coin		V	P	V	V			V	V	V	V	V			S				V				V																																																				0		2236.74781	103.1028104	1612.933505	0	689.9848127	26.66852849		1148.224133	90.9588455	4815.374687	1697.445808			62.51672156	11889.25204	2.825660767	370.8218508	1065.013306			133.0538647				291.3317038				168.8436751												0	0	0	0	0	0		0	0	0	0			0	0	0	0	0			0				0				0												0	0	0	0	0	0		0	0	0	0			0	0	0	0	0			0				0				0												0	0	0	0	0	0		0	0	0	0			0	0	0	0	0			0				0				0												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H0524_031_0	2009	5																					3350											D	D	D	V	T	Coin		V	P	V	V			V	V	V	V	V			S				V				V																																																				0		1135.489339	52.34034052	433.3220563	0	223.3500324	9.162117127		652.4392032	75.51642058	4012.044245	1414.267451			52.08729731	8943.872973	2.125646836	278.956449	801.1726641			133.0538647				291.3317038				143.3268034												$225/days 1-7	$225/days 1-7	$100/days 21-100	0	$300/trip	twenty percent		"$50/ER visit, $25/UR OOA"	$175/procedure	$20/routine lab	"$20/x-ray, $50/MRI,PET, CAT Scans"			$25/visit	$25/visit	$25/visit	$25/visit	$25/visit			"$10/generic, $35/brand"				$25/visit				$25/visit												225	225	100	0	300	9.162117127		46.375	166.25	19.2	22.7			23.75	23.75	24.5	23.875	24.5			16.905				23.75				22.5625												150.3	150.3	13.1	0	257.1	0.2		39.743375	142.47625	16.4544	19.4539			20.35375	20.35375	20.9965	20.460875	20.9965			16.905				20.35375				19.3360625												14.222	0.655562765	0.473043245	0	4.785274444	1.832423425	0	2.16084466	0.896608035	5.501315068	2.292751464	0	0	0.088347652	15.17011288	0.003719262	0.475641086	1.401818487	0	0	0.187439632	0	0	0	0.494141056	0	0	0	0.230948002	0	0	0	0	0	0	0	0	0	0	0	50.872	none	13.4263	14.222	0.655562765	0.473043245	0	4.785274444	1.832423425	0	2.16084466	0.896608035	5.501315068	2.292751464	0	0	0.088347652	15.17011288	0.003719262	0.475641086	1.401818487	0	0	0.187439632	0	0	0	0.494141056	0	0	0	0.230948002	0	0	0	0	0	0	0	0	0	0	0	50.872																																																																																		0			14.222	0.655562765	0.473043245	0	4.785274444	1.832423425	0	2.16084466	0.896608035	5.501315068	2.292751464	0	0	0.088347652	15.17011288	0.003719262	0.475641086	1.401818487	0	0	0.187439632	0	0	0	0.494141056	0	0	0	0.230948002	0	0	0	0	0	0	0	0	0	0	0	50.872
H0524_032_0	2009	5																					3350											D	D	D	V	T	Coin		V	P	V	V			V	V	V	V	V			S				V				V																																																				0		1217.383976	56.11527089	726.0104256	0	264.0300855	9.339146573		572.8031138	115.2658935	3982.957638	1404.014264			51.70967367	8966.833151	2.13110367	279.6725694	803.2293868			133.0538647				291.3317038				130.4694881												$225/days 1-7	$225/days 1-7	$100/days 21-100	0	$300/trip	twenty percent		"$50/ER visit, $25/UR OOA"	$175/procedure	$20/routine lab	"$20/x-ray, $50/MRI,PET, CAT Scans"			$25/visit	$25/visit	$25/visit	$25/visit	$25/visit			"$10/generic, $35/brand"				$25/visit				$25/visit												225	225	100	0	300	9.339146573		46.375	166.25	19.2	22.7			23.75	23.75	25	24.35	25			16.905				23.75				22.5625												150.3	150.3	13.1	0	257.1	0.2		39.743375	142.47625	16.4544	19.4539			20.35375	20.35375	21.425	20.86795	21.425			16.905				20.35375				19.3360625												15.2477	0.702843768	0.792561381	0	5.656844582	1.867829315	0	1.897094079	1.368554355	5.461431513	2.276129424	0	0	0.087707148	15.20905669	0.003804908	0.486349433	1.434099134	0	0	0.187439632	0	0	0	0.494141056	0	0	0	0.210230515	0	0	0	0	0	0	0	0	0	0	0	53.3839	none	16.0655	15.2477	0.702843768	0.792561381	0	5.656844582	1.867829315	0	1.897094079	1.368554355	5.461431513	2.276129424	0	0	0.087707148	15.20905669	0.003804908	0.486349433	1.434099134	0	0	0.187439632	0	0	0	0.494141056	0	0	0	0.210230515	0	0	0	0	0	0	0	0	0	0	0	53.3839																																																																																		0			15.2477	0.702843768	0.792561381	0	5.656844582	1.867829315	0	1.897094079	1.368554355	5.461431513	2.276129424	0	0	0.087707148	15.20905669	0.003804908	0.486349433	1.434099134	0	0	0.187439632	0	0	0	0.494141056	0	0	0	0.210230515	0	0	0	0	0	0	0	0	0	0	0	53.3839
H0524_033_0	2009	5																					3350											D	D	D	V	T	Coin		V	P	V	V			V	V	V	V	V			S				V				V																																																				0		1226.118054	56.51786789	859.345226	0	302.2950285	9.964938697		487.9062335	65.25823145	4007.604047	1412.702257			52.02965141	9228.356202	2.193258582	287.8293871	826.6560522			133.0538647				291.3317038				140.6147832												$225/days 1-7	$225/days 1-7	$100/days 21-100	0	$300/trip	twenty percent		"$50/ER visit, $25/UR OOA"	$175/procedure	$20/routine lab	"$20/x-ray, $50/MRI,PET, CAT Scans"			$25/visit	$25/visit	$25/visit	$25/visit	$25/visit			"$10/generic, $35/brand"				$25/visit				$25/visit												225	225	100	0	300	9.964938697		46.375	166.25	19.2	22.7			23.75	23.75	25	24.35	25			16.905				23.75				22.5625												150.3	150.3	13.1	0	257.1	0.2		39.743375	142.47625	16.4544	19.4539			20.35375	20.35375	21.425	20.86795	21.425			16.905				20.35375				19.3360625												15.3571	0.707886295	0.938118538	0	6.476670985	1.992987739	0	1.615920034	0.774812342	5.495226669	2.290214037	0	0	0.088249876	15.65263792	0.00391588	0.500534105	1.475925493	0	0	0.187439632	0	0	0	0.494141056	0	0	0	0.22657802	0	0	0	0	0	0	0	0	0	0	0	54.2784	none	17.1522	15.3571	0.707886295	0.938118538	0	6.476670985	1.992987739	0	1.615920034	0.774812342	5.495226669	2.290214037	0	0	0.088249876	15.65263792	0.00391588	0.500534105	1.475925493	0	0	0.187439632	0	0	0	0.494141056	0	0	0	0.22657802	0	0	0	0	0	0	0	0	0	0	0	54.2784																																																																																		0			15.3571	0.707886295	0.938118538	0	6.476670985	1.992987739	0	1.615920034	0.774812342	5.495226669	2.290214037	0	0	0.088249876	15.65263792	0.00391588	0.500534105	1.475925493	0	0	0.187439632	0	0	0	0.494141056	0	0	0	0.22657802	0	0	0	0	0	0	0	0	0	0	0	54.2784
H0524_034_0	2009	6																					3350											D	D	D	V	T	Coin		V	P	V	V			V	V	V	V	V			S				V				V																																																				0		1047.992501	60.38810356	447.8777884	0	281.8541255	7.698418046		615.9928347	30.44249365	3932.319319	1450.181282			56.36327693	11076.42212	3.382211342	304.2383485	1030.567591			822.6577126				269.4824105				76.09417885												$125/days 1-10	$125/days 1-10	$100/days 21-100	0	$300/trip	twenty percent		"$50/ER visit,$10U/R OOA"	$050/procedure	$15/routine lab	"$15/x-ray, $50/MRI,PET, CAT Scans"			$10/visit	$10/visit	$10/visit	$10/visit	$10/visit			"$5/generic, $35/brand"				$10/visit				$10/visit												125	125	100	0	300	7.698418046		45.625	47.5	14.4	18.15			9.5	10	10	9.75	10			11.368				10				9.5												97.375	97.375	17.4	0	269.1	0.2		40.925625	42.6075	12.9168	16.28055			8.5215	8.97	8.97	8.74575	8.97			11.368				8.97				8.5215												8.504	0.490024299	0.649422793	0	6.320578764	1.539683609	0	2.100824313	0.108089879	4.232748515	1.967479073	0	0	0.040024972	8.279625534	0.002528203	0.221732711	0.770349274	0	0	0.779331073	0	0	0	0.201438102	0	0	0	0.054036379	0	0	0	0	0	0	0	0	0	0	0	36.2619	None	8.4247	8.504	0.490024299	0.649422793	0	6.320578764	1.539683609	0	2.100824313	0.108089879	4.232748515	1.967479073	0	0	0.040024972	8.279625534	0.002528203	0.221732711	0.770349274	0	0	0.779331073	0	0	0	0.201438102	0	0	0	0.054036379	0	0	0	0	0	0	0	0	0	0	0	36.2619																																																																																		0			8.504	0.490024299	0.649422793	0	6.320578764	1.539683609	0	2.100824313	0.108089879	4.232748515	1.967479073	0	0	0.040024972	8.279625534	0.002528203	0.221732711	0.770349274	0	0	0.779331073	0	0	0	0.201438102	0	0	0	0.054036379	0	0	0	0	0	0	0	0	0	0	0	36.2619
H0524_035_0	2009	5																					3350											D	D	D	V	T	Coin		V	P	V	V			V	V	V	V	V			S				V				V																																																				0		976.419051	56.26385179	573.2293443	0	248.7916216	9.965436705		298.3818434	5.375368945	2859.198154	1054.430047			40.98186446	8980.474426	2.742208823	246.6685251	835.5573483			822.6577126				269.4824105				116.6210726												$200/days 1-9	$200/days 1-9	$100/days 21-100	0	$300/trip	twenty percent		"$50/ER visit,$15U/R OOA"	$100/procedure	$20/routine lab	"$20/x-ray, $50/MRI,PET, CAT Scans"			$15/visit	$15/visit	$15/visit	$15/visit	$15/visit			"$10/generic, $45/brand"				$15/visit				$15/visit												200	200	100	0	300	9.965436705		45.875	95	19.2	22.7			14.25	15	15	14.6	15			17.346				15				14.25												144	144	13	0	258.9	0.2		39.590125	81.985	16.5696	19.5901			12.29775	12.945	12.945	12.5998	12.945			17.346				12.945				12.29775												11.717	0.675166222	0.620998456	0	5.367679235	1.993087341	0	0.98441454	0.036724969	3.947980811	1.721365839	0	0	0.041998727	9.687686787	0.002958158	0.25899784	0.901357489	0	0	1.189151723	0	0	0	0.29070415	0	0	0	0.119514733	0	0	0	0	0	0	0	0	0	0	0	39.5568	None	12.6837	11.717	0.675166222	0.620998456	0	5.367679235	1.993087341	0	0.98441454	0.036724969	3.947980811	1.721365839	0	0	0.041998727	9.687686787	0.002958158	0.25899784	0.901357489	0	0	1.189151723	0	0	0	0.29070415	0	0	0	0.119514733	0	0	0	0	0	0	0	0	0	0	0	39.5568																																																																																		0			11.717	0.675166222	0.620998456	0	5.367679235	1.993087341	0	0.98441454	0.036724969	3.947980811	1.721365839	0	0	0.041998727	9.687686787	0.002958158	0.25899784	0.901357489	0	0	1.189151723	0	0	0	0.29070415	0	0	0	0.119514733	0	0	0	0	0	0	0	0	0	0	0	39.5568
H0524_801_0	2009	6																					2000											D	D	D	V	T	Coin		V	P	V	V			V	V	V	V	V			S				V				V																																																				0		1045.589781	60.24965246	588.0226593	0	260.144986	13.20746917		491.0884666	62.37739185	4439.65562	1637.279416			63.63510156	10158.33843	3.101872344	279.0211562	945.147652			792.6346161				269.4824105				179.8156708												$500/admit	$500/admit	$125/days 21-100	0	$200/trip	twenty percent		"$50/ER visit, $25/UR OOA"	$250/procedure	$00/routine lab	"$00/x-ray, $00/MRI,PET, CAT Scans"			$25/visit	$25/visit	$25/visit	$25/visit	$25/visit			"$11/generic, $50/brand"				$25/visit				$25/visit												500	500	125	0	200	13.20746917		47.125	237.5	0	0			23.75	25	25	24.35	25			21.4816				25				23.75												90.5	90.5	11.8	0	165.2	0.2		38.92525	196.175	0	0			19.6175	20.65	20.65	20.1131	20.65			21.4816				20.65				19.6175												7.8855	0.454382796	0.578222282	0	3.581329307	2.641493833	0	1.592978445	1.019740404	0	0	0	0	0.104030134	17.48080737	0.005337805	0.467665035	1.626441584	0	0	1.418921647	0	0	0	0.463734315	0	0	0	0.29396116	0	0	0	0	0	0	0	0	0	0	0	39.6145	None	13.7066	7.8855	0.454382796	0.578222282	0	3.581329307	2.641493833	0	1.592978445	1.019740404	0	0	0	0	0.104030134	17.48080737	0.005337805	0.467665035	1.626441584	0	0	1.418921647	0	0	0	0.463734315	0	0	0	0.29396116	0	0	0	0	0	0	0	0	0	0	0	39.6145																																																																																		0			7.8855	0.454382796	0.578222282	0	3.581329307	2.641493833	0	1.592978445	1.019740404	0	0	0	0	0.104030134	17.48080737	0.005337805	0.467665035	1.626441584	0	0	1.418921647	0	0	0	0.463734315	0	0	0	0.29396116	0	0	0	0	0	0	0	0	0	0	0	39.6145
H0524_802_0	2009	6																					3350											D	D	D	V	T	Coin		V	P	V	V			V	V	V	V	V			S				V				V																																																				0		1248.097043	57.53098859	748.3954719	0	291.3609418	14.71324582		581.231678	91.97471268	4315.587069	1521.26795			56.0281126	9948.513794	2.364414939	310.290865	891.1662011			132.1260465				291.3317038				201.0766711												$500/admit	$500/admit	$125/days 21-100	0	$200/trip	twenty percent		"$50/ER visit, $25/UR OOA"	$250/procedure	$00/routine lab	"$00/x-ray, $00/MRI,PET, CAT Scans"			$25/visit	$25/visit	$25/visit	$25/visit	$25/visit			"$11/generic, $50/brand"				$25/visit				$25/visit												500	500	125	0	200	14.71324582		46.375	237.5	0	0			23.75	23.75	25	24.35	25			22.6282				23.75				22.5625												92.5	92.5	26.125	0	185	0.2		42.896875	219.6875	0	0			21.96875	21.96875	23.125	22.52375	23.125			22.6282				21.96875				20.8703125												9.6207	0.443468037	1.629319309	0	4.491814519	2.942649164	0	2.077751886	1.683807891	0	0	0	0	0.1025723	18.21303437	0.004556425	0.582409489	1.717351533	0	0	0.249147884	0	0	0	0.533349447	0	0	0	0.34971108	0	0	0	0	0	0	0	0	0	0	0	44.6417	none	10.9128	9.6207	0.443468037	1.629319309	0	4.491814519	2.942649164	0	2.077751886	1.683807891	0	0	0	0	0.1025723	18.21303437	0.004556425	0.582409489	1.717351533	0	0	0.249147884	0	0	0	0.533349447	0	0	0	0.34971108	0	0	0	0	0	0	0	0	0	0	0	44.6417																																																																																		0			9.6207	0.443468037	1.629319309	0	4.491814519	2.942649164	0	2.077751886	1.683807891	0	0	0	0	0.1025723	18.21303437	0.004556425	0.582409489	1.717351533	0	0	0.249147884	0	0	0	0.533349447	0	0	0	0.34971108	0	0	0	0	0	0	0	0	0	0	0	44.6417
H0524_803_0	2009	6																					2000											D	D	D	V	T	Coin		V	P	V	V			V	V	V	V	V			S				V				V																																																				0		868.0772479	50.02091015	514.6725774	0	244.0203184	13.1300297		464.9240734	64.07216945	3930.502229	1449.511166			56.33723195	9068.5028	2.769088493	249.0864185	843.7476455			792.6346161				269.4824105				151.9801306												$500/admit	$500/admit	$125/days 21-100	0	$200/trip	twenty percent		"$50/ER visit, $25/UR OOA"	$250/procedure	$00/routine lab	"$00/x-ray, $00/MRI,PET, CAT Scans"			$25/visit	$25/visit	$25/visit	$25/visit	$25/visit			"$11/generic, $50/brand"				$25/visit				$25/visit												500	500	125	0	200	13.1300297		47.125	237.5	0	0			23.75	25	25	24.35	25			21.4816				25				23.75												92.5	92.5	26.125	0	185	0.2		43.590625	219.6875	0	0			21.96875	23.125	23.125	22.52375	23.125			21.4816				23.125				21.96875												6.6914	0.385577849	1.12048509	0	3.761979909	2.626005941	0	1.688860911	1.172987894	0	0	0	0	0.103138214	17.4757606	0.005336264	0.467530018	1.625972025	0	0	1.418921647	0	0	0	0.519315062	0	0	0	0.278234458	0	0	0	0	0	0	0	0	0	0	0	39.3415	None	37.615	6.6914	0.385577849	1.12048509	0	3.761979909	2.626005941	0	1.688860911	1.172987894	0	0	0	0	0.103138214	17.4757606	0.005336264	0.467530018	1.625972025	0	0	1.418921647	0	0	0	0.519315062	0	0	0	0.278234458	0	0	0	0	0	0	0	0	0	0	0	39.3415																																																																																		0			6.6914	0.385577849	1.12048509	0	3.761979909	2.626005941	0	1.688860911	1.172987894	0	0	0	0	0.103138214	17.4757606	0.005336264	0.467530018	1.625972025	0	0	1.418921647	0	0	0	0.519315062	0	0	0	0.278234458	0	0	0	0	0	0	0	0	0	0	0	39.3415
H0524_804_0	2009	6																					3350											D	D	D	V	T	Coin		V	P	V	V			V	V	V	V	V			S				V				V																																																				0		1207.536407	55.66134754	950.823457	0	304.3311897	14.24341228		573.5205601	78.6162722	4087.528587	1440.876093			53.06729034	9270.326237	2.203233397	289.1384187	830.4156366			132.1260465				291.3317038				185.1909642												$500/admit	$500/admit	$125/days 21-100	0	$200/trip	twenty percent		"$50/ER visit, $25/UR OOA"	$250/procedure	$00/routine lab	"$00/x-ray, $00/MRI,PET, CAT Scans"			$25/visit	$25/visit	$25/visit	$25/visit	$25/visit			"$11/generic, $50/brand"				$25/visit				$25/visit												500	500	125	0	200	14.24341228		46.375	237.5	0	0			23.75	23.75	25	24.35	25			22.6282				23.75				22.5625												92.5	92.5	26.125	0	185	0.2		42.896875	219.6875	0	0			21.96875	21.96875	23.125	22.52375	23.125			22.6282				21.96875				20.8703125												9.3081	0.429056221	2.070021901	0	4.691772508	2.848682456	0	2.050186648	1.439251025	0	0	0	0	0.097151836	16.97145663	0.004245814	0.542706788	1.600280133	0	0	0.249147884	0	0	0	0.533349447	0	0	0	0.322082775	0	0	0	0	0	0	0	0	0	0	0	43.1575	none	12.383	9.3081	0.429056221	2.070021901	0	4.691772508	2.848682456	0	2.050186648	1.439251025	0	0	0	0	0.097151836	16.97145663	0.004245814	0.542706788	1.600280133	0	0	0.249147884	0	0	0	0.533349447	0	0	0	0.322082775	0	0	0	0	0	0	0	0	0	0	0	43.1575																																																																																		0			9.3081	0.429056221	2.070021901	0	4.691772508	2.848682456	0	2.050186648	1.439251025	0	0	0	0	0.097151836	16.97145663	0.004245814	0.542706788	1.600280133	0	0	0.249147884	0	0	0	0.533349447	0	0	0	0.322082775	0	0	0	0	0	0	0	0	0	0	0	43.1575
H0524_805_0	2009	6																					2000											D	D	D	V	T	Coin		V	P	V	V			V	V	V	V	V			S				V				V																																																				0		1045.589781	60.24965246	588.0226593	0	260.144986	13.20746917		491.0884666	62.37739185	4439.65562	1637.279416			63.63510156	10158.33843	3.101872344	279.0211562	945.147652			792.6346161				269.4824105				179.8156708												$500/admit	$500/admit	$125/days 21-100	0	$200/trip	twenty percent		"$50/ER visit, $25/UR OOA"	$250/procedure	$00/routine lab	"$00/x-ray, $00/MRI,PET, CAT Scans"			$25/visit	$25/visit	$25/visit	$25/visit	$25/visit			"$11/generic, $50/brand"				$25/visit				$25/visit												500	500	125	0	200	13.20746917		47.125	237.5	0	0			23.75	25	25	24.35	25			21.4816				25				23.75												90.5	90.5	11.8	0	165.2	0.2		38.92525	196.175	0	0			19.6175	20.65	20.65	20.1131	20.65			21.4816				20.65				19.6175												7.8855	0.454382796	0.578222282	0	3.581329307	2.641493833	0	1.592978445	1.019740404	0	0	0	0	0.104030134	17.48080737	0.005337805	0.467665035	1.626441584	0	0	1.418921647	0	0	0	0.463734315	0	0	0	0.29396116	0	0	0	0	0	0	0	0	0	0	0	39.6145	None	13.7066	7.8855	0.454382796	0.578222282	0	3.581329307	2.641493833	0	1.592978445	1.019740404	0	0	0	0	0.104030134	17.48080737	0.005337805	0.467665035	1.626441584	0	0	1.418921647	0	0	0	0.463734315	0	0	0	0.29396116	0	0	0	0	0	0	0	0	0	0	0	39.6145																																																																																		0			7.8855	0.454382796	0.578222282	0	3.581329307	2.641493833	0	1.592978445	1.019740404	0	0	0	0	0.104030134	17.48080737	0.005337805	0.467665035	1.626441584	0	0	1.418921647	0	0	0	0.463734315	0	0	0	0.29396116	0	0	0	0	0	0	0	0	0	0	0	39.6145
H0524_806_0	2009	6																					3350											D	D	D	V	T	Coin		V	P	V	V			V	V	V	V	V			S				V				V																																																				0		1248.097043	57.53098859	748.3954719	0	291.3609418	14.71324582		581.231678	91.97471268	4315.587069	1521.26795			56.0281126	9948.513794	2.364414939	310.290865	891.1662011			132.1260465				291.3317038				201.0766711												$500/admit	$500/admit	$125/days 21-100	0	$200/trip	twenty percent		"$50/ER visit, $25/UR OOA"	$250/procedure	$00/routine lab	"$00/x-ray, $00/MRI,PET, CAT Scans"			$25/visit	$25/visit	$25/visit	$25/visit	$25/visit			"$11/generic, $50/brand"				$25/visit				$25/visit												500	500	125	0	200	14.71324582		46.375	237.5	0	0			23.75	23.75	25	24.35	25			22.6282				23.75				22.5625												92.5	92.5	26.125	0	185	0.2		42.896875	219.6875	0	0			21.96875	21.96875	23.125	22.52375	23.125			22.6282				21.96875				20.8703125												9.6207	0.443468037	1.629319309	0	4.491814519	2.942649164	0	2.077751886	1.683807891	0	0	0	0	0.1025723	18.21303437	0.004556425	0.582409489	1.717351533	0	0	0.249147884	0	0	0	0.533349447	0	0	0	0.34971108	0	0	0	0	0	0	0	0	0	0	0	44.6417	none	10.9128	9.6207	0.443468037	1.629319309	0	4.491814519	2.942649164	0	2.077751886	1.683807891	0	0	0	0	0.1025723	18.21303437	0.004556425	0.582409489	1.717351533	0	0	0.249147884	0	0	0	0.533349447	0	0	0	0.34971108	0	0	0	0	0	0	0	0	0	0	0	44.6417																																																																																		0			9.6207	0.443468037	1.629319309	0	4.491814519	2.942649164	0	2.077751886	1.683807891	0	0	0	0	0.1025723	18.21303437	0.004556425	0.582409489	1.717351533	0	0	0.249147884	0	0	0	0.533349447	0	0	0	0.34971108	0	0	0	0	0	0	0	0	0	0	0	44.6417
H0524_807_0	2009	6																					2000											D	D	D	V	T	Coin		V	P	V	V			V	V	V	V	V			S				V				V																																																				0		868.0772479	50.02091015	514.6725774	0	244.0203184	13.1300297		464.9240734	64.07216945	3930.502229	1449.511166			56.33723195	9068.5028	2.769088493	249.0864185	843.7476455			792.6346161				269.4824105				151.9801306												$500/admit	$500/admit	$125/days 21-100	0	$200/trip	twenty percent		"$50/ER visit, $25/UR OOA"	$250/procedure	$00/routine lab	"$00/x-ray, $00/MRI,PET, CAT Scans"			$25/visit	$25/visit	$25/visit	$25/visit	$25/visit			"$11/generic, $50/brand"				$25/visit				$25/visit												500	500	125	0	200	13.1300297		47.125	237.5	0	0			23.75	25	25	24.35	25			21.4816				25				23.75												90.5	90.5	11.8	0	165.2	0.2		38.92525	196.175	0	0			19.6175	20.65	20.65	20.1131	20.65			21.4816				20.65				19.6175												6.5467	0.377241031	0.506094701	0	3.359346384	2.626005941	0	1.508107149	1.047446487	0	0	0	0	0.092099637	15.6053819	0.00476514	0.41749167	1.451949073	0	0	1.418921647	0	0	0	0.463734315	0	0	0	0.248455851	0	0	0	0	0	0	0	0	0	0	0	35.6738	None	37.615	6.5467	0.377241031	0.506094701	0	3.359346384	2.626005941	0	1.508107149	1.047446487	0	0	0	0	0.092099637	15.6053819	0.00476514	0.41749167	1.451949073	0	0	1.418921647	0	0	0	0.463734315	0	0	0	0.248455851	0	0	0	0	0	0	0	0	0	0	0	35.6738																																																																																		0			6.5467	0.377241031	0.506094701	0	3.359346384	2.626005941	0	1.508107149	1.047446487	0	0	0	0	0.092099637	15.6053819	0.00476514	0.41749167	1.451949073	0	0	1.418921647	0	0	0	0.463734315	0	0	0	0.248455851	0	0	0	0	0	0	0	0	0	0	0	35.6738
H0524_808_0	2009	6																					3350											D	D	D	V	T	Coin		V	P	V	V			V	V	V	V	V			S				V				V																																																				0		1207.536407	55.66134754	950.823457	0	304.3311897	14.24341228		573.5205601	78.6162722	4087.528587	1440.876093			53.06729034	9270.326237	2.203233397	289.1384187	830.4156366			132.1260465				291.3317038				185.1909642												$500/admit	$500/admit	$125/days 21-100	0	$200/trip	twenty percent		"$50/ER visit, $25/UR OOA"	$250/procedure	$00/routine lab	"$00/x-ray, $00/MRI,PET, CAT Scans"			$25/visit	$25/visit	$25/visit	$25/visit	$25/visit			"$11/generic, $50/brand"				$25/visit				$25/visit												500	500	125	0	200	14.24341228		46.375	237.5	0	0			23.75	23.75	25	24.35	25			22.6282				23.75				22.5625												92.5	92.5	26.125	0	185	0.2		42.896875	219.6875	0	0			21.96875	21.96875	23.125	22.52375	23.125			22.6282				21.96875				20.8703125												9.3081	0.429056221	2.070021901	0	4.691772508	2.848682456	0	2.050186648	1.439251025	0	0	0	0	0.097151836	16.97145663	0.004245814	0.542706788	1.600280133	0	0	0.249147884	0	0	0	0.533349447	0	0	0	0.322082775	0	0	0	0	0	0	0	0	0	0	0	43.1575	none	12.383	9.3081	0.429056221	2.070021901	0	4.691772508	2.848682456	0	2.050186648	1.439251025	0	0	0	0	0.097151836	16.97145663	0.004245814	0.542706788	1.600280133	0	0	0.249147884	0	0	0	0.533349447	0	0	0	0.322082775	0	0	0	0	0	0	0	0	0	0	0	43.1575																																																																																		0			9.3081	0.429056221	2.070021901	0	4.691772508	2.848682456	0	2.050186648	1.439251025	0	0	0	0	0.097151836	16.97145663	0.004245814	0.542706788	1.600280133	0	0	0.249147884	0	0	0	0.533349447	0	0	0	0.322082775	0	0	0	0	0	0	0	0	0	0	0	43.1575
H0524_809_0	2009	6																					2000											D	D	D	V	T	Coin		V	P	V	V			V	V	V	V	V			S				V				V																																																				0		1050.870537	60.55394363	588.0226593	0	260.144986	13.20746917		491.0884666	64.15039265	4284.267674	1579.974637			61.407873	10475.87052	3.19883151	287.7428751	974.6913334			792.6346161				269.4824105				179.8156708												$250/admit	$250/admit	0	0	$125/trip	twenty percent		"$50/ER visit, $50/UR OOA"	$050/procedure	$10/routine lab	"$10/x-ray, $50/MRI,PET, CAT Scans"			$15/visit	$15/visit	$15/visit	$15/visit	$15/visit			"$10/generic, $30/brand"				$15/visit				$15/visit												250	250	0	0	125	13.20746917		47.625	47.5	9.6	13.6			14.25	14.25	15	14.6	15			15.288				14.25				13.5375												46.25	46.25	0	0	116.75	0.2		44.48175	44.365	8.9664	12.7024			13.3095	13.3095	14.01	13.6364	14.01			15.288				13.3095				12.644025												4.0502	0.233384991	0	0	2.530993926	2.641493833	0	1.820372867	0.237169347	3.201204806	1.672455819	0	0	0.068109007	11.61904989	0.003734636	0.326981412	1.137952132	0	0	1.009816501	0	0	0	0.298889679	0	0	0	0.189466153	0	0	0	0	0	0	0	0	0	0	0	31.0413	None	2.8209	4.0502	0.233384991	0	0	2.530993926	2.641493833	0	1.820372867	0.237169347	3.201204806	1.672455819	0	0	0.068109007	11.61904989	0.003734636	0.326981412	1.137952132	0	0	1.009816501	0	0	0	0.298889679	0	0	0	0.189466153	0	0	0	0	0	0	0	0	0	0	0	31.0413																																																																																		0			4.0502	0.233384991	0	0	2.530993926	2.641493833	0	1.820372867	0.237169347	3.201204806	1.672455819	0	0	0.068109007	11.61904989	0.003734636	0.326981412	1.137952132	0	0	1.009816501	0	0	0	0.298889679	0	0	0	0.189466153	0	0	0	0	0	0	0	0	0	0	0	31.0413
H0524_810_0	2009	6																					3350											D	D	D	V	T	Coin		V	P	V	V			V	V	V	V	V			S				V				V																																																				0		1254.400563	57.82154914	748.3954719	0	291.3609418	14.71324582		581.231678	94.93011537	4164.541522	1468.023572			54.06712866	10259.48713	2.438322462	319.9900209	919.0225157			132.1260465				291.3317038				201.0766711												$250/admit	$250/admit	0	0	$125/trip	twenty percent		"$50/ER visit, $50/UR OOA"	$050/procedure	$10/routine lab	"$10/x-ray, $50/MRI,PET, CAT Scans"			$15/visit	$15/visit	$15/visit	$15/visit	$15/visit			"$10/generic, $30/brand"				$15/visit				$15/visit												250	250	0	0	125	14.71324582		47.5	47.5	9.6	13.6			14.25	14.25	15	14.85	15			15.876				14.25				13.5375												46.5	46.5	0	0	122.875	0.2		46.6925	46.6925	9.4368	13.3688			14.00775	14.00775	14.745	14.59755	14.745			15.876				14.00775				13.3073625												4.8608	0.224058503	0	0	2.983414643	2.942649164	0	2.261596677	0.369377034	3.274995453	1.635476127	0	0	0.063113235	11.97602758	0.002996089	0.389255861	1.129248916	0	0	0.17480276	0	0	0	0.340075139	0	0	0	0.222983346	0	0	0	0	0	0	0	0	0	0	0	32.8509	none	1.5717	4.8608	0.224058503	0	0	2.983414643	2.942649164	0	2.261596677	0.369377034	3.274995453	1.635476127	0	0	0.063113235	11.97602758	0.002996089	0.389255861	1.129248916	0	0	0.17480276	0	0	0	0.340075139	0	0	0	0.222983346	0	0	0	0	0	0	0	0	0	0	0	32.8509																																																																																		0			4.8608	0.224058503	0	0	2.983414643	2.942649164	0	2.261596677	0.369377034	3.274995453	1.635476127	0	0	0.063113235	11.97602758	0.002996089	0.389255861	1.129248916	0	0	0.17480276	0	0	0	0.340075139	0	0	0	0.222983346	0	0	0	0	0	0	0	0	0	0	0	32.8509
H0524_811_0	2009	6																					2000											D	D	D	V	T	Coin		V	P	V	V			V	V	V	V	V			S				V				V																																																				0		1050.870537	60.55394363	588.0226593	0	260.144986	13.20746917		491.0884666	64.15039265	4284.267674	1579.974637			61.407873	10475.87052	3.19883151	287.7428751	974.6913334			792.6346161				269.4824105				179.8156708												$250/admit	$250/admit	0	0	$125/trip	twenty percent		"$50/ER visit, $50/UR OOA"	$050/procedure	$10/routine lab	"$10/x-ray, $50/MRI,PET, CAT Scans"			$15/visit	$15/visit	$15/visit	$15/visit	$15/visit			"$10/generic, $30/brand"				$15/visit				$15/visit												250	250	0	0	125	13.20746917		47.625	47.5	9.6	13.6			14.25	14.25	15	14.6	15			15.288				14.25				13.5375												46.25	46.25	0	0	116.75	0.2		44.48175	44.365	8.9664	12.7024			13.3095	13.3095	14.01	13.6364	14.01			15.288				13.3095				12.644025												4.0502	0.233384991	0	0	2.530993926	2.641493833	0	1.820372867	0.237169347	3.201204806	1.672455819	0	0	0.068109007	11.61904989	0.003734636	0.326981412	1.137952132	0	0	1.009816501	0	0	0	0.298889679	0	0	0	0.189466153	0	0	0	0	0	0	0	0	0	0	0	31.0413	None	2.8209	4.0502	0.233384991	0	0	2.530993926	2.641493833	0	1.820372867	0.237169347	3.201204806	1.672455819	0	0	0.068109007	11.61904989	0.003734636	0.326981412	1.137952132	0	0	1.009816501	0	0	0	0.298889679	0	0	0	0.189466153	0	0	0	0	0	0	0	0	0	0	0	31.0413																																																																																		0			4.0502	0.233384991	0	0	2.530993926	2.641493833	0	1.820372867	0.237169347	3.201204806	1.672455819	0	0	0.068109007	11.61904989	0.003734636	0.326981412	1.137952132	0	0	1.009816501	0	0	0	0.298889679	0	0	0	0.189466153	0	0	0	0	0	0	0	0	0	0	0	31.0413
H0524_812_0	2009	6																					3350											D	D	D	V	T	Coin		V	P	V	V			V	V	V	V	V			S				V				V																																																				0		1254.400563	57.82154914	748.3954719	0	291.3609418	14.71324582		581.231678	94.93011537	4164.541522	1468.023572			54.06712866	10259.48713	2.438322462	319.9900209	919.0225157			132.1260465				291.3317038				201.0766711												$250/admit	$250/admit	0	0	$125/trip	twenty percent		"$50/ER visit, $50/UR OOA"	$050/procedure	$10/routine lab	"$10/x-ray, $50/MRI,PET, CAT Scans"			$15/visit	$15/visit	$15/visit	$15/visit	$15/visit			"$10/generic, $30/brand"				$15/visit				$15/visit												250	250	0	0	125	14.71324582		47.5	47.5	9.6	13.6			14.25	14.25	15	14.85	15			15.876				14.25				13.5375												46.5	46.5	0	0	122.875	0.2		46.6925	46.6925	9.4368	13.3688			14.00775	14.00775	14.745	14.59755	14.745			15.876				14.00775				13.3073625												4.8608	0.224058503	0	0	2.983414643	2.942649164	0	2.261596677	0.369377034	3.274995453	1.635476127	0	0	0.063113235	11.97602758	0.002996089	0.389255861	1.129248916	0	0	0.17480276	0	0	0	0.340075139	0	0	0	0.222983346	0	0	0	0	0	0	0	0	0	0	0	32.8509	none	1.5717	4.8608	0.224058503	0	0	2.983414643	2.942649164	0	2.261596677	0.369377034	3.274995453	1.635476127	0	0	0.063113235	11.97602758	0.002996089	0.389255861	1.129248916	0	0	0.17480276	0	0	0	0.340075139	0	0	0	0.222983346	0	0	0	0	0	0	0	0	0	0	0	32.8509																																																																																		0			4.8608	0.224058503	0	0	2.983414643	2.942649164	0	2.261596677	0.369377034	3.274995453	1.635476127	0	0	0.063113235	11.97602758	0.002996089	0.389255861	1.129248916	0	0	0.17480276	0	0	0	0.340075139	0	0	0	0.222983346	0	0	0	0	0	0	0	0	0	0	0	32.8509
H0532_001_0	2009	8																					3500											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	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	220.800318	3.694138548	0	0	107.8488969	8.016698607	5.661793391	241.738941	306.0343121	0	0	74.94651778	0	343.7287955	3940.480981	5097.853258	165.1567381	637.5853013	0	1929.770664	128.6331449	474.9292672	0	0	264.0399895	0	112.7147824	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: $125	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $40"	9B ASC Services: $125	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $125	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: $10, one pair every 2 years, max $125 Benefit"	18A Routine Hearing Exams: $20	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											450	450	0	0	125	0.200000084	0.199828532	49.54814522	125	0	0	91.6031	0	20	15	20	20	20	20	18.6337289	76.518	20	0	0	20	10	20	0	0	0											385.3000927	385.3000927	0	0	107.0278035	0.171244558	0.171097671	42.42423321	107.3319952	0	0	78.65554793	0	17.12444856	12.84333642	17.12444856	17.12444856	17.12444856	17.12444856	15.9546166	65.51642776	17.12444856	0	0	17.12444856	8.562224281	17.12444856	0	0	0											7.0895	0.11861266	0	0	0.961902545	0.000114401	8.07E-05	0.854632434	2.737272777	0	0	0.491246618	0	0.49051384	4.217410242	7.274827159	0.235684839	0.909858058	0	2.565729256	0.702298679	0.677741817	0	0	0.376794935	0	0.160848208	0	0	0	0	0	0	0	0	0	0	0	0	0	29.8651	0	6.37	7.0895	0.11861266	0	0	0.961902545	0.000114401	8.07E-05	0.854632434	2.737272777	0	0	0.491246618	0	0.49051384	4.217410242	7.274827159	0.235684839	0.909858058	0	2.565729256	0.702298679	0.677741817	0	0	0.376794935	0	0.160848208	0	0	0	0	0	0	0	0	0	0	0	0	0	29.8651	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.0895	0.11861266	0	0	0.961902545	0.000114401	8.07E-05	0.854632434	2.737272777	0	0	0.491246618	0	0.49051384	4.217410242	7.274827159	0.235684839	0.909858058	0	2.565729256	0.702298679	0.677741817	0	0	0.376794935	0	0.160848208	0	0	0	0	0	0	0	0	0	0	0	0	0	29.8651
H0532_801_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	233.2521564	2.795547951	51.95875693	27.55538787	5.272124577	8.037876741	5.640615257	10.30582066	34.45705274	5.074484545	17.06171593	1.419975068	0.242166291	24.56887094	30.32929807	84.52666125	1.352593053	4.942166924	34.94892357	39.83906769	4.084307469	4.369100741	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											0.0617	0.0617	0.138	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0617	0.0617	0.138	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											14.3917	0.172485309	7.170308456	0	1.217860777	1.856749527	1.302982124	2.380644572	7.959579183	1.17220593	3.94125638	0.328014241	0.055940413	5.675409187	7.006067854	19.52565875	0.312448995	1.141640559	8.073201346	9.202824636	0.943475025	1.009262271	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.8397	0	0	14.3917	0.172485309	7.170308456	0	1.217860777	1.856749527	1.302982124	2.380644572	7.959579183	1.17220593	3.94125638	0.328014241	0.055940413	5.675409187	7.006067854	19.52565875	0.312448995	1.141640559	8.073201346	9.202824636	0.943475025	1.009262271	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.8397	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.3917	0.172485309	7.170308456	0	1.217860777	1.856749527	1.302982124	2.380644572	7.959579183	1.17220593	3.94125638	0.328014241	0.055940413	5.675409187	7.006067854	19.52565875	0.312448995	1.141640559	8.073201346	9.202824636	0.943475025	1.009262271	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.8397
H0532_802_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	233.2521564	2.795547951	51.95875693	27.55538787	5.272124577	8.037876741	5.640615257	10.30582066	34.45705274	5.074484545	17.06171593	1.419975068	0.242166291	24.56887094	30.32929807	84.52666125	1.352593053	4.942166924	34.94892357	39.83906769	4.084307469	4.369100741	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											0.0617	0.0617	0.138	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0617	0.0617	0.138	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											14.3917	0.172485309	7.170308456	0	1.217860777	1.856749527	1.302982124	2.380644572	7.959579183	1.17220593	3.94125638	0.328014241	0.055940413	5.675409187	7.006067854	19.52565875	0.312448995	1.141640559	8.073201346	9.202824636	0.943475025	1.009262271	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.8397	0	0	14.3917	0.172485309	7.170308456	0	1.217860777	1.856749527	1.302982124	2.380644572	7.959579183	1.17220593	3.94125638	0.328014241	0.055940413	5.675409187	7.006067854	19.52565875	0.312448995	1.141640559	8.073201346	9.202824636	0.943475025	1.009262271	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.8397	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.3917	0.172485309	7.170308456	0	1.217860777	1.856749527	1.302982124	2.380644572	7.959579183	1.17220593	3.94125638	0.328014241	0.055940413	5.675409187	7.006067854	19.52565875	0.312448995	1.141640559	8.073201346	9.202824636	0.943475025	1.009262271	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.8397
H0540_001_0	2009	7	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Ambulatory Surgical Center	Urgent Care	Radiology	Chiropractic	Podiatric	Vision Exam Diagnostic	Hearing Exam Diagnostic	Radiation-Chemotherapy	Radiology	Diabetes Supplies	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	Coin	V	V	0	Coin	0	0	0	V	V	V	0	0	0	V	V	V	V	V	V	V	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	0	0	0	0	0	0	0	0	0		1419.433964	44.64475805	544.5796554	36.05629577	113.5049142	13.31222383	0.48485289	314.9780425	273.8398164	4309.095785	324.7099391	114.2417941	0.260091614	773.6222558	3124.345364	2213.46017	0.219281342	1061.335742	216.2107264	0	39.01269519	0	0	0	365.8950172	351.2071332	190.2861391	0	0	0	76.99124467	11.00237919	589.7580161	1911.44105	275.5422631	753.5232213	0.559012338	16.51269678	2009.014112	2.470857496	$200/day (days 1-5); $1000 yrly max	$200/day (days 1-5); $1000 yrly max	$125/day (for days 21-100)	$0 copay	$100 copay	30% coinsurance	30% coinsurance	$50 copay	$175 copay	$15 copay	$100 copay/Higher Tier	$175 copay	20% coinsurance	$25 copay	$15 copay	$25 copay	50% coinsurance	$25 copay	$100 copay/Higher Tier	0	20% coinsurance	0	0	0	$25 copay	Covd up to $50/ Every 2 yrs.	$25 copay	0	0	0	$100 copay	$25 copay	$15 copay/Lower Tier	$25 copay	$25 copay	$25 copay	$25 copay	20% coinsurance	$15 copay/Lower Tier	20% coinsurance	200	200	125	0	100	0.3	0.3	50	175	15	100	175	0.2	25	15	25	0.5	25	100	0	0.2	0	0	0	25	30	25	0	0	0	100	25	15	25	25	25	25	0.2	15	0.2	87.98287491	44.18493272	112.056765	0	89.645412	0.268936236	0.268936236	44.822706	156.879471	13.4468118	89.645412	156.879471	0.179290824	22.411353	13.4468118	22.411353	0.44822706	22.411353	89.645412	0	0.179290824	0	0	0	22.411353	26.8936236	22.411353	0	0	0	89.645412	22.411353	13.4468118	22.411353	22.411353	22.411353	22.411353	0.179290824	13.4468118	0.179290824	10.4072	0.164385469	5.085319539	0	0.8479329	3.58013937	0.130394511	1.176514016	3.579987128	4.828633337	2.42572969	1.493516018	0.04663204	1.444826789	3.501040342	4.133886435	0.098287831	1.982164164	1.615191637	0	6.994618266	0	0	0	0.683350199	0.787102704	0.355380819	0	0	0	0.575159321	0.020548184	0.660863754	3.569831675	0.514606244	1.407289576	0.001044019	2.960575013	2.251236222	0.443002076	67.7663		7.8274	10.4072	0.164385469	5.085319539	0	0.8479329	3.58013937	0.130394511	1.176514016	3.579987128	4.828633337	2.42572969	1.493516018	0.04663204	1.444826789	3.501040342	4.133886435	0.098287831	1.982164164	1.615191637	0	6.994618266	0	0	0	0.683350199	0.787102704	0.355380819	0	0	0	0.575159321	0.020548184	0.660863754	3.569831675	0.514606244	1.407289576	0.001044019	2.960575013	2.251236222	0.443002076	67.7663	4000																																																																																	0		0	10.4072	0.164385469	5.085319539	0	0.8479329	3.58013937	0.130394511	1.176514016	3.579987128	4.828633337	2.42572969	1.493516018	0.04663204	1.444826789	3.501040342	4.133886435	0.098287831	1.982164164	1.615191637	0	6.994618266	0	0	0	0.683350199	0.787102704	0.355380819	0	0	0	0.575159321	0.020548184	0.660863754	3.569831675	0.514606244	1.407289576	0.001044019	2.960575013	2.251236222	0.443002076	67.7663
H0540_020_0	2009	7	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Ambulatory Surgical Center	Urgent Care	Radiology	Chiropractic	Podiatric	Vision Exam Diagnostic	Hearing Exam Diagnostic	Radiation-Chemotherapy	Radiology	Diabetes Supplies	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	Coin	V	V	0	Coin	0	0	0	V	V	V	0	0	0	V	V	V	V	V	V	V	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	0	0	0	0	0	0	0	0	0		1423.956347	77.76166382	492.3750785	42.08482029	107.3769077	15.19532091	0.466540239	323.3430431	271.0400977	4137.647907	297.8843247	95.25370847	0.411779698	640.451298	3253.347116	2156.024394	0.339525811	882.9152832	223.5864321	0	34.65505825	0	0	0	379.9730125	364.7200047	197.6074942	0	0	0	71.87325275	7.793485238	569.2707995	986.308854	199.5132221	676.3013301	0.692754243	12.81693682	1909.923449	2.576439807	$275/day (days 1-5); $1375 yrly max	$275/day (days 1-5); $1250 yrly max	$125/day (for days 21-100)	$0 copay	$150 copay	30% coinsurance	30% coinsurance	$50 copay	$200 copay	$20 copay	$100 copay/Higher Tier	$200 copay	20% coinsurance	$30 copay	$20 copay	$30 copay	50% coinsurance	$30 copay	$100 copay/Higher Tier	0	20% coinsurance	0	0	0	$30 copay	Covd up to $50/ Every 2 yrs.	$30 copay	0	0	0	$100 copay	$30 copay	$30 copay/Lower Tier	$30 copay	$30 copay	$30 copay	$30 copay	20% coinsurance	$30 copay/Lower Tier	20% coinsurance	275	275	125	0	150	0.3	0.3	50	200	20	100	200	0.2	30	20	30	0.5	30	100	0	0.2	0	0	0	30	30	30	0	0	0	100	30	30	30	30	30	30	0.2	30	0.2	116.12457	66.22163771	115.5148226	0	138.6177871	0.277235574	0.277235574	46.20592903	184.8237161	18.48237161	92.41185806	184.8237161	0.184823716	27.72355742	18.48237161	27.72355742	0.46205929	27.72355742	92.41185806	0	0.184823716	0	0	0	27.72355742	27.72355742	27.72355742	0	0	0	92.41185806	27.72355742	27.72355742	27.72355742	27.72355742	27.72355742	27.72355742	0.184823716	27.72355742	0.184823716	13.7797	0.429125394	4.739718319	0	1.240362444	4.212683518	0.129341551	1.245030475	4.174553173	6.372795518	2.294003661	1.467095364	0.076106654	1.479632361	5.010797531	4.981055507	0.156881055	2.039796046	1.721836469	0	6.405076647	0	0	0	0.877850302	0.842611333	0.456531893	0	0	0	0.553495069	0.018005261	1.315184308	2.278665845	0.460934689	1.562456563	0.001600468	2.368873891	4.412489367	0.476187179	77.5805		6.3703	13.7797	0.429125394	4.739718319	0	1.240362444	4.212683518	0.129341551	1.245030475	4.174553173	6.372795518	2.294003661	1.467095364	0.076106654	1.479632361	5.010797531	4.981055507	0.156881055	2.039796046	1.721836469	0	6.405076647	0	0	0	0.877850302	0.842611333	0.456531893	0	0	0	0.553495069	0.018005261	1.315184308	2.278665845	0.460934689	1.562456563	0.001600468	2.368873891	4.412489367	0.476187179	77.5805	4000																																																																																	0		0	13.7797	0.429125394	4.739718319	0	1.240362444	4.212683518	0.129341551	1.245030475	4.174553173	6.372795518	2.294003661	1.467095364	0.076106654	1.479632361	5.010797531	4.981055507	0.156881055	2.039796046	1.721836469	0	6.405076647	0	0	0	0.877850302	0.842611333	0.456531893	0	0	0	0.553495069	0.018005261	1.315184308	2.278665845	0.460934689	1.562456563	0.001600468	2.368873891	4.412489367	0.476187179	77.5805
H0540_088_0	2009	7	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Ambulatory Surgical Center	Urgent Care	Radiology	Chiropractic	Podiatric	Vision Exam Diagnostic	Hearing Exam Diagnostic	Radiation-Chemotherapy	Radiology	Diabetes Supplies	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	Coin	V	V	0	Coin	0	0	0	V	V	V	0	0	0	V	V	V	V	V	V	V	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	0	0	0	0	0	0	0	0	0		1431.687762	41.72930722	555.4540048	60.63330427	121.5116906	11.88443332	0.484274427	516.9434421	479.9850659	5137.377686	542.4156386	165.7571737	0.362144318	1288.804915	2987.632135	2447.193491	0.385459907	1478.400405	223.3024439	0	49.64698754	0	0	0	375.4593567	351.2071332	190.2861391	0	0	0	102.3135951	22.43317886	1001.96086	1870.972866	280.4229052	746.4873094	0.588196969	20.45393602	2060.274257	2.046308153	$250/day (days 1-5)	$250/day (days 1-5)	$125/day (for days 21-100)	$0 copay	$150 copay	30% coinsurance	30% coinsurance	$50 copay	$200 copay	$30 copay	$100 copay/Higher Tier	$200 copay	20% coinsurance	$20-$30 copay	$20 copay	$30 copay	50% coinsurance	$30 copay	$100 copay/Higher Tier	0	20% coinsurance	0	0	0	$25 copay	Covd up to $75/ Every 2 yrs.	$25 copay	0	0	0	$100 copay	$30 copay	$30 copay/Lower Tier	$30 copay	$30 copay	$25 copay	$25 copay	20% coinsurance	$30 copay/Lower Tier	20% coinsurance	250	250	125	0	150	0.3	0.3	50	200	30	100	200	0.2	22.1875	20	30	0.5	30	100	0	0.2	0	0	0	25	30	25	0	0	0	100	30	30	30	30	25	25	0.2	30	0.2	116.3697648	59.21171167	117.230009	0	140.6760108	0.281352022	0.281352022	46.8920036	187.5680144	28.13520216	93.7840072	187.5680144	0.187568014	20.8083266	18.75680144	28.13520216	0.468920036	28.13520216	93.7840072	0	0.187568014	0	0	0	23.4460018	28.13520216	23.4460018	0	0	0	93.7840072	28.13520216	28.13520216	28.13520216	28.13520216	23.4460018	23.4460018	0.187568014	28.13520216	0.187568014	13.8838	0.205905309	5.426323165	0	1.424481658	3.34370934	0.136251589	2.020042812	7.502487145	12.04509665	4.239159347	2.590895329	0.067926691	2.2348228	4.66986856	5.7376903	0.180749873	3.466257856	1.745183167	0	9.312186873	0	0	0	0.733585063	0.823440308	0.37178743	0	0	0	0.799614911	0.052596835	2.349197612	4.386683318	0.657479594	1.4585119	0.001149239	3.836504166	4.830519394	0.383821957	100.9177		6.6888	13.8838	0.205905309	5.426323165	0	1.424481658	3.34370934	0.136251589	2.020042812	7.502487145	12.04509665	4.239159347	2.590895329	0.067926691	2.2348228	4.66986856	5.7376903	0.180749873	3.466257856	1.745183167	0	9.312186873	0	0	0	0.733585063	0.823440308	0.37178743	0	0	0	0.799614911	0.052596835	2.349197612	4.386683318	0.657479594	1.4585119	0.001149239	3.836504166	4.830519394	0.383821957	100.9177	4500																																																																																	0		0	13.8838	0.205905309	5.426323165	0	1.424481658	3.34370934	0.136251589	2.020042812	7.502487145	12.04509665	4.239159347	2.590895329	0.067926691	2.2348228	4.66986856	5.7376903	0.180749873	3.466257856	1.745183167	0	9.312186873	0	0	0	0.733585063	0.823440308	0.37178743	0	0	0	0.799614911	0.052596835	2.349197612	4.386683318	0.657479594	1.4585119	0.001149239	3.836504166	4.830519394	0.383821957	100.9177
H0540_089_0	2009	9	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Ambulatory Surgical Center	Urgent Care	Radiology	Chiropractic	Podiatric	Vision Exam Diagnostic	Hearing Exam Diagnostic	Radiation-Chemotherapy	Radiology	Diabetes Supplies	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	Coin	V	V	0	Coin	0	0	0	V	V	V	0	0	0	V	V	V	V	V	V	V	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	0	0	0	0	0	0	0	0	0		1486.772671	43.33486335	576.8253776	62.96620121	126.1869141	12.81654574	0.522256735	536.8331016	498.4527332	5335.040882	563.2853538	172.1347646	0.390547793	1338.392334	3102.582787	2541.350494	0.415692057	1535.282606	231.894118	0	53.54086891	0	0	0	389.9053447	364.7200047	197.6074942	0	0	0	106.2501622	23.29630673	1040.511809	1942.95949	291.2123178	775.2087849	0.610828144	22.0581663	2139.544348	2.206802911	$250/day (days 1-5)	$250/day (days 1-5)	$125/day (for days 21-100)	$0 copay	$150 copay	30% coinsurance	30% coinsurance	$50 copay	$200 copay	$30 copay	$100 copay/Higher Tier	$200 copay	20% coinsurance	$20-$30 copay	$20 copay	$30 copay	50% coinsurance	$30 copay	$100 copay/Higher Tier	0	20% coinsurance	0	0	0	$25 copay	Covd up to $75/ Every 2 yrs.	$25 copay	0	0	0	$100 copay	$30 copay	$30 copay/Lower Tier	$30 copay	$30 copay	$25 copay	$25 copay	20% coinsurance	$30 copay/Lower Tier	20% coinsurance	250	250	125	0	150	0.3	0.3	50	200	30	100	200	0.2	22.1875	20	30	0.5	30	100	0	0.2	0	0	0	25	30	25	0	0	0	100	30	30	30	30	25	25	0.2	30	0.2	117.3139578	59.69213957	118.1811818	0	141.8174181	0.283634836	0.283634836	47.2724727	189.0898908	28.36348362	94.5449454	189.0898908	0.189089891	20.97715976	18.90898908	28.36348362	0.472724727	28.36348362	94.5449454	0	0.189089891	0	0	0	23.63623635	28.36348362	23.63623635	0	0	0	94.5449454	28.36348362	28.36348362	28.36348362	28.36348362	23.63623635	23.63623635	0.189089891	28.36348362	0.189089891	14.5349	0.215562559	5.680825399	0	1.491291864	3.635218851	0.148130203	2.114785678	7.854364408	12.61002872	4.437981918	2.712411986	0.07384864	2.339639151	4.888892003	6.006796094	0.196507914	3.628830254	1.827034727	0	10.12403706	0	0	0	0.76799124	0.862060823	0.389224786	0	0	0	0.837117982	0.055063701	2.459378304	4.592424972	0.688316317	1.526918172	0.00120314	4.170976257	5.057077588	0.417284121	106.3462		6.136	14.5349	0.215562559	5.680825399	0	1.491291864	3.635218851	0.148130203	2.114785678	7.854364408	12.61002872	4.437981918	2.712411986	0.07384864	2.339639151	4.888892003	6.006796094	0.196507914	3.628830254	1.827034727	0	10.12403706	0	0	0	0.76799124	0.862060823	0.389224786	0	0	0	0.837117982	0.055063701	2.459378304	4.592424972	0.688316317	1.526918172	0.00120314	4.170976257	5.057077588	0.417284121	106.3462	4500																																																																																	0		0	14.5349	0.215562559	5.680825399	0	1.491291864	3.635218851	0.148130203	2.114785678	7.854364408	12.61002872	4.437981918	2.712411986	0.07384864	2.339639151	4.888892003	6.006796094	0.196507914	3.628830254	1.827034727	0	10.12403706	0	0	0	0.76799124	0.862060823	0.389224786	0	0	0	0.837117982	0.055063701	2.459378304	4.592424972	0.688316317	1.526918172	0.00120314	4.170976257	5.057077588	0.417284121	106.3462
H0540_090_0	2009	6	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Ambulatory Surgical Center	Urgent Care	Radiology	Chiropractic	Podiatric	Vision Exam Diagnostic	Hearing Exam Diagnostic	Radiation-Chemotherapy	Radiology	Diabetes Supplies	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	Coin	V	V	0	Coin	0	0	0	V	V	V	0	0	0	V	V	V	V	V	V	V	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	0	0	0	0	0	0	0	0	0		1410.404588	35.66085547	586.8569516	41.95096369	113.1204946	8.53802946	0.389398593	312.1719838	338.4991303	4848.151637	348.6951928	100.5402782	0.030819747	1001.091014	2504.680512	2792.706596	0.213259145	1124.965564	221.6755881	0	48.2884135	0	0	0	365.8950172	351.2071332	190.2861391	0	0	0	24.1458993	22.77627896	657.8743025	1902.960643	269.1557598	724.681339	0.456540113	16.37867914	2077.358966	1.166185865	$200/day (days 1-5); $1000 yrly max	$200/day (days 1-5); $1000 yrly max	$125/day (for days 21-100)	$0 copay	$100 copay	30% coinsurance	30% coinsurance	$50 copay	$175 copay	$15 copay	$100 copay/Higher Tier	$175 copay	20% coinsurance	$25 copay	$15 copay	$25 copay	50% coinsurance	$25 copay	$100 copay/Higher Tier	0	20% coinsurance	0	0	0	$25 copay	Covd up to $50/ Every 2 yrs.	$25 copay	0	0	0	$100 copay	$25 copay	$15 copay/Lower Tier	$25 copay	$25 copay	$25 copay	$25 copay	20% coinsurance	$15 copay/Lower Tier	20% coinsurance	200	200	125	0	100	0.3	0.3	50	175	15	100	175	0.2	25	15	25	0.5	25	100	0	0.2	0	0	0	25	30	25	0	0	0	100	25	15	25	25	25	25	0.2	15	0.2	99.30736444	46.85893572	120.4014321	0	96.32114564	0.288963437	0.288963437	48.16057282	168.5620049	14.44817185	96.32114564	168.5620049	0.192642291	24.08028641	14.44817185	24.08028641	0.481605728	24.08028641	96.32114564	0	0.192642291	0	0	0	24.08028641	28.89634369	24.08028641	0	0	0	96.32114564	24.08028641	14.44817185	24.08028641	24.08028641	24.08028641	24.08028641	0.192642291	14.44817185	0.192642291	11.672	0.139252478	5.888201449	0	0.907991303	2.467178337	0.112521956	1.25286513	4.754841004	5.837244	2.798893371	1.412272572	0.005937187	2.008879862	3.015671205	5.604097892	0.102706826	2.25745775	1.779337217	0	9.30239062	0	0	0	0.734238068	0.845716836	0.381845394	0	0	0	0.19381339	0.045704943	0.792090081	3.81865311	0.540112315	1.454211183	0.000916135	3.155226279	2.501169944	0.224656717	76.0081		2.903	11.672	0.139252478	5.888201449	0	0.907991303	2.467178337	0.112521956	1.25286513	4.754841004	5.837244	2.798893371	1.412272572	0.005937187	2.008879862	3.015671205	5.604097892	0.102706826	2.25745775	1.779337217	0	9.30239062	0	0	0	0.734238068	0.845716836	0.381845394	0	0	0	0.19381339	0.045704943	0.792090081	3.81865311	0.540112315	1.454211183	0.000916135	3.155226279	2.501169944	0.224656717	76.0081	4000																																																																																	0		0	11.672	0.139252478	5.888201449	0	0.907991303	2.467178337	0.112521956	1.25286513	4.754841004	5.837244	2.798893371	1.412272572	0.005937187	2.008879862	3.015671205	5.604097892	0.102706826	2.25745775	1.779337217	0	9.30239062	0	0	0	0.734238068	0.845716836	0.381845394	0	0	0	0.19381339	0.045704943	0.792090081	3.81865311	0.540112315	1.454211183	0.000916135	3.155226279	2.501169944	0.224656717	76.0081
H0540_091_0	2009	7	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Ambulatory Surgical Center	Urgent Care	Radiology	Chiropractic	Podiatric	Vision Exam Diagnostic	Hearing Exam Diagnostic	Radiation-Chemotherapy	Radiology	Diabetes Supplies	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	Coin	V	V	0	Coin	0	0	0	V	V	V	0	0	0	V	V	V	V	V	V	V	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	0	0	0	0	0	0	0	0	0		1145.068411	41.89503783	329.3363288	24.04737598	88.67469891	10.74716379	0.107391339	291.5744337	293.0773947	4194.576277	303.9738619	92.05636116	0.081859812	710.1490718	2620.600371	2458.656323	0.240961402	844.8519513	213.6083319	0	42.37982579	0	0	0	379.9730125	364.7200047	197.6074942	0	0	0	48.4704922	14.65386974	578.6399844	1012.807843	166.0771903	665.0602418	0.563610374	10.70951484	1911.95426	1.075106187	$275/day (days 1-5); $1375 yrly max	$275/day (days 1-5); $1375 yrly max	$125/day (for days 21-100)	$0 copay	$150 copay	30% coinsurance	30% coinsurance	$50 copay	$200 copay	$20 copay	$100 copay/Higher Tier	$200 copay	20% coinsurance	$30 copay	$20 copay	$30 copay	50% coinsurance	$30 copay	$100 copay/Higher Tier	0	20% coinsurance	0	0	0	$30 copay	Covd up to $50/ Every 2 yrs.	$30 copay	0	0	0	$100 copay	$30 copay	$30 copay/Lower Tier	$30 copay	$30 copay	$30 copay	$30 copay	20% coinsurance	$30 copay/Lower Tier	20% coinsurance	275	275	125	0	150	0.3	0.3	50	200	20	100	200	0.2	30	20	30	0.5	30	100	0	0.2	0	0	0	30	30	30	0	0	0	100	30	30	30	30	30	30	0.2	30	0.2	132.4191049	76.83210085	117.9997141	0	141.5996569	0.283199314	0.283199314	47.19988565	188.7995426	18.87995426	94.39977129	188.7995426	0.188799543	28.31993139	18.87995426	28.31993139	0.471998856	28.31993139	94.39977129	0	0.188799543	0	0	0	28.31993139	28.31993139	28.31993139	0	0	0	94.39977129	28.31993139	28.31993139	28.31993139	28.31993139	28.31993139	28.31993139	0.188799543	28.31993139	0.188799543	12.6357	0.268240314	3.238466054	0	1.046358912	3.043589412	0.030413153	1.146856661	4.611073172	6.599450687	2.391255254	1.448349907	0.015455095	1.675947749	4.123067928	5.802414866	0.113733506	1.993845774	1.680381473	0	8.001291724	0	0	0	0.896734137	0.860737126	0.466352556	0	0	0	0.381300282	0.034583049	1.365587055	2.390220718	0.39194122	1.569538368	0.001330117	2.021951504	4.512201122	0.202979556	74.9614		4.4471	12.6357	0.268240314	3.238466054	0	1.046358912	3.043589412	0.030413153	1.146856661	4.611073172	6.599450687	2.391255254	1.448349907	0.015455095	1.675947749	4.123067928	5.802414866	0.113733506	1.993845774	1.680381473	0	8.001291724	0	0	0	0.896734137	0.860737126	0.466352556	0	0	0	0.381300282	0.034583049	1.365587055	2.390220718	0.39194122	1.569538368	0.001330117	2.021951504	4.512201122	0.202979556	74.9614	4000																																																																																	0		0	12.6357	0.268240314	3.238466054	0	1.046358912	3.043589412	0.030413153	1.146856661	4.611073172	6.599450687	2.391255254	1.448349907	0.015455095	1.675947749	4.123067928	5.802414866	0.113733506	1.993845774	1.680381473	0	8.001291724	0	0	0	0.896734137	0.860737126	0.466352556	0	0	0	0.381300282	0.034583049	1.365587055	2.390220718	0.39194122	1.569538368	0.001330117	2.021951504	4.512201122	0.202979556	74.9614
H0540_807_0	2009	4																																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	V																																																			0		362.3681118	4.338744076	15.41348198	6.988933913	6.946464808	19.72432852	1.927246919	15.816974	46.21555247	25.14304844	67.91674067	0	0.569721978	66.83274329	36.55599061	99.08144986	1.127234591	3.793492208	24.63537376	32.62188966	49.8640037	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.073286738	0.073286738	0.189204177	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.073286738	0.073286738	0.189204177	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			26.5568	0.317972401	2.916295178	0	1.604633371	4.556319888	0.445194038	3.653720993	10.67579262	5.80804419	15.6887671	0	0.131605777	15.4383637	8.44443383	22.88781492	0.260391191	0.8762967	5.69077134	7.535656511	11.51858486	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.0074			26.5568	0.317972401	2.916295178	0	1.604633371	4.556319888	0.445194038	3.653720993	10.67579262	5.80804419	15.6887671	0	0.131605777	15.4383637	8.44443383	22.88781492	0.260391191	0.8762967	5.69077134	7.535656511	11.51858486	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.0074																																																																																		0			26.5568	0.317972401	2.916295178	0	1.604633371	4.556319888	0.445194038	3.653720993	10.67579262	5.80804419	15.6887671	0	0.131605777	15.4383637	8.44443383	22.88781492	0.260391191	0.8762967	5.69077134	7.535656511	11.51858486	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.0074
H0540_808_0	2009	4																																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	V																																																			0		321.7787517	3.852755271	16.03431036	5.989351764	6.790802932	14.80211583	1.446301815	16.95841552	51.31532676	29.77703845	80.4341368	0	0.674724598	79.15035327	26.56994431	72.01524459	0.819306489	2.757219133	17.90569748	23.71052671	46.95307497	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.073286738	0.073286738	0.189204177	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.073286738	0.073286738	0.189204177	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			23.5821	0.282355866	3.033758501	0	1.568675477	3.419288756	0.334095719	3.917393986	11.85384048	6.878495881	18.5802856	0	0.155861382	18.28373161	6.137657136	16.6355215	0.189259799	0.63691762	4.136216119	5.477131669	10.84616032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.9488			23.5821	0.282355866	3.033758501	0	1.568675477	3.419288756	0.334095719	3.917393986	11.85384048	6.878495881	18.5802856	0	0.155861382	18.28373161	6.137657136	16.6355215	0.189259799	0.63691762	4.136216119	5.477131669	10.84616032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.9488																																																																																		0			23.5821	0.282355866	3.033758501	0	1.568675477	3.419288756	0.334095719	3.917393986	11.85384048	6.878495881	18.5802856	0	0.155861382	18.28373161	6.137657136	16.6355215	0.189259799	0.63691762	4.136216119	5.477131669	10.84616032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.9488
H0540_814_0	2009	4																																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	V																																																			0		321.7787517	3.852755271	16.03431036	5.989351764	6.790802932	14.80211583	1.446301815	16.95841552	51.31532676	29.77703845	80.4341368	0	0.674724598	79.15035327	26.56994431	72.01524459	0.819306489	2.757219133	17.90569748	23.71052671	46.95307497	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.073286738	0.073286738	0.189204177	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.073286738	0.073286738	0.189204177	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			23.5821	0.282355866	3.033758501	0	1.568675477	3.419288756	0.334095719	3.917393986	11.85384048	6.878495881	18.5802856	0	0.155861382	18.28373161	6.137657136	16.6355215	0.189259799	0.63691762	4.136216119	5.477131669	10.84616032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.9488			23.5821	0.282355866	3.033758501	0	1.568675477	3.419288756	0.334095719	3.917393986	11.85384048	6.878495881	18.5802856	0	0.155861382	18.28373161	6.137657136	16.6355215	0.189259799	0.63691762	4.136216119	5.477131669	10.84616032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.9488																																																																																		0			23.5821	0.282355866	3.033758501	0	1.568675477	3.419288756	0.334095719	3.917393986	11.85384048	6.878495881	18.5802856	0	0.155861382	18.28373161	6.137657136	16.6355215	0.189259799	0.63691762	4.136216119	5.477131669	10.84616032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.9488
H0543_001_0	2009	8																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	280.9229647	5.380291972	1187.677386	447.1499799	378.6787905	9.704909024	6.840742936	322.1398761	254.1440379	17034.09613	67.25244151	0	15.16334328	1171.001369	7012.095351	5781.00959	173.9577492	425.3927766	0	0	25.93347195	1075.434043	0	0	265.8397263	158.3018943	0	0	185.875867	0											"$250 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$100 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$150 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5, 9a); $30/$30 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$30 (7b); $0 n/c (7b1, 7f1); $10 (7d); $10/$30 (7f)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$10/$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 18a); $10/$30 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											249.9390744	912	55.10681964	0	100	0.2	0.098634822	50	150	2.8	0.166313249	0	0	52.41148697	6.619222394	10.38944911	30	8.334199101	0	0	0.2	29.02669419	0	0	30	30	0	0	0	0											249.9390744	912	55.10681964	0	100	0.2	0.098634822	50	150	2.8	0.166313249	0	0	52.41148697	6.619222394	10.38944911	30	8.334199101	0	0	0.2	29.02669419	0	0	30	30	0	0	0	0											5.8511	0.40890219	5.454093625	0	3.155656588	1.940981805	0.674735462	1.342249484	3.176800473	3.97462243	11.18497207	0	0	5.114493585	3.867884881	5.005125414	0.434894373	0.295442341	0	0	5.18669439	2.601357923	0	0	0.664599316	0.395754736	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.7304	0	0	5.8511	0.40890219	5.454093625	0	3.155656588	1.940981805	0.674735462	1.342249484	3.176800473	3.97462243	11.18497207	0	0	5.114493585	3.867884881	5.005125414	0.434894373	0.295442341	0	0	5.18669439	2.601357923	0	0	0.664599316	0.395754736	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.7304																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	5.8511	0.40890219	5.454093625	0	3.155656588	1.940981805	0.674735462	1.342249484	3.176800473	3.97462243	11.18497207	0	0	5.114493585	3.867884881	5.005125414	0.434894373	0.295442341	0	0	5.18669439	2.601357923	0	0	0.664599316	0.395754736	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.7304
H0543_004_0	2009	6																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1139.448854	5.746931612	1075.403314	379.5960437	321.3005157	10.01689909	5.75064267	332.2158698	254.2367008	16815.13024	70.36706203	0	15.22011221	1275.159183	7020.700212	5755.717129	182.9174638	408.6644421	0	0	26.38099469	1050.329036	0	0	263.7235866	158.5068104	0	0	1137.409365	0											"$150 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$100 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$100 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $100 (9a); $30/$30 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$30 (7b); $0 n/c (7b1, 7f1); $10 (7d); $10/$30 (7f)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$10/$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 18a); $10/$30 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$0 n/c (13b, 13d, 13e)"											91.7233809	912	55.10681964	0	100	0.2	0.115474579	50	100	2.8	0.166867053	0	0	35.16028862	6.575196464	10.39096086	30	8.334199101	0	0	0.2	29.10489179	0	0	30	30	0	0	0	0											91.7233809	912	55.10681964	0	100	0.2	0.115474579	50	100	2.8	0.166867053	0	0	35.16028862	6.575196464	10.39096086	30	8.334199101	0	0	0.2	29.10489179	0	0	30	30	0	0	0	0											8.7095	0.436766803	4.938504707	0	2.677504297	2.003379818	0.664053039	1.384232791	2.118639173	3.92353039	11.7419443	0	0	3.736247075	3.846873601	4.983952616	0.45729366	0.283824235	0	0	5.276198938	2.547476079	0	0	0.659308966	0.396267026	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.7855	0	0	8.7095	0.436766803	4.938504707	0	2.677504297	2.003379818	0.664053039	1.384232791	2.118639173	3.92353039	11.7419443	0	0	3.736247075	3.846873601	4.983952616	0.45729366	0.283824235	0	0	5.276198938	2.547476079	0	0	0.659308966	0.396267026	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.7855																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.7095	0.436766803	4.938504707	0	2.677504297	2.003379818	0.664053039	1.384232791	2.118639173	3.92353039	11.7419443	0	0	3.736247075	3.846873601	4.983952616	0.45729366	0.283824235	0	0	5.276198938	2.547476079	0	0	0.659308966	0.396267026	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.7855
H0543_007_0	2009	4																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	260.8245333	5.182704012	978.6812859	329.4950048	286.3611443	8.320047459	4.825855246	318.2686895	240.0251425	16261.40122	62.52219197	0	13.12385151	1289.145653	6821.891487	5601.871766	182.799929	391.8894781	0	0	24.32679387	1015.392651	0	0	258.2303329	158.5840237	0	0	185.8738373	0											"$250 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-20/$120 Days 21-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$100 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $100 (9a); $30/$30 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$30 (7b); $0 n/c (7b1, 7f1); $10 (7d); $10/$30 (7f)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$10/$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 18a); $10/$30 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											249.9343792	912	37.21990109	0	75	0.2	0.115430884	50	100	2.8	0.167227141	0	0	35.16523027	6.550677792	10.39311419	30	8.334199101	0	0	0.2	28.9133372	0	0	30	30	0	0	0	0											249.9343792	912	37.21990109	0	75	0.2	0.115430884	50	100	2.8	0.167227141	0	0	35.16523027	6.550677792	10.39311419	30	8.334199101	0	0	0.2	28.9133372	0	0	30	30	0	0	0	0											5.4324	0.393885505	3.035535055	0	1.789757152	1.664009492	0.557052735	1.32611954	2.000209521	3.794326951	10.45540743	0	0	3.777758646	3.724001089	4.851741076	0.456999823	0.272173745	0	0	4.865358773	2.446532509	0	0	0.645575832	0.396460059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.8853	0	0	5.4324	0.393885505	3.035535055	0	1.789757152	1.664009492	0.557052735	1.32611954	2.000209521	3.794326951	10.45540743	0	0	3.777758646	3.724001089	4.851741076	0.456999823	0.272173745	0	0	4.865358773	2.446532509	0	0	0.645575832	0.396460059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.8853																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	5.4324	0.393885505	3.035535055	0	1.789757152	1.664009492	0.557052735	1.32611954	2.000209521	3.794326951	10.45540743	0	0	3.777758646	3.724001089	4.851741076	0.456999823	0.272173745	0	0	4.865358773	2.446532509	0	0	0.645575832	0.396460059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.8853
H0543_013_0	2009	5																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1096.526588	4.955174001	979.1751036	311.287546	265.5875056	9.141024071	5.146410401	403.7871726	234.8026683	16042.55779	68.29114586	0	13.3134041	1388.733566	6802.1083	5665.431623	192.2888535	382.6008239	0	0	25.82337343	985.1199983	0	0	258.5990378	158.9160446	0	0	98.4	0											"$200 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$100 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$200 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$30 (3, 9d); $150 (5); $200 (9a); $30/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30 (7f)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$15/$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 18a); $15/$30 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											122.2975501	912	55.10681964	0	100	0.2	0.116001635	50	200	2.8	0.167526306	0	0	70.59022903	9.739689177	29.9999945	30	30	0	0	0.2	28.96013003	0	0	30	30	0	0	0	0											122.2975501	912	55.10681964	0	100	0.2	0.116001635	50	200	2.8	0.167526306	0	0	70.59022903	9.739689177	29.9999945	30	30	0	0	0.2	28.96013003	0	0	30	30	0	0	0	0											11.1752	0.376593224	4.496602153	0	2.213229213	1.828204814	0.596992023	1.682446553	3.913377805	3.743263485	11.44056338	0	0	8.169251705	5.520868382	14.16357646	0.480722134	0.95650206	0	0	5.164674686	2.377433604	0	0	0.646497595	0.397290111	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3433	0	0	11.1752	0.376593224	4.496602153	0	2.213229213	1.828204814	0.596992023	1.682446553	3.913377805	3.743263485	11.44056338	0	0	8.169251705	5.520868382	14.16357646	0.480722134	0.95650206	0	0	5.164674686	2.377433604	0	0	0.646497595	0.397290111	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3433																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.1752	0.376593224	4.496602153	0	2.213229213	1.828204814	0.596992023	1.682446553	3.913377805	3.743263485	11.44056338	0	0	8.169251705	5.520868382	14.16357646	0.480722134	0.95650206	0	0	5.164674686	2.377433604	0	0	0.646497595	0.397290111	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3433
H0543_019_0	2009	5																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	273.2740116	5.257042995	1017.305174	327.7900622	287.3110006	9.625679444	5.380400336	343.6621331	251.4946291	16950.81415	72.39124888	0	14.07917585	1456.77131	7188.024531	5865.542098	201.5638442	403.1355045	0	0	22.25195323	1041.399526	0	0	262.1973381	167.4714946	0	0	202.9800045	0											"$400 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-20/$120 Days 21-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$175 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $175 (9a); $30/$30 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$20 (7b, 7d); $0 n/c (7b1, 7f1); $10/$20 (7f)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$10/$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $10/$20 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											399.6211748	912	37.21990109	0	75	0.2	0.116684158	50	175	2.8	0.16750498	0	0	61.09199761	6.512153728	19.99999722	30	8.334199101	0	0	0.2	19.31247415	0	0	30	30	0	0	0	0											399.6211748	912	37.21990109	0	75	0.2	0.116684158	50	175	2.8	0.16750498	0	0	61.09199761	6.512153728	19.99999722	30	8.334199101	0	0	0.2	19.31247415	0	0	30	30	0	0	0	0											9.1005	0.399535268	3.155333164	0	1.795693754	1.925135889	0.627807484	1.431925555	3.667630008	3.955189969	12.12589467	0	0	7.416422449	3.900793396	9.775902138	0.50390961	0.279984297	0	0	4.450390646	1.676000119	0	0	0.655493345	0.418678737	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.2622	0	0	9.1005	0.399535268	3.155333164	0	1.795693754	1.925135889	0.627807484	1.431925555	3.667630008	3.955189969	12.12589467	0	0	7.416422449	3.900793396	9.775902138	0.50390961	0.279984297	0	0	4.450390646	1.676000119	0	0	0.655493345	0.418678737	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.2622																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	9.1005	0.399535268	3.155333164	0	1.795693754	1.925135889	0.627807484	1.431925555	3.667630008	3.955189969	12.12589467	0	0	7.416422449	3.900793396	9.775902138	0.50390961	0.279984297	0	0	4.450390646	1.676000119	0	0	0.655493345	0.418678737	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.2622
H0543_022_0	2009	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1455.667526	5.484128249	1291.999938	660.0745029	300.6786629	8.104322623	3.781574905	453.8570338	329.4552098	17088.54275	52.25638577	0	16.44679483	575.3847586	6578.814284	5521.798879	116.6603311	446.3209909	0	0	23.40734978	1137.621803	0	0	250.3423749	156.9331418	0	0	98.4	0											"$200 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$100 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$200 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $200 (9a); $30/$30 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$20 (7b, 7d); $0 n/c (7b1, 7f1); $10/$20 (7f)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$10/$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $10/$20 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											122.2994569	912	55.10681964	0	100	0.2	0.142820469	50	200	2.8	0.161381435	0	0	69.07112493	6.919763273	19.99996183	30	8.334199101	0	0	0.2	19.44467419	0	0	30	30	0	0	0	0											122.2994569	912	55.10681964	0	100	0.2	0.142820469	50	200	2.8	0.161381435	0	0	69.07112493	6.919763273	19.99996183	30	8.334199101	0	0	0.2	19.44467419	0	0	30	30	0	0	0	0											14.8356	0.416793747	5.933167297	0	2.505655524	1.620864525	0.540086302	1.891070974	5.490920163	3.987326641	8.433210512	0	0	3.311872712	3.793653122	9.202980567	0.291650828	0.309977333	0	0	4.681469957	1.843390443	0	0	0.625855937	0.392332855	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1079	0	0	14.8356	0.416793747	5.933167297	0	2.505655524	1.620864525	0.540086302	1.891070974	5.490920163	3.987326641	8.433210512	0	0	3.311872712	3.793653122	9.202980567	0.291650828	0.309977333	0	0	4.681469957	1.843390443	0	0	0.625855937	0.392332855	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1079																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.8356	0.416793747	5.933167297	0	2.505655524	1.620864525	0.540086302	1.891070974	5.490920163	3.987326641	8.433210512	0	0	3.311872712	3.793653122	9.202980567	0.291650828	0.309977333	0	0	4.681469957	1.843390443	0	0	0.625855937	0.392332855	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1079
H0543_028_0	2009	5																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	286.7013644	6.558359136	1074.075305	376.5020994	304.2416776	10.96874534	9.934297373	348.5903052	267.4860494	17947.24944	83.45780838	0	15.54226152	1554.632339	7626.698516	6193.70517	207.5767744	445.0029521	0	0	35.73324653	1101.671791	0	0	280.0036443	159.0806532	0	0	98.4	0											"$200 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$200 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$25 (10a)	20% (11a)	20% (11b); $0 (11c)	"$40 (4a, 4a1, 4b)"	$0 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9a, 9d); $10 (5); $10/$10 (9c)"	"$10 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$20 (7b, 7d); $0 n/c (7b1, 7f1); $10/$20 (7f)"	"$10/$10 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$10/$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $10/$20 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											199.9522418	200	0	0	25	0.2	0.087945366	40	0	2.8	0.168044353	0	0	0.022683553	6.489577188	19.99999739	10	0	0	0	0.2	19.30995436	0	0	30	30	0	0	0	0											199.9522418	200	0	0	25	0.2	0.087945366	40	0	2.8	0.168044353	0	0	0.022683553	6.489577188	19.99999739	10	0	0	0	0.2	19.30995436	0	0	30	30	0	0	0	0											4.7772	0.109305986	0	0	0.633836828	2.193749068	0.873675422	1.161967684	0	4.187691537	14.02461345	0	0	0.002938715	4.124504059	10.3228406	0.172980645	0	0	0	7.146649306	1.772769335	0	0	0.700009111	0.397701633	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.6024	0	0	4.7772	0.109305986	0	0	0.633836828	2.193749068	0.873675422	1.161967684	0	4.187691537	14.02461345	0	0	0.002938715	4.124504059	10.3228406	0.172980645	0	0	0	7.146649306	1.772769335	0	0	0.700009111	0.397701633	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.6024																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.7772	0.109305986	0	0	0.633836828	2.193749068	0.873675422	1.161967684	0	4.187691537	14.02461345	0	0	0.002938715	4.124504059	10.3228406	0.172980645	0	0	0	7.146649306	1.772769335	0	0	0.700009111	0.397701633	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.6024
H0543_029_0	2009	3																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1460.20082	4.527543811	1472.678522	670.0242166	332.8510035	12.1729494	9.84524648	345.3903781	337.0933403	19665.4921	70.54241096	0	6.876905606	533.8363237	7511.788352	6400.476747	137.231379	502.7148934	0	0	43.49394856	1275.906356	0	0	272.963837	156.9567616	0	0	98.4	0											"$250 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-20/$100 Days 21-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$200 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $200 (9a); $30/$30 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$20 (7b, 7d); $0 n/c (7b1, 7f1); $10/$20 (7f)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$10/$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $10/$20 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											152.8743437	912	31.01658425	0	75	0.2	0.08453589	50	200	2.8	0.16496276	0	0	67.97502023	6.805376726	19.99996293	30	8.334199101	0	0	0.2	19.4977234	0	0	30	30	0	0	0	0											152.8743437	912	31.01658425	0	75	0.2	0.08453589	50	200	2.8	0.16496276	0	0	67.97502023	6.805376726	19.99996293	30	8.334199101	0	0	0.2	19.4977234	0	0	30	30	0	0	0	0											18.6023	0.34409333	3.806454788	0	2.080318772	2.43458988	0.832276672	1.439126575	5.618222338	4.588614822	11.6368708	0	0	3.023961242	4.260045802	10.66744147	0.343078448	0.349143834	0	0	8.698789712	2.073105769	0	0	0.682409593	0.392391904	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.8732	0	0	18.6023	0.34409333	3.806454788	0	2.080318772	2.43458988	0.832276672	1.439126575	5.618222338	4.588614822	11.6368708	0	0	3.023961242	4.260045802	10.66744147	0.343078448	0.349143834	0	0	8.698789712	2.073105769	0	0	0.682409593	0.392391904	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.8732																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.6023	0.34409333	3.806454788	0	2.080318772	2.43458988	0.832276672	1.439126575	5.618222338	4.588614822	11.6368708	0	0	3.023961242	4.260045802	10.66744147	0.343078448	0.349143834	0	0	8.698789712	2.073105769	0	0	0.682409593	0.392391904	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.8732
H0543_032_0	2009	5																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1258.163358	4.779295459	1793.582043	457.5685691	248.1044509	9.830411023	5.705261307	428.3314343	348.4171892	17236.93855	57.79299069	0	7.997807744	444.7138021	6689.940307	5948.253631	118.0974606	447.7251397	0	0	25.74740987	1137.665551	0	0	251.7238113	156.9193224	0	0	98.4	0											"$200 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$100 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$200 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $200 (9a); $30/$30 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$20 (7b, 7d); $0 n/c (7b1, 7f1); $10/$20 (7f)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$10/$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $10/$20 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											122.298543	912	55.10681964	0	100	0.2	0.129276771	50	200	2.8	0.163842733	0	0	67.72455278	6.937313007	19.99996441	30	8.334199101	0	0	0.2	19.5178231	0	0	30	30	0	0	0	0											122.298543	912	55.10681964	0	100	0.2	0.129276771	50	200	2.8	0.163842733	0	0	67.72455278	6.937313007	19.99996441	30	8.334199101	0	0	0.2	19.5178231	0	0	30	30	0	0	0	0											12.8226	0.363226455	8.236550179	0	2.067537091	1.966082205	0.737557757	1.78471431	5.806953153	4.021952329	9.468961535	0	0	2.509836947	3.867517492	9.91373841	0.295243652	0.310952538	0	0	5.149481975	1.850396247	0	0	0.629309528	0.392298306	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.1949	0	0	12.8226	0.363226455	8.236550179	0	2.067537091	1.966082205	0.737557757	1.78471431	5.806953153	4.021952329	9.468961535	0	0	2.509836947	3.867517492	9.91373841	0.295243652	0.310952538	0	0	5.149481975	1.850396247	0	0	0.629309528	0.392298306	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.1949																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.8226	0.363226455	8.236550179	0	2.067537091	1.966082205	0.737557757	1.78471431	5.806953153	4.021952329	9.468961535	0	0	2.509836947	3.867517492	9.91373841	0.295243652	0.310952538	0	0	5.149481975	1.850396247	0	0	0.629309528	0.392298306	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.1949
H0543_035_0	2009	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1608.451565	4.194630287	1108.162377	541.1349097	374.9026817	11.64210478	8.764727366	331.4326295	339.0067735	18660.25748	56.49948274	0	9.437205197	1207.021856	7169.092966	5968.394355	140.947284	483.6185933	0	0	23.04924822	1203.679057	0	0	231.2025625	196.8527172	0	0	264.4778669	0											"$200 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$100 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$200 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $200 (9a); $30/$30 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$30 (7b); $0 n/c (7b1, 7f1); $10 (7d); $10/$30 (7f)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$10/$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 18a); $10/$30 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											122.3000975	912	55.10681964	0	100	0.2	0.104778349	50	200	2.8	0.162697407	0	0	70.09505328	6.835537954	10.37642956	30	8.334199101	0	0	0.2	29.75149207	0	0	30	30	0	0	0	0											122.3000975	912	55.10681964	0	100	0.2	0.104778349	50	200	2.8	0.162697407	0	0	70.09505328	6.835537954	10.37642956	30	8.334199101	0	0	0.2	29.75149207	0	0	30	30	0	0	0	0											16.3928	0.318791902	5.08894202	0	3.124189014	2.328420955	0.918353666	1.38096929	5.650112892	4.354060079	9.192319345	0	0	7.050521778	4.083717256	5.160885299	0.35236821	0.335881137	0	0	4.609849645	2.984270659	0	0	0.578006406	0.492131793	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.3966	0	0	16.3928	0.318791902	5.08894202	0	3.124189014	2.328420955	0.918353666	1.38096929	5.650112892	4.354060079	9.192319345	0	0	7.050521778	4.083717256	5.160885299	0.35236821	0.335881137	0	0	4.609849645	2.984270659	0	0	0.578006406	0.492131793	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.3966																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.3928	0.318791902	5.08894202	0	3.124189014	2.328420955	0.918353666	1.38096929	5.650112892	4.354060079	9.192319345	0	0	7.050521778	4.083717256	5.160885299	0.35236821	0.335881137	0	0	4.609849645	2.984270659	0	0	0.578006406	0.492131793	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.3966
H0543_036_0	2009	5																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	266.4203602	5.205047179	1017.668369	391.4434169	281.3028	10.98416529	14.82866064	326.2041847	249.8639154	17144.45225	82.96755447	0	14.14586127	1592.614127	7607.274974	5911.748343	197.6012197	411.4737883	0	0	32.72398984	1034.201704	0	0	268.6103765	158.9200231	0	0	98.4	0											"$200 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$200 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$25 (10a)	20% (11a)	20% (11b); $0 (11c)	"$40 (4a, 4a1, 4b)"	$0 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9a, 9d); $10 (5); $10/$10 (9c)"	"$10 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$10 (7b, 7d); $0 n/c (7b1, 7f1); $10/$10 (7f)"	"$10/$10 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$10/$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $10 (16b, 18a); $10/$10 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											199.9486063	200	0	0	25	0.2	0.090113843	40	0	2.8	0.167762077	0	0	0.020966901	6.106367511	10	10	0	0	0	0.2	9.653006009	0	0	30	30	0	0	0	0											199.9486063	200	0	0	25	0.2	0.090113843	40	0	2.8	0.167762077	0	0	0.020966901	6.106367511	10	10	0	0	0	0.2	9.653006009	0	0	30	30	0	0	0	0											4.4392	0.086750786	0	0	0.5860475	2.196833057	1.336267598	1.087347282	0	4.000372191	13.91880929	0	0	0.002782682	3.871068062	4.926456953	0.164667683	0	0	0	6.544797968	0.831929606	0	0	0.671525941	0.397300058	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0622	0	0	4.4392	0.086750786	0	0	0.5860475	2.196833057	1.336267598	1.087347282	0	4.000372191	13.91880929	0	0	0.002782682	3.871068062	4.926456953	0.164667683	0	0	0	6.544797968	0.831929606	0	0	0.671525941	0.397300058	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0622																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.4392	0.086750786	0	0	0.5860475	2.196833057	1.336267598	1.087347282	0	4.000372191	13.91880929	0	0	0.002782682	3.871068062	4.926456953	0.164667683	0	0	0	6.544797968	0.831929606	0	0	0.671525941	0.397300058	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0622
H0543_046_0	2009	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1732.466338	2.814590539	1355.008856	373.1224423	262.60352	11.60670646	8.080190871	350.2558943	364.3267162	18521.22852	67.35336789	0	43.12411182	1008.062554	7464.027987	6168.384857	124.7545996	476.6405012	0	0	37.30487865	1262.767223	0	0	223.9615751	198.8959798	0	0	98.4	0											"$200 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$100 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$200 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $200 (9a); $30/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30 (7f)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$15/$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 18a); $15/$30 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											122.3003921	912	55.10681964	0	100	0.2	0.09001028	50	200	2.8	0.164653084	0	0	69.85364574	9.752916311	29.99994526	30	8.334199101	0	0	0.2	28.10640578	0	0	30	30	0	0	0	0											122.3003921	912	55.10681964	0	100	0.2	0.09001028	50	200	2.8	0.164653084	0	0	69.85364574	9.752916311	29.99994526	30	8.334199101	0	0	0.2	28.10640578	0	0	30	30	0	0	0	0											17.6568	0.213908881	6.222519051	0	2.188362666	2.321341292	0.727300246	1.45939956	6.072111936	4.321619989	11.08993973	0	0	5.868070374	6.066336692	15.420934	0.311886499	0.331034736	0	0	7.46097573	2.957653999	0	0	0.559903938	0.49723995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.7473	0	0	17.6568	0.213908881	6.222519051	0	2.188362666	2.321341292	0.727300246	1.45939956	6.072111936	4.321619989	11.08993973	0	0	5.868070374	6.066336692	15.420934	0.311886499	0.331034736	0	0	7.46097573	2.957653999	0	0	0.559903938	0.49723995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.7473																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.6568	0.213908881	6.222519051	0	2.188362666	2.321341292	0.727300246	1.45939956	6.072111936	4.321619989	11.08993973	0	0	5.868070374	6.066336692	15.420934	0.311886499	0.331034736	0	0	7.46097573	2.957653999	0	0	0.559903938	0.49723995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.7473
H0543_049_0	2009	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1368.579284	2.766369153	1512.195858	512.6621163	230.8590669	8.473877208	3.787708295	502.009901	321.931	18241.57227	45.61918659	0	13.26306203	687.6639122	6955.715644	6148.014697	121.3306246	472.2410881	0	0	18.72925455	1209.380273	0	0	241.9431574	180.0203224	0	0	98.4	0											"$200 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$100 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$200 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$30 (3, 9d); $150 (5); $200 (9a); $30/$30 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$20 (7b, 7d); $0 n/c (7b1, 7f1); $10/$20 (7f)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$10/$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $10/$20 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											122.2990509	912	55.10681964	0	100	0.2	0.139279653	50	200	2.8	0.161239135	0	0	70.31414693	6.94286548	19.9999637	30	30	0	0	0.2	19.33318763	0	0	30	30	0	0	0	0											122.2990509	912	55.10681964	0	100	0.2	0.139279653	50	200	2.8	0.161239135	0	0	70.31414693	6.94286548	19.9999637	30	30	0	0	0.2	19.33318763	0	0	30	30	0	0	0	0											13.948	0.210244056	6.944358703	0	1.923825557	1.694775442	0.527550696	2.091707921	5.365516667	4.256366862	7.35559817	0	0	4.029375113	4.024383169	10.24667256	0.303326561	1.18060272	0	0	3.74585091	1.948431311	0	0	0.604857893	0.450050806	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.8515	0	0	13.948	0.210244056	6.944358703	0	1.923825557	1.694775442	0.527550696	2.091707921	5.365516667	4.256366862	7.35559817	0	0	4.029375113	4.024383169	10.24667256	0.303326561	1.18060272	0	0	3.74585091	1.948431311	0	0	0.604857893	0.450050806	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.8515																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	13.948	0.210244056	6.944358703	0	1.923825557	1.694775442	0.527550696	2.091707921	5.365516667	4.256366862	7.35559817	0	0	4.029375113	4.024383169	10.24667256	0.303326561	1.18060272	0	0	3.74585091	1.948431311	0	0	0.604857893	0.450050806	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.8515
H0543_060_0	2009	3																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1095.45873	4.790501048	962.3051953	313.8177996	264.3348536	9.488628918	5.355928939	579.0211097	238.4483314	16132.01774	72.419206	0	13.47930984	1399.303289	6859.95563	5794.932497	193.7120907	382.9418217	0	0	24.42009029	991.9273084	0	0	259.2612779	158.7268448	0	0	98.4	0											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-20/$100 Days 21-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$200 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$30 (3, 9d); $150 (5); $200 (9a); $30/$30 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$25 (7b, 7d); $0 n/c (7b1, 7f1); $10/$25 (7f)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$10/$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 18a); $10/$25 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											0	912	31.01658425	0	75	0.2	0.116693607	49.99800345	200	2.8	0.167477534	0	0	70.57679289	6.492094676	24.99999662	30	30	0	0	0.2	24.13172941	0	0	30	30	0	0	0	0											0	912	31.01658425	0	75	0.2	0.116693607	49.99800345	200	2.8	0.167477534	0	0	70.57679289	6.492094676	24.99999662	30	30	0	0	0.2	24.13172941	0	0	30	30	0	0	0	0											0	0.36407808	2.487285013	0	1.652092835	1.897725784	0.625002665	2.41249162	3.974138857	3.764137474	12.12859006	0	0	8.229861534	3.711290119	12.0727744	0.484280227	0.957354554	0	0	4.884018058	1.99474345	0	0	0.648153195	0.396817112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.6848	0	0	0	0.36407808	2.487285013	0	1.652092835	1.897725784	0.625002665	2.41249162	3.974138857	3.764137474	12.12859006	0	0	8.229861534	3.711290119	12.0727744	0.484280227	0.957354554	0	0	4.884018058	1.99474345	0	0	0.648153195	0.396817112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.6848																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0.36407808	2.487285013	0	1.652092835	1.897725784	0.625002665	2.41249162	3.974138857	3.764137474	12.12859006	0	0	8.229861534	3.711290119	12.0727744	0.484280227	0.957354554	0	0	4.884018058	1.99474345	0	0	0.648153195	0.396817112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.6848
H0543_065_0	2009	4																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	302.5454197	5.727256217	1171.289411	468.2636495	377.8038662	10.11583067	7.557183943	334.895708	256.3382629	18140.38885	73.10840854	0	13.01479321	1188.897991	7386.795985	6254.037163	183.5341852	448.1626425	0	0	31.02903086	1141.185917	0	0	244.8153097	195.5076634	0	0	98.4	0											"$400 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$100 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$175 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $175 (9a); $30/$30 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$30 (7b); $0 n/c (7b1, 7f1); $20 (7d); $10/$30 (7f)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$10/$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 18a); $10/$30 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											398.5239078	912	55.10681964	0	100	0.2	0.102246127	50	175	2.8	0.166395747	0	0	61.48855248	6.694094876	20.19045963	30	8.334199101	0	0	0.2	29.15257588	0	0	30	30	0	0	0	0											398.5239078	912	55.10681964	0	100	0.2	0.102246127	50	175	2.8	0.166395747	0	0	61.48855248	6.694094876	20.19045963	30	8.334199101	0	0	0.2	29.15257588	0	0	30	30	0	0	0	0											10.0476	0.435271472	5.378836194	0	3.148365552	2.023166134	0.772692791	1.395398783	3.738266334	4.232757399	12.16492823	0	0	6.091968045	4.120659429	10.52265707	0.458835463	0.311256391	0	0	6.205806172	2.772375754	0	0	0.612038274	0.488769158	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.9217	0	0	10.0476	0.435271472	5.378836194	0	3.148365552	2.023166134	0.772692791	1.395398783	3.738266334	4.232757399	12.16492823	0	0	6.091968045	4.120659429	10.52265707	0.458835463	0.311256391	0	0	6.205806172	2.772375754	0	0	0.612038274	0.488769158	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.9217																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.0476	0.435271472	5.378836194	0	3.148365552	2.023166134	0.772692791	1.395398783	3.738266334	4.232757399	12.16492823	0	0	6.091968045	4.120659429	10.52265707	0.458835463	0.311256391	0	0	6.205806172	2.772375754	0	0	0.612038274	0.488769158	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.9217
H0543_070_0	2009	3																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	310.6422199	6.404482838	1265.783503	525.9282314	372.6821326	11.94652041	10.47464284	403.7042962	301.8050064	18212.20903	96.32400217	0	13.28168965	1367.768467	7403.633569	6089.657328	178.7491794	444.3840977	0	0	27.93897855	1137.346672	0	0	274.063069	158.2923043	0	0	185.875867	0											"$495 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-20/$100 Days 21-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$200 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $200 (9a); $30/$30 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$15 (7b, 7d); $0 n/c (7b1, 7f1); $10/$15 (7f)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$10/$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 18a); $10/$15 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											494.8909082	912	31.01658425	0	75	0.2	0.096022073	50	200	2.8	0.168052053	0	0	69.86116853	6.655163119	14.99999226	30	8.334199101	0	0	0.2	14.591724	0	0	30	30	0	0	0	0											494.8909082	912	31.01658425	0	75	0.2	0.096022073	50	200	2.8	0.168052053	0	0	69.86116853	6.655163119	14.99999226	30	8.334199101	0	0	0.2	14.591724	0	0	30	30	0	0	0	0											12.8112	0.486740696	3.271690054	0	2.329263329	2.389304082	1.005796923	1.682101234	5.030083441	4.24951544	16.18744636	0	0	7.962825279	4.106032423	7.612067734	0.446872949	0.308632129	0	0	5.58779571	1.382987394	0	0	0.685157672	0.395730761	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.9312	0	0	12.8112	0.486740696	3.271690054	0	2.329263329	2.389304082	1.005796923	1.682101234	5.030083441	4.24951544	16.18744636	0	0	7.962825279	4.106032423	7.612067734	0.446872949	0.308632129	0	0	5.58779571	1.382987394	0	0	0.685157672	0.395730761	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.9312																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.8112	0.486740696	3.271690054	0	2.329263329	2.389304082	1.005796923	1.682101234	5.030083441	4.24951544	16.18744636	0	0	7.962825279	4.106032423	7.612067734	0.446872949	0.308632129	0	0	5.58779571	1.382987394	0	0	0.685157672	0.395730761	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.9312
H0543_072_0	2009	3																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	338.7515241	4.123457085	1376.852279	559.7215037	404.5533719	12.82777584	10.28764409	444.7080054	340.2460435	19620.27519	85.03717938	0	9.148235972	1047.192174	7665.71491	6483.528716	159.1868613	493.5368173	0	0	34.83183005	1286.385245	0	0	233.6287955	207.828847	0	0	283.119003	0											"$495 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-20/$100 Days 21-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$200 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $200 (9a); $30/$30 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$15 (7b, 7d); $0 n/c (7b1, 7f1); $10/$15 (7f)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$10/$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 18a); $10/$15 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											485.2123114	912	31.01658425	0	75	0.2	0.092444966	50	200	2.8	0.165857356	0	0	69.54219305	6.798022481	14.99998628	30	8.334199101	0	0	0.2	14.29202872	0	0	30	30	0	0	0	0											485.2123114	912	31.01658425	0	75	0.2	0.092444966	50	200	2.8	0.165857356	0	0	69.54219305	6.798022481	14.99998628	30	8.334199101	0	0	0.2	14.29202872	0	0	30	30	0	0	0	0											13.6972	0.313382738	3.558771225	0	2.528458575	2.565555169	0.95104091	1.852950023	5.670767392	4.578064212	14.10404174	0	0	6.068670025	4.342641858	8.104403481	0.397967153	0.342769508	0	0	6.966366011	1.532087906	0	0	0.584071989	0.519572118	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.6788	0	0	13.6972	0.313382738	3.558771225	0	2.528458575	2.565555169	0.95104091	1.852950023	5.670767392	4.578064212	14.10404174	0	0	6.068670025	4.342641858	8.104403481	0.397967153	0.342769508	0	0	6.966366011	1.532087906	0	0	0.584071989	0.519572118	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.6788																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	13.6972	0.313382738	3.558771225	0	2.528458575	2.565555169	0.95104091	1.852950023	5.670767392	4.578064212	14.10404174	0	0	6.068670025	4.342641858	8.104403481	0.397967153	0.342769508	0	0	6.966366011	1.532087906	0	0	0.584071989	0.519572118	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.6788
H0543_077_0	2009	5																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	272.2772151	5.259902631	1049.988569	359.6544904	285.1440925	9.682139265	5.575286522	327.2883688	259.0983602	17519.59912	72.9246756	0	14.90544783	1519.893763	7460.388484	6561.681608	209.110609	417.092603	0	0	26.54126562	1058.538238	626.4	0	275.5603755	159.0439553	18.89836242	6.3	1137.540304	473.3333333											"$150/$250 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$100 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$100 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $100 (9a); $30/$30 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$30 (7b); $10 (7b1, 7d); $10/$30 (7f); $0 n/c (7f1)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$10/$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 18a); $10/$30 (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$10 (13b); $0 n/c (13d, 13e)"											180.9334564	912	55.10681964	0	100	0.2	0.114819825	50	100	2.8	0.167573999	0	0	35.19672438	6.490325868	10.36617652	30	8.334199101	0	0	0.2	28.93868015	0	0	30	30	0	0	0	10											180.9334564	912	55.10681964	0	100	0.2	0.114819825	50	100	2.8	0.167573999	0	0	35.19672438	6.490325868	10.36617652	30	8.334199101	0	0	0.2	28.93868015	0	0	30	30	0	0	0	10											4.1053	0.3997526	4.821794227	0	2.376200771	1.936427853	0.640153421	1.363701537	2.159153001	4.087906461	12.22027951	0	0	4.457940157	4.035029364	5.66829582	0.522776523	0.289677733	0	0	5.308253123	2.552724959	0	0	0.688900939	0.397609888	0	0	0	0.394444444	0	0	0	0	0	0	0	0	0	0	58.4264	0	0	4.1053	0.3997526	4.821794227	0	2.376200771	1.936427853	0.640153421	1.363701537	2.159153001	4.087906461	12.22027951	0	0	4.457940157	4.035029364	5.66829582	0.522776523	0.289677733	0	0	5.308253123	2.552724959	0	0	0.688900939	0.397609888	0	0	0	0.394444444	0	0	0	0	0	0	0	0	0	0	58.4264																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.1053	0.3997526	4.821794227	0	2.376200771	1.936427853	0.640153421	1.363701537	2.159153001	4.087906461	12.22027951	0	0	4.457940157	4.035029364	5.66829582	0.522776523	0.289677733	0	0	5.308253123	2.552724959	0	0	0.688900939	0.397609888	0	0	0	0.394444444	0	0	0	0	0	0	0	0	0	0	58.4264
H0543_078_0	2009	7																																D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1387.738231	153.4426224	1219.372713	453.8631155	424.2012866	17.64417195	10.7648623	501.8236003	245.1526292	16078.95475	89.45609293	0	5.631620623	1010.839075	6701.63815	5186.007203	760.6278454	522.5124563	0	0	16.24342944	689.5081801	541.1465045	896.6930401	204.1416531	110.7185443	18.16954726	10.01572722	36.31394259	71.74428742											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$50 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4b); $0 (4a1)"	$0 (9b)	$0 (8a1); $0/$0 (8a2)	$0 (8b1); 20% (8b2); $20 (8b3)	Included in h.5.	20% (12)	"$0 (3, 9a, 9d); $10 (5, 9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $50 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$10 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a1, 14a4, 14a7, 14a8)"	"$0 n/c (13b, 13e); $0 (13d)"											0	0	0	0	50	0.2	0.085440672	49.94493558	0	0	0.132409356	0	0.2	0.582404049	0	0	10	0	0	0	0.2	0	0	0	0	0	0	0	0	0											0	0	0	0	50	0.2	0.085440672	49.94493558	0	0	0.132409356	0	0.2	0.582404049	0	0	10	0	0	0	0.2	0	0	0	0	0	0	0	0	0											0	0	0	0	1.767505361	3.52883439	0.919757068	2.088628949	0	0	11.84482366	0	1.126324125	0.049059731	0	0	0.633856538	0	0	0	3.248685888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2075	0	0	0	0	0	0	1.767505361	3.52883439	0.919757068	2.088628949	0	0	11.84482366	0	1.126324125	0.049059731	0	0	0.633856538	0	0	0	3.248685888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2075																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.767505361	3.52883439	0.919757068	2.088628949	0	0	11.84482366	0	1.126324125	0.049059731	0	0	0.633856538	0	0	0	3.248685888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2075
H0543_079_0	2009	7																																D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1336.810902	210.3560401	1230.65087	424.9074883	440.2339494	16.7278854	9.926141386	493.9799148	228.2616525	16186.14645	83.27270303	0	4.524139603	978.7552572	6725.696538	5256.901143	600.0726649	528.3588874	0	0	14.80051837	693.5679538	539.3136798	892.5356838	175.8573359	109.9171997	18.04167766	8.422525861	36.31394259	71.74428742											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$50 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4b); $0 (4a1)"	$0 (9b)	$0 (8a1); $0/$0 (8a2)	$0 (8b1); 20% (8b2); $20 (8b3)	Included in h.5.	20% (12)	"$0 (3, 9a, 9d); $10 (5, 9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $50 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$10 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a1, 14a4, 14a7, 14a8)"	"$0 n/c (13b, 13e); $0 (13d)"											0	0	0	0	50	0.2	0.096686112	49.94445491	0	0	0.132992492	0	0.2	0.493360884	0	0	10	0	0	0	0.2	0	0	0	0	0	0	0	0	0											0	0	0	0	50	0.2	0.096686112	49.94445491	0	0	0.132992492	0	0.2	0.493360884	0	0	10	0	0	0	0.2	0	0	0	0	0	0	0	0	0											0	0	0	0	1.834308123	3.345577081	0.959720014	2.055963132	0	0	11.07464431	0	0.904827921	0.040239963	0	0	0.500060554	0	0	0	2.960103674	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.6754	0	0	0	0	0	0	1.834308123	3.345577081	0.959720014	2.055963132	0	0	11.07464431	0	0.904827921	0.040239963	0	0	0.500060554	0	0	0	2.960103674	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.6754																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.834308123	3.345577081	0.959720014	2.055963132	0	0	11.07464431	0	0.904827921	0.040239963	0	0	0.500060554	0	0	0	2.960103674	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.6754
H0543_081_0	2009	7																																D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1428.9176	153.8480205	1266.688772	448.9302924	460.3190138	15.54225276	8.98313089	532.284124	242.6231188	16298.00374	76.66773657	0	3.88283423	956.8101861	6740.603983	5359.436287	746.7414518	531.5298921	0	0	15.11719133	697.0890098	540.8457181	896.1287289	201.8446738	110.5159038	18.14035818	8.730935025	36.31394259	71.74428742											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$50 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4b); $0 (4a1)"	$0 (9b)	$0 (8a1); $0/$0 (8a2)	$0 (8b1); 20% (8b2); $20 (8b3)	Included in h.5.	20% (12)	"$0 (3, 9a, 9d); $10 (5, 9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $50 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$10 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a1, 14a4, 14a7, 14a8)"	"$0 n/c (13b, 13e); $0 (13d)"											0	0	0	0	50	0.2	0.091036423	49.9481701	0	0	0.133849607	0	0.2	0.394369374	0	0	10	0	0	0	0.2	0	0	0	0	0	0	0	0	0											0	0	0	0	50	0.2	0.091036423	49.9481701	0	0	0.133849607	0	0.2	0.394369374	0	0	10	0	0	0	0.2	0	0	0	0	0	0	0	0	0											0	0	0	0	1.917995891	3.108450551	0.817792105	2.215551497	0	0	10.2619464	0	0.776566846	0.03144472	0	0	0.622284543	0	0	0	3.023438267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.7755	0	0	0	0	0	0	1.917995891	3.108450551	0.817792105	2.215551497	0	0	10.2619464	0	0.776566846	0.03144472	0	0	0.622284543	0	0	0	3.023438267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.7755																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.917995891	3.108450551	0.817792105	2.215551497	0	0	10.2619464	0	0.776566846	0.03144472	0	0	0.622284543	0	0	0	3.023438267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.7755
H0543_082_0	2009	6																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1224.09734	4.942646591	1179.592767	499.4496557	253.3174178	10.01232719	8.204944688	356.8596853	425.0226035	17689.95208	59.4868503	0	6.128849283	517.8290486	6757.696258	5758.775126	125.218556	454.6741978	0	0	30.8852993	1150.503182	0	0	184.3348908	238.5168024	0	0	98.4	0											"$200 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$100 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$200 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $200 (9a); $30/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30 (7f)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$15/$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 18a); $15/$30 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											122.2985062	912	55.10681964	0	100	0.2	0.084945493	50	200	2.8	0.164212569	0	0	67.26253417	10.31705902	29.99994546	30	8.334199101	0	0	0.2	29.38913577	0	0	30	30	0	0	0	0											122.2985062	912	55.10681964	0	100	0.2	0.084945493	50	200	2.8	0.164212569	0	0	67.26253417	10.31705902	29.99994546	30	8.334199101	0	0	0.2	29.38913577	0	0	30	30	0	0	0	0											12.4754	0.375641141	5.416967154	0	2.110978482	2.002465437	0.696973068	1.486915355	7.083710059	4.127655486	9.768488515	0	0	2.902541173	5.809962597	14.39691164	0.31304639	0.315778774	0	0	6.17705986	2.817691185	0	0	0.460837227	0.596292006	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3354	0	0	12.4754	0.375641141	5.416967154	0	2.110978482	2.002465437	0.696973068	1.486915355	7.083710059	4.127655486	9.768488515	0	0	2.902541173	5.809962597	14.39691164	0.31304639	0.315778774	0	0	6.17705986	2.817691185	0	0	0.460837227	0.596292006	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3354																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.4754	0.375641141	5.416967154	0	2.110978482	2.002465437	0.696973068	1.486915355	7.083710059	4.127655486	9.768488515	0	0	2.902541173	5.809962597	14.39691164	0.31304639	0.315778774	0	0	6.17705986	2.817691185	0	0	0.460837227	0.596292006	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3354
H0543_083_0	2009	5																					4000											D	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1136.688713	5.102031302	1008.42107	354.6571455	274.9245456	8.774054384	5.109573946	321.885595	247.7617593	16796.46332	68.5949008	0	14.12838726	1459.438286	7150.342749	5771.302375	196.6244944	398.9558892	0	0	21.68358862	1014.225326	0	0	266.971167	158.9467011	18.89836242	6.3	185.875867	0											"$125 Days 1-8 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$100 Days 11-50 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$100 (10a)	15% (11a)	15% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$125 (9b)	$0/$7 (8a1); $7 (8a2)	"$10 (8b1); 15% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$10 (3, 9d); $20 (5); $125 (9a); $20/$20 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$30 (7b); $0 n/c (7b1, 7f1); $20 (7d, 7f)"	"$20/$20 (7e, 7h)"	"$10 (7c, 7i)"	Included in h.2.	$10/$20 (7g)	"15% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 18a); $10/$30 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											94.13081089	912	48.65089231	0	100	0.15	0.083858312	50	125	2.8	0.136064231	0	0	43.63352821	6.492442239	20.19978753	20	10	0	0	0.15	28.93524608	0	0	30	30	0	0	0	0											77.99507911	755.6666247	40.31124516	0	82.85818253	0.124287274	0.069483473	41.42909127	103.5727282	2.320029111	0.112740349	0	0	36.15394845	5.379519641	16.73717682	16.57163651	8.285818253	0	0	0.124287274	23.97521902	0	0	24.85745476	30	0	0	0	0											7.388	0.321286231	3.387559082	0	1.898312348	1.0905033	0.355030946	1.111285641	2.138446779	3.247356988	7.733413031	0	0	4.397038046	3.205450772	8.049609029	0.271532471	0.275472999	0	0	2.694994116	2.026356194	0	0	0.553018642	0.397366753	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.542	0	10.374	7.388	0.321286231	3.387559082	0	1.898312348	1.0905033	0.355030946	1.111285641	2.138446779	3.247356988	7.733413031	0	0	4.397038046	3.205450772	8.049609029	0.271532471	0.275472999	0	0	2.694994116	2.026356194	0	0	0.553018642	0.397366753	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.542																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.388	0.321286231	3.387559082	0	1.898312348	1.0905033	0.355030946	1.111285641	2.138446779	3.247356988	7.733413031	0	0	4.397038046	3.205450772	8.049609029	0.271532471	0.275472999	0	0	2.694994116	2.026356194	0	0	0.553018642	0.397366753	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.542
H0543_084_0	2009	5																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1082.967717	4.754299133	955.2535581	415.8791495	259.5033396	9.154879051	5.132265766	311.8033264	235.6711423	15959.79377	68.94708209	0	13.36924634	1395.263103	6798.72133	5494.627101	192.8502421	380.4055529	0	0	23.84795548	982.7052511	0	0	257.8337988	158.8358949	0	0	1137.540304	0											"$150 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$100 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2, 6a3); $0 n/c (6a1)"	$200 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$100 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$10 Visits 1-12/$20 Visits 13-999 (3, 9d); $150 (5); $100 (9a); $30/$30 (9c)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$10 (7b, 7d); $0 n/c (7b1, 7f1); $5/$10 (7f)"	"$30/$30 (7e, 7h)"	"$10 Visits 1-12/$20 Visits 13-999 (7c, 7i)"	Included in h.2.	$5/$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $10 (16b, 18a); $5/$10 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$0 n/c (13b, 13d, 13e)"											91.72308996	912	55.10681964	0	200	0.2	0.11658336	50	100	2.8	0.167587208	0	0	35.36626468	3.246874184	9.999998823	30	12.77806637	0	0	0.2	9.65228053	0	0	30	30	0	0	0	0											91.72308996	912	55.10681964	0	200	0.2	0.11658336	50	100	2.8	0.167587208	0	0	35.36626468	3.246874184	9.999998823	30	12.77806637	0	0	0.2	9.65228053	0	0	30	30	0	0	0	0											8.2778	0.361326734	4.386748795	0	4.325055661	1.83097581	0.598336787	1.299180527	1.963926186	3.723951879	11.55464898	0	0	4.112103682	1.839549397	4.578855379	0.482125605	0.405070617	0	0	4.769591096	0.790445563	0	0	0.644584497	0.397089737	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3413	0	0	8.2778	0.361326734	4.386748795	0	4.325055661	1.83097581	0.598336787	1.299180527	1.963926186	3.723951879	11.55464898	0	0	4.112103682	1.839549397	4.578855379	0.482125605	0.405070617	0	0	4.769591096	0.790445563	0	0	0.644584497	0.397089737	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3413																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.2778	0.361326734	4.386748795	0	4.325055661	1.83097581	0.598336787	1.299180527	1.963926186	3.723951879	11.55464898	0	0	4.112103682	1.839549397	4.578855379	0.482125605	0.405070617	0	0	4.769591096	0.790445563	0	0	0.644584497	0.397089737	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3413
H0543_085_0	2009	5																																D	A	D	V	T	Coin	Coin	V	Coin	O	Coin	V	O	Coin	V	V	V	Coin	V	V	Coin	O	T	V	P	P	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	1639.772862	3.363769405	1650.602206	586.9321627	324.2415856	10.23652218	8.365954253	322.3409777	46.300499	16980.65927	60.56954239	0	5.890377848	6.545873016	6437.886534	5526.455116	119.3962231	3.479424673	0	0	38.41638843	1104.333807	0	0	163.4220242	265.6438289	0	0	98.4	0											"$275 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-5/$100 Days 6-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"20% (3, 9a, 9d); $150 (5); $30/$30 (9c)"	"$5 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$10 (7b, 7d); $0 n/c (7b1, 7f1); $5/$10 (7f)"	"$30/$30 (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$5/$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $10 (16b, 18a); $5/$10 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											222.1593059	912	74.33330748	0	100	0.2	0.083171698	50	0.2	2.8	0.165435499	0	0	0.009562766	3.447752191	9.999981605	30	0.2	0	0	0.2	9.756426369	0	0	30	30	0	0	0	0											222.1593059	912	74.33330748	0	100	0.2	0.083171698	50	0.2	2.8	0.165435499	0	0	0.009562766	3.447752191	9.999981605	30	0.2	0	0	0.2	9.756426369	0	0	30	30	0	0	0	0											30.3576	0.255646475	10.22456011	0	2.702013213	2.047304436	0.695810621	1.343087407	9.2600998	3.962153829	10.02035247	0	0	0.062596649	1.84968645	4.605370792	0.298490558	0.695884935	0	0	7.683277685	0.897862623	0	0	0.408555061	0.664109572	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.0344	0	0	30.3576	0.255646475	10.22456011	0	2.702013213	2.047304436	0.695810621	1.343087407	9.2600998	3.962153829	10.02035247	0	0	0.062596649	1.84968645	4.605370792	0.298490558	0.695884935	0	0	7.683277685	0.897862623	0	0	0.408555061	0.664109572	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.0344																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	30.3576	0.255646475	10.22456011	0	2.702013213	2.047304436	0.695810621	1.343087407	9.2600998	3.962153829	10.02035247	0	0	0.062596649	1.84968645	4.605370792	0.298490558	0.695884935	0	0	7.683277685	0.897862623	0	0	0.408555061	0.664109572	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.0344
H0543_086_0	2009	4																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	321.0161037	4.280053564	1366.245613	535.2179273	320.6970053	10.24107838	8.835890118	363.1170128	365.5730339	18205.66723	68.99872996	0	7.370989297	1237.522949	7250.928906	6199.822291	127.4964382	561.1927206	0	0	41.05267921	1288.839229	0	0	198.3897206	246.400011	0	0	98.4	0											"$400 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-20/$100 Days 21-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$175 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $175 (9a); $30/$30 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$20 (7b, 7d); $0 n/c (7b1, 7f1); $10/$20 (7f)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$10/$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $10/$20 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											385.8643408	912	31.01658425	0	75	0.2	0.094884009	50	175	2.8	0.166056657	0	0	61.38094282	6.881473586	19.99997094	30	8.334199101	0	0	0.2	19.62259346	0	0	30	30	0	0	0	0											385.8643408	912	31.01658425	0	75	0.2	0.094884009	50	175	2.8	0.166056657	0	0	61.38094282	6.881473586	19.99997094	30	8.334199101	0	0	0.2	19.62259346	0	0	30	30	0	0	0	0											10.3224	0.325284071	3.531356014	0	2.004356283	2.048215676	0.838384677	1.512987553	5.331273411	4.24798902	11.45769842	0	0	6.330027116	4.158089645	10.33302214	0.318741095	0.389757656	0	0	8.210535842	2.107530686	0	0	0.495974301	0.616000027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5796	0	0	10.3224	0.325284071	3.531356014	0	2.004356283	2.048215676	0.838384677	1.512987553	5.331273411	4.24798902	11.45769842	0	0	6.330027116	4.158089645	10.33302214	0.318741095	0.389757656	0	0	8.210535842	2.107530686	0	0	0.495974301	0.616000027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5796																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.3224	0.325284071	3.531356014	0	2.004356283	2.048215676	0.838384677	1.512987553	5.331273411	4.24798902	11.45769842	0	0	6.330027116	4.158089645	10.33302214	0.318741095	0.389757656	0	0	8.210535842	2.107530686	0	0	0.495974301	0.616000027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5796
H0543_089_0	2009	3																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	298.473205	6.451473052	1110.198246	417.9895884	581.4252812	13.65296229	12.39088197	371.7479603	269.7522342	18621.22151	89.8418033	0	17.29296549	1641.702904	8053.49726	6545.829141	212.164956	449.1511588	0	0	26.3072668	1122.173387	0	0	285.2803463	161.5089746	0	0	98.4	0											"$200 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$200 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$25 (10a)	20% (11a)	20% (11b); $0 (11c)	"$40 (4a, 4a1, 4b)"	$0 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9a, 9d); $10 (5); $10/$10 (9c)"	"$10 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$10 (7b, 7d); $0 n/c (7b1, 7f1); $10/$10 (7f)"	"$10/$10 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$10/$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $10 (16b, 18a); $10/$10 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											199.9541254	200	0	0	25	0.2	0.091136406	40	0	2.8	0.169383507	0	0	0.022021919	6.272331451	10	10	0	0	0	0.2	9.652426321	0	0	30	30	0	0	0	0											199.9541254	200	0	0	25	0.2	0.091136406	40	0	2.8	0.169383507	0	0	0.022021919	6.272331451	10	10	0	0	0	0.2	9.652426321	0	0	30	30	0	0	0	0											4.9734	0.107524551	0	0	1.211302669	2.730592458	1.129260456	1.239159868	0	4.344951687	15.21771969	0	0	0.003012787	4.209517013	5.454857618	0.17680413	0	0	0	5.261453359	0.902641328	0	0	0.713200866	0.403772437	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.0792	0	0	4.9734	0.107524551	0	0	1.211302669	2.730592458	1.129260456	1.239159868	0	4.344951687	15.21771969	0	0	0.003012787	4.209517013	5.454857618	0.17680413	0	0	0	5.261453359	0.902641328	0	0	0.713200866	0.403772437	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.0792																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.9734	0.107524551	0	0	1.211302669	2.730592458	1.129260456	1.239159868	0	4.344951687	15.21771969	0	0	0.003012787	4.209517013	5.454857618	0.17680413	0	0	0	5.261453359	0.902641328	0	0	0.713200866	0.403772437	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.0792
H0543_091_0	2009	5																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	277.9415727	5.918767919	1043.096996	370.3656299	364.19939	11.07483318	12.6462818	350.2916661	254.2187197	17775.02764	85.38346715	0	15.50395603	1527.140314	7679.379065	6120.816924	201.0309392	439.3645135	0	0	29.01240807	1056.290949	0	0	246.2898358	184.6108704	0	0	98.4	0											"$200 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$200 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$25 (10a)	20% (11a)	20% (11b); $0 (11c)	"$40 (4a, 4a1, 4b)"	$0 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9a, 9d); $10 (5); $10/$10 (9c)"	"$10 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$10 (7b, 7d); $0 n/c (7b1, 7f1); $10/$10 (7f)"	"$10/$10 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$10/$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $10 (16b, 18a); $10/$10 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											199.4472251	200	0	0	25	0.2	0.10589631	40	0	2.8	0.168516311	0	0	0.022239395	6.17520841	10	10	0	0	0	0.2	9.654136996	0	0	30	30	0	0	0	0											199.4472251	200	0	0	25	0.2	0.10589631	40	0	2.8	0.168516311	0	0	0.022239395	6.17520841	10	10	0	0	0	0.2	9.654136996	0	0	30	30	0	0	0	0											4.6196	0.098646132	0	0	0.758748729	2.214966635	1.339194579	1.167638887	0	4.14750645	14.38850691	0	0	0.002830223	3.951813849	5.10068077	0.167525783	0	0	0	5.802481614	0.849798128	0	0	0.61572459	0.461527176	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.6871	0	0	4.6196	0.098646132	0	0	0.758748729	2.214966635	1.339194579	1.167638887	0	4.14750645	14.38850691	0	0	0.002830223	3.951813849	5.10068077	0.167525783	0	0	0	5.802481614	0.849798128	0	0	0.61572459	0.461527176	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.6871																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.6196	0.098646132	0	0	0.758748729	2.214966635	1.339194579	1.167638887	0	4.14750645	14.38850691	0	0	0.002830223	3.951813849	5.10068077	0.167525783	0	0	0	5.802481614	0.849798128	0	0	0.61572459	0.461527176	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.6871
H0543_093_0	2009	4																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	292.0657747	6.237238434	1073.116399	404.724209	562.1178422	12.76059027	11.58123104	359.3770415	260.7945486	18002.86502	83.96830103	0	16.7187165	1587.186735	7472.002062	6328.461213	205.1195761	434.2361578	0	0	24.58747257	1084.909279	0	0	147.9890135	292.8	0	0	98.4	0											"$200 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$200 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$25 (10a)	20% (11a)	20% (11b); $0 (11c)	"$40 (4a, 4a1, 4b)"	$0 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9a, 9d); $10 (5); $10/$10 (9c)"	"$10 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$10 (7b, 7d); $0 n/c (7b1, 7f1); $10/$10 (7f)"	"$10/$10 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$10/$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $10 (16b, 18a); $10/$10 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											197.5552197	200	0	0	25	0.2	0.091135333	40	0	2.8	0.169383631	0	0	0.022021919	6.535969109	10	10	0	0	0	0.2	9.652426321	0	0	30	30	0	0	0	0											197.5552197	200	0	0	25	0.2	0.091135333	40	0	2.8	0.169383631	0	0	0.022021919	6.535969109	10	10	0	0	0	0.2	9.652426321	0	0	30	30	0	0	0	0											4.8083	0.103953974	0	0	1.171078838	2.552118053	1.055459345	1.197923472	0	4.200668504	14.22285568	0	0	0.002912741	4.069731221	5.273717677	0.17093298	0	0	0	4.917494514	0.87266724	0	0	0.369972534	0.732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.7217	0	0	4.8083	0.103953974	0	0	1.171078838	2.552118053	1.055459345	1.197923472	0	4.200668504	14.22285568	0	0	0.002912741	4.069731221	5.273717677	0.17093298	0	0	0	4.917494514	0.87266724	0	0	0.369972534	0.732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.7217																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.8083	0.103953974	0	0	1.171078838	2.552118053	1.055459345	1.197923472	0	4.200668504	14.22285568	0	0	0.002912741	4.069731221	5.273717677	0.17093298	0	0	0	4.917494514	0.87266724	0	0	0.369972534	0.732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.7217
H0543_095_0	2009	5																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	257.4879147	4.923424054	1035.132859	342.6896815	282.5117218	9.315173318	5.264879069	312.5266623	240.6904414	16151.8223	69.67118111	0	13.10561852	1374.825742	6849.173881	5552.610146	190.2751498	396.6046681	0	0	24.09318481	997.0595261	0	0	259.3423876	158.7683185	0	0	1137.540304	473.3333333											"$200 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-20/$120 Days 21-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$100 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $100 (9a); $30/$30 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $30 (7a1); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$5 (7b, 7d); $0 n/c (7b1, 7f1); $0/$5 (7f)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$0/$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $5 (16b, 18a); $0/$5 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$5 (13b); $0 n/c (13d, 13e)"											199.9468234	912	37.21990109	0	75	0.2	0.115324515	50	100	2.8	0.167432575	0	0	35.1934153	0.002356713	4.999997999	30	8.334199101	0	0	0.2	4.832665372	0	0	30	30	0	0	0	5											199.9468234	912	37.21990109	0	75	0.2	0.115324515	50	100	2.8	0.167432575	0	0	35.1934153	0.002356713	4.999997999	30	8.334199101	0	0	0.2	4.832665372	0	0	30	30	0	0	0	5											4.2903	0.374180228	3.210628553	0	1.765698261	1.863034664	0.607169623	1.302194426	2.005753679	3.768758536	11.66522524	0	0	4.032067774	0.001345128	2.313586635	0.475687875	0.275448522	0	0	4.818636961	0.40153792	0	0	0.648355969	0.396920796	0	0	0	0.197222222	0	0	0	0	0	0	0	0	0	0	44.4138	0	0	4.2903	0.374180228	3.210628553	0	1.765698261	1.863034664	0.607169623	1.302194426	2.005753679	3.768758536	11.66522524	0	0	4.032067774	0.001345128	2.313586635	0.475687875	0.275448522	0	0	4.818636961	0.40153792	0	0	0.648355969	0.396920796	0	0	0	0.197222222	0	0	0	0	0	0	0	0	0	0	44.4138																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.2903	0.374180228	3.210628553	0	1.765698261	1.863034664	0.607169623	1.302194426	2.005753679	3.768758536	11.66522524	0	0	4.032067774	0.001345128	2.313586635	0.475687875	0.275448522	0	0	4.818636961	0.40153792	0	0	0.648355969	0.396920796	0	0	0	0.197222222	0	0	0	0	0	0	0	0	0	0	44.4138
H0543_114_0	2009	3																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1413.657704	5.194693879	1168.285609	536.3379021	321.0775455	11.76075688	9.458117212	367.8151943	277.4083816	17217.39835	85.48959397	0	14.05444093	1261.328635	6891.385462	5768.723471	168.2984776	421.6459966	0	0	24.84653364	1081.153657	0	0	180.6283098	251.2194272	0	0	98.4	0											"$100 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-20/$100 Days 21-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$100 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $100 (9a); $30/$30 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$15 (7b, 7d); $0 n/c (7b1, 7f1); $10/$15 (7f)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$10/$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 18a); $10/$15 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											61.14973492	912	31.01658425	0	75	0.2	0.102828653	50	100	2.8	0.167604182	0	0	35.18870162	6.772179324	14.9999921	30	8.334199101	0	0	0.2	14.5933325	0	0	30	30	0	0	0	0											61.14973492	912	31.01658425	0	75	0.2	0.102828653	50	100	2.8	0.167604182	0	0	35.18870162	6.772179324	14.9999921	30	8.334199101	0	0	0.2	14.5933325	0	0	30	30	0	0	0	0											7.2037	0.394796735	3.019685752	0	2.006734659	2.352151376	0.972565454	1.532563309	2.311736513	4.017392948	14.32841345	0	0	3.698709749	3.889141512	7.210900539	0.420746194	0.292840141	0	0	4.969306727	1.3148029	0	0	0.451570774	0.628048568	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.0158	0	0	7.2037	0.394796735	3.019685752	0	2.006734659	2.352151376	0.972565454	1.532563309	2.311736513	4.017392948	14.32841345	0	0	3.698709749	3.889141512	7.210900539	0.420746194	0.292840141	0	0	4.969306727	1.3148029	0	0	0.451570774	0.628048568	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.0158																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.2037	0.394796735	3.019685752	0	2.006734659	2.352151376	0.972565454	1.532563309	2.311736513	4.017392948	14.32841345	0	0	3.698709749	3.889141512	7.210900539	0.420746194	0.292840141	0	0	4.969306727	1.3148029	0	0	0.451570774	0.628048568	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.0158
H0543_121_0	2009	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	971.3872111	4.413048079	859.3804822	308.9446504	238.680046	7.926607406	4.692833241	326.2608264	215.9371165	14311.80948	58.05377962	0	11.43371351	1226.515799	5986.927686	5557.102447	169.2102926	342.2361927	0	0	19.75705762	873.6986513	0	284.9284685	202.8358914	155.2014763	18.80256512	4.8	953.4977179	473.3333333											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$100 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$0 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $0 (9a); $30/$30 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $30 (7a1); $0 n/c (14b1, 14e1, 14f1, 14h1)"	$30 (7b); $10 (7b1); $0 (7d); $0/$30 (7f); $0 n/c (7f1)	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$0/$0 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 18a); $0/$30 (17a)"	$0 n/c (10b)	"$20 (16a, 16a1); $0 n/c (16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$10 (13b); $0 n/c (13d, 13e)"											0	912	55.10681964	0	100	0.2	0.116334042	49.99314097	0	2.8	0.167265154	0	0	0.612564461	0.009723676	1.774092779	30	8.334199101	0	0	0.2	28.86095273	0	20	0	0	0	0	0	10											0	912	55.10681964	0	100	0.2	0.116334042	49.99314097	0	2.8	0.167265154	0	0	0.612564461	0.009723676	1.774092779	30	8.334199101	0	0	0.2	28.86095273	0	20	0	0	0	0	0	10											0	0.335391654	3.946477103	0	1.989000383	1.585321481	0.545936259	1.359233624	0	3.339422211	9.710374406	0	0	0.062609999	0.004851245	0.821567944	0.423025732	0.237688714	0	0	3.951411524	2.101314623	0	0.474880781	0	0	0	0	0	0.394444444	0	0	0	0	0	0	0	0	0	0	31.283	0	0	0	0.335391654	3.946477103	0	1.989000383	1.585321481	0.545936259	1.359233624	0	3.339422211	9.710374406	0	0	0.062609999	0.004851245	0.821567944	0.423025732	0.237688714	0	0	3.951411524	2.101314623	0	0.474880781	0	0	0	0	0	0.394444444	0	0	0	0	0	0	0	0	0	0	31.283																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0.335391654	3.946477103	0	1.989000383	1.585321481	0.545936259	1.359233624	0	3.339422211	9.710374406	0	0	0.062609999	0.004851245	0.821567944	0.423025732	0.237688714	0	0	3.951411524	2.101314623	0	0.474880781	0	0	0	0	0	0.394444444	0	0	0	0	0	0	0	0	0	0	31.283
H0543_122_0	2009	5																					5000											D	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	886.7909571	4.720019417	783.2947323	251.4429638	212.693822	7.19534034	4.078630141	254.061494	190.9024757	12936.55242	52.88415616	0	10.82845958	1128.078882	5510.379564	4464.053993	159.4079496	308.5461489	0	0	16.2987752	800.5391412	0	0	223.7956236	158.4246653	0	0	185.875867	0											"$200 Days 1-8 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$100 Days 11-56 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$200 (9b)	$0/$2 (8a1); $2 (8a2)	"$10 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$30 (3, 9d); $150 (5); $200 (9a); $30/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30 (7f)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$15/$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 18a); $15/$30 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											150.60671	912	50.48729715	0	100	0.2	0.11207841	50	200	0.8	0.178010255	0	0	70.57851044	9.736013859	29.99999648	30	30	0	0	0.2	28.9628217	0	0	30	30	0	0	0	0											130.2706755	788.8549992	43.67012802	0	86.49725869	0.172994517	0.096944752	43.24862934	172.9945174	0.691978069	0.15397399	0	0	61.04847675	8.421385094	25.94917456	25.94917761	25.94917761	0	0	0.172994517	25.05204681	0	0	25.94917761	30	0	0	0	0											9.6269	0.310284243	2.850548436	0	1.533119378	1.244754429	0.395401789	0.915650949	2.752090137	0.745984214	8.142784553	0	0	5.738958118	3.867085693	9.653209693	0.344708766	0.667209901	0	0	2.819598749	1.671262003	0	0	0.483942699	0.396061663	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.1596	0	8.3928	9.6269	0.310284243	2.850548436	0	1.533119378	1.244754429	0.395401789	0.915650949	2.752090137	0.745984214	8.142784553	0	0	5.738958118	3.867085693	9.653209693	0.344708766	0.667209901	0	0	2.819598749	1.671262003	0	0	0.483942699	0.396061663	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.1596																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	9.6269	0.310284243	2.850548436	0	1.533119378	1.244754429	0.395401789	0.915650949	2.752090137	0.745984214	8.142784553	0	0	5.738958118	3.867085693	9.653209693	0.344708766	0.667209901	0	0	2.819598749	1.671262003	0	0	0.483942699	0.396061663	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.1596
H0543_125_0	2009	7																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1152.819229	2.851831692	941.5791578	441.6250893	253.6602374	8.721997267	7.464076283	301.8704626	322.8745586	15995.3963	53.12323567	0	5.901669599	1008.301196	6101.612664	5132.738259	110.4529835	409.4063922	0	0	25.73112288	1033.065697	0	0	183.8976475	230.3221061	0	0	330.5004583	0											"$250 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-5/$100 Days 6-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$200 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $200 (9a); $30/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$30 (7b, 7d); $0 n/c (7b1, 7f1); $15/$30 (7f)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$15/$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 18a); $15/$30 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											152.873115	912	74.33330748	0	100	0.2	0.085929682	50	200	2.8	0.163770515	0	0	69.99569327	10.25298074	29.99994354	30	8.334199101	0	0	0.2	29.55087809	0	0	30	30	0	0	0	0											152.873115	912	74.33330748	0	100	0.2	0.085929682	50	200	2.8	0.163770515	0	0	69.99569327	10.25298074	29.99994354	30	8.334199101	0	0	0.2	29.55087809	0	0	30	30	0	0	0	0											14.6863	0.216739209	5.832557754	0	2.113835311	1.744399453	0.641385702	1.257793594	5.381242643	3.732259138	8.700019651	0	0	5.881395105	5.213309759	12.8318215	0.276132459	0.284339532	0	0	5.146224577	2.543999872	0	0	0.459744119	0.575805265	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.5193	0	0	14.6863	0.216739209	5.832557754	0	2.113835311	1.744399453	0.641385702	1.257793594	5.381242643	3.732259138	8.700019651	0	0	5.881395105	5.213309759	12.8318215	0.276132459	0.284339532	0	0	5.146224577	2.543999872	0	0	0.459744119	0.575805265	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.5193																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.6863	0.216739209	5.832557754	0	2.113835311	1.744399453	0.641385702	1.257793594	5.381242643	3.732259138	8.700019651	0	0	5.881395105	5.213309759	12.8318215	0.276132459	0.284339532	0	0	5.146224577	2.543999872	0	0	0.459744119	0.575805265	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.5193
H0543_126_0	2009	6																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1148.218599	6.471805807	975.2726147	334.4798381	410.1056368	10.62509252	8.614768752	334.4759426	238.3185101	16306.54973	72.92610543	0	14.45837621	1432.328566	6856.325994	5702.033278	198.1447778	390.3499246	0	0	23.73130619	992.6357832	0	0	196.4350341	230.3845799	0	0	329.0043022	0											"$100 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$100 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$100 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $100 (9a); $30/$30 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$30 (7b); $0 n/c (7b1, 7f1); $20 (7d); $10/$30 (7f)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$10/$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 18a); $10/$30 (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											61.14909602	912	55.10681964	0	100	0.2	0.097371768	50	100	2.8	0.168657208	0	0	35.09089902	6.510771585	20.19635192	30	8.334199101	0	0	0.2	28.96276919	0	0	30	30	0	0	0	0											61.14909602	912	55.10681964	0	100	0.2	0.097371768	50	100	2.8	0.168657208	0	0	35.09089902	6.510771585	20.19635192	30	8.334199101	0	0	0.2	28.96276919	0	0	30	30	0	0	0	0											5.851	0.491857241	4.478681007	0	3.417546974	2.125018504	0.838835262	1.393649761	1.985987584	3.804861604	12.29951331	0	0	4.188474756	3.719997705	9.596689229	0.495361945	0.271104499	0	0	4.746261239	2.39579009	0	0	0.491087585	0.57596145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.1677	0	0	5.851	0.491857241	4.478681007	0	3.417546974	2.125018504	0.838835262	1.393649761	1.985987584	3.804861604	12.29951331	0	0	4.188474756	3.719997705	9.596689229	0.495361945	0.271104499	0	0	4.746261239	2.39579009	0	0	0.491087585	0.57596145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.1677																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	5.851	0.491857241	4.478681007	0	3.417546974	2.125018504	0.838835262	1.393649761	1.985987584	3.804861604	12.29951331	0	0	4.188474756	3.719997705	9.596689229	0.495361945	0.271104499	0	0	4.746261239	2.39579009	0	0	0.491087585	0.57596145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.1677
H0543_127_0	2009	4																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	918.3225797	3.499062836	800.9636079	310.3271258	222.6212748	7.8357754	4.616056321	281.8571914	219.8142737	14241.22012	58.73392983	0	10.38840813	1110.066121	5941.609023	5434.890263	158.5956415	346.3383024	0	0	20.93705825	890.6681392	626.4	0	234.8394779	158.2667243	0	0	185.875867	473.3333333											"$100 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-20/$120 Days 21-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$100 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $100 (9a); $30/$30 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $30 (7a1); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$0 (7b, 7d, 7f); $10 (7b1); $0 n/c (7f1)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$10 (13b); $0 n/c (13d, 13e)"											61.14802512	912	37.21990109	0	75	0.2	0.114607877	50	100	2.8	0.167165341	0	0	35.16990366	0.002082581	1.029132157	30	8.334199101	0	0	0.2	0	0	0	30	30	0	0	0	10											61.14802512	912	37.21990109	0	75	0.2	0.114607877	50	100	2.8	0.167165341	0	0	35.16990366	0.002082581	1.029132157	30	8.334199101	0	0	0.2	0	0	0	30	30	0	0	0	10											4.6795	0.265928776	2.484315522	0	1.391382967	1.56715508	0.529036415	1.174404964	1.831785614	3.322951362	9.818277391	0	0	3.253409879	0.001031157	0.466101695	0.396489104	0.240537697	0	0	4.18741165	0	0	0	0.587098695	0.395666811	0	0	0	0.394444444	0	0	0	0	0	0	0	0	0	0	36.9869	0	0	4.6795	0.265928776	2.484315522	0	1.391382967	1.56715508	0.529036415	1.174404964	1.831785614	3.322951362	9.818277391	0	0	3.253409879	0.001031157	0.466101695	0.396489104	0.240537697	0	0	4.18741165	0	0	0	0.587098695	0.395666811	0	0	0	0.394444444	0	0	0	0	0	0	0	0	0	0	36.9869																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.6795	0.265928776	2.484315522	0	1.391382967	1.56715508	0.529036415	1.174404964	1.831785614	3.322951362	9.818277391	0	0	3.253409879	0.001031157	0.466101695	0.396489104	0.240537697	0	0	4.18741165	0	0	0	0.587098695	0.395666811	0	0	0	0.394444444	0	0	0	0	0	0	0	0	0	0	36.9869
H0543_128_0	2009	6																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	946.4848552	4.442114817	796.2873503	289.2634082	263.1499506	6.76373981	3.991939633	280.9703608	209.1992254	14116.9473	50.31788558	0	10.90922621	1130.859148	5907.057549	5418.341773	163.3786297	339.173488	0	0	22.31809877	875.8893016	626.4	0	219.2662675	181.9256803	0	0	232.7226844	473.3333333											"$100 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-20/$120 Days 21-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$100 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $100 (9a); $30/$30 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $30 (7a1); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$0 (7b, 7d, 7f); $10 (7b1); $0 n/c (7f1)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$10 (13b); $0 n/c (13d, 13e)"											61.14815904	912	37.21990109	0	75	0.2	0.113662183	50	100	2.8	0.167136601	0	0	35.15837404	0.002241664	1.032275293	30	8.334199101	0	0	0.2	0	0	0	30	30	0	0	0	10											61.14815904	912	37.21990109	0	75	0.2	0.113662183	50	100	2.8	0.167136601	0	0	35.15837404	0.002241664	1.032275293	30	8.334199101	0	0	0.2	0	0	0	30	30	0	0	0	10											4.823	0.337600726	2.469811368	0	1.644687192	1.352747962	0.453732572	1.170709837	1.743326878	3.293954369	8.409960365	0	0	3.313264075	0.00110347	0.466101695	0.408446574	0.235561615	0	0	4.463619753	0	0	0	0.548165669	0.454814201	0	0	0	0.394444444	0	0	0	0	0	0	0	0	0	0	35.985	0	0	4.823	0.337600726	2.469811368	0	1.644687192	1.352747962	0.453732572	1.170709837	1.743326878	3.293954369	8.409960365	0	0	3.313264075	0.00110347	0.466101695	0.408446574	0.235561615	0	0	4.463619753	0	0	0	0.548165669	0.454814201	0	0	0	0.394444444	0	0	0	0	0	0	0	0	0	0	35.985																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.823	0.337600726	2.469811368	0	1.644687192	1.352747962	0.453732572	1.170709837	1.743326878	3.293954369	8.409960365	0	0	3.313264075	0.00110347	0.466101695	0.408446574	0.235561615	0	0	4.463619753	0	0	0	0.548165669	0.454814201	0	0	0	0.394444444	0	0	0	0	0	0	0	0	0	0	35.985
H0543_129_0	2009	5																																D	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	954.2713331	4.38504338	811.8802922	330.8528667	253.595023	7.736720125	6.143828203	270.5811451	235.1515345	14262.92123	55.14538007	0	12.78031676	1065.750043	5929.659372	5421.410999	155.3723765	354.5922138	0	0	20.04926436	896.4805959	626.4	0	237.0244661	158.1757639	0	0	1137.540304	473.3333333											"$50 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-20/$120 Days 21-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$50 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $50 (9a); $30/$30 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $30 (7a1); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$0 (7b, 7d, 7f); $10 (7b1); $0 n/c (7f1)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$10 (13b); $0 n/c (13d, 13e)"											30.57409947	912	37.21990109	0	75	0.2	0.094661167	50	50	2.8	0.16688049	0	0	18.61114265	0.001975257	1.03169089	30	8.334199101	0	0	0.2	0	0	0	30	30	0	0	0	10											30.57409947	912	37.21990109	0	75	0.2	0.094661167	50	50	2.8	0.16688049	0	0	18.61114265	0.001975257	1.03169089	30	8.334199101	0	0	0.2	0	0	0	30	30	0	0	0	10											2.4313	0.333263297	2.518175348	0	1.584968894	1.547344025	0.581581947	1.127421438	0.97979806	3.328014955	9.202688032	0	0	1.652902174	0.00097605	0.466101695	0.388430941	0.246270176	0	0	4.009852872	0	0	0	0.592561165	0.39543941	0	0	0	0.394444444	0	0	0	0	0	0	0	0	0	0	31.7816	0	0	2.4313	0.333263297	2.518175348	0	1.584968894	1.547344025	0.581581947	1.127421438	0.97979806	3.328014955	9.202688032	0	0	1.652902174	0.00097605	0.466101695	0.388430941	0.246270176	0	0	4.009852872	0	0	0	0.592561165	0.39543941	0	0	0	0.394444444	0	0	0	0	0	0	0	0	0	0	31.7816																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	2.4313	0.333263297	2.518175348	0	1.584968894	1.547344025	0.581581947	1.127421438	0.97979806	3.328014955	9.202688032	0	0	1.652902174	0.00097605	0.466101695	0.388430941	0.246270176	0	0	4.009852872	0	0	0	0.592561165	0.39543941	0	0	0	0.394444444	0	0	0	0	0	0	0	0	0	0	31.7816
H0543_130_0	2009	6																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		389.0945473	23.07	51.57643823	5572.267102	17.04941936	37.45025851	12.73518053	26.74445793	41.64421873	7.733671344	18.70998337	0	3.11881233	44.32524829	60.01704721	161.0533543	13.99	6.579806442	0	45321.1616	27.80099739	8.031585459	650.8553012	3695.017245	171.825827	117.9209622	39.92312156	10.96420631	20.2	0											"5.4% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"5.4% (1b); $0 n/c (1b1, 1b2)"	12.6% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.0532532	0.0539	0.1261	0	0.2	0.2	0.2	0.112596313	0.2	0.08	0.2	0	0.2	0.2	0	0.199636426	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											0.0532532	0.0539	0.1261	0	0.2	0.2	0.2	0.112596313	0.2	0.08	0.2	0	0.2	0.2	0	0.199636426	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											20.7205	1.243473	6.503788861	0	3.409883872	7.490051702	2.547036106	3.011327367	8.328843746	0.618693708	3.741996675	0	0.623762466	8.865049658	0	32.15211608	2.798	1.315961288	0	0	5.560199479	0.119423884	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.0501	0	0	20.7205	1.243473	6.503788861	0	3.409883872	7.490051702	2.547036106	3.011327367	8.328843746	0.618693708	3.741996675	0	0.623762466	8.865049658	0	32.15211608	2.798	1.315961288	0	0	5.560199479	0.119423884	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.0501																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.7205	1.243473	6.503788861	0	3.409883872	7.490051702	2.547036106	3.011327367	8.328843746	0.618693708	3.741996675	0	0.623762466	8.865049658	0	32.15211608	2.798	1.315961288	0	0	5.560199479	0.119423884	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.0501
H0543_131_0	2009	6																																Coin	Coin	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin	T	V	V	P	V	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		360.5468102	42.14	7874.027258	109.3812536	26.13743657	14.38008355	16.42873918	11.41512154	7.985156743	32.81693742	27.14992754	0	0.102577198	5.332219908	1.26654742	148.8371647	45.27	43.44226754	0	45555.39002	9.815383367	7.355002563	1576.881712	0	191.5790143	148.7435641	0	0	0	0											"5.4% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"5.4% (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.053257335	0.0539	0	0	0.2	0.2	0.2	0.064909195	0.2	0.08	0.15003742	0	0.2	0.2	0	0.198726795	0.2	0	0	0	0.2	0.022666282	0	0	0	0	0	0	0	0											0.053257335	0.0539	0	0	0.2	0.2	0.2	0.064909195	0.2	0.08	0.15003742	0	0.2	0.2	0	0.198726795	0.2	0	0	0	0.2	0.022666282	0	0	0	0	0	0	0	0											19.2018	2.271346	0	0	5.227487313	2.876016711	3.285747836	0.740946345	1.597031349	2.625354993	4.073505069	0	0.02051544	1.066443982	0	29.5779327	9.054	0	0	0	1.963076673	0.16671056	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.7479	0	0	19.2018	2.271346	0	0	5.227487313	2.876016711	3.285747836	0.740946345	1.597031349	2.625354993	4.073505069	0	0.02051544	1.066443982	0	29.5779327	9.054	0	0	0	1.963076673	0.16671056	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.7479																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.2018	2.271346	0	0	5.227487313	2.876016711	3.285747836	0.740946345	1.597031349	2.625354993	4.073505069	0	0.02051544	1.066443982	0	29.5779327	9.054	0	0	0	1.963076673	0.16671056	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.7479
H0543_133_0	2009	7																																D	A	D	V	T	Coin	Coin	V	V	V	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	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 Only	1228.301935	66.72332679	1238.695418	466.3578156	394.9453685	10.12646611	7.137103518	335.9777607	265.0610839	17765.81509	70.17983405	0	15.81470193	1239.605847	7289.987954	6029.339429	1516.577323	443.6660069	0	0	27.06115802	1121.630535	365.1399043	0	327.7093149	349.7142857	0	0	98.17983361	1123.992121											"$50 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	$0 Days 1-20/$120 Days 21-100 (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4b); $0 (4a1)"	$50 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $50 (9a); $30/$30 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $30 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13e); $0 (13d)"											30.94589301	912	37.21990109	0	75	0.2	0.098646432	49.91102065	50	2.8	0.16633644	0	0	18.07453752	0.002080128	0	30	8.334199101	0	0	0.2	0	0	0	0	0	0	0	0	0											30.94589301	912	37.21990109	0	75	0.2	0.098646432	49.91102065	50	2.8	0.16633644	0	0	18.07453752	0.002080128	0	30	8.334199101	0	0	0.2	0	0	0	0	0	0	0	0	0											3.1676	5.070972836	3.842010079	0	2.468408553	2.025293223	0.7040498	1.397416079	1.104421183	4.145356855	11.67346377	0	0	1.867108533	0.001263676	0	3.791443308	0.308133403	0	0	5.412231604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.9791	0	0	3.1676	5.070972836	3.842010079	0	2.468408553	2.025293223	0.7040498	1.397416079	1.104421183	4.145356855	11.67346377	0	0	1.867108533	0.001263676	0	3.791443308	0.308133403	0	0	5.412231604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.9791																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.1676	5.070972836	3.842010079	0	2.468408553	2.025293223	0.7040498	1.397416079	1.104421183	4.145356855	11.67346377	0	0	1.867108533	0.001263676	0	3.791443308	0.308133403	0	0	5.412231604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.9791
H0543_134_0	2009	6																																A	A	D	V	T	Coin	Coin	V	V	V	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	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 Only	277.932649	66.72332679	1117.323187	349.9141531	304.9433652	10.05480509	5.68291443	337.3415145	259.8014437	17434.28914	75.20312533	0	14.14621449	1502.231358	7368.758872	5993.491571	1516.577323	428.0953773	0	0	26.00620181	1076.226803	249.8325661	0	327.7093149	349.7142857	0	0	98.17983361	1123.992121											"$200 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	$0 Days 1-20/$120 Days 21-100 (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4b); $0 (4a1)"	$100 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $100 (9a); $30/$30 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $30 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$5 (7b, 7d); $0 n/c (7b1); $0/$5 (7f); $0 (7f1)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$0/$5 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $5 (16b, 18a); $0/$5 (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13e); $0 (13d)"											199.9468234	912	37.21990109	0	75	0.2	0.115324515	49.90828368	100	2.8	0.167455224	0	0	35.13034536	0.002364467	4.999997999	30	8.334199101	0	0	0.2	4.832665372	0	0	0	0	0	0	0	0											199.9468234	912	37.21990109	0	75	0.2	0.115324515	49.90828368	100	2.8	0.167455224	0	0	35.13034536	0.002364467	4.999997999	30	8.334199101	0	0	0.2	4.832665372	0	0	0	0	0	0	0	0											4.631	5.070972836	3.465554877	0	1.905896032	2.010961018	0.655379348	1.403011333	2.165012031	4.0680008	12.59315618	0	0	4.397825533	0.001451932	2.497287155	3.791443308	0.297319342	0	0	5.201240363	0.433420334	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5889	0	0	4.631	5.070972836	3.465554877	0	1.905896032	2.010961018	0.655379348	1.403011333	2.165012031	4.0680008	12.59315618	0	0	4.397825533	0.001451932	2.497287155	3.791443308	0.297319342	0	0	5.201240363	0.433420334	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5889																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.631	5.070972836	3.465554877	0	1.905896032	2.010961018	0.655379348	1.403011333	2.165012031	4.0680008	12.59315618	0	0	4.397825533	0.001451932	2.497287155	3.791443308	0.297319342	0	0	5.201240363	0.433420334	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5889
H0543_135_0	2009	6																																D	A	D	V	T	Coin	Coin	V	V	V	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	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 Only	1196.894968	66.72332679	1054.764177	355.1100164	308.6229205	8.968404776	5.201920235	343.010965	258.6847481	17525.56601	67.39436618	0	14.14410251	1407.625631	7328.363029	6037.362467	1516.577323	422.3550494	0	0	26.2225108	1094.329492	365.1399043	0	327.7093149	349.7142857	0	0	98.17983361	1123.992121											"$100 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	$0 Days 1-20/$120 Days 21-100 (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4b); $0 (4a1)"	$100 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $100 (9a); $30/$30 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $30 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13e); $0 (13d)"											61.89156845	912	37.21990109	0	75	0.2	0.115430884	49.90993787	100	2.8	0.167249633	0	0	35.09822029	0.002822484	0	30	8.334199101	0	0	0.2	0	0	0	0	0	0	0	0	0											61.89156845	912	37.21990109	0	75	0.2	0.115430884	49.90993787	100	2.8	0.167249633	0	0	35.09822029	0.002822484	0	30	8.334199101	0	0	0.2	0	0	0	0	0	0	0	0	0											6.1731	5.070972836	3.271518195	0	1.928893253	1.793680955	0.600462249	1.426637996	2.155706234	4.089298735	11.271683	0	0	4.117096206	0.001723682	0	3.791443308	0.293332589	0	0	5.244502159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.2301	0	0	6.1731	5.070972836	3.271518195	0	1.928893253	1.793680955	0.600462249	1.426637996	2.155706234	4.089298735	11.271683	0	0	4.117096206	0.001723682	0	3.791443308	0.293332589	0	0	5.244502159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.2301																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.1731	5.070972836	3.271518195	0	1.928893253	1.793680955	0.600462249	1.426637996	2.155706234	4.089298735	11.271683	0	0	4.117096206	0.001723682	0	3.791443308	0.293332589	0	0	5.244502159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.2301
H0543_136_0	2009	6																																A	A	D	V	T	Coin	Coin	V	V	V	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		367.6668732	66.72332679	1307.471505	54258.94931	94.47106168	23.99196381	10.60750596	386.0535274	404.7557436	6409.998345	20.1360797	0	16.756831	1569.596328	6314.394223	4680.880198	1512.926942	279.121926	0	0	30.95550643	1181.876988	810.5086242	0	327.7093149	349.7142857	0	0	98.17983361	0											"$495 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	$0 Days 1-20/$100 Days 21-100 (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4b); $0 (4a1)"	$200 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $200 (9a); $30/$30 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$15 (7b, 7d); $0 n/c (7b1, 7f1); $10/$15 (7f)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$10/$15 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 18a); $10/$15 (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											489.06	912	31.01658425	0	75	0.2	0.2	49.97409686	200	2.8	0.19042563	0	0	181.3427007	6.509025336	14.99831246	30	8.334199101	0	0	0.2	5.745984554	0	0	0	0	0	0	0	0											489.06	912	31.01658425	0	75	0.2	0.2	49.97409686	200	2.8	0.19042563	0	0	181.3427007	6.509025336	14.99831246	30	8.334199101	0	0	0.2	5.745984554	0	0	0	0	0	0	0	0											14.9843	5.070972836	3.379441675	0	0.590444136	4.798392762	2.121501192	1.607723031	6.745929059	1.495666281	3.834425664	0	0	23.71956976	3.425045998	5.850441982	3.782317355	0.193854809	0	0	6.191101286	0.565920577	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.357	0	0	14.9843	5.070972836	3.379441675	0	0.590444136	4.798392762	2.121501192	1.607723031	6.745929059	1.495666281	3.834425664	0	0	23.71956976	3.425045998	5.850441982	3.782317355	0.193854809	0	0	6.191101286	0.565920577	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.357																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.9843	5.070972836	3.379441675	0	0.590444136	4.798392762	2.121501192	1.607723031	6.745929059	1.495666281	3.834425664	0	0	23.71956976	3.425045998	5.850441982	3.782317355	0.193854809	0	0	6.191101286	0.565920577	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.357
H0543_137_0	2009	7																																D	A	D	V	T	Coin	Coin	V	V	V	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	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 Only	1214.908935	66.72332679	1073.118485	344.4783698	291.3918129	9.861729873	5.590104776	348.0657719	261.5375377	17723.15447	72.48758463	0	14.83505463	1563.63563	7524.400693	6115.780768	1516.577323	422.7100762	0	0	22.33919358	1096.743429	365.1399043	0	327.7093149	349.7142857	0	0	98.17983361	1123.992121											"$200 Days 1-8 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	$0 Days 1-10/$100 Days 11-56 (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4b); $0 (4a1)"	$200 (9b)	$0/$7 (8a1); $7 (8a2)	"$10 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$30 (3, 9d); $150 (5); $200 (9a); $30/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$30 (7b, 7d); $0 n/c (7b1); $15/$30 (7f); $0 (7f1)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$15/$30 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 18a); $15/$30 (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13e); $0 (13d)"											150.60671	912	50.48729715	0	100	0.2	0.112082191	49.88717772	200	2.8	0.178027681	0	0	70.1072128	9.768170998	29.99999648	30	30	0	0	0.2	28.9628217	0	0	0	0	0	0	0	0											150.60671	912	50.48729715	0	100	0.2	0.112082191	49.88717772	200	2.8	0.178027681	0	0	70.1072128	9.768170998	29.99999648	30	30	0	0	0.2	28.9628217	0	0	0	0	0	0	0	0											15.2478	5.070972836	4.514904321	0	2.428265108	1.972345975	0.626551193	1.447001585	4.358958962	4.135402711	12.90479656	0	0	9.135177988	6.124969386	15.28945013	3.791443308	1.056775191	0	0	4.467838715	2.647065365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.2197	0	0	15.2478	5.070972836	4.514904321	0	2.428265108	1.972345975	0.626551193	1.447001585	4.358958962	4.135402711	12.90479656	0	0	9.135177988	6.124969386	15.28945013	3.791443308	1.056775191	0	0	4.467838715	2.647065365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.2197																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	15.2478	5.070972836	4.514904321	0	2.428265108	1.972345975	0.626551193	1.447001585	4.358958962	4.135402711	12.90479656	0	0	9.135177988	6.124969386	15.28945013	3.791443308	1.056775191	0	0	4.467838715	2.647065365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.2197
H0543_138_0	2009	5																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	284.5793594	5.746931612	1075.403314	379.5960437	321.3005157	10.02232834	5.753620846	332.1705806	254.2367008	16815.13024	70.41246964	0	15.22011221	1275.159183	6770.571306	6315.039163	182.9174638	408.6644421	0	0	26.3951381	1050.329036	674.4	0	147.9890135	292.8	0	0	775.2	473.3333333											"$50 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-20/$120 Days 21-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$75 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1, 4b)"	$50 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $150 (5); $50 (9a); $30/$30 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $30 (7a1); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$0 (7b, 7d, 7f); $10 (7b1); $0 n/c (7f1)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$10 (13b); $0 n/c (13d, 13e)"											47.58558598	912	37.21990109	0	75	0.2	0.115481308	50	50	2.8	0.166866852	0	0	17.8864047	0.00296652	0.885698441	30	8.334199101	0	0	0.2	0	0	0	30	30	0	0	0	10											47.58558598	912	37.21990109	0	75	0.2	0.115481308	50	50	2.8	0.166866852	0	0	17.8864047	0.00296652	0.885698441	30	8.334199101	0	0	0.2	0	0	0	30	30	0	0	0	10											1.1285	0.436766803	3.33553375	0	2.008128223	2.004465669	0.664435659	1.384044086	1.059319586	3.92353039	11.74950718	0	0	1.900667767	0.001673753	0.466101695	0.45729366	0.283824235	0	0	5.279027621	0	0	0	0.369972534	0.732	0	0	0	0.394444444	0	0	0	0	0	0	0	0	0	0	37.5792	0	0	1.1285	0.436766803	3.33553375	0	2.008128223	2.004465669	0.664435659	1.384044086	1.059319586	3.92353039	11.74950718	0	0	1.900667767	0.001673753	0.466101695	0.45729366	0.283824235	0	0	5.279027621	0	0	0	0.369972534	0.732	0	0	0	0.394444444	0	0	0	0	0	0	0	0	0	0	37.5792																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	1.1285	0.436766803	3.33553375	0	2.008128223	2.004465669	0.664435659	1.384044086	1.059319586	3.92353039	11.74950718	0	0	1.900667767	0.001673753	0.466101695	0.45729366	0.283824235	0	0	5.279027621	0	0	0	0.369972534	0.732	0	0	0	0.394444444	0	0	0	0	0	0	0	0	0	0	37.5792
H0543_139_0	2009	7																																D	A	D	V	T	Coin	Coin	V	V	V	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	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 Only	1166.2946	66.72332679	1041.476466	331.0936442	282.4858758	9.728753535	5.477331009	429.4786867	249.742311	17063.28759	72.68870446	0	14.16048774	1495.337919	7211.053763	6025.9025	1516.577323	406.9443274	0	0	27.48111443	1047.799613	365.1399043	0	327.7093149	349.7142857	0	0	98.17983361	1123.992121											"$200 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$912 (1b); $0 n/c (1b1, 1b2)"	$0 Days 1-10/$100 Days 11-100 (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4b); $0 (4a1)"	$200 (9b)	$0/$7 (8a1); $7 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$30 (3, 9d); $150 (5); $200 (9a); $30/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$30 (7b, 7d); $0 n/c (7b1); $15/$30 (7f); $0 (7f1)"	"$30/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$15/$30 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 18a); $15/$30 (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13e); $0 (13d)"											122.2975501	912	55.10681964	0	100	0.2	0.116006387	49.92901261	200	2.8	0.167549155	0	0	70.09499707	9.771899781	29.9999945	30	30	0	0	0.2	28.96013003	0	0	0	0	0	0	0	0											122.2975501	912	55.10681964	0	100	0.2	0.116006387	49.92901261	200	2.8	0.167549155	0	0	70.09499707	9.771899781	29.9999945	30	30	0	0	0.2	28.96013003	0	0	0	0	0	0	0	0											11.8862	5.070972836	4.782704648	0	2.354048965	1.945750707	0.635405379	1.786953897	4.162371849	3.981433771	12.17893101	0	0	8.734642256	5.872141224	15.06475349	3.791443308	1.017360819	0	0	5.496222885	2.528701086	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.2901	0	0	11.8862	5.070972836	4.782704648	0	2.354048965	1.945750707	0.635405379	1.786953897	4.162371849	3.981433771	12.17893101	0	0	8.734642256	5.872141224	15.06475349	3.791443308	1.017360819	0	0	5.496222885	2.528701086	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.2901																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.8862	5.070972836	4.782704648	0	2.354048965	1.945750707	0.635405379	1.786953897	4.162371849	3.981433771	12.17893101	0	0	8.734642256	5.872141224	15.06475349	3.791443308	1.017360819	0	0	5.496222885	2.528701086	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.2901
H0543_140_0	2009	6																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1385.538563	60.3600016	1170.00122	420.9928225	612.7448773	15.16346474	13.76175352	391.6967125	284.2829594	19624.28959	99.78149707	0	0.792669778	1730.136402	8152.843394	6908.343194	223.5936312	473.3455537	0	0	29.21778469	1182.621425	0	0	147.9890135	0	18.41008798	0	453.6	0											"$250 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$250 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-5/$100 Days 6-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$200 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); $200 (9a); $40/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											201.9603047	168.2434595	74.33330748	0	150	0.2	0.091136406	49.99328445	200	2.8	0.183752032	0	0.2	70.21139317	9.79448153	30	37.5	25	0	0	0.2	0.718754521	0	0	30	0	30	0	0	0											201.9603047	168.2434595	74.33330748	0	150	0.2	0.091136406	49.99328445	200	2.8	0.183752032	0	0.2	70.21139317	9.79448153	30	37.5	25	0	0	0.2	0.718754521	0	0	30	0	30	0	0	0											23.3186	0.846264624	7.247505035	0	7.659310967	3.032692949	1.254196763	1.631850431	4.738049324	4.579000904	18.3350528	0	0.158533956	10.1229406	6.65440617	17.27085798	0.698730098	0.98613657	0	0	5.843556938	0.070834541	0	0	0.369972534	0	0.04602522	0	0	0	0	0	0	0	0	0	0	0	0	0	114.8646	0	0	23.3186	0.846264624	7.247505035	0	7.659310967	3.032692949	1.254196763	1.631850431	4.738049324	4.579000904	18.3350528	0	0.158533956	10.1229406	6.65440617	17.27085798	0.698730098	0.98613657	0	0	5.843556938	0.070834541	0	0	0.369972534	0	0.04602522	0	0	0	0	0	0	0	0	0	0	0	0	0	114.8646																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.3186	0.846264624	7.247505035	0	7.659310967	3.032692949	1.254196763	1.631850431	4.738049324	4.579000904	18.3350528	0	0.158533956	10.1229406	6.65440617	17.27085798	0.698730098	0.98613657	0	0	5.843556938	0.070834541	0	0	0.369972534	0	0.04602522	0	0	0	0	0	0	0	0	0	0	0	0	0	114.8646
H0543_802_0	2009	3																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1086.836742	38.31097992	977.1505769	352.4080188	260.8515602	10.68077078	6.466929954	322.9346837	253.6488469	15360.43521	139.0089833	0	0.340403256	1193.15558	6381.323054	5355.458388	165.3030982	373.2361056	0	0	23.37351503	969.0152442	0	0	0	0	0	0	0	0											"$500 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$500 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$300 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); $300 (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											403.9158893	336.486919	159.8131731	0	150	0.2	0.119235415	49.99646964	300	2.8	0.236136427	0	0.2	105.1037333	13.14140049	40	37.5	35	0	0	0.2	38.61913366	0	0	0	0	0	0	0	0											403.9158893	336.486919	159.8131731	0	150	0.2	0.119235415	49.99646964	300	2.8	0.236136427	0	0.2	105.1037333	13.14140049	40	37.5	35	0	0	0.2	38.61913366	0	0	0	0	0	0	0	0											36.5826	1.074261966	13.01346119	0	3.260644502	2.136154156	0.771087074	1.345466176	6.341221172	3.584101549	32.82508465	0	0.068080651	10.45042549	6.988293491	17.85152796	0.516572182	1.088605308	0	0	4.674703007	3.118544103	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.6908	0	0	36.5826	1.074261966	13.01346119	0	3.260644502	2.136154156	0.771087074	1.345466176	6.341221172	3.584101549	32.82508465	0	0.068080651	10.45042549	6.988293491	17.85152796	0.516572182	1.088605308	0	0	4.674703007	3.118544103	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.6908																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	36.5826	1.074261966	13.01346119	0	3.260644502	2.136154156	0.771087074	1.345466176	6.341221172	3.584101549	32.82508465	0	0.068080651	10.45042549	6.988293491	17.85152796	0.516572182	1.088605308	0	0	4.674703007	3.118544103	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.6908
H0543_804_0	2009	3																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1209.557115	40.24772903	1060.160625	368.7891183	297.6303607	11.33958402	7.164132793	341.1447512	285.2095452	17174.7986	157.33445	0	0.393338601	1312.518134	7011.46466	5968.692477	184.2316997	417.359947	0	0	26.17583764	1077.856752	0	0	0	0	0	0	0	0											"$500 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$500 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$300 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); $300 (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											403.918114	336.486919	159.8131731	0	150	0.2	0.116291796	49.99658995	300	2.8	0.236719276	0	0.2	105.0910034	13.39944302	40	37.5	35	0	0	0.2	38.72720157	0	0	0	0	0	0	0	0											403.918114	336.486919	159.8131731	0	150	0.2	0.116291796	49.99658995	300	2.8	0.236719276	0	0.2	105.0910034	13.39944302	40	37.5	35	0	0	0.2	38.72720157	0	0	0	0	0	0	0	0											40.7135	1.128569528	14.11896945	0	3.720379509	2.267916804	0.833129873	1.42133952	7.13023863	4.007453007	37.24409712	0	0.07866772	11.4944873	7.829143431	19.89564159	0.575724062	1.217299846	0	0	5.235167528	3.478531309	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	162.3903	0	0	40.7135	1.128569528	14.11896945	0	3.720379509	2.267916804	0.833129873	1.42133952	7.13023863	4.007453007	37.24409712	0	0.07866772	11.4944873	7.829143431	19.89564159	0.575724062	1.217299846	0	0	5.235167528	3.478531309	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	162.3903																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	40.7135	1.128569528	14.11896945	0	3.720379509	2.267916804	0.833129873	1.42133952	7.13023863	4.007453007	37.24409712	0	0.07866772	11.4944873	7.829143431	19.89564159	0.575724062	1.217299846	0	0	5.235167528	3.478531309	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	162.3903
H0543_805_0	2009	2																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1078.149348	38.18599231	936.8780613	343.8042095	267.3616748	9.121746984	9.083428273	308.4544118	277.3312663	15690.22182	150.6629059	0	0.370724503	1197.073438	6551.672174	5448.471666	165.1780584	386.869731	0	0	24.32189134	988.879111	0	0	0	0	0	0	0	0											"$525 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$525 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$300 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); $300 (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											424.111466	353.3112649	159.8131731	0	150	0.2	0.116116595	49.99265131	300	2.8	0.237136517	0	0.2	105.1606242	13.03267182	39.99989779	37.5	35	0	0	0.2	38.46198683	0	0	0	0	0	0	0	0											424.111466	353.3112649	159.8131731	0	150	0.2	0.116116595	49.99265131	300	2.8	0.237136517	0	0.2	105.1606242	13.03267182	39.99989779	37.5	35	0	0	0.2	38.46198683	0	0	0	0	0	0	0	0											38.1046	1.124295104	12.47712131	0	3.342020935	1.824349397	1.054736765	1.285037821	6.933281658	3.661051759	35.72767671	0	0.074144901	10.49041582	7.115482778	18.16152581	0.516181432	1.128370049	0	0	4.864378269	3.169521279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.0542	0	0	38.1046	1.124295104	12.47712131	0	3.342020935	1.824349397	1.054736765	1.285037821	6.933281658	3.661051759	35.72767671	0	0.074144901	10.49041582	7.115482778	18.16152581	0.516181432	1.128370049	0	0	4.864378269	3.169521279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.0542																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	38.1046	1.124295104	12.47712131	0	3.342020935	1.824349397	1.054736765	1.285037821	6.933281658	3.661051759	35.72767671	0	0.074144901	10.49041582	7.115482778	18.16152581	0.516181432	1.128370049	0	0	4.864378269	3.169521279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.0542
H0543_806_0	2009	2																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1097.332657	29.45905395	898.5353373	354.491404	255.3079507	9.192977591	7.96830576	304.9706369	284.0314982	15991.55674	149.8538546	0	0.748058059	1284.318123	6624.077742	5532.815028	163.5017231	393.0262686	0	0	24.29620052	1019.960412	0	0	0	0	0	0	0	0											"$500 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$500 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$300 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); $300 (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14f1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											403.916132	336.486919	159.8131731	0	150	0.2	0.106624295	49.98850557	300	2.8	0.236312622	0	0.2	105.388701	13.17419867	39.99991719	37.5	35	0	0	0.2	38.34088503	0	0	0	0	0	0	0	0											403.916132	336.486919	159.8131731	0	150	0.2	0.106624295	49.98850557	300	2.8	0.236312622	0	0.2	105.388701	13.17419867	39.99991719	37.5	35	0	0	0.2	38.34088503	0	0	0	0	0	0	0	0											36.9359	0.826048858	11.96648195	0	3.191349384	1.838595518	0.849614988	1.270418865	7.100787455	3.731363239	35.41235733	0	0.149611612	11.27938488	7.272243013	18.44267858	0.510942885	1.146326617	0	0	4.859240104	3.258848742	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.0422	0	0	36.9359	0.826048858	11.96648195	0	3.191349384	1.838595518	0.849614988	1.270418865	7.100787455	3.731363239	35.41235733	0	0.149611612	11.27938488	7.272243013	18.44267858	0.510942885	1.146326617	0	0	4.859240104	3.258848742	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.0422																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	36.9359	0.826048858	11.96648195	0	3.191349384	1.838595518	0.849614988	1.270418865	7.100787455	3.731363239	35.41235733	0	0.149611612	11.27938488	7.272243013	18.44267858	0.510942885	1.146326617	0	0	4.859240104	3.258848742	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.0422
H0544_002_0	2009	9																																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																																																			0			39.83365078	1089.834981		590.1511769	8.642487277		318.2874696						9.010344228			0.718590996				14.72738113			2715.639205		154.4367834															1a:$0	1b:$50/d 1-3	2:$0/d 1-31;$25/d 32-100	6:$0	10a:$50 (waived if admitted)	11a:20% if >$500	"11b,11c:$0"	4a:$50 (waived if admitted) ;4b:$0	9b:$0	8a:$0	8b:$0	9a:$0	12:$0	"5:$15,13a:$0"	"7a,14c,14d,14e,14f,14g:$0"	"7b,7d,7f,13b:$0"	"9c:$15 SA ;7e,7h:$0"	"3,7c,7i,9d:$0"	14h:$0	"7g,14i:$0"	15:20% for drugs >$50 w cap @ 550	18b:$0	10b:$0	"16a:$5-15 Oral Exams/$35 Prophylaxis/$5 Fluoride/$0-10 Dental X-Rays ;16b:$0-50 Emergency/$0-35 Diagnostic/$19-430 Restorative/$23-373 Endodontics,Periodontics,Extractions/$23-525 Prosthodontics,Other Oral,Maxillofacial Surgery,Other Services"	17a:$0	17b:$25/frames	18a:$0	18b:$0	14a:$0	"6,13c,13d,14i,14b,14j:$0"												40.15331817	2.063502182		50	0.018334683		50						15			15				0.165790973			42.33111677		24.97680441																40.15331817	2.063502182		50	0.018334683		50						15			15				0.165790973			42.33111677		24.97680441															0	0.133287771	0.187406405	0	2.458963237	0.158457261	0	1.32619779	0	0	0	0	0	0.01126293	0	0	0.000898239	0	0	0	2.441666849	0	0	9.579670026	0	0.321444778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.6193	0	0	0	0.133287771	0.187406405	0	2.458963237	0.158457261	0	1.32619779	0	0	0	0	0	0.01126293	0	0	0.000898239	0	0	0	2.441666849	0	0	9.579670026	0	0.321444778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.6193																																																																																		0	0	0	0	0.133287771	0.187406405	0	2.458963237	0.158457261	0	1.32619779	0	0	0	0	0	0.01126293	0	0	0.000898239	0	0	0	2.441666849	0	0	9.579670026	0	0.321444778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.6193
H0544_003_0	2009	8																																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																																																			0						14.66559187	11.49498951		428.8315177													15.26060119																				1a:$0	1b:$0	2:$0	6:$0	10a:20% (waived if admitted)	11a:20% if >$500	"11b,11c:$0"	4a:$50 (waived if admitted); 4b:$0	9b:$0	8a:$0	8b:$0	9a:$0	12:$0	"5,13a:$0"	"7a,14c,14d,14e,14f,14g:$0"	"7b,7d,7f,13b:$0"	"9c,7e,7h:$0"	"3,7c,7i,9d:$0"	14h:$0	"7g,14i:$0"	15:20% for drugs >$50 w cap @ 550	18b:$0	10b:$0	"16a,16b:$0"	17a:$0	17b:$0	18a:$0	18b:$0	14a:$0	"6,13c,13d,14i,14b,14j:$0"															0.2	0.028813305		50													0.169087445																								0.2	0.028813305		50													0.169087445																				0	0	0	0	2.933118374	0.331208641	0	1.78679799	0	0	0	0	0	0	0	0	0	0	0	0	2.580376061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.6315	0	0	0	0	0	0	2.933118374	0.331208641	0	1.78679799	0	0	0	0	0	0	0	0	0	0	0	0	2.580376061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.6315																																																																																		0	0	0	0	0	0	0	2.933118374	0.331208641	0	1.78679799	0	0	0	0	0	0	0	0	0	0	0	0	2.580376061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.6315
H0544_004_0	2009	9																																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																																																			0			50.05930466	1204.749961		735.3136503	13.53068327		382.6103425						13.80003302			0.104267036				13.98426227			2715.639205		154.9277295															1a:$0	1b:$50/d 1-3	2:$0/d 1-31;$25/d 32-100	6:$0	10a:$50 (waived if admitted)	11a:20% if >$500	"11b,11c:$0"	"4a:$50 (waived if admitted),4b:$0"	9b:$0	8a:$0	8b:$0	9a:$0	12:$0	"5:$15,13a:$0"	"7a,14c,14d,14e,14f,14g:$0"	"7b,7d,7f,13b:$0"	"9c:$15 SA,7e,7h:$0"	"3,7c,7i,9d:$0"	14h:$0	"7g,14i:$0"	15:20% for drugs >$50 w cap @ 550	18b:$0	10b:$0	16a:$5/15/35 ;16b:$19/23/35/50/373/430/525	17a:$0	17b:$25/frames	18a:$0	18b:$0	14a:$0	"6,13c,13d,14i,14b,14j:$0"												35.90252054	2.1215817		50	0.016940474		50						15			1.953448732				0.157745618			42.33111677		24.89765971																35.90252054	2.1215817		50	0.016940474		50						15			1.953448732				0.157745618			42.33111677		24.89765971															0	0.149771268	0.212997956	0	3.063806876	0.229216192	0	1.59420976	0	0	0	0	0	0.017250041	0	0	1.70E-05	0	0	0	2.205956098	0	0	9.579670026	0	0.321444824	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.3743	0	0	0	0.149771268	0.212997956	0	3.063806876	0.229216192	0	1.59420976	0	0	0	0	0	0.017250041	0	0	1.70E-05	0	0	0	2.205956098	0	0	9.579670026	0	0.321444824	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.3743																																																																																		0	0	0	0	0.149771268	0.212997956	0	3.063806876	0.229216192	0	1.59420976	0	0	0	0	0	0.017250041	0	0	1.70E-05	0	0	0	2.205956098	0	0	9.579670026	0	0.321444824	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.3743
H0544_005_0	2009	9																																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																																																			0						1036.44066	16.54829673		260.5671125													14.47045912																				1a:$0	1b:$0	2:$0	6:$0	10a:$50 (waived if admitted)	11a:20% if >$500	"11b,11c:$0"	"4a:$50 (waived if admitted),4b:$0"	9b:$0	8a:$0	8b:$0	9a:$0	12:$0	"5,13a:$0"	"7a,14c,14d,14e,14f,14g:$0"	"7b,7d,7f,13b:$0"	"9c,7e,7h:$0"	"3,7c,7i,9d:$0"	14h:$0	"7g,14i:$0"	15:20% for drugs >$50 w cap @ $550	18b:$0	10b:$0	"16a,16b:$0"	17a:$0	17b:$0	18a:$0	18b:$0	14a:$0	"6,13c,13d,14i,14b,14j:$0"															50	0.035742597		50													0.193448162																								50	0.035742597		50													0.193448162																				0	0	0	0	4.318502752	0.591479098	0	1.085696302	0	0	0	0	0	0	0	0	0	0	0	0	2.799283723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.795	0	0	0	0	0	0	4.318502752	0.591479098	0	1.085696302	0	0	0	0	0	0	0	0	0	0	0	0	2.799283723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.795																																																																																		0	0	0	0	0	0	0	4.318502752	0.591479098	0	1.085696302	0	0	0	0	0	0	0	0	0	0	0	0	2.799283723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.795
H0544_007_0	2009	8																																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																																																			0		1062.853731	35.4204454	943.2374161		546.0216942	7.549641063		310.0450091	250.9978827		168.6957474			52.32428748	8948.974122	3498.754313	607.8469885	3373.82005	4074.902093		12.86509748			2715.639205		154.4260687															1a:$100/d (1-4)	1b:$100/d (1-4)	2:$50/d (21-100)	6:$0	10a:$50 (waived if admitted)	11a:20% if >$500	"11b,11c:$0"	4a:$50 (waived if admitted) ;4b:$15	"9a,9b:$75"	8a:$0	8b:$0 for x-ray $10 for other radiology	No cost sharing for Observation	12:$0	"5:$30,13a:$0"	"7a:$5,14c,14d,14e,14f,14g:$0"	"7b,7d,7f:$20,13b:$0"	"7e,7h:$20 ;9c:$30"	"3,7c,7i,9d:$20"	8b:$0 for x-ray $10 for other radiology; 14h:$0	"7g,14i:$0"	15:20% for drugs >$50 w cap @ $550	18b:$0	10b:$0	16a:$5/15/35/10 ;16b:$19/23/35/50/373/430/525	17a:$0	17b:$0-$25	18a:$0	18b:$0	14a:$0	"6,13c,13d,14i,14b,14j:$0"											57.05405012	48.63866795	1.861882609		50	0.018334683		44.42704699	75		5.95084088			21.59325276	4.823002759	19.16838262	20.0109379	19.56127431	10		0.187477213			11.17437511		24.97853741															57.05405012	48.63866795	1.861882609		50	0.018334683		44.42704699	75		5.95084088			21.59325276	4.823002759	19.16838262	20.0109379	19.56127431	10		0.187477213			11.17437511		24.97853741															5.0533	0.14356694	0.146349778	0	2.275090393	0.138420273	0	1.147865349	1.568736767	0	0.083656796	0	0	0.094154297	3.596743907	5.588788446	1.013632362	5.499684956	3.395751744	0	2.411912622	0	0	2.528797595	0	0.321444778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0079	0	0	5.0533	0.14356694	0.146349778	0	2.275090393	0.138420273	0	1.147865349	1.568736767	0	0.083656796	0	0	0.094154297	3.596743907	5.588788446	1.013632362	5.499684956	3.395751744	0	2.411912622	0	0	2.528797595	0	0.321444778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0079																																																																																		0	0	0	5.0533	0.14356694	0.146349778	0	2.275090393	0.138420273	0	1.147865349	1.568736767	0	0.083656796	0	0	0.094154297	3.596743907	5.588788446	1.013632362	5.499684956	3.395751744	0	2.411912622	0	0	2.528797595	0	0.321444778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0079
H0544_008_0	2009	6																																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																																																			0		1041.745045	36.77722356	1006.212184		544.8690075	7.517799159	7.288032342	293.8653425	278.4781076		168.3396199			52.21382757		3487.258818	606.5637847	1314.681041	4055.421582		12.81083673			2715.639205		154.4257888															1a:$75/d (1-4)	1b:$50/d (1-3)	2:$30/d (32-100)	6:$0	10a:$90 (waived if admitted)	11a:20% if >$500	"11b:20% if >$500,11c:$0"	"4a:$50 (waived if admitted),4b:$0"	"9a,9b:$75"	8a:$0	8b:$0 for x-ray and $10 for other radiology	No cost sharing for Observation	12:$0	"5,9c:$30 9d,7e,7c,7i $10 ;13a:$0"	"7a,14c,14d,14e,14f,14g:$0"	"7b,7d,7f:$10,13b:$0"	"7e, 7h:$10 ;9c:$30"	"3,7c,7i:$10,9d:$10"	8b:$0 for x-ray and $10 for other radiology ;14h:$0	"7g,14i:$0"	15:20% for drugs >$50 w cap @ $550	18b:$0	10b:$0	"16a:$5,15,35,10;16b:$19/23/35/50/373/430/525,"	17a:$0	"17b:$25/frames,$0 Contacts"	18a:$0	18b:$0	14a:$0	"6,13c,13d,14i,14b,14j:$0"											51.47972049	37.83071785	2.332970894		90	0.018334683	0.018334683	50	75		5.95084088			13.18650553		9.708273201	10.02187581	10	10		0.189430229			42.33111677		24.97858268															51.47972049	37.83071785	2.332970894		90	0.018334683	0.018334683	50	75		5.95084088			13.18650553		9.708273201	10.02187581	10	10		0.189430229			42.33111677		24.97858268															4.4691	0.115942397	0.195621978	0	4.086517556	0.137836462	0.13362376	1.224438927	1.740488173	0	0.083480191	0	0	0.057376494	0	2.821271777	0.506575577	1.095567534	3.379517985	0	2.426759731	0	0	9.579670026	0	0.321444778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.3752	0	0	4.4691	0.115942397	0.195621978	0	4.086517556	0.137836462	0.13362376	1.224438927	1.740488173	0	0.083480191	0	0	0.057376494	0	2.821271777	0.506575577	1.095567534	3.379517985	0	2.426759731	0	0	9.579670026	0	0.321444778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.3752																																																																																		0	0	0	4.4691	0.115942397	0.195621978	0	4.086517556	0.137836462	0.13362376	1.224438927	1.740488173	0	0.083480191	0	0	0.057376494	0	2.821271777	0.506575577	1.095567534	3.379517985	0	2.426759731	0	0	9.579670026	0	0.321444778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.3752
H0544_009_0	2009	7																																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																																																			0						648.4930323	9.640347203	7.287829997	383.9629988													12.79840176																				1a:$0	1b:$0	2:$0	6:$0	10a:20% (waived if admitted)	11a:20% if >$500	"11b:20% if >$500,11c:$0"	"4a $50 (waived if admitted),4b:$0"	"9a,9b:$0"	8a:$0	8b:$0	No cost sharing for Observation	12:$0	"5,9c,9d,7e,7c,7i,13a:$0"	"7a,14c,14d,14e,14f,14g:$0"	"7b,7d,7f,13b:$0"	"9c,7e,7h:$0"	"3,7c,7i,9d:$0"	"8b,14h:$0"	"7g,14i:$0"	15:20% for drugs >$50 w cap @ $550	18b:$0	10b:$0	"16a,16b:$0"	17a:$0	17b:$0	18a:$0	18b:$0	14a:$0	"6,13c,13d,14i,14b,14j:$0"															45.51867573	0.028813305	0.028813305	50													0.192698189																								45.51867573	0.028813305	0.028813305	50													0.192698189																				0	0	0	0	2.459878671	0.277770266	0.20998647	1.599845828	0	0	0	0	0	0	0	0	0	0	0	0	2.466228838	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.0137	0	0	0	0	0	0	2.459878671	0.277770266	0.20998647	1.599845828	0	0	0	0	0	0	0	0	0	0	0	0	2.466228838	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.0137																																																																																		0	0	0	0	0	0	0	2.459878671	0.277770266	0.20998647	1.599845828	0	0	0	0	0	0	0	0	0	0	0	0	2.466228838	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.0137
H0544_010_0	2009	8																																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																																																			0		1290.3369	41.74023501	1212.832954		681.8130545	9.518507574	9.714384374	349.3395776						9.205464528			0.772884001				15.16545281			2715.639205		154.5032969															"1a:$75(1-4),$0(5-90)"	1b:$50(1-3)	"2:$0(1-31),$30(32-100)"	6:$0	10a:$90(Waived if admitted)	11a:20% if >$500	"11b:20% if >$500,11c:$0"	"4a:$50 (waived if admitted),4b:$0"	"9a,9b:$0"	8a:$0	8b:$0	No cost sharing for observation	12:$0	"5,9c:$30 ;9d,7e,7c,7i,13a:$0"	"7a,14c,14d,14e,14f,14g:$0"	"7b,7d,7f,13b:$0"	"9c:$30,7e,7h:$0"	"3,7c,7i,9d:$0"	14h:$0	"7g,14i:$0"	15:20% for drugs >$50 w cap @ $550	18b:$0	10b:$0	"16a:$5,15,35,10;16b:$19/23/35/50/373/430/525,"	17a:$0	17b:$25/frames;$0 contact lenses	18a:$0	18b:$0	14a:$0	"6,13c,13d,14i,14b,14j:$0"											53.29818345	38.69494934	2.361196203		90	0.016940474	0.016940474	50						30			30				0.189429632			42.33111677		24.96605193															53.29818345	38.69494934	2.361196203		90	0.016940474	0.016940474	50						30			30				0.189429632			42.33111677		24.96605193															5.7311	0.13459469	0.238644714	0	5.113597909	0.161248033	0.164566279	1.455581573	0	0	0	0	0	0.023013661	0	0	0.00193221	0	0	0	2.872786143	0	0	9.579670026	0	0.321444778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.7981	0	0	5.7311	0.13459469	0.238644714	0	5.113597909	0.161248033	0.164566279	1.455581573	0	0	0	0	0	0.023013661	0	0	0.00193221	0	0	0	2.872786143	0	0	9.579670026	0	0.321444778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.7981																																																																																		0	0	0	5.7311	0.13459469	0.238644714	0	5.113597909	0.161248033	0.164566279	1.455581573	0	0	0	0	0	0.023013661	0	0	0.00193221	0	0	0	2.872786143	0	0	9.579670026	0	0.321444778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.7981
H0544_012_0	2009	8																																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																																																			0		1306.838271	46.15024454	849.3129976		642.2663286	10.44568239	12.71022226	587.290686	277.6945503		198.4309405			61.54723956		4140.351822	714.9892721	3968.507185	4780.342971		17.8001472				372.9307243	256.1019723															1a:$100(1-5)	1b:$100(1-5)	2:$50(32-100)	6:$0	10a:$75 (waived if admitted)	11a:20% if >$500	"11b:20% if >$500, 11c:$0"	"4a:$50 (waived if admitted),4b:$15"	"9a,9b:$100"	8a:$0	8b:$0 for x-rays $25 for other radiology	No cost sharing on Observation	12:$0	"9c:$30 9d,7e,7c,7i $20 ;5:$15,13a:$0"	"7a,14c,14d,14e,14f,14g:$0"	"7b,7d,7f:$20, 13b:$0"	"7e,7h:$20,9c:$30"	"3:$20,7c,7i:$20,9d:$20"	8b:$0 for x-rays $25 for other radiology ;14h:$0	"7g,14i:$0"	15:20% for drugs >$50 w cap @ $550	18b:$0	10b:$0	"16a,16b:$0"	17a:$0 - $20	17b:$25/frames ;$0 contact lenses	18a:$0	18b:$0	14a:$0	"6,13c,13d,14i,14b,14j:$0"											83.20844661	62.27682325	6.400677842		75	0.018334683	0.018334683	44.44262153	100		25			20		19.23160929	20.0109379	20	25		0.187477213				20	24.98477718															83.20844661	62.27682325	6.400677842		75	0.018334683	0.018334683	44.44262153	100		25			20		19.23160929	20.0109379	20	25		0.187477213				20	24.98477718															9.0617	0.239507552	0.453014907	0	4.014164554	0.191518272	0.233037891	2.175061474	2.314121253	0	0.413397793	0	0	0.102578733	0	6.635469048	1.192300494	6.614178642	9.959047857	0	3.337121988	0	0	0	0.621551207	0.533220893	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.091	0	0	9.0617	0.239507552	0.453014907	0	4.014164554	0.191518272	0.233037891	2.175061474	2.314121253	0	0.413397793	0	0	0.102578733	0	6.635469048	1.192300494	6.614178642	9.959047857	0	3.337121988	0	0	0	0.621551207	0.533220893	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.091																																																																																		0	0	0	9.0617	0.239507552	0.453014907	0	4.014164554	0.191518272	0.233037891	2.175061474	2.314121253	0	0.413397793	0	0	0.102578733	0	6.635469048	1.192300494	6.614178642	9.959047857	0	3.337121988	0	0	0	0.621551207	0.533220893	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.091
H0545_001_0	2009	9																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	P	T	Coin	P	P	P	P	P	P																																																			0		1049.591478	53.1175452	1363.114459		294.567006	4.672491511	1.72532776	233.8346424	310.2113898		92.0904113	27.01015718		754.4521259	3296.939594	7218.631152	155.7053982	2373.001453			23.00232158	2.769974533			149.3119447	223.9613445															1a: $75 days 1-6	1b: $75 days 1-6	2: $40 days 21-100		10a: $50	11a: 20%	"11b: 20%, 11c: 0%"	"4a: $50, 4b: $30"	9b: $50		8b: $0-$50	9a: $50		"3, 5, 9c, 9d: $10"	"7a, 14c: $5;"	"7b, 7d, 7f, 7g, 14f, 16b, 17a: $10, 7b1: $25"	"7e, 7h: $10"	"7c, 7i: $10"	$0 (incl in i.2.)		15: 10%	18a: $10			17a: $15	17b: $25	18a: $10														57.93512778	47.44496298	11.66997541		50	0.2	0.2	49.97812238	50		44.86958764	50		43.65810046	5.000394995	10.53515686	10	10			0.1	10			15	25															57.93512778	47.44496298	11.66997541		50	0.2	0.2	49.97812238	50		44.86958764	50		43.65810046	5.000394995	10.53515686	10	10			0.1	10			15	25															5.0674	0.21001333	1.325626018	0	1.227362525	0.934498302	0.345065552	0.973884698	1.292547458	0	0.344338232	0.112542322	0	2.744828892	1.373833354	6.33745096	0.129754499	1.977501211	0	0	2.300232158	0.002308312	0	0	0.186639931	0.466586134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.3524	0	0	5.0674	0.21001333	1.325626018	0	1.227362525	0.934498302	0.345065552	0.973884698	1.292547458	0	0.344338232	0.112542322	0	2.744828892	1.373833354	6.33745096	0.129754499	1.977501211	0	0	2.300232158	0.002308312	0	0	0.186639931	0.466586134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.3524																																																																																		0	0	0	5.0674	0.21001333	1.325626018	0	1.227362525	0.934498302	0.345065552	0.973884698	1.292547458	0	0.344338232	0.112542322	0	2.744828892	1.373833354	6.33745096	0.129754499	1.977501211	0	0	2.300232158	0.002308312	0	0	0.186639931	0.466586134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.3524
H0545_008_0	2009	7																																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																																																			0						409.1238991			419.8055872								1763.655766																													10a: $85			"4a: $50, 4b: $30"						7c: $10		"7b, 13b: $5"																													50			45.99071473								5																													50			45.99071473								5																									0	0	0	0	1.704682913	0	0	1.608929917	0	0	0	0	0	0	0	0.734856569	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.0485	0	0	0	0	0	0	1.704682913	0	0	1.608929917	0	0	0	0	0	0	0	0.734856569	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.0485																																																																																		0	0	0	0	0	0	0	1.704682913	0	0	1.608929917	0	0	0	0	0	0	0	0.734856569	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.0485
H0545_009_0	2009	8																																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																																																			0		1562.82046	45.05040567	1660.080209		236.6170777	13.48039065	12.54569853	283.5894701	369.4974724		468.087497	37.37033153		1348.086217	6493.330425	9109.245281	404.7006958	1757.437388			34.41654202	0.400806814			147.9890135	225															1a: $75 days 1-6	1b: $75 days 1-6	2: $40 days 21-100		10a: $50	11a: 0%-20%	11b: 0%-20%; 11c: 0%	"4a: $50, 4b: $30"	"9a, 9b: $50"		8b: 0$-$50	9a: $50		"3, 5, 9c: $10"	"7a, 14c: $5"	"7b, 7d, 7f, 7g, 17a, 18a: $10"	"7e, 7h: $10"	"7c, 7i: $10"	$0 (incl in i.2.)		15: 10%	16b: $10			17a1: $15	17b1: $25															57.22042125	43.29604173	5.635257117		50	0.071068526	0.071068526	45.98694381	50		37.07947239	50		10	5	10	10	10			0.1	10			15	25															57.22042125	43.29604173	5.635257117		50	0.071068526	0.071068526	45.98694381	50		37.07947239	50		10	5	10	10	10			0.1	10			15	25															7.4521	0.16254202	0.779581568	0	0.985904491	0.958031492	0.891604301	1.086784419	1.539572802	0	1.446369785	0.155709715	0	1.123405181	2.705554344	7.591037734	0.33725058	1.464531157	0	0	3.441654202	0.000334006	0	0	0.184986267	0.46875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7757	0	0	7.4521	0.16254202	0.779581568	0	0.985904491	0.958031492	0.891604301	1.086784419	1.539572802	0	1.446369785	0.155709715	0	1.123405181	2.705554344	7.591037734	0.33725058	1.464531157	0	0	3.441654202	0.000334006	0	0	0.184986267	0.46875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7757																																																																																		0	0	0	7.4521	0.16254202	0.779581568	0	0.985904491	0.958031492	0.891604301	1.086784419	1.539572802	0	1.446369785	0.155709715	0	1.123405181	2.705554344	7.591037734	0.33725058	1.464531157	0	0	3.441654202	0.000334006	0	0	0.184986267	0.46875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7757
H0545_011_0	2009	8																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	P	T	Coin	P	P	P	P	P	P																																																			0		1029.456252	53.1175452	1363.114459		294.567006	4.878485205	1.801391384	233.8346424	310.2113898		112.3998274	27.01015718		754.4521259		7218.891607	155.7053982	2373.001453			24.01641292	2.769974533		8.004350881	149.3119447	223.9613445				500											1a: $75 days 1-6	1b: $75 days 1-6	2: $40 days 21-100		10a: $50	11a: 20%	"11b: 20%, 11c: 0%"	"4a: $50, 4b: $30"	"9a, 9b: $50"		8b: $0-$50	9a: $50		"3, 5, 9c, 9d: $10"	"7a, 14c: $0"	"7d, 7f, 7g, 14f, 16b, 17a: $10; 7b:$10/$25"	"7e, 7h: $10"	"7c, 7i: $10"	$0 (incl in i.2.)		15: 10%	18a: $10		"16a, 16b: $0-$580"	17a: $15	17b: $25				13b: $20											57.93512778	47.44496298	11.66997541		50	0.2	0.2	49.97812238	50		45.79659689	50		46.00495924		10.53513755	10	10			0.1	10		0.375339728	15	25				20											57.93512778	47.44496298	11.66997541		50	0.2	0.2	49.97812238	50		45.79659689	50		46.00495924		10.53513755	10	10			0.1	10		0.375339728	15	25				20											4.9701	0.21001333	1.325626018	0	1.227362525	0.975697041	0.360278277	0.973884698	1.292547458	0	0.428960799	0.112542322	0	2.892378275	0	6.337668006	0.129754499	1.977501211	0	0	2.401641292	0.002308312	0	3.004350881	0.186639931	0.466586134	0	0	0	0.833333333	0	0	0	0	0	0	0	0	0	0	30.1092	0	0	4.9701	0.21001333	1.325626018	0	1.227362525	0.975697041	0.360278277	0.973884698	1.292547458	0	0.428960799	0.112542322	0	2.892378275	0	6.337668006	0.129754499	1.977501211	0	0	2.401641292	0.002308312	0	3.004350881	0.186639931	0.466586134	0	0	0	0.833333333	0	0	0	0	0	0	0	0	0	0	30.1092																																																																																		0	0	0	4.9701	0.21001333	1.325626018	0	1.227362525	0.975697041	0.360278277	0.973884698	1.292547458	0	0.428960799	0.112542322	0	2.892378275	0	6.337668006	0.129754499	1.977501211	0	0	2.401641292	0.002308312	0	3.004350881	0.186639931	0.466586134	0	0	0	0.833333333	0	0	0	0	0	0	0	0	0	0	30.1092
H0545_012_0	2009	4																					0											D	A	D		T	Coin	Coin	V	V								V	V	Coin		Coin																				0	0	0		0	0	0	0	0								0	0	0		0																				0	0	561.2603285	2.84280608	109.5633773		399.1671987	2.773924843	1.655587297	371.2021039	246.6125562								213.3412177	139.5197384	4.00802179		10.04064299																				"days 1-5 $100/day,$0 after"	copay $912/stay	"1-20 days:$0, 21-100:$40/day"		$250 copay/trip	20% coinsurance	20% coinsurance	$50 copay/visit	$50 copay/visit								$20 copay/visit	$10 copay/visit	20% coinsurance		20% coinsurance																				100	912	40		250	0.2	0.2	50	50								20	10	0.2		0.2																				100	912	40		250	0.2	0.2	50	50								20	10	0.2		0.2																				4.6772	0.216053262	0.365211258	0	8.315983306	0.554784969	0.331117459	1.546675433	1.027552318	0	0	0	0	0	0	0	0.355568696	0.116266449	0.801604358	0	2.008128598	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.3161	0	0	4.6772	0.216053262	0.365211258	0	8.315983306	0.554784969	0.331117459	1.546675433	1.027552318	0	0	0	0	0	0	0	0.355568696	0.116266449	0.801604358	0	2.008128598	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.3161	0																																																																																	0	0	0	4.6772	0.216053262	0.365211258	0	8.315983306	0.554784969	0.331117459	1.546675433	1.027552318	0	0	0	0	0	0	0	0.355568696	0.116266449	0.801604358	0	2.008128598	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.3161
H0545_801_0	2009	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																																																			0		277.854943	5.476908147	74.17379355		15.22777145	4.906116087	5.553935931	6.711978593	24.05389603	0.864849723	3.566050384	1.354532634	0.553814743	7.570441522	28.35564248	89.73741939	1.913864935	19.50539002	49.8946377	64.18602852	24.15243766	0.066766176																			Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing																			0.062556157	0.062556157	0.161417832		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.062556157	0.062556157	0.161417832		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			17.3815	0.342614328	11.97297293	0	3.517615204	1.133312816	1.2829592	1.550467055	5.556449982	0.199780286	0.823757639	0.312897038	0.127931206	1.748771992	6.550153413	20.72934388	0.4421028	4.505745094	11.52566131	14.82697259	5.579213098	0.015422987	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.1257	0	0	17.3815	0.342614328	11.97297293	0	3.517615204	1.133312816	1.2829592	1.550467055	5.556449982	0.199780286	0.823757639	0.312897038	0.127931206	1.748771992	6.550153413	20.72934388	0.4421028	4.505745094	11.52566131	14.82697259	5.579213098	0.015422987	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.1257																																																																																		0	0	0	17.3815	0.342614328	11.97297293	0	3.517615204	1.133312816	1.2829592	1.550467055	5.556449982	0.199780286	0.823757639	0.312897038	0.127931206	1.748771992	6.550153413	20.72934388	0.4421028	4.505745094	11.52566131	14.82697259	5.579213098	0.015422987	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.1257
H0545_802_0	2009	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																																																			0		277.854943	5.476908147	74.17379355		15.22777145	4.906116087	5.553935931	6.711978593	24.05389603	0.864849723	3.566050384	1.354532634	0.553814743	7.570441522	28.35564248	89.73741939	1.913864935	19.50539002	49.8946377	64.18602852	24.15243766	0.066766176																			Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing																			0.062556157	0.062556157	0.161417832		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.062556157	0.062556157	0.161417832		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			17.3815	0.342614328	11.97297293	0	3.517615204	1.133312816	1.2829592	1.550467055	5.556449982	0.199780286	0.823757639	0.312897038	0.127931206	1.748771992	6.550153413	20.72934388	0.4421028	4.505745094	11.52566131	14.82697259	5.579213098	0.015422987	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.1257	0	0	17.3815	0.342614328	11.97297293	0	3.517615204	1.133312816	1.2829592	1.550467055	5.556449982	0.199780286	0.823757639	0.312897038	0.127931206	1.748771992	6.550153413	20.72934388	0.4421028	4.505745094	11.52566131	14.82697259	5.579213098	0.015422987	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.1257																																																																																		0	0	0	17.3815	0.342614328	11.97297293	0	3.517615204	1.133312816	1.2829592	1.550467055	5.556449982	0.199780286	0.823757639	0.312897038	0.127931206	1.748771992	6.550153413	20.72934388	0.4421028	4.505745094	11.52566131	14.82697259	5.579213098	0.015422987	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.1257
H0562_002_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		284.8809431	6.815370535	61.7744859	186.616412	332.7202543	13.70779778	0.485663179	247.9802785	185.3253174	2.361716938	2.333649132	0.277849052	352.2431351	30.84124472	6053.433041	13857.29918	233.3748928	3687.67631	3318.228714	233.4546158	24.52420935	0	0	0	685.210344	0	94.2884662	0	522.75	0											"$100 per day days 1-4, $0 per day days 5-90"	$900 per admission	"$0 per day days 1-20, $75 per day days 21-100"	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$100 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$8 per office visit	$11 per office visit	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate				Vision exams - $15 per visit		Hearing exams - $10 per visit		$0 per visit												292.1047424	900	274.55	0	125	0.2	0.2	50	100	0	110.4008667	0	25	0	8	11	25	0	0	10	0.2	0	0	0	15	0	10	0	0	0											292.1047424	900	274.55	0	125	0.2	0.2	50	100	0	110.4008667	0	25	0	8	11	25	0	0	10	0.2	0	0	0	15	0	10	0	0	0											6.9346	0.51115279	1.413348759	0	3.465835982	2.741559556	0.097132636	1.03325116	1.544377645	0	0.021469741	0	0.733839865	0	4.035622028	12.70252424	0.486197693	0	0	0.194545513	4.90484187	0	0	0	0.85651293	0	0.078573722	0	0	0	0	0	0	0	0	0	0	0	0	0	41.7554			6.9346	0.51115279	1.413348759	0	3.465835982	2.741559556	0.097132636	1.03325116	1.544377645	0	0.021469741	0	0.733839865	0	4.035622028	12.70252424	0.486197693	0	0	0.194545513	4.90484187	0	0	0	0.85651293	0	0.078573722	0	0	0	0	0	0	0	0	0	0	0	0	0	41.7554																																																																																		0			6.9346	0.51115279	1.413348759	0	3.465835982	2.741559556	0.097132636	1.03325116	1.544377645	0	0.021469741	0	0.733839865	0	4.035622028	12.70252424	0.486197693	0	0	0.194545513	4.90484187	0	0	0	0.85651293	0	0.078573722	0	0	0	0	0	0	0	0	0	0	0	0	0	41.7554
H0562_009_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		305.183641	6.79581826	41.45595806	268.4208102	315.6128128	14.64510749	0.637630868	300.4153485	323.6114979	0.756396178	16.67904915	0.252132059	347.6901096	119.8887941	5889.842355	11922.40787	232.7053753	2612.458326	2427.465377	243.5908516	14.18029696	0	0	1568.25	1264.454529	0	128.663352	0	522.75	0											"$250 per day days 1-8, $0 per day days 9-90"	$900 per admission	"$0 per day days 1-20, $75 per day days 21-100"	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$250 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$10 per office visit	$10 per office visit	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate			"One time annual $35 deductible, $500 annual max"	Vision exams - $10 per visit		Hearing exams - $10 per visit		$0 per visit												979.6187587	900	274.55	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	10	10	25	0	0	10	0.2	0	0	23.33333333	10	0	10	0	0	0											979.6187587	900	274.55	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	10	10	25	0	0	10	0.2	0	0	23.33333333	10	0	10	0	0	0											24.9136	0.509686369	0.948477774	0	3.287633467	2.929021498	0.127526174	1.251730619	6.741906207	0	0.153448457	0	0.724354395	0	4.908201962	9.935339893	0.484802865	0	0	0.202992376	2.836059393	0	0	3.049375	1.053712108	0	0.10721946	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1651			24.9136	0.509686369	0.948477774	0	3.287633467	2.929021498	0.127526174	1.251730619	6.741906207	0	0.153448457	0	0.724354395	0	4.908201962	9.935339893	0.484802865	0	0	0.202992376	2.836059393	0	0	3.049375	1.053712108	0	0.10721946	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1651																																																																																		0			24.9136	0.509686369	0.948477774	0	3.287633467	2.929021498	0.127526174	1.251730619	6.741906207	0	0.153448457	0	0.724354395	0	4.908201962	9.935339893	0.484802865	0	0	0.202992376	2.836059393	0	0	3.049375	1.053712108	0	0.10721946	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1651
H0562_010_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		305.3932209	5.172939208	75.84172879	217.9726022	345.340391	23.11701324	1.764664083	310.7192431	299.242226	61.02413963	8.110052171	0.559854492	178.5935829	45.90806834	5533.852795	14948.04593	177.1340424	3343.53962	3495.063432	194.5914876	16.03237096	0	0	0	1007.297112	0	98.29731764	0	522.75	0											"$100 per day days 1-4, $0 per day days 5-90"	$900 per admission	$0 per visit	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$100 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$10 per office visit	$15 per office visit	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate				Vision exams - $15 per visit		Hearing exams - $15 per visit		$0 per visit												292.1047424	900	0	0	125	0.2	0.2	50	100	0	110.4008667	0	25	0	10	15	25	0	0	10	0.2	0	0	0	15	0	15	0	0	0											292.1047424	900	0	0	125	0.2	0.2	50	100	0	110.4008667	0	25	0	10	15	25	0	0	10	0.2	0	0	0	15	0	15	0	0	0											7.4339	0.387970441	0	0	3.59729574	4.623402648	0.352932817	1.294663513	2.493685216	0	0.074613066	0	0.372069964	0	4.611543996	18.68505742	0.369029255	0	0	0.162159573	3.206474191	0	0	0	1.25912139	0	0.122871647	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0468			7.4339	0.387970441	0	0	3.59729574	4.623402648	0.352932817	1.294663513	2.493685216	0	0.074613066	0	0.372069964	0	4.611543996	18.68505742	0.369029255	0	0	0.162159573	3.206474191	0	0	0	1.25912139	0	0.122871647	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0468																																																																																		0			7.4339	0.387970441	0	0	3.59729574	4.623402648	0.352932817	1.294663513	2.493685216	0	0.074613066	0	0.372069964	0	4.611543996	18.68505742	0.369029255	0	0	0.162159573	3.206474191	0	0	0	1.25912139	0	0.122871647	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0468
H0562_011_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		283.1362963	6.845393641	66.96183085	185.7900509	350.8722524	16.7390498	0.937205214	362.3220896	321.3362747	21.89653124	21.47685964	134.1864351	273.8002155	65.68959373	6486.677475	14382.62849	234.4029571	2506.472096	3303.794594	431.2445441	25.43206316	0	0	1568.25	955.7766623	0	82.51067028	0	522.75	0											"$250 per day days 1-8, $0 per day days 9-90"	$900 per admission	"$0 per day days 1-20, $75 per day days 21-100"	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$250 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$10 per office visit	$20 per office visit	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate			"One time annual $35 deductible, $500 annual max"	Vision exams - $20 per visit		Hearing exams - $20 per visit		$0 per visit												979.6187587	900	274.55	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	10	20	25	0	0	10	0.2	0	0	23.33333333	20	0	20	0	0	0											979.6187587	900	274.55	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	10	20	25	0	0	10	0.2	0	0	23.33333333	20	0	20	0	0	0											23.1138	0.513404523	1.532030888	0	3.654919296	3.34780996	0.187441043	1.509675373	6.694505724	0	0.19758866	0	0.570417116	0	5.405564563	23.97104748	0.488339494	0	0	0.359370453	5.086412633	0	0	3.049375	1.592961104	0	0.137517784	0	0	0	0	0	0	0	0	0	0	0	0	0	81.4122			23.1138	0.513404523	1.532030888	0	3.654919296	3.34780996	0.187441043	1.509675373	6.694505724	0	0.19758866	0	0.570417116	0	5.405564563	23.97104748	0.488339494	0	0	0.359370453	5.086412633	0	0	3.049375	1.592961104	0	0.137517784	0	0	0	0	0	0	0	0	0	0	0	0	0	81.4122																																																																																		0			23.1138	0.513404523	1.532030888	0	3.654919296	3.34780996	0.187441043	1.509675373	6.694505724	0	0.19758866	0	0.570417116	0	5.405564563	23.97104748	0.488339494	0	0	0.359370453	5.086412633	0	0	3.049375	1.592961104	0	0.137517784	0	0	0	0	0	0	0	0	0	0	0	0	0	81.4122
H0562_012_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		296.5834848	6.848962575	77.07564726	202.8306507	320.4724281	15.19429964	0.786687413	274.5995734	190.9120844	4.358723388	0.035012436	1.307617016	90.66144647	24.84472331	4596.70772	11929.19647	234.5251661	3198.482691	3103.882158	454.3638963	16.30392276	0	0	0	753.9908619	0	83.69861247	0	522.75	0											"$200 per day days 1-5, $0 per day days 6-90"	$900 per admission	"$0 per day days 1-20, $75 per day days 21-100"	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$200 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$15 per office visit	$25 per office visit	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate				Vision exams - $35 per visit		Hearing exams - $25 per visit		$0 per visit												654.7325374	900	274.55	0	125	0.2	0.2	50	200	0	110.4008667	0	25	0	15	25	25	0	0	10	0.2	0	0	0	35	0	25	0	0	0											654.7325374	900	274.55	0	125	0.2	0.2	50	200	0	110.4008667	0	25	0	15	25	25	0	0	10	0.2	0	0	0	35	0	25	0	0	0											16.1819	0.513672193	1.76342658	0	3.338254459	3.038859928	0.157337483	1.144164889	3.181868073	0	0.000322117	0	0.188878013	0	5.74588465	24.85249265	0.488594096	0	0	0.37863658	3.260784553	0	0	0	2.199140014	0	0.174372109	0	0	0	0	0	0	0	0	0	0	0	0	0	66.6086			16.1819	0.513672193	1.76342658	0	3.338254459	3.038859928	0.157337483	1.144164889	3.181868073	0	0.000322117	0	0.188878013	0	5.74588465	24.85249265	0.488594096	0	0	0.37863658	3.260784553	0	0	0	2.199140014	0	0.174372109	0	0	0	0	0	0	0	0	0	0	0	0	0	66.6086																																																																																		0			16.1819	0.513672193	1.76342658	0	3.338254459	3.038859928	0.157337483	1.144164889	3.181868073	0	0.000322117	0	0.188878013	0	5.74588465	24.85249265	0.488594096	0	0	0.37863658	3.260784553	0	0	0	2.199140014	0	0.174372109	0	0	0	0	0	0	0	0	0	0	0	0	0	66.6086
H0562_017_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		288.915288	6.834451567	76.91900525	377.0907331	315.1803142	13.38060331	4.26136292	386.4271613	439.03931	83.45375314	0	0	1034.100854	50.79793669	5345.361657	15968.95517	234.0282738	4380.50495	2062.381188	308.7178218	12.77327669	0	0	0	825.6831683	0	91.33663366	0	522.75	0											"$200 per day days 1-5, $0 per day days 6-90"	$900 per admission	"$0 per day days 1-20, $100 per day days 21-100"	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$200 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$10 per office visit	$15 per office visit	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate				Vision exams - $15 per visit		Hearing exams - $15 per visit		$0 per visit												654.7325374	900	366.0666667	0	125	0.2	0.2	50	200	0	110.4008667	0	25	0	10	15	25	0	0	10	0.2	0	0	0	15	0	15	0	0	0											654.7325374	900	366.0666667	0	125	0.2	0.2	50	200	0	110.4008667	0	25	0	10	15	25	0	0	10	0.2	0	0	0	15	0	15	0	0	0											15.7635	0.512583867	2.346456988	0	3.283128273	2.676120661	0.852272584	1.610113172	7.317321833	0	0	0	2.154376779	0	4.454468047	19.96119397	0.487558904	0	0	0.257264851	2.554655337	0	0	0	1.03210396	0	0.114170792	0	0	0	0	0	0	0	0	0	0	0	0	0	65.3773			15.7635	0.512583867	2.346456988	0	3.283128273	2.676120661	0.852272584	1.610113172	7.317321833	0	0	0	2.154376779	0	4.454468047	19.96119397	0.487558904	0	0	0.257264851	2.554655337	0	0	0	1.03210396	0	0.114170792	0	0	0	0	0	0	0	0	0	0	0	0	0	65.3773																																																																																		0			15.7635	0.512583867	2.346456988	0	3.283128273	2.676120661	0.852272584	1.610113172	7.317321833	0	0	0	2.154376779	0	4.454468047	19.96119397	0.487558904	0	0	0.257264851	2.554655337	0	0	0	1.03210396	0	0.114170792	0	0	0	0	0	0	0	0	0	0	0	0	0	65.3773
H0562_036_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		209.7845918	1.724007224	33.25853285	148.3842235	145.8258748	10.49708846	0.058507857	205.3411859	321.6187249	4.947980383	1.181217862	0	356.2545876	64.32374498	4108.132394	10990.61985	59.03420792	1685.56162	1783.20086	131.0421381	14.47012062	0	0	0	687.9712252	0	131.6845016	0	522.75	0											"$250 per day days 1-8, $0 per day days 9-90"	$900 per admission	"$0 per day days 1-20, $75 per day days 21-100"	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$250 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$10 per office visit	$10 per office visit	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate				Vision exams - $10 per visit		Hearing exams - $10 per visit		$0 per visit												979.6187587	900	274.55	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	10	10	25	0	0	10	0.2	0	0	0	10	0	10	0	0	0											979.6187587	900	274.55	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	10	10	25	0	0	10	0.2	0	0	0	10	0	10	0	0	0											17.1257	0.129300542	0.760927516	0	1.519019529	2.099417693	0.011701571	0.855588275	6.700390102	0	0.01086729	0	0.742197057	0	3.423443661	9.158849872	0.122987933	0	0	0.109201782	2.894024123	0	0	0	0.573309354	0	0.109737085	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3467			17.1257	0.129300542	0.760927516	0	1.519019529	2.099417693	0.011701571	0.855588275	6.700390102	0	0.01086729	0	0.742197057	0	3.423443661	9.158849872	0.122987933	0	0	0.109201782	2.894024123	0	0	0	0.573309354	0	0.109737085	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3467																																																																																		0			17.1257	0.129300542	0.760927516	0	1.519019529	2.099417693	0.011701571	0.855588275	6.700390102	0	0.01086729	0	0.742197057	0	3.423443661	9.158849872	0.122987933	0	0	0.109201782	2.894024123	0	0	0	0.573309354	0	0.109737085	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3467
H0562_037_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		282.7424238	2.35207369	68.45342891	291.6711319	248.8133329	15.27063228	0.120155542	214.7061268	304.5027911	29.93222143	1.255897403	1.726858929	224.4916607	73.10369465	5726.789645	15405.41459	80.540734	2279.001214	2433.537935	267.2543652	13.52271136	0	0	0	1025.813646	0	165.6146222	0	522.75	0											"$100 per day days 1-4, $0 per day days 5-90"	$900 per admission	"$0 per day days 1-20, $75 per day days 21-100"	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$100 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$15 per office visit	$20 per office visit	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate				Vision exams - $20 per visit		Hearing exams - $20 per visit		$0 per visit												292.1047424	900	274.55	0	125	0.2	0.2	50	100	0	110.4008667	0	25	0	15	20	25	0	0	10	0.2	0	0	0	20	0	20	0	0	0											292.1047424	900	274.55	0	125	0.2	0.2	50	100	0	110.4008667	0	25	0	15	20	25	0	0	10	0.2	0	0	0	20	0	20	0	0	0											6.8825	0.176405527	1.566157409	0	2.591805551	3.054126456	0.024031108	0.894608862	2.537523259	0	0.011554347	0	0.46769096	0	7.158487056	25.67569098	0.167793196	0	0	0.222711971	2.704542271	0	0	0	1.709689411	0	0.27602437	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1214			6.8825	0.176405527	1.566157409	0	2.591805551	3.054126456	0.024031108	0.894608862	2.537523259	0	0.011554347	0	0.46769096	0	7.158487056	25.67569098	0.167793196	0	0	0.222711971	2.704542271	0	0	0	1.709689411	0	0.27602437	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1214																																																																																		0			6.8825	0.176405527	1.566157409	0	2.591805551	3.054126456	0.024031108	0.894608862	2.537523259	0	0.011554347	0	0.46769096	0	7.158487056	25.67569098	0.167793196	0	0	0.222711971	2.704542271	0	0	0	1.709689411	0	0.27602437	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1214
H0562_039_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		294.7448943	4.48898939	85.96726084	212.8713126	401.1805506	49.4232181	3.851987998	383.9934066	201.8934406	7.917389828	507.8431204	0	2367.299559	19.79347457	5221.036567	14187.59946	153.7139342	2753.766077	2869.655232	108.2964166	14.24366612	0	0	0	1033.011945	0	95.50864787	0	522.75	0											"$250 per day days 1-8, $0 per day days 9-90"	$900 per admission	$0 per visit	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$250 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$15 per office visit	$20 per office visit	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate				Vision exams - $20 per visit		Hearing exams - $20 per visit		$0 per visit												979.6187587	900	0	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	15	20	25	0	0	10	0.2	0	0	0	20	0	20	0	0	0											979.6187587	900	0	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	15	20	25	0	0	10	0.2	0	0	0	20	0	20	0	0	0											24.0615	0.336674204	0	0	4.178964069	9.88464362	0.7703976	1.599972528	4.206113346	0	4.672193388	0	4.93187408	0	6.526295709	23.6459991	0.320237363	0	0	0.090247014	2.848733224	0	0	0	1.721686574	0	0.15918108	0	0	0	0	0	0	0	0	0	0	0	0	0	89.9547			24.0615	0.336674204	0	0	4.178964069	9.88464362	0.7703976	1.599972528	4.206113346	0	4.672193388	0	4.93187408	0	6.526295709	23.6459991	0.320237363	0	0	0.090247014	2.848733224	0	0	0	1.721686574	0	0.15918108	0	0	0	0	0	0	0	0	0	0	0	0	0	89.9547																																																																																		0			24.0615	0.336674204	0	0	4.178964069	9.88464362	0.7703976	1.599972528	4.206113346	0	4.672193388	0	4.93187408	0	6.526295709	23.6459991	0.320237363	0	0	0.090247014	2.848733224	0	0	0	1.721686574	0	0.15918108	0	0	0	0	0	0	0	0	0	0	0	0	0	89.9547
H0562_040_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		285.4232154	6.796549983	63.66317071	203.7221463	287.5453211	15.35433945	0.443068988	350.9145365	388.8789746	0	1.201056771	4.104263585	208.2913769	75.92887632	6041.839147	16930.8353	232.7304312	5579.480866	4861.291092	331.2914664	20.76947393	0	0	0	888.1430801	0	187.9667894	0	522.75	0											"$200 per day days 1-5, $0 per day days 6-90"	$900 per admission	"$0 per day days 1-20, $75 per day days 21-100"	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$200 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$15 per office visit	$25 per office visit	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate				Vision exams - $25 per visit		Hearing exams - $25 per visit		$0 per visit												654.7325374	900	274.55	0	125	0.2	0.2	50	200	0	110.4008667	0	25	0	15	25	25	0	0	10	0.2	0	0	0	25	0	25	0	0	0											654.7325374	900	274.55	0	125	0.2	0.2	50	200	0	110.4008667	0	25	0	15	25	25	0	0	10	0.2	0	0	0	25	0	25	0	0	0											15.573	0.509741249	1.456560293	0	2.995263761	3.07086789	0.088613798	1.462143902	6.481316244	0	0.011049809	0	0.433940369	0	7.552298933	35.27257355	0.484855065	0	0	0.276076222	4.153894786	0	0	0	1.850298084	0	0.391597478	0	0	0	0	0	0	0	0	0	0	0	0	0	82.0641			15.573	0.509741249	1.456560293	0	2.995263761	3.07086789	0.088613798	1.462143902	6.481316244	0	0.011049809	0	0.433940369	0	7.552298933	35.27257355	0.484855065	0	0	0.276076222	4.153894786	0	0	0	1.850298084	0	0.391597478	0	0	0	0	0	0	0	0	0	0	0	0	0	82.0641																																																																																		0			15.573	0.509741249	1.456560293	0	2.995263761	3.07086789	0.088613798	1.462143902	6.481316244	0	0.011049809	0	0.433940369	0	7.552298933	35.27257355	0.484855065	0	0	0.276076222	4.153894786	0	0	0	1.850298084	0	0.391597478	0	0	0	0	0	0	0	0	0	0	0	0	0	82.0641
H0562_044_0	2009	2																																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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		284.8809431	6.815370535	61.7744859	186.616412	332.7202543	13.70779778	0.485663179	247.9802785	185.3253174	2.361716938	2.333649132	0.277849052	352.2431351	30.84124472	6053.433041	13857.29918	233.3748928	3687.67631	3318.228714	233.4546158	24.52420935	0	0	1568.25	685.210344	0	94.2884662	0	522.75	0											"$100 per day days 1-4, $0 per day days 5-90"	$900 per admission	"$0 per day days 1-20, $75 per day days 21-100"	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$100 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$7 per office visit	"Physician specialist services - $10 per visit, diagnostic vision exams - $10 per visit, diagnostic hearing exams - $10 per visit, podiatry services - $10 per visit, urgent care - $10 per visit"	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate			"One time annual $35 deductible, $500 annual max"	Vision exams - $10 per visit	$0 per visit	Hearing exams - $10 per visit		$0 per visit	$10 per visit											292.1047424	900	274.55	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	10											292.1047424	900	274.55	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	10											6.9346	0.51115279	1.413348759	0	3.465835982	2.741559556	0.097132636	1.03325116	1.544377645	0	0.021469741	0	0.733839865	0	3.531169274	11.54774931	0.486197693	0	0	0.194545513	4.90484187	0	0	3.049375	0.57100862	0	0.078573722	0	0	0	0	0	0	0	0	0	0	0	0	0	42.86			6.9346	0.51115279	1.413348759	0	3.465835982	2.741559556	0.097132636	1.03325116	1.544377645	0	0.021469741	0	0.733839865	0	3.531169274	11.54774931	0.486197693	0	0	0.194545513	4.90484187	0	0	3.049375	0.57100862	0	0.078573722	0	0	0	0	0	0	0	0	0	0	0	0	0	42.86																																																																																		0			6.9346	0.51115279	1.413348759	0	3.465835982	2.741559556	0.097132636	1.03325116	1.544377645	0	0.021469741	0	0.733839865	0	3.531169274	11.54774931	0.486197693	0	0	0.194545513	4.90484187	0	0	3.049375	0.57100862	0	0.078573722	0	0	0	0	0	0	0	0	0	0	0	0	0	42.86
H0562_045_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		305.3932209	5.172939208	75.84172879	217.9726022	345.340391	23.11701324	1.764664083	310.7192431	299.242226	61.02413963	8.110052171	0.559854492	178.5935829	45.90806834	5533.852795	14948.04593	177.1340424	3343.53962	3495.063432	194.5914876	16.03237096	0	0	0	1007.297112	0	98.29731764	0	522.75	0											"$250 per day days 1-8, $0 per day days 9-90"	$900 per admission	$0 per visit	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$250 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$10 per office visit	"Physician specialist services - $10 per visit, diagnostic vision exams - $10 per visit, diagnostic hearing exams - $10 per visit, podiatry services - $10 per visit, urgent care - $10 per visit"	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate				Vision exams - $10 per visit		Hearing exams - $10 per visit		$0 per visit												979.6187587	900	0	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	10	10	25	0	0	10	0.2	0	0	0	10	0	10	0	0	0											979.6187587	900	0	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	10	10	25	0	0	10	0.2	0	0	0	10	0	10	0	0	0											24.9307	0.387970441	0	0	3.59729574	4.623402648	0.352932817	1.294663513	6.234213041	0	0.074613066	0	0.372069964	0	4.611543996	12.45670494	0.369029255	0	0	0.162159573	3.206474191	0	0	0	0.83941426	0	0.081914431	0	0	0	0	0	0	0	0	0	0	0	0	0	63.5951			24.9307	0.387970441	0	0	3.59729574	4.623402648	0.352932817	1.294663513	6.234213041	0	0.074613066	0	0.372069964	0	4.611543996	12.45670494	0.369029255	0	0	0.162159573	3.206474191	0	0	0	0.83941426	0	0.081914431	0	0	0	0	0	0	0	0	0	0	0	0	0	63.5951																																																																																		0			24.9307	0.387970441	0	0	3.59729574	4.623402648	0.352932817	1.294663513	6.234213041	0	0.074613066	0	0.372069964	0	4.611543996	12.45670494	0.369029255	0	0	0.162159573	3.206474191	0	0	0	0.83941426	0	0.081914431	0	0	0	0	0	0	0	0	0	0	0	0	0	63.5951
H0562_046_0	2009	2																																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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		283.1362963	6.845393641	66.96183085	185.7900509	350.8722524	16.7390498	0.937205214	362.3220896	321.3362747	21.89653124	21.47685964	134.1864351	273.8002155	65.68959373	6486.677475	14382.62849	234.4029571	2506.472096	3303.794594	431.2445441	25.43206316	0	0	1568.25	955.7766623	0	82.51067028	0	522.75	0											"$250 per day days 1-8, $0 per day days 9-90"	$900 per admission	"$0 per day days 1-20, $75 per day days 21-100"	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$250 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$12 per office visit	"Physician specialist services - $20 per visit, diagnostic vision exams - $20 per visit, diagnostic hearing exams - $20 per visit, podiatry services - $20 per visit, urgent care - $20 per visit"	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate			"One time annual $35 deductible, $500 annual max"	Vision exams - $20 per visit		Hearing exams - $20 per visit		$0 per visit												979.6187587	900	274.55	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	12	20	25	0	0	10	0.2	0	0	23.33333333	20	0	20	0	0	0											979.6187587	900	274.55	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	12	20	25	0	0	10	0.2	0	0	23.33333333	20	0	20	0	0	0											23.1138	0.513404523	1.532030888	0	3.654919296	3.34780996	0.187441043	1.509675373	6.694505724	0	0.19758866	0	0.570417116	0	6.486677475	23.97104748	0.488339494	0	0	0.359370453	5.086412633	0	0	3.049375	1.592961104	0	0.137517784	0	0	0	0	0	0	0	0	0	0	0	0	0	82.4933			23.1138	0.513404523	1.532030888	0	3.654919296	3.34780996	0.187441043	1.509675373	6.694505724	0	0.19758866	0	0.570417116	0	6.486677475	23.97104748	0.488339494	0	0	0.359370453	5.086412633	0	0	3.049375	1.592961104	0	0.137517784	0	0	0	0	0	0	0	0	0	0	0	0	0	82.4933																																																																																		0			23.1138	0.513404523	1.532030888	0	3.654919296	3.34780996	0.187441043	1.509675373	6.694505724	0	0.19758866	0	0.570417116	0	6.486677475	23.97104748	0.488339494	0	0	0.359370453	5.086412633	0	0	3.049375	1.592961104	0	0.137517784	0	0	0	0	0	0	0	0	0	0	0	0	0	82.4933
H0562_047_0	2009	2																																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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		285.4232154	6.796549983	63.66317071	203.7221463	287.5453211	15.35433945	0.443068988	350.9145365	388.8789746	0	1.201056771	4.104263585	208.2913769	75.92887632	6041.839147	16930.8353	232.7304312	5579.480866	4861.291092	331.2914664	20.76947393	0	0	0	888.1430801	0	187.9667894	0	522.75	0											"$200 per day days 1-5, $0 per day days 6-90"	$900 per admission	"$0 per day days 1-20, $75 per day days 21-100"	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$200 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$15 per office visit	"Physician specialist services - $25 per visit, diagnostic vision exams - $25 per visit, diagnostic hearing exams - $25 per visit, podiatry services - $25 per visit, urgent care - $25 per visit"	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate				Vision exams - $25 per visit		Hearing exams - $25 per visit		$0 per visit												654.7325374	900	274.55	0	125	0.2	0.2	50	200	0	110.4008667	0	25	0	15	25	25	0	0	10	0.2	0	0	0	25	0	25	0	0	0											654.7325374	900	274.55	0	125	0.2	0.2	50	200	0	110.4008667	0	25	0	15	25	25	0	0	10	0.2	0	0	0	25	0	25	0	0	0											15.573	0.509741249	1.456560293	0	2.995263761	3.07086789	0.088613798	1.462143902	6.481316244	0	0.011049809	0	0.433940369	0	7.552298933	35.27257355	0.484855065	0	0	0.276076222	4.153894786	0	0	0	1.850298084	0	0.391597478	0	0	0	0	0	0	0	0	0	0	0	0	0	82.0641			15.573	0.509741249	1.456560293	0	2.995263761	3.07086789	0.088613798	1.462143902	6.481316244	0	0.011049809	0	0.433940369	0	7.552298933	35.27257355	0.484855065	0	0	0.276076222	4.153894786	0	0	0	1.850298084	0	0.391597478	0	0	0	0	0	0	0	0	0	0	0	0	0	82.0641																																																																																		0			15.573	0.509741249	1.456560293	0	2.995263761	3.07086789	0.088613798	1.462143902	6.481316244	0	0.011049809	0	0.433940369	0	7.552298933	35.27257355	0.484855065	0	0	0.276076222	4.153894786	0	0	0	1.850298084	0	0.391597478	0	0	0	0	0	0	0	0	0	0	0	0	0	82.0641
H0562_048_0	2009	2																																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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		296.5834848	6.848962575	77.07564726	202.8306507	320.4724281	15.19429964	0.786687413	274.5995734	190.9120844	4.358723388	0.035012436	1.307617016	90.66144647	24.84472331	4596.70772	11929.19647	234.5251661	3198.482691	3103.882158	454.3638963	16.30392276	0	0	1568.25	753.9908619	0	83.69861247	0	522.75	0											"$200 per day days 1-5, $0 per day days 6-90"	$900 per admission	"$0 per day days 1-20, $75 per day days 21-100"	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$200 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$12 per office visit	"Physician specialist services - $25 per visit, diagnostic vision exams - $25 per visit, diagnostic hearing exams - $25 per visit, podiatry services - $25 per visit, urgent care - $25 per visit"	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate			"One time annual $35 deductible, $500 annual max"	Vision exams - $25 per visit	$0 per visit	Hearing exams - $25 per visit		$0 per visit	$10 per visit											654.7325374	900	274.55	0	125	0.2	0.2	50	200	0	110.4008667	0	25	0	12	25	25	0	0	10	0.2	0	0	23.33333333	25	0	25	0	0	10											654.7325374	900	274.55	0	125	0.2	0.2	50	200	0	110.4008667	0	25	0	12	25	25	0	0	10	0.2	0	0	23.33333333	25	0	25	0	0	10											16.1819	0.513672193	1.76342658	0	3.338254459	3.038859928	0.157337483	1.144164889	3.181868073	0	0.000322117	0	0.188878013	0	4.59670772	24.85249265	0.488594096	0	0	0.37863658	3.260784553	0	0	3.049375	1.570814296	0	0.174372109	0	0	0	0	0	0	0	0	0	0	0	0	0	67.8805			16.1819	0.513672193	1.76342658	0	3.338254459	3.038859928	0.157337483	1.144164889	3.181868073	0	0.000322117	0	0.188878013	0	4.59670772	24.85249265	0.488594096	0	0	0.37863658	3.260784553	0	0	3.049375	1.570814296	0	0.174372109	0	0	0	0	0	0	0	0	0	0	0	0	0	67.8805																																																																																		0			16.1819	0.513672193	1.76342658	0	3.338254459	3.038859928	0.157337483	1.144164889	3.181868073	0	0.000322117	0	0.188878013	0	4.59670772	24.85249265	0.488594096	0	0	0.37863658	3.260784553	0	0	3.049375	1.570814296	0	0.174372109	0	0	0	0	0	0	0	0	0	0	0	0	0	67.8805
H0562_049_0	2009	2																																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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		305.183641	6.79581826	41.45595806	268.4208102	315.6128128	14.64510749	0.637630868	300.4153485	323.6114979	0.756396178	16.67904915	0.252132059	347.6901096	119.8887941	5889.842355	11922.40787	232.7053753	2612.458326	2427.465377	243.5908516	14.18029696	0	0	1568.25	1264.454529	0	128.663352	0	522.75	0											"$250 per day days 1-8, $0 per day days 9-90"	$900 per admission	"$0 per day days 1-20, $75 per day days 21-100"	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$250 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$10 per office visit	"Physician specialist services - $10 per visit, diagnostic vision exams - $10 per visit, diagnostic hearing exams - $10 per visit, podiatry services - $10 per visit, urgent care - $10 per visit"	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate			"One time annual $35 deductible, $500 annual max"	Vision exams - $10 per visit		Hearing exams - $10 per visit		$0 per visit												979.6187587	900	274.55	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	10	10	25	0	0	10	0.2	0	0	23.33333333	10	0	10	0	0	0											979.6187587	900	274.55	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	10	10	25	0	0	10	0.2	0	0	23.33333333	10	0	10	0	0	0											24.9136	0.509686369	0.948477774	0	3.287633467	2.929021498	0.127526174	1.251730619	6.741906207	0	0.153448457	0	0.724354395	0	4.908201962	9.935339893	0.484802865	0	0	0.202992376	2.836059393	0	0	3.049375	1.053712108	0	0.10721946	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1651			24.9136	0.509686369	0.948477774	0	3.287633467	2.929021498	0.127526174	1.251730619	6.741906207	0	0.153448457	0	0.724354395	0	4.908201962	9.935339893	0.484802865	0	0	0.202992376	2.836059393	0	0	3.049375	1.053712108	0	0.10721946	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1651																																																																																		0			24.9136	0.509686369	0.948477774	0	3.287633467	2.929021498	0.127526174	1.251730619	6.741906207	0	0.153448457	0	0.724354395	0	4.908201962	9.935339893	0.484802865	0	0	0.202992376	2.836059393	0	0	3.049375	1.053712108	0	0.10721946	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1651
H0562_053_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		306.0598796	13.5620078	50.86628985	132.7696379	248.2964657	17.29201176	0.65559583	231.7720621	331.8175565	66.69699628	4.663090178	6.669699628	25.84508606	78.36897062	5348.341883	12040.02762	464.396191	3041.50093	2767.888303	534.9796553	14.16787637	0	0	0	884.3619338	0	101.408876	0	522.75	0											"$150 per day days 1-4, $0 per day days 5-90"	$900 per admission	$0 per visit	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$150 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$10 per office visit	$20 per office visit	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate				Vision exams - $20 per visit		Hearing exams - $20 per visit		$0 per visit												438.1571136	900	0	0	125	0.2	0.2	50	150	0	110.4008667	0	25	0	10	20	25	0	0	10	0.2	0	0	0	20	0	20	0	0	0											438.1571136	900	0	0	125	0.2	0.2	50	150	0	110.4008667	0	25	0	10	20	25	0	0	10	0.2	0	0	0	20	0	20	0	0	0											11.1752	1.017150585	0	0	2.586421518	3.458402353	0.131119166	0.965716925	4.147719456	0	0.042900766	0	0.053843929	0	4.456951569	20.06671269	0.967492065	0	0	0.445816379	2.833575274	0	0	0	1.473936556	0	0.169014793	0	0	0	0	0	0	0	0	0	0	0	0	0	53.992			11.1752	1.017150585	0	0	2.586421518	3.458402353	0.131119166	0.965716925	4.147719456	0	0.042900766	0	0.053843929	0	4.456951569	20.06671269	0.967492065	0	0	0.445816379	2.833575274	0	0	0	1.473936556	0	0.169014793	0	0	0	0	0	0	0	0	0	0	0	0	0	53.992																																																																																		0			11.1752	1.017150585	0	0	2.586421518	3.458402353	0.131119166	0.965716925	4.147719456	0	0.042900766	0	0.053843929	0	4.456951569	20.06671269	0.967492065	0	0	0.445816379	2.833575274	0	0	0	1.473936556	0	0.169014793	0	0	0	0	0	0	0	0	0	0	0	0	0	53.992
H0562_055_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		335.0199891	8.014875749	72.64679541	219.4609006	391.279019	16.12037019	0.571139898	291.6248075	217.9425732	2.777379119	2.744371379	0.326750485	414.2379268	36.26930379	7118.837257	16296.18383	274.4488739	4336.707341	3902.236968	274.5426282	28.84047019	0	6000	1500	0	246	0	0	522.75	0											$0 per visit	$900 per admission	"$0 per day days 1-20, $50 per day days 21-100"	$0 per visit	$50 per trip	15% based on Medicare Allowable cost	15% based on Medicare Allowable cost	"$20 per visit, waived if admitted"	$0 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"Adv Rad and Rad Thrpy above $1,000"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$0 per office visit	"Physician specialist services - $0 per visit, diagnostic vision exams - $0 per visit, diagnostic hearing exams - $0 per visit, podiatry services - $0 per visit, urgent care - $0 per visit"	$10 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $0 per visit	20% of contracted rate		$0 per trip	$0 per visit	Vision exams - $0 per visit	$0 per visit	Hearing exams - $0 per visit		$0 per visit												0	900	183.0333333	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	900	183.0333333	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	0.601115681	1.108065427	0	1.630329246	2.418055528	0.085670985	0.486041346	0	0	0.062891844	0	0.862995681	0	0	0	0.228707395	0	0	0	5.768094039	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.252			0	0.601115681	1.108065427	0	1.630329246	2.418055528	0.085670985	0.486041346	0	0	0.062891844	0	0.862995681	0	0	0	0.228707395	0	0	0	5.768094039	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.252																																																																																		0			0	0.601115681	1.108065427	0	1.630329246	2.418055528	0.085670985	0.486041346	0	0	0.062891844	0	0.862995681	0	0	0	0.228707395	0	0	0	5.768094039	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.252
H0562_056_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		507.6578406	12.14499029	110.0821339	332.5504463	592.9074931	24.42729564	0.865451785	441.9008563	330.2497155	4.208579583	4.158562753	0.49512701	627.6972667	54.95909809	10787.21768	24693.70713	415.874059	6571.439185	5913.083569	416.0161254	43.70214106	0	6000	1500	0	0	0	0	522.75	0											"$50 per day days 1-8, $0 per day days 9-90"	$900 per admission	"$0 per day days 1-20, $20 per day days 21-100"	$0 per visit	$75 per trip	10% based on Medicare Allowable cost	10% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$25 per surgical visit (hospital facility & ASC)	Outpatient lab services - $10 per visit	"Adv Rad and Rad Thrpy above $1,000"	Outpatient observation services - $10 per visit	$0 per office visit	$10 per office visit	$10 per office visit	"Physician specialist services - $10 per visit, diagnostic vision exams - $10 per visit, diagnostic hearing exams - $10 per visit, podiatry services - $0 per visit, urgent care - $25 per visit"	$25 per visit	"Occupational therapy services - $10 per visit, physical/speech therapy - $10 per visit"	$10 per visit	Chiropractic services - $10 per visit	10% of contracted rate		$0 per trip	$0 per visit	Vision exams - $10 per visit		Hearing exams - $10 per visit		$0 per visit												195.9237517	900	73.21333333	0	75	0.1	0.1	50	25	10	275	10	0	10	10	10	25	10	10	10	0.1	0	0	0	10	0	10	0	0	0											195.9237517	900	73.21333333	0	75	0.1	0.1	50	25	10	275	10	0	10	10	10	25	10	10	10	0.1	0	0	0	10	0	10	0	0	0											8.2885	0.910874272	0.67162333	0	3.705671832	2.442729564	0.086545178	1.841253568	0.688020241	0.00350715	0.095300396	0.000412606	0	0.045799248	8.989348067	20.57808928	0.86640429	5.476199321	4.927569641	0.346680105	4.370214106	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3348			8.2885	0.910874272	0.67162333	0	3.705671832	2.442729564	0.086545178	1.841253568	0.688020241	0.00350715	0.095300396	0.000412606	0	0.045799248	8.989348067	20.57808928	0.86640429	5.476199321	4.927569641	0.346680105	4.370214106	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3348																																																																																		0			8.2885	0.910874272	0.67162333	0	3.705671832	2.442729564	0.086545178	1.841253568	0.688020241	0.00350715	0.095300396	0.000412606	0	0.045799248	8.989348067	20.57808928	0.86640429	5.476199321	4.927569641	0.346680105	4.370214106	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3348
H0562_057_0	2009	2																																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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		288.915288	6.834451567	76.91900525	377.0907331	315.1803142	13.38060331	4.26136292	386.4271613	439.03931	83.45375314	0	0	1034.100854	50.79793669	5345.361657	15968.95517	234.0282738	4380.50495	2062.381188	308.7178218	12.77327669	0	0	0	825.6831683	0	91.33663366	0	522.75	0											"$200 per day days 1-5, $0 per day days 6-90"	$900 per admission	"$0 per day days 1-20, $100 per day days 21-100"	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$200 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$10 per office visit	"Physician specialist services - $15 per visit, diagnostic vision exams - $15 per visit, diagnostic hearing exams - $15 per visit, podiatry services - $15 per visit, urgent care - $15 per visit"	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate				Vision exams - $15 per visit		Hearing exams - $15 per visit		$0 per visit												654.7325374	900	366.0666667	0	125	0.2	0.2	50	200	0	110.4008667	0	25	0	10	15	25	0	0	10	0.2	0	0	0	15	0	15	0	0	0											654.7325374	900	366.0666667	0	125	0.2	0.2	50	200	0	110.4008667	0	25	0	10	15	25	0	0	10	0.2	0	0	0	15	0	15	0	0	0											15.7635	0.512583867	2.346456988	0	3.283128273	2.676120661	0.852272584	1.610113172	7.317321833	0	0	0	2.154376779	0	4.454468047	19.96119397	0.487558904	0	0	0.257264851	2.554655337	0	0	0	1.03210396	0	0.114170792	0	0	0	0	0	0	0	0	0	0	0	0	0	65.3773			15.7635	0.512583867	2.346456988	0	3.283128273	2.676120661	0.852272584	1.610113172	7.317321833	0	0	0	2.154376779	0	4.454468047	19.96119397	0.487558904	0	0	0.257264851	2.554655337	0	0	0	1.03210396	0	0.114170792	0	0	0	0	0	0	0	0	0	0	0	0	0	65.3773																																																																																		0			15.7635	0.512583867	2.346456988	0	3.283128273	2.676120661	0.852272584	1.610113172	7.317321833	0	0	0	2.154376779	0	4.454468047	19.96119397	0.487558904	0	0	0.257264851	2.554655337	0	0	0	1.03210396	0	0.114170792	0	0	0	0	0	0	0	0	0	0	0	0	0	65.3773
H0562_058_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		283.8746171	2.542588749	85.16238512	145.0914709	269.1551925	18.97291401	1.869483981	350.7681329	318.2331177	57.95299587	6.709903231	1.016719226	289.7649793	62.01987277	5679.465701	15283.47101	87.06443379	4502.734177	3200.421941	393.3924051	10.86482089	0	0	0	1065.308017	0	74.04219409	0	522.75	0											"$100 per day days 1-4, $0 per day days 5-90"	$900 per admission	$0 per visit	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$100 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$10 per office visit	$15 per office visit	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate				Vision exams - $15 per visit		Hearing exams - $15 per visit		$0 per visit												292.1047424	900	0	0	125	0.2	0.2	50	100	0	110.4008667	0	25	0	10	15	25	0	0	10	0.2	0	0	0	15	0	15	0	0	0											292.1047424	900	0	0	125	0.2	0.2	50	100	0	110.4008667	0	25	0	10	15	25	0	0	10	0.2	0	0	0	15	0	15	0	0	0											6.9101	0.190694156	0	0	2.803699922	3.794582802	0.373896796	1.461533887	2.651942647	0	0.061731594	0	0.60367704	0	4.732888084	19.10433876	0.181384237	0	0	0.327827004	2.172964179	0	0	0	1.331635021	0	0.092552743	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7954			6.9101	0.190694156	0	0	2.803699922	3.794582802	0.373896796	1.461533887	2.651942647	0	0.061731594	0	0.60367704	0	4.732888084	19.10433876	0.181384237	0	0	0.327827004	2.172964179	0	0	0	1.331635021	0	0.092552743	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7954																																																																																		0			6.9101	0.190694156	0	0	2.803699922	3.794582802	0.373896796	1.461533887	2.651942647	0	0.061731594	0	0.60367704	0	4.732888084	19.10433876	0.181384237	0	0	0.327827004	2.172964179	0	0	0	1.331635021	0	0.092552743	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7954
H0562_059_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		306.0598796	13.5620078	50.86628985	132.7696379	248.2964657	17.29201176	0.65559583	231.7720621	331.8175565	66.69699628	4.663090178	6.669699628	25.84508606	78.36897062	5348.341883	12040.02762	464.396191	3041.50093	2767.888303	534.9796553	14.16787637	0	0	0	884.3619338	0	101.408876	0	522.75	0											"$250 per day days 1-8, $0 per day days 9-90"	$900 per admission	$0 per visit	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$250 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$10 per office visit	$20 per office visit	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate				Vision exams - $20 per visit		Hearing exams - $20 per visit		$0 per visit												979.6187587	900	0	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	10	20	25	0	0	10	0.2	0	0	0	20	0	20	0	0	0											979.6187587	900	0	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	10	20	25	0	0	10	0.2	0	0	0	20	0	20	0	0	0											24.9852	1.017150585	0	0	2.586421518	3.458402353	0.131119166	0.965716925	6.91286576	0	0.042900766	0	0.053843929	0	4.456951569	20.06671269	0.967492065	0	0	0.445816379	2.833575274	0	0	0	1.473936556	0	0.169014793	0	0	0	0	0	0	0	0	0	0	0	0	0	70.5671			24.9852	1.017150585	0	0	2.586421518	3.458402353	0.131119166	0.965716925	6.91286576	0	0.042900766	0	0.053843929	0	4.456951569	20.06671269	0.967492065	0	0	0.445816379	2.833575274	0	0	0	1.473936556	0	0.169014793	0	0	0	0	0	0	0	0	0	0	0	0	0	70.5671																																																																																		0			24.9852	1.017150585	0	0	2.586421518	3.458402353	0.131119166	0.965716925	6.91286576	0	0.042900766	0	0.053843929	0	4.456951569	20.06671269	0.967492065	0	0	0.445816379	2.833575274	0	0	0	1.473936556	0	0.169014793	0	0	0	0	0	0	0	0	0	0	0	0	0	70.5671
H0562_060_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		306.0598796	13.5620078	50.86628985	132.7696379	248.2964657	17.29201176	0.65559583	231.7720621	331.8175565	66.69699628	4.663090178	6.669699628	25.84508606	78.36897062	5348.341883	12040.02762	464.396191	3041.50093	2767.888303	534.9796553	14.16787637	0	0	0	884.3619338	0	101.408876	0	522.75	0											"$100 per day days 1-4, $0 per day days 5-90"	$900 per admission	$0 per visit	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$100 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$10 per office visit	$10 per office visit	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate				Vision exams - $10 per visit		Hearing exams - $10 per visit		$0 per visit												292.1047424	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											292.1047424	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											7.4501	1.017150585	0	0	2.586421518	3.458402353	0.131119166	0.965716925	2.765146304	0	0.042900766	0	0.053843929	0	4.456951569	10.03335635	0.967492065	0	0	0.445816379	2.833575274	0	0	0	0.736968278	0	0.084507397	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0295			7.4501	1.017150585	0	0	2.586421518	3.458402353	0.131119166	0.965716925	2.765146304	0	0.042900766	0	0.053843929	0	4.456951569	10.03335635	0.967492065	0	0	0.445816379	2.833575274	0	0	0	0.736968278	0	0.084507397	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0295																																																																																		0			7.4501	1.017150585	0	0	2.586421518	3.458402353	0.131119166	0.965716925	2.765146304	0	0.042900766	0	0.053843929	0	4.456951569	10.03335635	0.967492065	0	0	0.445816379	2.833575274	0	0	0	0.736968278	0	0.084507397	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0295
H0562_061_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		306.0598796	13.5620078	50.86628985	132.7696379	248.2964657	17.29201176	0.65559583	231.7720621	331.8175565	66.69699628	4.663090178	6.669699628	25.84508606	78.36897062	5348.341883	12040.02762	464.396191	3041.50093	2767.888303	534.9796553	14.16787637	0	0	0	884.3619338	0	101.408876	0	522.75	0											"$250 per day days 1-8, $0 per day days 9-90"	$900 per admission	$0 per visit	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$250 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$10 per office visit	$20 per office visit	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate				Vision exams - $20 per visit		Hearing exams - $20 per visit		$0 per visit												979.6187587	900	0	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	10	20	25	0	0	10	0.2	0	0	0	20	0	20	0	0	0											979.6187587	900	0	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	10	20	25	0	0	10	0.2	0	0	0	20	0	20	0	0	0											24.9852	1.017150585	0	0	2.586421518	3.458402353	0.131119166	0.965716925	6.91286576	0	0.042900766	0	0.053843929	0	4.456951569	20.06671269	0.967492065	0	0	0.445816379	2.833575274	0	0	0	1.473936556	0	0.169014793	0	0	0	0	0	0	0	0	0	0	0	0	0	70.5671			24.9852	1.017150585	0	0	2.586421518	3.458402353	0.131119166	0.965716925	6.91286576	0	0.042900766	0	0.053843929	0	4.456951569	20.06671269	0.967492065	0	0	0.445816379	2.833575274	0	0	0	1.473936556	0	0.169014793	0	0	0	0	0	0	0	0	0	0	0	0	0	70.5671																																																																																		0			24.9852	1.017150585	0	0	2.586421518	3.458402353	0.131119166	0.965716925	6.91286576	0	0.042900766	0	0.053843929	0	4.456951569	20.06671269	0.967492065	0	0	0.445816379	2.833575274	0	0	0	1.473936556	0	0.169014793	0	0	0	0	0	0	0	0	0	0	0	0	0	70.5671
H0562_062_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		306.0598796	13.5620078	50.86628985	132.7696379	248.2964657	17.29201176	0.65559583	231.7720621	331.8175565	66.69699628	4.663090178	6.669699628	25.84508606	78.36897062	5348.341883	12040.02762	464.396191	3041.50093	2767.888303	534.9796553	14.16787637	0	0	0	884.3619338	0	101.408876	0	522.75	0											"$150 per day days 1-4, $0 per day days 5-90"	$900 per admission	$0 per visit	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$150 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$10 per office visit	$20 per office visit	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate				Vision exams - $20 per visit		Hearing exams - $20 per visit		$0 per visit												438.1571136	900	0	0	125	0.2	0.2	50	150	0	110.4008667	0	25	0	10	20	25	0	0	10	0.2	0	0	0	20	0	20	0	0	0											438.1571136	900	0	0	125	0.2	0.2	50	150	0	110.4008667	0	25	0	10	20	25	0	0	10	0.2	0	0	0	20	0	20	0	0	0											11.1752	1.017150585	0	0	2.586421518	3.458402353	0.131119166	0.965716925	4.147719456	0	0.042900766	0	0.053843929	0	4.456951569	20.06671269	0.967492065	0	0	0.445816379	2.833575274	0	0	0	1.473936556	0	0.169014793	0	0	0	0	0	0	0	0	0	0	0	0	0	53.992			11.1752	1.017150585	0	0	2.586421518	3.458402353	0.131119166	0.965716925	4.147719456	0	0.042900766	0	0.053843929	0	4.456951569	20.06671269	0.967492065	0	0	0.445816379	2.833575274	0	0	0	1.473936556	0	0.169014793	0	0	0	0	0	0	0	0	0	0	0	0	0	53.992																																																																																		0			11.1752	1.017150585	0	0	2.586421518	3.458402353	0.131119166	0.965716925	4.147719456	0	0.042900766	0	0.053843929	0	4.456951569	20.06671269	0.967492065	0	0	0.445816379	2.833575274	0	0	0	1.473936556	0	0.169014793	0	0	0	0	0	0	0	0	0	0	0	0	0	53.992
H0562_068_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		322.8552093	6.358476067	59.04726542	346.0296737	357.1407183	13.81416167	0.860997077	336.4617025	309.4465293	115.7354579	15.49889511	2.762915441	97.31602163	115.1214767	6554.713546	14850.41283	217.729713	3173.436163	2999.712249	301.2404407	16.71013257	0	0	0	589.9870382	0	129.6979909	0	522.75	0											"$250 per day days 1-8, $0 per day days 9-90"	$900 per admission	"$0 per day days 1-20, $75 per day days 21-100"	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$250 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$10 per office visit	$20 per office visit	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate				Vision exams - $20 per visit		Hearing exams - $20 per visit		$0 per visit												979.6187587	900	274.55	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	10	20	25	0	0	10	0.2	0	0	0	20	0	20	0	0	0											979.6187587	900	274.55	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	10	20	25	0	0	10	0.2	0	0	0	20	0	20	0	0	0											26.3563	0.476885705	1.350952227	0	3.720215815	2.762832334	0.172199415	1.401923761	6.446802695	0	0.142590954	0	0.202741712	0	5.462261288	24.75068805	0.453603569	0	0	0.251033701	3.342026515	0	0	0	0.98331173	0	0.216163318	0	0	0	0	0	0	0	0	0	0	0	0	0	78.4925			26.3563	0.476885705	1.350952227	0	3.720215815	2.762832334	0.172199415	1.401923761	6.446802695	0	0.142590954	0	0.202741712	0	5.462261288	24.75068805	0.453603569	0	0	0.251033701	3.342026515	0	0	0	0.98331173	0	0.216163318	0	0	0	0	0	0	0	0	0	0	0	0	0	78.4925																																																																																		0			26.3563	0.476885705	1.350952227	0	3.720215815	2.762832334	0.172199415	1.401923761	6.446802695	0	0.142590954	0	0.202741712	0	5.462261288	24.75068805	0.453603569	0	0	0.251033701	3.342026515	0	0	0	0.98331173	0	0.216163318	0	0	0	0	0	0	0	0	0	0	0	0	0	78.4925
H0562_069_0	2009	2																																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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		322.8552093	6.358476067	59.04726542	346.0296737	357.1407183	13.81416167	0.860997077	336.4617025	309.4465293	115.7354579	15.49889511	2.762915441	97.31602163	115.1214767	6554.713546	14850.41283	217.729713	3173.436163	2999.712249	301.2404407	16.71013257	0	0	0	589.9870382	0	129.6979909	0	522.75	0											"$250 per day days 1-8, $0 per day days 9-90"	$900 per admission	"$0 per day days 1-20, $75 per day days 21-100"	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$250 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$10 per office visit	"Physician specialist services - $20 per visit, diagnostic vision exams - $20 per visit, diagnostic hearing exams - $20 per visit, podiatry services - $20 per visit, urgent care - $20 per visit"	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate				Vision exams - $20 per visit		Hearing exams - $20 per visit		$0 per visit												979.6187587	900	274.55	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	10	20	25	0	0	10	0.2	0	0	0	20	0	20	0	0	0											979.6187587	900	274.55	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	10	20	25	0	0	10	0.2	0	0	0	20	0	20	0	0	0											26.3563	0.476885705	1.350952227	0	3.720215815	2.762832334	0.172199415	1.401923761	6.446802695	0	0.142590954	0	0.202741712	0	5.462261288	24.75068805	0.453603569	0	0	0.251033701	3.342026515	0	0	0	0.98331173	0	0.216163318	0	0	0	0	0	0	0	0	0	0	0	0	0	78.4925			26.3563	0.476885705	1.350952227	0	3.720215815	2.762832334	0.172199415	1.401923761	6.446802695	0	0.142590954	0	0.202741712	0	5.462261288	24.75068805	0.453603569	0	0	0.251033701	3.342026515	0	0	0	0.98331173	0	0.216163318	0	0	0	0	0	0	0	0	0	0	0	0	0	78.4925																																																																																		0			26.3563	0.476885705	1.350952227	0	3.720215815	2.762832334	0.172199415	1.401923761	6.446802695	0	0.142590954	0	0.202741712	0	5.462261288	24.75068805	0.453603569	0	0	0.251033701	3.342026515	0	0	0	0.98331173	0	0.216163318	0	0	0	0	0	0	0	0	0	0	0	0	0	78.4925
H0562_070_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		397.9460244	0	29.30087578	7.622864186	14.46101509	17.91728302	0.536670071	35.62752724	19.33340163	0.010607966	0.453275054	0	12.91723623	2.143197253	147.432798	258.5457028	7.057633154	26.46612433	53.58396056	2.093409707	30.16307083	2.681161852	6000	1500	0	246	0	0	522.75	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, unlimited trips per year"	$0 per visit	$0 per visit	$0 per visit	$0 per visit		$0 per visit												0.060428982	0.060428982	0.160878736	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.060428982	0.060428982	0.160878736	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											24.0475	0	4.713887873	0	3.340494485	4.138892378	0.123970786	8.229958792	4.466015778	0.00245044	0.104706537	0	2.983881568	0.495078565	34.05697634	59.72405736	1.630313258	6.113674719	12.37789489	0.483577642	6.967669363	0.619348388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	174.6203			24.0475	0	4.713887873	0	3.340494485	4.138892378	0.123970786	8.229958792	4.466015778	0.00245044	0.104706537	0	2.983881568	0.495078565	34.05697634	59.72405736	1.630313258	6.113674719	12.37789489	0.483577642	6.967669363	0.619348388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	174.6203																																																																																		0			24.0475	0	4.713887873	0	3.340494485	4.138892378	0.123970786	8.229958792	4.466015778	0.00245044	0.104706537	0	2.983881568	0.495078565	34.05697634	59.72405736	1.630313258	6.113674719	12.37789489	0.483577642	6.967669363	0.619348388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	174.6203
H0562_071_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		284.8809431	6.815370535	61.7744859	186.616412	332.7202543	13.70779778	0.485663179	247.9802785	185.3253174	2.361716938	2.333649132	0.277849052	352.2431351	30.84124472	6053.433041	13857.29918	233.3748928	3687.67631	3318.228714	233.4546158	24.52420935	0	0	0	685.210344	0	94.2884662	0	522.75	0											$0 per visit	$900 per admission	"$0 per day days 1-20, $75 per day days 21-100"	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$0 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$0 per office visit	$0 per office visit	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $0 per visit	20% of contracted rate				Vision exams - $25 per visit		Hearing exams - $25 per visit		$0 per visit												0	900	274.55	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	25	0	25	0	0	0											0	900	274.55	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	25	0	25	0	0	0											0	0.51115279	1.413348759	0	3.465835982	2.741559556	0.097132636	1.03325116	0	0	0.021469741	0	0.733839865	0	0	0	0.486197693	0	0	0	4.90484187	0	0	0	1.42752155	0	0.196434305	0	0	0	0	0	0	0	0	0	0	0	0	0	17.0326			0	0.51115279	1.413348759	0	3.465835982	2.741559556	0.097132636	1.03325116	0	0	0.021469741	0	0.733839865	0	0	0	0.486197693	0	0	0	4.90484187	0	0	0	1.42752155	0	0.196434305	0	0	0	0	0	0	0	0	0	0	0	0	0	17.0326																																																																																		0			0	0.51115279	1.413348759	0	3.465835982	2.741559556	0.097132636	1.03325116	0	0	0.021469741	0	0.733839865	0	0	0	0.486197693	0	0	0	4.90484187	0	0	0	1.42752155	0	0.196434305	0	0	0	0	0	0	0	0	0	0	0	0	0	17.0326
H0562_072_0	2009	8																																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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		284.8809431	6.815370535	61.7744859	186.616412	332.7202543	13.70779778	0.485663179	247.9802785	185.3253174	2.361716938	2.333649132	0.277849052	352.2431351	30.84124472	6053.433041	13857.29918	233.3748928	3687.67631	3318.228714	233.4546158	24.52420935	0	0	0	685.210344	0	94.2884662	0	522.75	0											$0 per visit	$900 per admission	"$0 per day days 1-20, $75 per day days 21-100"	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$0 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$0 per office visit	$0 per office visit	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $0 per visit	20% of contracted rate				Vision exams - $25 per visit		Hearing exams - $25 per visit		$0 per visit												0	900	274.55	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	25	0	25	0	0	0											0	900	274.55	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	25	0	25	0	0	0											0	0.51115279	1.413348759	0	3.465835982	2.741559556	0.097132636	1.03325116	0	0	0.021469741	0	0.733839865	0	0	0	0.486197693	0	0	0	4.90484187	0	0	0	1.42752155	0	0.196434305	0	0	0	0	0	0	0	0	0	0	0	0	0	17.0326			0	0.51115279	1.413348759	0	3.465835982	2.741559556	0.097132636	1.03325116	0	0	0.021469741	0	0.733839865	0	0	0	0.486197693	0	0	0	4.90484187	0	0	0	1.42752155	0	0.196434305	0	0	0	0	0	0	0	0	0	0	0	0	0	17.0326																																																																																		0			0	0.51115279	1.413348759	0	3.465835982	2.741559556	0.097132636	1.03325116	0	0	0.021469741	0	0.733839865	0	0	0	0.486197693	0	0	0	4.90484187	0	0	0	1.42752155	0	0.196434305	0	0	0	0	0	0	0	0	0	0	0	0	0	17.0326
H0562_076_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		305.183641	6.79581826	41.45595806	268.4208102	315.6128128	14.64510749	0.637630868	300.4153485	323.6114979	0.756396178	16.67904915	0.252132059	347.6901096	119.8887941	5889.842355	11922.40787	232.7053753	2612.458326	2427.465377	243.5908516	14.18029696	0	0	0	1264.454529	0	128.663352	0	522.75	0											"$250 per day days 1-8, $0 per day days 9-90"	$900 per admission	"$0 per day days 1-20, $75 per day days 21-100"	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$250 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$10 per office visit	$10 per office visit	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate				Vision exams - $10 per visit		Hearing exams - $10 per visit		$0 per visit												979.6187587	900	274.55	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	10	10	25	0	0	10	0.2	0	0	0	10	0	10	0	0	0											979.6187587	900	274.55	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	10	10	25	0	0	10	0.2	0	0	0	10	0	10	0	0	0											24.9136	0.509686369	0.948477774	0	3.287633467	2.929021498	0.127526174	1.251730619	6.741906207	0	0.153448457	0	0.724354395	0	4.908201962	9.935339893	0.484802865	0	0	0.202992376	2.836059393	0	0	0	1.053712108	0	0.10721946	0	0	0	0	0	0	0	0	0	0	0	0	0	61.1157			24.9136	0.509686369	0.948477774	0	3.287633467	2.929021498	0.127526174	1.251730619	6.741906207	0	0.153448457	0	0.724354395	0	4.908201962	9.935339893	0.484802865	0	0	0.202992376	2.836059393	0	0	0	1.053712108	0	0.10721946	0	0	0	0	0	0	0	0	0	0	0	0	0	61.1157																																																																																		0			24.9136	0.509686369	0.948477774	0	3.287633467	2.929021498	0.127526174	1.251730619	6.741906207	0	0.153448457	0	0.724354395	0	4.908201962	9.935339893	0.484802865	0	0	0.202992376	2.836059393	0	0	0	1.053712108	0	0.10721946	0	0	0	0	0	0	0	0	0	0	0	0	0	61.1157
H0562_077_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		285.4232154	6.796549983	63.66317071	203.7221463	287.5453211	15.35433945	0.443068988	350.9145365	388.8789746	0	1.201056771	4.104263585	208.2913769	75.92887632	6041.839147	16930.8353	232.7304312	5579.480866	4861.291092	331.2914664	20.76947393	0	0	0	888.1430801	0	187.9667894	0	522.75	0											"$250 per day days 1-8, $0 per day days 9-90"	$900 per admission	"$0 per day days 1-20, $75 per day days 21-100"	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$250 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$15 per office visit	$25 per office visit	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate				Vision exams - $25 per visit		Hearing exams - $25 per visit		$0 per visit												979.6187587	900	274.55	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	15	25	25	0	0	10	0.2	0	0	0	25	0	25	0	0	0											979.6187587	900	274.55	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	15	25	25	0	0	10	0.2	0	0	0	25	0	25	0	0	0											23.3005	0.509741249	1.456560293	0	2.995263761	3.07086789	0.088613798	1.462143902	8.101645305	0	0.011049809	0	0.433940369	0	7.552298933	35.27257355	0.484855065	0	0	0.276076222	4.153894786	0	0	0	1.850298084	0	0.391597478	0	0	0	0	0	0	0	0	0	0	0	0	0	91.4119			23.3005	0.509741249	1.456560293	0	2.995263761	3.07086789	0.088613798	1.462143902	8.101645305	0	0.011049809	0	0.433940369	0	7.552298933	35.27257355	0.484855065	0	0	0.276076222	4.153894786	0	0	0	1.850298084	0	0.391597478	0	0	0	0	0	0	0	0	0	0	0	0	0	91.4119																																																																																		0			23.3005	0.509741249	1.456560293	0	2.995263761	3.07086789	0.088613798	1.462143902	8.101645305	0	0.011049809	0	0.433940369	0	7.552298933	35.27257355	0.484855065	0	0	0.276076222	4.153894786	0	0	0	1.850298084	0	0.391597478	0	0	0	0	0	0	0	0	0	0	0	0	0	91.4119
H0562_078_0	2009	2																																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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		285.4232154	6.796549983	63.66317071	203.7221463	287.5453211	15.35433945	0.443068988	350.9145365	388.8789746	0	1.201056771	4.104263585	208.2913769	75.92887632	6041.839147	16930.8353	232.7304312	5579.480866	4861.291092	331.2914664	20.76947393	0	0	0	888.1430801	0	187.9667894	0	522.75	0											"$250 per day days 1-8, $0 per day days 9-90"	$900 per admission	"$0 per day days 1-20, $75 per day days 21-100"	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$250 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$15 per office visit	"Physician specialist services - $25 per visit, diagnostic vision exams - $25 per visit, diagnostic hearing exams - $25 per visit, podiatry services - $25 per visit, urgent care - $25 per visit"	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate				Vision exams - $25 per visit		Hearing exams - $25 per visit		$0 per visit												979.6187587	900	274.55	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	15	25	25	0	0	10	0.2	0	0	0	25	0	25	0	0	0											979.6187587	900	274.55	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	15	25	25	0	0	10	0.2	0	0	0	25	0	25	0	0	0											23.3005	0.509741249	1.456560293	0	2.995263761	3.07086789	0.088613798	1.462143902	8.101645305	0	0.011049809	0	0.433940369	0	7.552298933	35.27257355	0.484855065	0	0	0.276076222	4.153894786	0	0	0	1.850298084	0	0.391597478	0	0	0	0	0	0	0	0	0	0	0	0	0	91.4119			23.3005	0.509741249	1.456560293	0	2.995263761	3.07086789	0.088613798	1.462143902	8.101645305	0	0.011049809	0	0.433940369	0	7.552298933	35.27257355	0.484855065	0	0	0.276076222	4.153894786	0	0	0	1.850298084	0	0.391597478	0	0	0	0	0	0	0	0	0	0	0	0	0	91.4119																																																																																		0			23.3005	0.509741249	1.456560293	0	2.995263761	3.07086789	0.088613798	1.462143902	8.101645305	0	0.011049809	0	0.433940369	0	7.552298933	35.27257355	0.484855065	0	0	0.276076222	4.153894786	0	0	0	1.850298084	0	0.391597478	0	0	0	0	0	0	0	0	0	0	0	0	0	91.4119
H0562_079_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		284.8809431	6.815370535	61.7744859	186.616412	332.7202543	13.70779778	0.485663179	247.9802785	185.3253174	2.361716938	2.333649132	0.277849052	352.2431351	30.84124472	6053.433041	13857.29918	233.3748928	3687.67631	3318.228714	233.4546158	24.52420935	0	0	0	685.210344	0	94.2884662	0	522.75	0											"$250 per day days 1-8, $0 per day days 9-90"	$900 per admission	"$0 per day days 1-20, $75 per day days 21-100"	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$250 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$8 per office visit	$11 per office visit	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate				Vision exams - $15 per visit		Hearing exams - $10 per visit		$0 per visit												979.6187587	900	274.55	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	8	11	25	0	0	10	0.2	0	0	0	15	0	10	0	0	0											979.6187587	900	274.55	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	8	11	25	0	0	10	0.2	0	0	0	15	0	10	0	0	0											23.2562	0.51115279	1.413348759	0	3.465835982	2.741559556	0.097132636	1.03325116	3.860944112	0	0.021469741	0	0.733839865	0	4.035622028	12.70252424	0.486197693	0	0	0.194545513	4.90484187	0	0	0	0.85651293	0	0.078573722	0	0	0	0	0	0	0	0	0	0	0	0	0	60.3936			23.2562	0.51115279	1.413348759	0	3.465835982	2.741559556	0.097132636	1.03325116	3.860944112	0	0.021469741	0	0.733839865	0	4.035622028	12.70252424	0.486197693	0	0	0.194545513	4.90484187	0	0	0	0.85651293	0	0.078573722	0	0	0	0	0	0	0	0	0	0	0	0	0	60.3936																																																																																		0			23.2562	0.51115279	1.413348759	0	3.465835982	2.741559556	0.097132636	1.03325116	3.860944112	0	0.021469741	0	0.733839865	0	4.035622028	12.70252424	0.486197693	0	0	0.194545513	4.90484187	0	0	0	0.85651293	0	0.078573722	0	0	0	0	0	0	0	0	0	0	0	0	0	60.3936
H0562_080_0	2009	2																																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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		284.8809431	6.815370535	61.7744859	186.616412	332.7202543	13.70779778	0.485663179	247.9802785	185.3253174	2.361716938	2.333649132	0.277849052	352.2431351	30.84124472	6053.433041	13857.29918	233.3748928	3687.67631	3318.228714	233.4546158	24.52420935	0	0	1568.25	685.210344	0	94.2884662	0	522.75	0											"$250 per day days 1-8, $0 per day days 9-90"	$900 per admission	"$0 per day days 1-20, $75 per day days 21-100"	$0 per visit	$125 per trip	20% based on Medicare Allowable cost	20% based on Medicare Allowable cost	"$50 per visit, waived if admitted"	$250 per surgical visit (hospital facility & ASC)	Outpatient lab services - $0 per visit	"$0 copay <$1K, $100 copay $1K-$2K, $250 copay $2K+"	Outpatient observation services - $0 per visit	$25 per office visit	$0 per office visit	$7 per office visit	"Physician specialist services - $10 per visit, diagnostic vision exams - $10 per visit, diagnostic hearing exams - $10 per visit, podiatry services - $10 per visit, urgent care - $10 per visit"	$25 per visit	"Occupational therapy services - $0 per visit, physical/speech therapy - $0 per visit"	$0 per visit	Chiropractic services - $10 per visit	20% of contracted rate			"One time annual $35 deductible, $500 annual max"	Vision exams - $10 per visit	$0 per visit	Hearing exams - $10 per visit		$0 per visit	$10 per visit											979.6187587	900	274.55	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	7	10	25	0	0	10	0.2	0	0	23.33333333	10	0	10	0	0	10											979.6187587	900	274.55	0	125	0.2	0.2	50	250	0	110.4008667	0	25	0	7	10	25	0	0	10	0.2	0	0	23.33333333	10	0	10	0	0	10											23.2562	0.51115279	1.413348759	0	3.465835982	2.741559556	0.097132636	1.03325116	3.860944112	0	0.021469741	0	0.733839865	0	3.531169274	11.54774931	0.486197693	0	0	0.194545513	4.90484187	0	0	3.049375	0.57100862	0	0.078573722	0	0	0	0	0	0	0	0	0	0	0	0	0	61.4982			23.2562	0.51115279	1.413348759	0	3.465835982	2.741559556	0.097132636	1.03325116	3.860944112	0	0.021469741	0	0.733839865	0	3.531169274	11.54774931	0.486197693	0	0	0.194545513	4.90484187	0	0	3.049375	0.57100862	0	0.078573722	0	0	0	0	0	0	0	0	0	0	0	0	0	61.4982																																																																																		0			23.2562	0.51115279	1.413348759	0	3.465835982	2.741559556	0.097132636	1.03325116	3.860944112	0	0.021469741	0	0.733839865	0	3.531169274	11.54774931	0.486197693	0	0	0.194545513	4.90484187	0	0	3.049375	0.57100862	0	0.078573722	0	0	0	0	0	0	0	0	0	0	0	0	0	61.4982
H0562_801_0	2009	2																																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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		255.1281434	0	26.80905154	14.04993038	10.48214386	15.21814142	0.568485339	19.85774493	49.51905907	5.88417736	6.201122586	1.521397075	16.25380593	13.9772132	89.28708553	192.2477687	5.197289324	19.48983496	35.52348803	2.062894982	17.81331944	1.979257716	0	0	0	0	0	0	522.75	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												0.059817447	0.059817447	0.14677807	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.059817447	0.059817447	0.14677807	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											15.2611	0	3.934980834	0	2.421375232	3.515390669	0.131320113	4.587139078	11.43890264	1.35924497	1.432459317	0.351442724	3.754629171	3.22873625	20.62531676	44.40923457	1.200573834	4.502151877	8.205925734	0.476528741	4.114876791	0.457208532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.4086			15.2611	0	3.934980834	0	2.421375232	3.515390669	0.131320113	4.587139078	11.43890264	1.35924497	1.432459317	0.351442724	3.754629171	3.22873625	20.62531676	44.40923457	1.200573834	4.502151877	8.205925734	0.476528741	4.114876791	0.457208532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.4086																																																																																		0			15.2611	0	3.934980834	0	2.421375232	3.515390669	0.131320113	4.587139078	11.43890264	1.35924497	1.432459317	0.351442724	3.754629171	3.22873625	20.62531676	44.40923457	1.200573834	4.502151877	8.205925734	0.476528741	4.114876791	0.457208532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.4086
H0562_803_0	2009	2																																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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		255.1281434	0	26.80905154	14.04993038	10.48214386	15.21814142	0.568485339	19.85774493	49.51905907	5.88417736	6.201122586	1.521397075	16.25380593	13.9772132	89.28708553	192.2477687	5.197289324	19.48983496	35.52348803	2.062894982	17.81331944	1.979257716	0	0	0	0	0	0	522.75	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												0.059817656	0.059817656	0.146779393	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.059817656	0.059817656	0.146779393	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											15.2612	0	3.935016314	0	2.421375232	3.515390669	0.131320113	4.587139078	11.43890264	1.35924497	1.432459317	0.351442724	3.754629171	3.22873625	20.62531676	44.40923457	1.200573834	4.502151877	8.205925734	0.476528741	4.114876791	0.457208532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.4086			15.2612	0	3.935016314	0	2.421375232	3.515390669	0.131320113	4.587139078	11.43890264	1.35924497	1.432459317	0.351442724	3.754629171	3.22873625	20.62531676	44.40923457	1.200573834	4.502151877	8.205925734	0.476528741	4.114876791	0.457208532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.4086																																																																																		0			15.2612	0	3.935016314	0	2.421375232	3.515390669	0.131320113	4.587139078	11.43890264	1.35924497	1.432459317	0.351442724	3.754629171	3.22873625	20.62531676	44.40923457	1.200573834	4.502151877	8.205925734	0.476528741	4.114876791	0.457208532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.4086
H0562_804_0	2009	2																																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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		255.1281434	0	26.80905154	14.04993038	10.48214386	15.21814142	0.568485339	19.85774493	49.51905907	5.88417736	6.201122586	1.521397075	16.25380593	13.9772132	89.28708553	192.2477687	5.197289324	19.48983496	35.52348803	2.062894982	17.81331944	1.979257716	0	0	0	0	0	0	522.75	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												0.059817526	0.059817526	0.146778949	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.059817526	0.059817526	0.146778949	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											15.2611	0	3.935004396	0	2.421375232	3.515390669	0.131320113	4.587139078	11.43890264	1.35924497	1.432459317	0.351442724	3.754629171	3.22873625	20.62531676	44.40923457	1.200573834	4.502151877	8.205925734	0.476528741	4.114876791	0.457208532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.4086			15.2611	0	3.935004396	0	2.421375232	3.515390669	0.131320113	4.587139078	11.43890264	1.35924497	1.432459317	0.351442724	3.754629171	3.22873625	20.62531676	44.40923457	1.200573834	4.502151877	8.205925734	0.476528741	4.114876791	0.457208532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.4086																																																																																		0			15.2611	0	3.935004396	0	2.421375232	3.515390669	0.131320113	4.587139078	11.43890264	1.35924497	1.432459317	0.351442724	3.754629171	3.22873625	20.62531676	44.40923457	1.200573834	4.502151877	8.205925734	0.476528741	4.114876791	0.457208532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.4086
H0562_806_0	2009	2																																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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		255.1281434	0	26.80905154	14.04993038	10.48214386	15.21814142	0.568485339	19.85774493	49.51905907	5.88417736	6.201122586	1.521397075	16.25380593	13.9772132	89.28708553	192.2477687	5.197289324	19.48983496	35.52348803	2.062894982	17.81331944	1.979257716	0	0	0	0	0	0	522.75	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												0.059816767	0.059816767	0.14677444	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.059816767	0.059816767	0.14677444	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											15.2609	0	3.934883536	0	2.421375232	3.515390669	0.131320113	4.587139078	11.43890264	1.35924497	1.432459317	0.351442724	3.754629171	3.22873625	20.62531676	44.40923457	1.200573834	4.502151877	8.205925734	0.476528741	4.114876791	0.457208532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.4083			15.2609	0	3.934883536	0	2.421375232	3.515390669	0.131320113	4.587139078	11.43890264	1.35924497	1.432459317	0.351442724	3.754629171	3.22873625	20.62531676	44.40923457	1.200573834	4.502151877	8.205925734	0.476528741	4.114876791	0.457208532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.4083																																																																																		0			15.2609	0	3.934883536	0	2.421375232	3.515390669	0.131320113	4.587139078	11.43890264	1.35924497	1.432459317	0.351442724	3.754629171	3.22873625	20.62531676	44.40923457	1.200573834	4.502151877	8.205925734	0.476528741	4.114876791	0.457208532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.4083
H0564_006_0	2009	12	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Urgent Care	Therapy (PT/OT/ST)	ASC	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemo-Radiation	D	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	0	Coin	0	0	V	V	V	V	0	0	0	V	V	V	V	V	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1178.652301	10.41046142	958.8424173	978.4460519	463.560138	13.81910419	1.704107584	454.5036672	292.1714627	5271.47249	913.6632663	152.6733524	0.712384764	176.2898281	4121.218895	3874.002171	21.65232707	336.5824825	2851.426201	0	46.63840515	0	0	379.1182125	367.1391729	338.5797369	177.7955182	0	0	0	2.807650986	1349.206911	167.0624964	92.87444829	533.2156275	78.03247744	0.713279193	807.0712592	31.21499109	18.26913771	$115/day (days 1-5); $575 yrly max	$1024/admit	$150/day (for days 21-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$100 copay	$0 copay	$30/$100 copay for Lower/Higher Tier	$100 copay	10% coinsurance	$20 copay	$5 coapy	$20 copay	$20 copay	$20 copay	$30/$100 copay for Lower/Higher Tier	0	20% coinsurance	0	0	$10/$20 copay; Exam/Cleaning 1/yr	$20 copay	$100 glasses/$80 contacts every yr.	$20 copay	0	0	0	$30 copay	$20 copay	$75 copay	$20 copay	$20 copay	$0 copay	20% coinsurance	$20 copay	$20 copay	20% coinsurance	115	1024	150	0	100	0.2	0.2	50	100	0	53.88	100	0.1	20	5	20	20	20	36.33	0	0.2	0	0	19.47935514	20	30	20	0	0	0	30	20	75	20	20	0	0.2	20	20	0.2	104.8889714	933.967884	136.8117018	0	91.20780118	0.182415602	0.182415602	45.60390059	91.20780118	0	49.14276327	91.20780118	0.091207801	18.24156024	4.560390059	18.24156024	18.24156024	18.24156024	33.13579417	0	0.182415602	0	0	19.47935514	18.24156024	27.36234035	18.24156024	0	0	0	27.36234035	18.24156024	68.40585088	18.24156024	18.24156024	0	0.182415602	18.24156024	18.24156024	0.182415602	10.3023	0.810253052	10.93173857	0	3.523358408	2.520820215	0.310855811	1.727261671	2.220693056	0	3.741661467	1.160416731	0.064975048	0.26798346	1.56619714	5.888986997	0.032914352	0.511649136	7.873689308	0	8.507572768	0	0	0.615414858	0.558099278	0.772027833	0.270272305	0	0	0	0.006401992	2.050969928	0.952337685	0.141181237	0.810557082	0	0.130113254	1.226853249	0.047450845	3.33257576	72.8776		6.9659	10.3023	0.810253052	10.93173857	0	3.523358408	2.520820215	0.310855811	1.727261671	2.220693056	0	3.741661467	1.160416731	0.064975048	0.26798346	1.56619714	5.888986997	0.032914352	0.511649136	7.873689308	0	8.507572768	0	0	0.615414858	0.558099278	0.772027833	0.270272305	0	0	0	0.006401992	2.050969928	0.952337685	0.141181237	0.810557082	0	0.130113254	1.226853249	0.047450845	3.33257576	72.8776	4000																																																																																	0		0	10.3023	0.810253052	10.93173857	0	3.523358408	2.520820215	0.310855811	1.727261671	2.220693056	0	3.741661467	1.160416731	0.064975048	0.26798346	1.56619714	5.888986997	0.032914352	0.511649136	7.873689308	0	8.507572768	0	0	0.615414858	0.558099278	0.772027833	0.270272305	0	0	0	0.006401992	2.050969928	0.952337685	0.141181237	0.810557082	0	0.130113254	1.226853249	0.047450845	3.33257576	72.8776
H0564_801_0	2009	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	V																																																			0		300.4066509	3.596860581	32.62031622	20.48585482	8.422232776	5.509954591	0	18.20530271	31.21849287	7.549647955	20.39321061	0	0.171069168	20.0677211	66.29798785	179.6942348	2.04435399	6.879881961	44.67874303	59.16309772	15.12028887	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.061609082	0.061609082	0.170429947	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.061609082	0.061609082	0.170429947	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			18.5078	0.22159928	5.559478773	0	1.945535771	1.272799511	0	4.205424925	7.211471853	1.743968678	4.710831651	0	0.039516978	4.635643574	15.31483519	41.50936824	0.472245772	1.589252733	10.32078964	13.66667557	3.492786728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.42			18.5078	0.22159928	5.559478773	0	1.945535771	1.272799511	0	4.205424925	7.211471853	1.743968678	4.710831651	0	0.039516978	4.635643574	15.31483519	41.50936824	0.472245772	1.589252733	10.32078964	13.66667557	3.492786728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.42																																																																																		0			18.5078	0.22159928	5.559478773	0	1.945535771	1.272799511	0	4.205424925	7.211471853	1.743968678	4.710831651	0	0.039516978	4.635643574	15.31483519	41.50936824	0.472245772	1.589252733	10.32078964	13.66667557	3.492786728	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.42
H0564_810_0	2009	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	V																																																			0		265.701158	3.181321115	25.36281445	7.054824639	18.49556132	18.49239129	0	14.53472203	26.41135222	6.702829761	18.10577392	0	0.151880924	17.81679345	55.64944113	150.8323867	1.715997132	5.774859819	37.50260243	49.66053164	55.83286871	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.061609082	0.061609082	0.170429947	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.061609082	0.061609082	0.170429947	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			16.3696	0.195998275	4.322583128	0	4.272474665	4.271742389	0	3.357520789	6.101022364	1.548353675	4.182433775	0	0.035084493	4.115679287	12.8550209	34.84228132	0.396395337	1.333992618	8.66310116	11.47158281	12.89739267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.2323			16.3696	0.195998275	4.322583128	0	4.272474665	4.271742389	0	3.357520789	6.101022364	1.548353675	4.182433775	0	0.035084493	4.115679287	12.8550209	34.84228132	0.396395337	1.333992618	8.66310116	11.47158281	12.89739267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.2323																																																																																		0			16.3696	0.195998275	4.322583128	0	4.272474665	4.271742389	0	3.357520789	6.101022364	1.548353675	4.182433775	0	0.035084493	4.115679287	12.8550209	34.84228132	0.396395337	1.333992618	8.66310116	11.47158281	12.89739267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.2323
H0564_811_0	2009	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	V																																																			0		265.701158	3.181321115	25.36281445	7.054824639	18.49556132	18.49239129	0	14.53472203	26.41135222	6.702829761	18.10577392	0	0.151880924	17.81679345	55.64944113	150.8323867	1.715997132	5.774859819	37.50260243	49.66053164	55.83286871	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.061609082	0.061609082	0.170429947	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.061609082	0.061609082	0.170429947	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			16.3696	0.195998275	4.322583128	0	4.272474665	4.271742389	0	3.357520789	6.101022364	1.548353675	4.182433775	0	0.035084493	4.115679287	12.8550209	34.84228132	0.396395337	1.333992618	8.66310116	11.47158281	12.89739267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.2323			16.3696	0.195998275	4.322583128	0	4.272474665	4.271742389	0	3.357520789	6.101022364	1.548353675	4.182433775	0	0.035084493	4.115679287	12.8550209	34.84228132	0.396395337	1.333992618	8.66310116	11.47158281	12.89739267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.2323																																																																																		0			16.3696	0.195998275	4.322583128	0	4.272474665	4.271742389	0	3.357520789	6.101022364	1.548353675	4.182433775	0	0.035084493	4.115679287	12.8550209	34.84228132	0.396395337	1.333992618	8.66310116	11.47158281	12.89739267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.2323
H0571_001_0	2009	5																					3500											D	D	D			Coin	Coin	V	V					V	V	V	V	V		V					V		V			V																																																			0		543.7583079	10.28934926	215.0455282	0	111.3589411	9.95034754	5.958225851	256.1280306	237.5390555	0	0	0	0	282.7376609	3335.683365	2973.152586	134.4995233	424.6710079	0	1495.582687	0	0	0	0	375.4150988	0	160.8921852	0	0	466.2256468											$225/Days 1-5	$225/Days 1-5	$100/Days 21-100	No cost sharing	$100/Trip	25% Coinsurance	25% Coinsurance	"ER: $50/Case, Urgent Care: $15/Visit"	$175/Case	No cost sharing	No cost sharing	No cost sharing	No cost sharing	PT/OT/ST/CORF:  $25/Case	$15/Visit	$15/Visit	$15/Visit	$25/Visit	No cost sharing	$15/Visit	No cost sharing	No cost sharing	No benefit	No benefit	$15/Exam	No cost sharing	$15/Exam	No benefit	No cost sharing	Acupunture:  $15/Visit											225	225	100	0	100	0.25	0.25	38.64511779	175	0	0	0	0	25	15	15	15.00000001	25	0	15	0	0	0	0	15	0	15	0	0	15											222.9513816	222.9513816	99.08950295	0	99.08950295	0.247605474	0.247605474	38.29325513	173.4066302	0	0	0	0	24.77237573	14.86342544	14.86342544	14.86342546	24.77237574	0	14.86342544	0	0	0	0	14.86342544	0	14.86342544	0	0	14.86342544											10.1026	0.191168719	1.775729541	0	0.919541844	2.46376052	1.475289337	0.817331335	3.432570596	0	0	0	0	0.583673631	4.131640083	3.68260265	0.166593637	0.876675814	0	1.852456813	0	0	0	0	0.464996194	0	0.199284083	0	0	0.577475845	0	0	0	0	0	0	0	0	0	0	33.7134	0	0.3026	10.1026	0.191168719	1.775729541	0	0.919541844	2.46376052	1.475289337	0.817331335	3.432570596	0	0	0	0	0.583673631	4.131640083	3.68260265	0.166593637	0.876675814	0	1.852456813	0	0	0	0	0.464996194	0	0.199284083	0	0	0.577475845	0	0	0	0	0	0	0	0	0	0	33.7134																																																																																		0			10.1026	0.191168719	1.775729541	0	0.919541844	2.46376052	1.475289337	0.817331335	3.432570596	0	0	0	0	0.583673631	4.131640083	3.68260265	0.166593637	0.876675814	0	1.852456813	0	0	0	0	0.464996194	0	0.199284083	0	0	0.577475845	0	0	0	0	0	0	0	0	0	0	33.7134
H0571_002_0	2009	5																					3500											D	D	D			Coin	Coin	V	V					V	V	V	V	V		V					V		V			V																																																			0		543.7583079	10.28934926	215.0455282	0	111.3589411	9.95034754	5.958225851	256.1280306	237.5390555	0	0	0	0	282.7376609	3335.683365	2973.152586	134.4995233	424.6710079	0	1495.582687	0	0	0	0	375.4150988	0	160.8921852	0	0	466.2256468											$225/Days 1-5	$225/Days 1-5	$100/Days 21-100	No cost sharing	$100/Trip	25% Coinsurance	25% Coinsurance	"ER: $50/Case, Urgent Care: $15/Visit"	$175/Case	No cost sharing	No cost sharing	No cost sharing	No cost sharing	PT/OT/ST/CORF:  $25/Case	$15/Visit	$15/Visit	$15/Visit	$25/Visit	No cost sharing	$15/Visit	No cost sharing	No cost sharing	No benefit	No benefit	$15/Exam	No cost sharing	$15/Exam	No benefit	No cost sharing	Acupunture:  $15/Visit											225	225	100	0	100	0.25	0.25	38.64511779	175	0	0	0	0	25	15	15	15.00000001	25	0	15	0	0	0	0	15	0	15	0	0	15											222.9513816	222.9513816	99.08950295	0	99.08950295	0.247605474	0.247605474	38.29325513	173.4066302	0	0	0	0	24.77237573	14.86342544	14.86342544	14.86342546	24.77237574	0	14.86342544	0	0	0	0	14.86342544	0	14.86342544	0	0	14.86342544											10.1026	0.191168719	1.775729541	0	0.919541844	2.46376052	1.475289337	0.817331335	3.432570596	0	0	0	0	0.583673631	4.131640083	3.68260265	0.166593637	0.876675814	0	1.852456813	0	0	0	0	0.464996194	0	0.199284083	0	0	0.577475845	0	0	0	0	0	0	0	0	0	0	33.7134	0	0.3026	10.1026	0.191168719	1.775729541	0	0.919541844	2.46376052	1.475289337	0.817331335	3.432570596	0	0	0	0	0.583673631	4.131640083	3.68260265	0.166593637	0.876675814	0	1.852456813	0	0	0	0	0.464996194	0	0.199284083	0	0	0.577475845	0	0	0	0	0	0	0	0	0	0	33.7134																																																																																		0			10.1026	0.191168719	1.775729541	0	0.919541844	2.46376052	1.475289337	0.817331335	3.432570596	0	0	0	0	0.583673631	4.131640083	3.68260265	0.166593637	0.876675814	0	1.852456813	0	0	0	0	0.464996194	0	0.199284083	0	0	0.577475845	0	0	0	0	0	0	0	0	0	0	33.7134
H0571_005_0	2009	4																																																																																																																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																																																																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																		0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	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_006_0	2009	4																					3500											D	D	D			Coin	Coin	V	V					V	V	V	V	V		V					V		V			V																																																			0		478.8221714	9.112488067	191.627287	0	97.86488543	9.071310953	5.419131624	228.7194906	213.1828155	0	0	0	0	253.1602353	2958.452105	2642.314276	119.7665064	380.1476154	0	1341.770906	0	0	0	0	318.354749	0	136.4377496	0	0	395.3627577											$225/Days 1-5	$225/Days 1-5	$100/Days 21-100	No cost sharing	$100/Trip	25% Coinsurance	25% Coinsurance	"ER: $50/Case, Urgent Care: $15/Visit"	$175/Case	No cost sharing	No cost sharing	No cost sharing	No cost sharing	PT/OT/ST/CORF:  $25/Case	$15/Visit	$15/Visit	$15/Visit	$25/Visit	No cost sharing	$15/Visit	No cost sharing	No cost sharing	No benefit	No benefit	$15/Exam	No cost sharing	$15/Exam	No benefit	No cost sharing	Acupunture:  $15/Visit											225	224.9999999	100	0	100	0.25	0.25	38.71751069	175	0	0	0	0	24.99999999	15	15	15.00000001	25	0	15	0	0	0	0	15	0	15	0	0	15											223.3886563	223.3886561	99.28384723	0	99.28384723	0.248132763	0.248132763	38.44023416	173.7467326	0	0	0	0	24.8209618	14.89257708	14.89257708	14.89257708	24.82096181	0	14.89257708	0	0	0	0	14.89257708	0	14.89257709	0	0	14.89257708											8.9136	0.169635539	1.585457857	0	0.809700195	2.250889455	1.344664105	0.732669231	3.086651471	0	0	0	0	0.523640044	3.671581336	3.279239087	0.148635994	0.786302454	0	1.66520222	0	0	0	0	0.395093553	0	0.169325809	0	0	0.490664195	0	0	0	0	0	0	0	0	0	0	30.023	0	0.2114	8.9136	0.169635539	1.585457857	0	0.809700195	2.250889455	1.344664105	0.732669231	3.086651471	0	0	0	0	0.523640044	3.671581336	3.279239087	0.148635994	0.786302454	0	1.66520222	0	0	0	0	0.395093553	0	0.169325809	0	0	0.490664195	0	0	0	0	0	0	0	0	0	0	30.023																																																																																		0			8.9136	0.169635539	1.585457857	0	0.809700195	2.250889455	1.344664105	0.732669231	3.086651471	0	0	0	0	0.523640044	3.671581336	3.279239087	0.148635994	0.786302454	0	1.66520222	0	0	0	0	0.395093553	0	0.169325809	0	0	0.490664195	0	0	0	0	0	0	0	0	0	0	30.023
H0571_801_0	2009	1																					3500											D	D	D		T	Coin	Coin	V	V					V	V	V	V	V		V					V		V			V																																																			0		543.7583079	10.28934926	215.0455282	0	111.3589411	9.95034754	5.958225851	256.1280306	237.5390555	0	0	0	0	282.7376609	3335.683365	2973.152586	134.4995233	424.6710079	0	1495.582687	0	0	0	0	375.4150988	0	160.8921852	0	0	466.2256468											$225/Days 1-5	$225/Days 1-5	$100/Days 21-100	No cost sharing	$100/Trip	20% Coinsurance	20% Coinsurance	"ER: $50/Case, Urgent Care: $15/Visit"	$175/Case	No cost sharing	No cost sharing	No cost sharing	No cost sharing	PT/OT/ST/CORF:  $25/Case	$15/Visit	$15/Visit	$15/Visit	$25/Visit	No cost sharing	$15/Visit	No cost sharing	No cost sharing	No benefit	No benefit	$15/Exam	No cost sharing	$15/Exam	No benefit	No cost sharing	Acupunture:  $15/Visit											225	225	100	0	100	0.2	0.2	38.64511779	175	0	0	0	0	25	15	15	15.00000001	25	0	15	0	0	0	0	15	0	15	0	0	15											222.9513816	222.9513816	99.08950295	0	99.08950295	0.198179006	0.198179006	38.29325513	173.4066302	0	0	0	0	24.77237573	14.86342544	14.86342544	14.86342546	24.77237574	0	14.86342544	0	0	0	0	14.86342544	0	14.86342544	0	0	14.86342544											10.1026	0.191168719	1.775729541	0	0.919541844	1.971949984	1.180795276	0.817331335	3.432570596	0	0	0	0	0.583673631	4.131640083	3.68260265	0.166593637	0.876675814	0	1.852456813	0	0	0	0	0.464996194	0	0.199284083	0	0	0.577475845	0	0	0	0	0	0	0	0	0	0	32.9271	0	0.3026	10.1026	0.191168719	1.775729541	0	0.919541844	1.971949984	1.180795276	0.817331335	3.432570596	0	0	0	0	0.583673631	4.131640083	3.68260265	0.166593637	0.876675814	0	1.852456813	0	0	0	0	0.464996194	0	0.199284083	0	0	0.577475845	0	0	0	0	0	0	0	0	0	0	32.9271																																																																																		0	0		10.1026	0.191168719	1.775729541	0	0.919541844	1.971949984	1.180795276	0.817331335	3.432570596	0	0	0	0	0.583673631	4.131640083	3.68260265	0.166593637	0.876675814	0	1.852456813	0	0	0	0	0.464996194	0	0.199284083	0	0	0.577475845	0	0	0	0	0	0	0	0	0	0	32.9271
H0609_002_0	2009	6																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1352.457292	155.0749708	954.2936116	215.3766293	175.3193558	24.46511986	11.55555936	276.6025336	347.1604751	17561.31151	42.95505318	0	0.007128836	1376.311483	6211.797157	5008.111961	731.123904	1289.061876	0	0	23.39511177	4020.469337	0	0	145.0034692	293.7557879	0	0	305.6298344	0											"$150 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$150 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-14/$95 Days 15-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$100 (9b)	$0/$0 (8a1); $0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); $100 (9a); $40/$30 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											91.72425953	67.97943836	41.37652798	0	149.2354028	0.2	0.073179524	49.95544178	100	0	0.194027214	0	0.2	35.24780133	6.750390217	30	37.5	25	0	0	0.2	29.09845559	0	0	30	30	0	0	0	0											91.72425953	67.97943836	41.37652798	0	149.2354028	0.2	0.073179524	49.95544178	100	0	0.194027214	0	0.2	35.24780133	6.750390217	30	37.5	25	0	0	0.2	29.09845559	0	0	30	30	0	0	0	0											10.3378	0.878492451	3.29044636	0	2.180321223	4.893023973	0.84563033	1.151483481	2.893003959	0	8.334449317	0	0.001425767	4.042662811	3.494337896	12.5202799	2.2847622	2.685545574	0	0	4.679022353	9.749120705	0	0	0.362508673	0.73438947	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.3587	0	0	10.3378	0.878492451	3.29044636	0	2.180321223	4.893023973	0.84563033	1.151483481	2.893003959	0	8.334449317	0	0.001425767	4.042662811	3.494337896	12.5202799	2.2847622	2.685545574	0	0	4.679022353	9.749120705	0	0	0.362508673	0.73438947	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.3587																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.3378	0.878492451	3.29044636	0	2.180321223	4.893023973	0.84563033	1.151483481	2.893003959	0	8.334449317	0	0.001425767	4.042662811	3.494337896	12.5202799	2.2847622	2.685545574	0	0	4.679022353	9.749120705	0	0	0.362508673	0.73438947	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.3587
H0609_006_0	2009	5																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1638.218816	152.5567576	1790.928616	819.9508283	398.4641337	27.78841893	12.64683393	386.9629426	441.7080621	17212.08801	63.73218241	0	0.237664333	861.798576	7600.202784	6542.067092	722.3104179	1084.540227	0	0	47.83508261	4049.156228	0	0	108.5756906	293.9271697	0	0	1284.614712	0											"$100 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$100 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-14/$95 Days 15-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$50 (9b)	$0/$0 (8a1); $0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$15 (3, 9d); $60 (5); $50 (9a); $40/$30 (9c)"	"$10 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$15 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$0 n/c (13b, 13d, 13e)"											61.15005298	45.31962557	41.37652798	0	146.5966338	0.2	0.067855166	49.99779391	50	0	0.191387002	0	0.2	18.04480597	6.379480168	20	37.5	15	0	0	0.2	19.47608099	0	0	20	30	0	0	0	0											61.15005298	45.31962557	41.37652798	0	146.5966338	0.2	0.067855166	49.99779391	50	0	0.191387002	0	0.2	18.04480597	6.379480168	20	37.5	15	0	0	0.2	19.47608099	0	0	20	30	0	0	0	0											8.3481	0.576151261	6.175200666	0	4.867791724	5.557683786	0.85815301	1.612274454	1.840450259	0	12.19751131	0	0.047532867	1.295915674	4.040445244	10.90344515	2.257220056	1.355675284	0	0	9.567016523	6.571807888	0	0	0.180959484	0.734817924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.9881	0	0	8.3481	0.576151261	6.175200666	0	4.867791724	5.557683786	0.85815301	1.612274454	1.840450259	0	12.19751131	0	0.047532867	1.295915674	4.040445244	10.90344515	2.257220056	1.355675284	0	0	9.567016523	6.571807888	0	0	0.180959484	0.734817924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.9881																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.3481	0.576151261	6.175200666	0	4.867791724	5.557683786	0.85815301	1.612274454	1.840450259	0	12.19751131	0	0.047532867	1.295915674	4.040445244	10.90344515	2.257220056	1.355675284	0	0	9.567016523	6.571807888	0	0	0.180959484	0.734817924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.9881
H0609_007_0	2009	5																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1132.257463	150.2393062	1171.821115	531.7016407	281.2976495	23.38620332	9.730867767	312.742089	353.7837462	13622.54746	54.26225222	0	0.081371461	672.5255738	6019.464243	5040.007323	722.7485786	941.4240258	0	0	34.09255204	3924.453097	0	0	94.95978467	293.6317267	0	0	353.5702449	0											"$150 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$150 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-14/$95 Days 15-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$100 (9b)	$0/$0 (8a1); $0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); $100 (9a); $40/$30 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											91.72334588	67.97943836	41.37652798	0	147.3838557	0.2	0.075339608	49.98450455	100	0	0.190630117	0	0.2	35.31625395	6.2397908	30	37.5	25	0	0	0.2	29.27796759	0	0	30	30	0	0	0	0											91.72334588	67.97943836	41.37652798	0	147.3838557	0.2	0.075339608	49.98450455	100	0	0.190630117	0	0.2	35.31625395	6.2397908	30	37.5	25	0	0	0.2	29.27796759	0	0	30	30	0	0	0	0											8.6545	0.851098638	4.040490761	0	3.454894349	4.677240663	0.733119763	1.302688198	2.948197885	0	10.34401949	0	0.016274292	1.979256996	3.130016467	12.60001831	2.258589308	1.961300054	0	0	6.818510408	9.575000882	0	0	0.237399462	0.734079317	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.3167	0	0	8.6545	0.851098638	4.040490761	0	3.454894349	4.677240663	0.733119763	1.302688198	2.948197885	0	10.34401949	0	0.016274292	1.979256996	3.130016467	12.60001831	2.258589308	1.961300054	0	0	6.818510408	9.575000882	0	0	0.237399462	0.734079317	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.3167																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.6545	0.851098638	4.040490761	0	3.454894349	4.677240663	0.733119763	1.302688198	2.948197885	0	10.34401949	0	0.016274292	1.979256996	3.130016467	12.60001831	2.258589308	1.961300054	0	0	6.818510408	9.575000882	0	0	0.237399462	0.734079317	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.3167
H0609_011_0	2009	7																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1318.936634	136.3559063	1221.991558	284.9476615	140.3098391	15.43177718	9.872246795	296.4117511	299.7721791	12034.27418	33.96923766	0	0.006344178	1210.527886	5321.182941	4205.409678	646.1949337	815.013906	0	0	18.01854318	3393.418326	0	0	102.8010787	292.8	0	0	392.9902195	0											"$205 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$205 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-14/$95 Days 15-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$175 (9b)	$0/$0 (8a1); $0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); $175 (9a); $40/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											125.3570565	92.90523242	41.37652798	0	150	0.2	0.063049788	49.98163375	175	0	0.199067126	0	0.2	60.91657317	10.14446002	30	37.5	25	0	0	0.2	29.17404012	0	0	30	30	0	0	0	0											125.3570565	92.90523242	41.37652798	0	150	0.2	0.063049788	49.98163375	175	0	0.199067126	0	0.2	60.91657317	10.14446002	30	37.5	25	0	0	0.2	29.17404012	0	0	30	30	0	0	0	0											13.7782	1.05568143	4.213480658	0	1.753872988	3.086355436	0.622443065	1.234595298	4.371677612	0	6.762158528	0	0.001268836	6.145100878	4.498377299	10.5135242	2.019359168	1.697945637	0	0	3.603708636	8.249976865	0	0	0.257002697	0.732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5967	0	0	13.7782	1.05568143	4.213480658	0	1.753872988	3.086355436	0.622443065	1.234595298	4.371677612	0	6.762158528	0	0.001268836	6.145100878	4.498377299	10.5135242	2.019359168	1.697945637	0	0	3.603708636	8.249976865	0	0	0.257002697	0.732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5967																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	13.7782	1.05568143	4.213480658	0	1.753872988	3.086355436	0.622443065	1.234595298	4.371677612	0	6.762158528	0	0.001268836	6.145100878	4.498377299	10.5135242	2.019359168	1.697945637	0	0	3.603708636	8.249976865	0	0	0.257002697	0.732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5967
H0609_012_0	2009	5																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1006.652245	152.9877615	663.5186975	353.6592515	203.8392918	18.56091993	9.202281864	321.9808354	320.9458815	11562.63419	43.75466896	0	0.080520861	643.5354334	5384.479417	4337.73202	727.6393558	834.5702987	0	0	24.17186137	3819.103476	0	0	85.47969408	293.3895766	0	0	353.5545615	0											"$200 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$200 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$100 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$150 (9b)	$0/$0 (8a1); $0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); $150 (9a); $40/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											122.2968612	90.63925114	55.10681964	0	147.3654706	0.2	0.070517861	49.98578752	150	0	0.192922995	0	0.2	52.06038392	9.121548289	30	37.5	25	0	0	0.2	29.39293895	0	0	30	30	0	0	0	0											122.2968612	90.63925114	55.10681964	0	147.3654706	0.2	0.070517861	49.98578752	150	0	0.192922995	0	0.2	52.06038392	9.121548289	30	37.5	25	0	0	0.2	29.39293895	0	0	30	30	0	0	0	0											10.2592	1.155558011	3.047033766	0	2.503239431	3.712183986	0.64892523	1.341205469	4.011823519	0	8.441281772	0	0.016104172	2.79189181	4.092899084	10.84433005	2.273872987	1.738688122	0	0	4.834372274	9.354556278	0	0	0.213699235	0.733473942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.0143	0	0	10.2592	1.155558011	3.047033766	0	2.503239431	3.712183986	0.64892523	1.341205469	4.011823519	0	8.441281772	0	0.016104172	2.79189181	4.092899084	10.84433005	2.273872987	1.738688122	0	0	4.834372274	9.354556278	0	0	0.213699235	0.733473942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.0143																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.2592	1.155558011	3.047033766	0	2.503239431	3.712183986	0.64892523	1.341205469	4.011823519	0	8.441281772	0	0.016104172	2.79189181	4.092899084	10.84433005	2.273872987	1.738688122	0	0	4.834372274	9.354556278	0	0	0.213699235	0.733473942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.0143
H0609_013_0	2009	5																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	917.004614	139.3634037	604.428898	322.1640512	185.6863401	15.40223006	7.636241249	293.3125982	292.3639774	10532.92133	36.30851705	0	0.066817854	586.2252477	4753.16876	3952.316933	662.8392774	760.2474623	0	0	20.05830375	3478.9924	0	0	147.9890135	292.8	0	0	98.4	0											"$200 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$200 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$95 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$150 (9b)	$0/$0 (8a1); $0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); $150 (9a); $40/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											122.2968612	90.63925114	52.35147866	0	150	0.2	0.070517861	49.9857878	150	0	0.195682988	0	0.2	52.05879518	9.412849244	30	37.5	25	0	0	0.2	29.39395362	0	0	30	30	0	0	0	0											122.2968612	90.63925114	52.35147866	0	150	0.2	0.070517861	49.9857878	150	0	0.195682988	0	0.2	52.05879518	9.412849244	30	37.5	25	0	0	0.2	29.39395362	0	0	30	30	0	0	0	0											9.3456	1.052649545	2.636895546	0	2.321079252	3.080446013	0.538491396	1.221788441	3.654549717	0	7.104959093	0	0.013363571	2.543181675	3.728405081	9.880792333	2.071372742	1.58384888	0	0	4.01166075	8.521778437	0	0	0.369972534	0.732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4128	0	0	9.3456	1.052649545	2.636895546	0	2.321079252	3.080446013	0.538491396	1.221788441	3.654549717	0	7.104959093	0	0.013363571	2.543181675	3.728405081	9.880792333	2.071372742	1.58384888	0	0	4.01166075	8.521778437	0	0	0.369972534	0.732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4128																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	9.3456	1.052649545	2.636895546	0	2.321079252	3.080446013	0.538491396	1.221788441	3.654549717	0	7.104959093	0	0.013363571	2.543181675	3.728405081	9.880792333	2.071372742	1.58384888	0	0	4.01166075	8.521778437	0	0	0.369972534	0.732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4128
H0609_015_0	2009	3																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1253.495017	145.0669197	856.1036291	197.1075225	150.8218668	22.05720133	9.430955529	250.683237	323.2885244	15852.83037	39.67240184	0	0.004720153	1161.607978	5733.809772	4861.521048	702.3854941	1265.712555	0	0	22.09061816	3780.631046	0	522.2428351	132.5744285	275.1216368	18.54385606	4.606629321	789.4470291	337.4778569											"$50 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$50 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$50 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$25 (9b)	$0/$0 (8a1); $0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$5 (3, 9d); $60 (5); $25 (9a); $40/$30 (9c)"	"$5 (7a); $10 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$10 (7b, 7b1, 7d, 7f, 7f1)"	"$40/$30 (7e, 7h)"	"$5 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $10 (16b, 17a, 18a)"	$0 n/c (10b)	"$20 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$10 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$10 (13b); $0 n/c (13d, 13e)"											30.57473705	22.65981279	27.55340982	0	150	0.2	0.080949381	49.96754971	25	0	0.193422352	0	0.2	8.98718281	3.355986414	10	37.5	5	0	0	0.2	9.715299971	0	20	10	0	0	0	0	10											30.57473705	22.65981279	27.55340982	0	150	0.2	0.080949381	49.96754971	25	0	0.193422352	0	0.2	8.98718281	3.355986414	10	37.5	5	0	0	0.2	9.715299971	0	20	10	0	0	0	0	10											3.1938	0.273932437	1.965714512	0	1.885273335	4.411440265	0.763430009	1.043835592	0.673517759	0	7.673529285	0	0.000944031	0.869965271	1.603548975	4.05126754	2.194954669	0.527380231	0	0	4.418123633	3.060830391	0	0.870404725	0.11047869	0	0	0	0	0.281231547	0	0	0	0	0	0	0	0	0	0	39.8736	0	0	3.1938	0.273932437	1.965714512	0	1.885273335	4.411440265	0.763430009	1.043835592	0.673517759	0	7.673529285	0	0.000944031	0.869965271	1.603548975	4.05126754	2.194954669	0.527380231	0	0	4.418123633	3.060830391	0	0.870404725	0.11047869	0	0	0	0	0.281231547	0	0	0	0	0	0	0	0	0	0	39.8736																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.1938	0.273932437	1.965714512	0	1.885273335	4.411440265	0.763430009	1.043835592	0.673517759	0	7.673529285	0	0.000944031	0.869965271	1.603548975	4.05126754	2.194954669	0.527380231	0	0	4.418123633	3.060830391	0	0.870404725	0.11047869	0	0	0	0	0.281231547	0	0	0	0	0	0	0	0	0	0	39.8736
H0609_018_0	2009	4																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	893.8795158	151.5743746	641.6731063	335.8059978	201.0743259	18.94851364	7.778964768	293.6625131	337.8053943	12055.50975	50.62296423	0	0.067411501	649.0853099	5495.169475	4428.516102	725.1958301	892.1544263	0	0	26.00361847	3850.892894	0	0	123.6529385	293.1764367	0	0	1016.388058	0											"$200 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$200 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$95 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$150 (9b)	$0/$0 (8a1); $0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); $150 (9a); $40/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$0 n/c (13b, 13d, 13e)"											122.2958043	90.63925114	52.35147866	0	150	0.2	0.080768	49.98475686	150	0	0.190480254	0	0.2	52.27082341	9.33479718	30	37.5	25	0	0	0.2	29.41574299	0	0	30	30	0	0	0	0											122.2958043	90.63925114	52.35147866	0	150	0.2	0.080768	49.98475686	150	0	0.190480254	0	0.2	52.27082341	9.33479718	30	37.5	25	0	0	0.2	29.41574299	0	0	30	30	0	0	0	0											9.1098	1.144882317	2.799377994	0	2.513429074	3.789702728	0.628291428	1.223220776	4.222567429	0	9.642675095	0	0.0134823	2.827351968	4.274691044	11.07129025	2.266236969	1.858655055	0	0	5.200723695	9.439739639	0	0	0.309132346	0.732941092	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.0682	0	0	9.1098	1.144882317	2.799377994	0	2.513429074	3.789702728	0.628291428	1.223220776	4.222567429	0	9.642675095	0	0.0134823	2.827351968	4.274691044	11.07129025	2.266236969	1.858655055	0	0	5.200723695	9.439739639	0	0	0.309132346	0.732941092	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.0682																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	9.1098	1.144882317	2.799377994	0	2.513429074	3.789702728	0.628291428	1.223220776	4.222567429	0	9.642675095	0	0.0134823	2.827351968	4.274691044	11.07129025	2.266236969	1.858655055	0	0	5.200723695	9.439739639	0	0	0.309132346	0.732941092	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.0682
H0609_020_0	2009	6																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1224.922466	146.4292969	608.8803618	183.6252188	137.7947452	23.32249905	10.77138051	247.4880813	285.0859106	15300.04501	40.68846041	0	0.003720441	1064.37539	5688.851693	4422.765396	693.7032281	1202.595784	0	0	17.493053	3792.756169	0	0	145.005747	293.1832588	0	0	409.9189827	0											"$200 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$200 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-14/$95 Days 15-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$150 (9b)	$0/$0 (8a1); $0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); $150 (9a); $40/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											122.298708	90.63925114	41.37652798	0	150	0.2	0.069639733	49.96565743	150	0	0.192626632	0	0.2	140.0369681	9.666169414	30	37.5	25	0	0	0.2	29.18786634	0	0	30	30	0	0	0	0											122.298708	90.63925114	41.37652798	0	150	0.2	0.069639733	49.96565743	150	0	0.192626632	0	0.2	140.0369681	9.666169414	30	37.5	25	0	0	0.2	29.18786634	0	0	30	30	0	0	0	0											12.4839	1.106020151	2.099446277	0	1.722434316	4.66449981	0.750116067	1.030492057	3.563573883	0	7.837681089	0	0.000744088	12.42099188	4.582450353	11.05691349	2.167822588	2.505407882	0	0	3.498610599	9.225205011	0	0	0.362514368	0.732958147	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.8118	0	0	12.4839	1.106020151	2.099446277	0	1.722434316	4.66449981	0.750116067	1.030492057	3.563573883	0	7.837681089	0	0.000744088	12.42099188	4.582450353	11.05691349	2.167822588	2.505407882	0	0	3.498610599	9.225205011	0	0	0.362514368	0.732958147	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.8118																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.4839	1.106020151	2.099446277	0	1.722434316	4.66449981	0.750116067	1.030492057	3.563573883	0	7.837681089	0	0.000744088	12.42099188	4.582450353	11.05691349	2.167822588	2.505407882	0	0	3.498610599	9.225205011	0	0	0.362514368	0.732958147	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.8118
H0609_801_0	2009	2																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1328.807709	146.0694249	1013.733266	456.967062	232.3907817	20.18313989	11.95576314	303.2893276	453.161315	12817.87097	71.53895115	0	0.07746124	1186.890309	6811.242175	5645.451466	730.6388303	764.6231328	0	0	55.66961779	3980.896656	0	0	0	0	0	0	0	0											"$225 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$225 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$300 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); $300 (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											137.5861943	101.9691575	159.8131731	0	150	0.2	0.09016356	49.97906591	300	2.8	0.273446164	0	0.2	104.2978026	12.53664555	40	37.5	35	0	0	0.2	37.90304509	0	0	0	0	0	0	0	0											137.5861943	101.9691575	159.8131731	0	150	0.2	0.09016356	49.97906591	300	2.8	0.273446164	0	0.2	104.2978026	12.53664555	40	37.5	35	0	0	0.2	37.90304509	0	0	0	0	0	0	0	0											15.2355	1.241214683	13.50066082	0	2.904884771	4.036627977	1.077974167	1.263176441	11.32903288	2.99083656	19.56205176	0	0.015492248	10.31583759	7.115844073	18.81817155	2.283246345	2.230150804	0	0	11.13392356	12.57400879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.6286	0	0	15.2355	1.241214683	13.50066082	0	2.904884771	4.036627977	1.077974167	1.263176441	11.32903288	2.99083656	19.56205176	0	0.015492248	10.31583759	7.115844073	18.81817155	2.283246345	2.230150804	0	0	11.13392356	12.57400879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.6286																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	15.2355	1.241214683	13.50066082	0	2.904884771	4.036627977	1.077974167	1.263176441	11.32903288	2.99083656	19.56205176	0	0.015492248	10.31583759	7.115844073	18.81817155	2.283246345	2.230150804	0	0	11.13392356	12.57400879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.6286
H0609_803_0	2009	3																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1305.097321	143.4630563	995.644863	448.8132365	228.2441505	19.46929604	11.53290783	297.8371224	445.0753968	12589.15715	69.00873829	0	0.074721566	1165.712203	6458.852745	5544.717671	717.6017823	750.9796908	0	0	53.70067667	3909.864103	0	0	0	0	0	0	0	0											"$225 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$225 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$300 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); $300 (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											137.5861943	101.9691575	149.8248497	0	150	0.2	0.09016356	49.97906307	300	2.8	0.273816009	0	0.2	104.2976259	12.98473364	40	37.5	35	0	0	0.2	37.90304509	0	0	0	0	0	0	0	0											137.5861943	101.9691575	149.8248497	0	150	0.2	0.09016356	49.97906307	300	2.8	0.273816009	0	0.2	104.2976259	12.98473364	40	37.5	35	0	0	0.2	37.90304509	0	0	0	0	0	0	0	0											14.9636	1.219067249	12.4310285	0	2.853051881	3.893859208	1.039848026	1.24046836	11.12688492	2.937470002	18.89569732	0	0.014944313	10.13175128	6.98887354	18.48239224	2.24250557	2.190357431	0	0	10.74013533	12.34964628	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.7416	0	0	14.9636	1.219067249	12.4310285	0	2.853051881	3.893859208	1.039848026	1.24046836	11.12688492	2.937470002	18.89569732	0	0.014944313	10.13175128	6.98887354	18.48239224	2.24250557	2.190357431	0	0	10.74013533	12.34964628	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.7416																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.9636	1.219067249	12.4310285	0	2.853051881	3.893859208	1.039848026	1.24046836	11.12688492	2.937470002	18.89569732	0	0.014944313	10.13175128	6.98887354	18.48239224	2.24250557	2.190357431	0	0	10.74013533	12.34964628	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.7416
H0609_804_0	2009	4																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1322.984668	144.932301	1095.632833	437.0836159	205.6865768	19.05555162	12.45717391	302.9472581	431.6922882	12231.8641	55.89613671	0	0.062486796	1119.598927	6602.737659	5267.255776	724.9729052	767.8453049	0	0	37.78359309	3960.243347	0	0	0	0	0	0	0	0											"$225 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$225 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$275 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); $275 (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											137.5862332	101.9691575	149.8248497	0	147.0206745	0.2	0.072352395	49.99287899	275	2.8	0.274478311	0	0.2	95.00766052	12.53310407	39.99708448	37.5	35	0	0	0.2	38.0153326	0	0	0	0	0	0	0	0											137.5862332	101.9691575	149.8248497	0	147.0206745	0.2	0.072352395	49.99287899	275	2.8	0.274478311	0	0.2	95.00766052	12.53310407	39.99708448	37.5	35	0	0	0.2	38.0153326	0	0	0	0	0	0	0	0											15.1687	1.231552052	13.67941872	0	2.520014939	3.811110324	0.901306364	1.262100468	9.892948271	2.854101622	15.34227719	0	0.012497359	8.864206231	6.896066518	17.55623952	2.265540329	2.239548806	0	0	7.556718618	12.54583067	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.6002	0	0	15.1687	1.231552052	13.67941872	0	2.520014939	3.811110324	0.901306364	1.262100468	9.892948271	2.854101622	15.34227719	0	0.012497359	8.864206231	6.896066518	17.55623952	2.265540329	2.239548806	0	0	7.556718618	12.54583067	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.6002																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	15.1687	1.231552052	13.67941872	0	2.520014939	3.811110324	0.901306364	1.262100468	9.892948271	2.854101622	15.34227719	0	0.012497359	8.864206231	6.896066518	17.55623952	2.265540329	2.239548806	0	0	7.556718618	12.54583067	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.6002
H0609_805_0	2009	2																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1354.532879	148.3883915	1121.759557	447.506417	210.5914284	19.97519397	13.05837113	310.1125361	441.9865264	12523.54807	58.59374712	0	0.06550248	1146.297152	6545.51392	5392.860025	742.2607836	786.1555289	0	0	39.60707178	4054.680263	0	0	0	0	0	0	0	0											"$225 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$225 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$300 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); $300 (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											137.5862332	101.9691575	159.8131731	0	150	0.2	0.072352395	49.99287764	300	2.8	0.273885398	0	0.2	103.4463787	12.94415418	40	37.5	35	0	0	0.2	38.0153326	0	0	0	0	0	0	0	0											137.5862332	101.9691575	159.8131731	0	150	0.2	0.072352395	49.99287764	300	2.8	0.273885398	0	0.2	103.4463787	12.94415418	40	37.5	35	0	0	0.2	38.0153326	0	0	0	0	0	0	0	0											15.5304	1.260919939	14.93932952	0	2.632392855	3.995038794	0.944804422	1.291951506	11.04966316	2.922161217	16.04797173	0	0.013100496	9.881690773	7.06051178	17.97620008	2.319564949	2.292953626	0	0	7.921414356	12.84500156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.9251	0	0	15.5304	1.260919939	14.93932952	0	2.632392855	3.995038794	0.944804422	1.291951506	11.04966316	2.922161217	16.04797173	0	0.013100496	9.881690773	7.06051178	17.97620008	2.319564949	2.292953626	0	0	7.921414356	12.84500156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.9251																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	15.5304	1.260919939	14.93932952	0	2.632392855	3.995038794	0.944804422	1.291951506	11.04966316	2.922161217	16.04797173	0	0.013100496	9.881690773	7.06051178	17.97620008	2.319564949	2.292953626	0	0	7.921414356	12.84500156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.9251
H0609_806_0	2009	2																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1332.49633	145.9742987	1103.509938	440.2260497	207.1653704	19.33053821	12.63694073	305.0759843	434.7959608	12319.80567	56.70276191	0	0.06338853	1127.648338	6441.308334	5305.124966	730.1851329	773.3657659	0	0	38.32884005	3988.715708	0	0	0	0	0	0	0	0											"$225 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$225 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$300 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 35% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $60 (5); $300 (9a); $40/$30 (9c)"	"$20 (7a); $45 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$45 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $45 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											137.5862332	101.9691575	149.8248497	0	150	0.2	0.072352395	49.99287784	300	2.8	0.315800157	0	0.2	103.7133373	12.94041131	45	37.5	40	0	0	0.2	42.76724917	0	0	0	0	0	0	0	0											137.5862332	101.9691575	149.8248497	0	150	0.2	0.072352395	49.99287784	300	2.8	0.315800157	0	0.2	103.7133373	12.94041131	45	37.5	40	0	0	0.2	42.76724917	0	0	0	0	0	0	0	0											15.2778	1.240406355	13.77776756	0	2.58956713	3.866107643	0.914312923	1.270968868	10.86989902	2.874621324	17.90674112	0	0.012677706	9.746014366	6.946098271	19.89421862	2.28182854	2.577885886	0	0	7.66576801	14.21553321	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.9282	0	0	15.2778	1.240406355	13.77776756	0	2.58956713	3.866107643	0.914312923	1.270968868	10.86989902	2.874621324	17.90674112	0	0.012677706	9.746014366	6.946098271	19.89421862	2.28182854	2.577885886	0	0	7.66576801	14.21553321	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.9282																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	15.2778	1.240406355	13.77776756	0	2.58956713	3.866107643	0.914312923	1.270968868	10.86989902	2.874621324	17.90674112	0	0.012677706	9.746014366	6.946098271	19.89421862	2.28182854	2.577885886	0	0	7.66576801	14.21553321	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.9282
H0620_002_0	2009	5																					500											D	D	D	V	T	P	P	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1500.211858	12.1648434	4967.148234	38.60712919	370.8080082	198.8716073	477.8668837	130.186831	61.05313453	9472.663174	867.9421345	0	3.591360855	182.7104835	121.8134686	4816.723132	962.6716226	14.3019862	0	0	839.7680465	363.2218965	425.5762613	3728.666879	145.2391357	6.904407129	17.42256233	59.20777213	0	0											"$0 (1a, 1a1); $0 n/c (1a2, 1a3); $500 (13c)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$50 (10a)	$0 (11a)	"$0 (11b, 11c)"	$50 (4a); $0 n/c (4a1); $0 (4b)	$0 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 5, 9a, 9c, 9d)"	"$0 (7a, 7a1, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$0 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a9, 14a10); $0 (14a8)"	"$0 n/c (13b, 13e); $0 (13d)"											0.277424324	0	0	0	50	0	0	49.82758621	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0.271704941	0	0	0	48.96919943	0	0	48.80034012	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0.034	0	0	0	1.513180942	0	0	0.529430136	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.0766	0	0.0437	0.034	0	0	0	1.513180942	0	0	0.529430136	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.0766		"20% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"20% (1b); $0 n/c (1b1, 1b2)"	"20% (2a, 2a2); $0 n/c (2a1)"	"20% (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	20% (9b)	"20% (8a1, 8a2)"	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"20% (7a, 7a1, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"20% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	20% (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	20% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	20% (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a9, 14a10); $0 (14a8)"	"$0 n/c (13b, 13e); 20% (13d)"											1.3451	0.2004	0.5296	0.0059	0.1451	0.0597	0.0922	0.0286	0.085	0.2917	0.336	0	0.0002	0.0603	0.0086	1.5249	0.3658	0.0022	0	0	0.0539	0.0306	0.0164	0	0.0075	0	0.0007	0	0	0.1972											5.3873	0	0	1.3791	0.20035	0.52960559	0.005880017	1.658250927	0.059674347	0.092174178	0.557997419	0.084970005	0.291683588	0.335953571	0	0.000153412	0.06030139	0.008581973	1.524850897	0.3658	0.002243122	0	0	0.053923211	0.03055057	0.0163956	0	0.007510301	0	0.000744644	0	0	0.1972	0	0	0	0	0	0	0	0	0	0	7.4639
H0621_001_0	2009	5																																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	P	P																																																			0		323.4772464	101.5441614	389.8246497		19.34157125	39.0107976	0.140383565	84.66257461	26.70372351	15.5189322	27.52823284	14.12174764		16.04122636	55.28496476	115.0273428	27.92719467	3.080762018		23.3434732	57.00740803	0.606076661																			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	Unlimited Trips	$1600 Annual Comp Dental Benefit	1 Routine Exam per year	$300 per year	1 Routine Exam per year	$400 for hearing aids (incl repair) every three years	"Smoking Cessation, Nutrition Therapy & $100/yr Health Clubs"	FFS Cost Sharing											723.9750479	515.6084778	67.72809778		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231																			723.9750479	515.6084778	67.72809778		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231																			19.5158	4.363085874	2.200173499	0	4.467902959	9.011494245	0.032428603	19.55705474	6.168560131	3.584873338	6.359021785	3.262123705	0	3.705523289	12.77082686	26.57131618	6.45118197	0.711656026	0	5.39234231	13.16871125	0.140003709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	147.4341	0	0	19.5158	4.363085874	2.200173499	0	4.467902959	9.011494245	0.032428603	19.55705474	6.168560131	3.584873338	6.359021785	3.262123705	0	3.705523289	12.77082686	26.57131618	6.45118197	0.711656026	0	5.39234231	13.16871125	0.140003709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	147.4341																																																																																		0	0	0	19.5158	4.363085874	2.200173499	0	4.467902959	9.011494245	0.032428603	19.55705474	6.168560131	3.584873338	6.359021785	3.262123705	0	3.705523289	12.77082686	26.57131618	6.45118197	0.711656026	0	5.39234231	13.16871125	0.140003709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	147.4341
H0621_004_0	2009	8																																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	P	P																																																			0		297.502383	134.171284	1260.81256		495.0750772			857.9009872	231.2664581		5138.731628	119.3256188	0.004558029	882.6787211	5377.337692	3752.185479	7984.069514	550.0272622																							$800 per admit	$800 per admit	$20 per day		$50 per trip			$50ER/$30UC	$200 per visit		$50 for Ther Rad	$50 per visit	20% coins	$50 per visit	$10 per visit	$10chiro/pod else $30	$10 per visit	$30 per visit																							800	800	20		50			50	200		3.587584807	50	0.2	47.61652103	10	27.91886165	10	30																							800	800	20		50			50	200		3.587584807	50	0.2	47.61652103	10	27.91886165	10	30																							19.8335	8.944752269	2.101354266	0	2.062812822	0	0	3.574587447	3.854440968	0	1.53630296	0.497190078	0.000911606	3.50250749	4.481114744	8.72972894	6.653391262	1.375068156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.1477	0	0	19.8335	8.944752269	2.101354266	0	2.062812822	0	0	3.574587447	3.854440968	0	1.53630296	0.497190078	0.000911606	3.50250749	4.481114744	8.72972894	6.653391262	1.375068156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.1477																																																																																		0	0	0	19.8335	8.944752269	2.101354266	0	2.062812822	0	0	3.574587447	3.854440968	0	1.53630296	0.497190078	0.000911606	3.50250749	4.481114744	8.72972894	6.653391262	1.375068156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.1477
H0621_005_0	2009	8																																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	P	P																																																			0		370.6463872	12.26529877	1508.150296		305.8524742			346.7149143	253.6027777		6410.71456	112.3740667	0.332235575	1455.386997	5775.187213	5432.797448	691.4454924	695.5653036																							$800 per admit	$800 per admit	$20 per day		$50 per trip			$50ER/$30UC	$200 per visit		$50 per Ther Rad	$50 per visit	20% coins	$50 per visit	$10 per visit	$10chiro/pod else $30	$30 per visit	$30 per visit																							800	800	20		50			50	200		4.249464125	50	0.2	49.82039267	10	28.28447006	30	30																							800	800	20		50			50	200		4.249464125	50	0.2	49.82039267	10	28.28447006	30	30																							24.7098	0.817686585	2.513583826	0	1.274385309	0	0	1.444645476	4.226712962	0	2.270175128	0.468225278	0.066447115	6.042329306	4.812656011	12.8053164	1.728613731	1.738913259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.9194	0	0	24.7098	0.817686585	2.513583826	0	1.274385309	0	0	1.444645476	4.226712962	0	2.270175128	0.468225278	0.066447115	6.042329306	4.812656011	12.8053164	1.728613731	1.738913259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.9194																																																																																		0	0	0	24.7098	0.817686585	2.513583826	0	1.274385309	0	0	1.444645476	4.226712962	0	2.270175128	0.468225278	0.066447115	6.042329306	4.812656011	12.8053164	1.728613731	1.738913259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.9194
H0621_006_0	2009	7																																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	P	P																																																			0		218.2621896	10.08621541	743.8835332		214.7248673			271.7244291	261.3245164		4956.064578	84.81103713		2121.230528	3792.274111	4035.583619	709.5343761	736.6729299			915.6099349																				$800 per admit	$800 per admit	$20 per day		$50 per trip			$50ER/$30UC	$200 per visit		$50 per Ther. Rad. visit	$50 per visit	20% coins	$50 per visit	$5 per visit	$10chiro/pod else $30	$30 per visit	$30 per visit			20% coins			$1100 Annual Comp Dental Benefit																	800	800	20		50			50	200		3.863014929	50		49.54595946	5	27.8932765	30	30			65.8024887																				800	800	20		50			50	200		3.863014929	50		49.54595946	5	27.8932765	30	30			65.8024887																				14.5508	0.672414361	1.239805889	0	0.894686947	0	0	1.132185121	4.355408606	0	1.595445954	0.353379321	0	8.758200144	1.580114213	9.380470812	1.77383594	1.841682325	0	0	5.020784366	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1492	0	0	14.5508	0.672414361	1.239805889	0	0.894686947	0	0	1.132185121	4.355408606	0	1.595445954	0.353379321	0	8.758200144	1.580114213	9.380470812	1.77383594	1.841682325	0	0	5.020784366	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1492																																																																																		0	0	0	14.5508	0.672414361	1.239805889	0	0.894686947	0	0	1.132185121	4.355408606	0	1.595445954	0.353379321	0	8.758200144	1.580114213	9.380470812	1.77383594	1.841682325	0	0	5.020784366	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1492
H0621_007_0	2009	6																																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	P	P																																																			0		187.4913436	4.924183197	425.2471431		151.430195			186.9775279	239.4605964		4700.329638	70.99141338	0.115304511	1616.943734	4166.642272	4245.473778	374.0897731	796.2364356			26.91593958																				$800 per admit	$800 per admit	$20 per day		$50 per trip			$50ER/$30UC	$200 per visit		$50 per Tx Rad Visit	$50 per visit	20% coins	$50 per visit	$5 per visit	$10chiro/pod else $30	$30 per visit	$30 per visit			20% coins																				800	800	20		50			50	200		3.993662585	50	0.2	49.45764722	5	27.90904615	30	30			0.2																				800	800	20		50			50	200		3.993662585	50	0.2	49.45764722	5	27.90904615	30	30			0.2																				12.4994	0.32827888	0.708745239	0	0.630959146	0	0	0.779073033	3.991009939	0	1.564294218	0.295797556	0.023060902	6.664186064	1.736100947	9.873926964	0.935224433	1.990591089	0	0	5.383187915	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4039	0	0	12.4994	0.32827888	0.708745239	0	0.630959146	0	0	0.779073033	3.991009939	0	1.564294218	0.295797556	0.023060902	6.664186064	1.736100947	9.873926964	0.935224433	1.990591089	0	0	5.383187915	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4039																																																																																		0	0	0	12.4994	0.32827888	0.708745239	0	0.630959146	0	0	0.779073033	3.991009939	0	1.564294218	0.295797556	0.023060902	6.664186064	1.736100947	9.873926964	0.935224433	1.990591089	0	0	5.383187915	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4039
H0623_001_0	2009	6	r.	s.	t.	u.	v.						OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered						5000	Renal Dialysis										D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin								O	O	P	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		1513.246921	67.377806	528.144875	754.838682	150.13812	10.626158	3.837456	339.601159	368.116697	650.821473	965.959094	0	0	738.950641	3616.640343	4359.540302	29.739018	939.650974			24.016919								3.36	0.27	19.801914	0.06	0.05	1.23	2.7						$200/Day(Days 1-7):1a	$200/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$10/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$150/Visit:14h. $150 DMAM -- OP,8b. $30 Radiology -- FSR,14h. $30 SMAM -- FSR,14h. $150 SMAM -- OP,8b. $150 Advanced Imaging -- FSR,8b. $150 Advanced Imaging -- Office,9a. $150 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $150 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$15-$150/Visit:9d. $15 Cardiac Rehab,8b. $150 Nuclear Medicine,9a. $150 OP Other,5. $35 Partial Hospitalization,8b. $100 Rad therapy,3. $40 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$150/Visit:7h. $150 Psych -- OP,7e. $35 Psych -- Other Provider"	"$35-$150/Visit:9a. $150 Therapy (AT,PT,ST,OT) -- OP,7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			"0%-15% Coins:15. 15% Part B Rx,15. 0% Part B Rx at Pharmacy,15. 15% Part B Rx - Chemo"								$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	$0/Proc:12	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0: Health Education Materials 14a	$0 Corp Health 14a						142.487199	102.214727	43.132801	9.999996	100	0.2	0.199999	50.000006	127.313181	43.978696	124.113603	0	0.2	93.012074	10	34.999997	132.050358	59.810969			0.116406								0	0	0	0	0	0	0						121.986283	87.508174	36.926897	8.561206	85.6121	0.171224	0.171224	42.806055	108.995488	37.651085	106.256262	0	0.17	79.62959	8.56121	29.964232	113.051084	51.205427			0.099658								0	0	0	0	0	0	0						15.3829	0.491342398	1.625229283	0.538527454	1.071136645	1.819453277	0.657064566	1.211415491	3.343588253	2.042011217	8.553266881	0	0	4.903528048	2.580234789	10.88585642	0.280169018	4.009602446	0	0	2.393478114	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.7889	0	10.3842	15.3829	0.491342398	1.625229283	0.538527454	1.071136645	1.819453277	0.657064566	1.211415491	3.343588253	2.042011217	8.553266881	0	0	4.903528048	2.580234789	10.88585642	0.280169018	4.009602446	0	0	2.393478114	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.7889		$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		20% Coins	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins								0	0		0	0	0	0						2.4612	0.0793	0.4977	0.7551	0.8585	2.7735	1.0016	0.257	3.5948	0.4631	1.9262		0	1.088	2.1815	4.9806	0.0315	0.4205			1.4867								0	0		0	0	0	0						24.8569	500	0	17.8442	0.570643398	2.122963283	1.293642454	1.929623645	4.592974277	1.658674566	1.468422491	6.938359253	2.505101217	10.47950488	0	0	5.991536048	4.761718789	15.86643942	0.311645018	4.430151446	0	0	3.880139114	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.6457
H0623_005_0	2009	5	r.	s.	t.	u.	v.						OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered						5000	Renal Dialysis										D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin								O	O	P	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		1311.04345	58.374631	457.572964	653.975434	130.076325	7.973388	2.879453	294.222885	318.928113	563.857237	836.885457	0	0	640.210389	3133.376692	3777.008683	25.765223	814.09269			18.02121								3.36	0.09	17.155937	0.06	0.05	1.23	2.7						$175/Day(Days 1-7):1a	$175/Day(Days 1-7):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$10/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$100/Visit:14h. $50 DMAM -- OP,8b. $30 Radiology -- FSR,14h. $30 SMAM -- FSR,14h. $30 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$15-$100/Visit:9d. $15 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $50 OP Other,5. $35 Partial Hospitalization,8b. $50 Rad therapy,3. $40 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$50/Visit:7h. $50 Psych -- OP,7e. $35 Psych -- Other Provider"	"$35-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			"0%-15% Coins:15. 15% Part B Rx,15. 0% Part B Rx at Pharmacy,15. 15% Part B Rx - Chemo"								$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	$0/Proc:12	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0: Health Education Materials 14a	$0 Corp Health 14a						124.676298	110.261733	43.132793	10.000008	99.999965	0.2	0.199999	50.000012	127.313179	0	63.268557	0	0.2	44.953759	9.999999	35.000002	47.658659	38.236211			0.116406								0	0	0	0	0	0	0						113.844171	100.681973	39.385329	9.131187	91.311768	0.182623	0.182623	45.655911	116.251955	0	57.771659	0	0.18	41.048087	9.131179	31.959131	43.51798	34.914172			0.106293								0	0	0	0	0	0	0						12.4379	0.489772752	1.501805144	0.497630998	0.989791601	1.456124037	0.525854345	1.119417821	3.089668053	0	4.02902177	0	0	2.189950979	2.384285287	10.05915961	0.093437538	2.36861435	0	0	1.915528475	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.148	0	4.2958	12.4379	0.489772752	1.501805144	0.497630998	0.989791601	1.456124037	0.525854345	1.119417821	3.089668053	0	4.02902177	0	0	2.189950979	2.384285287	10.05915961	0.093437538	2.36861435	0	0	1.915528475	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.148		$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		20% Coins	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			0%-30% Coins								0	0		0	0	0	0						2.3485	0.0757	0.4113	0.624	0.8192	2.2921	0.8278	0.2452	2.9708	0.3827	1.5919		0	0.8992	1.8028	4.1161	0.026	0.3476			0.7292								0	0		0	0	0	0						20.5102	500	0	14.7864	0.565441752	1.913146144	1.121679998	1.808970601	3.748240037	1.353612345	1.364656821	6.060489053	0.382711	5.62091877	0	0	3.089110979	4.187124287	14.17525261	0.119449538	2.71616835	0	0	2.644737475	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.6581
H0623_006_0	2009	5	r.	s.	t.	u.	v.						OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered						5000	Renal Dialysis										D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin								O	O	P	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		1311.04345	58.374631	457.572964	653.975434	130.076325	7.973388	2.879453	294.222885	318.928113	563.857237	836.885457	0	0	640.210389	3133.376692	3777.008683	25.765223	814.09269			18.02121								3.36	0.09	17.155937	0.06	0.05	1.23	2.7						$175/Day(Days 1-7):1a	$175/Day(Days 1-7):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$10/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$100/Visit:14h. $50 DMAM -- OP,8b. $30 Radiology -- FSR,14h. $30 SMAM -- FSR,14h. $30 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$15-$100/Visit:9d. $15 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $50 OP Other,5. $35 Partial Hospitalization,8b. $50 Rad therapy,3. $40 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$50/Visit:7h. $50 Psych -- OP,7e. $35 Psych -- Other Provider"	"$35-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			"0%-15% Coins:15. 15% Part B Rx,15. 0% Part B Rx at Pharmacy,15. 15% Part B Rx - Chemo"								$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	$0/Proc:12	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0: Health Education Materials 14a	$0 Corp Health 14a						124.676298	110.261733	43.132793	10.000008	99.999965	0.2	0.199999	50.000012	127.313179	0	63.268557	0	0.2	44.953759	9.999999	35.000002	47.658659	38.236211			0.116406								0	0	0	0	0	0	0						113.844171	100.681973	39.385329	9.131187	91.311768	0.182623	0.182623	45.655911	116.251955	0	57.771659	0	0.18	41.048087	9.131179	31.959131	43.51798	34.914172			0.106293								0	0	0	0	0	0	0						12.4379	0.489772752	1.501805144	0.497630998	0.989791601	1.456124037	0.525854345	1.119417821	3.089668053	0	4.02902177	0	0	2.189950979	2.384285287	10.05915961	0.093437538	2.36861435	0	0	1.915528475	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.148	0	4.2958	12.4379	0.489772752	1.501805144	0.497630998	0.989791601	1.456124037	0.525854345	1.119417821	3.089668053	0	4.02902177	0	0	2.189950979	2.384285287	10.05915961	0.093437538	2.36861435	0	0	1.915528475	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.148		$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		20% Coins	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			0%-30% Coins								0	0		0	0	0	0						2.3485	0.0757	0.4113	0.624	0.8192	2.2921	0.8278	0.2452	2.9708	0.3827	1.5919		0	0.8992	1.8028	4.1161	0.026	0.3476			0.7292								0	0		0	0	0	0						20.5102	500	0	14.7864	0.565441752	1.913146144	1.121679998	1.808970601	3.748240037	1.353612345	1.364656821	6.060489053	0.382711	5.62091877	0	0	3.089110979	4.187124287	14.17525261	0.119449538	2.71616835	0	0	2.644737475	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.6581
H0623_007_0	2009	5	r.	s.	t.	u.	v.						OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered						5000	Renal Dialysis										D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin								O	O	P	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		1284.64846	57.199385	448.360735	640.809071	127.457524	7.655577	2.764681	288.299352	312.507194	552.505206	820.036601	0	0	627.321152	3070.293012	3700.966882	25.246494	797.702715			17.302904								3.36	0.09	16.81054	0.06	0.05	1.23	2.7						$175/Day(Days 1-7):1a	$175/Day(Days 1-7):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$10/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$100/Visit:14h. $50 DMAM -- OP,8b. $30 Radiology -- FSR,14h. $30 SMAM -- FSR,14h. $30 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$15-$100/Visit:9d. $15 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $50 OP Other,5. $35 Partial Hospitalization,8b. $50 Rad therapy,3. $40 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$50/Visit:7h. $50 Psych -- OP,7e. $35 Psych -- Other Provider"	"$35-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			"0%-15% Coins:15. 15% Part B Rx,15. 0% Part B Rx at Pharmacy,15. 15% Part B Rx - Chemo"								$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	$0/Proc:12	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0: Health Education Materials 14a	$0 Corp Health 14a						124.676296	110.261675	43.132804	10.000008	99.999996	0.199999	0.199999	49.999987	127.313152	0	63.268551	0	0.2	44.953759	10.000001	35	47.658736	38.236214			0.116406								0	0	0	0	0	0	0						114.137533	100.941365	39.486831	9.154717	91.547097	0.183094	0.183094	45.773538	116.551498	0	57.920524	0	0.18	41.153862	9.154711	32.041485	43.63019	35.004145			0.106567								0	0	0	0	0	0	0						12.2189	0.481148667	1.475362047	0.488868808	0.972363859	1.401690215	0.506196503	1.099706779	3.035265133	0	3.958079136	0	0	2.151390677	2.342303768	9.88203957	0.091792444	2.326908459	0	0	1.843918571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2759	0	4.0882	12.2189	0.481148667	1.475362047	0.488868808	0.972363859	1.401690215	0.506196503	1.099706779	3.035265133	0	3.958079136	0	0	2.151390677	2.342303768	9.88203957	0.091792444	2.326908459	0	0	1.843918571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2759		$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		20% Coins	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			0%-30% Coins								0	0		0	0	0	0						2.3198	0.0747	0.3981	0.604	0.8091	2.2185	0.8012	0.2422	2.8754	0.3704	1.5407		0	0.8703	1.7449	3.9838	0.0252	0.3364			0.7058								0	0		0	0	0	0						19.9206	500	0	14.5387	0.555891667	1.873488047	1.092866808	1.781512859	3.620161215	1.307360503	1.341943779	5.910635133	0.370414	5.498828136	0	0	3.021662677	4.087219768	13.86588557	0.116969444	2.663294459	0	0	2.549697571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1965
H0623_008_0	2009	5	r.	s.	t.	u.	v.						OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered						5000	Renal Dialysis										D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin								O	O	P	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		1284.64846	57.199385	448.360735	640.809071	127.457524	7.655577	2.764681	288.299352	312.507194	552.505206	820.036601	0	0	627.321152	3070.293012	3700.966882	25.246494	797.702715			17.302904								3.36	0.09	16.81054	0.06	0.05	1.23	2.7						$175/Day(Days 1-7):1a	$175/Day(Days 1-7):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$10/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$100/Visit:14h. $50 DMAM -- OP,8b. $30 Radiology -- FSR,14h. $30 SMAM -- FSR,14h. $30 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$15-$100/Visit:9d. $15 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $50 OP Other,5. $35 Partial Hospitalization,8b. $50 Rad therapy,3. $40 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$50/Visit:7h. $50 Psych -- OP,7e. $35 Psych -- Other Provider"	"$35-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			"0%-15% Coins:15. 15% Part B Rx,15. 0% Part B Rx at Pharmacy,15. 15% Part B Rx - Chemo"								$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	$0/Proc:12	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0: Health Education Materials 14a	$0 Corp Health 14a						124.676296	110.261675	43.132804	10.000008	99.999996	0.199999	0.199999	49.999987	127.313152	0	63.268551	0	0.2	44.953759	10.000001	35	47.658736	38.236214			0.116406								0	0	0	0	0	0	0						114.137533	100.941365	39.486831	9.154717	91.547097	0.183094	0.183094	45.773538	116.551498	0	57.920524	0	0.18	41.153862	9.154711	32.041485	43.63019	35.004145			0.106567								0	0	0	0	0	0	0						12.2189	0.481148667	1.475362047	0.488868808	0.972363859	1.401690215	0.506196503	1.099706779	3.035265133	0	3.958079136	0	0	2.151390677	2.342303768	9.88203957	0.091792444	2.326908459	0	0	1.843918571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2759	0	4.0882	12.2189	0.481148667	1.475362047	0.488868808	0.972363859	1.401690215	0.506196503	1.099706779	3.035265133	0	3.958079136	0	0	2.151390677	2.342303768	9.88203957	0.091792444	2.326908459	0	0	1.843918571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2759		$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		20% Coins	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			0%-30% Coins								0	0		0	0	0	0						2.3198	0.0747	0.3981	0.604	0.8091	2.2185	0.8012	0.2422	2.8754	0.3704	1.5407		0	0.8703	1.7449	3.9838	0.0252	0.3364			0.7058								0	0		0	0	0	0						19.9206	500	0	14.5387	0.555891667	1.873488047	1.092866808	1.781512859	3.620161215	1.307360503	1.341943779	5.910635133	0.370414	5.498828136	0	0	3.021662677	4.087219768	13.86588557	0.116969444	2.663294459	0	0	2.549697571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1965
H0623_009_0	2009	5	r.	s.	t.	u.	v.						OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered						5000	Renal Dialysis										D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin								O	O	P	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		1514.927948	67.452653	528.731578	755.677214	150.304903	10.646161	3.84468	339.978413	368.525628	651.544454	967.032149	0	0	739.771524	3620.657974	4364.383204	29.772053	940.694808			24.062131								3.36	0.27	19.823911	0.06	0.05	1.23	2.7						$200/Day(Days 1-7):1a	$200/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$10/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$150/Visit:14h. $150 DMAM -- OP,8b. $30 Radiology -- FSR,14h. $30 SMAM -- FSR,14h. $150 SMAM -- OP,8b. $150 Advanced Imaging -- FSR,8b. $150 Advanced Imaging -- Office,9a. $150 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $150 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$15-$150/Visit:9d. $15 Cardiac Rehab,8b. $150 Nuclear Medicine,9a. $150 OP Other,5. $35 Partial Hospitalization,8b. $100 Rad therapy,3. $40 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$150/Visit:7h. $150 Psych -- OP,7e. $35 Psych -- Other Provider"	"$35-$150/Visit:9a. $150 Therapy (AT,PT,ST,OT) -- OP,7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			"0%-15% Coins:15. 15% Part B Rx,15. 0% Part B Rx at Pharmacy,15. 15% Part B Rx - Chemo"								$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	$0/Proc:12	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0: Health Education Materials 14a	$0 Corp Health 14a						142.487196	102.214808	43.132804	9.999999	100.000011	0.199999	0.2	50.000009	127.313197	43.978702	124.113611	0	0.2	93.012063	10	34.999999	132.05055	59.810986			0.116406								0	0	0	0	0	0	0						121.958353	87.488209	36.918446	8.559249	85.592509	0.171184	0.171185	42.796258	108.970548	37.642471	106.231942	0	0.17	79.61135	8.55925	29.957374	113.025367	51.193718			0.099635								0	0	0	0	0	0	0						15.3965	0.491775984	1.626662351	0.539002453	1.072081147	1.822452425	0.658151546	1.212483656	3.346536636	2.043811935	8.560808597	0	0	4.90785081	2.58250973	10.89545499	0.280416435	4.013138727	0	0	2.397430422	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8471	0	10.4105	15.3965	0.491775984	1.626662351	0.539002453	1.072081147	1.822452425	0.658151546	1.212483656	3.346536636	2.043811935	8.560808597	0	0	4.90785081	2.58250973	10.89545499	0.280416435	4.013138727	0	0	2.397430422	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8471		$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		20% Coins	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins								0	0		0	0	0	0						2.4629	0.0794	0.4985	0.7562	0.8591	2.7775	1.0031	0.2572	3.6	0.4638	1.929		0	1.0896	2.1846	4.9878	0.0315	0.4212			1.4888								0	0		0	0	0	0						24.8899	500	0	17.8594	0.571128984	2.125115351	1.295209453	1.931145147	4.599980425	1.661208546	1.469663656	6.946501636	2.507569935	10.4898286	0	0	5.99743081	4.76714473	15.88323399	0.311937435	4.434294727	0	0	3.886239422	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.737
H0623_801_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		273.619472	8.815972	531.573192	759.738526	5.452416	10.760902	3.886117	23.924664	61.498618	655.046115	33.253384	0	0.419612	18.944344	35.688618	81.481295	0.514938	6.880092			24.321465																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000017	1023.999622	43.132807	0	0.199999	0.199999	0.2	0.2	0.2	0	0.199999	0	0.199999	0.199999	0.2	0.2	0.5	0.2			0.199999																				1024.000017	1023.999622	43.132807	0	0.199999	0.199999	0.2	0.2	0.2	0	0.199999	0	0.199999	0.199999	0.2	0.2	0.5	0.2			0.199999																				23.3489	0.752296	1.910686991	0	1.090477748	2.152169639	0.7772234	4.7849328	12.2997236	0	6.650643547	0	0.08392198	3.788849856	7.1377236	16.296259	0.257469	1.3760184	0	0	4.864268679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.5715	0	0	23.3489	0.752296	1.910686991	0	1.090477748	2.152169639	0.7772234	4.7849328	12.2997236	0	6.650643547	0	0.08392198	3.788849856	7.1377236	16.296259	0.257469	1.3760184	0	0	4.864268679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.5715		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.5943	0.0836	0.2123		0.6914	1.3645	0.4927	0.9013	2.358		1.2635		0.0158	0.7137	1.4309	3.267	0.0516	0.2759			0.9752																				16.6915	0	0	25.9432	0.835885	2.122985991	0	1.781829748	3.516623639	1.2699724	5.6862228	14.6576886	0	7.914146547	0	0.09972998	4.502521856	8.5686526	19.563238	0.309086	1.6518744	0	0	5.839433679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.2631
H0623_802_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		273.619472	8.815972	531.573192	759.738526	5.452416	10.760902	3.886117	23.924664	61.498618	655.046115	33.253384	0	0.419612	18.944344	35.688618	81.481295	0.514938	6.880092			24.321465																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000017	1023.999622	43.132807	0	0.199999	0.199999	0.2	0.2	0.2	0	0.199999	0	0.199999	0.199999	0.2	0.2	0.5	0.2			0.199999																				1024.000017	1023.999622	43.132807	0	0.199999	0.199999	0.2	0.2	0.2	0	0.199999	0	0.199999	0.199999	0.2	0.2	0.5	0.2			0.199999																				23.3489	0.752296	1.910686991	0	1.090477748	2.152169639	0.7772234	4.7849328	12.2997236	0	6.650643547	0	0.08392198	3.788849856	7.1377236	16.296259	0.257469	1.3760184	0	0	4.864268679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.5715	0	0	23.3489	0.752296	1.910686991	0	1.090477748	2.152169639	0.7772234	4.7849328	12.2997236	0	6.650643547	0	0.08392198	3.788849856	7.1377236	16.296259	0.257469	1.3760184	0	0	4.864268679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.5715		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.5943	0.0836	0.2123		0.6914	1.3645	0.4927	0.9013	2.358		1.2635		0.0158	0.7137	1.4309	3.267	0.0516	0.2759			0.9752																				16.6915	0	0	25.9432	0.835885	2.122985991	0	1.781829748	3.516623639	1.2699724	5.6862228	14.6576886	0	7.914146547	0	0.09972998	4.502521856	8.5686526	19.563238	0.309086	1.6518744	0	0	5.839433679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.2631
H0623_803_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		273.619472	8.815972	531.573192	759.738526	5.452416	10.760902	3.886117	23.924664	61.498618	655.046115	33.253384	0	0.419612	18.944344	35.688618	81.481295	0.514938	6.880092			24.321465																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000017	1023.999622	43.132807	0	0.199999	0.199999	0.2	0.2	0.2	0	0.199999	0	0.199999	0.199999	0.2	0.2	0.5	0.2			0.199999																				1024.000017	1023.999622	43.132807	0	0.199999	0.199999	0.2	0.2	0.2	0	0.199999	0	0.199999	0.199999	0.2	0.2	0.5	0.2			0.199999																				23.3489	0.752296	1.910686991	0	1.090477748	2.152169639	0.7772234	4.7849328	12.2997236	0	6.650643547	0	0.08392198	3.788849856	7.1377236	16.296259	0.257469	1.3760184	0	0	4.864268679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.5715	0	0	23.3489	0.752296	1.910686991	0	1.090477748	2.152169639	0.7772234	4.7849328	12.2997236	0	6.650643547	0	0.08392198	3.788849856	7.1377236	16.296259	0.257469	1.3760184	0	0	4.864268679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.5715		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.5943	0.0836	0.2123		0.6914	1.3645	0.4927	0.9013	2.358		1.2635		0.0158	0.7137	1.4309	3.267	0.0516	0.2759			0.9752																				16.6915	0	0	25.9432	0.835885	2.122985991	0	1.781829748	3.516623639	1.2699724	5.6862228	14.6576886	0	7.914146547	0	0.09972998	4.502521856	8.5686526	19.563238	0.309086	1.6518744	0	0	5.839433679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.2631
H0623_804_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		273.619472	8.815972	531.573192	759.738526	5.452416	10.760902	3.886117	23.924664	61.498618	655.046115	33.253384	0	0.419612	18.944344	35.688618	81.481295	0.514938	6.880092			24.321465																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000017	1023.999622	43.132807	0	0.199999	0.199999	0.2	0.2	0.2	0	0.199999	0	0.199999	0.199999	0.2	0.2	0.5	0.2			0.199999																				1024.000017	1023.999622	43.132807	0	0.199999	0.199999	0.2	0.2	0.2	0	0.199999	0	0.199999	0.199999	0.2	0.2	0.5	0.2			0.199999																				23.3489	0.752296	1.910686991	0	1.090477748	2.152169639	0.7772234	4.7849328	12.2997236	0	6.650643547	0	0.08392198	3.788849856	7.1377236	16.296259	0.257469	1.3760184	0	0	4.864268679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.5715	0	0	23.3489	0.752296	1.910686991	0	1.090477748	2.152169639	0.7772234	4.7849328	12.2997236	0	6.650643547	0	0.08392198	3.788849856	7.1377236	16.296259	0.257469	1.3760184	0	0	4.864268679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.5715		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.5943	0.0836	0.2123		0.6914	1.3645	0.4927	0.9013	2.358		1.2635		0.0158	0.7137	1.4309	3.267	0.0516	0.2759			0.9752																				16.6915	0	0	25.9432	0.835885	2.122985991	0	1.781829748	3.516623639	1.2699724	5.6862228	14.6576886	0	7.914146547	0	0.09972998	4.502521856	8.5686526	19.563238	0.309086	1.6518744	0	0	5.839433679	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.2631
H0624_001_0	2009	7																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		397.6785553	23.09	69.25619144	1769.050353	18.34270405	38.48659618	10.07675434	45.08243431	39.67638083	21.36025344	39.72383174	0	0.656326873	33.08683704	40.63657482	145.8538943	14.56	2.595756965	0	0	22.7413101	5.367774316	366.6938143	0	259.4386263	241.0661672	0	0	20.2	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.074065734	0.075013537	0.159277344	0	0.2	0.2	0.2	0.070189313	0.2	0.08	0.2	0	0.2	0.2	0	0.199933576	0.2	0.2	0	0	0.2	0.017588402	0	0	0	0	0	0	0	0											0.074065734	0.075013537	0.159277344	0	0.2	0.2	0.2	0.070189313	0.2	0.08	0.2	0	0.2	0.2	0	0.199933576	0.2	0.2	0	0	0.2	0.017588402	0	0	0	0	0	0	0	0											29.4544	1.732062565	11.03094221	0	3.66854081	7.697319237	2.015350868	3.16430507	7.935276167	1.708820275	7.944766349	0	0.131265375	6.617367408	0	29.16109069	2.912	0.519151393	0	0	4.54826202	0.09441057	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.3353	0	0	29.4544	1.732062565	11.03094221	0	3.66854081	7.697319237	2.015350868	3.16430507	7.935276167	1.708820275	7.944766349	0	0.131265375	6.617367408	0	29.16109069	2.912	0.519151393	0	0	4.54826202	0.09441057	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.3353																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	29.4544	1.732062565	11.03094221	0	3.66854081	7.697319237	2.015350868	3.16430507	7.935276167	1.708820275	7.944766349	0	0.131265375	6.617367408	0	29.16109069	2.912	0.519151393	0	0	4.54826202	0.09441057	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.3353
H0624_004_0	2009	7																					500											D	D	D	V	T	P	P	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1414.166558	613.5912699	4611.312037	37.35050587	358.7385797	192.3985361	462.3127962	125.9493803	59.06591626	9164.337493	839.691489	0	3.474465663	184.8209237	146.5725743	4917.129199	4407.226891	13.8364709	0	0	812.4344393	351.3993882	2759.542995	3924.912504	191.5790143	327.2358411	49.32367985	62.32397067	0	0											"$0 (1a, 1a1); $0 n/c (1a2, 1a3); $500 (13c)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$50 (10a)	$0 (11a)	"$0 (11b, 11c)"	$50 (4a); $0 n/c (4a1); $0 (4b)	$0 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 5, 9a, 9c, 9d)"	"$0 (7a, 7a1, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$0 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a9, 14a10); $0 (14a8)"	"$0 n/c (13b, 13e); $0 (13d)"											0.277424324	0	0	0	50	0	0	49.82758621	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0.272132078	0	0	0	49.04618209	0	0	48.87705732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0.0321	0	0	0	1.466229808	0	0	0.513002923	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.0113	0	0.0391	0.0321	0	0	0	1.466229808	0	0	0.513002923	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.0113																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.0321	0	0	0	1.466229808	0	0	0.513002923	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.0113
H0624_005_0	2009	4																					3350											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1913.43763	267.4746995	46.15418097	51973.71967	90.49221446	22.01357804	9.732807292	369.8024955	387.7086051	6140.027799	469.5667732	0	0.941014185	1497.768997	6051.578753	4483.735095	1301.980366	267.3661197	0	0	29.37183292	1132.099756	810.5086242	0	327.7093149	349.7142857	0	0	20.2	0											"$175 Days 1-20 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-20 (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$75 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5, 9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											172.9	175	0.159259719	0	75	0.14	0.2	49.97295854	75	4.4	64.79010385	0	0.2	70.32067415	3.25283017	25	20	20	0	0	0.2	13.67894853	0	0	0	0	0	0	0	0											130.4344341	132.0186579	0.159259719	0	56.57942483	0.105614926	0.150878466	37.69921668	56.57942483	3.319326257	48.87715747	0	0.150878466	53.0493773	3.25283017	25	20	20	0	0	0.150878466	13.67894853	0	0	0	0	0	0	0	0											20.7982	2.942637572	7.350501896	0	0.426666454	2.324962424	1.468471036	1.161772034	1.82802749	1.698396291	1.91259076	0	0.141978777	6.621309386	1.640396495	9.341114782	2.169967277	0.445610199	0	0	4.431577101	1.290494525	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.9947	0	14.897	20.7982	2.942637572	7.350501896	0	0.426666454	2.324962424	1.468471036	1.161772034	1.82802749	1.698396291	1.91259076	0	0.141978777	6.621309386	1.640396495	9.341114782	2.169967277	0.445610199	0	0	4.431577101	1.290494525	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.9947																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.7982	2.942637572	7.350501896	0	0.426666454	2.324962424	1.468471036	1.161772034	1.82802749	1.698396291	1.91259076	0	0.141978777	6.621309386	1.640396495	9.341114782	2.169967277	0.445610199	0	0	4.431577101	1.290494525	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.9947
H0630_013_0	2009	8	j.	j.	j.	j.							Part B Rx	Part B Rx	Part B Rx	Part B Rx							3350	Generic	Brand	Office Administered	Home Infusions							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	3350	518.8865713	26.31532389	259.6007553	0	6.693765138	10.55041075	0.431140103	176.4072927	55.08372301	0	306.873308	0.385891704	0	122.4022208	3313.127753	3172.850406	297.2690464	545.935097	0	3470.930954	0	0	0	0	469.9955314	0	54.45856455	0	46.30649091	30.87473201	173	297	2.4	0							$210/day days 1-5; $0 days 6-90	$210/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 (0% for Diabetic Supplies)	20% Coinsurance	$50/visit waived if admitted to hospital	$275/visit;colonoscopies $0	$0 Copay	"MRI,CT,PET $225/procedure, Radiation Therapy $35/visit"	Partial hospital-20% Coinsurance	$0 Copay	Pulmonary Rehab $5; $0-$275/visit	Primary Care OV $0-$30/visit	Specialty Care OV $0-$35/visit	"$10 Group Visit, $15 OV"	Therapies=Primary Care OV	$0 Copay	"PA, NP $0-$35"		$0 Copay			$15/visit; $35/specialty visit		$15/visit		$0-$150 copay	$3 copay	$8 Generic copay	$35 Brand copay	20% coinsurance	$0 Copay							130.08	130.08	36.35	0	0.2	0.2	0.2	45.35	275	0	198.79	0.2	0	14.61	14.79	32	12.98	15	0	15	0	0	0	0	23.82	0	15	0	16.32	0.01	8	35	0.2	0							126.1	126.1	16.13	0	0.18	0.18	0.18	41.37	250.91	0	181.37	0.18	0	13.33	13.49	29.2	11.84	13.69	0	13.69	0	0	0	0	21.73	0	13.69	0	16.32	0.01	8	35	0.2	0							5.4526	0.276530195	0.348946682	0	1.204877725	1.899073934	0.077605218	0.608164142	1.151754745	0	4.638134322	0.069460507	0	0.135968467	3.724507782	7.720602654	0.293305459	0.622820957	0	3.959753731	0	0	0	0	0.851083575	0	0.062128146	0	0.062976828	2.57E-05	0.115333333	0.86625	0.48	0	0	0	0	0	0	0	34.6219	0	3.2609	5.4526	0.276530195	0.348946682	0	1.204877725	1.899073934	0.077605218	0.608164142	1.151754745	0	4.638134322	0.069460507	0	0.135968467	3.724507782	7.720602654	0.293305459	0.622820957	0	3.959753731	0	0	0	0	0.851083575	0	0.062128146	0	0.062976828	2.57E-05	0.115333333	0.86625	0.48	0	0	0	0	0	0	0	34.6219	3350																																																																																	0	0	0	5.4526	0.276530195	0.348946682	0	1.204877725	1.899073934	0.077605218	0.608164142	1.151754745	0	4.638134322	0.069460507	0	0.135968467	3.724507782	7.720602654	0.293305459	0.622820957	0	3.959753731	0	0	0	0	0.851083575	0	0.062128146	0	0.062976828	2.57E-05	0.115333333	0.86625	0.48	0	0	0	0	0	0	0	34.6219
H0630_014_0	2009	5	j.	j.	j.	j.							Part B Rx	Part B Rx	Part B Rx	Part B Rx							3350	Generic	Brand	Office Administered	Home Infusions							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	3350	1674.992814	182.8221446	1239.027405	0	39.71758491	61.83125477	2.141014573	729.9733113	71.02443029	0	490.5946759	2.310873888	0	131.5267228	6908.422392	5701.452232	1432.603532	542.1936264	0	6691.544942	0	113.0886394	0	0	511.0192893	0	72.80081161	0	72.09400762	115.9158554	495	921	1.28	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% Diabetic Supplies	0%-20% Coinsurance	$50/visit waived if admitted to hospital	$0-$200/visit;colonoscopies $0	$0 Copay	"MRI,CT,PET $0-$125/procedure, Radiation Therapy $0-$30/visit"	Partial hospitalizaton 0%-20% coin	$0 Copay	Pulmonary Rehab $0-$30/visit; $0 - $200/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	"PA, NP $0-$30"		$0 Copay			$0-$15/visit; $0-$30/specialty visit		$0-$15/visit		$0-$150 copay	$0-$3 copay	0%-20% coinsurance	0%-20% coinsurance	0%-20% coinsurance	$0 Copay							40.2394269	40.2394269	12.42844055	0	0.068382066	0.068382066	0.068382066	0.013676413	0	0	0.341910331	0.068382066	0	0.683820663	0.683820663	0.683820663	0.683820663	0.683820663	0	0.683820663	0	0	0	0	0.683820663	0	0.683820663	0	0.683820663	0	0.341910331	1.025730994	0	0							39.32310721	39.32310721	5.874019493	0	0.06154386	0.06154386	0.06154386	0.013676413	0	0	0.314557505	0.06154386	0	0.62911501	0.62911501	0.62911501	0.62911501	0.62911501	0	0.62911501	0	0	0	0	0.62911501	0	0.62911501	0	0.683820663	0	0.341910331	1.025730994	0	0							5.4888	0.599094566	0.606505928	0	2.444373471	3.805334066	0.1317663	0.000831951	0	0	0.01286002	0.142220098	0	0.006895453	0.362182685	0.298905765	0.075106032	0.028425179	0	0.350812613	0	0	0	0	0.026790825	0	0.003816674	0	0.004108281	0	0.014103801	0.078724854	0	0	0	0	0	0	0	0	14.4817	0	1.64	5.4888	0.599094566	0.606505928	0	2.444373471	3.805334066	0.1317663	0.000831951	0	0	0.01286002	0.142220098	0	0.006895453	0.362182685	0.298905765	0.075106032	0.028425179	0	0.350812613	0	0	0	0	0.026790825	0	0.003816674	0	0.004108281	0	0.014103801	0.078724854	0	0	0	0	0	0	0	0	14.4817	3350																																																																																	0	0	0	5.4888	0.599094566	0.606505928	0	2.444373471	3.805334066	0.1317663	0.000831951	0	0	0.01286002	0.142220098	0	0.006895453	0.362182685	0.298905765	0.075106032	0.028425179	0	0.350812613	0	0	0	0	0.026790825	0	0.003816674	0	0.004108281	0	0.014103801	0.078724854	0	0	0	0	0	0	0	0	14.4817
H0630_015_0	2009	6	j.	j.	j.	j.							Part B Rx	Part B Rx	Part B Rx	Part B Rx							2850	Generic	Brand	Office Administered	Home Infusions							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	2850	886.7994675	46.94224744	615.0633974	0	12.05178737	20.55651405	0.932784407	285.5184339	84.35345504	0	502.7060664	0.902893199	0	190.4707019	4761.210097	4728.390068	280.9686579	725.4994287	0	5167.079335	0	80.01349291	0	0	658.5788	0	71.66531094	0	66.38216196	65.25293928	378	629	1.3	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 (0% for Diabetic Supplies)	20% Coinsurance	$50/visit waived if admitted to hospital	$225 per visit;colonoscopies $0	$0 Copay	"MRI,CT,PET $150/procedure, Radiation Therapy $30/visit"	Partial hospitalizaton 20% coin	$0 Copay	"Pulmonary Rehab $5, OV $0-$30/visit"	Primary Care OV $0-$30/visit	Specialty Care OV $0-$30/visit	"$10 Group Visit, $15 OV"	Therapies=Primary Care OV	$0 Copay	"PA, NP $0-$30"		$0 Copay			$15/visit; $30/specialty visit		$15/visit		$0-$150 copay	$3 copay	$7 Generic copay	$35 Brand copay	20% coinsurance	$0 Copay							96.01	96.01	36.35	0	0.2	0.15	0.2	43.02	210.18	0	124.28	0.2	0	14.61	14.8	27.75	14.02	15	0	15	0	0	0	0	21.59	0	15	0	16.43	0.01	7	35	0.2	0							94.11	94.11	16.05	0	0.18	0.14	0.18	39.4	192.46	0	113.81	0.18	0	13.38	13.55	25.41	12.84	13.74	0	13.74	0	0	0	0	19.77	0	13.74	0	16.43	0.01	7	35	0.2	0							6.9547	0.368144576	0.822647294	0	2.169321726	2.877911967	0.167901193	0.937452191	1.35288883	0	4.767748118	0.162520776	0	0.212374833	5.376199735	10.01236597	0.300636464	0.830696846	0	5.916305839	0	0	0	0	1.085008573	0	0.082056781	0	0.090888243	5.44E-05	0.2205	1.834583333	0.26	0	0	0	0	0	0	0	46.8029	0	4.51	6.9547	0.368144576	0.822647294	0	2.169321726	2.877911967	0.167901193	0.937452191	1.35288883	0	4.767748118	0.162520776	0	0.212374833	5.376199735	10.01236597	0.300636464	0.830696846	0	5.916305839	0	0	0	0	1.085008573	0	0.082056781	0	0.090888243	5.44E-05	0.2205	1.834583333	0.26	0	0	0	0	0	0	0	46.8029	2850																																																																																	0	0	0	6.9547	0.368144576	0.822647294	0	2.169321726	2.877911967	0.167901193	0.937452191	1.35288883	0	4.767748118	0.162520776	0	0.212374833	5.376199735	10.01236597	0.300636464	0.830696846	0	5.916305839	0	0	0	0	1.085008573	0	0.082056781	0	0.090888243	5.44E-05	0.2205	1.834583333	0.26	0	0	0	0	0	0	0	46.8029
H0630_016_0	2009	7	j.	j.	j.	j.							Part B Rx	Part B Rx	Part B Rx	Part B Rx							2350	Generic	Brand	Office Administered	Home Infusions							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	2350	1498.224918	66.2051237	1206.287906	0	20.28264371	41.31114119	0.966911678	407.4732389	95.15131007	0	688.9192356	1.608537937	0	279.5162509	6290.573865	6699.08033	505.1979833	867.1830565	0	7122.485802	0	115.0289089	0	0	748.4058414	0	91.25733133	0	90.61916818	107.067214	630	989	3.08	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 (0% for Diabetic Supplies)	20% Coinsurance	$50/visit waived if admitted to hospital	$150 per visit;colonoscopies $0	$0 Copay	"MRI,CT,PET $125/procedure, Radiation Therapy $25/visit"	Partial hospitalizaton 20% coin	$0 Copay	"Pulmonary Rehab $5, OV $0-$150/visit"	Primary Care OV $0-$30/visit	Specialty Care OV $0-$25/visit	"$10 Group Visit, $15 OV"	Therapies=Primary Care OV	$0 Copay	"PA, NP $0-$25"		$0 Copay			$15/visit; $25/specialty visit		$15/visit		$0-$150 copay	$3 copay	$6 Generic copay	$30 Brand copay	20% coinsurance	$0 Copay							68.14	68.14	36.35	0	0.2	0.16	0.2	42	144.58	0	99.26	0.2	0	14.66	14.93	23.65	14.21	15	0	15	0	0	0	0	19.38	0	15	0	18.4	0.01	6	30	0.2	0							67.34	67.34	15.43	0	0.18	0.15	0.18	37.91	130.51	0	89.6	0.18	0	13.23	13.47	21.35	12.83	13.54	0	13.54	0	0	0	0	17.49	0	13.54	0	18.4	0.01	6	30	0.2	0							8.4075	0.371521086	1.551085199	0	3.650875867	6.196671178	0.174044102	1.287275874	1.03484979	0	5.143930292	0.289536829	0	0.308166667	7.061169164	11.91878042	0.540140844	0.978471549	0	8.036538146	0	0	0	0	1.090801514	0	0.102968689	0	0.138949391	8.92E-05	0.315	2.4725	0.616	0	0	0	0	0	0	0	61.6869	0	7.12	8.4075	0.371521086	1.551085199	0	3.650875867	6.196671178	0.174044102	1.287275874	1.03484979	0	5.143930292	0.289536829	0	0.308166667	7.061169164	11.91878042	0.540140844	0.978471549	0	8.036538146	0	0	0	0	1.090801514	0	0.102968689	0	0.138949391	8.92E-05	0.315	2.4725	0.616	0	0	0	0	0	0	0	61.6869	2350																														"Travel Benefit for certain routine, follow-up and diag care"																																								0.0314											0.0314	0	0	8.4075	0.371521086	1.551085199	0	3.650875867	6.196671178	0.174044102	1.287275874	1.03484979	0	5.143930292	0.289536829	0	0.308166667	7.061169164	11.91878042	0.540140844	0.978471549	0	8.036538146	0	0	0	0	1.090801514	0	0.102968689	0	0.138949391	0.031464845	0.315	2.4725	0.616	0	0	0	0	0	0	0	61.7183
H0630_017_0	2009	8	j.	j.	j.	j.							Part B Rx	Part B Rx	Part B Rx	Part B Rx							3350	Generic	Brand	Office Administered	Home Infusion							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	3350	505.9144071	25.65744079	275.5402417	0	7.104762318	11.19820597	0.457612105	171.9971104	53.70662994	0	299.2014753	0.376244412	0	119.3421653	2981.814977	2855.565365	267.5421418	491.3415873	0	3123.837859	0	46.64711537	0	0	498.853257	0	57.80232042	0	49.14970945	32.77044055	173	297	2.4	0							$210/day days 1-5; $0 days 6-90	$210/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 (0% for Diabetic Supplies)	20% Coinsurance	$50/visit waived if admitted to hospital	$275/visit;colonoscopies $0	$0 Copay	"MRI,CT,PET $225/procedure, Radiation Therapy $35/visit"	Partial hospital-20% Coinsurance	$0 Copay	"Pulmonary Rehab $5, OV $0-$275/visit"	Primary Care OV $0-$30/visit	Specialty Care OV $0-$35/visit	"$10 Group Visit, $20 OV"	Therapies=Primary Care OV	$0 Copay	"PA, NP $0-$35"		$0 Copay			$20/visit; $35/specialty visit		$20/visit		$0-$150 copay	$3 copay	$9 Generic copay	$35 Brand copay	20% coinsurance	$0 Copay							130.08	130.08	36.35	0	0.2	0.2	0.2	45.35	275	0	198.79	0.2	0	19.42	19.63	32.75	17.98	20	0	20	0	0	0	0	26.62	0	20	0	16.32	0.01	9	35	0.2	0							126.1	126.1	16.13	0	0.18	0.18	0.18	40.99	248.6	0	179.71	0.18	0	17.55	17.74	29.61	16.25	18.08	0	18.08	0	0	0	0	24.06	0	18.08	0	16.32	0.01	9	35	0.2	0							5.3163	0.26961694	0.370372008	0	1.278857217	2.015677074	0.082370179	0.587513463	1.11262235	0	4.480791427	0.067723994	0	0.174537917	4.408116475	7.046107539	0.36229665	0.740287992	0	4.706582374	0	0	0	0	1.00020078	0	0.087088829	0	0.066843605	2.73E-05	0.12975	0.86625	0.48	0	0	0	0	0	0	0	35.65	0	3.65	5.3163	0.26961694	0.370372008	0	1.278857217	2.015677074	0.082370179	0.587513463	1.11262235	0	4.480791427	0.067723994	0	0.174537917	4.408116475	7.046107539	0.36229665	0.740287992	0	4.706582374	0	0	0	0	1.00020078	0	0.087088829	0	0.066843605	2.73E-05	0.12975	0.86625	0.48	0	0	0	0	0	0	0	35.65	3350																																																																																	0	0	0	5.3163	0.26961694	0.370372008	0	1.278857217	2.015677074	0.082370179	0.587513463	1.11262235	0	4.480791427	0.067723994	0	0.174537917	4.408116475	7.046107539	0.36229665	0.740287992	0	4.706582374	0	0	0	0	1.00020078	0	0.087088829	0	0.066843605	2.73E-05	0.12975	0.86625	0.48	0	0	0	0	0	0	0	35.65
H0630_018_0	2009	5	j.	j.	j.	j.							Part B Rx	Part B Rx	Part B Rx	Part B Rx							2850	Generic	Brand	Office Administered	Home Infusion							D	D	D		Coin	Coin	Coin	V	V		P	Coin		V	V	V	V	V		V		V	Coin	Coin	V	Coin	V	Coin	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	2850	657.4510609	34.67873728	484.7332919	0	9.685013558	16.41868167	0.739485743	212.6748487	63.14955245	0	374.0540651	0.654163055	0	142.3808341	3310.327566	3275.923513	205.3871334	508.4716568	0	3580.222297	0	64.24289317	0	0	541.368474	0	59.29631562	0	54.44366044	51.8138344	378	629	1.3	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 (0% for Diabetic Supplies)	20% Coinsurance	$50/visit waived if admitted to hospital	$225 per visit;colonoscopies $0	$0 Copay	"MRI,CT,PET $150/procedure, Radiation Therapy $30/visit"	Partial hospitalizaton 20% coin	$0 Copay	"Pulmonary Rehab $5, OV $0-$225/visit"	Primary Care OV $0-$30/visit	Specialty Care OV $0-$30/visit	"$10 Group Visit, $15 OV"	Therapies=Primary Care OV	$0 Copay	"PA, NP $0-$30"		$0 Copay			$15/visit; $30/specialty visit		$15/visit		$0-$150 copay	$3 copay	$8 Generic copay	$35 Brand copay	20% coinsurance	$0 Copay							96.01	96.01	36.35	0	0.2	0.15	0.2	43.02	210.18	0	124.28	0.2	0	14.61	14.8	27.75	14.02	15	0	15	0	0	0	0	21.59	0	15	0	16.43	0.01	8	35	0.2	0							94.11	94.11	16.05	0	0.18	0.14	0.18	39.4	192.46	0	113.81	0.18	0	13.38	13.55	25.41	12.84	13.74	0	13.74	0	0	0	0	19.77	0	13.74	0	16.43	0.01	8	35	0.2	0							5.1561	0.271967997	0.648330778	0	1.74330244	2.298615434	0.133107434	0.69828242	1.012813572	0	3.547591096	0.11774935	0	0.15875463	3.737911543	6.936768039	0.219764233	0.582200047	0	4.09935453	0	0	0	0	0.891904561	0	0.067894281	0	0.074542445	4.32E-05	0.252	1.834583333	0.26	0	0	0	0	0	0	0	34.7435	0	3.34	5.1561	0.271967997	0.648330778	0	1.74330244	2.298615434	0.133107434	0.69828242	1.012813572	0	3.547591096	0.11774935	0	0.15875463	3.737911543	6.936768039	0.219764233	0.582200047	0	4.09935453	0	0	0	0	0.891904561	0	0.067894281	0	0.074542445	4.32E-05	0.252	1.834583333	0.26	0	0	0	0	0	0	0	34.7435	2850																																																																																	0	0	0	5.1561	0.271967997	0.648330778	0	1.74330244	2.298615434	0.133107434	0.69828242	1.012813572	0	3.547591096	0.11774935	0	0.15875463	3.737911543	6.936768039	0.219764233	0.582200047	0	4.09935453	0	0	0	0	0.891904561	0	0.067894281	0	0.074542445	4.32E-05	0.252	1.834583333	0.26	0	0	0	0	0	0	0	34.7435
H0630_805_0	2009	5	j.	j.	j.	j.							Part B Rx	Part B Rx	Part B Rx	Part B Rx							2500	Generic	Brand	Office Administered	Home Infusions							D	D	D		Coin	Coin	Coin	V	V		P	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	2500	845.5799271	39.11292687	544.2302216	0	10.50501495	20.12079399	0.997573592	260.9979025	88.78922245	0	521.449117	0.957327162	0	204.0512489	4509.592182	5203.425899	209.0316945	868.5180372	0	5312.234009	0	75.2570266	0	0	709.0416409	0	103.7048681	0	81.76918309	96.60514865	5.69	13.34	1.16	0							"$250/day days 1-2, $500 Max"	"$250/day days 1-2, $500 Max"	"$0 days 1-20, $100 /day days 21-100"	$0 Copay	"20% Coinsurance, max $500/trip"	20% Coinsurance; 0% Diabetic Supplies	20% Coinsurance	$50/visit waived if admitted to hospital	$200 per visit;colonoscopies $0	$0 Copay	"MRI,CT,PET $100/procedure, Radiation Therapy $30/visit"	Partial hospitalizaton 20% coin	$0 Copay	"Pulmonary Rehab $5, OV $0-$200/visit"	Primary Care OV $0-$30/visit	Specialty Care OV $0-$30/visit	"$10 Group Visit, $20 OV"	Therapies=Primary Care OV	$0 Copay	"PA, NP $0-$30"		$0 Copay			"$20/routine visit, $30/specialty"		$20/routine visit/test		$0-$150 copay	$3 copay	25% Generic copay	25% Brand copay	20% coinsurance	$0 Copay							84.41	84.41	36.35	0	0.2	0.2	0.2	44	200	0	99.33	0.2	0	19.37	19.6	28.18	17.75	20	0	20	0	0	0	0	24.41	0	20	0	18.31	0.01	0.25	0.25	0.2	0							83.41	83.41	15.95	0	0.18	0.18	0.18	39.49	179.52	0	89.16	0.18	0	17.38	17.59	25.29	15.93	17.95	0	17.95	0	0	0	0	21.91	0	17.95	0	18.31	0.01	0.25	0.25	0.2	0							5.8775	0.271867436	0.72337267	0	1.890902691	3.621742918	0.179563246	0.858900597	1.328286768	0	3.87436694	0.172318889	0	0.295534226	6.61031054	10.96622008	0.277489574	1.299158231	0	7.946216704	0	0	0	0	1.294591863	0	0.155125199	0	0.124766145	8.05E-05	1.4225	3.335	0.232	0	0	0	0	0	0	0	52.7578	0	5.64	5.8775	0.271867436	0.72337267	0	1.890902691	3.621742918	0.179563246	0.858900597	1.328286768	0	3.87436694	0.172318889	0	0.295534226	6.61031054	10.96622008	0.277489574	1.299158231	0	7.946216704	0	0	0	0	1.294591863	0	0.155125199	0	0.124766145	8.05E-05	1.4225	3.335	0.232	0	0	0	0	0	0	0	52.7578	2500																																																																																	0	0	0	5.8775	0.271867436	0.72337267	0	1.890902691	3.621742918	0.179563246	0.858900597	1.328286768	0	3.87436694	0.172318889	0	0.295534226	6.61031054	10.96622008	0.277489574	1.299158231	0	7.946216704	0	0	0	0	1.294591863	0	0.155125199	0	0.124766145	8.05E-05	1.4225	3.335	0.232	0	0	0	0	0	0	0	52.7578
H0630_806_0	2009	5	j.	j.	j.	j.							Part B Rx	Part B Rx	Part B Rx	Part B Rx							2500	Generic	Brand	Office Administered	Home Infusions							D	D	D		Coin	Coin	Coin	V	V		P	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	2500	845.5799271	39.11292687	544.2302216	0	10.50501495	20.12079399	0.997573592	260.9979025	88.78922245	0	521.449117	0.957327162	0	204.0512489	4509.592182	5203.425899	209.0316945	868.5180372	0	5312.234009	0	75.2570266	0	0	709.0416409	0	103.7048681	0	81.76918309	96.60514865	5.69	13.34	1.16	0							"$250/day days 1-2, $500 Max"	"$250/day days 1-2, $500 Max"	"$0 days 1-20, $100 /day days 21-100"	$0 Copay	"20% Coinsurance, max $500/trip"	20% Coinsurance; 0% Diabetic Supplies	20% Coinsurance	$50/visit waived if admitted to hospital	$200 per visit;colonoscopies $0	$0 Copay	"MRI,CT,PET $100/procedure, Radiation Therapy $30/visit"	Partial hospitalizaton 20% coin	$0 Copay	"Pulmonary Rehab $5, OV $0-$200/visit"	Primary Care OV $0-$30/visit	Specialty Care OV $0-$30/visit	"$10 Group Visit, $20 OV"	Therapies=Primary Care OV	$0 Copay	"PA, NP $0-$30"		$0 Copay			"$20/routine visit, $30/specialty"		$20/routine visit/test		$0-$150 copay	$3 copay	25% Generic copay	25% Brand copay	20% coinsurance	$0 Copay							84.41	84.41	36.35	0	0.2	0.2	0.2	44	200	0	99.33	0.2	0	19.37	19.6	28.18	17.75	20	0	20	0	0	0	0	24.41	0	20	0	18.31	0.01	0.25	0.25	0.2	0							83.41	83.41	15.95	0	0.18	0.18	0.18	39.49	179.52	0	89.16	0.18	0	17.38	17.59	25.29	15.93	17.95	0	17.95	0	0	0	0	21.91	0	17.95	0	18.31	0.01	0.25	0.25	0.2	0							5.8775	0.271867436	0.72337267	0	1.890902691	3.621742918	0.179563246	0.858900597	1.328286768	0	3.87436694	0.172318889	0	0.295534226	6.61031054	10.96622008	0.277489574	1.299158231	0	7.946216704	0	0	0	0	1.294591863	0	0.155125199	0	0.124766145	8.05E-05	1.4225	3.335	0.232	0	0	0	0	0	0	0	52.7578	0	5.64	5.8775	0.271867436	0.72337267	0	1.890902691	3.621742918	0.179563246	0.858900597	1.328286768	0	3.87436694	0.172318889	0	0.295534226	6.61031054	10.96622008	0.277489574	1.299158231	0	7.946216704	0	0	0	0	1.294591863	0	0.155125199	0	0.124766145	8.05E-05	1.4225	3.335	0.232	0	0	0	0	0	0	0	52.7578	2500																																																																																	0	0	0	5.8775	0.271867436	0.72337267	0	1.890902691	3.621742918	0.179563246	0.858900597	1.328286768	0	3.87436694	0.172318889	0	0.295534226	6.61031054	10.96622008	0.277489574	1.299158231	0	7.946216704	0	0	0	0	1.294591863	0	0.155125199	0	0.124766145	8.05E-05	1.4225	3.335	0.232	0	0	0	0	0	0	0	52.7578
H0630_807_0	2009	5	j.	j.	j.	j.							Part B Rx	Part B Rx	Part B Rx	Part B Rx							2500	Generic	Brand	Office Administered	Home Infusions							D	D	D		Coin	Coin	Coin	V	V		P	Coin	O	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	2500	845.5799271	39.11292687	544.2302216	0	10.50501495	20.12079399	0.997573592	260.9979025	88.78922245	0	521.449117	0.957327162	0	204.0512489	4509.592182	5203.425899	209.0316945	868.5180372	0	5312.234009	0	75.2570266	0	0	709.0416409	0	103.7048681	0	81.76918309	96.60514865	5.69	13.34	1.16	0							"$250/day days 1-2, $500 Max"	"$250/day days 1-2, $500 Max"	"$0 days 1-20, $100 /day days 21-100"	$0 Copay	"20% Coinsurance, max $500/trip"	20% Coinsurance; 0% Diabetic Supplies	20% Coinsurance	$50/visit waived if admitted to hospital	$200 per visit;colonoscopies $0	$0 Copay	"MRI,CT,PET $100/procedure, Radiation Therapy $30/visit"	Partial hospitalizaton 20% coin	$0 Copay	"Pulmonary Rehab $5, OV $0-$200/visit"	Primary Care OV $0-$30/visit	Specialty Care OV $0-$30/visit	"$10 Group Visit, $20 OV"	Therapies=Primary Care OV	$0 Copay	"PA, NP $0-$30"		$0 Copay			"$20/routine visit, $30/specialty"		$20/routine visit/test		$0-$150 copay	$3 copay	25% Generic copay	25% Brand copay	20% coinsurance	$0 Copay							84.41	84.41	36.35	0	0.2	0.2	0.2	44	200	0	99.33	0.2	0	19.37	19.6	28.18	17.75	20	0	20	0	0	0	0	24.41	0	20	0	18.31	0.01	0.25	0.25	0.2	0							83.41	83.41	15.95	0	0.18	0.18	0.18	39.49	179.52	0	89.16	0.18	0	17.38	17.59	25.29	15.93	17.95	0	17.95	0	0	0	0	21.91	0	17.95	0	18.31	0.01	0.25	0.25	0.2	0							5.8775	0.271867436	0.72337267	0	1.890902691	3.621742918	0.179563246	0.858900597	1.328286768	0	3.87436694	0.172318889	0	0.295534226	6.61031054	10.96622008	0.277489574	1.299158231	0	7.946216704	0	0	0	0	1.294591863	0	0.155125199	0	0.124766145	8.05E-05	1.4225	3.335	0.232	0	0	0	0	0	0	0	52.7578	0	5.64	5.8775	0.271867436	0.72337267	0	1.890902691	3.621742918	0.179563246	0.858900597	1.328286768	0	3.87436694	0.172318889	0	0.295534226	6.61031054	10.96622008	0.277489574	1.299158231	0	7.946216704	0	0	0	0	1.294591863	0	0.155125199	0	0.124766145	8.05E-05	1.4225	3.335	0.232	0	0	0	0	0	0	0	52.7578	2500																																																																																	0	0	0	5.8775	0.271867436	0.72337267	0	1.890902691	3.621742918	0.179563246	0.858900597	1.328286768	0	3.87436694	0.172318889	0	0.295534226	6.61031054	10.96622008	0.277489574	1.299158231	0	7.946216704	0	0	0	0	1.294591863	0	0.155125199	0	0.124766145	8.05E-05	1.4225	3.335	0.232	0	0	0	0	0	0	0	52.7578
H0630_808_0	2009	5	j.	j.	j.	j.							Part B Rx	Part B Rx	Part B Rx	Part B Rx							2500	Generic	Brand	Office Administered	Home Infusions							D	D	D		Coin	Coin	Coin	V	V		P	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	2500	845.5799271	39.11292687	544.2302216	0	10.50501495	20.12079399	0.997573592	260.9979025	88.78922245	0	521.449117	0.957327162	0	204.0512489	4509.592182	5203.425899	209.0316945	868.5180372	0	5312.234009	0	75.2570266	0	0	709.0416409	0	103.7048681	0	81.76918309	96.60514865	5.69	13.34	1.16	0							"$250/day days 1-2, $500 Max"	"$250/day days 1-2, $500 Max"	"$0 days 1-20, $100 /day days 21-100"	$0 Copay	"20% Coinsurance, max $500/trip"	20% Coinsurance; 0% Diabetic Supplies	20% Coinsurance	$50/visit waived if admitted to hospital	$200 per visit;colonoscopies $0	$0 Copay	"MRI,CT,PET $100/procedure, Radiation Therapy $30/visit"	Partial hospitalizaton 20% coin	$0 Copay	"Pulmonary Rehab $5, OV $0-$200/visit"	Primary Care OV $0-$30/visit	Specialty Care OV $0-$30/visit	"$10 Group Visit, $20 OV"	Therapies=Primary Care OV	$0 Copay	"PA, NP $0-$30"		$0 Copay			"$20/routine visit, $30/specialty"		$20/routine visit/test		$0-$150 copay	$3 copay	25% Generic copay	25% Brand copay	20% coinsurance	$0 Copay							84.41	84.41	36.35	0	0.2	0.2	0.2	44	200	0	99.33	0.2	0	19.37	19.6	28.18	17.75	20	0	20	0	0	0	0	24.41	0	20	0	18.31	0.01	0.25	0.25	0.2	0							83.41	83.41	15.95	0	0.18	0.18	0.18	39.49	179.52	0	89.16	0.18	0	17.38	17.59	25.29	15.93	17.95	0	17.95	0	0	0	0	21.91	0	17.95	0	18.31	0.01	0.25	0.25	0.2	0							5.8775	0.271867436	0.72337267	0	1.890902691	3.621742918	0.179563246	0.858900597	1.328286768	0	3.87436694	0.172318889	0	0.295534226	6.61031054	10.96622008	0.277489574	1.299158231	0	7.946216704	0	0	0	0	1.294591863	0	0.155125199	0	0.124766145	8.05E-05	1.4225	3.335	0.232	0	0	0	0	0	0	0	52.7578	0	5.64	5.8775	0.271867436	0.72337267	0	1.890902691	3.621742918	0.179563246	0.858900597	1.328286768	0	3.87436694	0.172318889	0	0.295534226	6.61031054	10.96622008	0.277489574	1.299158231	0	7.946216704	0	0	0	0	1.294591863	0	0.155125199	0	0.124766145	8.05E-05	1.4225	3.335	0.232	0	0	0	0	0	0	0	52.7578	2500																																																																																	0	0	0	5.8775	0.271867436	0.72337267	0	1.890902691	3.621742918	0.179563246	0.858900597	1.328286768	0	3.87436694	0.172318889	0	0.295534226	6.61031054	10.96622008	0.277489574	1.299158231	0	7.946216704	0	0	0	0	1.294591863	0	0.155125199	0	0.124766145	8.05E-05	1.4225	3.335	0.232	0	0	0	0	0	0	0	52.7578
H0630_809_0	2009	5	j.	j.	j.	j.							Part B Rx	Part B Rx	Part B Rx	Part B Rx							2950	Generic	Brand	Office Administered	Home Infusions							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	2950	811.4839623	37.53579272	544.2302216	0	10.50501495	20.12079399	0.997573592	260.9979025	23.02581214	0	12.66121554	0.957327162	0	204.0512489	4606.462675	5089.197433	208.1258905	887.1746621	0	5312.234009	0	75.2570266	0	0	709.0416409	0	103.7048681	0	81.76918309	96.60514865	5.69	13.34	1.16	0							$250/day days 1-3; $750 max	$250/day days 1-3; $750 max	"$0 days 1-20, $100 /day days 21-100"	$0 Copay	"20% Coinsurance, max $500/trip"	20% Coinsurance; 0% Diabetic Supplies	20% Coinsurance	$50/visit waived if admitted to hospital	20% Coinsurance	$0 Copay	"MRI,CT,PET, Nuclear medicine 20% of cost/procedure; colonoscopies 0%"	Partial hospitalizaton 20% coin	$0 Copay	"Pulmonary Rehab $5, OV $0-$25/visit"	Primary Care OV $0-$40/visit	Specialty Care OV $0-$40/visit	"$10 Group Visit, $25 OV"	Therapies=Primary Care OV	$0 Copay	"PA, NP $0-$40"		$0 Copay			"$25/routine visit, $40/specialty"		$25/routine visit/test		$0-$150 copay	$3 copay	25% Generic copay	25% Brand copay	0% coinsurance	$0 Copay							114.79	114.79	36.35	0	0.2	0.2	0.2	44	0.2	0	0.2	0.2	0	24.16	24.43	37.26	21.62	25	0	25	0	0	0	0	31.61	0	25	0	18.31	0.01	0.25	0.25	0	0							112.18	112.18	15.9	0	0.18	0.18	0.18	39.31	0.18	0	0.18	0.18	0	21.58	21.91	33.3	19.32	22.34	0	22.34	0	0	0	0	28.24	0	22.34	0	18.31	0.01	0.25	0.25	0	0							7.586	0.350897102	0.721105044	0	1.890902691	3.621742918	0.179563246	0.854985629	4.144646184	0	2.279018797	0.172318889	0	0.366952163	8.4106331	14.12252288	0.335082684	1.651623496	0	9.889608979	0	0	0	0	1.668611328	0	0.193063896	0	0.124766145	8.05E-05	1.4225	3.335	0	0	0	0	0	0	0	0	63.3216	0	6.91	7.586	0.350897102	0.721105044	0	1.890902691	3.621742918	0.179563246	0.854985629	4.144646184	0	2.279018797	0.172318889	0	0.366952163	8.4106331	14.12252288	0.335082684	1.651623496	0	9.889608979	0	0	0	0	1.668611328	0	0.193063896	0	0.124766145	8.05E-05	1.4225	3.335	0	0	0	0	0	0	0	0	63.3216	2950																																																																																	0	0	0	7.586	0.350897102	0.721105044	0	1.890902691	3.621742918	0.179563246	0.854985629	4.144646184	0	2.279018797	0.172318889	0	0.366952163	8.4106331	14.12252288	0.335082684	1.651623496	0	9.889608979	0	0	0	0	1.668611328	0	0.193063896	0	0.124766145	8.05E-05	1.4225	3.335	0	0	0	0	0	0	0	0	63.3216
H0630_810_0	2009	5	j.	j.	j.	j.							Part B Rx	Part B Rx	Part B Rx	Part B Rx							2950	Generic	Brand	Office Administered	Home Infusions							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	2950	811.4839623	37.53579272	544.2302216	0	10.50501495	20.12079399	0.997573592	260.9979025	23.02581214	0	12.66121554	0.957327162	0	204.0512489	4606.462675	5089.197433	208.1258905	887.1746621	0	5312.234009	0	75.2570266	0	0	709.0416409	0	103.7048681	0	81.76918309	96.60514865	5.69	13.34	1.16	0							$250/day days 1-3; $750 max	$250/day days 1-3; $750 max	"$0 days 1-20, $100 /day days 21-100"	$0 Copay	"20% Coinsurance, max $500/trip"	20% Coinsurance; 0% Diabetic Supplies	20% Coinsurance	$50/visit waived if admitted to hospital	20% Coinsurance	$0 Copay	"MRI,CT,PET, Nuclear medicine 20% of cost/procedure; colonoscopies 0%"	Partial hospitalizaton 20% coin	$0 Copay	"Pulmonary Rehab $5, OV $0-$25/visit"	Primary Care OV $0-$40/visit	Specialty Care OV $0-$40/visit	"$10 Group Visit, $25 OV"	Therapies=Primary Care OV	$0 Copay	"PA, NP $0-$40"		$0 Copay			"$25/routine visit, $40/specialty"		$25/routine visit/test		$0-$150 copay	$3 copay	25% Generic copay	25% Brand copay	0% coinsurance	$0 Copay							114.79	114.79	36.35	0	0.2	0.2	0.2	44	0.2	0	0.2	0.2	0	24.16	24.43	37.26	21.62	25	0	25	0	0	0	0	31.61	0	25	0	18.31	0.01	0.25	0.25	0	0							112.18	112.18	15.9	0	0.18	0.18	0.18	39.31	0.18	0	0.18	0.18	0	21.58	21.91	33.3	19.32	22.34	0	22.34	0	0	0	0	28.24	0	22.34	0	18.31	0.01	0.25	0.25	0	0							7.586	0.350897102	0.721105044	0	1.890902691	3.621742918	0.179563246	0.854985629	4.144646184	0	2.279018797	0.172318889	0	0.366952163	8.4106331	14.12252288	0.335082684	1.651623496	0	9.889608979	0	0	0	0	1.668611328	0	0.193063896	0	0.124766145	8.05E-05	1.4225	3.335	0	0	0	0	0	0	0	0	63.3216	0	6.91	7.586	0.350897102	0.721105044	0	1.890902691	3.621742918	0.179563246	0.854985629	4.144646184	0	2.279018797	0.172318889	0	0.366952163	8.4106331	14.12252288	0.335082684	1.651623496	0	9.889608979	0	0	0	0	1.668611328	0	0.193063896	0	0.124766145	8.05E-05	1.4225	3.335	0	0	0	0	0	0	0	0	63.3216	2950																																																																																	0	0	0	7.586	0.350897102	0.721105044	0	1.890902691	3.621742918	0.179563246	0.854985629	4.144646184	0	2.279018797	0.172318889	0	0.366952163	8.4106331	14.12252288	0.335082684	1.651623496	0	9.889608979	0	0	0	0	1.668611328	0	0.193063896	0	0.124766145	8.05E-05	1.4225	3.335	0	0	0	0	0	0	0	0	63.3216
H0630_811_0	2009	5	j.	j.	j.	j.							Part B Rx	Part B Rx	Part B Rx	Part B Rx							2500	Generic	Brand	Office Administered	Home Infusion							D	D	D		Coin	Coin	Coin	V	V		P	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	2500	831.601093	38.46632553	577.6459572	0	11.15002287	21.35621074	1.05882461	254.4729549	87.45980942	0	508.4128891	0.933393983	0	198.9499677	4221.666003	4683.083309	188.5898364	813.0653332	0	4781.010608	0	79.87780803	0	0	752.5767977	0	110.072347	0	86.78981094	102.5367048	5.69	13.34	1.16	0							"$250/day days 1-2, $500 Max"	"$250/day days 1-2, $500 Max"	"$0 days 1-20, $100 /day days 21-100"	$0 Copay	"20% Coinsurance, max $500/trip"	20% Coinsurance; 0% Diabetic Supplies	20% Coinsurance	$50/visit waived if admitted to hospital	$200 per visit;colonoscopies $0	$0 Copay	"MRI,CT,PET $100/procedure, Radiation Therapy $30/visit"	Partial hospitalizaton 20% coin	$0 Copay	"Pulmonary Rehab $5, OV $0-$200/visit"	Primary Care OV $0-$30/visit	Specialty Care OV $0-$30/visit	"$10 Group Visit, $20 OV"	Therapies=Primary Care OV	$0 Copay	"PA, NP $0-$30"		$0 Copay			"$20/routine visit, $30/specialty"		$20/routine visit/test		$0-$150 copay	$3 copay	25% Generic copay	25% Brand copay	20% coinsurance	$0 Copay							84.41	84.41	36.35	0	0.2	0.2	0.2	44	200	0	99.33	0.2	0	19.37	19.6	28.18	17.75	20	0	20	0	0	0	0	24.41	0	20	0	18.31	0.01	0.25	0.25	0.2	0							83.41	83.41	15.95	0	0.18	0.18	0.18	39.49	179.52	0	89.16	0.18	0	17.38	17.59	25.29	15.93	17.95	0	17.95	0	0	0	0	21.91	0	17.95	0	18.31	0.01	0.25	0.25	0.2	0							5.7803	0.267373018	0.767787751	0	2.007004116	3.844117933	0.19058843	0.837428082	1.308398749	0	3.777507766	0.168010917	0	0.28814587	6.188258749	9.869598074	0.250353008	1.216210228	0	7.151595034	0	0	0	0	1.374079803	0	0.164649886	0	0.132426787	8.54E-05	1.4225	3.335	0.232	0	0	0	0	0	0	0	50.5734	0	5.45	5.7803	0.267373018	0.767787751	0	2.007004116	3.844117933	0.19058843	0.837428082	1.308398749	0	3.777507766	0.168010917	0	0.28814587	6.188258749	9.869598074	0.250353008	1.216210228	0	7.151595034	0	0	0	0	1.374079803	0	0.164649886	0	0.132426787	8.54E-05	1.4225	3.335	0.232	0	0	0	0	0	0	0	50.5734	2500																																																																																	0	0	0	5.7803	0.267373018	0.767787751	0	2.007004116	3.844117933	0.19058843	0.837428082	1.308398749	0	3.777507766	0.168010917	0	0.28814587	6.188258749	9.869598074	0.250353008	1.216210228	0	7.151595034	0	0	0	0	1.374079803	0	0.164649886	0	0.132426787	8.54E-05	1.4225	3.335	0.232	0	0	0	0	0	0	0	50.5734
H0630_812_0	2009	5	j.	j.	j.	j.							Part B Rx	Part B Rx	Part B Rx	Part B Rx							2500	Generic	Brand	Office Administered	Home Infusion							D	D	D		Coin	Coin	Coin	V	V		P	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	2500	831.601093	38.46632553	577.6459572	0	11.15002287	21.35621074	1.05882461	254.4729549	87.45980942	0	508.4128891	0.933393983	0	198.9499677	4221.666003	4683.083309	188.5898364	813.0653332	0	4781.010608	0	79.87780803	0	0	752.5767977	0	110.072347	0	86.78981094	102.5367048	5.69	13.34	1.16	0							"$250/day days 1-2, $500 Max"	"$250/day days 1-2, $500 Max"	"$0 days 1-20, $100 /day days 21-100"	$0 Copay	"20% Coinsurance, max $500/trip"	20% Coinsurance; 0% Diabetic Supplies	20% Coinsurance	$50/visit waived if admitted to hospital	$200 per visit;colonoscopies $0	$0 Copay	"MRI,CT,PET $100/procedure, Radiation Therapy $30/visit"	Partial hospitalizaton 20% coin	$0 Copay	"Pulmonary Rehab $5, OV $0-$200/visit"	Primary Care OV $0-$30/visit	Specialty Care OV $0-$30/visit	"$10 Group Visit, $20 OV"	Therapies=Primary Care OV	$0 Copay	"PA, NP $0-$30"		$0 Copay			"$20/routine visit, $30/specialty"		$20/routine visit/test		$0-$150 copay	$3 copay	25% Generic copay	25% Brand copay	20% coinsurance	$0 Copay							84.41	84.41	36.35	0	0.2	0.2	0.2	44	200	0	99.33	0.2	0	19.37	19.6	28.18	17.75	20	0	20	0	0	0	0	24.41	0	20	0	18.31	0.01	0.25	0.25	0.2	0							83.41	83.41	15.95	0	0.18	0.18	0.18	39.49	179.52	0	89.16	0.18	0	17.38	17.59	25.29	15.93	17.95	0	17.95	0	0	0	0	21.91	0	17.95	0	18.31	0.01	0.25	0.25	0.2	0							5.7803	0.267373018	0.767787751	0	2.007004116	3.844117933	0.19058843	0.837428082	1.308398749	0	3.777507766	0.168010917	0	0.28814587	6.188258749	9.869598074	0.250353008	1.216210228	0	7.151595034	0	0	0	0	1.374079803	0	0.164649886	0	0.132426787	8.54E-05	1.4225	3.335	0.232	0	0	0	0	0	0	0	50.5734	0	5.45	5.7803	0.267373018	0.767787751	0	2.007004116	3.844117933	0.19058843	0.837428082	1.308398749	0	3.777507766	0.168010917	0	0.28814587	6.188258749	9.869598074	0.250353008	1.216210228	0	7.151595034	0	0	0	0	1.374079803	0	0.164649886	0	0.132426787	8.54E-05	1.4225	3.335	0.232	0	0	0	0	0	0	0	50.5734	2500																																																																																	0	0	0	5.7803	0.267373018	0.767787751	0	2.007004116	3.844117933	0.19058843	0.837428082	1.308398749	0	3.777507766	0.168010917	0	0.28814587	6.188258749	9.869598074	0.250353008	1.216210228	0	7.151595034	0	0	0	0	1.374079803	0	0.164649886	0	0.132426787	8.54E-05	1.4225	3.335	0.232	0	0	0	0	0	0	0	50.5734
H0630_813_0	2009	5	j.	j.	j.	j.							Part B Rx	Part B Rx	Part B Rx	Part B Rx							2500	Generic	Brand	Office Administered	Home Infusion							D	D	D		Coin	Coin	Coin	V	V		P	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	2500	831.601093	38.46632553	577.6459572	0	11.15002287	21.35621074	1.05882461	254.4729549	87.45980942	0	508.4128891	0.933393983	0	198.9499677	4221.666003	4683.083309	188.5898364	813.0653332	0	4781.010608	0	79.87780803	0	0	752.5767977	0	110.072347	0	86.78981094	102.5367048	5.69	13.34	1.16	0							"$250/day days 1-2, $500 Max"	"$250/day days 1-2, $500 Max"	"$0 days 1-20, $100 /day days 21-100"	$0 Copay	"20% Coinsurance, max $500/trip"	20% Coinsurance; 0% Diabetic Supplies	20% Coinsurance	$50/visit waived if admitted to hospital	$200 per visit;colonoscopies $0	$0 Copay	"MRI,CT,PET $100/procedure, Radiation Therapy $30/visit"	Partial hospitalizaton 20% coin	$0 Copay	"Pulmonary Rehab $5, OV $0-$200/visit"	Primary Care OV $0-$30/visit	Specialty Care OV $0-$30/visit	"$10 Group Visit, $20 OV"	Therapies=Primary Care OV	$0 Copay	"PA, NP $0-$30"		$0 Copay			"$20/routine visit, $30/specialty"		$20/routine visit/test		$0-$150 copay	$3 copay	25% Generic copay	25% Brand copay	20% coinsurance	$0 Copay							84.41	84.41	36.35	0	0.2	0.2	0.2	44	200	0	99.33	0.2	0	19.37	19.6	28.18	17.75	20	0	20	0	0	0	0	24.41	0	20	0	18.31	0.01	0.25	0.25	0.2	0							83.41	83.41	15.95	0	0.18	0.18	0.18	39.49	179.52	0	89.16	0.18	0	17.38	17.59	25.29	15.93	17.95	0	17.95	0	0	0	0	21.91	0	17.95	0	18.31	0.01	0.25	0.25	0.2	0							5.7803	0.267373018	0.767787751	0	2.007004116	3.844117933	0.19058843	0.837428082	1.308398749	0	3.777507766	0.168010917	0	0.28814587	6.188258749	9.869598074	0.250353008	1.216210228	0	7.151595034	0	0	0	0	1.374079803	0	0.164649886	0	0.132426787	8.54E-05	1.4225	3.335	0.232	0	0	0	0	0	0	0	50.5734	0	5.45	5.7803	0.267373018	0.767787751	0	2.007004116	3.844117933	0.19058843	0.837428082	1.308398749	0	3.777507766	0.168010917	0	0.28814587	6.188258749	9.869598074	0.250353008	1.216210228	0	7.151595034	0	0	0	0	1.374079803	0	0.164649886	0	0.132426787	8.54E-05	1.4225	3.335	0.232	0	0	0	0	0	0	0	50.5734	2500																																																																																	0	0	0	5.7803	0.267373018	0.767787751	0	2.007004116	3.844117933	0.19058843	0.837428082	1.308398749	0	3.777507766	0.168010917	0	0.28814587	6.188258749	9.869598074	0.250353008	1.216210228	0	7.151595034	0	0	0	0	1.374079803	0	0.164649886	0	0.132426787	8.54E-05	1.4225	3.335	0.232	0	0	0	0	0	0	0	50.5734
H0630_814_0	2009	5	j.	j.	j.	j.							Part B Rx	Part B Rx	Part B Rx	Part B Rx							2500	Generic	Brand	Office Administered	Home Infusion							D	D	D		Coin	Coin	Coin	V	V		P	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	2500	831.601093	38.46632553	577.6459572	0	11.15002287	21.35621074	1.05882461	254.4729549	87.45980942	0	508.4128891	0.933393983	0	198.9499677	4221.666003	4683.083309	188.5898364	813.0653332	0	4781.010608	0	79.87780803	0	0	752.5767977	0	110.072347	0	86.78981094	102.5367048	5.69	13.34	1.16	0							"$250/day days 1-2, $500 Max"	"$250/day days 1-2, $500 Max"	"$0 days 1-20, $100 /day days 21-100"	$0 Copay	"20% Coinsurance, max $500/trip"	20% Coinsurance; 0% Diabetic Supplies	20% Coinsurance	$50/visit waived if admitted to hospital	$200 per visit;colonoscopies $0	$0 Copay	"MRI,CT,PET $100/procedure, Radiation Therapy $30/visit"	Partial hospitalizaton 20% coin	$0 Copay	"Pulmonary Rehab $5, OV $0-$200/visit"	Primary Care OV $0-$30/visit	Specialty Care OV $0-$30/visit	"$10 Group Visit, $20 OV"	Therapies=Primary Care OV	$0 Copay	"PA, NP $0-$30"		$0 Copay			"$20/routine visit, $30/specialty"		$20/routine visit/test		$0-$150 copay	$3 copay	25% Generic copay	25% Brand copay	20% coinsurance	$0 Copay							84.41	84.41	36.35	0	0.2	0.2	0.2	44	200	0	99.33	0.2	0	19.37	19.6	28.18	17.75	20	0	20	0	0	0	0	24.41	0	20	0	18.31	0.01	0.25	0.25	0.2	0							83.41	83.41	15.95	0	0.18	0.18	0.18	39.49	179.52	0	89.16	0.18	0	17.38	17.59	25.29	15.93	17.95	0	17.95	0	0	0	0	21.91	0	17.95	0	18.31	0.01	0.25	0.25	0.2	0							5.7803	0.267373018	0.767787751	0	2.007004116	3.844117933	0.19058843	0.837428082	1.308398749	0	3.777507766	0.168010917	0	0.28814587	6.188258749	9.869598074	0.250353008	1.216210228	0	7.151595034	0	0	0	0	1.374079803	0	0.164649886	0	0.132426787	8.54E-05	1.4225	3.335	0.232	0	0	0	0	0	0	0	50.5734	0	5.45	5.7803	0.267373018	0.767787751	0	2.007004116	3.844117933	0.19058843	0.837428082	1.308398749	0	3.777507766	0.168010917	0	0.28814587	6.188258749	9.869598074	0.250353008	1.216210228	0	7.151595034	0	0	0	0	1.374079803	0	0.164649886	0	0.132426787	8.54E-05	1.4225	3.335	0.232	0	0	0	0	0	0	0	50.5734	2500																																																																																	0	0	0	5.7803	0.267373018	0.767787751	0	2.007004116	3.844117933	0.19058843	0.837428082	1.308398749	0	3.777507766	0.168010917	0	0.28814587	6.188258749	9.869598074	0.250353008	1.216210228	0	7.151595034	0	0	0	0	1.374079803	0	0.164649886	0	0.132426787	8.54E-05	1.4225	3.335	0.232	0	0	0	0	0	0	0	50.5734
H0630_815_0	2009	5	j.	j.	j.	j.							Part B Rx	Part B Rx	Part B Rx	Part B Rx							2950	Generic	Brand	Office Administered	Home Infusion							D	D	D	V	Coin	Coin	Coin	V	Coin	O	Coin	Coin	O	V	V	V	V	V	V	V	O	V	T	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	2950	831.601093	38.46632553	577.6459572	0	11.15002287	21.35621074	1.05882461	254.4729549	22.48828968	0	12.34468515	0.933393983	0	198.9499677	4221.666003	4683.083309	188.5898364	813.0653332	0	4781.010608	0	0	0	0	752.5767977	0	110.072347	0	86.78981094	102.5367048	5.69	13.34	1.16	0							$250/day days 1-3; $750 max	$250/day days 1-3; $750 max	"$0 days 1-20, $100 /day days 21-100"	$0 Copay	"20% Coinsurance, max $500/trip"	20% Coinsurance; 0% Diabetic Supplies	20% Coinsurance	$50/visit waived if admitted to hospital	20% Coinsurance	$0 Copay	"MRI,CT,PET, Nuclear medicine 20% of cost/procedure; colonoscopies 0%"	Partial hospitalizaton 20% coin	$0 Copay	"Pulmonary Rehab $5, OV $0-$25/visit"	Primary Care OV $0-$30/visit	Specialty Care OV $0-$40/visit	"$10 Group Visit, $25 OV"	Therapies=Primary Care OV	$0 Copay	"PA, NP $0-$40"		$0 Copay			"$25/routine visit, $40/specialty"		$25/routine visit/test		$0-$150 copay	$3 copay	25% Generic copay	25% Brand copay	0% coinsurance	$0 Copay							114.79	114.79	36.35	0	0.2	0.2	0.2	44	0.2	0	0.2	0.2	0	24.16	24.43	37.26	21.62	25	0	25	0	0	0	0	31.61	0	25	0	18.31	0.01	0.25	0.25	0	0							112.18	112.18	15.9	0	0.18	0.18	0.18	39.31	0.18	0	0.18	0.18	0	21.58	21.91	33.3	19.32	22.34	0	22.34	0	0	0	0	28.24	0	22.34	0	18.31	0.01	0.25	0.25	0	0							7.7741	0.359596033	0.765380893	0	2.007004116	3.844117933	0.19058843	0.833610988	4.047892143	0	2.222043328	0.168010917	0	0.357778359	7.70805851	12.99555618	0.303629637	1.513656629	0	8.900648081	0	0	0	0	1.771064064	0	0.204918019	0	0.132426787	8.54E-05	1.4225	3.335	0	0	0	0	0	0	0	0	60.8577	0	6.65	7.7741	0.359596033	0.765380893	0	2.007004116	3.844117933	0.19058843	0.833610988	4.047892143	0	2.222043328	0.168010917	0	0.357778359	7.70805851	12.99555618	0.303629637	1.513656629	0	8.900648081	0	0	0	0	1.771064064	0	0.204918019	0	0.132426787	8.54E-05	1.4225	3.335	0	0	0	0	0	0	0	0	60.8577	2950																																																																																	0	0	0	7.7741	0.359596033	0.765380893	0	2.007004116	3.844117933	0.19058843	0.833610988	4.047892143	0	2.222043328	0.168010917	0	0.357778359	7.70805851	12.99555618	0.303629637	1.513656629	0	8.900648081	0	0	0	0	1.771064064	0	0.204918019	0	0.132426787	8.54E-05	1.4225	3.335	0	0	0	0	0	0	0	0	60.8577
H0630_816_0	2009	5	j.	j.	j.	j.							Part B Rx	Part B Rx	Part B Rx	Part B Rx							2950	Generic	Brand	Office Administered	Home Infusion							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	2950	831.601093	38.46632553	577.6459572	0	11.15002287	21.35621074	1.05882461	254.4729549	22.48828968	0	12.34468515	0.933393983	0	198.9499677	4221.666003	4683.083309	188.5898364	813.0653332	0	4781.010608	0	79.87780803	0	0	752.5767977	0	110.072347	0	86.78981094	102.5367048	5.69	13.34	1.16	0							$250/day days 1-3; $750 max	$250/day days 1-3; $750 max	"$0 days 1-20, $100 /day days 21-100"	$0 Copay	"20% Coinsurance, max $500/trip"	20% Coinsurance; 0% Diabetic Supplies	20% Coinsurance	$50/visit waived if admitted to hospital	20% Coinsurance	$0 Copay	"MRI,CT,PET, Nuclear medicine 20% of cost/procedure; colonoscopies 0%"	Partial hospitalizaton 20% coin	$0 Copay	"Pulmonary Rehab $5, OV $0-$25/visit"	Primary Care OV $0-$30/visit	Specialty Care OV $0-$40/visit	"$10 Group Visit, $25 OV"	Therapies=Primary Care OV	$0 Copay	"PA, NP $0-$40"		$0 Copay			"$25/routine visit, $40/specialty"		$25/routine visit/test		$0-$150 copay	$3 copay	25% Generic copay	25% Brand copay	0% coinsurance	$0 Copay							114.79	114.79	36.35	0	0.2	0.2	0.2	44	0.2	0	0.2	0.2	0	24.16	24.43	37.26	21.62	25	0	25	0	0	0	0	31.61	0	25	0	18.31	0.01	0.25	0.25	0	0							112.18	112.18	15.9	0	0.18	0.18	0.18	39.31	0.18	0	0.18	0.18	0	21.58	21.91	33.3	19.32	22.34	0	22.34	0	0	0	0	28.24	0	22.34	0	18.31	0.01	0.25	0.25	0	0							7.7741	0.359596033	0.765380893	0	2.007004116	3.844117933	0.19058843	0.833610988	4.047892143	0	2.222043328	0.168010917	0	0.357778359	7.70805851	12.99555618	0.303629637	1.513656629	0	8.900648081	0	0	0	0	1.771064064	0	0.204918019	0	0.132426787	8.54E-05	1.4225	3.335	0	0	0	0	0	0	0	0	60.8577	0	6.65	7.7741	0.359596033	0.765380893	0	2.007004116	3.844117933	0.19058843	0.833610988	4.047892143	0	2.222043328	0.168010917	0	0.357778359	7.70805851	12.99555618	0.303629637	1.513656629	0	8.900648081	0	0	0	0	1.771064064	0	0.204918019	0	0.132426787	8.54E-05	1.4225	3.335	0	0	0	0	0	0	0	0	60.8577	2950																																																																																	0	0	0	7.7741	0.359596033	0.765380893	0	2.007004116	3.844117933	0.19058843	0.833610988	4.047892143	0	2.222043328	0.168010917	0	0.357778359	7.70805851	12.99555618	0.303629637	1.513656629	0	8.900648081	0	0	0	0	1.771064064	0	0.204918019	0	0.132426787	8.54E-05	1.4225	3.335	0	0	0	0	0	0	0	0	60.8577
H0710_001_0	2009	6																																Coin	Coin	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		379.3335143	20.3385	12487.37513	161.6310346	38.492289	24.87207938	18.61238846	15.62398174	6.685045996	29.00624337	29.23817126	0	0.021523251	5.562168322	2.680423766	167.5542372	67.811	34.3733997	0	0	10.0834551	7.657678428	955.8862172	0	131.3485509	44.37754901	0	0	0	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.066744475	0.067624478	0	0	0.2	0.2	0.2	0.05990432	0.2	0.08	0.153166698	0	0.2	0.2	0	0.198406182	0.2	0	0	0	0.2	0.019204343	0	0	0	0	0	0	0	0											0.066744475	0.067624478	0	0	0.2	0.2	0.2	0.05990432	0.2	0.08	0.153166698	0	0.2	0.2	0	0.198406182	0.2	0	0	0	0.2	0.019204343	0	0	0	0	0	0	0	0											25.3184	1.375380439	0	0	7.6984578	4.974415877	3.722477691	0.935944	1.337009199	2.320499469	4.478314135	0	0.00430465	1.112433664	0	33.2437964	13.5622	0	0	0	2.01669102	0.147060682	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.2474	0	0	25.3184	1.375380439	0	0	7.6984578	4.974415877	3.722477691	0.935944	1.337009199	2.320499469	4.478314135	0	0.00430465	1.112433664	0	33.2437964	13.5622	0	0	0	2.01669102	0.147060682	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.2474		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.918	0.1565	1.1122	0.0345	0.6078	0.3927	0.2939	0.0493	0.1056	0.458	0.4617	0	0.0002	0.0878	0.0423	2.6456	1.0707	0.0043	0	0	0.1592	0.1199	0.0705	0	0.0132	0	0	0	0	0											10.8037	0	0	28.2364	1.531830439	1.112174759	0.034539374	8.306230785	5.36713292	4.016357509	0.985204211	1.442562557	2.778492786	4.939969471	0	0.004531211	1.200257375	0.042322481	35.88938961	14.6329	0.004316047	0	0	2.175903468	0.266923202	0.070500827	0	0.013177558	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.0511
H0710_002_0	2009	4																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		373.1583005	22.224	64.61303168	4930.546867	24.15185671	29.42454918	15.64419061	53.00143373	34.20307692	16.50757258	58.01113257	0	1.877097889	56.46274493	39.62381534	134.13354	13.9175	3.630762482	0	0	26.76189302	10.24511188	1563.128537	0	174.0218876	199.8939723	0	0	20.2	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.067157343	0.068003654	0.178325358	0	0.2	0.2	0.2	0.06014202	0.2	0.08	0.2	0	0.2	0.2	0	0.19978947	0.2	0.2	0	0	0.2	0.005594157	0	0	0	0	0	0	0	0											0.067157343	0.068003654	0.178325358	0	0.2	0.2	0.2	0.06014202	0.2	0.08	0.2	0	0.2	0.2	0	0.19978947	0.2	0.2	0	0	0.2	0.005594157	0	0	0	0	0	0	0	0											25.0603	1.511313216	11.52214202	0	4.830371341	5.884909836	3.128838122	3.187613295	6.840615384	1.320605807	11.60222651	0	0.375419578	11.29254899	0	26.79846885	2.7835	0.726152496	0	0	5.352378604	0.057312762	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.2747	0	0	25.0603	1.511313216	11.52214202	0	4.830371341	5.884909836	3.128838122	3.187613295	6.840615384	1.320605807	11.60222651	0	0.375419578	11.29254899	0	26.79846885	2.7835	0.726152496	0	0	5.352378604	0.057312762	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.2747		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											4.6645	0.2778	1.0202	0.7464	0.3813	0.4646	0.247	0.1679	0.54	0.2606	0.916	0	0.0198	0.8915	0.6256	2.1179	0.2198	0.0573	0	0	0.4226	0.1463	0.0261	0	0.0155	0	0	0	0.003	0											14.2316	0	0	29.7248	1.789113216	12.54234778	0.746351085	5.211716447	6.349507981	3.375851658	3.355492116	7.380663967	1.581251689	12.51819177	0	0.395178503	12.18406601	0.62563919	28.91636685	3.00325	0.783480325	0	0	5.77493481	0.20357651	0.0261	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	136.5063
H0710_003_0	2009	4																					3350											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2029.640582	157.9106745	55.7377491	28666.01926	185.2025442	21.14276055	11.15911789	413.1158079	367.1715276	5755.194115	907.6458065	0	1.23056214	1469.217293	5588.247948	5394.483493	864.2630292	418.983364	0	0	28.43936433	1539.093888	1033.594282	0	311.9178222	316.7219116	0	0	20.2	0											"$200 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$200 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$125 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5); $125 (9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											197.8144229	200	0.177242623	0	100	0.14	0.123694312	49.3069929	125	4.4	46.11407951	0	0.2	118.6796922	3.206051701	25	20	20	0	0	0.2	20.42087874	0	0	0	0	0	0	0	0											140.1632252	141.7118359	0.177242623	0	70.85591793	0.099198285	0.08764474	34.93692242	88.56989741	3.117660389	32.67455433	0	0.141711836	84.09158528	3.206051701	25	20	20	0	0	0.141711836	20.42087874	0	0	0	0	0	0	0	0											23.7067	1.864817631	9.87910486	0	1.093558023	2.097325589	0.978037988	1.202749577	2.710028711	1.495228393	2.471410185	0	0.17438522	10.29573427	1.493017653	11.23850728	1.440438382	0.698305607	0	0	4.03019453	2.61913747	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.4887	0	21.4378	23.7067	1.864817631	9.87910486	0	1.093558023	2.097325589	0.978037988	1.202749577	2.710028711	1.495228393	2.471410185	0	0.17438522	10.29573427	1.493017653	11.23850728	1.440438382	0.698305607	0	0	4.03019453	2.61913747	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.4887		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											4.9552	0.198	0.8801	0.4399	0.2012	0.3338	0.1762	0.0894	0.7442	0.2296	0.8364	0	0.013	0.6456	0.6196	2.3572	0.1416	0.0823	0	0	0.449	0.145	0.0996	0	0.0155	0	0	0	0.003	0											13.6555	0	0	28.6619	2.062817631	10.75917458	0.4398735	1.294784719	2.43115865	1.154234587	1.292199182	3.45423409	1.724866966	3.307833882	0	0.187338506	10.94131169	2.112665751	13.59574086	1.582038382	0.780650181	0	0	4.479237125	2.764151834	0.099553573	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	93.1443
H0712_001_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1562.773474	70.05890222	1401.094456	408.1262821	549.4254271	5.548393594	5.264517173	1015.237203	219.7099794	5126.249216	839.899919	18.52804592	0.074501078	267.1010464	6912.539318	19387.69558	105.7814551	1757.202038	3728.339284	2217.034484	9.569856632	9.781516564	0	526.6666667	516.9089668	118.2857143	23.4	17.82857143	1664	13350											"$175 days 1 - 6, $0 after day 6, unlimited coverage"	"$175 days 1 - 6, $0 after day 6, unlimited coverage"	Medicare FFS Cost Sharing	Copay between $0.00 and $30.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $30.00	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $0.00 and $75.00	Copay between $0.00 and $75.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $50.00, No benefit limit"	$10.00 copayment	"$10.00 copayment, $150 benefit limit,"	$0.00 copayment	"$0.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											86.78278498	71.73894424	35.63	1.621990725	48.97195691	0.2	0.066813131	27.43648624	71.63944457	0	21.029663	45.93614383	0.2	23.90485129	5.553899367	4.325788892	16.74410489	12.67311998	10.51764262	5.979051446	0.2	0	0	50	8.473053955	10	0	0	0	0											83.76668644	69.24568795	34.3916946	1.565619132	47.26995752	0.193049086	0.064491069	26.48294291	69.14964635	0	20.29878607	44.33965282	0.193049086	23.07404841	5.360875972	4.175447951	16.16217069	12.23267112	10.15210645	5.771252073	0.193049086	0	0	50	8.473053955	10	0	0	0	0											10.909	0.404273073	4.015501054	0.053247526	2.164276383	1.07111231	0.339514339	2.240539073	1.266072281	0	1.420745731	0.068460594	0.014382365	0.513591873	3.088105495	6.746026147	0.142471494	1.791272886	3.154208108	1.066255405	1.847452072	0	0	2.194444444	0.36498313	0.098571429	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.9745	0	1.5236	10.909	0.404273073	4.015501054	0.053247526	2.164276383	1.07111231	0.339514339	2.240539073	1.266072281	0	1.420745731	0.068460594	0.014382365	0.513591873	3.088105495	6.746026147	0.142471494	1.791272886	3.154208108	1.066255405	1.847452072	0	0	2.194444444	0.36498313	0.098571429	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.9745	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											5.4529	0.0829	0.4459	0.0593	0.2467	0.1356	0.1278	0	0.4337	0.1193	0.3786	0.0104	0	0.1495	0.1408	1.9411	0.021	0.1603	0.7182	0.3267	0.2232	0.0051	0	0	0	0	0	0	0	0											11.179	0	0	16.3619	0.487142453	4.461382472	0.112580707	2.410994056	1.206739709	0.467279569	2.240539073	1.699781191	0.119324508	1.79934012	0.078827822	0.014382365	0.663092241	3.228946329	8.687107038	0.163448289	1.951609755	3.872437448	1.392933806	2.070650709	0.005105297	0	2.194444444	0.36498313	0.098571429	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1536
H0712_005_0	2009	9																					0											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	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	0	0	0											0		340.9070127	35.03119544	1169.968708	1871.423492	29.53680053	14.53856053	7.455587996	37.65718798	18.40695646	12045.0796	20.74425249	0.841922949	0.011974114	8.177855042	6093.443733	90.56642539	12.59957884	10.47063807	26.68208581	13.61478952	14.70882881	0.178827086	2250	671.25	563.2733751	118.2857143	23.4	17.82857143	1664	10665.78947											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"Copay between $0.00 and $10.00, 20% coinsurance"	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	"Copay between $0.00 and $195.00, No benefit limit"	$10.00 copayment	"$10.00 copayment, $150 benefit limit,"	$0.00 copayment	"$0.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											679.621996	522.4195087	60.32343159	0	0.167378294	0.17	0.17	0.150224272	0.17	0	0.169703011	0.17	0.17	0.17	0	0.087682369	0.17	0.17	0.129644971	0.054920349	0.17	0.17	0	20	7.918062882	10	0	0	0	0											679.621996	522.4195087	60.32343159	0	0.167378294	0.17	0.17	0.150224272	0.17	0	0.169703011	0.17	0.17	0.17	0	0.087682369	0.17	0.17	0.129644971	0.054920349	0.17	0.17	0	20	7.918062882	10	0	0	0	0											19.3073	1.525081659	5.881377277	0	4.943819272	2.47155529	1.267449959	5.657023637	3.129182599	0	3.520362109	0.143126901	0.002035599	1.390235357	0	7.941078732	2.141928403	1.780008473	3.459198234	0.747728991	2.500500898	0.030400605	0	1.11875	0.3716695	0.098571429	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4284	0	0	19.3073	1.525081659	5.881377277	0	4.943819272	2.47155529	1.267449959	5.657023637	3.129182599	0	3.520362109	0.143126901	0.002035599	1.390235357	0	7.941078732	2.141928403	1.780008473	3.459198234	0.747728991	2.500500898	0.030400605	0	1.11875	0.3716695	0.098571429	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4284	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.3073	1.525081659	5.881377277	0	4.943819272	2.47155529	1.267449959	5.657023637	3.129182599	0	3.520362109	0.143126901	0.002035599	1.390235357	0	7.941078732	2.141928403	1.780008473	3.459198234	0.747728991	2.500500898	0.030400605	0	1.11875	0.3716695	0.098571429	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4284
H0712_008_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1381.402581	39.87934003	1146.304427	730.8723935	596.6307505	9.212698415	3.97285787	836.4915921	228.1381736	5172.071675	821.0387535	40.3122524	0.028474616	468.4905256	5799.110981	18646.78599	383.5539366	2598.646352	3423.69756	2230.140117	25.16587829	46.34091665	0	671.25	473.1423303	118.2857143	23.4	17.82857143	1664	15150											"$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	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $20.00	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $195.00, No benefit limit"	$10.00 copayment	"$10.00 copayment, $150 benefit limit,"	$0.00 copayment	"$0.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											83.33301594	66.90632438	33.02	3.238113332	42.84272261	0.2	0.175731961	23.11238481	62.64999962	0	18.43228161	39.37383757	0.2	9.464681754	2.463014982	4.375945941	13.94066567	8.36137718	11.85931438	4.327757942	0.2	0	0	20	8.822115517	10	0	0	0	0											80.18806898	64.38131266	31.77384147	3.11590853	41.22585937	0.192452099	0.169099924	22.24013479	60.2856195	0	17.73665638	37.88788834	0.192452099	9.107489328	2.37006201	4.210799897	13.41455182	8.045822925	11.4117497	4.16443049	0.192452099	0	0	20	8.822115517	10	0	0	0	0											9.231	0.213957022	3.035207927	0.189777627	2.049717951	1.773003143	0.671809963	1.550307147	1.146120927	0	1.213540187	0.127278843	0.00548	0.355564372	1.145354386	6.543157044	0.428767013	1.742354033	3.255864967	0.773938625	4.84322609	0	0	1.11875	0.347843024	0.098571429	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.8606	0	1.5804	9.231	0.213957022	3.035207927	0.189777627	2.049717951	1.773003143	0.671809963	1.550307147	1.146120927	0	1.213540187	0.127278843	0.00548	0.355564372	1.145354386	6.543157044	0.428767013	1.742354033	3.255864967	0.773938625	4.84322609	0	0	1.11875	0.347843024	0.098571429	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.8606	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	9.231	0.213957022	3.035207927	0.189777627	2.049717951	1.773003143	0.671809963	1.550307147	1.146120927	0	1.213540187	0.127278843	0.00548	0.355564372	1.145354386	6.543157044	0.428767013	1.742354033	3.255864967	0.773938625	4.84322609	0	0	1.11875	0.347843024	0.098571429	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.8606
H0712_011_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1492.763915	338.0414091	978.7210105	2119.599723	1217.861341	16.4139002	6.338328203	2727.797949	276.5352755	9113.364788	1227.297011	122.5300973	0.009611479	962.8761156	6466.545702	20282.9721	2666.351753	3419.612952	3890.420678	2017.441511	15.41276763	13.15159973	0	671.25	544.0974381	118.2857143	23.4	17.82857143	1664	11035.71429											"$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	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $10.00	Copay between $5.00 and $10.00	$10.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $195.00, No benefit limit"	$10.00 copayment	"$10.00 copayment, $150 benefit limit,"	$0.00 copayment	"$0.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											47.65874031	26.69733936	34.64	0.648819686	40.81729605	0.2	0.156086844	21.74039147	33.10655837	0	7.65900608	19.68691878	0.2	4.95093328	0	1.89347002	6.216931671	3.93137485	9.17533383	5.14742821	0.2	0	0	20	8.28448996	10	0	0	0	0											47.65874031	26.69733936	34.64	0.648819686	40.81729605	0.2	0.156086844	21.74039147	33.10655837	0	7.65900608	19.68691878	0.2	4.95093328	0	1.89347002	6.216931671	3.93137485	9.17533383	5.14742821	0.2	0	0	20	8.28448996	10	0	0	0	0											5.9286	0.752067185	2.825241317	0.114603169	4.142483909	3.28278004	0.989329645	4.941949604	0.762927603	0	0.783322939	0.201020006	0.001922296	0.397261284	0	3.2004333	1.381377221	1.12031503	2.974659038	0.865386279	3.082553526	0	0	1.11875	0.375630814	0.098571429	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.3412	0	0	5.9286	0.752067185	2.825241317	0.114603169	4.142483909	3.28278004	0.989329645	4.941949604	0.762927603	0	0.783322939	0.201020006	0.001922296	0.397261284	0	3.2004333	1.381377221	1.12031503	2.974659038	0.865386279	3.082553526	0	0	1.11875	0.375630814	0.098571429	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.3412	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											6.0884	0.6058	0.3711	0.4144	0.4635	0.4012	0.1545	0	0.4643	0.2027	0.4935	0.0304	0	0.2511	0.2039	2.0726	0.5193	0.3308	0.596	0.3261	0.3727	0.0064	0	0	0	0	0	0	0	0											14.3688	0	0	12.017	1.357876309	3.196339214	0.528967952	4.605993079	3.684008711	1.14380215	4.941949604	1.227244306	0.202677448	1.276850694	0.231426254	0.001922296	0.648375287	0.203884546	5.273078435	1.900709056	1.451065094	3.570690664	1.191494572	3.455300881	0.006404243	0	1.11875	0.375630814	0.098571429	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.71
H0712_018_0	2009	8																					1500											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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		219.3779655	12.01506168	683.5082465	1802.320785	565.4276937	12.11767222	4.794759971	1164.52602	289.8070845	6655.384146	1159.977167	73.56465934	0.044813116	744.0793338	8435.126893	26159.25916	1240.816796	4739.152887	4341.354437	2780.941407	39.40022657	44.6404375	0	526.6666667	368	118.2857143	23.4	17.82857143	0	0											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	Copay between $0.00 and $25.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $50.00, No benefit limit"	$10.00 copayment	"$10.00 copayment, $150 benefit limit,"	$0.00 copayment	"$0.00 copayment, $350 benefit limit"	Not Covered	Not Covered											0	0	0	0	9.797687705	0.2	0.2	16.78838838	0	0	8.163676951	0	0.2	0	0	0	0	0	9.648588164	4.128081789	0.2	0	0	50	10	10	0	0	0	0											0	0	0	0	9.505085648	0.19402712	0.19402712	16.28701324	0	0	7.919873644	0	0.19402712	0	0	0	0	0	9.360438876	4.004799107	0.19402712	0	0	50	10	10	0	0	0	0											0	0	0	0	0.447869888	2.351157043	0.930313469	1.580554226	0	0	0.765572716	0	0.00869496	0	0	0	0	0	3.386415237	0.928092638	7.644712494	0	0	2.194444444	0.306666667	0.098571429	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.6431	0	0.5554	0	0	0	0	0.447869888	2.351157043	0.930313469	1.580554226	0	0	0.765572716	0	0.00869496	0	0	0	0	0	3.386415237	0.928092638	7.644712494	0	0	2.194444444	0.306666667	0.098571429	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.6431	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											5.6939	0.2041	0.3009	0.52	0.2142	0.2962	0.1172	0	0.6475	0.1613	0.5612	0.0285	0	0.2679	0.1779	3.0503	0.2587	0.3928	0.8738	0.5145	0.9382	0.0266	0	0	0	0	0	0	0	0											15.2457	0	0	5.6939	0.204093434	0.300895285	0.519991896	0.662100642	2.647366808	1.047518713	1.580554226	0.647471306	0.161298324	1.326773394	0.028493654	0.00869496	0.267916413	0.177907831	3.050254722	0.258653632	0.3928163	4.260194003	1.442579067	8.582927695	0.026616586	0	2.194444444	0.306666667	0.098571429	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.8887
H0712_801_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.3911	0.3921	0.1884	0.4176	0.771	0	0.7514	0.0398	0.0002	0.5335	1.049	4.1556	0.2051	0.5039	1.4314	0.2626	0	0	0	0	0	0	0	0	0	0											11.0926		234.4205105	7.118205398	1593.084742	2518.809552	9.415096734	9.438936698	4.536138059	10.05176396	18.56002025	6136.089185	18.08767547	0.958267634	0.004343244	12.84152625	26.09568296	112.0873593	4.937824679	12.12945408	34.45826089	6.321229683	31.88864351	0	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											757.76	757.76	70.95675	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199982205	0.19664667	0.5	0.2	0.2	0.193529502	0.2	0	0	0	0	0	0	0	0	0											757.76	757.76	70.95675	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199982205	0.19664667	0.5	0.2	0.2	0.193529502	0.2	0	0	0	0	0	0	0	0	0											14.8029	0.449490944	9.420009647	0	1.883019347	1.88778734	0.907227612	2.010352792	3.71200405	0	3.617535094	0.191653527	0.000868649	2.568305251	5.218672219	22.04160594	2.468912339	2.425890816	6.891652177	1.22334443	6.377728701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.0989	135	0	14.8029	0.449490944	9.420009647	0	2.274132407	2.279890738	1.095663577	2.427913681	4.48300689	0	4.368916234	0.231460976	0.001049072	3.101755812	6.267712118	26.19715996	2.674034791	2.929761147	8.323084723	1.485934987	6.377728701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.1916		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			14.8029	0.449490944	9.420009647	0	2.274132407	2.279890738	1.095663577	2.427913681	4.48300689	0	4.368916234	0.231460976	0.001049072	3.101755812	6.267712118	26.19715996	2.674034791	2.929761147	8.323084723	1.485934987	6.377728701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.1916
H0712_802_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.3911	0.3921	0.1884	0.4176	0.771	0	0.7514	0.0398	0.0002	0.5335	1.049	4.1556	0.2051	0.5039	1.4314	0.2626	0	0	0	0	0	0	0	0	0	0											11.0926		234.4205105	7.118205398	1593.084742	2518.809552	9.415096734	9.438936698	4.536138059	10.05176396	18.56002025	6136.089185	18.08767547	0.958267634	0.004343244	12.84152625	26.09568296	112.0873593	4.937824679	12.12945408	34.45826089	6.321229683	31.88864351	0	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											757.76	757.76	70.95675	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199982205	0.19664667	0.5	0.2	0.2	0.193529502	0.2	0	0	0	0	0	0	0	0	0											757.76	757.76	70.95675	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199982205	0.19664667	0.5	0.2	0.2	0.193529502	0.2	0	0	0	0	0	0	0	0	0											14.8029	0.449490944	9.420009647	0	1.883019347	1.88778734	0.907227612	2.010352792	3.71200405	0	3.617535094	0.191653527	0.000868649	2.568305251	5.218672219	22.04160594	2.468912339	2.425890816	6.891652177	1.22334443	6.377728701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.0989	135	0	14.8029	0.449490944	9.420009647	0	2.274132407	2.279890738	1.095663577	2.427913681	4.48300689	0	4.368916234	0.231460976	0.001049072	3.101755812	6.267712118	26.19715996	2.674034791	2.929761147	8.323084723	1.485934987	6.377728701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.1916		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			14.8029	0.449490944	9.420009647	0	2.274132407	2.279890738	1.095663577	2.427913681	4.48300689	0	4.368916234	0.231460976	0.001049072	3.101755812	6.267712118	26.19715996	2.674034791	2.929761147	8.323084723	1.485934987	6.377728701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.1916
H0712_803_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.3911	0.3921	0.1884	0.4176	0.771	0	0.7514	0.0398	0.0002	0.5335	1.049	4.1556	0.2051	0.5039	1.4314	0.2626	0	0	0	0	0	0	0	0	0	0											11.0926		234.4205105	7.118205398	1593.084742	2518.809552	9.415096734	9.438936698	4.536138059	10.05176396	18.56002025	6136.089185	18.08767547	0.958267634	0.004343244	12.84152625	26.09568296	112.0873593	4.937824679	12.12945408	34.45826089	6.321229683	31.88864351	0	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											757.76	757.76	70.95675	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199982205	0.19664667	0.5	0.2	0.2	0.193529502	0.2	0	0	0	0	0	0	0	0	0											757.76	757.76	70.95675	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199982205	0.19664667	0.5	0.2	0.2	0.193529502	0.2	0	0	0	0	0	0	0	0	0											14.8029	0.449490944	9.420009647	0	1.883019347	1.88778734	0.907227612	2.010352792	3.71200405	0	3.617535094	0.191653527	0.000868649	2.568305251	5.218672219	22.04160594	2.468912339	2.425890816	6.891652177	1.22334443	6.377728701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.0989	135	0	14.8029	0.449490944	9.420009647	0	2.274132407	2.279890738	1.095663577	2.427913681	4.48300689	0	4.368916234	0.231460976	0.001049072	3.101755812	6.267712118	26.19715996	2.674034791	2.929761147	8.323084723	1.485934987	6.377728701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.1916		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			14.8029	0.449490944	9.420009647	0	2.274132407	2.279890738	1.095663577	2.427913681	4.48300689	0	4.368916234	0.231460976	0.001049072	3.101755812	6.267712118	26.19715996	2.674034791	2.929761147	8.323084723	1.485934987	6.377728701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.1916
H0712_804_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.3911	0.3921	0.1884	0.4176	0.771	0	0.7514	0.0398	0.0002	0.5335	1.049	4.1556	0.2051	0.5039	1.4314	0.2626	0	0	0	0	0	0	0	0	0	0											11.0926		234.4205105	7.118205398	1593.084742	2518.809552	9.415096734	9.438936698	4.536138059	10.05176396	18.56002025	6136.089185	18.08767547	0.958267634	0.004343244	12.84152625	26.09568296	112.0873593	4.937824679	12.12945408	34.45826089	6.321229683	31.88864351	0	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											757.76	757.76	70.95675	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199982205	0.19664667	0.5	0.2	0.2	0.193529502	0.2	0	0	0	0	0	0	0	0	0											757.76	757.76	70.95675	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199982205	0.19664667	0.5	0.2	0.2	0.193529502	0.2	0	0	0	0	0	0	0	0	0											14.8029	0.449490944	9.420009647	0	1.883019347	1.88778734	0.907227612	2.010352792	3.71200405	0	3.617535094	0.191653527	0.000868649	2.568305251	5.218672219	22.04160594	2.468912339	2.425890816	6.891652177	1.22334443	6.377728701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.0989	135	0	14.8029	0.449490944	9.420009647	0	2.274132407	2.279890738	1.095663577	2.427913681	4.48300689	0	4.368916234	0.231460976	0.001049072	3.101755812	6.267712118	26.19715996	2.674034791	2.929761147	8.323084723	1.485934987	6.377728701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.1916		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			14.8029	0.449490944	9.420009647	0	2.274132407	2.279890738	1.095663577	2.427913681	4.48300689	0	4.368916234	0.231460976	0.001049072	3.101755812	6.267712118	26.19715996	2.674034791	2.929761147	8.323084723	1.485934987	6.377728701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.1916
H0747_005_0	2009	4																					900											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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	601.35	10.24	0	0	172.13	13.99	9.86	292.88	0	0	0	0	0	0	4196.51	5039.29	139.52	538.62	0	1226.56	0	558.92	0	0	310.92	0	132.73	0	0	0											PBP: 1A IP Acute: $125 per day (days 1-3)	1B IP Psych: $125 per day (days 1-3)	2 SNF: $0	6 Home Health: $0	10A Ambulance: $100	11A DME: 10%	"11B Prosthetic Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: $5"	"4A ER: $50, 9A 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: $0, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $0"	"7A PCP: $5, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $5, 14D Pelvic Exams: $5, 14E Prostate Screening: $5, 14F Colorectal Screening: $5, 14G Bone Mass Measurement: $5, 14H Mammography: $5, 14I Diabetes Monitoring: $5"	"7B Chiropractic: $5, 7D Physician Specialist (excl. Radiology): $5, 7F Podiatry: $5"	"7E Mental Health: $5, 7H Psychiatric: $5"	"7C Occupational Therapy: $5, 7I Physical and Speech Therapy: $5"	7D Physician Specialist (Radiology): $0	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $5"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 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: $100 limit every two years, Routine: Not Covered"	18A Routine Hearing Exams: $5	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											125	125	0	0	100	0.100000214	0.717234301	48.37612674	0	0	0	0	0	0	5	5	5	5	0	5	0	5	0	0	5	0	5	0	0	0											89.02620736	89.02620736	0	0	71.22096589	0.071221118	0.510821197	34.45394472	0	0	0	0	0	0	3.561048294	3.561048294	3.561048294	3.561048294	0	3.561048294	0	3.561048294	0	0	3.561048294	0	3.561048294	0	0	0											4.4613	0.07596903	0	0	1.021605405	0.996383443	5.036697001	0.840905944	0	0	0	0	0	0	1.245331231	1.495429588	0.041403122	0.159837653	0	0.363986616	0	0.165861759	0	0	0.092266761	0	0.039388162	0	0	0	0	0	0	0	0	0	0	0	0	0	16.0364	0	6.48	4.4613	0.07596903	0	0	1.021605405	0.996383443	5.036697001	0.840905944	0	0	0	0	0	0	1.245331231	1.495429588	0.041403122	0.159837653	0	0.363986616	0	0.165861759	0	0	0.092266761	0	0.039388162	0	0	0	0	0	0	0	0	0	0	0	0	0	16.0364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.4613	0.07596903	0	0	1.021605405	0.996383443	5.036697001	0.840905944	0	0	0	0	0	0	1.245331231	1.495429588	0.041403122	0.159837653	0	0.363986616	0	0.165861759	0	0	0.092266761	0	0.039388162	0	0	0	0	0	0	0	0	0	0	0	0	0	16.0364
H0747_006_0	2009	5																					900											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	Coin	V	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	601.35	10.24	0	0	172.13	13.99	9.86	292.88	0	0	0	0	0	0	4196.51	5039.29	139.52	538.62	0	1226.56	0	558.92	0	46	310.92	0	132.73	0	0	0											PBP: 1A IP Acute: $125 per day (days 1-3)	1B IP Psych: $125 per day (days 1-3)	2 SNF: $0	6 Home Health: $0	10A Ambulance: $100	11A DME: 10%	"11B Prosthetic Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: $5"	"4A ER: $50, 9A 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: $0, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $0"	"7A PCP: $5, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $5, 14D Pelvic Exams: $5, 14E Prostate Screening: $5, 14F Colorectal Screening: $5, 14G Bone Mass Measurement: $5, 14H Mammography: $5, 14I Diabetes Monitoring: $5"	"7B Chiropractic: $5, 7D Physician Specialist (excl. Radiology): $5, 7F Podiatry: $5"	"7E Mental Health: $5, 7H Psychiatric: $5"	"7C Occupational Therapy: $5, 7I Physical and Speech Therapy: $5"	7D Physician Specialist (Radiology): $0	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $5"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 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: $100 limit every two years, Routine: Not Covered"	18A Routine Hearing Exams: $5	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											125	125	0	0	100	0.100000214	0.717234301	48.37612674	0	0	0	0	0	0	5	5	5	5	0	5	0	5	0	0.44499986	5	0	5	0	0	0											106.1568245	106.1568245	0	0	84.92545957	0.084925641	0.609114526	41.08364796	0	0	0	0	0	0	4.246272979	4.246272979	4.246272979	4.246272979	0	4.246272979	0	4.246272979	0	0.377918176	4.246272979	0	4.246272979	0	0	0											5.3198	0.090587157	0	0	1.218184946	1.188109719	6.00586923	1.002714901	0	0	0	0	0	0	1.484960585	1.783183413	0.04937	0.190593963	0	0.434025715	0	0.197777241	0	17.38423611	0.110020933	0	0.046967318	0	0	0	0	0	0	0	0	0	0	0	0	0	36.5064	0	6.48	5.3198	0.090587157	0	0	1.218184946	1.188109719	6.00586923	1.002714901	0	0	0	0	0	0	1.484960585	1.783183413	0.04937	0.190593963	0	0.434025715	0	0.197777241	0	17.38423611	0.110020933	0	0.046967318	0	0	0	0	0	0	0	0	0	0	0	0	0	36.5064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	5.3198	0.090587157	0	0	1.218184946	1.188109719	6.00586923	1.002714901	0	0	0	0	0	0	1.484960585	1.783183413	0.04937	0.190593963	0	0.434025715	0	0.197777241	0	17.38423611	0.110020933	0	0.046967318	0	0	0	0	0	0	0	0	0	0	0	0	0	36.5064
H0747_007_0	2009	5																					900											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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	601.35	10.24	0	0	172.13	13.99	9.86	292.88	0	0	0	0	0	0	4196.51	5039.29	139.52	538.62	0	1226.56	0	558.92	0	0	310.92	0	132.73	0	0	0											PBP: 1A IP Acute: $125 per day (days 1-3)	1B IP Psych: $125 per day (days 1-3)	2 SNF: $0	6 Home Health: $0	10A Ambulance: $100	11A DME: 10%	"11B Prosthetic Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: $5"	"4A ER: $50, 9A 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: $0, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $0"	"7A PCP: $5, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $5, 14D Pelvic Exams: $5, 14E Prostate Screening: $5, 14F Colorectal Screening: $5, 14G Bone Mass Measurement: $5, 14H Mammography: $5, 14I Diabetes Monitoring: $5"	"7B Chiropractic: $5, 7D Physician Specialist (excl. Radiology): $5, 7F Podiatry: $5"	"7E Mental Health: $5, 7H Psychiatric: $5"	"7C Occupational Therapy: $5, 7I Physical and Speech Therapy: $5"	7D Physician Specialist (Radiology): $0	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $5"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 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: $100 limit every two years, Routine: Not Covered"	18A Routine Hearing Exams: $5	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											125	125	0	0	100	0.100000214	0.717234301	48.37612674	0	0	0	0	0	0	5	5	5	5	0	5	0	5	0	0	5	0	5	0	0	0											89.02620736	89.02620736	0	0	71.22096589	0.071221118	0.510821197	34.45394472	0	0	0	0	0	0	3.561048294	3.561048294	3.561048294	3.561048294	0	3.561048294	0	3.561048294	0	0	3.561048294	0	3.561048294	0	0	0											4.4613	0.07596903	0	0	1.021605405	0.996383443	5.036697001	0.840905944	0	0	0	0	0	0	1.245331231	1.495429588	0.041403122	0.159837653	0	0.363986616	0	0.165861759	0	0	0.092266761	0	0.039388162	0	0	0	0	0	0	0	0	0	0	0	0	0	16.0364	0	6.48	4.4613	0.07596903	0	0	1.021605405	0.996383443	5.036697001	0.840905944	0	0	0	0	0	0	1.245331231	1.495429588	0.041403122	0.159837653	0	0.363986616	0	0.165861759	0	0	0.092266761	0	0.039388162	0	0	0	0	0	0	0	0	0	0	0	0	0	16.0364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.4613	0.07596903	0	0	1.021605405	0.996383443	5.036697001	0.840905944	0	0	0	0	0	0	1.245331231	1.495429588	0.041403122	0.159837653	0	0.363986616	0	0.165861759	0	0	0.092266761	0	0.039388162	0	0	0	0	0	0	0	0	0	0	0	0	0	16.0364
H0747_008_0	2009	6																					900											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	Coin	V	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	601.35	10.24	0	0	172.13	13.99	9.86	292.88	0	0	0	0	0	0	4196.51	5039.29	139.52	538.62	0	1226.56	0	558.92	0	46	310.92	0	132.73	0	0	0											PBP: 1A IP Acute: $125 per day (days 1-3)	1B IP Psych: $125 per day (days 1-3)	2 SNF: $0	6 Home Health: $0	10A Ambulance: $100	11A DME: 10%	"11B Prosthetic Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: $5"	"4A ER: $50, 9A 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: $0, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $0"	"7A PCP: $5, 14B Immunizations: $0, 14C Routine Physical Exams: $0, 14D Pap Smears: $5, 14D Pelvic Exams: $5, 14E Prostate Screening: $5, 14F Colorectal Screening: $5, 14G Bone Mass Measurement: $5, 14H Mammography: $5, 14I Diabetes Monitoring: $5"	"7B Chiropractic: $5, 7D Physician Specialist (excl. Radiology): $5, 7F Podiatry: $5"	"7E Mental Health: $5, 7H Psychiatric: $5"	"7C Occupational Therapy: $5, 7I Physical and Speech Therapy: $5"	7D Physician Specialist (Radiology): $0	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $5"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 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: $100 limit every two years, Routine: Not Covered"	18A Routine Hearing Exams: $5	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											125	125	0	0	100	0.100000214	0.717234301	48.37612674	0	0	0	0	0	0	5	5	5	5	0	5	0	5	0	0.44499986	5	0	5	0	0	0											106.1568245	106.1568245	0	0	84.92545957	0.084925641	0.609114526	41.08364796	0	0	0	0	0	0	4.246272979	4.246272979	4.246272979	4.246272979	0	4.246272979	0	4.246272979	0	0.377918176	4.246272979	0	4.246272979	0	0	0											5.3198	0.090587157	0	0	1.218184946	1.188109719	6.00586923	1.002714901	0	0	0	0	0	0	1.484960585	1.783183413	0.04937	0.190593963	0	0.434025715	0	0.197777241	0	17.38423611	0.110020933	0	0.046967318	0	0	0	0	0	0	0	0	0	0	0	0	0	36.5064	0	6.48	5.3198	0.090587157	0	0	1.218184946	1.188109719	6.00586923	1.002714901	0	0	0	0	0	0	1.484960585	1.783183413	0.04937	0.190593963	0	0.434025715	0	0.197777241	0	17.38423611	0.110020933	0	0.046967318	0	0	0	0	0	0	0	0	0	0	0	0	0	36.5064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	5.3198	0.090587157	0	0	1.218184946	1.188109719	6.00586923	1.002714901	0	0	0	0	0	0	1.484960585	1.783183413	0.04937	0.190593963	0	0.434025715	0	0.197777241	0	17.38423611	0.110020933	0	0.046967318	0	0	0	0	0	0	0	0	0	0	0	0	0	36.5064
H0747_009_0	2009	3																					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	O	V											0	0	0	0	0.26	0.4284	0.301	0.0017	1.1548	0.2222	0.6334	0.0553	0.0096	1.0845	0.8358	2.7078	0.0302	0.1102	0.6386	0.8919	0.2821	0.1524	0	0	0	0	0	0	0	0											9.8	0	185.87	3.14	797.92	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											PBP: 1A IP Acute: $952 Medicare deductible per admit (150 day limit)	1B IP Psych: $952 Medicare deductible per admit (150 day limit)	2 SNF: Entire balance	6 Home Health: Entire balance	10A Ambulance: $0	11A DME: $124 deductible +excess over approved allowance	"11B Prosthetic Medical Supplies: $124 deductible +excess over approved allowance, 11C Diabetes Monitoring Supplies: $124 deductible +excess over approved allowance"	"4A ER: $0, 9A Urgent Care: $0"	9B ASC Services: $124 deductible +excess over approved allowance	8A OP C/D/T: $124 deductible +excess over approved allowance	8B OP X-Ray: $124 deductible +excess over approved allowance	9A OP Hospital: $124 deductible +excess over approved allowance	12 Renal Dialysis: $124 deductible +excess over approved allowance	"3 CORF: $0, 5 Partial Hosp: $0, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $0"	"7A PCP: $124 deductible +excess over approved allowance, 14B Immunizations: Not covered, 14C Routine Physical Exams: Not covered, 14D Pap Smears: $124 deductible +excess over approved allowance, 14D Pelvic Exams: $124 deductible +excess over approved allowance, 14E Prostate Screening: $124 deductible +excess over approved allowance, 14F Colorectal Screening: $124 deductible +excess over approved allowance, 14G Bone Mass Measurement: $124 deductible +excess over approved allowance, 14H Mammography: $124 deductible +excess over approved allowance, 14I Diabetes Monitoring: $124 deductible +excess over approved allowance"	"7B Chiropractic: $124 deductible +excess over approved allowance, 7D Physician Specialist (excl. Radiology): $124 deductible +excess over approved allowance, 7F Podiatry: $124 deductible +excess over approved allowance"	"7E Mental Health: $0, 7H Psychiatric: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	7D Physician Specialist (Radiology): $124 deductible +excess over approved allowance	"7G Other Health Care: $124 deductible +excess over approved allowance, 18A Medicare Covered Hearing Exams: Entire balance"	15 Part B Drugs: Entire balance	"13A Blood: Entire balance, 16B Medicare Covered Comprehensive Dental Services: Entire balance, 17A Medicare Covered Eye Exams: Entire balance"	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: Not covered, Routine: $100 limit every two years"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not covered	13B Acupuncture: Not Covered											1064	1064	133	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											1064	1064	133	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											16.4805	0.278413333	8.843613333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.6025	0	0	16.4805	0.278413333	8.843613333	0	0.259991691	0.428375571	0.300997092	0.001744911	1.15484005	0.222185293	0.633402576	0.055255505	0.009597009	1.084461986	0.835812214	2.707810553	0.030245118	0.110220191	0.638637308	0.891940174	0.282093893	0.152388866	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.4025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.4805	0.278413333	8.843613333	0	0.259991691	0.428375571	0.300997092	0.001744911	1.15484005	0.222185293	0.633402576	0.055255505	0.009597009	1.084461986	0.835812214	2.707810553	0.030245118	0.110220191	0.638637308	0.891940174	0.282093893	0.152388866	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.4025
H0747_010_0	2009	4																					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	O	V											0	0	0	0	0.26	0.4284	0.301	0.0017	1.1548	0.2222	0.6334	0.0553	0.0096	1.0845	0.8358	2.7078	0.0302	0.1102	0.6386	0.8919	0.2821	0.1524	0	0	0	0	0	0	0	0											9.8	0	185.87	3.14	797.92	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											PBP: 1A IP Acute: $952 Medicare deductible per admit (150 day limit)	1B IP Psych: $952 Medicare deductible per admit (150 day limit)	2 SNF: Entire balance	6 Home Health: Entire balance	10A Ambulance: $0	11A DME: $124 deductible +excess over approved allowance	"11B Prosthetic Medical Supplies: $124 deductible +excess over approved allowance, 11C Diabetes Monitoring Supplies: $124 deductible +excess over approved allowance"	"4A ER: $0, 9A Urgent Care: $0"	9B ASC Services: $124 deductible +excess over approved allowance	8A OP C/D/T: $124 deductible +excess over approved allowance	8B OP X-Ray: $124 deductible +excess over approved allowance	9A OP Hospital: $124 deductible +excess over approved allowance	12 Renal Dialysis: $124 deductible +excess over approved allowance	"3 CORF: $0, 5 Partial Hosp: $0, 9C OP Substance Abuse: $0, 9D Cardiac Rehab: $0"	"7A PCP: $124 deductible +excess over approved allowance, 14B Immunizations: Not covered, 14C Routine Physical Exams: Not covered, 14D Pap Smears: $124 deductible +excess over approved allowance, 14D Pelvic Exams: $124 deductible +excess over approved allowance, 14E Prostate Screening: $124 deductible +excess over approved allowance, 14F Colorectal Screening: $124 deductible +excess over approved allowance, 14G Bone Mass Measurement: $124 deductible +excess over approved allowance, 14H Mammography: $124 deductible +excess over approved allowance, 14I Diabetes Monitoring: $124 deductible +excess over approved allowance"	"7B Chiropractic: $124 deductible +excess over approved allowance, 7D Physician Specialist (excl. Radiology): $124 deductible +excess over approved allowance, 7F Podiatry: $124 deductible +excess over approved allowance"	"7E Mental Health: $0, 7H Psychiatric: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	7D Physician Specialist (Radiology): $124 deductible +excess over approved allowance	"7G Other Health Care: $124 deductible +excess over approved allowance, 18A Medicare Covered Hearing Exams: Entire balance"	15 Part B Drugs: Entire balance	"13A Blood: Entire balance, 16B Medicare Covered Comprehensive Dental Services: Entire balance, 17A Medicare Covered Eye Exams: Entire balance"	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: Not covered, Routine: $100 limit every two years"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not covered	13B Acupuncture: Not Covered											1064	1064	133	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											1064	1064	133	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											16.4805	0.278413333	8.843613333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.6025	0	0	16.4805	0.278413333	8.843613333	0	0.259991691	0.428375571	0.300997092	0.001744911	1.15484005	0.222185293	0.633402576	0.055255505	0.009597009	1.084461986	0.835812214	2.707810553	0.030245118	0.110220191	0.638637308	0.891940174	0.282093893	0.152388866	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.4025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.4805	0.278413333	8.843613333	0	0.259991691	0.428375571	0.300997092	0.001744911	1.15484005	0.222185293	0.633402576	0.055255505	0.009597009	1.084461986	0.835812214	2.707810553	0.030245118	0.110220191	0.638637308	0.891940174	0.282093893	0.152388866	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.4025
H0747_801_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	211.97	2.55	49.15	42.89	9.15	15.08	10.59	16.26	41.85	8.09	22.75	1.69	0.29	35.76	31.39	98.54	1.07	3.93	21.82	31.36	9.52	5.3	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: Standard Medicare Benefits	1B IP Psych:  Standard Medicare Benefits	2 SNF:  Standard Medicare Benefits	6 Home Health:  Standard Medicare Benefits	10A Ambulance:  Standard Medicare Benefits	11A DME:  Standard Medicare Benefits	"11B Prosthetic Medical Supplies:  Standard Medicare Benefits, 11C Diabetes Monitoring Supplies: Standard Medicare Benefits"	"4A ER:  Standard Medicare Benefits, 4B Urgent Care:  Standard Medicare Benefits"	9B ASC Services:  Standard Medicare Benefits	8A OP C/D/T:  Standard Medicare Benefits	8B OP X-Ray:  Standard Medicare Benefits	9A OP Hospital:  Standard Medicare Benefits	12 Renal Dialysis:  Standard Medicare Benefits	"3 CORF:  Standard Medicare Benefits, 5 Partial Hosp:  Standard Medicare Benefits, 9C OP Substance Abuse:  Standard Medicare Benefits, 9D Cardiac Rehab:  Standard Medicare Benefits"	"7A PCP:  Standard Medicare Benefits, 14B Immunizations:  Standard Medicare Benefits, 14C Routine Physical Exams:  Standard Medicare Benefits, 14D Pap Smears:  Standard Medicare Benefits, 14D Pelvic Exams:  Standard Medicare Benefits, 14E Prostate Screening:  Standard Medicare Benefits, 14F Colorectal Screening:  Standard Medicare Benefits, 14G Bone Mass Measurement:  Standard Medicare Benefits, 14H Mammography:  Standard Medicare Benefits, 14I Diabetes Monitoring:  Standard Medicare Benefits"	"7B Chiropractic:  Standard Medicare Benefits, 7D Physician Specialist (excl. Radiology):  Standard Medicare Benefits, 7F Podiatry:  Standard Medicare Benefits"	"7E Mental Health:  Standard Medicare Benefits, 7H Psychiatric:  Standard Medicare Benefits"	"7C Occupational Therapy:  Standard Medicare Benefits, 7I Physical and Speech Therapy:  Standard Medicare Benefits"	7D Physician Specialist (Radiology):  Standard Medicare Benefits	"7G Other Health Care:  Standard Medicare Benefits, 18A Medicare Covered Hearing Exams:  Standard Medicare Benefits"	15 Part B Drugs:  Standard Medicare Benefits	"13A Blood:  Standard Medicare Benefits, 16B Medicare Covered Comprehensive Dental Services:  Standard Medicare Benefits, 17A Medicare Covered Eye Exams:  Standard Medicare Benefits"	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: Not covered, Routine: Not Covered"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not covered	13B Acupuncture: Not Covered											0.078305063	0.078256648	0.178778904	0	0.23110223	0.23098981	0.231008974	0.231000725	0.230990009	0.23110521	0.231031465	0.230990216	0.23098999	0.230979542	0.230994411	0.230994831	0.230995397	0.231021278	0.23100391	0.230993484	0.230989102	0.230999116	0	0	0	0	0	0	0	0											0.078305063	0.078256648	0.178778904	0	0.23110223	0.23098981	0.231008974	0.231000725	0.230990009	0.23110521	0.231031465	0.230990216	0.23098999	0.230979542	0.230994411	0.230994831	0.230995397	0.231021278	0.23100391	0.230993484	0.230989102	0.230999116	0	0	0	0	0	0	0	0											16.5983	0.199554452	8.786983138	0	2.114585403	3.483326329	2.446385036	3.756071788	9.666931864	1.86964115	5.255965837	0.390373465	0.066987097	8.259828413	7.250914575	22.76223068	0.247165075	0.907913623	5.040505315	7.243955663	2.199016255	1.224295314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.771	0	0	16.5983	0.199554452	8.786983138	0	2.114585403	3.483326329	2.446385036	3.756071788	9.666931864	1.86964115	5.255965837	0.390373465	0.066987097	8.259828413	7.250914575	22.76223068	0.247165075	0.907913623	5.040505315	7.243955663	2.199016255	1.224295314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.771	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.5983	0.199554452	8.786983138	0	2.114585403	3.483326329	2.446385036	3.756071788	9.666931864	1.86964115	5.255965837	0.390373465	0.066987097	8.259828413	7.250914575	22.76223068	0.247165075	0.907913623	5.040505315	7.243955663	2.199016255	1.224295314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.771
H0747_802_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	211.97	2.55	49.15	42.89	9.15	15.08	10.59	16.26	41.85	8.09	22.75	1.69	0.29	35.76	31.39	98.54	1.07	3.93	21.82	31.36	9.52	5.3	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: Standard Medicare Benefits	1B IP Psych:  Standard Medicare Benefits	2 SNF:  Standard Medicare Benefits	6 Home Health:  Standard Medicare Benefits	10A Ambulance:  Standard Medicare Benefits	11A DME:  Standard Medicare Benefits	"11B Prosthetic Medical Supplies:  Standard Medicare Benefits, 11C Diabetes Monitoring Supplies: Standard Medicare Benefits"	"4A ER:  Standard Medicare Benefits, 4B Urgent Care:  Standard Medicare Benefits"	9B ASC Services:  Standard Medicare Benefits	8A OP C/D/T:  Standard Medicare Benefits	8B OP X-Ray:  Standard Medicare Benefits	9A OP Hospital:  Standard Medicare Benefits	12 Renal Dialysis:  Standard Medicare Benefits	"3 CORF:  Standard Medicare Benefits, 5 Partial Hosp:  Standard Medicare Benefits, 9C OP Substance Abuse:  Standard Medicare Benefits, 9D Cardiac Rehab:  Standard Medicare Benefits"	"7A PCP:  Standard Medicare Benefits, 14B Immunizations:  Standard Medicare Benefits, 14C Routine Physical Exams:  Standard Medicare Benefits, 14D Pap Smears:  Standard Medicare Benefits, 14D Pelvic Exams:  Standard Medicare Benefits, 14E Prostate Screening:  Standard Medicare Benefits, 14F Colorectal Screening:  Standard Medicare Benefits, 14G Bone Mass Measurement:  Standard Medicare Benefits, 14H Mammography:  Standard Medicare Benefits, 14I Diabetes Monitoring:  Standard Medicare Benefits"	"7B Chiropractic:  Standard Medicare Benefits, 7D Physician Specialist (excl. Radiology):  Standard Medicare Benefits, 7F Podiatry:  Standard Medicare Benefits"	"7E Mental Health:  Standard Medicare Benefits, 7H Psychiatric:  Standard Medicare Benefits"	"7C Occupational Therapy:  Standard Medicare Benefits, 7I Physical and Speech Therapy:  Standard Medicare Benefits"	7D Physician Specialist (Radiology):  Standard Medicare Benefits	"7G Other Health Care:  Standard Medicare Benefits, 18A Medicare Covered Hearing Exams:  Standard Medicare Benefits"	15 Part B Drugs:  Standard Medicare Benefits	"13A Blood:  Standard Medicare Benefits, 16B Medicare Covered Comprehensive Dental Services:  Standard Medicare Benefits, 17A Medicare Covered Eye Exams:  Standard Medicare Benefits"	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: Not covered, Routine: Not Covered"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not covered	13B Acupuncture: Not Covered											0.078305063	0.078256648	0.178778904	0	0.23110223	0.23098981	0.231008974	0.231000725	0.230990009	0.23110521	0.231031465	0.230990216	0.23098999	0.230979542	0.230994411	0.230994831	0.230995397	0.231021278	0.23100391	0.230993484	0.230989102	0.230999116	0	0	0	0	0	0	0	0											0.078305063	0.078256648	0.178778904	0	0.23110223	0.23098981	0.231008974	0.231000725	0.230990009	0.23110521	0.231031465	0.230990216	0.23098999	0.230979542	0.230994411	0.230994831	0.230995397	0.231021278	0.23100391	0.230993484	0.230989102	0.230999116	0	0	0	0	0	0	0	0											16.5983	0.199554452	8.786983138	0	2.114585403	3.483326329	2.446385036	3.756071788	9.666931864	1.86964115	5.255965837	0.390373465	0.066987097	8.259828413	7.250914575	22.76223068	0.247165075	0.907913623	5.040505315	7.243955663	2.199016255	1.224295314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.771	0	0	16.5983	0.199554452	8.786983138	0	2.114585403	3.483326329	2.446385036	3.756071788	9.666931864	1.86964115	5.255965837	0.390373465	0.066987097	8.259828413	7.250914575	22.76223068	0.247165075	0.907913623	5.040505315	7.243955663	2.199016255	1.224295314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.771	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.5983	0.199554452	8.786983138	0	2.114585403	3.483326329	2.446385036	3.756071788	9.666931864	1.86964115	5.255965837	0.390373465	0.066987097	8.259828413	7.250914575	22.76223068	0.247165075	0.907913623	5.040505315	7.243955663	2.199016255	1.224295314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.771
H0747_804_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	211.97	2.55	49.15	42.89	9.15	15.08	10.59	16.26	41.85	8.09	22.75	1.69	0.29	35.76	31.39	98.54	1.07	3.93	21.82	31.36	9.52	5.3	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: Standard Medicare Benefits	1B IP Psych:  Standard Medicare Benefits	2 SNF:  Standard Medicare Benefits	6 Home Health:  Standard Medicare Benefits	10A Ambulance:  Standard Medicare Benefits	11A DME:  Standard Medicare Benefits	"11B Prosthetic Medical Supplies:  Standard Medicare Benefits, 11C Diabetes Monitoring Supplies: Standard Medicare Benefits"	"4A ER:  Standard Medicare Benefits, 4B Urgent Care:  Standard Medicare Benefits"	9B ASC Services:  Standard Medicare Benefits	8A OP C/D/T:  Standard Medicare Benefits	8B OP X-Ray:  Standard Medicare Benefits	9A OP Hospital:  Standard Medicare Benefits	12 Renal Dialysis:  Standard Medicare Benefits	"3 CORF:  Standard Medicare Benefits, 5 Partial Hosp:  Standard Medicare Benefits, 9C OP Substance Abuse:  Standard Medicare Benefits, 9D Cardiac Rehab:  Standard Medicare Benefits"	"7A PCP:  Standard Medicare Benefits, 14B Immunizations:  Standard Medicare Benefits, 14C Routine Physical Exams:  Standard Medicare Benefits, 14D Pap Smears:  Standard Medicare Benefits, 14D Pelvic Exams:  Standard Medicare Benefits, 14E Prostate Screening:  Standard Medicare Benefits, 14F Colorectal Screening:  Standard Medicare Benefits, 14G Bone Mass Measurement:  Standard Medicare Benefits, 14H Mammography:  Standard Medicare Benefits, 14I Diabetes Monitoring:  Standard Medicare Benefits"	"7B Chiropractic:  Standard Medicare Benefits, 7D Physician Specialist (excl. Radiology):  Standard Medicare Benefits, 7F Podiatry:  Standard Medicare Benefits"	"7E Mental Health:  Standard Medicare Benefits, 7H Psychiatric:  Standard Medicare Benefits"	"7C Occupational Therapy:  Standard Medicare Benefits, 7I Physical and Speech Therapy:  Standard Medicare Benefits"	7D Physician Specialist (Radiology):  Standard Medicare Benefits	"7G Other Health Care:  Standard Medicare Benefits, 18A Medicare Covered Hearing Exams:  Standard Medicare Benefits"	15 Part B Drugs:  Standard Medicare Benefits	"13A Blood:  Standard Medicare Benefits, 16B Medicare Covered Comprehensive Dental Services:  Standard Medicare Benefits, 17A Medicare Covered Eye Exams:  Standard Medicare Benefits"	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: Not covered, Routine: Not Covered"	18A Routine Hearing Exams: Not covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not covered	13B Acupuncture: Not Covered											0.078305063	0.078256648	0.178778904	0	0.23110223	0.23098981	0.231008974	0.231000725	0.230990009	0.23110521	0.231031465	0.230990216	0.23098999	0.230979542	0.230994411	0.230994831	0.230995397	0.231021278	0.23100391	0.230993484	0.230989102	0.230999116	0	0	0	0	0	0	0	0											0.078305063	0.078256648	0.178778904	0	0.23110223	0.23098981	0.231008974	0.231000725	0.230990009	0.23110521	0.231031465	0.230990216	0.23098999	0.230979542	0.230994411	0.230994831	0.230995397	0.231021278	0.23100391	0.230993484	0.230989102	0.230999116	0	0	0	0	0	0	0	0											16.5983	0.199554452	8.786983138	0	2.114585403	3.483326329	2.446385036	3.756071788	9.666931864	1.86964115	5.255965837	0.390373465	0.066987097	8.259828413	7.250914575	22.76223068	0.247165075	0.907913623	5.040505315	7.243955663	2.199016255	1.224295314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.771	0	0	16.5983	0.199554452	8.786983138	0	2.114585403	3.483326329	2.446385036	3.756071788	9.666931864	1.86964115	5.255965837	0.390373465	0.066987097	8.259828413	7.250914575	22.76223068	0.247165075	0.907913623	5.040505315	7.243955663	2.199016255	1.224295314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.771	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.5983	0.199554452	8.786983138	0	2.114585403	3.483326329	2.446385036	3.756071788	9.666931864	1.86964115	5.255965837	0.390373465	0.066987097	8.259828413	7.250914575	22.76223068	0.247165075	0.907913623	5.040505315	7.243955663	2.199016255	1.224295314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.771
H0752_002_0	2009	11																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1468.364579	135.7449408	1463.135699	1184.529818	163.048913	11.94168461	6.812540788	332.9843226	412.3599275	9230.913795	52.01686106	0	0.15082563	510.6379631	6379.30134	4965.253069	630.036364	459.0697793	0	0	30.7804707	1397.96794	0	524.4195685	147.9890135	386.4	18.41008798	9.36	417.323485	0											"$175 Days 1-7 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$175 Days 1-7 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-5/$100 Days 6-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$100 (9b)	$0/$7 (8a1); $7 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); $100 (9a); $40/$40 (9c)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$40 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$25/$0 (18a1); $0 (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a3, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											125.315098	98.22485799	74.33330748	0	150	0.2	0.07903203	49.65090591	100	2.8	0.188390246	0	0.2	35.62771229	3.351158511	25	40	25	0	0	0.2	24.4793963	0	0	0	0	25	0	0	0											125.315098	98.22485799	74.33330748	0	150	0.2	0.07903203	49.65090591	100	2.8	0.188390246	0	0.2	35.62771229	3.351158511	25	40	25	0	0	0.2	24.4793963	0	0	0	0	25	0	0	0											15.334	1.111127294	9.06330965	0	2.038111413	2.388336922	0.538408927	1.377747773	3.436332729	2.153879886	9.799469244	0	0.030165126	1.516071869	1.781504165	10.34427723	2.100121213	0.956395374	0	0	6.15609414	2.851784267	0	0	0	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	73.0155	0	0	15.334	1.111127294	9.06330965	0	2.038111413	2.388336922	0.538408927	1.377747773	3.436332729	2.153879886	9.799469244	0	0.030165126	1.516071869	1.781504165	10.34427723	2.100121213	0.956395374	0	0	6.15609414	2.851784267	0	0	0	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	73.0155																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	15.334	1.111127294	9.06330965	0	2.038111413	2.388336922	0.538408927	1.377747773	3.436332729	2.153879886	9.799469244	0	0.030165126	1.516071869	1.781504165	10.34427723	2.100121213	0.956395374	0	0	6.15609414	2.851784267	0	0	0	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	73.0155
H0752_801_0	2009	6																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1541.782708	142.5321785	1536.292384	1243.756227	171.2013475	12.5387672	7.153166892	349.5805772	48.78545463	9692.458851	54.61769697	0	0.158366891	22.89584239	6423.054534	5208.522054	661.5381389	482.0232367	0	0	32.31949001	1487.196832	0	0	0	0	0	0	0	0											"$175 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$175 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$155 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $60 (5); 20% (9a); $40/$40 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$40 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											141.3723802	117.7704216	154.8190114	0	150	0.2	0.07903203	49.65085304	0.2	2.8	0.188390246	0	0.2	0.196978522	13.02994321	39.8059453	40	40	0	0	0.2	39.17786097	0	0	0	0	0	0	0	0											141.3723802	117.7704216	154.8190114	0	150	0.2	0.07903203	49.65085304	0.2	2.8	0.188390246	0	0.2	0.196978522	13.02994321	39.8059453	40	40	0	0	0.2	39.17786097	0	0	0	0	0	0	0	0											18.1638	1.398839563	19.82060567	0	2.140016844	2.50775344	0.565329299	1.446414489	9.757090925	2.261573732	10.28944136	0	0.031673378	4.509989201	6.97433632	17.277512	2.20512713	1.606744122	0	0	6.463898002	4.855432559	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.2756	0	0	18.1638	1.398839563	19.82060567	0	2.140016844	2.50775344	0.565329299	1.446414489	9.757090925	2.261573732	10.28944136	0	0.031673378	4.509989201	6.97433632	17.277512	2.20512713	1.606744122	0	0	6.463898002	4.855432559	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.2756																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.1638	1.398839563	19.82060567	0	2.140016844	2.50775344	0.565329299	1.446414489	9.757090925	2.261573732	10.28944136	0	0.031673378	4.509989201	6.97433632	17.277512	2.20512713	1.606744122	0	0	6.463898002	4.855432559	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.2756
H0752_802_0	2009	6																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1541.781982	142.5321114	1536.29166	1243.755642	171.2012669	12.53875539	7.153160157	349.5804129	48.78540869	9692.454288	54.61764554	0	0.158366742	22.89582084	6423.051576	5208.519602	661.5378275	482.0230098	0	0	32.31945958	1487.196132	0	0	0	0	0	0	0	0											"$175 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$175 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$155 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $60 (5); 20% (9a); $40/$40 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$40 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											141.3723802	117.7704216	154.8190114	0	150	0.2	0.07903203	49.65085304	0.2	2.8	0.188390246	0	0.2	0.196978524	13.02994308	39.8059449	40	40	0	0	0.2	39.17786097	0	0	0	0	0	0	0	0											141.3723802	117.7704216	154.8190114	0	150	0.2	0.07903203	49.65085304	0.2	2.8	0.188390246	0	0.2	0.196978524	13.02994308	39.8059449	40	40	0	0	0.2	39.17786097	0	0	0	0	0	0	0	0											18.1638	1.398838905	19.82059634	0	2.140015836	2.507751079	0.565328767	1.446413809	9.757081738	2.261572667	10.28943167	0	0.031673348	4.509984991	6.974333036	17.27750369	2.205126092	1.606743366	0	0	6.463891916	4.855430273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.2755	0	0	18.1638	1.398838905	19.82059634	0	2.140015836	2.507751079	0.565328767	1.446413809	9.757081738	2.261572667	10.28943167	0	0.031673348	4.509984991	6.974333036	17.27750369	2.205126092	1.606743366	0	0	6.463891916	4.855430273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.2755																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.1638	1.398838905	19.82059634	0	2.140015836	2.507751079	0.565328767	1.446413809	9.757081738	2.261572667	10.28943167	0	0.031673348	4.509984991	6.974333036	17.27750369	2.205126092	1.606743366	0	0	6.463891916	4.855430273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.2755
H0752_803_0	2009	6																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1541.782513	142.5321605	1536.29219	1243.75607	171.2013259	12.53876404	7.153165088	349.5805332	48.78544232	9692.457629	54.61768319	0	0.158366851	22.89583662	6423.053742	5208.521397	661.5380555	482.0231759	0	0	32.31948186	1487.196644	0	0	0	0	0	0	0	0											"$175 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$175 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$155 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $60 (5); 20% (9a); $40/$40 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$40 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											141.3723802	117.7704216	154.8190114	0	150	0.2	0.07903203	49.65085304	0.2	2.8	0.188390246	0	0.2	0.196978523	13.02994318	39.80594519	40	40	0	0	0.2	39.17786097	0	0	0	0	0	0	0	0											141.3723802	117.7704216	154.8190114	0	150	0.2	0.07903203	49.65085304	0.2	2.8	0.188390246	0	0.2	0.196978523	13.02994318	39.80594519	40	40	0	0	0.2	39.17786097	0	0	0	0	0	0	0	0											18.1638	1.398839387	19.82060317	0	2.140016574	2.507752808	0.565329157	1.446414307	9.757088464	2.261573447	10.28943877	0	0.03167337	4.509988074	6.97433544	17.27750977	2.205126852	1.60674392	0	0	6.463896372	4.855431947	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.2756	0	0	18.1638	1.398839387	19.82060317	0	2.140016574	2.507752808	0.565329157	1.446414307	9.757088464	2.261573447	10.28943877	0	0.03167337	4.509988074	6.97433544	17.27750977	2.205126852	1.60674392	0	0	6.463896372	4.855431947	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.2756																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.1638	1.398839387	19.82060317	0	2.140016574	2.507752808	0.565329157	1.446414307	9.757088464	2.261573447	10.28943877	0	0.03167337	4.509988074	6.97433544	17.27750977	2.205126852	1.60674392	0	0	6.463896372	4.855431947	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.2756
H0752_804_0	2009	6																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1541.780742	142.5319968	1536.290425	1243.754641	171.2011292	12.53873523	7.153148651	349.5801321	48.78533022	9692.446493	54.61755769	0	0.158366487	22.89578401	6423.046523	5208.515413	661.5372955	482.0226221	0	0	32.31940759	1487.194936	0	0	0	0	0	0	0	0											"$175 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$175 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$155 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $60 (5); 20% (9a); $40/$40 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$40 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											141.3723802	117.7704216	154.8190114	0	150	0.2	0.07903203	49.65085304	0.2	2.8	0.188390246	0	0.2	0.196978526	13.02994285	39.80594421	40	40	0	0	0.2	39.17786097	0	0	0	0	0	0	0	0											141.3723802	117.7704216	154.8190114	0	150	0.2	0.07903203	49.65085304	0.2	2.8	0.188390246	0	0.2	0.196978526	13.02994285	39.80594421	40	40	0	0	0.2	39.17786097	0	0	0	0	0	0	0	0											18.1638	1.39883778	19.8205804	0	2.140014115	2.507747045	0.565327858	1.446412647	9.757066044	2.261570848	10.28941512	0	0.031673297	4.509977797	6.974327427	17.2774895	2.205124318	1.606742074	0	0	6.463881519	4.855426369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.2754	0	0	18.1638	1.39883778	19.8205804	0	2.140014115	2.507747045	0.565327858	1.446412647	9.757066044	2.261570848	10.28941512	0	0.031673297	4.509977797	6.974327427	17.2774895	2.205124318	1.606742074	0	0	6.463881519	4.855426369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.2754																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.1638	1.39883778	19.8205804	0	2.140014115	2.507747045	0.565327858	1.446412647	9.757066044	2.261570848	10.28941512	0	0.031673297	4.509977797	6.974327427	17.2774895	2.205124318	1.606742074	0	0	6.463881519	4.855426369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.2754
H0755_001_0	2009	5																					2250											D	D	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	753.6071654	15.27333317	1151.66899	20.55295798	391.6701249	8.569265386	2.822857279	362.2342753	452.3521525	12.06492237	1077.644298	0	0.124941838	501.950259	4078.307244	6230.635996	386.0332791	248.3635138	31.95601136	40.5228304	43.05894696	0	0	0	468.5422944	0	75.55783533	0	0	500											1a:  Acute - $100/$0/day for 1-3/4-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $100/$0/day for 1-3/4-190	2:  Skilled Nursing Services - $0/$50/day for 1-15/16-100/2:  Non-Medicare Covered Stay - $0/$50/day for 1-15/16-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $75/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $10 to $25/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $75/visit/9b:  Ambulatory Surgical Center Services - $75/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $20 to $50/visit/8b:  Outpatient Therapeutic Radiological Services - $20 to $50/visit/8b:  Outpatient X-Ray Services - $20/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $0/visit/3:  Rehab Services (CORF) - $10/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $30/visit/7f:  Podiatry Services - $30/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $10/visit/7i:  Physical/Speech Therapy - $10/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $10 to $20/visit	15:  Medicare Part B Rx Drugs - $0/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $20/visit		18a:  Routine Hearing Test - $20/visit		14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												100	100	50	0	75	0.2	0.051958627	40.82836809	75	0	25.12403525	0	0.2	10	10.00374669	22.59688761	50	10	0	50	0	0	0	0	20	0	20	0	0	0											86.76007751	86.76007751	50	0	65.07005813	0.173520155	0.045079345	35.4227238	65.07005813	0	21.79763246	0	0.173520155	8.676007751	8.67925838	19.6050772	43.38003875	8.676007751	0	43.38003875	0	0	0	0	17.3520155	0	17.3520155	0	0	0											5.4486	0.110426297	4.798620793	0	2.12383315	1.486940258	0.127252556	1.069277057	2.452881738	0	1.957507861	0	0.021679927	0.362910361	2.949723527	10.17934164	1.395511551	0.179566981	0	0.146490163	0	0	0	0	0.677512763	0	0.109256727	0	0	0	0	0	0	0	0	0	0	0	0	0	35.5973	0	4.7	5.4486	0.110426297	4.798620793	0	2.12383315	1.486940258	0.127252556	1.069277057	2.452881738	0	1.957507861	0	0.021679927	0.362910361	2.949723527	10.17934164	1.395511551	0.179566981	0	0.146490163	0	0	0	0	0.677512763	0	0.109256727	0	0	0	0	0	0	0	0	0	0	0	0	0	35.5973																																																																																		0			5.4486	0.110426297	4.798620793	0	2.12383315	1.486940258	0.127252556	1.069277057	2.452881738	0	1.957507861	0	0.021679927	0.362910361	2.949723527	10.17934164	1.395511551	0.179566981	0	0.146490163	0	0	0	0	0.677512763	0	0.109256727	0	0	0	0	0	0	0	0	0	0	0	0	0	35.5973
H0755_020_0	2009	5																					none											D	D	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	755.7919729	21.49621911	612.941221	11.00802023	284.0313096	6.486082274	1.754503059	271.1232986	446.2116231	12.44039604	814.9537717	0	0.160103633	266.5568886	3581.097201	5587.229939	623.6246681	515.3739274	29.6674341	65.46336295	30.41060066	0	0	0	369.4310928	0	74.38795723	0	0	425											1a:  Acute - $150/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $150/$0/day for 1-5/6-190	2:  Skilled Nursing Services - $0/$75/day for 1-15/16-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-15/16-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $75/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $20 to $35/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $20 to $100/visit/8b:  Outpatient Therapeutic Radiological Services - $20 to $100/visit/8b:  Outpatient X-Ray Services - $20/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $0/visit/3:  Rehab Services (CORF) - $15/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $35/visit/7b:  Chiropractic Services - $40/visit/7f:  Podiatry Services - $40/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $15/visit/7i:  Physical/Speech Therapy - $15/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $20 to $35/visit	15:  Medicare Part B Rx Drugs - $0/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $35/visit		18a:  Routine Hearing Test - $35/visit		14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												150	150	75	0	75	0.2	0.019716178	44.66818593	100	0	33.66409401	0	0.2	15	20.00535605	36.35166997	50	15	0	50	0	0	0	0	35	0	35	0	0	0											150	150	75	0	75	0.2	0.019716178	44.66818593	100	0	33.66409401	0	0.2	15	20.00535605	36.35166997	50	15	0	50	0	0	0	0	35	0	35	0	0	0											9.4474	0.268702739	3.830882631	0	1.775195685	1.297216455	0.034592094	1.009215492	3.718430193	0	2.286223365	0	0.032020727	0.333196111	5.970093713	16.92542823	2.598436117	0.644217409	0	0.272764012	0	0	0	0	1.077507354	0	0.216964875	0	0	0	0	0	0	0	0	0	0	0	0	0	51.7385	0	0	9.4474	0.268702739	3.830882631	0	1.775195685	1.297216455	0.034592094	1.009215492	3.718430193	0	2.286223365	0	0.032020727	0.333196111	5.970093713	16.92542823	2.598436117	0.644217409	0	0.272764012	0	0	0	0	1.077507354	0	0.216964875	0	0	0	0	0	0	0	0	0	0	0	0	0	51.7385	none	"1a:  Acute - $1,000 deductible"	1b:  Psych - $0/admit for 1-190	2:  Skilled Nursing Services - 0/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $75/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $35 to $45/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - 20.0%	8a:  Outpatient Diagnostic Procedures/Tests - 20.0%/8a:  Outpatient Lab Services - 20.0%	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - 20.0%/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - $0/day	7a:  Primary Care - $45/visit/17a:  Vision Exams - $45/visit/18a:  Hearing Exams - $45/visit/14c:  Physical Exams (Initial Exam) - $45/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $45/visit/7b:  Chiropractic Services - 20.0%/7f:  Podiatry Services - 20.0%/17a:  Vision Exams - $45/visit/18a:  Hearing Exams - $45/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $0/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $0/visit/7h:  Psychiatric Services - Individual - $0/visit/7h:  Psychiatric Services - Group - $0/visit	7c:  Occupational Therapy Services - 20.0%/7i:  Physical/Speech Therapy - 20.0%	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%	9c:  Outpatient Substance Abuse Svcs - Individual - $0/visit/9c:  Outpatient Substance Abuse Svcs - Group - $0/visit/7g:  Other Health Care Professional Services - 20.0%	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Emergency Svcs - $45/visit/16b:	17a:  Routine Eye Exams - $45/visit		18a:  Routine Hearing Test - $45/visit		14b:  Other Immunizations - $0/visit/14a:  Membership in Health Club/Fitness Classes - $0/service/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $45/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit	0											8.076	0	0	0	0.3171	0.2289	0.0563	0.1832	1.5378	0.4832	1.0537	0	0.0054	0.5632	2.1913	3.4534	0	0.0896	0.1963	0.3787	1.029	0.1094	0	0	0.2315	0	0.0466	0	0.1254	0											20.356	0	0	17.5234	0.268702739	3.830882631	0	2.092278353	1.526070847	0.090917534	1.192383262	5.256217205	0.483236448	3.339970549	0	0.037403014	0.896415363	8.161351964	20.37879511	2.598436117	0.733814004	0.196314952	0.651466472	1.028955972	0.109406268	0	0	1.309051436	0	0.263588161	0	0.125427369	0	0	0	0	0	0	0	0	0	0	0	72.0945
H0755_022_0	2009	4																																D	D	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1288.938294	39.47966106	757.3238793	9.502722754	299.7510193	5.265712483	1.700130147	274.0787504	410.217714	9.81895309	1069.713051	0	0.082628295	430.6140551	2850.82789	4656.66426	592.8243568	222.8044256	20.84289982	62.2301811	17.71827248	0	0	0	375.3694382	0	61.0751081	0	0	500											1a:  Acute - $200/$0/day for 1-/1-90/1a:  Additional Days - $0/day for 91-999; a $2500 in network OOP maximum applies	1b:  Psych - $200/$0/day for 1-/1-190; a $2500 in network OOP maximum applies	2:  Skilled Nursing Services - $0/$75/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $75/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $20 to $30/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $125/visit/9b:  Ambulatory Surgical Center Services - $125/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $20 to $100/visit/8b:  Outpatient Therapeutic Radiological Services - $20 to $100/visit/8b:  Outpatient X-Ray Services - $20/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $0/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $35/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $20 to $30/visit	15:  Medicare Part B Rx Drugs - $0/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $30/visit		18a:  Routine Hearing Test - $30/visit		14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												200	200	75	0	75	0.2	0.2	42.77650898	125	0	33.66409401	0	0.2	30	20.00368265	31.30316612	50	30	0	50	0	0	0	0	30	0	30	0	0	0											173.2614274	173.2614274	75	0	75	0.2	0.2	42.77650898	125	0	33.66409401	0	0.2	30	20.00368265	31.30316612	50	30	0	50	0	0	0	0	30	0	30	0	0	0											18.6103	0.570025202	4.733274245	0	1.873443871	1.053142497	0.340026029	0.97701101	4.273101188	0	3.00091006	0	0.016525659	1.076535138	4.752254699	12.14736124	2.470101487	0.557011064	0	0.259292421	0	0	0	0	0.938423595	0	0.15268777	0	0	0	0	0	0	0	0	0	0	0	0	0	57.8014	0	2.96	18.6103	0.570025202	4.733274245	0	1.873443871	1.053142497	0.340026029	0.97701101	4.273101188	0	3.00091006	0	0.016525659	1.076535138	4.752254699	12.14736124	2.470101487	0.557011064	0	0.259292421	0	0	0	0	0.938423595	0	0.15268777	0	0	0	0	0	0	0	0	0	0	0	0	0	57.8014																																																																																		0			18.6103	0.570025202	4.733274245	0	1.873443871	1.053142497	0.340026029	0.97701101	4.273101188	0	3.00091006	0	0.016525659	1.076535138	4.752254699	12.14736124	2.470101487	0.557011064	0	0.259292421	0	0	0	0	0.938423595	0	0.15268777	0	0	0	0	0	0	0	0	0	0	0	0	0	57.8014
H0755_023_0	2009	2																																D	D	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1271.250528	38.47433709	714.7292093	9.946885428	281.4390282	4.627464956	1.528392744	285.4995381	368.1441695	10.2986178	655.6457512	0	0.108083301	279.6585648	2788.112823	4409.573353	378.4923106	173.7718681	20.98139074	39.73123702	28.59401524	0	0	0	350.9747964	0	53.52744272	0	0	500											1a:  Acute - $100/$0/day for 1-/1-90/1a:  Additional Days - $0/day for 91-999; a $2000 in network OOP Maximum applies	1b:  Psych - $100/$0/day for 1-/1-190; a $2000 in network OOP Maximum applies	2:  Skilled Nursing Services - $0/$75/day for 1-15/16-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-15/16-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $75/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $15 to $25/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $20 to $100/visit/8b:  Outpatient Therapeutic Radiological Services - $20 to $100/visit/8b:  Outpatient X-Ray Services - $20/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $0/visit/3:  Rehab Services (CORF) - $25/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $15/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $25/visit/7b:  Chiropractic Services - $25/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $15 to $25/visit	15:  Medicare Part B Rx Drugs - $0/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $25/visit		18a:  Routine Hearing Test - $25/visit		14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												100	100	75	0	75	0.2	0.2	40.82965981	100	0	33.66409401	0	0.2	25	15.00330014	25	25	25	0	25	0	0	0	0	25	0	25	0	0	0											92.21210479	92.21210479	75	0	75	0.2	0.2	40.82965981	100	0	33.66409401	0	0.2	25	15.00330014	25	25	25	0	25	0	0	0	0	25	0	25	0	0	0											9.7687	0.295649967	4.467057558	0	1.758993926	0.925492991	0.305678549	0.971404085	3.067868079	0	1.839310017	0	0.02161666	0.58262201	3.485907793	9.186611152	0.788525647	0.362024725	0	0.08277341	0	0	0	0	0.731197493	0	0.111515506	0	0	0	0	0	0	0	0	0	0	0	0	0	38.753	0	0.85	9.7687	0.295649967	4.467057558	0	1.758993926	0.925492991	0.305678549	0.971404085	3.067868079	0	1.839310017	0	0.02161666	0.58262201	3.485907793	9.186611152	0.788525647	0.362024725	0	0.08277341	0	0	0	0	0.731197493	0	0.111515506	0	0	0	0	0	0	0	0	0	0	0	0	0	38.753																																																																																		0			9.7687	0.295649967	4.467057558	0	1.758993926	0.925492991	0.305678549	0.971404085	3.067868079	0	1.839310017	0	0.02161666	0.58262201	3.485907793	9.186611152	0.788525647	0.362024725	0	0.08277341	0	0	0	0	0.731197493	0	0.111515506	0	0	0	0	0	0	0	0	0	0	0	0	0	38.753
H0755_027_0	2009	6																					none											D	D	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	791.2984003	16.03722026	1209.250498	21.58087526	411.252632	8.997761399	2.964010929	380.3436184	474.9708121	12.66782306	1131.509048	0	0.131192752	527.0445492	4282.295113	6542.289662	405.3444361	260.7877971	33.55490037	42.54996843	45.21223233	0	0	0	491.9777383	0	93.33772972	0	0	500											1a:  Acute - $100/$0/day for 1-3/4-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $100/$0/day for 1-3/4-190	2:  Skilled Nursing Services - $0/$50/day for 1-15/16-100/2:  Non-Medicare Covered Stay - $0/$50/day for 1-15/16-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $75/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $10 to $25/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $75/visit/9b:  Ambulatory Surgical Center Services - $75/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $20 to $50/visit/8b:  Outpatient Therapeutic Radiological Services - $20 to $50/visit/8b:  Outpatient X-Ray Services - $20/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $0/visit/3:  Rehab Services (CORF) - $10/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $25/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $10/visit/7i:  Physical/Speech Therapy - $10/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $10 to $20/visit	15:  Medicare Part B Rx Drugs - $0/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $20/visit		18a:  Routine Hearing Test - $20/visit		14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												100	100	50	0	75	0.2	0.051958627	40.82836852	75	0	25.12403525	0	0.2	10	10.00374669	21.29845003	50	10	0	50	0	0	0	0	20	0	20	0	0	0											100	100	50	0	75	0.2	0.051958627	40.82836852	75	0	25.12403525	0	0.2	10	10.00374669	21.29845003	50	10	0	50	0	0	0	0	20	0	20	0	0	0											6.5942	0.133643502	5.038543741	0	2.57032895	1.79955228	0.154005937	1.294067451	2.968567576	0	2.369006101	0	0.02623855	0.439203791	3.569916296	11.61171912	1.68893515	0.217323164	0	0.177291535	0	0	0	0	0.819962897	0	0.155562883	0	0	0	0	0	0	0	0	0	0	0	0	0	41.628	0	0	6.5942	0.133643502	5.038543741	0	2.57032895	1.79955228	0.154005937	1.294067451	2.968567576	0	2.369006101	0	0.02623855	0.439203791	3.569916296	11.61171912	1.68893515	0.217323164	0	0.177291535	0	0	0	0	0.819962897	0	0.155562883	0	0	0	0	0	0	0	0	0	0	0	0	0	41.628																																																																																		0			6.5942	0.133643502	5.038543741	0	2.57032895	1.79955228	0.154005937	1.294067451	2.968567576	0	2.369006101	0	0.02623855	0.439203791	3.569916296	11.61171912	1.68893515	0.217323164	0	0.177291535	0	0	0	0	0.819962897	0	0.155562883	0	0	0	0	0	0	0	0	0	0	0	0	0	41.628
H0755_028_0	2009	4																					none											D	D	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	973.5847917	28.30141692	796.9546728	13.31653202	289.4369783	7.17941163	2.159738243	333.1986248	399.6166481	9.736523649	836.429896	0	0.078832258	338.9931577	3273.771998	5104.967967	445.2204278	214.0267559	24.67254695	46.73584601	29.64031097	0	0	0	390.7480593	0	73.01125089	0	0	500											1a:  Acute - $125/$0/day for 1-10/11-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $125/$0/day for 1-10/11-190	2:  Skilled Nursing Services - $0/$75/day for 1-15/16-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-15/16-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $75/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $15 to $25/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $20 to $100/visit/8b:  Outpatient Therapeutic Radiological Services - $20 to $100/visit/8b:  Outpatient X-Ray Services - $20/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $0/visit/3:  Rehab Services (CORF) - $25/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - $15/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $25/visit/7b:  Chiropractic Services - $30/visit/7f:  Podiatry Services - $30/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $15 to $25/visit	15:  Medicare Part B Rx Drugs - $0/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $25/visit		18a:  Routine Hearing Test - $25/visit		14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												125	125	75	0	75	0.2	0.037887625	40.82897253	100	0	33.66409401	0	0.2	25	15.00383361	26.32351214	50	25	0	50	0	0	0	0	25	0	25	0	0	0											125	125	75	0	75	0.2	0.037887625	40.82897253	100	0	33.66409401	0	0.2	25	15.00383361	26.32351214	50	25	0	50	0	0	0	0	25	0	25	0	0	0											10.1415	0.294806426	4.980966705	0	1.808981114	1.435882326	0.081827352	1.133679792	3.330138734	0	2.346471221	0	0.015766452	0.706235745	4.093260862	11.19839052	1.855085116	0.445889075	0	0.194732692	0	0	0	0	0.814058457	0	0.152106773	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0298	0	0	10.1415	0.294806426	4.980966705	0	1.808981114	1.435882326	0.081827352	1.133679792	3.330138734	0	2.346471221	0	0.015766452	0.706235745	4.093260862	11.19839052	1.855085116	0.445889075	0	0.194732692	0	0	0	0	0.814058457	0	0.152106773	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0298																																																																																		0			10.1415	0.294806426	4.980966705	0	1.808981114	1.435882326	0.081827352	1.133679792	3.330138734	0	2.346471221	0	0.015766452	0.706235745	4.093260862	11.19839052	1.855085116	0.445889075	0	0.194732692	0	0	0	0	0.814058457	0	0.152106773	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0298
H0755_801_0	2009	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	261.585999	4.996913158	64.00585689	15.50694562	11.69865094	8.032080268	3.360742758	11.30152468	37.65636632	13.23897639	35.13551267	0	0.169104481	18.94424253	42.60128622	117.558075	4.133968295	1.34180673	33.45256276	21018.85902	40.29713361	4.28469158	0	0	0	0	0	0	0	0											Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share											0.065364781	0.065364781	0.17061814	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.022671693	0.231	0.231	0	0	0	0	0	0	0	0											0.065364781	0.065364781	0.17061814	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.022671693	0.231	0.231	0	0	0	0	0	0	0	0											17.0985	0.326622136	10.92056023	0	2.702388366	1.855410542	0.776331577	2.610652202	8.69862062	3.058203547	8.116303427	0	0.039063135	4.376120023	9.840897117	27.15591532	0.954946676	0.309957355	7.727541998	8.797569019	9.308637865	0.989763755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.664	0	0	17.0985	0.326622136	10.92056023	0	2.702388366	1.855410542	0.776331577	2.610652202	8.69862062	3.058203547	8.116303427	0	0.039063135	4.376120023	9.840897117	27.15591532	0.954946676	0.309957355	7.727541998	8.797569019	9.308637865	0.989763755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.664	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	17.0985	0.326622136	10.92056023	0	2.702388366	1.855410542	0.776331577	2.610652202	8.69862062	3.058203547	8.116303427	0	0.039063135	4.376120023	9.840897117	27.15591532	0.954946676	0.309957355	7.727541998	8.797569019	9.308637865	0.989763755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.664
H0755_803_0	2009	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	312.4172418	5.967910488	76.44343872	18.5202465	13.96832849	9.592869546	4.013800382	13.47088307	44.97373005	15.81156677	41.96302556	0	0.201964768	22.62120058	50.78375422	140.2651733	4.937278667	1.600215599	39.92580503	25069.5769	48.12764974	5.117290414	0	0	0	0	0	0	0	0											Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share											0.065364781	0.065364781	0.17061814	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.02288622	0.231	0.231	0	0	0	0	0	0	0	0											0.065364781	0.065364781	0.17061814	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.02288622	0.231	0.231	0	0	0	0	0	0	0	0											20.4211	0.390091164	13.04263731	0	3.22668388	2.215952865	0.927187888	3.111773989	10.38893164	3.652471924	9.693458904	0	0.046653861	5.225497333	11.73104722	32.40125503	1.140511372	0.369649803	9.222860963	10.49346936	11.11748709	1.182094086	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.0008	0	0	20.4211	0.390091164	13.04263731	0	3.22668388	2.215952865	0.927187888	3.111773989	10.38893164	3.652471924	9.693458904	0	0.046653861	5.225497333	11.73104722	32.40125503	1.140511372	0.369649803	9.222860963	10.49346936	11.11748709	1.182094086	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.0008	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	20.4211	0.390091164	13.04263731	0	3.22668388	2.215952865	0.927187888	3.111773989	10.38893164	3.652471924	9.693458904	0	0.046653861	5.225497333	11.73104722	32.40125503	1.140511372	0.369649803	9.222860963	10.49346936	11.11748709	1.182094086	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.0008
H0755_804_0	2009	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	261.585999	4.996913158	64.00585689	15.50694562	11.69865094	8.032080268	3.360742758	11.30152468	37.65636632	13.23897639	35.13551267	0	0.169104481	18.94424252	42.60128622	117.558075	4.133968295	1.34180673	33.45256276	21018.85902	40.29713361	4.284691579	0	0	0	0	0	0	0	0											Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share											0.065364781	0.065364781	0.17061814	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.022671693	0.231	0.231	0	0	0	0	0	0	0	0											0.065364781	0.065364781	0.17061814	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.022671693	0.231	0.231	0	0	0	0	0	0	0	0											17.0985	0.326622136	10.92056024	0	2.702388366	1.855410542	0.776331577	2.610652202	8.69862062	3.058203547	8.116303427	0	0.039063135	4.376120023	9.840897117	27.15591532	0.954946676	0.309957355	7.727541998	8.797569019	9.308637864	0.989763755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.664	0	0	17.0985	0.326622136	10.92056024	0	2.702388366	1.855410542	0.776331577	2.610652202	8.69862062	3.058203547	8.116303427	0	0.039063135	4.376120023	9.840897117	27.15591532	0.954946676	0.309957355	7.727541998	8.797569019	9.308637864	0.989763755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.664	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	17.0985	0.326622136	10.92056024	0	2.702388366	1.855410542	0.776331577	2.610652202	8.69862062	3.058203547	8.116303427	0	0.039063135	4.376120023	9.840897117	27.15591532	0.954946676	0.309957355	7.727541998	8.797569019	9.308637864	0.989763755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.664
H0755_806_0	2009	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	312.4154802	5.967876836	76.44300763	18.52014206	13.96824972	9.592815456	4.013777751	13.47080711	44.97347646	15.81147762	41.96278894	0	0.201963629	22.62107303	50.78346786	140.2643824	4.937250828	1.600206577	39.9255799	25069.43554	48.12737837	5.117261561	0	0	0	0	0	0	0	0											Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share	Standard Medicare FFS Cost Share											0.065364781	0.065364781	0.17061814	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.022886219	0.231	0.231	0	0	0	0	0	0	0	0											0.065364781	0.065364781	0.17061814	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.022886219	0.231	0.231	0	0	0	0	0	0	0	0											20.421	0.390088964	13.04256376	0	3.226665684	2.21594037	0.92718266	3.111756443	10.38887306	3.65245133	9.693404244	0	0.046653598	5.22546787	11.73098107	32.40107233	1.140504941	0.369647719	9.222808957	10.49341019	11.1174244	1.18208742	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150	0	0	20.421	0.390088964	13.04256376	0	3.226665684	2.21594037	0.92718266	3.111756443	10.38887306	3.65245133	9.693404244	0	0.046653598	5.22546787	11.73098107	32.40107233	1.140504941	0.369647719	9.222808957	10.49341019	11.1174244	1.18208742	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150	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	20.421	0.390088964	13.04256376	0	3.226665684	2.21594037	0.92718266	3.111756443	10.38887306	3.65245133	9.693404244	0	0.046653598	5.22546787	11.73098107	32.40107233	1.140504941	0.369647719	9.222808957	10.49341019	11.1174244	1.18208742	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150
H0768_001_0	2009	6																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	5000	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$150/day 1-7	$150/day 1-7	"$0 1-10, $75 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$25 per visit	$25 X-ray; $150 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$15 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											108.4282617	108.4282617	47.56208437	0	100	0.2	0.2	47.5	150	25	47.5	25	25	25	15	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											86.73028104	86.73028104	38.04425968	0	100	0.15997726	0.15997726	37.99459924	119.982945	19.9971575	37.99459924	19.9971575	19.9971575	19.9971575	15	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											12.4277	0	3.762748969	0	2.003577927	1.109443578	0	0.708880668	3.383027068	1.538603291	13.13545271	0	0.097996986	1.154118146	8.037413413	16.99839126	0	1.232107151	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.5036	0	9.3361	12.4277	0	3.762748969	0	2.003577927	1.109443578	0	0.708880668	3.383027068	1.538603291	13.13545271	0	0.097996986	1.154118146	8.037413413	16.99839126	0	1.232107151	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.5036		$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$100 copay	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$50 copay	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$25 copay	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP				$1000 ded; 30% coinsurance; $5000 max OOP	0	$1000 ded; 30% coinsurance; $5000 max OOP	0	Not Covered												7.109	0	0.8778	0.1331	0.1893	0.209	0	0.1183	0.9546	0.3254	1.3263	0	0.0286	0.2751	0.9717	4.2209	0	0.1251	0	0	0.1888				0.088	0	0.0056		0	0											17.1465	1000	7.964602824	19.5367	0	4.640569422	0.133088109	2.19283852	1.318406615	0	0.827197724	4.337607741	1.86398721	14.46174101	0	0.12655257	1.429221725	9.00912337	21.21925195	0	1.357203692	0	0	1.102945533	0	0	0	0.088041591	0	0.005619921	0	0	0	0	0	0	0	0	0	0	0	0	0	83.6501
H0768_002_0	2009	6																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3500	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$0 	$0 	"$0 1-10, $75 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$15 per visit	$15 X-ray; $150 Complex Radiology	$15 per visit	$15 per visit	$15 per visit	$0 PCP visit; $15 if no PCP selected	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											0	0	47.56208437	0	100	0.2	0.2	47.5	150	15	39.3	15	15	15	0	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											0	0	40.3662528	0	100	0.169741311	0.169741311	40.31356139	127.3059833	12.73059833	33.35416763	12.73059833	12.73059833	12.73059833	0	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											0	0	3.992404567	0	2.003577927	1.177157351	0	0.752146486	3.589506722	0.979506237	11.5311676	0	0.06238688	0.734735152	0	10.19903476	0	0.739264291	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.6751	0	4.0678	0	0	3.992404567	0	2.003577927	1.177157351	0	0.752146486	3.589506722	0.979506237	11.5311676	0	0.06238688	0.734735152	0	10.19903476	0	0.739264291	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.6751		$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$100 copay	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$50 copay	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$15 copay	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP				$1000 ded; 30% coinsurance; $3500 max OOP	0	$1000 ded; 30% coinsurance; $3500 max OOP	0	Not Covered												6.2079	0	0.7665	0.1162	0.1647	0.1825	0	0.1044	0.8336	0.2841	1.1582	0	0.0226	0.2402	0.8485	3.6858	0	0.1092	0	0	0.1648				0.0769	0	0.0049		0	0											14.9712	1000	9.751655717	6.2079	0	4.758953299	0.116217982	2.168312547	1.359632423	0	0.856566603	4.423085618	1.263644787	12.6893368	0	0.084973541	0.974966851	0.848536888	13.88486299	0	0.848503708	0	0	1.079016936	0	0	0	0.076881519	0	0.004907545	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6463
H0768_801_0	2009	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																																																			0	Unlimited	307.298032	0	37.94523898	5.75295335	6.78517128	9.032772426	0	7.984200579	41.26332625	14.06525735	57.33100209	0	3.128488433	11.89180657	42.00376788	182.4536749	0	5.407504589	0	0	8.159991865	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.067175707	0.067175707	0.174831351	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.643	0	6.634017413	0	1.567374566	2.08657043	0	1.844350334	9.531828365	3.249074447	13.24346148	0	0.722680828	2.747007317	9.702870381	42.14679891	0	1.24913356	0	0	1.884958121	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.2531			20.643	0	6.634017413	0	1.567374566	2.08657043	0	1.844350334	9.531828365	3.249074447	13.24346148	0	0.722680828	2.747007317	9.702870381	42.14679891	0	1.24913356	0	0	1.884958121	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.2531		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											2.8149	0	0.9046	0	0.2137	0.2845	0	0.2515	1.2998	0.4431	1.8059	0	0.0985	0.3746	1.3231	5.7473	0	0.1703	0	0	0.257	0	0	0	0	0	0	0	0	0											15.9891	135	0	23.4579	0	7.538656151	0	1.781107461	2.371102762	0	2.095852652	10.83162314	3.692130054	15.04938805	0	0.821228214	3.121599224	11.02598907	47.89408966	0	1.419469954	0	0	2.141997865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.2421
H0768_802_0	2009	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																																																			0	Unlimited	307.298032	0	37.94523898	5.75295335	6.78517128	9.032772426	0	7.984200579	41.26332625	14.06525735	57.33100209	0	3.128488433	11.89180657	42.00376788	182.4536749	0	5.407504589	0	0	8.159991865	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.067175707	0.067175707	0.174831351	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.643	0	6.634017413	0	1.567374566	2.08657043	0	1.844350334	9.531828365	3.249074447	13.24346148	0	0.722680828	2.747007317	9.702870381	42.14679891	0	1.24913356	0	0	1.884958121	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.2531			20.643	0	6.634017413	0	1.567374566	2.08657043	0	1.844350334	9.531828365	3.249074447	13.24346148	0	0.722680828	2.747007317	9.702870381	42.14679891	0	1.24913356	0	0	1.884958121	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.2531		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											2.8149	0	0.9046	0	0.2137	0.2845	0	0.2515	1.2998	0.4431	1.8059	0	0.0985	0.3746	1.3231	5.7473	0	0.1703	0	0	0.257	0	0	0	0	0	0	0	0	0											15.9891	135	0	23.4579	0	7.538656151	0	1.781107461	2.371102762	0	2.095852652	10.83162314	3.692130054	15.04938805	0	0.821228214	3.121599224	11.02598907	47.89408966	0	1.419469954	0	0	2.141997865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.2421
H0806_001_0	2009	5																					1000											D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	V	Coin	Coin	T	V	V	P	V	P	O	V																																																			0	3000	861.4813279	50.93692827	777.7202116		62.137932	9.200219289	15.4841492	265.7418686	318.0252872			6.394500863		666.8870176	2741.060002	3972.450642	259.3185977	740.1330253		4.438091977	17.06898136				133.1901121		237.1062288			98.46											1a: $100/d (1-3) then $0;1a1: $100/d (1-3) then $0	1b: $100/d (1-3) then $0	2: $0/d (1-20) then $75/d (21-100)	6: $0	10a: $50/trip	11a: 10%	11b: 10%;11c: $5/visit	4a: $50/visit;4a1: $50/visit;4b: $20/visit	9a: $50/visit;9b: $50/visit	8a: $0/visit	8b: $0/visit	9a: $50/visit	12a: $0/visit	3: $0/visit;5: $5/visit;9a: $50/visit;9c: $5/visit;9d: $5/visit; 7i: $5/visit; 7c: $5/visit; 7e: $5/visit	7a: $5/visit;14c: $5/visit;14d: $0/visit;14d1: $0/visit;14e: $0/visit;14e1: $0/visit;14f: $0/visit;14f1: $0/visit;14g: $0/visit;14g1: $0/visit	7b: $5/visit;7b1: $5/visit;7d: $5/visit;7f: $5/visit;7f1: $5/visit;16b: 10%;17a: $5/visit;18a: $5/visit	7e: $5/visit;7h: $5/visit	7c: $5/visit;7i: $5/visit	7a: $5; 7d: $5/visit; 8b: $0/visit; 8b: $0/visit; 8b: 0%; 14h: $0/visit	7g: $0/visit;14b: $0/visit;14i: $5/visit;17b: 10%; 7a: $5/visit; 7d: $5/visit; 8a: $0/visit; 12: $0/visit	15: 10%	13a: $0		"16a: $1,000 max"	17a1: $5/visit	17b1: $100/year	18a1: $5/visit			14c1: $5/visit											64.43941214	41.35371861	13.71918452		50	0.1	0.1	44	46.37931312			50		35.18829026	4.999607557	4.998621826	4.980901535	5		5	0.1				5		5			5											52.92884824	33.9668632	11.26857945		41.06869266	0.082137385	0.082137385	36.14044954	38.09475512			41.06869266		28.90274155	4.999607557	4.998621826	4.091182286	5		5	0.082137385				5		5			5											3.7998	0.14418064	0.730316833	0	0.212660303	0.755681957	1.271827529	0.800335883	1.009591287	0	0	0.021884483	0	1.606238593	1.142018692	1.65473154	0.088409971	0.308388761	0	0.001849205	1.402001499	0	0	0	0.05549588	0	0.098794262	0	0	0.041025	0	0	0	0	0	0	0	0	0	0	15.1452	0	2.5755	3.7998	0.14418064	0.730316833	0	0.212660303	0.755681957	1.271827529	0.800335883	1.009591287	0	0	0.021884483	0	1.606238593	1.142018692	1.65473154	0.088409971	0.308388761	0	0.001849205	1.402001499	0	0	0	0.05549588	0	0.098794262	0	0	0.041025	0	0	0	0	0	0	0	0	0	0	15.1452	3000	OON: 20%		OON: 20%	OON: 20%	OON: $50/trip	OON: 20%	OON: 20%	OON: $50/visit;OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%		OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%		"OON: $1,000 max"	OON: 20%	OON: $100/year	OON: 20%			OON: 20%											3.1562		0.4927	0.6442	0.0213	0.1513	0.2547	0.0917	0.6402	0.0838	0.2343	0.0125	0.0009	0.4235	0.3892	1.3813		0.0905	0.3101	0.1556	0.2808				0.0149		0.0208			0.031											8.8816	250	5.281982956	6.956	0.14418064	1.223009147	0.644178834	0.233955504	0.907025668	1.526541959	0.892083993	1.649791814	0.083781964	0.234270801	0.034369504	0.000930057	2.02973712	1.531265041	3.035993297	0.088409971	0.398927623	0.310077296	0.157466146	1.682786436	0	0	0	0.070375761	0	0.119631189	0	0	0.072051082	0	0	0	0	0	0	0	0	0	0	24.0268
H0806_002_0	2009	5																					2000											D	D	D	V	T	Coin	Coin	V	V	P	P	V	Coin	V	V	V	V	V	P	V	Coin	Coin	T	V	V	P	V	P	O	P																																																			0	3000	862.5287795	50.99886109	778.6654955		62.21348382	9.211405584	15.50297595	266.0649769	318.4119655	1185.095644	367.1376203	6.402275762	0.05448808	714.0606899	2744.392782	3976.811554	259.6338961	741.0329328	2937.311872	5048.974618	17.08973507				133.1901121		237.1062288			98.46											1a: $125/d (1-5) then $0;1a1: $125/d (1-5) then $0	1b: $125/d (1-5) then $0	"2: $0 (1-6), $75/d (7-100)"	6: $0	10a: $100/trip	11a: 20%	11b: 20%;11c: $15/visit	4a: $50/visit;4a1: $50/visit;4b: $20/visit	9a: $50/visit;9b: $50/visit	8a: $15/visit	8b: $50/visit;8b: $15/visit	9a: $50/visit	12a: 10%	3: $15/visit;5: $40/day;9a: $50/visit;9c: $15/visit;9d: $15/visit; 7i: $15/visit; 7c: $15/visit; 7e: $15/visit	7a: $5/visit;14b: $0/visit;14c: $5/visit;14d: $0/visit;14d1: $0/visit;14e: $0/visit;14e1: $0/visit;14f: $0/visit;14f1: $0/visit;14g: $0/visit;14g1: $0/visit	7b: $15/visit;7b1: $15/visit;7d: $15/visit;7f: $15/visit;7f1: $15/visit;16b: 20%;17a: $15/visit;18a: $15/visit	7e: $15/visit;7h: $15/visit	7c: $15/visit;7i: $15/visit	7a: $5; 7d: $15/visit; 8b: $50/visit; 8b: $50/visit; 8b: $15/visit; 14h: $0/visit	7g: $0/visit;14b: $0/visit;14i: $5/visit;17b: 20%; 7a: $5/visit; 7d: $15/visit; 8a: $15/visit; 12: 10%	15: 20%	13a: $0		"16a: $1,000 max"	17a1: $15/visit	17b1: $100/year	18a1: $15/visit			14c1: $5/visit											95.84135455	69.2228248	41.63132711		100	0.2	0.2	44	46.37931312	15	46.62793503	50	0.1	39.14182606	4.999607557	14.99586499	14.88643256	14.73166814	3.897002417	3.592430978	0.2				15		15			5											78.26323398	56.52676926	33.9957872		81.65914844	0.163318297	0.163318297	35.93002531	37.87295214	12.24887227	38.07597468	40.82957422	0.081659148	31.96288184	4.999607557	14.99586499	14.88643256	14.73166814	3.897002417	3.592430978	0.163318297				15		15			5											5.6254	0.240233404	2.20594554	0	0.423358342	1.504391072	2.531919629	0.796643446	1.004933428	1.209673764	1.164926894	0.021783516	0.00444945	1.901953122	1.143407241	4.969644096	0.322085207	0.909720937	0.953892622	1.511507735	2.791066425	0	0	0	0.16648764	0	0.296382786	0	0	0.041025	0	0	0	0	0	0	0	0	0	0	31.7408	0	4.8125	5.6254	0.240233404	2.20594554	0	0.423358342	1.504391072	2.531919629	0.796643446	1.004933428	1.209673764	1.164926894	0.021783516	0.00444945	1.901953122	1.143407241	4.969644096	0.322085207	0.909720937	0.953892622	1.511507735	2.791066425	0	0	0	0.16648764	0	0.296382786	0	0	0.041025	0	0	0	0	0	0	0	0	0	0	31.7408	3000	OON: 30%		OON: 30%	OON: 30%	OON: $100/trip	OON: 30%	OON: 30%	OON: $50/visit;OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%		OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%		"OON: $1,000 max"	OON: 30%	OON: $100/year	OON: 30%			OON: 30%											3.3015		0.5154	0.6738	0.0297	0.1583	0.2664	0.064	0.6697	0.0876	0.2451	0.0131	0.001	0.443	0.4072	1.4449		0.0947	0.3244	0.1628	0.2937				0.0155		0.0218			0.0324											9.2659	250	10.99317157	8.9269	0.240233404	2.721323936	0.673840375	0.453059343	1.662703481	2.798362514	0.860624672	1.674612313	1.297313511	1.409984814	0.034843416	0.005422332	2.344951853	1.550576635	6.414500351	0.322085207	1.004428707	1.278247584	1.674290137	3.084780247	0	0	0	0.18203377	0	0.31815269	0	0	0.07344028	0	0	0	0	0	0	0	0	0	0	41.0067
H0806_003_0	2009	5																					3000											D	D	D	V	T	Coin	Coin	V	V	P	P	V	Coin	V	V	V	V	V	P	V	Coin	Coin	T	V	V	P	V	P	O	P																																																			0	3000	838.0565012	49.55188524	756.5802271		60.44831873	8.950053052	15.06311453	258.5159927	309.3777554	1151.47127	356.7209314	6.220625853	0.052942105	693.8008536	2666.526924	3874.924799	252.2673791	720.0078209	2853.972377	4905.721529	16.60485299				133.1901121		237.1062288			98.46											1a: Range: $150/d (1-7) then $0;1a1: Range: $150/d (1-7) then $0	1b: Range: $150/d (1-7) then $0	"2: $0 (1-6), $75/d (7-100)"	6: $0	10a: $150/trip	11a: 20%	11b: 20%;11c: $25/visit	4a: $50/visit;4a1: $50/visit;4b: $35/visit	9a: $200/visit;9b: $200/visit	8a: $25/visit	8b: $75/visit;8b: $25/visit	9a: $200/visit	12a: 20%	3: $25/visit;5: $60/day;9a: $200/visit;9c: $25/visit;9d: 25%; 7i: $25/visit; 7c: $25/visit; 7e: $25/visit	7a: $10/visit;14b: $0/visit;14c: $10/visit;14d: $0/visit;14d1: $0/visit;14e: $0/visit;14e1: $0/visit;14f: $0/visit;14f1: $0/visit;14g: $0/visit;14g1: $0/visit	7b: $25/visit;7b1: $25/visit;7d: $25/visit;7f: $25/visit;7f1: $25/visit;16b: 20%;17a: $25/visit;18a: $25/visit	7e: $25/visit;7h: $25/visit	7c: $25/visit;7i: $25/visit	7a: $10; 7d: $25/visit; 8b: $75/visit; 8b: $75/visit; 8b: $25/visit; 14h: $0/visit	7g: $0/visit;14b: $0/visit;14i: 20%;17b: 20%; 7a: $10/visit; 7d: $25/visit; 8a: $25/visit; 12: 20%	15: 20%	13a: $0		"16a: $1,000 max"	17a1: $25/visit	17b1: $100/year	18a1: $25/visit			14c1: $10/visit;13a1: 0;13c: $10/month											125.3931179	98.39705994	41.63132711		150	0.2	0.2	47	185.5172525	25	70.18276432	200	0.2	94.18378152	9.999215114	24.99312778	24.72135583	24.59750221	6.525534713	6.066082367	0.2				25		25			10											112.1450036	88.00115051	37.23286737		134.1521036	0.178869471	0.178869471	42.03432579	165.9168645	22.35868393	62.7677698	178.8694714	0.178869471	84.2330161	9.999215114	24.99312778	22.10947925	24.59750221	6.525534713	6.066082367	0.178869471				25		25			10											7.832	0.363385243	2.347470938	0	0.675772426	1.600891259	2.694331333	0.905545455	4.277582259	2.145448515	1.865881442	0.092723338	0.009469726	4.870078206	2.22193136	8.070540887	0.464791699	1.475866164	1.551974651	2.479875906	2.970101277	0	0	0	0.2774794	0	0.49397131	0	0	0.08205	0	0	0	0	0	0	0	0	0	0	49.7692	0	3.9121	7.832	0.363385243	2.347470938	0	0.675772426	1.600891259	2.694331333	0.905545455	4.277582259	2.145448515	1.865881442	0.092723338	0.009469726	4.870078206	2.22193136	8.070540887	0.464791699	1.475866164	1.551974651	2.479875906	2.970101277	0	0	0	0.2774794	0	0.49397131	0	0	0.08205	0	0	0	0	0	0	0	0	0	0	49.7692	3000	OON: 30%		OON: 30%	OON: 30%	OON: $150/trip	OON: 30%	OON: 30%	OON: $50/visit;OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%		OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%		"OON: $1,000 max"	OON: 30%	OON: $100/year	OON: 30%			OON: 30%											3.082		0.4811	0.629	0.0416	0.1478	0.2487	0.0597	0.6251	0.0818	0.2288	0.0122	0.0009	0.4135	0.3801	1.3489		0.0884	0.3028	0.152	0.2742				0.0149		0.0209			0.0311											8.6656	250	11.08856516	10.914	0.363385243	2.82857941	0.629028154	0.71736113	1.748675462	2.94305504	0.965284592	4.902725673	2.22725998	2.094642341	0.104914719	0.010377909	5.283616314	2.60202288	9.419453735	0.464791699	1.564275609	1.854759124	2.631832834	3.244282329	0	0	0	0.292415446	0	0.514886888	0	0	0.113193193	0	0	0	0	0	0	0	0	0	0	58.4348
H0806_801_0	2009	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																																																			0		207.1489792	0.847016733	23.66531646		8.610736763	9.077008396	18.69776103	16.41657947	38.01839511	7.879959091	16.38968932	2.853865755		23.39912527	20.80455215	76.79289762	0.20646053	6.425355204	22.08025963	8.018609083	17.39014841																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.0785	0.0785	0.1835		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.0785	0.0785	0.1835		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				16.2612	0.066490814	4.342585571	0	1.989080192	2.096788939	4.319182798	3.792229857	8.78224927	1.82027055	3.786018233	0.65924299	0	5.405197938	4.805851546	17.73915935	0.047692382	1.484257052	5.100539975	1.852298698	4.017124282	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.3675	0	0	16.2612	0.066490814	4.342585571	0	1.989080192	2.096788939	4.319182798	3.792229857	8.78224927	1.82027055	3.786018233	0.65924299	0	5.405197938	4.805851546	17.73915935	0.047692382	1.484257052	5.100539975	1.852298698	4.017124282	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.3675		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				1.8784		0.501		0.2242	0.2452	0.5052	0.4168	0.9655	0.2002	0.4168	0.0725		0.5927	0.5621	2.0216		0.1736	0.5966	0.2166	0.4698																				10.0588	0	0	18.1395	0.066490814	4.843615778	0	2.213248639	2.342027412	4.824350376	4.209011092	9.747788607	2.020440418	4.202784943	0.731771484	0	5.997936014	5.367939446	19.76072507	0.047692382	1.657854368	5.697094358	2.068941821	4.486963379	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.4262
H0806_802_0	2009	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																																																			0		207.1489792	0.847016733	23.66531646		8.610736763	9.077008396	18.69776103	16.41657947	38.01839511	7.879959091	16.38968932	2.853865755		23.39912527	20.80455215	76.79289762	0.20646053	6.425355204	22.08025963	8.018609083	17.39014841																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.0785	0.0785	0.1835		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.0785	0.0785	0.1835		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				16.2612	0.066490814	4.342585571	0	1.989080192	2.096788939	4.319182798	3.792229857	8.78224927	1.82027055	3.786018233	0.65924299	0	5.405197938	4.805851546	17.73915935	0.047692382	1.484257052	5.100539975	1.852298698	4.017124282	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.3675	0	0	16.2612	0.066490814	4.342585571	0	1.989080192	2.096788939	4.319182798	3.792229857	8.78224927	1.82027055	3.786018233	0.65924299	0	5.405197938	4.805851546	17.73915935	0.047692382	1.484257052	5.100539975	1.852298698	4.017124282	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.3675		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				1.8784		0.501		0.2242	0.2452	0.5052	0.4168	0.9655	0.2002	0.4168	0.0725		0.5927	0.5621	2.0216		0.1736	0.5966	0.2166	0.4698																				10.0588	0	0	18.1395	0.066490814	4.843615778	0	2.213248639	2.342027412	4.824350376	4.209011092	9.747788607	2.020440418	4.202784943	0.731771484	0	5.997936014	5.367939446	19.76072507	0.047692382	1.657854368	5.697094358	2.068941821	4.486963379	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.4262
H0806_803_0	2009	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																																																			0		207.1489792	0.847016733	23.66531646		8.610736763	9.077008396	18.69776103	16.41657947	38.01839511	7.879959091	16.38968932	2.853865755		23.39912527	20.80455215	76.79289762	0.20646053	6.425355204	22.08025963	8.018609083	17.39014841																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.0785	0.0785	0.1835		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.0785	0.0785	0.1835		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				16.2612	0.066490814	4.342585571	0	1.989080192	2.096788939	4.319182798	3.792229857	8.78224927	1.82027055	3.786018233	0.65924299	0	5.405197938	4.805851546	17.73915935	0.047692382	1.484257052	5.100539975	1.852298698	4.017124282	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.3675	0	0	16.2612	0.066490814	4.342585571	0	1.989080192	2.096788939	4.319182798	3.792229857	8.78224927	1.82027055	3.786018233	0.65924299	0	5.405197938	4.805851546	17.73915935	0.047692382	1.484257052	5.100539975	1.852298698	4.017124282	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.3675		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				1.8784		0.501		0.2242	0.2452	0.5052	0.4168	0.9655	0.2002	0.4168	0.0725		0.5927	0.5621	2.0216		0.1736	0.5966	0.2166	0.4698																				10.0588	0	0	18.1395	0.066490814	4.843615778	0	2.213248639	2.342027412	4.824350376	4.209011092	9.747788607	2.020440418	4.202784943	0.731771484	0	5.997936014	5.367939446	19.76072507	0.047692382	1.657854368	5.697094358	2.068941821	4.486963379	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.4262
H0838_020_0	2009	6																					0											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	136.0401919	199.0594788	22.74003717	5.258113672	23.09156377	2.377418604	0	49.69577026	7.183386156	2.400818481	2.664653467	0	0	72.79276632	80.82022158	44.94887536	75.23390222	0.092072287	10.1668571	63.61952384	4.799893181	0	12.42067229	0.5	1.488248333	0.35	0	0	1.833333333	2.4975											Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	No Cost Sharing	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% on Worldwide ER	20% Coinsurance	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	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											0.06168122	0.06168122	0.1685111	0	0.2	0.2	0.2	0.002	0.2	0	0	0	0.2	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0.06168122	0.06168122	0.1685111	0	0.2	0.2	0.2	0.002	0.2	0	0	0	0.2	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											8.3911	12.2782316	3.831948685	0	4.618312753	0.475483721	0	0.099391541	1.436677231	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.1312	0	0	8.3911	12.2782316	3.831948685	0	4.618312753	0.475483721	0	0.099391541	1.436677231	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.1312	0																																																																																	0	0		8.3911	12.2782316	3.831948685	0	4.618312753	0.475483721	0	0.099391541	1.436677231	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.1312
H0846_004_0	2009	4																					2500											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	COIN	COIN	P	COIN	P	P	COIN	P	COIN	V	T	COIN	V	V	V	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	2315.729791	31.5791286	1609.725473	0	228.7628858	23.52494229	14.656911	384.0992725	0	0	38.44843945	0	0.104015512	18.92059796	0	149.2499172	318.8852315	1388.360717	23.96661862	0	49.53998591	0	0	2.693683176	27.46213386	0	6.329747732	0	0	0											1a:$50 days 1-5	1b:$100 days 1-21	2a:$125 days 8-27		10a:$150 WIA;	11a:20%	11b:20%;11c:20%	4a:$50 WIA			8b:0-20%;8b base 3:$0-$110		12:20%;	3:20%; 13a 20%		7b:$15; 17a:$20; 17b 20%	5:15; 7e:$15; 7h:$15  9c:$15	7c:$15; 7i:$15	8b:0-20%;8b base 3:$0-$110		15:20%			16a:50%	17a:$20		18a:$20														31.83718332	63.67436664	68.32647478	0	90	0.199998575	0.186652633	50	0	0	0.198225225	0	0.19884077	0.01273808	0	0.016612668	15	15	0.312704401	0	0.19244102	0	0	0.5	20	0	20	0	0	0											23.72057406	47.44114811	50.90724228	0	67.05529329	0.149010701	0.13906719	37.25294072	0	0	0.147689451	0	0.148148069	0.009490619	0	0.012377415	11.17588221	11.17588221	0.23298317	0	0.143379879	0	0	0.372529407	14.90117629	0	14.90117629	0	0	0											4.5775	0.124845843	6.828890391	0	1.278313533	3.505468137	2.038295421	1.192402286	0	0	5.678428927	0	0.015409697	0.179568178	0	1.847328132	0.296985316	1.293012987	5.583818784	0	7.103037161	0	0	1.003476196	0.034101508	0	0.007860057	0	0	0	0	0	0	0	0	0	0	0	0	0	42.5888	0	14.5729	4.5775	0.124845843	6.828890391	0	1.278313533	3.505468137	2.038295421	1.192402286	0	0	5.678428927	0	0.015409697	0.179568178	0	1.847328132	0.296985316	1.293012987	5.583818784	0	7.103037161	0	0	1.003476196	0.034101508	0	0.007860057	0	0	0	0	0	0	0	0	0	0	0	0	0	42.5888	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.5775	0.124845843	6.828890391	0	1.278313533	3.505468137	2.038295421	1.192402286	0	0	5.678428927	0	0.015409697	0.179568178	0	1.847328132	0.296985316	1.293012987	5.583818784	0	7.103037161	0	0	1.003476196	0.034101508	0	0.007860057	0	0	0	0	0	0	0	0	0	0	0	0	0	42.5888
H0846_005_0	2009	5																					3000											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	COIN	COIN	P	COIN	P	P	COIN	P	COIN	V	T	COIN	V	V	V	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	1861.640856	60.00727303	763.9864085	0	203.1199892	15.15413548	11.7312606	431.9211549	302.3372065	1316.486755	23.69528659	58.64845258	0.132389001	14.57602157	3310.562287	88.83626317	256.6856525	659.3545869	14.61097679	2133.980446	19.61027599	0	0	0.952352395	19.99083748	0	2.602213637	0	0	0											1a:$180 Days1-5	1b:$180 Days1-5	2a:$80 4-37		10a:$150 (WIA)	11a:20%	11b:20%; 11c:20%	4a:$50	9a:$90; 9b:$90	8a:$5	8b:$15-110;20%	9a:$90	12:20%	3:20%; 7a:$15-$50; 7d:$30; 9a:$90; 9d:$30; 13a 20%	7a:$15-$50	7b:$30; 7d:$30; 7f:$30; 17a:$30; 17b 20%	5:$30; 7e:$30; 7h:$30 ;9c:$30;	7c:$30; 7i:$30	8b:$15-110;20%	7g:$30	15:20%			16a:50%	17a:$30		18a:$30														114.61	114.61	63.77009519	0	90	0.199999486	0.19189598	50	90	5	0.216678228	90	0.198097913	0.129596169	14.75528012	0.095275462	30	30	0.451531933	0.019702996	0.190146021	0	0	0.5	30	0	30	0	0	0											86.08773708	86.08773708	47.90003655	0	67.60227151	0.150226884	0.144140046	37.5568175	67.60227151	3.75568175	0.162754894	67.60227151	0.148798543	0.097344393	11.08322725	0.071564863	22.5340905	22.5340905	0.339162048	0.014799636	0.142825588	0	0	0.375568175	22.5340905	0	22.5340905	0	0	0											13.3554	0.430490862	3.049581407	0	1.144281055	2.276558549	1.690944443	1.351798666	1.703223494	0.41202544	3.85652385	0.330397385	0.01969929	1.418893977	3.057642847	6.357554998	0.48201481	1.238162995	4.955488817	0.002631845	2.800849198	0	0	0.357673251	0.037539612	0	0.004886543	0	0	0	0	0	0	0	0	0	0	0	0	0	50.3342	0	16.6765	13.3554	0.430490862	3.049581407	0	1.144281055	2.276558549	1.690944443	1.351798666	1.703223494	0.41202544	3.85652385	0.330397385	0.01969929	1.418893977	3.057642847	6.357554998	0.48201481	1.238162995	4.955488817	0.002631845	2.800849198	0	0	0.357673251	0.037539612	0	0.004886543	0	0	0	0	0	0	0	0	0	0	0	0	0	50.3342	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	13.3554	0.430490862	3.049581407	0	1.144281055	2.276558549	1.690944443	1.351798666	1.703223494	0.41202544	3.85652385	0.330397385	0.01969929	1.418893977	3.057642847	6.357554998	0.48201481	1.238162995	4.955488817	0.002631845	2.800849198	0	0	0.357673251	0.037539612	0	0.004886543	0	0	0	0	0	0	0	0	0	0	0	0	0	50.3342
H0846_006_0	2009	4																					3350											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	COIN	COIN	P	COIN	P	P	COIN	P	COIN	V	T	COIN	V	V	V	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	2171.01425	65.44952906	835.9256532	0	223.8674511	16.68734429	13.15223988	464.2248738	318.6766291	1386.439195	26.49093875	44.76768433	0.153512172	15.40013845	3619.909526	98.83684263	255.4261744	661.9899002	16.89195605	2477.336253	21.73130905	0	0	0.741121555	19.15979133	0	1.432507763	0	0	0											1a:$265 Days 1-11	1b:$260 Days 1-8	2a:$100 Days 1-25		10a:$150 (WIA)	11a:20%	11b:20%; 11c:20%	4a:$50	9a:$200;  9b:$200	8a:$5;	8b:$35-200;20%	9a:$200;	12:20%;	3:20%; 7a $20-$50; 7d:$30 9a:$200; 9d:$35; 13a:20%	7a:$20-$50;	7b:$35; 7d:$30; 7f:$30; 17a:$30; 17b:20%;	5:$40; 7e:$40; 7h:$40;  9c:$40	7c:$35; 7i:$35;	8b:$35-200;20%	7g:$30;	15:20%;			16a:50%;	17a:$30;		18a:$30;														224.8863537	201.3804358	91.54701879	0	90	0.19999765	0.193672905	50	200	5	0.349042007	200	0.19835422	0.190863677	19.60165612	0.094247156	40	35	0.814803509	0.018513213	0.192248289	0	0	0.5	30	0	30	0	0	0											143.9289302	128.8849689	58.59076936	0	57.60066589	0.127999976	0.123952092	32.00036994	128.0014798	3.200036994	0.223389467	128.0014798	0.126948168	0.122154166	12.54520495	0.060318877	25.60029595	22.40025896	0.521480275	0.011848593	0.123040327	0	0	0.320003699	19.20022196	0	19.20022196	0	0	0											26.0393	0.702955043	4.081460596	0	1.074576188	2.135979667	1.630247648	1.237947308	3.399256674	0.369721393	5.917796689	0.477527487	0.019488089	1.881191064	3.784375574	5.961727342	0.544915472	1.235728766	8.808821877	0.002446079	2.67382738	0	0	0.237161639	0.030656021	0	0.002292039	0	0	0	0	0	0	0	0	0	0	0	0	0	72.2494	0	40.639	26.0393	0.702955043	4.081460596	0	1.074576188	2.135979667	1.630247648	1.237947308	3.399256674	0.369721393	5.917796689	0.477527487	0.019488089	1.881191064	3.784375574	5.961727342	0.544915472	1.235728766	8.808821877	0.002446079	2.67382738	0	0	0.237161639	0.030656021	0	0.002292039	0	0	0	0	0	0	0	0	0	0	0	0	0	72.2494	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	26.0393	0.702955043	4.081460596	0	1.074576188	2.135979667	1.630247648	1.237947308	3.399256674	0.369721393	5.917796689	0.477527487	0.019488089	1.881191064	3.784375574	5.961727342	0.544915472	1.235728766	8.808821877	0.002446079	2.67382738	0	0	0.237161639	0.030656021	0	0.002292039	0	0	0	0	0	0	0	0	0	0	0	0	0	72.2494
H0846_009_0	2009	4																					3000											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	COIN	COIN	P	COIN	P	P	COIN	P	COIN	V	T	COIN	V	V	V	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	1899.420472	61.22504377	779.490534	0	207.2420492	15.77544402	12.21223376	440.6861704	308.4727528	1343.203168	24.65648202	59.8386478	0.137765233	15.1672955	3377.745908	92.44661394	261.894759	672.7353436	15.20471377	2177.286846	20.41428305	0	0	0.99139815	20.39652591	0	2.65502223	0	0	0											1a:$180 Days1-5	1b:$180 Days1-5	2a:$80 4-37		10a:$150 (WIA)	11a:20%	11b:20%; 11c:20%	4a:$50	9a:$90; 9b:$90	8a:$5	8b:$15-$110;20%	9a:$90	12:20%	3:20%; 7a:$15-$50; 7d:$30; 9a:$90; 9d:$30; 13a 20%	7a:$15-$50	7b:$30; 7d:$30; 7f:$30; 17a:$30; 17b 20%	5:$30; 7e:$30; 7h:$30 ;9c:$30;	7c:$30; 7i:$30	8b:$15-$110;20%	7g:$30	15:20%			16a:50%	17a:$30		18a:$30														114.61	114.61	63.77009519	0	90	0.199999486	0.19189598	50	90	5	0.213912817	90	0.198172141	0.127225555	14.75528012	0.094933561	30	30	0.429875796	0.019702996	0.190146021	0	0	0.5	30	0	30	0	0	0											85.40981663	85.40981663	47.52283515	0	67.0699197	0.149043883	0.143004977	37.2610665	67.0699197	3.72610665	0.159412394	67.0699197	0.147682106	0.094811197	10.99594947	0.070746515	22.3566399	22.3566399	0.320352613	0.014683093	0.14170087	0	0	0.372610665	22.3566399	0	22.3566399	0	0	0											13.5191	0.435768313	3.086966679	0	1.158308967	2.351233428	1.746410213	1.368369725	1.724103563	0.417076521	3.93054882	0.334447775	0.02034546	1.438029448	3.095126945	6.54027572	0.487923902	1.253341819	4.870869782	0.002664109	2.892721676	0	0	0.369405524	0.037999815	0	0.004946448	0	0	0	0	0	0	0	0	0	0	0	0	0	51.086	0	17.4654	13.5191	0.435768313	3.086966679	0	1.158308967	2.351233428	1.746410213	1.368369725	1.724103563	0.417076521	3.93054882	0.334447775	0.02034546	1.438029448	3.095126945	6.54027572	0.487923902	1.253341819	4.870869782	0.002664109	2.892721676	0	0	0.369405524	0.037999815	0	0.004946448	0	0	0	0	0	0	0	0	0	0	0	0	0	51.086	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	13.5191	0.435768313	3.086966679	0	1.158308967	2.351233428	1.746410213	1.368369725	1.724103563	0.417076521	3.93054882	0.334447775	0.02034546	1.438029448	3.095126945	6.54027572	0.487923902	1.253341819	4.870869782	0.002664109	2.892721676	0	0	0.369405524	0.037999815	0	0.004946448	0	0	0	0	0	0	0	0	0	0	0	0	0	51.086
H0846_010_0	2009	4																					3000											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	COIN	COIN	P	COIN	P	P	COIN	P	COIN	V	T	COIN	V	V	V	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	1965.81193	63.36507541	806.7364828	0	214.4858912	16.89753269	13.0808755	456.0897094	319.2549656	1390.152865	26.39240941	61.93022	0.147474754	16.23514141	3495.810064	98.96693912	271.0489063	696.2498212	16.27700798	2253.390715	21.86632686	0	0	1.061915128	21.10945657	0	2.747824639	0	0	0											1a:$180 Days1-5	1b:$180 Days1-5	2a:$80 4-37		10a:$150 (WIA)	11a:20%	11b:20%; 11c:20%	4a:$50	9a:$90; 9b:$90	8a:$5	8b:$15-$110;20%	9a:$90	12:20%	3:20%; 7a:$15-$50; 7d:$30; 9a:$90; 9d:$30; 13a 20%	7a:$15-$50	7b:$30; 7d:$30; 7f:$30; 17a:$30; 17b 20%	5:$30; 7e:$30; 7h:$30 ;9c:$30;	7c:$30; 7i:$30	8b:$15-$110;20%	7g:$30	15:20%			16a:50%	17a:$30		18a:$30														114.61	114.61	63.77009519	0	90	0.199999486	0.19189598	50	90	5	0.209301569	90	0.198292484	0.123273666	14.75528012	0.090316903	30	30	0.430089925	0.019702996	0.190146021	0	0	0.5	30	0	30	0	0	0											84.15850809	84.15850809	46.82659517	0	66.0873024	0.146860294	0.140909863	36.715168	66.0873024	3.6715168	0.153690845	66.0873024	0.145606838	0.090520267	10.83485177	0.066320006	22.0291008	22.0291008	0.315816477	0.014467976	0.139624862	0	0	0.36715168	22.0291008	0	22.0291008	0	0	0											13.7866	0.444392518	3.148060224	0	1.181232829	2.481576625	1.843224373	1.395450859	1.758224955	0.4253308	4.056271704	0.341066765	0.021473333	1.469609343	3.156381988	6.563487957	0.497580307	1.278146458	5.140547319	0.002716834	3.053082867	0	0	0.389883923	0.038751862	0	0.005044342	0	0	0	0	0	0	0	0	0	0	0	0	0	52.4782	0	18.9884	13.7866	0.444392518	3.148060224	0	1.181232829	2.481576625	1.843224373	1.395450859	1.758224955	0.4253308	4.056271704	0.341066765	0.021473333	1.469609343	3.156381988	6.563487957	0.497580307	1.278146458	5.140547319	0.002716834	3.053082867	0	0	0.389883923	0.038751862	0	0.005044342	0	0	0	0	0	0	0	0	0	0	0	0	0	52.4782	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	13.7866	0.444392518	3.148060224	0	1.181232829	2.481576625	1.843224373	1.395450859	1.758224955	0.4253308	4.056271704	0.341066765	0.021473333	1.469609343	3.156381988	6.563487957	0.497580307	1.278146458	5.140547319	0.002716834	3.053082867	0	0	0.389883923	0.038751862	0	0.005044342	0	0	0	0	0	0	0	0	0	0	0	0	0	52.4782
H0846_012_0	2009	5																					2500											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	COIN	COIN	P	COIN	P	P	COIN	P	COIN	V	T	COIN	V	V	V	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	1703.156547	54.89876288	698.947087	0	185.8280765	12.68377412	9.818881439	395.150809	276.5987816	1204.412241	19.87351382	53.65562087	0.11101277	12.22507965	3028.729099	74.4812841	234.8336137	603.222731	12.25024164	1952.311455	16.41349395	0	0	0.797104042	18.28898717	0	2.380683244	0	0	0											1a:$170 Days1-4	1b:$170 Days1-4	2a:$85 4-32		10a:$150 (WIA)	11a:20%	11b:20%; 11c:20%	4a:$50	9a:$75; 9b:$75	8a:$5	8b:$15-100;20%	9a:$75; 9b:$75	12:20%	3:20%; 7a:$10-$50; 7d:$20; 9a:$75; 9d:$30; 13a 20%	7a:$10-$50	7b:$30; 7d:$20; 7f:$30; 17a:$30; 17b 20%	5:$30; 7e:$30; 7h:$30 ;9c:$30;	7c:$30; 7i:$30	8b:$15-100;20%	7g:$20	15:20%			16a:50%	17a:$30		18a:$30														95.82831814	95.82831814	67.28678183	0	90	0.199999486	0.19189598	50	75	5	0.217118843	75	0.197731653	0.105461213	9.836853411	0.079778091	30	30	0.458783705	0.01313533	0.190146021	0	0	0.5	30	0	30	0	0	0											73.11568182	73.11568182	51.33888423	0	68.66875566	0.152596842	0.14641398	38.1493087	57.22396305	3.81493087	0.165658676	57.22396305	0.150866518	0.080465448	7.505383149	0.06086958	22.88958522	22.88958522	0.350045624	0.010022075	0.145078785	0	0	0.381493087	22.88958522	0	22.88958522	0	0	0											10.3773	0.334496707	2.990263632	0	1.063381899	1.93550388	1.437621506	1.256227516	1.319006538	0.382895787	3.292219978	0.255865606	0.01674811	0.983696508	1.894314362	4.533644501	0.447937001	1.150626509	4.288143473	0.001630518	2.381249756	0	0	0.304089682	0.034885611	0	0.004541071	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6863	0	12.6388	10.3773	0.334496707	2.990263632	0	1.063381899	1.93550388	1.437621506	1.256227516	1.319006538	0.382895787	3.292219978	0.255865606	0.01674811	0.983696508	1.894314362	4.533644501	0.447937001	1.150626509	4.288143473	0.001630518	2.381249756	0	0	0.304089682	0.034885611	0	0.004541071	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6863	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.3773	0.334496707	2.990263632	0	1.063381899	1.93550388	1.437621506	1.256227516	1.319006538	0.382895787	3.292219978	0.255865606	0.01674811	0.983696508	1.894314362	4.533644501	0.447937001	1.150626509	4.288143473	0.001630518	2.381249756	0	0	0.304089682	0.034885611	0	0.004541071	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6863
H0846_013_0	2009	4																					3350											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	COIN	COIN	P	COIN	P	P	COIN	P	COIN	V	T	COIN	V	V	V	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	2182.336505	65.79086088	840.2851654	0	225.0349627	16.86185355	13.2897805	466.645651	320.3385887	1393.669741	26.76538803	45.00115637	0.155104328	15.55968572	3638.788047	99.86224901	256.8273125	665.4423042	17.06719108	2490.256036	21.95856597	0	0	0.748871894	19.2597133	0	1.439978565	0	0	0											1a:$265 Days 1-11	1b:$260 Days 1-8	2a:$100 Days 1-25		10a:$150 (WIA)	11a:20%	11b:20%; 11c:20%	4a:$50	9a:$200;  9b:$200	8a:$5;	8b:$35-200;20%	9a:$200;	12:20%;	3:20%; 7a $20-$50; 7d:$30 9a:$200; 9d:$35; 13a:20%	7a:$20-$50;	7b:$35; 7d:$30; 7f:$30; 17a:$30; 17b:20%;	5:$40; 7e:$40; 7h:$40;  9c:$40	7c:$35; 7i:$35;	8b:$35-200;20%	7g:$30;	15:20%;			16a:50%;	17a:$30;		18a:$30;														224.8863537	201.3804358	91.54701879	0	90	0.19999765	0.193672905	50	200	5	0.347648356	200	0.198371114	0.189924613	19.60165612	0.093766588	40	35	0.810868866	0.018513213	0.192248289	0	0	0.5	30	0	30	0	0	0											143.5687631	128.5624478	58.44415209	0	57.45652625	0.127679669	0.123641915	31.92029236	127.6811694	3.192029236	0.221940743	127.6811694	0.126641279	0.121248983	12.51381188	0.059861138	25.53623389	22.34420465	0.517663426	0.011818943	0.122732432	0	0	0.319202924	19.15217542	0	19.15217542	0	0	0											26.1096	0.704852843	4.092479501	0	1.07747727	2.152915885	1.643173908	1.241288801	3.408433802	0.370719547	5.940330117	0.478816689	0.01964261	1.886596076	3.794592425	5.977867863	0.546533527	1.239064919	8.835060601	0.002452683	2.695028202	0	0	0.239042098	0.030738784	0	0.002298227	0	0	0	0	0	0	0	0	0	0	0	0	0	72.489	0	41.0579	26.1096	0.704852843	4.092479501	0	1.07747727	2.152915885	1.643173908	1.241288801	3.408433802	0.370719547	5.940330117	0.478816689	0.01964261	1.886596076	3.794592425	5.977867863	0.546533527	1.239064919	8.835060601	0.002452683	2.695028202	0	0	0.239042098	0.030738784	0	0.002298227	0	0	0	0	0	0	0	0	0	0	0	0	0	72.489	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	26.1096	0.704852843	4.092479501	0	1.07747727	2.152915885	1.643173908	1.241288801	3.408433802	0.370719547	5.940330117	0.478816689	0.01964261	1.886596076	3.794592425	5.977867863	0.546533527	1.239064919	8.835060601	0.002452683	2.695028202	0	0	0.239042098	0.030738784	0	0.002298227	0	0	0	0	0	0	0	0	0	0	0	0	0	72.489
H0846_014_0	2009	5																					3350											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	COIN	COIN	P	COIN	P	P	COIN	P	COIN	V	T	COIN	V	V	V	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	1821.777191	58.72232603	747.6270242	0	198.7705428	14.51208733	11.23423231	422.6720862	295.8632032	1288.296577	22.70200595	57.39260226	0.126833308	13.96501059	3239.672596	85.10539696	251.1891945	645.2357034	13.99742055	2088.285122	18.77943075	0	0	0.912003271	19.56276992	0	2.546491949	0	0	0											1a:$265 Days1-8	1b:$260 Days1-8	2a:$80 4-37		10a:$150 (WIA)	11a:20%;	11b:20%; 11c:20%;	4a:$50	9a:$175;  9b:$175;	8a:$5;	8b:$35-200;20%	9a:$175;	12:20%;	3:20%;  9a:$175; 9d:$35; 13a:20%	7a:$20-50;	7b:$40; 7d:$35; 7f:$35; 17a:$35; 17b:20%	5:$40; 7e:$40; 7h:$40;  9c:$40	7c:$35; 7i:$35;	8b:$35-200;20%	7g:$15-35;	15:20%;			16a:50%;	17a:$35;		18a:$35;														204.9386983	201.3804358	63.77009519	0	90	0.199999486	0.19189598	50	175	5	0.349980017	175	0.2	0.191577344	19.67370682	0.11404243	40	35	0.861476273	0.022986828	0.190146021	0	0	0.5	35	0	35	0	0	0											141.156201	138.7053666	43.92310699	0	61.98955196	0.137754206	0.132172731	34.43863998	120.5352399	3.443863998	0.241056716	120.5352399	0.13775456	0.131953263	13.55071412	0.078549324	27.55091198	24.10704798	0.593361424	0.015832702	0.130967407	0	0	0.3443864	24.10704798	0	24.10704798	0	0	0											21.4296	0.67875848	2.736508481	0	1.026808074	1.999101063	1.484859168	1.213020984	2.971828515	0.369726517	5.472471009	0.576485924	0.017471867	1.842728718	3.6583231	6.684971378	0.576707616	1.296227339	8.305529391	0.002755266	2.459493349	0	0	0.314081523	0.039300053	0	0.0051157	0	0	0	0	0	0	0	0	0	0	0	0	0	65.1619	0	29.4439	21.4296	0.67875848	2.736508481	0	1.026808074	1.999101063	1.484859168	1.213020984	2.971828515	0.369726517	5.472471009	0.576485924	0.017471867	1.842728718	3.6583231	6.684971378	0.576707616	1.296227339	8.305529391	0.002755266	2.459493349	0	0	0.314081523	0.039300053	0	0.0051157	0	0	0	0	0	0	0	0	0	0	0	0	0	65.1619	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.4296	0.67875848	2.736508481	0	1.026808074	1.999101063	1.484859168	1.213020984	2.971828515	0.369726517	5.472471009	0.576485924	0.017471867	1.842728718	3.6583231	6.684971378	0.576707616	1.296227339	8.305529391	0.002755266	2.459493349	0	0	0.314081523	0.039300053	0	0.0051157	0	0	0	0	0	0	0	0	0	0	0	0	0	65.1619
H0846_015_0	2009	5																					3350											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	COIN	COIN	P	COIN	P	P	COIN	P	COIN	V	T	COIN	V	V	V	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	1899.420472	61.22504377	779.490534	0	207.2420492	15.77544402	12.21223376	440.6861704	308.4727528	1343.203168	24.65648202	59.8386478	0.137765233	15.1672955	3377.745908	92.44661394	261.894759	672.7353436	15.20471377	2177.286846	20.41428305	0	0	0.99139815	20.39652591	0	2.65502223	0	0	0											1a:$180 Days1-6	1b:$180 Days1-6	2a:$80 4-40		10a:$150 (WIA)	11a:20%	11b:20%; 11c:20%	4a:$50	9a:$90; 9b:$90	8a:$5	8b:$15-$110;20%	9a:$90	12:20%	3:20%; 7a:$15-$50; 7d:$30; 9a:$90; 9d:$30; 13a 20%	7a:$15-$50	7b:$35; 7d:$30; 7f:$30; 17a:$30; 17b 20%	5:$35; 7e:$35; 7h:$35 ;9c:$35;	7c:$30; 7i:$30	8b:$15-$110;20%	7g:$30	15:20%			16a:50%	17a:$30		18a:$30														124.8406378	124.8406378	63.96816424	0	90	0.199999486	0.19189598	50	90	5	0.214665743	90	0.2	0.127305227	14.75528012	0.095062819	35	30	0.443829828	0.019702996	0.190146021	0	0	0.5	30	0	30	0	0	0											95.64020873	95.64020873	49.00590617	0	68.94885304	0.153219279	0.147011197	38.30491836	68.94885304	3.830491836	0.164455075	68.94885304	0.153219673	0.097528326	11.303996	0.072827471	26.81344285	22.98295101	0.340017307	0.015094433	0.145670556	0	0	0.383049184	22.98295101	0	22.98295101	0	0	0											15.1384	0.487964664	3.183303331	0	1.190758466	2.417102165	1.795335102	1.406703981	1.772403542	0.428760731	4.054883612	0.343817178	0.021108344	1.479240947	3.18183552	6.732653074	0.585191679	1.288453621	5.169865828	0.002738742	2.973759961	0	0	0.379754252	0.039064363	0	0.00508502	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0782	0	16.5109	15.1384	0.487964664	3.183303331	0	1.190758466	2.417102165	1.795335102	1.406703981	1.772403542	0.428760731	4.054883612	0.343817178	0.021108344	1.479240947	3.18183552	6.732653074	0.585191679	1.288453621	5.169865828	0.002738742	2.973759961	0	0	0.379754252	0.039064363	0	0.00508502	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0782	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	15.1384	0.487964664	3.183303331	0	1.190758466	2.417102165	1.795335102	1.406703981	1.772403542	0.428760731	4.054883612	0.343817178	0.021108344	1.479240947	3.18183552	6.732653074	0.585191679	1.288453621	5.169865828	0.002738742	2.973759961	0	0	0.379754252	0.039064363	0	0.00508502	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0782
H0846_016_0	2009	4																					3350											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	COIN	COIN	P	COIN	P	P	COIN	P	COIN	V	T	COIN	V	V	V	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	2109.31799	63.58957299	812.1701729	0	217.5055471	15.75237318	12.41533626	451.0324743	309.6204214	1347.039126	25.02051727	43.49546851	0.144981854	14.54532939	3517.038309	93.34300587	248.167429	643.1773563	15.95309638	2406.934882	20.51373087	0	0	0.699597437	18.61530505	0	1.391798509	0	0	0											1a:$265 Days 1-11	1b:$260 Days 1-8	2a:$100 Days 1-25		10a:$150 (WIA)	11a:20%	11b:20%; 11c:20%	4a:$50	9a:$200;  9b:$200	8a:$5;	8b:$35-200;20%	9a:$200;	12:20%;	3:20%; 7a $20-$50; 7d:$30 9a:$200; 9d:$35; 13a:20%	7a:$20-$50;	7b:$35; 7d:$30; 7f:$30; 17a:$30; 17b:20%;	5:$40; 7e:$40; 7h:$40;  9c:$40	7c:$35; 7i:$35;	8b:$35-200;20%	7g:$30;	15:20%;			16a:50%;	17a:$30;		18a:$30;														224.8863537	201.3804358	91.54701879	0	90	0.19999765	0.193672905	50	200	5	0.357627303	200	0.2	0.19621571	19.60165612	0.096954228	40	35	0.837338438	0.018513213	0.192248289	0	0	0.5	30	0	30	0	0	0											145.9413677	130.6870593	59.40999494	0	58.40604768	0.129789692	0.12568521	32.44780427	129.7912171	3.244780427	0.232084415	129.7912171	0.129791217	0.127335379	12.72061402	0.062919036	25.95824341	22.71346299	0.543395875	0.012014262	0.124760697	0	0	0.324478043	19.46868256	0	19.46868256	0	0	0											25.6531	0.692527858	4.020918822	0	1.058636613	2.044495665	1.560424147	1.219584454	3.348834277	0.364237182	5.806872106	0.47044415	0.018817371	1.852135029	3.728240569	5.87305197	0.536832544	1.217398756	8.668846766	0.002409796	2.559307363	0	0	0.227004007	0.030201289	0	0.00225804	0	0	0	0	0	0	0	0	0	0	0	0	0	70.9565	0	38.383	25.6531	0.692527858	4.020918822	0	1.058636613	2.044495665	1.560424147	1.219584454	3.348834277	0.364237182	5.806872106	0.47044415	0.018817371	1.852135029	3.728240569	5.87305197	0.536832544	1.217398756	8.668846766	0.002409796	2.559307363	0	0	0.227004007	0.030201289	0	0.00225804	0	0	0	0	0	0	0	0	0	0	0	0	0	70.9565	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	25.6531	0.692527858	4.020918822	0	1.058636613	2.044495665	1.560424147	1.219584454	3.348834277	0.364237182	5.806872106	0.47044415	0.018817371	1.852135029	3.728240569	5.87305197	0.536832544	1.217398756	8.668846766	0.002409796	2.559307363	0	0	0.227004007	0.030201289	0	0.00225804	0	0	0	0	0	0	0	0	0	0	0	0	0	70.9565
H0846_017_0	2009	4																					2500											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	COIN	COIN	P	COIN	P	P	COIN	P	COIN	V	T	COIN	V	V	V	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	2296.346993	31.31480939	1596.251974	0	226.8481266	22.73555047	14.16509064	380.8843385	503.5724499	2464.009189	37.16775674	101.1160711	0.100545447	18.29036997	5002.96327	144.268327	316.2161429	1376.740054	23.16676044	2041.229268	47.87764561	0	0	2.603295219	27.23227414	0	6.276767361	0	0	0											1a:$100 days 1-5	1b:$100 Days 1-21	2a:125 days 1-20		10a:$150 WIA;	11a:20%	11b:20%;11c:20%	4a:$50 WIA	9a:$50; 9b: $50	8a: $5	8b:0-20%;$0-$110	9a:$50	12:20%;	3:20%; 7a:$0-$15; 7d:$15; 9a:$50; 13a 20%	7a:$5	7b:$15; 7d:$15;7f:$15; 17a:$20; 17b 20%	5:$15; 7e:$15; 7h:$15  9c:$15	7c:$15; 7i:$15	8b:0-20%;$0-$110	7g:$15	15:20%			16a:50%	17a:$20		18a:$20														63.67436664	63.67436664	102.9857327	0	90	0.199998575	0.186652633	50	50	5	0.202089633	50	0.2	0.082891745	4.924724834	0.06554529	15	15	0.320037846	0.022093023	0.19244102	0	0	0.5	20	0	20	0	0	0											41.50462012	41.50462012	67.12879827	0	58.66435753	0.13036431	0.121665076	32.59130974	32.59130974	3.259130974	0.131727316	32.59130974	0.130365239	0.054031011	3.210064649	0.042724137	9.777392922	9.777392922	0.208609051	0.014400811	0.125438098	0	0	0.325913097	13.0365239	0	13.0365239	0	0	0											7.9424	0.108309106	8.92953973	0	1.108991634	2.963904345	1.723396824	1.034459954	1.367673808	0.669210722	4.896008855	0.274625433	0.013107631	0.988247178	1.338319628	6.163739783	0.257647456	1.121744038	4.832795915	0.002449613	6.005680806	0	0	0.848448008	0.029584516	0	0.006818936	0	0	0	0	0	0	0	0	0	0	0	0	0	52.6271	0	28.1108	7.9424	0.108309106	8.92953973	0	1.108991634	2.963904345	1.723396824	1.034459954	1.367673808	0.669210722	4.896008855	0.274625433	0.013107631	0.988247178	1.338319628	6.163739783	0.257647456	1.121744038	4.832795915	0.002449613	6.005680806	0	0	0.848448008	0.029584516	0	0.006818936	0	0	0	0	0	0	0	0	0	0	0	0	0	52.6271	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.9424	0.108309106	8.92953973	0	1.108991634	2.963904345	1.723396824	1.034459954	1.367673808	0.669210722	4.896008855	0.274625433	0.013107631	0.988247178	1.338319628	6.163739783	0.257647456	1.121744038	4.832795915	0.002449613	6.005680806	0	0	0.848448008	0.029584516	0	0.006818936	0	0	0	0	0	0	0	0	0	0	0	0	0	52.6271
H0846_018_0	2009	8																																Coin	Coin	Coin	Coin	Coin	Coin	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		387.2687586	43.34221431	44.81676598		15.1460877	26.47000436	14.1934825	31.89487487	30.04824906	5.25613478	15.61915186	2.491639622	4.133912413	38.14111231	37.76875056	95.08794925	7.761174851	1.770336072	20.81874462	10.79290964	21.24479961																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS			16a; 1 routine cleaning and exam	17a1; $300/yr allowance combined with 17b1	17b1; $300/yr allowance combined with 17a1			14a:$0												0.079976558	0.079976558	0.19346235		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.079976558	0.079976558	0.19346235		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				30.9724	3.466361137	8.670356862	0	3.498746258	6.114571007	3.278694458	7.367716096	6.941145532	1.214167134	3.60802408	0.575568753	0.954933767	8.810596943	8.724581379	21.96531628	1.792831391	0.408947633	4.809130008	2.493162127	4.907548709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.5748	0	0	30.9724	3.466361137	8.670356862	0	3.498746258	6.114571007	3.278694458	7.367716096	6.941145532	1.214167134	3.60802408	0.575568753	0.954933767	8.810596943	8.724581379	21.96531628	1.792831391	0.408947633	4.809130008	2.493162127	4.907548709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.5748																																																																																		0	0	0	30.9724	3.466361137	8.670356862	0	3.498746258	6.114571007	3.278694458	7.367716096	6.941145532	1.214167134	3.60802408	0.575568753	0.954933767	8.810596943	8.724581379	21.96531628	1.792831391	0.408947633	4.809130008	2.493162127	4.907548709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.5748
H0846_801_0	2009	4																					0											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	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	365.8897692	2.35995852	96.80766592	0	13.56220105	14.57888694	8.13324894	13.96331392	44.74709076	11.83385566	28.66566862	0.414598747	0.293792642	15.40209497	32.56043849	150.467602	1.563568402	12.16500422	20.3501035	4.933203218	37.78508509	0	0	0	0	0	0	0	0	0											Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.075951523	0.075951523	0.18619053	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.075951523	0.075951523	0.18619053	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											27.7899	0.179242444	18.02467061	0	3.132868442	3.367722882	1.878780505	3.225525515	10.33657797	2.733620658	6.621769451	0.095772311	0.0678661	3.557883938	7.521461292	34.75801606	0.361184301	2.810115974	4.700873909	1.139569943	8.728354656	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.0318	0	0	27.7899	0.179242444	18.02467061	0	3.132868442	3.367722882	1.878780505	3.225525515	10.33657797	2.733620658	6.621769451	0.095772311	0.0678661	3.557883938	7.521461292	34.75801606	0.361184301	2.810115974	4.700873909	1.139569943	8.728354656	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.0318	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	27.7899	0.179242444	18.02467061	0	3.132868442	3.367722882	1.878780505	3.225525515	10.33657797	2.733620658	6.621769451	0.095772311	0.0678661	3.557883938	7.521461292	34.75801606	0.361184301	2.810115974	4.700873909	1.139569943	8.728354656	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.0318
H0846_803_0	2009	6																					0											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	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	382.6441912	2.468023146	101.2399671	0	14.18741181	15.25125698	8.508349794	14.60260612	46.79577824	12.37565338	29.97808905	0.433580613	0.307254116	16.1072599	34.05378415	157.3692046	1.635252073	12.72222196	21.28343671	5.159458696	39.5277119	0	0	0	0	0	0	0	0	0											Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.073310123	0.073310123	0.176985905	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.073310123	0.073310123	0.176985905	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											28.0517	0.18093108	17.91804721	0	3.277292129	3.523040362	1.965428802	3.373202014	10.80982477	2.858775931	6.924938571	0.100157122	0.070975701	3.720777036	7.866424138	36.35228627	0.377743229	2.938833272	4.91647388	1.191834959	9.13090145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.5496	0	0	28.0517	0.18093108	17.91804721	0	3.277292129	3.523040362	1.965428802	3.373202014	10.80982477	2.858775931	6.924938571	0.100157122	0.070975701	3.720777036	7.866424138	36.35228627	0.377743229	2.938833272	4.91647388	1.191834959	9.13090145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.5496	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	28.0517	0.18093108	17.91804721	0	3.277292129	3.523040362	1.965428802	3.373202014	10.80982477	2.858775931	6.924938571	0.100157122	0.070975701	3.720777036	7.866424138	36.35228627	0.377743229	2.938833272	4.91647388	1.191834959	9.13090145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.5496
H0846_804_0	2009	6																					0											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	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	382.6441912	2.468023146	101.2399671	0	14.18741181	15.25125698	8.508349794	14.60260612	46.79577824	12.37565338	29.97808905	0.433580613	0.307254116	16.1072599	34.05378415	157.3692046	1.635252073	12.72222196	21.28343671	5.159458696	39.5277119	0	0	0	0	0	0	0	0	0											Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.073310123	0.073310123	0.176985905	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.073310123	0.073310123	0.176985905	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											28.0517	0.18093108	17.91804721	0	3.277292129	3.523040362	1.965428802	3.373202014	10.80982477	2.858775931	6.924938571	0.100157122	0.070975701	3.720777036	7.866424138	36.35228627	0.377743229	2.938833272	4.91647388	1.191834959	9.13090145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.5496	0	0	28.0517	0.18093108	17.91804721	0	3.277292129	3.523040362	1.965428802	3.373202014	10.80982477	2.858775931	6.924938571	0.100157122	0.070975701	3.720777036	7.866424138	36.35228627	0.377743229	2.938833272	4.91647388	1.191834959	9.13090145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.5496	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	28.0517	0.18093108	17.91804721	0	3.277292129	3.523040362	1.965428802	3.373202014	10.80982477	2.858775931	6.924938571	0.100157122	0.070975701	3.720777036	7.866424138	36.35228627	0.377743229	2.938833272	4.91647388	1.191834959	9.13090145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.5496
H0901_002_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$75/day 1-8	$75/day 1-8	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$200 per procedure	$25 per visit	$25 X-ray; $140 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											58	58	47.8866492	20	100	0.2	0.2	48.5	200	25	71	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											58	58	47.8866492	20	100	0.2	0.2	48.5	200	25	71	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											9.4442	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	6.408158995	2.185826699	27.89323295	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.5296	0	0	9.4442	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	6.408158995	2.185826699	27.89323295	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.5296																																																																																		0			9.4442	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	6.408158995	2.185826699	27.89323295	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.5296
H0901_004_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$150/day 1-10	$150/day 1-10	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$200 per procedure	$35 per visit	$45 X-ray; $140 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$0 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											122.95	122.95	47.8866492	20	100	0.2	0.2	48.5	200	35	83	35	25	35	0	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											122.95	122.95	47.8866492	20	100	0.2	0.2	48.5	200	35	83	35	25	35	0	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											20.0201	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	6.408158995	3.060157379	32.60758218	0	0.139220051	2.295447554	0	27.04289519	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.5477	0	0	20.0201	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	6.408158995	3.060157379	32.60758218	0	0.139220051	2.295447554	0	27.04289519	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.5477																																																																																		0			20.0201	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	6.408158995	3.060157379	32.60758218	0	0.139220051	2.295447554	0	27.04289519	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.5477
H0901_005_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$100/day 1-7	$100/day 1-7	"$0/d 1-20, $100/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$0 X-ray; $100 Complex Radiology	$0 per visit	$0 per visit	$0 per visit	$0 PCP visit; $0 if no PCP selected	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$45 per script	0	$0 per Trip/50 One Way Trips	0	$0 per visit	$150 Every 2 Years	$0 per visit	$1000 Every 3 Yrs	Coaching Only	0											72.2855078	72.2855078	40.33133874	0	100	0.2	0.2	47.5	150	0	40	0	0	0	0	0	0	0	0	0	45	0	0	0	0	0	0	0	0	0											72.2855078	72.2855078	40.33133874	0	100	0.2	0.2	47.5	150	0	40	0	0	0	0	0	0	0	0	0	45	0	0	0	0	0	0	0	0	0											11.7703	0	4.532899329	0	2.276793099	1.576138182	0	1.007075897	4.806119247	0	15.71449744	0	0	0	0	0	0	0	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.7227	0	0	11.7703	0	4.532899329	0	2.276793099	1.576138182	0	1.007075897	4.806119247	0	15.71449744	0	0	0	0	0	0	0	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.7227																																																																																		0			11.7703	0	4.532899329	0	2.276793099	1.576138182	0	1.007075897	4.806119247	0	15.71449744	0	0	0	0	0	0	0	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.7227
H0901_007_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$75/day 1-8	$75/day 1-8	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$200 per procedure	$25 per visit	$25 X-ray; $140 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											57.1373915	57.1373915	47.8866492	20	100	0.2	0.2	48.5	200	25	71	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											57.1373915	57.1373915	47.8866492	20	100	0.2	0.2	48.5	200	25	71	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											9.3037	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	6.408158995	2.185826699	27.89323295	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.3892	0	0	9.3037	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	6.408158995	2.185826699	27.89323295	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.3892																																																																																		0			9.3037	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	6.408158995	2.185826699	27.89323295	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.3892
H0901_801_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		339.6211985	0	41.93651177	6.358078177	7.498870027	9.982885267	0	8.824019312	45.6036123	15.54471249	63.36136782	0	3.457558722	13.14264713	46.42193734	201.6450783	0	5.976293362	0	0	9.018301218	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.0667	0.0667	0.1553	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0667	0.0667	0.1553	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											22.6527	0	6.512740277	0	1.732238976	2.306046497	0	2.038348461	10.53443444	3.590828585	14.63647597	0	0.798696065	3.035951487	10.72346752	46.58001309	0	1.380523767	0	0	2.083227581	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.6057	0	0	22.6527	0	6.512740277	0	1.732238976	2.306046497	0	2.038348461	10.53443444	3.590828585	14.63647597	0	0.798696065	3.035951487	10.72346752	46.58001309	0	1.380523767	0	0	2.083227581	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.6057																																																																																		0			22.6527	0	6.512740277	0	1.732238976	2.306046497	0	2.038348461	10.53443444	3.590828585	14.63647597	0	0.798696065	3.035951487	10.72346752	46.58001309	0	1.380523767	0	0	2.083227581	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.6057
H0901_802_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		339.6211985	0	41.93651177	6.358078177	7.498870027	9.982885267	0	8.824019312	45.6036123	15.54471249	63.36136782	0	3.457558722	13.14264713	46.42193734	201.6450783	0	5.976293362	0	0	9.018301218	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.0667	0.0667	0.1553	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0667	0.0667	0.1553	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											22.6527	0	6.512740277	0	1.732238976	2.306046497	0	2.038348461	10.53443444	3.590828585	14.63647597	0	0.798696065	3.035951487	10.72346752	46.58001309	0	1.380523767	0	0	2.083227581	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.6057	0	0	22.6527	0	6.512740277	0	1.732238976	2.306046497	0	2.038348461	10.53443444	3.590828585	14.63647597	0	0.798696065	3.035951487	10.72346752	46.58001309	0	1.380523767	0	0	2.083227581	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.6057																																																																																		0			22.6527	0	6.512740277	0	1.732238976	2.306046497	0	2.038348461	10.53443444	3.590828585	14.63647597	0	0.798696065	3.035951487	10.72346752	46.58001309	0	1.380523767	0	0	2.083227581	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.6057
H0902_002_0	2009	9																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	5000	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$50/day 1-7	$50/day 1-7	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$200 per procedure	$25 per visit	$25 X-ray; $150 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											36.14	36.14	47.8866492	20	100	0.2	0.2	48.5	200	25	75	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											36.14	36.14	47.8866492	20	100	0.2	0.2	48.5	200	25	75	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											5.1785	0	4.73620571	1.506462933	2.003577927	1.3870016	0	0.904884196	5.639179916	1.923527495	25.92892077	0	0.122513645	1.442852748	5.358275608	16.99839126	0	1.232107151	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.2766	0	0	5.1785	0	4.73620571	1.506462933	2.003577927	1.3870016	0	0.904884196	5.639179916	1.923527495	25.92892077	0	0.122513645	1.442852748	5.358275608	16.99839126	0	1.232107151	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.2766		$500 ded; 20% coinsurance; $5000 max OOP	$500 ded; 20% coinsurance; $5000 max OOP	$500 ded; 20% coinsurance; $5000 max OOP	$500 ded; 20% coinsurance; $5000 max OOP	$100 copay	$500 ded; 20% coinsurance; $5000 max OOP	$500 ded; 20% coinsurance; $5000 max OOP	$50 copay	$500 ded; 20% coinsurance; $5000 max OOP	$500 ded; 20% coinsurance; $5000 max OOP	$500 ded; 20% coinsurance; $5000 max OOP	$500 ded; 20% coinsurance; $5000 max OOP	$25 copay	$500 ded; 20% coinsurance; $5000 max OOP	$500 ded; 20% coinsurance; $5000 max OOP	$500 ded; 20% coinsurance; $5000 max OOP	$500 ded; 20% coinsurance; $5000 max OOP	$500 ded; 20% coinsurance; $5000 max OOP	$500 ded; 20% coinsurance; $5000 max OOP	$500 ded; 20% coinsurance; $5000 max OOP	$500 ded; 20% coinsurance; $5000 max OOP		0	0	$500 ded; 20% coinsurance; $5000 max OOP	0	$500 ded; 20% coinsurance; $5000 max OOP	0	Not Covered												5.3355	0	0.6588	0.0999	0.2002	0.1568	0	0.1135	0.7164	0.2442	0.9954	0	5.1556	0.2065	0.7293	3.1679	0	0.0939	0	0	0.1417	0	0	0	0.0661	0	0.0042	0	0	0											18.086	500	3.136721414	10.5141	0	5.395039657	1.606350061	2.20374504	1.543835429	0	1.018409722	6.355625005	2.167739135	26.924345	0	5.278091014	1.649327291	6.087576805	20.16629001	0	1.325996337	0	0	1.055853245	0	0	0	0.066078193	0	0.004217941	0	0	0	0	0	0	0	0	0	0	0	0	0	93.3626
H0902_801_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		322.6521068	0	39.84116403	6.040398327	7.124190787	9.484092801	0	8.383129305	43.32503876	14.76802466	60.19553229	0	3.284802631	12.48597792	44.10247638	191.5699304	0	5.677689299	0	0	8.567703963	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.0667	0.0667	0.1553	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.0667	0.0667	0.1553	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			21.5209	0	6.187332773	0	1.645688072	2.190825437	0	1.93650287	10.00808395	3.411413697	13.90516796	0	0.758789408	2.8842609	10.18767204	44.25265392	0	1.311546228	0	0	1.979139615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.18			21.5209	0	6.187332773	0	1.645688072	2.190825437	0	1.93650287	10.00808395	3.411413697	13.90516796	0	0.758789408	2.8842609	10.18767204	44.25265392	0	1.311546228	0	0	1.979139615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.18		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered												2.9347	0	0.8437	0	0.2244	0.2987	0	0.2641	1.3647	0.4652	1.8962	0	0.1035	0.3933	1.3892	6.0345	0	0.1788	0	0	0.2699	0	0	0	0	0	0	0	0	0											16.6609	0	0	24.4556	0	7.031059969	0	1.870100081	2.48957436	0	2.200571443	11.37282267	3.876606474	15.80132723	0	0.862260691	3.277569204	11.57690005	50.28710673	0	1.490393441	0	0	2.24902229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.8409
H0902_802_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		322.6521068	0	39.84116403	6.040398327	7.124190787	9.484092801	0	8.383129305	43.32503876	14.76802466	60.19553229	0	3.284802631	12.48597792	44.10247638	191.5699304	0	5.677689299	0	0	8.567703963	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.0667	0.0667	0.1553	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0667	0.0667	0.1553	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											21.5209	0	6.187332773	0	1.645688072	2.190825437	0	1.93650287	10.00808395	3.411413697	13.90516796	0	0.758789408	2.8842609	10.18767204	44.25265392	0	1.311546228	0	0	1.979139615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.18			21.5209	0	6.187332773	0	1.645688072	2.190825437	0	1.93650287	10.00808395	3.411413697	13.90516796	0	0.758789408	2.8842609	10.18767204	44.25265392	0	1.311546228	0	0	1.979139615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.18		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered												2.9347	0	0.8437	0	0.2244	0.2987	0	0.2641	1.3647	0.4652	1.8962	0	0.1035	0.3933	1.3892	6.0345	0	0.1788	0	0	0.2699	0	0	0	0	0	0	0	0	0											16.6609	0	0	24.4556	0	7.031059969	0	1.870100081	2.48957436	0	2.200571443	11.37282267	3.876606474	15.80132723	0	0.862260691	3.277569204	11.57690005	50.28710673	0	1.490393441	0	0	2.24902229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.8409
H0902_804_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		322.6521068	0	39.84116403	6.040398327	7.124190787	9.484092801	0	8.383129305	43.32503876	14.76802466	60.19553229	0	3.284802631	12.48597792	44.10247638	191.5699304	0	5.677689299	0	0	8.567703963	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.0667	0.0667	0.1553	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.0667	0.0667	0.1553	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			21.5209	0	6.187332773	0	1.645688072	2.190825437	0	1.93650287	10.00808395	3.411413697	13.90516796	0	0.758789408	2.8842609	10.18767204	44.25265392	0	1.311546228	0	0	1.979139615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.18			21.5209	0	6.187332773	0	1.645688072	2.190825437	0	1.93650287	10.00808395	3.411413697	13.90516796	0	0.758789408	2.8842609	10.18767204	44.25265392	0	1.311546228	0	0	1.979139615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.18		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered												2.9347	0	0.8437	0	0.2244	0.2987	0	0.2641	1.3647	0.4652	1.8962	0	0.1035	0.3933	1.3892	6.0345	0	0.1788	0	0	0.2699	0	0	0	0	0	0	0	0	0											16.6609	0	0	24.4556	0	7.031059969	0	1.870100081	2.48957436	0	2.200571443	11.37282267	3.876606474	15.80132723	0	0.862260691	3.277569204	11.57690005	50.28710673	0	1.490393441	0	0	2.24902229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.8409
H0908_001_0	2009	6																																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		368.7111097	28.10150162	95.71965938	0	14.68204152	24.7118763	18.34432219	25.07153037	31.30493582	12.1561367	24.82912632	0	5.153151193	50.20577526	62.8829183	116.4587233	8.654545411	5.449534637	21.84362114	36.24880508	10.74763201	0.81772743	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											0.077456679	0.077456679	0.1822753	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.077456679	0.077456679	0.1822753	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											28.5591	2.176648998	17.44732966	0	3.391551592	5.708443425	4.237538426	5.791523516	7.231440174	2.808067577	5.73552818	0	1.190377926	11.59753408	14.52595413	26.90196509	1.99919999	1.258842501	5.045876483	8.373473973	2.482702993	0.188895036	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	156.652	0		28.5591	2.176648998	17.44732966	0	3.391551592	5.708443425	4.237538426	5.791523516	7.231440174	2.808067577	5.73552818	0	1.190377926	11.59753408	14.52595413	26.90196509	1.99919999	1.258842501	5.045876483	8.373473973	2.482702993	0.188895036	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	156.652																																																																																		0	0		28.5591	2.176648998	17.44732966	0	3.391551592	5.708443425	4.237538426	5.791523516	7.231440174	2.808067577	5.73552818	0	1.190377926	11.59753408	14.52595413	26.90196509	1.99919999	1.258842501	5.045876483	8.373473973	2.482702993	0.188895036	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	156.652
H0913_001_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1551.586527	132.3108169	526.8843982	963.4710806	444.3431619	11.93286653	3.985117999	906.3801517	236.2572866	3530.193137	980.9830551	26.00753175	0.217321552	526.3853952	7574.406832	27225.4113	709.1951409	4267.557185	4509.553906	2621.717079	29.44528635	37.98310155	0	526.6666667	360	249.2307692	60	12.20338983	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, $85 days 8 - 100"	Copay between $0.00 and $25.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $25.00	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $50.00, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $1,000 benefit limit"	Not Covered	Not Covered											50.37501721	30.00376878	56.13	4.02529859	38.13577026	0.2	0.2	19.33347472	49.4569552	0	12.70952832	26.24922505	0.2	7.304684969	2.202137862	5.551696888	16.68063018	10.75287198	15.99442264	4.679237619	0.2	0	0	50	10	10	10	10	0	0											47.59904666	28.35037821	53.03689482	3.803480099	36.03425683	0.188978781	0.188978781	18.2680824	46.73157547	0	12.00915583	24.80273272	0.188978781	6.902152296	2.080786641	5.245764545	15.76142577	10.16032318	15.11303245	4.4213831	0.188978781	0	0	50	10	10	10	10	0	0											6.1545	0.312588475	2.328692701	0.30537859	1.334297968	2.255058567	0.753102741	1.379818941	0.920056268	0	0.981731531	0.053754822	0.041069162	0.302766014	1.313393712	11.90150811	0.931493881	3.613313349	5.679419541	0.965967966	5.564534314	0	0	2.194444444	0.3	0.207692308	0.05	0.010169492	0	0	0	0	0	0	0	0	0	0	0	0	49.8548	0	2.7464	6.1545	0.312588475	2.328692701	0.30537859	1.334297968	2.255058567	0.753102741	1.379818941	0.920056268	0	0.981731531	0.053754822	0.041069162	0.302766014	1.313393712	11.90150811	0.931493881	3.613313349	5.679419541	0.965967966	5.564534314	0	0	2.194444444	0.3	0.207692308	0.05	0.010169492	0	0	0	0	0	0	0	0	0	0	0	0	49.8548	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.1545	0.312588475	2.328692701	0.30537859	1.334297968	2.255058567	0.753102741	1.379818941	0.920056268	0	0.981731531	0.053754822	0.041069162	0.302766014	1.313393712	11.90150811	0.931493881	3.613313349	5.679419541	0.965967966	5.564534314	0	0	2.194444444	0.3	0.207692308	0.05	0.010169492	0	0	0	0	0	0	0	0	0	0	0	0	49.8548
H0913_002_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1630.524234	178.1003517	535.1279197	916.4655831	432.5708491	12.85811142	5.296095677	949.9486719	213.0124972	3834.125986	981.4937573	48.79697377	0.10121201	568.1482752	6754.339307	31350.06443	1101.754258	4719.803715	5156.607125	2670.45635	43.83776877	28.75110098	0	526.6666667	360	249.2307692	60	12.20338983	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, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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 $10.00	Copay between $0.00 and $35.00	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $50.00, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $1,000 benefit limit"	Not Covered	Not Covered											79.9868346	36.91159204	56.13	6.424439108	41.58765165	0.2	0.2	18.63500913	62.92038424	0	16.43605929	39.37383757	0.2	9.597424377	4.557787702	7.886453212	23.76072067	15.07029492	18.43136458	4.967724263	0.2	0	0	50	10	10	10	10	0	0											72.07704499	33.26145476	50.57938041	5.789135036	37.47510517	0.180222271	0.180222271	16.79221835	56.69827276	0	14.81071967	35.48021217	0.180222271	8.648348095	4.107074257	7.106572548	21.41105522	13.58001389	16.60871193	4.476472747	0.180222271	0	0	50	10	10	10	10	0	0											9.7936	0.493656399	2.255536552	0.442128585	1.350886506	2.317318043	0.954474391	1.329312127	1.006453389	0	1.211385742	0.144277249	0.018240658	0.409462004	2.311714424	18.56595894	1.965810104	5.341250002	7.137050189	0.996185423	7.900542252	0	0	2.194444444	0.3	0.207692308	0.05	0.010169492	0	0	0	0	0	0	0	0	0	0	0	0	68.7076	0	7.2369	9.7936	0.493656399	2.255536552	0.442128585	1.350886506	2.317318043	0.954474391	1.329312127	1.006453389	0	1.211385742	0.144277249	0.018240658	0.409462004	2.311714424	18.56595894	1.965810104	5.341250002	7.137050189	0.996185423	7.900542252	0	0	2.194444444	0.3	0.207692308	0.05	0.010169492	0	0	0	0	0	0	0	0	0	0	0	0	68.7076	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	9.7936	0.493656399	2.255536552	0.442128585	1.350886506	2.317318043	0.954474391	1.329312127	1.006453389	0	1.211385742	0.144277249	0.018240658	0.409462004	2.311714424	18.56595894	1.965810104	5.341250002	7.137050189	0.996185423	7.900542252	0	0	2.194444444	0.3	0.207692308	0.05	0.010169492	0	0	0	0	0	0	0	0	0	0	0	0	68.7076
H0913_003_0	2009	7																					0											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	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		364.3512504	45.00397133	846.382076	1580.833352	17.57025333	23.27861799	5.978671222	21.19946493	19.05724482	5318.597199	19.42132749	0.816486206	0.869694546	9.826342107	8197.118622	138.3403328	16.73185735	19.70272449	38.27545785	14.93600027	19.62085302	0.137424987	4500	1145.454545	0	0	0	0	1664	10830											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	$0.00 copayment	"$0.00 copayment, No benefit limit"	Not Covered	Not Covered	Not Covered	Not Covered	$0.00 copayment	$0.00 copayment											698.0250295	551.7966688	70.45935046	0	0.162367733	0.17	0.17	0.125379974	0.17	0	0.17	0.17	0.17	0.17	0	0.090823513	0.17	0.17	0.17	0.130059082	0.17	0.17	0	0	0	0	0	0	0	0											698.0250295	551.7966688	70.45935046	0	0.162367733	0.17	0.17	0.125379974	0.17	0	0.17	0.17	0.17	0.17	0	0.090823513	0.17	0.17	0.17	0.130059082	0.17	0.17	0	0	0	0	0	0	0	0											21.1939	2.069420122	4.96962761	0	2.852842195	3.957365058	1.016374108	2.657988371	3.23973162	0	3.301625673	0.138802655	0.147848073	1.670478158	0	12.56455501	2.844415749	3.349463163	6.506827834	1.942562488	3.335545014	0.023362248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.7827	0	0	21.1939	2.069420122	4.96962761	0	2.852842195	3.957365058	1.016374108	2.657988371	3.23973162	0	3.301625673	0.138802655	0.147848073	1.670478158	0	12.56455501	2.844415749	3.349463163	6.506827834	1.942562488	3.335545014	0.023362248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.7827	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.1939	2.069420122	4.96962761	0	2.852842195	3.957365058	1.016374108	2.657988371	3.23973162	0	3.301625673	0.138802655	0.147848073	1.670478158	0	12.56455501	2.844415749	3.349463163	6.506827834	1.942562488	3.335545014	0.023362248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.7827
H0913_004_0	2009	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	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		2405.513745	558.0187973	788.7158699	1592.655163	1786.885744	24.01016399	6.025656563	2120.810776	287.2405449	5357.678973	1275.347976	19.56277858	1.057759851	539.9566827	9489.42188	27222.23467	1885.459407	6297.819176	5115.010679	2358.311721	22.65906723	11.88980447	0	526.6666667	360	249.2307692	60	12.20338983	1664	13778.57143											"$25 days 1 - 5, $0 after day 5, unlimited coverage"	"$25 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $20.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $20.00	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $50.00, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $1,000 benefit limit"	$0.00 copayment	$0.00 copayment											11.69720312	6.431706812	58.89	1.750808774	32.25105196	0.2	0.2	20.91900733	18.52065243	0	8.539443076	6.562306262	0.2	3.884525083	0	3.83925927	11.00592092	8.35414834	15.08820192	5.147898625	0.2	0	0	50	10	10	10	10	0	0											10.345119	5.688263391	52.08288265	1.548432126	28.52314068	0.176881924	0.176881924	18.50097137	16.37984322	0	7.552365624	5.803766801	0.176881924	3.435511361	0	3.39547784	9.733742363	7.388489176	13.34415096	4.552851077	0.176881924	0	0	50	10	10	10	10	0	0											2.0738	0.264513158	3.423216341	0.205509868	4.247299454	4.246964011	1.065829729	3.269754954	0.392079591	0	0.802657851	0.009461484	0.187098598	0.15458561	0	7.702707881	1.529381342	3.877614068	5.687956222	0.894753505	4.007979416	0	0	2.194444444	0.3	0.207692308	0.05	0.010169492	0	0	0	0	0	0	0	0	0	0	0	0	46.8054	0	5.7563	2.0738	0.264513158	3.423216341	0.205509868	4.247299454	4.246964011	1.065829729	3.269754954	0.392079591	0	0.802657851	0.009461484	0.187098598	0.15458561	0	7.702707881	1.529381342	3.877614068	5.687956222	0.894753505	4.007979416	0	0	2.194444444	0.3	0.207692308	0.05	0.010169492	0	0	0	0	0	0	0	0	0	0	0	0	46.8054	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	2.0738	0.264513158	3.423216341	0.205509868	4.247299454	4.246964011	1.065829729	3.269754954	0.392079591	0	0.802657851	0.009461484	0.187098598	0.15458561	0	7.702707881	1.529381342	3.877614068	5.687956222	0.894753505	4.007979416	0	0	2.194444444	0.3	0.207692308	0.05	0.010169492	0	0	0	0	0	0	0	0	0	0	0	0	46.8054
H0913_005_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2340.558904	652.9560421	1238.290363	1257.028111	2086.024517	25.37610369	5.847064091	2555.311858	199.8091835	6895.620849	1396.255829	32.46859454	0.515457956	543.1094233	8046.689982	26022.64472	2542.764362	5427.654798	4912.083642	2109.20321	14.1771286	10.39964186	0	526.6666667	360	249.2307692	60	12.20338983	1664	12750											"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$50 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	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $25.00	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $50.00, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $1,000 benefit limit"	$0.00 copayment	$0.00 copayment											24.06831887	12.3276405	58.89	3.531228523	27.13984611	0.2	0.2	20.65004462	18.40768532	0	8.023654164	13.12461252	0.2	3.461396034	0	4.645110047	16.40721571	10.26731574	16.03206767	6.043860568	0.2	0	0	50	10	10	10	10	0	0											22.55520004	11.55263062	55.18772364	3.309228458	25.43362756	0.187426468	0.187426468	19.35182468	17.25043727	0	7.519225822	12.29949888	0.187426468	3.243786173	0	4.353082859	15.37573249	9.621833646	15.02416913	5.663897211	0.187426468	0	0	50	10	10	10	10	0	0											4.3993	0.62861333	5.694868864	0.346649433	4.42126422	4.756153498	1.095894574	4.120828924	0.287232982	0	0.874896907	0.033278954	0.096610464	0.146810903	0	9.439894054	3.258072051	4.351999297	6.14999795	0.995525848	2.657169147	0	0	2.194444444	0.3	0.207692308	0.05	0.010169492	0	0	0	0	0	0	0	0	0	0	0	0	56.5174	0	3.6062	4.3993	0.62861333	5.694868864	0.346649433	4.42126422	4.756153498	1.095894574	4.120828924	0.287232982	0	0.874896907	0.033278954	0.096610464	0.146810903	0	9.439894054	3.258072051	4.351999297	6.14999795	0.995525848	2.657169147	0	0	2.194444444	0.3	0.207692308	0.05	0.010169492	0	0	0	0	0	0	0	0	0	0	0	0	56.5174	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.3993	0.62861333	5.694868864	0.346649433	4.42126422	4.756153498	1.095894574	4.120828924	0.287232982	0	0.874896907	0.033278954	0.096610464	0.146810903	0	9.439894054	3.258072051	4.351999297	6.14999795	0.995525848	2.657169147	0	0	2.194444444	0.3	0.207692308	0.05	0.010169492	0	0	0	0	0	0	0	0	0	0	0	0	56.5174
H0913_006_0	2009	5																					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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1333.838198	121.667388	450.7612329	708.6307763	428.9656574	11.77582221	3.707133768	806.3196222	195.0363932	3056.034469	824.4409569	27.36451747	0.154932535	455.2471	6335.520002	24382.80225	704.6153223	3788.675883	4003.222464	2491.400147	27.86590974	29.58061653	0	671.25	360	249.2307692	60	12.20338983	1664	15150											"$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	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $25.00	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $195.00, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $1,000 benefit limit"	$0.00 copayment	$0.00 copayment											76.70857929	42.36437345	56.13	4.785598172	39.09490505	0.2	0.2	19.12189141	62.3614672	0	15.87187992	39.37383757	0.2	8.731964254	2.247894314	5.638728322	16.72766473	10.75673803	16.04827238	4.611988092	0.2	0	0	20	10	10	10	10	0	0											72.68258506	40.14090999	53.1840576	4.534429518	37.04303727	0.189503145	0.189503145	18.11829278	59.08847076	0	15.0388558	37.30733022	0.189503145	8.273673435	2.129915209	5.34278375	15.84972537	10.19217842	15.20599043	4.369931237	0.189503145	0	0	20	10	10	10	10	0	0											8.0789	0.406986639	1.997775948	0.267769692	1.32418257	2.231555343	0.702513507	1.217427916	0.960366851	0	1.033220722	0.085074757	0.029360203	0.313880486	1.124510034	10.8560033	0.930663279	3.217905049	5.072746873	0.90727061	5.28067753	0	0	1.11875	0.3	0.207692308	0.05	0.010169492	0	0	0	0	0	0	0	0	0	0	0	0	47.7254	0	2.5502	8.0789	0.406986639	1.997775948	0.267769692	1.32418257	2.231555343	0.702513507	1.217427916	0.960366851	0	1.033220722	0.085074757	0.029360203	0.313880486	1.124510034	10.8560033	0.930663279	3.217905049	5.072746873	0.90727061	5.28067753	0	0	1.11875	0.3	0.207692308	0.05	0.010169492	0	0	0	0	0	0	0	0	0	0	0	0	47.7254	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.0789	0.406986639	1.997775948	0.267769692	1.32418257	2.231555343	0.702513507	1.217427916	0.960366851	0	1.033220722	0.085074757	0.029360203	0.313880486	1.124510034	10.8560033	0.930663279	3.217905049	5.072746873	0.90727061	5.28067753	0	0	1.11875	0.3	0.207692308	0.05	0.010169492	0	0	0	0	0	0	0	0	0	0	0	0	47.7254
H0967_001_0	2009	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	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		1295.111955	136.1253335	661.4585452	1510.909452	460.3616702	14.18860709	5.134908887	1724.064404	311.7392977	8614.83368	1490.611544	56.00386327	0.126583813	711.9105408	9039.566894	18609.71061	472.3328968	2591.928323	4244.276607	2128.090637	38.41123358	28.67432799	0	530	324	129.6	46.2	12.32	0	5800											"$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 $30.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $30.00	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, $1,000 benefit limit"	$0.00 copayment	"$0.00 copayment, $150 benefit limit,"	$0.00 copayment	"$0.00 copayment, $1,000 benefit limit"	Not Covered	$0.00 copayment											64.18331423	28.65453743	49.53	4.631933955	32.93362025	0.2	0.2	20.59756385	52.90810347	0	12.89533032	26.24922505	0.2	6.700811266	4.508762222	7.957497953	22.13868188	11.86401239	17.15529777	5.556757417	0.2	0	0	0	0	0	0	0	0	0											61.75088585	27.56858369	47.65290501	4.456392263	31.68549722	0.192420372	0.192420372	19.81695445	50.90298463	0	12.40662125	25.25442818	0.192420372	6.446862967	4.337888509	7.655923563	21.29966696	11.41438836	16.50514385	5.346166634	0.192420372	0	0	0	0	0	0	0	0	0											6.6645	0.312731887	2.626701769	0.561100433	1.215565702	2.730177047	0.988061076	2.847142146	1.322371723	0	1.541121072	0.117862129	0.024357304	0.382465808	3.267719446	11.87287683	0.838377783	2.465439706	5.837699663	0.94809393	7.391103836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.9555	0	2.1254	6.6645	0.312731887	2.626701769	0.561100433	1.215565702	2.730177047	0.988061076	2.847142146	1.322371723	0	1.541121072	0.117862129	0.024357304	0.382465808	3.267719446	11.87287683	0.838377783	2.465439706	5.837699663	0.94809393	7.391103836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.9555	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Coin between 20% and 50%	20% coinsurance	20% coinsurance	20% coinsurance	"50% coinsurance, $1,000 benefit limit"	50% coinsurance	"50% coinsurance, $150 benefit limit"	50% coinsurance	"50% coinsurance, $1,000 benefit limit"	20% coinsurance	20% coinsurance											8.3819	0.2768	0.5817	0.6527	0.1903	0.6009	0.1859	0	0.819	0.2862	0.7845	0.0362	0	0.3556	0.6226	3.5293	0.1396	0.3526	0.892	0.5275	1.3371	0.0278	0	0	0	0	0	0	0	0											20.5802	0	0	15.0464	0.589581303	3.208433467	1.213829314	1.405839149	3.331106289	1.173979152	2.847142146	2.141366293	0.286187383	2.325590596	0.154052255	0.024357304	0.738052831	3.890356882	15.40217397	0.977941126	2.81804825	6.729650604	1.475579931	8.728222461	0.027816488	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5357
H0974_001_0	2009	5																																Coin		Coin	Coin	Coin	Coin		V	Coin					Coin						Coin	Coin	Coin																																																											0		255.224386		27.41668249	8.5645773	6.553882558	31.35442862		927.7895839	36.75770989					93.50942398						156.7333019	26.94893277	3.414289447																			traditional Medicare	included in a.1	traditional Medicare	traditional Medicare	traditional Medicare	traditional Medicare	included in e.1	$50 Copay (max for MA)	traditional Medicare	included in h.5	included in h.5	included in h.5	included in h.5	traditional Medicare	included in i.6	included in i.6	included in i.6	included in i.6	included in i.6	traditional Medicare	traditional Medicare	traditional Medicare								no cost share											0.078611153		0.147181777	0	0.231	0.231		50	0.231					0.231						0.231	0.231	0.231																			0.078611153		0.147181777	0	0.231	0.231		50	0.231					0.231						0.231	0.231	0.231																			20.0635	0	4.035236047	0	1.513946871	7.242873011	0	3.865789933	8.491030985	0	0	0	0	21.60067694	0	0	0	0	0	36.20539273	6.22520347	0.788700862	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.0323			20.0635	0	4.035236047	0	1.513946871	7.242873011	0	3.865789933	8.491030985	0	0	0	0	21.60067694	0	0	0	0	0	36.20539273	6.22520347	0.788700862	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.0323																																																																																		0			20.0635	0	4.035236047	0	1.513946871	7.242873011	0	3.865789933	8.491030985	0	0	0	0	21.60067694	0	0	0	0	0	36.20539273	6.22520347	0.788700862	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.0323
H0979_004_0	2009	11	X1	X2		X4	X5		X7				OP Facility - Other	OP Facility - Other		OP Facility - Other	OP Facility - Other		Professional				3350	Non-facility lab	Diabetic supplies		Ambulatory surgical center	MRI/PET/CAT		Podiatry				D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	V	V	V	V	V	V	V	V	Coin	O	T	P	V	V	V	V	O	O	V	Coin		V	Coin		V																																												0		1772.418081	74.57280863	940.1903665	2649.471971	343.9422085	23.87721746	1.304751183	321.6881245	236.6393561	2662.687752	12.12086681	58.20244538	0	2803.543566	4874.64299	4788.310112	531.6342304	1967.540183	6554.407718	5306.210899	18.63824081	0	0	0	0	0	0	0	0	0	6772.308531	3.961899691		3.439354182	8.132756351		318.6151934				$350 for 1st 7 days	$300 for 1st 7 days	$100 for days 10-100	$25 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$250 Copay	$15 Copay	20% Coinsurance	$350 Copay	$25 Copay	$15 Copay	$15 per Visit	$30 per Visit	$30 per Visit	$30 per Visit	$30 per Visit	$30 per Visit	20% Coinsurance			$0 per Procedure	$0 - 1 / Year ($3.85 Cap)	$0 - up to $100 ($3.85 Cap)	$0 (1 / 3 Years)	"$1,000 allowable/hearing aid"			$15 Copay	20% Coinsurance		$100 Copay	20% Coinsurance		$30 Copay				262.9246013	157.6419886	40.74391478	25	100	0.3	0.3	32.05	250	15	0.2	350	25	15	15	30	30	30	30	30	0.2	0	0	0	0	0	0	0	0	0	15	0.2		100	0.2		30				182.4280312	109.3785727	28.26982382	17.34604049	69.38416196	0.208152486	0.208152486	22.23762391	173.4604049	10.40762429	0.138768324	242.8445669	17.34604049	10.40762429	10.40762429	20.81524859	20.81524859	20.81524859	20.81524859	20.81524859	0.138768324	0	0	0	0	0	0	0	0	0	10.40762429	0.138768324		69.38416196	0.138768324		20.81524859				26.9449	0.679722281	2.214918001	3.829820674	1.988678492	4.970102171	0.271587202	0.596131627	3.420629877	2.309354478	1.681992372	1.177845637	0	2.43151901	4.227787735	8.305822108	0.922174889	3.412903168	11.36930217	9.204174911	2.586397438	0	0	0	0	0	0	0	0	0	5.8736369	0.54978618	0	0.019886392	1.128568968	0	0.552671205	0	0	0	100.6703		44.4209	26.9449	0.679722281	2.214918001	3.829820674	1.988678492	4.970102171	0.271587202	0.596131627	3.420629877	2.309354478	1.681992372	1.177845637	0	2.43151901	4.227787735	8.305822108	0.922174889	3.412903168	11.36930217	9.204174911	2.586397438	0	0	0	0	0	0	0	0	0	5.8736369	0.54978618	0	0.019886392	1.128568968	0	0.552671205	0	0	0	100.6703	3350																																																																																	0			26.9449	0.679722281	2.214918001	3.829820674	1.988678492	4.970102171	0.271587202	0.596131627	3.420629877	2.309354478	1.681992372	1.177845637	0	2.43151901	4.227787735	8.305822108	0.922174889	3.412903168	11.36930217	9.204174911	2.586397438	0	0	0	0	0	0	0	0	0	5.8736369	0.54978618	0	0.019886392	1.128568968	0	0.552671205	0	0	0	100.6703
H0979_005_0	2009	11	X1	X2		X4	X5		X7				OP Facility - Other	OP Facility - Other		OP Facility - Other	OP Facility - Other		Professional				3350	Non-facility lab	Diabetic supplies		Ambulatory surgical center	MRI/PET/CAT		Podiatry				D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	V	V	V	V	V	V	V	V	Coin	O									V	Coin		V	Coin		V																																												0		1772.418081	74.57280863	940.1903665	2649.471971	343.9422085	23.87721746	1.304751183	321.6881245	236.6393561	2662.687752	12.12086681	58.20244538	0	2803.543566	4874.64299	4788.310112	531.6342304	1967.540183	6554.407718	5306.210899	18.63824081	0									6772.308531	3.961899691		3.439354182	8.132756351		318.6151934				$350 for 1st 7 days	$300 for 1st 7 days	$100 for days 10-100	$25 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$250 Copay	$15 Copay	20% Coinsurance	$350 Copay	$25 Copay	$15 Copay	$15 per Visit	$30 per Visit	$30 per Visit	$30 per Visit	$30 per Visit	$30 per Visit	20% Coinsurance										$15 Copay	20% Coinsurance		$100 Copay	20% Coinsurance		$30 Copay				262.9246013	157.6419886	40.74391478	25	100	0.3	0.3	32.05	250	15	0.2	350	25	15	15	30	30	30	30	30	0.2	0	0								15	0.2		100	0.2		30				182.4280312	109.3785727	28.26982382	17.34604049	69.38416196	0.208152486	0.208152486	22.23762391	173.4604049	10.40762429	0.138768324	242.8445669	17.34604049	10.40762429	10.40762429	20.81524859	20.81524859	20.81524859	20.81524859	20.81524859	0.138768324	0	0								10.40762429	0.138768324		69.38416196	0.138768324		20.81524859				26.9449	0.679722281	2.214918001	3.829820674	1.988678492	4.970102171	0.271587202	0.596131627	3.420629877	2.309354478	1.681992372	1.177845637	0	2.43151901	4.227787735	8.305822108	0.922174889	3.412903168	11.36930217	9.204174911	2.586397438	0	0	0	0	0	0	0	0	0	5.8736369	0.54978618	0	0.019886392	1.128568968	0	0.552671205	0	0	0	100.6703		44.4209	26.9449	0.679722281	2.214918001	3.829820674	1.988678492	4.970102171	0.271587202	0.596131627	3.420629877	2.309354478	1.681992372	1.177845637	0	2.43151901	4.227787735	8.305822108	0.922174889	3.412903168	11.36930217	9.204174911	2.586397438	0	0	0	0	0	0	0	0	0	5.8736369	0.54978618	0	0.019886392	1.128568968	0	0.552671205	0	0	0	100.6703	3350																																																																																	0			26.9449	0.679722281	2.214918001	3.829820674	1.988678492	4.970102171	0.271587202	0.596131627	3.420629877	2.309354478	1.681992372	1.177845637	0	2.43151901	4.227787735	8.305822108	0.922174889	3.412903168	11.36930217	9.204174911	2.586397438	0	0	0	0	0	0	0	0	0	5.8736369	0.54978618	0	0.019886392	1.128568968	0	0.552671205	0	0	0	100.6703
H0979_006_0	2009	8	X1	X2		X4	X5		X7				OP Facility - Other	OP Facility - Other		OP Facility - Other	OP Facility - Other		Professional				3350	Non-facility lab	Diabetic supplies		Ambulatory surgical center	MRI/PET/CAT		Podiatry				D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	V	V	V	V	V	V	V	V	Coin	Coin	T	P	V	V	V	V	O	O	V	Coin		V	Coin		V																																												0		2023.843924	85.15131235	1073.560793	3025.312034	392.7320288	27.26431308	1.489836276	367.3210983	270.207762	1493.804064	13.84026879	66.45873606	0	3201.239409	5566.13403	5467.554427	607.0490469	2246.645014	7484.181287	6058.921877	21.28216295	0	0	0	0	0	0	0	0	0	7732.992355	4.5239138		3.927242752	9.286426099		363.8122575				$150 for 1st 7 days	$150 for 1st 7 days	$100 for days 10-100	$0 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$150 Copay	$15 Copay	20% Coinsurance	$150 Copay	$25 Copay	$15 Copay	$10 per Visit	$25 per Visit	$25 per Visit	$30 per Visit	$25 per Visit	$25 per Visit	20% Coinsurance			$0 per Procedure	$0 - 1 / Year ($3.85 Cap)	$0 - up to $100 ($3.85 Cap)	$0 (1 / 3 Years)	"$1,000 allowable/hearing aid"			$15 Copay	20% Coinsurance		$75 Copay	20% Coinsurance		$25 Copay				112.681972	78.82099431	40.74391478	0	100	0.3	0.3	0.56	150	15	0.2	150	25	15	10	25	25	30	25	25	0.2	0	0	0	0	0	0	0	0	0	15	0.2		75	0.2		25				83.09608177	58.12567595	30.04615214	0	73.74390092	0.221231703	0.221231703	0.412965845	110.6158514	11.06158514	0.147487802	110.6158514	18.43597523	11.06158514	7.374390092	18.43597523	18.43597523	22.12317028	18.43597523	18.43597523	0.147487802	0	0	0	0	0	0	0	0	0	11.06158514	0.147487802		55.30792569	0.147487802		18.43597523				14.0145	0.412456466	2.68803091	0	2.413465985	6.031730408	0.329599016	0.012640922	2.490771803	1.376986737	2.04127082	0.612615806	0	2.950898523	3.420570304	8.399974832	0.932628433	4.141909183	11.49818174	9.308511138	3.138859432	0	0	0	0	0	0	0	0	0	7.128262776	0.667222102	0	0.018100638	1.369634572	0	0.558936147	0	0	0	85.9577		30.6048	14.0145	0.412456466	2.68803091	0	2.413465985	6.031730408	0.329599016	0.012640922	2.490771803	1.376986737	2.04127082	0.612615806	0	2.950898523	3.420570304	8.399974832	0.932628433	4.141909183	11.49818174	9.308511138	3.138859432	0	0	0	0	0	0	0	0	0	7.128262776	0.667222102	0	0.018100638	1.369634572	0	0.558936147	0	0	0	85.9577																																																																																		0			14.0145	0.412456466	2.68803091	0	2.413465985	6.031730408	0.329599016	0.012640922	2.490771803	1.376986737	2.04127082	0.612615806	0	2.950898523	3.420570304	8.399974832	0.932628433	4.141909183	11.49818174	9.308511138	3.138859432	0	0	0	0	0	0	0	0	0	7.128262776	0.667222102	0	0.018100638	1.369634572	0	0.558936147	0	0	0	85.9577
H0979_007_0	2009	9	X1	X2		X4	X5		X7				OP Facility - Other	OP Facility - Other		OP Facility - Other	OP Facility - Other		Professional				3350	Non-facility lab	Diabetic supplies		Ambulatory surgical center	MRI/PET/CAT		Podiatry				D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	V	V	V	V	V	V	V	V	Coin	Coin								O	V	Coin		V	Coin		V																																												0		2023.843924	85.15131235	1073.560793	3025.312034	392.7320288	27.26431308	1.489836276	367.3210983	270.207762	1493.804064	13.84026879	66.45873606	0	3201.239409	5566.13403	5467.554427	607.0490469	2246.645014	7484.181287	6058.921877	21.28216295	0								0	7732.992355	4.5239138		3.927242752	9.286426099		363.8122575				$150 for 1st 7 days	$150 for 1st 7 days	$100 for days 10-100	$0 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$150 Copay	$15 Copay	20% Coinsurance	$150 Copay	$25 Copay	$15 Copay	$10 per Visit	$25 per Visit	$25 per Visit	$30 per Visit	$25 per Visit	$25 per Visit	20% Coinsurance										$15 Copay	20% Coinsurance		$75 Copay	20% Coinsurance		$25 Copay				112.681972	78.82099431	40.74391478	0	100	0.3	0.3	0.56	150	15	0.2	150	25	15	10	25	25	30	25	25	0.2	0								0	15	0.2		75	0.2		25				83.09608177	58.12567595	30.04615214	0	73.74390092	0.221231703	0.221231703	0.412965845	110.6158514	11.06158514	0.147487802	110.6158514	18.43597523	11.06158514	7.374390092	18.43597523	18.43597523	22.12317028	18.43597523	18.43597523	0.147487802	0								0	11.06158514	0.147487802		55.30792569	0.147487802		18.43597523				14.0145	0.412456466	2.68803091	0	2.413465985	6.031730408	0.329599016	0.012640922	2.490771803	1.376986737	2.04127082	0.612615806	0	2.950898523	3.420570304	8.399974832	0.932628433	4.141909183	11.49818174	9.308511138	3.138859432	0	0	0	0	0	0	0	0	0	7.128262776	0.667222102	0	0.018100638	1.369634572	0	0.558936147	0	0	0	85.9577		30.6048	14.0145	0.412456466	2.68803091	0	2.413465985	6.031730408	0.329599016	0.012640922	2.490771803	1.376986737	2.04127082	0.612615806	0	2.950898523	3.420570304	8.399974832	0.932628433	4.141909183	11.49818174	9.308511138	3.138859432	0	0	0	0	0	0	0	0	0	7.128262776	0.667222102	0	0.018100638	1.369634572	0	0.558936147	0	0	0	85.9577																																																																																		0			14.0145	0.412456466	2.68803091	0	2.413465985	6.031730408	0.329599016	0.012640922	2.490771803	1.376986737	2.04127082	0.612615806	0	2.950898523	3.420570304	8.399974832	0.932628433	4.141909183	11.49818174	9.308511138	3.138859432	0	0	0	0	0	0	0	0	0	7.128262776	0.667222102	0	0.018100638	1.369634572	0	0.558936147	0	0	0	85.9577
H0979_020_0	2009	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		267.8344555	8.955584789	70.08194819	23.99421946	9.378781001	25.18915249	5.556027295	6.339934349	19.43715066	15.94617438	12.7868485	1.05885916	0	32.12448458	26.46160173	24.65696056	3.275447623	4.514033652	28.73546842	108.4020928	19.66231998	0																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			0.080745248	0.080745248	0.201450061	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.080745248	0.080745248	0.201450061	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											21.6264	0.723120912	14.11801276	0	2.166498411	5.818694224	1.283442305	1.464524835	4.489981802	3.683566282	2.953762004	0.244596466	0	7.420755937	6.112629999	5.69575789	0.756628401	1.042741774	6.637893205	25.04088344	4.541995915	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.8218			21.6264	0.723120912	14.11801276	0	2.166498411	5.818694224	1.283442305	1.464524835	4.489981802	3.683566282	2.953762004	0.244596466	0	7.420755937	6.112629999	5.69575789	0.756628401	1.042741774	6.637893205	25.04088344	4.541995915	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.8218	0																																																																																	0			21.6264	0.723120912	14.11801276	0	2.166498411	5.818694224	1.283442305	1.464524835	4.489981802	3.683566282	2.953762004	0.244596466	0	7.420755937	6.112629999	5.69575789	0.756628401	1.042741774	6.637893205	25.04088344	4.541995915	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.8218
H0979_021_0	2009	8	X1	X2	X3	X4	X5	X6	X7	X8			OP Facility - Other	OP Facility - Other	Professional	OP Facility - Other	OP Facility - Other	Professional	Professional	Other Non-Covered			3350	Non-facility lab	Diabetic supplies	Biannual Physical	Ambulatory surgical center	MRI/PET/CAT	Chiropractic	Podiatry	Gym Membership			D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	V	V	V	V	V	V	V	V	Coin	O	T	P	V	V	V	V	O	O	V	Coin	V	V	Coin	V	V	V																																											0		1853.954254	107.8655065	998.0828009	2286.534619	561.2095259	24.81032218	0.874637492	425.0195878	260.4077164	1659.315928	13.23182628	90.5458178	0.100618584	3271.126617	5494.422711	4760.08208	523.5098038	1726.899756	5098.881281	5228.073671	19.72682999	0	0	0	0	0	0	0	0	0	7441.727718	4.643447932	711.1472413	19.85945933	12.39866248	0	330.828879	12000			$250 for 1st 7 days	$250 for 1st 7 days	$100 for days 10-100	$0 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$150 Copay	$15 Copay	20% Coinsurance	$250 Copay	$25 Copay	$15 Copay	$10 per Visit	$35 per Visit	$35 per Visit	$30 per Visit	$35 per Visit	$22.75 per Visit	20% Coinsurance			$0 per Procedure	$0 - 1 / Year ($3.85 Cap)	$0 - up to $100 ($3.85 Cap)	$0 (1 / 3 Years)	"$1,000 allowable/hearing aid"			$15 Copay	20% Coinsurance	$0 Copay	$75 Copay	20% Coinsurance	$35 Copay	$35 Copay	$0 Copay			187.8032866	131.3683238	40.74391478	0	100	0.3	0.25	30.7	112.5	15	0.2	250	25	15	10	22.75	35	30	35	22.75	0.2	0	0	0	0	0	0	0	0	0	15	0.2	0	75	0.2	35	35	0			136.8616349	95.73465881	29.69212566	0	72.87499453	0.218624984	0.182187486	22.37262332	81.98436884	10.93124918	0.145749989	182.1874863	18.21874863	10.93124918	7.287499453	16.57906125	25.50624808	21.86249836	25.50624808	16.57906125	0.145749989	0	0	0	0	0	0	0	0	0	10.93124918	0.145749989	0	54.65624589	0.145749989	25.50624808	25.50624808	0			21.1446	0.860538955	2.469599996	0	3.408178428	5.424156278	0.159348006	0.792400262	1.779113522	1.511532989	1.928538536	1.374692912	0.000152762	2.979791679	3.336716875	6.576474365	1.112730911	3.146195257	10.83777758	7.223046137	2.875185255	0	0	0	0	0	0	0	0	0	6.778948334	0.676782485	0	0.090453624	1.807104921	0	0.703183622	0	0	0	88.9972		33.1259	21.1446	0.860538955	2.469599996	0	3.408178428	5.424156278	0.159348006	0.792400262	1.779113522	1.511532989	1.928538536	1.374692912	0.000152762	2.979791679	3.336716875	6.576474365	1.112730911	3.146195257	10.83777758	7.223046137	2.875185255	0	0	0	0	0	0	0	0	0	6.778948334	0.676782485	0	0.090453624	1.807104921	0	0.703183622	0	0	0	88.9972	3350																																																																																	0			21.1446	0.860538955	2.469599996	0	3.408178428	5.424156278	0.159348006	0.792400262	1.779113522	1.511532989	1.928538536	1.374692912	0.000152762	2.979791679	3.336716875	6.576474365	1.112730911	3.146195257	10.83777758	7.223046137	2.875185255	0	0	0	0	0	0	0	0	0	6.778948334	0.676782485	0	0.090453624	1.807104921	0	0.703183622	0	0	0	88.9972
H0979_022_0	2009	11	X1	X2	X3	X4	X5		X7	X8			OP Facility - Other	OP Facility - Other	Professional	OP Facility - Other	OP Facility - Other		Professional	Other Non-Covered			3350	Non-facility lab	Diabetic supplies	Biannual Physical	Ambulatory surgical center	MRI/PET/CAT		Podiatry	Gym Membership			D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	V	V	V	V	V	V	V	V	Coin	O	T								V	Coin	V	V	Coin		V	V																																											0		1853.954254	107.8655065	998.0828009	2286.534619	561.2095259	24.81032218	0.874637492	425.0195878	260.4077164	1659.315928	13.23182628	90.5458178	0.100618584	3271.126617	5494.422711	4760.08208	523.5098038	1726.899756	5098.881281	5228.073671	19.72682999	0	0								7441.727718	4.643447932	711.1472413	19.85945933	12.39866248		330.828879	12000			$250 for 1st 7 days	$250 for 1st 7 days	$100 for days 10-100	$0 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$150 Copay	$15 Copay	20% Coinsurance	$250 Copay	$25 Copay	$15 Copay	$10 per Visit	$35 per Visit	$35 per Visit	$30 per Visit	$35 per Visit	$22.75 per Visit	20% Coinsurance										$15 Copay	20% Coinsurance	$0 Copay	$75 Copay	20% Coinsurance		$35 Copay	$0 Copay			187.8032866	131.3683238	40.74391478	0	100	0.3	0.25	30.7	112.5	15	0.2	250	25	15	10	22.75	35	30	35	22.75	0.2	0	0								15	0.2	0	75	0.2		35	0			136.8616349	95.73465881	29.69212566	0	72.87499453	0.218624984	0.182187486	22.37262332	81.98436884	10.93124918	0.145749989	182.1874863	18.21874863	10.93124918	7.287499453	16.57906125	25.50624808	21.86249836	25.50624808	16.57906125	0.145749989	0	0								10.93124918	0.145749989	0	54.65624589	0.145749989		25.50624808	0			21.1446	0.860538955	2.469599996	0	3.408178428	5.424156278	0.159348006	0.792400262	1.779113522	1.511532989	1.928538536	1.374692912	0.000152762	2.979791679	3.336716875	6.576474365	1.112730911	3.146195257	10.83777758	7.223046137	2.875185255	0	0	0	0	0	0	0	0	0	6.778948334	0.676782485	0	0.090453624	1.807104921	0	0.703183622	0	0	0	88.9972		33.1259	21.1446	0.860538955	2.469599996	0	3.408178428	5.424156278	0.159348006	0.792400262	1.779113522	1.511532989	1.928538536	1.374692912	0.000152762	2.979791679	3.336716875	6.576474365	1.112730911	3.146195257	10.83777758	7.223046137	2.875185255	0	0	0	0	0	0	0	0	0	6.778948334	0.676782485	0	0.090453624	1.807104921	0	0.703183622	0	0	0	88.9972	3350																																																																																	0			21.1446	0.860538955	2.469599996	0	3.408178428	5.424156278	0.159348006	0.792400262	1.779113522	1.511532989	1.928538536	1.374692912	0.000152762	2.979791679	3.336716875	6.576474365	1.112730911	3.146195257	10.83777758	7.223046137	2.875185255	0	0	0	0	0	0	0	0	0	6.778948334	0.676782485	0	0.090453624	1.807104921	0	0.703183622	0	0	0	88.9972
H0979_023_0	2009	6			x.3					x.8					Professional					Other Non-Covered						Biannual Physical					Gym Membership			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	V	V	V	O	O			V					V																																											0		266.3162739	9.439686745	66.55212061	19.42165124	10.20172833	24.54840713	5.45983267	7.364862318	21.03990055	19.00049875	13.09214191	1.002359849	0.000854647	39.38530662	28.46108515	23.04013706	2.569295799	3.915833619	31.69157604	100.848821	19.51857983	0	0	0	0	0	0	0	0	0	0	0	703.6398757	0	0	0	0	12000			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	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 per Procedure	$0 - 1 / Year ($3.85 Cap)	$0 - up to $100 ($3.85 Cap)	$0 (1 / 3 Years)	"$1,000 allowable/hearing aid"					$0 Copay					$0 Copay			0.077424372	0.077424372	0.200743521	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231											0					0			0.077424372	0.077424372	0.200743521	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0			0					0			20.6194	0.730861816	13.35990702	0	2.356599244	5.670682047	1.261221347	1.701283196	4.860217028	4.389115211	3.024284781	0.231545125	0.000197423	9.098005829	6.57451067	5.32227166	0.59350733	0.904557566	7.320754065	23.29607766	4.50879194	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.8238			20.6194	0.730861816	13.35990702	0	2.356599244	5.670682047	1.261221347	1.701283196	4.860217028	4.389115211	3.024284781	0.231545125	0.000197423	9.098005829	6.57451067	5.32227166	0.59350733	0.904557566	7.320754065	23.29607766	4.50879194	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.8238	0																																																																																	0			20.6194	0.730861816	13.35990702	0	2.356599244	5.670682047	1.261221347	1.701283196	4.860217028	4.389115211	3.024284781	0.231545125	0.000197423	9.098005829	6.57451067	5.32227166	0.59350733	0.904557566	7.320754065	23.29607766	4.50879194	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.8238
H1013_011_0	2009	7																																		D					V	V		V	V	V	V							S			P																																																									0				978.9623012					221.6652835	92.50880831		89.66112014	46.91321008	0	57.698553							883.9875604			701.3173445																	$0 copay	$0 copay	$30 per day (days 11 through 100)  PBP L.2	$0 copay	$0 copay	$0 copay	$0 copay	$50 copay PBP L.4a	$100 copay @ Hospital PBP L.9a	$0 copay	$50 copay (Diag); $25 copay (Therap.)  PBP L.8a/8b	$50 copay PBP L.9a	$25 copay @ Hospital PBP L.12	"$25 copay @ Hospital PBP L.9a, 7c, 7i"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	18% chemo; $50 copay Part B Rx PBP L.15	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay													13.82142857					50	100		44.1356529	50	25	25							84.73702193			79.65242276																			13.82142857					50	100		44.1356529	50	25	25							84.73702193			79.65242276																	0	0	1.127554793	0	0	0	0	0.923605348	0.770906736	0	0.329771006	0.195471709	0	0.120205319	0	0	0	0	0	0	6.242206108	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.3649			0	0	1.127554793	0	0	0	0	0.923605348	0.770906736	0	0.329771006	0.195471709	0	0.120205319	0	0	0	0	0	0	6.242206108	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.3649																																																																																		0			0	0	1.127554793	0	0	0	0	0.923605348	0.770906736	0	0.329771006	0.195471709	0	0.120205319	0	0	0	0	0	0	6.242206108	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.3649
H1013_021_0	2009	8																																D		D					V	V		V		V	V		V					S			P																																																									0		1502.101331		756.8293252					339.8519279	93.57775423		1659.957878	72.96237557	6.044117893	97.2388935		6764.05239					1097.800304			701.3173445																	$50 copay (days 1-10) PBP L.1a	$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	$0 copay	$150 diag copay (hosp); $50 diag copay (freest); $50 therap. Copay PBP L.8a/8b	$50 copay PBP L.9a	$30 copay @ Hospital; $15 copay @ Freestanding facility PBP L.12	"$50 copay @ Hospital PBP L.9a, 7c, 7i"	$0 copay	$15 copay PBP L.7a thru 7f	Included in i.2.	Included in i.2.	Included in i.2.	Included in i.2.	18% chemo; $50 copay Part B Rx PBP L.15	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											43.83183008		29.52247191					50	150		55.64977203	50	15	50		15					87.88232605			79.65242276																	43.83183008		29.52247191					50	150		55.64977203	50	15	50		15					87.88232605			79.65242276																	5.4867	0	1.861956041	0	0	0	0	1.4160497	1.169721928	0	7.698023124	0.304009898	0.007555147	0.405162056	0	8.455065488	0	0	0	0	8.039770352	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4991			5.4867	0	1.861956041	0	0	0	0	1.4160497	1.169721928	0	7.698023124	0.304009898	0.007555147	0.405162056	0	8.455065488	0	0	0	0	8.039770352	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4991																																																																																		0			5.4867	0	1.861956041	0	0	0	0	1.4160497	1.169721928	0	7.698023124	0.304009898	0.007555147	0.405162056	0	8.455065488	0	0	0	0	8.039770352	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4991
H1013_024_0	2009	6																																																							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																																		23.60651183																																								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	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	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	4.1323
H1013_028_0	2009	6																																		D					V	V		V	V	V	V							S			P																																																									0				978.9623012					221.6652835	92.50880831		89.66112014	46.91321008	0	57.698553							883.9875604			701.3173445																	$0 copay	$0 copay	$30 per day (days 15 through 34)  PBP L.2	$0 copay	$0 copay	$0 copay	$0 copay	$50 copay PBP L.4a	$100 copay @ Hospital PBP L.9a	$0 copay	$50 copay (Diag); $25 copay (Therap.)  PBP L.8a/8b	$50 copay PBP L.9a	$25 copay @ Hospital PBP L.12	"$25 copay @ Hospital PBP L.9a, 7c, 7i"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	18% chemo; $50 copay Part B Rx PBP L.15	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay													7.844301766					50	100		44.1356529	50	25	25							84.73702193			79.7356581																			7.844301766					50	100		44.1356529	50	25	25							84.73702193			79.7356581																	0	0	0.639939642	0	0	0	0	0.923605348	0.770906736	0	0.329771006	0.195471709	0	0.120205319	0	0	0	0	0	0	6.242206108	0	0	4.66	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.8821			0	0	0.639939642	0	0	0	0	0.923605348	0.770906736	0	0.329771006	0.195471709	0	0.120205319	0	0	0	0	0	0	6.242206108	0	0	4.66	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.8821																																																																																		0			0	0	0.639939642	0	0	0	0	0.923605348	0.770906736	0	0.329771006	0.195471709	0	0.120205319	0	0	0	0	0	0	6.242206108	0	0	4.66	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.8821
H1013_802_0	2009	4																																																																																																																0		1801.873193		909.2622337		399.9220779	947.1342372		277.3566687	304.7247668					1868.255936						22046.64249	2587.961766																				Medicare FFS cost sharing	included in a.1	Medicare FFS cost sharing		Medicare FFS cost sharing	Medicare FFS cost sharing	included in e.1.	Medicare FFS cost sharing	Medicare FFS cost sharing	included in h.5	included in h.5	included in h.5	included in h.5	Medicare FFS cost sharing	included in i.6.	included in i.6.	included in i.6.	included in i.6.	included in i.6.	Medicare FFS cost sharing	Medicare FFS cost sharing																				167.8985862		48.7152835		78.90519467	23.52783388		167.4638703	385.2013789					105.5730298						42.96018633	85.5630481																				167.8985862		48.7152835		78.90519467	23.52783388		167.4638703	385.2013789					105.5730298						42.96018633	85.5630481																				25.211	0	3.691247291	0	2.629660784	1.857001416	0	3.870601766	9.781700032	0	0	0	0	16.4364533	0	0	0	0	0	78.92732243	18.45282476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.8578			25.211	0	3.691247291	0	2.629660784	1.857001416	0	3.870601766	9.781700032	0	0	0	0	16.4364533	0	0	0	0	0	78.92732243	18.45282476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.8578																																																																																		0			25.211	0	3.691247291	0	2.629660784	1.857001416	0	3.870601766	9.781700032	0	0	0	0	16.4364533	0	0	0	0	0	78.92732243	18.45282476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.8578
H1013_803_0	2009	4																																																																																																																0		1801.873193		909.2622337		399.9220779	947.1342372		277.3566687	304.7247668					1868.255936						22046.64249	2587.961766																				Medicare FFS cost sharing	included in a.1	Medicare FFS cost sharing		Medicare FFS cost sharing	Medicare FFS cost sharing	included in e.1.	Medicare FFS cost sharing	Medicare FFS cost sharing	included in h.5	included in h.5	included in h.5	included in h.5	Medicare FFS cost sharing	included in i.6.	included in i.6.	included in i.6.	included in i.6.	included in i.6.	Medicare FFS cost sharing	Medicare FFS cost sharing																				167.8985862		48.7152835		78.90519467	23.52783388		167.4638703	385.2013789					105.5730298						42.96018633	85.5630481																				167.8985862		48.7152835		78.90519467	23.52783388		167.4638703	385.2013789					105.5730298						42.96018633	85.5630481																				25.211	0	3.691247291	0	2.629660784	1.857001416	0	3.870601766	9.781700032	0	0	0	0	16.4364533	0	0	0	0	0	78.92732243	18.45282476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.8578			25.211	0	3.691247291	0	2.629660784	1.857001416	0	3.870601766	9.781700032	0	0	0	0	16.4364533	0	0	0	0	0	78.92732243	18.45282476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.8578																																																																																		0			25.211	0	3.691247291	0	2.629660784	1.857001416	0	3.870601766	9.781700032	0	0	0	0	16.4364533	0	0	0	0	0	78.92732243	18.45282476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.8578
H1013_804_0	2009	4																																																																																																																0		1801.873193		909.2622337		399.9220779	947.1342372		277.3566687	304.7247668					1868.255936						22046.64249	2587.961766																				Medicare FFS cost sharing	included in a.1	Medicare FFS cost sharing		Medicare FFS cost sharing	Medicare FFS cost sharing	included in e.1.	Medicare FFS cost sharing	Medicare FFS cost sharing	included in h.5	included in h.5	included in h.5	included in h.5	Medicare FFS cost sharing	included in i.6.	included in i.6.	included in i.6.	included in i.6.	included in i.6.	Medicare FFS cost sharing	Medicare FFS cost sharing																				167.8985862		48.7152835		78.90519467	23.52783388		167.4638703	385.2013789					105.5730298						42.96018633	85.5630481																				167.8985862		48.7152835		78.90519467	23.52783388		167.4638703	385.2013789					105.5730298						42.96018633	85.5630481																				25.211	0	3.691247291	0	2.629660784	1.857001416	0	3.870601766	9.781700032	0	0	0	0	16.4364533	0	0	0	0	0	78.92732243	18.45282476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.8578			25.211	0	3.691247291	0	2.629660784	1.857001416	0	3.870601766	9.781700032	0	0	0	0	16.4364533	0	0	0	0	0	78.92732243	18.45282476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.8578																																																																																		0			25.211	0	3.691247291	0	2.629660784	1.857001416	0	3.870601766	9.781700032	0	0	0	0	16.4364533	0	0	0	0	0	78.92732243	18.45282476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.8578
H1013_805_0	2009	4																																																																																																																0		1801.873193		909.2622337		399.9220779	947.1342372		277.3566687	304.7247668					1868.255936						22046.64249	2587.961766																				Medicare FFS cost sharing	included in a.1	Medicare FFS cost sharing		Medicare FFS cost sharing	Medicare FFS cost sharing	included in e.1.	Medicare FFS cost sharing	Medicare FFS cost sharing	included in h.5	included in h.5	included in h.5	included in h.5	Medicare FFS cost sharing	included in i.6.	included in i.6.	included in i.6.	included in i.6.	included in i.6.	Medicare FFS cost sharing	Medicare FFS cost sharing																				167.8985862		48.7152835		78.90519467	23.52783388		167.4638703	385.2013789					105.5730298						42.96018633	85.5630481																				167.8985862		48.7152835		78.90519467	23.52783388		167.4638703	385.2013789					105.5730298						42.96018633	85.5630481																				25.211	0	3.691247291	0	2.629660784	1.857001416	0	3.870601766	9.781700032	0	0	0	0	16.4364533	0	0	0	0	0	78.92732243	18.45282476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.8578			25.211	0	3.691247291	0	2.629660784	1.857001416	0	3.870601766	9.781700032	0	0	0	0	16.4364533	0	0	0	0	0	78.92732243	18.45282476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.8578																																																																																		0			25.211	0	3.691247291	0	2.629660784	1.857001416	0	3.870601766	9.781700032	0	0	0	0	16.4364533	0	0	0	0	0	78.92732243	18.45282476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.8578
H1016_001_0	2009	9																					3350											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																																																			0				726.8713992		243.8075867			183.0342129	419.5940294		571.9249053										2757.538525																				"$0/Day, Unlimited days"	$0/Day	$100 for Days 11-100	No Cost Sharing	$75/Trip	0% Coinsurance	$15/Item for Diabetes Supplies Only	$50 per ER Visit; $25 per Urgent Care Visit	$100/$0 Per Episode	No Cost Sharing	$50/$0 Complex/Simple	No Cost Sharing	No Cost Sharing	No Cost Sharing	$0/Visit Copayment	$0/Visit Copayment	$0/Visit Copayment for Individual; $0/Visit Copayment for Group	$0/Visit Copayment	No Cost Sharing	No Cost Sharing	$15/Script	$15 for Nutrition Therapy	Not Covered	Not Covered	$0/Visit Copayment	$10/Pair	Not Covered	Not Covered	N/A	Not Covered													56.68		75			49.53724139	60.88		50										15																						56.06517234		74.18644893			48.99989372	60.21961348		49.45763262										14.83728979																				0	0	3.396014189	0	1.507268257	0	0	0.747388082	2.105649189	0	2.357170988	0	0	0	0	0	0	0	0	0	3.409533183	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.523	0	0.1483	0	0	3.396014189	0	1.507268257	0	0	0.747388082	2.105649189	0	2.357170988	0	0	0	0	0	0	0	0	0	3.409533183	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.523																																																																																		0	0	0	0	0	3.396014189	0	1.507268257	0	0	0.747388082	2.105649189	0	2.357170988	0	0	0	0	0	0	0	0	0	3.409533183	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.523
H1016_002_0	2009	11																					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																																																			0		1546.634868	0.604863069	777.1220252		264.9724876	0.00071797		169.8551319	358.7985217		938.6134022			482.8995602		9743.021407					3552.419766	0.181647475			0.109121214																"$135/Day for Days 1-10, unlimited days,$1,700 OOPM"	"$135/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											93.21282135	135	64.55		100	0.2		48.53198709	141.33		37.33543352			25		24.99811772					25	15.86660006			25																87.80311557	127.1651306	60.80377171		100	0.2		48.53198709	141.33		37.33543352			25		24.99811772					25	15.86660006			25																11.3166	0.006409791	3.937662518	0	2.208104064	0.000143594	0	0.686950589	4.22574959	0	2.920294856	0	0	1.00604075	0	20.29643301	0	0	0	0	7.400874513	0.000240177	0	0	0.000227336	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0057	0	0.9402	11.3166	0.006409791	3.937662518	0	2.208104064	0.000143594	0	0.686950589	4.22574959	0	2.920294856	0	0	1.00604075	0	20.29643301	0	0	0	0	7.400874513	0.000240177	0	0	0.000227336	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0057																																																																																		0	0	0	11.3166	0.006409791	3.937662518	0	2.208104064	0.000143594	0	0.686950589	4.22574959	0	2.920294856	0	0	1.00604075	0	20.29643301	0	0	0	0	7.400874513	0.000240177	0	0	0.000227336	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0057
H1016_017_0	2009	10																																			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																																																			0						266.9088854	0.000723217		171.0964197	361.4205927		945.4727141			486.4285517		9859.102168					3578.380566	0.18297494			0.109918663																			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															100	0.2		48.53198709	141.33		37.33543352			25		24.99812629					25	15.86660006			25																				100	0.2		48.53198709	141.33		37.33543352			25		24.99812629					25	15.86660006			25																0	0	0	0	2.224240712	0.000144643	0	0.691970769	4.25663103	0	2.941636138	0	0	1.013392816	0	20.53825676	0	0	0	0	7.454959513	0.000241933	0	0	0.000228997	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1217	0	0	0	0	0	0	2.224240712	0.000144643	0	0.691970769	4.25663103	0	2.941636138	0	0	1.013392816	0	20.53825676	0	0	0	0	7.454959513	0.000241933	0	0	0.000228997	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1217																																																																																		0	0	0	0	0	0	0	2.224240712	0.000144643	0	0.691970769	4.25663103	0	2.941636138	0	0	1.013392816	0	20.53825676	0	0	0	0	7.454959513	0.000241933	0	0	0.000228997	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1217
H1019_001_0	2009	4	r.	s.	t.	u.							Part B Rx	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin	V		V		O	O	S	O	O	O							0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0			0	0		0		0	0	0	0	0	0							0		1445.281448	10.698332	758.726497	16.879536	320.002271	4.232107	2.850195	328.438233	207.025336	46.16733	1091.893345	0	14.704823	81.736643	6761.469472	5195.104299	0.276068	499.810256			22.100192			3.23	2.65		0.33		0.05	1.76	1868.423211	1.7	0.65	0.51							$0/Day(Days 1-5):1a	$0/Day(Days 1-5):1b	"$0/Day(Days 1-14) $25(Days 15-100):2. $0 SNF 1, 2. $25 SNF 2"	$0/Visit:6	$50/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$75/Visit:9b. $0 Surgery ASC -- Physician, 9b. $50 Surgery ASC -- Facility, 9a. $0 Surgery OP -- Physician, 9a. $75 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$75/Visit:14h. $0 DMAM -- OP, 8b. $0 Radiology -- FSR, 14h. $0 SMAM -- FSR, 14h. $0 SMAM -- OP, 8b. $25 Advanced Imaging -- FSR, 8b. $25 Advanced Imaging -- Office, 9a. $75 Advanced Imaging -- OP, 8a. $0 Radiology OP -- Physician, 8a. $0 Radiology OP -- Facility"	$0/Visit:9a	"$0-$5/Proc:12. $0 Dialysis -- Dialysis Center, 12. $5 Dialysis -- OP Hosp"	"$0-$75/Visit:9d. $5 Cardiac Rehab, 8b. $75 Nuclear Medicine, 9a. $0 OP Other, 5. $5 Partial Hospitalization, 8b. $25 Rad therapy, 3. $5 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$5/Visit:7b, 7d, 7f"	"$5/Visit:7e, 7h"	"$5/Visit:7d, 9a"			0% Coins:15			DEN ADI	VIS 140		HER 751		SMC 001	TRN 005	$0/Script:15	FTP 002	Acupuncture 6 Visits	MOW 001							0	0	11.566397	0	50.000007	0	0	50.000013	62.584166	0	8.401666	0	0.192589	21.495915	0	4.999998	4.998768	5.000017			0			0	0		0		0	0	0	0	0	0							0	0	11.566397	0	50.000007	0	0	50.000013	62.584166	0	8.401666	0	0.192589	21.495915	0	4.999998	4.998768	5.000017			0			0	0		0		0	0	0	0	0	0							0	0	0.73131099	0	1.333342983	0	0	1.368492993	1.079709	0	0.764476933	0	0.000235999	0.146416994	0	2.164625925	0.000115	0.208254981	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.797	0	0	0	0	0.73131099	0	1.333342983	0	0	1.368492993	1.079709	0	0.764476933	0	0.000235999	0.146416994	0	2.164625925	0.000115	0.208254981	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.797																																																																																		0	0	0	0	0	0.73131099	0	1.333342983	0	0	1.368492993	1.079709	0	0.764476933	0	0.000235999	0.146416994	0	2.164625925	0.000115	0.208254981	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.797
H1019_002_0	2009	4	r.	s.	t.	u.	v.						Part B Rx	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																	D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin	V		V		O	O	S	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		1589.192785	8.740653	596.398662	36.681388	293.49535	4.846464	1.805713	222.781116	207.566247	75.475386	1230.570026	0	12.25632	300.5031	7961.207411	4181.77702	0.356117	475.810934			8.349538			4.16	2.65		0.33		0.05	5.64	2270.026833	1.7	0.51	0.81	6.19						$0/Day(Days 1-1):1a	$0/Day(Days 1-1):1b	"$0/Day(Days 1-14) $50(Days 15-100):2. $0 SNF 1,2. $50 SNF 2"	$0/Visit:6	$25/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"$0-$25/Visit:9d. $0 Cardiac Rehab,8b. $0 Nuclear Medicine,9a. $0 OP Other,5. $0 Partial Hospitalization,8b. $25 Rad therapy,3. $0 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			0% Coins:15			"DEN ADI + Dent 16a, 16b"	VIS 140		HER 751		$0 Additional Smoking Cessation 14a	TRN 009	$0/Script:15	$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	Acupuncture 10 Visits	OTC 003						0	0	23.132808	0	25	0	0	50.000018	0	0	0	0	0	19.306103	0	0	0	0			0			0	0		0		0	0	0	0	0	0	0						0	0	23.132808	0	25	0	0	50.000018	0	0	0	0	0	19.306103	0	0	0	0			0			0	0		0		0	0	0	0	0	0	0						0	0	1.149697978	0	0.611448646	0	0	0.928254984	0	0	0	0	0	0.483461983	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.1729	0	0	0	0	1.149697978	0	0.611448646	0	0	0.928254984	0	0	0	0	0	0.483461983	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.1729																																																																																		0	0	0	0	0	1.149697978	0	0.611448646	0	0	0.928254984	0	0	0	0	0	0.483461983	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.1729
H1019_004_0	2009	4	r.										Health & Education (Non-Covered)																					D	D	D	V	T	Coin	Coin	V	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										0		1202.049961	8.897872	631.037752	14.038819	266.147966	2.927507	1.971587	273.164209	172.184317	38.397669	908.13478	0	12.230096	67.980898	5623.558048	4320.801966	0.229608	415.695435			38.657248				2.65		0.33		0.05	0.51	1.7										$195/Day(Days 1-10):1a	$195/Day(Days 1-7):1b	"$0/Day(Days 1-14) $100(Days 15-100):2. $0 SNF 1, 2. $100 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician, 9b. $75 Surgery ASC -- Facility, 9a. $0 Surgery OP -- Physician, 9a. $150 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$50/Visit:14h. $0 DMAM -- OP, 8b. $0 Radiology -- FSR, 14h. $0 SMAM -- FSR, 14h. $0 SMAM -- OP, 8b. $50 Advanced Imaging -- FSR, 8b. $50 Advanced Imaging -- Office, 9a. $50 Advanced Imaging -- OP, 8a. $0 Radiology OP -- Physician, 8a. $0 Radiology OP -- Facility"	$150/Visit:9a	$0/Proc:12	"$0-$50/Visit:9d. $0 Cardiac Rehab, 8b. $50 Nuclear Medicine, 9a. $0 OP Other, 5. $0 Partial Hospitalization, 8b. $50 Rad therapy, 3. $0 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			20% Coins:15				VIS 140		HER 751		SMC 001	MOW 001	FTP 002										156.416713	122.863534	46.265599	0	100.000012	0	0	49.999991	112.752429	0	14.601581	0	0	26.914913	0	0	0	0			0.199999				0		0		0	0	0										156.416713	122.863534	46.265599	0	100.000012	0	0	49.999991	112.752429	0	14.601581	0	0	26.914913	0	0	0	0			0.199999				0		0		0	0	0										15.6684	0.091102	2.432944966	0	2.217899983	0	0	1.138183999	1.617849998	0	1.105016962	0	0	0.152474996	0	0	0	0	0	0	7.731410943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.1553	0	0	15.6684	0.091102	2.432944966	0	2.217899983	0	0	1.138183999	1.617849998	0	1.105016962	0	0	0.152474996	0	0	0	0	0	0	7.731410943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.1553																																																																																		0	0	0	15.6684	0.091102	2.432944966	0	2.217899983	0	0	1.138183999	1.617849998	0	1.105016962	0	0	0.152474996	0	0	0	0	0	0	7.731410943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.1553
H1019_005_0	2009	3	r.	s.									Part B Rx	Other Non-Covered																				D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin				V		V		O	O	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		1358.094906	7.469601	509.671321	31.347239	250.815725	3.539417	1.318729	190.384642	177.382294	64.499877	1051.622497	0	10.474026	256.80442	6803.501334	3573.669679	0.304332	406.619267			6.097745				2.65		0.05		0.05	0.51	1939.923152	8.4									$125/Day(Days 1-10):1a	$125/Day(Days 1-10):1b	"$0/Day(Days 1-14) $50(Days 15-100):2. $0 SNF 1, 2. $50 SNF 2"	$0/Visit:6	$75/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician, 9b. $50 Surgery ASC -- Facility, 9a. $0 Surgery OP -- Physician, 9a. $100 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$50/Visit:14h. $0 DMAM -- OP, 8b. $0 Radiology -- FSR, 14h. $0 SMAM -- FSR, 14h. $0 SMAM -- OP, 8b. $25 Advanced Imaging -- FSR, 8b. $25 Advanced Imaging -- Office, 9a. $50 Advanced Imaging -- OP, 8a. $0 Radiology OP -- Physician, 8a. $0 Radiology OP -- Facility"	$50/Visit:9a	$0/Proc:12	"$0-$50/Visit:9d. $0 Cardiac Rehab, 8b. $50 Nuclear Medicine, 9a. $0 OP Other, 5. $0 Partial Hospitalization, 8b. $25 Rad therapy, 3. $0 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			0% Coins:15				VIS 140		HER 722		SMC 001	MOW 001	$0/Script:15	OTC 008									100.267122	93.135898	23.13279	0	75	0	0	49.999978	73.683295	0	8.602558	0	0	20.707587	0	0	0	0			0				0		0		0	0	0	0									100.267122	93.135898	23.13279	0	75	0	0	49.999978	73.683295	0	8.602558	0	0	20.707587	0	0	0	0			0				0		0		0	0	0	0									11.3477	0.057974	0.98250997	0	1.567598281	0	0	0.793268993	1.089175991	0	0.75388696	0	0	0.443149989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.0353	0	0	11.3477	0.057974	0.98250997	0	1.567598281	0	0	0.793268993	1.089175991	0	0.75388696	0	0	0.443149989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.0353																																																																																		0	0	0	11.3477	0.057974	0.98250997	0	1.567598281	0	0	0.793268993	1.089175991	0	0.75388696	0	0	0.443149989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.0353
H1019_006_0	2009	2	r.	s.	t.	u.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	Coin	Coin	V	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							0		1801.584926	9.908823	676.106041	41.583775	332.720362	6.228465	2.320623	252.555325	235.307022	85.562506	1395.033021	0	13.894351	340.664682	9025.205381	4740.662379	0.403713	539.402026			2663.046682			4.16	3.66		0.33		0.05	0.51	1.7	0.81	1.09	9.22							$0/Day(Days 1-1):1a	$0/Day(Days 1-1):1b	"$0/Day(Days 1-14) $25(Days 15-100):2. $0 SNF 1, 2. $25 SNF 2"	$0/Visit:6	$25/Trip:10a	0% Coins:11a	0% Coins:11b	$25/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"$0/Visit:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			$0/Script:15			DEN ADI + Dent	VIS 140		HER 751		SMC 001	MOW 001	FTP 002	Acupuncture 10 Visits	TRN 001	OTC 002							0	0	11.566398	0	25	0	0	25.000003	0	0	0	0	0	0	0	0	0	0			0			0	0		0		0	0	0	0	0	0							0	0	11.566398	0	25	0	0	25.000003	0	0	0	0	0	0	0	0	0	0			0			0	0		0		0	0	0	0	0	0							0	0	0.651675963	0	0.693167421	0	0	0.52615699	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.871	0	0	0	0	0.651675963	0	0.693167421	0	0	0.52615699	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.871																																																																																		0	0	0	0	0	0.651675963	0	0.693167421	0	0	0.52615699	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.871
H1019_010_0	2009	4	r.	s.									Health & Education (Non-Covered)	Other Non-Covered																				D	D	D	V	T	Coin	Coin	V	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									0		1262.683721	10.419154	924.275109	4.432481	287.252738	5.007547	2.969002	234.598229	219.240764	39.401444	1216.83395	0	12.137927	182.841022	7461.120738	4552.887499	0.392409	482.981651			1468.742775		1.44	3.23	1.98		0.33		0.05	0.51	1.7	2.43									$75/Day(Days 1-10):1a	$75/Day(Days 1-10):1b	"$0/Day(Days 1-6) $50(Days 7-100):2. $0 SNF 1, 2. $50 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$75/Visit:9b. $0 Surgery ASC -- Physician, 9b. $50 Surgery ASC -- Facility, 9a. $0 Surgery OP -- Physician, 9a. $75 Surgery OP -- Facility"	"$0-$20/Visit:8a. $0 Lab -- FSL, 8. $20 Lab -- OP"	"$0-$50/Visit:14h. $20 DMAM -- OP, 8b. $0 Radiology -- FSR, 14h. $0 SMAM -- FSR, 14h. $20 SMAM -- OP, 8b. $25 Advanced Imaging -- FSR, 8b. $25 Advanced Imaging -- Office, 9a. $50 Advanced Imaging -- OP, 8a. $0 Radiology OP -- Physician, 8a. $0 Radiology OP -- Facility"	$50/Visit:9a	"$0-$20/Proc:12. $0 Dialysis -- Dialysis Center, 12. $20 Dialysis -- OP Hosp"	"$15-$100/Visit:9d. $15 Cardiac Rehab, 8b. $50 Nuclear Medicine, 9a. $15 OP Other, 5. $15 Partial Hospitalization, 8b. $100 Rad therapy, 3. $15 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$15/Visit:7b, 7d, 7f"	"$15/Visit:7e, 7h"	"$15/Visit:7d, 9a"			$0/Script:15		TRN 003	DEN 310	VIS 140		HER 751		SMC 001	MOW 001	FTP 002	OTC 015									60.160271	55.880544	35.997554	0	100.000007	0	0	50.000019	59.083483	17.206882	7.653129	0	0.278795	77.489022	0	14.999999	15.014946	14.999998			0		0	0	0		0		0	0	0	0									60.160271	55.880544	35.997554	0	100.000007	0	0	50.000019	59.083483	17.206882	7.653129	0	0.278795	77.489022	0	14.999999	15.014946	14.999998			0		0	0	0		0		0	0	0	0									6.3303	0.048518999	2.772636929	0	2.393772984	0	0	0.977492992	1.079458996	0.056498	0.776048933	0	0.000281999	1.180680998	0	5.691108994	0.000491	0.603726983	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.911	0	0	6.3303	0.048518999	2.772636929	0	2.393772984	0	0	0.977492992	1.079458996	0.056498	0.776048933	0	0.000281999	1.180680998	0	5.691108994	0.000491	0.603726983	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.911																																																																																		0	0	0	6.3303	0.048518999	2.772636929	0	2.393772984	0	0	0.977492992	1.079458996	0.056498	0.776048933	0	0.000281999	1.180680998	0	5.691108994	0.000491	0.603726983	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.911
H1019_011_0	2009	5	r.	s.									Health & Education (Non-Covered)	Other Non-Covered																				D	D	D	V	T	Coin	Coin	V	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									0		1145.63316	9.4533	838.594968	4.02159	260.624458	4.171716	2.473433	212.851015	198.917183	35.748937	1104.033655	0	11.012745	165.89169	6769.476143	4130.835618	0.356033	438.209338			34.057057				1.98		0.33		0.05	0.51	1.7	2.85									$200/Day(Days 1-10):1a	$200/Day(Days 1-7):1b	"$0/Day(Days 1-14) $100(Days 15-100):2. $0 SNF 1,2. $100 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician, 9b. $50 Surgery ASC -- Facility, 9a. $0 Surgery OP -- Physician, 9a. $100 Surgery OP -- Facility"	"$0-$20/Visit:8a. $0 Lab -- FSL, 8. $20 Lab -- OP"	"$0-$50/Visit:14h. $20 DMAM -- OP, 8b. $20 Radiology -- FSR, 14h. $20 SMAM -- FSR, 14h. $20 SMAM -- OP, 8b. $20 Advanced Imaging -- FSR, 8b. $20 Advanced Imaging -- Office, 9a. $50 Advanced Imaging -- OP, 8a. $0 Radiology OP -- Physician, 8a. $20 Radiology OP -- Facility"	$150/Visit:9a	"$0-$20/Proc:12. $0 Dialysis -- Dialysis Center, 12. $20 Dialysis -- OP Hosp"	"$20-$100/Visit:9d. $20 Cardiac Rehab, 8b. $50 Nuclear Medicine, 9a. $20 OP Other, 5. $20 Partial Hospitalization, 8b. $100 Rad therapy, 3. $20 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$20/Visit:7b, 7d, 7f"	"$20/Visit:7e, 7h"	"$20/Visit:7d, 9a"			20% Coins:15				VIS 140		HER 751		SMC 001	MOW 001	FTP 002	OTC 015									160.427395	126.013138	46.2656	0	99.999977	0.199999	0.199999	49.999987	68.167021	17.207001	20.29575	0	0.278949	78.702893	0	19.999999	19.986899	19.999975			0.199999				0		0		0	0	0	0									160.427395	126.013138	46.2656	0	99.999977	0.199999	0.199999	49.999987	68.167021	17.207001	20.29575	0	0.278949	78.702893	0	19.999999	19.986899	19.999975			0.199999				0		0		0	0	0	0									15.3159	0.09927	3.233174946	0	2.171869984	0.834339028	0.494684127	0.886878999	1.129965983	0.051261	1.867265921	0	0.000256	1.088012994	0	6.884725686	0.000593	0.730347984	0	0	6.811377343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.5999	0	0	15.3159	0.09927	3.233174946	0	2.171869984	0.834339028	0.494684127	0.886878999	1.129965983	0.051261	1.867265921	0	0.000256	1.088012994	0	6.884725686	0.000593	0.730347984	0	0	6.811377343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.5999																																																																																		0	0	0	15.3159	0.09927	3.233174946	0	2.171869984	0.834339028	0.494684127	0.886878999	1.129965983	0.051261	1.867265921	0	0.000256	1.088012994	0	6.884725686	0.000593	0.730347984	0	0	6.811377343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.5999
H1019_014_0	2009	6	r.	s.									Other Non-Covered	Other Non-Covered																				D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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									0		1203.574151	57.290607	815.403301	558.831326	214.597688	2.559991	3.605775	239.873451	205.286057	55.48203	1235.369525	0	0.010569	181.832687	5909.550342	3177.798031	1.295759	385.357693			1273.449798			1.48	1.98		0.07		1.7	0.05	0.51	1									$95/Day(Days 1-10):1a	$95/Day(Days 1-10):1b	"$0/Day(Days 1-20) $100(Days 21-100):2. $0 SNF 1,2. $100 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $50 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $100 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $50 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$95/Visit:9a	20% Coins:12	"$20-$100/Visit:9d. $20 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $20 OP Other,5. $20 Partial Hospitalization,8b. $100 Rad therapy,3. $20 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$20/Visit:7b, 7d, 7f"	"$20/Visit:7e, 7h"	"$20/Visit:7d, 9a"			$0/Script:15			DEN ADI	VIS 116		HER 722		FTP 002	SMC 001	MOW 001	OTC 006									76.203012	70.782702	33.697494	0	99.999996	0	0.2	50.000014	67.569791	89.43566	13.344972	0	0.200018	28.642902	0	20.000003	19.994458	20.000005			0			0	0		0		0	0	0	0									76.203012	70.782702	33.697494	0	99.999996	0	0.2	50.000014	67.569791	89.43566	13.344972	0	0.200018	28.642902	0	20.000003	19.994458	20.000005			0			0	0		0		0	0	0	0									7.643	0.337931997	2.289753987	0	1.788313995	0	0.721155	0.999472992	1.155927997	0.413505998	1.373830977	0	0.00211399	0.434017986	0	5.296330846	0.002159	0.642262982	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.0998	0	0	7.643	0.337931997	2.289753987	0	1.788313995	0	0.721155	0.999472992	1.155927997	0.413505998	1.373830977	0	0.00211399	0.434017986	0	5.296330846	0.002159	0.642262982	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.0998																																																																																		0	0	0	7.643	0.337931997	2.289753987	0	1.788313995	0	0.721155	0.999472992	1.155927997	0.413505998	1.373830977	0	0.00211399	0.434017986	0	5.296330846	0.002159	0.642262982	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.0998
H1019_021_0	2009	3	r.										Other Non-Covered																					D	D	D	V	T	Coin	Coin	V	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										0		1241.450034	10.243941	908.732209	4.357942	282.422205	4.840548	2.869987	230.653153	215.553943	38.738858	1196.371289	0	11.933812	179.766307	7335.652186	4476.324711	0.38581	474.85968			39.517266				1.98		0.33		1.7	0.05	0.51										$200/Day(Days 1-10):1a	$200/Day(Days 1-7):1b	"$0/Day(Days 1-14) $100(Days 15-100):2. $0 SNF 1,2. $100 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician, 9b. $50 Surgery ASC -- Facility, 9a. $0 Surgery OP -- Physician, 9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL, 8. $100 Lab -- OP"	"$0-$100/Visit:14h. $25 DMAM -- OP, 8b. $20 Radiology -- FSR, 14h. $20 SMAM -- FSR, 14h. $25 SMAM -- OP, 8b. $50 Advanced Imaging -- FSR, 8b. $50 Advanced Imaging -- Office, 9a. $100 Advanced Imaging -- OP, 8a. $0 Radiology OP -- Physician, 8a. $100 Radiology OP -- Facility"	$150/Visit:9a	"$0-$25/Proc:12. $0 Dialysis -- Dialysis Center, 12. $25 Dialysis -- OP Hosp"	"$25-$100/Visit:9d. $25 Cardiac Rehab, 8b. $100 Nuclear Medicine, 9a. $25 OP Other, 5. $25 Partial Hospitalization, 8b. $100 Rad therapy, 3. $25 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$25/Visit:7b, 7d, 7f"	"$25/Visit:7e, 7h"	"$25/Visit:7d, 9a"			20% Coins:15				VIS 140		HER 751		FTP 002	QuitNet	MOW 001										160.427395	126.013611	46.265603	0	99.999984	0	0	50.00001	68.166992	86.034544	30.252531	0	0.348924	81.794526	0	24.999998	25.007127	25			0.199999				0		0		0	0	0										160.427395	126.013611	46.265603	0	99.999984	0	0	50.00001	68.166992	86.034544	30.252531	0	0.348924	81.794526	0	24.999998	25.007127	25			0.199999				0		0		0	0	0										16.5969	0.107573	3.503586968	0	2.353517998	0	0	0.961054996	1.224471992	0.277739999	3.016104959	0	0.000346999	1.225324989	0	9.325675735	0.000804	0.989291	0	0	7.903413683	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4858	0	0	16.5969	0.107573	3.503586968	0	2.353517998	0	0	0.961054996	1.224471992	0.277739999	3.016104959	0	0.000346999	1.225324989	0	9.325675735	0.000804	0.989291	0	0	7.903413683	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4858																																																																																		0	0	0	16.5969	0.107573	3.503586968	0	2.353517998	0	0	0.961054996	1.224471992	0.277739999	3.016104959	0	0.000346999	1.225324989	0	9.325675735	0.000804	0.989291	0	0	7.903413683	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4858
H1019_023_0	2009	5	r.	s.	t.								Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered																			D	D	D	V	T	Coin	Coin	V	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								0		1474.469785	10.914391	774.04944	17.220428	326.464912	4.413605	2.972427	335.071243	211.206338	47.099708	1113.944794	0	15.001796	83.387364	6898.021455	5300.022585	0.281644	509.904229			2051.460215		2.86	4.16	2.65		0.33		0.05	0.51	1.7	2.24	45								$0/Day(Days 1-10):1a	$0/Day(Days 1-10):1b	$0/Day(Days 1-100) $0(Days 100-100):2	$0/Visit:6	$0/Trip:10a	0% Coins:11a	0% Coins:11b	$25/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"$0/Visit:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			$0/Script:15		TRN 026	DEN ADI + Dent	VIS 140		HER 751		SMC 001	MOW 001	FTP 002	OTC 009	ILS 005								0	0	0	0	0	0	0	24.999996	0	0	0	0	0	0	0	0	0	0			0		0	0	0		0		0	0	0	0	0								0	0	0	0	0	0	0	24.999996	0	0	0	0	0	0	0	0	0	0			0		0	0	0		0		0	0	0	0	0								0	0	0	0	0	0	0	0.698064978	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.6981	0	0	0	0	0	0	0	0	0	0.698064978	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.6981																																																																																		0	0	0	0	0	0	0	0	0	0	0.698064978	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.6981
H1019_024_0	2009	4	r.	s.	t.	u.	v.						Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered																	D	D	D	V	T	Coin	Coin	V	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						0		1647.369776	9.060629	618.231557	38.024216	304.239594	5.207791	1.940337	230.936662	215.164809	78.238382	1275.618597	0	12.705	311.503884	8252.650396	4334.863045	0.369155	493.229366			2435.090653			4.16	2.65		0.33		0.05	4.93	1.7	0.65	0.51	10.42	120						$0/Day(Days 1-1):1a	$0/Day(Days 1-1):1b	$0/Day(Days 1-100) $0(Days 100-100):2	$0/Visit:6	$0/Trip:10a	0% Coins:11a	0% Coins:11b	$25/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"$0/Visit:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			$0/Script:15			DEN ADI + Dent	VIS 140		HER 751		SMC 001	TRN 009	FTP 002	Acupuncture 6 Visits	MOW 001	OTC 009	ILS 020						0	0	0	0	0	0	0	24.999997	0	0	0	0	0	0	0	0	0	0			0			0	0		0		0	0	0	0	0	0	0						0	0	0	0	0	0	0	24.999997	0	0	0	0	0	0	0	0	0	0			0			0	0		0		0	0	0	0	0	0	0						0	0	0	0	0	0	0	0.481117988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4811	0	0	0	0	0	0	0	0	0	0.481117988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4811																																																																																		0	0	0	0	0	0	0	0	0	0	0.481117988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4811
H1019_025_0	2009	3	r.	s.	t.	u.							Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	Coin	Coin	V	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							0		1238.793886	10.222024	906.787929	4.348619	281.817948	4.821344	2.858601	230.159659	215.092752	38.655972	1193.811591	0	11.90828	179.381688	7319.957172	4466.747379	0.384985	473.843692			1440.954326			4.16	1.98		0.33		1.7	3.15	0.05	0.51	4.48	35							$0/Day(Days 1-1):1a	$0/Day(Days 1-1):1b	$0/Day(Days 1-100) $0(Days 100-100):2	$0/Visit:6	$0/Trip:10a	0% Coins:11a	0% Coins:11b	$25/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"$0/Visit:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			$0/Script:15			DEN ADI + Dent	VIS 140		HER 751		FTP 002	TRN 003	SMC 001	MOW 001	OTC 009	ILS 004							0	0	0	0	0	0	0	24.999984	0	0	0	0	0	0	0	0	0	0			0			0	0		0		0	0	0	0	0	0							0	0	0	0	0	0	0	24.999984	0	0	0	0	0	0	0	0	0	0			0			0	0		0		0	0	0	0	0	0							0	0	0	0	0	0	0	0.479498983	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4795	0	0	0	0	0	0	0	0	0	0.479498983	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4795																																																																																		0	0	0	0	0	0	0	0	0	0	0.479498983	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4795
H1019_026_0	2009	4	r.	s.	t.								Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered																			D	D	D	V	T	Coin	Coin	V	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								0		1244.122003	59.220701	842.873857	577.658092	221.827385	2.735385	3.852819	247.954675	212.20205	57.351194	1276.988545	0	393.808555	187.958545	6108.640334	3284.856564	1.339413	398.340212			1316.351725		4.96	4.16	2.58		0.33		0.05	1	1.7	0.51	35								$0/Day(Days 1-1):1a	$0/Day(Days 1-1):1b	$0/Day(Days 1-100) $0(Days 100-100):2	$0/Visit:6	$0/Trip:10a	0% Coins:11a	0% Coins:11b	$25/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"$0/Visit:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			$0/Script:15		TRN 003	DEN 818	VIS 140		HER 751		SMC 001	OTC 006	FTP 002	MOW 001	ILS 004								0	0	0	0	0	0	0	24.999988	0	0	0	0	0	0	0	0	0	0			0		0	0	0		0		0	0	0	0	0								0	0	0	0	0	0	0	24.999988	0	0	0	0	0	0	0	0	0	0			0		0	0	0		0		0	0	0	0	0								0	0	0	0	0	0	0	0.516571992	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.5166	0	0	0	0	0	0	0	0	0	0.516571992	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.5166																																																																																		0	0	0	0	0	0	0	0	0	0	0.516571992	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.5166
H1019_027_0	2009	4	r.	s.									Health & Education (Non-Covered)	Other Non-Covered																				D	D	D	V	T	Coin	Coin	V	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									0		1323.44035	50.5468	730.604151	632.958434	230.342671	2.476823	1.584787	278.473483	280.65593	86.898214	1224.585963	0	13.939199	189.129248	5803.0497	4787.555716	2.562883	531.564835			1262.75247			1.48	2.25		0.07		0.05	1.08	1.7	0.51									$95/Day(Days 1-10):1a	$95/Day(Days 1-10):1b	"$0/Day(Days 1-14) $100(Days 15-100):2. $0 SNF 1,2. $100 SNF 2"	$0/Visit:6	$140/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$150/Visit:14h. $100 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $100 SMAM -- OP,8b. $25 Advanced Imaging -- FSR,8b. $25 Advanced Imaging -- Office,9a. $150 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$95/Visit:9a	$0/Proc:12	"$20-$150/Visit:9d. $20 Cardiac Rehab,8b. $150 Nuclear Medicine,9a. $20 OP Other,5. $20 Partial Hospitalization,8b. $25 Rad therapy,3. $20 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$20/Visit:7b, 7d, 7f"	"$20/Visit:7e, 7h"	"$20/Visit:7d, 9a"			$0/Script:15			DEN ADI	VIS 120		HER 722		SMC 001	OTC 001	FTP 002	MOW 001									76.203017	70.782641	46.2656	0	140	0.2	0.2	49.999992	117.859829	91.77703	13.852995	0	0	28.770864	0	20.000001	19.997791	19.999991			0			0	0		0		0	0	0	0									76.203017	70.782641	46.2656	0	140	0.2	0.2	49.999992	117.859829	91.77703	13.852995	0	0	28.770864	0	20.000001	19.997791	19.999991			0			0	0		0		0	0	0	0									8.4042	0.298153	2.816819951	0	2.687331162	0.4953646	0.3169574	1.160305994	2.756504993	0.664604999	1.413681935	0	0	0.453450989	0	7.979259926	0.004271	0.885940993	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.3368	0	0	8.4042	0.298153	2.816819951	0	2.687331162	0.4953646	0.3169574	1.160305994	2.756504993	0.664604999	1.413681935	0	0	0.453450989	0	7.979259926	0.004271	0.885940993	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.3368																																																																																		0	0	0	8.4042	0.298153	2.816819951	0	2.687331162	0.4953646	0.3169574	1.160305994	2.756504993	0.664604999	1.413681935	0	0	0.453450989	0	7.979259926	0.004271	0.885940993	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.3368
H1019_028_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	Coin	Coin	V	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							0		1384.680712	52.885784	764.411843	662.247705	241.001459	2.711354	1.734851	291.359457	293.642893	90.919309	1281.251972	0	14.584214	197.880945	6071.577761	5009.093204	2.681478	556.162261			1321.184587			3.23	2.25		0.33		0.05	1	1.7	35	4.96	0.51							$0/Day(Days 1-7):1a	$0/Day(Days 1-7):1b	$0/Day(Days 1-6) $0(Days 7-100):2	$0/Visit:6	$0/Trip:10a	0% Coins:11a	0% Coins:11b	$25/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"$0/Visit:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			$0/Script:15			DEN ADI	VIS 120		HER 751		SMC 001	OTC 006	FTP 002	4 Meals per Month	TRN 003	MOW 001							0	0	0	0	0	0	0	25.000005	0	0	0	0	0	0	0	0	0	0			0			0	0		0		0	0	0	0	0	0							0	0	0	0	0	0	0	25.000005	0	0	0	0	0	0	0	0	0	0			0			0	0		0		0	0	0	0	0	0							0	0	0	0	0	0	0	0.60699899	0	0	0	0	0	0	0	0	0	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	0	0	0	0	0	0	0	0	0	0.60699899	0	0	0	0	0	0	0	0	0	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																																																																																		0	0	0	0	0	0	0	0	0	0	0.60699899	0	0	0	0	0	0	0	0	0	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
H1019_029_0	2009	4	r.	s.	t.								Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered																			D	D	D	V	T	Coin	Coin	V	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								0		1515.673381	57.88885	836.726238	724.897235	263.800524	3.248614	2.078615	318.922456	321.421908	99.520399	1402.460146	0	15.9639	216.600747	6645.95723	5482.960199	2.935149	608.775962			1446.170435			1.48	2.25		0.07		0.05	0.51	1.7	1.08	1.12								$145/Day(Days 1-10):1a	$145/Day(Days 1-7):1b	"$0/Day(Days 1-14) $100(Days 15-100):2. $0 SNF 1,2. $100 SNF 2"	$0/Visit:6	$150/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$150/Visit:14h. $100 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $100 SMAM -- OP,8b. $25 Advanced Imaging -- FSR,8b. $25 Advanced Imaging -- Office,9a. $150 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$95/Visit:9a	$0/Proc:12	"$20-$150/Visit:9d. $20 Cardiac Rehab,8b. $150 Nuclear Medicine,9a. $20 OP Other,5. $20 Partial Hospitalization,8b. $25 Rad therapy,3. $20 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$20/Visit:7b, 7d, 7f"	"$20/Visit:7e, 7h"	"$20/Visit:7d, 9a"			$0/Script:15			DEN ADI	VIS 120		HER 722		SMC 001	MOW001	FTP 002	OTC 006	TRN 003								116.309863	91.359769	46.265598	0	150.00002	0.2	0.2	50.000016	117.859819	91.776963	13.852996	0	0	28.770814	0	20	20.000347	19.999988			0			0	0		0		0	0	0	0	0								116.309863	91.359769	46.265598	0	150.00002	0.2	0.2	50.000016	117.859819	91.776963	13.852996	0	0	28.770814	0	20	20.000347	19.999988			0			0	0		0		0	0	0	0	0								14.6906	0.440725997	3.22596998	0	3.29750699	0.6497228	0.415723	1.328843992	3.156893992	0.761139998	1.619022899	0	0	0.519314984	0	9.138266998	0.004892	1.014625995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2633	0	0	14.6906	0.440725997	3.22596998	0	3.29750699	0.6497228	0.415723	1.328843992	3.156893992	0.761139998	1.619022899	0	0	0.519314984	0	9.138266998	0.004892	1.014625995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2633																																																																																		0	0	0	14.6906	0.440725997	3.22596998	0	3.29750699	0.6497228	0.415723	1.328843992	3.156893992	0.761139998	1.619022899	0	0	0.519314984	0	9.138266998	0.004892	1.014625995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2633
H1019_030_0	2009	6	r.	s.	t.								Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered																			D	D	D	V	T	Coin	Coin	V	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								0		1327.15408	50.688641	732.654314	634.734591	230.989041	2.490744	1.593694	279.254913	281.443483	87.142062	1228.022294	0	13.978312	189.659968	5819.333745	4800.990166	2.570075	533.05647			1266.295905		1.12	1.48	2.25		0.33		0.05	0.51	1.7	1.08	0.65								$120/Day(Days 1-10):1a	$120/Day(Days 1-10):1b	"$0/Day(Days 1-14) $100(Days 15-100):2. $0 SNF 1,2. $100 SNF 2"	$0/Visit:6	$140/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$150/Visit:14h. $100 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $100 SMAM -- OP,8b. $25 Advanced Imaging -- FSR,8b. $25 Advanced Imaging -- Office,9a. $150 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$95/Visit:9a	$0/Proc:12	"$20-$150/Visit:9d. $20 Cardiac Rehab,8b. $150 Nuclear Medicine,9a. $20 OP Other,5. $20 Partial Hospitalization,8b. $25 Rad therapy,3. $20 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$20/Visit:7b, 7d, 7f"	"$20/Visit:7e, 7h"	"$20/Visit:7d, 9a"			$0/Script:15		TRN 003	DEN ADI	VIS 120		HER 751		SMC 001	MOW001	FTP 002	OTC 006	Acupuncture 6 Visits								96.25644	89.409617	46.265595	0	140	0.2	0.2	49.999994	117.859783	91.777034	13.852986	0	0	28.770836	0	19.999999	19.997859	19.999989			0		0	0	0		0		0	0	0	0	0								96.25644	89.409617	46.265595	0	140	0.2	0.2	49.999994	117.859783	91.777034	13.852986	0	0	28.770836	0	19.999999	19.997859	19.999989			0		0	0	0		0		0	0	0	0	0								10.6456	0.377670998	2.824723981	0	2.694872145	0.4981488	0.3187388	1.163561998	2.764238986	0.666469999	1.417647971	0	0	0.454722986	0	8.001649877	0.004283	0.888426961	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7208	0	0	10.6456	0.377670998	2.824723981	0	2.694872145	0.4981488	0.3187388	1.163561998	2.764238986	0.666469999	1.417647971	0	0	0.454722986	0	8.001649877	0.004283	0.888426961	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7208																																																																																		0	0	0	10.6456	0.377670998	2.824723981	0	2.694872145	0.4981488	0.3187388	1.163561998	2.764238986	0.666469999	1.417647971	0	0	0.454722986	0	8.001649877	0.004283	0.888426961	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7208
H1019_031_0	2009	9	r.										Health & Education (Non-Covered)																					D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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										0		1419.408226	10.506811	745.143884	16.57736	314.273637	4.081943	2.749064	322.558578	203.319199	45.340849	1072.346427	0	0	80.273404	6640.426614	5102.102285	0.271125	490.862725			53.90138				1.95		0.05		0.05	0.51	1.7										$225/Day(Days 1-7):1a	$225/Day(Days 1-7):1b	"$0/Day(Days 1-14) $100(Days 15-100):2. $0 SNF 1, 2. $100 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician, 9b. $50 Surgery ASC -- Facility, 9a. $0 Surgery OP -- Physician, 9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL, 8. $100 Lab -- OP"	"$0-$100/Visit:14h. $20 DMAM -- OP, 8b. $0 Radiology -- FSR, 14h. $0 SMAM -- FSR, 14h. $20 SMAM -- OP, 8b. $50 Advanced Imaging -- FSR, 8b. $50 Advanced Imaging -- Office, 9a. $100 Advanced Imaging -- OP, 8a. $0 Radiology OP -- Physician, 8a. $100 Radiology OP -- Facility"	$150/Visit:9a	20% Coins:12	"$20-$100/Visit:9d. $20 Cardiac Rehab, 8b. $100 Nuclear Medicine, 9a. $100 OP Other, 5. $20 Partial Hospitalization, 8b. $100 Rad therapy, 3. $20 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$20/Visit:7b, 7d, 7f"	"$20/Visit:7e, 7h"	"$20/Visit:7d, 9a"			20% Coins:15				VIS 115		HER 722		SMC 001	MOW 001	FTP 002										160.298095	141.765184	46.265593	0	100	0	0	49.999997	75.168326	71.55349	19.477754	0	0	92.124609	0	20	20.005532	20.000011			0.2				0		0		0	0	0										160.298095	141.765184	46.265593	0	100	0	0	49.999997	75.168326	71.55349	19.477754	0	0	92.124609	0	20	20.005532	20.000011			0.2				0		0		0	0	0										18.9607	0.124125	2.872876972	0	2.618946975	0	0	1.343993994	1.273596986	0.270357999	1.740574992	0	0	0.616262996	0	8.503503808	0.000452	0.818104992	0	0	10.780276	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.9238	0	0	18.9607	0.124125	2.872876972	0	2.618946975	0	0	1.343993994	1.273596986	0.270357999	1.740574992	0	0	0.616262996	0	8.503503808	0.000452	0.818104992	0	0	10.780276	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.9238																																																																																		0	0	0	18.9607	0.124125	2.872876972	0	2.618946975	0	0	1.343993994	1.273596986	0.270357999	1.740574992	0	0	0.616262996	0	8.503503808	0.000452	0.818104992	0	0	10.780276	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.9238
H1019_032_0	2009	5	r.	s.	t.	u.	v.						Part B Rx	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																	D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin	V		V		O	O	S	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		1684.718801	12.470706	884.423443	19.67594	373.016511	5.750518	3.872798	382.850044	241.322876	53.815795	1272.785481	0	17.140945	95.277814	7881.630771	6055.768508	0.321804	582.612983			30.02938			3.23	2.65		0.33		0.05	2.2	2177.961746	1.7	0.93	0.51	2.46						$50/Day(Days 1-10):1a	$50/Day(Days 1-10):1b	"$0/Day(Days 1-14) $25(Days 15-100):2. $0 SNF 1, 2. $25 SNF 2"	$0/Visit:6	$50/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$75/Visit:9b. $0 Surgery ASC -- Physician, 9b. $50 Surgery ASC -- Facility, 9a. $0 Surgery OP -- Physician, 9a. $75 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$75/Visit:14h. $0 DMAM -- OP, 8b. $0 Radiology -- FSR, 14h. $0 SMAM -- FSR, 14h. $0 SMAM -- OP, 8b. $25 Advanced Imaging -- FSR, 8b. $25 Advanced Imaging -- Office, 9a. $75 Advanced Imaging -- OP, 8a. $0 Radiology OP -- Physician, 8a. $0 Radiology OP -- Facility"	$0/Visit:9a	"$0-$5/Proc:12. $0 Dialysis -- Dialysis Center, 12. $5 Dialysis -- OP Hosp"	"$0-$75/Visit:9d. $5 Cardiac Rehab, 8b. $75 Nuclear Medicine, 9a. $0 OP Other, 5. $5 Partial Hospitalization, 8b. $25 Rad therapy, 3. $5 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$5/Visit:7b, 7d, 7f"	"$5/Visit:7e, 7h"	"$5/Visit:7d, 9a"			0% Coins:15			DEN ADI	VIS 140		HER 751		SMC 001	TRN 020	$0/Script:15	FTP 002	Acupuncture 16 Visits	MOW 001	OTC 008						40.106847	37.253704	11.566396	0	49.999985	0	0	50.000015	62.584137	0	8.40167	0	0.192521	21.495959	0	5	4.99683	5.000012			0			0	0		0		0	0	0	0	0	0	0						40.106847	37.253704	11.566396	0	49.999985	0	0	50.000015	62.584137	0	8.40167	0	0.192521	21.495959	0	5	4.99683	5.000012			0			0	0		0		0	0	0	0	0	0	0						5.6307	0.038714999	0.852465981	0	1.554234996	0	0	1.595208995	1.258581994	0	0.891126966	0	0.000274999	0.170673999	0	2.523236878	0.000134	0.242755992	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.7581	0	0	5.6307	0.038714999	0.852465981	0	1.554234996	0	0	1.595208995	1.258581994	0	0.891126966	0	0.000274999	0.170673999	0	2.523236878	0.000134	0.242755992	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.7581																																																																																		0	0	0	5.6307	0.038714999	0.852465981	0	1.554234996	0	0	1.595208995	1.258581994	0	0.891126966	0	0.000274999	0.170673999	0	2.523236878	0.000134	0.242755992	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.7581
H1019_033_0	2009	5	r.	s.	t.	u.	v.						Part B Rx	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																	D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin	V		V		O	O	S	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		1447.755596	10.716645	760.025346	16.908431	320.550077	4.246613	2.859964	329.000479	207.379738	46.246362	1093.762533	0	14.729994	81.876564	6773.044294	5203.997691	0.27654	500.665872			22.175939			3.23	2.65		0.33		0.05	2.64	1871.621724	1.7	0.93	0.51	2.46						$25/Day(Days 1-10):1a	$25/Day(Days 1-10):1b	"$0/Day(Days 1-14) $25(Days 15-100):2. $0 SNF 1, 2. $25 SNF 2"	$0/Visit:6	$50/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$75/Visit:9b. $0 Surgery ASC -- Physician, 9b. $50 Surgery ASC -- Facility, 9a. $0 Surgery OP -- Physician, 9a. $75 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$75/Visit:14h. $0 DMAM -- OP, 8b. $0 Radiology -- FSR, 14h. $0 SMAM -- FSR, 14h. $0 SMAM -- OP, 8b. $25 Advanced Imaging -- FSR, 8b. $25 Advanced Imaging -- Office, 9a. $75 Advanced Imaging -- OP, 8a. $0 Radiology OP -- Physician, 8a. $0 Radiology OP -- Facility"	$0/Visit:9a	"$0-$5/Proc:12. $0 Dialysis -- Dialysis Center, 12. $5 Dialysis -- OP Hosp"	"$0-$75/Visit:9d. $5 Cardiac Rehab, 8b. $75 Nuclear Medicine, 9a. $0 OP Other, 5. $5 Partial Hospitalization, 8b. $25 Rad therapy, 3. $5 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$5/Visit:7b, 7d, 7f"	"$5/Visit:7e, 7h"	"$5/Visit:7d, 9a"			0% Coins:15			DEN ADI	VIS 140		HER 751		SMC 001	TRN 024	$0/Script:15	FTP 002	Acupuncture 16 Visits	MOW 001	OTC 008						20.053428	18.627098	11.566398	0	49.999987	0	0	49.999987	62.584146	0	8.40167	0	0.19226	21.495821	0	5.000001	4.990236	5.000005			0			0	0		0		0	0	0	0	0	0	0						20.053428	18.627098	11.566398	0	49.999987	0	0	49.999987	62.584146	0	8.40167	0	0.19226	21.495821	0	5.000001	4.990236	5.000005			0			0	0		0		0	0	0	0	0	0	0						2.4194	0.016635	0.73256297	0	1.335624974	0	0	1.370834973	1.081556983	0	0.765785988	0	0.000235999	0.146666997	0	2.168332805	0.000115	0.208610989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.2463	0	0	2.4194	0.016635	0.73256297	0	1.335624974	0	0	1.370834973	1.081556983	0	0.765785988	0	0.000235999	0.146666997	0	2.168332805	0.000115	0.208610989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.2463																																																																																		0	0	0	2.4194	0.016635	0.73256297	0	1.335624974	0	0	1.370834973	1.081556983	0	0.765785988	0	0.000235999	0.146666997	0	2.168332805	0.000115	0.208610989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.2463
H1019_034_0	2009	3	r.										Health & Education (Non-Covered)																					D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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		1636.351316	9.000027	614.096506	37.76989	302.204684	5.138361	1.914469	229.39204	213.725675	77.715082	1267.086602	0	0.040748	309.420383	8197.452415	4305.869244	0.366685	489.930396			41.572763			4.16	2.65		0.33		0.05	0.51	1.7										$0/Day(Days 1-10):1a	$0/Day(Days 1-10):1b	"$0/Day(Days 1-20) $50(Days 21-100):2. $0 SNF 1, 2. $50 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$50/Visit:9b. $0 Surgery ASC -- Physician, 9b. $0 Surgery ASC -- Facility, 9a. $0 Surgery OP -- Physician, 9a. $50 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL, 8. $50 Lab -- OP"	"$0-$50/Visit:14h. $20 DMAM -- OP, 8b. $0 Radiology -- FSR, 14h. $0 SMAM -- FSR, 14h. $20 SMAM -- OP, 8b. $25 Advanced Imaging -- FSR, 8b. $25 Advanced Imaging -- Office, 9a. $50 Advanced Imaging -- OP, 8a. $0 Radiology OP -- Physician, 8a. $50 Radiology OP -- Facility"	$0/Visit:9a	20% Coins:12	"$0-$50/Visit:9d. $0 Cardiac Rehab, 8b. $50 Nuclear Medicine, 9a. $0 OP Other, 5. $0 Partial Hospitalization, 8b. $25 Rad therapy, 3. $0 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			20% Coins:15			DEN ADI	VIS 140		HER 751		SMC 001	MOW 001	FTP 002										0	0	16.848752	0	99.999985	0	0	49.999991	23.683312	41.893644	10.333178	0	0.200009	20.707595	0	0	0	0			0.199999			0	0		0		0	0	0										0	0	16.848752	0	99.999985	0	0	49.999991	23.683312	41.893644	10.333178	0	0.200009	20.707595	0	0	0	0			0.199999			0	0		0		0	0	0										0	0	0.862229978	0	2.518371989	0	0	0.955799995	0.421810987	0.271313998	1.09108595	0	0.008149967	0.533945998	0	0	0	0	0	0	8.314511027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.9772	0	0	0	0	0.862229978	0	2.518371989	0	0	0.955799995	0.421810987	0.271313998	1.09108595	0	0.008149967	0.533945998	0	0	0	0	0	0	8.314511027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.9772																																																																																		0	0	0	0	0	0.862229978	0	2.518371989	0	0	0.955799995	0.421810987	0.271313998	1.09108595	0	0.008149967	0.533945998	0	0	0	0	0	0	8.314511027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.9772
H1019_035_0	2009	5	r.	s.	t.	u.	v.						Part B Rx	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																	D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin	V		V		O	O	S	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		1853.682362	10.195361	695.657376	42.786275	342.341822	6.593899	2.456778	259.858608	242.111527	88.036764	1435.373971	0	14.296144	350.515873	9286.192276	4877.750756	0.415387	555.000214			11.360038			4.16	2.61		0.33		0.05	5.86	2647.827715	1.7	0.51	0.93	7.43						$50/Day(Days 1-10):1a	$50/Day(Days 1-10):1b	"$0/Day(Days 1-14) $50(Days 15-100):2. $0 SNF 1,2. $50 SNF 2"	$0/Visit:6	$25/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"$0-$25/Visit:9d. $0 Cardiac Rehab,8b. $0 Nuclear Medicine,9a. $0 OP Other,5. $0 Partial Hospitalization,8b. $25 Rad therapy,3. $0 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			0% Coins:15			"DEN 330 16a, 16b"	VIS 140		HER 751		$0 Additional Smoking Cessation 14a	TRN 042	$0/Script:15	$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	Acupuncture 16 Visits	OTC 009						40.106851	37.25459	23.132801	0	25	0	0	49.99999	0	0	0	0	0	19.306081	0	0	0	0			0			0	0		0		0	0	0	0	0	0	0						40.106851	37.25459	23.132801	0	25	0	0	49.99999	0	0	0	0	0	19.306081	0	0	0	0			0			0	0		0		0	0	0	0	0	0	0						6.1954	0.031651999	1.34104197	0	0.713212129	0	0	1.082743983	0	0	0	0	0	0.563923986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.928	0	0	6.1954	0.031651999	1.34104197	0	0.713212129	0	0	1.082743983	0	0	0	0	0	0.563923986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.928																																																																																		0	0	0	6.1954	0.031651999	1.34104197	0	0.713212129	0	0	1.082743983	0	0	0	0	0	0.563923986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.928
H1019_036_0	2009	5	r.	s.	t.	u.	v.						Part B Rx	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																	D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin	V		V		O	O	S	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		1589.495093	8.742315	596.512114	36.688365	293.551181	4.848305	1.806398	222.823495	207.605732	75.489743	1230.804115	0	12.258652	300.560265	7962.721854	4182.57251	0.356185	475.901446			8.35271			4.16	2.61		0.33		0.05	5.64	2270.458654	1.7	0.51	0.93	7.43						$25/Day(Days 1-10):1a	$25/Day(Days 1-10):1b	"$0/Day(Days 1-14) $50(Days 15-100):2. $0 SNF 1,2. $50 SNF 2"	$0/Visit:6	$25/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"$0-$25/Visit:9d. $0 Cardiac Rehab,8b. $0 Nuclear Medicine,9a. $0 OP Other,5. $0 Partial Hospitalization,8b. $25 Rad therapy,3. $0 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			0% Coins:15			"DEN 330 16a, 16b"	VIS 140		HER 751		$0 Additional Smoking Cessation 14a	TRN 009	$0/Script:15	$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	Acupuncture 16 Visits	OTC 009						20.053424	18.626645	23.132794	0	25	0	0	49.999987	0	0	0	0	0	19.306104	0	0	0	0			0			0	0		0		0	0	0	0	0	0	0						20.053424	18.626645	23.132794	0	25	0	0	49.999987	0	0	0	0	0	19.306104	0	0	0	0			0			0	0		0		0	0	0	0	0	0	0						2.6562	0.01357	1.149915988	0	0.61156496	0	0	0.928430988	0	0	0	0	0	0.483553978	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.8433	0	0	2.6562	0.01357	1.149915988	0	0.61156496	0	0	0.928430988	0	0	0	0	0	0.483553978	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.8433																																																																																		0	0	0	2.6562	0.01357	1.149915988	0	0.61156496	0	0	0.928430988	0	0	0	0	0	0.483553978	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.8433
H1019_037_0	2009	4	r.	s.	t.								Dental (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered																			D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			S			Coin	V		V		O	O	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		1470.825073	12.13665	1076.633034	5.163134	334.603609	6.794506	4.0285	273.269507	255.38051	45.896395	1417.417404	0	14.138749	212.980618	8691.015234	5303.38752	0.457094	562.596564			1710.850994			1.16	2.25		0.33		0.05	0.51	3.23	1.7	2.43								$125/Day(Days 1-10):1a	$125/Day(Days 1-10):1b	"$0/Day(Days 1-6) $50(Days 7-100):2. $0 SNF 1, 2. $50 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$75/Visit:9b. $0 Surgery ASC -- Physician, 9b. $50 Surgery ASC -- Facility, 9a. $0 Surgery OP -- Physician, 9a. $75 Surgery OP -- Facility"	"$0-$20/Visit:8a. $0 Lab -- FSL, 8. $20 Lab -- OP"	"$0-$50/Visit:14h. $20 DMAM -- OP, 8b. $0 Radiology -- FSR, 14h. $0 SMAM -- FSR, 14h. $20 SMAM -- OP, 8b. $25 Advanced Imaging -- FSR, 8b. $25 Advanced Imaging -- Office, 9a. $50 Advanced Imaging -- OP, 8a. $0 Radiology OP -- Physician, 8a. $0 Radiology OP -- Facility"	$50/Visit:9a	"$0-$20/Proc:12. $0 Dialysis -- Dialysis Center, 12. $20 Dialysis -- OP Hosp"	"$15-$100/Visit:9d. $15 Cardiac Rehab, 8b. $50 Nuclear Medicine, 9a. $15 OP Other, 5. $15 Partial Hospitalization, 8b. $100 Rad therapy, 3. $15 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$15/Visit:7b, 7d, 7f"	"$15/Visit:7e, 7h"	"$15/Visit:7d, 9a"			$0/Script:15			TRN 005	VIS 140		HER 751		SMC 001	MOW 001	DEN 330	FTP 002	OTC 015								100.267126	93.13542	35.997546	0	99.999985	0	0	50.000002	59.083506	17.206841	7.653127	0	0.279232	77.489135	0	14.999999	14.990352	15.000006			0			0	0		0		0	0	0	0	0								100.267126	93.13542	35.997546	0	99.999985	0	0	50.000002	59.083506	17.206841	7.653127	0	0.279232	77.489135	0	14.999999	14.990352	15.000006			0			0	0		0		0	0	0	0	0								12.2896	0.094196	3.229678931	0	2.78836299	0	0	1.138622991	1.257397991	0.065810998	0.90397295	0	0.000328999	1.375306988	0	6.629233958	0.000571	0.703245986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.4763	0	0	12.2896	0.094196	3.229678931	0	2.78836299	0	0	1.138622991	1.257397991	0.065810998	0.90397295	0	0.000328999	1.375306988	0	6.629233958	0.000571	0.703245986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.4763																																																																																		0	0	0	12.2896	0.094196	3.229678931	0	2.78836299	0	0	1.138622991	1.257397991	0.065810998	0.90397295	0	0.000328999	1.375306988	0	6.629233958	0.000571	0.703245986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.4763
H1019_038_0	2009	4	r.	s.	t.								Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered																			D	D	D	V	T	Coin	Coin	V	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								0		1265.42701	10.441789	926.283177	4.442111	287.876819	5.029331	2.981918	235.107915	219.717081	39.487048	1219.477626	0	12.164299	183.23826	7477.330665	4562.779038	0.393261	484.03097			1471.933746		1.16	3.23	2.25		0.33		0.05	0.51	1.7	0.65	2.43								$100/Day(Days 1-10):1a	$100/Day(Days 1-10):1b	"$0/Day(Days 1-6) $50(Days 7-100):2. $0 SNF 1, 2. $50 SNF 2"	$0/Visit:6	$75/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$75/Visit:9b. $0 Surgery ASC -- Physician, 9b. $50 Surgery ASC -- Facility, 9a. $0 Surgery OP -- Physician, 9a. $75 Surgery OP -- Facility"	"$0-$20/Visit:8a. $0 Lab -- FSL, 8. $20 Lab -- OP"	"$0-$50/Visit:14h. $20 DMAM -- OP, 8b. $0 Radiology -- FSR, 14h. $0 SMAM -- FSR, 14h. $20 SMAM -- OP, 8b. $25 Advanced Imaging -- FSR, 8b. $25 Advanced Imaging -- Office, 9a. $50 Advanced Imaging -- OP, 8a. $0 Radiology OP -- Physician, 8a. $0 Radiology OP -- Facility"	$50/Visit:9a	"$0-$20/Proc:12. $0 Dialysis -- Dialysis Center, 12. $20 Dialysis -- OP Hosp"	"$15-$100/Visit:9d. $15 Cardiac Rehab, 8b. $50 Nuclear Medicine, 9a. $15 OP Other, 5. $15 Partial Hospitalization, 8b. $100 Rad therapy, 3. $15 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$15/Visit:7b, 7d, 7f"	"$15/Visit:7e, 7h"	"$15/Visit:7d, 9a"			$0/Script:15		TRN 005	DEN 330	VIS 140		HER 751		SMC 001	MOW 001	FTP 002	Acupuncture 6 Visits	OTC 015								80.213697	74.507921	35.997544	0	75	0	0	49.999984	59.083526	17.206958	7.653119	0	0.279177	77.489144	0	14.999997	15.01293	14.999982			0		0	0	0		0		0	0	0	0	0								80.213697	74.507921	35.997544	0	75	0	0	49.999984	59.083526	17.206958	7.653119	0	0.279177	77.489144	0	14.999997	15.01293	14.999982			0		0	0	0		0		0	0	0	0	0								8.4587	0.064832999	2.778659952	0	1.799230119	0	0	0.979615999	1.081804989	0.056620998	0.777733949	0	0.000282999	1.183247993	0	5.703472657	0.000492	0.605037986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.4897	0	0	8.4587	0.064832999	2.778659952	0	1.799230119	0	0	0.979615999	1.081804989	0.056620998	0.777733949	0	0.000282999	1.183247993	0	5.703472657	0.000492	0.605037986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.4897																																																																																		0	0	0	8.4587	0.064832999	2.778659952	0	1.799230119	0	0	0.979615999	1.081804989	0.056620998	0.777733949	0	0.000282999	1.183247993	0	5.703472657	0.000492	0.605037986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.4897
H1019_039_0	2009	2	r.										Health & Education (Non-Covered)																					D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			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		1177.809026	56.064178	797.947818	546.868324	210.003757	2.451559	3.453046	234.738438	200.891463	54.294316	1208.923747	0	372.818155	177.940163	5783.043547	3109.770344	1.268021	377.108271			31.255693						0.07		0.05	0.51	1.7										$275/Day(Days 1-5):1a	$275/Day(Days 1-5):1b	"$0/Day(Days 1-20) $124(Days 21-100):2. $0 SNF 1,2. $124 SNF 2"	$25/Visit:6	$150/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$150/Visit:8a. $0 Lab -- FSL,8. $150 Lab -- OP"	"$0-$150/Visit:14h. $150 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $150 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $75 Advanced Imaging -- Office,9a. $150 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $150 Radiology OP -- Facility"	$150/Visit:9a	"$0-$20/Proc:12. $0 Dialysis -- Dialysis Center,12. $20 Dialysis -- OP Hosp"	"$35-$150/Visit:9d. $35 Cardiac Rehab,8b. $150 Nuclear Medicine,9a. $35 OP Other,5. $35 Partial Hospitalization,8b. $100 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$5/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35/Visit:7e, 7h"	"$35/Visit:7d, 9a"			20% Coins:15						HER 722		SMC 001	MOW 001	FTP 002										168.603048	140.545358	41.784897	24.999999	150.000002	0.2	0.2	50.000008	117.569814	134.15349	20.017451	0	0.019666	43.741895	4.999999	34.999998	34.996265	34.999996			0.2						0		0	0	0										168.603048	140.545358	41.784897	24.999999	150.000002	0.2	0.2	50.000008	117.569814	134.15349	20.017451	0	0.019666	43.741895	4.999999	34.999998	34.996265	34.999996			0.2						0		0	0	0										16.5485	0.656629997	2.778513949	1.139308963	2.625046998	0.4903118	0.6906092	0.978076981	1.968230995	0.606980998	2.016630989	0	0.000610987	0.648619994	2.409600996	9.070162985	0.003698	1.099898998	0	0	6.2511386	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.9826	0	0	16.5485	0.656629997	2.778513949	1.139308963	2.625046998	0.4903118	0.6906092	0.978076981	1.968230995	0.606980998	2.016630989	0	0.000610987	0.648619994	2.409600996	9.070162985	0.003698	1.099898998	0	0	6.2511386	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.9826																																																																																		0	0	0	16.5485	0.656629997	2.778513949	1.139308963	2.625046998	0.4903118	0.6906092	0.978076981	1.968230995	0.606980998	2.016630989	0	0.000610987	0.648619994	2.409600996	9.070162985	0.003698	1.099898998	0	0	6.2511386	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.9826
H1019_040_0	2009	6	r.	s.	t.								Other Non-Covered	Other Non-Covered	Other Non-Covered																			D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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								0		1410.249377	67.128429	955.422643	654.792667	251.447953	3.514666	4.950444	281.064017	240.537348	65.009288	1447.504585	0	0.014511	213.056616	6924.325915	3723.482834	1.518263	451.530504			1492.123922			1.48	2.4		0.07		1.7		0.05	0.51	1								$145/Day(Days 1-10):1a	$145/Day(Days 1-7):1b	"$0/Day(Days 1-20) $100(Days 21-100):2. $0 SNF 1,2. $100 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $50 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $100 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $50 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$95/Visit:9a	20% Coins:12	"$20-$100/Visit:9d. $20 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $20 OP Other,5. $20 Partial Hospitalization,8b. $100 Rad therapy,3. $20 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$20/Visit:7b, 7d, 7f"	"$20/Visit:7e, 7h"	"$20/Visit:7d, 9a"			$0/Script:15			DEN ADI	VIS 116		HER 722		FTP 002		SMC 001	MOW 001	OTC 008								116.309863	91.359802	33.697497	0	100.000018	0	0.2	49.999996	67.569864	89.435774	13.344969	0	0.199986	28.642809	0	19.999997	20.004439	20.000004			0			0	0		0		0		0	0	0								116.309863	91.359802	33.697497	0	100.000018	0	0.2	49.999996	67.569864	89.435774	13.344969	0	0.199986	28.642809	0	19.999997	20.004439	20.000004			0			0	0		0		0		0	0	0								13.6688	0.511069999	2.682945971	0	2.095399986	0	0.9900888	1.171099977	1.354422991	0.484512999	1.609741985	0	0.002901997	0.508544997	0	6.205803792	0.002531	0.752550991	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.0404	0	0	13.6688	0.511069999	2.682945971	0	2.095399986	0	0.9900888	1.171099977	1.354422991	0.484512999	1.609741985	0	0.002901997	0.508544997	0	6.205803792	0.002531	0.752550991	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.0404																																																																																		0	0	0	13.6688	0.511069999	2.682945971	0	2.095399986	0	0.9900888	1.171099977	1.354422991	0.484512999	1.609741985	0	0.002901997	0.508544997	0	6.205803792	0.002531	0.752550991	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.0404
H1019_041_0	2009	5	r.	s.	t.	u.							Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1203.574151	57.290607	815.403301	558.831326	214.597688	2.559991	3.605775	239.873451	205.286057	55.48203	1235.369525	0	0.010569	181.832687	5909.550342	3177.798031	1.295759	385.357693			1273.449798			1.48	2.58		0.33		1.7	1.12	0.05	0.51	1.83	0.93							$120/Day(Days 1-10):1a	$120/Day(Days 1-10):1b	"$0/Day(Days 1-20) $100(Days 21-100):2. $0 SNF 1,2. $100 SNF 2"	$0/Visit:6	$75/Trip:10a	0% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $50 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $100 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $50 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$95/Visit:9a	20% Coins:12	"$20-$100/Visit:9d. $20 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $20 OP Other,5. $20 Partial Hospitalization,8b. $100 Rad therapy,3. $20 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$20/Visit:7b, 7d, 7f"	"$20/Visit:7e, 7h"	"$20/Visit:7d, 9a"			$0/Script:15			DEN ADI	VIS 120		HER 751		FTP 002	TRN 003	SMC 001	MOW 001	OTC 009	Acupuncture 16 Visits							96.256444	89.40963	33.697494	0	75	0	0.2	50.000014	67.569791	89.43566	13.344972	0	0.200018	28.642902	0	20.000003	19.994458	20.000005			0			0	0		0		0	0	0	0	0	0							96.256444	89.40963	33.697494	0	75	0	0.2	50.000014	67.569791	89.43566	13.344972	0	0.200018	28.642902	0	20.000003	19.994458	20.000005			0			0	0		0		0	0	0	0	0	0							9.6543	0.426860998	2.289753987	0	1.34123555	0	0.721155	0.999472992	1.155927997	0.413505998	1.373830977	0	0.00211399	0.434017986	0	5.296330846	0.002159	0.642262982	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.7529	0	0	9.6543	0.426860998	2.289753987	0	1.34123555	0	0.721155	0.999472992	1.155927997	0.413505998	1.373830977	0	0.00211399	0.434017986	0	5.296330846	0.002159	0.642262982	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.7529																																																																																		0	0	0	9.6543	0.426860998	2.289753987	0	1.34123555	0	0.721155	0.999472992	1.155927997	0.413505998	1.373830977	0	0.00211399	0.434017986	0	5.296330846	0.002159	0.642262982	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.7529
H1019_043_0	2009	6	r.	s.									Health & Education (Non-Covered)	Other Non-Covered																				D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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									0		1198.970042	9.893414	1034.893773	4.508586	292.184805	4.873675	2.889629	238.074256	230.547717	40.302937	1283.251637	0	0.007988	185.538768	7076.516612	4319.912908	0.420877	491.168646			39.003107				2.25		0.33		0.05	0.51	1.7	1									$75/Day(Days 1-10):1a	$75/Day(Days 1-10):1b	"$0/Day(Days 1-13) $75(Days 14-100):2. $0 SNF 1,2. $75 SNF 2"	$0/Visit:6	$75/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$75/Visit:9b. $15 Surgery ASC -- Physician,9b. $0 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $75 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$75/Visit:14h. $50 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $25 Advanced Imaging -- FSR,8b. $25 Advanced Imaging -- Office,9a. $75 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$15-$75/Visit:9d. $15 Cardiac Rehab,8b. $75 Nuclear Medicine,9a. $15 OP Other,5. $15 Partial Hospitalization,8b. $75 Rad therapy,3. $15 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$15/Visit:7b, 7d, 7f"	"$15/Visit:7e, 7h"	"$15/Visit:7d, 9a"			20% Coins:15				VIS 140		HER 751		SMC 001	MOW 001	FTP 002	OTC 002									60.160275	55.880811	36.641476	0	75	0.2	0.2	49.999996	26.298035	42.67818	8.499523	0	0.20005	60.438323	0	14.999999	14.997255	14.99998			0.2				0		0		0	0	0	0									60.160275	55.880811	36.641476	0	75	0.2	0.2	49.999996	26.298035	42.67818	8.499523	0	0.20005	60.438323	0	14.999999	14.997255	14.99998			0.2				0		0		0	0	0	0									6.0109	0.046071	3.160002945	0	1.826155031	0.974735	0.5779258	0.991975987	0.505245994	0.143338	0.9089189	0	0.001597999	0.934470999	0	5.399890775	0.000526	0.613959989	0	0	7.8006214	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.8963	0	0	6.0109	0.046071	3.160002945	0	1.826155031	0.974735	0.5779258	0.991975987	0.505245994	0.143338	0.9089189	0	0.001597999	0.934470999	0	5.399890775	0.000526	0.613959989	0	0	7.8006214	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.8963																																																																																		0	0	0	6.0109	0.046071	3.160002945	0	1.826155031	0.974735	0.5779258	0.991975987	0.505245994	0.143338	0.9089189	0	0.001597999	0.934470999	0	5.399890775	0.000526	0.613959989	0	0	7.8006214	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.8963
H1026_001_0	2009	7	e.3.	g.2.	h.6.	h.7.	i.8.	i.7.	h.8.				DME/Prosthetics/Supplies	OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	OP Facility - Other					Electric Wheelchairs	Ambulatory Surgical Center	Rehab	Substance Abuse and Mental Health	Advanced Imaging	Allergy Shots	IDTF				D	D	D		T			V	V	V	V		V	V		V	V	V			Coin			V							O	V	V	V	V	O	V																																												0		1714.162482	26.08649899	839.1467728		242.5200629			258.0478991	225.4976005	1162.412312	391.1773119		4.435774033	166.762568		4680.441217	153.0997699	215.7361934			82.24089275			369.6130905							11.76529748	156.6825154	143.4546792	144.6454917	2027.487968	93.47544847	685.1032674				$200 for days 1-5	$200 for days 1-5	$75 for days 7-25		$100 per transport			$50 per visit	$175 per visit	$15 per visit	$50 per visit		$15 per visit	$175 per visit		$15 per visit	$15 per visit	$15 per visit			20% coinsurance			"$10 copay for select services, $15 for Medicare covered"							$500 per electric wheelchair	$100 per visit	$15 per visit	$15 per visit	$100 per visit	$5 per shot	$75 per visit				131.3858801	189.9420891	35.70500297		100			50	175	15	50		15	175		15	15	15			0.2			3.25							500	100	15	15	100	5	75				131.3858801	189.9420891	35.70500297		100			50	175	15	50		15	175		15	15	15			0.2			3.25							500	100	15	15	100	5	75				18.7681	0.412910343	2.496811501	0	2.021000524	0	0	1.075199579	3.288506674	1.45301539	1.629905466	0	0.005544718	2.431954117	0	5.850551522	0.191374712	0.269670242	0	0	16.44817855	0	0	0.100103545	0	0	0	0	0	0	0.490220728	1.305687628	0.179318349	0.180806865	16.89573307	0.038948104	4.281895421	0	0	0	79.8154			18.7681	0.412910343	2.496811501	0	2.021000524	0	0	1.075199579	3.288506674	1.45301539	1.629905466	0	0.005544718	2.431954117	0	5.850551522	0.191374712	0.269670242	0	0	16.44817855	0	0	0.100103545	0	0	0	0	0	0	0.490220728	1.305687628	0.179318349	0.180806865	16.89573307	0.038948104	4.281895421	0	0	0	79.8154																																																																																		0			18.7681	0.412910343	2.496811501	0	2.021000524	0	0	1.075199579	3.288506674	1.45301539	1.629905466	0	0.005544718	2.431954117	0	5.850551522	0.191374712	0.269670242	0	0	16.44817855	0	0	0.100103545	0	0	0	0	0	0	0.490220728	1.305687628	0.179318349	0.180806865	16.89573307	0.038948104	4.281895421	0	0	0	79.8154
H1026_033_0	2009	7	e.3.	i.9.	f.1.	i.10.	g.1.	h.6.	h.7.	h.8.	i.7.	i.8.	DME/Prosthetics/Supplies	Professional	OP Facility - Emergency	Professional	OP Facility - Surgery	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional		Electric Wheelchairs	Urgent Care	Worldwide ER	Worldwide Urgent Care	Ambulatory Surgical Center	Cardiac Rehab	Chemotherapy	Radiation Therapy	Allergy Shots	Advanced Imaging	A	A	D		T	O		V	V	V			V	V	V	V	V	V			Coin			V							O	V	V	V	V	V	V	V	V	V																																									0		301.1323424	3.191457642	1600.682119	0	251.315413	0	0	260.9866318	112.2847432	2013.531	0	0	52.92810806	353.5748341	5394.255426	7593.935475	247.741	0	0	0	59.34311273	0	0	369.6130905	0	0	0	0	0	0	0.019029351	409.3195402	0.898368218	1.408959775	123.0802568	435.591	9.736007588	359.0194673	470.407	311.6697743	$200 for days 1-5	$200 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	$125 copay	$15 copay	$0 copay	$0 copay	$15 copay	"$125 copay on OP Facility, $75 copay on IDTF"	$15 copay	$30 copay	$30 copay	with Cardiac Rehab	$0 copay	$0 copay	20% coinsurance	$0 copay	$0 copay	"$0 copay for select services, $15 copay for Medicare-covered services"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$500 copay	$30 copay	$50 copay	$30 copay	$100 copay	$30 copay for Cardiac Rehab and PT/OT/ST	$125 copay	$50 copay	$5 copay	$100 copay	822.7851725	822.7851725	47.27491929	0	100	0	0	50	125	15	0	0	15	125	15	30	30	0	0	0	0.2	0	0	3.25	0	0	0	0	0	0	500	30	50	30	100	30	125	50	5	100	822.7851725	822.7851725	47.27491929	0	100	0	0	50	125	15	0	0	15	125	15	30	30	0	0	0	0.2	0	0	3.25	0	0	0	0	0	0	500	30	50	30	100	30	125	50	5	100	20.6473	0.218823669	6.306009831	0	2.094295109	0	0	1.087444299	1.169632741	2.51691375	0	0	0.066160135	3.683071189	6.742819283	18.98483869	0.6193525	0	0	0	11.86862255	0	0	0.100103545	0	0	0	0	0	0	0.00079289	1.023298851	0.003743201	0.003522399	1.025668807	1.0889775	0.101416746	1.495914447	0.196002917	2.597248119	83.6419	0	0	20.6473	0.218823669	6.306009831	0	2.094295109	0	0	1.087444299	1.169632741	2.51691375	0	0	0.066160135	3.683071189	6.742819283	18.98483869	0.6193525	0	0	0	11.86862255	0	0	0.100103545	0	0	0	0	0	0	0.00079289	1.023298851	0.003743201	0.003522399	1.025668807	1.0889775	0.101416746	1.495914447	0.196002917	2.597248119	83.6419																																																																																		0	0	0	20.6473	0.218823669	6.306009831	0	2.094295109	0	0	1.087444299	1.169632741	2.51691375	0	0	0.066160135	3.683071189	6.742819283	18.98483869	0.6193525	0	0	0	11.86862255	0	0	0.100103545	0	0	0	0	0	0	0.00079289	1.023298851	0.003743201	0.003522399	1.025668807	1.0889775	0.101416746	1.495914447	0.196002917	2.597248119	83.6419
H1026_035_0	2009	6	e.3.	i.9.	f.1.	i.10.	g.1.	h.6.	h.7.	h.8.	i.7.	i.8.	DME/Prosthetics/Supplies	Professional	OP Facility - Emergency	Professional	OP Facility - Surgery	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional		Electric Wheelchairs	Urgent Care	Worldwide ER	Worldwide Urgent Care	Ambulatory Surgical Center	Cardiac Rehab	Chemotherapy	Radiation Therapy	Allergy Shots	Advanced Imaging	A	A	D		T	O		V	V	V			V	V	V	V	V	V			Coin			V							O	V	V	V	V	V	V	V	V	V																																									0		277.7434226	2.943577437	1586.130463	0	249.2721983	0	0	163.967193	70.53785147	1264.9105	0	0	33.24970891	213.0330812	4642.596883	6474.74299	207.8505	0	0	0	59.34311273	0	0	369.6130905	0	0	0	0	0	0	0.018874641	413.8530256	0.550307043	1.388974409	77.31964853	273.6405	6.116209895	225.5378705	394.6635	303.4679381	$200 for days 1-5	$200 for days 1-5	$75 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	$125 copay	$15 copay	$0 copay	$0 copay	$15 copay	"$125 copay on OP Facility, $75 copay on IDTF"	$10 copay	$25 copay	$25 copay	with Cardiac Rehab	$0 copay	$0 copay	20% coinsurance	$0 copay	$0 copay	"$0 copay for select services, $15 copay for Medicare-covered services"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$500 copay	$25 copay	$50 copay	$25 copay	$75 copay	$25 copay for Cardiac Rehab and PT/OT/ST	$125 copay	$50 copay	$5 copay	$100 copay	822.7851725	822.7851725	35.45618947	0	100	0	0	50	125	15	0	0	15	125	10	25	25	0	0	0	0.2	0	0	3.25	0	0	0	0	0	0	500	25	50	25	75	25	125	50	5	100	822.7851725	822.7851725	35.45618947	0	100	0	0	50	125	15	0	0	15	125	10	25	25	0	0	0	0.2	0	0	3.25	0	0	0	0	0	0	500	25	50	25	75	25	125	50	5	100	19.0436	0.201827656	4.686511852	0	2.077268319	0	0	0.683196637	0.734769286	1.581138125	0	0	0.041562136	2.219094596	3.868830736	13.4890479	0.433021875	0	0	0	11.86862255	0	0	0.100103545	0	0	0	0	0	0	0.000786443	0.862193803	0.002292946	0.002893697	0.483247803	0.570084375	0.06371052	0.939741127	0.164443125	2.528899484	66.6469	0	0	19.0436	0.201827656	4.686511852	0	2.077268319	0	0	0.683196637	0.734769286	1.581138125	0	0	0.041562136	2.219094596	3.868830736	13.4890479	0.433021875	0	0	0	11.86862255	0	0	0.100103545	0	0	0	0	0	0	0.000786443	0.862193803	0.002292946	0.002893697	0.483247803	0.570084375	0.06371052	0.939741127	0.164443125	2.528899484	66.6469																																																																																		0	0	0	19.0436	0.201827656	4.686511852	0	2.077268319	0	0	0.683196637	0.734769286	1.581138125	0	0	0.041562136	2.219094596	3.868830736	13.4890479	0.433021875	0	0	0	11.86862255	0	0	0.100103545	0	0	0	0	0	0	0.000786443	0.862193803	0.002292946	0.002893697	0.483247803	0.570084375	0.06371052	0.939741127	0.164443125	2.528899484	66.6469
H1026_038_0	2009	7	e.3.	g.2.	h.6.	h.7.	i.9.	i.7.	h.8.	i.8.			DME/Prosthetics/Supplies	OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	OP Facility - Other	Professional				Electric Wheelchairs	Ambulatory Surgical Center	Rehab	Substance Abuse and Mental Health	E-Medicine	Allergy Shots	IDTF	Advanced Imaging			D	D	D		T			V	V	V	V		V	V	V	V	V	V			Coin			V							O	V	V	V	S	O	V	V																																											0		1884.117091	19.69882756	1330.024429		268.1752003			221.6573577	179.2535947	707.1737393	618.5204454		2.866837608	113.4066914	6432.598894	5721.677445	164.0615317	683.5374432			105.6239876			369.6130905							9.385576242	271.9294106	131.5032262	579.5471214	0.099250775	114.436144	1412.294866	1659.594653			$200 for days 1-5	$200 for days 1-5	$75 for days 7-25		$100 per transport			$50 per visit	$150 per visit	$15 per visit	$50 per visit		$15 per visit	$150 per visit	$15 per visit	"$35 per visit, $15 at Minute Clinics"	$35 per visit	$35 per visit			20% coinsurance			"$10 copay for select services, $15 for Medicare covered"							$500 per electric wheelchair	$75 per visit	$35 per visit	$35 per visit	$5 copay	$5 per shot	$75 per visit	$100 per visit			129.3442711	111.7948718	35.03341941		100			50	150	15	50		15	150	15	35	35	35			0.2			3.25							500	75	35	35	5	5	75	100			129.3442711	111.7948718	35.03341941		100			50	150	15	50		15	150	15	35	35	35			0.2			3.25							500	75	35	35	5	5	75	100			20.3083	0.183518992	3.882941971	0	2.234793335	0	0	0.923572324	2.240669934	0.883967174	2.577168522	0	0.003583547	1.417583643	8.040748617	16.68822588	0.478512801	1.993650876	0	0	21.12479751	0	0	0.100103545	0	0	0	0	0	0	0.391065677	1.699558816	0.383551076	1.690345771	4.14E-05	0.047681727	8.826842915	13.82995544	0	0	109.9512			20.3083	0.183518992	3.882941971	0	2.234793335	0	0	0.923572324	2.240669934	0.883967174	2.577168522	0	0.003583547	1.417583643	8.040748617	16.68822588	0.478512801	1.993650876	0	0	21.12479751	0	0	0.100103545	0	0	0	0	0	0	0.391065677	1.699558816	0.383551076	1.690345771	4.14E-05	0.047681727	8.826842915	13.82995544	0	0	109.9512																																																																																		0			20.3083	0.183518992	3.882941971	0	2.234793335	0	0	0.923572324	2.240669934	0.883967174	2.577168522	0	0.003583547	1.417583643	8.040748617	16.68822588	0.478512801	1.993650876	0	0	21.12479751	0	0	0.100103545	0	0	0	0	0	0	0.391065677	1.699558816	0.383551076	1.690345771	4.14E-05	0.047681727	8.826842915	13.82995544	0	0	109.9512
H1026_039_0	2009	6	e.3.	i.9.	f.1.	i.10.	g.1.	h.6.	h.7.	h.8.	i.7.	i.8.	DME/Prosthetics/Supplies	Professional	OP Facility - Emergency	Professional	OP Facility - Surgery	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional		Electric Wheelchairs	Urgent Care	Worldwide ER	Worldwide Urgent Care	Ambulatory Surgical Center	Cardiac Rehab	Chemotherapy	Radiation Therapy	Allergy Shots	Advanced Imaging	A	A	D		T	O		V	V	V			V	V	V	V	V	V			Coin			V							O	V	V	V	V	V	V	V	V	V																																									0		301.1323424	3.191457642	1600.682119	0	251.315413	0	0	261.000752	112.2847432	2013.531	0	0	52.92810806	339.1138844	5394.255426	7593.935475	247.741	0	0	0	59.34311273	0	0	369.6130905	0	0	0	0	0	0	0.019029351	409.3416857	0.884248001	1.38681427	123.0802568	435.591	9.736007588	359.0194673	470.407	311.6697743	$200 for days 1-5	$200 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	$125 copay	$15 copay	$0 copay	$0 copay	$15 copay	"$125 copay on OP Facility, $75 copay on IDTF"	$15 copay	$30 copay	$30 copay	with Cardiac Rehab	$0 copay	$0 copay	20% coinsurance	$0 copay	$0 copay	"$0 copay for select services, $15 copay for Medicare-covered services"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$500 copay	$30 copay	$50 copay	$30 copay	$100 copay	$30 copay for Cardiac Rehab and PT/OT/ST	$125 copay	$50 copay	$5 copay	$100 copay	822.7851725	822.7851725	47.27491929	0	100	0	0	50	125	15	0	0	15	125	15	30	30	0	0	0	0.2	0	0	3.25	0	0	0	0	0	0	500	30	50	30	100	30	125	50	5	100	822.7851725	822.7851725	47.27491929	0	100	0	0	50	125	15	0	0	15	125	15	30	30	0	0	0	0.2	0	0	3.25	0	0	0	0	0	0	500	30	50	30	100	30	125	50	5	100	20.6473	0.218823669	6.306009831	0	2.094295109	0	0	1.087503133	1.169632741	2.51691375	0	0	0.066160135	3.532436295	6.742819283	18.98483869	0.6193525	0	0	0	11.86862255	0	0	0.100103545	0	0	0	0	0	0	0.00079289	1.023354214	0.003684367	0.003467036	1.025668807	1.0889775	0.101416746	1.495914447	0.196002917	2.597248119	83.4913	0	0	20.6473	0.218823669	6.306009831	0	2.094295109	0	0	1.087503133	1.169632741	2.51691375	0	0	0.066160135	3.532436295	6.742819283	18.98483869	0.6193525	0	0	0	11.86862255	0	0	0.100103545	0	0	0	0	0	0	0.00079289	1.023354214	0.003684367	0.003467036	1.025668807	1.0889775	0.101416746	1.495914447	0.196002917	2.597248119	83.4913																																																																																		0	0	0	20.6473	0.218823669	6.306009831	0	2.094295109	0	0	1.087503133	1.169632741	2.51691375	0	0	0.066160135	3.532436295	6.742819283	18.98483869	0.6193525	0	0	0	11.86862255	0	0	0.100103545	0	0	0	0	0	0	0.00079289	1.023354214	0.003684367	0.003467036	1.025668807	1.0889775	0.101416746	1.495914447	0.196002917	2.597248119	83.4913
H1026_801_0	2009	3																																Coin		Coin		Coin	Coin		Coin	Coin					Coin						Coin	Coin	Coin																			0		0		0	0		0	0					0						0	0	0																			0		299.0600398		29.70684105		8.298298819	3.619304233		24.31396025	67.93109246					118.3286293						264.81524	93.57779325	19.4266516																			7.2% coinsurance		17.4% coinsurance		23.1% coinsurance	23.1% coinsurance		23.1% coinsurance	23.1% coinsurance					23.1% coinsurance						23.1% coinsurance	23.1% coinsurance	23.1% coinsurance																																																											0.071857444		0.173709022		0.231	0.231		0.231	0.231					0.231						0.231	0.231	0.231																			21.4897	0	5.160346305	0	1.916907027	0.836059278	0	5.616524818	15.69208236	0	0	0	0	27.33391338	0	0	0	0	0	61.17232044	21.61647024	4.487556519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	165.3219			21.4897	0	5.160346305	0	1.916907027	0.836059278	0	5.616524818	15.69208236	0	0	0	0	27.33391338	0	0	0	0	0	61.17232044	21.61647024	4.487556519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	165.3219																																																																																		0			21.4897	0	5.160346305	0	1.916907027	0.836059278	0	5.616524818	15.69208236	0	0	0	0	27.33391338	0	0	0	0	0	61.17232044	21.61647024	4.487556519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	165.3219
H1026_802_0	2009	3																																Coin		Coin		Coin	Coin		Coin	Coin					Coin						Coin	Coin	Coin																			0		0		0	0		0	0					0						0	0	0																			0		299.0600398		29.70684105		8.298298819	3.619304233		24.31396025	67.93109246					118.3286293						264.81524	93.57779325	19.4266516																			7.2% coinsurance		17.4% coinsurance		23.1% coinsurance	23.1% coinsurance		23.1% coinsurance	23.1% coinsurance					23.1% coinsurance						23.1% coinsurance	23.1% coinsurance	23.1% coinsurance																																																											0.071857444		0.173709022		0.231	0.231		0.231	0.231					0.231						0.231	0.231	0.231																			21.4897	0	5.160346305	0	1.916907027	0.836059278	0	5.616524818	15.69208236	0	0	0	0	27.33391338	0	0	0	0	0	61.17232044	21.61647024	4.487556519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	165.3219			21.4897	0	5.160346305	0	1.916907027	0.836059278	0	5.616524818	15.69208236	0	0	0	0	27.33391338	0	0	0	0	0	61.17232044	21.61647024	4.487556519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	165.3219																																																																																		0			21.4897	0	5.160346305	0	1.916907027	0.836059278	0	5.616524818	15.69208236	0	0	0	0	27.33391338	0	0	0	0	0	61.17232044	21.61647024	4.487556519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	165.3219
H1026_803_0	2009	3																																Coin		Coin		Coin	Coin		Coin	Coin					Coin						Coin	Coin	Coin																			0		0		0	0		0	0					0						0	0	0																			0		299.0600398		29.70684105		8.298298819	3.619304233		24.31396025	67.93109246					118.3286293						264.81524	93.57779325	19.4266516																			7.2% coinsurance		17.4% coinsurance		23.1% coinsurance	23.1% coinsurance		23.1% coinsurance	23.1% coinsurance					23.1% coinsurance						23.1% coinsurance	23.1% coinsurance	23.1% coinsurance																																																											0.071857444		0.173709022		0.231	0.231		0.231	0.231					0.231						0.231	0.231	0.231																			21.4897	0	5.160346305	0	1.916907027	0.836059278	0	5.616524818	15.69208236	0	0	0	0	27.33391338	0	0	0	0	0	61.17232044	21.61647024	4.487556519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	165.3219			21.4897	0	5.160346305	0	1.916907027	0.836059278	0	5.616524818	15.69208236	0	0	0	0	27.33391338	0	0	0	0	0	61.17232044	21.61647024	4.487556519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	165.3219																																																																																		0			21.4897	0	5.160346305	0	1.916907027	0.836059278	0	5.616524818	15.69208236	0	0	0	0	27.33391338	0	0	0	0	0	61.17232044	21.61647024	4.487556519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	165.3219
H1032_002_0	2009	11																					2000											A	A	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		294.2521669	10.74193047	1153.713171	877.5731661	575.3627419	968.0199392	7.606193942	938.952383	301.2833233	1856.4255	534.5756775	36.4005	0.156696725	247.526272	9746.94564	15175.10391	242.7244521	138.0086502	5177.568456	664.4868484	25.66286152	21.31528092	0	162.8571429	304	210.4615385	32.8	13.57241379	1664	7480											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	"$0 days 1 - 14, $50 days 15 - 100"	Copay between $0.00 and $15.00	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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 $15.00	$0.00 copayment	Copay between $0.00 and $15.00	Copay between $5.00 and $15.00	$15.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											0	0	20.85	1.187723968	49.39537059	0	0.11129701	9.212365805	0	0	2.182752399	0	0.2	2.365731402	0	3.325197431	12.09784138	6.144495315	7.384344562	1.058960371	0.2	0	0	0	10	10	10	10	0	0											0	0	20.50060267	1.167820487	48.56761948	0	0.109431932	9.057988059	0	0	2.146174564	0	0.196648467	2.326087266	0	3.269474884	11.8951098	6.041527916	7.260600185	1.041214667	0.196648467	0	0	0	10	10	10	10	0	0											0	0	1.97098461	0.085403993	2.328666559	0	0.832360495	0.708751623	0	0	0.095607727	0	0.030814171	0.047980642	0	4.134551759	0.240602834	0.069481926	3.132687874	0.057656121	5.046562373	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	19.2495	0	0.3201	0	0	1.97098461	0.085403993	2.328666559	0	0.832360495	0.708751623	0	0	0.095607727	0	0.030814171	0.047980642	0	4.134551759	0.240602834	0.069481926	3.132687874	0.057656121	5.046562373	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	19.2495	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											6.0902	0.0819	0.3698	0.1221	0.2312	0.3253	0.1731	0	0.4015	0.1086	0.3448	0.0192	0	0.1008	0.1148	1.7293	0.0289	0.01	0.9702	0.1645	0.521	0.0058	0	0	0	0	0	0	0	0											11.913	0	0	6.0902	0.081922312	2.34081721	0.207522435	2.559833092	0.325253165	1.005507748	0.708751623	0.401461382	0.108591717	0.440366327	0.019185176	0.030814171	0.148810052	0.114833676	5.863879002	0.269545856	0.079512137	4.102889646	0.222142727	5.56752445	0.005830986	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	31.1625
H1032_008_0	2009	7																					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	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		317.8325382	12.97275666	1151.380104	1813.252648	609.2354068	680.2016408	1147.224653	1061.910179	164.6135043	1831.842238	920.2639376	47.97780529	0.131722506	155.9278672	9183.477835	15149.18013	288.152028	179.7423797	5674.816207	696.8068232	35.98297911	11.19984319	2340	653.3333333	252.4622575	201.6	45	12	1664	9272.727273											"$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, $1,000 benefit limit"	$0.00 copayment	"$0.00 copayment, $75 benefit limit,"	$0.00 copayment	"$0.00 copayment, $1,000 benefit limit"	$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	0.2	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	0.026344501	0	0	0	0	0	0	0	7.196595822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.2229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.026344501	0	0	0	0	0	0	0	7.196595822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.2229	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											7.5249	0.1654	0.2929	0.0574	0.2396	0.1071	0.1822	0	0.3936	0.1357	0.4226	0.0312	0	0.0416	0.139	1.8941	0.036	0.0061	0.7426	0.134	0.1494	0.0027	0	0	0	0	0	0	0	0											12.6981	0	0	7.5249	0.165362869	0.292860064	0.057363518	0.239555016	0.107085108	0.182227671	0	0.393625813	0.135708609	0.422590151	0.031228209	0.026344501	0.04162538	0.139021279	1.894141259	0.035970265	0.006125249	0.742565981	0.134024675	7.346004811	0.002668922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.921
H1032_010_0	2009	6																					3250											D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		1732.823436	94.82294815	931.5096314	1333.54589	424.5688449	1387.685427	7.802911101	992.8023506	357.3494399	2870.964225	1144.013765	145.0820086	0.208186487	286.8131035	14276.31301	26013.48882	449.0022105	3347.831831	6146.808095	2184.413747	23.70293862	37.73954961	0	162.8571429	0	0	32.8	13.57241379	1664	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	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $20.00	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	Not Covered	Not Covered	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	Not Covered											24.08596392	20.54891414	33.02	2.818931433	46.34379226	0	0.138082353	13.89203444	12.70737635	0	6.518915837	13.12461252	0.2	3.779732957	0	5.240748619	15.89642164	8.560246525	10.66223288	4.601708855	0.2	0	0	0	0	0	10	10	0	0											23.5133881	20.0604217	32.23504269	2.751919294	45.2420994	0	0.134799835	13.56179053	12.40529435	0	6.363947012	12.8126119	0.195245564	3.689880474	0	5.116164612	15.51852908	8.356750823	10.40876838	4.492316215	0.195245564	0	0	0	0	0	10	10	0	0											3.3954	0.158515694	2.502271061	0.305817555	1.600698823	0	1.051831127	1.122014793	0.369418749	0	0.606703582	0.154906623	0.040647488	0.088192173	0	11.09077424	0.580654488	2.331416367	5.331725145	0.817756441	4.62789363	0	0	0	0	0	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	36.2153	0	0.8809	3.3954	0.158515694	2.502271061	0.305817555	1.600698823	0	1.051831127	1.122014793	0.369418749	0	0.606703582	0.154906623	0.040647488	0.088192173	0	11.09077424	0.580654488	2.331416367	5.331725145	0.817756441	4.62789363	0	0	0	0	0	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	36.2153	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											5.1911	0.0996	0.2471	0.3215	0.1378	0.2906	0.1915	0	0.4977	0.1754	0.5843	0.0712	0	0.1012	0.2144	3.5788	0.0824	0.2731	1.2976	0.4669	0.5441	0.0116	0	0	0	0	0	0	0	0											14.3779	0	0	8.5865	0.258140495	2.7493432	0.62733665	1.738507545	0.290626188	1.243351726	1.122014793	0.867163822	0.175409888	1.191017462	0.226080187	0.040647488	0.189355115	0.21444686	14.66954925	0.663015525	2.604468441	6.629303468	1.284686669	5.171971756	0.011567896	0	0	0	0	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	50.5931
H1032_012_0	2009	6																					3000											D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		1790.671065	91.435597	1112.46643	696.9091261	434.8659945	1173.042662	6.894087269	947.915881	291.5325157	1476.206392	456.6092942	79.72543233	1.106185733	197.4709059	8384.569893	13561.00172	226.2521801	96.82844402	4316.565181	962.5698438	9.249052832	22.03237479	0	162.8571429	340.9917677	257.7137965	32.8	13.57241379	0	8200											"$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	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $35.00	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	Not Covered	$0.00 copayment											49.1650819	35.34203008	49.53	1.130685376	49.90765223	0	0.060933287	9.586278686	29.53323496	0	2.589838296	26.24922505	0.2	9.864041991	2.139580343	8.762218009	28.29664723	14.11389836	9.429874064	4.249439523	0.2	0	0	0	9.424986424	9.152904083	10	10	0	0											48.00297765	34.50665827	48.35927026	1.103959614	48.72799601	0	0.05949302	9.35968992	28.83516437	0	2.528622856	25.62877787	0.195272644	9.630887795	2.089007552	8.555107385	27.62780559	13.78029124	9.206982199	4.148996453	0.195272644	0	0	0	9.424986424	9.152904083	10	10	0	0											7.1631	0.262928075	4.483172062	0.064113294	1.765845704	0	0.410150074	0.739349893	0.700532334	0	0.096216058	0.170272116	0.216007813	0.158485011	1.459619152	9.667985497	0.52090427	0.11119368	3.311878232	0.332808239	1.806087	0	0	0	0.267820232	0.196569138	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	33.9437	0	0.8096	7.1631	0.262928075	4.483172062	0.064113294	1.765845704	0	0.410150074	0.739349893	0.700532334	0	0.096216058	0.170272116	0.216007813	0.158485011	1.459619152	9.667985497	0.52090427	0.11119368	3.311878232	0.332808239	1.806087	0	0	0	0.267820232	0.196569138	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	33.9437	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											5.7559	0.0934	0.3204	0.0383	0.1805	0.2636	0.1662	0	0.3865	0.1407	0.2895	0.0539	0	0.0997	0.0995	1.8177	0.0266	0.0078	0.682	0.1927	0.2	0.0054	0	0	0	0	0	0	0	0											10.8204	0	0	12.919	0.356366373	4.803586008	0.102374495	1.946389487	0.26359699	0.576301409	0.739349893	1.087025533	0.14071815	0.385732669	0.224154909	0.216007813	0.258152718	1.559120581	11.48564397	0.547548824	0.119000817	3.993856908	0.525550102	2.00611749	0.005448061	0	0	0.267820232	0.196569138	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	44.7641
H1032_014_0	2009	6																					3000											D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		1690.009612	68.58278654	1327.040878	713.6128144	460.4817927	1142.222895	5.039112193	938.0758542	257.2205587	1606.485761	654.2690558	124.3395395	0.686547466	141.2077809	7588.775456	11813.50751	175.4162451	101.9050239	3998.453748	851.2976204	10.57685515	19.89642609	0	162.8571429	304	210.4615385	32.8	13.57241379	1664	7480											"$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	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $20.00	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											24.01027694	16.17952703	33.02	0.985307951	49.78528419	0	0.057988785	9.267922613	10.10309131	0	2.827632272	13.12461252	0.2	4.15479464	0	4.533799071	16.38892946	8.148541855	6.584950656	2.383486713	0.2	0	0	0	10	10	10	10	0	0											23.78383701	16.02693858	32.70858974	0.976015552	49.31576123	0	0.057441895	9.180517218	10.00780948	0	2.800964989	13.00083484	0.198113808	4.115610943	0	4.491040999	16.23436615	8.071693293	6.522848258	2.361008148	0.198113808	0	0	0	10	10	10	10	0	0											3.3496	0.091597676	3.617136303	0.058041434	1.892417512	0	0.289456154	0.717668461	0.214517862	0	0.152715393	0.134709818	0.136014533	0.048429691	0	4.421245547	0.237314296	0.068545508	2.173442256	0.167493385	2.095421052	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	20.3331	0	0.1891	3.3496	0.091597676	3.617136303	0.058041434	1.892417512	0	0.289456154	0.717668461	0.214517862	0	0.152715393	0.134709818	0.136014533	0.048429691	0	4.421245547	0.237314296	0.068545508	2.173442256	0.167493385	2.095421052	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	20.3331	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											5.0604	0.0866	0.3775	0.0948	0.1864	0.214	0.1205	0	0.3562	0.1441	0.3524	0.0733	0	0.047	0.1522	1.6484	0.0196	0.0106	0.5362	0.1719	0.2122	0.0054	0	0	0	0	0	0	0	0											9.8695	0	0	8.4099	0.178224739	3.994591257	0.152832792	2.078809297	0.213976026	0.409950304	0.717668461	0.570677488	0.14410294	0.505090162	0.20796178	0.136014533	0.095417602	0.152208604	6.069647564	0.256899477	0.079157509	2.709675204	0.339389234	2.307607344	0.005355948	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	30.2026
H1032_019_0	2009	6																					3250											A	A	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		239.798868	14.91750345	1064.249918	496.7509503	312.8367097	1064.384706	4.492936477	947.0125631	436.2247573	2165.904432	512.7020152	55.93112893	0.014658879	179.5883868	5906.826117	12901.89742	388.1383606	144.9766948	4489.304405	937.6887405	10.21693225	23.20951609	0	162.8571429	310.3715672	219.0301978	33.01970921	13.57241379	1664	5771.764706											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											0	0	0	0	49.58570028	0	0.071876615	10.3516916	0	0	1.292096983	0	0.2	0	0	0	0	0	5.311306327	0.24966405	0.2	0	0	0	9.891186884	9.819259046	9.96417141	10	0	0											0	0	0	0	49.45887833	0	0.071692781	10.32521579	0	0	1.288792275	0	0.199488474	0	0	0	0	0	5.297721963	0.249025501	0.199488474	0	0	0	9.891186884	9.819259046	9.96417141	10	0	0											0	0	0	0	1.289379397	0	0.322111109	0.814842422	0	0	0.055063866	0	0.002924277	0	0	0	0	0	1.981923879	0.019459034	2.03816022	0	0	0	0.255828598	0.179226188	0.027417837	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	6.9976	0	0.0167	0	0	0	0	1.289379397	0	0.322111109	0.814842422	0	0	0.055063866	0	0.002924277	0	0	0	0	0	1.981923879	0.019459034	2.03816022	0	0	0	0.255828598	0.179226188	0.027417837	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	6.9976	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											5.118	0.0725	0.3288	0.0445	0.1413	0.1903	0.1068	0	0.4475	0.1421	0.301	0.0638	0	0.0759	0.0896	1.8347	0.0535	0.0126	0.7139	0.2016	0.2001	0.0077	0	0	0	0	0	0	0	0											10.1462	0	0	5.118	0.072481765	0.328760619	0.044524041	1.430642158	0.190314733	0.428940517	0.814842422	0.447506675	0.142081819	0.356026034	0.063840725	0.002924277	0.075934257	0.08959575	1.834660842	0.053534854	0.012593768	2.695853951	0.22109656	2.238241315	0.007671893	0	0	0.255828598	0.179226188	0.027417837	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	17.1438
H1032_025_0	2009	6																					2500											D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		1238.068209	213.6961025	446.4506833	1300.315967	297.1361234	2267.055203	8.421125291	1773.286736	239.9180485	9019.098298	1663.266111	40.39957681	0.13212544	604.7189059	11472.32592	19970.50287	391.3293056	3223.038022	4628.172924	2730.250408	29.20217774	44.87241226	0	162.8571429	252	201.8886568	20.4	15.54285714	1682.871988	7480											"$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	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $25.00	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$0.00 copayment	"$0.00 copayment, $75 benefit limit,"	$0.00 copayment	"$0.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											94.72412571	45.53455754	56.13	4.284408171	45.86418347	0	0.120115148	21.36423964	69.93267239	0	16.17810076	39.37383757	0.2	6.975677059	4.767573181	7.672221268	20.24407337	9.653966957	15.49607314	4.603094814	0.2	0	0	0	0	0	0	0	0	0											85.42788103	41.06578694	50.62139055	3.863935495	41.36306332	0	0.108327023	19.26754888	63.06946591	0	14.59037871	35.50968126	0.18037196	6.291082715	4.299682594	6.919267936	18.25731595	8.706524706	13.97528542	4.151346167	0.18037196	0	0	0	0	0	0	0	0	0											8.8138	0.731299885	1.883329534	0.418694752	1.024205024	0	0.912235436	2.84724074	1.260958599	0	2.022306872	0.119548008	0.023831725	0.317028055	4.110613338	11.51510501	0.595385231	2.338455014	5.390003131	0.944517881	5.267254033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.5358	0	5.4993	8.8138	0.731299885	1.883329534	0.418694752	1.024205024	0	0.912235436	2.84724074	1.260958599	0	2.022306872	0.119548008	0.023831725	0.317028055	4.110613338	11.51510501	0.595385231	2.338455014	5.390003131	0.944517881	5.267254033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.5358	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											4.9172	0.2285	0.1387	0.3284	0.1436	0.549	0.207	0	0.534	0.2112	0.5938	0.0107	0	0.1978	0.1725	3.0626	0.0623	0.274	0.8479	0.4834	0.7042	0.0127	0	0	0	0	0	0	0	0											13.6794	0	0	13.731	0.959760252	2.022062028	0.747088433	1.167770011	0.549023745	1.119266551	2.84724074	1.794960342	0.211153773	2.616057498	0.130223421	0.023831725	0.514852816	4.283155125	14.57766319	0.657666417	2.612458847	6.237931589	1.427908596	5.971469237	0.012650992	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2152
H1032_028_0	2009	6																					2000											D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		1547.886266	55.95360987	912.3546943	767.3294664	449.5090633	1005.638085	6.583285011	920.4305291	291.4101749	1899.355229	541.1609077	52.24520491	0.093939177	219.5932366	11296.29947	13719.72426	238.5905178	97.05312612	4846.355426	739.3655236	19.12827751	14.37252241	0	162.8571429	304	210.4615385	32.8	13.57241379	1664	7480											"$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	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $15.00	Copay between $5.00 and $15.00	$15.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											76.91577529	83.16087719	33.02	0.763043795	49.6705279	0	0.093833706	9.485404968	40.90927404	0	5.022867765	39.37383757	0.2	7.731623594	0	3.4784094	12.14401922	6.376326066	7.807924291	1.084159765	0.2	0	0	0	10	10	10	10	0	0											73.7380215	79.72510877	31.65578792	0.731518853	47.61840391	0	0.089956993	9.093518109	39.21911881	0	4.815349386	37.74711846	0.191737056	7.412193724	0	3.334699886	11.64229245	6.112889935	7.485342078	1.039368007	0.191737056	0	0	0	10	10	10	10	0	0											9.5115	0.371742303	2.406775559	0.046776331	1.783742012	0	0.592212523	0.697495974	0.952404189	0	0.21715657	0.164342162	0.018011621	0.135638968	0	3.81259691	0.231478382	0.04943959	3.02305235	0.064039406	3.667599614	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	28.2134	0	1.1957	9.5115	0.371742303	2.406775559	0.046776331	1.783742012	0	0.592212523	0.697495974	0.952404189	0	0.21715657	0.164342162	0.018011621	0.135638968	0	3.81259691	0.231478382	0.04943959	3.02305235	0.064039406	3.667599614	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	28.2134	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											5.3492	0.0749	0.2918	0.0738	0.1819	0.2484	0.1486	0	0.3923	0.1135	0.3515	0.0283	0	0.0748	0.1193	1.6251	0.0304	0.0059	0.9806	0.193	0.3569	0.0039	0	0	0	0	0	0	0	0											10.6442	0	0	14.8607	0.446686947	2.698608499	0.120591038	1.965594238	0.248384262	0.740833438	0.697495974	1.34467253	0.113479616	0.568693111	0.192655305	0.018011621	0.210471831	0.119281337	5.437702642	0.261925229	0.055348846	4.003612033	0.257042665	4.02452292	0.003882769	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	38.8576
H1032_031_0	2009	6																					3000											D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		1088.06265	49.77058478	344.9278941	1080.179801	302.0094825	955.19178	5.698032372	736.1936659	216.7651707	1544.260326	841.4820052	37.02359812	0.1107418	202.3723181	17545.3407	15357.31806	165.4923818	1360.582167	5024.01229	1369.967735	14.93384125	11.08056589	0	162.8571429	304	211.3929112	32.8	13.57241379	1664	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, $85 days 8 - 100"	Copay between $0.00 and $30.00	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $30.00	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	Not Covered											26.3014249	17.42473196	56.13	1.701682314	48.32845462	0	0.146037797	12.00772294	12.43485652	0	6.866702743	13.12461252	0.2	6.399089582	0	7.779956752	24.11815824	12.80609677	11.50563857	3.988185569	0.2	0	0	0	10	9.979644547	10	10	0	0											25.88488823	17.14877581	55.24106706	1.674732707	47.56307504	0	0.143724991	11.81755617	12.23792522	0	6.75795451	12.91675754	0.196832592	6.297746957	0	7.656745281	23.73619805	12.60328613	11.32342333	3.925024522	0.196832592	0	0	0	10	9.979644547	10	10	0	0											2.347	0.071125383	1.587848744	0.150751037	1.19704164	0	0.81894965	0.725000833	0.221062996	0	0.473891426	0.03985207	0.021797596	0.106207471	0	9.798922713	0.327346663	1.428983862	4.740751499	0.448096413	2.939466687	0	0	0	0.253333333	0.175802176	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	27.9119	0	0.4416	2.347	0.071125383	1.587848744	0.150751037	1.19704164	0	0.81894965	0.725000833	0.221062996	0	0.473891426	0.03985207	0.021797596	0.106207471	0	9.798922713	0.327346663	1.428983862	4.740751499	0.448096413	2.939466687	0	0	0	0.253333333	0.175802176	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	27.9119	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											3.8608	0.0469	0.0947	0.0979	0.1196	0.1837	0.1379	0	0.3503	0.115	0.4437	0.0165	0	0.0812	0.1736	2.0048	0.0279	0.115	1.0527	0.3012	0.3295	0.003	0	0	0	0	0	0	0	0											9.556	0	0	6.2078	0.117998761	1.682514588	0.248650071	1.316633462	0.183740223	0.956893922	0.725000833	0.571396964	0.11498553	0.917621151	0.056367636	0.021797596	0.187392418	0.173555507	11.80374609	0.355223847	1.543942995	5.793476389	0.749334922	3.269014897	0.002992274	0	0	0.253333333	0.175802176	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	37.4679
H1032_032_0	2009	6																					3000											D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		857.1949972	73.52959935	400.0145552	527.5904986	240.5396	1120.712628	3.160188762	683.6303405	252.030305	1677.227838	376.3388671	33.22417697	0.002452273	145.2175134	7179.504789	11338.9151	183.0650682	243.370481	3621.08108	968.6181338	13.091773	17.07378764	0	162.8571429	307.8850597	212.4040683	32.8	13.57241379	1664	7480											"$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	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $25.00	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											55.12080411	50.54123353	20.85	1.190131996	49.5510715	0	0.096331633	11.57397862	32.06540403	0	3.012797826	26.24922505	0.2	8.49640998	1.777786528	7.083040461	19.06139135	10.70333772	9.875154318	2.256818889	0.2	0	0	0	9.933115422	9.957747485	10	10	0	0											54.52127254	49.99151251	20.62322114	1.177187307	49.01212015	0	0.095283864	11.44809211	31.71663876	0	2.980028577	25.96372052	0.197824663	8.403997214	1.758450106	7.006000469	18.85406662	10.5869209	9.767745386	2.232272183	0.197824663	0	0	0	9.933115422	9.957747485	10	10	0	0											3.8946	0.306321324	0.687465719	0.05175607	0.982446315	0	0.301114998	0.652188592	0.666129512	0	0.093458382	0.07188527	0.00048512	0.101700631	1.052066746	6.620037044	0.287626749	0.214712003	2.947483168	0.180184943	2.589875584	0	0	0	0.25485482	0.176255506	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	22.1713	0	0.2386	3.8946	0.306321324	0.687465719	0.05175607	0.982446315	0	0.301114998	0.652188592	0.666129512	0	0.093458382	0.07188527	0.00048512	0.101700631	1.052066746	6.620037044	0.287626749	0.214712003	2.947483168	0.180184943	2.589875584	0	0	0	0.25485482	0.176255506	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	22.1713	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											3.3402	0.0847	0.1291	0.046	0.1136	0.1447	0.0751	0	0.3337	0.0905	0.1987	0.0337	0	0.0691	0.0631	1.5206	0.0432	0.018	0.5578	0.2165	0.2771	0.0052	0	0	0	0	0	0	0	0											7.3606	0	0	7.2348	0.391015079	0.816537788	0.09777142	1.096056381	0.144733297	0.376169555	0.652188592	0.999879274	0.090500104	0.292148799	0.105590829	0.00048512	0.170754443	1.115178438	8.140589449	0.330843091	0.232707429	3.505256296	0.396727393	2.867005441	0.005155357	0	0	0.25485482	0.176255506	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	29.5319
H1032_033_0	2009	6																					3000											D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		860.8528577	74.02390471	328.4319778	659.5656854	221.8797798	985.0554466	2.532788198	556.7680166	133.9076838	1400.94427	424.295239	43.07090664	0.013295656	110.8904731	8755.118164	10683.53886	101.6400524	510.7317359	2928.138556	1007.134548	10.58902553	16.64747636	0	162.8571429	304	210.4615385	32.8	13.57241379	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, $85 days 8 - 100"	Copay between $0.00 and $25.00	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $25.00	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	Not Covered	Not Covered											80.10669978	48.20513355	56.13	1.661861381	48.37294334	0	0.121297565	11.60619483	48.73588345	0	8.902886643	39.37383757	0.2	10.21664459	2.406241429	5.906001675	20.0580412	10.08948968	9.805663774	3.838975404	0.2	0	0	0	10	10	10	10	0	0											79.18097039	47.64806517	55.48135025	1.642656571	47.81393572	0	0.119895825	11.47207127	48.17268162	0	8.800003065	38.91882546	0.197688759	10.09857896	2.378434411	5.837750713	19.82624637	9.972893477	9.692347519	3.794611419	0.197688759	0	0	0	10	10	10	10	0	0											5.6803	0.293924653	1.518487466	0.090286659	0.884078794	0	0.303670731	0.53227353	0.537557685	0	0.31114995	0.139689091	0.002628402	0.093319683	1.735289526	5.197319715	0.167928393	0.4244561	2.365044706	0.318473688	2.093331318	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	23.1565	0	0.2653	5.6803	0.293924653	1.518487466	0.090286659	0.884078794	0	0.303670731	0.53227353	0.537557685	0	0.31114995	0.139689091	0.002628402	0.093319683	1.735289526	5.197319715	0.167928393	0.4244561	2.365044706	0.318473688	2.093331318	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	23.1565	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											3.3156	0.0696	0.0927	0.0529	0.0927	0.1484	0.0602	0	0.2272	0.0783	0.2248	0.0176	0	0.0356	0.0946	1.3722	0.0146	0.0382	0.5269	0.196	0.2234	0.0044	0	0	0	0	0	0	0	0											6.8859	0	0	8.9959	0.363494806	1.611211639	0.143182938	0.976806285	0.148369119	0.363821634	0.53227353	0.764724939	0.078293004	0.535928983	0.157274194	0.002628402	0.128965266	1.829901158	6.569546191	0.182514539	0.462692777	2.891971731	0.514514826	2.316733811	0.004387365	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	30.0425
H1032_035_0	2009	6																					0											A	A	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		282.602886	14.15874783	1212.53546	816.3090258	371.5280378	1348.832679	4.810924837	1095.074172	353.2058042	1820.392818	614.4778835	78.50042771	0.296540913	230.1025548	10612.45368	14532.32343	341.247288	223.6185597	4771.380234	983.3184808	12.49773998	25.68618687	0	162.8571429	327.0861934	237.4235161	26.4	15.84	1664	7480											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											0	0	0	0	49.68841575	0	0.078995541	9.989430418	0	0	1.374405377	0	0.2	0	0	0	0	0	5.223491417	0.723858991	0.2	0	0	0	9.625883361	9.475342722	10	10	0	0											0	0	0	0	49.68841575	0	0.078995541	9.989430418	0	0	1.374405377	0	0.2	0	0	0	0	0	5.223491417	0.723858991	0.2	0	0	0	9.625883361	9.475342722	10	10	0	0											0	0	0	0	1.538386634	0	0.38004161	0.91159727	0	0	0.070378476	0	0.059308183	0	0	0	0	0	2.076938642	0.059315327	2.499547996	0	0	0	0.262374462	0.187472432	0.022	0.0132	0	0	0	0	0	0	0	0	0	0	0	0	8.0806	0	0	0	0	0	0	1.538386634	0	0.38004161	0.91159727	0	0	0.070378476	0	0.059308183	0	0	0	0	0	2.076938642	0.059315327	2.499547996	0	0	0	0.262374462	0.187472432	0.022	0.0132	0	0	0	0	0	0	0	0	0	0	0	0	8.0806	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											5.6669	0.1113	0.3534	0.0368	0.1561	0.2109	0.1156	0	0.4459	0.1833	0.4036	0.0544	0	0.1101	0.1229	2.0124	0.0455	0.0214	0.8125	0.2139	0.2696	0.0055	0	0	0	0	0	0	0	0											11.352	0	0	5.6669	0.111336	0.353365018	0.036791242	1.694474891	0.21090473	0.495616159	0.91159727	0.445872004	0.183318068	0.473957655	0.054368061	0.059308183	0.110082444	0.122941518	2.012389957	0.045549346	0.021381395	2.889479342	0.273247608	2.769148256	0.005527861	0	0	0.262374462	0.187472432	0.022	0.0132	0	0	0	0	0	0	0	0	0	0	0	0	19.4326
H1032_037_0	2009	5																					0											A	A	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		249.9281664	12.89137496	666.5221889	810.2864581	381.8543219	987.7434705	4.323571803	761.8488311	289.5197878	2122.185712	572.2631836	45.76233656	0.028116166	176.0289736	11943.46062	14791.13366	181.6757843	290.784772	5262.774906	696.6869451	15.44686772	18.16201291	0	162.8571429	304	210.4615385	32.8	13.57241379	1664	7480											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											0	0	0	0	49.26434544	0	0.169270322	9.477731823	0	0	3.119136942	0	0.2	0	0	0	0	0	5.191196487	0.859167373	0.2	0	0	0	10	10	10	10	0	0											0	0	0	0	49.26434544	0	0.169270322	9.477731823	0	0	3.119136942	0	0.2	0	0	0	0	0	5.191196487	0.859167373	0.2	0	0	0	10	10	10	10	0	0											0	0	0	0	1.567650268	0	0.731852393	0.601716576	0	0	0.14874727	0	0.005623233	0	0	0	0	0	2.276674884	0.049880891	3.089373543	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	8.9389	0	0	0	0	0	0	1.567650268	0	0.731852393	0.601716576	0	0	0.14874727	0	0.005623233	0	0	0	0	0	2.276674884	0.049880891	3.089373543	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	8.9389	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.567650268	0	0.731852393	0.601716576	0	0	0.14874727	0	0.005623233	0	0	0	0	0	2.276674884	0.049880891	3.089373543	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	8.9389
H1032_040_0	2009	6																					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	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		192.4704827	9.423272921	533.3295162	2031.156365	370.8960756	645.0571039	738.2082791	760.2166178	166.9791336	1340.387045	615.2928075	21.25188973	0.054450865	105.7534513	9325.217839	11439.15388	131.9431075	208.7756103	4416.08645	625.5773174	35.90202183	6.61784285	0	0	0	0	0	0	1664	7340											"$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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	$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	0.2	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	0.010890173	0	0	0	0	0	0	0	7.180404366	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.1913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.010890173	0	0	0	0	0	0	0	7.180404366	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.1913	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											4.7175	0.0935	0.1378	0.0226	0.1483	0.0926	0.1146	0	0.3555	0.0969	0.3281	0.018	0	0.0632	0.0737	1.3713	0.013	0.0052	0.5634	0.1333	0.0965	0.0018	0	0	0	0	0	0	0	0											8.4468	0	0	4.7175	0.093509095	0.137842097	0.022645031	0.148265107	0.092565052	0.114595919	0	0.355495021	0.096948687	0.328121744	0.017960443	0.010890173	0.063187681	0.073722914	1.371293632	0.012952909	0.005177013	0.563372622	0.133347179	7.276869058	0.001791027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.6381
H1032_043_0	2009	6																					0											D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		1330.264902	94.57851446	639.3326137	1436.342703	468.4448173	1269.350114	4.574579523	1036.548039	225.1992532	2742.425739	767.4185659	84.80486209	0.417394117	313.6728928	11777.88438	19788.75042	439.2999828	2313.316051	4958.263655	1669.90636	50.20414112	19.75632458	0	0	0	0	0	0	1664	0											"$200 days 1 - 5, $0 after day 5, unlimited coverage"	"$200 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 14, $50 days 15 - 100"	Copay between $0.00 and $25.00	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $25.00	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $75.00	Copay between $0.00 and $75.00	20% coinsurance	$0.00 copayment	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	$0.00 copayment	Not Covered											91.07222412	82.2452118	20.85	2.490309714	45.48668131	0	0.175586246	15.78264771	79.02967181	0	19.78620964	52.49845009	0.2	9.669691399	0	6.180987953	19.64489619	10.57348811	14.23794975	9.274635091	0.2	0	0	0	0	0	0	0	0	0											91.07222412	82.2452118	20.85	2.490309714	45.48668131	0	0.175586246	15.78264771	79.02967181	0	19.78620964	52.49845009	0.2	9.669691399	0	6.180987953	19.64489619	10.57348811	14.23794975	9.274635091	0.2	0	0	0	0	0	0	0	0	0											10.0958	0.648219163	1.110840416	0.298078182	1.775666676	0	0.803233247	1.363289378	1.483118589	0	1.265358719	0.371010318	0.083478823	0.252760006	0	10.19283566	0.71916688	2.038318314	5.882959063	1.290647677	10.04082822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.7157	0	0	10.0958	0.648219163	1.110840416	0.298078182	1.775666676	0	0.803233247	1.363289378	1.483118589	0	1.265358719	0.371010318	0.083478823	0.252760006	0	10.19283566	0.71916688	2.038318314	5.882959063	1.290647677	10.04082822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.7157	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											5.0525	0.1141	0.1831	0.2398	0.1388	0.249	0.1102	0	0.315	0.1306	0.3095	0.0281	0	0.1128	0.1469	2.5166	0.0836	0.1739	0.9566	0.3316	0.9526	0.0024	0	0	0	0	0	0	0	0											12.1479	0	0	15.1484	0.762369146	1.293893471	0.537904461	1.914439686	0.249033883	0.913480911	1.363289378	1.79809645	0.130594666	1.574830154	0.399129296	0.083478823	0.365531301	0.146906125	12.709481	0.802758135	2.212238676	6.83958997	1.62229404	10.99340242	0.002395875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8635
H1032_044_0	2009	6																					0											D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		1837.631704	183.8965034	952.637741	2280.666859	557.118155	1565.087537	6.503618564	1586.822554	318.7031707	4084.707674	1215.198024	177.2151367	0.051641084	365.4645591	11114.0139	25854.76601	914.4243152	3734.997479	6086.028579	2144.928065	78.89075252	29.18334808	0	162.8571429	0	0	32.8	13.57241379	1664	0											"$75 days 1 - 5, $0 after day 5, unlimited coverage"	"$75 days 1 - 5, $0 after day 5, unlimited coverage"	$0 days 1 - 100	Copay between $0.00 and $10.00	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $10.00	Copay between $5.00 and $10.00	$10.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	Not Covered	Not Covered	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	Not Covered											37.75467173	30.02527437	0	1.02933405	44.61334956	0	0.151593095	15.95612659	26.80753439	0	6.504270021	19.68691878	0.2	3.660153152	0	2.556998886	7.773090293	4.175138681	9.084962751	4.860427327	0.2	0	0	0	0	0	10	10	0	0											37.75467173	30.02527437	0	1.02933405	44.61334956	0	0.151593095	15.95612659	26.80753439	0	6.504270021	19.68691878	0.2	3.660153152	0	2.556998886	7.773090293	4.175138681	9.084962751	4.860427327	0.2	0	0	0	0	0	10	10	0	0											5.7816	0.460128581	0	0.195630671	2.07124225	0	0.985903666	2.109961795	0.711970517	0	0.658664673	0.290735	0.010328217	0.111471355	0	5.509217323	0.592325231	1.299511037	4.607611912	0.868772249	15.7781505	0	0	0	0	0	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	42.0819	0	0	5.7816	0.460128581	0	0.195630671	2.07124225	0	0.985903666	2.109961795	0.711970517	0	0.658664673	0.290735	0.010328217	0.111471355	0	5.509217323	0.592325231	1.299511037	4.607611912	0.868772249	15.7781505	0	0	0	0	0	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	42.0819	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											6.056	0.265	0.2801	0.4338	0.1923	0.4342	0.1588	0	0.4895	0.192	0.5791	0.054	0	0.1409	0.1624	3.347	0.1799	0.3084	1.2755	0.3874	1.3125	0.0087	0	0	0	0	0	0	0	0											16.2577	0	0	11.8376	0.725104158	0.280141303	0.629429907	2.263539954	0.434248634	1.144734738	2.109961795	1.201511267	0.19201647	1.237774376	0.344722288	0.010328217	0.252412957	0.162435187	8.856188699	0.772239713	1.607899759	5.883121253	1.256175718	17.09063791	0.008662606	0	0	0	0	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	58.3395
H1032_060_0	2009	7																					0											A	A	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		304.4406296	51.29222548	1038.937511	2552.520829	941.1083247	2158.447276	5.897767505	1642.100937	223.7001882	4737.249639	1080.133087	88.58623847	0.49677206	347.7565879	10366.65641	24039.661	1809.45154	5963.798539	6157.563373	1639.433002	47.8031947	18.25423541	2340	395.3333333	308.0307869	210.4615385	32.8	13.57241379	3248	8200											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											0	0	0	0	32.27066915	0	0.166320327	18.38933255	0	0	4.519415486	0	0.2	0	0	0	0	0	7.13661671	3.3588167	0.2	0	0	0	9.930639436	10	10	10	0	0											0	0	0	0	32.27066915	0	0.166320327	18.38933255	0	0	4.519415486	0	0.2	0	0	0	0	0	7.13661671	3.3588167	0.2	0	0	0	9.930639436	10	10	10	0	0											0	0	0	0	2.530849616	0	0.980918623	2.516428351	0	0	0.406797517	0	0.099354412	0	0	0	0	0	3.662014138	0.458879579	9.56063894	0	0	0	0.25491189	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	20.6848	0	0	0	0	0	0	2.530849616	0	0.980918623	2.516428351	0	0	0.406797517	0	0.099354412	0	0	0	0	0	3.662014138	0.458879579	9.56063894	0	0	0	0.25491189	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	20.6848	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											5.9264	0.5351	0.3033	0.5929	0.2594	0.6261	0.1451	0	0.344	0.183	0.462	0.0235	0	0.1108	0.3062	2.9768	0.3416	0.4698	1.2924	0.3422	0.3912	0.0072	0	0	0	0	0	0	0	0											15.6388	0	0	5.9264	0.53505426	0.303272091	0.592860996	2.790245115	0.626104955	1.125995707	2.516428351	0.343990195	0.182961325	0.868809175	0.02354222	0.099354412	0.11075512	0.306217472	2.976848213	0.341611334	0.469752477	4.954432786	0.801102291	9.951806525	0.007154797	0	0	0.25491189	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	36.3236
H1032_061_0	2009	8																																A	A	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		338.6593964	29.38779886	993.6393156	1077.99164	503.3487162	1072.674493	7.388654868	1542.911258	271.7457198	2994.437949	767.6459651	78.5254707	0.318067183	197.9793686	13334.93912	16071.75864	1002.428915	204.9541289	4868.457616	674.5259774	18.68226655	23.31968524	2340	395.3333333	304	210.4615385	32.8	13.57241379	3248	9300											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											0	0	0	0	49.7582875	0	0.09765065	10.11587638	0	0	1.742235288	0	0.2	0	0	0	0	0	5.395252101	0.426550929	0.2	0	0	0	10	10	10	10	0	0											0	0	0	0	49.7582875	0	0.09765065	10.11587638	0	0	1.742235288	0	0.2	0	0	0	0	0	5.395252101	0.426550929	0.2	0	0	0	10	10	10	10	0	0											0	0	0	0	2.087147511	0	0.72150695	1.300658296	0	0	0.111451657	0	0.063613437	0	0	0	0	0	2.188879682	0.02397664	3.73645331	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	10.701	0	0	0	0	0	0	2.087147511	0	0.72150695	1.300658296	0	0	0.111451657	0	0.063613437	0	0	0	0	0	2.188879682	0.02397664	3.73645331	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	10.701	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											6.5011	0.1919	0.319	0.0996	0.2058	0.335	0.1666	0	0.3855	0.1636	0.4632	0.0454	0	0.075	0.2107	1.6887	0.1242	0.011	0.7591	0.1727	0.2559	0.0067	0	0	0	0	0	0	0	0											12.1807	0	0	6.5011	0.191938911	0.31898668	0.099603364	2.29293847	0.335007942	0.888090064	1.300658296	0.385503777	0.163580926	0.574699223	0.045360427	0.063613437	0.074995094	0.210674142	1.68869463	0.12416021	0.010956502	2.948004343	0.196706476	3.992371698	0.006687117	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	22.8817
H1032_064_0	2009	7																																A	A	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		345.0000386	95.08112361	1238.77001	2258.575614	1049.384724	2481.565026	5.483363879	2103.414404	188.8825012	5729.556995	950.9882147	113.7364192	0.05498855	408.834622	9834.31939	20946.20395	3124.12414	3497.569959	4779.367457	1264.971751	23.556439	34.2729239	2340	395.3333333	304	210.4615385	32.8	13.57241379	3248	8792.941176											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											0	0	0	0	31.45524261	0	0.15949137	16.70512806	0	0	5.117887833	0	0.2	0	0	0	0	0	7.245931963	3.386552447	0.2	0	0	0	10	10	10	10	0	0											0	0	0	0	31.45524261	0	0.15949137	16.70512806	0	0	5.117887833	0	0.2	0	0	0	0	0	7.245931963	3.386552447	0.2	0	0	0	10	10	10	10	0	0											0	0	0	0	2.750720924	0	0.874549217	2.928150581	0	0	0.405587584	0	0.01099771	0	0	0	0	0	2.885914285	0.356991098	4.711287799	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	15.3916	0	0	0	0	0	0	2.750720924	0	0.874549217	2.928150581	0	0	0.405587584	0	0.01099771	0	0	0	0	0	2.885914285	0.356991098	4.711287799	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	15.3916	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											6.4858	1.0991	0.4142	0.5795	0.3025	0.5955	0.1328	0	0.3021	0.2017	0.407	0.0514	0	0.137	0.3424	2.5524	0.6356	0.3281	0.6586	0.2237	0.5602	0.0083	0	0	0	0	0	0	0	0											16.0181	0	0	6.4858	1.099129412	0.414197548	0.579535645	3.053262781	0.595540154	1.007349312	2.928150581	0.302146002	0.201660056	0.812589702	0.051402956	0.01099771	0.136997809	0.342410568	2.552396709	0.635569197	0.32813264	3.54447353	0.580724006	5.271468956	0.008326427	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	31.4096
H1032_065_0	2009	7																																A	A	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		279.4669855	62.89274803	1154.717763	3040.128845	872.7452318	2066.753352	5.478521225	2284.13514	236.1112002	3825.834212	914.0374004	117.0155988	2.084661487	302.9394548	8059.805104	16050.29622	1161.12559	1923.872413	4447.796091	1055.266557	17.93096721	24.18851494	2340	395.3333333	304	210.4615385	32.8	13.57241379	3248	7133.333333											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											0	0	0	0	37.82623347	0	0.137316853	17.51030203	0	0	4.310669637	0	0.2	0	0	0	0	0	7.665725418	3.252176808	0.2	0	0	0	10	10	10	10	0	0											0	0	0	0	37.82623347	0	0.137316853	17.51030203	0	0	4.310669637	0	0.2	0	0	0	0	0	7.665725418	3.252176808	0.2	0	0	0	10	10	10	10	0	0											0	0	0	0	2.751055408	0	0.752293295	3.33299135	0	0	0.328342772	0	0.416932297	0	0	0	0	0	2.841298629	0.285992785	3.586193442	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	14.7625	0	0	0	0	0	0	2.751055408	0	0.752293295	3.33299135	0	0	0.328342772	0	0.416932297	0	0	0	0	0	2.841298629	0.285992785	3.586193442	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	14.7625	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											5.2091	0.5327	0.3667	0.5043	0.263	0.5019	0.1324	0	0.3506	0.2193	0.4395	0.0505	0	0.1101	0.2312	2.0679	0.1915	0.1787	0.7639	0.1871	0.2873	0.0033	0	0	0	0	0	0	0	0											12.5911	0	0	5.2091	0.532742157	0.366693331	0.504333551	3.014037462	0.5019035	0.884712712	3.33299135	0.350562516	0.219280754	0.767880756	0.050470927	0.416932297	0.110133861	0.231203904	2.067938048	0.191547984	0.178653209	3.605239265	0.473074346	3.873513121	0.003250332	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	27.3535
H1032_066_0	2009	6																																D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		1987.401781	986.7937567	520.7414124	5405.209208	932.6958921	2540.390301	6.39258387	1970.477759	168.8244696	4019.79443	1031.383526	111.9489433	0.12833161	273.7822752	6428.399319	21192.57358	3132.738827	8572.916132	4575.96598	1334.846359	214.8873991	18.92746395	2340	162.8571429	304	210.4615385	32.8	13.57241379	1664	0											"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$50 days 1 - 5, $0 after day 5, unlimited coverage"	Medicare FFS Cost Sharing	Copay between $0.00 and $10.00	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $10.00	Copay between $5.00 and $10.00	$10.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	Not Covered											23.46490314	16.43137262	40.51	0.63226659	33.96664586	0	0.174743306	17.06986718	13.14637341	0	5.964634606	13.12461252	0.2	2.674615722	0	1.706648791	6.951416088	3.841601895	8.626806361	4.551995139	0.2	0	0	0	10	10	10	10	0	0											23.46490314	16.43137262	40.51	0.63226659	33.96664586	0	0.174743306	17.06986718	13.14637341	0	5.964634606	13.12461252	0.2	2.674615722	0	1.706648791	6.951416088	3.841601895	8.626806361	4.551995139	0.2	0	0	0	10	10	10	10	0	0											3.8862	1.351197993	1.757936218	0.284794433	2.640045922	0	1.11706124	2.802982803	0.18495246	0	0.512652156	0.122440542	0.025666322	0.061021865	0	3.01402334	1.81474759	2.744477571	3.289664369	0.506351178	42.97747982	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	69.561	0	0	3.8862	1.351197993	1.757936218	0.284794433	2.640045922	0	1.11706124	2.802982803	0.18495246	0	0.512652156	0.122440542	0.025666322	0.061021865	0	3.01402334	1.81474759	2.744477571	3.289664369	0.506351178	42.97747982	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	69.561	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											6.1148	1.0291	0.1753	0.8843	0.2356	0.9554	0.1568	0	0.2314	0.2998	0.4545	0.0878	0	0.1022	0.266	2.5057	0.6468	0.6102	0.7283	0.231	1.3988	0.0012	0	0	0	0	0	0	0	0											17.1149	0	0	10.001	2.380299252	1.93322114	1.169138871	2.875600557	0.955353233	1.273826556	2.802982803	0.416377255	0.299815774	0.967130855	0.210266497	0.025666322	0.163193853	0.265967439	5.519768313	2.461574947	3.354671238	4.01792445	0.737345349	44.37627451	0.001213908	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	86.6759
H1032_069_0	2009	7																					0											D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		1263.148074	84.95091393	467.5493477	985.0284464	281.1265144	1166.957683	7.397369717	1101.72203	449.5893578	2516.120713	762.9385418	51.78039622	0.063554784	236.7619062	11739.37979	20947.47304	551.150479	3193.329859	4705.887251	2139.406215	25.06440054	45.25164706	0	162.8571429	304	210.4615385	32.8	13.57241379	0	0											"$75 days 1 - 5, $0 after day 5, unlimited coverage"	"$75 days 1 - 5, $0 after day 5, unlimited coverage"	Medicare FFS Cost Sharing	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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 $25.00 and $50.00	$0.00 copayment	Copay between $0.00 and $35.00	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	Not Covered	Not Covered											36.57237031	37.5244882	35.63	6.396241588	41.3838468	0	0.183160161	19.3426058	26.24590636	0	6.998267952	19.68691878	0.2	6.96399952	0	9.496258994	27.33446533	14.93217681	14.87941638	5.861199112	0.2	0	0	0	10	10	10	10	0	0											36.57237031	37.5244882	35.63	6.396241588	41.3838468	0	0.183160161	19.3426058	26.24590636	0	6.998267952	19.68691878	0.2	6.96399952	0	9.496258994	27.33446533	14.93217681	14.87941638	5.861199112	0.2	0	0	0	10	10	10	10	0	0											3.8497	0.265644964	1.388231938	0.525039993	0.969508051	0	1.354903426	1.77584791	0.983323349	0	0.444937362	0.084949705	0.012710957	0.137400817	0	16.57688577	1.255450305	3.97361384	5.83507132	1.044957151	5.012880107	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	45.9584	0	0	3.8497	0.265644964	1.388231938	0.525039993	0.969508051	0	1.354903426	1.77584791	0.983323349	0	0.444937362	0.084949705	0.012710957	0.137400817	0	16.57688577	1.255450305	3.97361384	5.83507132	1.044957151	5.012880107	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	45.9584	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											3.7795	0.1136	0.1657	0.2704	0.1028	0.3994	0.1802	0	0.7047	0.0672	0.3335	0.0156	0	0.1055	0.2488	2.8103	0.1026	0.2686	1.1155	0.386	0.5874	0.0126	0	0	0	0	0	0	0	0											11.7697	0	0	7.6292	0.379270497	1.553932131	0.795404229	1.072274642	0.399424949	1.535108567	1.77584791	1.68798292	0.067181548	0.778465992	0.100504267	0.012710957	0.242881285	0.24876973	19.38713682	1.35806396	4.242251226	6.950559607	1.430962378	5.600268483	0.012560542	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	57.7281
H1032_073_0	2009	11																					0											D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		2432.457844	113.6246108	1286.407791	925.4216358	503.7001536	1460.922847	8.779318684	1029.870682	251.9928474	1862.963204	989.7326056	37.27744819	0.281979474	218.0082408	12130.03794	18396.4608	155.442765	79.73147093	6139.355786	993.3162088	23.9940206	14.95927059	0	162.8571429	305.5242463	210.4615385	25.2	13.44	0	8200											"$200 days 1 - 5, $0 after day 5, unlimited coverage"	"$200 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $75 days 8 - 100"	Copay between $0.00 and $30.00	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $30.00	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $0.00 and $75.00	Copay between $0.00 and $75.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$0.00 copayment	"$0.00 copayment, $500 benefit limit"	Not Covered	$0.00 copayment											81.52705624	120.7042353	49.53	1.236257336	48.95822819	0	0.09149326	8.071276044	78.37051124	0	10.73580133	52.49845009	0.2	14.40020319	4.563435161	6.299466427	23.77632215	13.46370798	10.62077757	6.853494036	0.2	0	0	0	9.973556047	10	0	0	0	0											81.52705624	120.7042353	49.53	1.236257336	48.95822819	0	0.09149326	8.071276044	78.37051124	0	10.73580133	52.49845009	0.2	14.40020319	4.563435161	6.299466427	23.77632215	13.46370798	10.62077757	6.853494036	0.2	0	0	0	9.973556047	10	0	0	0	0											16.5259	1.142914313	5.309648159	0.095338274	2.055022255	0	0.80324849	0.692697547	1.645734023	0	0.885464385	0.163084021	0.056395895	0.26161358	4.612886803	9.65732393	0.307988105	0.08945677	5.433727685	0.567307226	4.798804121	0	0	0	0.253930266	0.175384615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.5339	0	0	16.5259	1.142914313	5.309648159	0.095338274	2.055022255	0	0.80324849	0.692697547	1.645734023	0	0.885464385	0.163084021	0.056395895	0.26161358	4.612886803	9.65732393	0.307988105	0.08945677	5.433727685	0.567307226	4.798804121	0	0	0	0.253930266	0.175384615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.5339	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											6.7074	0.1554	0.3482	0.0873	0.2137	0.3283	0.2132	0	0.5694	0.1176	0.5376	0.0219	0	0.0634	0.1661	2.6102	0.019	0.0072	1.3574	0.2094	0.4794	0.007	0	0	0	0	0	0	0	0											14.219	0	0	23.2333	1.298295219	5.657830448	0.182600611	2.268698708	0.328280692	1.016486748	0.692697547	2.215148819	0.117563639	1.423099058	0.184974015	0.056395895	0.325035391	4.778943488	12.26749841	0.327022947	0.096647943	6.791173813	0.776691167	5.278193658	0.007037151	0	0	0.253930266	0.175384615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.7529
H1032_077_0	2009	5																					0											A	A	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		248.3937059	4.31767062	526.2487839	933.4611607	334.383897	1443.924343	4.806817205	893.207272	222.5793972	3571.782975	965.2207483	52.68046996	0.076305962	324.9214293	11865.36004	25605.1737	239.7823899	2583.923892	5473.85637	1877.578916	36.26960864	33.71645474	0	162.8571429	304	210.4615385	32.8	13.57241379	1664	6200											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											0	0	0	0	43.38986067	0	0.172875214	15.71934647	0	0	6.177775347	0	0.2	0	0	0	0	0	7.13335891	3.733252254	0.2	0	0	0	10	10	10	10	0	0											0	0	0	0	43.38986067	0	0.172875214	15.71934647	0	0	6.177775347	0	0.2	0	0	0	0	0	7.13335891	3.733252254	0.2	0	0	0	10	10	10	10	0	0											0	0	0	0	1.209072558	0	0.830979552	1.170052881	0	0	0.496909745	0	0.015261192	0	0	0	0	0	3.253915176	0.584122977	7.253921728	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	15.2816	0	0	0	0	0	0	1.209072558	0	0.830979552	1.170052881	0	0	0.496909745	0	0.015261192	0	0	0	0	0	3.253915176	0.584122977	7.253921728	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	15.2816	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.209072558	0	0.830979552	1.170052881	0	0	0.496909745	0	0.015261192	0	0	0	0	0	3.253915176	0.584122977	7.253921728	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	15.2816
H1032_079_0	2009	6																					3250											D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		1205.89986	109.7143656	420.3039426	1307.532656	282.185155	2390.099204	6.371387069	1758.171384	241.5260367	8970.428474	1664.98923	52.6463369	0.147179943	611.2847569	9960.456142	19436.53078	380.8724668	3179.194253	4479.228414	2573.941079	28.81915097	45.77960633	0	162.8571429	304	210.4615385	32.8	13.57241379	19.91147946	0											"$200 days 1 - 5, $0 after day 5, unlimited coverage"	"$200 days 1 - 5, $0 after day 5, unlimited coverage"	Medicare FFS Cost Sharing	Copay between $0.00 and $30.00	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $30.00	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $0.00 and $75.00	Copay between $0.00 and $75.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	Not Covered											127.396839	51.7336418	35.63	4.6689277	46.12156368	0	0.161494572	21.72648386	105.0773482	0	23.67596683	52.49845009	0.2	9.83047853	4.760104137	9.262313877	24.27445038	11.58624144	21.45751658	8.746082457	0.2	0	0	0	10	10	10	10	0	0											117.1997976	47.59280052	32.7781193	4.295219454	42.42992188	0	0.148568295	19.98746225	96.6667936	0	21.78090557	48.29639237	0.183991688	9.043631715	4.379097987	8.520943846	22.33148555	10.65886063	19.74002352	8.046032393	0.183991688	0	0	0	10	10	10	10	0	0											11.7776	0.435134493	1.148064398	0.468011642	0.99775784	0	0.946586113	2.92844868	1.945628962	0	3.022081098	0.211885679	0.027079886	0.460686185	3.634817786	13.80146561	0.708787333	2.823882371	7.368339522	1.725834441	5.302484247	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	60.2019	0	5.1972	11.7776	0.435134493	1.148064398	0.468011642	0.99775784	0	0.946586113	2.92844868	1.945628962	0	3.022081098	0.211885679	0.027079886	0.460686185	3.634817786	13.80146561	0.708787333	2.823882371	7.368339522	1.725834441	5.302484247	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	60.2019	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											4.894	0.1229	0.13	0.3255	0.1387	0.5606	0.1569	0	0.5332	0.2128	0.5999	0.0133	0	0.1998	0.172	3.0404	0.0641	0.2733	0.8438	0.438	0.7005	0.0132	0	0	0	0	0	0	0	0											13.4328	0	0	16.6716	0.558054926	1.27804832	0.793479929	1.136496717	0.560604331	1.103491993	2.92844868	2.478833279	0.212805008	3.621933822	0.225155501	0.027079886	0.660506223	3.80678755	16.84187174	0.772875578	3.097143508	8.212105434	2.163869097	6.002978112	0.013245291	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	73.6347
H1032_085_0	2009	7																																A	A	D	V	Coin	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	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	0	0	0											0		279.0724456	93.56502084	606.4383098	2199.917991	12.90860654	1582.002959	5.490924245	25.59575951	9.896332969	3993.381152	24.88638956	2.361599094	0.092289298	3.296991924	8840.761994	82.85382264	4.268856496	3.767290921	26.41660664	6.660395374	16.36241072	0.099645463	2340	829.8	253.0973342	201.6	25.2	13.44	3248	6998.139535											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	$0.00 copayment	"$0.00 copayment, $1,000 benefit limit"	$0.00 copayment	"$0.00 copayment, $75 benefit limit,"	$0.00 copayment	"$0.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											740.8990655	316.4245982	56.91563448	0	0.166426265	0	0.099638705	0.107951463	0.17	0	0.097813035	0.17	0.17	0.17	0	0.091043562	0.17	0.17	0.143530399	0.041685126	0.17	0.17	0	0	0	0	0	0	0	0											740.8990655	316.4245982	56.91563448	0	0.166426265	0	0.099638705	0.107951463	0.17	0	0.097813035	0.17	0.17	0.17	0	0.091043562	0.17	0.17	0.143530399	0.041685126	0.17	0.17	0	0	0	0	0	0	0	0											17.2304	2.46718951	2.876318431	0	2.148331168	0	0.547108581	2.763099675	1.682376605	0	2.434213303	0.401471846	0.015689181	0.560488627	0	7.543307177	0.725705604	0.640439457	3.791586093	0.277639421	2.781609822	0.016939729	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9039	0	0	17.2304	2.46718951	2.876318431	0	2.148331168	0	0.547108581	2.763099675	1.682376605	0	2.434213303	0.401471846	0.015689181	0.560488627	0	7.543307177	0.725705604	0.640439457	3.791586093	0.277639421	2.781609822	0.016939729	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9039	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.2304	2.46718951	2.876318431	0	2.148331168	0	0.547108581	2.763099675	1.682376605	0	2.434213303	0.401471846	0.015689181	0.560488627	0	7.543307177	0.725705604	0.640439457	3.791586093	0.277639421	2.781609822	0.016939729	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9039
H1032_086_0	2009	7																																A	A	D	V	Coin	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	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	0	0	0											0		342.298049	90.87880067	1044.883511	2051.19708	13.80714602	2235.17338	4.852511892	25.89983633	14.31973725	5916.546223	17.78803081	1.982176211	0.055596805	5.343988849	9393.158742	96.10005989	19.78144992	9.84477832	25.58975197	7.478541022	22.01158998	0.273181885	2340	829.8	252	201.6	25.2	13.44	3248	9320											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	$0.00 copayment	"$0.00 copayment, $1,000 benefit limit"	$0.00 copayment	"$0.00 copayment, $75 benefit limit,"	$0.00 copayment	"$0.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											639.8392019	433.2683051	60.32630303	0	0.156975493	0	0.133756801	0.106823256	0.17	0	0.113983086	0.17	0.17	0.17	0	0.093501717	0.17	0.17	0.150863437	0.023553477	0.17	0.17	0	0	0	0	0	0	0	0											639.8392019	433.2683051	60.32630303	0	0.156975493	0	0.133756801	0.106823256	0.17	0	0.113983086	0.17	0.17	0.17	0	0.093501717	0.17	0.17	0.150863437	0.023553477	0.17	0.17	0	0	0	0	0	0	0	0											18.2513	3.281241995	5.252829943	0	2.16738356	0	0.649056469	2.766704859	2.434355332	0	2.027534654	0.336969956	0.009451457	0.908478104	0	8.985520617	3.362846486	1.673612314	3.860557931	0.176145645	3.741970296	0.04644092	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.9324	0	0	18.2513	3.281241995	5.252829943	0	2.16738356	0	0.649056469	2.766704859	2.434355332	0	2.027534654	0.336969956	0.009451457	0.908478104	0	8.985520617	3.362846486	1.673612314	3.860557931	0.176145645	3.741970296	0.04644092	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.9324	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.2513	3.281241995	5.252829943	0	2.16738356	0	0.649056469	2.766704859	2.434355332	0	2.027534654	0.336969956	0.009451457	0.908478104	0	8.985520617	3.362846486	1.673612314	3.860557931	0.176145645	3.741970296	0.04644092	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.9324
H1032_088_0	2009	8																																A	A	D	V	Coin	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	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	0	0	0											0		336.943079	70.5604413	780.5615651	7022.391202	11.11427923	2540.56786	6.807884454	18.35277371	9.004191562	4335.257539	15.82306424	3.097532274	0.170010157	3.563766631	6802.95861	127.2067429	20.46203608	24.83640468	35.7000505	10.22717383	157.2157984	0.050087637	0	829.8	252	201.6	25.2	13.44	3248	6200											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	Not Covered	"$0.00 copayment, $1,000 benefit limit"	$0.00 copayment	"$0.00 copayment, $75 benefit limit,"	$0.00 copayment	"$0.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											793.1181697	402.4397866	64.05857014	0	0.157673539	0	0.155337197	0.101472018	0.17	0	0.135597861	0.17	0.17	0.17	0	0.088429912	0.17	0.17	0.158571302	0.018509664	0.17	0.17	0	0	0	0	0	0	0	0											793.1181697	402.4397866	64.05857014	0	0.157673539	0	0.155337197	0.101472018	0.17	0	0.135597861	0.17	0.17	0.17	0	0.088429912	0.17	0.17	0.158571302	0.018509664	0.17	0.17	0	0	0	0	0	0	0	0											22.2696	2.366360745	4.166804814	0	1.752427741	0	1.057517691	1.862292988	1.530712566	0	2.145573671	0.526580487	0.028901727	0.605840327	0	11.24888107	3.478546133	4.222188796	5.661003475	0.189301553	26.72668573	0.008514898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.8478	0	0	22.2696	2.366360745	4.166804814	0	1.752427741	0	1.057517691	1.862292988	1.530712566	0	2.145573671	0.526580487	0.028901727	0.605840327	0	11.24888107	3.478546133	4.222188796	5.661003475	0.189301553	26.72668573	0.008514898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.8478	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.2696	2.366360745	4.166804814	0	1.752427741	0	1.057517691	1.862292988	1.530712566	0	2.145573671	0.526580487	0.028901727	0.605840327	0	11.24888107	3.478546133	4.222188796	5.661003475	0.189301553	26.72668573	0.008514898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.8478
H1032_089_0	2009	7																																A	A	D	V	Coin	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	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	0	0	0											0		338.7091499	45.44810058	1127.10561	2646.915545	11.73805572	1865.077115	5.566211316	16.40659894	12.6562747	4621.371638	15.00203703	0.980355729	0.418305832	3.069348099	9084.625207	122.4527657	10.26121116	16.36963775	49.42057688	11.56039249	42.03327314	0.205215974	0	829.8	252	207.6158682	25.2	13.44	3248	9266.666667											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	Not Covered	"$0.00 copayment, $1,000 benefit limit"	$0.00 copayment	"$0.00 copayment, $75 benefit limit,"	$0.00 copayment	"$0.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											621.4128885	347.9717004	54.8912641	0	0.155039046	0	0.142862036	0.106326983	0.17	0	0.147733662	0.17	0.17	0.17	0	0.094734924	0.17	0.17	0.159228587	0.016760859	0.17	0.164353461	0	0	0	0	0	0	0	0											621.4128885	347.9717004	54.8912641	0	0.155039046	0	0.142862036	0.106326983	0.17	0	0.147733662	0.17	0.17	0.17	0	0.094734924	0.17	0.17	0.159228587	0.016760859	0.17	0.164353461	0	0	0	0	0	0	0	0											17.5399	1.317887737	5.15568764	0	1.819856965	0	0.795200279	1.744464167	2.151566699	0	2.216305867	0.166660474	0.071111991	0.521789177	0	11.60055344	1.744405898	2.782838417	7.86916862	0.193762113	7.145656434	0.033727955	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.8705	0	0	17.5399	1.317887737	5.15568764	0	1.819856965	0	0.795200279	1.744464167	2.151566699	0	2.216305867	0.166660474	0.071111991	0.521789177	0	11.60055344	1.744405898	2.782838417	7.86916862	0.193762113	7.145656434	0.033727955	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.8705	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.5399	1.317887737	5.15568764	0	1.819856965	0	0.795200279	1.744464167	2.151566699	0	2.216305867	0.166660474	0.071111991	0.521789177	0	11.60055344	1.744405898	2.782838417	7.86916862	0.193762113	7.145656434	0.033727955	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.8705
H1032_091_0	2009	6																					0											A	A	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		266.641622	12.01369508	894.2661771	868.0035509	445.2238707	1109.946368	6.441186575	971.4802269	269.824083	1997.060666	564.570671	49.98222932	0.53525945	227.7852553	15203.31004	15031.20923	238.3825233	120.3034018	5338.545021	814.8168277	16.32583967	27.24845089	0	0	304.1838349	210.4615385	32.8	13.57241379	1664	7480											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	Copay between $0.00 and $20.00	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $20.00	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	Not Covered	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											0	0	0	0.819620579	49.64856397	0	0.113070776	9.7450073	0	0	2.412371878	0	0.2	3.117751681	0	4.221519015	16.03192977	8.399470664	8.359738899	1.371837102	0.2	0	0	0	9.996796618	10	10	10	0	0											0	0	0	0.819620579	49.64856397	0	0.113070776	9.7450073	0	0	2.412371878	0	0.2	3.117751681	0	4.221519015	16.03192977	8.399470664	8.359738899	1.371837102	0.2	0	0	0	9.996796618	10	10	10	0	0											0	0	0	0.059286131	1.842060485	0	0.728309964	0.788923492	0	0	0.113496201	0	0.10705189	0.059181489	0	5.287877967	0.318477656	0.084207075	3.719070206	0.093149663	3.265167935	0	0	0	0.253405328	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	16.9337	0	0	0	0	0	0.059286131	1.842060485	0	0.728309964	0.788923492	0	0	0.113496201	0	0.10705189	0.059181489	0	5.287877967	0.318477656	0.084207075	3.719070206	0.093149663	3.265167935	0	0	0	0.253405328	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	16.9337	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											5.9474	0.0856	0.2778	0.0497	0.1794	0.1997	0.1429	0	0.3467	0.1174	0.3682	0.0336	0	0.0655	0.1585	1.6345	0.0325	0.0086	1.0493	0.2069	0.27	0.0078	0	0	0	0	0	0	0	0											11.1818	0	0	5.9474	0.085613168	0.277766103	0.109003524	2.02142603	0.199691369	0.871184491	0.788923492	0.346688003	0.117368491	0.48166634	0.033640673	0.10705189	0.124656544	0.158524964	6.922377391	0.350968932	0.092838842	4.768341875	0.30000028	3.535121345	0.007799948	0	0	0.253405328	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	28.1155
H1032_097_0	2009	9																					0											D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		995.7537172	57.13499835	452.815695	768.6856678	245.6632087	1173.399812	5.151471658	915.2822081	221.5311	2069.626184	642.132534	49.71160561	0.043545462	196.952495	10617.60677	17197.2939	325.4343001	2304.13391	3946.369095	1788.930408	18.54378228	26.61705269	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"	Medicare FFS Cost Sharing	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $40.00	Copay between $30.00 and $40.00	$40.00 copayment	Copay between $0.00 and $75.00	Copay between $0.00 and $75.00	20% coinsurance	$0.00 copayment	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											139.0843662	126.6152053	35.63	5.849011556	43.232509	0	0.181746467	17.74008645	81.94253349	0	17.91070495	65.62306262	0.2	13.68911351	3.459630082	11.12990693	31.12842643	17.00317627	18.6781428	12.04323048	0.2	0	0	0	0	0	0	0	0	0											139.0843662	126.6152053	35.63	5.849011556	43.232509	0	0.181746467	17.74008645	81.94253349	0	17.91070495	65.62306262	0.2	13.68911351	3.459630082	11.12990693	31.12842643	17.00317627	18.6781428	12.04323048	0.2	0	0	0	0	0	0	0	0	0											11.5411	0.602846629	1.344485268	0.374670946	0.885053073	0	0.936261774	1.353098791	1.512734965	0	0.95842053	0.271852317	0.008709092	0.224675422	3.061082648	15.95035671	0.844188139	3.264799586	6.142570459	1.795375101	3.708756457	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.7811	0	0	11.5411	0.602846629	1.344485268	0.374670946	0.885053073	0	0.936261774	1.353098791	1.512734965	0	0.95842053	0.271852317	0.008709092	0.224675422	3.061082648	15.95035671	0.844188139	3.264799586	6.142570459	1.795375101	3.708756457	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.7811	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											3.7312	0.0836	0.1483	0.1712	0.0996	0.3871	0.125	0	0.3496	0.0615	0.2682	0.017	0	0.0874	0.1904	2.34	0.063	0.1887	0.9281	0.3206	0.4289	0.0074	0	0	0	0	0	0	0	0											9.997	0	0	15.2723	0.686496596	1.492790254	0.545856085	0.984698552	0.387083761	1.061284158	1.353098791	1.862322599	0.061523586	1.226615437	0.288896014	0.008709092	0.312113458	3.251437879	18.29035948	0.907184813	3.453546227	7.070654583	2.11601697	4.137698618	0.007424549	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.7781
H1032_098_0	2009	6																																D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		811.6527216	49.3099197	298.7844719	687.7512397	295.1980707	1709.033241	4.345142034	905.514342	155.6940368	2466.229292	808.8756692	58.56434691	0.013027913	281.2552086	9023.303054	17175.00602	188.0873486	1347.876548	3710.239708	1503.42468	27.23889253	29.1629761	0	0	0	0	0	0	1664	7480											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	Medicare FFS Cost Sharing	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $35.00	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $0.00 and $75.00	Copay between $0.00 and $75.00	20% coinsurance	$0.00 copayment	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	$0.00 copayment	$0.00 copayment											164.0116596	139.2250767	35.63	5.608039458	46.33850142	0	0.183401941	17.20307125	89.65785365	0	15.74166634	65.62306262	0.2	9.58958855	5.585882484	8.030200672	26.71164446	14.07594061	18.21781257	10.66361864	0.2	0	0	0	0	0	0	0	0	0											164.0116596	139.2250767	35.63	5.608039458	46.33850142	0	0.183401941	17.20307125	89.65785365	0	15.74166634	65.62306262	0.2	9.58958855	5.585882484	8.030200672	26.71164446	14.07594061	18.21781257	10.66361864	0.2	0	0	0	0	0	0	0	0	0											11.0934	0.572098113	0.887140895	0.321411341	1.139919685	0	0.796907483	1.298135646	1.163266097	0	1.061087575	0.320264317	0.002605583	0.224760144	4.200259206	11.49322874	0.418676865	1.58105252	5.632704297	1.33599562	5.447778505	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9907	0	0	11.0934	0.572098113	0.887140895	0.321411341	1.139919685	0	0.796907483	1.298135646	1.163266097	0	1.061087575	0.320264317	0.002605583	0.224760144	4.200259206	11.49322874	0.418676865	1.58105252	5.632704297	1.33599562	5.447778505	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9907	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											3.4299	0.0612	0.1202	0.1661	0.145	0.3904	0.1053	0	0.3198	0.1093	0.3273	0.0356	0	0.1135	0.1485	1.9851	0.027	0.1068	0.7388	0.2687	0.6334	0.0097	0	0	0	0	0	0	0	0											9.2413	0	0	14.5233	0.633254509	1.007301842	0.487494174	1.2848795	0.390374257	0.902178652	1.298135646	1.483073161	0.109345493	1.388350536	0.355829518	0.002605583	0.338229343	4.348768345	13.47829737	0.445627979	1.687860431	6.37147729	1.60474228	6.081182058	0.009745033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.232
H1032_101_0	2009	7																					1500											A	A	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		360.409656	55.52628487	1817.369563	2203.644671	1454.725026	2773.11297	6.882348902	2460.094538	228.2548015	5317.25324	1367.090956	94.40762945	0.016579575	538.7635345	10631.53321	21350.61998	791.0858227	3368.700643	5462.091641	1365.862177	24.4030974	24.81261746	2340	829.8	304	210.4615385	32.8	13.57241379	3248	6200											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $15.00	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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 $15.00	$0.00 copayment	Copay between $0.00 and $15.00	Copay between $5.00 and $15.00	$15.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"$0.00 copayment, $1,000 benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											0	0	58.89	1.652874342	26.49048539	0	0.158694684	16.9238454	0	0	5.484452813	0	0.2	2.087505047	0	2.671274833	10.68276048	5.597210788	9.075539008	5.910701479	0.2	0	0	0	10	10	10	10	0	0											0	0	52.87269452	1.483985739	23.7837212	0	0.142479462	15.19458835	0	0	4.924058383	0	0.179564254	1.874206429	0	2.39832736	9.591209567	5.025294892	8.148211947	5.306753501	0.179564254	0	0	0	10	10	10	10	0	0											0	0	8.007435479	0.272514772	2.883231203	0	0.98059337	3.115010318	0	0	0.56096964	0	0.002977099	0.084146173	0	4.267148004	0.632289159	1.410726178	3.708856697	0.604024491	4.381923975	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	31.3792	0	3.518	0	0	8.007435479	0.272514772	2.883231203	0	0.98059337	3.115010318	0	0	0.56096964	0	0.002977099	0.084146173	0	4.267148004	0.632289159	1.410726178	3.708856697	0.604024491	4.381923975	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	31.3792	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											7.129	0.6012	0.5208	0.5118	0.3447	0.7628	0.1679	0	0.4278	0.1771	0.5267	0.0379	0	0.1555	0.3413	2.5079	0.1481	0.3361	0.8138	0.2196	0.5844	0.0063	0	0	0	0	0	0	0	0											16.3207	0	0	7.129	0.601198239	8.528250939	0.784327196	3.227925635	0.762775625	1.148528609	3.115010318	0.427767774	0.177086764	1.087715292	0.037872612	0.002977099	0.23960044	0.341311473	6.775011876	0.78043778	1.746854226	4.522693402	0.82364776	4.966283282	0.006278753	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	47.7
H1032_102_0	2009	7																																A	A	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		302.1139306	54.07955538	1042.246779	1404.277081	1186.988068	2209.66638	5.623578131	2365.011985	203.1596981	6357.886314	1277.025533	113.8839511	0.082229488	307.8053742	11860.82226	23661.45931	1393.198254	5437.441804	5018.986873	1143.52687	22.62473813	77.82851553	2340	395.3333333	304	210.4615385	32.8	13.57241379	3248	6048.888889											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											0	0	0	0	21.17000862	0	0.149086747	15.6045535	0	0	4.598248573	0	0.2	0	0	0	0	0	6.393940472	3.430694564	0.2	0	0	0	10	10	10	10	0	0											0	0	0	0	21.17000862	0	0.149086747	15.6045535	0	0	4.598248573	0	0.2	0	0	0	0	0	6.393940472	3.430694564	0.2	0	0	0	10	10	10	10	0	0											0	0	0	0	2.094045637	0	0.838400969	3.075413003	0	0	0.48934007	0	0.016445898	0	0	0	0	0	2.674258608	0.326924285	4.524947626	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	14.5071	0	0	0	0	0	0	2.094045637	0	0.838400969	3.075413003	0	0	0.48934007	0	0.016445898	0	0	0	0	0	2.674258608	0.326924285	4.524947626	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	14.5071	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											5.3197	0.5252	0.3683	0.3087	0.2342	0.5426	0.1365	0	0.33	0.1709	0.4336	0.0431	0	0.0864	0.3462	2.4899	0.2178	0.5412	0.9738	0.1917	0.504	0.0387	0	0	0	0	0	0	0	0											13.8024	0	0	5.3197	0.525227134	0.368343109	0.308686683	2.328232277	0.542563974	0.97487612	3.075413003	0.330020155	0.170880524	0.92291298	0.043069998	0.016445898	0.086383557	0.346162582	2.489890967	0.217823552	0.541213476	3.648037377	0.518580095	5.028986343	0.038743432	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	28.3095
H1032_104_0	2009	8																					2000											D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		1524.296634	355.7759602	1116.602875	1923.445199	1616.854657	3029.632899	5.752638727	2573.762687	188.9591683	5973.31374	901.548743	39.92094931	0.004081645	292.2508147	7543.231308	23338.86906	1888.847915	6719.008684	4635.816818	1473.061805	31.61464439	25.22764987	2340	395.3333333	252	201.6	25.2	13.44	3248	6800											"$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	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $20.00	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"$0.00 copayment, No benefit limit"	$0.00 copayment	"$0.00 copayment, $75 benefit limit,"	$0.00 copayment	"$0.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											53.69856283	45.41700398	34.64	3.020248277	21.19222374	0	0.2	22.02190687	51.8440668	0	10.44069781	26.24922505	0.2	5.287530667	0	4.276918811	15.64221987	8.072676433	13.92788836	2.560278433	0.2	0	0	0	0	0	0	0	0	0											47.50174655	40.17587992	30.64254263	2.671711506	18.74664028	0	0.176919992	19.48057794	45.86125944	0	9.235840866	23.22006344	0.176919992	4.677349419	0	3.783362211	13.83710708	7.141089253	12.32060949	2.2648222	0.176919992	0	0	0	0	0	0	0	0	0											6.0339	1.191134354	2.851295932	0.428240889	2.52588272	0	1.017756798	4.178198719	0.722158787	0	0.69388006	0.077247248	0.000722125	0.113913265	0	7.358282938	2.178015905	3.998420058	4.759674058	0.27801859	5.593262635	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44	0	5.74	6.0339	1.191134354	2.851295932	0.428240889	2.52588272	0	1.017756798	4.178198719	0.722158787	0	0.69388006	0.077247248	0.000722125	0.113913265	0	7.358282938	2.178015905	3.998420058	4.759674058	0.27801859	5.593262635	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											4.4088	0.5923	0.3629	0.5726	0.3152	0.9268	0.1406	0	0.3848	0.1471	0.242	0.0132	0	0.1422	0.2733	2.7386	0.3303	0.6198	1.2556	0.2535	0.6584	0.0082	0	0	0	0	0	0	0	0											14.3862	0	0	10.4427	1.783408966	3.21416622	1.000808898	2.841126962	0.926820616	1.158376856	4.178198719	1.106946068	0.147083093	0.935907047	0.09046097	0.000722125	0.256154378	0.273309872	10.09689189	2.508280249	4.618220365	6.015241455	0.531537502	6.251646207	0.008233699	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.3862
H1032_106_0	2009	7																																A	A	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		360.373825	44.66758336	908.0870344	2200.315418	716.4256773	1994.245579	6.112909666	2028.781235	184.1068622	5409.305005	1091.548432	123.615985	1.21617063	407.7434772	8636.448575	19828.51934	822.4901789	1806.832439	4810.708293	938.5797637	17.41298083	11.99155277	2340	395.3333333	305.7733591	210.4615385	32.8	13.57241379	3248	6800											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											0	0	0	0	37.93452504	0	0.138513766	15.98440963	0	0	3.625268899	0	0.2	0	0	0	0	0	5.775493868	2.758067549	0.2	0	0	0	9.969259285	10	10	10	0	0											0	0	0	0	37.93452504	0	0.138513766	15.98440963	0	0	3.625268899	0	0.2	0	0	0	0	0	5.775493868	2.758067549	0.2	0	0	0	9.969259285	10	10	10	0	0											0	0	0	0	2.264772316	0	0.846722138	2.702405859	0	0	0.329763048	0	0.243234126	0	0	0	0	0	2.315351354	0.215722199	3.482596165	0	0	0	0.254027825	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	12.8686	0	0	0	0	0	0	2.264772316	0	0.846722138	2.702405859	0	0	0.329763048	0	0.243234126	0	0	0	0	0	2.315351354	0.215722199	3.482596165	0	0	0	0.254027825	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	12.8686	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											6.2329	0.3819	0.3078	0.3839	0.2447	0.4997	0.1475	0	0.2854	0.2377	0.4836	0.0676	0	0.099	0.2733	2.2794	0.1267	0.1663	0.6336	0.1688	0.3291	0.0022	0	0	0	0	0	0	0	0											13.351	0	0	6.2329	0.381868309	0.307778702	0.383891714	2.509473828	0.499748017	0.994188695	2.702405859	0.285354091	0.237728497	0.813350616	0.067551979	0.243234126	0.09897636	0.27327476	2.279401576	0.126699022	0.166322572	2.948992808	0.384510445	3.81169416	0.002201451	0	0	0.254027825	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	26.2196
H1032_107_0	2009	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	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		333.4335238	42.23534901	1214.190555	9273.405858	862.9567468	2309.627683	940.2797929	1413.57626	129.6617721	2568.708979	677.35733	37.63493959	0.062189858	188.5666805	7903.416189	19446.79402	1778.162306	9958.175946	5402.031716	1096.931437	89.24406286	9.462461947	2340	829.8	252	201.6	45	12	3248	9177.777778											"$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, $1,000 benefit limit"	$0.00 copayment	"$0.00 copayment, $75 benefit limit,"	$0.00 copayment	"$0.00 copayment, $1,000 benefit limit"	$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	0.2	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	0.012437972	0	0	0	0	0	0	0	17.84881257	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.8613	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.012437972	0	0	0	0	0	0	0	17.84881257	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.8613	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											8.3492	0.4774	0.351	0.5408	0.2801	0.911	0.1749	0	0.2192	0.1366	0.2438	0.0368	0	0.0921	0.2154	2.0512	0.5887	0.628	0.6323	0.1716	0.7345	0.0019	0	0	0	0	0	0	0	0											16.8365	0	0	8.3492	0.477373222	0.351038896	0.540824725	0.280133739	0.911014611	0.174946807	0	0.219184781	0.136630988	0.243775582	0.036756696	0.012437972	0.092089019	0.215400141	2.051154163	0.588689335	0.627978348	0.632314663	0.171603844	18.58332738	0.001868747	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.6977
H1032_113_0	2009	6																					0											A	A	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		260.3579599	11.32655744	838.8184496	1587.953783	412.9699363	1317.920601	8.583841909	929.1701199	294.6494987	2779.594273	922.3299912	165.8666123	0.231145806	355.3901554	19327.57648	27245.80399	414.6448852	3765.207771	6773.404948	2172.240925	27.36499746	25.65379502	0	653.3333333	0	0	32.8	13.57241379	1664	0											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, $1,000 benefit limit"	Not Covered	Not Covered	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	Not Covered											0	0	0	0	47.75811336	0	0.13735333	14.01387178	0	0	5.164949337	0	0.2	0	0	0	0	0	8.595283385	3.62585278	0.2	0	0	0	0	0	10	10	0	0											0	0	0	0	47.75811336	0	0.13735333	14.01387178	0	0	5.164949337	0	0.2	0	0	0	0	0	8.595283385	3.62585278	0.2	0	0	0	0	0	10	10	0	0											0	0	0	0	1.643555419	0	1.179019268	1.08510591	0	0	0.396982306	0	0.046229161	0	0	0	0	0	4.851611251	0.65635215	5.472999492	0	0	0	0	0	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	15.3705	0	0	0	0	0	0	1.643555419	0	1.179019268	1.08510591	0	0	0.396982306	0	0.046229161	0	0	0	0	0	4.851611251	0.65635215	5.472999492	0	0	0	0	0	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	15.3705	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											6.0943	0.0981	0.2319	0.3127	0.1636	0.3921	0.2115	0	0.5825	0.1809	0.4799	0.0591	0	0.1318	0.2613	3.8602	0.0819	0.3708	1.5721	0.4883	0.6401	0.0112	0	0	0	0	0	0	0	0											16.2241	0	0	6.0943	0.09814847	0.231862272	0.312650853	1.807115228	0.392112221	1.390470362	1.08510591	0.58248563	0.180914723	0.876879934	0.059131052	0.046229161	0.131761444	0.26125352	3.86019735	0.081856092	0.37078652	6.423759145	1.144683232	6.11305247	0.0112353	0	0	0	0	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	31.5946
H1032_122_0	2009	7																																A	A	D	V	Coin	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	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	0	0	0											0		278.8920696	71.67515166	515.9406844	2025.840262	9.635847663	2030.826664	7.525299356	21.22952044	16.73875142	7018.428866	17.77264928	1.146935802	0.141980175	3.579157787	9440.887359	107.1118182	8.254585667	14.69288347	35.12010404	8.38472182	33.75503659	0.578714057	2340	829.8	265.3353314	201.6	25.2	13.44	3248	6310											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	$0.00 copayment	"$0.00 copayment, $1,000 benefit limit"	$0.00 copayment	"$0.00 copayment, $75 benefit limit,"	$0.00 copayment	"$0.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											727.7148084	446.2944832	66.49173731	0	0.156330201	0	0.145059725	0.103278689	0.17	0	0.142742202	0.17	0.17	0.17	0	0.098636207	0.17	0.17	0.159290392	0.022197838	0.17	0.17	0	0	0	0	0	0	0	0											727.7148084	446.2944832	66.49173731	0	0.156330201	0	0.145059725	0.103278689	0.17	0	0.142742202	0.17	0.17	0.17	0	0.098636207	0.17	0.17	0.159290392	0.022197838	0.17	0.17	0	0	0	0	0	0	0	0											16.9128	2.665685397	2.858816038	0	1.506374004	0	1.091617858	2.192557029	2.845587741	0	2.53690709	0.194979086	0.02413663	0.608456824	0	10.56510342	1.403279563	2.49779019	5.594295122	0.186122699	5.73835622	0.09838139	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.5213	0	0	16.9128	2.665685397	2.858816038	0	1.506374004	0	1.091617858	2.192557029	2.845587741	0	2.53690709	0.194979086	0.02413663	0.608456824	0	10.56510342	1.403279563	2.49779019	5.594295122	0.186122699	5.73835622	0.09838139	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.5213	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.9128	2.665685397	2.858816038	0	1.506374004	0	1.091617858	2.192557029	2.845587741	0	2.53690709	0.194979086	0.02413663	0.608456824	0	10.56510342	1.403279563	2.49779019	5.594295122	0.186122699	5.73835622	0.09838139	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.5213
H1032_123_0	2009	7																																A	A	D	V	Coin	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	T	V	V	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	0	0	0											0		383.3962411	67.98696377	1443.784607	2882.248483	16.29628073	2768.96247	6.385986157	24.46367993	14.90266395	6185.887095	21.52217527	1.662044819	0.0306006	5.733578091	10059.51111	22093.73198	903.6777676	3705.821181	5608.319303	1384.138118	31.11210072	0.340586895	0	829.8	252	201.6	25.2	13.44	3248	6988.571429											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	"$0.00 copayment, Coin between 20% and 50%"	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	20% coinsurance	"$0.00 copayment, 20% coinsurance"	Not Covered	"$0.00 copayment, $1,000 benefit limit"	$0.00 copayment	"$0.00 copayment, $75 benefit limit,"	$0.00 copayment	"$0.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											759.0659029	489.2497191	61.44275145	0	0.160360881	0	0.137341578	0.104018094	0.17	0	0.140997106	0.17	0.17	0.163301713	0	0.724176708	0	0	2.04817865	1.0019893	0.17	0.17	0	0	0	0	0	0	0	0											759.0659029	489.2497191	61.44275145	0	0.160360881	0	0.137341578	0.104018094	0.17	0	0.140997106	0.17	0.17	0.163301713	0	0.724176708	0	0	2.04817865	1.0019893	0.17	0.17	0	0	0	0	0	0	0	0											24.2519	2.771883577	7.392508229	0	2.613285933	0	0.877061417	2.544665366	2.533452871	0	3.034564432	0.282547619	0.005202102	0.936303123	0	1.33331384	0	0	0.957236655	0.115574299	5.289057123	0.057899772	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.9965	0	0	24.2519	2.771883577	7.392508229	0	2.613285933	0	0.877061417	2.544665366	2.533452871	0	3.034564432	0.282547619	0.005202102	0.936303123	0	1.33331384	0	0	0.957236655	0.115574299	5.289057123	0.057899772	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.9965	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.2519	2.771883577	7.392508229	0	2.613285933	0	0.877061417	2.544665366	2.533452871	0	3.034564432	0.282547619	0.005202102	0.936303123	0	1.33331384	0	0	0.957236655	0.115574299	5.289057123	0.057899772	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.9965
H1032_124_0	2009	7																																A	A	D	V	Coin	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	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	0	0	0											0		358.8921971	49.06231079	949.5356154	1912.091014	11.15231582	1915.127271	6.949810929	19.26100521	15.79050622	6444.903687	20.77560562	2.532442619	0.996300014	4.729266482	11451.30447	100.5431374	5.676855547	9.820378584	33.80601729	9.093104425	30.59796797	0.145047618	2340	829.8	252	201.6	25.2	13.44	3248	8942.857143											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	$0.00 copayment	"$0.00 copayment, $1,000 benefit limit"	$0.00 copayment	"$0.00 copayment, $75 benefit limit,"	$0.00 copayment	"$0.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											690.1490808	313.3492637	60.66959573	0	0.161031313	0	0.123956776	0.097292691	0.17	0	0.115994658	0.17	0.17	0.17	0	0.094129937	0.17	0.17	0.15428991	0.019682571	0.17	0.17	0	0	0	0	0	0	0	0											690.1490808	313.3492637	60.66959573	0	0.161031313	0	0.123956776	0.097292691	0.17	0	0.115994658	0.17	0.17	0.17	0	0.094129937	0.17	0.17	0.15428991	0.019682571	0.17	0.17	0	0	0	0	0	0	0	0											20.6408	1.28113658	4.800661826	0	1.795872058	0	0.861476157	1.87395502	2.684386057	0	2.409859265	0.430515245	0.169371002	0.803975302	0	9.464119196	0.965065443	1.669464359	5.215927374	0.178975674	5.201654555	0.024658095	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4718	0	0	20.6408	1.28113658	4.800661826	0	1.795872058	0	0.861476157	1.87395502	2.684386057	0	2.409859265	0.430515245	0.169371002	0.803975302	0	9.464119196	0.965065443	1.669464359	5.215927374	0.178975674	5.201654555	0.024658095	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4718	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.6408	1.28113658	4.800661826	0	1.795872058	0	0.861476157	1.87395502	2.684386057	0	2.409859265	0.430515245	0.169371002	0.803975302	0	9.464119196	0.965065443	1.669464359	5.215927374	0.178975674	5.201654555	0.024658095	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4718
H1032_125_0	2009	7																																A	A	D	V	Coin	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	T	V	V	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	0	0	0											0		381.9200972	68.30136063	1086.049599	2243.998454	16.48332657	3673.264477	8.591617558	28.82477427	15.9173398	12404.7129	18.61036356	0.835137786	0.012741135	6.677148936	7890.120613	18888.74641	1228.438617	3851.581625	4773.843873	1644.480293	28.2942774	0.783089071	2340	829.8	252	201.6	25.2	13.44	1606.220161	6800											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	"$0.00 copayment, Coin between 20% and 50%"	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	"$0.00 copayment, $1,000 benefit limit"	$0.00 copayment	"$0.00 copayment, $75 benefit limit,"	$0.00 copayment	"$0.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											722.6250975	437.5152979	72.06679809	0	0.160705218	0	0.157281725	0.13351177	0.17	0	0.169830956	0.17	0.17	0.165061588	0	0.771574956	0	0	1.5943946	0.79555346	0.17	0.17	0	0	0	0	0	0	0	0											722.6250975	437.5152979	72.06679809	0	0.160705218	0	0.157281725	0.13351177	0.17	0	0.169830956	0.17	0.17	0.165061588	0	0.771574956	0	0	1.5943946	0.79555346	0.17	0.17	0	0	0	0	0	0	0	0											22.9988	2.490240845	6.5223431	0	2.648956594	0	1.351304434	3.84844662	2.705947766	0	3.16061584	0.141973424	0.002165993	1.102140804	0	1.214506973	0	0	0.634282574	0.109022666	4.810027157	0.133125142	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.8739	0	0	22.9988	2.490240845	6.5223431	0	2.648956594	0	1.351304434	3.84844662	2.705947766	0	3.16061584	0.141973424	0.002165993	1.102140804	0	1.214506973	0	0	0.634282574	0.109022666	4.810027157	0.133125142	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.8739	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.9988	2.490240845	6.5223431	0	2.648956594	0	1.351304434	3.84844662	2.705947766	0	3.16061584	0.141973424	0.002165993	1.102140804	0	1.214506973	0	0	0.634282574	0.109022666	4.810027157	0.133125142	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.8739
H1032_126_0	2009	7																					1500											D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		1934.270809	513.3624335	772.1294176	1629.16543	883.5774055	4077.244446	8.964776228	3325.830944	220.6286021	17047.6795	1675.37242	8.40038485	0	683.038552	7118.431736	16021.98815	937.9567134	4486.321907	4389.711938	1440.620123	32.74763889	89.20143178	2340	829.8	304	210.4615385	32.8	13.57241379	3271.193343	6200											"$75 days 1 - 5, $0 after day 5, unlimited coverage"	"$75 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $20.00	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $20.00	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"$0.00 copayment, $1,000 benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											45.63988719	26.22847335	58.89	2.360491449	35.94020499	0	0.2	22.04062376	33.53289634	0	7.861721138	19.68691878	0	4.399896307	0	4.764805778	15.68689092	7.411212751	14.2976191	7.155064071	0.2	0	0	0	10	10	10	10	0	0											38.06974728	21.87804163	49.1221069	1.968964396	29.97891988	0	0.166826649	18.38481706	27.9709037	0	6.557722978	16.42151348	0	3.670099792	0	3.974482913	13.08495726	6.181938954	11.92611944	5.968276824	0.166826649	0	0	0	10	10	10	10	0	0											6.1364	0.935947058	3.160718649	0.26731406	2.207391354	0	1.49556358	5.095399457	0.514265115	0	0.915552351	0.011495586	0	0.208901637	0	5.306593178	1.022760292	2.31118068	4.362685741	0.716501641	5.463178869	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	40.5992	0	7.9802	6.1364	0.935947058	3.160718649	0.26731406	2.207391354	0	1.49556358	5.095399457	0.514265115	0	0.915552351	0.011495586	0	0.208901637	0	5.306593178	1.022760292	2.31118068	4.362685741	0.716501641	5.463178869	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	40.5992	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											6.6793	0.6192	0.2399	0.4794	0.3281	0.9469	0.2227	0	0.5248	0.3868	0.5532	0.0041	0	0.1629	0.2618	2.4293	0.1337	0.4415	0.5197	0.2541	0.8089	0.0345	0	0	0	0	0	0	0	0											16.0309	0	0	12.8158	1.555173645	3.400599989	0.746751481	2.535526562	0.94688157	1.718237054	5.095399457	1.039047273	0.386818288	1.468717848	0.015585231	0	0.37178726	0.261832664	7.735913823	1.156455387	2.75269415	4.882337073	0.970618269	6.27209297	0.034538815	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	56.6301
H1032_127_0	2009	7																																A	A	D	V	Coin	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	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	0	0	0											0		281.2122219	96.4244913	671.3876808	3679.988442	10.05160784	2467.210604	5.516682078	22.18690237	12.70760187	5033.622842	12.22762081	1.205232309	0.029697159	3.637520913	6153.755777	103.1741061	16.69304498	11.34824634	30.45158974	7.726460257	27.36286237	0.226864057	2340	653.3333333	252	240.958859	25.2	13.44	1664	6988.571429											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	$0.00 copayment	"$0.00 copayment, $1,000 benefit limit"	$0.00 copayment	"$0.00 copayment, $75 benefit limit,"	$0.00 copayment	"$0.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											773.2963123	415.0818346	66.40591475	0	0.158884196	0	0.17	0.121660696	0.17	0	0.17	0.17	0.17	0.17	0	0.08888785	0.17	0.17	0.17	0.02605668	0.17	0.17	0	0	0	0	0	0	0	0											773.2963123	415.0818346	66.40591475	0	0.158884196	0	0.17	0.121660696	0.17	0	0.17	0.17	0.17	0.17	0	0.08888785	0.17	0.17	0.17	0.02605668	0.17	0.17	0	0	0	0	0	0	0	0											18.1217	3.335337896	3.715342758	0	1.597041631	0	0.937835953	2.699273985	2.160292318	0	2.078695537	0.204889493	0.005048517	0.618378555	0	9.170924475	2.837817647	1.929201878	5.176770256	0.201325902	4.651686602	0.03856689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.4801	0	0	18.1217	3.335337896	3.715342758	0	1.597041631	0	0.937835953	2.699273985	2.160292318	0	2.078695537	0.204889493	0.005048517	0.618378555	0	9.170924475	2.837817647	1.929201878	5.176770256	0.201325902	4.651686602	0.03856689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.4801	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.1217	3.335337896	3.715342758	0	1.597041631	0	0.937835953	2.699273985	2.160292318	0	2.078695537	0.204889493	0.005048517	0.618378555	0	9.170924475	2.837817647	1.929201878	5.176770256	0.201325902	4.651686602	0.03856689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.4801
H1032_128_0	2009	8																																A	A	D	V	Coin	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	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	0	0	0											0		296.9339734	59.52201931	865.3413121	2018.84052	11.75823132	2136.906455	5.627239398	24.27066559	19.94419627	5388.426399	10.89012988	1.038203314	0.030778374	4.591065255	8703.40842	115.8583571	12.9421927	18.61839343	41.90462338	7.257288612	26.39929635	0.227759491	2340	829.8	252	201.6	25.2	13.44	3248	6800											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	$0.00 copayment	"$0.00 copayment, $1,000 benefit limit"	$0.00 copayment	"$0.00 copayment, $75 benefit limit,"	$0.00 copayment	"$0.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											781.215068	425.2445502	57.21907723	0	0.155599733	0	0.149266319	0.11604709	0.17	0	0.145195867	0.17	0.17	0.17	0	0.093152514	0.17	0.17	0.164666683	0.029855666	0.17	0.17	0	0	0	0	0	0	0	0											781.215068	425.2445502	57.21907723	0	0.155599733	0	0.149266319	0.11604709	0.17	0	0.145195867	0.17	0.17	0.17	0	0.093152514	0.17	0.17	0.164666683	0.029855666	0.17	0.17	0	0	0	0	0	0	0	0											19.3308	2.109284527	4.12616928	0	1.829577657	0	0.839957312	2.816540107	3.390513366	0	1.581201854	0.176494563	0.005232324	0.780481093	0	10.7924972	2.200172759	3.165126884	6.900295347	0.216671188	4.487880379	0.038719113	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.7876	0	0	19.3308	2.109284527	4.12616928	0	1.829577657	0	0.839957312	2.816540107	3.390513366	0	1.581201854	0.176494563	0.005232324	0.780481093	0	10.7924972	2.200172759	3.165126884	6.900295347	0.216671188	4.487880379	0.038719113	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.7876	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.3308	2.109284527	4.12616928	0	1.829577657	0	0.839957312	2.816540107	3.390513366	0	1.581201854	0.176494563	0.005232324	0.780481093	0	10.7924972	2.200172759	3.165126884	6.900295347	0.216671188	4.487880379	0.038719113	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.7876
H1032_130_0	2009	7																																A	A	D	V	Coin	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	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	0	0	0											0		364.9050579	86.65353823	1152.243293	2387.266259	11.01713689	1905.641761	5.146593582	26.29166147	13.14551641	5655.47754	20.34977468	2.345649148	0.874487473	4.798409121	9689.568563	91.51189489	5.554145984	5.685072717	27.21930292	6.687978411	18.6632701	0.083612182	2340	829.8	252	201.6	25.2	13.44	3248	6735.384615											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	$0.00 copayment	"$0.00 copayment, $1,000 benefit limit"	$0.00 copayment	"$0.00 copayment, $75 benefit limit,"	$0.00 copayment	"$0.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											693.9175553	358.7044533	60.98605176	0	0.164318439	0	0.130463669	0.100233225	0.17	0	0.110365476	0.17	0.17	0.17	0	0.087675284	0.17	0.17	0.142876891	0.021540705	0.17	0.17	0	0	0	0	0	0	0	0											693.9175553	358.7044533	60.98605176	0	0.164318439	0	0.130463669	0.100233225	0.17	0	0.110365476	0.17	0.17	0.17	0	0.087675284	0.17	0.17	0.142876891	0.021540705	0.17	0.17	0	0	0	0	0	0	0	0											21.1012	2.590250838	5.855897424	0	1.810318732	0	0.671443484	2.635298018	2.234737789	0	2.245912574	0.398760355	0.14866287	0.815729551	0	8.023331338	0.944204817	0.966462362	3.889009373	0.144063767	3.172755918	0.014214071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.6622	0	0	21.1012	2.590250838	5.855897424	0	1.810318732	0	0.671443484	2.635298018	2.234737789	0	2.245912574	0.398760355	0.14866287	0.815729551	0	8.023331338	0.944204817	0.966462362	3.889009373	0.144063767	3.172755918	0.014214071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.6622	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.1012	2.590250838	5.855897424	0	1.810318732	0	0.671443484	2.635298018	2.234737789	0	2.245912574	0.398760355	0.14866287	0.815729551	0	8.023331338	0.944204817	0.966462362	3.889009373	0.144063767	3.172755918	0.014214071	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.6622
H1032_131_0	2009	6																					3000											D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		781.1510371	59.28041222	240.303579	870.0557482	238.5870517	1555.181168	3.839001197	764.8914277	135.5198703	2335.950949	582.4351394	103.2434228	0.021923057	318.9491005	6148.558327	17121.82209	416.1043667	2251.106065	3620.185969	2146.213402	23.98228196	44.16379208	0	162.8571429	304	237.1855133	32.8	13.57241379	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, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $35.00	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $0.00 and $75.00	Copay between $0.00 and $75.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	Not Covered	Not Covered											166.5671045	101.5645223	56.13	6.110499422	46.43505156	0	0.2	21.14745649	105.1497384	0	25.15832675	65.62306262	0.2	10.89699461	4.899428617	9.105308016	27.35530227	14.39743107	22.91118628	5.818555373	0.2	0	0	0	10	9.479452237	10	10	0	0											156.8448916	95.63638955	52.85379602	5.753840906	43.72472374	0	0.188326371	19.91311869	99.01234324	0	23.68988189	61.79276619	0.188326371	10.26095725	4.613458057	8.573848078	25.75862402	13.55707972	21.57390284	5.47893709	0.188326371	0	0	0	10	9.479452237	10	10	0	0											10.21	0.47244705	1.058413029	0.417180196	0.869346077	0	0.722985164	1.269281149	1.118178326	0	1.149818305	0.531641391	0.00412869	0.272726924	2.363842996	12.23332512	0.893189661	2.543202032	6.508461695	0.979914017	4.51649613	0	0	0	0.253333333	0.187365729	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	48.6139	0	2.9837	10.21	0.47244705	1.058413029	0.417180196	0.869346077	0	0.722985164	1.269281149	1.118178326	0	1.149818305	0.531641391	0.00412869	0.272726924	2.363842996	12.23332512	0.893189661	2.543202032	6.508461695	0.979914017	4.51649613	0	0	0	0.253333333	0.187365729	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	48.6139	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											3.4588	0.0828	0.0944	0.2363	0.1011	0.3923	0.0938	0	0.2945	0.0617	0.2174	0.0433	0	0.1307	0.129	2.2753	0.0751	0.1836	0.8245	0.3357	0.57	0.0199	0	0	0	0	0	0	0	0											9.6204	0	0	13.6688	0.555278884	1.152839773	0.653502091	0.970464155	0.392317972	0.816827415	1.269281149	1.4126689	0.06171083	1.36723676	0.574943922	0.00412869	0.403422712	2.492827739	14.50862383	0.968323367	2.726785947	7.332952638	1.315621564	5.086487641	0.019930896	0	0	0.253333333	0.187365729	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	58.2343
H1032_132_0	2009	6																					0											A	A	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		289.5262693	16.19963244	807.8359476	721.5120658	305.0066224	1189.92762	5.432868102	1121.912097	224.5752292	2727.90594	956.1958644	87.70752187	0.134981054	311.7428731	12321.12251	18941.631	131.8126599	332.4163866	5145.056939	899.6360132	14.25613983	16.64245513	0	162.8571429	305.4035157	210.4615385	32.8	13.57241379	1664	7480											"$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	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $25.00	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											0	0	33.02	1.1569105	48.17620752	0	0.100338604	10.66335898	0	0	4.386179099	0	0.2	5.430679979	0	4.271164247	20.14694965	9.94525806	7.010230069	2.306003234	0.2	0	0	0	9.975640961	10	10	10	0	0											0	0	33.02	1.1569105	48.17620752	0	0.100338604	10.66335898	0	0	4.386179099	0	0.2	5.430679979	0	4.271164247	20.14694965	9.94525806	7.010230069	2.306003234	0.2	0	0	0	9.975640961	10	10	10	0	0											0	0	2.222895249	0.069560407	1.224505195	0	0.5451264	0.996945953	0	0	0.34950386	0	0.026996211	0.141081315	0	6.741901425	0.221301919	0.275497229	3.005669405	0.172880296	2.851227967	0	0	0	0.253882985	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	19.313	0	0	0	0	2.222895249	0.069560407	1.224505195	0	0.5451264	0.996945953	0	0	0.34950386	0	0.026996211	0.141081315	0	6.741901425	0.221301919	0.275497229	3.005669405	0.172880296	2.851227967	0	0	0	0.253882985	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	19.313	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											6.0225	0.1176	0.2481	0.0681	0.1348	0.1757	0.1299	0	0.2712	0.1719	0.5324	0.0376	0	0.1027	0.184	2.0775	0.0189	0.0279	0.8313	0.2095	0.3014	0.0033	0	0	0	0	0	0	0	0											11.6663	0	0	6.0225	0.11761248	2.470983076	0.137655363	1.359312585	0.17573951	0.675026732	0.996945953	0.271158071	0.171863758	0.881921793	0.037557304	0.026996211	0.243742288	0.184027474	8.819444051	0.240190492	0.303412532	3.836960892	0.382389001	3.15267059	0.003285205	0	0	0.253882985	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	30.9794
H1032_133_0	2009	6																					3000											D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		1407.171809	64.44674345	380.1980309	898.6976133	338.4382021	1174.416351	5.873402546	1174.145386	249.8491695	3083.973407	886.7652148	38.06621693	0.08992057	180.1358618	14652.08925	22309.25805	350.4375819	1254.369417	5540.786097	1465.064328	20.53395167	40.4674246	0	162.8571429	306.2463432	211.5847101	32.8	13.57241379	1664	7480											"$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	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $20.00	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											36.85134867	58.51361723	33.02	1.584680124	48.06307424	0	0.112792018	12.78645496	25.83695279	0	4.625163397	19.68691878	0.2	5.380006139	0	4.036945664	16.21860486	8.162713728	8.705669366	3.627317256	0.2	0	0	0	9.961120371	9.975474971	10	10	0	0											36.28108935	57.60814329	32.50902921	1.560157857	47.31931812	0	0.111046609	12.58858988	25.43713667	0	4.553590913	19.38227189	0.196905083	5.296752777	0	3.974475605	15.96762868	8.036399121	8.570952746	3.571186027	0.196905083	0	0	0	9.961120371	9.975474971	10	10	0	0											4.2545	0.309388103	1.029989074	0.116842512	1.334555412	0	0.652221434	1.231736227	0.529620623	0	0.336497169	0.061484147	0.017705817	0.079511261	0	7.388966825	0.466304765	0.840051107	3.957484651	0.436001438	4.043239457	0	0	0	0.254213057	0.175888165	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	27.5548	0	0.4257	4.2545	0.309388103	1.029989074	0.116842512	1.334555412	0	0.652221434	1.231736227	0.529620623	0	0.336497169	0.061484147	0.017705817	0.079511261	0	7.388966825	0.466304765	0.840051107	3.957484651	0.436001438	4.043239457	0	0	0	0.254213057	0.175888165	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	27.5548	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											3.8702	0.1172	0.1251	0.1424	0.1539	0.2367	0.142	0	0.5557	0.0913	0.3124	0.0132	0	0.0649	0.1963	2.6016	0.0547	0.1053	1.1806	0.2857	0.3837	0.0107	0	0	0	0	0	0	0	0											10.6436	0	0	8.1246	0.426587871	1.155098181	0.259273585	1.488435598	0.236719745	0.794263674	1.231736227	1.085326444	0.091258933	0.648852495	0.074641968	0.017705817	0.144447075	0.196330393	9.990601698	0.521024715	0.945304161	5.138122007	0.721683895	4.426896163	0.010703724	0	0	0.254213057	0.175888165	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	38.1984
H1032_136_0	2009	7																																A	A	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		298.5005289	107.4243955	1128.241629	2061.329488	985.1903224	2329.397498	5.521693303	2210.233344	242.0104158	5741.569071	923.0141943	79.06208371	0.01977479	424.0894907	8218.002494	21006.23982	3475.129659	3401.536877	4528.589603	1275.351906	20.45092649	36.91527146	2340	395.3333333	338.0116319	268.2813128	32.8	13.57241379	3248	6800											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											0	0	0	0	30.67170597	0	0.163421409	17.91351976	0	0	5.473382704	0	0.2	0	0	0	0	0	8.233886744	3.083228326	0.2	0	0	0	9.466649469	9.004288187	10	10	0	0											0	0	0	0	30.67170597	0	0.163421409	17.91351976	0	0	5.473382704	0	0.2	0	0	0	0	0	8.233886744	3.083228326	0.2	0	0	0	9.466649469	9.004288187	10	10	0	0											0	0	0	0	2.518122324	0	0.902362898	3.299421557	0	0	0.421000827	0	0.003954958	0	0	0	0	0	3.107324491	0.327683427	4.090185297	0	0	0	0.266653136	0.201306855	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	15.1767	0	0	0	0	0	0	2.518122324	0	0.902362898	3.299421557	0	0	0.421000827	0	0.003954958	0	0	0	0	0	3.107324491	0.327683427	4.090185297	0	0	0	0.266653136	0.201306855	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	15.1767	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											4.8478	1.2207	0.3761	0.526	0.2978	0.5717	0.1339	0	0.416	0.2107	0.4051	0.0513	0	0.1806	0.2657	2.5021	0.7112	0.3209	0.7267	0.2172	0.484	0.008	0	0	0	0	0	0	0	0											14.4734	0	0	4.8478	1.220688477	0.376055592	0.52601659	2.815881465	0.571658969	1.036286484	3.299421557	0.416007691	0.210672081	0.826112957	0.05130161	0.003954958	0.180594721	0.265723605	2.50205792	0.711222786	0.320865418	3.833976385	0.544905695	4.574198704	0.008020961	0	0	0.266653136	0.201306855	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	29.6501
H1032_138_0	2009	7																																A	A	D	V	Coin	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	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	0	0	0											0		351.8226377	111.1611106	1020.030391	2075.366675	12.3546319	2170.851635	6.12329161	24.18866342	16.13058678	5776.475132	18.08267605	2.041340909	0.016277189	6.732015048	7291.574972	108.2009909	27.57635421	10.35617506	31.03177805	8.840002215	29.58873313	0.277236178	2340	829.8	293.8241499	276.2859819	25.2	13.44	3248	8942.857143											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	$0.00 copayment	"$0.00 copayment, $1,000 benefit limit"	$0.00 copayment	"$0.00 copayment, $75 benefit limit,"	$0.00 copayment	"$0.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											701.918106	468.3080347	58.06231947	0	0.156034862	0	0.128016613	0.10735778	0.17	0	0.12097459	0.17	0.17	0.17	0	0.089562475	0.17	0.17	0.156185847	0.025593951	0.17	0.17	0	0	0	0	0	0	0	0											701.918106	468.3080347	58.06231947	0	0.156034862	0	0.128016613	0.10735778	0.17	0	0.12097459	0.17	0.17	0.17	0	0.089562475	0.17	0.17	0.156185847	0.025593951	0.17	0.17	0	0	0	0	0	0	0	0											20.5792	4.338136771	4.935444203	0	1.927753287	0	0.78388305	2.596841216	2.742199753	0	2.18754432	0.347027955	0.002767122	1.144442558	0	9.690748524	4.687980215	1.76054976	4.846724527	0.226250587	5.030084632	0.04713015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.8747	0	0	20.5792	4.338136771	4.935444203	0	1.927753287	0	0.78388305	2.596841216	2.742199753	0	2.18754432	0.347027955	0.002767122	1.144442558	0	9.690748524	4.687980215	1.76054976	4.846724527	0.226250587	5.030084632	0.04713015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.8747	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.5792	4.338136771	4.935444203	0	1.927753287	0	0.78388305	2.596841216	2.742199753	0	2.18754432	0.347027955	0.002767122	1.144442558	0	9.690748524	4.687980215	1.76054976	4.846724527	0.226250587	5.030084632	0.04713015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.8747
H1032_144_0	2009	6																					2000											D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		970.7813581	83.38828372	477.5778025	1173.065595	285.9804728	1853.822726	6.008914446	1225.685538	209.7806266	4244.811783	1010.525725	63.63973387	0.019131467	444.1289827	9974.594838	25142.32275	299.3949709	4121.63339	5615.495014	2785.39002	35.64545236	66.49132579	0	162.8571429	304	210.4615385	32.8	13.57241379	1664	7480											"$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	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $15.00	Copay between $5.00 and $15.00	$15.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											104.419981	53.31889792	33.02	3.094794054	38.65740495	0	0.2	21.99329511	65.78578175	0	15.15103183	39.37383757	0.2	6.546341415	0	3.939026936	11.73139806	6.029699982	12.80777052	5.081505457	0.2	0	0	0	10	10	10	10	0	0											94.98844657	48.50297079	30.03753186	2.81526272	35.16574903	0	0.181935384	20.00679293	59.84380725	0	13.78254396	35.81747125	0.181935384	5.955055689	0	3.583241887	10.67178204	5.485078902	11.65093322	4.622528228	0.181935384	0	0	0	10	10	10	10	0	0											7.6844	0.337048291	1.195438205	0.27520732	0.838059795	0	1.093234156	2.043503063	1.046172615	0	1.160634602	0.189951195	0.003480691	0.220401069	0	7.507585335	0.26625649	1.883957029	5.452146452	1.072961999	6.485169056	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	39.223	0	3.8481	7.6844	0.337048291	1.195438205	0.27520732	0.838059795	0	1.093234156	2.043503063	1.046172615	0	1.160634602	0.189951195	0.003480691	0.220401069	0	7.507585335	0.26625649	1.883957029	5.452146452	1.072961999	6.485169056	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	39.223	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											4.6164	0.1027	0.1982	0.3739	0.1061	0.5143	0.1469	0	0.4475	0.1047	0.4002	0.0377	0	0.1962	0.2036	3.2436	0.0563	0.3573	1.1789	0.475	0.8146	0.0206	0	0	0	0	0	0	0	0											13.5947	0	0	12.3009	0.439788665	1.393625191	0.649071312	0.944160934	0.514342996	1.240118731	2.043503063	1.493643108	0.104726208	1.56082356	0.227603103	0.003480691	0.416594546	0.203609555	10.75119569	0.322583801	2.24128844	6.63102923	1.547999924	7.299731911	0.020595947	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	52.8177
H1032_145_0	2009	6																					3200											D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		1340.382581	65.90432207	386.269614	1142.346042	265.0878678	2457.19433	5.267074241	1495.029466	225.0702543	5521.429186	1105.353352	66.87952649	0.015308742	383.8846593	9662.842408	17406.42237	347.7023552	2699.537663	4053.365744	2172.013237	22.7704886	42.87493791	0	0	304	210.4615385	32.8	13.57241379	0	8200											"$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	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $30.00	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $0.00 and $75.00	Copay between $0.00 and $75.00	20% coinsurance	$0.00 copayment	Not Covered	Not Covered	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	Not Covered	$0.00 copayment											118.6499168	67.09030031	56.13	5.893237058	48.1535919	0	0.2	21.7972418	100.4022386	0	24.99104704	52.49845009	0.2	8.679915675	2.078714084	8.645072637	21.81402598	12.2453454	22.16028006	5.977188763	0.2	0	0	0	10	10	10	10	0	0											111.227967	62.89357726	52.61888045	5.524595336	45.14142339	0	0.18748933	20.4337513	94.12174223	0	23.42777332	49.21449615	0.18748933	8.136957869	1.948683554	8.10429438	20.44948557	11.47935802	20.7740803	5.60329558	0.18748933	0	0	0	10	10	10	10	0	0											12.424	0.345413214	1.69375622	0.525916635	0.99720364	0	0.98752022	2.545755024	1.765333705	0	2.157997313	0.27428685	0.002870226	0.260304442	1.56915184	11.75556425	0.592527858	2.582413276	7.017078789	1.014202681	4.269223651	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	53.2479	0	3.5219	12.424	0.345413214	1.69375622	0.525916635	0.99720364	0	0.98752022	2.545755024	1.765333705	0	2.157997313	0.27428685	0.002870226	0.260304442	1.56915184	11.75556425	0.592527858	2.582413276	7.017078789	1.014202681	4.269223651	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	53.2479	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											5.5233	0.0775	0.1299	0.3359	0.1702	0.5729	0.1308	0	0.4313	0.1405	0.4127	0.0176	0	0.1771	0.2183	2.8743	0.0783	0.2389	0.7377	0.4073	0.5126	0.0174	0	0	0	0	0	0	0	0											13.2046	0	0	17.9473	0.4229508	1.823628243	0.861823936	1.167369209	0.572949804	1.118347548	2.545755024	2.196660451	0.140540407	2.570714644	0.291902981	0.002870226	0.437382507	1.787440971	14.62985053	0.670823637	2.821312584	7.754819244	1.421454466	4.781786228	0.017419988	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	66.4524
H1032_146_0	2009	6																					3250											D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		1012.097851	35.39817605	545.4787786	1126.288556	266.9718395	1775.096261	6.216187276	1526.515182	139.9622067	3422.441659	678.2681099	68.65548282	0.01381899	308.2081352	10043.07372	21873.86263	266.937282	3171.831628	5621.594005	2368.298122	32.2850797	45.15866033	0	0	304	210.4615385	32.8	13.57241379	0	8200											"$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 $30.00	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $30.00	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	Not Covered	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	Not Covered	$0.00 copayment											68.40436361	42.74864429	56.13	6.072429532	41.45768078	0	0.2	21.54921718	53.27789967	0	12.6162406	26.24922505	0.2	7.059519704	1.878764064	7.86097533	23.05355017	11.84882974	16.0037457	4.936663208	0.2	0	0	0	10	10	10	10	0	0											65.20013579	40.74619316	53.50073341	5.78798207	39.51570154	0	0.19063151	20.5397991	50.78223245	0	12.02526501	25.0196471	0.19063151	6.728834522	1.790758157	7.492748005	21.97366545	11.29380155	15.25409108	4.70541782	0.19063151	0	0	0	10	10	10	10	0	0											5.4991	0.120195077	2.43195956	0.543244831	0.879131627	0	1.18500117	2.612859597	0.592299443	0	0.679696147	0.143144663	0.002634335	0.172823462	1.498726349	13.65794505	0.488799211	2.985169747	7.146025583	0.928652682	6.15455351	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	48.1893	0	2.3453	5.4991	0.120195077	2.43195956	0.543244831	0.879131627	0	1.18500117	2.612859597	0.592299443	0	0.679696147	0.143144663	0.002634335	0.172823462	1.498726349	13.65794505	0.488799211	2.985169747	7.146025583	0.928652682	6.15455351	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	48.1893	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											4.2776	0.0569	0.2257	0.3682	0.1169	0.4546	0.152	0	0.3574	0.087	0.244	0.0213	0	0.153	0.233	3.1271	0.0522	0.266	1.4096	0.4369	0.7602	0.016	0	0	0	0	0	0	0	0											12.8156	0	0	9.7767	0.177077158	2.657670474	0.911410107	0.996050699	0.454638878	1.336952414	2.612859597	0.949684587	0.087028523	0.923742009	0.164417566	0.002634335	0.32579307	1.731738586	16.78508423	0.540954506	3.251129564	8.555613333	1.365565277	6.914762389	0.015976552	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	61.0049
H1032_148_0	2009	7																																A	A	D	V	Coin	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	T	V	V	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	0	0	0											0		335.8747607	29.31876925	1216.916809	2723.027844	14.30624043	3506.810886	9.994214814	24.95460251	13.02593282	4640.873833	14.81137775	1.885230433	0.07386884	9.45718647	8027.535023	22634.53355	919.6274072	5963.074723	5993.032659	1544.771457	18.55285699	0.371686545	2340	829.8	252	201.6	20.4	15.54285714	3248	6200											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	"$0.00 copayment, Coin between 20% and 50%"	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	"$0.00 copayment, $1,000 benefit limit"	$0.00 copayment	"$0.00 copayment, $75 benefit limit,"	$0.00 copayment	"$0.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											755.2122999	380.1017874	63.66540566	0	0.155858561	0	0.17	0.13000723	0.17	0	0.169945224	0.17	0.17	0.122098719	0	0.885464838	0	0	0.681379422	0.239984713	0.17	0.17	0	0	0	0	0	0	0	0											755.2122999	380.1017874	63.66540566	0	0.155858561	0	0.17	0.13000723	0.17	0	0.169945224	0.17	0.17	0.122098719	0	0.885464838	0	0	0.681379422	0.239984713	0.17	0.17	0	0	0	0	0	0	0	0											21.1381	0.928676383	6.456291858	0	2.229750048	0	1.699016518	3.244278742	2.21440858	0	2.51712291	0.320489174	0.012557703	1.154710352	0	1.670173632	0	0	0.340294094	0.030893461	3.153985688	0.063186713	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1739	0	0	21.1381	0.928676383	6.456291858	0	2.229750048	0	1.699016518	3.244278742	2.21440858	0	2.51712291	0.320489174	0.012557703	1.154710352	0	1.670173632	0	0	0.340294094	0.030893461	3.153985688	0.063186713	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1739	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.1381	0.928676383	6.456291858	0	2.229750048	0	1.699016518	3.244278742	2.21440858	0	2.51712291	0.320489174	0.012557703	1.154710352	0	1.670173632	0	0	0.340294094	0.030893461	3.153985688	0.063186713	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1739
H1032_152_0	2009	8																					0											D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		1607.559201	177.7431224	1197.088227	2312.811811	1369.403896	3731.817887	9.229781619	2941.841594	149.967149	4247.444595	922.0165556	62.25225727	0.073274928	405.653507	8591.298183	21886.41156	906.8026095	6094.999905	5603.071804	1639.11795	17.37989661	42.70191576	0	829.8	304	210.4615385	32.8	13.57241379	3248	6200											"$135 days 1 - 5, $0 after day 5, unlimited coverage"	"$135 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $75 days 8 - 100"	Copay between $0.00 and $10.00	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $10.00	Copay between $5.00 and $10.00	$10.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, $1,000 benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											79.51698361	66.70307758	51.96	1.633541192	20.73119189	0	0.2	22.25066139	65.71877505	0	14.54207825	35.43645381	0.2	3.289715881	0	1.939211941	8.053673566	3.729717156	13.0284828	3.895964793	0.2	0	0	0	10	10	10	10	0	0											79.51698361	66.70307758	51.96	1.633541192	20.73119189	0	0.2	22.25066139	65.71877505	0	14.54207825	35.43645381	0.2	3.289715881	0	1.939211941	8.053673566	3.729717156	13.0284828	3.895964793	0.2	0	0	0	10	10	10	10	0	0											10.6524	0.988001107	5.183392022	0.314839447	2.365781244	0	1.845956324	5.454826765	0.821304777	0	1.117336408	0.18383327	0.014654986	0.111207065	0	3.536865888	0.608591017	1.894385476	6.083293719	0.532162152	3.475979323	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	45.6521	0	0	10.6524	0.988001107	5.183392022	0.314839447	2.365781244	0	1.845956324	5.454826765	0.821304777	0	1.117336408	0.18383327	0.014654986	0.111207065	0	3.536865888	0.608591017	1.894385476	6.083293719	0.532162152	3.475979323	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	45.6521	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											5.4754	0.2403	0.4214	0.6456	0.3217	1.166	0.2256	0	0.298	0.1064	0.3353	0.0418	0	0.2345	0.3349	2.6401	0.1524	0.5979	1.0239	0.2892	0.4153	0.0085	0	0	0	0	0	0	0	0											14.9743	0	0	16.1278	1.228323148	5.604817431	0.960448347	2.687527856	1.166040232	2.071573208	5.454826765	1.119258865	0.106351203	1.452674946	0.225648467	0.014654986	0.345749263	0.334882239	6.176977044	0.760963331	2.492285986	7.107174605	0.821361859	3.89125039	0.008518884	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	60.6265
H1032_153_0	2009	7																					3200											D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		1702.952231	295.5838857	1119.55104	2223.377389	1031.563182	3781.96952	6.734093814	3112.497027	158.8721596	7221.294943	1174.581325	152.9679776	0.293037437	350.6919205	7337.176735	16467.96602	766.5929064	3423.766864	3853.669881	1738.602932	16.40734782	51.55619382	0	653.3333333	304	210.4615385	32.8	13.57241379	0	6800											"$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	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $25.00	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, $1,000 benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	Not Covered	$0.00 copayment											82.63551872	50.68894995	34.64	3.440776041	33.02702073	0	0.2	22.13658385	64.5088317	0	12.18061187	39.37383757	0.2	5.295021731	0	5.181374402	18.78701056	9.658958745	15.52509743	4.655234617	0.2	0	0	0	10	10	10	10	0	0											78.70361938	48.27710754	32.99178631	3.277059697	31.45555457	0	0.190483755	21.08329804	61.43942236	0	11.60104342	37.50038208	0.190483755	5.043078103	0	4.934838253	17.89310155	9.199373641	14.78639425	4.433732844	0.190483755	0	0	0	10	10	10	10	0	0											11.169	1.189161253	3.077999057	0.607178369	2.704032665	0	1.282735474	5.468475207	0.813417809	0	1.135530746	0.4780298	0.055818871	0.147380562	0	6.772229055	1.143060394	2.62470922	4.74849018	0.642375077	3.125333217	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	47.6524	0	2.3573	11.169	1.189161253	3.077999057	0.607178369	2.704032665	0	1.282735474	5.468475207	0.813417809	0	1.135530746	0.4780298	0.055818871	0.147380562	0	6.772229055	1.143060394	2.62470922	4.74849018	0.642375077	3.125333217	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	47.6524	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											5.9552	0.3944	0.4033	0.5852	0.4496	1.0015	0.1646	0	0.2763	0.1662	0.3373	0.0357	0	0.1496	0.2669	2.0622	0.1401	0.3307	0.6855	0.2738	0.3944	0.016	0	0	0	0	0	0	0	0											14.0885	0	0	17.1242	1.583586277	3.481254654	1.192396481	3.153593734	1.001502396	1.447346656	5.468475207	1.089689023	0.166180249	1.472813102	0.513775612	0.055818871	0.296958545	0.266876328	8.834396009	1.283175876	2.955439197	5.433953722	0.916213687	3.519771694	0.016048027	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	61.7408
H1032_162_0	2009	6																																A	A	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		301.2828609	46.43930249	1222.568625	4679.883597	1388.32737	3205.93119	6.294763525	2539.719396	146.8225092	5082.636052	863.6190775	125.6437885	0.047336006	293.0349809	7651.694343	22051.94347	1456.958996	4888.372177	4724.096864	1582.527378	21.49810059	29.91297415	2340	162.8571429	304	210.4615385	32.8	13.57241379	1664	6200											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											0	0	0	0	26.85518231	0	0.2	21.07564496	0	0	7.196609246	0	0.2	0	0	0	0	0	9.837264324	4.211025481	0.2	0	0	0	10	10	10	10	0	0											0	0	0	0	26.85518231	0	0.2	21.07564496	0	0	7.196609246	0	0.2	0	0	0	0	0	9.837264324	4.211025481	0.2	0	0	0	10	10	10	10	0	0											0	0	0	0	3.106982052	0	1.258952705	4.460518691	0	0	0.51792742	0	0.009467201	0	0	0	0	0	3.872682462	0.555338593	4.299620118	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	18.5489	0	0	0	0	0	0	3.106982052	0	1.258952705	4.460518691	0	0	0.51792742	0	0.009467201	0	0	0	0	0	3.872682462	0.555338593	4.299620118	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	18.5489	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											5.8865	0.5014	0.4505	1.0908	0.3068	0.818	0.1539	0	0.3193	0.1206	0.283	0.048	0	0.1245	0.354	2.713	0.2618	0.4543	0.792	0.2616	0.4443	0.0064	0	0	0	0	0	0	0	0											15.3907	0	0	5.8865	0.501380204	0.450491799	1.090838175	3.413743556	0.817962851	1.412824702	4.460518691	0.319324999	0.120589163	0.800971491	0.047963071	0.009467201	0.124505525	0.353990471	2.713041307	0.261759606	0.454341506	4.664682857	0.816936104	4.743956374	0.006419409	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	33.9396
H1032_163_0	2009	8																																A	A	D	V	T	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	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	0	0	0											0		241.5149551	65.2459477	367.1873908	31450.30169	1035.888324	6764.032122	13.29792048	10.47326651	9.628429567	2937.173534	7.986880622	0.289810198	0.169469793	3.02140284	9370.684359	136.6937699	87.2236763	96.28661029	44.42345187	15.83332943	255.4256955	0.126862015	2340	829.8	252	201.6	20.4	15.54285714	3248	9145.454545											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	$0.00 copayment	$0.00 copayment	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	$0.00 copayment	"$0.00 copayment, $1,000 benefit limit"	$0.00 copayment	"$0.00 copayment, $75 benefit limit,"	$0.00 copayment	"$0.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											723.638413	456.3488722	61.66983685	0	0	0	0.17	0.124680937	0.17	0	0.17	0.17	0.17	0.17	0	0.105723824	0.17	0.17	0.156422779	0.009937043	0.17	0.17	0	0	0	0	0	0	0	0											723.638413	456.3488722	61.66983685	0	0	0	0.17	0.124680937	0.17	0	0.17	0.17	0.17	0.17	0	0.105723824	0.17	0.17	0.156422779	0.009937043	0.17	0.17	0	0	0	0	0	0	0	0											14.5641	2.481242887	1.887032207	0	0	0	2.260646482	1.305816684	1.636833026	0	1.357769706	0.049267734	0.028809865	0.513638483	0	14.45178808	14.82802497	16.36872375	6.948839788	0.157336482	43.42236824	0.021566543	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.2838	0	0	14.5641	2.481242887	1.887032207	0	0	0	2.260646482	1.305816684	1.636833026	0	1.357769706	0.049267734	0.028809865	0.513638483	0	14.45178808	14.82802497	16.36872375	6.948839788	0.157336482	43.42236824	0.021566543	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.2838	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.5641	2.481242887	1.887032207	0	0	0	2.260646482	1.305816684	1.636833026	0	1.357769706	0.049267734	0.028809865	0.513638483	0	14.45178808	14.82802497	16.36872375	6.948839788	0.157336482	43.42236824	0.021566543	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.2838
H1032_164_0	2009	6																					3200											D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		1149.538388	55.58954384	459.0683045	1745.687447	316.0806566	1709.436517	5.066954952	988.4629006	186.1797528	3269.648627	803.401558	136.1660946	0.033506616	406.569624	9439.827309	24288.95319	412.8148331	3293.519	5120.658115	2751.467058	32.34834482	61.72483217	0	162.8571429	304	210.4615385	32.8	13.57241379	1664	7480											"$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 $25.00	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $25.00	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											63.9182451	41.57099742	56.13	4.48072859	44.73754655	0	0.2	20.85690279	52.60212754	0	13.02849994	26.24922505	0.2	6.375297632	0	6.489969029	19.33857542	10.20690288	15.60919949	4.934312341	0.2	0	0	0	10	10	10	10	0	0											61.32278601	39.88296886	53.85078976	4.298784488	42.92093735	0	0.191878816	20.00998908	50.46616981	0	12.49946573	25.18335114	0.191878816	6.116422812	0	6.226437872	18.55331479	9.792442202	14.97537359	4.733950053	0.191878816	0	0	0	10	10	10	10	0	0											5.8744	0.184756337	2.060099229	0.625361177	1.130539839	0	0.972241318	1.648260987	0.782981585	0	0.836840853	0.285759881	0.00642921	0.20722931	0	12.60280483	0.638256963	2.687632871	6.390314027	1.085442302	6.20696211	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	44.6937	0	1.8719	5.8744	0.184756337	2.060099229	0.625361177	1.130539839	0	0.972241318	1.648260987	0.782981585	0	0.836840853	0.285759881	0.00642921	0.20722931	0	12.60280483	0.638256963	2.687632871	6.390314027	1.085442302	6.20696211	0	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	44.6937	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											4.7164	0.0788	0.1835	0.5242	0.1256	0.4193	0.1239	0	0.4086	0.0867	0.3049	0.0509	0	0.163	0.1977	3.2547	0.0773	0.2783	1.1312	0.4501	0.7718	0.0373	0	0	0	0	0	0	0	0											13.3842	0	0	10.5908	0.263566926	2.243618111	1.149554773	1.256090342	0.419307621	1.096100217	1.648260987	1.191549315	0.086730415	1.141787506	0.336672364	0.00642921	0.370208908	0.197656741	15.85748475	0.715576569	2.965907017	7.521533469	1.535565926	6.97880173	0.03730268	0	0	0.253333333	0.175384615	0.027333333	0.011310345	0	0	0	0	0	0	0	0	0	0	0	0	58.0778
H1032_166_0	2009	8																					0											A	A	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		239.209744	9.120185297	554.7089235	1599.625152	311.9253201	1488.141766	4.309187441	918.2605687	218.6530241	5546.475449	1124.968471	101.8535215	0.058845402	484.2890051	8572.97369	26645.82106	516.9880104	4175.757272	4796.332428	3110.144765	41.75487475	54.50345601	0	162.8571429	304	210.4615385	26.4	15.84	0	8200											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	Not Covered	$0.00 copayment											0	0	0	0	43.2285787	0	0.2	20.91772325	0	0	6.845299774	0	0.2	0	0	0	0	0	9.11927778	5.045522787	0.2	0	0	0	10	10	10	10	0	0											0	0	0	0	43.2285787	0	0.2	20.91772325	0	0	6.845299774	0	0.2	0	0	0	0	0	9.11927778	5.045522787	0.2	0	0	0	10	10	10	10	0	0											0	0	0	0	1.123674021	0	0.861837488	1.600660037	0	0	0.641728868	0	0.01176908	0	0	0	0	0	3.644923978	1.30769219	8.35097495	0	0	0	0.253333333	0.175384615	0.022	0.0132	0	0	0	0	0	0	0	0	0	0	0	0	18.0072	0	0	0	0	0	0	1.123674021	0	0.861837488	1.600660037	0	0	0.641728868	0	0.01176908	0	0	0	0	0	3.644923978	1.30769219	8.35097495	0	0	0	0.253333333	0.175384615	0.022	0.0132	0	0	0	0	0	0	0	0	0	0	0	0	18.0072	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											4.5029	0.0958	0.2061	0.5245	0.119	0.372	0.1053	0	0.4476	0.1419	0.4003	0.0302	0	0.1574	0.2089	3.6279	0.0916	0.3235	1.0192	0.5181	0.9999	0.0195	0	0	0	0	0	0	0	0											13.9116	0	0	4.5029	0.095773565	0.206118294	0.524455683	1.242692729	0.371961204	0.967173181	1.600660037	0.447597898	0.141940487	1.0419994	0.030191973	0.01176908	0.157380567	0.208918725	3.627873031	0.09160289	0.323547522	4.664129057	1.825753227	9.350912881	0.01948066	0	0	0.253333333	0.175384615	0.022	0.0132	0	0	0	0	0	0	0	0	0	0	0	0	31.9187
H1032_168_0	2009	8																					0											D	D	D	V	T	P	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	0											0		2007.212655	78.11563773	671.5575007	1309.789201	416.2231004	1814.982105	7.34470968	1011.198872	239.2824349	3506.921299	920.0181371	58.88345291	1.039039556	292.7383559	11101.89758	21070.95038	291.6507318	1480.465517	5352.666511	1688.794005	28.35800733	17.21750035	0	162.8571429	304	210.4615385	25.2	13.44	1664	8200											"$200 days 1 - 5, $0 after day 5, unlimited coverage"	"$200 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $75 days 8 - 100"	Copay between $0.00 and $30.00	Copay between $0.00 and $100.00	$0.00 copayment	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $30.00	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $0.00 and $75.00	Copay between $0.00 and $75.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$0.00 copayment	"$0.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											86.63418076	101.1461238	49.53	3.632616503	46.4554236	0	0.144270478	15.34141619	96.55890824	0	22.45902184	52.49845009	0.2	13.10681558	4.611602038	6.760993075	22.7920768	11.78305498	15.68687993	7.885166134	0.2	0	0	0	10	10	0	0	0	0											86.63418076	101.1461238	49.53	3.632616503	46.4554236	0	0.144270478	15.34141619	96.55890824	0	22.45902184	52.49845009	0.2	13.10681558	4.611602038	6.760993075	22.7920768	11.78305498	15.68687993	7.885166134	0.2	0	0	0	10	10	0	0	0	0											14.4911	0.658424497	2.771853584	0.396496822	1.61131837	0	1.059624776	1.292768562	1.925404223	0	1.721892286	0.257607501	0.207807911	0.31973897	4.266461126	11.87171247	0.553943823	1.453700549	6.997219738	1.109701775	5.671601465	0	0	0	0.253333333	0.175384615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.0671	0	0	14.4911	0.658424497	2.771853584	0.396496822	1.61131837	0	1.059624776	1.292768562	1.925404223	0	1.721892286	0.257607501	0.207807911	0.31973897	4.266461126	11.87171247	0.553943823	1.453700549	6.997219738	1.109701775	5.671601465	0	0	0	0.253333333	0.175384615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.0671	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											7.133	0.1049	0.203	0.2899	0.1894	0.4865	0.1801	0	0.5383	0.1638	0.5457	0.0371	0	0.1628	0.3043	3.1329	0.054	0.1439	1.1813	0.2861	0.6321	0.0074	0	0	0	0	0	0	0	0											15.7764	0	0	21.6241	0.763360252	2.974897357	0.686359074	1.800715716	0.486452198	1.239708974	1.292768562	2.463660677	0.163768399	2.26755047	0.294668293	0.207807911	0.482558504	4.570759264	15.00466029	0.607984555	1.597587116	8.178471321	1.395812219	6.303708621	0.007355378	0	0	0.253333333	0.175384615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.8435
H1032_801_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.183	0.5968	0.2531	0.3255	0.5111	0	0.5674	0.0481	0.0014	0.3445	1.11	4.4827	0.096	0.433	1.8832	0.2569	0	0	0	0	0	0	0	0	0	0											11.0926		272.3479425	6.350989627	895.9298179	2962.772415	5.234903014	17.0740197	7.239832045	9.311964131	14.62111369	4980.938682	16.23345718	1.375471912	0.04095373	9.857005234	33.25713272	145.5684256	2.745810691	12.38840397	53.87612809	7.34908605	41.62068678	0.00083499	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											757.76	757.76	70.95675	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199959458	0.197918	0.5	0.2	0.2	0.195905094	0.2	0.2	0	0	0	0	0	0	0	0											757.76	757.76	70.95675	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199959458	0.197918	0.5	0.2	0.2	0.195905094	0.2	0.2	0	0	0	0	0	0	0	0											17.1979	0.401043825	5.297689009	0	1.046980603	3.414803939	1.447966409	1.862392826	2.924222737	0	3.246691436	0.275094382	0.008190746	1.971401047	6.650078235	28.81061159	1.372905345	2.477680794	10.77522562	1.439723396	8.324137355	0.000166998	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.9449	135	0	17.1979	0.401043825	5.297689009	0	1.229958447	4.011599582	1.70102341	2.187877962	3.435280888	0	3.814106531	0.323171851	0.00962222	2.315937241	7.760095352	33.29335246	1.468880862	2.91069807	12.65838138	1.6965992	8.324137355	0.000196184	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.0375		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			17.1979	0.401043825	5.297689009	0	1.229958447	4.011599582	1.70102341	2.187877962	3.435280888	0	3.814106531	0.323171851	0.00962222	2.315937241	7.760095352	33.29335246	1.468880862	2.91069807	12.65838138	1.6965992	8.324137355	0.000196184	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.0375
H1032_802_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.183	0.5968	0.2531	0.3255	0.5111	0	0.5674	0.0481	0.0014	0.3445	1.11	4.4827	0.096	0.433	1.8832	0.2569	0	0	0	0	0	0	0	0	0	0											11.0926		272.3479425	6.350989627	895.9298179	2962.772415	5.234903014	17.0740197	7.239832045	9.311964131	14.62111369	4980.938682	16.23345718	1.375471912	0.04095373	9.857005234	33.25713272	145.5684256	2.745810691	12.38840397	53.87612809	7.34908605	41.62068678	0.00083499	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											757.76	757.76	70.95675	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199959458	0.197918	0.5	0.2	0.2	0.195905094	0.2	0.2	0	0	0	0	0	0	0	0											757.76	757.76	70.95675	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199959458	0.197918	0.5	0.2	0.2	0.195905094	0.2	0.2	0	0	0	0	0	0	0	0											17.1979	0.401043825	5.297689009	0	1.046980603	3.414803939	1.447966409	1.862392826	2.924222737	0	3.246691436	0.275094382	0.008190746	1.971401047	6.650078235	28.81061159	1.372905345	2.477680794	10.77522562	1.439723396	8.324137355	0.000166998	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.9449	135	0	17.1979	0.401043825	5.297689009	0	1.229958447	4.011599582	1.70102341	2.187877962	3.435280888	0	3.814106531	0.323171851	0.00962222	2.315937241	7.760095352	33.29335246	1.468880862	2.91069807	12.65838138	1.6965992	8.324137355	0.000196184	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.0375		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			17.1979	0.401043825	5.297689009	0	1.229958447	4.011599582	1.70102341	2.187877962	3.435280888	0	3.814106531	0.323171851	0.00962222	2.315937241	7.760095352	33.29335246	1.468880862	2.91069807	12.65838138	1.6965992	8.324137355	0.000196184	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.0375
H1032_803_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.183	0.5968	0.2531	0.3255	0.5111	0	0.5674	0.0481	0.0014	0.3445	1.11	4.4827	0.096	0.433	1.8832	0.2569	0	0	0	0	0	0	0	0	0	0											11.0926		272.3479425	6.350989627	895.9298179	2962.772415	5.234903014	17.0740197	7.239832045	9.311964131	14.62111369	4980.938682	16.23345718	1.375471912	0.04095373	9.857005234	33.25713272	145.5684256	2.745810691	12.38840397	53.87612809	7.34908605	41.62068678	0.00083499	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											757.76	757.76	70.95675	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199959458	0.197918	0.5	0.2	0.2	0.195905094	0.2	0.2	0	0	0	0	0	0	0	0											757.76	757.76	70.95675	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199959458	0.197918	0.5	0.2	0.2	0.195905094	0.2	0.2	0	0	0	0	0	0	0	0											17.1979	0.401043825	5.297689009	0	1.046980603	3.414803939	1.447966409	1.862392826	2.924222737	0	3.246691436	0.275094382	0.008190746	1.971401047	6.650078235	28.81061159	1.372905345	2.477680794	10.77522562	1.439723396	8.324137355	0.000166998	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.9449	135	0	17.1979	0.401043825	5.297689009	0	1.229958447	4.011599582	1.70102341	2.187877962	3.435280888	0	3.814106531	0.323171851	0.00962222	2.315937241	7.760095352	33.29335246	1.468880862	2.91069807	12.65838138	1.6965992	8.324137355	0.000196184	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.0375		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			17.1979	0.401043825	5.297689009	0	1.229958447	4.011599582	1.70102341	2.187877962	3.435280888	0	3.814106531	0.323171851	0.00962222	2.315937241	7.760095352	33.29335246	1.468880862	2.91069807	12.65838138	1.6965992	8.324137355	0.000196184	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.0375
H1032_804_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.183	0.5968	0.2531	0.3255	0.5111	0	0.5674	0.0481	0.0014	0.3445	1.11	4.4827	0.096	0.433	1.8832	0.2569	0	0	0	0	0	0	0	0	0	0											11.0926		272.3479425	6.350989627	895.9298179	2962.772415	5.234903014	17.0740197	7.239832045	9.311964131	14.62111369	4980.938682	16.23345718	1.375471912	0.04095373	9.857005234	33.25713272	145.5684256	2.745810691	12.38840397	53.87612809	7.34908605	41.62068678	0.00083499	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											757.76	757.76	70.95675	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199959458	0.197918	0.5	0.2	0.2	0.195905094	0.2	0.2	0	0	0	0	0	0	0	0											757.76	757.76	70.95675	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199959458	0.197918	0.5	0.2	0.2	0.195905094	0.2	0.2	0	0	0	0	0	0	0	0											17.1979	0.401043825	5.297689009	0	1.046980603	3.414803939	1.447966409	1.862392826	2.924222737	0	3.246691436	0.275094382	0.008190746	1.971401047	6.650078235	28.81061159	1.372905345	2.477680794	10.77522562	1.439723396	8.324137355	0.000166998	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.9449	135	0	17.1979	0.401043825	5.297689009	0	1.229958447	4.011599582	1.70102341	2.187877962	3.435280888	0	3.814106531	0.323171851	0.00962222	2.315937241	7.760095352	33.29335246	1.468880862	2.91069807	12.65838138	1.6965992	8.324137355	0.000196184	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.0375		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			17.1979	0.401043825	5.297689009	0	1.229958447	4.011599582	1.70102341	2.187877962	3.435280888	0	3.814106531	0.323171851	0.00962222	2.315937241	7.760095352	33.29335246	1.468880862	2.91069807	12.65838138	1.6965992	8.324137355	0.000196184	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.0375
H1035_002_0	2009	6																					$2000 Inpatient only											Coin	Coin	Coin	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin		T		V	Coin	V		O																																																				0	N/A	288.6352	0.0376	20.5465	0	119.4674	11.17299428	3.256066181	301.2014	53.3448	9.4499	29.2181	3.7121		13.7554	3185.6564	5235.5987	2.5149	3.7891	56.1826	104.318	36.1901		0		85.9771	0	0		0												"PBP Line 1a: 10% coinsurance subject to $2,000 MOOP along with a.2."	"PBP Line 1b: 10% coinsurance subject to $2,000 MOOP along with a.1."	PBP Line 2: 10% coinsurance	PBP Line 6: $0 copay/0% coinsurance	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 and 4b: $50 copay per ER visit; $30 copay per urgent care visit	"PBP Lines 8a, 8b, 9a, 9b: 10% coinsurance"	"PBP Lines 8a, 14d and 14e: 0-10% coinsurance"	"PBP Lines 8a, 8b and 14g: 10% coinsurance"	"PBP Lines 8a, 9a and 9b: 10% coinsurance"	PBP Line 12: $0 copay/0% coinsurance	"PBP Line 3, 5, 8a, 9a, 9b, 9d, 13a and 14i: 10% coinsurance; 0% coinsurance for blood"	"PBP Lines 7a, 14c, 14d, 14e and 14g: $10 per office visit; 10% coinsurance for non-office locations"	"PBP Lines 7d, 14c, 14d, 14e and 14g: $30 per office visit; 10% coinsurance for non-office locations"	"PBP Lines 7e, 7h and 9c: 10% coinsurance"	"PBP Lines 7c and 7i: 10% coinsurance per occupational therapy, physical therapy, speech therapy visit."	"PBP Lines 8b, 14g, 14h: 10% coinsurance"	"PBP Lines 7a,7b, 7d, 7f, 7g, 14b, 14f, 14g, 14i, 14j: $20 copay per chiropractic visit; 10% coinsurance per podiatry visit; $0 copay Medicare covered immunizations; 10% coinsurance for other health care"	PBP Line 15: 20% coinsurance		PBP Line 10b: $0 copay/0% coinsurance 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/0% coinsurance	PBP Line 18a: $0 copay/0% coinsurance		"PBP Lines 13b, 14a: $0 copay"												0.1	0.0999	0.1	0	100	0.149653592	0.443503825	49.2338	0.0953	0.0118	0.1	0.0798		0.0999	10	30	0.1507	0.2461	0.0932	0.096	0.1981		0		15	0	0		0												0.0645	0.0999	0.1	0	100	0.149653592	0.443503825	49.2338	0.0953	0.0118	0.1	0.0798		0.0999	10	30	0.1507	0.2461	0.0932	0.096	0.1981		0		15	0	0		0												18.617	0.00375624	2.05465	0	0.995561667	1.672078725	1.444077805	1.235774124	5.08375944	0.11150882	2.92181	0.29622558	0	1.37416446	2.654713667	13.08899675	0.37899543	0.93249751	5.23621832	10.014528	7.16925881	0	0	0	0.107471375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.393		10.2465	18.617	0.00375624	2.05465	0	0.995561667	1.672078725	1.444077805	1.235774124	5.08375944	0.11150882	2.92181	0.29622558	0	1.37416446	2.654713667	13.08899675	0.37899543	0.93249751	5.23621832	10.014528	7.16925881	0	0	0	0.107471375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.393	N/A	$200/day for Days 1-10; $0/day for Days 11-999	$200/day for Days 1-10; $0/day for Days 11-999	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														0.0528	0	0.0379	0.0158	0.0077	0.0093		0.0005	0.0253	0.0072	0.0106	0		0.0023	0.145	0.143	0.0034	0.0158	0.0937	0.2563	0.0255		0.0052		0	0.0002	0.0002														0.8577		0	18.6698	0.00375624	2.09255	0.0158	1.003261667	1.681378725	1.444077805	1.236274124	5.10905944	0.11870882	2.93241	0.29622558	0	1.37646446	2.799713667	13.23199675	0.38239543	0.94829751	5.32991832	10.270828	7.19475881	0	0.0052	0	0.107471375	0.0002	0.0002	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2507
H1035_006_0	2009	7																					$2000 Inpatient only											Coin	Coin	Coin	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin		T		V	Coin	V		O																																																				0	N/A	282.1736107	0.772817912	17.38585836		142.7613524	9.493702193	3.023901236	393.0008102	45.44845011	8.681397011	27.92193174	3.307296832		10.62616508	3084.296363	4160.705998	3.82337504	2.742058006	50.37209176	97.03331483	35.15298223				84.13688208																"PBP Line 1a: 10% coinsurance subject to $2,000 MOOP along with a.2."	"PBP Line 1b: 10% coinsurance subject to $2,000 MOOP along with a.1."	PBP Line 2: 10% coinsurance	PBP Line 6: $0 copay/0% coinsurance	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 and 4b: $50 copay per ER visit; $30 copay per urgent care visit	"PBP Lines 8a, 8b, 9a, 9b: 10% coinsurance"	"PBP Lines 8a, 14d and 14e: 0-10% coinsurance"	"PBP Lines 8a, 8b and 14g: 10% coinsurance"	"PBP Lines 8a, 9a and 9b: 10% coinsurance"	PBP Line 12: $0 copay/0% coinsurance	"PBP Line 3, 5, 8a, 9a, 9b, 9d, 13a and 14i: 10% coinsurance; 0% coinsurance for blood"	"PBP Lines 7a, 14c, 14d, 14e and 14g: $10 per office visit; 10% coinsurance for non-office locations"	"PBP Lines 7d, 14c, 14d, 14e and 14g: $30 per office visit; 10% coinsurance for non-office locations"	"PBP Lines 7e, 7h and 9c: 10% coinsurance"	"PBP Lines 7c and 7i: 10% coinsurance per occupational therapy, physical therapy, speech therapy visit."	"PBP Lines 8b, 14g, 14h: 10% coinsurance"	"PBP Lines 7a,7b, 7d, 7f, 7g, 14b, 14f, 14g, 14i, 14j: $20 copay per chiropractic visit; 10% coinsurance per podiatry visit; $0 copay Medicare covered immunizations; 10% coinsurance for other health care"	PBP Line 15: 20% coinsurance		PBP Line 10b: $0 copay/0% coinsurance 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/0% coinsurance	PBP Line 18a: $0 copay/0% coinsurance		"PBP Lines 13b, 14a: $0 copay"												0.1	0.1	0.1		100	0.149842529	0.346832493	49.337	0.0956	0.0118	0.1	0.0873		0.0999	10	30	0.1529	0.2514	0.0931	0.094	0.1997		0		15	0	0														0.0655	0.1	0.1		100	0.149842529	0.346832493	49.337	0.0956	0.0118	0.1	0.0873		0.0999	10	30	0.1529	0.2514	0.0931	0.094	0.1997		0		15	0	0														18.4824	0.077281791	1.738585836	0	1.189677937	1.422560349	1.048787204	1.615790081	4.34487183	0.102440485	2.792193174	0.288727013	0	1.061553891	2.570246969	10.40176499	0.584594044	0.689353383	4.689641743	9.121131594	7.020050551	0	0	0	0.105171103	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.3468		9.735	18.4824	0.077281791	1.738585836	0	1.189677937	1.422560349	1.048787204	1.615790081	4.34487183	0.102440485	2.792193174	0.288727013	0	1.061553891	2.570246969	10.40176499	0.584594044	0.689353383	4.689641743	9.121131594	7.020050551	0	0	0	0.105171103	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.3468	N/A	$200/day for Days 1-10; $0/day for Days 11-999	$200/day for Days 1-10; $0/day for Days 11-999	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	0.0122		0	0	0.0091	0	0		0	0.1075	0.1985	0.0076	0.013	0.0693	0.1542	0.0126		0.0045		0	0.0012	0.0014														0.5911		0	18.4824	0.077281791	1.738585836	0	1.189677937	1.434796362	1.048787204	1.615790081	4.34487183	0.111536282	2.792193174	0.288727013	0	1.061553891	2.677772286	10.60024828	0.592173875	0.702347379	4.758943055	9.275327013	7.032611414	0	0.004547899	0	0.105171103	0.001191116	0.001407683	0	0	0	0	0	0	0	0	0	0	0	0	0	69.9379
H1035_007_0	2009	4																					$2000 Inpatient only											Coin	Coin	Coin	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin		T		V	Coin	V		O																																																				0	N/A	262.7977063	0.0711	18.93923248		110.6883119	9.726306602	2.112066123	304.9239458	53.54492827	9.795135625	27.748289	2.664525918		16.59265227	3148.617357	5208.815261	2.476282916	3.868653461	52.33314825	102.6954643	39.86244648				92.64271858	0	0														"PBP Line 1a: 10% coinsurance subject to $2,000 MOOP along with a.2."	"PBP Line 1b: 10% coinsurance subject to $2,000 MOOP along with a.1."	PBP Line 2: 10% coinsurance	PBP Line 6: $0 copay/0% coinsurance	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 and 4b: $50 copay per ER visit; $30 copay per urgent care visit	"PBP Lines 8a, 8b, 9a, 9b: 10% coinsurance"	"PBP Lines 8a, 14d and 14e: 0-10% coinsurance"	"PBP Lines 8a, 8b and 14g: 10% coinsurance"	"PBP Lines 8a, 9a and 9b: 10% coinsurance"	PBP Line 12: $0 copay/0% coinsurance	"PBP Line 3, 5, 8a, 9a, 9b, 9d, 13a and 14i: 10% coinsurance; 0% coinsurance for blood"	"PBP Lines 7a, 14c, 14d, 14e and 14g: $10 per office visit; 10% coinsurance for non-office locations"	"PBP Lines 7d, 14c, 14d, 14e and 14g: $30 per office visit; 10% coinsurance for non-office locations"	"PBP Lines 7e, 7h and 9c: 10% coinsurance"	"PBP Lines 7c and 7i: 10% coinsurance per occupational therapy, physical therapy, speech therapy visit."	"PBP Lines 8b, 14g, 14h: 10% coinsurance"	"PBP Lines 7a,7b, 7d, 7f, 7g, 14b, 14f, 14g, 14i, 14j: $20 copay per chiropractic visit; 10% coinsurance per podiatry visit; $0 copay Medicare covered immunizations; 10% coinsurance for other health care"	PBP Line 15: 20% coinsurance		PBP Line 10b: $0 copay/0% coinsurance 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/0% coinsurance	PBP Line 18a: $0 copay/0% coinsurance		"PBP Lines 13b, 14a: $0 copay"												0.1	0.0999	0.1		100	0.149276306	0.42132518	49.33404416	0.095819722	0.0118	0.099966576	0.080698412		0.099853302	10	30	0.149054767	0.237288046	0.092183995	0.094419064	0.198959561				15	0	0														0.06632	0.0999	0.1		100	0.149276306	0.42132518	49.33404416	0.095819722	0.0118	0.099966576	0.080698412		0.099853302	10	30	0.149054767	0.237288046	0.092183995	0.094419064	0.198959561				15	0	0														17.4287	0.00710289	1.893923248	0	0.922402599	1.451907116	0.88986664	1.253594284	5.130660115	0.1155826	2.773901449	0.215023011	0	1.656831115	2.623847798	13.02203815	0.369101772	0.91798522	4.824278675	9.696409587	7.931014847	0	0	0	0.115803398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.24		8.851	17.4287	0.00710289	1.893923248	0	0.922402599	1.451907116	0.88986664	1.253594284	5.130660115	0.1155826	2.773901449	0.215023011	0	1.656831115	2.623847798	13.02203815	0.369101772	0.91798522	4.824278675	9.696409587	7.931014847	0	0	0	0.115803398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.24	N/A	$200/day for Days 1-10; $0/day for Days 11-999	$200/day for Days 1-10; $0/day for Days 11-999	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														0.0272	0	0.0196	0.0082	0.004	0.0552	0	0.013	0.0131	0.0047	0.0055	0	0	0.0012	0.0958	0.1732	0.0057	0.009	0.1263	0.2511	0.0176		0		0	0.0002	0.0002														0.8304		0	17.456	0.00710289	1.913483248	0.00816	0.926362599	1.507087116	0.88986664	1.266554284	5.143740115	0.1202626	2.779361449	0.215023011	0	1.658031115	2.719627798	13.19519815	0.374761772	0.92698522	4.950538675	9.947469587	7.948594847	0	0	0	0.115803398	0.0002	0.0002	0	0	0	0	0	0	0	0	0	0	0	0	0	74.0704
H1036_011_0	2009	3		s.	t.	u.	v.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered																	D	D	D	V	T	Coin	Coin	V	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						0		1551.052241	11.481274	808.281026	17.981984	340.902506	4.832452	3.254508	342.446892	229.089294	49.826874	1230.528413	0	17.151862	85.2229	7157.167922	5499.230812	0.323377	530.946494			64.753076				2.15		0.05		0.05	0.3		1.23	2.77	0.06	0.41						$150/Day(Days 1-10):1a	$150/Day(Days 1-7):1b	"$0/Day(Days 1-14) $50(Days 15-100):2. $0 SNF 1, 2. $50 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$200/Visit:9b. $0 Surgery ASC -- Physician, 9b. $100 Surgery ASC -- Facility, 9a. $0 Surgery OP -- Physician, 9a. $200 Surgery OP -- Facility"	"$0-$25/Visit:8a. $0 Lab -- FSL, 8. $25 Lab -- OP"	"$0-$100/Visit:14h. $25 DMAM -- OP, 8b. $0 Radiology -- FSR, 14h. $0 SMAM -- FSR, 14h. $25 SMAM -- OP, 8b. $50 Advanced Imaging -- FSR, 8b. $50 Advanced Imaging -- Office, 9a. $100 Advanced Imaging -- OP, 8a. $0 Radiology OP -- Physician, 8a. $25 Radiology OP -- Facility"	$200/Visit:9a	"$0-$25/Proc:12. $0 Dialysis -- Dialysis Center, 12. $25 Dialysis -- OP Hosp"	"$25-$100/Visit:9d. $40 Cardiac Rehab, 8b. $100 Nuclear Medicine, 9a. $25 OP Other, 5. $25 Partial Hospitalization, 8b. $25 Rad therapy, 3. $25 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$25/Visit:7b, 7d, 7f"	"$25/Visit:7e, 7h"	"$25-$40/Visit:9a. $40 Therapy (AT,PT,ST,OT) -- OP, 7d. $25 Therapy (AT,PT,ST,OT) - Specialist"			0% Coins:15				VIS 829		HER 722		SMC 001	NSP 001		HAM 001	FTP 002	Other Added Benefit	MOW 001						120.32055	94.510417	23.132795	0	99.999992	0	0	49.999998	147.428801	17.281517	15.751457	0	0.860547	37.796038	0	25	25.011055	26.959959			0				0		0		0	0		0	0	0	0						120.32055	94.510417	23.132795	0	99.999992	0	0	49.999998	147.428801	17.281517	15.751457	0	0.860547	37.796038	0	25	25.011055	26.959959			0				0		0		0	0		0	0	0	0						15.552	0.090424999	1.55814994	0	2.840853989	0	0	1.426861993	2.814529995	0.071756998	1.615217949	0	0.001229999	0.268423997	0	11.45673086	0.000674	1.192857976	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.8897	0	0	15.552	0.090424999	1.55814994	0	2.840853989	0	0	1.426861993	2.814529995	0.071756998	1.615217949	0	0.001229999	0.268423997	0	11.45673086	0.000674	1.192857976	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.8897																																																																																		0	0	0	15.552	0.090424999	1.55814994	0	2.840853989	0	0	1.426861993	2.814529995	0.071756998	1.615217949	0	0.001229999	0.268423997	0	11.45673086	0.000674	1.192857976	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.8897
H1036_025_0	2009	6	r.	s.	t.	u.	v.						Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered						3250											D	D	D	V	T	Coin	Coin	V	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						0		1214.175676	57.795243	822.587203	563.75419	216.488126	2.68336	3.779541	241.98642	207.094357	55.970754	1246.251504	0	384.329606	183.434355	6078.26714	3268.453258	1.307175	388.752373			34.114197			3.98	2.25		0.33		0.05	0.27	1.23	3.09	0.06	0.58	0.3						$100/Day(Days 1-7):1a	$100/Day(Days 1-7):1b	"$0/Day(Days 1-9) $75(Days 10-100):2. $0 SNF 1,2. $75 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $50 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $100 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $50 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	"$0-$100/Proc:12. $0 Dialysis -- Dialysis Center,12. $100 Dialysis -- OP Hosp"	"$20-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $20 Partial Hospitalization,8b. $100 Rad therapy,3. $20 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$20/Visit:7b, 7d, 7f"	"$20-$100/Visit:7h. $100 Psych -- OP,7e. $20 Psych -- Other Provider"	"$20-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $20 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			DEN ADI	VIS 140		HER 751		SMC 001	MOW 001	HAM 001	FTP 002	Other Added Benefit	OTC 006	NSP 001						71.243604	63.006638	45.65467	0	100.000015	0	0	50.000012	67.569837	89.435779	13.344966	0	0.098321	42.911787	0	20.000003	85.182167	26.706913			0.199999			0	0		0		0	0	0	0	0	0	0						58.238583	51.505217	37.32073	0	81.745712	0	0	40.87286	55.235436	73.109903	10.908935	0	0.080373	35.07854	0	16.349142	69.632759	21.831753			0.163491			0	0		0		0	0	0	0	0	0	0						5.8927	0.248063044	2.558296242	0	1.474748	0	0	0.824223089	0.953245592	0.341001366	1.132939721	0	0.002574144	0.536217447	0	4.45303387	0.007585183	0.707262149	0	0	5.577364182	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.7092	0	5.5177	5.8927	0.248063044	2.558296242	0	1.474748	0	0	0.824223089	0.953245592	0.341001366	1.132939721	0	0.002574144	0.536217447	0	4.45303387	0.007585183	0.707262149	0	0	5.577364182	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.7092	3250																																																																																	0	0	0	5.8927	0.248063044	2.558296242	0	1.474748	0	0	0.824223089	0.953245592	0.341001366	1.132939721	0	0.002574144	0.536217447	0	4.45303387	0.007585183	0.707262149	0	0	5.577364182	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.7092
H1036_034_0	2009	3		s.	t.	u.	v.	w.	x.					Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered															D	D	D	V	T	Coin	Coin	V	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				0		1735.810911	9.547061	669.980096	44.247125	354.030373	6.665901	2.483605	250.507467	234.953542	85.042834	1395.047873	0	13.937788	337.901445	9275.4789	4872.738729	0.405506	569.243031			2641.453223			3.98	2.15		0.33		0.05	0.3		1.23	2.77	0.06	0.41	0.65	0.58				$50/Day(Days 1-5):1a	$50/Day(Days 1-5):1b	"$0/Day(Days 1-14) $50(Days 15-100):2. $0 SNF 1,2. $50 SNF 2"	$0/Visit:6	$40/Trip:10a	0% Coins:11a	0% Coins:11b	$40/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $25 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$25/Visit:8a. $0 Lab -- FSL,8. $25 Lab -- OP"	"$0-$50/Visit:14h. $25 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $25 SMAM -- OP,8b. $25 Advanced Imaging -- FSR,8b. $25 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $25 Radiology OP -- Facility"	$100/Visit:9a	"$0-$25/Proc:12. $0 Dialysis -- Dialysis Center,12. $25 Dialysis -- OP Hosp"	"$0-$50/Visit:9d. $40 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $25 OP Other,5. $0 Partial Hospitalization,8b. $25 Rad therapy,3. $0 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0-$25/Visit:7h. $25 Psych -- OP,7e. $0 Psych -- Other Provider"	"$0-$40/Visit:9a. $40 Therapy (AT,PT,ST,OT) -- OP,7d. $0 Therapy (AT,PT,ST,OT) - Specialist"			$0/Script:15			"DEN ADI 16a, 16b"	VIS 140		HER 751		$0 Additional Smoking Cessation 14a	NSP 002		$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0: Nurse hotline 14a	$0: Nutritional benefit 14a	Acupuncture 6 Visits	OTC 003				30.655099	25.553413	23.1328	0	40	0	0	40	60.28991	20.903912	9.622637	0	2.593237	25.951176	0	0	25.005795	4.546226			0			0	0		0		0	0		0	0	0	0	0	0				30.655099	25.553413	23.1328	0	40	0	0	40	60.28991	20.903912	9.622637	0	2.593237	25.951176	0	0	25.005795	4.546226			0			0	0		0		0	0		0	0	0	0	0	0				4.4343	0.020329999	1.291542964	0	1.180101243	0	0	0.83502489	1.180443992	0.148143993	1.11866994	0	0.003011999	0.730744989	0	0	0.000845	0.215658956	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.1588	0	0	4.4343	0.020329999	1.291542964	0	1.180101243	0	0	0.83502489	1.180443992	0.148143993	1.11866994	0	0.003011999	0.730744989	0	0	0.000845	0.215658956	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.1588																																																																																		0	0	0	4.4343	0.020329999	1.291542964	0	1.180101243	0	0	0.83502489	1.180443992	0.148143993	1.11866994	0	0.003011999	0.730744989	0	0	0.000845	0.215658956	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.1588
H1036_035_0	2009	3	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered																		D	D	D	V	T	Coin	Coin	V	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							0		1416.602184	11.689225	1001.149982	4.712374	305.391569	6.057676	3.591629	284.280927	256.958909	47.402341	1422.219208	0	13.961443	221.547	8270.350525	5045.559662	0.451019	520.156792			56.360972				2.15		0.33		0.05	0.41	1.23	2.77	0.06	0.58							$150/Day(Days 1-10):1a	$150/Day(Days 1-7):1b	"$0/Day(Days 1-13) $75(Days 14-100):2. $0 SNF 1,2. $75 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician, 9b. $125 Surgery ASC -- Facility, 9a. $0 Surgery OP -- Physician, 9a. $150 Surgery OP -- Facility"	"$0-$25/Visit:8a. $0 Lab -- FSL, 8. $25 Lab -- OP"	"$0-$75/Visit:14h. $25 DMAM -- OP, 8b. $0 Radiology -- FSR, 14h. $0 SMAM -- FSR, 14h. $25 SMAM -- OP, 8b. $25 Advanced Imaging -- FSR, 8b. $25 Advanced Imaging -- Office, 9a. $75 Advanced Imaging -- OP, 8a. $0 Radiology OP -- Physician, 8a. $25 Radiology OP -- Facility"	$150/Visit:9a	"$0-$25/Proc:12. $0 Dialysis -- Dialysis Center, 12. $25 Dialysis -- OP Hosp"	"$25-$75/Visit:9d. $40 Cardiac Rehab, 8b. $75 Nuclear Medicine, 9a. $25 OP Other, 5. $30 Partial Hospitalization, 8b. $25 Rad therapy, 3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$25-$30/Visit:7h. $25 Psych -- OP, 7e. $30 Psych -- Other Provider"	"$30-$40/Visit:9a. $40 Therapy (AT,PT,ST,OT) -- OP, 7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			0% Coins:15				VIS 829		HER 751		SMC 001	MOW 001	HAM 001	FTP 002	Other Added Benefit	OTC 006							120.320551	94.509601	36.641478	0	100.00001	0	0	50.000005	134.391464	21.664499	8.577673	0	0.36787	27.75393	0	29.999997	25.010032	31.0465			0				0		0		0	0	0	0	0	0							120.320551	94.509601	36.641478	0	100.00001	0	0	50.000005	134.391464	21.664499	8.577673	0	0.36787	27.75393	0	29.999997	25.010032	31.0465			0				0		0		0	0	0	0	0	0							14.2039	0.092061999	3.05696792	0	2.544929996	0	0	1.184503981	2.877756997	0.085578997	1.016610942	0	0.000428	0.512399994	0	12.61389789	0.00094	1.345753987	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5357	0	0	14.2039	0.092061999	3.05696792	0	2.544929996	0	0	1.184503981	2.877756997	0.085578997	1.016610942	0	0.000428	0.512399994	0	12.61389789	0.00094	1.345753987	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5357																																																																																		0	0	0	14.2039	0.092061999	3.05696792	0	2.544929996	0	0	1.184503981	2.877756997	0.085578997	1.016610942	0	0.000428	0.512399994	0	12.61389789	0.00094	1.345753987	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5357
H1036_037_0	2009	4	r.	s.	t.	u.	v.						Health & Education (Non-Covered)	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	V	Coin	V	V	V	V	V			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		1528.500088	142.326877	1210.310436	288.433562	362.63677	2.791596	2.886872	279.681245	118.644444	335.89558	595.345965	0	0	324.504579	7226.94327	6331.536507	1.790893	218.702933			16.454339				1.05		0.33		0.05	0.24	1.23	3.51	0.06	0.27	0.3						$140/Day(Days 1-10):1a	$140/Day(Days 1-7):1b	"$0/Day(Days 1-20) $115(Days 21-100):2. $0 SNF 1,2. $115 SNF 2"	$0/Visit:6	$150/Trip:10a	20% Coins:11a	"0%-20% Coins:11b. 0% Supplies,11b. 20% Prosthetics"	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $150 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $140 Surgery OP -- Facility"	"$0-$5/Visit:8a. $5 Lab -- FSL,8. $0 Lab -- OP"	"$0-$150/Visit:14h. $50 DMAM -- OP,8b. $75 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $150 Advanced Imaging -- FSR,8b. $140 Advanced Imaging -- Office,9a. $140 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$140/Visit:9a	20% Coins:12	"$40-$140/Visit:9d. $40 Cardiac Rehab,8b. $140 Nuclear Medicine,9a. $75 OP Other,5. $40 Partial Hospitalization,8b. $50 Rad therapy,3. $40 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$40/Visit:7b, 7d, 7f"	"$40-$75/Visit:7h. $75 Psych -- OP,7e. $40 Psych -- Other Provider"	"$40/Visit:7d, 9a"			20% Coins:15				VIS 116		HER 751		SMC 001	OTC 001	HAM 001	FTP 002	Other Added Benefit	MOW 001	NSP 001						112.29918	88.209397	38.75212	0	150.000012	0.199999	0.147854	50.00002	145.1361	2.428147	76.504343	0	0	51.587105	0	40	64.894999	40.000012			0.2				0		0		0	0	0	0	0	0	0						112.29918	88.209397	38.75212	0	150.000012	0.199999	0.147854	50.00002	145.1361	2.428147	76.504343	0	0	51.587105	0	40	64.894999	40.000012			0.2				0		0		0	0	0	0	0	0	0						14.3041	1.046214	3.908507938	0	4.532959988	0.558316408	0.426835573	1.165338987	1.434965991	0.067966987	3.795545993	0	0	1.395020982	0	21.10512169	0.009685	0.729009995	0	0	3.2908678	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7705	0	0	14.3041	1.046214	3.908507938	0	4.532959988	0.558316408	0.426835573	1.165338987	1.434965991	0.067966987	3.795545993	0	0	1.395020982	0	21.10512169	0.009685	0.729009995	0	0	3.2908678	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7705																																																																																		0	0	0	14.3041	1.046214	3.908507938	0	4.532959988	0.558316408	0.426835573	1.165338987	1.434965991	0.067966987	3.795545993	0	0	1.395020982	0	21.10512169	0.009685	0.729009995	0	0	3.2908678	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7705
H1036_040_0	2009	7	r.	s.	t.	u.	u.						Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered						3250											D	D	D	V	T	Coin	Coin	V	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						0		1177.220371	56.036156	797.550496	546.595464	209.898977	2.522502	3.552971	234.621192	200.791122	54.267199	1208.319919	0	372.631943	177.851248	5893.26573	3168.972858	1.267388	376.920097			32.069171			3.98	2.25		0.33		0.05	0.27	1.23	3.09	0.06	0.58	0.3						$100/Day(Days 1-7):1a	$100/Day(Days 1-7):1b	"$0/Day(Days 1-9) $75(Days 10-100):2. $0 SNF 1,2. $75 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $50 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $100 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $50 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	"$0-$100/Proc:12. $0 Dialysis -- Dialysis Center,12. $100 Dialysis -- OP Hosp"	"$20-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $20 Partial Hospitalization,8b. $100 Rad therapy,3. $20 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$20/Visit:7b, 7d, 7f"	"$20-$100/Visit:7h. $100 Psych -- OP,7e. $20 Psych -- Other Provider"	"$20-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $20 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			DEN ADI	VIS 140		HER 751		SMC 001	MOW 001	HAM 001	FTP 002	Other Added Benefit	OTC 006	NSP 001						71.243598	63.006677	45.654679	0	99.999991	0	0	49.999984	67.569859	89.435682	13.344965	0	0.098316	42.911725	0	20.000002	85.176757	26.706933			0.2			0	0		0		0	0	0	0	0	0	0						58.817219	52.016989	37.691544	0	82.557893	0	0	41.278937	55.784257	73.836221	11.017323	0	0.081168	35.427019	0	16.511581	70.320142	22.048683			0.165115			0	0		0		0	0	0	0	0	0	0						5.7701	0.242902676	2.505075801	0	1.444068107	0	0	0.807076117	0.933415296	0.333907075	1.109370903	0	0.002520482	0.525061629	0	4.360396003	0.007426909	0.692549311	0	0	5.29510117	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.0289	0	5.0766	5.7701	0.242902676	2.505075801	0	1.444068107	0	0	0.807076117	0.933415296	0.333907075	1.109370903	0	0.002520482	0.525061629	0	4.360396003	0.007426909	0.692549311	0	0	5.29510117	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.0289	3250																																																																																	0	0	0	5.7701	0.242902676	2.505075801	0	1.444068107	0	0	0.807076117	0.933415296	0.333907075	1.109370903	0	0.002520482	0.525061629	0	4.360396003	0.007426909	0.692549311	0	0	5.29510117	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.0289
H1036_044_0	2009	3	r.	s.	t.	u.	u.						Health & Education (Non-Covered)	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	V	P	V	V	V	V	V			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		1324.734685	43.033907	874.351763	115.366043	191.978412	3.192669	2.015849	375.20853	226.271354	151.189832	1706.422956	0	3.111806	509.171906	5295.059377	4451.49637	3.06675	140.757881			12.166347				2.5		0.33		0.05	0.24	1.23	4.21	0.06	0.27	0.3						$150/Day(Days 1-10):1a	$150/Day(Days 1-7):1b	"$0/Day(Days 1-20) $120(Days 21-100):2. $0 SNF 1,2. $120 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	"0%-20% Coins:11b. 0% Supplies,11b. 20% Prosthetics"	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$75/Visit:14h. $25 DMAM -- OP,8b. $25 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $75 Advanced Imaging -- Office,9a. $75 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $25 Radiology OP -- Facility"	$150/Visit:9a	$0/Proc:12	"$0-$75/Visit:9d. $25 Cardiac Rehab,8b. $75 Nuclear Medicine,9a. $0 OP Other,5. $30 Partial Hospitalization,8b. $25 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$5/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$0-$30/Visit:7h. $0 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$150/Visit:9a. $150 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15				VIS 140		HER 751		SMC 001	OTC 001	HAM 001	FTP 002	Other Added Benefit	MOW 001	NSP 001						120.320551	94.510033	40.437002	0	99.999993	0	0.148108	50.000003	125.048617	0	32.667661	0	0	23.388988	5	30	2.53167	49.606458			0.2				0		0		0	0	0	0	0	0	0						120.320551	94.510033	40.437002	0	99.999993	0	0.148108	50.000003	125.048617	0	32.667661	0	0	23.388988	5	30	2.53167	49.606458			0.2				0		0		0	0	0	0	0	0	0						13.2827	0.338927998	2.946346999	0	1.599819988	0	0.298563364	1.563368969	2.35790999	0	4.645403887	0	0	0.992417967	2.20627474	11.12874093	0.000647	0.581874993	0	0	2.4332694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.3763	0	0	13.2827	0.338927998	2.946346999	0	1.599819988	0	0.298563364	1.563368969	2.35790999	0	4.645403887	0	0	0.992417967	2.20627474	11.12874093	0.000647	0.581874993	0	0	2.4332694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.3763																																																																																		0	0	0	13.2827	0.338927998	2.946346999	0	1.599819988	0	0.298563364	1.563368969	2.35790999	0	4.645403887	0	0	0.992417967	2.20627474	11.12874093	0.000647	0.581874993	0	0	2.4332694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.3763
H1036_047_0	2009	6	r.	s.	t.	u.	v.						Health & Education (Non-Covered)	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	V	Coin	V	V	V	V	V			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		1429.760584	54.607542	656.366677	669.265513	243.55534	2.849227	1.823069	298.955051	290.872929	92.876608	1267.2453	0	0.022901	203.849691	6229.628197	5138.44633	2.623623	562.467269			22.443276				0.91		0.33		0.05	0.24	1.23	3.14	0.06	0.27	0.3						$100/Day(Days 1-10):1a	$100/Day(Days 1-10):1b	"$0/Day(Days 1-14) $100(Days 15-100):2. $0 SNF 1,2. $100 SNF 2"	$0/Visit:6	$140/Trip:10a	20% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $150 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$150/Visit:14h. $100 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $100 SMAM -- OP,8b. $25 Advanced Imaging -- FSR,8b. $25 Advanced Imaging -- Office,9a. $150 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$150/Visit:9a	20% Coins:12	"$25-$150/Visit:9d. $100 Cardiac Rehab,8b. $150 Nuclear Medicine,9a. $100 OP Other,5. $25 Partial Hospitalization,8b. $100 Rad therapy,3. $25 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$25/Visit:7b, 7d, 7f"	"$25-$100/Visit:7h. $100 Psych -- OP,7e. $25 Psych -- Other Provider"	"$25-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $25 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15				VIS 989		HER 751		SMC 001	OTC 001	HAM 001	FTP 002	Other Added Benefit	MOW 001	NSP 001						80.213701	74.508169	46.265602	0	140	0.199999	0	49.999998	150.000015	92.18502	14.371228	0	0.199991	55.748546	0	25.000001	85.21956	28.637677			0.199999				0		0		0	0	0	0	0	0	0						80.213701	74.508169	46.265602	0	140	0.199999	0	49.999998	150.000015	92.18502	14.371228	0	0.199991	55.748546	0	25.000001	85.21956	28.637677			0.199999				0		0		0	0	0	0	0	0	0						9.5572	0.339058997	2.530599954	0	2.841478967	0.569842551	0	1.245645996	3.635911976	0.713485997	1.517655928	0	0.004579994	0.94702699	0	10.70509695	0.018632	1.342312998	0	0	4.488632757	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.4572	0	0	9.5572	0.339058997	2.530599954	0	2.841478967	0.569842551	0	1.245645996	3.635911976	0.713485997	1.517655928	0	0.004579994	0.94702699	0	10.70509695	0.018632	1.342312998	0	0	4.488632757	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.4572																																																																																		0	0	0	9.5572	0.339058997	2.530599954	0	2.841478967	0.569842551	0	1.245645996	3.635911976	0.713485997	1.517655928	0	0.004579994	0.94702699	0	10.70509695	0.018632	1.342312998	0	0	4.488632757	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.4572
H1036_052_0	2009	4	r.	s.	t.	u.	v.						Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered						3250											D	D	D	V	T	Coin	Coin	V	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						0		1254.701053	59.724268	850.042585	582.570538	223.713822	2.86547	4.036045	250.063168	214.006519	57.838884	1287.847467	0	397.157322	189.556816	6281.14064	3377.543982	1.350802	401.727709			36.429407			3.98	2.25		0.33		0.05	0.27	1.23	3.09	0.06	0.58	0.3						$100/Day(Days 1-7):1a	$100/Day(Days 1-7):1b	"$0/Day(Days 1-9) $75(Days 10-100):2. $0 SNF 1,2. $75 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $50 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $50 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$100/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$20-$50/Visit:9d. $50 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $20 Partial Hospitalization,8b. $50 Rad therapy,3. $20 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$20/Visit:7b, 7d, 7f"	"$20-$50/Visit:7h. $50 Psych -- OP,7e. $20 Psych -- Other Provider"	"$20-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $20 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			DEN ADI	VIS 140		HER 751		SMC 001	MOW 001	HAM 001	FTP 002	Other Added Benefit	OTC 006	NSP 001						71.243596	63.006749	45.654677	0	100.000008	0	0	50.000006	67.569829	44.717875	11.781752	0	0.049159	28.591828	0	20	44.444707	22.515101			0.199999			0	0		0		0	0	0	0	0	0	0						57.996847	51.291526	37.165829	0	81.406406	0	0	40.703205	55.006165	36.403212	9.5911	0	0.040018	23.275578	0	16.28128	36.180836	18.328733			0.162812			0	0		0		0	0	0	0	0	0	0						6.0641	0.25527907	2.632711446	0	1.517644852	0	0	0.848197699	0.980973158	0.175460096	1.02932282	0	0.001324453	0.367670371	0	4.582561607	0.004072762	0.61359666	0	0	5.931144612	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.004	0	5.711	6.0641	0.25527907	2.632711446	0	1.517644852	0	0	0.848197699	0.980973158	0.175460096	1.02932282	0	0.001324453	0.367670371	0	4.582561607	0.004072762	0.61359666	0	0	5.931144612	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.004	3250																																																																																	0	0	0	6.0641	0.25527907	2.632711446	0	1.517644852	0	0	0.848197699	0.980973158	0.175460096	1.02932282	0	0.001324453	0.367670371	0	4.582561607	0.004072762	0.61359666	0	0	5.931144612	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.004
H1036_053_0	2009	2			t.	u.	v.	w.	x.						Health & Education (Non-Covered)	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	V	P	V	V	V	V	V			S				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		1466.549715	10.855765	764.245251	17.002313	322.329874	4.320244	2.909553	323.79012	216.608331	47.112268	1163.488275	0	16.217415	80.579891	6767.239876	5199.628464	0.30576	502.020119			1982.391996				1.05		0.05		0.05	0.3			1.23	2.77	0.06	0.41	0.58				$0/Day(Days 1-7):1a	$0/Day(Days 1-7):1b	$0/Day(Days 1-14) $50(Days 15-100):2	$0/Visit:6	$100/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$50/Visit:9b. $0 Surgery ASC -- Physician,9b. $0 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $50 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$50/Visit:14h. $0 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $0 Advanced Imaging -- FSR,8b. $0 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $0 Radiology OP -- Facility"	$50/Visit:9a	$0/Proc:12	"$0-$50/Visit:9d. $0 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $0 OP Other,5. $5 Partial Hospitalization,8b. $0 Rad therapy,3. $5 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$5/Visit:7b, 7d, 7f"	"$0-$5/Visit:7h. $0 Psych -- OP,7e. $5 Psych -- Other Provider"	"$0-$5/Visit:9a. $0 Therapy (AT,PT,ST,OT) -- OP,7d. $5 Therapy (AT,PT,ST,OT) - Specialist"			$0/Script:15				VIS 115		HER 722		$0 Additional Smoking Cessation 14a	NSP 001			$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0: Nurse hotline 14a	$0: Nutritional benefit 14a	OTC 006				0	0	23.132799	0	99.999989	0	0	50.000018	23.714434	0	1.018509	0	0	7.546249	0	5	0	4.346694			0				0		0		0	0			0	0	0	0	0				0	0	23.132799	0	99.999989	0	0	50.000018	23.714434	0	1.018509	0	0	7.546249	0	5	0	4.346694			0				0		0		0	0			0	0	0	0	0				0	0	1.473260982	0	2.686081988	0	0	1.349125986	0.428061997	0	0.09875194	0	0	0.050672993	0	2.16651186	0	0.181843987	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.4343	0	0	0	0	1.473260982	0	2.686081988	0	0	1.349125986	0.428061997	0	0.09875194	0	0	0.050672993	0	2.16651186	0	0.181843987	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.4343																																																																																		0	0	0	0	0	1.473260982	0	2.686081988	0	0	1.349125986	0.428061997	0	0.09875194	0	0	0.050672993	0	2.16651186	0	0.181843987	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.4343
H1036_054_0	2009	2	r.	s.	t.	u.	v.	w.					Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																D	D	D	V	T	Coin	Coin	V	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					0		1691.830198	9.305165	653.004629	43.126024	345.060209	6.332395	2.359346	244.160291	229.000458	82.888081	1359.701166	0	13.584642	329.339945	9040.463572	4749.276826	0.395231	554.819965			2574.526006			5.75	2.15		0.33		0.05	0.3	1.23	2.77	0.06	0.41	0.81	6.19					$0/Day(Days 1-10):1a	$0/Day(Days 1-10):1b	"$0/Day(Days 1-6) $25(Days 7-100):2. $0 SNF 1,2. $25 SNF 2"	$0/Visit:6	$25/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$20/Visit:9b. $0 Surgery ASC -- Physician,9b. $0 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $20 Surgery OP -- Facility"	"$0-$15/Visit:8a. $0 Lab -- FSL,8. $15 Lab -- OP"	"$0-$25/Visit:14h. $15 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $0 Advanced Imaging -- FSR,8b. $0 Advanced Imaging -- Office,9a. $25 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $15 Radiology OP -- Facility"	$20/Visit:9a	"$0-$15/Proc:12. $0 Dialysis -- Dialysis Center,12. $15 Dialysis -- OP Hosp"	"$0-$25/Visit:9d. $0 Cardiac Rehab,8b. $25 Nuclear Medicine,9a. $15 OP Other,5. $0 Partial Hospitalization,8b. $15 Rad therapy,3. $0 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0-$15/Visit:7h. $15 Psych -- OP,7e. $0 Psych -- Other Provider"	"$0-$15/Visit:9a. $15 Therapy (AT,PT,ST,OT) -- OP,7d. $0 Therapy (AT,PT,ST,OT) - Specialist"			$0/Script:15			DEN ADI + Dent	VIS 140		HER 751		SMC 001	NSP 001	HAM 001	FTP 002	Other Added Benefit	MOW 001	Acupuncture 10 Visits	OTC 006					0	0	17.998769	0	25	0	0	50.000022	9.410653	12.542309	1.391299	0	1.556463	15.026091	0	0	14.998823	1.704834			0			0	0		0		0	0	0	0	0	0	0	0					0	0	17.998769	0	25	0	0	50.000022	9.410653	12.542309	1.391299	0	1.556463	15.026091	0	0	14.998823	1.704834			0			0	0		0		0	0	0	0	0	0	0	0					0	0	0.979439956	0	0.718875435	0	0	1.017334993	0.179586987	0.086633994	0.157645906	0	0.001761999	0.412390999	0	0	0.000494	0.078822995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.633	0	0	0	0	0.979439956	0	0.718875435	0	0	1.017334993	0.179586987	0.086633994	0.157645906	0	0.001761999	0.412390999	0	0	0.000494	0.078822995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.633																																																																																		0	0	0	0	0	0.979439956	0	0.718875435	0	0	1.017334993	0.179586987	0.086633994	0.157645906	0	0.001761999	0.412390999	0	0	0.000494	0.078822995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.633
H1036_056_0	2009	2	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered																		D	D	D	V	T	Coin	Coin	V	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							0		1258.214236	40.872996	830.446917	109.573033	182.338377	2.880078	1.81848	356.367745	214.909326	143.597961	1620.736348	0	2.95555	483.604265	5029.172381	4227.968185	2.912757	133.68984			10.975152				1.98		0.07		0.05	0.24	1.23	4.21	0.06	0.27							$50/Day(Days 1-7):1a	$50/Day(Days 1-7):1b	"$0/Day(Days 1-6) $50(Days 7-100):2. $0 SNF 1,2. $50 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	"0%-20% Coins:11b. 0% Supplies,11b. 20% Prosthetics"	$50/Visit:4a	"$0-$50/Visit:9b. $0 Surgery ASC -- Physician,9b. $50 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $50 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$100/Visit:14h. $0 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $0 Radiology OP -- Facility"	$50/Visit:9a	$0/Proc:12	"$0-$50/Visit:9d. $25 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $0 OP Other,5. $20 Partial Hospitalization,8b. $0 Rad therapy,3. $20 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$20/Visit:7b, 7d, 7f"	"$0-$20/Visit:7h. $0 Psych -- OP,7e. $20 Psych -- Other Provider"	"$20-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $20 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15				VIS 116		HER 722		SMC 001	OTC 001	HAM 001	FTP 002	Other Added Benefit	MOW 001							35.6218	31.503342	35.997547	0	99.999968	0	0.148108	50.000013	50.000026	0	14.385135	0	0	7.530578	0	20.000001	1.689121	24.901578			0.2				0		0		0	0	0	0	0	0							35.6218	31.503342	35.997547	0	99.999968	0	0.148108	50.000013	50.000026	0	14.385135	0	0	7.530578	0	20.000001	1.689121	24.901578			0.2				0		0		0	0	0	0	0	0							3.735	0.107302998	2.491170994	0	1.519485989	0	0.269331436	1.48486599	0.895455991	0	1.94287593	0	0	0.30348497	0	7.046613994	0.00041	0.277423998	0	0	2.1950304	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2684	0	0	3.735	0.107302998	2.491170994	0	1.519485989	0	0.269331436	1.48486599	0.895455991	0	1.94287593	0	0	0.30348497	0	7.046613994	0.00041	0.277423998	0	0	2.1950304	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2684																																																																																		0	0	0	3.735	0.107302998	2.491170994	0	1.519485989	0	0.269331436	1.48486599	0.895455991	0	1.94287593	0	0	0.30348497	0	7.046613994	0.00041	0.277423998	0	0	2.1950304	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2684
H1036_062_0	2009	3	r.	s.	t.	u.	v.	w.					Part B Rx	Health & Education (Non-Covered)	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	V	P	V	V	V	V	V			Coin			Coin	V		V		O	O	S	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		1423.349738	11.744904	1005.918654	4.734819	306.846209	6.115513	3.625921	285.635014	258.182854	47.628126	1428.993516	0	14.027944	222.602271	8309.743825	5069.592652	0.453168	522.6344			9.939572			3.98	2.1		0.33		0.05	0.3	1123.754705	1.23	2.77	0.06	0.41	1.45					$75/Day(Days 1-10):1a	$75/Day(Days 1-10):1b	"$0/Day(Days 1-14) $50(Days 15-100):2. $0 SNF 1, 2. $50 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$75/Visit:9b. $0 Surgery ASC -- Physician, 9b. $50 Surgery ASC -- Facility, 9a. $0 Surgery OP -- Physician, 9a. $75 Surgery OP -- Facility"	"$0-$20/Visit:8a. $0 Lab -- FSL, 8. $20 Lab -- OP"	"$0-$50/Visit:14h. $20 DMAM -- OP, 8b. $0 Radiology -- FSR, 14h. $0 SMAM -- FSR, 14h. $20 SMAM -- OP, 8b. $25 Advanced Imaging -- FSR, 8b. $25 Advanced Imaging -- Office, 9a. $50 Advanced Imaging -- OP, 8a. $0 Radiology OP -- Physician, 8a. $20 Radiology OP -- Facility"	$75/Visit:9a	"$0-$20/Proc:12. $0 Dialysis -- Dialysis Center, 12. $20 Dialysis -- OP Hosp"	"$15-$50/Visit:9d. $20 Cardiac Rehab, 8b. $50 Nuclear Medicine, 9a. $20 OP Other, 5. $15 Partial Hospitalization, 8b. $20 Rad therapy, 3. $15 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$15/Visit:7b, 7d, 7f"	"$15-$20/Visit:7h. $20 Psych -- OP, 7e. $15 Psych -- Other Provider"	"$15-$20/Visit:9a. $20 Therapy (AT,PT,ST,OT) -- OP, 7d. $15 Therapy (AT,PT,ST,OT) - Specialist"			0% Coins:15			DEN 824	VIS 140		HER 751		SMC 001	NSP 002	$0/Script:15	HAM 001	FTP 002	Other Added Benefit	MOW 001	OTC 006					60.160272	55.880916	23.1328	0	100.00001	0.2	0	50.000004	59.391488	17.331523	8.206198	0	0.294269	21.122426	0	14.999998	19.992585	15.523272			0			0	0		0		0	0	0	0	0	0	0	0					60.160272	55.880916	23.1328	0	100.00001	0.2	0	50.000004	59.391488	17.331523	8.206198	0	0.294269	21.122426	0	14.999998	19.992585	15.523272			0			0	0		0		0	0	0	0	0	0	0	0					7.1358	0.054692999	1.93914292	0	2.557051997	1.2231026	0	1.190145987	1.27782199	0.068788997	0.977216978	0	0.000343999	0.391825	0	6.33698997	0.000755	0.676082996	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.8297	0	0	7.1358	0.054692999	1.93914292	0	2.557051997	1.2231026	0	1.190145987	1.27782199	0.068788997	0.977216978	0	0.000343999	0.391825	0	6.33698997	0.000755	0.676082996	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.8297																																																																																		0	0	0	7.1358	0.054692999	1.93914292	0	2.557051997	1.2231026	0	1.190145987	1.27782199	0.068788997	0.977216978	0	0.000343999	0.391825	0	6.33698997	0.000755	0.676082996	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.8297
H1036_063_0	2009	3	r.	s.	t.	u.	v.						Health & Education (Non-Covered)	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	V	P	V	V	V	V	V			Coin			Coin	V		V		O	O	O	O	O	O	O						5.28	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						5.32		1294.211904	10.679311	914.653555	4.305238	279.006631	5.056159	2.997824	259.719888	234.758413	43.306916	1299.343634	0	12.755214	202.405989	7555.816461	4609.638084	0.412053	475.216769			47.042799			3.98	1.05		0.05		0.05	0.3	1.23	2.77	0.06	0.41	0.58						"$50/Day(Days 1-10), $250 IP Deductible:1a"	"$50/Day(Days 1-10), $250 IP Deductible:1b"	"$0/Day(Days 1-14) $50(Days 15-100):2. $0 SNF 1, 2. $50 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$50/Visit:9b. $0 Surgery ASC -- Physician, 9b. $0 Surgery ASC -- Facility, 9a. $0 Surgery OP -- Physician, 9a. $50 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$50/Visit:9a	$0/Proc:12	"$0/Visit:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			20% Coins:15			DEN ADI	VIS 115		HER 722		SMC 001	NSP 001	HAM 001	FTP 001	Other Added Benefit	MOW 001	OTC 006						40.106854	37.254088	23.132798	0	99.999988	0	0	49.99999	18.782969	0	0	0	0	0	0	0	0	0			0.2			0	0		0		0	0	0	0	0	0	0						40.106854	37.254088	23.132798	0	99.999988	0	0	49.99999	18.782969	0	0	0	0	0	0	0	0	0			0.2			0	0		0		0	0	0	0	0	0	0						4.3256	0.033153999	1.763207994	0	2.325054979	0	0	1.082165984	0.367454999	0	0	0	0	0	0	0	0	0	0	0	9.4085598	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.3052	250	0	9.6056	0.073153999	1.763207994	0	2.325054979	0	0	1.082165984	0.367454999	0	0	0	0	0	0	0	0	0	0	0	9.4085598	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.6252																																																																																		0	0	0	9.6056	0.073153999	1.763207994	0	2.325054979	0	0	1.082165984	0.367454999	0	0	0	0	0	0	0	0	0	0	0	9.4085598	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.6252
H1036_065_0	2009	2		s.	t.	u.	v.	w.	x.					Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered															D	D	D	V	T	Coin	Coin	V	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				0		1497.740831	11.086649	780.499498	17.363924	329.185304	4.50597	3.034633	330.676608	221.215235	48.114268	1188.23377	0	16.562333	82.293692	6911.168009	5310.216063	0.312262	512.697266			60.378339			3.98	2.15		0.05		0.05	0.3		1.23	2.77	0.06	0.65	1.45	0.41				$25/Day(Days 1-10):1a	$25/Day(Days 1-10):1b	"$0/Day(Days 1-14) $50(Days 15-100):2. $0 SNF 1, 2. $50 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$75/Visit:9b. $0 Surgery ASC -- Physician, 9b. $25 Surgery ASC -- Facility, 9a. $0 Surgery OP -- Physician, 9a. $75 Surgery OP -- Facility"	"$0-$15/Visit:8a. $0 Lab -- FSL, 8. $15 Lab -- OP"	"$0-$75/Visit:14h. $15 DMAM -- OP, 8b. $0 Radiology -- FSR, 14h. $0 SMAM -- FSR, 14h. $15 SMAM -- OP, 8b. $0 Advanced Imaging -- FSR, 8b. $0 Advanced Imaging -- Office, 9a. $75 Advanced Imaging -- OP, 8a. $0 Radiology OP -- Physician, 8a. $15 Radiology OP -- Facility"	$25/Visit:9a	"$0-$15/Proc:12. $0 Dialysis -- Dialysis Center, 12. $15 Dialysis -- OP Hosp"	"$5-$75/Visit:9d. $15 Cardiac Rehab, 8b. $75 Nuclear Medicine, 9a. $15 OP Other, 5. $5 Partial Hospitalization, 8b. $15 Rad therapy, 3. $5 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$5/Visit:7b, 7d, 7f"	"$5-$15/Visit:7h. $15 Psych -- OP, 7e. $5 Psych -- Other Provider"	"$5-$15/Visit:9a. $15 Therapy (AT,PT,ST,OT) -- OP, 7d. $5 Therapy (AT,PT,ST,OT) - Specialist"			0% Coins:15			DEN ADI	VIS 829		HER 722		SMC 001	NSP 001		HAM 001	FTP 002	Other Added Benefit	Acupuncture 6Visits	OTC 006	MOW 001				20.053426	18.626728	23.132801	0	100.000004	0	0	49.999992	48.71442	10.368816	2.262049	0	0.516593	24.055646	0	4.999999	14.987414	6.306622			0			0	0		0		0	0		0	0	0	0	0	0				20.053426	18.626728	23.132801	0	100.000004	0	0	49.999992	48.71442	10.368816	2.262049	0	0.516593	24.055646	0	4.999999	14.987414	6.306622			0			0	0		0		0	0		0	0	0	0	0	0				2.5029	0.017209	1.504594964	0	2.743210976	0	0	1.37781898	0.898030989	0.041573999	0.223986918	0	0.000712999	0.164968994	0	2.212589584	0.00039	0.269448988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.9574	0	0	2.5029	0.017209	1.504594964	0	2.743210976	0	0	1.37781898	0.898030989	0.041573999	0.223986918	0	0.000712999	0.164968994	0	2.212589584	0.00039	0.269448988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.9574																																																																																		0	0	0	2.5029	0.017209	1.504594964	0	2.743210976	0	0	1.37781898	0.898030989	0.041573999	0.223986918	0	0.000712999	0.164968994	0	2.212589584	0.00039	0.269448988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.9574
H1036_067_0	2009	4	r.	s.	t.	u.	v.						Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered						3250											D	D	D	V	T	Coin	Coin	V	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						0		1222.519878	58.19243	828.240285	567.628489	217.975902	2.720372	3.831673	243.649428	208.517576	56.355403	1254.816142	0	386.970841	184.694973	6120.038929	3290.915114	1.316157	391.424002			34.584739			3.98	2.25		0.33		0.05	0.27	1.23	3.09	0.06	0.58	0.3						$50/Day(Days 1-5):1a	$50/Day(Days 1-5):1b	"$0/Day(Days 1-9) $50(Days 10-100):2. $0 SNF 1,2. $50 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$50/Visit:9b. $0 Surgery ASC -- Physician,9b. $50 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $50 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $50 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$20-$50/Visit:9d. $50 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $20 Partial Hospitalization,8b. $50 Rad therapy,3. $20 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$20/Visit:7b, 7d, 7f"	"$20-$50/Visit:7h. $50 Psych -- OP,7e. $20 Psych -- Other Provider"	"$20-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $20 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			DEN ADI	VIS 140		HER 751		SMC 001	MOW 001	HAM 001	FTP 002	Other Added Benefit	OTC 006	NSP 001						30.655099	25.553633	30.436457	0	100.000008	0	0	50.000002	50.000044	44.717912	11.781748	0	0.04915	28.591898	0	20.000001	44.438467	22.515113			0.2			0	0		0		0	0	0	0	0	0	0						26.454584	22.052146	26.265901	0	86.297507	0	0	43.148752	43.148788	38.59044	10.167354	0	0.042416	24.674093	0	17.259501	38.349286	19.42998			0.172595			0	0		0		0	0	0	0	0	0	0						2.6951	0.106938997	1.812873111	0	1.567564744	0	0	0.876097395	0.74977339	0.18123165	1.063179993	0	0.001367813	0.379765078	0	4.733296058	0.00420614	0.633780044	0	0	5.969153028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.7743	0	3.2986	2.6951	0.106938997	1.812873111	0	1.567564744	0	0	0.876097395	0.74977339	0.18123165	1.063179993	0	0.001367813	0.379765078	0	4.733296058	0.00420614	0.633780044	0	0	5.969153028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.7743	3250																																																																																	0	0	0	2.6951	0.106938997	1.812873111	0	1.567564744	0	0	0.876097395	0.74977339	0.18123165	1.063179993	0	0.001367813	0.379765078	0	4.733296058	0.00420614	0.633780044	0	0	5.969153028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.7743
H1036_068_0	2009	4	r.	s.	t.	u.	v.						Health & Education (Non-Covered)	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	V	Coin	V	V	V	V	V			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		1480.769377	137.882413	1172.515885	279.426602	351.312656	2.619962	2.709381	270.947595	114.939515	325.406515	576.755003	0	0	314.371219	7001.266389	6133.82063	1.734968	211.873462			15.442691				1.05		0.33		0.05	0.24	1.23	3.51	0.06	0.27	0.3						$125/Day(Days 1-10):1a	$125/Day(Days 1-10):1b	"$0/Day(Days 1-14) $100(Days 15-100):2. $0 SNF 1,2. $100 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	"0%-20% Coins:11b. 0% Supplies,11b. 20% Prosthetics"	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $0 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $75 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $0 Radiology OP -- Facility"	$125/Visit:9a	20% Coins:12	"$0-$100/Visit:9d. $30 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $30 Partial Hospitalization,8b. $0 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15				VIS 116		HER 751		SMC 001	OTC 001	HAM 001	FTP 002	Other Added Benefit	MOW 001	NSP 001						100.267122	93.135097	46.2656	0	99.999984	0.199999	0.147854	49.999986	99.999969	51.437261	19.584828	0	0	42.756547	0	30	79.775534	49.871031			0.2				0		0		0	0	0	0	0	0	0						100.267122	93.135097	46.2656	0	99.999984	0.199999	0.147854	49.999986	99.999969	51.437261	19.584828	0	0	42.756547	0	30	79.775534	49.871031			0.2				0		0		0	0	0	0	0	0	0						12.3727	1.070140992	4.520595911	0	2.927604998	0.52398978	0.400592818	1.128947996	0.957828995	1.394834987	0.941303961	0	0	1.120118983	0	15.33455158	0.011534	0.880528999	0	0	3.0885382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.6738	0	0	12.3727	1.070140992	4.520595911	0	2.927604998	0.52398978	0.400592818	1.128947996	0.957828995	1.394834987	0.941303961	0	0	1.120118983	0	15.33455158	0.011534	0.880528999	0	0	3.0885382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.6738																																																																																		0	0	0	12.3727	1.070140992	4.520595911	0	2.927604998	0.52398978	0.400592818	1.128947996	0.957828995	1.394834987	0.941303961	0	0	1.120118983	0	15.33455158	0.011534	0.880528999	0	0	3.0885382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.6738
H1036_074_0	2009	4	r.	s.	t.	u.	v.						Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered						3250											D	D	D	V	T	Coin	Coin	V	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						0		1113.50521	53.00329	754.384356	517.011863	198.538532	2.256837	3.17878	221.922696	189.923626	51.330074	1142.921545	0	352.463838	168.225334	5574.302189	2997.457291	1.198791	356.519902			28.691715			3.98	2.25		0.33		0.05	0.58	1.23	3.09	0.06	0.27	0.3						$50/Day(Days 1-5):1a	$50/Day(Days 1-5):1b	"$0/Day(Days 1-9) $50(Days 10-100):2. $0 SNF 1,2. $50 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $50 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $100 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $50 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$50/Visit:9a	"$0-$100/Proc:12. $0 Dialysis -- Dialysis Center,12. $100 Dialysis -- OP Hosp"	"$20-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $20 Partial Hospitalization,8b. $100 Rad therapy,3. $20 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$20/Visit:7b, 7d, 7f"	"$20-$100/Visit:7h. $100 Psych -- OP,7e. $20 Psych -- Other Provider"	"$20-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $20 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			DEN ADI	VIS 140		HER 751		SMC 001	OTC 006	HAM 001	FTP 002	Other Added Benefit	MOW 001	NSP 001						30.655098	25.553659	30.436442	0	100.000014	0	0	50.000005	67.569792	89.435756	13.344968	0	0.098324	42.911729	0	19.999999	85.175814	26.706907			0.2			0	0		0		0	0	0	0	0	0	0						26.850739	22.382398	26.659219	0	87.589812	0	0	43.794904	59.184246	78.3366	11.688831	0	0.086122	37.586297	0	17.517959	74.605325	23.392526			0.175179			0	0		0		0	0	0	0	0	0	0						2.4915	0.098861728	1.67594148	0	1.449162724	0	0	0.809923597	0.936707217	0.33508529	1.113284732	0	0.002529574	0.526913947	0	4.375777827	0.007453016	0.694991756	0	0	5.026185942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.5444	0	2.7692	2.4915	0.098861728	1.67594148	0	1.449162724	0	0	0.809923597	0.936707217	0.33508529	1.113284732	0	0.002529574	0.526913947	0	4.375777827	0.007453016	0.694991756	0	0	5.026185942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.5444	3250																																																																																	0	0	0	2.4915	0.098861728	1.67594148	0	1.449162724	0	0	0.809923597	0.936707217	0.33508529	1.113284732	0	0.002529574	0.526913947	0	4.375777827	0.007453016	0.694991756	0	0	5.026185942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.5444
H1036_077_0	2009	3	r.	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	Other Non-Covered														D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			S			Coin	V		V		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			0		1647.364494	9.060601	635.841967	41.99256	335.991129	6.0039	2.236954	237.743122	222.98173	80.709565	1323.96468	0	13.227605	320.684034	8802.856649	4624.45346	0.384843	540.237853			2506.860759			5.75	2.15		0.33		0.05	0.3	2.77	0.06	0.41	1.23	8.69	0.93	4.62	120			$0/Day(Days 1-10):1a	$0/Day(Days 1-10):1b	$0/Day(Days 1-100) $0(Days 100-100):2	$0/Visit:6	$0/Trip:10a	0% Coins:11a	0% Coins:11b	$25/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"$0/Visit:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			$0/Script:15			DEN ADI + Dent	VIS 140		HER 751		SMC 001	NSP 002	FTP 002	Other Added Benefit	MOW 001	HAM 001	OTC 006	Acupuncture 16 Visits	TRN 068	ILS 020			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	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	0	0.495297993	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4953	0	0	0	0	0	0	0	0	0	0.495297993	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4953																																																																																		0	0	0	0	0	0	0	0	0	0	0.495297993	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.4953
H1036_081_0	2009	4	r.	s.	t.	u.	v.						Health & Education (Non-Covered)	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	V	Coin	V	V	V	V	V			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		1439.050724	133.997766	1139.481851	271.554139	341.414901	2.474416	2.558867	263.314017	111.701251	316.238632	560.505722	0	0	305.514244	6804.015275	5961.008617	1.686089	205.904218			14.584804				1.05		0.33		0.05	0.24	1.23	3.51	0.06	0.27	0.3						$150/Day(Days 1-10):1a	$150/Day(Days 1-7):1b	"$0/Day(Days 1-20) $115(Days 21-100):2. $0 SNF 1,2. $115 SNF 2"	$0/Visit:6	$150/Trip:10a	20% Coins:11a	"0%-20% Coins:11b. 0% Supplies,11b. 20% Prosthetics"	$50/Visit:4a	"$0-$200/Visit:9b. $0 Surgery ASC -- Physician,9b. $125 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $200 Surgery OP -- Facility"	"$0-$75/Visit:8a. $0 Lab -- FSL,8. $75 Lab -- OP"	"$0-$150/Visit:14h. $75 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $75 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $75 Advanced Imaging -- Office,9a. $150 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $75 Radiology OP -- Facility"	$150/Visit:9a	20% Coins:12	"$40-$150/Visit:9d. $75 Cardiac Rehab,8b. $150 Nuclear Medicine,9a. $75 OP Other,5. $40 Partial Hospitalization,8b. $75 Rad therapy,3. $40 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$40/Visit:7b, 7d, 7f"	"$40-$75/Visit:7h. $75 Psych -- OP,7e. $40 Psych -- Other Provider"	"$40-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $40 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15				VIS 116		HER 751		SMC 001	OTC 001	HAM 001	FTP 002	Other Added Benefit	MOW 001	NSP 001						120.32055	94.510083	38.752129	0	149.99999	0.199999	0.147854	50.000011	161.478979	38.577943	62.210576	0	0	55.630663	0	40	64.893371	49.935528			0.2				0		0		0	0	0	0	0	0	0						120.32055	94.510083	38.752129	0	149.99999	0.199999	0.147854	50.000011	161.478979	38.577943	62.210576	0	0	55.630663	0	40	64.893371	49.935528			0.2				0		0		0	0	0	0	0	0	0						14.4289	1.055344999	3.679778974	0	4.267685978	0.494880726	0.378338721	1.097141979	1.503116997	1.016652993	2.905781985	0	0	1.416329996	0	19.87002872	0.009118	0.856827987	0	0	2.9169608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.8969	0	0	14.4289	1.055344999	3.679778974	0	4.267685978	0.494880726	0.378338721	1.097141979	1.503116997	1.016652993	2.905781985	0	0	1.416329996	0	19.87002872	0.009118	0.856827987	0	0	2.9169608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.8969																																																																																		0	0	0	14.4289	1.055344999	3.679778974	0	4.267685978	0.494880726	0.378338721	1.097141979	1.503116997	1.016652993	2.905781985	0	0	1.416329996	0	19.87002872	0.009118	0.856827987	0	0	2.9169608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.8969
H1036_100_0	2009	6	r.	s.	t.	u.	v.						Health & Education (Non-Covered)	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	V	P	V	V	V	V	V			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		1468.693102	56.09451	674.239606	687.489678	250.187376	3.006509	1.923705	307.095625	298.793426	95.405646	1301.752504	0	14.558305	209.40054	6399.261569	5278.366716	2.695066	577.783307			23.682177				0.91		0.33		0.05	0.24	1.23	3.14	0.06	0.27	0.3						$100/Day(Days 1-10):1a	$100/Day(Days 1-10):1b	"$0/Day(Days 1-14) $50(Days 15-100):2. $0 SNF 1,2. $50 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"$0/Visit:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			20% Coins:15				VIS 989		HER 751		SMC 001	OTC 001	HAM 001	FTP 002	Other Added Benefit	MOW 001	NSP 001						80.213697	74.50804	23.132797	0	100.000009	0	0	49.999995	0	0	0	0	0	0	0	0	0	0			0.199999				0		0		0	0	0	0	0	0	0						80.213697	74.50804	23.132797	0	100.000009	0	0	49.999995	0	0	0	0	0	0	0	0	0	0			0.199999				0		0		0	0	0	0	0	0	0						9.8174	0.348291	1.299753995	0	2.084894988	0	0	1.279564976	0	0	0	0	0	0	0	0	0	0	0	0	4.736411718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.5664	0	0	9.8174	0.348291	1.299753995	0	2.084894988	0	0	1.279564976	0	0	0	0	0	0	0	0	0	0	0	0	4.736411718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.5664																																																																																		0	0	0	9.8174	0.348291	1.299753995	0	2.084894988	0	0	1.279564976	0	0	0	0	0	0	0	0	0	0	0	0	4.736411718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.5664
H1036_102_0	2009	6	r.	s.	t.	u.	v.	w.					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	Coin	V	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					0		2589.330079	123.253139	877.117633	601.126226	230.83942	3.063065	4.314359	258.028031	220.822926	59.681132	1328.867215	0	409.807341	195.594468	6481.20377	3485.123491	1.393828	414.523299			1369.829559			3.98	2.25		0.33		3.09	0.96	0.06	0.05	0.27	1.23	2.1	35					$0/Day(Days 1-10):1a	$0/Day(Days 1-10):1b	$0/Day(Days 1-100) $0(Days 100-100):2	$0/Visit:6	$0/Trip:10a	0% Coins:11a	0% Coins:11b	$25/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"$0/Visit:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			$0/Script:15			DEN ADI	VIS 140		HER 751		FTP 002	TRN 003	Other Added Benefit	SMC 001	MOW 001	HAM 001	OTC 006	ILS 004					0	0	0	0	0	0	0	24.999981	0	0	0	0	0	0	0	0	0	0			0			0	0		0		0	0	0	0	0	0	0	0					0	0	0	0	0	0	0	24.999981	0	0	0	0	0	0	0	0	0	0			0			0	0		0		0	0	0	0	0	0	0	0					0	0	0	0	0	0	0	0.537557989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.5376	0	0	0	0	0	0	0	0	0	0.537557989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.5376																																																																																		0	0	0	0	0	0	0	0	0	0	0.537557989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.5376
H1036_103_0	2009	3	r.	s.	t.	u.	v.	w.	x.				Health & Education (Non-Covered)	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	Coin	V	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				0		1577.547889	11.6774	822.088381	18.289159	346.725929	4.998968	3.366652	348.296697	233.002682	50.678035	1251.548757	0	17.444857	86.67871	7279.429308	5593.170704	0.328901	540.016318			2132.432521			5.75	2.1		0.33		0.05	0.96	1.23	2.77	0.06	1.45	35	0.3	0.41				$0/Day(Days 1-10):1a	$0/Day(Days 1-10):1b	$0/Day(Days 1-100) $0(Days 100-100):2	$0/Visit:6	$25/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"$0/Visit:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			$0/Script:15			DEN ADI + Dent	VIS 140		HER 751		SMC 001	TRN 003	HAM 001	FTP 002	Other Added Benefit	OTC 006	ILS 004	NSP 001	MOW 001				0	0	0	0	25.00001	0	0	49.999991	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	25.00001	0	0	49.999991	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	0.722345974	0	0	1.451235976	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.1736	0	0	0	0	0	0	0.722345974	0	0	1.451235976	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.1736																																																																																		0	0	0	0	0	0	0	0.722345974	0	0	1.451235976	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.1736
H1036_104_0	2009	4	r.	s.	t.	u.	v.	w.	x.	y.	z.		DME/Prosthetics/Supplies	OP Facility - Surgery	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered	Health & Education (Non-Covered)	Other Non-Covered			Prosthetics/Supplies										D	D	D	V	T	Coin	Coin	V	Coin	V	V	V	P	V	V	V	V	V			S			Coin	V		V		O	O	O	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	0	0	0		0		1370.162438	11.306024	968.329794	4.55789	295.380073	5.66702	2.163423	274.961491	11.501673	45.848373	1375.595322	0	13.503751	214.284138	7999.227853	4880.15366	0.436234	503.104757			1721.44395			5.75	2.1		0.33		0.96	0.05	2638.586636	93.364609	2.77	0.3	0.41	1.23	35	0.06	1.45		$0/Day(Days 1-100):1a	$0/Day(Days 1-100):1b	$0/Day(Days 1-100) $0(Days 100-100):2	$0/Visit:6	$25/Trip:10a	0% Coins:11a	0% Coins:11b	$25/Visit:4a	"0% Coins:9a, 9b"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"$0/Visit:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			$0/Script:15			DEN ADI  + Dent	VIS 140		HER 751		TRN 003	SMC 001	:11b	"$0/Visit:9a, 9b"	FTP 002	NSP 002	MOW 001	HAM 001	ILS 004	Other Added Benefit	OTC 006		0	0	0	0	24.999993	0	0	24.99998	0	0	0	0	0	0	0	0	0	0			0			0	0		0		0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	24.999993	0	0	24.99998	0	0	0	0	0	0	0	0	0	0			0			0	0		0		0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0.61537498	0	0	0.572835981	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.1882	0	0	0	0	0	0	0.61537498	0	0	0.572835981	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.1882																																																																																		0	0	0	0	0	0	0	0.61537498	0	0	0.572835981	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.1882
H1036_105_0	2009	6	r.	s.	t.	u.	v.	w.	x.				Part B Rx	Health & Education (Non-Covered)	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	V	P	V	V	V	V	V			Coin				V		V		O	O	S	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		1420.805685	46.154767	937.760571	123.732497	205.900867	286.369201	1470.114147	402.419004	242.680763	162.154261	1830.174345	0	3.337478	546.09753	5679.06204	4774.323055	3.289154	150.965773			2.560051				2.2		0.33		0.05	0.96	1588.797109	1.23	4.21	0.06	0.24	0.27	0.3				$0/Day(Days 1-7):1a	$0/Day(Days 1-7):1b	$0/Day(Days 1-6) $0(Days 7-100):2	$0/Visit:6	$25/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"$0/Visit:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			0% Coins:15				VIS 140		HER 751		SMC 001	TRN 003	$0/Script:15	HAM 001	FTP 002	Other Added Benefit	OTC 006	MOW 001	NSP 001				0	0	0	0	25	0	0	50.000004	0	0	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	0	0	50.000004	0	0	0	0	0	0	0	0	0	0			0				0		0		0	0	0	0	0	0	0	0	0				0	0	0	0	0.42896014	0	0	1.676745984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.1057	0	0	0	0	0	0	0.42896014	0	0	1.676745984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.1057																																																																																		0	0	0	0	0	0	0	0.42896014	0	0	1.676745984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.1057
H1036_106_0	2009	3	r.	s.	t.	u.	v.						Health & Education (Non-Covered)	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	V	P	V	V	V	V	V			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		1418.692924	46.086133	936.366105	123.548504	205.594689	3.661614	2.311941	401.820601	242.319893	161.913134	1827.452846	0	3.332516	545.285474	5670.617185	4767.223559	3.284262	150.741284			13.953361				2.5		0.33		0.05	0.24	1.23	4.21	0.06	0.27	0.3						$200/Day(Days 1-10):1a	$200/Day(Days 1-7):1b	"$0/Day(Days 1-20) $120(Days 21-100):2. $0 SNF 1,2. $120 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	"0%-20% Coins:11b. 0% Supplies,11b. 20% Prosthetics"	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$75/Visit:14h. $25 DMAM -- OP,8b. $25 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $75 Advanced Imaging -- Office,9a. $75 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $25 Radiology OP -- Facility"	$150/Visit:9a	$0/Proc:12	"$0-$75/Visit:9d. $25 Cardiac Rehab,8b. $75 Nuclear Medicine,9a. $0 OP Other,5. $30 Partial Hospitalization,8b. $25 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$5/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$0-$30/Visit:7h. $0 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$150/Visit:9a. $150 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15				VIS 140		HER 751		SMC 001	OTC 001	HAM 001	FTP 002	Other Added Benefit	MOW 001	NSP 001						160.427401	126.013436	40.437004	0	99.999995	0	0.148108	50.000014	125.048652	0	32.667653	0	0	23.388981	4.999999	29.999997	2.532075	49.60645			0.199999				0		0		0	0	0	0	0	0	0						160.427401	126.013436	40.437004	0	99.999995	0	0.148108	50.000014	125.048652	0	32.667653	0	0	23.388981	4.999999	29.999997	2.532075	49.60645			0.199999				0		0		0	0	0	0	0	0	0						18.9664	0.483955998	3.155319994	0	1.713288989	0	0.342416958	1.674252973	2.525147998	0	4.974882954	0	0	1.062805966	2.362756688	11.91805771	0.000693	0.623144997	0	0	2.790658247	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5938	0	0	18.9664	0.483955998	3.155319994	0	1.713288989	0	0.342416958	1.674252973	2.525147998	0	4.974882954	0	0	1.062805966	2.362756688	11.91805771	0.000693	0.623144997	0	0	2.790658247	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5938																																																																																		0	0	0	18.9664	0.483955998	3.155319994	0	1.713288989	0	0.342416958	1.674252973	2.525147998	0	4.974882954	0	0	1.062805966	2.362756688	11.91805771	0.000693	0.623144997	0	0	2.790658247	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5938
H1036_108_0	2009	4	r.	s.	t.	u.	v.						Health & Education (Non-Covered)	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	V	Coin	V	V	V	V	V			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		1490.365281	138.77594	1180.114197	281.237384	353.589284	2.654037	2.744619	272.703431	115.684365	327.515264	580.492577	0	0	316.408461	7046.637049	6173.569939	1.746212	213.246477			15.643535				1.05		0.33		0.05	0.24	1.23	3.51	0.06	0.27	0.3						$200/Day(Days 1-10):1a	$200/Day(Days 1-7):1b	"$0/Day(Days 1-20) $115(Days 21-100):2. $0 SNF 1,2. $115 SNF 2"	$0/Visit:6	$150/Trip:10a	20% Coins:11a	"0%-20% Coins:11b. 0% Supplies,11b. 20% Prosthetics"	$50/Visit:4a	"$0-$200/Visit:9b. $0 Surgery ASC -- Physician,9b. $125 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $200 Surgery OP -- Facility"	"$0-$75/Visit:8a. $0 Lab -- FSL,8. $75 Lab -- OP"	"$0-$150/Visit:14h. $75 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $75 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $75 Advanced Imaging -- Office,9a. $150 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $75 Radiology OP -- Facility"	$150/Visit:9a	20% Coins:12	"$40-$150/Visit:9d. $75 Cardiac Rehab,8b. $150 Nuclear Medicine,9a. $75 OP Other,5. $40 Partial Hospitalization,8b. $75 Rad therapy,3. $40 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$40/Visit:7b, 7d, 7f"	"$40-$75/Visit:7h. $75 Psych -- OP,7e. $40 Psych -- Other Provider"	"$40-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $40 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15				VIS 116		HER 722		SMC 001	OTC 001	HAM 001	FTP 002	Other Added Benefit	MOW 001	NSP 001						160.4274	126.01337	38.75212	0	149.999998	0.199999	0.147854	49.999986	161.479072	38.577927	62.210593	0	0	55.630686	0	39.999999	64.885592	49.935511			0.2				0		0		0	0	0	0	0	0	0						160.4274	126.01337	38.75212	0	149.999998	0.199999	0.147854	49.999986	161.479072	38.577927	62.210593	0	0	55.630686	0	39.999999	64.885592	49.935511			0.2				0		0		0	0	0	0	0	0	0						19.9246	1.45730199	3.810993915	0	4.419865991	0.530804746	0.405802898	1.136263978	1.556716992	1.052904995	3.009398954	0	0	1.466834978	0	20.57856595	0.009442	0.887380983	0	0	3.128707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.3756	0	0	19.9246	1.45730199	3.810993915	0	4.419865991	0.530804746	0.405802898	1.136263978	1.556716992	1.052904995	3.009398954	0	0	1.466834978	0	20.57856595	0.009442	0.887380983	0	0	3.128707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.3756																																																																																		0	0	0	19.9246	1.45730199	3.810993915	0	4.419865991	0.530804746	0.405802898	1.136263978	1.556716992	1.052904995	3.009398954	0	0	1.466834978	0	20.57856595	0.009442	0.887380983	0	0	3.128707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.3756
H1036_109_0	2009	6	r.	s.	t.	u.	v.	w.	x.				Health & Education (Non-Covered)	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	Coin	V	V	V	V	V	P	V	V	V	V	V			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		1560.276727	145.285771	1235.472095	294.42993	370.175781	2.908876	3.008155	285.495658	121.110993	342.878655	607.72287	0	0.12017	331.250843	7377.187268	6463.165513	1.828125	223.249642			8.62526				2.5		0.33		0.05	0.27	1.23	3.51	0.06	45	0.96	0.24	0.3				$0/Day(Days 1-10):1a	$0/Day(Days 1-10):1b	$0/Day(Days 1-20) $0(Days 21-100):2	$0/Visit:6	$25/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"$0/Visit:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			0% Coins:15				VIS 140		HER 751		SMC 001	MOW 001	HAM 001	FTP 002	Other Added Benefit	ILS 005	TRN 003	OTC 001	NSP 001				0	0	0	0	25	0	0	49.999989	0	0	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	0	0	49.999989	0	0	0	0	0	0	0	0	0	0			0				0		0		0	0	0	0	0	0	0	0	0				0	0	0	0	0.771199544	0	0	1.18956498	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.9608	0	0	0	0	0	0	0.771199544	0	0	1.18956498	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.9608																																																																																		0	0	0	0	0	0	0	0.771199544	0	0	1.18956498	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.9608
H1036_110_0	2009	4	r.	s.	t.	u.	v.						Health & Education (Non-Covered)	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	V	Coin	V	V	V	V	V			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		1503.523955	140.001215	1190.533616	283.720474	356.71118	2.701107	2.793295	275.111173	116.705759	330.406948	585.617838	0	0	319.202078	7108.852935	6228.077374	1.761629	215.129263			15.920976				1.05		0.33		0.05	0.24	1.23	3.51	0.06	0.27	0.3						$175/Day(Days 1-10):1a	$175/Day(Days 1-7):1b	"$0/Day(Days 1-14) $100(Days 15-100):2. $0 SNF 1,2. $100 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	"0%-20% Coins:11b. 0% Supplies,11b. 20% Prosthetics"	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $0 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $75 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $0 Radiology OP -- Facility"	$125/Visit:9a	20% Coins:12	"$0-$100/Visit:9d. $30 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $30 Partial Hospitalization,8b. $0 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15				VIS 116		HER 751		SMC 001	OTC 001	HAM 001	FTP 002	Other Added Benefit	MOW 001	NSP 001						140.373978	110.261728	46.265603	0	99.999994	0.199999	0.147854	50.000019	100	51.437259	19.584813	0	0	42.756526	0	29.999999	79.773891	49.870983			0.2				0		0		0	0	0	0	0	0	0						140.373978	110.261728	46.265603	0	99.999994	0.199999	0.147854	50.000019	100	51.437259	19.584813	0	0	42.756526	0	29.999999	79.773891	49.870983			0.2				0		0		0	0	0	0	0	0	0						17.588	1.286397991	4.59006297	0	2.972592988	0.540218699	0.412999839	1.14629699	0.972547992	1.41626898	0.955767987	0	0	1.137330996	0	15.57019292	0.011711	0.894058985	0	0	3.1841952	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.6786	0	0	17.588	1.286397991	4.59006297	0	2.972592988	0.540218699	0.412999839	1.14629699	0.972547992	1.41626898	0.955767987	0	0	1.137330996	0	15.57019292	0.011711	0.894058985	0	0	3.1841952	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.6786																																																																																		0	0	0	17.588	1.286397991	4.59006297	0	2.972592988	0.540218699	0.412999839	1.14629699	0.972547992	1.41626898	0.955767987	0	0	1.137330996	0	15.57019292	0.011711	0.894058985	0	0	3.1841952	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.6786
H1036_114_0	2009	6	r.	s.	t.	u.	v.	w.	x.				Part B Rx	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered															D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin		T	Coin	V		V		O	O	S	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				0		1462.284837	55.849755	671.297734	684.489993	249.095747	2.980329	1.906953	305.755692	297.489718	94.989369	1296.07264	0	14.494785	208.486875	6371.340034	5255.335915	2.683305	575.262298			5.413844		0.96	3.98	1.3		0.33		0.05	0.27	797.021159	1.23	3.14	0.06	50	0.3	0.24				$0/Day(Days 1-7):1a	$0/Day(Days 1-7):1b	$0/Day(Days 1-6) $0(Days 7-100):2	$0/Visit:6	$25/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"$0/Visit:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			0% Coins:15		TRN 003	DEN ADI	VIS 978		HER 751		SMC 001	MOW 001	$0/Script:15	HAM 001	FTP 002	Other Added Benefit	ILS 006	NSP 001	OTC 001				0	0	0	0	25	0	0	49.999998	0	0	0	0	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	0	0	49.999998	0	0	0	0	0	0	0	0	0	0			0		0	0	0		0		0	0	0	0	0	0	0	0	0				0	0	0	0	0.518949473	0	0	1.273981999	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.7929	0	0	0	0	0	0	0.518949473	0	0	1.273981999	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.7929																																																																																		0	0	0	0	0	0	0	0.518949473	0	0	1.273981999	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.7929
H1036_115_0	2009	6	r.	s.	t.	u.	v.						Health & Education (Non-Covered)	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	V	Coin	V	V	V	V	V			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		1503.998344	57.44294	690.447343	704.015928	256.201515	3.152786	2.0173	314.477757	305.975984	97.69906	1333.044735	0	0.025341	214.434224	6553.090492	5405.25096	2.75985	591.672375			24.834402				0.91		0.33		0.05	0.24	1.23	3.14	0.06	0.27	0.3						$150/Day(Days 1-10):1a	$150/Day(Days 1-7):1b	"$0/Day(Days 1-14) $100(Days 15-100):2. $0 SNF 1,2. $100 SNF 2"	$0/Visit:6	$140/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $150 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$150/Visit:14h. $100 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $100 SMAM -- OP,8b. $25 Advanced Imaging -- FSR,8b. $25 Advanced Imaging -- Office,9a. $150 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$150/Visit:9a	20% Coins:12	"$25-$150/Visit:9d. $100 Cardiac Rehab,8b. $150 Nuclear Medicine,9a. $100 OP Other,5. $25 Partial Hospitalization,8b. $100 Rad therapy,3. $25 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$25/Visit:7b, 7d, 7f"	"$25-$100/Visit:7h. $100 Psych -- OP,7e. $25 Psych -- Other Provider"	"$25-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $25 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15				VIS 989		HER 751		SMC 001	OTC 001	HAM 001	FTP 002	Other Added Benefit	MOW 001	NSP 001						120.32055	94.509995	46.265604	0	140	0	0	50	149.999968	92.185083	14.371241	0	0.199992	55.748563	0	24.999998	85.217674	28.637693			0.199999				0		0		0	0	0	0	0	0	0						120.32055	94.509995	46.265604	0	140	0	0	50	149.999968	92.185083	14.371241	0	0.199992	55.748563	0	24.999998	85.217674	28.637693			0.199999				0		0		0	0	0	0	0	0	0						15.0802	0.452410998	2.661996946	0	2.989017675	0	0	1.310323988	3.824698984	0.750532996	1.596458929	0	0.005067997	0.996199987	0	11.2609386	0.019599	1.412010986	0	0	4.966855566	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.3263	0	0	15.0802	0.452410998	2.661996946	0	2.989017675	0	0	1.310323988	3.824698984	0.750532996	1.596458929	0	0.005067997	0.996199987	0	11.2609386	0.019599	1.412010986	0	0	4.966855566	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.3263																																																																																		0	0	0	15.0802	0.452410998	2.661996946	0	2.989017675	0	0	1.310323988	3.824698984	0.750532996	1.596458929	0	0.005067997	0.996199987	0	11.2609386	0.019599	1.412010986	0	0	4.966855566	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.3263
H1036_116_0	2009	6	r.	s.	t.	u.	v.	w.					Other Non-Covered	Health & Education (Non-Covered)	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	V	Coin	V	V	V	V	V			Coin			V	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					0		1368.132198	52.253738	628.074656	640.417499	233.057133	2.60889	1.66929	286.068896	278.335145	88.873255	1212.621962	0	0.02097	195.062957	5961.106359	4916.958784	2.510534	538.222683			20.55015			1.62	0.91		0.33		0.05	0.24	0.65	1.23	3.14	0.06	0.27						$125/Day(Days 1-10):1a	$125/Day(Days 1-10):1b	"$0/Day(Days 1-14) $100(Days 15-100):2. $0 SNF 1,2. $100 SNF 2"	$0/Visit:6	$140/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $150 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$150/Visit:14h. $100 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $100 SMAM -- OP,8b. $25 Advanced Imaging -- FSR,8b. $25 Advanced Imaging -- Office,9a. $150 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$150/Visit:9a	20% Coins:12	"$25-$150/Visit:9d. $100 Cardiac Rehab,8b. $150 Nuclear Medicine,9a. $100 OP Other,5. $25 Partial Hospitalization,8b. $100 Rad therapy,3. $25 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$25/Visit:7b, 7d, 7f"	"$25-$100/Visit:7h. $100 Psych -- OP,7e. $25 Psych -- Other Provider"	"$25-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $25 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			DEN 723	VIS 989		HER 751		SMC 001	OTC 001	Acupuncture 6 Visits	HAM 001	FTP 002	Other Added Benefit	MOW 001	NSP 001					100.267126	93.135155	46.265601	0	140	0	0	50.000011	149.999986	92.185033	14.371238	0	0.2	55.748524	0	24.999999	85.220116	28.6377			0.2			0	0		0		0	0	0	0	0	0	0	0					100.267126	93.135155	46.265601	0	140	0	0	50.000011	149.999986	92.185033	14.371238	0	0.2	55.748524	0	24.999999	85.220116	28.6377			0.2			0	0		0		0	0	0	0	0	0	0	0					11.4316	0.405554999	2.421520953	0	2.718999885	0	0	1.191953996	3.479188988	0.682731995	1.452239902	0	0.004194	0.906205995	0	10.24366372	0.017829	1.284454977	0	0	4.11003	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3501	0	0	11.4316	0.405554999	2.421520953	0	2.718999885	0	0	1.191953996	3.479188988	0.682731995	1.452239902	0	0.004194	0.906205995	0	10.24366372	0.017829	1.284454977	0	0	4.11003	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3501																																																																																		0	0	0	11.4316	0.405554999	2.421520953	0	2.718999885	0	0	1.191953996	3.479188988	0.682731995	1.452239902	0	0.004194	0.906205995	0	10.24366372	0.017829	1.284454977	0	0	4.11003	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3501
H1036_117_0	2009	7	r.	s.	t.	u.	v.						Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered						3250											D	D	D	V	T	Coin	Coin	V	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						0		1313.766544	62.535808	890.058637	609.995249	234.245227	3.141611	4.424993	261.83498	224.08095	60.561667	1348.473339	0	415.853642	198.48027	6576.827533	3536.543044	1.414393	420.63918			39.940051			3.98	2.25		0.33		1.23	0.27	0.05	3.09	0.06	0.58	0.3						$150/Day(Days 1-7):1a	$150/Day(Days 1-7):1b	"$0/Day(Days 1-9) $75(Days 10-100):2. $0 SNF 1,2. $75 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $50 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $100 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $50 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	"$0-$100/Proc:12. $0 Dialysis -- Dialysis Center,12. $100 Dialysis -- OP Hosp"	"$20-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $20 Partial Hospitalization,8b. $100 Rad therapy,3. $20 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$20/Visit:7b, 7d, 7f"	"$20-$100/Visit:7h. $100 Psych -- OP,7e. $20 Psych -- Other Provider"	"$20-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $20 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			DEN ADI	VIS 140		HER 751		HAM 001	MOW 001	SMC 001	FTP 002	Other Added Benefit	OTC 006	NSP 001						106.865397	94.510076	45.654672	0	100.000022	0	0	49.999996	67.569813	89.435781	13.344975	0	0.098313	42.911731	0	19.999998	85.181417	26.706898			0.2			0	0		0		0	0	0	0	0	0	0						82.251517	72.741948	35.139214	0	76.967417	0	0	38.483697	52.006728	68.836395	10.27128	0	0.075669	33.028043	0	15.393478	65.561921	20.555605			0.153934			0	0		0		0	0	0	0	0	0	0						9.0049	0.379081374	2.606330077	0	1.502437506	0	0	0.83969817	0.971143085	0.347403903	1.15421227	0	0.002622269	0.546284574	0	4.536641462	0.007727527	0.720541069	0	0	6.148131811	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.7672	0	8.6086	9.0049	0.379081374	2.606330077	0	1.502437506	0	0	0.83969817	0.971143085	0.347403903	1.15421227	0	0.002622269	0.546284574	0	4.536641462	0.007727527	0.720541069	0	0	6.148131811	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.7672	3250																																																																																	0	0	0	9.0049	0.379081374	2.606330077	0	1.502437506	0	0	0.83969817	0.971143085	0.347403903	1.15421227	0	0.002622269	0.546284574	0	4.536641462	0.007727527	0.720541069	0	0	6.148131811	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.7672
H1036_118_0	2009	8	r.	s.	t.	u.	v.	w.					Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Health & Education (Non-Covered)					3250											D	D	D	V	T	Coin	Coin	V	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					0		1188.331021	56.565026	805.077807	551.754252	211.880013	2.570342	3.620354	236.835555	202.686198	54.779372	1219.724093	0	376.148856	179.529816	5948.886596	3198.881743	1.27935	380.477482			32.677373			4.91	2.25		0.33		1.23	0.27	0.05	3.09	0.06	0.93	0.58	0.3					$125/Day(Days 1-7):1a	$125/Day(Days 1-7):1b	"$0/Day(Days 1-9) $75(Days 10-100):2. $0 SNF 1,2. $75 SNF 2"	$0/Visit:6	$75/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $50 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $100 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $50 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	"$0-$100/Proc:12. $0 Dialysis -- Dialysis Center,12. $100 Dialysis -- OP Hosp"	"$20-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $20 Partial Hospitalization,8b. $100 Rad therapy,3. $20 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$20/Visit:7b, 7d, 7f"	"$20-$100/Visit:7h. $100 Psych -- OP,7e. $20 Psych -- Other Provider"	"$20-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $20 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			DEN 825	VIS 140		HER 751		HAM 001	MOW 001	SMC 001	FTP 002	Other Added Benefit	Acupuncture 16 Visits	OTC 006	NSP 001					89.054499	78.758277	45.654677	0	75	0	0	50.000009	67.56981	89.435636	13.344972	0	0.098322	42.911757	0	20.000001	85.177629	26.706926			0.199999			0	0		0		0	0	0	0	0	0	0	0					72.152667	63.810586	36.989785	0	75	0	0	40.510407	54.745601	72.461468	10.812203	0	0.079661	34.767449	0	16.204161	69.011596	21.638165			0.162041			0	0		0		0	0	0	0	0	0	0	0					7.1451	0.300787288	2.481637916	0	1.324250081	0	0	0.799525394	0.924681477	0.330782809	1.098992041	0	0.002497033	0.520149477	0	4.319599565	0.007357499	0.686069545	0	0	5.295074198	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2365	0	5.9366	7.1451	0.300787288	2.481637916	0	1.324250081	0	0	0.799525394	0.924681477	0.330782809	1.098992041	0	0.002497033	0.520149477	0	4.319599565	0.007357499	0.686069545	0	0	5.295074198	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2365	3250																																																																																	0	0	0	7.1451	0.300787288	2.481637916	0	1.324250081	0	0	0.799525394	0.924681477	0.330782809	1.098992041	0	0.002497033	0.520149477	0	4.319599565	0.007357499	0.686069545	0	0	5.295074198	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2365
H1036_119_0	2009	4	r.	s.	t.								Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)																			D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin						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		1202.344828	57.232091	814.571968	558.261006	214.378681	2.631323	3.706246	239.62852	205.076444	55.425378	1234.10811	0	0.010833	181.646983	6019.040908	3236.605668	1.294437	384.964394			33.452636						0.07		0.05	0.27	1.23	3.09	0.06								$275/Day(Days 1-5):1a	$275/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$25/Visit:6	$150/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$150/Visit:8a. $0 Lab -- FSL,8. $150 Lab -- OP"	"$0-$150/Visit:14h. $150 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $150 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $50 Advanced Imaging -- Office,9a. $150 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $150 Radiology OP -- Facility"	$150/Visit:9a	20% Coins:12	"$35-$150/Visit:9d. $150 Cardiac Rehab,8b. $150 Nuclear Medicine,9a. $150 OP Other,5. $35 Partial Hospitalization,8b. $150 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$150/Visit:7h. $150 Psych -- OP,7e. $35 Psych -- Other Provider"	"$35-$150/Visit:9a. $150 Therapy (AT,PT,ST,OT) -- OP,7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15						HER 722		SMC 001	MOW 001	HAM 001	FTP 001	Other Added Benefit								168.603045	140.545415	43.132792	25.000005	150.000027	0	0	49.999991	117.569856	134.153564	23.929472	0	0.200036	67.935661	9.999999	35	128.692242	44.641198			0.2						0		0	0	0	0	0								168.603045	140.545415	43.132792	25.000005	150.000027	0	0	49.999991	117.569856	134.153564	23.929472	0	0.200036	67.935661	9.999999	35	128.692242	44.641198			0.2						0		0	0	0	0	0								16.8932	0.670308998	2.927896939	1.163043995	2.679733995	0	0	0.998451987	2.009233999	0.619626	2.460962955	0	0.00216699	1.028358988	5.015866922	9.440099865	0.013882	1.432105978	0	0	6.6905272	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0455	0	0	16.8932	0.670308998	2.927896939	1.163043995	2.679733995	0	0	0.998451987	2.009233999	0.619626	2.460962955	0	0.00216699	1.028358988	5.015866922	9.440099865	0.013882	1.432105978	0	0	6.6905272	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0455																																																																																		0	0	0	16.8932	0.670308998	2.927896939	1.163043995	2.679733995	0	0	0.998451987	2.009233999	0.619626	2.460962955	0	0.00216699	1.028358988	5.015866922	9.440099865	0.013882	1.432105978	0	0	6.6905272	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0455
H1036_121_0	2009	3		s.	t.	u.	v.	w.	x.					Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered															D	D	D	V	T	Coin	Coin	V	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				0		1744.815661	12.915559	909.254605	20.228364	383.489361	6.115251	4.118434	385.226677	257.708009	56.051438	1384.250764	0	19.294539	95.869274	8051.268906	6186.215905	0.363774	597.274375			81.942114			3.98	2.15		0.05		0.05	0.3		1.23	2.77	0.06	0.41	0.65	1.45				$75/Day(Days 1-10):1a	$75/Day(Days 1-10):1b	"$0/Day(Days 1-14) $50(Days 15-100):2. $0 SNF 1, 2. $50 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$75/Visit:9b. $0 Surgery ASC -- Physician, 9b. $25 Surgery ASC -- Facility, 9a. $0 Surgery OP -- Physician, 9a. $75 Surgery OP -- Facility"	"$0-$15/Visit:8a. $0 Lab -- FSL, 8. $15 Lab -- OP"	"$0-$75/Visit:14h. $15 DMAM -- OP, 8b. $0 Radiology -- FSR, 14h. $0 SMAM -- FSR, 14h. $15 SMAM -- OP, 8b. $0 Advanced Imaging -- FSR, 8b. $0 Advanced Imaging -- Office, 9a. $75 Advanced Imaging -- OP, 8a. $0 Radiology OP -- Physician, 8a. $15 Radiology OP -- Facility"	$25/Visit:9a	"$0-$15/Proc:12. $0 Dialysis -- Dialysis Center, 12. $15 Dialysis -- OP Hosp"	"$5-$75/Visit:9d. $15 Cardiac Rehab, 8b. $75 Nuclear Medicine, 9a. $15 OP Other, 5. $5 Partial Hospitalization, 8b. $15 Rad therapy, 3. $5 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$5/Visit:7b, 7d, 7f"	"$5-$15/Visit:7h. $15 Psych -- OP, 7e. $5 Psych -- Other Provider"	"$5-$15/Visit:9a. $15 Therapy (AT,PT,ST,OT) -- OP, 7d. $5 Therapy (AT,PT,ST,OT) - Specialist"			0% Coins:15			DEN ADI	VIS 829		HER 722		SMC 001	NSP 002		HAM 001	FTP 002	Other Added Benefit	MOW 001	Acupuncture 6 Visits	OTC 006				60.160271	55.881437	23.132794	0	100.00001	0	0	49.999995	48.714388	10.368975	2.262041	0	0.516208	24.055507	0	5.000002	15.009318	6.306629			0			0	0		0		0	0		0	0	0	0	0	0				60.160271	55.881437	23.132794	0	100.00001	0	0	49.999995	48.714388	10.368975	2.262041	0	0.516208	24.055507	0	5.000002	15.009318	6.306629			0			0	0		0		0	0		0	0	0	0	0	0				8.7474	0.060145	1.752799956	0	3.195744995	0	0	1.605110994	1.046173995	0.048432997	0.260935999	0	0.00083	0.192181999	0	2.577590991	0.000455	0.313898991	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.8017	0	0	8.7474	0.060145	1.752799956	0	3.195744995	0	0	1.605110994	1.046173995	0.048432997	0.260935999	0	0.00083	0.192181999	0	2.577590991	0.000455	0.313898991	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.8017																																																																																		0	0	0	8.7474	0.060145	1.752799956	0	3.195744995	0	0	1.605110994	1.046173995	0.048432997	0.260935999	0	0.00083	0.192181999	0	2.577590991	0.000455	0.313898991	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.8017
H1036_122_0	2009	3		s.	t.	u.	v.	w.	x.					Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered															D	D	D	V	T	Coin	Coin	V	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				0		1497.740831	11.086649	780.499498	17.363924	329.185304	4.50597	3.034633	330.676608	221.215235	48.114268	1188.23377	0	16.562333	82.293692	6911.168009	5310.216063	0.312262	512.697266			60.378339			3.98	2.15		0.05		0.05	1.45		1.23	2.77	0.06	0.3	0.41	0.93				$50/Day(Days 1-10):1a	$50/Day(Days 1-10):1b	"$0/Day(Days 1-14) $50(Days 15-100):2. $0 SNF 1, 2. $50 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$75/Visit:9b. $0 Surgery ASC -- Physician, 9b. $25 Surgery ASC -- Facility, 9a. $0 Surgery OP -- Physician, 9a. $75 Surgery OP -- Facility"	"$0-$15/Visit:8a. $0 Lab -- FSL, 8. $15 Lab -- OP"	"$0-$75/Visit:14h. $15 DMAM -- OP, 8b. $0 Radiology -- FSR, 14h. $0 SMAM -- FSR, 14h. $15 SMAM -- OP, 8b. $0 Advanced Imaging -- FSR, 8b. $0 Advanced Imaging -- Office, 9a. $75 Advanced Imaging -- OP, 8a. $0 Radiology OP -- Physician, 8a. $15 Radiology OP -- Facility"	$25/Visit:9a	"$0-$15/Proc:12. $0 Dialysis -- Dialysis Center, 12. $15 Dialysis -- OP Hosp"	"$5-$75/Visit:9d. $15 Cardiac Rehab, 8b. $75 Nuclear Medicine, 9a. $15 OP Other, 5. $5 Partial Hospitalization, 8b. $15 Rad therapy, 3. $5 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$5/Visit:7b, 7d, 7f"	"$5-$15/Visit:7h. $15 Psych -- OP, 7e. $5 Psych -- Other Provider"	"$5-$15/Visit:9a. $15 Therapy (AT,PT,ST,OT) -- OP, 7d. $5 Therapy (AT,PT,ST,OT) - Specialist"			0% Coins:15			DEN ADI	VIS 829		HER 722		SMC 001	OTC 006		HAM 001	FTP 002	Other Added Benefit	NSP 002	MOW 001	Acupuncture 16 Visits				40.106853	37.254539	23.132801	0	100.000004	0	0	49.999992	48.71442	10.368816	2.262049	0	0.516593	24.055646	0	4.999999	14.987414	6.306622			0			0	0		0		0	0		0	0	0	0	0	0				40.106853	37.254539	23.132801	0	100.000004	0	0	49.999992	48.71442	10.368816	2.262049	0	0.516593	24.055646	0	4.999999	14.987414	6.306622			0			0	0		0		0	0		0	0	0	0	0	0				5.0058	0.034419	1.504594964	0	2.743210976	0	0	1.37781898	0.898030989	0.041573999	0.223986918	0	0.000712999	0.164968994	0	2.212589584	0.00039	0.269448988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.4776	0	0	5.0058	0.034419	1.504594964	0	2.743210976	0	0	1.37781898	0.898030989	0.041573999	0.223986918	0	0.000712999	0.164968994	0	2.212589584	0.00039	0.269448988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.4776																																																																																		0	0	0	5.0058	0.034419	1.504594964	0	2.743210976	0	0	1.37781898	0.898030989	0.041573999	0.223986918	0	0.000712999	0.164968994	0	2.212589584	0.00039	0.269448988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.4776
H1036_123_0	2009	3	r.	s.	t.								Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)																			D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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								0		1467.714156	10.864384	764.852062	17.015812	322.585805	4.327111	2.914177	324.047209	216.780319	47.149674	1164.412087	0	0	80.64387	6772.61307	5203.756973	0.306002	502.418722			57.981696				1.05		0.05		0.05	0.41	1.23	2.77	0.06								$225/Day(Days 1-7):1a	$225/Day(Days 1-7):1b	"$0/Day(Days 1-14) $75(Days 15-100):2. $0 SNF 1, 2. $75 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician, 9b. $50 Surgery ASC -- Facility, 9a. $0 Surgery OP -- Physician, 9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL, 8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP, 8b. $0 Radiology -- FSR, 14h. $0 SMAM -- FSR, 14h. $25 SMAM -- OP, 8b. $50 Advanced Imaging -- FSR, 8b. $50 Advanced Imaging -- Office, 9a. $100 Advanced Imaging -- OP, 8a. $0 Radiology OP -- Physician, 8a. $100 Radiology OP -- Facility"	$225/Visit:9a	20% Coins:12	"$20-$100/Visit:9d. $50 Cardiac Rehab, 8b. $100 Nuclear Medicine, 9a. $20 OP Other, 5. $20 Partial Hospitalization, 8b. $100 Rad therapy, 3. $20 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$20/Visit:7b, 7d, 7f"	"$20/Visit:7e, 7h"	"$20-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP, 7d. $20 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15				VIS 115		HER 722		SMC 001	MOW 001	HAM 001	FTP 002	Other Added Benefit								160.298103	141.764871	34.699196	0	99.999998	0	0	50.00001	73.714422	69.126077	18.65825	0	0	66.017069	0	19.999999	19.999869	23.91988			0.199999				0		0		0	0	0	0	0								160.298103	141.764871	34.699196	0	99.999998	0	0	50.00001	73.714422	69.126077	18.65825	0	0	66.017069	0	19.999999	19.999869	23.91988			0.199999				0		0		0	0	0	0	0								19.606	0.128349	2.211645968	0	2.688214988	0	0	1.350196974	1.331652993	0.271606	1.810490985	0	0	0.443655994	0	8.672927855	0.00051	1.001482962	0	0	11.59628122	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.113	0	0	19.606	0.128349	2.211645968	0	2.688214988	0	0	1.350196974	1.331652993	0.271606	1.810490985	0	0	0.443655994	0	8.672927855	0.00051	1.001482962	0	0	11.59628122	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.113																																																																																		0	0	0	19.606	0.128349	2.211645968	0	2.688214988	0	0	1.350196974	1.331652993	0.271606	1.810490985	0	0	0.443655994	0	8.672927855	0.00051	1.001482962	0	0	11.59628122	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.113
H1036_125_0	2009	3	r.	s.	t.	u.	v.	w.					Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																D	D	D	V	T	Coin	Coin	V	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					0		1972.545222	10.849114	761.353688	50.281661	402.313937	8.608122	3.207244	284.672312	266.997103	96.641193	1585.308056	0	15.838659	383.985301	10540.49233	5537.295242	0.460811	646.877844			3001.701339			5.75	2.15		0.33		0.05	0.3	1.23	2.77	0.06	0.41	0.58	0.81					$50/Day(Days 1-7):1a	$50/Day(Days 1-7):1b	"$0/Day(Days 1-6) $25(Days 7-100):2. $0 SNF 1,2. $25 SNF 2"	$0/Visit:6	$25/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$20/Visit:9b. $0 Surgery ASC -- Physician,9b. $0 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $20 Surgery OP -- Facility"	"$0-$15/Visit:8a. $0 Lab -- FSL,8. $15 Lab -- OP"	"$0-$25/Visit:14h. $15 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $0 Advanced Imaging -- FSR,8b. $0 Advanced Imaging -- Office,9a. $25 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $15 Radiology OP -- Facility"	$20/Visit:9a	"$0-$15/Proc:12. $0 Dialysis -- Dialysis Center,12. $15 Dialysis -- OP Hosp"	"$0-$25/Visit:9d. $0 Cardiac Rehab,8b. $25 Nuclear Medicine,9a. $15 OP Other,5. $0 Partial Hospitalization,8b. $15 Rad therapy,3. $0 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0-$15/Visit:7h. $15 Psych -- OP,7e. $0 Psych -- Other Provider"	"$0-$15/Visit:9a. $15 Therapy (AT,PT,ST,OT) -- OP,7d. $0 Therapy (AT,PT,ST,OT) - Specialist"			$0/Script:15			DEN ADI + Dent	VIS 140		HER 751		SMC 001	NSP 001	HAM 001	FTP 002	Other Added Benefit	MOW 001	OTC 006	Acupuncture 10 Visits					32.05962	31.503402	17.998777	0	25	0	0	50.000015	9.410663	12.542353	1.391298	0	1.556192	15.026106	0	0	14.999641	1.704841			0			0	0		0		0	0	0	0	0	0	0	0					32.05962	31.503402	17.998777	0	25	0	0	50.000015	9.410663	12.542353	1.391298	0	1.556192	15.026106	0	0	14.999641	1.704841			0			0	0		0		0	0	0	0	0	0	0	0					5.2699	0.028482	1.141952937	0	0.838154035	0	0	1.186134989	0.20938498	0.101008996	0.183802994	0	0.002054	0.480816986	0	0	0.000576	0.091901989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.5342	0	0	5.2699	0.028482	1.141952937	0	0.838154035	0	0	1.186134989	0.20938498	0.101008996	0.183802994	0	0.002054	0.480816986	0	0	0.000576	0.091901989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.5342																																																																																		0	0	0	5.2699	0.028482	1.141952937	0	0.838154035	0	0	1.186134989	0.20938498	0.101008996	0.183802994	0	0.002054	0.480816986	0	0	0.000576	0.091901989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.5342
H1036_126_0	2009	3	r.	s.	t.	u.	v.	w.					Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																D	D	D	V	T	Coin	Coin	V	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					0		1695.759931	9.326779	654.521409	43.226195	345.861705	6.361847	2.370319	244.72742	229.532374	83.080612	1362.85944	0	13.616198	330.104925	9061.462485	4760.308301	0.39615	556.108684			2580.506037			5.75	2.15		0.33		0.05	0.3	1.23	2.77	0.06	0.41	0.58	0.87					$25/Day(Days 1-7):1a	$25/Day(Days 1-7):1b	"$0/Day(Days 1-6) $25(Days 7-100):2. $0 SNF 1,2. $25 SNF 2"	$0/Visit:6	$25/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$20/Visit:9b. $0 Surgery ASC -- Physician,9b. $0 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $20 Surgery OP -- Facility"	"$0-$15/Visit:8a. $0 Lab -- FSL,8. $15 Lab -- OP"	"$0-$25/Visit:14h. $15 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $0 Advanced Imaging -- FSR,8b. $0 Advanced Imaging -- Office,9a. $25 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $15 Radiology OP -- Facility"	$20/Visit:9a	"$0-$15/Proc:12. $0 Dialysis -- Dialysis Center,12. $15 Dialysis -- OP Hosp"	"$0-$25/Visit:9d. $0 Cardiac Rehab,8b. $25 Nuclear Medicine,9a. $15 OP Other,5. $0 Partial Hospitalization,8b. $15 Rad therapy,3. $0 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0-$15/Visit:7h. $15 Psych -- OP,7e. $0 Psych -- Other Provider"	"$0-$15/Visit:9a. $15 Therapy (AT,PT,ST,OT) -- OP,7d. $0 Therapy (AT,PT,ST,OT) - Specialist"			$0/Script:15			DEN ADI + Dent	VIS 140		HER 751		SMC 001	NSP 001	HAM 001	FTP 002	Other Added Benefit	MOW 001	OTC 006	Acupuncture 12 Visits					17.810903	15.752061	17.998769	0	25	0	0	50.00002	9.410646	12.54242	1.391298	0	1.556381	15.026131	0	0	14.99432	1.704832			0			0	0		0		0	0	0	0	0	0	0	0					17.810903	15.752061	17.998769	0	25	0	0	50.00002	9.410646	12.54242	1.391298	0	1.556381	15.026131	0	0	14.99432	1.704832			0			0	0		0		0	0	0	0	0	0	0	0					2.5169	0.012242999	0.981714971	0	0.720545219	0	0	1.019697991	0.180003993	0.086835994	0.158011968	0	0.001765999	0.413349987	0	0	0.000495	0.07900599	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.1706	0	0	2.5169	0.012242999	0.981714971	0	0.720545219	0	0	1.019697991	0.180003993	0.086835994	0.158011968	0	0.001765999	0.413349987	0	0	0.000495	0.07900599	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.1706																																																																																		0	0	0	2.5169	0.012242999	0.981714971	0	0.720545219	0	0	1.019697991	0.180003993	0.086835994	0.158011968	0	0.001765999	0.413349987	0	0	0.000495	0.07900599	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.1706
H1036_127_0	2009	3	r.	s.	t.	u.	v.	w.					Part B Rx	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin				V		V		O	O	S	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		1661.683566	9.139357	641.368775	42.357563	338.9116	6.108732	2.276012	239.809612	224.919913	81.411103	1335.472726	0	0.046308	323.471451	8879.372034	4664.649714	0.388189	544.933658			10.060432				2.15		0.05		1.23	0.05	2443.538587	2.77	0.06	0.41	0.3	0.58					$125/Day(Days 1-10):1a	$125/Day(Days 1-10):1b	"$0/Day(Days 1-14) $50(Days 15-100):2. $0 SNF 1,2. $50 SNF 2"	$0/Visit:6	$75/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $50 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $25 SMAM -- OP,8b. $25 Advanced Imaging -- FSR,8b. $25 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$0-$50/Visit:9d. $40 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $0 Partial Hospitalization,8b. $50 Rad therapy,3. $0 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0-$20/Visit:7h. $20 Psych -- OP,7e. $0 Psych -- Other Provider"	"$0-$40/Visit:9a. $40 Therapy (AT,PT,ST,OT) -- OP,7d. $0 Therapy (AT,PT,ST,OT) - Specialist"			0% Coins:15				VIS 140		HER 722		$0: Health Education Materials 14a	$0 Additional Smoking Cessation 14a	$0/Script:15	$0: Membership in health club/fitness class 14a	$0: Nurse hotline 14a	$0: Nutritional benefit 14a	NSP 001	OTC 006					100.267126	93.135217	23.1328	0	75	0	0	50.000014	73.526597	41.80781	10.498224	0	0.200008	49.826765	0	0	20.000566	4.546219			0				0		0		0	0	0	0	0	0	0	0					100.267126	93.135217	23.1328	0	75	0	0	50.000014	73.526597	41.80781	10.498224	0	0.200008	49.826765	0	0	20.000566	4.546219			0				0		0		0	0	0	0	0	0	0	0					13.8844	0.070933	1.236387967	0	2.1181975	0	0	0.999206996	1.378132983	0.283634994	1.168340985	0	0.00926197	1.343127998	0	0	0.000647	0.206448979	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.6987	0	0	13.8844	0.070933	1.236387967	0	2.1181975	0	0	0.999206996	1.378132983	0.283634994	1.168340985	0	0.00926197	1.343127998	0	0	0.000647	0.206448979	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.6987																																																																																		0	0	0	13.8844	0.070933	1.236387967	0	2.1181975	0	0	0.999206996	1.378132983	0.283634994	1.168340985	0	0.00926197	1.343127998	0	0	0.000647	0.206448979	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.6987
H1036_128_0	2009	3	r.	s.	t.	u.	v.						Health & Education (Non-Covered)	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	V	Coin	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						0		1660.535058	9.13304	640.92548	42.328286	338.677354	6.100289	2.272867	239.643863	224.764454	81.354834	1334.549688	0	0.046244	323.247878	8873.234869	4661.425643	0.38792	544.557015			47.18053			3.98	2.15		0.33		0.05	0.3	1.23	2.77	0.06	0.41	0.58						$0/Day(Days 1-10):1a	$0/Day(Days 1-10):1b	"$0/Day(Days 1-14) $50(Days 15-100):2. $0 SNF 1,2. $50 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$50/Visit:9b. $0 Surgery ASC -- Physician,9b. $0 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $50 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $25 SMAM -- OP,8b. $25 Advanced Imaging -- FSR,8b. $25 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$0-$50/Visit:9d. $25 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $0 Partial Hospitalization,8b. $50 Rad therapy,3. $0 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0-$20/Visit:7h. $20 Psych -- OP,7e. $0 Psych -- Other Provider"	"$0-$25/Visit:9a. $25 Therapy (AT,PT,ST,OT) -- OP,7d. $0 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			"DEN ADI 16a, 16b"	VIS 140		HER 751		$0 Additional Smoking Cessation 14a	NSP 001	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0: Nurse hotline 14a	$0: Nutritional benefit 14a	OTC006						0	0	23.132792	0	99.999989	0	0	49.999995	23.526602	41.807816	10.498228	0	0.200004	49.574005	0	0	20.014435	2.841399			0.2			0	0		0		0	0	0	0	0	0	0						0	0	23.132792	0	99.999989	0	0	49.999995	23.526602	41.807816	10.498228	0	0.200004	49.574005	0	0	20.014435	2.841399			0.2			0	0		0		0	0	0	0	0	0	0						0	0	1.235532985	0	2.822310973	0	0	0.998515996	0.440661988	0.283438994	1.167533908	0	0.009248985	1.335390993	0	0	0.000647	0.12894198	0	0	9.436106	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.8583	0	0	0	0	1.235532985	0	2.822310973	0	0	0.998515996	0.440661988	0.283438994	1.167533908	0	0.009248985	1.335390993	0	0	0.000647	0.12894198	0	0	9.436106	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.8583																																																																																		0	0	0	0	0	1.235532985	0	2.822310973	0	0	0.998515996	0.440661988	0.283438994	1.167533908	0	0.009248985	1.335390993	0	0	0.000647	0.12894198	0	0	9.436106	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.8583
H1036_129_0	2009	3	r.	s.	t.	u.	v.						Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered																	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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						0		1411.950886	11.650844	997.862789	4.696901	304.388842	6.017963	3.568083	283.347514	256.115206	47.246697	1417.549467	0	0.011467	220.81957	8243.195511	5028.992983	0.449538	518.4489			55.991485			3.98	2.1		0.33		2.77	0.05	0.06	0.3	0.41	0.58	1.23						$200/Day(Days 1-10):1a	$200/Day(Days 1-7):1b	"$0/Day(Days 1-13) $75(Days 14-100):2. $0 SNF 1,2. $75 SNF 2"	$0/Visit:6	$100/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician, 9b. $50 Surgery ASC -- Facility, 9a. $0 Surgery OP -- Physician, 9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL, 8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP, 8b. $0 Radiology -- FSR, 14h. $0 SMAM -- FSR, 14h. $25 SMAM -- OP, 8b. $50 Advanced Imaging -- FSR, 8b. $50 Advanced Imaging -- Office, 9a. $100 Advanced Imaging -- OP, 8a. $0 Radiology OP -- Physician, 8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$20-$100/Visit:9d. $50 Cardiac Rehab, 8b. $100 Nuclear Medicine, 9a. $20 OP Other, 5. $20 Partial Hospitalization, 8b. $100 Rad therapy, 3. $20 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$20/Visit:7b, 7d, 7f"	"$20/Visit:7e, 7h"	"$20-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP, 7d. $20 Therapy (AT,PT,ST,OT) - Specialist"			0% Coins:15			DEN ADI	VIS 140		HER 751		FTP 002	SMC 001	Other Added Benefit	NSP 001	Mow 001	OTC 003	HAM 001						160.427401	126.013531	36.64147	0	100.000012	0	0	50.000015	68.782999	86.65774	17.361087	0	0.199965	82.32792	0	20	19.99386	23.139553			0			0	0		0		0	0	0	0	0	0	0						160.427401	126.013531	36.64147	0	100.000012	0	0	50.000015	68.782999	86.65774	17.361087	0	0.199965	82.32792	0	20	19.99386	23.139553			0			0	0		0		0	0	0	0	0	0	0						18.8763	0.122346999	3.046929954	0	2.536573988	0	0	1.180614996	1.468030997	0.341190999	2.050849969	0	0.002292999	1.514967991	0	8.381654972	0.000749	0.999722983	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5222	0	0	18.8763	0.122346999	3.046929954	0	2.536573988	0	0	1.180614996	1.468030997	0.341190999	2.050849969	0	0.002292999	1.514967991	0	8.381654972	0.000749	0.999722983	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5222																																																																																		0	0	0	18.8763	0.122346999	3.046929954	0	2.536573988	0	0	1.180614996	1.468030997	0.341190999	2.050849969	0	0.002292999	1.514967991	0	8.381654972	0.000749	0.999722983	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5222
H1036_130_0	2009	3	r.	s.	t.	u.	v.	w.					Part B Rx	Health & Education (Non-Covered)	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	V	P	V	V	V	V	V			Coin			Coin	V		V		O	O	S	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		1653.429188	13.643426	1168.521847	5.500186	356.446813	8.252413	4.892901	331.806903	299.9172	55.327045	1659.985265	0	16.295512	258.585142	9652.984517	5889.074371	0.526421	607.116402			13.412685			3.98	2.1		0.33		0.05	0.3	1305.405678	1.23	2.77	0.06	0.41	0.58					$125/Day(Days 1-10):1a	$125/Day(Days 1-10):1b	"$0/Day(Days 1-14) $50(Days 15-100):2. $0 SNF 1, 2. $50 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$75/Visit:9b. $0 Surgery ASC -- Physician, 9b. $50 Surgery ASC -- Facility, 9a. $0 Surgery OP -- Physician, 9a. $75 Surgery OP -- Facility"	"$0-$20/Visit:8a. $0 Lab -- FSL, 8. $20 Lab -- OP"	"$0-$50/Visit:14h. $20 DMAM -- OP, 8b. $0 Radiology -- FSR, 14h. $0 SMAM -- FSR, 14h. $20 SMAM -- OP, 8b. $25 Advanced Imaging -- FSR, 8b. $25 Advanced Imaging -- Office, 9a. $50 Advanced Imaging -- OP, 8a. $0 Radiology OP -- Physician, 8a. $20 Radiology OP -- Facility"	$75/Visit:9a	"$0-$20/Proc:12. $0 Dialysis -- Dialysis Center, 12. $20 Dialysis -- OP Hosp"	"$15-$50/Visit:9d. $20 Cardiac Rehab, 8b. $50 Nuclear Medicine, 9a. $20 OP Other, 5. $15 Partial Hospitalization, 8b. $20 Rad therapy, 3. $15 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$15/Visit:7b, 7d, 7f"	"$15-$20/Visit:7h. $20 Psych -- OP, 7e. $15 Psych -- Other Provider"	"$15-$20/Visit:9a. $20 Therapy (AT,PT,ST,OT) -- OP, 7d. $15 Therapy (AT,PT,ST,OT) - Specialist"			0% Coins:15			DEN 824	VIS 140		HER 751		SMC 001	NSP 002	$0/Script:15	HAM 001	FTP 002	Other Added Benefit	MOW 001	OTC 006					100.267127	93.134964	23.132804	0	99.999996	0.2	0	50.000008	59.391472	17.331632	8.2062	0	0.293823	21.122373	0	15.000002	19.991603	15.523263			0			0	0		0		0	0	0	0	0	0	0	0					100.267127	93.134964	23.132804	0	99.999996	0.2	0	50.000008	59.391472	17.331632	8.2062	0	0.293823	21.122373	0	15.000002	19.991603	15.523263			0			0	0		0		0	0	0	0	0	0	0	0					13.8154	0.105889999	2.252598905	0	2.97038999	1.6504826	0	1.382528984	1.484376999	0.079908999	1.135180923	0	0.000399	0.455160985	0	7.361343945	0.000877	0.785368965	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.4799	0	0	13.8154	0.105889999	2.252598905	0	2.97038999	1.6504826	0	1.382528984	1.484376999	0.079908999	1.135180923	0	0.000399	0.455160985	0	7.361343945	0.000877	0.785368965	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.4799																																																																																		0	0	0	13.8154	0.105889999	2.252598905	0	2.97038999	1.6504826	0	1.382528984	1.484376999	0.079908999	1.135180923	0	0.000399	0.455160985	0	7.361343945	0.000877	0.785368965	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.4799
H1036_131_0	2009	3	r.	s.	t.	u.	v.	w.	x.				Part B Rx	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered															D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin	V		V		O	O	S	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		1437.512067	11.861765	1015.927545	4.781931	309.899329	6.237824	3.698439	288.477082	260.751774	48.102025	1443.212001	0	14.167522	224.817166	8392.425776	5120.035099	0.457678	527.834612			10.138363			3.98	2.1		0.33		0.05	0.3	1134.936066	1.23	2.77	0.06	0.41	0.58	0.93				$100/Day(Days 1-10):1a	$100/Day(Days 1-10):1b	"$0/Day(Days 1-14) $50(Days 15-100):2. $0 SNF 1, 2. $50 SNF 2"	$0/Visit:6	$75/Trip:10a	20% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0-$75/Visit:9b. $0 Surgery ASC -- Physician, 9b. $50 Surgery ASC -- Facility, 9a. $0 Surgery OP -- Physician, 9a. $75 Surgery OP -- Facility"	"$0-$20/Visit:8a. $0 Lab -- FSL, 8. $20 Lab -- OP"	"$0-$50/Visit:14h. $20 DMAM -- OP, 8b. $0 Radiology -- FSR, 14h. $0 SMAM -- FSR, 14h. $20 SMAM -- OP, 8b. $25 Advanced Imaging -- FSR, 8b. $25 Advanced Imaging -- Office, 9a. $50 Advanced Imaging -- OP, 8a. $0 Radiology OP -- Physician, 8a. $20 Radiology OP -- Facility"	$75/Visit:9a	"$0-$20/Proc:12. $0 Dialysis -- Dialysis Center, 12. $20 Dialysis -- OP Hosp"	"$15-$50/Visit:9d. $20 Cardiac Rehab, 8b. $50 Nuclear Medicine, 9a. $20 OP Other, 5. $15 Partial Hospitalization, 8b. $20 Rad therapy, 3. $15 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$15/Visit:7b, 7d, 7f"	"$15-$20/Visit:7h. $20 Psych -- OP, 7e. $15 Psych -- Other Provider"	"$15-$20/Visit:9a. $20 Therapy (AT,PT,ST,OT) -- OP, 7d. $15 Therapy (AT,PT,ST,OT) - Specialist"			0% Coins:15			DEN 824	VIS 140		HER 751		SMC 001	NSP 002	$0/Script:15	HAM 001	FTP 002	Other Added Benefit	MOW 001	OTC 006	Acupuncture 16 Visits				80.213696	74.508304	23.132795	0	75	0.2	0	50.000006	59.391473	17.331661	8.206212	0	0.293911	21.122444	0	15	20.005331	15.523271			0			0	0		0		0	0	0	0	0	0	0	0	0				80.213696	74.508304	23.132795	0	75	0.2	0	50.000006	59.391473	17.331661	8.206212	0	0.293911	21.122444	0	15	20.005331	15.523271			0			0	0		0		0	0	0	0	0	0	0	0	0				9.609	0.073649999	1.958436969	0	1.936870806	1.2475648	0	1.201987986	1.290535995	0.069473999	0.98694197	0	0.000346999	0.395724	0	6.400043874	0.000763	0.682809977	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.8542	0	0	9.609	0.073649999	1.958436969	0	1.936870806	1.2475648	0	1.201987986	1.290535995	0.069473999	0.98694197	0	0.000346999	0.395724	0	6.400043874	0.000763	0.682809977	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.8542																																																																																		0	0	0	9.609	0.073649999	1.958436969	0	1.936870806	1.2475648	0	1.201987986	1.290535995	0.069473999	0.98694197	0	0.000346999	0.395724	0	6.400043874	0.000763	0.682809977	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.8542
H1036_801_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		260.230591	10.477449	861.266009	590.262429	11.165726	2.941643	4.143335	51.276663	55.052458	58.602551	39.758109	0	0.859536	7.213908	89.900754	74.233249	0.038519	5.176521			37.397812																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.00001	1024.000403	43.132806	0	0.199999	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.2	0.500012	0.199999			0.199999																				1024.00001	1024.000403	43.132806	0	0.199999	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.2	0.500012	0.199999			0.199999																				22.2063	0.894076	3.095734973	0	2.233134034	0.5883286	0.828667	10.2553326	11.0104916	0	7.9516218	0	0.17190634	1.442774386	17.9801508	14.8466498	0.019259962	1.035299023	0	0	7.479525002	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.0393	0	0	22.2063	0.894076	3.095734973	0	2.233134034	0.5883286	0.828667	10.2553326	11.0104916	0	7.9516218	0	0.17190634	1.442774386	17.9801508	14.8466498	0.019259962	1.035299023	0	0	7.479525002	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.0393																																																																																		0	0	0	22.2063	0.894076	3.095734973	0	2.233134034	0.5883286	0.828667	10.2553326	11.0104916	0	7.9516218	0	0.17190634	1.442774386	17.9801508	14.8466498	0.019259962	1.035299023	0	0	7.479525002	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.0393
H1036_806_0	2009	5																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		253.399678	10.202421	838.658239	574.768358	10.587225	2.789235	3.928667	48.619999	52.20017	57.064266	37.698225	0	0.815003	6.840152	85.242961	70.387195	0.036524	4.908324			35.460217																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999991	1024.000479	43.132797	0	0.2	0.2	0.2	0.2	0.199999	0	0.2	0	0.2	0.2	0.199999	0.2	0.5	0.2			0.2																				1023.999991	1024.000479	43.132797	0	0.2	0.2	0.2	0.2	0.199999	0	0.2	0	0.2	0.2	0.199999	0.2	0.5	0.2			0.2																				21.6234	0.870606999	3.014472965	0	2.117445	0.557847	0.7857334	9.7239998	10.4399818	0	7.539645	0	0.1630006	1.3680304	17.04850696	14.077439	0.018262	0.9816648	0	0	7.0920434	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.4221	0	0	21.6234	0.870606999	3.014472965	0	2.117445	0.557847	0.7857334	9.7239998	10.4399818	0	7.539645	0	0.1630006	1.3680304	17.04850696	14.077439	0.018262	0.9816648	0	0	7.0920434	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.4221																																																																																		0	0	0	21.6234	0.870606999	3.014472965	0	2.117445	0.557847	0.7857334	9.7239998	10.4399818	0	7.539645	0	0.1630006	1.3680304	17.04850696	14.077439	0.018262	0.9816648	0	0	7.0920434	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.4221
H1036_807_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		260.230591	10.477449	861.266009	590.262429	11.165726	2.941643	4.143335	51.276663	55.052458	58.602551	39.758109	0	0.859536	7.213908	89.900754	74.233249	0.038519	5.176521			37.397812																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.00001	1024.000403	43.132806	0	0.199999	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.2	0.500012	0.199999			0.199999																				1024.00001	1024.000403	43.132806	0	0.199999	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.2	0.500012	0.199999			0.199999																				22.2063	0.894076	3.095734973	0	2.233134034	0.5883286	0.828667	10.2553326	11.0104916	0	7.9516218	0	0.17190634	1.442774386	17.9801508	14.8466498	0.019259962	1.035299023	0	0	7.479525002	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.0393	0	0	22.2063	0.894076	3.095734973	0	2.233134034	0.5883286	0.828667	10.2553326	11.0104916	0	7.9516218	0	0.17190634	1.442774386	17.9801508	14.8466498	0.019259962	1.035299023	0	0	7.479525002	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.0393																																																																																		0	0	0	22.2063	0.894076	3.095734973	0	2.233134034	0.5883286	0.828667	10.2553326	11.0104916	0	7.9516218	0	0.17190634	1.442774386	17.9801508	14.8466498	0.019259962	1.035299023	0	0	7.479525002	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.0393
H1036_808_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		260.230591	10.477449	861.266009	590.262429	11.165726	2.941643	4.143335	51.276663	55.052458	58.602551	39.758109	0	0.859536	7.213908	89.900754	74.233249	0.038519	5.176521			37.397812																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.00001	1024.000403	43.132806	0	0.199999	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.2	0.500012	0.199999			0.199999																				1024.00001	1024.000403	43.132806	0	0.199999	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.2	0.500012	0.199999			0.199999																				22.2063	0.894076	3.095734973	0	2.233134034	0.5883286	0.828667	10.2553326	11.0104916	0	7.9516218	0	0.17190634	1.442774386	17.9801508	14.8466498	0.019259962	1.035299023	0	0	7.479525002	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.0393	0	0	22.2063	0.894076	3.095734973	0	2.233134034	0.5883286	0.828667	10.2553326	11.0104916	0	7.9516218	0	0.17190634	1.442774386	17.9801508	14.8466498	0.019259962	1.035299023	0	0	7.479525002	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.0393																																																																																		0	0	0	22.2063	0.894076	3.095734973	0	2.233134034	0.5883286	0.828667	10.2553326	11.0104916	0	7.9516218	0	0.17190634	1.442774386	17.9801508	14.8466498	0.019259962	1.035299023	0	0	7.479525002	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.0393
H1045_001_0	2009	4																																							V													Coin			V																																																									0									243.9338446													1.63			7.194907672																								"$50 ER (WIA), $0 UC"													20% on non-cancer Part B			12 Copay																								28													0.134634083			12																								28													0.134634083			12																	0	0	0	0	0	0	0	0.569178971	0	0	0	0	0	0	0	0	0	0	0	0	0.219453555	0	0	0.007194908	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7958			0	0	0	0	0	0	0	0.569178971	0	0	0	0	0	0	0	0	0	0	0	0	0.219453555	0	0	0.007194908	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7958																																																																																		0			0	0	0	0	0	0	0	0.569178971	0	0	0	0	0	0	0	0	0	0	0	0	0.219453555	0	0	0.007194908	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7958
H1045_005_0	2009	3																																D		D		T			V	V		P										Coin			V																																																									0		1882.869394		1252.810674		105.5319745			301.0764558	70.96203201		6292.349682										1.515165099			6.575884144																	$100/day for days 1-5		$50/day for days 7-21		$100 per trip			$50 ER/$0 UC; waived if admitted	$100 OP $25ASC		$40 per radiation therapy										20% on non-cancer drugs			$12 copay on exams																	64.84414681		27.18562162		100			28	62.5		0.583406665										0.134634083			1.333333333																	64.84414681		27.18562162		100			28	62.5		0.583406665										0.134634083			1.333333333																	10.1744	0	2.838203078	0	0.879433121	0	0	0.70251173	0.369593917	0	0.305916562	0	0	0	0	0	0	0	0	0	0.203992864	0	0	0.000730654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.4748			10.1744	0	2.838203078	0	0.879433121	0	0	0.70251173	0.369593917	0	0.305916562	0	0	0	0	0	0	0	0	0	0.203992864	0	0	0.000730654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.4748																																																																																		0			10.1744	0	2.838203078	0	0.879433121	0	0	0.70251173	0.369593917	0	0.305916562	0	0	0	0	0	0	0	0	0	0.203992864	0	0	0.000730654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.4748
H1045_008_0	2009	4																																																				Coin																																																												0																						1.63																																								20% on non-cancer Part B																																								0.134634083																																								0.134634083																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.219453555	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.2195			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.219453555	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.2195																																																																																		0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.219453555	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.2195
H1045_009_0	2009	4																					2500											D	D	D					V	V		V					V	V	V	V		Coin			V																																																									0		1437.701785	159.7446428	771.6148407					243.1871083	62.44036904		1800.591478					8051.623504	352.8505998	1404.220287	6525.119929		1.63			7.172882444	1136.659683																$150/day for 1-5	$150/day for 1-5	$50/day for 7-100					"$50 ER (WIA), $0 UC"	125		$0-$150					$35 for SCP	35	35	$0-$150		20% on non-cancer Part B			12 Copay																	97.26622022	64.5066954	28.02297209					28	125		14.21282914					10.5	35	35	14.21282914		0.134634083			1.333333333	0																97.1961527	64.46022681	28.00278522					27.97982968	124.9099539		14.20259067					10.49243613	34.9747871	34.9747871	14.20259067		0.134537097			1.332372842																	11.6449	0.858097992	1.800613721	0	0	0	0	0.567027823	0.649951968	0	2.131088643	0	0	0	0	7.040095447	1.028406217	4.092692133	7.722800617	0	0.219295468	0	0	0.000796413	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.7558		0.0217	11.6449	0.858097992	1.800613721	0	0	0	0	0.567027823	0.649951968	0	2.131088643	0	0	0	0	7.040095447	1.028406217	4.092692133	7.722800617	0	0.219295468	0	0	0.000796413	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.7558																																																																																		0			11.6449	0.858097992	1.800613721	0	0	0	0	0.567027823	0.649951968	0	2.131088643	0	0	0	0	7.040095447	1.028406217	4.092692133	7.722800617	0	0.219295468	0	0	0.000796413	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.7558
H1045_010_0	2009	4																																		D		T			V			V										Coin			V																																																									0				773.98418		104.0516528			243.9338446			1806.120418										1.63			7.194907672																			$25 for days 7-21; otherwise $0		$50/trip			"$50 ER (WIA), $0 UC"			$50 for CT/MRI/MRA/PET										20% on non-cancer Part B			12 Copay																			13.69279295		50			28			1.870030899										0.134634083			12																			13.69279295		50			28			1.870030899										0.134634083			12																	0	0	0.883167094	0	0.433548553	0	0	0.569178971	0	0	0.281458416	0	0	0	0	0	0	0	0	0	0.219453555	0	0	0.007194908	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.394			0	0	0.883167094	0	0.433548553	0	0	0.569178971	0	0	0.281458416	0	0	0	0	0	0	0	0	0	0.219453555	0	0	0.007194908	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.394																																																																																		0			0	0	0.883167094	0	0.433548553	0	0	0.569178971	0	0	0.281458416	0	0	0	0	0	0	0	0	0	0.219453555	0	0	0.007194908	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.394
H1045_011_0	2009	5																																D		D		T			V	V		V										Coin			V																																																									0		2070.718051		1384.997117		322.0488192			296.6412613	76.10143962		148.5210509										5.627351895			6.575884144																	$150 for days 1-5; then $0		$25 for days 7-21; otherwise $0		$50/trip			"$50 ER (WIA), $0 UC"	$100 OP/$25 ASC		$50 diag/$40 therapy										20% on non-cancer Part B			12 Copay																	97.26622022		13.69279295		50			28	62.5		2.064022064										0.134634083			12																	97.26622022		13.69279295		50			28	62.5		2.064022064										0.134634083			12																	16.7842	0	1.58037323	0	1.34187008	0	0	0.692162943	0.396361665	0	0.025545894	0	0	0	0	0	0	0	0	0	0.757633362	0	0	0.006575884	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.5848			16.7842	0	1.58037323	0	1.34187008	0	0	0.692162943	0.396361665	0	0.025545894	0	0	0	0	0	0	0	0	0	0.757633362	0	0	0.006575884	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.5848																																																																																		0			16.7842	0	1.58037323	0	1.34187008	0	0	0.692162943	0.396361665	0	0.025545894	0	0	0	0	0	0	0	0	0	0.757633362	0	0	0.006575884	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.5848
H1045_012_0	2009	4																																																				Coin																																																												0																						5.627351895																																								20% coinsurance non-cancer																																								0.134634083																																								0.134634083																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.757633362	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7576			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.757633362	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7576																																																																																		0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.757633362	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7576
H1045_014_0	2009	8																																D	D	D	V	T	Coin	P	V	V	V	V	V	V	V		V	V	V	V	V	Coin	V	T	V	V	V																																																							0		1001.686104	80.3256562	1465.759453		194.8736939	16.84215895	53.53134942	337.6876653	109.4069767		766.6936092	45.89024843	16.37223421			5455.23737	550.8705471	1718.790352	1333.813276		18.31230027				778.4	194.6															$100 Days 1-7	$150 Days 1-7	$75 Days 11-100		$150 copay	20% coin on 'high cost' items		$50 ER; $25UC	$150 copay		$25 MRI/MRA/PET	150	100			$5 SCP	$25 copay	$25 copay	$25 MRI/MRA/PET		33% Coinsurance				$10 for exam	$15 glasses/$50 contacts															75.12131465	78.82099431	27.35136583		150	0.075	0	34.75	150		0.643312117	150	100			4.85	25	25	0.643312117		0.2				10	22															75.12131465	78.82099431	27.35136583		150	0.075	0	34.75	150		0.643312117	150	100			4.85	25	25	0.643312117		0.2				10	22															6.2707	0.527612341	3.340876919	0	2.435921173	1.263161921	0	0.977887197	1.367587209	0	0.041101941	0.573628105	0.136435285	0	0	2.204825104	1.147646973	3.580813233	0.071504854	0	3.662460053	0	0	0	0.648666667	0.356766667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.6076			6.2707	0.527612341	3.340876919	0	2.435921173	1.263161921	0	0.977887197	1.367587209	0	0.041101941	0.573628105	0.136435285	0	0	2.204825104	1.147646973	3.580813233	0.071504854	0	3.662460053	0	0	0	0.648666667	0.356766667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.6076																20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance																																			0.2831	0.265	0.0346	0.0404	0.3741	1.5652																					2.5625			6.2707	0.527612341	3.340876919	0	2.435921173	1.263161921	0	0.977887197	1.367587209	0	0.041101941	0.573628105	0.136435285	0	0.283128304	2.469820738	1.182276677	3.621248544	0.445611365	1.565206943	3.662460053	0	0	0	0.648666667	0.356766667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.1701
H1045_015_0	2009	7																																D	D	D	V	T	Coin	P	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V																																																							0		1001.686104	80.3256562	1465.759453		194.8736939	16.84215895	53.53134942	337.6876653	109.4069767		766.6936092	45.89024843				5455.23737	550.8705471	1718.790352	1333.813276		18.31230027				778.4	194.6															$150 Days 1-7	$150 Days 1-7	$75 Days 11-100		$150 copay	20% coin on 'high cost' items		$50 ER; $25UC	$150 copay		up to $100	150				$25 copay	$25 copay	$25 copay	up to $100		20% Coinsurance				$10 for exam	$15 glasses/$50 contacts															112.681972	78.82099431	27.35136583		150	0.075	0	34.75	150		0.625192238	150				25	25	25	0.643312117		0.2				10	23.75															112.681972	78.82099431	27.35136583		150	0.075	0	34.75	150		0.625192238	150				25	25	25	0.643312117		0.2				10	23.75															9.406	0.527612341	3.340876919	0	2.435921173	1.263161921	0	0.977887197	1.367587209	0	0.039944241	0.573628105	0	0	0	11.36507785	1.147646973	3.580813233	0.071504854	0	3.662460053	0	0	0	0.648666667	0.385145833	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7939			9.406	0.527612341	3.340876919	0	2.435921173	1.263161921	0	0.977887197	1.367587209	0	0.039944241	0.573628105	0	0	0	11.36507785	1.147646973	3.580813233	0.071504854	0	3.662460053	0	0	0	0.648666667	0.385145833	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7939																	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance																																				0.265	0.0346	0.0404	0.3741	1.5652																					2.2794			9.406	0.527612341	3.340876919	0	2.435921173	1.263161921	0	0.977887197	1.367587209	0	0.039944241	0.573628105	0	0	0	11.63007349	1.182276677	3.621248544	0.445611365	1.565206943	3.662460053	0	0	0	0.648666667	0.385145833	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.0733
H1076_003_0	2009	6																																D		D					V	V		V		V	V		V					S			P																																																									0		1409.197496		835.5006313					318.8672047	96.08249398		1632.127562	62.35344439	1.894001695	67.38967991		6480.659819					935.828857			701.3173445																	$50 copay (days 1-10) PBP L.1a	$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	$0 copay	$150 diag copay (hosp); $50 diag copay (freest); $50 therap. Copay PBP L.8a/8b	$50 copay PBP L.9a	$30 copay @ Hospital; $15 copay @ Freestanding facility PBP L.12	"$50 copay @ Hospital PBP L.9a, 7c, 7i"	$0 copay	$15 copay PBP L.7a thru 7f	Included in i.2.	Included in i.2.	Included in i.2.	Included in i.2.	18% chemo; $50 copay Part B Rx PBP L.15	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											43.83183008		29.52247191					50	150		55.25876645	50	15	50		15					89.81102583			79.65242276																	43.83183008		29.52247191					50	150		55.25876645	50	15	50		15					89.81102583			79.65242276																	5.1473	0	2.05550366	0	0	0	0	1.328613353	1.201031175	0	7.515779647	0.259806018	0.002367502	0.280790333	0	8.100824773	0	0	0	0	7.003979137	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5511			5.1473	0	2.05550366	0	0	0	0	1.328613353	1.201031175	0	7.515779647	0.259806018	0.002367502	0.280790333	0	8.100824773	0	0	0	0	7.003979137	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5511																																																																																		0			5.1473	0	2.05550366	0	0	0	0	1.328613353	1.201031175	0	7.515779647	0.259806018	0.002367502	0.280790333	0	8.100824773	0	0	0	0	7.003979137	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5511
H1076_010_0	2009	6																																																				S			P																																																									0																						1214.06848			701.3173445																	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	18% chemo; $50 copay Part B Rx PBP L.15	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay																															42.18976476			79.65242276																																					42.18976476			79.65242276																	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.268438629	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.9236			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.268438629	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.9236																																																																																		0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.268438629	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.9236
H1076_011_0	2009	6																																																							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																																								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	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	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	4.1323
H1076_016_0	2009	8																																D		D		T			V	V		V		V	V		V					S			P																																																									0		1577.183601		1215.923945		324.1804309			266.3329022	472.757277		2080.487817	30.24231245	8.279147756	112.7809087		7270.291416					789.6792988			701.3173445																	$100 copay (days 1-7) PBP L.1a	$0 copay	$50 per day (days 8 through 100)  PBP L.2	$0 copay	$100 copay PBP L.10a	$0 copay	$0 copay	$50 copay PBP L.4a	$300 copay (hosp.); $50 copay (ASC) PBP L.9a	$0 copay	$200 diag copay (hosp); $100 diag copay (freest); $100 therap. Copay PBP L.8a/8b	$50 copay PBP L.9a	$30 copay @ Hospital; $0 copay @ Freestanding facility PBP L.12	"$100 copay @ Hospital PBP L.9a, 7c, 7i"	$0 copay	$30 copay PBP L.7a thru 7f	Included in i.2.	Included in i.2.	Included in i.2.	Included in i.2.	18% chemo; $50 copay Part B Rx PBP L.15	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay										79.50806831		29.52247191		100			50	99.99875149		102.6496605	50	30	100		30					98.90233657			79.65242276																	79.50806831		29.52247191		100			50	99.99875149		102.6496605	50	30	100		30					98.90233657			79.65242276																	10.4499	0	2.991423377	0	2.701503591	0	0	1.109720426	3.939594788	0	17.79678067	0.126009635	0.020697869	0.939840906	0	18.17572854	0	0	0	0	6.508427316	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4148			10.4499	0	2.991423377	0	2.701503591	0	0	1.109720426	3.939594788	0	17.79678067	0.126009635	0.020697869	0.939840906	0	18.17572854	0	0	0	0	6.508427316	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4148																																																																																		0			10.4499	0	2.991423377	0	2.701503591	0	0	1.109720426	3.939594788	0	17.79678067	0.126009635	0.020697869	0.939840906	0	18.17572854	0	0	0	0	6.508427316	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4148
H1076_802_0	2009	4																																																																																																																0		1801.873193		909.2622337		399.9220779	947.1342372		277.3566687	304.7247668					1868.255936						22046.64249	2587.961766																				Medicare FFS cost sharing	included in a.1	Medicare FFS cost sharing		Medicare FFS cost sharing	Medicare FFS cost sharing	included in e.1.	Medicare FFS cost sharing	Medicare FFS cost sharing	included in h.5	included in h.5	included in h.5	included in h.5	Medicare FFS cost sharing	included in i.6.	included in i.6.	included in i.6.	included in i.6.	included in i.6.	Medicare FFS cost sharing	Medicare FFS cost sharing																				167.8985862		48.7152835		78.90519467	23.52783388		167.4638703	385.2013789					105.5730298						42.96018633	85.5630481																				167.8985862		48.7152835		78.90519467	23.52783388		167.4638703	385.2013789					105.5730298						42.96018633	85.5630481																				25.211	0	3.691247291	0	2.629660784	1.857001416	0	3.870601766	9.781700032	0	0	0	0	16.4364533	0	0	0	0	0	78.92732243	18.45282476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.8578			25.211	0	3.691247291	0	2.629660784	1.857001416	0	3.870601766	9.781700032	0	0	0	0	16.4364533	0	0	0	0	0	78.92732243	18.45282476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.8578																																																																																		0			25.211	0	3.691247291	0	2.629660784	1.857001416	0	3.870601766	9.781700032	0	0	0	0	16.4364533	0	0	0	0	0	78.92732243	18.45282476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.8578
H1076_803_0	2009	4																																																																																																																0		1801.873193		909.2622337		399.9220779	947.1342372		277.3566687	304.7247668					1868.255936						22046.64249	2587.961766																				Medicare FFS cost sharing	included in a.1	Medicare FFS cost sharing		Medicare FFS cost sharing	Medicare FFS cost sharing	included in e.1.	Medicare FFS cost sharing	Medicare FFS cost sharing	included in h.5	included in h.5	included in h.5	included in h.5	Medicare FFS cost sharing	included in i.6.	included in i.6.	included in i.6.	included in i.6.	included in i.6.	Medicare FFS cost sharing	Medicare FFS cost sharing																				167.8985862		48.7152835		78.90519467	23.52783388		167.4638703	385.2013789					105.5730298						42.96018633	85.5630481																				167.8985862		48.7152835		78.90519467	23.52783388		167.4638703	385.2013789					105.5730298						42.96018633	85.5630481																				25.211	0	3.691247291	0	2.629660784	1.857001416	0	3.870601766	9.781700032	0	0	0	0	16.4364533	0	0	0	0	0	78.92732243	18.45282476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.8578			25.211	0	3.691247291	0	2.629660784	1.857001416	0	3.870601766	9.781700032	0	0	0	0	16.4364533	0	0	0	0	0	78.92732243	18.45282476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.8578																																																																																		0			25.211	0	3.691247291	0	2.629660784	1.857001416	0	3.870601766	9.781700032	0	0	0	0	16.4364533	0	0	0	0	0	78.92732243	18.45282476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.8578
H1076_804_0	2009	4																																																																																																																0		1801.873193		909.2622337		399.9220779	947.1342372		277.3566687	304.7247668					1868.255936						22046.64249	2587.961766																				Medicare FFS cost sharing	included in a.1	Medicare FFS cost sharing		Medicare FFS cost sharing	Medicare FFS cost sharing	included in e.1.	Medicare FFS cost sharing	Medicare FFS cost sharing	included in h.5	included in h.5	included in h.5	included in h.5	Medicare FFS cost sharing	included in i.6.	included in i.6.	included in i.6.	included in i.6.	included in i.6.	Medicare FFS cost sharing	Medicare FFS cost sharing																				167.8985862		48.7152835		78.90519467	23.52783388		167.4638703	385.2013789					105.5730298						42.96018633	85.5630481																				167.8985862		48.7152835		78.90519467	23.52783388		167.4638703	385.2013789					105.5730298						42.96018633	85.5630481																				25.211	0	3.691247291	0	2.629660784	1.857001416	0	3.870601766	9.781700032	0	0	0	0	16.4364533	0	0	0	0	0	78.92732243	18.45282476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.8578			25.211	0	3.691247291	0	2.629660784	1.857001416	0	3.870601766	9.781700032	0	0	0	0	16.4364533	0	0	0	0	0	78.92732243	18.45282476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.8578																																																																																		0			25.211	0	3.691247291	0	2.629660784	1.857001416	0	3.870601766	9.781700032	0	0	0	0	16.4364533	0	0	0	0	0	78.92732243	18.45282476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.8578
H1076_805_0	2009	4																																																																																																																0		1801.873193		909.2622337		399.9220779	947.1342372		277.3566687	304.7247668					1868.255936						22046.64249	2587.961766																				Medicare FFS cost sharing	included in a.1	Medicare FFS cost sharing		Medicare FFS cost sharing	Medicare FFS cost sharing	included in e.1.	Medicare FFS cost sharing	Medicare FFS cost sharing	included in h.5	included in h.5	included in h.5	included in h.5	Medicare FFS cost sharing	included in i.6.	included in i.6.	included in i.6.	included in i.6.	included in i.6.	Medicare FFS cost sharing	Medicare FFS cost sharing																				167.8985862		48.7152835		78.90519467	23.52783388		167.4638703	385.2013789					105.5730298						42.96018633	85.5630481																				167.8985862		48.7152835		78.90519467	23.52783388		167.4638703	385.2013789					105.5730298						42.96018633	85.5630481																				25.211	0	3.691247291	0	2.629660784	1.857001416	0	3.870601766	9.781700032	0	0	0	0	16.4364533	0	0	0	0	0	78.92732243	18.45282476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.8578			25.211	0	3.691247291	0	2.629660784	1.857001416	0	3.870601766	9.781700032	0	0	0	0	16.4364533	0	0	0	0	0	78.92732243	18.45282476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.8578																																																																																		0			25.211	0	3.691247291	0	2.629660784	1.857001416	0	3.870601766	9.781700032	0	0	0	0	16.4364533	0	0	0	0	0	78.92732243	18.45282476	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.8578
H1080_004_0	2009	7																					3600											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1681.190077	119.3733831	1169.949243	2157.089357	151.3213892	12.36123597	4.796632625	254.0477668	51.97371627	12365.33324	72.15236241	0	0.306548128	22.84542301	6734.991363	7133.868876	548.2557764	456.9122687	0	0	32.42012397	2123.015585	0	276.5058618	282.1061607	0	18.89751481	11.22	467.840531	0											"$250 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$250 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$115 Days 1-25 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20%/30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20%/30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20%/30% (9a); $40/$30 (9c)"	"$10 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											247.0509004	250	87.8078022	0	150	0.2	0.085651739	49.5849113	0.265	2.8	0.184364333	0	0.2	0.289351445	7.489503015	24.98848187	37.5	25	0	0	0.2	24.5221694	0	0	25	0	25	0	0	0											163.0436693	164.9689336	57.94223798	0	98.98136018	0.131975147	0.056519504	32.71987977	0.17486707	1.847652057	0.12165755	0	0.131975147	0.191249856	7.489503015	24.98848187	37.5	16.49689336	0	0	0.131975147	24.5221694	0	0	25	0	25	0	0	0											22.8423	1.641074976	5.649123124	0	1.248166411	1.631375933	0.271103296	0.692701032	9.088491464	1.903902782	8.777879636	0	0.040456734	4.36918385	4.203478177	14.85537942	1.713299301	0.628136081	0	0	4.278650623	4.338412317	0	0	0.587721168	0	0.039369823	0	0	0	0	0	0	0	0	0	0	0	0	0	88.8002	0	32.4895	22.8423	1.641074976	5.649123124	0	1.248166411	1.631375933	0.271103296	0.692701032	9.088491464	1.903902782	8.777879636	0	0.040456734	4.36918385	4.203478177	14.85537942	1.713299301	0.628136081	0	0	4.278650623	4.338412317	0	0	0.587721168	0	0.039369823	0	0	0	0	0	0	0	0	0	0	0	0	0	88.8002																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.8423	1.641074976	5.649123124	0	1.248166411	1.631375933	0.271103296	0.692701032	9.088491464	1.903902782	8.777879636	0	0.040456734	4.36918385	4.203478177	14.85537942	1.713299301	0.628136081	0	0	4.278650623	4.338412317	0	0	0.587721168	0	0.039369823	0	0	0	0	0	0	0	0	0	0	0	0	0	88.8002
H1080_011_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1376.850561	108.4550963	967.8972917	878.7196321	104.9484439	11.02908303	4.348566532	254.3950281	41.1741943	9938.161343	67.56319774	0	0.172029559	12.52969638	5933.525456	5914.322027	504.1007556	601.7519562	0	0	23.16326427	1495.788814	0	276.5196064	169.3501261	0	17.67005464	0	467.8461301	0											"$250 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$250 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-29 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	15%/30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 15%/30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 15%/30% (9a); $40/$30 (9c)"	"$15 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											247.0574929	250	80.97811618	0	150	0.2	0.073126536	48.6913474	0.225	2.8	0.132203057	0	0.2	0.272057061	11.57505217	25	37.5	25	0	0	0.2	23.92210858	0	0	25	0	25	0	0	0											173.4876772	175.5331571	56.85737756	0	105.3198943	0.140426526	0.051344527	34.18778373	0.157979841	1.96597136	0.09282408	0	0.140426526	0.19146201	11.57505217	25	37.5	17.55331571	0	0	0.140426526	23.92210858	0	0	25	0	25	0	0	0											19.9056	1.586455454	4.58600848	0	0.921096585	1.548775811	0.22327509	0.72476685	6.504692686	1.628178381	6.271491679	0	0.024157513	2.398960851	5.723405559	12.32150422	1.575314861	0.880228506	0	0	3.252736725	2.981868535	0	0	0.352812763	0	0.036812614	0	0	0	0	0	0	0	0	0	0	0	0	0	73.4481	0	21.394	19.9056	1.586455454	4.58600848	0	0.921096585	1.548775811	0.22327509	0.72476685	6.504692686	1.628178381	6.271491679	0	0.024157513	2.398960851	5.723405559	12.32150422	1.575314861	0.880228506	0	0	3.252736725	2.981868535	0	0	0.352812763	0	0.036812614	0	0	0	0	0	0	0	0	0	0	0	0	0	73.4481		"$325 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$325 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$180 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$40 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$40 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											3.027	0.2372	0.526	0.2579	0.1621	0.4089	0.1612	0.1276	1.5267	0.2866	1.4618	0	0.0043	0.4569	1.1177	1.3702	0.1241	0.1394	0	0	0.4831	0.3357	0	0	0.0317	0	0.0041	0	0	0											12.2501	0	0	22.9326	1.823673788	5.11196986	0.25791331	1.083236035	1.957719339	0.384514074	0.852346629	8.031376295	1.914784532	7.733272365	0	0.028409929	2.855811279	6.841071471	13.69165855	1.699430577	1.019671918	0	0	3.735820846	3.317580985	0	0	0.384479078	0	0.040907279	0	0	0	0	0	0	0	0	0	0	0	0	0	85.6982
H1080_036_0	2009	5																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		398.688538	23.29	56.57547963	4206.361033	16.88800373	31.54841344	12.27525948	36.00474298	43.97504229	16.07163374	43.08977452	0	2.592239032	44.52049217	46.10402595	176.5056575	14.57	6.613636158	0	0	22.07877153	7.374024334	356.0538923	700.4026555	190.4547268	270.4234378	0	0	20.2	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.082100038	0.083145746	0.171810883	0	0.2	0.2	0.2	0.078358263	0.2	0.08	0.2	0	0.2	0.2	0	0.199815895	0.2	0.2	0	0	0.2	0.011487011	0	0	0	0	0	0	0	0											0.082100038	0.083145746	0.171810883	0	0.2	0.2	0.2	0.078358263	0.2	0.08	0.2	0	0.2	0.2	0	0.199815895	0.2	0.2	0	0	0.2	0.011487011	0	0	0	0	0	0	0	0											32.7323	1.936464428	9.720283126	0	3.377600746	6.309682687	2.455051896	2.821269117	8.795008457	1.285730699	8.617954904	0	0.518447806	8.904098433	0	35.26863589	2.914	1.322727232	0	0	4.415754305	0.0847055	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.4798	0	0	32.7323	1.936464428	9.720283126	0	3.377600746	6.309682687	2.455051896	2.821269117	8.795008457	1.285730699	8.617954904	0	0.518447806	8.904098433	0	35.26863589	2.914	1.322727232	0	0	4.415754305	0.0847055	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.4798																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	32.7323	1.936464428	9.720283126	0	3.377600746	6.309682687	2.455051896	2.821269117	8.795008457	1.285730699	8.617954904	0	0.518447806	8.904098433	0	35.26863589	2.914	1.322727232	0	0	4.415754305	0.0847055	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.4798
H1080_042_0	2009	4																					2800											D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1677.110512	119.0837124	1167.110252	2151.854978	150.9541937	12.30131737	4.773381914	253.3874236	401.6534968	12335.3276	71.80261837	0	0.305062197	405.0996667	6601.931502	7115.851835	546.9253825	455.8035283	0	0	32.26297395	2117.863889	0	985	147.9890135	0	18.41008798	0	453.6	0											"$175 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-28 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$175 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 10%/20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); $175 (9a); $40/$30 (9c)"	"$5 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											172.9539544	175	100	0	150	0.2	0.085651739	49.58483943	175	2.8	0.099752555	0	0.2	60.69497402	3.711480874	20	37.5	20	0	0	0.2	19.61838275	0	0	20	0	20	0	0	0											119.0340757	120.4229745	68.81312831	0	103.2196925	0.137626257	0.058939641	34.12087918	120.4229745	1.926767593	0.068642854	0	0.137626257	41.96039178	3.711480874	20	37.5	13.76262566	0	0	0.137626257	19.61838275	0	0	20	0	20	0	0	0											16.6361	1.195034572	6.692708962	0	1.298453788	1.692984261	0.281341415	0.720483472	4.030692401	1.980609122	4.928736614	0	0.041984568	1.416511727	2.041911875	11.85975306	1.70914182	0.522754445	0	0	4.440232332	3.462422031	0	0	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	65.2292	0	20.7793	16.6361	1.195034572	6.692708962	0	1.298453788	1.692984261	0.281341415	0.720483472	4.030692401	1.980609122	4.928736614	0	0.041984568	1.416511727	2.041911875	11.85975306	1.70914182	0.522754445	0	0	4.440232332	3.462422031	0	0	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	65.2292																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.6361	1.195034572	6.692708962	0	1.298453788	1.692984261	0.281341415	0.720483472	4.030692401	1.980609122	4.928736614	0	0.041984568	1.416511727	2.041911875	11.85975306	1.70914182	0.522754445	0	0	4.440232332	3.462422031	0	0	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	65.2292
H1080_801_0	2009	4																					5275											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1472.658937	125.8975787	1097.054808	1859.557367	135.9121213	12.14506102	5.353402632	300.2645224	57.13671911	13137.5482	75.97012859	0	0.230358488	21.50697569	7072.42582	7595.998844	563.7802365	610.3574374	0	0	34.03256156	2166.634741	0	0	0	0	0	0	0	0											"$500 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$500 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-36 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											494.0478936	500	150	0	150	0.2	0.080152681	48.06230155	0.2	2.8	0.162584633	0	0.2	0.197335822	21.70559163	35	37.5	35	0	0	0.2	34.2676477	0	0	0	0	0	0	0	0											340.4582705	344.5373798	103.3612139	0	103.3612139	0.137814952	0.055231189	33.11851889	0.137814952	1.929409327	0.112032967	0	0.137814952	0.13629235	21.70559163	35	37.5	24.11761659	0	0	0.137814952	34.2676477	0	0	0	0	0	0	0	0											41.7816	3.614701825	9.449409726	0	1.170670154	1.673771001	0.295674794	0.828693021	7.874294197	2.112309003	8.51115891	0	0.031746844	2.931236253	12.79259889	22.15499663	1.761813239	1.226697221	0	0	4.690195836	6.187123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.0887	0	38.878	41.7816	3.614701825	9.449409726	0	1.170670154	1.673771001	0.295674794	0.828693021	7.874294197	2.112309003	8.51115891	0	0.031746844	2.931236253	12.79259889	22.15499663	1.761813239	1.226697221	0	0	4.690195836	6.187123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.0887																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	41.7816	3.614701825	9.449409726	0	1.170670154	1.673771001	0.295674794	0.828693021	7.874294197	2.112309003	8.51115891	0	0.031746844	2.931236253	12.79259889	22.15499663	1.761813239	1.226697221	0	0	4.690195836	6.187123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.0887
H1080_804_0	2009	4																					5275											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1472.658935	125.8975786	1097.054807	1859.557365	135.9121211	12.145061	5.353402622	300.2645221	57.136719	13137.54819	75.97012844	0	0.230358488	21.50697565	7072.425813	7595.998837	563.7802359	610.3574369	0	0	34.0325615	2166.634739	0	0	0	0	0	0	0	0											"$500 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$500 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-36 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											494.0478936	500	150	0	150	0.2	0.080152681	48.06230155	0.2	2.8	0.162584633	0	0.2	0.197335822	21.70559163	35	37.5	35	0	0	0.2	34.2676477	0	0	0	0	0	0	0	0											340.4582706	344.53738	103.361214	0	103.361214	0.137814952	0.055231189	33.1185189	0.137814952	1.929409328	0.112032967	0	0.137814952	0.13629235	21.70559163	35	37.5	24.1176166	0	0	0.137814952	34.2676477	0	0	0	0	0	0	0	0											41.7816	3.614701823	9.449409722	0	1.170670153	1.673770999	0.295674794	0.828693021	7.874294185	2.112309002	8.511158899	0	0.031746844	2.931236249	12.79259888	22.15499661	1.761813237	1.226697221	0	0	4.690195829	6.187122994	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.0887	0	38.878	41.7816	3.614701823	9.449409722	0	1.170670153	1.673770999	0.295674794	0.828693021	7.874294185	2.112309002	8.511158899	0	0.031746844	2.931236249	12.79259888	22.15499661	1.761813237	1.226697221	0	0	4.690195829	6.187122994	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.0887																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	41.7816	3.614701823	9.449409722	0	1.170670153	1.673770999	0.295674794	0.828693021	7.874294185	2.112309002	8.511158899	0	0.031746844	2.931236249	12.79259888	22.15499661	1.761813237	1.226697221	0	0	4.690195829	6.187122994	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.0887
H1099_001_0	2009	4	X1	X2	X3	X4	X5	X6	X7	X8			Professional	OP Facility - Other	OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Professional	Other Non-Covered			3350	Non-facility lab	Xrays	Urgent Care	"OP other OT/ST/PT, PH, MH/SA, Corf"	MRI/PET/CAT	Chiropractic	Podiatry	Travel vaccinations			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	P	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	10000	1534.024135	91.61535779	725.3972313	4717.472391	142.9666152	14.39721708	0.601458079	188.7044641	266.4377828	9803.228446	1079.951304	0	310.8103659	43922.90785	4321.796678	7156.817011	158.1807095	357.1871797	4369.808996	23655.08795	8.453806912	0	0	318.2710453	1350.421385	322.4244132	8.562706362	17.4595281	12000	0	0	0	62.90148803	401.7122722	356.0604242	0	0	0			"$250/day, 1-5"	"$250/day, 1-5"	"$75/day, 1-14"	0	150	0.15	0.15	50 WIA	300	0	0	0	0	0	10	"25 Podiatrist, chiro, specialist"	25	25	0	0	0	0	0	$60 limit	0	$100 limit	15	$250 limit	0	0	0	0	10	"$15 PH&Corf, $25 all other"	75	0	0	0			170.1067515	107.865192	60.75	0	150	0.15	0.15	35	300	0.00431164	0	0	0	0	10	25	25	25	0	0	0	0	0	0	0	0	15	0	0	0	0	0	10	24.95	75	0	0	0			150.967554	95.72897047	53.9148436	0	133.1230706	0.133123071	0.133123071	31.06204981	266.2461412	0.003826525	0	0	0	0	8.874871375	22.18717844	22.18717844	22.18717844	0	0	0	0	0	0	0	0	13.31230706	0	0	0	0	0	8.874871375	22.14280408	66.56153531	0	0	0			19.299	0.730853657	3.259139856	0	1.5860129	1.916601747	0.080067946	0.488462289	5.911502629	0.003126025	0	0	0	0	3.196282469	13.23246467	0.292465302	0.660414641	0	0	0	0	0	0	0	0	0.009499115	0	0	0	0	0	0.046520218	0.741253012	1.974994042	0	0	0	0	0	53.4286		6.7735	19.299	0.730853657	3.259139856	0	1.5860129	1.916601747	0.080067946	0.488462289	5.911502629	0.003126025	0	0	0	0	3.196282469	13.23246467	0.292465302	0.660414641	0	0	0	0	0	0	0	0	0.009499115	0	0	0	0	0	0.046520218	0.741253012	1.974994042	0	0	0	0	0	53.4286		0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.2	0	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2			0.3237	0.0037	0.0452	0.0191	0.0073	0.0173	0.0007	0.012	0.0281	0.0344	0.0227	0	0	0.0312	0.042	0.2462	0.0012	0.0027	0.0366	0.131	0.0102	0	0	0	0.0013	0	0	0	0	0	0	0	0.0006	0.0034	0.0112	0	0	0			1.0318		0.16033707	19.6227	0.734595908	3.304351727	0.019090511	1.593274729	1.93390144	0.080790658	0.500447395	5.939632484	0.037494714	0.02265105	0	0	0.03119512	3.238247298	13.47868519	0.29361864	0.663140331	0.036616664	0.131037287	0.010158093	0	0	0	0.001343503	0	0.009542467	0	0	0	0	0	0.047151013	0.744625018	1.986161299	0	0	0	0	0	54.4604
H1099_006_0	2009	4	X1	X2	X3	X4	X5						Professional	OP Facility - Other	OP Facility - Emergency	OP Facility - Other	OP Facility - Other						3350	Non-facility lab	Xrays	Urgent care	"OP other OT/ST/PT, PH, MH/SA, Corf"	MRI/PET/CAT						Coin	Coin	Coin	V	Coin	Coin	Coin	V	Coin	V	V	V	V	V	V	V	V	V	V	V	Coin	V	T	V	V	V	V	V	V	P	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	0	0	0	0	0	0	0	0	0	0	0						0	0	204.9881931	2.794890124	22.94371221	3193.740435	4.757933626	10.59860775	0.567968149	177.5079303	20.96231727	74.5695415	884.3277602	0	0	44687.38893	3927.174797	9164.211265	180.6342931	267.0917325	9051.476354	13637.88913	11.57701374	0	0	0	0	0	0	0	12000	0	0	0	59.1693101	259.6723831	301.3742661						0.15	0.15	0.15	0	0.15	0.15	0.15	50 WIA	0.15	0	35	0	0	0	10	30	30	30	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10	"15% PH and CORF, $30 all other"	250						0.15	0.15	0.15	0	0.15	0.15	0.15	35	0.15	0	35	0	0	0	10	30	30	30	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10	29.95	250						0.125243313	0.125243313	0.125243313	0	0.125243313	0.125243313	0.125243313	29.22343973	0.125243313	0	29.22343973	0	0	0	8.349554209	25.04866263	25.04866263	25.04866263	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.349554209	25.00691486	208.7388552						25.6734	0.350041299	2.873546533	0	0.595899371	1.32740475	0.071134213	0.432282692	2.625390066	0	2.153591584	0	0	0	2.732513238	19.12926968	0.377053955	0.557524225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.04116978	0.541133765	5.242376608	0	0	0	0	0	64.7237		12.7977	25.6734	0.350041299	2.873546533	0	0.595899371	1.32740475	0.071134213	0.432282692	2.625390066	0	2.153591584	0	0	0	2.732513238	19.12926968	0.377053955	0.557524225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.04116978	0.541133765	5.242376608	0	0	0	0	0	64.7237		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0	25.6734	0.350041299	2.873546533	0	0.595899371	1.32740475	0.071134213	0.432282692	2.625390066	0	2.153591584	0	0	0	2.732513238	19.12926968	0.377053955	0.557524225	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.04116978	0.541133765	5.242376608	0	0	0	0	0	64.7237
H1099_008_0	2009	4	X1	X2	X3	X4	X5						Professional	OP Facility - Other	OP Facility - Emergency	OP Facility - Other	OP Facility - Other						2000	Non-facility lab	Xrays	Urgent care	"OP other OT/ST/PT, PH, MH/SA, Corf"	MRI/PET/CAT						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	P	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	2242.665689	46.63499803	2413.677501	2439.846791	222.8561062	30.30989042	0.344644348	347.6413106	194.2391513	10069.12312	1093.19704	0	0	41510.07023	6497.523564	8664.294848	738.7239969	340.3901963	8160.984486	30054.07655	8880.470428	0	0	105.1597593	354.0163948	434.1674877	2.746241251	8.433048223	12000	0	0	0	115.8804369	495.340051	478.4245861						$250/admit	$250/admit	"$25/day, 1-14"	0	50	0.1	0.1	50 WIA	150	0	0	0	0	0	10	20	20	15	0	0	0	0	0	$60 limit	0	$200 limit	0	$350 limit	0	0	0	0	10	"$0 PH&Corf, $15 all other"	0						47.66435107	27.78205326	20.25	0	50	0.1	0.1	35	150	0	0	0	0	0	10	20	20	15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10	0	0						40.95490319	23.87132681	17.39951916	0	42.9617757	0.085923551	0.085923551	30.07324299	128.8853271	0	0	0	0	0	8.592355139	17.18471028	17.18471028	12.88853271	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.592355139	0	0						7.654	0.09276994	3.49973566	0	0.797857837	2.604333427	0.029613066	0.871225134	2.086214712	0	0	0	0	0	4.652419166	12.40778306	1.057896489	0.365594182	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.082973822	0	0	0	0	0	0	0	36.2024		5.8902	7.654	0.09276994	3.49973566	0	0.797857837	2.604333427	0.029613066	0.871225134	2.086214712	0	0	0	0	0	4.652419166	12.40778306	1.057896489	0.365594182	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.082973822	0	0	0	0	0	0	0	36.2024		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0	7.654	0.09276994	3.49973566	0	0.797857837	2.604333427	0.029613066	0.871225134	2.086214712	0	0	0	0	0	4.652419166	12.40778306	1.057896489	0.365594182	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.082973822	0	0	0	0	0	0	0	36.2024
H1099_009_0	2009	3	X1	X2	X3	X4	X5						Professional	OP Facility - Other	OP Facility - Emergency	OP Facility - Other	OP Facility - Other						3350	Non-facility lab	Xrays	Urgent care	"OP other OT/ST/PT, PH, MH/SA, Corf"	MRI/PET/CAT						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	P	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	1370.544026	32.15566703	290.4582723	37348.82836	129.4309431	10.92789255	0.38460366	186.2358185	221.6885682	7477.433637	1036.197044	0	197.5558655	32987.96843	3974.220859	6150.082252	103.0495259	342.4360111	5206.058477	18940.6639	8.876154162	0	0	261.2144713	947.8190425	248.6501624	5.475440963	16.79914064	12000	0	0	0	62.07860616	302.5890848	279.2748651						"$250/day, 1-5"	"$250/day, 1-5"	"$75/day, 1-14"	0	150	0.15	0.15	50 WIA	300	0	0	0	0	0	10	25	25	25	0	0	0	0	0	$60 limit	0	$100 limit	15	$250 limit	0	0	0	0	10	"$15 PH & Corf, $25 all other"	75						157.3676301	107.5	60.75	0	150	0.15	0.15	35	300	0	0	0	0	0	10	25	25	25	0	0	0	0	0	0	0	0	15	0	0	0	0	0	10	24.95	75						145.3608614	99.29801058	56.11492226	0	138.5553636	0.138555364	0.138555364	32.32958484	277.1107272	0	0	0	0	0	9.23702424	23.0925606	23.0925606	23.0925606	0	0	0	0	0	0	0	0	13.85553636	0	0	0	0	0	9.23702424	23.04637548	69.2776818						16.602	0.266082814	1.358253614	0	1.494445948	1.514118125	0.0532889	0.501743891	5.119356695	0	0	0	0	0	3.059164534	11.83509559	0.198306452	0.658977028	0	0	0	0	0	0	0	0	0.006322098	0	0	0	0	0	0.047785132	0.581131805	1.612292937	0	0	0	0	0	44.9083		3.7094	16.602	0.266082814	1.358253614	0	1.494445948	1.514118125	0.0532889	0.501743891	5.119356695	0	0	0	0	0	3.059164534	11.83509559	0.198306452	0.658977028	0	0	0	0	0	0	0	0	0.006322098	0	0	0	0	0	0.047785132	0.581131805	1.612292937	0	0	0	0	0	44.9083		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0	16.602	0.266082814	1.358253614	0	1.494445948	1.514118125	0.0532889	0.501743891	5.119356695	0	0	0	0	0	3.059164534	11.83509559	0.198306452	0.658977028	0	0	0	0	0	0	0	0	0.006322098	0	0	0	0	0	0.047785132	0.581131805	1.612292937	0	0	0	0	0	44.9083
H1099_010_0	2009	4	X1	X2	X3	X4	X5						Professional	OP Facility - Other	OP Facility - Emergency	OP Facility - Other	OP Facility - Other						3350	Non-facility lab	Xrays	Urgent care	"OP other OT/ST/PT, PH, MH/SA, Corf"	MRI/PET/CAT						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	P	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	1745.455181	39.63284861	1143.085348	5367.670846	162.6713775	16.38155266	0.684355674	214.7131698	540.1211673	11154.38505	1175.429767	0	351.5267574	49976.70201	4917.460052	8143.224769	179.9823957	406.4174736	4972.089798	26915.41474	9.618975828	0	0	359.9647915	1536.546883	364.6622537	9.742884641	19.74673941	12000	0	0	0	71.57105659	457.079358	458.5041817						"$200/day, 1-5"	"$200/day, 1-5"	"$75/day, 1-14"	0	150	0.15	0.15	50 WIA	250	0	0	0	0	0	10	25	25	25	0	0	0	0	0	$250 limit	0	$250 limit	15	$250 limit	0	0	0	0	10	"$15 PH&Corf, $25 all other"	75						136.0854012	86	60.80789145	0	150	0.15	0.15	35	250	0.00431164	0	0	0	0	10	25	25	25	0	0	0	0	0	0	0	0	15	0	0	0	0	0	10	24.95	75						123.1061176	77.79766251	55.00827694	0	135.6935974	0.135693597	0.135693597	31.66183939	226.1559957	0.003900413	0	0	0	0	9.046239827	22.61559957	22.61559957	22.61559957	0	0	0	0	0	0	0	0	13.56935974	0	0	0	0	0	9.046239827	22.57036837	67.8467987						17.9064	0.256945248	5.239929613	0	1.839455367	2.222871812	0.092862683	0.566517825	10.17930336	0.003625559	0	0	0	0	3.707043581	15.34699255	0.339200816	0.765947903	0	0	0	0	0	0	0	0	0.011017059	0	0	0	0	0	0.053954079	0.859704124	2.592336743	0	0	0	0	0	61.9841		6.5351	17.9064	0.256945248	5.239929613	0	1.839455367	2.222871812	0.092862683	0.566517825	10.17930336	0.003625559	0	0	0	0	3.707043581	15.34699255	0.339200816	0.765947903	0	0	0	0	0	0	0	0	0.011017059	0	0	0	0	0	0.053954079	0.859704124	2.592336743	0	0	0	0	0	61.9841		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0	17.9064	0.256945248	5.239929613	0	1.839455367	2.222871812	0.092862683	0.566517825	10.17930336	0.003625559	0	0	0	0	3.707043581	15.34699255	0.339200816	0.765947903	0	0	0	0	0	0	0	0	0.011017059	0	0	0	0	0	0.053954079	0.859704124	2.592336743	0	0	0	0	0	61.9841
H1099_011_0	2009	4	X1	X2	X3	X4	X5	X6	X7	X8			Professional	OP Facility - Other	OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Professional	Other Non-Covered			3100	Non-facility lab	Xrays	Urgent Care	"OP other OT/ST/PT, PH, MH/SA, Corf"	MRI/PET/CAT	Chiropractic	Podiatry	Travel vaccinations			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	P	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	10000	1396.364145	31.70627889	914.468278	4294.136677	130.137102	13.10524213	0.547484539	171.7705358	242.5282355	8923.508042	944.0898135	0	351.5267574	39981.36161	3933.968042	6514.579815	143.9859166	325.1339789	3977.671839	21532.33179	7.695180663	0	0	366.8370047	1229.237507	364.6622537	7.794307713	19.74673941	12000	0	0	0	57.25684527	365.6634864	363.0573451	0	0	96			"$200/day, 1-5"	"$200/day, 1-5"	"$75/day, 1-14"	0	150	0.15	0.15	$50 WIA	250	0	0	0	0	0	10	25	25	25	0	0	0	0	0	$250 limit	0	$250 limit	$15 	$250 limit	0	0	0	0	10	"$15 PH, $25 all other"	75	0	0	0			136.0854012	86	75	0	150	0.15	0.15	35	250	0	0	0	0	0	10	25	25	25	0	0	0	0	0	0	0	0	15	0	0	0	0	0	10	27.04699379	75	0	0	0			116.7670683	73.79166159	64.35319325	0	128.7063865	0.128706386	0.128706386	30.03149018	214.5106442	0	0	0	0	0	8.580425766	21.45106442	21.45106442	21.45106442	0	0	0	0	0	0	0	0	12.87063865	0	0	0	0	0	8.580425766	23.20747224	64.35319325	0	0	0			13.5874	0.194971584	4.904079484	0	1.395789679	1.686728359	0.070464757	0.429877097	4.335407336	0	0	0	0	0	2.812926729	11.64538927	0.257387598	0.581205827	0	0	0	0	0	0	0	0	0.00835981	0	0	0	0	0	0.040940676	0.707177101	1.946991624	0	0	0	0	0	44.6051		7.3796	13.5874	0.194971584	4.904079484	0	1.395789679	1.686728359	0.070464757	0.429877097	4.335407336	0	0	0	0	0	2.812926729	11.64538927	0.257387598	0.581205827	0	0	0	0	0	0	0	0	0.00835981	0	0	0	0	0	0.040940676	0.707177101	1.946991624	0	0	0	0	0	44.6051		0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.2	0	0	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2			11.8332	0.1017	1.6529	0.6204	0.2655	0.6325	0.0264	0.4382	1.0284	1.2565	0.7794	0	0	1.1405	1.5323	8.9904	0.0422	0.0996	1.3387	4.7907	0.3714	0	0	0	0.0491	0	0.0016	0	0	0	0	0	0.0231	0.1233	0.4569	0	0	0.0521			37.647		7.207302381	25.4207	0.296657401	6.55700474	0.620398168	1.661278792	2.319197213	0.096886773	0.868047068	5.363821914	1.256503488	0.779439969	0	0	1.140479271	4.345221126	20.63583017	0.299553099	0.680855799	1.338688446	4.790663063	0.371375214	0	0	0	0.049117847	0	0.009944756	0	0	0	0	0	0.064002253	0.8304561	2.403933457	0	0	0.052121613	0	0	82.2521
H1099_802_0	2009	2	X1	X2	X3	X4	X5						Professional	OP Facility - Other	OP Facility - Emergency	OP Facility - Other	OP Facility - Other							Non-facility lab	Xrays	Urgent care	"OP other OT/ST/PT, PH, MH/SA, Corf"	MRI/PET/CAT						Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	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	0	0						0		228.2623942	2.623651335	20.37956463	15.74640855	5.269809462	13.35040821	0.42310448	10.3017462	20.91884184	25.82450097	14.08629369	0	0.016179403	27.50893907	28.85636512	184.6078138	0.800185369	2.927564386	44.17309109	63.24186267	28.61859385	0	0	0	0	0	0	0	0.001976709	0	0	0	0.103093239	0	7.819168495						Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	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	0	0	0	0	0	0	0	0	0	0	Medicare FFS	Medicare FFS	Medicare FFS						0.086360593	0.086360593	0.160517223	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0	0	0.231	0	0.231						0.086360593	0.086360593	0.160517223	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0	0	0.231	0	0.231						19.7129	0.226580085	3.271271116	0	1.217325986	3.083944296	0.097737135	2.379703373	4.832252465	5.965459725	3.253933842	0	0.003737442	6.354564925	6.665820342	42.64440498	0.18484282	0.676267373	10.20398404	14.60887028	6.61089518	0	0	0	0	0	0	0	0	0	0	0	0.023814538	0	1.806227922	0	0	0	0	0	133.8245		0	19.7129	0.226580085	3.271271116	0	1.217325986	3.083944296	0.097737135	2.379703373	4.832252465	5.965459725	3.253933842	0	0.003737442	6.354564925	6.665820342	42.64440498	0.18484282	0.676267373	10.20398404	14.60887028	6.61089518	0	0	0	0	0	0	0	0	0	0	0	0.023814538	0	1.806227922	0	0	0	0	0	133.8245		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0	19.7129	0.226580085	3.271271116	0	1.217325986	3.083944296	0.097737135	2.379703373	4.832252465	5.965459725	3.253933842	0	0.003737442	6.354564925	6.665820342	42.64440498	0.18484282	0.676267373	10.20398404	14.60887028	6.61089518	0	0	0	0	0	0	0	0	0	0	0	0.023814538	0	1.806227922	0	0	0	0	0	133.8245
H1099_803_0	2009	2	X1	X2	X3	X4	X5						Professional	OP Facility - Other	OP Facility - Emergency	OP Facility - Other	OP Facility - Other							Non-facility lab	Xrays	Urgent care	"OP other OT/ST/PT, PH, MH/SA, Corf"	MRI/PET/CAT						Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	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	0	0						0	0	195.6073632	2.478225652	33.90117567	15.75322204	4.688152951	11.80183406	0.394938839	7.635719166	16.6450809	20.75218289	17.54129435	0	0.054098498	22.36368453	28.17522199	152.3011549	0.630262057	1.504492866	25.97049052	84.04009898	5.551071308	0	0	0	0	0	0	0	0.001976709	0	0	0	0.344709221	0	5.923050433						Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	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	0	0	0	0	0	0	0	0	0	0	Medicare FFS	Medicare FFS	Medicare FFS						0.0864	0.0864	0.160517223	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0	0	0.231	0	0.231						0.0864	0.0864	0.160517223	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0	0	0.231	0	0.231						16.9005	0.214118696	5.441722566	0	1.082963332	2.726223668	0.091230872	1.763851127	3.845013689	4.793754247	4.052038994	0	0.012496753	5.166011127	6.508476281	35.18156678	0.145590535	0.347537852	5.99918331	19.41326286	1.282297472	0	0	0	0	0	0	0	0	0	0	0	0.07962783	0	1.36822465	0	0	0	0	0	116.4157		0	16.9005	0.214118696	5.441722566	0	1.082963332	2.726223668	0.091230872	1.763851127	3.845013689	4.793754247	4.052038994	0	0.012496753	5.166011127	6.508476281	35.18156678	0.145590535	0.347537852	5.99918331	19.41326286	1.282297472	0	0	0	0	0	0	0	0	0	0	0	0.07962783	0	1.36822465	0	0	0	0	0	116.4157		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0	16.9005	0.214118696	5.441722566	0	1.082963332	2.726223668	0.091230872	1.763851127	3.845013689	4.793754247	4.052038994	0	0.012496753	5.166011127	6.508476281	35.18156678	0.145590535	0.347537852	5.99918331	19.41326286	1.282297472	0	0	0	0	0	0	0	0	0	0	0	0.07962783	0	1.36822465	0	0	0	0	0	116.4157
H1099_804_0	2009	2	X1	X2	X3	X4	X5	X6	X7	X8			Professional	OP Facility - Other	OP Facility - Emergency	OP Facility - Other	OP Facility - Other	Professional	Professional	Other Non-Covered				Non-facility lab	Xrays	Urgent Care	"OP other OT/ST/PT, PH, MH/SA, Corf"	MRI/PET/CAT	Chiropractic	Podiatry	Travel vaccinations			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	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	0	0	0	0	0			0		216.7931595	2.054106465	30.28281386	12.78377112	4.863957011	11.58729745	0.484070889	8.027598126	18.84131611	23.02007373	15.24958099	0	0.082884695	23.1529867	28.1079519	164.9179693	0.772503193	1.825661221	24.52576297	87.76849245	6.803868742	0	0	0	0	0	0	0	0	0	0	0	0.422505165	0	7.401848548	0	0	0			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	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	0	0	0	0	0	0	0	0	0	0	Medicare FFS	Medicare FFS	Medicare FFS	0	0	0			0.086116962	0.086116962	0.161250784	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0	0	0.231	0.231	0.231	0.231	0.231				0.086116962	0.086116962	0.161250784	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0	0	0.231	0.231	0.231	0.231	0.231	0			18.6696	0.176893409	4.883127463	0	1.123574069	2.676665711	0.111820375	1.854375167	4.35234402	5.317637032	3.522653209	0	0.019146364	5.348339928	6.492936888	38.09605091	0.178448238	0.421727742	5.665451245	20.27452176	1.57169368	0	0	0	0	0	0	0	0	0	0	0	0.097598693	0	1.709827015	0	0	0	0	0	122.5644		0	18.6696	0.176893409	4.883127463	0	1.123574069	2.676665711	0.111820375	1.854375167	4.35234402	5.317637032	3.522653209	0	0.019146364	5.348339928	6.492936888	38.09605091	0.178448238	0.421727742	5.665451245	20.27452176	1.57169368	0	0	0	0	0	0	0	0	0	0	0	0.097598693	0	1.709827015	0	0	0	0	0	122.5644		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	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	0	0	0	0	0	0	0	0	0	0	Medicare FFS	Medicare FFS	Medicare FFS	0	0	0			5.3675	0.0509	1.4039	0	0.323	0.7695	0.0321	0.5331	1.2513	1.5288	1.0128	0	0	1.5376	1.8667	10.9526	0.0513	0.1212	1.6288	5.8289	0.4519	0	0	0	0	0	0	0	0	0	0	0	0.0281	0	0.4916	0	0	0			35.2318		0	24.0371	0.227750474	6.287017186	0	1.446601614	3.446207103	0.143968733	2.387508028	5.603642926	6.846457679	4.535416007	0	0.019146364	6.885987658	8.359656243	49.04866555	0.229752106	0.542974468	7.294268478	26.10344676	2.023555612	0	0	0	0	0	0	0	0	0	0	0	0.125658317	0	2.201402281	0	0	0	0	0	157.7962
H1108_001_0	2009	4																																Coin	Coin	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		355.2528687	42.36375	8770.92673	27.80854263	40.69548554	10.05689824	21.57687639	14.19205768	9.07994072	33.92637371	37.85816381	0	0.028528285	3.084081688	1.012298937	145.051788	43.2725	173.9757534	0	0	6.419942761	5.60942086	3207.284556	0	7.314726646	40.44613557	17.44777212	0	0	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.075870097	0.076916124	0	0	0.2	0.2	0.2	0.056920469	0.2	0.08	0.147952971	0	0.2	0.2	0	0.19958933	0.2	0	0	0	0.2	0.01467108	0	0	0	0	0	0	0	0											0.075870097	0.076916124	0	0	0.2	0.2	0.2	0.056920469	0.2	0.08	0.147952971	0	0.2	0.2	0	0.19958933	0.2	0	0	0	0.2	0.01467108	0	0	0	0	0	0	0	0											26.9531	3.258455445	0	0	8.139097108	2.011379649	4.315375278	0.80781858	1.815988144	2.714109897	5.601227803	0	0.005705657	0.616816338	0	28.95078916	8.6545	0	0	0	1.283988552	0.082296261	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.2106	0	0	26.9531	3.258455445	0	0	8.139097108	2.011379649	4.315375278	0.80781858	1.815988144	2.714109897	5.601227803	0	0.005705657	0.616816338	0	28.95078916	8.6545	0	0	0	1.283988552	0.082296261	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.2106		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.7327	0.3259	1.0029	0.0028	0.6426	0.1588	0.3407	0.0425	0.1434	0.5357	0.5978	0	0.0003	0.0487	0.016	2.2903	0.6833	0.0146	0	0	0.1014	0.0885	0.3842	0	0.0006	0	0.0011	0	0	0											10.1545	0	0	29.6858	3.584330445	1.002877437	0.002752599	8.781657406	2.170172779	4.6560628	0.850335347	1.959355629	3.249789482	6.198988284	0	0.006005955	0.665512364	0.015983667	31.24108055	9.33775	0.014574352	0	0	1.38535607	0.170774733	0.384182321	0	0.000632494	0	0.001124343	0	0	0	0	0	0	0	0	0	0	0	0	0	105.3651
H1108_002_0	2009	4																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		382.6797456	22.4256	33.41613363	2135.120158	14.34738933	34.06499817	13.48681479	47.76297015	35.74888732	15.54351787	47.9886962	0	0.966472316	27.64880637	37.33941928	139.5164706	13.9175	4.051054039	0	0	40.64891574	5.341025196	200.4491464	0	145.1631284	171.7688134	0	0	20.2	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.075902724	0.076888589	0.193412297	0	0.2	0.2	0.2	0.07081932	0.2	0.08	0.2	0	0.2	0.2	0	0.199896343	0.2	0.2	0	0	0.2	0.022180501	0	0	0	0	0	0	0	0											0.075902724	0.076888589	0.193412297	0	0.2	0.2	0.2	0.07081932	0.2	0.08	0.2	0	0.2	0.2	0	0.199896343	0.2	0.2	0	0	0.2	0.022180501	0	0	0	0	0	0	0	0											29.0464	1.724272739	6.463091154	0	2.869477865	6.812999634	2.697362958	3.382541067	7.149777464	1.24348143	9.59773924	0	0.193294463	5.529761275	0	27.88883226	2.7835	0.810210808	0	0	8.129783147	0.118466613	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.441	0	0	29.0464	1.724272739	6.463091154	0	2.869477865	6.812999634	2.697362958	3.382541067	7.149777464	1.24348143	9.59773924	0	0.193294463	5.529761275	0	27.88883226	2.7835	0.810210808	0	0	8.129783147	0.118466613	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.441		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											4.7835	0.2803	0.5276	0.3622	0.2265	0.5379	0.2129	0.1781	0.5645	0.2454	0.7577	0	0.0102	0.4366	0.5896	2.2029	0.2198	0.064	0	0	0.6418	0.0759	0.0261	0	0.0155	0	0	0	0.003	0											12.9619	0	0	33.8299	2.004592739	6.990714317	0.36217887	3.096015591	7.350868026	2.910312666	3.560679244	7.71423358	1.488905396	10.3554555	0	0.203467856	5.966321375	0.589569778	30.0917239	3.00325	0.874174819	0	0	8.771608133	0.19440062	0.0261	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	129.403
H1108_006_0	2009	4																					2900											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2582.979901	66.35483895	25.67024768	20266.65146	186.0953129	20.71822712	10.25376934	433.0613566	281.0257678	4645.830524	954.797659	0	0.446919991	1421.27349	5465.895383	5534.777554	606.7789132	253.8707981	0	0	20.21719331	881.6636286	305.6190003	0	228.3414822	229.9252577	0	0	20.2	0											"$175 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$75 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5, 9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											173.1586516	175	0.192151142	0	75	0.14	0.107752164	49.97806315	75	4.4	40.90412717	0	0.2	72.63475692	3.382602946	25	20	20	0	0	0.2	19.45505046	0	0	0	0	0	0	0	0											121.9956671	123.2929544	0.192151142	0	52.83983762	0.098634364	0.075914758	35.21110322	52.83983762	3.09993714	28.81823251	0	0.140906234	51.17345015	3.382602946	25	20	20	0	0	0.140906234	19.45505046	0	0	0	0	0	0	0	0											26.2594	0.681757011	4.9325674	0	0.819437176	2.043529146	0.778412417	1.270714011	1.237446328	1.200148549	2.292965078	0	0.062973813	6.060955674	1.540746152	11.53078657	1.011298189	0.423117997	0	0	2.848728565	1.429400865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4243	0	19.1056	26.2594	0.681757011	4.9325674	0	0.819437176	2.043529146	0.778412417	1.270714011	1.237446328	1.200148549	2.292965078	0	0.062973813	6.060955674	1.540746152	11.53078657	1.011298189	0.423117997	0	0	2.848728565	1.429400865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4243		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											4.4677	0.1837	0.4053	0.2973	0.1876	0.3271	0.1619	0.095	0.4584	0.2302	0.4937	0	0.0047	0.5655	0.548	2.0898	0.135	0.0522	0	0	0.3192	0.0809	0.0227	0	0.0155	0	0	0	0.003	0											11.1445	0	0	30.7271	0.865477011	5.337887101	0.297341068	1.00704024	2.370659047	0.940314038	1.36575164	1.695803993	1.430338791	2.786630685	0	0.067678234	6.626505087	2.08875353	13.6206288	1.146298189	0.475311199	0	0	3.167947407	1.510256875	0.022681729	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	77.5689
H1108_007_0	2009	5																					3000											D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1530.165364	157.4945998	651.9141064	691.3401223	104.3397751	10.48032589	3.871160283	296.7374124	207.595945	9240.386373	37.05152577	0	0.19284919	541.4134799	4436.892879	3415.475286	537.7271213	193.4173309	0	0	14.90524927	741.3641319	0	0	103.5923094	204.96	12.88706159	0	347.04	0											"$200 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$200 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$150 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); $150 (9a); $40/$30 (9c)"	"$5 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											197.6553105	200	77.60718127	0	150	0.2	0.076056143	49.51692404	150	2.8	0.174410892	0	0.2	52.82955463	3.936173971	20	37.5	20	0	0	0.2	19.04196652	0	0	20	30	20	0	0	0											138.8364375	140.4641639	54.50513914	0	105.3481229	0.140464164	0.053415813	34.77676667	105.3481229	1.966498294	0.122492401	0	0.140464164	37.25107902	3.936173971	20	37.5	14.04641639	0	0	0.140464164	19.04196652	0	0	20	30	20	0	0	0											17.7036	1.84352894	2.961055756	0	0.915999954	1.472110214	0.206781173	0.859963979	1.822486927	1.514267004	4.538530335	0	0.0270884	1.68068636	1.455365188	5.69245881	1.680397254	0.226401697	0	0	2.093653376	1.176419248	0	0	0.172653849	0.5124	0.021478436	0	0	0	0	0	0	0	0	0	0	0	0	0	48.5773	0	16.0366	17.7036	1.84352894	2.961055756	0	0.915999954	1.472110214	0.206781173	0.859963979	1.822486927	1.514267004	4.538530335	0	0.0270884	1.68068636	1.455365188	5.69245881	1.680397254	0.226401697	0	0	2.093653376	1.176419248	0	0	0.172653849	0.5124	0.021478436	0	0	0	0	0	0	0	0	0	0	0	0	0	48.5773		"$275 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$275 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$10 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$10 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"50% (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a7, 14a8, 14a9, 14a10); $0 (14a6)"	"$0 n/c (13b, 13d, 13e)"											4.7916	0.4902	5.4263	0.5952	0.4347	1.048	0.3871	0.4082	3.1838	0.7187	3.1704	0	0.0129	2.3683	1.4143	3.6579	0.8162	0.2072	0	0	1.9164	0.7737	0	0	0.111	0.4301	0.0138	0	0	0											32.3758	0	0	22.4952	2.333750412	8.387329814	0.595183162	1.350749017	2.520142803	0.593897201	1.268117421	5.006269531	2.232963722	7.708890515	0	0.039945013	4.048992101	2.86963556	9.350364492	2.496590206	0.433634552	0	0	4.010042568	1.950092258	0	0	0.283645609	0.94245	0.035286002	0	0	0	0	0	0	0	0	0	0	0	0	0	80.9531
H1108_801_0	2009	2																					3200											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1606.673633	165.3693298	684.5098117	725.9071284	109.5567638	11.00434219	4.064718298	311.5544835	33.42971734	9702.405692	38.90410206	0	0.20249165	25.29521282	4553.600839	3578.964966	564.6134773	203.0881975	0	0	15.65051173	778.4323385	0	0	0	0	0	0	0	0											"$270 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$270 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-20 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											266.8123323	270	160	0	150	0.2	0.076056143	49.51689334	0.3	2.8	0.24686359	0	0.2	0.295046612	21.52104741	34.75590232	37.5	35	0	0	0.2	33.30989645	0	0	0	0	0	0	0	0											158.8652421	160.7371064	95.25161859	0	89.29839243	0.119064523	0.045277942	29.47852649	0.178596785	1.666903325	0.146963478	0	0.119064523	0.176024177	21.52104741	34.75590232	37.5	20.83629157	0	0	0.119064523	33.30989645	0	0	0	0	0	0	0	0											21.2704	2.215082296	5.433388959	0	0.815270241	1.310226756	0.184042079	0.765347258	5.970440035	1.347747693	5.717482145	0	0.024109572	4.452569017	8.166521628	10.3658464	1.764417117	0.352633741	0	0	1.863420718	2.160791716	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1797	0	35.1369	21.2704	2.215082296	5.433388959	0	0.815270241	1.310226756	0.184042079	0.765347258	5.970440035	1.347747693	5.717482145	0	0.024109572	4.452569017	8.166521628	10.3658464	1.764417117	0.352633741	0	0	1.863420718	2.160791716	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1797		"$375 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$375 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$185 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$35 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$35 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											6.835	0.7019	7.027	0.6249	0.4565	1.1004	0.4065	0.4285	3.343	0.7546	3.3289	0	0.0135	2.4888	4.4875	4.4425	0.857	0.2539	0	0	2.0122	0.9446	0	0	0	0	0	0	0	0											40.5072	0	0	28.1053	2.916990314	12.46041386	0.62494232	1.271756757	2.410660975	0.590513909	1.193880872	9.313411768	2.102379246	9.046360334	0	0.037609015	6.941369905	12.654024	14.80835199	2.621419716	0.606493988	0	0	3.875629369	3.10537002	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.6869
H1108_802_0	2009	2																					3200											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1606.673633	165.3693298	684.5098117	725.9071284	109.5567638	11.00434219	4.064718298	311.5544835	33.42971734	9702.405692	38.90410206	0	0.20249165	25.29521282	4553.600839	3578.964966	564.6134773	203.0881975	0	0	15.65051173	778.4323385	0	0	0	0	0	0	0	0											"$270 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$270 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-20 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											266.8123323	270	160	0	150	0.2	0.076056143	49.51689334	0.3	2.8	0.24686359	0	0.2	0.295046612	21.52104741	34.75590232	37.5	35	0	0	0.2	33.30989645	0	0	0	0	0	0	0	0											158.8652421	160.7371064	95.25161859	0	89.29839243	0.119064523	0.045277942	29.47852649	0.178596785	1.666903325	0.146963478	0	0.119064523	0.176024177	21.52104741	34.75590232	37.5	20.83629157	0	0	0.119064523	33.30989645	0	0	0	0	0	0	0	0											21.2704	2.215082296	5.433388959	0	0.815270241	1.310226756	0.184042079	0.765347258	5.970440035	1.347747693	5.717482145	0	0.024109572	4.452569017	8.166521628	10.3658464	1.764417117	0.352633741	0	0	1.863420718	2.160791716	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1797	0	35.1369	21.2704	2.215082296	5.433388959	0	0.815270241	1.310226756	0.184042079	0.765347258	5.970440035	1.347747693	5.717482145	0	0.024109572	4.452569017	8.166521628	10.3658464	1.764417117	0.352633741	0	0	1.863420718	2.160791716	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1797		"$375 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$375 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$185 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$35 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$35 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											6.835	0.7019	7.027	0.6249	0.4565	1.1004	0.4065	0.4285	3.343	0.7546	3.3289	0	0.0135	2.4888	4.4875	4.4425	0.857	0.2539	0	0	2.0122	0.9446	0	0	0	0	0	0	0	0											40.5072	0	0	28.1053	2.916990314	12.46041386	0.62494232	1.271756757	2.410660975	0.590513909	1.193880872	9.313411768	2.102379246	9.046360334	0	0.037609015	6.941369905	12.654024	14.80835199	2.621419716	0.606493988	0	0	3.875629369	3.10537002	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.6869
H1108_803_0	2009	2																					3200											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1606.673633	165.3693298	684.5098117	725.9071284	109.5567638	11.00434219	4.064718298	311.5544835	33.42971734	9702.405692	38.90410206	0	0.20249165	25.29521282	4553.600839	3578.964966	564.6134773	203.0881975	0	0	15.65051173	778.4323385	0	0	0	0	0	0	0	0											"$270 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$270 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-20 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											266.8123323	270	160	0	150	0.2	0.076056143	49.51689334	0.3	2.8	0.24686359	0	0.2	0.295046612	21.52104741	34.75590232	37.5	35	0	0	0.2	33.30989645	0	0	0	0	0	0	0	0											158.8652421	160.7371064	95.25161859	0	89.29839243	0.119064523	0.045277942	29.47852649	0.178596785	1.666903325	0.146963478	0	0.119064523	0.176024177	21.52104741	34.75590232	37.5	20.83629157	0	0	0.119064523	33.30989645	0	0	0	0	0	0	0	0											21.2704	2.215082296	5.433388959	0	0.815270241	1.310226756	0.184042079	0.765347258	5.970440035	1.347747693	5.717482145	0	0.024109572	4.452569017	8.166521628	10.3658464	1.764417117	0.352633741	0	0	1.863420718	2.160791716	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1797	0	35.1369	21.2704	2.215082296	5.433388959	0	0.815270241	1.310226756	0.184042079	0.765347258	5.970440035	1.347747693	5.717482145	0	0.024109572	4.452569017	8.166521628	10.3658464	1.764417117	0.352633741	0	0	1.863420718	2.160791716	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1797		"$375 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$375 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$185 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$35 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$35 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											6.835	0.7019	7.027	0.6249	0.4565	1.1004	0.4065	0.4285	3.343	0.7546	3.3289	0	0.0135	2.4888	4.4875	4.4425	0.857	0.2539	0	0	2.0122	0.9446	0	0	0	0	0	0	0	0											40.5072	0	0	28.1053	2.916990314	12.46041386	0.62494232	1.271756757	2.410660975	0.590513909	1.193880872	9.313411768	2.102379246	9.046360334	0	0.037609015	6.941369905	12.654024	14.80835199	2.621419716	0.606493988	0	0	3.875629369	3.10537002	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.6869
H1108_804_0	2009	3																					3200											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1606.673633	165.3693298	684.5098117	725.9071284	109.5567638	11.00434219	4.064718298	311.5544835	33.42971734	9702.405692	38.90410206	0	0.20249165	25.29521282	4553.600839	3578.964966	564.6134773	203.0881975	0	0	15.65051173	778.4323385	0	0	0	0	0	0	0	0											"$270 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$270 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-20 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											266.8123323	270	160	0	150	0.2	0.076056143	49.51689334	0.3	2.8	0.24686359	0	0.2	0.295046612	21.52104741	34.75590232	37.5	35	0	0	0.2	33.30989645	0	0	0	0	0	0	0	0											158.8652421	160.7371064	95.25161859	0	89.29839243	0.119064523	0.045277942	29.47852649	0.178596785	1.666903325	0.146963478	0	0.119064523	0.176024177	21.52104741	34.75590232	37.5	20.83629157	0	0	0.119064523	33.30989645	0	0	0	0	0	0	0	0											21.2704	2.215082296	5.433388959	0	0.815270241	1.310226756	0.184042079	0.765347258	5.970440035	1.347747693	5.717482145	0	0.024109572	4.452569017	8.166521628	10.3658464	1.764417117	0.352633741	0	0	1.863420718	2.160791716	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1797	0	35.1369	21.2704	2.215082296	5.433388959	0	0.815270241	1.310226756	0.184042079	0.765347258	5.970440035	1.347747693	5.717482145	0	0.024109572	4.452569017	8.166521628	10.3658464	1.764417117	0.352633741	0	0	1.863420718	2.160791716	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1797		"$375 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$375 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$185 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$35 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$35 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											6.835	0.7019	7.027	0.6249	0.4565	1.1004	0.4065	0.4285	3.343	0.7546	3.3289	0	0.0135	2.4888	4.4875	4.4425	0.857	0.2539	0	0	2.0122	0.9446	0	0	0	0	0	0	0	0											40.5072	0	0	28.1053	2.916990314	12.46041386	0.62494232	1.271756757	2.410660975	0.590513909	1.193880872	9.313411768	2.102379246	9.046360334	0	0.037609015	6.941369905	12.654024	14.80835199	2.621419716	0.606493988	0	0	3.875629369	3.10537002	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.6869
H1109_001_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	10570.53335	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$200/day 1-10	$200/day 1-10	"$0/d 1-10, $75/d 11-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$225 per procedure	$35 per visit	$35 X-ray; $175 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$20 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											163.9294809	163.9294809	47.56208437	20	100	0.2	0.2	47.5	225	35	60.2	30	25	30	20	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											141.4093826	141.4093826	41.0281601	20	100	0.172524651	0.172524651	40.97460468	194.0902327	30.19181397	51.92992004	25.87869769	21.56558141	25.87869769	20	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											23.0258	0	4.611216121	1.711889696	2.276793099	1.359613451	0	0.86872709	6.218805353	2.639762923	20.40131488	0	0.120094454	1.697234095	12.17789911	26.42633338	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.2545	0	9.7054	23.0258	0	4.611216121	1.711889696	2.276793099	1.359613451	0	0.86872709	6.218805353	2.639762923	20.40131488	0	0.120094454	1.697234095	12.17789911	26.42633338	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.2545																																																																					0	0	0											0			23.0258	0	4.611216121	1.711889696	2.276793099	1.359613451	0	0.86872709	6.218805353	2.639762923	20.40131488	0	0.120094454	1.697234095	12.17789911	26.42633338	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.2545
H1109_002_0	2009	4																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	10347.32211	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$100/day 1-10	$100/day 1-10	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$25 X-ray; $175 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											81.96474044	81.96474044	47.56208437	0	100	0.2	0.2	47.5	150	0	52	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											73.23453716	73.23453716	42.49616623	0	100	0.178697661	0.178697661	42.44069458	134.023246	0	46.46139196	0	22.33720767	22.33720767	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											11.9248	0	4.77620752	0	2.276793099	1.408261036	0	0.899810538	4.294211348	0	18.25293562	0	0.124391487	1.464968249	6.088949555	21.55692107	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5073	0	5.1433	11.9248	0	4.77620752	0	2.276793099	1.408261036	0	0.899810538	4.294211348	0	18.25293562	0	0.124391487	1.464968249	6.088949555	21.55692107	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5073																																																																					0	0	0											0			11.9248	0	4.77620752	0	2.276793099	1.408261036	0	0.899810538	4.294211348	0	18.25293562	0	0.124391487	1.464968249	6.088949555	21.55692107	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5073
H1109_003_0	2009	4																					2500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	10103.81894	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$0 	$0 	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$25 X-ray; $175 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$0 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											0	0	47.56208437	0	100	0.2	0.2	47.5	150	0	52	25	25	25	0	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											0	0	42.47287082	0	100	0.178599703	0.178599703	42.41742957	133.9497776	0	46.4359229	0	22.32496293	22.32496293	0	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											0	0	4.773589314	0	2.276793099	1.40748906	0	0.899317283	4.291857361	0	18.24292979	0	0.124323299	1.464165187	0	21.0496228	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.969	0	3.7389	0	0	4.773589314	0	2.276793099	1.40748906	0	0.899317283	4.291857361	0	18.24292979	0	0.124323299	1.464165187	0	21.0496228	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.969																																																																					0	0	0											0			0	0	4.773589314	0	2.276793099	1.40748906	0	0.899317283	4.291857361	0	18.24292979	0	0.124323299	1.464165187	0	21.0496228	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.969
H1109_004_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	10570.53335	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$150/day 1-10	$150/day 1-10	"$0/d 1-10, $75/d 11-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$200 per procedure	$30 per visit	$30 X-ray; $150 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$20 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											122.9471107	122.9471107	47.56208437	20	100	0.2	0.2	47.5	200	30	51.6	30	25	30	20	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											105.7055662	105.7055662	40.89219364	20	100	0.171952908	0.171952908	40.83881571	171.9529082	25.79293624	44.36385033	25.79293624	21.49411353	25.79293624	20	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											17.2121	0	4.595934648	1.711889696	2.276793099	1.355107721	0	0.865848147	5.509507879	2.255155547	17.42889031	0	0.119696463	1.691609497	12.17789911	26.42633338	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.3458	0	8.3241	17.2121	0	4.595934648	1.711889696	2.276793099	1.355107721	0	0.865848147	5.509507879	2.255155547	17.42889031	0	0.119696463	1.691609497	12.17789911	26.42633338	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.3458																																																																					0	0	0											0			17.2121	0	4.595934648	1.711889696	2.276793099	1.355107721	0	0.865848147	5.509507879	2.255155547	17.42889031	0	0.119696463	1.691609497	12.17789911	26.42633338	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.3458
H1109_801_0	2009	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																																																			0		310.0074842	0	38.27980282	5.803677241	6.844996255	9.11241454	0	8.054597417	41.62714573	14.18927097	57.83649055	0	3.156072371	11.99665684	42.37411585	184.0623722	0	5.455182652	0	0	8.231938658	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.0762	0.0762	0.1886	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.6226	0	7.219570812	0	1.581194135	2.104967759	0	1.860612003	9.615870664	3.277721594	13.36022932	0	0.729052718	2.771227729	9.78842076	42.51840798	0	1.260147193	0	0	1.90157783	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.6116			23.6226	0	7.219570812	0	1.581194135	2.104967759	0	1.860612003	9.615870664	3.277721594	13.36022932	0	0.729052718	2.771227729	9.78842076	42.51840798	0	1.260147193	0	0	1.90157783	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.6116																																																																																		0			23.6226	0	7.219570812	0	1.581194135	2.104967759	0	1.860612003	9.615870664	3.277721594	13.36022932	0	0.729052718	2.771227729	9.78842076	42.51840798	0	1.260147193	0	0	1.90157783	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.6116
H1109_802_0	2009	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																																																			0		308.9835364	0	38.15336548	5.784507823	6.822387384	9.082316436	0	8.027993259	41.48965219	14.14240412	57.6454579	0	3.145647934	11.95703214	42.23415508	183.4544182	0	5.437164304	0	0	8.204748746	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.0762	0.0762	0.1886	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.5445	0	7.195724729	0	1.575971486	2.098015097	0	1.854466443	9.584109655	3.266895352	13.31610077	0	0.726644673	2.762074425	9.756089823	42.37797061	0	1.255984954	0	0	1.89529696	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.2099			23.5445	0	7.195724729	0	1.575971486	2.098015097	0	1.854466443	9.584109655	3.266895352	13.31610077	0	0.726644673	2.762074425	9.756089823	42.37797061	0	1.255984954	0	0	1.89529696	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.2099																																																																																		0			23.5445	0	7.195724729	0	1.575971486	2.098015097	0	1.854466443	9.584109655	3.266895352	13.31610077	0	0.726644673	2.762074425	9.756089823	42.37797061	0	1.255984954	0	0	1.89529696	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.2099
H1110_001_0	2009	6																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	5000	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$100/day 1-10	$100/day 1-10	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$25 X-ray; $175 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											81.96474044	81.96474044	47.56208437	0	100	0.2	0.2	47.5	150	0	52	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											71.33308194	71.33308194	41.39279943	0	100	0.174057971	0.174057971	41.33876803	130.543478	0	45.25507237	0	21.75724633	21.75724633	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											10.2214	0	4.093934661	0	2.003577927	1.207093419	0	0.771274183	3.680790796	0	15.64553581	0	0.106622382	1.255700107	5.358275608	16.99839126	0	1.232107151	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4889	0	5.5119	10.2214	0	4.093934661	0	2.003577927	1.207093419	0	0.771274183	3.680790796	0	15.64553581	0	0.106622382	1.255700107	5.358275608	16.99839126	0	1.232107151	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4889		$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP	$100 copay	$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP	$50 copay	$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP	$25 copay	$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP		Not Covered		$0 ded; 35% coinsurance; $5000 max OOP	0	$0 ded; 35% coinsurance; $5000 max OOP	0	Not Covered												5.2416	0	0.6472	0.0981	0.1272	0.1541	0	0.0592	0.7038	0.2399	0.9779	0	0.0078	0.2028	0.7165	3.1121	0	0.0922	0	0	0.1392	0	0	0	0.0649	0	0.0041	0	0	0											12.5888	0	11.20993845	15.463	0	4.741170646	0.098128738	2.130757586	1.361166381	0	0.830489313	4.384623749	0.239912593	16.62343682	0	0.114399091	1.458539918	6.074738353	20.11052303	0	1.324343533	0	0	1.053359144	0	0	0	0.064914967	0	0.004143689	0	0	0	0	0	0	0	0	0	0	0	0	0	76.0777
H1110_003_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3500	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$0 	$0 	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$25 X-ray; $175 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$0 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											0	0	47.56208437	0	100	0.2	0.2	47.5	150	0	52	25	25	25	0	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											0	0	40.34749471	0	100	0.169662433	0.169662433	40.29482779	127.2468246	0	44.11223253	0	21.2078041	21.2078041	0	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											0	0	3.990549308	0	2.003577927	1.176610329	0	0.751796966	3.587838688	0	15.25043443	0	0.103929815	1.223989537	0	16.99839126	0	1.232107151	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.2334	0	4.6643	0	0	3.990549308	0	2.003577927	1.176610329	0	0.751796966	3.587838688	0	15.25043443	0	0.103929815	1.223989537	0	16.99839126	0	1.232107151	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.2334		$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP	$100 copay	$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP	$50 copay	$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP	$25 copay	$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP		Not Covered		$0 ded; 35% coinsurance; $3500 max OOP	0	$0 ded; 35% coinsurance; $3500 max OOP	0	Not Covered												4.3557	0	0.5378	0.0815	0.1057	0.128	0	0.0492	0.5849	0.1994	0.8126	0	0.0065	0.1686	0.5954	2.5861	0	0.0766	0	0	0.1157	0	0	0	0.0539	0	0.0034	0	0	0											10.4611	0	13.33763049	4.3557	0	4.528392788	0.081543522	2.109262333	1.304642669	0	0.801003858	4.172713407	0.199363798	16.06305563	0	0.110392145	1.392546405	0.595369888	19.58452649	0	1.308754213	0	0	1.029834665	0	0	0	0.053943373	0	0.003443344	0	0	0	0	0	0	0	0	0	0	0	0	0	57.6945
H1110_801_0	2009	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																																																			0	Unlimited	274.1973899	0	33.85796328	5.133273331	6.054305791	8.059806326	0	7.124181514	36.81864241	12.55021657	51.15558674	0	2.791502949	10.61087928	37.47932729	162.8006568	0	4.825034622	0	0	7.281037422	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.0762	0.0762	0.1886	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.8938	0	6.385611875	0	1.398544638	1.861815261	0	1.64568593	8.505106398	2.899100027	11.81694054	0	0.644837181	2.451113114	8.657724604	37.60695171	0	1.114582998	0	0	1.681919644	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.5638			20.8938	0	6.385611875	0	1.398544638	1.861815261	0	1.64568593	8.505106398	2.899100027	11.81694054	0	0.644837181	2.451113114	8.657724604	37.60695171	0	1.114582998	0	0	1.681919644	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.5638		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											2.8492	0	0.8708	0	0.1907	0.2539	0	0.2244	1.1598	0.3953	1.6114	0	0.0879	0.3342	1.1806	5.1282	0	0.152	0	0	0.2294	0	0	0	0	0	0	0	0	0											14.6678		0	23.743	0	7.256377131	0	1.58925527	2.115699161	0	1.870097647	9.664893634	3.294431849	13.42834152	0	0.732769524	2.785355812	9.838323414	42.7351724	0	1.266571588	0	0	1.911272323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.2316
H1110_802_0	2009	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																																																			0	Unlimited	274.6033871	0	33.90809593	5.140874041	6.063270251	8.071740281	0	7.134730112	36.87315886	12.56879936	51.23133154	0	2.795636258	10.62659055	37.534822	163.0417116	0	4.832178931	0	0	7.291818273	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.0762	0.0762	0.1886	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.9248	0	6.395066892	0	1.400615428	1.864572005	0	1.648122656	8.517699697	2.903392652	11.83443759	0	0.645791976	2.454742417	8.670543881	37.66263539	0	1.116233333	0	0	1.684410021	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.723			20.9248	0	6.395066892	0	1.400615428	1.864572005	0	1.648122656	8.517699697	2.903392652	11.83443759	0	0.645791976	2.454742417	8.670543881	37.66263539	0	1.116233333	0	0	1.684410021	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.723		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											2.8534	0	0.8721	0	0.191	0.2543	0	0.2247	1.1615	0.3959	1.6138	0	0.0881	0.3347	1.1823	5.1358	0	0.1522	0	0	0.2297	0	0	0	0	0	0	0	0	0											14.6895		0	23.7782	0	7.267121468	0	1.591608441	2.118831824	0	1.872866654	9.679204202	3.299309832	13.44822453	0	0.733854518	2.789480019	9.852890774	42.79844931	0	1.268446969	0	0	1.914102297	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.4125
H1111_002_0	2009	5																					3000											D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1510.457183	148.9355096	668.4032175	473.4136463	90.31201885	8.578456691	3.717576161	315.163276	202.3376844	8261.232779	30.86289358	0	0.115865964	508.5279429	3961.876388	3201.206575	498.1607669	174.9112233	0	0	12.78058978	687.9912376	636.4223748	0	95.11251446	245.6088059	13.01236055	0	458.8608858	0											"$200 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$200 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$150 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); $150 (9a); $40/$30 (9c)"	"$5 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											197.6535754	200	77.60718127	0	150	0.2	0.066443311	48.14846499	150	2.8	0.178426455	0	0.2	52.97661729	3.659908201	20	37.5	20	0	0	0.2	19.36971247	0	0	20	30	20	0	0	0											141.8690154	143.5355395	55.69694316	0	107.6516546	0.143535539	0.047684882	34.55507949	107.6516546	2.009497553	0.128052687	0	0.143535539	38.15842759	3.659908201	20	37.5	14.35355395	0	0	0.143535539	19.36971247	0	0	20	30	20	0	0	0											17.8573	1.781461561	3.102334668	0	0.810186522	1.231313409	0.177272182	0.907541005	1.815165543	1.383410588	3.952076462	0	0.016630884	1.617052224	1.20834199	5.335344291	1.556752397	0.209216473	0	0	1.834468849	1.110516038	0	0	0.158520857	0.614022015	0.021687268	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7006	0	14.4241	17.8573	1.781461561	3.102334668	0	0.810186522	1.231313409	0.177272182	0.907541005	1.815165543	1.383410588	3.952076462	0	0.016630884	1.617052224	1.20834199	5.335344291	1.556752397	0.209216473	0	0	1.834468849	1.110516038	0	0	0.158520857	0.614022015	0.021687268	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7006		"$275 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$275 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$10 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$10 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											4.7272	0.4636	5.5635	0.3849	0.3763	0.8578	0.3718	0.4215	2.9976	0.6425	2.6975	0	0.0077	1.7655	1.291	3.4299	0.7561	0.1874	0	0	1.6432	0.7245	0	0	0.1019	0	0.0139	0	0	0											29.4254	0	0	22.5845	2.245041804	8.665857536	0.384859474	1.1864866	2.089159078	0.549029798	1.329058448	4.812767149	2.025950915	6.649613007	0	0.024355281	3.382517023	2.499307188	8.765208478	2.312889275	0.396621355	0	0	3.477687534	1.835019068	0	0	0.260427123	0.614022015	0.035629082	0	0	0	0	0	0	0	0	0	0	0	0	0	76.126
H1111_004_0	2009	4																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		308.0309084	22.368	30.05640653	3202.155676	11.62650598	23.54287374	10.45963424	24.69540793	48.7566721	9.775554922	19.41299135	0	1.764236204	34.69645638	40.04213995	120.7633746	13.9175	4.549345169	0	0	26.23301626	5.680727318	352.9685741	0	183.3153308	242.2559035	0	0	20.2	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.073371776	0.074297432	0.204924307	0	0.2	0.2	0.2	0.121487452	0.2	0.08	0.2	0	0.2	0.2	0	0.199701876	0.2	0.2	0	0	0.2	0.012791239	0	0	0	0	0	0	0	0											0.073371776	0.074297432	0.204924307	0	0.2	0.2	0.2	0.121487452	0.2	0.08	0.2	0	0.2	0.2	0	0.199701876	0.2	0.2	0	0	0.2	0.012791239	0	0	0	0	0	0	0	0											22.6008	1.661884955	6.159288286	0	2.325301195	4.708574747	2.091926848	3.000182176	9.75133442	0.782044394	3.88259827	0	0.352847241	6.939291277	0	24.11667247	2.7835	0.909869034	0	0	5.246603253	0.07266354	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.3854	0	0	22.6008	1.661884955	6.159288286	0	2.325301195	4.708574747	2.091926848	3.000182176	9.75133442	0.782044394	3.88259827	0	0.352847241	6.939291277	0	24.11667247	2.7835	0.909869034	0	0	5.246603253	0.07266354	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.3854		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.8504	0.2796	0.4746	0.6312	0.1836	0.3717	0.1652	0.158	0.7698	0.1544	0.3065	0	0.0186	0.5478	0.6322	1.9068	0.2198	0.0718	0	0	0.4142	0.0693	0.0261	0	0.0155	0	0	0	0.003	0											11.27	0	0	26.4512	1.941484955	6.633863126	0.631177783	2.508877605	5.080304333	2.257078968	3.158196201	10.52117661	0.936395261	4.189119186	0	0.371418148	7.487130062	0.632244315	26.0234626	3.00325	0.9817008	0	0	5.660808773	0.141976422	0.0261	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	108.6554
H1111_005_0	2009	3																					2900											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1737.854083	257.9576481	37.32063826	46853.56382	81.16954797	18.6436463	8.242867937	331.7153988	347.7661853	5507.471377	421.1911814	0	0.862395022	1344.45676	5434.022563	4031.35259	1242.868229	240.3667323	0	0	23.72397292	1017.992488	769.983193	0	314.3760437	332.2285714	0	0	20.2	0											"$175 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$75 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5, 9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											172.9	175	0.204840606	0	75	0.14	0.2	49.97136099	75	4.4	64.79010385	0	0.2	70.27991579	3.249305553	25	20	20	0	0	0.2	13.6791576	0	0	0	0	0	0	0	0											129.187168	130.7562429	0.204840606	0	56.03838981	0.104604994	0.149435706	37.33752809	56.03838981	3.287585535	48.4097746	0	0.149435706	52.51164422	3.249305553	25	20	20	0	0	0.149435706	13.6791576	0	0	0	0	0	0	0	0											18.709	2.810797741	7.644782167	0	0.379050897	1.950218515	1.231778791	1.032119418	1.624021421	1.508856936	1.699147513	0	0.128872609	5.88330292	1.471399974	8.398651228	2.071447048	0.40061122	0	0	3.545208647	1.160439974	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.6497	0	13.7047	18.709	2.810797741	7.644782167	0	0.379050897	1.950218515	1.231778791	1.032119418	1.624021421	1.508856936	1.699147513	0	0.128872609	5.88330292	1.471399974	8.398651228	2.071447048	0.40061122	0	0	3.545208647	1.160439974	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.6497		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.3698	0.2095	0.5893	0.4986	0.1283	0.2944	0.1302	0.0728	0.6938	0.1091	0.2943	0	0.0091	0.5528	0.6274	1.9757	0.1512	0.0678	0	0	0.3746	0.0779	0.0569	0	0.0155	0	0	0	0.003	0											10.3019	0	0	22.0788	3.020317741	8.234055402	0.498576553	0.507380901	2.244591877	1.361929337	1.104932057	2.317806269	1.617974181	1.993399493	0	0.137950451	6.436054375	2.098847943	10.37439178	2.222647048	0.468458328	0	0	3.919797693	1.238336966	0.056935837	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	71.9516
H1111_801_0	2009	2																					3700											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1802.250115	177.7071487	1169.705674	662.7791292	126.436831	12.00984025	5.204607008	441.1847692	41.96642557	11565.72632	43.20805419	0	0.162212362	25.16648338	5977.028992	4791.404204	747.2411779	262.3668446	0	0	19.17088607	1031.986894	0	0	0	0	0	0	0	0											"$415 Days 1-9 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$415 Days 1-9 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-24 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											410.0647148	415	160	0	150	0.2	0.066443311	48.14828103	0.2	2.8	0.178426454	0	0.2	0.197498749	21.83374715	34.8017974	37.5	35	0	0	0.2	33.89699683	0	0	0	0	0	0	0	0											251.2702105	254.270113	98.03185081	0	91.90486013	0.122539814	0.040709755	29.50040689	0.122539814	1.715557389	0.109321722	0	0.122539814	0.121454535	21.83374715	34.8017974	37.5	21.44446736	0	0	0.122539814	33.89699683	0	0	0	0	0	0	0	0											37.7376	3.765468066	9.555701007	0	0.968346606	1.471683585	0.211878274	1.084594184	5.142557963	1.65347227	4.72357888	0	0.019877473	3.056583525	10.87507831	13.89578986	2.335128681	0.46885977	0	0	2.349196804	2.915104707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.2305	0	45.621	37.7376	3.765468066	9.555701007	0	0.968346606	1.471683585	0.211878274	1.084594184	5.142557963	1.65347227	4.72357888	0	0.019877473	3.056583525	10.87507831	13.89578986	2.335128681	0.46885977	0	0	2.349196804	2.915104707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.2305																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	37.7376	3.765468066	9.555701007	0	0.968346606	1.471683585	0.211878274	1.084594184	5.142557963	1.65347227	4.72357888	0	0.019877473	3.056583525	10.87507831	13.89578986	2.335128681	0.46885977	0	0	2.349196804	2.915104707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.2305
H1111_804_0	2009	2																					3700											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1802.250645	177.707201	1169.706018	662.7793242	126.4368682	12.00984732	5.204610069	441.1848988	41.96645025	11565.72972	43.20807961	0	0.162212457	25.16649818	5977.030708	4791.405613	747.2413977	262.3669218	0	0	19.17089735	1031.987198	0	0	0	0	0	0	0	0											"$415 Days 1-9 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$415 Days 1-9 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-24 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											410.0647148	415	160	0	150	0.2	0.066443311	48.14828103	0.2	2.8	0.178426444	0	0.2	0.197498748	21.8337473	34.80179787	37.5	35	0	0	0.2	33.89699683	0	0	0	0	0	0	0	0											251.2701742	254.2700763	98.03183665	0	91.90484686	0.122539796	0.040709749	29.50040263	0.122539796	1.715557141	0.1093217	0	0.122539796	0.121454517	21.8337473	34.80179787	37.5	21.44446427	0	0	0.122539796	33.89699683	0	0	0	0	0	0	0	0											37.7377	3.76546863	9.555702438	0	0.968346751	1.471684238	0.211878368	1.084594346	5.142560245	1.653472518	4.723580723	0	0.019877481	3.056584869	10.87508151	13.89579414	2.335129368	0.46885984	0	0	2.349197847	2.915105564	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.2306	0	45.621	37.7377	3.76546863	9.555702438	0	0.968346751	1.471684238	0.211878368	1.084594346	5.142560245	1.653472518	4.723580723	0	0.019877481	3.056584869	10.87508151	13.89579414	2.335129368	0.46885984	0	0	2.349197847	2.915105564	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.2306																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	37.7377	3.76546863	9.555702438	0	0.968346751	1.471684238	0.211878368	1.084594346	5.142560245	1.653472518	4.723580723	0	0.019877481	3.056584869	10.87508151	13.89579414	2.335129368	0.46885984	0	0	2.349197847	2.915105564	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.2306
H1111_805_0	2009	2																					3700											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1802.250247	177.7071618	1169.70576	662.779178	126.4368403	12.00984202	5.204607773	441.1848016	41.96643174	11565.72717	43.20806055	0	0.162212386	25.16648708	5977.029421	4791.404556	747.2412328	262.3668639	0	0	19.17088889	1031.98697	0	0	0	0	0	0	0	0											"$415 Days 1-9 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$415 Days 1-9 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-24 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											410.0647148	415	160	0	150	0.2	0.066443311	48.14828103	0.2	2.8	0.178426451	0	0.2	0.197498749	21.83374719	34.80179751	37.5	35	0	0	0.2	33.89699683	0	0	0	0	0	0	0	0											251.2702014	254.2701038	98.03184727	0	91.90485681	0.122539809	0.040709753	29.50040582	0.122539809	1.715557327	0.109321716	0	0.122539809	0.12145453	21.83374719	34.80179751	37.5	21.44446659	0	0	0.122539809	33.89699683	0	0	0	0	0	0	0	0											37.7376	3.765468207	9.555701365	0	0.968346642	1.471683748	0.211878298	1.084594224	5.142558533	1.653472332	4.723579341	0	0.019877475	3.056583861	10.87507911	13.89579093	2.335128853	0.468859787	0	0	2.349197065	2.915104921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.2306	0	45.621	37.7376	3.765468207	9.555701365	0	0.968346642	1.471683748	0.211878298	1.084594224	5.142558533	1.653472332	4.723579341	0	0.019877475	3.056583861	10.87507911	13.89579093	2.335128853	0.468859787	0	0	2.349197065	2.915104921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.2306																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	37.7376	3.765468207	9.555701365	0	0.968346642	1.471683748	0.211878298	1.084594224	5.142558533	1.653472332	4.723579341	0	0.019877475	3.056583861	10.87507911	13.89579093	2.335128853	0.468859787	0	0	2.349197065	2.915104921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.2306
H1111_806_0	2009	2																					3700											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1802.251819	177.7073168	1169.70678	662.7797561	126.4369506	12.00986297	5.204616853	441.185186	41.96650496	11565.73726	43.20813593	0	0.162212669	25.16653099	5977.034512	4791.408736	747.2418847	262.3670928	0	0	19.17092234	1031.98787	0	0	0	0	0	0	0	0											"$415 Days 1-9 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$415 Days 1-9 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-24 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											410.0647148	415	160	0	150	0.2	0.066443311	48.14828103	0.2	2.8	0.178426423	0	0.2	0.197498746	21.83374764	34.80179892	37.5	35	0	0	0.2	33.89699683	0	0	0	0	0	0	0	0											251.2700938	254.2699949	98.03180528	0	91.90481745	0.122539757	0.040709736	29.50039319	0.122539757	1.715556592	0.109321652	0	0.122539757	0.121454477	21.83374764	34.80179892	37.5	21.4444574	0	0	0.122539757	33.89699683	0	0	0	0	0	0	0	0											37.7377	3.765469879	9.555705608	0	0.968347072	1.471685685	0.211878577	1.084594705	5.142565303	1.653473066	4.723584807	0	0.019877501	3.056587847	10.8750886	13.89580361	2.33513089	0.468859995	0	0	2.349200157	2.915107464	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.2306	0	45.6211	37.7377	3.765469879	9.555705608	0	0.968347072	1.471685685	0.211878577	1.084594705	5.142565303	1.653473066	4.723584807	0	0.019877501	3.056587847	10.8750886	13.89580361	2.33513089	0.468859995	0	0	2.349200157	2.915107464	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.2306																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	37.7377	3.765469879	9.555705608	0	0.968347072	1.471685685	0.211878577	1.084594705	5.142565303	1.653473066	4.723584807	0	0.019877501	3.056587847	10.8750886	13.89580361	2.33513089	0.468859995	0	0	2.349200157	2.915107464	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.2306
H1112_001_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1712.155187	166.7381579	632.0917721	869.7427321	217.7685379	6.981734176	5.64942943	1092.165909	216.2261658	2394.196531	946.5902397	35.98627755	0.022356554	270.0629226	8777.724139	16495.75216	152.67475	988.9662542	4264.302115	1807.114564	24.50004769	13.44559803	2370	1136.181818	528.1421836	293.410808	30.4	20.27235554	1664	5960											"$250 days 1 - 5, $0 after day 5, unlimited coverage"	"$250 days 1 - 5, $0 after day 5, unlimited coverage"	Medicare FFS Cost Sharing	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $35.00	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $0.00 and $75.00	Copay between $0.00 and $75.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"Copay between $0.00 and $195.00, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											106.462832	82.67640241	35.63	6.047727066	48.9253762	0.2	0.123637831	19.51217335	95.24023588	0	29.25499975	65.62306262	0.2	22.20802	4.692934191	7.33659668	23.09136993	14.88810755	11.59272275	10.63554708	0.2	0	0	0	8.312504071	9.30433897	10	9.026117988	0	0											100.1921242	77.80672579	33.53137726	5.691513271	46.04364993	0.188219912	0.116355509	18.36289773	89.63054392	0	27.53186734	61.75783524	0.188219912	20.89995781	4.416518294	6.904467895	21.73127804	14.01119144	10.90990626	10.00910866	0.188219912	0	0	0	8.312504071	9.30433897	10	9.026117988	0	0											14.2954	1.081112511	1.766242306	0.412512692	0.835571527	1.31410139	0.657342234	1.671277574	1.615039071	0	2.171783075	0.185202883	0.004207949	0.470358641	3.230581604	9.491199264	0.276484787	1.154716293	3.876928029	1.507300503	4.611396811	0	0	0	0.365848671	0.227499468	0.025333333	0.015248389	0	0	0	0	0	0	0	0	0	0	0	0	51.2627	0	3.1687	14.2954	1.081112511	1.766242306	0.412512692	0.835571527	1.31410139	0.657342234	1.671277574	1.615039071	0	2.171783075	0.185202883	0.004207949	0.470358641	3.230581604	9.491199264	0.276484787	1.154716293	3.876928029	1.507300503	4.611396811	0	0	0	0.365848671	0.227499468	0.025333333	0.015248389	0	0	0	0	0	0	0	0	0	0	0	0	51.2627	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.2954	1.081112511	1.766242306	0.412512692	0.835571527	1.31410139	0.657342234	1.671277574	1.615039071	0	2.171783075	0.185202883	0.004207949	0.470358641	3.230581604	9.491199264	0.276484787	1.154716293	3.876928029	1.507300503	4.611396811	0	0	0	0.365848671	0.227499468	0.025333333	0.015248389	0	0	0	0	0	0	0	0	0	0	0	0	51.2627
H1112_003_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1040.346723	64.2724905	377.1190063	650.3419739	235.3243063	11.02770738	3.626630679	914.49815	209.2942046	2794.676975	826.7489495	32.54958556	0.032258776	230.5182307	7164.27407	17023.48664	263.3106506	1676.261742	3575.220582	1837.263534	23.65016657	21.0724578	0	1136.181818	472.374142	259.4564871	30.4	18.24	1664	6200											"$175 days 1 - 5, $0 after day 5, unlimited coverage"	"$175 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $75 days 8 - 100"	Copay between $0.00 and $25.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $25.00	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $75.00	Copay between $0.00 and $75.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $195.00, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											93.48936729	62.39240545	49.53	6.490180781	47.64023487	0.2	0.192501769	21.10311462	85.74819972	0	22.69802923	45.93614383	0.2	9.036366989	2.185149052	6.360563332	18.28817144	10.43095557	17.86263058	7.733337858	0.2	0	0	0	8.739051992	9.81791383	10	10	0	0											93.48936729	62.39240545	49.53	6.490180781	47.64023487	0.2	0.192501769	21.10311462	85.74819972	0	22.69802923	45.93614383	0.2	9.036366989	2.185149052	6.360563332	18.28817144	10.43095557	17.86263058	7.733337858	0.2	0	0	0	8.739051992	9.81791383	10	10	0	0											8.1051	0.334176274	1.556558698	0.351736415	0.934242102	2.205541477	0.69813282	1.60822994	1.495550105	0	1.563797652	0.124600204	0.006451755	0.173587278	1.304583891	9.023247073	0.401289193	1.457084312	5.321903709	1.18401497	4.730033314	0	0	0	0.344008516	0.212276786	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	43.1767	0	0	8.1051	0.334176274	1.556558698	0.351736415	0.934242102	2.205541477	0.69813282	1.60822994	1.495550105	0	1.563797652	0.124600204	0.006451755	0.173587278	1.304583891	9.023247073	0.401289193	1.457084312	5.321903709	1.18401497	4.730033314	0	0	0	0.344008516	0.212276786	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	43.1767	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.1051	0.334176274	1.556558698	0.351736415	0.934242102	2.205541477	0.69813282	1.60822994	1.495550105	0	1.563797652	0.124600204	0.006451755	0.173587278	1.304583891	9.023247073	0.401289193	1.457084312	5.321903709	1.18401497	4.730033314	0	0	0	0.344008516	0.212276786	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	43.1767
H1112_005_0	2009	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	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		1959.805317	305.0451676	773.3413756	1595.767425	773.5111077	23.48576393	5.491132648	2598.62874	243.2049215	5448.334423	1273.562805	66.80222846	0.772738767	433.5437594	7872.798692	18067.59623	700.9458119	3067.663729	4591.12618	1406.501413	26.24230982	33.35289723	2370	1136.181818	532.4961734	304.7296271	30.4	18.24	1664	6485.714286											"$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	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $15.00	Copay between $5.00 and $15.00	$15.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"Copay between $0.00 and $195.00, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											49.57138037	32.39091214	34.64	2.582830244	43.90433305	0.2	0.164147243	20.89286087	51.93680787	0	11.77767131	26.24922505	0.2	6.379781644	0	3.036031356	9.238434731	5.882239983	10.13959368	7.206232401	0.2	0	0	0	8.2829621	9.158571815	10	10	0	0											49.57138037	32.39091214	34.64	2.582830244	43.90433305	0.2	0.164147243	20.89286087	51.93680787	0	11.77767131	26.24922505	0.2	6.379781644	0	3.036031356	9.238434731	5.882239983	10.13959368	7.206232401	0.2	0	0	0	8.2829621	9.158571815	10	10	0	0											8.0959	0.823390935	2.232378771	0.343466364	2.830040774	4.697152786	0.901354287	4.524399059	1.052607273	0	1.249967009	0.146125561	0.154547753	0.230492876	0	4.571149056	0.539636844	1.503727854	3.879346165	0.844631338	5.248461963	0	0	0	0.367553802	0.232574014	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	44.5094	0	0	8.0959	0.823390935	2.232378771	0.343466364	2.830040774	4.697152786	0.901354287	4.524399059	1.052607273	0	1.249967009	0.146125561	0.154547753	0.230492876	0	4.571149056	0.539636844	1.503727854	3.879346165	0.844631338	5.248461963	0	0	0	0.367553802	0.232574014	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	44.5094	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.0959	0.823390935	2.232378771	0.343466364	2.830040774	4.697152786	0.901354287	4.524399059	1.052607273	0	1.249967009	0.146125561	0.154547753	0.230492876	0	4.571149056	0.539636844	1.503727854	3.879346165	0.844631338	5.248461963	0	0	0	0.367553802	0.232574014	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	44.5094
H1112_006_0	2009	9																					0											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	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	0	0	0											0		315.8194592	27.01327674	851.8931264	1324.162603	14.17989584	19.84961479	6.301664475	22.47863511	15.88309292	5307.711089	18.70399657	0.471184394	0.92067087	4.631199263	7955.390463	75.73030349	4.418211744	10.29006206	22.73446262	8.098149801	17.89992555	0.313245684	2370	1136.181818	406.6047316	168.1488747	23.4	17.82857143	1664	8200											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	$0.00 copayment	"Copay between $0.00 and $195.00, No benefit limit"	$0.00 copayment	"$0.00 copayment, $150 benefit limit,"	$0.00 copayment	"$0.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											840.9505022	449.6534935	71.711798	0	0.164632372	0.17	0.17	0.103885181	0.17	0	0.17	0.17	0.17	0.17	0	0.092541489	0.17	0.17	0.146401372	0.033855777	0.17	0.169463118	0	0	0	0	0	0	0	0											840.9505022	449.6534935	71.711798	0	0.164632372	0.17	0.17	0.103885181	0.17	0	0.17	0.17	0.17	0.17	0	0.092541489	0.17	0.17	0.146401372	0.033855777	0.17	0.169463118	0	0	0	0	0	0	0	0											22.1324	1.012217855	5.090898983	0	2.334469892	3.374434515	1.071282961	2.335197076	2.700125796	0	3.179679417	0.080101347	0.156514048	0.787303875	0	7.008195022	0.751095997	1.74931055	3.328356517	0.274169157	3.042987343	0.05308359	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4618	0	0	22.1324	1.012217855	5.090898983	0	2.334469892	3.374434515	1.071282961	2.335197076	2.700125796	0	3.179679417	0.080101347	0.156514048	0.787303875	0	7.008195022	0.751095997	1.74931055	3.328356517	0.274169157	3.042987343	0.05308359	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4618	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.1324	1.012217855	5.090898983	0	2.334469892	3.374434515	1.071282961	2.335197076	2.700125796	0	3.179679417	0.080101347	0.156514048	0.787303875	0	7.008195022	0.751095997	1.74931055	3.328356517	0.274169157	3.042987343	0.05308359	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4618
H1112_027_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1302.88732	118.1541814	309.5429359	1279.30089	307.7190297	15.70134874	5.000321339	1244.089282	261.0609122	4203.129604	1185.127812	50.9248934	0.051578835	361.457202	8362.458448	23208.89782	437.0819724	2715.326654	4684.965296	2409.223997	35.21693582	29.56902736	0	1136.181818	324	129.6	23.4	17.82857143	1664	5960											"$125 days 1 - 5, $0 after day 5, unlimited coverage"	"$125 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	20% coinsurance	20% coinsurance	Copay between $0.00 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 $10.00	Copay between $0.00 and $25.00	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $75.00	Copay between $0.00 and $75.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $195.00, No benefit limit"	$0.00 copayment	"$0.00 copayment, $150 benefit limit,"	$0.00 copayment	"$0.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											72.60025867	46.56909814	56.13	5.192462956	46.80340795	0.2	0.2	21.753766	72.84411613	0	18.1519318	32.81153131	0.2	6.563229567	4.083852763	6.575881722	18.11265768	10.38749091	20.1104465	6.636906444	0.2	0	0	0	0	0	0	0	0	0											68.18650633	43.73791723	52.71756149	4.876785767	43.95798212	0.187840946	0.187840946	20.43123992	68.41553841	0	17.0483802	30.8167454	0.187840946	6.164216252	3.835573831	6.176099216	17.01149376	9.755980591	18.88782647	6.233413924	0.187840946	0	0	0	0	0	0	0	0	0											7.4033	0.430651484	1.359862396	0.519906365	1.127225634	2.9493562	0.93926509	2.11819055	1.488385239	0	1.683709126	0.13077829	0.009688617	0.18567503	2.672902232	11.94503797	0.619618104	2.207556178	7.374067628	1.251474201	6.615182539	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.0318	0	3.4328	7.4033	0.430651484	1.359862396	0.519906365	1.127225634	2.9493562	0.93926509	2.11819055	1.488385239	0	1.683709126	0.13077829	0.009688617	0.18567503	2.672902232	11.94503797	0.619618104	2.207556178	7.374067628	1.251474201	6.615182539	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.0318	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.4033	0.430651484	1.359862396	0.519906365	1.127225634	2.9493562	0.93926509	2.11819055	1.488385239	0	1.683709126	0.13077829	0.009688617	0.18567503	2.672902232	11.94503797	0.619618104	2.207556178	7.374067628	1.251474201	6.615182539	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.0318
H1112_030_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	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	0	0	0											0		300.7273326	19.59611879	162.5197604	1376.371922	6.374719347	12.88185804	7.449385095	12.81263985	26.091927	4429.051671	15.64880774	0.361314731	0.009496068	7.490881796	9868.044339	134.6918728	3.087647557	8.21994926	39.37117749	20.15608975	25.43421705	0.415734626	2370	1136.181818	324	129.6	23.4	17.82857143	1664	8942.857143											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS Cost Sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	$0.00 copayment	"Copay between $0.00 and $195.00, No benefit limit"	$0.00 copayment	"$0.00 copayment, $150 benefit limit,"	$0.00 copayment	"$0.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											918.5043435	348.5069849	74.94803827	0	0.19634325	0.2	0.2	0.125722251	0.2	0	0.2	0.2	0.2	0.2	0	0.129741623	0.2	0.2	0.2	0.024671508	0.2	0.195704261	0	0	0	0	0	0	0	0											918.5043435	348.5069849	74.94803827	0	0.19634325	0.2	0.2	0.125722251	0.2	0	0.2	0.2	0.2	0.2	0	0.129741623	0.2	0.2	0.2	0.024671508	0.2	0.195704261	0	0	0	0	0	0	0	0											23.0183	0.569115356	1.015044768	0	1.251633117	2.576371607	1.489877019	1.610833926	5.218385399	0	3.129761548	0.072262946	0.001899214	1.498176359	0	17.47514219	0.617529511	1.643989852	7.874235498	0.497281123	5.086843411	0.081361038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.728	0	0	23.0183	0.569115356	1.015044768	0	1.251633117	2.576371607	1.489877019	1.610833926	5.218385399	0	3.129761548	0.072262946	0.001899214	1.498176359	0	17.47514219	0.617529511	1.643989852	7.874235498	0.497281123	5.086843411	0.081361038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.728	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.0183	0.569115356	1.015044768	0	1.251633117	2.576371607	1.489877019	1.610833926	5.218385399	0	3.129761548	0.072262946	0.001899214	1.498176359	0	17.47514219	0.617529511	1.643989852	7.874235498	0.497281123	5.086843411	0.081361038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.728
H1112_801_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.2029	0.575	0.2323	0.4831	0.7763	0	0.6994	0.0189	0.0002	0.3681	1.0564	4.1927	0.1348	0.3912	1.6397	0.3217	0	0.0001	0	0	0	0	0	0	0	0											11.0926		237.8280512	12.43661255	694.6592491	1981.246696	4.801950201	13.60533783	5.495910736	11.43036309	18.36936877	3867.320306	16.55066294	0.446683636	0.004348099	8.710767058	26.53067008	111.9961219	3.189578624	9.256281736	38.80076601	7.611966575	32.72867222	0.00195936	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											765.952	765.952	71.72385	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199997159	0.197556025	0.5	0.2	0.2	0.196314335	0.2	0.2	0	0	0	0	0	0	0	0											765.952	765.952	71.72385	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199997159	0.197556025	0.5	0.2	0.2	0.196314335	0.2	0.2	0	0	0	0	0	0	0	0											15.1804	0.793820688	4.151969648	0	0.96039004	2.721067566	1.099182147	2.286072619	3.673873755	0	3.310132589	0.089336727	0.00086962	1.742153412	5.306058654	22.12550871	1.594789312	1.851256347	7.760153202	1.494338156	6.545734444	0.000391872	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.6875	135	0	15.1804	0.793820688	4.151969648	0	1.163323634	3.296038147	1.331442972	2.769127327	4.450175436	0	4.009574558	0.108213873	0.001053373	2.110276192	6.362413996	26.31816597	1.729583015	2.242432939	9.399899252	1.816024901	6.545734444	0.000474676	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.7802		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			15.1804	0.793820688	4.151969648	0	1.163323634	3.296038147	1.331442972	2.769127327	4.450175436	0	4.009574558	0.108213873	0.001053373	2.110276192	6.362413996	26.31816597	1.729583015	2.242432939	9.399899252	1.816024901	6.545734444	0.000474676	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.7802
H1112_802_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.2029	0.575	0.2323	0.4831	0.7763	0	0.6994	0.0189	0.0002	0.3681	1.0564	4.1927	0.1348	0.3912	1.6397	0.3217	0	0.0001	0	0	0	0	0	0	0	0											11.0926		237.8280512	12.43661255	694.6592491	1981.246696	4.801950201	13.60533783	5.495910736	11.43036309	18.36936877	3867.320306	16.55066294	0.446683636	0.004348099	8.710767058	26.53067008	111.9961219	3.189578624	9.256281736	38.80076601	7.611966575	32.72867222	0.00195936	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											765.952	765.952	71.72385	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199997159	0.197556025	0.5	0.2	0.2	0.196314335	0.2	0.2	0	0	0	0	0	0	0	0											765.952	765.952	71.72385	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199997159	0.197556025	0.5	0.2	0.2	0.196314335	0.2	0.2	0	0	0	0	0	0	0	0											15.1804	0.793820688	4.151969648	0	0.96039004	2.721067566	1.099182147	2.286072619	3.673873755	0	3.310132589	0.089336727	0.00086962	1.742153412	5.306058654	22.12550871	1.594789312	1.851256347	7.760153202	1.494338156	6.545734444	0.000391872	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.6875	135	0	15.1804	0.793820688	4.151969648	0	1.163323634	3.296038147	1.331442972	2.769127327	4.450175436	0	4.009574558	0.108213873	0.001053373	2.110276192	6.362413996	26.31816597	1.729583015	2.242432939	9.399899252	1.816024901	6.545734444	0.000474676	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.7802		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			15.1804	0.793820688	4.151969648	0	1.163323634	3.296038147	1.331442972	2.769127327	4.450175436	0	4.009574558	0.108213873	0.001053373	2.110276192	6.362413996	26.31816597	1.729583015	2.242432939	9.399899252	1.816024901	6.545734444	0.000474676	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.7802
H1112_803_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.2029	0.575	0.2323	0.4831	0.7763	0	0.6994	0.0189	0.0002	0.3681	1.0564	4.1927	0.1348	0.3912	1.6397	0.3217	0	0.0001	0	0	0	0	0	0	0	0											11.0926		237.8280512	12.43661255	694.6592491	1981.246696	4.801950201	13.60533783	5.495910736	11.43036309	18.36936877	3867.320306	16.55066294	0.446683636	0.004348099	8.710767058	26.53067008	111.9961219	3.189578624	9.256281736	38.80076601	7.611966575	32.72867222	0.00195936	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											765.952	765.952	71.72385	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199997159	0.197556025	0.5	0.2	0.2	0.196314335	0.2	0.2	0	0	0	0	0	0	0	0											765.952	765.952	71.72385	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199997159	0.197556025	0.5	0.2	0.2	0.196314335	0.2	0.2	0	0	0	0	0	0	0	0											15.1804	0.793820688	4.151969648	0	0.96039004	2.721067566	1.099182147	2.286072619	3.673873755	0	3.310132589	0.089336727	0.00086962	1.742153412	5.306058654	22.12550871	1.594789312	1.851256347	7.760153202	1.494338156	6.545734444	0.000391872	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.6875	135	0	15.1804	0.793820688	4.151969648	0	1.163323634	3.296038147	1.331442972	2.769127327	4.450175436	0	4.009574558	0.108213873	0.001053373	2.110276192	6.362413996	26.31816597	1.729583015	2.242432939	9.399899252	1.816024901	6.545734444	0.000474676	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.7802		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			15.1804	0.793820688	4.151969648	0	1.163323634	3.296038147	1.331442972	2.769127327	4.450175436	0	4.009574558	0.108213873	0.001053373	2.110276192	6.362413996	26.31816597	1.729583015	2.242432939	9.399899252	1.816024901	6.545734444	0.000474676	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.7802
H1112_804_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.2029	0.575	0.2323	0.4831	0.7763	0	0.6994	0.0189	0.0002	0.3681	1.0564	4.1927	0.1348	0.3912	1.6397	0.3217	0	0.0001	0	0	0	0	0	0	0	0											11.0926		237.8280512	12.43661255	694.6592491	1981.246696	4.801950201	13.60533783	5.495910736	11.43036309	18.36936877	3867.320306	16.55066294	0.446683636	0.004348099	8.710767058	26.53067008	111.9961219	3.189578624	9.256281736	38.80076601	7.611966575	32.72867222	0.00195936	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											765.952	765.952	71.72385	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199997159	0.197556025	0.5	0.2	0.2	0.196314335	0.2	0.2	0	0	0	0	0	0	0	0											765.952	765.952	71.72385	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199997159	0.197556025	0.5	0.2	0.2	0.196314335	0.2	0.2	0	0	0	0	0	0	0	0											15.1804	0.793820688	4.151969648	0	0.96039004	2.721067566	1.099182147	2.286072619	3.673873755	0	3.310132589	0.089336727	0.00086962	1.742153412	5.306058654	22.12550871	1.594789312	1.851256347	7.760153202	1.494338156	6.545734444	0.000391872	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.6875	135	0	15.1804	0.793820688	4.151969648	0	1.163323634	3.296038147	1.331442972	2.769127327	4.450175436	0	4.009574558	0.108213873	0.001053373	2.110276192	6.362413996	26.31816597	1.729583015	2.242432939	9.399899252	1.816024901	6.545734444	0.000474676	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.7802		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			15.1804	0.793820688	4.151969648	0	1.163323634	3.296038147	1.331442972	2.769127327	4.450175436	0	4.009574558	0.108213873	0.001053373	2.110276192	6.362413996	26.31816597	1.729583015	2.242432939	9.399899252	1.816024901	6.545734444	0.000474676	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.7802
H1170_002_0	2009	11																					2700											D	D	D	V	T	Coin	Coin	V	V	V	V	Coin	V	V	V	V	V	V	V	V	S	Coin	T	Coin	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	2700	1297.586834	238.251714	482.8014388		236.2999108	9.929411407	1.565983779	254.6562943	196.3030239	270.3770614	760.3396633			237.8715334	5041.067548	5511.680549	232.951324	263.5593933	1718.507231		471.5377938	0.334929977		2.38	548.1476126		40.89668196		18.04091784												"$150 per Day, days 1-7, $0 per Day, days 8-365"	"$150 per Day, days 1-7, $0 per Day, days 8-365"	$100/day for days 21-100		$150 per trip	20% coinsurance	20% coinsurance	$50 per visit	$200 per visit	$0-50 per visit	$0-50 per visit			$30-$50 per visit	"$15 per visit, $0 per Immunization"	$30 per visit	$15 Group Therapy & $30 Individual Therapy	$30 per visit	$0-30 per visit		"$8 generic Kaiser retail, $40 brand Kaiser retail, $24 Generic community pharmacy, $60 Brand community pharmacy"	20% coinsurance Medicare covered Optical		20% coinsurance	$30 per visit		$30 per visit		$0 - $75 copay (varies by class)												107.1783521	107.1783521	36.34779837		150	0.2	0.2	50	200	10.39980961	10.73720729			30	15.00206521	30	27.75	30	4.392473528		24	0.059713974		0.2	30		30		37.5												102.7908661	102.7908661	13.37415293		132.7403857	0.176987181	0.176987181	44.24679524	176.987181	9.203164931	9.501740245			26.54807715	13.27586615	26.54807715	24.55697136	26.54807715	3.887057536		24	0.05284304		0.176987181	26.54807715		26.54807715		33.18509643												11.115	2.040841668	0.538088357	0	2.613878443	1.757378534	0.277159054	0.938977076	2.895259902	0.207360391	0.602045832	0	0	0.526252652	5.577044834	12.19371003	0.476714916	0.583082925	0.556661374	0	0.943075588	0.017698718	0	0.421229491	1.212688759	0	0.090477356	0	0.0498908	0	0	0	0	0	0	0	0	0	0	0	45.6345	0	5.5163	11.115	2.040841668	0.538088357	0	2.613878443	1.757378534	0.277159054	0.938977076	2.895259902	0.207360391	0.602045832	0	0	0.526252652	5.577044834	12.19371003	0.476714916	0.583082925	0.556661374	0	0.943075588	0.017698718	0	0.421229491	1.212688759	0	0.090477356	0	0.0498908	0	0	0	0	0	0	0	0	0	0	0	45.6345	2700																																																																																	0	0	0	11.115	2.040841668	0.538088357	0	2.613878443	1.757378534	0.277159054	0.938977076	2.895259902	0.207360391	0.602045832	0	0	0.526252652	5.577044834	12.19371003	0.476714916	0.583082925	0.556661374	0	0.943075588	0.017698718	0	0.421229491	1.212688759	0	0.090477356	0	0.0498908	0	0	0	0	0	0	0	0	0	0	0	45.6345
H1170_008_0	2009	12																					2700											A	A	D	V	T	Coin	Coin	V	V	V	V	Coin	V	V	V	V	V	V	V	V	S	Coin	T	V	V	V	V	V	V												0	0			0			0	0	0	0			0	0	0	0	0	0		0				0		0		0												0	2700	371.1723884	10.34779773			564.7045118			467.2850217	251.856794	329.3566289	1117.68564			361.6923675	6729.564982	6536.657493	390.4674923	246.499011	2002.787064		612.5607337				687.3625236		58.06379716		23.92158078												$50 per admit	$50 per admit			$25 per trip			$25 per visit	$5 per visit	$0-5 per visit	$0-5 per visit			$5 per visit	"$2 per visit, $0 per Immunization"	$5 per visit	$2 Group Therapy & $5 Individual Therapy	$5 per visit	$0-5 per visit		"$2 generic Kaiser retail, $6 brand Kaiser retail, $16 Generic community pharmacy, $20 Brand community pharmacy"				$5 per visit		$5 per visit		$0 - $75 copay (varies by class)												50	50			25			25	5	0.796296296	0.79481398			5	1.99922179	5	4.55	5	0.635461872		4				5		5		37.5												50	50			24.67233229			24.67233229	4.934466458	0.785859473	0.784396585			4.934466458	1.973018573	4.934466458	4.490364476	4.934466458	0.627133059		4				4.934466458		4.934466458		37.00849843												1.5466	0.043115824	0	0	1.161048113	0	0	0.960750944	0.103564909	0.021569002	0.073059067	0	0	0.148729905	1.106463058	2.687909762	0.14611178	0.101361758	0.104667831	0	0.204186911	0	0	0	0.282647276	0	0.023876155	0	0.073775149	0	0	0	0	0	0	0	0	0	0	0	8.7894	0	0.0929	1.5466	0.043115824	0	0	1.161048113	0	0	0.960750944	0.103564909	0.021569002	0.073059067	0	0	0.148729905	1.106463058	2.687909762	0.14611178	0.101361758	0.104667831	0	0.204186911	0	0	0	0.282647276	0	0.023876155	0	0.073775149	0	0	0	0	0	0	0	0	0	0	0	8.7894	2700																																																																																	0	0	0	1.5466	0.043115824	0	0	1.161048113	0	0	0.960750944	0.103564909	0.021569002	0.073059067	0	0	0.148729905	1.106463058	2.687909762	0.14611178	0.101361758	0.104667831	0	0.204186911	0	0	0	0.282647276	0	0.023876155	0	0.073775149	0	0	0	0	0	0	0	0	0	0	0	8.7894
H1170_009_0	2009	9																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	Coin	V	V	V	V	V	V	V	V	S	Coin	T	V	V	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	3250	836.2576008	153.5464152	295.610408		153.4599842	6.448446434	1.016995076	165.3811495	127.4848511	174.5815278	493.7865287			154.4806412	3097.803255	3540.843277	149.9037141	169.5950994	1116.04821		306.2302568	0.334929977			352.7318996		26.31693358		11.71629289												"$200 per Day, days 1-7, $0 per Day, days 8-365"	"$200 per Day, days 1-7, $0 per Day, days 8-365"	$100/day for days 21-100		$150 per trip	20% coinsurance	20% coinsurance	$50 per visit	$200 per visit	$0-50 per visit	$0-50 per visit			$40-$50 per visit	"$25 per visit, $0 per Immunization"	$40 per visit	$20 Group Therapy & $40 Individual Therapy	$40 per visit	$0-40 per visit		"$10 generic Kaiser retail, $40 brand Kaiser retail, $24 Generic community pharmacy, $60 Brand community pharmacy"	20% coinsurance Medicare covered Optical			$40 per visit		$40 per visit		$0 - $75 copay (varies by class)												142.9044695	142.9044695	36.34779837		150	0.2	0.2	50	200	10.39980961	10.73720729			40	24.99958696	40	37	30	5.85663137		25	0.059713974			40		40		37.5												133.7206116	133.7206116	12.37818186		129.1189755	0.172158634	0.172158634	43.03965849	172.158634	8.952085083	9.242514694			34.43172679	21.5194737	34.43172679	31.84934728	25.82379509	5.041348282		25	0.051401381			34.43172679		34.43172679		32.27974387												9.3187	1.711026712	0.304926616	0	1.651216327	1.110155729	0.175084483	0.59316235	1.828968151	0.130239058	0.380319104	0	0	0.443252936	5.555257973	10.15977903	0.397861288	0.364965758	0.468865644	0	0.637979702	0.017215863	0	0	1.012097366	0	0.075511456	0	0.031516578	0	0	0	0	0	0	0	0	0	0	0	36.3681	0	5.2932	9.3187	1.711026712	0.304926616	0	1.651216327	1.110155729	0.175084483	0.59316235	1.828968151	0.130239058	0.380319104	0	0	0.443252936	5.555257973	10.15977903	0.397861288	0.364965758	0.468865644	0	0.637979702	0.017215863	0	0	1.012097366	0	0.075511456	0	0.031516578	0	0	0	0	0	0	0	0	0	0	0	36.3681	3250																																																																																	0	0	0	9.3187	1.711026712	0.304926616	0	1.651216327	1.110155729	0.175084483	0.59316235	1.828968151	0.130239058	0.380319104	0	0	0.443252936	5.555257973	10.15977903	0.397861288	0.364965758	0.468865644	0	0.637979702	0.017215863	0	0	1.012097366	0	0.075511456	0	0.031516578	0	0	0	0	0	0	0	0	0	0	0	36.3681
H1170_801_0	2009	6	i.2.										Professional										3000	Inpatient Professional										Coin	Coin	Coin	V	T	Coin	Coin	V	V	V	V	Coin	V	V	V	V	V	V	V	V	S	Coin	T	V	V	V	V	V	V	O	Coin										17.7138	0.0987	1.0092		0	1.2516	0.0635	0	0	0	0			0	0	0	0	0	0		0	0.0077			0		0				1.8457										21.9902	3000	211.2189113	1.176359163	12.03405599		195.0243157	14.92387459	0.757266856	245.4714643	211.8961606	252.7365696	775.595415			278.0436393	4856.273774	6323.365844	268.1493258	583.632719	2035.690909		558.5161709	0.71364029			586.2597877		43.94203552				22.00757625										10% Coinsurance	10% Coinsurance	10% coinsurance		$150 per trip	20% coinsurance	20% coinsurance	$50 per visit	$300 per visit	$0-$300 per visit	$0-$300 per visit			$50-$300 per visit	"$35 per visit, $0 per Immunization"	$50 per visit	$25 Group Therapy & $50 Individual Therapy	$50 per visit	$0-$300 coinsurance		"$20 generic Kaiser retail, $40 brand Kaiser retail"	20% coinsurance Medicare covered Optical			$50 per visit		$50 per visit				10% Coinsurance										0.1	0.1	0.1		150	0.2	0.2	50	300	67.23259762	55.69080949			50	34.99748939	50	46.25	50	7.639773122		30	0.025856847			50		50				0.1										0.092489886	0.092489886	0.092489886		129.8812107	0.173174948	0.173174948	43.29373689	259.7624214	58.21500784	48.22126507			43.29373689	30.30344195	43.29373689	40.04670663	43.29373689	6.615086549		30	0.02238879			43.29373689		43.29373689				0.092489886										19.5356	0.108801325	1.113028468	0	2.110832853	2.584441199	0.131139648	0.885614749	4.586888314	1.226088448	3.116682675	0	0	1.003129014	12.2634842	22.81351143	0.894874782	2.105636781	1.122189296	0	1.396290427	0.015977543	0	0	2.11511475	0	0.158534577	0	0	0	2.03547822	0	0	0	0	0	0	0	0	0	81.3234	500	10.7009	37.2494	0.20745634	2.122261035	0	2.110832853	3.836027554	0.19464761	0.885614749	4.586888314	1.226088448	3.116682675	0	0	1.003129014	12.2634842	22.81351143	0.894874782	2.105636781	1.122189296	0	1.396290427	0.023715105	0	0	2.11511475	0	0.158534577	0	0	0	3.881137133	0	0	0	0	0	0	0	0	0	103.3135	3000																																																																																	0	500	0	37.2494	0.20745634	2.122261035	0	2.110832853	3.836027554	0.19464761	0.885614749	4.586888314	1.226088448	3.116682675	0	0	1.003129014	12.2634842	22.81351143	0.894874782	2.105636781	1.122189296	0	1.396290427	0.023715105	0	0	2.11511475	0	0.158534577	0	0	0	3.881137133	0	0	0	0	0	0	0	0	0	103.3135
H1170_802_0	2009	8	i.2.										Professional										3000	Inpatient Professional										Coin	Coin	Coin	V	T	Coin	Coin	V	V	V	V	Coin	V	V	V	V	V	V	V	V	S	Coin	T	V	V	V	V	V	V		Coin										17.7138	0.0987	1.0092		0	1.2516	0.0635	0	0	0	0			0	0	0	0	0	0		0	0.0077			0		0				1.8457										21.9902	3000	211.2189113	1.176359163	12.03405599		195.0243157	14.92387459	0.757266856	245.4714643	211.8961606	252.7365696	775.595415			278.0436393	4856.273774	6323.365844	268.1493258	583.632719	2035.690909		558.5161709	0.71364029			586.2597877		43.94203552				22.00757625										10% Coinsurance	10% Coinsurance	10% coinsurance		$150 per trip	20% coinsurance	20% coinsurance	$50 per visit	$300 per visit	$0-$300 per visit	$0-$300 per visit			$50-$300 per visit	"$35 per visit, $0 per Immunization"	$50 per visit	$25 Group Therapy & $50 Individual Therapy	$50 per visit	$0-$300 coinsurance		"$20 generic Kaiser retail, $40 brand Kaiser retail"	20% coinsurance Medicare covered Optical			$50 per visit		$50 per visit				10% Coinsurance										0.1	0.1	0.1		150	0.2	0.2	50	300	67.23259762	55.69080949			50	34.99748939	50	46.25	50	7.639773122		30	0.025856847			50		50				0.1										0.092489886	0.092489886	0.092489886		129.8812107	0.173174948	0.173174948	43.29373689	259.7624214	58.21500784	48.22126507			43.29373689	30.30344195	43.29373689	40.04670663	43.29373689	6.615086549		30	0.02238879			43.29373689		43.29373689				0.092489886										19.5356	0.108801325	1.113028468	0	2.110832853	2.584441199	0.131139648	0.885614749	4.586888314	1.226088448	3.116682675	0	0	1.003129014	12.2634842	22.81351143	0.894874782	2.105636781	1.122189296	0	1.396290427	0.015977543	0	0	2.11511475	0	0.158534577	0	0	0	2.03547822	0	0	0	0	0	0	0	0	0	81.3234	500	10.7009	37.2494	0.20745634	2.122261035	0	2.110832853	3.836027554	0.19464761	0.885614749	4.586888314	1.226088448	3.116682675	0	0	1.003129014	12.2634842	22.81351143	0.894874782	2.105636781	1.122189296	0	1.396290427	0.023715105	0	0	2.11511475	0	0.158534577	0	0	0	3.881137133	0	0	0	0	0	0	0	0	0	103.3135	3000																																																																																	0	500	0	37.2494	0.20745634	2.122261035	0	2.110832853	3.836027554	0.19464761	0.885614749	4.586888314	1.226088448	3.116682675	0	0	1.003129014	12.2634842	22.81351143	0.894874782	2.105636781	1.122189296	0	1.396290427	0.023715105	0	0	2.11511475	0	0.158534577	0	0	0	3.881137133	0	0	0	0	0	0	0	0	0	103.3135
H1170_805_0	2009	8																					2500											D	D	Coin	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	V	V	V	V	V	Coin	V	V	S	Coin	T	V	V	V	V	V	V	O											14.6481	0.0816	0.8346		0	1.035	0.0525	0	3.0098	0.5456	0.803			1.1609	0	1.5262	0	0.2644	0		0	0.0064			0		0														23.9681	2500	1105.536597	221.319311	0		199.1445478	15.14048448	0.768258069	245.4714643	44.03042517	7.981915333	11.74680633			260.2531959	4900.826744	6360.65828	271.2457384	3.86739129	2035.690909		558.5161709	0.723998293			593.0295312		44.44944933														"$250 per Day, days 1-3 after the $500 deductible is met, $0 per Day, days 4-365"	"$250 per Day, days 1-3 after the $500 deductible is met, $0 per Day, days 4-365"			$125 per trip	20% coinsurance	20% coinsurance	$50 per visit	20% coinsurance	20% coinsurance	20% coinsurance			$15 - 20% coinsurance	"$20 per visit, $0 per Immunization"	$30 per visit	$15 Group Therapy & $30 Individual Therapy	20% coinsurance	$0-30 per visit		"$20 generic Kaiser retail, $30 brand Kaiser retail"	20% coinsurance Medicare covered Optical			$30 per visit		$30 per visit														114.7904391	114.7904391	0		125	0.2	0.2	50	0.2	0.044821732	0.037127206			28.4295416	20.00273885	30	27.75	0.2	4.583863873		25	0.025856847			30		30														110.5484339	110.5484339	0		100.0027571	0.160004411	0.160004411	40.00110282	0.160004411	0.035858374	0.029702584			22.74426033	16.00263227	24.00066169	22.20061207	0.160004411	3.667192202		25	0.020686048			24.00066169		24.00066169														10.1846	2.038875268	0	0	1.659583652	2.422544305	0.12292468	0.818260774	7.045062259	0.286218505	0.348910501	0	0	0.493272203	6.535510684	12.72166729	0.501818451	0.618799667	0.622105819	0	1.163575356	0.014976663	0	0	1.186091763	0	0.08890135	0	0	0	0	0	0	0	0	0	0	0	0	0	48.8737	500	9.3395	24.8327	2.120456231	0.83456643	0	1.659583652	3.457520771	0.175441429	0.818260774	10.05490345	0.831847975	1.151901192	0	0	1.654159498	6.535510684	14.24790121	0.501818451	0.883167625	0.622105819	0	1.163575356	0.021375099	0	0	1.186091763	0	0.08890135	0	0	0	0	0	0	0	0	0	0	0	0	0	72.8418	2500																																																																																	0	500	0	24.8327	2.120456231	0.83456643	0	1.659583652	3.457520771	0.175441429	0.818260774	10.05490345	0.831847975	1.151901192	0	0	1.654159498	6.535510684	14.24790121	0.501818451	0.883167625	0.622105819	0	1.163575356	0.021375099	0	0	1.186091763	0	0.08890135	0	0	0	0	0	0	0	0	0	0	0	0	0	72.8418
H1216_001_0	2009	9																					1750											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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1507.919414	132.071751	621.9374933	1537.660483	699.7179469	16.60941353	4.328072085	1175.863245	337.7114845	5079.645957	1438.545449	46.08191534	0.047566729	647.3949132	8689.475667	20061.30287	631.179601	3564.084771	4286.522344	2358.048735	32.00440499	25.46520847	3090	646.2	368	118.2857143	37.6	15.55862069	1664	5960											"$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 $20.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $20.00	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"Copay between $0.00 and $195.00, $1,000 benefit limit"	$10.00 copayment	"$10.00 copayment, $150 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											60.97521071	35.44480838	56.13	4.187164867	27.95995122	0.2	0.2	19.93090101	50.00334498	0	12.77284417	26.24922505	0.2	6.109268332	0	4.980288478	14.14713058	7.963256326	13.96388097	6.724331985	0.2	0	0	0	10	10	10	10	0	0											53.11253806	30.87424729	48.89211085	3.647235504	24.35455254	0.174210265	0.174210265	17.36083773	43.55547988	0	11.12580283	22.86442225	0.174210265	5.321486273	0	4.338086876	12.32287683	6.936404971	12.16325702	5.857238282	0.174210265	0	0	0	10	10	10	10	0	0											6.6741	0.339801325	2.533986405	0.467350826	1.420109792	2.89353033	0.753994584	1.701164249	1.225765481	0	1.333747753	0.087803031	0.008286613	0.287091929	0	7.252306224	0.648162373	2.060161277	4.344839415	1.15097111	5.575495873	0	0	0	0.306666667	0.098571429	0.031333333	0.012965517	0	0	0	0	0	0	0	0	0	0	0	0	41.2082	0	6.0338	6.6741	0.339801325	2.533986405	0.467350826	1.420109792	2.89353033	0.753994584	1.701164249	1.225765481	0	1.333747753	0.087803031	0.008286613	0.287091929	0	7.252306224	0.648162373	2.060161277	4.344839415	1.15097111	5.575495873	0	0	0	0.306666667	0.098571429	0.031333333	0.012965517	0	0	0	0	0	0	0	0	0	0	0	0	41.2082	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											5.8233	0.2061	0.2165	0.4753	0.1723	0.406	0.1058	0	0.5598	0.1258	0.5137	0.0119	0	0.1934	0.2701	2.5129	0.1376	0.3211	0.5677	0.342	0.7154	0.0149	0	0	0	0	0	0	0	0											13.6915	0	0	12.4974	0.545876985	2.750502731	0.942685224	1.592442743	3.299538217	0.859791902	1.701164249	1.785551821	0.125760591	1.847463002	0.099685572	0.008286613	0.480493653	0.270134516	9.7652379	0.78576279	2.38123613	4.912509806	1.49293566	6.290896393	0.01490079	0	0	0.306666667	0.098571429	0.031333333	0.012965517	0	0	0	0	0	0	0	0	0	0	0	0	54.8998
H1216_003_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	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	0	0	0											0		459.794891	83.70536599	1156.377154	4357.077466	17.9827252	33.91575819	7.592926078	24.54895857	17.99698327	6654.361714	17.06127558	0.388750861	0.037041878	6.736380163	6748.731556	84.35966836	28.72629552	18.69949322	19.69843736	7.997976456	28.59482253	0.216056241	3090	928.3636364	0	0	0	0	1664	5960											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	$0.00 copayment	"$0.00 copayment, No benefit limit"	Not Covered	Not Covered	Not Covered	Not Covered	$0.00 copayment	$0.00 copayment											757.3422182	644.4367342	66.04612626	0	0.158778527	0.17	0.17	0.134026282	0.17	0	0.17	0.17	0.17	0.17	0	0.089468274	0.17	0.17	0.17	0.030399562	0.17	0.17	0	0	0	0	0	0	0	0											757.3422182	644.4367342	66.04612626	0	0.158778527	0.17	0.17	0.134026282	0.17	0	0.17	0.17	0.17	0.17	0	0.089468274	0.17	0.17	0.17	0.030399562	0.17	0.17	0	0	0	0	0	0	0	0											29.0185	4.495234391	6.36451929	0	2.855270626	5.765678892	1.290797433	3.290205651	3.059487156	0	2.900416848	0.066087646	0.006297119	1.145184628	0	7.547513899	4.883470238	3.178913848	3.348734352	0.243134981	4.861119831	0.036729561	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.3573	0	0	29.0185	4.495234391	6.36451929	0	2.855270626	5.765678892	1.290797433	3.290205651	3.059487156	0	2.900416848	0.066087646	0.006297119	1.145184628	0	7.547513899	4.883470238	3.178913848	3.348734352	0.243134981	4.861119831	0.036729561	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.3573	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	29.0185	4.495234391	6.36451929	0	2.855270626	5.765678892	1.290797433	3.290205651	3.059487156	0	2.900416848	0.066087646	0.006297119	1.145184628	0	7.547513899	4.883470238	3.178913848	3.348734352	0.243134981	4.861119831	0.036729561	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.3573
H1216_004_0	2009	8																					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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2212.003051	908.7689199	1098.946223	3663.248527	1630.596199	31.25761164	6.961921724	2968.263355	376.6479864	6085.036331	1319.286034	16.4178987	0.036582981	531.662355	7147.094417	16512.80975	2607.678223	4883.45314	4350.552972	1358.005258	26.02990529	9.560562309	3090	224.5714286	368	118.2857143	37.6	15.55862069	1664	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, $85 days 8 - 100"	Copay between $0.00 and $20.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $20.00	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $150 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	Not Covered											58.57490505	27.59239348	58.89	3.024326697	28.8466822	0.2	0.2	20.17498147	53.61380339	0	11.32208114	26.24922505	0.2	5.477699826	0	3.777988487	11.92387743	7.390465454	13.98264651	6.640798413	0.2	0	0	0	10	10	10	10	0	0											38.62695726	18.19567958	38.8347452	1.994378615	19.02281462	0.131889099	0.131889099	13.30430064	35.35538112	0	7.466295399	17.3099332	0.131889099	3.612244473	0	2.491377488	7.863147252	4.873609149	9.220793246	4.379244596	0.131889099	0	0	0	10	10	10	10	0	0											7.1202	1.37797234	3.556441381	0.608825377	2.584877435	4.122538236	0.918201583	3.290889004	1.109711092	0	0.820848271	0.023682727	0.004824896	0.1600412	0	3.428303539	1.708713155	1.983336825	3.342962455	0.495586432	3.433060756	0	0	0	0.306666667	0.098571429	0.031333333	0.012965517	0	0	0	0	0	0	0	0	0	0	0	0	40.5406	0	20.704	7.1202	1.37797234	3.556441381	0.608825377	2.584877435	4.122538236	0.918201583	3.290889004	1.109711092	0	0.820848271	0.023682727	0.004824896	0.1600412	0	3.428303539	1.708713155	1.983336825	3.342962455	0.495586432	3.433060756	0	0	0	0.306666667	0.098571429	0.031333333	0.012965517	0	0	0	0	0	0	0	0	0	0	0	0	40.5406	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											8.0505	1.2464	0.365	1.1775	0.4031	0.7641	0.1702	0	0.408	0.1551	0.3902	0.0086	0	0.1664	0.4125	1.9149	0.7192	0.4382	0.4422	0.1994	0.6288	0.0049	0	0	0	0	0	0	0	0											18.0651	0	0	15.1708	2.624396181	3.921392448	1.786356701	2.987966094	4.886613187	1.088381892	3.290889004	1.517738619	0.155108632	1.211057312	0.032295273	0.004824896	0.326448411	0.412523815	5.3431998	2.427872427	2.421501856	3.78511822	0.694987189	4.061815164	0.004888432	0	0	0.306666667	0.098571429	0.031333333	0.012965517	0	0	0	0	0	0	0	0	0	0	0	0	58.6057
H1230_001_0	2009	11																					3000											D	Coin	D	V	Coin	Coin	Coin	V	V	O	O	Coin	O	V	V	V	Coin	V	V	V	O	Coin	Coin	Coin	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	3000	1378.023847	2.91523656	358.701857	407.5886199	13.88186427	5.998421455	0.285667084	262.2940837	134.2932046	0	193.8853775	1.166348801	2.642627097	181.1040795	11950.73323	2873.218042	5.709917757	425.9996434	1209.884273	3665.898836	1170.353396	0.223278754	0	0	427.431168	0	51.62402136	0	0.83451382	2946.916548											0	20% 191-220	$50/day 21 to 100	0	Twenty percent	Twenty percent	Twenty percent	$50/visit	$10/visit	0	$10 per test	Twenty percent	0	$10/visit	$10/visit	$10/visit	20% for 1st 20 visit & 50% for vis 21+	$10/visit	$10 per test	0	$10/$40 generic/brand some @ 0	$10/$40 generic/brand some @ 0			$10/visit		$10/visit		$10/visit	0											0	0	1.919348585	0	0.2	0.2	0.2	45.5138384	10	0	10	0.2	0	10	9.9208646	8.06260095	0.26	10	8.974677012	0	7.159591002	0.031565393	0	0	10	0	10	0	10	0											0	0	0.644444904	0	0.197862838	0.197862838	0.197862838	45.02748608	9.89314188	0	9.89314188	0.197862838	0	9.89314188	9.814852106	7.976445512	0.257221689	9.89314188	8.878775301	0	7.083084959	0.031228091	0	0	9.89314188	0	9.89314188	0	9.89314188	0											0	0	0.019263632	0	2.746705055	1.18686469	0.0565229	0.9842036	0.110715144	0	0.159844629	0.230777083	0	0.149307363	9.774556598	1.90983893	1.468714689	0.351206243	0.895190883	0	0.690809378	0.006972569	0	0	0.352386432	0	0.042560314	0	0.000687997	0	0	0	0	0	0	0	0	0	0	0	21.1371	0	0.2662	0	0	0.019263632	0	2.746705055	1.18686469	0.0565229	0.9842036	0.110715144	0	0.159844629	0.230777083	0	0.149307363	9.774556598	1.90983893	1.468714689	0.351206243	0.895190883	0	0.690809378	0.006972569	0	0	0.352386432	0	0.042560314	0	0.000687997	0	0	0	0	0	0	0	0	0	0	0	21.1371	3000																																																																																	0	0	0	0	0	0.019263632	0	2.746705055	1.18686469	0.0565229	0.9842036	0.110715144	0	0.159844629	0.230777083	0	0.149307363	9.774556598	1.90983893	1.468714689	0.351206243	0.895190883	0	0.690809378	0.006972569	0	0	0.352386432	0	0.042560314	0	0.000687997	0	0	0	0	0	0	0	0	0	0	0	21.1371
H1230_003_0	2009	11																					3000											D	Coin	D	V	Coin	Coin	Coin	V	V	O	O	Coin	O	V	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	0	0	0	0	0	0											0	3000	824.3559135	1.743941154	214.5811901	243.8260338	8.304353315	3.588351689	0.17089062	156.9085176	80.33634369	0	115.985335	0.697728514	1.580861811	108.339358	6553.621987	1575.634279	3.131242397	233.612497	723.7721301	2192.999338	700.1241273	0.223278754	0	0	234.3975259	0	28.30992166	0	0.499219519	1762.89263											$170/day (1-12 days)	20% 191-220	$50/day 21 to 100	0	Twenty percent	Twenty percent	Twenty percent	$50/visit	$170/visit	0	$25/$100 (routine/advanced) 20% XRT	Twenty percent	0	$25/visit	$25/visit	$25/visit	20% for 1st 20 visit & 50% for vis 21+	$25/visit	$25/$100 (routine/advanced)	0	$10/generic & $40/brand	$10/generic & $40/brand			$25/visit		$25/visit		$25/visit	0											170	0	1.919348585	0	0.2	0.2	0.2	45.5138384	97.5	0	34.75	0.2	0	25	24.8021615	20.15650238	0.26	25	31.18700262	0	7.159591002	0.031565393	0	0	25	0	25	0	25	0											129.1137816	0	0.313629233	0	0.176293453	0.176293453	0.176293453	40.11895876	85.94305857	0	30.63098754	0.176293453	0	22.03668168	21.86229352	17.76729707	0.22918149	22.03668168	27.49032198	0	6.310945116	0.027823861	0	0	22.03668168	0	22.03668168	0	22.03668168	0											8.8696	0	0.005608244	0	1.464003125	0.632602912	0.030126898	0.524583862	0.575362591	0	0.296062113	0.123004969	0	0.198953329	11.93976729	2.332896859	0.717622797	0.429003686	1.658060741	0	0.368203745	0.006212477	0	0	0.430445305	0	0.051988061	0	0.000916762	0	0	0	0	0	0	0	0	0	0	0	30.6551	0	5.7662	8.8696	0	0.005608244	0	1.464003125	0.632602912	0.030126898	0.524583862	0.575362591	0	0.296062113	0.123004969	0	0.198953329	11.93976729	2.332896859	0.717622797	0.429003686	1.658060741	0	0.368203745	0.006212477	0	0	0.430445305	0	0.051988061	0	0.000916762	0	0	0	0	0	0	0	0	0	0	0	30.6551	3000																																																																																	0	0	0	8.8696	0	0.005608244	0	1.464003125	0.632602912	0.030126898	0.524583862	0.575362591	0	0.296062113	0.123004969	0	0.198953329	11.93976729	2.332896859	0.717622797	0.429003686	1.658060741	0	0.368203745	0.006212477	0	0	0.430445305	0	0.051988061	0	0.000916762	0	0	0	0	0	0	0	0	0	0	0	30.6551
H1230_801_0	2009	5																					3000											Coin	Coin	D	V	Coin	Coin	Coin	V	V	Coin	Coin	Coin	O	V	V	V	Coin	V	Coin	Coin	O	Coin	Coin	Coin	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	3000	244.455273	2.038362741	337.2483617	363.1923741	11.21643212	6.058221986	0.487958924	250.3636989	143.0343274	0.085040851	10.42262482	1.033199382	2.820079758	179.7590274	10814.68606	2567.830102	2.830985674	483.3748718	27.73571909	23.65834061	1239.74095	0.223278754	0	0	420.9671764	0	52.9038551	0	1.244152835	2606.936833											10% Room & Board	10% Room & Board	0	0	Twenty percent	Twenty percent	Twenty percent	$50/visit	$25/visit	20% OP Lab	20% OP Radiology	Twenty percent	0	$25/visit	$25/visit	$25/visit	20% for 1st 20 visit & 50% for vis 21+	$25/visit	20% OP Radiology	20% OP Lab	$10/$40 generic/brand some @ 0	$10/$40 generic/brand some @ 0			$25/visit		$25/visit		$25/visit	0											0.071634071	0.071634071	0	0	0.2	0.2	0.2	45.58558526	25	0.2	0.198003376	0.2	0	25	24.8207948	20.39158866	0.26	25	0.197280119	0.2	7.62179996	0.031565393	0	0	25	0	25	0	25	0											0.061632768	0.061632768	0	0	0.181346663	0.181346663	0.181346663	41.33396877	22.66833284	0.181346663	0.179536257	0.181346663	0	22.66833284	22.50584151	18.48973275	0.235750662	22.66833284	0.178880456	0.181346663	6.910939933	0.028621393	0	0	22.66833284	0	22.66833284	0	22.66833284	0											15.0665	0.125629939	0	0	2.034062533	1.098638339	0.088489722	0.862377109	0.270195812	0.015421875	1.871239051	0.18736726	0	0.339569789	20.28280087	3.956541028	0.667406745	0.91310854	4.961378074	4.290361115	0.71398127	0.006390549	0	0	0.795218672	0	0.09993685	0	0.002350239	0	0	0	0	0	0	0	0	0	0	0	58.6489	0	6.9352	15.0665	0.125629939	0	0	2.034062533	1.098638339	0.088489722	0.862377109	0.270195812	0.015421875	1.871239051	0.18736726	0	0.339569789	20.28280087	3.956541028	0.667406745	0.91310854	4.961378074	4.290361115	0.71398127	0.006390549	0	0	0.795218672	0	0.09993685	0	0.002350239	0	0	0	0	0	0	0	0	0	0	0	58.6489	3000																																																																																	0	0	0	15.0665	0.125629939	0	0	2.034062533	1.098638339	0.088489722	0.862377109	0.270195812	0.015421875	1.871239051	0.18736726	0	0.339569789	20.28280087	3.956541028	0.667406745	0.91310854	4.961378074	4.290361115	0.71398127	0.006390549	0	0	0.795218672	0	0.09993685	0	0.002350239	0	0	0	0	0	0	0	0	0	0	0	58.6489
H1230_802_0	2009	6																					3000											Coin	Coin	D	V	Coin	Coin	Coin	V	V	Coin	Coin	Coin	O	V	V	V	Coin	V	Coin	Coin	O	Coin	Coin	Coin	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	3000	243.8984009	2.038362741	337.2483617	363.1923741	11.21643212	6.058221986	0.487958924	250.3636989	143.0343274	0.085040851	10.42262482	1.033199382	2.820079758	179.7590274	10814.68606	2567.830102	2.830985674	483.3748718	27.73571909	23.65834061	1239.74095	0.223278754	0	0	420.9671764	0	52.9038551	0	1.244152835	2.787945759											10% Room & Board	10% Room & Board	0	0	Twenty percent	Twenty percent	Twenty percent	$50/visit	$25/visit	20% OP Lab	20% OP Radiology	Twenty percent	0	$25/visit	$25/visit	$25/visit	20% for 1st 20 visit & 50% for vis 21+	$25/visit	20% OP Radiology	20% OP Lab	$10/$40 generic/brand some @ 0	$10/$40 generic/brand some @ 0			$25/visit		$25/visit		$25/visit	0											0.071634071	0.071634071	0	0	0.2	0.2	0.2	45.58558526	25	0.2	0.198003376	0.2	0	25	24.8207948	20.39158866	0.26	25	0.197280119	0.2	7.62179996	0.031565393	0	0	25	0	25	0	25	0											0.061632768	0.061632768	0	0	0.181346663	0.181346663	0.181346663	41.33396877	22.66833284	0.181346663	0.179536257	0.181346663	0	22.66833284	22.50584151	18.48973275	0.235750662	22.66833284	0.178880456	0.181346663	6.910939933	0.028621393	0	0	22.66833284	0	22.66833284	0	22.66833284	0											15.0321	0.125629939	0	0	2.034062533	1.098638339	0.088489722	0.862377109	0.270195812	0.015421875	1.871239051	0.18736726	0	0.339569789	20.28280087	3.956541028	0.667406745	0.91310854	4.961378074	4.290361115	0.71398127	0.006390549	0	0	0.795218672	0	0.09993685	0	0.002350239	0	0	0	0	0	0	0	0	0	0	0	58.6146	0	6.9297	15.0321	0.125629939	0	0	2.034062533	1.098638339	0.088489722	0.862377109	0.270195812	0.015421875	1.871239051	0.18736726	0	0.339569789	20.28280087	3.956541028	0.667406745	0.91310854	4.961378074	4.290361115	0.71398127	0.006390549	0	0	0.795218672	0	0.09993685	0	0.002350239	0	0	0	0	0	0	0	0	0	0	0	58.6146	3000																																																																																	0	0	0	15.0321	0.125629939	0	0	2.034062533	1.098638339	0.088489722	0.862377109	0.270195812	0.015421875	1.871239051	0.18736726	0	0.339569789	20.28280087	3.956541028	0.667406745	0.91310854	4.961378074	4.290361115	0.71398127	0.006390549	0	0	0.795218672	0	0.09993685	0	0.002350239	0	0	0	0	0	0	0	0	0	0	0	58.6146
H1230_803_0	2009	5																					3000											Coin	Coin	D	V	Coin	Coin	Coin	V	V	Coin	Coin	Coin	O	V	V	V	Coin	V	Coin	Coin	O	Coin	Coin	Coin	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	3000	244.455273	2.038362741	337.2483617	363.1923741	11.21643212	6.058221986	0.487958924	250.3636989	143.0343274	0.085040851	10.42262482	1.033199382	2.820079758	179.7590274	10814.68606	2567.830102	2.830985674	483.3748718	27.73571909	23.65834061	1239.74095	0.223278754	0	0	420.9671764	0	52.9038551	0	1.244152835	2606.936833											10% Room & Board	10% Room & Board	0	0	Twenty percent	Twenty percent	Twenty percent	$50/visit	$25/visit	20% OP Lab	20% OP Radiology	Twenty percent	0	$25/visit	$25/visit	$25/visit	20% for 1st 20 visit & 50% for vis 21+	$25/visit	20% OP Radiology	20% OP Lab	$10/$40 generic/brand some @ 0	$10/$40 generic/brand some @ 0			$25/visit		$25/visit		$25/visit	0											0.071634071	0.071634071	0	0	0.2	0.2	0.2	45.58558526	25	0.2	0.198003376	0.2	0	25	24.8207948	20.39158866	0.26	25	0.197280119	0.2	7.62179996	0.031565393	0	0	25	0	25	0	25	0											0.061632768	0.061632768	0	0	0.181346663	0.181346663	0.181346663	41.33396877	22.66833284	0.181346663	0.179536257	0.181346663	0	22.66833284	22.50584151	18.48973275	0.235750662	22.66833284	0.178880456	0.181346663	6.910939933	0.028621393	0	0	22.66833284	0	22.66833284	0	22.66833284	0											15.0665	0.125629939	0	0	2.034062533	1.098638339	0.088489722	0.862377109	0.270195812	0.015421875	1.871239051	0.18736726	0	0.339569789	20.28280087	3.956541028	0.667406745	0.91310854	4.961378074	4.290361115	0.71398127	0.006390549	0	0	0.795218672	0	0.09993685	0	0.002350239	0	0	0	0	0	0	0	0	0	0	0	58.6489	0	6.9352	15.0665	0.125629939	0	0	2.034062533	1.098638339	0.088489722	0.862377109	0.270195812	0.015421875	1.871239051	0.18736726	0	0.339569789	20.28280087	3.956541028	0.667406745	0.91310854	4.961378074	4.290361115	0.71398127	0.006390549	0	0	0.795218672	0	0.09993685	0	0.002350239	0	0	0	0	0	0	0	0	0	0	0	58.6489	3000																																																																																	0	0	0	15.0665	0.125629939	0	0	2.034062533	1.098638339	0.088489722	0.862377109	0.270195812	0.015421875	1.871239051	0.18736726	0	0.339569789	20.28280087	3.956541028	0.667406745	0.91310854	4.961378074	4.290361115	0.71398127	0.006390549	0	0	0.795218672	0	0.09993685	0	0.002350239	0	0	0	0	0	0	0	0	0	0	0	58.6489
H1230_804_0	2009	5																					3000											Coin	Coin	D	V	Coin	Coin	Coin	V	V	Coin	Coin	Coin	O	V	V	V	Coin	V	Coin	Coin	O	Coin	Coin	Coin	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	3000	243.8984009	2.038362741	337.2483617	363.1923741	11.21643212	6.058221986	0.487958924	250.3636989	143.0343274	0.085040851	10.42262482	1.033199382	2.820079758	179.7590274	10814.68606	2567.830102	2.830985674	483.3748718	27.73571909	23.65834061	1239.74095	0.223278754	0	0	420.9671764	0	52.9038551	0	1.244152835	2.787945759											10% Room & Board	10% Room & Board	0	0	Twenty percent	Twenty percent	Twenty percent	$50/visit	$25/visit	20% OP Lab	20% OP Radiology	Twenty percent	0	$25/visit	$25/visit	$25/visit	20% for 1st 20 visit & 50% for vis 21+	$25/visit	20% OP Radiology	20% OP Lab	$10/$40 generic/brand some @ 0	$10/$40 generic/brand some @ 0			$25/visit		$25/visit		$25/visit	0											0.071634071	0.071634071	0	0	0.2	0.2	0.2	45.58558526	25	0.2	0.198003376	0.2	0	25	24.8207948	20.39158866	0.26	25	0.197280119	0.2	7.62179996	0.031565393	0	0	25	0	25	0	25	0											0.061632768	0.061632768	0	0	0.181346663	0.181346663	0.181346663	41.33396877	22.66833284	0.181346663	0.179536257	0.181346663	0	22.66833284	22.50584151	18.48973275	0.235750662	22.66833284	0.178880456	0.181346663	6.910939933	0.028621393	0	0	22.66833284	0	22.66833284	0	22.66833284	0											15.0321	0.125629939	0	0	2.034062533	1.098638339	0.088489722	0.862377109	0.270195812	0.015421875	1.871239051	0.18736726	0	0.339569789	20.28280087	3.956541028	0.667406745	0.91310854	4.961378074	4.290361115	0.71398127	0.006390549	0	0	0.795218672	0	0.09993685	0	0.002350239	0	0	0	0	0	0	0	0	0	0	0	58.6146	0	6.9297	15.0321	0.125629939	0	0	2.034062533	1.098638339	0.088489722	0.862377109	0.270195812	0.015421875	1.871239051	0.18736726	0	0.339569789	20.28280087	3.956541028	0.667406745	0.91310854	4.961378074	4.290361115	0.71398127	0.006390549	0	0	0.795218672	0	0.09993685	0	0.002350239	0	0	0	0	0	0	0	0	0	0	0	58.6146	3000																																																																																	0	0	0	15.0321	0.125629939	0	0	2.034062533	1.098638339	0.088489722	0.862377109	0.270195812	0.015421875	1.871239051	0.18736726	0	0.339569789	20.28280087	3.956541028	0.667406745	0.91310854	4.961378074	4.290361115	0.71398127	0.006390549	0	0	0.795218672	0	0.09993685	0	0.002350239	0	0	0	0	0	0	0	0	0	0	0	58.6146
H1230_805_0	2009	5																					2500											Coin	Coin	D	V	Coin	Coin	Coin	V	V	Coin	Coin	Coin	O	V	V	V	V	V	Coin	Coin	O	Coin	Coin	Coin	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	2500	244.455273	2.038362741	337.2483617	363.1923741	11.21643212	6.058221986	0.487958924	250.3636989	143.0343274	0.085040851	10.42262482	1.033199382	2.820079758	179.7590274	11429.15686	2713.729539	99.6834833	510.8393532	27.73571909	23.65834061	1239.74095	0.223278754	0	0	444.885766	0	55.90975596	0	1.244152835	2606.936833											10% Room & Board	10% Room & Board	0	0	Twenty percent	Twenty percent	Twenty percent	$50/visit	$15/visit	10% OP Lab	"10%, 15 OV for rad therapy"	Ten Percent	0	$15/visit	$15/visit	$15/visit	$15/visit	$15/visit	10% OP Radiology	10% OP Lab	$10/$40 generic/brand some @ 0	$10/$40 generic/brand some @ 0			$15/visit		$15/visit		$15/visit	0											0.071634071	0.071634071	0	0	0.2	0.2	0.2	45.58558526	15	0.1	0.1	0.1	0	15	14.89247688	12.2349532	15	15	0.098640059	0.1	7.62179996	0.031565393	0	0	15	0	15	0	15	0											0.0593263	0.0593263	0	0	0.181319617	0.181319617	0.181319617	41.32780419	13.59897124	0.090659808	0.090659808	0.090659808	0	13.59897124	13.50149098	11.09218511	13.59897124	13.59897124	0.089426889	0.090659808	6.90990923	0.028617125	0	0	13.59897124	0	13.59897124	0	13.59897124	0											14.5026	0.120928519	0	0	2.033759172	1.098474487	0.088476525	0.862248494	0.162093309	0.007709787	0.944913168	0.093669658	0	0.203711487	12.85922152	2.508432532	0.112966069	0.578907473	2.480319065	2.144860624	0.713874786	0.006389596	0	0	0.504165728	0	0.063359597	0	0.001409933	0	0	0	0	0	0	0	0	0	0	0	42.0925	0	5.8638	14.5026	0.120928519	0	0	2.033759172	1.098474487	0.088476525	0.862248494	0.162093309	0.007709787	0.944913168	0.093669658	0	0.203711487	12.85922152	2.508432532	0.112966069	0.578907473	2.480319065	2.144860624	0.713874786	0.006389596	0	0	0.504165728	0	0.063359597	0	0.001409933	0	0	0	0	0	0	0	0	0	0	0	42.0925	2500																																																																																	0	0	0	14.5026	0.120928519	0	0	2.033759172	1.098474487	0.088476525	0.862248494	0.162093309	0.007709787	0.944913168	0.093669658	0	0.203711487	12.85922152	2.508432532	0.112966069	0.578907473	2.480319065	2.144860624	0.713874786	0.006389596	0	0	0.504165728	0	0.063359597	0	0.001409933	0	0	0	0	0	0	0	0	0	0	0	42.0925
H1230_806_0	2009	5																					2500											Coin	Coin	D	V	Coin	Coin	Coin	V	V	Coin	Coin	Coin	O	V	V	V	V	V	Coin	Coin	O	Coin	Coin	Coin	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	2500	244.8483451	2.046301829	337.6418838	363.6161692	11.26011828	6.081817765	0.489859444	250.6558387	143.2012286	0.085372071	10.46321923	1.037223523	2.823370401	179.9687812	11446.94197	2717.952422	99.83860253	511.6342793	27.84374516	23.75048596	1241.187556	0.223278754	0	0	445.404886	0	55.9749949	0	1.245604589	2.791198906											10% Room & Board	10% Room & Board	0	0	Twenty percent	Twenty percent	Twenty percent	$50/visit	$15/visit	10% OP Lab	"10%, 15 OV for rad therapy"	Ten Percent	0	$15/visit	$15/visit	$15/visit	$15/visit	$15/visit	10% OP Radiology	10% OP Lab	$10/$40 generic/brand some @ 0	$10/$40 generic/brand some @ 0			$15/visit		$15/visit		$15/visit	0											0.071634071	0.071634071	0	0	0.2	0.2	0.2	45.58558526	15	0.1	0.1	0.1	0	15	14.89247688	12.2349532	15	15	0.098640059	0.1	7.62179996	0.031565393	0	0	15	0	15	0	15	0											0.0593263	0.0593263	0	0	0.181319617	0.181319617	0.181319617	41.32780419	13.59897124	0.090659808	0.090659808	0.090659808	0	13.59897124	13.50149098	11.09218511	13.59897124	13.59897124	0.089426889	0.090659808	6.90990923	0.028617125	0	0	13.59897124	0	13.59897124	0	13.59897124	0											14.5259	0.121399516	0	0	2.041680329	1.102752865	0.088821127	0.863254618	0.162282449	0.007739816	0.948593449	0.094034486	0	0.20394919	12.87923199	2.512335948	0.113141857	0.579808321	2.4899795	2.153214503	0.714707779	0.006389596	0	0	0.50475402	0	0.063433529	0	0.001411578	0	0	0	0	0	0	0	0	0	0	0	42.1789	0	5.8751	14.5259	0.121399516	0	0	2.041680329	1.102752865	0.088821127	0.863254618	0.162282449	0.007739816	0.948593449	0.094034486	0	0.20394919	12.87923199	2.512335948	0.113141857	0.579808321	2.4899795	2.153214503	0.714707779	0.006389596	0	0	0.50475402	0	0.063433529	0	0.001411578	0	0	0	0	0	0	0	0	0	0	0	42.1789	2500																																																																																	0	0	0	14.5259	0.121399516	0	0	2.041680329	1.102752865	0.088821127	0.863254618	0.162282449	0.007739816	0.948593449	0.094034486	0	0.20394919	12.87923199	2.512335948	0.113141857	0.579808321	2.4899795	2.153214503	0.714707779	0.006389596	0	0	0.50475402	0	0.063433529	0	0.001411578	0	0	0	0	0	0	0	0	0	0	0	42.1789
H1254_801_0	2009	3																																A	A	D		T	coin	coin	V	V		P	V		V	V	V	V	V			S	P	V	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		421.5664622	8.682146818	1257.946606	1412.14634	242.853203	16.36301586	2.472646514	673.930054	277.6174651	32014.40904	3468.976734	196.1697652	25.82488048	5037.838223	17746.16258	10170.4157	68.53525973	1403.752463	0	0	283.9540775	151.7913863	13.90570487	0	0	194.2407292	0	7.900119384	28.60356486	113.2321683											1a (IP Acute) - $300	1b (IP Psych) - $300	"2 (SNF) - $0 days 1 - 15, $50 days 16 - 100"	6 (Home Health)- $0	10a (Ambulance) - $100	11a (Medical Equip) - 20%	"11a (Medical Equip), 11b (Med Supp) - 100%"	4a (ER) $50 Copay	"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) - $300	12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT) - $25; 9c (OP SA) - $25; 3 (CORF), 5 (Part Hospital)"	"7a (PCP),  14c (Routine Physical) - $10; 9d (Cardiac Rehab), 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), 18a (MCR Hear Exam), 7b (Chiro), 7d (Spec), 7f (Pod), 7g (Other) - $25"	"7e (MH), 7h (Psychiatric) - $25"	"7c (OT), 7i (PT/ST) - $25"			15 (Part B Rx) - $25/75 31/90 day supply	"11c (Diab Supp) - $25/75 31/90 day supply, 16b (MCR Comp Dental) - $25, 17a (MCR Eye Exam) - $25; 18a (MCR Hearing Exam) - $25"	10a:  $100 per Trip																		298.9702517	300	50	0	100	0.055901115	0.2	50	125	0	13.98639943	300	0	0.729495268	3.542663644	18.96642795	4.528985507	25	0	0	0	168.7650723	59.95396871	0	0	0	0	0	0	0											298.9702517	300	50	0	100	0.055901115	0.2	50	125	0	13.98639943	300	0	0.729495268	3.542663644	18.96642795	4.528985507	25	0	0	0	168.7650723	59.95396871	0	0	0	0	0	0	0											10.503	0.21705367	5.24144419	0	2.023776691	0.91471083	0.494529303	2.808041892	2.891848595	0	4.04320785	4.904244129	0	0.306256595	5.239057083	16.07470471	0.025866267	2.924484298	0	0	0	2.134757023	0.069475183	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.8164	0	0.4978	10.503	0.21705367	5.24144419	0	2.023776691	0.91471083	0.494529303	2.808041892	2.891848595	0	4.04320785	4.904244129	0	0.306256595	5.239057083	16.07470471	0.025866267	2.924484298	0	0	0	2.134757023	0.069475183	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.8164																																																																																		0			10.503	0.21705367	5.24144419	0	2.023776691	0.91471083	0.494529303	2.808041892	2.891848595	0	4.04320785	4.904244129	0	0.306256595	5.239057083	16.07470471	0.025866267	2.924484298	0	0	0	2.134757023	0.069475183	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.8164
H1264_004_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1573.685802	82.33315371	324.9296347	2504.704631	595.5584852	17.95791062	5.361500642	1245.656115	219.5598213	4159.269683	1146.118846	71.15418816	0.5353598	456.9373861	6987.022539	21658.64821	732.0716097	2438.23568	4554.649677	2018.771092	31.82711035	40.25198917	3750	483	496	117.4736842	30.4	18.24	0	5800											"$50 days 1 - 3, $0 after day 3, unlimited coverage"	"$50 days 1 - 3, $0 after day 3, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $20.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $20.00	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"Copay between $0.00 and $20.00, No benefit limit"	$10.00 copayment	"$10.00 copayment, $200 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	Not Covered	$0.00 copayment											16.86776347	11.85212196	56.13	3.231031669	37.58007949	0.2	0.2	20.8748758	17.5846102	0	8.800486981	13.12461252	0.2	3.333999476	0	4.310523416	12.34282675	7.873700784	14.5475551	5.989000446	0.2	0	0	20	10	10	10	10	0	0											16.36859059	11.50137849	54.46892773	3.13541476	36.4679607	0.194081339	0.194081339	20.25711921	17.06422345	0	8.540051477	12.73621185	0.194081339	3.235335409	0	4.182960777	11.9775617	7.640691947	14.11704485	5.811766123	0.194081339	0	0	20	10	10	10	10	0	0											2.1466	0.078912064	1.474880732	0.654440656	1.809900286	3.485295335	1.040567223	2.102783701	0.312218154	0	0.815659496	0.075519568	0.103903347	0.123195475	0	7.549772995	0.73070274	1.552483977	5.358182814	0.977718787	6.177048187	0	0	0.805	0.413333333	0.097894737	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	37.9265	0	1.1152	2.1466	0.078912064	1.474880732	0.654440656	1.809900286	3.485295335	1.040567223	2.102783701	0.312218154	0	0.815659496	0.075519568	0.103903347	0.123195475	0	7.549772995	0.73070274	1.552483977	5.358182814	0.977718787	6.177048187	0	0	0.805	0.413333333	0.097894737	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	37.9265	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											6.4302	0.1304	0.1209	0.8213	0.1876	0.439	0.1311	0	0.4607	0.1026	0.4545	0.0454	0	0.1843	0.2186	2.7086	0.2178	0.2465	0.8685	0.3553	0.7219	0.0339	0	0	0	0	0	0	0	0											14.879	0	0	8.5768	0.20930119	1.595730992	1.475718954	1.997536057	3.924266484	1.171626127	2.102783701	0.772890973	0.102554193	1.270208018	0.120904912	0.103903347	0.307458521	0.218638406	10.25834167	0.94850097	1.799000977	6.226649012	1.333059841	6.898911556	0.033938116	0	0.805	0.413333333	0.097894737	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	52.8055
H1264_005_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1346.736206	88.89849403	356.1398952	3796.434101	467.5134178	20.62750949	5.184206836	1511.904768	235.2825321	3215.797014	940.0191902	31.49499606	0.183279426	489.4666049	8936.082092	20409.67221	442.1705944	2409.586862	4427.265721	2122.097633	35.96119115	56.22762306	0	483	496	117.4736842	30.4	18.24	0	5800											"$75 days 1 - 5, $0 after day 5, unlimited coverage"	"$75 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	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $25.00	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $20.00, No benefit limit"	$10.00 copayment	"$10.00 copayment, $200 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	Not Covered	$0.00 copayment											39.9154827	23.20773624	56.13	2.653306059	29.91235108	0.2	0.2	21.8530985	33.82696378	0	8.305138076	19.68691878	0.2	5.670341651	0	5.718933533	18.30937238	9.701622562	15.65187167	5.863593573	0.2	0	0	20	10	10	10	10	0	0											38.50258947	22.38624915	54.14315951	2.559386659	28.85353992	0.192920575	0.192920575	21.07956169	32.6295866	0	8.011160086	18.99005851	0.192920575	5.469627872	0	5.516499741	17.66127328	9.358213039	15.09784045	5.656039233	0.192920575	0	0	20	10	10	10	10	0	0											4.3211	0.165841986	1.606878263	0.809711899	1.124118089	3.979471002	1.000140166	2.655857486	0.639764313	0	0.627553685	0.049840985	0.035358372	0.223100015	0	9.382495957	0.650774642	1.879118932	5.570179289	1.000222289	6.937653692	0	0	0.805	0.413333333	0.097894737	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	44.0159	0	1.5654	4.3211	0.165841986	1.606878263	0.809711899	1.124118089	3.979471002	1.000140166	2.655857486	0.639764313	0	0.627553685	0.049840985	0.035358372	0.223100015	0	9.382495957	0.650774642	1.879118932	5.570179289	1.000222289	6.937653692	0	0	0.805	0.413333333	0.097894737	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	44.0159	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											5.6119	0.123	0.1314	0.8748	0.1416	0.5042	0.1267	0	0.5041	0.0867	0.3504	0.0132	0	0.1807	0.2274	2.5654	0.0937	0.2342	0.8675	0.378	0.8481	0.0329	0	0	0	0	0	0	0	0											13.896	0	0	9.933	0.288867456	1.73829845	1.684545406	1.265761906	4.483699012	1.126865222	2.655857486	1.143908043	0.08668349	0.977910942	0.063063303	0.035358372	0.403805363	0.227438428	11.9478481	0.744452909	2.113288098	6.437671314	1.37825436	7.785707744	0.032912486	0	0.805	0.413333333	0.097894737	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	57.912
H1264_006_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	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		393.4709504	60.97438371	683.0814038	8425.484278	18.70298458	37.51975888	9.465791146	21.90502917	14.37480597	6846.127479	17.60066243	1.946002994	0.592592459	7.600075226	7493.061264	118.9862148	40.76828981	13.66766133	33.94404473	11.49039273	38.51784371	0.225538493	5400	818.4	0	0	0	0	1664	5800											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	$0.00 copayment	"Copay between $0.00 and $195.00, No benefit limit"	Not Covered	Not Covered	Not Covered	Not Covered	$0.00 copayment	$0.00 copayment											838.5671711	461.4507319	71.7312729	0	0.153041306	0.17	0.17	0.123911536	0.17	0	0.17	0.17	0.17	0.17	0	0.079526018	0.17	0.17	0.169995992	0.135365064	0.17	0.17	0	0	0	0	0	0	0	0											838.5671711	461.4507319	71.7312729	0	0.153041306	0.17	0.17	0.123911536	0.17	0	0.17	0.17	0.17	0.17	0	0.079526018	0.17	0.17	0.169995992	0.135365064	0.17	0.17	0	0	0	0	0	0	0	0											27.496	2.344722833	4.083191549	0	2.862329188	6.37835901	1.609184495	2.714285811	2.443717014	0	2.992112612	0.330820509	0.100740718	1.292012788	0	9.462499862	6.930609268	2.323502426	5.770351565	1.555397747	6.548033431	0.038341544	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.2762	0	0	27.496	2.344722833	4.083191549	0	2.862329188	6.37835901	1.609184495	2.714285811	2.443717014	0	2.992112612	0.330820509	0.100740718	1.292012788	0	9.462499862	6.930609268	2.323502426	5.770351565	1.555397747	6.548033431	0.038341544	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.2762	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	27.496	2.344722833	4.083191549	0	2.862329188	6.37835901	1.609184495	2.714285811	2.443717014	0	2.992112612	0.330820509	0.100740718	1.292012788	0	9.462499862	6.930609268	2.323502426	5.770351565	1.555397747	6.548033431	0.038341544	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.2762
H1264_007_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	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		310.2864314	47.18855534	521.1331794	11612.09469	14.18106392	41.88203123	8.376893199	24.56870772	15.51219526	6837.479429	13.88447691	1.134219595	0.839958653	6.709656429	7493.435544	86.437626	16.34033846	13.67423068	27.73209851	9.471404197	29.29752077	0.927765915	5400	818.4	0	0	0	0	1664	8200											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	$0.00 copayment	"Copay between $0.00 and $195.00, No benefit limit"	Not Covered	Not Covered	Not Covered	Not Covered	$0.00 copayment	$0.00 copayment											837.952094	470.2570348	72.68880373	0	0.147159299	0.17	0.17	0.126213058	0.17	0	0.17	0.17	0.17	0.17	0	0.090341286	0.17	0.17	0.17	0.128120872	0.17	0.169845645	0	0	0	0	0	0	0	0											837.952094	470.2570348	72.68880373	0	0.147159299	0.17	0.17	0.126213058	0.17	0	0.17	0.17	0.17	0.17	0	0.090341286	0.17	0.17	0.17	0.128120872	0.17	0.169845645	0	0	0	0	0	0	0	0											21.6671	1.849229176	3.156712283	0	2.086875424	7.119945309	1.424071844	3.100891724	2.637073195	0	2.360361074	0.192817331	0.142792971	1.140641593	0	7.808886332	2.777857539	2.324619215	4.714456747	1.213484568	4.980578531	0.157577	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.856	0	0	21.6671	1.849229176	3.156712283	0	2.086875424	7.119945309	1.424071844	3.100891724	2.637073195	0	2.360361074	0.192817331	0.142792971	1.140641593	0	7.808886332	2.777857539	2.324619215	4.714456747	1.213484568	4.980578531	0.157577	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.856	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.6671	1.849229176	3.156712283	0	2.086875424	7.119945309	1.424071844	3.100891724	2.637073195	0	2.360361074	0.192817331	0.142792971	1.140641593	0	7.808886332	2.777857539	2.324619215	4.714456747	1.213484568	4.980578531	0.157577	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.856
H1264_008_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1289.834385	69.95907469	250.7327808	1753.427833	576.1423718	15.78484268	4.320707367	1069.729921	177.6212936	3382.619217	909.203723	52.33848083	0.537246996	360.6762734	5018.31192	17359.48968	615.0521454	1867.254165	3604.968674	1837.812673	22.34709742	24.2915691	0	0	328	227.0769231	30.4	18.24	0	0											"$150 days 1 - 3, $0 after day 3, unlimited coverage"	"$150 days 1 - 3, $0 after day 3, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $35.00	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	Not Covered	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	Not Covered	Not Covered											49.8819758	35.63487479	56.13	6.573302102	37.18117872	0.2	0.2	20.87568273	70.43380172	0	17.14245048	39.37383757	0.2	8.4045954	7.05456857	7.302612382	22.54947091	13.66709911	18.14330478	6.098203043	0.2	0	0	0	10	10	10	10	0	0											47.57021618	33.98339119	53.52867827	6.268665124	35.45803231	0.190731082	0.190731082	19.90820781	67.16957619	0	16.34799067	37.54907329	0.190731082	8.015087888	6.727627496	6.96417582	21.50442497	13.03370303	17.3024608	5.815584335	0.190731082	0	0	0	10	10	10	10	0	0											5.1131	0.19812055	1.11844953	0.915970992	1.702406236	3.010660129	0.824093193	1.774700464	0.994228918	0	1.238637832	0.163771788	0.102469701	0.240904336	2.813444438	10.07454486	1.102195226	2.028103023	5.19790243	0.890662883	4.262286079	0	0	0	0.273333333	0.189230769	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	44.2698	0	2.1269	5.1131	0.19812055	1.11844953	0.915970992	1.702406236	3.010660129	0.824093193	1.774700464	0.994228918	0	1.238637832	0.163771788	0.102469701	0.240904336	2.813444438	10.07454486	1.102195226	2.028103023	5.19790243	0.890662883	4.262286079	0	0	0	0.273333333	0.189230769	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	44.2698	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											5.1038	0.1092	0.0917	0.5745	0.1735	0.3859	0.1056	0	0.3605	0.079	0.351	0.0363	0	0.1406	0.1718	2.1305	0.1783	0.1885	0.6775	0.3165	0.5128	0.015	0	0	0	0	0	0	0	0											11.7023	0	0	10.2169	0.307319629	1.210131001	1.490479872	1.875877085	3.396511839	0.929710484	1.774700464	1.354730258	0.078954692	1.589594675	0.20009823	0.102469701	0.381462014	2.985291143	12.20499689	1.280484553	2.216582653	5.87538492	1.207169777	4.775109077	0.014995524	0	0	0.273333333	0.189230769	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	55.9721
H1264_009_0	2009	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	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		2572.707355	570.8014427	638.6604389	6939.372164	1611.316441	33.4901904	8.469832188	2784.328272	150.0816564	6059.977227	1193.14429	65.53185802	0.577577823	466.4938411	8124.056488	22244.48575	3417.587293	3219.193809	4820.9494	1730.483788	33.8409058	9.125064257	3750	483	328	227.0769231	30.4	18.24	1664	5800											"$50 days 1 - 3, $0 after day 3, unlimited coverage"	"$50 days 1 - 3, $0 after day 3, unlimited coverage"	Medicare FFS Cost Sharing	Copay between $0.00 and $10.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $10.00	Copay between $5.00 and $10.00	$10.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"Copay between $0.00 and $20.00, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											14.46745285	10.26033702	40.51	1.44178138	28.87702269	0.2	0.2	21.5070527	17.49755853	0	6.861527384	13.12461252	0.2	2.241859788	0	1.656577726	6.032430331	3.853495163	11.59912793	4.443820809	0.2	0	0	20	10	10	10	10	0	0											13.14482784	9.322329581	36.80654646	1.309972682	26.23706436	0.181715855	0.181715855	19.54086237	15.89791906	0	6.234241581	11.92475094	0.181715855	2.036907343	0	1.50513219	5.480941181	3.501205845	10.53872725	4.037563492	0.181715855	0	0	20	10	10	10	10	0	0											2.8181	0.443433265	1.958907093	0.75753233	3.523017764	6.085698588	1.539102799	4.534014628	0.198832169	0	0.619862479	0.065120924	0.104955048	0.079183728	0	2.790074297	1.560966245	0.939255015	4.233889236	0.582244847	6.149429137	0	0	0.805	0.273333333	0.189230769	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	40.2918	0	3.9225	2.8181	0.443433265	1.958907093	0.75753233	3.523017764	6.085698588	1.539102799	4.534014628	0.198832169	0	0.619862479	0.065120924	0.104955048	0.079183728	0	2.790074297	1.560966245	0.939255015	4.233889236	0.582244847	6.149429137	0	0	0.805	0.273333333	0.189230769	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	40.2918	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											8.9188	0.7604	0.2275	2.8174	0.4098	0.8186	0.207	0	0.3204	0.1524	0.3993	0.0417	0	0.1846	0.348	2.6818	1.0286	0.3281	0.751	0.2845	0.8124	0.005	0	0	0	0	0	0	0	0											21.4974	0	0	11.7369	1.203828227	2.186393257	3.5749587	3.932813611	6.904347687	1.746143142	4.534014628	0.519210428	0.152405127	1.019210645	0.106835966	0.104955048	0.263829588	0.347985275	5.471889527	2.589574566	1.267345062	4.984910217	0.866710068	6.961799046	0.005026065	0	0.805	0.273333333	0.189230769	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	61.7892
H1264_010_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1852.995917	368.0189973	473.6910968	12265.66971	1349.575787	39.39324008	7.203892251	3444.480737	158.6228796	6221.499794	1145.115699	26.35629626	1.141246367	405.0761216	7479.750481	17115.00823	1687.107271	3330.052404	4118.988597	1535.879984	29.85287878	52.90319342	0	483	328	227.0769231	30.4	18.24	1664	6200											"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$50 days 1 - 5, $0 after day 5, unlimited coverage"	Medicare FFS Cost Sharing	Copay between $0.00 and $20.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $20.00	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $20.00, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											23.08879664	16.08174131	40.51	0.941025219	21.32060852	0.2	0.2	22.39295449	16.59718825	0	7.65765911	13.12461252	0.2	3.382456243	0	3.61876596	15.27953261	7.472937963	14.60854101	5.770798454	0.2	0	0	20	10	10	10	10	0	0											21.94841978	15.28744935	38.50917391	0.89454712	20.26756409	0.190121816	0.190121816	21.28694591	15.77743789	0	7.279440298	12.47637586	0.190121816	3.215393624	0	3.440031787	14.52486247	7.103842698	13.88701176	5.485773421	0.190121816	0	0	20	10	10	10	10	0	0											3.3892	0.468839315	1.520121069	0.914351626	2.279384481	7.489514358	1.36961708	6.11020626	0.208555219	0	0.694650114	0.027402588	0.216975832	0.108539932	0	4.906347696	2.042083424	1.971347371	4.766703589	0.702124133	5.675683538	0	0	0.805	0.273333333	0.189230769	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	46.1697	0	2.3309	3.3892	0.468839315	1.520121069	0.914351626	2.279384481	7.489514358	1.36961708	6.11020626	0.208555219	0	0.694650114	0.027402588	0.216975832	0.108539932	0	4.906347696	2.042083424	1.971347371	4.766703589	0.702124133	5.675683538	0	0	0.805	0.273333333	0.189230769	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	46.1697	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											6.5542	0.4999	0.1676	2.6679	0.3104	0.9629	0.1761	0	0.3493	0.1706	0.3482	0.0137	0	0.1656	0.2803	1.9385	0.3215	0.3255	0.6111	0.232	0.6924	0.0234	0	0	0	0	0	0	0	0											16.8111	0	0	9.9434	0.968696326	1.687694986	3.582269234	2.589805111	8.452460227	1.545712224	6.11020626	0.557858535	0.170633544	1.042874121	0.041103249	0.216975832	0.274146986	0.280282113	6.844837487	2.363581952	2.296856871	5.377770633	0.934082809	6.368111074	0.023368409	0	0.805	0.273333333	0.189230769	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	62.9808
H1264_011_0	2009	8																					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	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		292.9447726	53.67777727	589.1781777	5231.999971	1522.107413	36.33483788	8.409668623	2246.027074	213.7365587	6327.558448	957.4309551	189.1040411	0.133655392	433.2153627	9564.059073	20517.24285	2474.584897	3717.666017	4919.148555	1663.332264	20.16331551	26.74951112	4500	483	328	227.0769231	30.4	18.24	1664	6200											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	Medicare FFS Cost Sharing	$0.00 copayment	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"Copay between $0.00 and $20.00, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											0	0	40.51	0	21.92122424	0.2	0.2	21.60494074	0	0	6.663939054	0	0.2	0	0	0	0	0	9.174515061	3.934489867	0.2	0	0	20	10	10	10	10	0	0											0	0	39.66559321	0	21.46428939	0.195831119	0.195831119	21.15459864	0	0	6.525033219	0	0.195831119	0	0	0	0	0	8.983277767	3.852477773	0.195831119	0	0	20	10	10	10	10	0	0											0	0	1.947508494	0	2.7225795	7.115491971	1.646874819	3.95948344	0	0	0.520605732	0	0.026173885	0	0	0	0	0	3.682506487	0.533995881	3.948604645	0	0	0.805	0.273333333	0.189230769	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	27.4119	0	0.5557	0	0	1.947508494	0	2.7225795	7.115491971	1.646874819	3.95948344	0	0	0.520605732	0	0.026173885	0	0	0	0	0	3.682506487	0.533995881	3.948604645	0	0	0.805	0.273333333	0.189230769	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	27.4119	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											6.9758	0.6858	0.199	1.2204	0.3442	0.8882	0.2056	0	0.3626	0.1509	0.2793	0.0464	0	0.1761	0.3053	2.083	0.5549	0.3426	0.645	0.2461	0.4667	0.0168	0	0	0	0	0	0	0	0											16.1948	0	0	6.9758	0.685822477	2.146490448	1.220382324	3.066823801	8.003676897	1.852444497	3.95948344	0.362569536	0.150872428	0.799954852	0.046447961	0.026173885	0.176079493	0.305318713	2.082986172	0.554948725	0.342614271	4.327463325	0.7801081	4.415303742	0.016807573	0	0.805	0.273333333	0.189230769	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	43.6067
H1264_013_0	2009	8																					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	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		206.5600434	10.79097231	371.3756187	2834.553638	502.102191	19.18281025	5.915231334	1069.309222	173.9161342	3099.148589	567.1554487	48.20023917	0.063822842	298.5387755	8905.253226	22812.78328	519.4535835	3163.147063	4692.532535	2258.96701	34.73074294	25.83963697	3750	434.6666667	328	227.0769231	30.4	18.24	0	6200											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $20.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $20.00	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"Copay between $0.00 and $50.00, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	Not Covered	$0.00 copayment											0	0	56.13	3.042683049	32.54486217	0.2	0.2	21.3696633	0	0	6.904479109	0	0.2	2.393022806	0	4.681567424	15.46051407	8.232232526	14.47651072	3.910022122	0.2	0	0	50	10	10	10	10	0	0											0	0	53.81641737	2.917268856	31.2034186	0.191756342	0.191756342	20.48884232	0	0	6.619888286	0	0.191756342	2.294386498	0	4.48860122	14.82325812	7.892913977	13.8798137	3.748857696	0.191756342	0	0	50	10	10	10	10	0	0											0	0	1.665508775	0.689096254	1.305608737	3.678425522	1.134283123	1.825742338	0	0	0.312875476	0	0.012238435	0.057080278	0	8.533123906	0.641666212	2.080537305	5.427623113	0.705712155	6.65984022	0	0	1.811111111	0.273333333	0.189230769	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	37.0436	0	1.493	0	0	1.665508775	0.689096254	1.305608737	3.678425522	1.134283123	1.825742338	0	0	0.312875476	0	0.012238435	0.057080278	0	8.533123906	0.641666212	2.080537305	5.427623113	0.705712155	6.65984022	0	0	1.811111111	0.273333333	0.189230769	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	37.0436	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											4.8671	0.1426	0.1372	0.6504	0.1443	0.4689	0.1446	0	0.4135	0.0829	0.2015	0.015	0	0.3309	0.197	2.6049	0.101	0.2642	1.0336	0.38	0.8211	0.0162	0	0	0	0	0	0	0	0											13.0168	0	0	4.8671	0.142602089	1.802696426	1.33946302	1.449907704	4.147338662	1.278877666	1.825742338	0.413487577	0.082903544	0.514364662	0.015007926	0.012238435	0.387956423	0.197023151	11.13799172	0.742626995	2.34475456	6.461178181	1.085761819	7.480939293	0.016161433	0	1.811111111	0.273333333	0.189230769	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	50.0603
H1264_014_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1143.109366	75.01124785	312.1640915	2407.255783	459.9860831	19.26049187	4.639634493	1224.755644	187.4972882	2737.793666	701.7585527	30.7370095	0.125877206	370.4168959	7163.334468	17913.62339	387.0873407	2201.17103	3846.812681	2016.192583	29.87026599	40.58254551	0	818.4	496	117.4736842	65.6	13.34237288	0	0											"$150 days 1 - 3, $0 after day 3, unlimited coverage"	"$150 days 1 - 3, $0 after day 3, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $35.00	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $195.00, No benefit limit"	$10.00 copayment	"$10.00 copayment, $200 benefit limit,"	$10.00 copayment	"$10.00 copayment, $1,000 benefit limit"	Not Covered	Not Covered											53.96070317	34.12899668	56.13	4.964664226	30.75029637	0.2	0.2	21.74201887	68.45878377	0	15.71670131	39.37383757	0.2	9.309427074	6.140851775	7.96703572	26.31734061	13.83520124	18.17292853	5.588775197	0.2	0	0	0	10	10	10	10	0	0											50.95871891	32.23030551	53.00733172	4.688466123	29.03957171	0.188873443	0.188873443	20.53244979	64.65023089	0	14.84233743	37.18336129	0.188873443	8.791517709	5.799219082	7.523807326	24.85323363	13.06551045	17.16191788	5.277856062	0.188873443	0	0	0	10	10	10	10	0	0											4.8543	0.20146962	1.378915462	0.940528099	1.113149904	3.637795408	0.87630374	2.095602814	1.010145248	0	0.867978103	0.095242111	0.023774861	0.271377225	3.461812161	11.23155424	0.801697676	2.39661859	5.501556945	0.886764521	5.641699974	0	0	0	0.413333333	0.097894737	0.054666667	0.011118644	0	0	0	0	0	0	0	0	0	0	0	0	47.8653	0	2.7858	4.8543	0.20146962	1.378915462	0.940528099	1.113149904	3.637795408	0.87630374	2.095602814	1.010145248	0	0.867978103	0.095242111	0.023774861	0.271377225	3.461812161	11.23155424	0.801697676	2.39661859	5.501556945	0.886764521	5.641699974	0	0	0	0.413333333	0.097894737	0.054666667	0.011118644	0	0	0	0	0	0	0	0	0	0	0	0	47.8653	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											4.5511	0.1075	0.1133	0.5632	0.1351	0.4708	0.1134	0	0.4033	0.0725	0.2549	0.0115	0	0.1856	0.1849	2.1531	0.0784	0.2011	0.7678	0.3421	0.7043	0.0235	0	0	0	0	0	0	0	0											11.4375	0	0	9.4054	0.308993125	1.492172812	1.503752317	1.248287333	4.108607432	0.989717028	2.095602814	1.413438992	0.072485628	1.122845152	0.106741314	0.023774861	0.45700931	3.646697675	13.38467209	0.880107992	2.597698309	6.269381741	1.228886611	6.346015025	0.023526942	0	0	0.413333333	0.097894737	0.054666667	0.011118644	0	0	0	0	0	0	0	0	0	0	0	0	59.3028
H1264_016_0	2009	9																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	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		389.2966524	11.48285615	578.0811225	3142.937115	9.453619185	26.8536846	8.354622845	15.6633689	29.64980836	6377.520999	27.91495016	2.707411172	0.058284976	11.33561163	11927.84786	166.9596219	8.043889631	16.29069735	57.47463337	17.68122523	72.62487568	5.369002991	5400	818.4	0	0	0	0	1664	5800											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS Cost Sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	$0.00 copayment	"Copay between $0.00 and $195.00, No benefit limit"	Not Covered	Not Covered	Not Covered	Not Covered	$0.00 copayment	$0.00 copayment											830.9543236	464.8195031	74.50521894	0	0.189224612	0.2	0.2	0.135235258	0.2	0	0.2	0.2	0.2	0.2	0	0.118028276	0.2	0.2	0.199998508	0.124445123	0.2	0.2	0	0	0	0	0	0	0	0											830.9543236	464.8195031	74.50521894	0	0.189224612	0.2	0.2	0.135235258	0.2	0	0.2	0.2	0.2	0.2	0	0.118028276	0.2	0.2	0.199998508	0.124445123	0.2	0.2	0	0	0	0	0	0	0	0											26.9573	0.444787958	3.589171716	0	1.788857422	5.37073692	1.670924569	2.118239734	5.929961672	0	5.582990031	0.541482234	0.011656995	2.267122326	0	19.70595632	1.608777926	3.25813947	11.49484092	2.200342251	14.52497514	1.073800598	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.1401	0	0	26.9573	0.444787958	3.589171716	0	1.788857422	5.37073692	1.670924569	2.118239734	5.929961672	0	5.582990031	0.541482234	0.011656995	2.267122326	0	19.70595632	1.608777926	3.25813947	11.49484092	2.200342251	14.52497514	1.073800598	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.1401	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	26.9573	0.444787958	3.589171716	0	1.788857422	5.37073692	1.670924569	2.118239734	5.929961672	0	5.582990031	0.541482234	0.011656995	2.267122326	0	19.70595632	1.608777926	3.25813947	11.49484092	2.200342251	14.52497514	1.073800598	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.1401
H1286_001_0	2009	4																					800											D	D	D	V	T	P	P	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1341.666388	650.1689737	6584.696408	87.77486087	507.7902775	403.9035185	1129.204748	143.644904	94.0227694	10605.97595	1394.283489	0	5.224338523	236.0701496	147.5911982	6793.345289	4250.443019	34.86099182	0	0	1248.434887	798.6133189	1498.037626	0	182.0000636	141.3063859	46.85749586	13.66333203	0	0											"$75 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $800 (13c)"	"$75 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0 (11a)	"$0 (11b, 11c)"	$50 (4a); $0 n/c (4a1); $10 (4b)	$25 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$25 (3, 5, 9a); $0 (9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $10 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$0 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a9, 14a10); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											74.48352753	75	0	0	75	0	0	49.511026	25	0	0	0	0	24.09069289	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											57.59847086	57.99786151	0	0	57.99786151	0	0	38.28711506	19.3326205	0	0	0	0	18.62944893	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											6.4398	3.142367508	0	0	2.454229183	0	0	0.458312414	0.151475543	0	0	0	0	0.366488066	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.0127	0	3.8147	6.4398	3.142367508	0	0	2.454229183	0	0	0.458312414	0.151475543	0	0	0	0	0.366488066	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.0127		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $10 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $10 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a9, 14a10); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											1.9449	0.325	0.754	0.0367	0.2797	0.1539	0.1758	0.0312	0.0861	0.354	0.2929	0	0	0.0576	0.0157	1.7319	0.5516	0.0037	0	0	0.114	0.0853	0.1107	0	0.0089	0	0.004	0	0	0											7.1178	0	0	8.3847	3.467342508	0.754047673	0.036660412	2.733973676	0.153907564	0.175833973	0.489505425	0.237623014	0.354043916	0.292905659	0	0	0.424117152	0.015723156	1.731892253	0.55155	0.003682712	0	0	0.114001782	0.085322847	0.110719388	0	0.008933819	0	0.003969466	0	0	0	0	0	0	0	0	0	0	0	0	0	20.1305
H1286_002_0	2009	6																					2400											D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	3000	1554.214952	156.0414522	838.369459	476.0730775	93.39738022	9.979247512	4.041390704	414.4083221	205.08843	8949.394015	32.13035739	0	0.274878055	476.0475751	4302.654918	3718.135263	545.3527445	326.4760412	0	0	14.93360033	716.7527033	0	596.4349318	137.8935143	293.0916673	12.99373761	5.04	453.6	0											"$185 Days 1-13 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$185 Days 1-13 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-24 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$100 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); $100 (9a); $40/$30 (9c)"	"$5 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$25 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											182.8324056	185	100	0	150	0.2	0.0620578	47.4853051	100	2.8	0.169342279	0	0.2	35.52907331	3.611818663	20	37.5	20	0	0	0.2	18.97032991	0	25	20	0	20	0	0	0											119.7001114	121.0983392	65.45856171	0	98.18784257	0.130917123	0.040622143	31.08319775	65.45856171	1.832839728	0.11084902	0	0.130917123	23.45412684	3.611818663	20	37.5	13.09171234	0	0	0.130917123	18.97032991	0	25	20	0	20	0	0	0											15.5033	1.574696726	4.573204915	0	0.764207272	1.306454378	0.164169953	1.073427985	1.118732805	1.366900408	3.561618628	0	0.035986244	0.930440017	1.295034111	6.196892105	1.704227327	0.356177535	0	0	1.955063998	1.13308627	0	1.242572774	0.229822524	0	0.021656229	0	0	0	0	0	0	0	0	0	0	0	0	0	46.1077	0	18.0753	15.5033	1.574696726	4.573204915	0	0.764207272	1.306454378	0.164169953	1.073427985	1.118732805	1.366900408	3.561618628	0	0.035986244	0.930440017	1.295034111	6.196892105	1.704227327	0.356177535	0	0	1.955063998	1.13308627	0	1.242572774	0.229822524	0	0.021656229	0	0	0	0	0	0	0	0	0	0	0	0	0	46.1077		"$185 Days 1-17/$300 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$185 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-18 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	$175 (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); $175 (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.1175	0.1857	4.6138	0.3908	0.2203	0.5649	0.2288	0.3094	0.5643	0.394	1.5068	0	0.0104	0.4664	2.4187	4.6389	0.8278	0.231	0	0	1.0868	0.8562	0	0	0.1724	0	0.0162	0	0	0											21.821	0	9.684924828	17.6208	1.760386333	9.187013263	0.390812484	0.984490794	1.871334578	0.392934856	1.382844691	1.68306557	1.760910837	5.068397859	0	0.046359316	1.396818168	3.713685216	10.83581689	2.531994885	0.58718174	0	0	3.041908848	1.98927429	0	1.242572774	0.402189417	0	0.037898401	0	0	0	0	0	0	0	0	0	0	0	0	0	67.9287
H1286_003_0	2009	5																					2000											D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2500	1554.214952	156.0414522	838.369459	476.0730775	93.39738022	9.979247512	4.041390704	414.4083221	205.08843	8949.394015	32.13035739	0	0.274878055	476.0475751	4302.654918	3718.135263	545.3527445	326.4760412	0	0	14.93360033	716.7527033	0	596.4349318	137.8935143	293.0916673	12.99373761	5.04	453.6	0											"$125 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$125 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$75 Days 1-27 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$75 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$15 (3, 9d); $60 (5); $75 (9a); $40/$30 (9c)"	"$8 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$15 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$15 (7c, 7i)"	Included in h.2.	$8 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 n/c (10b)	"$25 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$15 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$15 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											123.5547968	125	75	0	150	0.2	0.0620578	47.4853051	75	2.8	0.169342279	0	0.2	26.79415683	5.778909861	15	37.5	15	0	0	0.2	14.22774743	0	25	15	0	15	0	0	0											82.67948948	83.62656263	50.17593758	0	100.3518752	0.1338025	0.041517444	31.76826273	50.17593758	1.873235003	0.113292101	0	0.1338025	18.11469146	5.778909861	15	37.5	10.03518752	0	0	0.1338025	14.22774743	0	25	15	0	15	0	0	0											10.7085	1.08743419	3.505497804	0	0.781050187	1.335248267	0.167788213	1.097086038	0.857542022	1.39702651	3.640115707	0	0.036779371	0.718621245	2.072054578	4.647669079	1.704227327	0.273020691	0	0	1.998153062	0.849814703	0	1.242572774	0.172366893	0	0.016242172	0	0	0	0	0	0	0	0	0	0	0	0	0	38.3088	0	13.6417	10.7085	1.08743419	3.505497804	0	0.781050187	1.335248267	0.167788213	1.097086038	0.857542022	1.39702651	3.640115707	0	0.036779371	0.718621245	2.072054578	4.647669079	1.704227327	0.273020691	0	0	1.998153062	0.849814703	0	1.242572774	0.172366893	0	0.016242172	0	0	0	0	0	0	0	0	0	0	0	0	0	38.3088		"$125 Days 1-20/$250 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$250 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$120 Days 1-21 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	$120 (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $75 (5); $120 (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $25 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.9053	0.2496	3.147	0.3908	0.2191	0.5619	0.2276	0.3078	0.3849	0.3919	1.4988	0	0.0103	0.3211	2.4176	3.3198	0.8278	0.1641	0	0	1.0811	0.6134	0	0	0.1231	0	0.0116	0	0	0											18.1746	0	8.22772372	12.6137	1.33704048	6.652538764	0.390812484	1.000170005	1.897144344	0.395344607	1.404868171	1.242468788	1.78895548	5.138934993	0	0.047097644	1.039711207	4.489656567	7.967432707	2.531994885	0.437152025	0	0	3.079256377	1.463164853	0	1.242572774	0.295486102	0	0.027843723	0	0	0	0	0	0	0	0	0	0	0	0	0	56.4834
H1286_004_0	2009	4																					2900											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	3600	1344.02807	163.4591212	592.3452046	580.2883182	106.6931789	10.64940447	4.22320878	403.1960823	30.52791085	9345.195984	37.82598821	0	0.15160697	21.02079985	4886.204763	3541.346796	618.5933418	228.9528919	0	0	12.39168985	763.4402318	0	0	127.2254496	0	14.81719058	0	453.6	0											"$225 Days 1-13 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$225 Days 1-13 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											222.3621995	225	77.60718127	0	150	0.2	0.067405292	47.48244294	0.2	2.8	0.172563894	0	0.2	0.197381602	6.97953404	20	37.5	20	0	0	0.2	19.11263966	0	0	20	0	20	0	0	0											154.6568024	156.4688863	53.96937432	0	104.3125909	0.139083454	0.046874805	33.02011096	0.139083454	1.947168363	0.120003912	0	0.139083454	0.137625583	6.97953404	20	37.5	13.90834545	0	0	0.139083454	19.11263966	0	0	20	0	20	0	0	0											17.3219	2.131355554	2.664041673	0	0.927453494	1.481155962	0.197962086	1.109464948	4.245927299	1.516389164	4.539266578	0	0.021086021	2.892999834	2.841952705	5.90224466	1.933104193	0.265362993	0	0	1.723479032	1.215946504	0	0	0.212042416	0	0.024695318	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1679	0	17.9594	17.3219	2.131355554	2.664041673	0	0.927453494	1.481155962	0.197962086	1.109464948	4.245927299	1.516389164	4.539266578	0	0.021086021	2.892999834	2.841952705	5.90224466	1.933104193	0.265362993	0	0	1.723479032	1.215946504	0	0	0.212042416	0	0.024695318	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1679		"$375 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$375 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-21 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.6222	0.1959	2.2243	0.1502	0.1414	0.3387	0.1343	0.1692	0.971	0.2312	1.0185	0	0.0032	0.6614	1.5774	2.5599	0.5477	0.1003	0	0	0.5584	0.5381	0	0	0.0928	0	0.0108	0	0	0											13.847	0	5.74511829	18.9441	2.327250488	4.888352729	0.150214398	1.06885682	1.819890543	0.332293246	1.278618481	5.216954284	1.747584015	5.557735101	0	0.024300881	3.554437795	4.419379221	8.462148287	2.480817048	0.365665911	0	0	2.281862337	1.754084188	0	0	0.304810973	0	0.035499519	0	0	0	0	0	0	0	0	0	0	0	0	0	67.0149
H1286_007_0	2009	3																					2900											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1616.063589	271.6976603	32.27299986	43570.02078	75.48110758	16.12208211	7.128015172	308.4817784	323.3943948	5121.502458	391.6736963	0	0.631168455	1251.479716	5058.14642	3748.831503	1242.868229	223.5215993	0	0	20.66242174	946.6505904	769.983193	0	314.3760437	332.2285714	0	0	20.2	0											"$225 Days 1-13 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$225 Days 1-13 (1b); $0 n/c (1b1, 1b2)"	13.1% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$75 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5, 9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											222.3	225	0.1306	0	75	0.14	0.2	49.96920402	75	4.4	64.79010385	0	0.2	70.22497571	3.246128667	25	20	20	0	0	0.2	13.6791576	0	0	0	0	0	0	0	0											162.5493188	164.523602	0.1306	0	54.84120068	0.102370241	0.146243202	36.53828194	54.84120068	3.21735044	47.37556116	0	0.146243202	51.34962648	3.246128667	25	20	20	0	0	0.146243202	13.6791576	0	0	0	0	0	0	0	0											21.8908	3.725056478	4.214853781	0	0.344956214	1.650421435	1.042423761	0.939282849	1.477944742	1.373139016	1.546313429	0	0.092304096	5.355251332	1.368282842	7.810065631	2.071447048	0.372535999	0	0	3.021738712	1.079115218	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.376	0	15.6075	21.8908	3.725056478	4.214853781	0	0.344956214	1.650421435	1.042423761	0.939282849	1.477944742	1.373139016	1.546313429	0	0.092304096	5.355251332	1.368282842	7.810065631	2.071447048	0.372535999	0	0	3.021738712	1.079115218	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.376		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											2.9082	0.2207	0.5096	0.4311	0.111	0.2546	0.1125	0.0677	0.5078	0.0799	0.2154	0	0.0066	0.405	0.5493	1.7258	0.1512	0.0593	0	0	0.3262	0.068	0.0569	0	0.0155	0	0	0	0.003	0											8.7853	0	0	24.7991	3.945736478	4.724427463	0.431143779	0.455929509	1.904980626	1.154971369	1.007000395	1.98571102	1.452999591	1.761670155	0	0.098947974	5.760240689	1.917591496	9.53584389	2.222647048	0.431799379	0	0	3.347987477	1.147157015	0.056935837	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	68.1612
H1286_008_0	2009	5																					3200											D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	3600	1662.826535	166.9459344	896.956358	509.3419961	99.92417198	11.42271975	4.625967374	443.3289721	219.420411	9574.795188	36.77793015	0	0.314638452	509.3147115	4613.923708	3977.481047	583.4630618	349.2908261	0	0	17.09370684	766.8407853	0	0	103.5923094	0	12.88706159	0	98.4	0											"$250 Days 1-13 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$250 Days 1-13 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$200 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); $200 (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											247.0498153	250	77.60718127	0	150	0.2	0.0620578	47.4850838	200	2.8	0.167197326	0	0.2	70.04055879	7.207056124	25	37.5	25	0	0	0.2	23.71291238	0	0	25	0	25	0	0	0											163.0770011	165.0038447	51.22193313	0	99.00230679	0.132003076	0.040959103	31.34088556	132.0030757	1.84804306	0.110352807	0	0.132003076	46.42205082	7.207056124	25	37.5	16.50038447	0	0	0.132003076	23.71291238	0	0	25	0	25	0	0	0											22.5974	2.295560085	3.828653216	0	0.824393628	1.50783414	0.189475472	1.157860215	2.413680761	1.474552817	4.058547815	0	0.041533243	1.970286119	2.77106726	8.286418848	1.823322068	0.480286077	0	0	2.256421879	1.515335696	0	0	0.215817311	0	0.026848045	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7353	0	23.2132	22.5974	2.295560085	3.828653216	0	0.824393628	1.50783414	0.189475472	1.157860215	2.413680761	1.474552817	4.058547815	0	0.041533243	1.970286119	2.77106726	8.286418848	1.823322068	0.480286077	0	0	2.256421879	1.515335696	0	0	0.215817311	0	0.026848045	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7353		"$275 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$275 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-24 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	$250 (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); $250 (9a); $45/$35 (9c)"	"$15 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$15 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											3.0514	0.3028	4.3376	0.4473	0.2416	0.6629	0.2684	0.3393	0.8842	0.4322	1.7478	0	0.0122	0.7229	2.0061	4.9706	0.8856	0.2534	0	0	1.2754	0.9167	0	0	0.1295	0	0.0161	0	0	0											23.9041	0	10.61894845	25.6488	2.598311399	8.166260547	0.447342495	1.066006175	2.170706163	0.457925055	1.497204852	3.29793001	1.906713438	5.806367353	0	0.053705769	2.693216825	4.777190187	13.25706131	2.708935644	0.733657342	0	0	3.531805656	2.432016034	0	0	0.345307698	0	0.042956872	0	0	0	0	0	0	0	0	0	0	0	0	0	83.6394
H1286_801_0	2009	2																					3350											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	4500	1643.212692	164.9767263	886.3763238	503.3340608	98.74551803	10.62365335	4.302361861	438.1043632	27.78893521	9461.855846	34.20516212	0	0.292628193	18.31136061	4560.658274	3923.709339	576.5808327	345.1707718	0	0	15.89793149	757.7955272	0	0	0	0	0	0	0	0											"$260 Days 1-13 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$260 Days 1-13 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-23 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											256.9294167	260	150	0	150	0.2	0.0620578	47.48511061	0.3	2.8	0.237368408	0	0.2	0.294994755	25.21829146	34.96896951	37.5	35	0	0	0.2	33.19807734	0	0	0	0	0	0	0	0											159.2060767	161.085747	92.93408479	0	92.93408479	0.123912113	0.038448566	29.41990197	0.18586817	1.734769583	0.147064105	0	0.123912113	0.183264874	25.21829146	34.96896951	37.5	21.68461978	0	0	0.123912113	33.19807734	0	0	0	0	0	0	0	0											21.8008	2.214616599	6.864547702	0	0.764735362	1.316399335	0.165419643	1.074082285	5.165078523	1.367844976	5.030351564	0	0.036260178	3.355829199	9.584334133	11.43400602	1.801815102	0.623741412	0	0	1.969946284	2.09644621	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.6662	0	31.757	21.8008	2.214616599	6.864547702	0	0.764735362	1.316399335	0.165419643	1.074082285	5.165078523	1.367844976	5.030351564	0	0.036260178	3.355829199	9.584334133	11.43400602	1.801815102	0.623741412	0	0	1.969946284	2.09644621	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.6662		"$375 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 40% (13c)"	"$375 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 40% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											4.0685	0.4044	4.9565	0.5547	0.2366	0.611	0.2475	0.3324	2.1311	0.4233	2.0755	0	0.0112	1.3822	5.0137	5.5251	0.8752	0.2836	0	0	1.1756	1.0337	0	0	0	0	0	0	0	0											31.3417	0	13.71449445	25.8693	2.618967513	11.820999	0.554732055	1.001378167	1.92742724	0.412873421	1.406450653	7.296148917	1.79111646	7.105834685	0	0.047480674	4.737999714	14.59805211	16.95907721	2.676982438	0.907352448	0	0	3.14558057	3.13017099	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.0079
H1286_803_0	2009	2																					3350											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	4500	1643.212692	164.9767263	886.3763238	503.3340608	98.74551803	10.62365335	4.302361861	438.1043632	27.78893521	9461.855846	34.20516212	0	0.292628193	18.31136061	4560.658274	3923.709339	576.5808327	345.1707718	0	0	15.89793149	757.7955272	0	0	0	0	0	0	0	0											"$260 Days 1-13 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$260 Days 1-13 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-23 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											256.9294167	260	150	0	150	0.2	0.0620578	47.48511061	0.3	2.8	0.237368408	0	0.2	0.294994755	25.21829146	34.96896951	37.5	35	0	0	0.2	33.19807734	0	0	0	0	0	0	0	0											159.2060767	161.085747	92.93408479	0	92.93408479	0.123912113	0.038448566	29.41990197	0.18586817	1.734769583	0.147064105	0	0.123912113	0.183264874	25.21829146	34.96896951	37.5	21.68461978	0	0	0.123912113	33.19807734	0	0	0	0	0	0	0	0											21.8008	2.214616599	6.864547702	0	0.764735362	1.316399335	0.165419643	1.074082285	5.165078523	1.367844976	5.030351564	0	0.036260178	3.355829199	9.584334133	11.43400602	1.801815102	0.623741412	0	0	1.969946284	2.09644621	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.6662	0	31.757	21.8008	2.214616599	6.864547702	0	0.764735362	1.316399335	0.165419643	1.074082285	5.165078523	1.367844976	5.030351564	0	0.036260178	3.355829199	9.584334133	11.43400602	1.801815102	0.623741412	0	0	1.969946284	2.09644621	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.6662		"$375 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 40% (13c)"	"$375 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 40% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											4.0685	0.4044	4.9565	0.5547	0.2366	0.611	0.2475	0.3324	2.1311	0.4233	2.0755	0	0.0112	1.3822	5.0137	5.5251	0.8752	0.2836	0	0	1.1756	1.0337	0	0	0	0	0	0	0	0											31.3417	0	13.71449445	25.8693	2.618967513	11.820999	0.554732055	1.001378167	1.92742724	0.412873421	1.406450653	7.296148917	1.79111646	7.105834685	0	0.047480674	4.737999714	14.59805211	16.95907721	2.676982438	0.907352448	0	0	3.14558057	3.13017099	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.0079
H1302_001_0	2009	13																					1500											A	A	D	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	V	V	V	V	V	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	3000	183.8715486	2.719636085	290.0581165	22.2820982	4.526247815	7.566693039	4.8162633	248.3842581	29.78004208	4.455570948	13.62864786	0	0.531486501	386.9677407	2599.217163	3483.19023	103.5170807	339.5406534	15.995416	8.846458543	6.819400219	0	0	0	337.4092707	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/Days Custom 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/Visit for Prof - CORF; $20/Visit 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 Chiropractor; $20/Service for Podiatrist; $20/Exam for Vision Exams; 10% Coinsurance for Hearing/Speech Exams;	$20/Visit for OP Psych - Non-Physician; $20/Visit for OP Psych - Psychiatrist; $20/Visit for OP Substance Abuse;	$20/Visit for PT/ST (PCP); $20/Visit for Occ Therapy (PCP); $20/Visit for PT/ST (Specialist); $20/Visit for Occ Therapy (Specialist);	10% Coinsurance for Prof Radiology (Office); 10% Coinsurance for Prof Radiology (OP); 10% Coinsurance for Prof Radiology (IP);	10% Coinsurance for Misc. Medical (PCP); 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)																500	499.9999999	25	0.1	0.1	0.1	0.1	42.18935459	0.1	0.1	0.1	0	0.1	20	20	19.69753798	20	20.00000001	0.1	0.1	0.1	0	0	0	20	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	449.0419607	449.0419606	22.45209804	0.089808392	0.089808392	0.089808392	0.089808392	37.88958101	0.089808392	0.089808392	0.089808392	0	0.089808392	17.96167842	17.96167843	17.69004215	17.96167843	17.96167843	0.089808392	0.089808392	0.089808392	0	0	0	17.96167843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.8805	0.101769227	0.542701106	2.001119413	0.406495039	0.679552536	0.432540863	0.784264622	2.674497697	0.400147663	1.223966952	0	0.047731948	0.579215843	3.890525237	5.134815167	0.154945043	0.508226669	1.436522593	0.794486218	0.612439369	0	0	0	0.505036402	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7915	0	3.3751	6.8805	0.101769227	0.542701106	2.001119413	0.406495039	0.679552536	0.432540863	0.784264622	2.674497697	0.400147663	1.223966952	0	0.047731948	0.579215843	3.890525237	5.134815167	0.154945043	0.508226669	1.436522593	0.794486218	0.612439369	0	0	0	0.505036402	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7915	0	$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		10% 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 Blood Products	25% Coinsurance for OP Fac - Cardiovascular;																			1.2602	0.0208	0.4368	0.517	0.0529	0.2282	0.1407	0.1206	0.8774	0.1295	0.4008	0	0.0071	0.3662	0.4986	1.1419	0.0186	0.1974	0.445	0.5057	0.1937	0.0216	0	0	0	0	0	0	0	0											7.5806	0	1.024692919	8.1407	0.122597687	0.979524069	2.518099571	0.459383825	0.907759278	0.573250768	0.904870182	3.551855716	0.529643807	1.62473431	0	0.054881431	0.945392847	4.38914549	6.276686519	0.173526507	0.705578146	1.881489293	1.300165864	0.806186975	0.021604211	0	0	0.505036402	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.3721
H1302_004_0	2009	13																					1500											A	A	D	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	V	V	V	V	V	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	3000	187.2140416	2.889860587	298.0439741	20.11287175	4.578010683	7.745450199	4.871547799	249.3976539	29.87487397	4.796909961	14.05596038	0	0.57434552	387.6087344	2367.61903	3261.146949	96.00622213	327.2167565	15.28178264	8.232527101	7.059155908	0	0	0	344.135544	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/Days Custom 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/Visit for Prof - CORF; $20/Visit 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 Chiropractor; $20/Service for Podiatrist; $20/Exam for Vision Exams; 10% Coinsurance for Hearing/Speech Exams;	$20/Visit for OP Psych - Non-Physician; $20/Visit for OP Psych - Psychiatrist; $20/Visit for OP Substance Abuse;	$20/Visit for PT/ST (PCP); $20/Visit for Occ Therapy (PCP); $20/Visit for PT/ST (Specialist); $20/Visit for Occ Therapy (Specialist);	10% Coinsurance for Prof Radiology (Office); 10% Coinsurance for Prof Radiology (OP); 10% Coinsurance for Prof Radiology (IP);	10% Coinsurance for Misc. Medical (PCP); 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)																500	500	25	0.1	0.1	0.1	0.1	42.93102825	0.1	0.1	0.1	0	0.1	20	20	19.69747516	20.00000001	20	0.1	0.1	0.1	0	0	0	20	0	0	0	0	0											450.3245409	450.3245407	22.51622704	0.090064908	0.090064908	0.090064908	0.090064908	38.66579117	0.090064908	0.090064908	0.090064908	0	0.090064908	18.01298164	18.01298164	17.74051292	18.01298165	18.01298164	0.090064908	0.090064908	0.090064908	0	0	0	18.01298164	0	0	0	0	0											7.0256	0.108447928	0.559235483	1.811463947	0.412318112	0.697593261	0.438755505	0.803596467	2.690677781	0.432033255	1.26594878	0	0.051728376	0.581832418	3.553989843	4.821201632	0.144113193	0.491179119	1.37635235	0.741461798	0.635782229	0	0	0	0.516575603	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.1599	0	3.2109	7.0256	0.108447928	0.559235483	1.811463947	0.412318112	0.697593261	0.438755505	0.803596467	2.690677781	0.432033255	1.26594878	0	0.051728376	0.581832418	3.553989843	4.821201632	0.144113193	0.491179119	1.37635235	0.741461798	0.635782229	0	0	0	0.516575603	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.1599	0	$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		10% 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 Blood Products	25% Coinsurance for OP Fac - Cardiovascular;																			1.2418	0.0205	0.4173	0.4737	0.05	0.2158	0.133	0.1139	0.8206	0.1325	0.3887	0	0.0072	0.3484	0.4644	1.0627	0.0173	0.1839	0.4147	0.4631	0.1917	0.0214	0	0	0	0	0	0	0	0											7.1826	0	0.90642203	8.2674	0.128975207	0.97652695	2.285135172	0.462326069	0.913360157	0.571800982	0.917526103	3.511279584	0.564520517	1.654675349	0	0.05894877	0.930233987	4.018389395	5.883942065	0.161427317	0.675057124	1.79102846	1.204512068	0.82746537	0.021374009	0	0	0.516575603	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.3424
H1303_001_0	2009	4																					2400											D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	3000	1128.377114	145.220111	1073.991218	425.6199445	103.861175	11.76100219	4.739450266	371.4536356	245.8313272	7805.775924	33.52486556	0	0.08759691	812.9429899	4294.399806	3680.872855	562.0403405	342.0483855	0	0	9.076067506	668.9377956	0	0	162.1440608	196.0223467	14.95173635	8.976	390.9644297	0											"$195 Days 1-5 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$195 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-24 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$100 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); $100 (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											119.327871	88.37326986	100	0	150	0.2	0.074140787	48.76070554	100	2.8	0.180462703	0	0.2	35.82004376	7.123300655	25	37.5	25	0	0	0.2	24.26769207	0	0	25	0	25	0	0	0											87.62517749	64.87732929	73.41284235	0	110.1192635	0.146825685	0.054428859	35.79661989	73.41284235	2.055559586	0.1324828	0	0.146825685	26.38602693	7.123300655	25	37.5	18.35321059	0	0	0.146825685	24.26769207	0	0	25	0	25	0	0	0											8.2395	0.785124414	6.570395666	0	0.953093008	1.7268172	0.25796287	1.108065383	1.503931372	1.337103127	4.441468058	0	0.012861476	1.787527968	2.549191746	7.668485114	1.756376064	0.523140504	0	0	1.332599826	1.352798036	0	0	0.337800127	0	0.031149451	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2754	0	11.0635	8.2395	0.785124414	6.570395666	0	0.953093008	1.7268172	0.25796287	1.108065383	1.503931372	1.337103127	4.441468058	0	0.012861476	1.787527968	2.549191746	7.668485114	1.756376064	0.523140504	0	0	1.332599826	1.352798036	0	0	0.337800127	0	0.031149451	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2754		"$300 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$300 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-18 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"50% (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a7, 14a8, 14a9, 14a10); $0 (14a6)"	"$0 n/c (13b, 13d, 13e)"											0.9801	0.1235	3.577	0.0943	0.1221	0.3318	0.1337	0.1419	0.8212	0.1713	0.8364	0	0.0016	0.6566	1.3877	2.6802	0.4976	0.1329	0	0	0.3627	0.4761	0	0	0.1182	0.1641	0.0109	0	0	0											13.8219	0	7.508812426	9.2196	0.908612126	10.14735763	0.094301682	1.075179932	2.058613465	0.391670174	1.250003571	2.325086281	1.508380019	5.277849674	0	0.014508974	2.44408437	3.936876509	10.3487246	2.254015949	0.656047526	0	0	1.695337409	1.828924241	0	0	0.456030171	0.164055467	0.042051758	0	0	0	0	0	0	0	0	0	0	0	0	0	58.0973
H1303_003_0	2009	3																					2200											D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2600	1128.377114	145.220111	1073.991218	425.6199445	103.861175	11.76100219	4.739450266	371.4536356	245.8313272	7805.775924	33.52486556	0	0.08759691	812.9429899	4294.399806	3680.872855	562.0403405	342.0483855	0	0	9.076067506	668.9377956	0	0	162.1440608	196.0223467	14.95173635	8.992	390.9644297	0											"$140 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$140 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$75 Days 1-30 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$75 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$15 (3, 9d); $60 (5); $75 (9a); $40/$30 (9c)"	"$8 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$15 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$15 (7c, 7i)"	Included in h.2.	$8 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$15 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$15 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											138.3991012	140	75	0	150	0.2	0.074140787	48.76070554	75	2.8	0.151215947	0	0.2	26.89440165	5.698640524	15	37.5	15	0	0	0.2	14.56061524	0	0	15	0	15	0	0	0											100.4927083	101.6309468	54.44515006	0	108.8903001	0.145187067	0.053821417	35.39711907	54.44515006	2.032618936	0.109772999	0	0.145187067	19.6158696	5.698640524	15	37.5	10.88903001	0	0	0.145187067	14.56061524	0	0	15	0	15	0	0	0											9.4495	1.229904781	4.872801086	0	0.942456209	1.707545411	0.255083929	1.095699047	1.115360292	1.322180663	3.680125046	0	0.012717938	1.328881973	2.039353397	4.601091069	1.756376064	0.310381261	0	0	1.317727619	0.811678822	0	0	0.202680076	0	0.01868967	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0702	0	10.801	9.4495	1.229904781	4.872801086	0	0.942456209	1.707545411	0.255083929	1.095699047	1.115360292	1.322180663	3.680125046	0	0.012717938	1.328881973	2.039353397	4.601091069	1.756376064	0.310381261	0	0	1.317727619	0.811678822	0	0	0.202680076	0	0.01868967	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0702		"$265 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$265 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"50% (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a7, 14a8, 14a9, 14a10); $0 (14a6)"	"$0 n/c (13b, 13d, 13e)"											0.9092	0.1143	2.141	0.0988	0.1279	0.3475	0.1401	0.1487	0.8601	0.1794	0.7373	0	0.0017	0.687	1.3931	2.3005	0.4976	0.1193	0	0	0.3799	0.4086	0	0	0.1013	0.1641	0.0093	0	0	0											11.8667	0	5.601746833	10.3587	1.34416075	7.013752474	0.098775667	1.070335343	2.055083194	0.395134752	1.244371255	1.975473519	1.501583499	4.417448525	0	0.014443598	2.015856626	3.432403473	6.901636603	2.254015949	0.429706324	0	0	1.697674679	1.220290702	0	0	0.304020114	0.164055467	0.028034506	0	0	0	0	0	0	0	0	0	0	0	0	0	49.937
H1303_004_0	2009	4																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		325.6404987	22.4928	64.61154675	2649.801267	13.94615372	34.9733567	13.60771787	26.23972093	34.21225855	12.55602746	26.10736773	0	1.285365916	42.37181674	37.67673988	121.497145	13.9175	7.729450514	0	0	16.40764726	5.474357561	65.40385931	0	153.3814709	170.6206518	0	0	20.2	0											"8% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"8% (1b); $0 n/c (1b1, 1b2)"	17.9% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.078785652	0.0798	0.1787	0	0.2	0.2	0.2	0.127034004	0.2	0.08	0.2	0	0.2	0.2	0	0.199754189	0.2	0.2	0	0	0.2	0.015702801	0	0	0	0	0	0	0	0											0.078785652	0.0798	0.1787	0	0.2	0.2	0.2	0.127034004	0.2	0.08	0.2	0	0.2	0.2	0	0.199754189	0.2	0.2	0	0	0.2	0.015702801	0	0	0	0	0	0	0	0											25.6558	1.79492544	11.5460834	0	2.789230743	6.994671339	2.721543573	3.333336821	6.842451709	1.004482197	5.221473545	0	0.257073183	8.474363349	0	24.26956371	2.7835	1.545890103	0	0	3.281529451	0.085962747	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.6019	0	0	25.6558	1.79492544	11.5460834	0	2.789230743	6.994671339	2.721543573	3.333336821	6.842451709	1.004482197	5.221473545	0	0.257073183	8.474363349	0	24.26956371	2.7835	1.545890103	0	0	3.281529451	0.085962747	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.6019		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											4.0705	0.2812	1.0202	0.5098	0.2202	0.5522	0.2149	0.1755	0.5402	0.1983	0.4122	0	0.0135	0.669	0.5949	1.9184	0.2198	0.122	0	0	0.2591	0.0704	0.0261	0	0.0155	0	0	0	0.003	0											12.1067	0	0	29.7263	2.07608544	12.56626572	0.509787578	3.00943317	7.546882235	2.936402276	3.508885301	7.382645265	1.202735262	5.633695141	0	0.270603351	9.143392034	0.594895893	26.18793969	3.00325	1.667934058	0	0	3.540597566	0.156328846	0.0261	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	120.7086
H1303_006_0	2009	3																					2500											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1711.118325	255.8892592	36.18116364	46132.75215	79.92080715	18.07441804	7.991196496	326.6150957	342.4160282	5422.742504	414.7114284	0	0.701985186	1324.046204	5351.509282	3969.332846	1242.868229	236.6688461	0	0	23.22210031	1002.331334	769.983193	0	314.3760437	332.2285714	0	0	20.2	0											"$175 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	17.9% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$75 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5, 9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											172.9	175	0.1787	0	75	0.14	0.2	49.97091378	75	4.4	64.79010385	0	0.2	70.2685162	3.248646386	25	20	20	0	0	0.2	13.6791576	0	0	0	0	0	0	0	0											123.7907547	125.2942862	0.1787	0	53.69755121	0.100235429	0.14319347	35.77754269	53.69755121	3.150256338	46.38759892	0	0.14319347	50.3099633	3.248646386	25	20	20	0	0	0.14319347	13.6791576	0	0	0	0	0	0	0	0											17.6517	2.671788505	6.465573943	0	0.357629303	1.811697045	1.144287155	0.973790461	1.532241851	1.423585745	1.603122284	0	0.100519695	5.551059661	1.44876344	8.269443429	2.071447048	0.394448077	0	0	3.325253121	1.142587358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.939	0	15.1332	17.6517	2.671788505	6.465573943	0	0.357629303	1.811697045	1.144287155	0.973790461	1.532241851	1.423585745	1.603122284	0	0.100519695	5.551059661	1.44876344	8.269443429	2.071447048	0.394448077	0	0	3.325253121	1.142587358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.939		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.2345	0.2078	0.5713	0.4834	0.1244	0.2854	0.1262	0.0717	0.5647	0.0888	0.2395	0	0.0074	0.4502	0.6146	1.9348	0.1512	0.0664	0	0	0.3667	0.0763	0.0569	0	0.0155	0	0	0	0.003	0											9.7408	0	0	20.8862	2.879628505	7.036855474	0.483354002	0.482041132	2.097082593	1.270463942	1.045484611	2.096979208	1.51240663	1.842641908	0	0.107909012	6.001303458	2.063402222	10.20420828	2.222647048	0.460888075	0	0	3.691917863	1.218868812	0.056935837	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	67.6797
H1303_801_0	2009	2																					3900											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	4800	1184.795941	152.4811129	1127.690752	446.9009309	109.0542311	12.3490517	4.976422536	389.9807253	30.56238266	8196.064521	35.20110712	0	0.091976751	24.59172166	4539.790229	3858.929051	590.1423431	359.150796	0	0	9.529870417	702.3846683	0	0	0	0	0	0	0	0											"$170 Days 1-23 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$170 Days 1-23 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											168.0373563	170	150	0	150	0.2	0.074140787	48.76056069	0.3	2.8	0.2545014	0	0.2	0.297005743	24.76311626	34.95408858	37.5	35	0	0	0.2	33.97476889	0	0	0	0	0	0	0	0											122.5699099	123.9776081	109.3920071	0	109.3920071	0.14585601	0.054069397	35.56010402	0.218784014	2.041984133	0.185602793	0	0.14585601	0.216864009	24.76311626	34.95408858	37.5	25.52480167	0	0	0.14585601	33.97476889	0	0	0	0	0	0	0	0											12.1017	1.575353638	10.28002956	0	0.994138435	1.801183402	0.269072164	1.155646263	6.686560765	1.394686142	6.5334238	0	0.013415362	5.333059348	9.368279438	11.24044565	1.844194822	0.763937736	0	0	1.38998887	1.988613065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.7337	0	18.6571	12.1017	1.575353638	10.28002956	0	0.994138435	1.801183402	0.269072164	1.155646263	6.686560765	1.394686142	6.5334238	0	0.013415362	5.333059348	9.368279438	11.24044565	1.844194822	0.763937736	0	0	1.38998887	1.988613065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.7337		"$415 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 40% (13c)"	"$415 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-28 (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 40% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.6166	0.2047	4.287	0.1507	0.1463	0.3977	0.1602	0.1701	1.3122	0.2053	1.2822	0	0.002	1.0459	2.8867	3.1727	0.5225	0.182	0	0	0.4347	0.5713	0	0	0	0	0	0	0	0											18.751	0	7.57468294	13.7183	1.780089222	14.56706494	0.150695717	1.1404612	2.198845527	0.429322101	1.325740638	7.998780501	1.599963722	7.815590814	0	0.015389909	6.378932058	12.25497036	14.4131924	2.366716688	0.945984356	0	0	1.824734565	2.559960561	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.4848
H1303_803_0	2009	2																					3900											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	4800	1184.795941	152.4811129	1127.690752	446.9009309	109.0542311	12.3490517	4.976422536	389.9807253	30.56238266	8196.064521	35.20110712	0	0.091976751	24.59172166	4539.790229	3858.929051	590.1423431	359.150796	0	0	9.529870417	702.3846683	0	0	0	0	0	0	0	0											"$170 Days 1-23 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$170 Days 1-23 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											168.0373563	170	150	0	150	0.2	0.074140787	48.76056069	0.3	2.8	0.2545014	0	0.2	0.297005743	24.76311626	34.95408858	37.5	35	0	0	0.2	33.97476889	0	0	0	0	0	0	0	0											122.5699099	123.9776081	109.3920071	0	109.3920071	0.14585601	0.054069397	35.56010402	0.218784014	2.041984133	0.185602793	0	0.14585601	0.216864009	24.76311626	34.95408858	37.5	25.52480167	0	0	0.14585601	33.97476889	0	0	0	0	0	0	0	0											12.1017	1.575353638	10.28002956	0	0.994138435	1.801183402	0.269072164	1.155646263	6.686560765	1.394686142	6.5334238	0	0.013415362	5.333059348	9.368279438	11.24044565	1.844194822	0.763937736	0	0	1.38998887	1.988613065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.7337	0	18.6571	12.1017	1.575353638	10.28002956	0	0.994138435	1.801183402	0.269072164	1.155646263	6.686560765	1.394686142	6.5334238	0	0.013415362	5.333059348	9.368279438	11.24044565	1.844194822	0.763937736	0	0	1.38998887	1.988613065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.7337		"$415 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 40% (13c)"	"$415 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-28 (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 40% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.6166	0.2047	4.287	0.1507	0.1463	0.3977	0.1602	0.1701	1.3122	0.2053	1.2822	0	0.002	1.0459	2.8867	3.1727	0.5225	0.182	0	0	0.4347	0.5713	0	0	0	0	0	0	0	0											18.751	0	7.57468294	13.7183	1.780089222	14.56706494	0.150695717	1.1404612	2.198845527	0.429322101	1.325740638	7.998780501	1.599963722	7.815590814	0	0.015389909	6.378932058	12.25497036	14.4131924	2.366716688	0.945984356	0	0	1.824734565	2.559960561	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.4848
H1304_001_0	2009	6	h.5.										OP Facility - Other										1500	Urgent Care										D	D	D		T	Coin	Coin	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	3000	677.4380423	8.557411173			0.890892766	14.67108843	0.617862813	308.541784							7117.441631	865.7061266	250.7821721	1967.075046		707.839101	6.965952266				87.55971072						69.93931602										$100/day (days 1-5)	$100/day (days 1-5)			$100 	10%	10%	$50 							$10 	$10 	$10 	$10 		$10 chiro	10%				$10 						$10 										100	100			100	0.1	0.1	50	0	0	0	0	0	0	10	10	10	10	0	10	0.1	0	0	0	10	0					10										99.20135606	99.20135606	0	0	99.20135606	0.099201356	0.099201356	49.60067803	0	0	0	0	0	0	9.920135606	9.920135606	9.920135606	9.920135606	0	9.920135606	0.099201356	0	0	0	9.920135606	0					9.920135606										5.6002	0.070742233	0	0	0.007364814	1.455391867	0.061292829	1.275323474	0	0	0	0	0	0	5.883832179	0.715660181	0.207316096	1.6261376	0	0.585154989	0.691031911	0	0	0	0.072383684	0	0	0	0	0	0.057817292	0	0	0	0	0	0	0	0	0	18.3097	0	0.15	5.6002	0.070742233	0	0	0.007364814	1.455391867	0.061292829	1.275323474	0	0	0	0	0	0	5.883832179	0.715660181	0.207316096	1.6261376	0	0.585154989	0.691031911	0	0	0	0.072383684	0	0	0	0	0	0.057817292	0	0	0	0	0	0	0	0	0	18.3097	N/A	$250/day (days 1-5)	$250/day (days 1-5)	$25/day (days 1-100)	20%	$100 	20%	20%	$50 	$100 	No cost sharing	20%	No cost sharing	No cost sharing	No cost sharing	$25 	$25 	$25 	$25 	No cost sharing	$25 	10%	No cost sharing	No cost sharing	No cost sharing	$25 	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$25 										1.4966	0.1136	0.5573	0.1865	0.8437	0.9033	0.0569	0.0669	0.2709	0	0	0	0	0	2.7819	0.4927	0.8037	1.1538	0	2.1548	0.0349	0	0	0	0.0268	0	0	0	0	0	0.107										12.0514	0	0.19	7.0968	0.184376298	0.557273064	0.186543631	0.851034062	2.358718641	0.118240822	1.342208964	0.270886234	0	0	0	0	0	8.665763951	1.20838329	1.011056734	2.779912302	0	2.739982524	0.725892479	0	0	0	0.099191062	0	0	0	0	0	0.164834076	0	0	0	0	0	0	0	0	0	30.3611
H1304_002_0	2009	7	h.5.										OP Facility - Other										1500	Urgent Care										D	D	D		T	Coin	Coin	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	3000	677.4380423	8.557411173			0.890892766	14.67108843	0.617862813	308.541784							7117.441631	865.7061266	250.7821721	1967.075046		707.839101	6.965952266				87.55971072						69.93931602										$100/day (days 1-5)	$100/day (days 1-5)			$100 	10%	10%	$50 							$10 	$10 	$10 	$10 		$10 chiro	10%				$10 						$10 										100	100			100	0.1	0.1	50	0	0	0	0	0	0	10	10	10	10	0	10	0.1	0	0	0	10	0					10										99.20135606	99.20135606	0	0	99.20135606	0.099201356	0.099201356	49.60067803	0	0	0	0	0	0	9.920135606	9.920135606	9.920135606	9.920135606	0	9.920135606	0.099201356	0	0	0	9.920135606	0					9.920135606										5.6002	0.070742233	0	0	0.007364814	1.455391867	0.061292829	1.275323474	0	0	0	0	0	0	5.883832179	0.715660181	0.207316096	1.6261376	0	0.585154989	0.691031911	0	0	0	0.072383684	0	0	0	0	0	0.057817292	0	0	0	0	0	0	0	0	0	18.3097	0	0.15	5.6002	0.070742233	0	0	0.007364814	1.455391867	0.061292829	1.275323474	0	0	0	0	0	0	5.883832179	0.715660181	0.207316096	1.6261376	0	0.585154989	0.691031911	0	0	0	0.072383684	0	0	0	0	0	0.057817292	0	0	0	0	0	0	0	0	0	18.3097	N/A	$250/day (days 1-5)	$250/day (days 1-5)	$25/day (days 1-100)	20%	$100 	20%	20%	$50 	$100 	No cost sharing	20%	No cost sharing	No cost sharing	No cost sharing	$25 	$25 	$25 	$25 	No cost sharing	$25 	10%	No cost sharing	No cost sharing	No cost sharing	$25 	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$25 										1.4966	0.1136	0.5573	0.1865	0.8437	0.9033	0.0569	0.0669	0.2709	0	0	0	0	0	2.7819	0.4927	0.8037	1.1538	0	2.1548	0.0349	0	0	0	0.0268	0	0	0	0	0	0.107										12.0514	0	0.19	7.0968	0.184376298	0.557273064	0.186543631	0.851034062	2.358718641	0.118240822	1.342208964	0.270886234	0	0	0	0	0	8.665763951	1.20838329	1.011056734	2.779912302	0	2.739982524	0.725892479	0	0	0	0.099191062	0	0	0	0	0	0.164834076	0	0	0	0	0	0	0	0	0	30.3611
H1304_004_0	2009	7	h.5.										OP Facility - Other										1500	Urgent Care										D	D	D		T	Coin	Coin	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	3000	677.4380423	8.557411173			0.890892766	14.67108843	0.617862813	308.541784							7117.441631	865.7061266	250.7821721	1967.075046		707.839101	6.965952266				87.55971072						69.93931602										$100/day (days 1-5)	$100/day (days 1-5)			$100 	10%	10%	$50 							$10 	$10 	$10 	$10 		$10 chiro	10%				$10 						$10 										100	100			100	0.1	0.1	50	0	0	0	0	0	0	10	10	10	10	0	10	0.1	0	0	0	10	0					10										99.20135606	99.20135606	0	0	99.20135606	0.099201356	0.099201356	49.60067803	0	0	0	0	0	0	9.920135606	9.920135606	9.920135606	9.920135606	0	9.920135606	0.099201356	0	0	0	9.920135606	0					9.920135606										5.6002	0.070742233	0	0	0.007364814	1.455391867	0.061292829	1.275323474	0	0	0	0	0	0	5.883832179	0.715660181	0.207316096	1.6261376	0	0.585154989	0.691031911	0	0	0	0.072383684	0	0	0	0	0	0.057817292	0	0	0	0	0	0	0	0	0	18.3097	0	0.15	5.6002	0.070742233	0	0	0.007364814	1.455391867	0.061292829	1.275323474	0	0	0	0	0	0	5.883832179	0.715660181	0.207316096	1.6261376	0	0.585154989	0.691031911	0	0	0	0.072383684	0	0	0	0	0	0.057817292	0	0	0	0	0	0	0	0	0	18.3097	N/A	$250/day (days 1-5)	$250/day (days 1-5)	$25/day (days 1-100)	20%	$100 	20%	20%	$50 	$100 	No cost sharing	20%	No cost sharing	No cost sharing	No cost sharing	$25 	$25 	$25 	$25 	No cost sharing	$25 	10%	No cost sharing	No cost sharing	No cost sharing	$25 	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$25 										1.4966	0.1136	0.5573	0.1865	0.8437	0.9033	0.0569	0.0669	0.2709	0	0	0	0	0	2.7819	0.4927	0.8037	1.1538	0	2.1548	0.0349	0	0	0	0.0268	0	0	0	0	0	0.107										12.0514	0	0.19	7.0968	0.184376298	0.557273064	0.186543631	0.851034062	2.358718641	0.118240822	1.342208964	0.270886234	0	0	0	0	0	8.665763951	1.20838329	1.011056734	2.779912302	0	2.739982524	0.725892479	0	0	0	0.099191062	0	0	0	0	0	0.164834076	0	0	0	0	0	0	0	0	0	30.3611
H1304_006_0	2009	6	h.5.										OP Facility - Other										2500	Urgent Care										D	D	D	Coin	T	Coin	Coin	V	V		Coin				V	V	V	V	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	5000	677.4380423	8.557411173	767.4482939	9.673762614	0.749159826	14.30199453	0.590972014	308.541784	1198.240481	0	10.72805149	0	0	0	6263.348635	831.0778816	220.6883114	1731.026041	16.80969711	601.6632358	6.92928926										61.54659809										$250/day (days 1-5)	$250/day (days 1-5)	$25/day	10%	$100 	20%	20%	$50 	$250 		20%				$25 	$25 	$25 	$25 	20%	$25 chiro	20%										$25 										250	250	25	0.1	100	0.2	0.2	50	250	0	0.2	0	0	0	25	25	25	25	0.2	25	0.2	0	0	0	0	0	0	0	0	0	25										241.1849058	241.1849058	24.11849058	0.096473962	96.47396233	0.192947925	0.192947925	48.23698116	241.1849058	0	0.192947925	0	0	0	24.11849058	24.11849058	24.11849058	24.11849058	0.192947925	24.11849058	0.192947925	0	0	0	0	0	0	0	0	0	24.11849058										13.6157	0.171993201	1.542474537	0.93326621	0.006022868	2.759540163	0.114026824	1.240260352	24.08312647	0	2.06995527	0	0	0	12.58854292	1.670362005	0.443555747	3.479144605	3.243396171	1.209267424	1.336991982	0	0	0	0	0	0	0	0	0	0.123700921	0	0	0	0	0	0	0	0	0	70.6313	0	2.5815	13.6157	0.171993201	1.542474537	0.93326621	0.006022868	2.759540163	0.114026824	1.240260352	24.08312647	0	2.06995527	0	0	0	12.58854292	1.670362005	0.443555747	3.479144605	3.243396171	1.209267424	1.336991982	0	0	0	0	0	0	0	0	0	0.123700921	0	0	0	0	0	0	0	0	0	70.6313	N/A	$500/day (days 1-5)	$500/day (days 1-5)	$35/day (days 1-100)	40%	$100 	40%	40%	$50 	$500 	No cost sharing	40%	No cost sharing	No cost sharing	No cost sharing	$35 	$35 	$35 	$35 	40%	$35 	20%	No cost sharing	Not covered	Not covered	Not covered	Not covered	Not covered	Not covered	Not covered	Not covered	$35 										3.7314	0.2833	0.7781	0.3721	0.8414	1.7923	0	0.0667	1.3508	0	0.261	0	0	0	3.8843	0.688	1.1222	1.611	0.9078	3.0087	0.0692	0	0	0	0	0	0	0	0	0	0.1494										20.9178	0	0.500143842	17.3471	0.455319521	2.32057282	1.30535689	0.847438524	4.551884485	0.114026824	1.306967179	25.43393972	0	2.330985338	0	0	0	16.47284395	2.358331745	1.565786929	5.090114472	4.151173682	4.217967668	1.406160906	0	0	0	0	0	0	0	0	0	0.273124213	0	0	0	0	0	0	0	0	0	91.5491
H1317_001_0	2009	2																					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																																																			0		335.0396747	6.056991082	995.223723	1727.524608	188.0588325	12.21579493	10.55469056	352.7935392	307.1616351		5038.396147	26.09550956	8.967296119	69.63192219	3017.069703	3095.825718	147.9526256	470.5242311			11.63523871	1086.968879					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	19.52567798	100	0.2	0.2	48.5333251	47.5		8.631700813	50	50	14.96406842	10	24.45546948	26.69493058	15			0.2	15					15														153.2550913	131.6922392	53.91258057	16.19777553	82.9562771	0.165912554	0.165912554	40.26143966	39.40423162		7.160537645	41.47813855	41.47813855	12.41363406	8.29562771	20.28734703	22.14512058	12.44344157			0.165912554	12.44344157					12.44344157														4.2789	0.06647156	4.471256596	2.331837985	1.300055051	2.026753739	1.751155669	1.183664649	1.008622351	0	3.006468773	0.09019943	0.030995563	0.0720321	2.085707253	5.233840892	0.273035728	0.487911731	0	0	1.930432172	1.127136144	0	0	0	0	0.225550878	0	0	0	0	0	0	0	0	0	0	0	0	0	32.982	0	6.7763	4.2789	0.06647156	4.471256596	2.331837985	1.300055051	2.026753739	1.751155669	1.183664649	1.008622351	0	3.006468773	0.09019943	0.030995563	0.0720321	2.085707253	5.233840892	0.273035728	0.487911731	0	0	1.930432172	1.127136144	0	0	0	0	0.225550878	0	0	0	0	0	0	0	0	0	0	0	0	0	32.982		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										6.2861	0.099	1.9185	1.1476	0.365	0.7481	0.6464	0.3938	1.9629	0.9139	2.2184	0.1005	0.0083	1.5183	1.8471	2.2586	0.105	0.2706			0.5119	0.6084					0.1171														24.0453	500	0	10.565	0.16543699	6.389744912	3.479425734	1.665021429	2.774836724	2.397514295	1.577447026	2.971555364	0.913912868	5.224893115	0.190718837	0.039283246	1.590282239	3.932766003	7.492443134	0.377999094	0.758472763	0	0	2.442355259	1.735561408	0	0	0	0	0.342629984	0	0	0	0	0	0	0	0	0	0	0	0	0	57.0273
H1317_002_0	2009	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																																																			0		335.0396747	6.056991082	995.223723	1727.524608	188.0588325	12.21579493	10.55469056	352.7935392	307.1616351		5038.396147	26.09550956	8.967296119	69.63192219	3017.069703	3095.825718	147.9526256	470.5242311			11.63523871	1086.968879					217.5130188														"1a: $195 per admit, $600 Max OOP"	"1b : $95 days 1-5, $1,250 Max OOP"	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $50	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	19.52567798	100	0.2	0.2	48.5333251	47.5		8.631700813	50	50	14.96406842	10	24.45546948	26.69493058	15			0.2	15					15														153.2550913	131.6922392	53.91258057	16.19777553	82.9562771	0.165912554	0.165912554	40.26143966	39.40423162		7.160537645	41.47813855	41.47813855	12.41363406	8.29562771	20.28734703	22.14512058	12.44344157			0.165912554	12.44344157					12.44344157														4.2789	0.06647156	4.471256596	2.331837985	1.300055051	2.026753739	1.751155669	1.183664649	1.008622351	0	3.006468773	0.09019943	0.030995563	0.0720321	2.085707253	5.233840892	0.273035728	0.487911731	0	0	1.930432172	1.127136144	0	0	0	0	0.225550878	0	0	0	0	0	0	0	0	0	0	0	0	0	32.982	0	6.7763	4.2789	0.06647156	4.471256596	2.331837985	1.300055051	2.026753739	1.751155669	1.183664649	1.008622351	0	3.006468773	0.09019943	0.030995563	0.0720321	2.085707253	5.233840892	0.273035728	0.487911731	0	0	1.930432172	1.127136144	0	0	0	0	0.225550878	0	0	0	0	0	0	0	0	0	0	0	0	0	32.982		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										6.2861	0.099	1.9185	1.1476	0.365	0.7481	0.6464	0.3938	1.9629	0.9139	2.2184	0.1005	0.0083	1.5183	1.8471	2.2585	0.105	0.2706			0.5119	0.6084					0.1171														24.0453	500	0	10.565	0.16543699	6.389744912	3.479425734	1.665021429	2.774836724	2.397514295	1.577447026	2.971555364	0.913912868	5.224893115	0.190718837	0.039283246	1.590282239	3.932828656	7.492380481	0.377999094	0.758472763	0	0	2.442355259	1.735561408	0	0	0	0	0.342629984	0	0	0	0	0	0	0	0	0	0	0	0	0	57.0273
H1317_003_0	2009	5																					3000											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																																																			0		435.4445699	16.99564158	1428.496333		336.1984398	19.94270946	17.48884026	642.5964285	275.7061024			30.44485858	27.89394053	53.19150126		2889.940193	372.2312532	382.0268767			7.934749699	643.2609478					217.5130188														1a: $250 days 1-5	1b : $250 days 1-5	2a: $105 days 21 - 100  2a2: $105 days 21-100	6a: 0%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50  4b: $25	9a: $150 9b: $100	8a: 0%	8b1: 0% 8b2: 0% 8b3: 0%	9a: $150	12: $50	9a: $150 9c: 30% 9d: $25 3: $15 5: $25	"7a: $0, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $10, 14j: $10"	7b: $30 7d: $25 7f: $25	"7e: $35, 7h: $35"	7c: $25 7i: $25	8b1: 0% 8b2: 0% 8b3: 0%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $10 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $25 18a1: $25	18b: (n/c)		13c (: $											462.7102261	417.7604594	68.23860903		100	0.1	0.2	47.51813179	145			150	50	23.81339088		25.19712344	35	25			0.2	14.98841517					25														376.3959063	339.8311035	55.50932667		81.34592345	0.081345923	0.162691847	38.65406311	117.951589			122.0188852	40.67296172	19.37122272		20.49683274	28.47107321	20.33648086			0.162691847	12.19246473					20.33648086														13.6583	0.48130397	6.607905801	0	2.279031045	1.622258117	2.845291722	2.069913575	2.70999774	0	0	0.309570642	0.094544098	0.085865368	0	4.936218398	0.883151938	0.647423522	0	0	1.290919083	0.653578035	0	0	0	0	0.368620779	0	0	0	0	0	0	0	0	0	0	0	0	0	41.5439	0	9.5268	13.6583	0.48130397	6.607905801	0	2.279031045	1.622258117	2.845291722	2.069913575	2.70999774	0	0	0.309570642	0.094544098	0.085865368	0	4.936218398	0.883151938	0.647423522	0	0	1.290919083	0.653578035	0	0	0	0	0.368620779	0	0	0	0	0	0	0	0	0	0	0	0	0	41.5439		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50  4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: 30%9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										7.491	0.2728	2.6972	1.4573	0.6238	1.2024	1.0544	0.6752	1.8456	0.9056	2.1191	0.0991	0.0333	1.8684	1.8605	2.0551	0.2843	0.2171			0.3405	0.3707					0.1164														27.5895	500	0	21.1492	0.754096016	9.305088252	1.457269826	2.902802222	2.824632626	3.899718943	2.745130864	4.555559712	0.905589402	2.119066105	0.408631585	0.127837786	1.954297776	1.860454743	6.991291535	1.167467779	0.864498972	0	0	1.631436615	1.024305847	0	0	0	0	0.484970927	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1334
H1317_801_0	2009	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																																																			0		252.9656432	3.084091889	31.31910203		9.959844905	12.21579493	10.55469056	15.52288089	32.05364594	14.96210011	36.24160677	1.641428141	0.194154397	24.42075171	34.75896659	73.75723776	1.097106964	3.570477146			11.63523871	6.496972214																			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																			0.082	0.082	0.2118		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.082	0.082	0.2118		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			20.7432	0.252895535	6.633385809	0	2.300724173	2.821848629	2.438133519	3.585785485	7.404392213	3.456245125	8.371811163	0.379169901	0.044849666	5.641193646	8.029321281	17.03792192	0.253431709	0.824780221	0	0	2.687740141	1.500800581	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.4076	0	0	20.7432	0.252895535	6.633385809	0	2.300724173	2.821848629	2.438133519	3.585785485	7.404392213	3.456245125	8.371811163	0.379169901	0.044849666	5.641193646	8.029321281	17.03792192	0.253431709	0.824780221	0	0	2.687740141	1.500800581	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.4076		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																			3.7738	0.046	1.2068		0.4186	0.5134	0.4436	0.6524	1.3471	0.6272	1.5224	0.069	0.0082	1.0263	1.4222	3.0997	0.0461	0.1499			0.489	0.273																			17.1344	0	0	24.517	0.298904425	7.840187351	0	2.719291336	3.335223152	2.88169935	4.238141849	8.751461748	4.083420976	9.894212502	0.44815169	0.053001602	6.66748719	9.451482905	20.1376045	0.299514625	0.974717909	0	0	3.176716516	1.773838719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.542
H1317_802_0	2009	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																																																			0		252.9656432	3.084091889	31.31910203		9.959844905	12.21579493	10.55469056	15.52288089	32.05364594	14.96210011	36.24160677	1.641428141	0.194154397	24.42075171	34.75896659	73.75723776	1.097106964	3.570477146			11.63523871	6.496972214																			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																			0.082	0.082	0.2118		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.082	0.082	0.2118		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			20.7432	0.252895535	6.633385809	0	2.300724173	2.821848629	2.438133519	3.585785485	7.404392213	3.456245125	8.371811163	0.379169901	0.044849666	5.641193646	8.029321281	17.03792192	0.253431709	0.824780221	0	0	2.687740141	1.500800581	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.4076	0	0	20.7432	0.252895535	6.633385809	0	2.300724173	2.821848629	2.438133519	3.585785485	7.404392213	3.456245125	8.371811163	0.379169901	0.044849666	5.641193646	8.029321281	17.03792192	0.253431709	0.824780221	0	0	2.687740141	1.500800581	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.4076		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																			3.7738	0.046	1.2068		0.4186	0.5134	0.4436	0.6524	1.3471	0.6272	1.5224	0.069	0.0082	1.0263	1.4222	3.0997	0.0461	0.1499			0.489	0.273																			17.1344	0	0	24.517	0.298904425	7.840187351	0	2.719291336	3.335223152	2.88169935	4.238141849	8.751461748	4.083420976	9.894212502	0.44815169	0.053001602	6.66748719	9.451482905	20.1376045	0.299514625	0.974717909	0	0	3.176716516	1.773838719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.542
H1317_803_0	2009	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																																																			0		252.9656432	3.084091889	31.31910203		9.959844905	12.21579493	10.55469056	15.52288089	32.05364594	14.96210011	36.24160677	1.641428141	0.194154397	24.42075171	34.75896659	73.75723776	1.097106964	3.570477146			11.63523871	6.496972214																			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																			0.082	0.082	0.2118		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.082	0.082	0.2118		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			20.7432	0.252895535	6.633385809	0	2.300724173	2.821848629	2.438133519	3.585785485	7.404392213	3.456245125	8.371811163	0.379169901	0.044849666	5.641193646	8.029321281	17.03792192	0.253431709	0.824780221	0	0	2.687740141	1.500800581	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.4076	0	0	20.7432	0.252895535	6.633385809	0	2.300724173	2.821848629	2.438133519	3.585785485	7.404392213	3.456245125	8.371811163	0.379169901	0.044849666	5.641193646	8.029321281	17.03792192	0.253431709	0.824780221	0	0	2.687740141	1.500800581	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.4076		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																			3.7738	0.046	1.2068		0.4186	0.5134	0.4436	0.6524	1.3471	0.6272	1.5224	0.069	0.0082	1.0263	1.4222	3.0997	0.0461	0.1499			0.489	0.273																			17.1344	0	0	24.517	0.298904425	7.840187351	0	2.719291336	3.335223152	2.88169935	4.238141849	8.751461748	4.083420976	9.894212502	0.44815169	0.053001602	6.66748719	9.451482905	20.1376045	0.299514625	0.974717909	0	0	3.176716516	1.773838719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.542
H1326_801_0	2009	2																																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		230.5057924	2.75860178	39.3670743	0	6.744445852	17.95721218	0.893941437	13.36639612	35.72887198	9.823216657	25.69715905	0	14.05972614	19.31606657	20.31433615	42.73936334	1.390460199	5.456204628	25.23870214	78.9786287	26.26693999	21.90095752	0	0	0	0	0	0	0	0											Medicare FFS Cost Sharing -- PBP 1a	Medicare FFS Cost Sharing -- PBP 1b	Medicare FFS Cost Sharing -- PBP 2	Medicare FFS Cost Sharing -- PBP 6	Medicare FFS Cost Sharing -- PBP 10a	Medicare FFS Cost Sharing -- PBP 11a	"Medicare FFS Cost Sharing -- PBP 11b, 11c"	"Medicare FFS Cost Sharing -- PBP 4a, 4b"	"Medicare FFS Cost Sharing -- PBP 9a, 9b"	Medicare FFS Cost Sharing -- PBP 8a	Medicare FFS Cost Sharing -- PBP 8b	0	Medicare FFS Cost Sharing -- PBP 12	"Medicare FFS Cost Sharing -- PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"Medicare FFS Cost Sharing -- PBP 4b, 7a, 14b-i"	"Medicare FFS Cost Sharing -- PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"Medicare FFS Cost Sharing -- PBP 7e, 7h"	"Medicare FFS Cost Sharing -- PBP 7c, 7i"	Medicare FFS Cost Sharing -- PBP 7d	"Medicare FFS Cost Sharing -- PBP 7d, 7g"	Medicare FFS Cost Sharing -- PBP 15	Medicare FFS Cost Sharing -- PBP 7g	Medicare FFS Cost Sharing -- PBP 10b	"Medicare FFS Cost Sharing -- PBP 16a, 16b"	Medicare FFS Cost Sharing -- PBP 17a	Medicare FFS Cost Sharing -- PBP 17b	Medicare FFS Cost Sharing -- PBP 18a	Medicare FFS Cost Sharing -- PBP 18b	Medicare FFS Cost Sharing -- PBP 14a	0											0.07386712	0.07386712	0.184270075	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.07386712	0.07386712	0.184270075	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											17.0268	0.203769968	7.254173724	0	1.557966992	4.148116014	0.206500472	3.087637505	8.253369428	2.269163048	5.93604374	0	3.247796739	4.462011378	4.692611651	9.872792931	0.321196306	1.260383269	5.830140195	18.24406323	6.067663138	5.059121186	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.0013	135		17.0268	0.203769968	7.254173724	0	1.557966992	4.148116014	0.206500472	3.087637505	8.253369428	2.269163048	5.93604374	0	3.247796739	4.462011378	4.692611651	9.872792931	0.321196306	1.260383269	5.830140195	18.24406323	6.067663138	5.059121186	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.0013																																																																																		0			17.0268	0.203769968	7.254173724	0	1.557966992	4.148116014	0.206500472	3.087637505	8.253369428	2.269163048	5.93604374	0	3.247796739	4.462011378	4.692611651	9.872792931	0.321196306	1.260383269	5.830140195	18.24406323	6.067663138	5.059121186	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.0013
H1326_802_0	2009	2																																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		230.5057924	2.75860178	39.3670743	0	6.744445852	17.95721218	0.893941437	13.36639612	35.72887198	9.823216657	25.69715905	0	14.05972614	19.31606657	20.31433615	42.73936334	1.390460199	5.456204628	25.23870214	78.9786287	26.26693999	21.90095752	0	0	0	0	0	0	0	0											Medicare FFS Cost Sharing -- PBP 1a	Medicare FFS Cost Sharing -- PBP 1b	Medicare FFS Cost Sharing -- PBP 2	Medicare FFS Cost Sharing -- PBP 6	Medicare FFS Cost Sharing -- PBP 10a	Medicare FFS Cost Sharing -- PBP 11a	"Medicare FFS Cost Sharing -- PBP 11b, 11c"	"Medicare FFS Cost Sharing -- PBP 4a, 4b"	"Medicare FFS Cost Sharing -- PBP 9a, 9b"	Medicare FFS Cost Sharing -- PBP 8a	Medicare FFS Cost Sharing -- PBP 8b	0	Medicare FFS Cost Sharing -- PBP 12	"Medicare FFS Cost Sharing -- PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"Medicare FFS Cost Sharing -- PBP 4b, 7a, 14b-i"	"Medicare FFS Cost Sharing -- PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"Medicare FFS Cost Sharing -- PBP 7e, 7h"	"Medicare FFS Cost Sharing -- PBP 7c, 7i"	Medicare FFS Cost Sharing -- PBP 7d	"Medicare FFS Cost Sharing -- PBP 7d, 7g"	Medicare FFS Cost Sharing -- PBP 15	Medicare FFS Cost Sharing -- PBP 7g	Medicare FFS Cost Sharing -- PBP 10b	"Medicare FFS Cost Sharing -- PBP 16a, 16b"	Medicare FFS Cost Sharing -- PBP 17a	Medicare FFS Cost Sharing -- PBP 17b	Medicare FFS Cost Sharing -- PBP 18a	Medicare FFS Cost Sharing -- PBP 18b	Medicare FFS Cost Sharing -- PBP 14a	0											0.07386712	0.07386712	0.184270075	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.07386712	0.07386712	0.184270075	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											17.0268	0.203769968	7.254173724	0	1.557966992	4.148116014	0.206500472	3.087637505	8.253369428	2.269163048	5.93604374	0	3.247796739	4.462011378	4.692611651	9.872792931	0.321196306	1.260383269	5.830140195	18.24406323	6.067663138	5.059121186	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.0013	135		17.0268	0.203769968	7.254173724	0	1.557966992	4.148116014	0.206500472	3.087637505	8.253369428	2.269163048	5.93604374	0	3.247796739	4.462011378	4.692611651	9.872792931	0.321196306	1.260383269	5.830140195	18.24406323	6.067663138	5.059121186	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.0013																																																																																		0			17.0268	0.203769968	7.254173724	0	1.557966992	4.148116014	0.206500472	3.087637505	8.253369428	2.269163048	5.93604374	0	3.247796739	4.462011378	4.692611651	9.872792931	0.321196306	1.260383269	5.830140195	18.24406323	6.067663138	5.059121186	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.0013
H1326_803_0	2009	2																																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		230.5057924	2.75860178	39.3670743	0	6.744445852	17.95721218	0.893941437	13.36639612	35.72887198	9.823216657	25.69715905	0	14.05972614	19.31606657	20.31433615	42.73936334	1.390460199	5.456204628	25.23870214	78.9786287	26.26693999	21.90095752	0	0	0	0	0	0	0	0											Medicare FFS Cost Sharing -- PBP 1a	Medicare FFS Cost Sharing -- PBP 1b	Medicare FFS Cost Sharing -- PBP 2	Medicare FFS Cost Sharing -- PBP 6	Medicare FFS Cost Sharing -- PBP 10a	Medicare FFS Cost Sharing -- PBP 11a	"Medicare FFS Cost Sharing -- PBP 11b, 11c"	"Medicare FFS Cost Sharing -- PBP 4a, 4b"	"Medicare FFS Cost Sharing -- PBP 9a, 9b"	Medicare FFS Cost Sharing -- PBP 8a	Medicare FFS Cost Sharing -- PBP 8b	0	Medicare FFS Cost Sharing -- PBP 12	"Medicare FFS Cost Sharing -- PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"Medicare FFS Cost Sharing -- PBP 4b, 7a, 14b-i"	"Medicare FFS Cost Sharing -- PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"Medicare FFS Cost Sharing -- PBP 7e, 7h"	"Medicare FFS Cost Sharing -- PBP 7c, 7i"	Medicare FFS Cost Sharing -- PBP 7d	"Medicare FFS Cost Sharing -- PBP 7d, 7g"	Medicare FFS Cost Sharing -- PBP 15	Medicare FFS Cost Sharing -- PBP 7g	Medicare FFS Cost Sharing -- PBP 10b	"Medicare FFS Cost Sharing -- PBP 16a, 16b"	Medicare FFS Cost Sharing -- PBP 17a	Medicare FFS Cost Sharing -- PBP 17b	Medicare FFS Cost Sharing -- PBP 18a	Medicare FFS Cost Sharing -- PBP 18b	Medicare FFS Cost Sharing -- PBP 14a	0											0.07386712	0.07386712	0.184270075	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.07386712	0.07386712	0.184270075	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											17.0268	0.203769968	7.254173724	0	1.557966992	4.148116014	0.206500472	3.087637505	8.253369428	2.269163048	5.93604374	0	3.247796739	4.462011378	4.692611651	9.872792931	0.321196306	1.260383269	5.830140195	18.24406323	6.067663138	5.059121186	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.0013	135		17.0268	0.203769968	7.254173724	0	1.557966992	4.148116014	0.206500472	3.087637505	8.253369428	2.269163048	5.93604374	0	3.247796739	4.462011378	4.692611651	9.872792931	0.321196306	1.260383269	5.830140195	18.24406323	6.067663138	5.059121186	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.0013																																																																																		0			17.0268	0.203769968	7.254173724	0	1.557966992	4.148116014	0.206500472	3.087637505	8.253369428	2.269163048	5.93604374	0	3.247796739	4.462011378	4.692611651	9.872792931	0.321196306	1.260383269	5.830140195	18.24406323	6.067663138	5.059121186	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.0013
H1326_804_0	2009	2																																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		230.5057924	2.75860178	39.3670743	0	6.744445852	17.95721218	0.893941437	13.36639612	35.72887198	9.823216657	25.69715905	0	14.05972614	19.31606657	20.31433615	42.73936334	1.390460199	5.456204628	25.23870214	78.9786287	26.26693999	21.90095752	0	0	0	0	0	0	0	0											Medicare FFS Cost Sharing -- PBP 1a	Medicare FFS Cost Sharing -- PBP 1b	Medicare FFS Cost Sharing -- PBP 2	Medicare FFS Cost Sharing -- PBP 6	Medicare FFS Cost Sharing -- PBP 10a	Medicare FFS Cost Sharing -- PBP 11a	"Medicare FFS Cost Sharing -- PBP 11b, 11c"	"Medicare FFS Cost Sharing -- PBP 4a, 4b"	"Medicare FFS Cost Sharing -- PBP 9a, 9b"	Medicare FFS Cost Sharing -- PBP 8a	Medicare FFS Cost Sharing -- PBP 8b	0	Medicare FFS Cost Sharing -- PBP 12	"Medicare FFS Cost Sharing -- PBP 3, 5, 9a, 9c, 9d, 13a, 13b"	"Medicare FFS Cost Sharing -- PBP 4b, 7a, 14b-i"	"Medicare FFS Cost Sharing -- PBP 4b, 7b, 7d, 7f, 7g, 14d-i, 17a, 18a"	"Medicare FFS Cost Sharing -- PBP 7e, 7h"	"Medicare FFS Cost Sharing -- PBP 7c, 7i"	Medicare FFS Cost Sharing -- PBP 7d	"Medicare FFS Cost Sharing -- PBP 7d, 7g"	Medicare FFS Cost Sharing -- PBP 15	Medicare FFS Cost Sharing -- PBP 7g	Medicare FFS Cost Sharing -- PBP 10b	"Medicare FFS Cost Sharing -- PBP 16a, 16b"	Medicare FFS Cost Sharing -- PBP 17a	Medicare FFS Cost Sharing -- PBP 17b	Medicare FFS Cost Sharing -- PBP 18a	Medicare FFS Cost Sharing -- PBP 18b	Medicare FFS Cost Sharing -- PBP 14a	0											0.07386712	0.07386712	0.184270075	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.07386712	0.07386712	0.184270075	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											17.0268	0.203769968	7.254173724	0	1.557966992	4.148116014	0.206500472	3.087637505	8.253369428	2.269163048	5.93604374	0	3.247796739	4.462011378	4.692611651	9.872792931	0.321196306	1.260383269	5.830140195	18.24406323	6.067663138	5.059121186	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.0013	135		17.0268	0.203769968	7.254173724	0	1.557966992	4.148116014	0.206500472	3.087637505	8.253369428	2.269163048	5.93604374	0	3.247796739	4.462011378	4.692611651	9.872792931	0.321196306	1.260383269	5.830140195	18.24406323	6.067663138	5.059121186	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.0013																																																																																		0			17.0268	0.203769968	7.254173724	0	1.557966992	4.148116014	0.206500472	3.087637505	8.253369428	2.269163048	5.93604374	0	3.247796739	4.462011378	4.692611651	9.872792931	0.321196306	1.260383269	5.830140195	18.24406323	6.067663138	5.059121186	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.0013
H1340_002_0	2009	6																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.6568	1.8985	0.631	1.3706	1.0557	0	1.25	0.0824	0.0028	0.7417	1.6955	4.1034	0.283	0.2635	1.3491	0.1159	0	0.0003	0	0	0	0	0	0	0	0											15.5		511.7174853	48.83384321	2000.379092	4122.018305	15.92423845	46.02825123	15.29925369	33.22892007	25.59486509	10198.59096	30.30544693	1.998567343	0.068135956	17.98141935	44.34452102	107.7256617	6.860637978	6.387893518	32.70809147	6.05169661	39.49109097	0.006596223	0	684	2.76	158.976	116.4	31.04	0.07	6.8											Medicare FFS cost sharing	Medicare FFS cost sharing	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $0.00	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											730.0093982	771.7910248	66.79809598	11.28795085	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.185347303	0.180646998	0.5	0.2	0.2	0.019888824	0.2	0.2	0	0	0.2	10	0	0	0	0											730.0093982	771.7910248	66.79809598	11.28795085	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.185347303	0.180646998	0.5	0.2	0.2	0.019888824	0.2	0.2	0	0	0.2	10	0	0	0	0											31.1299	3.140793491	11.13512621	3.877428338	3.184847691	9.205650246	3.059850738	6.645784013	5.118973018	0	6.061089386	0.399713469	0.013627191	3.59628387	8.219137368	19.46031739	3.430318989	1.277578704	6.541618293	0.120361131	7.898218194	0.001319245	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.2024	135	0	31.1299	3.140793491	11.13512621	3.877428338	3.841657201	11.10412679	3.690882191	8.01634065	6.174656205	0	7.311064749	0.482146173	0.01643752	4.337943653	9.914612577	23.56375768	3.713292161	1.541053106	7.890692887	0.236253976	7.898218194	0.001591312	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	149.7024		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			31.1299	3.140793491	11.13512621	3.877428338	3.841657201	11.10412679	3.690882191	8.01634065	6.174656205	0	7.311064749	0.482146173	0.01643752	4.337943653	9.914612577	23.56375768	3.713292161	1.541053106	7.890692887	0.236253976	7.898218194	0.001591312	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	149.7024
H1340_014_0	2009	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		1684.307214	107.2075864	1399.354094	1227.008761	411.9699385	16.50596583	6.420191924	1977.451077	280.5082887	6720.71725	24.31501839	77.76118559	0.034310265	1066.46787	8631.21578	16649.16128	595.957055	1936.578647	31.86158072	922.7831859	28.12883315	0.008866241	0	275	1.785	285.6	116.4	31.04	1848	4558.153846											"$175 days 1 - 6, $0 days 7 - 90"	"$175 days 1 - 6, $0 days 7 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $50.00 and $100.00	$20.00 copayment	20% coinsurance	$175.00 copayment	20% coinsurance	"Copay between $20.00 and $100.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$20.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											113.5639446	93.07893053	66.81681887	15.28450314	54.19062619	0.2	0.2	26.2392596	69.11661047	5.263718881	0.2	81.83145459	0.2	39.98107432	7.26721334	15.81822294	23.37332956	11.57455804	0.175457449	0.534106555	0.2	0.2	0	20	0.2	10	0	0	0	0											100.7433888	82.57098608	59.27367868	13.55899223	48.07289271	0.177421433	0.177421433	23.27703516	61.31384029	4.669482727	0.177421433	72.59326959	0.177421433	35.46749745	6.446797015	14.03245889	20.73464809	10.26787336	0.15564956	0.473809751	0.177421433	0.177421433	0	20	0.2	10	0	0	0	0											14.1402	0.737686344	6.912072078	1.386416854	1.650382221	2.928512106	1.13907965	3.83576652	1.433253368	2.615189426	4.314005401	0.470411559	0.006087376	3.152078871	4.636974677	19.46905594	1.029746651	1.657045358	4.959241016	0.036435306	4.99065788	0.001573061	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.5552	0	10.3719	14.1402	0.737686344	6.912072078	1.386416854	1.650382221	2.928512106	1.13907965	3.83576652	1.433253368	2.615189426	4.314005401	0.470411559	0.006087376	3.152078871	4.636974677	19.46905594	1.029746651	1.657045358	4.959241016	0.036435306	4.99065788	0.001573061	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.5552		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			14.1402	0.737686344	6.912072078	1.386416854	1.650382221	2.928512106	1.13907965	3.83576652	1.433253368	2.615189426	4.314005401	0.470411559	0.006087376	3.152078871	4.636974677	19.46905594	1.029746651	1.657045358	4.959241016	0.036435306	4.99065788	0.001573061	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.5552
H1340_020_0	2009	6																					3750											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		1391.050094	118.8117942	970.0088297	1591.401206	449.8074919	18.9062324	6.793177876	2101.797267	266.1734281	6540.380716	22.17877939	93.81888865	0.074927909	1093.197352	9190.461179	18018.60595	465.6284241	3052.786079	27.78383426	921.386351	31.72958395	0.021770465	0	275	1.785	285.6	116.4	31.04	168	4080											"$250 days 1 - 5, $0 days 6 - 90"	"$250 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	20% coinsurance	$250.00 copayment	20% coinsurance	"Copay between $20.00 and $150.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$20.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											164.2565716	111.0456662	66.7	14.7109286	53.90371619	0.2	0.2	25.74249313	110.4701049	5.299026872	0.2	117.5815136	0.2	46.68191547	9.508626582	15.45061981	27.33119735	10.35458551	0.170734527	0.592286348	0.2	0.2	0	20	0.2	10	0	0	0	0											143.3720507	96.92668441	58.21938013	12.84049692	47.05008911	0.174570855	0.174570855	22.46944517	96.4243033	4.625278257	0.174570855	102.6315268	0.174570855	40.74650947	8.29964536	13.48613955	23.85615244	9.038044226	0.149026362	0.51697967	0.174570855	0.174570855	0	20	0.2	10	0	0	0	0											16.6198	0.95966944	4.706109399	1.70286519	1.763623548	3.300477154	1.18589087	3.935518205	2.138798947	2.520923394	3.87176848	0.802397982	0.013080229	3.71199802	6.35646404	20.25011952	0.925675222	2.299267967	4.140523745	0.039694834	5.539060597	0.003800489	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.8409	0	12.642	16.6198	0.95966944	4.706109399	1.70286519	1.763623548	3.300477154	1.18589087	3.935518205	2.138798947	2.520923394	3.87176848	0.802397982	0.013080229	3.71199802	6.35646404	20.25011952	0.925675222	2.299267967	4.140523745	0.039694834	5.539060597	0.003800489	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.8409		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			16.6198	0.95966944	4.706109399	1.70286519	1.763623548	3.300477154	1.18589087	3.935518205	2.138798947	2.520923394	3.87176848	0.802397982	0.013080229	3.71199802	6.35646404	20.25011952	0.925675222	2.299267967	4.140523745	0.039694834	5.539060597	0.003800489	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.8409
H1340_024_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		1626.525612	157.2172623	1284.803841	2006.332392	529.4951265	22.98032199	8.213032572	2378.150937	284.7180596	7300.565525	24.38913411	101.0224634	0.105869243	1217.985955	10327.31432	20168.45018	608.7479208	3634.77447	28.89791421	968.0451389	34.51722975	0.021939737	0	474.9090909	2.76	158.976	116.4	31.04	1848	4080											"$125 days 1 - 6, $0 days 7 - 90"	"$125 days 1 - 6, $0 days 7 - 90"	"$0 days 1 - 20, $128 days 21 - 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	$10.00 copayment	20% coinsurance	$125.00 copayment	20% coinsurance	"Copay between $10.00 and $75.00, 20% coinsurance"	"Copay between $0.00 and $10.00, 20% coinsurance"	"Copay between $0.00 and $15.00, 20% coinsurance"	Copay between $10.00 and $20.00	$15.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $15.00	20% coinsurance	20% coinsurance		$15.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											89.27588917	62.75324379	66.7	6.15212503	54.05778607	0.2	0.2	21.55377366	55.84147842	2.635793429	0.2	55.49469601	0.2	29.2713066	5.055057408	7.271521187	15.50471206	4.30203642	0.169667755	0.259269312	0.2	0.2	0	15	0.2	10	0	0	0	0											81.02137337	56.95103171	60.53286788	5.583294927	49.05956255	0.18150785	0.18150785	19.56089555	50.67833337	2.392085988	0.18150785	50.36361471	0.18150785	26.56485959	4.587663001	6.599190874	14.07113473	3.9042669	0.153980147	0.235297077	0.18150785	0.18150785	0	15	0.2	10	0	0	0	0											10.9819	0.746140441	6.481071761	0.933495456	2.164733273	4.17110883	1.490729882	3.876563507	1.202419728	1.455298375	4.426819288	0.423988035	0.019216099	2.696302156	3.948186484	11.0912877	0.713814501	1.182594138	4.449705081	0.018981516	6.265148151	0.003982234	0	0.593636364	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.0216	0	7.0036	10.9819	0.746140441	6.481071761	0.933495456	2.164733273	4.17110883	1.490729882	3.876563507	1.202419728	1.455298375	4.426819288	0.423988035	0.019216099	2.696302156	3.948186484	11.0912877	0.713814501	1.182594138	4.449705081	0.018981516	6.265148151	0.003982234	0	0.593636364	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.0216		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			10.9819	0.746140441	6.481071761	0.933495456	2.164733273	4.17110883	1.490729882	3.876563507	1.202419728	1.455298375	4.426819288	0.423988035	0.019216099	2.696302156	3.948186484	11.0912877	0.713814501	1.182594138	4.449705081	0.018981516	6.265148151	0.003982234	0	0.593636364	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.0216
H1340_025_0	2009	5																					4000											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		1808.765189	186.8622633	1246.301603	2078.475932	559.6112758	22.92417279	8.933026653	2193.585574	285.9711502	7441.419123	24.3725833	98.48782751	0.122765887	1197.652026	10050.59237	20875.57963	570.1739762	3535.756896	35.59956715	954.1755378	36.96579026	0.002262515	0	275	0.75	0	58.2	31.04	168	4080											"$200 days 1 - 6, $0 days 7 - 90"	"$200 days 1 - 6, $0 days 7 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	20% coinsurance	$200.00 copayment	20% coinsurance	"Copay between $20.00 and $150.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$20.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											140.476579	89.68514416	66.7	14.45605777	52.6986099	0.2	0.2	25.11914679	109.7116262	5.224133476	0.2	86.07388126	0.2	46.28615552	9.520159385	15.21249464	26.41679541	9.442521694	0.173330202	0.578612097	0.2	0.2	0	20	0.2	0	0	0	0	0											120.786824	77.11451836	57.35106324	12.42983933	45.31216356	0.171967206	0.171967206	21.59834747	94.33400917	4.491898191	0.171967206	74.0094244	0.171967206	39.79850424	8.185776056	13.08025101	22.7141125	8.119020372	0.149035552	0.497511529	0.171967206	0.171967206	0	20	0.2	0	0	0	0	0											18.2063	1.20081612	5.956393506	2.152926825	2.113099805	3.942205947	1.536187636	3.948151953	2.248067092	2.785508092	4.191285056	0.607418952	0.021111707	3.97206327	6.855991529	22.75481846	1.079249653	2.392240189	5.305601157	0.039559444	6.356903672	0.000389078	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.2746	0	15.9208	18.2063	1.20081612	5.956393506	2.152926825	2.113099805	3.942205947	1.536187636	3.948151953	2.248067092	2.785508092	4.191285056	0.607418952	0.021111707	3.97206327	6.855991529	22.75481846	1.079249653	2.392240189	5.305601157	0.039559444	6.356903672	0.000389078	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.2746		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			18.2063	1.20081612	5.956393506	2.152926825	2.113099805	3.942205947	1.536187636	3.948151953	2.248067092	2.785508092	4.191285056	0.607418952	0.021111707	3.97206327	6.855991529	22.75481846	1.079249653	2.392240189	5.305601157	0.039559444	6.356903672	0.000389078	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.2746
H1340_026_0	2009	6																					4000											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	V	V	V	V	V											0	0	0	0	0.5245	1.2869	0.4817	1.1232	1.3357	0	1.3568	0.0659	0.0145	0.8333	1.6246	5.3265	0.2517	0.6299	1.8727	0.2354	0	0.0001	0	0	0	0	0	0	0	0											16.9633		2075.074238	229.6752885	1307.970284	2535.850632	618.3811985	26.20185449	9.80778325	2438.209604	315.8171623	8352.486776	27.62536798	96.62369762	0.295030671	1240.030576	10407.37633	21408.73723	613.1962333	3625.630449	38.13000629	974.0674827	40.45596564	0.00172619	0	275	0.75	0	58.2	31.04	1848	0											"$200 days 1 - 6, $0 days 7 - 90"	"$200 days 1 - 6, $0 days 7 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	20% coinsurance	$200.00 copayment	20% coinsurance	"Copay between $20.00 and $150.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$20.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											137.5833494	89.79766413	66.7	16.37651903	57.6782834	0.2	0.2	25.75627564	113.0128436	6.691268558	0.2	99.19413044	0.2	49.86607543	9.785050123	16.06069195	26.78026773	11.71828981	0.174033647	0.916189734	0.2	0.2	0	20	0.2	0	0	0	0	0											114.9683547	75.03734823	55.73631759	13.68466066	48.19752806	0.16712539	0.16712539	21.52263807	94.43657787	5.591404339	0.16712539	82.88928871	0.16712539	41.66943654	8.176651593	13.42074703	22.37831345	9.792118774	0.145427206	0.765592833	0.16712539	0.16712539	0	20	0.2	0	0	0	0	0											19.8807	1.436185384	6.075120594	2.891854615	2.483703764	4.378995152	1.639129601	4.37305857	2.485391003	3.891844233	4.616900399	0.667422464	0.049307116	4.305947949	7.091457518	23.94343722	1.143524793	2.958550333	5.545140271	0.062144924	6.761219039	0.00028849	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.2896	135	20.9849	19.8807	1.436185384	6.075120594	2.891854615	3.008172731	5.665845371	2.120818713	5.496294849	3.821126753	3.891844233	5.973663556	0.733350904	0.063796941	5.13923006	8.716031221	29.26998437	1.395247114	3.588406053	7.417817144	0.297522349	6.761219039	0.000373268	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.2529		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			19.8807	1.436185384	6.075120594	2.891854615	3.008172731	5.665845371	2.120818713	5.496294849	3.821126753	3.891844233	5.973663556	0.733350904	0.063796941	5.13923006	8.716031221	29.26998437	1.395247114	3.588406053	7.417817144	0.297522349	6.761219039	0.000373268	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.2529
H1340_027_0	2009	5																					4000											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	V	V	V	V	V											0	0	0	0	0.5368	1.2311	0.4758	1.1163	1.3501	0	1.1968	0.0644	0.0079	0.773	1.4954	5.5462	0.2265	0.5434	1.964	0.2389	0	0.0003	0	0	0	0	0	0	0	0											16.7671		1992.88145	209.6367587	1255.578972	2273.361629	662.9591488	25.3980986	9.814860497	2465.548321	316.217595	7236.072628	24.69023465	97.02003284	0.163288355	1051.355735	10001.80587	24106.16378	538.080207	3220.339511	40.5175405	923.2841434	41.80529768	0.007189568	0	275	0.75	0	58.2	31.04	1848	0											"$200 days 1 - 6, $0 days 7 - 90"	"$200 days 1 - 6, $0 days 7 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	20% coinsurance	$200.00 copayment	20% coinsurance	"Copay between $20.00 and $150.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$20.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											139.2730043	101.2090929	66.7	15.24568493	53.31820201	0.2	0.2	24.92190003	110.1396196	5.050522041	0.2	83.96012372	0.2	47.11815425	9.535629095	14.60495616	25.67544448	9.073776489	0.175631454	0.548637862	0.2	0.2	0	20	0.2	0	0	0	0	0											117.7620648	85.57718569	56.39807772	12.89096437	45.08311995	0.169109678	0.169109678	21.07267249	93.12837819	4.270460788	0.169109678	70.99234757	0.169109678	39.84067954	8.062835845	12.34919719	21.70983078	7.672317117	0.148504894	0.463899862	0.169109678	0.169109678	0	20	0.2	0	0	0	0	0											19.5572	1.495010319	5.901020036	2.442151981	2.490688903	4.295064284	1.659787902	4.329641023	2.454069314	2.575113702	4.17535764	0.573973324	0.027613641	3.490560578	6.720243243	24.8076475	0.973469187	2.058955496	6.017053041	0.035692616	7.069680443	0.001215826	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.7595	135	18.842	19.5572	1.495010319	5.901020036	2.442151981	3.027521179	5.526193045	2.135546234	5.445970361	3.804213303	2.575113702	5.372173924	0.638356266	0.035528761	4.263608581	8.215613127	30.35388375	1.199963609	2.602358936	7.981070514	0.27456395	7.069680443	0.001564327	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.5266		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			19.5572	1.495010319	5.901020036	2.442151981	3.027521179	5.526193045	2.135546234	5.445970361	3.804213303	2.575113702	5.372173924	0.638356266	0.035528761	4.263608581	8.215613127	30.35388375	1.199963609	2.602358936	7.981070514	0.27456395	7.069680443	0.001564327	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.5266
H1340_030_0	2009	6																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.6733	1.548	0.5208	0.8702	0.9376	0	1.0974	0.0476	0	0.6314	1.4926	3.3445	0.177	0.167	1.2535	0.0849	0	0	0	0	0	0	0	0	0	0											12.8458		583.1454408	31.93839315	2571.327097	4394.412348	20.43889561	46.99002928	15.80773974	26.41460811	28.46183028	8690.280312	33.31156645	1.446220686	0	19.16737295	48.90801215	111.7184684	5.374405348	5.068228572	38.04956043	5.50540208	46.55410428	0.001325945	0	684	2.76	158.976	116.4	31.04	0.07	6.8											Medicare FFS cost sharing	Medicare FFS cost sharing	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $0.00	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											716.2524188	706.9035867	66.73794751	6.844572331	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.185193894	0.178177974	0.5	0.2	0.2	0.016632362	0.2	0.2	0	0	0.2	10	0	0	0	0											716.2524188	706.9035867	66.73794751	6.844572331	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.185193894	0.178177974	0.5	0.2	0.2	0.016632362	0.2	0.2	0	0	0.2	10	0	0	0	0											34.8066	1.881447056	14.3004244	2.506489431	4.087779122	9.398005856	3.161547948	5.282921622	5.692366055	0	6.662313289	0.289244137	0	3.833474589	9.057465221	19.90577034	2.687202674	1.013645714	7.609912085	0.091567838	9.310820856	0.000265189	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.2638	135	0	34.8066	1.881447056	14.3004244	2.506489431	4.761094671	10.94599152	3.682300006	6.153094194	6.629979968	0	7.759691351	0.336886774	0	4.464902553	10.5500562	23.25023778	2.864250923	1.180607627	8.863373189	0.176504003	9.310820856	0.000308869	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	155.1096		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			34.8066	1.881447056	14.3004244	2.506489431	4.761094671	10.94599152	3.682300006	6.153094194	6.629979968	0	7.759691351	0.336886774	0	4.464902553	10.5500562	23.25023778	2.864250923	1.180607627	8.863373189	0.176504003	9.310820856	0.000308869	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	155.1096
H1340_031_0	2009	7																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.4555	1.0304	0.4693	0.6381	0.6781	0	0.8968	0.053	0.0076	0.624	1.1114	3.0122	0.0398	0.1142	0.9854	0.078	0	0.0001	0	0	0	0	0	0	0	0											10.194		640.0341835	27.50177939	912.1701603	4194.996315	16.2839897	36.83682216	16.7783119	22.81086072	24.24184607	10352.40936	32.05987293	1.894617318	0.270370159	22.30854322	42.89796366	115.65251	1.421089801	4.082545361	35.2262851	6.617534018	36.19587641	0.003431222	0	684	2.76	158.976	116.4	31.04	0.07	6.8											Medicare FFS cost sharing	Medicare FFS cost sharing	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $0.00	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											707.3991174	672.3192706	66.4919944	8.471989354	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.185241989	0.182182271	0.5	0.2	0.2	0.008899898	0.2	0.2	0	0	0.2	10	0	0	0	0											707.3991174	672.3192706	66.4919944	8.471989354	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.185241989	0.182182271	0.5	0.2	0.2	0.008899898	0.2	0.2	0	0	0.2	10	0	0	0	0											37.73	1.540831355	5.054334432	2.961663677	3.256797941	7.367364433	3.35566238	4.562172144	4.848369214	0	6.411974585	0.378923464	0.054074032	4.461708645	7.946504093	21.06983691	0.7105449	0.816509072	7.04525702	0.058895375	7.239175283	0.000686244	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.5557	135	0	37.73	1.540831355	5.054334432	2.961663677	3.712308796	8.397798171	3.825000874	5.200258687	5.526484605	0	7.308783071	0.431921456	0.061637076	5.085743896	9.057938988	24.08203453	0.750296942	0.930709816	8.030639322	0.136915106	7.239175283	0.000782226	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.7497		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			37.73	1.540831355	5.054334432	2.961663677	3.712308796	8.397798171	3.825000874	5.200258687	5.526484605	0	7.308783071	0.431921456	0.061637076	5.085743896	9.057938988	24.08203453	0.750296942	0.930709816	8.030639322	0.136915106	7.239175283	0.000782226	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.7497
H1340_033_0	2009	8																					3750											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	V	V	V	V	V											0	0	0	0	0.4074	1.0155	0.4005	0.8267	1.2409	0	1.1045	0.0781	0.0029	0.8463	1.4978	5.1149	0.1596	0.5347	1.8228	0.1981	0	0	0	0	0	0	0	0	0	0											15.2508		1597.842305	179.1990236	903.535001	1551.182543	461.405879	20.46485131	8.07051731	1816.412067	268.0864669	9032.836401	22.25907741	80.31204688	0.058960646	1296.003854	9414.644043	18356.77377	436.3465559	3041.979878	36.73428519	940.7301207	26.90005707	0.000990591	0	275	0.75	0	58.2	31.04	168	10472											"$250 days 1 - 5, $0 days 6 - 90"	"$250 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	20% coinsurance	$250.00 copayment	20% coinsurance	"Copay between $20.00 and $150.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$20.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											172.4019198	73.82526506	66.50299446	14.67081281	53.04208581	0.2	0.2	25.18394476	111.106486	4.811701478	0.2	95.89544041	0.2	42.18837456	9.542612342	16.06049225	26.75117458	11.15924541	0.176929113	0.500653231	0.2	0.2	0	20	0.2	0	0	0	0	0											148.3673257	63.53326668	57.23179563	12.62555119	45.64747557	0.172117951	0.172117951	21.67304483	95.61710342	4.14090099	0.172117951	82.52663346	0.172117951	36.30688287	8.212274406	13.82149507	23.02178675	9.603532259	0.152263382	0.43085704	0.172117951	0.172117951	0	20	0.2	0	0	0	0	0											19.7556	0.948758279	4.30924421	1.63204455	1.755167799	3.52236827	1.389080901	3.280598346	2.136137619	3.117006766	3.83118679	0.552323571	0.010148186	3.921155012	6.442970027	21.14317151	0.837123113	2.434479324	5.593286484	0.033776683	4.629982698	0.000170498	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.8841	135	14.7861	19.7556	0.948758279	4.30924421	1.63204455	2.16253674	4.537845336	1.789544364	4.107257283	3.377078507	3.117006766	4.935694331	0.630426101	0.013073845	4.767494167	7.940774515	26.25802471	0.996769689	2.969193901	7.416061717	0.231906065	4.629982698	0.000219652	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.1349		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			19.7556	0.948758279	4.30924421	1.63204455	2.16253674	4.537845336	1.789544364	4.107257283	3.377078507	3.117006766	4.935694331	0.630426101	0.013073845	4.767494167	7.940774515	26.25802471	0.996769689	2.969193901	7.416061717	0.231906065	4.629982698	0.000219652	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.1349
H1340_034_0	2009	8																					3750											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	V	V	V	V	V											0	0	0	0	0.6494	1.2124	0.4369	1.1829	1.2024	0	1.3482	0.0572	0.0056	0.7879	1.6654	5.1743	0.1531	0.4596	1.752	0.2022	0	0.0001	0	0	0	0	0	0	0	0											16.2896		2033.928801	151.9455877	1128.611953	2784.865792	593.6636047	22.02319435	7.937040656	2245.873787	258.989436	7419.173179	24.49005228	67.65920544	0.102413052	1049.428626	9557.087177	17979.97368	396.8025506	2347.468366	31.82456593	848.2063768	37.71129706	0.001376376	0	275	1.785	285.6	116.4	31.04	168	10472											"$250 days 1 - 5, $0 days 6 - 90"	"$250 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	20% coinsurance	$250.00 copayment	20% coinsurance	"Copay between $20.00 and $150.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$20.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											143.2148112	106.1464669	66.94819241	12.56429031	54.42069223	0.2	0.2	25.97249639	111.4045897	5.174836381	0.2	98.1785593	0.2	44.02096335	9.241991326	15.73819513	26.72068277	10.183703	0.171176669	0.972959675	0.2	0.2	0	20	0.2	10	0	0	0	0											122.2048291	90.57450647	57.12671993	10.72107652	46.43703633	0.170659484	0.170659484	22.16226419	95.06124906	4.415674538	0.170659484	83.77551146	0.170659484	37.5629745	7.886167364	13.42936132	22.8006897	8.689727508	0.14606461	0.830223982	0.170659484	0.170659484	0	20	0.2	10	0	0	0	0											20.713	1.146866384	5.372824912	2.48806327	2.297331532	3.758466989	1.354531265	4.147804017	2.05165494	2.730054508	4.17945969	0.472348712	0.017477759	3.284971727	6.280732416	20.12163026	0.753947652	1.699905036	4.648442822	0.05868344	6.435790505	0.000234892	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.0675	135	16.1633	20.713	1.146866384	5.372824912	2.48806327	2.946768218	4.970874509	1.791476406	5.330658114	3.254007277	2.730054508	5.527671175	0.529535934	0.02311574	4.072900778	7.94612963	25.29593672	0.907077187	2.159480869	6.400429498	0.26083386	6.435790505	0.000310663	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.3571		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			20.713	1.146866384	5.372824912	2.48806327	2.946768218	4.970874509	1.791476406	5.330658114	3.254007277	2.730054508	5.527671175	0.529535934	0.02311574	4.072900778	7.94612963	25.29593672	0.907077187	2.159480869	6.400429498	0.26083386	6.435790505	0.000310663	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.3571
H1340_035_0	2009	8																					3750											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	V	V	V	V	V											0	0	0	0	0.4372	1.0619	0.4271	0.9767	1.3125	0	1.1318	0.0624	0.0048	0.7467	1.4302	5.3238	0.1809	0.4993	1.8577	0.235	0	0.0004	0	0	0	0	0	0	0	0											15.6885		1842.793886	154.9358283	1035.746992	2126.167634	546.957425	22.17181811	8.917736537	2231.854686	305.3465717	6559.868985	23.63258943	91.26780652	0.100509054	1010.081028	10032.31267	23524.05391	434.7056994	2972.774085	38.78926054	932.1928491	41.22919747	0.00843773	0	275	1.785	285.6	116.4	31.04	168	10472											"$250 days 1 - 5, $0 days 6 - 90"	"$250 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	20% coinsurance	$250.00 copayment	20% coinsurance	"Copay between $20.00 and $150.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$20.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											161.0876028	108.1806553	66.7	15.06474556	53.83180228	0.2	0.2	25.30783489	111.3818917	5.125874451	0.2	103.1213939	0.2	47.8625114	9.330713827	14.56466952	25.81087425	9.472428994	0.175635711	0.47602397	0.2	0.2	0	20	0.2	10	0	0	0	0											135.1582573	90.76743706	55.96368439	12.63986006	45.16680649	0.16780715	0.16780715	21.23417817	93.45338879	4.300791904	0.16780715	86.52253587	0.16780715	40.15835806	7.828802455	12.22027838	21.65624619	7.947706546	0.14736464	0.399401128	0.16780715	0.16780715	0	20	0.2	10	0	0	0	0											20.7557	1.171927337	4.83035148	2.239538447	2.058693348	3.720589598	1.496459949	3.949300005	2.377972657	2.351052618	3.96571747	0.658060172	0.016866138	3.380266301	6.54508284	23.95587396	0.784507804	1.968894671	5.716165431	0.031026573	6.918554108	0.001415911	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.9474	135	18.9723	20.7557	1.171927337	4.83035148	2.239538447	2.495857761	4.782463569	1.923556738	4.925980949	3.69049036	2.351052618	5.097552102	0.720461147	0.021679814	4.127002049	7.975272341	29.27970819	0.965386062	2.468199526	7.573897888	0.266067854	6.918554108	0.001820019	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.6359		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			20.7557	1.171927337	4.83035148	2.239538447	2.495857761	4.782463569	1.923556738	4.925980949	3.69049036	2.351052618	5.097552102	0.720461147	0.021679814	4.127002049	7.975272341	29.27970819	0.965386062	2.468199526	7.573897888	0.266067854	6.918554108	0.001820019	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.6359
H1340_036_0	2009	8																					3750											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	V	V	V	V	V											0	0	0	0	0.379	0.8264	0.3094	0.7214	0.8335	0	0.7322	0.0508	0	0.5612	1.1875	3.817	0.0937	0.3697	1.4858	0.2184	0	0	0	0	0	0	0	0	0	0											11.5859		1835.628073	233.7586203	889.211357	2184.319352	603.9358439	23.52782971	8.810080259	2112.37184	254.7385676	5164.440904	20.84651866	150.0187809	0	1086.941019	11284.13936	22495.31995	389.0782857	3092.760459	42.30206731	977.3688055	41.60005074	0	0	275	1.785	285.6	116.4	31.04	168	10472											"$250 days 1 - 5, $0 days 6 - 90"	"$250 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	20% coinsurance	$250.00 copayment	20% coinsurance	"Copay between $20.00 and $150.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$20.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											166.3300378	95.98781511	66.7	14.44294549	49.78751572	0.2	0.2	23.89724644	105.0238462	4.687770738	0.2	114.7765568	0	45.91033192	9.201444109	14.43443044	26.24224681	11.40722417	0.174906073	0.247068396	0.2	0	0	20	0.2	10	0	0	0	0											139.7289404	80.63652171	56.03269531	12.13309091	41.82501797	0.168014079	0.168014079	20.07536924	88.22742392	3.938057414	0.168014079	96.42038732	0	38.56791065	7.729860783	12.12593768	22.04533463	9.582871309	0.146933414	0.207554845	0.168014079	0	0	20	0.2	10	0	0	0	0											21.3742	1.570790172	4.152075753	2.20854544	2.10496896	3.953006637	1.48021752	3.533887056	1.872910633	1.694822066	3.502508631	1.205405746	0	3.493420341	7.268735523	22.73140398	0.714780084	2.469793789	6.215587169	0.016904803	6.989394207	0	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.6067	135	18.7622	21.3742	1.570790172	4.152075753	2.20854544	2.483986185	4.779399334	1.789663231	4.255242566	2.7063857	1.694822066	4.234722822	1.2561708	0	4.054573616	8.45627097	26.54836754	0.808460738	2.839539038	7.701407151	0.235255567	6.989394207	0	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.1926		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			21.3742	1.570790172	4.152075753	2.20854544	2.483986185	4.779399334	1.789663231	4.255242566	2.7063857	1.694822066	4.234722822	1.2561708	0	4.054573616	8.45627097	26.54836754	0.808460738	2.839539038	7.701407151	0.235255567	6.989394207	0	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.1926
H1340_037_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		1605.840633	130.4846048	1140.155756	2089.531383	478.2700662	21.2311019	7.735041074	2206.989007	293.4504431	7046.234473	24.37642932	98.69213134	0.070962784	1198.124363	10425.67963	21264.93294	551.2450707	3592.792479	30.92409275	1022.02055	34.84192067	0.043407882	0	964.3636364	2.76	158.976	116.4	31.04	1848	4080											"$100 days 1 - 5, $0 days 6 - 90"	"$100 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 20, $128 days 21 - 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	$10.00 copayment	20% coinsurance	$100.00 copayment	20% coinsurance	"Copay between $10.00 and $75.00, 20% coinsurance"	"Copay between $0.00 and $10.00, 20% coinsurance"	"Copay between $0.00 and $10.00, 20% coinsurance"	Copay between $10.00 and $20.00	$10.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $10.00	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											64.61873269	44.55677337	66.7	4.156125953	53.66550911	0.2	0.2	21.46175145	55.83769506	2.619737867	0.2	46.11446763	0.2	30.86398029	2.843454673	5.118396934	14.88911398	2.928906272	0.171173285	0.174440783	0.2	0.2	0	0	0.2	10	0	0	0	0											60.16828103	41.48803838	62.10620632	3.869883298	49.969433	0.186225506	0.186225506	19.98362764	51.99201514	2.439310052	0.186225506	42.93845038	0.186225506	28.73830177	2.647618929	4.7658803	13.86366394	2.727185265	0.159384159	0.162426615	0.186225506	0.186225506	0	0	0.2	10	0	0	0	0											8.0517	0.451129191	5.900895716	0.67385355	1.991573669	3.953772698	1.440461939	3.675303877	1.271423323	1.432329215	4.539512889	0.353140599	0.01321508	2.869338292	2.300268896	8.445510417	0.636856367	0.816517559	4.928810501	0.013833612	6.488454313	0.008083655	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.9405	0	4.4569	8.0517	0.451129191	5.900895716	0.67385355	1.991573669	3.953772698	1.440461939	3.675303877	1.271423323	1.432329215	4.539512889	0.353140599	0.01321508	2.869338292	2.300268896	8.445510417	0.636856367	0.816517559	4.928810501	0.013833612	6.488454313	0.008083655	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.9405		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			8.0517	0.451129191	5.900895716	0.67385355	1.991573669	3.953772698	1.440461939	3.675303877	1.271423323	1.432329215	4.539512889	0.353140599	0.01321508	2.869338292	2.300268896	8.445510417	0.636856367	0.816517559	4.928810501	0.013833612	6.488454313	0.008083655	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.9405
H1340_038_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		1807.672835	146.7499546	1192.986392	2171.184021	493.8029093	22.36391909	8.951293175	1994.232461	294.5354272	7286.34919	24.65043702	109.614409	0.131622899	1211.32642	10780.82874	23272.49785	539.8317166	3831.848332	40.79542468	1017.449697	38.1621092	0.002583393	0	964.3636364	2.76	158.976	116.4	31.04	1848	4080											"$100 days 1 - 5, $0 days 6 - 90"	"$100 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 20, $128 days 21 - 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 $90.00	$20.00 copayment	20% coinsurance	$100.00 copayment	20% coinsurance	"Copay between $20.00 and $90.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $25.00, 20% coinsurance"	Copay between $15.00 and $25.00	$25.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $25.00	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											65.32334522	40.98089685	66.7	10.71745404	51.11172234	0.2	0.2	21.10023243	65.956162	5.201037959	0.2	44.97399411	0.2	35.79466529	5.109254105	11.21959688	18.96148009	7.109223358	0.174130261	0.350979655	0.2	0.2	0	0	0.2	10	0	0	0	0											57.55390828	36.10670535	58.7668263	9.442740033	45.03258934	0.176212373	0.176212373	18.59061011	58.11145901	4.582436197	0.176212373	39.62487106	0.176212373	31.5373145	4.501568944	9.885158933	16.70623698	6.263665581	0.153419532	0.309234789	0.176212373	0.176212373	0	0	0.2	10	0	0	0	0											8.6699	0.441554781	5.842335342	1.708493856	1.853101969	3.940799246	1.577328609	3.089499846	1.426323617	2.782435856	4.343711996	0.361954735	0.023193583	3.183498523	4.044220322	19.17102833	0.751546382	2.000118042	6.258814966	0.026219237	6.72463581	0.000455226	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.9056	0	10.5594	8.6699	0.441554781	5.842335342	1.708493856	1.853101969	3.940799246	1.577328609	3.089499846	1.426323617	2.782435856	4.343711996	0.361954735	0.023193583	3.183498523	4.044220322	19.17102833	0.751546382	2.000118042	6.258814966	0.026219237	6.72463581	0.000455226	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.9056		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			8.6699	0.441554781	5.842335342	1.708493856	1.853101969	3.940799246	1.577328609	3.089499846	1.426323617	2.782435856	4.343711996	0.361954735	0.023193583	3.183498523	4.044220322	19.17102833	0.751546382	2.000118042	6.258814966	0.026219237	6.72463581	0.000455226	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.9056
H1340_039_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		2004.773052	170.1566638	1227.748211	2508.809411	532.5547179	23.99580276	9.330664034	2145.250851	310.7436991	7962.136981	26.72317377	99.63952233	0.188783272	1274.55887	10555.00371	21929.27629	518.4559989	3721.955963	39.7002099	1007.370946	42.2025085	0.001730902	0	964.3636364	2.76	158.976	116.4	31.04	1848	4080											"$125 days 1 - 5, $0 days 6 - 90"	"$125 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $55.00 and $105.00	$20.00 copayment	20% coinsurance	$125.00 copayment	20% coinsurance	"Copay between $20.00 and $105.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											79.93398202	52.61056374	66.7	14.70384708	53.50833586	0.2	0.2	24.99445068	76.6541474	5.382996866	0.2	55.45557678	0.2	37.68085094	7.424381173	15.46130448	26.53848623	9.493989805	0.174261599	0.60167938	0.2	0.2	0	0	0.2	10	0	0	0	0											67.51300656	44.43538587	56.33545863	12.41901002	45.19365279	0.168921915	0.168921915	21.11055236	64.74282683	4.546530694	0.168921915	46.83831112	0.168921915	31.82560748	6.270703425	13.0587658	22.41465956	8.018714691	0.147183015	0.508184166	0.168921915	0.168921915	0	0	0.2	10	0	0	0	0											11.279	0.630081418	5.763813214	2.596410769	2.005674418	4.053416952	1.576153636	3.773952535	1.676535458	3.016675014	4.514129686	0.388912246	0.031889632	3.38030086	5.515608159	23.86410694	0.968417893	2.48710858	5.843196577	0.04266083	7.128928551	0.000292387	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.2218	0	16.657	11.279	0.630081418	5.763813214	2.596410769	2.005674418	4.053416952	1.576153636	3.773952535	1.676535458	3.016675014	4.514129686	0.388912246	0.031889632	3.38030086	5.515608159	23.86410694	0.968417893	2.48710858	5.843196577	0.04266083	7.128928551	0.000292387	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.2218		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			11.279	0.630081418	5.763813214	2.596410769	2.005674418	4.053416952	1.576153636	3.773952535	1.676535458	3.016675014	4.514129686	0.388912246	0.031889632	3.38030086	5.515608159	23.86410694	0.968417893	2.48710858	5.843196577	0.04266083	7.128928551	0.000292387	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.2218
H1340_040_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		2162.132264	169.0589873	1303.410107	2586.540288	665.6695214	25.37131793	9.275715419	2068.032288	340.5698976	7426.762206	28.67288153	109.2375719	0.160676175	1211.360845	11248.86007	24515.52293	515.2686101	3562.166847	39.90613473	1008.756804	43.92632507	0.002093095	0	964.3636364	2.76	158.976	116.4	31.04	1848	4080											"$125 days 1 - 5, $0 days 6 - 90"	"$125 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $55.00 and $105.00	$20.00 copayment	20% coinsurance	$125.00 copayment	20% coinsurance	"Copay between $20.00 and $105.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											77.34712261	54.28812336	66.7	14.81764471	52.81755616	0.2	0.2	23.83432884	77.54029922	5.062412586	0.2	59.84171716	0.2	39.0569078	7.315793332	14.85151106	25.98602546	9.250657934	0.173868363	0.449613055	0.2	0.2	0	0	0.2	10	0	0	0	0											64.66195889	45.38470576	55.76099682	12.38750584	44.15531606	0.167199391	0.167199391	19.92542631	64.82345395	4.232161501	0.167199391	50.02749326	0.167199391	32.65145594	6.115980941	12.415818	21.72423813	7.733521854	0.145353422	0.375875144	0.167199391	0.167199391	0	0	0.2	10	0	0	0	0											11.6506	0.639391033	6.05662057	2.670065242	2.449404009	4.2420689	1.550893967	3.433868747	1.839743089	2.619271424	4.794088323	0.455406824	0.026864959	3.296057939	5.733151148	25.36502257	0.932818165	2.295674597	5.800493239	0.031597217	7.34445479	0.000349964	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.9124	0	18.2891	11.6506	0.639391033	6.05662057	2.670065242	2.449404009	4.2420689	1.550893967	3.433868747	1.839743089	2.619271424	4.794088323	0.455406824	0.026864959	3.296057939	5.733151148	25.36502257	0.932818165	2.295674597	5.800493239	0.031597217	7.34445479	0.000349964	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.9124		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			11.6506	0.639391033	6.05662057	2.670065242	2.449404009	4.2420689	1.550893967	3.433868747	1.839743089	2.619271424	4.794088323	0.455406824	0.026864959	3.296057939	5.733151148	25.36502257	0.932818165	2.295674597	5.800493239	0.031597217	7.34445479	0.000349964	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.9124
H1340_041_0	2009	6																					2500											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	V	T	V	Coin	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		1601.837908	103.7084847	1147.469017	2075.107472	443.0174799	20.650538	7.713553276	2114.982315	300.2564202	6979.925571	24.73488629	114.7057537	0.047803875	1320.872221	11059.17997	21473.72911	475.9225874	3505.494643	31.78263653	1057.331166	35.5890143	1.68647036	0	964.3636364	2.76	158.976	116.4	31.04	1848	3960											"$0 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 7, $0 days 8 - 100"	Copay between $0.00 and $15.00	$150.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	20% coinsurance	$0.00 copayment	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	"Copay between $0.00 and $15.00, 20% coinsurance"	$15.00 copayment	$15.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $15.00	20% coinsurance	$0.00 copayment		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											0	114.2401914	0	5.371389629	72.71549949	0.2	0.2	20.88357622	0	0	0.2	0	0.2	12.28100044	0.05531766	6.681255273	10.93826392	3.343802317	0.171502179	0.149696875	0.2	0	0	0	0.2	10	0	0	0	0											0	106.3304078	0	4.999484354	67.6808102	0.186152363	0.186152363	19.43763529	0	0	0.186152363	0	0.186152363	11.43068624	0.051487565	6.218657276	10.18091837	3.112283509	0.15962768	0.139332135	0.186152363	0	0	0	0.2	10	0	0	0	0											0	0.918947122	0	0.864538945	2.498648498	3.844146442	1.435896168	3.425854572	0	0	4.604457527	0	0.008898804	1.258206327	0.047450854	11.12814682	0.403777418	0.909174431	5.07338852	0.012276684	6.624979101	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7433	0	3.2031	0	0.918947122	0	0.864538945	2.498648498	3.844146442	1.435896168	3.425854572	0	0	4.604457527	0	0.008898804	1.258206327	0.047450854	11.12814682	0.403777418	0.909174431	5.07338852	0.012276684	6.624979101	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7433		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	0.918947122	0	0.864538945	2.498648498	3.844146442	1.435896168	3.425854572	0	0	4.604457527	0	0.008898804	1.258206327	0.047450854	11.12814682	0.403777418	0.909174431	5.07338852	0.012276684	6.624979101	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7433
H1340_801_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.3436	0.7469	0.3288	0.6945	0.9788	0	0.9956	0.054	0.0043	0.6676	1.3813	4.895	0.1462	0.5606	1.7388	0.3052	0	0.0003	0	0	0	0	0	0	0	0											13.8414		327.6041783	8.944189615	1201.16344	2540.773897	8.5859254	18.66371944	8.216061195	17.35388953	24.45830428	7813.312892	24.87751845	1.349482697	0.107609766	16.6831031	36.25450555	135.8676867	3.653017311	14.00755082	43.45001293	7.625248938	40.01868761	0.007142617	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											819.2	819.2	76.71	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199937572	0.197199066	0.5	0.2	0.2	0.195807763	0.2	0.2	0	0	0	0	0	0	0	0											819.2	819.2	76.71	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199937572	0.197199066	0.5	0.2	0.2	0.195807763	0.2	0.2	0	0	0	0	0	0	0	0											22.3644	0.610590011	7.678437292	0	1.71718508	3.732743888	1.643212239	3.470777907	4.891660855	0	4.975503691	0.269896539	0.021521953	3.336620619	7.248637807	26.79298088	1.826508656	2.801510164	8.690002586	1.493082937	8.003737523	0.001428523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.5705	135	0	22.3644	0.610590011	7.678437292	0	2.060786386	4.479649792	1.9720119	4.165265551	5.870461031	0	5.971080455	0.323901669	0.025828403	4.004263971	8.629913647	31.68798691	1.972699248	3.362080228	10.42883451	1.798238802	8.003737523	0.001714365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4119		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			22.3644	0.610590011	7.678437292	0	2.060786386	4.479649792	1.9720119	4.165265551	5.870461031	0	5.971080455	0.323901669	0.025828403	4.004263971	8.629913647	31.68798691	1.972699248	3.362080228	10.42883451	1.798238802	8.003737523	0.001714365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4119
H1340_802_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.3436	0.7469	0.3288	0.6945	0.9788	0	0.9956	0.054	0.0043	0.6676	1.3813	4.895	0.1462	0.5606	1.7388	0.3052	0	0.0003	0	0	0	0	0	0	0	0											13.8414		327.6041783	8.944189615	1201.16344	2540.773897	8.5859254	18.66371944	8.216061195	17.35388953	24.45830428	7813.312892	24.87751845	1.349482697	0.107609766	16.6831031	36.25450555	135.8676867	3.653017311	14.00755082	43.45001293	7.625248938	40.01868761	0.007142617	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											819.2	819.2	76.71	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199937572	0.197199066	0.5	0.2	0.2	0.195807763	0.2	0.2	0	0	0	0	0	0	0	0											819.2	819.2	76.71	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199937572	0.197199066	0.5	0.2	0.2	0.195807763	0.2	0.2	0	0	0	0	0	0	0	0											22.3644	0.610590011	7.678437292	0	1.71718508	3.732743888	1.643212239	3.470777907	4.891660855	0	4.975503691	0.269896539	0.021521953	3.336620619	7.248637807	26.79298088	1.826508656	2.801510164	8.690002586	1.493082937	8.003737523	0.001428523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.5705	135	0	22.3644	0.610590011	7.678437292	0	2.060786386	4.479649792	1.9720119	4.165265551	5.870461031	0	5.971080455	0.323901669	0.025828403	4.004263971	8.629913647	31.68798691	1.972699248	3.362080228	10.42883451	1.798238802	8.003737523	0.001714365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4119		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			22.3644	0.610590011	7.678437292	0	2.060786386	4.479649792	1.9720119	4.165265551	5.870461031	0	5.971080455	0.323901669	0.025828403	4.004263971	8.629913647	31.68798691	1.972699248	3.362080228	10.42883451	1.798238802	8.003737523	0.001714365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4119
H1340_803_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.3436	0.7469	0.3288	0.6945	0.9788	0	0.9956	0.054	0.0043	0.6676	1.3813	4.895	0.1462	0.5606	1.7388	0.3052	0	0.0003	0	0	0	0	0	0	0	0											13.8414		327.6041783	8.944189615	1201.16344	2540.773897	8.5859254	18.66371944	8.216061195	17.35388953	24.45830428	7813.312892	24.87751845	1.349482697	0.107609766	16.6831031	36.25450555	135.8676867	3.653017311	14.00755082	43.45001293	7.625248938	40.01868761	0.007142617	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											819.2	819.2	76.71	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199937572	0.197199066	0.5	0.2	0.2	0.195807763	0.2	0.2	0	0	0	0	0	0	0	0											819.2	819.2	76.71	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199937572	0.197199066	0.5	0.2	0.2	0.195807763	0.2	0.2	0	0	0	0	0	0	0	0											22.3644	0.610590011	7.678437292	0	1.71718508	3.732743888	1.643212239	3.470777907	4.891660855	0	4.975503691	0.269896539	0.021521953	3.336620619	7.248637807	26.79298088	1.826508656	2.801510164	8.690002586	1.493082937	8.003737523	0.001428523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.5705	135	0	22.3644	0.610590011	7.678437292	0	2.060786386	4.479649792	1.9720119	4.165265551	5.870461031	0	5.971080455	0.323901669	0.025828403	4.004263971	8.629913647	31.68798691	1.972699248	3.362080228	10.42883451	1.798238802	8.003737523	0.001714365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4119		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			22.3644	0.610590011	7.678437292	0	2.060786386	4.479649792	1.9720119	4.165265551	5.870461031	0	5.971080455	0.323901669	0.025828403	4.004263971	8.629913647	31.68798691	1.972699248	3.362080228	10.42883451	1.798238802	8.003737523	0.001714365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4119
H1340_804_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.3436	0.7469	0.3288	0.6945	0.9788	0	0.9956	0.054	0.0043	0.6676	1.3813	4.895	0.1462	0.5606	1.7388	0.3052	0	0.0003	0	0	0	0	0	0	0	0											13.8414		327.6041783	8.944189615	1201.16344	2540.773897	8.5859254	18.66371944	8.216061195	17.35388953	24.45830428	7813.312892	24.87751845	1.349482697	0.107609766	16.6831031	36.25450555	135.8676867	3.653017311	14.00755082	43.45001293	7.625248938	40.01868761	0.007142617	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											819.2	819.2	76.71	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199937572	0.197199066	0.5	0.2	0.2	0.195807763	0.2	0.2	0	0	0	0	0	0	0	0											819.2	819.2	76.71	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199937572	0.197199066	0.5	0.2	0.2	0.195807763	0.2	0.2	0	0	0	0	0	0	0	0											22.3644	0.610590011	7.678437292	0	1.71718508	3.732743888	1.643212239	3.470777907	4.891660855	0	4.975503691	0.269896539	0.021521953	3.336620619	7.248637807	26.79298088	1.826508656	2.801510164	8.690002586	1.493082937	8.003737523	0.001428523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.5705	135	0	22.3644	0.610590011	7.678437292	0	2.060786386	4.479649792	1.9720119	4.165265551	5.870461031	0	5.971080455	0.323901669	0.025828403	4.004263971	8.629913647	31.68798691	1.972699248	3.362080228	10.42883451	1.798238802	8.003737523	0.001714365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4119		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			22.3644	0.610590011	7.678437292	0	2.060786386	4.479649792	1.9720119	4.165265551	5.870461031	0	5.971080455	0.323901669	0.025828403	4.004263971	8.629913647	31.68798691	1.972699248	3.362080228	10.42883451	1.798238802	8.003737523	0.001714365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4119
H1350_001_0	2009	15																					0													D					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	133.4	0	0	0	0	359.3	0	0	0	0	0	110.1	3501.9	5472.6	241.3	910.4	0	0	0	0	0	0	0	0	8.6	0	0	0													$25/Days Custom 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; $10/Case for OP Fac - CORF; $10/Visit for Prof - CORF; $10/Visit 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/Visit for Podiatrist; $20/Exam for Vistion Exams; $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/Visit for PT/ST (PCP); $10/Visit for Occ Therapy (PCP); $10/Visit for PT/ST (Specialist); $10/Visit for Occ Therapy (Specialist);							$20/Exam for Vision (Refractions)		$10/Exam for Routine Hearing Exams														0	0	25	0	0	0	0	44.08107757	0	0	0	0	0	11.71695063	10	20	20	10	0	0	0	0	0	0	20	0	10	0	0	0											0	0	25	0	0	0	0	44.08107757	0	0	0	0	0	11.71695063	10	20	20	10	0	0	0	0	0	0	20	0	10	0	0	0											0	0	0.277916667	0	0	0	0	1.319860931	0	0	0	0	0	0.107503022	2.91825	9.121	0.402166667	0.758666667	0	0	0	0	0	0	0	0	0.007166667	0	0	0	0	0	0	0	0	0	0	0	0	0	14.9125	0	0	0	0	0.277916667	0	0	0	0	1.319860931	0	0	0	0	0	0.107503022	2.91825	9.121	0.402166667	0.758666667	0	0	0	0	0	0	0	0	0.007166667	0	0	0	0	0	0	0	0	0	0	0	0	0	14.9125	0																																																																																	0	0		0	0	0.277916667	0	0	0	0	1.319860931	0	0	0	0	0	0.107503022	2.91825	9.121	0.402166667	0.758666667	0	0	0	0	0	0	0	0	0.007166667	0	0	0	0	0	0	0	0	0	0	0	0	0	14.9125
H1350_006_0	2009	13																					0													D					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	56.5	0	0	0	0	290.4	0	0	0	0	0	14.9	2415.4	4506	89.4	726.9	0	0	0	0	0	0	0	0	14.2	0	0	0													$25/Days Custom 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/Visit for Prof - CORF; $20/Visit 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/Visit for Podiatrist; $20/Exam for Vistion Exams; $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/Visit for PT/ST (PCP); $10/Visit for Occ Therapy (PCP); $10/Visit for PT/ST (Specialist); $10/Visit for Occ Therapy (Specialist);							$20/Exam for Vision (Refractions)		$10/Exam for Routine Hearing Exams														0	0	25	0	0	0	0	44.05508463	0	0	0	0	0	11.70540597	10	20	20.00000001	10	0	0	0	0	0	0	20	0	10	0	0	0											0	0	25	0	0	0	0	44.05508463	0	0	0	0	0	11.70540597	10	20	20.00000001	10	0	0	0	0	0	0	20	0	10	0	0	0											0	0	0.117708333	0	0	0	0	1.066133048	0	0	0	0	0	0.014534212	2.012833333	7.51	0.149	0.60575	0	0	0	0	0	0	0	0	0.011833333	0	0	0	0	0	0	0	0	0	0	0	0	0	11.4878	0	0	0	0	0.117708333	0	0	0	0	1.066133048	0	0	0	0	0	0.014534212	2.012833333	7.51	0.149	0.60575	0	0	0	0	0	0	0	0	0.011833333	0	0	0	0	0	0	0	0	0	0	0	0	0	11.4878	0																																																																																	0	0		0	0	0.117708333	0	0	0	0	1.066133048	0	0	0	0	0	0.014534212	2.012833333	7.51	0.149	0.60575	0	0	0	0	0	0	0	0	0.011833333	0	0	0	0	0	0	0	0	0	0	0	0	0	11.4878
H1350_009_0	2009	15																					0													D					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	726.8449382	0	0	0	0	606.7421091	0	0	0	0	0	704.6085931	5719.967806	6038.024861	1121.372515	613.1805484	0	0	0	0	0	0	275.1657186	0	145.0396176	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														0	0	25	0	0	0	0	43.19717545	0	0	0	0	0	11.51699465	10	20	20	9.999999998	0	0	0	0	0	0	20	0	10	0	0	0											0	0	25	0	0	0	0	43.19717545	0	0	0	0	0	11.51699465	10	20	20	9.999999998	0	0	0	0	0	0	20	0	10	0	0	0											0	0	1.514260288	0	0	0	0	2.184128778	0	0	0	0	0	0.676247783	4.766639838	10.06337477	1.868954193	0.51098379	0	0	0	0	0	0	0.458609531	0	0.120866348	0	0	0	0	0	0	0	0	0	0	0	0	0	22.1641	0	0	0	0	1.514260288	0	0	0	0	2.184128778	0	0	0	0	0	0.676247783	4.766639838	10.06337477	1.868954193	0.51098379	0	0	0	0	0	0	0.458609531	0	0.120866348	0	0	0	0	0	0	0	0	0	0	0	0	0	22.1641	0																																																																																	0	0	0	0	0	1.514260288	0	0	0	0	2.184128778	0	0	0	0	0	0.676247783	4.766639838	10.06337477	1.868954193	0.51098379	0	0	0	0	0	0	0.458609531	0	0.120866348	0	0	0	0	0	0	0	0	0	0	0	0	0	22.1641
H1355_001_0	2009	2																																D	coin	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		697.3765212	2.374323004	603.6355801	43.36343663	201.5749313	11.13263887	3.167696609	192.3241851	224.467037	1.647103988	108.6760248	0	0.178331229	332.2672903	1.79438684	4138.190028	130.9692281	602.8223249	28.2124181	13.56288214	6.157942385	0	0	0	0	0	0	0	310.5048387	0											1a:  Acute - $100/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - MC Cost Shares for 1-/1-190	2:  Skilled Nursing Services - $0/$85/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$85/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $75/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $15/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $75/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $100/visit/8b:  Outpatient Therapeutic Radiological Services - $100/visit/8b:  Outpatient X-Ray Services - $0/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $15/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $0/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $15/visit/7b:  Chiropractic Services - $15/visit/7f:  Podiatry Services - $15/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $15/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $15/visit/7h:  Psychiatric Services - Individual - $15/visit/7h:  Psychiatric Services - Group - $15/visit	7c:  Occupational Therapy Services - $15/visit/7i:  Physical/Speech Therapy - $15/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $15/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $0/visit/18a:  Fitting for Hearing Aid - $0/visit	18b:  Hearing Aids - $0/service	14a:  Written health education materials - $0/service/14c:  Routine Exams - $0/visit/												100	0.0721	85	0	75	0.2	0.2	36.65484182	80.0452538	0	100	0	0.2	15	15	15	15	15	0	17.08875058	0.2	0	0	0	0	0	0	0	0	0											97.31801496	0.070165753	82.71968162	-7.00E-19	72.98795437	0.194634545	0.194634545	35.6714923	77.89785776	0	97.31727249	0	0.194634545	14.59759087	14.59759087	14.59759087	14.59759087	14.59759087	0	16.63030597	0.194634545	0	0	0	0	0	0	0	0	0											5.6556	0.166596163	4.16104525	-3.04E-17	1.226045157	2.166796101	0.616543188	0.571707557	1.45712511	0	0.88133786	0	0.034709418	0.40419183	0.00218281	5.033967082	0.159319601	0.733312806	0	0.01879624	1.198548314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.4878	0	0.829	5.6556	0.166596163	4.16104525	-3.04E-17	1.226045157	2.166796101	0.616543188	0.571707557	1.45712511	0	0.88133786	0	0.034709418	0.40419183	0.00218281	5.033967082	0.159319601	0.733312806	0	0.01879624	1.198548314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.4878	4000	1a:  Acute - 20.0% for 1-90/1a:  Additional Days - 20.0% for 91-999	1b:  Psych - 30.0% for 1-/1-190	2:  Skilled Nursing Services - 20.0% for 1-100/2:  Non-Medicare Covered Stay - 20.0% for 1-100	6:  Home Health Services - 20.0%	10a:  Ambulance - 20.0%	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $15/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - 20.0%	8a:  Outpatient Diagnostic Procedures/Tests - 20.0%/8a:  Outpatient Lab Services - 20.0%	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - 20.0%/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - 20.0%	9d:  Cardiac Rehabilitation Services - 30.0%/3:  Rehab Services (CORF) - 30.0%/5:  Partial Hospitalization - 30.0%/7c:  Occupational Therapy Services - 20.0%/7i:  Physical/Speech Therapy - 20.0%/9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%	7a:  Primary Care - 20.0%/17a:  Vision Exams - 20.0%/18a:  Hearing Exams - 20.0%/14c:  Physical Exams (Initial Exam) - 20.0%/14d:  Pap Smears and Pelvic Exams Screening - 20.0%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%	7d:  Physician Specialist Services - 20.0%/7b:  Chiropractic Services - 20.0%/7f:  Podiatry Services - 20.0%/17a:  Vision Exams - 20.0%/18a:  Hearing Exams - 20.0%/14d:  Pap Smears and Pelvic Exams Screening - 20.0%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%	7e:  Mental Hlth Spec-Non-Physician - Individual - 30.0%/7e:  Mental Hlth Spec-Non-Physician - Group - 30.0%/7h:  Psychiatric Services - Individual - 30.0%/7h:  Psychiatric Services - Group - 30.0%	7c:  Occupational Therapy Services - 20.0%/7i:  Physical/Speech Therapy - 20.0%	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%	9c:  Outpatient Substance Abuse Svcs - Individual - 30.0%/9c:  Outpatient Substance Abuse Svcs - Group - 30.0%/7g:  Other Health Care Professional Services - 20.0%	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%			17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $0/visit/18a:  Fitting for Hearing Aid - $0/visit	18b:  Hearing Aids - $0/service	14c:  Routine Exams - 20.0%/												5.3621	0.0871	0.9133	0.5995	0.1334	0.4099	0.1166	0.0801	0.7248	0.1316	0.4168	0	0.0046	0.6237	0.5847	1.7489	0.0343	0.1123	0.5476	0.688	0.1635	0.0175	0	0	0	0	0	0	0.0144	0											13.5148	0	0.154	11.0177	0.253743297	5.074388743	0.599539229	1.359410926	2.576696753	0.733176892	0.651854068	2.181912102	0.13162265	1.29818119	0	0.039335139	1.027864144	0.586922048	6.782827249	0.193652606	0.845625713	0.547559019	0.706789531	1.362006845	0.017477269	0	0	0	0	0	0	0.014357583	0	0	0	0	0	0	0	0	0	0	0	38.0027
H1356_001_0	2009	2																					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																																																			0		282.7776549	6.83775213	989.170922	1229.687238	153.3453418	9.008557815	15.87429777	308.8962564	306.1848566		3947.364935	89.84899201	3.247597436	119.8966099	2398.108047	2659.981051	184.2255905	612.4837795			18.27298673	1148.740719					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	20.46922012	100	0.2	0.2	48.54038586	47.5		10.08064795	50	50	14.96950061	10	24.04229167	27.09735519	15			0.2	15					15														154.9899365	133.1829933	54.52287013	17.17272198	83.89534084	0.167790682	0.167790682	40.72312216	39.8502869		8.457193959	41.94767042	41.94767042	12.55871356	8.389534084	20.17036254	22.73341849	12.58430113			0.167790682	12.58430113					12.58430113														3.6523	0.075889358	4.49436981	1.759756422	1.072079976	1.511552057	2.663559244	1.048268332	1.016796198	0	2.781969241	0.314079659	0.011352429	0.125478932	1.6765841	4.471065179	0.349006454	0.642306693	0	0	3.0660369	1.204674927	0	0	0	0	0.228104111	0	0	0	0	0	0	0	0	0	0	0	0	0	32.1652	0	6.1745	3.6523	0.075889358	4.49436981	1.759756422	1.072079976	1.511552057	2.663559244	1.048268332	1.016796198	0	2.781969241	0.314079659	0.011352429	0.125478932	1.6765841	4.471065179	0.349006454	0.642306693	0	0	3.0660369	1.204674927	0	0	0	0	0.228104111	0	0	0	0	0	0	0	0	0	0	0	0	0	32.1652		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										5.3743	0.1057	2.0851	0.8617	0.3029	0.5551	0.9782	0.3621	2.0346	0.9834	2.0433	0.4345	0.0027	2.2461	1.4675	2.0225	0.1331	0.3617			0.8119	0.6468					0.1174														23.9305	500	0	9.0266	0.181598761	6.57944363	2.621427339	1.374978422	2.06665464	3.641725103	1.410407441	3.051396715	0.983388367	4.825270764	0.748605443	0.014061084	2.371534808	3.144091969	6.49358181	0.48211809	1.003979059	0	0	3.877950966	1.85144358	0	0	0	0	0.345475918	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0957
H1356_002_0	2009	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																																																			0		282.7776549	6.83775213	989.170922	1229.687238	153.3453418	9.008557815	15.87429777	308.8962564	306.1848566		3947.364935	89.84899201	3.247597436	119.8966099	2398.108047	2659.981051	184.2255905	612.4837795			18.27298673	1148.740719					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	20.46922012	100	0.2	0.2	48.54038586	47.5		10.08064795	50	50	14.96950061	10	24.04229167	27.09735519	15			0.2	15					15														154.9899365	133.1829933	54.52287013	17.17272198	83.89534084	0.167790682	0.167790682	40.72312216	39.8502869		8.457193959	41.94767042	41.94767042	12.55871356	8.389534084	20.17036254	22.73341849	12.58430113			0.167790682	12.58430113					12.58430113														3.6523	0.075889358	4.49436981	1.759756422	1.072079976	1.511552057	2.663559244	1.048268332	1.016796198	0	2.781969241	0.314079659	0.011352429	0.125478932	1.6765841	4.471065179	0.349006454	0.642306693	0	0	3.0660369	1.204674927	0	0	0	0	0.228104111	0	0	0	0	0	0	0	0	0	0	0	0	0	32.1652	0	6.1745	3.6523	0.075889358	4.49436981	1.759756422	1.072079976	1.511552057	2.663559244	1.048268332	1.016796198	0	2.781969241	0.314079659	0.011352429	0.125478932	1.6765841	4.471065179	0.349006454	0.642306693	0	0	3.0660369	1.204674927	0	0	0	0	0.228104111	0	0	0	0	0	0	0	0	0	0	0	0	0	32.1652		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										5.3743	0.1057	2.0851	0.8617	0.3029	0.5551	0.9782	0.3621	2.0346	0.9834	2.0433	0.4345	0.0027	2.2461	1.4675	2.0225	0.1331	0.3617			0.8119	0.6468					0.1174														23.9305	500	0	9.0266	0.181598761	6.57944363	2.621427339	1.374978422	2.06665464	3.641725103	1.410407441	3.051396715	0.983388367	4.825270764	0.748605443	0.014061084	2.371534808	3.144091969	6.49358181	0.48211809	1.003979059	0	0	3.877950966	1.85144358	0	0	0	0	0.345475918	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0957
H1356_003_0	2009	4																					3000											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																																																			0		374.8973003	14.62531501	1371.241857		316.7953742	14.52986116	26.30985483	548.2766569	256.2435443			78.46738124	1.101402611	63.52366255	0.897834896	2297.975733	484.028111	547.3928623			11.61171094	704.3682273					217.5130188														1a: $250 days 1-5	1b : $250 days 1-5	2a: $105 days 21 - 100  2a2: $105 days 21-100	6a: 0%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50  4b: $25	9a: $150 9b: $100	8a: 0%	8b1: 0% 8b2: 0% 8b3: 0%	9a: $150	12: $50	9a: $150 9c: 30% 9d: $25 3: $15 5: $25	"7a: $0, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $10, 14j: $10"	7b: $30 7d: $25 7f: $25	"7e: $35, 7h: $35"	7c: $25 7i: $25	8b1: 0% 8b2: 0% 8b3: 0%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $10 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $25 18a1: $25	18b: (n/c)		13c (: $											462.7102261	417.7604594	68.23860903		100	0.1	0.2	47.52253313	145			150	50	24.51612094	10	25.61207344	35	25			0.2	14.9744604					25														379.6339688	342.7546059	55.98686285		82.04572697	0.082045727	0.164091454	38.99020778	118.9663041			123.0685904	41.02286348	20.11442965	8.204572697	21.01361185	28.71600444	20.51143174			0.164091454	12.2859049					20.51143174														11.8603	0.417741174	6.39762748	0	2.165975565	1.192113022	4.317222332	1.781451731	2.540362285	0	0	0.804739167	0.003765224	0.10647852	0.000613863	4.024064173	1.158279449	0.935650944	0	0	1.905382531	0.721150088	0	0	0	0	0.371791953	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7047	0	8.9075	11.8603	0.417741174	6.39762748	0	2.165975565	1.192113022	4.317222332	1.781451731	2.540362285	0	0	0.804739167	0.003765224	0.10647852	0.000613863	4.024064173	1.158279449	0.935650944	0	0	1.905382531	0.721150088	0	0	0	0	0.371791953	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7047		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50  4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: 30%9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										6.5295	0.2219	2.8985	1.0977	0.5977	0.8827	1.5984	0.6055	1.7462	1.025	1.9361	0.3994	0.0009	2.6073	1.5575	1.7123	0.31	0.3248			0.5044	0.4071					0.1167														27.0798	500	0	18.3898	0.639686465	9.296169334	1.097703724	2.763660312	2.074828746	5.915594284	2.386986597	4.286602878	1.025046587	1.936105704	1.204122868	0.004673531	2.713791903	1.558151085	5.736373352	1.468296813	1.260429264	0	0	2.4098056	1.128247315	0	0	0	0	0.488496289	0	0	0	0	0	0	0	0	0	0	0	0	0	67.7846
H1356_801_0	2009	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																																																			0		209.7275573	2.720335798	33.82911847		8.278545635	9.008557815	15.87429777	14.64528526	33.0187914	15.95905195	33.15999688	7.051760823	0.038074316	35.96495452	25.55559821	68.50948708	1.386673961	5.432426161			18.27298673	7.050707098																			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																			0.0895	0.0895	0.1597		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.0895	0.0895	0.1597		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			18.7706	0.243470054	5.40251022	0	1.912344042	2.080976855	3.666962785	3.383060894	7.627340814	3.686541001	7.659959279	1.62895675	0.008795167	8.307904493	5.903343187	15.82569152	0.320321685	1.254890443	0	0	4.221059934	1.62871334	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5335	0	0	18.7706	0.243470054	5.40251022	0	1.912344042	2.080976855	3.666962785	3.383060894	7.627340814	3.686541001	7.659959279	1.62895675	0.008795167	8.307904493	5.903343187	15.82569152	0.320321685	1.254890443	0	0	4.221059934	1.62871334	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5335		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																			3.4149	0.0443	0.9829		0.3479	0.3786	0.6671	0.6155	1.3876	0.6707	1.3936	0.2964	0.0016	1.5114	1.074	2.8791	0.0583	0.2283			0.7679	0.2963																			17.0164	0	0	22.1855	0.287764181	6.385380485	0	2.260253813	2.459565731	4.334087609	3.99853589	9.014971041	4.35722766	9.053523733	1.925310313	0.010395258	9.81934861	6.977329213	18.70483491	0.37859731	1.483190706	0	0	4.98899079	1.925022619	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.5499
H1356_802_0	2009	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																																																			0		209.7275573	2.720335798	33.82911847		8.278545635	9.008557815	15.87429777	14.64528526	33.0187914	15.95905195	33.15999688	7.051760823	0.038074316	35.96495452	25.55559821	68.50948708	1.386673961	5.432426161			18.27298673	7.050707098																			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																			0.0895	0.0895	0.1597		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.0895	0.0895	0.1597		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			18.7706	0.243470054	5.40251022	0	1.912344042	2.080976855	3.666962785	3.383060894	7.627340814	3.686541001	7.659959279	1.62895675	0.008795167	8.307904493	5.903343187	15.82569152	0.320321685	1.254890443	0	0	4.221059934	1.62871334	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5335	0	0	18.7706	0.243470054	5.40251022	0	1.912344042	2.080976855	3.666962785	3.383060894	7.627340814	3.686541001	7.659959279	1.62895675	0.008795167	8.307904493	5.903343187	15.82569152	0.320321685	1.254890443	0	0	4.221059934	1.62871334	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5335		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																			3.4149	0.0443	0.9829		0.3479	0.3786	0.6671	0.6155	1.3876	0.6707	1.3936	0.2964	0.0016	1.5114	1.074	2.8791	0.0583	0.2283			0.7679	0.2963																			17.0164	0	0	22.1855	0.287764181	6.385380485	0	2.260253813	2.459565731	4.334087609	3.99853589	9.014971041	4.35722766	9.053523733	1.925310313	0.010395258	9.81934861	6.977329213	18.70483491	0.37859731	1.483190706	0	0	4.98899079	1.925022619	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.5499
H1356_803_0	2009	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																																																			0		209.7275573	2.720335798	33.82911847		8.278545635	9.008557815	15.87429777	14.64528526	33.0187914	15.95905195	33.15999688	7.051760823	0.038074316	35.96495452	25.55559821	68.50948708	1.386673961	5.432426161			18.27298673	7.050707098																			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																			0.0895	0.0895	0.1597		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.0895	0.0895	0.1597		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			18.7706	0.243470054	5.40251022	0	1.912344042	2.080976855	3.666962785	3.383060894	7.627340814	3.686541001	7.659959279	1.62895675	0.008795167	8.307904493	5.903343187	15.82569152	0.320321685	1.254890443	0	0	4.221059934	1.62871334	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5335	0	0	18.7706	0.243470054	5.40251022	0	1.912344042	2.080976855	3.666962785	3.383060894	7.627340814	3.686541001	7.659959279	1.62895675	0.008795167	8.307904493	5.903343187	15.82569152	0.320321685	1.254890443	0	0	4.221059934	1.62871334	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5335		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																			3.4149	0.0443	0.9829		0.3479	0.3786	0.6671	0.6155	1.3876	0.6707	1.3936	0.2964	0.0016	1.5114	1.074	2.8791	0.0583	0.2283			0.7679	0.2963																			17.0164	0	0	22.1855	0.287764181	6.385380485	0	2.260253813	2.459565731	4.334087609	3.99853589	9.014971041	4.35722766	9.053523733	1.925310313	0.010395258	9.81934861	6.977329213	18.70483491	0.37859731	1.483190706	0	0	4.98899079	1.925022619	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.5499
H1364_003_0	2009	5																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0.1846	0.5694	0.1779	0.7909	1.271	0.3825	0.3809	0	0.0312	0.0383	0.7704	2.104	0.1854	0.0484	0.2506	0	0.5593	0.0141	0	0	0	0	0	0	0	0											7.7588		285.0447215	47.80666077	1098.605735	16.94441622	5.953980453	18.36655261	5.739165918	25.51397709	41.00141851	12.33961121	12.28587643	0	1.006221707	1.233916587	24.85079288	67.86965231	5.981875905	1.561567368	8.084662058	0	18.04109607	0.453266762	1.912983534	28.64749764	2.576410859	2.072045936	0.057931703	0.100857905	0.00347427	12000											Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											642.42874	434.9387696	58.61927726	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											642.42874	434.9387696	58.61927726	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											15.2601	1.732747518	5.366622849	0	1.190796091	3.673310523	1.147833184	5.102795418	8.200283703	2.467922243	2.457175287	0	0.201244341	0.246783317	4.970158575	13.57393046	1.196375181	0.312313474	1.616932412	0	3.608219213	0.090653352	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.4162	135	0	15.2601	1.732747518	5.366622849	0	1.375369485	4.242673654	1.325747327	5.893728707	9.471327677	2.850450191	2.838037456	0	0.232437214	0.285034732	5.740533154	15.67788968	1.381813334	0.360722062	1.867556935	0	4.167493191	0.104704622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.175		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											2.8544	0.3241	0.3843	0	2.4189	0.5307	0.1658	1.0386	0.7293	0.756	0.7527	0	0.0616	0.0756	1.9561	5.3422	0.4709	0.1229	0.6364	0	1.0761	0.0288	0	0	0	0	0	0	0	0											19.7254	135	0	18.1144	2.056854561	5.750937367	0	3.794286313	4.773382375	1.491582771	6.932376663	10.20063389	3.606423518	3.590718779	0	0.294082331	0.360629336	7.696613966	21.02011459	1.852664817	0.483637736	2.503925055	0	5.243555219	0.133526325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.9004
H1364_006_0	2009	10																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	Coin	T	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		1525.142964	396.7393386	1012.233642	314.8841641	185.2696931	18.68499454	5.8386724	819.14562	2889.196204	2803.406375	746.8253778	0	1.023667724	137.7293224	3872.630015	6244.039393	832.383056	173.7147247	1899.915073	0	18.35389518	0.461125566	8227.886166	1689.981239	578.1828958	545.5073773	18.83336445	1.739228907	3.557446925	12000											$100/day - 1st 10 days	$100/day - 1st 10 days	$100/Day 6-100	Zero Cost Sharing	$150/Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $30 visit Urgent Care	$100/visit	$0 Lab / $35 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$35/visit	$15/visit	$35/visit	$35/visit	$35/visit	$35/visit	$35/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$0/visit Preventative  / $50/visit Comprehensive	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											77.33153234	77.33153234	81.32675022	0	124.2484388	0.2	0.122529278	46.84373331	33	0	0	0	0	0	12.02126323	17.5	34.34793939	35	0.039241334	0	0.2	0	0	46.66282528	0	0	0	0	0	0											56.77555321	56.77555321	81.32675022	0	124.2484388	0.2	0.122529278	46.84373331	33	0	0	0	0	0	12.02126323	17.5	34.34793939	35	0.039241334	0	0.2	0	0	46.66282528	0	0	0	0	0	0											7.2159	1.877091286	6.860139382	0	1.918289177	3.736998908	0.715408314	3.197653247	7.94528956	0	0	0	0	0	3.879492066	9.105890781	2.382553563	0.506667947	0.006212934	0	3.670779036	0	0	6.571608273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.59	0	0	7.2159	1.877091286	6.860139382	0	1.918289177	3.736998908	0.715408314	3.197653247	7.94528956	0	0	0	0	0	3.879492066	9.105890781	2.382553563	0.506667947	0.006212934	0	3.670779036	0	0	6.571608273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.59		$100/day - 1st 10 days	$100/day - 1st 10 days	$100/Day 6-100	Zero Cost Sharing	$150/Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $30 visit Urgent Care	$100/visit	$0 Lab / $35 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$35/visit	$15/visit	$35/visit	$35/visit	$35/visit	$35/visit	$35/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$0/visit Preventative  / $50/visit Comprehensive	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											1.3497	0.3511	0.4913	0	3.3738	0.0328	0.0895	0.5635	0.6118	0	0	0	0	0	1.3219	3.1028	0.8119	0.1726	0.0021	0	0.9478	0	0	0.5494	0	0	0	0	0	0											13.772	0	0	8.5656	2.228197549	7.351407586	0	5.292060389	3.769774902	0.804897505	3.761173588	8.557088585	0	0	0	0	0	5.201425026	12.20871377	3.194406258	0.679314533	0.008329984	0	4.618587647	0	0	7.12097004	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.362
H1364_007_0	2009	7																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	Coin	T	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		1942.865918	505.4026787	1289.475342	401.1281073	236.0133973	23.80264665	7.437832309	1043.502245	3680.521084	3571.234192	951.3741383	0	1.304041115	175.4521463	4933.30858	7954.225678	1060.365296	221.293627	2420.28474	0	23.38086215	0.587423716	8227.886166	1961.918638	736.5419958	694.9169464	23.99165375	2.215588077	4.531799673	12000											$50/day - 1st 5 days	$50/day - 1st 5 days	$0/Day 1-5; $50/Day 6-20; $100/day 21-100	Zero Cost Sharing	$150/Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $20 visit Urgent Care	$100/visit	$0 Lab / $20 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$20/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	$20/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$5/visit Preventative; $20/Visit Comprehensive	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											28.63574966	28.63574966	63.45106976	0	125.3164557	0.2	0.122529278	46.64706534	33	0	0	0	0	0	4.270845528	10	20	20	0	0	0.2	0	0	18.04400978	0	0	0	0	0	0											18.46304381	18.46304381	63.45106976	0	125.3164557	0.2	0.122529278	46.64706534	33	0	0	0	0	0	4.270845528	10	20	20	0	0	0.2	0	0	18.04400978	0	0	0	0	0	0											2.9893	0.777605983	6.818215821	0	2.464696871	4.760529331	0.911352223	4.056359784	10.12143298	0	0	0	0	0	1.755783241	6.628521398	1.767275493	0.368822712	0	0	4.676172431	0	0	2.950073258	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.0461	0	0	2.9893	0.777605983	6.818215821	0	2.464696871	4.760529331	0.911352223	4.056359784	10.12143298	0	0	0	0	0	1.755783241	6.628521398	1.767275493	0.368822712	0	0	4.676172431	0	0	2.950073258	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.0461		$50/day - 1st 5 days	$50/day - 1st 5 days	$0/Day 1-5; $50/Day 6-20; $100/day 21-100	Zero Cost Sharing	$150/Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $20 visit Urgent Care	$100/visit	$0 Lab / $20 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$20/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	$20/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$5/visit Preventative; $20/Visit Comprehensive	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											0.5591	0.1454	0.4883	0	4.3348	0.0418	0.114	0.7148	0.7794	0	0	0	0	0	0.5983	2.2587	0.6022	0.1257	0	0	1.2074	0	0	0.2466	0	0	0	0	0	0											12.2164	0	0	3.5484	0.923055665	7.306481795	0	6.799456952	4.802282376	1.025351699	4.771209416	10.90079826	0	0	0	0	0	2.354064587	8.887183298	2.369472813	0.494498674	0	0	5.883577304	0	0	3.196688301	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.2625
H1364_008_0	2009	6																																D	D	D	V	P	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	Coin	T	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		1524.14049	396.4785624	1011.568303	314.6771912	185.1479156	18.67271292	5.834834649	818.6071968	2887.297139	2801.5637	746.3344905	0	1.022994868	137.6387932	3870.084541	6239.935195	831.8359318	173.6005423	1898.666262	0	18.34183119	0.460822469	8227.886166	1689.981239	577.802857	545.1488161	18.82098531	1.738085714	3.55510862	12000											$50/day - 1st 5 days	$50/day - 1st 5 days	$0/Day 1-5; $50/Day 6-14; $100/day 15-100	Zero Cost Sharing	$150/Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $30 visit Urgent Care	$100/visit	$0 Lab / $20 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$30/visit	$5/visit	$15/visit	$15/visit	$15/visit	$15/visit	$15/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$0/visit Preventative; $35/Visit Comprehensive	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											28.63574966	28.63574966	69.89808837	0	124.2484388	0.2	0.122529278	46.84373331	33	0	0	0	0	0	4.007087742	7.5	14.72054545	15	0.016817715	0	0.2	0	0	32.6639777	0	0	0	0	0	0											18.46304381	18.46304381	69.89808837	0	124.2484388	0.2	0.122529278	46.84373331	33	0	0	0	0	0	4.007087742	7.5	14.72054545	15	0.016817715	0	0.2	0	0	32.6639777	0	0	0	0	0	0											2.345	0.610016755	5.892224217	0	1.917028289	3.734542584	0.714938077	3.195551434	7.940067133	0	0	0	0	0	1.292314027	3.899959497	1.02042322	0.217000678	0.002660936	0	3.668366238	0	0	4.600125791	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.0502	0	0	2.345	0.610016755	5.892224217	0	1.917028289	3.734542584	0.714938077	3.195551434	7.940067133	0	0	0	0	0	1.292314027	3.899959497	1.02042322	0.217000678	0.002660936	0	3.668366238	0	0	4.600125791	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.0502		$50/day - 1st 5 days	$50/day - 1st 5 days	$0/Day 1-5; $50/Day 6-14; $100/day 15-100	Zero Cost Sharing	$150/Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $30 visit Urgent Care	$100/visit	$0 Lab / $20 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$30/visit	$5/visit	$15/visit	$15/visit	$15/visit	$15/visit	$15/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$0/visit Preventative; $35/Visit Comprehensive	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											0.4386	0.1141	0.422	0	3.3716	0.0328	0.0894	0.5631	0.6114	0	0	0	0	0	0.4404	1.3289	0.3477	0.0739	0.0009	0	0.9472	0	0	0.3846	0	0	0	0	0	0											9.1665	0	0	2.7837	0.724119199	6.314178093	0	5.288581925	3.767297035	0.804368447	3.758701374	8.551464023	0	0	0	0	0	1.732668712	5.228866714	1.368131391	0.290943437	0.003567647	0	4.615551856	0	0	4.984679028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2168
H1364_801_0	2009	5																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																							0.203	0.6262	0.1957	0.8698	1.3978	0.4207	0.4188	0	0.0343	0.0421	0.8472	2.3138	0.2039	0.0532	0.2756	0	0.6151	0.0155																			8.5327		215.4318123	24.46179949	32.19802139	18.634476	6.547838795	20.19845827	6.311598357	28.05877687	45.09095737	13.5703813	13.51128694	0	1.106583668	1.356989154	27.32944573	74.6390664	6.578516578	1.717320282	8.891037565	0	19.84054023	0.498476223																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			0.076224247	0.076224247	0.195563224	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																			0.076224247	0.076224247	0.195563224	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																			16.4211	1.864582242	6.296748854	0	1.309567759	4.039691655	1.262319671	5.611755373	9.018191474	2.714076261	2.702257388	0	0.221316734	0.271397831	5.465889146	14.92781328	1.315703316	0.343464056	1.778207513	0	3.968108047	0.099695245	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.6319	135	0	16.4211	1.864582242	6.296748854	0	1.512550762	4.665843861	1.457979221	6.481577456	10.41601115	3.134758081	3.121107284	0	0.255620827	0.313464495	6.313101964	17.24162434	1.51963733	0.396700985	2.053829678	0	4.583164794	0.115148008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.1646		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			3.0715	0.3488	0.4509	0	2.3032	0.5053	0.1579	0.989	0.6944	0.7198	0.7167	0	0.0587	0.072	1.8625	5.0866	0.4483	0.117	0.6059	0	1.0246	0.0274																			19.2606	135	0	19.4927	2.213348712	6.747671543	0	3.815739487	5.171161915	1.615880609	7.470533435	11.11042521	3.854563419	3.837778115	0	0.31431666	0.385442431	8.17559811	22.32826147	1.967961891	0.513736012	2.659752072	0	5.607744846	0.142590796	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.4252
H1364_802_0	2009	5																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																							0.203	0.6262	0.1957	0.8698	1.3978	0.4207	0.4188	0	0.0343	0.0421	0.8472	2.3138	0.2039	0.0532	0.2756	0	0.6151	0.0155																			8.5327		215.4318123	24.46179949	32.19802139	18.634476	6.547838795	20.19845827	6.311598357	28.05877687	45.09095737	13.5703813	13.51128694	0	1.106583668	1.356989154	27.32944573	74.6390664	6.578516578	1.717320282	8.891037565	0	19.84054023	0.498476223																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			0.076224247	0.076224247	0.195563224	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																			0.076224247	0.076224247	0.195563224	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																			16.4211	1.864582242	6.296748854	0	1.309567759	4.039691655	1.262319671	5.611755373	9.018191474	2.714076261	2.702257388	0	0.221316734	0.271397831	5.465889146	14.92781328	1.315703316	0.343464056	1.778207513	0	3.968108047	0.099695245	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.6319	135	0	16.4211	1.864582242	6.296748854	0	1.512550762	4.665843861	1.457979221	6.481577456	10.41601115	3.134758081	3.121107284	0	0.255620827	0.313464495	6.313101964	17.24162434	1.51963733	0.396700985	2.053829678	0	4.583164794	0.115148008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.1646		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			3.0715	0.3488	0.4509	0	2.3032	0.5053	0.1579	0.989	0.6944	0.7198	0.7167	0	0.0587	0.072	1.8625	5.0866	0.4483	0.117	0.6059	0	1.0246	0.0274																			19.2606	135	0	19.4927	2.213348712	6.747671543	0	3.815739487	5.171161915	1.615880609	7.470533435	11.11042521	3.854563419	3.837778115	0	0.31431666	0.385442431	8.17559811	22.32826147	1.967961891	0.513736012	2.659752072	0	5.607744846	0.142590796	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.4252
H1406_013_0	2009	3	r.	s.	t.	u.	v.						DME/Prosthetics/Supplies	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered							Prosthetics/Supplies										A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin				V				O	O	O	P	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		322.105015	19.161223	676.53121	214.151491	376.671855	2.108109	0.556859	236.65742	277.151542	398.741943	551.41425	0	0	342.793334	6868.263627	5576.830782	18.127829	247.682548			13.411888				1.5				1.23	0.27	2775.150365	58.336252	2.06	0.05	0.06	2.7					$550/Admit:1a	$550/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$200/Visit:9b. $0 Surgery ASC -- Physician,9b. $0 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $200 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$100/Visit:14h. $50 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $0 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$15-$100/Visit:9d. $30 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $100 OP Other,5. $30 Partial Hospitalization,8b. $50 Rad therapy,3. $15 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15				VIS 734				$0: Health Education Materials 14a	$0: Nutritional benefit 14a	:11b	$0/Proc:12	$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	$0: Nurse hotline 14a	$0 Corp Health 14a					550.000017	550.000174	43.132803	0	99.999996	0.2	0.2	50.000021	64.874371	38.085022	30.368899	0	0	50.699235	0	30	99.99984	34.459723			0.2				0				0	0	0	0	0	0	0	0					515.404466	515.404613	40.419707	0	93.709896	0.187419	0.18742	46.854969	60.793708	35.689436	28.458665	0	0	47.510202	0	28.11297	93.70975	32.292171			0.187419				0				0	0	0	0	0	0	0	0					13.8345	0.822981894	2.278766107	0	2.94149003	0.395099681	0.104366514	0.924048006	1.40408916	1.185906255	1.307709451	0	0	1.357181712	0	13.06510637	0.14156286	0.666517266	0	0	2.513642637	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.943	0	2.8825	13.8345	0.822981894	2.278766107	0	2.94149003	0.395099681	0.104366514	0.924048006	1.40408916	1.185906255	1.307709451	0	0	1.357181712	0	13.06510637	0.14156286	0.666517266	0	0	2.513642637	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.943																																																																																		0	0	0	13.8345	0.822981894	2.278766107	0	2.94149003	0.395099681	0.104366514	0.924048006	1.40408916	1.185906255	1.307709451	0	0	1.357181712	0	13.06510637	0.14156286	0.666517266	0	0	2.513642637	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.943
H1406_022_0	2009	3	r.	s.	t.	u.	v.						OP Facility - Other	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered						10879	Renal Dialysis										A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin				V				O	O	P	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		317.170604	18.867688	666.167252	210.870848	370.901519	2.044012	1.243762	233.032002	272.905786	392.633509	542.966991	0	0	337.541992	6763.046899	5491.397851	17.850124	243.888235			13.004097				1.5				0.06	0.05	57.442584	0.27	1.23	2.06	2.7						$550/Admit:1a	$550/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	"0%-20% Coins:11b. 0% Supplies,11b. 20% Prosthetics"	$50/Visit:4a	"$0-$200/Visit:9b. $0 Surgery ASC -- Physician,9b. $0 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $200 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$100/Visit:14h. $50 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $0 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$15-$100/Visit:9d. $30 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $100 OP Other,5. $30 Partial Hospitalization,8b. $50 Rad therapy,3. $15 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15				VIS 734				$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0/Proc:12	$0: Nutritional benefit 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a						549.999999	549.999978	43.132807	0	100	0.199999	0.086822	50.000016	64.874388	38.085012	30.368917	0	0	50.699256	0	30	99.999977	34.459768			0.199999				0				0	0	0	0	0	0	0						512.813949	512.81393	40.216555	0	93.2389	0.186477	0.080951	46.619465	60.488166	35.510046	28.315645	0	0	47.271428	0	27.97167	93.238879	32.129908			0.186477				0				0	0	0	0	0	0	0						13.5541	0.806301103	2.232579327	0	2.881870803	0.381161226	0.100683778	0.905318938	1.375630874	1.161869497	1.281205047	0	0	1.329674331	0	12.80029738	0.138693796	0.653008879	0	0	2.424964996	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.0274	0	3.0476	13.5541	0.806301103	2.232579327	0	2.881870803	0.381161226	0.100683778	0.905318938	1.375630874	1.161869497	1.281205047	0	0	1.329674331	0	12.80029738	0.138693796	0.653008879	0	0	2.424964996	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.0274	10879																																																																																	0	0	0	13.5541	0.806301103	2.232579327	0	2.881870803	0.381161226	0.100683778	0.905318938	1.375630874	1.161869497	1.281205047	0	0	1.329674331	0	12.80029738	0.138693796	0.653008879	0	0	2.424964996	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.0274
H1406_024_0	2009	3	r.	s.	t.	u.	v.	w.	x.				Part B Rx	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered															A	A	A	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin	V				O	O	S	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		336.092769	19.993319	54.241875	223.451247	393.02923	2.295175	1.396593	246.934521	289.187144	416.057737	575.360008	0	60.869568	357.679505	7166.525308	5819.010614	18.915049	258.438428			6.822162			2.83	0.35				0.05	0.27	69.350232	1.23	2.06	0.06	0.3	3.5	2.7				$0/Admit:1a	$0/Admit:1b	$0/Admit(Days 1-6) $0(Days 7-100):2	$0/Visit:6	$0/Trip:10a	0% Coins:11a	0% Coins:11b	$25/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"$0/Visit:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			0% Coins:15			"DEN 756 16a, 16b"	VIS 740				$0 Additional Smoking Cessation 14a	$0: Nutritional benefit 14a	$0/Script:15	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0: Nurse hotline 14a	NSP 002	$0 Other - Transportation 10b	$0 Corp Health 14a				0	0	0	0	0	0	0	25.000003	0	0	0	0	0	0	0	0	0	0			0			0	0				0	0	0	0	0	0	0	0	0				0	0	0	0	0	0	0	25.000003	0	0	0	0	0	0	0	0	0	0			0			0	0				0	0	0	0	0	0	0	0	0				0	0	0	0	0	0	0	0.51444698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.5144	0	0	0	0	0	0	0	0	0	0.51444698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.5144																																																																																		0	0	0	0	0	0	0	0	0	0	0.51444698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.5144
H1406_801_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		327.983806	19.510937	688.878695	218.060004	14.11466	2.185762	1.330015	24.727323	42.918676	406.019448	14.32169	0	1.278957	12.515706	81.654714	105.666731	0.651105	2.345399			13.905917																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999983	1023.999821	43.132807	0	0.2	0.199999	0.2	0.2	0.199999	0	0.199999	0	0.199999	0.199999	0.2	0.199999	0.5	0.2			0.199999																				1023.999983	1023.999821	43.132807	0	0.2	0.199999	0.2	0.2	0.199999	0	0.199999	0	0.199999	0.199999	0.2	0.199999	0.5	0.2			0.199999																				27.988	1.664933	2.476105983	0	2.822932	0.437150214	0.266003	4.9454646	8.583692281	0	2.864323678	0	0.255790121	2.503128684	16.3309428	21.13324053	0.3255525	0.4690798	0	0	2.781169494	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.8475	0	0	27.988	1.664933	2.476105983	0	2.822932	0.437150214	0.266003	4.9454646	8.583692281	0	2.864323678	0	0.255790121	2.503128684	16.3309428	21.13324053	0.3255525	0.4690798	0	0	2.781169494	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.8475																																																																																		0	0	0	27.988	1.664933	2.476105983	0	2.822932	0.437150214	0.266003	4.9454646	8.583692281	0	2.864323678	0	0.255790121	2.503128684	16.3309428	21.13324053	0.3255525	0.4690798	0	0	2.781169494	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.8475
H1406_802_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		322.105015	19.161223	676.53121	214.151491	13.613202	2.108107	1.282764	23.848823	41.393883	398.741943	13.812875	0	1.233519	12.071054	78.753727	101.912657	0.627973	2.262073			13.411875																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000014	1023.999981	43.132803	0	0.199999	0.199999	0.2	0.2	0.2	0	0.2	0	0.2	0.2	0.199999	0.199999	0.5	0.2			0.2																				1024.000014	1023.999981	43.132803	0	0.199999	0.199999	0.2	0.2	0.2	0	0.2	0	0.2	0.2	0.199999	0.199999	0.5	0.2			0.2																				27.4863	1.635090999	2.43172395	0	2.722626787	0.421619292	0.2565528	4.7697646	8.2787766	0	2.762575	0	0.2467038	2.4142108	15.75066665	20.38242949	0.3139865	0.4524146	0	0	2.682375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0078	0	0	27.4863	1.635090999	2.43172395	0	2.722626787	0.421619292	0.2565528	4.7697646	8.2787766	0	2.762575	0	0.2467038	2.4142108	15.75066665	20.38242949	0.3139865	0.4524146	0	0	2.682375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0078																																																																																		0	0	0	27.4863	1.635090999	2.43172395	0	2.722626787	0.421619292	0.2565528	4.7697646	8.2787766	0	2.762575	0	0.2467038	2.4142108	15.75066665	20.38242949	0.3139865	0.4524146	0	0	2.682375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0078
H1406_803_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		327.983806	19.510937	688.878695	218.060004	14.11466	2.185762	1.330015	24.727323	42.918676	406.019448	14.32169	0	1.278957	12.515706	81.654714	105.666731	0.651105	2.345399			13.905917																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999983	1023.999821	43.132807	0	0.2	0.199999	0.2	0.2	0.199999	0	0.199999	0	0.199999	0.199999	0.2	0.199999	0.5	0.2			0.199999																				1023.999983	1023.999821	43.132807	0	0.2	0.199999	0.2	0.2	0.199999	0	0.199999	0	0.199999	0.199999	0.2	0.199999	0.5	0.2			0.199999																				27.988	1.664933	2.476105983	0	2.822932	0.437150214	0.266003	4.9454646	8.583692281	0	2.864323678	0	0.255790121	2.503128684	16.3309428	21.13324053	0.3255525	0.4690798	0	0	2.781169494	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.8475	0	0	27.988	1.664933	2.476105983	0	2.822932	0.437150214	0.266003	4.9454646	8.583692281	0	2.864323678	0	0.255790121	2.503128684	16.3309428	21.13324053	0.3255525	0.4690798	0	0	2.781169494	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.8475																																																																																		0	0	0	27.988	1.664933	2.476105983	0	2.822932	0.437150214	0.266003	4.9454646	8.583692281	0	2.864323678	0	0.255790121	2.503128684	16.3309428	21.13324053	0.3255525	0.4690798	0	0	2.781169494	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.8475
H1406_804_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		327.983806	19.510937	688.878695	218.060004	14.11466	2.185762	1.330015	24.727323	42.918676	406.019448	14.32169	0	1.278957	12.515706	81.654714	105.666731	0.651105	2.345399			13.905917																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999983	1023.999821	43.132807	0	0.2	0.199999	0.2	0.2	0.199999	0	0.199999	0	0.199999	0.199999	0.2	0.199999	0.5	0.2			0.199999																				1023.999983	1023.999821	43.132807	0	0.2	0.199999	0.2	0.2	0.199999	0	0.199999	0	0.199999	0.199999	0.2	0.199999	0.5	0.2			0.199999																				27.988	1.664933	2.476105983	0	2.822932	0.437150214	0.266003	4.9454646	8.583692281	0	2.864323678	0	0.255790121	2.503128684	16.3309428	21.13324053	0.3255525	0.4690798	0	0	2.781169494	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.8475	0	0	27.988	1.664933	2.476105983	0	2.822932	0.437150214	0.266003	4.9454646	8.583692281	0	2.864323678	0	0.255790121	2.503128684	16.3309428	21.13324053	0.3255525	0.4690798	0	0	2.781169494	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.8475																																																																																		0	0	0	27.988	1.664933	2.476105983	0	2.822932	0.437150214	0.266003	4.9454646	8.583692281	0	2.864323678	0	0.255790121	2.503128684	16.3309428	21.13324053	0.3255525	0.4690798	0	0	2.781169494	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.8475
H1415_005_0	2009	3																																A	A	D	V	T	COIN		V	P	P	P	P	P	P	V	V	V	V	V	V	COIN	V	T		V		V																																																						0																																																																																																																																																																		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																		0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	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_010_0	2009	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
H1415_013_0	2009	5																																A	A	D		T	COIN		V	P		P	P	P		V	V	V	V	V		COIN																																																												0		282.4970492	7.806945968	329.6065343		65.21803582	8.888611416		158.4139512	141.0843992		200.8491804	216.4809933	1.032864138		2618.820566	3494.701715	286.0441124	281.190408			9.6724913																				"$175/day 1-3, towards $2,500 OOP"	"$500/admit; towards $2,500 OOP"	$125/day 6-15 towards $2500 OOP		$100 COPAY	20% Coinsurance	included in line e.1	$50 COPAY	$100 COPAY		$0 - $100 Copay	$100 COPAY	$30 COPAY		$5 COPAY	$30 COPAY	$25-$30 COPAY	$15 COPAY			20% Coinsurance				$30 copay for routine eye exams up to 1 per plan year		$30 copay for routine eye exams up to 1 per plan year														525	500	125		100	0.2		50	100		25	100	30		5	30	28.75	15			0.2																				514.5	490	122.5		100	0.2		50	100		25	100	30		5	30	28.75	15			0.2																				12.1121	0.318783627	3.364733371	0	0.543483632	1.777722283	0	0.66005813	1.175703326	0	0.418435793	1.804008277	0.00258216	0	1.091175236	8.736754287	0.685314019	0.35148801	0	0	1.93449826	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.9768	0	0.3224	12.1121	0.318783627	3.364733371	0	0.543483632	1.777722283	0	0.66005813	1.175703326	0	0.418435793	1.804008277	0.00258216	0	1.091175236	8.736754287	0.685314019	0.35148801	0	0	1.93449826	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.9768		30% Coinsurance	incld in Line a.1	30% Coinsurance	30% Coinsurance	$100 COPAY	30% Coinsurance	incld in Line e.1	30% Coinsurance	30% Coinsurance	30% Coinsurance	incld in Line h.1	incld in Line h.1	incld in Line h.1	incld in Line h.1	30% Coinsurance	incld in Line i.1	incld in Line i.1	incld in Line i.1	incld in Line i.1	incld in Line i.1	30% Coinsurance	30% Coinsurance																			0		0	0	0	0		0	0	0					0						0	0																			0	0	0	12.1121	0.318783627	3.364733371	0	0.543483632	1.777722283	0	0.66005813	1.175703326	0	0.418435793	1.804008277	0.00258216	0	1.091175236	8.736754287	0.685314019	0.35148801	0	0	1.93449826	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.9768
H1415_015_0	2009	5																																A	A	D		T	COIN		V	P		P	P	P			V	V	V	V		COIN																																																												0		331.5258995	9.161882546	386.8114839		79.26266071	10.86423738		183.068131	163.041557		232.1545319	262.6518478	1.26243354		3177.360054	4240.048278	347.0513209	341.1624231			11.82234621																				"$175/day 1-3, towards $2,500 OOP"	"$500/admit; towards $2,500 OOP"	$125/day 6-15 towards $2500 OOP		$100 COPAY	20% Coinsurance	included in line e.1	$50 Copay	$100 Copay		$0 - $100 Copay	$100 COPAY	$30 COPAY		$5 COPAY	$35 COPAY	$25-$30 COPAY	$15 COPAY			20% Coinsurance				$35 copay for routine eye exams up to 1 per plan year		$35 copay for routine eye exams up to 1 per plan year														525	500	125		100	0.2		50	100		25	100	30		5	35	28.75	15			0.2																				514.5	490	122.5		100	0.2		50	100		25	100	30		5	35	28.75	15			0.2																				14.2142	0.374110204	3.948700564	0	0.660522173	2.172847475	0	0.762783879	1.358679642	0	0.483655275	2.188765398	0.003156084	0	1.323900023	12.36680748	0.831477123	0.426453029	0	0	2.364469242	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4805	0	0.3783	14.2142	0.374110204	3.948700564	0	0.660522173	2.172847475	0	0.762783879	1.358679642	0	0.483655275	2.188765398	0.003156084	0	1.323900023	12.36680748	0.831477123	0.426453029	0	0	2.364469242	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4805																																																																																		0			14.2142	0.374110204	3.948700564	0	0.660522173	2.172847475	0	0.762783879	1.358679642	0	0.483655275	2.188765398	0.003156084	0	1.323900023	12.36680748	0.831477123	0.426453029	0	0	2.364469242	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.4805
H1415_017_0	2009	7																																A	A	D		T	COIN		V	P		P	P	P			V	V	V	V		COIN																																																												0		331.5258995	9.161882546	390.7186706		79.26266071	10.86423738		183.068131	163.041557		234.4995271	265.3048967	1.275185394			4282.877049	350.5568898	344.6085082			11.82234621																				"$175/day 1-3, towards $2,500 OOP"	"$500/admit; towards $2,500 OOP"	$125/day 6-15 towards $2500 OOP		$100 COPAY	20% Coinsurance	included in line e.1	$50 Copay	$50 Copay ASC; $75 OP		$0 - $100 Copay	$100 COPAY	$30 COPAY			$15 COPAY	$25-$30 COPAY	$15 COPAY			20% Coinsurance				$30 copay for routine eye exams up to 1 per plan year		$30 copay for routine eye exams up to 1 per plan year														525	500	125		100	0.2		50	62.5		25	100	30			15	28.75	15			0.2																				514.5	490	122.5		100	0.2		50	62.5		25	100	30			15	28.75	15			0.2																				14.2142	0.374110204	3.988586429	0	0.660522173	2.172847475	0	0.762783879	0.849174776	0	0.488540682	2.210874139	0.003187963	0	0	5.353596311	0.839875882	0.430760635	0	0	2.364469242	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.7135	0	0.3791	14.2142	0.374110204	3.988586429	0	0.660522173	2.172847475	0	0.762783879	0.849174776	0	0.488540682	2.210874139	0.003187963	0	0	5.353596311	0.839875882	0.430760635	0	0	2.364469242	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.7135		30% Coinsurance	incld in Line a.1	30% Coinsurance	30% Coinsurance	$100 COPAY	30% Coinsurance	incld in Line e.1	30% Coinsurance	30% Coinsurance	30% Coinsurance	incld in Line h.1	incld in Line h.1	incld in Line h.1	incld in Line h.1	30% Coinsurance	incld in Line i.1	incld in Line i.1	incld in Line i.1	incld in Line i.1	incld in Line i.1	30% Coinsurance	30% Coinsurance																			0.9265		0.1171	0.0783	0.0067	0.0329		0.025	0.0596	0.1053					0.6469						0.0358	0.0011																			2.0352	0	0	15.1406	0.374110204	4.1057025	0.078311097	0.667194114	2.205769407	0	0.787769554	0.908808858	0.105273903	0.488540682	2.210874139	0.003187963	0	0.646932444	5.353596311	0.839875882	0.430760635	0	0	2.400294534	0.001070311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.7487
H1415_021_0	2009	6																																A	A	D		T	COIN		V	P		P	P	P		V	V	V	V	V		COIN																																																												0		331.5258995	9.161882546	390.7186706		79.26266071	10.86423738		183.068131	163.041557		234.4995271	265.3048967	1.275185394		3209.4546	4282.877049	350.5568898	344.6085082			11.82234621																				"$175/day 1-3, towards $2,500 OOP"	"$500/admit; towards $2,500 OOP"	$125/day 6-15 towards $2500 OOP		$100 COPAY	20% Coinsurance	included in line e.1	$50 COPAY	$100 COPAY		$0 - $100 Copay	$100 COPAY	$30 COPAY		$5 COPAY	$35 COPAY	$25-$30 COPAY	$15 COPAY			20% Coinsurance				$35 copay for routine eye exams up to 1 per plan year		$35 copay for routine eye exams up to 1 per plan year														525	500	125		100	0.2		50	100		25	100	30		5	35	28.75	15			0.2																				514.5	490	122.5		100	0.2		50	100		25	100	30		5	35	28.75	15			0.2																				14.2142	0.374110204	3.988586429	0	0.660522173	2.172847475	0	0.762783879	1.358679642	0	0.488540682	2.210874139	0.003187963	0	1.33727275	12.49172473	0.839875882	0.430760635	0	0	2.364469242	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.6984	0	0.3791	14.2142	0.374110204	3.988586429	0	0.660522173	2.172847475	0	0.762783879	1.358679642	0	0.488540682	2.210874139	0.003187963	0	1.33727275	12.49172473	0.839875882	0.430760635	0	0	2.364469242	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.6984		30% Coinsurance	incld in Line a.1	30% Coinsurance	30% Coinsurance	$100 COPAY	30% Coinsurance	incld in Line e.1	30% Coinsurance	30% Coinsurance	30% Coinsurance	incld in Line h.1	incld in Line h.1	incld in Line h.1	incld in Line h.1	30% Coinsurance	incld in Line i.1	incld in Line i.1	incld in Line i.1	incld in Line i.1	incld in Line i.1	30% Coinsurance	30% Coinsurance																			0.9265		0.1171	0.0783	0.0067	0.0329		0.025	0.0596	0.1053					0.6469						0.0358	0.0011																			2.0352	0	0	15.1406	0.374110204	4.1057025	0.078311097	0.667194114	2.205769407	0	0.787769554	1.418313723	0.105273903	0.488540682	2.210874139	0.003187963	0	1.984205194	12.49172473	0.839875882	0.430760635	0	0	2.400294534	0.001070311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.7336
H1415_022_0	2009	6																																A	A	D		T	COIN		V	P		P	P	P		V	V	V	V	V		COIN																																																												0		384.4080307	10.62330645	453.0427184		86.81549289	11.78861556		217.5723798	193.7712445		278.6075609	291.4016277	1.383683903			4704.162489	385.0394379	378.5059434			12.82824461																				"$175/day 1-3, towards $2,500 OOP"	"$500/admit; towards $2,500 OOP"	$125/day 6-15 towards $2500 OOP		$100 COPAY	20% Coinsurance	included in line e.1	$50 COPAY	$75 COPAY		$0 - $100 Copay	$100 COPAY	$25 COPAY			$30 COPAY	$25-$30 COPAY	$15 COPAY			20% Coinsurance				$30 copay for routine eye exams up to 1 per plan year		$30 copay for routine eye exams up to 1 per plan year														525	500	125		100	0.2		50	75		25	100	25			30	28.75	15			0.2																				514.5	490	122.5		100	0.2		50	75		25	100	25			30	28.75	15			0.2																				16.4815	0.433785013	4.624811083	0	0.723462441	2.357723113	0	0.906551582	1.211070278	0	0.580432419	2.428346898	0.002882675	0	0	11.76040622	0.92249032	0.473132429	0	0	2.565648922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4722	0	0.4396	16.4815	0.433785013	4.624811083	0	0.723462441	2.357723113	0	0.906551582	1.211070278	0	0.580432419	2.428346898	0.002882675	0	0	11.76040622	0.92249032	0.473132429	0	0	2.565648922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4722		30% Coinsurance	incld in Line a.1	30% Coinsurance	30% Coinsurance	$100 COPAY	30% Coinsurance	incld in Line e.1	30% Coinsurance	30% Coinsurance	30% Coinsurance	incld in Line h.1	incld in Line h.1	incld in Line h.1	incld in Line h.1	30% Coinsurance	incld in Line i.1	incld in Line i.1	incld in Line i.1	incld in Line i.1	incld in Line i.1	30% Coinsurance	30% Coinsurance																			1.0742		0.1358	0.0989	0.0073	0.0357		0.0297	0.0709	0.1251					0.7106						0.0389	0.0013																			2.3284	0	0	17.5557	0.433785013	4.760608493	0.098932867	0.730770142	2.39344619	0	0.936246498	1.28194405	0.125075329	0.580432419	2.428346898	0.002882675	0	0.71056799	11.76040622	0.92249032	0.473132429	0	0	2.60452239	0.00127204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.8006
H1415_802_0	2009	2																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																			20.8954		6.6231		0.1266	0.3368		0.2556	0.6101	1.077					6.6181						0.3665	0.0109																			36.92		1692.224568		1018.983039		4.082473742	10.86423738		8.245272733	19.67924681	34.74038812					213.4877066						11.82234621	0.353202508																			Standard Medicare benefits	Std Med benefit included in a.1	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Std Med benefit included in e.1	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Std Med benefit included in h.1	Std Med benefit included in h.1	Std Med benefit included in h.1	Std Med benefit included in h.1	Standard Medicare benefits	Std Med benefit included in i.1	Std Med benefit included in i.1	Std Med benefit included in i.1	Std Med benefit included in i.1	Std Med benefit included in i.1	Standard Medicare benefits	Standard Medicare benefits																			4.582724864		2.412268744		0.2	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																			4.582724864		2.412268744		0.2	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																			0.6462	0	0.204838411	0	0.816494748	2.172847475	0	1.649054547	3.935849362	6.948077625	0	0	0	0	42.69754132	0	0	0	0	0	2.364469242	0.070640502	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.5061	36.92004532		21.5417	0	6.827947041	0	0.943051434	2.509638834	0	1.904658001	4.545906013	8.025029657	0	0	0	0	49.31566022	0	0	0	0	0	2.730961975	0.081589779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.4261																																																																																		0			21.5417	0	6.827947041	0	0.943051434	2.509638834	0	1.904658001	4.545906013	8.025029657	0	0	0	0	49.31566022	0	0	0	0	0	2.730961975	0.081589779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.4261
H1415_804_0	2009	2																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																			20.8954		6.6231		0.1266	0.3368		0.2556	0.6101	1.077					6.6181						0.3665	0.0109																			36.92		1692.224568		1018.983039		4.082473742	10.86423738		8.245272733	19.67924681	34.74038812					213.4877066						11.82234621	0.353202508																			Standard Medicare benefits	Std Med benefit included in a.1	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Std Med benefit included in e.1	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Std Med benefit included in h.1	Std Med benefit included in h.1	Std Med benefit included in h.1	Std Med benefit included in h.1	Standard Medicare benefits	Std Med benefit included in i.1	Std Med benefit included in i.1	Std Med benefit included in i.1	Std Med benefit included in i.1	Std Med benefit included in i.1	Standard Medicare benefits	Standard Medicare benefits																			4.582724864		2.412268744		0.2	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																			4.582724864		2.412268744		0.2	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																			0.6462	0	0.204838411	0	0.816494748	2.172847475	0	1.649054547	3.935849362	6.948077625	0	0	0	0	42.69754132	0	0	0	0	0	2.364469242	0.070640502	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.5061	36.92004532		21.5417	0	6.827947041	0	0.943051434	2.509638834	0	1.904658001	4.545906013	8.025029657	0	0	0	0	49.31566022	0	0	0	0	0	2.730961975	0.081589779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.4261																																																																																		0			21.5417	0	6.827947041	0	0.943051434	2.509638834	0	1.904658001	4.545906013	8.025029657	0	0	0	0	49.31566022	0	0	0	0	0	2.730961975	0.081589779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.4261
H1415_805_0	2009	2																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																			20.8954		6.6231		0.1266	0.3368		0.2556	0.6101	1.077					6.6181						0.3665	0.0109																			36.92		1692.224568		1018.983039		4.082473742	10.86423738		8.245272733	19.67924681	34.74038812					213.4877066						11.82234621	0.353202508																			Standard Medicare benefits	Std Med benefit included in a.1	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Std Med benefit included in e.1	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Std Med benefit included in h.1	Std Med benefit included in h.1	Std Med benefit included in h.1	Std Med benefit included in h.1	Standard Medicare benefits	Std Med benefit included in i.1	Std Med benefit included in i.1	Std Med benefit included in i.1	Std Med benefit included in i.1	Std Med benefit included in i.1	Standard Medicare benefits	Standard Medicare benefits																			4.582724864		2.412268744		0.2	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																			4.582724864		2.412268744		0.2	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																			0.6462	0	0.204838411	0	0.816494748	2.172847475	0	1.649054547	3.935849362	6.948077625	0	0	0	0	42.69754132	0	0	0	0	0	2.364469242	0.070640502	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.5061	36.92004532		21.5417	0	6.827947041	0	0.943051434	2.509638834	0	1.904658001	4.545906013	8.025029657	0	0	0	0	49.31566022	0	0	0	0	0	2.730961975	0.081589779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.4261																																																																																		0			21.5417	0	6.827947041	0	0.943051434	2.509638834	0	1.904658001	4.545906013	8.025029657	0	0	0	0	49.31566022	0	0	0	0	0	2.730961975	0.081589779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.4261
H1415_806_0	2009	2																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																			20.8954		6.6231		0.1266	0.3368		0.2556	0.6101	1.077					6.6181						0.3665	0.0109																			36.92		1692.224568		1018.983039		4.082473742	10.86423738		8.245272733	19.67924681	34.74038812					213.4877066						11.82234621	0.353202508																			Standard Medicare benefits	Std Med benefit included in a.1	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Std Med benefit included in e.1	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Std Med benefit included in h.1	Std Med benefit included in h.1	Std Med benefit included in h.1	Std Med benefit included in h.1	Standard Medicare benefits	Std Med benefit included in i.1	Std Med benefit included in i.1	Std Med benefit included in i.1	Std Med benefit included in i.1	Std Med benefit included in i.1	Standard Medicare benefits	Standard Medicare benefits																			4.582724864		2.412268744		0.2	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																			4.582724864		2.412268744		0.2	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																			0.6462	0	0.204838411	0	0.816494748	2.172847475	0	1.649054547	3.935849362	6.948077625	0	0	0	0	42.69754132	0	0	0	0	0	2.364469242	0.070640502	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.5061	36.92004532		21.5417	0	6.827947041	0	0.943051434	2.509638834	0	1.904658001	4.545906013	8.025029657	0	0	0	0	49.31566022	0	0	0	0	0	2.730961975	0.081589779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.4261																																																																																		0			21.5417	0	6.827947041	0	0.943051434	2.509638834	0	1.904658001	4.545906013	8.025029657	0	0	0	0	49.31566022	0	0	0	0	0	2.730961975	0.081589779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.4261
H1416_002_0	2009	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	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		2126.671394	77.65021197	743.3489263	1265.461019	545.1734171	12.58540129	8.084948023	1664.460974	291.8784354	5624.991419	1346.87722	71.1715012	0.28985208	612.7191396	9890.20987	17082.41335	498.8428313	3232.829837	4251.930137	2034.512962	28.89111354	27.09177542	2250	224.5714286	398.3829431	118.2857143	39.2	16.22068966	1671.749033	6061.818182											"$160 days 1 - 7, $0 after day 7, unlimited coverage"	"$160 days 1 - 7, $0 after day 7, unlimited coverage"	"$0 days 1 - 7, $75 days 8 - 100"	Copay between $0.00 and $30.00	Copay between $3.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $30.00	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $150 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											96.02826187	97.91211006	49.53	5.740526353	37.2017408	0.2	0.076561524	19.89867231	64.54496679	0	16.95757298	41.99876007	0.2	10.29706049	0	7.32808799	23.27404378	12.37397401	13.11998497	8.400273759	0.2	0	0	0	9.595753739	10	10	10	0	0											96.02826187	97.91211006	49.53	5.740526353	37.2017408	0.2	0.076561524	19.89867231	64.54496679	0	16.95757298	41.99876007	0.2	10.29706049	0	7.32808799	23.27404378	12.37397401	13.11998497	8.400273759	0.2	0	0	0	9.595753739	10	10	10	0	0											17.0184	0.633574675	3.068172693	0.605367694	1.69011668	2.517080258	0.618995943	2.760046958	1.569940327	0	1.903314063	0.2490929	0.057970416	0.52576717	0	10.43178568	0.967507491	3.333579364	4.648771624	1.424205487	5.778222708	0	0	0	0.318565385	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	60.2652	0	0	17.0184	0.633574675	3.068172693	0.605367694	1.69011668	2.517080258	0.618995943	2.760046958	1.569940327	0	1.903314063	0.2490929	0.057970416	0.52576717	0	10.43178568	0.967507491	3.333579364	4.648771624	1.424205487	5.778222708	0	0	0	0.318565385	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	60.2652	0	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	Not covered OON	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	Not covered OON	25% coinsurance	Not covered OON	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											6.4195	0.1289	0.2023	0.3906	0.1452	0.2605	0.1663	0	0.4531	0.1277	0.4279	0.0167	0	0.1778	0.2449	1.9324	0.0733	0.2457	0.5131	0.2707	0.5617	0.0122	0	0	0	0	0	0	0	0											12.7705	0	0	23.4379	0.762502821	3.270466688	0.995985994	1.835334979	2.777584533	0.785283409	2.760046958	2.023082613	0.127718584	2.331223158	0.265787111	0.057970416	0.70356546	0.244857064	12.3641921	1.040771807	3.579242699	5.161856051	1.694916345	6.339953697	0.012185205	0	0	0.318565385	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	73.0357
H1416_003_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		410.2805291	97.96875036	844.1021945	3866.640952	1594.476841	21.19171996	5.948543016	2669.418203	197.356349	6514.647194	1191.614074	31.38720583	0.74442782	537.2707232	7546.285093	15385.54127	3794.386111	4447.13352	3875.846786	1103.583815	18.89725183	10.43012627	2250	224.5714286	374.8066481	118.2857143	39.2	16.22068966	1669.471859	6200											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	Medicare FFS Cost Sharing	$0.00 copayment	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $150 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											0	0	40.51	0	29.06421794	0.2	0.143871656	20.50695344	0	0	7.204197005	0	0.2	0	0	0	0	0	8.463983991	7.047032643	0.2	0	0	0	9.903740651	10	10	10	0	0											0	0	40.51	0	29.06421794	0.2	0.143871656	20.50695344	0	0	7.204197005	0	0.2	0	0	0	0	0	8.463983991	7.047032643	0.2	0	0	0	9.903740651	10	10	10	0	0											0	0	2.849548325	0	3.861851867	4.238343992	0.855826735	4.5618029	0	0	0.715385212	0	0.148885564	0	0	0	0	0	2.733758763	0.648082598	3.779450365	0	0	0	0.30933232	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	24.847	0	0	0	0	2.849548325	0	3.861851867	4.238343992	0.855826735	4.5618029	0	0	0.715385212	0	0.148885564	0	0	0	0	0	2.733758763	0.648082598	3.779450365	0	0	0	0.30933232	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	24.847	0	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	Not covered OON	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	Not covered OON	25% coinsurance	Not covered OON	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											7.6778	0.9837	0.2171	1.2306	0.298	0.4386	0.1225	0	0.3193	0.1547	0.3538	0.0115	0	0.1587	0.335	1.5522	0.4037	0.3269	0.3614	0.1431	0.3723	0.0038	0	0	0	0	0	0	0	0											15.4647	0	0	7.6778	0.983713456	3.066629549	1.230578005	4.159865583	4.676989808	0.978337783	4.5618029	0.319291383	0.15471267	1.06917636	0.011451802	0.148885564	0.158652002	0.334995391	1.55219036	0.403702714	0.326924898	3.095176035	0.791181279	4.151715506	0.003827082	0	0	0.30933232	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	40.3117
H1416_007_0	2009	6																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	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	0	0	0											0		494.8809571	99.96927399	900.5441683	2475.084773	17.31245664	18.00619252	5.760803942	25.49195797	15.84538787	7134.003499	19.40190726	0.646232757	0.72513824	6.500095528	6536.909992	70.70405649	14.10740631	9.868214061	19.2412948	5.863633062	13.53170476	0.178994526	2250	646.2	388.5939365	118.2857143	39.2	16.22068966	1668.600336	6200											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"Copay between $0.00 and $10.00, 20% coinsurance"	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	"Copay between $0.00 and $195.00, $1,000 benefit limit"	$10.00 copayment	"$10.00 copayment, $150 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											712.6587747	399.9205283	65.1471157	0	0.166320181	0.17	0.17	0.111349194	0.17	0	0.17	0.17	0.17	0.17	0	0.076088374	0.17	0.17	0.128985408	0.057938995	0.17	0.164896605	0	0	9.68173627	10	10	10	0	0											712.6587747	399.9205283	65.1471157	0	0.166320181	0.17	0.17	0.111349194	0.17	0	0.17	0.17	0.17	0.17	0	0.076088374	0.17	0.17	0.128985408	0.057938995	0.17	0.164896605	0	0	9.68173627	10	10	10	0	0											29.3901	3.331647072	4.888987927	0	2.879410913	3.061052729	0.97933667	2.838508972	2.693715938	0	3.298324234	0.109859569	0.123273501	1.10501624	0	5.37975666	2.398259073	1.67759639	2.481846254	0.339733009	2.30038981	0.02951559	0	0	0.313522001	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	69.7646	0	0	29.3901	3.331647072	4.888987927	0	2.879410913	3.061052729	0.97933667	2.838508972	2.693715938	0	3.298324234	0.109859569	0.123273501	1.10501624	0	5.37975666	2.398259073	1.67759639	2.481846254	0.339733009	2.30038981	0.02951559	0	0	0.313522001	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	69.7646	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	29.3901	3.331647072	4.888987927	0	2.879410913	3.061052729	0.97933667	2.838508972	2.693715938	0	3.298324234	0.109859569	0.123273501	1.10501624	0	5.37975666	2.398259073	1.67759639	2.481846254	0.339733009	2.30038981	0.02951559	0	0	0.313522001	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	69.7646
H1416_009_0	2009	6																					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	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		1900.848754	124.9182673	563.9201766	974.9839921	422.3230654	9.663378437	5.594380333	1505.553079	225.5849439	5224.304447	1232.138619	42.11009991	0.190720473	527.63261	7854.174131	13789.13383	484.5650092	2564.89824	3638.482744	1691.532009	19.90741374	20.25165519	2250	224.5714286	393.8966689	118.2857143	39.2	16.22068966	1669.81815	7480											"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$50 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 $3.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $30.00	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $150 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											25.52124762	22.35533226	56.13	5.317693498	37.43585855	0.2	0.093861767	19.72982197	16.88827948	0	9.03932087	13.12461252	0.2	5.143598609	0	7.177371819	23.32380479	12.48516094	11.78687471	9.093302085	0.2	0	0	0	9.651519482	10	10	10	0	0											22.73782128	19.91719046	50.00828828	4.737729368	33.35298782	0.17818738	0.083624912	17.57802646	15.04639139	0	8.053464528	11.69320162	0.17818738	4.582621808	0	6.39458541	20.78003837	11.12349061	10.50136164	8.101558385	0.17818738	0	0	0	9.651519482	10	10	10	0	0											3.6018	0.207335077	2.350056897	0.384934191	1.173811338	1.721892089	0.467829561	2.205387654	0.28285328	0	0.826915389	0.041033491	0.033983981	0.201495059	0	7.347982834	0.839106624	2.37755179	3.184085258	1.142003778	3.547249903	0	0	0	0.316808448	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	32.3988	0	3.9096	3.6018	0.207335077	2.350056897	0.384934191	1.173811338	1.721892089	0.467829561	2.205387654	0.28285328	0	0.826915389	0.041033491	0.033983981	0.201495059	0	7.347982834	0.839106624	2.37755179	3.184085258	1.142003778	3.547249903	0	0	0	0.316808448	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	32.3988	0	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	Not covered OON	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	Not covered OON	25% coinsurance	Not covered OON	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											5.8554	0.1767	0.166	0.3101	0.111	0.2	0.1147	0	0.3733	0.1209	0.373	0.0116	0	0.1631	0.2007	1.5613	0.0687	0.1931	0.3991	0.2194	0.3825	0.0087	0	0	0	0	0	0	0	0											11.0093	0	0	9.4572	0.38399809	2.51606838	0.695078452	1.28476217	1.921913632	0.582526013	2.205387654	0.656181365	0.120884529	1.199900739	0.052600937	0.033983981	0.364606331	0.200702831	8.909306209	0.907767975	2.570670055	3.583179257	1.361417919	3.929787898	0.008686835	0	0	0.316808448	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	43.4081
H1416_013_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1954.056255	243.8306372	1254.277284	578.2537924	1502.264635	28.36193977	6.43352859	4612.049576	275.3668324	7214.055257	1330.183849	37.26253676	0.816438412	1305.683486	6223.35036	19144.3144	1098.880256	2725.445126	4741.689035	1309.93423	21.1942914	14.56698904	0	224.5714286	368	118.2857143	39.2	16.22068966	1664	5800											"$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 $15.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $15.00	Copay between $5.00 and $15.00	$15.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $150 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											62.3347387	28.70478934	58.89	1.887365879	37.84131603	0.2	0.2	22.57614579	44.8777275	0	11.53063837	26.24922505	0.2	2.557604686	0	3.349863793	10.94533266	5.578406892	13.15027238	5.556210519	0.2	0	0	0	10	10	10	10	0	0											57.65800904	26.55118217	54.4717155	1.745764259	35.00223129	0.184994789	0.184994789	20.88234658	41.51072855	0	10.66554004	24.27984919	0.184994789	2.365717691	0	3.098536721	10.1241475	5.159881018	12.16365929	5.139349952	0.184994789	0	0	0	10	10	10	10	0	0											9.3889	0.539499306	5.693552948	0.084124567	4.381884518	5.246811053	1.190169261	8.025868142	0.952556486	0	1.182260759	0.075394064	0.151036852	0.257406543	0	4.943280096	0.92710215	1.171914381	4.806357491	0.561017535	3.920833456	0	0	0	0.306666667	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	53.9514	0	4.3395	9.3889	0.539499306	5.693552948	0.084124567	4.381884518	5.246811053	1.190169261	8.025868142	0.952556486	0	1.182260759	0.075394064	0.151036852	0.257406543	0	4.943280096	0.92710215	1.171914381	4.806357491	0.561017535	3.920833456	0	0	0	0.306666667	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	53.9514	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											7.3751	0.2454	0.4303	0.2176	0.445	0.6933	0.1573	0	0.5865	0.228	0.5178	0.0221	0	0.1942	0.2527	2.1721	0.2042	0.2635	0.6771	0.1789	0.5042	0.0086	0	0	0	0	0	0	0	0											15.3739	0	0	16.764	0.784923438	6.123874432	0.301705261	4.826876506	5.940102914	1.347433294	8.025868142	1.539054619	0.228031893	1.700030315	0.09748435	0.151036852	0.451604832	0.252720475	7.115420525	1.131345378	1.435458422	5.483435626	0.73994725	4.425031254	0.008570116	0	0	0.306666667	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	69.3254
H1416_014_0	2009	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	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		956.161263	40.22017438	550.5655908	455.243234	374.4676513	16.31050313	4.82599522	2274.259308	308.2237949	4253.717109	987.0857771	31.46687559	0.173111897	505.5923429	7290.708348	18397.19594	342.5380722	2160.896015	3960.880748	1822.311587	24.25967409	12.41126424	2250	224.5714286	368	118.2857143	39.2	16.22068966	1664	7480											"$125 days 1 - 5, $0 after day 5, unlimited coverage"	"$125 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 $3.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $25.00	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $75.00	Copay between $0.00 and $75.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $150 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											101.2644859	58.06116304	56.13	4.64484054	43.86493507	0.2	0.2	22.73908828	66.35374102	0	15.79110711	32.81153131	0.2	6.172799642	2.063950023	6.712795257	19.23966816	9.768890792	20.53488418	7.104864493	0.2	0	0	0	10	10	10	10	0	0											96.335961	55.23533633	53.39816266	4.418776958	41.7300363	0.190266035	0.190266035	21.63238081	63.12431598	0	15.02255667	31.21459978	0.190266035	5.872370556	1.963497934	6.386084679	18.30327685	9.293440575	19.53545493	6.759071973	0.190266035	0	0	0	10	10	10	10	0	0											7.6761	0.185131238	2.449932581	0.167634859	1.30221239	3.103334756	0.918222974	4.099803617	1.621368019	0	1.235712669	0.081852161	0.032937314	0.247418799	1.192940898	9.79050426	0.522464097	1.673513225	6.448133946	1.026427931	4.615791993	0	0	0	0.306666667	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	48.8428	0	2.4757	7.6761	0.185131238	2.449932581	0.167634859	1.30221239	3.103334756	0.918222974	4.099803617	1.621368019	0	1.235712669	0.081852161	0.032937314	0.247418799	1.192940898	9.79050426	0.522464097	1.673513225	6.448133946	1.026427931	4.615791993	0	0	0	0.306666667	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	48.8428	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											4.7008	0.0545	0.1886	0.1478	0.1501	0.3987	0.118	0	0.5574	0.1358	0.3801	0.0195	0	0.175	0.1568	2.1458	0.065	0.1891	0.7163	0.2841	0.5797	0.0038	0	0	0	0	0	0	0	0											11.1669	0	0	12.3768	0.239645059	2.638553976	0.315445039	1.452272916	3.502035944	1.036191746	4.099803617	2.178796427	0.135781456	1.615798949	0.101398508	0.032937314	0.422427019	1.349702211	11.93626975	0.587456603	1.86262061	7.164462563	1.310535103	5.195526759	0.003783703	0	0	0.306666667	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	60.0097
H1416_017_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2075.542334	492.764086	821.1252435	2780.698741	1957.268063	26.55444502	6.54137559	3373.675807	472.7402669	6931.998501	1475.67793	46.16854577	1.915539003	672.3400572	6567.592914	17947.88065	2192.822209	5112.769581	4284.805921	1577.350412	38.46838764	24.16186447	3090	224.5714286	368	118.2857143	39.2	16.22068966	1664	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, $85 days 8 - 100"	Copay between $0.00 and $20.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $20.00	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $150 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	Not Covered											58.10851946	34.50495126	58.89	3.449164879	26.12303092	0.2	0.2	20.66142557	54.75176562	0	11.2696821	26.24922505	0.2	5.966148155	0	4.04484947	11.16165317	7.366668796	14.1768803	6.464158539	0.2	0	0	0	10	10	10	10	0	0											37.89601737	22.50272842	38.40566725	2.249405309	17.03638025	0.130431881	0.130431881	13.47454297	35.70687879	0	7.349629155	17.11867894	0.130431881	3.89087962	0	2.637886616	7.279177068	4.804242325	9.245585793	4.215661775	0.130431881	0	0	0	10	10	10	10	0	0											6.5546	0.9240447	2.627988573	0.521243209	2.778730247	3.463546203	0.85320392	3.788228302	1.406673284	0	0.903807128	0.065862043	0.249847355	0.217999519	0	3.945372846	1.330161761	2.046915335	3.301295062	0.55413132	5.017504145	0	0	0	0.306666667	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	41.0025	0	21.6286	6.5546	0.9240447	2.627988573	0.521243209	2.778730247	3.463546203	0.85320392	3.788228302	1.406673284	0	0.903807128	0.065862043	0.249847355	0.217999519	0	3.945372846	1.330161761	2.046915335	3.301295062	0.55413132	5.017504145	0	0	0	0.306666667	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	41.0025	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											7.9678	0.7008	0.2935	0.9566	0.4154	0.6491	0.1599	0	0.4596	0.1977	0.4329	0.0131	0	0.1656	0.3247	2.0311	0.5434	0.4825	0.3734	0.2083	0.9348	0.0146	0	0	0	0	0	0	0	0											17.3247	0	0	14.5223	1.624858432	2.921490815	1.477825274	3.194109768	4.112654859	1.013104212	3.788228302	1.866307984	0.197686359	1.336685274	0.078918211	0.249847355	0.383570113	0.324738178	5.976435849	1.873549226	2.529383982	3.674711691	0.762411853	5.952341603	0.014649265	0	0	0.306666667	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	58.3273
H1416_018_0	2009	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	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		1524.890428	114.9122693	620.9315696	932.9152298	606.765183	16.01269616	4.75839142	1265.907659	374.2705566	5558.644605	1397.886992	129.976378	1.949852165	666.9114518	8703.544011	19214.11784	358.6051941	3177.457841	4274.945774	2209.364376	30.85741033	43.18489558	3090	224.5714286	368	118.2857143	39.2	16.22068966	1664	7480											"$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	20% coinsurance	20% coinsurance	Copay between $0.00 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 $5.00	Copay between $0.00 and $30.00	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $150 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											92.44742103	51.2160297	56.13	6.831444198	33.74644285	0.2	0.2	20.72011808	66.9742049	0	16.93728234	39.37383757	0.2	7.481309592	2.08285351	7.741766215	19.59012817	12.00636574	16.34653048	7.461411432	0.2	0	0	0	10	10	10	10	0	0											78.48125084	43.47874747	47.65035693	5.799407704	28.64831725	0.169785701	0.169785701	17.58989884	56.85631158	0	14.37854176	33.42557303	0.169785701	6.35109696	1.768193714	6.572206011	16.6306182	10.1925461	13.87703567	6.334204845	0.169785701	0	0	0	10	10	10	10	0	0											9.9729	0.416353461	2.465634244	0.450862981	1.448566788	2.718726839	0.807906822	1.855598972	1.773303615	0	1.674964706	0.362044576	0.331057016	0.352968275	1.282462651	10.52326173	0.496985506	2.698865461	4.94363125	1.166213878	5.239147037	0	0	0	0.306666667	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	51.4329	0	9.0724	9.9729	0.416353461	2.465634244	0.450862981	1.448566788	2.718726839	0.807906822	1.855598972	1.773303615	0	1.674964706	0.362044576	0.331057016	0.352968275	1.282462651	10.52326173	0.496985506	2.698865461	4.94363125	1.166213878	5.239147037	0	0	0	0.306666667	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	51.4329	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											6.0525	0.1445	0.2138	0.307	0.1766	0.3914	0.1163	0	0.6391	0.1505	0.4769	0.0255	0	0.2411	0.227	2.3499	0.067	0.2627	0.6024	0.2988	0.7319	0.0241	0	0	0	0	0	0	0	0											13.4992	0	0	16.0254	0.560884429	2.679436628	0.757899315	1.625208955	3.1101483	0.924223057	1.855598972	2.412384672	0.150462271	2.151889574	0.387539931	0.331057016	0.59410954	1.50947268	12.8731386	0.564016905	2.961574489	5.545995012	1.46505507	5.971055262	0.024100266	0	0	0.306666667	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	64.9321
H1416_019_0	2009	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	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		1359.123046	113.7312009	518.1540724	1519.329643	471.9608686	12.72458972	4.105502653	1775.614028	293.3120226	5542.240439	1334.487073	50.15370182	0.336421629	630.5566233	7909.38703	17536.91338	803.9634389	3752.000006	3826.362237	2011.768825	29.7373821	28.53019189	2250	646.2	368	118.2857143	39.2	16.22068966	1664	6485.714286											"$50 days 1 - 5, $0 after day 5, unlimited coverage"	"$50 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 $3.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $30.00	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"Copay between $0.00 and $195.00, $1,000 benefit limit"	$10.00 copayment	"$10.00 copayment, $150 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											31.24502991	21.80716493	56.13	5.142875968	32.06855856	0.2	0.2	20.80814073	16.88068675	0	9.897709803	13.12461252	0.2	3.508757708	0	7.834775644	23.28218763	12.51848762	17.24718151	7.961108147	0.2	0	0	0	10	10	10	10	0	0											26.36570566	18.40168799	47.36455887	4.339747934	27.06062943	0.168767357	0.168767357	17.55867462	14.24454447	0	8.352051641	11.07503087	0.168767357	2.960818832	0	6.611271909	19.64636641	10.56356038	14.55380623	6.717875922	0.168767357	0	0	0	10	10	10	10	0	0											2.9862	0.17440384	2.045178255	0.549458973	1.064296514	2.147495382	0.692874834	2.598119081	0.348174679	0	0.928808745	0.046287816	0.056776989	0.155580327	0	9.661775234	1.316246692	3.302873217	4.640677882	1.126234446	5.018699395	0	0	0	0.306666667	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	39.3116	0	7.1916	2.9862	0.17440384	2.045178255	0.549458973	1.064296514	2.147495382	0.692874834	2.598119081	0.348174679	0	0.928808745	0.046287816	0.056776989	0.155580327	0	9.661775234	1.316246692	3.302873217	4.640677882	1.126234446	5.018699395	0	0	0	0.306666667	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	39.3116	0	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	Not covered OON	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	Not covered OON	25% coinsurance	Not covered OON	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											5.4527	0.1791	0.158	0.477	0.1047	0.2634	0.085	0	0.4537	0.1236	0.4396	0.0139	0	0.1893	0.212	1.9932	0.1156	0.2845	0.5293	0.2761	0.581	0.0137	0	0	0	0	0	0	0	0											11.9452	0	0	8.4389	0.353470205	2.20316309	1.026471239	1.168968448	2.410880707	0.777854324	2.598119081	0.801831831	0.123591316	1.36844917	0.060140496	0.056776989	0.344877274	0.212034969	11.65497509	1.431892526	3.587336672	5.169981568	1.4023155	5.59971362	0.013659358	0	0	0.306666667	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	51.2568
H1416_020_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1000.64046	42.10997935	575.2847396	476.5241954	374.3396626	16.30492839	5.031739209	2371.921802	322.5988462	4452.904914	1033.455595	32.94539375	0.181245818	528.918856	7613.016639	19160.8787	357.025038	2254.940472	4139.67781	1853.875587	25.36949597	12.96457294	2250	646.2	368	118.2857143	39.2	16.22068966	1664	6485.714286											"$125 days 1 - 5, $0 after day 5, unlimited coverage"	"$125 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 $3.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $25.00	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $75.00	Copay between $0.00 and $75.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"Copay between $0.00 and $195.00, $1,000 benefit limit"	$10.00 copayment	"$10.00 copayment, $150 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											101.2624113	58.06116304	56.13	4.645906137	43.86493507	0.2	0.2	22.73833859	66.3629321	0	15.79111074	32.81153131	0.2	6.166458634	2.060318058	6.67147807	19.23386187	9.768702857	20.53351483	7.193159479	0.2	0	0	0	10	10	10	10	0	0											95.90328393	54.98838246	53.15942269	4.400030075	41.54346382	0.189415367	0.189415367	21.53495372	62.85079562	0	14.95539517	31.07504119	0.189415367	5.840110119	1.951279503	6.318402327	18.215945	9.251712172	19.44681621	6.812474705	0.189415367	0	0	0	10	10	10	10	0	0											7.9971	0.192963304	2.54848372	0.174726733	1.295947186	3.088403992	0.953088728	4.256602186	1.689632846	0	1.287978067	0.085314956	0.034330743	0.25741203	1.237926944	10.08884505	0.541962371	1.738505018	6.708629463	1.052456712	4.805372383	0	0	0	0.306666667	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	50.4871	0	2.796	7.9971	0.192963304	2.54848372	0.174726733	1.295947186	3.088403992	0.953088728	4.256602186	1.689632846	0	1.287978067	0.085314956	0.034330743	0.25741203	1.237926944	10.08884505	0.541962371	1.738505018	6.708629463	1.052456712	4.805372383	0	0	0	0.306666667	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	50.4871	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											4.9195	0.0571	0.1971	0.1547	0.15	0.3986	0.123	0	0.5835	0.1421	0.3979	0.0205	0	0.1832	0.164	2.2385	0.0678	0.1973	0.7488	0.2904	0.6063	0.004	0	0	0	0	0	0	0	0											11.6442	0	0	12.9166	0.250038538	2.745573789	0.329450671	1.445956423	3.486968908	1.076086797	4.256602186	2.273144183	0.142139662	1.685921968	0.105779718	0.034330743	0.440588366	1.401968212	12.32730619	0.609753471	1.935840695	7.457388908	1.342826326	5.411636958	0.003959756	0	0	0.306666667	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	62.1313
H1416_021_0	2009	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	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		1538.486384	115.9381007	626.3312916	941.2342854	606.7663302	16.01272643	4.796070766	1274.831437	377.5840697	5608.133623	1410.3074	131.136688	1.967258658	672.6486969	8776.753326	19367.67482	361.4679166	3203.810135	4311.789979	2217.748369	31.13244197	43.56859806	3090	646.2	368	118.2857143	39.2	16.22068966	1664	6200											"$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	20% coinsurance	20% coinsurance	Copay between $0.00 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 $5.00	Copay between $0.00 and $30.00	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"Copay between $0.00 and $195.00, $1,000 benefit limit"	$10.00 copayment	"$10.00 copayment, $150 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											92.44699353	51.2160297	56.13	6.831510657	33.74644285	0.2	0.2	20.72093717	66.97627225	0	16.93743474	39.37383757	0.2	7.479643962	2.082057899	7.732159676	19.59096647	12.0063058	16.34651915	7.478328892	0.2	0	0	0	10	10	10	10	0	0											78.32497328	43.3923701	47.555692	5.787942574	28.59140286	0.169448395	0.169448395	17.55564771	56.74510911	0	14.35010564	33.35916786	0.169448395	6.337068315	1.764006844	6.551010227	16.5982891	10.17224623	13.84945715	6.335954132	0.169448395	0	0	0	10	10	10	10	0	0											10.0418	0.419235748	2.482134832	0.453984166	1.445691715	2.71333079	0.812686493	1.865040966	1.785504103	0	1.686505014	0.364550899	0.333348822	0.355218395	1.290187745	10.57315299	0.499979082	2.715828796	4.976329212	1.170962662	5.275342317	0	0	0	0.306666667	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	51.7123	0	9.2423	10.0418	0.419235748	2.482134832	0.453984166	1.445691715	2.71333079	0.812686493	1.865040966	1.785504103	0	1.686505014	0.364550899	0.333348822	0.355218395	1.290187745	10.57315299	0.499979082	2.715828796	4.976329212	1.170962662	5.275342317	0	0	0	0.306666667	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	51.7123	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											6.1065	0.1458	0.2157	0.3098	0.1766	0.3914	0.1172	0	0.6448	0.1518	0.4812	0.0257	0	0.2433	0.229	2.3694	0.0676	0.2649	0.6076	0.3	0.7384	0.0243	0	0	0	0	0	0	0	0											13.6109	0	0	16.1483	0.565056956	2.697796477	0.763758701	1.622334216	3.104752991	0.929923778	1.865040966	2.430263782	0.151801847	2.167669185	0.390273853	0.333348822	0.598472236	1.519222441	12.94250579	0.567543451	2.980716527	5.583902776	1.471009717	6.013784348	0.024315114	0	0	0.306666667	0.098571429	0.032666667	0.013517241	0	0	0	0	0	0	0	0	0	0	0	0	65.3232
H1416_801_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.241	0.494	0.2003	0.6189	0.7138	0	0.8403	0.0287	0.0098	0.6127	1.275	3.9593	0.166	0.5429	1.1906	0.1993	0	0.0001	0	0	0	0	0	0	0	0											11.0926		313.5259456	11.93724051	1345.974513	2603.042588	5.687179967	11.65955791	4.726373882	14.6068022	16.84760943	5646.421862	19.8328941	0.67674885	0.230308914	14.4604178	30.6942052	102.2453482	3.917117136	12.81424843	28.10124817	4.703979522	28.27577719	0.003448771	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											753.664	753.664	70.5732	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.19998942	0.196013194	0.5	0.2	0.2	0.196125068	0.2	0.2	0	0	0	0	0	0	0	0											753.664	753.664	70.5732	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.19998942	0.196013194	0.5	0.2	0.2	0.196125068	0.2	0.2	0	0	0	0	0	0	0	0											19.6911	0.749722369	7.915810711	0	1.137435993	2.331911583	0.945274776	2.921360439	3.369521887	0	3.96657882	0.13534977	0.046061783	2.89208356	6.138516287	20.04143731	1.958558568	2.562849686	5.620249635	0.922568302	5.655155437	0.000689754	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.0022	135	0	19.6911	0.749722369	7.915810711	0	1.378397543	2.825918307	1.145527693	3.540239693	4.083342462	0	4.806883667	0.164023111	0.055819799	3.504760617	7.41351249	24.00077793	2.124523883	3.105779781	6.810878443	1.121872386	5.655155437	0.000835876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.0949		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			19.6911	0.749722369	7.915810711	0	1.378397543	2.825918307	1.145527693	3.540239693	4.083342462	0	4.806883667	0.164023111	0.055819799	3.504760617	7.41351249	24.00077793	2.124523883	3.105779781	6.810878443	1.121872386	5.655155437	0.000835876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.0949
H1416_802_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.241	0.494	0.2003	0.6189	0.7138	0	0.8403	0.0287	0.0098	0.6127	1.275	3.9593	0.166	0.5429	1.1906	0.1993	0	0.0001	0	0	0	0	0	0	0	0											11.0926		313.5259456	11.93724051	1345.974513	2603.042588	5.687179967	11.65955791	4.726373882	14.6068022	16.84760943	5646.421862	19.8328941	0.67674885	0.230308914	14.4604178	30.6942052	102.2453482	3.917117136	12.81424843	28.10124817	4.703979522	28.27577719	0.003448771	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											753.664	753.664	70.5732	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.19998942	0.196013194	0.5	0.2	0.2	0.196125068	0.2	0.2	0	0	0	0	0	0	0	0											753.664	753.664	70.5732	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.19998942	0.196013194	0.5	0.2	0.2	0.196125068	0.2	0.2	0	0	0	0	0	0	0	0											19.6911	0.749722369	7.915810711	0	1.137435993	2.331911583	0.945274776	2.921360439	3.369521887	0	3.96657882	0.13534977	0.046061783	2.89208356	6.138516287	20.04143731	1.958558568	2.562849686	5.620249635	0.922568302	5.655155437	0.000689754	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.0022	135	0	19.6911	0.749722369	7.915810711	0	1.378397543	2.825918307	1.145527693	3.540239693	4.083342462	0	4.806883667	0.164023111	0.055819799	3.504760617	7.41351249	24.00077793	2.124523883	3.105779781	6.810878443	1.121872386	5.655155437	0.000835876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.0949		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			19.6911	0.749722369	7.915810711	0	1.378397543	2.825918307	1.145527693	3.540239693	4.083342462	0	4.806883667	0.164023111	0.055819799	3.504760617	7.41351249	24.00077793	2.124523883	3.105779781	6.810878443	1.121872386	5.655155437	0.000835876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.0949
H1416_803_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.241	0.494	0.2003	0.6189	0.7138	0	0.8403	0.0287	0.0098	0.6127	1.275	3.9593	0.166	0.5429	1.1906	0.1993	0	0.0001	0	0	0	0	0	0	0	0											11.0926		313.5259456	11.93724051	1345.974513	2603.042588	5.687179967	11.65955791	4.726373882	14.6068022	16.84760943	5646.421862	19.8328941	0.67674885	0.230308914	14.4604178	30.6942052	102.2453482	3.917117136	12.81424843	28.10124817	4.703979522	28.27577719	0.003448771	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											753.664	753.664	70.5732	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.19998942	0.196013194	0.5	0.2	0.2	0.196125068	0.2	0.2	0	0	0	0	0	0	0	0											753.664	753.664	70.5732	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.19998942	0.196013194	0.5	0.2	0.2	0.196125068	0.2	0.2	0	0	0	0	0	0	0	0											19.6911	0.749722369	7.915810711	0	1.137435993	2.331911583	0.945274776	2.921360439	3.369521887	0	3.96657882	0.13534977	0.046061783	2.89208356	6.138516287	20.04143731	1.958558568	2.562849686	5.620249635	0.922568302	5.655155437	0.000689754	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.0022	135	0	19.6911	0.749722369	7.915810711	0	1.378397543	2.825918307	1.145527693	3.540239693	4.083342462	0	4.806883667	0.164023111	0.055819799	3.504760617	7.41351249	24.00077793	2.124523883	3.105779781	6.810878443	1.121872386	5.655155437	0.000835876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.0949		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			19.6911	0.749722369	7.915810711	0	1.378397543	2.825918307	1.145527693	3.540239693	4.083342462	0	4.806883667	0.164023111	0.055819799	3.504760617	7.41351249	24.00077793	2.124523883	3.105779781	6.810878443	1.121872386	5.655155437	0.000835876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.0949
H1416_804_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.241	0.494	0.2003	0.6189	0.7138	0	0.8403	0.0287	0.0098	0.6127	1.275	3.9593	0.166	0.5429	1.1906	0.1993	0	0.0001	0	0	0	0	0	0	0	0											11.0926		313.5259456	11.93724051	1345.974513	2603.042588	5.687179967	11.65955791	4.726373882	14.6068022	16.84760943	5646.421862	19.8328941	0.67674885	0.230308914	14.4604178	30.6942052	102.2453482	3.917117136	12.81424843	28.10124817	4.703979522	28.27577719	0.003448771	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											753.664	753.664	70.5732	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.19998942	0.196013194	0.5	0.2	0.2	0.196125068	0.2	0.2	0	0	0	0	0	0	0	0											753.664	753.664	70.5732	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.19998942	0.196013194	0.5	0.2	0.2	0.196125068	0.2	0.2	0	0	0	0	0	0	0	0											19.6911	0.749722369	7.915810711	0	1.137435993	2.331911583	0.945274776	2.921360439	3.369521887	0	3.96657882	0.13534977	0.046061783	2.89208356	6.138516287	20.04143731	1.958558568	2.562849686	5.620249635	0.922568302	5.655155437	0.000689754	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.0022	135	0	19.6911	0.749722369	7.915810711	0	1.378397543	2.825918307	1.145527693	3.540239693	4.083342462	0	4.806883667	0.164023111	0.055819799	3.504760617	7.41351249	24.00077793	2.124523883	3.105779781	6.810878443	1.121872386	5.655155437	0.000835876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.0949		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			19.6911	0.749722369	7.915810711	0	1.378397543	2.825918307	1.145527693	3.540239693	4.083342462	0	4.806883667	0.164023111	0.055819799	3.504760617	7.41351249	24.00077793	2.124523883	3.105779781	6.810878443	1.121872386	5.655155437	0.000835876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.0949
H1417_001_0	2009	5																					1500											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	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	246.0212343	3.038215297	1280.484619	252.5741471	150.1991911	10.08697525	1.807718169	346.1197138	314.925585	499.096121	253.757353	0	0.438350212	2497.518646	4368.537897	8456.92577	99.2192266	47.69669285	621.388822	1445.907299	1797.195652	0	0	0	26.23613777	0	5.940877458	0	110.5719456	0											PBP: 1A IP Acute: $0 per admit	1B IP Psych: $0 per admit	2 SNF: $0	6 Home Health: $0	10A Ambulance: $50	11A DME: 10%	"11B Prosthetic Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: 10%"	"4A ER: $50, 4B Urgent Care: $10"	9B ASC Services: $100	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	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: $10, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $0"	"7B Chiropractic: $10, 7D Physician Specialist (excl. Radiology): $10, 7F Podiatry: $10"	"7E Mental Health: $10, 7H Psychiatric: $10"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	7D Physician Specialist (Radiology): $10	"7G Other Health Care: $10, 18A Medicare Covered Hearing Exams: $10"	15 Part B Drugs: $0	"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, 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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0	0	0	0	50	0.1	0.1	48.36	100	0	0	0	10	10	6.666666667	10	10	10	10	10	0	0	0	0	10	0	10	0	0	0											0	0	0	0	44.45481009	0.08890962	0.08890962	42.99669232	88.90962018	0	0	0	8.890962018	8.890962018	5.927308012	8.890962018	8.890962018	8.890962018	8.890962018	8.890962018	0	0	0	0	8.890962018	0	8.890962018	0	0	0											0	0	0	0	0.556423043	0.896829138	0.160723536	1.240166903	2.333326179	0	0	0	0.00032478	1.850445285	2.157805807	6.265850484	0.073512865	0.035339124	0.460395368	1.071292239	0	0	0	0	0.019438709	0	0.004401676	0	0	0	0	0	0	0	0	0	0	0	0	0	17.1263	0	2.1363	0	0	0	0	0.556423043	0.896829138	0.160723536	1.240166903	2.333326179	0	0	0	0.00032478	1.850445285	2.157805807	6.265850484	0.073512865	0.035339124	0.460395368	1.071292239	0	0	0	0	0.019438709	0	0.004401676	0	0	0	0	0	0	0	0	0	0	0	0	0	17.1263	0	PBP: 1A IP Acute: $175 per day (days 1-5)	1B IP Psych: $175 per day (days 1-5)	2 SNF: $100 per day (days 21-100)	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: $200	8A OP C/D/T: $30	8B OP X-Ray: $30	9A OP Hospital: $30	12 Renal Dialysis: $10	"3 CORF: $30, 5 Partial Hosp: $30, 9C OP Substance Abuse: $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: $0, 14J Nutrition Therapy: $0"	"7B Chiropractic: $30, 7D Physician Specialist (excl. Radiology): $30, 7F Podiatry: $30"	"7E Mental Health: $30, 7H Psychiatric: $30"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	7D Physician Specialist (Radiology): $30	"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: $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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0.8347	0.0164	0.9245	0.0719	0.348	0.4432	0.0178	0.122	0.1797	0.0543	0.0375	0	0	0.726	0.3579	3.1289	0.1346	0.1165	0.112	0.306	0.0327	0	0	0	0.005	0	0.0001	0	0.0004	0											7.97	110	0	0.8347	0.016374881	0.924543885	0.071928357	0.904455524	1.339982937	0.178508862	1.36214972	2.513064414	0.054307735	0.037488147	0	0.000357011	2.576447136	2.515697594	9.394755654	0.208086336	0.151802366	0.572352523	1.377275278	0.032730155	0	0	0	0.024399158	0	0.004477589	0	0.000408452	0	0	0	0	0	0	0	0	0	0	0	25.0963
H1417_002_0	2009	7																					1500											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	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	282.6160811	3.490139796	1470.952481	290.143718	172.5408251	11.58737953	2.076610281	397.6038791	361.7697265	573.3350221	291.5029219	0	0.503553359	2869.016303	5018.343494	9714.865572	113.9777592	54.79141852	713.8183588	1660.981238	2064.522575	0	0	0	30.13867669	0	6.824563376	0	127.0191577	0											PBP: 1A IP Acute: $0 per admit	1B IP Psych: $0 per admit	2 SNF: $0	6 Home Health: $0	10A Ambulance: $50	11A DME: 10%	"11B Prosthetic Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: 10%"	"4A ER: $50, 4B Urgent Care: $10"	9B ASC Services: $100	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	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: $10, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $0"	"7B Chiropractic: $10, 7D Physician Specialist (excl. Radiology): $10, 7F Podiatry: $10"	"7E Mental Health: $10, 7H Psychiatric: $10"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	7D Physician Specialist (Radiology): $10	"7G Other Health Care: $10, 18A Medicare Covered Hearing Exams: $10"	15 Part B Drugs: $0	"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, 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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0	0	0	0	50	0.1	0.1	48.36	100	0	0	0	10	10	6.666666667	10	10	10	10	10	0	0	0	0	10	0	10	0	0	0											0	0	0	0	43.87351127	0.087747023	0.087747023	42.4344601	87.74702254	0	0	0	8.774702254	8.774702254	5.849801503	8.774702254	8.774702254	8.774702254	8.774702254	8.774702254	0	0	0	0	8.774702254	0	8.774702254	0	0	0											0	0	0	0	0.630830986	1.016758053	0.182216369	1.406008829	2.645351362	0	0	0	0.000368211	2.097896985	2.446359443	7.103754403	0.083343408	0.040064865	0.521961963	1.214551318	0	0	0	0	0.02203816	0	0.004990293	0	0	0	0	0	0	0	0	0	0	0	0	0	19.4165	0	2.7113	0	0	0	0	0.630830986	1.016758053	0.182216369	1.406008829	2.645351362	0	0	0	0.000368211	2.097896985	2.446359443	7.103754403	0.083343408	0.040064865	0.521961963	1.214551318	0	0	0	0	0.02203816	0	0.004990293	0	0	0	0	0	0	0	0	0	0	0	0	0	19.4165	0	PBP: 1A IP Acute: $175 per day (days 1-5)	1B IP Psych: $175 per day (days 1-5)	2 SNF: $100 per day (days 21-100)	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: $200	8A OP C/D/T: $30	8B OP X-Ray: $30	9A OP Hospital: $30	12 Renal Dialysis: $10	"3 CORF: $30, 5 Partial Hosp: $30, 9C OP Substance Abuse: $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: $0, 14J Nutrition Therapy: $0"	"7B Chiropractic: $30, 7D Physician Specialist (excl. Radiology): $30, 7F Podiatry: $30"	"7E Mental Health: $30, 7H Psychiatric: $30"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	7D Physician Specialist (Radiology): $30	"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: $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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0.9482	0.0188	1.0638	0.0828	0.4011	0.5084	0.0203	0.1393	0.2049	0.0624	0.0427	0	0	0.8362	0.4111	3.6065	0.1553	0.1344	0.1267	0.3489	0.0351	0	0	0	0.0057	0	0.0001	0	0.0004	0											9.1533	110	0	0.9482	0.018804404	1.063799059	0.082786302	1.031929623	1.525197711	0.202549802	1.545322777	2.850280677	0.062416364	0.04271713	0	0.000402781	2.934068505	2.857475931	10.71021773	0.23861266	0.174475665	0.648679754	1.563489748	0.035104898	0	0	0	0.027753113	0	0.005071714	0	0.000438087	0	0	0	0	0	0	0	0	0	0	0	28.5698
H1417_003_0	2009	9																					3000											A	A	D	V	T	Coin	Coin	V	Coin	Coin	Coin	V	Coin	V	V	V	V	V	V	V	Coin	Coin	T	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	5000	244.4532703	3.012307602	1238.589886	250.587356	148.6820276	9.646111073	1.772040953	344.201747	35.56693908	3.775780843	7.651818197	0	0.036370188	2471.014946	4131.708713	7762.313433	94.92837136	47.78013333	585.7794473	1367.999258	35.67920375	0	0	0	0	0	0	0	110.5719456	0											PBP: 1A IP Acute: $125 per day (days 1-5)	1B IP Psych: $125 per day (days 1-5)	2 SNF: $100 per day (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: $35	12 Renal Dialysis: 10%	"3 CORF: $35, 5 Partial Hosp: $35, 9C OP Substance Abuse: $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: $0, 14J Nutrition Therapy: $0"	"7B Chiropractic: $35, 7D Physician Specialist (excl. Radiology): $35, 7F Podiatry: $35"	"7E Mental Health: $35, 7H Psychiatric: $35"	"7C Occupational Therapy: $35, 7I Physical and Speech Therapy: $35"	7D Physician Specialist (Radiology): $35	"7G Other Health Care: $35, 18A Medicare Covered Hearing Exams: $35"	15 Part B Drugs: 10%	"13A Blood: 10%, 16B Medicare Covered Comprehensive Dental Services: $35, 17A Medicare Covered Eye Exams: $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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											337.7368059	461.7679584	47	0	100	0.2	0.2	49.385	0.1	0.1	0.1	35	0.1	35	13.33333333	35	35	35	35	35	0.1	0.1	0	0	0	0	0	0	0	0											251.6401566	344.0530002	35.01865107	0	74.50776823	0.149015536	0.149015536	36.79566134	0.074507768	0.074507768	0.074507768	26.07771888	0.074507768	26.07771888	9.934369098	26.07771888	26.07771888	26.07771888	26.07771888	26.07771888	0.074507768	0.074507768	0	0	0	0	0	0	0	0											5.1262	0.086366122	3.614478921	0	0.923163837	1.437420416	0.264061633	1.055427576	2.650013253	0.281325004	0.570119897	0	0.002709862	5.369869425	3.42049328	16.86861897	0.206292949	0.103833074	1.272982646	2.972858339	2.658377844	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.8846	0	16.7255	5.1262	0.086366122	3.614478921	0	0.923163837	1.437420416	0.264061633	1.055427576	2.650013253	0.281325004	0.570119897	0	0.002709862	5.369869425	3.42049328	16.86861897	0.206292949	0.103833074	1.272982646	2.972858339	2.658377844	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.8846	0	PBP: 1A IP Acute: $180 per day (days 1-5)	1B IP Psych: $180 per day (days 1-5)	2 SNF: $115 per day (days 21-100)	6 Home Health: $20	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: 15%	8A OP C/D/T: 15%	8B OP X-Ray: 15%	9A OP Hospital: 15%	12 Renal Dialysis: 10%	"3 CORF: 15%, 5 Partial Hosp: 15%, 9C OP Substance Abuse: 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: $0, 14J Nutrition Therapy: $0"	"7B Chiropractic: 15%, 7D Physician Specialist (excl. Radiology): 15%, 7F Podiatry: 15%"	"7E Mental Health: 15%, 7H Psychiatric: 15%"	"7C Occupational Therapy: 15%, 7I Physical and Speech Therapy: 15%"	7D Physician Specialist (Radiology): 15%	"7G Other Health Care: 15%, 18A Medicare Covered Hearing Exams: 15%"	15 Part B Drugs: 15%	"13A Blood: 15%, 16B Medicare Covered Comprehensive Dental Services: 15%, 17A Medicare Covered Eye Exams: 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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0.856	0.0142	0.8365	0.1116	0.6361	0.3729	0.0163	0.1153	0.1893	0.0267	0.0622	0	0.0001	0.4091	0.1498	1.3212	0.0487	0.0251	0.0937	0.185	0.384	0	0	0	0	0	0	0	0.0008	0											5.8545	200	0.792576145	5.9822	0.100561044	4.450990546	0.111590092	1.559275876	1.810354603	0.280377849	1.170684828	2.839291918	0.308048519	0.632322024	0	0.002766637	5.77893173	3.570332507	18.18978241	0.25502524	0.12892318	1.36670237	3.157832551	3.042349352	0	0	0	0	0	0	0	0.000754226	0	0	0	0	0	0	0	0	0	0	0	54.7391
H1417_004_0	2009	9																					3000											A	A	D	V	T	Coin	Coin	V	Coin	Coin	Coin	V	Coin	V	V	V	V	V	V	V	Coin	Coin	T	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	5000	280.8148876	3.460378418	1422.826045	287.8613984	170.7979885	11.08093826	2.035626197	395.4006211	40.8574039	4.337415784	8.790000904	0	0.041780133	2838.570265	4746.28675	8916.931942	109.0486534	54.88727049	672.9122071	1571.484633	40.98636757	0	0	0	0	0	0	0	127.0191577	0											PBP: 1A IP Acute: $125 per day (days 1-5)	1B IP Psych: $125 per day (days 1-5)	2 SNF: $100 per day (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: $35	12 Renal Dialysis: 10%	"3 CORF: $35, 5 Partial Hosp: $35, 9C OP Substance Abuse: $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: $0, 14J Nutrition Therapy: $0"	"7B Chiropractic: $35, 7D Physician Specialist (excl. Radiology): $35, 7F Podiatry: $35"	"7E Mental Health: $35, 7H Psychiatric: $35"	"7C Occupational Therapy: $35, 7I Physical and Speech Therapy: $35"	7D Physician Specialist (Radiology): $35	"7G Other Health Care: $35, 18A Medicare Covered Hearing Exams: $35"	15 Part B Drugs: 10%	"13A Blood: 10%, 16B Medicare Covered Comprehensive Dental Services: $35, 17A Medicare Covered Eye Exams: $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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											337.7368059	461.7679584	47	0	100	0.2	0.2	49.385	0.1	0.1	0.1	35	0.1	35	13.33333333	35	35	35	35	35	0.1	0.1	0	0	0	0	0	0	0	0											245.3712686	335.4819131	34.14626249	0	72.65162232	0.145303245	0.145303245	35.87900368	0.072651622	0.072651622	0.072651622	25.42806781	0.072651622	25.42806781	9.686882976	25.42806781	25.42806781	25.42806781	25.42806781	25.42806781	0.072651622	0.072651622	0	0	0	0	0	0	0	0											5.742	0.096741198	4.048682634	0	1.03406258	1.610096284	0.295783091	1.182215028	2.968356677	0.315120293	0.638607826	0	0.003035394	6.014946432	3.831393693	18.89502918	0.231074713	0.116306436	1.425904769	3.329984818	2.977726097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.7571	0	20.6123	5.742	0.096741198	4.048682634	0	1.03406258	1.610096284	0.295783091	1.182215028	2.968356677	0.315120293	0.638607826	0	0.003035394	6.014946432	3.831393693	18.89502918	0.231074713	0.116306436	1.425904769	3.329984818	2.977726097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.7571	0	PBP: 1A IP Acute: $180 per day (days 1-5)	1B IP Psych: $180 per day (days 1-5)	2 SNF: $115 per day (days 21-100)	6 Home Health: $20	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: 15%	8A OP C/D/T: 15%	8B OP X-Ray: 15%	9A OP Hospital: 15%	12 Renal Dialysis: 10%	"3 CORF: 15%, 5 Partial Hosp: 15%, 9C OP Substance Abuse: 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: $0, 14J Nutrition Therapy: $0"	"7B Chiropractic: 15%, 7D Physician Specialist (excl. Radiology): 15%, 7F Podiatry: 15%"	"7E Mental Health: 15%, 7H Psychiatric: 15%"	"7C Occupational Therapy: 15%, 7I Physical and Speech Therapy: 15%"	7D Physician Specialist (Radiology): 15%	"7G Other Health Care: 15%, 18A Medicare Covered Hearing Exams: 15%"	15 Part B Drugs: 15%	"13A Blood: 15%, 16B Medicare Covered Comprehensive Dental Services: 15%, 17A Medicare Covered Eye Exams: 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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0.9544	0.0161	0.9505	0.1271	0.717	0.42	0.0183	0.1294	0.211	0.0299	0.0696	0	0.0001	0.4597	0.167	1.4858	0.0549	0.0283	0.1033	0.2046	0.4306	0	0	0	0	0	0	0	0.0008	0											6.5783	200	1.014735963	6.6964	0.112807013	4.999134273	0.12710109	1.751038433	2.030128688	0.314072442	1.31158048	3.179355063	0.34499688	0.708228074	0	0.003096364	6.474628887	3.998400092	20.38080252	0.285991132	0.144590516	1.529242743	3.534600357	3.408292187	0	0	0	0	0	0	0	0.000809948	0	0	0	0	0	0	0	0	0	0	0	61.3353
H1417_005_0	2009	8																					1500											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	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	282.6160811	3.490139796	1470.952481	290.143718	172.5408251	11.58737953	2.076610281	397.6038791	361.7697265	573.3350221	291.5029219	0	0.503553359	2869.016303	5018.343494	9714.865572	113.9777592	54.79141852	713.8183588	1660.981238	2064.522575	0	0	0	30.13867669	0	6.824563376	0	127.0191577	0											PBP: 1A IP Acute: $0 per admit	1B IP Psych: $0 per admit	2 SNF: $0	6 Home Health: $0	10A Ambulance: $50	11A DME: 10%	"11B Prosthetic Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: 10%"	"4A ER: $50, 4B Urgent Care: $10"	9B ASC Services: $100	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	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: $10, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $0"	"7B Chiropractic: $10, 7D Physician Specialist (excl. Radiology): $10, 7F Podiatry: $10"	"7E Mental Health: $10, 7H Psychiatric: $10"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	7D Physician Specialist (Radiology): $10	"7G Other Health Care: $10, 18A Medicare Covered Hearing Exams: $10"	15 Part B Drugs: $0	"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, 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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0	0	0	0	50	0.1	0.1	48.36	100	0	0	0	10	10	6.666666667	10	10	10	10	10	0	0	0	0	10	0	10	0	0	0											0	0	0	0	43.87351127	0.087747023	0.087747023	42.4344601	87.74702254	0	0	0	8.774702254	8.774702254	5.849801503	8.774702254	8.774702254	8.774702254	8.774702254	8.774702254	0	0	0	0	8.774702254	0	8.774702254	0	0	0											0	0	0	0	0.630830986	1.016758053	0.182216369	1.406008829	2.645351362	0	0	0	0.000368211	2.097896985	2.446359443	7.103754403	0.083343408	0.040064865	0.521961963	1.214551318	0	0	0	0	0.02203816	0	0.004990293	0	0	0	0	0	0	0	0	0	0	0	0	0	19.4165	0	2.7113	0	0	0	0	0.630830986	1.016758053	0.182216369	1.406008829	2.645351362	0	0	0	0.000368211	2.097896985	2.446359443	7.103754403	0.083343408	0.040064865	0.521961963	1.214551318	0	0	0	0	0.02203816	0	0.004990293	0	0	0	0	0	0	0	0	0	0	0	0	0	19.4165	0	PBP: 1A IP Acute: $175 per day (days 1-5)	1B IP Psych: $175 per day (days 1-5)	2 SNF: $100 per day (days 21-100)	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: $200	8A OP C/D/T: $30	8B OP X-Ray: $30	9A OP Hospital: $30	12 Renal Dialysis: $10	"3 CORF: $30, 5 Partial Hosp: $30, 9C OP Substance Abuse: $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: $0, 14J Nutrition Therapy: $0"	"7B Chiropractic: $30, 7D Physician Specialist (excl. Radiology): $30, 7F Podiatry: $30"	"7E Mental Health: $30, 7H Psychiatric: $30"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	7D Physician Specialist (Radiology): $30	"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: $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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0.9482	0.0188	1.0638	0.0828	0.4011	0.5084	0.0203	0.1393	0.2049	0.0624	0.0427	0	0	0.8362	0.4111	3.6065	0.1553	0.1344	0.1267	0.3489	0.0351	0	0	0	0.0057	0	0.0001	0	0.0004	0											9.1533	110	0	0.9482	0.018804404	1.063799059	0.082786302	1.031929623	1.525197711	0.202549802	1.545322777	2.850280677	0.062416364	0.04271713	0	0.000402781	2.934068505	2.857475931	10.71021773	0.23861266	0.174475665	0.648679754	1.563489748	0.035104898	0	0	0	0.027753113	0	0.005071714	0	0.000438087	0	0	0	0	0	0	0	0	0	0	0	28.5698
H1417_006_0	2009	9																					3000											A	A	D	V	T	Coin	Coin	V	Coin	Coin	Coin	V	Coin	V	V	V	V	V	V	V	Coin	Coin	T	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	5000	280.8148876	3.460378418	1422.826045	287.8613984	170.7979885	11.08093826	2.035626197	395.4006211	40.8574039	4.337415784	8.790000904	0	0.041780133	2838.570265	4746.28675	8916.931942	109.0486534	54.88727049	672.9122071	1571.484633	40.98636757	0	0	0	0	0	0	0	127.0191577	0											PBP: 1A IP Acute: $125 per day (days 1-5)	1B IP Psych: $125 per day (days 1-5)	2 SNF: $100 per day (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: $35	12 Renal Dialysis: 10%	"3 CORF: $35, 5 Partial Hosp: $35, 9C OP Substance Abuse: $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: $0, 14J Nutrition Therapy: $0"	"7B Chiropractic: $35, 7D Physician Specialist (excl. Radiology): $35, 7F Podiatry: $35"	"7E Mental Health: $35, 7H Psychiatric: $35"	"7C Occupational Therapy: $35, 7I Physical and Speech Therapy: $35"	7D Physician Specialist (Radiology): $35	"7G Other Health Care: $35, 18A Medicare Covered Hearing Exams: $35"	15 Part B Drugs: 10%	"13A Blood: 10%, 16B Medicare Covered Comprehensive Dental Services: $35, 17A Medicare Covered Eye Exams: $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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											337.7368059	461.7679584	47	0	100	0.2	0.2	49.385	0.1	0.1	0.1	35	0.1	35	13.33333333	35	35	35	35	35	0.1	0.1	0	0	0	0	0	0	0	0											245.3712686	335.4819131	34.14626249	0	72.65162232	0.145303245	0.145303245	35.87900368	0.072651622	0.072651622	0.072651622	25.42806781	0.072651622	25.42806781	9.686882976	25.42806781	25.42806781	25.42806781	25.42806781	25.42806781	0.072651622	0.072651622	0	0	0	0	0	0	0	0											5.742	0.096741198	4.048682634	0	1.03406258	1.610096284	0.295783091	1.182215028	2.968356677	0.315120293	0.638607826	0	0.003035394	6.014946432	3.831393693	18.89502918	0.231074713	0.116306436	1.425904769	3.329984818	2.977726097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.7571	0	20.6123	5.742	0.096741198	4.048682634	0	1.03406258	1.610096284	0.295783091	1.182215028	2.968356677	0.315120293	0.638607826	0	0.003035394	6.014946432	3.831393693	18.89502918	0.231074713	0.116306436	1.425904769	3.329984818	2.977726097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.7571	0	PBP: 1A IP Acute: $180 per day (days 1-5)	1B IP Psych: $180 per day (days 1-5)	2 SNF: $115 per day (days 21-100)	6 Home Health: $20	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: 15%	8A OP C/D/T: 15%	8B OP X-Ray: 15%	9A OP Hospital: 15%	12 Renal Dialysis: 10%	"3 CORF: 15%, 5 Partial Hosp: 15%, 9C OP Substance Abuse: 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: $0, 14J Nutrition Therapy: $0"	"7B Chiropractic: 15%, 7D Physician Specialist (excl. Radiology): 15%, 7F Podiatry: 15%"	"7E Mental Health: 15%, 7H Psychiatric: 15%"	"7C Occupational Therapy: 15%, 7I Physical and Speech Therapy: 15%"	7D Physician Specialist (Radiology): 15%	"7G Other Health Care: 15%, 18A Medicare Covered Hearing Exams: 15%"	15 Part B Drugs: 15%	"13A Blood: 15%, 16B Medicare Covered Comprehensive Dental Services: 15%, 17A Medicare Covered Eye Exams: 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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0.9544	0.0161	0.9505	0.1271	0.717	0.42	0.0183	0.1294	0.211	0.0299	0.0696	0	0.0001	0.4597	0.167	1.4858	0.0549	0.0283	0.1033	0.2046	0.4306	0	0	0	0	0	0	0	0.0008	0											6.5783	200	1.014735963	6.6964	0.112807013	4.999134273	0.12710109	1.751038433	2.030128688	0.314072442	1.31158048	3.179355063	0.34499688	0.708228074	0	0.003096364	6.474628887	3.998400092	20.38080252	0.285991132	0.144590516	1.529242743	3.534600357	3.408292187	0	0	0	0	0	0	0	0.000809948	0	0	0	0	0	0	0	0	0	0	0	61.3353
H1417_007_0	2009	8																					4000											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	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	243.317694	2.99230352	1210.888924	231.6504537	146.4062822	9.646111073	1.772040953	343.4345603	310.2453154	499.096121	253.757353	0	0.430598038	2453.791899	3925.808662	7551.982488	91.02889512	44.58256582	574.3155231	1339.819142	1755.995779	0	0	0	0	0	0	0	110.5719456	0											PBP: 1A IP Acute: $200 per day (days 1-5)	1B IP Psych: $200 per day (days 1-5)	2 SNF: $200 per day (days 23-100)	6 Home Health: $30	10A Ambulance: $200	11A DME: 25%	"11B Prosthetic Medical Supplies: 25%, 11C Diabetes Monitoring Supplies: 25%"	"4A ER: $50, 4B Urgent Care: $45"	9B ASC Services: $200	8A OP C/D/T: $45	8B OP X-Ray: $45	9A OP Hospital: $45	12 Renal Dialysis: $45	"3 CORF: $45, 5 Partial Hosp: $45, 9C OP Substance Abuse: $45, 9D Cardiac Rehab: $45"	"7A PCP: $35, 14B Immunizations: $0, 14C Routine Physical Exams: $35, 14D Pap Smears: $0, 14D Pelvic Exams: $45, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $0"	"7B Chiropractic: $45, 7D Physician Specialist (excl. Radiology): $45, 7F Podiatry: $45"	"7E Mental Health: $45, 7H Psychiatric: $45"	"7C Occupational Therapy: $45, 7I Physical and Speech Therapy: $45"	7D Physician Specialist (Radiology): $45	"7G Other Health Care: $45, 18A Medicare Covered Hearing Exams: $45"	15 Part B Drugs: $45	"13A Blood: $45, 16B Medicare Covered Comprehensive Dental Services: $45, 17A Medicare Covered Eye Exams: $45"	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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											540.3788894	738.8287334	92	30	200	0.25	0.25	49.795	200	45	45	45	45	45	23.33333333	45	45	45	45	45	45	45	0	0	0	0	0	0	0	0											352.8954871	482.4935446	60.08077934	19.59155848	130.6103899	0.163262987	0.163262987	32.51872182	130.6103899	29.38733772	29.38733772	29.38733772	29.38733772	29.38733772	15.23787882	29.38733772	29.38733772	29.38733772	29.38733772	29.38733772	29.38733772	29.38733772	0	0	0	0	0	0	0	0											7.1555	0.120313928	6.062595855	0.378199451	1.593515134	1.57485291	0.2893087	0.930671077	3.3767718	1.222258855	0.621437753	0	0.001054511	6.009200935	4.985083054	18.49438832	0.22292474	0.109180243	1.40646702	3.281143134	4.30033675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.1352	0	33.0107	7.1555	0.120313928	6.062595855	0.378199451	1.593515134	1.57485291	0.2893087	0.930671077	3.3767718	1.222258855	0.621437753	0	0.001054511	6.009200935	4.985083054	18.49438832	0.22292474	0.109180243	1.40646702	3.281143134	4.30033675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.1352	0	PBP: 1A IP Acute: $400 per day (days 1-5)	1B IP Psych: $400 per day (days 1-5)	2 SNF: $400 per day (days 21-100)	6 Home Health: $60	10A Ambulance: $200	11A DME: 30%	"11B Prosthetic Medical Supplies: 30%, 11C Diabetes Monitoring Supplies: 30%"	"4A ER: $50, 4B Urgent Care: $45"	9B ASC Services: $400	8A OP C/D/T: $60	8B OP X-Ray: $60	9A OP Hospital: $60	12 Renal Dialysis: $45	"3 CORF: $60, 5 Partial Hosp: $60, 9C OP Substance Abuse: $60, 9D Cardiac Rehab: $60"	"7A PCP: $60, 14B Immunizations: $0, 14C Routine Physical Exams: $60, 14D Pap Smears: $0, 14D Pelvic Exams: $60, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $0"	"7B Chiropractic: $60, 7D Physician Specialist (excl. Radiology): $60, 7F Podiatry: $60"	"7E Mental Health: $60, 7H Psychiatric: $60"	"7C Occupational Therapy: $60, 7I Physical and Speech Therapy: $60"	7D Physician Specialist (Radiology): $60	"7G Other Health Care: $60, 18A Medicare Covered Hearing Exams: $60"	15 Part B Drugs: $60	"13A Blood: $60, 16B Medicare Covered Comprehensive Dental Services: $60, 17A Medicare Covered Eye Exams: $60"	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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											2.1915	0.0372	3.3022	0.3674	1.2759	0.6546	0.0291	0.1798	0.4105	0.1103	0.0877	0	0.0001	1.3935	0.659	5.3815	0.2333	0.2046	0.2669	0.6553	0.6944	0	0	0	0	0	0	0	0.0018	0											18.1368	500	0	9.347	0.157536135	9.364746639	0.74561804	2.869438038	2.229474044	0.31845376	1.110454217	3.787272595	1.332525895	0.709138565	0	0.001195228	7.402746655	5.644090925	23.87588531	0.456216335	0.313789226	1.673410911	3.936410329	4.994719658	0	0	0	0	0	0	0	0.001815323	0	0	0	0	0	0	0	0	0	0	0	80.2719
H1417_008_0	2009	10																					4000											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	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	279.510398	3.437398794	1391.004656	266.1076943	168.1837336	11.08093826	2.035626197	394.5193179	356.3932823	573.3350221	291.5029219	0	0.494648075	2818.785346	4509.759745	8675.314962	104.5691429	51.21407537	659.743062	1539.112818	2017.194357	0	0	0	0	0	0	0	127.0191577	0											PBP: 1A IP Acute: $200 per day (days 1-5)	1B IP Psych: $200 per day (days 1-5)	2 SNF: $200 per day (days 23-100)	6 Home Health: $30	10A Ambulance: $200	11A DME: 25%	"11B Prosthetic Medical Supplies: 25%, 11C Diabetes Monitoring Supplies: 25%"	"4A ER: $50, 4B Urgent Care: $45"	9B ASC Services: $200	8A OP C/D/T: $45	8B OP X-Ray: $45	9A OP Hospital: $45	12 Renal Dialysis: $45	"3 CORF: $45, 5 Partial Hosp: $45, 9C OP Substance Abuse: $45, 9D Cardiac Rehab: $45"	"7A PCP: $35, 14B Immunizations: $0, 14C Routine Physical Exams: $35, 14D Pap Smears: $0, 14D Pelvic Exams: $45, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $0"	"7B Chiropractic: $45, 7D Physician Specialist (excl. Radiology): $45, 7F Podiatry: $45"	"7E Mental Health: $45, 7H Psychiatric: $45"	"7C Occupational Therapy: $45, 7I Physical and Speech Therapy: $45"	7D Physician Specialist (Radiology): $45	"7G Other Health Care: $45, 18A Medicare Covered Hearing Exams: $45"	15 Part B Drugs: $45	"13A Blood: $45, 16B Medicare Covered Comprehensive Dental Services: $45, 17A Medicare Covered Eye Exams: $45"	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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											540.3788894	738.8287334	92	30	200	0.25	0.25	49.795	200	45	45	45	45	45	23.33333333	45	45	45	45	45	45	45	0	0	0	0	0	0	0	0											342.0669527	467.6883171	58.23721146	18.99039504	126.6026336	0.158253292	0.158253292	31.5208907	126.6026336	28.48559256	28.48559256	28.48559256	28.48559256	28.48559256	14.77030725	28.48559256	28.48559256	28.48559256	28.48559256	28.48559256	28.48559256	28.48559256	0	0	0	0	0	0	0	0											7.9676	0.133969271	6.750686023	0.421124187	1.7743753	1.753594959	0.322144547	1.036300025	3.760027344	1.36098232	0.691969455	0	0.001174195	6.691230908	5.55087809	20.59345728	0.248226167	0.12157194	1.566097672	3.653545053	4.788414714	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1874	0	40.1111	7.9676	0.133969271	6.750686023	0.421124187	1.7743753	1.753594959	0.322144547	1.036300025	3.760027344	1.36098232	0.691969455	0	0.001174195	6.691230908	5.55087809	20.59345728	0.248226167	0.12157194	1.566097672	3.653545053	4.788414714	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1874	0	PBP: 1A IP Acute: $400 per day (days 1-5)	1B IP Psych: $400 per day (days 1-5)	2 SNF: $400 per day (days 21-100)	6 Home Health: $60	10A Ambulance: $200	11A DME: 30%	"11B Prosthetic Medical Supplies: 30%, 11C Diabetes Monitoring Supplies: 30%"	"4A ER: $50, 4B Urgent Care: $45"	9B ASC Services: $400	8A OP C/D/T: $60	8B OP X-Ray: $60	9A OP Hospital: $60	12 Renal Dialysis: $45	"3 CORF: $60, 5 Partial Hosp: $60, 9C OP Substance Abuse: $60, 9D Cardiac Rehab: $60"	"7A PCP: $60, 14B Immunizations: $0, 14C Routine Physical Exams: $60, 14D Pap Smears: $0, 14D Pelvic Exams: $60, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $0"	"7B Chiropractic: $60, 7D Physician Specialist (excl. Radiology): $60, 7F Podiatry: $60"	"7E Mental Health: $60, 7H Psychiatric: $60"	"7C Occupational Therapy: $60, 7I Physical and Speech Therapy: $60"	7D Physician Specialist (Radiology): $60	"7G Other Health Care: $60, 18A Medicare Covered Hearing Exams: $60"	15 Part B Drugs: $60	"13A Blood: $60, 16B Medicare Covered Comprehensive Dental Services: $60, 17A Medicare Covered Eye Exams: $60"	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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											2.4734	0.0427	3.8134	0.4249	1.4762	0.7498	0.0331	0.2018	0.4647	0.1266	0.0992	0	0.0002	1.6072	0.7559	6.217	0.2701	0.2371	0.2991	0.742	0.7933	0	0	0	0	0	0	0	0.002	0											20.8297	500	0	10.441	0.17668952	10.56404496	0.846036064	3.250593705	2.503391506	0.3552776	1.238118151	4.224726818	1.487590646	0.791159314	0	0.001325817	8.298420603	6.30677019	26.81044444	0.51835501	0.358640911	1.865202211	4.395562048	5.58171133	0	0	0	0	0	0	0	0.001955998	0	0	0	0	0	0	0	0	0	0	0	90.017
H1417_009_0	2009	10																					4000											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	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	279.510398	3.437398794	1391.004656	266.1076943	168.1837336	11.08093826	2.035626197	394.5193179	356.3932823	573.3350221	291.5029219	0	0.494648075	2818.785346	4509.759745	8675.314962	104.5691429	51.21407537	659.743062	1539.112818	2017.194357	0	0	0	0	0	0	0	127.0191577	0											PBP: 1A IP Acute: $200 per day (days 1-5)	1B IP Psych: $200 per day (days 1-5)	2 SNF: $200 per day (days 23-100)	6 Home Health: $30	10A Ambulance: $200	11A DME: 25%	"11B Prosthetic Medical Supplies: 25%, 11C Diabetes Monitoring Supplies: 25%"	"4A ER: $50, 4B Urgent Care: $45"	9B ASC Services: $200	8A OP C/D/T: $45	8B OP X-Ray: $45	9A OP Hospital: $45	12 Renal Dialysis: $45	"3 CORF: $45, 5 Partial Hosp: $45, 9C OP Substance Abuse: $45, 9D Cardiac Rehab: $45"	"7A PCP: $35, 14B Immunizations: $0, 14C Routine Physical Exams: $35, 14D Pap Smears: $0, 14D Pelvic Exams: $45, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $0"	"7B Chiropractic: $45, 7D Physician Specialist (excl. Radiology): $45, 7F Podiatry: $45"	"7E Mental Health: $45, 7H Psychiatric: $45"	"7C Occupational Therapy: $45, 7I Physical and Speech Therapy: $45"	7D Physician Specialist (Radiology): $45	"7G Other Health Care: $45, 18A Medicare Covered Hearing Exams: $45"	15 Part B Drugs: $45	"13A Blood: $45, 16B Medicare Covered Comprehensive Dental Services: $45, 17A Medicare Covered Eye Exams: $45"	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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											540.3788894	738.8287334	92	30	200	0.25	0.25	49.795	200	45	45	45	45	45	23.33333333	45	45	45	45	45	45	45	0	0	0	0	0	0	0	0											342.0669527	467.6883171	58.23721146	18.99039504	126.6026336	0.158253292	0.158253292	31.5208907	126.6026336	28.48559256	28.48559256	28.48559256	28.48559256	28.48559256	14.77030725	28.48559256	28.48559256	28.48559256	28.48559256	28.48559256	28.48559256	28.48559256	0	0	0	0	0	0	0	0											7.9676	0.133969271	6.750686023	0.421124187	1.7743753	1.753594959	0.322144547	1.036300025	3.760027344	1.36098232	0.691969455	0	0.001174195	6.691230908	5.55087809	20.59345728	0.248226167	0.12157194	1.566097672	3.653545053	4.788414714	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1874	0	40.1111	7.9676	0.133969271	6.750686023	0.421124187	1.7743753	1.753594959	0.322144547	1.036300025	3.760027344	1.36098232	0.691969455	0	0.001174195	6.691230908	5.55087809	20.59345728	0.248226167	0.12157194	1.566097672	3.653545053	4.788414714	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1874	0	PBP: 1A IP Acute: $400 per day (days 1-5)	1B IP Psych: $400 per day (days 1-5)	2 SNF: $400 per day (days 21-100)	6 Home Health: $60	10A Ambulance: $200	11A DME: 30%	"11B Prosthetic Medical Supplies: 30%, 11C Diabetes Monitoring Supplies: 30%"	"4A ER: $50, 4B Urgent Care: $45"	9B ASC Services: $400	8A OP C/D/T: $60	8B OP X-Ray: $60	9A OP Hospital: $60	12 Renal Dialysis: $45	"3 CORF: $60, 5 Partial Hosp: $60, 9C OP Substance Abuse: $60, 9D Cardiac Rehab: $60"	"7A PCP: $60, 14B Immunizations: $0, 14C Routine Physical Exams: $60, 14D Pap Smears: $0, 14D Pelvic Exams: $60, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $0"	"7B Chiropractic: $60, 7D Physician Specialist (excl. Radiology): $60, 7F Podiatry: $60"	"7E Mental Health: $60, 7H Psychiatric: $60"	"7C Occupational Therapy: $60, 7I Physical and Speech Therapy: $60"	7D Physician Specialist (Radiology): $60	"7G Other Health Care: $60, 18A Medicare Covered Hearing Exams: $60"	15 Part B Drugs: $60	"13A Blood: $60, 16B Medicare Covered Comprehensive Dental Services: $60, 17A Medicare Covered Eye Exams: $60"	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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											2.4734	0.0427	3.8134	0.4249	1.4762	0.7498	0.0331	0.2018	0.4647	0.1266	0.0992	0	0.0002	1.6072	0.7559	6.217	0.2701	0.2371	0.2991	0.742	0.7933	0	0	0	0	0	0	0	0.002	0											20.8297	500	0	10.441	0.17668952	10.56404496	0.846036064	3.250593705	2.503391506	0.3552776	1.238118151	4.224726818	1.487590646	0.791159314	0	0.001325817	8.298420603	6.30677019	26.81044444	0.51835501	0.358640911	1.865202211	4.395562048	5.58171133	0	0	0	0	0	0	0	0.001955998	0	0	0	0	0	0	0	0	0	0	0	90.017
H1417_801_0	2009	9																					0											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	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	207.0011488	1.294756182	41.72959987	2.587579099	5.945099139	10.11276492	1.802797596	19.87795136	36.48294517	3.775780843	7.651818197	0	0.038310867	24.24275689	26.25756891	63.31091998	0.647388311	0.181278377	33.10689366	56.01444373	36.11028715	0	0	0	0	0	0	0	0	0											Medicare FFS Cost Sharing 8.3%	Medicare FFS Cost Sharing 8.3%	Medicare FFS Cost Sharing 19.5%	Medicare FFS Cost Sharing 0.0%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.083370581	0.083370581	0.195474225	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.083370581	0.083370581	0.195474225	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											17.2578	0.107944575	8.15706118	0	1.373317901	2.336048696	0.416446245	4.591806765	8.427560333	0.872205375	1.767570003	0	0.00884981	5.600076843	6.065498417	14.62482252	0.1495467	0.041875305	7.647692435	12.9393365	8.341476331	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.7269	0	0	17.2578	0.107944575	8.15706118	0	1.373317901	2.336048696	0.416446245	4.591806765	8.427560333	0.872205375	1.767570003	0	0.00884981	5.600076843	6.065498417	14.62482252	0.1495467	0.041875305	7.647692435	12.9393365	8.341476331	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.7269	0	Medicare FFS Cost Sharing 8.3%	Medicare FFS Cost Sharing 8.3%	Medicare FFS Cost Sharing 19.5%	Medicare FFS Cost Sharing 0.0%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											1.0971	0.0096	1.5407	0	0.8011	0.5035	0.019	0.3664	0.256	0.0382	0.0918	0	0	0.6768	0.298	2.2746	0.0865	0.0438	0.4289	0.9751	0.6014	0	0	0	0	0	0	0	0	0											10.1086	0	0	18.3549	0.117512494	9.697772412	0	2.174407079	2.839597846	0.435459869	4.958222838	8.683607374	0.910448127	1.859322091	0	0.00884981	6.276883632	6.363532376	16.89943965	0.2360485	0.085651143	8.076565761	13.91442075	8.942865712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.8355
H1417_802_0	2009	9																					0											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	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	237.7918866	1.487346892	47.93674015	2.972472951	6.829413018	11.61700533	2.070957789	22.83473104	41.90966287	4.337415784	8.790000904	0	0.044009482	27.84878698	30.16329563	72.72821041	0.743685186	0.208242937	38.03143484	64.34640739	41.4815732	0	0	0	0	0	0	0	0	0											Medicare FFS Cost Sharing 8.3%	Medicare FFS Cost Sharing 8.3%	Medicare FFS Cost Sharing 19.5%	Medicare FFS Cost Sharing 0.0%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.083370581	0.083370581	0.195474225	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.083370581	0.083370581	0.195474225	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											19.8248	0.124000974	9.370397113	0	1.577594407	2.68352823	0.478391249	5.274822869	9.681132123	1.001943046	2.030490209	0	0.01016619	6.433069793	6.967721292	16.80021661	0.171791278	0.048104118	8.785261449	14.86402011	9.582243409	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.7097	0	0	19.8248	0.124000974	9.370397113	0	1.577594407	2.68352823	0.478391249	5.274822869	9.681132123	1.001943046	2.030490209	0	0.01016619	6.433069793	6.967721292	16.80021661	0.171791278	0.048104118	8.785261449	14.86402011	9.582243409	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.7097	0	Medicare FFS Cost Sharing 8.3%	Medicare FFS Cost Sharing 8.3%	Medicare FFS Cost Sharing 19.5%	Medicare FFS Cost Sharing 0.0%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											1.2603	0.011	1.7699	0	0.9202	0.5785	0.0218	0.4209	0.2941	0.0439	0.1054	0	0	0.7775	0.3424	2.613	0.0994	0.0503	0.4927	1.1201	0.6908	0	0	0	0	0	0	0	0	0											11.6122	0	0	21.0852	0.13499209	11.14028406	0	2.497842956	3.261978655	0.500233087	5.695742124	9.975265317	1.045874282	2.135890116	0	0.01016619	7.21054936	7.310086818	19.41317553	0.271159936	0.098391468	9.277928266	15.98414492	10.27308748	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.322
H1417_809_0	2009	9																					0											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	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	243.0786233	1.520414511	50.18356059	3.112621578	7.046365691	11.98604734	2.136746727	23.97407456	44.00075398	4.553832022	9.228579777	0	0.046205344	29.23830785	31.12150501	75.03859632	0.767310128	0.214858273	39.23959452	66.39052524	43.55130469	0	0	0	0	0	0	0	0	0											Medicare FFS Cost Sharing 8.3%	Medicare FFS Cost Sharing 8.3%	Medicare FFS Cost Sharing 19.5%	Medicare FFS Cost Sharing 0.0%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.083370581	0.083370581	0.195474225	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.083370581	0.083370581	0.195474225	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.2656	0.126757841	9.809592596	0	1.627710475	2.768776936	0.493588494	5.538011223	10.16417417	1.051935197	2.131801928	0	0.010673435	6.754049112	7.189067658	17.33391575	0.17724864	0.049632261	9.064346334	15.33621133	10.06035138	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.9535	0	0	20.2656	0.126757841	9.809592596	0	1.627710475	2.768776936	0.493588494	5.538011223	10.16417417	1.051935197	2.131801928	0	0.010673435	6.754049112	7.189067658	17.33391575	0.17724864	0.049632261	9.064346334	15.33621133	10.06035138	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.9535	0	Medicare FFS Cost Sharing 8.3%	Medicare FFS Cost Sharing 8.3%	Medicare FFS Cost Sharing 19.5%	Medicare FFS Cost Sharing 0.0%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											1.2883	0.0112	1.8528	0	0.9495	0.5968	0.0225	0.4419	0.3088	0.0461	0.1107	0	0	0.8163	0.3532	2.696	0.1025	0.0519	0.5083	1.1557	0.7253	0	0	0	0	0	0	0	0	0											12.038	0	0	21.5539	0.137993318	11.66243508	0	2.577192925	3.365603225	0.51612419	5.97993233	10.4729832	1.098058391	2.242460786	0	0.010673435	7.570321179	7.542309246	20.02988158	0.279773981	0.101517109	9.572663894	16.49191959	10.78566525	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.9915
H1418_002_0	2009	3	r.	s.	t.	u.	v.	w.	x.				Professional	Professional	OP Facility - Other	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered				5000	Mental Health (MH)	Therapy (PT/OT/ST)	Renal Dialysis								A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin	V				O	O	V	V	P	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		280.608623	9.041161	545.151175	779.144877	154.972645	11.213346	4.049508	350.536596	379.970276	671.778423	997.063672	0	0	762.745344	3732.887094	4499.716885	4.791178	209.255468			25.344096			3.78	0.35				0.05	0.27	25.905444	760.652812	20.764458	1.23	2.06	0.06	2.7				$650/Admit:1a	$650/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $50 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	12. 20% Coins	"$35-$50/Visit:9d. $50 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $35 Partial Hospitalization,8b. $50 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35/Visit:7e, 7h"	"$50/Visit:7d, 9a"			20% Coins:15			"DEN 767 16a, 16b"	VIS 738				$0 Additional Smoking Cessation 14a	$0: Nutritional benefit 14a	"$50/Visit:7e, 7h"	"$35/Visit:7d, 9a"	12. $0/proc	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0: Nurse hotline 14a	$0 Corp Health 14a				650.00001	650.000591	43.132791	0	100.000022	0.199999	0.199999	49.999994	127.31319	43.978697	48.236967	0	0.2	44.607532	9.999999	34.999999	34.999325	50.000012			0.2			0	0				0	0	49.999837	35.000004	0	0	0	0	0				581.629109	581.629629	38.595825	0	89.48142	0.178962	0.178962	44.740695	113.921624	39.352754	43.163113	0	0.178962	39.915444	8.948139	31.318489	31.317886	44.740711			0.178962			0	0				0	0	44.740554	31.318494	0	0	0	0	0				13.6008	0.43821726	1.753379946	0	1.155597695	2.006762827	0.724708051	1.306937577	3.607235909	2.203027585	3.586364329	0	0	2.537109922	2.783532716	11.74369448	0.012504131	0.780186535	0	0	4.535630108	0	0	0	0	0	0	0	0	0	0.096585326	1.985208377	0	0	0	0	0	0	0	0	54.8575	0	6.4487	13.6008	0.43821726	1.753379946	0	1.155597695	2.006762827	0.724708051	1.306937577	3.607235909	2.203027585	3.586364329	0	0	2.537109922	2.783532716	11.74369448	0.012504131	0.780186535	0	0	4.535630108	0	0	0	0	0	0	0	0	0	0.096585326	1.985208377	0	0	0	0	0	0	0	0	54.8575	10000	$1200/Admit	$1200/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		20% Coins	30% Coins	$40/Visit	$40/Visit	$40/Visit	30% Coins			30% Coins			"DEN 767 16a, 16b"	VIS 738				0	0	30% Coins	$40/Visit	0	0	0	0					2.7899	0.0899	0.4566	0.6928	0.7704	1.9084	0.6892	0.2306	3.298	0.4249	1.7672		0.0002	0.9982	1.9648	2.3685	0.0025	0.0957			1.3639			0	0				0	0	0.0276	0.4004	0	0	0	0					20.3397	0	2.390943416	16.3908	0.52810726	2.210020946	0.692772	1.925995695	3.915163827	1.413895051	1.537573577	6.905221909	2.627884585	5.353571329	0	0.000214	3.535291922	4.748379716	14.11217048	0.015026131	0.875851535	0	0	5.899552108	0	0	0	0	0	0	0	0	0	0.124169326	2.385586377	0	0	0	0	0	0	0	0	75.1972
H1418_007_0	2009	3	r.	s.	t.	u.	v.	w.					Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered						Mental Health (MH)	Therapy (PT/OT/ST)									A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin	V				O	O	P	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	0	0	0				0		242.931667	7.827216	471.954572	674.530009	134.164648	8.482471	3.0633	303.470368	328.952086	581.57938	863.188931	0	0	660.332325	3231.859335	3895.720805	4.147874	181.158928			19.171824			3.25	0.35				0.05	0.09	17.695152	22.427154	658.520854	1.23	2.06	0.06	2.7				$650/Admit:1a	$650/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$95/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $95 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $50 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$30-$50/Visit:9d. $50 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $30 Partial Hospitalization,8b. $50 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30/Visit:7e, 7h"	"$50/Visit:7d, 9a"			20% Coins:15			"DEN 767 16a, 16b"	VIS 738				$0 Additional Smoking Cessation 14a	$0: Nutritional benefit 14a	$0/Proc:12	"$50/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0: Nurse hotline 14a	$0 Corp Health 14a				650.000018	649.999693	43.132812	0	100.000023	0.199999	0.2	50.000005	85.925255	43.978691	47.649313	0	0	42.810044	9.999999	29.999999	30.000911	50.000008			0.2			0	0				0	0	0	49.999745	29.999997	0	0	0	0				650.000018	649.999693	43.132812	0	100.000023	0.199999	0.2	50.000005	85.925255	43.978691	47.649313	0	0	42.810044	9.999999	29.999999	30.000911	50.000008			0.2			0	0				0	0	0	49.999745	29.999997	0	0	0	0				13.1588	0.423974	1.696393986	0	1.11803899	1.696485718	0.61266	1.264459993	2.355440989	2.131424987	3.427529963	0	0	2.355737991	2.693215843	9.739301688	0.01037	0.754828987	0	0	3.8343648	0	0	0	0	0	0	0	0	0	0	0.093445998	1.64630197	0	0	0	0	0	0	0	49.0128	0	0	13.1588	0.423974	1.696393986	0	1.11803899	1.696485718	0.61266	1.264459993	2.355440989	2.131424987	3.427529963	0	0	2.355737991	2.693215843	9.739301688	0.01037	0.754828987	0	0	3.8343648	0	0	0	0	0	0	0	0	0	0	0.093445998	1.64630197	0	0	0	0	0	0	0	49.0128		30% Coins	30% Coins	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins			30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			"DEN 767 16a, 16b"	VIS 738				0	0		30% Coins	$35/Visit	0	0	0	0				7.0026	0.1002	0.439	0.6659	0.8475	1.8345	0.6625	0.2537	3.1703	0.4084	1.6988			0.9595	1.8915	2.28	0.0024	0.092			1.3111			0	0				0	0		0.0265	0.3854	0	0	0	0				24.032	500	0	20.1614	0.524187	2.135353986	0.665949	1.96558199	3.530995718	1.275162	1.518190993	5.525726989	2.539830987	5.126310963	0	0	3.315270991	4.584720843	12.01934369	0.012798	0.846788987	0	0	5.1454748	0	0	0	0	0	0	0	0	0	0	0.119962998	2.03171397	0	0	0	0	0	0	0	73.0448
H1418_801_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		280.608623	9.041161	545.151175	779.144877	5.681664	11.213346	4.049508	24.930612	64.084409	671.778423	34.65157	0	0.437255	19.740883	37.18916	84.907207	0.536589	7.169369			25.344096																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999993	1023.999462	43.132791	0	0.2	0.199999	0.199999	0.199999	0.2	0	0.2	0	0.2	0.199999	0.2	0.2	0.5	0.2			0.2																				1023.999993	1023.999462	43.132791	0	0.2	0.199999	0.199999	0.199999	0.2	0	0.2	0	0.2	0.199999	0.2	0.2	0.5	0.2			0.2																				23.9453	0.771512	1.959490975	0	1.1363328	2.242657987	0.80989755	4.986097469	12.8168818	0	6.930314	0	0.087451	3.948156859	7.437832	16.9814414	0.2682945	1.4338738	0	0	5.0688192	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.8243	0	0	23.9453	0.771512	1.959490975	0	1.1363328	2.242657987	0.80989755	4.986097469	12.8168818	0	6.930314	0	0.087451	3.948156859	7.437832	16.9814414	0.2682945	1.4338738	0	0	5.0688192	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.8243		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.6606	0.0857	0.2177		0.7204	1.4218	0.5135	0.9392	2.4571		1.3166		0.0165	0.7437	1.4911	3.4043	0.0538	0.2875			1.0162																				17.3457	0	0	26.6059	0.857236	2.177211975	0	1.8567528	3.664480987	1.32336455	5.925283469	15.2739918	0	8.246941	0	0.103923	4.691835859	8.928925	20.3857824	0.3220815	1.7213278	0	0	6.0849872	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.17
H1418_802_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		280.608623	9.041161	545.151175	779.144877	5.681664	11.213346	4.049508	24.930612	64.084409	671.778423	34.65157	0	0.437255	19.740883	37.18916	84.907207	0.536589	7.169369			25.344096																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999993	1023.999462	43.132791	0	0.2	0.199999	0.199999	0.199999	0.2	0	0.2	0	0.2	0.199999	0.2	0.2	0.5	0.2			0.2																				1023.999993	1023.999462	43.132791	0	0.2	0.199999	0.199999	0.199999	0.2	0	0.2	0	0.2	0.199999	0.2	0.2	0.5	0.2			0.2																				23.9453	0.771512	1.959490975	0	1.1363328	2.242657987	0.80989755	4.986097469	12.8168818	0	6.930314	0	0.087451	3.948156859	7.437832	16.9814414	0.2682945	1.4338738	0	0	5.0688192	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.8243	0	0	23.9453	0.771512	1.959490975	0	1.1363328	2.242657987	0.80989755	4.986097469	12.8168818	0	6.930314	0	0.087451	3.948156859	7.437832	16.9814414	0.2682945	1.4338738	0	0	5.0688192	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.8243		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.6606	0.0857	0.2177		0.7204	1.4218	0.5135	0.9392	2.4571		1.3166		0.0165	0.7437	1.4911	3.4043	0.0538	0.2875			1.0162																				17.3457	0	0	26.6059	0.857236	2.177211975	0	1.8567528	3.664480987	1.32336455	5.925283469	15.2739918	0	8.246941	0	0.103923	4.691835859	8.928925	20.3857824	0.3220815	1.7213278	0	0	6.0849872	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.17
H1418_803_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		280.608623	9.041161	545.151175	779.144877	5.681664	11.213346	4.049508	24.930612	64.084409	671.778423	34.65157	0	0.437255	19.740883	37.18916	84.907207	0.536589	7.169369			25.344096																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999993	1023.999462	43.132791	0	0.2	0.199999	0.199999	0.199999	0.2	0	0.2	0	0.2	0.199999	0.2	0.2	0.5	0.2			0.2																				1023.999993	1023.999462	43.132791	0	0.2	0.199999	0.199999	0.199999	0.2	0	0.2	0	0.2	0.199999	0.2	0.2	0.5	0.2			0.2																				23.9453	0.771512	1.959490975	0	1.1363328	2.242657987	0.80989755	4.986097469	12.8168818	0	6.930314	0	0.087451	3.948156859	7.437832	16.9814414	0.2682945	1.4338738	0	0	5.0688192	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.8243	0	0	23.9453	0.771512	1.959490975	0	1.1363328	2.242657987	0.80989755	4.986097469	12.8168818	0	6.930314	0	0.087451	3.948156859	7.437832	16.9814414	0.2682945	1.4338738	0	0	5.0688192	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.8243		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.6606	0.0857	0.2177		0.7204	1.4218	0.5135	0.9392	2.4571		1.3166		0.0165	0.7437	1.4911	3.4043	0.0538	0.2875			1.0162																				17.3457	0	0	26.6059	0.857236	2.177211975	0	1.8567528	3.664480987	1.32336455	5.925283469	15.2739918	0	8.246941	0	0.103923	4.691835859	8.928925	20.3857824	0.3220815	1.7213278	0	0	6.0849872	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.17
H1418_804_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		280.608623	9.041161	545.151175	779.144877	5.681664	11.213346	4.049508	24.930612	64.084409	671.778423	34.65157	0	0.437255	19.740883	37.18916	84.907207	0.536589	7.169369			25.344096																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999993	1023.999462	43.132791	0	0.2	0.199999	0.199999	0.199999	0.2	0	0.2	0	0.2	0.199999	0.2	0.2	0.5	0.2			0.2																				1023.999993	1023.999462	43.132791	0	0.2	0.199999	0.199999	0.199999	0.2	0	0.2	0	0.2	0.199999	0.2	0.2	0.5	0.2			0.2																				23.9453	0.771512	1.959490975	0	1.1363328	2.242657987	0.80989755	4.986097469	12.8168818	0	6.930314	0	0.087451	3.948156859	7.437832	16.9814414	0.2682945	1.4338738	0	0	5.0688192	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.8243	0	0	23.9453	0.771512	1.959490975	0	1.1363328	2.242657987	0.80989755	4.986097469	12.8168818	0	6.930314	0	0.087451	3.948156859	7.437832	16.9814414	0.2682945	1.4338738	0	0	5.0688192	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.8243		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.6606	0.0857	0.2177		0.7204	1.4218	0.5135	0.9392	2.4571		1.3166		0.0165	0.7437	1.4911	3.4043	0.0538	0.2875			1.0162																				17.3457	0	0	26.6059	0.857236	2.177211975	0	1.8567528	3.664480987	1.32336455	5.925283469	15.2739918	0	8.246941	0	0.103923	4.691835859	8.928925	20.3857824	0.3220815	1.7213278	0	0	6.0849872	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.17
H1419_001_0	2009	5																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		2269.226532	0	955.8099129	716.6379794	255.1813782	12.19365174	0	369.6182643	210.6404537	1672.147583	2717.707937	0	0	286.7460325	5938.584843	4822.359988	0	475.0361194	0	0	268.0269672	0	0	0	221.6416044	0	7.53883008	0	0	0											$750 per stay	$750 per stay	"$0/d 1-10, $75/d 11-100"	$20 per visit	$150 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$200 per procedure	$40 per visit	$40 X-ray; $175 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	15 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											126.8076968	126.8076968	47.56	20	150	0.2	0.2	47.5	200	40	67	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											104.7952411	104.7952411	39.30409427	20	150	0.165282146	0.165282146	39.25450963	165.2821458	33.05642916	55.36951885	24.79232187	0	24.79232187	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											19.817	0	3.130603577	1.194396632	3.189767227	2.015392925	0	1.209098643	2.901258849	4.60626901	12.5398484	0	0	0.592424994	7.423231054	12.05589997	0	1.187590299	0	0	1.005101127	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.8679	0	9.8329	19.817	0	3.130603577	1.194396632	3.189767227	2.015392925	0	1.209098643	2.901258849	4.60626901	12.5398484	0	0	0.592424994	7.423231054	12.05589997	0	1.187590299	0	0	1.005101127	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.8679																																																																																		0			19.817	0	3.130603577	1.194396632	3.189767227	2.015392925	0	1.209098643	2.901258849	4.60626901	12.5398484	0	0	0.592424994	7.423231054	12.05589997	0	1.187590299	0	0	1.005101127	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.8679
H1419_002_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		2286.554329	0	963.1084705	722.1102218	257.1299413	12.28676238	0	372.4406667	212.2489027	1684.91609	2738.460335	0	0	288.9356231	5983.931834	4859.183494	0	478.6634918	0	0	270.0736192	0	0	0	223.334058	0	7.596396532	0	0	0											$350 per stay	$350 per stay	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$25 X-ray; $175 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											59.17692516	59.17692516	47.56	0	100	0.2	0.2	47.5	150	0	55	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											46.32225061	46.32225061	37.22880553	0	100	0.156555112	0.156555112	37.181839	117.4163337	0	43.05265569	0	0	19.56938895	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											8.8265	0	2.987948163	0	2.142749511	1.923555455	0	1.154002409	2.076790665	0	9.824832493	0	0	0.471191133	4.986609861	10.12329895	0	0.997215608	0	0	1.012776072	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.5275	0	7.5661	8.8265	0	2.987948163	0	2.142749511	1.923555455	0	1.154002409	2.076790665	0	9.824832493	0	0	0.471191133	4.986609861	10.12329895	0	0.997215608	0	0	1.012776072	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.5275																																																																																		0			8.8265	0	2.987948163	0	2.142749511	1.923555455	0	1.154002409	2.076790665	0	9.824832493	0	0	0.471191133	4.986609861	10.12329895	0	0.997215608	0	0	1.012776072	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.5275
H1419_003_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		2326.444976	0	979.9106163	734.7079734	261.615765	12.50111411	0	378.938172	215.9517432	1714.310708	2786.234819	0	0	293.9763207	6088.325989	4943.955575	0	487.0141335	0	0	274.785255	0	0	0	227.2302873	0	7.728921337	0	0	0											$0 	$0 	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$15 X-ray; $175 Complex Radiology	$15 per visit	$15 per visit	$15 per visit	0 PCP visit; $15 if no PCP selected	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											0	0	47.56	0	100	0.2	0.2	47.5	150	0	47	15	15	15	0	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											0	0	41.59565079	0	100	0.174918632	0.174918632	41.5431752	131.1889743	0	41.10587862	0	0	13.11889743	0	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											0	0	3.396668317	0	2.180131375	2.186677785	0	1.311857906	2.360873974	0	9.544219189	0	0	0.3213871	0	6.179944469	0	0.608767667	0	0	1.030444706	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.121	0	2.7418	0	0	3.396668317	0	2.180131375	2.186677785	0	1.311857906	2.360873974	0	9.544219189	0	0	0.3213871	0	6.179944469	0	0.608767667	0	0	1.030444706	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.121																																																																																		0			0	0	3.396668317	0	2.180131375	2.186677785	0	1.311857906	2.360873974	0	9.544219189	0	0	0.3213871	0	6.179944469	0	0.608767667	0	0	1.030444706	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.121
H1419_005_0	2009	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		4233.314946	0	1783.094078	1336.911157	476.0490533	22.74764878	0	689.5347382	392.9565288	3119.444998	5069.971405	0	0	534.9339293	11078.62067	8996.267373	0	886.1951312	0	0	500.012912	0	0	3445.51	413.4795284	0	14.06392954	0	0	0											$175/stay	$175/stay	$0/day 1-10;  $75/day 11-100	$0 per visit	$150 per trip	0.2	0.2	$50 Emer Rm; $0 Urgent Care Ctr	$150 per procedure	$0 per visit	$25 X-ray; $150 Complex Radiology	$0 per visit	$0 per visit	$0 per visit	0 PCP visit; $0 if no PCP selected	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$45 per script	0	$0 per Trip/50 One Way Trips	$5 per visit	$0 per visit	$150 Every 2 Years	$0 per visit	$1000 Every 3 Yrs	Fitness/Coaching	0											29.58846258	29.58846258	47.56208437	0	150	0.2	0.2	45	150	0	50	0	0	0	0	0	0	0	0	0	45	0	0	5	0	0	0	0	0	0											29.58846258	29.58846258	47.56208437	0	150	0.2	0.2	45	150	0	50	0	0	0	0	0	0	0	0	0	45	0	0	5	0	0	0	0	0	0											10.4381	0	7.067305913	0	5.950613166	4.549529757	0	2.585755268	4.911956609	0	21.12488085	0	0	0	0	0	0	0	0	0	1.87504842	0	0	1.435629167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.9388	0	0	10.4381	0	7.067305913	0	5.950613166	4.549529757	0	2.585755268	4.911956609	0	21.12488085	0	0	0	0	0	0	0	0	0	1.87504842	0	0	1.435629167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.9388																																																																																		0			10.4381	0	7.067305913	0	5.950613166	4.549529757	0	2.585755268	4.911956609	0	21.12488085	0	0	0	0	0	0	0	0	0	1.87504842	0	0	1.435629167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.9388
H1419_006_0	2009	2																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		2269.516249	0	955.931943	716.729474	255.2139577	12.19520853	0	369.6654542	210.6673466	1672.361069	2718.054912	0	0	286.7826419	5939.343033	4822.975668	0	475.0967682	0	0	268.0611867	0	0	0	221.6699018	0	7.539792577	0	0	0											$350 per stay	$350 per stay	"$0/d 1-10, $75/d 11-100"	$20 per visit	$150 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$200 per procedure	$30 per visit	$30 X-ray; $175 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	10 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											59.17692516	59.17692516	47.56	20	150	0.2	0.2	47.5	200	30	59	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											48.72244536	48.72244536	39.15782199	20	150	0.16466704	0.16466704	39.10842188	164.6670395	24.70005593	48.57677665	24.70005593	0	24.70005593	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											9.2147	0	3.119351072	1.194549123	3.190174471	2.008148884	0	1.204752711	2.89083069	3.442284328	11.0028622	0	0	0.590295608	4.949452528	12.05743917	0	1.18774192	0	0	1.00522945	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.0578	0	7.1824	9.2147	0	3.119351072	1.194549123	3.190174471	2.008148884	0	1.204752711	2.89083069	3.442284328	11.0028622	0	0	0.590295608	4.949452528	12.05743917	0	1.18774192	0	0	1.00522945	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.0578																																																																																		0			9.2147	0	3.119351072	1.194549123	3.190174471	2.008148884	0	1.204752711	2.89083069	3.442284328	11.0028622	0	0	0.590295608	4.949452528	12.05743917	0	1.18774192	0	0	1.00522945	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.0578
H1419_801_0	2009	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																																																			0		337.5612667	0	41.68215088	6.319514015	7.453386529	9.922335272	0	8.770498279	45.32700905	15.4504279	62.97705703	0	3.436587314	13.06293198	46.14037063	200.4220242	0	5.94004487	0	0	8.963601792	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.0697	0.0697	0.1755	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.528	0	7.315217479	0	1.721732288	2.292059448	0	2.025985103	10.47053909	3.569048844	14.54770017	0	0.793851669	3.017537287	10.65842562	46.2974876	0	1.372150365	0	0	2.070592014	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.6803			23.528	0	7.315217479	0	1.721732288	2.292059448	0	2.025985103	10.47053909	3.569048844	14.54770017	0	0.793851669	3.017537287	10.65842562	46.2974876	0	1.372150365	0	0	2.070592014	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.6803																																																																																		0			23.528	0	7.315217479	0	1.721732288	2.292059448	0	2.025985103	10.47053909	3.569048844	14.54770017	0	0.793851669	3.017537287	10.65842562	46.2974876	0	1.372150365	0	0	2.070592014	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.6803
H1419_802_0	2009	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																																																			0		337.7429637	0	41.70458687	6.32291558	7.457398417	9.927676106	0	8.775219121	45.35140694	15.4587443	63.0109553	0	3.438437104	13.06996328	46.16520633	200.5299042	0	5.943242181	0	0	8.968426574	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.0697	0.0697	0.1755	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.5407	0	7.319154996	0	1.722659034	2.29329318	0	2.027075617	10.476175	3.570969934	14.55553067	0	0.794278971	3.019161518	10.66416266	46.32240786	0	1.372888944	0	0	2.071706539	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.7501			23.5407	0	7.319154996	0	1.722659034	2.29329318	0	2.027075617	10.476175	3.570969934	14.55553067	0	0.794278971	3.019161518	10.66416266	46.32240786	0	1.372888944	0	0	2.071706539	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.7501																																																																																		0			23.5407	0	7.319154996	0	1.722659034	2.29329318	0	2.027075617	10.476175	3.570969934	14.55553067	0	0.794278971	3.019161518	10.66416266	46.32240786	0	1.372888944	0	0	2.071706539	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.7501
H1420_001_0	2009	5																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	5000	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$500/stay	$500/stay	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$30 X-ray; $175 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	10 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											84.53846451	84.53846451	47.56	0	100	0.2	0.2	47.5	150	0	59	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											68.92305435	68.92305435	38.77501778	0	100	0.163057266	0.163057266	38.7261006	122.2929493	0	48.10189338	0	20.38215821	24.45858985	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											9.8761	0	3.835024243	0	2.003577927	1.130803442	0	0.722528586	3.448159717	0	16.62973576	0	0.0998837	1.411605744	5.358275608	20.39806951	0	1.478528581	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3064	0	8.4177	9.8761	0	3.835024243	0	2.003577927	1.130803442	0	0.722528586	3.448159717	0	16.62973576	0	0.0998837	1.411605744	5.358275608	20.39806951	0	1.478528581	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3064	0	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$100 copay	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$50 copay	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$25 copay	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP		0	0	$500 ded; 30% coinsurance; $5000 max OOP	0	$500 ded; 30% coinsurance; $5000 max OOP	0	0												6.1213	0	0.7559	0.1146	0.1666	0.1799	0	0.0943	0.822	0.2802	1.142	0	0.0196	0.2369	0.8367	3.6344	0	0.1077	0	0	0.1625	0	0	0	0.0758	0	0.0048	0	0	0											14.7552	500	5.696109862	15.9973	0	4.590880029	0.114596803	2.170225623	1.310733085	0	0.816835061	4.270110632	0.280174969	17.77174912	0	0.119474285	1.648486339	6.19497586	24.03248241	0	1.586244167	0	0	1.076717455	0	0	0	0.075809063	0	0.004839087	0	0	0	0	0	0	0	0	0	0	0	0	0	82.0617
H1420_003_0	2009	6																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3500	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$0 	$0 	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$15 X-ray; $175 Complex Radiology	$15 per visit	$15 per visit	$15 per visit	0 PCP visit; $15 if no PCP selected	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											0	0	47.56	0	100	0.2	0.2	47.5	150	0	47	15	15	15	0	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											0	0	42.14172796	0	100	0.177215004	0.177215004	42.08856346	132.911253	0	41.64552595	0	13.2911253	13.2911253	0	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											0	0	4.168007073	0	2.003577927	1.228987471	0	0.78526342	3.747552343	0	14.39764724	0	0.065133768	0.767085467	0	10.19903476	0	0.739264291	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.0157	0	3.2348	0	0	4.168007073	0	2.003577927	1.228987471	0	0.78526342	3.747552343	0	14.39764724	0	0.065133768	0.767085467	0	10.19903476	0	0.739264291	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.0157	0	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$100 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$50 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$15 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP		0	0	$500 ded; 30% coinsurance; $3500 max OOP	0	$500 ded; 30% coinsurance; $3500 max OOP	0	0												5.2917	0	0.6534	0.0991	0.1436	0.1555	0	0.0824	0.7106	0.2422	0.9872	0	0.0145	0.2048	0.7233	3.1419	0	0.0931	0	0	0.1405	0	0	0	0.0655	0	0.0042	0	0	0											12.7535	500	10.08515721	5.2917	0	4.821423663	0.099065792	2.147220091	1.384531711	0	0.86765262	4.458106359	0.242203574	15.38488645	0	0.079659555	0.971862243	0.723304412	13.34088499	0	0.832381459	0	0	1.054688261	0	0	0	0.065534855	0	0.004183258	0	0	0	0	0	0	0	0	0	0	0	0	0	51.7693
H1420_801_0	2009	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																																																			0	Unlimited	321.8453037	0	39.74153978	6.025294096	7.106376494	9.46037749	0	8.362166992	43.21670296	14.73109669	60.04501122	0	3.276588865	12.45475629	43.99219657	191.090903	0	5.663492035	0	0	8.546280114	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.0697	0.0697	0.1755	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											22.4326	0	6.974640231	0	1.64157297	2.1853472	0	1.931660575	9.983058384	3.402883336	13.87039759	0	0.756892028	2.877048703	10.16219741	44.14199858	0	1.30826666	0	0	1.974190706	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.6428			22.4326	0	6.974640231	0	1.64157297	2.1853472	0	1.931660575	9.983058384	3.402883336	13.87039759	0	0.756892028	2.877048703	10.16219741	44.14199858	0	1.30826666	0	0	1.974190706	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.6428		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.059	0	0.9511	0	0.2239	0.298	0	0.2634	1.3613	0.464	1.8914	0	0.1032	0.3923	1.3858	6.0194	0	0.1784	0	0	0.2692	0	0	0	0	0	0	0	0	0											16.8604		0	25.4916	0	7.925727535	0	1.86542383	2.483349091	0	2.195068835	11.34438453	3.866912881	15.76181544	0	0.860104577	3.269373526	11.5479516	50.16136203	0	1.486666659	0	0	2.24339853	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.5032
H1420_802_0	2009	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																																																			0	Unlimited	321.8453037	0	39.74153978	6.025294096	7.106376494	9.46037749	0	8.362166992	43.21670296	14.73109669	60.04501122	0	3.276588865	12.45475629	43.99219657	191.090903	0	5.663492035	0	0	8.546280114	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.0697	0.0697	0.1755	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											22.4326	0	6.974640231	0	1.64157297	2.1853472	0	1.931660575	9.983058384	3.402883336	13.87039759	0	0.756892028	2.877048703	10.16219741	44.14199858	0	1.30826666	0	0	1.974190706	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.6428			22.4326	0	6.974640231	0	1.64157297	2.1853472	0	1.931660575	9.983058384	3.402883336	13.87039759	0	0.756892028	2.877048703	10.16219741	44.14199858	0	1.30826666	0	0	1.974190706	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.6428		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.059	0	0.9511	0	0.2239	0.298	0	0.2634	1.3613	0.464	1.8914	0	0.1032	0.3923	1.3858	6.0194	0	0.1784	0	0	0.2692	0	0	0	0	0	0	0	0	0											16.8604		0	25.4916	0	7.925727535	0	1.86542383	2.483349091	0	2.195068835	11.34438453	3.866912881	15.76181544	0	0.860104577	3.269373526	11.5479516	50.16136203	0	1.486666659	0	0	2.24339853	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.5032
H1463_001_0	2009	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	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	290.2126325	2.675967129	1754.853783	351.6790352	267.5928216	13.15511463	2.048153055	400.6801608	349.8133605	477.7188299	222.5924909	0	0.564568675	3072.118264	4813.3171	10201.71474	126.3532857	62.49323132	697.1830642	1685.177436	2165.151363	0	0	0	29.0005982	0	7.211561566	0	121.7989044	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: 10%	"11B Prosthetic Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: 10%"	"4A ER: $50, 4B Urgent Care: $20"	9B ASC Services: $100	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	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: $20, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $0"	"7B Chiropractic: $20, 7D Physician Specialist (excl. Radiology): $20, 7F Podiatry: $20"	"7E Mental Health: $20, 7H Psychiatric: $20"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	7D Physician Specialist (Radiology): $20	"7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $20"	15 Part B Drugs: $0	"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: $0, Routine: Not Covered"	18A Routine Hearing Exams: $20	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											250	250	0	0	50	0.1	0.1	48.77	100	0	0	0	20	20	13.33333333	20	20	20	20	20	0	0	0	0	20	0	20	0	0	0											143.1728526	143.1728526	0	0	28.63457052	0.057269141	0.057269141	27.93016008	57.26914104	0	0	0	11.45382821	11.45382821	7.635885472	11.45382821	11.45382821	11.45382821	11.45382821	11.45382821	0	0	0	0	11.45382821	0	11.45382821	0	0	0											3.4625	0.031927154	0	0	0.638533793	0.753382115	0.117295966	0.932588419	1.669459223	0	0	0	0.000538873	2.932292902	3.062828176	9.73739067	0.120602402	0.059648895	0.665451254	1.608477737	0	0	0	0	0.027680656	0	0.006883332	0	0	0	0	0	0	0	0	0	0	0	0	0	25.8275	0	19.271	3.4625	0.031927154	0	0	0.638533793	0.753382115	0.117295966	0.932588419	1.669459223	0	0	0	0.000538873	2.932292902	3.062828176	9.73739067	0.120602402	0.059648895	0.665451254	1.608477737	0	0	0	0	0.027680656	0	0.006883332	0	0	0	0	0	0	0	0	0	0	0	0	0	25.8275	0																																																																																	0	0	0	3.4625	0.031927154	0	0	0.638533793	0.753382115	0.117295966	0.932588419	1.669459223	0	0	0	0.000538873	2.932292902	3.062828176	9.73739067	0.120602402	0.059648895	0.665451254	1.608477737	0	0	0	0	0.027680656	0	0.006883332	0	0	0	0	0	0	0	0	0	0	0	0	0	25.8275
H1463_003_0	2009	7																					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	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	333.380804	3.074008409	2015.882492	403.9901312	307.3963709	15.11189452	2.352809063	460.2800125	401.8469435	548.7779294	255.7023894	0	0.648546402	3529.085718	5529.282135	11719.18614	145.1479201	71.78889326	800.8867444	1935.842018	2487.210484	0	0	0	33.31434149	0	8.284257552	0	139.9160895	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: 10%	"11B Prosthetic Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: 10%"	"4A ER: $50, 4B Urgent Care: $20"	9B ASC Services: $100	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	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: $20, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $0"	"7B Chiropractic: $20, 7D Physician Specialist (excl. Radiology): $20, 7F Podiatry: $20"	"7E Mental Health: $20, 7H Psychiatric: $20"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	7D Physician Specialist (Radiology): $20	"7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $20"	15 Part B Drugs: $0	"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: $0, Routine: Not Covered"	18A Routine Hearing Exams: $20	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											250	250	0	0	50	0.1	0.1	48.77	100	0	0	0	20	20	13.33333333	20	20	20	20	20	0	0	0	0	20	0	20	0	0	0											140.161732	140.161732	0	0	28.03234639	0.056064693	0.056064693	27.34275067	56.06469278	0	0	0	11.21293856	11.21293856	7.475292371	11.21293856	11.21293856	11.21293856	11.21293856	11.21293856	0	0	0	0	11.21293856	0	11.21293856	0	0	0											3.8939	0.035904862	0	0	0.718086796	0.847243724	0.131909517	1.048776802	1.877452119	0	0	0	0.000606009	3.297618443	3.444416713	10.95054285	0.135627892	0.067080371	0.748357821	1.808873134	0	0	0	0	0.031129305	0	0.007740906	0	0	0	0	0	0	0	0	0	0	0	0	0	29.0453	0	22.7615	3.8939	0.035904862	0	0	0.718086796	0.847243724	0.131909517	1.048776802	1.877452119	0	0	0	0.000606009	3.297618443	3.444416713	10.95054285	0.135627892	0.067080371	0.748357821	1.808873134	0	0	0	0	0.031129305	0	0.007740906	0	0	0	0	0	0	0	0	0	0	0	0	0	29.0453	0																																																																																	0	0	0	3.8939	0.035904862	0	0	0.718086796	0.847243724	0.131909517	1.048776802	1.877452119	0	0	0	0.000606009	3.297618443	3.444416713	10.95054285	0.135627892	0.067080371	0.748357821	1.808873134	0	0	0	0	0.031129305	0	0.007740906	0	0	0	0	0	0	0	0	0	0	0	0	0	29.0453
H1463_005_0	2009	7																					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	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	333.380804	3.074008409	2015.882492	403.9901312	307.3963709	15.11189452	2.352809063	460.2800125	401.8469435	548.7779294	255.7023894	0	0.648546402	3529.085718	5529.282135	11719.18614	145.1479201	71.78889326	800.8867444	1935.842018	2487.210484	0	0	0	33.31434149	0	8.284257552	0	139.9160895	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: 10%	"11B Prosthetic Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: 10%"	"4A ER: $50, 4B Urgent Care: $20"	9B ASC Services: $100	8A OP C/D/T: $0	8B OP X-Ray: $0	9A OP Hospital: $0	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: $20, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $0"	"7B Chiropractic: $20, 7D Physician Specialist (excl. Radiology): $20, 7F Podiatry: $20"	"7E Mental Health: $20, 7H Psychiatric: $20"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	7D Physician Specialist (Radiology): $20	"7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $20"	15 Part B Drugs: $0	"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: $0, Routine: Not Covered"	18A Routine Hearing Exams: $20	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											250	250	0	0	50	0.1	0.1	48.77	100	0	0	0	20	20	13.33333333	20	20	20	20	20	0	0	0	0	20	0	20	0	0	0											140.161732	140.161732	0	0	28.03234639	0.056064693	0.056064693	27.34275067	56.06469278	0	0	0	11.21293856	11.21293856	7.475292371	11.21293856	11.21293856	11.21293856	11.21293856	11.21293856	0	0	0	0	11.21293856	0	11.21293856	0	0	0											3.8939	0.035904862	0	0	0.718086796	0.847243724	0.131909517	1.048776802	1.877452119	0	0	0	0.000606009	3.297618443	3.444416713	10.95054285	0.135627892	0.067080371	0.748357821	1.808873134	0	0	0	0	0.031129305	0	0.007740906	0	0	0	0	0	0	0	0	0	0	0	0	0	29.0453	0	22.7615	3.8939	0.035904862	0	0	0.718086796	0.847243724	0.131909517	1.048776802	1.877452119	0	0	0	0.000606009	3.297618443	3.444416713	10.95054285	0.135627892	0.067080371	0.748357821	1.808873134	0	0	0	0	0.031129305	0	0.007740906	0	0	0	0	0	0	0	0	0	0	0	0	0	29.0453	0																																																																																	0	0	0	3.8939	0.035904862	0	0	0.718086796	0.847243724	0.131909517	1.048776802	1.877452119	0	0	0	0.000606009	3.297618443	3.444416713	10.95054285	0.135627892	0.067080371	0.748357821	1.808873134	0	0	0	0	0.031129305	0	0.007740906	0	0	0	0	0	0	0	0	0	0	0	0	0	29.0453
H1463_801_0	2009	4																					0											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	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	244.8340588	1.193113082	56.6323404	3.63240549	10.59786092	13.15463357	2.048002711	24.61062224	41.49935734	4.030629712	7.301683187	0	0.049538371	28.93489632	30.79066535	80.59507418	0.799254465	0.343014623	40.29299674	67.00060141	42.67878178	0	0	0	0	0	0	0	0	0											Medicare FFS Cost Sharing 8.3%	Medicare FFS Cost Sharing 8.3%	Medicare FFS Cost Sharing 19.4%	Medicare FFS Cost Sharing 0.0%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.083498061	0.083498061	0.194028821	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.083498061	0.083498061	0.194028821	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.4432	0.099622629	10.98830625	0	2.448105872	3.038720355	0.473088626	5.685053738	9.586351545	0.931075463	1.686688816	0	0.011443364	6.683961049	7.112643695	18.61746214	0.184627781	0.079236378	9.307682247	15.47713893	9.858798592	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.7132	0	0	20.4432	0.099622629	10.98830625	0	2.448105872	3.038720355	0.473088626	5.685053738	9.586351545	0.931075463	1.686688816	0	0.011443364	6.683961049	7.112643695	18.61746214	0.184627781	0.079236378	9.307682247	15.47713893	9.858798592	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.7132	0																																																																																	0	0	0	20.4432	0.099622629	10.98830625	0	2.448105872	3.038720355	0.473088626	5.685053738	9.586351545	0.931075463	1.686688816	0	0.011443364	6.683961049	7.112643695	18.61746214	0.184627781	0.079236378	9.307682247	15.47713893	9.858798592	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.7132
H1463_802_0	2009	4																					0											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	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	281.2523171	1.370584716	65.05621415	4.17271382	12.17425776	15.11134191	2.352636356	28.27137109	47.6722498	4.630172581	8.387784467	0	0.05690704	33.23886666	35.37067521	92.58332551	0.918140929	0.394036917	46.28644704	76.96671978	49.02710974	0	0	0	0	0	0	0	0	0											Medicare FFS Cost Sharing 8.3%	Medicare FFS Cost Sharing 8.3%	Medicare FFS Cost Sharing 19.4%	Medicare FFS Cost Sharing 0.0%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.083498061	0.083498061	0.194028821	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.083498061	0.083498061	0.194028821	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.484	0.114441167	12.62278054	0	2.812253542	3.49071998	0.543458998	6.530686722	11.0122897	1.069569866	1.937578212	0	0.013145526	7.678178199	8.170625974	21.38674819	0.212090555	0.091022528	10.69216927	17.77931227	11.32526235	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.9664	0	0	23.484	0.114441167	12.62278054	0	2.812253542	3.49071998	0.543458998	6.530686722	11.0122897	1.069569866	1.937578212	0	0.013145526	7.678178199	8.170625974	21.38674819	0.212090555	0.091022528	10.69216927	17.77931227	11.32526235	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.9664	0																																																																																	0	0	0	23.484	0.114441167	12.62278054	0	2.812253542	3.49071998	0.543458998	6.530686722	11.0122897	1.069569866	1.937578212	0	0.013145526	7.678178199	8.170625974	21.38674819	0.212090555	0.091022528	10.69216927	17.77931227	11.32526235	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.9664
H1463_809_0	2009	4																					0											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	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	288.1941979	1.404413542	68.11874991	4.369452402	12.56100223	15.5913899	2.427373488	29.71207831	50.10162453	4.866125873	8.815225415	0	0.059807019	34.93271713	36.49430948	95.52445674	0.947307876	0.406554444	47.75684697	79.4117521	51.52552805	0	0	0	0	0	0	0	0	0											Medicare FFS Cost Sharing 8.3%	Medicare FFS Cost Sharing 8.3%	Medicare FFS Cost Sharing 19.4%	Medicare FFS Cost Sharing 0.0%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Medicare FFS Cost Sharing 23.1%	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.083498061	0.083498061	0.194028821	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.083498061	0.083498061	0.194028821	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											24.0637	0.117265808	13.21700075	0	2.901591516	3.601611067	0.560723276	6.863490091	11.57347527	1.124075077	2.036317071	0	0.013815421	8.069457658	8.430185491	22.06614951	0.218828119	0.093914076	11.03183165	18.34411473	11.90239698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	146.2299	0	0	24.0637	0.117265808	13.21700075	0	2.901591516	3.601611067	0.560723276	6.863490091	11.57347527	1.124075077	2.036317071	0	0.013815421	8.069457658	8.430185491	22.06614951	0.218828119	0.093914076	11.03183165	18.34411473	11.90239698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	146.2299	0																																																																																	0	0	0	24.0637	0.117265808	13.21700075	0	2.901591516	3.601611067	0.560723276	6.863490091	11.57347527	1.124075077	2.036317071	0	0.013815421	8.069457658	8.430185491	22.06614951	0.218828119	0.093914076	11.03183165	18.34411473	11.90239698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	146.2299
H1468_004_0	2009	3																																D	D	D	Coin	T	Coin	Coin	V	V	V	V	Coin	Coin	V	V	V	V	V	P	P	Coin	Coin		Coin	Coin	Coin	V	Coin	Coin	Coin																																																			0		943.1473981	20.46101653	1139.198737	0	252.1556251	13.09120895	7.885607808	417.9172553	198.6269206	3378.378084	1232.216945	0	0.71	2111.668246	7997.637557	13336.5297	182.4467723	623.5562176	1454.743467	4716.139912	14.37367143	0	0	0	0	0	151.1135089	0	0	0											1a. $150/day (Days 1 - 5)	1b. $150/day (Days 1 - 5)	2.  $75/day (Days 14 - 100)	6. No cost sharing	10a.  $50	11a.  20%	11b.  20%	4a. $50; 4b. $10-$20	9a. $50 - $200;  9b.  No cost sharing	8a.  $0-$50	8b.  $0-$100	No cost sharing	12.  20%	3. $0; 5. $20; 9c. $20 - $100; 9d. $50	7a/14d-j. $10; 14b/14c. $0;	7d/14d-j. $20;	7e/7h. $20	7c/7i. $0-$50	7d. $20	7b/7f $20; 7g. $0	15. 20%	13a.  No cost sharing	10b.  No benefit	16a-b.  No cost sharing	17a.  No cost sharing	17b.  No cost sharing	18a.  $20	18b.  No benefit	14a.  No cost sharing	13b.  No benefit											150	150	75	0	50	0.2	0.2	42.93849909	100	50	61.43902385	0	0.2	50	5.675124332	7.142564818	20	19.31533312	20	15.6673905	0.2	0	0	0	0	0	20	0	0	0											150	150	75	0	50	0.2	0.2	42.93849909	100	50	61.43902385	0	0.2	50	5.675124332	7.142564818	20	19.31533312	20	15.6673905	0.2	0	0	0	0	0	20	0	0	0											11.7893	0.255762707	7.119992105	0	1.050648438	2.61824179	1.577121562	1.495394974	1.655224338	14.07657535	6.308850522	0	0.142	8.798617692	3.782298959	7.938085654	0.304077954	1.003683005	2.424572446	6.157467139	2.874734286	0	0	0	0	0	0.251855848	0	0	0	0	0	0	0	0	0	0	0	0	0	81.6245	0		11.7893	0.255762707	7.119992105	0	1.050648438	2.61824179	1.577121562	1.495394974	1.655224338	14.07657535	6.308850522	0	0.142	8.798617692	3.782298959	7.938085654	0.304077954	1.003683005	2.424572446	6.157467139	2.874734286	0	0	0	0	0	0.251855848	0	0	0	0	0	0	0	0	0	0	0	0	0	81.6245																																																																																		0			11.7893	0.255762707	7.119992105	0	1.050648438	2.61824179	1.577121562	1.495394974	1.655224338	14.07657535	6.308850522	0	0.142	8.798617692	3.782298959	7.938085654	0.304077954	1.003683005	2.424572446	6.157467139	2.874734286	0	0	0	0	0	0.251855848	0	0	0	0	0	0	0	0	0	0	0	0	0	81.6245
H1468_005_0	2009	4																																D	D	D		T	Coin	Coin	V	V	V	V		Coin	V	V	V	V	V	P	P	Coin						V																																																						0		930.9021575	20.20686246	1117.936678	0	247.4493806	12.84687401	7.738430452	410.1172279	194.9197384	3315.323876	1209.21879	0	0.7	2072.25597	7848.369273	13087.61608	179.0415772	611.918135	1427.592067	4631.510294	14.10540055	0	0	0	0	0	151.1135089	0	0	0											1a. $150/day (Days 1 - 5)	1b. $150/day (Days 1 - 5)	2.  $75/day (Days 14 - 100)	6.  No cost sharing	10a.  $50	11a.  20%	11b.  20%	4a. $50; 4b. $10-$20	9a. $50 - $200;  9b.  No cost sharing	8a.  $0-$50	8b.  $0-$100	No cost sharing	12.  20%	3. $0; 5. $20; 9c. $20 - $100; 9d. $50	7a/14d-j. $10; 14b/14c. $0;	7d/14d-j. $20;	7e/7h. $20	7c/7i. $0-$50	7d. $20	7b/7f $20; 7g. $0	15. 20%	13a.  No cost sharing	10b.  No benefit	16a-b.  No cost sharing	17a.  No cost sharing	17b.  No cost sharing	18a.  $20	18b.  No benefit	14a.  No cost sharing	13b.  No benefit											150	150	75	0	50	0.2	0.2	42.93849909	100	50	61.43902386	0	0.2	50	5.675124332	7.142564819	19.99999999	19.31533313	20	15.6705642	0.2	0	0	0	0	0	20	0	0	0											150	150	75	0	50	0.2	0.2	42.93849909	100	50	61.43902386	0	0.2	50	5.675124332	7.142564819	19.99999999	19.31533313	20	15.6705642	0.2	0	0	0	0	0	20	0	0	0											11.6363	0.252585781	6.987104237	0	1.031039086	2.569374802	1.54768609	1.467484851	1.624331153	13.81384949	6.191101839	0	0.14	8.634399876	3.711705953	7.78992885	0.298402629	0.984950219	2.379320111	6.048198282	2.82108011	0	0	0	0	0	0.251855848	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1807	0		11.6363	0.252585781	6.987104237	0	1.031039086	2.569374802	1.54768609	1.467484851	1.624331153	13.81384949	6.191101839	0	0.14	8.634399876	3.711705953	7.78992885	0.298402629	0.984950219	2.379320111	6.048198282	2.82108011	0	0	0	0	0	0.251855848	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1807																																																																																		0			11.6363	0.252585781	6.987104237	0	1.031039086	2.569374802	1.54768609	1.467484851	1.624331153	13.81384949	6.191101839	0	0.14	8.634399876	3.711705953	7.78992885	0.298402629	0.984950219	2.379320111	6.048198282	2.82108011	0	0	0	0	0	0.251855848	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1807
H1468_007_0	2009	5																																D	D	D		T	Coin	Coin	V	V	V	V		Coin	V	V	V	V	V	P	P	Coin						V																																																						0		976.5054871	21.15090755	1198.508691	0	265.2835702	13.77277484	8.296155169	439.6752263	208.9680078	3554.266138	1296.369693	0	0.75	2221.607752	8414.017509	14030.86769	191.9454746	656.0203429	1530.481585	4952.212003	15.12200599	0	0	0	0	0	151.1135089	0	0	0											1a. $150/day (Days 1 - 5)	1b. $150/day (Days 1 - 5)	2.  $75/day (Days 14 - 100)	6.  No cost sharing	10a.  $50	11a.  20%	11b.  20%	4a. $50; 4b. $10-$20	9a. $50 - $200;  9b.  No cost sharing	8a.  $0-$50	8b.  $0-$100	No cost sharing	12.  20%	3. $0; 5. $20; 9c. $20 - $100; 9d. $50	7a/14d-j. $10; 14b/14c. $0;	7d/14d-j. $20;	7e/7h. $20	7c/7i. $0-$50	7d. $20	7b/7f $20; 7g. $0	15. 20%	13a.  No cost sharing	10b.  No benefit	16a-b.  No cost sharing	17a.  No cost sharing	17b.  No cost sharing	18a.  $20	18b.  No benefit	14a.  No cost sharing	13b.  No benefit											150	150	75	0	50	0.2	0.2	42.93849909	100	50	61.43902386	0	0.2	50	5.675124332	7.142564819	20	19.31533313	20	15.65911089	0.2	0	0	0	0	0	20	0	0	0											150	150	75	0	50	0.2	0.2	42.93849909	100	50	61.43902386	0	0.2	50	5.675124332	7.142564819	20	19.31533313	20	15.65911089	0.2	0	0	0	0	0	20	0	0	0											12.2063	0.264386344	7.490679317	0	1.105348209	2.754554967	1.659231034	1.573249525	1.741400065	14.80944224	6.637307377	0	0.15	9.256698967	3.979216291	8.351365163	0.319909124	1.055937622	2.550802642	6.46226974	3.024401199	0	0	0	0	0	0.251855848	0	0	0	0	0	0	0	0	0	0	0	0	0	85.6444	0		12.2063	0.264386344	7.490679317	0	1.105348209	2.754554967	1.659231034	1.573249525	1.741400065	14.80944224	6.637307377	0	0.15	9.256698967	3.979216291	8.351365163	0.319909124	1.055937622	2.550802642	6.46226974	3.024401199	0	0	0	0	0	0.251855848	0	0	0	0	0	0	0	0	0	0	0	0	0	85.6444																																																																																		0			12.2063	0.264386344	7.490679317	0	1.105348209	2.754554967	1.659231034	1.573249525	1.741400065	14.80944224	6.637307377	0	0.15	9.256698967	3.979216291	8.351365163	0.319909124	1.055937622	2.550802642	6.46226974	3.024401199	0	0	0	0	0	0.251855848	0	0	0	0	0	0	0	0	0	0	0	0	0	85.6444
H1509_001_0	2009	5																					1950											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	3500	1401.256925	142.2761017	1305.425958	248.8956623	96.07046302	11.40775113	6.008713565	508.62489	32.46697438	9065.001068	31.84718689	0	0.064175115	15.53701084	4590.608396	3866.356012	544.1066057	305.8655004	0	0	32.79142206	657.3030191	0	0	182.6213476	117.0077084	15.00150002	0	394.0339269	0											"$195 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$195 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-18 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$15 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											192.7207072	195	110	0	150	0.2	0.074218554	46.25608239	0.2	2.8	0.180002776	0	0.2	0.19783804	6.985503201	20	37.5	20	0	0	0.2	19.60345912	0	0	20	15	20	0	0	0											107.0392039	108.2737473	61.07749845	0	83.28749789	0.111049997	0.041209851	25.68368909	0.111049997	1.554699961	0.099946539	0	0.111049997	0.11048973	6.985503201	20	37.5	11.10499972	0	0	0.111049997	19.60345912	0	0	20	15	20	0	0	0											12.4991	1.283730556	6.644345996	0	0.66678904	1.266830731	0.247618193	1.088613628	3.605457413	1.1744464	3.183016105	0	0.007126646	1.716680139	2.672309137	6.443926687	1.700333143	0.283053025	0	0	3.641487327	1.073784406	0	0	0.304368913	0.146259635	0.0250025	0	0	0	0	0	0	0	0	0	0	0	0	0	49.6743	0	29.8592	12.4991	1.283730556	6.644345996	0	0.66678904	1.266830731	0.247618193	1.088613628	3.605457413	1.1744464	3.183016105	0	0.007126646	1.716680139	2.672309137	6.443926687	1.700333143	0.283053025	0	0	3.641487327	1.073784406	0	0	0.304368913	0.146259635	0.0250025	0	0	0	0	0	0	0	0	0	0	0	0	0	49.6743		"$325 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$325 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$185 Days 1-19 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$40 (17a1)	"50% (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$40 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a7, 14a8, 14a9, 14a10); $0 (14a6)"	"$0 n/c (13b, 13d, 13e)"											1.3055	0.1308	4.5881	0.0515	0.1127	0.3213	0.1692	0.184	0.9143	0.1986	0.7886	0	0.0012	0.4354	1.4586	3.1772	0.4818	0.1356	0	0	1.3082	0.5386	0	0	0.1466	0.1145	0.0125	0	0	0											16.5747	0	9.443130449	13.8046	1.41456595	11.23245492	0.051470611	0.779519171	1.588094244	0.416834755	1.272659179	4.519787866	1.373003196	3.971567004	0	0.008331507	2.152057973	4.130862984	9.62115855	2.1820942	0.418639705	0	0	4.949732957	1.612353036	0	0	0.450987624	0.260731035	0.03750375	0	0	0	0	0	0	0	0	0	0	0	0	0	66.249
H1509_004_0	2009	4																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		416.016811	22.4064	56.11971496	2843.499305	17.22047971	35.86461061	15.60938351	38.56882926	48.82756199	12.70937557	33.9518119	0	1.45897985	30.04228456	45.64250066	154.4207914	13.9175	6.167622329	0	0	43.25370159	5.424120151	343.2407893	0	178.6259116	186.0693524	0	0	20.2	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.074991344	0.07593443	0.200640409	0	0.2	0.2	0.2	0.110106323	0.2	0.08	0.2	0	0.2	0.2	0	0.199772721	0.2	0.2	0	0	0.2	0.013827962	0	0	0	0	0	0	0	0											0.074991344	0.07593443	0.200640409	0	0.2	0.2	0.2	0.110106323	0.2	0.08	0.2	0	0.2	0.2	0	0.199772721	0.2	0.2	0	0	0.2	0.013827962	0	0	0	0	0	0	0	0											31.1977	1.701417217	11.25988254	0	3.444095942	7.172922122	3.121876701	4.246671955	9.765512398	1.016750045	6.79036238	0	0.29179597	6.008456912	0	30.84906173	2.7835	1.233524466	0	0	8.650740319	0.075004527	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.6092	0	0	31.1977	1.701417217	11.25988254	0	3.444095942	7.172922122	3.121876701	4.246671955	9.765512398	1.016750045	6.79036238	0	0.29179597	6.008456912	0	30.84906173	2.7835	1.233524466	0	0	8.650740319	0.075004527	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.6092		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											5.2002	0.2801	0.8861	0.571	0.2719	0.5663	0.2465	0.2236	0.771	0.2007	0.5361	0	0.0154	0.4744	0.7207	2.4382	0.2198	0.0974	0	0	0.683	0.0671	0.0261	0	0.0155	0	0	0	0.003	0											14.5137	0	0	36.3979	1.981497217	12.1459833	0.571001999	3.715998253	7.739205447	3.368340651	4.470290706	10.5364739	1.217424396	7.32644362	0	0.307153653	6.482808773	0.720671063	33.28728475	3.00325	1.330907976	0	0	9.333693502	0.142094333	0.0261	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	144.1229
H1509_005_0	2009	3																					2500											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1734.33818	255.7415171	37.16978211	46758.77304	81.00533153	18.56828562	8.209548911	331.0446803	347.0626096	5496.329054	420.3390575	0	0.721166314	1341.772657	5423.171603	4023.196645	1242.868229	239.8804394	0	0	23.86960273	1015.932958	769.983193	0	314.3760437	332.2285714	0	0	20.2	0											"$175 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	20.1% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$75 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5, 9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											172.9	175	0.201	0	75	0.14	0.2	49.97130297	75	4.4	64.79010385	0	0.2	70.27843648	3.249220014	25	20	20	0	0	0.2	13.6791576	0	0	0	0	0	0	0	0											123.1884698	124.684686	0.201	0	53.43629401	0.099747749	0.142496784	35.60374983	53.43629401	3.134929248	46.16190717	0	0.142496784	50.07225592	3.249220014	25	20	20	0	0	0.142496784	13.6791576	0	0	0	0	0	0	0	0											17.8042	2.65725423	7.471126204	0	0.360718726	1.85214469	1.169834318	0.982202665	1.545478304	1.435883559	1.616971046	0	0.10276388	5.598798656	1.468423143	8.381659676	2.071447048	0.399800732	0	0	3.401341625	1.158092254	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.4781	0	15.5474	17.8042	2.65725423	7.471126204	0	0.360718726	1.85214469	1.169834318	0.982202665	1.545478304	1.435883559	1.616971046	0	0.10276388	5.598798656	1.468423143	8.381659676	2.071447048	0.399800732	0	0	3.401341625	1.158092254	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.4781		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.3229	0.2077	0.5869	0.4966	0.1278	0.2932	0.1296	0.0727	0.5802	0.0912	0.2461	0	0.0076	0.4625	0.6312	1.9876	0.1512	0.0683	0	0	0.3769	0.0784	0.0569	0	0.0155	0	0	0	0.003	0											9.9938	0	0	21.1271	2.86497423	8.058017501	0.496561225	0.488529999	2.145328147	1.299458774	1.054868216	2.125646612	1.527131397	1.863035333	0	0.110355105	6.061299884	2.09958799	10.36929027	2.222647048	0.468056145	0	0	3.778230089	1.236458032	0.056935837	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	69.472
H1509_006_0	2009	7																																Coin	Coin	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		361.6086205	42.1785	7538.275697	100.486197	23.22022448	12.77511539	14.59511956	10.14107424	7.09392949	29.15422297	24.11971084	0	0.091128507	4.740784863	1.143617661	132.2837519	43.2725	39.9094736	0	0	8.719883624	6.534107126	1498.037626	0	182.0000636	141.3063859	0	0	0	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.07189135	0.072854778	0	0	0.2	0.2	0.2	0.067109635	0.2	0.08	0.15003742	0	0.2	0.2	0	0.198639098	0.2	0	0	0	0.2	0.022666282	0	0	0	0	0	0	0	0											0.07189135	0.072854778	0	0	0.2	0.2	0.2	0.067109635	0.2	0.08	0.15003742	0	0.2	0.2	0	0.198639098	0.2	0	0	0	0.2	0.022666282	0	0	0	0	0	0	0	0											25.9965	3.072905244	0	0	4.644044895	2.555023078	2.919023911	0.680563794	1.418785898	2.332337837	3.618859174	0	0.018225701	0.948156973	0	26.27672515	8.6545	0	0	0	1.743976725	0.148103913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.0278	0	0	25.9965	3.072905244	0	0	4.644044895	2.555023078	2.919023911	0.680563794	1.418785898	2.332337837	3.618859174	0	0.018225701	0.948156973	0	26.27672515	8.6545	0	0	0	1.743976725	0.148103913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.0278		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.7816	0.3245	0.7602	0.048	0.3666	0.2017	0.2304	0.0358	0.112	0.4603	0.3808	0	0.001	0.0749	0.0181	2.0887	0.6833	0.0044	0	0	0.1377	0.103	0.1107	0	0.0089	0	0	0	0	0											8.9327	0	0	28.7781	3.397355244	0.760200188	0.048047397	5.010680018	2.756735426	3.149473167	0.716382941	1.530795311	2.792667674	3.999696713	0	0.019184949	1.02301147	0.018057121	28.36541597	9.33775	0.00444769	0	0	1.881659098	0.251150127	0.110719388	0	0.008933819	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.9605
H1509_007_0	2009	7																					3500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1441.516468	146.3638395	1342.932181	256.0466891	98.83066562	12.0726806	6.358946552	523.1958568	34.35939366	9325.447815	33.7034803	0	0.067915723	16.4426246	4733.902111	3980.526985	559.7393446	314.6533289	0	0	34.70275259	676.1880066	0	0	118.3912108	0	14.72807038	0	382.56	0											"$195 Days 1-18 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$195 Days 1-18 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$5 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											192.7207072	195	77.60718127	0	150	0.2	0.074218554	46.25577936	0.2	2.8	0.178957409	0	0.2	0.19774915	3.484339869	20	37.5	20	0	0	0.2	19.60345912	0	0	20	0	20	0	0	0											136.9558766	138.5552061	55.1429692	0	106.5809278	0.142107904	0.052735216	32.86655919	0.142107904	1.989510652	0.127156311	0	0.142107904	0.140913591	3.484339869	20	37.5	14.21079037	0	0	0.142107904	19.60345912	0	0	20	0	20	0	0	0											16.452	1.689955996	6.171105656	0	0.877788669	1.715623332	0.335340419	1.432970633	4.882741405	1.546089813	4.285610238	0	0.009651361	2.316989277	1.374543655	6.634211641	1.749185452	0.372622708	0	0	4.931535423	1.104635329	0	0	0.197318685	0	0.024546784	0	0	0	0	0	0	0	0	0	0	0	0	0	58.1045	0	19.1423	16.452	1.689955996	6.171105656	0	0.877788669	1.715623332	0.335340419	1.432970633	4.882741405	1.546089813	4.285610238	0	0.009651361	2.316989277	1.374543655	6.634211641	1.749185452	0.372622708	0	0	4.931535423	1.104635329	0	0	0.197318685	0	0.024546784	0	0	0	0	0	0	0	0	0	0	0	0	0	58.1045		"$250 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$250 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a7, 14a8, 14a9, 14a10); $0 (14a6)"	"$0 n/c (13b, 13d, 13e)"											1.9282	0.1939	8.3835	0.1024	0.218	0.6391	0.3367	0.3559	1.819	0.384	1.5605	0	0.0024	0.8604	1.6216	2.8946	0.4956	0.2294	0	0	2.6027	0.4866	0	0	0.0863	0	0.0107	0	0	0											25.2115	0	0	18.3802	1.883817953	14.55463116	0.102398883	1.095797491	2.354765247	0.671990531	1.788865223	6.701768129	1.930078841	5.846113176	0	0.012048387	3.177348407	2.996139812	9.528803451	2.244787997	0.602057427	0	0	7.534241867	1.591248477	0	0	0.283645609	0	0.035286002	0	0	0	0	0	0	0	0	0	0	0	0	0	83.316
H1509_008_0	2009	6																					3600											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1463.110322	148.5563634	1363.049246	259.8822573	100.3111447	12.43708615	6.550886975	531.0265849	35.3965083	9465.142614	34.72079664	0	0.069965713	16.9389339	4803.134996	4040.036339	568.1242154	319.366822	0	0	35.75023128	686.3172733	0	0	118.3912108	0	14.72807038	0	382.56	0											"$225 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$225 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											222.3593116	225	85.36789939	0	150	0.2	0.074218554	46.25573196	0.2	2.8	0.178420414	0	0.2	0.198120916	6.971118288	25	37.5	25	0	0	0.2	24.50432391	0	0	25	0	25	0	0	0											154.353757	156.1652259	59.2510991	0	104.1101506	0.138813534	0.051512699	32.10460815	0.138813534	1.943389478	0.123835841	0	0.138813534	0.137931057	6.971118288	25	37.5	17.35169177	0	0	0.138813534	24.50432391	0	0	25	0	25	0	0	0											18.8197	1.933278171	6.730180494	0	0.870284032	1.726435884	0.33745387	1.420700035	4.913514414	1.532871547	4.299679052	0	0.009712188	2.336405063	2.790268518	8.416742374	1.775388173	0.461796221	0	0	4.962615952	1.401478397	0	0	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	65.0159	0	22.1814	18.8197	1.933278171	6.730180494	0	0.870284032	1.726435884	0.33745387	1.420700035	4.913514414	1.532871547	4.299679052	0	0.009712188	2.336405063	2.790268518	8.416742374	1.775388173	0.461796221	0	0	4.962615952	1.401478397	0	0	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	65.0159		"$295 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$295 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a7, 14a8, 14a9, 14a10); $0 (14a6)"	"$0 n/c (13b, 13d, 13e)"											2.3036	0.2322	8.5091	0.1055	0.2213	0.6584	0.3468	0.3612	1.8739	0.3897	1.6032	0	0.0025	0.8861	1.6482	2.9412	0.503	0.2329	0	0	2.6813	0.494	0	0	0.0863	0	0.0107	0	0	0											26.0912	0	0	21.1233	2.165462053	15.23929084	0.105489722	1.091558615	2.384869857	0.684265534	1.781920967	6.787447207	1.922612714	5.902897658	0	0.012181566	3.22253274	4.438501264	11.35791279	2.278414822	0.694667862	0	0	7.643883298	1.895431698	0	0	0.33297528	0	0.041422698	0	0	0	0	0	0	0	0	0	0	0	0	0	91.107
H1509_801_0	2009	2																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1503.153296	152.6221119	1400.353709	266.9948163	103.0564992	12.50206471	6.58511261	545.5476451	35.5814402	9724.188331	34.90219823	0	0.070331254	17.02743272	4931.518319	4142.460392	583.6728607	328.1073778	0	0	35.93701124	705.1006723	0	0	0	0	0	0	0	0											"$280 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$280 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											276.6967531	280	150	0	150	0.2	0.074218554	46.25564766	0.3	2.8	0.250496493	0	0.2	0.296351676	24.41410669	34.89653166	37.5	35	0	0	0.2	34.30605347	0	0	0	0	0	0	0	0											183.7717833	185.9419582	99.61176332	0	99.61176332	0.132815684	0.049286941	30.71737751	0.199223527	1.859419582	0.166349316	0	0.132815684	0.19727403	24.41410669	34.89653166	37.5	23.24274477	0	0	0.132815684	34.30605347	0	0	0	0	0	0	0	0											23.0198	2.36490453	11.62430852	0	0.855469967	1.660470281	0.324560054	1.396482747	7.088659999	1.50677885	5.805956803	0	0.009341094	3.359070276	10.03321786	12.04645835	1.82397769	0.63550967	0	0	4.772998743	2.015768447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.3437	0	32.5722	23.0198	2.36490453	11.62430852	0	0.855469967	1.660470281	0.324560054	1.396482747	7.088659999	1.50677885	5.805956803	0	0.009341094	3.359070276	10.03321786	12.04645835	1.82397769	0.63550967	0	0	4.772998743	2.015768447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.3437	4700	"40% (1a, 13c); $0 (1a1); $0 n/c (1a2, 1a3)"	"40% (1b); $0 n/c (1b1, 1b2)"	"40% (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 40% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											3.6209	0.1734	4.592	0.0939	0.151	0.4395	0.2315	0.2464	1.6679	0.2659	1.3661	0	0.0016	0.7884	3.1124	3.4098	0.5168	0.1816	0	0	1.7899	0.5782	0	0	0	0	0	0	0	0											23.2273	0	7.995347694	26.6407	2.538301785	16.21628719	0.093892598	1.006435256	2.100006532	0.55607347	1.642920879	8.756579999	1.772681	7.172064286	0	0.010989522	4.147422783	13.14560634	15.45626979	2.340771368	0.817083861	0	0	6.562873272	2.593995892	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.571
H1509_803_0	2009	2																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1481.788018	150.4527964	1380.449588	263.1998484	101.5916914	12.14919081	6.399246161	537.7998069	34.57714516	9585.972231	33.91707496	0	0.068346137	16.54682918	4863.018278	4083.580957	575.3767455	323.443778	0	0	34.92268011	695.0786261	0	0	0	0	0	0	0	0											"$265 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$265 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-30 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											261.8774509	265	150	0	150	0.2	0.074218554	46.25569207	0.3	2.8	0.251024751	0	0.2	0.296415049	24.40610032	34.85960035	37.5	35	0	0	0.2	34.30605347	0	0	0	0	0	0	0	0											173.5198015	175.5649698	99.376398	0	99.376398	0.132501864	0.049170484	30.6448271	0.198752796	1.855026096	0.166306237	0	0.132501864	0.196860076	24.40610032	34.85960035	37.5	23.1878262	0	0	0.132501864	34.30605347	0	0	0	0	0	0	0	0											21.4266	2.201186721	11.43200897	0	0.841318029	1.609790428	0.314654031	1.373398508	6.872304278	1.481852387	5.640621108	0	0.009055991	3.257410051	9.89060933	11.86266668	1.79805233	0.624996509	0	0	4.627320211	1.987117043	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.251	0	31.4207	21.4266	2.201186721	11.43200897	0	0.841318029	1.609790428	0.314654031	1.373398508	6.872304278	1.481852387	5.640621108	0	0.009055991	3.257410051	9.89060933	11.86266668	1.79805233	0.624996509	0	0	4.627320211	1.987117043	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.251	4500	"40% (1a, 13c); $0 (1a1); $0 n/c (1a2, 1a3)"	"40% (1b); $0 n/c (1b1, 1b2)"	"40% (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 40% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											3.5105	0.1681	4.4518	0.091	0.1485	0.4261	0.2244	0.2424	1.617	0.2615	1.3272	0	0.0016	0.7645	3.0659	3.3582	0.5094	0.1786	0	0	1.7352	0.57	0	0	0	0	0	0	0	0											22.652	0	7.81434922	24.9372	2.369291652	15.88383409	0.091026866	0.989785917	2.035911424	0.539101337	1.615762951	8.489317049	1.743355749	6.967826074	0	0.010654107	4.021874392	12.95650014	15.22087037	2.30750049	0.80356694	0	0	6.362565289	2.557088368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.903
H1509_804_0	2009	2																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1503.153296	152.6221119	1400.353709	266.9948163	103.0564992	12.50206471	6.58511261	545.5476451	35.5814402	9724.188331	34.90219823	0	0.070331254	17.02743272	4931.518319	4142.460392	583.6728607	328.1073778	0	0	35.93701124	705.1006723	0	0	0	0	0	0	0	0											"$280 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$280 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											276.6967531	280	150	0	150	0.2	0.074218554	46.25564766	0.3	2.8	0.250496493	0	0.2	0.296351676	24.41410669	34.89653166	37.5	35	0	0	0.2	34.30605347	0	0	0	0	0	0	0	0											183.7717833	185.9419582	99.61176332	0	99.61176332	0.132815684	0.049286941	30.71737751	0.199223527	1.859419582	0.166349316	0	0.132815684	0.19727403	24.41410669	34.89653166	37.5	23.24274477	0	0	0.132815684	34.30605347	0	0	0	0	0	0	0	0											23.0198	2.36490453	11.62430852	0	0.855469967	1.660470281	0.324560054	1.396482747	7.08866	1.50677885	5.805956803	0	0.009341094	3.359070276	10.03321786	12.04645835	1.82397769	0.63550967	0	0	4.772998743	2.015768447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.3437	0	32.5722	23.0198	2.36490453	11.62430852	0	0.855469967	1.660470281	0.324560054	1.396482747	7.08866	1.50677885	5.805956803	0	0.009341094	3.359070276	10.03321786	12.04645835	1.82397769	0.63550967	0	0	4.772998743	2.015768447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.3437	4700	"40% (1a, 13c); $0 (1a1); $0 n/c (1a2, 1a3)"	"40% (1b); $0 n/c (1b1, 1b2)"	"40% (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 40% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											3.6209	0.1734	4.592	0.0939	0.151	0.4395	0.2315	0.2464	1.6679	0.2659	1.3661	0	0.0016	0.7884	3.1124	3.4098	0.5168	0.1816	0	0	1.7899	0.5782	0	0	0	0	0	0	0	0											23.2273	0	7.995347695	26.6407	2.538301785	16.21628719	0.093892598	1.006435256	2.100006532	0.55607347	1.642920879	8.756579999	1.772681	7.172064286	0	0.010989522	4.147422784	13.14560634	15.45626979	2.340771368	0.817083861	0	0	6.562873272	2.593995892	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.571
H1509_805_0	2009	2																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1503.153296	152.6221119	1400.353709	266.9948163	103.0564992	12.50206471	6.585112611	545.5476452	35.5814402	9724.188331	34.90219824	0	0.070331254	17.02743272	4931.518319	4142.460393	583.6728607	328.1073778	0	0	35.93701124	705.1006723	0	0	0	0	0	0	0	0											"$280 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$280 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											276.6967531	280	150	0	150	0.2	0.074218554	46.25564766	0.3	2.8	0.250496493	0	0.2	0.296351676	24.41410669	34.89653166	37.5	35	0	0	0.2	34.30605347	0	0	0	0	0	0	0	0											183.7717833	185.9419582	99.61176331	0	99.61176331	0.132815684	0.049286941	30.71737751	0.199223527	1.859419582	0.166349316	0	0.132815684	0.19727403	24.41410669	34.89653166	37.5	23.24274477	0	0	0.132815684	34.30605347	0	0	0	0	0	0	0	0											23.0198	2.36490453	11.62430852	0	0.855469967	1.660470281	0.324560054	1.396482747	7.08866	1.50677885	5.805956804	0	0.009341094	3.359070276	10.03321786	12.04645836	1.82397769	0.63550967	0	0	4.772998744	2.015768447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.3437	0	32.5722	23.0198	2.36490453	11.62430852	0	0.855469967	1.660470281	0.324560054	1.396482747	7.08866	1.50677885	5.805956804	0	0.009341094	3.359070276	10.03321786	12.04645836	1.82397769	0.63550967	0	0	4.772998744	2.015768447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.3437	4700	"40% (1a, 13c); $0 (1a1); $0 n/c (1a2, 1a3)"	"40% (1b); $0 n/c (1b1, 1b2)"	"40% (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 40% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											3.6209	0.1734	4.592	0.0939	0.151	0.4395	0.2315	0.2464	1.6679	0.2659	1.3661	0	0.0016	0.7884	3.1124	3.4098	0.5168	0.1816	0	0	1.7899	0.5782	0	0	0	0	0	0	0	0											23.2273	0	7.995347696	26.6407	2.538301785	16.21628719	0.093892598	1.006435256	2.100006532	0.55607347	1.642920879	8.75658	1.772681	7.172064287	0	0.010989522	4.147422784	13.14560634	15.45626979	2.340771368	0.817083861	0	0	6.562873273	2.593995892	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.571
H1510_001_0	2009	5	r.	s.	t.	u.							OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered							4600	Renal Dialysis										D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin					O	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							0		1451.64074	64.63477	506.643435	724.108253	144.025808	9.776166	3.530496	325.77557	353.130204	624.325713	926.633687	0	0	708.867033	3469.402377	4182.05795	28.528304	901.396605			22.095794			3.46					2.23	0.05	18.995753	0.06	1.23	2.7							$175/Day(Days 1-5):1a	$175/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $50 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$30-$100/Visit:9d. $50 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $30 Partial Hospitalization,8b. $100 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			"Dental 767 16a, 16b"					$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	$0/Proc:12	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a							107.292852	89.437867	43.132796	0	99.999994	0.199999	0.199999	49.999992	127.313154	87.957396	83.490169	0	0	71.766198	10.000001	29.999997	89.074486	39.708647			0.2			0					0	0	0	0	0	0							93.802814	78.192754	37.709666	0	87.426895	0.174853	0.174853	43.713443	111.305943	76.898424	72.992867	0	0	62.742962	8.742691	26.228067	77.875062	34.716039			0.174853			0					0	0	0	0	0	0							11.3473	0.421164223	1.592112893	0	1.049310766	1.709391954	0.617317817	1.186730984	3.27545753	4.000805283	5.636470789	0	0	3.70636811	2.527659411	9.140608009	0.185136954	2.607743308	0	0	3.863515868	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.8671	0	7.603	11.3473	0.421164223	1.592112893	0	1.049310766	1.709391954	0.617317817	1.186730984	3.27545753	4.000805283	5.636470789	0	0	3.70636811	2.527659411	9.140608009	0.185136954	2.607743308	0	0	3.863515868	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.8671		30% Coins	30% Coins	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins			30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins			"Dental 767 16a, 16b"					0	0		0	0	0							7.3167	0.1047	0.4586	0.6958	0.8248	1.9168	0.6922	0.2469	3.3125	0.4267	1.775			1.0026	2.0102	4.5894	0.029	0.3875			1.3699			0					0	0		0	0	0							27.1593	500	0	18.664	0.525871223	2.050757893	0.695813	1.874149766	3.626169954	1.309529817	1.433664984	6.58791653	4.427525283	7.411430789	0	0	4.70893011	4.537821411	13.73004401	0.214139954	2.995265308	0	0	5.233422868	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.0265
H1510_004_0	2009	6	r.	s.	t.	u.							OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered							4600	Renal Dialysis										D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin								O	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		1427.774579	63.572122	498.313803	712.203322	141.657906	9.45645	3.415036	320.419552	347.324455	614.061289	911.39907	0	0	697.212681	3412.362564	4113.301495	28.059274	886.576907			21.373181								2.23	0.05	18.683448	0.06	1.23	2.7							$175/Day(Days 1-5):1a	$175/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $50 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$30-$100/Visit:9d. $50 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $30 Partial Hospitalization,8b. $100 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	$0/Proc:12	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a							107.292852	89.437882	43.132796	0	100.000038	0.2	0.199999	49.999982	127.313177	87.957396	83.490144	0	0	71.766181	9.999998	30	89.074293	39.708636			0.199999								0	0	0	0	0	0							94.774995	79.003165	38.100493	0	88.333033	0.176666	0.176665	44.166484	112.459549	77.695406	73.749349	0	0	63.393221	8.833298	26.4999	78.681995	35.075829			0.176665								0	0	0	0	0	0							11.2764	0.418533237	1.582166797	0	1.04275604	1.670633196	0.603317335	1.179317085	3.254995964	3.975811763	5.601257341	0	0	3.683213131	2.511867951	9.083506524	0.183979971	2.591451665	0	0	3.775893021	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.4351	0	6.9256	11.2764	0.418533237	1.582166797	0	1.04275604	1.670633196	0.603317335	1.179317085	3.254995964	3.975811763	5.601257341	0	0	3.683213131	2.511867951	9.083506524	0.183979971	2.591451665	0	0	3.775893021	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.4351		$975/Admit	$975/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	30% Coins	30% Coins	30% Coins			30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins								0	0		0	0	0							2.4825	0.08	0.4614	0.7	0.8437	2.5709	0.9285	0.2526	3.3322	0.4293	1.7855			1.0085	2.0221	4.6168	0.0292	0.3898			1.3781								0	0		0	0	0							23.3111	500	0	13.759	0.498519237	2.043545797	0.699962	1.88646404	4.241575196	1.531769335	1.431900085	6.587204964	4.405077763	7.386801341	0	0	4.691754131	4.534015951	13.70030752	0.213155971	2.981283665	0	0	5.153969021	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.7463
H1510_005_0	2009	3	r.	s.	t.	u.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered							3700											A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			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		244.668833	7.883188	475.329448	679.353472	135.12404	8.604232	3.107271	305.640438	331.304372	585.738167	869.361466	0	18.10499	665.054262	3254.969871	3923.578512	26.765062	845.684205			19.447024				2.69				2.23	0.09	0.06	0.05	1.23	2.7							$650/Admit:1a	$650/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $50 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$50/Visit:9a	"$0-$100/Proc:12. $0 Dialysis -- Dialysis Center,12. $100 Dialysis -- OP Hosp"	"$30-$100/Visit:9d. $50 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $30 Partial Hospitalization,8b. $100 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15				VIS752				$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0: Health Education Materials 14a	$0 Corp Health 14a							649.999994	649.999974	43.132795	0	100.000029	0.199999	0.199999	50.000006	127.313176	87.957402	83.49016	0	1.564872	71.76618	10	29.999999	89.074181	39.708652			0.2				0				0	0	0	0	0	0							558.156944	558.156928	37.038261	0	85.870325	0.17174	0.17174	42.935155	109.324206	75.529285	71.69325	0	1.34376	61.625834	8.58703	25.761089	76.488267	34.097938			0.17174				0				0	0	0	0	0	0							11.3803	0.366671333	1.46711468	0	0.966928769	1.477690804	0.533642722	1.093559965	3.018298951	3.686698746	5.193945744	0	0.002027397	3.415376963	2.329210328	8.422971271	0.170601101	2.403007299	0	0	3.339831902	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.2679	0	8.1069	11.3803	0.366671333	1.46711468	0	0.966928769	1.477690804	0.533642722	1.093559965	3.018298951	3.686698746	5.193945744	0	0.002027397	3.415376963	2.329210328	8.422971271	0.170601101	2.403007299	0	0	3.339831902	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.2679		$975/Admit	$975/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$100/Proc	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins				VIS752				0	0	0	0	0	0							1.8967	0.0611	0.3362	0.5101	0.6446	1.8737	0.6766	0.193	2.4285	0.3128	1.3013		0.0004	0.735	1.4737	3.3647	0.0213	0.2841			1.0043				0				0	0	0	0	0	0							17.1182	0	0	13.277	0.427783333	1.80336368	0.510126	1.611547769	3.351370804	1.210290722	1.286540965	5.446782951	3.999542746	6.495234744	0	0.002385397	4.150391963	3.802933328	11.78765427	0.191865101	2.687113299	0	0	4.344160902	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3861
H1510_805_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		260.801211	8.40297	506.670562	724.147026	4.953523	9.776286	3.530539	21.735572	55.871532	624.359143	30.210719	0	0.381218	17.210949	32.423132	74.025809	0.467821	6.250568			22.096066																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000015	1023.999371	43.132807	0	0.2	0.199999	0.2	0.199999	0.2	0	0.2	0	0.200001	0.199999	0.199999	0.2	0.500001	0.199999			0.2																				1024.000015	1023.999371	43.132807	0	0.2	0.199999	0.2	0.199999	0.2	0	0.2	0	0.200001	0.199999	0.199999	0.2	0.500001	0.199999			0.2																				22.255	0.717053	1.821176964	0	0.9907046	1.955247424	0.7061078	4.347092664	11.1743064	0	6.0421438	0	0.076243981	3.442172589	6.484593977	14.8051618	0.233910968	1.250107349	0	0	4.4192132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.7203	0	0	22.255	0.717053	1.821176964	0	0.9907046	1.955247424	0.7061078	4.347092664	11.1743064	0	6.0421438	0	0.076243981	3.442172589	6.484593977	14.8051618	0.233910968	1.250107349	0	0	4.4192132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.7203		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4728	0.0797	0.2024		0.6281	1.2396	0.4477	0.8188	2.1422		1.1479		0.0144	0.6484	1.3	2.9681	0.0469	0.2506			0.8859																				15.2933	0	0	24.7278	0.796725	2.023529964	0	1.6187986	3.194855424	1.1537708	5.165915664	13.3165194	0	7.1900368	0	0.090604981	4.090544589	7.784593977	17.7732148	0.280804968	1.500722349	0	0	5.3051522	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.0136
H1510_806_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		260.801211	8.40297	506.670562	724.147026	4.953523	9.776286	3.530539	21.735572	55.871532	624.359143	30.210719	0	0.381218	17.210949	32.423132	74.025809	0.467821	6.250568			22.096066																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000015	1023.999371	43.132807	0	0.2	0.199999	0.2	0.199999	0.2	0	0.2	0	0.200001	0.199999	0.199999	0.2	0.500001	0.199999			0.2																				1024.000015	1023.999371	43.132807	0	0.2	0.199999	0.2	0.199999	0.2	0	0.2	0	0.200001	0.199999	0.199999	0.2	0.500001	0.199999			0.2																				22.255	0.717053	1.821176964	0	0.9907046	1.955247424	0.7061078	4.347092664	11.1743064	0	6.0421438	0	0.076243981	3.442172589	6.484593977	14.8051618	0.233910968	1.250107349	0	0	4.4192132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.7203	0	0	22.255	0.717053	1.821176964	0	0.9907046	1.955247424	0.7061078	4.347092664	11.1743064	0	6.0421438	0	0.076243981	3.442172589	6.484593977	14.8051618	0.233910968	1.250107349	0	0	4.4192132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.7203		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4728	0.0797	0.2024		0.6281	1.2396	0.4477	0.8188	2.1422		1.1479		0.0144	0.6484	1.3	2.9681	0.0469	0.2506			0.8859																				15.2933	0	0	24.7278	0.796725	2.023529964	0	1.6187986	3.194855424	1.1537708	5.165915664	13.3165194	0	7.1900368	0	0.090604981	4.090544589	7.784593977	17.7732148	0.280804968	1.500722349	0	0	5.3051522	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.0136
H1510_807_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		260.801211	8.40297	506.670562	724.147026	4.953523	9.776286	3.530539	21.735572	55.871532	624.359143	30.210719	0	0.381218	17.210949	32.423132	74.025809	0.467821	6.250568			22.096066																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000015	1023.999371	43.132807	0	0.2	0.199999	0.2	0.199999	0.2	0	0.2	0	0.200001	0.199999	0.199999	0.2	0.500001	0.199999			0.2																				1024.000015	1023.999371	43.132807	0	0.2	0.199999	0.2	0.199999	0.2	0	0.2	0	0.200001	0.199999	0.199999	0.2	0.500001	0.199999			0.2																				22.255	0.717053	1.821176964	0	0.9907046	1.955247424	0.7061078	4.347092664	11.1743064	0	6.0421438	0	0.076243981	3.442172589	6.484593977	14.8051618	0.233910968	1.250107349	0	0	4.4192132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.7203	0	0	22.255	0.717053	1.821176964	0	0.9907046	1.955247424	0.7061078	4.347092664	11.1743064	0	6.0421438	0	0.076243981	3.442172589	6.484593977	14.8051618	0.233910968	1.250107349	0	0	4.4192132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.7203		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4728	0.0797	0.2024		0.6281	1.2396	0.4477	0.8188	2.1422		1.1479		0.0144	0.6484	1.3	2.9681	0.0469	0.2506			0.8859																				15.2933	0	0	24.7278	0.796725	2.023529964	0	1.6187986	3.194855424	1.1537708	5.165915664	13.3165194	0	7.1900368	0	0.090604981	4.090544589	7.784593977	17.7732148	0.280804968	1.500722349	0	0	5.3051522	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.0136
H1510_808_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		260.801211	8.40297	506.670562	724.147026	4.953523	9.776286	3.530539	21.735572	55.871532	624.359143	30.210719	0	0.381218	17.210949	32.423132	74.025809	0.467821	6.250568			22.096066																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000015	1023.999371	43.132807	0	0.2	0.199999	0.2	0.199999	0.2	0	0.2	0	0.200001	0.199999	0.199999	0.2	0.500001	0.199999			0.2																				1024.000015	1023.999371	43.132807	0	0.2	0.199999	0.2	0.199999	0.2	0	0.2	0	0.200001	0.199999	0.199999	0.2	0.500001	0.199999			0.2																				22.255	0.717053	1.821176964	0	0.9907046	1.955247424	0.7061078	4.347092664	11.1743064	0	6.0421438	0	0.076243981	3.442172589	6.484593977	14.8051618	0.233910968	1.250107349	0	0	4.4192132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.7203	0	0	22.255	0.717053	1.821176964	0	0.9907046	1.955247424	0.7061078	4.347092664	11.1743064	0	6.0421438	0	0.076243981	3.442172589	6.484593977	14.8051618	0.233910968	1.250107349	0	0	4.4192132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.7203		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4728	0.0797	0.2024		0.6281	1.2396	0.4477	0.8188	2.1422		1.1479		0.0144	0.6484	1.3	2.9681	0.0469	0.2506			0.8859																				15.2933	0	0	24.7278	0.796725	2.023529964	0	1.6187986	3.194855424	1.1537708	5.165915664	13.3165194	0	7.1900368	0	0.090604981	4.090544589	7.784593977	17.7732148	0.280804968	1.500722349	0	0	5.3051522	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.0136
H1511_001_0	2009	7	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		CORF	Partial Hospitalization	Ambulatory Surgical Center	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemo/Radiation	A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	0	Coin	0	0	0	V	V	V	V	0	0	V	V	V	V	V	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		398.8141217	8.256096737	870.6327802	750.76363	382.5923796	13.90508969	1.397001845	413.0529223	280.0620894	5491.137403	919.7924096	134.9290611	0.061307404	153.6319517	4341.899353	3829.678886	69.46295185	1564.265244	2936.891982	0	40.39417728	0	0	0	365.5917243	343.1752547	185.934419	0	0	0	0.044708105	0.670621576	127.7570628	201.2600263	482.2577077	78.77984583	0.533852276	777.1130032	32.42118375	13.70898805	$750/admt w/$1500 yrly max	$750/admt w/$1500 yrly max	$100/day (for days 21-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$200 copay	$0 copay	$75/$125 copay for Lower/Higher Tier	$200 copay	20% coinsurance	$30 copay	$15 coapy	$30 copay	$35 copay	$30 copay	$75/$125 copay for Lower/Higher Tier	0	20% coinsurance	0	0	0	$30 copay 1/yr $50 limit	$30 copay/ Covd up to $75 1 every yr.	$30 copay 1/yr $50 limit	Silver Sneakers	0	0	$30 copay	$35 copay	$200 copay	$30 copay	$30 copay	$0 copay	20% coinsurance	$30 copay	$30 copay	20% coinsurance	750	750	100	0	100	0.2	0.2	50	200	0	92.07500412	200	0.2	30	15	30	35	30	79.61600459	0	0.2	0	0	0	30	30	30	0	0	0	30	35	200	30	30	0	0.2	30	30	0.2	572.4577761	459.5641633	91.27423685	0	91.27423685	0.182548474	0.182548474	45.63711842	182.5484737	0	84.04075734	182.5484737	0.182548474	27.38227105	13.69113553	27.38227105	31.9459829	27.38227105	72.6689006	0	0.182548474	0	0	0	27.38227105	27.38227105	27.38227105	0	0	0	27.38227105	31.9459829	182.5484737	27.38227105	27.38227105	0	0.182548474	27.38227105	27.38227105	0.182548474	19.0254	0.316183849	6.622195216	0	2.910068956	2.5383529	0.255020555	1.570878761	4.260408914	0	6.441670891	2.05259118	0.011191573	0.350565979	4.953794374	8.738775443	0.184921856	3.569427908	17.78505929	0	7.373895409	0	0	0	0.834227641	0.783076487	0.424275555	0	0	0	0.000102017	0.001785305	1.943488069	0.459246383	1.100442606	0	0.097453918	1.773259908	0.07398047	2.502554845	98.9543		9.46	19.0254	0.316183849	6.622195216	0	2.910068956	2.5383529	0.255020555	1.570878761	4.260408914	0	6.441670891	2.05259118	0.011191573	0.350565979	4.953794374	8.738775443	0.184921856	3.569427908	17.78505929	0	7.373895409	0	0	0	0.834227641	0.783076487	0.424275555	0	0	0	0.000102017	0.001785305	1.943488069	0.459246383	1.100442606	0	0.097453918	1.773259908	0.07398047	2.502554845	98.9543	3500																																																																																	0		0	19.0254	0.316183849	6.622195216	0	2.910068956	2.5383529	0.255020555	1.570878761	4.260408914	0	6.441670891	2.05259118	0.011191573	0.350565979	4.953794374	8.738775443	0.184921856	3.569427908	17.78505929	0	7.373895409	0	0	0	0.834227641	0.783076487	0.424275555	0	0	0	0.000102017	0.001785305	1.943488069	0.459246383	1.100442606	0	0.097453918	1.773259908	0.07398047	2.502554845	98.9543
H1511_005_0	2009	8	H.6	H.7	I.7	I.8	I.9	I.10	I.11	I.12	I.13		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional	0		CORF	Partial Hospitalization	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemo/Radiation	0	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	0	Coin	0	0	0	V	V	V	0	V	0	V	V	V	V	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1465.252231	49.13998408	417.4911919	405.3502892	224.100283	9.952133388	1.265724458	332.2333402	433.9246139	4695.287652	939.5307557	124.2329422	0	171.7918947	4082.115145	3214.578676	20.76957788	1226.926867	2732.44251	0	35.01877298	0	0	0	365.8580112	343.1752547	185.934419	0	0	0	0	0.395226752	208.5888529	426.1645834	110.3427055	0.523466057	825.6762094	24.82385954	9.582661504	0	$240/day w/$2400 yrly max	$240/day w/$2400 yrly max	$100/day (for days 21-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$200 copay	$0 copay	$75/$125 copay for Lower/Higher Tier	$200 copay	20% coinsurance	$30 copay	$15 coapy	$30 copay	$35 copay	$30 copay	$75/$125 copay for Lower/Higher Tier	0	20% coinsurance	0	0	0	$30 copay	$30 copay/ Covd up to $75 1 every yr.	$30 copay	0	Silver Sneakers	0	$30 copay	$35 copay	$30 copay	$30 copay	$0 copay	20% coinsurance	$30 copay	$30 copay	20% coinsurance	0	240	240	75	0	100	0.2	0.2	50	200	0	90.79238781	200	0.2	30	15	30	35	30	80.66216003	0	0.2	0	0	0	30	30	30	0	0	0	30	35	30	30	0	0.2	30	30	0.2	0	156.9601798	109.9607244	69.46216676	0	92.61622234	0.185232445	0.185232445	46.30811117	185.2324447	0	84.08847976	185.2324447	0	27.7848667	13.89243335	27.7848667	32.41567782	27.7848667	74.70624548	0	0.185232445	0	0	0	27.7848667	27.7848667	27.7848667	0	0	0	0	32.41567782	27.7848667	27.7848667	0	0.185232445	27.7848667	27.7848667	0.185232445	0	19.1655	0.450289021	2.416653566	0	1.729610136	1.843457997	0.234453236	1.282091538	6.698076419	0	6.583642745	1.9176643	0	0.397767908	4.725876048	7.443053334	0.056104995	2.840833287	17.01087674	0	6.48661293	0	0	0	0.847109673	0.794589892	0.430513587	0	0	0	0	0.001067629	0.482967789	0.986743845	0	0.096962897	1.911775285	0.057477302	1.775019817	0	88.6668		7.0689	19.1655	0.450289021	2.416653566	0	1.729610136	1.843457997	0.234453236	1.282091538	6.698076419	0	6.583642745	1.9176643	0	0.397767908	4.725876048	7.443053334	0.056104995	2.840833287	17.01087674	0	6.48661293	0	0	0	0.847109673	0.794589892	0.430513587	0	0	0	0	0.001067629	0.482967789	0.986743845	0	0.096962897	1.911775285	0.057477302	1.775019817	0	88.6668	3500																																																																																	0		0	19.1655	0.450289021	2.416653566	0	1.729610136	1.843457997	0.234453236	1.282091538	6.698076419	0	6.583642745	1.9176643	0	0.397767908	4.725876048	7.443053334	0.056104995	2.840833287	17.01087674	0	6.48661293	0	0	0	0.847109673	0.794589892	0.430513587	0	0	0	0	0.001067629	0.482967789	0.986743845	0	0.096962897	1.911775285	0.057477302	1.775019817	0	88.6668
H1511_801_0	2009	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	V																																																			0		150.623175	1.803457278	7.388182656	2.767771644	3.129020913	7.889005842	0	7.813985674	25.00205103	14.24930727	38.49042048	0	0.322878252	37.87608719	14.00412378	37.95681269	0.431828887	1.453237447	9.437490761	12.49702096	22.59170198	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.077426338	0.077426338	0.194112944	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.077426338	0.077426338	0.194112944	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			11.6622	0.139635092	1.434141885	0	0.722803831	1.822360349	0	1.805030691	5.775473788	3.29158998	8.891287131	0	0.074584876	8.74937614	3.234952593	8.768023732	0.099752473	0.33569785	2.180060366	2.886811842	5.218683157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.0925			11.6622	0.139635092	1.434141885	0	0.722803831	1.822360349	0	1.805030691	5.775473788	3.29158998	8.891287131	0	0.074584876	8.74937614	3.234952593	8.768023732	0.099752473	0.33569785	2.180060366	2.886811842	5.218683157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.0925																																																																																		0			11.6622	0.139635092	1.434141885	0	0.722803831	1.822360349	0	1.805030691	5.775473788	3.29158998	8.891287131	0	0.074584876	8.74937614	3.234952593	8.768023732	0.099752473	0.33569785	2.180060366	2.886811842	5.218683157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.0925
H1511_803_0	2009	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	V																																																			0		157.7860601	1.889220689	7.870127576	2.948318545	3.333132776	7.975217946	0	8.323706518	25.1871243	14.78136723	39.927628	0	0.334934318	39.2903559	13.72205965	37.19230536	0.423131204	1.423967057	9.247405494	12.24531215	23.92995931	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.077426338	0.077426338	0.194112944	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.077426338	0.077426338	0.194112944	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			12.2168	0.146275439	1.527693632	0	0.769953671	1.842275346	0	1.922776206	5.818225714	3.41449583	9.223282068	0	0.077369827	9.076072212	3.16979578	8.591422538	0.097743308	0.32893639	2.136150669	2.828667106	5.527820602	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7158			12.2168	0.146275439	1.527693632	0	0.769953671	1.842275346	0	1.922776206	5.818225714	3.41449583	9.223282068	0	0.077369827	9.076072212	3.16979578	8.591422538	0.097743308	0.32893639	2.136150669	2.828667106	5.527820602	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7158																																																																																		0			12.2168	0.146275439	1.527693632	0	0.769953671	1.842275346	0	1.922776206	5.818225714	3.41449583	9.223282068	0	0.077369827	9.076072212	3.16979578	8.591422538	0.097743308	0.32893639	2.136150669	2.828667106	5.527820602	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7158
H1511_804_0	2009	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	V																																																			0		157.7860601	1.889220689	7.870127576	2.948318545	3.333132776	7.975217946	0	8.323706518	25.1871243	14.78136723	39.927628	0	0.334934318	39.2903559	13.72205965	37.19230536	0.423131204	1.423967057	9.247405494	12.24531215	23.92995931	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.077426338	0.077426338	0.194112944	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.077426338	0.077426338	0.194112944	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			12.2168	0.146275439	1.527693632	0	0.769953671	1.842275346	0	1.922776206	5.818225714	3.41449583	9.223282068	0	0.077369827	9.076072212	3.16979578	8.591422538	0.097743308	0.32893639	2.136150669	2.828667106	5.527820602	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7158			12.2168	0.146275439	1.527693632	0	0.769953671	1.842275346	0	1.922776206	5.818225714	3.41449583	9.223282068	0	0.077369827	9.076072212	3.16979578	8.591422538	0.097743308	0.32893639	2.136150669	2.828667106	5.527820602	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7158																																																																																		0			12.2168	0.146275439	1.527693632	0	0.769953671	1.842275346	0	1.922776206	5.818225714	3.41449583	9.223282068	0	0.077369827	9.076072212	3.16979578	8.591422538	0.097743308	0.32893639	2.136150669	2.828667106	5.527820602	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7158
H1517_001_0	2009	9	H.6	H.7	I.7	I.8	I.9	I.10	I.11	I.12	I.13	I.14	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional	Professional		CORF	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies\Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Partial Hosp	Chemo/Radiation	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	0	Coin	0	0	0	V	V	V	0	V	0	V	V	V	V	V	Coin	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	0	0	0	0	0	0	0	0	0		1181.001995	72.2147061	519.4076377	385.0703428	91.6513137	9.097331198	1.789022323	279.4395149	369.1472243	4276.110187	765.2067615	118.6384457	0.023798246	96.8843262	3059.42638	2923.800956	25.45493425	1102.057441	2002.521562	0	33.96151299	0	0	0	301.0780768	276.076979	149.5801692	0	0	0	0	0.004931279	161.9540143	338.2891911	99.11939675	0.4603431	636.7536247	26.32858976	1.345615642	16.27136311	$220/day (days 1-10) w/$2200 yrly max	$220/day (days 1-10) w/$2200 yrly max	$100/day (for days 21-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$200 copay	$0 copay	$75/$125 copay for Lower/Higher Tier	$200 copay	20% coinsurance	$0 copay	$15 coapy	$30 copay	$35 copay	$30 copay	$125/$75 copay for Lower/Higher Tier	0	20% coinsurance	0	0	0	$30 copay	$30 copay / Covd up to $75	$30 copay/ $50 limit	0	Foreever Fit	0	$30 copay	$0 copay	$30 copay	$30 copay	$0 copay	20% coinsurance	$30 copay	$30 copay	$35 copay	20% coinsurance	220	220	100	0	100	0.2	0.2	50	200	0	92.27725674	200	0.2	0	15	30	35	30	80.68445476	0	0.2	0	0	0	30	30	30	0	0	0	30	0	30	30	0	0.2	30	30	35	0.2	135.2058647	88.72138135	91.44777463	0	91.44777463	0.182895549	0.182895549	45.72388731	182.8955493	0	84.38549778	182.8955493	0.182895549	0	13.71716619	27.43433239	32.00672112	27.43433239	73.78413835	0	0.182895549	0	0	0	27.43433239	27.43433239	27.43433239	0	0	0	0	0	27.43433239	27.43433239	0	0.182895549	27.43433239	27.43433239	32.00672112	0.182895549	13.3065	0.533915707	3.958222716	0	0.69844239	1.663861386	0.32720422	1.064755074	5.626282029	0	5.381029456	1.808203641	0.004352593	0	3.497221676	6.684377271	0.067894082	2.519517513	12.31286067	0	6.211409572	0	0	0	0.688323003	0.631165634	0.34196934	0	0	0	0	0	0.370258355	0.773394843	0	0.084194704	1.455742549	0.060192274	0.003589062	2.975959892	73.0509		6.8317	13.3065	0.533915707	3.958222716	0	0.69844239	1.663861386	0.32720422	1.064755074	5.626282029	0	5.381029456	1.808203641	0.004352593	0	3.497221676	6.684377271	0.067894082	2.519517513	12.31286067	0	6.211409572	0	0	0	0.688323003	0.631165634	0.34196934	0	0	0	0	0	0.370258355	0.773394843	0	0.084194704	1.455742549	0.060192274	0.003589062	2.975959892	73.0509	4500	$300/day (Days 1-10)	$300/day (Days 1-10)	25% Coinsurance	$0 copay	$100 copay	30% Coinsurance	30% Coinsurance	$50 copay	$275 copay	$0 copay	25% Coinsurance	$275 copay	20% Coinsurance	$0 copay	$20 copay	$40 copay	$45 copay	$40 copay	25% Coinsurance		20% Coinsurance				$40 copay / $50 limit	$40 copay / Covd up to $75	$40 copay / $50 limit		Forever Fit		$40 copay	$40 copay	$40 copay	$40 copay	$0 copay	30% Coinsurance	$40 copay	$40 copay	$45 copay	20% coinsurance	5.6194	0.1231	0.8478		0.8871	0.3646	0.0117	0.2	1.1092		1.0209	0.4042			0.9759	1.3954	0.0235	0.3681	2.8824		0.7938				0.2349	0.2045	0.1108					0	0.872	0.3021		0.2159	0.2084	0.0162		0.3193	19.5112		1.824696218	18.926	0.656969262	4.806054904	0	1.585585171	2.028435673	0.338922651	1.264717103	6.73547311	0	6.401904554	2.212400391	0.004352593	0	4.473112095	8.079758941	0.091424951	2.88760542	15.1952677	0	7.005193387	0	0	0	0.923204982	0.835698567	0.452786515	0	0	0	0	2.03E-06	1.242287596	1.075536451	0	0.300095258	1.664139328	0.076378431	0.003589062	3.295224565	92.5621
H1517_801_0	2009	4																					none											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	V											0	0	0	0	0	0	0	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	234.1995736	2.547503676	42.64514576	24.24115755	6.435053397	12.81577212	3.630654396	7.935550012	27.43799791	5.287447946	19.79981607	0	0.161075438	30.50652406	28.68853839	85.43302372	0.818427623	3.872789058	19.11175999	26.54467039	8.903601867	0.953106955	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.080788383	0.080788383	0.198610557	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.080788383	0.080788383	0.198610557	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											18.9206	0.205808703	8.469776164	0	1.486497335	2.960443359	0.838681165	1.833112053	6.338177517	1.221400476	4.573757511	0	0.037208426	7.047007058	6.627052369	19.73502848	0.189056781	0.894614272	4.414816558	6.131818861	2.056732031	0.220167707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.2018	0	0	18.9206	0.205808703	8.469776164	0	1.486497335	2.960443359	0.838681165	1.833112053	6.338177517	1.221400476	4.573757511	0	0.037208426	7.047007058	6.627052369	19.73502848	0.189056781	0.894614272	4.414816558	6.131818861	2.056732031	0.220167707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.2018	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											5.2425	0.057	2.3077	0	0.3822	0.7624	0.216	0.5075	1.9902	0.3646	1.1415	0	0.0128	1.5291	2.1189	6.0786	0.0639	0.3056	1.6186	1.9194	0.4444	0.0478	0	0	0	0	0	0	0	0											27.1105	0	0	24.1631	0.262834179	10.77748074	0	1.868689606	3.722801556	1.05465404	2.340570228	8.32838648	1.586017716	5.715291745	0	0.050009742	8.576090043	8.745906113	25.81357897	0.252986181	1.200187589	6.033369729	8.051187106	2.501129659	0.267993023	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.3123
H1517_802_0	2009	4																					none											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	V											0	0	0	0	0	0	0	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	234.1995736	2.547503676	42.64514576	24.24115755	6.435053397	12.81577212	3.630654396	7.935550012	27.43799791	5.287447946	19.79981607	0	0.161075438	30.50652406	28.68853839	85.43302372	0.818427623	3.872789058	19.11175999	26.54467039	8.903601867	0.953106955	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.080788383	0.080788383	0.198610557	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.080788383	0.080788383	0.198610557	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											18.9206	0.205808703	8.469776164	0	1.486497335	2.960443359	0.838681165	1.833112053	6.338177517	1.221400476	4.573757511	0	0.037208426	7.047007058	6.627052369	19.73502848	0.189056781	0.894614272	4.414816558	6.131818861	2.056732031	0.220167707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.2018	0	0	18.9206	0.205808703	8.469776164	0	1.486497335	2.960443359	0.838681165	1.833112053	6.338177517	1.221400476	4.573757511	0	0.037208426	7.047007058	6.627052369	19.73502848	0.189056781	0.894614272	4.414816558	6.131818861	2.056732031	0.220167707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.2018	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											5.2425	0.057	2.3077	0	0.3822	0.7624	0.216	0.5075	1.9902	0.3646	1.1415	0	0.0128	1.5291	2.1189	6.0786	0.0639	0.3056	1.6186	1.9194	0.4444	0.0478	0	0	0	0	0	0	0	0											27.1105	0	0	24.1631	0.262834179	10.77748074	0	1.868689606	3.722801556	1.05465404	2.340570228	8.32838648	1.586017716	5.715291745	0	0.050009742	8.576090043	8.745906113	25.81357897	0.252986181	1.200187589	6.033369729	8.051187106	2.501129659	0.267993023	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.3123
H1517_803_0	2009	4																					none											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	V											0	0	0	0	0	0	0	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	234.1995736	2.547503676	42.64514576	24.24115755	6.435053397	12.81577212	3.630654396	7.935550012	27.43799791	5.287447946	19.79981607	0	0.161075438	30.50652406	28.68853839	85.43302372	0.818427623	3.872789058	19.11175999	26.54467039	8.903601867	0.953106955	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.080788383	0.080788383	0.198610557	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.080788383	0.080788383	0.198610557	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											18.9206	0.205808703	8.469776164	0	1.486497335	2.960443359	0.838681165	1.833112053	6.338177517	1.221400476	4.573757511	0	0.037208426	7.047007058	6.627052369	19.73502848	0.189056781	0.894614272	4.414816558	6.131818861	2.056732031	0.220167707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.2018	0	0	18.9206	0.205808703	8.469776164	0	1.486497335	2.960443359	0.838681165	1.833112053	6.338177517	1.221400476	4.573757511	0	0.037208426	7.047007058	6.627052369	19.73502848	0.189056781	0.894614272	4.414816558	6.131818861	2.056732031	0.220167707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.2018	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											5.2425	0.057	2.3077	0	0.3822	0.7624	0.216	0.5075	1.9902	0.3646	1.1415	0	0.0128	1.5291	2.1189	6.0786	0.0639	0.3056	1.6186	1.9194	0.4444	0.0478	0	0	0	0	0	0	0	0											27.1105	0	0	24.1631	0.262834179	10.77748074	0	1.868689606	3.722801556	1.05465404	2.340570228	8.32838648	1.586017716	5.715291745	0	0.050009742	8.576090043	8.745906113	25.81357897	0.252986181	1.200187589	6.033369729	8.051187106	2.501129659	0.267993023	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.3123
H1607_001_0	2009	10	H.6	H.7	I.7	I.8	I.9	I.10	I.11	I.12	I.13	I.14	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional	Professional		CORF	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies\Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Partial Hosp	Chemo/Radiation	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	0	Coin	0	0	0	V	V	V	0	V	0	V	V	V	V	V	Coin	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	0	0	0	0	0	0	0	0	0		1035.038923	65.08760515	568.1878424	170.1943018	35.09290029	11.00680349	1.964557583	259.9179056	268.8039157	3391.026547	744.5783005	242.7766812	0.003347188	66.43934874	2562.112223	2753.789927	30.94577815	1188.860931	1443.500873	0	47.73583882	0	0	0	240.5883645	226.0737886	122.4881396	0	0	0	0	0.003699087	291.1369239	220.3948127	91.04409491	0.498115529	532.5544537	24.40142612	9.025950199	8.710000045	$220/day (days 1-10) w/$2200 yrly max	$220/day (days 1-10) w/$2200 yrly max	$100/day (for days 21-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$200 copay	$0 copay	$75/$125 copay for Lower/Higher Tier	$200 copay	20% coinsurance	$0 copay	$15 coapy	$30 copay	$35 copay	$30 copay	$75/$125 copay for Lower/Higher Tier	0	20% coinsurance	0	0	0	$30 copay/ $50 limit	$30 copay / Covd up to $75	$30 copay/ $50 limit	0	Silver Sneakers	0	$30 copay	$0 copay	$30 copay	$30 copay	$0 copay	20% coinsurance	$30 copay	$30 copay	$35 copay	20% coinsurance	220	220	100	0	100	0.2	0.2	50	200	0	92.2112016	200	0.2	0	15	30	35	30	79.89677716	0	0.2	0	0	0	30	30	30	0	0	0	30	0	30	30	0	0.2	30	30	35	0.2	137.8643502	132.0272079	91.66823796	0	91.66823796	0.183336476	0.183336476	45.83411898	183.3364759	0	84.52838371	183.3364759	0.183336476	0	13.75023569	27.50047139	32.08388329	27.50047139	73.23996781	0	0.183336476	0	0	0	27.50047139	27.50047139	27.50047139	0	0	0	0	0	27.50047139	27.50047139	0	0.183336476	27.50047139	27.50047139	32.08388329	0.183336476	11.8912	0.716111231	4.340398195	0	0.268075361	2.017948564	0.360175064	0.992759017	4.106796884	0	5.244833357	3.709151764	0.000613662	0	2.935803912	6.310876757	0.082738395	2.724519668	8.810163123	0	8.751720465	0	0	0	0.551357786	0.518094646	0.280706798	0	0	0	0	0	0.66720022	0.505080103	0	0.091322746	1.22045821	0.055920893	0.024132294	1.596860713	68.7751		6.251	11.8912	0.716111231	4.340398195	0	0.268075361	2.017948564	0.360175064	0.992759017	4.106796884	0	5.244833357	3.709151764	0.000613662	0	2.935803912	6.310876757	0.082738395	2.724519668	8.810163123	0	8.751720465	0	0	0	0.551357786	0.518094646	0.280706798	0	0	0	0	0	0.66720022	0.505080103	0	0.091322746	1.22045821	0.055920893	0.024132294	1.596860713	68.7751	4500	$300/day (Days 1-10)	$300/day (Days 1-10)	25% Coinsurance	$0 copay	$100 copay	30% Coinsurance	30% Coinsurance	$50 copay	$275 copay	$0 copay	25% Coinsurance	$275 copay	20% Coinsurance	$0 copay	$20 copay	$40 copay	$45 copay	$40 copay	25% Coinsurance		20% Coinsurance				$40 copay / $50 limit	$40 copay / Covd up to $75	$40 copay / $50 limit		Silver Sneakers		$40 copay	$40 copay	$40 copay	$40 copay	$0 copay	30% Coinsurance	$40 copay	$40 copay	$45 copay	20% coinsurance	9.2426	0.0111	1.372		1.1916	0.5239	0.0278	0.2744	2.9632		1.5077	0.1346			1.4646	2.4787	0.0672	0.5998	4.6167		1.6947				0.3848	0.3578	0.1939					0	1.0555	0.1669		0.4538	0.4094	0.0199		0.5327	31.7451		2.88532359	21.1338	0.727241056	5.712402508	0	1.459635951	2.54182292	0.38796744	1.267127761	7.069951119	0	6.752507115	3.843762419	0.000613662	0	4.400371015	8.789587388	0.149895165	3.324340465	13.42690842	0	10.44643148	0	0	0	0.936137693	0.875910815	0.474573753	0	0	0	0	4.27E-06	1.722671409	0.671942544	0	0.545144245	1.629859323	0.075793926	0.024132294	2.129584286	100.5202
H1608_001_0	2009	12																					2000											D	D	D	V	T	COIN	COIN	V	V	COIN	COIN	COIN	COIN	COIN	P	P	P	P	P	P	COIN	V	T	V	V	V	V	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	5000	859.9606524	34.23419743	297.9008439	0	125.6679064	0	11.67154786	278.3507198	566.3032678	14.04153022	19.26402184	0.824958192	0.018061331	5.119853121	6051.636799	16638.76039	174.7718505	2654.26265	0	0	2.040463284	0	0	0	128.303666	0	0	0	0	0											1a $600 per stay	1b $600 per stay	2 $75 days 7-26	6 $0	10a $150	11a 30%	11b 30%; 11c 10%	4a $50	"9a $100,9b $100"	8a 20% Diagnostic	8b 20%	9a 20%	12 20%	3 $0; 4b $50; 5 $50; 9a 20%; 9d 20%; 13a $0; 14b $0	7a $10; 14d - j $0	7b $20; 7d $30; 7f $30; 7g $30; 14c $10; 14d - j $0; 17a $30	7e $30; 7h $30; 9c $30	7c $25; 7i $25	14h $0	7g $30	15 20%			16a 50%; 16b $30	17a $30	17b $0	18a $30	18b $0	14a $0	14b $0											110.1338432	110.1338432	35.68239796	0	104.2603844	0	0.3	50	97.36524006	0.049787957	0.196181829	0.2	0.2	0.177021394	5.778896041	8.9069988	30	25	0	0	0.283313441	0	0	0	29.86276526	0	0	0	0	0											87.9121779	87.9121779	28.48277356	0	83.22380477	0	0.23946911	39.91151827	77.71989114	0.039742259	0.156598293	0.159646073	0.2	0.141303852	5.778896041	8.595541086	23.94691096	19.95575913	0	0	0.226149391	0	0	0	29.86276526	0	0	0	0	0											6.3001	0.250800238	0.707086857	0	0.871546776	0	2.794975174	0.92578332	3.66775236	0.558042133	3.016712939	0.131701336	0.003612266	0.72345497	2.914314995	11.91826238	0.348770495	4.41398551	0	0	0.46144953	0	0	0	0.319291855	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3276	0	6.7946	6.3001	0.250800238	0.707086857	0	0.871546776	0	2.794975174	0.92578332	3.66775236	0.558042133	3.016712939	0.131701336	0.003612266	0.72345497	2.914314995	11.91826238	0.348770495	4.41398551	0	0	0.46144953	0	0	0	0.319291855	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3276	0	0.2	0.2	0.2	0.2	150	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			0.5	0.2		0.2			0.2											3.9211	0.0246	0.1794	0.1904	0.394	0	0.3374	0.0901	0.6252	0.3032	0.3523	0.1085	0.0002	0.1324	0.5108	2.4224	0.049	0.0715	0.7071	0.4439	0.0845	0	0	0.2408	0.0055	0.1023	0	0	0	0.0001											11.2967	0	0	10.2212	0.275439923	0.886504433	0.190376148	1.265572973	0	3.132333416	1.015897203	4.292952299	0.861220496	3.36897629	0.24021794	0.003800654	0.855831561	3.425087324	14.34067669	0.397802946	4.485483067	0.70714476	0.443915642	0.545953068	0	0	0.24076092	0.324794825	0.102333587	0	0	0	5.15E-05	0	0	0	0	0	0	0	0	0	0	51.6243
H1608_002_0	2009	10																					2000											D	D	D	V	T	COIN	COIN	V	V	COIN	COIN	COIN	COIN	COIN	P	P	P	P	P	P	COIN	V	T	V	V	V	V	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	5000	1070.726294	35.9572263	422.497409	0	191.8975219	0	14.05815099	347.093332	687.8949419	15.87575015	22.11876635	1.424321302	0.015117019	6.894918198	0	19017.07104	159.1716396	2143.826605	0	0	4.062465394	0	0	0	132.3954984	0	0	0	0	0											1a $250 per stay	1b $250 per stay	2 $100 days 16-36	6 $0	10a $150	11a 10%	11b 10%; 11c 10%	4a $50	9a $100; 9b $100	8a 10% Diagnostic	8b 10%	9a 10%	12 10%	3 $0; 4b $50; 5 $50; 9a 10%; 9d 10%; 13a $0; 14b $0	7a $0; 14d - j $0	7b $0; 7d $0; 7f $0; 7g $0; 14c $0; 14d - j $0; 17a $10	7e $10; 7h $10; 9c $10	7c $10; 7i $10	14h $0	7g $0	15 10%			16a $50 ded; 16b $50 ded 50% - 80%	17a $10	17b $0	18a $10	18b $0	14a $0	14b $0											45.88910134	45.88910134	23.85204082	0	105.7377049	0	0.1	50	97.40853659	0.022318399	0.098452299	0.1	0.1	0.088832868	0	0.504405956	10	10	0	0	0.123021378	0	0	0	10	0	0	0	0	0											41.12309278	41.12309278	21.37478527	0	94.7558641	0	0.089614073	44.80703651	87.2917571	0.020000426	0.088227115	0.089614073	0.1	0.079606751	0	0.481253438	8.961407302	9.482866856	0	0	0.110396411	0	0	0	8.961407302	0	0	0	0	0											3.6693	0.123222696	0.75256595	0	1.515284625	0	1.259808169	1.296018633	5.003963182	0.317521773	1.951474949	0.127639233	0.001511702	0.548882038	0	0.762669234	0.118866824	1.694135188	0	0	0.448481598	0	0	0	0.098870832	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.6902	0	2.1255	3.6693	0.123222696	0.75256595	0	1.515284625	0	1.259808169	1.296018633	5.003963182	0.317521773	1.951474949	0.127639233	0.001511702	0.548882038	0	0.762669234	0.118866824	1.694135188	0	0	0.448481598	0	0	0	0.098870832	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.6902	0	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			16a $50 ded; 16b $50 ded 10% - 80%	0.1		0.1			0.1											1.7955	0.022	0.1386	0.1053	0.1892	0	0.1769	0.1607	0.3988	0.1764	0.242	0.0158	0.0002	0.0805	0.325	0.9757	0.0173	0.061	0.3757	0.3201	0.0451	0	0	0	0.0036	0.0174	0	0	0	0											5.6429	0	0	5.4648	0.145191477	0.891176279	0.105338737	1.70445021	0	1.436670077	1.456709991	5.40273844	0.493918997	2.193435327	0.143465025	0.001679669	0.629401279	0.325032096	1.738374556	0.13621236	1.755162554	0.375691036	0.320096072	0.493620102	0	0	0	0.102447491	0.01744822	0	0	0	4.59E-05	0	0	0	0	0	0	0	0	0	0	25.3331
H1608_003_0	2009	10																					0											D	D	D	COIN	T	COIN	COIN	V	V	O	COIN	O	COIN	O	P	P	P	P	P	P	COIN	V	T	V	V	V	V	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	1399.024455	46.98216455	552.0404334	12.38732278	250.7357179	0	18.36855706	453.5165171	898.8121909	0	28.90065857	78.78308076	0.019752088	1050.21272	9061.698913	24847.94443	207.9756681	2801.150831	0	28067.79215	5.308068427	0	0	0	172.9896249	0	0	0	0	0											1a $180 days 1-10	1b $180 days 1-10	2 $100 days 7-26	6 20%	10a $150	11a 20%	11b 20%; 11c 20%	4a $50	9a $100; 9b $100	8a $0	8b 20% Therapeutic $100 Diagnostic	9a $100	12 20%	3 $30; 4b $50; 5 $100; 9d $35; 13a $0; 14b $0	7a $10; 14d - j $0	7b $10; 7d $10; 7f $10; 7g $10; 14c $10; 14d - j $0; 17a $10	7e $30; 7h $30; 9c $30	7c $30; 7i $30	14h $0	7g $10	15 20%			16a 50%; 16b $10	17a $10	17b $0	18a $10	18b $0	14a $0	14b $0											160.2963671	160.2963671	47.57653061	0.2	105.7377049	0	0.2	50	32.14481707	0	0.308846568	75	0.2	5.485975212	4.302378428	2.604900417	30	15	0	0.143793407	0.246042756	0	0	0	10	0	0	0	0	0											115.5430116	115.5430116	34.29357586	0.144161734	76.21665469	0	0.144161734	36.04043362	23.17026292	0	0.222619284	54.06065042	0.2	3.954338509	4.302378428	2.603820701	28.94957718	13.02356348	0	0.143793407	0.177349752	0	0	0	10	0	0	0	0	0											13.4706	0.452371732	1.57762004	1.785777938	1.592519803	0	2.648043045	1.362077661	1.735476231	0	6.433843927	0.354922049	0.003950418	0.346074717	3.248904827	5.391632675	0.501733971	3.040080471	0	0.336330288	0.941384619	0	0	0	0.144158021	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.3675	0	13.1478	13.4706	0.452371732	1.57762004	1.785777938	1.592519803	0	2.648043045	1.362077661	1.735476231	0	6.433843927	0.354922049	0.003950418	0.346074717	3.248904827	5.391632675	0.501733971	3.040080471	0	0.336330288	0.941384619	0	0	0	0.144158021	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.3675	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			0.5	0.2		0.2			0.2											4.5076	0.0864	0.348	0.2644	0.2391	0	0.3921	0.2017	1.0011	0.4428	0.617	0.0397	0.0004	0.197	0.8413	2.4843	0.0448	0.1562	0.9432	0.8036	0.1133	0	0	0.0652	0.0093	0.057	0	0	0.0643	0.0001											13.92	0	0.5	17.9782	0.538724125	1.925593346	2.050224814	1.831580936	0	3.040178425	1.563780893	2.736578713	0.442835144	7.050820573	0.394651795	0.004389353	0.543033977	4.090247796	7.875944411	0.546574155	3.196297758	0.943150862	1.139913174	1.054702253	0	0	0.065226995	0.153504635	0.056995159	0	0	0.064261061	0.000115258	0	0	0	0	0	0	0	0	0	0	59.2875
H1608_801_0	2009	9																					0											COIN	COIN	COIN	COIN	COIN	O	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	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	173.296184	3.319876271	13.37806959	0	5.23309128	0	15.07591046	6.334532721	38.48806346	17.02509725	23.72008533	1.527437031	0.016211437	7.394085428	31.37069234	94.17085835	1.67411608	5.890097416	36.26007415	30.8942887	5.359516434	0	0	0	0	0	0	0	0	0											FFS Medicare  8.6%	FFS Medicare  8.6%	FFS Medicare  12.7%		FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%																			0.086334828	0.086334828	0.12728044	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.086334828	0.086334828	0.12728044	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											14.9615	0.286620947	1.702766586	0	1.208844086	0	3.482535315	1.463277059	8.890742659	3.932797465	5.47933971	0.352837954	0.003744842	1.708033734	7.246629931	21.75346828	0.386720814	1.360612503	8.376077128	7.136580689	1.238048296	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.9712	0	0	14.9615	0.286620947	1.702766586	0	1.208844086	0	3.482535315	1.463277059	8.890742659	3.932797465	5.47933971	0.352837954	0.003744842	1.708033734	7.246629931	21.75346828	0.386720814	1.360612503	8.376077128	7.136580689	1.238048296	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.9712	0	FFS Medicare  8.6%	FFS Medicare  8.6%	FFS Medicare  12.7%		FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%																			1.6624	0.0318	0.1892	0	0.1343	0	0.3869	0.1626	0.9879	0.437	0.6088	0.0392	0.0004	0.1898	0.8052	2.4171	0.043	0.1512	0.9307	0.793	0.1376	0	0	0	0	0	0	0	0	0											10.1079	0	0	16.6239	0.318467719	1.891962873	0	1.343160095	0	3.869483684	1.625863398	9.878602954	4.369774961	6.088155234	0.392042171	0.004160935	1.89781526	8.051811035	24.17052031	0.429689794	1.51179167	9.306752365	7.929534099	1.375609218	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.0791
H1608_802_0	2009	9																					0											COIN	COIN	COIN	COIN	COIN	O	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	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	173.296184	3.319876271	13.37806959	0	5.23309128	0	15.07591046	6.334532721	38.48806346	17.02509725	23.72008533	1.527437031	0.016211437	7.394085428	31.37069234	94.17085835	1.67411608	5.890097416	36.26007415	30.8942887	5.359516434	0	0	0	0	0	0	0	0	0											FFS Medicare  8.6%	FFS Medicare  8.6%	FFS Medicare  12.7%		FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%																			0.086334828	0.086334828	0.12728044	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.086334828	0.086334828	0.12728044	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											14.9615	0.286620947	1.702766586	0	1.208844086	0	3.482535315	1.463277059	8.890742659	3.932797465	5.47933971	0.352837954	0.003744842	1.708033734	7.246629931	21.75346828	0.386720814	1.360612503	8.376077128	7.136580689	1.238048296	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.9712	0	0	14.9615	0.286620947	1.702766586	0	1.208844086	0	3.482535315	1.463277059	8.890742659	3.932797465	5.47933971	0.352837954	0.003744842	1.708033734	7.246629931	21.75346828	0.386720814	1.360612503	8.376077128	7.136580689	1.238048296	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.9712	0	FFS Medicare  8.6%	FFS Medicare  8.6%	FFS Medicare  12.7%		FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%																			1.6624	0.0318	0.1892	0	0.1343	0	0.3869	0.1626	0.9879	0.437	0.6088	0.0392	0.0004	0.1898	0.8052	2.4171	0.043	0.1512	0.9307	0.793	0.1376	0	0	0	0	0	0	0	0	0											10.1079	0	0	16.6239	0.318467719	1.891962873	0	1.343160095	0	3.869483684	1.625863398	9.878602954	4.369774961	6.088155234	0.392042171	0.004160935	1.89781526	8.051811035	24.17052031	0.429689794	1.51179167	9.306752365	7.929534099	1.375609218	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.0791
H1608_803_0	2009	10																					0											COIN	COIN	COIN	COIN	COIN	O	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	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	173.296184	3.319876271	13.37806959	0	5.23309128	0	15.07591046	6.334532721	38.48806346	17.02509725	23.72008533	1.527437031	0.016211437	7.394085428	31.37069234	94.17085835	1.67411608	5.890097416	36.26007415	30.8942887	5.359516434	0	0	0	0	0	0	0	0	0											FFS Medicare  8.6%	FFS Medicare  8.6%	FFS Medicare  12.7%		FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%																			0.086334828	0.086334828	0.12728044	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.086334828	0.086334828	0.12728044	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											14.9615	0.286620947	1.702766586	0	1.208844086	0	3.482535315	1.463277059	8.890742659	3.932797465	5.47933971	0.352837954	0.003744842	1.708033734	7.246629931	21.75346828	0.386720814	1.360612503	8.376077128	7.136580689	1.238048296	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.9712	0	0	14.9615	0.286620947	1.702766586	0	1.208844086	0	3.482535315	1.463277059	8.890742659	3.932797465	5.47933971	0.352837954	0.003744842	1.708033734	7.246629931	21.75346828	0.386720814	1.360612503	8.376077128	7.136580689	1.238048296	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.9712	0	FFS Medicare  8.6%	FFS Medicare  8.6%	FFS Medicare  12.7%		FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%																			1.6624	0.0318	0.1892	0	0.1343	0	0.3869	0.1626	0.9879	0.437	0.6088	0.0392	0.0004	0.1898	0.8052	2.4171	0.043	0.1512	0.9307	0.793	0.1376	0	0	0	0	0	0	0	0	0											10.1079	0	0	16.6239	0.318467719	1.891962873	0	1.343160095	0	3.869483684	1.625863398	9.878602954	4.369774961	6.088155234	0.392042171	0.004160935	1.89781526	8.051811035	24.17052031	0.429689794	1.51179167	9.306752365	7.929534099	1.375609218	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.0791
H1609_001_0	2009	11																					1700											D	D	D	COIN	T	COIN	COIN	V	V	COIN	COIN	COIN	COIN	COIN	P	P	P	P	P	P	COIN	V	T	V	V	V	V	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	1012.268362	46.58507575	394.2173503	0	171.2350555	0	14.1732354	388.1574161	734.7291618	16.65811471	21.89316283	1.459277374	0.01403367	6.735325816	7379.420485	18929.43618	133.608719	1729.089311	0	21069.71211	2.853703953	0	0	0	127.9228631	0	0	0	0	0											1a $150 days 1-9	1b $150 days 1-9	2 $75 days 7-22	6 $0	10a $115	11a 30%	"11b 30%,11c 10%"	4a $50	"9a $50,9b $50"	8a 20% Diagnostic	8b 20%	9a 20%	12 20%	"3 $0; 4b $50; 5 $50; 9a 20%, 9d 20%; 13a $0; 14b $0"	7a $10; 14d - j $0	7b $20; 7d $30; 7f $30; 7g $30; 14c $10; 14d - j $0; 17a $30	"7e $30,7h $30; 9c $30"	"7c $25,7i $25"	14h $0	7g $30	15 20%			16a 50%; 16b $30	17a $30	17b $0	18a $30	18b $0	14a $0	14b $0											130.4254302	130.4254302	32.90816327	0	89.57365355	0	0.114888565	50	48.79187263	0.046683855	0.196438735	0.2	0.2	0.193491145	5.650574306	7.737073421	30	25	0	0.454945738	0.270933335	0	0	0	29.74923998	0	0	0	0	0											103.7057403	103.7057403	26.16641116	0	71.22308922	0	0.091351845	39.75671774	38.79609416	0.037119937	0.156794635	0.159026871	0.2	0.153851457	5.650574306	7.737073421	29.19954377	22.81999092	0	0.454945738	0.215428402	0	0	0	29.74923998	0	0	0	0	0											8.7482	0.402594981	0.85960444	0	1.016324136	0	1.294751204	1.285988736	2.375385145	0.618348166	3.432730482	0.232064315	0.002806734	1.036239687	3.474830316	12.2048698	0.32510947	3.288150198	0	0.798797978	0.614768884	0	0	0	0.317133996	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.3287	0	5.9534	8.7482	0.402594981	0.85960444	0	1.016324136	0	1.294751204	1.285988736	2.375385145	0.618348166	3.432730482	0.232064315	0.002806734	1.036239687	3.474830316	12.2048698	0.32510947	3.288150198	0	0.798797978	0.614768884	0	0	0	0.317133996	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.3287	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.7482	0.402594981	0.85960444	0	1.016324136	0	1.294751204	1.285988736	2.375385145	0.618348166	3.432730482	0.232064315	0.002806734	1.036239687	3.474830316	12.2048698	0.32510947	3.288150198	0	0.798797978	0.614768884	0	0	0	0.317133996	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.3287
H1609_003_0	2009	13																					0											D	D	D	COIN	T	O	COIN	V	COIN	COIN	COIN	COIN	COIN	COIN	P	COIN	P	P	COIN	P	COIN	V	T	V	V	V	V	V	P	O											25.6644	0.1748	2.0333	1.4575	0.7776	0	2.2475	0.8414	5.2758	2.1317	3.387	0.2139	0.0023	0.9985	4.1641	13.0208	0.2347	0.9536	3.7502	3.7959	1.0565	0	0	0	0	0	0	0	0	0											72.1815	0	0	0	0	0	0	0	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 $1,000 ded"	"1b $1,000 ded"	"2 $1,000 ded"	"6 $1,000 ded"	"10a $1,000 ded"	"11a $1,000 ded"	"11b, 11c $1,000 ded"	"4a $1,000 ded"	"9a, b $1,000 ded"	"8a $1,000 ded"	"8b $1,000 ded"	"9a $1,000 ded"	"12 $1,000 ded"	"3, 4b, 5, 9a, d, 13a $1,000 ded; 14b $0"	"7a $1,000 ded; 14d - j $0"	"7b, d, f, g, 17a $1,000 ded; 14c - j $0"	"7e, h, 9c $1,000 ded"	"7c, i $1,000 ded"	14 h $0	"7g $1,000 ded"	"15 $1,000 ded"			16a $50 ded ; 16b $50 ded 50% - 80%	17a $0	17b $0	18a $0	18b $0	14a $0	13c $0; 14b $0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	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	25.6644	0.17484475	2.033267421	1.457476687	0.777606466	0	2.247516833	0.841411501	5.275784315	2.131743167	3.387000862	0.213876266	0.002293038	0.998473547	4.164106733	13.02077258	0.234674654	0.953632865	3.750249571	3.795932746	1.056456658	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.1815	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	25.6644	0.17484475	2.033267421	1.457476687	0.777606466	0	2.247516833	0.841411501	5.275784315	2.131743167	3.387000862	0.213876266	0.002293038	0.998473547	4.164106733	13.02077258	0.234674654	0.953632865	3.750249571	3.795932746	1.056456658	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.1815
H1609_004_0	2009	11																					1800											D	D	D	COIN	T	COIN	COIN	V	V	COIN	COIN	COIN	COIN	COIN	P	P	P	P	P	P	COIN	V	T	V	V	V	V	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	1744.813325	58.59447734	688.4851087	0	312.7086306	0	21.53409171	565.6095997	1120.966457	24.31826632	33.88123684	2.181756731	0.023156052	10.56154547	11301.42718	30989.46868	259.379824	3493.495254	0	0	6.131389955	0	0	0	215.7464807	0	0	0	0	0											1a $250 days 1-7	1b $250 days 1-7	2 $75 days 7-22	6 $0	10a $115	11a 30%	11b 30%; 11c 0%	4a $50	"9a $200,9b $200"	8a 20% Diagnostic	8b 20%	9a 20%	12 20%	3 $0; 4b $50; 5 $50; 9a 20%; 9d 20%; 13a $0; 14b $0	7a $10; 14d - j $0	7b $20; 7d $30; 7f $00; 7g $30; 14c $10; 14d - j $0; 17a $30	7e $30; 7h $30; 9c $30	"7c $25,7i $25"	14h $0	7g $30	15 20%			16a 50%; 16b $30	17a $30	17b $0	18a $30	18b $0	14a $0	14b $0											200.5258126	200.5258126	32.90816327	0	81.06557377	0	0.019839957	50	194.8170732	0.044636798	0.196904598	0.2	0.2	0.172623169	5.655961218	8.236236568	30	25	0	0	0.24971215	0	0	0	29.76284585	0	0	0	0	0											118.4106621	118.4106621	19.43229827	0	47.86928994	0	0.011715511	29.52504233	115.0396466	0.026358067	0.116272332	0.118100169	0.2	0.101934128	5.655961218	8.236236568	28.45931012	20.16849198	0	0	0.147455236	0	0	0	29.76284585	0	0	0	0	0											17.217	0.578184238	1.114903999	0	1.247428342	0	0.252282894	1.391637281	10.74629876	0.640982495	3.93945042	0.257665839	0.00463121	1.076581923	5.326702822	21.26971626	0.615147571	5.87154425	0	0	0.904105552	0	0	0	0.535102437	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9894	0	28.7397	17.217	0.578184238	1.114903999	0	1.247428342	0	0.252282894	1.391637281	10.74629876	0.640982495	3.93945042	0.257665839	0.00463121	1.076581923	5.326702822	21.26971626	0.615147571	5.87154425	0	0	0.904105552	0	0	0	0.535102437	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9894	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.217	0.578184238	1.114903999	0	1.247428342	0	0.252282894	1.391637281	10.74629876	0.640982495	3.93945042	0.257665839	0.00463121	1.076581923	5.326702822	21.26971626	0.615147571	5.87154425	0	0	0.904105552	0	0	0	0.535102437	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9894
H1609_005_0	2009	12																					1700											D	D	D	COIN	T	COIN	COIN	V	V	COIN	COIN	COIN	COIN	COIN	P	P	P	P	P	P	COIN	V	T	V	V	V	V	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	1475.083729	49.53639388	582.0526281	0	264.3671998	0	18.97983723	478.1723669	947.6769567	21.4337685	29.86243251	1.922968852	0.02040941	9.308793542	9554.346654	26198.82618	219.2824599	2953.438017	0	0	5.4589451	0	0	0	182.3943677	0	0	0	0	0											1a $250 days 1-7	1b $250 days 1-7	2 $100 days 7-26	6 $0	10a $115	11a 30%	"11b 30%,11c 10%"	4a $50	9a $200; 9b $200	8a 20% Diagnostic	8b 20%	9a 20%	12 20%	3 $0; 4b $50; 5 $50; 9a 20%; 9d 20%; 13a $0; 14b $0	7a $10; 14d - j $0	7b $20; 7d $30; 7f $30; 7g $30; 14c $10; 14d - j $0; 17a $30	7e $30; 7h $30; 9c $30	"7c $25,7i $25"	14h $0	7g $30	15 20%			16a 50%; 16b $30	17a $30	17b $0	18a $30	18b $0	14a $0	14b $0											200.5258126	200.5258126	47.57653061	0	81.06557377	0	0.3	50	194.8170732	0.044636798	0.196904598	0.2	0.2	0.172389284	5.655961218	8.300875666	30	25	0	0	0.24720418	0	0	0	29.76284585	0	0	0	0	0											118.8545794	118.8545794	28.19930491	0	48.04875016	0	0.177814384	29.63573063	115.4709261	0.026456882	0.117566118	0.118542923	0.2	0.102177648	5.655961218	8.300875666	28.46763914	20.19461127	0	0	0.14652153	0	0	0	29.76284585	0	0	0	0	0											14.61	0.490635605	1.367789961	0	1.058542795	0	3.374888062	1.180915622	9.11909465	0.567070695	3.510810268	0.227954348	0.004081882	0.951150627	4.503251178	18.12276656	0.520204495	4.970294388	0	0	0.799852988	0	0	0	0.452381287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8317	0	26.7699	14.61	0.490635605	1.367789961	0	1.058542795	0	3.374888062	1.180915622	9.11909465	0.567070695	3.510810268	0.227954348	0.004081882	0.951150627	4.503251178	18.12276656	0.520204495	4.970294388	0	0	0.799852988	0	0	0	0.452381287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8317	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.61	0.490635605	1.367789961	0	1.058542795	0	3.374888062	1.180915622	9.11909465	0.567070695	3.510810268	0.227954348	0.004081882	0.951150627	4.503251178	18.12276656	0.520204495	4.970294388	0	0	0.799852988	0	0	0	0.452381287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8317
H1609_006_0	2009	12																																Coin	Coin	Coin	Coin	Coin	Coin	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		309.276317	35.94606679	52.04710241		14.03296375	28.73759234	20.63752598	40.00248616	42.15330429	14.62347713	24.9230164	6.331100172	1.763813032	40.79858459	35.53329387	88.41285805	18.79752311	14.66814151	19.87076918	10.77842848	21.17183488																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS								14a: $0	13c: OTC $21/month											0.087309296	0.087309296	0.12381367		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.087309296	0.087309296	0.12381367		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				27.0027	3.138425793	6.44414275	0	3.241614627	6.638383831	4.767268502	9.240574302	9.737413291	3.378023216	5.757216789	1.46248414	0.40744081	9.424473041	8.208190885	20.42337021	4.342227839	3.388340689	4.590147681	2.48981698	4.890693858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.9729	0	0	27.0027	3.138425793	6.44414275	0	3.241614627	6.638383831	4.767268502	9.240574302	9.737413291	3.378023216	5.757216789	1.46248414	0.40744081	9.424473041	8.208190885	20.42337021	4.342227839	3.388340689	4.590147681	2.48981698	4.890693858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.9729																																																																																		0	0	0	27.0027	3.138425793	6.44414275	0	3.241614627	6.638383831	4.767268502	9.240574302	9.737413291	3.378023216	5.757216789	1.46248414	0.40744081	9.424473041	8.208190885	20.42337021	4.342227839	3.388340689	4.590147681	2.48981698	4.890693858	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.9729
H1609_007_0	2009	10																					3300											D	D	D	COIN	T	COIN	COIN	V	V	O	O	O	COIN	O	P	P	P	P	P	P	COIN	V	T	V	V	V	V	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	1400.490938	47.0314121	552.6190922	12.4003074	250.9985436	0	18.38781131	453.9919013	899.7543421	0	2860.423293	78.86566261	0.019772792	1051.313572	9071.19755	24873.99049	208.193672	2804.087047	0	28097.21332	5.31363244	0	0	0	173.1709557	0	0	0	0	0											1a $225 days 1-10	1b $225 days 1-10	2a $100 days 4-26	6a 20%	10a $150	11a 20%	11b 20%; 11c 20%	4a $50	9a $175; 9b $175	8a $0	8b $30 Therapeutic $150 Diagnostic	9a $175	12 20%	3 $30; 4b $50; 5 $100; 9d $35; 13a $0; 14b $0	7a $10; 14d - j $0	7b $25; 7d $30; 7f $25; 7g $30; 14c $10; 14d - j $0; 17a $30	7e $30; 7h $30; 9c $30	7c $30; 7i $30	14h $0	7g $30	15 20%			16a  50%; 16b $30	17a $30	17b $0	18a $30	18b $0	14a $0	14b $0											200.3704589	200.3704589	63.7755102	0.2	105.7377049	0	0.2	50	56.25342988	0	54.63258211	131.25	0.2	5.485975212	4.302378428	7.447584321	30	15	0	0.425022009	0.2	0	0	0	29.76284585	0	0	0	0	0											157.5678119	157.5678119	50.1519418	0.157276489	83.15027518	0	0.157276489	39.31912237	44.23670987	0	42.96210363	103.2126962	0.2	4.314074614	4.302378428	7.445519015	29.1962904	13.48776989	0	0.425022009	0.157276489	0	0	0	29.76284585	0	0	0	0	0											18.3894	0.617553058	2.309576712	1.950276816	1.739216498	0	2.891970412	1.487546927	3.316847648	0	10.24081683	0.67832814	0.003954558	0.377953766	3.252310387	15.4333141	0.506540242	3.15174007	0	0.995161171	0.835709457	0	0	0	0.429505038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.6077	0	12.5509	18.3894	0.617553058	2.309576712	1.950276816	1.739216498	0	2.891970412	1.487546927	3.316847648	0	10.24081683	0.67832814	0.003954558	0.377953766	3.252310387	15.4333141	0.506540242	3.15174007	0	0.995161171	0.835709457	0	0	0	0.429505038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.6077	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.3894	0.617553058	2.309576712	1.950276816	1.739216498	0	2.891970412	1.487546927	3.316847648	0	10.24081683	0.67832814	0.003954558	0.377953766	3.252310387	15.4333141	0.506540242	3.15174007	0	0.995161171	0.835709457	0	0	0	0.429505038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.6077
H1609_008_0	2009	10																					3000											D	D	D	COIN	T	COIN	COIN	V	V	O	O	O	COIN	O	P	P	P	P	P	P	COIN	V	T	V	V	V	V	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	1444.485418	48.50883866	569.9788542	12.78984585	258.8833146	0	18.96543889	468.253427	928.0188764	0	2950.279522	81.34311798	0.020393927	1084.339129	0	25655.37239	214.7337873	2892.173552	0	28979.84829	5.48055283	0	0	0	178.610881	0	0	0	0	0											1a $225 days 1-10	1b $225 days 1-10	2a $100 days 4-26	6a 20%	10a $150	11a 20%	11b 20%; 11c 20%	4a $50;	9a $125; 9b $125	8a $0	8b $30 Therapeutic $100 Diagnostic	9a $125	12 20%	3 $30; 4b $50; 5 $100; 9d $35; 13a $0; 14b $0	7a $0; 14d - j $0	7b $20; 7d $25; 7f $20; 7g $25; 14c - j $0; 17a $25	7e $30; 7h $30; 9c $30	7c $30; 7i $30	14h $0	7g $25	15 20%			16a $50 ded; 16b $50 ded 50% - 80%	17a $25	17b $0	18a $25	18b $0	14a $0	14b $0											200.3704589	200.3704589	63.7755102	0.2	105.7377049	0	0.2	37.5	40.18102134	0	36.65667706	93.75	0.2	5.485975212	0	6.103975028	30	15	0	0.351535753	0.246042756	0	0	0	24.70355731	0	0	0	0	0											156.7266755	156.7266755	49.8842182	0.156436908	82.70639823	0	0.156436908	29.3319203	31.42897375	0	28.67228613	73.32980076	0.2	4.291045006	0	6.102290314	29.18049629	13.45805229	0	0.351535753	0.19245084	0	0	0	24.70355731	0	0	0	0	0											18.8658	0.633552418	2.369412461	2.000803943	1.784275543	0	2.966894624	1.14456435	2.430556742	0	7.049271553	0.497072886	0.004078785	0.387745667	0	13.04637754	0.522169874	3.243585241	0	0.848954398	1.054736995	0	0	0	0.367693678	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.2175	0	11.8586	18.8658	0.633552418	2.369412461	2.000803943	1.784275543	0	2.966894624	1.14456435	2.430556742	0	7.049271553	0.497072886	0.004078785	0.387745667	0	13.04637754	0.522169874	3.243585241	0	0.848954398	1.054736995	0	0	0	0.367693678	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.2175	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.8658	0.633552418	2.369412461	2.000803943	1.784275543	0	2.966894624	1.14456435	2.430556742	0	7.049271553	0.497072886	0.004078785	0.387745667	0	13.04637754	0.522169874	3.243585241	0	0.848954398	1.054736995	0	0	0	0.367693678	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.2175
H1609_801_0	2009	8																					0											COIN	COIN	COIN	COIN	COIN	O	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	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	192.5513156	3.688751413	14.86452177	0	5.814545867	0	16.75101162	7.03836969	42.76451495	18.91677472	26.35565036	1.697152257	0.018012708	8.215650475	34.85632483	104.6342871	1.860128977	6.544552684	40.28897128	34.32698744	5.95501826	0	0	0	0	0	0	0	0	0											FFS Medicare  8.7%	FFS Medicare  8.7%	FFS Medicare  12.5%		FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%																			0.086578396	0.086578396	0.125076277	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.086578396	0.086578396	0.125076277	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											16.6708	0.319366182	1.859199043	0	1.343160095	0	3.869483684	1.625863398	9.878602954	4.369774961	6.088155234	0.392042171	0.004160935	1.89781526	8.051811035	24.17052031	0.429689794	1.51179167	9.306752365	7.929534099	1.375609218	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.0941	0	0	16.6708	0.319366182	1.859199043	0	1.343160095	0	3.869483684	1.625863398	9.878602954	4.369774961	6.088155234	0.392042171	0.004160935	1.89781526	8.051811035	24.17052031	0.429689794	1.51179167	9.306752365	7.929534099	1.375609218	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.0941	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.6708	0.319366182	1.859199043	0	1.343160095	0	3.869483684	1.625863398	9.878602954	4.369774961	6.088155234	0.392042171	0.004160935	1.89781526	8.051811035	24.17052031	0.429689794	1.51179167	9.306752365	7.929534099	1.375609218	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.0941
H1609_802_0	2009	8																					0											COIN	COIN	COIN	COIN	COIN	O	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	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	192.5513156	3.688751413	14.86452177	0	5.814545867	0	16.75101162	7.03836969	42.76451495	18.91677472	26.35565036	1.697152257	0.018012708	8.215650475	34.85632483	104.6342871	1.860128977	6.544552684	40.28897128	34.32698744	5.95501826	0	0	0	0	0	0	0	0	0											FFS Medicare  8.7%	FFS Medicare  8.7%	FFS Medicare  12.5%		FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%																			0.086578396	0.086578396	0.125076277	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.086578396	0.086578396	0.125076277	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											16.6708	0.319366182	1.859199043	0	1.343160095	0	3.869483684	1.625863398	9.878602954	4.369774961	6.088155234	0.392042171	0.004160935	1.89781526	8.051811035	24.17052031	0.429689794	1.51179167	9.306752365	7.929534099	1.375609218	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.0941	0	0	16.6708	0.319366182	1.859199043	0	1.343160095	0	3.869483684	1.625863398	9.878602954	4.369774961	6.088155234	0.392042171	0.004160935	1.89781526	8.051811035	24.17052031	0.429689794	1.51179167	9.306752365	7.929534099	1.375609218	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.0941	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.6708	0.319366182	1.859199043	0	1.343160095	0	3.869483684	1.625863398	9.878602954	4.369774961	6.088155234	0.392042171	0.004160935	1.89781526	8.051811035	24.17052031	0.429689794	1.51179167	9.306752365	7.929534099	1.375609218	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.0941
H1609_803_0	2009	8																					0											COIN	COIN	COIN	COIN	COIN	O	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	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	192.5513156	3.688751413	14.86452177	0	5.814545867	0	16.75101162	7.03836969	42.76451495	18.91677472	26.35565036	1.697152257	0.018012708	8.215650475	34.85632483	104.6342871	1.860128977	6.544552684	40.28897128	34.32698744	5.95501826	0	0	0	0	0	0	0	0	0											FFS Medicare  8.7%	FFS Medicare  8.7%	FFS Medicare  12.5%		FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%																			0.086578396	0.086578396	0.125076277	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.086578396	0.086578396	0.125076277	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											16.6708	0.319366182	1.859199043	0	1.343160095	0	3.869483684	1.625863398	9.878602954	4.369774961	6.088155234	0.392042171	0.004160935	1.89781526	8.051811035	24.17052031	0.429689794	1.51179167	9.306752365	7.929534099	1.375609218	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.0941	0	0	16.6708	0.319366182	1.859199043	0	1.343160095	0	3.869483684	1.625863398	9.878602954	4.369774961	6.088155234	0.392042171	0.004160935	1.89781526	8.051811035	24.17052031	0.429689794	1.51179167	9.306752365	7.929534099	1.375609218	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.0941	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.6708	0.319366182	1.859199043	0	1.343160095	0	3.869483684	1.625863398	9.878602954	4.369774961	6.088155234	0.392042171	0.004160935	1.89781526	8.051811035	24.17052031	0.429689794	1.51179167	9.306752365	7.929534099	1.375609218	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.0941
H1643_001_0	2009	8																					5000											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		973.4238134	0	256.2685855	0	200.5556023	22.21412127	0	378.1902369	48.48827479	0	0	0	0	5612.816963	3135.324921	8476.9896	0	0	0	0	1177.952222	0	0	0	407.0854721	0	12.26384245	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											150	0	50	0	50	0.12930561	0	50	100	0	0	0	0	27	25	25	0	0	0	0	2.1	0	0	0	25	0	25	0	0	0											143.8182792	0	47.93942641	0	47.93942641	0.123976736	0	47.93942641	95.87885282	0	0	0	0	25.88729026	23.96971321	23.96971321	0	0	0	0	2.013455909	0	0	0	25	0	25	0	0	0											11.6663	0	1.02378075	0	0.801210045	2.754034238	0	1.510851919	0.38741668	0	0	0	0	12.10838516	6.262736596	16.93258413	0	0	0	0	0.197646239	0	0	0	0.848094733	0	0.025549672	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5186	0	2.3058	11.6663	0	1.02378075	0	0.801210045	2.754034238	0	1.510851919	0.38741668	0	0	0	0	12.10838516	6.262736596	16.93258413	0	0	0	0	0.197646239	0	0	0	0.848094733	0	0.025549672	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5186																																																																																		0	0	0	11.6663	0	1.02378075	0	0.801210045	2.754034238	0	1.510851919	0.38741668	0	0	0	0	12.10838516	6.262736596	16.93258413	0	0	0	0	0.197646239	0	0	0	0.848094733	0	0.025549672	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5186
H1643_002_0	2009	4																					4000											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		978.1113965	0	257.5026629	0	201.5213903	22.32109476	0	380.0114356	48.7217731	0	0	0	0	5615.768021	3150.423273	8517.811073	0	0	0	0	1177.952222	0	0	0	409.0458176	0	12.32289975	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											125	0	35	0	50	0.12930561	0	50	75	0	0	0	0	24	20	20	0	0	0	0	2.1	0	0	0	20	0	20	0	0	0											119.2335089	0	33.3853825	0	47.69340358	0.123340493	0	47.69340358	71.54010537	0	0	0	0	22.89283372	19.07736143	19.07736143	0	0	0	0	2.00312295	0	0	0	20	0	20	0	0	0											9.7186	0	0.716402075	0	0.80093675	2.753094829	0	1.510336564	0.290463398	0	0	0	0	10.71340362	5.008480288	13.5414467	0	0	0	0	0.196631928	0	0	0	0.681743029	0	0.020538166	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9521	0	2.1884	9.7186	0	0.716402075	0	0.80093675	2.753094829	0	1.510336564	0.290463398	0	0	0	0	10.71340362	5.008480288	13.5414467	0	0	0	0	0.196631928	0	0	0	0.681743029	0	0.020538166	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9521																																																																																		0	0	0	9.7186	0	0.716402075	0	0.80093675	2.753094829	0	1.510336564	0.290463398	0	0	0	0	10.71340362	5.008480288	13.5414467	0	0	0	0	0.196631928	0	0	0	0.681743029	0	0.020538166	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9521
H1643_003_0	2009	8																					3000											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		982.9362581	0	258.7728809	0	202.5154619	22.43120102	0	381.8859691	48.96210954	0	0	0	0	5618.805503	3165.96379	8559.828025	0	0	0	0	1177.952222	0	0	0	411.0635729	0	12.38368658	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											100	0	25	0	25	0.12930561	0	50	50	0	0	0	0	21	15	15	0	0	0	0	2.1	0	0	0	15	0	15	0	0	0											94.75398002	0	23.68849501	0	23.68849501	0.122522212	0	47.37699001	47.37699001	0	0	0	0	19.8983358	14.213097	14.213097	0	0	0	0	1.98983358	0	0	0	15	0	15	0	0	0											7.7614	0	0.510828341	0	0.399773876	2.748320365	0	1.507717312	0.193306448	0	0	0	0	9.317073226	3.749845871	10.13847217	0	0	0	0	0.195327407	0	0	0	0.513829466	0	0.015479608	0	0	0	0	0	0	0	0	0	0	0	0	0	37.0514	0	2.022	7.7614	0	0.510828341	0	0.399773876	2.748320365	0	1.507717312	0.193306448	0	0	0	0	9.317073226	3.749845871	10.13847217	0	0	0	0	0.195327407	0	0	0	0.513829466	0	0.015479608	0	0	0	0	0	0	0	0	0	0	0	0	0	37.0514																																																																																		0	0	0	7.7614	0	0.510828341	0	0.399773876	2.748320365	0	1.507717312	0.193306448	0	0	0	0	9.317073226	3.749845871	10.13847217	0	0	0	0	0.195327407	0	0	0	0.513829466	0	0.015479608	0	0	0	0	0	0	0	0	0	0	0	0	0	37.0514
H1643_004_0	2009	8																					5000											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		1035.29249	0	272.5564531	0	213.3024752	23.62600196	0	402.2271766	51.57008289	0	0	0	0	5651.766261	3334.599277	9015.768415	0	0	0	0	1177.952222	0	0	0	432.9589293	0	13.04330531	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											150	0	50	0	50	0.12930561	0	50	100	0	0	0	0	27	25	25	0	0	0	0	2.1	0	0	0	25	0	25	0	0	0											143.1891576	0	47.72971922	0	47.72971922	0.123434409	0	47.72971922	95.45943843	0	0	0	0	25.77404838	23.86485961	23.86485961	0	0	0	0	2.004648207	0	0	0	25	0	25	0	0	0											12.3536	0	1.084086915	0	0.848405604	2.916261594	0	1.599849183	0.410237596	0	0	0	0	12.13907475	6.631645299	17.93000396	0	0	0	0	0.196781651	0	0	0	0.901997769	0	0.027173553	0	0	0	0	0	0	0	0	0	0	0	0	0	57.0391	0	2.6689	12.3536	0	1.084086915	0	0.848405604	2.916261594	0	1.599849183	0.410237596	0	0	0	0	12.13907475	6.631645299	17.93000396	0	0	0	0	0.196781651	0	0	0	0.901997769	0	0.027173553	0	0	0	0	0	0	0	0	0	0	0	0	0	57.0391																																																																																		0	0	0	12.3536	0	1.084086915	0	0.848405604	2.916261594	0	1.599849183	0.410237596	0	0	0	0	12.13907475	6.631645299	17.93000396	0	0	0	0	0.196781651	0	0	0	0.901997769	0	0.027173553	0	0	0	0	0	0	0	0	0	0	0	0	0	57.0391
H1643_005_0	2009	4																					4000											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		1040.20152	0	273.8488298	0	214.3138882	23.738029	0	404.1344109	51.81461194	0	0	0	0	5654.856731	3350.410894	9058.518342	0	0	0	0	1177.952222	0	0	0	435.0118839	0	13.10515254	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											125	0	35	0	50	0.12930561	0	50	75	0	0	0	0	24	20	20	0	0	0	0	2.1	0	0	0	20	0	20	0	0	0											118.7455624	0	33.24875747	0	47.49822496	0.122835739	0	47.49822496	71.24733744	0	0	0	0	22.79914798	18.99928998	18.99928998	0	0	0	0	1.994925448	0	0	0	20	0	20	0	0	0											10.2933	0	0.75876111	0	0.848294106	2.915878337	0	1.59963893	0.307637762	0	0	0	0	10.74382628	5.304619011	14.34211807	0	0	0	0	0.195827239	0	0	0	0.725019806	0	0.021841921	0	0	0	0	0	0	0	0	0	0	0	0	0	48.0567	0	2.4919	10.2933	0	0.75876111	0	0.848294106	2.915878337	0	1.59963893	0.307637762	0	0	0	0	10.74382628	5.304619011	14.34211807	0	0	0	0	0.195827239	0	0	0	0.725019806	0	0.021841921	0	0	0	0	0	0	0	0	0	0	0	0	0	48.0567																																																																																		0	0	0	10.2933	0	0.75876111	0	0.848294106	2.915878337	0	1.59963893	0.307637762	0	0	0	0	10.74382628	5.304619011	14.34211807	0	0	0	0	0.195827239	0	0	0	0.725019806	0	0.021841921	0	0	0	0	0	0	0	0	0	0	0	0	0	48.0567
H1643_006_0	2009	8																					3000											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		1045.262634	0	275.1812447	0	215.3566351	23.85352668	0	406.1007319	52.06671658	0	0	0	0	5658.042944	3366.71236	9102.592677	0	0	0	0	1177.952222	0	0	0	437.1284396	0	13.16891583	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											100	0	25	0	25	0.12930561	0	50	50	0	0	0	0	21	15	15	0	0	0	0	2.1	0	0	0	15	0	15	0	0	0											94.37763663	0	23.59440916	0	23.59440916	0.122035579	0	47.18881831	47.18881831	0	0	0	0	19.81930369	14.15664549	14.15664549	0	0	0	0	1.981930369	0	0	0	15	0	15	0	0	0											8.2208	0	0.541061573	0	0.42343438	2.910978934	0	1.596951138	0.204747236	0	0	0	0	9.344872618	3.971779447	10.7385148	0	0	0	0	0.194551607	0	0	0	0.54641055	0	0.016461145	0	0	0	0	0	0	0	0	0	0	0	0	0	38.7105	0	2.2726	8.2208	0	0.541061573	0	0.42343438	2.910978934	0	1.596951138	0.204747236	0	0	0	0	9.344872618	3.971779447	10.7385148	0	0	0	0	0.194551607	0	0	0	0.54641055	0	0.016461145	0	0	0	0	0	0	0	0	0	0	0	0	0	38.7105																																																																																		0	0	0	8.2208	0	0.541061573	0	0.42343438	2.910978934	0	1.596951138	0.204747236	0	0	0	0	9.344872618	3.971779447	10.7385148	0	0	0	0	0.194551607	0	0	0	0.54641055	0	0.016461145	0	0	0	0	0	0	0	0	0	0	0	0	0	38.7105
H1643_801_0	2009	2																																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		234.194084	0	14.76762604	0	10.07344919	23.12148372	0	11.54660024	41.28024521	0	0	0	0	69.64480357	34.74048849	138.961954	0	0	0	0	16.90412789	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											0.077695141	0	0.203053609	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0.231	0	0	0	0	0.231	0	0	0	0	0	0	0	0	0											0.077695141	0	0.203053609	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0.231	0	0	0	0	0.231	0	0	0	0	0	0	0	0	0											18.1957	0	2.99861976	0	2.326966762	5.341062738	0	2.667264654	9.535736645	0	0	0	0	16.08794962	8.025052842	32.10021137	0	0	0	0	3.904853542	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1835	0	0	18.1957	0	2.99861976	0	2.326966762	5.341062738	0	2.667264654	9.535736645	0	0	0	0	16.08794962	8.025052842	32.10021137	0	0	0	0	3.904853542	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1835																																																																																		0	0	0	18.1957	0	2.99861976	0	2.326966762	5.341062738	0	2.667264654	9.535736645	0	0	0	0	16.08794962	8.025052842	32.10021137	0	0	0	0	3.904853542	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1835
H1643_802_0	2009	2																																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		234.194084	0	14.76762604	0	10.07344919	23.12148372	0	11.54660024	41.28024521	0	0	0	0	69.64480357	34.74048849	138.961954	0	0	0	0	16.90412789	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											0.077695141	0	0.203053609	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0.231	0	0	0	0	0.231	0	0	0	0	0	0	0	0	0											0.077695141	0	0.203053609	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0.231	0	0	0	0	0.231	0	0	0	0	0	0	0	0	0											18.1957	0	2.99861976	0	2.326966762	5.341062738	0	2.667264654	9.535736645	0	0	0	0	16.08794962	8.025052842	32.10021137	0	0	0	0	3.904853542	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1835	0	0	18.1957	0	2.99861976	0	2.326966762	5.341062738	0	2.667264654	9.535736645	0	0	0	0	16.08794962	8.025052842	32.10021137	0	0	0	0	3.904853542	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1835																																																																																		0	0	0	18.1957	0	2.99861976	0	2.326966762	5.341062738	0	2.667264654	9.535736645	0	0	0	0	16.08794962	8.025052842	32.10021137	0	0	0	0	3.904853542	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1835
H1643_803_0	2009	2																																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		234.194084	0	14.76762604	0	10.07344919	23.12148372	0	11.54660024	41.28024521	0	0	0	0	69.64480357	34.74048849	138.961954	0	0	0	0	16.90412789	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											0.077695141	0	0.203053609	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0.231	0	0	0	0	0.231	0	0	0	0	0	0	0	0	0											0.077695141	0	0.203053609	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0.231	0	0	0	0	0.231	0	0	0	0	0	0	0	0	0											18.1957	0	2.99861976	0	2.326966762	5.341062738	0	2.667264654	9.535736645	0	0	0	0	16.08794962	8.025052842	32.10021137	0	0	0	0	3.904853542	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1835	0	0	18.1957	0	2.99861976	0	2.326966762	5.341062738	0	2.667264654	9.535736645	0	0	0	0	16.08794962	8.025052842	32.10021137	0	0	0	0	3.904853542	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1835																																																																																		0	0	0	18.1957	0	2.99861976	0	2.326966762	5.341062738	0	2.667264654	9.535736645	0	0	0	0	16.08794962	8.025052842	32.10021137	0	0	0	0	3.904853542	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1835
H1657_002_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1772.126609	46.53441134	419.9943583	1862.106288	468.4330193	15.82157378	6.28107442	1203.200256	300.873723	7245.547872	1416.912634	85.70743037	0.836141959	603.6193167	7226.395749	17612.93743	249.578304	2868.242745	4473.291779	1592.597317	35.53881496	26.23760169	3750	224.5714286	360	249.2307692	30.4	18.24	1664	7480											"$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	Copay between $3.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $35.00	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											82.77136045	54.28219079	56.13	5.846347098	44.53257947	0.2	0.2	20.35219669	74.30660268	0	17.23399692	39.37383757	0.2	8.432650804	2.59273508	9.439649009	27.63929851	14.39596173	18.32881184	7.587841012	0.2	0	0	0	10	10	10	10	0	0											76.56457995	50.21172921	51.92097665	5.407946751	41.19321252	0.185002589	0.185002589	18.82604542	68.73456944	0	15.94167026	36.42130948	0.185002589	7.800311161	2.398313514	8.731797536	25.56670893	13.31645097	16.95438824	7.018851166	0.185002589	0	0	0	10	10	10	10	0	0											11.3068	0.194714438	1.817209772	0.839180971	1.608021743	2.927032114	1.16201503	1.887625222	1.723368817	0	1.8823295	0.260131404	0.154688427	0.392368208	1.444263548	12.8160503	0.531741321	3.182901156	6.32016046	0.931516961	6.574772783	0	0	0	0.3	0.207692308	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	58.5052	0	4.6983	11.3068	0.194714438	1.817209772	0.839180971	1.608021743	2.927032114	1.16201503	1.887625222	1.723368817	0	1.8823295	0.260131404	0.154688427	0.392368208	1.444263548	12.8160503	0.531741321	3.182901156	6.32016046	0.931516961	6.574772783	0	0	0	0.3	0.207692308	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	58.5052	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											7.1222	0.0735	0.1532	0.519	0.1513	0.3867	0.1535	0	0.6115	0.1656	0.6428	0.049	0	0.3019	0.2331	2.3806	0.0399	0.2474	0.6932	0.2548	0.8532	0.0176	0	0	0	0	0	0	0	0											15.0501	0	0	18.4291	0.268186283	1.970449656	1.358194498	1.759345133	3.313781696	1.315552405	1.887625222	2.334854311	0.165641271	2.525111701	0.309110439	0.154688427	0.694273194	1.677345348	15.19660699	0.571662663	3.430256619	7.013389633	1.186363458	7.427955043	0.017632336	0	0	0.3	0.207692308	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	73.5553
H1657_003_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1117.869703	79.17046485	480.315535	878.2004817	321.223072	16.07877922	5.039503092	1498.961421	279.5492114	7729.45286	1407.806336	111.1862107	0.373248776	546.1244851	7581.367003	18148.20738	407.4257735	2409.857068	3933.484661	2015.650706	34.87701269	34.22324057	3750	646.2	360	249.2307692	30.4	18.24	1664	7480											"$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 $3.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $25.00	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"Copay between $0.00 and $195.00, $1,000 benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											92.69414507	46.77493059	56.13	5.251714196	38.50803563	0.2	0.2	21.31753504	75.66103596	0	15.98057524	39.37383757	0.2	7.048646331	2.475477141	6.578645981	15.48792725	9.582987054	15.89209466	7.004632388	0.2	0	0	0	10	10	10	10	0	0											81.49030553	41.12129609	49.34562853	4.616945267	33.85361164	0.17582622	0.17582622	18.74090798	66.51596961	0	14.04902065	34.61476505	0.17582622	6.196684188	2.176268937	5.783492264	13.61591849	8.42470193	13.97123463	6.157990162	0.17582622	0	0	0	10	10	10	10	0	0											7.5913	0.271299344	1.975122664	0.33788363	0.906213428	2.827070966	0.886076777	2.340991505	1.549540571	0	1.648191691	0.320723713	0.065626921	0.282013413	1.374924459	8.74666808	0.462289677	1.691860624	4.579636425	1.034363102	6.132293292	0	0	0	0.3	0.207692308	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	45.5723	0	6.1902	7.5913	0.271299344	1.975122664	0.33788363	0.906213428	2.827070966	0.886076777	2.340991505	1.549540571	0	1.648191691	0.320723713	0.065626921	0.282013413	1.374924459	8.74666808	0.462289677	1.691860624	4.579636425	1.034363102	6.132293292	0	0	0	0.3	0.207692308	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	45.5723	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											5.1297	0.1071	0.1815	0.2679	0.1102	0.393	0.1232	0	0.6267	0.1346	0.5463	0.024	0	0.2894	0.128	2.2763	0.0994	0.2175	0.5946	0.3246	0.8067	0.0311	0	0	0	0	0	0	0	0											12.4116	0	0	12.721	0.378391373	2.156573668	0.605755272	1.016417235	3.220107792	1.009264631	2.340991505	2.176247916	0.134554624	2.194505656	0.344719768	0.065626921	0.57137673	1.502910918	11.0230171	0.561667126	1.909398056	5.174230083	1.358941723	6.938975421	0.031084098	0	0	0.3	0.207692308	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	57.9839
H1657_004_0	2009	7																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	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	0	0	0											0		355.7646708	39.43385018	1108.317548	3921.139712	20.87240291	41.49978274	7.376081571	24.46974782	18.2974313	11346.00702	21.29221392	1.346495072	2.826724628	9.525530686	6793.413238	81.79290956	9.864500918	25.60232998	17.92189966	6.976011977	28.13064619	2.554311234	5400	918	360	249.2307692	30.4	18.24	1664	8942.857143											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"Copay between $0.00 and $10.00, 20% coinsurance"	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											721.1157146	445.8550004	68.48945021	0	0.155547161	0.17	0.17	0.124371414	0.17	0	0.17	0.17	0.17	0.17	0	0.090480272	0.17	0.17	0.169998723	0.050490232	0.17	0.17	0	0	10	10	10	10	0	0											721.1157146	445.8550004	68.48945021	0	0.155547161	0.17	0.17	0.124371414	0.17	0	0.17	0.17	0.17	0.17	0	0.090480272	0.17	0.17	0.169998723	0.050490232	0.17	0.17	0	0	10	10	10	10	0	0											21.379	1.465148274	6.325671629	0	3.24664301	7.054963066	1.253933867	3.043337136	3.110563322	0	3.619676367	0.228904162	0.480543187	1.619340217	0	7.400644688	1.676965156	4.352396096	3.046700047	0.352220464	4.782209852	0.43423291	0	0	0.3	0.207692308	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	75.4213	0	0	21.379	1.465148274	6.325671629	0	3.24664301	7.054963066	1.253933867	3.043337136	3.110563322	0	3.619676367	0.228904162	0.480543187	1.619340217	0	7.400644688	1.676965156	4.352396096	3.046700047	0.352220464	4.782209852	0.43423291	0	0	0.3	0.207692308	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	75.4213	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.379	1.465148274	6.325671629	0	3.24664301	7.054963066	1.253933867	3.043337136	3.110563322	0	3.619676367	0.228904162	0.480543187	1.619340217	0	7.400644688	1.676965156	4.352396096	3.046700047	0.352220464	4.782209852	0.43423291	0	0	0.3	0.207692308	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	75.4213
H1657_005_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1621.576058	332.5843069	1109.090082	2083.991285	1796.893955	37.66942408	6.787584299	3031.80457	247.6748119	11791.39037	1557.620826	110.0140085	4.060162716	641.392251	7148.26806	17148.00782	1653.57832	7501.998238	3867.41552	1255.770168	26.70076174	70.66302589	3750	918	360	249.2307692	30.4	18.24	1664	7133.333333											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	Medicare FFS Cost Sharing	Copay between $0.00 and $15.00	Copay between $3.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $15.00	Copay between $5.00 and $15.00	$15.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											56.05481721	35.74471113	40.51	2.090519922	27.58323368	0.2	0.2	21.7825031	55.26168644	0	10.64883439	26.24922505	0.2	4.812330161	0	2.978515923	9.813650341	5.477475396	12.82516784	6.913816113	0.2	0	0	0	10	10	10	10	0	0											38.95969061	24.84358982	28.15560098	1.452970742	19.17113111	0.139005682	0.139005682	15.13945855	38.40844219	0	7.401242459	18.24395721	0.139005682	3.344706191	0	2.070153193	6.820765816	3.807001028	8.913856039	4.805298636	0.139005682	0	0	0	10	10	10	10	0	0											5.2647	0.688549009	2.60225815	0.25233153	2.870707467	5.236264003	0.943512788	3.824989967	0.792733641	0	0.960694116	0.167257572	0.564385689	0.178772386	0	2.958250261	0.939889206	2.380009584	2.872798766	0.502862556	3.711557608	0	0	0	0.3	0.207692308	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	38.2607	0	16.5479	5.2647	0.688549009	2.60225815	0.25233153	2.870707467	5.236264003	0.943512788	3.824989967	0.792733641	0	0.960694116	0.167257572	0.564385689	0.178772386	0	2.958250261	0.939889206	2.380009584	2.872798766	0.502862556	3.711557608	0	0	0	0.3	0.207692308	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	38.2607	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											5.9317	0.4445	0.3927	0.5415	0.4072	0.9208	0.1659	0	0.4856	0.214	0.5297	0.0325	0	0.2614	0.2367	1.8167	0.26	0.6686	0.394	0.1819	0.6456	0.0548	0	0	0	0	0	0	0	0											14.5857	0	0	11.1964	1.133015145	2.994961116	0.793866566	3.277904368	6.157072147	1.109431515	3.824989967	1.278361211	0.214039055	1.490370349	0.199708464	0.564385689	0.440208263	0.236673358	4.774930923	1.199854194	3.048614772	3.266783022	0.68476251	4.357117009	0.054763014	0	0	0.3	0.207692308	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	52.8465
H1657_006_0	2009	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	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		1534.220691	265.4361209	956.5246347	1936.83076	2007.575751	39.23668052	7.095148	3355.7007	213.1954843	10299.08673	1584.793146	126.3325754	1.69078115	558.7759573	5950.355817	16386.5116	1246.986469	6210.133802	3474.749604	1211.148452	17.62847377	128.671668	3750	918	360	249.2307692	30.4	18.24	1664	7836.363636											"$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 $20.00	Copay between $3.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $20.00	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											55.9123124	33.72867201	58.89	3.403886605	23.49163802	0.2	0.2	22.10994058	54.4212496	0	11.3202618	26.24922505	0.2	5.392747251	2.261371008	3.584553538	12.79752766	7.276539775	14.3913725	7.377862314	0.2	0	0	0	10	10	10	10	0	0											44.82018195	27.03742971	47.20714278	2.728608609	18.83126355	0.16032312	0.16032312	17.72367332	43.62492274	0	9.074498472	21.04178833	0.16032312	4.322910333	1.812750281	2.873434041	10.25869784	5.83298781	11.53634873	5.914209538	0.16032312	0	0	0	10	10	10	10	0	0											5.7303	0.598059205	3.762899584	0.440404424	3.150432338	6.290547053	1.137516267	4.95627858	0.775053044	0	1.198433582	0.221521943	0.27107131	0.201294863	0.898875765	3.923796688	1.066038115	3.01863623	3.340493598	0.596915477	2.826251922	0	0	0	0.3	0.207692308	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	44.9531	0	10.9893	5.7303	0.598059205	3.762899584	0.440404424	3.150432338	6.290547053	1.137516267	4.95627858	0.775053044	0	1.198433582	0.221521943	0.27107131	0.201294863	0.898875765	3.923796688	1.066038115	3.01863623	3.340493598	0.596915477	2.826251922	0	0	0	0.3	0.207692308	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	44.9531	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											6.1605	0.3601	0.3495	0.5511	0.3894	0.9591	0.1734	0	0.4077	0.1822	0.5454	0.0327	0	0.2973	0.2141	1.5843	0.1986	0.5488	0.3294	0.17	0.4291	0.097	0	0	0	0	0	0	0	0											13.9797	0	0	11.8908	0.958147515	4.112370209	0.991535015	3.539861577	7.24966591	1.310953218	4.95627858	1.182784038	0.182200296	1.743810752	0.254267342	0.27107131	0.498557276	1.112954917	5.508123474	1.264622749	3.567397635	3.669854206	0.766929772	3.255398967	0.096987882	0	0	0.3	0.207692308	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	58.9328
H1657_007_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2704.40065	274.9483623	1294.826991	4985.317493	2474.201391	33.08827808	7.829186418	2259.473145	273.4336243	9614.139754	1295.45296	107.9391092	1.311172348	647.9958519	8647.215852	18609.10513	2330.803537	5747.947079	4467.389863	1338.672333	33.94805271	10.09749814	3750	224.5714286	360	249.2307692	30.4	18.24	1664	5800											"$125 days 1 - 5, $0 after day 5, unlimited coverage"	"$125 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 $3.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $30.00	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $0.00 and $75.00	Copay between $0.00 and $75.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											64.26011522	54.75003038	58.89	3.470387489	31.89072326	0.2	0.2	20.60009275	73.89474673	0	16.89224062	32.81153131	0.2	8.235650326	2.145739244	5.613949709	24.04006205	11.12446561	22.03041008	8.551609965	0.2	0	0	0	10	10	10	10	0	0											49.63195379	42.286743	45.48429066	2.680389085	24.63112458	0.154472035	0.154472035	15.91069122	57.07335946	0	13.04689391	25.34232004	0.154472035	6.360888321	1.657283536	4.335991176	18.56758651	8.592094197	17.01541137	6.604922963	0.154472035	0	0	0	10	10	10	10	0	0											11.1854	0.968889228	4.907857269	1.113549216	5.078530223	5.111213645	1.209390357	2.995814962	1.300481294	0	1.408469778	0.227952287	0.202539461	0.343485771	1.194240706	6.724076301	3.606449694	4.115575228	6.334539689	0.73681897	5.244024781	0	0	0	0.3	0.207692308	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	64.5575	0	18.8656	11.1854	0.968889228	4.907857269	1.113549216	5.078530223	5.111213645	1.209390357	2.995814962	1.300481294	0	1.408469778	0.227952287	0.202539461	0.343485771	1.194240706	6.724076301	3.606449694	4.115575228	6.334539689	0.73681897	5.244024781	0	0	0	0.3	0.207692308	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	64.5575	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											8.4107	0.425	0.4235	1.3071	0.5282	0.8088	0.1914	0	0.5487	0.2216	0.4721	0.0418	0	0.2457	0.4398	2.1369	0.2899	0.4921	0.4729	0.176	0.8196	0.0056	0	0	0	0	0	0	0	0											18.4573	0	0	19.5961	1.393926936	5.331383818	2.42060227	5.606744059	5.920038221	1.40077047	2.995814962	1.849198706	0.221563538	1.88054815	0.269776555	0.202539461	0.589202609	1.634037856	8.861005258	3.896340234	4.607650617	6.80745801	0.912795227	6.063613594	0.005560205	0	0	0.3	0.207692308	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	83.0149
H1657_008_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1776.22857	46.64226495	420.926476	1866.407754	468.4381156	15.82174591	6.294087534	1205.423614	301.5675099	7262.300058	1420.185926	85.90607596	0.838063075	604.9727972	7242.070972	17650.60312	250.1008275	2874.334893	4483.264399	1594.115066	35.6202563	26.29841303	3750	646.2	360	249.2307692	30.4	18.24	1664	6200											"$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	Copay between $3.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $35.00	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"Copay between $0.00 and $195.00, $1,000 benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											82.77129726	54.28219079	56.13	5.846392111	44.53257947	0.2	0.2	20.35249321	74.30702101	0	17.23399583	39.37383757	0.2	8.432350604	2.592517353	9.437621153	27.63918586	14.39597956	18.32882898	7.59269746	0.2	0	0	0	10	10	10	10	0	0											76.54091091	50.19624516	51.9049655	5.406320699	41.18050955	0.184945539	0.184945539	18.82051413	68.71376024	0	15.93675323	36.41007805	0.184945539	7.797628135	2.397372595	8.727229653	25.55872062	13.31236099	16.94917577	7.021177619	0.184945539	0	0	0	10	10	10	10	0	0											11.3295	0.195105547	1.820681185	0.840866573	1.607543358	2.926161325	1.164063411	1.89055768	1.726819798	0	1.886096053	0.260653911	0.154996027	0.393112742	1.44682854	12.83673891	0.532688098	3.188681975	6.332303026	0.932713752	6.5878075	0	0	0	0.3	0.207692308	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	58.6022	0	4.7256	11.3295	0.195105547	1.820681185	0.840866573	1.607543358	2.926161325	1.164063411	1.89055768	1.726819798	0	1.886096053	0.260653911	0.154996027	0.393112742	1.44682854	12.83673891	0.532688098	3.188681975	6.332303026	0.932713752	6.5878075	0	0	0	0.3	0.207692308	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	58.6022	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											7.1387	0.0736	0.1536	0.5202	0.1513	0.3868	0.1539	0	0.6129	0.166	0.6443	0.0491	0	0.3026	0.2336	2.3857	0.04	0.2479	0.6948	0.2551	0.8551	0.0177	0	0	0	0	0	0	0	0											15.0829	0	0	18.4682	0.268747679	1.974261163	1.361079395	1.758868394	3.312915114	1.317918884	1.89055768	2.339718863	0.166024245	2.530365892	0.309746466	0.154996027	0.695708722	1.680449999	15.22248855	0.572693105	3.436562072	7.027085888	1.187850908	7.442945705	0.017673203	0	0	0.3	0.207692308	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	73.6851
H1657_009_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1077.309986	76.28599825	463.5163871	846.2814185	321.259674	16.08061133	4.876764288	1455.085312	269.3994269	7448.394898	1356.608936	107.1352946	0.359878931	526.3305014	7323.928215	17545.10245	393.5593981	2328.33788	3767.700663	2001.673042	33.61290802	33.00522538	3750	918	360	249.2307692	30.4	18.24	1664	6200											"$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 $3.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 and $50.00	Copay between $75.00 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	Copay between $0.00 and $25.00	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $75.00	Copay between $0.00 and $75.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $75 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											92.69587046	46.77493059	56.13	5.251236616	38.50803563	0.2	0.2	21.31462955	75.73099688	0	15.98065551	39.37383757	0.2	7.048864455	2.47902796	6.603764146	15.50044972	9.583064811	20.6586689	8.656605912	0.2	0	0	0	10	10	10	10	0	0											81.43024685	41.09022468	49.30834278	4.613037148	33.82803173	0.175693365	0.175693365	18.7241949	66.52716824	0	14.03847568	34.58861001	0.175693365	6.192193564	2.177743816	5.801187711	13.61663083	8.418404501	18.14795524	7.604541095	0.175693365	0	0	0	10	10	10	10	0	0											7.3105	0.261217401	1.904602075	0.325327302	0.90563187	2.82525671	0.856815126	2.270441748	1.49353175	0	1.587060129	0.308805077	0.06322834	0.271595029	1.329136615	8.481869392	0.446579419	1.633407507	5.69800525	1.268483742	5.905564906	0	0	0	0.3	0.207692308	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	45.6953	0	6.246	7.3105	0.261217401	1.904602075	0.325327302	0.90563187	2.82525671	0.856815126	2.270441748	1.49353175	0	1.587060129	0.308805077	0.06322834	0.271595029	1.329136615	8.481869392	0.446579419	1.633407507	5.69800525	1.268483742	5.905564906	0	0	0	0.3	0.207692308	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	45.6953	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											4.9437	0.1032	0.1751	0.2581	0.1102	0.3931	0.1192	0	0.6039	0.1297	0.5264	0.0231	0	0.2788	0.1234	2.1989	0.0959	0.2102	0.5679	0.2967	0.7773	0.03	0	0	0	0	0	0	0	0											11.9649	0	0	12.2541	0.364407679	2.079706788	0.583458303	1.015848235	3.21833832	0.97602492	2.270441748	2.097443736	0.129661956	2.113487334	0.331926868	0.06322834	0.550425462	1.452508668	10.68074933	0.542490638	1.843592044	6.265919444	1.565219959	6.682905782	0.029998626	0	0	0.3	0.207692308	0.025333333	0.0152	0	0	0	0	0	0	0	0	0	0	0	0	57.6602
H1681_001_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered							4000											D	D	D	V	T	Coin	Coin	V	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							0		1394.792439	62.103582	486.802562	695.751152	138.385554	9.024607	3.259083	313.017738	339.301125	599.876237	890.345401	0	18.541993	681.1068	3333.535679	4018.282651	27.411097	866.096642			20.397143								1.46	0.09	0.06	0.05	1.23	2.7							$195/Day(Days 1-5):1a	$195/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$175/Visit:9b. $0 Surgery ASC -- Physician,9b. $175 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $175 Surgery OP -- Facility"	"$0-$75/Visit:8a. $0 Lab -- FSL,8. $75 Lab -- OP"	"$0-$100/Visit:14h. $75 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $75 Radiology OP -- Facility"	$50/Visit:9a	"$0-$75/Proc:12. $0 Dialysis -- Dialysis Center,12. $75 Dialysis -- OP Hosp"	"$35-$100/Visit:9d. $75 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $75 OP Other,5. $35 Partial Hospitalization,8b. $75 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$75/Visit:7h. $75 Psych -- OP,7e. $35 Psych -- Other Provider"	"$35-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0:Membership in health club/fitness class 14a.	$0 Nutritional benefit 14a.	$0 Nurse hotline 14a.	$0 Additional Smoking Cessation 14a	$0 Health Education Materials 14a	$0 Corp Health 14a							119.554889	99.659372	43.132796	0	100.000004	0.199999	0.199999	50.000016	175.00002	65.968047	68.319917	0	1.173336	61.867301	9.999998	35.000002	68.757116	43.629902			0.2								0	0	0	0	0	0							103.39872	86.191803	37.304003	0	86.486403	0.172972	0.172972	43.243214	151.351218	57.053389	59.087436	0	1.014776	53.506802	8.648638	30.270242	59.465555	37.733931			0.172972								0	0	0	0	0	0							12.0183	0.446068309	1.513307019	0	0.997372399	1.561004322	0.563730105	1.127991086	4.279469878	2.852081025	4.384018908	0	0.001567997	3.036987224	2.402545279	10.13619902	0.135834675	2.723435911	0	0	3.528134619	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.7081	0	8.0794	12.0183	0.446068309	1.513307019	0	0.997372399	1.561004322	0.563730105	1.127991086	4.279469878	2.852081025	4.384018908	0	0.001567997	3.036987224	2.402545279	10.13619902	0.135834675	2.723435911	0	0	3.528134619	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.7081		$950/Admit:1a	$950/Admit:1b	"30% Coins(Days 1-20) 30%(Days 21-100):2. 30% SNF 1,2. 30% SNF 2"	30% Coins:6	$100/Trip:10a	40% Coins:11a	40% Coins:11b	$50/Visit:4a	"30% Coins:9b. 30% Surgery ASC -- Physician,9b. 30% Surgery ASC -- Facility,9a. 30% Surgery OP -- Physician,9a. 30% Surgery OP -- Facility"	"30% Coins:8a. 30% Lab -- FSL,8. 30% Lab -- OP"	"30% Coins:14h. 30% DMAM -- OP,8b. 30% Radiology -- FSR,14h. 30% SMAM -- FSR,14h. 30% SMAM -- OP,8b. 30% Advanced Imaging -- FSR,8b. 30% Advanced Imaging -- Office,9a. 30% Advanced Imaging -- OP,8a. 30% Radiology OP -- Physician,8a. 30% Radiology OP -- Facility"		"$0-$75/Proc:12. $0 Dialysis -- Dialysis Center,12. $75 Dialysis -- OP Hosp"	"30% Coins:9d. 30% Cardiac Rehab,8b. 30% Nuclear Medicine,9a. 30% OP Other,5. 30% Partial Hospitalization,8b. 30% Rad therapy,3. 30% Therapy (AT,PT,ST,OT) -- CORF"	30% Coins:7a	"30% Coins:7b, 7d, 7f"	"30% Coins:7h. 30% Psych -- OP,7e. 30% Psych -- Other Provider"	"30% Coins:9a. 30% Therapy (AT,PT,ST,OT) -- OP,7d. 30% Therapy (AT,PT,ST,OT) - Specialist"			30% Coins:15								0	0	0	0	0	0							2.3385	0.0753	0.4357	0.6611	0.8157	2.4281	0.8769	0.2442	3.1471	0.4054	1.6863		0.0003	0.9525	1.9098	4.3603	0.0276	0.3682			1.3015								0	0	0	0	0	0							22.0346	500	0	14.3568	0.521414309	1.949054019	0.661076	1.813051399	3.989119322	1.440602105	1.372182086	7.426559878	3.257500025	6.070366908	0	0.001907997	3.989499224	4.312353279	14.49651502	0.163390675	3.091610911	0	0	4.829650619	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.7427
H1681_002_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered							4000											D	D	D	V	T	Coin	Coin	V	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							0		1451.024138	64.607317	506.428231	723.800679	143.964631	9.766927	3.527159	325.637191	352.980207	624.060523	926.240088	0	19.289521	708.565935	3467.928703	4180.281566	28.516186	901.013724			22.074912								1.46	0.09	0.06	0.05	1.23	2.7							$195/Day(Days 1-5):1a	$195/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$175/Visit:9b. $0 Surgery ASC -- Physician,9b. $175 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $175 Surgery OP -- Facility"	"$0-$75/Visit:8a. $0 Lab -- FSL,8. $75 Lab -- OP"	"$0-$100/Visit:14h. $75 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $75 Radiology OP -- Facility"	$50/Visit:9a	"$0-$75/Proc:12. $0 Dialysis -- Dialysis Center,12. $75 Dialysis -- OP Hosp"	"$30-$100/Visit:9d. $75 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $75 OP Other,5. $30 Partial Hospitalization,8b. $75 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$75/Visit:7h. $75 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0:Membership in health club/fitness class 14a.	$0 Nutritional benefit 14a.	$0 Nurse hotline 14a.	$0 Additional Smoking Cessation 14a	$0 Health Education Materials 14a	$0 Corp Health 14a							119.554887	99.659485	43.132808	0	99.999978	0.199999	0.2	50.000013	174.999999	65.968043	68.319901	0	1.173279	60.069831	10.000001	30	67.976131	39.708633			0.199999								0	0	0	0	0	0							102.742481	85.64487	37.067257	0	85.937481	0.171874	0.171875	42.968761	150.390624	56.691287	58.712415	0	1.008287	51.622511	8.593751	25.78125	58.416987	34.124607			0.171874								0	0	0	0	0	0							12.4235	0.461107105	1.564325449	0	1.030996478	1.678680811	0.606230453	1.166018886	4.423742799	2.948232851	4.531816036	0	0.001620781	3.048162731	2.48354298	8.981073677	0.138819139	2.562228269	0	0	3.794103425	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.8442	0	8.4836	12.4235	0.461107105	1.564325449	0	1.030996478	1.678680811	0.606230453	1.166018886	4.423742799	2.948232851	4.531816036	0	0.001620781	3.048162731	2.48354298	8.981073677	0.138819139	2.562228269	0	0	3.794103425	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.8442		$950/Admit:1a	$950/Admit:1b	"30% Coins(Days 1-20) 30%(Days 21-100):2. 30% SNF 1,2. 30% SNF 2"	30% Coins:6	$100/Trip:10a	40% Coins:11a	40% Coins:11b	$50/Visit:4a	"30% Coins:9b. 30% Surgery ASC -- Physician,9b. 30% Surgery ASC -- Facility,9a. 30% Surgery OP -- Physician,9a. 30% Surgery OP -- Facility"	"30% Coins:8a. 30% Lab -- FSL,8. 30% Lab -- OP"	"30% Coins:14h. 30% DMAM -- OP,8b. 30% Radiology -- FSR,14h. 30% SMAM -- FSR,14h. 30% SMAM -- OP,8b. 30% Advanced Imaging -- FSR,8b. 30% Advanced Imaging -- Office,9a. 30% Advanced Imaging -- OP,8a. 30% Radiology OP -- Physician,8a. 30% Radiology OP -- Facility"		"$0-$75/Proc:12. $0 Dialysis -- Dialysis Center,12. $75 Dialysis -- OP Hosp"	"30% Coins:9d. 30% Cardiac Rehab,8b. 30% Nuclear Medicine,9a. 30% OP Other,5. 30% Partial Hospitalization,8b. 30% Rad therapy,3. 30% Therapy (AT,PT,ST,OT) -- CORF"	30% Coins:7a	"30% Coins:7b, 7d, 7f"	"30% Coins:7h. 30% Psych -- OP,7e. 30% Psych -- Other Provider"	"30% Coins:9a. 30% Therapy (AT,PT,ST,OT) -- OP,7d. 30% Therapy (AT,PT,ST,OT) - Specialist"			30% Coins:15								0	0	0	0	0	0							2.3939	0.0771	0.4641	0.704	0.835	2.5859	0.9339	0.25	3.3516	0.4318	1.7959		0.0003	1.0144	2.0339	4.6437	0.0293	0.3921			1.3861								0	0	0	0	0	0							23.3231	500	0	14.8174	0.538240105	2.028388449	0.704033	1.866015478	4.264577811	1.540082453	1.415999886	7.775334799	3.379995851	6.327744036	0	0.001968781	4.062568731	4.51745298	13.62472868	0.168166139	2.954327269	0	0	5.180194425	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1673
H1681_003_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered							4000											D	D	D	V	T	Coin	Coin	V	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							0		1433.061358	63.807518	500.158964	714.840476	142.182438	9.526606	3.440371	321.606005	348.610531	616.335042	914.77381	0	19.050727	699.794329	3424.997897	4128.532273	28.163174	889.859733			21.531746								1.46	0.09	0.06	0.05	1.23	2.7							$195/Day(Days 1-5):1a	$195/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$175/Visit:9b. $0 Surgery ASC -- Physician,9b. $175 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $175 Surgery OP -- Facility"	"$0-$75/Visit:8a. $0 Lab -- FSL,8. $75 Lab -- OP"	"$0-$100/Visit:14h. $75 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $75 Radiology OP -- Facility"	$50/Visit:9a	"$0-$75/Proc:12. $0 Dialysis -- Dialysis Center,12. $75 Dialysis -- OP Hosp"	"$35-$100/Visit:9d. $75 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $75 OP Other,5. $35 Partial Hospitalization,8b. $75 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$75/Visit:7h. $75 Psych -- OP,7e. $35 Psych -- Other Provider"	"$35-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								Silver Sneakers	Meals on Wheels	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit							119.554892	99.659353	43.13279	0	100.000029	0.199999	0.199999	49.999999	175.000014	65.968055	68.319905	0	1.173498	61.867326	10	35.000001	68.756596	43.629909			0.199999								0	0	0	0	0	0							102.591607	85.518986	37.012808	0	85.811325	0.171622	0.171622	42.905649	150.169787	56.608045	58.626198	0	1.006994	53.089156	8.58113	30.033956	59.000929	37.439392			0.171622								0	0	0	0	0	0							12.2517	0.45472952	1.542690642	0	1.016738616	1.634975175	0.590443352	1.149892864	4.362564099	2.907460149	4.469142543	0	0.001598664	3.095957525	2.449196017	10.33301305	0.138471119	2.776317281	0	0	3.695321312	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.8702	0	8.742	12.2517	0.45472952	1.542690642	0	1.016738616	1.634975175	0.590443352	1.149892864	4.362564099	2.907460149	4.469142543	0	0.001598664	3.095957525	2.449196017	10.33301305	0.138471119	2.776317281	0	0	3.695321312	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.8702		$950/Admit:1a	$950/Admit:1b	"30% Coins(Days 1-20) 30%(Days 21-100):2. 30% SNF 1,2. 30% SNF 2"	30% Coins:6	$100/Trip:10a	40% Coins:11a	40% Coins:11b	$50/Visit:4a	"30% Coins:9b. 30% Surgery ASC -- Physician,9b. 30% Surgery ASC -- Facility,9a. 30% Surgery OP -- Physician,9a. 30% Surgery OP -- Facility"	"30% Coins:8a. 30% Lab -- FSL,8. 30% Lab -- OP"	"30% Coins:14h. 30% DMAM -- OP,8b. 30% Radiology -- FSR,14h. 30% SMAM -- FSR,14h. 30% SMAM -- OP,8b. 30% Advanced Imaging -- FSR,8b. 30% Advanced Imaging -- Office,9a. 30% Advanced Imaging -- OP,8a. 30% Radiology OP -- Physician,8a. 30% Radiology OP -- Facility"		"$0-$75/Proc:12. $0 Dialysis -- Dialysis Center,12. $75 Dialysis -- OP Hosp"	"30% Coins:9d. 30% Cardiac Rehab,8b. 30% Nuclear Medicine,9a. 30% OP Other,5. 30% Partial Hospitalization,8b. 30% Rad therapy,3. 30% Therapy (AT,PT,ST,OT) -- CORF"	30% Coins:7a	"30% Coins:7b, 7d, 7f"	"30% Coins:7h. 30% Psych -- OP,7e. 30% Psych -- Other Provider"	"30% Coins:9a. 30% Therapy (AT,PT,ST,OT) -- OP,7d. 30% Therapy (AT,PT,ST,OT) - Specialist"			30% Coins:15								Silver Sneakers	Meals on Wheels	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit							2.3695	0.0763	0.4536	0.6882	0.8265	2.5278	0.9129	0.2474	3.2763	0.4221	1.7556		0.0003	0.9916	1.9882	4.5393	0.0287	0.3833			1.355								0	0	0	0	0	0							22.8427	500	0	14.6212	0.53107452	1.996328642	0.688218	1.843229616	4.162780175	1.503316352	1.397321864	7.638862099	3.329523149	6.224727543	0	0.001942664	4.087575525	4.437414017	14.87234705	0.167158119	3.159607281	0	0	5.050272312	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.7129
H1681_801_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		260.676475	8.398951	506.428231	723.800679	4.948781	9.766927	3.527159	21.714765	55.818046	624.060523	30.1818	0	0.380853	17.194473	32.392093	73.954942	0.467373	6.244584			22.074912																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000021	1023.999306	43.132808	0	0.199999	0.199999	0.2	0.2	0.199999	0	0.199999	0	0.200001	0.199999	0.2	0.2	0.500001	0.199999			0.199999																				1024.000021	1023.999306	43.132808	0	0.199999	0.199999	0.2	0.2	0.199999	0	0.199999	0	0.200001	0.199999	0.2	0.2	0.500001	0.199999			0.199999																				22.2444	0.71671	1.820305971	0	0.989751251	1.953375633	0.7054318	4.342953	11.16355338	0	6.036329818	0	0.076170981	3.438877406	6.4784186	14.7909884	0.233686967	1.248910555	0	0	4.414960325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6548	0	0	22.2444	0.71671	1.820305971	0	0.989751251	1.953375633	0.7054318	4.342953	11.16355338	0	6.036329818	0	0.076170981	3.438877406	6.4784186	14.7909884	0.233686967	1.248910555	0	0	4.414960325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6548		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4716	0.0796	0.2023		0.6275	1.2384	0.4472	0.818	2.1402		1.1468		0.0143	0.6478	1.2988	2.9652	0.0468	0.2504			0.8851																				15.28	0	0	24.716	0.796344	2.022561971	0	1.617244251	3.191796633	1.1526668	5.160992	13.30371538	0	7.183123818	0	0.090518981	4.086627406	7.7771746	17.7561994	0.280535967	1.499286555	0	0	5.300051325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.9348
H1681_802_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		260.676475	8.398951	506.428231	723.800679	4.948781	9.766927	3.527159	21.714765	55.818046	624.060523	30.1818	0	0.380853	17.194473	32.392093	73.954942	0.467373	6.244584			22.074912																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000021	1023.999306	43.132808	0	0.199999	0.199999	0.2	0.2	0.199999	0	0.199999	0	0.200001	0.199999	0.2	0.2	0.500001	0.199999			0.199999																				1024.000021	1023.999306	43.132808	0	0.199999	0.199999	0.2	0.2	0.199999	0	0.199999	0	0.200001	0.199999	0.2	0.2	0.500001	0.199999			0.199999																				22.2444	0.71671	1.820305971	0	0.989751251	1.953375633	0.7054318	4.342953	11.16355338	0	6.036329818	0	0.076170981	3.438877406	6.4784186	14.7909884	0.233686967	1.248910555	0	0	4.414960325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6548	0	0	22.2444	0.71671	1.820305971	0	0.989751251	1.953375633	0.7054318	4.342953	11.16355338	0	6.036329818	0	0.076170981	3.438877406	6.4784186	14.7909884	0.233686967	1.248910555	0	0	4.414960325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6548		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4716	0.0796	0.2023		0.6275	1.2384	0.4472	0.818	2.1402		1.1468		0.0143	0.6478	1.2988	2.9652	0.0468	0.2504			0.8851																				15.28	0	0	24.716	0.796344	2.022561971	0	1.617244251	3.191796633	1.1526668	5.160992	13.30371538	0	7.183123818	0	0.090518981	4.086627406	7.7771746	17.7561994	0.280535967	1.499286555	0	0	5.300051325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.9348
H1681_803_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		260.676475	8.398951	506.428231	723.800679	4.948781	9.766927	3.527159	21.714765	55.818046	624.060523	30.1818	0	0.380853	17.194473	32.392093	73.954942	0.467373	6.244584			22.074912																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000021	1023.999306	43.132808	0	0.199999	0.199999	0.2	0.2	0.199999	0	0.199999	0	0.200001	0.199999	0.2	0.2	0.500001	0.199999			0.199999																				1024.000021	1023.999306	43.132808	0	0.199999	0.199999	0.2	0.2	0.199999	0	0.199999	0	0.200001	0.199999	0.2	0.2	0.500001	0.199999			0.199999																				22.2444	0.71671	1.820305971	0	0.989751251	1.953375633	0.7054318	4.342953	11.16355338	0	6.036329818	0	0.076170981	3.438877406	6.4784186	14.7909884	0.233686967	1.248910555	0	0	4.414960325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6548	0	0	22.2444	0.71671	1.820305971	0	0.989751251	1.953375633	0.7054318	4.342953	11.16355338	0	6.036329818	0	0.076170981	3.438877406	6.4784186	14.7909884	0.233686967	1.248910555	0	0	4.414960325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6548		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4716	0.0796	0.2023		0.6275	1.2384	0.4472	0.818	2.1402		1.1468		0.0143	0.6478	1.2988	2.9652	0.0468	0.2504			0.8851																				15.28	0	0	24.716	0.796344	2.022561971	0	1.617244251	3.191796633	1.1526668	5.160992	13.30371538	0	7.183123818	0	0.090518981	4.086627406	7.7771746	17.7561994	0.280535967	1.499286555	0	0	5.300051325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.9348
H1681_804_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		260.676475	8.398951	506.428231	723.800679	4.948781	9.766927	3.527159	21.714765	55.818046	624.060523	30.1818	0	0.380853	17.194473	32.392093	73.954942	0.467373	6.244584			22.074912																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000021	1023.999306	43.132808	0	0.199999	0.199999	0.2	0.2	0.199999	0	0.199999	0	0.200001	0.199999	0.2	0.2	0.500001	0.199999			0.199999																				1024.000021	1023.999306	43.132808	0	0.199999	0.199999	0.2	0.2	0.199999	0	0.199999	0	0.200001	0.199999	0.2	0.2	0.500001	0.199999			0.199999																				22.2444	0.71671	1.820305971	0	0.989751251	1.953375633	0.7054318	4.342953	11.16355338	0	6.036329818	0	0.076170981	3.438877406	6.4784186	14.7909884	0.233686967	1.248910555	0	0	4.414960325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6548	0	0	22.2444	0.71671	1.820305971	0	0.989751251	1.953375633	0.7054318	4.342953	11.16355338	0	6.036329818	0	0.076170981	3.438877406	6.4784186	14.7909884	0.233686967	1.248910555	0	0	4.414960325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6548		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4716	0.0796	0.2023		0.6275	1.2384	0.4472	0.818	2.1402		1.1468		0.0143	0.6478	1.2988	2.9652	0.0468	0.2504			0.8851																				15.28	0	0	24.716	0.796344	2.022561971	0	1.617244251	3.191796633	1.1526668	5.160992	13.30371538	0	7.183123818	0	0.090518981	4.086627406	7.7771746	17.7561994	0.280535967	1.499286555	0	0	5.300051325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.9348
H1689_012_0	2009	6	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Ambulatory Surgical Center	Urgent Care	Radiology	Chiropractic	Podiatric	Vision Exam Diagnostic	Hearing Exam Diagnostic	Radiation-Chemotherapy	Radiology	Diabetes Supplies	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	Coin	V	V	0	Coin	0	0	0	V	V	V	0	0	0	V	V	V	V	V	V	V	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	0	0	0	0	0	0	0	0	0		1242.906286	65.48233226	431.5523263	33.44769119	101.4330012	11.54884034	0.665417168	386.2767926	371.1854243	4510.67224	413.8415138	124.676556	0.573193987	880.7683401	3268.670701	2740.627583	0.516058385	1226.766239	188.6884162	0	46.28115513	0	0	0	425.3129871	351.2071332	190.2861391	0	0	0	48.18606732	8.374475279	755.2976137	959.3592788	269.788109	626.7995065	1.151609883	16.60308951	2030.762463	2.181431093	$200/day (days 1-5); $1000 yrly max	$200/day (days 1-5); $1000 yrly max	$125/day (for days 21-100)	$0 copay	$100 copay	30% coinsurance	30% coinsurance	$50 copay	$175 copay	$15 copay	$100 copay/Higher Tier	$175 copay	20% coinsurance	$25 copay	$15 copay	$25 copay	50% coinsurance	$25 copay	$100 copay/Higher Tier	0	20% coinsurance	0	0	0	$25 copay	Covd up to $50/ Every 2 yrs.	$25 copay	0	0	0	$100 copay	$25 copay	$15 copay/Lower Tier	$25 copay	$25 copay	$25 copay	$25 copay	20% coinsurance	$15 copay/Lower Tier	20% coinsurance	200	200	125	0	100	0.3	0.3	50	175	15	100	175	0.2	25	15	25	0.5	25	100	0	0.2	0	0	0	25	0	25	0	0	0	100	25	15	25	25	25	25	0.2	15	0.2	100.9885575	66.29080319	120.5084346	0	96.40674771	0.289220243	0.289220243	48.20337386	168.7118085	14.46101216	96.40674771	168.7118085	0.192813495	24.10168693	14.46101216	24.10168693	0.482033739	24.10168693	96.40674771	0	0.192813495	0	0	0	24.10168693	0	24.10168693	0	0	0	96.40674771	24.10168693	14.46101216	24.10168693	24.10168693	24.10168693	24.10168693	0.192813495	14.46101216	0.192813495	10.4599	0.3617397	4.333807942	0	0.814902146	3.340158412	0.192452115	1.55165372	5.218613686	5.435740508	3.324759535	1.75286727	0.110519536	1.769000232	3.939023895	5.504479	0.248757552	2.463927986	1.515903045	0	8.923631293	0	0	0	0.854230038	0	0.382184746	0	0	0	0.387121836	0.016819915	0.910197331	1.926848082	0.541862378	1.258910456	0.002312978	3.201299723	2.447240056	0.420609354	73.6115		2.7436	10.4599	0.3617397	4.333807942	0	0.814902146	3.340158412	0.192452115	1.55165372	5.218613686	5.435740508	3.324759535	1.75286727	0.110519536	1.769000232	3.939023895	5.504479	0.248757552	2.463927986	1.515903045	0	8.923631293	0	0	0	0.854230038	0	0.382184746	0	0	0	0.387121836	0.016819915	0.910197331	1.926848082	0.541862378	1.258910456	0.002312978	3.201299723	2.447240056	0.420609354	73.6115	4000																																																																																	0		0	10.4599	0.3617397	4.333807942	0	0.814902146	3.340158412	0.192452115	1.55165372	5.218613686	5.435740508	3.324759535	1.75286727	0.110519536	1.769000232	3.939023895	5.504479	0.248757552	2.463927986	1.515903045	0	8.923631293	0	0	0	0.854230038	0	0.382184746	0	0	0	0.387121836	0.016819915	0.910197331	1.926848082	0.541862378	1.258910456	0.002312978	3.201299723	2.447240056	0.420609354	73.6115
H1689_013_0	2009	9	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Ambulatory Surgical Center	Urgent Care	Radiology	Chiropractic	Podiatric	Vision Exam Diagnostic	Hearing Exam Diagnostic	Radiation-Chemotherapy	Radiology	Diabetes Supplies	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	Coin	V	V	0	Coin	0	0	0	V	V	V	0	0	0	V	V	V	V	V	V	V	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	0	0	0	0	0	0	0	0	0		1188.649513	98.11968252	119.8324114	13.0784018	79.56758844	9.267798053	1.505542248	290.617608	268.0792468	4105.815384	357.405714	56.25331883	0.265311998	578.4303559	3473.573914	2610.10593	0.821269296	1026.843866	195.9225366	0	21.45044944	0	0	0	436.4552359	364.7200047	197.6074942	0	0	0	33.04162523	5.451196573	618.2612526	467.2313966	241.0261956	622.760254	0.142689092	13.85023793	1919.852423	1.304468845	$275/day (days 1-5); $1375 yrly max	$275/day (days 1-5); $1375 yrly max	$125/day (for days 21-100)	$0 copay	$150 copay	30% coinsurance	30% coinsurance	$50 copay	$200 copay	$20 copay	$100 copay/Higher Tier	$200 copay	20% coinsurance	$30 copay	$20 copay	$30 copay	50% coinsurance	$30 copay	$100 copay/Higher Tier	0	20% coinsurance	0	0	0	$30 copay	Covd up to $50/ Every 2 yrs.	$30 copay	0	0	0	$100 copay	$30 copay	$30 copay/Lower Tier	$30 copay	$30 copay	$30 copay	$30 copay	20% coinsurance	$30 copay/Lower Tier	20% coinsurance	275	275	125	0	150	0.3	0.3	50	200	20	100	200	0.2	30	20	30	0.5	30	100	0	0.2	0	0	0	30	0	30	0	0	0	100	30	30	30	30	30	30	0.2	30	0.2	123.3792934	72.68301658	121.3045705	0	145.5654845	0.291130969	0.291130969	48.52182818	194.0873127	19.40873127	97.04365636	194.0873127	0.194087313	29.11309691	19.40873127	29.11309691	0.485218282	29.11309691	97.04365636	0	0.194087313	0	0	0	29.11309691	0	29.11309691	0	0	0	97.04365636	29.11309691	29.11309691	29.11309691	29.11309691	29.11309691	29.11309691	0.194087313	29.11309691	0.194087313	12.2212	0.594302876	1.2113516	0	0.965191214	2.698143029	0.438309974	1.175108137	4.335898384	6.640722287	2.890329774	0.909837957	0.051493693	1.403324917	5.618138555	6.332355574	0.398494877	2.491217083	1.584419943	0	4.163260089	0	0	0	1.058880298	0	0.479413844	0	0	0	0.267206677	0.013225101	1.499958314	1.133546077	0.584751582	1.510873302	0.000346177	2.68815546	4.65773747	0.253180853	70.2704		2.1407	12.2212	0.594302876	1.2113516	0	0.965191214	2.698143029	0.438309974	1.175108137	4.335898384	6.640722287	2.890329774	0.909837957	0.051493693	1.403324917	5.618138555	6.332355574	0.398494877	2.491217083	1.584419943	0	4.163260089	0	0	0	1.058880298	0	0.479413844	0	0	0	0.267206677	0.013225101	1.499958314	1.133546077	0.584751582	1.510873302	0.000346177	2.68815546	4.65773747	0.253180853	70.2704	4000																																																																																	0		0	12.2212	0.594302876	1.2113516	0	0.965191214	2.698143029	0.438309974	1.175108137	4.335898384	6.640722287	2.890329774	0.909837957	0.051493693	1.403324917	5.618138555	6.332355574	0.398494877	2.491217083	1.584419943	0	4.163260089	0	0	0	1.058880298	0	0.479413844	0	0	0	0.267206677	0.013225101	1.499958314	1.133546077	0.584751582	1.510873302	0.000346177	2.68815546	4.65773747	0.253180853	70.2704
H1689_801_0	2009	4																																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	V																																																			0		362.1445937	4.336067825	32.2768371	2.567608646	10.07597009	17.49061051	3.431471275	13.99484559	48.06698852	10.35000477	27.95757212	0	0.234523081	27.51135025	50.26604463	136.2412151	1.549995592	5.216213416	33.87468857	44.85648821	63.42803066	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.076557244	0.076557244	0.17917473	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.076557244	0.076557244	0.17917473	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			27.7248	0.331957401	5.783193564	0	2.32754909	4.040331028	0.792669865	3.23280933	11.10347435	2.390851102	6.458199159	0	0.054174832	6.355121907	11.61145631	31.4717207	0.358048982	1.204945299	7.82505306	10.36184878	14.65187508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.0801			27.7248	0.331957401	5.783193564	0	2.32754909	4.040331028	0.792669865	3.23280933	11.10347435	2.390851102	6.458199159	0	0.054174832	6.355121907	11.61145631	31.4717207	0.358048982	1.204945299	7.82505306	10.36184878	14.65187508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.0801																																																																																		0			27.7248	0.331957401	5.783193564	0	2.32754909	4.040331028	0.792669865	3.23280933	11.10347435	2.390851102	6.458199159	0	0.054174832	6.355121907	11.61145631	31.4717207	0.358048982	1.204945299	7.82505306	10.36184878	14.65187508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.0801
H1689_802_0	2009	4																																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	V																																																			0		277.307893	3.320292098	7.847282633	3.946133421	5.697341776	12.26164999	0.31440182	8.806015924	45.36807761	8.942977692	24.15689164	0	0.202640939	23.77133122	56.99214597	154.4716573	1.757400561	5.914195131	38.40746193	50.8587366	63.67631615	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.073126813	0.073126813	0.179054023	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.073126813	0.073126813	0.179054023	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			20.2786	0.242802381	1.405087527	0	1.31608595	2.832441147	0.07262682	2.034189678	10.48002593	2.065827847	5.580241969	0	0.046810057	5.491177511	13.16518572	35.68295284	0.405959529	1.366179075	8.872123707	11.74836815	14.70922903	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.796			20.2786	0.242802381	1.405087527	0	1.31608595	2.832441147	0.07262682	2.034189678	10.48002593	2.065827847	5.580241969	0	0.046810057	5.491177511	13.16518572	35.68295284	0.405959529	1.366179075	8.872123707	11.74836815	14.70922903	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.796																																																																																		0			20.2786	0.242802381	1.405087527	0	1.31608595	2.832441147	0.07262682	2.034189678	10.48002593	2.065827847	5.580241969	0	0.046810057	5.491177511	13.16518572	35.68295284	0.405959529	1.366179075	8.872123707	11.74836815	14.70922903	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.796
H1689_807_0	2009	4																																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	V																																																			0		362.1445937	4.336067825	32.2768371	2.567608646	10.07597009	17.49061051	3.431471275	13.99484559	48.06698852	10.35000477	27.95757212	0	0.234523081	27.51135025	50.26604463	136.2412151	1.549995592	5.216213416	33.87468857	44.85648821	63.42803066	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.076557244	0.076557244	0.17917473	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.076557244	0.076557244	0.17917473	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			27.7248	0.331957401	5.783193564	0	2.32754909	4.040331028	0.792669865	3.23280933	11.10347435	2.390851102	6.458199159	0	0.054174832	6.355121907	11.61145631	31.4717207	0.358048982	1.204945299	7.82505306	10.36184878	14.65187508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.0801			27.7248	0.331957401	5.783193564	0	2.32754909	4.040331028	0.792669865	3.23280933	11.10347435	2.390851102	6.458199159	0	0.054174832	6.355121907	11.61145631	31.4717207	0.358048982	1.204945299	7.82505306	10.36184878	14.65187508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.0801																																																																																		0			27.7248	0.331957401	5.783193564	0	2.32754909	4.040331028	0.792669865	3.23280933	11.10347435	2.390851102	6.458199159	0	0.054174832	6.355121907	11.61145631	31.4717207	0.358048982	1.204945299	7.82505306	10.36184878	14.65187508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.0801
H1716_001_0	2009	3	r.	s.	t.								Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered								4000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			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		252.384692	8.131792	490.319168	700.777813	139.385361	9.32459	3.367416	315.278989	341.752286	604.209781	896.777331	0	18.675943	686.02722	3357.985637	4047.665773	27.609121	872.35387			21.075159						0.77		0.05	0.42	3.5	1.23	0.06	2.7							$650/Admit:1a	$650/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$5/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$100/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$0-$100/Visit:9d. $0 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $50 OP Other,5. $35 Partial Hospitalization,8b. $50 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$50/Visit:7h. $50 Psych -- OP,7e. $35 Psych -- Other Provider"	"$35-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15						HER 831		$0 Additional Smoking Cessation 14a	$0: Nutritional benefit 14a	$0: Membership in health club/fitness class 14a	$0: Health Education Materials 14a	$0: Nurse hotline 14a	$0 Corp Health 14a							649.999977	649.999901	43.132794	5.000004	100.000027	0.2	0.199999	49.999982	100.000009	0	53.871326	0	0.782611	44.033092	9.999998	35	47.659032	38.236217			0.2						0		0	0	0	0	0	0							564.56593	564.565864	37.463549	4.342818	86.856324	0.173712	0.173712	43.428134	86.856308	0	46.79064	0	0.679747	38.245514	8.685628	30.399705	41.394872	33.210563			0.173712						0		0	0	0	0	0	0							11.874	0.382577681	1.530758015	0.253612542	1.008875006	1.619793178	0.584960568	1.140998182	2.473611818	0	3.496732105	0	0.00105791	2.186455304	2.430517839	10.25398712	0.095239669	2.414280263	0	0	3.66100802	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4084	0	7.0537	11.874	0.382577681	1.530758015	0.253612542	1.008875006	1.619793178	0.584960568	1.140998182	2.473611818	0	3.496732105	0	0.00105791	2.186455304	2.430517839	10.25398712	0.095239669	2.414280263	0	0	3.66100802	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4084		30% Coins	30% Coins	30% Coins(Days 1-13) 30%(Days 14-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins						HER 831		0	0	0	0	0	0							6.9824	0.0999	0.4377	0.664	0.7987	1.8292	0.6606	0.2391	3.1611	0.4072	1.6939		0.0002	0.9568	1.9183	4.3798	0.0277	0.3698			1.3073						0		0	0	0	0	0	0							25.9337	500	0	18.8564	0.482500681	1.968450015	0.917637542	1.807562006	3.449002178	1.245548568	1.380103182	5.634740818	0.407226	5.190603105	0	0.00127991	3.143215304	4.348845839	14.63375512	0.122918669	2.784097263	0	0	4.96833102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.3422
H1716_002_0	2009	4	r.	s.	t.	u.	v.						OP Facility - Other	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered							Renal Dialysis										D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin								O	O	Coin	P	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		1345.68809	59.917194	469.66444	671.256893	133.513623	8.400349	3.033643	301.997795	327.355864	578.757302	859.000359	0	0	657.128104	3216.176929	3876.817051	26.446074	835.605285			18.986215								0.05	0.09	0	17.609287	3.5	1.23	0.06	2.7					$195/Day(Days 1-7):1a	$195/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$5/Visit:6	$125/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $150 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$75/Visit:14h. $25 DMAM -- OP,8b. $25 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $75 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $25 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$0-$75/Visit:9d. $0 Cardiac Rehab,8b. $75 Nuclear Medicine,9a. $50 OP Other,5. $30 Partial Hospitalization,8b. $25 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$50/Visit:7h. $50 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a	$0: Nutritional benefit 14a	$0/Proc:12	$0/Proc:12	$0: Membership in health club/fitness class 14a	$0: Health Education Materials 14a	$0: Nurse hotline 14a	$0 Corp Health 14a					138.925016	99.659339	43.132803	4.999993	125.000008	0.2	0.2	49.999994	150.000025	0	35.402723	0	0	37.308615	9.999998	30.000001	46.878186	34.314957			0.2								0	0	0	0	0	0	0	0					138.925016	99.659339	43.132803	4.999993	125.000008	0.2	0.2	49.999994	150.000025	0	35.402723	0	0	37.308615	9.999998	30.000001	46.878186	34.314957			0.2								0	0	0	0	0	0	0	0					15.5791	0.497608996	1.688161981	0.279689981	1.390766995	1.6800698	0.6067286	1.258323995	4.091948982	0	2.534245981	0	0	2.043044953	2.680146905	9.692042951	0.103311998	2.389479952	0	0	3.797243	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.312	0	0	15.5791	0.497608996	1.688161981	0.279689981	1.390766995	1.6800698	0.6067286	1.258323995	4.091948982	0	2.534245981	0	0	2.043044953	2.680146905	9.692042951	0.103311998	2.389479952	0	0	3.797243	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.312		30% Coins	30% Coins	25% Coins(Days 1-20) 25%(Days 21-100)	25% Coins	$125/Trip	25% Coins	25% Coins	$50/Visit	25% Coins	25% Coins	25% Coins		20% Coins	25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins								0	0	0	0	0	0	0						6.0987	0.0873	0.3186	0.4833	0.9272	1.3314	0.4808	0.2221	2.3009	0.2964	1.2329			0.6964	1.3963	3.1879	0.0201	0.2692			0.9516								0	0	0	0	0	0	0						20.3011	0	0	21.6779	0.584886996	2.006744981	0.763013981	2.317944995	3.0114978	1.0875516	1.480380995	6.392841982	0.296408	3.767165981	0	0	2.739443953	4.076440905	12.87994595	0.123458998	2.658658952	0	0	4.748805	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.6131
H1716_004_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered							3000											A	A	D	V	T	Coin	Coin	V	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							0		231.791697	7.468288	450.312438	643.598497	128.012343	7.722358	2.788798	289.554311	313.86753	554.910248	823.606202	0	17.152107	630.051868	3083.657926	3717.077103	25.356394	801.175096			17.453839			3.15	2.69		0.77		0.05	0.09	2.64	1.23	0.06	2.7							$625/Admit:1a	$625/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$5/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $150 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$75/Visit:14h. $25 DMAM -- OP,8b. $25 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $75 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $25 Radiology OP -- Facility"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$0-$75/Visit:9d. $0 Cardiac Rehab,8b. $75 Nuclear Medicine,9a. $50 OP Other,5. $35 Partial Hospitalization,8b. $25 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$50/Visit:7h. $50 Psych -- OP,7e. $35 Psych -- Other Provider"	"$35-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			"DEN 767 16a, 16b"	VIS 752		HER  831		$0 Additional Smoking Cessation 14a	$0: Nutritional benefit 14a	$0: Membership in health club/fitness class 14a	$0: Health Education Materials 14a	$0: Nurse hotline 14a	$0 Corp Health 14a							624.999988	624.999464	43.132799	4.999999	100.000044	0.2	0.2	49.999987	149.999995	0	35.990389	0	0.782177	39.106094	10	35	47.658511	38.23621			0.2			0	0		0		0	0	0	0	0	0							519.921865	519.921429	35.881097	4.159374	83.187537	0.166375	0.166375	41.593739	124.781246	0	29.939505	0	0.650674	32.531382	8.31875	29.115625	39.645924	31.807748			0.166375			0	0		0		0	0	0	0	0	0							10.0428	0.323576914	1.346475356	0.223080571	0.887419293	1.284807312	0.463986267	1.003637203	3.263731789	0	2.0548635	0	0.000930036	1.708038166	2.137681614	9.018751919	0.083773139	2.123631296	0	0	2.903882464	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.8711	0	7.856	10.0428	0.323576914	1.346475356	0.223080571	0.887419293	1.284807312	0.463986267	1.003637203	3.263731789	0	2.0548635	0	0.000930036	1.708038166	2.137681614	9.018751919	0.083773139	2.123631296	0	0	2.903882464	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.8711	5000	25% Coins	25% Coins	25% Coins(Days 1-20) 25%(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 767 16a, 16b"	VIS 752		HER  831		0	0	0	0	0	0							3.8866	0.0556	0.2436	0.3696	0.5916	1.0182	0.3677	0.1771	1.7596	0.2267	0.9429		0.0002	0.5326	1.0678	2.4379	0.0154	0.2059			0.7277			0	0		0		0	0	0	0	0	0							14.6266	0	2.956080341	13.9294	0.379196914	1.590106356	0.592695571	1.479032293	2.302996312	0.831688267	1.180750203	5.023303789	0.226674	2.9977195	0	0.001094036	2.240598166	3.205475614	11.45665192	0.099180139	2.329482296	0	0	3.631574464	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4976
H1716_006_0	2009	3	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered																		A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin	V		V		O	O	P	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		521.637908	16.807084	506.705032	724.19629	144.043318	9.777605	3.531015	325.815177	353.173136	624.401619	926.746346	0	0	708.953217	3469.824183	4182.566398	28.531771	901.506196			22.099047			3.15	2.69		0.77		0.05	0.09	18.998063	2.64	1.23	0.06	2.7						$750/Admit:1a	$750/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$5/Visit:6	$150/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $150 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$150/Visit:14h. $25 DMAM -- OP,8b. $25 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $150 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $150 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $25 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$0-$150/Visit:9d. $0 Cardiac Rehab,8b. $150 Nuclear Medicine,9a. $50 OP Other,5. $35 Partial Hospitalization,8b. $25 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$50/Visit:7h. $50 Psych -- OP,7e. $35 Psych -- Other Provider"	"$35-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			"DEN 767 16a, 16b"	VIS 752		HER  831		$0 Additional Smoking Cessation 14a	$0: Nutritional benefit 14a	$0/Proc:12	$0: Membership in health club/fitness class 14a	$0: Health Education Materials 14a	$0: Nurse hotline 14a	$0 Corp Health 14a						375.000008	374.999732	43.13281	4.999992	149.99996	0.2	0.2	49.999991	150.000027	0	56.984032	0	0	42.847837	9.999999	34.999997	47.658871	38.236223			0.199999			0	0		0		0	0	0	0	0	0	0						375.000008	374.999732	43.13281	4.999992	149.99996	0.2	0.2	49.999991	150.000027	0	56.984032	0	0	42.847837	9.999999	34.999997	47.658871	38.236223			0.199999			0	0		0		0	0	0	0	0	0	0						16.3012	0.525221	1.821300989	0.301747971	1.800540995	1.955521	0.706203	1.357562993	4.414664995	0	4.400811953	0	0	2.53142599	2.891519863	12.19915095	0.113315999	2.872515996	0	0	4.419787301	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.6125	0	0	16.3012	0.525221	1.821300989	0.301747971	1.800540995	1.955521	0.706203	1.357562993	4.414664995	0	4.400811953	0	0	2.53142599	2.891519863	12.19915095	0.113315999	2.872515996	0	0	4.419787301	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.6125		30% Coins	30% Coins	25% Coins(Days 1-20) 25%(Days 21-100)	25% Coins	$150/Trip	25% Coins	25% Coins	$50/Visit	25% Coins	25% Coins	25% Coins			25% Coins	25% Coins	25% Coins	25% Coins	25% Coins			25% Coins			"DEN 767 16a, 16b"	VIS 752		HER  831		0	0		0	0	0	0						7.0987	0.1016	0.3708	0.5626	1.2004	1.5497	0.5597	0.2396	2.6781	0.345	1.4351			0.8106	1.6252	3.7106	0.0234	0.3133			1.1076			0	0		0		0	0		0	0	0	0						23.7318	0	0	23.3998	0.626808	2.192115989	0.864313971	3.000901995	3.50524	1.265858	1.597132993	7.092793995	0.345006	5.835870953	0	0	3.34199999	4.516739863	15.90971895	0.136765999	3.185827996	0	0	5.527359301	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.3443
H1716_009_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered							3000											A	A	D	V	T	Coin	Coin	V	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							0		233.530745	7.52432	453.690969	648.427185	128.972773	7.838675	2.830804	291.726733	316.222364	559.073539	829.785422	0	17.280794	634.778918	3106.793496	3744.964987	25.546633	807.186023			17.716736			3.15	2.69		0.77		0.05	0.09	2.64	1.23	0.06	2.7							$650/Admit:1a	$650/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$5/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $150 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$75/Visit:14h. $25 DMAM -- OP,8b. $25 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $75 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $25 Radiology OP -- Facility"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$0-$75/Visit:9d. $0 Cardiac Rehab,8b. $75 Nuclear Medicine,9a. $50 OP Other,5. $35 Partial Hospitalization,8b. $25 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$50/Visit:7h. $50 Psych -- OP,7e. $35 Psych -- Other Provider"	"$35-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			"DEN 767 16a, 16b"	VIS 752		HER  831		$0 Additional Smoking Cessation 14a	$0: Nutritional benefit 14a	$0: Membership in health club/fitness class 14a	$0: Health Education Materials 14a	$0: Nurse hotline 14a	$0 Corp Health 14a							649.999998	649.999468	43.132804	5	99.999989	0.2	0.2	49.999997	150.000017	0	35.990393	0	0.782602	39.1061	10.000001	35.000001	47.658726	38.236226			0.199999			0	0		0		0	0	0	0	0	0							532.063999	532.063564	35.306788	4.0928	81.855991	0.163712	0.163712	40.927998	122.784013	0	29.460296	0	0.640607	32.010689	8.185601	28.649601	39.011527	31.298645			0.163711			0	0		0		0	0	0	0	0	0							10.3544	0.333618043	1.334864238	0.221156899	0.879766179	1.283285162	0.463436584	0.994982595	3.235587571	0	2.037143679	0	0.000922516	1.693309211	2.119247662	8.940979386	0.083051097	2.105319065	0	0	2.900424567	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.9815	0	8.6406	10.3544	0.333618043	1.334864238	0.221156899	0.879766179	1.283285162	0.463436584	0.994982595	3.235587571	0	2.037143679	0	0.000922516	1.693309211	2.119247662	8.940979386	0.083051097	2.105319065	0	0	2.900424567	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.9815	5000	30% Coins	30% Coins	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins			"DEN 767 16a, 16b"	VIS 752		HER  831		0	0	0	0	0	0							4.6584	0.0667	0.292	0.443	0.5865	1.2204	0.4407	0.1756	2.109	0.2717	1.1301		0.0002	0.6383	1.2798	2.922	0.0185	0.2467			0.8722			0	0		0		0	0	0	0	0	0							17.3718	0	3.850579737	15.0128	0.400283043	1.626875238	0.664168899	1.466277179	2.503664162	0.904155584	1.170567595	5.344571571	0.271687	3.167229679	0	0.001085516	2.331623211	3.399082662	11.86299339	0.101518097	2.352047065	0	0	3.772620567	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3533
H1716_010_0	2009	3	r.	s.	t.	u.	v.						Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered						3000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin	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		259.14952	8.349752	503.461745	719.5609	143.121335	9.652836	3.485957	323.729719	350.912567	620.404987	920.814484	0	19.17653	704.415394	3447.614745	4155.794884	28.349149	895.735891			21.817048			6.46	2.69				3.5	0.42	0.06	0.65	0.05	1.23	2.7						$550/Admit:1a	$550/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$150/Visit:14h. $75 DMAM -- OP,8b. $100 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $150 Advanced Imaging -- FSR,8b. $25 Advanced Imaging -- Office,9a. $150 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $75 Radiology OP -- Facility"	$100/Visit:9a	"$0-$100/Proc:12. $0 Dialysis -- Dialysis Center,12. $100 Dialysis -- OP Hosp"	"$0-$150/Visit:9d. $0 Cardiac Rehab,8b. $150 Nuclear Medicine,9a. $125 OP Other,5. $25 Partial Hospitalization,8b. $75 Rad therapy,3. $25 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$25/Visit:7b, 7d, 7f"	"$25-$100/Visit:7h. $100 Psych -- OP,7e. $25 Psych -- Other Provider"	"$25-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $25 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			"DEN 750 16a, 16b"	VIS 752				$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	$0: Nurse hotline 14a	Personal Health Coach	$0 Additional Smoking Cessation 14a	$0 Health Education Materials 14a	$0 Corp Health 14a						549.999984	550.000047	43.132802	0	100.000017	0.199999	0.2	50.000006	127.313183	0	81.648993	0	1.565038	75.265578	0	24.999999	88.293867	41.181071			0.2			0	0				0	0	0	0	0	0	0						470.557986	470.55804	36.9027	0	85.556014	0.171111	0.171112	42.778005	108.924067	0	69.855613	0	1.338983	64.394218	0	21.388999	75.540701	35.232877			0.171112			0	0				0	0	0	0	0	0	0						10.1621	0.327420245	1.548258145	0	1.020407578	1.651706421	0.596489074	1.154042628	3.18523533	0	5.360338353	0	0.002139754	3.780023204	0	7.407357718	0.178459549	2.629946039	0	0	3.733158717	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.7371	0	7.2151	10.1621	0.327420245	1.548258145	0	1.020407578	1.651706421	0.596489074	1.154042628	3.18523533	0	5.360338353	0	0.002139754	3.780023204	0	7.407357718	0.178459549	2.629946039	0	0	3.733158717	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.7371	6000	$800/Admit	$800/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$100/Proc	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			20%-30% Coins			"DEN 750 16a, 16b"	VIS 752				0	0	0	Personal Health Coach	0	0	0						1.6424	0.0529	0.3758	0.5702	0.6803	1.5708	0.5673	0.2037	2.7145	0.3497	1.4545		0.0004	0.8216	1.6473	3.7609	0.0238	0.3176			1.0388			0	0				0	0	0	0	0	0	0						17.7922	0	3.003773084	11.8044	0.380336245	1.924106145	0.570201	1.700679578	3.222456421	1.163739074	1.357697628	5.89970733	0.349687	6.814870353	0	0.002516754	4.601598204	1.647276	11.16827972	0.202227549	2.947510039	0	0	4.771957717	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.5293
H1716_801_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		252.384692	8.131792	490.319168	700.777813	4.724654	9.32459	3.367416	20.731322	53.290085	604.209781	28.814892	0	0.363604	16.415746	30.925098	70.605619	0.446206	5.961772			21.075159																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999997	1024.000121	43.132794	0	0.2	0.2	0.199999	0.199999	0.2	0	0.199999	0	0.2	0.2	0.2	0.199999	0.500002	0.199999			0.2																				1023.999997	1024.000121	43.132794	0	0.2	0.2	0.199999	0.199999	0.2	0	0.199999	0	0.2	0.2	0.2	0.199999	0.500002	0.199999			0.2																				21.5368	0.693912999	1.762402972	0	0.9449308	1.864918	0.673479833	4.146243669	10.658017	0	5.762949585	0	0.0727208	3.2831492	6.1850196	14.12105319	0.223103892	1.192348438	0	0	4.2150318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.3361	0	0	21.5368	0.693912999	1.762402972	0	0.9449308	1.864918	0.673479833	4.146243669	10.658017	0	5.762949585	0	0.0727208	3.2831492	6.1850196	14.12105319	0.223103892	1.192348438	0	0	4.2150318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.3361		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.393	0.0771	0.1958		0.5991	1.1823	0.427	0.781	2.0432		1.0949		0.0137	0.6184	1.2399	2.8309	0.0447	0.239			0.845																				14.6251	0	0	23.9298	0.771013999	1.958225972	0	1.5440048	3.047252	1.100458833	4.927234669	12.701253	0	6.857804585	0	0.0864188	3.9015632	7.4249566	16.95197419	0.267830892	1.431384438	0	0	5.0600368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.9612
H1716_802_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		252.384692	8.131792	490.319168	700.777813	4.724654	9.32459	3.367416	20.731322	53.290085	604.209781	28.814892	0	0.363604	16.415746	30.925098	70.605619	0.446206	5.961772			21.075159																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999997	1024.000121	43.132794	0	0.2	0.2	0.199999	0.199999	0.2	0	0.199999	0	0.2	0.2	0.2	0.199999	0.500002	0.199999			0.2																				1023.999997	1024.000121	43.132794	0	0.2	0.2	0.199999	0.199999	0.2	0	0.199999	0	0.2	0.2	0.2	0.199999	0.500002	0.199999			0.2																				21.5368	0.693912999	1.762402972	0	0.9449308	1.864918	0.673479833	4.146243669	10.658017	0	5.762949585	0	0.0727208	3.2831492	6.1850196	14.12105319	0.223103892	1.192348438	0	0	4.2150318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.3361	0	0	21.5368	0.693912999	1.762402972	0	0.9449308	1.864918	0.673479833	4.146243669	10.658017	0	5.762949585	0	0.0727208	3.2831492	6.1850196	14.12105319	0.223103892	1.192348438	0	0	4.2150318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.3361		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.393	0.0771	0.1958		0.5991	1.1823	0.427	0.781	2.0432		1.0949		0.0137	0.6184	1.2399	2.8309	0.0447	0.239			0.845																				14.6251	0	0	23.9298	0.771013999	1.958225972	0	1.5440048	3.047252	1.100458833	4.927234669	12.701253	0	6.857804585	0	0.0864188	3.9015632	7.4249566	16.95197419	0.267830892	1.431384438	0	0	5.0600368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.9612
H1716_803_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		252.384692	8.131792	490.319168	700.777813	4.724654	9.32459	3.367416	20.731322	53.290085	604.209781	28.814892	0	0.363604	16.415746	30.925098	70.605619	0.446206	5.961772			21.075159																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999997	1024.000121	43.132794	0	0.2	0.2	0.199999	0.199999	0.2	0	0.199999	0	0.2	0.2	0.2	0.199999	0.500002	0.199999			0.2																				1023.999997	1024.000121	43.132794	0	0.2	0.2	0.199999	0.199999	0.2	0	0.199999	0	0.2	0.2	0.2	0.199999	0.500002	0.199999			0.2																				21.5368	0.693912999	1.762402972	0	0.9449308	1.864918	0.673479833	4.146243669	10.658017	0	5.762949585	0	0.0727208	3.2831492	6.1850196	14.12105319	0.223103892	1.192348438	0	0	4.2150318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.3361	0	0	21.5368	0.693912999	1.762402972	0	0.9449308	1.864918	0.673479833	4.146243669	10.658017	0	5.762949585	0	0.0727208	3.2831492	6.1850196	14.12105319	0.223103892	1.192348438	0	0	4.2150318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.3361		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.393	0.0771	0.1958		0.5991	1.1823	0.427	0.781	2.0432		1.0949		0.0137	0.6184	1.2399	2.8309	0.0447	0.239			0.845																				14.6251	0	0	23.9298	0.771013999	1.958225972	0	1.5440048	3.047252	1.100458833	4.927234669	12.701253	0	6.857804585	0	0.0864188	3.9015632	7.4249566	16.95197419	0.267830892	1.431384438	0	0	5.0600368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.9612
H1716_804_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		252.384692	8.131792	490.319168	700.777813	4.724654	9.32459	3.367416	20.731322	53.290085	604.209781	28.814892	0	0.363604	16.415746	30.925098	70.605619	0.446206	5.961772			21.075159																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999997	1024.000121	43.132794	0	0.2	0.2	0.199999	0.199999	0.2	0	0.199999	0	0.2	0.2	0.2	0.199999	0.500002	0.199999			0.2																				1023.999997	1024.000121	43.132794	0	0.2	0.2	0.199999	0.199999	0.2	0	0.199999	0	0.2	0.2	0.2	0.199999	0.500002	0.199999			0.2																				21.5368	0.693912999	1.762402972	0	0.9449308	1.864918	0.673479833	4.146243669	10.658017	0	5.762949585	0	0.0727208	3.2831492	6.1850196	14.12105319	0.223103892	1.192348438	0	0	4.2150318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.3361	0	0	21.5368	0.693912999	1.762402972	0	0.9449308	1.864918	0.673479833	4.146243669	10.658017	0	5.762949585	0	0.0727208	3.2831492	6.1850196	14.12105319	0.223103892	1.192348438	0	0	4.2150318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.3361		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.393	0.0771	0.1958		0.5991	1.1823	0.427	0.781	2.0432		1.0949		0.0137	0.6184	1.2399	2.8309	0.0447	0.239			0.845																				14.6251	0	0	23.9298	0.771013999	1.958225972	0	1.5440048	3.047252	1.100458833	4.927234669	12.701253	0	6.857804585	0	0.0864188	3.9015632	7.4249566	16.95197419	0.267830892	1.431384438	0	0	5.0600368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.9612
H1717_001_0	2009	5																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1736.576187	144.5233961	562.9777629	630.4124413	98.31796856	10.57820262	4.278162476	350.897284	30.19418239	8685.269397	34.88796132	0	0.138877408	21.87438347	4157.132017	3474.05711	509.89034	145.6411049	0	0	14.47283025	776.533417	0	0	129.1822656	0	13.00003349	0	103.25893	0											"$225 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$225 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											222.3473267	225	85.36789939	0	150	0.2	0.066028517	47.82835934	0.2	2.8	0.170804648	0	0.2	0.197005602	14.62297959	25	37.5	25	0	0	0.2	23.70918757	0	0	25	0	25	0	0	0											146.1359462	147.8600771	56.10001861	0	98.57338475	0.13143118	0.04339103	31.43068845	0.13143118	1.840036515	0.112245282	0	0.13143118	0.129795944	14.62297959	25	37.5	16.42889746	0	0	0.13143118	23.70918757	0	0	25	0	25	0	0	0											21.148	1.780770041	2.631921915	0	0.807627912	1.390305649	0.185633874	0.919078601	3.968457011	1.331767736	3.916009042	0	0.018252822	2.839206259	5.065804721	7.23761898	1.593407312	0.199393565	0	0	1.902181152	1.534248037	0	0	0.26912972	0	0.027083403	0	0	0	0	0	0	0	0	0	0	0	0	0	58.7659	0	22.4384	21.148	1.780770041	2.631921915	0	0.807627912	1.390305649	0.185633874	0.919078601	3.968457011	1.331767736	3.916009042	0	0.018252822	2.839206259	5.065804721	7.23761898	1.593407312	0.199393565	0	0	1.902181152	1.534248037	0	0	0.26912972	0	0.027083403	0	0	0	0	0	0	0	0	0	0	0	0	0	58.7659	3600	"30% Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"30% Days 1-999 (1b); $0 n/c (1b1, 1b2)"	"30% Days 1-999 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$30 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											6.831	0.2602	1.9985	0.3629	0.2692	0.6952	0.2811	0.3064	1.9842	0.4439	1.917	0	0.0061	1.4163	3.4721	4.3414	0.7739	0.1196	0	0	1.2228	0.9344	0	0	0.1615	0	0.0163	0	0	0											27.814	0	9.530355816	27.979	2.040973769	4.630418342	0.362897963	1.076837216	2.085458473	0.466775845	1.225438135	5.952685517	1.775690315	5.832984679	0	0.024337095	4.255478655	8.53793913	11.57898152	2.367348007	0.319029704	0	0	3.125011893	2.468612988	0	0	0.430607552	0	0.043333445	0	0	0	0	0	0	0	0	0	0	0	0	0	86.5799
H1717_006_0	2009	4																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		338.7309435	22.9632	44.43277594	5041.035759	14.68796715	32.26316129	10.97127763	23.04712934	35.87623154	6.662509042	16.11853256	0	2.686837134	38.20604234	51.7646736	138.7723604	13.3855	5.668461713	0	0	23.90613059	6.919160171	304.6889633	0	136.088209	160.7728067	0	0	20.2	0											"7.9% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"7.9% (1b); $0 n/c (1b1, 1b2)"	19.4% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.0778544	0.0788	0.1943	0	0.2	0.2	0.2	0.118203132	0.2	0.08	0.2	0	0.2	0.2	0	0.199599149	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											0.0778544	0.0788	0.1943	0	0.2	0.2	0.2	0.118203132	0.2	0.08	0.2	0	0.2	0.2	0	0.199599149	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											26.3717	1.80950016	8.633288365	0	2.937593429	6.452632258	2.194255527	2.724242873	7.175246309	0.533000723	3.223706513	0	0.537367427	7.641208468	0	27.69884503	2.6771	1.133692343	0	0	4.781226119	0.102882922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.6275	0	0	26.3717	1.80950016	8.633288365	0	2.937593429	6.452632258	2.194255527	2.724242873	7.175246309	0.533000723	3.223706513	0	0.537367427	7.641208468	0	27.69884503	2.6771	1.133692343	0	0	4.781226119	0.102882922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.6275		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											4.2341	0.287	0.7016	1.039	0.2319	0.5094	0.1732	0.1435	0.5665	0.1052	0.2545	0	0.0283	0.6033	0.8173	2.1911	0.2114	0.0895	0	0	0.3775	0.0751	0.0261	0	0.0155	0	0	0	0.003	0											12.684	0	0	30.6058	2.09654016	9.334858512	1.039023601	3.1695087	6.962050594	2.367486226	2.867733776	7.741713122	0.638198235	3.478209658	0	0.565649923	8.244461768	0.817336952	29.88998756	2.88845	1.22319437	0	0	5.158691339	0.177963667	0.0261	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	119.3114
H1717_007_0	2009	4																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		351.629966	23.088	46.12479548	5136.121413	15.24729136	33.49175658	11.38906868	23.92450953	37.24241413	6.9162203	16.73233333	0	2.789153067	39.64674221	53.71122065	144.046281	13.376	5.884319214	0	0	24.83457471	7.182644816	352.9685741	0	314.3760437	332.2285714	0	0	20.2	0											"8.4% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"8.4% (1b); $0 n/c (1b1, 1b2)"	18.5% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.0828932	0.0839	0.1847	0	0.2	0.2	0.2	0.116016106	0.2	0.08	0.2	0	0.2	0.2	0	0.199613825	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											0.0828932	0.0839	0.1847	0	0.2	0.2	0.2	0.116016106	0.2	0.08	0.2	0	0.2	0.2	0	0.199613825	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											29.1477	1.9370832	8.519249726	0	3.049458272	6.698351316	2.277813737	2.775628427	7.448482826	0.553297624	3.346466667	0	0.557830613	7.929348442	0	28.75362916	2.6752	1.176863843	0	0	4.966914942	0.106800749	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.9202	0	0	29.1477	1.9370832	8.519249726	0	3.049458272	6.698351316	2.277813737	2.775628427	7.448482826	0.553297624	3.346466667	0	0.557830613	7.929348442	0	28.75362916	2.6752	1.176863843	0	0	4.966914942	0.106800749	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.9202		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											4.3954	0.2886	0.7283	1.0786	0.2407	0.5288	0.1798	0.1462	0.588	0.1092	0.2642	0	0.0294	0.626	0.8481	2.2744	0.2112	0.0929	0	0	0.3921	0.0779	0.0261	0	0.0155	0	0	0	0.003	0											13.1444	0	0	33.5431	2.2256832	9.24753597	1.078590074	3.290204977	7.227168525	2.457641137	2.921823834	8.036520944	0.662501102	3.610661403	0	0.587190119	8.555349634	0.848071905	31.02804412	2.8864	1.269774146	0	0	5.359039806	0.184740601	0.0261	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	125.0646
H1717_008_0	2009	3																					3350											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1806.220966	263.8673307	40.3147716	48696.77504	84.36274415	20.13937535	8.904170821	344.7575515	361.4472477	5724.134362	437.7607707	0	0.782185248	1396.649262	5645.019986	4189.945313	1242.868229	249.8227185	0	0	25.92943508	1058.040139	769.983193	0	314.3760437	332.2285714	0	0	20.2	0											"$200 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$200 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	19.4% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$125 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5); $125 (9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											197.6	200	0.1943	0	100	0.14	0.2	49.9724444	125	4.4	64.79010385	0	0.2	115.5088755	3.250903491	25	20	20	0	0	0.2	13.6791576	0	0	0	0	0	0	0	0											143.8899833	145.6376349	0.1943	0	72.81881745	0.101946344	0.145637635	36.38934307	91.02352181	3.204027968	47.17938745	0	0.145637635	84.11219718	3.250903491	25	20	20	0	0	0.145637635	13.6791576	0	0	0	0	0	0	0	0											21.6581	3.202417831	7.833160122	0	0.511932939	2.053135696	1.296782379	1.045458401	2.741683453	1.528357216	1.721107084	0	0.11391561	9.78960318	1.529284598	8.729052736	2.071447048	0.416371198	0	0	3.7763016	1.206091484	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2242	0	18.4541	21.6581	3.202417831	7.833160122	0	0.511932939	2.053135696	1.296782379	1.045458401	2.741683453	1.528357216	1.721107084	0	0.11391561	9.78960318	1.529284598	8.729052736	2.071447048	0.416371198	0	0	3.7763016	1.206091484	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2242		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.6041	0.2143	0.6365	0.5386	0.1386	0.318	0.1406	0.0757	0.6293	0.099	0.2669	0	0.0082	0.5015	0.6837	2.1558	0.1512	0.074	0	0	0.4094	0.085	0.0569	0	0.0155	0	0	0	0.0003	0											10.8031	0	0	25.2622	3.416737831	8.469709148	0.538575995	0.65055851	2.371125834	1.43737455	1.121131161	3.370940648	1.627325666	1.987991229	0	0.122149138	10.2910977	2.213022105	10.88485965	2.222647048	0.4904018	0	0	4.185713733	1.291087905	0.056935837	0	0.01545	0	0	0	0.0003	0	0	0	0	0	0	0	0	0	0	0	82.0273
H1717_009_0	2009	5																																Coin	Coin	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		357.2464699	42.6855	7492.669947	99.87826641	22.94011468	12.62100685	14.41905597	10.01874061	7.008354128	28.80253027	23.82875038	0	0.090029207	4.684283514	1.133250155	130.6988473	43.2725	39.66802561	0	0	8.614694082	6.455285003	1498.037626	0	182.0000636	141.3063859	0	0	0	0											"8.4% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"8.4% (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.08274561	0.0839	0	0	0.2	0.2	0.2	0.067515866	0.2	0.08	0.15003742	0	0.2	0.2	0	0.198622595	0.2	0	0	0	0.2	0.022666282	0	0	0	0	0	0	0	0											0.08274561	0.0839	0	0	0.2	0.2	0.2	0.067515866	0.2	0.08	0.15003742	0	0.2	0.2	0	0.198622595	0.2	0	0	0	0.2	0.022666282	0	0	0	0	0	0	0	0											29.5606	3.58131345	0	0	4.588022937	2.52420137	2.883811195	0.676423948	1.401670826	2.304202422	3.575204217	0	0.018005841	0.936856703	0	25.95974423	8.6545	0	0	0	1.722938816	0.146317308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.5338	0	0	29.5606	3.58131345	0	0	4.588022937	2.52420137	2.883811195	0.676423948	1.401670826	2.304202422	3.575204217	0	0.018005841	0.936856703	0	25.95974423	8.6545	0	0	0	1.722938816	0.146317308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.5338		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.748	0.3284	0.7886	0.0475	0.3622	0.1993	0.2277	0.0356	0.1107	0.4548	0.3762	0	0.0009	0.074	0.0179	2.0637	0.6833	0.0044	0	0	0.136	0.1018	0.1107	0	0.0089	0	0	0	0	0											8.8805	0	0	32.3086	3.90966345	0.788581243	0.047467792	4.950235274	2.723480425	3.111480499	0.712025209	1.512329049	2.758979215	3.951447644	0	0.018953517	1.010819074	0.017893423	28.02341024	9.33775	0.004394036	0	0	1.858960302	0.248120457	0.110719388	0	0.008933819	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.4143
H1717_010_0	2009	3																					2500											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1831.223224	254.7073226	41.43859485	49370.85055	85.53051881	20.70078491	9.152385403	349.5271599	366.45051	5803.369564	443.8203879	0	0.803989612	1415.736434	5722.183251	4247.943806	1242.868229	253.2808403	0	0	26.6654908	1072.685851	769.983193	0	314.3760437	332.2285714	0	0	20.2	0											"$175 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	18.5% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$75 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5, 9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											172.9	175	0.1847	0	75	0.14	0.2	49.97282042	75	4.4	64.79010385	0	0.2	70.31714815	3.25145844	25	20	20	0	0	0.2	13.6791576	0	0	0	0	0	0	0	0											120.49678	121.9603036	0.1847	0	52.26870156	0.097568243	0.139383204	34.82685916	52.26870156	3.066430491	45.15326136	0	0.139383204	49.00514708	3.25145844	25	20	20	0	0	0.139383204	13.6791576	0	0	0	0	0	0	0	0											18.388	2.588681867	7.653708469	0	0.37254743	2.019739211	1.275688803	1.014411097	1.596157695	1.482969115	1.669994831	0	0.112062648	5.781531013	1.550453419	8.849882928	2.071447048	0.422134734	0	0	3.716721548	1.222786568	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.789	0	17.4038	18.388	2.588681867	7.653708469	0	0.37254743	2.019739211	1.275688803	1.014411097	1.596157695	1.482969115	1.669994831	0	0.112062648	5.781531013	1.550453419	8.849882928	2.071447048	0.422134734	0	0	3.716721548	1.222786568	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.789		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.7045	0.2069	0.6543	0.5536	0.1425	0.3269	0.1445	0.0767	0.6468	0.1017	0.2743	0	0.0085	0.5154	0.7025	2.2159	0.1512	0.0761	0	0	0.421	0.0874	0.0569	0	0.0155	0	0	0	0.003	0											11.0861	0	0	22.0926	2.795561867	8.308002072	0.553589455	0.515037357	2.34659371	1.420200151	1.091129824	2.2429562	1.584696431	1.944318696	0	0.120525697	6.296959309	2.252977118	11.06578558	2.222647048	0.498229029	0	0	4.137755613	1.310152367	0.056935837	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	72.8751
H1717_801_0	2009	5																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	Coin	V	V	Coin	O	T	V	P	P	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		1823.404997	151.7495659	591.1266511	661.9330634	103.233867	11.10711275	4.4920706	368.4105604	31.70389151	9119.532867	36.63235939	0	0.145821279	22.96810264	4382.98382	3640.475882	535.384857	1.252585101	0	0	15.19647176	815.3600878	0	0	0	0	0	0	0	0											"$345 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$345 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$135 Days 1-37 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 9a, 9d); $60 (5); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											340.9028724	345	135	0	150	0.2	0.066028517	47.82817314	0.3	2.8	0.240100952	0	0.2	0.300396313	18.20367759	30	32.91125662	0.3	0	0	0.2	28.44276644	0	0	0	0	0	0	0	0											219.4205003	222.0375138	86.88424454	0	96.53804949	0.128717399	0.042495095	30.7815903	0.193076099	1.80204359	0.154525851	0	0.128717399	0.193676873	18.20367759	30	32.91125662	0.193076099	0	0	0.128717399	28.44276644	0	0	0	0	0	0	0	0											33.341	2.807841361	4.279966042	0	0.83049968	1.429678667	0.190890967	0.945021911	6.121263696	1.369482979	5.660646497	0	0.018769736	4.448390304	6.648868696	9.101189705	1.468349035	0.241844245	0	0	1.956050323	1.932591379	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.7924	0	35.227	33.341	2.807841361	4.279966042	0	0.83049968	1.429678667	0.190890967	0.945021911	6.121263696	1.369482979	5.660646497	0	0.018769736	4.448390304	6.648868696	9.101189705	1.468349035	0.241844245	0	0	1.956050323	1.932591379	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.7924	4900	"40% Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 40% (13c)"	"40% Days 1-999 (1b); $0 n/c (1b1, 1b2)"	"40% Days 1-999 (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"40% (3, 9a, 9d); $75 (5); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"40% (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											9.368	0.3568	2.7401	0.4976	0.2768	0.7148	0.2891	0.315	2.7206	0.4565	2.5158	0	0.0063	1.9755	3.1277	4.5506	0.7249	0.1382	0	0	1.2575	0.9808	0	0	0	0	0	0	0	0											33.0125	0	13.18958548	42.709	3.164604849	7.020090332	0.497566826	1.107332907	2.144518001	0.47999479	1.260029215	8.841825339	1.825977306	8.176489385	0	0.025026314	6.423908671	9.776613102	13.65178456	2.193245917	0.380040956	0	0	3.213511246	2.913365108	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.8049
H1717_803_0	2009	5																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	Coin	V	V	Coin	O	T	V	P	P	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		1823.404997	151.7495659	591.1266511	661.9330634	103.233867	11.10711275	4.4920706	368.4105604	31.70389151	9119.532867	36.63235939	0	0.145821279	22.96810264	4382.98382	3640.475882	535.384857	1.252585101	0	0	15.19647176	815.3600878	0	0	0	0	0	0	0	0											"$345 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$345 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$135 Days 1-37 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 9a, 9d); $60 (5); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											340.9028724	345	135	0	150	0.2	0.066028517	47.82817314	0.3	2.8	0.240100952	0	0.2	0.300396313	18.20367759	30	37.5	0.3	0	0	0.2	28.44276644	0	0	0	0	0	0	0	0											219.4205003	222.0375138	86.88424454	0	96.53804949	0.128717399	0.042495095	30.7815903	0.193076099	1.80204359	0.154525851	0	0.128717399	0.193676873	18.20367759	30	37.5	0.193076099	0	0	0.128717399	28.44276644	0	0	0	0	0	0	0	0											33.341	2.807841361	4.279966042	0	0.83049968	1.429678667	0.190890967	0.945021911	6.121263696	1.369482979	5.660646497	0	0.018769736	4.448390304	6.648868696	9.101189705	1.673077678	0.241844245	0	0	1.956050323	1.932591379	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9971	0	35.227	33.341	2.807841361	4.279966042	0	0.83049968	1.429678667	0.190890967	0.945021911	6.121263696	1.369482979	5.660646497	0	0.018769736	4.448390304	6.648868696	9.101189705	1.673077678	0.241844245	0	0	1.956050323	1.932591379	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9971	4900	"40% Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 40% (13c)"	"40% Days 1-999 (1b); $0 n/c (1b1, 1b2)"	"40% Days 1-999 (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"40% (3, 9a, 9d); $75 (5); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"40% (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											9.368	0.3568	2.7401	0.4976	0.2768	0.7148	0.2891	0.315	2.7206	0.4565	2.5158	0	0.0063	1.9755	3.1277	4.5506	0.8126	0.1382	0	0	1.2575	0.9808	0	0	0	0	0	0	0	0											33.1003	0	13.18958548	42.709	3.164604849	7.020090332	0.497566826	1.107332907	2.144518001	0.47999479	1.260029215	8.841825339	1.825977306	8.176489385	0	0.025026314	6.423908671	9.776613102	13.65178456	2.485715407	0.380040956	0	0	3.213511246	2.913365108	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.0974
H1717_804_0	2009	5																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	Coin	V	V	Coin	O	T	V	P	P	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		1823.404997	151.7495659	591.1266511	661.9330634	103.233867	11.10711275	4.4920706	368.4105604	31.70389151	9119.532867	36.63235939	0	0.145821279	22.96810264	4382.98382	3640.475882	535.384857	1.252585101	0	0	15.19647176	815.3600878	0	0	0	0	0	0	0	0											"$345 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$345 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$135 Days 1-37 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 9a, 9d); $60 (5); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											340.9028724	345	135	0	150	0.2	0.066028517	47.82817314	0.3	2.8	0.240100952	0	0.2	0.300396313	18.20367759	30	37.5	0.3	0	0	0.2	28.44276644	0	0	0	0	0	0	0	0											219.4205003	222.0375138	86.88424454	0	96.53804949	0.128717399	0.042495095	30.7815903	0.193076099	1.80204359	0.154525851	0	0.128717399	0.193676873	18.20367759	30	37.5	0.193076099	0	0	0.128717399	28.44276644	0	0	0	0	0	0	0	0											33.341	2.807841361	4.279966042	0	0.83049968	1.429678667	0.190890967	0.945021911	6.121263696	1.369482979	5.660646497	0	0.018769736	4.448390304	6.648868696	9.101189705	1.673077678	0.241844245	0	0	1.956050323	1.932591379	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9971	0	35.227	33.341	2.807841361	4.279966042	0	0.83049968	1.429678667	0.190890967	0.945021911	6.121263696	1.369482979	5.660646497	0	0.018769736	4.448390304	6.648868696	9.101189705	1.673077678	0.241844245	0	0	1.956050323	1.932591379	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9971	4900	"40% Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 40% (13c)"	"40% Days 1-999 (1b); $0 n/c (1b1, 1b2)"	"40% Days 1-999 (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"40% (3, 9a, 9d); $75 (5); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"40% (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											9.368	0.3568	2.7401	0.4976	0.2768	0.7148	0.2891	0.315	2.7206	0.4565	2.5158	0	0.0063	1.9755	3.1277	4.5506	0.8126	0.1382	0	0	1.2575	0.9808	0	0	0	0	0	0	0	0											33.1003	0	13.18958548	42.709	3.164604849	7.020090332	0.497566826	1.107332907	2.144518001	0.47999479	1.260029215	8.841825339	1.825977306	8.176489385	0	0.025026314	6.423908671	9.776613102	13.65178456	2.485715407	0.380040956	0	0	3.213511246	2.913365108	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.0974
H1717_805_0	2009	5																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	Coin	V	V	Coin	O	T	V	P	P	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		1823.404997	151.7495659	591.1266511	661.9330634	103.233867	11.10711275	4.4920706	368.4105604	31.70389151	9119.532867	36.63235939	0	0.145821279	22.96810264	4382.98382	3640.475882	535.384857	1.252585101	0	0	15.19647176	815.3600878	0	0	0	0	0	0	0	0											"$345 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$345 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$135 Days 1-37 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 9a, 9d); $60 (5); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											340.9028724	345	135	0	150	0.2	0.066028517	47.82817314	0.3	2.8	0.240100952	0	0.2	0.300396313	18.20367759	30	37.5	0.3	0	0	0.2	28.44276644	0	0	0	0	0	0	0	0											219.4205003	222.0375138	86.88424454	0	96.53804949	0.128717399	0.042495095	30.7815903	0.193076099	1.80204359	0.154525851	0	0.128717399	0.193676873	18.20367759	30	37.5	0.193076099	0	0	0.128717399	28.44276644	0	0	0	0	0	0	0	0											33.341	2.807841361	4.279966042	0	0.83049968	1.429678667	0.190890967	0.945021911	6.121263696	1.369482979	5.660646497	0	0.018769736	4.448390304	6.648868696	9.101189705	1.673077678	0.241844245	0	0	1.956050323	1.932591379	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9971	0	35.227	33.341	2.807841361	4.279966042	0	0.83049968	1.429678667	0.190890967	0.945021911	6.121263696	1.369482979	5.660646497	0	0.018769736	4.448390304	6.648868696	9.101189705	1.673077678	0.241844245	0	0	1.956050323	1.932591379	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9971	4900	"40% Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 40% (13c)"	"40% Days 1-999 (1b); $0 n/c (1b1, 1b2)"	"40% Days 1-999 (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"40% (3, 9a, 9d); $75 (5); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"40% (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											9.368	0.3568	2.7401	0.4976	0.2768	0.7148	0.2891	0.315	2.7206	0.4565	2.5158	0	0.0063	1.9755	3.1277	4.5506	0.8126	0.1382	0	0	1.2575	0.9808	0	0	0	0	0	0	0	0											33.1003	0	13.18958548	42.709	3.164604849	7.020090332	0.497566826	1.107332907	2.144518001	0.47999479	1.260029215	8.841825339	1.825977306	8.176489385	0	0.025026314	6.423908671	9.776613102	13.65178456	2.485715407	0.380040956	0	0	3.213511246	2.913365108	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.0974
H1777_001_0	2009	8																					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																																																			0		4803.882927	521.6039412			123.9475398	8.097992035	9.044079662	350.2023587	115.0315365			47.146122	66.26848794	1308.478855			4371.555312					427.5507375																			"1a (IP Acute) , 1a1 (Add'l Days) - $250 1-8"	1b (IP Psych) - $250 1-8			10a (Ambulance) - $75	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) - $25-35"		"7b (Chiro), 7d (Spec), 7f (Pod) - $15"	"7e (MH), 7h (Psychiatric) - $25-35"					"16b(Comp Den),  17a (Eye Exam), 18a (MCR Hearing Exam) - $15"																			189.83	189.83			75	0.2	0.2	47	35			35	35	34.99338475			20.04599247					15																			108.378395	108.378395			42.81925735	0.114184686	0.114184686	26.83340127	19.9823201			19.9823201	19.9823201	19.9785433			11.44472681					8.56385147																			43.3864	4.710883163	0	0	0.442278467	0.92466668	1.032695399	0.783093368	0.191549749	0	0	0.078507408	0.110349845	2.178458454	0	0	4.169271356	0	0	0	0	0.305123418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.3133	0	43.8253	43.3864	4.710883163	0	0	0.442278467	0.92466668	1.032695399	0.783093368	0.191549749	0	0	0.078507408	0.110349845	2.178458454	0	0	4.169271356	0	0	0	0	0.305123418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.3133																																																																																		0	0	0	43.3864	4.710883163	0	0	0.442278467	0.92466668	1.032695399	0.783093368	0.191549749	0	0	0.078507408	0.110349845	2.178458454	0	0	4.169271356	0	0	0	0	0.305123418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.3133
H1804_001_0	2009	4	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		254.216569	5.888088	619.204838	206.283687	8.088277	17.271288	8.715358	469.623885	35.78256	10.678401	14.237868	0	0.18789	19.559934	4967.383161	5128.469182	0.584546	2.338184			19.822369								0.05		0	381.388835	289.990483	3.753116	508.277584	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999982	949.999388	43.132802	0	0.199999	0.2	0.199999	49.999995	0.240475	0.249999	0.244134	0	0.2	0.231352	15	29.999997	0.25	0.25			0.2								0		0	0	14.225515	30.000671	30	0	0	0	0		802.504884	802.504383	36.436089	0	0.168948	0.168948	0.168948	42.237095	0.203139	0.211185	0.206231	0	0.168948	0.195433	12.67113	25.342258	0.211186	0.211185			0.168948								0		0	0	12.01689	25.342827	25.34226	0	0	0	0		17.0008	0.393768036	1.880116882	0	1.366498223	2.917949565	1.472442303	1.652962387	7.268833456	2.255118115	2.936289756	0	0.03174364	3.822656581	5.245196483	10.83058243	0.123447932	0.493789388	0	0	3.348949598	0	0	0	0	0	0	0	0	0	0	0	0.290398645	0.007926214	1.073408557	0	0	0	0	0	64.4129	0	11.8387	17.0008	0.393768036	1.880116882	0	1.366498223	2.917949565	1.472442303	1.652962387	7.268833456	2.255118115	2.936289756	0	0.03174364	3.822656581	5.245196483	10.83058243	0.123447932	0.493789388	0	0	3.348949598	0	0	0	0	0	0	0	0	0	0	0	0.290398645	0.007926214	1.073408557	0	0	0	0	0	64.4129	6000																																																																																	0	0	0	17.0008	0.393768036	1.880116882	0	1.366498223	2.917949565	1.472442303	1.652962387	7.268833456	2.255118115	2.936289756	0	0.03174364	3.822656581	5.245196483	10.83058243	0.123447932	0.493789388	0	0	3.348949598	0	0	0	0	0	0	0	0	0	0	0	0.290398645	0.007926214	1.073408557	0	0	0	0	0	64.4129
H1804_005_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		292.815268	6.782098	713.221101	237.604545	10.631059	22.701013	11.45528	540.92867	47.03183	14.035461	18.713949	0	0.246958	25.709157	5721.507877	5907.06448	0.768315	3.073258			26.054097								0.05		0	439.296556	334.020842	4.322967	585.451357	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000011	949.999837	43.132801	0	0.2	0.2	0.2	49.999989	0.240475	0.249999	0.244134	0	0.200001	0.231352	15	29.999999	0.25	0.25			0.2								0		0	0	14.225507	29.998841	29.999991	0	0	0	0		761.718559	761.718419	34.584268	0	0.160361	0.160361	0.160361	40.090441	0.192815	0.200452	0.195749	0	0.160363	0.1855	12.027135	24.054269	0.200452	0.200452			0.160361								0		0	0	11.406139	24.05334	24.054263	0	0	0	0		18.5869	0.430504081	2.055519142	0	1.704807252	3.640357146	1.836980156	1.807172411	9.068442301	2.813436228	3.663236803	0	0.039602926	4.769048624	5.734445637	11.84084317	0.154010278	0.616040713	0	0	4.178061049	0	0	0	0	0	0	0	0	0	0	0	0.317490679	0.00866515	1.173550076	0	0	0	0	0	74.4391	0	18.3999	18.5869	0.430504081	2.055519142	0	1.704807252	3.640357146	1.836980156	1.807172411	9.068442301	2.813436228	3.663236803	0	0.039602926	4.769048624	5.734445637	11.84084317	0.154010278	0.616040713	0	0	4.178061049	0	0	0	0	0	0	0	0	0	0	0	0.317490679	0.00866515	1.173550076	0	0	0	0	0	74.4391	6000																																																																																	0	0	0	18.5869	0.430504081	2.055519142	0	1.704807252	3.640357146	1.836980156	1.807172411	9.068442301	2.813436228	3.663236803	0	0.039602926	4.769048624	5.734445637	11.84084317	0.154010278	0.616040713	0	0	4.178061049	0	0	0	0	0	0	0	0	0	0	0	0.317490679	0.00866515	1.173550076	0	0	0	0	0	74.4391
H1804_006_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		277.541206	6.428327	676.017499	225.210428	9.550903	20.394503	10.29138	512.712323	42.253215	12.609405	16.81254	0	0.221866	23.097007	5423.058064	5598.935519	0.690251	2.761004			23.406901								0.05		0	416.381623	316.597384	4.097469	554.912581	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999993	949.999587	43.132794	0	0.2	0.2	0.2	49.999991	0.240475	0.249999	0.244134	0	0.199999	0.231352	15	30	0.25	0.25			0.199999								0		0	0	14.225499	30.000959	29.99999	0	0	0	0		778.171594	778.171262	35.331279	0	0.163825	0.163825	0.163825	40.956393	0.19698	0.204781	0.199977	0	0.163824	0.189507	12.28692	24.57384	0.204782	0.204782			0.163825								0		0	0	11.652505	24.574625	24.573831	0	0	0	0		17.9979	0.416861611	1.990380239	0	1.564676684	3.341129454	1.685985329	1.74990395	8.323038291	2.582166565	3.362121312	0	0.036346976	4.377044506	5.552723382	11.46561213	0.14135098	0.565403921	0	0	3.834635556	0	0	0	0	0	0	0	0	0	0	0	0.307429383	0.008391147	1.136360665	0	0	0	0	0	70.4395	0	15.5538	17.9979	0.416861611	1.990380239	0	1.564676684	3.341129454	1.685985329	1.74990395	8.323038291	2.582166565	3.362121312	0	0.036346976	4.377044506	5.552723382	11.46561213	0.14135098	0.565403921	0	0	3.834635556	0	0	0	0	0	0	0	0	0	0	0	0.307429383	0.008391147	1.136360665	0	0	0	0	0	70.4395	6000																																																																																	0	0	0	17.9979	0.416861611	1.990380239	0	1.564676684	3.341129454	1.685985329	1.74990395	8.323038291	2.582166565	3.362121312	0	0.036346976	4.377044506	5.552723382	11.46561213	0.14135098	0.565403921	0	0	3.834635556	0	0	0	0	0	0	0	0	0	0	0	0.307429383	0.008391147	1.136360665	0	0	0	0	0	70.4395
H1804_007_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		273.089309	6.325212	665.173847	221.597943	9.246962	19.745484	9.963875	504.488166	40.908582	12.208133	16.277511	0	0.214806	22.361986	5336.069557	5509.125851	0.668285	2.67314			22.662018								0.05		0	409.702657	311.519007	4.031743	546.01151	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999987	950.000094	43.132802	0	0.199999	0.2	0.2	49.999999	0.240475	0.249999	0.244134	0	0.199999	0.231352	15	29.999998	0.249999	0.25			0.199999								0		0	0	14.225507	29.998935	30.000004	0	0	0	0		782.892139	782.892228	35.545612	0	0.164819	0.164819	0.164819	41.204849	0.198175	0.206024	0.20119	0	0.164818	0.190656	12.361455	24.722908	0.206023	0.206024			0.164819								0		0	0	11.723198	24.722033	24.722914	0	0	0	0		17.8166	0.412663276	1.97033429	0	1.52407503	3.254430927	1.642235914	1.732279892	8.107058238	2.515168393	3.274872438	0	0.035403895	4.263446803	5.496798642	11.3501343	0.137682081	0.550730995	0	0	3.735131145	0	0	0	0	0	0	0	0	0	0	0	0.30433325	0.008306074	1.1249163	0	0	0	0	0	69.2566	0	14.7828	17.8166	0.412663276	1.97033429	0	1.52407503	3.254430927	1.642235914	1.732279892	8.107058238	2.515168393	3.274872438	0	0.035403895	4.263446803	5.496798642	11.3501343	0.137682081	0.550730995	0	0	3.735131145	0	0	0	0	0	0	0	0	0	0	0	0.30433325	0.008306074	1.1249163	0	0	0	0	0	69.2566	6000																																																																																	0	0	0	17.8166	0.412663276	1.97033429	0	1.52407503	3.254430927	1.642235914	1.732279892	8.107058238	2.515168393	3.274872438	0	0.035403895	4.263446803	5.496798642	11.3501343	0.137682081	0.550730995	0	0	3.735131145	0	0	0	0	0	0	0	0	0	0	0	0.30433325	0.008306074	1.1249163	0	0	0	0	0	69.2566
H1804_008_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		278.614991	6.453196	678.63299	226.081752	9.71535	20.745654	10.468577	514.696014	42.980732	12.826514	17.102019	0	0.225687	23.494694	5444.127499	5620.673746	0.702136	2.808543			23.809922								0.05		0	417.992609	317.822303	4.113323	557.059499	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999994	949.999969	43.132792	0	0.2	0.2	0.199999	50.000006	0.240475	0.25	0.244134	0	0.199998	0.231352	14.999999	29.999999	0.25	0.25			0.199999								0		0	0	14.225496	29.999102	30.000005	0	0	0	0		776.180395	776.180374	35.240871	0	0.163406	0.163406	0.163406	40.851605	0.196476	0.204258	0.199466	0	0.163404	0.189022	12.255479	24.510959	0.204258	0.204258			0.163406								0		0	0	11.622685	24.510227	24.510964	0	0	0	0		18.0213	0.417403674	1.992968138	0	1.587546482	3.389964338	1.710628293	1.752179855	8.4446823	2.619918097	3.411271322	0	0.036878159	4.441014049	5.56003252	11.48067531	0.143416895	0.573667376	0	0	3.890684114	0	0	0	0	0	0	0	0	0	0	0	0.307829043	0.00840154	1.137838777	0	0	0	0	0	70.9283	0	15.8839	18.0213	0.417403674	1.992968138	0	1.587546482	3.389964338	1.710628293	1.752179855	8.4446823	2.619918097	3.411271322	0	0.036878159	4.441014049	5.56003252	11.48067531	0.143416895	0.573667376	0	0	3.890684114	0	0	0	0	0	0	0	0	0	0	0	0.307829043	0.00840154	1.137838777	0	0	0	0	0	70.9283	6000																																																																																	0	0	0	18.0213	0.417403674	1.992968138	0	1.587546482	3.389964338	1.710628293	1.752179855	8.4446823	2.619918097	3.411271322	0	0.036878159	4.441014049	5.56003252	11.48067531	0.143416895	0.573667376	0	0	3.890684114	0	0	0	0	0	0	0	0	0	0	0	0.307829043	0.00840154	1.137838777	0	0	0	0	0	70.9283
H1804_009_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		283.57142	6.567995	690.705485	230.103635	9.879672	21.09654	10.645638	523.851631	43.707646	13.043443	17.391258	0	0.229503	23.892049	5540.79857	5720.508992	0.71401	2.856042			24.212608								0.05		0	425.428028	323.475856	4.186496	566.969314	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999995	949.999475	43.132803	0	0.199999	0.2	0.2	49.999997	0.240475	0.25	0.244134	0	0.199997	0.231352	14.999999	29.999998	0.25	0.25			0.2								0		0	0	14.225494	29.999312	29.999993	0	0	0	0		772.533345	772.532923	35.075293	0	0.162638	0.162638	0.162638	40.659647	0.195552	0.203298	0.198528	0	0.162636	0.188134	12.197894	24.395789	0.203298	0.203298			0.162638								0		0	0	11.568072	24.39523	24.395785	0	0	0	0		18.2557	0.422832698	2.018891439	0	1.606810095	3.431099073	1.731385273	1.774968533	8.547117591	2.651705875	3.452651668	0	0.03732545	4.494906747	5.632172803	11.6296942	0.145156805	0.580627627	0	0	3.93789014	0	0	0	0	0	0	0	0	0	0	0	0.311832666	0.008510878	1.152638457	0	0	0	0	0	71.8239	0	16.4994	18.2557	0.422832698	2.018891439	0	1.606810095	3.431099073	1.731385273	1.774968533	8.547117591	2.651705875	3.452651668	0	0.03732545	4.494906747	5.632172803	11.6296942	0.145156805	0.580627627	0	0	3.93789014	0	0	0	0	0	0	0	0	0	0	0	0.311832666	0.008510878	1.152638457	0	0	0	0	0	71.8239	6000																																																																																	0	0	0	18.2557	0.422832698	2.018891439	0	1.606810095	3.431099073	1.731385273	1.774968533	8.547117591	2.651705875	3.452651668	0	0.03732545	4.494906747	5.632172803	11.6296942	0.145156805	0.580627627	0	0	3.93789014	0	0	0	0	0	0	0	0	0	0	0	0.311832666	0.008510878	1.152638457	0	0	0	0	0	71.8239
H1804_011_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		311.989464	7.226205	759.924409	253.16342	12.102001	25.841985	13.040263	576.349888	53.539278	15.977445	21.30326	0	0.281129	29.266344	6096.164977	6293.872243	0.874621	3.498483			29.659011								0.05		0	468.062675	355.893274	4.606044	623.788019	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000002	950.000711	43.132795	0	0.199999	0.199999	0.2	50.000002	0.240475	0.249999	0.244134	0	0.2	0.231352	14.999999	30	0.249999	0.25			0.2								0		0	0	14.225511	29.999713	29.999999	0	0	0	0		741.244151	741.244704	33.654665	0	0.156051	0.156051	0.156051	39.012852	0.187632	0.195064	0.190487	0	0.156052	0.180514	11.703854	23.40771	0.195064	0.195064			0.156051								0		0	0	11.099555	23.407486	23.407709	0	0	0	0		19.2717	0.446365516	2.131250118	0	1.888529358	4.032667601	2.034946081	1.873754407	10.04568181	3.116624331	4.057994088	0	0.043870743	5.282984821	5.945718738	12.27709469	0.170607071	0.682428088	0	0	4.628318326	0	0	0	0	0	0	0	0	0	0	0	0.329188081	0.008984659	1.216787369	0	0	0	0	0	79.4855	0	22.3855	19.2717	0.446365516	2.131250118	0	1.888529358	4.032667601	2.034946081	1.873754407	10.04568181	3.116624331	4.057994088	0	0.043870743	5.282984821	5.945718738	12.27709469	0.170607071	0.682428088	0	0	4.628318326	0	0	0	0	0	0	0	0	0	0	0	0.329188081	0.008984659	1.216787369	0	0	0	0	0	79.4855	6000																																																																																	0	0	0	19.2717	0.446365516	2.131250118	0	1.888529358	4.032667601	2.034946081	1.873754407	10.04568181	3.116624331	4.057994088	0	0.043870743	5.282984821	5.945718738	12.27709469	0.170607071	0.682428088	0	0	4.628318326	0	0	0	0	0	0	0	0	0	0	0	0.329188081	0.008984659	1.216787369	0	0	0	0	0	79.4855
H1804_013_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		293.083718	6.788316	713.874977	237.822378	10.650571	22.742678	11.476305	541.424592	47.11815	14.061222	18.748296	0	0.247412	25.756342	5726.753326	5912.480045	0.769725	3.078899			26.101916								0.05		0	439.699302	334.327071	4.32693	585.988095	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999999	949.999381	43.132796	0	0.199999	0.2	0.2	50.000004	0.240475	0.25	0.244134	0	0.199998	0.231352	15	29.999999	0.249999	0.25			0.2								0		0	0	14.225506	29.999098	29.999995	0	0	0	0		761.434499	761.434004	34.571367	0	0.160301	0.160302	0.160302	40.075503	0.192743	0.200377	0.195676	0	0.1603	0.185431	12.02265	24.045299	0.200377	0.200377			0.160302								0		0	0	11.401885	24.044577	24.045296	0	0	0	0		18.597	0.430737886	2.056636152	0	1.707297182	3.645696769	1.839674644	1.808155238	9.081693585	2.817545481	3.668591568	0	0.039660144	4.776024253	5.737562573	11.84727921	0.154235186	0.616940545	0	0	4.184189339	0	0	0	0	0	0	0	0	0	0	0	0.317663235	0.008669933	1.1741881	0	0	0	0	0	74.5094	0	18.4519	18.597	0.430737886	2.056636152	0	1.707297182	3.645696769	1.839674644	1.808155238	9.081693585	2.817545481	3.668591568	0	0.039660144	4.776024253	5.737562573	11.84727921	0.154235186	0.616940545	0	0	4.184189339	0	0	0	0	0	0	0	0	0	0	0	0.317663235	0.008669933	1.1741881	0	0	0	0	0	74.5094	6000																																																																																	0	0	0	18.597	0.430737886	2.056636152	0	1.707297182	3.645696769	1.839674644	1.808155238	9.081693585	2.817545481	3.668591568	0	0.039660144	4.776024253	5.737562573	11.84727921	0.154235186	0.616940545	0	0	4.184189339	0	0	0	0	0	0	0	0	0	0	0	0.317663235	0.008669933	1.1741881	0	0	0	0	0	74.5094
H1804_014_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		294.339293	6.817397	716.933226	238.841213	10.742006	22.937924	11.574829	543.744061	47.522661	14.181938	18.90925	0	0.249536	25.977461	5751.286794	5937.809167	0.776333	3.105331			26.326								0.05		0	441.582977	335.759332	4.345467	588.498474	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000012	950.000711	43.132803	0	0.199999	0.2	0.2	49.999994	0.240475	0.25	0.244134	0	0.199999	0.231352	14.999998	30.000002	0.249999	0.25			0.2								0		0	0	14.22551	30.000918	29.999996	0	0	0	0		760.114959	760.115519	34.511461	0	0.160024	0.160024	0.160024	40.006045	0.192409	0.20003	0.195337	0	0.160023	0.185109	12.001814	24.003631	0.200029	0.20003			0.160024								0		0	0	11.382129	24.004364	24.003626	0	0	0	0		18.6443	0.431834105	2.061867756	0	1.718978768	3.67061835	1.852250436	1.812754114	9.14378768	2.836813058	3.693676167	0	0.039931499	4.808661828	5.752156197	11.87741502	0.155289114	0.62115936	0	0	4.212791824	0	0	0	0	0	0	0	0	0	0	0	0.318471336	0.008692514	1.177174773	0	0	0	0	0	74.8386	0	18.6955	18.6443	0.431834105	2.061867756	0	1.718978768	3.67061835	1.852250436	1.812754114	9.14378768	2.836813058	3.693676167	0	0.039931499	4.808661828	5.752156197	11.87741502	0.155289114	0.62115936	0	0	4.212791824	0	0	0	0	0	0	0	0	0	0	0	0.318471336	0.008692514	1.177174773	0	0	0	0	0	74.8386	6000																																																																																	0	0	0	18.6443	0.431834105	2.061867756	0	1.718978768	3.67061835	1.852250436	1.812754114	9.14378768	2.836813058	3.693676167	0	0.039931499	4.808661828	5.752156197	11.87741502	0.155289114	0.62115936	0	0	4.212791824	0	0	0	0	0	0	0	0	0	0	0	0.318471336	0.008692514	1.177174773	0	0	0	0	0	74.8386
H1804_016_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		283.98848	6.577656	691.721364	230.44206	10.0064	21.367149	10.782192	524.622614	44.268338	13.210767	17.614357	0	0.232448	24.198541	5549.035535	5728.998617	0.72317	2.89268			24.523213								0.05		0	426.054155	323.951931	4.192653	567.803183	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999984	949.999813	43.132795	0	0.199999	0.2	0.199999	50.00001	0.240475	0.25	0.244134	0	0.199997	0.231352	14.999999	29.999998	0.249999	0.25			0.2								0		0	0	14.225517	30.001049	30	0	0	0	0		771.180537	771.180398	35.013866	0	0.162353	0.162353	0.162353	40.588458	0.19521	0.202942	0.198181	0	0.162351	0.187804	12.176534	24.353069	0.202941	0.202942			0.162353								0		0	0	11.547834	24.353922	24.35307	0	0	0	0		18.2505	0.422713281	2.018319929	0	1.624569059	3.469020742	1.750521218	1.774468578	8.641622261	2.681019477	3.490830885	0	0.037738165	4.544582794	5.630668322	11.62655822	0.146760843	0.587046265	0	0	3.9814172	0	0	0	0	0	0	0	0	0	0	0	0.31174526	0.008508962	1.152312555	0	0	0	0	0	72.151	0	16.7302	18.2505	0.422713281	2.018319929	0	1.624569059	3.469020742	1.750521218	1.774468578	8.641622261	2.681019477	3.490830885	0	0.037738165	4.544582794	5.630668322	11.62655822	0.146760843	0.587046265	0	0	3.9814172	0	0	0	0	0	0	0	0	0	0	0	0.31174526	0.008508962	1.152312555	0	0	0	0	0	72.151	6000																																																																																	0	0	0	18.2505	0.422713281	2.018319929	0	1.624569059	3.469020742	1.750521218	1.774468578	8.641622261	2.681019477	3.490830885	0	0.037738165	4.544582794	5.630668322	11.62655822	0.146760843	0.587046265	0	0	3.9814172	0	0	0	0	0	0	0	0	0	0	0	0.31174526	0.008508962	1.152312555	0	0	0	0	0	72.151
H1804_018_0	2009	5	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		283.33315	6.562477	690.125152	229.910293	9.954817	21.257	10.726609	523.411998	44.040132	13.142665	17.523553	0	0.231249	24.073796	5536.23062	5715.77842	0.719442	2.877768			24.396794								0.05		0	425.070996	323.204383	4.182977	566.492925	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999999	949.999226	43.132802	0	0.199999	0.2	0.2	49.999992	0.240475	0.249999	0.244134	0	0.2	0.231352	14.999999	29.999999	0.249999	0.25			0.2								0		0	0	14.225524	29.998731	29.999993	0	0	0	0		771.939599	771.938971	35.048335	0	0.162513	0.162513	0.162513	40.628393	0.195402	0.203141	0.198376	0	0.162513	0.187989	12.188519	24.377039	0.203141	0.203142			0.162513								0		0	0	11.559206	24.376009	24.377034	0	0	0	0		18.2263	0.422152645	2.015644793	0	1.617787175	3.454538841	1.743213408	1.772115696	8.605529873	2.669814111	3.47625235	0	0.037580969	4.525608836	5.623204342	11.61114612	0.146148167	0.584595547	0	0	3.964796183	0	0	0	0	0	0	0	0	0	0	0	0.31133217	0.008497024	1.150784774	0	0	0	0	0	71.9671	0	16.6004	18.2263	0.422152645	2.015644793	0	1.617787175	3.454538841	1.743213408	1.772115696	8.605529873	2.669814111	3.47625235	0	0.037580969	4.525608836	5.623204342	11.61114612	0.146148167	0.584595547	0	0	3.964796183	0	0	0	0	0	0	0	0	0	0	0	0.31133217	0.008497024	1.150784774	0	0	0	0	0	71.9671	6000																																																																																	0	0	0	18.2263	0.422152645	2.015644793	0	1.617787175	3.454538841	1.743213408	1.772115696	8.605529873	2.669814111	3.47625235	0	0.037580969	4.525608836	5.623204342	11.61114612	0.146148167	0.584595547	0	0	3.964796183	0	0	0	0	0	0	0	0	0	0	0	0.31133217	0.008497024	1.150784774	0	0	0	0	0	71.9671
H1804_019_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		288.329988	6.678212	702.296137	233.96497	10.307963	22.01109	11.107135	532.642844	45.602452	13.6089	18.1452	0	0.239453	24.927812	5633.867077	5816.581366	0.744964	2.979857			25.262269								0.05		0	432.567508	328.904384	4.25675	576.483542	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999999	950.000342	43.132795	0	0.2	0.2	0.2	49.999995	0.240475	0.25	0.244134	0	0.200001	0.231352	15	29.999999	0.249999	0.249999			0.199999								0		0	0	14.22552	30.000352	30.000003	0	0	0	0		766.549299	766.549576	34.803594	0	0.161378	0.161378	0.161378	40.344696	0.194038	0.201723	0.196991	0	0.161379	0.186676	12.10341	24.206819	0.201723	0.201723			0.161378								0		0	0	11.478486	24.207104	24.206822	0	0	0	0		18.4183	0.426598381	2.036869135	0	1.663478453	3.552105682	1.792447232	1.790776135	8.848608581	2.745228135	3.574441093	0	0.038642686	4.653424233	5.682416927	11.73341103	0.150276373	0.601105694	0	0	4.076774447	0	0	0	0	0	0	0	0	0	0	0	0.314610364	0.008586966	1.162902874	0	0	0	0	0	73.271	0	17.5352	18.4183	0.426598381	2.036869135	0	1.663478453	3.552105682	1.792447232	1.790776135	8.848608581	2.745228135	3.574441093	0	0.038642686	4.653424233	5.682416927	11.73341103	0.150276373	0.601105694	0	0	4.076774447	0	0	0	0	0	0	0	0	0	0	0	0.314610364	0.008586966	1.162902874	0	0	0	0	0	73.271	6000																																																																																	0	0	0	18.4183	0.426598381	2.036869135	0	1.663478453	3.552105682	1.792447232	1.790776135	8.848608581	2.745228135	3.574441093	0	0.038642686	4.653424233	5.682416927	11.73341103	0.150276373	0.601105694	0	0	4.076774447	0	0	0	0	0	0	0	0	0	0	0	0.314610364	0.008586966	1.162902874	0	0	0	0	0	73.271
H1804_020_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		287.255597	6.653327	699.679203	233.093156	10.23119	21.847153	11.024409	530.658081	45.262808	13.507542	18.010055	0	0.237669	24.742151	5612.873854	5794.907301	0.739416	2.957663			25.074117								0.05		0	430.955651	327.678803	4.240887	574.335418	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999995	950.000503	43.132801	0	0.2	0.2	0.2	49.999992	0.240475	0.25	0.244134	0	0.199996	0.231352	14.999999	29.999999	0.25	0.25			0.199999								0		0	0	14.225515	29.999384	30.000009	0	0	0	0		767.732996	767.733406	34.857342	0	0.161628	0.161628	0.161628	40.406993	0.194337	0.202035	0.197295	0	0.161625	0.186965	12.122099	24.244199	0.202035	0.202035			0.161627								0		0	0	11.496208	24.243702	24.244207	0	0	0	0		18.378	0.425665117	2.032413106	0	1.653646777	3.531111645	1.781853178	1.786858114	8.796238318	2.728996248	3.553293801	0	0.038413252	4.625916262	5.669984378	11.70774048	0.149387912	0.597551444	0	0	4.052654308	0	0	0	0	0	0	0	0	0	0	0	0.313921973	0.0085679	1.160358897	0	0	0	0	0	72.9925	0	17.3291	18.378	0.425665117	2.032413106	0	1.653646777	3.531111645	1.781853178	1.786858114	8.796238318	2.728996248	3.553293801	0	0.038413252	4.625916262	5.669984378	11.70774048	0.149387912	0.597551444	0	0	4.052654308	0	0	0	0	0	0	0	0	0	0	0	0.313921973	0.0085679	1.160358897	0	0	0	0	0	72.9925	6000																																																																																	0	0	0	18.378	0.425665117	2.032413106	0	1.653646777	3.531111645	1.781853178	1.786858114	8.796238318	2.728996248	3.553293801	0	0.038413252	4.625916262	5.669984378	11.70774048	0.149387912	0.597551444	0	0	4.052654308	0	0	0	0	0	0	0	0	0	0	0	0.313921973	0.0085679	1.160358897	0	0	0	0	0	72.9925
H1804_022_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		248.101569	5.746454	604.310303	201.321677	7.703847	16.450396	8.301123	458.327415	34.081839	10.170864	13.561152	0	0.178959	18.630262	4847.896265	5005.107477	0.556763	2.227051			18.880225								0.05		0	372.214796	283.014967	3.662837	496.051326	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999989	950.000817	43.1328	0	0.199999	0.199999	0.2	50.000011	0.240475	0.25	0.244134	0	0.200001	0.231352	14.999999	29.999998	0.25	0.25			0.2								0		0	0	14.225523	29.999696	29.999992	0	0	0	0		772.267341	772.268014	35.063214	0	0.162582	0.162582	0.162582	40.645659	0.195485	0.203228	0.19846	0	0.162583	0.188069	12.193694	24.387388	0.203228	0.203228			0.162582								0		0	0	11.564112	24.387143	24.387383	0	0	0	0		15.9667	0.369816885	1.765755123	0	1.252506853	2.674538282	1.34961318	1.552418318	6.662488297	2.067004349	2.691346226	0	0.029095691	3.503774744	4.926146967	10.1717915	0.113149831	0.452599121	0	0	3.069584741	0	0	0	0	0	0	0	0	0	0	0	0.272734731	0.007443844	1.00811614	0	0	0	0	0	59.9067	0	13.7872	15.9667	0.369816885	1.765755123	0	1.252506853	2.674538282	1.34961318	1.552418318	6.662488297	2.067004349	2.691346226	0	0.029095691	3.503774744	4.926146967	10.1717915	0.113149831	0.452599121	0	0	3.069584741	0	0	0	0	0	0	0	0	0	0	0	0.272734731	0.007443844	1.00811614	0	0	0	0	0	59.9067	5000																																																																																	0	0	0	15.9667	0.369816885	1.765755123	0	1.252506853	2.674538282	1.34961318	1.552418318	6.662488297	2.067004349	2.691346226	0	0.029095691	3.503774744	4.926146967	10.1717915	0.113149831	0.452599121	0	0	3.069584741	0	0	0	0	0	0	0	0	0	0	0	0.272734731	0.007443844	1.00811614	0	0	0	0	0	59.9067
H1804_023_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		290.272943	6.723214	707.028666	235.541578	10.447278	22.308576	11.257251	536.232138	46.218781	13.792828	18.390437	0	0.242689	25.264718	5671.831752	5855.777285	0.755033	3.02013			25.603695								0.05		0	435.482431	331.120757	4.285433	580.368263	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999986	949.999211	43.132802	0	0.2	0.199999	0.199999	50.000009	0.240475	0.25	0.244134	0	0.2	0.231352	15	30.000001	0.249999	0.25			0.2								0		0	0	14.225505	30.001169	30.000007	0	0	0	0		764.436489	764.435865	34.707672	0	0.160934	0.160933	0.160933	40.233507	0.193503	0.201167	0.196448	0	0.160934	0.186162	12.07005	24.140101	0.201167	0.201167			0.160934								0		0	0	11.446837	24.14104	24.140105	0	0	0	0		18.4913	0.428288826	2.044943253	0	1.681322238	3.590186061	1.811663175	1.797874956	8.94347278	2.77466183	3.612764568	0	0.039056912	4.703330432	5.70494107	11.77992126	0.151887724	0.607550492	0	0	4.120505051	0	0	0	0	0	0	0	0	0	0	0	0.315857111	0.008621234	1.167512567	0	0	0	0	0	73.7756	0	17.9087	18.4913	0.428288826	2.044943253	0	1.681322238	3.590186061	1.811663175	1.797874956	8.94347278	2.77466183	3.612764568	0	0.039056912	4.703330432	5.70494107	11.77992126	0.151887724	0.607550492	0	0	4.120505051	0	0	0	0	0	0	0	0	0	0	0	0.315857111	0.008621234	1.167512567	0	0	0	0	0	73.7756	6000																																																																																	0	0	0	18.4913	0.428288826	2.044943253	0	1.681322238	3.590186061	1.811663175	1.797874956	8.94347278	2.77466183	3.612764568	0	0.039056912	4.703330432	5.70494107	11.77992126	0.151887724	0.607550492	0	0	4.120505051	0	0	0	0	0	0	0	0	0	0	0	0.315857111	0.008621234	1.167512567	0	0	0	0	0	73.7756
H1804_025_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		256.084506	5.931352	623.75461	207.799418	8.131231	17.36301	8.761642	473.074551	35.972586	10.735109	14.31348	0	0.188887	19.663807	5003.801647	5166.082019	0.58765	2.350601			19.927637								0.05		0	384.191175	292.121252	3.780694	512.012309	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000012	949.999258	43.132808	0	0.199999	0.2	0.199999	50	0.240475	0.249999	0.244134	0	0.199997	0.231352	14.999999	30.000002	0.25	0.249999			0.199999								0		0	0	14.225517	30.000841	30.000005	0	0	0	0		763.45421	763.453603	34.663077	0	0.160727	0.160727	0.160727	40.1818	0.193254	0.200908	0.196195	0	0.160725	0.185923	12.054539	24.109081	0.200909	0.200908			0.160727								0		0	0	11.432138	24.109755	24.109084	0	0	0	0		16.2924	0.377359338	1.801771173	0	1.306908365	2.790704508	1.408232434	1.584082249	6.951846135	2.156769279	2.808233209	0	0.030358863	3.655953989	5.026543509	10.37912415	0.118064174	0.472254546	0	0	3.202909312	0	0	0	0	0	0	0	0	0	0	0	0.278297539	0.007595967	1.028678981	0	0	0	0	0	61.6781	0	15.0707	16.2924	0.377359338	1.801771173	0	1.306908365	2.790704508	1.408232434	1.584082249	6.951846135	2.156769279	2.808233209	0	0.030358863	3.655953989	5.026543509	10.37912415	0.118064174	0.472254546	0	0	3.202909312	0	0	0	0	0	0	0	0	0	0	0	0.278297539	0.007595967	1.028678981	0	0	0	0	0	61.6781	5000																																																																																	0	0	0	16.2924	0.377359338	1.801771173	0	1.306908365	2.790704508	1.408232434	1.584082249	6.951846135	2.156769279	2.808233209	0	0.030358863	3.655953989	5.026543509	10.37912415	0.118064174	0.472254546	0	0	3.202909312	0	0	0	0	0	0	0	0	0	0	0	0.278297539	0.007595967	1.028678981	0	0	0	0	0	61.6781
H1804_061_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		254.731901	5.900023	620.460021	206.70185	8.045556	17.180063	8.669324	470.575833	35.593558	10.621998	14.162664	0	0.186897	19.456618	4977.372227	5138.795457	0.581458	2.325833			19.717669								0.05		0	382.161928	290.578307	3.760724	509.307929	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999976	949.999686	43.13279	0	0.199999	0.2	0.2	50.000009	0.240475	0.25	0.244134	0	0.199997	0.231352	14.999999	30	0.25	0.249999			0.2								0		0	0	14.225521	30.000606	30.000004	0	0	0	0		765.075831	765.075597	34.73669	0	0.161068	0.161068	0.161068	40.267157	0.193665	0.201335	0.196612	0	0.161066	0.186318	12.080144	24.16029	0.201336	0.201335			0.161068								0		0	0	11.456424	24.160778	24.160293	0	0	0	0		16.2408	0.376163635	1.796060617	0	1.295881614	2.767158387	1.396350678	1.579062579	6.89322641	2.138579967	2.784549694	0	0.030102752	3.625118153	5.010614437	10.34623237	0.117068428	0.468271587	0	0	3.17588551	0	0	0	0	0	0	0	0	0	0	0	0.277415691	0.007571835	1.025419066	0	0	0	0	0	61.3515	0	14.8291	16.2408	0.376163635	1.796060617	0	1.295881614	2.767158387	1.396350678	1.579062579	6.89322641	2.138579967	2.784549694	0	0.030102752	3.625118153	5.010614437	10.34623237	0.117068428	0.468271587	0	0	3.17588551	0	0	0	0	0	0	0	0	0	0	0	0.277415691	0.007571835	1.025419066	0	0	0	0	0	61.3515	5000																																																																																	0	0	0	16.2408	0.376163635	1.796060617	0	1.295881614	2.767158387	1.396350678	1.579062579	6.89322641	2.138579967	2.784549694	0	0.030102752	3.625118153	5.010614437	10.34623237	0.117068428	0.468271587	0	0	3.17588551	0	0	0	0	0	0	0	0	0	0	0	0.277415691	0.007571835	1.025419066	0	0	0	0	0	61.3515
H1804_063_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		283.69662	6.570896	691.010468	230.205229	9.97946	21.309622	10.753163	524.083449	44.149153	13.175199	17.566932	0	0.231822	24.133391	5543.33268	5723.110809	0.721223	2.884892			24.457189								0.05		0	425.616291	323.618999	4.188344	567.21964	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000012	950.000125	43.132799	0	0.199999	0.199999	0.2	49.999999	0.240475	0.25	0.244134	0	0.200002	0.231352	15	29.999999	0.25	0.25			0.2								0		0	0	14.225505	30.000402	29.999997	0	0	0	0		731.243509	731.243596	33.200609	0	0.153945	0.153945	0.153946	38.486499	0.185101	0.192432	0.187917	0	0.153948	0.178078	11.54595	23.091899	0.192432	0.192432			0.153946								0		0	0	10.949798	23.092209	23.091898	0	0	0	0		17.2876	0.400410468	1.911830697	0	1.53628797	3.280509759	1.655406431	1.680844761	8.172052369	2.535329894	3.301125161	0	0.035688533	4.297626002	5.33358683	11.01312473	0.138786384	0.555145537	0	0	3.765086418	0	0	0	0	0	0	0	0	0	0	0	0.295296889	0.008059843	1.091514839	0	0	0	0	0	68.2953	0	20.431	17.2876	0.400410468	1.911830697	0	1.53628797	3.280509759	1.655406431	1.680844761	8.172052369	2.535329894	3.301125161	0	0.035688533	4.297626002	5.33358683	11.01312473	0.138786384	0.555145537	0	0	3.765086418	0	0	0	0	0	0	0	0	0	0	0	0.295296889	0.008059843	1.091514839	0	0	0	0	0	68.2953	5000																																																																																	0	0	0	17.2876	0.400410468	1.911830697	0	1.53628797	3.280509759	1.655406431	1.680844761	8.172052369	2.535329894	3.301125161	0	0.035688533	4.297626002	5.33358683	11.01312473	0.138786384	0.555145537	0	0	3.765086418	0	0	0	0	0	0	0	0	0	0	0	0.295296889	0.008059843	1.091514839	0	0	0	0	0	68.2953
H1804_066_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		257.935974	5.974235	628.264302	209.301791	8.266094	17.650987	8.90696	476.494839	36.569215	10.913159	14.550877	0	0.192021	19.989945	5039.978696	5203.432344	0.597397	2.389587			20.25815								0.05		0	386.968843	294.233263	3.808028	515.714114	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999987	949.999389	43.132796	0	0.2	0.199999	0.2	49.999995	0.240475	0.25	0.244134	0	0.199999	0.231352	14.999999	30	0.249999	0.25			0.2								0		0	0	14.225529	29.999782	29.999993	0	0	0	0		761.085839	761.08536	34.555537	0	0.160228	0.160228	0.160228	40.057146	0.192655	0.200285	0.195587	0	0.160228	0.185346	12.017144	24.03429	0.200285	0.200285			0.160228								0		0	0	11.396683	24.034115	24.034284	0	0	0	0		16.3593	0.378908566	1.809167528	0	1.324459709	2.828182345	1.427144387	1.590585278	7.045242116	2.18574205	2.84596238	0	0.030767141	3.705056346	5.047179146	10.4217335	0.119649658	0.478598432	0	0	3.245922858	0	0	0	0	0	0	0	0	0	0	0	0.279440269	0.007626882	1.032901623	0	0	0	0	0	62.1636	0	15.43	16.3593	0.378908566	1.809167528	0	1.324459709	2.828182345	1.427144387	1.590585278	7.045242116	2.18574205	2.84596238	0	0.030767141	3.705056346	5.047179146	10.4217335	0.119649658	0.478598432	0	0	3.245922858	0	0	0	0	0	0	0	0	0	0	0	0.279440269	0.007626882	1.032901623	0	0	0	0	0	62.1636	5000																																																																																	0	0	0	16.3593	0.378908566	1.809167528	0	1.324459709	2.828182345	1.427144387	1.590585278	7.045242116	2.18574205	2.84596238	0	0.030767141	3.705056346	5.047179146	10.4217335	0.119649658	0.478598432	0	0	3.245922858	0	0	0	0	0	0	0	0	0	0	0	0.279440269	0.007626882	1.032901623	0	0	0	0	0	62.1636
H1804_067_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		276.804103	6.411254	674.222078	224.612306	9.412694	20.099379	10.142456	511.350124	41.641737	12.426924	16.569233	0	0.218656	22.762754	5408.56965	5583.991353	0.680262	2.721047			23.068162								0.05		0	415.275361	315.756231	4.086588	553.438822	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999993	950.000733	43.132802	0	0.2	0.2	0.199999	50.000011	0.240475	0.25	0.244134	0	0.200003	0.231352	14.999999	29.999999	0.25	0.25			0.2								0		0	0	14.225505	29.998619	29.999998	0	0	0	0		779.772344	779.772951	35.403965	0	0.164162	0.164162	0.164162	41.040659	0.197385	0.205203	0.200389	0	0.164165	0.189897	12.312194	24.624389	0.205203	0.205203			0.164162								0		0	0	11.676479	24.623257	24.624389	0	0	0	0		17.987	0.416610204	1.989177904	0	1.545206672	3.299554255	1.665005862	1.748845506	8.219454258	2.550042086	3.320292032	0	0.035895662	4.322578696	5.549279899	11.45853127	0.139591803	0.558367008	0	0	3.78691561	0	0	0	0	0	0	0	0	0	0	0	0.307243417	0.008385426	1.135674403	0	0	0	0	0	70.0437	0	15.2908	17.987	0.416610204	1.989177904	0	1.545206672	3.299554255	1.665005862	1.748845506	8.219454258	2.550042086	3.320292032	0	0.035895662	4.322578696	5.549279899	11.45853127	0.139591803	0.558367008	0	0	3.78691561	0	0	0	0	0	0	0	0	0	0	0	0.307243417	0.008385426	1.135674403	0	0	0	0	0	70.0437	6000																																																																																	0	0	0	17.987	0.416610204	1.989177904	0	1.545206672	3.299554255	1.665005862	1.748845506	8.219454258	2.550042086	3.320292032	0	0.035895662	4.322578696	5.549279899	11.45853127	0.139591803	0.558367008	0	0	3.78691561	0	0	0	0	0	0	0	0	0	0	0	0.307243417	0.008385426	1.135674403	0	0	0	0	0	70.0437
H1804_068_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		284.581758	6.591396	693.166436	230.923475	10.041622	21.442359	10.820145	525.718601	44.424157	13.257268	17.676355	0	0.233265	24.283717	5560.628	5740.967042	0.725716	2.902862			24.609532								0.05		0	426.944222	324.628699	4.201412	568.989378	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999992	950.000273	43.132792	0	0.199999	0.2	0.2	49.999996	0.240475	0.25	0.244134	0	0.2	0.231352	15	29.999998	0.25	0.25			0.2								0		0	0	14.225507	30.001342	29.99999	0	0	0	0		770.602944	770.603171	34.987639	0	0.162232	0.162232	0.162232	40.558046	0.195064	0.20279	0.198032	0	0.162232	0.187664	12.167415	24.334828	0.20279	0.20279			0.162232								0		0	0	11.539176	24.335918	24.334822	0	0	0	0		18.275	0.423279222	2.021021419	0	1.62907242	3.478636785	1.755373764	1.776843267	8.665553761	2.688441378	3.500483933	0	0.037843047	4.557179467	5.638205711	11.64212046	0.147167948	0.588671385	0	0	3.992453595	0	0	0	0	0	0	0	0	0	0	0	0.312162308	0.008520435	1.153854603	0	0	0	0	0	72.2918	0	16.8296	18.275	0.423279222	2.021021419	0	1.62907242	3.478636785	1.755373764	1.776843267	8.665553761	2.688441378	3.500483933	0	0.037843047	4.557179467	5.638205711	11.64212046	0.147167948	0.588671385	0	0	3.992453595	0	0	0	0	0	0	0	0	0	0	0	0.312162308	0.008520435	1.153854603	0	0	0	0	0	72.2918	6000																																																																																	0	0	0	18.275	0.423279222	2.021021419	0	1.62907242	3.478636785	1.755373764	1.776843267	8.665553761	2.688441378	3.500483933	0	0.037843047	4.557179467	5.638205711	11.64212046	0.147167948	0.588671385	0	0	3.992453595	0	0	0	0	0	0	0	0	0	0	0	0.312162308	0.008520435	1.153854603	0	0	0	0	0	72.2918
H1804_075_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		278.254192	6.44484	677.754143	225.78898	9.600049	20.499447	10.344337	514.029447	42.470638	12.674289	16.899052	0	0.223008	23.215858	5436.989553	5613.318825	0.693803	2.775211			23.527346								0.05		0	417.45128	317.410702	4.107995	556.338116	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000005	950.00093	43.132791	0	0.2	0.199999	0.2	49.999991	0.240475	0.249999	0.244134	0	0.200001	0.231352	15	29.999999	0.25	0.25			0.199999								0		0	0	14.225493	30.000036	29.999993	0	0	0	0		777.402104	777.402861	35.296339	0	0.163663	0.163663	0.163663	40.915893	0.196785	0.204579	0.19978	0	0.163665	0.189319	12.27477	24.549539	0.204579	0.204579			0.163663								0		0	0	11.640977	24.549569	24.549534	0	0	0	0		18.0263	0.417519755	1.993519999	0	1.571172819	3.355000994	1.692985226	1.752664488	8.357584499	2.592893369	3.376092609	0	0.036498604	4.395203021	5.561483021	11.48369912	0.141937524	0.567749891	0	0	3.850556028	0	0	0	0	0	0	0	0	0	0	0	0.307914223	0.008404126	1.138153458	0	0	0	0	0	70.6273	0	15.6806	18.0263	0.417519755	1.993519999	0	1.571172819	3.355000994	1.692985226	1.752664488	8.357584499	2.592893369	3.376092609	0	0.036498604	4.395203021	5.561483021	11.48369912	0.141937524	0.567749891	0	0	3.850556028	0	0	0	0	0	0	0	0	0	0	0	0.307914223	0.008404126	1.138153458	0	0	0	0	0	70.6273	6000																																																																																	0	0	0	18.0263	0.417519755	1.993519999	0	1.571172819	3.355000994	1.692985226	1.752664488	8.357584499	2.592893369	3.376092609	0	0.036498604	4.395203021	5.561483021	11.48369912	0.141937524	0.567749891	0	0	3.850556028	0	0	0	0	0	0	0	0	0	0	0	0.307914223	0.008404126	1.138153458	0	0	0	0	0	70.6273
H1804_077_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		289.510855	6.705564	705.172419	234.923184	10.392573	22.19176	11.198304	534.824305	45.976764	13.720603	18.294138	0	0.241418	25.132423	5656.940813	5840.403417	0.751079	3.004316			25.469625								0.05		0	434.339107	330.251426	4.274182	578.844555	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999985	949.999799	43.132804	0	0.2	0.199999	0.2	50.000008	0.240475	0.25	0.244134	0	0.200001	0.231352	14.999999	29.999998	0.25	0.249999			0.199999								0		0	0	14.225525	29.998725	29.999991	0	0	0	0		765.261088	765.260938	34.745112	0	0.161107	0.161107	0.161107	40.276907	0.193712	0.201384	0.19666	0	0.161108	0.186363	12.083069	24.166139	0.201384	0.201384			0.161107								0		0	0	11.459201	24.165113	24.166133	0	0	0	0		18.4626	0.427625516	2.041774556	0	1.674316258	3.575247878	1.804125163	1.795089066	8.906250908	2.763109915	3.597725179	0	0.038894371	4.683753748	5.696100514	11.76166673	0.151255293	0.605021173	0	0	4.103334875	0	0	0	0	0	0	0	0	0	0	0	0.315368123	0.008607174	1.165702875	0	0	0	0	0	73.5776	0	17.7621	18.4626	0.427625516	2.041774556	0	1.674316258	3.575247878	1.804125163	1.795089066	8.906250908	2.763109915	3.597725179	0	0.038894371	4.683753748	5.696100514	11.76166673	0.151255293	0.605021173	0	0	4.103334875	0	0	0	0	0	0	0	0	0	0	0	0.315368123	0.008607174	1.165702875	0	0	0	0	0	73.5776	6000																																																																																	0	0	0	18.4626	0.427625516	2.041774556	0	1.674316258	3.575247878	1.804125163	1.795089066	8.906250908	2.763109915	3.597725179	0	0.038894371	4.683753748	5.696100514	11.76166673	0.151255293	0.605021173	0	0	4.103334875	0	0	0	0	0	0	0	0	0	0	0	0.315368123	0.008607174	1.165702875	0	0	0	0	0	73.5776
H1804_081_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		268.16548	6.211167	653.180693	217.602509	8.916519	19.039874	9.607814	495.392191	39.446703	11.771872	15.695829	0	0.207129	21.562876	5239.859669	5409.79574	0.644404	2.577614			21.852185								0.05		0	402.315677	305.902287	3.959051	536.166867	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999992	949.999251	43.132805	0	0.2	0.2	0.199999	49.999996	0.240475	0.25	0.244134	0	0.2	0.231352	15	29.999999	0.25	0.25			0.2								0		0	0	14.225522	30.001129	29.999996	0	0	0	0		749.459744	749.459159	34.027686	0	0.157781	0.157781	0.15778	39.445247	0.189712	0.197226	0.192599	0	0.157781	0.182515	11.833575	23.667149	0.197226	0.197226			0.157781								0		0	0	11.222586	23.66804	23.667147	0	0	0	0		16.7483	0.387918	1.852185627	0	1.406857284	3.00413036	1.515920893	1.628405611	7.48351292	2.321719227	3.02300097	0	0.032681021	3.935548313	5.167189365	10.66953682	0.127093223	0.508372499	0	0	3.447859601	0	0	0	0	0	0	0	0	0	0	0	0.28608456	0.007808581	1.057461671	0	0	0	0	0	64.6116	0	17.2888	16.7483	0.387918	1.852185627	0	1.406857284	3.00413036	1.515920893	1.628405611	7.48351292	2.321719227	3.02300097	0	0.032681021	3.935548313	5.167189365	10.66953682	0.127093223	0.508372499	0	0	3.447859601	0	0	0	0	0	0	0	0	0	0	0	0.28608456	0.007808581	1.057461671	0	0	0	0	0	64.6116	5000																																																																																	0	0	0	16.7483	0.387918	1.852185627	0	1.406857284	3.00413036	1.515920893	1.628405611	7.48351292	2.321719227	3.02300097	0	0.032681021	3.935548313	5.167189365	10.66953682	0.127093223	0.508372499	0	0	3.447859601	0	0	0	0	0	0	0	0	0	0	0	0.28608456	0.007808581	1.057461671	0	0	0	0	0	64.6116
H1804_086_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		290.246752	6.722607	706.964835	235.520323	10.349102	22.098936	11.151463	536.183208	45.784404	13.663199	18.217598	0	0.240408	25.027274	5671.230119	5855.170962	0.747937	2.991746			25.363063								0.05		0	435.442693	331.090544	4.285046	580.31589	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000005	949.999308	43.132793	0	0.199999	0.199999	0.2	50.000006	0.240475	0.25	0.244134	0	0.199997	0.231352	15	30.000001	0.249999	0.25			0.2								0		0	0	14.225498	30.001078	30.000005	0	0	0	0		765.343754	765.343192	34.748856	0	0.161124	0.161124	0.161125	40.281255	0.193733	0.201406	0.196681	0	0.161122	0.186383	12.084375	24.16875	0.201405	0.201406			0.161125								0		0	0	11.460417	24.169618	24.168754	0	0	0	0		18.5115	0.428758458	2.047184937	0	1.667488711	3.560668964	1.796779476	1.799844377	8.86994994	2.751850258	3.583055392	0	0.038735018	4.66465841	5.711105956	11.79268027	0.150638251	0.602555595	0	0	4.086623526	0	0	0	0	0	0	0	0	0	0	0	0.316202975	0.00863066	1.168792666	0	0	0	0	0	73.5577	0	17.7475	18.5115	0.428758458	2.047184937	0	1.667488711	3.560668964	1.796779476	1.799844377	8.86994994	2.751850258	3.583055392	0	0.038735018	4.66465841	5.711105956	11.79268027	0.150638251	0.602555595	0	0	4.086623526	0	0	0	0	0	0	0	0	0	0	0	0.316202975	0.00863066	1.168792666	0	0	0	0	0	73.5577	6000																																																																																	0	0	0	18.5115	0.428758458	2.047184937	0	1.667488711	3.560668964	1.796779476	1.799844377	8.86994994	2.751850258	3.583055392	0	0.038735018	4.66465841	5.711105956	11.79268027	0.150638251	0.602555595	0	0	4.086623526	0	0	0	0	0	0	0	0	0	0	0	0.316202975	0.00863066	1.168792666	0	0	0	0	0	73.5577
H1804_087_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		293.836298	6.805748	715.708061	238.433058	10.705338	22.859624	11.535318	542.814858	47.36044	14.133527	18.844702	0	0.248683	25.888785	5741.458442	5927.662071	0.773683	3.094731			26.236136								0.05		0	440.828357	335.185553	4.33804	587.492792	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999989	949.999324	43.132799	0	0.2	0.2	0.199999	50.000009	0.240475	0.25	0.244134	0	0.200001	0.231352	14.999999	30.000001	0.25	0.25			0.199999								0		0	0	14.225517	29.999723	30	0	0	0	0		760.642191	760.641658	34.535397	0	0.160135	0.160135	0.160135	40.033807	0.192542	0.200169	0.195472	0	0.160136	0.185238	12.010139	24.020281	0.200169	0.200169			0.160135								0		0	0	11.39003	24.020058	24.02028	0	0	0	0		18.6254	0.43139462	2.059771835	0	1.714299301	3.660625889	1.847208148	1.810912105	9.118873838	2.829093966	3.683611589	0	0.039823101	4.795586756	5.746309496	11.86534238	0.154867352	0.61946921	0	0	4.201323638	0	0	0	0	0	0	0	0	0	0	0	0.318147792	0.008683331	1.175978447	0	0	0	0	0	74.7067	0	18.5978	18.6254	0.43139462	2.059771835	0	1.714299301	3.660625889	1.847208148	1.810912105	9.118873838	2.829093966	3.683611589	0	0.039823101	4.795586756	5.746309496	11.86534238	0.154867352	0.61946921	0	0	4.201323638	0	0	0	0	0	0	0	0	0	0	0	0.318147792	0.008683331	1.175978447	0	0	0	0	0	74.7067	6000																																																																																	0	0	0	18.6254	0.43139462	2.059771835	0	1.714299301	3.660625889	1.847208148	1.810912105	9.118873838	2.829093966	3.683611589	0	0.039823101	4.795586756	5.746309496	11.86534238	0.154867352	0.61946921	0	0	4.201323638	0	0	0	0	0	0	0	0	0	0	0	0.318147792	0.008683331	1.175978447	0	0	0	0	0	74.7067
H1804_089_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		289.6946	6.709818	705.619978	235.072284	10.405675	22.21974	11.212422	535.163746	46.034732	13.737903	18.317204	0	0.241722	25.164111	5660.53115	5844.110192	0.752026	3.008104			25.501738								0.05		0	434.614772	330.46103	4.276896	579.211934	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000006	950.000134	43.132792	0	0.2	0.2	0.199999	50.000001	0.240475	0.25	0.244134	0	0.200002	0.231352	15	29.999999	0.25	0.25			0.199999								0		0	0	14.225507	29.999326	30.000003	0	0	0	0		765.062555	765.062658	34.736088	0	0.161065	0.161065	0.161065	40.266451	0.193661	0.201332	0.196608	0	0.161067	0.186314	12.079935	24.159869	0.201332	0.201332			0.161065								0		0	0	11.456214	24.159327	24.159872	0	0	0	0		18.4695	0.427785933	2.042539804	0	1.675990044	3.578822423	1.805928749	1.795762063	8.915132234	2.765879487	3.601308844	0	0.038933437	4.688426177	5.698237363	11.76607806	0.151406899	0.605627595	0	0	4.107437431	0	0	0	0	0	0	0	0	0	0	0	0.315486023	0.008610577	1.166140516	0	0	0	0	0	73.6251	0	17.7973	18.4695	0.427785933	2.042539804	0	1.675990044	3.578822423	1.805928749	1.795762063	8.915132234	2.765879487	3.601308844	0	0.038933437	4.688426177	5.698237363	11.76607806	0.151406899	0.605627595	0	0	4.107437431	0	0	0	0	0	0	0	0	0	0	0	0.315486023	0.008610577	1.166140516	0	0	0	0	0	73.6251	6000																																																																																	0	0	0	18.4695	0.427785933	2.042539804	0	1.675990044	3.578822423	1.805928749	1.795762063	8.915132234	2.765879487	3.601308844	0	0.038933437	4.688426177	5.698237363	11.76607806	0.151406899	0.605627595	0	0	4.107437431	0	0	0	0	0	0	0	0	0	0	0	0.315486023	0.008610577	1.166140516	0	0	0	0	0	73.6251
H1804_090_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		283.348593	6.562835	690.162768	229.922824	9.954778	21.256918	10.726568	523.440526	44.039962	13.142614	17.523485	0	0.231248	24.073704	5536.532368	5716.089956	0.719439	2.877757			24.396699								0.05		0	425.094164	323.221998	4.183207	566.523801	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000016	950.000419	43.132799	0	0.2	0.2	0.2	49.999995	0.240475	0.25	0.244134	0	0.200001	0.231352	14.999999	30	0.25	0.249999			0.2								0		0	0	14.225529	29.999949	30.00001	0	0	0	0		771.932963	771.93329	35.04803	0	0.162512	0.162512	0.162512	40.628046	0.195401	0.20314	0.198374	0	0.162513	0.187987	12.188414	24.37683	0.20314	0.20314			0.162512								0		0	0	11.55911	24.376789	24.376838	0	0	0	0		18.2272	0.422172568	2.015737116	0	1.617770882	3.454504258	1.743196019	1.772197147	8.605452615	2.669790608	3.476203813	0	0.037580806	4.525543394	5.623462385	11.61167943	0.146146838	0.584587557	0	0	3.964756348	0	0	0	0	0	0	0	0	0	0	0	0.311346552	0.008497763	1.150838243	0	0	0	0	0	71.9686	0	16.6015	18.2272	0.422172568	2.015737116	0	1.617770882	3.454504258	1.743196019	1.772197147	8.605452615	2.669790608	3.476203813	0	0.037580806	4.525543394	5.623462385	11.61167943	0.146146838	0.584587557	0	0	3.964756348	0	0	0	0	0	0	0	0	0	0	0	0.311346552	0.008497763	1.150838243	0	0	0	0	0	71.9686	6000																																																																																	0	0	0	18.2272	0.422172568	2.015737116	0	1.617770882	3.454504258	1.743196019	1.772197147	8.605452615	2.669790608	3.476203813	0	0.037580806	4.525543394	5.623462385	11.61167943	0.146146838	0.584587557	0	0	3.964756348	0	0	0	0	0	0	0	0	0	0	0	0.311346552	0.008497763	1.150838243	0	0	0	0	0	71.9686
H1804_091_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		267.829659	6.20339	652.362719	217.330008	8.894196	18.992207	9.58376	494.771815	39.347945	11.7424	15.656533	0	0.206611	21.50889	5233.297829	5403.021092	0.64279	2.571161			21.797477								0.05		0	401.811858	305.519206	3.954092	535.495429	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999984	950.000564	43.132808	0	0.199999	0.199999	0.2	49.999994	0.240475	0.25	0.244134	0	0.199999	0.231352	14.999999	30	0.25	0.249999			0.2								0		0	0	14.225527	29.999301	30.000009	0	0	0	0		788.576937	788.577418	35.803724	0	0.166016	0.166016	0.166016	41.504045	0.199614	0.20752	0.202651	0	0.166015	0.192041	12.451214	24.90243	0.20752	0.20752			0.166016								0		0	0	11.80834	24.90185	24.902437	0	0	0	0		17.6004	0.407654439	1.946417895	0	1.476578843	3.153010237	1.5910575	1.71125264	7.854400693	2.436782848	3.172812069	0	0.034300525	4.130588744	5.430075933	11.21236288	0.133391781	0.533567331	0	0	3.618729942	0	0	0	0	0	0	0	0	0	0	0	0.300639555	0.00820535	1.111261765	0	0	0	0	0	67.8634	0	13.8918	17.6004	0.407654439	1.946417895	0	1.476578843	3.153010237	1.5910575	1.71125264	7.854400693	2.436782848	3.172812069	0	0.034300525	4.130588744	5.430075933	11.21236288	0.133391781	0.533567331	0	0	3.618729942	0	0	0	0	0	0	0	0	0	0	0	0.300639555	0.00820535	1.111261765	0	0	0	0	0	67.8634	6000																																																																																	0	0	0	17.6004	0.407654439	1.946417895	0	1.476578843	3.153010237	1.5910575	1.71125264	7.854400693	2.436782848	3.172812069	0	0.034300525	4.130588744	5.430075933	11.21236288	0.133391781	0.533567331	0	0	3.618729942	0	0	0	0	0	0	0	0	0	0	0	0.300639555	0.00820535	1.111261765	0	0	0	0	0	67.8634
H1804_093_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		315.279349	7.302406	767.937704	255.832993	12.325546	26.319333	13.28114	582.427413	54.528245	16.272577	21.69677	0	0.286321	29.806946	6160.448163	6360.240224	0.890776	3.563106			30.206866								0.05		0	472.998329	359.646117	4.654615	630.365772	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999996	949.999764	43.132795	0	0.199999	0.2	0.199999	50.000002	0.240475	0.249999	0.244134	0	0.199999	0.231352	14.999999	30	0.249999	0.25			0.199999								0		0	0	14.225517	30.001194	29.999991	0	0	0	0		738.027447	738.027266	33.508618	0	0.155374	0.155374	0.155374	38.843551	0.186818	0.194217	0.189661	0	0.155373	0.17973	11.653064	23.30613	0.194217	0.194217			0.155374								0		0	0	11.051391	23.307058	23.306123	0	0	0	0		19.3904	0.449114561	2.144377598	0	1.915069384	4.089340046	2.063543846	1.885295743	10.18685767	3.160411087	4.115031095	0	0.044486553	5.357202405	5.982341393	12.35271546	0.173003842	0.692015758	0	0	4.693361598	0	0	0	0	0	0	0	0	0	0	0	0.331215822	0.009040448	1.224281851	0	0	0	0	0	80.2591	0	23.0516	19.3904	0.449114561	2.144377598	0	1.915069384	4.089340046	2.063543846	1.885295743	10.18685767	3.160411087	4.115031095	0	0.044486553	5.357202405	5.982341393	12.35271546	0.173003842	0.692015758	0	0	4.693361598	0	0	0	0	0	0	0	0	0	0	0	0.331215822	0.009040448	1.224281851	0	0	0	0	0	80.2591	6000																																																																																	0	0	0	19.3904	0.449114561	2.144377598	0	1.915069384	4.089340046	2.063543846	1.885295743	10.18685767	3.160411087	4.115031095	0	0.044486553	5.357202405	5.982341393	12.35271546	0.173003842	0.692015758	0	0	4.693361598	0	0	0	0	0	0	0	0	0	0	0	0.331215822	0.009040448	1.224281851	0	0	0	0	0	80.2591
H1804_094_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		274.198542	6.350905	667.875648	222.498029	9.322218	19.906181	10.044965	506.537294	41.241512	12.307487	16.409983	0	0.216554	22.543978	5357.743592	5531.502803	0.673724	2.694895			22.846451								0.05		0	411.366787	312.784334	4.048119	548.229299	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000018	950.000039	43.132795	0	0.2	0.199999	0.2	49.999998	0.240475	0.25	0.244134	0	0.2	0.231352	14.999998	30.000002	0.25	0.25			0.199999								0		0	0	14.225507	29.999118	29.999994	0	0	0	0		781.713215	781.713232	35.492079	0	0.164571	0.164571	0.164571	41.142798	0.197876	0.205714	0.200887	0	0.164571	0.190369	12.342839	24.685681	0.205714	0.205714			0.164571								0		0	0	11.705544	24.684954	24.685675	0	0	0	0		17.8621	0.413715539	1.975357938	0	1.534166738	3.275980113	1.653109935	1.736696797	8.160705429	2.531822381	3.296552255	0	0.035638508	4.291674548	5.51081388	11.37907614	0.138594459	0.55437763	0	0	3.759863288	0	0	0	0	0	0	0	0	0	0	0	0.305109232	0.008327303	1.127784192	0	0	0	0	0	69.5514	0	14.973	17.8621	0.413715539	1.975357938	0	1.534166738	3.275980113	1.653109935	1.736696797	8.160705429	2.531822381	3.296552255	0	0.035638508	4.291674548	5.51081388	11.37907614	0.138594459	0.55437763	0	0	3.759863288	0	0	0	0	0	0	0	0	0	0	0	0.305109232	0.008327303	1.127784192	0	0	0	0	0	69.5514	6000																																																																																	0	0	0	17.8621	0.413715539	1.975357938	0	1.534166738	3.275980113	1.653109935	1.736696797	8.160705429	2.531822381	3.296552255	0	0.035638508	4.291674548	5.51081388	11.37907614	0.138594459	0.55437763	0	0	3.759863288	0	0	0	0	0	0	0	0	0	0	0	0.305109232	0.008327303	1.127784192	0	0	0	0	0	69.5514
H1804_095_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		295.924974	6.854125	720.795531	240.127912	10.859451	23.188709	11.701379	546.673349	48.042236	14.336992	19.115989	0	0.252264	26.261478	5782.270466	5969.797686	0.784821	3.139283			26.613829								0.05		0	443.9619	337.568155	4.368876	591.668867	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000009	949.999551	43.132792	0	0.199999	0.2	0.2	50.000008	0.240475	0.25	0.244134	0	0.199996	0.231352	14.999999	29.999999	0.249999	0.25			0.2								0		0	0	14.2255	29.999476	29.999996	0	0	0	0		758.454357	758.453992	34.436056	0	0.159674	0.159674	0.159674	39.918656	0.191989	0.199593	0.19491	0	0.159672	0.184705	11.975594	23.951189	0.199593	0.199593			0.159674								0		0	0	11.357255	23.950772	23.951187	0	0	0	0		18.7038	0.433211539	2.068446273	0	1.733971979	3.702633921	1.86840599	1.81853878	9.223580847	2.861563244	3.725897416	0	0.040279497	4.850626294	5.770510292	11.91531272	0.156644778	0.626578912	0	0	4.249536532	0	0	0	0	0	0	0	0	0	0	0	0.319487301	0.008719829	1.180930973	0	0	0	0	0	75.2587	0	19.0064	18.7038	0.433211539	2.068446273	0	1.733971979	3.702633921	1.86840599	1.81853878	9.223580847	2.861563244	3.725897416	0	0.040279497	4.850626294	5.770510292	11.91531272	0.156644778	0.626578912	0	0	4.249536532	0	0	0	0	0	0	0	0	0	0	0	0.319487301	0.008719829	1.180930973	0	0	0	0	0	75.2587	6000																																																																																	0	0	0	18.7038	0.433211539	2.068446273	0	1.733971979	3.702633921	1.86840599	1.81853878	9.223580847	2.861563244	3.725897416	0	0.040279497	4.850626294	5.770510292	11.91531272	0.156644778	0.626578912	0	0	4.249536532	0	0	0	0	0	0	0	0	0	0	0	0.319487301	0.008719829	1.180930973	0	0	0	0	0	75.2587
H1804_097_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		260.611769	6.036211	634.781833	211.47306	8.421268	17.982341	9.074166	481.437934	37.255711	11.118026	14.824035	0	0.195625	20.365207	5092.262774	5257.412067	0.608611	2.434446			20.638447								0.05		0	390.983207	297.285598	3.847532	521.064063	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999997	950.000588	43.132803	0	0.2	0.199999	0.199999	49.99999	0.240475	0.25	0.244134	0	0.2	0.231352	14.999998	29.999999	0.25	0.25			0.2								0		0	0	14.225512	30.00053	29.999996	0	0	0	0		796.377398	796.377893	36.157884	0	0.167658	0.167658	0.167658	41.914591	0.201588	0.209573	0.204656	0	0.167658	0.19394	12.574379	25.148759	0.209573	0.209573			0.167658								0		0	0	11.925133	25.149204	25.148756	0	0	0	0		17.2954	0.400592083	1.912697324	0	1.41189295	3.014883327	1.521356523	1.681606175	7.510304269	2.330038063	3.033827707	0	0.032798096	3.949628246	5.336003507	11.01811575	0.127548433	0.510194152	0	0	3.460200747	0	0	0	0	0	0	0	0	0	0	0	0.295430858	0.008063531	1.092009415	0	0	0	0	0	65.9426	0	12.7205	17.2954	0.400592083	1.912697324	0	1.41189295	3.014883327	1.521356523	1.681606175	7.510304269	2.330038063	3.033827707	0	0.032798096	3.949628246	5.336003507	11.01811575	0.127548433	0.510194152	0	0	3.460200747	0	0	0	0	0	0	0	0	0	0	0	0.295430858	0.008063531	1.092009415	0	0	0	0	0	65.9426	6000																																																																																	0	0	0	17.2954	0.400592083	1.912697324	0	1.41189295	3.014883327	1.521356523	1.681606175	7.510304269	2.330038063	3.033827707	0	0.032798096	3.949628246	5.336003507	11.01811575	0.127548433	0.510194152	0	0	3.460200747	0	0	0	0	0	0	0	0	0	0	0	0.295430858	0.008063531	1.092009415	0	0	0	0	0	65.9426
H1804_098_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		281.368387	6.516969	685.339508	228.315989	9.816126	20.960847	10.577166	519.782419	43.426565	12.959561	17.279415	0	0.228027	23.738399	5497.839855	5676.142585	0.709419	2.837675			24.056898								0.05		0	422.123357	320.963137	4.153971	562.564604	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999987	950.000529	43.132794	0	0.199999	0.199999	0.199999	49.999998	0.240475	0.249999	0.244134	0	0.199998	0.231352	15	29.999999	0.25	0.25			0.2								0		0	0	14.225521	30.000209	30.00001	0	0	0	0		774.093239	774.093681	35.14611	0	0.162966	0.162966	0.162966	40.741748	0.195947	0.203708	0.198929	0	0.162965	0.188514	12.222525	24.445049	0.203709	0.203708			0.162967								0		0	0	11.591452	24.44522	24.445058	0	0	0	0		18.1504	0.420395377	2.007251478	0	1.59969479	3.415905392	1.723718434	1.764737027	8.509305132	2.639966252	3.437376747	0	0.03716042	4.475020549	5.599790423	11.56279864	0.144515035	0.578057099	0	0	3.920480496	0	0	0	0	0	0	0	0	0	0	0	0.310035733	0.008462061	1.145993698	0	0	0	0	0	71.4511	0	16.2367	18.1504	0.420395377	2.007251478	0	1.59969479	3.415905392	1.723718434	1.764737027	8.509305132	2.639966252	3.437376747	0	0.03716042	4.475020549	5.599790423	11.56279864	0.144515035	0.578057099	0	0	3.920480496	0	0	0	0	0	0	0	0	0	0	0	0.310035733	0.008462061	1.145993698	0	0	0	0	0	71.4511	6000																																																																																	0	0	0	18.1504	0.420395377	2.007251478	0	1.59969479	3.415905392	1.723718434	1.764737027	8.509305132	2.639966252	3.437376747	0	0.03716042	4.475020549	5.599790423	11.56279864	0.144515035	0.578057099	0	0	3.920480496	0	0	0	0	0	0	0	0	0	0	0	0.310035733	0.008462061	1.145993698	0	0	0	0	0	71.4511
H1804_103_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		272.624727	6.314451	664.042244	221.220957	9.215535	19.678377	9.930011	503.629923	40.76955	12.166642	16.22219	0	0.214076	22.285987	5326.991763	5499.75365	0.666014	2.664055			22.584998								0.05		0	409.005666	310.989047	4.024884	545.08263	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000004	949.999928	43.132792	0	0.2	0.199999	0.199999	49.999999	0.240475	0.25	0.244134	0	0.199999	0.231352	15	29.999999	0.25	0.25			0.199999								0		0	0	14.225517	29.999373	30.000009	0	0	0	0		783.389954	783.389891	35.568206	0	0.164924	0.164924	0.164924	41.231049	0.198301	0.206155	0.201318	0	0.164923	0.190778	12.369315	24.738629	0.206155	0.206155			0.164924								0		0	0	11.73066	24.738113	24.738637	0	0	0	0		17.7976	0.41222309	1.968232611	0	1.519862894	3.245436648	1.637697134	1.730432503	8.084642535	2.508214082	3.265818846	0	0.035306056	4.251676028	5.490936593	11.33803043	0.137302116	0.549208259	0	0	3.72480821	0	0	0	0	0	0	0	0	0	0	0	0.304008898	0.008297336	1.123716777	0	0	0	0	0	69.1335	0	14.7032	17.7976	0.41222309	1.968232611	0	1.519862894	3.245436648	1.637697134	1.730432503	8.084642535	2.508214082	3.265818846	0	0.035306056	4.251676028	5.490936593	11.33803043	0.137302116	0.549208259	0	0	3.72480821	0	0	0	0	0	0	0	0	0	0	0	0.304008898	0.008297336	1.123716777	0	0	0	0	0	69.1335	6000																																																																																	0	0	0	17.7976	0.41222309	1.968232611	0	1.519862894	3.245436648	1.637697134	1.730432503	8.084642535	2.508214082	3.265818846	0	0.035306056	4.251676028	5.490936593	11.33803043	0.137302116	0.549208259	0	0	3.72480821	0	0	0	0	0	0	0	0	0	0	0	0.304008898	0.008297336	1.123716777	0	0	0	0	0	69.1335
H1804_122_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		279.688565	6.478062	681.247901	226.9529	9.699425	20.71165	10.451417	516.679219	42.910278	12.805489	17.073985	0	0.225316	23.456181	5465.016713	5642.254945	0.700985	2.803939			23.770892								0.05		0	419.6032	319.046926	4.129171	559.205986	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999984	950.000756	43.132791	0	0.199999	0.199999	0.199999	49.999998	0.240475	0.249999	0.244134	0	0.200003	0.231352	15	30.000001	0.249999	0.25			0.2								0		0	0	14.225506	30.000208	30	0	0	0	0		775.865937	775.866567	35.226594	0	0.16334	0.16334	0.16334	40.835048	0.196396	0.204175	0.199385	0	0.163343	0.188945	12.250515	24.501031	0.204174	0.204175			0.16334								0		0	0	11.617985	24.5012	24.50103	0	0	0	0		18.0834	0.418842644	1.999836935	0	1.58430408	3.383040911	1.707134453	1.758218392	8.427406958	2.614560717	3.404296499	0	0.036803791	4.431928119	5.579105768	11.52008861	0.143122911	0.572494245	0	0	3.882737499	0	0	0	0	0	0	0	0	0	0	0	0.3088902	0.008430804	1.14176022	0	0	0	0	0	71.0064	0	15.9366	18.0834	0.418842644	1.999836935	0	1.58430408	3.383040911	1.707134453	1.758218392	8.427406958	2.614560717	3.404296499	0	0.036803791	4.431928119	5.579105768	11.52008861	0.143122911	0.572494245	0	0	3.882737499	0	0	0	0	0	0	0	0	0	0	0	0.3088902	0.008430804	1.14176022	0	0	0	0	0	71.0064	6000																																																																																	0	0	0	18.0834	0.418842644	1.999836935	0	1.58430408	3.383040911	1.707134453	1.758218392	8.427406958	2.614560717	3.404296499	0	0.036803791	4.431928119	5.579105768	11.52008861	0.143122911	0.572494245	0	0	3.882737499	0	0	0	0	0	0	0	0	0	0	0	0.3088902	0.008430804	1.14176022	0	0	0	0	0	71.0064
H1804_125_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		329.51299	7.63208	802.607116	267.38286	13.473587	28.7708	14.518188	608.721756	59.607179	17.788257	23.717676	0	0.312989	32.58326	6438.568532	6647.380428	0.973746	3.894985			33.02043								0.05		0	494.35237	375.882746	4.864753	658.824345	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999998	949.999491	43.132799	0	0.199999	0.2	0.2	50.000006	0.240475	0.249999	0.244134	0	0.2	0.231352	15	29.999999	0.25	0.249999			0.199999								0		0	0	14.225521	30.000288	30.000002	0	0	0	0		723.165648	723.165262	32.833851	0	0.152245	0.152245	0.152245	38.061355	0.183056	0.190306	0.185842	0	0.152245	0.176111	11.418405	22.836809	0.190307	0.190306			0.152245								0		0	0	10.82885	22.837029	22.836811	0	0	0	0		19.8577	0.459937928	2.196056872	0	2.051286253	4.380210446	2.210321532	1.930731238	10.91145176	3.385212037	4.407740343	0	0.04765101	5.738270502	6.12651526	12.6504131	0.18531068	0.741239015	0	0	5.027195365	0	0	0	0	0	0	0	0	0	0	0	0.339198156	0.009258042	1.253787254	0	0	0	0	0	83.9095	0	26.3198	19.8577	0.459937928	2.196056872	0	2.051286253	4.380210446	2.210321532	1.930731238	10.91145176	3.385212037	4.407740343	0	0.04765101	5.738270502	6.12651526	12.6504131	0.18531068	0.741239015	0	0	5.027195365	0	0	0	0	0	0	0	0	0	0	0	0.339198156	0.009258042	1.253787254	0	0	0	0	0	83.9095	6000																																																																																	0	0	0	19.8577	0.459937928	2.196056872	0	2.051286253	4.380210446	2.210321532	1.930731238	10.91145176	3.385212037	4.407740343	0	0.04765101	5.738270502	6.12651526	12.6504131	0.18531068	0.741239015	0	0	5.027195365	0	0	0	0	0	0	0	0	0	0	0	0.339198156	0.009258042	1.253787254	0	0	0	0	0	83.9095
H1804_126_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		267.86733	6.204263	652.454476	217.360575	8.896718	18.99759	9.586476	494.841406	39.3591	11.745729	15.660972	0	0.20667	21.514988	5234.033906	5403.78104	0.642972	2.57189			21.803655								0.05		0	401.868375	305.562179	3.954649	535.570748	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000016	950.000346	43.132793	0	0.2	0.2	0.199999	49.999995	0.240475	0.249999	0.244134	0	0.2	0.231352	14.999999	30	0.25	0.25			0.2								0		0	0	14.22553	30.001145	30.000002	0	0	0	0		788.537063	788.537337	35.8019	0	0.166007	0.166007	0.166007	41.501946	0.199604	0.207509	0.202641	0	0.166007	0.192031	12.450584	24.90117	0.207509	0.207509			0.166007								0		0	0	11.807744	24.90212	24.901172	0	0	0	0		17.6019	0.407691085	1.946592492	0	1.476917465	3.153732923	1.591422121	1.711406776	7.856233796	2.437344479	3.173555027	0	0.034308667	4.131544661	5.4305649	11.21337253	0.133422477	0.533690322	0	0	3.619559356	0	0	0	0	0	0	0	0	0	0	0	0.300666665	0.008206595	1.11136161	0	0	0	0	0	67.8735	0	13.898	17.6019	0.407691085	1.946592492	0	1.476917465	3.153732923	1.591422121	1.711406776	7.856233796	2.437344479	3.173555027	0	0.034308667	4.131544661	5.4305649	11.21337253	0.133422477	0.533690322	0	0	3.619559356	0	0	0	0	0	0	0	0	0	0	0	0.300666665	0.008206595	1.11136161	0	0	0	0	0	67.8735	6000																																																																																	0	0	0	17.6019	0.407691085	1.946592492	0	1.476917465	3.153732923	1.591422121	1.711406776	7.856233796	2.437344479	3.173555027	0	0.034308667	4.131544661	5.4305649	11.21337253	0.133422477	0.533690322	0	0	3.619559356	0	0	0	0	0	0	0	0	0	0	0	0.300666665	0.008206595	1.11136161	0	0	0	0	0	67.8735
H1804_127_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		277.955553	6.437923	677.026736	225.54665	9.587175	20.471956	10.330464	513.477758	42.413682	12.657292	16.876389	0	0.222709	23.184725	5431.15424	5607.294262	0.692873	2.771489			23.495795								0.05		0	417.003245	317.07004	4.103585	555.74102	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000017	950.000208	43.132801	0	0.2	0.199999	0.2	50.000007	0.240475	0.249999	0.244134	0	0.200001	0.231352	15	29.999998	0.249999	0.249999			0.199999								0		0	0	14.225525	30.000106	30.000009	0	0	0	0		777.651964	777.65212	35.307691	0	0.163716	0.163716	0.163716	40.929056	0.196848	0.204645	0.199844	0	0.163717	0.18938	12.278715	24.557428	0.204645	0.204645			0.163716								0		0	0	11.644745	24.557517	24.557437	0	0	0	0		18.0127	0.417205372	1.992020899	0	1.569573942	3.351586748	1.691262244	1.751346659	8.349048474	2.590251521	3.372645083	0	0.036461249	4.390723221	5.557299586	11.47506043	0.141792995	0.567171366	0	0	3.846637574	0	0	0	0	0	0	0	0	0	0	0	0.307683314	0.008397822	1.137297924	0	0	0	0	0	70.5662	0	15.6393	18.0127	0.417205372	1.992020899	0	1.569573942	3.351586748	1.691262244	1.751346659	8.349048474	2.590251521	3.372645083	0	0.036461249	4.390723221	5.557299586	11.47506043	0.141792995	0.567171366	0	0	3.846637574	0	0	0	0	0	0	0	0	0	0	0	0.307683314	0.008397822	1.137297924	0	0	0	0	0	70.5662	6000																																																																																	0	0	0	18.0127	0.417205372	1.992020899	0	1.569573942	3.351586748	1.691262244	1.751346659	8.349048474	2.590251521	3.372645083	0	0.036461249	4.390723221	5.557299586	11.47506043	0.141792995	0.567171366	0	0	3.846637574	0	0	0	0	0	0	0	0	0	0	0	0.307683314	0.008397822	1.137297924	0	0	0	0	0	70.5662
H1804_128_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		277.830083	6.435017	676.721128	225.444837	9.57079	20.436969	10.31281	513.245975	42.341197	12.635661	16.847547	0	0.222328	23.145102	5428.702625	5604.76314	0.691688	2.766753			23.45564								0.05		0	416.815012	316.926914	4.101735	555.490158	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000018	950.000287	43.132792	0	0.2	0.2	0.2	50.000002	0.240475	0.249999	0.244134	0	0.199997	0.231352	14.999999	30	0.25	0.249999			0.2								0		0	0	14.225513	29.999012	29.999991	0	0	0	0		777.859065	777.859285	35.317087	0	0.163759	0.163759	0.163759	40.939951	0.196901	0.204699	0.199897	0	0.163757	0.189431	12.281984	24.56397	0.204699	0.204699			0.163759								0		0	0	11.647835	24.563161	24.563963	0	0	0	0		18.0094	0.417128144	1.991651579	0	1.567303	3.346737606	1.688815453	1.751022089	8.33702403	2.586507171	3.367774103	0	0.036407766	4.384399817	5.556269898	11.47293614	0.141587842	0.566351572	0	0	3.841072151	0	0	0	0	0	0	0	0	0	0	0	0.307626033	0.008395965	1.137086641	0	0	0	0	0	70.5155	0	15.6052	18.0094	0.417128144	1.991651579	0	1.567303	3.346737606	1.688815453	1.751022089	8.33702403	2.586507171	3.367774103	0	0.036407766	4.384399817	5.556269898	11.47293614	0.141587842	0.566351572	0	0	3.841072151	0	0	0	0	0	0	0	0	0	0	0	0.307626033	0.008395965	1.137086641	0	0	0	0	0	70.5155	6000																																																																																	0	0	0	18.0094	0.417128144	1.991651579	0	1.567303	3.346737606	1.688815453	1.751022089	8.33702403	2.586507171	3.367774103	0	0.036407766	4.384399817	5.556269898	11.47293614	0.141587842	0.566351572	0	0	3.841072151	0	0	0	0	0	0	0	0	0	0	0	0.307626033	0.008395965	1.137086641	0	0	0	0	0	70.5155
H1804_129_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		292.977815	6.785863	713.617025	237.736443	10.642856	22.726204	11.467992	541.22895	47.08402	14.051036	18.734715	0	0.247232	25.737686	5724.684002	5910.34361	0.769167	3.076669			26.083009								0.05		0	439.540417	334.206265	4.325367	585.776353	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999999	949.999727	43.132799	0	0.199999	0.2	0.2	50.000008	0.240475	0.25	0.244134	0	0.199998	0.231352	14.999999	29.999999	0.25	0.249999			0.2								0		0	0	14.225514	29.998841	30.000002	0	0	0	0		761.546599	761.546381	34.576459	0	0.160325	0.160325	0.160325	40.081406	0.192771	0.200407	0.195705	0	0.160324	0.185458	12.024419	24.048839	0.200407	0.200406			0.160325								0		0	0	11.40357	24.047911	24.048841	0	0	0	0		18.593	0.430645784	2.056195817	0	1.706315888	3.643578656	1.838605817	1.807768107	9.076433619	2.815925972	3.666477399	0	0.039637223	4.77325977	5.736333257	11.84474183	0.154146451	0.616582928	0	0	4.181758418	0	0	0	0	0	0	0	0	0	0	0	0.317595378	0.008668003	1.173936865	0	0	0	0	0	74.4816	0	18.4314	18.593	0.430645784	2.056195817	0	1.706315888	3.643578656	1.838605817	1.807768107	9.076433619	2.815925972	3.666477399	0	0.039637223	4.77325977	5.736333257	11.84474183	0.154146451	0.616582928	0	0	4.181758418	0	0	0	0	0	0	0	0	0	0	0	0.317595378	0.008668003	1.173936865	0	0	0	0	0	74.4816	6000																																																																																	0	0	0	18.593	0.430645784	2.056195817	0	1.706315888	3.643578656	1.838605817	1.807768107	9.076433619	2.815925972	3.666477399	0	0.039637223	4.77325977	5.736333257	11.84474183	0.154146451	0.616582928	0	0	4.181758418	0	0	0	0	0	0	0	0	0	0	0	0.317595378	0.008668003	1.173936865	0	0	0	0	0	74.4816
H1804_130_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		244.495226	5.662924	595.526195	198.395315	7.48152	15.975651	8.061559	451.665278	33.098265	9.877341	13.169788	0	0.173795	18.092608	4777.428426	4932.354454	0.540695	2.16278			18.335357								0.05		0	366.804372	278.90113	3.609595	488.840846	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999997	950.000388	43.132792	0	0.2	0.199999	0.199999	50.000009	0.240475	0.249999	0.244134	0	0.2	0.231352	15.000001	29.999999	0.25	0.25			0.199999								0		0	0	14.225514	30.000041	29.999997	0	0	0	0		812.975797	812.976132	36.911491	0	0.171152	0.171152	0.171152	42.788207	0.20579	0.21394	0.208921	0	0.171152	0.197983	12.836461	25.672919	0.213941	0.213941			0.171152								0		0	0	12.173682	25.672955	25.672917	0	0	0	0		16.5641	0.383651837	1.831813316	0	1.280477111	2.73426462	1.379751946	1.610495617	6.811291954	2.113158334	2.751445279	0	0.029745362	3.58202881	5.110439473	10.55232803	0.115676829	0.462707316	0	0	3.138133021	0	0	0	0	0	0	0	0	0	0	0	0.282937806	0.007722414	1.045830872	0	0	0	0	0	61.788	0	10.4142	16.5641	0.383651837	1.831813316	0	1.280477111	2.73426462	1.379751946	1.610495617	6.811291954	2.113158334	2.751445279	0	0.029745362	3.58202881	5.110439473	10.55232803	0.115676829	0.462707316	0	0	3.138133021	0	0	0	0	0	0	0	0	0	0	0	0.282937806	0.007722414	1.045830872	0	0	0	0	0	61.788	6000																																																																																	0	0	0	16.5641	0.383651837	1.831813316	0	1.280477111	2.73426462	1.379751946	1.610495617	6.811291954	2.113158334	2.751445279	0	0.029745362	3.58202881	5.110439473	10.55232803	0.115676829	0.462707316	0	0	3.138133021	0	0	0	0	0	0	0	0	0	0	0	0.282937806	0.007722414	1.045830872	0	0	0	0	0	61.788
H1804_131_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		272.866109	6.320043	664.630187	221.416827	9.23185	19.713215	9.947592	504.075837	40.841727	12.188182	16.250908	0	0.214455	22.325441	5331.708287	5504.623137	0.667193	2.668771			22.624982								0.05		0	409.3678	311.264399	4.028449	545.565245	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999986	950.000498	43.132804	0	0.2	0.2	0.2	50	0.240475	0.25	0.244134	0	0.2	0.231352	14.999999	29.999998	0.249999	0.25			0.2								0		0	0	14.2255	29.999635	29.999997	0	0	0	0		783.131539	783.13196	35.556484	0	0.164869	0.164869	0.164869	41.21745	0.198235	0.206087	0.201252	0	0.164869	0.190715	12.365234	24.730468	0.206086	0.206087			0.164869								0		0	0	11.726777	24.730169	24.730467	0	0	0	0		17.8075	0.412452305	1.969326051	0	1.522045878	3.250098044	1.640049545	1.731393384	8.096259752	2.511825864	3.270527737	0	0.035356981	4.25779648	5.493985049	11.34432553	0.137499137	0.549999009	0	0	3.730158157	0	0	0	0	0	0	0	0	0	0	0	0.30417735	0.008302019	1.124340274	0	0	0	0	0	69.1974	0	14.7445	17.8075	0.412452305	1.969326051	0	1.522045878	3.250098044	1.640049545	1.731393384	8.096259752	2.511825864	3.270527737	0	0.035356981	4.25779648	5.493985049	11.34432553	0.137499137	0.549999009	0	0	3.730158157	0	0	0	0	0	0	0	0	0	0	0	0.30417735	0.008302019	1.124340274	0	0	0	0	0	69.1974	6000																																																																																	0	0	0	17.8075	0.412452305	1.969326051	0	1.522045878	3.250098044	1.640049545	1.731393384	8.096259752	2.511825864	3.270527737	0	0.035356981	4.25779648	5.493985049	11.34432553	0.137499137	0.549999009	0	0	3.730158157	0	0	0	0	0	0	0	0	0	0	0	0.30417735	0.008302019	1.124340274	0	0	0	0	0	69.1974
H1804_132_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		277.682558	6.431599	676.361794	225.325129	9.560646	20.415309	10.301879	512.973447	42.296322	12.622269	16.829692	0	0.222092	23.120571	5425.82003	5601.787058	0.690955	2.76382			23.43078								0.05		0	416.593686	316.758629	4.099556	555.195198	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000021	949.999525	43.132802	0	0.199999	0.2	0.2	49.999991	0.240475	0.249999	0.244134	0	0.200002	0.231352	14.999999	30	0.25	0.25			0.2								0		0	0	14.225494	30.000321	30	0	0	0	0		778.017717	778.017311	35.324299	0	0.163793	0.163793	0.163793	40.948293	0.196941	0.204741	0.199938	0	0.163795	0.189469	12.284489	24.56898	0.204741	0.204741			0.163793								0		0	0	11.650195	24.569243	24.56898	0	0	0	0		18.0035	0.41699128	1.99100052	0	1.56596689	3.343884707	1.687375667	1.750448917	8.329879951	2.584295977	3.364894959	0	0.036377559	4.380631467	5.554452206	11.46918285	0.141466818	0.565867271	0	0	3.837797749	0	0	0	0	0	0	0	0	0	0	0	0.307524983	0.008393582	1.136714976	0	0	0	0	0	70.4766	0	15.579	18.0035	0.41699128	1.99100052	0	1.56596689	3.343884707	1.687375667	1.750448917	8.329879951	2.584295977	3.364894959	0	0.036377559	4.380631467	5.554452206	11.46918285	0.141466818	0.565867271	0	0	3.837797749	0	0	0	0	0	0	0	0	0	0	0	0.307524983	0.008393582	1.136714976	0	0	0	0	0	70.4766	6000																																																																																	0	0	0	18.0035	0.41699128	1.99100052	0	1.56596689	3.343884707	1.687375667	1.750448917	8.329879951	2.584295977	3.364894959	0	0.036377559	4.380631467	5.554452206	11.46918285	0.141466818	0.565867271	0	0	3.837797749	0	0	0	0	0	0	0	0	0	0	0	0.307524983	0.008393582	1.136714976	0	0	0	0	0	70.4766
H1804_133_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		318.719349	7.382082	776.316639	258.624374	12.595248	26.895241	13.571752	588.782253	55.721407	16.628646	22.171528	0	0.292587	30.459168	6227.664547	6429.636529	0.910268	3.641072			30.867838								0.05		0	478.159194	363.570199	4.705401	637.243666	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999982	950.000284	43.132807	0	0.2	0.199999	0.199999	49.999992	0.240475	0.25	0.244134	0	0.200002	0.231352	15	29.999999	0.25	0.25			0.199999								0		0	0	14.225522	30.001268	29.999996	0	0	0	0		734.465886	734.466119	33.346922	0	0.154624	0.154624	0.154624	38.656093	0.185916	0.19328	0.188746	0	0.154625	0.178863	11.59683	23.193659	0.19328	0.19328			0.154624								0		0	0	10.998064	23.19464	23.193657	0	0	0	0		19.5074	0.451824093	2.157314201	0	1.947527627	4.158649744	2.098518581	1.896668461	10.3595011	3.213984699	4.184787224	0	0.045241265	5.448018166	6.018430587	12.4272331	0.175936599	0.703746396	0	0	4.772908583	0	0	0	0	0	0	0	0	0	0	0	0.333214026	0.009095007	1.231667585	0	0	0	0	0	81.1416	0	23.8116	19.5074	0.451824093	2.157314201	0	1.947527627	4.158649744	2.098518581	1.896668461	10.3595011	3.213984699	4.184787224	0	0.045241265	5.448018166	6.018430587	12.4272331	0.175936599	0.703746396	0	0	4.772908583	0	0	0	0	0	0	0	0	0	0	0	0.333214026	0.009095007	1.231667585	0	0	0	0	0	81.1416	6000																																																																																	0	0	0	19.5074	0.451824093	2.157314201	0	1.947527627	4.158649744	2.098518581	1.896668461	10.3595011	3.213984699	4.184787224	0	0.045241265	5.448018166	6.018430587	12.4272331	0.175936599	0.703746396	0	0	4.772908583	0	0	0	0	0	0	0	0	0	0	0	0.333214026	0.009095007	1.231667585	0	0	0	0	0	81.1416
H1804_137_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		261.674687	6.06083	637.370825	212.335565	8.490107	18.129336	9.148342	483.401505	37.560255	11.208909	14.945211	0	0.197224	20.53168	5113.031847	5278.854711	0.613586	2.454346			20.807153								0.05		0	392.577854	298.498095	3.863223	523.189253	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000012	950.000577	43.132805	0	0.199999	0.199999	0.2	50.000001	0.240475	0.249999	0.244134	0	0.200001	0.231352	15	30	0.25	0.25			0.2								0		0	0	14.225497	29.999821	29.999996	0	0	0	0		795.24121	795.241683	36.106299	0	0.167419	0.167419	0.167419	41.854801	0.201301	0.209273	0.204364	0	0.16742	0.193664	12.55644	25.11288	0.209274	0.209274			0.167419								0		0	0	11.908107	25.11273	25.112877	0	0	0	0		17.3412	0.401652054	1.917758465	0	1.421405224	3.035195304	1.531606269	1.68605615	7.560916892	2.345722013	3.054263101	0	0.033019242	3.976247276	5.350123134	11.04727041	0.128407597	0.513630805	0	0	3.483512748	0	0	0	0	0	0	0	0	0	0	0	0.296212271	0.008084673	1.094898947	0	0	0	0	0	66.2272	0	12.8882	17.3412	0.401652054	1.917758465	0	1.421405224	3.035195304	1.531606269	1.68605615	7.560916892	2.345722013	3.054263101	0	0.033019242	3.976247276	5.350123134	11.04727041	0.128407597	0.513630805	0	0	3.483512748	0	0	0	0	0	0	0	0	0	0	0	0.296212271	0.008084673	1.094898947	0	0	0	0	0	66.2272	6000																																																																																	0	0	0	17.3412	0.401652054	1.917758465	0	1.421405224	3.035195304	1.531606269	1.68605615	7.560916892	2.345722013	3.054263101	0	0.033019242	3.976247276	5.350123134	11.04727041	0.128407597	0.513630805	0	0	3.483512748	0	0	0	0	0	0	0	0	0	0	0	0.296212271	0.008084673	1.094898947	0	0	0	0	0	66.2272
H1804_138_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		260.54595	6.034687	634.621515	211.419651	8.437142	18.016236	9.091271	481.316343	37.325936	11.138982	14.851978	0	0.195993	20.403592	5090.976692	5256.084277	0.609759	2.439035			20.677348								0.05		0	390.884461	297.210519	3.84656	520.932467	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999984	949.999931	43.132808	0	0.199999	0.199999	0.199999	50.000005	0.240475	0.25	0.244134	0	0.200001	0.231352	15	30	0.25	0.25			0.199999								0		0	0	14.225512	29.998755	29.999996	0	0	0	0		796.254836	796.254792	36.152323	0	0.167632	0.167632	0.167632	41.908154	0.201557	0.20954	0.204624	0	0.167633	0.193911	12.572445	25.14489	0.209541	0.20954			0.167632								0		0	0	11.923298	25.143846	25.144886	0	0	0	0		17.2884	0.400429037	1.911920166	0	1.414334988	3.020097673	1.52398794	1.680923285	7.523303682	2.334062288	3.039071146	0	0.032854895	3.956480928	5.333835371	11.01363841	0.127769511	0.511075394	0	0	3.4661852	0	0	0	0	0	0	0	0	0	0	0	0.295310799	0.008059776	1.091565625	0	0	0	0	0	65.9733	0	12.7385	17.2884	0.400429037	1.911920166	0	1.414334988	3.020097673	1.52398794	1.680923285	7.523303682	2.334062288	3.039071146	0	0.032854895	3.956480928	5.333835371	11.01363841	0.127769511	0.511075394	0	0	3.4661852	0	0	0	0	0	0	0	0	0	0	0	0.295310799	0.008059776	1.091565625	0	0	0	0	0	65.9733	6000																																																																																	0	0	0	17.2884	0.400429037	1.911920166	0	1.414334988	3.020097673	1.52398794	1.680923285	7.523303682	2.334062288	3.039071146	0	0.032854895	3.956480928	5.333835371	11.01363841	0.127769511	0.511075394	0	0	3.4661852	0	0	0	0	0	0	0	0	0	0	0	0.295310799	0.008059776	1.091565625	0	0	0	0	0	65.9733
H1804_145_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		319.684533	7.404437	778.667577	259.407572	12.671643	27.05837	13.65407	590.565279	56.059378	16.729505	22.306006	0	0.294361	30.643914	6246.523935	6449.107553	0.915789	3.663157			31.055063								0.05		0	479.607214	364.671207	4.71965	639.173446	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000005	950.000711	43.132804	0	0.2	0.199999	0.2	50.000006	0.240475	0.249999	0.244134	0	0.199999	0.231352	15	29.999998	0.249999	0.249999			0.199999								0		0	0	14.225515	29.999684	30.000007	0	0	0	0		733.480754	733.481299	33.30219	0	0.154417	0.154416	0.154417	38.604255	0.185667	0.193021	0.188492	0	0.154416	0.178623	11.581275	23.162548	0.193021	0.193021			0.154416								0		0	0	10.983307	23.162306	23.162555	0	0	0	0		19.5402	0.452584672	2.160944633	0	1.956717097	4.178245262	2.108420527	1.899861052	10.40837654	3.229145785	4.204503683	0	0.045454048	5.47370785	6.02855929	12.44814694	0.176766509	0.707066227	0	0	4.795398608	0	0	0	0	0	0	0	0	0	0	0	0.333774652	0.009109831	1.233740841	0	0	0	0	0	81.3907	0	24.0261	19.5402	0.452584672	2.160944633	0	1.956717097	4.178245262	2.108420527	1.899861052	10.40837654	3.229145785	4.204503683	0	0.045454048	5.47370785	6.02855929	12.44814694	0.176766509	0.707066227	0	0	4.795398608	0	0	0	0	0	0	0	0	0	0	0	0.333774652	0.009109831	1.233740841	0	0	0	0	0	81.3907	6000																																																																																	0	0	0	19.5402	0.452584672	2.160944633	0	1.956717097	4.178245262	2.108420527	1.899861052	10.40837654	3.229145785	4.204503683	0	0.045454048	5.47370785	6.02855929	12.44814694	0.176766509	0.707066227	0	0	4.795398608	0	0	0	0	0	0	0	0	0	0	0	0.333774652	0.009109831	1.233740841	0	0	0	0	0	81.3907
H1804_146_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		300.929841	6.970046	732.986072	244.189104	11.228446	23.976641	12.098982	555.919028	49.674669	14.82415	19.765534	0	0.260835	27.15382	5880.063801	6070.762597	0.811488	3.245953			27.518144								0.05		0	451.470458	343.277316	4.442766	601.675539	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999983	949.999469	43.132797	0	0.199999	0.199999	0.199999	49.999993	0.240475	0.25	0.244134	0	0.2	0.231352	15	29.999999	0.25	0.249999			0.2								0		0	0	14.225501	30.000229	30.000003	0	0	0	0		753.280636	753.280229	34.201159	0	0.158585	0.158585	0.158585	39.646345	0.190679	0.198231	0.193581	0	0.158585	0.183445	11.893905	23.787809	0.198231	0.198231			0.158585								0		0	0	11.279784	23.787992	23.787812	0	0	0	0		18.8904	0.437533154	2.089081099	0	1.780663109	3.802335613	1.91871706	1.836679798	9.47191621	2.938606079	3.826231837	0	0.041364518	4.98123251	5.828076687	12.03417843	0.160862078	0.643448509	0	0	4.363964866	0	0	0	0	0	0	0	0	0	0	0	0.322674498	0.00880704	1.192712051	0	0	0	0	0	76.5695	0	19.9962	18.8904	0.437533154	2.089081099	0	1.780663109	3.802335613	1.91871706	1.836679798	9.47191621	2.938606079	3.826231837	0	0.041364518	4.98123251	5.828076687	12.03417843	0.160862078	0.643448509	0	0	4.363964866	0	0	0	0	0	0	0	0	0	0	0	0.322674498	0.00880704	1.192712051	0	0	0	0	0	76.5695	6000																																																																																	0	0	0	18.8904	0.437533154	2.089081099	0	1.780663109	3.802335613	1.91871706	1.836679798	9.47191621	2.938606079	3.826231837	0	0.041364518	4.98123251	5.828076687	12.03417843	0.160862078	0.643448509	0	0	4.363964866	0	0	0	0	0	0	0	0	0	0	0	0.322674498	0.00880704	1.192712051	0	0	0	0	0	76.5695
H1804_147_0	2009	6	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O	O	V	V	V	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	0	0	0		0		288.940912	6.692361	703.784188	234.460703	10.351606	22.104283	11.154161	533.771428	45.795528	13.666518	18.222025	0	0.240467	25.033353	5645.804324	5828.905753	0.748118	2.992473			25.369226								0.05	0.27	0	433.484049	329.601279	4.265769	577.705017	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a	$0: Nutritional benefit 14a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000005	950.000156	43.132801	0	0.199999	0.2	0.199999	50.000008	0.240475	0.25	0.244134	0	0.199998	0.231352	14.999999	30.000001	0.25	0.249999			0.199999								0	0	0	0	14.225515	29.998811	30.000009	0	0	0	0		765.882404	765.882526	34.773319	0	0.161238	0.161238	0.161238	40.309606	0.193869	0.201548	0.196819	0	0.161237	0.186514	12.092879	24.185761	0.201548	0.201547			0.161238								0	0	0	0	11.468496	24.184801	24.185767	0	0	0	0		18.4412	0.427130196	2.03940934	0	1.669072248	3.564050382	1.798474611	1.793009663	8.878333218	2.75445937	3.586440738	0	0.038772178	4.669070801	5.689502379	11.74804345	0.150781687	0.603123956	0	0	4.090483262	0	0	0	0	0	0	0	0	0	0	0	0.315002579	0.008597231	1.164353245	0	0	0	0	0	73.4293	0	17.6524	18.4412	0.427130196	2.03940934	0	1.669072248	3.564050382	1.798474611	1.793009663	8.878333218	2.75445937	3.586440738	0	0.038772178	4.669070801	5.689502379	11.74804345	0.150781687	0.603123956	0	0	4.090483262	0	0	0	0	0	0	0	0	0	0	0	0.315002579	0.008597231	1.164353245	0	0	0	0	0	73.4293	6000																																																																																	0	0	0	18.4412	0.427130196	2.03940934	0	1.669072248	3.564050382	1.798474611	1.793009663	8.878333218	2.75445937	3.586440738	0	0.038772178	4.669070801	5.689502379	11.74804345	0.150781687	0.603123956	0	0	4.090483262	0	0	0	0	0	0	0	0	0	0	0	0.315002579	0.008597231	1.164353245	0	0	0	0	0	73.4293
H1804_148_0	2009	6	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		274.263009	6.352397	668.03267	222.55034	9.364077	19.995566	10.09007	506.656383	41.4267	12.362752	16.48367	0	0.217526	22.645207	5359.003227	5532.80329	0.676749	2.706995			22.949039								0.05		0	411.463501	312.857872	4.049072	548.358191	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999991	949.999774	43.132806	0	0.199999	0.199999	0.2	49.999993	0.240475	0.25	0.244134	0	0.200003	0.231352	14.999999	29.999999	0.249999	0.25			0.2								0		0	0	14.225501	30.000949	29.999989	0	0	0	0		741.780893	741.780723	33.679044	0	0.156164	0.156164	0.156164	39.041095	0.187768	0.195205	0.190625	0	0.156166	0.180645	11.712329	23.424659	0.195205	0.195205			0.156164								0		0	0	11.107584	23.425401	23.424651	0	0	0	0		16.9536	0.392673803	1.874891807	0	1.462331721	3.122587569	1.575705691	1.648368332	7.778608606	2.413271004	3.142199594	0	0.033970165	4.090743419	5.230534076	10.80033587	0.132104789	0.528418959	0	0	3.583813726	0	0	0	0	0	0	0	0	0	0	0	0.289591258	0.007904261	1.070424937	0	0	0	0	0	66.1321	0	18.5634	16.9536	0.392673803	1.874891807	0	1.462331721	3.122587569	1.575705691	1.648368332	7.778608606	2.413271004	3.142199594	0	0.033970165	4.090743419	5.230534076	10.80033587	0.132104789	0.528418959	0	0	3.583813726	0	0	0	0	0	0	0	0	0	0	0	0.289591258	0.007904261	1.070424937	0	0	0	0	0	66.1321	5000																																																																																	0	0	0	16.9536	0.392673803	1.874891807	0	1.462331721	3.122587569	1.575705691	1.648368332	7.778608606	2.413271004	3.142199594	0	0.033970165	4.090743419	5.230534076	10.80033587	0.132104789	0.528418959	0	0	3.583813726	0	0	0	0	0	0	0	0	0	0	0	0.289591258	0.007904261	1.070424937	0	0	0	0	0	66.1321
H1804_149_0	2009	6	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		271.495847	6.288305	661.292594	220.304931	9.139379	19.515756	9.84795	501.544504	40.432632	12.066098	16.08813	0	0.212307	22.101817	5304.933879	5476.980399	0.66051	2.642039			22.398357								0.05		0	407.312065	309.701309	4.008219	542.825564	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.99999	949.999721	43.132798	0	0.2	0.199999	0.2	50.000005	0.240475	0.25	0.244134	0	0.200002	0.231352	14.999999	30.000002	0.25	0.25			0.2								0		0	0	14.2255	30.001354	30.000001	0	0	0	0		745.522942	745.522731	33.848937	0	0.156952	0.156952	0.156952	39.238054	0.188715	0.19619	0.191587	0	0.156954	0.181556	11.771414	23.542831	0.19619	0.19619			0.156952								0		0	0	11.163617	23.543893	23.542831	0	0	0	0		16.8672	0.39067286	1.865337613	0	1.434443813	3.063036936	1.545655448	1.639969194	7.630244148	2.367247767	3.082276562	0	0.033322433	4.012717487	5.203881078	10.74530199	0.129585457	0.518341631	0	0	3.515466928	0	0	0	0	0	0	0	0	0	0	0	0.288115567	0.00786409	1.064970876	0	0	0	0	0	65.4057	0	17.939	16.8672	0.39067286	1.865337613	0	1.434443813	3.063036936	1.545655448	1.639969194	7.630244148	2.367247767	3.082276562	0	0.033322433	4.012717487	5.203881078	10.74530199	0.129585457	0.518341631	0	0	3.515466928	0	0	0	0	0	0	0	0	0	0	0	0.288115567	0.00786409	1.064970876	0	0	0	0	0	65.4057	5000																																																																																	0	0	0	16.8672	0.39067286	1.865337613	0	1.434443813	3.063036936	1.545655448	1.639969194	7.630244148	2.367247767	3.082276562	0	0.033322433	4.012717487	5.203881078	10.74530199	0.129585457	0.518341631	0	0	3.515466928	0	0	0	0	0	0	0	0	0	0	0	0.288115567	0.00786409	1.064970876	0	0	0	0	0	65.4057
H1804_150_0	2009	8	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		291.309896	6.747232	709.554414	236.383014	10.529955	22.485121	11.346338	538.147743	46.584545	13.901981	18.535973	0	0.244609	25.464658	5692.093468	5876.696121	0.761008	3.044031			25.806316								0.05		0	437.038122	332.303634	4.300743	582.441537	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.99998	950.000261	43.132793	0	0.2	0.199999	0.2	49.999994	0.240475	0.249999	0.244134	0	0.2	0.231352	15	30.000001	0.25	0.25			0.199999								0		0	0	14.225495	30.0004	30.000003	0	0	0	0		722.325835	722.326048	32.795717	0	0.152068	0.152068	0.152068	38.017145	0.182843	0.190085	0.185626	0	0.152069	0.175907	11.405145	22.810291	0.190085	0.190085			0.152068								0		0	0	10.816256	22.810594	22.810292	0	0	0	0		17.5351	0.406141785	1.93919548	0	1.601269197	3.41926738	1.725414927	1.704903398	8.517657961	2.642558058	3.440758524	0	0.037197446	4.479411595	5.40992928	11.17076239	0.144656206	0.578624633	0	0	3.924314861	0	0	0	0	0	0	0	0	0	0	0	0.299523431	0.008175209	1.107138461	0	0	0	0	0	70.092	0	22.0927	17.5351	0.406141785	1.93919548	0	1.601269197	3.41926738	1.725414927	1.704903398	8.517657961	2.642558058	3.440758524	0	0.037197446	4.479411595	5.40992928	11.17076239	0.144656206	0.578624633	0	0	3.924314861	0	0	0	0	0	0	0	0	0	0	0	0.299523431	0.008175209	1.107138461	0	0	0	0	0	70.092	5000																																																																																	0	0	0	17.5351	0.406141785	1.93919548	0	1.601269197	3.41926738	1.725414927	1.704903398	8.517657961	2.642558058	3.440758524	0	0.037197446	4.479411595	5.40992928	11.17076239	0.144656206	0.578624633	0	0	3.924314861	0	0	0	0	0	0	0	0	0	0	0	0.299523431	0.008175209	1.107138461	0	0	0	0	0	70.092
H1804_153_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1566.69762	53.030562	695.609831	231.737475	224.439673	21.59379	10.896559	527.571745	370.892248	1897.424611	1013.637105	0	0.234913	1129.944653	5580.22908	5761.203811	54.736979	976.298272			24.78333								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947949	114.991728	43.1328	0	100.00002	0.2	0.199999	50.000009	91.015156	77.419436	70.072332	0	0.200001	92.025031	14.999999	29.999998	94.608144	59.060004			0.2								0		0	0	0	0							110.606803	92.200483	34.583922	0	80.180116	0.16036	0.16036	40.090057	72.976043	62.074981	56.184066	0	0.160361	73.785762	12.027014	24.054029	75.856904	47.35437			0.16036								0		0	0	0	0							14.4406	0.407453619	2.004743011	0	1.499633251	3.462780164	1.747372201	1.762531777	2.25552072	9.81521639	4.745854501	0	0.037670884	6.947818937	5.592791106	11.54834696	0.346014813	3.8526658	0	0	3.974254799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4413	0	18.4013	14.4406	0.407453619	2.004743011	0	1.499633251	3.462780164	1.747372201	1.762531777	2.25552072	9.81521639	4.745854501	0	0.037670884	6.947818937	5.592791106	11.54834696	0.346014813	3.8526658	0	0	3.974254799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4413	6000																																																																																	0	0	0	14.4406	0.407453619	2.004743011	0	1.499633251	3.462780164	1.747372201	1.762531777	2.25552072	9.81521639	4.745854501	0	0.037670884	6.947818937	5.592791106	11.54834696	0.346014813	3.8526658	0	0	3.974254799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4413
H1804_154_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1613.705633	54.621719	716.481271	238.690646	231.173877	22.909024	11.560245	543.401284	382.020694	1954.355931	1044.050801	0	0.249221	1163.848101	5747.661184	5934.065976	56.379336	1005.591635			26.292832								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947947	114.99162	43.132795	0	100.000001	0.2	0.2	49.999999	91.015132	77.419435	70.072325	0	0.199999	92.025019	14.999998	30	94.608067	59.060002			0.2								0		0	0	0	0							109.575365	91.340604	34.261414	0	79.432401	0.158864	0.158864	39.716199	72.295503	61.496115	55.66013	0	0.158864	73.097681	11.914859	23.82972	75.149458	46.912777			0.158864								0		0	0	0	0							14.7352	0.415765067	2.045638454	0	1.530224675	3.639419189	1.836506762	1.798486128	2.301531519	10.01544142	4.842666943	0	0.039592245	7.089549768	5.706881049	11.78392756	0.353073045	3.93125801	0	0	4.176984463	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2421	0	19.7416	14.7352	0.415765067	2.045638454	0	1.530224675	3.639419189	1.836506762	1.798486128	2.301531519	10.01544142	4.842666943	0	0.039592245	7.089549768	5.706881049	11.78392756	0.353073045	3.93125801	0	0	4.176984463	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2421	6000																																																																																	0	0	0	14.7352	0.415765067	2.045638454	0	1.530224675	3.639419189	1.836506762	1.798486128	2.301531519	10.01544142	4.842666943	0	0.039592245	7.089549768	5.706881049	11.78392756	0.353073045	3.93125801	0	0	4.176984463	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2421
H1804_155_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1689.080734	57.173062	749.947628	249.839726	241.971852	25.166799	12.699553	568.783192	399.864621	2045.642576	1092.817711	0	0.273783	1218.210661	6016.13056	6211.242194	59.012778	1052.562143			28.884095								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947949	114.991706	43.132803	0	99.999995	0.2	0.2	50	91.015133	77.419436	70.072341	0	0.199997	92.025019	14.999999	30	94.608052	59.059988			0.199999								0		0	0	0	0							107.89047	89.936163	33.734597	0	78.210996	0.156422	0.156422	39.1055	71.183846	60.550515	54.804279	0	0.15642	71.973688	11.731649	23.4633	73.993903	46.191407			0.156421								0		0	0	0	0							15.1863	0.428493819	2.108265083	0	1.577071629	3.936641033	1.986489479	1.853545926	2.3719918	10.32205929	4.990923894	0	0.042825137	7.306592836	5.881594339	12.14468658	0.363882148	4.051610528	0	0	4.518079024	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.0711	0	22.0286	15.1863	0.428493819	2.108265083	0	1.577071629	3.936641033	1.986489479	1.853545926	2.3719918	10.32205929	4.990923894	0	0.042825137	7.306592836	5.881594339	12.14468658	0.363882148	4.051610528	0	0	4.518079024	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.0711	6000																																																																																	0	0	0	15.1863	0.428493819	2.108265083	0	1.577071629	3.936641033	1.986489479	1.853545926	2.3719918	10.32205929	4.990923894	0	0.042825137	7.306592836	5.881594339	12.14468658	0.363882148	4.051610528	0	0	4.518079024	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.0711
H1804_156_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1604.944132	54.325154	712.591187	237.394693	229.918735	22.774135	11.492179	540.450924	379.946538	1943.74489	1038.382201	0	0.247754	1157.529071	5716.454661	5901.84738	56.073229	1000.131846			26.138019								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947949	114.991592	43.132804	0	99.999976	0.199999	0.2	50.000003	91.015152	77.419437	70.072337	0	0.200001	92.02502	14.999999	29.999999	94.608142	59.060005			0.2								0		0	0	0	0							109.748629	91.485011	34.315596	0	79.557981	0.159115	0.159116	39.779002	72.409834	61.593356	55.74815	0	0.159116	73.213265	11.933699	23.867399	75.268346	46.986958			0.159116								0		0	0	0	0							14.6784	0.414161443	2.037749274	0	1.524322529	3.623706491	1.828589554	1.791549866	2.292655479	9.976814249	4.823990558	0	0.039421625	7.062206885	5.684870773	11.73847885	0.3517116	3.916096087	0	0	4.158977031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.9437	0	19.5133	14.6784	0.414161443	2.037749274	0	1.524322529	3.623706491	1.828589554	1.791549866	2.292655479	9.976814249	4.823990558	0	0.039421625	7.062206885	5.684870773	11.73847885	0.3517116	3.916096087	0	0	4.158977031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.9437	6000																																																																																	0	0	0	14.6784	0.414161443	2.037749274	0	1.524322529	3.623706491	1.828589554	1.791549866	2.292655479	9.976814249	4.823990558	0	0.039421625	7.062206885	5.684870773	11.73847885	0.3517116	3.916096087	0	0	4.158977031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.9437
H1804_157_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1602.075972	54.228071	711.317731	236.97045	229.507852	22.580036	11.394234	539.485096	379.267543	1940.271266	1036.526533	0	0.245643	1155.460476	5706.238911	5891.300321	55.973022	998.344533			25.915251								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947952	114.991661	43.132792	0	99.999977	0.199999	0.199999	50.000009	91.015149	77.419434	70.072336	0	0.200001	92.025046	15	30	94.608148	59.059987			0.199999								0		0	0	0	0							109.829331	91.552336	34.340819	0	79.616481	0.159232	0.159232	39.808257	72.463076	61.638643	55.789141	0	0.159234	73.267121	11.942475	23.88495	75.323696	47.021495			0.159232								0		0	0	0	0							14.6629	0.413725548	2.035602788	0	1.522717295	3.595464292	1.814326668	1.789663446	2.290241066	9.966307324	4.818910408	0	0.039114717	7.054771875	5.678884628	11.7261178	0.351341241	3.911971039	0	0	4.126537247	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.7986	0	19.4061	14.6629	0.413725548	2.035602788	0	1.522717295	3.595464292	1.814326668	1.789663446	2.290241066	9.966307324	4.818910408	0	0.039114717	7.054771875	5.678884628	11.7261178	0.351341241	3.911971039	0	0	4.126537247	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.7986	6000																																																																																	0	0	0	14.6629	0.413725548	2.035602788	0	1.522717295	3.595464292	1.814326668	1.789663446	2.290241066	9.966307324	4.818910408	0	0.039114717	7.054771875	5.678884628	11.7261178	0.351341241	3.911971039	0	0	4.126537247	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.7986
H1804_161_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		268.148722	6.210779	653.139871	217.588909	210.736669	19.048053	9.611941	495.361231	348.247688	1781.578714	951.75022	0	0.207219	1060.956693	5239.532197	5409.457647	51.395053	916.691082			21.861572								0.05		0.06	1.22	2.07	2.7							$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							949.999978	950.000576	43.1328	0	100.000005	0.2	0.2	49.999996	91.015116	77.419434	70.072343	0	0.2	92.025026	14.999999	30.000001	94.608094	59.059987			0.199999								0		0	0	0	0							725.784783	725.78524	32.952769	0	76.398404	0.152796	0.152796	38.199197	69.534093	59.147209	53.534149	0	0.152797	70.305647	11.459759	22.919521	72.27907	45.120885			0.152796								0		0	0	0	0							16.2182	0.375640977	1.793563941	0	1.341662098	2.910466306	1.468666137	1.576866771	2.017923927	8.781284046	4.245928174	0	0.031662442	6.215937228	5.003648021	10.33184818	0.309565553	3.446826074	0	0	3.340360755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.41	0	21.4427	16.2182	0.375640977	1.793563941	0	1.341662098	2.910466306	1.468666137	1.576866771	2.017923927	8.781284046	4.245928174	0	0.031662442	6.215937228	5.003648021	10.33184818	0.309565553	3.446826074	0	0	3.340360755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.41	5000																																																																																	0	0	0	16.2182	0.375640977	1.793563941	0	1.341662098	2.910466306	1.468666137	1.576866771	2.017923927	8.781284046	4.245928174	0	0.031662442	6.215937228	5.003648021	10.33184818	0.309565553	3.446826074	0	0	3.340360755	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.41
H1804_162_0	2009	7	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		281.069306	6.510042	684.611023	228.0733	220.890888	20.929514	10.561355	519.229914	365.027794	1867.423012	997.609729	0	0.227686	1112.078253	5491.9959	5670.109105	53.87149	960.86129			24.020936								0.05		0.06	1.22	2.07	2.7							$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							949.999998	949.999416	43.132802	0	99.999978	0.2	0.199999	50	91.01514	77.419435	70.072315	0	0.199998	92.025031	15	30	94.608038	59.06			0.199999								0		0	0	0	0							713.465199	713.464761	32.393424	0	75.101583	0.150203	0.150203	37.5508	68.353826	58.143235	52.62543	0	0.150202	69.11227	11.26524	22.53048	71.05215	44.355005			0.150203								0		0	0	0	0							16.7111	0.38705713	1.848074595	0	1.382437947	3.143675791	1.586347205	1.624791555	2.07925386	9.048167919	4.37497008	0	0.034198893	6.404854374	5.155720991	10.64585665	0.318973766	3.551583944	0	0	3.60801665	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9051	0	23.8387	16.7111	0.38705713	1.848074595	0	1.382437947	3.143675791	1.586347205	1.624791555	2.07925386	9.048167919	4.37497008	0	0.034198893	6.404854374	5.155720991	10.64585665	0.318973766	3.551583944	0	0	3.60801665	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9051	5000																																																																																	0	0	0	16.7111	0.38705713	1.848074595	0	1.382437947	3.143675791	1.586347205	1.624791555	2.07925386	9.048167919	4.37497008	0	0.034198893	6.404854374	5.155720991	10.64585665	0.318973766	3.551583944	0	0	3.60801665	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9051
H1804_163_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1594.487088	53.971197	707.948284	235.847944	228.420695	22.367724	11.287098	536.929606	377.470989	1931.080383	1031.616602	0	0.243332	1149.987168	5679.208991	5863.393783	55.707883	993.615468			25.671579								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947946	114.991556	43.132794	0	100.000011	0.2	0.199999	50.000006	91.015121	77.419434	70.072334	0	0.200002	92.02503	14.999999	30.000001	94.608226	59.059998			0.2								0		0	0	0	0							109.992933	91.688632	34.391976	0	79.735108	0.15947	0.15947	39.867555	72.570998	61.730463	55.872246	0	0.159471	73.376249	11.960264	23.92053	75.435963	47.091548			0.15947								0		0	0	0	0							14.6152	0.412378768	2.028978366	0	1.517762399	3.566980946	1.799953518	1.783839217	2.282787199	9.933873844	4.803228047	0	0.038804397	7.031812065	5.660403237	11.68795724	0.35019815	3.899240875	0	0	4.093846703	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5072	0	19.1904	14.6152	0.412378768	2.028978366	0	1.517762399	3.566980946	1.799953518	1.783839217	2.282787199	9.933873844	4.803228047	0	0.038804397	7.031812065	5.660403237	11.68795724	0.35019815	3.899240875	0	0	4.093846703	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5072	6000																																																																																	0	0	0	14.6152	0.412378768	2.028978366	0	1.517762399	3.566980946	1.799953518	1.783839217	2.282787199	9.933873844	4.803228047	0	0.038804397	7.031812065	5.660403237	11.68795724	0.35019815	3.899240875	0	0	4.093846703	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5072
H1804_165_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1794.393053	60.73774	796.706034	265.416958	257.058531	28.427522	14.344965	604.246194	424.795738	2173.186132	1160.953687	0	0.309256	1294.16475	6391.229657	6598.506287	62.692158	1118.188229			32.626448								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.94795	114.991699	43.132797	0	99.99998	0.199999	0.2	49.99999	91.01515	77.419433	70.072335	0	0.199999	92.025028	14.999999	30	94.608005	59.059992			0.199999								0		0	0	0	0							105.611571	88.036495	33.022038	0	76.558984	0.153117	0.153118	38.279492	69.680289	59.271544	53.646679	0	0.153117	70.453441	11.483849	22.9677	72.430943	45.215739			0.153117								0		0	0	0	0							15.7924	0.445594812	2.192404744	0	1.640011663	4.352736886	2.196472351	1.927519779	2.466657482	10.73400812	5.190109148	0	0.047352351	7.598196655	6.116326359	12.62937607	0.378404344	4.213308926	0	0	4.995663838	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9165	0	25.3876	15.7924	0.445594812	2.192404744	0	1.640011663	4.352736886	2.196472351	1.927519779	2.466657482	10.73400812	5.190109148	0	0.047352351	7.598196655	6.116326359	12.62937607	0.378404344	4.213308926	0	0	4.995663838	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9165	6000																																																																																	0	0	0	15.7924	0.445594812	2.192404744	0	1.640011663	4.352736886	2.196472351	1.927519779	2.466657482	10.73400812	5.190109148	0	0.047352351	7.598196655	6.116326359	12.62937607	0.378404344	4.213308926	0	0	4.995663838	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9165
H1804_166_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1609.398778	54.475938	714.569039	238.0536	230.556892	22.847871	11.529388	541.950987	381.001109	1949.139906	1041.264312	0	0.248556	1160.74188	5732.321122	5918.228416	56.228864	1002.907789			26.222647								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947948	114.991613	43.1328	0	99.999977	0.199999	0.199999	49.999997	91.015136	77.419433	70.072341	0	0.199999	92.025027	14.999999	29.999999	94.608135	59.060001			0.199999								0		0	0	0	0							109.661032	91.412007	34.288204	0	79.494482	0.158988	0.158988	39.747247	72.352027	61.544191	55.703657	0	0.158988	73.154835	11.924174	23.848349	75.208263	46.949453			0.158988								0		0	0	0	0							14.7074	0.414979569	2.041774082	0	1.527333392	3.632537315	1.833034339	1.795088312	2.297183544	9.996519888	4.833519173	0	0.039517421	7.076156726	5.69609954	11.76166473	0.352406266	3.923831009	0	0	4.169086201	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.0981	0	19.6294	14.7074	0.414979569	2.041774082	0	1.527333392	3.632537315	1.833034339	1.795088312	2.297183544	9.996519888	4.833519173	0	0.039517421	7.076156726	5.69609954	11.76166473	0.352406266	3.923831009	0	0	4.169086201	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.0981	6000																																																																																	0	0	0	14.7074	0.414979569	2.041774082	0	1.527333392	3.632537315	1.833034339	1.795088312	2.297183544	9.996519888	4.833519173	0	0.039517421	7.076156726	5.69609954	11.76166473	0.352406266	3.923831009	0	0	4.169086201	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.0981
H1804_167_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1674.672264	56.685356	743.550303	247.708502	239.907746	24.692074	12.460001	563.931264	396.45363	2028.192507	1083.49558	0	0.268618	1207.818885	5964.810788	6158.258049	58.509375	1043.583405			28.339251								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947948	114.991604	43.132796	0	99.999989	0.2	0.199999	50.000008	91.015133	77.419437	70.072322	0	0.200001	92.025029	14.999999	29.999999	94.608017	59.059992			0.199999								0		0	0	0	0							108.228166	90.217583	33.84018	0	78.455791	0.156911	0.156911	39.227906	71.406651	60.740039	54.975801	0	0.156912	72.198972	11.768369	23.536739	74.225476	46.335989			0.156911								0		0	0	0	0							15.1039	0.426167984	2.096823008	0	1.568512665	3.874458023	1.955111217	1.843486885	2.359118833	10.266041	4.963836449	0	0.042149388	7.266940155	5.849674531	12.07877603	0.361907184	4.029622431	0	0	4.446740214	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.5333	0	21.5655	15.1039	0.426167984	2.096823008	0	1.568512665	3.874458023	1.955111217	1.843486885	2.359118833	10.266041	4.963836449	0	0.042149388	7.266940155	5.849674531	12.07877603	0.361907184	4.029622431	0	0	4.446740214	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.5333	6000																																																																																	0	0	0	15.1039	0.426167984	2.096823008	0	1.568512665	3.874458023	1.955111217	1.843486885	2.359118833	10.266041	4.963836449	0	0.042149388	7.266940155	5.849674531	12.07877603	0.361907184	4.029622431	0	0	4.446740214	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.5333
H1804_168_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1682.231464	56.941224	746.906568	248.826618	240.990649	24.948776	12.589536	566.476759	398.243158	2037.347436	1088.386306	0	0.271411	1213.270781	5991.734978	6186.05543	58.773478	1048.293973			28.633869								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947948	114.991626	43.1328	0	99.999979	0.199999	0.2	50.000003	91.015137	77.419437	70.072336	0	0.199999	92.025016	15	30	94.608183	59.060005			0.2								0		0	0	0	0							108.048834	90.068111	33.784111	0	78.325783	0.156651	0.156651	39.162902	71.288334	60.639393	54.884718	0	0.15665	72.07933	11.74887	23.49774	74.102616	46.259221			0.156651								0		0	0	0	0							15.1469	0.427382374	2.102797867	0	1.572981773	3.908250709	1.972163404	1.848739483	2.365840938	10.29529265	4.97798129	0	0.042516533	7.287645417	5.866342944	12.11319351	0.362939039	4.041105214	0	0	4.485524213	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.8176	0	21.8103	15.1469	0.427382374	2.102797867	0	1.572981773	3.908250709	1.972163404	1.848739483	2.365840938	10.29529265	4.97798129	0	0.042516533	7.287645417	5.866342944	12.11319351	0.362939039	4.041105214	0	0	4.485524213	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.8176	6000																																																																																	0	0	0	15.1469	0.427382374	2.102797867	0	1.572981773	3.908250709	1.972163404	1.848739483	2.365840938	10.29529265	4.97798129	0	0.042516533	7.287645417	5.866342944	12.11319351	0.362939039	4.041105214	0	0	4.485524213	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.8176
H1804_169_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		250.93568	5.812097	611.213422	203.62141	7.807532	16.671799	8.412847	463.562931	34.540539	10.307751	13.743667	0	0.181368	18.881004	4903.195385	5062.212955	0.564256	2.257025			19.13433								0.05		0	376.46664	286.247874	3.704678	501.717809	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999984	949.999285	43.132809	0	0.199999	0.2	0.2	49.999994	0.240475	0.25	0.244134	0	0.199996	0.231352	14.999999	30.000001	0.25	0.249999			0.2								0		0	0	14.225503	30.000987	30.000011	0	0	0	0		769.666237	769.665671	34.945123	0	0.162034	0.162035	0.162035	40.508745	0.194827	0.202543	0.197792	0	0.162032	0.187435	12.152624	24.305251	0.202543	0.202543			0.162035								0		0	0	11.525146	24.30605	24.305259	0	0	0	0		16.0947	0.372780961	1.779910684	0	1.26508564	2.701414951	1.363175664	1.564862714	6.729429592	2.087762811	2.718387383	0	0.02938742	3.538960985	4.965557493	10.25319637	0.114286103	0.457144615	0	0	3.100431162	0	0	0	0	0	0	0	0	0	0	0	0.274920712	0.007503841	1.016198441	0	0	0	0	0	60.4351	0	14.16	16.0947	0.372780961	1.779910684	0	1.26508564	2.701414951	1.363175664	1.564862714	6.729429592	2.087762811	2.718387383	0	0.02938742	3.538960985	4.965557493	10.25319637	0.114286103	0.457144615	0	0	3.100431162	0	0	0	0	0	0	0	0	0	0	0	0.274920712	0.007503841	1.016198441	0	0	0	0	0	60.4351	5000																																																																																	0	0	0	16.0947	0.372780961	1.779910684	0	1.26508564	2.701414951	1.363175664	1.564862714	6.729429592	2.087762811	2.718387383	0	0.02938742	3.538960985	4.965557493	10.25319637	0.114286103	0.457144615	0	0	3.100431162	0	0	0	0	0	0	0	0	0	0	0	0.274920712	0.007503841	1.016198441	0	0	0	0	0	60.4351
H1804_170_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		255.897502	5.92702	623.299119	207.647676	201.1085	17.353735	8.756961	472.729094	332.336894	1700.181678	908.266516	0	0.188787	1012.483545	5000.147667	5162.309538	49.046907	874.809162			19.916992								0.05		0.06	1.22	2.07	2.7							$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							949.999987	949.999118	43.132793	0	99.99999	0.2	0.199999	50.000011	91.015113	77.419432	70.072331	0	0.199997	92.025033	15	30	94.608045	59.059998			0.2								0		0	0	0	0							737.57714	737.576465	33.488171	0	77.639692	0.155279	0.155279	38.819858	70.66386	60.108214	54.403947	0	0.155277	71.447959	11.645955	23.29191	73.453403	45.854005			0.155279								0		0	0	0	0							15.7287	0.364302538	1.739428957	0	1.301166833	2.694670617	1.359772147	1.529273025	1.957017313	8.516240345	4.117773617	0	0.029314279	6.028323568	4.85262456	10.0200041	0.300221852	3.342791974	0	0	3.092690601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.9743	0	19.2887	15.7287	0.364302538	1.739428957	0	1.301166833	2.694670617	1.359772147	1.529273025	1.957017313	8.516240345	4.117773617	0	0.029314279	6.028323568	4.85262456	10.0200041	0.300221852	3.342791974	0	0	3.092690601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.9743	5000																																																																																	0	0	0	15.7287	0.364302538	1.739428957	0	1.301166833	2.694670617	1.359772147	1.529273025	1.957017313	8.516240345	4.117773617	0	0.029314279	6.028323568	4.85262456	10.0200041	0.300221852	3.342791974	0	0	3.092690601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.9743
H1804_171_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		244.911964	5.672578	596.541233	198.733475	7.437204	15.88102	8.013808	452.435096	32.902207	9.818833	13.091778	0	0.172766	17.985437	4785.494098	4940.69445	0.537492	2.149969			18.226749								0.05		0	367.429553	279.376489	3.615748	489.674064	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000008	949.999806	43.132803	0	0.2	0.2	0.2	49.999993	0.240475	0.249999	0.244134	0	0.199998	0.231352	15	29.999999	0.25	0.249999			0.199999								0		0	0	14.225491	29.998772	29.999996	0	0	0	0		776.864407	776.864241	35.271936	0	0.16355	0.16355	0.16355	40.887594	0.196649	0.204437	0.199641	0	0.163549	0.189188	12.26628	24.532559	0.204438	0.204437			0.16355								0		0	0	11.632924	24.531555	24.532556	0	0	0	0		15.8553	0.36723525	1.753430349	0	1.216354714	2.597340821	1.310658298	1.541581876	6.470186104	2.007332762	2.613655652	0	0.028255707	3.402628855	4.891684212	10.10065651	0.109883789	0.439533212	0	0	2.980984799	0	0	0	0	0	0	0	0	0	0	0	0.270830455	0.00739166	1.0010797	0	0	0	0	0	58.966	0	13.1414	15.8553	0.36723525	1.753430349	0	1.216354714	2.597340821	1.310658298	1.541581876	6.470186104	2.007332762	2.613655652	0	0.028255707	3.402628855	4.891684212	10.10065651	0.109883789	0.439533212	0	0	2.980984799	0	0	0	0	0	0	0	0	0	0	0	0.270830455	0.00739166	1.0010797	0	0	0	0	0	58.966	5000																																																																																	0	0	0	15.8553	0.36723525	1.753430349	0	1.216354714	2.597340821	1.310658298	1.541581876	6.470186104	2.007332762	2.613655652	0	0.028255707	3.402628855	4.891684212	10.10065651	0.109883789	0.439533212	0	0	2.980984799	0	0	0	0	0	0	0	0	0	0	0	0.270830455	0.00739166	1.0010797	0	0	0	0	0	58.966
H1804_172_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		246.415131	5.707394	600.202552	199.953218	193.656354	16.126049	8.137452	455.211951	320.022035	1637.180852	874.610379	0	0.175431	974.965613	4814.865444	4971.01835	47.229457	842.392801			18.507969								0.05		0.06	1.22	2.07	2.7							$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							950.000023	949.999304	43.132798	0	100.000002	0.2	0.2	49.999987	91.01512	77.419434	70.072321	0	0.200004	92.02503	15	30	94.608243	59.060006			0.2								0		0	0	0	0							747.114218	747.113652	33.921185	0	78.643602	0.157287	0.157287	39.32179	71.577567	60.88543	55.107396	0	0.15729	72.371796	11.79654	23.59308	74.403328	46.446914			0.157287								0		0	0	0	0							15.3417	0.355339331	1.696631817	0	1.269152769	2.536417869	1.279915413	1.491645729	1.908866554	8.306705013	4.016458375	0	0.027593542	5.880001038	4.7332294	9.773469468	0.292835732	3.260545499	0	0	2.91106292	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.0816	0	17.6735	15.3417	0.355339331	1.696631817	0	1.269152769	2.536417869	1.279915413	1.491645729	1.908866554	8.306705013	4.016458375	0	0.027593542	5.880001038	4.7332294	9.773469468	0.292835732	3.260545499	0	0	2.91106292	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.0816	5000																																																																																	0	0	0	15.3417	0.355339331	1.696631817	0	1.269152769	2.536417869	1.279915413	1.491645729	1.908866554	8.306705013	4.016458375	0	0.027593542	5.880001038	4.7332294	9.773469468	0.292835732	3.260545499	0	0	2.91106292	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.0816
H1804_173_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		240.127976	5.561771	584.888693	194.851514	7.14948	15.266628	7.703775	443.597453	31.629314	9.43897	12.585293	0	0.166081	17.289631	4692.016636	4844.185382	0.516698	2.066793			17.521606								0.05		0	360.252367	273.919287	3.545121	480.109013	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999978	950.000278	43.132801	0	0.2	0.2	0.2	50.000007	0.240475	0.25	0.244134	0	0.199998	0.231352	15	30.000001	0.25	0.249999			0.2								0		0	0	14.225504	30.000668	30.000011	0	0	0	0		782.531132	782.531379	35.529222	0	0.164743	0.164743	0.164743	41.185856	0.198083	0.205929	0.201098	0	0.164742	0.190568	12.355755	24.711511	0.20593	0.205929			0.164743								0		0	0	11.717789	24.71206	24.711519	0	0	0	0		15.659	0.362688361	1.731720018	0	1.177826784	2.515070097	1.269143005	1.522495068	6.265229405	1.943757653	2.530877252	0	0.027360516	3.2948504	4.831117334	9.975595029	0.106403619	0.425612616	0	0	2.886561937	0	0	0	0	0	0	0	0	0	0	0	0.267477367	0.007300604	0.98868525	0	0	0	0	0	57.7887	0	12.3673	15.659	0.362688361	1.731720018	0	1.177826784	2.515070097	1.269143005	1.522495068	6.265229405	1.943757653	2.530877252	0	0.027360516	3.2948504	4.831117334	9.975595029	0.106403619	0.425612616	0	0	2.886561937	0	0	0	0	0	0	0	0	0	0	0	0.267477367	0.007300604	0.98868525	0	0	0	0	0	57.7887	5000																																																																																	0	0	0	15.659	0.362688361	1.731720018	0	1.177826784	2.515070097	1.269143005	1.522495068	6.265229405	1.943757653	2.530877252	0	0.027360516	3.2948504	4.831117334	9.975595029	0.106403619	0.425612616	0	0	2.886561937	0	0	0	0	0	0	0	0	0	0	0	0.267477367	0.007300604	0.98868525	0	0	0	0	0	57.7887
H1804_174_0	2009	6	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		256.739823	5.946531	625.35079	208.331174	201.770474	17.53773	8.849808	474.285142	333.430825	1705.778047	911.256191	0	0.190789	1015.816268	5016.606305	5179.301952	49.208351	877.688711			20.128165								0.05		0.06	1.22	2.07	2.7							$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							950.000001	949.999999	43.132802	0	100.000022	0.199999	0.2	49.999997	91.015112	77.419434	70.072333	0	0.200001	92.025035	15	30	94.608088	59.059996			0.2								0		0	0	0	0							736.655651	736.655649	33.446339	0	77.542717	0.155085	0.155085	38.771348	70.575575	60.033119	54.335979	0	0.155086	71.358697	11.631405	23.26281	73.361666	45.796715			0.155085								0		0	0	0	0							15.7607	0.365045471	1.742974543	0	1.30381923	2.719838857	1.372472474	1.532389524	1.961006016	8.53359804	4.126166438	0	0.029588703	6.04061044	4.862514972	10.04042644	0.300833884	3.34960498	0	0	3.121576469	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.1632	0	19.4513	15.7607	0.365045471	1.742974543	0	1.30381923	2.719838857	1.372472474	1.532389524	1.961006016	8.53359804	4.126166438	0	0.029588703	6.04061044	4.862514972	10.04042644	0.300833884	3.34960498	0	0	3.121576469	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.1632	5000																																																																																	0	0	0	15.7607	0.365045471	1.742974543	0	1.30381923	2.719838857	1.372472474	1.532389524	1.961006016	8.53359804	4.126166438	0	0.029588703	6.04061044	4.862514972	10.04042644	0.300833884	3.34960498	0	0	3.121576469	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.1632
H1804_175_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		239.755497	5.553144	583.981433	194.549267	7.127336	15.219345	7.679916	442.909358	31.531353	9.409736	12.546315	0	0.165567	17.236083	4684.738529	4836.671234	0.515098	2.060392			17.46734								0.05		0	359.693554	273.494391	3.539622	479.364283	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000024	950.000216	43.132802	0	0.199999	0.2	0.2	50.000009	0.240475	0.25	0.244134	0	0.199997	0.231352	14.999999	29.999999	0.25	0.25			0.2								0		0	0	14.225491	29.999813	30.000007	0	0	0	0		782.97387	782.974028	35.549322	0	0.164836	0.164836	0.164836	41.209157	0.198195	0.206045	0.201211	0	0.164834	0.190676	12.362744	24.725489	0.206046	0.206045			0.164836								0		0	0	11.724407	24.725336	24.725496	0	0	0	0		15.6435	0.362330627	1.730012	0	1.174841557	2.508695952	1.265926634	1.520993439	6.249356508	1.938829054	2.524456587	0	0.027291071	3.286507362	4.826351928	9.965755116	0.106133883	0.42453347	0	0	2.879246456	0	0	0	0	0	0	0	0	0	0	0	0.267213296	0.007293195	0.987709972	0	0	0	0	0	57.697	0	12.3081	15.6435	0.362330627	1.730012	0	1.174841557	2.508695952	1.265926634	1.520993439	6.249356508	1.938829054	2.524456587	0	0.027291071	3.286507362	4.826351928	9.965755116	0.106133883	0.42453347	0	0	2.879246456	0	0	0	0	0	0	0	0	0	0	0	0.267213296	0.007293195	0.987709972	0	0	0	0	0	57.697	5000																																																																																	0	0	0	15.6435	0.362330627	1.730012	0	1.174841557	2.508695952	1.265926634	1.520993439	6.249356508	1.938829054	2.524456587	0	0.027291071	3.286507362	4.826351928	9.965755116	0.106133883	0.42453347	0	0	2.879246456	0	0	0	0	0	0	0	0	0	0	0	0.267213296	0.007293195	0.987709972	0	0	0	0	0	57.697
H1804_176_0	2009	6	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		243.697555	5.644448	593.583248	197.748043	191.520625	15.857872	8.002126	450.191669	316.492687	1619.125286	864.964784	0	0.172513	964.213253	4761.764944	4916.195726	46.70859	833.102518			18.200181								0.05		0.06	1.22	2.07	2.7							$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							949.999996	949.999661	43.132807	0	99.999986	0.199999	0.2	50.00001	91.015145	77.419432	70.072323	0	0.200001	92.02502	14.999999	30.000001	94.608123	59.060001			0.199999								0		0	0	0	0							749.739046	749.738782	34.040368	0	78.919889	0.157839	0.157839	39.459957	71.829061	61.099338	55.301007	0	0.157841	72.626053	11.837984	23.675971	74.664636	46.610094			0.157839								0		0	0	0	0							15.2258	0.352655131	1.683816017	0	1.259565539	2.502990659	1.263047566	1.480378658	1.89444771	8.243956926	3.986118631	0	0.027229624	5.835583568	4.697474768	9.699642287	0.290623323	3.235915556	0	0	2.872698369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5519	0	17.2423	15.2258	0.352655131	1.683816017	0	1.259565539	2.502990659	1.263047566	1.480378658	1.89444771	8.243956926	3.986118631	0	0.027229624	5.835583568	4.697474768	9.699642287	0.290623323	3.235915556	0	0	2.872698369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5519	5000																																																																																	0	0	0	15.2258	0.352655131	1.683816017	0	1.259565539	2.502990659	1.263047566	1.480378658	1.89444771	8.243956926	3.986118631	0	0.027229624	5.835583568	4.697474768	9.699642287	0.290623323	3.235915556	0	0	2.872698369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5519
H1804_177_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		259.633706	6.013557	632.399529	210.679411	8.363576	17.859148	9.012	479.631122	37.000481	11.041859	14.722478	0	0.194285	20.225689	5073.151768	5237.681266	0.604442	2.417768			20.497058								0.05		0	389.515867	296.169903	3.833093	519.108538	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999997	949.999491	43.132802	0	0.199999	0.2	0.199999	49.999999	0.240475	0.25	0.244134	0	0.2	0.231352	15	29.999999	0.25	0.249999			0.2								0		0	0	14.225496	30.000839	29.999992	0	0	0	0		759.230497	759.230093	34.471304	0	0.159837	0.159838	0.159837	39.959499	0.192185	0.199797	0.19511	0	0.159838	0.184894	11.98785	23.975699	0.199798	0.199797			0.159838								0		0	0	11.368874	23.97637	23.975693	0	0	0	0		16.4268	0.380472787	1.816636368	0	1.336808897	2.854570498	1.440451044	1.597151612	7.110937441	2.206130303	2.872502683	0	0.031054126	3.739608542	5.068015202	10.46475579	0.120766303	0.483062793	0	0	3.276208757	0	0	0	0	0	0	0	0	0	0	0	0.280593192	0.007658638	1.037165578	0	0	0	0	0	62.5514	0	15.7171	16.4268	0.380472787	1.816636368	0	1.336808897	2.854570498	1.440451044	1.597151612	7.110937441	2.206130303	2.872502683	0	0.031054126	3.739608542	5.068015202	10.46475579	0.120766303	0.483062793	0	0	3.276208757	0	0	0	0	0	0	0	0	0	0	0	0.280593192	0.007658638	1.037165578	0	0	0	0	0	62.5514	5000																																																																																	0	0	0	16.4268	0.380472787	1.816636368	0	1.336808897	2.854570498	1.440451044	1.597151612	7.110937441	2.206130303	2.872502683	0	0.031054126	3.739608542	5.068015202	10.46475579	0.120766303	0.483062793	0	0	3.276208757	0	0	0	0	0	0	0	0	0	0	0	0.280593192	0.007658638	1.037165578	0	0	0	0	0	62.5514
H1804_178_0	2009	7	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		272.039177	6.300889	662.616	220.745814	213.794158	19.597171	9.889034	502.548217	353.300266	1807.426883	965.558759	0	0.213193	1076.349664	5315.550346	5487.941172	52.140721	929.990964			22.491798								0.05		0.06	1.22	2.07	2.7							$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							950.000005	949.999327	43.1328	0	100.000001	0.199999	0.2	50.000002	91.015125	77.419437	70.07233	0	0.200002	92.025028	15	30	94.608127	59.060006			0.199999								0		0	0	0	0							721.990504	721.989988	32.780497	0	75.999	0.151997	0.151998	37.999501	69.170585	58.837998	53.25427	0	0.151999	69.938101	11.39985	22.7997	71.90123	44.885014			0.151997								0		0	0	0	0							16.3675	0.379098231	1.810073483	0	1.354011851	2.9787112	1.50311339	1.59138179	2.03649884	8.862114944	4.285010571	0	0.032405123	6.273154293	5.049706384	10.42695103	0.312415164	3.478554787	0	0	3.418685821	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1594	0	22.1568	16.3675	0.379098231	1.810073483	0	1.354011851	2.9787112	1.50311339	1.59138179	2.03649884	8.862114944	4.285010571	0	0.032405123	6.273154293	5.049706384	10.42695103	0.312415164	3.478554787	0	0	3.418685821	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1594	5000																																																																																	0	0	0	16.3675	0.379098231	1.810073483	0	1.354011851	2.9787112	1.50311339	1.59138179	2.03649884	8.862114944	4.285010571	0	0.032405123	6.273154293	5.049706384	10.42695103	0.312415164	3.478554787	0	0	3.418685821	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1594
H1804_179_0	2009	6	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		271.084715	6.278784	660.291181	219.971318	9.111696	19.456644	9.818122	500.785003	40.310165	12.02955	16.0394	0	0.211664	22.034873	5296.900485	5468.686468	0.658509	2.634036			22.330514								0.05		0	406.695261	309.232323	4.002148	542.003549	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999988	949.999235	43.132806	0	0.199999	0.2	0.2	49.999995	0.240475	0.25	0.244134	0	0.2	0.231352	15	29.999999	0.249999	0.25			0.2								0		0	0	14.225498	29.99889	30.000002	0	0	0	0		746.00364	746.003049	33.870769	0	0.157053	0.157053	0.157053	39.263346	0.188837	0.196316	0.191711	0	0.157054	0.181673	11.779005	23.558009	0.196316	0.196316			0.157053								0		0	0	11.170814	23.557138	23.558012	0	0	0	0		16.8525	0.390332667	1.863714172	0	1.431019192	3.05572431	1.541965514	1.638541237	7.612050628	2.361593138	3.074929413	0	0.033242678	4.003141483	5.199351441	10.73594709	0.129275853	0.517103411	0	0	3.507074215	0	0	0	0	0	0	0	0	0	0	0	0.28786473	0.007856596	1.064043843	0	0	0	0	0	65.3073	0	17.8584	16.8525	0.390332667	1.863714172	0	1.431019192	3.05572431	1.541965514	1.638541237	7.612050628	2.361593138	3.074929413	0	0.033242678	4.003141483	5.199351441	10.73594709	0.129275853	0.517103411	0	0	3.507074215	0	0	0	0	0	0	0	0	0	0	0	0.28786473	0.007856596	1.064043843	0	0	0	0	0	65.3073	5000																																																																																	0	0	0	16.8525	0.390332667	1.863714172	0	1.431019192	3.05572431	1.541965514	1.638541237	7.612050628	2.361593138	3.074929413	0	0.033242678	4.003141483	5.199351441	10.73594709	0.129275853	0.517103411	0	0	3.507074215	0	0	0	0	0	0	0	0	0	0	0	0.28786473	0.007856596	1.064043843	0	0	0	0	0	65.3073
H1804_180_0	2009	6	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		256.881276	5.949806	625.695332	208.445956	8.181908	17.471222	8.816247	474.546455	36.196779	10.802014	14.402686	0	0.190065	19.786359	5019.370251	5182.155537	0.591313	2.36525			20.051834								0.05		0	385.38653	293.030145	3.792457	513.605362	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999983	949.999378	43.132794	0	0.2	0.199999	0.2	50.000002	0.240475	0.25	0.244134	0	0.2	0.231352	15	30	0.249999	0.25			0.2								0		0	0	14.225498	29.999549	29.99999	0	0	0	0		762.507036	762.50655	34.620062	0	0.160527	0.160527	0.160527	40.131952	0.193015	0.200659	0.195952	0	0.160527	0.185692	12.039585	24.07917	0.200659	0.200659			0.160527								0		0	0	11.41794	24.078808	24.079162	0	0	0	0		16.3228	0.378063837	1.805134266	0	1.313417146	2.804602854	1.415245682	1.587039629	6.986521299	2.167521327	2.822235127	0	0.030510564	3.674168575	5.035927899	10.39850035	0.118652275	0.4746087	0	0	3.218860757	0	0	0	0	0	0	0	0	0	0	0	0.278816718	0.00760982	1.030598893	0	0	0	0	0	61.8709	0	15.2134	16.3228	0.378063837	1.805134266	0	1.313417146	2.804602854	1.415245682	1.587039629	6.986521299	2.167521327	2.822235127	0	0.030510564	3.674168575	5.035927899	10.39850035	0.118652275	0.4746087	0	0	3.218860757	0	0	0	0	0	0	0	0	0	0	0	0.278816718	0.00760982	1.030598893	0	0	0	0	0	61.8709	5000																																																																																	0	0	0	16.3228	0.378063837	1.805134266	0	1.313417146	2.804602854	1.415245682	1.587039629	6.986521299	2.167521327	2.822235127	0	0.030510564	3.674168575	5.035927899	10.39850035	0.118652275	0.4746087	0	0	3.218860757	0	0	0	0	0	0	0	0	0	0	0	0.278816718	0.00760982	1.030598893	0	0	0	0	0	61.8709
H1804_181_0	2009	6	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		263.059825	6.092912	640.744658	213.459532	206.737331	18.321755	9.24544	485.960322	341.638681	1747.768114	933.688012	0	0.199317	1040.821976	5140.096947	5306.79757	50.419683	899.294222			21.027996								0.05		0.06	1.22	2.07	2.7							$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							949.999978	950.000919	43.132807	0	99.999994	0.2	0.2	50.000008	91.015138	77.419435	70.072327	0	0.199997	92.02504	14.999999	29.999997	94.608052	59.060008			0.199999								0		0	0	0	0							730.700083	730.700806	33.175943	0	76.915795	0.153831	0.153831	38.457906	70.005022	59.547777	53.896691	0	0.15383	70.781795	11.537369	23.074738	72.76854	45.426477			0.153831								0		0	0	0	0							16.0182	0.371007976	1.771442354	0	1.325113848	2.818453893	1.422235281	1.557418032	1.993035282	8.672975492	4.193557856	0	0.030660934	6.139270645	4.941932931	10.20441363	0.305747227	3.404314024	0	0	3.234757653	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.4045	0	20.5298	16.0182	0.371007976	1.771442354	0	1.325113848	2.818453893	1.422235281	1.557418032	1.993035282	8.672975492	4.193557856	0	0.030660934	6.139270645	4.941932931	10.20441363	0.305747227	3.404314024	0	0	3.234757653	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.4045	5000																																																																																	0	0	0	16.0182	0.371007976	1.771442354	0	1.325113848	2.818453893	1.422235281	1.557418032	1.993035282	8.672975492	4.193557856	0	0.030660934	6.139270645	4.941932931	10.20441363	0.305747227	3.404314024	0	0	3.234757653	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.4045
H1804_184_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1440.282385	48.75158	639.481782	213.038814	206.329863	18.249613	9.209035	485.002519	340.965332	1744.323353	931.847758	0	0.198533	1038.770569	5129.966082	5296.338147	50.320307	897.521759			20.945196								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947948	114.991719	43.132794	0	100.000027	0.2	0.2	50.000004	91.015141	77.419437	70.072326	0	0.199996	92.025036	15	29.999999	94.608166	59.060001			0.199999								0		0	0	0	0							113.520539	94.62933	35.494968	0	82.292322	0.164584	0.164584	41.146153	74.898453	63.710235	57.664128	0	0.164582	75.729519	12.343845	24.687689	77.855236	48.601833			0.164584								0		0	0	0	0							13.6251	0.384444113	1.891532116	0	1.41494696	3.003594306	1.515659816	1.662998988	2.128147991	9.260937561	4.477849033	0	0.032674958	6.555466295	5.276958848	10.89619575	0.326474948	3.63510022	0	0	3.447244138	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.5354	0	14.9627	13.6251	0.384444113	1.891532116	0	1.41494696	3.003594306	1.515659816	1.662998988	2.128147991	9.260937561	4.477849033	0	0.032674958	6.555466295	5.276958848	10.89619575	0.326474948	3.63510022	0	0	3.447244138	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.5354	6000																																																																																	0	0	0	13.6251	0.384444113	1.891532116	0	1.41494696	3.003594306	1.515659816	1.662998988	2.128147991	9.260937561	4.477849033	0	0.032674958	6.555466295	5.276958848	10.89619575	0.326474948	3.63510022	0	0	3.447244138	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.5354
H1804_185_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1639.203937	55.484801	727.802454	242.462218	234.826677	23.63904	11.928623	551.987615	388.057035	1985.236877	1060.547938	0	0.257163	1182.238167	5838.480482	6027.830672	57.27019	1021.481078			27.130677								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947948	114.991707	43.132797	0	100.000001	0.2	0.199999	49.999991	91.015157	77.419434	70.072317	0	0.200001	92.025041	15	30	94.607962	59.059995			0.2								0		0	0	0	0							109.014607	90.873231	34.086081	0	79.025901	0.158051	0.158051	39.512943	71.925547	61.181404	55.375279	0	0.158053	72.723616	11.853885	23.70777	74.764793	46.672693			0.158051								0		0	0	0	0							14.8914	0.420173595	2.067327783	0	1.546449144	3.736173911	1.885330794	1.817554597	2.325934542	10.12163162	4.894011497	0	0.040645384	7.16471954	5.767389684	11.9088686	0.356816158	3.972939397	0	0	4.288030631	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.2054	0	20.4909	14.8914	0.420173595	2.067327783	0	1.546449144	3.736173911	1.885330794	1.817554597	2.325934542	10.12163162	4.894011497	0	0.040645384	7.16471954	5.767389684	11.9088686	0.356816158	3.972939397	0	0	4.288030631	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.2054	6000																																																																																	0	0	0	14.8914	0.420173595	2.067327783	0	1.546449144	3.736173911	1.885330794	1.817554597	2.325934542	10.12163162	4.894011497	0	0.040645384	7.16471954	5.767389684	11.9088686	0.356816158	3.972939397	0	0	4.288030631	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.2054
H1804_187_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1531.678217	51.845204	680.061302	226.557593	219.422914	20.669971	10.430385	515.779268	362.601926	1855.012678	990.979915	0	0.224863	1104.687714	5455.49774	5632.427258	53.513478	954.475693			23.723056								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947951	114.991697	43.132793	0	99.999984	0.199999	0.199999	49.999993	91.015147	77.419434	70.072338	0	0.199997	92.025033	14.999999	29.999999	94.608165	59.059997			0.199999								0		0	0	0	0							111.406351	92.86695	34.833914	0	80.759687	0.161519	0.161519	40.379844	73.50356	62.523702	56.59021	0	0.161517	74.319141	12.113954	24.227909	76.40527	47.696676			0.161519								0		0	0	0	0							14.2199	0.401225497	1.974099742	0	1.476710488	3.338593046	1.684705355	1.735590532	2.221044369	9.665188324	4.673313458	0	0.036319197	6.841620165	5.507304056	11.37182792	0.340725978	3.79377649	0	0	3.831724282	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.1137	0	17.4187	14.2199	0.401225497	1.974099742	0	1.476710488	3.338593046	1.684705355	1.735590532	2.221044369	9.665188324	4.673313458	0	0.036319197	6.841620165	5.507304056	11.37182792	0.340725978	3.79377649	0	0	3.831724282	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.1137	6000																																																																																	0	0	0	14.2199	0.401225497	1.974099742	0	1.476710488	3.338593046	1.684705355	1.735590532	2.221044369	9.665188324	4.673313458	0	0.036319197	6.841620165	5.507304056	11.37182792	0.340725978	3.79377649	0	0	3.831724282	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.1137
H1804_188_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1621.358185	54.880747	719.878985	239.822571	232.270154	23.126858	11.670169	545.978212	383.832318	1963.62392	1049.001922	0	0.251591	1169.367328	5774.917872	5962.206638	56.646699	1010.360373			26.542842								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947946	114.991583	43.132799	0	100.000019	0.2	0.2	49.999995	91.01515	77.419437	70.072321	0	0.199999	92.025033	14.999999	29.999998	94.60809	59.059988			0.199999								0		0	0	0	0							109.405136	91.198674	34.208192	0	79.309015	0.158618	0.158618	39.654496	72.183205	61.400581	55.573657	0	0.158617	72.984134	11.896349	23.792699	75.03273	46.839886			0.158617								0		0	0	0	0							14.7821	0.417087613	2.052146545	0	1.535093094	3.668335962	1.851098866	1.804207569	2.308853908	10.04730413	4.85807275	0	0.03990661	7.112105147	5.725036538	11.82141566	0.354196373	3.943763724	0	0	4.21014597	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.5308	0	19.9662	14.7821	0.417087613	2.052146545	0	1.535093094	3.668335962	1.851098866	1.804207569	2.308853908	10.04730413	4.85807275	0	0.03990661	7.112105147	5.725036538	11.82141566	0.354196373	3.943763724	0	0	4.21014597	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.5308	6000																																																																																	0	0	0	14.7821	0.417087613	2.052146545	0	1.535093094	3.668335962	1.851098866	1.804207569	2.308853908	10.04730413	4.85807275	0	0.03990661	7.112105147	5.725036538	11.82141566	0.354196373	3.943763724	0	0	4.21014597	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.5308
H1804_190_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		279.960226	6.484355	681.909594	227.173338	9.718104	20.751536	10.471544	517.181066	42.992915	12.830149	17.106866	0	0.225751	23.501352	5470.324856	5647.735238	0.702335	2.809339			23.81667								0.05		0	420.01076	319.356814	4.133182	559.74914	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000004	950.000424	43.132802	0	0.2	0.199999	0.2	49.999997	0.240475	0.249999	0.244134	0	0.199999	0.231352	14.999999	30.000001	0.25	0.25			0.2								0		0	0	14.225492	30.00013	30.000003	0	0	0	0		775.579053	775.579396	35.213577	0	0.163279	0.163279	0.163279	40.819947	0.196323	0.204099	0.199311	0	0.163279	0.188875	12.245984	24.491971	0.2041	0.204099			0.163279								0		0	0	11.613677	24.492076	24.491972	0	0	0	0		18.0943	0.419094345	2.001039666	0	1.586762303	3.388290047	1.709783233	1.759275309	8.440498052	2.618620581	3.409586569	0	0.036860398	4.438817859	5.582459222	11.52701397	0.143346574	0.573383281	0	0	3.888762061	0	0	0	0	0	0	0	0	0	0	0	0.309075574	0.008435851	1.142446689	0	0	0	0	0	71.0778	0	15.9848	18.0943	0.419094345	2.001039666	0	1.586762303	3.388290047	1.709783233	1.759275309	8.440498052	2.618620581	3.409586569	0	0.036860398	4.438817859	5.582459222	11.52701397	0.143346574	0.573383281	0	0	3.888762061	0	0	0	0	0	0	0	0	0	0	0	0.309075574	0.008435851	1.142446689	0	0	0	0	0	71.0778	6000																																																																																	0	0	0	18.0943	0.419094345	2.001039666	0	1.586762303	3.388290047	1.709783233	1.759275309	8.440498052	2.618620581	3.409586569	0	0.036860398	4.438817859	5.582459222	11.52701397	0.143346574	0.573383281	0	0	3.888762061	0	0	0	0	0	0	0	0	0	0	0	0.309075574	0.008435851	1.142446689	0	0	0	0	0	71.0778
H1804_192_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		304.630888	7.055769	742.00085	247.192313	11.506355	24.570076	12.398438	562.756112	50.904143	15.191056	20.25474	0	0.267292	27.825892	5952.380966	6145.42511	0.831573	3.326292			28.199232								0.05		0	457.02296	347.499183	4.497406	609.075367	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000001	950.000488	43.132802	0	0.2	0.199999	0.2	49.999997	0.240475	0.25	0.244134	0	0.199998	0.231352	14.999999	30	0.249999	0.25			0.199999								0		0	0	14.225506	30.001294	29.999991	0	0	0	0		749.447401	749.447785	34.027122	0	0.157778	0.157778	0.157778	39.444597	0.189709	0.197223	0.192596	0	0.157777	0.182512	11.833379	23.66676	0.197222	0.197223			0.157778								0		0	0	11.222388	23.66778	23.666753	0	0	0	0		19.0254	0.440660871	2.104012787	0	1.815449679	3.876617451	1.956200751	1.849807337	9.656974064	2.996025637	3.900981905	0	0.04217253	5.078559201	5.86973166	12.12019176	0.16400449	0.656021287	0	0	4.449218426	0	0	0	0	0	0	0	0	0	0	0	0.324980888	0.008870301	1.201236356	0	0	0	0	0	77.5371	0	20.749	19.0254	0.440660871	2.104012787	0	1.815449679	3.876617451	1.956200751	1.849807337	9.656974064	2.996025637	3.900981905	0	0.04217253	5.078559201	5.86973166	12.12019176	0.16400449	0.656021287	0	0	4.449218426	0	0	0	0	0	0	0	0	0	0	0	0.324980888	0.008870301	1.201236356	0	0	0	0	0	77.5371	6000																																																																																	0	0	0	19.0254	0.440660871	2.104012787	0	1.815449679	3.876617451	1.956200751	1.849807337	9.656974064	2.996025637	3.900981905	0	0.04217253	5.078559201	5.86973166	12.12019176	0.16400449	0.656021287	0	0	4.449218426	0	0	0	0	0	0	0	0	0	0	0	0.324980888	0.008870301	1.201236356	0	0	0	0	0	77.5371
H1804_193_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1500.589201	50.792884	666.257858	221.959073	214.969209	19.814384	9.998644	505.310313	355.242066	1817.360827	970.865642	0	0.215555	1082.265475	5344.765566	5518.103884	52.427296	935.102361			22.741094								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947949	114.991698	43.132795	0	99.999995	0.2	0.2	50.000008	91.015133	77.419436	70.072332	0	0.199999	92.02504	15	29.999998	94.608273	59.059998			0.2								0		0	0	0	0							112.129197	93.469507	35.059932	0	81.283696	0.162567	0.162567	40.641856	73.980467	62.929382	56.957384	0	0.162567	74.801357	12.192555	24.385108	76.901105	48.006151			0.162567								0		0	0	0	0							14.0217	0.395632152	1.9465796	0	1.456124319	3.221164964	1.625449559	1.711395748	2.190081162	9.530449476	4.608163932	0	0.03504213	6.746243847	5.43052901	11.2132966	0.335976416	3.740888762	0	0	3.696951428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9056	0	16.5569	14.0217	0.395632152	1.9465796	0	1.456124319	3.221164964	1.625449559	1.711395748	2.190081162	9.530449476	4.608163932	0	0.03504213	6.746243847	5.43052901	11.2132966	0.335976416	3.740888762	0	0	3.696951428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9056	6000																																																																																	0	0	0	14.0217	0.395632152	1.9465796	0	1.456124319	3.221164964	1.625449559	1.711395748	2.190081162	9.530449476	4.608163932	0	0.03504213	6.746243847	5.43052901	11.2132966	0.335976416	3.740888762	0	0	3.696951428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9056
H1804_195_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1666.202735	56.398674	739.789853	246.455736	238.69443	24.429062	12.32728	561.079224	394.448597	2017.935073	1078.015884	0	0.265758	1201.710431	5934.644207	6127.113124	58.213469	1038.305561			28.03739								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947947	114.991639	43.132805	0	99.999987	0.199999	0.199999	49.999997	91.015144	77.419438	70.072332	0	0.199997	92.025031	14.999999	29.999998	94.608207	59.060001			0.199999								0		0	0	0	0							108.41743	90.375379	33.899366	0	78.59299	0.157185	0.157185	39.296498	71.531532	60.846259	55.071948	0	0.157184	72.325232	11.788949	23.577898	74.355428	46.417026			0.157185								0		0	0	0	0							15.0538	0.424754295	2.089867249	0	1.563309079	3.83988211	1.937663507	1.837370717	2.351292703	10.23198334	4.947369559	0	0.041772905	7.242832143	5.830268157	12.03870402	0.360707284	4.016254685	0	0	4.407057147	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2149	0	21.304	15.0538	0.424754295	2.089867249	0	1.563309079	3.83988211	1.937663507	1.837370717	2.351292703	10.23198334	4.947369559	0	0.041772905	7.242832143	5.830268157	12.03870402	0.360707284	4.016254685	0	0	4.407057147	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2149	6000																																																																																	0	0	0	15.0538	0.424754295	2.089867249	0	1.563309079	3.83988211	1.937663507	1.837370717	2.351292703	10.23198334	4.947369559	0	0.041772905	7.242832143	5.830268157	12.03870402	0.360707284	4.016254685	0	0	4.407057147	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2149
H1804_196_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		253.506695	5.871646	617.475741	205.707658	199.229577	17.035446	8.596348	468.312465	329.231929	1684.297168	899.780731	0	0.185324	1003.024082	4953.432128	5114.078949	48.588669	866.635968			19.55169								0.05		0.06	1.22	2.07	2.7							$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							949.999998	950.000703	43.132803	0	99.999971	0.199999	0.2	50.000001	91.015145	77.419437	70.072338	0	0.2	92.025036	14.999999	29.999999	94.60823	59.060008			0.199999								0		0	0	0	0							739.942648	739.943197	33.59558	0	77.888677	0.155777	0.155777	38.944351	70.890513	60.300993	54.578433	0	0.155778	71.677104	11.683304	23.366609	73.68912	46.001073			0.155777								0		0	0	0	0							15.6317	0.362057043	1.728704638	0	1.293144014	2.653730672	1.339113302	1.519843751	1.944951695	8.463732645	4.092385195	0	0.028869402	5.99115512	4.82270445	9.9582236	0.298371355	3.322182036	0	0	3.045703613	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4966	0	18.8773	15.6317	0.362057043	1.728704638	0	1.293144014	2.653730672	1.339113302	1.519843751	1.944951695	8.463732645	4.092385195	0	0.028869402	5.99115512	4.82270445	9.9582236	0.298371355	3.322182036	0	0	3.045703613	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4966	5000																																																																																	0	0	0	15.6317	0.362057043	1.728704638	0	1.293144014	2.653730672	1.339113302	1.519843751	1.944951695	8.463732645	4.092385195	0	0.028869402	5.99115512	4.82270445	9.9582236	0.298371355	3.322182036	0	0	3.045703613	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4966
H1804_197_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		269.06007	6.231889	655.359674	218.32842	211.452891	19.1671	9.672013	497.044798	349.431266	1787.633703	954.984899	0	0.208514	1064.562528	5257.339613	5427.842583	51.569728	919.806606			21.998202								0.05		0.06	1.22	2.07	2.7							$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							950.000005	950.000232	43.132803	0	99.999975	0.2	0.2	50	91.015152	77.419437	70.072312	0	0.2	92.025035	15.000001	29.999998	94.608294	59.060006			0.199999								0		0	0	0	0							724.898454	724.898627	32.912528	0	76.305081	0.15261	0.15261	38.15255	69.449203	59.074979	53.468747	0	0.15261	70.219795	11.445765	22.891529	72.190953	45.065796			0.15261								0		0	0	0	0							16.2534	0.376457315	1.797461968	0	1.344577498	2.925091131	1.476045904	1.580293876	2.022310244	8.800368622	4.255153829	0	0.031821322	6.229446873	5.014522811	10.35430132	0.310238984	3.454318072	0	0	3.357145607	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.583	0	21.6075	16.2534	0.376457315	1.797461968	0	1.344577498	2.925091131	1.476045904	1.580293876	2.022310244	8.800368622	4.255153829	0	0.031821322	6.229446873	5.014522811	10.35430132	0.310238984	3.454318072	0	0	3.357145607	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.583	5000																																																																																	0	0	0	16.2534	0.376457315	1.797461968	0	1.344577498	2.925091131	1.476045904	1.580293876	2.022310244	8.800368622	4.255153829	0	0.031821322	6.229446873	5.014522811	10.35430132	0.310238984	3.454318072	0	0	3.357145607	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.583
H1804_198_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1698.168171	57.480659	753.982427	251.183891	243.273686	25.369968	12.802076	571.843306	402.015934	2056.648354	1098.697191	0	0.275993	1224.764768	6048.497993	6244.659348	59.330273	1058.225041			29.117274								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947948	114.991583	43.132793	0	100.000013	0.2	0.199999	49.99999	91.015138	77.419436	70.072337	0	0.199997	92.025031	14.999999	29.999999	94.608025	59.059989			0.199999								0		0	0	0	0							107.697894	89.775539	33.674375	0	78.07141	0.156142	0.156142	39.035692	71.056793	60.442437	54.706454	0	0.156141	71.84523	11.710709	23.421419	73.86181	46.10896			0.156142								0		0	0	0	0							15.2408	0.430029762	2.115823916	0	1.58272664	3.961317543	1.998941751	1.860191597	2.380496917	10.35906988	5.008818945	0	0.043093823	7.332792204	5.902683324	12.18823193	0.365186779	4.066138007	0	0	4.546429397	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3827	0	22.2969	15.2408	0.430029762	2.115823916	0	1.58272664	3.961317543	1.998941751	1.860191597	2.380496917	10.35906988	5.008818945	0	0.043093823	7.332792204	5.902683324	12.18823193	0.365186779	4.066138007	0	0	4.546429397	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3827	6000																																																																																	0	0	0	15.2408	0.430029762	2.115823916	0	1.58272664	3.961317543	1.998941751	1.860191597	2.380496917	10.35906988	5.008818945	0	0.043093823	7.332792204	5.902683324	12.18823193	0.365186779	4.066138007	0	0	4.546429397	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3827
H1804_199_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1532.614432	51.876894	680.47698	226.696073	219.557032	20.674911	10.432878	516.094529	362.823562	1856.146525	991.585635	0	0.224917	1105.362938	5458.832329	5635.869993	53.546188	955.059102			23.728726								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947948	114.99154	43.132791	0	100.000003	0.199999	0.2	50.000003	91.015147	77.419433	70.07235	0	0.200002	92.025032	14.999999	30	94.607967	59.059993			0.199999								0		0	0	0	0							111.388139	92.851644	34.828219	0	80.746502	0.161492	0.161493	40.373252	73.491546	62.513482	56.58097	0	0.161495	74.306992	12.111974	24.22395	76.392622	47.688877			0.161492								0		0	0	0	0							14.2263	0.401404574	1.97498344	0	1.47737186	3.338832727	1.684836767	1.736367873	2.222038708	9.669515198	4.675406422	0	0.036322971	6.844682916	5.509769603	11.37691941	0.340877808	3.79547467	0	0	3.831999419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.1431	0	17.4405	14.2263	0.401404574	1.97498344	0	1.47737186	3.338832727	1.684836767	1.736367873	2.222038708	9.669515198	4.675406422	0	0.036322971	6.844682916	5.509769603	11.37691941	0.340877808	3.79547467	0	0	3.831999419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.1431	6000																																																																																	0	0	0	14.2263	0.401404574	1.97498344	0	1.47737186	3.338832727	1.684836767	1.736367873	2.222038708	9.669515198	4.675406422	0	0.036322971	6.844682916	5.509769603	11.37691941	0.340877808	3.79547467	0	0	3.831999419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.1431
H1804_200_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1560.254748	52.81248	692.749211	230.78448	223.516688	21.416547	10.807119	525.402164	369.366993	1889.62166	1009.468633	0	0.232985	1125.297878	5557.280996	5737.511489	54.511881	972.283353			24.579906								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.94795	114.991683	43.132804	0	99.999996	0.199999	0.2	50.000007	91.015138	77.419434	70.072322	0	0.2	92.02502	14.999999	30	94.608072	59.059992			0.2								0		0	0	0	0							110.752201	92.321648	34.629387	0	80.285497	0.16057	0.160571	40.142755	73.071958	62.156579	56.257914	0	0.160571	73.882747	12.042824	24.08565	75.956564	47.41661			0.160571								0		0	0	0	0							14.4001	0.406311266	1.999123377	0	1.495429032	3.438854952	1.735309905	1.757590862	2.24919745	9.787701499	4.732549962	0	0.037410634	6.928341535	5.577113079	11.51597447	0.345044598	3.841865047	0	0	3.946820086	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1948	0	18.2189	14.4001	0.406311266	1.999123377	0	1.495429032	3.438854952	1.735309905	1.757590862	2.24919745	9.787701499	4.732549962	0	0.037410634	6.928341535	5.577113079	11.51597447	0.345044598	3.841865047	0	0	3.946820086	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1948	6000																																																																																	0	0	0	14.4001	0.406311266	1.999123377	0	1.495429032	3.438854952	1.735309905	1.757590862	2.24919745	9.787701499	4.732549962	0	0.037410634	6.928341535	5.577113079	11.51597447	0.345044598	3.841865047	0	0	3.946820086	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1948
H1804_201_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		257.663684	5.967929	627.601074	209.08084	202.496533	17.587716	8.875032	475.991827	334.630654	1711.91618	914.535286	0	0.191332	1019.471613	5034.658235	5197.939333	49.385425	880.847018			20.185533								0.05		0.06	1.22	2.07	2.7							$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							950	949.999943	43.132794	0	99.999993	0.199999	0.2	49.999993	91.01514	77.419435	70.072336	0	0.199997	92.025024	15	29.999999	94.608074	59.059994			0.2								0		0	0	0	0							735.86335	735.863306	33.41036	0	77.459295	0.154918	0.154918	38.729644	70.49969	59.968552	54.277541	0	0.154916	71.281939	11.618895	23.237789	73.282752	45.747458			0.154918								0		0	0	0	0							15.8004	0.365964997	1.747364818	0	1.307103224	2.724653787	1.374902207	1.536249501	1.965946448	8.555094538	4.13656054	0	0.029640388	6.055826111	4.874763783	10.06571812	0.301591654	3.358042663	0	0	3.127102401	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.327	0	19.5922	15.8004	0.365964997	1.747364818	0	1.307103224	2.724653787	1.374902207	1.536249501	1.965946448	8.555094538	4.13656054	0	0.029640388	6.055826111	4.874763783	10.06571812	0.301591654	3.358042663	0	0	3.127102401	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.327	5000																																																																																	0	0	0	15.8004	0.365964997	1.747364818	0	1.307103224	2.724653787	1.374902207	1.536249501	1.965946448	8.555094538	4.13656054	0	0.029640388	6.055826111	4.874763783	10.06571812	0.301591654	3.358042663	0	0	3.127102401	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.327
H1804_202_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1558.260745	52.744986	691.86388	230.489538	223.231035	21.3963	10.796903	524.730702	368.894943	1887.206727	1008.178534	0	0.232764	1123.859752	5550.178801	5730.178961	54.442214	971.040775			24.55667								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947952	114.991631	43.132808	0	100.00002	0.199999	0.199999	50.000001	91.015115	77.419435	70.072338	0	0.2	92.025048	15.000001	30.000001	94.608129	59.059987			0.199999								0		0	0	0	0							110.791243	92.354148	34.641597	0	80.313816	0.160627	0.160627	40.156901	73.097698	62.17849	56.277758	0	0.160628	73.908813	12.04707	24.094141	75.983383	47.43332			0.160627								0		0	0	0	0							14.3868	0.405934854	1.997272476	0	1.494044689	3.43682348	1.734274138	1.755963238	2.247114261	9.778638717	4.728168963	0	0.037388416	6.921928354	5.571949377	11.50531165	0.3447253	3.838307318	0	0	3.944464232	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1291	0	18.1702	14.3868	0.405934854	1.997272476	0	1.494044689	3.43682348	1.734274138	1.755963238	2.247114261	9.778638717	4.728168963	0	0.037388416	6.921928354	5.571949377	11.50531165	0.3447253	3.838307318	0	0	3.944464232	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1291	6000																																																																																	0	0	0	14.3868	0.405934854	1.997272476	0	1.494044689	3.43682348	1.734274138	1.755963238	2.247114261	9.778638717	4.728168963	0	0.037388416	6.921928354	5.571949377	11.50531165	0.3447253	3.838307318	0	0	3.944464232	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1291
H1804_203_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1643.049962	55.614984	729.51008	243.031101	235.377644	23.752296	11.985773	553.282729	388.967523	1989.894793	1063.036277	0	0.258395	1185.012024	5852.17917	6041.973629	57.404563	1023.877752			27.260661								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947951	114.991599	43.132799	0	99.999981	0.199999	0.2	50.000006	91.015135	77.419433	70.072336	0	0.2	92.02503	15	29.999999	94.608088	59.059999			0.199999								0		0	0	0	0							108.931151	90.803576	34.059987	0	78.965385	0.15793	0.15793	39.482705	71.870466	61.134565	55.3329	0	0.15793	72.667933	11.84481	23.689619	74.707655	46.636965			0.15793								0		0	0	0	0							14.9149	0.420836619	2.070591987	0	1.548890523	3.751200107	1.89291313	1.820424898	2.329606428	10.13761271	4.901740001	0	0.040808322	7.176031197	5.776495863	11.92767111	0.357380024	3.979212574	0	0	4.305276192	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.3516	0	20.6047	14.9149	0.420836619	2.070591987	0	1.548890523	3.751200107	1.89291313	1.820424898	2.329606428	10.13761271	4.901740001	0	0.040808322	7.176031197	5.776495863	11.92767111	0.357380024	3.979212574	0	0	4.305276192	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.3516	6000																																																																																	0	0	0	14.9149	0.420836619	2.070591987	0	1.548890523	3.751200107	1.89291313	1.820424898	2.329606428	10.13761271	4.901740001	0	0.040808322	7.176031197	5.776495863	11.92767111	0.357380024	3.979212574	0	0	4.305276192	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.3516
H1804_204_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1570.016407	53.142899	697.083364	232.228372	224.91511	21.709414	10.954904	528.689317	371.67792	1901.44399	1015.784328	0	0.236171	1132.338253	5592.04986	5773.407956	54.85293	978.366396			24.916033								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947952	114.991619	43.132792	0	100.000022	0.2	0.2	49.999996	91.015156	77.419433	70.072339	0	0.199998	92.025021	14.999999	30	94.608109	59.060008			0.2								0		0	0	0	0							110.528037	92.134734	34.559287	0	80.123017	0.160246	0.160246	40.061497	72.924073	62.030772	56.14406	0	0.160245	73.733207	12.018449	24.0369	75.802855	47.32065			0.160246								0		0	0	0	0							14.4609	0.408025572	2.00755867	0	1.501739765	3.478846756	1.755479546	1.765007124	2.258688981	9.829003218	4.752521355	0	0.037845222	6.957577567	5.600647171	11.56456914	0.346500725	3.858077816	0	0	3.992694624	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5757	0	18.5008	14.4609	0.408025572	2.00755867	0	1.501739765	3.478846756	1.755479546	1.765007124	2.258688981	9.829003218	4.752521355	0	0.037845222	6.957577567	5.600647171	11.56456914	0.346500725	3.858077816	0	0	3.992694624	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5757	6000																																																																																	0	0	0	14.4609	0.408025572	2.00755867	0	1.501739765	3.478846756	1.755479546	1.765007124	2.258688981	9.829003218	4.752521355	0	0.037845222	6.957577567	5.600647171	11.56456914	0.346500725	3.858077816	0	0	3.992694624	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5757
H1804_205_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1599.246843	54.132309	710.061603	236.551981	229.10256	22.508583	11.358177	538.532413	378.597789	1936.844915	1034.696115	0	0.244865	1153.420032	5696.162182	5880.896788	55.874177	996.581543			25.833245								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.94795	114.991584	43.132792	0	99.999999	0.2	0.2	49.999998	91.015143	77.419437	70.072341	0	0.199999	92.025022	15	30	94.608212	59.059998			0.2								0		0	0	0	0							109.888785	91.601836	34.35941	0	79.659599	0.159319	0.159319	39.829799	72.502299	61.672014	55.819347	0	0.159318	73.306764	11.94894	23.89788	75.364523	47.046958			0.159319								0		0	0	0	0							14.6449	0.413218241	2.033108145	0	1.520851505	3.586044935	1.809573401	1.787469814	2.287434175	9.954093893	4.813005124	0	0.039011402	7.046124173	5.671925012	11.71174714	0.350910891	3.9071775	0	0	4.11572676	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.6924	0	19.3274	14.6449	0.413218241	2.033108145	0	1.520851505	3.586044935	1.809573401	1.787469814	2.287434175	9.954093893	4.813005124	0	0.039011402	7.046124173	5.671925012	11.71174714	0.350910891	3.9071775	0	0	4.11572676	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.6924	6000																																																																																	0	0	0	14.6449	0.413218241	2.033108145	0	1.520851505	3.586044935	1.809573401	1.787469814	2.287434175	9.954093893	4.813005124	0	0.039011402	7.046124173	5.671925012	11.71174714	0.350910891	3.9071775	0	0	4.11572676	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.6924
H1804_207_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1440.807755	48.769363	639.715044	213.116523	206.405126	18.342168	9.25574	485.179432	341.089704	1744.959625	932.187669	0	0.19954	1039.149481	5131.837327	5298.27008	50.338663	897.849146			21.051424								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947952	114.991618	43.132804	0	100.000016	0.2	0.2	50	91.01513	77.419437	70.072353	0	0.2	92.025027	15	29.999999	94.608233	59.059997			0.2								0		0	0	0	0							113.493643	94.606824	35.486566	0	82.272813	0.164545	0.164545	41.1364	74.880696	63.695138	57.650487	0	0.164545	75.711567	12.34092	24.681839	77.836842	48.590313			0.164545								0		0	0	0	0							13.6269	0.384492878	1.891774178	0	1.415127528	3.018112034	1.522985738	1.663211266	2.128419536	9.262120343	4.478422758	0	0.032833309	6.556302963	5.277632825	10.89758742	0.32651688	3.635564253	0	0	3.463906562	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.5819	0	14.9927	13.6269	0.384492878	1.891774178	0	1.415127528	3.018112034	1.522985738	1.663211266	2.128419536	9.262120343	4.478422758	0	0.032833309	6.556302963	5.277632825	10.89758742	0.32651688	3.635564253	0	0	3.463906562	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.5819	6000																																																																																	0	0	0	13.6269	0.384492878	1.891774178	0	1.415127528	3.018112034	1.522985738	1.663211266	2.128419536	9.262120343	4.478422758	0	0.032833309	6.556302963	5.277632825	10.89758742	0.32651688	3.635564253	0	0	3.463906562	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.5819
H1804_209_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1667.955873	56.458015	740.568242	246.71505	238.945579	24.475289	12.350608	561.669579	394.863626	2020.058298	1079.150147	0	0.266261	1202.974839	5940.888495	6133.559924	58.27472	1039.398042			28.090445								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947951	114.991715	43.132792	0	99.999992	0.2	0.2	50.000001	91.015149	77.419436	70.072339	0	0.199999	92.025026	15	30	94.608228	59.060003			0.2								0		0	0	0	0							108.379635	90.343931	33.887536	0	78.565593	0.157131	0.157131	39.282801	71.506598	60.825045	55.052754	0	0.15713	72.300014	11.78484	23.56968	74.329522	46.400846			0.157131								0		0	0	0	0							15.0644	0.425053251	2.09133608	0	1.564408426	3.845826636	1.940663386	1.838662858	2.352946214	10.23917807	4.950848964	0	0.041837591	7.247924808	5.834368364	12.04717039	0.360961007	4.01907904	0	0	4.413879713	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2785	0	21.3561	15.0644	0.425053251	2.09133608	0	1.564408426	3.845826636	1.940663386	1.838662858	2.352946214	10.23917807	4.950848964	0	0.041837591	7.247924808	5.834368364	12.04717039	0.360961007	4.01907904	0	0	4.413879713	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2785	6000																																																																																	0	0	0	15.0644	0.425053251	2.09133608	0	1.564408426	3.845826636	1.940663386	1.838662858	2.352946214	10.23917807	4.950848964	0	0.041837591	7.247924808	5.834368364	12.04717039	0.360961007	4.01907904	0	0	4.413879713	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2785
H1804_210_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		272.475269	6.310989	663.678207	221.099682	214.136881	19.672798	9.927197	503.353827	353.866624	1810.324278	967.106598	0	0.214016	1078.075106	5324.07144	5496.738617	52.224305	931.481786			22.578596								0.05		0.06	1.22	2.07	2.7							$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							950.000009	950.000001	43.1328	0	99.999999	0.2	0.199999	50.000009	91.015138	77.419437	70.072337	0	0.199999	92.025039	14.999999	29.999998	94.608132	59.060001			0.199999								0		0	0	0	0							721.553507	721.5535	32.760656	0	75.952999	0.151906	0.151905	37.976506	69.128728	58.802385	53.222042	0	0.151905	69.895778	11.392949	22.785899	71.857715	44.857843			0.151905								0		0	0	0	0							16.3838	0.37947635	1.811877786	0	1.355361526	2.988416053	1.50799086	1.592968303	2.038529133	8.870948764	4.289282331	0	0.0325101	6.27940819	5.054739532	10.43734425	0.312726602	3.482021976	0	0	3.429801625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.2472	0	22.2405	16.3838	0.37947635	1.811877786	0	1.355361526	2.988416053	1.50799086	1.592968303	2.038529133	8.870948764	4.289282331	0	0.0325101	6.27940819	5.054739532	10.43734425	0.312726602	3.482021976	0	0	3.429801625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.2472	5000																																																																																	0	0	0	16.3838	0.37947635	1.811877786	0	1.355361526	2.988416053	1.50799086	1.592968303	2.038529133	8.870948764	4.289282331	0	0.0325101	6.27940819	5.054739532	10.43734425	0.312726602	3.482021976	0	0	3.429801625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.2472
H1804_211_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		256.674127	5.945008	625.190773	208.277866	8.168716	17.443053	8.802033	474.163781	36.138419	10.784598	14.379465	0	0.189758	19.754458	5015.322638	5177.976653	0.590359	2.361437			20.019503								0.05		0	385.075754	292.793845	3.789399	513.191192	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999997	949.999058	43.132805	0	0.199999	0.2	0.199999	49.999989	0.240475	0.25	0.244134	0	0.200002	0.231352	14.999999	29.999998	0.25	0.249999			0.2								0		0	0	14.225503	29.998424	30	0	0	0	0		762.752147	762.751393	34.6312	0	0.160579	0.160579	0.160579	40.144841	0.193077	0.200724	0.196015	0	0.160581	0.185752	12.043454	24.086908	0.200724	0.200724			0.160579								0		0	0	11.421614	24.085645	24.08691	0	0	0	0		16.3149	0.377880261	1.804258891	0	1.311724247	2.800988008	1.413421657	1.586269133	6.977497525	2.164727649	2.818590832	0	0.030471529	3.669430082	5.033483957	10.39345394	0.11849922	0.47399708	0	0	3.214711772	0	0	0	0	0	0	0	0	0	0	0	0.278681523	0.007605843	1.030099171	0	0	0	0	0	61.8207	0	15.1764	16.3149	0.377880261	1.804258891	0	1.311724247	2.800988008	1.413421657	1.586269133	6.977497525	2.164727649	2.818590832	0	0.030471529	3.669430082	5.033483957	10.39345394	0.11849922	0.47399708	0	0	3.214711772	0	0	0	0	0	0	0	0	0	0	0	0.278681523	0.007605843	1.030099171	0	0	0	0	0	61.8207	5000																																																																																	0	0	0	16.3149	0.377880261	1.804258891	0	1.311724247	2.800988008	1.413421657	1.586269133	6.977497525	2.164727649	2.818590832	0	0.030471529	3.669430082	5.033483957	10.39345394	0.11849922	0.47399708	0	0	3.214711772	0	0	0	0	0	0	0	0	0	0	0	0.278681523	0.007605843	1.030099171	0	0	0	0	0	61.8207
H1804_212_0	2009	4	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		292.054113	6.764469	711.367131	236.986907	10.602344	22.639697	11.424339	539.522563	46.904795	13.997551	18.663401	0	0.246291	25.639715	5706.635209	5891.709471	0.766239	3.064957			25.983724								0.05		0	438.154635	333.152577	4.31173	583.929516	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000014	949.999236	43.132799	0	0.2	0.199999	0.2	50.000007	0.240475	0.25	0.244134	0	0.199998	0.231352	14.999999	29.999998	0.25	0.249999			0.199999								0		0	0	14.225518	29.999092	30.000004	0	0	0	0		721.28466	721.28407	32.748448	0	0.151849	0.151849	0.151849	37.962355	0.18258	0.189811	0.185358	0	0.151848	0.175653	11.388704	22.777408	0.189811	0.189811			0.151849								0		0	0	10.800681	22.776721	22.777413	0	0	0	0		17.5545	0.406591978	1.941347458	0	1.609955334	3.43781535	1.734774453	1.706795589	8.563877471	2.656889153	3.459410683	0	0.037398796	4.503692859	5.415931603	11.18315587	0.145440591	0.581762553	0	0	3.945602506	0	0	0	0	0	0	0	0	0	0	0	0.299856226	0.008183923	1.108366979	0	0	0	0	0	70.3014	0	22.2922	17.5545	0.406591978	1.941347458	0	1.609955334	3.43781535	1.734774453	1.706795589	8.563877471	2.656889153	3.459410683	0	0.037398796	4.503692859	5.415931603	11.18315587	0.145440591	0.581762553	0	0	3.945602506	0	0	0	0	0	0	0	0	0	0	0	0.299856226	0.008183923	1.108366979	0	0	0	0	0	70.3014	5000																																																																																	0	0	0	17.5545	0.406591978	1.941347458	0	1.609955334	3.43781535	1.734774453	1.706795589	8.563877471	2.656889153	3.459410683	0	0.037398796	4.503692859	5.415931603	11.18315587	0.145440591	0.581762553	0	0	3.945602506	0	0	0	0	0	0	0	0	0	0	0	0.299856226	0.008183923	1.108366979	0	0	0	0	0	70.3014
H1804_213_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		259.091863	6.001007	631.079741	210.239734	203.61893	17.778103	8.971104	478.630155	336.485445	1721.404988	919.604373	0	0.193403	1025.122342	5062.564337	5226.75047	49.659158	885.729375			20.404041								0.05		0.06	1.22	2.07	2.7							$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							949.999993	950.000542	43.132799	0	99.999975	0.2	0.2	49.999992	91.015146	77.419434	70.072333	0	0.199996	92.025035	14.999999	29.999999	94.608288	59.060003			0.199999								0		0	0	0	0							734.493445	734.493869	33.348167	0	77.315081	0.15463	0.15463	38.657543	70.368451	59.856912	54.176494	0	0.154627	71.149248	11.597264	23.194529	73.146493	45.6623			0.15463								0		0	0	0	0							15.8584	0.367308571	1.753779383	0	1.311901172	2.749028067	1.387201812	1.541888817	1.973163296	8.586498907	4.151745066	0	0.029905326	6.078056978	4.892657928	10.10266795	0.302699438	3.370370037	0	0	3.15507686	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.6124	0	19.838	15.8584	0.367308571	1.753779383	0	1.311901172	2.749028067	1.387201812	1.541888817	1.973163296	8.586498907	4.151745066	0	0.029905326	6.078056978	4.892657928	10.10266795	0.302699438	3.370370037	0	0	3.15507686	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.6124	5000																																																																																	0	0	0	15.8584	0.367308571	1.753779383	0	1.311901172	2.749028067	1.387201812	1.541888817	1.973163296	8.586498907	4.151745066	0	0.029905326	6.078056978	4.892657928	10.10266795	0.302699438	3.370370037	0	0	3.15507686	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.6124
H1804_214_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		280.09333	6.487437	682.233803	227.281347	220.123874	20.77132	10.481527	517.426958	363.760283	1860.938636	994.145668	0	0.225966	1108.21671	5472.925689	5650.420421	53.68443	957.524828			23.839375								0.05		0.06	1.22	2.07	2.7							$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							949.999987	950.000439	43.132796	0	100.00002	0.2	0.199999	50.000007	91.015126	77.419434	70.072338	0	0.199999	92.025033	14.999999	29.999999	94.608213	59.059999			0.2								0		0	0	0	0							714.41709	714.41743	32.436639	0	75.201815	0.150403	0.150403	37.600905	68.445013	58.220807	52.69566	0	0.150402	69.204481	11.280269	22.560539	71.147079	44.414182			0.150403								0		0	0	0	0							16.6753	0.386228172	1.844114298	0	1.379476237	3.124068842	1.576453105	1.621310158	2.074798108	9.028779097	4.365596843	0	0.033985738	6.391130188	5.144672832	10.62304419	0.318290865	3.543973498	0	0	3.585513518	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7167	0	23.649	16.6753	0.386228172	1.844114298	0	1.379476237	3.124068842	1.576453105	1.621310158	2.074798108	9.028779097	4.365596843	0	0.033985738	6.391130188	5.144672832	10.62304419	0.318290865	3.543973498	0	0	3.585513518	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7167	5000																																																																																	0	0	0	16.6753	0.386228172	1.844114298	0	1.379476237	3.124068842	1.576453105	1.621310158	2.074798108	9.028779097	4.365596843	0	0.033985738	6.391130188	5.144672832	10.62304419	0.318290865	3.543973498	0	0	3.585513518	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7167
H1804_215_0	2009	4	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		279.418974	6.471817	680.591248	226.734141	9.680581	20.671412	10.431113	516.181193	42.826913	12.78061	17.040813	0	0.224879	23.41061	5459.748988	5636.816379	0.699623	2.798491			23.724711								0.05		0	419.198746	318.739395	4.125192	558.666967	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000009	949.999667	43.132796	0	0.199999	0.199999	0.2	50	0.240475	0.25	0.244134	0	0.2	0.231352	14.999999	30.000002	0.25	0.25			0.2								0		0	0	14.225527	30.000058	29.999991	0	0	0	0		736.112257	736.111992	33.421663	0	0.15497	0.15497	0.154971	38.74275	0.186333	0.193713	0.189169	0	0.154971	0.179264	11.622824	23.245651	0.193714	0.193713			0.154971								0		0	0	11.022721	23.245695	23.245643	0	0	0	0		17.1403	0.396998509	1.895540944	0	1.500199638	3.203448718	1.616520013	1.666523243	7.98006718	2.475770305	3.223593554	0	0.034849724	4.196679591	5.288141798	10.91928886	0.13552677	0.542104087	0	0	3.676642188	0	0	0	0	0	0	0	0	0	0	0	0.292781285	0.00799108	1.082214406	0	0	0	0	0	67.2752	0	19.5478	17.1403	0.396998509	1.895540944	0	1.500199638	3.203448718	1.616520013	1.666523243	7.98006718	2.475770305	3.223593554	0	0.034849724	4.196679591	5.288141798	10.91928886	0.13552677	0.542104087	0	0	3.676642188	0	0	0	0	0	0	0	0	0	0	0	0.292781285	0.00799108	1.082214406	0	0	0	0	0	67.2752	5000																																																																																	0	0	0	17.1403	0.396998509	1.895540944	0	1.500199638	3.203448718	1.616520013	1.666523243	7.98006718	2.475770305	3.223593554	0	0.034849724	4.196679591	5.288141798	10.91928886	0.13552677	0.542104087	0	0	3.676642188	0	0	0	0	0	0	0	0	0	0	0	0.292781285	0.00799108	1.082214406	0	0	0	0	0	67.2752
H1804_216_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1547.748028	52.389145	687.19626	228.934553	221.725019	21.074603	10.634569	521.190636	366.406215	1874.474793	1001.376918	0	0.229265	1116.277697	5512.734837	5691.520637	54.074921	964.489706			24.187456								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.94795	114.991607	43.132795	0	99.999973	0.2	0.2	50.000008	91.015115	77.419433	70.07234	0	0.2	92.025025	15	30	94.608071	59.060002			0.199999								0		0	0	0	0							111.038029	92.559849	34.718751	0	80.492678	0.160985	0.160985	40.246356	73.260523	62.316992	56.403118	0	0.160985	74.073428	12.073905	24.14781	76.152591	47.53899			0.160985								0		0	0	0	0							14.3216	0.404094279	1.98821632	0	1.487270047	3.392694964	1.71200609	1.74800199	2.236925912	9.734302557	4.706731706	0	0.036908226	6.890542968	5.546686393	11.45314658	0.343162112	3.820905541	0	0	3.893817604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.717	0	17.8652	14.3216	0.404094279	1.98821632	0	1.487270047	3.392694964	1.71200609	1.74800199	2.236925912	9.734302557	4.706731706	0	0.036908226	6.890542968	5.546686393	11.45314658	0.343162112	3.820905541	0	0	3.893817604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.717	6000																																																																																	0	0	0	14.3216	0.404094279	1.98821632	0	1.487270047	3.392694964	1.71200609	1.74800199	2.236925912	9.734302557	4.706731706	0	0.036908226	6.890542968	5.546686393	11.45314658	0.343162112	3.820905541	0	0	3.893817604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.717
H1804_217_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1588.394495	53.764972	705.243189	234.946759	227.547891	22.196018	11.200453	534.877979	376.028659	1923.701655	1027.674754	0	0.241465	1145.593025	5657.508526	5840.989539	55.49502	989.818826			25.474511								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947949	114.991597	43.132797	0	99.999977	0.2	0.2	49.999994	91.015137	77.419433	70.072345	0	0.2	92.025036	15	29.999998	94.608272	59.060008			0.199999								0		0	0	0	0							110.125917	91.799516	34.433559	0	79.831482	0.159663	0.159663	39.915745	72.658749	61.805094	55.939804	0	0.159663	73.464967	11.974725	23.949448	75.527203	47.14849			0.159662								0		0	0	0	0							14.577	0.411299867	2.023669413	0	1.513790447	3.543882822	1.788297927	1.779171085	2.276814329	9.907880135	4.79066036	0	0.038553026	7.013412815	5.645592399	11.65737294	0.34928197	3.889038585	0	0	4.067311375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.273	0	19.0168	14.577	0.411299867	2.023669413	0	1.513790447	3.543882822	1.788297927	1.779171085	2.276814329	9.907880135	4.79066036	0	0.038553026	7.013412815	5.645592399	11.65737294	0.34928197	3.889038585	0	0	4.067311375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.273	6000																																																																																	0	0	0	14.577	0.411299867	2.023669413	0	1.513790447	3.543882822	1.788297927	1.779171085	2.276814329	9.907880135	4.79066036	0	0.038553026	7.013412815	5.645592399	11.65737294	0.34928197	3.889038585	0	0	4.067311375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.273
H1804_218_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1538.619796	52.080167	683.143347	227.584354	220.41734	20.826734	10.50949	518.116783	364.245243	1863.419612	995.471041	0	0.226569	1109.694165	5480.222104	5657.953467	53.756002	958.801385			23.902974								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.94795	114.991566	43.132792	0	99.99999	0.2	0.2	50.000001	91.015118	77.419438	70.072334	0	0.2	92.025031	15	30	94.608151	59.060002			0.199999								0		0	0	0	0							111.249504	92.736098	34.784871	0	80.645992	0.161292	0.161292	40.323001	73.400052	62.43568	56.510535	0	0.161292	74.214506	12.0969	24.1938	76.29769	47.629529			0.161291								0		0	0	0	0							14.2642	0.402475956	1.980254433	0	1.481314587	3.35918558	1.695096661	1.741001963	2.227968315	9.69532255	4.687883425	0	0.036543767	6.862950356	5.524474897	11.40728288	0.341788231	3.805604864	0	0	3.855334579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3687	0	17.6075	14.2642	0.402475956	1.980254433	0	1.481314587	3.35918558	1.695096661	1.741001963	2.227968315	9.69532255	4.687883425	0	0.036543767	6.862950356	5.524474897	11.40728288	0.341788231	3.805604864	0	0	3.855334579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3687	6000																																																																																	0	0	0	14.2642	0.402475956	1.980254433	0	1.481314587	3.35918558	1.695096661	1.741001963	2.227968315	9.69532255	4.687883425	0	0.036543767	6.862950356	5.524474897	11.40728288	0.341788231	3.805604864	0	0	3.855334579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3687
H1804_219_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1693.489601	57.322298	751.905153	250.491862	242.603451	25.2407	12.736845	570.267839	400.908355	2050.982145	1095.670199	0	0.274586	1221.390454	6031.833959	6227.45488	59.166812	1055.309555			28.968912								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.94795	114.991691	43.132801	0	99.999979	0.2	0.2	50	91.015154	77.419437	70.072333	0	0.200002	92.025029	14.999999	29.999999	94.608173	59.05999			0.199999								0		0	0	0	0							107.801219	89.861752	33.706688	0	78.146283	0.156292	0.156292	39.07315	71.124975	60.500425	54.758936	0	0.156294	71.914155	11.721944	23.443889	73.932787	46.153197			0.156292								0		0	0	0	0							15.2134	0.429256844	2.112019366	0	1.579879828	3.944919484	1.990666979	1.856846734	2.376216394	10.34044095	4.999811192	0	0.042916144	7.319605202	5.892068324	12.16631341	0.364530609	4.058825816	0	0	4.527609194	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.2153	0	22.1527	15.2134	0.429256844	2.112019366	0	1.579879828	3.944919484	1.990666979	1.856846734	2.376216394	10.34044095	4.999811192	0	0.042916144	7.319605202	5.892068324	12.16631341	0.364530609	4.058825816	0	0	4.527609194	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.2153	6000																																																																																	0	0	0	15.2134	0.429256844	2.112019366	0	1.579879828	3.944919484	1.990666979	1.856846734	2.376216394	10.34044095	4.999811192	0	0.042916144	7.319605202	5.892068324	12.16631341	0.364530609	4.058825816	0	0	4.527609194	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.2153
H1804_223_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1469.650396	49.745647	652.521105	217.382772	210.537023	19.012262	9.59388	494.89194	347.917766	1779.890894	950.848557	0	0.20683	1059.951573	5234.568408	5404.332876	51.346363	915.822634			21.820494								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.94795	114.991769	43.132802	0	99.999988	0.199999	0.2	50.000006	91.015127	77.419435	70.072357	0	0.2	92.025026	15.000001	29.999999	94.608298	59.060003			0.199999								0		0	0	0	0							112.842527	94.064187	35.282977	0	81.80079	0.163601	0.163601	40.900404	74.451102	63.329717	57.319748	0	0.163601	75.277208	12.27012	24.540239	77.390345	48.311555			0.163601								0		0	0	0	0							13.8199	0.38994032	1.918573928	0	1.435174567	3.110425075	1.569568362	1.686773357	2.158571757	9.393332217	4.541866639	0	0.033837595	6.649182919	5.352398543	11.05196837	0.331142729	3.687067963	0	0	3.569854639	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.6996	0	15.7294	13.8199	0.38994032	1.918573928	0	1.435174567	3.110425075	1.569568362	1.686773357	2.158571757	9.393332217	4.541866639	0	0.033837595	6.649182919	5.352398543	11.05196837	0.331142729	3.687067963	0	0	3.569854639	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.6996	6000																																																																																	0	0	0	13.8199	0.38994032	1.918573928	0	1.435174567	3.110425075	1.569568362	1.686773357	2.158571757	9.393332217	4.541866639	0	0.033837595	6.649182919	5.352398543	11.05196837	0.331142729	3.687067963	0	0	3.569854639	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.6996
H1804_224_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1669.64213	56.515092	741.316936	246.964472	239.187146	24.687416	12.45765	562.237411	395.262821	2022.100519	1080.241138	0	0.268568	1204.191016	5946.894567	6139.760779	58.333636	1040.448842			28.333904								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947946	114.991726	43.132806	0	99.999989	0.199999	0.2	50.000002	91.015127	77.419433	70.072332	0	0.200001	92.025021	14.999999	30	94.608127	59.059995			0.2								0		0	0	0	0							108.314244	90.289434	33.867103	0	78.518191	0.157036	0.157036	39.259102	71.463439	60.788345	55.019534	0	0.157037	72.25639	11.777729	23.55546	74.284598	46.372845			0.157036								0		0	0	0	0							15.0705	0.425226306	2.092188086	0	1.565045168	3.876813059	1.956299525	1.839411322	2.353903375	10.24334533	4.952863668	0	0.042175113	7.250874641	5.836742717	12.05207412	0.361107558	4.020714407	0	0	4.449442949	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.3887	0	21.4464	15.0705	0.425226306	2.092188086	0	1.565045168	3.876813059	1.956299525	1.839411322	2.353903375	10.24334533	4.952863668	0	0.042175113	7.250874641	5.836742717	12.05207412	0.361107558	4.020714407	0	0	4.449442949	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.3887	6000																																																																																	0	0	0	15.0705	0.425226306	2.092188086	0	1.565045168	3.876813059	1.956299525	1.839411322	2.353903375	10.24334533	4.952863668	0	0.042175113	7.250874641	5.836742717	12.05207412	0.361107558	4.020714407	0	0	4.449442949	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.3887
H1804_225_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1558.408987	52.750003	691.929698	230.511465	223.252271	21.366924	10.782079	524.780621	368.930037	1887.386264	1008.274445	0	0.232445	1123.966667	5550.706809	5730.724091	54.447392	971.133154			24.522954								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947951	114.991613	43.132798	0	100.000022	0.2	0.199999	50.000001	91.015142	77.419433	70.072326	0	0.199999	92.025028	15.000001	30.000001	94.608167	59.059991			0.2								0		0	0	0	0							110.793863	92.356319	34.642408	0	80.315717	0.160631	0.160631	40.157851	73.099449	62.17996	56.279079	0	0.160631	73.910545	12.047355	24.094711	75.985211	47.434445			0.160631								0		0	0	0	0							14.3885	0.405983009	1.997509242	0	1.494222185	3.432190369	1.731936132	1.756171832	2.247381869	9.7798002	4.728729762	0	0.037337873	6.922749077	5.572611286	11.5066784	0.344766381	3.838763515	0	0	3.939146624	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1245	0	18.1669	14.3885	0.405983009	1.997509242	0	1.494222185	3.432190369	1.731936132	1.756171832	2.247381869	9.7798002	4.728729762	0	0.037337873	6.922749077	5.572611286	11.5066784	0.344766381	3.838763515	0	0	3.939146624	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1245	6000																																																																																	0	0	0	14.3885	0.405983009	1.997509242	0	1.494222185	3.432190369	1.731936132	1.756171832	2.247381869	9.7798002	4.728729762	0	0.037337873	6.922749077	5.572611286	11.5066784	0.344766381	3.838763515	0	0	3.939146624	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.1245
H1804_226_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1690.42206	57.218465	750.543172	250.038128	242.164006	25.443507	12.839185	569.23487	400.182159	2047.267052	1093.685535	0	0.276793	1219.178061	6020.908063	6216.174639	59.059639	1053.397997			29.201675								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947946	114.99169	43.132793	0	99.99998	0.199999	0.2	50	91.015121	77.419433	70.072324	0	0.199998	92.025031	14.999999	29.999998	94.608163	59.05999			0.199999								0		0	0	0	0							107.818183	89.875895	33.711987	0	78.158585	0.156317	0.156317	39.0793	71.136145	60.509945	54.767548	0	0.156315	71.925476	11.723789	23.447579	73.944416	46.160461			0.156317								0		0	0	0	0							15.1882	0.428546729	2.108525138	0	1.577266337	3.977252684	2.006982882	1.853775021	2.372284674	10.32333473	4.991539586	0	0.043266898	7.307496864	5.88232131	12.14618716	0.363927543	4.05211143	0	0	4.564718231	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.1877	0	22.129	15.1882	0.428546729	2.108525138	0	1.577266337	3.977252684	2.006982882	1.853775021	2.372284674	10.32333473	4.991539586	0	0.043266898	7.307496864	5.88232131	12.14618716	0.363927543	4.05211143	0	0	4.564718231	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.1877	6000																																																																																	0	0	0	15.1882	0.428546729	2.108525138	0	1.577266337	3.977252684	2.006982882	1.853775021	2.372284674	10.32333473	4.991539586	0	0.043266898	7.307496864	5.88232131	12.14618716	0.363927543	4.05211143	0	0	4.564718231	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.1877
H1804_227_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		282.269944	6.537851	687.535461	229.047555	9.879123	21.095367	10.645046	521.447897	43.705262	13.042731	17.390309	0	0.22949	23.890745	5515.455944	5694.32999	0.713972	2.855886			24.211287								0.05		0	423.47592	321.991559	4.167282	564.367162	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000018	950.000237	43.132791	0	0.2	0.199999	0.199999	50.000009	0.240475	0.25	0.244134	0	0.2	0.231352	15	30	0.25	0.25			0.199999								0		0	0	14.225515	29.999409	30.000002	0	0	0	0		773.107164	773.107342	35.101336	0	0.162759	0.162759	0.162759	40.689858	0.195698	0.203449	0.198676	0	0.162759	0.188273	12.206955	24.41391	0.203449	0.203449			0.162759								0		0	0	11.576682	24.413429	24.413911	0	0	0	0		18.1854	0.421205051	2.011117769	0	1.60791618	3.433460838	1.732577042	1.76813674	8.553032363	2.653530579	3.455037031	0	0.037351563	4.497982233	5.610576876	11.58507166	0.145256889	0.581027151	0	0	3.940604861	0	0	0	0	0	0	0	0	0	0	0	0.310632824	0.008478137	1.148200805	0	0	0	0	0	71.6866	0	16.4025	18.1854	0.421205051	2.011117769	0	1.60791618	3.433460838	1.732577042	1.76813674	8.553032363	2.653530579	3.455037031	0	0.037351563	4.497982233	5.610576876	11.58507166	0.145256889	0.581027151	0	0	3.940604861	0	0	0	0	0	0	0	0	0	0	0	0.310632824	0.008478137	1.148200805	0	0	0	0	0	71.6866	6000																																																																																	0	0	0	18.1854	0.421205051	2.011117769	0	1.60791618	3.433460838	1.732577042	1.76813674	8.553032363	2.653530579	3.455037031	0	0.037351563	4.497982233	5.610576876	11.58507166	0.145256889	0.581027151	0	0	3.940604861	0	0	0	0	0	0	0	0	0	0	0	0.310632824	0.008478137	1.148200805	0	0	0	0	0	71.6866
H1804_228_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		288.544033	6.683171	702.817496	234.138657	10.323177	22.043578	11.123528	533.038259	45.66976	13.628986	18.171982	0	0.239806	24.964606	5638.049456	5820.899385	0.746064	2.984255			25.299556								0.05		0	432.88863	329.148552	4.259909	576.911503	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999988	949.999334	43.132796	0	0.199999	0.2	0.2	50.000005	0.240475	0.25	0.244134	0	0.200003	0.231352	15	30.000001	0.25	0.25			0.2								0		0	0	14.225503	30.00064	30.000005	0	0	0	0		766.31559	766.315062	34.792983	0	0.161329	0.161329	0.161329	40.332404	0.193979	0.201662	0.19693	0	0.161332	0.186619	12.09972	24.19944	0.201662	0.201662			0.161329								0		0	0	11.474974	24.199956	24.199444	0	0	0	0		18.4263	0.42678455	2.037759766	0	1.665427822	3.556268395	1.794547649	1.791559534	8.858974375	2.748448575	3.578608415	0	0.038688382	4.658869807	5.684901647	11.73854212	0.150452758	0.601810832	0	0	4.08155207	0	0	0	0	0	0	0	0	0	0	0	0.31474759	0.008590801	1.163411467	0	0	0	0	0	73.3263	0	17.5762	18.4263	0.42678455	2.037759766	0	1.665427822	3.556268395	1.794547649	1.791559534	8.858974375	2.748448575	3.578608415	0	0.038688382	4.658869807	5.684901647	11.73854212	0.150452758	0.601810832	0	0	4.08155207	0	0	0	0	0	0	0	0	0	0	0	0.31474759	0.008590801	1.163411467	0	0	0	0	0	73.3263	6000																																																																																	0	0	0	18.4263	0.42678455	2.037759766	0	1.665427822	3.556268395	1.794547649	1.791559534	8.858974375	2.748448575	3.578608415	0	0.038688382	4.658869807	5.684901647	11.73854212	0.150452758	0.601810832	0	0	4.08155207	0	0	0	0	0	0	0	0	0	0	0	0.31474759	0.008590801	1.163411467	0	0	0	0	0	73.3263
H1804_229_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		303.496071	7.029484	739.236732	246.271466	11.420772	24.387324	12.306219	560.659719	50.525519	15.078065	20.104087	0	0.265303	27.618924	5930.20702	6122.532032	0.825388	3.301551			27.989487								0.05		0	455.320447	346.20467	4.480653	606.806427	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999988	950.000312	43.132807	0	0.199999	0.2	0.199999	49.999996	0.240475	0.249999	0.244134	0	0.200001	0.231352	15	29.999999	0.25	0.25			0.199999								0		0	0	14.225527	30.000984	29.999998	0	0	0	0		750.611141	750.611397	34.079964	0	0.158023	0.158023	0.158023	39.505847	0.190003	0.197529	0.192895	0	0.158024	0.182795	11.851755	23.703509	0.197529	0.197529			0.158023								0		0	0	11.23983	23.704287	23.703508	0	0	0	0		18.984	0.4397009	2.099430101	0	1.804744654	3.8537581	1.944665645	1.84577809	9.600000187	2.978355101	3.877977862	0	0.041924241	5.048601213	5.856946725	12.09379109	0.163038066	0.652152067	0	0	4.422982704	0	0	0	0	0	0	0	0	0	0	0	0.32427347	0.00885089	1.198620083	0	0	0	0	0	77.2396	0	20.5176	18.984	0.4397009	2.099430101	0	1.804744654	3.8537581	1.944665645	1.84577809	9.600000187	2.978355101	3.877977862	0	0.041924241	5.048601213	5.856946725	12.09379109	0.163038066	0.652152067	0	0	4.422982704	0	0	0	0	0	0	0	0	0	0	0	0.32427347	0.00885089	1.198620083	0	0	0	0	0	77.2396	6000																																																																																	0	0	0	18.984	0.4397009	2.099430101	0	1.804744654	3.8537581	1.944665645	1.84577809	9.600000187	2.978355101	3.877977862	0	0.041924241	5.048601213	5.856946725	12.09379109	0.163038066	0.652152067	0	0	4.422982704	0	0	0	0	0	0	0	0	0	0	0	0.32427347	0.00885089	1.198620083	0	0	0	0	0	77.2396
H1804_230_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1511.513262	51.162647	671.108113	223.574901	216.534153	20.116971	10.151334	508.988894	357.828174	1830.590938	977.933397	0	0.218848	1090.144203	5383.67465	5558.274844	52.808959	941.909765			23.088376								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947947	114.991626	43.132799	0	99.999984	0.199999	0.2	49.999998	91.015147	77.419432	70.07233	0	0.199997	92.025029	14.999999	29.999999	94.608037	59.060001			0.2								0		0	0	0	0							111.873854	93.256599	34.980096	0	81.098587	0.162197	0.162197	40.549298	73.81201	62.786076	56.827678	0	0.162195	74.63101	12.164789	24.329579	76.725793	47.896834			0.162197								0		0	0	0	0							14.0916	0.397604538	1.956285518	0	1.463384487	3.262912345	1.646515921	1.719928528	2.201001396	9.57796848	4.631140349	0	0.035496051	6.779880243	5.457605513	11.26920724	0.337650771	3.759541305	0	0	3.744865322	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.3326	0	16.8583	14.0916	0.397604538	1.956285518	0	1.463384487	3.262912345	1.646515921	1.719928528	2.201001396	9.57796848	4.631140349	0	0.035496051	6.779880243	5.457605513	11.26920724	0.337650771	3.759541305	0	0	3.744865322	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.3326	6000																																																																																	0	0	0	14.0916	0.397604538	1.956285518	0	1.463384487	3.262912345	1.646515921	1.719928528	2.201001396	9.57796848	4.631140349	0	0.035496051	6.779880243	5.457605513	11.26920724	0.337650771	3.759541305	0	0	3.744865322	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.3326
H1804_231_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1614.087622	54.634649	716.650872	238.747149	231.228599	22.921066	11.566323	543.529915	382.111123	1954.818557	1044.297943	0	0.249352	1164.123602	5749.021747	5935.470663	56.392682	1005.829674			26.306653								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947953	114.991641	43.132801	0	100	0.199999	0.2	50	91.015136	77.419436	70.072335	0	0.199998	92.025032	14.999999	30	94.60802	59.059995			0.2								0		0	0	0	0							109.566679	91.333376	34.258702	0	79.4261	0.158852	0.158852	39.71305	72.289773	61.491239	55.655723	0	0.15885	73.091894	11.913914	23.82783	75.14346	46.909051			0.158852								0		0	0	0	0							14.7375	0.415830578	2.045960722	0	1.530465486	3.641057176	1.837333541	1.798769224	2.301893862	10.01701792	4.843429754	0	0.039609565	7.090666577	5.707779223	11.78578216	0.353128437	3.93187629	0	0	4.178864442	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.257	0	19.753	14.7375	0.415830578	2.045960722	0	1.530465486	3.641057176	1.837333541	1.798769224	2.301893862	10.01701792	4.843429754	0	0.039609565	7.090666577	5.707779223	11.78578216	0.353128437	3.93187629	0	0	4.178864442	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.257	6000																																																																																	0	0	0	14.7375	0.415830578	2.045960722	0	1.530465486	3.641057176	1.837333541	1.798769224	2.301893862	10.01701792	4.843429754	0	0.039609565	7.090666577	5.707779223	11.78578216	0.353128437	3.93187629	0	0	4.178864442	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.257
H1804_232_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1670.320378	56.53805	741.618076	247.064795	239.284309	24.571548	12.399181	562.465804	395.423387	2022.921943	1080.679954	0	0.267307	1204.680184	5949.310332	6142.254893	58.357331	1040.871498			28.200922								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947947	114.991725	43.132799	0	100.000004	0.2	0.2	50.00001	91.015132	77.419436	70.072327	0	0.199998	92.025028	15	29.999999	94.608165	59.059993			0.199999								0		0	0	0	0							108.322798	90.296562	33.869772	0	78.524403	0.157048	0.157048	39.262208	71.469086	60.793147	55.023875	0	0.157047	72.262101	11.77866	23.557319	74.290494	46.376505			0.157048								0		0	0	0	0							15.0778	0.425432628	2.093202929	0	1.565804793	3.85891247	1.947266578	1.840304116	2.355045671	10.24831592	4.955266559	0	0.041979762	7.254393427	5.839575303	12.05792149	0.361282912	4.022665186	0	0	4.428898398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.3741	0	21.4345	15.0778	0.425432628	2.093202929	0	1.565804793	3.85891247	1.947266578	1.840304116	2.355045671	10.24831592	4.955266559	0	0.041979762	7.254393427	5.839575303	12.05792149	0.361282912	4.022665186	0	0	4.428898398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.3741	6000																																																																																	0	0	0	15.0778	0.425432628	2.093202929	0	1.565804793	3.85891247	1.947266578	1.840304116	2.355045671	10.24831592	4.955266559	0	0.041979762	7.254393427	5.839575303	12.05792149	0.361282912	4.022665186	0	0	4.428898398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.3741
H1804_233_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1447.453138	48.9943	642.665579	214.099472	207.357121	18.431787	9.300963	487.417208	342.6629	1753.007837	936.487163	0	0.200515	1043.942309	5155.50671	5322.707093	50.57084	901.990264			21.15428								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947951	114.991743	43.132797	0	99.999999	0.199999	0.199999	49.999999	91.015163	77.419437	70.072336	0	0.2	92.025039	14.999999	29.999998	94.608118	59.060007			0.2								0		0	0	0	0							113.356522	94.492625	35.443685	0	82.173399	0.164346	0.164346	41.086699	74.790254	63.618183	57.580821	0	0.164346	75.620103	12.326009	24.652018	77.742707	48.531616			0.164346								0		0	0	0	0							13.6732	0.385800001	1.898203029	0	1.41993662	3.029190466	1.528576065	1.668863676	2.135653777	9.293597781	4.493641642	0	0.032953838	6.578585411	5.295568509	10.93462259	0.327626166	3.647920427	0	0	3.476621301	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.8205	0	15.1468	13.6732	0.385800001	1.898203029	0	1.41993662	3.029190466	1.528576065	1.668863676	2.135653777	9.293597781	4.493641642	0	0.032953838	6.578585411	5.295568509	10.93462259	0.327626166	3.647920427	0	0	3.476621301	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.8205	6000																																																																																	0	0	0	13.6732	0.385800001	1.898203029	0	1.41993662	3.029190466	1.528576065	1.668863676	2.135653777	9.293597781	4.493641642	0	0.032953838	6.578585411	5.295568509	10.93462259	0.327626166	3.647920427	0	0	3.476621301	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.8205
H1804_234_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1483.592458	50.217566	658.711347	219.445007	212.534314	19.388899	9.783937	499.586808	351.218342	1796.776102	959.868929	0	0.210927	1070.006965	5284.226942	5455.601906	51.833467	924.510727			22.252763								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947948	114.991713	43.132798	0	99.999984	0.2	0.2	50.000007	91.015144	77.419435	70.072329	0	0.199998	92.025023	15	29.999998	94.607986	59.060004			0.2								0		0	0	0	0							112.519865	93.795175	35.182086	0	81.566887	0.163133	0.163133	40.783455	74.238231	63.148633	57.155827	0	0.163132	75.061958	12.235035	24.470068	77.168801	48.173415			0.163133								0		0	0	0	0							13.9111	0.392513783	1.931236605	0	1.444646864	3.162969261	1.596082995	1.697906342	2.172819034	9.455329554	4.571841871	0	0.034408943	6.693068156	5.387725132	11.12491247	0.333327208	3.711403244	0	0	3.630159986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2515	0	16.102	13.9111	0.392513783	1.931236605	0	1.444646864	3.162969261	1.596082995	1.697906342	2.172819034	9.455329554	4.571841871	0	0.034408943	6.693068156	5.387725132	11.12491247	0.333327208	3.711403244	0	0	3.630159986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2515	6000																																																																																	0	0	0	13.9111	0.392513783	1.931236605	0	1.444646864	3.162969261	1.596082995	1.697906342	2.172819034	9.455329554	4.571841871	0	0.034408943	6.693068156	5.387725132	11.12491247	0.333327208	3.711403244	0	0	3.630159986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2515
H1804_235_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1628.441395	55.120505	723.023913	240.870281	233.284871	23.329374	11.772361	548.363424	385.509164	1972.202384	1053.584688	0	0.253794	1174.475932	5800.146696	5988.253669	56.894172	1014.774325			26.775271								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947952	114.991689	43.132797	0	100.000021	0.2	0.199999	50.000008	91.015143	77.419437	70.072328	0	0.2	92.025027	14.999999	29.999999	94.608073	59.06			0.199999								0		0	0	0	0							109.249122	91.068703	34.159407	0	79.195916	0.158391	0.158391	39.597956	72.080262	61.31302	55.49441	0	0.158392	72.880048	11.879384	23.758769	74.925715	46.773098			0.158391								0		0	0	0	0							14.8255	0.418312742	2.058172343	0	1.539600754	3.695162877	1.864636031	1.809505895	2.315633462	10.07680702	4.872338387	0	0.040198939	7.132988525	5.741847488	11.85612797	0.355236376	3.955344913	0	0	4.240961949	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.7984	0	20.1743	14.8255	0.418312742	2.058172343	0	1.539600754	3.695162877	1.864636031	1.809505895	2.315633462	10.07680702	4.872338387	0	0.040198939	7.132988525	5.741847488	11.85612797	0.355236376	3.955344913	0	0	4.240961949	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.7984	6000																																																																																	0	0	0	14.8255	0.418312742	2.058172343	0	1.539600754	3.695162877	1.864636031	1.809505895	2.315633462	10.07680702	4.872338387	0	0.040198939	7.132988525	5.741847488	11.85612797	0.355236376	3.955344913	0	0	4.240961949	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.7984
H1804_236_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1655.857048	56.048486	735.196394	244.925458	237.212343	24.259244	12.241587	557.595404	391.999411	2005.40543	1071.322333	0	0.26391	1194.248842	5897.795167	6089.069016	57.852014	1031.858575			27.842489								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947951	114.99158	43.132801	0	100.000024	0.2	0.199999	49.999996	91.015146	77.419435	70.072333	0	0.2	92.025032	15	30	94.607942	59.06			0.199999								0		0	0	0	0							108.624079	90.54759	33.963975	0	78.742819	0.157485	0.157485	39.371396	71.667875	60.962231	55.176917	0	0.157485	72.463086	11.81142	23.62284	74.496943	46.505498			0.157485								0		0	0	0	0							14.9888	0.422921278	2.080849329	0	1.556564049	3.820467041	1.927866329	1.829442455	2.341147066	10.18783242	4.926021954	0	0.041561866	7.211579712	5.805111316	11.98675859	0.359149849	3.998924741	0	0	4.38477438	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.8698	0	21.0215	14.9888	0.422921278	2.080849329	0	1.556564049	3.820467041	1.927866329	1.829442455	2.341147066	10.18783242	4.926021954	0	0.041561866	7.211579712	5.805111316	11.98675859	0.359149849	3.998924741	0	0	4.38477438	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.8698	6000																																																																																	0	0	0	14.9888	0.422921278	2.080849329	0	1.556564049	3.820467041	1.927866329	1.829442455	2.341147066	10.18783242	4.926021954	0	0.041561866	7.211579712	5.805111316	11.98675859	0.359149849	3.998924741	0	0	4.38477438	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.8698
H1804_237_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1819.258008	61.579385	807.746013	269.094847	260.620596	29.11969	14.694244	612.619252	430.682145	2203.300033	1177.041057	0	0.316786	1312.098029	6479.793106	6689.941973	63.560886	1133.682994			33.420853								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947949	114.991664	43.132796	0	99.999986	0.199999	0.2	49.999995	91.015149	77.419436	70.072345	0	0.199999	92.025029	14.999999	30	94.608184	59.060002			0.2								0		0	0	0	0							105.092748	87.603985	32.859814	0	76.182889	0.152365	0.152365	38.091446	69.33798	58.980372	53.383145	0	0.152365	70.107336	11.427434	22.85487	72.075258	44.993622			0.152365								0		0	0	0	0							15.9326	0.44954996	2.211865312	0	1.654569161	4.436821567	2.238888487	1.94462943	2.488552496	10.82928796	5.236179451	0	0.048267099	7.665641449	6.170617338	12.74147951	0.381763938	4.250708675	0	0	5.092168267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.7736	0	26.1902	15.9326	0.44954996	2.211865312	0	1.654569161	4.436821567	2.238888487	1.94462943	2.488552496	10.82928796	5.236179451	0	0.048267099	7.665641449	6.170617338	12.74147951	0.381763938	4.250708675	0	0	5.092168267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.7736	6000																																																																																	0	0	0	15.9326	0.44954996	2.211865312	0	1.654569161	4.436821567	2.238888487	1.94462943	2.488552496	10.82928796	5.236179451	0	0.048267099	7.665641449	6.170617338	12.74147951	0.381763938	4.250708675	0	0	5.092168267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.7736
H1804_238_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1736.962346	58.79379	771.206943	256.922115	248.831206	26.542384	13.393695	584.906905	411.199875	2103.631908	1123.796616	0	0.288747	1252.744171	6186.674226	6387.316831	60.685655	1082.399892			30.462862								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.94795	114.991736	43.132796	0	99.999981	0.2	0.2	49.999997	91.015124	77.419436	70.072341	0	0.199998	92.025039	15	29.999999	94.608059	59.059994			0.199999								0		0	0	0	0							106.848688	89.067769	33.408852	0	77.455785	0.154911	0.154911	38.727898	70.496493	59.965843	54.275092	0	0.15491	71.27873	11.61837	23.236739	73.279429	45.745391			0.154911								0		0	0	0	0							15.466	0.436385976	2.147094885	0	1.606118033	4.111707248	2.074830686	1.88768458	2.415679092	10.51217173	5.08284706	0	0.044729798	7.441167794	5.989922519	12.36836784	0.370584179	4.126233856	0	0	4.719032415	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.8006	0	23.5177	15.466	0.436385976	2.147094885	0	1.606118033	4.111707248	2.074830686	1.88768458	2.415679092	10.51217173	5.08284706	0	0.044729798	7.441167794	5.989922519	12.36836784	0.370584179	4.126233856	0	0	4.719032415	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.8006	6000																																																																																	0	0	0	15.466	0.436385976	2.147094885	0	1.606118033	4.111707248	2.074830686	1.88768458	2.415679092	10.51217173	5.08284706	0	0.044729798	7.441167794	5.989922519	12.36836784	0.370584179	4.126233856	0	0	4.719032415	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.8006
H1804_239_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1441.824906	48.803793	640.166656	213.266975	206.550838	18.290101	9.229466	485.521949	341.3305	1746.191497	932.845755	0	0.198973	1039.883076	5135.460196	5302.010443	50.3742	898.482992			20.991665								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947954	114.991636	43.132799	0	100	0.199999	0.199999	49.999996	91.015154	77.419433	70.072343	0	0.200001	92.02503	14.999999	29.999999	94.607954	59.060002			0.199999								0		0	0	0	0							113.484815	94.599479	35.483801	0	82.2664	0.164532	0.164532	41.133197	74.87489	63.69018	57.645994	0	0.164534	75.705679	12.339959	24.679919	77.830558	48.586538			0.164532								0		0	0	0	0							13.6354	0.384734449	1.892962186	0	1.416016155	3.009306898	1.5185425	1.664255831	2.12975697	9.267937563	4.481235066	0	0.032737824	6.560421196	5.280947355	10.90443236	0.326721008	3.637848169	0	0	3.453800626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.5971	0	15.0026	13.6354	0.384734449	1.892962186	0	1.416016155	3.009306898	1.5185425	1.664255831	2.12975697	9.267937563	4.481235066	0	0.032737824	6.560421196	5.280947355	10.90443236	0.326721008	3.637848169	0	0	3.453800626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.5971	6000																																																																																	0	0	0	13.6354	0.384734449	1.892962186	0	1.416016155	3.009306898	1.5185425	1.664255831	2.12975697	9.267937563	4.481235066	0	0.032737824	6.560421196	5.280947355	10.90443236	0.326721008	3.637848169	0	0	3.453800626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.5971
H1804_240_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1628.187288	55.111903	722.91109	240.832695	233.248468	23.322279	11.768781	548.277854	385.449008	1971.894635	1053.420283	0	0.253717	1174.292665	5799.241625	5987.319243	56.885295	1014.615978			26.767127								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947953	114.991565	43.132806	0	99.999987	0.2	0.199999	49.999998	91.01512	77.419434	70.072339	0	0.200002	92.025031	14.999999	30.000001	94.608071	59.060004			0.199999								0		0	0	0	0							109.254641	91.073204	34.161139	0	79.19989	0.158399	0.158399	39.599948	72.083884	61.316114	55.497223	0	0.158401	72.883733	11.879984	23.759971	74.929497	46.775464			0.158399								0		0	0	0	0							14.8239	0.418268132	2.057955519	0	1.539437751	3.694225671	1.864163142	1.809314542	2.315388465	10.07574302	4.87182503	0	0.040189027	7.132236088	5.741241476	11.85487763	0.355198878	3.954927763	0	0	4.23988615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.7888	0	20.1669	14.8239	0.418268132	2.057955519	0	1.539437751	3.694225671	1.864163142	1.809314542	2.315388465	10.07574302	4.87182503	0	0.040189027	7.132236088	5.741241476	11.85487763	0.355198878	3.954927763	0	0	4.23988615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.7888	6000																																																																																	0	0	0	14.8239	0.418268132	2.057955519	0	1.539437751	3.694225671	1.864163142	1.809314542	2.315388465	10.07574302	4.87182503	0	0.040189027	7.132236088	5.741241476	11.85487763	0.355198878	3.954927763	0	0	4.23988615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.7888
H1804_241_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		312.692639	7.242492	761.63716	253.734011	245.7435	25.912965	13.07608	577.648889	406.097364	2077.528276	1109.851606	0	0.2819	1237.199072	6109.904777	6308.057642	59.932617	1068.968567			29.740475								0.05		0.06	1.22	2.07	2.7							$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							950.000001	950.000048	43.132806	0	99.999975	0.2	0.199999	49.999992	91.015138	77.419434	70.07234	0	0.199999	92.025035	15	30.000001	94.60805	59.06			0.2								0		0	0	0	0							684.763801	684.763834	31.090299	0	72.080382	0.14416	0.14416	36.040194	65.604076	55.804237	50.508423	0	0.14416	66.332013	10.81206	21.624121	68.19386	42.570684			0.14416								0		0	0	0	0							17.8434	0.413283049	1.973293919	0	1.476107113	3.735613034	1.885047693	1.734881502	2.220136861	9.661240024	4.671404532	0	0.040638704	6.838825411	5.505054754	11.36718348	0.340586374	3.792226923	0	0	4.287386876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.7863	0	30.1297	17.8434	0.413283049	1.973293919	0	1.476107113	3.735613034	1.885047693	1.734881502	2.220136861	9.661240024	4.671404532	0	0.040638704	6.838825411	5.505054754	11.36718348	0.340586374	3.792226923	0	0	4.287386876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.7863	5000																																																																																	0	0	0	17.8434	0.413283049	1.973293919	0	1.476107113	3.735613034	1.885047693	1.734881502	2.220136861	9.661240024	4.671404532	0	0.040638704	6.838825411	5.505054754	11.36718348	0.340586374	3.792226923	0	0	4.287386876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.7863
H1804_244_0	2009	4	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		283.973104	6.5773	691.683912	230.429582	9.998692	21.350688	10.773886	524.594209	44.234235	13.20059	17.600786	0	0.232269	24.179898	5548.735092	5728.688431	0.722613	2.890452			24.504321								0.05		0	426.031086	323.934392	4.192427	567.77244	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999997	950.000152	43.132806	0	0.199999	0.2	0.2	49.999995	0.240475	0.25	0.244134	0	0.199996	0.231352	15	29.999999	0.249999	0.25			0.199999								0		0	0	14.22551	29.999806	29.999997	0	0	0	0		730.922397	730.922516	33.186035	0	0.153878	0.153878	0.153878	38.469596	0.185019	0.192348	0.187835	0	0.153875	0.178	11.54088	23.081759	0.192347	0.192348			0.153878								0		0	0	10.944993	23.081611	23.081758	0	0	0	0		17.2969	0.400624722	1.912853876	0	1.538578728	3.285401168	1.65786403	1.68174394	8.184173925	2.539107085	3.306043638	0	0.035740392	4.304021844	5.336440487	11.01901715	0.138992443	0.555972661	0	0	3.770675907	0	0	0	0	0	0	0	0	0	0	0	0.295454971	0.008063997	1.092098838	0	0	0	0	0	68.3597	0	20.4893	17.2969	0.400624722	1.912853876	0	1.538578728	3.285401168	1.65786403	1.68174394	8.184173925	2.539107085	3.306043638	0	0.035740392	4.304021844	5.336440487	11.01901715	0.138992443	0.555972661	0	0	3.770675907	0	0	0	0	0	0	0	0	0	0	0	0.295454971	0.008063997	1.092098838	0	0	0	0	0	68.3597	5000																																																																																	0	0	0	17.2969	0.400624722	1.912853876	0	1.538578728	3.285401168	1.65786403	1.68174394	8.184173925	2.539107085	3.306043638	0	0.035740392	4.304021844	5.336440487	11.01901715	0.138992443	0.555972661	0	0	3.770675907	0	0	0	0	0	0	0	0	0	0	0	0.295454971	0.008063997	1.092098838	0	0	0	0	0	68.3597
H1804_245_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		254.202688	5.887766	619.170994	206.272419	8.014965	17.114741	8.636362	469.598197	35.458224	10.581611	14.108815	0	0.186186	19.382641	4967.031572	5128.11944	0.579248	2.31699			19.642698								0.05		0	381.367974	289.974619	3.752913	508.249824	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999978	950.000398	43.132795	0	0.199999	0.199999	0.199999	49.999996	0.240475	0.25	0.244134	0	0.199998	0.231352	14.999998	30	0.25	0.25			0.2								0		0	0	14.225507	29.999099	30.00001	0	0	0	0		765.684782	765.685121	34.764343	0	0.161196	0.161196	0.161196	40.299196	0.193819	0.201496	0.196768	0	0.161195	0.186466	12.089759	24.17952	0.201496	0.201496			0.161196								0		0	0	11.465531	24.178794	24.179528	0	0	0	0		16.2199	0.375681235	1.793756068	0	1.291980298	2.75882779	1.392147009	1.577035815	6.872477517	2.13215229	2.77616331	0	0.030012252	3.614203537	5.004184554	10.33295555	0.116716155	0.466864217	0	0	3.166324347	0	0	0	0	0	0	0	0	0	0	0	0.277059415	0.007561743	1.024103404	0	0	0	0	0	61.2301	0	14.7393	16.2199	0.375681235	1.793756068	0	1.291980298	2.75882779	1.392147009	1.577035815	6.872477517	2.13215229	2.77616331	0	0.030012252	3.614203537	5.004184554	10.33295555	0.116716155	0.466864217	0	0	3.166324347	0	0	0	0	0	0	0	0	0	0	0	0.277059415	0.007561743	1.024103404	0	0	0	0	0	61.2301	5000																																																																																	0	0	0	16.2199	0.375681235	1.793756068	0	1.291980298	2.75882779	1.392147009	1.577035815	6.872477517	2.13215229	2.77616331	0	0.030012252	3.614203537	5.004184554	10.33295555	0.116716155	0.466864217	0	0	3.166324347	0	0	0	0	0	0	0	0	0	0	0	0.277059415	0.007561743	1.024103404	0	0	0	0	0	61.2301
H1804_246_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		257.373283	5.961203	626.893736	208.845195	202.268309	17.538214	8.850052	475.455361	334.253509	1709.986765	913.50456	0	0.190793	1018.322623	5028.98393	5192.081	49.329765	879.854258			20.128719								0.05		0.06	1.22	2.07	2.7							$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							950.000004	950.000863	43.132802	0	99.999985	0.2	0.199999	49.999999	91.015122	77.419434	70.072346	0	0.199996	92.025039	15	29.999998	94.608032	59.060008			0.2								0		0	0	0	0							736.158803	736.159469	33.423781	0	77.490388	0.15498	0.15498	38.745199	70.527982	59.992629	54.299341	0	0.154978	71.310571	11.62356	23.247119	73.312142	45.765836			0.15498								0		0	0	0	0							15.789	0.36569967	1.746096579	0	1.306154145	2.718072406	1.371581059	1.535134381	1.964518789	8.548883466	4.133557967	0	0.029568718	6.051430642	4.871224704	10.05841041	0.301372561	3.355605473	0	0	3.119548871	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.2658	0	19.5396	15.789	0.36569967	1.746096579	0	1.306154145	2.718072406	1.371581059	1.535134381	1.964518789	8.548883466	4.133557967	0	0.029568718	6.051430642	4.871224704	10.05841041	0.301372561	3.355605473	0	0	3.119548871	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.2658	5000																																																																																	0	0	0	15.789	0.36569967	1.746096579	0	1.306154145	2.718072406	1.371581059	1.535134381	1.964518789	8.548883466	4.133557967	0	0.029568718	6.051430642	4.871224704	10.05841041	0.301372561	3.355605473	0	0	3.119548871	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.2658
H1804_251_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		267.554997	6.197028	651.693713	217.107132	8.875968	18.953283	9.564118	494.264421	39.267304	11.718335	15.624446	0	0.206188	21.464809	5227.931017	5397.480222	0.641473	2.565892			21.752804								0.05		0	401.399795	305.205892	3.950037	534.946272	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999988	949.999903	43.132802	0	0.2	0.2	0.2	49.999997	0.240475	0.25	0.244134	0	0.200001	0.231352	15	30	0.249999	0.25			0.2								0		0	0	14.225505	29.999718	30.000007	0	0	0	0		750.15419	750.154123	34.059213	0	0.157927	0.157927	0.157927	39.481798	0.189888	0.197409	0.192777	0	0.157928	0.182684	11.84454	23.68908	0.197408	0.197409			0.157927								0		0	0	11.232971	23.688858	23.689085	0	0	0	0		16.7256	0.387393842	1.849681248	0	1.401754998	2.993235124	1.510432463	1.626204002	7.456389822	2.313304794	3.012033827	0	0.032562858	3.921277167	5.160203171	10.65511173	0.126631902	0.506530174	0	0	3.435355077	0	0	0	0	0	0	0	0	0	0	0	0.285697411	0.007797655	1.056032309	0	0	0	0	0	64.4633	0	17.1734	16.7256	0.387393842	1.849681248	0	1.401754998	2.993235124	1.510432463	1.626204002	7.456389822	2.313304794	3.012033827	0	0.032562858	3.921277167	5.160203171	10.65511173	0.126631902	0.506530174	0	0	3.435355077	0	0	0	0	0	0	0	0	0	0	0	0.285697411	0.007797655	1.056032309	0	0	0	0	0	64.4633	5000																																																																																	0	0	0	16.7256	0.387393842	1.849681248	0	1.401754998	2.993235124	1.510432463	1.626204002	7.456389822	2.313304794	3.012033827	0	0.032562858	3.921277167	5.160203171	10.65511173	0.126631902	0.506530174	0	0	3.435355077	0	0	0	0	0	0	0	0	0	0	0	0.285697411	0.007797655	1.056032309	0	0	0	0	0	64.4633
H1804_252_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		272.385177	6.308903	663.458767	221.026575	214.066078	19.643803	9.912566	503.187396	353.749619	1809.725708	966.786828	0	0.213699	1077.718648	5322.311072	5494.921156	52.207039	931.173798			22.545317								0.05		0.06	1.22	2.07	2.7							$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							950.000021	950.00034	43.132796	0	100	0.2	0.199999	49.999996	91.015153	77.419436	70.07234	0	0.2	92.025023	15	29.999998	94.607932	59.059999			0.2								0		0	0	0	0							721.661816	721.662058	32.76557	0	75.9644	0.151928	0.151928	37.982197	69.139115	58.81121	53.230033	0	0.151929	69.906257	11.39466	22.789318	71.868347	44.864574			0.151928								0		0	0	0	0							16.3808	0.379407994	1.811550389	0	1.355116765	2.984443702	1.505996327	1.592680234	2.038161299	8.869346555	4.288507897	0	0.032467075	6.278273065	5.05382709	10.4354588	0.312669466	3.481392981	0	0	3.425264921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.2254	0	22.2198	16.3808	0.379407994	1.811550389	0	1.355116765	2.984443702	1.505996327	1.592680234	2.038161299	8.869346555	4.288507897	0	0.032467075	6.278273065	5.05382709	10.4354588	0.312669466	3.481392981	0	0	3.425264921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.2254	5000																																																																																	0	0	0	16.3808	0.379407994	1.811550389	0	1.355116765	2.984443702	1.505996327	1.592680234	2.038161299	8.869346555	4.288507897	0	0.032467075	6.278273065	5.05382709	10.4354588	0.312669466	3.481392981	0	0	3.425264921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.2254
H1804_253_0	2009	4	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		265.742434	6.155047	647.278787	215.636333	8.756094	18.69731	9.434951	490.916008	38.736981	11.560073	15.41343	0	0.203403	21.174918	5192.514192	5360.91478	0.632809	2.531238			21.459022								0.05		0	398.680498	303.138263	3.923277	531.322257	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000013	950.000869	43.132802	0	0.2	0.2	0.199999	49.999991	0.240475	0.249999	0.244134	0	0.199997	0.231352	15	30	0.249999	0.25			0.199999								0		0	0	14.225508	29.999411	30.000008	0	0	0	0		752.238511	752.239188	34.153846	0	0.158366	0.158366	0.158365	39.591492	0.190415	0.197957	0.193313	0	0.158363	0.183191	11.87745	23.7549	0.197957	0.197957			0.158365								0		0	0	11.264184	23.754433	23.754906	0	0	0	0		16.6585	0.385838963	1.842255001	0	1.386667582	2.961018195	1.494166015	1.619674767	7.376102237	2.288397371	2.979616394	0	0.032211509	3.879054403	5.139485641	10.61233288	0.125268971	0.501076281	0	0	3.398358019	0	0	0	0	0	0	0	0	0	0	0	0.284550431	0.007766268	1.051792523	0	0	0	0	0	64.0241	0	16.8318	16.6585	0.385838963	1.842255001	0	1.386667582	2.961018195	1.494166015	1.619674767	7.376102237	2.288397371	2.979616394	0	0.032211509	3.879054403	5.139485641	10.61233288	0.125268971	0.501076281	0	0	3.398358019	0	0	0	0	0	0	0	0	0	0	0	0.284550431	0.007766268	1.051792523	0	0	0	0	0	64.0241	5000																																																																																	0	0	0	16.6585	0.385838963	1.842255001	0	1.386667582	2.961018195	1.494166015	1.619674767	7.376102237	2.288397371	2.979616394	0	0.032211509	3.879054403	5.139485641	10.61233288	0.125268971	0.501076281	0	0	3.398358019	0	0	0	0	0	0	0	0	0	0	0	0.284550431	0.007766268	1.051792523	0	0	0	0	0	64.0241
H1804_254_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		301.708466	6.98808	734.882599	244.820919	11.286639	24.100906	12.161688	557.357414	49.932119	14.90098	19.867973	0	0.262188	27.294552	5895.277884	6086.470095	0.815694	3.262776			27.660763								0.05		0	452.638593	344.165512	4.454262	603.232314	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000017	950	43.132799	0	0.2	0.199999	0.2	50.000009	0.240475	0.25	0.244134	0	0.199997	0.231352	14.999999	29.999999	0.25	0.25			0.199999								0		0	0	14.225504	30.000929	30.000004	0	0	0	0		710.533513	710.5335	32.260314	0	0.149586	0.149585	0.149586	37.396507	0.179858	0.186982	0.182595	0	0.149584	0.173035	11.218949	22.437899	0.186982	0.186982			0.149585								0		0	0	10.639681	22.438595	22.437903	0	0	0	0		17.8645	0.413772078	1.975628616	0	1.688323181	3.605134024	1.819218261	1.736935036	8.980691059	2.786215042	3.62779253	0	0.03921913	4.722912805	5.511568493	11.38063344	0.152520096	0.610080382	0	0	4.137635233	0	0	0	0	0	0	0	0	0	0	0	0.305150938	0.008328948	1.127939012	0	0	0	0	0	72.4942	0	24.4323	17.8645	0.413772078	1.975628616	0	1.688323181	3.605134024	1.819218261	1.736935036	8.980691059	2.786215042	3.62779253	0	0.03921913	4.722912805	5.511568493	11.38063344	0.152520096	0.610080382	0	0	4.137635233	0	0	0	0	0	0	0	0	0	0	0	0.305150938	0.008328948	1.127939012	0	0	0	0	0	72.4942	5000																																																																																	0	0	0	17.8645	0.413772078	1.975628616	0	1.688323181	3.605134024	1.819218261	1.736935036	8.980691059	2.786215042	3.62779253	0	0.03921913	4.722912805	5.511568493	11.38063344	0.152520096	0.610080382	0	0	4.137635233	0	0	0	0	0	0	0	0	0	0	0	0.305150938	0.008328948	1.127939012	0	0	0	0	0	72.4942
H1804_256_0	2009	4	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		302.336844	7.002634	736.413161	245.330813	11.333715	24.201429	12.212413	558.518238	50.140384	14.963131	19.950842	0	0.263281	27.408395	5907.556158	6099.146571	0.819096	3.276384			27.776134								0.05		0	453.581318	344.882314	4.463539	604.488685	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999994	949.999671	43.132792	0	0.2	0.2	0.2	49.999993	0.240475	0.25	0.244134	0	0.199999	0.231352	14.999999	29.999999	0.25	0.25			0.2								0		0	0	14.225513	30.000409	30.000005	0	0	0	0		709.821945	709.821704	32.228002	0	0.149436	0.149436	0.149436	37.359044	0.179678	0.186795	0.182413	0	0.149435	0.172862	11.207714	22.415429	0.186795	0.186795			0.149436								0		0	0	10.629033	22.415736	22.415434	0	0	0	0		17.8838	0.414218467	1.977760402	0	1.693665035	3.616564744	1.824974149	1.738808952	9.009123916	2.795038055	3.639292942	0	0.039343396	4.737869976	5.517516655	11.39291558	0.153003037	0.612012149	0	0	4.15075436	0	0	0	0	0	0	0	0	0	0	0	0.305480458	0.008337793	1.129156352	0	0	0	0	0	72.6396	0	24.5786	17.8838	0.414218467	1.977760402	0	1.693665035	3.616564744	1.824974149	1.738808952	9.009123916	2.795038055	3.639292942	0	0.039343396	4.737869976	5.517516655	11.39291558	0.153003037	0.612012149	0	0	4.15075436	0	0	0	0	0	0	0	0	0	0	0	0.305480458	0.008337793	1.129156352	0	0	0	0	0	72.6396	5000																																																																																	0	0	0	17.8838	0.414218467	1.977760402	0	1.693665035	3.616564744	1.824974149	1.738808952	9.009123916	2.795038055	3.639292942	0	0.039343396	4.737869976	5.517516655	11.39291558	0.153003037	0.612012149	0	0	4.15075436	0	0	0	0	0	0	0	0	0	0	0	0.305480458	0.008337793	1.129156352	0	0	0	0	0	72.6396
H1804_257_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		271.480837	6.287957	661.256032	220.29275	9.164424	19.569237	9.874938	501.516775	40.543435	12.099164	16.132219	0	0.212888	22.162386	5304.640582	5476.677588	0.66232	2.64928			22.459739								0.05		0	407.289545	309.684188	4.007997	542.795552	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000002	950.00071	43.132805	0	0.2	0.199999	0.199999	49.999994	0.240475	0.25	0.244134	0	0.200001	0.231352	15	30	0.25	0.25			0.2								0		0	0	14.225511	30.000024	30.000002	0	0	0	0		745.268351	745.268907	33.837384	0	0.156898	0.156898	0.156898	39.224645	0.188651	0.196123	0.191522	0	0.156899	0.181494	11.767395	23.53479	0.196123	0.196123			0.156898								0		0	0	11.159814	23.534809	23.534792	0	0	0	0		16.8605	0.390518237	1.864597856	0	1.437879797	3.070374147	1.549358022	1.639318122	7.648559556	2.372924341	3.089674847	0	0.033401914	4.022340085	5.201816755	10.74103808	0.129896185	0.519584741	0	0	3.52388813	0	0	0	0	0	0	0	0	0	0	0	0.288001495	0.00786062	1.064548368	0	0	0	0	0	65.4561	0	17.9814	16.8605	0.390518237	1.864597856	0	1.437879797	3.070374147	1.549358022	1.639318122	7.648559556	2.372924341	3.089674847	0	0.033401914	4.022340085	5.201816755	10.74103808	0.129896185	0.519584741	0	0	3.52388813	0	0	0	0	0	0	0	0	0	0	0	0.288001495	0.00786062	1.064548368	0	0	0	0	0	65.4561	5000																																																																																	0	0	0	16.8605	0.390518237	1.864597856	0	1.437879797	3.070374147	1.549358022	1.639318122	7.648559556	2.372924341	3.089674847	0	0.033401914	4.022340085	5.201816755	10.74103808	0.129896185	0.519584741	0	0	3.52388813	0	0	0	0	0	0	0	0	0	0	0	0.288001495	0.00786062	1.064548368	0	0	0	0	0	65.4561
H1804_258_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		279.103793	6.464519	679.823548	226.478388	219.346202	20.62479	10.407587	515.598946	362.475159	1854.364151	990.633461	0	0.224372	1104.301508	5453.59046	5630.458122	53.494769	954.142002			23.671202								0.05		0.06	1.22	2.07	2.7							$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							950.000002	949.999218	43.132804	0	99.999999	0.2	0.199999	50.000001	91.01513	77.419434	70.072339	0	0.199998	92.02503	14.999999	30.000001	94.608054	59.060001			0.199999								0		0	0	0	0							715.360451	715.359861	32.479476	0	75.301099	0.150602	0.150602	37.650551	68.535394	58.297685	52.765242	0	0.1506	69.29586	11.295164	22.590331	71.240905	44.47283			0.150602								0		0	0	0	0							16.6383	0.385371451	1.840026051	0	1.376417506	3.106134624	1.567403417	1.617715368	2.070198153	9.008761429	4.355917859	0	0.033790423	6.376960225	5.133266553	10.59949272	0.317584646	3.536116254	0	0	3.564930364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.5284	0	23.4615	16.6383	0.385371451	1.840026051	0	1.376417506	3.106134624	1.567403417	1.617715368	2.070198153	9.008761429	4.355917859	0	0.033790423	6.376960225	5.133266553	10.59949272	0.317584646	3.536116254	0	0	3.564930364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.5284	5000																																																																																	0	0	0	16.6383	0.385371451	1.840026051	0	1.376417506	3.106134624	1.567403417	1.617715368	2.070198153	9.008761429	4.355917859	0	0.033790423	6.376960225	5.133266553	10.59949272	0.317584646	3.536116254	0	0	3.564930364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.5284
H1804_259_0	2009	4	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		278.046609	6.440031	677.248526	225.620536	9.585713	20.468836	10.32889	513.645972	42.407218	12.655363	16.873817	0	0.222675	23.18119	5432.933456	5609.131181	0.692767	2.771067			23.492214								0.05		0	417.139853	317.173908	4.10493	555.923077	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.99999	950.000395	43.132798	0	0.2	0.199999	0.2	50.00001	0.240475	0.25	0.244134	0	0.2	0.231352	15	29.999997	0.25	0.25			0.2								0		0	0	14.22552	29.999049	30.000006	0	0	0	0		737.700642	737.700957	33.493782	0	0.155305	0.155305	0.155305	38.826358	0.186735	0.194131	0.189577	0	0.155305	0.179651	11.647905	23.295808	0.194132	0.194131			0.155305								0		0	0	11.0465	23.295072	23.295815	0	0	0	0		17.0929	0.395901419	1.890301207	0	1.488709157	3.178912575	1.604128261	1.661916866	7.918911853	2.456798275	3.198887605	0	0.034582541	4.164523965	5.273524397	10.88910359	0.134488243	0.537950008	0	0	3.648458295	0	0	0	0	0	0	0	0	0	0	0	0.291971798	0.00796872	1.07922343	0	0	0	0	0	66.9492	0	19.267	17.0929	0.395901419	1.890301207	0	1.488709157	3.178912575	1.604128261	1.661916866	7.918911853	2.456798275	3.198887605	0	0.034582541	4.164523965	5.273524397	10.88910359	0.134488243	0.537950008	0	0	3.648458295	0	0	0	0	0	0	0	0	0	0	0	0.291971798	0.00796872	1.07922343	0	0	0	0	0	66.9492	5000																																																																																	0	0	0	17.0929	0.395901419	1.890301207	0	1.488709157	3.178912575	1.604128261	1.661916866	7.918911853	2.456798275	3.198887605	0	0.034582541	4.164523965	5.273524397	10.88910359	0.134488243	0.537950008	0	0	3.648458295	0	0	0	0	0	0	0	0	0	0	0	0.291971798	0.00796872	1.07922343	0	0	0	0	0	66.9492
H1804_261_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		269.245115	6.236173	655.810401	218.478577	211.59832	19.210853	9.694092	497.386642	349.671587	1788.863153	955.641691	0	0.20899	1065.294684	5260.955362	5431.575596	51.605193	920.439207			22.048418								0.05		0.06	1.22	2.07	2.7							$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							949.999987	949.999888	43.132801	0	99.999981	0.2	0.199999	49.999991	91.015161	77.419438	70.072334	0	0.199999	92.025038	14.999999	29.999997	94.607919	59.06			0.199999								0		0	0	0	0							724.69229	724.692215	32.903167	0	76.283385	0.152566	0.152566	38.141693	69.429459	59.058179	53.453559	0	0.152566	70.199827	11.442509	22.885018	72.170137	45.052976			0.152566								0		0	0	0	0							16.26	0.376608835	1.798186595	0	1.345119676	2.930922999	1.47898884	1.580930717	2.023125759	8.803916691	4.256870793	0	0.031884768	6.231958543	5.01654409	10.35847544	0.310362821	3.455710459	0	0	3.363838941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.6234	0	21.646	16.26	0.376608835	1.798186595	0	1.345119676	2.930922999	1.47898884	1.580930717	2.023125759	8.803916691	4.256870793	0	0.031884768	6.231958543	5.01654409	10.35847544	0.310362821	3.455710459	0	0	3.363838941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.6234	5000																																																																																	0	0	0	16.26	0.376608835	1.798186595	0	1.345119676	2.930922999	1.47898884	1.580930717	2.023125759	8.803916691	4.256870793	0	0.031884768	6.231958543	5.01654409	10.35847544	0.310362821	3.455710459	0	0	3.363838941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.6234
H1804_262_0	2009	5	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		269.873523	6.25073	657.341034	218.988498	9.036377	19.295812	9.736964	498.54752	39.976954	11.930112	15.906817	0	0.209914	21.852728	5273.234201	5444.252655	0.653065	2.612263			22.145927								0.05		0	404.878168	307.850688	3.984267	539.581905	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.99999	949.999156	43.132807	0	0.199999	0.199999	0.2	49.999991	0.240475	0.249999	0.244134	0	0.2	0.231352	15	29.999998	0.249999	0.25			0.199999								0		0	0	14.225493	30.000998	30.000005	0	0	0	0		747.365942	747.365286	33.932622	0	0.15734	0.15734	0.15734	39.335043	0.189182	0.196675	0.192061	0	0.15734	0.182005	11.800515	23.601028	0.196674	0.196675			0.15734								0		0	0	11.19121	23.601815	23.601034	0	0	0	0		16.8079	0.389298218	1.858775403	0	1.421783557	3.03600306	1.532013916	1.634199011	7.562920112	2.346354778	3.05507918	0	0.033027869	3.97730576	5.185573274	10.70749661	0.128440906	0.513766826	0	0	3.484440154	0	0	0	0	0	0	0	0	0	0	0	0.287101808	0.007836328	1.06122424	0	0	0	0	0	65.0305	0	17.6318	16.8079	0.389298218	1.858775403	0	1.421783557	3.03600306	1.532013916	1.634199011	7.562920112	2.346354778	3.05507918	0	0.033027869	3.97730576	5.185573274	10.70749661	0.128440906	0.513766826	0	0	3.484440154	0	0	0	0	0	0	0	0	0	0	0	0.287101808	0.007836328	1.06122424	0	0	0	0	0	65.0305	5000																																																																																	0	0	0	16.8079	0.389298218	1.858775403	0	1.421783557	3.03600306	1.532013916	1.634199011	7.562920112	2.346354778	3.05507918	0	0.033027869	3.97730576	5.185573274	10.70749661	0.128440906	0.513766826	0	0	3.484440154	0	0	0	0	0	0	0	0	0	0	0	0.287101808	0.007836328	1.06122424	0	0	0	0	0	65.0305
H1804_263_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		296.778074	6.873883	722.873456	240.820157	10.920781	23.319671	11.767464	548.249311	48.313561	14.417962	19.223949	0	0.253689	26.409795	5798.939709	5987.007536	0.789253	3.157012			26.764134								0.05		0	445.241761	338.541304	4.381472	593.374543	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000005	949.999294	43.132794	0	0.199999	0.199999	0.2	49.999997	0.240475	0.25	0.244134	0	0.199996	0.231352	15	29.999998	0.249999	0.25			0.199999								0		0	0	14.225513	30.000876	29.999992	0	0	0	0		716.179354	716.178818	32.516648	0	0.150774	0.150774	0.150774	37.693647	0.181287	0.188468	0.184046	0	0.150772	0.17441	11.308095	22.616188	0.188468	0.188468			0.150774								0		0	0	10.72423	22.61685	22.616184	0	0	0	0		17.7122	0.410244117	1.958785143	0	1.646569834	3.516000075	1.774227617	1.722126333	8.758620533	2.717324462	3.538090918	0	0.038249198	4.606132346	5.464580094	11.28360733	0.148748934	0.594995738	0	0	4.03533554	0	0	0	0	0	0	0	0	0	0	0	0.302549567	0.008257925	1.11832232	0	0	0	0	0	71.355	0	23.2962	17.7122	0.410244117	1.958785143	0	1.646569834	3.516000075	1.774227617	1.722126333	8.758620533	2.717324462	3.538090918	0	0.038249198	4.606132346	5.464580094	11.28360733	0.148748934	0.594995738	0	0	4.03533554	0	0	0	0	0	0	0	0	0	0	0	0.302549567	0.008257925	1.11832232	0	0	0	0	0	71.355	5000																																																																																	0	0	0	17.7122	0.410244117	1.958785143	0	1.646569834	3.516000075	1.774227617	1.722126333	8.758620533	2.717324462	3.538090918	0	0.038249198	4.606132346	5.464580094	11.28360733	0.148748934	0.594995738	0	0	4.03533554	0	0	0	0	0	0	0	0	0	0	0	0.302549567	0.008257925	1.11832232	0	0	0	0	0	71.355
H1804_265_0	2009	5	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		297.450452	6.889457	724.511195	241.365759	10.970301	23.425413	11.820824	549.491424	48.532638	14.48334	19.31112	0	0.254839	26.529548	5812.077779	6000.571695	0.792832	3.171328			26.885496								0.05		0	446.2505	339.308302	4.391399	594.718892	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000008	949.999397	43.132799	0	0.199999	0.2	0.2	50.000008	0.240475	0.25	0.244134	0	0.2	0.231352	14.999999	29.999999	0.25	0.25			0.199999								0		0	0	14.225505	29.99864	29.999995	0	0	0	0		715.431706	715.431246	32.482707	0	0.150617	0.150617	0.150617	37.654306	0.181098	0.188271	0.183854	0	0.150617	0.174228	11.296289	22.592579	0.188271	0.188271			0.150617								0		0	0	10.713028	22.591556	22.592576	0	0	0	0		17.7338	0.4107444	1.961173739	0	1.652313826	3.52826543	1.780417048	1.724226519	8.789163677	2.726792905	3.550426656	0	0.038383086	4.622190089	5.471242524	11.29736584	0.149267273	0.597069094	0	0	4.049412751	0	0	0	0	0	0	0	0	0	0	0	0.302918278	0.008267378	1.119685981	0	0	0	0	0	71.5131	0	23.447	17.7338	0.4107444	1.961173739	0	1.652313826	3.52826543	1.780417048	1.724226519	8.789163677	2.726792905	3.550426656	0	0.038383086	4.622190089	5.471242524	11.29736584	0.149267273	0.597069094	0	0	4.049412751	0	0	0	0	0	0	0	0	0	0	0	0.302918278	0.008267378	1.119685981	0	0	0	0	0	71.5131	5000																																																																																	0	0	0	17.7338	0.4107444	1.961173739	0	1.652313826	3.52826543	1.780417048	1.724226519	8.789163677	2.726792905	3.550426656	0	0.038383086	4.622190089	5.471242524	11.29736584	0.149267273	0.597069094	0	0	4.049412751	0	0	0	0	0	0	0	0	0	0	0	0.302918278	0.008267378	1.119685981	0	0	0	0	0	71.5131
H1804_268_0	2009	5	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		263.411366	6.101055	641.600919	213.74479	8.612399	18.390471	9.280114	486.609737	38.101274	11.370363	15.160484	0	0.200065	20.827421	5146.965946	5313.889341	0.622425	2.489698			21.106862								0.05		0	395.183309	300.479164	3.888863	526.661548	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000009	949.999693	43.132793	0	0.2	0.199999	0.2	50.00001	0.240475	0.25	0.244134	0	0.2	0.231352	14.999998	30.000001	0.249999	0.25			0.199999								0		0	0	14.225518	29.999516	30.000002	0	0	0	0		754.869057	754.868806	34.273274	0	0.158919	0.158919	0.158919	39.729958	0.191081	0.198649	0.193989	0	0.158919	0.183832	11.918984	23.837971	0.198649	0.198649			0.158919								0		0	0	11.303583	23.837585	23.837972	0	0	0	0		16.5701	0.383791342	1.832480341	0	1.368673837	2.922595261	1.474786437	1.611082034	7.280429537	2.25871124	2.940967131	0	0.03179413	3.828746457	5.112217063	10.55602833	0.123644104	0.494576018	0	0	3.354281402	0	0	0	0	0	0	0	0	0	0	0	0.283040931	0.007725092	1.046211936	0	0	0	0	0	63.4819	0	16.4099	16.5701	0.383791342	1.832480341	0	1.368673837	2.922595261	1.474786437	1.611082034	7.280429537	2.25871124	2.940967131	0	0.03179413	3.828746457	5.112217063	10.55602833	0.123644104	0.494576018	0	0	3.354281402	0	0	0	0	0	0	0	0	0	0	0	0.283040931	0.007725092	1.046211936	0	0	0	0	0	63.4819	5000																																																																																	0	0	0	16.5701	0.383791342	1.832480341	0	1.368673837	2.922595261	1.474786437	1.611082034	7.280429537	2.25871124	2.940967131	0	0.03179413	3.828746457	5.112217063	10.55602833	0.123644104	0.494576018	0	0	3.354281402	0	0	0	0	0	0	0	0	0	0	0	0.283040931	0.007725092	1.046211936	0	0	0	0	0	63.4819
H1804_269_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		275.092138	6.371601	670.052213	223.223136	9.384329	20.03881	10.111892	508.188068	41.516293	12.389489	16.519319	0	0.217997	22.694182	5375.204135	5549.529617	0.678212	2.71285			22.99867								0.05		0	412.707405	313.803678	4.061312	550.015944	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000019	949.999227	43.132805	0	0.2	0.199999	0.2	49.999993	0.240475	0.249999	0.244134	0	0.199998	0.231352	14.999999	29.999999	0.249999	0.249999			0.199999								0		0	0	14.225492	29.999169	30.000003	0	0	0	0		741.167215	741.166597	33.651179	0	0.156035	0.156035	0.156035	39.008794	0.187613	0.195043	0.190468	0	0.156033	0.180495	11.702639	23.405279	0.195043	0.195043			0.156035								0		0	0	11.098388	23.404632	23.405282	0	0	0	0		16.9908	0.393534819	1.879003913	0	1.464283776	3.126755718	1.577809068	1.651983638	7.788996279	2.416483103	3.146401651	0	0.034014726	4.09618638	5.242006129	10.82402408	0.132280503	0.529122403	0	0	3.588597473	0	0	0	0	0	0	0	0	0	0	0	0.290226248	0.007921126	1.072773189	0	0	0	0	0	66.2532	0	18.6676	16.9908	0.393534819	1.879003913	0	1.464283776	3.126755718	1.577809068	1.651983638	7.788996279	2.416483103	3.146401651	0	0.034014726	4.09618638	5.242006129	10.82402408	0.132280503	0.529122403	0	0	3.588597473	0	0	0	0	0	0	0	0	0	0	0	0.290226248	0.007921126	1.072773189	0	0	0	0	0	66.2532	5000																																																																																	0	0	0	16.9908	0.393534819	1.879003913	0	1.464283776	3.126755718	1.577809068	1.651983638	7.788996279	2.416483103	3.146401651	0	0.034014726	4.09618638	5.242006129	10.82402408	0.132280503	0.529122403	0	0	3.588597473	0	0	0	0	0	0	0	0	0	0	0	0.290226248	0.007921126	1.072773189	0	0	0	0	0	66.2532
H1804_270_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		277.034142	6.416582	674.782421	224.798971	217.719673	20.325637	10.256629	511.775602	359.787281	1840.613399	983.287573	0	0.221117	1096.112729	5413.150199	5588.706326	53.098088	947.066708			23.327862								0.05		0.06	1.22	2.07	2.7							$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							950.000019	949.99925	43.132801	0	100.000021	0.199999	0.2	49.999992	91.015146	77.419438	70.072342	0	0.199997	92.025027	15	30	94.608151	59.060004			0.2								0		0	0	0	0							717.261414	717.260834	32.565782	0	75.501216	0.151002	0.151002	37.750593	68.717527	58.452605	52.905459	0	0.151	69.48	11.32518	22.65036	71.430289	44.591012			0.151002								0		0	0	0	0							16.5588	0.383530246	1.831234768	0	1.369841672	3.069211838	1.548771492	1.609986038	2.060307683	8.965720664	4.335106698	0	0.033388667	6.346492701	5.108741698	10.54885085	0.316067648	3.519221912	0	0	3.522553818	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.1279	0	23.0797	16.5588	0.383530246	1.831234768	0	1.369841672	3.069211838	1.548771492	1.609986038	2.060307683	8.965720664	4.335106698	0	0.033388667	6.346492701	5.108741698	10.54885085	0.316067648	3.519221912	0	0	3.522553818	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.1279	5000																																																																																	0	0	0	16.5588	0.383530246	1.831234768	0	1.369841672	3.069211838	1.548771492	1.609986038	2.060307683	8.965720664	4.335106698	0	0.033388667	6.346492701	5.108741698	10.54885085	0.316067648	3.519221912	0	0	3.522553818	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.1279
H1804_271_0	2009	4	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		259.553405	6.011697	632.20394	210.614253	8.40482	17.947217	9.056441	479.482781	37.182942	11.09631	14.795079	0	0.195244	20.325428	5071.582738	5236.061349	0.607422	2.429691			20.598134								0.05		0	389.395399	296.078302	3.831906	518.947988	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000004	950.000002	43.132802	0	0.2	0.199999	0.199999	50.000001	0.240475	0.249999	0.244134	0	0.200001	0.231352	14.999998	29.999999	0.25	0.25			0.2								0		0	0	14.22552	30.000737	30	0	0	0	0		758.841953	758.841951	34.453663	0	0.159756	0.159756	0.159756	39.939051	0.192087	0.199695	0.19501	0	0.159757	0.184799	11.981714	23.963429	0.199695	0.199695			0.159756								0		0	0	11.363075	23.964019	23.96343	0	0	0	0		16.4133	0.380160657	1.815145125	0	1.342720424	2.867175599	1.446820788	1.595840604	7.14235978	2.215877625	2.885188356	0	0.031191596	3.756118769	5.063854491	10.45616536	0.121299136	0.485197144	0	0	3.290675495	0	0	0	0	0	0	0	0	0	0	0	0.280363329	0.007652322	1.036314482	0	0	0	0	0	62.6335	0	15.7779	16.4133	0.380160657	1.815145125	0	1.342720424	2.867175599	1.446820788	1.595840604	7.14235978	2.215877625	2.885188356	0	0.031191596	3.756118769	5.063854491	10.45616536	0.121299136	0.485197144	0	0	3.290675495	0	0	0	0	0	0	0	0	0	0	0	0.280363329	0.007652322	1.036314482	0	0	0	0	0	62.6335	5000																																																																																	0	0	0	16.4133	0.380160657	1.815145125	0	1.342720424	2.867175599	1.446820788	1.595840604	7.14235978	2.215877625	2.885188356	0	0.031191596	3.756118769	5.063854491	10.45616536	0.121299136	0.485197144	0	0	3.290675495	0	0	0	0	0	0	0	0	0	0	0	0.280363329	0.007652322	1.036314482	0	0	0	0	0	62.6335
H1804_272_0	2009	4	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		285.362061	6.60947	695.067046	231.55665	10.106508	21.580913	10.890061	527.160081	44.711213	13.342932	17.790577	0	0.234773	24.440631	5575.874829	5756.708346	0.730405	2.92162			24.768552								0.05		0	428.114871	325.518806	4.212931	570.549505	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999994	950.000542	43.1328	0	0.2	0.2	0.199999	49.999992	0.240475	0.249999	0.244134	0	0.199997	0.231352	15	30	0.249999	0.25			0.199999								0		0	0	14.2255	29.999064	30.000005	0	0	0	0		729.213346	729.213766	33.108435	0	0.153518	0.153518	0.153518	38.379644	0.184587	0.191898	0.187396	0	0.153516	0.177584	11.513895	23.02779	0.191897	0.191898			0.153518								0		0	0	10.919394	23.027071	23.027793	0	0	0	0		17.3408	0.401643042	1.917715176	0	1.551530895	3.313058602	1.671820385	1.68601802	8.253108674	2.560481965	3.333882967	0	0.036041412	4.340265016	5.35000311	11.04702257	0.140162528	0.560653035	0	0	3.802418566	0	0	0	0	0	0	0	0	0	0	0	0.296205675	0.008084288	1.094874658	0	0	0	0	0	68.7058	0	20.8023	17.3408	0.401643042	1.917715176	0	1.551530895	3.313058602	1.671820385	1.68601802	8.253108674	2.560481965	3.333882967	0	0.036041412	4.340265016	5.35000311	11.04702257	0.140162528	0.560653035	0	0	3.802418566	0	0	0	0	0	0	0	0	0	0	0	0.296205675	0.008084288	1.094874658	0	0	0	0	0	68.7058	5000																																																																																	0	0	0	17.3408	0.401643042	1.917715176	0	1.551530895	3.313058602	1.671820385	1.68601802	8.253108674	2.560481965	3.333882967	0	0.036041412	4.340265016	5.35000311	11.04702257	0.140162528	0.560653035	0	0	3.802418566	0	0	0	0	0	0	0	0	0	0	0	0.296205675	0.008084288	1.094874658	0	0	0	0	0	68.7058
H1804_273_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		282.584191	6.54513	688.300885	229.302551	9.94405	21.234011	10.715009	522.028418	43.992503	13.128451	17.504603	0	0.230999	24.047761	5521.596222	5700.669407	0.718664	2.874656			24.370409								0.05		0	423.947368	322.350028	4.171921	564.995465	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999981	949.999751	43.132805	0	0.199999	0.199999	0.2	49.99999	0.240475	0.25	0.244134	0	0.2	0.231352	14.999999	30.000001	0.25	0.25			0.199999								0		0	0	14.225517	30.00057	30.000007	0	0	0	0		732.105135	732.104958	33.239735	0	0.154127	0.154127	0.154127	38.531842	0.185319	0.192659	0.188139	0	0.154128	0.178288	11.559554	23.11911	0.192659	0.192659			0.154127								0		0	0	10.96271	23.119549	23.119115	0	0	0	0		17.2401	0.399310177	1.906578251	0	1.532646594	3.272734413	1.651472192	1.676226377	8.152646663	2.529314241	3.293298504	0	0.035603414	4.287427213	5.318932475	10.98286692	0.138457088	0.55382835	0	0	3.756138028	0	0	0	0	0	0	0	0	0	0	0	0.294485823	0.008037744	1.088516261	0	0	0	0	0	68.1186	0	20.274	17.2401	0.399310177	1.906578251	0	1.532646594	3.272734413	1.651472192	1.676226377	8.152646663	2.529314241	3.293298504	0	0.035603414	4.287427213	5.318932475	10.98286692	0.138457088	0.55382835	0	0	3.756138028	0	0	0	0	0	0	0	0	0	0	0	0.294485823	0.008037744	1.088516261	0	0	0	0	0	68.1186	5000																																																																																	0	0	0	17.2401	0.399310177	1.906578251	0	1.532646594	3.272734413	1.651472192	1.676226377	8.152646663	2.529314241	3.293298504	0	0.035603414	4.287427213	5.318932475	10.98286692	0.138457088	0.55382835	0	0	3.756138028	0	0	0	0	0	0	0	0	0	0	0	0.294485823	0.008037744	1.088516261	0	0	0	0	0	68.1186
H1804_274_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		288.505749	6.682283	702.724248	234.107591	226.73515	22.037865	11.120646	532.967537	374.685583	1916.830706	1024.004178	0	0.239744	1141.501271	5637.301412	5820.12708	55.296808	986.283459			25.292999								0.05		0.06	1.22	2.07	2.7							$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							949.99998	949.999935	43.132799	0	100.000021	0.199999	0.199999	49.999998	91.015159	77.419437	70.072331	0	0.2	92.025043	15	29.999998	94.607993	59.059994			0.199999								0		0	0	0	0							706.555835	706.555801	32.079717	0	74.374316	0.148748	0.148748	37.187148	67.691887	57.580165	52.115805	0	0.148749	68.442981	11.156145	22.312288	70.364032	43.925457			0.148748								0		0	0	0	0							16.9871	0.393450485	1.878599584	0	1.405272641	3.278088343	1.654173851	1.651628556	2.113597845	9.197619027	4.447233505	0	0.03566168	6.510645817	5.24087933	10.82169597	0.324242197	3.610245972	0	0	3.762283015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3124	0	25.2598	16.9871	0.393450485	1.878599584	0	1.405272641	3.278088343	1.654173851	1.651628556	2.113597845	9.197619027	4.447233505	0	0.03566168	6.510645817	5.24087933	10.82169597	0.324242197	3.610245972	0	0	3.762283015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3124	5000																																																																																	0	0	0	16.9871	0.393450485	1.878599584	0	1.405272641	3.278088343	1.654173851	1.651628556	2.113597845	9.197619027	4.447233505	0	0.03566168	6.510645817	5.24087933	10.82169597	0.324242197	3.610245972	0	0	3.762283015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3124
H1804_275_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		294.473914	6.820517	717.261128	238.950451	231.425499	22.961498	11.586726	543.992751	382.436505	1956.483156	1045.187205	0	0.249792	1165.114898	5753.917253	5940.524938	56.440701	1006.686175			26.353057								0.05		0.06	1.22	2.07	2.7							$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							949.999992	950.000681	43.132793	0	100.000008	0.2	0.199999	49.999989	91.015139	77.419434	70.072338	0	0.199998	92.025042	15	30.000001	94.608108	59.060002			0.199999								0		0	0	0	0							700.959394	700.959902	31.825617	0	73.785206	0.14757	0.14757	36.892592	67.155703	57.124084	51.703015	0	0.147569	67.900861	11.06778	22.13556	69.806782	43.57754			0.14757								0		0	0	0	0							17.2012	0.398409077	1.902273162	0	1.42298151	3.38842826	1.709853156	1.672441884	2.140232696	9.313525679	4.503277478	0	0.036861556	6.592692062	5.306924191	10.95807052	0.328328643	3.655742255	0	0	3.888920621	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4202	0	26.4404	17.2012	0.398409077	1.902273162	0	1.42298151	3.38842826	1.709853156	1.672441884	2.140232696	9.313525679	4.503277478	0	0.036861556	6.592692062	5.306924191	10.95807052	0.328328643	3.655742255	0	0	3.888920621	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4202	5000																																																																																	0	0	0	17.2012	0.398409077	1.902273162	0	1.42298151	3.38842826	1.709853156	1.672441884	2.140232696	9.313525679	4.503277478	0	0.036861556	6.592692062	5.306924191	10.95807052	0.328328643	3.655742255	0	0	3.888920621	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4202
H1804_276_0	2009	4	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		291.286075	6.74668	709.496391	236.363684	10.520464	22.464855	11.336111	538.103738	46.542558	13.889451	18.519268	0	0.24439	25.441703	5691.628006	5876.215561	0.760322	3.041287			25.783056								0.05		0	437.002384	332.276462	4.30039	582.393909	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000016	949.999691	43.132802	0	0.2	0.2	0.199999	50.000002	0.240475	0.25	0.244134	0	0.2	0.231352	14.999999	30	0.249999	0.25			0.199999								0		0	0	14.225503	30.00007	30.000004	0	0	0	0		722.429412	722.429165	32.800426	0	0.15209	0.15209	0.15209	38.022601	0.18287	0.190113	0.185652	0	0.15209	0.175932	11.406779	22.81356	0.190112	0.190113			0.15209								0		0	0	10.817812	22.813613	22.813563	0	0	0	0		17.5361	0.406166533	1.939315323	0	1.60005737	3.416679797	1.724109122	1.705008644	8.511237581	2.640565198	3.438139143	0	0.037169275	4.476009692	5.410261901	11.17144969	0.144546336	0.578188195	0	0	3.921344987	0	0	0	0	0	0	0	0	0	0	0	0.299542025	0.008175619	1.107206678	0	0	0	0	0	70.0713	0	22.073	17.5361	0.406166533	1.939315323	0	1.60005737	3.416679797	1.724109122	1.705008644	8.511237581	2.640565198	3.438139143	0	0.037169275	4.476009692	5.410261901	11.17144969	0.144546336	0.578188195	0	0	3.921344987	0	0	0	0	0	0	0	0	0	0	0	0.299542025	0.008175619	1.107206678	0	0	0	0	0	70.0713	5000																																																																																	0	0	0	17.5361	0.406166533	1.939315323	0	1.60005737	3.416679797	1.724109122	1.705008644	8.511237581	2.640565198	3.438139143	0	0.037169275	4.476009692	5.410261901	11.17144969	0.144546336	0.578188195	0	0	3.921344987	0	0	0	0	0	0	0	0	0	0	0	0.299542025	0.008175619	1.107206678	0	0	0	0	0	70.0713
H1804_277_0	2009	4	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		298.62409	6.91664	727.369867	242.318107	11.057032	23.610613	11.914279	551.659528	48.916333	14.597844	19.463792	0	0.256853	26.73929	5835.010233	6024.24788	0.7991	3.1964			27.098051								0.05		0	448.01125	340.647092	4.408725	597.065447	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000008	949.999421	43.132795	0	0.199999	0.2	0.2	49.999992	0.240475	0.25	0.244134	0	0.199997	0.231352	15	29.999998	0.25	0.25			0.199999								0		0	0	14.225502	30.00051	30.000007	0	0	0	0		714.077006	714.076565	32.421197	0	0.150331	0.150332	0.150332	37.582994	0.180755	0.187915	0.183506	0	0.15033	0.173898	11.2749	22.549798	0.187915	0.187915			0.150331								0		0	0	10.692741	22.550183	22.549805	0	0	0	0		17.77	0.411584211	1.965183479	0	1.662214678	3.549430674	1.791097391	1.727751394	8.841871771	2.743153855	3.571722615	0	0.038612711	4.649909052	5.48242974	11.3204644	0.150162877	0.600651506	0	0	4.073677105	0	0	0	0	0	0	0	0	0	0	0	0.303537594	0.008284796	1.121975784	0	0	0	0	0	71.7838	0	23.7166	17.77	0.411584211	1.965183479	0	1.662214678	3.549430674	1.791097391	1.727751394	8.841871771	2.743153855	3.571722615	0	0.038612711	4.649909052	5.48242974	11.3204644	0.150162877	0.600651506	0	0	4.073677105	0	0	0	0	0	0	0	0	0	0	0	0.303537594	0.008284796	1.121975784	0	0	0	0	0	71.7838	5000																																																																																	0	0	0	17.77	0.411584211	1.965183479	0	1.662214678	3.549430674	1.791097391	1.727751394	8.841871771	2.743153855	3.571722615	0	0.038612711	4.649909052	5.48242974	11.3204644	0.150162877	0.600651506	0	0	4.073677105	0	0	0	0	0	0	0	0	0	0	0	0.303537594	0.008284796	1.121975784	0	0	0	0	0	71.7838
H1804_278_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		279.244236	6.46777	680.165633	226.59235	9.668463	20.645534	10.418054	515.858394	42.773301	12.764611	17.019481	0	0.224597	23.381305	5456.334679	5633.291339	0.698747	2.794988			23.695012								0.05		0	418.936597	318.540069	4.122612	558.3176	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999984	950.000386	43.132793	0	0.2	0.2	0.2	50	0.240475	0.25	0.244134	0	0.200002	0.231352	14.999999	30.000001	0.25	0.25			0.199999								0		0	0	14.2255	30.001368	30	0	0	0	0		776.340937	776.341265	35.248162	0	0.16344	0.16344	0.16344	40.86005	0.196516	0.2043	0.199507	0	0.163442	0.189061	12.258014	24.516031	0.2043	0.2043			0.16344								0		0	0	11.625093	24.517147	24.51603	0	0	0	0		18.0657	0.418433062	1.997882368	0	1.580213593	3.374306077	1.702726746	1.756499981	8.405638019	2.607810027	3.395505596	0	0.036708583	4.420492905	5.57365224	11.50882876	0.142754012	0.571016048	0	0	3.872712761	0	0	0	0	0	0	0	0	0	0	0	0.308588161	0.00842289	1.140644253	0	0	0	0	0	70.8886	0	15.857	18.0657	0.418433062	1.997882368	0	1.580213593	3.374306077	1.702726746	1.756499981	8.405638019	2.607810027	3.395505596	0	0.036708583	4.420492905	5.57365224	11.50882876	0.142754012	0.571016048	0	0	3.872712761	0	0	0	0	0	0	0	0	0	0	0	0.308588161	0.00842289	1.140644253	0	0	0	0	0	70.8886	6000																																																																																	0	0	0	18.0657	0.418433062	1.997882368	0	1.580213593	3.374306077	1.702726746	1.756499981	8.405638019	2.607810027	3.395505596	0	0.036708583	4.420492905	5.57365224	11.50882876	0.142754012	0.571016048	0	0	3.872712761	0	0	0	0	0	0	0	0	0	0	0	0.308588161	0.00842289	1.140644253	0	0	0	0	0	70.8886
H1804_279_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1612.598286	54.584236	715.989611	238.526854	231.015243	22.877619	11.544399	543.028395	381.758546	1953.014822	1043.334358	0	0.248879	1163.049453	5743.717058	5929.993937	56.340647	1004.901585			26.256789								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947952	114.991661	43.132799	0	99.999998	0.2	0.2	49.999993	91.015141	77.419437	70.072332	0	0.2	92.025025	14.999999	30	94.608072	59.060004			0.199999								0		0	0	0	0							109.6002	91.361335	34.269181	0	79.450398	0.1589	0.1589	39.725194	72.311893	61.510052	55.672748	0	0.158901	73.114251	11.917559	23.83512	75.166491	46.923409			0.1589								0		0	0	0	0							14.7284	0.415574056	2.044698131	0	1.529521083	3.635253659	1.834405001	1.797659028	2.300473594	10.01083694	4.840440899	0	0.039547122	7.086290803	5.704257243	11.77850976	0.352910728	3.929450673	0	0	4.172203772	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2005	0	19.709	14.7284	0.415574056	2.044698131	0	1.529521083	3.635253659	1.834405001	1.797659028	2.300473594	10.01083694	4.840440899	0	0.039547122	7.086290803	5.704257243	11.77850976	0.352910728	3.929450673	0	0	4.172203772	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2005	6000																																																																																	0	0	0	14.7284	0.415574056	2.044698131	0	1.529521083	3.635253659	1.834405001	1.797659028	2.300473594	10.01083694	4.840440899	0	0.039547122	7.086290803	5.704257243	11.77850976	0.352910728	3.929450673	0	0	4.172203772	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2005
H1804_280_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		277.565631	6.428891	676.07699	225.230248	9.552583	20.398092	10.293191	512.757442	42.260651	12.611624	16.815499	0	0.221906	23.101072	5423.535316	5599.428248	0.690372	2.761489			23.41102								0.05		0	416.418266	316.625246	4.09783	554.961415	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000009	950.000241	43.132797	0	0.2	0.199999	0.2	49.999992	0.240475	0.25	0.244134	0	0.199999	0.231352	14.999999	29.999998	0.25	0.249999			0.199999								0		0	0	14.225498	30.001244	30.00001	0	0	0	0		738.261157	738.261337	33.51923	0	0.155423	0.155423	0.155423	38.855843	0.186877	0.194279	0.189721	0	0.155422	0.179787	11.656754	23.313508	0.194279	0.194279			0.155423								0		0	0	11.054876	23.314477	23.313517	0	0	0	0		17.0763	0.395516805	1.88846501	0	1.484691108	3.170332653	1.599798625	1.660301889	7.897543677	2.450173699	3.190253286	0	0.034489074	4.153272432	5.268401416	10.87852627	0.134124782	0.536499321	0	0	3.638610961	0	0	0	0	0	0	0	0	0	0	0	0.291687736	0.007961564	1.078175199	0	0	0	0	0	66.8352	0	19.1688	17.0763	0.395516805	1.88846501	0	1.484691108	3.170332653	1.599798625	1.660301889	7.897543677	2.450173699	3.190253286	0	0.034489074	4.153272432	5.268401416	10.87852627	0.134124782	0.536499321	0	0	3.638610961	0	0	0	0	0	0	0	0	0	0	0	0.291687736	0.007961564	1.078175199	0	0	0	0	0	66.8352	5000																																																																																	0	0	0	17.0763	0.395516805	1.88846501	0	1.484691108	3.170332653	1.599798625	1.660301889	7.897543677	2.450173699	3.190253286	0	0.034489074	4.153272432	5.268401416	10.87852627	0.134124782	0.536499321	0	0	3.638610961	0	0	0	0	0	0	0	0	0	0	0	0.291687736	0.007961564	1.078175199	0	0	0	0	0	66.8352
H1804_281_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		277.565352	6.428885	676.076314	225.230023	218.13715	20.398072	10.293181	512.756929	360.47717	1844.142764	985.173019	0	0.221905	1098.214518	5423.529879	5599.422635	53.199902	948.882703			23.410996								0.05		0.06	1.22	2.07	2.7							$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							950.000012	949.999261	43.132805	0	100.000022	0.199999	0.199999	49.999995	91.015128	77.419437	70.072333	0	0.2	92.025026	14.999999	30	94.608219	59.059995			0.199999								0		0	0	0	0							716.775959	716.775392	32.543744	0	75.450117	0.1509	0.1509	37.725046	68.671005	58.413043	52.869645	0	0.1509	69.432974	11.317514	22.63503	71.381996	44.560825			0.1509								0		0	0	0	0							16.5793	0.384005547	1.833504541	0	1.371539457	3.078069065	1.553241013	1.611981561	2.062860795	8.976832548	4.340478982	0	0.033485465	6.35435834	5.115072945	10.56192494	0.316459599	3.523583006	0	0	3.532719296	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2295	0	23.1766	16.5793	0.384005547	1.833504541	0	1.371539457	3.078069065	1.553241013	1.611981561	2.062860795	8.976832548	4.340478982	0	0.033485465	6.35435834	5.115072945	10.56192494	0.316459599	3.523583006	0	0	3.532719296	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2295	5000																																																																																	0	0	0	16.5793	0.384005547	1.833504541	0	1.371539457	3.078069065	1.553241013	1.611981561	2.062860795	8.976832548	4.340478982	0	0.033485465	6.35435834	5.115072945	10.56192494	0.316459599	3.523583006	0	0	3.532719296	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2295
H1804_282_0	2009	2	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		255.235764	5.911695	621.687299	207.110709	200.588444	17.248093	8.703653	471.506639	331.477488	1695.785096	905.917782	0	0.187637	1009.865313	4987.217537	5148.960064	48.920075	872.54695			19.795746								0.05		0.06	1.22	2.07	2.7							$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							950.000016	949.999619	43.132803	0	99.999978	0.2	0.2	50	91.015158	77.419432	70.072345	0	0.199997	92.025028	15	30.000001	94.608031	59.059996			0.2								0		0	0	0	0							738.251662	738.251354	33.518803	0	77.710682	0.155421	0.155421	38.85535	70.728516	60.163183	54.45371	0	0.155419	71.513293	11.656605	23.313211	73.520563	45.895936			0.155421								0		0	0	0	0							15.7024	0.36369307	1.736517842	0	1.298988732	2.680715862	1.352730453	1.526712957	1.953742568	8.501985755	4.110882015	0	0.029162355	6.018232835	4.844502073	10.0032327	0.299719288	3.337196581	0	0	3.076674639	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.837	0	19.1705	15.7024	0.36369307	1.736517842	0	1.298988732	2.680715862	1.352730453	1.526712957	1.953742568	8.501985755	4.110882015	0	0.029162355	6.018232835	4.844502073	10.0032327	0.299719288	3.337196581	0	0	3.076674639	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.837	5000																																																																																	0	0	0	15.7024	0.36369307	1.736517842	0	1.298988732	2.680715862	1.352730453	1.526712957	1.953742568	8.501985755	4.110882015	0	0.029162355	6.018232835	4.844502073	10.0032327	0.299719288	3.337196581	0	0	3.076674639	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.837
H1804_283_0	2009	4	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		265.016811	6.138241	645.51136	215.047525	8.708363	18.595387	9.383519	489.575533	38.525818	11.497057	15.32941	0	0.202294	21.059488	5178.33576	5346.276521	0.62936	2.51744			21.342045								0.05		0	397.591879	302.310529	3.912565	529.871454	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.00002	949.999845	43.132799	0	0.2	0.199999	0.199999	49.999998	0.240475	0.249999	0.244134	0	0.2	0.231352	15	30.000001	0.25	0.25			0.2								0		0	0	14.225518	29.998734	30.000008	0	0	0	0		753.082116	753.081977	34.192146	0	0.158543	0.158543	0.158543	39.635898	0.190629	0.198179	0.19353	0	0.158544	0.183397	11.89077	23.781541	0.198179	0.198179			0.158543								0		0	0	11.276824	23.780537	23.781546	0	0	0	0		16.6316	0.385216556	1.839284889	0	1.380649995	2.948168441	1.487691253	1.617063824	7.34413816	2.278475259	2.966700717	0	0.0320725	3.862246921	5.131199959	10.59522452	0.124725935	0.498903742	0	0	3.38363184	0	0	0	0	0	0	0	0	0	0	0	0.284091886	0.007753575	1.050096863	0	0	0	0	0	63.849	0	16.6954	16.6316	0.385216556	1.839284889	0	1.380649995	2.948168441	1.487691253	1.617063824	7.34413816	2.278475259	2.966700717	0	0.0320725	3.862246921	5.131199959	10.59522452	0.124725935	0.498903742	0	0	3.38363184	0	0	0	0	0	0	0	0	0	0	0	0.284091886	0.007753575	1.050096863	0	0	0	0	0	63.849	5000																																																																																	0	0	0	16.6316	0.385216556	1.839284889	0	1.380649995	2.948168441	1.487691253	1.617063824	7.34413816	2.278475259	2.966700717	0	0.0320725	3.862246921	5.131199959	10.59522452	0.124725935	0.498903742	0	0	3.38363184	0	0	0	0	0	0	0	0	0	0	0	0.284091886	0.007753575	1.050096863	0	0	0	0	0	63.849
H1804_284_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000											A	A	D	V	T	Coin	Coin	V	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							0		268.935774	6.22901	655.056926	218.227563	211.355209	19.149428	9.663097	496.815183	349.26984	1786.807888	954.543733	0	5.833992	1064.070743	5254.910933	5425.335137	51.545903	919.381693			21.977921								0.05		0.06	1.22	2.07	2.7							$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	$50/Proc:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							950.00001	950.00008	43.132807	0	99.999976	0.2	0.199999	49.999993	91.01513	77.419436	70.072326	0	49.999382	92.025028	15	30	94.608023	59.059996			0.199999								0		0	0	0	0							725.066607	725.066661	32.920166	0	76.322782	0.152645	0.152645	38.161395	69.465295	59.088681	53.481161	0	38.160929	70.236078	11.44842	22.89684	72.207492	45.076243			0.152645								0		0	0	0	0							16.2497	0.376370624	1.797048562	0	1.344268128	2.923064437	1.475023442	1.579930037	2.021844373	8.798343442	4.254175589	0	0.018552546	6.228012975	5.013368952	10.35191921	0.310166698	3.453522717	0	0	3.354819751	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.5501	0	21.5762	16.2497	0.376370624	1.797048562	0	1.344268128	2.923064437	1.475023442	1.579930037	2.021844373	8.798343442	4.254175589	0	0.018552546	6.228012975	5.013368952	10.35191921	0.310166698	3.453522717	0	0	3.354819751	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.5501	5000																																																																																	0	0	0	16.2497	0.376370624	1.797048562	0	1.344268128	2.923064437	1.475023442	1.579930037	2.021844373	8.798343442	4.254175589	0	0.018552546	6.228012975	5.013368952	10.35191921	0.310166698	3.453522717	0	0	3.354819751	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.5501
H1804_285_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		266.85772	6.180879	649.995331	216.541328	8.82975	18.854591	9.514317	492.976315	39.062835	11.657316	15.543088	0	0.205114	21.35304	5214.306482	5383.413827	0.638133	2.552531			21.639534								0.05		0	400.353706	304.410494	3.939744	533.552145	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999992	950.0008	43.132795	0	0.2	0.199999	0.199999	50	0.240475	0.25	0.244134	0	0.199996	0.231352	14.999999	29.999998	0.249999	0.25			0.2								0		0	0	14.225501	29.998903	29.999991	0	0	0	0		750.952194	750.952833	34.09544	0	0.158095	0.158095	0.158095	39.5238	0.19009	0.197619	0.192982	0	0.158092	0.182878	11.857139	23.714279	0.197618	0.197619			0.158095								0		0	0	11.244917	23.713413	23.714273	0	0	0	0		16.6998	0.386795716	1.846823067	0	1.395939326	2.980816564	1.504165946	1.62369144	7.425454305	2.303707131	2.999536208	0	0.032426882	3.905001249	5.152229729	10.63864812	0.126106567	0.504428624	0	0	3.421102128	0	0	0	0	0	0	0	0	0	0	0	0.285255895	0.007785398	1.054400102	0	0	0	0	0	64.2941	0	17.0418	16.6998	0.386795716	1.846823067	0	1.395939326	2.980816564	1.504165946	1.62369144	7.425454305	2.303707131	2.999536208	0	0.032426882	3.905001249	5.152229729	10.63864812	0.126106567	0.504428624	0	0	3.421102128	0	0	0	0	0	0	0	0	0	0	0	0.285255895	0.007785398	1.054400102	0	0	0	0	0	64.2941	5000																																																																																	0	0	0	16.6998	0.386795716	1.846823067	0	1.395939326	2.980816564	1.504165946	1.62369144	7.425454305	2.303707131	2.999536208	0	0.032426882	3.905001249	5.152229729	10.63864812	0.126106567	0.504428624	0	0	3.421102128	0	0	0	0	0	0	0	0	0	0	0	0.285255895	0.007785398	1.054400102	0	0	0	0	0	64.2941
H1804_286_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		272.301796	6.306972	663.255671	220.958917	9.19388	19.632136	9.906677	503.033363	40.673747	12.138052	16.18407	0	0.213572	22.233618	5320.681832	5493.239078	0.664448	2.657794			22.531926								0.05		0	408.52119	310.620673	4.020117	544.436969	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.00002	950.000053	43.132796	0	0.2	0.199999	0.199999	49.999991	0.240475	0.249999	0.244134	0	0.199997	0.231352	14.999999	30	0.249999	0.25			0.2								0		0	0	14.225505	29.999127	29.99999	0	0	0	0		783.735766	783.735794	35.58391	0	0.164997	0.164996	0.164996	41.249243	0.198388	0.206246	0.201407	0	0.164995	0.190862	12.374774	24.74955	0.206246	0.206246			0.164997								0		0	0	11.735828	24.748829	24.749542	0	0	0	0		17.7844	0.411916642	1.966769175	0	1.516962618	3.239223911	1.634562078	1.729145452	8.06918332	2.503424673	3.259584986	0	0.035238312	4.243552799	5.486852933	11.3295996	0.137039742	0.548159381	0	0	3.717700194	0	0	0	0	0	0	0	0	0	0	0	0.303782566	0.008291099	1.122880469	0	0	0	0	0	69.0483	0	14.6481	17.7844	0.411916642	1.966769175	0	1.516962618	3.239223911	1.634562078	1.729145452	8.06918332	2.503424673	3.259584986	0	0.035238312	4.243552799	5.486852933	11.3295996	0.137039742	0.548159381	0	0	3.717700194	0	0	0	0	0	0	0	0	0	0	0	0.303782566	0.008291099	1.122880469	0	0	0	0	0	69.0483	6000																																																																																	0	0	0	17.7844	0.411916642	1.966769175	0	1.516962618	3.239223911	1.634562078	1.729145452	8.06918332	2.503424673	3.259584986	0	0.035238312	4.243552799	5.486852933	11.3295996	0.137039742	0.548159381	0	0	3.717700194	0	0	0	0	0	0	0	0	0	0	0	0.303782566	0.008291099	1.122880469	0	0	0	0	0	69.0483
H1804_287_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	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							0		1528.423854	51.735049	678.616374	226.076226	218.956704	20.563614	10.376716	514.683389	361.831504	1851.071322	988.874378	0	6.043816	1102.340579	5443.90642	5620.460015	53.399778	952.447713			23.60099								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	$50/Proc:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947951	114.991599	43.132805	0	99.999989	0.2	0.199999	49.999997	91.015126	77.419435	70.072338	0	50.000862	92.025018	14.999999	29.999999	94.608033	59.059997			0.2								0		0	0	0	0							111.493535	92.939545	34.861184	0	80.822891	0.161645	0.161645	40.411447	73.561064	62.572632	56.634495	0	40.412147	74.377288	12.123434	24.246869	76.464956	47.734003			0.161645								0		0	0	0	0							14.2008	0.400685993	1.971447523	0	1.474726152	3.324005385	1.677344258	1.733258375	2.218059202	9.652200386	4.667033418	0	0.020353632	6.832425227	5.499903349	11.35654648	0.34026764	3.788678499	0	0	3.814982029	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9727	0	17.3145	14.2008	0.400685993	1.971447523	0	1.474726152	3.324005385	1.677344258	1.733258375	2.218059202	9.652200386	4.667033418	0	0.020353632	6.832425227	5.499903349	11.35654648	0.34026764	3.788678499	0	0	3.814982029	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9727	6000																																																																																	0	0	0	14.2008	0.400685993	1.971447523	0	1.474726152	3.324005385	1.677344258	1.733258375	2.218059202	9.652200386	4.667033418	0	0.020353632	6.832425227	5.499903349	11.35654648	0.34026764	3.788678499	0	0	3.814982029	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9727
H1804_288_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		276.581097	6.406089	673.678925	224.431348	9.484922	20.253612	10.220285	510.938677	41.961319	12.522296	16.696394	0	0.220333	22.937447	5404.297869	5579.5669	0.685482	2.74193			23.245199								0.05		0	414.941217	315.502167	4.083295	552.992951	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000021	950.000538	43.132808	0	0.199999	0.199999	0.2	49.999996	0.240475	0.25	0.244134	0	0.200001	0.231352	14.999999	29.999999	0.25	0.25			0.2								0		0	0	14.225512	29.999302	29.999991	0	0	0	0		779.213767	779.214191	35.378607	0	0.164044	0.164044	0.164045	41.011247	0.197244	0.205056	0.200245	0	0.164046	0.189761	12.303374	24.606749	0.205056	0.205056			0.164045								0		0	0	11.66812	24.606177	24.606743	0	0	0	0		17.9596	0.415976288	1.986151828	0	1.555944545	3.322483527	1.676586653	1.746186024	8.276618405	2.567771929	3.343369417	0	0.036144747	4.35263288	5.540924824	11.44125019	0.140562197	0.562249198	0	0	3.81325867	0	0	0	0	0	0	0	0	0	0	0	0.306776429	0.008372857	1.133946286	0	0	0	0	0	70.1869	0	15.3834	17.9596	0.415976288	1.986151828	0	1.555944545	3.322483527	1.676586653	1.746186024	8.276618405	2.567771929	3.343369417	0	0.036144747	4.35263288	5.540924824	11.44125019	0.140562197	0.562249198	0	0	3.81325867	0	0	0	0	0	0	0	0	0	0	0	0.306776429	0.008372857	1.133946286	0	0	0	0	0	70.1869	6000																																																																																	0	0	0	17.9596	0.415976288	1.986151828	0	1.555944545	3.322483527	1.676586653	1.746186024	8.276618405	2.567771929	3.343369417	0	0.036144747	4.35263288	5.540924824	11.44125019	0.140562197	0.562249198	0	0	3.81325867	0	0	0	0	0	0	0	0	0	0	0	0.306776429	0.008372857	1.133946286	0	0	0	0	0	70.1869
H1804_289_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	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							0		1590.380452	53.832193	706.124949	235.240511	227.832392	22.256145	11.230793	535.546733	376.498803	1926.106845	1028.959652	0	6.288809	1147.025352	5664.582069	5848.292486	55.564405	991.056389			25.543519								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	$50/Proc:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.94795	114.991562	43.132808	0	99.999985	0.199999	0.2	50.000006	91.01511	77.419437	70.072333	0	50.001198	92.025034	15	29.999999	94.608049	59.059997			0.2								0		0	0	0	0							110.088948	91.768671	34.422008	0	79.804688	0.159609	0.159609	39.902355	72.634335	61.784349	55.921015	0	39.903306	73.440302	11.970705	23.941409	75.501669	47.132653			0.159609								0		0	0	0	0							14.5903	0.411675734	2.025519887	0	1.515174413	3.552281047	1.79253564	1.780797988	2.278895015	9.916938127	4.795039011	0	0.020912022	7.019824021	5.650753408	11.6680302	0.349600443	3.892593074	0	0	4.076975524	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.3378	0	19.0649	14.5903	0.411675734	2.025519887	0	1.515174413	3.552281047	1.79253564	1.780797988	2.278895015	9.916938127	4.795039011	0	0.020912022	7.019824021	5.650753408	11.6680302	0.349600443	3.892593074	0	0	4.076975524	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.3378	6000																																																																																	0	0	0	14.5903	0.411675734	2.025519887	0	1.515174413	3.552281047	1.79253564	1.780797988	2.278895015	9.916938127	4.795039011	0	0.020912022	7.019824021	5.650753408	11.6680302	0.349600443	3.892593074	0	0	4.076975524	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.3378
H1804_801_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		312.656608	7.241657	761.549395	253.704772	12.120629	25.881764	13.060336	35.367165	75.3488	2077.28888	36.540335	0	0.281561	29.311393	55.158423	77.356267	0.891894	8.297967			29.704664																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000017	1024.000446	43.132797	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				1024.000017	1024.000446	43.132797	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167	0	0	26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167																																																																																		0	0	0	26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167
H1804_804_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		333.556094	7.725726	812.455054	270.66363	13.795181	29.457515	14.864715	40.253393	85.758777	2216.144953	41.588644	0	0.320461	33.360972	62.778954	88.04359	1.015116	9.44439			33.808578																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999987	1024.000074	43.132793	0	0.199999	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.2	0.5	0.2			0.199999																				1023.999987	1024.000074	43.132793	0	0.199999	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.2	0.5	0.2			0.199999																				28.4635	0.659262	2.920287972	0	2.759022405	5.891503	2.972943	8.0506786	17.1517554	0	8.3177288	0	0.06409188	6.672161039	12.5557908	17.608718	0.507558	1.888878	0	0	6.761681791	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.2455	0	0	28.4635	0.659262	2.920287972	0	2.759022405	5.891503	2.972943	8.0506786	17.1517554	0	8.3177288	0	0.06409188	6.672161039	12.5557908	17.608718	0.507558	1.888878	0	0	6.761681791	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.2455																																																																																		0	0	0	28.4635	0.659262	2.920287972	0	2.759022405	5.891503	2.972943	8.0506786	17.1517554	0	8.3177288	0	0.06409188	6.672161039	12.5557908	17.608718	0.507558	1.888878	0	0	6.761681791	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.2455
H1804_805_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		312.656608	7.241657	761.549395	253.704772	12.120629	25.881764	13.060336	35.367165	75.3488	2077.28888	36.540335	0	0.281561	29.311393	55.158423	77.356267	0.891894	8.297967			29.704664																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000017	1024.000446	43.132797	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				1024.000017	1024.000446	43.132797	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167	0	0	26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167																																																																																		0	0	0	26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167
H1804_806_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		312.656608	7.241657	761.549395	253.704772	12.120629	25.881764	13.060336	35.367165	75.3488	2077.28888	36.540335	0	0.281561	29.311393	55.158423	77.356267	0.891894	8.297967			29.704664																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000017	1024.000446	43.132797	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				1024.000017	1024.000446	43.132797	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167	0	0	26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167																																																																																		0	0	0	26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167
H1804_807_0	2009	5																																			V	Coin	Coin	Coin	Coin	Coin	V	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					253.704772	12.120629	25.881764	13.060336	35.367165	75.3488	2077.28888	36.540335	0	0.281561	29.311393	55.158423	77.356267	0.891894	8.297967			29.704664																							$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																							0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																							0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317	0	0	0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317																																																																																		0	0	0	0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317
H1804_808_0	2009	5																																			V	Coin	Coin	Coin	Coin	Coin	V	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					253.704772	12.120629	25.881764	13.060336	35.367165	75.3488	2077.28888	36.540335	0	0.281561	29.311393	55.158423	77.356267	0.891894	8.297967			29.704664																							$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																							0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																							0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317	0	0	0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317																																																																																		0	0	0	0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317
H1804_809_0	2009	5																																			V	Coin	Coin	Coin	Coin	Coin	V	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					253.704772	12.120629	25.881764	13.060336	35.367165	75.3488	2077.28888	36.540335	0	0.281561	29.311393	55.158423	77.356267	0.891894	8.297967			29.704664																							$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																							0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																							0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317	0	0	0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317																																																																																		0	0	0	0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317
H1804_810_0	2009	5																																			V	Coin	Coin	Coin	Coin	Coin	V	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					253.704772	12.120629	25.881764	13.060336	35.367165	75.3488	2077.28888	36.540335	0	0.281561	29.311393	55.158423	77.356267	0.891894	8.297967			29.704664																							$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																							0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																							0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317	0	0	0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317																																																																																		0	0	0	0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317
H1806_001_0	2009	7	r.	s.	t.	u.	v.						OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered						4700	Renal Dialysis										D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin					O	O	P	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		1469.236816	65.418241	512.78464	732.885271	145.771565	9.967273	3.599511	329.724532	357.410789	631.89364	937.866135	0	0	717.459673	3511.355657	4232.653245	28.87412	912.322675			22.527764			3.14					1.58	0.09	19.226019	0.06	0.05	1.23	2.7						$175/Day(Days 1-5):1a	$175/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$175/Visit:9b. $0 Surgery ASC -- Physician,9b. $125 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $175 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $50 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$35-$100/Visit:9d. $50 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $35 Partial Hospitalization,8b. $100 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$100/Visit:7h. $100 Psych -- OP,7e. $35 Psych -- Other Provider"	"$35-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			"Dental 767 16a, 16b"					$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	$0/Proc:12	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0: Health Education Materials 14a	$0 Corp Health 14a						107.292846	89.43799	43.132797	0	99.999996	0.2	0.2	49.999992	152.313174	87.957391	83.490132	0	0	73.563649	10	35.000001	89.854998	43.629905			0.2			0					0	0	0	0	0	0	0						93.254221	77.735565	37.489129	0	86.915597	0.173831	0.173831	43.457793	132.383909	76.448694	72.565949	0	0	63.938287	8.69156	30.42046	78.09801	37.921194			0.173831			0					0	0	0	0	0	0	0						11.4177	0.423776994	1.60198746	0	1.05581855	1.732621033	0.625706597	1.194091705	3.942953114	4.025620294	5.671428843	0	0	3.822761874	2.543263198	10.72993823	0.187917609	2.883030429	0	0	3.916023744	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.7747	0	8.3964	11.4177	0.423776994	1.60198746	0	1.05581855	1.732621033	0.625706597	1.194091705	3.942953114	4.025620294	5.671428843	0	0	3.822761874	2.543263198	10.72993823	0.187917609	2.883030429	0	0	3.916023744	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.7747		30% Coins	30% Coins	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins			30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins			"Dental 767 16a, 16b"					0	0		0	0	0	0						7.4047	0.106	0.4642	0.7042	0.8287	1.9398	0.7005	0.2481	3.3523	0.4319	1.7963			1.0146	2.0343	4.6447	0.0294	0.3922			1.3864			0					0	0		0	0	0	0						27.4782	500	0	18.8224	0.529743994	2.06615046	0.704184	1.88449955	3.672458033	1.326245597	1.442176705	7.295266114	4.457475294	7.467746843	0	0	4.837386874	4.577610198	15.37459023	0.217270609	3.275214429	0	0	5.302412744	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.2528
H1806_002_0	2009	7	r.	s.	t.	u.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered							3600											D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			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		1329.876957	59.213199	464.146058	663.369733	131.944859	8.17892	2.953677	298.449545	323.509708	571.957346	848.90778	0	17.679031	649.407282	3178.297008	3831.178171	26.135354	825.787162			18.485776			6.43	2.69				1.58	0.09	0.06	0.05	1.23	2.7							$175/Day(Days 1-5):1a	$175/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$75/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $50 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$50/Visit:9a	"$0-$100/Proc:12. $0 Dialysis -- Dialysis Center,12. $100 Dialysis -- OP Hosp"	"$25-$100/Visit:9d. $50 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $25 Partial Hospitalization,8b. $100 Rad therapy,3. $25 Therapy (AT,PT,ST,OT) -- CORF"	$5/Visit:7a	"$25/Visit:7b, 7d, 7f"	"$25-$100/Visit:7h. $100 Psych -- OP,7e. $25 Psych -- Other Provider"	"$25-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $25 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			"Dental 750 16a, 16b"	VIS752				$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0: Health Education Materials 14a	$0 Corp Health 14a							107.292849	89.438032	43.13281	0	74.999966	0.199999	0.2	50.000009	127.313174	87.957391	83.490143	0	1.564565	69.968676	4.999998	24.999999	88.293733	35.787395			0.199999			0	0				0	0	0	0	0	0							90.168159	75.163096	36.248512	0	63.029446	0.168078	0.168078	42.019657	106.9931	73.918775	70.164531	0	1.314849	58.801185	4.201963	21.009824	74.201435	30.075476			0.168078			0	0				0	0	0	0	0	0							9.9927	0.37088728	1.402050329	0	0.69303428	1.374696516	0.496448123	1.045062293	2.884442212	3.523198864	4.963601354	0	0.001937105	3.182159811	1.112923869	6.707698257	0.161606731	2.069661831	0	0	3.107052259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.0892	0	8.1835	9.9927	0.37088728	1.402050329	0	0.69303428	1.374696516	0.496448123	1.045062293	2.884442212	3.523198864	4.963601354	0	0.001937105	3.182159811	1.112923869	6.707698257	0.161606731	2.069661831	0	0	3.107052259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.0892	6000	30% Coins	30% Coins	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$75/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$100/Proc	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins			"Dental 750 16a, 16b"	VIS752				0	0	0	0	0	0							5.5933	0.08	0.3506	0.5319	0.5179	1.4653	0.5292	0.2067	2.5323	0.3262	1.3569		0.0004	0.7664	1.5367	3.5085	0.0222	0.2962			1.0473			0	0				0	0	0	0	0	0							20.668	250	3.50201731	15.5861	0.45093228	1.752669329	0.531926	1.21089628	2.840010516	1.025620123	1.251773293	5.416710212	3.849413864	6.320501354	0	0.002320105	3.948586811	2.649628869	10.21617426	0.183778731	2.365908831	0	0	4.154302259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.7572
H1806_801_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		263.948289	8.504368	512.784459	732.885011	5.050292	9.967269	3.59951	22.16022	56.963097	631.893417	30.800945	0	0.388666	17.547194	33.056576	75.472029	0.476961	6.372678			22.527755																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999985	1023.999902	43.132789	0	0.199999	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.2	0.199999	0.199999	0.500001	0.2			0.2																				1023.999985	1023.999902	43.132789	0	0.199999	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.2	0.199999	0.199999	0.500001	0.2			0.2																				22.5236	0.725706	1.843151989	0	1.01005335	1.9934538	0.719902	4.432044	11.3926194	0	6.160189	0	0.077732811	3.5094388	6.611282143	15.09433033	0.238480977	1.2745356	0	0	4.505551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1121	0	0	22.5236	0.725706	1.843151989	0	1.01005335	1.9934538	0.719902	4.432044	11.3926194	0	6.160189	0	0.077732811	3.5094388	6.611282143	15.09433033	0.238480977	1.2745356	0	0	4.505551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1121		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.5026	0.0806	0.2048		0.6404	1.2638	0.4564	0.8348	2.1841		1.1703		0.0146	0.661	1.3254	3.026	0.0478	0.2555			0.9032																				15.5715	0	0	25.0262	0.80634	2.047946989	0	1.65041735	3.2572778	1.17631	5.266864	13.5766844	0	7.330508	0	0.092374811	4.1704778	7.936680143	18.12036933	0.286290977	1.5300466	0	0	5.408798	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.6836
H1806_803_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		263.948289	8.504368	512.784459	732.885011	5.050292	9.967269	3.59951	22.16022	56.963097	631.893417	30.800945	0	0.388666	17.547194	33.056576	75.472029	0.476961	6.372678			22.527755																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999985	1023.999902	43.132789	0	0.199999	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.2	0.199999	0.199999	0.500001	0.2			0.2																				1023.999985	1023.999902	43.132789	0	0.199999	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.2	0.199999	0.199999	0.500001	0.2			0.2																				22.5236	0.725706	1.843151989	0	1.01005335	1.9934538	0.719902	4.432044	11.3926194	0	6.160189	0	0.077732811	3.5094388	6.611282143	15.09433033	0.238480977	1.2745356	0	0	4.505551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1121	0	0	22.5236	0.725706	1.843151989	0	1.01005335	1.9934538	0.719902	4.432044	11.3926194	0	6.160189	0	0.077732811	3.5094388	6.611282143	15.09433033	0.238480977	1.2745356	0	0	4.505551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1121		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.5026	0.0806	0.2048		0.6404	1.2638	0.4564	0.8348	2.1841		1.1703		0.0146	0.661	1.3254	3.026	0.0478	0.2555			0.9032																				15.5715	0	0	25.0262	0.80634	2.047946989	0	1.65041735	3.2572778	1.17631	5.266864	13.5766844	0	7.330508	0	0.092374811	4.1704778	7.936680143	18.12036933	0.286290977	1.5300466	0	0	5.408798	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.6836
H1806_804_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		263.948289	8.504368	512.784459	732.885011	5.050292	9.967269	3.59951	22.16022	56.963097	631.893417	30.800945	0	0.388666	17.547194	33.056576	75.472029	0.476961	6.372678			22.527755																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999985	1023.999902	43.132789	0	0.199999	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.2	0.199999	0.199999	0.500001	0.2			0.2																				1023.999985	1023.999902	43.132789	0	0.199999	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.2	0.199999	0.199999	0.500001	0.2			0.2																				22.5236	0.725706	1.843151989	0	1.01005335	1.9934538	0.719902	4.432044	11.3926194	0	6.160189	0	0.077732811	3.5094388	6.611282143	15.09433033	0.238480977	1.2745356	0	0	4.505551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1121	0	0	22.5236	0.725706	1.843151989	0	1.01005335	1.9934538	0.719902	4.432044	11.3926194	0	6.160189	0	0.077732811	3.5094388	6.611282143	15.09433033	0.238480977	1.2745356	0	0	4.505551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1121		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.5026	0.0806	0.2048		0.6404	1.2638	0.4564	0.8348	2.1841		1.1703		0.0146	0.661	1.3254	3.026	0.0478	0.2555			0.9032																				15.5715	0	0	25.0262	0.80634	2.047946989	0	1.65041735	3.2572778	1.17631	5.266864	13.5766844	0	7.330508	0	0.092374811	4.1704778	7.936680143	18.12036933	0.286290977	1.5300466	0	0	5.408798	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.6836
H1806_805_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		263.948289	8.504368	512.784459	732.885011	5.050292	9.967269	3.59951	22.16022	56.963097	631.893417	30.800945	0	0.388666	17.547194	33.056576	75.472029	0.476961	6.372678			22.527755																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999985	1023.999902	43.132789	0	0.199999	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.2	0.199999	0.199999	0.500001	0.2			0.2																				1023.999985	1023.999902	43.132789	0	0.199999	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.2	0.199999	0.199999	0.500001	0.2			0.2																				22.5236	0.725706	1.843151989	0	1.01005335	1.9934538	0.719902	4.432044	11.3926194	0	6.160189	0	0.077732811	3.5094388	6.611282143	15.09433033	0.238480977	1.2745356	0	0	4.505551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1121	0	0	22.5236	0.725706	1.843151989	0	1.01005335	1.9934538	0.719902	4.432044	11.3926194	0	6.160189	0	0.077732811	3.5094388	6.611282143	15.09433033	0.238480977	1.2745356	0	0	4.505551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1121		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.5026	0.0806	0.2048		0.6404	1.2638	0.4564	0.8348	2.1841		1.1703		0.0146	0.661	1.3254	3.026	0.0478	0.2555			0.9032																				15.5715	0	0	25.0262	0.80634	2.047946989	0	1.65041735	3.2572778	1.17631	5.266864	13.5766844	0	7.330508	0	0.092374811	4.1704778	7.936680143	18.12036933	0.286290977	1.5300466	0	0	5.408798	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.6836
H1807_001_0	2009	4																					none											coin	coin	D	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	V											0	0	0	0	0	0	0	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	349.7112925	35.98578618	931.0101961	27.87828912	26.9835701	42.62433291	7.423314891	45.03864515	40.75674666	6.618946987	24.11696788	0	0.099239403	24.70054409	50.95327465	116.0751808	6.608065255	1.49194241	23.4879226	24.7314529	16.01597218	1.06223913	0	0	0	0	0	0	0	0											Medicare cost sharing less Part B deductible	Medicare cost sharing less Part B deductible	Medicare cost sharing less Part B deductible	Medicare cost sharing less Part B deductible	Medicare cost sharing less Part B deductible	Medicare cost sharing less Part B deductible	Medicare cost sharing less Part B deductible	Medicare cost sharing less Part B deductible	Medicare cost sharing less Part B deductible	Medicare cost sharing less Part B deductible	Medicare cost sharing less Part B deductible	Medicare cost sharing less Part B deductible	Medicare cost sharing less Part B deductible	Medicare cost sharing less Part B deductible	Medicare cost sharing less Part B deductible	Medicare cost sharing less Part B deductible	Medicare cost sharing less Part B deductible	Medicare cost sharing less Part B deductible	Medicare cost sharing less Part B deductible	Medicare cost sharing less Part B deductible	Medicare cost sharing less Part B deductible	Medicare cost sharing less Part B deductible																			0.07789407	0.07789407	133	0	0.20647889	0.20647889	0.20647889	0.20647889	0.20647889	0.20647889	0.20647889	0	0.20647889	0.20647889	0.20647889	0.20647889	0.20647889	0.20647889	0.20647889	0.20647889	0.20647889	0.20647889	0	0	0	0	0	0	0	0											0.07789407	0.07789407	133	0	0.20647889	0.20647889	0.20647889	0.20647889	0.20647889	0.20647889	0.20647889	0	0.20647889	0.20647889	0.20647889	0.20647889	0.20647889	0.20647889	0.20647889	0.20647889	0.20647889	0.20647889	0	0	0	0	0	0	0	0											27.2404	2.803079331	10.31869634	0	5.571537591	8.801024928	1.532757816	9.299529439	8.415407792	1.366672824	4.979644747	0	0.020490842	5.100140916	10.52077557	23.96707443	1.364425976	0.308054612	4.849760176	5.106522931	3.30696015	0.219329956	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.0923	0	0	27.2404	2.803079331	10.31869634	0	5.571537591	8.801024928	1.532757816	9.299529439	8.415407792	1.366672824	4.979644747	0	0.020490842	5.100140916	10.52077557	23.96707443	1.364425976	0.308054612	4.849760176	5.106522931	3.30696015	0.219329956	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.0923	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	27.2404	2.803079331	10.31869634	0	5.571537591	8.801024928	1.532757816	9.299529439	8.415407792	1.366672824	4.979644747	0	0.020490842	5.100140916	10.52077557	23.96707443	1.364425976	0.308054612	4.849760176	5.106522931	3.30696015	0.219329956	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.0923
H1837_001_0	2009	10																					2600											D	D	D	V	T	Coin	Coin	V	V	Coin	V	V	Coin	Coin	V	V	V	Coin	Coin	V	Coin	Coin	T	V	V	V	V	V	Coin	Coin																																																			0	0	1219.997276	4.614645622	1481.614735	1107.494029	178.2611041	6.992263315	2.336925474	689.8115922	310.2991634	23.4991265	826.3189584	39.07212297	0	32.43828989	6242.414756	9987.538383	279.1802437	4.035397324	0	151.5670359	18.7411609	0	199.6266302	325.138068	0	3.617898952	0	0	0.1008049	0											1a: $280 Days 1-7	1b: $275	2: $100 Days 4-22	6: none	10a: $175	11a: 30%	11b: 30%; 11c: 30%	4a: $50; 4b: $50	9b: $100	8a: 30%; 8a: $40; 8a: 30%; 8a: $40; 8a: 30%	8b: $15	5: $270	12: 20%	9a: 30%; 9a: 20%; 9a: $40; 9a: 30%; 9a: 20%; 9d: 30%	14c: $5; 7a: $5	7d: $25	7e: $35; 7h: $35	7c: 30%; 7i: 30%		7b: $25; 7f: $25	15: 20%		10b: none	16a: $20	17a: $20	17b: $20	18a. $25	18b. $0	14a: none												157.2976704	275	38.94018114	0	174.4425111	0.300390508	0.207275848	15.05845431	71.10484842	0.103227558	5.664292499	134.7770396	0	0.169403762	3.233820124	7.039464676	35	0.300390508	0	24.75666103	0.193733668	0	0	19.61904762	0	18.38153542	0	0	0	0											150.2152837	275	26.30632324	0	127.1455011	0.26221119	0.182646033	14.13796348	70.1351895	0.096966931	5.360854182	123.2858493	0	0.107447763	3.2306727	7.030751386	35	0.278704369	0	24.75666103	0.099571937	0	0	19.61904762	0	18.38153542	0	0	0	0											15.2719	0.105752296	3.247986344	0	1.888758118	1.833449686	0.426830166	0.812710925	1.813574219	2.278638168	0.369147954	0.401419989	0	3.485421693	1.680599911	5.851658278	0.814275711	1.124682865	0	0.312691144	1.866093685	0	0	0.531574936	0	0.005541878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.1227	0	7.4613	15.2719	0.105752296	3.247986344	0	1.888758118	1.833449686	0.426830166	0.812710925	1.813574219	2.278638168	0.369147954	0.401419989	0	3.485421693	1.680599911	5.851658278	0.814275711	1.124682865	0	0.312691144	1.866093685	0	0	0.531574936	0	0.005541878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.1227	0																																																																																	0		0	15.2719	0.105752296	3.247986344	0	1.888758118	1.833449686	0.426830166	0.812710925	1.813574219	2.278638168	0.369147954	0.401419989	0	3.485421693	1.680599911	5.851658278	0.814275711	1.124682865	0	0.312691144	1.866093685	0	0	0.531574936	0	0.005541878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.1227
H1837_002_0	2009	8																					1350											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	Coin	V	V	V	V	Coin	V	Coin	Coin	T	V	V	V	V	V	Coin	Coin																																																			0	0	1211.375032	4.582031943	1471.143528	1099.666894	177.0012565	6.73312538	1.829014618	684.9363979	308.1061461	15420.82965	820.479008	38.79598352	0	66.7432086	6198.296934	9916.952167	277.2071572	652.7505484	0	150.4958467	17.81954127	0	198.2157832	322.8401778	0	3.614212175	0	0	0.097069003	0											1a: $100 Days 1-5	1b: $275	2: $70 Days 11-27	6: none	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4b: $50	9b: $70	8a: $100; 8a: $40; 8a: $100; 8a: $40; 8a: $100	8b: $15	5: $100	12: 20%	9a: $100; 9a: 20%; 9a: $100; 9a: $40; 9a: $100; 9a: 20%; 9d: $25	14c: $10; 7a: $10	7d: $25	7e: $35; 7h: $35	7c: $25; 7i: $25		7b: $25; 7f: $25	15: 20%		10b: none	16a: $20	17a: $20	17b: $20	18a. $25	18b. $0	14a: none												46.41961299	275	20.46823681	0	100	0.200262055	0.1702058	15.05672303	49.82890776	2.067780973	5.664292499	31.95331773	0	0.086519247	0.7542501	7.035803452	35	22.87728882	0	24.75666103	0.221766401	0	0	19.61904762	0	18.35335597	0	0	0	0											44.84448274	275	15.18091197	0	79.48153819	0.176145529	0.157131272	14.28086138	49.16068859	1.946505863	5.481329961	29.07412253	0	0.059508372	0.75221099	7.027090162	35	21.69439528	0	24.75666103	0.089257446	0	0	19.61904762	0	18.35335597	0	0	0	0											4.527	0.105004899	1.861108366	0	1.172361011	1.186009929	0.287395394	0.815123479	1.262225858	2.501394611	0.374776347	0.093996598	0	3.971779688	0.38853559	5.807276418	0.808520875	1.180085701	0	0.310481222	1.590526749	0	0	0.527818068	0	0.005527744	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.7769	0	5.7719	4.527	0.105004899	1.861108366	0	1.172361011	1.186009929	0.287395394	0.815123479	1.262225858	2.501394611	0.374776347	0.093996598	0	3.971779688	0.38853559	5.807276418	0.808520875	1.180085701	0	0.310481222	1.590526749	0	0	0.527818068	0	0.005527744	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.7769	0																																																																																	0		0	4.527	0.105004899	1.861108366	0	1.172361011	1.186009929	0.287395394	0.815123479	1.262225858	2.501394611	0.374776347	0.093996598	0	3.971779688	0.38853559	5.807276418	0.808520875	1.180085701	0	0.310481222	1.590526749	0	0	0.527818068	0	0.005527744	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.7769
H1837_003_0	2009	5																					1250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	Coin	V	V	V	Coin	Coin	Coin	Coin	Coin	T	V	V	V	V	V	Coin	Coin																																																			0	0	1911.416749	7.229943138	2321.302904	1735.153577	279.2885418	10.95504841	3.012719939	1080.754406	486.1576578	24332.37544	1294.625757	61.21580085	0	99.45395805	9780.231772	15649.8033	437.402447	6.322412507	0	1.623406464	28.79726222	0	312.7627349	509.4063415	0	3.91354233	0	0	0.157934921	0											1a: $70 Days 1-4	1b: $70	2: $50 Days 4-13	6: none	10a: $125	11a: 30%	11b: 30%; 11c: 30%	4a: $50; 4b: $50	9b: $50	8a: $75; 8a: $40	8b: $15	5: $70	12: 20%	9a: $75; 9a: 20%; 9a: $40; 9d: 25%	7a: none	7d: none	7e: $35; 7h: $35	7c: 25%; 7i: 25%		7f: none	15: 20%		10b: none	16a: $20	17a: $20	17b: $20	18a. $25	18b. $0	14a: none												20.01256818	70	7.967107192	0	125	0.300390508	0.249247122	15.05845431	35.61769352	2.054342639	5.664292499	13.80795505	0	0.082131405	0	0.28935287	35	0.250325423	0	0	0.223004582	0	0	19.61904762	0	17.65584609	0	0	0	0											19.16813954	70	6.996969742	0	93.1590054	0.19945815	0.212662483	13.96316486	34.68287569	1.869709349	5.400557076	9.600159888	0	0.049939043	0	0.28935287	35	0.201968819	0	0	0.070141265	0	0	19.61904762	0	17.65584609	0	0	0	0											3.0532	0.042174668	1.353507182	0	2.168186898	2.185073687	0.640692502	1.257562662	1.405112134	3.79120582	0.582641691	0.048973456	0	4.966635488	0	0.377359626	1.275757137	1.276930188	0	0	2.0198764	0	0	0.832838939	0	0.005758075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.2835	0	10.7494	3.0532	0.042174668	1.353507182	0	2.168186898	2.185073687	0.640692502	1.257562662	1.405112134	3.79120582	0.582641691	0.048973456	0	4.966635488	0	0.377359626	1.275757137	1.276930188	0	0	2.0198764	0	0	0.832838939	0	0.005758075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.2835	0																																																																																	0		0	3.0532	0.042174668	1.353507182	0	2.168186898	2.185073687	0.640692502	1.257562662	1.405112134	3.79120582	0.582641691	0.048973456	0	4.966635488	0	0.377359626	1.275757137	1.276930188	0	0	2.0198764	0	0	0.832838939	0	0.005758075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.2835
H1837_004_0	2009	7																					700											D	D	D	V	T	Coin	Coin	V	V	Coin	V	V	Coin	Coin	V	V	V	V	Coin	V	Coin	Coin	T	V	V	V	V	V	Coin	Coin																																																			0	0	1897.907948	7.17884603	2304.897261	1722.890503	277.3146899	10.54913742	2.527317031	1073.116251	482.7217732	35.45282888	1285.476082	60.78316253	0	76.3368297	9711.110681	15537.27115	434.3111364	1022.68944	0	235.7876429	27.47660033	0	310.5523065	505.8061484	0	3.907766115	0	0	0.152083051	0											1a: $75 Days 1-5	1b: $275	2: $50 Days 11-22	6: none	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4b: $50	9b: $50	8a: $100; 8a: $40; 8a: $100; 8a: $40; 8a: $100	8b: $15	5: $75	12: 20%	9a: $100; 9a: 20%; 9a: $100; 9a: $40; 9a: $100; 9a: 20%; 9d: $25	14c: $10; 7a: $10	7d: $25	7e: $35; 7h: $35	7c: $25; 7i: $25		7b: $25; 7f: $25	15: 20%		10b: none	16a: $20	17a: $20	17b: $20	18a. $25	18b. $0	14a: none												25.70358667	275	8.52126319	0	100	0.200260338	0.190877404	15.05672303	35.61769352	0.117943861	5.664292499	16.83218216	0	0.131888434	0.7542501	7.035803452	35	22.87728882	0	24.75666103	0.199132208	0	0	19.61904762	0	17.61394016	0	0	0	0											21.88515047	275	3.354461119	0	57.54123812	0.117945305	0.143135648	12.82656344	31.24119729	0.095680711	4.987140237	5.978331757	0	0.058846545	0.727324678	7.021190772	35	16.26252861	0	24.75666103	0.05545369	0	0	19.61904762	0	17.61394016	0	0	0	0											3.4613	0.164515222	0.644307354	0	1.329752551	1.244221228	0.36174916	1.147032806	1.256733846	3.392151876	0.534237458	0.030281826	0	4.492158662	0.588594204	9.0908454	1.266740814	1.38595969	0	0.486442896	1.523678884	0	0	0.826952909	0	0.00573593	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.2334	0	14.9869	3.4613	0.164515222	0.644307354	0	1.329752551	1.244221228	0.36174916	1.147032806	1.256733846	3.392151876	0.534237458	0.030281826	0	4.492158662	0.588594204	9.0908454	1.266740814	1.38595969	0	0.486442896	1.523678884	0	0	0.826952909	0	0.00573593	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.2334	0																																																																																	0		0	3.4613	0.164515222	0.644307354	0	1.329752551	1.244221228	0.36174916	1.147032806	1.256733846	3.392151876	0.534237458	0.030281826	0	4.492158662	0.588594204	9.0908454	1.266740814	1.38595969	0	0.486442896	1.523678884	0	0	0.826952909	0	0.00573593	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.2334
H1837_801_0	2009	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																																																			0	0	193.7078736	0.794036247	45.3798716	6.384395156	6.124541909	6.733183083	1.995806955	9.00153714	27.01187247	22.62842715	2.17321017	2.41042062	0	85.99728002	16.23492161	84.49222963	6.083249021	3.863210589	0	0.991956952	18.03769529																				Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing											0.06875818	0.06875818	0.154765234	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.06875818	0.06875818	0.154765234	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				13.319	0.054596487	7.023226469	0	1.414769181	1.555365292	0.461031407	2.079355079	6.239742541	5.227166671	0.502011549	0.556807163	0	19.86537169	3.750266893	19.51770504	1.405230524	0.892401646	0	0.229142056	4.166707612	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.2599	0	0	13.319	0.054596487	7.023226469	0	1.414769181	1.555365292	0.461031407	2.079355079	6.239742541	5.227166671	0.502011549	0.556807163	0	19.86537169	3.750266893	19.51770504	1.405230524	0.892401646	0	0.229142056	4.166707612	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.2599	0																																																																																	0		0	13.319	0.054596487	7.023226469	0	1.414769181	1.555365292	0.461031407	2.079355079	6.239742541	5.227166671	0.502011549	0.556807163	0	19.86537169	3.750266893	19.51770504	1.405230524	0.892401646	0	0.229142056	4.166707612	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.2599
H1837_803_0	2009	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																																																			0	0	193.7078736	0.794036247	45.3798716	6.384395156	6.124541909	6.733183083	1.995806955	9.00153714	27.01187247	22.62842715	2.17321017	2.41042062	0	85.99728002	16.23492161	84.49222963	6.083249021	3.863210589	0	0.991956952	18.03769529																				Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing											0.06875818	0.06875818	0.154765234	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.06875818	0.06875818	0.154765234	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				13.319	0.054596487	7.023226469	0	1.414769181	1.555365292	0.461031407	2.079355079	6.239742541	5.227166671	0.502011549	0.556807163	0	19.86537169	3.750266893	19.51770504	1.405230524	0.892401646	0	0.229142056	4.166707612	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.2599	0	0	13.319	0.054596487	7.023226469	0	1.414769181	1.555365292	0.461031407	2.079355079	6.239742541	5.227166671	0.502011549	0.556807163	0	19.86537169	3.750266893	19.51770504	1.405230524	0.892401646	0	0.229142056	4.166707612	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.2599	0																																																																																	0		0	13.319	0.054596487	7.023226469	0	1.414769181	1.555365292	0.461031407	2.079355079	6.239742541	5.227166671	0.502011549	0.556807163	0	19.86537169	3.750266893	19.51770504	1.405230524	0.892401646	0	0.229142056	4.166707612	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.2599
H1846_001_0	2009	6																					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	O	V											0	0	0	0	0	0	0	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	0	0	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	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	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 Lab: $0	8B OP X-Ray: $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: $30, 14D Pelvic Exams: $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, Nutrition Therapy: $10-$30"	7D Physician Specialist: $30	"7E Mental Health: $30, 7H Psychiatric: $30"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	8B OP X-Rays: $30	"7B Chiropractic: $30, 7F Podiatry: $30, 7G Other Health Care: $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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											1.4111	0.024	0.4559	0	0	0.2162	0.1527	0	0.5335	0	0.264	0.0109	0	0.1758	0.3185	0.8428	0.0331	0.1277	0.4361	0.2895	0.1052	0.1494	0	0	0.0829	0	0.0356	0	0	0											5.665	0	0.148257391	1.4111	0.024029266	0.455929267	0	0	0.21619635	0.152730736	0	0.533460582	0	0.26403451	0.010913397	0	0.175760924	0.31849359	0.842832185	0.033057568	0.127681031	0.436111268	0.289476445	0.105180659	0.149449905	0	0	0.082945325	0	0.035579845	0	0	0	0	0	0	0	0	0	0	0	0	0	5.665
H1846_801_0	2009	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											0	0	0	0	0	0	0	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	196.308	1.035	22.977	19.485	6.471	9.207	6.460413642	13.527	44.85514778	6.507	38.448	42.849	0.072	14.1059825	38.48580629	100.081805	0.64782	3.678552	17.66050013	27.66332338	20.259	6.518214195	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	0	0	0	0	0	0	0											0.07526434	0.075693809	0.172260191	0	0.2310117	0.231001532	0.231171018	0.231070465	0.23099955	0.230888424	0.230976764	0.230999951	0.231000142	0.230962478	0.230995037	0.230679194	0.231004283	0.231023798	0.23100267	0.230997732	0.231041151	0.231002723	0	0	0	0	0	0	0	0											0.07526434	0.075693809	0.172260191	0	0.2310117	0.231001532	0.231171018	0.231070465	0.23099955	0.230888424	0.230976764	0.230999951	0.231000142	0.230962478	0.230995037	0.230679194	0.231004283	0.231023798	0.23100267	0.230997732	0.231041151	0.231002723	0	0	0	0	0	0	0	0											14.775	0.078343093	3.958022397	0	1.494876711	2.126831107	1.493460397	3.12569018	10.36151896	1.502390977	8.880594626	9.898116908	0.01663201	3.257952673	8.890030248	23.08679015	0.149649194	0.849833053	4.079622692	6.390164967	4.680662679	1.505725229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.6019	0	0	14.775	0.078343093	3.958022397	0	1.494876711	2.126831107	1.493460397	3.12569018	10.36151896	1.502390977	8.880594626	9.898116908	0.01663201	3.257952673	8.890030248	23.08679015	0.149649194	0.849833053	4.079622692	6.390164967	4.680662679	1.505725229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.6019	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	0	0	0	0	0	0	0											2.173	0.0242	0.086	0	0.1672	0.2853	0.1932	0.3551	0.9562	0.2146	0.6918	0.0206	0.004	0.6419	0.9056	2.4369	0.0231	0.0848	0.5911	0.7555	0.245	0.1325	0	0	0	0	0	0	0	0											10.9874	0	0	16.948	0.102544426	4.044020383	0	1.662047098	2.41209831	1.686656492	3.480756122	11.3177259	1.717027976	9.572380569	9.918700293	0.02063201	3.89981613	9.795643852	25.52366881	0.172719706	0.934661244	4.670766587	7.145623593	4.925627619	1.63823394	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.5893
H1846_802_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	196.308	1.035	22.977	19.485	6.471	9.207	6.460413642	13.527	44.85514778	6.507	38.448	42.849	0.072	14.1059825	38.48580629	100.081805	0.64782	3.678552	17.66050013	27.66332338	20.259	6.518214195	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	0	0	0	0	0	0	0											0.07526434	0.075693809	0.172260191	0	0.2310117	0.231001532	0.231171018	0.231070465	0.23099955	0.230888424	0.230976764	0.230999951	0.231000142	0.230962478	0.230995037	0.230679194	0.231004283	0.231023798	0.23100267	0.230997732	0.231041151	0.231002723	0	0	0	0	0	0	0	0											0.07526434	0.075693809	0.172260191	0	0.2310117	0.231001532	0.231171018	0.231070465	0.23099955	0.230888424	0.230976764	0.230999951	0.231000142	0.230962478	0.230995037	0.230679194	0.231004283	0.231023798	0.23100267	0.230997732	0.231041151	0.231002723	0	0	0	0	0	0	0	0											14.775	0.078343093	3.958022397	0	1.494876711	2.126831107	1.493460397	3.12569018	10.36151896	1.502390977	8.880594626	9.898116908	0.01663201	3.257952673	8.890030248	23.08679015	0.149649194	0.849833053	4.079622692	6.390164967	4.680662679	1.505725229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.6019	0	0	14.775	0.078343093	3.958022397	0	1.494876711	2.126831107	1.493460397	3.12569018	10.36151896	1.502390977	8.880594626	9.898116908	0.01663201	3.257952673	8.890030248	23.08679015	0.149649194	0.849833053	4.079622692	6.390164967	4.680662679	1.505725229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.6019	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	0	0	0	0	0	0	0											2.173	0.0242	0.086	0	0.1672	0.2853	0.1932	0.3551	0.9562	0.2146	0.6918	0.0206	0.004	0.6419	0.9056	2.4369	0.0231	0.0848	0.5911	0.7555	0.245	0.1325	0	0	0	0	0	0	0	0											10.9874	0	0	16.948	0.102544426	4.044020383	0	1.662047098	2.41209831	1.686656492	3.480756122	11.3177259	1.717027976	9.572380569	9.918700293	0.02063201	3.89981613	9.795643852	25.52366881	0.172719706	0.934661244	4.670766587	7.145623593	4.925627619	1.63823394	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.5893
H1849_005_0	2009	7	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		CORF	Partial Hospitalization	Ambulatory Surgical Center	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemo/Radiation	A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	0	Coin	0	0	0	V	V	V	V	0	0	V	V	V	V	V	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		449.0758969	15.01244228	650.5391656	1239.175174	453.6524887	18.68216376	0.946179553	373.8283467	331.7564406	5535.826795	687.6069243	237.2336558	0.085739473	120.4702159	3910.455431	4183.120123	23.8376705	1378.739404	2885.258192	0	35.29959059	0	0	0	357.5272364	343.1752547	185.934419	0	0	0	0.556016381	5.930841396	111.388615	128.7226724	390.2020612	94.06656832	0.664021863	685.2373602	28.23830706	21.01852734	$750/admt w/$1500 yrly max	$750/admt w/$1500 yrly max	$100/day (for days 21-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$200 copay	$0 copay	$75/$125 copay for Lower/Higher Tier	$200 copay	20% coinsurance	$30 copay	$15 coapy	$30 copay	$35 copay	$30 copay	$75/$125 copay for Lower/Higher Tier	0	20% coinsurance	0	0	0	$30 copay 1/yr $50 limit	Covd up to $75/ $30 copay/ 1 per yr	$30 copay 1/yr $50 limit	Silver Sneakers	0	0	$30 copay	$35 copay	$200 copay	$30 copay	$30 copay	$0 copay	20% coinsurance	$30 copay	$30 copay	20% coinsurance	750	750	100	0	100	0.2	0.2	50	200	0	94.16442049	200	0.2	30	15	30	35	30	80.24308866	0	0.2	0	0	0	30	30	30	0	0	0	30	35	200	30	30	0	0.2	30	30	0.2	550.4780074	480.9025915	89.54737911	0	89.54737911	0.179094758	0.179094758	44.77368956	179.0947582	0	84.3217706	179.0947582	0.179094758	26.86421373	13.43210687	26.86421373	31.34158269	26.86421373	71.85558281	0	0.179094758	0	0	0	26.86421373	26.86421373	26.86421373	0	0	0	26.86421373	31.34158269	179.0947582	26.86421373	26.86421373	0	0.179094758	26.86421373	26.86421373	0.179094758	20.6005	0.601626867	4.854506441	0	3.385282616	3.345877602	0.169455798	1.394806195	4.951319959	0	4.831686111	3.540608686	0.01535549	0.269694802	4.377137937	9.364686088	0.062259193	3.086562502	17.27682574	0	6.321971642	0	0	0	0.800390675	0.768261116	0.416248498	0	0	0	0.001244745	0.015490163	1.662426422	0.288169449	0.873539298	0	0.118922835	1.534030242	0.06321666	3.764308071	98.7564		11.5276	20.6005	0.601626867	4.854506441	0	3.385282616	3.345877602	0.169455798	1.394806195	4.951319959	0	4.831686111	3.540608686	0.01535549	0.269694802	4.377137937	9.364686088	0.062259193	3.086562502	17.27682574	0	6.321971642	0	0	0	0.800390675	0.768261116	0.416248498	0	0	0	0.001244745	0.015490163	1.662426422	0.288169449	0.873539298	0	0.118922835	1.534030242	0.06321666	3.764308071	98.7564	3500																																																																																	0		0	20.6005	0.601626867	4.854506441	0	3.385282616	3.345877602	0.169455798	1.394806195	4.951319959	0	4.831686111	3.540608686	0.01535549	0.269694802	4.377137937	9.364686088	0.062259193	3.086562502	17.27682574	0	6.321971642	0	0	0	0.800390675	0.768261116	0.416248498	0	0	0	0.001244745	0.015490163	1.662426422	0.288169449	0.873539298	0	0.118922835	1.534030242	0.06321666	3.764308071	98.7564
H1849_014_0	2009	8	H.6	H.7	I.7	I.8	I.9	I.10	I.11	I.12	I.13		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional	0		CORF	Partial Hospitalization	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemo/Radiation	0	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	0	Coin	0	0	0	V	V	V	0	V	0	V	V	V	V	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1425.778454	131.0461606	355.5745986	613.0071894	239.6484725	12.75064846	3.005116665	330.769682	483.9803613	5022.082535	908.9975816	205.5168365	0	139.191608	4025.386883	3257.47134	18.80400928	1234.46656	2667.775875	0	36.73200926	0	0	0	361.9486318	343.1752547	185.934419	0	0	0	0	1.326419952	112.3354354	399.6278358	127.0581445	0.83656058	752.4931692	30.85114239	11.22129168	0	$240/day w/$2400 yrly max	$240/day w/$2400 yrly max	$100/day (for days 21-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$200 copay	$0 copay	$75/$125 copay for Lower/Higher Tier	$200 copay	20% coinsurance	$30 copay	$15 coapy	$30 copay	$35 copay	$30 copay	$75/$125 copay for Lower/Higher Tier	0	20% coinsurance	0	0	0	$30 copay	Covd up to $75/ $30 copay/ 1 per yr	$30 copay	0	Silver Sneakers	0	$30 copay	$35 copay	$30 copay	$30 copay	$0 copay	20% coinsurance	$30 copay	$30 copay	20% coinsurance	0	240	240	75	0	100	0.2	0.2	50	200	0	94.99814096	200	0.2	30	15	30	35	30	80.6399357	0	0.2	0	0	0	30	30	30	0	0	0	30	35	30	30	0	0.2	30	30	0.2	0	147.5841125	82.26174236	63.83861759	0	85.11815679	0.170236314	0.170236314	42.5590784	170.2363136	0	80.86066658	170.2363136	0	25.53544704	12.76772352	25.53544704	29.79135488	25.53544704	68.6392269	0	0.170236314	0	0	0	25.53544704	25.53544704	25.53544704	0	0	0	0	29.79135488	25.53544704	25.53544704	0	0.170236314	25.53544704	25.53544704	0.170236314	0	17.5352	0.898340458	1.891615902	0	1.699869688	2.17062339	0.511579983	1.173104402	6.865919379	0	6.125179197	2.915535718	0	0.296193328	4.282918898	6.931748907	0.046683076	2.626887956	15.25950614	0	6.253121846	0	0	0	0.77021001	0.730261129	0.395659876	0	0	0	0	0.003292987	0.23904463	0.85038962	0	0.142412989	1.601270789	0.065649809	1.910271329	0	84.1925		14.72	17.5352	0.898340458	1.891615902	0	1.699869688	2.17062339	0.511579983	1.173104402	6.865919379	0	6.125179197	2.915535718	0	0.296193328	4.282918898	6.931748907	0.046683076	2.626887956	15.25950614	0	6.253121846	0	0	0	0.77021001	0.730261129	0.395659876	0	0	0	0	0.003292987	0.23904463	0.85038962	0	0.142412989	1.601270789	0.065649809	1.910271329	0	84.1925	3500																																																																																	0		0	17.5352	0.898340458	1.891615902	0	1.699869688	2.17062339	0.511579983	1.173104402	6.865919379	0	6.125179197	2.915535718	0	0.296193328	4.282918898	6.931748907	0.046683076	2.626887956	15.25950614	0	6.253121846	0	0	0	0.77021001	0.730261129	0.395659876	0	0	0	0	0.003292987	0.23904463	0.85038962	0	0.142412989	1.601270789	0.065649809	1.910271329	0	84.1925
H1849_801_0	2009	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	V																																																			0		388.1391858	4.647309016	47.25254825	9.334042341	10.85183794	15.79719185	0.771566635	14.71908312	53.56493271	11.10968622	30.00963386	0	0.251736874	29.53065969	47.20028574	127.9317744	1.455460348	4.898073153	31.80864919	42.12066169	27.60085326	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.077469969	0.077469969	0.192824591	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.077469969	0.077469969	0.192824591	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			30.0691	0.360026884	9.111453308	0	2.506774565	3.649151317	0.178231893	3.400108201	12.37349946	2.566337516	6.932225421	0	0.058151218	6.821582388	10.90326601	29.55223989	0.33621134	1.131454898	7.347797963	9.729872851	6.375797102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.4033			30.0691	0.360026884	9.111453308	0	2.506774565	3.649151317	0.178231893	3.400108201	12.37349946	2.566337516	6.932225421	0	0.058151218	6.821582388	10.90326601	29.55223989	0.33621134	1.131454898	7.347797963	9.729872851	6.375797102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.4033																																																																																		0			30.0691	0.360026884	9.111453308	0	2.506774565	3.649151317	0.178231893	3.400108201	12.37349946	2.566337516	6.932225421	0	0.058151218	6.821582388	10.90326601	29.55223989	0.33621134	1.131454898	7.347797963	9.729872851	6.375797102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.4033
H1849_803_0	2009	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	V																																																			0		388.1391858	4.647309016	47.25254825	9.334042341	10.85183794	15.79719185	0.771566635	14.71908312	53.56493271	11.10968622	30.00963386	0	0.251736874	29.53065969	47.20028574	127.9317744	1.455460348	4.898073153	31.80864919	42.12066169	27.60085326	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.077469969	0.077469969	0.192824591	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.077469969	0.077469969	0.192824591	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			30.0691	0.360026884	9.111453308	0	2.506774565	3.649151317	0.178231893	3.400108201	12.37349946	2.566337516	6.932225421	0	0.058151218	6.821582388	10.90326601	29.55223989	0.33621134	1.131454898	7.347797963	9.729872851	6.375797102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.4033			30.0691	0.360026884	9.111453308	0	2.506774565	3.649151317	0.178231893	3.400108201	12.37349946	2.566337516	6.932225421	0	0.058151218	6.821582388	10.90326601	29.55223989	0.33621134	1.131454898	7.347797963	9.729872851	6.375797102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.4033																																																																																		0			30.0691	0.360026884	9.111453308	0	2.506774565	3.649151317	0.178231893	3.400108201	12.37349946	2.566337516	6.932225421	0	0.058151218	6.821582388	10.90326601	29.55223989	0.33621134	1.131454898	7.347797963	9.729872851	6.375797102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.4033
H1849_804_0	2009	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	V																																																			0		388.1391858	4.647309016	47.25254825	9.334042341	10.85183794	15.79719185	0.771566635	14.71908312	53.56493271	11.10968622	30.00963386	0	0.251736874	29.53065969	47.20028574	127.9317744	1.455460348	4.898073153	31.80864919	42.12066169	27.60085326	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.077469969	0.077469969	0.192824591	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.077469969	0.077469969	0.192824591	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			30.0691	0.360026884	9.111453308	0	2.506774565	3.649151317	0.178231893	3.400108201	12.37349946	2.566337516	6.932225421	0	0.058151218	6.821582388	10.90326601	29.55223989	0.33621134	1.131454898	7.347797963	9.729872851	6.375797102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.4033			30.0691	0.360026884	9.111453308	0	2.506774565	3.649151317	0.178231893	3.400108201	12.37349946	2.566337516	6.932225421	0	0.058151218	6.821582388	10.90326601	29.55223989	0.33621134	1.131454898	7.347797963	9.729872851	6.375797102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.4033																																																																																		0			30.0691	0.360026884	9.111453308	0	2.506774565	3.649151317	0.178231893	3.400108201	12.37349946	2.566337516	6.932225421	0	0.058151218	6.821582388	10.90326601	29.55223989	0.33621134	1.131454898	7.347797963	9.729872851	6.375797102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.4033
H1903_005_0	2009	6																					3350											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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		316.1776478	7.541020561	544.3059828	2789.056935	528.9509239	17.14619368	4.335762176	1053.469592	315.6410804	6783.197697	962.7305277	56.31833593	0.082958214	486.6738121	13748.84725	18788.70299	334.2101418	3296.064043	5162.48805	2060.63148	29.45541792	34.2549136	0	225.2307692	408	131.1428571	39.2	20.35303562	0	6200											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	Copay between $0.00 and $15.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$10.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $150 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	Not Covered	$0.00 copayment											0	0	0	4.806179024	41.4333853	0.2	0.2	16.32009209	0	0	5.598677604	0	0.2	0	0	0	0	0	7.338099944	4.319156365	0.2	0	0	10	10	10	10	8.02767557	0	0											0	0	0	4.768489971	41.10847334	0.198431642	0.198431642	16.19211334	0	0	5.554773942	0	0.198431642	0	0	0	0	0	7.280556095	4.285286442	0.198431642	0	0	10	10	10	10	8.02767557	0	0											0	0	0	1.108299169	1.812030413	3.402347361	0.860352407	1.421491587	0	0	0.445645871	0	0.016461535	0	0	0	0	0	3.132148653	0.735866345	5.844886935	0	0	0.187692308	0.34	0.109285714	0.032666667	0.013615631	0	0	0	0	0	0	0	0	0	0	0	0	19.4628	0	0.1484	0	0	0	1.108299169	1.812030413	3.402347361	0.860352407	1.421491587	0	0	0.445645871	0	0.016461535	0	0	0	0	0	3.132148653	0.735866345	5.844886935	0	0	0.187692308	0.34	0.109285714	0.032666667	0.013615631	0	0	0	0	0	0	0	0	0	0	0	0	19.4628	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	1.108299169	1.812030413	3.402347361	0.860352407	1.421491587	0	0	0.445645871	0	0.016461535	0	0	0	0	0	3.132148653	0.735866345	5.844886935	0	0	0.187692308	0.34	0.109285714	0.032666667	0.013615631	0	0	0	0	0	0	0	0	0	0	0	0	19.4628
H1903_011_0	2009	8																																A	A	D	V	Coin	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	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	0	0	0											0		401.8518597	27.00007294	629.1135017	5143.726248	12.28848415	2460.63585	6.636351241	19.94198673	17.45867962	8426.767399	17.05235179	0.513106629	1.188500632	4.877346432	14520.22456	95.06372254	18.14008007	16.10780129	32.8887236	7.923689174	24.04236117	0.2721877	0	418.2857143	336.4612608	132	30	16	1584	7480											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	Not Covered	"Copay between $0.00 and $10.00, No benefit limit"	$0.00 copayment	"$0.00 copayment, $150 benefit limit,"	$0.00 copayment	"$0.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											742.6341556	652.3221938	56.49275891	0	0.158602742	0	0.13597473	0.121705502	0.17	0	0.140107799	0.17	0.17	0.17	0	0.086881849	0.17	0.17	0.150401796	0.022705846	0.17	0.17	0	0	0	0	0	0	0	0											742.6341556	652.3221938	56.49275891	0	0.158602742	0	0.13597473	0.121705502	0.17	0	0.140107799	0.17	0.17	0.17	0	0.086881849	0.17	0.17	0.150401796	0.022705846	0.17	0.17	0	0	0	0	0	0	0	0											24.8691	1.467728901	2.961696448	0	1.948987282	0	0.90237607	2.427049511	2.967975535	0	2.38916748	0.087228127	0.202045107	0.829148893	0	8.259311975	3.083813612	2.73832622	4.946523091	0.17991407	4.087201398	0.046271909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3938	0	0	24.8691	1.467728901	2.961696448	0	1.948987282	0	0.90237607	2.427049511	2.967975535	0	2.38916748	0.087228127	0.202045107	0.829148893	0	8.259311975	3.083813612	2.73832622	4.946523091	0.17991407	4.087201398	0.046271909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3938	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.8691	1.467728901	2.961696448	0	1.948987282	0	0.90237607	2.427049511	2.967975535	0	2.38916748	0.087228127	0.202045107	0.829148893	0	8.259311975	3.083813612	2.73832622	4.946523091	0.17991407	4.087201398	0.046271909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3938
H1903_014_0	2009	9																					3350											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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		423.9493093	28.47177819	685.9756486	5616.82232	943.6423287	36.01811327	7.206924043	2435.164543	325.3106334	8508.855607	1306.52182	64.56055815	0.027737724	563.6779508	12706.31241	16635.02821	1470.480554	4157.955468	5413.505584	1412.737229	22.70743421	11.41838274	0	225.2307692	330	132	30	16	1584	6485.714286											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	Copay between $0.00 and $15.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$10.00 copayment, No benefit limit"	$0.00 copayment	"$0.00 copayment, $150 benefit limit,"	$0.00 copayment	"$0.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											0	0	0	4.358829098	40.45928358	0.2	0.2	17.34264766	0	0	4.176637657	0	0.2	0	0	0	0	0	7.064149546	2.486884505	0.2	0	0	10	0	0	0	0	0	0											0	0	0	4.308285234	39.99012811	0.197680851	0.197680851	17.14154677	0	0	4.128206438	0	0.197680851	0	0	0	0	0	6.98223548	2.45804723	0.197680851	0	0	10	0	0	0	0	0	0											0	0	0	2.016572722	3.144698134	7.120091294	1.42467088	3.478540575	0	0	0.449465982	0	0.005483217	0	0	0	0	0	3.14986423	0.289381236	4.488824926	0	0	0.187692308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.7553	0	0.3	0	0	0	2.016572722	3.144698134	7.120091294	1.42467088	3.478540575	0	0	0.449465982	0	0.005483217	0	0	0	0	0	3.14986423	0.289381236	4.488824926	0	0	0.187692308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.7553	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											8.684	0.5112	0.164	1.5296	0.3444	0.8946	0.1788	0	0.4094	0.3179	0.4308	0.0271	0	0.1652	0.2702	2.2084	0.691	0.4375	0.783	0.2093	0.5311	0.0054	0	0	0	0	0	0	0	0											18.7931	0	0	8.684	0.511218984	0.163965497	3.546185514	3.489085144	8.014734752	1.603501363	3.478540575	0.409428382	0.317925	0.88025385	0.027056205	0.005483217	0.165184888	0.270219909	2.20839398	0.691029421	0.437541441	3.932846151	0.498726394	5.019960933	0.005427684	0	0.187692308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.5484
H1903_018_0	2009	8																					3350											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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		384.9062831	5.971099857	854.2471529	1844.882264	506.095599	28.06005992	6.134900535	1384.168874	465.0054342	8313.67653	1025.927055	21.15798235	0.80937166	412.3455671	23495.05703	14046.51403	49.04252999	2894.96689	5697.846821	1103.826878	24.6349403	18.82591655	0	0	397.6146045	158.4	30	18.09553934	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 $15.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	Not Covered	$0.00 copayment	"$0.00 copayment, $150 benefit limit,"	$0.00 copayment	"$0.00 copayment, $500 benefit limit"	Not Covered	Not Covered											0	0	16.51	4.415947993	50.0421742	0.2	0.2	9.351094626	0	0	1.946418887	0	0.2	0	0	0	0	0	4.487925183	0.445338658	0.2	0	0	0	0	0	0	0	0	0											0	0	16.37811165	4.380671669	49.6424177	0.198402322	0.198402322	9.276394416	0	0	1.93087013	0	0.198402322	0	0	0	0	0	4.452073877	0.441781118	0.198402322	0	0	0	0	0	0	0	0	0											0	0	1.165912937	0.673485289	2.09365076	5.567181032	1.217178509	1.070008035	0	0	0.165077659	0	0.160581216	0	0	0	0	0	2.113936249	0.040637489	4.887629348	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.1553	0	0.1543	0	0	1.165912937	0.673485289	2.09365076	5.567181032	1.217178509	1.070008035	0	0	0.165077659	0	0.160581216	0	0	0	0	0	2.113936249	0.040637489	4.887629348	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.1553	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											8.0869	0.0448	0.2487	0.352	0.2332	0.697	0.1521	0	0.5176	0.4702	0.4218	0.0107	0	0.0925	0.114	1.967	0.0075	0.3434	1.0186	0.1674	0.554	0.0055	0	0	0	0	0	0	0	0											15.5047	0	0	8.0869	0.044781989	1.414654652	1.025442473	2.326812089	6.264156714	1.369280203	1.070008035	0.517568473	0.470150912	0.586871727	0.010673717	0.160581216	0.092498843	0.114009038	1.967005607	0.007474572	0.343360249	3.132537275	0.208066305	5.441632342	0.005461556	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.6599
H1903_022_0	2009	8																					3350											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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1817.153554	119.6949578	380.71012	3758.602645	586.486524	19.13692338	5.801290031	1244.189296	286.9080034	6641.791081	1209.747585	90.8962063	0.024544475	530.4666298	7421.710936	17983.64262	455.7155597	3664.543388	4540.09047	2234.491999	31.95212255	56.01686306	0	0	396	158.4	30	16	0	0											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	Medicare FFS Cost Sharing	Copay between $0.00 and $30.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $30.00	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	Not Covered	$0.00 copayment	"$0.00 copayment, $150 benefit limit,"	$0.00 copayment	"$0.00 copayment, $500 benefit limit"	Not Covered	Not Covered											53.21421205	29.7235462	35.63	5.849033851	33.53578669	0.2	0.2	20.61166419	53.68202219	0	11.66364252	26.24922505	0.2	7.443707571	2.316140319	8.139712945	14.12765052	12.74885657	16.69109793	4.317229637	0.2	0	0	0	0	0	0	0	0	0											50.3807307	28.14086537	33.73281997	5.537592083	31.75011662	0.189350659	0.189350659	19.51416103	50.8236315	0	11.04259202	24.85154036	0.189350659	7.047354685	2.192813483	7.706300067	13.37539971	12.07002199	15.802352	4.087351393	0.189350659	0	0	0	0	0	0	0	0	0											7.6291	0.280693308	1.070202162	1.734467354	1.551751294	3.623589062	1.098478093	2.023275856	1.21514222	0	1.113229085	0.188242562	0.004647512	0.311532207	1.356202318	11.54894553	0.507948147	3.685926606	5.978675641	0.761096165	6.050155474	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.7333	0	2.9096	7.6291	0.280693308	1.070202162	1.734467354	1.551751294	3.623589062	1.098478093	2.023275856	1.21514222	0	1.113229085	0.188242562	0.004647512	0.311532207	1.356202318	11.54894553	0.507948147	3.685926606	5.978675641	0.761096165	6.050155474	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.7333	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	30% coinsurance	Not covered OON	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											6.826	0.1806	0.1106	0.9893	0.2013	0.4753	0.1441	0	0.4902	0.1712	0.4319	0.0195	0	0.245	0.2046	2.3666	0.1652	0.2932	0.814	0.365	0.7719	0.0427	0	0	0	0	0	0	0	0											15.3081	0	0	14.4551	0.461328841	1.180822143	2.723765288	1.753010649	4.098925546	1.242574652	2.023275856	1.705301576	0.171245244	1.545123381	0.2077598	0.004647512	0.556548584	1.560797832	13.91550353	0.673112547	3.979111377	6.792669716	1.126078505	6.82202314	0.042652448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.0414
H1903_023_0	2009	8																					0											A	A	D	V	Coin	P	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	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	0	0	0											0		392.0126548	8.890176594	425.9768517	5142.910282	6.895794017	2066.214745	6.38037794	11.574884	19.58043607	7072.873307	20.01900681	0.911827544	0.034963795	10.10686517	9544.106688	124.2651181	6.419701036	11.99879555	32.68921567	21.85703623	42.25192036	3.615234271	0	418.2857143	330	132	30	16	1584	6800											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS Cost Sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	Not Covered	"Copay between $0.00 and $10.00, No benefit limit"	$0.00 copayment	"$0.00 copayment, $150 benefit limit,"	$0.00 copayment	"$0.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											833.7411803	637.7523156	80.20698469	0	0.183656629	0	0.2	0.126375367	0.2	0	0.2	0.2	0.2	0.2	0	0.128383018	0.2	0.2	0.2	0.025271349	0.2	0.2	0	0	0	0	0	0	0	0											833.7411803	637.7523156	80.20698469	0	0.183656629	0	0.2	0.126375367	0.2	0	0.2	0.2	0.2	0.2	0	0.128383018	0.2	0.2	0.2	0.025271349	0.2	0.2	0	0	0	0	0	0	0	0											27.2364	0.472477559	2.847193235	0	1.266458284	0	1.276075588	1.462780209	3.916087213	0	4.003801362	0.182365509	0.006992759	2.021373035	0	15.95353095	1.283940207	2.399759109	6.537843135	0.552356791	8.450384072	0.723046854	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.5929	0	0	27.2364	0.472477559	2.847193235	0	1.266458284	0	1.276075588	1.462780209	3.916087213	0	4.003801362	0.182365509	0.006992759	2.021373035	0	15.95353095	1.283940207	2.399759109	6.537843135	0.552356791	8.450384072	0.723046854	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.5929	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	27.2364	0.472477559	2.847193235	0	1.266458284	0	1.276075588	1.462780209	3.916087213	0	4.003801362	0.182365509	0.006992759	2.021373035	0	15.95353095	1.283940207	2.399759109	6.537843135	0.552356791	8.450384072	0.723046854	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.5929
H1903_801_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.2731	0.6905	0.2806	0.459	0.7079	0	0.5799	0.0222	0.0001	0.4582	0.9333	3.9096	0.4323	0.4996	1.5962	0.2501	0	0	0	0	0	0	0	0	0	0											11.0926		330.6650221	17.87447005	871.6211327	6484.03545	7.766600059	19.64018598	7.98207215	13.05439683	20.13575307	7802.24118	16.49330372	0.631862789	0.003276341	13.03290048	27.95509583	121.0868849	12.295612	14.20911349	45.40109442	7.114775496	42.05630906	0.000571019	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											794.624	794.624	74.4087	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199981425	0.19751494	0.5	0.2	0.2	0.195910032	0.2	0.2	0	0	0	0	0	0	0	0											794.624	794.624	74.4087	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199981425	0.19751494	0.5	0.2	0.2	0.195910032	0.2	0.2	0	0	0	0	0	0	0	0											21.8962	1.183623574	5.404682948	0	1.553320012	3.928037196	1.59641443	2.610879367	4.027150615	0	3.298660744	0.126372558	0.000655268	2.606580096	5.590499889	23.91646883	6.147806	2.841822698	9.080218883	1.393855897	8.411261811	0.000114204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.6146	135	0	21.8962	1.183623574	5.404682948	0	1.826380306	4.618552341	1.877050352	3.069849497	4.735089046	0	3.878536923	0.148587766	0.000770459	3.064794451	6.52375129	27.82607386	6.580098561	3.341390679	10.67644324	1.643999161	8.411261811	0.00013428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.7073		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			21.8962	1.183623574	5.404682948	0	1.826380306	4.618552341	1.877050352	3.069849497	4.735089046	0	3.878536923	0.148587766	0.000770459	3.064794451	6.52375129	27.82607386	6.580098561	3.341390679	10.67644324	1.643999161	8.411261811	0.00013428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.7073
H1903_802_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.2731	0.6905	0.2806	0.459	0.7079	0	0.5799	0.0222	0.0001	0.4582	0.9333	3.9096	0.4323	0.4996	1.5962	0.2501	0	0	0	0	0	0	0	0	0	0											11.0926		330.6650221	17.87447005	871.6211327	6484.03545	7.766600059	19.64018598	7.98207215	13.05439683	20.13575307	7802.24118	16.49330372	0.631862789	0.003276341	13.03290048	27.95509583	121.0868849	12.295612	14.20911349	45.40109442	7.114775496	42.05630906	0.000571019	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											794.624	794.624	74.4087	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199981425	0.19751494	0.5	0.2	0.2	0.195910032	0.2	0.2	0	0	0	0	0	0	0	0											794.624	794.624	74.4087	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199981425	0.19751494	0.5	0.2	0.2	0.195910032	0.2	0.2	0	0	0	0	0	0	0	0											21.8962	1.183623574	5.404682948	0	1.553320012	3.928037196	1.59641443	2.610879367	4.027150615	0	3.298660744	0.126372558	0.000655268	2.606580096	5.590499889	23.91646883	6.147806	2.841822698	9.080218883	1.393855897	8.411261811	0.000114204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.6146	135	0	21.8962	1.183623574	5.404682948	0	1.826380306	4.618552341	1.877050352	3.069849497	4.735089046	0	3.878536923	0.148587766	0.000770459	3.064794451	6.52375129	27.82607386	6.580098561	3.341390679	10.67644324	1.643999161	8.411261811	0.00013428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.7073		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			21.8962	1.183623574	5.404682948	0	1.826380306	4.618552341	1.877050352	3.069849497	4.735089046	0	3.878536923	0.148587766	0.000770459	3.064794451	6.52375129	27.82607386	6.580098561	3.341390679	10.67644324	1.643999161	8.411261811	0.00013428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.7073
H1903_803_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.2731	0.6905	0.2806	0.459	0.7079	0	0.5799	0.0222	0.0001	0.4582	0.9333	3.9096	0.4323	0.4996	1.5962	0.2501	0	0	0	0	0	0	0	0	0	0											11.0926		330.6650221	17.87447005	871.6211327	6484.03545	7.766600059	19.64018598	7.98207215	13.05439683	20.13575307	7802.24118	16.49330372	0.631862789	0.003276341	13.03290048	27.95509583	121.0868849	12.295612	14.20911349	45.40109442	7.114775496	42.05630906	0.000571019	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											794.624	794.624	74.4087	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199981425	0.19751494	0.5	0.2	0.2	0.195910032	0.2	0.2	0	0	0	0	0	0	0	0											794.624	794.624	74.4087	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199981425	0.19751494	0.5	0.2	0.2	0.195910032	0.2	0.2	0	0	0	0	0	0	0	0											21.8962	1.183623574	5.404682948	0	1.553320012	3.928037196	1.59641443	2.610879367	4.027150615	0	3.298660744	0.126372558	0.000655268	2.606580096	5.590499889	23.91646883	6.147806	2.841822698	9.080218883	1.393855897	8.411261811	0.000114204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.6146	135	0	21.8962	1.183623574	5.404682948	0	1.826380306	4.618552341	1.877050352	3.069849497	4.735089046	0	3.878536923	0.148587766	0.000770459	3.064794451	6.52375129	27.82607386	6.580098561	3.341390679	10.67644324	1.643999161	8.411261811	0.00013428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.7073		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			21.8962	1.183623574	5.404682948	0	1.826380306	4.618552341	1.877050352	3.069849497	4.735089046	0	3.878536923	0.148587766	0.000770459	3.064794451	6.52375129	27.82607386	6.580098561	3.341390679	10.67644324	1.643999161	8.411261811	0.00013428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.7073
H1903_804_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.2731	0.6905	0.2806	0.459	0.7079	0	0.5799	0.0222	0.0001	0.4582	0.9333	3.9096	0.4323	0.4996	1.5962	0.2501	0	0	0	0	0	0	0	0	0	0											11.0926		330.6650221	17.87447005	871.6211327	6484.03545	7.766600059	19.64018598	7.98207215	13.05439683	20.13575307	7802.24118	16.49330372	0.631862789	0.003276341	13.03290048	27.95509583	121.0868849	12.295612	14.20911349	45.40109442	7.114775496	42.05630906	0.000571019	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											794.624	794.624	74.4087	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199981425	0.19751494	0.5	0.2	0.2	0.195910032	0.2	0.2	0	0	0	0	0	0	0	0											794.624	794.624	74.4087	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199981425	0.19751494	0.5	0.2	0.2	0.195910032	0.2	0.2	0	0	0	0	0	0	0	0											21.8962	1.183623574	5.404682948	0	1.553320012	3.928037196	1.59641443	2.610879367	4.027150615	0	3.298660744	0.126372558	0.000655268	2.606580096	5.590499889	23.91646883	6.147806	2.841822698	9.080218883	1.393855897	8.411261811	0.000114204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.6146	135	0	21.8962	1.183623574	5.404682948	0	1.826380306	4.618552341	1.877050352	3.069849497	4.735089046	0	3.878536923	0.148587766	0.000770459	3.064794451	6.52375129	27.82607386	6.580098561	3.341390679	10.67644324	1.643999161	8.411261811	0.00013428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.7073		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			21.8962	1.183623574	5.404682948	0	1.826380306	4.618552341	1.877050352	3.069849497	4.735089046	0	3.878536923	0.148587766	0.000770459	3.064794451	6.52375129	27.82607386	6.580098561	3.341390679	10.67644324	1.643999161	8.411261811	0.00013428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.7073
H1906_001_0	2009	5	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		295.27517	6.839074	719.212778	239.600629	10.810433	23.084039	11.648561	545.472942	47.82538	14.272276	19.029702	0	0.251125	26.142938	5769.573512	5956.688953	0.781278	3.125112			26.493699								0.05		0	442.987028	336.826908	4.359283	590.369657	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000001	950.000541	43.132793	0	0.2	0.2	0.199999	50.000001	0.240475	0.25	0.244134	0	0.2	0.231352	15	30.000001	0.25	0.25			0.199999								0		0	0	14.225526	29.999428	29.999997	0	0	0	0		759.139301	759.139732	34.467156	0	0.159818	0.159818	0.159818	39.954701	0.192162	0.199773	0.195086	0	0.159818	0.184872	11.98641	23.97282	0.199774	0.199773			0.159818								0		0	0	11.367532	23.972363	23.972817	0	0	0	0		18.6796	0.432651067	2.065768251	0	1.727701781	3.689244945	1.861649722	1.816184025	9.190220672	2.851215393	3.712428444	0	0.040134295	4.833097234	5.76303947	11.89988601	0.156079031	0.624313	0	0	4.234169987	0	0	0	0	0	0	0	0	0	0	0	0.319074221	0.008708526	1.179401979	0	0	0	0	0	75.0846	0	18.8776	18.6796	0.432651067	2.065768251	0	1.727701781	3.689244945	1.861649722	1.816184025	9.190220672	2.851215393	3.712428444	0	0.040134295	4.833097234	5.76303947	11.89988601	0.156079031	0.624313	0	0	4.234169987	0	0	0	0	0	0	0	0	0	0	0	0.319074221	0.008708526	1.179401979	0	0	0	0	0	75.0846	6000																																																																																	0	0	0	18.6796	0.432651067	2.065768251	0	1.727701781	3.689244945	1.861649722	1.816184025	9.190220672	2.851215393	3.712428444	0	0.040134295	4.833097234	5.76303947	11.89988601	0.156079031	0.624313	0	0	4.234169987	0	0	0	0	0	0	0	0	0	0	0	0.319074221	0.008708526	1.179401979	0	0	0	0	0	75.0846
H1906_002_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		322.480946	7.469207	785.478903	261.676717	12.896358	27.538215	13.896207	595.731196	57.053518	17.026181	22.701575	0	0.299581	31.187344	6301.164851	6505.520551	0.93203	3.728118			31.605785								0.05		0	483.802536	367.861138	4.760936	644.76456	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000016	949.999682	43.132794	0	0.2	0.199999	0.199999	49.999993	0.240475	0.249999	0.244134	0	0.199999	0.231352	14.999999	29.999999	0.249999	0.249999			0.199999								0		0	0	14.225498	29.999142	29.999992	0	0	0	0		730.588012	730.587755	33.170844	0	0.153808	0.153807	0.153807	38.451995	0.184935	0.192259	0.187749	0	0.153807	0.177919	11.535599	23.071199	0.192259	0.192259			0.153807								0		0	0	10.939977	23.07054	23.071194	0	0	0	0		19.6334	0.454742598	2.171249846	0	1.983563031	4.235570235	2.13733391	1.908921081	10.55119235	3.273436533	4.262198005	0	0.046077655	5.548821057	6.057309246	12.50751327	0.179191156	0.716764239	0	0	4.861190973	0	0	0	0	0	0	0	0	0	0	0	0.335366032	0.009153114	1.239624021	0	0	0	0	0	82.1126	0	24.6603	19.6334	0.454742598	2.171249846	0	1.983563031	4.235570235	2.13733391	1.908921081	10.55119235	3.273436533	4.262198005	0	0.046077655	5.548821057	6.057309246	12.50751327	0.179191156	0.716764239	0	0	4.861190973	0	0	0	0	0	0	0	0	0	0	0	0.335366032	0.009153114	1.239624021	0	0	0	0	0	82.1126	6000																																																																																	0	0	0	19.6334	0.454742598	2.171249846	0	1.983563031	4.235570235	2.13733391	1.908921081	10.55119235	3.273436533	4.262198005	0	0.046077655	5.548821057	6.057309246	12.50751327	0.179191156	0.716764239	0	0	4.861190973	0	0	0	0	0	0	0	0	0	0	0	0.335366032	0.009153114	1.239624021	0	0	0	0	0	82.1126
H1906_003_0	2009	6	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		6000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		329.723955	7.636966	803.120972	267.554048	13.500674	28.828641	14.547376	609.111481	59.727015	17.824019	23.765358	0	0.313619	32.648766	6442.690729	6651.636313	0.975704	3.902815			33.086815								0.05		0	494.668872	376.123398	4.867867	659.246148	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		949.999983	949.999719	43.132799	0	0.2	0.199999	0.199999	50.000009	0.240475	0.25	0.244134	0	0.2	0.231352	14.999999	29.999998	0.25	0.25			0.2								0		0	0	14.225512	30.000818	29.999993	0	0	0	0		722.863537	722.863336	32.820135	0	0.152181	0.152181	0.152181	38.045457	0.182979	0.190227	0.185764	0	0.152182	0.176038	11.413634	22.827268	0.190227	0.190227			0.152181								0		0	0	10.82432	22.827892	22.827264	0	0	0	0		19.8621	0.460040227	2.196544894	0	2.05454607	4.387171416	2.213834227	1.931160388	10.92878948	3.390609662	4.414747964	0	0.047727167	5.747423469	6.127876163	12.65322373	0.185605245	0.742420789	0	0	5.035184594	0	0	0	0	0	0	0	0	0	0	0	0.339273335	0.009260262	1.254065488	0	0	0	0	0	83.9816	0	26.3886	19.8621	0.460040227	2.196544894	0	2.05454607	4.387171416	2.213834227	1.931160388	10.92878948	3.390609662	4.414747964	0	0.047727167	5.747423469	6.127876163	12.65322373	0.185605245	0.742420789	0	0	5.035184594	0	0	0	0	0	0	0	0	0	0	0	0.339273335	0.009260262	1.254065488	0	0	0	0	0	83.9816	6000																																																																																	0	0	0	19.8621	0.460040227	2.196544894	0	2.05454607	4.387171416	2.213834227	1.931160388	10.92878948	3.390609662	4.414747964	0	0.047727167	5.747423469	6.127876163	12.65322373	0.185605245	0.742420789	0	0	5.035184594	0	0	0	0	0	0	0	0	0	0	0	0.339273335	0.009260262	1.254065488	0	0	0	0	0	83.9816
H1906_006_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1577.845501	53.407904	700.559462	233.386409	226.036678	21.934701	11.068587	531.325698	373.531341	1910.92579	1020.849671	0	0.238622	1137.984806	5619.935356	5802.197818	55.126463	983.24515			25.174595								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947947	114.991744	43.132801	0	100.000001	0.199999	0.199999	49.999998	91.015141	77.419433	70.072346	0	0.199998	92.025042	14.999999	29.999998	94.60821	59.060001			0.2								0		0	0	0	0							110.352288	91.988336	34.504343	0	79.9956	0.159991	0.159991	39.997798	72.808108	61.93214	56.054794	0	0.15999	73.615984	11.999339	23.998679	75.682405	47.245402			0.159991								0		0	0	0	0							14.5099	0.409408685	2.014361997	0	1.506828307	3.509354748	1.770874303	1.770988162	2.266342518	9.862310296	4.768626501	0	0.038177134	6.981155939	5.619625791	11.60375691	0.347675275	3.871151031	0	0	4.027708629	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.8783	0	18.7247	14.5099	0.409408685	2.014361997	0	1.506828307	3.509354748	1.770874303	1.770988162	2.266342518	9.862310296	4.768626501	0	0.038177134	6.981155939	5.619625791	11.60375691	0.347675275	3.871151031	0	0	4.027708629	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.8783	6000																																																																																	0	0	0	14.5099	0.409408685	2.014361997	0	1.506828307	3.509354748	1.770874303	1.770988162	2.266342518	9.862310296	4.768626501	0	0.038177134	6.981155939	5.619625791	11.60375691	0.347675275	3.871151031	0	0	4.027708629	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.8783
H1906_007_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							6000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		1774.990982	60.081006	788.091563	262.547108	254.279057	27.717326	13.986589	597.712716	420.202589	2149.68832	1148.40075	0	0.301529	1280.171452	6322.123787	6527.159215	62.014291	1106.097698			31.811352								0.05		0.06	1.22	2.07	2.7							$225/Day(Days 1-5):1a	$225/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							137.947948	114.991749	43.132795	0	99.999993	0.199999	0.2	50.000007	91.015155	77.419433	70.072336	0	0.2	92.025029	15	29.999999	94.608063	59.059998			0.199999								0		0	0	0	0							106.041691	88.395077	33.156524	0	76.870794	0.153741	0.153741	38.435405	69.964078	59.512937	53.865165	0	0.153742	70.740376	11.53062	23.061239	72.725975	45.399893			0.153741								0		0	0	0	0							15.6853	0.442572096	2.177531402	0	1.628886084	4.261289417	2.150312179	1.914444193	2.449923893	10.6611888	5.154899657	0	0.046357672	7.546650822	6.074833915	12.54369822	0.375837481	4.184726428	0	0	4.890709068	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1891	0	24.7294	15.6853	0.442572096	2.177531402	0	1.628886084	4.261289417	2.150312179	1.914444193	2.449923893	10.6611888	5.154899657	0	0.046357672	7.546650822	6.074833915	12.54369822	0.375837481	4.184726428	0	0	4.890709068	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1891	6000																																																																																	0	0	0	15.6853	0.442572096	2.177531402	0	1.628886084	4.261289417	2.150312179	1.914444193	2.449923893	10.6611888	5.154899657	0	0.046357672	7.546650822	6.074833915	12.54369822	0.375837481	4.184726428	0	0	4.890709068	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1891
H1906_801_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		345.358835	7.999097	841.203438	280.240951	14.788734	31.579097	15.935298	43.152513	91.935272	2294.562317	44.58393	0	0.34354	35.763688	67.300405	94.384644	1.088226	10.124592			36.24353																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000014	1024.000584	43.132805	0	0.2	0.199999	0.199999	0.2	0.2	0	0.199999	0	0.2	0.199999	0.2	0.2	0.5	0.199999			0.199999																				1024.000014	1024.000584	43.132805	0	0.2	0.199999	0.199999	0.2	0.2	0	0.199999	0	0.2	0.199999	0.2	0.2	0.5	0.199999			0.199999																				29.4706	0.68259	3.023621988	0	2.9577468	6.315787821	3.187043665	8.6305026	18.3870544	0	8.916741416	0	0.068708	7.152701836	13.460081	18.8769288	0.544113	2.024908275	0	0	7.248669756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.9478	0	0	29.4706	0.68259	3.023621988	0	2.9577468	6.315787821	3.187043665	8.6305026	18.3870544	0	8.916741416	0	0.068708	7.152701836	13.460081	18.8769288	0.544113	2.024908275	0	0	7.248669756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.9478																																																																																		0	0	0	29.4706	0.68259	3.023621988	0	2.9577468	6.315787821	3.187043665	8.6305026	18.3870544	0	8.916741416	0	0.068708	7.152701836	13.460081	18.8769288	0.544113	2.024908275	0	0	7.248669756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.9478
H1906_802_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		345.358835	7.999097	841.203438	280.240951	14.788734	31.579097	15.935298	43.152513	91.935272	2294.562317	44.58393	0	0.34354	35.763688	67.300405	94.384644	1.088226	10.124592			36.24353																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000014	1024.000584	43.132805	0	0.2	0.199999	0.199999	0.2	0.2	0	0.199999	0	0.2	0.199999	0.2	0.2	0.5	0.199999			0.199999																				1024.000014	1024.000584	43.132805	0	0.2	0.199999	0.199999	0.2	0.2	0	0.199999	0	0.2	0.199999	0.2	0.2	0.5	0.199999			0.199999																				29.4706	0.68259	3.023621988	0	2.9577468	6.315787821	3.187043665	8.6305026	18.3870544	0	8.916741416	0	0.068708	7.152701836	13.460081	18.8769288	0.544113	2.024908275	0	0	7.248669756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.9478	0	0	29.4706	0.68259	3.023621988	0	2.9577468	6.315787821	3.187043665	8.6305026	18.3870544	0	8.916741416	0	0.068708	7.152701836	13.460081	18.8769288	0.544113	2.024908275	0	0	7.248669756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.9478																																																																																		0	0	0	29.4706	0.68259	3.023621988	0	2.9577468	6.315787821	3.187043665	8.6305026	18.3870544	0	8.916741416	0	0.068708	7.152701836	13.460081	18.8769288	0.544113	2.024908275	0	0	7.248669756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.9478
H1906_803_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		345.358835	7.999097	841.203438	280.240951	14.788734	31.579097	15.935298	43.152513	91.935272	2294.562317	44.58393	0	0.34354	35.763688	67.300405	94.384644	1.088226	10.124592			36.24353																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000014	1024.000584	43.132805	0	0.2	0.199999	0.199999	0.2	0.2	0	0.199999	0	0.2	0.199999	0.2	0.2	0.5	0.199999			0.199999																				1024.000014	1024.000584	43.132805	0	0.2	0.199999	0.199999	0.2	0.2	0	0.199999	0	0.2	0.199999	0.2	0.2	0.5	0.199999			0.199999																				29.4706	0.68259	3.023621988	0	2.9577468	6.315787821	3.187043665	8.6305026	18.3870544	0	8.916741416	0	0.068708	7.152701836	13.460081	18.8769288	0.544113	2.024908275	0	0	7.248669756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.9478	0	0	29.4706	0.68259	3.023621988	0	2.9577468	6.315787821	3.187043665	8.6305026	18.3870544	0	8.916741416	0	0.068708	7.152701836	13.460081	18.8769288	0.544113	2.024908275	0	0	7.248669756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.9478																																																																																		0	0	0	29.4706	0.68259	3.023621988	0	2.9577468	6.315787821	3.187043665	8.6305026	18.3870544	0	8.916741416	0	0.068708	7.152701836	13.460081	18.8769288	0.544113	2.024908275	0	0	7.248669756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.9478
H1906_804_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		345.358835	7.999097	841.203438	280.240951	14.788734	31.579097	15.935298	43.152513	91.935272	2294.562317	44.58393	0	0.34354	35.763688	67.300405	94.384644	1.088226	10.124592			36.24353																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000014	1024.000584	43.132805	0	0.2	0.199999	0.199999	0.2	0.2	0	0.199999	0	0.2	0.199999	0.2	0.2	0.5	0.199999			0.199999																				1024.000014	1024.000584	43.132805	0	0.2	0.199999	0.199999	0.2	0.2	0	0.199999	0	0.2	0.199999	0.2	0.2	0.5	0.199999			0.199999																				29.4706	0.68259	3.023621988	0	2.9577468	6.315787821	3.187043665	8.6305026	18.3870544	0	8.916741416	0	0.068708	7.152701836	13.460081	18.8769288	0.544113	2.024908275	0	0	7.248669756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.9478	0	0	29.4706	0.68259	3.023621988	0	2.9577468	6.315787821	3.187043665	8.6305026	18.3870544	0	8.916741416	0	0.068708	7.152701836	13.460081	18.8769288	0.544113	2.024908275	0	0	7.248669756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.9478																																																																																		0	0	0	29.4706	0.68259	3.023621988	0	2.9577468	6.315787821	3.187043665	8.6305026	18.3870544	0	8.916741416	0	0.068708	7.152701836	13.460081	18.8769288	0.544113	2.024908275	0	0	7.248669756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.9478
H1906_805_0	2009	4																																			V	Coin	Coin	Coin	Coin	Coin	V	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					280.240951	14.788734	31.579097	15.935298	43.152513	91.935272	2294.562317	44.58393	0	0.34354	35.763688	67.300405	94.384644	1.088226	10.124592			36.24353																							$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																							0	0.2	0.199999	0.199999	0.2	0.2	0	0.199999	0	0.2	0.199999	0.2	0.2	0.5	0.199999			0.199999																							0	0.2	0.199999	0.199999	0.2	0.2	0	0.199999	0	0.2	0.199999	0.2	0.2	0.5	0.199999			0.199999																				0	0	0	0	2.9577468	6.315787821	3.187043665	8.6305026	18.3870544	0	8.916741416	0	0.068708	7.152701836	13.460081	18.8769288	0.544113	2.024908275	0	0	7.248669756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.771	0	0	0	0	0	0	2.9577468	6.315787821	3.187043665	8.6305026	18.3870544	0	8.916741416	0	0.068708	7.152701836	13.460081	18.8769288	0.544113	2.024908275	0	0	7.248669756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.771																																																																																		0	0	0	0	0	0	0	2.9577468	6.315787821	3.187043665	8.6305026	18.3870544	0	8.916741416	0	0.068708	7.152701836	13.460081	18.8769288	0.544113	2.024908275	0	0	7.248669756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.771
H1906_806_0	2009	4																																			V	Coin	Coin	Coin	Coin	Coin	V	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					280.240951	14.788734	31.579097	15.935298	43.152513	91.935272	2294.562317	44.58393	0	0.34354	35.763688	67.300405	94.384644	1.088226	10.124592			36.24353																							$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																							0	0.2	0.199999	0.199999	0.2	0.2	0	0.199999	0	0.2	0.199999	0.2	0.2	0.5	0.199999			0.199999																							0	0.2	0.199999	0.199999	0.2	0.2	0	0.199999	0	0.2	0.199999	0.2	0.2	0.5	0.199999			0.199999																				0	0	0	0	2.9577468	6.315787821	3.187043665	8.6305026	18.3870544	0	8.916741416	0	0.068708	7.152701836	13.460081	18.8769288	0.544113	2.024908275	0	0	7.248669756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.771	0	0	0	0	0	0	2.9577468	6.315787821	3.187043665	8.6305026	18.3870544	0	8.916741416	0	0.068708	7.152701836	13.460081	18.8769288	0.544113	2.024908275	0	0	7.248669756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.771																																																																																		0	0	0	0	0	0	0	2.9577468	6.315787821	3.187043665	8.6305026	18.3870544	0	8.916741416	0	0.068708	7.152701836	13.460081	18.8769288	0.544113	2.024908275	0	0	7.248669756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.771
H1906_807_0	2009	4																																			V	Coin	Coin	Coin	Coin	Coin	V	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					280.240951	14.788734	31.579097	15.935298	43.152513	91.935272	2294.562317	44.58393	0	0.34354	35.763688	67.300405	94.384644	1.088226	10.124592			36.24353																							$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																							0	0.2	0.199999	0.199999	0.2	0.2	0	0.199999	0	0.2	0.199999	0.2	0.2	0.5	0.199999			0.199999																							0	0.2	0.199999	0.199999	0.2	0.2	0	0.199999	0	0.2	0.199999	0.2	0.2	0.5	0.199999			0.199999																				0	0	0	0	2.9577468	6.315787821	3.187043665	8.6305026	18.3870544	0	8.916741416	0	0.068708	7.152701836	13.460081	18.8769288	0.544113	2.024908275	0	0	7.248669756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.771	0	0	0	0	0	0	2.9577468	6.315787821	3.187043665	8.6305026	18.3870544	0	8.916741416	0	0.068708	7.152701836	13.460081	18.8769288	0.544113	2.024908275	0	0	7.248669756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.771																																																																																		0	0	0	0	0	0	0	2.9577468	6.315787821	3.187043665	8.6305026	18.3870544	0	8.916741416	0	0.068708	7.152701836	13.460081	18.8769288	0.544113	2.024908275	0	0	7.248669756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.771
H1906_808_0	2009	4																																			V	Coin	Coin	Coin	Coin	Coin	V	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					280.240951	14.788734	31.579097	15.935298	43.152513	91.935272	2294.562317	44.58393	0	0.34354	35.763688	67.300405	94.384644	1.088226	10.124592			36.24353																							$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																							0	0.2	0.199999	0.199999	0.2	0.2	0	0.199999	0	0.2	0.199999	0.2	0.2	0.5	0.199999			0.199999																							0	0.2	0.199999	0.199999	0.2	0.2	0	0.199999	0	0.2	0.199999	0.2	0.2	0.5	0.199999			0.199999																				0	0	0	0	2.9577468	6.315787821	3.187043665	8.6305026	18.3870544	0	8.916741416	0	0.068708	7.152701836	13.460081	18.8769288	0.544113	2.024908275	0	0	7.248669756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.771	0	0	0	0	0	0	2.9577468	6.315787821	3.187043665	8.6305026	18.3870544	0	8.916741416	0	0.068708	7.152701836	13.460081	18.8769288	0.544113	2.024908275	0	0	7.248669756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.771																																																																																		0	0	0	0	0	0	0	2.9577468	6.315787821	3.187043665	8.6305026	18.3870544	0	8.916741416	0	0.068708	7.152701836	13.460081	18.8769288	0.544113	2.024908275	0	0	7.248669756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.771
H1944_001_0	2009	5																					3400											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	6000	1661.656656	171.0285411	707.9348671	769.2640925	113.3059771	12.35892326	4.565065378	322.2028406	37.54475317	10034.43803	43.69300807	0	0.227417388	28.40893066	4706.072845	3708.380276	583.9354823	210.0382107	0	0	17.57701371	805.0715777	0	0	103.5923094	0	12.88706159	0	775.2	0											"$195 Days 1-18 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$195 Days 1-18 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$8 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$8 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$0 n/c (13b, 13d, 13e)"											192.7155233	195	85.36789939	0	150	0.2	0.076056143	49.51687302	0.2	2.8	0.172048983	0	0.2	0.196702335	5.743043088	20	37.5	20	0	0	0.2	19.04351846	0	0	20	0	20	0	0	0											130.953245	132.4848805	57.9997741	0	101.9114465	0.135881929	0.051673277	33.64224105	0.135881929	1.902347002	0.116891738	0	0.135881929	0.13391595	5.743043088	20	37.5	13.58819287	0	0	0.135881929	19.04351846	0	0	20	0	20	0	0	0											18.1333	1.888224653	3.421671864	0	0.962264669	1.67935433	0.235891888	0.903302136	5.101653474	1.590748591	5.107351668	0	0.030901913	3.804408944	2.252264927	6.180633794	1.824798382	0.237836643	0	0	2.388398524	1.277616287	0	0	0.172653849	0	0.021478436	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2147	0	21.4473	18.1333	1.888224653	3.421671864	0	0.962264669	1.67935433	0.235891888	0.903302136	5.101653474	1.590748591	5.107351668	0	0.030901913	3.804408944	2.252264927	6.180633794	1.824798382	0.237836643	0	0	2.388398524	1.277616287	0	0	0.172653849	0	0.021478436	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2147		"$250 Days 1-24 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$250 Days 1-24 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-35 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$15 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$15 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											3.2697	0.3324	4.7081	0.4801	0.3229	0.8454	0.3123	0.3032	2.5682	0.5339	2.526	0	0.0104	1.912	2.0621	3.9733	0.8863	0.1539	0	0	1.5459	0.8353	0	0	0.111	0	0.0138	0	0	0											27.7062	0	9.238757242	21.403	2.220587366	8.12976682	0.480112321	1.285209209	2.524763594	0.548164121	1.206458328	7.669893562	2.124617898	7.633359524	0	0.041272869	5.716438356	4.314377041	10.15389838	2.711129025	0.391775374	0	0	3.934279057	2.112890719	0	0	0.283645609	0	0.035286002	0	0	0	0	0	0	0	0	0	0	0	0	0	84.9209
H1944_801_0	2009	3																					5665											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	5665	1743.140028	179.4153413	742.6501739	787.5636637	118.8622111	12.95308768	4.784534289	337.9834217	39.34974509	10526.50108	45.79358191	0	0.238350648	29.77471112	4932.032288	3882.95231	612.5701779	220.3379449	0	0	18.42204171	844.5502192	0	0	0	0	0	0	0	0											"$435 Days 1-13 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$435 Days 1-13 (1b); $0 n/c (1b1, 1b2)"	"$135 Days 1-42 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											429.8253121	435	135	0	150	0.2	0.076056143	49.51684526	0.3	2.8	0.244517507	0	0.2	0.294611285	17.96452816	30	37.5	30	0	0	0.2	28.55545377	0	0	0	0	0	0	0	0											282.2532747	285.6291573	88.64353158	0	98.49281287	0.13132375	0.04993989	32.51368916	0.196985626	1.838532507	0.160554781	0	0.13132375	0.193741565	17.96452816	30	37.5	19.69856257	0	0	0.13132375	28.55545377	0	0	0	0	0	0	0	0											41.0006	4.270521063	5.485927845	0	0.975589459	1.701048055	0.238939115	0.915757326	7.751334159	1.612776202	7.352378499	0	0.031301101	5.768599117	7.383469411	9.707380775	1.914281806	0.361695066	0	0	2.419251609	2.009709562	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.9005	0	41.7583	41.0006	4.270521063	5.485927845	0	0.975589459	1.701048055	0.238939115	0.915757326	7.751334159	1.612776202	7.352378499	0	0.031301101	5.768599117	7.383469411	9.707380775	1.914281806	0.361695066	0	0	2.419251609	2.009709562	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.9005		"$435 Days 1-13 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$435 Days 1-13 (1b); $0 n/c (1b1, 1b2)"	"$135 Days 1-42 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											5.5067	0.565	3.5484	0.4686	0.3155	0.8252	0.3048	0.2962	2.5069	0.5216	2.466	0	0.0101	1.867	3.4313	4.1603	0.9298	0.1504	0	0	1.509	0.8752	0	0	0	0	0	0	0	0											30.2581	0	11.99110901	46.5073	4.835534741	9.034375077	0.468642806	1.291108348	2.526261141	0.543751404	1.21192569	10.25822096	2.134369943	9.818365122	0	0.041424303	7.635629635	10.81477044	13.86768682	2.844075826	0.512094194	0	0	3.928202242	2.884905298	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.1586
H1944_802_0	2009	3																					5665											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	5665	1743.139863	179.4153243	742.6501034	787.5635889	118.8621998	12.95308522	4.78453338	338.0926286	39.34973761	10526.50008	45.79357321	0	0.238350603	29.77470547	5009.211068	3882.951941	612.5701197	220.337924	0	0	18.42203821	844.550139	0	0	0	0	0	0	0	0											"$435 Days 1-13 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$435 Days 1-13 (1b); $0 n/c (1b1, 1b2)"	"$135 Days 1-42 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											429.8253121	435	135	0	150	0.2	0.076056143	49.51700137	0.3	2.8	0.24451751	0	0.2	0.294611285	17.68774031	30	37.5	30	0	0	0.2	28.55545376	0	0	0	0	0	0	0	0											282.1893395	285.5644427	88.62344775	0	98.4704975	0.131293997	0.049928575	32.50642506	0.196940995	1.838115953	0.160518406	0	0.131293997	0.193697863	17.68774031	30	37.5	19.6940995	0	0	0.131293997	28.55545376	0	0	0	0	0	0	0	0											40.9913	4.269553092	5.484684386	0	0.975368329	1.700662328	0.238884933	0.915848558	7.749576478	1.612410645	7.350711362	0	0.031294003	5.767296824	7.383468709	9.707379852	1.914281624	0.361613083	0	0	2.418703024	2.009709371	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.8827	0	41.7766	40.9913	4.269553092	5.484684386	0	0.975368329	1.700662328	0.238884933	0.915848558	7.749576478	1.612410645	7.350711362	0	0.031294003	5.767296824	7.383468709	9.707379852	1.914281624	0.361613083	0	0	2.418703024	2.009709371	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.8827		"$435 Days 1-13 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$435 Days 1-13 (1b); $0 n/c (1b1, 1b2)"	"$135 Days 1-42 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											5.5073	0.5651	3.5488	0.4687	0.3156	0.8253	0.3048	0.2963	2.5072	0.5216	2.4662	0	0.0101	1.8672	3.4752	4.1603	0.9298	0.1504	0	0	1.5091	0.8752	0	0	0	0	0	0	0	0											30.3043	0	12.01393113	46.4986	4.834626723	9.033508143	0.468692489	1.290920697	2.525962899	0.543729537	1.212145017	10.25672905	2.134059731	9.81695945	0	0.041418278	7.634524254	10.8587035	13.8676855	2.844075556	0.51202817	0	0	3.927813628	2.884906498	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.1871
H1944_803_0	2009	6																					5665											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	5665	1743.139887	179.4153268	742.6501137	787.5635998	118.8622014	12.95308558	4.784533514	338.0926333	39.34973871	10526.50023	45.79357448	0	0.23835061	29.7747063	5009.211138	3882.951995	612.5701282	220.337927	0	0	18.42203873	844.5501508	0	0	0	0	0	0	0	0											"$435 Days 1-13 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$435 Days 1-13 (1b); $0 n/c (1b1, 1b2)"	"$135 Days 1-42 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											429.8253121	435	135	0	150	0.2	0.076056143	49.51700137	0.3	2.8	0.24451751	0	0.2	0.294611285	17.68774031	30	37.5	30	0	0	0.2	28.55545376	0	0	0	0	0	0	0	0											282.1893375	285.5644408	88.62344713	0	98.47049681	0.131293996	0.049928575	32.50642484	0.196940994	1.838115941	0.160518404	0	0.131293996	0.193697862	17.68774031	30	37.5	19.69409936	0	0	0.131293996	28.55545376	0	0	0	0	0	0	0	0											40.9913	4.269553122	5.484684424	0	0.975368336	1.700662364	0.238884938	0.915848564	7.74957664	1.612410656	7.350711505	0	0.031294004	5.767296944	7.383468812	9.707379988	1.914281651	0.361613086	0	0	2.418703074	2.009709399	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.8827	0	41.7766	40.9913	4.269553122	5.484684424	0	0.975368336	1.700662364	0.238884938	0.915848564	7.74957664	1.612410656	7.350711505	0	0.031294004	5.767296944	7.383468812	9.707379988	1.914281651	0.361613086	0	0	2.418703074	2.009709399	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.8827		"$435 Days 1-13 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$435 Days 1-13 (1b); $0 n/c (1b1, 1b2)"	"$135 Days 1-42 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											5.5073	0.5651	3.5488	0.4687	0.3156	0.8253	0.3048	0.2963	2.5072	0.5216	2.4662	0	0.0101	1.8672	3.4752	4.1603	0.9298	0.1504	0	0	1.5091	0.8752	0	0	0	0	0	0	0	0											30.3043	0	12.01393156	46.4986	4.834626756	9.0335082	0.468692498	1.290920706	2.52596295	0.543729548	1.212145025	10.25672926	2.134059745	9.816959635	0	0.041418279	7.63452441	10.85870365	13.8676857	2.844075595	0.512028173	0	0	3.927813707	2.884906538	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.1871
H1944_804_0	2009	4																					5665											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	5665	1743.13979	179.4153168	742.6500723	787.563556	118.8621948	12.95308414	4.78453298	338.0926145	39.34973432	10526.49964	45.79356938	0	0.238350583	29.77470298	5009.210859	3882.951779	612.5700941	220.3379148	0	0	18.42203667	844.5501037	0	0	0	0	0	0	0	0											"$435 Days 1-13 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$435 Days 1-13 (1b); $0 n/c (1b1, 1b2)"	"$135 Days 1-42 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											429.8253121	435	135	0	150	0.2	0.076056143	49.51700137	0.3	2.8	0.244517511	0	0.2	0.294611285	17.68774031	30	37.5	30	0	0	0.2	28.55545376	0	0	0	0	0	0	0	0											282.1893454	285.5644487	88.62344959	0	98.47049955	0.131293999	0.049928576	32.50642574	0.196940999	1.838115992	0.16051841	0	0.131293999	0.193697867	17.68774031	30	37.5	19.69409991	0	0	0.131293999	28.55545376	0	0	0	0	0	0	0	0											40.9913	4.269553002	5.484684271	0	0.975368308	1.700662221	0.238884918	0.915848539	7.749575992	1.612410611	7.350710935	0	0.031294001	5.767296464	7.383468401	9.707379447	1.914281544	0.361613076	0	0	2.418702872	2.009709287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.8827	0	41.7766	40.9913	4.269553002	5.484684271	0	0.975368308	1.700662221	0.238884918	0.915848539	7.749575992	1.612410611	7.350710935	0	0.031294001	5.767296464	7.383468401	9.707379447	1.914281544	0.361613076	0	0	2.418702872	2.009709287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.8827		"$435 Days 1-13 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$435 Days 1-13 (1b); $0 n/c (1b1, 1b2)"	"$135 Days 1-42 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											5.5073	0.5651	3.5488	0.4687	0.3156	0.8253	0.3048	0.2963	2.5072	0.5216	2.4662	0	0.0101	1.8672	3.4752	4.1603	0.9298	0.1504	0	0	1.5091	0.8752	0	0	0	0	0	0	0	0											30.3043	0	12.01392985	46.4986	4.834626625	9.033507971	0.468692462	1.290920672	2.525962745	0.543729504	1.212144993	10.25672842	2.134059689	9.816958896	0	0.041418275	7.634523786	10.85870304	13.86768492	2.844075437	0.51202816	0	0	3.927813389	2.884906377	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.1871
H1951_001_0	2009	6	r.	s.	t.	u.	v.						Part B Rx	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																	D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin	V		V		O	O	S	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		1964.942108	84.876256	405.502818	2289.687081	226.428593	11.362516	4.463075	437.884318	364.602261	3110.894239	1256.105254	0	0.01	562.982983	7512.339548	4399.487884	30.639388	1342.736857			10.798035			4.6	2.47		0.3		2.73	6.39	65.809666	0.06	0.05	1.23	2.7						$10/Day(Days 1-10):1a	$10/Day(Days 1-10):1b	"$0/Day(Days 1-20) $20(Days 21-100):2. $0 SNF 1,2. $20 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	"0%-20% Coins:11b. 0% Supplies,11b. 20% Prosthetics"	$50/Visit:4a	"$0-$50/Visit:9b. $0 Surgery ASC -- Physician,9b. $50 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $50 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$100/Visit:14h. $0 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $0 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$0-$100/Visit:9d. $5 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $50 OP Other,5. $15 Partial Hospitalization,8b. $0 Rad therapy,3. $5 Therapy (AT,PT,ST,OT) -- CORF"	$5/Visit:7a	"$15/Visit:7b, 7d, 7f"	"$15-$50/Visit:7h. $50 Psych -- OP,7e. $15 Psych -- Other Provider"	"$5/Visit:7d, 9a"			20% Coins:15			DEN 766	Vision Benefit		HER 757		Silver Sneakers	See PBP	$50/Script:15	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit						8.021372	7.450847	6.739514	0	100.000003	0.199999	0.05169	50	49.999997	0	32.859924	0	0.2	26.693112	4.999999	15.000003	49.92789	5.000002			0.2			0	0		0		0	0	50.00001	0	0	0	0						8.021372	7.450847	6.739514	0	100.000003	0.199999	0.05169	50	49.999997	0	32.859924	0	0.2	26.693112	4.999999	15.000003	49.92789	5.000002			0.2			0	0		0		0	0	50.00001	0	0	0	0						1.3135	0.0527	0.227740993	0	1.886904998	2.272491837	0.230696347	1.824517992	1.519175996	0	3.439626932	0	1.67E-07	1.252313985	3.130140852	5.499360955	0.127479999	0.559473914	0	0	2.159607	0	0	0	0	0	0	0	0	0	0.274206997	0	0	0	0	0	0	0	0	0	25.7699	0	0	1.3135	0.0527	0.227740993	0	1.886904998	2.272491837	0.230696347	1.824517992	1.519175996	0	3.439626932	0	1.67E-07	1.252313985	3.130140852	5.499360955	0.127479999	0.559473914	0	0	2.159607	0	0	0	0	0	0	0	0	0	0.274206997	0	0	0	0	0	0	0	0	0	25.7699																																																																																		0	0	0	1.3135	0.0527	0.227740993	0	1.886904998	2.272491837	0.230696347	1.824517992	1.519175996	0	3.439626932	0	1.67E-07	1.252313985	3.130140852	5.499360955	0.127479999	0.559473914	0	0	2.159607	0	0	0	0	0	0	0	0	0	0.274206997	0	0	0	0	0	0	0	0	0	25.7699
H1951_005_0	2009	6	r.	s.	t.	u.	v.	w.					Part B Rx	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin	V		V		O	O	S	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		1996.420625	86.235981	393.348818	2395.2802	236.870762	11.49347	4.514513	382.408257	321.061101	2716.940628	1099.733289	0	0.01	505.042941	7274.127181	4286.777727	27.405856	1337.498788			9.003539			2.35	2.47		0.3		2.73	0.3	57.472166	0.06	6.37	0.05	1.23	2.7					$10/Day(Days 1-10):1a	$10/Day(Days 1-10):1b	"$0/Day(Days 1-20) $20(Days 21-100):2. $0 SNF 1,2. $20 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	"0%-20% Coins:11b. 0% Supplies,11b. 20% Prosthetics"	$50/Visit:4a	"$0-$50/Visit:9b. $0 Surgery ASC -- Physician,9b. $50 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $50 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$100/Visit:14h. $0 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $0 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$0-$100/Visit:9d. $5 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $50 OP Other,5. $15 Partial Hospitalization,8b. $0 Rad therapy,3. $5 Therapy (AT,PT,ST,OT) -- CORF"	$5/Visit:7a	"$15/Visit:7b, 7d, 7f"	"$15-$50/Visit:7h. $50 Psych -- OP,7e. $15 Psych -- Other Provider"	"$5/Visit:7d, 9a"			20% Coins:15			DEN 756	Vision Benefit		HER 757		Silver Sneakers	Nutritional Supplements	$50/Script:15	Other Added Benefit	See PBP	Other Added Benefit	Other Added Benefit	Other Added Benefit					8.021367	7.450811	6.739514	0	99.999999	0.2	0.05169	50.000008	49.999978	0	32.777285	0	0.2	26.383214	4.999999	14.999999	49.915463	4.999998			0.2			0	0		0		0	0	49.999925	0	0	0	0	0					8.021367	7.450811	6.739514	0	99.999999	0.2	0.05169	50.000008	49.999978	0	32.777285	0	0.2	26.383214	4.999999	14.999999	49.915463	4.999998			0.2			0	0		0		0	0	49.999925	0	0	0	0	0					1.3345	0.053544	0.220914989	0	1.973922997	2.298694	0.233355177	1.593367992	1.337753999	0	3.003855953	0	0.002	1.110387999	3.030885719	5.358471802	0.113997999	0.557290939	0	0	1.8007078	0	0	0	0	0	0	0	0	0	0.239466999	0	0	0	0	0	0	0	0	0	24.2631	0	0	1.3345	0.053544	0.220914989	0	1.973922997	2.298694	0.233355177	1.593367992	1.337753999	0	3.003855953	0	0.002	1.110387999	3.030885719	5.358471802	0.113997999	0.557290939	0	0	1.8007078	0	0	0	0	0	0	0	0	0	0.239466999	0	0	0	0	0	0	0	0	0	24.2631																																																																																		0	0	0	1.3345	0.053544	0.220914989	0	1.973922997	2.298694	0.233355177	1.593367992	1.337753999	0	3.003855953	0	0.002	1.110387999	3.030885719	5.358471802	0.113997999	0.557290939	0	0	1.8007078	0	0	0	0	0	0	0	0	0	0.239466999	0	0	0	0	0	0	0	0	0	24.2631
H1951_013_0	2009	6	r.	s.	t.	u.	v.						Part B Rx	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin	V		V		O	O	S	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		1830.869892	79.084968	360.731046	2196.656271	217.228717	9.696378	3.808634	350.697609	294.437508	2491.642271	1008.539434	0	0.01	463.162966	6682.5493	3937.574832	25.133248	1226.589145			7.741489			2.35	1.5		0.3		2.73	6.27	52.70637	0.06	0.05	1.23	2.7						$50/Day(Days 1-5):1a	$50/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	"0%-20% Coins:11b. 0% Supplies,11b. 20% Prosthetics"	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$100/Visit:14h. $0 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $0 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$0-$100/Visit:9d. $10 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $50 OP Other,5. $20 Partial Hospitalization,8b. $0 Rad therapy,3. $10 Therapy (AT,PT,ST,OT) -- CORF"	$5/Visit:7a	"$20/Visit:7b, 7d, 7f"	"$20-$50/Visit:7h. $50 Psych -- OP,7e. $20 Psych -- Other Provider"	"$10/Visit:7d, 9a"			20% Coins:15			DEN 756	Vision Benefit		HER 757		Silver Sneakers	See PBP	$50/Script:15	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit						30.6551	25.553629	43.13281	0	99.999982	0.2	0.05169	49.999998	100.000004	0	32.777292	0	0.2	28.224173	5	19.999997	49.92749	10.000003			0.2			0	0		0		0	0	50.000028	0	0	0	0						30.6551	25.553629	43.13281	0	99.999982	0.2	0.05169	49.999998	100.000004	0	32.777292	0	0.2	28.224173	5	19.999997	49.92749	10.000003			0.2			0	0		0		0	0	50.000028	0	0	0	0						4.6771	0.168408994	1.296611972	0	1.810238982	1.9392756	0.196868291	1.461239979	2.453645998	0	2.75476596	0	0.002	1.089365973	2.784395542	6.562623736	0.104569999	1.022157927	0	0	1.5482978	0	0	0	0	0	0	0	0	0	0.219609998	0	0	0	0	0	0	0	0	0	30.0912	0	0	4.6771	0.168408994	1.296611972	0	1.810238982	1.9392756	0.196868291	1.461239979	2.453645998	0	2.75476596	0	0.002	1.089365973	2.784395542	6.562623736	0.104569999	1.022157927	0	0	1.5482978	0	0	0	0	0	0	0	0	0	0.219609998	0	0	0	0	0	0	0	0	0	30.0912																																																																																		0	0	0	4.6771	0.168408994	1.296611972	0	1.810238982	1.9392756	0.196868291	1.461239979	2.453645998	0	2.75476596	0	0.002	1.089365973	2.784395542	6.562623736	0.104569999	1.022157927	0	0	1.5482978	0	0	0	0	0	0	0	0	0	0.219609998	0	0	0	0	0	0	0	0	0	30.0912
H1951_017_0	2009	8	r.	s.	t.	u.	v.	w.					Health & Education (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	V	P	V	V	V	V	V			S		T	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	0					0		2174.79203	93.940786	448.809302	2534.218793	250.610488	7519.224538	15156.39921	484.649049	403.540689	3443.128411	1390.253527	0	19.352528	623.107877	8314.634875	4869.339991	33.911582	1486.137124			1740.042825		7.75	4.6	2.47		0.3		2.73	0.3	0.06	0.39	5	0.05	1.23	2.7					$0/Day(Days 1-7):1a	$0/Day(Days 1-1):1b	$0/Day(Days 1-100) $0(Days 100-100):2	$0/Visit:6	$0/Trip:10a	:11a	:11b	$0/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"$0/Visit:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			$0/Script:15		$0 Other - Transportation 10b	"Den 766 16a, 16b"	Vision Benefit		HER 757		$0: Membership in health club/fitness class 14a	Nutritional Supplements (NSP 001)	$0: Nurse hotline 14a	$0: Nutritional benefit 14a	See PBP	$0 Additional Smoking Cessation 14a	$0: Health Education Materials 14a	$0 Corp Health 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	0	0	0	0	0	0	0			0		0	0	0		0		0	0	0	0	0	0	0	0					0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	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	2009	9	r.	s.	t.	u.	v.	w.					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	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin		T	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	0					0		2169.586156	93.715917	427.467108	2603.042014	257.416459	13.573788	5.33164	415.577585	348.909298	2952.602623	1195.121956	0	16.982698	548.849355	7905.070425	4658.604252	29.782985	1453.510758			17.786852		7.75	4.6	5.88		0.3		2.73	0.3	0.06	0.37	8.33	0.05	1.23	2.7					$0/Day(Days 1-1):1a	$0/Day(Days 1-1):1b	$0/Day(Days 1-1) $0(Days 1-100):2	$0/Visit:6	$0/Trip:10a	0% Coins:11a	0% Coins:11b	$0/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"$0/Visit:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			0% Coins:15		$0 Other - Transportation 10b	"Den 766 16a, 16b"	Vision Benefit		HER 757		$0: Membership in health club/fitness class 14a	Nuritional Supplements (NSP 002)	$0: Nurse hotline 14a	$0: Nutritional benefit 14a	See PBP	$0 Additional Smoking Cessation 14a	$0: Health Education Materials 14a	$0 Corp Health 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	0	0	0	0	0	0	0			0		0	0	0		0		0	0	0	0	0	0	0	0					0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	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	2009	8	r.	s.	t.	u.	v.	w.					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	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin		T	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	0					0		2038.770661	88.065302	401.693138	2446.09318	241.895689	12.023509	4.722707	390.520375	327.871769	2774.575727	1123.062109	0	15.958718	515.75651	7441.372821	4384.698268	27.987204	1365.872021			16.057656		7.75	4.6	5.88		0.3		2.73	0.27	0.06	0.3	8.33	0.05	1.23	2.7					$0/Day(Days 1-1):1a	$0/Day(Days 1-1):1b	$0/Day(Days 1-100) $0(Days 100-100):2	$0/Visit:6	$0/Trip:10a	0% Coins:11a	0% Coins:11b	$0/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"$0/Visit:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			0% Coins:15		$0 Other - Transportation 10b	"Dental (DEN 766) 16a, 16b"	Vision Benefit		HER 757		$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	$0: Nurse hotline 14a	Nutritional Supplements (NSP 002)	See PBP	$0 Additional Smoking Cessation 14a	$0: Health Education Materials 14a	$0 Corp Health 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	0	0	0	0	0	0	0			0		0	0	0		0		0	0	0	0	0	0	0	0					0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	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	2009	6	r.	s.	t.	u.	v.						Part B Rx	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered																	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin	V		V		O	O	S	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		2059.582226	88.964265	405.793581	2471.062652	244.364937	12.270235	4.819618	394.506767	331.218652	2802.898316	1134.526219	0	0.01	521.021302	7517.333602	4429.456822	28.272895	1379.814706			9.796431			2.35	1.5		0.3		2.73	0.09	59.290451	0.06	0.05	1.23	2.7						$150/Day(Days 1-5):1a	$150/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	"0%-20% Coins:11b. 0% Supplies,11b. 20% Prosthetics"	$50/Visit:4a	"$0-$175/Visit:9b. $0 Surgery ASC -- Physician,9b. $175 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $175 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$150/Visit:14h. $0 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $150 Advanced Imaging -- FSR,8b. $150 Advanced Imaging -- Office,9a. $150 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $0 Radiology OP -- Facility"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$0-$150/Visit:9d. $15 Cardiac Rehab,8b. $150 Nuclear Medicine,9a. $50 OP Other,5. $35 Partial Hospitalization,8b. $0 Rad therapy,3. $15 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$50/Visit:7h. $50 Psych -- OP,7e. $35 Psych -- Other Provider"	"$15/Visit:7d, 9a"			20% Coins:15			Dental (DEN 756)	Vision Benefit		HER 757		Silver Sneakers	See PBP	$50/Script:15	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit						91.965301	76.661162	43.132786	0	99.999976	0.2	0.05169	49.999994	174.999999	0	49.165925	0	0.2	35.802574	14.999999	34.999999	49.963613	15.000005			0.2			0	0		0		0	0	50.000091	0	0	0	0						91.965301	76.661162	43.132786	0	99.999976	0.2	0.05169	49.999994	174.999999	0	49.165925	0	0.2	35.802574	14.999999	34.999999	49.963613	15.000005			0.2			0	0		0		0	0	50.000091	0	0	0	0						15.7842	0.568341994	1.458583974	0	2.036373986	2.454047	0.249126054	1.643777999	4.830271981	0	4.648335916	0	0.002	1.554491977	9.396666376	12.9192487	0.117717999	1.724768957	0	0	1.9592862	0	0	0	0	0	0	0	0	0	0.247043995	0	0	0	0	0	0	0	0	0	61.5943	0	0	15.7842	0.568341994	1.458583974	0	2.036373986	2.454047	0.249126054	1.643777999	4.830271981	0	4.648335916	0	0.002	1.554491977	9.396666376	12.9192487	0.117717999	1.724768957	0	0	1.9592862	0	0	0	0	0	0	0	0	0	0.247043995	0	0	0	0	0	0	0	0	0	61.5943																																																																																		0	0	0	15.7842	0.568341994	1.458583974	0	2.036373986	2.454047	0.249126054	1.643777999	4.830271981	0	4.648335916	0	0.002	1.554491977	9.396666376	12.9192487	0.117717999	1.724768957	0	0	1.9592862	0	0	0	0	0	0	0	0	0	0.247043995	0	0	0	0	0	0	0	0	0	61.5943
H1951_801_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		311.736513	8.077644	385.102211	2174.494279	6.990817	10.248012	4.02531	24.648106	77.14102	2954.386991	33.841747	0	0.443397	21.857427	92.077708	62.925498	1.06482	8.658064			16.290926																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000008	1023.999572	43.132787	0	0.199999	0.199999	0.2	0.199999	0.2	0	0.199999	0	0.200001	0.199999	0.2	0.199999	0.5	0.2			0.199999																				1024.000008	1023.999572	43.132787	0	0.199999	0.199999	0.2	0.199999	0.2	0	0.199999	0	0.200001	0.199999	0.2	0.199999	0.5	0.2			0.199999																				26.6015	0.689292	1.38421097	0	1.398156409	2.049592152	0.805062	4.929596552	15.428204	0	6.768315558	0	0.088679843	4.371463543	18.4155416	12.58503667	0.53241	1.7316128	0	0	3.258168909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.0369	0	0	26.6015	0.689292	1.38421097	0	1.398156409	2.049592152	0.805062	4.929596552	15.428204	0	6.768315558	0	0.088679843	4.371463543	18.4155416	12.58503667	0.53241	1.7316128	0	0	3.258168909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.0369																																																																																		0	0	0	26.6015	0.689292	1.38421097	0	1.398156409	2.049592152	0.805062	4.929596552	15.428204	0	6.768315558	0	0.088679843	4.371463543	18.4155416	12.58503667	0.53241	1.7316128	0	0	3.258168909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.0369
H1951_804_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		311.736513	8.077644	385.102211	2174.494279	6.990817	10.248012	4.02531	24.648106	77.14102	2954.386991	33.841747	0	0.443397	21.857427	92.077708	62.925498	1.06482	8.658064			16.290926																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000008	1023.999572	43.132787	0	0.199999	0.199999	0.2	0.199999	0.2	0	0.199999	0	0.200001	0.199999	0.2	0.199999	0.5	0.2			0.199999																				1024.000008	1023.999572	43.132787	0	0.199999	0.199999	0.2	0.199999	0.2	0	0.199999	0	0.200001	0.199999	0.2	0.199999	0.5	0.2			0.199999																				26.6015	0.689292	1.38421097	0	1.398156409	2.049592152	0.805062	4.929596552	15.428204	0	6.768315558	0	0.088679843	4.371463543	18.4155416	12.58503667	0.53241	1.7316128	0	0	3.258168909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.0369	0	0	26.6015	0.689292	1.38421097	0	1.398156409	2.049592152	0.805062	4.929596552	15.428204	0	6.768315558	0	0.088679843	4.371463543	18.4155416	12.58503667	0.53241	1.7316128	0	0	3.258168909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.0369																																																																																		0	0	0	26.6015	0.689292	1.38421097	0	1.398156409	2.049592152	0.805062	4.929596552	15.428204	0	6.768315558	0	0.088679843	4.371463543	18.4155416	12.58503667	0.53241	1.7316128	0	0	3.258168909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.0369
H1951_805_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		311.736513	8.077644	385.102211	2174.494279	6.990817	10.248012	4.02531	24.648106	77.14102	2954.386991	33.841747	0	0.443397	21.857427	92.077708	62.925498	1.06482	8.658064			16.290926																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000008	1023.999572	43.132787	0	0.199999	0.199999	0.2	0.199999	0.2	0	0.199999	0	0.200001	0.199999	0.2	0.199999	0.5	0.2			0.199999																				1024.000008	1023.999572	43.132787	0	0.199999	0.199999	0.2	0.199999	0.2	0	0.199999	0	0.200001	0.199999	0.2	0.199999	0.5	0.2			0.199999																				26.6015	0.689292	1.38421097	0	1.398156409	2.049592152	0.805062	4.929596552	15.428204	0	6.768315558	0	0.088679843	4.371463543	18.4155416	12.58503667	0.53241	1.7316128	0	0	3.258168909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.0369	0	0	26.6015	0.689292	1.38421097	0	1.398156409	2.049592152	0.805062	4.929596552	15.428204	0	6.768315558	0	0.088679843	4.371463543	18.4155416	12.58503667	0.53241	1.7316128	0	0	3.258168909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.0369																																																																																		0	0	0	26.6015	0.689292	1.38421097	0	1.398156409	2.049592152	0.805062	4.929596552	15.428204	0	6.768315558	0	0.088679843	4.371463543	18.4155416	12.58503667	0.53241	1.7316128	0	0	3.258168909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.0369
H1951_806_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		311.736513	8.077644	385.102211	2174.494279	6.990817	10.248012	4.02531	24.648106	77.14102	2954.386991	33.841747	0	0.443397	21.857427	92.077708	62.925498	1.06482	8.658064			16.290926																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000008	1023.999572	43.132787	0	0.199999	0.199999	0.2	0.199999	0.2	0	0.199999	0	0.200001	0.199999	0.2	0.199999	0.5	0.2			0.199999																				1024.000008	1023.999572	43.132787	0	0.199999	0.199999	0.2	0.199999	0.2	0	0.199999	0	0.200001	0.199999	0.2	0.199999	0.5	0.2			0.199999																				26.6015	0.689292	1.38421097	0	1.398156409	2.049592152	0.805062	4.929596552	15.428204	0	6.768315558	0	0.088679843	4.371463543	18.4155416	12.58503667	0.53241	1.7316128	0	0	3.258168909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.0369	0	0	26.6015	0.689292	1.38421097	0	1.398156409	2.049592152	0.805062	4.929596552	15.428204	0	6.768315558	0	0.088679843	4.371463543	18.4155416	12.58503667	0.53241	1.7316128	0	0	3.258168909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.0369																																																																																		0	0	0	26.6015	0.689292	1.38421097	0	1.398156409	2.049592152	0.805062	4.929596552	15.428204	0	6.768315558	0	0.088679843	4.371463543	18.4155416	12.58503667	0.53241	1.7316128	0	0	3.258168909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.0369
H1961_001_0	2009	6																																D	D	D	Coin	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		183.0210546	0	332.6131688	26.88315506	490.3773028	11.04113169	11.55911893	401.6327219	30.40043082	0	0	0	0	0	2346.04764	4880.983268	372.4092551	344.8289225	0	1067.388514	15.33216475	0	0	0	399.6326016	0	0	0	0	0											"Choice 1: $0, Choice 2: $150 copay days 1-3, $0 Copay afterwards"	- zero -	"$0 Copay days 1-20, $50 Copay 21+"	Choice 2: 10% for MC services $500 max OOP	"$75 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	- zero -	- zero -	- zero -	- zero -	- zero -	"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"	- zero -	"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"	- zero -	"$5 Copay, 12 one-way trips"	Varies by Service	"$15 Copay, 1 Exam per BP"	- zero -	- zero -	- zero -	- zero -	- zero -											63.21	0	8.37	0.008913528	75	0.093661264	0.108818063	45.13184109	150	0	0	0	0	0	6.631723857	15.75995577	10	4.999999999	0	15.81807302	0.063370291	0	0	0	15	0	0	0	0	0											63.21	0	8.37	0.008913528	75	0.093661264	0.108818063	45.13184109	150	0	0	0	0	0	6.631723857	15.75995577	10	4.999999999	0	15.81807302	0.063370291	0	0	0	15	0	0	0	0	0											0.9641	0	0.231997685	0.239623744	3.064858143	1.034126356	1.257840937	1.510535349	0.380005385	0	0	0	0	0	1.296528342	6.410340034	0.310341046	0.143678718	0	1.407002455	0.971603747	0	0	0	0.499540752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.7221	0		0.9641	0	0.231997685	0.239623744	3.064858143	1.034126356	1.257840937	1.510535349	0.380005385	0	0	0	0	0	1.296528342	6.410340034	0.310341046	0.143678718	0	1.407002455	0.971603747	0	0	0	0.499540752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.7221																																																																																		0			0.9641	0	0.231997685	0.239623744	3.064858143	1.034126356	1.257840937	1.510535349	0.380005385	0	0	0	0	0	1.296528342	6.410340034	0.310341046	0.143678718	0	1.407002455	0.971603747	0	0	0	0.499540752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.7221
H1961_002_0	2009	7																																D	D	D	Coin	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		59.22757279	0	236.23708	22.16655958	415.8106333	9.008777861	10.48513718	391.6843462	11.44272528	0	0	0	0	0	2454.249224	4466.551211	378.1683128	0	0	1277.057136	10.14045037	0	0	0	400.8524236	0	0	0	0	0											"Choice 1: $0, Choice 2: $150 copay days 1-3, $0 Copay afterwards"	- zero -	"$0 Copay days 1-20, $50 Copay 21+"	Choice 2: 10% for MC services $500 max OOP	"$25 Copay, per Trip"	"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	- zero -	- zero -	- zero -	- zero -	- zero -	"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"	- zero -	- zero -	"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"	- zero -	"$5 Copay, 12 one-way trips"	Varies by Service	"$15 Copay, 1 Exam per BP"	- zero -	- zero -	- zero -	- zero -	- zero -											63.21	0	8.370000001	0.003534281	25	0.048458603	0.055181536	41.76875575	150	0	0	0	0	0	5.640105039	10.43837604	9.999999995	0	0	10.47583818	0.05176714	0	0	0	15	0	0	0	0	0											63.21	0	8.370000001	0.003534281	25	0.048458603	0.055181536	41.76875575	150	0	0	0	0	0	5.640105039	10.43837604	9.999999995	0	0	10.47583818	0.05176714	0	0	0	15	0	0	0	0	0											0.312	0	0.164775363	0.078342841	0.866272153	0.436552786	0.578585974	1.363347316	0.143034066	0	0	0	0	0	1.153518618	3.885295096	0.315140261	0	0	1.114853658	0.524942117	0	0	0	0.50106553	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.4377	0		0.312	0	0.164775363	0.078342841	0.866272153	0.436552786	0.578585974	1.363347316	0.143034066	0	0	0	0	0	1.153518618	3.885295096	0.315140261	0	0	1.114853658	0.524942117	0	0	0	0.50106553	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.4377		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	- zero -	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	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -											1.8572	0.039	0.118	0.4682	0.1394	0.1613	0.2111	0.0997	0.6779	0.1155	0.5394	0	0	0.2286	0.5439	2.09	0.035	0.098	0.4216	0.7513	0.1391	0.0155	0	0	0	0	0	0	0	0											8.75	0		2.1692	0.039044396	0.282781164	0.54657734	1.005690185	0.597859901	0.78966451	1.463036991	0.820971472	0.115525313	0.539399865	0	0	0.22862668	1.697404153	5.975301473	0.350179051	0.09798019	0.421625838	1.866195612	0.664076225	0.015514425	0	0	0.50106553	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.1877
H1961_003_0	2009	7																																D	D	D	Coin	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	P	O	V	T	V	V	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	0	0	0											0		264.7147574	0	751.9833141	56.22716733	628.0166472	19.00280496	20.53448039	650.2337429	39.36641368	0	0	0	0	0	541.88876	711.1969682	744.4374393	0	0	106.5411022	0	0	0	0	385.326284	0	0	0	0	0											"Choice 1: $0, Choice 2: $150 copay days 1-3, $0 Copay afterwards"	- zero -	"$0 Copay days 1-20, $50 Copay 21+"	Choice 2: 10% for MC services $500 max OOP	"$25 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	- zero -	- zero -	- zero -	- zero -	- zero -	Office Visit:  Choice 2: $25 Copay	Office Visit:  Choice 2: $25 Copay	"$10 Copay days 1-20, 50% coins after"	- zero -	- zero -	"Chiropractor & Podiatrist: Choice 2: $25 Copay, Vision Exams: Choice 2: $15 Copay"	- zero -	- zero -	"$5 Copay, 24 one-way trips"	Varies by Service	Choice 2: $15 copay	- zero -	- zero -	- zero -	- zero -	- zero -											63.21	0	8.37	0.011768011	25	0.005511034	0.005844599	37.83095741	150	0	0	0	0	0	25	25	9.999999999	0	0	25	0	0	0	0	15	0	0	0	0	0											63.21	0	8.37	0.011768011	25	0.005511034	0.005844599	37.83095741	150	0	0	0	0	0	25	25	9.999999999	0	0	25	0	0	0	0	15	0	0	0	0	0											1.3944	0	0.524508362	0.661681948	1.308368015	0.104725107	0.120015809	2.049913753	0.492080171	0	0	0	0	0	1.128934917	1.48166035	0.620364533	0	0	0.22196063	0	0	0	0	0.481657855	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.5903	0		1.3944	0	0.524508362	0.661681948	1.308368015	0.104725107	0.120015809	2.049913753	0.492080171	0	0	0	0	0	1.128934917	1.48166035	0.620364533	0	0	0.22196063	0	0	0	0	0.481657855	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.5903																																																																																		0			1.3944	0	0.524508362	0.661681948	1.308368015	0.104725107	0.120015809	2.049913753	0.492080171	0	0	0	0	0	1.128934917	1.48166035	0.620364533	0	0	0.22196063	0	0	0	0	0.481657855	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.5903
H1961_801_0	2009	4																					0											Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	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	0	0	0											0	0	235.7913288	2.089577471	35.87595803	0	6.540025147	10.76412101	6.958695924	12.7919404	38.23627423	6.45628393	18.37373364	0	0.517798035	27.69289485	40.78371994	103.8721094	1.303309268	4.231895977	28.63934834	44.68119599	8.281146649	0.923405679	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 Speclst - Office Visits; 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 - 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 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 Chiropractor; 23% Coinsurance for Vistion Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical (PCP); 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 Part B Rx	23% Coinsurance for Blood Products																			0.076079744	0.076079744	0.213315955	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.076079744	0.076079744	0.213315955	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											17.9389	0.158974519	7.652914232	0	1.510745809	2.486511953	1.607458758	2.954938233	8.832579348	1.491401588	4.244332472	0	0.119611346	6.39705871	9.421039306	23.99445728	0.301064441	0.977567971	6.615689467	10.32135627	1.912944876	0.213306712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.1529	0	0	17.9389	0.158974519	7.652914232	0	1.510745809	2.486511953	1.607458758	2.954938233	8.832579348	1.491401588	4.244332472	0	0.119611346	6.39705871	9.421039306	23.99445728	0.301064441	0.977567971	6.615689467	10.32135627	1.912944876	0.213306712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.1529	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 Speclst - Office Visits; 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 - 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 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 Chiropractor; 23% Coinsurance for Vistion Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical (PCP); 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 Part B Rx	23% Coinsurance for Blood Products																			1.4336	0.0127	0.6116		0.1207	0.1987	0.1285	0.2361	0.7058	0.1192	0.3392		0.0096	0.5112	0.7529	1.9175	0.0241	0.0781	0.5287	0.8248	0.1529	0.017																			8.7228	0	0	19.3725	0.171678746	8.264486212	0	1.631474956	2.685218092	1.735916586	3.191078006	9.538422622	1.610584868	4.583512389	0	0.12916992	6.908270745	10.17390854	25.91194091	0.325123586	1.055688953	7.144373074	11.14617308	2.065815201	0.230352821	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.8757
H1961_802_0	2009	4																					0											Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	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	0	0	0											0	0	235.7913288	2.089577471	35.87595803	0	6.540025147	10.76412101	6.958695924	12.7919404	38.23627423	6.45628393	18.37373364	0	0.517798035	27.69289485	40.78371994	103.8721094	1.303309268	4.231895977	28.63934834	44.68119599	8.281146649	0.923405679	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 Speclst - Office Visits; 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 - 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 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 Chiropractor; 23% Coinsurance for Vistion Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical (PCP); 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 Part B Rx	23% Coinsurance for Blood Products																			0.076079744	0.076079744	0.213315955	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.076079744	0.076079744	0.213315955	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											17.9389	0.158974519	7.652914232	0	1.510745809	2.486511953	1.607458758	2.954938233	8.832579348	1.491401588	4.244332472	0	0.119611346	6.39705871	9.421039306	23.99445728	0.301064441	0.977567971	6.615689467	10.32135627	1.912944876	0.213306712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.1529	0	0	17.9389	0.158974519	7.652914232	0	1.510745809	2.486511953	1.607458758	2.954938233	8.832579348	1.491401588	4.244332472	0	0.119611346	6.39705871	9.421039306	23.99445728	0.301064441	0.977567971	6.615689467	10.32135627	1.912944876	0.213306712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.1529	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 Speclst - Office Visits; 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 - 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 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 Chiropractor; 23% Coinsurance for Vistion Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical (PCP); 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 Part B Rx	23% Coinsurance for Blood Products																			1.4336	0.0127	0.6116		0.1207	0.1987	0.1285	0.2361	0.7058	0.1192	0.3392		0.0096	0.5112	0.7529	1.9175	0.0241	0.0781	0.5287	0.8248	0.1529	0.017																			8.7228	0	0	19.3725	0.171678746	8.264486212	0	1.631474956	2.685218092	1.735916586	3.191078006	9.538422622	1.610584868	4.583512389	0	0.12916992	6.908270745	10.17390854	25.91194091	0.325123586	1.055688953	7.144373074	11.14617308	2.065815201	0.230352821	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.8757
H1961_803_0	2009	4																					0											Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	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	0	0	0											0	0	254.6342644	2.256563144	38.74293523	0	7.062662146	11.62432074	7.514790415	13.8141905	41.29187282	6.972228866	19.84204497	0	0.559177144	29.90593396	44.0428941	112.1729044	1.407461413	4.570082049	30.92802197	48.25183152	8.942922947	0.997198357	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 Speclst - Office Visits; 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 - 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 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 Chiropractor; 23% Coinsurance for Vistion Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical (PCP); 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 Part B Rx	23% Coinsurance for Blood Products																			0.076079744	0.076079744	0.213315955	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.076079744	0.076079744	0.213315955	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											19.3725	0.171678746	8.264486212	0	1.631474956	2.685218092	1.735916586	3.191078006	9.538422622	1.610584868	4.583512389	0	0.12916992	6.908270745	10.17390854	25.91194091	0.325123586	1.055688953	7.144373074	11.14617308	2.065815201	0.230352821	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.8757	0	0	19.3725	0.171678746	8.264486212	0	1.631474956	2.685218092	1.735916586	3.191078006	9.538422622	1.610584868	4.583512389	0	0.12916992	6.908270745	10.17390854	25.91194091	0.325123586	1.055688953	7.144373074	11.14617308	2.065815201	0.230352821	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.8757	0																																																																																	0	0	0	19.3725	0.171678746	8.264486212	0	1.631474956	2.685218092	1.735916586	3.191078006	9.538422622	1.610584868	4.583512389	0	0.12916992	6.908270745	10.17390854	25.91194091	0.325123586	1.055688953	7.144373074	11.14617308	2.065815201	0.230352821	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.8757
H1961_804_0	2009	4																					0											Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	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	0	0	0											0	0	254.6342644	2.256563144	38.74293523	0	7.062662146	11.62432074	7.514790415	13.8141905	41.29187282	6.972228866	19.84204497	0	0.559177144	29.90593396	44.0428941	112.1729044	1.407461413	4.570082049	30.92802197	48.25183152	8.942922947	0.997198357	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 Speclst - Office Visits; 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 - 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 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 Chiropractor; 23% Coinsurance for Vistion Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical (PCP); 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 Part B Rx	23% Coinsurance for Blood Products																			0.076079744	0.076079744	0.213315955	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.076079744	0.076079744	0.213315955	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											19.3725	0.171678746	8.264486212	0	1.631474956	2.685218092	1.735916586	3.191078006	9.538422622	1.610584868	4.583512389	0	0.12916992	6.908270745	10.17390854	25.91194091	0.325123586	1.055688953	7.144373074	11.14617308	2.065815201	0.230352821	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.8757	0	0	19.3725	0.171678746	8.264486212	0	1.631474956	2.685218092	1.735916586	3.191078006	9.538422622	1.610584868	4.583512389	0	0.12916992	6.908270745	10.17390854	25.91194091	0.325123586	1.055688953	7.144373074	11.14617308	2.065815201	0.230352821	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.8757	0																																																																																	0	0	0	19.3725	0.171678746	8.264486212	0	1.631474956	2.685218092	1.735916586	3.191078006	9.538422622	1.610584868	4.583512389	0	0.12916992	6.908270745	10.17390854	25.91194091	0.325123586	1.055688953	7.144373074	11.14617308	2.065815201	0.230352821	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.8757
H1991_801_0	2009	2		r.										OP Facility - Other									4000		ASC									Coin		Coin	Coin	Coin	Coin		Coin	Coin	Coin				Coin	Coin	Coin			Coin	Coin					Coin	Coin	Coin	Coin				Coin									24.9383		4.0955	0.0678	1.108	1.4477		0.7415	2.2362	0.5959				8.8713	3.1216	3.558			4.5477	17.9376					0	0.0163	0	0				1.4669									74.7503		296.8848622		48.75603555	0.806580022	13.19019972	17.2345096		8.8268394	26.62123319	7.094400733				105.6110344	37.16212617	42.35765787			54.13968639	213.5425499					0.000198962	0.193928841	0	0				17.4625322									$1000 Ded; 80% to 15k		$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k		$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k				$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k			$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k					$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k				$1000 Ded; 80% to 15k									0.2		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									0.087		0.087	0.087	0.087	0.087		0.087	0.087	0.087				0.087	0.087	0.087			0.087	0.087					0.087	0.087	0.087	0.087				0.087									25.829	0	4.241775092	0.070172462	1.147547376	1.499402335	0	0.767935028	2.316047288	0.617212864	0	0	0	9.188159995	3.233104977	3.685116235	0	0	4.710152716	18.57820184	0	0	0	0	1.73E-05	0.016871809	0	0	0	0	0	1.519240301	0	0	0	0	0	0	0	0	77.4199	1000	74.6529	50.7673	0	8.337282078	0.137925184	2.255524152	2.947101142	0	1.509389537	4.552230876	1.213142525	0	0	0	18.05948689	6.354723576	7.243159496	0	0	9.257886373	36.51577603	0	0	0	0	3.40E-05	0.033161832	0	0	0	0	0	2.986093006	0	0	0	0	0	0	0	0	152.1702																																																																																		0			50.7673	0	8.337282078	0.137925184	2.255524152	2.947101142	0	1.509389537	4.552230876	1.213142525	0	0	0	18.05948689	6.354723576	7.243159496	0	0	9.257886373	36.51577603	0	0	0	0	3.40E-05	0.033161832	0	0	0	0	0	2.986093006	0	0	0	0	0	0	0	0	152.1702
H1991_802_0	2009	1		r.										OP Facility - Other									4000		ASC									coin		coin	coin	coin	coin		coin	coin	coin				coin	coin	coin			coin	coin					coin	coin	coin	coin				coin									24.9383		4.0955	0.0678	1.108	1.4477		0.7415	2.2362	0.5959				8.8713	3.1216	3.558			4.5477	17.9376					0	0.0163	0	0				1.4669									74.7503		296.8848622		48.75603555	0.806580022	13.19019972	17.2345096		8.8268394	26.62123319	7.094400733				105.6110344	37.16212617	42.35765787			54.13968639	213.5425499					0.000198962	0.193928841	0	0				17.4625322									$1000 Ded; 80% to 15k		$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k		$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k				$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k			$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k					$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k				$1000 Ded; 80% to 15k									0.2		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									0.087		0.087	0.087	0.087	0.087		0.087	0.087	0.087				0.087	0.087	0.087			0.087	0.087					0.087	0.087	0.087	0.087				0.087									25.829	0	4.241775092	0.070172462	1.147547376	1.499402335	0	0.767935028	2.316047288	0.617212864	0	0	0	9.188159995	3.233104977	3.685116235	0	0	4.710152716	18.57820184	0	0	0	0	1.73E-05	0.016871809	0	0	0	0	0	1.519240301	0	0	0	0	0	0	0	0	77.4199	1000	74.6529	50.7673	0	8.337282078	0.137925184	2.255524152	2.947101142	0	1.509389537	4.552230876	1.213142525	0	0	0	18.05948689	6.354723576	7.243159496	0	0	9.257886373	36.51577603	0	0	0	0	3.40E-05	0.033161832	0	0	0	0	0	2.986093006	0	0	0	0	0	0	0	0	152.1702																																																																																		0			50.7673	0	8.337282078	0.137925184	2.255524152	2.947101142	0	1.509389537	4.552230876	1.213142525	0	0	0	18.05948689	6.354723576	7.243159496	0	0	9.257886373	36.51577603	0	0	0	0	3.40E-05	0.033161832	0	0	0	0	0	2.986093006	0	0	0	0	0	0	0	0	152.1702
H1991_803_0	2009	1	r										OP Facility - Other										4000	ASC										coin		coin	coin	coin	coin		coin	coin	coin				coin	coin	coin			coin	coin					coin	coin	coin	coin			coin										24.9383		4.0955	0.0678	1.108	1.4477		0.7415	2.2362	0.5959				8.8713	3.1216	3.558			4.5477	17.9376					0	0.0163	0	0			1.4669										74.7503		296.8848622		48.75603555	0.806580022	13.19019972	17.2345096		8.8268394	26.62123319	7.094400733				105.6110344	37.16212617	42.35765787			54.13968639	213.5425499					0.000198962	0.193928841	0	0			17.4625322										$1000 Ded; 80% to 15k		$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k		$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k				$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k			$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k					$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k			$1000 Ded; 80% to 15k										0.2		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										0.087		0.087	0.087	0.087	0.087		0.087	0.087	0.087				0.087	0.087	0.087			0.087	0.087					0.087	0.087	0.087	0.087			0.087										25.829	0	4.241775092	0.070172462	1.147547376	1.499402335	0	0.767935028	2.316047288	0.617212864	0	0	0	9.188159995	3.233104977	3.685116235	0	0	4.710152716	18.57820184	0	0	0	0	1.73E-05	0.016871809	0	0	0	0	1.519240301	0	0	0	0	0	0	0	0	0	77.4199	1000	74.6529	50.7673	0	8.337282078	0.137925184	2.255524152	2.947101142	0	1.509389537	4.552230876	1.213142525	0	0	0	18.05948689	6.354723576	7.243159496	0	0	9.257886373	36.51577603	0	0	0	0	3.40E-05	0.033161832	0	0	0	0	2.986093006	0	0	0	0	0	0	0	0	0	152.1702																																																																																		0			50.7673	0	8.337282078	0.137925184	2.255524152	2.947101142	0	1.509389537	4.552230876	1.213142525	0	0	0	18.05948689	6.354723576	7.243159496	0	0	9.257886373	36.51577603	0	0	0	0	3.40E-05	0.033161832	0	0	0	0	2.986093006	0	0	0	0	0	0	0	0	0	152.1702
H2001_001_0	2009	5																					3250											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1498.420957	154.872851	641.1854618	446.6906834	130.2024816	9.353362858	4.980070037	384.1387895	28.08246179	8570.516701	30.92217234	0	0.109689296	20.20189278	4798.309359	3853.38084	589.2085137	436.7872035	0	0	13.05459679	914.2978649	0	0	115.6616715	0	14.91839934	8.976	389.7971675	0											"$250 Days 1-13 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$250 Days 1-13 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											247.0547332	250	85.36789939	0	150	0.2	0.078251122	48.46749013	0.2	2.8	0.181555286	0	0.2	0.19894736	13.71564618	25	37.5	25	0	0	0.2	24.22672248	0	0	25	0	25	0	0	0											172.9212229	174.9627572	59.74481221	0	104.9776543	0.139970206	0.054764129	33.92002283	0.139970206	1.959582881	0.127061654	0	0.139970206	0.140241757	13.71564618	25	37.5	17.49627572	0	0	0.139970206	24.22672248	0	0	25	0	25	0	0	0											21.5924	2.258081752	3.192292084	0	1.139029259	1.309192124	0.272729196	1.085833043	3.930707955	1.39955315	3.929022363	0	0.015353233	2.833148944	5.484326119	8.027876751	1.841276605	0.636845779	0	0	1.827254599	1.845870053	0	0	0.240961816	0	0.031079999	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8928	0	19.4475	21.5924	2.258081752	3.192292084	0	1.139029259	1.309192124	0.272729196	1.085833043	3.930707955	1.39955315	3.929022363	0	0.015353233	2.833148944	5.484326119	8.027876751	1.841276605	0.636845779	0	0	1.827254599	1.845870053	0	0	0.240961816	0	0.031079999	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8928		"30% Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"30% Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"30% Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$30 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a7, 14a8, 14a9, 14a10); $0 (14a6)"	"$0 n/c (13b, 13d, 13e)"											3.8054	0.1939	2.8549	0.3274	0.2872	0.4952	0.2637	0.2738	1.4867	0.3529	1.4536	0	0.0039	1.0588	2.3625	2.7898	0.5217	0.3185	0	0	0.9791	0.6516	0	0	0.0843	0	0.0109	0	0	0											20.5758	0	0	25.3978	2.451931931	6.047218187	0.327418344	1.426240615	1.804370157	0.536379962	1.359630734	5.41742652	1.752456779	5.382666848	0	0.01922462	3.891899549	7.846860589	10.8176748	2.362971644	0.955336448	0	0	2.806349359	2.497490628	0	0	0.325298451	0	0.041957998	0	0	0	0	0	0	0	0	0	0	0	0	0	83.4686
H2001_003_0	2009	4																					2600											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1567.325275	161.1985218	719.862571	673.6798979	117.1814583	10.46055404	4.669132866	387.0316242	32.10460445	10279.93652	39.23577034	0	0.16964379	30.57785299	5248.636416	4090.790777	635.1602576	327.5195647	0	0	17.44892388	875.2640559	0	0	137.0742908	0	14.81870014	8.976	386.006538	0											"$150 Days 1-18 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$150 Days 1-18 (1b); $0 n/c (1b1, 1b2)"	"$75 Days 1-35 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	15% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 15% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 15% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											148.2613646	150	75	0	150	0.2	0.071093918	47.82178825	0.15	2.8	0.143583825	0	0.2	0.148766423	7.030168668	25	37.5	25	0	0	0.2	24.07094608	0	0	25	0	25	0	0	0											103.1266314	104.3149697	52.15748487	0	104.3149697	0.139086626	0.049441066	33.25685596	0.10431497	1.947212768	0.099852949	0	0.139086626	0.103716759	7.030168668	25	37.5	17.38582829	0	0	0.139086626	24.07094608	0	0	25	0	25	0	0	0											13.4694	1.40128491	3.128851763	0	1.018648357	1.454923171	0.230846907	1.072621248	3.348990841	1.668101972	3.917807386	0	0.023595182	3.171435796	3.07489994	8.522480786	1.984875805	0.474516576	0	0	2.426911955	1.755702825	0	0	0.285571439	0	0.030872292	0	0	0	0	0	0	0	0	0	0	0	0	0	52.4624	0	16.1048	13.4694	1.40128491	3.128851763	0	1.018648357	1.454923171	0.230846907	1.072621248	3.348990841	1.668101972	3.917807386	0	0.023595182	3.171435796	3.07489994	8.522480786	1.984875805	0.474516576	0	0	2.426911955	1.755702825	0	0	0.285571439	0	0.030872292	0	0	0	0	0	0	0	0	0	0	0	0	0	52.4624		"$250 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 25% (13c)"	"$250 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$125 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"25% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	25%/$7 (8a1); $7 (8a2)	"$20 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 25% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 25% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a7, 14a8, 14a9, 14a10); $0 (14a6)"	"$0 n/c (13b, 13d, 13e)"											2.0871	0.2135	3.2099	0.2418	0.2585	0.5538	0.2472	0.2722	1.4164	0.4233	1.58	0	0.006	1.3338	1.7617	2.9581	0.5624	0.2388	0	0	1.3087	0.6236	0	0	0.1	0	0.0108	0	0	0											19.4076	0	0	15.5565	1.614795714	6.338771452	0.241820891	1.277136868	2.008717209	0.478036295	1.344805724	4.765370449	2.091393475	5.497840571	0	0.02958261	4.505266189	4.836562539	11.48057813	2.547257283	0.713332925	0	0	3.735581246	2.379328027	0	0	0.385521443	0	0.041677594	0	0	0	0	0	0	0	0	0	0	0	0	0	71.8699
H2001_007_0	2009	4																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		302.3175343	22.9152	39.65627446	4762.379615	13.10901793	28.79488737	9.791870703	20.57032118	32.01955436	5.946292608	14.38579827	0	2.398003468	34.11218783	46.26965143	123.8842995	13.3855	5.059104876	0	0	21.28517109	6.175353867	314.4512947	0	314.3760437	332.2285714	0	0	20.2	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.075818153	0.076739021	0.147356344	0	0.2	0.2	0.2	0.125114886	0.2	0.08	0.2	0	0.2	0.2	0	0.199550976	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											0.075818153	0.076739021	0.147356344	0	0.2	0.2	0.2	0.125114886	0.2	0.08	0.2	0	0.2	0.2	0	0.199550976	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											22.9212	1.758490024	5.843603628	0	2.621803585	5.758977475	1.958374141	2.573653381	6.403910872	0.475703409	2.877159654	0	0.479600694	6.822437567	0	24.72123286	2.6771	1.011820975	0	0	4.257034218	0.091823059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.2539	0	0	22.9212	1.758490024	5.843603628	0	2.621803585	5.758977475	1.958374141	2.573653381	6.403910872	0.475703409	2.877159654	0	0.479600694	6.822437567	0	24.72123286	2.6771	1.011820975	0	0	4.257034218	0.091823059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.2539		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.779	0.2864	0.6262	0.9273	0.207	0.4547	0.1546	0.1356	0.5056	0.0939	0.2271	0	0.0252	0.5386	0.7306	1.9561	0.2114	0.0799	0	0	0.3361	0.067	0.0261	0	0.0155	0	0	0	0.003	0											11.3867	0	0	26.7001	2.044930024	6.46975533	0.927329076	2.828788079	6.213633591	2.112982625	2.709218522	6.909482783	0.569592239	3.104303837	0	0.504842835	7.361051059	0.730573444	26.67730075	2.88845	1.091701579	0	0	4.593115867	0.158832661	0.0261	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	104.6406
H2001_801_0	2009	2																					3465											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1572.604367	162.5402533	672.9290943	468.8053222	136.64851	9.811824277	5.224171545	403.1147241	29.45894269	8994.823472	32.43784357	0	0.115065791	21.19210225	4948.222515	4035.832189	618.3788859	458.4115436	0	0	13.6944767	959.5626708	0	0	0	0	0	0	0	0											"$385 Days 1-9 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$385 Days 1-9 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-20 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$15 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											380.428822	385	175	0	150	0.2	0.078251122	48.46733083	0.2	7	0.181572015	0	0.2	0.198949817	10.46892766	25	37.5	25	0	0	0.2	24.22672248	0	0	0	0	0	0	0	0											234.5119845	237.3043477	107.8656126	0	92.45623935	0.123274986	0.04823203	29.8740476	0.123274986	4.314624503	0.111916438	0	0.123274986	0.123916934	10.46892766	25	37.5	15.40937322	0	0	0.123274986	24.22672248	0	0	0	0	0	0	0	0											30.7329	3.214292398	6.048825748	0	1.052833946	1.209552498	0.251972399	1.003555705	3.631550741	3.234107146	3.630327911	0	0.014184734	2.626060336	4.316881965	8.407983727	1.932434018	0.588652881	0	0	1.688186421	1.937254877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5215	0	36.6258	30.7329	3.214292398	6.048825748	0	1.052833946	1.209552498	0.251972399	1.003555705	3.631550741	3.234107146	3.630327911	0	0.014184734	2.626060336	4.316881965	8.407983727	1.932434018	0.588652881	0	0	1.688186421	1.937254877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5215		"30% Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"30% Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"30% Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											3.9919	0.2034	2.9949	0.3435	0.3014	0.5194	0.2766	0.2873	1.5596	0.9259	1.525	0	0.0041	1.1107	2.0532	2.9226	0.5475	0.3343	0	0	1.0271	0.6839	0	0	0	0	0	0	0	0											21.6122	0	0	34.7248	3.417644274	9.043687989	0.343466976	1.354264483	1.729002019	0.528546186	1.290877686	5.191141825	4.160044856	5.155351448	0	0.018245879	3.736717608	6.370085308	11.33058204	2.47995699	0.922911298	0	0	2.715272174	2.621132965	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.1338
H2001_803_0	2009	2																					3465											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1572.604367	162.5402533	672.9290943	468.8053222	136.64851	9.811824277	5.224171545	403.1147241	29.45894269	8994.823472	32.43784357	0	0.115065791	21.19210225	4948.222515	4035.832189	618.3788859	458.4115436	0	0	13.6944767	959.5626708	0	0	0	0	0	0	0	0											"$385 Days 1-9 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$385 Days 1-9 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-20 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$15 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											380.428822	385	175	0	150	0.2	0.078251122	48.46733083	0.2	7	0.181572015	0	0.2	0.198949817	10.46892766	25	37.5	25	0	0	0.2	24.22672248	0	0	0	0	0	0	0	0											234.5119845	237.3043477	107.8656126	0	92.45623935	0.123274986	0.04823203	29.8740476	0.123274986	4.314624503	0.111916438	0	0.123274986	0.123916934	10.46892766	25	37.5	15.40937322	0	0	0.123274986	24.22672248	0	0	0	0	0	0	0	0											30.7329	3.214292398	6.048825748	0	1.052833946	1.209552498	0.251972399	1.003555705	3.631550741	3.234107146	3.630327911	0	0.014184734	2.626060336	4.316881965	8.407983727	1.932434018	0.588652881	0	0	1.688186421	1.937254877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5215	0	36.6258	30.7329	3.214292398	6.048825748	0	1.052833946	1.209552498	0.251972399	1.003555705	3.631550741	3.234107146	3.630327911	0	0.014184734	2.626060336	4.316881965	8.407983727	1.932434018	0.588652881	0	0	1.688186421	1.937254877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5215		"30% Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"30% Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"30% Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											3.9919	0.2034	2.9949	0.3435	0.3014	0.5194	0.2766	0.2873	1.5596	0.9259	1.525	0	0.0041	1.1107	2.0532	2.9226	0.5475	0.3343	0	0	1.0271	0.6839	0	0	0	0	0	0	0	0											21.6122	0	0	34.7248	3.417644274	9.043687989	0.343466976	1.354264483	1.729002019	0.528546186	1.290877686	5.191141825	4.160044856	5.155351448	0	0.018245879	3.736717608	6.370085308	11.33058204	2.47995699	0.922911298	0	0	2.715272174	2.621132965	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.1338
H2001_804_0	2009	2																					3465											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1572.604367	162.5402533	672.9290943	468.8053222	136.64851	9.811824277	5.224171545	403.1147241	29.45894269	8994.823472	32.43784357	0	0.115065791	21.19210225	4948.222515	4035.832189	618.3788859	458.4115436	0	0	13.6944767	959.5626708	0	0	0	0	0	0	0	0											"$385 Days 1-9 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$385 Days 1-9 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-20 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$15 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											380.428822	385	175	0	150	0.2	0.078251122	48.46733083	0.2	7	0.181572015	0	0.2	0.198949817	10.46892766	25	37.5	25	0	0	0.2	24.22672248	0	0	0	0	0	0	0	0											234.5119845	237.3043477	107.8656126	0	92.45623935	0.123274986	0.04823203	29.8740476	0.123274986	4.314624503	0.111916438	0	0.123274986	0.123916934	10.46892766	25	37.5	15.40937322	0	0	0.123274986	24.22672248	0	0	0	0	0	0	0	0											30.7329	3.214292398	6.048825748	0	1.052833946	1.209552498	0.251972399	1.003555705	3.631550741	3.234107146	3.630327911	0	0.014184734	2.626060336	4.316881965	8.407983727	1.932434018	0.588652881	0	0	1.688186421	1.937254877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5215	0	36.6258	30.7329	3.214292398	6.048825748	0	1.052833946	1.209552498	0.251972399	1.003555705	3.631550741	3.234107146	3.630327911	0	0.014184734	2.626060336	4.316881965	8.407983727	1.932434018	0.588652881	0	0	1.688186421	1.937254877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5215		"30% Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"30% Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"30% Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											3.9919	0.2034	2.9949	0.3435	0.3014	0.5194	0.2766	0.2873	1.5596	0.9259	1.525	0	0.0041	1.1107	2.0532	2.9226	0.5475	0.3343	0	0	1.0271	0.6839	0	0	0	0	0	0	0	0											21.6122	0	0	34.7248	3.417644274	9.043687989	0.343466976	1.354264483	1.729002019	0.528546186	1.290877686	5.191141825	4.160044856	5.155351448	0	0.018245879	3.736717608	6.370085308	11.33058204	2.47995699	0.922911298	0	0	2.715272174	2.621132965	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.1338
H2001_805_0	2009	2																					3465											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1572.604367	162.5402533	672.9290943	468.8053222	136.64851	9.811824277	5.224171545	403.1147241	29.45894269	8994.823472	32.43784357	0	0.115065791	21.19210225	4948.222515	4035.832189	618.3788859	458.4115436	0	0	13.6944767	959.5626708	0	0	0	0	0	0	0	0											"$385 Days 1-9 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$385 Days 1-9 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-20 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$15 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											380.428822	385	175	0	150	0.2	0.078251122	48.46733083	0.2	7	0.181572015	0	0.2	0.198949817	10.46892766	25	37.5	25	0	0	0.2	24.22672248	0	0	0	0	0	0	0	0											234.5119845	237.3043477	107.8656126	0	92.45623935	0.123274986	0.04823203	29.8740476	0.123274986	4.314624503	0.111916438	0	0.123274986	0.123916934	10.46892766	25	37.5	15.40937322	0	0	0.123274986	24.22672248	0	0	0	0	0	0	0	0											30.7329	3.214292398	6.048825748	0	1.052833946	1.209552498	0.251972399	1.003555705	3.631550741	3.234107146	3.630327911	0	0.014184734	2.626060336	4.316881965	8.407983727	1.932434018	0.588652881	0	0	1.688186421	1.937254877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5215	0	36.6258	30.7329	3.214292398	6.048825748	0	1.052833946	1.209552498	0.251972399	1.003555705	3.631550741	3.234107146	3.630327911	0	0.014184734	2.626060336	4.316881965	8.407983727	1.932434018	0.588652881	0	0	1.688186421	1.937254877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5215		"30% Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"30% Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"30% Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											3.9919	0.2034	2.9949	0.3435	0.3014	0.5194	0.2766	0.2873	1.5596	0.9259	1.525	0	0.0041	1.1107	2.0532	2.9226	0.5475	0.3343	0	0	1.0271	0.6839	0	0	0	0	0	0	0	0											21.6122	0	0	34.7248	3.417644274	9.043687989	0.343466976	1.354264483	1.729002019	0.528546186	1.290877686	5.191141825	4.160044856	5.155351448	0	0.018245879	3.736717608	6.370085308	11.33058204	2.47995699	0.922911298	0	0	2.715272174	2.621132965	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.1338
H2003_001_0	2009	4																					2400											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1417.571262	743.6504578	6957.226089	92.74073004	536.5185496	10.88160687	12.43185273	151.7716249	99.34211446	11206.00982	1473.165179	0	5.519905857	252.1963138	154.1152935	7163.830874	169.1796969	36.83325499	0	0	1319.065182	843.7949258	1498.037626	0	182.0000636	141.3063859	46.85749586	0	0	0											"$175 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $35 (4b)	$35 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$35 (3, 5, 9a, 9d); $35/$25 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $35 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$15 (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"$35/$25 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											173.6011825	175	0	0	75	0.2	0.2	49.81663475	35	0	0	0	0	34.80533718	0	14.48746789	32.5	0	0	0	0	14.67406104	0	0	0	0	0	0	0	0											149.160275	150.3621562	0	0	64.44092409	0.171842464	0.171842464	42.80306638	30.07243124	0	0	0	0	29.90517455	0	12.44781091	27.92440044	0	0	0	0	12.60813404	0	0	0	0	0	0	0	0											17.6204	9.318073857	0	0	2.881145927	1.869922139	2.136320209	0.541357578	0.248954909	0	0	0	0	0.628497899	0	7.431167678	0.3936868	0	0	0	0	0.886556628	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.9561	0	7.2025	17.6204	9.318073857	0	0	2.881145927	1.869922139	2.136320209	0.541357578	0.248954909	0	0	0	0	0.628497899	0	7.431167678	0.3936868	0	0	0	0	0.886556628	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.9561		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $35 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $35 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.1539	0.3717	0.8418	0.0409	0.3123	0.1718	0.1963	0.0332	0.0954	0.3921	0.3244	0	0	0.064	0.0161	1.7901	0.5576	0.0038	0	0	0.1179	0.0882	0.1107	0	0.0089	0	0.004	0	0	0											7.6951	0	0	19.7744	9.689773857	0.841781787	0.040925884	3.19343894	2.041736984	2.33261262	0.574518769	0.344362454	0.392100436	0.324390368	0	0	0.692540971	0.016103935	9.221270466	0.9512368	0.003807516	0	0	0.117865194	0.974770984	0.110719388	0	0.008933819	0	0.003969466	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6512
H2003_002_0	2009	4																					3350											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1717.83945	271.106692	36.46595483	46313.95761	80.23472917	18.21668641	8.054097247	327.8972653	343.7610088	5444.042568	416.3403791	0	0.707510691	1329.177231	5372.252366	3984.924043	1242.868229	237.5984609	0	0	23.40862624	1006.268405	769.983193	0	4996.961919	5677.881263	0	0	20.2	0											"$225 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$225 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$125 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$125 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5); $125 (9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											222.3	225	0.148103575	0	125	0.14	0.2	49.97102751	125	4.4	64.79010385	0	0.2	115.4432069	3.248814	25	20	20	0	0	0.2	13.6791576	0	0	0	0	0	0	0	0											161.2225839	163.1807529	0.148103575	0	90.65597384	0.101534691	0.145049558	36.2413773	90.65597384	3.191090279	46.98887967	0	0.145049558	83.72493075	3.248814	25	20	20	0	0	0.145049558	13.6791576	0	0	0	0	0	0	0	0											23.0795	3.686616177	5.400738274	0	0.606146459	1.84962562	1.168243247	0.990287376	2.596999085	1.44770261	1.630280665	0	0.102624113	9.273772637	1.454454058	8.301925089	2.071447048	0.395997435	0	0	3.395410893	1.147075342	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5989	0	18.8765	23.0795	3.686616177	5.400738274	0	0.606146459	1.84962562	1.168243247	0.990287376	2.596999085	1.44770261	1.630280665	0	0.102624113	9.273772637	1.454454058	8.301925089	2.071447048	0.395997435	0	0	3.395410893	1.147075342	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5989		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.26	0.2202	0.5758	0.4872	0.1254	0.2876	0.1272	0.072	0.5692	0.0895	0.2414	0	0.0074	0.4538	0.6194	1.95	0.1512	0.067	0	0	0.3696	0.0769	0.0569	0	0.0155	0	0	0	0.003	0											9.8261	0	0	26.3395	3.906816177	5.976516508	0.487158605	0.731537565	2.137257511	1.295413203	1.062262704	3.166181634	1.537222627	1.871685608	0	0.110071594	9.72754743	2.073853501	10.25191896	2.222647048	0.462960399	0	0	3.765020781	1.223957227	0.056935837	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	78.4249
H2029_001_0	2009	4	r.	s.	t.	u.							Skilled Nursing Facility	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered																		D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin	V		V		O	O	D	O	O	O							0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0			0	0		0		0	0	0	0	0	0							0		1098.150161	48.895489	383.270153	547.779883	108.953931	5.59414	2.020229	246.445614	267.139093	472.295495	700.988134	0	14.59851	536.25007	2624.564517	3163.680572	21.581347	681.896559			12.643705			4.31	2.47		0.33		1.3	0.25	383.270153	0.06	0.05	1.23							$25/Day(Days 1-3):1a	$25/Day(Days 1-3):1b	$0/Day(Days 1-20) $0(Days 20-100):2	$0/Visit:6	$10/Trip:10a	0% Coins:11a	0% Coins:11b	$25/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$10/Visit:14h. $0 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $0 Advanced Imaging -- FSR,8b. $5 Advanced Imaging -- Office,9a. $10 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $0 Radiology OP -- Facility"	$0/Visit:9a	$0/Proc:12	"$0-$5/Visit:9d. $0 Cardiac Rehab,8b. $0 Nuclear Medicine,9a. $0 OP Other,5. $5 Partial Hospitalization,8b. $0 Rad therapy,3. $0 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$5/Visit:7b, 7d, 7f"	"$0-$5/Visit:7h. $0 Psych -- OP,7e. $5 Psych -- Other Provider"	"$0-$5/Visit:9a. $0 Therapy (AT,PT,ST,OT) -- OP,7d. $5 Therapy (AT,PT,ST,OT) - Specialist"			0% Coins:15			Dental DEN732 PPO	Vision Plan 8 PPO		Hearing $300		$0: Membership in health club/fitness class 14a	Assist America	$0/Day(Days 1-21) $0(Days 21-100):2	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0 Health Education Materials 14a							11.297526	8.676137	0	0	10.000006	0	0	24.999982	0	0	2.332421	0	0	1.797482	0	4.999999	0.780674	3.921269			0			0	0		0		0	0	0	0	0	0							11.297526	8.676137	0	0	10.000006	0	0	24.999982	0	0	2.332421	0	0	1.797482	0	4.999999	0.780674	3.921269			0			0	0		0		0	0	0	0	0	0							1.0339	0.035351997	0	0	0.090794997	0	0	0.513427993	0	0	0.136249954	0	0	0.080324987	0	1.318199975	0.001404	0.222824987	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.4324	0	0	1.0339	0.035351997	0	0	0.090794997	0	0	0.513427993	0	0	0.136249954	0	0	0.080324987	0	1.318199975	0.001404	0.222824987	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.4324		$250/Admit	$300/Admit			$10/Trip			$25/Visit	$0-$10/Visit	$0-$10/Visit	$0-$15/Visit			$10/Visit	$10/Visit	$10/Visit	$10/Visit	$10/Visit						Dental DEN732 PPO	Vision Plan 8 PPO		Hearing $300		0	Assist America		0	0	0							0.4567	0.0177			0.0605			0.0906	0.0215	0.0611	0.079			0.0789	0.386	0.4652	0.0032	0.1003						0	0		0		0	0		0	0	0							1.8205	0	0	1.4905	0.053008997	0	0	0.151324997	0	0	0.604032993	0.02146	0.061091	0.215221954	0	0	0.159183987	0.385965	1.783447975	0.004577	0.323103987	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.253
H2029_801_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		197.282667	6.356414	383.270153	547.779883	2.834482	5.59414	2.020229	12.437426	31.970543	472.295495	17.287034	0	0.218139	9.848367	18.55301	42.358695	0.267695	3.576671			12.643705																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000025	1024.00001	43.132792	0	0.199999	0.2	0.2	0.199999	0.199999	0	0.199999	0	0.2	0.2	0.2	0.2	0.500001	0.2			0.2																				1024.000025	1024.00001	43.132792	0	0.199999	0.2	0.2	0.199999	0.199999	0	0.199999	0	0.2	0.2	0.2	0.2	0.500001	0.2			0.2																				16.8348	0.542414	1.377625982	0	0.566893566	1.118828	0.4040458	2.487472763	6.394076629	0	3.457389513	0	0.0436278	1.9696734	3.710602	8.471739	0.133847768	0.7153342	0	0	2.528741	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.7571	0	0	16.8348	0.542414	1.377625982	0	0.566893566	1.118828	0.4040458	2.487472763	6.394076629	0	3.457389513	0	0.0436278	1.9696734	3.710602	8.471739	0.133847768	0.7153342	0	0	2.528741	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.7571		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				1.8705	0.0603	0.1531		0.3594	0.7093	0.2562	0.4685	1.2258		0.6568		0.0082	0.371	0.7439	1.6984	0.0268	0.1434			0.5069																				9.2586	0	0	18.7053	0.602682	1.530695982	0	0.926298566	1.82815	0.6602048	2.956015763	7.619884629	0	4.114231513	0	0.0518458	2.3406824	4.454482	10.170105	0.160680768	0.8587402	0	0	3.035688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.0157
H2029_802_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		197.282667	6.356414	383.270153	547.779883	2.834482	5.59414	2.020229	12.437426	31.970543	472.295495	17.287034	0	0.218139	9.848367	18.55301	42.358695	0.267695	3.576671			12.643705																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000025	1024.00001	43.132792	0	0.199999	0.2	0.2	0.199999	0.199999	0	0.199999	0	0.2	0.2	0.2	0.2	0.500001	0.2			0.2																				1024.000025	1024.00001	43.132792	0	0.199999	0.2	0.2	0.199999	0.199999	0	0.199999	0	0.2	0.2	0.2	0.2	0.500001	0.2			0.2																				16.8348	0.542414	1.377625982	0	0.566893566	1.118828	0.4040458	2.487472763	6.394076629	0	3.457389513	0	0.0436278	1.9696734	3.710602	8.471739	0.133847768	0.7153342	0	0	2.528741	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.7571	0	0	16.8348	0.542414	1.377625982	0	0.566893566	1.118828	0.4040458	2.487472763	6.394076629	0	3.457389513	0	0.0436278	1.9696734	3.710602	8.471739	0.133847768	0.7153342	0	0	2.528741	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.7571		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				1.8705	0.0603	0.1531		0.3594	0.7093	0.2562	0.4685	1.2258		0.6568		0.0082	0.371	0.7439	1.6984	0.0268	0.1434			0.5069																				9.2586	0	0	18.7053	0.602682	1.530695982	0	0.926298566	1.82815	0.6602048	2.956015763	7.619884629	0	4.114231513	0	0.0518458	2.3406824	4.454482	10.170105	0.160680768	0.8587402	0	0	3.035688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.0157
H2029_803_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		197.282667	6.356414	383.270153	547.779883	2.834482	5.59414	2.020229	12.437426	31.970543	472.295495	17.287034	0	0.218139	9.848367	18.55301	42.358695	0.267695	3.576671			12.643705																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000025	1024.00001	43.132792	0	0.199999	0.2	0.2	0.199999	0.199999	0	0.199999	0	0.2	0.2	0.2	0.2	0.500001	0.2			0.2																				1024.000025	1024.00001	43.132792	0	0.199999	0.2	0.2	0.199999	0.199999	0	0.199999	0	0.2	0.2	0.2	0.2	0.500001	0.2			0.2																				16.8348	0.542414	1.377625982	0	0.566893566	1.118828	0.4040458	2.487472763	6.394076629	0	3.457389513	0	0.0436278	1.9696734	3.710602	8.471739	0.133847768	0.7153342	0	0	2.528741	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.7571	0	0	16.8348	0.542414	1.377625982	0	0.566893566	1.118828	0.4040458	2.487472763	6.394076629	0	3.457389513	0	0.0436278	1.9696734	3.710602	8.471739	0.133847768	0.7153342	0	0	2.528741	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.7571		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				1.8705	0.0603	0.1531		0.3594	0.7093	0.2562	0.4685	1.2258		0.6568		0.0082	0.371	0.7439	1.6984	0.0268	0.1434			0.5069																				9.2586	0	0	18.7053	0.602682	1.530695982	0	0.926298566	1.82815	0.6602048	2.956015763	7.619884629	0	4.114231513	0	0.0518458	2.3406824	4.454482	10.170105	0.160680768	0.8587402	0	0	3.035688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.0157
H2029_804_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		197.282667	6.356414	383.270153	547.779883	2.834482	5.59414	2.020229	12.437426	31.970543	472.295495	17.287034	0	0.218139	9.848367	18.55301	42.358695	0.267695	3.576671			12.643705																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000025	1024.00001	43.132792	0	0.199999	0.2	0.2	0.199999	0.199999	0	0.199999	0	0.2	0.2	0.2	0.2	0.500001	0.2			0.2																				1024.000025	1024.00001	43.132792	0	0.199999	0.2	0.2	0.199999	0.199999	0	0.199999	0	0.2	0.2	0.2	0.2	0.500001	0.2			0.2																				16.8348	0.542414	1.377625982	0	0.566893566	1.118828	0.4040458	2.487472763	6.394076629	0	3.457389513	0	0.0436278	1.9696734	3.710602	8.471739	0.133847768	0.7153342	0	0	2.528741	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.7571	0	0	16.8348	0.542414	1.377625982	0	0.566893566	1.118828	0.4040458	2.487472763	6.394076629	0	3.457389513	0	0.0436278	1.9696734	3.710602	8.471739	0.133847768	0.7153342	0	0	2.528741	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.7571		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				1.8705	0.0603	0.1531		0.3594	0.7093	0.2562	0.4685	1.2258		0.6568		0.0082	0.371	0.7439	1.6984	0.0268	0.1434			0.5069																				9.2586	0	0	18.7053	0.602682	1.530695982	0	0.926298566	1.82815	0.6602048	2.956015763	7.619884629	0	4.114231513	0	0.0518458	2.3406824	4.454482	10.170105	0.160680768	0.8587402	0	0	3.035688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.0157
H2034_001_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	776.2537008	27.5773298	304.3019607	67.58994013	30.99759821	36.66029427	33.46653369	28.49468656	56.18527027	15.49313641	41.04322102	3.510871555	7.655965069	134.0699918	95.62028561	177.8992593	5.662696057	10.40803535	40.09188808	63.04845789	21.13318168	8.007052224	0	0	0	0	0	0	0	0											Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	0	0	0	0	0	0	0	0											0.073200463	0.073204648	0.16330118	0	0.23096676	0.230999915	0.231011862	0.230961739	0.231000012	0.230966588	0.230973935	0.23100014	0.231000013	0.230996552	0.231013371	0.230995918	0.230986925	0.230995011	0.231015145	0.231001033	0.230996636	0.231004195	0	0	0	0	0	0	0	0											0.073200463	0.073204648	0.16330118	0	0.23096676	0.230999915	0.231011862	0.230961739	0.231000012	0.230966588	0.230973935	0.23100014	0.231000013	0.230996552	0.231013371	0.230995918	0.230986925	0.230995011	0.231015145	0.231001033	0.230996636	0.231004195	0	0	0	0	0	0	0	0											56.8221	2.018788707	49.69286925	0	7.159414843	8.468524861	7.731166248	6.581182356	12.97879809	3.57839686	9.479914257	0.811011821	1.768528029	30.96970588	22.08956455	41.09400266	1.308008752	2.404204235	9.261833343	14.56425893	4.881693876	1.849662656	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	295.5137	0	0	56.8221	2.018788707	49.69286925	0	7.159414843	8.468524861	7.731166248	6.581182356	12.97879809	3.57839686	9.479914257	0.811011821	1.768528029	30.96970588	22.08956455	41.09400266	1.308008752	2.404204235	9.261833343	14.56425893	4.881693876	1.849662656	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	295.5137	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	56.8221	2.018788707	49.69286925	0	7.159414843	8.468524861	7.731166248	6.581182356	12.97879809	3.57839686	9.479914257	0.811011821	1.768528029	30.96970588	22.08956455	41.09400266	1.308008752	2.404204235	9.261833343	14.56425893	4.881693876	1.849662656	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	295.5137
H2034_002_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	618.7967743	64.43015573	188.8169373	48.34809893	25.96912412	33.6024384	31.7337487	37.86078583	51.48523255	17.38447689	43.24034709	4.190395082	6.614028994	138.2377361	89.25541524	166.2454308	14.41722416	8.471393301	35.16534251	55.426469	24.08910902	6.262941839	0	0	0	0	0	0	0	0											Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	0	0	0	0	0	0	0	0											0.073601872	0.073600165	0.164737172	0	0.230963896	0.230999984	0.230965114	0.230991932	0.231000009	0.230945523	0.231050582	0.230999988	0.231000013	0.23100058	0.231008991	0.231004256	0.230996162	0.231003284	0.231013297	0.231016065	0.230998235	0.231007129	0	0	0	0	0	0	0	0											0.073601872	0.073600165	0.164737172	0	0.230963896	0.230999984	0.230965114	0.230991932	0.231000009	0.230945523	0.231050582	0.230999988	0.231000013	0.23100058	0.231008991	0.231004256	0.230996162	0.231003284	0.231013297	0.231016065	0.230998235	0.231007129	0	0	0	0	0	0	0	0											45.5446	4.742070123	31.10516822	0	5.997930091	7.762162734	7.329388871	8.745536064	11.89308921	4.014867111	9.990707367	0.967981214	1.527840782	31.93299721	20.61880339	38.40340207	3.330323444	1.956919674	8.123661706	12.80440479	5.564541672	1.446784215	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	263.8032	0	0	45.5446	4.742070123	31.10516822	0	5.997930091	7.762162734	7.329388871	8.745536064	11.89308921	4.014867111	9.990707367	0.967981214	1.527840782	31.93299721	20.61880339	38.40340207	3.330323444	1.956919674	8.123661706	12.80440479	5.564541672	1.446784215	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	263.8032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	45.5446	4.742070123	31.10516822	0	5.997930091	7.762162734	7.329388871	8.745536064	11.89308921	4.014867111	9.990707367	0.967981214	1.527840782	31.93299721	20.61880339	38.40340207	3.330323444	1.956919674	8.123661706	12.80440479	5.564541672	1.446784215	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	263.8032
H2047_001_0	2009	6																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	5000	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$0 	$0 	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$100 per procedure	$0 per visit	$10 X-ray; $175 Complex Radiology	$10 per visit	$10 per visit	$10 per visit	$0 PCP visit; $10 if no PCP selected	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$750 Every 3 Yrs	Fitness/Coaching	0											0	0	47.56208437	0	100	0.2	0.2	47.5	100	0	39.7	10	10	10	0	10	10	10	10	10	45	0	0	0	0	0	0	0	0	0											0	0	45.35592164	0	100	0.190723019	0.190723019	45.29671705	95.36150959	0	37.85851931	0	9.536150959	9.536150959	0	10	10	10	10	10	45	0	0	0	0	0	0	0	0	0											0	0	4.485905334	0	2.003577927	1.322665664	0	0.845119245	2.688803548	0	13.0884073	0	0.046732344	0.550370465	0	6.799356505	0	0.49284286	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.238	0	1.1201	0	0	4.485905334	0	2.003577927	1.322665664	0	0.845119245	2.688803548	0	13.0884073	0	0.046732344	0.550370465	0	6.799356505	0	0.49284286	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.238	0	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$100 copay	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$50 copay	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$10 copay	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP		Not Covered		$1000 ded; 30% coinsurance; $5000 max OOP	0	$1000 ded; 30% coinsurance; $5000 max OOP	0	Not Covered												7.109	0	0.8778	0.1331	0.1893	0.209	0	0.1183	0.9546	0.3254	1.3263	0	0.0232	0.2751	0.9717	4.2209	0	0.1251	0	0	0.1888	0	0	0	0.088	0	0.0056	0	0	0											17.1411	1000	7.961167568	7.109	0	5.363725787	0.133088109	2.19283852	1.531628701	0	0.963436302	3.643384221	0.325383919	14.41469559	0	0.069902203	0.825474043	0.971709958	11.0202172	0	0.617939401	0	0	1.102945533	0	0	0	0.088041591	0	0.005619921	0	0	0	0	0	0	0	0	0	0	0	0	0	50.379
H2047_002_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3500	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$0 	$0 	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$100 per procedure	$0 per visit	$15 X-ray; $175 Complex Radiology	$15 per visit	$15 per visit	$15 per visit	$5 PCP visit; $15 if no PCP selected	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$750 Every 3 Yrs	Fitness/Coaching	0											0	0	47.56208437	0	100	0.2	0.2	47.5	100	0	43.8	15	15	15	5	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											0	0	41.18071938	0	100	0.173166168	0.173166168	41.12696482	86.58308384	0	37.92339072	0	12.98746258	12.98746258	5	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											0	0	4.072958988	0	2.003577927	1.200908758	0	0.767322484	2.441287937	0	13.11083458	0	0.063645655	0.749559843	2.679137804	10.19903476	0	0.739264291	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.9417	0	3.4721	0	0	4.072958988	0	2.003577927	1.200908758	0	0.767322484	2.441287937	0	13.11083458	0	0.063645655	0.749559843	2.679137804	10.19903476	0	0.739264291	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.9417	0	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$100 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$50 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$15 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP		Not Covered		$500 ded; 30% coinsurance; $3500 max OOP	0	$500 ded; 30% coinsurance; $3500 max OOP	0	Not Covered												5.2917	0	0.6534	0.0991	0.1436	0.1555	0	0.0824	0.7106	0.2422	0.9872	0	0.0145	0.2048	0.7233	3.1419	0	0.0931	0	0	0.1405	0	0	0	0.0655	0	0.0042	0	0	0											12.7535	500	10.08515721	5.2917	0	4.726375578	0.099065792	2.147220091	1.356452998	0	0.849711684	3.151841953	0.242203574	14.09807379	0	0.078171442	0.954336619	3.402442216	13.34088499	0	0.832381459	0	0	1.054688261	0	0	0	0.065534855	0	0.004183258	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6952
H2047_801_0	2009	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																																																			0	Unlimited	264.0130246	0	32.60039527	4.942610937	5.829433986	7.7604453	0	6.859571894	35.4511075	12.08407066	49.25554245	0	2.687819665	10.21676513	36.08725291	156.75384	0	4.645820972	0	0	7.010601788	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.076870157	0.076870157	0.147147286	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.2947	0	4.797059689	0	1.346599251	1.792662864	0	1.584561107	8.189205832	2.791420323	11.37803031	0	0.620886343	2.360072746	8.336155423	36.21013705	0	1.073184644	0	0	1.619449013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.3941			20.2947	0	4.797059689	0	1.346599251	1.792662864	0	1.584561107	8.189205832	2.791420323	11.37803031	0	0.620886343	2.360072746	8.336155423	36.21013705	0	1.073184644	0	0	1.619449013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.3941		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											2.7675	0	0.6541	0	0.1836	0.2445	0	0.2161	1.1167	0.3806	1.5515	0	0.0847	0.3218	1.1367	4.9377	0	0.1463	0	0	0.2208	0	0	0	0	0	0	0	0	0											13.9628		0	23.0622	0	5.451204192	0	1.530226421	2.037116891	0	1.800637622	9.305915718	3.172068549	12.92957989	0	0.705552662	2.681900848	9.472903889	41.14788301	0	1.219528005	0	0	1.840282969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.357
H2047_802_0	2009	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																																																			0	Unlimited	264.0130246	0	32.60039527	4.942610937	5.829433986	7.7604453	0	6.859571894	35.4511075	12.08407066	49.25554245	0	2.687819665	10.21676513	36.08725291	156.75384	0	4.645820972	0	0	7.010601788	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.076870157	0.076870157	0.147147286	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.2947	0	4.797059689	0	1.346599251	1.792662864	0	1.584561107	8.189205832	2.791420323	11.37803031	0	0.620886343	2.360072746	8.336155423	36.21013705	0	1.073184644	0	0	1.619449013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.3941			20.2947	0	4.797059689	0	1.346599251	1.792662864	0	1.584561107	8.189205832	2.791420323	11.37803031	0	0.620886343	2.360072746	8.336155423	36.21013705	0	1.073184644	0	0	1.619449013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.3941		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											2.7675	0	0.6541	0	0.1836	0.2445	0	0.2161	1.1167	0.3806	1.5515	0	0.0847	0.3218	1.1367	4.9377	0	0.1463	0	0	0.2208	0	0	0	0	0	0	0	0	0											13.9628		0	23.0622	0	5.451204192	0	1.530226421	2.037116891	0	1.800637622	9.305915718	3.172068549	12.92957989	0	0.705552662	2.681900848	9.472903889	41.14788301	0	1.219528005	0	0	1.840282969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.357
H2108_001_0	2009	2																																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	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		583.3363405	8.310100264	84.92732123	8.177136399	16.23152992	25.1792536	7.185953181	20.78838781	37.71587562	8.387416707	21.78339598	0	4.292000887	21.40231367	87.23875779	139.5491112	3.818472162	8.5100291	40.88496733	22.93319445	23.16963215	0.502830841	5367.76005	2996.241164	17.09328085	0	0	0	1033.068844	4778.664821											Medicare Cost Shares	Medicare Cost Shares	2:  Skilled Nursing Services - 0/day for 1-100/2:  Non-Medicare Covered Stay - $0/day for 1-100	Medicare Cost Shares	Medicare Cost Shares	Medicare Cost Shares	Medicare Cost Shares	Medicare Cost Shares	Medicare Cost Shares	Medicare Cost Shares	Medicare Cost Shares	Medicare Cost Shares	Medicare Cost Shares	Medicare Cost Shares	Medicare Cost Shares	Medicare Cost Shares	Medicare Cost Shares	Medicare Cost Shares	Medicare Cost Shares	Medicare Cost Shares	Medicare Cost Shares	Medicare Cost Shares	10b:  Transportation - $0/trip	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Emergency Svcs - $0/visit/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $0/visit/18a:  Fitting for Hearing Aid - $0/visit	18b:  Hearing Aids - $0/service	14a:  Written health education materials - $0/service/14a:  Membership in Health Club/Fitness Classes - $0/service/14c:  Routine Exams - $0/visit/	13d:  Other: Over the Counter Benefit - $0/visit											0.059336582	0.059337678	0	0	0.231	0.231	0.231	0.228334531	0.231	0.231	0.231	0	0.231	0.231	0.176636832	0.230532458	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.059336582	0.059337678	0	0	0.231	0.231	0.231	0.228334531	0.231	0.231	0.231	0	0.231	0.231	0.176636832	0.230532458	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											34.6132	0.493102057	0	0	3.749483411	5.816407583	1.659955185	4.746706773	8.712367268	1.937493259	5.031964471	0	0.991452205	4.943934457	15.40957776	32.17059962	0.882067069	1.965816722	9.444427452	5.297567919	5.352185027	0.116153924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.3344	135	0	34.6132	0.493102057	0	0	3.749483411	5.816407583	1.659955185	4.746706773	8.712367268	1.937493259	5.031964471	0	0.991452205	4.943934457	15.40957776	32.17059962	0.882067069	1.965816722	9.444427452	5.297567919	5.352185027	0.116153924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.3344																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	34.6132	0.493102057	0	0	3.749483411	5.816407583	1.659955185	4.746706773	8.712367268	1.937493259	5.031964471	0	0.991452205	4.943934457	15.40957776	32.17059962	0.882067069	1.965816722	9.444427452	5.297567919	5.352185027	0.116153924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.3344
H2108_020_0	2009	2																																coin	coin	coin	coin	coin	coin	coin	V	coin	coin	coin	O	coin	P	V	V	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		742.2083005	6.705806757	183.6015648	1.222692495	15.86071587	31.64617491	8.945281572	119.4333968	52.33517458	5.199794423	11.93181012	0	0.349949064	375.482832	27463.47063	0	5.780764598	9.414272946	60.28227139	4567.757084	4.915107264	0.522610837	5348.000917	2996.241164	17.04562995	0	0	0	310.5048387	552.0086021											1a:  Acute - MC Cost Shares for 1-/1-90	1b:  Psych - MC Cost Shares for 1-/1-190	2:  Skilled Nursing Services - 0/day for 1-100/2:  Non-Medicare Covered Stay - $0/day for 1-100	6:  Home Health Services - $0/visit	10a:  Ambulance - 20.0%	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $0/visit/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - 20.0%	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $0/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $0/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - $0/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $0/visit/7b:  Chiropractic Services - $0/visit/7f:  Podiatry Services - $0/visit/7-12 Additional Visits/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - 50.0%/7e:  Mental Hlth Spec-Non-Physician - Group - 50.0%/7h:  Psychiatric Services - Individual - 50.0%/7h:  Psychiatric Services - Group - 50.0%	7c:  Occupational Therapy Services - $0/visit/7i:  Physical/Speech Therapy - $0/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%	10b:  Transportation - $0/trip	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Emergency Svcs - $0/visit/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $0/visit/18a:  Fitting for Hearing Aid - $0/visit	18b:  Hearing Aids - $0/service	14a:  Written health education materials - $0/service/14c:  Routine Exams - $0/visit/	13d:  Other: Over the Counter Benefit - $0/visit											0.059485392	0.059486491	0	0	0.2	0.2	0.2	50	0.2	0	0.2	0	0.2	49.8578958	0	0	0.5	0	0	0.199273051	0.2	0.2	0	0	0	0	0	0	0	0											0.059485392	0.059486491	0	0	0.2	0.2	0.2	50	0.2	0	0.2	0	0.2	49.8578958	0	0	0.5	0	0	0.199273051	0.2	0.2	0	0	0	0	0	0	0	0											44.1506	0.398904914	0	0	3.172143173	6.329234982	1.789056314	0.497639153	10.46703492	0	2.386362025	0	0.069989813	1.560065326	0	0	2.890382299	0	0	0.075852574	0.983021453	0.104522167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.8748	0	0	44.1506	0.398904914	0	0	3.172143173	6.329234982	1.789056314	0.497639153	10.46703492	0	2.386362025	0	0.069989813	1.560065326	0	0	2.890382299	0	0	0.075852574	0.983021453	0.104522167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.8748																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	44.1506	0.398904914	0	0	3.172143173	6.329234982	1.789056314	0.497639153	10.46703492	0	2.386362025	0	0.069989813	1.560065326	0	0	2.890382299	0	0	0.075852574	0.983021453	0.104522167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.8748
H2108_021_0	2009	2																																D	coin	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	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1392.350524	9.22010059	1219.516225	7.980044886	239.5776105	16.18840394	4.660940511	338.6896561	35.03896428	4.649447087	10.01896849	0	0.364926563	17.92589876	4167.128494	4872.40243	356.2517423	625.3666386	38.3139491	4509.267194	26.8782251	0	0	249.2333325	17.11376704	0	0	0	1037.511128	1920.251358											1a:  Acute - $250/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - MC Cost Shares for 1-/1-190	2:  Skilled Nursing Services - $0/$85/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$85/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $40/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - $50/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $40/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $10/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $40/visit/7b:  Chiropractic Services - $40/visit/7f:  Podiatry Services - $40/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $40/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $40/visit/7h:  Psychiatric Services - Individual - $40/visit/7h:  Psychiatric Services - Group - $40/visit	7c:  Occupational Therapy Services - $40/visit/7i:  Physical/Speech Therapy - $40/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $40/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service	17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $0/visit/18a:  Fitting for Hearing Aid - $0/visit	18b:  Hearing Aids - $0/service	14a:  Written health education materials - $0/service/14a:  Membership in Health Club/Fitness Classes - $0/service/14c:  Routine Exams - $0/visit/	13d:  Other: Over the Counter Benefit - $0/visit/13c:  Other: Massage benefit - $10/visit and 7b:  Chiropractic Services - 20 Combined Visits											249.2534098	0.05888779	85	0	50	0.2	0.2	46.50339568	0.106339949	0	0.2	0	0.2	0.242300045	10.01244509	39.51458912	38.79741627	40	0	0.204922203	0.2	0	0	0	0	0	0	0	0	6.377879472											249.2534098	0.05888779	85	0	50	0.2	0.2	46.50339568	0.106339949	0	0.2	0	0.2	0.242300045	10.01244509	39.51458912	38.79741627	40	0	0.204922203	0.2	0	0	0	0	0	0	0	0	6.377879472											28.9207	0.542951345	8.638239926	0	0.998240044	3.237680788	0.932188102	1.312518258	3.726041682	0	2.003793697	0	0.072985313	4.343446082	3.476928771	16.04424834	1.151803929	2.084555462	0	0.077004081	5.37564502	0	0	0	0	0	0	0	0	1.02059431	0	0	0	0	0	0	0	0	0	0	83.9595	0	0	28.9207	0.542951345	8.638239926	0	0.998240044	3.237680788	0.932188102	1.312518258	3.726041682	0	2.003793697	0	0.072985313	4.343446082	3.476928771	16.04424834	1.151803929	2.084555462	0	0.077004081	5.37564502	0	0	0	0	0	0	0	0	1.02059431	0	0	0	0	0	0	0	0	0	0	83.9595																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	28.9207	0.542951345	8.638239926	0	0.998240044	3.237680788	0.932188102	1.312518258	3.726041682	0	2.003793697	0	0.072985313	4.343446082	3.476928771	16.04424834	1.151803929	2.084555462	0	0.077004081	5.37564502	0	0	0	0	0	0	0	0	1.02059431	0	0	0	0	0	0	0	0	0	0	83.9595
H2108_022_0	2009	2																																D	coin	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	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1401.559839	9.223515486	1226.991068	8.054628081	239.941171	16.20902134	4.666876641	341.6682845	34.84063178	4.631669025	10.11876705	0	0.368561644	18.00722535	4205.986517	4917.666291	353.271437	630.8019265	38.6092041	4483.395635	27.67198737	0	0	249.2333325	17.11790657	0	0	0	1038.013101	487.1122932											1a:  Acute - $250/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - MC Cost Shares for 1-/1-190	2:  Skilled Nursing Services - $0/$85/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$85/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $40/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - $50/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $40/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $10/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $40/visit/7b:  Chiropractic Services - $40/visit/7f:  Podiatry Services - $40/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $40/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $40/visit/7h:  Psychiatric Services - Individual - $40/visit/7h:  Psychiatric Services - Group - $40/visit	7c:  Occupational Therapy Services - $40/visit/7i:  Physical/Speech Therapy - $40/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $40/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service	17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service			14a:  Written health education materials - $0/service/14a:  Membership in Health Club/Fitness Classes - $0/service/14c:  Routine Exams - $0/visit/	13d:  Other: Over the Counter Benefit - $0/visit											249.2617607	0.059129721	85	0	50	0.2	0.2	46.50341244	0.106667876	0	0.2	0	0.2	0.24232218	10.01246859	39.51704724	38.77708228	40	0	0.206151465	0.2	0	0	0	0	0	0	0	0	0											249.2617607	0.059129721	85	0	50	0.2	0.2	46.50341244	0.106667876	0	0.2	0	0.2	0.24232218	10.01246859	39.51704724	38.77708228	40	0	0.206151465	0.2	0	0	0	0	0	0	0	0	0											29.1129	0.5453839	8.691186733	0	0.999754879	3.241804268	0.933375328	1.324061763	3.716376204	0	2.023753411	0	0.073712329	4.363550108	3.509358989	16.19430426	1.141569632	2.102673088	0	0.077021548	5.534397473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.5852	0	0	29.1129	0.5453839	8.691186733	0	0.999754879	3.241804268	0.933375328	1.324061763	3.716376204	0	2.023753411	0	0.073712329	4.363550108	3.509358989	16.19430426	1.141569632	2.102673088	0	0.077021548	5.534397473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.5852																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	29.1129	0.5453839	8.691186733	0	0.999754879	3.241804268	0.933375328	1.324061763	3.716376204	0	2.023753411	0	0.073712329	4.363550108	3.509358989	16.19430426	1.141569632	2.102673088	0	0.077021548	5.534397473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.5852
H2108_023_0	2009	2																																A	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	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		365.9787951	7.349697835	1176.147668	23.15316615	5.886909206	9.784453645	2.731240998	361.3751674	32.04167118	3.745897886	15.87591723	0	0.541934903	358.4786009	3.308917939	5942.45374	348.7201316	495.3383049	32.56027934	4924.38144	6.258088952	0	0	988.759584	17.2832919	0	0	0	1038.013101	1719.831705											1a:  Acute - $100/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - MC Cost Shares for 1-/1-190	2:  Skilled Nursing Services - $0/$85/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$85/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $0/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $15/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $50/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $50/visit/8b:  Outpatient Therapeutic Radiological Services - $50/visit/8b:  Outpatient X-Ray Services - $0/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $15/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $0/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $15/visit/7b:  Chiropractic Services - $15/visit/7f:  Podiatry Services - $15/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $15/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $15/visit/7h:  Psychiatric Services - Individual - $15/visit/7h:  Psychiatric Services - Group - $15/visit	7c:  Occupational Therapy Services - $15/visit/7i:  Physical/Speech Therapy - $15/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $15/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Emergency Svcs - $0/visit/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $0/visit/18a:  Fitting for Hearing Aid - $0/visit	18b:  Hearing Aids - $0/service	14a:  Written health education materials - $0/service/14a:  Membership in Health Club/Fitness Classes - $0/service/14c:  Routine Exams - $0/visit/	13d:  Other: Over the Counter Benefit - $0/visit/7b:  Chiropractic Services - 20 Additional Visits											99.36162809	0.0667	85	0	0	0.2	0.2	36.65855381	0.010117618	0	0.043420816	0	0.2	15	15	15	15	15	0	0.18484167	0.2	0	0	0	0	0	0	0	0	7.167674652											96.40907904	0.066537951	82.43644822	0	0	0.193968113	0.193968113	35.55295263	0.009812476	0	0.042111269	0	0.193968113	14.54760851	14.54760851	14.54760851	14.995075	14.54760851	0	0.18484167	0.193968113	0	0	0	0	0	0	0	0	7.167674652											2.9403	0.489033834	8.079786364	0	0	1.897872015	0.529773664	1.070662851	0.314408139	0	0.668555014	0	0.105118091	0.434583862	0.004011404	7.204040883	0.435757044	0.600498978	0	0.075852574	1.213869708	0	0	0	0	0	0	0	0	1.027266177	0	0	0	0	0	0	0	0	0	0	27.0914	0	0.9234	2.9403	0.489033834	8.079786364	0	0	1.897872015	0.529773664	1.070662851	0.314408139	0	0.668555014	0	0.105118091	0.434583862	0.004011404	7.204040883	0.435757044	0.600498978	0	0.075852574	1.213869708	0	0	0	0	0	0	0	0	1.027266177	0	0	0	0	0	0	0	0	0	0	27.0914	4000	1a:  Acute - 20.0% for 1-90/1a:  Additional Days - 20.0% for 91-999		2:  Skilled Nursing Services - 20.0% for 1-100/2:  Non-Medicare Covered Stay - 20.0% for 1-100	6:  Home Health Services - 20.0%	10a:  Ambulance - 20.0%			4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $15/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - 20.0%	8a:  Outpatient Diagnostic Procedures/Tests - 20.0%/8a:  Outpatient Lab Services - 20.0%	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - 20.0%/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - 20.0%	7a:  Primary Care - 20.0%/17a:  Vision Exams - 20.0%/18a:  Hearing Exams - 20.0%/14c:  Physical Exams (Initial Exam) - 20.0%/14d:  Pap Smears and Pelvic Exams Screening - 20.0%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%	7d:  Physician Specialist Services - 20.0%/7b:  Chiropractic Services - 20.0%/17a:  Vision Exams - 20.0%/18a:  Hearing Exams - 20.0%/14d:  Pap Smears and Pelvic Exams Screening - 20.0%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%		7c:  Occupational Therapy Services - 20.0%/7i:  Physical/Speech Therapy - 20.0%	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%	7a:  Primary Care - 20.0%/17a:  Vision Exams - 20.0%/18a:  Hearing Exams - 20.0%/14c:  Physical Exams (Initial Exam) - 20.0%/14d:  Pap Smears and Pelvic Exams Screening - 20.0%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%/7d:  Physician Specialist Services - 20.0%/7b:  Chiropractic Services - 20.0%/17a:  Vision Exams - 20.0%/18a:  Hearing Exams - 20.0%/14d:  Pap Smears and Pelvic Exams Screening - 20.0%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%																			7.0722	0	1.4236	0.5513	0.1765	0	0	0.1288	0.6768	0.1194	0.4339	0	0.012	0.3483	0.8157	1.9186	0	0.0926	0.6054	0.633	0.1671	0.0133	0	0	0	0	0	0	0	0											15.1886	0	0.144	10.0126	0.489033834	9.503390411	0.551287809	0.176542671	1.897872015	0.529773664	1.199497929	0.991236517	0.119356534	1.102456717	0	0.117136906	0.782833952	0.819665699	9.122687629	0.435757044	0.693136233	0.605396064	0.708874569	1.380967334	0.013275639	0	0	0	0	0	0	0	1.027266177	0	0	0	0	0	0	0	0	0	0	42.28
H2108_025_0	2009	2																																D	coin	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1138.477966	7.295874048	1188.027948	23.38703652	234.8956824	8.894957859	2.482946362	350.2451447	387.055674	3.783735239	587.6111103	0	0.547408993	348.7763967	4525.925183	5536.021846	348.1894562	473.4416295	32.22285368	4924.38144	6.321301971	0	0	988.759584	17.2832919	0	0	0	1038.013101	4016.21823											1a:  Acute - $100/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - MC Cost Shares for 1-/1-190	2:  Skilled Nursing Services - $0/$85/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$85/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $35/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $150/visit/9b:  Ambulatory Surgical Center Services - $50/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $100/visit/8b:  Outpatient Therapeutic Radiological Services - $100/visit/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $35/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $5/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $35/visit/7b:  Chiropractic Services - $35/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $35/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $35/visit/7h:  Psychiatric Services - Individual - $35/visit/7h:  Psychiatric Services - Group - $35/visit	7c:  Occupational Therapy Services - $35/visit/7i:  Physical/Speech Therapy - $35/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $35/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Emergency Svcs - $0/visit/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $0/visit/18a:  Fitting for Hearing Aid - $0/visit	18b:  Hearing Aids - $0/service	14a:  Written health education materials - $0/service/14a:  Membership in Health Club/Fitness Classes - $0/service/14c:  Routine Exams - $0/visit/	13d:  Other: Over the Counter Benefit - $0/visit/13c:  Other: Massage benefit - $10/visit and 7b:  Chiropractic Services - 20 Combined Visits											99.79478691	0.0667	85	0	50	0.2	0.2	44.66821742	70.09957725	0	39.17362486	0	0.2	35	5.017115411	35	34.84680563	35	0	0.18484167	0.2	0	0	0	0	0	0	0	0	3.069353659											91.75492091	0.066301695	78.11962277	0	45.95271928	0.183810877	0.183810877	41.05252111	64.4253239	0	36.00269173	0	0.183810877	32.16690349	4.611001921	32.16690349	34.83263422	32.16690349	0	0.18484167	0.183810877	0	0	0	0	0	0	0	0	3.069353659											8.7051	0.483728814	7.734024594	0	0.899507946	1.634990006	0.456392549	1.19820385	2.078015597	0	1.762965138	0	0.100619727	0.934921391	1.739087476	14.83972337	1.010696331	1.269095934	0	0.075852574	1.16192406	0	0	0	0	0	0	0	0	1.027266177	0	0	0	0	0	0	0	0	0	0	47.1121	0	3.92	8.7051	0.483728814	7.734024594	0	0.899507946	1.634990006	0.456392549	1.19820385	2.078015597	0	1.762965138	0	0.100619727	0.934921391	1.739087476	14.83972337	1.010696331	1.269095934	0	0.075852574	1.16192406	0	0	0	0	0	0	0	0	1.027266177	0	0	0	0	0	0	0	0	0	0	47.1121	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	8.7051	0.483728814	7.734024594	0	0.899507946	1.634990006	0.456392549	1.19820385	2.078015597	0	1.762965138	0	0.100619727	0.934921391	1.739087476	14.83972337	1.010696331	1.269095934	0	0.075852574	1.16192406	0	0	0	0	0	0	0	0	1.027266177	0	0	0	0	0	0	0	0	0	0	47.1121
H2108_026_0	2009	2																																A	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	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		445.8037419	9.453642405	1204.987947	7.830214126	7.362316376	17.63459255	5.077324923	349.7753326	35.38195117	4.584809461	9.728655759	0	0.363838018	837.748829	3.109835532	5399.148045	359.676886	680.4337842	39.12787262	4525.624678	26.46798885	0	0	988.759584	17.11790657	0	0	0	1038.013101	1227.126602											1a:  Acute - $100/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - MC Cost Shares for 1-/1-190	2:  Skilled Nursing Services - $0/$85/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$85/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $0/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $15/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $50/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $50/visit/8b:  Outpatient Therapeutic Radiological Services - $50/visit/8b:  Outpatient X-Ray Services - $0/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $15/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $0/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $15/visit/7b:  Chiropractic Services - $15/visit/7f:  Podiatry Services - $15/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $15/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $15/visit/7h:  Psychiatric Services - Individual - $15/visit/7h:  Psychiatric Services - Group - $15/visit	7c:  Occupational Therapy Services - $15/visit/7i:  Physical/Speech Therapy - $15/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $15/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Emergency Svcs - $0/visit/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $0/visit/18a:  Fitting for Hearing Aid - $0/visit	18b:  Hearing Aids - $0/service	14a:  Written health education materials - $0/service/14a:  Membership in Health Club/Fitness Classes - $0/service/14c:  Routine Exams - $0/visit/	/7b:  Chiropractic Services - 20 Additional Visits											99.69770664	0.058970646	85	0	0	0.2	0.2	36.65741565	0.013106417	0	0.108481631	0	0.2	10.39019032	15	15	14.66636114	15	0	0.204510284	0.2	0	0	0	0	0	0	0	0	10											95.8231627	0.058296494	81.66137049	0	0	0.192144401	0.192144401	35.21758589	0.012591624	0	0.10422069	0	0.192144401	9.982084489	14.41083009	14.41083009	14.65341188	14.41083009	0	0.204377444	0.192144401	0	0	0	0	0	0	0	0	10											3.5599	0.551114211	8.200080601	0	0	3.388388225	0.975579557	1.026520235	0.445516215	0	1.013927217	0	0.069909438	0.696873299	0.003734609	6.483850424	0.439207796	0.817134637	0	0.077077967	5.085675868	0	0	0	0	0	0	0	0	1.022605501	0	0	0	0	0	0	0	0	0	0	33.8571	0	1.608	3.5599	0.551114211	8.200080601	0	0	3.388388225	0.975579557	1.026520235	0.445516215	0	1.013927217	0	0.069909438	0.696873299	0.003734609	6.483850424	0.439207796	0.817134637	0	0.077077967	5.085675868	0	0	0	0	0	0	0	0	1.022605501	0	0	0	0	0	0	0	0	0	0	33.8571	4000	1a:  Acute - 20.0% for 1-90/1a:  Additional Days - 20.0% for 91-999		2:  Skilled Nursing Services - 20.0% for 1-100/2:  Non-Medicare Covered Stay - 20.0% for 1-100	6:  Home Health Services - 20.0%	10a:  Ambulance - 20.0%			4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $15/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - 20.0%	8a:  Outpatient Diagnostic Procedures/Tests - 20.0%/8a:  Outpatient Lab Services - 20.0%	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - 20.0%/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - 20.0%	7a:  Primary Care - 20.0%/17a:  Vision Exams - 20.0%/18a:  Hearing Exams - 20.0%/14c:  Physical Exams (Initial Exam) - 20.0%/14d:  Pap Smears and Pelvic Exams Screening - 20.0%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%	7d:  Physician Specialist Services - 20.0%/7b:  Chiropractic Services - 20.0%/17a:  Vision Exams - 20.0%/18a:  Hearing Exams - 20.0%/14d:  Pap Smears and Pelvic Exams Screening - 20.0%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%		7c:  Occupational Therapy Services - 20.0%/7i:  Physical/Speech Therapy - 20.0%	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%	7a:  Primary Care - 20.0%/17a:  Vision Exams - 20.0%/18a:  Hearing Exams - 20.0%/14c:  Physical Exams (Initial Exam) - 20.0%/14d:  Pap Smears and Pelvic Exams Screening - 20.0%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%/7d:  Physician Specialist Services - 20.0%/7b:  Chiropractic Services - 20.0%/17a:  Vision Exams - 20.0%/18a:  Hearing Exams - 20.0%/14d:  Pap Smears and Pelvic Exams Screening - 20.0%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%																			10.3849	0	1.3212	0.1586	0.1583	0	0	0.1169	0.7242	0.0986	0.2199	0	0.0078	0.3598	0.7368	1.6321	0	0.0927	0.7428	0.2205	0.5965	0.0058	0	0	0	0	0	0	0	0											17.5773	0	0.304	13.9448	0.551114211	9.521250891	0.158642962	0.158278086	3.388388225	0.975579557	1.143392501	1.169719503	0.098554448	1.233851042	0	0.077757217	1.056672609	0.740493176	8.115975795	0.439207796	0.909856993	0.742762751	0.297532952	5.682134671	0.005836612	0	0	0	0	0	0	0	1.022605501	0	0	0	0	0	0	0	0	0	0	51.4344
H2108_028_0	2009	2																																D	coin	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1138.477966	7.295874048	1188.027948	23.38703652	234.8956824	8.894957859	2.482946362	350.2451447	387.055674	3.783735239	587.6111103	0	0.547408993	348.7763967	4525.925183	5536.021846	348.1894562	473.4416295	32.22285368	4924.38144	6.321301971	0	0	249.2333325	17.2832919	0	0	0	1038.013101	487.1122932											1a:  Acute - $100/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - MC Cost Shares for 1-/1-190	2:  Skilled Nursing Services - $0/$85/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$85/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $35/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $150/visit/9b:  Ambulatory Surgical Center Services - $50/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $100/visit/8b:  Outpatient Therapeutic Radiological Services - $100/visit/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $35/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $5/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $35/visit/7b:  Chiropractic Services - $35/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $35/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $35/visit/7h:  Psychiatric Services - Individual - $35/visit/7h:  Psychiatric Services - Group - $35/visit	7c:  Occupational Therapy Services - $35/visit/7i:  Physical/Speech Therapy - $35/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $35/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service	17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service			14a:  Written health education materials - $0/service/14a:  Membership in Health Club/Fitness Classes - $0/service/14c:  Routine Exams - $0/visit/	13d:  Other: Over the Counter Benefit - $0/visit											99.79478691	0.0667	85	0	50	0.2	0.2	44.66821742	70.09957725	0	39.17362486	0	0.2	35	5.017115411	35	34.84680563	35	0	0.18484167	0.2	0	0	0	0	0	0	0	0	0											91.75492091	0.066301695	78.11962277	0	45.95271928	0.183810877	0.183810877	41.05252111	64.4253239	0	36.00269173	0	0.183810877	32.16690349	4.611001921	32.16690349	34.83263422	32.16690349	0	0.18484167	0.183810877	0	0	0	0	0	0	0	0	0											8.7051	0.483728814	7.734024594	0	0.899507946	1.634990006	0.456392549	1.19820385	2.078015597	0	1.762965138	0	0.100619727	0.934921391	1.739087476	14.83972337	1.010696331	1.269095934	0	0.075852574	1.16192406	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.0848	0	3.92	8.7051	0.483728814	7.734024594	0	0.899507946	1.634990006	0.456392549	1.19820385	2.078015597	0	1.762965138	0	0.100619727	0.934921391	1.739087476	14.83972337	1.010696331	1.269095934	0	0.075852574	1.16192406	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.0848	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	8.7051	0.483728814	7.734024594	0	0.899507946	1.634990006	0.456392549	1.19820385	2.078015597	0	1.762965138	0	0.100619727	0.934921391	1.739087476	14.83972337	1.010696331	1.269095934	0	0.075852574	1.16192406	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.0848
H2111_001_0	2009	4																					800											D	D	D	V	T	P	P	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1780.065047	37.38554654	6504.429827	89.94525467	494.5122923	342.6130448	1281.274845	123.9079857	142.9420437	12186.52456	1775.840294	0	13.06258885	185.7698148	113.1617342	7515.890937	3494.893559	31.02380877	0	0	1832.531092	489.5475022	1022.240882	3510.266383	34.23552465	134.0720546	17.35053287	4.510069116	0	0											"$75 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $800 (13c)"	"$75 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0 (11a)	"$0 (11b, 11c)"	$50 (4a); $0 n/c (4a1); $10 (4b)	$25 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$25 (3, 5, 9a); $0 (9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $10 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$0 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a9, 14a10); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											74.43800548	75	0	0	75	0	0	49.63855422	25	0	0	0	0	23.85682232	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											58.82404029	59.26815198	0	0	59.26815198	0	0	39.22647167	19.75605066	0	0	0	0	18.85266361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											8.7259	0.184647688	0	0	2.442402475	0	0	0.405039424	0.235330855	0	0	0	0	0.291854652	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.2852	0	3.2609	8.7259	0.184647688	0	0	2.442402475	0	0	0.405039424	0.235330855	0	0	0	0	0.291854652	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.2852		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $10 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $10 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a9, 14a10); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.4837	0.3026	0.8953	0.0834	0.2289	0.1865	0.2106	0.027	0.2972	0.735	0.6877	0	0	0.0933	0.0147	2.4183	0.5516	0.0054	0	0	0.177	0.0917	0.0666	0	0.0035	0	0.0011	0	0	0											10.5609	0	0	12.2096	0.487272688	0.895308968	0.083411704	2.671275872	0.186467361	0.210590329	0.432015798	0.532550072	0.73497477	0.687656315	0	0	0.385153388	0.014660397	2.418252883	0.55155	0.005371751	0	0	0.177008245	0.091679006	0.066625696	0	0.003498753	0	0.001108153	0	0	0	0	0	0	0	0	0	0	0	0	0	22.8461
H2111_008_0	2009	4																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		395.2369051	22.6752	51.84490283	5445.290918	17.13816464	37.64519381	12.80146943	26.89061529	41.86098435	7.773926488	18.80737219	0	3.135046307	44.54934452	60.29179364	161.8755032	13.376	6.614055513	0	0	27.97330915	8.073391299	352.9685741	0	314.3760437	332.2285714	0	0	20.2	0											"6.7% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"6.7% (1b); $0 n/c (1b1, 1b2)"	15.5% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.0658996	0.0667	0.1553	0	0.2	0.2	0.2	0.109432518	0.2	0.08	0.2	0	0.2	0.2	0	0.199656359	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											0.0658996	0.0667	0.1553	0	0.2	0.2	0.2	0.109432518	0.2	0.08	0.2	0	0.2	0.2	0	0.199656359	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											26.046	1.51243584	8.051513409	0	3.427632928	7.529038762	2.560293885	2.942707746	8.372196869	0.621914119	3.761474438	0	0.627009261	8.909868904	0	32.3194736	2.6752	1.322811103	0	0	5.59466183	0.120045507	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.3942	0	0	26.046	1.51243584	8.051513409	0	3.427632928	7.529038762	2.560293885	2.942707746	8.372196869	0.621914119	3.761474438	0	0.627009261	8.909868904	0	32.3194736	2.6752	1.322811103	0	0	5.59466183	0.120045507	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.3942		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											4.9405	0.2834	0.8186	1.2124	0.2706	0.5944	0.2021	0.155	0.661	0.1227	0.297	0	0.033	0.7034	0.952	2.5559	0.2112	0.1044	0	0	0.4417	0.0876	0.0261	0	0.0155	0	0	0	0.003	0											14.6914	0	0	30.9864	1.79587584	8.870117138	1.212350038	3.698235527	8.123436559	2.76242235	3.097696801	9.03315978	0.744660327	4.058432946	0	0.660009749	9.613279607	0.951975689	34.8754026	2.8864	1.427243558	0	0	6.036345659	0.20765097	0.0261	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	131.0857
H2111_009_0	2009	4																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		352.5003624	22.752	46.23896908	5142.474255	15.28503327	33.57465938	11.41726027	23.98371314	37.334601	6.933340154	16.7737512	0	2.796057112	39.74459837	53.84256918	144.4021531	13.376	5.898884783	0	0	24.89722399	7.200424156	352.9685741	0	314.3760437	332.2285714	0	0	20.2	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.069051124	0.069889802	0.159763638	0	0.2	0.2	0.2	0.115872866	0.2	0.08	0.2	0	0.2	0.2	0	0.199614777	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											0.069051124	0.069889802	0.159763638	0	0.2	0.2	0.2	0.115872866	0.2	0.08	0.2	0	0.2	0.2	0	0.199614777	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											24.3405	1.590132768	7.387305929	0	3.057006655	6.714931875	2.283452053	2.779061587	7.4669202	0.554667212	3.35475024	0	0.559211422	7.948919674	0	28.82480358	2.6752	1.179776957	0	0	4.979444798	0.107065115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.8032	0	0	24.3405	1.590132768	7.387305929	0	3.057006655	6.714931875	2.283452053	2.779061587	7.4669202	0.554667212	3.35475024	0	0.559211422	7.948919674	0	28.82480358	2.6752	1.179776957	0	0	4.979444798	0.107065115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.8032		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											4.4063	0.2844	0.7301	1.0813	0.2413	0.5301	0.1803	0.1464	0.5895	0.1095	0.2648	0	0.0294	0.6275	0.8501	2.28	0.2112	0.0931	0	0	0.3931	0.0781	0.0261	0	0.0155	0	0	0	0.003	0											13.1712	0	0	28.7468	1.874532768	8.117394915	1.081259929	3.298349286	7.245058076	2.463724584	2.925437687	8.0564139	0.664141004	3.619598944	0	0.588643602	8.576465964	0.850145829	31.10483757	2.8864	1.272917243	0	0	5.372558861	0.185197893	0.0261	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	118.9744
H2111_010_0	2009	4																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		413.0877151	22.5504	54.18646936	5566.900795	17.91220703	39.34543281	13.37964569	28.10481173	43.75162884	8.125034603	19.65680407	0	3.276640159	46.55625957	62.98559789	169.1740218	13.376	6.912778245	0	0	29.25817237	8.438024693	352.9685741	0	314.3760437	332.2285714	0	0	20.2	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.060510191	0.061245133	0.160086602	0	0.2	0.2	0.2	0.107043142	0.2	0.08	0.2	0	0.2	0.2	0	0.199671184	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											0.060510191	0.061245133	0.160086602	0	0.2	0.2	0.2	0.107043142	0.2	0.08	0.2	0	0.2	0.2	0	0.199671184	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											24.996	1.381102239	8.674527736	0	3.582441406	7.869086563	2.675929139	3.008427343	8.750325767	0.650002768	3.931360813	0	0.655328032	9.311251913	0	33.77917732	2.6752	1.382555649	0	0	5.851634474	0.125467343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.2998	0	0	24.996	1.381102239	8.674527736	0	3.582441406	7.869086563	2.675929139	3.008427343	8.750325767	0.650002768	3.931360813	0	0.655328032	9.311251913	0	33.77917732	2.6752	1.382555649	0	0	5.851634474	0.125467343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.2998		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											5.1636	0.2819	0.8556	1.2671	0.2828	0.6212	0.2113	0.1584	0.6908	0.1283	0.3104	0	0.0345	0.7351	0.9945	2.6712	0.2112	0.1091	0	0	0.462	0.0916	0.0261	0	0.0155	0	0	0	0.003	0											15.3251	0	0	30.1596	1.662982239	9.530103567	1.267105629	3.865265728	8.490330239	2.887186702	3.166875324	9.441140959	0.778292788	4.241731404	0	0.689818981	10.04635075	0.99450944	36.45034609	2.8864	1.491704779	0	0	6.313605616	0.217029492	0.0261	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	134.6249
H2111_011_0	2009	3																					3350											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1951.067022	262.242168	47.03994679	52601.90952	91.1280353	23.49895851	10.38953478	372.3894147	390.4327424	6183.169164	472.8660663	0	0.912666771	1507.227334	6092.051399	4525.949082	1242.868229	269.856721	0	0	30.33413452	1142.887422	769.983193	0	314.3760437	332.2285714	0	0	20.2	0											"$200 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$200 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	15.5% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$125 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5); $125 (9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											197.6	200	0.1553	0	100	0.14	0.2	49.97448907	125	4.4	64.79010385	0	0.2	115.6037844	3.253923295	25	20	20	0	0	0.2	13.6791576	0	0	0	0	0	0	0	0											139.8167055	141.5148841	0.1553	0	70.75744207	0.099060419	0.141514884	35.36067015	88.44680258	3.113327451	45.84382019	0	0.141514884	81.79828078	3.253923295	25	20	20	0	0	0.141514884	13.6791576	0	0	0	0	0	0	0	0											22.7326	3.092597502	7.305303737	0	0.537332223	2.327816673	1.47027381	1.097328272	2.87771064	1.604185858	1.80649891	0	0.129155932	10.27405039	1.65192233	9.429060587	2.071447048	0.449761202	0	0	4.292731532	1.30281143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4526	0	21.5907	22.7326	3.092597502	7.305303737	0	0.537332223	2.327816673	1.47027381	1.097328272	2.87771064	1.604185858	1.80649891	0	0.129155932	10.27405039	1.65192233	9.429060587	2.071447048	0.449761202	0	0	4.292731532	1.30281143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4526		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											4.2053	0.213	0.7427	0.6284	0.1618	0.371	0.164	0.0817	0.7342	0.1155	0.3114	0	0.0096	0.5849	0.7962	2.5154	0.1512	0.0864	0	0	0.479	0.0992	0.0569	0	0.0155	0	0	0	0.003	0											12.5263	0	0	26.9379	3.305597502	8.048039739	0.628419438	0.699082848	2.69885286	1.634319096	1.17906065	3.611938414	1.719663893	2.117903774	0	0.138762951	10.8589273	2.448080036	11.944492	2.222647048	0.536141341	0	0	4.77169155	1.401986669	0.056935837	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	86.9789
H2111_012_0	2009	3																					3350											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1846.016027	269.3337872	42.11078915	49769.6732	86.22144286	21.03658176	9.300850411	352.3491403	369.4107338	5850.249761	447.4056132	0	0.817031493	1427.029525	5767.83757	4282.259119	1242.868229	255.3268681	0	0	27.10574905	1081.351114	769.983193	0	314.3760437	332.2285714	0	0	20.2	0											"$225 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$225 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$125 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$125 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5); $125 (9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											222.3	225	0.159691652	0	125	0.14	0.2	49.97303811	125	4.4	64.79010385	0	0.2	115.5364162	3.251779789	25	20	20	0	0	0.2	13.6791576	0	0	0	0	0	0	0	0											157.0426129	158.9500131	0.159691652	0	88.30556282	0.09890223	0.1412889	35.30317805	88.30556282	3.108355811	45.77061268	0	0.141288901	81.62006608	3.251779789	25	20	20	0	0	0.141288901	13.6791576	0	0	0	0	0	0	0	0											24.1586	3.56755075	6.724741505	0	0.634486087	2.080564856	1.314106928	1.036587036	2.718418563	1.515388154	1.70650242	0	0.115437481	9.706187009	1.562978136	8.921373164	2.071447048	0.42554478	0	0	3.82974148	1.23266436	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3223	0	21.7674	24.1586	3.56755075	6.724741505	0	0.634486087	2.080564856	1.314106928	1.036587036	2.718418563	1.515388154	1.70650242	0	0.115437481	9.706187009	1.562978136	8.921373164	2.071447048	0.42554478	0	0	3.82974148	1.23266436	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3223		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.7646	0.2188	0.6649	0.5626	0.1448	0.3322	0.1469	0.0773	0.6573	0.1034	0.2788	0	0.0086	0.5238	0.7138	2.2518	0.1512	0.0773	0	0	0.428	0.0888	0.0569	0	0.0155	0	0	0	0.003	0											11.2701	0	0	27.9232	3.78631075	7.389648702	0.562569481	0.779287408	2.41272141	1.460962461	1.113924618	3.37570908	1.618765635	1.985276217	0	0.124037813	10.22994954	2.276738452	11.17322099	2.222647048	0.502873436	0	0	4.257726992	1.32144736	0.056935837	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	84.5924
H2111_013_0	2009	3																					3350											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1969.357376	258.1053902	47.92603643	53095.02819	91.98231866	23.94160747	10.58524204	375.8786128	394.0928695	6241.133527	477.2989679	0	0.92985864	1521.190518	6148.50004	4568.37777	1242.868229	272.3865035	0	0	30.91448498	1153.601465	769.983193	0	314.3760437	332.2285714	0	0	20.2	0											"$175 Days 1-20 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-20 (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$75 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5, 9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											172.9	175	0.16043553	0	75	0.14	0.2	49.97472588	75	4.4	64.79010385	0	0.2	70.36583163	3.254273393	25	20	20	0	0	0.2	13.6791576	0	0	0	0	0	0	0	0											129.3432808	130.9142518	0.16043553	0	56.10610792	0.104731401	0.149616288	37.38516485	56.10610792	3.291558331	48.46827411	0	0.149616288	52.63937257	3.254273393	25	20	20	0	0	0.149616288	13.6791576	0	0	0	0	0	0	0	0											21.2269	2.81580617	7.689039039	0	0.430064158	2.507438103	1.583724619	1.171023658	1.842584755	1.711921255	1.927821434	0	0.139121998	6.672876204	1.667408341	9.517453687	2.071447048	0.453977506	0	0	4.625310481	1.315024687	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.369	0	15.7111	21.2269	2.81580617	7.689039039	0	0.430064158	2.507438103	1.583724619	1.171023658	1.842584755	1.711921255	1.927821434	0	0.139121998	6.672876204	1.667408341	9.517453687	2.071447048	0.453977506	0	0	4.625310481	1.315024687	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.369		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											4.2845	0.2096	0.7567	0.6403	0.1648	0.378	0.1671	0.0825	0.7481	0.1177	0.3173	0	0.0098	0.5959	0.811	2.5628	0.1512	0.088	0	0	0.4881	0.101	0.0569	0	0.0155	0	0	0	0.003	0											12.7498	0	0	25.5114	3.02544617	8.44576593	0.640256951	0.594861673	2.885463484	1.750860019	1.253521212	2.590643148	1.829574546	2.245092219	0	0.148909984	7.268739338	2.478378208	12.08026818	2.222647048	0.541984785	0	0	5.113433928	1.416068087	0.056935837	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	82.1187
H2112_001_0	2009	3																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1954.053053	0	1348.910759	1027.155625	273.2236478	8.015977228	0	254.4364303	385.2538831	1049.265596	4714.637071	0	66.82277183	788.3021666	7307.177077	9272.285824	0	672.1334747	0	0	277.0435882	0	0	0	886.0288901	0	75.20564196	0	0	0											$100/day 1-7	$100/day 1-7	"$0 1-15, $75 16-20, $100 21+"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$30 per visit	$30 X-ray; $150 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$10 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											72.2855078	72.2855078	47.8866492	20	100	0.2	0.2	48.5	250	30	78	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											72.2855078	72.2855078	47.8866492	20	100	0.2	0.2	48.5	250	30	78	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											11.7708	0	5.382901362	1.711926042	2.276863731	1.603195446	0	1.028347239	8.026122564	2.623163991	30.64514096	0	0.139214108	1.970755417	6.08931423	23.18071456	0	1.680333687	0	0	1.038913456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.1677	0	0	11.7708	0	5.382901362	1.711926042	2.276863731	1.603195446	0	1.028347239	8.026122564	2.623163991	30.64514096	0	0.139214108	1.970755417	6.08931423	23.18071456	0	1.680333687	0	0	1.038913456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.1677																																																																																		0			11.7708	0	5.382901362	1.711926042	2.276863731	1.603195446	0	1.028347239	8.026122564	2.623163991	30.64514096	0	0.139214108	1.970755417	6.08931423	23.18071456	0	1.680333687	0	0	1.038913456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.1677
H2112_002_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$100/day 1-7	$100/day 1-7	"$0 1-15, $75 16-20, $100 21+"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$25 per visit	$25 X-ray; $150 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											72.2855078	72.2855078	47.8866492	20	100	0.2	0.2	48.5	250	25	75	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											72.2855078	72.2855078	47.8866492	20	100	0.2	0.2	48.5	250	25	75	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											11.7703	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	8.010198744	2.185826699	29.46468269	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0293	0	0	11.7703	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	8.010198744	2.185826699	29.46468269	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0293																																																																																		0			11.7703	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	8.010198744	2.185826699	29.46468269	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0293
H2112_007_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$150/day 1-10	$150/day 1-10	"$0 1-15, $75 16-20, $100 21+"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$35 per visit	$35 X-ray; $150 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$20 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											122.9471107	122.9471107	47.8866492	20	100	0.2	0.2	48.5	250	35	81	35	25	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											122.9471107	122.9471107	47.8866492	20	100	0.2	0.2	48.5	250	35	81	35	25	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											20.0196	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	8.010198744	3.060157379	31.82185731	0	0.139220051	2.295447554	12.17789911	27.04289519	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.5414	0	0	20.0196	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	8.010198744	3.060157379	31.82185731	0	0.139220051	2.295447554	12.17789911	27.04289519	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.5414																																																																																		0			20.0196	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	8.010198744	3.060157379	31.82185731	0	0.139220051	2.295447554	12.17789911	27.04289519	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.5414
H2112_008_0	2009	3																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1954.053053	0	1348.910759	1027.155625	273.2236478	8.015977228	0	254.4364303	385.2538831	1049.265596	4714.637071	0	66.82277183	788.3021666	7307.177077	9272.285824	0	672.1334747	0	0	277.0435882	0	0	0	886.0288901	0	75.20564196	0	0	0											$175/day 1-8	$175/day 1-8	"$0 1-15, $75 16-20, $100 21+"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$35 per visit	$35 X-ray; $150 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$10 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											133.3205801	133.3205801	47.8866492	20	100	0.2	0.2	48.5	250	35	81	35	25	35	10	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											133.3205801	133.3205801	47.8866492	20	100	0.2	0.2	48.5	250	35	81	35	25	35	10	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											21.7096	0	5.382901362	1.711926042	2.276863731	1.603195446	0	1.028347239	8.026122564	3.06035799	31.82380023	0	0.139214108	2.299214653	6.08931423	27.04416699	0	1.960389301	0	0	1.038913456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.1944	0	0	21.7096	0	5.382901362	1.711926042	2.276863731	1.603195446	0	1.028347239	8.026122564	3.06035799	31.82380023	0	0.139214108	2.299214653	6.08931423	27.04416699	0	1.960389301	0	0	1.038913456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.1944																																																																																		0			21.7096	0	5.382901362	1.711926042	2.276863731	1.603195446	0	1.028347239	8.026122564	3.06035799	31.82380023	0	0.139214108	2.299214653	6.08931423	27.04416699	0	1.960389301	0	0	1.038913456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.1944
H2112_009_0	2009	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1954.053053	0	1348.910759	1027.155625	273.2236478	8.015977228	0	254.4364303	385.2538831	1049.265596	4714.637071	0	66.82277183	788.3021666	7307.177077	9272.285824	0	672.1334747	0	0	277.0435882	0	0	0	886.0288901	0	75.20564196	0	0	0											$150/day 1-8	$150/day 1-8	"$0 1-15, $75 16-20, $100 21+"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$25 per visit	$35 X-ray; $125 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											114.2747829	114.2747829	47.8866492	20	100	0.2	0.2	48.5	250	25	71	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											114.2747829	114.2747829	47.8866492	20	100	0.2	0.2	48.5	250	25	71	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											18.6082	0	5.382901362	1.711926042	2.276863731	1.603195446	0	1.028347239	8.026122564	2.185969993	27.894936	0	0.139214108	1.64229618	6.08931423	19.31726213	0	1.400278072	0	0	1.038913456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.3458	0	0	18.6082	0	5.382901362	1.711926042	2.276863731	1.603195446	0	1.028347239	8.026122564	2.185969993	27.894936	0	0.139214108	1.64229618	6.08931423	19.31726213	0	1.400278072	0	0	1.038913456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.3458																																																																																		0			18.6082	0	5.382901362	1.711926042	2.276863731	1.603195446	0	1.028347239	8.026122564	2.185969993	27.894936	0	0.139214108	1.64229618	6.08931423	19.31726213	0	1.400278072	0	0	1.038913456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.3458
H2112_011_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1954.053053	0	1348.910759	1027.155625	273.2236478	8.015977228	0	254.4364303	385.2538831	1049.265596	4714.637071	0	66.82277183	788.3021666	7307.177077	9272.285824	0	672.1334747	0	0	277.0435882	0	0	0	886.0288901	0	75.20564196	0	0	0											$175/day 1-8	$175/day 1-8	"$0 1-15, $75 16-20, $100 21+"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$30 per visit	$40 X-ray; $150 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$15 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											133.3205801	133.3205801	47.8866492	20	100	0.2	0.2	48.5	250	30	84	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											133.3205801	133.3205801	47.8866492	20	100	0.2	0.2	48.5	250	30	84	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											21.7096	0	5.382901362	1.711926042	2.276863731	1.603195446	0	1.028347239	8.026122564	2.623163991	33.0024595	0	0.139214108	1.970755417	9.133971346	23.18071456	0	1.680333687	0	0	1.038913456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.5085	0	0	21.7096	0	5.382901362	1.711926042	2.276863731	1.603195446	0	1.028347239	8.026122564	2.623163991	33.0024595	0	0.139214108	1.970755417	9.133971346	23.18071456	0	1.680333687	0	0	1.038913456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.5085																																																																																		0			21.7096	0	5.382901362	1.711926042	2.276863731	1.603195446	0	1.028347239	8.026122564	2.623163991	33.0024595	0	0.139214108	1.970755417	9.133971346	23.18071456	0	1.680333687	0	0	1.038913456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.5085
H2112_013_0	2009	7																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$950 per stay	$950 per stay	"$0/d 1-20, $100/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$200 per procedure	$0 per visit	$25 X-ray; $150 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$0 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	$0 per Trip/50 One Way Trips	0	$0 per visit	$150 Every 2 Years	$0 per visit	$1000 Every 3 Yrs	not covered	0											160.6230826	160.6230826	40.33133874	0	100	0.2	0.2	47.5	200	0	75	25	25	25	0	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											160.6230826	160.6230826	40.33133874	0	100	0.2	0.2	47.5	200	0	75	25	25	25	0	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											26.1544	0	4.532899329	0	2.276793099	1.576138182	0	1.007075897	6.408158995	0	29.46468269	0	0.139220051	1.639605396	0	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.9543	0	0	26.1544	0	4.532899329	0	2.276793099	1.576138182	0	1.007075897	6.408158995	0	29.46468269	0	0.139220051	1.639605396	0	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.9543																																																																																		0			26.1544	0	4.532899329	0	2.276793099	1.576138182	0	1.007075897	6.408158995	0	29.46468269	0	0.139220051	1.639605396	0	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.9543
H2112_014_0	2009	7																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$100/day 1-7	$100/day 1-7	"$0 1-15, $75 16-20, $100 21+"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$25 per visit	$25 X-ray; $150 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											72.2855078	72.2855078	47.8866492	20	100	0.2	0.2	48.5	250	25	75	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											72.2855078	72.2855078	47.8866492	20	100	0.2	0.2	48.5	250	25	75	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											11.7703	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	8.010198744	2.185826699	29.46468269	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0293	0	0	11.7703	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	8.010198744	2.185826699	29.46468269	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0293																																																																																		0			11.7703	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	8.010198744	2.185826699	29.46468269	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0293
H2112_015_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$150/day 1-8	$150/day 1-8	"$0 1-15, $75 16-20, $100 21+"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$25 per visit	$25 X-ray; $125 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											114.2747829	114.2747829	47.8866492	20	100	0.2	0.2	48.5	250	25	65	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											114.2747829	114.2747829	47.8866492	20	100	0.2	0.2	48.5	250	25	65	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											18.6075	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	8.010198744	2.185826699	25.53605833	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.9378	0	0	18.6075	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	8.010198744	2.185826699	25.53605833	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.9378																																																																																		0			18.6075	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	8.010198744	2.185826699	25.53605833	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.9378
H2112_801_0	2009	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																																																			0		358.4171351	0	44.25743879	6.709958551	7.913886187	10.53537634	0	9.312374304	48.1274907	16.40501636	66.86802836	0	3.648913251	13.87001151	48.99110497	212.8048885	0	6.307044304	0	0	9.517408514	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.061579846	0.061579846	0.16152282	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											22.0713	0	7.148586341	0	1.828107709	2.433671933	0	2.151158464	11.11745035	3.789558779	15.44651455	0	0.842898961	3.203972659	11.31694525	49.15792924	0	1.456927234	0	0	2.198521367	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.1635			22.0713	0	7.148586341	0	1.828107709	2.433671933	0	2.151158464	11.11745035	3.789558779	15.44651455	0	0.842898961	3.203972659	11.31694525	49.15792924	0	1.456927234	0	0	2.198521367	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.1635																																																																																		0			22.0713	0	7.148586341	0	1.828107709	2.433671933	0	2.151158464	11.11745035	3.789558779	15.44651455	0	0.842898961	3.203972659	11.31694525	49.15792924	0	1.456927234	0	0	2.198521367	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.1635
H2112_802_0	2009	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																																																			0		359.6074669	0	44.40442126	6.732242856	7.940168832	10.57036516	0	9.343301439	48.28732592	16.45949872	67.09010239	0	3.661031582	13.91607492	49.15380833	213.5116304	0	6.327990499	0	0	9.549016584	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.061342033	0.061342033	0.160988455	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											22.0591	0	7.14859918	0	1.834179	2.441754351	0	2.158302632	11.15437229	3.802144205	15.49781365	0	0.845698296	3.214613306	11.35452972	49.32118663	0	1.461765805	0	0	2.205822831	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.4998			22.0591	0	7.14859918	0	1.834179	2.441754351	0	2.158302632	11.15437229	3.802144205	15.49781365	0	0.845698296	3.214613306	11.35452972	49.32118663	0	1.461765805	0	0	2.205822831	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.4998																																																																																		0			22.0591	0	7.14859918	0	1.834179	2.441754351	0	2.158302632	11.15437229	3.802144205	15.49781365	0	0.845698296	3.214613306	11.35452972	49.32118663	0	1.461765805	0	0	2.205822831	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.4998
H2169_001_0	2009	2																					3100											A	A	D	V	T	O	O	V	V	P	P	P	P	P	P	P	P	P	P	P	S	P	T	P	P	P	P	P	P	P																																																			0		366.8946336	9.106729308	1268.265355		153.2431807	1550.961378	295.1671326	359.4680921	454.4665338		1147.177805			221.3948726	4695.094143	8595.975878	312.9255598	396.0061541			1239.421442	1076.831092			0.075671385																1A: $250/stay - $750 annual max	1B: $250/stay - $750 annual max	"2: $0/day days 1-15, $60/day days 16-65, $0/day days 66-100 - $3000 annual max"	6: $0	10A: $100; 10B: $0	11A: 20%	"11B: 20% prosthetics, $0 medical supplies; 11C: $0 training/ $20/60/50 for R30/R90/MO90"	4A: $50; 4B: $50	9A: $150 - $300 max; 9B: $150 - $300 max		"8A: $0 labs, $15 x-rays, $50 advanced imaging, $0 ther rad; 8B: $0 labs, $15 x-rays, $50 advanced imaging, $0 ther rad"		12: $0	3: $0; 5: $0; 7C: $30; 7I: $30; 9C: $30; 9D: $0	7A: $15; 14B: $0; 14C: $15; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0	"7B: $30; 7D: $30; 7F: $30; 13B: n/a; 14B: $0; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0; 18A: $30 n/c on routine hearing test,7A $30"	7E: $30; 7H: $30	"7I, 7c: $30"			15: $32/96/80 for R30/R90/MO	13A: $0; 16A: $0; 16B: $30; 17A: $30 n/c on routine exams; 17B: $0; 18A: $30 n/c on routine hearing test	10B: $0	16A: $0; 16B: $30	17A: $30 n/c on routine exams	17B: $0	18A: $30 n/c on routine hearing test	18B: $0 n/c	14A: $0	13B: n/a											226.2793177	226.2793177	22.01852033		100	19.6856161	31.07606003	50	143.4262948		35.55769025			30	15	29.85566687	30	30			35.2	30			30																186.6291124	186.6291124	18.16028503		82.47731799	16.23616819	25.63070085	41.238659	118.2941613		29.32702926			24.7431954	12.3715977	24.70601924	24.7431954	24.7431954			29.03201593	24.7431954			24.7431954																5.7061	0.141631734	1.919338361	0	1.053257212	2.098472483	0.63044504	1.235331839	4.480061453	0	2.803609754	0	0	0.456501383	4.840484658	17.69769546	0.645231523	0.816538138	0	0	2.998575254	2.220353509	0	0	0.000156029	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.7438	0	10.4972	5.7061	0.141631734	1.919338361	0	1.053257212	2.098472483	0.63044504	1.235331839	4.480061453	0	2.803609754	0	0	0.456501383	4.840484658	17.69769546	0.645231523	0.816538138	0	0	2.998575254	2.220353509	0	0	0.000156029	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.7438																																																																																		0	0	0	5.7061	0.141631734	1.919338361	0	1.053257212	2.098472483	0.63044504	1.235331839	4.480061453	0	2.803609754	0	0	0.456501383	4.840484658	17.69769546	0.645231523	0.816538138	0	0	2.998575254	2.220353509	0	0	0.000156029	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.7438
H2169_002_0	2009	4																					3100											A	A	D	V	T	O	O	V	V	P	P	P	P	P	P	P	P	P	P	P	S	P	T	P	P	P	P	P	P	P																																																			0		366.8946336	9.106729308	1268.265355		153.2431807	1550.961378	295.1671326	359.4680921	454.4665338		1147.177805			221.3948726	4695.094143	8595.975878	312.9255598	396.0061541			1239.421442	1076.831092			0.075671385		259.3826119														1A: $250/stay - $750 annual max	1B: $250/stay - $750 annual max	"2: $0/day days 1-15, $60/day days 16-65, $0/day days 66-100 - $3000 annual max"	6: $0	10A: $100; 10B: $0	11A: 20%	"11B: 20% prosthetics, $0 medical supplies; 11C: $0 training/ $20/60/50 for R30/R90/MO90"	4A: $50; 4B: $50	9A: $150 - $300 max; 9B: $150 - $300 max		"8A: $0 labs, $15 x-rays, $50 advanced imaging, $0 ther rad; 8B: $0 labs, $15 x-rays, $50 advanced imaging, $0 ther rad"		12: $0	3: $0; 5: $0; 7C: $30; 7I: $30; 9C: $30; 9D: $0	7A: $15; 14B: $0; 14C: $15; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0	"7B: $30; 7D: $30; 7F: $30; 13B: n/a; 14B: $0; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0; 18A: $30,7a: $30"	7E: $30; 7H: $30	"7I, 7c: $30"			15: $32/96/80 for R30/R90/MO	13A: $0; 16A: $0; 16B: $30; 17A: $30 n/c on routine exams; 17B: $0; 18A: $30	10B: $0	16A: $0; 16B: $30	17A: $30 n/c on routine exams	17B: $0	18A: $30	18B: $0	14A: $0	13B: n/a											226.2793177	226.2793177	22.01852033		100	19.6856161	31.07606003	50	143.4262948		35.55769025			30	15	29.85566687	30	30			35.2	30			30		30														186.6291124	186.6291124	18.16028503		82.47731799	16.23616819	25.63070085	41.238659	118.2941613		29.32702926			24.7431954	12.3715977	24.70601924	24.7431954	24.7431954			29.03201593	24.7431954			24.7431954		24.7431954														5.7061	0.141631734	1.919338361	0	1.053257212	2.098472483	0.63044504	1.235331839	4.480061453	0	2.803609754	0	0	0.456501383	4.840484658	17.69769546	0.645231523	0.816538138	0	0	2.998575254	2.220353509	0	0	0.000156029	0	0.534829554	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2786	0	10.6108	5.7061	0.141631734	1.919338361	0	1.053257212	2.098472483	0.63044504	1.235331839	4.480061453	0	2.803609754	0	0	0.456501383	4.840484658	17.69769546	0.645231523	0.816538138	0	0	2.998575254	2.220353509	0	0	0.000156029	0	0.534829554	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2786																																																																																		0	0	0	5.7061	0.141631734	1.919338361	0	1.053257212	2.098472483	0.63044504	1.235331839	4.480061453	0	2.803609754	0	0	0.456501383	4.840484658	17.69769546	0.645231523	0.816538138	0	0	2.998575254	2.220353509	0	0	0.000156029	0	0.534829554	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2786
H2169_003_0	2009	3																					3100											A	A	D	V	T	O	O	V	V	P	P	P	P	P	P	P	P	P	P	P	S	P	T	P	P	P	P	P	P	P																																																			0		366.8946336	9.106729308	1268.265355		153.2431807	1550.961378	295.1671326	359.4680921	454.4665338		1147.177805			221.3948726		8595.975878	312.9255598	396.0061541			1239.421442	1076.831092					259.3826119														1A: $100/stay - $200 annual max	1B: $100/stay - $200 annual max	"2: $0/day days 1-15, $60/day days 16-50, $0/day days 51-100 - $2100 annual max"	6: $0	10A: $100; 10B: $0	11A: 20%	"11B: 20% prosthetics, $0 medical supplies; 11C: $0 training/ $15/45/37.50 for R30/R90/MO90"	4A: $50; 4B: $50	9A: $60 - $120 max; 9B: $60 - $120 max		"8A: $0 labs, $15 x-rays, $50 advanced imaging, $0 ther rad - $200 max; 8B: $0 labs, $15 x-rays, $50 advanced imaging, $0 ther rad - $200 max"		12: $0	3: $0; 5: $0; 7C: $15; 7I: $15; 9C: $25; 9D: $0	7A: $0; 14B: $0; 14C: $0; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0	"7B: $25; 7D: $25; 7F: $25; 13B: n/a; 14B: $0; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0; 18A: $25, 7A: $25"	7E: $25; 7H: $25	"7I, 7C: $15"			15: $25/75/62.50 for R30/R90/MO	13A: $0; 16B: $25; 16A: $0; 17A: $25 n/c on routine exams; 17B: $0; 18A: $25	10B: $0	16B: $25 MC Covered Dentist; 16A: $0 preventive dental	17A: $25 n/c on routine exams	17B: $0	18A: $25	18B: $0	14A: $0	13B: n/a											86.34920635	86.34920635	20.1012119		100	19.6856161	31.07606003	50	57.21518987		29.9327449			15.00404281		24.95758903	25	15			27.5	25					25														78.02110248	78.02110248	18.16251452		90.35532089	17.7870016	28.07887376	45.17766044	51.69696841		27.0458277			13.55695103		22.58883022	22.58883022	13.55329813			24.84771324	22.58883022					22.58883022														2.3855	0.059209755	1.919573993	0	1.153861398	2.29891271	0.690663388	1.353327284	1.957878503	0	2.585531105	0	0	0.250119954	0	16.18108664	0.589051862	0.447265789	0	0	2.566399048	2.027029559	0	0	0	0	0.488262482	0	0	0	0	0	0	0	0	0	0	0	0	0	36.9536	0	3.9141	2.3855	0.059209755	1.919573993	0	1.153861398	2.29891271	0.690663388	1.353327284	1.957878503	0	2.585531105	0	0	0.250119954	0	16.18108664	0.589051862	0.447265789	0	0	2.566399048	2.027029559	0	0	0	0	0.488262482	0	0	0	0	0	0	0	0	0	0	0	0	0	36.9536																																																																																		0	0	0	2.3855	0.059209755	1.919573993	0	1.153861398	2.29891271	0.690663388	1.353327284	1.957878503	0	2.585531105	0	0	0.250119954	0	16.18108664	0.589051862	0.447265789	0	0	2.566399048	2.027029559	0	0	0	0	0.488262482	0	0	0	0	0	0	0	0	0	0	0	0	0	36.9536
H2169_004_0	2009	2																					3100											A	A	D	V	T	O	O	V	V	P	P	P	P	P	P	P	P	P	P	P	S	P	T	P	P	P	P	P	P	P																																																			0		391.3991474	7.571409517	780.4671527		197.2420248	2059.972081	266.6739564	420.0508411	373.0926112		1162.243216			103.6282828	3784.36181	7303.26945	262.732938	569.6285785			1041.871849	953.075264																			1A: $250/stay - $750 annual max	1B: $250/stay - $750 annual max	"2: $0/day days 1-15, $60/day days 16-65, $0/day days 66-100 - $3000 annual max"	6: $0	10A: $100; 10B: $0	11A: 20%	"11B: 20% prosthetics, $0 medical supplies; 11C: $0 training/ $20/60/50 for R30/R90/MO90"	4A: $50; 4B: $50	9A: $150 - $300 max; 9B: $150 - $300 max		"8A: $0 labs, $15 x-rays, $50 advanced imaging, $0 ther rad; 8B: $0 labs, $15 x-rays, $50 advanced imaging, $0 ther rad"		12: $0	3: $0; 5: $0; 7C: $30; 7I: $30; 9C: $30; 9D: $0	7A: $15; 14B: $0; 14C: $15; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0	"7A: $30,7B: $30; 7D: $30; 7F: $30; 13B: n/a; 14B: $0; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0; 18A: $30 n/c on routine hearing test"	7E: $30; 7H: $30	"7I,7C: $30"			15: $32/96/80 for R30/R90/MO	13A: $0; 16A: $0; 16B: $30; 17A: $30 n/c on routine exams; 17B: $0; 18A: $30 n/c on routine hearing test	10B: $0	16A: $0; 16B: $30	17A: $30 n/c on routine exams	17B: $0	18A: $30 n/c on routine hearing test	18B: $0 n/c	14A: $0	13B: n/a											226.2793177	226.2793177	22.01852033		100	17.48859121	28.27868602	50	143.4262948		34.52918816			30	15	29.91435822	30	30			35.2	30																			192.2822308	192.2822308	18.710372		84.97561014	14.86103709	24.02998598	42.48780507	121.8773691		29.34138832			25.49268304	12.74634152	25.49268304	25.49268304	25.49268304			29.91141477	25.49268304																			6.2716	0.121320626	1.216902563	0	1.396730117	2.551110125	0.534014286	1.487253188	3.789295491	0	2.841819126	0	0	0.220146914	4.019730672	15.51499444	0.558147293	1.2101134	0	0	2.596988418	2.024703802	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3549	0	8.1438	6.2716	0.121320626	1.216902563	0	1.396730117	2.551110125	0.534014286	1.487253188	3.789295491	0	2.841819126	0	0	0.220146914	4.019730672	15.51499444	0.558147293	1.2101134	0	0	2.596988418	2.024703802	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3549																																																																																		0	0	0	6.2716	0.121320626	1.216902563	0	1.396730117	2.551110125	0.534014286	1.487253188	3.789295491	0	2.841819126	0	0	0.220146914	4.019730672	15.51499444	0.558147293	1.2101134	0	0	2.596988418	2.024703802	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3549
H2169_005_0	2009	4																					3100											A	A	D	V	T	O	O	V	V	P	P	P	P	P	P	P	P	P	P	P	S	P	T	P	P	P	P	P	P	P																																																			0		391.3991474	7.571409517	780.4671527		197.2420248	2059.972081	266.6739564	420.0508411	373.0926112		1162.243216			103.6282828	3784.36181	7303.26945	262.732938	569.6285785			1041.871849	953.075264					259.3826119														1A: $250/stay - $750 annual max	1B: $250/stay - $750 annual max	"2: $0/day days 1-15, $60/day days 16-65, $0/day days 66-100 - $3000 annual max"	6: $0	10A: $100; 10B: $0	11A: 20%	"11B: 20% prosthetics, $0 medical supplies; 11C: $0 training/ $20/60/50 for R30/R90/MO90"	4A: $50; 4B: $50	9A: $150 - $300 max; 9B: $150 - $300 max		"8A: $0 labs, $15 x-rays, $50 advanced imaging, $0 ther rad; 8B: $0 labs, $15 x-rays, $50 advanced imaging, $0 ther rad"		12: $0	3: $0; 5: $0; 7C: $30; 7I: $30; 9C: $30; 9D: $0	7A: $15; 14B: $0; 14C: $15; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0	"7B: $30; 7D: $30; 7F: $30; 13B: n/a; 14B: $0; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0; 18A: $30, 7A: $30"	7E: $30; 7H: $30	"7I, 7C: $30"			15: $32/96/80 for R30/R90/MO	13A: $0; 16A: $0; 16B: $30; 17A: $30 n/c on routine exams; 17B: $0; 18A: $30	10B: $0	16A: $0; 16B: $30	17A: $30 n/c on routine exams	17B: $0	18A: $30	18B: $0	14A: $0	13B: n/a											226.2793177	226.2793177	22.01852033		100	17.48859121	28.27868602	50	143.4262948		34.52918816			30	15	29.91435822	30	30			35.2	30					30														192.2822308	192.2822308	18.710372		84.97561014	14.86103709	24.02998598	42.48780507	121.8773691		29.34138832			25.49268304	12.74634152	25.49268304	25.49268304	25.49268304			29.91141477	25.49268304					25.49268304														6.2716	0.121320626	1.216902563	0	1.396730117	2.551110125	0.534014286	1.487253188	3.789295491	0	2.841819126	0	0	0.220146914	4.019730672	15.51499444	0.558147293	1.2101134	0	0	2.596988418	2.024703802	0	0	0	0	0.551029893	0	0	0	0	0	0	0	0	0	0	0	0	0	46.9059	0	8.2412	6.2716	0.121320626	1.216902563	0	1.396730117	2.551110125	0.534014286	1.487253188	3.789295491	0	2.841819126	0	0	0.220146914	4.019730672	15.51499444	0.558147293	1.2101134	0	0	2.596988418	2.024703802	0	0	0	0	0.551029893	0	0	0	0	0	0	0	0	0	0	0	0	0	46.9059																																																																																		0	0	0	6.2716	0.121320626	1.216902563	0	1.396730117	2.551110125	0.534014286	1.487253188	3.789295491	0	2.841819126	0	0	0.220146914	4.019730672	15.51499444	0.558147293	1.2101134	0	0	2.596988418	2.024703802	0	0	0	0	0.551029893	0	0	0	0	0	0	0	0	0	0	0	0	0	46.9059
H2169_006_0	2009	3																					3100											A	A	D	V	T	O	O	V	V	P	P	P	P	P	P	P	P	P	P	P	S	P	T	P	P	P	P	P	P	P																																																			0		391.3991474	7.571409517	780.4671527		197.2420248	2059.972081	266.6739564	420.0508411	373.0926112		1162.243216			103.6282828		7303.26945	262.732938	569.6285785			1041.871849	953.075264					259.3826119														1A: $100/stay - $200 annual max	1B: $100/stay - $200 annual max	"2: $0/day days 1-15, $60/day days 16-50, $0/day days 51-100 - $2100 annual max"	6: $0	10A: $100; 10B: $0	11A: 20%	"11B: 20% prosthetics, $0 medical supplies; 11C: $0 training/ $15/45/37.50 for R30/R90/MO90"	4A: $50; 4B: $50	9A: $60 - $120 max; 9B: $60 - $120 max		"8A: $0 labs, $15 x-rays, $50 advanced imaging, $0 ther rad - $200 max; 8B: $0 labs, $15 x-rays, $50 advanced imaging, $0 ther rad - $200 max"		12: $0	3: $0; 5: $0; 7C: $15; 7I: $15; 9C: $25; 9D: $0	7A: $0; 14B: $0; 14C: $0; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0	"7B: $25; 7D: $25; 7F: $25; 13B: n/a; 14B: $0; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0; 18A: $25, 7A $25"	7E: $25; 7H: $25	"7I, 7C: $15"			15: $25/75/62.50 for R30/R90/MO	13A: $0; 16A: $0 n/c on routine exams; 16B: $25; 17A: $25 n/c on routine exams; 17B: $0; 18A: $25	10B: $0	16A: $0 n/c on routine exams; 16B: $25	17A: $25 n/c on routine exams	17B: $0	18A: $25	18B: $0	14A: $0	13B: n/a											86.34920635	86.34920635	20.1012119		100	17.48859121	28.27868602	50	57.21518987		29.06694371			15		25	25	15			27.5	25					25														79.3475649	79.3475649	18.4713014		91.89148141	16.07052554	25.9857035	45.9457407	52.57588556		26.71004517			13.78372221		22.97287035	22.97287035	13.78372221			25.27015739	22.97287035					22.97287035														2.588	0.050064409	1.201353667	0	1.510405155	2.758736162	0.577475864	1.608295586	1.634639536	0	2.586964066	0	0	0.119031955	0	13.98142185	0.502977477	0.654300174	0	0	2.194022134	1.824572873	0	0	0	0	0.496563593	0	0	0	0	0	0	0	0	0	0	0	0	0	34.2889	0	3.0257	2.588	0.050064409	1.201353667	0	1.510405155	2.758736162	0.577475864	1.608295586	1.634639536	0	2.586964066	0	0	0.119031955	0	13.98142185	0.502977477	0.654300174	0	0	2.194022134	1.824572873	0	0	0	0	0.496563593	0	0	0	0	0	0	0	0	0	0	0	0	0	34.2889																																																																																		0	0	0	2.588	0.050064409	1.201353667	0	1.510405155	2.758736162	0.577475864	1.608295586	1.634639536	0	2.586964066	0	0	0.119031955	0	13.98142185	0.502977477	0.654300174	0	0	2.194022134	1.824572873	0	0	0	0	0.496563593	0	0	0	0	0	0	0	0	0	0	0	0	0	34.2889
H2169_801_0	2009	4																					3100											A	A	D	V	T	O	O	V	V	P	P	P	P	P	P	P	P	P	P	P	S	P	T	P	P	P	P	P	P	P																																																			0		364.6875449	8.669945052	1158.536439		158.3453448	1613.920717	284.7955652	363.8349601	431.8038559		1129.296481			196.4230286	4450.469543	8218.506377	298.3677911	419.8602994			1181.983079	1035.455885		522	0.060838331		259.3826119														1A: $100/stay	1B: $100/stay	"2: $0/day days 1-20, $30/day days 21-100"	6: $0	10A: $75; 10B: $0	11A: 15%	"11B: 15% prosthetics, $0 medical supplies; 11C: $0 training/ $20/60 for R30/R90"	4A: $50; 4B: $50	9A: $100; 9B: $100		"8A: $0 labs, $5 x-rays, $40 advanced imaging, $0 ther rad; 8B: $0 labs, $5 x-rays, $40 advanced imaging, $0 ther rad"		12: $0	3: $0; 5: $0; 7C: $25; 7I: $25; 9C: $25; 9D: $0	7A: $5; 14B: $0; 14C: $5; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0	"7B: $25; 7D: $25; 7F: $25; 13B: n/a; 14B: $0; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0; 18A: $25, 7A$25"	7E: $25; 7H: $25	"7I, 7C: $25"			15: $20/60 for R30/R90	"13A: $0; 16A: $25; : $25 bitewing x-ray, 16B 20% restorative; 17A: $25; 17B: $0; 18A: $25"	10B: $0	"16A: $25;  $25 bitewing x-ray, 16B: 20% restorative"	17A: $25	17B: $0	18A: $25	18B: $0	14A: $0	13B: n/a											100	100	8.752481557		75	14.13671234	22.53651154	50	100		25.36894035			25	5	24.95819155	25	25			22	25		31.98275862	25		25														90.49189756	90.49189756	7.920286645		67.86892317	12.79257925	20.39371693	45.24594878	90.49189756		22.95683551			22.62297439	4.524594878	22.62297439	22.62297439	22.62297439			19.90821746	22.62297439		28.94180517	22.62297439		22.62297439														2.7501	0.065379982	0.764661724	0	0.89556067	1.72051739	0.484003345	1.371838164	3.256229191	0	2.160422798	0	0	0.370306095	1.678047642	15.49392161	0.562497241	0.791540733	0	0	1.960931348	1.952090998	0	1.258968525	0.000114695	0	0.489000516	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0261	0	3.9668	2.7501	0.065379982	0.764661724	0	0.89556067	1.72051739	0.484003345	1.371838164	3.256229191	0	2.160422798	0	0	0.370306095	1.678047642	15.49392161	0.562497241	0.791540733	0	0	1.960931348	1.952090998	0	1.258968525	0.000114695	0	0.489000516	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0261																																																																																		0	0	0	2.7501	0.065379982	0.764661724	0	0.89556067	1.72051739	0.484003345	1.371838164	3.256229191	0	2.160422798	0	0	0.370306095	1.678047642	15.49392161	0.562497241	0.791540733	0	0	1.960931348	1.952090998	0	1.258968525	0.000114695	0	0.489000516	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0261
H2169_802_0	2009	4																					3100											A	A	D	V	T	O	O	V	V	P	P	P	P	P	P	P	P	P	P	P	S	P	T	P	P	P	P	P	P	P																																																			0		364.6875449	8.669945052	1158.536439		158.3453448	1613.920717	284.7955652	363.8349601	431.8038559		1129.296481			196.4230286	4450.469543	8218.506377	298.3677911	419.8602994			1181.983079	1035.455885		522	0.060838331		259.3826119														1A: $100/stay	1B: $100/stay	"2: $0/day days 1-20, $30/day days 21-100"	6: $0	10A: $75; 10B: $0	11A: 15%	"11B: 15% prosthetics, $0 medical supplies; 11C: $0 training/ $20/60 for R30/R90"	4A: $50; 4B: $50	9A: $100; 9B: $100		"8A: $0 labs, $5 x-rays, $40 advanced imaging, $0 ther rad; 8B: $0 labs, $5 x-rays, $40 advanced imaging, $0 ther rad"		12: $0	3: $0; 5: $0; 7C: $25; 7I: $25; 9C: $25; 9D: $0	7A: $5; 14B: $0; 14C: $5; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0	"7B: $25; 7D: $25; 7F: $25; 13B: n/a; 14B: $0; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0; 18A: $25, 7A$25"	7E: $25; 7H: $25	"7I, 7C: $25"			15: $20/60 for R30/R90	"13A: $0; 16A: $25; : $25 bitewing x-ray, 16B 20% restorative; 17A: $25; 17B: $0; 18A: $25"	10B: $0	"16A: $25;  $25 bitewing x-ray, 16B: 20% restorative"	17A: $25	17B: $0	18A: $25	18B: $0	14A: $0	13B: n/a											100	100	8.752481557		75	14.13671234	22.53651154	50	100		25.36894035			25	5	24.95819155	25	25			22	25		31.98275862	25		25														90.49189756	90.49189756	7.920286645		67.86892317	12.79257925	20.39371693	45.24594878	90.49189756		22.95683551			22.62297439	4.524594878	22.62297439	22.62297439	22.62297439			19.90821746	22.62297439		28.94180517	22.62297439		22.62297439														2.7501	0.065379982	0.764661724	0	0.89556067	1.72051739	0.484003345	1.371838164	3.256229191	0	2.160422798	0	0	0.370306095	1.678047642	15.49392161	0.562497241	0.791540733	0	0	1.960931348	1.952090998	0	1.258968525	0.000114695	0	0.489000516	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0261	0	3.9668	2.7501	0.065379982	0.764661724	0	0.89556067	1.72051739	0.484003345	1.371838164	3.256229191	0	2.160422798	0	0	0.370306095	1.678047642	15.49392161	0.562497241	0.791540733	0	0	1.960931348	1.952090998	0	1.258968525	0.000114695	0	0.489000516	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0261																																																																																		0	0	0	2.7501	0.065379982	0.764661724	0	0.89556067	1.72051739	0.484003345	1.371838164	3.256229191	0	2.160422798	0	0	0.370306095	1.678047642	15.49392161	0.562497241	0.791540733	0	0	1.960931348	1.952090998	0	1.258968525	0.000114695	0	0.489000516	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0261
H2169_803_0	2009	4																					3100											A	A	D	V	T	O	O	V	V	P	P	P	P	P	P	P	P	P	P	P	S	P	T	P	P	P	P	P	P	P																																																			0		364.6875449	8.669945052	1158.536439		158.3453448	1613.920717	284.7955652	363.8349601	431.8038559		1129.296481			196.4230286	4450.469543	8218.506377	298.3677911	419.8602994			1181.983079	1035.455885		522	0.060838331		259.3826119														1A: $100/stay	1B: $100/stay	"2: $0/day days 1-20, $30/day days 21-100"	6: $0	10A: $75; 10B: $0	11A: 15%	"11B: 15% prosthetics, $0 medical supplies; 11C: $0 training/ $20/60 for R30/R90"	4A: $50; 4B: $50	9A: $100; 9B: $100		"8A: $0 labs, $5 x-rays, $40 advanced imaging, $0 ther rad; 8B: $0 labs, $5 x-rays, $40 advanced imaging, $0 ther rad"		12: $0	3: $0; 5: $0; 7C: $25; 7I: $25; 9C: $25; 9D: $0	7A: $5; 14B: $0; 14C: $5; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0	"7B: $25; 7D: $25; 7F: $25; 13B: n/a; 14B: $0; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0; 18A: $25, 7A$25"	7E: $25; 7H: $25	"7I, 7C: $25"			15: $20/60 for R30/R90	"13A: $0; 16A: $25; : $25 bitewing x-ray, 16B 20% restorative; 17A: $25; 17B: $0; 18A: $25"	10B: $0	"16A: $25;  $25 bitewing x-ray, 16B: 20% restorative"	17A: $25	17B: $0	18A: $25	18B: $0	14A: $0	13B: n/a											100	100	8.752481557		75	14.13671234	22.53651154	50	100		25.36894035			25	5	24.95819155	25	25			22	25		31.98275862	25		25														90.49189756	90.49189756	7.920286645		67.86892317	12.79257925	20.39371693	45.24594878	90.49189756		22.95683551			22.62297439	4.524594878	22.62297439	22.62297439	22.62297439			19.90821746	22.62297439		28.94180517	22.62297439		22.62297439														2.7501	0.065379982	0.764661724	0	0.89556067	1.72051739	0.484003345	1.371838164	3.256229191	0	2.160422798	0	0	0.370306095	1.678047642	15.49392161	0.562497241	0.791540733	0	0	1.960931348	1.952090998	0	1.258968525	0.000114695	0	0.489000516	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0261	0	3.9668	2.7501	0.065379982	0.764661724	0	0.89556067	1.72051739	0.484003345	1.371838164	3.256229191	0	2.160422798	0	0	0.370306095	1.678047642	15.49392161	0.562497241	0.791540733	0	0	1.960931348	1.952090998	0	1.258968525	0.000114695	0	0.489000516	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0261																																																																																		0	0	0	2.7501	0.065379982	0.764661724	0	0.89556067	1.72051739	0.484003345	1.371838164	3.256229191	0	2.160422798	0	0	0.370306095	1.678047642	15.49392161	0.562497241	0.791540733	0	0	1.960931348	1.952090998	0	1.258968525	0.000114695	0	0.489000516	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0261
H2174_001_0	2009	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		395.1341408	1.423127634	67.80351447	0	18.90457195	43.0776804	0.227828409	24.12415604	12.95718467	8.40116298	16.42495604	0	0.046077467	57.91651412	0	179.2633626	5.907759977	2.183431765	32.06435318	27.50229731	8.171505758	0.104127798	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											0.0744	0.0744	0.1306	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0744	0.0744	0.1306	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											29.398	0.105880696	8.85513899	0	4.366956119	9.950944172	0.052628363	5.572680045	2.993109659	1.940668648	3.794164845	0	0.010643895	13.37871476	0	41.40983677	1.364692555	0.504372738	7.406865584	6.353030679	1.88761783	0.024053521	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.37	0	0	29.398	0.105880696	8.85513899	0	4.366956119	9.950944172	0.052628363	5.572680045	2.993109659	1.940668648	3.794164845	0	0.010643895	13.37871476	0	41.40983677	1.364692555	0.504372738	7.406865584	6.353030679	1.88761783	0.024053521	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.37																																																																																		0	0		29.398	0.105880696	8.85513899	0	4.366956119	9.950944172	0.052628363	5.572680045	2.993109659	1.940668648	3.794164845	0	0.010643895	13.37871476	0	41.40983677	1.364692555	0.504372738	7.406865584	6.353030679	1.88761783	0.024053521	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.37
H2174_002_0	2009	6																					1500											D	D				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		592.4560156	9.492031897	0	0	183.3977096	9.83611116	0	305.4865359	260.0249411	0	101.2382853	0	0	255.0237865	4109.227622	3702.039661	163.2041396	491.255969	1921.971128	1624.87288	0	0	0	615.0601978	379.213991	0	0	0	0	0											"$100 per day, max $500"	"$100 per day, max $500"	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;	$10/Visit for PCP - Office Visits; $10/Consult for PCP - Consults;	$10/Visit for Speclst - Office Visits; $10/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);	$75/Procedure for Advanced Imaging and $0 for Other Prof Radiology (Office);	$20/Visit for Chiropractor; $20/Exam for Vistion Exams; $10/Service for Podiatrist; $20/Exam for Hearing/Speech Exams;	No Copay	No Copay	No Copay	$10/Procedure for Dental	$20/Exam for Vision (Refractions)	No Copay	No Copay	No Copay	No Copay	No Copay											100	99.99999999	0	0	50	0.2	0	41.64425199	50	0	75	0	0	20	10	10	20	20	7.5	16.29829559	0	0	0	10	20	0	0	0	0	0											91.61062379	91.61062376	0	0	45.80531189	0.183221248	0	38.15055903	45.8053119	0	68.70796784	0	0	18.32212476	9.161062379	9.161062379	18.32212475	18.32212476	6.870796785	14.93097026	0	0	0	9.161062379	18.32212476	0	0	0	0	0											4.5229	0.072464247	0	0	0.700049107	1.802184558	0	0.971206843	0.992543627	0	0.579656404	0	0	0.389381469	3.137074215	2.826218022	0.249187217	0.750071096	1.100456087	2.021744054	0	0	0	0.469550403	0.579000505	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.1637	0	1.8951	4.5229	0.072464247	0	0	0.700049107	1.802184558	0	0.971206843	0.992543627	0	0.579656404	0	0	0.389381469	3.137074215	2.826218022	0.249187217	0.750071096	1.100456087	2.021744054	0	0	0	0.469550403	0.579000505	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.1637																																																																																		0	0		4.5229	0.072464247	0	0	0.700049107	1.802184558	0	0.971206843	0.992543627	0	0.579656404	0	0	0.389381469	3.137074215	2.826218022	0.249187217	0.750071096	1.100456087	2.021744054	0	0	0	0.469550403	0.579000505	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.1637
H2174_003_0	2009	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		493.1920445	25.89660983	424.0810386	0	65.69329752	8.088986098	38.5469116	35.01751374	19.81699494	14.82724305	9.492135601	0	5.668330229	158.0043195	62.94725901	120.9009329	11.06378628	1.208757118	31.94113975	62.63530969	3.506439137	1.280500272	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											0.0744	0.0744	0.1306	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0744	0.0744	0.1306	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											36.6935	1.926707771	55.38498364	0	15.17515173	1.868555789	8.904336579	8.089045675	4.577725832	3.425093145	2.192683324	0	1.309384283	36.49899781	14.54081683	27.92811551	2.55573463	0.279222894	7.378403283	14.46875654	0.809987441	0.295795563	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	244.303	0	0	36.6935	1.926707771	55.38498364	0	15.17515173	1.868555789	8.904336579	8.089045675	4.577725832	3.425093145	2.192683324	0	1.309384283	36.49899781	14.54081683	27.92811551	2.55573463	0.279222894	7.378403283	14.46875654	0.809987441	0.295795563	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	244.303																																																																																		0	0		36.6935	1.926707771	55.38498364	0	15.17515173	1.868555789	8.904336579	8.089045675	4.577725832	3.425093145	2.192683324	0	1.309384283	36.49899781	14.54081683	27.92811551	2.55573463	0.279222894	7.378403283	14.46875654	0.809987441	0.295795563	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	244.303
H2174_004_0	2009	3																					1500											D	D				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		555.5922692	8.857859194	0	0	166.717829	9.0063129	0	278.4850261	237.088925	0	93.43202384	0	0	232.8866304	3753.059961	3381.118789	148.8050962	447.7186448	1756.026187	1481.710367	0	0	0	615.0601978	379.2989651	0	0	0	0	0											"$100 per day, max $500"	"$100 per day, max $500"	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;	$10/Visit for PCP - Office Visits; $10/Consult for PCP - Consults;	$10/Visit for Speclst - Office Visits; $10/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);	$75/Procedure for Advanced Imaging and $0 for Other Prof Radiology (Office);	$20/Visit for Chiropractor; $20/Exam for Vistion Exams; $10/Service for Podiatrist; $20/Exam for Hearing/Speech Exams;	No Copay	No Copay	No Copay	$10/Procedure for Dental	$20/Exam for Vision (Refractions)	No Copay	No Copay	No Copay	No Copay	No Copay											100	100	0	0	50	0.2	0	41.62845194	50	0	75	0	0	20	10	10	20	20	7.5	16.30072139	0	0	0	10	20	0	0	0	0	0											90.89546063	90.89546071	0	0	45.44773031	0.181790921	0	37.83837314	45.44773032	0	68.17159548	0	0	18.17909212	9.089546064	9.089546063	18.17909213	18.17909213	6.817159547	14.81661579	0	0	0	9.089546063	18.17909213	0	0	0	0	0											4.2084	0.067094933	0	0	0.631412244	1.637265919	0	0.878118361	0.897929461	0	0.530784178	0	0	0.352805626	2.84280095	2.561069582	0.225428463	0.678259874	0.997592557	1.829494436	0	0	0	0.465884833	0.574609236	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.379	0	1.8944	4.2084	0.067094933	0	0	0.631412244	1.637265919	0	0.878118361	0.897929461	0	0.530784178	0	0	0.352805626	2.84280095	2.561069582	0.225428463	0.678259874	0.997592557	1.829494436	0	0	0	0.465884833	0.574609236	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.379																																																																																		0	0		4.2084	0.067094933	0	0	0.631412244	1.637265919	0	0.878118361	0.897929461	0	0.530784178	0	0	0.352805626	2.84280095	2.561069582	0.225428463	0.678259874	0.997592557	1.829494436	0	0	0	0.465884833	0.574609236	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.379
H2182_001_0	2009	6																					3000											D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1567.579541	161.3455109	667.8541023	708.2441264	106.890994	10.99910192	4.062782679	303.9832765	212.6718875	9466.323686	38.88557593	0	0.202395223	554.6516176	4445.190021	3498.817681	550.8751235	198.1465912	0	0	15.64305896	759.4912764	0	0	103.5923094	292.8	12.88706159	0	453.6	0											"$200 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$200 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$150 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); $150 (9a); $40/$30 (9c)"	"$5 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											197.6553105	200	77.60718127	0	150	0.2	0.076056143	49.51690865	150	2.8	0.17370667	0	0.2	52.82997651	3.584913672	20	37.5	20	0	0	0.2	19.0424081	0	0	20	30	20	0	0	0											137.3781552	138.9881061	53.93237572	0	104.2410796	0.138988106	0.052854496	34.41130677	104.2410796	1.945833485	0.120715805	0	0.138988106	36.86513877	3.584913672	20	37.5	13.89881061	0	0	0.138988106	19.0424081	0	0	20	30	20	0	0	0											17.9459	1.868758916	3.001579864	0	0.928536051	1.528744345	0.214736332	0.871705148	1.847428929	1.534990801	4.694103616	0	0.028130529	1.703942404	1.32796854	5.831362801	1.721484761	0.229500162	0	0	2.174199138	1.205211903	0	0	0.172653849	0.732	0.021478436	0	0	0	0	0	0	0	0	0	0	0	0	0	49.5844	0	16.9184	17.9459	1.868758916	3.001579864	0	0.928536051	1.528744345	0.214736332	0.871705148	1.847428929	1.534990801	4.694103616	0	0.028130529	1.703942404	1.32796854	5.831362801	1.721484761	0.229500162	0	0	2.174199138	1.205211903	0	0	0.172653849	0.732	0.021478436	0	0	0	0	0	0	0	0	0	0	0	0	0	49.5844		"$275 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$275 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$10 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$10 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											4.9105	0.5022	5.559	0.6246	0.4454	1.0999	0.4063	0.4181	3.3414	0.7363	3.3151	0	0.0135	2.485	1.4547	3.7487	0.8361	0.2123	0	0	2.0113	0.793	0	0	0.111	0	0.0138	0	0	0											33.0382	0	0	22.8564	2.370966827	8.560532116	0.624644723	1.373915193	2.628654536	0.6210146	1.28982493	5.188808739	2.271260421	8.009225894	0	0.041623544	4.188969594	2.782678036	9.58009603	2.557634502	0.441800081	0	0	4.185449576	1.99825595	0	0	0.283645609	0.732	0.035286002	0	0	0	0	0	0	0	0	0	0	0	0	0	82.6227
H2224_001_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	484.4284592	0	81.48700012	32.69443398	37.88519611	46.44697643	22.83325994	17.01437536	4.104123147	68.45829071	73.84867801	5.079653086	8.09826663	135.6088171	3.974176233	192.1966614	4.318956026	85.02253816	29.27769015	25.30391767	10.66213828	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0.072673869	0.072673869	0.165514956	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											35.2053	0	13.48731724	0	8.751480301	10.72925155	5.274483045	3.930320708	0.948052447	15.81386515	17.05904462	1.173399863	1.870699591	31.32563675	0.91803471	44.39742879	0.997678842	19.64020632	6.763146425	5.845204982	2.462953944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	226.5935	0	0	35.2053	0	13.48731724	0	8.751480301	10.72925155	5.274483045	3.930320708	0.948052447	15.81386515	17.05904462	1.173399863	1.870699591	31.32563675	0.91803471	44.39742879	0.997678842	19.64020632	6.763146425	5.845204982	2.462953944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	226.5935	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	35.2053	0	13.48731724	0	8.751480301	10.72925155	5.274483045	3.930320708	0.948052447	15.81386515	17.05904462	1.173399863	1.870699591	31.32563675	0.91803471	44.39742879	0.997678842	19.64020632	6.763146425	5.845204982	2.462953944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	226.5935
H2225_001_0	2009	7																																Coin		Coin	Coin	Coin	Coin		Coin	Coin	Coin					Coin						Coin	Coin																																																											0		409.9183618		215.2083247	121.1626227	12.91095193	57.87158894		25.09043308	20.03114112	119.3163754					476.9401627						22.95091164	11.5378034																			Medicare FFS Cost Sharing		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing					Medicare FFS Cost Sharing						Medicare FFS Cost Sharing	Medicare FFS Cost Sharing																			0.071749405		0.168397154	0	0.231	0.231		0.231	0.231	0.231					0.231						0.231	0.231																			0.071749405		0.168397154	0	0.231	0.231		0.231	0.231	0.231					0.231						0.231	0.231																			29.4114	0	36.24046942	0	2.982429897	13.36833704	0	5.795890041	4.627193599	27.56208272	0	0	0	0	110.1731776	0	0	0	0	0	5.301660588	2.665232585	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	238.1279	0	0	29.4114	0	36.24046942	0	2.982429897	13.36833704	0	5.795890041	4.627193599	27.56208272	0	0	0	0	110.1731776	0	0	0	0	0	5.301660588	2.665232585	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	238.1279																																																																																		0	0	0	29.4114	0	36.24046942	0	2.982429897	13.36833704	0	5.795890041	4.627193599	27.56208272	0	0	0	0	110.1731776	0	0	0	0	0	5.301660588	2.665232585	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	238.1279
H2226_001_0	2009	6																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		377.3463279	10.04398095	149.6233641	6660.949974	28.09456792	42.81856041	16.18322569	41.53328314	63.38515907	14.343953	29.72675079	0	8.515346023	94.9033503	83.66733515	170.4562683	10.24947704	7.582029041	0	0	28.93998753	9.229105108	0	0	0	0	39.92312156	0	20.2	0											"FFS (1a); $0 n/c (1a1, 1a2, 1a3, 13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"20% (7a, 7a1, 14b, 14c, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1); $0/20% (14d)"	"20% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b); $0 (13a1, 17b, 18a); $0 n/c (17a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a7)"	"$0 n/c (13b, 13d, 13e)"											0.07085231	0.07085231	0.165041997	0	0.2	0.2	0.2	0.062299576	0.2	0.08	0.2	0	0.2	0.2	0.199727877	0.2	0.2	0.2	0	0	0.2	0.01389151	0	0	0	0	0	0	0	0											0.07085231	0.07085231	0.165041997	0	0.2	0.2	0.2	0.062299576	0.2	0.08	0.2	0	0.2	0.2	0.199727877	0.2	0.2	0.2	0	0	0.2	0.01389151	0	0	0	0	0	0	0	0											26.7359	0.711639254	24.69413884	0	5.618913585	8.563712083	3.236645138	2.587505943	12.67703181	1.14751624	5.945350158	0	1.703069205	18.98067006	16.71069926	34.09125367	2.049895408	1.516405808	0	0	5.787997505	0.128206207	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	172.8865	0	0	26.7359	0.711639254	24.69413884	0	5.618913585	8.563712083	3.236645138	2.587505943	12.67703181	1.14751624	5.945350158	0	1.703069205	18.98067006	16.71069926	34.09125367	2.049895408	1.516405808	0	0	5.787997505	0.128206207	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	172.8865																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	26.7359	0.711639254	24.69413884	0	5.618913585	8.563712083	3.236645138	2.587505943	12.67703181	1.14751624	5.945350158	0	1.703069205	18.98067006	16.71069926	34.09125367	2.049895408	1.516405808	0	0	5.787997505	0.128206207	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	172.8865
H2228_001_0	2009	5																																Coin	Coin	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		308.7027603	42.09075	8783.542111	195.2404777	30.48902123	21.30786934	15.9850682	19.93807151	6.766715832	45.39403312	29.57976918	0	0.014743576	9.420615192	1.10657605	128.8166493	43.2725	6.762123476	0	0	9.961915677	9.930709708	2872.343284	0	391.1465798	1417.791889	0	0	0	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.069863696	0.070815742	0	0	0.2	0.2	0.2	0.042680992	0.2	0.08	0.154268542	0	0.2	0.2	0	0.197200117	0.2	0	0	0	0.2	0.022071665	0	0	0	0	0	0	0	0											0.069863696	0.070815742	0	0	0.2	0.2	0.2	0.042680992	0.2	0.08	0.154268542	0	0.2	0.2	0	0.197200117	0.2	0	0	0	0.2	0.022071665	0	0	0	0	0	0	0	0											21.5671	2.980687712	0	0	6.097804246	4.261573869	3.197013641	0.850976662	1.353343166	3.63152265	4.56322787	0	0.002948715	1.884123038	0	25.4026583	8.6545	0	0	0	1.992383135	0.219187297	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.6591	0	0	21.5671	2.980687712	0	0	6.097804246	4.261573869	3.197013641	0.850976662	1.353343166	3.63152265	4.56322787	0	0.002948715	1.884123038	0	25.4026583	8.6545	0	0	0	1.992383135	0.219187297	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.6591		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.3746	0.3238	1.1816	0.092	0.4814	0.3364	0.2524	0.0448	0.1068	0.7167	0.467	0	0.0002	0.1487	0.0175	2.0339	0.6833	0.0022	0	0	0.1573	0.1565	0.1828	0	0.0437	0	0	0	0	0											9.8037	0	0	23.9418	3.304462712	1.181616758	0.091992145	6.579209845	4.598013911	3.449409454	0.895764908	1.460186048	4.348270541	5.030276857	0	0.003103911	2.032869594	0.017472253	27.43660539	9.33775	0.002215347	0	0	2.149676541	0.375675928	0.182773215	0	0.043697185	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.4628
H2228_002_0	2009	6																																Coin	Coin	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		332.3828852	20.514	10756.61711	162.5497127	37.41923438	10.6245663	14.42706155	22.87879465	10.21235588	53.29949368	36.95916574	0	0.002441372	9.176310291	1.460673308	150.9980129	75.17801286	1.968148889	0	0	11.50946225	9.145160475	1285.863484	0	71.6225391	208.0870514	0	0	0	0											"7.6% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"7.6% (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.074487465	0.0755	0	0	0.2	0.2	0.2	0.068503094	0.2	0.08	0.149174174	0	0.2	0.2	0	0.196661682	0.2	0	0	0	0.2	0.019272653	0	0	0	0	0	0	0	0											0.074487465	0.0755	0	0	0.2	0.2	0.2	0.068503094	0.2	0.08	0.149174174	0	0.2	0.2	0	0.196661682	0.2	0	0	0	0.2	0.019272653	0	0	0	0	0	0	0	0											24.7584	1.548807	0	0	7.483846876	2.124913261	2.885412309	1.567268226	2.042471177	4.263959495	5.513353028	0	0.000488274	1.835262058	0	29.69552321	15.03560257	0	0	0	2.30189245	0.176251501	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.2334	0	0	24.7584	1.548807	0	0	7.483846876	2.124913261	2.885412309	1.567268226	2.042471177	4.263959495	5.513353028	0	0.000488274	1.835262058	0	29.69552321	15.03560257	0	0	0	2.30189245	0.176251501	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.2334		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.5568	0.1578	1.0929	0.0567	0.5908	0.1678	0.2278	0.0825	0.1612	0.8416	0.5836	0	0	0.1449	0.0231	2.3842	1.187	0.0006	0	0	0.1817	0.1441	0.0805	0	0.004	0	0	0	0	0											10.6694	0	0	27.3152	1.706607	1.092860142	0.056749558	8.074676892	2.292669571	3.113208018	1.649756027	2.203718901	5.105530448	6.096918803	0	0.000513973	1.980151168	0.023063263	32.07970236	16.22262383	0.000556855	0	0	2.483620801	0.32035567	0.080454628	0	0.003965825	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.9029
H2228_004_0	2009	4																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		350.9000602	22.2912	42.84778126	2134.530206	14.31647971	21.77556146	18.60672774	78.06550825	43.92271985	37.54243856	59.52277962	0	1.228788993	58.58234924	56.90842719	126.0267821	13.9175	2.30137714	0	0	14.8492598	6.731017724	178.199689	0	149.8276358	190.4281154	0	0	20.2	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.070280557	0.071187476	0.165876211	0	0.2	0.2	0.2	0.053662915	0.2	0.08	0.2	0	0.2	0.2	0	0.199868407	0.2	0.2	0	0	0.2	0.008119739	0	0	0	0	0	0	0	0											0.070280557	0.071187476	0.165876211	0	0.2	0.2	0.2	0.053662915	0.2	0.08	0.2	0	0.2	0.2	0	0.199868407	0.2	0.2	0	0	0.2	0.008119739	0	0	0	0	0	0	0	0											24.6615	1.586854264	7.107427591	0	2.863295943	4.355112292	3.721345548	4.189222768	8.784543971	3.003395085	11.90455592	0	0.245757799	11.71646985	0	25.18877212	2.7835	0.460275428	0	0	2.969851959	0.054654109	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.5965	0	0	24.6615	1.586854264	7.107427591	0	2.863295943	4.355112292	3.721345548	4.189222768	8.784543971	3.003395085	11.90455592	0	0.245757799	11.71646985	0	25.18877212	2.7835	0.460275428	0	0	2.969851959	0.054654109	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.5965		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											4.3863	0.2786	0.6765	0.3654	0.226	0.3438	0.2938	0.2206	0.6935	0.5928	0.9398	0	0.0129	0.925	0.8986	1.9899	0.2198	0.0363	0	0	0.2345	0.0978	0.0261	0	0.0155	0	0	0	0.003	0											13.4764	0	0	29.0477	1.865494264	7.783971505	0.365362094	3.089345622	4.698936946	4.015135986	4.409817877	9.4780606	3.59617043	12.84438929	0	0.25869242	12.64145431	0.898554113	27.17866868	3.00325	0.496612962	0	0	3.204313956	0.152423888	0.0261	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	129.0729
H2228_009_0	2009	4																					3350											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2093.846254	42.95459583	51.43186747	31163.99609	135.3049558	19.7123604	11.7081556	441.2867842	395.4689745	6087.469432	1052.410633	0	0.82075268	2580.906707	5805.718602	5325.521394	615.8603919	270.9938295	0	0	17.41757326	1130.126881	524.0202747	0	133.4221731	179.0221564	0	0	20.2	0											"$250 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$250 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$125 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5); $125 (9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											247.2041252	250	0.165869359	0	150	0.14	0.123872027	49.97847205	125	4.4	45.63149179	0	0.2	121.0637255	3.365479753	25	20	20	0	0	0.2	18.16809543	0	0	0	0	0	0	0	0											161.1296458	162.9520195	0.165869359	0	97.77121173	0.091253131	0.080740788	32.57637182	81.47600977	2.867955544	29.74297497	0	0.130361616	78.91031425	3.365479753	25	20	20	0	0	0.130361616	18.16809543	0	0	0	0	0	0	0	0											28.1151	0.583294845	8.530970873	0	1.102410791	1.798814605	0.945325707	1.197960197	2.685102836	1.454882642	2.608485259	0	0.106994645	16.97167994	1.628252367	11.09483624	1.026433986	0.451656382	0	0	2.27058299	1.711021086	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.2838	0	31.9665	28.1151	0.583294845	8.530970873	0	1.102410791	1.798814605	0.945325707	1.197960197	2.685102836	1.454882642	2.608485259	0	0.106994645	16.97167994	1.628252367	11.09483624	1.026433986	0.451656382	0	0	2.27058299	1.711021086	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.2838		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											4.2894	0.1825	0.8121	0.4083	0.1749	0.3112	0.1849	0.0968	0.8056	0.4388	0.9212	0	0.0086	1.1289	0.6762	2.2108	0.1353	0.0598	0	0	0.275	0.1153	0.0377	0	0.0155	0	0	0	0.003	0											13.2921	0	0	32.4045	0.765814845	9.343052991	0.40834217	1.277334101	2.1100624	1.130191322	1.294801648	3.490717582	1.893669587	3.52971887	0	0.115634147	18.1006046	2.30447721	13.30564486	1.161733986	0.511490378	0	0	2.545597305	1.826319702	0.037732633	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	97.5759
H2229_028_0	2009	6																																D	D	D	V	T	O	O	V	V	O	O	O	O	O	P	P	P	P	P	P	O	O			V	V	V	V	O	O																																																			0		541.56	0	0	0	0	0	0	200.88	215.52	0	0	0	0		3032.8	3764.4	420	0	0	19.8	0	0	0		183.6	0	16.8	0	0	0											"PBP 1a ($100/day, days 1-5)"	"PBP 1b ($100/day, days 1-5)"	"PBP 2 ($25/day, days 11-100)"	PBP 6 ($0.00 copay)	PBP 10a ($0.00 copay)	PBP 11a ($0.00 copay)	"PBP 11b ($0.00 copay), 11c ($0.00 copay)"	"PBP 4a ($50/visit), 4b ($20/visit)"	"PBP 9a ($150), 9b ($150)"	PBP 8a ($0.00 copay)	PBP 8b ($0.00 copay)	PBP 5 ($0.00 copay)	PBP 12 ($0.00 copay)	"PBP 3 ($0.00 copay), 9c ($20/visit), 9d ($0.00 copay)"	"PBP 7a ($15/visit), 14b ($0.00 copay), 14c ($15/visit)"	"PBP 7b ($20/visit), 7d ($20/visit), 7f($20/visit)"	"PBP 7e ($20/visit), 7h ($20/visit)"	"PBP 7c ($0/visit), 7i ($0/visit)"	PBP 7d ($20/visit)	PBP 7g ($20/visit)	PBP 15 ($0.00 copay)	PBP 13a ($0.00 copay)	PBP 10b ($0.00 copay)		PBP 17a ($20/visit)	PBP 17b ($0.00 copay)	PBP 18a ($20/visit)	PBP 18b ($0.00 copay)	PBP 19 ($0.00 copay)	"PBP 13d ($0.00 co-pay), 13e ($0.00 co-pay), 14a ($0.00 copay)"											100	0	25	0	0	0	0	50	150	0	0	0	0	0	15	20	20	0	0	20	0	0	0		20	0	20	0	0	0											100	0	25	0	0	0	0	50	150	0	0	0	0	0	15	20	20	0	0	20	0	0	0		20	0	20	0	0	0											4.513	0	0	0	0	0	0	0.837	2.694	0	0	0	0	0	3.791	6.274	0.7	0	0	0.033	0	0	0	0	0.306	0	0.028	0	0	0	0	0	0	0	0	0	0	0	0	0	19.176	0	0.166	4.513	0	0	0	0	0	0	0.837	2.694	0	0	0	0	0	3.791	6.274	0.7	0	0	0.033	0	0	0	0	0.306	0	0.028	0	0	0	0	0	0	0	0	0	0	0	0	0	19.176	3350	PBP 1a ($750/stay)	PBP 1b ($750/stay)	"PBP 2 ($50/day, days 11-100)"	PBP 6 (20% coin)	PBP 10a ($0.00 copay)	PBP 11a (20% coin)	"PBP 11b (20% coin), 11c (20% coin)"	"PBP 4a ($50/visit), 4b ($20/visit)"	"PBP 9a (20% coin), 9b (20% coin)"	PBP 8a (20% coin)	PBP 8b (20% coin)	PBP 5 ($30/visit)	PBP 12 (20% coin)	"PBP 3 ($30/visit), 9c ($30/visit), 9d ($30/visit)"	"PBP 7a ($30/visit), 14b (20% coin), 14c ($30/visit)"	"PBP 7b ($30/visit), 7d ($30/visit), 7f ($30/visit)"	"PBP 7e ($30/visit), 7h ($30/visit)"	"PBP 7c ($30/visit), 7i ($30/visit)"	PBP 7d ($30 visit)	PBP 7g ($30/visit)	PBP 15 (20% coin)	PBP 13a (20% coin)	PBP 10b ($0.00 copay)		PBP 17a ($30/visit)	PBP 17b ($0.00 copay)	PBP 18a ($30/visit)	PBP 18b ($0.00 copay)	PBP 19 ($0.00 copay)	"PBP 13d ($0.00 co-pay), 13e ($0.00 co-pay), 14a (20% coin)"											1.2328	0	0	0	0	0.0176	0.0059	0.2695	1.1059	0.0878	0.0274	0	0	0.0579	0.0016	10.3189	1.0184	0.1664	1.7892	0.1172	0	0	0	0	0.0371	0	0.0138	0	0	0											16.2675	0	0.140823008	5.7458	0	0	0	0	0.017595624	0.005891103	1.106514039	3.799924228	0.087834745	0.027429728	0	0	0.057890472	3.792626186	16.59288926	1.718401024	0.166411807	1.78921453	0.150169479	0	0	0	0	0.343078949	0	0.041795841	0	0	0	0	0	0	0	0	0	0	0	0	0	35.4435
H2229_029_0	2009	6																																D	D	D	V	T	O	O	V	V	O	O	O	O	O	P	P	P	P	P	P	O	O	T		V	V	V	V	O	O																																																			0		541.56	0	0	0	0	0	0	200.88	215.52	0	0	0	0		3032.8	3764.4	420	0	0	19.8	0	0	0		183.6	0	16.8	0	0	0											"PBP 1a ($100/day, days 1-5)"	"PBP 1b ($100/day, days 1-5)"	"PBP 2 ($25/day, days 11-100)"	PBP 6 ($0.00 copay)	PBP 10a ($0.00 copay)	PBP 11a ($0.00 copay)	"PBP 11b ($0.00 copay), 11c ($0.00 copay)"	"PBP 4a ($50/visit), 4b ($20/visit)"	"PBP 9a ($150), 9b ($150)"	PBP 8a ($0.00 copay)	PBP 8b ($0.00 copay)	PBP 5 ($0.00 copay)	PBP 12 ($0.00 copay)	"PBP 3 ($0.00 copay), 9c ($20/visit), 9d ($0.00 copay)"	"PBP 7a ($15/visit), 14b ($0.00 copay), 14c ($15/visit)"	"PBP 7b ($20/visit), 7d ($20/visit), 7f($20/visit)"	"PBP 7e ($20/visit), 7h ($20/visit)"	"PBP 7c ($0/visit), 7i ($0/visit)"	PBP 7d ($20/visit)	PBP 7g ($20/visit)	PBP 15 ($0.00 copay)	PBP 13a ($0.00 copay)	PBP 10b ($0.00 copay)		PBP 17a ($20/visit)	PBP 17b ($0.00 copay)	PBP 18a ($20/visit)	PBP 18b ($0.00 copay)	PBP 19 ($0.00 copay)	"PBP 13d ($0.00 co-pay), 13e ($0.00 co-pay), 14a ($0.00 copay)"											100	0	25	0	0	0	0	50	150	0	0	0	0	0	15	20	20	0	0	20	0	0	0		20	0	20	0	0	0											100	0	25	0	0	0	0	50	150	0	0	0	0	0	15	20	20	0	0	20	0	0	0		20	0	20	0	0	0											4.513	0	0	0	0	0	0	0.837	2.694	0	0	0	0	0	3.791	6.274	0.7	0	0	0.033	0	0	0	0	0.306	0	0.028	0	0	0	0	0	0	0	0	0	0	0	0	0	19.176	0	0.166	4.513	0	0	0	0	0	0	0.837	2.694	0	0	0	0	0	3.791	6.274	0.7	0	0	0.033	0	0	0	0	0.306	0	0.028	0	0	0	0	0	0	0	0	0	0	0	0	0	19.176	3350	PBP 1a ($750/stay)	PBP 1b ($750/stay)	"PBP 2 ($50/day, days 11-100)"	PBP 6 (20% coin)	PBP 10a ($0.00 copay)	PBP 11a (20% coin)	"PBP 11b (20% coin), 11c (20% coin)"	"PBP 4a ($50/visit), 4b ($20/visit)"	"PBP 9a (20% coin), 9b (20% coin)"	PBP 8a (20% coin)	PBP 8b (20% coin)	PBP 5 ($30/visit)	PBP 12 (20% coin)	"PBP 3 ($30/visit), 9c ($30/visit), 9d ($30/visit)"	"PBP 7a ($30/visit), 14b (20% coin), 14c ($30/visit)"	"PBP 7b ($30/visit), 7d ($30/visit), 7f ($30/visit)"	"PBP 7e ($30/visit), 7h ($30/visit)"	"PBP 7c ($30/visit), 7i ($30/visit)"	PBP 7d ($30 visit)	PBP 7g ($30/visit)	PBP 15 (20% coin)	PBP 13a (20% coin)	PBP 10b ($0.00 copay)		PBP 17a ($30/visit)	PBP 17b ($0.00 copay)	PBP 18a ($30/visit)	PBP 18b ($0.00 copay)	PBP 19 ($0.00 copay)	"PBP 13d ($0.00 co-pay), 13e ($0.00 co-pay), 14a (20% coin)"											1.2328	0	0	0	0	0.0176	0.0059	0.2695	1.1059	0.0878	0.0274	0	0	0.0579	0.0016	10.3189	1.0184	0.1664	1.7892	0.1172	0	0	0	0	0.0371	0	0.0138	0	0	0											16.2675	0	0.140823008	5.7458	0	0	0	0	0.017595624	0.005891103	1.106514039	3.799924228	0.087834745	0.027429728	0	0	0.057890472	3.792626186	16.59288926	1.718401024	0.166411807	1.78921453	0.150169479	0	0	0	0	0.343078949	0	0.041795841	0	0	0	0	0	0	0	0	0	0	0	0	0	35.4435
H2229_030_0	2009	4																																D	D	D	V	T	O	O	V	V	O	O	O	O	O	P	P	P	P	P	P	O	O	T		V	V	V	V	O	O																																																			0		541.56	0	0	0	0	0	0	200.88	215.52	0	0	0	0		3032.8	3764.4	420	0	0	19.8	0	0	0		183.6	0	16.8	0	0	0											"PBP 1a ($100/day, days 1-5)"	"PBP 1b ($100/day, days 1-5)"	"PBP 2 ($25/day, days 11-100)"	PBP 6 ($0.00 copay)	PBP 10a ($0.00 copay)	PBP 11a ($0.00 copay)	"PBP 11b ($0.00 copay), 11c ($0.00 copay)"	"PBP 4a ($50/visit), 4b ($20/visit)"	"PBP 9a ($150), 9b ($150)"	PBP 8a ($0.00 copay)	PBP 8b ($0.00 copay)	PBP 5 ($0.00 copay)	PBP 12 ($0.00 copay)	"PBP 3 ($0.00 copay), 9c ($20/visit), 9d ($0.00 copay)"	"PBP 7a ($15/visit), 14b ($0.00 copay), 14c ($15/visit)"	"PBP 7b ($20/visit), 7d ($20/visit), 7f($20/visit)"	"PBP 7e ($20/visit), 7h ($20/visit)"	"PBP 7c ($0/visit), 7i ($0/visit)"	PBP 7d ($20/visit)	PBP 7g ($20/visit)	PBP 15 ($0.00 copay)	PBP 13a ($0.00 copay)	PBP 10b ($0.00 copay)		PBP 17a ($20/visit)	PBP 17b ($0.00 copay)	PBP 18a ($20/visit)	PBP 18b ($0.00 copay)	PBP 19 ($0.00 copay)	"PBP 13d ($0.00 co-pay), 13e ($0.00 co-pay), 14a ($0.00 copay)"											100	0	25	0	0	0	0	50	150	0	0	0	0	0	15	20	20	0	0	20	0	0	0		20	0	20	0	0	0											100	0	25	0	0	0	0	50	150	0	0	0	0	0	15	20	20	0	0	20	0	0	0		20	0	20	0	0	0											4.513	0	0	0	0	0	0	0.837	2.694	0	0	0	0	0	3.791	6.274	0.7	0	0	0.033	0	0	0	0	0.306	0	0.028	0	0	0	0	0	0	0	0	0	0	0	0	0	19.176	0	0.166	4.513	0	0	0	0	0	0	0.837	2.694	0	0	0	0	0	3.791	6.274	0.7	0	0	0.033	0	0	0	0	0.306	0	0.028	0	0	0	0	0	0	0	0	0	0	0	0	0	19.176	3350	PBP 1a ($750/stay)	PBP 1b ($750/stay)	"PBP 2 ($50/day, days 11-100)"	PBP 6 (20% coin)	PBP 10a ($0.00 copay)	PBP 11a (20% coin)	"PBP 11b (20% coin), 11c (20% coin)"	"PBP 4a ($50/visit), 4b ($20/visit)"	"PBP 9a (20% coin), 9b (20% coin)"	PBP 8a (20% coin)	PBP 8b (20% coin)	PBP 5 ($30/visit)	PBP 12 (20% coin)	"PBP 3 ($30/visit), 9c ($30/visit), 9d ($30/visit)"	"PBP 7a ($30/visit), 14b (20% coin), 14c ($30/visit)"	"PBP 7b ($30/visit), 7d ($30/visit), 7f ($30/visit)"	"PBP 7e ($30/visit), 7h ($30/visit)"	"PBP 7c ($30/visit), 7i ($30/visit)"	PBP 7d ($30 visit)	PBP 7g ($30/visit)	PBP 15 (20% coin)	PBP 13a (20% coin)	PBP 10b ($0.00 copay)		PBP 17a ($30/visit)	PBP 17b ($0.00 copay)	PBP 18a ($30/visit)	PBP 18b ($0.00 copay)	PBP 19 ($0.00 copay)	"PBP 13d ($0.00 co-pay), 13e ($0.00 co-pay), 14a (20% coin)"											1.2328	0	0	0	0	0.0176	0.0059	0.2695	1.1059	0.0878	0.0274	0	0	0.0579	0.0016	10.3189	1.0184	0.1664	1.7892	0.1172	0	0	0		0.0371	0	0.0138	0	0	0											16.2675	0	0.140823008	5.7458	0	0	0	0	0.017595624	0.005891103	1.106514039	3.799924228	0.087834745	0.027429728	0	0	0.057890472	3.792626186	16.59288926	1.718401024	0.166411807	1.78921453	0.150169479	0	0	0	0	0.343078949	0	0.041795841	0	0	0	0	0	0	0	0	0	0	0	0	0	35.4435
H2229_801_0	2009	4																																D	D	D	V	T	O	O	V	V	O	O	O	O	O	P	P	P	P	P	P	O	O			V	V	V	V	O	O																																																			0		79.39068381	0	0	0	0	0	0	172.6838837	311.4651405	0	0	0	0	0	2837.820602	3472.376964	651.2231206	0	0	0	0	0	0		210.5702725	0	24.63428284	0	0	0											PBP 1a ($200/yr)	PBP 1b ($0.00 copay)	PBP 2 ($0.00 copay)	PBP 6 ($0.00 copay)	PBP 10a ($0.00 copay)	PBP 11a ($0.00 copay)	"PBP 11b ($0.00 copay), 11c ($0.00 copay)"	"PBP 4a ($50/visit), 4b ($15/visit)"	"PBP 9a (20% up to $50), 9b (20% up to $50)"	PBP 8a ($0.00 copay)	PBP 8b ($0.00 copay)	PBP 5 ($0.00 copay)	PBP 12 ($0.00 copay)	"PBP 3 ($0.00 copay), 9c ($15/visit), 9d ($0.00 copay)"	"PBP 7a ($10/visit), 14b ($0.00 copay), 14c ($10/visit)"	"PBP 7b ($15/visit), 7d ($15/visit), 7f ($15/visit)"	"PBP 7e ($15/visit), 7h ($15/visit)"	"PBP 7c ($0/visit), 7i ($0/visit)"	PBP 7d ($15/visit)	PBP 7g ($15/visit)	PBP 15 ($0.00 copay)	PBP 13a ($0.00 copay)	PBP 10b ($0.00 copay)		PBP 17a ($15/visit)	PBP 17b ($0.00 copay)	PBP 18a ($15/visit)	PBP 18b ($0.00 copay)	PBP 19 ($0.00 copay)	"PBP 13d ($0.00 co-pay), 13e ($0.00 co-pay), 14a ($0.00 copay)"											200	0	0	0	0	0	0	50	50	0	0	0	0	0	10	15	15	15	15	15	0	0	0		15	0	15	0	0	0											196.7989095	0	0	0	0	0	0	49.19972738	49.19972738	0	0	0	0	0	9.839945477	14.75991821	14.75991821	14.75991821	14.75991821	14.75991821	0	0	0		14.75991821	0	14.75991821	0	0	0											1.302	0	0	0	0	0	0	0.708	1.277	0	0	0	0	0	2.327	4.271	0.801	0	0	0	0	0	0	0	0.259	0	0.0303	0	0	0	0	0	0	0	0	0	0	0	0	0	10.9753	0	0.1785	1.302	0	0	0	0	0	0	0.708	1.277	0	0	0	0	0	2.327	4.271	0.801	0	0	0	0	0	0	0	0.259	0	0.0303	0	0	0	0	0	0	0	0	0	0	0	0	0	10.9753	3350	PBP 1a ($500/stay)	PBP 1b ($500/stay)	"PBP 2 ($50/day, days 11-100)"	PBP 6 (20% coin)	PBP 10a ($0.00 copay)	PBP 11a (20% coin)	"PBP 11b (20% coin), 11c (20% coin)"	"PBP 4a ($50/visit), 4b ($20/visit)"	"PBP 9a (20% coin), 9b (20% coin)"	PBP 8a (20% coin)	PBP 8b (20% coin)	PBP 5 ($30/visit)	PBP 12 (20% coin)	"PBP 3 ($30/visit), 9c ($30/visit), 9d ($30/visit)"	"PBP 7a ($30/visit), 14b (20% coin), 14c ($30/visit)"	"PBP 7b ($30/visit), 7d ($30/visit) 7f ($30/visit)"	"PBP 7e ($30/visit), 7h ($30/visit)"	"PBP 7c ($30/visit), 7i ($30/visit)"	PBP 7d ($30/visit)	PBP 7g ($30/visit)	PBP 15 (20% coin)	PBP 13a (20% coin)	PBP 10b ($0.00 copay)		PBP 17a ($30/visit)	PBP 17b ($0.00 copay)	PBP 18a ($30/visit)	PBP 18b ($0.00 copay)	PBP 19 ($0.00 copay)	"PBP 13d ($0.00 co-pay), 13e ($0.00 co-pay), 14a (20% coin)"											1.6278	0	0	0	0	0.0324	0.0066	0.3162	1.0112	0.1626	0.1453	0	0	0.0663	0	11.0018	0.2324	0.1236	1.6981	0.0122	0	0	0		0.0489	0	0.0245	0	0	0											16.5098	0	0.221582148	2.9298	0	0	0	0	0.032386636	0.006616503	1.024166636	2.288159859	0.162641912	0.145250786	0	0	0.066340238	2.327	15.27277166	1.033372565	0.123589591	1.698089863	0.012230135	0	0	0	0	0.30792054	0	0.05476027	0	0	0	0	0	0	0	0	0	0	0	0	0	27.4851
H2229_802_0	2009	4																																D	D	D	V	T	O	O	V	V	O	O	O	O	O	P	P	P	P	P	P	O	O			V	V	V	V	O	O																																																			0		79.39068381	0	0	0	0	0	0	172.6838837	311.4651405	0	0	0	0	0	2837.820602	3472.376964	651.2231206	0	0	0	0	0	0		210.5702725	0	24.63428284	0	0	0											PBP 1a ($200/yr)	PBP 1b ($0.00 copay)	PBP 2 ($0.00 copay)	PBP 6 ($0.00 copay)	PBP 10a ($0.00 copay)	PBP 11a ($0.00 copay)	"PBP 11b ($0.00 copay), 11c ($0.00 copay)"	"PBP 4a ($50/visit), 4b ($15/visit)"	"PBP 9a (20% up to $50), 9b (20% up to $50)"	PBP 8a ($0.00 copay)	PBP 8b ($0.00 copay)	PBP 5 ($0.00 copay)	PBP 12 ($0.00 copay)	"PBP 3 ($0.00 copay), 9c ($15/visit), 9d ($0.00 copay)"	"PBP 7a ($10/visit), 14b ($0.00 copay), 14c ($10/visit)"	"PBP 7b ($15/visit), 7d ($15/visit), 7f ($15/visit)"	"PBP 7e ($15/visit), 7h ($15/visit)"	"PBP 7c ($0/visit), 7i ($0/visit)"	PBP 7d ($15/visit)	PBP 7g ($15/visit)	PBP 15 ($0.00 copay)	PBP 13a ($0.00 copay)	PBP 10b ($0.00 copay)		PBP 17a ($15/visit)	PBP 17b ($0.00 copay)	PBP 18a ($15/visit)	PBP 18b ($0.00 copay)	PBP 19 ($0.00 copay)	"PBP 13d ($0.00 co-pay), 13e ($0.00 co-pay), 14a ($0.00 copay)"											200	0	0	0	0	0	0	50	50	0	0	0	0	0	10	15	15	15	15	15	0	0	0		15	0	15	0	0	0											196.7989095	0	0	0	0	0	0	49.19972738	49.19972738	0	0	0	0	0	9.839945477	14.75991821	14.75991821	14.75991821	14.75991821	14.75991821	0	0	0		14.75991821	0	14.75991821	0	0	0											1.302	0	0	0	0	0	0	0.708	1.277	0	0	0	0	0	2.327	4.271	0.801	0	0	0	0	0	0	0	0.259	0	0.0303	0	0	0	0	0	0	0	0	0	0	0	0	0	10.9753	0	0.1785	1.302	0	0	0	0	0	0	0.708	1.277	0	0	0	0	0	2.327	4.271	0.801	0	0	0	0	0	0	0	0.259	0	0.0303	0	0	0	0	0	0	0	0	0	0	0	0	0	10.9753	3350	PBP 1a ($500/stay)	PBP 1b ($500/stay)	"PBP 2 ($50/day, days 11-100)"	PBP 6 (20% coin)	PBP 10a ($0.00 copay)	PBP 11a (20% coin)	"PBP 11b (20% coin), 11c (20% coin)"	"PBP 4a ($50/visit), 4b ($20/visit)"	"PBP 9a (20% coin), 9b (20% coin)"	PBP 8a (20% coin)	PBP 8b (20% coin)	PBP 5 ($30/visit)	PBP 12 (20% coin)	"PBP 3 ($30/visit), 9c ($30/visit), 9d ($30/visit)"	"PBP 7a ($30/visit), 14b (20% coin), 14c ($30/visit)"	"PBP 7b ($30/visit), 7d ($30/visit) 7f ($30/visit)"	"PBP 7e ($30/visit), 7h ($30/visit)"	"PBP 7c ($30/visit), 7i ($30/visit)"	PBP 7d ($30/visit)	PBP 7g ($30/visit)	PBP 15 (20% coin)	PBP 13a (20% coin)	PBP 10b ($0.00 copay)		PBP 17a ($30/visit)	PBP 17b ($0.00 copay)	PBP 18a ($30/visit)	PBP 18b ($0.00 copay)	PBP 19 ($0.00 copay)	"PBP 13d ($0.00 co-pay), 13e ($0.00 co-pay), 14a (20% coin)"											1.6278	0	0	0	0	0.0324	0.0066	0.3162	1.0112	0.1626	0.1453	0	0	0.0663	0	11.0018	0.2324	0.1236	1.6981	0.0122	0	0	0		0.0489	0	0.0245	0	0	0											16.5098	0	0.221582148	2.9298	0	0	0	0	0.032386636	0.006616503	1.024166636	2.288159859	0.162641912	0.145250786	0	0	0.066340238	2.327	15.27277166	1.033372565	0.123589591	1.698089863	0.012230135	0	0	0	0	0.30792054	0	0.05476027	0	0	0	0	0	0	0	0	0	0	0	0	0	27.4851
H2229_803_0	2009	4																																D	D	D	V	T	O	O	V	V	O	O	O	O	O	P	P	P	P	P	P	O	O			V	V	V	V	O	O																																																			0		79.39068381	0	0	0	0	0	0	172.6838837	311.4651405	0	0	0	0	0	2837.820602	3472.376964	651.2231206	0	0	0	0	0	0		210.5702725	0	24.63428284	0	0	0											PBP 1a ($200/yr)	PBP 1b ($0.00 copay)	PBP 2 ($0.00 copay)	PBP 6 ($0.00 copay)	PBP 10a ($0.00 copay)	PBP 11a ($0.00 copay)	"PBP 11b ($0.00 copay), 11c ($0.00 copay)"	"PBP 4a ($50/visit), 4b ($15/visit)"	"PBP 9a (20% up to $50), 9b (20% up to $50)"	PBP 8a ($0.00 copay)	PBP 8b ($0.00 copay)	PBP 5 ($0.00 copay)	PBP 12 ($0.00 copay)	"PBP 3 ($0.00 copay), 9c ($15/visit), 9d ($0.00 copay)"	"PBP 7a ($10/visit), 14b ($0.00 copay), 14c ($10/visit)"	"PBP 7b ($15/visit), 7d ($15/visit), 7f ($15/visit)"	"PBP 7e ($15/visit), 7h ($15/visit)"	"PBP 7c ($0/visit), 7i ($0/visit)"	PBP 7d ($15/visit)	PBP 7g ($15/visit)	PBP 15 ($0.00 copay)	PBP 13a ($0.00 copay)	PBP 10b ($0.00 copay)		PBP 17a ($15/visit)	PBP 17b ($0.00 copay)	PBP 18a ($15/visit)	PBP 18b ($0.00 copay)	PBP 19 ($0.00 copay)	"PBP 13d ($0.00 co-pay), 13e ($0.00 co-pay), 14a ($0.00 copay)"											200	0	0	0	0	0	0	50	50	0	0	0	0	0	10	15	15	15	15	15	0	0	0		15	0	15	0	0	0											196.7989095	0	0	0	0	0	0	49.19972738	49.19972738	0	0	0	0	0	9.839945477	14.75991821	14.75991821	14.75991821	14.75991821	14.75991821	0	0	0		14.75991821	0	14.75991821	0	0	0											1.302	0	0	0	0	0	0	0.708	1.277	0	0	0	0	0	2.327	4.271	0.801	0	0	0	0	0	0	0	0.259	0	0.0303	0	0	0	0	0	0	0	0	0	0	0	0	0	10.9753	0	0.1785	1.302	0	0	0	0	0	0	0.708	1.277	0	0	0	0	0	2.327	4.271	0.801	0	0	0	0	0	0	0	0.259	0	0.0303	0	0	0	0	0	0	0	0	0	0	0	0	0	10.9753	3350	PBP 1a ($500/stay)	PBP 1b ($500/stay)	"PBP 2 ($50/day, days 11-100)"	PBP 6 (20% coin)	PBP 10a ($0.00 copay)	PBP 11a (20% coin)	"PBP 11b (20% coin), 11c (20% coin)"	"PBP 4a ($50/visit), 4b ($20/visit)"	"PBP 9a (20% coin), 9b (20% coin)"	PBP 8a (20% coin)	PBP 8b (20% coin)	PBP 5 ($30/visit)	PBP 12 (20% coin)	"PBP 3 ($30/visit), 9c ($30/visit), 9d ($30/visit)"	"PBP 7a ($30/visit), 14b (20% coin), 14c ($30/visit)"	"PBP 7b ($30/visit), 7d ($30/visit) 7f ($30/visit)"	"PBP 7e ($30/visit), 7h ($30/visit)"	"PBP 7c ($30/visit), 7i ($30/visit)"	PBP 7d ($30/visit)	PBP 7g ($30/visit)	PBP 15 (20% coin)	PBP 13a (20% coin)	PBP 10b ($0.00 copay)		PBP 17a ($30/visit)	PBP 17b ($0.00 copay)	PBP 18a ($30/visit)	PBP 18b ($0.00 copay)	PBP 19 ($0.00 copay)	"PBP 13d ($0.00 co-pay), 13e ($0.00 co-pay), 14a (20% coin)"											1.6278	0	0	0	0	0.0324	0.0066	0.3162	1.0112	0.1626	0.1453	0	0	0.0663	0	11.0018	0.2324	0.1236	1.6981	0.0122	0	0	0		0.0489	0	0.0245	0	0	0											16.5098	0	0.221582148	2.9298	0	0	0	0	0.032386636	0.006616503	1.024166636	2.288159859	0.162641912	0.145250786	0	0	0.066340238	2.327	15.27277166	1.033372565	0.123589591	1.698089863	0.012230135	0	0	0	0	0.30792054	0	0.05476027	0	0	0	0	0	0	0	0	0	0	0	0	0	27.4851
H2230_002_0	2009	8																					2000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	Coin	V	V	S	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	4000	1758.880976	73.99871727	2394.83571	2750.621395	437.9105159	15.70957624	2.586373431	316.6367126	400.7356848	5359.537681	1372.952463	165.1279236	7.087175517	2165.050471	5679.184974	7053.717418	243.1974832	13.85852087	2279.64957	73.4643074	1040.861402	0.225860125	0	313.0715791	410.4952944	0	2.255468651	17.29192632	45.23467683	342.740474											"$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	$100/visit	$0 	$0 	$0 	$0 	$0 - $100 per visit	"(4a) $0 - $15  (POC), $0 - $25 (non POC) per visit"	"(7a), (7b), (7d), $0 - $25 per visit"	(7e) $15-$25/visit	(7c) & (7i) 10% per visit	(7d) $0 Co-pay	(7d) & (14)$0 - $25 per visit	$0 Co-pay	$0 Co-pay	0	(16a) $25 per covered visit	(17a) $25 one exam per calendar year	0	(18a) $0 Co-pay	0	(14) $0 Copay	$0 - $100 per visit											44.88698857	23.54753978	4.963323429	0	29.75243148	0.1	0.1	43.86927385	92.91748492	0	0	0	0	6.129188768	10.92519213	19.89390924	25	0.1	0	4.314446367	0	0	0	20.08871686	14.27493513	0	0	0	0	15.04725473											44.88698857	23.54753978	4.963323429	0	29.75243148	0.1	0.1	43.86927385	92.91748492	0	0	0	0	6.129188768	10.92519213	19.89390924	25	0.1	0	4.314446367	0	0	0	20.08871686	14.27493513	0	0	0	0	15.04725473											6.5792	0.145207312	0.990528682	0	1.085741885	1.570957624	0.258637343	1.157551888	3.102945996	0	0	0	0	1.105833586	5.170515584	11.69383451	0.506661423	1.385852087	0	0.026413151	0	0	0	0.524100526	0.488316142	0	0	0	0	0.429775268	0	0	0	0	0	0	0	0	0	0	36.2221	0	0.021	6.5792	0.145207312	0.990528682	0	1.085741885	1.570957624	0.258637343	1.157551888	3.102945996	0	0	0	0	1.105833586	5.170515584	11.69383451	0.506661423	1.385852087	0	0.026413151	0	0	0	0.524100526	0.488316142	0	0	0	0	0.429775268	0	0	0	0	0	0	0	0	0	0	36.2221		20%  per stay	20%  per stay	20%  per day	20%  per day	$100 per day	20% each item	20% each item	$0 - $50/visit	20%	20%	20%	20%	0-20%	0-20%	$0-$40 per visit	$0-$40 per visit	(7e) 20% per visit	(7c) & (7i) 20% per visit	(7d) 20%	(7d) & (14) 20%	0	0	0	(16a) $40 per covered visit	(17a) $40 one exam per calendar year	0	(18a) $40 per exam	0	(14) $0 Co-pay	"$0 - $40 per visit, or 20%"											2.3931	0.0445	0.768	0.2219	0.0555	0.1148	0.0189	0.0591	0.269	0.2457	0.2442	0.1351	0.0019	0.273	0.5414	0.9465	0.0254	0.0216	0.1275	0.007	0	0	0	0.0441	0.0326	0	0.0075	0	0	0.036											6.6342	500	2.804967915	8.9723	0.189738265	1.758499447	0.221948978	1.141221797	1.685711396	0.277544246	1.216701193	3.371966607	0.245688336	0.244247426	0.135057339	0.00188307	1.378876491	5.711870086	12.64031759	0.532016596	1.407421221	0.127454847	0.033399548	0	0	0	0.568235307	0.520950512	0	0.00751054	0	0	0.465771987	0	0	0	0	0	0	0	0	0	0	42.8563
H2230_006_0	2009	7																					2000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	Coin	V	V	S	V	V	V	V	V	V	V	V	V																																																			0	4000	1758.880976	73.99871727	2394.83571	2750.621395	437.9105159	15.70957624	2.586373431	316.6367126	400.7356848	5359.537681	1372.952463	165.1279236	7.087175517	2165.050471	5679.184974	7053.717418	243.1974832	13.85852087	2279.64957	73.4643074	1040.861402	0.225860125	0	313.0715791	410.4952944	0	2.255468651	17.29192632	45.23467683	342.740474											"$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	$100/visit	$0 	$0 	$0 	$0 	$0 - $100 per visit	"(4a) $0 - $15  (POC), $0 - $25 (non POC) per visit"	"(7a), (7b), (7d), $0 - $25 per visit"	(7e) $15-$25/visit	(7c) & (7i) 10% per visit	(7d) $0 Co-pay	(7d) & (14)$0 - $25 per visit	$0 Co-pay	$0 Co-pay	0	(16a) $25 per covered visit	(17a) $25 one exam per calendar year	0	(18a) $0 Co-pay	0	(14) $0 Copay	$0 - $100 per visit											44.88698857	23.54753978	4.963323429	0	29.75243148	0.1	0.1	43.86927385	92.91748492	0	0	0	0	6.129188768	10.92519213	19.89390924	25	0.1	0	4.314446367	0	0	0	20.08871686	14.27493513	0	0	0	0	15.04725473											44.88698857	23.54753978	4.963323429	0	29.75243148	0.1	0.1	43.86927385	92.91748492	0	0	0	0	6.129188768	10.92519213	19.89390924	25	0.1	0	4.314446367	0	0	0	20.08871686	14.27493513	0	0	0	0	15.04725473											6.5792	0.145207312	0.990528682	0	1.085741885	1.570957624	0.258637343	1.157551888	3.102945996	0	0	0	0	1.105833586	5.170515584	11.69383451	0.506661423	1.385852087	0	0.026413151	0	0	0	0.524100526	0.488316142	0	0	0	0	0.429775268	0	0	0	0	0	0	0	0	0	0	36.2221	0	0.021	6.5792	0.145207312	0.990528682	0	1.085741885	1.570957624	0.258637343	1.157551888	3.102945996	0	0	0	0	1.105833586	5.170515584	11.69383451	0.506661423	1.385852087	0	0.026413151	0	0	0	0.524100526	0.488316142	0	0	0	0	0.429775268	0	0	0	0	0	0	0	0	0	0	36.2221		20%  per stay	20%  per stay	20%  per day	20%  per day	$100 per day	20% each item	20% each item	$0 - $50/visit	20%	20%	20%	20%	0-20%	0-20%	$0-$40 per visit	$0-$40 per visit	(7e) 20% per visit	(7c) & (7i) 20% per visit	(7d) 20%	(7d) & (14) 20%	0	0	0	(16a) $40 per covered visit	(17a) $40 one exam per calendar year	0	(18a) $40 per exam	0	(14) $0 Co-pay	"$0 - $40 per visit, or 20%"											2.3931	0.0445	0.768	0.2219	0.0555	0.1148	0.0189	0.0591	0.269	0.2457	0.2442	0.1351	0.0019	0.273	0.5414	0.9465	0.0254	0.0216	0.1275	0.007	0	0	0	0.0441	0.0326	0	0.0075	0	0	0.036											6.6342	500	2.804967915	8.9723	0.189738265	1.758499447	0.221948978	1.141221797	1.685711396	0.277544246	1.216701193	3.371966607	0.245688336	0.244247426	0.135057339	0.00188307	1.378876491	5.711870086	12.64031759	0.532016596	1.407421221	0.127454847	0.033399548	0	0	0	0.568235307	0.520950512	0	0.00751054	0	0	0.465771987	0	0	0	0	0	0	0	0	0	0	42.8563
H2230_801_0	2009	5																					2000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	Coin	V	V	S	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	4000	1758.880976	73.99871727	2394.83571	2750.621395	437.9105159	15.70957624	2.586373431	316.6367126	400.7356848	5359.537681	1372.952463	165.1279236	7.087175517	2165.050471	5679.184974	7053.717418	243.1974832	13.85852087	2279.64957	73.4643074	1040.861402	0.225860125	0	313.0715791	410.4952944	0	2.255468651	17.29192632	45.23467683	342.740474											"$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	$100/visit	$0 	$0 	$0 	$0 	$0 - $100 per visit	"(4a) $0 - $15  (POC), $0 - $25 (non POC) per visit"	"(7a), (7b), (7d), $0 - $25 per visit"	(7e) $15-$25/visit	(7c) & (7i) 10% per visit	(7d) $0 Co-pay	(7d) & (14)$0 - $25 per visit	$0 Co-pay	$0 Co-pay	0	(16a) $25 per covered visit	(17a) $25 one exam per calendar year	0	(18a) $0 Co-pay	0	(14) $0 Copay	$0 - $100 per visit											44.88698857	23.54753978	4.963323429	0	29.75243148	0.1	0.1	43.86927385	92.91748492	0	0	0	0	6.129188768	10.92519213	19.89390924	25	0.1	0	4.314446367	0	0	0	20.08871686	14.27493513	0	0	0	0	15.04725473											44.88698857	23.54753978	4.963323429	0	29.75243148	0.1	0.1	43.86927385	92.91748492	0	0	0	0	6.129188768	10.92519213	19.89390924	25	0.1	0	4.314446367	0	0	0	20.08871686	14.27493513	0	0	0	0	15.04725473											6.5792	0.145207312	0.990528682	0	1.085741885	1.570957624	0.258637343	1.157551888	3.102945996	0	0	0	0	1.105833586	5.170515584	11.69383451	0.506661423	1.385852087	0	0.026413151	0	0	0	0.524100526	0.488316142	0	0	0	0	0.429775268	0	0	0	0	0	0	0	0	0	0	36.2221	0	0.021	6.5792	0.145207312	0.990528682	0	1.085741885	1.570957624	0.258637343	1.157551888	3.102945996	0	0	0	0	1.105833586	5.170515584	11.69383451	0.506661423	1.385852087	0	0.026413151	0	0	0	0.524100526	0.488316142	0	0	0	0	0.429775268	0	0	0	0	0	0	0	0	0	0	36.2221		20%  per stay	20%  per stay	20%  per day	20%  per day	$100 per day	20% each item	20% each item	$0 - $50/visit	20%	20%	20%	20%	0-20%	0-20%	$0-$40 per visit	$0-$40 per visit	(7e) 20% per visit	(7c) & (7i) 20% per visit	(7d) 20%	(7d) & (14) 20%	0	0	0	(16a) $40 per covered visit	(17a) $40 one exam per calendar year	0	(18a) $40 per exam	0	(14) $0 Co-pay	"$0 - $40 per visit, or 20%"											2.3931	0.0445	0.768	0.2219	0.0555	0.1148	0.0189	0.0591	0.269	0.2457	0.2442	0.1351	0.0019	0.273	0.5414	0.9465	0.0254	0.0216	0.1275	0.007	0	0	0	0.0441	0.0326	0	0.0075	0	0	0.036											6.6342	500	2.804967915	8.9723	0.189738265	1.758499447	0.221948978	1.141221797	1.685711396	0.277544246	1.216701193	3.371966607	0.245688336	0.244247426	0.135057339	0.00188307	1.378876491	5.711870086	12.64031759	0.532016596	1.407421221	0.127454847	0.033399548	0	0	0	0.568235307	0.520950512	0	0.00751054	0	0	0.465771987	0	0	0	0	0	0	0	0	0	0	42.8563
H2230_809_0	2009	5																					2000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	Coin	V	V	S	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	4000	1758.880976	73.99871727	2394.83571	2750.621395	437.9105159	15.70957624	2.586373431	316.6367126	400.7356848	5359.537681	1372.952463	165.1279236	7.087175517	2165.050471	5679.184974	7053.717418	243.1974832	13.85852087	2279.64957	73.4643074	1040.861402	0.225860125	0	313.0715791	410.4952944	0	2.255468651	17.29192632	45.23467683	342.740474											"$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	$100/visit	$0 	$0 	$0 	$0 	$0 - $100 per visit	"(4a) $0 - $15  (POC), $0 - $25 (non POC) per visit"	"(7a), (7b), (7d), $0 - $25 per visit"	(7e) $15-$25/visit	(7c) & (7i) 10% per visit	(7d) $0 Co-pay	(7d) & (14)$0 - $25 per visit	$0 Co-pay	$0 Co-pay	0	(16a) $25 per covered visit	(17a) $25 one exam per calendar year	0	(18a) $0 Co-pay	0	(14) $0 Copay	$0 - $100 per visit											44.88698857	23.54753978	4.963323429	0	29.75243148	0.1	0.1	43.86927385	92.91748492	0	0	0	0	6.129188768	10.92519213	19.89390924	25	0.1	0	4.314446367	0	0	0	20.08871686	14.27493513	0	0	0	0	15.04725473											44.88698857	23.54753978	4.963323429	0	29.75243148	0.1	0.1	43.86927385	92.91748492	0	0	0	0	6.129188768	10.92519213	19.89390924	25	0.1	0	4.314446367	0	0	0	20.08871686	14.27493513	0	0	0	0	15.04725473											6.5792	0.145207312	0.990528682	0	1.085741885	1.570957624	0.258637343	1.157551888	3.102945996	0	0	0	0	1.105833586	5.170515584	11.69383451	0.506661423	1.385852087	0	0.026413151	0	0	0	0.524100526	0.488316142	0	0	0	0	0.429775268	0	0	0	0	0	0	0	0	0	0	36.2221	0	0.021	6.5792	0.145207312	0.990528682	0	1.085741885	1.570957624	0.258637343	1.157551888	3.102945996	0	0	0	0	1.105833586	5.170515584	11.69383451	0.506661423	1.385852087	0	0.026413151	0	0	0	0.524100526	0.488316142	0	0	0	0	0.429775268	0	0	0	0	0	0	0	0	0	0	36.2221		20%  per stay	20%  per stay	20%  per day	20%  per day	$100 per day	20% each item	20% each item	$0 - $50/visit	20%	20%	20%	20%	0-20%	0-20%	$0-$40 per visit	$0-$40 per visit	(7e) 20% per visit	(7c) & (7i) 20% per visit	(7d) 20%	(7d) & (14) 20%	0	0	0	(16a) $40 per covered visit	(17a) $40 one exam per calendar year	0	(18a) $40 per exam	0	(14) $0 Co-pay	"$0 - $40 per visit, or 20%"											2.3931	0.0445	0.768	0.2219	0.0555	0.1148	0.0189	0.0591	0.269	0.2457	0.2442	0.1351	0.0019	0.273	0.5414	0.9465	0.0254	0.0216	0.1275	0.007	0	0	0	0.0441	0.0326	0	0.0075	0	0	0.036											6.6342	500	2.804967915	8.9723	0.189738265	1.758499447	0.221948978	1.141221797	1.685711396	0.277544246	1.216701193	3.371966607	0.245688336	0.244247426	0.135057339	0.00188307	1.378876491	5.711870086	12.64031759	0.532016596	1.407421221	0.127454847	0.033399548	0	0	0	0.568235307	0.520950512	0	0.00751054	0	0	0.465771987	0	0	0	0	0	0	0	0	0	0	42.8563
H2237_001_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	340.3441233	40.00306384	30.5878313	7.664109422	17.07397563	24.14374402	20.21790821	37.43602529	10.73903153	15.56696453	22.01021322	0.432727239	0.770560025	35.21618341	97.67663197	92.10065135	13.02319932	2.438805594	22.90959865	8.288107203	77.25731693	1.191715576	0	0	0	0	0	0	0	28.9											Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	13C: Prepaid Wellness Benefit Card: $0											0.0732	0.0732	0.1633	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0732	0.0732	0.1633	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											24.9132	2.928224273	4.994992852	0	3.944088371	5.577204869	4.670336796	8.647721841	2.480716284	3.595968806	5.084359253	0.099959992	0.177999366	8.134938368	22.56330199	21.27525046	3.008359043	0.563364092	5.292117287	1.914552764	17.84644021	0.275286298	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	147.9884	0	0	24.9132	2.928224273	4.994992852	0	3.944088371	5.577204869	4.670336796	8.647721841	2.480716284	3.595968806	5.084359253	0.099959992	0.177999366	8.134938368	22.56330199	21.27525046	3.008359043	0.563364092	5.292117287	1.914552764	17.84644021	0.275286298	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	147.9884	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.9132	2.928224273	4.994992852	0	3.944088371	5.577204869	4.670336796	8.647721841	2.480716284	3.595968806	5.084359253	0.099959992	0.177999366	8.134938368	22.56330199	21.27525046	3.008359043	0.563364092	5.292117287	1.914552764	17.84644021	0.275286298	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	147.9884
H2237_002_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	300.22	27.33	77.51	35.15	12.92	21.29	17.46	20.69	26.93	10.19	28.19	2.93	4.63	78.22	48.33	95.33	7.75	5.75	20.62	33.65	15.77	3.58	0	0	0	0	0	0	0	28.9											Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	13C: Prepaid Wellness Benefit Card: $0											0.075796099	0.075796099	0.166620271	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.075796099	0.075796099	0.166620271	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											22.7555	2.071507385	12.91473721	0	2.98452	4.91799	4.03326	4.77939	6.22083	2.35389	6.51189	0.67683	1.06953	18.06882	11.16423	22.02123	1.79025	1.32825	4.76322	7.77315	3.64287	0.82698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.6689	0	0	22.7555	2.071507385	12.91473721	0	2.98452	4.91799	4.03326	4.77939	6.22083	2.35389	6.51189	0.67683	1.06953	18.06882	11.16423	22.02123	1.79025	1.32825	4.76322	7.77315	3.64287	0.82698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.6689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.7555	2.071507385	12.91473721	0	2.98452	4.91799	4.03326	4.77939	6.22083	2.35389	6.51189	0.67683	1.06953	18.06882	11.16423	22.02123	1.79025	1.32825	4.76322	7.77315	3.64287	0.82698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.6689
H2237_006_0	2009	5																					3350											D	D	D	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	S	Coin	T	V	V	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	798.53	19.82	971.5	0	179.55	9.04	6.4	325.45	34.68	9.18	26.32	2	0.35	43.14	29.56	91	1.07	5.06	22.84	36.05	432.25	4.94	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $250 per day for days 1 - 7.  $0 per day for days 8 - 90	1B IP Psych: $250 per day for days 1 - 7.  $0 per day for days 8 - 90	2 SNF: $110 per day for days 1 - 25.  $0 per day for days 26 - 100	6 Home Health: $0	10A Ambulance: $175	11A DME: 25%	"11B Prosthetic Medical Supplies: 25%, 11C Diabetes Monitoring Supplies: 25%"	"4A ER: $50, 4B Urgent Care: $40"	9B ASC Services: 25% Coinsurance	8A OP C/D/T: 0 - 25% Coinsurance	"8B OP X-Ray: 25% Coinsurance, Therapeutic Radiology Services: 25% Coinsurance"	9A OP Hospital: 20% Coinsurance	12 Renal Dialysis: 25% Coinsurance	"3 CORF: 20% Coinsurance, 5 Partial Hosp: 20% Coinsurance, 9C OP Substance Abuse: 20% Coinsurance, 9D Cardiac Rehab: 20% Coinsurance"	"7A PCP: $10, 14B Immunizations: $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 (excl. Mental Health): $25	"7E Mental Health: 50%, 7H Psychiatric: 50%"	"7C Occupational Therapy: 25% Coinsurance, 7I Physical and Speech Therapy: 25% Coinsurance"	"8B OP X-Ray: 25% Coinsurance, Therapeutic Radiology Services: 25% Coinsurance"	"7B Chiropractic: $25, 7F Podiatry: $25, 7G Other Health Care: 20%, 18A Medicare Covered Hearing Exams: $25"	15 Part B Drugs: 20% Coinsurance	"13A Blood: 20% Coinsurance, 16B Medicare Covered Comprehensive Dental Services: 20%, 17A Medicare Covered Eye Exams: $25"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Additional Comprehensive Dental: Not Covered"	17A Routine Eye Exams: Not Covered	17B Eye Wear: Not Covered	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											250	250	110	0	175	0.250000109	0.250001268	49.61837456	0.249999992	0.249878738	0.245005377	0.199999956	0.25000001	0.163383046	0.101024475	0.074430181	0.500005413	0.08250601	0.187137455	0.197177474	79.676	0.281009678	0	0	0	0	0	0	0	0											177.6263891	177.6263891	78.1556112	0	124.3384724	0.177626466	0.17762729	35.25413082	0.177626384	0.177540232	0.174077682	0.14210108	0.177626396	0.116084562	0.071778451	0.052883057	0.355256624	0.058620978	0.132962202	0.140095691	56.61024071	0.199658937	0	0	0	0	0	0	0	0											11.82	0.293379586	6.327348023	0	1.860414393	1.605743255	1.136814655	0.956121406	6.160082987	1.629819329	4.581724578	0.28420216	0.062169239	5.007888003	2.121771015	4.812358189	0.380124588	0.29662215	3.036856688	5.05044965	2.039148045	0.986315151	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4494	0	24.63	11.82	0.293379586	6.327348023	0	1.860414393	1.605743255	1.136814655	0.956121406	6.160082987	1.629819329	4.581724578	0.28420216	0.062169239	5.007888003	2.121771015	4.812358189	0.380124588	0.29662215	3.036856688	5.05044965	2.039148045	0.986315151	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4494	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.82	0.293379586	6.327348023	0	1.860414393	1.605743255	1.136814655	0.956121406	6.160082987	1.629819329	4.581724578	0.28420216	0.062169239	5.007888003	2.121771015	4.812358189	0.380124588	0.29662215	3.036856688	5.05044965	2.039148045	0.986315151	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.4494
H2256_001_1	2009	8																																D							P	P						P	P	P			P					P		P														0							0	0						0	0	0			0					0		0														0		223.8							316.8	374.409372						204	4376	248			24					248		16.56														$200 deductible							$50 per visit	20% up to $50						$10 per visit	$15 per visit	$15 per visit			$15 per visit					$15 per visit		$15 per visit														200							50	50						10	15	15			15					15		15														200							50	50						10	15	15			15					15		15														3.73	0	0	0	0	0	0	1.32	1.56003905	0	0	0	0	0	0.17	5.47	0.31	0	0	0.03	0	0	0	0	0.31	0	0.0207	0	0	0	0	0	0	0	0	0	0	0	0	0	12.9207			3.73	0	0	0	0	0	0	1.32	1.56003905	0	0	0	0	0	0.17	5.47	0.31	0	0	0.03	0	0	0	0	0.31	0	0.0207	0	0	0	0	0	0	0	0	0	0	0	0	0	12.9207																																																																																		0			3.73	0	0	0	0	0	0	1.32	1.56003905	0	0	0	0	0	0.17	5.47	0.31	0	0	0.03	0	0	0	0	0.31	0	0.0207	0	0	0	0	0	0	0	0	0	0	0	0	0	12.9207
H2256_001_2	2009	9																																D							P	P						P	P	P			P					P		P														0							0	0						0	0	0			0					0		0														0		201							283.2	334.765368						384	4200	216			24					280		32														$200 deductible							$50 per visit	20% up to $50						$10 per visit	$15 per visit	$15 per visit			$15 per visit					$15 per visit		$15 per visit														200							50	50						10	15	15			15					15		15														200							50	50						10	15	15			15					15		15														3.35	0	0	0	0	0	0	1.18	1.3948557	0	0	0	0	0	0.32	5.25	0.27	0	0	0.03	0	0	0	0	0.35	0	0.04	0	0	0	0	0	0	0	0	0	0	0	0	0	12.1849			3.35	0	0	0	0	0	0	1.18	1.3948557	0	0	0	0	0	0.32	5.25	0.27	0	0	0.03	0	0	0	0	0.35	0	0.04	0	0	0	0	0	0	0	0	0	0	0	0	0	12.1849																																																																																		0			3.35	0	0	0	0	0	0	1.18	1.3948557	0	0	0	0	0	0.32	5.25	0.27	0	0	0.03	0	0	0	0	0.35	0	0.04	0	0	0	0	0	0	0	0	0	0	0	0	0	12.1849
H2256_015_1	2009	8																																D							P	P						P	P	P			P					P		P														0							0	0						0	0	0			0					0		0														0		223.8							316.8	374.409372						204	4376	248			24					248		16.56														$200 deductible							$50 per visit	20% up to $50						$10 per visit	$15 per visit	$15 per visit			$15 per visit					$15 per visit		$15 per visit														200							50	50						10	15	15			15					15		15														200							50	50						10	15	15			15					15		15														3.73	0	0	0	0	0	0	1.32	1.56003905	0	0	0	0	0	0.17	5.47	0.31	0	0	0.03	0	0	0	0	0.31	0	0.0207	0	0	0	0	0	0	0	0	0	0	0	0	0	12.9207			3.73	0	0	0	0	0	0	1.32	1.56003905	0	0	0	0	0	0.17	5.47	0.31	0	0	0.03	0	0	0	0	0.31	0	0.0207	0	0	0	0	0	0	0	0	0	0	0	0	0	12.9207																																																																																		0			3.73	0	0	0	0	0	0	1.32	1.56003905	0	0	0	0	0	0.17	5.47	0.31	0	0	0.03	0	0	0	0	0.31	0	0.0207	0	0	0	0	0	0	0	0	0	0	0	0	0	12.9207
H2256_015_2	2009	8																																D							P	P						P	P	P			P					P		P														0							0	0						0	0	0			0					0		0														0		201							283.2	334.765368						384	4200	216			24					280		32														$200 deductible							$50 per visit	20% up to $50						$10 per visit	$15 per visit	$15 per visit			$15 per visit					$15 per visit		$15 per visit														200							50	50						10	15	15			15					15		15														200							50	50						10	15	15			15					15		15														3.35	0	0	0	0	0	0	1.18	1.3948557	0	0	0	0	0	0.32	5.25	0.27	0	0	0.03	0	0	0	0	0.35	0	0.04	0	0	0	0	0	0	0	0	0	0	0	0	0	12.1849			3.35	0	0	0	0	0	0	1.18	1.3948557	0	0	0	0	0	0.32	5.25	0.27	0	0	0.03	0	0	0	0	0.35	0	0.04	0	0	0	0	0	0	0	0	0	0	0	0	0	12.1849																																																																																		0			3.35	0	0	0	0	0	0	1.18	1.3948557	0	0	0	0	0	0.32	5.25	0.27	0	0	0.03	0	0	0	0	0.35	0	0.04	0	0	0	0	0	0	0	0	0	0	0	0	0	12.1849
H2256_016_1	2009	5																																D							P	P						P	P	P			P					P		P														0							0	0						0	0	0			0					0		0														0		223.8							316.8	374.409372						204	4376	248			24					248		16.56														$200 deductible							$50 per visit	20% up to $50						$10 per visit	$15 per visit	$15 per visit			$15 per visit					$15 per visit		$15 per visit														200							50	50						10	15	15			15					15		15														200							50	50						10	15	15			15					15		15														3.73	0	0	0	0	0	0	1.32	1.56003905	0	0	0	0	0	0.17	5.47	0.31	0	0	0.03	0	0	0	0	0.31	0	0.0207	0	0	0	0	0	0	0	0	0	0	0	0	0	12.9207			3.73	0	0	0	0	0	0	1.32	1.56003905	0	0	0	0	0	0.17	5.47	0.31	0	0	0.03	0	0	0	0	0.31	0	0.0207	0	0	0	0	0	0	0	0	0	0	0	0	0	12.9207																																																																																		0			3.73	0	0	0	0	0	0	1.32	1.56003905	0	0	0	0	0	0.17	5.47	0.31	0	0	0.03	0	0	0	0	0.31	0	0.0207	0	0	0	0	0	0	0	0	0	0	0	0	0	12.9207
H2256_016_2	2009	5																																D							P	P						P	P	P			P					P		P														0							0	0						0	0	0			0					0		0														0		201							283.2	334.765368						384	4200	216			24					280		32														$200 deductible							$50 per visit	20% up to $50						$10 per visit	$15 per visit	$15 per visit			$15 per visit					$15 per visit		$15 per visit														200							50	50						10	15	15			15					15		15														200							50	50						10	15	15			15					15		15														3.35	0	0	0	0	0	0	1.18	1.3948557	0	0	0	0	0	0.32	5.25	0.27	0	0	0.03	0	0	0	0	0.35	0	0.04	0	0	0	0	0	0	0	0	0	0	0	0	0	12.1849			3.35	0	0	0	0	0	0	1.18	1.3948557	0	0	0	0	0	0.32	5.25	0.27	0	0	0.03	0	0	0	0	0.35	0	0.04	0	0	0	0	0	0	0	0	0	0	0	0	0	12.1849																																																																																		0			3.35	0	0	0	0	0	0	1.18	1.3948557	0	0	0	0	0	0.32	5.25	0.27	0	0	0.03	0	0	0	0	0.35	0	0.04	0	0	0	0	0	0	0	0	0	0	0	0	0	12.1849
H2256_017_1	2009	8																					3350											D	D	D					P	P						P	P	P			P					P		P														0	0						0	0						0	0	0			0					0		0														0		649.1642066	0	684.2213186					188.2334874	370.2690389						136.7508242	2503.746707	374.053725			24.13249838					162.8943641		12.06624919														$100 each day for days 1-5	$100 each day for days 1-5	$25/day for days 11-100					$50 per visit	20% up to $150						$15 per visit	$20 per visit	$20 per visit			$20 per visit					$20 per visit		$20 per visit														100	0	25					50	74.05380779						15	20	20			20					20		20														99.45095455		24.86273864					49.72547727	73.24286202						14.91764318	19.89019091	19.89019091			19.89019091					19.89019091		19.89019091														5.38	0	1.417634651	0	0	0	0	0.78	2.259963678	0	0	0	0	0	0.17	4.15	0.62	0	0	0.04	0	0	0	0	0.27	0	0.02	0	0	0	0	0	0	0	0	0	0	0	0	0	15.1076		0.0686	5.38	0	1.417634651	0	0	0	0	0.78	2.259963678	0	0	0	0	0	0.17	4.15	0.62	0	0	0.04	0	0	0	0	0.27	0	0.02	0	0	0	0	0	0	0	0	0	0	0	0	0	15.1076																																																																																		0			5.38	0	1.417634651	0	0	0	0	0.78	2.259963678	0	0	0	0	0	0.17	4.15	0.62	0	0	0.04	0	0	0	0	0.27	0	0.02	0	0	0	0	0	0	0	0	0	0	0	0	0	15.1076
H2256_017_7	2009	8																					3350											D	D	D					P	P						P	P	P			P					P		P														0	0	0					0	0						0	0	0			0					0		0														0		619.6828523	0	683.645046					183.2525166	371.5903505						233.0843413	2350.936891	265.2339057			12.05608662					235.0936891		18.08412993														$100 each day for days 1-5	$100 each day for days 1-5	$25/day for days 11-100					$50 per visit	20% up to $150						$15 per visit	$20 per visit	$20 per visit			$20 per visit					$20 per vist		$20 per visit														100	0	25					50	74.31807011						15	20	20			20					20		20														99.53478585		24.88369646					49.76739293	73.62820218						14.93021788	19.90695717	19.90695717			19.90695717					19.90695717		19.90695717														5.14	0	1.417634651	0	0	0	0	0.76	2.279960788	0	0	0	0	0	0.29	3.9	0.44	0	0	0.02	0	0	0	0	0.39	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	14.6676		0.0686	5.14	0	1.417634651	0	0	0	0	0.76	2.279960788	0	0	0	0	0	0.29	3.9	0.44	0	0	0.02	0	0	0	0	0.39	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	14.6676																																																																																		0			5.14	0	1.417634651	0	0	0	0	0.76	2.279960788	0	0	0	0	0	0.29	3.9	0.44	0	0	0.02	0	0	0	0	0.39	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	14.6676
H2256_018_1	2009	8																					3350											D	D	D					P	P						P	P	P			P					P		P														0	0						0	0						0	0	0			0					0		0														0		649.1642066	0	684.2213186					188.2334874	370.2690389						136.7508242	2503.746707	374.053725			24.13249838					162.8943641		12.06624919														$100 each day for days 1-5	$100 each day for days 1-5	$25/day for days 11-100					$50 per visit	20% up to $150						$15 per visit	$20 per visit	$20 per visit			$20 per visit					$20 per visit		$20 per visit														100	0	25					50	74.05380779						15	20	20			20					20		20														99.45095455		24.86273864					49.72547727	73.24286202						14.91764318	19.89019091	19.89019091			19.89019091					19.89019091		19.89019091														5.38	0	1.417634651	0	0	0	0	0.78	2.259963678	0	0	0	0	0	0.17	4.15	0.62	0	0	0.04	0	0	0	0	0.27	0	0.02	0	0	0	0	0	0	0	0	0	0	0	0	0	15.1076		0.0686	5.38	0	1.417634651	0	0	0	0	0.78	2.259963678	0	0	0	0	0	0.17	4.15	0.62	0	0	0.04	0	0	0	0	0.27	0	0.02	0	0	0	0	0	0	0	0	0	0	0	0	0	15.1076																																																																																		0			5.38	0	1.417634651	0	0	0	0	0.78	2.259963678	0	0	0	0	0	0.17	4.15	0.62	0	0	0.04	0	0	0	0	0.27	0	0.02	0	0	0	0	0	0	0	0	0	0	0	0	0	15.1076
H2256_018_7	2009	7																					3350											D	D	D					P	P						P	P	P			P					P		P														0	0	0					0	0						0	0	0			0					0		0														0		619.6828523	0	683.645046					183.2525166	371.5903505						233.0843413	2350.936891	265.2339057			12.05608662					235.0936891		18.08412993														$100 each day for days 1-5	$100 each day for days 1-5	$25/day for days 11-100					$50 per visit	20% up to $150						$15 per visit	$20 per visit	$20 per visit			$20 per visit					$20 per vist		$20 per visit														100	0	25					50	74.31807011						15	20	20			20					20		20														99.53478585		24.88369646					49.76739293	73.62820218						14.93021788	19.90695717	19.90695717			19.90695717					19.90695717		19.90695717														5.14	0	1.417634651	0	0	0	0	0.76	2.279960788	0	0	0	0	0	0.29	3.9	0.44	0	0	0.02	0	0	0	0	0.39	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	14.6676		0.0686	5.14	0	1.417634651	0	0	0	0	0.76	2.279960788	0	0	0	0	0	0.29	3.9	0.44	0	0	0.02	0	0	0	0	0.39	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	14.6676																																																																																		0			5.14	0	1.417634651	0	0	0	0	0.76	2.279960788	0	0	0	0	0	0.29	3.9	0.44	0	0	0.02	0	0	0	0	0.39	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	14.6676
H2256_019_1	2009	4																					3350											D	D	D					P	P						P	P	P			P					P		P														0	0						0	0						0	0	0			0					0		0														0		649.1642066	0	684.2213186					188.2334874	370.2690389						136.7508242	2503.746707	374.053725			24.13249838					162.8943641		12.06624919														$100 each day for days 1-5	$100 each day for days 1-5	$25/day for days 11-100					$50 per visit	20% up to $150						$15 per visit	$20 per visit	$20 per visit			$20 per visit					$20 per visit		$20 per visit														100	0	25					50	74.05380779						15	20	20			20					20		20														99.45095455		24.86273864					49.72547727	73.24286202						14.91764318	19.89019091	19.89019091			19.89019091					19.89019091		19.89019091														5.38	0	1.417634651	0	0	0	0	0.78	2.259963678	0	0	0	0	0	0.17	4.15	0.62	0	0	0.04	0	0	0	0	0.27	0	0.02	0	0	0	0	0	0	0	0	0	0	0	0	0	15.1076		0.0686	5.38	0	1.417634651	0	0	0	0	0.78	2.259963678	0	0	0	0	0	0.17	4.15	0.62	0	0	0.04	0	0	0	0	0.27	0	0.02	0	0	0	0	0	0	0	0	0	0	0	0	0	15.1076																																																																																		0			5.38	0	1.417634651	0	0	0	0	0.78	2.259963678	0	0	0	0	0	0.17	4.15	0.62	0	0	0.04	0	0	0	0	0.27	0	0.02	0	0	0	0	0	0	0	0	0	0	0	0	0	15.1076
H2256_019_7	2009	4																					3350											D	D	D					P	P						P	P	P			P					P		P														0	0	0					0	0						0	0	0			0					0		0														0		619.6828523	0	683.645046					183.2525166	371.5903505						233.0843413	2350.936891	265.2339057			12.05608662					235.0936891		18.08412993														$100 each day for days 1-5	$100 each day for days 1-5	$25/day for days 11-100					$50 per visit	20% up to $150						$15 per visit	$20 per visit	$20 per visit			$20 per visit					$20 per vist		$20 per visit														100	0	25					50	74.31807011						15	20	20			20					20		20														99.53478585		24.88369646					49.76739293	73.62820218						14.93021788	19.90695717	19.90695717			19.90695717					19.90695717		19.90695717														5.14	0	1.417634651	0	0	0	0	0.76	2.279960788	0	0	0	0	0	0.29	3.9	0.44	0	0	0.02	0	0	0	0	0.39	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	14.6676		0.0686	5.14	0	1.417634651	0	0	0	0	0.76	2.279960788	0	0	0	0	0	0.29	3.9	0.44	0	0	0.02	0	0	0	0	0.39	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	14.6676																																																																																		0			5.14	0	1.417634651	0	0	0	0	0.76	2.279960788	0	0	0	0	0	0.29	3.9	0.44	0	0	0.02	0	0	0	0	0.39	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	14.6676
H2256_023_0	2009	5																					3350											D	D	D		T	O	O	P	P		P				P	P	P	P		P					P		P														0	0						0	0						0	0	0	0		0							0														0		579.3903236	0	680.3163799		124.6000696	583.6267259	0	166.56	352.4165355		423.6402366				189.3921058	2192.961225	254.184142	1031.688576		9.968005567					204.3441141		14.95200835														$200 each day for days 1-5	$200 each day for days 1-5	$100/day for days 11-100		$50/day	20% up to $50	20% up to $50	$50 per visit	20% up to $150		$0-$50				$25 per visit	$25 per visit	$25 per visit	$25 per visit		$25 per visit					$25 per visit		$25 per visit														200	0	100		50	50	50	50	70.48330711		50				25	25	25	25		25					25		25														192.6262648		96.30813241		48.15406621	48.15406621	48.15406621	48.15406621	67.88115674		48.15406621				24.0770331	24.0770331	24.0770331	24.0770331		24.0770331					24.0770331		24.0770331														9.3005	0	5.46	0	0.5	2.342	0	0.668378439	1.99353684	0	1.7	0	0	0	0.38	4.4	0.51	2.07	0	0.02	0	0	0	0	0.41	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7844		1.1456	9.3005	0	5.46	0	0.5	2.342	0	0.668378439	1.99353684	0	1.7	0	0	0	0.38	4.4	0.51	2.07	0	0.02	0	0	0	0	0.41	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7844																																																																																		0			9.3005	0	5.46	0	0.5	2.342	0	0.668378439	1.99353684	0	1.7	0	0	0	0.38	4.4	0.51	2.07	0	0.02	0	0	0	0	0.41	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7844
H2256_024_0	2009	5																					3350											D	D	D		T	O	O	P	P		P				P	P	P	P		P					P		P														0	0						0	0						0	0	0	0		0							0														0		579.3903236	0	680.3163799		124.6000696	583.6267259	0	166.56	352.4165355		423.6402366				189.3921058	2192.961225	254.184142	1031.688576		9.968005567					204.3441141		14.95200835														$200 each day for days 1-5	$200 each day for days 1-5	$100/day for days 11-100		$50/day	20% up to $50	20% up to $50	$50 per visit	20% up to $150		$0-$50				$25 per visit	$25 per visit	$25 per visit	$25 per visit		$25 per visit					$25 per visit		$25 per visit														200	0	100		50	50	50	50	70.48330711		50				25	25	25	25		25					25		25														192.6262648		96.30813241		48.15406621	48.15406621	48.15406621	48.15406621	67.88115674		48.15406621				24.0770331	24.0770331	24.0770331	24.0770331		24.0770331					24.0770331		24.0770331														9.3005	0	5.46	0	0.5	2.342	0	0.668378439	1.99353684	0	1.7	0	0	0	0.38	4.4	0.51	2.07	0	0.02	0	0	0	0	0.41	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7844		1.1456	9.3005	0	5.46	0	0.5	2.342	0	0.668378439	1.99353684	0	1.7	0	0	0	0.38	4.4	0.51	2.07	0	0.02	0	0	0	0	0.41	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7844																																																																																		0			9.3005	0	5.46	0	0.5	2.342	0	0.668378439	1.99353684	0	1.7	0	0	0	0.38	4.4	0.51	2.07	0	0.02	0	0	0	0	0.41	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7844
H2256_025_0	2009	4																					3350											D	D	D		T	O	O	P	P		P				P	P	P	P		P					P		P														0	0						0	0						0	0	0	0		0							0														0		579.3903236	0	680.3163799		124.6000696	583.6267259	0	166.56	352.4165355		423.6402366				189.3921058	2192.961225	254.184142	1031.688576		9.968005567					204.3441141		14.95200835														$200 each day for days 1-5	$200 each day for days 1-5	$100/day for days 11-100		$50/day	20% up to $50	20% up to $50	$50 per visit	20% up to $150		$0-$50				$25 per visit	$25 per visit	$25 per visit	$25 per visit		$25 per visit					$25 per visit		$25 per visit														200	0	100		50	50	50	50	70.48330711		50				25	25	25	25		25					25		25														192.6262648		96.30813241		48.15406621	48.15406621	48.15406621	48.15406621	67.88115674		48.15406621				24.0770331	24.0770331	24.0770331	24.0770331		24.0770331					24.0770331		24.0770331														9.3005	0	5.46	0	0.5	2.342	0	0.668378439	1.99353684	0	1.7	0	0	0	0.38	4.4	0.51	2.07	0	0.02	0	0	0	0	0.41	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7844		1.1456	9.3005	0	5.46	0	0.5	2.342	0	0.668378439	1.99353684	0	1.7	0	0	0	0.38	4.4	0.51	2.07	0	0.02	0	0	0	0	0.41	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7844																																																																																		0			9.3005	0	5.46	0	0.5	2.342	0	0.668378439	1.99353684	0	1.7	0	0	0	0.38	4.4	0.51	2.07	0	0.02	0	0	0	0	0.41	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7844
H2256_801_0	2009	4																																D							P	P						P	P	P			P					P		P														0							0	0						0	0	0			0					0		0														0		157.2							228.096	314.38449						420	3960	296			16					280		24														$200 deductible							$50 per visit	20% up to $50						$10 per visit	$15 per visit	$15 per visit			$15 per visit					$15 per visit		$15 per visit														200							50	50						10	15	15			15					15		15														200							50	50						10	15	15			15					15		15														2.62	0	0	0	0	0	0	0.9504	1.309935375	0	0	0	0	0	0.35	4.95	0.37	0	0	0.02	0	0	0	0	0.35	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	10.9503			2.62	0	0	0	0	0	0	0.9504	1.309935375	0	0	0	0	0	0.35	4.95	0.37	0	0	0.02	0	0	0	0	0.35	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	10.9503																																																																																		0			2.62	0	0	0	0	0	0	0.9504	1.309935375	0	0	0	0	0	0.35	4.95	0.37	0	0	0.02	0	0	0	0	0.35	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	10.9503
H2256_802_0	2009	4																																D							P	P						P	P	P			P					P		P														0							0	0						0	0	0			0					0		0														0		157.2							228.096	314.38449						420	3960	296			16					280		24														$200 deductible							$50 per visit	20% up to $50						$10 per visit	$15 per visit	$15 per visit			$15 per visit					$15 per visit		$15 per visit														200							50	50						10	15	15			15					15		15														200							50	50						10	15	15			15					15		15														2.62	0	0	0	0	0	0	0.9504	1.309935375	0	0	0	0	0	0.35	4.95	0.37	0	0	0.02	0	0	0	0	0.35	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	10.9503			2.62	0	0	0	0	0	0	0.9504	1.309935375	0	0	0	0	0	0.35	4.95	0.37	0	0	0.02	0	0	0	0	0.35	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	10.9503																																																																																		0			2.62	0	0	0	0	0	0	0.9504	1.309935375	0	0	0	0	0	0.35	4.95	0.37	0	0	0.02	0	0	0	0	0.35	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	10.9503
H2256_803_0	2009	4																																D							P	P						P	P	P			P					P		P														0							0	0						0	0	0			0					0		0														0		157.2							228.096	314.38449						420	3960	296			16					280		24														$200 deductible							$50 per visit	20% up to $50						$10 per visit	$15 per visit	$15 per visit			$15 per visit					$15 per visit		$15 per visit														200							50	50						10	15	15			15					15		15														200							50	50						10	15	15			15					15		15														2.62	0	0	0	0	0	0	0.9504	1.309935375	0	0	0	0	0	0.35	4.95	0.37	0	0	0.02	0	0	0	0	0.35	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	10.9503			2.62	0	0	0	0	0	0	0.9504	1.309935375	0	0	0	0	0	0.35	4.95	0.37	0	0	0.02	0	0	0	0	0.35	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	10.9503																																																																																		0			2.62	0	0	0	0	0	0	0.9504	1.309935375	0	0	0	0	0	0.35	4.95	0.37	0	0	0.02	0	0	0	0	0.35	0	0.03	0	0	0	0	0	0	0	0	0	0	0	0	0	10.9503
H2261_005_0	2009	4																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	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		1797.527824	75.62464719	2447.362972	2811.059167	447.5324639	1417.878604	210.9390783	323.5939833	409.5408122	5477.299623	1403.119533	168.7561815	7.24289782	2212.621841	5803.970337	7208.704566	348.7642892	569.3560785	2329.738957	75.07849504	1063.731632	0.230822815	0	329.5490306	432.1003099	212.3240152	2.374177527	18.20202771	47.61544929	360.7794463											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$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	"(4a) $10/visit,  (4b) & (14b) $0 -$20 per visit, no cost for immunization"	"(7b), (7d), (7f), $20 per visit"	"$20/Visit 1-10, $30/visit 11-beyond"	(7c) & (7i) '$15 per visit	$0 Co-pay	(7d) & (14j) $0 - $20 per visit	$0 Co-pay	$0 Co-pay	0	(16a) $20 visit every six months	(17a) $20  exam per calendar year	(17b) $0 - $57 contact lenses every two years.	$0 Co-pay	$0 Co-pay	$0 Co-pay	$0 - $20 per visit											44.88698857	23.54753978	4.963323429	0	14.87621574	0	0	43.86927385	46.45874246	0	0	0	0	5.82272933	7.283461422	15.91512739	21.69957449	14.95373752	0	4.314446367	0	0	0	19.72723634	11.41994811	21.3964715	0	0	0	12.03780378											44.88698857	23.54753978	4.963323429	0	14.87621574	0	0	43.86927385	46.45874246	0	0	0	0	5.82272933	7.283461422	15.91512739	21.69957449	14.95373752	0	4.314446367	0	0	0	19.72723634	11.41994811	21.3964715	0	0	0	12.03780378											6.7238	0.148397866	1.012254498	0	0.554799124	0	0	1.182986089	1.585562594	0	0	0	0	1.073624841	3.522749504	9.56062096	0.630669723	0.709500113	0	0.026993512	0	0	0	0.541757634	0.411213593	0.378582062	0	0	0	0.361916015	0	0	0	0	0	0	0	0	0	0	28.4254			6.7238	0.148397866	1.012254498	0	0.554799124	0	0	1.182986089	1.585562594	0	0	0	0	1.073624841	3.522749504	9.56062096	0.630669723	0.709500113	0	0.026993512	0	0	0	0.541757634	0.411213593	0.378582062	0	0	0	0.361916015	0	0	0	0	0	0	0	0	0	0	28.4254																																																																																		0			6.7238	0.148397866	1.012254498	0	0.554799124	0	0	1.182986089	1.585562594	0	0	0	0	1.073624841	3.522749504	9.56062096	0.630669723	0.709500113	0	0.026993512	0	0	0	0.541757634	0.411213593	0.378582062	0	0	0	0.361916015	0	0	0	0	0	0	0	0	0	0	28.4254
H2261_011_0	2009	4																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	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		1797.527824	75.62464719	2447.362972	2811.059167	447.5324639	1417.878604	210.9390783	323.5939833	409.5408122	5477.299623	1403.119533	168.7561815	7.24289782	2212.621841	5803.970337	7208.704566	348.7642892	569.3560785	2329.738957	75.07849504	1063.731632	0.230822815	0	329.5490306	432.1003099	212.3240152	2.374177527	18.20202771	47.61544929	360.7794463											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$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	"(4a) $10/visit,  (4b) & (14b) $0 -$20 per visit, no cost for immunization"	"(7b), (7d), (7f), $20 per visit"	"$20/Visit 1-10, $30/visit 11-beyond"	(7c) & (7i) '$15 per visit	$0 Co-pay	(7d) & (14j) $0 - $20 per visit	$0 Co-pay	$0 Co-pay	0	(16a) $20 visit every six months	(17a) $20  exam per calendar year	(17b) $0 - $57 contact lenses every two years.	$0 Co-pay	$0 Co-pay	$0 Co-pay	$0 - $20 per visit											44.88698857	23.54753978	4.963323429	0	14.87621574	0	0	43.86927385	46.45874246	0	0	0	0	5.82272933	7.283461422	15.91512739	21.69957449	14.95373752	0	4.314446367	0	0	0	19.72723634	11.41994811	21.3964715	0	0	0	12.03780378											44.88698857	23.54753978	4.963323429	0	14.87621574	0	0	43.86927385	46.45874246	0	0	0	0	5.82272933	7.283461422	15.91512739	21.69957449	14.95373752	0	4.314446367	0	0	0	19.72723634	11.41994811	21.3964715	0	0	0	12.03780378											6.7238	0.148397866	1.012254498	0	0.554799124	0	0	1.182986089	1.585562594	0	0	0	0	1.073624841	3.522749504	9.56062096	0.630669723	0.709500113	0	0.026993512	0	0	0	0.541757634	0.411213593	0.378582062	0	0	0	0.361916015	0	0	0	0	0	0	0	0	0	0	28.4254			6.7238	0.148397866	1.012254498	0	0.554799124	0	0	1.182986089	1.585562594	0	0	0	0	1.073624841	3.522749504	9.56062096	0.630669723	0.709500113	0	0.026993512	0	0	0	0.541757634	0.411213593	0.378582062	0	0	0	0.361916015	0	0	0	0	0	0	0	0	0	0	28.4254																																																																																		0			6.7238	0.148397866	1.012254498	0	0.554799124	0	0	1.182986089	1.585562594	0	0	0	0	1.073624841	3.522749504	9.56062096	0.630669723	0.709500113	0	0.026993512	0	0	0	0.541757634	0.411213593	0.378582062	0	0	0	0.361916015	0	0	0	0	0	0	0	0	0	0	28.4254
H2261_801_0	2009	3																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	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		1797.527824	75.62464719	2447.456015	2811.059167	447.5324639	1417.878604	210.9390783	323.5939833	409.5408122	5477.299623	1403.119533	168.7561815	7.24289782	2212.621841	5803.970337	7208.704566	348.7642892	569.3560785	2329.738957	75.07849504	1063.731632	0.230822815	0	329.5490306	432.1003099	212.3240152	2.374177527	18.20202771	47.61544929	360.7794463											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$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	"(4a) $10/visit,  (4b) & (14b) $0 -$20 per visit, no cost for immunization"	"(7b), (7d), (7f), $20 per visit"	"$20/Visit 1-10, $30/visit 11-beyond"	(7c) & (7i) '$15 per visit	$0 Co-pay	(7d) & (14j) $0 - $20 per visit	$0 Co-pay	$0 Co-pay	0	(16a) $20 visit every six months	(17a) $20  exam per calendar year	(17b) $0 - $57 contact lenses every two years.	$0 Co-pay	$0 Co-pay	$0 Co-pay	$0 - $20 per visit											44.88698857	23.54753978	4.963323429	0	14.87621574	0	0	43.86927385	46.45874246	0	0	0	0	5.82272933	7.283461422	15.91512739	21.69957449	14.95373752	0	4.314446367	0	0	0	19.72723634	11.41994811	21.3964715	0	0	0	12.03780378											44.88698857	23.54753978	4.963323429	0	14.87621574	0	0	43.86927385	46.45874246	0	0	0	0	5.82272933	7.283461422	15.91512739	21.69957449	14.95373752	0	4.314446367	0	0	0	19.72723634	11.41994811	21.3964715	0	0	0	12.03780378											6.7238	0.148397866	1.012292981	0	0.554799124	0	0	1.182986089	1.585562594	0	0	0	0	1.073624841	3.522749504	9.56062096	0.630669723	0.709500113	0	0.026993512	0	0	0	0.541757634	0.411213593	0.378582062	0	0	0	0.361916015	0	0	0	0	0	0	0	0	0	0	28.4255			6.7238	0.148397866	1.012292981	0	0.554799124	0	0	1.182986089	1.585562594	0	0	0	0	1.073624841	3.522749504	9.56062096	0.630669723	0.709500113	0	0.026993512	0	0	0	0.541757634	0.411213593	0.378582062	0	0	0	0.361916015	0	0	0	0	0	0	0	0	0	0	28.4255																																																																																		0			6.7238	0.148397866	1.012292981	0	0.554799124	0	0	1.182986089	1.585562594	0	0	0	0	1.073624841	3.522749504	9.56062096	0.630669723	0.709500113	0	0.026993512	0	0	0	0.541757634	0.411213593	0.378582062	0	0	0	0.361916015	0	0	0	0	0	0	0	0	0	0	28.4255
H2261_809_0	2009	3																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	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		1797.527824	75.62464719	2447.456015	2811.059167	447.5324639	1417.878604	210.9390783	323.5939833	409.5408122	5477.299623	1403.119533	168.7561815	7.24289782	2212.621841	5803.970337	7208.704566	348.7642892	569.3560785	2329.738957	75.07849504	1063.731632	0.230822815	0	329.5490306	432.1003099	212.3240152	2.374177527	18.20202771	47.61544929	360.7794463											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$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	"(4a) $10/visit,  (4b) & (14b) $0 -$20 per visit, no cost for immunization"	"(7b), (7d), (7f), $20 per visit"	"$20/Visit 1-10, $30/visit 11-beyond"	(7c) & (7i) '$15 per visit	$0 Co-pay	(7d) & (14j) $0 - $20 per visit	$0 Co-pay	$0 Co-pay	0	(16a) $20 visit every six months	(17a) $20  exam per calendar year	(17b) $0 - $57 contact lenses every two years.	$0 Co-pay	$0 Co-pay	$0 Co-pay	$0 - $20 per visit											44.88698857	23.54753978	4.963323429	0	14.87621574	0	0	43.86927385	46.45874246	0	0	0	0	5.82272933	7.283461422	15.91512739	21.69957449	14.95373752	0	4.314446367	0	0	0	19.72723634	11.41994811	21.3964715	0	0	0	12.03780378											44.88698857	23.54753978	4.963323429	0	14.87621574	0	0	43.86927385	46.45874246	0	0	0	0	5.82272933	7.283461422	15.91512739	21.69957449	14.95373752	0	4.314446367	0	0	0	19.72723634	11.41994811	21.3964715	0	0	0	12.03780378											6.7238	0.148397866	1.012292981	0	0.554799124	0	0	1.182986089	1.585562594	0	0	0	0	1.073624841	3.522749504	9.56062096	0.630669723	0.709500113	0	0.026993512	0	0	0	0.541757634	0.411213593	0.378582062	0	0	0	0.361916015	0	0	0	0	0	0	0	0	0	0	28.4255			6.7238	0.148397866	1.012292981	0	0.554799124	0	0	1.182986089	1.585562594	0	0	0	0	1.073624841	3.522749504	9.56062096	0.630669723	0.709500113	0	0.026993512	0	0	0	0.541757634	0.411213593	0.378582062	0	0	0	0.361916015	0	0	0	0	0	0	0	0	0	0	28.4255																																																																																		0			6.7238	0.148397866	1.012292981	0	0.554799124	0	0	1.182986089	1.585562594	0	0	0	0	1.073624841	3.522749504	9.56062096	0.630669723	0.709500113	0	0.026993512	0	0	0	0.541757634	0.411213593	0.378582062	0	0	0	0.361916015	0	0	0	0	0	0	0	0	0	0	28.4255
H2291_002_0	2009	6																					0											D	D	D	V	T	O	O	V	V	V	O	V	V	O	V	V	V	V	V	V	S	V	T	V	V	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	0	0	0	0	0	0	0	431.19	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	466.48	0	188.07	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/World Wide Coverage: $25, 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 (excl. Radiology): $0, 7F Podiatry: $0"	"7E Mental Health: $0, 7H Psychiatric: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	7D Physician Specialist (Radiology): $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: $0"	17A Routine Eye Exams: $15	17B Eye Wear: Medicare Covered: $0	18A Routine Hearing Exams: $15	18B Hearing Aids: $0	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0	0	0	0	0	0	0	24.08021986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15	0	15	0	0	0											0	0	0	0	0	0	0	24.08021986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15	0	15	0	0	0											0	0	0	0	0	0	0	0.8652625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.5831	0	0.2350875	0	0	0	0	0	0	0	0	0	0	0	0	0	1.6834	0	0	0	0	0	0	0	0	0	0.8652625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.5831	0	0.2350875	0	0	0	0	0	0	0	0	0	0	0	0	0	1.6834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0.8652625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.5831	0	0.2350875	0	0	0	0	0	0	0	0	0	0	0	0	0	1.6834
H2312_004_0	2009	10																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	V	V	V	P	V	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	298.6894245	6.672619861	611.3997762	0.318894133	410.3153899	16.72233049	0	472.3010333	307.1890135	0	680.8649577	0	0	1702.04027	3057.8464	2630.819605	204.716368	10.79623358	0	606.3197743	589.260077	0	0	0	21.75729515	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: 20%, 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: $50	9A OP Hospital: Included in h.5.	12 Renal Dialysis: Included in h.5.	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0, 9A OP Hospital: $50, 12 Renal Dialysis: $25"	"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: $25"	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: $0 Up to $400/yr. including exam and fitting	"14A Health Education/Wellness Programs: $0 Up to $20/mo. in fitness or weight loss program, or services for acupuncture, chiropractor, or massage"	13B Acupuncture: Included in p.											250	250	130	0	50	0.2	0	49.17	50	0	50	0	0	37.46496659	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0											250	250	130	0	50	0.2	0	49.17	50	0	50	0	0	37.46496659	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0											6.2227	0.139012914	6.623497576	0	1.709647458	3.344466097	0	1.935253484	1.279954223	0	2.836937324	0	0	5.31390682	2.548205334	5.480874178	0.426492433	0.013495292	0	1.263166196	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1376	0	0	6.2227	0.139012914	6.623497576	0	1.709647458	3.344466097	0	1.935253484	1.279954223	0	2.836937324	0	0	5.31390682	2.548205334	5.480874178	0.426492433	0.013495292	0	1.263166196	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1376	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.2227	0.139012914	6.623497576	0	1.709647458	3.344466097	0	1.935253484	1.279954223	0	2.836937324	0	0	5.31390682	2.548205334	5.480874178	0.426492433	0.013495292	0	1.263166196	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1376
H2312_006_0	2009	7																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	V	V	V	P	V	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	286.3257771	6.525090884	597.3898865	0.266068316	388.1593177	17.13366426	0	449.7068298	296.800151	0	657.4138755	0	0	1661.600406	2946.875966	2580.632561	222.582137	12.17084901	0	571.4798085	583.6506576	0	0	0	21.10989065	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: 20%, 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: $50	9A OP Hospital: Included in h.5.	12 Renal Dialysis: Included in h.5.	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0, 9A OP Hospital: $50, 12 Renal Dialysis: $25"	"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: $25"	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: $0 Up to $400/yr. including exam and fitting	"14A Health Education/Wellness Programs: $0 Up to $20/mo. in fitness or weight loss program, or services for acupuncture, chiropractor, or massage"	13B Acupuncture: Included in p.											250	250	130	0	50	0.2	0	49.17	50	0	50	0	0	37.35579455	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0											250	250	130	0	50	0.2	0	49.17	50	0	50	0	0	37.35579455	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0											5.9651	0.135939393	6.47172377	0	1.617330491	3.426732852	0	1.842673735	1.236667296	0	2.739224481	0	0	5.172533616	2.455729972	5.376317835	0.463712785	0.015213561	0	1.190582934	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.1095	0	0	5.9651	0.135939393	6.47172377	0	1.617330491	3.426732852	0	1.842673735	1.236667296	0	2.739224481	0	0	5.172533616	2.455729972	5.376317835	0.463712785	0.015213561	0	1.190582934	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.1095	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	5.9651	0.135939393	6.47172377	0	1.617330491	3.426732852	0	1.842673735	1.236667296	0	2.739224481	0	0	5.172533616	2.455729972	5.376317835	0.463712785	0.015213561	0	1.190582934	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.1095
H2312_007_0	2009	8																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	V	V	V	P	V	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	294.5923613	9.006822616	801.2366295	0.585084364	398.2702253	15.66742354	0	384.362328	313.9199202	0	436.3749949	0	0	692.6086023	3959.73473	3411.225473	258.6675928	307.0186256	0	689.1616648	743.432226	0	0	0	10.35274727	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: 20%, 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: $50	9A OP Hospital: Included in h.5.	12 Renal Dialysis: Included in h.5.	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0, 9A OP Hospital: $50, 12 Renal Dialysis: $25"	"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: $25"	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: $0 Up to $400/yr. including exam and fitting	"14A Health Education/Wellness Programs: $0 Up to $20/mo. in fitness or weight loss program, or services for acupuncture, chiropractor, or massage"	13B Acupuncture: Included in p.											250	250	130	0	50	0.21	0	49.18	50	0	50	0	0	34.52088616	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0											250	250	130	0	50	0.21	0	49.18	50	0	50	0	0	34.52088616	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0											6.1373	0.187642138	8.680063487	0	1.659459272	3.290158942	0	1.575244941	1.307999667	0	1.818229145	0	0	1.992455226	3.299778942	7.106719735	0.538890818	0.383773282	0	1.435753468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4135	0	0	6.1373	0.187642138	8.680063487	0	1.659459272	3.290158942	0	1.575244941	1.307999667	0	1.818229145	0	0	1.992455226	3.299778942	7.106719735	0.538890818	0.383773282	0	1.435753468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4135	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.1373	0.187642138	8.680063487	0	1.659459272	3.290158942	0	1.575244941	1.307999667	0	1.818229145	0	0	1.992455226	3.299778942	7.106719735	0.538890818	0.383773282	0	1.435753468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4135
H2312_008_0	2009	6																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	V	V	V	P	V	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	294.5923613	9.006822616	801.2366295	0.585084364	398.2702253	15.66742354	0	384.362328	313.9199202	0	436.3749949	0	0	692.6086023	3959.73473	3411.225473	258.6675928	307.0186256	0	689.1616648	743.432226	0	0	0	10.35274727	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: 20%, 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: $50	9A OP Hospital: Included in h.5.	12 Renal Dialysis: Included in h.5.	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0, 9A OP Hospital: $50, 12 Renal Dialysis: $25"	"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: $25"	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: $0 Up to $400/yr. including exam and fitting	"14A Health Education/Wellness Programs: $0 Up to $20/mo. in fitness or weight loss program, or services for acupuncture, chiropractor, or massage"	13B Acupuncture: Included in p.											250	250	130	0	50	0.21	0	49.18	50	0	50	0	0	34.52088616	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0											250	250	130	0	50	0.21	0	49.18	50	0	50	0	0	34.52088616	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0											6.1373	0.187642138	8.680063487	0	1.659459272	3.290158942	0	1.575244941	1.307999667	0	1.818229145	0	0	1.992455226	3.299778942	7.106719735	0.538890818	0.383773282	0	1.435753468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4135	0	0	6.1373	0.187642138	8.680063487	0	1.659459272	3.290158942	0	1.575244941	1.307999667	0	1.818229145	0	0	1.992455226	3.299778942	7.106719735	0.538890818	0.383773282	0	1.435753468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4135	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.1373	0.187642138	8.680063487	0	1.659459272	3.290158942	0	1.575244941	1.307999667	0	1.818229145	0	0	1.992455226	3.299778942	7.106719735	0.538890818	0.383773282	0	1.435753468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4135
H2312_009_0	2009	8																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	V	V	V	P	V	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	311.4257885	7.097096163	649.7585315	0.289392509	422.1863041	17.13366426	0	489.1292203	322.8183715	0	715.0443689	0	0	1807.260324	3205.206254	2806.857065	242.0942265	13.23777513	0	621.5771134	634.8148885	0	0	0	22.96043482	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: 20%, 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: $50	9A OP Hospital: Included in h.5.	12 Renal Dialysis: Included in h.5.	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0, 9A OP Hospital: $50, 12 Renal Dialysis: $25"	"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: $25"	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: $0 Up to $400/yr. including exam and fitting	"14A Health Education/Wellness Programs: $0 Up to $20/mo. in fitness or weight loss program, or services for acupuncture, chiropractor, or massage"	13B Acupuncture: Included in p.											250	250	130	0	50	0.2	0	49.17	50	0	50	0	0	37.35579455	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0											250	250	130	0	50	0.2	0	49.17	50	0	50	0	0	37.35579455	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0											6.488	0.14785617	7.039050758	0	1.759109601	3.426732852	0	2.00420698	1.345076548	0	2.979351537	0	0	5.625970448	2.671005212	5.847618885	0.504362972	0.016547219	0	1.29495232	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1499	0	0	6.488	0.14785617	7.039050758	0	1.759109601	3.426732852	0	2.00420698	1.345076548	0	2.979351537	0	0	5.625970448	2.671005212	5.847618885	0.504362972	0.016547219	0	1.29495232	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1499	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.488	0.14785617	7.039050758	0	1.759109601	3.426732852	0	2.00420698	1.345076548	0	2.979351537	0	0	5.625970448	2.671005212	5.847618885	0.504362972	0.016547219	0	1.29495232	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1499
H2312_010_0	2009	8																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	V	V	V	P	V	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	294.5923613	9.006822616	801.2366295	0.585084364	398.2702253	15.66742354	0	384.362328	313.9199202	0	436.3749949	0	0	692.6086023	3959.73473	3411.225473	258.6675928	307.0186256	0	689.1616648	743.432226	0	0	0	10.35274727	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: 20%, 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: $50	9A OP Hospital: Included in h.5.	12 Renal Dialysis: Included in h.5.	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0, 9A OP Hospital: $50, 12 Renal Dialysis: $25"	"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: $25"	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: $0 Up to $400/yr. including exam and fitting	"14A Health Education/Wellness Programs: $0 Up to $20/mo. in fitness or weight loss program, or services for acupuncture, chiropractor, or massage"	13B Acupuncture: Included in p.											250	250	130	0	50	0.21	0	49.18	50	0	50	0	0	34.52088616	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0											250	250	130	0	50	0.21	0	49.18	50	0	50	0	0	34.52088616	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0											6.1373	0.187642138	8.680063487	0	1.659459272	3.290158942	0	1.575244941	1.307999667	0	1.818229145	0	0	1.992455226	3.299778942	7.106719735	0.538890818	0.383773282	0	1.435753468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4135	0	0	6.1373	0.187642138	8.680063487	0	1.659459272	3.290158942	0	1.575244941	1.307999667	0	1.818229145	0	0	1.992455226	3.299778942	7.106719735	0.538890818	0.383773282	0	1.435753468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4135	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.1373	0.187642138	8.680063487	0	1.659459272	3.290158942	0	1.575244941	1.307999667	0	1.818229145	0	0	1.992455226	3.299778942	7.106719735	0.538890818	0.383773282	0	1.435753468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4135
H2312_801_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	255.8713814	3.919013632	46.36690466	22.46832978	15.21432383	21.74782087	0	32.80154049	32.12866809	2.173076668	25.95175225	0	0	136.5290308	26.03532402	104.4651678	2.019942821	0.795524949	0	63.03716783	23.66626973	0.265424729	0	0	0	0	0	0	0	0											6.82% Medicare Equivalent Coinsurance	6.82% Medicare Equivalent Coinsurance	17.89% Medicare Equivalent Coinsurance	0.00% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	0	0	0	0	0	0	0	0											0.0682	0.0682	0.1789	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0682	0.0682	0.1789	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											17.4504	0.26727673	8.295039244	0	3.514508804	5.023746622	0	7.577155853	7.421722328	0.50198071	5.994854769	0	0	31.53820611	6.014159849	24.13145376	0.466606792	0.183766263	0	14.56158577	5.466908308	0.061313112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.4707	0	0	17.4504	0.26727673	8.295039244	0	3.514508804	5.023746622	0	7.577155853	7.421722328	0.50198071	5.994854769	0	0	31.53820611	6.014159849	24.13145376	0.466606792	0.183766263	0	14.56158577	5.466908308	0.061313112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.4707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.4504	0.26727673	8.295039244	0	3.514508804	5.023746622	0	7.577155853	7.421722328	0.50198071	5.994854769	0	0	31.53820611	6.014159849	24.13145376	0.466606792	0.183766263	0	14.56158577	5.466908308	0.061313112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.4707
H2312_803_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	255.8713814	3.919013632	46.36690466	22.46832978	15.21432383	21.74782087	0	32.80154049	32.12866809	2.173076668	25.95175225	0	0	136.5290308	26.03532402	104.4651678	2.019942821	0.795524949	0	63.03716783	23.66626973	0.265424729	0	0	0	0	0	0	0	0											6.82% Medicare Equivalent Coinsurance	6.82% Medicare Equivalent Coinsurance	17.89% Medicare Equivalent Coinsurance	0.00% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	0	0	0	0	0	0	0	0											0.0682	0.0682	0.1789	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0682	0.0682	0.1789	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											17.4504	0.26727673	8.295039244	0	3.514508804	5.023746622	0	7.577155853	7.421722328	0.50198071	5.994854769	0	0	31.53820611	6.014159849	24.13145376	0.466606792	0.183766263	0	14.56158577	5.466908308	0.061313112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.4707	0	0	17.4504	0.26727673	8.295039244	0	3.514508804	5.023746622	0	7.577155853	7.421722328	0.50198071	5.994854769	0	0	31.53820611	6.014159849	24.13145376	0.466606792	0.183766263	0	14.56158577	5.466908308	0.061313112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.4707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.4504	0.26727673	8.295039244	0	3.514508804	5.023746622	0	7.577155853	7.421722328	0.50198071	5.994854769	0	0	31.53820611	6.014159849	24.13145376	0.466606792	0.183766263	0	14.56158577	5.466908308	0.061313112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.4707
H2312_804_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	255.8713814	3.919013632	46.36690466	22.46832978	15.21432383	21.74782087	0	32.80154049	32.12866809	2.173076668	25.95175225	0	0	136.5290308	26.03532402	104.4651678	2.019942821	0.795524949	0	63.03716783	23.66626973	0.265424729	0	0	0	0	0	0	0	0											6.82% Medicare Equivalent Coinsurance	6.82% Medicare Equivalent Coinsurance	17.89% Medicare Equivalent Coinsurance	0.00% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	0	0	0	0	0	0	0	0											0.0682	0.0682	0.1789	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0682	0.0682	0.1789	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											17.4504	0.26727673	8.295039244	0	3.514508804	5.023746622	0	7.577155853	7.421722328	0.50198071	5.994854769	0	0	31.53820611	6.014159849	24.13145376	0.466606792	0.183766263	0	14.56158577	5.466908308	0.061313112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.4707	0	0	17.4504	0.26727673	8.295039244	0	3.514508804	5.023746622	0	7.577155853	7.421722328	0.50198071	5.994854769	0	0	31.53820611	6.014159849	24.13145376	0.466606792	0.183766263	0	14.56158577	5.466908308	0.061313112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.4707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.4504	0.26727673	8.295039244	0	3.514508804	5.023746622	0	7.577155853	7.421722328	0.50198071	5.994854769	0	0	31.53820611	6.014159849	24.13145376	0.466606792	0.183766263	0	14.56158577	5.466908308	0.061313112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.4707
H2312_805_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	273.8770823	4.194795107	49.62974949	24.04942893	16.28495768	23.27821773	0	35.10978896	34.38956644	2.325996343	27.77798027	0	0	146.1365956	27.867433	111.8163946	2.162086448	0.851506139	0	67.47310115	25.33166807	0.2841027	0	0	0	0	0	0	0	0											6.83% Medicare Equivalent Coinsurance	6.83% Medicare Equivalent Coinsurance	17.90% Medicare Equivalent Coinsurance	0.00% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	0	0	0	0	0	0	0	0											0.068258603	0.068258603	0.178986532	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.068258603	0.068258603	0.178986532	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											18.6945	0.286330853	8.883056722	0	3.761825225	5.377268295	0	8.11036125	7.943989849	0.537305155	6.416713443	0	0	33.75755359	6.437377024	25.82958715	0.499441969	0.196697918	0	15.58628637	5.851615323	0.065627724	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.2355	0	0	18.6945	0.286330853	8.883056722	0	3.761825225	5.377268295	0	8.11036125	7.943989849	0.537305155	6.416713443	0	0	33.75755359	6.437377024	25.82958715	0.499441969	0.196697918	0	15.58628637	5.851615323	0.065627724	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.2355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.6945	0.286330853	8.883056722	0	3.761825225	5.377268295	0	8.11036125	7.943989849	0.537305155	6.416713443	0	0	33.75755359	6.437377024	25.82958715	0.499441969	0.196697918	0	15.58628637	5.851615323	0.065627724	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.2355
H2312_807_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	273.8770823	4.194795107	49.62974949	24.04942893	16.28495768	23.27821773	0	35.10978896	34.38956644	2.325996343	27.77798027	0	0	146.1365956	27.867433	111.8163946	2.162086448	0.851506139	0	67.47310115	25.33166807	0.2841027	0	0	0	0	0	0	0	0											6.83% Medicare Equivalent Coinsurance	6.83% Medicare Equivalent Coinsurance	17.90% Medicare Equivalent Coinsurance	0.00% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	0	0	0	0	0	0	0	0											0.068258603	0.068258603	0.178986532	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.068258603	0.068258603	0.178986532	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											18.6945	0.286330853	8.883056722	0	3.761825225	5.377268295	0	8.11036125	7.943989849	0.537305155	6.416713443	0	0	33.75755359	6.437377024	25.82958715	0.499441969	0.196697918	0	15.58628637	5.851615323	0.065627724	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.2355	0	0	18.6945	0.286330853	8.883056722	0	3.761825225	5.377268295	0	8.11036125	7.943989849	0.537305155	6.416713443	0	0	33.75755359	6.437377024	25.82958715	0.499441969	0.196697918	0	15.58628637	5.851615323	0.065627724	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.2355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.6945	0.286330853	8.883056722	0	3.761825225	5.377268295	0	8.11036125	7.943989849	0.537305155	6.416713443	0	0	33.75755359	6.437377024	25.82958715	0.499441969	0.196697918	0	15.58628637	5.851615323	0.065627724	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.2355
H2312_808_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	273.8770823	4.194795107	49.62974949	24.04942893	16.28495768	23.27821773	0	35.10978896	34.38956644	2.325996343	27.77798027	0	0	146.1365956	27.867433	111.8163946	2.162086448	0.851506139	0	67.47310115	25.33166807	0.2841027	0	0	0	0	0	0	0	0											6.83% Medicare Equivalent Coinsurance	6.83% Medicare Equivalent Coinsurance	17.90% Medicare Equivalent Coinsurance	0.00% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	0	0	0	0	0	0	0	0											0.068258603	0.068258603	0.178986532	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.068258603	0.068258603	0.178986532	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											18.6945	0.286330853	8.883056722	0	3.761825225	5.377268295	0	8.11036125	7.943989849	0.537305155	6.416713443	0	0	33.75755359	6.437377024	25.82958715	0.499441969	0.196697918	0	15.58628637	5.851615323	0.065627724	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.2355	0	0	18.6945	0.286330853	8.883056722	0	3.761825225	5.377268295	0	8.11036125	7.943989849	0.537305155	6.416713443	0	0	33.75755359	6.437377024	25.82958715	0.499441969	0.196697918	0	15.58628637	5.851615323	0.065627724	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.2355	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.6945	0.286330853	8.883056722	0	3.761825225	5.377268295	0	8.11036125	7.943989849	0.537305155	6.416713443	0	0	33.75755359	6.437377024	25.82958715	0.499441969	0.196697918	0	15.58628637	5.851615323	0.065627724	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.2355
H2319_008_3	2009	9																					4000											A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	V	V	V	O	O																																																			0	n/a	128.6977666	1.937052478	436.2817494	105.1156002	171.7546926	6.88399901	1.457298177	90.26589074	537.8648993	748.9359717	579.7047711	0	15.5512429	458.3654555	3346.054812	1265.071194	165.5369166	189.1539043	779.3751264	5248.009552	372.5506683	657.4592442	0	1362.9	0	0	0	0	0	23.42857143											"$700 copay per admit (PBP Section B-01, #1a)"	"$700 copay per admit (PBP Section B-01,#1b)"	"$130 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)"	"$100 copay (PBP Section B-09,#9a & #9b)"	"$25 copay (PBP Section B-08,#8a)"	"$35 copay (PBP Section B-08,#8b)"	"$35 copay (PBP Section B-05,#5)"	"$35 copay (PBP Section B-12, #12)"	"$35 copay (PBP Sections B-03, #3; B-09, #9c & #9d)"	"$25 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$35 copay (PBP Section B-07,#7b, #7d & #7f)"	"$35 copay (PBP Section B-07,#7e & #7h)"	"$35 copay (PBP Section B-07,#7c & #7i)"	"$35 copay (PBP Section B-07,#7d)"	"$35 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h, #14i & #14j)"	"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-14, #14a)"	"Full body skin exam (once per lifetime PBP Section B-14, #14c)"											700	700	130	0	50	0.125	0.125	50	100	25	35	35	35	35	25	35	35	35	35	35	0	0	0	0	0	0	0	0	0	35											589.0066414	589.0066414	109.3869477	0	42.07190296	0.105179757	0.105179757	42.07190296	84.14380591	21.03595148	29.45033207	29.45033207	29.45033207	29.45033207	21.03595148	29.45033207	29.45033207	29.45033207	29.45033207	29.45033207	0	0	0	0	0	0	0	0	0	29.45033207											6.317	0.095078065	3.976960742	0	0.602170563	0.724057346	0.153278269	0.316471483	3.771499975	1.31288173	1.422708168	0	0.038165772	1.124917906	5.865620556	3.104730564	0.406259764	0.464220441	1.912738023	12.87963533	0	0	0	0	0	0	0	0	0	0.057498267	0	0	0	0	0	0	0	0	0	0	44.5459	0	8.3943	6.317	0.095078065	3.976960742	0	0.602170563	0.724057346	0.153278269	0.316471483	3.771499975	1.31288173	1.422708168	0	0.038165772	1.124917906	5.865620556	3.104730564	0.406259764	0.464220441	1.912738023	12.87963533	0	0	0	0	0	0	0	0	0	0.057498267	0	0	0	0	0	0	0	0	0	0	44.5459																																																																																		0	0	0	6.317	0.095078065	3.976960742	0	0.602170563	0.724057346	0.153278269	0.316471483	3.771499975	1.31288173	1.422708168	0	0.038165772	1.124917906	5.865620556	3.104730564	0.406259764	0.464220441	1.912738023	12.87963533	0	0	0	0	0	0	0	0	0	0.057498267	0	0	0	0	0	0	0	0	0	0	44.5459
H2319_008_4	2009	8																					4000											A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	V	V	V	O	O																																																			0	n/a	151.2194461	2.276030194	512.6295991	123.5104793	201.8111904	8.088675854	1.712320493	106.0621203	631.9894611	879.9972665	681.1511707	0	18.27265849	538.57788	3931.603233	1486.45443	194.5053244	222.255206	915.7631716	6166.393703	437.7457915	772.5124171	0	1362.9	0	0	0	0	0	23.42857143											"$700 copay per admit (PBP Section B-01, #1a)"	"$700 copay per admit (PBP Section B-01,#1b)"	"$130 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)"	"$100 copay (PBP Section B-09,#9a & #9b)"	"$25 copay (PBP Section B-08,#8a)"	"$35 copay (PBP Section B-08,#8b)"	"$35 copay (PBP Section B-05,#5)"	"$35 copay (PBP Section B-12, #12)"	"$35 copay (PBP Sections B-03, #3; B-09, #9c & #9d)"	"$25 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$35 copay (PBP Section B-07,#7b, #7d & #7f)"	"$35 copay (PBP Section B-07,#7e & #7h)"	"$35 copay (PBP Section B-07,#7c & #7i)"	"$35 copay (PBP Section B-07,#7d)"	"$35 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h, #14i & #14j)"	"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-14, #14a)"	"Full body skin exam (once per lifetime PBP Section B-14, #14c)"											700	700	130	0	50	0.125	0.125	50	100	25	35	35	35	35	25	35	35	35	35	35	0	0	0	0	0	0	0	0	0	35											589.0066414	589.0066414	109.3869477	0	42.07190296	0.105179757	0.105179757	42.07190296	84.14380591	21.03595148	29.45033207	29.45033207	29.45033207	29.45033207	21.03595148	29.45033207	29.45033207	29.45033207	29.45033207	29.45033207	0	0	0	0	0	0	0	0	0	29.45033207											7.4224	0.111716408	4.672915595	0	0.707548401	0.850764964	0.180101454	0.371852936	4.431499879	1.54263165	1.671677347	0	0.044844655	1.321774784	6.892084571	3.648048048	0.477353866	0.545457468	2.247460792	15.13352852	0	0	0	0	0	0	0	0	0	0.057498267	0	0	0	0	0	0	0	0	0	0	52.3312	0	9.8614	7.4224	0.111716408	4.672915595	0	0.707548401	0.850764964	0.180101454	0.371852936	4.431499879	1.54263165	1.671677347	0	0.044844655	1.321774784	6.892084571	3.648048048	0.477353866	0.545457468	2.247460792	15.13352852	0	0	0	0	0	0	0	0	0	0.057498267	0	0	0	0	0	0	0	0	0	0	52.3312																																																																																		0	0	0	7.4224	0.111716408	4.672915595	0	0.707548401	0.850764964	0.180101454	0.371852936	4.431499879	1.54263165	1.671677347	0	0.044844655	1.321774784	6.892084571	3.648048048	0.477353866	0.545457468	2.247460792	15.13352852	0	0	0	0	0	0	0	0	0	0.057498267	0	0	0	0	0	0	0	0	0	0	52.3312
H2319_008_5	2009	8																					4000											A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	V	V	V	O	O																																																			0	n/a	158.4259152	2.384496015	537.0593234	129.3964581	211.4286447	8.474147394	1.793922331	111.1165852	662.1073636	921.9341554	713.6119091	0	19.14345489	564.2441878	4118.966552	1557.292462	203.7746125	232.8469343	959.4045099	6460.257534	458.6068752	809.3270399	0	1362.9	0	0	0	0	0	23.42857143											"$700 copay per admit (PBP Section B-01, #1a)"	"$700 copay per admit (PBP Section B-01,#1b)"	"$130 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)"	"$100 copay (PBP Section B-09,#9a & #9b)"	"$25 copay (PBP Section B-08,#8a)"	"$35 copay (PBP Section B-08,#8b)"	"$35 copay (PBP Section B-05,#5)"	"$35 copay (PBP Section B-12, #12)"	"$35 copay (PBP Sections B-03, #3; B-09, #9c & #9d)"	"$25 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$35 copay (PBP Section B-07,#7b, #7d & #7f)"	"$35 copay (PBP Section B-07,#7e & #7h)"	"$35 copay (PBP Section B-07,#7c & #7i)"	"$35 copay (PBP Section B-07,#7d)"	"$35 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h, #14i & #14j)"	"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-14, #14a)"	"Full body skin exam (once per lifetime PBP Section B-14, #14c)"											700	700	130	0	50	0.125	0.125	50	100	25	35	35	35	35	25	35	35	35	35	35	0	0	0	0	0	0	0	0	0	35											589.0066414	589.0066414	109.3869477	0	42.07190296	0.105179757	0.105179757	42.07190296	84.14380591	21.03595148	29.45033207	29.45033207	29.45033207	29.45033207	21.03595148	29.45033207	29.45033207	29.45033207	29.45033207	29.45033207	0	0	0	0	0	0	0	0	0	29.45033207											7.7762	0.117040332	4.895606676	0	0.741267118	0.891308767	0.188684316	0.389573849	4.642686124	1.616146847	1.751342308	0	0.046981759	1.384764892	7.220531711	3.821898345	0.5001025	0.571451628	2.354565117	15.85472747	0	0	0	0	0	0	0	0	0	0.057498267	0	0	0	0	0	0	0	0	0	0	54.8223	0	10.3308	7.7762	0.117040332	4.895606676	0	0.741267118	0.891308767	0.188684316	0.389573849	4.642686124	1.616146847	1.751342308	0	0.046981759	1.384764892	7.220531711	3.821898345	0.5001025	0.571451628	2.354565117	15.85472747	0	0	0	0	0	0	0	0	0	0.057498267	0	0	0	0	0	0	0	0	0	0	54.8223																																																																																		0	0	0	7.7762	0.117040332	4.895606676	0	0.741267118	0.891308767	0.188684316	0.389573849	4.642686124	1.616146847	1.751342308	0	0.046981759	1.384764892	7.220531711	3.821898345	0.5001025	0.571451628	2.354565117	15.85472747	0	0	0	0	0	0	0	0	0	0.057498267	0	0	0	0	0	0	0	0	0	0	54.8223
H2319_008_7	2009	9																					4000											A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	V	V	V	O	O																																																			0	n/a	183.2299873	2.757826419	621.1444186	149.6555115	244.5311288	9.800908628	2.074789125	128.5136366	765.7706988	1066.277467	825.3390921	0	22.14066424	652.5855017	4763.855635	1801.111123	235.6787373	269.3027889	1109.614396	7471.712594	530.4090041	936.0399341	0	1362.9	0	0	0	0	0	23.42857143											"$700 copay per admit (PBP Section B-01, #1a)"	"$700 copay per admit (PBP Section B-01,#1b)"	"$130 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)"	"$100 copay (PBP Section B-09,#9a & #9b)"	"$25 copay (PBP Section B-08,#8a)"	"$35 copay (PBP Section B-08,#8b)"	"$35 copay (PBP Section B-05,#5)"	"$35 copay (PBP Section B-12, #12)"	"$35 copay (PBP Sections B-03, #3; B-09, #9c & #9d)"	"$25 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$35 copay (PBP Section B-07,#7b, #7d & #7f)"	"$35 copay (PBP Section B-07,#7e & #7h)"	"$35 copay (PBP Section B-07,#7c & #7i)"	"$35 copay (PBP Section B-07,#7d)"	"$35 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h, #14i & #14j)"	"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-14, #14a)"	"Full body skin exam (once per lifetime PBP Section B-14, #14c)"											700	700	130	0	50	0.125	0.125	50	100	25	35	35	35	35	25	35	35	35	35	35	0	0	0	0	0	0	0	0	0	35											589.0066414	589.0066414	109.3869477	0	42.07190296	0.105179757	0.105179757	42.07190296	84.14380591	21.03595148	29.45033207	29.45033207	29.45033207	29.45033207	21.03595148	29.45033207	29.45033207	29.45033207	29.45033207	29.45033207	0	0	0	0	0	0	0	0	0	29.45033207											8.9936	0.13536484	5.662091002	0	0.85732416	1.030857192	0.218225817	0.450567771	5.369571755	1.869180088	2.025542528	0	0.054337493	1.601571644	8.351019666	4.420276722	0.578401423	0.66092138	2.723209368	18.33703475	0	0	0	0	0	0	0	0	0	0.057498267	0	0	0	0	0	0	0	0	0	0	63.3966	0	11.9466	8.9936	0.13536484	5.662091002	0	0.85732416	1.030857192	0.218225817	0.450567771	5.369571755	1.869180088	2.025542528	0	0.054337493	1.601571644	8.351019666	4.420276722	0.578401423	0.66092138	2.723209368	18.33703475	0	0	0	0	0	0	0	0	0	0.057498267	0	0	0	0	0	0	0	0	0	0	63.3966																																																																																		0	0	0	8.9936	0.13536484	5.662091002	0	0.85732416	1.030857192	0.218225817	0.450567771	5.369571755	1.869180088	2.025542528	0	0.054337493	1.601571644	8.351019666	4.420276722	0.578401423	0.66092138	2.723209368	18.33703475	0	0	0	0	0	0	0	0	0	0.057498267	0	0	0	0	0	0	0	0	0	0	63.3966
H2319_008_8	2009	8																					4000											A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	V	V	V	O	O																																																			0	n/a	144.0677288	2.168388453	488.385482	117.6692198	192.2668056	7.706132972	1.631338633	101.0460571	602.1003823	838.378997	648.937056	0	17.40847805	513.1065744	3745.663426	1416.154597	185.3064606	211.7439495	872.4534025	5874.762531	417.0432019	735.9774969	0	1362.9	0	0	0	0	0	23.42857143											"$700 copay per admit (PBP Section B-01, #1a)"	"$700 copay per admit (PBP Section B-01,#1b)"	"$130 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)"	"$100 copay (PBP Section B-09,#9a & #9b)"	"$25 copay (PBP Section B-08,#8a)"	"$35 copay (PBP Section B-08,#8b)"	"$35 copay (PBP Section B-05,#5)"	"$35 copay (PBP Section B-12, #12)"	"$35 copay (PBP Sections B-03, #3; B-09, #9c & #9d)"	"$25 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$35 copay (PBP Section B-07,#7b, #7d & #7f)"	"$35 copay (PBP Section B-07,#7e & #7h)"	"$35 copay (PBP Section B-07,#7c & #7i)"	"$35 copay (PBP Section B-07,#7d)"	"$35 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h, #14i & #14j)"	"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-14, #14a)"	"Full body skin exam (once per lifetime PBP Section B-14, #14c)"											700	700	130	0	50	0.125	0.125	50	100	25	35	35	35	35	25	35	35	35	35	35	0	0	0	0	0	0	0	0	0	35											589.0066414	589.0066414	109.3869477	0	42.07190296	0.105179757	0.105179757	42.07190296	84.14380591	21.03595148	29.45033207	29.45033207	29.45033207	29.45033207	21.03595148	29.45033207	29.45033207	29.45033207	29.45033207	29.45033207	0	0	0	0	0	0	0	0	0	29.45033207											7.0714	0.106432933	4.451916431	0	0.674085866	0.810529196	0.171583802	0.354266659	4.221918142	1.469674992	1.592617649	0	0.042723788	1.25926325	6.56613284	3.475518596	0.454778067	0.519660802	2.141170202	14.41780895	0	0	0	0	0	0	0	0	0	0.057498267	0	0	0	0	0	0	0	0	0	0	49.859	0	9.3955	7.0714	0.106432933	4.451916431	0	0.674085866	0.810529196	0.171583802	0.354266659	4.221918142	1.469674992	1.592617649	0	0.042723788	1.25926325	6.56613284	3.475518596	0.454778067	0.519660802	2.141170202	14.41780895	0	0	0	0	0	0	0	0	0	0.057498267	0	0	0	0	0	0	0	0	0	0	49.859																																																																																		0	0	0	7.0714	0.106432933	4.451916431	0	0.674085866	0.810529196	0.171583802	0.354266659	4.221918142	1.469674992	1.592617649	0	0.042723788	1.25926325	6.56613284	3.475518596	0.454778067	0.519660802	2.141170202	14.41780895	0	0	0	0	0	0	0	0	0	0.057498267	0	0	0	0	0	0	0	0	0	0	49.859
H2319_009_1	2009	8																					3500											A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	V	V	V	O	O																																																			0	n/a	180.5810886	1.717802902	608.8245068	146.687212	239.6810459	9.11792219	2.522230424	125.9646696	750.5822384	1038.887648	759.5681366	0	3.086867792	695.4392223	4697.09917	1949.829342	176.9491131	232.3998512	1116.225746	7233.528903	519.8887581	917.4743171	0	1362.9	0	0	0	0	0	24.30714286											"$500 copay per admit (PBP Section B-01, #1a)"	"$500 copay per admit (PBP Section B-01,#1b)"	"$130 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)"	"$100 copay (PBP Section B-09,#9a & #9b)"	"$15 copay (PBP Section B-08,#8a)"	"$30 copay (PBP Section B-08,#8b)"	"$30 copay (PBP Section B-05,#5)"	"$30 copay (PBP Section B-12, #12)"	"$30 copay (PBP Sections B-03, #3; B-09, #9c & #9d)"	"$15 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$30 copay (PBP Section B-07,#7b, #7d & #7f)"	"$30 copay (PBP Section B-07,#7e & #7h)"	"$30 copay (PBP Section B-07,#7c & #7i)"	"$30 copay (PBP Section B-07,#7d)"	"$30 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h, #14i & #14j)"	"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-14, #14a)"	"Full body skin exam (once per lifetime PBP Section B-14, #14c)"											500	500	130	0	50	0.015	0.015	50	100	15	30	30	30	30	15	30	30	30	30	30	0	0	0	0	0	0	0	0	0	30											423.0570529	423.0570529	109.9948337	0	42.30570529	0.012691712	0.012691712	42.30570529	84.61141058	12.69171159	25.38342317	25.38342317	25.38342317	25.38342317	12.69171159	25.38342317	25.38342317	25.38342317	25.38342317	25.38342317	0	0	0	0	0	0	0	0	0	25.38342317											6.3663	0.060560719	5.580629201	0	0.844989641	0.115722039	0.032011421	0.444085349	5.292318496	1.098771866	1.606703287	0	0.006529606	1.471052339	4.96785233	4.124445275	0.374297851	0.491591981	2.361135872	15.3009771	0	0	0	0	0	0	0	0	0	0.051416541	0	0	0	0	0	0	0	0	0	0	50.5914	0	9.2013	6.3663	0.060560719	5.580629201	0	0.844989641	0.115722039	0.032011421	0.444085349	5.292318496	1.098771866	1.606703287	0	0.006529606	1.471052339	4.96785233	4.124445275	0.374297851	0.491591981	2.361135872	15.3009771	0	0	0	0	0	0	0	0	0	0.051416541	0	0	0	0	0	0	0	0	0	0	50.5914																																																																																		0	0	0	6.3663	0.060560719	5.580629201	0	0.844989641	0.115722039	0.032011421	0.444085349	5.292318496	1.098771866	1.606703287	0	0.006529606	1.471052339	4.96785233	4.124445275	0.374297851	0.491591981	2.361135872	15.3009771	0	0	0	0	0	0	0	0	0	0.051416541	0	0	0	0	0	0	0	0	0	0	50.5914
H2319_009_2	2009	8																					3500											A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	V	V	V	O	O																																																			0	n/a	187.317017	1.781879364	631.5345166	152.1588511	248.6214857	9.458033502	2.616313163	130.6633288	778.5800108	1077.639617	787.9010956	0	3.202012299	721.3800827	4872.30757	2022.560717	183.5495637	241.0686923	1157.862535	7503.349697	539.2813394	951.6973985	0	1362.9	0	0	0	0	0	24.30714286											"$500 copay per admit (PBP Section B-01, #1a)"	"$500 copay per admit (PBP Section B-01,#1b)"	"$130 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)"	"$100 copay (PBP Section B-09,#9a & #9b)"	"$15 copay (PBP Section B-08,#8a)"	"$30 copay (PBP Section B-08,#8b)"	"$30 copay (PBP Section B-05,#5)"	"$30 copay (PBP Section B-12, #12)"	"$30 copay (PBP Sections B-03, #3; B-09, #9c & #9d)"	"$15 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$30 copay (PBP Section B-07,#7b, #7d & #7f)"	"$30 copay (PBP Section B-07,#7e & #7h)"	"$30 copay (PBP Section B-07,#7c & #7i)"	"$30 copay (PBP Section B-07,#7d)"	"$30 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h, #14i & #14j)"	"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-14, #14a)"	"Full body skin exam (once per lifetime PBP Section B-14, #14c)"											500	500	130	0	50	0.015	0.015	50	100	15	30	30	30	30	15	30	30	30	30	30	0	0	0	0	0	0	0	0	0	30											423.0570529	423.0570529	109.9948337	0	42.30570529	0.012691712	0.012691712	42.30570529	84.61141058	12.69171159	25.38342317	25.38342317	25.38342317	25.38342317	12.69171159	25.38342317	25.38342317	25.38342317	25.38342317	25.38342317	0	0	0	0	0	0	0	0	0	25.38342317											6.6038	0.062819719	5.788794513	0	0.876508942	0.120038633	0.033205492	0.460650357	5.489729413	1.139757601	1.666635577	0	0.006773169	1.525924659	5.153160204	4.27829288	0.388259687	0.509929052	2.449209558	15.87172505	0	0	0	0	0	0	0	0	0	0.051416541	0	0	0	0	0	0	0	0	0	0	52.4766	0	9.5441	6.6038	0.062819719	5.788794513	0	0.876508942	0.120038633	0.033205492	0.460650357	5.489729413	1.139757601	1.666635577	0	0.006773169	1.525924659	5.153160204	4.27829288	0.388259687	0.509929052	2.449209558	15.87172505	0	0	0	0	0	0	0	0	0	0.051416541	0	0	0	0	0	0	0	0	0	0	52.4766																																																																																		0	0	0	6.6038	0.062819719	5.788794513	0	0.876508942	0.120038633	0.033205492	0.460650357	5.489729413	1.139757601	1.666635577	0	0.006773169	1.525924659	5.153160204	4.27829288	0.388259687	0.509929052	2.449209558	15.87172505	0	0	0	0	0	0	0	0	0	0.051416541	0	0	0	0	0	0	0	0	0	0	52.4766
H2319_009_3	2009	8																					3500											A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	V	V	V	O	O																																																			0	n/a	179.457992	1.707119288	605.0380155	145.7749132	238.1903861	9.061214662	2.506543796	125.1812515	745.9141065	1032.426444	754.8441183	0	3.067669488	691.114044	4667.886277	1937.702675	175.848605	230.9544757	1109.28355	7188.541072	516.6553892	911.7682253	0	1362.9	0	0	0	0	0	24.30714286											"$500 copay per admit (PBP Section B-01, #1a)"	"$500 copay per admit (PBP Section B-01,#1b)"	"$130 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)"	"$100 copay (PBP Section B-09,#9a & #9b)"	"$15 copay (PBP Section B-08,#8a)"	"$30 copay (PBP Section B-08,#8b)"	"$30 copay (PBP Section B-05,#5)"	"$30 copay (PBP Section B-12, #12)"	"$30 copay (PBP Sections B-03, #3; B-09, #9c & #9d)"	"$15 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$30 copay (PBP Section B-07,#7b, #7d & #7f)"	"$30 copay (PBP Section B-07,#7e & #7h)"	"$30 copay (PBP Section B-07,#7c & #7i)"	"$30 copay (PBP Section B-07,#7d)"	"$30 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h, #14i & #14j)"	"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-14, #14a)"	"Full body skin exam (once per lifetime PBP Section B-14, #14c)"											500	500	130	0	50	0.015	0.015	50	100	15	30	30	30	30	15	30	30	30	30	30	0	0	0	0	0	0	0	0	0	30											423.0570529	423.0570529	109.9948337	0	42.30570529	0.012691712	0.012691712	42.30570529	84.61141058	12.69171159	25.38342317	25.38342317	25.38342317	25.38342317	12.69171159	25.38342317	25.38342317	25.38342317	25.38342317	25.38342317	0	0	0	0	0	0	0	0	0	25.38342317											6.3267	0.060184071	5.545921328	0	0.839734356	0.115002323	0.031812331	0.441323428	5.259403727	1.091938222	1.59671064	0	0.006488996	1.461903353	4.936955529	4.098793916	0.371969963	0.488534599	2.346451147	15.205815	0	0	0	0	0	0	0	0	0	0.051416541	0	0	0	0	0	0	0	0	0	0	50.2771	0	9.1441	6.3267	0.060184071	5.545921328	0	0.839734356	0.115002323	0.031812331	0.441323428	5.259403727	1.091938222	1.59671064	0	0.006488996	1.461903353	4.936955529	4.098793916	0.371969963	0.488534599	2.346451147	15.205815	0	0	0	0	0	0	0	0	0	0.051416541	0	0	0	0	0	0	0	0	0	0	50.2771																																																																																		0	0	0	6.3267	0.060184071	5.545921328	0	0.839734356	0.115002323	0.031812331	0.441323428	5.259403727	1.091938222	1.59671064	0	0.006488996	1.461903353	4.936955529	4.098793916	0.371969963	0.488534599	2.346451147	15.205815	0	0	0	0	0	0	0	0	0	0.051416541	0	0	0	0	0	0	0	0	0	0	50.2771
H2319_009_4	2009	8																					3500											A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	V	V	V	O	O																																																			0	n/a	198.7942837	1.891058472	670.2298268	161.4819107	263.8549928	10.03754504	2.776619603	138.6693172	826.2850756	1143.668628	836.1772809	0	3.398205628	765.5804001	5170.843039	2146.486824	194.7959914	255.8394255	1228.806955	7963.094077	572.3241236	1010.009692	0	1362.9	0	0	0	0	0	24.30714286											"$500 copay per admit (PBP Section B-01, #1a)"	"$500 copay per admit (PBP Section B-01,#1b)"	"$130 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)"	"$100 copay (PBP Section B-09,#9a & #9b)"	"$15 copay (PBP Section B-08,#8a)"	"$30 copay (PBP Section B-08,#8b)"	"$30 copay (PBP Section B-05,#5)"	"$30 copay (PBP Section B-12, #12)"	"$30 copay (PBP Sections B-03, #3; B-09, #9c & #9d)"	"$15 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$30 copay (PBP Section B-07,#7b, #7d & #7f)"	"$30 copay (PBP Section B-07,#7e & #7h)"	"$30 copay (PBP Section B-07,#7c & #7i)"	"$30 copay (PBP Section B-07,#7d)"	"$30 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h, #14i & #14j)"	"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-14, #14a)"	"Full body skin exam (once per lifetime PBP Section B-14, #14c)"											500	500	130	0	50	0.015	0.015	50	100	15	30	30	30	30	15	30	30	30	30	30	0	0	0	0	0	0	0	0	0	30											423.0570529	423.0570529	109.9948337	0	42.30570529	0.012691712	0.012691712	42.30570529	84.61141058	12.69171159	25.38342317	25.38342317	25.38342317	25.38342317	12.69171159	25.38342317	25.38342317	25.38342317	25.38342317	25.38342317	0	0	0	0	0	0	0	0	0	25.38342317											7.0084	0.066668802	6.143484865	0	0.930214297	0.127393627	0.035240055	0.488875272	5.826095482	1.209592698	1.768753481	0	0.007188174	1.619420939	5.468904043	4.54043195	0.41204909	0.541173367	2.599277244	16.84421556	0	0	0	0	0	0	0	0	0	0.051416541	0	0	0	0	0	0	0	0	0	0	55.6888	0	10.1283	7.0084	0.066668802	6.143484865	0	0.930214297	0.127393627	0.035240055	0.488875272	5.826095482	1.209592698	1.768753481	0	0.007188174	1.619420939	5.468904043	4.54043195	0.41204909	0.541173367	2.599277244	16.84421556	0	0	0	0	0	0	0	0	0	0.051416541	0	0	0	0	0	0	0	0	0	0	55.6888																																																																																		0	0	0	7.0084	0.066668802	6.143484865	0	0.930214297	0.127393627	0.035240055	0.488875272	5.826095482	1.209592698	1.768753481	0	0.007188174	1.619420939	5.468904043	4.54043195	0.41204909	0.541173367	2.599277244	16.84421556	0	0	0	0	0	0	0	0	0	0.051416541	0	0	0	0	0	0	0	0	0	0	55.6888
H2319_009_5	2009	8																					3500											A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	V	V	V	O	O																																																			0	n/a	204.7856001	1.948051708	690.4293964	166.3486967	271.8071267	10.34005932	2.860302123	142.848571	851.1878809	1178.136825	861.3782202	0	3.500621678	788.6536714	5326.683319	2211.17823	200.6668062	263.549984	1265.841075	8203.087981	589.5729844	1040.44964	0	1362.9	0	0	0	0	0	24.30714286											"$500 copay per admit (PBP Section B-01, #1a)"	"$500 copay per admit (PBP Section B-01,#1b)"	"$130 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)"	"$100 copay (PBP Section B-09,#9a & #9b)"	"$15 copay (PBP Section B-08,#8a)"	"$30 copay (PBP Section B-08,#8b)"	"$30 copay (PBP Section B-05,#5)"	"$30 copay (PBP Section B-12, #12)"	"$30 copay (PBP Sections B-03, #3; B-09, #9c & #9d)"	"$15 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$30 copay (PBP Section B-07,#7b, #7d & #7f)"	"$30 copay (PBP Section B-07,#7e & #7h)"	"$30 copay (PBP Section B-07,#7c & #7i)"	"$30 copay (PBP Section B-07,#7d)"	"$30 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h, #14i & #14j)"	"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-14, #14a)"	"Full body skin exam (once per lifetime PBP Section B-14, #14c)"											500	500	130	0	50	0.015	0.015	50	100	15	30	30	30	30	15	30	30	30	30	30	0	0	0	0	0	0	0	0	0	30											423.0570529	423.0570529	109.9948337	0	42.30570529	0.012691712	0.012691712	42.30570529	84.61141058	12.69171159	25.38342317	25.38342317	25.38342317	25.38342317	12.69171159	25.38342317	25.38342317	25.38342317	25.38342317	25.38342317	0	0	0	0	0	0	0	0	0	25.38342317											7.2197	0.068678085	6.32863889	0	0.95824935	0.131233051	0.03630213	0.503609129	6.001683939	1.246047733	1.822060656	0	0.007404813	1.66822749	5.633727367	4.677272728	0.424467538	0.557483398	2.677614972	17.35187113	0	0	0	0	0	0	0	0	0	0.051416541	0	0	0	0	0	0	0	0	0	0	57.3657	0	10.4333	7.2197	0.068678085	6.32863889	0	0.95824935	0.131233051	0.03630213	0.503609129	6.001683939	1.246047733	1.822060656	0	0.007404813	1.66822749	5.633727367	4.677272728	0.424467538	0.557483398	2.677614972	17.35187113	0	0	0	0	0	0	0	0	0	0.051416541	0	0	0	0	0	0	0	0	0	0	57.3657																																																																																		0	0	0	7.2197	0.068678085	6.32863889	0	0.95824935	0.131233051	0.03630213	0.503609129	6.001683939	1.246047733	1.822060656	0	0.007404813	1.66822749	5.633727367	4.677272728	0.424467538	0.557483398	2.677614972	17.35187113	0	0	0	0	0	0	0	0	0	0.051416541	0	0	0	0	0	0	0	0	0	0	57.3657
H2319_009_6	2009	8																					3500											A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	V	V	V	O	O																																																			0	n/a	249.2549013	2.371072165	840.3565044	202.471404	330.8301877	12.58540866	3.481418239	173.8682136	1036.023779	1433.969859	1048.426956	0	4.260783523	959.9102325	6483.375415	2691.336751	244.2417091	320.7800021	1540.719132	9984.392868	717.5990692	1266.383829	0	1362.9	0	0	0	0	0	24.30714286											"$500 copay per admit (PBP Section B-01, #1a)"	"$500 copay per admit (PBP Section B-01,#1b)"	"$130 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)"	"$100 copay (PBP Section B-09,#9a & #9b)"	"$15 copay (PBP Section B-08,#8a)"	"$30 copay (PBP Section B-08,#8b)"	"$30 copay (PBP Section B-05,#5)"	"$30 copay (PBP Section B-12, #12)"	"$30 copay (PBP Sections B-03, #3; B-09, #9c & #9d)"	"$15 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$30 copay (PBP Section B-07,#7b, #7d & #7f)"	"$30 copay (PBP Section B-07,#7e & #7h)"	"$30 copay (PBP Section B-07,#7c & #7i)"	"$30 copay (PBP Section B-07,#7d)"	"$30 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h, #14i & #14j)"	"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-14, #14a)"	"Full body skin exam (once per lifetime PBP Section B-14, #14c)"											500	500	130	0	50	0.015	0.015	50	100	15	30	30	30	30	15	30	30	30	30	30	0	0	0	0	0	0	0	0	0	30											423.0570529	423.0570529	109.9948337	0	42.30570529	0.012691712	0.012691712	42.30570529	84.61141058	12.69171159	25.38342317	25.38342317	25.38342317	25.38342317	12.69171159	25.38342317	25.38342317	25.38342317	25.38342317	25.38342317	0	0	0	0	0	0	0	0	0	25.38342317											8.7874	0.083591567	7.702906166	0	1.166333702	0.159730377	0.044185156	0.612968117	7.304952776	1.516627656	2.21772209	0	0.009012773	2.03048397	6.857094239	5.69294497	0.516640888	0.678541212	3.259060477	21.11983911	0	0	0	0	0	0	0	0	0	0.051416541	0	0	0	0	0	0	0	0	0	0	69.8115	0	12.6969	8.7874	0.083591567	7.702906166	0	1.166333702	0.159730377	0.044185156	0.612968117	7.304952776	1.516627656	2.21772209	0	0.009012773	2.03048397	6.857094239	5.69294497	0.516640888	0.678541212	3.259060477	21.11983911	0	0	0	0	0	0	0	0	0	0.051416541	0	0	0	0	0	0	0	0	0	0	69.8115																																																																																		0	0	0	8.7874	0.083591567	7.702906166	0	1.166333702	0.159730377	0.044185156	0.612968117	7.304952776	1.516627656	2.21772209	0	0.009012773	2.03048397	6.857094239	5.69294497	0.516640888	0.678541212	3.259060477	21.11983911	0	0	0	0	0	0	0	0	0	0.051416541	0	0	0	0	0	0	0	0	0	0	69.8115
H2319_010_1	2009	8																					3000											A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	V	V	V	O	O																																																			0	n/a	182.5006525	1.614428849	614.890045	148.1486132	242.0689171	9.454569751	2.301550255	127.2196183	758.0600669	1034.364039	729.7120941	0	10.80293648	743.1415374	4576.360816	1905.335452	179.4638146	267.6191239	1079.385951	7473.521769	525.0682558	926.6148419	0	1362.9	0	0	0	0	0	24.55119048											"$300 copay per admit (PBP Section B-01, #1a)"	"$300 copay per admit (PBP Section B-01,#1b)"	"$130 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)"	"$50 copay (PBP Section B-09,#9a & #9b)"	"$10 copay (PBP Section B-08,#8a)"	"$20 copay (PBP Section B-08,#8b)"	"$20 copay (PBP Section B-05,#5)"	"$20 copay (PBP Section B-12, #12)"	"$20 copay (PBP Sections B-03, #3; B-09, #9c & #9d)"	"$10 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$20 copay (PBP Section B-07,#7b, #7d & #7f)"	"$20 copay (PBP Section B-07,#7e & #7h)"	"$20 copay (PBP Section B-07,#7c & #7i)"	"$20 copay (PBP Section B-07,#7d)"	"$20 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h, #14i & #14j)"	"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-14, #14a)"	"Full body skin exam (once per lifetime PBP Section B-14, #14c)"											300	300	130	0	50	0.015	0.015	50	50	10	20	20	20	20	10	20	20	20	20	20	0	0	0	0	0	0	0	0	0	20											261.691771	261.691771	113.3997675	0	43.61529517	0.013084589	0.013084589	43.61529517	43.61529517	8.723059035	17.44611807	17.44611807	17.44611807	17.44611807	8.723059035	17.44611807	17.44611807	17.44611807	17.44611807	17.44611807	0	0	0	0	0	0	0	0	0	17.44611807											3.9799	0.035206895	5.810699009	0	0.879825606	0.123709155	0.030114838	0.462393434	2.755251131	0.751901548	1.060886946	0	0.015705775	1.08041125	3.326655464	2.770058938	0.260912242	0.389076236	1.569257896	10.8653286	0	0	0	0	0	0	0	0	0	0.035693581	0	0	0	0	0	0	0	0	0	0	36.203	0	5.2996	3.9799	0.035206895	5.810699009	0	0.879825606	0.123709155	0.030114838	0.462393434	2.755251131	0.751901548	1.060886946	0	0.015705775	1.08041125	3.326655464	2.770058938	0.260912242	0.389076236	1.569257896	10.8653286	0	0	0	0	0	0	0	0	0	0.035693581	0	0	0	0	0	0	0	0	0	0	36.203																																																																																		0	0	0	3.9799	0.035206895	5.810699009	0	0.879825606	0.123709155	0.030114838	0.462393434	2.755251131	0.751901548	1.060886946	0	0.015705775	1.08041125	3.326655464	2.770058938	0.260912242	0.389076236	1.569257896	10.8653286	0	0	0	0	0	0	0	0	0	0.035693581	0	0	0	0	0	0	0	0	0	0	36.203
H2319_010_2	2009	8																					3000											A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	V	V	V	O	O																																																			0	n/a	193.8904297	1.71518457	653.2650344	157.3944962	257.1763208	10.04462486	2.445188889	135.1593329	805.3702278	1098.918196	775.2530718	0	11.4771425	789.5206401	4861.969274	2024.246513	190.6640642	284.3211035	1146.749905	7939.940636	557.8375108	984.4444245	0	1362.9	0	0	0	0	0	24.55119048											"$300 copay per admit (PBP Section B-01, #1a)"	"$300 copay per admit (PBP Section B-01,#1b)"	"$130 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)"	"$50 copay (PBP Section B-09,#9a & #9b)"	"$10 copay (PBP Section B-08,#8a)"	"$20 copay (PBP Section B-08,#8b)"	"$20 copay (PBP Section B-05,#5)"	"$20 copay (PBP Section B-12, #12)"	"$20 copay (PBP Sections B-03, #3; B-09, #9c & #9d)"	"$10 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$20 copay (PBP Section B-07,#7b, #7d & #7f)"	"$20 copay (PBP Section B-07,#7e & #7h)"	"$20 copay (PBP Section B-07,#7c & #7i)"	"$20 copay (PBP Section B-07,#7d)"	"$20 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h, #14i & #14j)"	"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-14, #14a)"	"Full body skin exam (once per lifetime PBP Section B-14, #14c)"											300	300	130	0	50	0.015	0.015	50	50	10	20	20	20	20	10	20	20	20	20	20	0	0	0	0	0	0	0	0	0	20											261.691771	261.691771	113.3997675	0	43.61529517	0.013084589	0.013084589	43.61529517	43.61529517	8.723059035	17.44611807	17.44611807	17.44611807	17.44611807	8.723059035	17.44611807	17.44611807	17.44611807	17.44611807	17.44611807	0	0	0	0	0	0	0	0	0	17.44611807											4.2283	0.037404141	6.173341915	0	0.934735095	0.131429783	0.031994291	0.491251183	2.927205017	0.798827358	1.127096385	0	0.016685965	1.147839192	3.534270417	2.942936972	0.277195648	0.413358295	1.66719452	11.54342848	0	0	0	0	0	0	0	0	0	0.035693581	0	0	0	0	0	0	0	0	0	0	38.4602	0	5.6301	4.2283	0.037404141	6.173341915	0	0.934735095	0.131429783	0.031994291	0.491251183	2.927205017	0.798827358	1.127096385	0	0.016685965	1.147839192	3.534270417	2.942936972	0.277195648	0.413358295	1.66719452	11.54342848	0	0	0	0	0	0	0	0	0	0.035693581	0	0	0	0	0	0	0	0	0	0	38.4602																																																																																		0	0	0	4.2283	0.037404141	6.173341915	0	0.934735095	0.131429783	0.031994291	0.491251183	2.927205017	0.798827358	1.127096385	0	0.016685965	1.147839192	3.534270417	2.942936972	0.277195648	0.413358295	1.66719452	11.54342848	0	0	0	0	0	0	0	0	0	0.035693581	0	0	0	0	0	0	0	0	0	0	38.4602
H2319_010_3	2009	8																					3000											A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	V	V	V	O	O																																																			0	n/a	186.0526224	1.645850121	626.8575142	151.0319969	246.780251	9.638581955	2.346344819	129.6956656	772.8140226	1054.495637	743.9143195	0	11.01319165	757.605137	4665.429517	1942.418575	182.9566792	272.8277358	1100.393802	7618.977273	535.2875433	944.649342	0	1362.9	0	0	0	0	0	24.55119048											"$300 copay per admit (PBP Section B-01, #1a)"	"$300 copay per admit (PBP Section B-01,#1b)"	"$130 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)"	"$50 copay (PBP Section B-09,#9a & #9b)"	"$10 copay (PBP Section B-08,#8a)"	"$20 copay (PBP Section B-08,#8b)"	"$20 copay (PBP Section B-05,#5)"	"$20 copay (PBP Section B-12, #12)"	"$20 copay (PBP Sections B-03, #3; B-09, #9c & #9d)"	"$10 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$20 copay (PBP Section B-07,#7b, #7d & #7f)"	"$20 copay (PBP Section B-07,#7e & #7h)"	"$20 copay (PBP Section B-07,#7c & #7i)"	"$20 copay (PBP Section B-07,#7d)"	"$20 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h, #14i & #14j)"	"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-14, #14a)"	"Full body skin exam (once per lifetime PBP Section B-14, #14c)"											300	300	130	0	50	0.015	0.015	50	50	10	20	20	20	20	10	20	20	20	20	20	0	0	0	0	0	0	0	0	0	20											261.691771	261.691771	113.3997675	0	43.61529517	0.013084589	0.013084589	43.61529517	43.61529517	8.723059035	17.44611807	17.44611807	17.44611807	17.44611807	8.723059035	17.44611807	17.44611807	17.44611807	17.44611807	17.44611807	0	0	0	0	0	0	0	0	0	17.44611807											4.0574	0.035892119	5.923791361	0	0.896949458	0.126116879	0.030700957	0.471392895	2.808875976	0.766535641	1.081534754	0	0.016011453	1.101439056	3.391401425	2.823971984	0.265990319	0.396648741	1.599800016	11.07679809	0	0	0	0	0	0	0	0	0	0.035693581	0	0	0	0	0	0	0	0	0	0	36.9069	0	5.4027	4.0574	0.035892119	5.923791361	0	0.896949458	0.126116879	0.030700957	0.471392895	2.808875976	0.766535641	1.081534754	0	0.016011453	1.101439056	3.391401425	2.823971984	0.265990319	0.396648741	1.599800016	11.07679809	0	0	0	0	0	0	0	0	0	0.035693581	0	0	0	0	0	0	0	0	0	0	36.9069																																																																																		0	0	0	4.0574	0.035892119	5.923791361	0	0.896949458	0.126116879	0.030700957	0.471392895	2.808875976	0.766535641	1.081534754	0	0.016011453	1.101439056	3.391401425	2.823971984	0.265990319	0.396648741	1.599800016	11.07679809	0	0	0	0	0	0	0	0	0	0.035693581	0	0	0	0	0	0	0	0	0	0	36.9069
H2319_010_4	2009	8																					3000											A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	V	V	V	O	O																																																			0	n/a	218.6985079	1.934640647	736.8496141	177.5329579	290.0817628	11.32982414	2.758048257	152.4528286	908.4165084	1239.523633	874.4458937	0	12.94563092	890.5389825	5484.053172	2283.246743	215.0593323	320.6996922	1293.475359	8955.847758	629.2122385	1110.403062	0	1362.9	0	0	0	0	0	24.55119048											"$300 copay per admit (PBP Section B-01, #1a)"	"$300 copay per admit (PBP Section B-01,#1b)"	"$130 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)"	"$50 copay (PBP Section B-09,#9a & #9b)"	"$10 copay (PBP Section B-08,#8a)"	"$20 copay (PBP Section B-08,#8b)"	"$20 copay (PBP Section B-05,#5)"	"$20 copay (PBP Section B-12, #12)"	"$20 copay (PBP Sections B-03, #3; B-09, #9c & #9d)"	"$10 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$20 copay (PBP Section B-07,#7b, #7d & #7f)"	"$20 copay (PBP Section B-07,#7e & #7h)"	"$20 copay (PBP Section B-07,#7c & #7i)"	"$20 copay (PBP Section B-07,#7d)"	"$20 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h, #14i & #14j)"	"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-14, #14a)"	"Full body skin exam (once per lifetime PBP Section B-14, #14c)"											300	300	130	0	50	0.015	0.015	50	50	10	20	20	20	20	10	20	20	20	20	20	0	0	0	0	0	0	0	0	0	20											261.691771	261.691771	113.3997675	0	43.61529517	0.013084589	0.013084589	43.61529517	43.61529517	8.723059035	17.44611807	17.44611807	17.44611807	17.44611807	8.723059035	17.44611807	17.44611807	17.44611807	17.44611807	17.44611807	0	0	0	0	0	0	0	0	0	17.44611807											4.7693	0.042189961	6.963214574	0	1.054333476	0.148246087	0.036087927	0.55410626	3.301737846	0.901036486	1.271307192	0	0.018820917	1.294704019	3.98647663	3.319482688	0.312662542	0.466247058	1.880510319	13.02039812	0	0	0	0	0	0	0	0	0	0.035693581	0	0	0	0	0	0	0	0	0	0	43.3766	0	6.3498	4.7693	0.042189961	6.963214574	0	1.054333476	0.148246087	0.036087927	0.55410626	3.301737846	0.901036486	1.271307192	0	0.018820917	1.294704019	3.98647663	3.319482688	0.312662542	0.466247058	1.880510319	13.02039812	0	0	0	0	0	0	0	0	0	0.035693581	0	0	0	0	0	0	0	0	0	0	43.3766																																																																																		0	0	0	4.7693	0.042189961	6.963214574	0	1.054333476	0.148246087	0.036087927	0.55410626	3.301737846	0.901036486	1.271307192	0	0.018820917	1.294704019	3.98647663	3.319482688	0.312662542	0.466247058	1.880510319	13.02039812	0	0	0	0	0	0	0	0	0	0.035693581	0	0	0	0	0	0	0	0	0	0	43.3766
H2319_010_5	2009	8																					3000											A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	V	V	V	O	O																																																			0	n/a	209.2356909	1.850931112	704.9670323	169.8513239	277.5302796	10.8395965	2.638710882	145.8563811	869.1104369	1185.890961	836.6096892	0	12.3854893	852.0064497	5246.764897	2184.453448	205.753978	306.8234086	1237.508262	8568.339177	601.9869943	1062.357279	0	1362.9	0	0	0	0	0	24.55119048											"$300 copay per admit (PBP Section B-01, #1a)"	"$300 copay per admit (PBP Section B-01,#1b)"	"$130 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)"	"$50 copay (PBP Section B-09,#9a & #9b)"	"$10 copay (PBP Section B-08,#8a)"	"$20 copay (PBP Section B-08,#8b)"	"$20 copay (PBP Section B-05,#5)"	"$20 copay (PBP Section B-12, #12)"	"$20 copay (PBP Sections B-03, #3; B-09, #9c & #9d)"	"$10 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$20 copay (PBP Section B-07,#7b, #7d & #7f)"	"$20 copay (PBP Section B-07,#7e & #7h)"	"$20 copay (PBP Section B-07,#7c & #7i)"	"$20 copay (PBP Section B-07,#7d)"	"$20 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h, #14i & #14j)"	"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-14, #14a)"	"Full body skin exam (once per lifetime PBP Section B-14, #14c)"											300	300	130	0	50	0.015	0.015	50	50	10	20	20	20	20	10	20	20	20	20	20	0	0	0	0	0	0	0	0	0	20											261.691771	261.691771	113.3997675	0	43.61529517	0.013084589	0.013084589	43.61529517	43.61529517	8.723059035	17.44611807	17.44611807	17.44611807	17.44611807	8.723059035	17.44611807	17.44611807	17.44611807	17.44611807	17.44611807	0	0	0	0	0	0	0	0	0	17.44611807											4.5629	0.040364453	6.661924794	0	1.008713755	0.14183166	0.034526446	0.53013076	3.158875687	0.862049739	1.216299285	0	0.018006559	1.23868376	3.813986661	3.175852731	0.299134016	0.446073118	1.799142937	12.45702141	0	0	0	0	0	0	0	0	0	0.035693581	0	0	0	0	0	0	0	0	0	0	41.5012	0	6.0752	4.5629	0.040364453	6.661924794	0	1.008713755	0.14183166	0.034526446	0.53013076	3.158875687	0.862049739	1.216299285	0	0.018006559	1.23868376	3.813986661	3.175852731	0.299134016	0.446073118	1.799142937	12.45702141	0	0	0	0	0	0	0	0	0	0.035693581	0	0	0	0	0	0	0	0	0	0	41.5012																																																																																		0	0	0	4.5629	0.040364453	6.661924794	0	1.008713755	0.14183166	0.034526446	0.53013076	3.158875687	0.862049739	1.216299285	0	0.018006559	1.23868376	3.813986661	3.175852731	0.299134016	0.446073118	1.799142937	12.45702141	0	0	0	0	0	0	0	0	0	0.035693581	0	0	0	0	0	0	0	0	0	0	41.5012
H2319_010_6	2009	8																					3000											A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	V	V	V	O	O																																																			0	n/a	269.9602078	2.388109531	909.5630184	219.1456845	358.0752961	13.98547118	3.404519253	188.1869139	1121.344228	1530.061	1079.411092	0	15.98001397	1099.27631	6769.484384	2818.426935	265.4680299	395.8698959	1596.658707	11055.04809	776.6960475	1370.675293	0	1362.9	0	0	0	0	0	24.55119048											"$300 copay per admit (PBP Section B-01, #1a)"	"$300 copay per admit (PBP Section B-01,#1b)"	"$130 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)"	"$50 copay (PBP Section B-09,#9a & #9b)"	"$10 copay (PBP Section B-08,#8a)"	"$20 copay (PBP Section B-08,#8b)"	"$20 copay (PBP Section B-05,#5)"	"$20 copay (PBP Section B-12, #12)"	"$20 copay (PBP Sections B-03, #3; B-09, #9c & #9d)"	"$10 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$20 copay (PBP Section B-07,#7b, #7d & #7f)"	"$20 copay (PBP Section B-07,#7e & #7h)"	"$20 copay (PBP Section B-07,#7c & #7i)"	"$20 copay (PBP Section B-07,#7d)"	"$20 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h, #14i & #14j)"	"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-14, #14a)"	"Full body skin exam (once per lifetime PBP Section B-14, #14c)"											300	300	130	0	50	0.015	0.015	50	50	10	20	20	20	20	10	20	20	20	20	20	0	0	0	0	0	0	0	0	0	20											261.691771	261.691771	113.3997675	0	43.61529517	0.013084589	0.013084589	43.61529517	43.61529517	8.723059035	17.44611807	17.44611807	17.44611807	17.44611807	8.723059035	17.44611807	17.44611807	17.44611807	17.44611807	17.44611807	0	0	0	0	0	0	0	0	0	17.44611807											5.8872	0.052079051	8.595352897	0	1.301463311	0.182994136	0.044546734	0.68398565	4.075646623	1.112234369	1.569294446	0	0.023232434	1.598175358	4.920884326	4.097550756	0.385948883	0.575532745	2.321291359	16.07230619	0	0	0	0	0	0	0	0	0	0.035693581	0	0	0	0	0	0	0	0	0	0	53.5354	0	7.8369	5.8872	0.052079051	8.595352897	0	1.301463311	0.182994136	0.044546734	0.68398565	4.075646623	1.112234369	1.569294446	0	0.023232434	1.598175358	4.920884326	4.097550756	0.385948883	0.575532745	2.321291359	16.07230619	0	0	0	0	0	0	0	0	0	0.035693581	0	0	0	0	0	0	0	0	0	0	53.5354																																																																																		0	0	0	5.8872	0.052079051	8.595352897	0	1.301463311	0.182994136	0.044546734	0.68398565	4.075646623	1.112234369	1.569294446	0	0.023232434	1.598175358	4.920884326	4.097550756	0.385948883	0.575532745	2.321291359	16.07230619	0	0	0	0	0	0	0	0	0	0.035693581	0	0	0	0	0	0	0	0	0	0	53.5354
H2319_011_1	2009	8																					3000											A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	V	V	V	O	O																																																			0	n/a	248.1205352	2.923607907	838.4133625	202.0032328	330.0652148	13.54268685	2.486989004	173.4661811	1033.628199	1421.207948	950.6029358	0	42.07619879	986.4575939	6117.073586	2686.393124	313.8453183	377.7826941	1482.12764	10124.10717	715.9397773	1263.455591	0	1362.9	0	0	0	0	0	25.8202381											"$100 copay per admit (PBP Section B-01, #1a)"	"$100 copay per admit (PBP Section B-01,#1b)"	"$50 for days 51-100 (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)"	"$50 copay, waived if admitted (PBP Section B-04,#4a)"	"$25 copay (PBP Section B-09,#9a & #9b)"	"$5 copay (PBP Section B-08,#8a)"	"$10 copay (PBP Section B-08,#8b)"	"$10 copay (PBP Section B-05,#5)"	"$10 copay (PBP Section B-12, #12)"	"$10 copay (PBP Sections B-03, #3; B-09, #9c & #9d)"	"$5 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$10 copay (PBP Section B-07,#7b, #7d & #7f)"	"$10 copay (PBP Section B-07,#7e & #7h)"	"$10 copay (PBP Section B-07,#7c & #7i)"	"$10 copay (PBP Section B-07,#7d)"	"$10 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h, #14i & #14j)"	"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-14, #14a)"	"Full body skin exam (once per lifetime PBP Section B-14, #14c)"											100	100	50	0	50	0.015	0.015	50	25	5	10	10	10	10	5	10	10	10	10	10	0	0	0	0	0	0	0	0	0	10											95.74509101	95.74509101	47.8725455	0	47.8725455	0.014361764	0.014361764	47.8725455	23.93627275	4.78725455	9.574509101	9.574509101	9.574509101	9.574509101	4.78725455	9.574509101	9.574509101	9.574509101	9.574509101	9.574509101	0	0	0	0	0	0	0	0	0	9.574509101											1.9797	0.023326759	3.344748487	0	1.316755168	0.194496868	0.035717548	0.692022304	2.061767207	0.566973685	0.758463038	0	0.033571579	0.787070601	2.440332363	2.143407951	0.250409571	0.301423654	1.182553715	8.077779688	0	0	0	0	0	0	0	0	0	0.020601342	0	0	0	0	0	0	0	0	0	0	26.2111	0	1.1648	1.9797	0.023326759	3.344748487	0	1.316755168	0.194496868	0.035717548	0.692022304	2.061767207	0.566973685	0.758463038	0	0.033571579	0.787070601	2.440332363	2.143407951	0.250409571	0.301423654	1.182553715	8.077779688	0	0	0	0	0	0	0	0	0	0.020601342	0	0	0	0	0	0	0	0	0	0	26.2111																																																																																		0	0	0	1.9797	0.023326759	3.344748487	0	1.316755168	0.194496868	0.035717548	0.692022304	2.061767207	0.566973685	0.758463038	0	0.033571579	0.787070601	2.440332363	2.143407951	0.250409571	0.301423654	1.182553715	8.077779688	0	0	0	0	0	0	0	0	0	0.020601342	0	0	0	0	0	0	0	0	0	0	26.2111
H2319_011_2	2009	8																					3000											A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	V	V	V	O	O																																																			0	n/a	246.3611899	2.902877516	832.468435	200.570891	327.7248253	13.44665988	2.469354541	172.2361866	1026.299064	1411.130606	943.862507	0	41.7778496	979.462931	6073.699326	2667.344749	311.6199391	375.1039549	1471.618336	10052.32029	710.8632717	1254.496822	0	1362.9	0	0	0	0	0	25.8202381											"$100 copay per admit (PBP Section B-01, #1a)"	"$100 copay per admit (PBP Section B-01,#1b)"	"$50 for days 51-100 (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)"	"$50 copay, waived if admitted (PBP Section B-04,#4a)"	"$25 copay (PBP Section B-09,#9a & #9b)"	"$5 copay (PBP Section B-08,#8a)"	"$10 copay (PBP Section B-08,#8b)"	"$10 copay (PBP Section B-05,#5)"	"$10 copay (PBP Section B-12, #12)"	"$10 copay (PBP Sections B-03, #3; B-09, #9c & #9d)"	"$5 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$10 copay (PBP Section B-07,#7b, #7d & #7f)"	"$10 copay (PBP Section B-07,#7e & #7h)"	"$10 copay (PBP Section B-07,#7c & #7i)"	"$10 copay (PBP Section B-07,#7d)"	"$10 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h, #14i & #14j)"	"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-14, #14a)"	"Full body skin exam (once per lifetime PBP Section B-14, #14c)"											100	100	50	0	50	0.015	0.015	50	25	5	10	10	10	10	5	10	10	10	10	10	0	0	0	0	0	0	0	0	0	10											95.74509101	95.74509101	47.8725455	0	47.8725455	0.014361764	0.014361764	47.8725455	23.93627275	4.78725455	9.574509101	9.574509101	9.574509101	9.574509101	4.78725455	9.574509101	9.574509101	9.574509101	9.574509101	9.574509101	0	0	0	0	0	0	0	0	0	9.574509101											1.9657	0.023161356	3.32103192	0	1.307418468	0.193117751	0.035464286	0.68711539	2.04714786	0.562953451	0.753085014	0	0.033333533	0.781489729	2.423028728	2.128209714	0.248633995	0.299286353	1.174168596	8.020502673	0	0	0	0	0	0	0	0	0	0.020601342	0	0	0	0	0	0	0	0	0	0	26.0254	0	1.1566	1.9657	0.023161356	3.32103192	0	1.307418468	0.193117751	0.035464286	0.68711539	2.04714786	0.562953451	0.753085014	0	0.033333533	0.781489729	2.423028728	2.128209714	0.248633995	0.299286353	1.174168596	8.020502673	0	0	0	0	0	0	0	0	0	0.020601342	0	0	0	0	0	0	0	0	0	0	26.0254																																																																																		0	0	0	1.9657	0.023161356	3.32103192	0	1.307418468	0.193117751	0.035464286	0.68711539	2.04714786	0.562953451	0.753085014	0	0.033333533	0.781489729	2.423028728	2.128209714	0.248633995	0.299286353	1.174168596	8.020502673	0	0	0	0	0	0	0	0	0	0.020601342	0	0	0	0	0	0	0	0	0	0	26.0254
H2319_011_3	2009	8																					3000											A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	V	V	V	O	O																																																			0	n/a	225.1478463	2.652920376	760.7873437	183.3003979	299.5055294	12.28881267	2.256726625	157.4055007	937.9278609	1289.622838	862.5896422	0	38.18049776	895.1246319	5550.713255	2437.668554	284.7873814	342.8049995	1344.90217	9186.748383	649.653197	1146.476268	0	1362.9	0	0	0	0	0	25.8202381											"$100 copay per admit (PBP Section B-01, #1a)"	"$100 copay per admit (PBP Section B-01,#1b)"	"$50 for days 51-100 (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)"	"$50 copay, waived if admitted (PBP Section B-04,#4a)"	"$25 copay (PBP Section B-09,#9a & #9b)"	"$5 copay (PBP Section B-08,#8a)"	"$10 copay (PBP Section B-08,#8b)"	"$10 copay (PBP Section B-05,#5)"	"$10 copay (PBP Section B-12, #12)"	"$10 copay (PBP Sections B-03, #3; B-09, #9c & #9d)"	"$5 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$10 copay (PBP Section B-07,#7b, #7d & #7f)"	"$10 copay (PBP Section B-07,#7e & #7h)"	"$10 copay (PBP Section B-07,#7c & #7i)"	"$10 copay (PBP Section B-07,#7d)"	"$10 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h, #14i & #14j)"	"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-14, #14a)"	"Full body skin exam (once per lifetime PBP Section B-14, #14c)"											100	100	50	0	50	0.015	0.015	50	25	5	10	10	10	10	5	10	10	10	10	10	0	0	0	0	0	0	0	0	0	10											95.74509101	95.74509101	47.8725455	0	47.8725455	0.014361764	0.014361764	47.8725455	23.93627275	4.78725455	9.574509101	9.574509101	9.574509101	9.574509101	4.78725455	9.574509101	9.574509101	9.574509101	9.574509101	9.574509101	0	0	0	0	0	0	0	0	0	9.574509101											1.7964	0.021167009	3.035068894	0	1.194841007	0.176489023	0.032410574	0.627950166	1.870874758	0.5144794	0.688239365	0	0.030463294	0.714198245	2.214389774	1.944956646	0.227224948	0.273515799	1.073064839	7.329883834	0	0	0	0	0	0	0	0	0	0.020601342	0	0	0	0	0	0	0	0	0	0	23.7862	0	1.0571	1.7964	0.021167009	3.035068894	0	1.194841007	0.176489023	0.032410574	0.627950166	1.870874758	0.5144794	0.688239365	0	0.030463294	0.714198245	2.214389774	1.944956646	0.227224948	0.273515799	1.073064839	7.329883834	0	0	0	0	0	0	0	0	0	0.020601342	0	0	0	0	0	0	0	0	0	0	23.7862																																																																																		0	0	0	1.7964	0.021167009	3.035068894	0	1.194841007	0.176489023	0.032410574	0.627950166	1.870874758	0.5144794	0.688239365	0	0.030463294	0.714198245	2.214389774	1.944956646	0.227224948	0.273515799	1.073064839	7.329883834	0	0	0	0	0	0	0	0	0	0.020601342	0	0	0	0	0	0	0	0	0	0	23.7862
H2319_011_4	2009	8																					3000											A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	V	V	V	O	O																																																			0	n/a	267.5083654	3.152054994	903.9259404	217.7875143	355.8561003	14.60089556	2.681319233	187.0206129	1114.394621	1532.259371	1024.881867	0	45.36398066	1063.538164	6595.054112	2896.304543	338.3688013	407.3021642	1597.939251	10915.19232	771.8824215	1362.18044	0	1362.9	0	0	0	0	0	25.8202381											"$100 copay per admit (PBP Section B-01, #1a)"	"$100 copay per admit (PBP Section B-01,#1b)"	"$50 for days 51-100 (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)"	"$50 copay, waived if admitted (PBP Section B-04,#4a)"	"$25 copay (PBP Section B-09,#9a & #9b)"	"$5 copay (PBP Section B-08,#8a)"	"$10 copay (PBP Section B-08,#8b)"	"$10 copay (PBP Section B-05,#5)"	"$10 copay (PBP Section B-12, #12)"	"$10 copay (PBP Sections B-03, #3; B-09, #9c & #9d)"	"$5 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$10 copay (PBP Section B-07,#7b, #7d & #7f)"	"$10 copay (PBP Section B-07,#7e & #7h)"	"$10 copay (PBP Section B-07,#7c & #7i)"	"$10 copay (PBP Section B-07,#7d)"	"$10 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h, #14i & #14j)"	"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-14, #14a)"	"Full body skin exam (once per lifetime PBP Section B-14, #14c)"											100	100	50	0	50	0.015	0.015	50	25	5	10	10	10	10	5	10	10	10	10	10	0	0	0	0	0	0	0	0	0	10											95.74509101	95.74509101	47.8725455	0	47.8725455	0.014361764	0.014361764	47.8725455	23.93627275	4.78725455	9.574509101	9.574509101	9.574509101	9.574509101	4.78725455	9.574509101	9.574509101	9.574509101	9.574509101	9.574509101	0	0	0	0	0	0	0	0	0	9.574509101											2.1344	0.025149483	3.606102976	0	1.41964478	0.209694611	0.038508473	0.746096067	2.222871134	0.611276304	0.817728397	0	0.03619482	0.848571319	2.631016901	2.310891184	0.269976264	0.324976523	1.274956992	8.708967352	0	0	0	0	0	0	0	0	0	0.020601342	0	0	0	0	0	0	0	0	0	0	28.2576	0	1.2558	2.1344	0.025149483	3.606102976	0	1.41964478	0.209694611	0.038508473	0.746096067	2.222871134	0.611276304	0.817728397	0	0.03619482	0.848571319	2.631016901	2.310891184	0.269976264	0.324976523	1.274956992	8.708967352	0	0	0	0	0	0	0	0	0	0.020601342	0	0	0	0	0	0	0	0	0	0	28.2576																																																																																		0	0	0	2.1344	0.025149483	3.606102976	0	1.41964478	0.209694611	0.038508473	0.746096067	2.222871134	0.611276304	0.817728397	0	0.03619482	0.848571319	2.631016901	2.310891184	0.269976264	0.324976523	1.274956992	8.708967352	0	0	0	0	0	0	0	0	0	0.020601342	0	0	0	0	0	0	0	0	0	0	28.2576
H2319_011_5	2009	8																					3000											A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	V	V	V	O	O																																																			0	n/a	269.5838738	3.176510741	910.9392013	219.4772553	358.6170695	14.71417905	2.702122697	188.4716436	1123.040839	1544.147662	1032.833585	0	45.71594471	1071.789803	6646.222944	2918.776007	340.9940924	410.4622863	1610.337131	10999.87967	777.8712005	1372.749146	0	1362.9	0	0	0	0	0	25.8202381											"$100 copay per admit (PBP Section B-01, #1a)"	"$100 copay per admit (PBP Section B-01,#1b)"	"$50 for days 51-100 (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)"	"$50 copay, waived if admitted (PBP Section B-04,#4a)"	"$25 copay (PBP Section B-09,#9a & #9b)"	"$5 copay (PBP Section B-08,#8a)"	"$10 copay (PBP Section B-08,#8b)"	"$10 copay (PBP Section B-05,#5)"	"$10 copay (PBP Section B-12, #12)"	"$10 copay (PBP Sections B-03, #3; B-09, #9c & #9d)"	"$5 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$10 copay (PBP Section B-07,#7b, #7d & #7f)"	"$10 copay (PBP Section B-07,#7e & #7h)"	"$10 copay (PBP Section B-07,#7c & #7i)"	"$10 copay (PBP Section B-07,#7d)"	"$10 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h, #14i & #14j)"	"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-14, #14a)"	"Full body skin exam (once per lifetime PBP Section B-14, #14c)"											100	100	50	0	50	0.015	0.015	50	25	5	10	10	10	10	5	10	10	10	10	10	0	0	0	0	0	0	0	0	0	10											95.74509101	95.74509101	47.8725455	0	47.8725455	0.014361764	0.014361764	47.8725455	23.93627275	4.78725455	9.574509101	9.574509101	9.574509101	9.574509101	4.78725455	9.574509101	9.574509101	9.574509101	9.574509101	9.574509101	0	0	0	0	0	0	0	0	0	9.574509101											2.1509	0.025344609	3.63408153	0	1.430659332	0.211321562	0.038807248	0.751884778	2.240117652	0.616018993	0.82407288	0	0.036475644	0.855155102	2.651430086	2.32882062	0.27207092	0.327497908	1.28484896	8.776537334	0	0	0	0	0	0	0	0	0	0.020601342	0	0	0	0	0	0	0	0	0	0	28.4767	0	1.2655	2.1509	0.025344609	3.63408153	0	1.430659332	0.211321562	0.038807248	0.751884778	2.240117652	0.616018993	0.82407288	0	0.036475644	0.855155102	2.651430086	2.32882062	0.27207092	0.327497908	1.28484896	8.776537334	0	0	0	0	0	0	0	0	0	0.020601342	0	0	0	0	0	0	0	0	0	0	28.4767																																																																																		0	0	0	2.1509	0.025344609	3.63408153	0	1.430659332	0.211321562	0.038807248	0.751884778	2.240117652	0.616018993	0.82407288	0	0.036475644	0.855155102	2.651430086	2.32882062	0.27207092	0.327497908	1.28484896	8.776537334	0	0	0	0	0	0	0	0	0	0.020601342	0	0	0	0	0	0	0	0	0	0	28.4767
H2319_011_6	2009	8																					3000											A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	V	V	V	O	O																																																			0	n/a	323.025868	3.806218542	1091.522731	262.9861715	429.708901	17.63110083	3.237788363	225.8340435	1345.671151	1850.257702	1237.581316	0	54.77862051	1284.260169	7963.762464	3497.390774	408.5923653	491.8318534	1929.568494	13180.48304	932.0754842	1644.881342	0	1362.9	0	0	0	0	0	25.8202381											"$100 copay per admit (PBP Section B-01, #1a)"	"$100 copay per admit (PBP Section B-01,#1b)"	"$50 for days 51-100 (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)"	"$50 copay, waived if admitted (PBP Section B-04,#4a)"	"$25 copay (PBP Section B-09,#9a & #9b)"	"$5 copay (PBP Section B-08,#8a)"	"$10 copay (PBP Section B-08,#8b)"	"$10 copay (PBP Section B-05,#5)"	"$10 copay (PBP Section B-12, #12)"	"$10 copay (PBP Sections B-03, #3; B-09, #9c & #9d)"	"$5 copay (PBP Section B-07,#7a;B-14,#14b & #14c)"	"$10 copay (PBP Section B-07,#7b, #7d & #7f)"	"$10 copay (PBP Section B-07,#7e & #7h)"	"$10 copay (PBP Section B-07,#7c & #7i)"	"$10 copay (PBP Section B-07,#7d)"	"$10 copay (PBP Section B-07,#7g); $0 copay (PBP Section-14, #14d, #14e, #14f, #14g, #14h, #14i & #14j)"	"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-14, #14a)"	"Full body skin exam (once per lifetime PBP Section B-14, #14c)"											100	100	50	0	50	0.015	0.015	50	25	5	10	10	10	10	5	10	10	10	10	10	0	0	0	0	0	0	0	0	0	10											95.74509101	95.74509101	47.8725455	0	47.8725455	0.014361764	0.014361764	47.8725455	23.93627275	4.78725455	9.574509101	9.574509101	9.574509101	9.574509101	4.78725455	9.574509101	9.574509101	9.574509101	9.574509101	9.574509101	0	0	0	0	0	0	0	0	0	9.574509101											2.5773	0.030368895	4.354497634	0	1.714271576	0.253213703	0.046500351	0.900937543	2.684195975	0.738137883	0.987436131	0	0.043706533	1.024680056	3.177046508	2.790483316	0.326005943	0.392420713	1.539555926	10.5163879	0	0	0	0	0	0	0	0	0	0.020601342	0	0	0	0	0	0	0	0	0	0	34.1178	0	1.5162	2.5773	0.030368895	4.354497634	0	1.714271576	0.253213703	0.046500351	0.900937543	2.684195975	0.738137883	0.987436131	0	0.043706533	1.024680056	3.177046508	2.790483316	0.326005943	0.392420713	1.539555926	10.5163879	0	0	0	0	0	0	0	0	0	0.020601342	0	0	0	0	0	0	0	0	0	0	34.1178																																																																																		0	0	0	2.5773	0.030368895	4.354497634	0	1.714271576	0.253213703	0.046500351	0.900937543	2.684195975	0.738137883	0.987436131	0	0.043706533	1.024680056	3.177046508	2.790483316	0.326005943	0.392420713	1.539555926	10.5163879	0	0	0	0	0	0	0	0	0	0.020601342	0	0	0	0	0	0	0	0	0	0	34.1178
H2319_801_0	2009	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																																																			0	n/a	275.2119792	1.248552563	48.57679597	27.27637077	8.25099102	14.51645069	0.155829565	15.75046763	50.75741514	14.93323791	26.37407624	0	0.218688437	24.47077984	48.16063993	23.80204274	2.24878515	6.830425421	32.77622088	154.8712443	11.84170844	33.07376058	0	0	0	0	0.684533015	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-14, #14b)"	"Medicare FFS Cost Sharing (PBP Section B-13, #13b)"											0.072350012	0.072350012	0.183257544	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.072350012	0.072350012	0.183257544	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											19.9116	0.090332793	8.902064312	0	1.905978926	3.35330011	0.035996629	3.638358023	11.7249629	3.449577956	6.092411611	0	0.050517029	5.652750144	11.12510782	5.498271872	0.51946937	1.577828272	7.571307023	35.77525743	2.735434649	7.640038695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.2506	0	0	19.9116	0.090332793	8.902064312	0	1.905978926	3.35330011	0.035996629	3.638358023	11.7249629	3.449577956	6.092411611	0	0.050517029	5.652750144	11.12510782	5.498271872	0.51946937	1.577828272	7.571307023	35.77525743	2.735434649	7.640038695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.2506																																																																																		0	0	0	19.9116	0.090332793	8.902064312	0	1.905978926	3.35330011	0.035996629	3.638358023	11.7249629	3.449577956	6.092411611	0	0.050517029	5.652750144	11.12510782	5.498271872	0.51946937	1.577828272	7.571307023	35.77525743	2.735434649	7.640038695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.2506
H2319_802_0	2009	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																																																			0	n/a	275.2119792	1.248552563	48.57679597	27.27637077	8.25099102	14.51645069	0.155829565	15.75046763	50.75741514	14.93323791	26.37407624	0	0.218688437	24.47077984	48.16063993	23.80204274	2.24878515	6.830425421	32.77622088	154.8712443	11.84170844	33.07376058	0	0	0	0	0.684533015	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-14, #14b)"	"Medicare FFS Cost Sharing (PBP Section B-13, #13b)"											0.07236795	0.07236795	0.183253435	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.07236795	0.07236795	0.183253435	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											19.9165	0.09035519	8.901864721	0	1.905978926	3.35330011	0.035996629	3.638358023	11.7249629	3.449577956	6.092411611	0	0.050517029	5.652750144	11.12510782	5.498271872	0.51946937	1.577828272	7.571307023	35.77525743	2.735434649	7.640038695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.2553	0	0	19.9165	0.09035519	8.901864721	0	1.905978926	3.35330011	0.035996629	3.638358023	11.7249629	3.449577956	6.092411611	0	0.050517029	5.652750144	11.12510782	5.498271872	0.51946937	1.577828272	7.571307023	35.77525743	2.735434649	7.640038695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.2553																																																																																		0	0	0	19.9165	0.09035519	8.901864721	0	1.905978926	3.35330011	0.035996629	3.638358023	11.7249629	3.449577956	6.092411611	0	0.050517029	5.652750144	11.12510782	5.498271872	0.51946937	1.577828272	7.571307023	35.77525743	2.735434649	7.640038695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.2553
H2319_803_0	2009	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																																																			0	n/a	275.2119792	1.248552563	48.57679597	27.27637077	8.25099102	14.51645069	0.155829565	15.75046763	50.75741514	14.93323791	26.37407624	0	0.218688437	24.47077984	48.16063993	23.80204274	2.24878515	6.830425421	32.77622088	154.8712443	11.84170844	33.07376058	0	0	0	0	0.684533015	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-14, #14b)"	"Medicare FFS Cost Sharing (PBP Section B-13, #13b)"											0.07308121	0.07308121	0.183023717	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.07308121	0.07308121	0.183023717	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.1128	0.091245732	8.890705777	0	1.905978926	3.35330011	0.035996629	3.638358023	11.7249629	3.449577956	6.092411611	0	0.050517029	5.652750144	11.12510782	5.498271872	0.51946937	1.577828272	7.571307023	35.77525743	2.735434649	7.640038695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.4413	0	0	20.1128	0.091245732	8.890705777	0	1.905978926	3.35330011	0.035996629	3.638358023	11.7249629	3.449577956	6.092411611	0	0.050517029	5.652750144	11.12510782	5.498271872	0.51946937	1.577828272	7.571307023	35.77525743	2.735434649	7.640038695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.4413																																																																																		0	0	0	20.1128	0.091245732	8.890705777	0	1.905978926	3.35330011	0.035996629	3.638358023	11.7249629	3.449577956	6.092411611	0	0.050517029	5.652750144	11.12510782	5.498271872	0.51946937	1.577828272	7.571307023	35.77525743	2.735434649	7.640038695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.4413
H2319_804_0	2009	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																																																			0	n/a	275.2119792	1.248552563	48.57679597	27.27637077	8.25099102	14.51645069	0.155829565	15.75046763	50.75741514	14.93323791	26.37407624	0	0.218688437	24.47077984	48.16063993	23.80204274	2.24878515	6.830425421	32.77622088	154.8712443	11.84170844	33.07376058	0	0	0	0	0.684533015	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-14, #14b)"	"Medicare FFS Cost Sharing (PBP Section B-13, #13b)"											0.072689154	0.072689154	0.183128048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.072689154	0.072689154	0.183128048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.0049	0.090756229	8.895773821	0	1.905978926	3.35330011	0.035996629	3.638358023	11.7249629	3.449577956	6.092411611	0	0.050517029	5.652750144	11.12510782	5.498271872	0.51946937	1.577828272	7.571307023	35.77525743	2.735434649	7.640038695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.338	0	0	20.0049	0.090756229	8.895773821	0	1.905978926	3.35330011	0.035996629	3.638358023	11.7249629	3.449577956	6.092411611	0	0.050517029	5.652750144	11.12510782	5.498271872	0.51946937	1.577828272	7.571307023	35.77525743	2.735434649	7.640038695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.338																																																																																		0	0	0	20.0049	0.090756229	8.895773821	0	1.905978926	3.35330011	0.035996629	3.638358023	11.7249629	3.449577956	6.092411611	0	0.050517029	5.652750144	11.12510782	5.498271872	0.51946937	1.577828272	7.571307023	35.77525743	2.735434649	7.640038695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.338
H2320_007_0	2009	4																					3350											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O			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	3350	781.7973385	28.32226789	447.6324087	746.6010905	97.7034169	0	18.0569759	704.129842	264.9810542	3944.48995	1709.93688	17.34085158	0	2262.524794	4865.835761	7264.181325	252.8791126	0	2777.001369	4480.205663	30.44060092	0	0	0	265.7967939	356.2545825	134.6118717	21.14908156	0	0											"$50 days 1-5, $0 days 6+, unlimited coverage"	"$50 days 1-5, $0 days 6-90"	"$0 copay days 1-10, $75 copay days 11-100, coverage for Non-Medicare Covered Stay"	$0 copay	$50 copay	20% coinsurance	"20% coin Prosth, 0% Diab Mon Supp"	"$50 ER, $40 Urgent Care"	$25 OP Hosp Facility - $30 Amb Surg Center	$0 copay	$15 - $20 copay	$0 - $25 copay	$10 copay	$0 - $25 copay	"$10 PCP & Physical Exam, $0 Immun & Screenings"	"$20 Specialist, $0 Screening/Exams"	$40 copay	$20 copay	$15 - $20 copay	$0 - $20 copay	20% coinsurance	$0 - $20 copay	Not Covered	Not Covered	$20 copay	$75 every year	$20 copay	$300 every three years	Not Covered	Not Covered											46.62632849	17.28989546	54.06321737	0	50	0	0.151948646	18.78272067	25.8829247	0	12.13025029	0	0	10.17229773	9.295757862	15.82775674	31.21818922	0	2.944647222	1.223728383	0.2	0	0	0	20	0	20	0	0	0											44.35019853	16.44586484	51.42404519	0	47.5591795	0	0.144531058	17.86581568	24.61941323	0	11.53809502	0	0	9.675722672	8.841972336	15.05510248	29.6942293	0	2.800900116	1.163990356	0.190236718	0	0	0	19.0236718	0	19.0236718	0	0	0											2.8894	0.038815349	1.918255768	0	0.387224529	0	2.609793834	1.048321164	0.543639839	0	1.64411785	0	0	1.82429687	3.585298766	9.113582854	0.625754196	0	0.648175288	0.434576349	5.790920013	0	0	0	0.421369248	0	0.213401006	0	0	0	0	0	0	0	0	0	0	0	0	0	33.7369	0	1.7314	2.8894	0.038815349	1.918255768	0	0.387224529	0	2.609793834	1.048321164	0.543639839	0	1.64411785	0	0	1.82429687	3.585298766	9.113582854	0.625754196	0	0.648175288	0.434576349	5.790920013	0	0	0	0.421369248	0	0.213401006	0	0	0	0	0	0	0	0	0	0	0	0	0	33.7369		"$150 days 1-5, $0 days 6+, unlimited coverage"	"$150 days 1-5, $0 days 6-90"	"$0 copay days 1-10, $100 copay days 11-100, coverage for Non-Medicare Covered Stay"	$0 copay	$100 copay	30% coinsurance	"30% coin Prosth, $10 Diab Mon Supp"	"$50 ER, $40 Urgent Care"	$30 OP Hosp Facility - $35 Amb Surg Center	$20 copay	$20 - $25 copay	$0 - $30 copay	$10 copay	$0 - $30 copay	"$25 PCP, $15 Physical Exam, $10 Immun & Screenings"	"$25 Specialist, $0 Screening/Exams"	$50 copay	$25 copay	$20 - $25 copay	$0 - $25 copay	20% coinsurance	$0 - $20 copay	Not Covered	Not Covered	$25 copay	$75 every year	$25 copay	$300 every three years	Not Covered	Not Covered											0.5149	0	0.2468	0	0.2481	0	1.8319	0.1298	0.0134	0	0.0382	0	0	0.0446	0	1.8292	0.2077	0	0.0585	0.0947	0.1255	0	0	0	0.0423	0	0.0349	0	0	0											5.4602	300	0.280227253	3.4043	0.038815349	2.165048907	0	0.635290242	0	4.441687376	1.178087426	0.557005051	0	1.68231135	0	0	1.868892429	3.585298766	10.9427616	0.833415987	0	0.706633164	0.529303701	5.916385552	0	0	0	0.463655389	0	0.248300582	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1972
H2320_008_0	2009	4																					3350											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O			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	3350	714.0129594	25.86663489	504.5954697	613.3302511	99.86358999	0	18.61518121	655.5393919	246.6952951	3672.289384	1591.937901	16.1441976	0	2106.392939	4973.416926	7424.788697	258.4701418	0	2838.399463	4579.260743	31.38162809	0	0	0	271.6734265	364.131191	137.588072	21.61667705	0	0											"$50 days 1-5, $0 days 6+, unlimited coverage"	"$50 days 1-5, $0 days 6-90"	"$0 copay days 1-10, $75 copay days 11-100, coverage for Non-Medicare Covered Stay"	$0 copay	$50 copay	20% coinsurance	"20% coin Prosth, 0% Diab Mon Supp"	"$50 ER, $40 Urgent Care"	$25 OP Hosp Facility - $30 Amb Surg Center	$0 copay	$15 - $20 copay	$0 - $25 copay	$10 copay	$0 - $25 copay	"$10 PCP & Physical Exam, $0 Immun & Screenings"	"$20 Specialist, $0 Screening/Exams"	$40 copay	$20 copay	$15 - $20 copay	$0 - $20 copay	20% coinsurance	$0 - $20 copay	Not Covered	Not Covered	$20 copay	$75 every year	$20 copay	$300 every three years	Not Covered	Not Covered											46.62632849	17.28989546	54.06321737	0	50	0	0.151948646	18.78272067	25.8829247	0	12.13025029	0	0	10.17229773	9.295757862	15.82775674	31.21818922	0	2.944647222	1.223728383	0.2	0	0	0	20	0	20	0	0	0											44.35019853	16.44586484	51.42404519	0	47.5591795	0	0.144531058	17.86581568	24.61941323	0	11.53809502	0	0	9.675722672	8.841972336	15.05510248	29.6942293	0	2.800900116	1.163990356	0.190236718	0	0	0	19.0236718	0	19.0236718	0	0	0											2.6389	0.035449932	2.162361686	0	0.395785867	0	2.690471837	0.975978829	0.506124451	0	1.530660897	0	0	1.69840616	3.664567907	9.315079558	0.639589305	0	0.662506115	0.444184612	5.969937934	0	0	0	0.430685509	0	0.218119194	0	0	0	0	0	0	0	0	0	0	0	0	0	33.9788	0	1.7439	2.6389	0.035449932	2.162361686	0	0.395785867	0	2.690471837	0.975978829	0.506124451	0	1.530660897	0	0	1.69840616	3.664567907	9.315079558	0.639589305	0	0.662506115	0.444184612	5.969937934	0	0	0	0.430685509	0	0.218119194	0	0	0	0	0	0	0	0	0	0	0	0	0	33.9788		"$150 days 1-5, $0 days 6+, unlimited coverage"	"$150 days 1-5, $0 days 6-90"	"$0 copay days 1-10, $100 copay days 11-100, coverage for Non-Medicare Covered Stay"	$0 copay	$100 copay	30% coinsurance	"30% coin Prosth, $10 Diab Mon Supp"	"$50 ER, $40 Urgent Care"	$30 OP Hosp Facility - $35 Amb Surg Center	$20 copay	$20 - $25 copay	$0 - $30 copay	$10 copay	$0 - $30 copay	"$25 PCP, $15 Physical Exam, $10 Immun & Screenings"	"$25 Specialist, $0 Screening/Exams"	$50 copay	$25 copay	$20 - $25 copay	$0 - $25 copay	20% coinsurance	$0 - $20 copay	Not Covered	Not Covered	$25 copay	$75 every year	$25 copay	$300 every three years	Not Covered	Not Covered											0.4702	0	0.2782	0	0.2536	0	1.8885	0.1208	0.0124	0	0.0356	0	0	0.0415	0	1.8696	0.2123	0	0.0598	0.0968	0.1293	0	0	0	0.0432	0	0.0357	0	0	0											5.5475	300	0.284707439	3.1091	0.035449932	2.440560266	0	0.649336188	0	4.57899572	1.096790207	0.518567359	0	1.566218748	0	0	1.739924277	3.664567907	11.18470052	0.851842393	0	0.722256466	0.541006338	6.099282059	0	0	0	0.473906575	0	0.253790382	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5263
H2320_009_0	2009	5																					3350											A	A	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O			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	3350	167.7286688	6.076327019	447.6324087	746.6010905	97.7034169	0	18.0569759	704.129842	264.9810542	3913.833293	1696.647215	17.34085158	0	2262.524794	4714.409221	7264.181325	252.8791126	0	2755.418457	4461.717025	30.44060092	0	0	0	265.7967939	356.2545825	134.6118717	21.14908156	0	0											"$250 copay per admit, unlimited coverage"	$250 copay per admit	"$0 copay days 1-10, $75 copay days 11-100, coverage for Non-Medicare Covered Stay"	$0 copay	$50 copay	20% coinsurance	"20% coin Prosth, 0% Diab Mon Supp"	"$50 ER, $40 Urgent Care"	$25 OP Hosp Facility - $30 Amb Surg Center	$0 copay	$15 - $20 copay	$0 - $25 copay	$10 copay	$0 - $25 copay	"$15 PCP & Physical Exam, $0 Immun & Screening"	"$20 Specialist, $0 Screening/Exams"	$40 copay	$20 copay	$15 - $20 copay	$0 - $20 copay	20% coinsurance	$0 - $20 copay	Not Covered	Not Covered	$20 copay	$75 every year	$20 copay	$300 every three years	Not Covered	Not Covered											250	250	54.06321737	0	50	0	0.151948646	18.78272067	25.8829247	0	12.13025029	0	0	10.17229773	13.94177102	15.82775674	31.21818922	0	2.944647222	1.228799316	0.2	0	0	0	20	0	20	0	0	0											237.7958975	237.7958975	51.42404519	0	47.5591795	0	0.144531058	17.86581568	24.61941323	0	11.53809502	0	0	9.675722672	13.26118381	15.05510248	29.6942293	0	2.800900116	1.168813745	0.190236718	0	0	0	19.0236718	0	19.0236718	0	0	0											3.3238	0.12041047	1.918255768	0	0.387224529	0	2.609793834	1.048321164	0.543639839	0	1.631339732	0	0	1.82429687	5.209887269	9.113582854	0.625754196	0	0.643137656	0.434576349	5.790920013	0	0	0	0.421369248	0	0.213401006	0	0	0	0	0	0	0	0	0	0	0	0	0	35.8597	0	1.8404	3.3238	0.12041047	1.918255768	0	0.387224529	0	2.609793834	1.048321164	0.543639839	0	1.631339732	0	0	1.82429687	5.209887269	9.113582854	0.625754196	0	0.643137656	0.434576349	5.790920013	0	0	0	0.421369248	0	0.213401006	0	0	0	0	0	0	0	0	0	0	0	0	0	35.8597		"$500 copay per admit, unlimited coverage"	$500 copay per admit	"$0 copay days 1-10, $100 copay days 11-100, coverage for Non-Medicare Covered Stay"	$0 copay	$100 copay	30% coinsurance	"30% coin Prosth, $10 Diab Mon Supp"	"$50 ER, $40 Urgent Care"	$30 OP Hosp Facility - $35 Amb Surg Center	$20 copay	$20 - $25 copay	$0 - $30 copay	$10 copay	$0 - $30 copay	"$25 PCP, $20 Physical Exam, $10 Immun & Screenings"	"$25 Specialist, $0 Screening/Exams"	$50 copay	$25 copay	$20 - $25 copay	$0 - $25 copay	20% coinsurance	$0 - $20 copay	Not Covered	Not Covered	$25 copay	$75 every year	$25 copay	$300 every three years	Not Covered	Not Covered											0.3948	0	0.2468	0	0.2481	0	1.8319	0.1298	0.0134	0	0.0379	0	0	0.0446	0	1.8292	0.2077	0	0.058	0.0947	0.1255	0	0	0	0.0423	0	0.0349	0	0	0											5.3394	300	0.274029071	3.7186	0.12041047	2.165048907	0	0.635290242	0	4.441687376	1.178087426	0.557005051	0	1.669236392	0	0	1.868892429	5.209887269	10.9427616	0.833415987	0	0.701141197	0.529303701	5.916385552	0	0	0	0.463655389	0	0.248300582	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1991
H2320_010_0	2009	5																					3350											A	A	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O			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	3350	153.1860462	5.549489649	504.5954697	613.3302511	99.86358999	0	18.61518121	655.5393919	246.6952951	3643.748274	1579.565326	16.1441976	0	2106.392939	4818.642422	7424.788697	258.4701418	0	2816.339364	4560.36333	31.38162809	0	0	0	271.6734265	364.131191	137.588072	21.61667705	0	0											"$250 copay per admit, unlimited coverage"	$250 copay per admit	"$0 copay days 1-10, $75 copay days 11-100, coverage for Non-Medicare Covered Stay"	$0 copay	$50 copay	20% coinsurance	"20% coin Prosth, 0% Diab Mon Supp"	"$50 ER, $40 Urgent Care"	$25 OP Hosp Facility - $30 Amb Surg Center	$0 copay	$15 - $20 copay	$0 - $25 copay	$10 copay	$0 - $25 copay	"$15 PCP & Physical Exam, $0 Immun & Screening"	"$20 Specialist, $0 Screening/Exams"	$40 copay	$20 copay	$15 - $20 copay	$0 - $20 copay	20% coinsurance	$0 - $20 copay	Not Covered	Not Covered	$20 copay	$75 every year	$20 copay	$300 every three years	Not Covered	Not Covered											250	250	54.06321737	0	50	0	0.151948646	18.78272067	25.8829247	0	12.13025029	0	0	10.17229773	13.94177102	15.82775674	31.21818922	0	2.944647222	1.228799316	0.2	0	0	0	20	0	20	0	0	0											237.7958975	237.7958975	51.42404519	0	47.5591795	0	0.144531058	17.86581568	24.61941323	0	11.53809502	0	0	9.675722672	13.26118381	15.05510248	29.6942293	0	2.800900116	1.168813745	0.190236718	0	0	0	19.0236718	0	19.0236718	0	0	0											3.0356	0.109970489	2.162361686	0	0.395785867	0	2.690471837	0.975978829	0.506124451	0	1.518764569	0	0	1.69840616	5.325075239	9.315079558	0.639589305	0	0.657357104	0.444184612	5.969937934	0	0	0	0.430685509	0	0.218119194	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0935	0	1.8524	3.0356	0.109970489	2.162361686	0	0.395785867	0	2.690471837	0.975978829	0.506124451	0	1.518764569	0	0	1.69840616	5.325075239	9.315079558	0.639589305	0	0.657357104	0.444184612	5.969937934	0	0	0	0.430685509	0	0.218119194	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0935		"$500 copay per admit, unlimited coverage"	$500 copay per admit	"$0 copay days 1-10, $100 copay days 11-100, coverage for Non-Medicare Covered Stay"	$0 copay	$100 copay	30% coinsurance	"30% coin Prosth, $10 Diab Mon Supp"	"$50 ER, $40 Urgent Care"	$30 OP Hosp Facility - $35 Amb Surg Center	$20 copay	$20 - $25 copay	$0 - $30 copay	$10 copay	$0 - $30 copay	"$25 PCP, $20 Physical Exam, $10 Immun & Screenings"	"$25 Specialist, $0 Screening/Exams"	$50 copay	$25 copay	$20 - $25 copay	$0 - $25 copay	20% coinsurance	$0 - $20 copay	Not Covered	Not Covered	$25 copay	$75 every year	$25 copay	$300 every three years	Not Covered	Not Covered											0.3606	0	0.2782	0	0.2536	0	1.8885	0.1208	0.0124	0	0.0353	0	0	0.0415	0	1.8696	0.2123	0	0.0593	0.0968	0.1293	0	0	0	0.0432	0	0.0357	0	0	0											5.4371	300	0.279043853	3.3962	0.109970489	2.440560266	0	0.649336188	0	4.57899572	1.096790207	0.518567359	0	1.554046063	0	0	1.739924277	5.325075239	11.18470052	0.851842393	0	0.716643074	0.541006338	6.099282059	0	0	0	0.473906575	0	0.253790382	0	0	0	0	0	0	0	0	0	0	0	0	0	41.5306
H2320_011_0	2009	4																					3350											A	A	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O			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	3350	166.0513821	6.045792713	438.1083149	746.6010905	97.7034169	0	18.0569759	704.129842	262.4313406	3872.957749	1678.927662	16.90184268	0	2205.245685	4714.409221	6940.479894	252.8791126	0	2747.417014	4392.356269	30.44060092	0	0	0	0	0	0	0	0	0											"$500 copay per admit, unlimited coverage"	$500 copay per admit	"$0 copay days 1-10, $100 copay days 11-100, coverage for Non-Medicare Covered Stay"	$0 copay	$50 copay	20% coinsurance	"20% coin Prosth, 0% Diab Mon Supp"	"$50 ER, $40 Urgent Care"	$75 copay	$0 copay	$10 - $35 copay	$0 - $75 copay	$10 copay	$0 - $75 copay	"$15 PCP & Physical Exam, $0 Immun & Screening"	"$30 Specialist, $0 Screening/Exams"	$40 copay	$30 copay	$10 - $35 copay	$0 - $30 copay	20% coinsurance	$0 - $30 copay	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											500	500	72.08428983	0	50	0	0.151948646	18.78272067	71.49979198	0	12.13025029	0	0	30.51689318	13.94177102	23.74086961	31.21818922	0	2.374715501	1.832469089	0.2	0	0	0	0	0	0	0	0	0											475.591795	475.591795	68.56539359	0	47.5591795	0	0.144531058	17.86581568	68.00942883	0	11.53809502	0	0	29.02716802	13.26118381	22.58192559	29.6942293	0	2.258790416	1.743014527	0.190236718	0	0	0	0	0	0	0	0	0											6.5811	0.239610784	2.503255754	0	0.387224529	0	2.609793834	1.048321164	1.487317132	0	1.614302241	0	0	5.334336418	5.209887269	13.06078338	0.625754196	0	0.517153268	0.637995065	5.790920013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.6477	0	2.4454	6.5811	0.239610784	2.503255754	0	0.387224529	0	2.609793834	1.048321164	1.487317132	0	1.614302241	0	0	5.334336418	5.209887269	13.06078338	0.625754196	0	0.517153268	0.637995065	5.790920013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.6477		"$700 copay per admit, unlimited coverage"	$700 copay per admit	"$0 copay days 1-10, $120 copay days 11-100, coverage for Non-Medicare Covered Stay"	$0 copay	$100 copay	30% coinsurance	"30% coin Prosth, $10 Diab Mon Supp"	"$50 ER, $40 Urgent Care"	$100 copay	$20 copay	$20 - $40 copay	$0 - $100 copay	$10 copay	$0 - $100 copay	"$35 PCP, $20 Physical Exam, $10 Immun & Screenings"	"$35 Specialist, $0 Screening/Exams"	$50 copay	$35 copay	$20 - $40 copay	$0 - $35 copay	20% coinsurance	$0 - $35 copay	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.5472	0	0.2899	0	0.2481	0	1.8319	0.1298	0.0412	0	0.0441	0	0	0.1449	0	2.4462	0.2077	0	0.0621	0.1298	0.1255	0	0	0	0	0	0	0	0	0											6.2482	300	0.32066622	7.1283	0.239610784	2.79310642	0	0.635290242	0	4.441687376	1.178087426	1.52848854	0	1.658420914	0	0	5.479224942	5.209887269	15.5069513	0.833415987	0	0.57922021	0.767791693	5.916385552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.8959
H2320_012_0	2009	4																					3350											A	A	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O			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	3350	151.6541857	5.521602766	493.8593958	613.3302511	99.86358999	0	18.61518121	655.5393919	244.3215316	3605.693462	1563.06856	15.73548373	0	2053.066536	4818.642422	7093.930391	258.4701418	0	2808.161014	4489.469043	31.38162809	0	0	0	0	0	0	0	0	0											"$500 copay per admit, unlimited coverage"	$500 copay per admit	"$0 copay days 1-10, $100 copay days 11-100, coverage for Non-Medicare Covered Stay"	$0 copay	$50 copay	20% coinsurance	"20% coin Prosth, 0% Diab Mon Supp"	"$50 ER, $40 Urgent Care"	$75 copay	$0 copay	$10 - $35 copay	$0 - $75 copay	$10 copay	$0 - $75 copay	"$15 PCP & Physical Exam, $0 Immun & Screening"	"$30 Specialist, $0 Screening/Exams"	$40 copay	$30 copay	$10 - $35 copay	$0 - $30 copay	20% coinsurance	$0 - $30 copay	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											500	500	72.08428983	0	50	0	0.151948646	18.78272067	71.49979198	0	12.13025029	0	0	30.51689318	13.94177102	23.74086961	31.21818922	0	2.374715501	1.832469089	0.2	0	0	0	0	0	0	0	0	0											475.591795	475.591795	68.56539359	0	47.5591795	0	0.144531058	17.86581568	68.00942883	0	11.53809502	0	0	29.02716802	13.26118381	22.58192559	29.6942293	0	2.258790416	1.743014527	0.190236718	0	0	0	0	0	0	0	0	0											6.0105	0.218835748	2.821805321	0	0.395785867	0	2.690471837	0.975978829	1.384680651	0	1.502902798	0	0	4.966225607	5.325075239	13.34955069	0.639589305	0	0.528587265	0.652100813	5.969937934	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.432	0	2.4343	6.0105	0.218835748	2.821805321	0	0.395785867	0	2.690471837	0.975978829	1.384680651	0	1.502902798	0	0	4.966225607	5.325075239	13.34955069	0.639589305	0	0.528587265	0.652100813	5.969937934	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.432		"$700 copay per admit, unlimited coverage"	$700 copay per admit	"$0 copay days 1-10, $120 copay days 11-100, coverage for Non-Medicare Covered Stay"	$0 copay	$100 copay	30% coinsurance	"30% coin Prosth, $10 Diab Mon Supp"	"$50 ER, $40 Urgent Care"	$100 copay	$20 copay	$20 - $40 copay	$0 - $100 copay	$10 copay	$0 - $100 copay	"$35 PCP, $20 Physical Exam, $10 Immun & Screenings"	"$35 Specialist, $0 Screening/Exams"	$50 copay	$35 copay	$20 - $40 copay	$0 - $35 copay	20% coinsurance	$0 - $35 copay	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.4998	0	0.3267	0	0.2536	0	1.8885	0.1208	0.0383	0	0.0411	0	0	0.1349	0	2.5003	0.2123	0	0.0634	0.1327	0.1293	0	0	0	0	0	0	0	0	0											6.3417	300	0.325465242	6.5103	0.218835748	3.148540674	0	0.649336188	0	4.57899572	1.096790207	1.423010911	0	1.543976938	0	0	5.101115693	5.325075239	15.84980215	0.851842393	0	0.592026475	0.784767179	6.099282059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.7736
H2320_013_0	2009	4																					3350											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O			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	3350	715.861666	25.93360821	549.7069158	808.7769477	89.26381077	0	18.58431965	534.7584587	201.2425148	2995.682388	1298.628684	13.16968336	0	1718.297108	4445.525616	6636.702459	231.0354537	0	2537.124418	4093.206187	31.32960142	0	0	0	242.8373077	325.4813664	122.9841189	19.32222715	0	0											"$50 days 1-5, $0 days 6+, unlimited coverage"	"$50 days 1-5, $0 days 6-90"	"$0 copay days 1-10, $75 copay days 11-100, coverage for Non-Medicare Covered Stay"	$0 copay	$50 copay	20% coinsurance	"20% coin Prosth, 0% Diab Mon Supp"	"$50 ER, $40 Urgent Care"	$25 OP Hosp Facility - $30 Amb Surg Center	$0 copay	$15 - $20 copay	$0 - $25 copay	$10 copay	$0 - $25 copay	"$10 PCP & Physical Exam, $0 Immun & Screenings"	"$20 Specialist, $0 Screening/Exams"	$40 copay	$20 copay	$15 - $20 copay	$0 - $20 copay	20% coinsurance	$0 - $20 copay	Not Covered	Not Covered	$20 copay	$75 every year	$20 copay	$300 every three years	Not Covered	Not Covered											46.62632849	17.28989546	54.06321737	0	50	0	0.151948646	18.78272067	25.8829247	0	12.13025029	0	0	10.17229773	9.295757862	15.82775674	31.21818922	0	2.944647222	1.223728383	0.2	0	0	0	20	0	20	0	0	0											44.35019853	16.44586484	51.42404519	0	47.5591795	0	0.144531058	17.86581568	24.61941323	0	11.53809502	0	0	9.675722672	8.841972336	15.05510248	29.6942293	0	2.800900116	1.163990356	0.190236718	0	0	0	19.0236718	0	19.0236718	0	0	0											2.6457	0.035541718	2.35567944	0	0.353776133	0	2.686011383	0.796158005	0.412872719	0	1.248641763	0	0	1.385480524	3.275601209	8.326352968	0.571701645	0	0.592186006	0.397037711	5.96004055	0	0	0	0.384971437	0	0.19496746	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6227	0	1.6229	2.6457	0.035541718	2.35567944	0	0.353776133	0	2.686011383	0.796158005	0.412872719	0	1.248641763	0	0	1.385480524	3.275601209	8.326352968	0.571701645	0	0.592186006	0.397037711	5.96004055	0	0	0	0.384971437	0	0.19496746	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6227		"$150 days 1-5, $0 days 6+, unlimited coverage"	"$150 days 1-5, $0 days 6-90"	"$0 copay days 1-10, $100 copay days 11-100, coverage for Non-Medicare Covered Stay"	$0 copay	$100 copay	30% coinsurance	"30% coin Prosth, $10 Diab Mon Supp"	"$50 ER, $40 Urgent Care"	$30 OP Hosp Facility - $35 Amb Surg Center	$20 copay	$20 - $25 copay	$0 - $30 copay	$10 copay	$0 - $30 copay	"$25 PCP, $15 Physical Exam, $10 Immun & Screenings"	"$25 Specialist, $0 Screening/Exams"	$50 copay	$25 copay	$20 - $25 copay	$0 - $25 copay	20% coinsurance	$0 - $20 copay	Not Covered	Not Covered	$25 copay	$75 every year	$25 copay	$300 every three years	Not Covered	Not Covered											0.4714	0	0.3031	0	0.2266	0	1.8854	0.0986	0.0102	0	0.029	0	0	0.0339	0	1.6712	0.1897	0	0.0534	0.0865	0.1291	0	0	0	0.0386	0	0.0319	0	0	0											5.2586	300	0.269881097	3.1171	0.035541718	2.658749309	0	0.580413969	0	4.571404338	0.894710292	0.423023063	0	1.277648199	0	0	1.419349068	3.275601209	9.997527537	0.761425642	0	0.6455943	0.483582529	6.089170239	0	0	0	0.423604907	0	0.226852416	0	0	0	0	0	0	0	0	0	0	0	0	0	36.8813
H2320_014_0	2009	5																					3350											A	A	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O			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	3350	153.5826721	5.563858265	549.7069158	808.7769477	89.26381077	0	18.58431965	534.7584587	201.2425148	2972.399882	1288.535715	13.16968336	0	1718.297108	4307.179277	6636.702459	231.0354537	0	2517.405834	4076.314595	31.32960142	0	0	0	242.8373077	325.4813664	122.9841189	19.32222715	0	0											"$250 copay per admit, unlimited coverage"	$250 copay per admit	"$0 copay days 1-10, $75 copay days 11-100, coverage for Non-Medicare Covered Stay"	$0 copay	$50 copay	20% coinsurance	"20% coin Prosth, 0% Diab Mon Supp"	"$50 ER, $40 Urgent Care"	$25 OP Hosp Facility - $30 Amb Surg Center	$0 copay	$15 - $20 copay	$0 - $25 copay	$10 copay	$0 - $25 copay	"$15 PCP & Physical Exam, $0 Immun & Screening"	"$20 Specialist, $0 Screening/Exams"	$40 copay	$20 copay	$15 - $20 copay	$0 - $20 copay	20% coinsurance	$0 - $20 copay	Not Covered	Not Covered	$20 copay	$75 every year	$20 copay	$300 every three years	Not Covered	Not Covered											250	250	54.06321737	0	50	0	0.151948646	18.78272067	25.8829247	0	12.13025029	0	0	10.17229773	13.94177102	15.82775674	31.21818922	0	2.944647222	1.228799316	0.2	0	0	0	20	0	20	0	0	0											237.7958975	237.7958975	51.42404519	0	47.5591795	0	0.144531058	17.86581568	24.61941323	0	11.53809502	0	0	9.675722672	13.26118381	15.05510248	29.6942293	0	2.800900116	1.168813745	0.190236718	0	0	0	19.0236718	0	19.0236718	0	0	0											3.0434	0.110255222	2.35567944	0	0.353776133	0	2.686011383	0.796158005	0.412872719	0	1.238937294	0	0	1.385480524	4.759858007	8.326352968	0.571701645	0	0.587583524	0.397037711	5.96004055	0	0	0	0.384971437	0	0.19496746	0	0	0	0	0	0	0	0	0	0	0	0	0	33.5651	0	1.7226	3.0434	0.110255222	2.35567944	0	0.353776133	0	2.686011383	0.796158005	0.412872719	0	1.238937294	0	0	1.385480524	4.759858007	8.326352968	0.571701645	0	0.587583524	0.397037711	5.96004055	0	0	0	0.384971437	0	0.19496746	0	0	0	0	0	0	0	0	0	0	0	0	0	33.5651		"$500 copay per admit, unlimited coverage"	$500 copay per admit	"$0 copay days 1-10, $100 copay days 11-100, coverage for Non-Medicare Covered Stay"	$0 copay	$100 copay	30% coinsurance	"30% coin Prosth, $10 Diab Mon Supp"	"$50 ER, $40 Urgent Care"	$30 OP Hosp Facility - $35 Amb Surg Center	$20 copay	$20 - $25 copay	$0 - $30 copay	$10 copay	$0 - $30 copay	"$25 PCP, $20 Physical Exam, $10 Immun & Screenings"	"$25 Specialist, $0 Screening/Exams"	$50 copay	$25 copay	$20 - $25 copay	$0 - $25 copay	20% coinsurance	$0 - $20 copay	Not Covered	Not Covered	$25 copay	$75 every year	$25 copay	$300 every three years	Not Covered	Not Covered											0.3615	0	0.3031	0	0.2266	0	1.8854	0.0986	0.0102	0	0.0288	0	0	0.0339	0	1.6712	0.1897	0	0.053	0.0865	0.1291	0	0	0	0.0386	0	0.0319	0	0	0											5.1481	300	0.264208088	3.405	0.110255222	2.658749309	0	0.580413969	0	4.571404338	0.894710292	0.423023063	0	1.267718291	0	0	1.419349068	4.759858007	9.997527537	0.761425642	0	0.640576728	0.483582529	6.089170239	0	0	0	0.423604907	0	0.226852416	0	0	0	0	0	0	0	0	0	0	0	0	0	38.7132
H2320_015_0	2009	4																					3350											A	A	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O			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	3350	152.0468454	5.535899178	538.0110239	808.7769477	89.26381077	0	18.58431965	534.7584587	199.3061092	2941.356541	1275.078423	12.83627366	0	1674.795916	4307.179277	6340.962308	231.0354537	0	2510.095555	4012.94521	31.32960142	0	0	0	0	0	0	0	0	0											"$500 copay per admit, unlimited coverage"	$500 copay per admit	"$0 copay days 1-10, $100 copay days 11-100, coverage for Non-Medicare Covered Stay"	$0 copay	$50 copay	20% coinsurance	"20% coin Prosth, 0% Diab Mon Supp"	"$50 ER, $40 Urgent Care"	$75 copay	$0 copay	$10 - $35 copay	$0 - $75 copay	$10 copay	$0 - $75 copay	"$15 PCP & Physical Exam, $0 Immun & Screening"	"$30 Specialist, $0 Screening/Exams"	$40 copay	$30 copay	$10 - $35 copay	$0 - $30 copay	20% coinsurance	$0 - $30 copay	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											500	500	72.08428983	0	50	0	0.151948646	18.78272067	71.49979198	0	12.13025029	0	0	30.51689318	13.94177102	23.74086961	31.21818922	0	2.374715501	1.832469089	0.2	0	0	0	0	0	0	0	0	0											475.591795	475.591795	68.56539359	0	47.5591795	0	0.144531058	17.86581568	68.00942883	0	11.53809502	0	0	29.02716802	13.26118381	22.58192559	29.6942293	0	2.258790416	1.743014527	0.190236718	0	0	0	0	0	0	0	0	0											6.026	0.219402352	3.074078134	0	0.353776133	0	2.686011383	0.796158005	1.129557888	0	1.225998001	0	0	4.051215203	4.759858007	11.93259492	0.571701645	0	0.472481649	0.58288515	5.96004055	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.8418	0	2.25	6.026	0.219402352	3.074078134	0	0.353776133	0	2.686011383	0.796158005	1.129557888	0	1.225998001	0	0	4.051215203	4.759858007	11.93259492	0.571701645	0	0.472481649	0.58288515	5.96004055	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.8418		"$700 copay per admit, unlimited coverage"	$700 copay per admit	"$0 copay days 1-10, $120 copay days 11-100, coverage for Non-Medicare Covered Stay"	$0 copay	$100 copay	30% coinsurance	"30% coin Prosth, $10 Diab Mon Supp"	"$50 ER, $40 Urgent Care"	$100 copay	$20 copay	$20 - $40 copay	$0 - $100 copay	$10 copay	$0 - $100 copay	"$35 PCP, $20 Physical Exam, $10 Immun & Screenings"	"$35 Specialist, $0 Screening/Exams"	$50 copay	$35 copay	$20 - $40 copay	$0 - $35 copay	20% coinsurance	$0 - $35 copay	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.5011	0	0.3559	0	0.2266	0	1.8854	0.0986	0.0313	0	0.0335	0	0	0.11	0	2.2349	0.1897	0	0.0567	0.1186	0.1291	0	0	0	0	0	0	0	0	0											5.9714	300	0.30646476	6.5271	0.219402352	3.430024024	0	0.580413969	0	4.571404338	0.894710292	1.160825926	0	1.259504369	0	0	4.161252244	4.759858007	14.16746323	0.761425642	0	0.529187257	0.701469965	6.089170239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8132
H2320_016_0	2009	4																					3350											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O			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	3350	898.6846686	32.55675951	584.2195112	788.5061113	91.5315775	0	20.24767566	762.8054996	287.0621203	4273.187199	1852.427178	18.7858775	0	2451.062649	4558.465171	6805.309343	236.9049602	0	2601.580621	4197.194989	34.13370089	0	0	0	249.0066429	333.7502921	126.1085575	19.81311258	0	0											"$50 days 1-5, $0 days 6+, unlimited coverage"	"$50 days 1-5, $0 days 6-90"	"$0 copay days 1-10, $75 copay days 11-100, coverage for Non-Medicare Covered Stay"	$0 copay	$50 copay	20% coinsurance	"20% coin Prosth, 0% Diab Mon Supp"	"$50 ER, $40 Urgent Care"	$25 OP Hosp Facility - $30 Amb Surg Center	$0 copay	$15 - $20 copay	$0 - $25 copay	$10 copay	$0 - $25 copay	"$10 PCP & Physical Exam, $0 Immun & Screenings"	"$20 Specialist, $0 Screening/Exams"	$40 copay	$20 copay	$15 - $20 copay	$0 - $20 copay	20% coinsurance	$0 - $20 copay	Not Covered	Not Covered	$20 copay	$75 every year	$20 copay	$300 every three years	Not Covered	Not Covered											46.62632849	17.28989546	54.06321737	0	50	0	0.151948646	18.78272067	25.8829247	0	12.13025029	0	0	10.17229773	9.295757862	15.82775674	31.21818922	0	2.944647222	1.223728383	0.2	0	0	0	20	0	20	0	0	0											44.35019853	16.44586484	51.42404519	0	47.5591795	0	0.144531058	17.86581568	24.61941323	0	11.53809502	0	0	9.675722672	8.841972336	15.05510248	29.6942293	0	2.800900116	1.163990356	0.190236718	0	0	0	19.0236718	0	19.0236718	0	0	0											3.3214	0.044618672	2.503577545	0	0.362763894	0	2.926417988	1.135678538	0.588941747	0	1.7811234	0	0	1.97631687	3.358818578	8.537885795	0.586225851	0	0.607230622	0.407124541	6.49348323	0	0	0	0.394751721	0	0.199920651	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2263	0	1.8079	3.3214	0.044618672	2.503577545	0	0.362763894	0	2.926417988	1.135678538	0.588941747	0	1.7811234	0	0	1.97631687	3.358818578	8.537885795	0.586225851	0	0.607230622	0.407124541	6.49348323	0	0	0	0.394751721	0	0.199920651	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2263		"$150 days 1-5, $0 days 6+, unlimited coverage"	"$150 days 1-5, $0 days 6-90"	"$0 copay days 1-10, $100 copay days 11-100, coverage for Non-Medicare Covered Stay"	$0 copay	$100 copay	30% coinsurance	"30% coin Prosth, $10 Diab Mon Supp"	"$50 ER, $40 Urgent Care"	$30 OP Hosp Facility - $35 Amb Surg Center	$20 copay	$20 - $25 copay	$0 - $30 copay	$10 copay	$0 - $30 copay	"$25 PCP, $15 Physical Exam, $10 Immun & Screenings"	"$25 Specialist, $0 Screening/Exams"	$50 copay	$25 copay	$20 - $25 copay	$0 - $25 copay	20% coinsurance	$0 - $20 copay	Not Covered	Not Covered	$25 copay	$75 every year	$25 copay	$300 every three years	Not Covered	Not Covered											0.5918	0	0.3221	0	0.2324	0	2.0541	0.1406	0.0145	0	0.0414	0	0	0.0483	0	1.7136	0.1945	0	0.0548	0.0887	0.1407	0	0	0	0.0396	0	0.0327	0	0	0											5.7099	300	0.293041729	3.9132	0.044618672	2.825675241	0	0.595159513	0	4.980559639	1.276258318	0.603420691	0	1.822499592	0	0	2.02462861	3.358818578	10.25151692	0.780769828	0	0.661995765	0.49586805	6.634170439	0	0	0	0.434366683	0	0.232615651	0	0	0	0	0	0	0	0	0	0	0	0	0	40.9362
H2320_017_0	2009	5																					3350											A	A	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O			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	3350	192.8059559	6.984804968	584.2195112	788.5061113	91.5315775	0	20.24767566	762.8054996	287.0621203	4239.975899	1838.030075	18.7858775	0	2451.062649	4416.604113	6805.309343	236.9049602	0	2581.361082	4179.874262	34.13370089	0	0	0	249.0066429	333.7502921	126.1085575	19.81311258	0	0											"$250 copay per admit, unlimited coverage"	$250 copay per admit	"$0 copay days 1-10, $75 copay days 11-100, coverage for Non-Medicare Covered Stay"	$0 copay	$50 copay	20% coinsurance	"20% coin Prosth, 0% Diab Mon Supp"	"$50 ER, $40 Urgent Care"	$25 OP Hosp Facility - $30 Amb Surg Center	$0 copay	$15 - $20 copay	$0 - $25 copay	$10 copay	$0 - $25 copay	"$15 PCP & Physical Exam, $0 Immun & Screening"	"$20 Specialist, $0 Screening/Exams"	$40 copay	$20 copay	$15 - $20 copay	$0 - $20 copay	20% coinsurance	$0 - $20 copay	Not Covered	Not Covered	$20 copay	$75 every year	$20 copay	$300 every three years	Not Covered	Not Covered											250	250	54.06321737	0	50	0	0.151948646	18.78272067	25.8829247	0	12.13025029	0	0	10.17229773	13.94177102	15.82775674	31.21818922	0	2.944647222	1.228799316	0.2	0	0	0	20	0	20	0	0	0											237.7958975	237.7958975	51.42404519	0	47.5591795	0	0.144531058	17.86581568	24.61941323	0	11.53809502	0	0	9.675722672	13.26118381	15.05510248	29.6942293	0	2.800900116	1.168813745	0.190236718	0	0	0	19.0236718	0	19.0236718	0	0	0											3.8207	0.138413164	2.503577545	0	0.362763894	0	2.926417988	1.135678538	0.588941747	0	1.767280472	0	0	1.97631687	4.880783246	8.537885795	0.586225851	0	0.602511213	0.407124541	6.49348323	0	0	0	0.394751721	0	0.199920651	0	0	0	0	0	0	0	0	0	0	0	0	0	37.3228	0	1.9155	3.8207	0.138413164	2.503577545	0	0.362763894	0	2.926417988	1.135678538	0.588941747	0	1.767280472	0	0	1.97631687	4.880783246	8.537885795	0.586225851	0	0.602511213	0.407124541	6.49348323	0	0	0	0.394751721	0	0.199920651	0	0	0	0	0	0	0	0	0	0	0	0	0	37.3228		"$500 copay per admit, unlimited coverage"	$500 copay per admit	"$0 copay days 1-10, $100 copay days 11-100, coverage for Non-Medicare Covered Stay"	$0 copay	$100 copay	30% coinsurance	"30% coin Prosth, $10 Diab Mon Supp"	"$50 ER, $40 Urgent Care"	$30 OP Hosp Facility - $35 Amb Surg Center	$20 copay	$20 - $25 copay	$0 - $30 copay	$10 copay	$0 - $30 copay	"$25 PCP, $20 Physical Exam, $10 Immun & Screenings"	"$25 Specialist, $0 Screening/Exams"	$50 copay	$25 copay	$20 - $25 copay	$0 - $25 copay	20% coinsurance	$0 - $20 copay	Not Covered	Not Covered	$25 copay	$75 every year	$25 copay	$300 every three years	Not Covered	Not Covered											0.4539	0	0.3221	0	0.2324	0	2.0541	0.1406	0.0145	0	0.0411	0	0	0.0483	0	1.7136	0.1945	0	0.0543	0.0887	0.1407	0	0	0	0.0396	0	0.0327	0	0	0											5.5712	300	0.285922818	4.2746	0.138413164	2.825675241	0	0.595159513	0	4.980559639	1.276258318	0.603420691	0	1.808335088	0	0	2.02462861	4.880783246	10.25151692	0.780769828	0	0.656850721	0.49586805	6.634170439	0	0	0	0.434366683	0	0.232615651	0	0	0	0	0	0	0	0	0	0	0	0	0	42.894
H2320_018_0	2009	4																					3350											A	A	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O			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	3350	190.8778963	6.949705445	571.7893088	788.5061113	91.5315775	0	20.24767566	762.8054996	284.2999372	4195.694166	1818.833939	18.31028566	0	2389.01043	4416.604113	6502.055849	236.9049602	0	2573.865084	4114.894964	34.13370089	0	0	0	0	0	0	0	0	0											"$500 copay per admit, unlimited coverage"	$500 copay per admit	"$0 copay days 1-10, $100 copay days 11-100, coverage for Non-Medicare Covered Stay"	$0 copay	$50 copay	20% coinsurance	"20% coin Prosth, 0% Diab Mon Supp"	"$50 ER, $40 Urgent Care"	$75 copay	$0 copay	$10 - $35 copay	$0 - $75 copay	$10 copay	$0 - $75 copay	"$15 PCP & Physical Exam, $0 Immun & Screening"	"$30 Specialist, $0 Screening/Exams"	$40 copay	$30 copay	$10 - $35 copay	$0 - $30 copay	20% coinsurance	$0 - $30 copay	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											500	500	72.08428983	0	50	0	0.151948646	18.78272067	71.49979198	0	12.13025029	0	0	30.51689318	13.94177102	23.74086961	31.21818922	0	2.374715501	1.832469089	0.2	0	0	0	0	0	0	0	0	0											475.591795	475.591795	68.56539359	0	47.5591795	0	0.144531058	17.86581568	68.00942883	0	11.53809502	0	0	29.02716802	13.26118381	22.58192559	29.6942293	0	2.258790416	1.743014527	0.190236718	0	0	0	0	0	0	0	0	0											7.565	0.275435241	3.267079918	0	0.362763894	0	2.926417988	1.135678538	1.611256362	0	1.748823234	0	0	5.778850594	4.880783246	12.23574511	0.586225851	0	0.484485149	0.597693475	6.49348323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.9497	0	2.5635	7.565	0.275435241	3.267079918	0	0.362763894	0	2.926417988	1.135678538	1.611256362	0	1.748823234	0	0	5.778850594	4.880783246	12.23574511	0.586225851	0	0.484485149	0.597693475	6.49348323	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.9497		"$700 copay per admit, unlimited coverage"	$700 copay per admit	"$0 copay days 1-10, $120 copay days 11-100, coverage for Non-Medicare Covered Stay"	$0 copay	$100 copay	30% coinsurance	"30% coin Prosth, $10 Diab Mon Supp"	"$50 ER, $40 Urgent Care"	$100 copay	$20 copay	$20 - $40 copay	$0 - $100 copay	$10 copay	$0 - $100 copay	"$35 PCP, $20 Physical Exam, $10 Immun & Screenings"	"$35 Specialist, $0 Screening/Exams"	$50 copay	$35 copay	$20 - $40 copay	$0 - $35 copay	20% coinsurance	$0 - $35 copay	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.6291	0	0.3783	0	0.2324	0	2.0541	0.1406	0.0446	0	0.0478	0	0	0.157	0	2.2916	0.1945	0	0.0581	0.1216	0.1407	0	0	0	0	0	0	0	0	0											6.4904	300	0.333101249	8.1941	0.275435241	3.645373382	0	0.595159513	0	4.980559639	1.276258318	1.655858614	0	1.796618349	0	0	5.935812786	4.880783246	14.52739075	0.780769828	0	0.542631376	0.719290963	6.634170439	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.4402
H2320_802_0	2009	5																																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		182.83562	1.216329421	14.80292532	10.41223575	2.706629781	0	19.13059502	6.757945084	27.97194636	12.35578668	25.1830826	0.182681583	0	28.41437248	31.53128319	57.80180584	1.438392841	0	18.21849249	66.15104977	24.31589294	0	0	0	0	0	0	0	0	7.24											Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing																			0.073800831	0.073800831	0.187288475	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.073800831	0.073800831	0.187288475	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											13.4934	0.089766122	2.772417307	0	0.625231479	0	4.419167449	1.561085314	6.461519608	2.854186723	5.81729208	0.042199446	0	6.563720042	7.283726416	13.35221715	0.332268746	0	4.208471765	15.2808925	5.616971268	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.7746	135		13.4934	0.089766122	2.772417307	0	0.625231479	0	4.419167449	1.561085314	6.461519608	2.854186723	5.81729208	0.042199446	0	6.563720042	7.283726416	13.35221715	0.332268746	0	4.208471765	15.2808925	5.616971268	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.7746		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing																			1.003	0	0.6277	0	0.4514	0	0.2567	0.217	0.1306	0.1656	0.1126	0.0064	0	0.2816	0	2.2805	0.0999	0	0.1912	1.8751	0.5849	0	0	0	0	0	0	0	0	0											8.2843			14.4964	0.089766122	3.400101638	0	1.076656945	0	4.675827601	1.778099339	6.592124629	3.019778052	5.929852241	0.048649422	0	6.845306591	7.283726416	15.63276645	0.432163676	0	4.399708209	17.15595787	6.201915186	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.0588
H2320_803_0	2009	5																																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		182.83562	1.216329421	14.80292532	10.41223575	2.706629781	0	19.13059502	6.757945084	27.97194636	12.35578668	25.1830826	0.182681583	0	28.41437248	31.53128319	57.80180584	1.438392841	0	18.21849249	66.15104977	24.31589294	0	0	0	0	0	0	0	0	7.24											Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing																			0.073800831	0.073800831	0.187288475	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.073800831	0.073800831	0.187288475	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											13.4934	0.089766122	2.772417307	0	0.625231479	0	4.419167449	1.561085314	6.461519608	2.854186723	5.81729208	0.042199446	0	6.563720042	7.283726416	13.35221715	0.332268746	0	4.208471765	15.2808925	5.616971268	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.7746	135		13.4934	0.089766122	2.772417307	0	0.625231479	0	4.419167449	1.561085314	6.461519608	2.854186723	5.81729208	0.042199446	0	6.563720042	7.283726416	13.35221715	0.332268746	0	4.208471765	15.2808925	5.616971268	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.7746		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing																			1.003	0	0.6277	0	0.4514	0	0.2567	0.217	0.1306	0.1656	0.1126	0.0064	0	0.2816	0	2.2805	0.0999	0	0.1912	1.8751	0.5849	0	0	0	0	0	0	0	0	0											8.2843			14.4964	0.089766122	3.400101638	0	1.076656945	0	4.675827601	1.778099339	6.592124629	3.019778052	5.929852241	0.048649422	0	6.845306591	7.283726416	15.63276645	0.432163676	0	4.399708209	17.15595787	6.201915186	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.0588
H2320_804_0	2009	5																																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		195.0264182	1.216329421	17.90299865	10.45478324	4.367719156	0	20.07501549	7.626940636	28.49493183	13.01886884	25.61431958	0.208509412	0	29.54193766	31.53128319	67.13132571	1.847053917	0	18.95115159	73.82177176	26.70884533	0	0	0	0	0	0	0	0	16.7											Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing																			0.073800831	0.073800831	0.187288475	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.073800831	0.073800831	0.187288475	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											14.3931	0.089766122	3.353025314	0	1.008943125	0	4.637328578	1.761823287	6.582329252	3.007358702	5.916907823	0.048165674	0	6.8241876	7.283726416	15.50733624	0.426669455	0	4.377716018	17.05282928	6.16974327	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.441	135		14.3931	0.089766122	3.353025314	0	1.008943125	0	4.637328578	1.761823287	6.582329252	3.007358702	5.916907823	0.048165674	0	6.8241876	7.283726416	15.50733624	0.426669455	0	4.377716018	17.05282928	6.16974327	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.441		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			14.3931	0.089766122	3.353025314	0	1.008943125	0	4.637328578	1.761823287	6.582329252	3.007358702	5.916907823	0.048165674	0	6.8241876	7.283726416	15.50733624	0.426669455	0	4.377716018	17.05282928	6.16974327	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.441
H2320_805_0	2009	5																																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		195.0264182	1.216329421	17.90299865	10.45478324	4.367719156	0	20.07501549	7.626940636	28.49493183	13.01886884	25.61431958	0.208509412	0	29.54193766	31.53128319	67.13132571	1.847053917	0	18.95115159	73.82177176	26.70884533	0	0	0	0	0	0	0	0	16.7											Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing																			0.073800831	0.073800831	0.187288475	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.073800831	0.073800831	0.187288475	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											14.3931	0.089766122	3.353025314	0	1.008943125	0	4.637328578	1.761823287	6.582329252	3.007358702	5.916907823	0.048165674	0	6.8241876	7.283726416	15.50733624	0.426669455	0	4.377716018	17.05282928	6.16974327	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.441	135		14.3931	0.089766122	3.353025314	0	1.008943125	0	4.637328578	1.761823287	6.582329252	3.007358702	5.916907823	0.048165674	0	6.8241876	7.283726416	15.50733624	0.426669455	0	4.377716018	17.05282928	6.16974327	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.441		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			14.3931	0.089766122	3.353025314	0	1.008943125	0	4.637328578	1.761823287	6.582329252	3.007358702	5.916907823	0.048165674	0	6.8241876	7.283726416	15.50733624	0.426669455	0	4.377716018	17.05282928	6.16974327	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.441
H2320_806_0	2009	5																																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		182.83562	1.216329421	14.80292532	10.41223575	2.706629781	0	19.13059502	6.757945084	27.97194636	12.35578668	25.1830826	0.182681583	0	28.41437248	31.53128319	57.80180584	1.438392841	0	18.21849249	66.15104977	24.31589294	0	0	0	0	0	0	0	0	7.24											Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing																			0.073800831	0.073800831	0.187288475	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.073800831	0.073800831	0.187288475	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											13.4934	0.089766122	2.772417307	0	0.625231479	0	4.419167449	1.561085314	6.461519608	2.854186723	5.81729208	0.042199446	0	6.563720042	7.283726416	13.35221715	0.332268746	0	4.208471765	15.2808925	5.616971268	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.7746	135		13.4934	0.089766122	2.772417307	0	0.625231479	0	4.419167449	1.561085314	6.461519608	2.854186723	5.81729208	0.042199446	0	6.563720042	7.283726416	13.35221715	0.332268746	0	4.208471765	15.2808925	5.616971268	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.7746		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing																			1.003	0	0.6277	0	0.4514	0	0.2567	0.217	0.1306	0.1656	0.1126	0.0064	0	0.2816	0	2.2805	0.0999	0	0.1912	1.8751	0.5849	0	0	0	0	0	0	0	0	0											8.2843			14.4964	0.089766122	3.400101638	0	1.076656945	0	4.675827601	1.778099339	6.592124629	3.019778052	5.929852241	0.048649422	0	6.845306591	7.283726416	15.63276645	0.432163676	0	4.399708209	17.15595787	6.201915186	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.0588
H2320_807_0	2009	5																																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		182.83562	1.216329421	14.80292532	10.41223575	2.706629781	0	19.13059502	6.757945084	27.97194636	12.35578668	25.1830826	0.182681583	0	28.41437248	31.53128319	57.80180584	1.438392841	0	18.21849249	66.15104977	24.31589294	0	0	0	0	0	0	0	0	7.24											Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing																			0.073800831	0.073800831	0.187288475	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.073800831	0.073800831	0.187288475	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											13.4934	0.089766122	2.772417307	0	0.625231479	0	4.419167449	1.561085314	6.461519608	2.854186723	5.81729208	0.042199446	0	6.563720042	7.283726416	13.35221715	0.332268746	0	4.208471765	15.2808925	5.616971268	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.7746	135		13.4934	0.089766122	2.772417307	0	0.625231479	0	4.419167449	1.561085314	6.461519608	2.854186723	5.81729208	0.042199446	0	6.563720042	7.283726416	13.35221715	0.332268746	0	4.208471765	15.2808925	5.616971268	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.7746		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing																			1.003	0	0.6277	0	0.4514	0	0.2567	0.217	0.1306	0.1656	0.1126	0.0064	0	0.2816	0	2.2805	0.0999	0	0.1912	1.8751	0.5849	0	0	0	0	0	0	0	0	0											8.2843			14.4964	0.089766122	3.400101638	0	1.076656945	0	4.675827601	1.778099339	6.592124629	3.019778052	5.929852241	0.048649422	0	6.845306591	7.283726416	15.63276645	0.432163676	0	4.399708209	17.15595787	6.201915186	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.0588
H2320_808_0	2009	5																																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		195.0264182	1.216329421	17.90299865	10.45478324	4.367719156	0	20.07501549	7.626940636	28.49493183	13.01886884	25.61431958	0.208509412	0	29.54193766	31.53128319	67.13132571	1.847053917	0	18.95115159	73.82177176	26.70884533	0	0	0	0	0	0	0	0	16.7											Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing																			0.073800831	0.073800831	0.187288475	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.073800831	0.073800831	0.187288475	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											14.3931	0.089766122	3.353025314	0	1.008943125	0	4.637328578	1.761823287	6.582329252	3.007358702	5.916907823	0.048165674	0	6.8241876	7.283726416	15.50733624	0.426669455	0	4.377716018	17.05282928	6.16974327	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.441	135		14.3931	0.089766122	3.353025314	0	1.008943125	0	4.637328578	1.761823287	6.582329252	3.007358702	5.916907823	0.048165674	0	6.8241876	7.283726416	15.50733624	0.426669455	0	4.377716018	17.05282928	6.16974327	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.441		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			14.3931	0.089766122	3.353025314	0	1.008943125	0	4.637328578	1.761823287	6.582329252	3.007358702	5.916907823	0.048165674	0	6.8241876	7.283726416	15.50733624	0.426669455	0	4.377716018	17.05282928	6.16974327	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.441
H2320_809_0	2009	5																																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		195.0264182	1.216329421	17.90299865	10.45478324	4.367719156	0	20.07501549	7.626940636	28.49493183	13.01886884	25.61431958	0.208509412	0	29.54193766	31.53128319	67.13132571	1.847053917	0	18.95115159	73.82177176	26.70884533	0	0	0	0	0	0	0	0	16.7											Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing																			0.073800831	0.073800831	0.187288475	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.073800831	0.073800831	0.187288475	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											14.3931	0.089766122	3.353025314	0	1.008943125	0	4.637328578	1.761823287	6.582329252	3.007358702	5.916907823	0.048165674	0	6.8241876	7.283726416	15.50733624	0.426669455	0	4.377716018	17.05282928	6.16974327	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.441	135		14.3931	0.089766122	3.353025314	0	1.008943125	0	4.637328578	1.761823287	6.582329252	3.007358702	5.916907823	0.048165674	0	6.8241876	7.283726416	15.50733624	0.426669455	0	4.377716018	17.05282928	6.16974327	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.441		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			14.3931	0.089766122	3.353025314	0	1.008943125	0	4.637328578	1.761823287	6.582329252	3.007358702	5.916907823	0.048165674	0	6.8241876	7.283726416	15.50733624	0.426669455	0	4.377716018	17.05282928	6.16974327	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.441
H2322_001_0	2009	8																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	V	V	V	P	V	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	273.3700319	8.357974304	743.5158264	0.542935094	369.5789793	16.61571188	0	356.828066	291.3052403	0	462.7870797	0	0	708.4880046	3674.476842	3165.481998	240.033271	284.9011126	0	639.5147025	689.8756316	0	0	0	9.60693902	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: 20%, 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: $50	9A OP Hospital: Included in h.5.	12 Renal Dialysis: Included in h.5.	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0, 9A OP Hospital: $50, 12 Renal Dialysis: $25"	"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: $25"	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: $0 Up to $400/yr. including exam and fitting	"14A Health Education/Wellness Programs: $0 Up to $20/mo. in fitness or weight loss program, or services for acupuncture, chiropractor, or massage"	13B Acupuncture: Included in p.											250	250	130	0	50	0.21	0	49.18	50	0	50	0	0	35.23840485	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0											250	250	130	0	50	0.21	0	49.18	50	0	50	0	0	35.23840485	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0											5.6952	0.174124465	8.054754786	0	1.539912414	3.489299494	0	1.462400357	1.213771834	0	1.928279499	0	0	2.080498928	3.062064035	6.594754162	0.500069314	0.356126391	0	1.332322297	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.4836	0	0	5.6952	0.174124465	8.054754786	0	1.539912414	3.489299494	0	1.462400357	1.213771834	0	1.928279499	0	0	2.080498928	3.062064035	6.594754162	0.500069314	0.356126391	0	1.332322297	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.4836	0	1A IP Acute: $500 per admit	1B IP Psych: $500 per admit	"2 SNF: $100 days 1-20, $130 days 21-100"	20% Coinsurance	20% Coinsurance	11A DME: 50%	"11B Prosthetic Medical Supplies: 50%, 11C Diabetes Monitoring Supplies: 20%"	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	20% Coinsurance	20% Coinsurance	0	0	0	0											2.4314	0.0289	0.2536	0.1322	0.1521	0.1371	0	0.2563	0.3003	0.01	0.185	0	0	0.5506	0.3249	1.4252	0.0225	0.0272	0	0.6556	0.1533	0.003	0	0	0.0022	0.0044	0	0.0007	0	0											7.0567	0	0	8.1267	0.203053148	8.30837491	0.132216482	1.692055664	3.626379117	0	1.718695114	1.514061353	0.010019983	2.113271196	0	0	2.631077358	3.386951298	8.019940634	0.52258993	0.383290077	0	1.987965827	0.153325096	0.002976136	0	0	0.002216554	0.004435335	3.34E-05	0.000674576	0	0	0	0	0	0	0	0	0	0	0	0	44.5403
H2322_003_0	2009	6																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	V	V	V	P	V	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	273.3700319	8.357974304	743.5158264	0.542935094	369.5789793	16.61571188	0	356.828066	291.3052403	0	462.7870797	0	0	708.4880046	3674.476842	3165.481998	240.033271	284.9011126	0	639.5147025	689.8756316	0	0	0	9.60693902	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: 20%, 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: $50	9A OP Hospital: Included in h.5.	12 Renal Dialysis: Included in h.5.	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0, 9A OP Hospital: $50, 12 Renal Dialysis: $25"	"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: $25"	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: $0 Up to $400/yr. including exam and fitting	"14A Health Education/Wellness Programs: $0 Up to $20/mo. in fitness or weight loss program, or services for acupuncture, chiropractor, or massage"	13B Acupuncture: Included in p.											250	250	130	0	50	0.21	0	49.18	50	0	50	0	0	35.23840485	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0											250	250	130	0	50	0.21	0	49.18	50	0	50	0	0	35.23840485	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0											5.6952	0.174124465	8.054754786	0	1.539912414	3.489299494	0	1.462400357	1.213771834	0	1.928279499	0	0	2.080498928	3.062064035	6.594754162	0.500069314	0.356126391	0	1.332322297	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.4836	0	0	5.6952	0.174124465	8.054754786	0	1.539912414	3.489299494	0	1.462400357	1.213771834	0	1.928279499	0	0	2.080498928	3.062064035	6.594754162	0.500069314	0.356126391	0	1.332322297	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.4836	0	1A IP Acute: $500 per admit	1B IP Psych: $500 per admit	"2 SNF: $100 days 1-20, $130 days 21-100"	20% Coinsurance	20% Coinsurance	11A DME: 50%	"11B Prosthetic Medical Supplies: 50%, 11C Diabetes Monitoring Supplies: 20%"	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	20% Coinsurance	20% Coinsurance	0	0	0	0											2.4314	0.0289	0.2536	0.1322	0.1521	0.1371	0	0.2563	0.3003	0.01	0.185	0	0	0.5506	0.3249	1.4252	0.0225	0.0272	0	0.6556	0.1533	0.003	0	0	0.0022	0.0044	0	0	0	0											7.056	0	0	8.1267	0.203053148	8.30837491	0.132216482	1.692055664	3.626379117	0	1.718695114	1.514061353	0.010019983	2.113271196	0	0	2.631077358	3.386951298	8.019940634	0.52258993	0.383290077	0	1.987965827	0.153325096	0.002976136	0	0	0.002216554	0.004435335	1.33E-06	8.87E-07	0	0	0	0	0	0	0	0	0	0	0	0	44.5396
H2322_004_0	2009	8																					0											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	V	V	V	P	V	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	273.3700319	8.357974304	743.5158264	0.542935094	369.5789793	16.61571188	0	356.828066	291.3052403	0	462.7870797	0	0	708.4880046	3674.476842	3165.481998	240.033271	284.9011126	0	639.5147025	689.8756316	0	0	0	9.60693902	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: 20%, 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: $50	9A OP Hospital: Included in h.5.	12 Renal Dialysis: Included in h.5.	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0, 9A OP Hospital: $50, 12 Renal Dialysis: $25"	"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: $25"	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: $0 Up to $400/yr. including exam and fitting	"14A Health Education/Wellness Programs: $0 Up to $20/mo. in fitness or weight loss program, or services for acupuncture, chiropractor, or massage"	13B Acupuncture: Included in p.											250	250	130	0	50	0.21	0	49.18	50	0	50	0	0	35.23840485	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0											250	250	130	0	50	0.21	0	49.18	50	0	50	0	0	35.23840485	10	25	25	15	0	25	0	0	0	0	0	0	0	0	0	0											5.6952	0.174124465	8.054754786	0	1.539912414	3.489299494	0	1.462400357	1.213771834	0	1.928279499	0	0	2.080498928	3.062064035	6.594754162	0.500069314	0.356126391	0	1.332322297	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.4836	0	0	5.6952	0.174124465	8.054754786	0	1.539912414	3.489299494	0	1.462400357	1.213771834	0	1.928279499	0	0	2.080498928	3.062064035	6.594754162	0.500069314	0.356126391	0	1.332322297	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.4836	0	1A IP Acute: $500 per admit	1B IP Psych: $500 per admit	"2 SNF: $100 days 1-20, $130 days 21-100"	20% Coinsurance	20% Coinsurance	11A DME: 50%	"11B Prosthetic Medical Supplies: 50%, 11C Diabetes Monitoring Supplies: 20%"	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	20% Coinsurance	20% Coinsurance	0	0	0	0											2.4314	0.0289	0.2536	0.1322	0.1521	0.1371	0	0.2563	0.3003	0.01	0.185	0	0	0.5506	0.3249	1.4252	0.0225	0.0272	0	0.6556	0.1533	0.003	0	0	0.0022	0.0044	0	0	0	0											7.056	0	0	8.1267	0.203053148	8.30837491	0.132216482	1.692055664	3.626379117	0	1.718695114	1.514061353	0.010019983	2.113271196	0	0	2.631077358	3.386951298	8.019940634	0.52258993	0.383290077	0	1.987965827	0.153325096	0.002976136	0	0	0.002216554	0.004435335	1.33E-06	8.87E-07	0	0	0	0	0	0	0	0	0	0	0	0	44.5396
H2322_005_0	2009	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	O	V											12.672	0.1503	1.9571	1.8435	0.2671	0.3962	0.2782	0.0059	1.5895	0.4335	0.8951	0.0526	0.0115	1.4099	1.7728	4.2982	0.0543	0.2249	1.538	1.8214	0.4082	0.2914	0	0	0.1082	0.2719	0.0207	0.1264	0.023	0.0829											33.0046	0	296.235	4.95	420.3	0	174.114	10.35878255	7.272806187	282.168	312.822	0	859.536	78.084	1.512	447.174	5072.274	6356.169	198.279	765.423	0	2240.145	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: 20%, 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: $50	9A OP Hospital: $50	12 Renal Dialysis: $25	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0, 7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	"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: $10 to $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: $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: $0 Up to $400/yr. including exam and fitting	"14A Health Education/Wellness Programs: $0 Up to $20/mo. in fitness or weight loss program, or services for acupuncture, chiropractor, or massage"	13B Acupuncture: Included in p.											250	250	130	0	50	0.207649755	0.207612225	49.02079612	50	0	43.5	50	25	15	10	25	25	15	0	20.94146361	0	0	0	0	0	0	0	0	0	0											250	250	130	0	50	0.207649755	0.207612225	49.02079612	50	0	43.5	50	25	15	10	25	25	15	0	20.94146361	0	0	0	0	0	0	0	0	0	0											6.1716	0.103125	4.55325	0	0.725475	2.150998663	1.509923477	1.152675	1.303425	0	3.115818	0.32535	0.00315	0.5589675	4.226895	13.24201875	0.41308125	0.95677875	0	3.90932625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.4218	500	0	18.8436	0.253381603	6.510333191	1.843488439	0.992545276	2.547216114	1.78811729	1.158544695	2.892926073	0.43351819	4.010953487	0.377923406	0.014609635	1.968893196	5.999654905	17.54017528	0.467416946	1.181698949	1.53803633	5.730695487	0.408236536	0.291360695	0	0	0.108172321	0.271881389	0.020722667	0.126408268	0.023025185	0.082890667	0	0	0	0	0	0	0	0	0	0	77.4264	0	1A IP Acute: $500 per admit	1B IP Psych: $500 per admit	"2 SNF: $100 days 1-20, $130 days 21-100"	20% Coinsurance	20% Coinsurance	11A DME: 50%	"11B Prosthetic Medical Supplies: 50%, 11C Diabetes Monitoring Supplies: 20%"	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	20% Coinsurance	20% Coinsurance	0	0	0	0											1.3853	0.0232	1.4197	1.0885	0.1772	0.2924	0.2054	0.1287	0.9738	0.256	0.6133	0.0399	0.0068	0.8479	1.1745	2.8979	0.0433	0.1587	0.9081	1.1813	0.2408	0.172	0	0	0.0897	0.1606	0.0261	0.0745	0	0											14.5854	500	0	20.2289	0.27654827	7.930018124	2.931956275	1.169786207	2.83966365	1.993508251	1.287213219	3.866708601	0.689474946	4.624259238	0.417802615	0.021386494	2.816782533	7.174136723	20.43806451	0.510684585	1.340433842	2.446135454	6.911954164	0.649075684	0.463388658	0	0	0.19783538	0.43244082	0.04678751	0.200953718	0.023025185	0.082890667	0	0	0	0	0	0	0	0	0	0	92.0118
H2322_006_0	2009	9																					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	O	V											12.672	0.1503	1.9571	1.8435	0.2671	0.3962	0.2782	0.0059	1.5895	0.4335	0.8951	0.0526	0.0115	1.4099	1.7728	4.2982	0.0543	0.2249	1.538	1.8214	0.4082	0.2914	0	0	0.1082	0.2719	0.0207	0.1264	0.023	0.0829											33.0046	0	296.235	4.95	420.3	0	174.114	10.35878255	7.272806187	282.168	312.822	0	859.536	78.084	1.512	447.174	5072.274	6356.169	198.279	765.423	0	2240.145	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: 20%, 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: $50	9A OP Hospital: $50	12 Renal Dialysis: $25	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0, 7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	"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: $10 to $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: $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: $0 Up to $400/yr. including exam and fitting	"14A Health Education/Wellness Programs: $0 Up to $20/mo. in fitness or weight loss program, or services for acupuncture, chiropractor, or massage"	13B Acupuncture: Included in p.											250	250	130	0	50	0.207649755	0.207612225	49.02079612	50	0	43.5	50	25	15	10	25	25	15	0	20.94146361	0	0	0	0	0	0	0	0	0	0											250	250	130	0	50	0.207649755	0.207612225	49.02079612	50	0	43.5	50	25	15	10	25	25	15	0	20.94146361	0	0	0	0	0	0	0	0	0	0											6.1716	0.103125	4.55325	0	0.725475	2.150998663	1.509923477	1.152675	1.303425	0	3.115818	0.32535	0.00315	0.5589675	4.226895	13.24201875	0.41308125	0.95677875	0	3.90932625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.4218	500	0	18.8436	0.253381603	6.510333191	1.843488439	0.992545276	2.547216114	1.78811729	1.158544695	2.892926073	0.43351819	4.010953487	0.377923406	0.014609635	1.968893196	5.999654905	17.54017528	0.467416946	1.181698949	1.53803633	5.730695487	0.408236536	0.291360695	0	0	0.108172321	0.271881389	0.020722667	0.126408268	0.023025185	0.082890667	0	0	0	0	0	0	0	0	0	0	77.4264	0	1A IP Acute: $500 per admit	1B IP Psych: $500 per admit	"2 SNF: $100 days 1-20, $130 days 21-100"	20% Coinsurance	20% Coinsurance	11A DME: 50%	"11B Prosthetic Medical Supplies: 50%, 11C Diabetes Monitoring Supplies: 20%"	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	20% Coinsurance	20% Coinsurance	0	0	0	0											1.3853	0.0232	1.4197	1.0885	0.1772	0.2924	0.2054	0.1287	0.9738	0.256	0.6133	0.0399	0.0068	0.8479	1.1745	2.8979	0.0433	0.1587	0.9081	1.1813	0.2408	0.172	0	0	0.0897	0.1606	0.0261	0.0745	0	0											14.5854	500	0	20.2289	0.27654827	7.930018124	2.931956275	1.169786207	2.83966365	1.993508251	1.287213219	3.866708601	0.689474946	4.624259238	0.417802615	0.021386494	2.816782533	7.174136723	20.43806451	0.510684585	1.340433842	2.446135454	6.911954164	0.649075684	0.463388658	0	0	0.19783538	0.43244082	0.04678751	0.200953718	0.023025185	0.082890667	0	0	0	0	0	0	0	0	0	0	92.0118
H2322_007_0	2009	8																					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	O	V											12.672	0.1503	1.9571	1.8435	0.2671	0.3962	0.2782	0.0059	1.5895	0.4335	0.8951	0.0526	0.0115	1.4099	1.7728	4.2982	0.0543	0.2249	1.538	1.8214	0.4082	0.2914	0	0	0.1082	0.2719	0.0207	0.1264	0.023	0.0829											33.0046	0	296.235	4.95	420.3	0	174.114	10.35878255	7.272806187	282.168	312.822	0	859.536	78.084	1.512	447.174	5072.274	6356.169	198.279	765.423	0	2240.145	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: 20%, 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: $50	9A OP Hospital: $50	12 Renal Dialysis: $25	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0, 7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	"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: $10 to $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: $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: $0 Up to $400/yr. including exam and fitting	"14A Health Education/Wellness Programs: $0 Up to $20/mo. in fitness or weight loss program, or services for acupuncture, chiropractor, or massage"	13B Acupuncture: Included in p.											250	250	130	0	50	0.207649755	0.207612225	49.02079612	50	0	43.5	50	25	15	10	25	25	15	0	20.94146361	0	0	0	0	0	0	0	0	0	0											250	250	130	0	50	0.207649755	0.207612225	49.02079612	50	0	43.5	50	25	15	10	25	25	15	0	20.94146361	0	0	0	0	0	0	0	0	0	0											6.1716	0.103125	4.55325	0	0.725475	2.150998663	1.509923477	1.152675	1.303425	0	3.115818	0.32535	0.00315	0.5589675	4.226895	13.24201875	0.41308125	0.95677875	0	3.90932625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.4218	500	0	18.8436	0.253381603	6.510333191	1.843488439	0.992545276	2.547216114	1.78811729	1.158544695	2.892926073	0.43351819	4.010953487	0.377923406	0.014609635	1.968893196	5.999654905	17.54017528	0.467416946	1.181698949	1.53803633	5.730695487	0.408236536	0.291360695	0	0	0.108172321	0.271881389	0.020722667	0.126408268	0.023025185	0.082890667	0	0	0	0	0	0	0	0	0	0	77.4264	0	1A IP Acute: $500 per admit	1B IP Psych: $500 per admit	"2 SNF: $100 days 1-20, $130 days 21-100"	20% Coinsurance	20% Coinsurance	11A DME: 50%	"11B Prosthetic Medical Supplies: 50%, 11C Diabetes Monitoring Supplies: 20%"	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	20% Coinsurance	20% Coinsurance	0	0	0	0											1.3853	0.0232	1.4197	1.0885	0.1772	0.2924	0.2054	0.1287	0.9738	0.256	0.6133	0.0399	0.0068	0.8479	1.1745	2.8979	0.0433	0.1587	0.9081	1.1813	0.2408	0.172	0	0	0.0897	0.1606	0.0261	0.0745	0	0											14.5854	500	0	20.2289	0.27654827	7.930018124	2.931956275	1.169786207	2.83966365	1.993508251	1.287213219	3.866708601	0.689474946	4.624259238	0.417802615	0.021386494	2.816782533	7.174136723	20.43806451	0.510684585	1.340433842	2.446135454	6.911954164	0.649075684	0.463388658	0	0	0.19783538	0.43244082	0.04678751	0.200953718	0.023025185	0.082890667	0	0	0	0	0	0	0	0	0	0	92.0118
H2322_801_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	242.4545502	3.713516854	43.935617	21.290184	14.41654796	20.60745559	0	31.08156411	30.44397434	2.059129564	24.59095028	0	0	129.3700162	24.6701399	98.9874488	1.914025419	0.753810929	0	59.73176089	22.42530896	0.25150696	0	0	0	0	0	0	0	0											6.86% Medicare Equivalent Coinsurance	6.86% Medicare Equivalent Coinsurance	17.95% Medicare Equivalent Coinsurance	0.00% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	0	0	0	0	0	0	0	0											0.068574987	0.068574987	0.179471867	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.068574987	0.068574987	0.179471867	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											16.6263	0.254654369	7.885207212	0	3.330222578	4.76032224	0	7.179841309	7.032558072	0.475658929	5.680509515	0	0	29.88447373	5.698802317	22.86610067	0.442139872	0.174130325	0	13.79803677	5.18024637	0.058098108	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.3273	0	0	16.6263	0.254654369	7.885207212	0	3.330222578	4.76032224	0	7.179841309	7.032558072	0.475658929	5.680509515	0	0	29.88447373	5.698802317	22.86610067	0.442139872	0.174130325	0	13.79803677	5.18024637	0.058098108	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.3273	0	6.86% Medicare Equivalent Coinsurance	6.86% Medicare Equivalent Coinsurance	17.95% Medicare Equivalent Coinsurance	0.00% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	0	0	0	0	0	0	0	0											2.3752	0.0364	1.1265	0	0.4757	0.68	0	1.0257	1.0047	0.068	0.8115	0	0	4.2692	0.8141	3.2666	0.0632	0.0249	0	1.9711	0.74	0.0083	0	0	0	0	0	0	0	0											18.761	0	0	19.0015	0.291033565	9.011665385	0	3.80596866	5.440368275	0	8.205532925	8.037209225	0.543610205	6.492010874	0	0	34.15368427	6.512916933	26.13268648	0.505302711	0.199006085	0	15.76918487	5.920281566	0.066397837	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.0884
H2322_803_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	242.4545502	3.713516854	43.935617	21.290184	14.41654796	20.60745559	0	31.08156411	30.44397434	2.059129564	24.59095028	0	0	129.3700162	24.6701399	98.9874488	1.914025419	0.753810929	0	59.73176089	22.42530896	0.25150696	0	0	0	0	0	0	0	0											6.86% Medicare Equivalent Coinsurance	6.86% Medicare Equivalent Coinsurance	17.95% Medicare Equivalent Coinsurance	0.00% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	0	0	0	0	0	0	0	0											0.068574987	0.068574987	0.179471867	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.068574987	0.068574987	0.179471867	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											16.6263	0.254654369	7.885207212	0	3.330222578	4.76032224	0	7.179841309	7.032558072	0.475658929	5.680509515	0	0	29.88447373	5.698802317	22.86610067	0.442139872	0.174130325	0	13.79803677	5.18024637	0.058098108	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.3273	0	0	16.6263	0.254654369	7.885207212	0	3.330222578	4.76032224	0	7.179841309	7.032558072	0.475658929	5.680509515	0	0	29.88447373	5.698802317	22.86610067	0.442139872	0.174130325	0	13.79803677	5.18024637	0.058098108	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.3273	0	6.86% Medicare Equivalent Coinsurance	6.86% Medicare Equivalent Coinsurance	17.95% Medicare Equivalent Coinsurance	0.00% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	0	0	0	0	0	0	0	0											2.3752	0.0364	1.1265	0	0.4757	0.68	0	1.0257	1.0047	0.068	0.8115	0	0	4.2692	0.8141	3.2666	0.0632	0.0249	0	1.9711	0.74	0.0083	0	0	0	0	0	0	0	0											18.761	0	0	19.0015	0.291033565	9.011665385	0	3.80596866	5.440368275	0	8.205532925	8.037209225	0.543610205	6.492010874	0	0	34.15368427	6.512916933	26.13268648	0.505302711	0.199006085	0	15.76918487	5.920281566	0.066397837	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.0884
H2322_804_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	242.4545502	3.713516854	43.935617	21.290184	14.41654796	20.60745559	0	31.08156411	30.44397434	2.059129564	24.59095028	0	0	129.3700162	24.6701399	98.9874488	1.914025419	0.753810929	0	59.73176089	22.42530896	0.25150696	0	0	0	0	0	0	0	0											6.86% Medicare Equivalent Coinsurance	6.86% Medicare Equivalent Coinsurance	17.95% Medicare Equivalent Coinsurance	0.00% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	0	0	0	0	0	0	0	0											0.068574987	0.068574987	0.179471867	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.068574987	0.068574987	0.179471867	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											16.6263	0.254654369	7.885207212	0	3.330222578	4.76032224	0	7.179841309	7.032558072	0.475658929	5.680509515	0	0	29.88447373	5.698802317	22.86610067	0.442139872	0.174130325	0	13.79803677	5.18024637	0.058098108	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.3273	0	0	16.6263	0.254654369	7.885207212	0	3.330222578	4.76032224	0	7.179841309	7.032558072	0.475658929	5.680509515	0	0	29.88447373	5.698802317	22.86610067	0.442139872	0.174130325	0	13.79803677	5.18024637	0.058098108	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.3273	0	6.86% Medicare Equivalent Coinsurance	6.86% Medicare Equivalent Coinsurance	17.95% Medicare Equivalent Coinsurance	0.00% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	23.10% Medicare Equivalent Coinsurance	0	0	0	0	0	0	0	0											2.3752	0.0364	1.1265	0	0.4757	0.68	0	1.0257	1.0047	0.068	0.8115	0	0	4.2692	0.8141	3.2666	0.0632	0.0249	0	1.9711	0.74	0.0083	0	0	0	0	0	0	0	0											18.761	0	0	19.0015	0.291033565	9.011665385	0	3.80596866	5.440368275	0	8.205532925	8.037209225	0.543610205	6.492010874	0	0	34.15368427	6.512916933	26.13268648	0.505302711	0.199006085	0	15.76918487	5.920281566	0.066397837	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.0884
H2323_005_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	502.4690244	20.74108021	389.8342149	7.473657703	53.92522095	12.34096661	60.27110309	12.86496743	20.49778165	20.53195793	12.61138989	1.340234814	2.043308815	131.079359	65.5254053	104.1902816	6.494270663	1.127803878	18.33621138	39.35095697	1.322692609	5.372799189	15.25904963	0	0	0	0	0	0	22.62472071											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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0.069274968	0.069265888	0	0	0.23101844	0.230999871	0.231013179	0.231002443	0.231000022	0.230999189	0.230974465	0.230999838	0.231000003	0.230999625	0	0.231005321	0.230994125	0.230980379	0.230989102	0.22997721	0.230992734	0.230996231	0	0	0	0	0	0	0	0											0.069274968	0.069265888	0	0	0.23101844	0.230999871	0.231013179	0.231002443	0.231000022	0.230999189	0.230974465	0.230999838	0.231000003	0.230999625	0	0.231005321	0.230994125	0.230980379	0.230989102	0.22997721	0.230992734	0.230996231	0	0	0	0	0	0	0	0											34.8085	1.436649339	0	0	12.4577204	2.850761697	13.92341911	2.971838901	4.734988019	4.742865621	2.912909033	0.309594024	0.472004341	30.27928276	0	24.06850942	1.500138366	0.260500568	4.235464995	9.049823305	0.305532382	1.241096361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	152.5616	0	0	34.8085	1.436649339	0	0	12.4577204	2.850761697	13.92341911	2.971838901	4.734988019	4.742865621	2.912909033	0.309594024	0.472004341	30.27928276	0	24.06850942	1.500138366	0.260500568	4.235464995	9.049823305	0.305532382	1.241096361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	152.5616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	34.8085	1.436649339	0	0	12.4577204	2.850761697	13.92341911	2.971838901	4.734988019	4.742865621	2.912909033	0.309594024	0.472004341	30.27928276	0	24.06850942	1.500138366	0.260500568	4.235464995	9.049823305	0.305532382	1.241096361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	152.5616
H2323_006_0	2009	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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1836.22	141.81	0	0	1503.28	0	0	305.62	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	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											25	25	0	0	50	0	0	49.67017865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											19.59207933	19.59207933	0	0	39.18415866	0	0	38.92568322	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											2.9979	0.231529397	0	0	4.908730169	0	0	0.991372275	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.1296	0	2.52	2.9979	0.231529397	0	0	4.908730169	0	0	0.991372275	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.1296	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	2.9979	0.231529397	0	0	4.908730169	0	0	0.991372275	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.1296
H2323_007_0	2009	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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1730.15	129.62	0	0	1429.88	0	0	292.08	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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											25	25	0	0	50	0	0	49.66618735	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											19.88281611	19.88281611	0	0	39.76563222	0	0	39.5001468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											2.8667	0.214767552	0	0	4.738340184	0	0	0.961433573	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.7812	0	2.26	2.8667	0.214767552	0	0	4.738340184	0	0	0.961433573	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.7812	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	2.8667	0.214767552	0	0	4.738340184	0	0	0.961433573	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.7812
H2354_001_0	2009	5																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	S				P		P																																																						0		852.8673709	38.72606625	1409.234739		2599.757862	18.18621479	4.27482957	258.6029711	30.12335354			22.89917417		2.744756837	5324.220707	5235.650779	364.2702377	1879.423848							161.8817082		87.23476674														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	6 HH: $0	10A Ambulance: $50	11A DME: 20%	11B Prosthetics/Supplies: 20%	4A ER: $50	"9A Outpatient Hospital: $200, 9B ASC Services: $200"	8A OP Lab: $0	8B OP Radiology: $0	9A Outpatient Hospital: $200	12 Renal Dialysis: $0	3 CORF: $35	"7A PCP: $15, 14C Routine Physical Exams: $15, 4B Urgent Care: $30"	"7B Chiropractic: $35,  7D Physician Specialist: $35, 7F Podiatry: $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"	"7C Occupational Therapy: $35,  7I PT and ST: $35"	8B Prof Radiology: $0	Other Prof: $0	15 Part B: $0	Other Part B: $0			17A Routine Eye Exams: $35		18A Routine Hearing Exams: $35														300	300	26.0375484		41.48158458	0.2	0.2	50	200			200		35	28.23891546	34.98295134	35	27.83207279							35		35														300	300	26.0375484		41.48158458	0.2	0.2	50	200			200		35	28.23891546	34.98295134	35	27.83207279							35		35														21.3217	0.968151656	3.057751476	0	8.986839637	3.637242957	0.854965914	1.07751238	0.502055892	0	0	0.381652903	0	0.008005541	12.52918487	15.2632097	1.06245486	4.359021778	0	0	0	0	0	0	0.472154982	0	0.254434736	0	0	0	0	0	0	0	0	0	0	0	0	0	74.7363	0	0	21.3217	0.968151656	3.057751476	0	8.986839637	3.637242957	0.854965914	1.07751238	0.502055892	0	0	0.381652903	0	0.008005541	12.52918487	15.2632097	1.06245486	4.359021778	0	0	0	0	0	0	0.472154982	0	0.254434736	0	0	0	0	0	0	0	0	0	0	0	0	0	74.7363																																																																																		0	0	0	21.3217	0.968151656	3.057751476	0	8.986839637	3.637242957	0.854965914	1.07751238	0.502055892	0	0	0.381652903	0	0.008005541	12.52918487	15.2632097	1.06245486	4.359021778	0	0	0	0	0	0	0.472154982	0	0.254434736	0	0	0	0	0	0	0	0	0	0	0	0	0	74.7363
H2354_013_0	2009	5																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	S				P		P																																																						0		906.1984424	39.27457581	850.2467839		2685.55263	21.36359002	4.755207191	260.2367302	504.4981107			14.23561028		2.841439527	5682.052622	6164.907671	482.9813726	2609.396867							177.4610447		94.00257975														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	6 HH: $0	10A Ambulance: $25	11A DME: 20%	11B Prosthetics/Supplies: 20%	4A ER: $50	"9A Outpatient Hospital: $150, 9B ASC Services: $75"	8A OP Lab: $0	8B OP Radiology: $0	9A Outpatient Hospital: $150	12 Renal Dialysis: $0	3 CORF: $30	"7A PCP: $10, 14C Routine Physical Exams: $10, 4B Urgent Care: $20"	"7B Chiropractic: $35,  7D Physician Specialist: $35, 7F Podiatry: $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"	"7C Occupational Therapy: $35,  7I PT and ST: $35"	8B Prof Radiology: $0	Other Prof: $0	15 Part B: $0	Other Part B: $0			17A Routine Eye Exams: $35		18A Routine Hearing Exams: $35														300	300	13.0187742		25	0.2	0.2	50	144.932855			150		35	10.04713559	34.96068439	35	24.39099863							35		35														300	300	13.0187742		25	0.2	0.2	50	144.932855			150		35	10.04713559	34.96068439	35	24.39099863							35		35														22.655	0.981864395	0.922430908	0	5.594901312	4.272718004	0.951041438	1.084319709	6.093195959	0	0	0.177945129	0	0.008287532	4.757362759	17.96078262	1.40869567	5.303816283	0	0	0	0	0	0	0.517594714	0	0.274174191	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9641	0	0	22.655	0.981864395	0.922430908	0	5.594901312	4.272718004	0.951041438	1.084319709	6.093195959	0	0	0.177945129	0	0.008287532	4.757362759	17.96078262	1.40869567	5.303816283	0	0	0	0	0	0	0.517594714	0	0.274174191	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9641																																																																																		0	0	0	22.655	0.981864395	0.922430908	0	5.594901312	4.272718004	0.951041438	1.084319709	6.093195959	0	0	0.177945129	0	0.008287532	4.757362759	17.96078262	1.40869567	5.303816283	0	0	0	0	0	0	0.517594714	0	0.274174191	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9641
H2354_801_0	2009	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		263.8390779	7.965970839	14.63081809		5.41310246	17.02657447	0.510437023	16.80362982	88.60674428	7.050828123	8.137093461	0.395635872	0.056414389	24.76529515	37.76696372	81.88774785	1.959985638	7.195766585	49.03146382	64.13343093	53.11662674	3.30666186																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																			0.066615695	0.066615695	0.176831589		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.066615695	0.066615695	0.176831589		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			17.5758	0.530658686	2.587190813	0	1.250426668	3.933138703	0.117910952	3.881638489	20.46815793	1.628741296	1.879668589	0.091391886	0.013031724	5.720783181	8.72416862	18.91606975	0.452756682	1.662222081	11.32626814	14.81482255	12.26994078	0.76383889	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.6087	0	0	17.5758	0.530658686	2.587190813	0	1.250426668	3.933138703	0.117910952	3.881638489	20.46815793	1.628741296	1.879668589	0.091391886	0.013031724	5.720783181	8.72416862	18.91606975	0.452756682	1.662222081	11.32626814	14.81482255	12.26994078	0.76383889	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.6087																																																																																		0	0	0	17.5758	0.530658686	2.587190813	0	1.250426668	3.933138703	0.117910952	3.881638489	20.46815793	1.628741296	1.879668589	0.091391886	0.013031724	5.720783181	8.72416862	18.91606975	0.452756682	1.662222081	11.32626814	14.81482255	12.26994078	0.76383889	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.6087
H2354_802_0	2009	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		259.1006111	4.61640452	25.91228496		6.492574845	12.01865016	9.819365227	10.73038202	47.53499782	9.042301587	19.3295186	2.072359068	0.198489154	22.05880302	43.00741826	68.51338594	3.793087205	12.7565437	27.9546501	67.49276199	21.98944027	0.931775432																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																			0.0662	0.0662	0.176		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.0662	0.0662	0.176		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			17.1525	0.305605979	4.560562153	0	1.499784789	2.776308186	2.268273367	2.478718246	10.9805845	2.088771667	4.465118797	0.478714945	0.045850995	5.095583497	9.934713618	15.82659215	0.876203144	2.946761595	6.457524173	15.59082802	5.079560702	0.215240125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.1238	0	0	17.1525	0.305605979	4.560562153	0	1.499784789	2.776308186	2.268273367	2.478718246	10.9805845	2.088771667	4.465118797	0.478714945	0.045850995	5.095583497	9.934713618	15.82659215	0.876203144	2.946761595	6.457524173	15.59082802	5.079560702	0.215240125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.1238																																																																																		0	0	0	17.1525	0.305605979	4.560562153	0	1.499784789	2.776308186	2.268273367	2.478718246	10.9805845	2.088771667	4.465118797	0.478714945	0.045850995	5.095583497	9.934713618	15.82659215	0.876203144	2.946761595	6.457524173	15.59082802	5.079560702	0.215240125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.1238
H2354_803_0	2009	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		259.1006111	4.61640452	25.91228496		6.492574845	12.01865016	9.819365227	10.73038202	47.53499782	9.042301587	19.3295186	2.072359068	0.198489154	22.05880302	43.00741826	68.51338594	3.793087205	12.7565437	27.9546501	67.49276199	21.98944027	0.931775432																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																			0.0662	0.0662	0.176		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.0662	0.0662	0.176		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			17.1525	0.305605979	4.560562153	0	1.499784789	2.776308186	2.268273367	2.478718246	10.9805845	2.088771667	4.465118797	0.478714945	0.045850995	5.095583497	9.934713618	15.82659215	0.876203144	2.946761595	6.457524173	15.59082802	5.079560702	0.215240125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.1238	0	0	17.1525	0.305605979	4.560562153	0	1.499784789	2.776308186	2.268273367	2.478718246	10.9805845	2.088771667	4.465118797	0.478714945	0.045850995	5.095583497	9.934713618	15.82659215	0.876203144	2.946761595	6.457524173	15.59082802	5.079560702	0.215240125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.1238																																																																																		0	0	0	17.1525	0.305605979	4.560562153	0	1.499784789	2.776308186	2.268273367	2.478718246	10.9805845	2.088771667	4.465118797	0.478714945	0.045850995	5.095583497	9.934713618	15.82659215	0.876203144	2.946761595	6.457524173	15.59082802	5.079560702	0.215240125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.1238
H2406_001_0	2009	4																					2400											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2578.807944	195.8538794	7908.87612	81.16427345	883.9880538	6.566459574	7.258388699	291.0254888	154.2569617	14573.24709	1830.994262	0	21.52422721	390.6052256	212.3209749	4162.020706	1945.865084	9.688273412	0	0	1545.525242	833.6044814	2075.443714	0	164.0438159	592.3311839	0	0	0	0											"$175 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $35 (4b)	$35 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$35 (3, 5, 9a, 9d); $35/$25 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $35 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$15 (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"$35/$25 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											173.3287258	175	0	0	75	0.2	0.2	49.60708783	35	0	0	0	0	34.8767603	0	14.9390437	32.5	0	0	0	0	14.48072918	0	0	0	0	0	0	0	0											142.8808006	144.2584891	0	0	61.82506676	0.164866845	0.164866845	40.89282022	28.85169782	0	0	0	0	28.75010712	0	12.31476498	26.79086226	0	0	0	0	11.93696065	0	0	0	0	0	0	0	0											30.7052	2.354465394	0	0	4.554385036	1.082591471	1.196667642	0.991737749	0.37088127	0	0	0	0	0.935828507	0	4.271192238	4.344283619	0	0	0	0	0.829225324	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6364	0	11.0037	30.7052	2.354465394	0	0	4.554385036	1.082591471	1.196667642	0.991737749	0.37088127	0	0	0	0	0.935828507	0	4.271192238	4.344283619	0	0	0	0	0.829225324	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.6364		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $35 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $35 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											3.5619	0.3191	0.8144	0.0194	0.5811	0.1037	0.1146	0.0633	0.3668	0.6464	0.615	0	0	0.1604	0.024	2.5697	0.6177	0.0014	0	0	0.1082	0.1046	0.0798	0	0.0126	0	0	0	0	0											10.8842	0	0	34.267	2.673515394	0.814425524	0.019403937	5.135501573	1.186272411	1.31127378	1.055057605	0.737684586	0.64638308	0.615018472	0	0	1.096195764	0.024041181	6.840904144	4.961983619	0.001441415	0	0	0.108241044	0.933847871	0.079772827	0	0.012614055	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.5206
H2407_001_0	2009	5																																Coin		Coin		Coin	Coin		Coin	Coin	Coin					Coin						Coin																																																												0		748.113066		73.51761388		39.02973941	125.4262422		51.9037067	106.9227779	126.4329847					377.8720863						33.36512082																				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																				0.0769		0.1344		0.231	0.231		0.231	0.231	0.231					0.231						0.231																				0.0769		0.1344		0.231	0.231		0.231	0.231	0.231					0.231						0.231																				57.5299	0	9.880767305	0	9.015869803	28.97346194	0	11.98975625	24.6991617	29.20601946	0	0	0	0	87.28845193	0	0	0	0	0	7.707342909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	266.2907			57.5299	0	9.880767305	0	9.015869803	28.97346194	0	11.98975625	24.6991617	29.20601946	0	0	0	0	87.28845193	0	0	0	0	0	7.707342909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	266.2907																																																																																		0			57.5299	0	9.880767305	0	9.015869803	28.97346194	0	11.98975625	24.6991617	29.20601946	0	0	0	0	87.28845193	0	0	0	0	0	7.707342909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	266.2907
H2409_003_0	2009	6																					3350											A	A	D	V	Coin	Coin	Coin	P	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P			Coin	P					P	P																																																					0		178.6923463	11.28424078	236.3883903		5.704663882	4.115069056	3.330493381	225.0364812	35.32610951	4.988885065	18.29335675	1.595493635	0.053650767	32.49116742	2789.635826	3244.967743	403.422385	456.692113			11.19481061	3.372316366					166.0992713														$550 (1a); $0 (1a1)	$550 (1b)	"$90 days 10-100 (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)											550	550	49.68		0.2	0.2	0.2	47.16440829	0.2	0.2	0.2	0.2	0.2	0.194372081	14.97250632	29.93140914	29.86675462	29.10173651			0.2	735.3969361					30														487.2716341	487.2716341	44.01391779		0.177189685	0.177189685	0.177189685	41.78523328	0.177189685	0.177189685	0.177189685	0.177189685	0.177189685	0.172203639	13.2648684	26.5176848	26.46040424	25.78263765			0.177189685	651.5237577					26.57845277														7.256	0.458207537	0.867031598	0	1.010807597	0.72914779	0.590129073	0.783600155	6.259422221	0.883978974	3.241394122	0.282705015	0.009506362	5.595097256	3.083679343	7.170752651	0.889559949	0.981227272	0	0	1.983604968	0.183095353	0	0	0	0	0.36788847	0	0	0	0	0	0	0	0	0	0	0	0	0	42.6268	0	5.4875	7.256	0.458207537	0.867031598	0	1.010807597	0.72914779	0.590129073	0.783600155	6.259422221	0.883978974	3.241394122	0.282705015	0.009506362	5.595097256	3.083679343	7.170752651	0.889559949	0.981227272	0	0	1.983604968	0.183095353	0	0	0	0	0.36788847	0	0	0	0	0	0	0	0	0	0	0	0	0	42.6268																																																																																		0	0	0	7.256	0.458207537	0.867031598	0	1.010807597	0.72914779	0.590129073	0.783600155	6.259422221	0.883978974	3.241394122	0.282705015	0.009506362	5.595097256	3.083679343	7.170752651	0.889559949	0.981227272	0	0	1.983604968	0.183095353	0	0	0	0	0.36788847	0	0	0	0	0	0	0	0	0	0	0	0	0	42.6268
H2409_006_0	2009	9																					3350											A	A	D	V	Coin	Coin	Coin	P	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P			Coin	P					P	P																																																					0		178.6923463	11.28424078	236.3883903		5.704663882	4.115069056	3.330493381	225.0364812	35.32610951	4.988885065	18.29335675	1.595493635	0.053650767	32.49116742	2789.635826	3244.967743	403.422385	456.692113			11.19481061	3.372316366					166.0992713														$550 (1a); $0 (1a1)	$550 (1b)	"$90 days 10-100 (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)"			"20% (15, 15a1)"	"$0 (13a, 13a1); $30 (17b)"					$30 (18a1)			$0 (14a)											550	550	49.68		0.2	0.25	0.25	47.16440829	0.2	0.2	0.2	0.2	0.2	0.194372081	14.97250632	29.93140914	29.86675462	29.10173651			0.2	735.3969361					30														486.358924	486.358924	43.93147517		0.176857791	0.221072238	0.221072238	41.70696521	0.176857791	0.176857791	0.176857791	0.176857791	0.176857791	0.171881084	13.24002193	26.46801444	26.41084117	25.7343441			0.176857791	650.3033864					26.52866858														7.2424	0.457349267	0.865407558	0	1.00891425	0.909727527	0.736279626	0.782132391	6.247697677	0.88232319	3.235322656	0.282175479	0.009488556	5.584617061	3.077903293	7.15732109	0.887893711	0.979389332	0	0	1.979889471	0.182752396	0	0	0	0	0.367199377	0	0	0	0	0	0	0	0	0	0	0	0	0	42.8762	0	5.6104	7.2424	0.457349267	0.865407558	0	1.00891425	0.909727527	0.736279626	0.782132391	6.247697677	0.88232319	3.235322656	0.282175479	0.009488556	5.584617061	3.077903293	7.15732109	0.887893711	0.979389332	0	0	1.979889471	0.182752396	0	0	0	0	0.367199377	0	0	0	0	0	0	0	0	0	0	0	0	0	42.8762																																																																																		0	0	0	7.2424	0.457349267	0.865407558	0	1.00891425	0.909727527	0.736279626	0.782132391	6.247697677	0.88232319	3.235322656	0.282175479	0.009488556	5.584617061	3.077903293	7.15732109	0.887893711	0.979389332	0	0	1.979889471	0.182752396	0	0	0	0	0.367199377	0	0	0	0	0	0	0	0	0	0	0	0	0	42.8762
H2409_801_0	2009	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																																																			0		255.6387873	3.134543939	44.80631898		10.67355746	5.429736399	5.051427516	14.51706926	50.42883557	6.617743813	15.79925131	2.212898311	0.078209988	30.77312631	40.0910263	65.11002446	5.581307022	3.485658178	30.84645506	77.93421184	37.67400976	0.650183676			0.581570278																FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins		FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins																			0.081435954	0.081435954	0.157745996		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231																0.081435954	0.081435954	0.157745996		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231																20.8182	0.255264575	7.068017395	0	2.465591774	1.254269108	1.166879756	3.353443	11.64906102	1.528698821	3.649627052	0.51117951	0.018066507	7.108592177	9.261027075	15.04041565	1.289281922	0.805187039	7.125531118	18.00280294	8.702696256	0.150192429	0	0	0.134342734	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.3584	0	0	20.8182	0.255264575	7.068017395	0	2.465591774	1.254269108	1.166879756	3.353443	11.64906102	1.528698821	3.649627052	0.51117951	0.018066507	7.108592177	9.261027075	15.04041565	1.289281922	0.805187039	7.125531118	18.00280294	8.702696256	0.150192429	0	0	0.134342734	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.3584																																																																																		0	0	0	20.8182	0.255264575	7.068017395	0	2.465591774	1.254269108	1.166879756	3.353443	11.64906102	1.528698821	3.649627052	0.51117951	0.018066507	7.108592177	9.261027075	15.04041565	1.289281922	0.805187039	7.125531118	18.00280294	8.702696256	0.150192429	0	0	0.134342734	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.3584
H2409_802_0	2009	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																																																			0		249.119109	3.035820226	43.6506505		10.48170619	5.202282496	4.83740219	14.1878331	49.43295681	6.4440481	15.3296345	2.123331948	0.074771421	29.898243	39.26447467	63.79725153	5.538468867	3.424133344	30.29923891	76.57420242	37.09844445	0.621597813			0.580492069																FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins		FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins																			0.082560806	0.082560806	0.162179859		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231																0.082560806	0.082560806	0.162179859		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231																20.5675	0.250639765	7.079256325	0	2.421274131	1.201727257	1.117439906	3.277389446	11.41901302	1.488575111	3.541145569	0.49048968	0.017272198	6.906494134	9.070093648	14.7371651	1.279386308	0.790974802	6.999124189	17.68864076	8.569740667	0.143589095	0	0	0.134093668	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.191	0	0	20.5675	0.250639765	7.079256325	0	2.421274131	1.201727257	1.117439906	3.277389446	11.41901302	1.488575111	3.541145569	0.49048968	0.017272198	6.906494134	9.070093648	14.7371651	1.279386308	0.790974802	6.999124189	17.68864076	8.569740667	0.143589095	0	0	0.134093668	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.191																																																																																		0	0	0	20.5675	0.250639765	7.079256325	0	2.421274131	1.201727257	1.117439906	3.277389446	11.41901302	1.488575111	3.541145569	0.49048968	0.017272198	6.906494134	9.070093648	14.7371651	1.279386308	0.790974802	6.999124189	17.68864076	8.569740667	0.143589095	0	0	0.134093668	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.191
H2409_803_0	2009	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																																																			0		255.6387873	3.134543939	44.80631898		10.67355746	5.429736399	5.051427516	14.51706926	50.42883557	6.617743813	15.79925131	2.212898311	0.078209988	30.77312631	40.0910263	65.11002446	5.581307022	3.485658178	30.84645506	77.93421184	37.67400976	0.650183676			0.581570278																FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins		FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins																			0.081435954	0.081435954	0.157745996		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231																0.081435954	0.081435954	0.157745996		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231																20.8182	0.255264575	7.068017395	0	2.465591774	1.254269108	1.166879756	3.353443	11.64906102	1.528698821	3.649627052	0.51117951	0.018066507	7.108592177	9.261027075	15.04041565	1.289281922	0.805187039	7.125531118	18.00280294	8.702696256	0.150192429	0	0	0.134342734	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.3584	0	0	20.8182	0.255264575	7.068017395	0	2.465591774	1.254269108	1.166879756	3.353443	11.64906102	1.528698821	3.649627052	0.51117951	0.018066507	7.108592177	9.261027075	15.04041565	1.289281922	0.805187039	7.125531118	18.00280294	8.702696256	0.150192429	0	0	0.134342734	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.3584																																																																																		0	0	0	20.8182	0.255264575	7.068017395	0	2.465591774	1.254269108	1.166879756	3.353443	11.64906102	1.528698821	3.649627052	0.51117951	0.018066507	7.108592177	9.261027075	15.04041565	1.289281922	0.805187039	7.125531118	18.00280294	8.702696256	0.150192429	0	0	0.134342734	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.3584
H2410_001_0	2009	5																					3350											A	A	D	V	Coin	Coin	Coin	P	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P			Coin	P					P	P																																																					0		189.3787944	11.78180331	257.9025539		6.206066357	4.958981106	3.980335627	236.3706267	38.58124565	5.577464545	19.82086673	1.890383469	0.064653384	35.69389826	2929.207758	3403.235673	425.3330658	470.8759061			13.0234401	3.701996239					166.0992713														$550 (1a); $0 (1a1)	$550 (1b)	"$90 days 10-100 (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)											550	550	49.68		0.2	0.2	0.2	47.03646008	0.2	0.2	0.2	0.2	0.2	0.194521299	14.99564723	29.93459896	30.00048488	29.09368512			0.2	717.3122685					30														478.4610439	478.4610439	43.2180812		0.173985834	0.173985834	0.173985834	40.91838871	0.173985834	0.173985834	0.173985834	0.173985834	0.173985834	0.169219752	13.04515096	26.04098085	26.09829693	25.30944537			0.173985834	624.0108669					26.09787512														7.5509	0.469761159	0.928837793	0	1.079767632	0.862792464	0.692522014	0.805992098	6.712590206	0.970399821	3.448550032	0.328899945	0.011248773	6.040112623	3.184329783	7.385299583	0.925039054	0.993134002	0	0	2.26589409	0.192507157	0	0	0	0	0.361236503	0	0	0	0	0	0	0	0	0	0	0	0	0	45.2098	0	6.7597	7.5509	0.469761159	0.928837793	0	1.079767632	0.862792464	0.692522014	0.805992098	6.712590206	0.970399821	3.448550032	0.328899945	0.011248773	6.040112623	3.184329783	7.385299583	0.925039054	0.993134002	0	0	2.26589409	0.192507157	0	0	0	0	0.361236503	0	0	0	0	0	0	0	0	0	0	0	0	0	45.2098																																																																																		0	0	0	7.5509	0.469761159	0.928837793	0	1.079767632	0.862792464	0.692522014	0.805992098	6.712590206	0.970399821	3.448550032	0.328899945	0.011248773	6.040112623	3.184329783	7.385299583	0.925039054	0.993134002	0	0	2.26589409	0.192507157	0	0	0	0	0.361236503	0	0	0	0	0	0	0	0	0	0	0	0	0	45.2098
H2410_009_0	2009	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																																																			0		487.9391611	9.370116879	87.23987068		33.23167083	13.71949234	10.32017727	21.94200974	40.3843357	7.698341245	21.2632848	2.184983778	12.41203019	64.10304285	71.86699547	84.62479775	6.075434569	13.24315903	42.47088761	88.42300433	36.43502624	8.290017737																			FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins		FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins																			0.077045189	0.077045189	0.135567988		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.077045189	0.077045189	0.135567988		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			37.5934	0.721922427	11.82693376	0	7.676515961	3.169202729	2.383960949	5.06860425	9.328781548	1.778316828	4.911818789	0.504731253	2.867178975	14.8078029	16.60127595	19.54832828	1.403425385	3.059169737	9.810775037	20.425714	8.416491062	1.914994097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	183.8193	0	0	37.5934	0.721922427	11.82693376	0	7.676515961	3.169202729	2.383960949	5.06860425	9.328781548	1.778316828	4.911818789	0.504731253	2.867178975	14.8078029	16.60127595	19.54832828	1.403425385	3.059169737	9.810775037	20.425714	8.416491062	1.914994097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	183.8193																																																																																		0	0	0	37.5934	0.721922427	11.82693376	0	7.676515961	3.169202729	2.383960949	5.06860425	9.328781548	1.778316828	4.911818789	0.504731253	2.867178975	14.8078029	16.60127595	19.54832828	1.403425385	3.059169737	9.810775037	20.425714	8.416491062	1.914994097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	183.8193
H2410_015_0	2009	8																					3350											A	A	D	V	Coin	Coin	Coin	P	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P			Coin	P					P	P																																																					0		189.3787944	11.78180331	257.9025539		6.206066357	4.958981106	3.980335627	236.3706267	38.58124565	5.577464545	19.82086673	1.890383469	0.064653384	35.69389826	2929.207758	3403.235673	425.3330658	470.8759061			13.0234401	3.701996239					166.0992713														$550 (1a); $0 (1a1)	$550 (1b)	"$90 days 10-100 (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)"			"20% (15, 15a1)"	"$0 (13a, 13a1); $30 (17b)"					$30 (18a1)			$0 (14a)											550	550	49.68		0.2	0.25	0.25	47.03646008	0.2	0.2	0.2	0.2	0.2	0.194521299	14.99564723	29.93459896	30.00048488	29.09368512			0.2	717.3122685					30														477.52445	477.52445	43.13348123		0.173645255	0.217056568	0.217056568	40.83829041	0.173645255	0.173645255	0.173645255	0.173645255	0.173645255	0.168888502	13.0196149	25.99000528	26.04720916	25.25990179			0.173645255	622.7893572					26.04678818														7.5361	0.468841596	0.927019581	0	1.077653972	1.07637942	0.863957991	0.804414358	6.69945022	0.968500251	3.441799449	0.328256119	0.011226753	6.028289021	3.178096415	7.37084276	0.923228277	0.991189929	0	0	2.261458572	0.192130322	0	0	0	0	0.360529378	0	0	0	0	0	0	0	0	0	0	0	0	0	45.5093	0	6.9071	7.5361	0.468841596	0.927019581	0	1.077653972	1.07637942	0.863957991	0.804414358	6.69945022	0.968500251	3.441799449	0.328256119	0.011226753	6.028289021	3.178096415	7.37084276	0.923228277	0.991189929	0	0	2.261458572	0.192130322	0	0	0	0	0.360529378	0	0	0	0	0	0	0	0	0	0	0	0	0	45.5093																																																																																		0	0	0	7.5361	0.468841596	0.927019581	0	1.077653972	1.07637942	0.863957991	0.804414358	6.69945022	0.968500251	3.441799449	0.328256119	0.011226753	6.028289021	3.178096415	7.37084276	0.923228277	0.991189929	0	0	2.261458572	0.192130322	0	0	0	0	0.360529378	0	0	0	0	0	0	0	0	0	0	0	0	0	45.5093
H2410_801_0	2009	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																																																			0		288.5309207	3.632610469	50.63672968		11.6414576	6.577253779	6.131196991	16.17808373	55.45309841	7.494048186	18.16849378	2.664765507	0.095557745	35.18696041	44.26102447	71.7330357	5.797427856	3.796054331	33.60719042	84.79553376	40.57776826	0.794400916			0.5870099																FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins		FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins																			0.077063585	0.077063585	0.135730289		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231																0.077063585	0.077063585	0.135730289		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231																22.2352	0.279941986	6.872937968	0	2.689176705	1.519345623	1.416306505	3.737137342	12.80966573	1.731125131	4.196922063	0.615560832	0.022073839	8.128187855	10.22429665	16.57033125	1.339205835	0.87688855	7.763260987	19.5877683	9.373464468	0.183506612	0	0	0.135599287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.3079	0	0	22.2352	0.279941986	6.872937968	0	2.689176705	1.519345623	1.416306505	3.737137342	12.80966573	1.731125131	4.196922063	0.615560832	0.022073839	8.128187855	10.22429665	16.57033125	1.339205835	0.87688855	7.763260987	19.5877683	9.373464468	0.183506612	0	0	0.135599287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.3079																																																																																		0	0	0	22.2352	0.279941986	6.872937968	0	2.689176705	1.519345623	1.416306505	3.737137342	12.80966573	1.731125131	4.196922063	0.615560832	0.022073839	8.128187855	10.22429665	16.57033125	1.339205835	0.87688855	7.763260987	19.5877683	9.373464468	0.183506612	0	0	0.135599287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.3079
H2410_802_0	2009	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																																																			0		288.5309207	3.632610469	50.63672968		11.6414576	6.577253779	6.131196991	16.17808373	55.45309841	7.494048186	18.16849378	2.664765507	0.095557745	35.18696041	44.26102447	71.7330357	5.797427856	3.796054331	33.60719042	84.79553376	40.57776826	0.794400916			0.5870099																FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins		FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins																			0.077063585	0.077063585	0.135730289		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231																0.077063585	0.077063585	0.135730289		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231																22.2352	0.279941986	6.872937968	0	2.689176705	1.519345623	1.416306505	3.737137342	12.80966573	1.731125131	4.196922063	0.615560832	0.022073839	8.128187855	10.22429665	16.57033125	1.339205835	0.87688855	7.763260987	19.5877683	9.373464468	0.183506612	0	0	0.135599287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.3079	0	0	22.2352	0.279941986	6.872937968	0	2.689176705	1.519345623	1.416306505	3.737137342	12.80966573	1.731125131	4.196922063	0.615560832	0.022073839	8.128187855	10.22429665	16.57033125	1.339205835	0.87688855	7.763260987	19.5877683	9.373464468	0.183506612	0	0	0.135599287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.3079																																																																																		0	0	0	22.2352	0.279941986	6.872937968	0	2.689176705	1.519345623	1.416306505	3.737137342	12.80966573	1.731125131	4.196922063	0.615560832	0.022073839	8.128187855	10.22429665	16.57033125	1.339205835	0.87688855	7.763260987	19.5877683	9.373464468	0.183506612	0	0	0.135599287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.3079
H2410_803_0	2009	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																																																			0		270.0465286	3.352712023	47.3602138		11.09752676	5.93238344	5.524398942	15.24464344	52.62961344	7.00159142	16.83705059	2.4108297	0.085808826	32.70651807	41.91761061	68.01110209	5.675974431	3.621621005	32.05573997	80.9396767	38.9459431	0.713355154			0.583952995																FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins		FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins																			0.078621862	0.078621862	0.145137382		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231																0.078621862	0.078621862	0.145137382		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231																21.2316	0.263596463	6.873737435	0	2.563528682	1.370380575	1.276136156	3.521512634	12.1574407	1.617367618	3.889358687	0.556901661	0.019821839	7.555205674	9.68296805	15.71056458	1.311150094	0.836594452	7.404875934	18.69706532	8.996512857	0.164785041	0	0	0.134893142	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.836	0	0	21.2316	0.263596463	6.873737435	0	2.563528682	1.370380575	1.276136156	3.521512634	12.1574407	1.617367618	3.889358687	0.556901661	0.019821839	7.555205674	9.68296805	15.71056458	1.311150094	0.836594452	7.404875934	18.69706532	8.996512857	0.164785041	0	0	0.134893142	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.836																																																																																		0	0	0	21.2316	0.263596463	6.873737435	0	2.563528682	1.370380575	1.276136156	3.521512634	12.1574407	1.617367618	3.889358687	0.556901661	0.019821839	7.555205674	9.68296805	15.71056458	1.311150094	0.836594452	7.404875934	18.69706532	8.996512857	0.164785041	0	0	0.134893142	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.836
H2411_002_0	2009	7																					3350											D	D	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	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	7500	786.6724239	11.85214778	82.42004163	0	324.8574248	0	0	970.001373	478.2375562	0	2164.608586	39.38241462	0	0	4343.471625	2384.835759	308.7427856	456.4441474	0	917.3006015	129.5767957	179.9679255	0	0	50.79281004	0	0	0	2.786411217	0											"PBP: 1A IP Acute: $125 per day, days 1-5"	"1B IP Psych: $125 per day, days 1-5"	"2 SNF: $20 per day, days 1-20"	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: $20	9A OP Hospital and 9B ASC Services: $0-75	8A OP C/D/T: $0	"8B OP X-Ray: $0-50, $150 annual OOP Max"	Included in g.	12 Renal Dialysis: $0	3 CORF: $0; 5 Partial Hosp: $0; 9D Cardiac Rehab: $0	7A PCP: $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; Nutrition Therapy: $25	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: $25; 7I Physical and Speech Therapy: $25	Included in i.2.	7G Other Health Care: $20-25; 18A Medicare Covered Hearing Exams: $20-25; 17A Medicare Covered Eye Exams: $20-$25	15 Part B Drugs: $10-$55	13A Blood: $0; 16B Medicare Covered Comprehensive Dental Services: $10-$25	10B Transportation: Not Covered	16A Preventive Dental Services: Not Covered; 16B Non-Medicare Covered Comprehensive Dental Services: Not Covered	17A Routine Eye Exams: $20-25	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $20	13B Acupuncture: Not Covered											125	125	247	0	50	0	0	48.99749264	75	0	50	75	0	0	18.68237347	23.84594045	24.29100707	20	0	20	9.0435	12.2953886	0	0	20	0	0	0	15	0											124.375	124.375	245.765	0	49.75	0	0	48.75250518	74.625	0	49.75	74.625	0	0	18.58896161	23.72671075	24.16955204	19.9	0	19.9	8.9982825	12.23391166	0	0	19.9	0	0	0	14.925	0											8.1535	0.122842573	1.687996794	0	1.34680474	0	0	3.94083308	2.974039803	0	8.974106429	0.244909391	0	0	6.728385606	4.715359019	0.621847902	0.756936544	0	1.521190164	0.097164051	0.183475975	0	0	0.08423141	0	0	0	0.003465599	0	0	0	0	0	0	0	0	0	0	0	42.1571	0	0.2259	8.1535	0.122842573	1.687996794	0	1.34680474	0	0	3.94083308	2.974039803	0	8.974106429	0.244909391	0	0	6.728385606	4.715359019	0.621847902	0.756936544	0	1.521190164	0.097164051	0.183475975	0	0	0.08423141	0	0	0	0.003465599	0	0	0	0	0	0	0	0	0	0	0	42.1571	10600	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	40	40	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2		15	0.2											3.0197	0.0482	0.9099	0.4549	0.1072	0.2241	0.0271	0.3568	0.4658	0.7553	0.6375	0.5681	0.0016	0.0119	1.0011	0.5368	0.0592	0.0933		0.2144	0.0418	0.0346			0.0041	0.0037			0.2116	0.064											9.853	500	0.049512482	11.1733	0.171027512	2.597859667	0.454862258	1.454032089	0.224147802	0.027075226	4.297615379	3.439880296	0.755311866	9.611616658	0.813048625	0.001618269	0.011862349	7.729515823	5.252118408	0.681091359	0.850283539	0	1.735596006	0.139008261	0.218116065	0	0	0.088340522	0.003722531	0	0	0.215111287	0.063969671	0	0	0	0	0	0	0	0	0	0	52.0101
H2411_801_0	2009	4																					3350											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	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	7500	177.6216606	3.515213306	72.78988503	0	331.9819292	0	0	892.1502704	449.6399338	0	2185.815693	31.02041579	0	0	4053.285686	2257.12872	273.0204264	506.4107057	0	896.3656826	157.6180975	0	0	0	42.02070971	0	0	0	0.342560133	0											PBP: 1A IP Acute: $450 per admit	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: $0-50	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: $0; Nutrition Therapy: $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: $20-25; 18A Medicare Covered Hearing Exams: $20-25; 17A Medicare Covered Eye Exams: $20-$25	15 Part B Drugs: $10-$60	13A Blood: $0; 16B Medicare Covered Comprehensive Dental Services: $20-$25	10B Transportation: Not Covered	16A Preventive Dental Services: Not Covered; 16B Non-Medicare Covered Comprehensive Dental Services: Not Covered	17A Routine Eye Exams: Not Covered	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $20	13B Acupuncture: Not Covered											450	450	450	0	50	0	0	48.73570858	225	0	50	225	0	0	19.64842099	23.8268326	24.5273944	20	0	20	12.5984507	0	0	0	20	0	0	0	20	0											447.75	447.75	447.75	0	49.75	0	0	48.49203003	223.875	0	49.75	223.875	0	0	19.55017889	23.70769844	24.40475742	19.9	0	19.9	12.53545845	0	0	0	19.9	0	0	0	19.9	0											6.6275	0.131161396	2.715972585	0	1.376341748	0	0	3.605181476	8.388595015	0	9.062027561	0.578724632	0	0	6.603538354	4.459277251	0.555249773	0.839797754	0	1.48647309	0.164651259	0	0	0	0.069684344	0	0	0	0.000568079	0	0	0	0	0	0	0	0	0	0	0	46.6648	0	0.2345	6.6275	0.131161396	2.715972585	0	1.376341748	0	0	3.605181476	8.388595015	0	9.062027561	0.578724632	0	0	6.603538354	4.459277251	0.555249773	0.839797754	0	1.48647309	0.164651259	0	0	0	0.069684344	0	0	0	0.000568079	0	0	0	0	0	0	0	0	0	0	0	46.6648	10600	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	0.2	0.2	0.2		15	0.2											2.8102	0.0423	0.7424	0.3774	0.091	0.2068	0.0189	0.2665	0.5481	0.6443	0.5615	0.5232	0.001	0.0096	0.6174	0.318	0.0549	0.042		0.1284	0.0358	0.0109			0.0031	0.0026			0.162	0.0561											8.2741	0	0.041578563	9.4377	0.173445353	3.458341431	0.377399273	1.467327522	0.206767732	0.018920712	3.871679069	8.936742344	0.644311559	9.623554713	1.10188822	0.000988004	0.009590263	7.220954179	4.777283584	0.610144812	0.881749736	0	1.614824245	0.200469926	0.010860574	0	0	0.072738663	0.002594085	0	0	0.162521078	0.056091138	0	0	0	0	0	0	0	0	0	0	54.9389
H2411_803_0	2009	4																					3350											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	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	7500	210.4075604	4.164061149	86.22564433	0	393.2600764	0	0	1056.825847	532.6357226	0	2589.279629	36.74625035	0	0	4801.452424	2673.755812	323.4152956	599.8854013	0	1061.819352	186.711684	0	0	0	49.7770091	0	0	0	0.405790835	0											PBP: 1A IP Acute: $450 per admit	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: $0-50	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: $0; Nutrition Therapy: $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: $20-25; 18A Medicare Covered Hearing Exams: $20-25; 17A Medicare Covered Eye Exams: $20-$25	15 Part B Drugs: $10-$60	13A Blood: $0; 16B Medicare Covered Comprehensive Dental Services: $20-$25	10B Transportation: Not Covered	16A Preventive Dental Services: Not Covered; 16B Non-Medicare Covered Comprehensive Dental Services: Not Covered	17A Routine Eye Exams: Not Covered	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $20	13B Acupuncture: Not Covered											450	450	450	0	50	0	0	48.73570858	225	0	50	225	0	0	19.64842099	23.8268326	24.5273944	20	0	20	12.5984507	0	0	0	20	0	0	0	20	0											447.75	447.75	447.75	0	49.75	0	0	48.49203003	223.875	0	49.75	223.875	0	0	19.55017889	23.70769844	24.40475742	19.9	0	19.9	12.53545845	0	0	0	19.9	0	0	0	19.9	0											7.8508	0.155371532	3.217294354	0	1.630390733	0	0	4.270635893	9.936985199	0	10.7347218	0.685547233	0	0	7.822437818	5.282383041	0.65773932	0.994809957	0	1.760850425	0.195043046	0	0	0	0.082546873	0	0	0	0.000672936	0	0	0	0	0	0	0	0	0	0	0	55.2783	0	0.2778	7.8508	0.155371532	3.217294354	0	1.630390733	0	0	4.270635893	9.936985199	0	10.7347218	0.685547233	0	0	7.822437818	5.282383041	0.65773932	0.994809957	0	1.760850425	0.195043046	0	0	0	0.082546873	0	0	0	0.000672936	0	0	0	0	0	0	0	0	0	0	0	55.2783	10600	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	0.2	0.2	0.2		15	0.2											3.3289	0.0501	0.8794	0.4471	0.1078	0.2449	0.0224	0.3157	0.6493	0.7632	0.6652	0.6197	0.0012	0.0114	0.7314	0.3767	0.065	0.0497		0.152	0.0424	0.0129			0.0036	0.0031			0.2273	0.0664											9.8368	0	0.049431197	11.1797	0.205460378	4.096691705	0.44706068	1.738170915	0.244933495	0.02241315	4.586324353	10.58631109	0.763240378	11.39989719	1.305277811	0.001170372	0.011360461	8.553817972	5.659087867	0.722767037	1.044505553	0	1.912892993	0.237473222	0.012865249	0	0	0.086164967	0.003072908	0	0	0.227931273	0.066444596	0	0	0	0	0	0	0	0	0	0	65.1151
H2416_001_0	2009	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																																																			0		398.2312363		201.0282927		22.21649641	37.91333457		31.82158146	37.10312082	138.1837415					252.4115045						3.990404764	0.517302026																			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											0.0793		0.1517		0.231	0.231		0.231	0.231	0.231					0.231						0.231	0.231																			0.0793		0.1517		0.231	0.231		0.231	0.231	0.231					0.231						0.231	0.231																			31.5797	0	30.495992	0	5.132010671	8.757980285	0	7.350785317	8.570820909	31.92044428	0	0	0	0	58.30705754	0	0	0	0	0	0.921783501	0.119496768	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	183.1561			31.5797	0	30.495992	0	5.132010671	8.757980285	0	7.350785317	8.570820909	31.92044428	0	0	0	0	58.30705754	0	0	0	0	0	0.921783501	0.119496768	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	183.1561																																																																																		0			31.5797	0	30.495992	0	5.132010671	8.757980285	0	7.350785317	8.570820909	31.92044428	0	0	0	0	58.30705754	0	0	0	0	0	0.921783501	0.119496768	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	183.1561
H2417_001_0	2009	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																																																			0		403.3209267		101.8382906		7.283996113	33.5594471		16.82336048	46.66914468	149.8226086					189.1318266						11.78136988	1.723225271																			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																																																			0.0793		0.1517		0.231	0.231		0.231	0.231	0.231					0.231						0.231	0.231																			31.9833	0	15.44886869	0	1.682603102	7.752232279	0	3.886196271	10.78057242	34.60902259	0	0	0	0	43.68945194	0	0	0	0	0	2.721496441	0.398065038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	152.9519			31.9833	0	15.44886869	0	1.682603102	7.752232279	0	3.886196271	10.78057242	34.60902259	0	0	0	0	43.68945194	0	0	0	0	0	2.721496441	0.398065038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	152.9519																																																																																		0			31.9833	0	15.44886869	0	1.682603102	7.752232279	0	3.886196271	10.78057242	34.60902259	0	0	0	0	43.68945194	0	0	0	0	0	2.721496441	0.398065038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	152.9519
H2419_001_0	2009	5																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		436.2927369		303.3984928		27.41634231	45.25757478		39.65439497	45.44304066	109.0242314					159.288274						15.1698493	0.965411836																			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																			0.0793		0.1517		0.231	0.231		0.231	0.231	0.231					0.231						0.231	0.231																			0.0793		0.1517		0.231	0.231		0.231	0.231	0.231					0.231						0.231	0.231																			34.598	0	46.02555136	0	6.333175073	10.45449978	0	9.160165238	10.49734239	25.18459745	0	0	0	0	36.7955913	0	0	0	0	0	3.504235189	0.223010134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	182.7762	0	0	34.598	0	46.02555136	0	6.333175073	10.45449978	0	9.160165238	10.49734239	25.18459745	0	0	0	0	36.7955913	0	0	0	0	0	3.504235189	0.223010134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	182.7762																																																																																		0	0	0	34.598	0	46.02555136	0	6.333175073	10.45449978	0	9.160165238	10.49734239	25.18459745	0	0	0	0	36.7955913	0	0	0	0	0	3.504235189	0.223010134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	182.7762
H2422_002_0	2009	5																																Coin		Coin	Coin	Coin	Coin		Coin	Coin	Coin					Coin						Coin	Coin																																																											0		483.3632505		166.7784036	24.78252805	34.65702674	44.49260549		25.52167543	25.88134148	259.1339615					232.8114049						21.63714592	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		16b. 100% with $2000 max		17b. 100% coverage			14a. 100% coverage	13c. 100% coverage											0.072		0.167	0	0.219	0.219		0.219	0.219	0.219					0.219						0.219	0.219																			0.072		0.167	0	0.219	0.219		0.219	0.219	0.219					0.219						0.219	0.219																			34.8022	0	27.85199341	0	7.589888855	9.743880601	0	5.589246918	5.668013783	56.75033756	0	0	0	0	50.98569767	0	0	0	0	0	4.738534956	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	203.7197			34.8022	0	27.85199341	0	7.589888855	9.743880601	0	5.589246918	5.668013783	56.75033756	0	0	0	0	50.98569767	0	0	0	0	0	4.738534956	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	203.7197																																																																																		0			34.8022	0	27.85199341	0	7.589888855	9.743880601	0	5.589246918	5.668013783	56.75033756	0	0	0	0	50.98569767	0	0	0	0	0	4.738534956	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	203.7197
H2424_001_0	2009	3																																Coin		Coin	Coin	Coin	Coin		V	Coin					Coin						Coin	Coin	Coin																																																											0		472.6031693		212.1829075	16.03939144	23.74297069	45.42938676		804.8229218	35.95609215					94.34393613						193.3894507	18.89434883	9.078279921																			traditional Medicare	included in a.1	traditional Medicare	traditional Medicare	traditional Medicare	traditional Medicare	included in e.1	$50 Copay (max for MA)	traditional Medicare	included in h.5	included in h.5	included in h.5	included in h.5	traditional Medicare	included in i.6	included in i.6	included in i.6	included in i.6	included in i.6	traditional Medicare	traditional Medicare	traditional Medicare								no cost share											0.0793		0.1517	0	0.231	0.231		50	0.231					0.231						0.231	0.231	0.231																			0.0793		0.1517	0	0.231	0.231		50	0.231					0.231						0.231	0.231	0.231																			37.4774	0	32.18814707	0	5.484626229	10.49418834	0	3.353428841	8.305857286	0	0	0	0	21.79344925	0	0	0	0	0	44.67296311	4.36459458	2.097082662	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	170.2318			37.4774	0	32.18814707	0	5.484626229	10.49418834	0	3.353428841	8.305857286	0	0	0	0	21.79344925	0	0	0	0	0	44.67296311	4.36459458	2.097082662	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	170.2318																																																																																		0			37.4774	0	32.18814707	0	5.484626229	10.49418834	0	3.353428841	8.305857286	0	0	0	0	21.79344925	0	0	0	0	0	44.67296311	4.36459458	2.097082662	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	170.2318
H2425_001_0	2009	6																																Coin		Coin	Coin	Coin	Coin		V	Coin					Coin						Coin	Coin	Coin																																																											0		434.8650894		253.500478	11.48931336	23.86887827	46.39396991		686.9730408	39.38799746					106.6252575						181.8085127	21.16169109	10.12659464																			traditional Medicare	included in a.1	traditional Medicare	traditional Medicare	traditional Medicare	traditional Medicare	included in e.1	$50 Copay (max for MA)	traditional Medicare	included in h.5	included in h.5	included in h.5	included in h.5	traditional Medicare	included in i.6	included in i.6	included in i.6	included in i.6	included in i.6	traditional Medicare	traditional Medicare	traditional Medicare								no cost share											0.078769468		0.148248939	0	0.231	0.231		50	0.231					0.231						0.231	0.231	0.231																			0.078769468		0.148248939	0	0.231	0.231		50	0.231					0.231						0.231	0.231	0.231																			34.2541	0	37.58117696	0	5.513710881	10.71700705	0	2.86238767	9.098627413	0	0	0	0	24.63043449	0	0	0	0	0	41.99776643	4.888350642	2.339243361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	173.8828			34.2541	0	37.58117696	0	5.513710881	10.71700705	0	2.86238767	9.098627413	0	0	0	0	24.63043449	0	0	0	0	0	41.99776643	4.888350642	2.339243361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	173.8828																																																																																		0			34.2541	0	37.58117696	0	5.513710881	10.71700705	0	2.86238767	9.098627413	0	0	0	0	24.63043449	0	0	0	0	0	41.99776643	4.888350642	2.339243361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	173.8828
H2456_002_0	2009	6																																Coin		Coin		Coin	Coin		Coin	Coin	Coin					Coin						Coin																																																												0		382.3107579		160.5353014		20.6491926	49.9154336		35.03922156	72.11226915	33.92662103					283.1507487						4.424415129																				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																				0.0778393		0.141713391		0.231	0.231		0.231	0.231	0.231					0.231						0.231																				0.0778393		0.141713391		0.231	0.231		0.231	0.231	0.231					0.231						0.231																				29.7588	0	22.75000194	0	4.76996349	11.53046516	0	8.09406018	16.65793417	7.837049458	0	0	0	0	65.40782294	0	0	0	0	0	1.022039895	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	167.8281		0	29.7588	0	22.75000194	0	4.76996349	11.53046516	0	8.09406018	16.65793417	7.837049458	0	0	0	0	65.40782294	0	0	0	0	0	1.022039895	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	167.8281																																																																																		0		0	29.7588	0	22.75000194	0	4.76996349	11.53046516	0	8.09406018	16.65793417	7.837049458	0	0	0	0	65.40782294	0	0	0	0	0	1.022039895	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	167.8281
H2457_002_0	2009	3																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin		Coin	Coin		Coin	Coin	Coin	Coin																																																											0		550.5983665	26.40012146	86.57221449		23.92644433	35.53392715	3.739530585	19.78265887	46.08260161	31.99247777	35.70734779			99.85303748		220.7301766	4.958480294		25.27218473	11.56186462	11.95439017	0.587792154																			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																			0.076922771	0.076922771	0.13458668		0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231		0.231	0.231		0.231	0.231	0.231	0.231																			0.076922771	0.076922771	0.13458668		0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231		0.231	0.231		0.231	0.231	0.231	0.231																			42.3536	2.030770489	11.65146689	0	5.527008641	8.208337173	0.863831565	4.569794198	10.64508097	7.390262365	8.24839734	0	0	23.06605166	0	50.98867079	1.145408948	0	5.837874671	2.670790726	2.76146413	0.135779988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	188.0945			42.3536	2.030770489	11.65146689	0	5.527008641	8.208337173	0.863831565	4.569794198	10.64508097	7.390262365	8.24839734	0	0	23.06605166	0	50.98867079	1.145408948	0	5.837874671	2.670790726	2.76146413	0.135779988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	188.0945																																																																																		0			42.3536	2.030770489	11.65146689	0	5.527008641	8.208337173	0.863831565	4.569794198	10.64508097	7.390262365	8.24839734	0	0	23.06605166	0	50.98867079	1.145408948	0	5.837874671	2.670790726	2.76146413	0.135779988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	188.0945
H2458_002_0	2009	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																																																			0		425.3439763	25.41323677	171.8484541		33.52232162	12.70045297	3.995301264	38.20756678	54.72289679	34.97719032	46.97785082	4.095445612	4.640767236	58.83895297	66.39118212	46.42721451	9.715691186	2.914256677	26.50965701	62.31008931	13.36994693	4.706357779																			FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins		FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins	FFS Mcare effective coins																			0.077821177	0.077821177	0.141579426		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.077821177	0.077821177	0.141579426		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			33.1008	1.977687996	24.33020544	0	7.743656294	2.933804637	0.922914592	8.825947926	12.64098916	8.079730963	10.85188354	0.946047936	1.072017231	13.59179814	15.33636307	10.72468655	2.244324664	0.673193292	6.123730768	14.39363063	3.088457741	1.087168647	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	180.689	0	0	33.1008	1.977687996	24.33020544	0	7.743656294	2.933804637	0.922914592	8.825947926	12.64098916	8.079730963	10.85188354	0.946047936	1.072017231	13.59179814	15.33636307	10.72468655	2.244324664	0.673193292	6.123730768	14.39363063	3.088457741	1.087168647	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	180.689																																																																																		0	0	0	33.1008	1.977687996	24.33020544	0	7.743656294	2.933804637	0.922914592	8.825947926	12.64098916	8.079730963	10.85188354	0.946047936	1.072017231	13.59179814	15.33636307	10.72468655	2.244324664	0.673193292	6.123730768	14.39363063	3.088457741	1.087168647	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	180.689
H2459_001_0	2009	3																					3350											A	A	D		T	Coin	Coin	V	P	V	V			V		V	V	V		V																																																													0	0	279.0950099	1.691047784	713.1214763		163.9806682	7.697769714	1.232342823	160.0617929	564.4285497	1238.086304	297.488653			1045.632015		1221.184924	34.85834366	271.9428398		172.5773735																					#1A $250	#1B $250	#2 $75/day days 21-100		#10A $100	#11A 20%	#11B 20%/10%	#4A $50	"#9A $100, #9B $100"	#8A $25	#8B $25			"#4B $25, #7A $25, #9A $25, #9C $25, #9D $25"		#7D $25	"#7E $25, #7H $25"	#7I $25		#7F $25																					250	250	75	0	100	0.2	0.19	50	100	25	25			25		25	25	25		25																					247.75	247.75	74.325	0	99.1	0.1982	0.18829	49.55	99.1	24.775	24.775			24.775		24.775	24.775	24.775		24.775																					5.7621	0.034913091	4.416896144	0	1.354207018	1.525697957	0.23203783	0.66092182	4.661239106	2.556132349	0.614190115	0	0	2.158794431	0	2.521238042	0.071967955	0.561448655	0	0.356300369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.4881		0.25	5.7621	0.034913091	4.416896144	0	1.354207018	1.525697957	0.23203783	0.66092182	4.661239106	2.556132349	0.614190115	0	0	2.158794431	0	2.521238042	0.071967955	0.561448655	0	0.356300369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.4881	0						Section C POS	Section C POS							Section C POS						Section C POS																										0.0631	0.007							0.3069						0.5023																					0.8793		0	5.7621	0.034913091	4.416896144	0	1.354207018	1.588760251	0.239044752	0.66092182	4.661239106	2.556132349	0.614190115	0	0	2.465736175	0	2.521238042	0.071967955	0.561448655	0	0.858587134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.3674
H2459_002_0	2009	5																					3350											A	A	D		T	Coin	Coin	V						V		V	V	V		V																																																													0	0	346.9647629	4.987548932	970.0128601		221.9584061	10.35703768	2.177615433	217.8432792						117.0155305		2081.187211	184.7649534	668.5257344		374.5500281																					#1A $100	#1B $100	#2 $50/day days 21-100		#10A $100	#11A 20%	#11B 10%	#4A $50						"#4B $20, #7A $20"		#7D $10	"#7E $10, #7H $10"	#7I $10		#7F $10																					100	100	50		100	0.2	0.1	50						20		10	10	10		10																					99.8	99.8	49.9		99.8	0.1996	0.0998	49.9						19.96		9.98	9.98	9.98		9.98																					2.8856	0.041479782	4.03363681	0	1.845954077	2.067264721	0.21732602	0.905864969	0	0	0	0	0	0.194635832	0	1.73085403	0.153662853	0.555990569	0	0.311500773	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.9438		0.03	2.8856	0.041479782	4.03363681	0	1.845954077	2.067264721	0.21732602	0.905864969	0	0	0	0	0	0.194635832	0	1.73085403	0.153662853	0.555990569	0	0.311500773	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.9438	0						Section C POS	Section C POS							Section C POS						Section C POS																										0.0762	0.0085							0.3069						0.6066																					0.9981		0	2.8856	0.041479782	4.03363681	0	1.845954077	2.143421478	0.225787882	0.905864969	0	0	0	0	0	0.501577577	0	1.73085403	0.153662853	0.555990569	0	0.918084026	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.9419
H2459_005_0	2009	3																					3350											A	A	D		T	Coin	Coin	V	P	V	V			V		V	V	V		V																																																													0	0	228.467777	2.867466412	442.2952734		114.2861469	5.609367866	1.286347057	128.3771291	572.6430757	1141.035451	317.2477333			1284.034482		1052.792407	23.66298737	257.7841367		155.2374929																					#1A $250	#1B $250	#2 $75/day days 21-100		#10A $100	#11A 20%	#11B 20%/10%	#4A $50	"#9A $100, #9B $100"	#8A $25	#8B $25			"#4B $25, #7A $25, #9A $25, #9C $25, #9D $25"		#7D $25	"#7E $25, #7H $25"	#7I $25		#7F $25																					250	250	75		100	0.2	0.19	50	100	25	25			25		25	25	25		25																					247.75	247.75	74.325		99.1	0.1982	0.18829	49.55	99.1	24.775	24.775			24.775		24.775	24.775	24.775		24.775																					4.7169	0.059201234	2.73946635	0	0.943813096	1.111776711	0.242206287	0.530090562	4.7290774	2.355762775	0.654984383	0	0	2.650996192	0	2.173577656	0.048854209	0.532216832	0	0.320500741	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.8094		0.22	4.7169	0.059201234	2.73946635	0	0.943813096	1.111776711	0.242206287	0.530090562	4.7290774	2.355762775	0.654984383	0	0	2.650996192	0	2.173577656	0.048854209	0.532216832	0	0.320500741	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.8094	0						Section C POS	Section C POS							Section C POS						Section C POS																										0.051	0.0057							0.4763						0.842																					1.375		0	4.7169	0.059201234	2.73946635	0	0.943813096	1.162753201	0.247870342	0.530090562	4.7290774	2.355762775	0.654984383	0	0	3.127327146	0	2.173577656	0.048854209	0.532216832	0	1.162489387	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.1844
H2459_006_0	2009	5																					3350											A	A	D		T	Coin	Coin	V						V		V	V	V		V																																																													0	0	296.016678	5.185809081	924.7589049		104.0742647	7.083048351	1.386183757	162.7596446						42.21023473		1644.43702	188.6554778	47.34021286		251.8342429																					#1A $100	#1B $100	#2 $50/day days 21-100		#10A $100	#11A 20%	#11B 10%	#4A $50						"#4B $20, #7A $20"		#7D $10	"#7E $10, #7H $10"	#7I $10		#7F $10																					100	100	50		100	0.2	0.1	50						20		10	10	10		10																					99.8	99.8	49.9		99.8	0.1996	0.0998	49.9						19.96		9.98	9.98	9.98		9.98																					2.4619	0.043128646	3.84545578	0	0.865550968	1.413776451	0.138341139	0.676808856	0	0	0	0	0	0.07020969	0	1.367623455	0.156898472	0.039371277	0	0.209442145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.2885		0.02	2.4619	0.043128646	3.84545578	0	0.865550968	1.413776451	0.138341139	0.676808856	0	0	0	0	0	0.07020969	0	1.367623455	0.156898472	0.039371277	0	0.209442145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.2885	0						Section C POS	Section C POS							Section C POS						Section C POS																										0.0616	0.0068							0.5752						0.6066																					1.2502		0	2.4619	0.043128646	3.84545578	0	0.865550968	1.475337869	0.145181296	0.676808856	0	0	0	0	0	0.645447582	0	1.367623455	0.156898472	0.039371277	0	0.816025398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.5387
H2459_013_0	2009	5																					3350											A	A	D		T	Coin	Coin	V	P	V	V			V		V	V	V		V																																																													0	0	285.6041202	3.138731696	390.2765005		178.0407699	9.059565854	1.556930424	194.8394161	581.5817265	1161.230349	310.0821619			1283.303081		1425.165542	135.0592926	447.877953		225.7893083																					#1A $250	#1B $250	#2 $75/day days 21-100		#10A $100	#11A 20%	#11B 20%/10%	#4A $50	"#9A $100, #9B $100"	#8A $25	#8B $25			"#4B $25, #7A $25, #9A $25, #9C $25, #9D $25"		#7D $25	"#7E $25, #7H $25"	#7I $25		#7F $25																					250	250	75		100	0.2	0.19	50	100	25	25			25		25	25	25		25																					247.75	247.75	74.325		99.1	0.1982	0.18829	49.55	99.1	24.775	24.775			24.775		24.775	24.775	24.775		24.775																					5.8965	0.064801731	2.417275075	0	1.470320025	1.795605952	0.29315443	0.804524422	4.802895758	2.397456824	0.640190463	0	0	2.649486153	0	2.942373025	0.278841165	0.924681357	0	0.466160843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.8443		0.26	5.8965	0.064801731	2.417275075	0	1.470320025	1.795605952	0.29315443	0.804524422	4.802895758	2.397456824	0.640190463	0	0	2.649486153	0	2.942373025	0.278841165	0.924681357	0	0.466160843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.8443	0						Section C POS	Section C POS							Section C POS						Section C POS																										0.0676	0.0075							0.2723						0.5381																					0.8855		0	5.8965	0.064801731	2.417275075	0	1.470320025	1.863166957	0.300661208	0.804524422	4.802895758	2.397456824	0.640190463	0	0	2.921783629	0	2.942373025	0.278841165	0.924681357	0	1.00427953	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.7298
H2459_014_0	2009	4																					3350											A	A	D		T	Coin	Coin	V	P	V	V			V		V	V	V		V																																																													0	0	222.6021313	3.379809029	474.5267199		118.4314638	12.17005687	1.450409555	147.1045311	527.2913289	1209.161393	381.421781			1311.924766		1068.407126	127.0593673	352.5367239		156.9739661																					#1A $250	#1B $250	#2 $75/day days 21-100		#10A $100	#11A 20%	#11B 20%/10%	#4A $50	"#9A $100, #9B $100"	#8A $25	#8B $25			"#4B $25, #7A $25, #9A $25, #9C $25, #9D $25"		#7D $25	"#7E $25, #7H $25"	#7I $25		#7F $25																					250	250	75		100	0.2	0.19	50	100	25	25			25		25	25	25		25																					247.75	247.75	74.325		99.1	0.1982	0.18829	49.55	99.1	24.775	24.775			24.775		24.775	24.775	24.775		24.775																					4.5958	0.069778974	2.939099872	0	0.978046505	2.412105272	0.273097615	0.607419126	4.354547558	2.496414459	0.787477052	0	0	2.708578007	0	2.205815546	0.262324652	0.727841445	0	0.324085834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.7424		0.24	4.5958	0.069778974	2.939099872	0	0.978046505	2.412105272	0.273097615	0.607419126	4.354547558	2.496414459	0.787477052	0	0	2.708578007	0	2.205815546	0.262324652	0.727841445	0	0.324085834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.7424	0						Section C POS	Section C POS							Section C POS						Section C POS																										0.0546	0.0061							0.2723						0.5381																					0.8711		0	4.5958	0.069778974	2.939099872	0	0.978046505	2.466718302	0.27916573	0.607419126	4.354547558	2.496414459	0.787477052	0	0	2.980875483	0	2.205815546	0.262324652	0.727841445	0	0.862204521	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.6135
H2459_016_0	2009	5																																Coin		Coin		Coin	Coin		Coin	Coin	Coin					Coin						Coin																																																												0		664.4808735		65.29901763		34.66657182	111.4047365		46.10134742	94.96979012	112.2989344					332.6713313						29.63520574																				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																				0.07902331		0.149923696		0.231	0.231		0.231	0.231	0.231					0.231						0.231																				0.07902331		0.149923696		0.231	0.231		0.231	0.231	0.231					0.231						0.231																				52.5095	0	9.789870089	0	8.00797809	25.73449412	0	10.64941125	21.93802152	25.94105384	0	0	0	0	76.84707754	0	0	0	0	0	6.845732525	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	238.2631		0	52.5095	0	9.789870089	0	8.00797809	25.73449412	0	10.64941125	21.93802152	25.94105384	0	0	0	0	76.84707754	0	0	0	0	0	6.845732525	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	238.2631																																																																																		0		0	52.5095	0	9.789870089	0	8.00797809	25.73449412	0	10.64941125	21.93802152	25.94105384	0	0	0	0	76.84707754	0	0	0	0	0	6.845732525	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	238.2631
H2459_017_0	2009	4																					3350											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	P	P	Coin	P	T	P	V	P	V	P	P	P																																																			0		700.4684243	13.68107299			523.3332216	36.70522151	31.7476214	490.8149184																																	#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 $0"	"#7B $0, #7D $0, #7F $0"	"#7E $0, #7H $0"	"#7C $0, #7I $0"	#7D $0	#7G $0	#15 $0	"#13A $0, #14J $0, #16B $0, #17A $0, #17B $0, #18A $0"	#10B $0	"#16A $0, #16B opt.supp"	#17A $0	#17B $0	#18A $0	#18B $0	#14A $0	#13B $0 n/c											100	100			100	0.2	0.1	46.98829169																																	99.99909713	99.99909713			99.99909713	0.199998194	0.099999097	46.98786744																																	5.8372	0.114007912	0	0	4.361070805	7.340978021	3.174733476	1.921862194	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.7498	0	0.0002	5.8372	0.114007912	0	0	4.361070805	7.340978021	3.174733476	1.921862194	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.7498																																																																																		0	0	0	5.8372	0.114007912	0	0	4.361070805	7.340978021	3.174733476	1.921862194	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.7498
H2459_801_0	2009	2																					3350											A	A	D		T	Coin	Coin	V	P	V	V			V	V	V	V	V		V																																																													0	0	293.2892439	3.888261827	550.1744972		169.8481149	10.73342271	2.438915406	202.3648867	675.5219231	1227.107604	350.7102275			1795.327566	2452.132592	2162.144308	282.5103619	806.2391874		193.2440693																					#1A $250	#1B $250	#2 $75/day days 21-100		#10A $100	#11A 20%	#11B 20%/10%	#4A $50	"#9A $100, #9B $100"	#8A $25	#8B $25			"#9A $25, #9C $25, #9D $25"	#7A $25	#7D $25	"#7E $25, #7H $25"	#7I $25		"#4B $25, #7A $25, #7F $25"																					250	250	75		100	0.2	0.19	50	100	25	25			25	25	25	25	25		25																					247.75	247.75	74.325		99.1	0.1982	0.18829	49.55	99.1	24.775	24.775			24.775	24.775	24.775	24.775	24.775		24.775																					6.0552	0.080276406	3.407643292	0	1.402662349	2.127364382	0.459223382	0.835598345	5.578685215	2.533465907	0.72407049	0	0	3.706603371	5.06263208	4.463927102	0.583266185	1.664547989	0	0.398968485	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.0841		0.36	6.0552	0.080276406	3.407643292	0	1.402662349	2.127364382	0.459223382	0.835598345	5.578685215	2.533465907	0.72407049	0	0	3.706603371	5.06263208	4.463927102	0.583266185	1.664547989	0	0.398968485	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.0841	0						Section C POS	Section C POS							Section C POS						Section C POS																										0.0534	0.0059							0.3451						0.6176																					1.022		0	6.0552	0.080276406	3.407643292	0	1.402662349	2.180729291	0.465152816	0.835598345	5.578685215	2.533465907	0.72407049	0	0	4.051711412	5.06263208	4.463927102	0.583266185	1.664547989	0	1.01651953	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.1061
H2459_803_0	2009	2																					3350											A	A	D		T	Coin	Coin	V	P	V	V			V	V	V	V	V		V																																																													0	0	256.0875196	3.632732329	278.0212307		119.1036444	10.02548807	2.612975828	178.1573446	666.7710253	1033.599821	320.0833176			1547.872357	2239.329376	2272.998056	180.464084	980.2002747		145.123814																					#1A $250	#1B $250	#2 $75/day days 21-100		#10A $100	#11A 20%	#11B 20%/10%	#4A $50	"#9A $100, #9B $100"	#8A $25	#8B $25			"#9A $25, #9C $25, #9D $25"	#7A $25	#7D $25	"#7E $25, #7H $25"	#7I $25		"#4B $25, #7A $25, #7F $25"																					250	250	75		100	0.2	0.19	50	100	25	25			25	25	25	25	25		25																					247.75	247.75	74.325		99.1	0.1982	0.18829	49.55	99.1	24.775	24.775			24.775	24.775	24.775	24.775	24.775		24.775																					5.2871	0.075000786	1.721993998	0	0.983597596	1.987051735	0.491997219	0.735641369	5.506417384	2.133952964	0.660838683	0	0	3.19571147	4.623282107	4.692793903	0.37258314	2.02370515	0	0.299620208	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.7913		0.32	5.2871	0.075000786	1.721993998	0	0.983597596	1.987051735	0.491997219	0.735641369	5.506417384	2.133952964	0.660838683	0	0	3.19571147	4.623282107	4.692793903	0.37258314	2.02370515	0	0.299620208	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.7913	0						Section C POS	Section C POS							Section C POS	Section C POS																															0.041	0.0046							0.2648	0.4739																										0.7842		0	5.2871	0.075000786	1.721993998	0	0.983597596	2.02800337	0.4965474	0.735641369	5.506417384	2.133952964	0.660838683	0	0	3.460543524	5.097183878	4.692793903	0.37258314	2.02370515	0	0.299620208	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.5756
H2469_001_0	2009	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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1175.89	28.97	581.08	0	224.59	10.1	7.21	266.96	311.16	0	751.31	44.33	0.19	1119.11	0	6491.91	162.44	607.02	1751.48	1312.44	9.79	667.38	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $100 per day for the first 10 days	1B IP Psych: $100 per day for the first 10 days	2 SNF: $130 per day for 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: $50,4A Non Covered Foreign Travel: $50,  4B Urgent Care: $25"	9B ASC Services: $100	8A OP Lab Services: $0	8B OP X-Ray: $20	"9A OP Hospital: $100, 5 Partial Hosp: $100"	12 Renal Dialysis: 20%	"3 CORF: $100, 8A OP Diagnostic Procedures/Tests: $100, 9A OP Hospital: $100, 9D Cardiac Rehab: $100"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $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"	"8B Physician Specialist Services - Radiology: $20, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7B Chiropractic: $25, 7F Podiatry: $25, 7F Non Medicare Covered Podiatry: $0,  7G Other Health Care: $25, 14D Pap Smears & Pelvic Exams: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $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, 17B Medicare Covered Eyewear: $25"	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: Not Covered	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: Over-the-Counter Drugs: $0, 13D Other: PERS: Not Covered, 13E Other: Assistive Devices: Not Covered"											100	100	130	0	100	0.19999981	0.199993967	48.56439167	100	0	20	100	0.19999998	75.67397307	0	25	25	25	20	25	0.200000919	25	0	0	0	0	0	0	0	0											100	100	130	0	100	0.19999981	0.199993967	48.56439167	100	0	20	100	0.19999998	75.67397307	0	25	25	25	20	25	0.200000919	25	0	0	0	0	0	0	0	0											9.7991	0.241416667	6.295033333	0	1.871583333	2.019998081	1.441956502	1.080395833	2.593	0	1.252183333	0.369416667	0.037999996	7.057291667	0	13.5248125	0.338416667	1.264625	2.919133333	2.73425	1.958009	1.390375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.189	0	0	9.7991	0.241416667	6.295033333	0	1.871583333	2.019998081	1.441956502	1.080395833	2.593	0	1.252183333	0.369416667	0.037999996	7.057291667	0	13.5248125	0.338416667	1.264625	2.919133333	2.73425	1.958009	1.390375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.189	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	9.7991	0.241416667	6.295033333	0	1.871583333	2.019998081	1.441956502	1.080395833	2.593	0	1.252183333	0.369416667	0.037999996	7.057291667	0	13.5248125	0.338416667	1.264625	2.919133333	2.73425	1.958009	1.390375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.189
H2481_003_0	2009	4																					1000											D	D			T			V	V					V	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	2000	371.5997743	5.476314358	0	0	141.8358728	0	0	241.2115382	197.5099622	0	0	0	0	362.4529111	2843.995468	2474.077707	110.188809	355.2910049	0	1155.753662	0	0	0	1556.912342	269.1335325	0	0	0	0	357.0358872											$100/Days 1-3 for IP Medical; $100/Days 1-3 for IP Surgical;	$100/Days 1-3 for IP Psych; $100/Days 1-3 for IP Substance Abuse;	No Cost-Sharing	No Cost-Sharing	$50/Run 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	$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/Visit for Prof - CORF; $10/Visit for Prof - CORF;	$10/Visit for PCP - Office Visits; $10/Consult for PCP - Consults;	$20/Visit for Speclst - Office Visits; $20/Consult for Speclst - Consults;	$10/Visit for OP Psych - Non-Physician; $20/Visit for OP Psych - Psychiatrist; $10/Visit for OP Substance Abuse;	$10/Visit for PT/ST (PCP); $10/Visit for Occ Therapy (PCP); $10/Visit for PT/ST (Specialist); $10/Visit for Occ Therapy (Specialist);	No Cost-Sharing	$10/Visit for Chiropractor; $20/Exam for Vistion Exams; $20/Service for Podiatrist; $20/Exam for Hearing/Speech Exams;	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$10/Procedure for Dental - Preventive;	$10/Exam for Vision (Refractions)	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$10/Visit for Acupunture; $10/Service for Care Coordination Counseling;											100	100.0000001	0	0	50	0	0	42.80342126	50	0	0	0	0	9.999999998	10	20	14.57620998	9.999999999	0	17.89152007	0	0	0	10	10	0	0	0	0	9.999999999											93.21413992	93.21414003	0	0	46.60706996	0	0	39.89884098	46.60706995	0	0	0	0	9.321413989	9.321413992	18.64282798	13.58708877	9.321413991	0	16.67742655	0	0	0	10	9.321413993	0	0	0	0	9.321413991											2.8865	0.042539161	0	0	0.550879537	0	0	0.802005067	0.767113385	0	0	0	0	0.281547803	2.209171596	3.843650426	0.124762094	0.275984545	0	1.606249734	0	0	0	1.297426952	0.209058756	0	0	0	0	0.277339943	0	0	0	0	0	0	0	0	0	0	15.1743	0	1.1885	2.8865	0.042539161	0	0	0.550879537	0	0	0.802005067	0.767113385	0	0	0	0	0.281547803	2.209171596	3.843650426	0.124762094	0.275984545	0	1.606249734	0	0	0	1.297426952	0.209058756	0	0	0	0	0.277339943	0	0	0	0	0	0	0	0	0	0	15.1743	3000	$200/Days Custom for IP Medical; $200/Days Custom for IP Surgical;	$200/Days Custom for IP Psych; $200/Days Custom for IP Substance Abuse;	$200/Days Custom for SNF	20% Coinsurance for Home Health	$50/Run 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;	$200/Case for OP Fac - Surgery; $200/Case for OP Fac - ASC	20% Coinsurance for OP Fac - Pathology	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	No Cost-Sharing	No Cost-Sharing	$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/Visit for Prof - CORF; $20/Visit for Prof - CORF;	$20/Visit for PCP - Office Visits; $20/Consult for PCP - Consults;	$40/Visit for Speclst - Office Visits; $20/Consult for Speclst - Consults;	$20/Visit for OP Psych - Non-Physician; $40/Visit for OP Psych - Psychiatrist; $20/Visit for OP Substance Abuse;	$20/Visit for PT/ST (PCP); $20/Visit for Occ Therapy (PCP); $20/Visit for PT/ST (Specialist); $20/Visit for Occ Therapy (Specialist);	No Cost-Sharing	$20/Visit for Chiropractor; $20/Exam for Vistion Exams; $40/Service for Podiatrist; $20/Exam for Hearing/Speech Exams;	20% Coinsurance for Part B Rx	No Cost-Sharing	No Cost-Sharing	$20/Procedure for Dental - Preventive;	$20/Exam for Vision (Refractions)	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$20/Visit for Acupunture; $20/Service for Care Coordination Counseling;											1.7961	0.0511	1.4349	0.3158	0.1062	0.2912	0.1634	0.1664	0.5841	0.1983	0.6399	0	0	0.0934	0.498	0.7908	0.0321	0.0861	0	0.3788	0.2092	0	0	0	0	0	0	0	0	0											7.8357	0	25.43371909	4.6826	0.093593056	1.434900722	0.315824382	0.657079337	0.291174601	0.163353701	0.968387716	1.351224431	0.198291346	0.63989371	0	0	0.374961964	2.707186706	4.63441301	0.15686827	0.362075045	0	1.985023314	0.209219919	0	0	1.297426952	0.209058756	0	0	0	0	0.277339943	0	0	0	0	0	0	0	0	0	0	23.0099
H2481_004_0	2009	7																					1000											D	D			T			V	V					V	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	2000	396.3742946	5.964330617	0	0	157.8496003	0	0	268.445099	219.8094741	0	0	0	0	403.375014	3165.091731	2753.409061	122.629481	395.4045055	0	1286.241978	0	0	0	1556.912342	299.5195765	0	0	0	0	397.3463906											$100/Days 1-3 for IP Medical; $100/Days 1-3 for IP Surgical;	$100/Days 1-3 for IP Psych; $100/Days 1-3 for IP Substance Abuse;	No Cost-Sharing	No Cost-Sharing	$50/Run 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	$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/Visit for Prof - CORF; $10/Visit for Prof - CORF;	$10/Visit for PCP - Office Visits; $10/Consult for PCP - Consults;	$20/Visit for Speclst - Office Visits; $20/Consult for Speclst - Consults;	$10/Visit for OP Psych - Non-Physician; $20/Visit for OP Psych - Psychiatrist; $10/Visit for OP Substance Abuse;	$10/Visit for PT/ST (PCP); $10/Visit for Occ Therapy (PCP); $10/Visit for PT/ST (Specialist); $10/Visit for Occ Therapy (Specialist);	No Cost-Sharing	$10/Visit for Chiropractor; $20/Exam for Vistion Exams; $20/Service for Podiatrist; $20/Exam for Hearing/Speech Exams;	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$10/Procedure for Dental - Preventive;	$10/Exam for Vision (Refractions)	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$10/Visit for Acupunture; $10/Service for Care Coordination Counseling;											100	100	0	0	50	0	0	42.80342126	50	0	0	0	0	9.999999998	10	20	14.57620997	9.999999996	0	17.89152007	0	0	0	10	10	0	0	0	0	10											92.27606326	92.2760633	0	0	46.13803163	0	0	39.49731208	46.13803163	0	0	0	0	9.227606324	9.227606326	18.45521265	13.45035274	9.227606321	0	16.50959038	0	0	0	10	9.227606326	0	0	0	0	9.227606328											3.048	0.045863746	0	0	0.606905821	0	0	0.883571654	0.845131372	0	0	0	0	0.310182152	2.433851706	4.234562478	0.137450815	0.304053093	0	1.769610683	0	0	0	1.297426952	0.230320728	0	0	0	0	0.305546339	0	0	0	0	0	0	0	0	0	0	16.4525	0	1.4924	3.048	0.045863746	0	0	0.606905821	0	0	0.883571654	0.845131372	0	0	0	0	0.310182152	2.433851706	4.234562478	0.137450815	0.304053093	0	1.769610683	0	0	0	1.297426952	0.230320728	0	0	0	0	0.305546339	0	0	0	0	0	0	0	0	0	0	16.4525	3000	$200/Days Custom for IP Medical; $200/Days Custom for IP Surgical;	$200/Days Custom for IP Psych; $200/Days Custom for IP Substance Abuse;	$200/Days Custom for SNF	20% Coinsurance for Home Health	$50/Run 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;	$200/Case for OP Fac - Surgery; $200/Case for OP Fac - ASC	20% Coinsurance for OP Fac - Pathology	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	No Cost-Sharing	No Cost-Sharing	$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/Visit for Prof - CORF; $20/Visit for Prof - CORF;	$20/Visit for PCP - Office Visits; $20/Consult for PCP - Consults;	$40/Visit for Speclst - Office Visits; $20/Consult for Speclst - Consults;	$20/Visit for OP Psych - Non-Physician; $40/Visit for OP Psych - Psychiatrist; $20/Visit for OP Substance Abuse;	$20/Visit for PT/ST (PCP); $20/Visit for Occ Therapy (PCP); $20/Visit for PT/ST (Specialist); $20/Visit for Occ Therapy (Specialist);	No Cost-Sharing	$20/Visit for Chiropractor; $20/Exam for Vistion Exams; $40/Service for Podiatrist; $20/Exam for Hearing/Speech Exams;	20% Coinsurance for Part B Rx	No Cost-Sharing	No Cost-Sharing	$20/Procedure for Dental - Preventive;	$20/Exam for Vision (Refractions)	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$20/Visit for Acupunture; $20/Service for Care Coordination Counseling;											1.9489	0.055	1.5681	0.3354	0.1128	0.3093	0.1735	0.1767	0.6204	0.2106	0.6796	0	0	0.0992	0.5289	0.8399	0.0341	0.0914	0	0.4023	0.2222	0	0	0	0	0	0	0	0	0											8.4083	0	30.51062246	4.9969	0.100894285	1.568070632	0.335432894	0.719699222	0.309252688	0.173495803	1.060284462	1.465507978	0.210602613	0.679622636	0	0	0.409396096	2.96278696	5.074420948	0.171550359	0.395488672	0	2.171901086	0.222209705	0	0	1.297426952	0.230320728	0	0	0	0	0.305546339	0	0	0	0	0	0	0	0	0	0	24.8608
H2481_005_0	2009	5																					1000											D	D			T			V	V					V	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	2000	400.2871955	6.166653605	0	0	142.9369092	0	0	248.4197934	222.0703593	0	0	0	0	399.0417345	3174.584621	2764.249559	126.6295924	420.9841628	0	1360.139839	0	0	0	1556.912342	334.1539409	0	0	0	0	446.4150003											$100/Days 1-3 for IP Medical; $100/Days 1-3 for IP Surgical;	$100/Days 1-3 for IP Psych; $100/Days 1-3 for IP Substance Abuse;	No Cost-Sharing	No Cost-Sharing	$50/Run 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	$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/Visit for Prof - CORF; $10/Visit for Prof - CORF;	$10/Visit for PCP - Office Visits; $10/Consult for PCP - Consults;	$20/Visit for Speclst - Office Visits; $20/Consult for Speclst - Consults;	$10/Visit for OP Psych - Non-Physician; $20/Visit for OP Psych - Psychiatrist; $10/Visit for OP Substance Abuse;	$10/Visit for PT/ST (PCP); $10/Visit for Occ Therapy (PCP); $10/Visit for PT/ST (Specialist); $10/Visit for Occ Therapy (Specialist);	No Cost-Sharing	$10/Visit for Chiropractor; $20/Exam for Vistion Exams; $20/Service for Podiatrist; $20/Exam for Hearing/Speech Exams;	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$10/Procedure for Dental - Preventive;	$10/Exam for Vision (Refractions)	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$10/Visit for Acupunture; $10/Service for Care Coordination Counseling;											100	100	0	0	50	0	0	42.2407314	50	0	0	0	0	10	10	20	14.58367221	10	0	17.67625506	0	0	0	10	10	0	0	0	0	10											92.21213439	92.21213449	0	0	46.10606719	0	0	38.95108	46.1060672	0	0	0	0	9.221213437	9.221213439	18.44242688	13.44791542	9.221213439	0	16.29965207	0	0	0	10	9.22121344	0	0	0	0	9.221213438											3.0759	0.047386691	0	0	0.549188228	0	0	0.806351604	0.853232576	0	0	0	0	0.306637417	2.439460197	4.248289197	0.141908671	0.323498735	0	1.847483845	0	0	0	1.297426952	0.256775401	0	0	0	0	0.343040667	0	0	0	0	0	0	0	0	0	0	16.5366	0	1.5142	3.0759	0.047386691	0	0	0.549188228	0	0	0.806351604	0.853232576	0	0	0	0	0.306637417	2.439460197	4.248289197	0.141908671	0.323498735	0	1.847483845	0	0	0	1.297426952	0.256775401	0	0	0	0	0.343040667	0	0	0	0	0	0	0	0	0	0	16.5366	3000	$200/Days Custom for IP Medical; $200/Days Custom for IP Surgical;	$200/Days Custom for IP Psych; $200/Days Custom for IP Substance Abuse;	$200/Days Custom for SNF	20% Coinsurance for Home Health	$50/Run 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;	$200/Case for OP Fac - Surgery; $200/Case for OP Fac - ASC	20% Coinsurance for OP Fac - Pathology	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	No Cost-Sharing	No Cost-Sharing	$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/Visit for Prof - CORF; $20/Visit for Prof - CORF;	$20/Visit for PCP - Office Visits; $20/Consult for PCP - Consults;	$40/Visit for Speclst - Office Visits; $20/Consult for Speclst - Consults;	$20/Visit for OP Psych - Non-Physician; $40/Visit for OP Psych - Psychiatrist; $20/Visit for OP Substance Abuse;	$20/Visit for PT/ST (PCP); $20/Visit for Occ Therapy (PCP); $20/Visit for PT/ST (Specialist); $20/Visit for Occ Therapy (Specialist);	No Cost-Sharing	$20/Visit for Chiropractor; $20/Exam for Vistion Exams; $40/Service for Podiatrist; $20/Exam for Hearing/Speech Exams;	20% Coinsurance for Part B Rx	No Cost-Sharing	No Cost-Sharing	$20/Procedure for Dental - Preventive;	$20/Exam for Vision (Refractions)	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$20/Visit for Acupunture; $20/Service for Care Coordination Counseling;											1.9521	0.0553	1.8747	0.5362	0.0866	0.2809	0.1576	0.1384	0.6175	0.1807	0.4905	0	0	0.0966	0.5823	0.9246	0.0397	0.1063	0	0.4617	0.1494	0	0	0	0	0	0	0	0	0											8.731	0	32.07747655	5.028	0.102677869	1.874747681	0.536208576	0.635769484	0.280867557	0.157571282	0.944773569	1.470748703	0.180735316	0.490491203	0	0	0.403188055	3.021769094	5.172895859	0.181565785	0.429836555	0	2.309146333	0.149405375	0	0	1.297426952	0.256775401	0	0	0	0	0.343040667	0	0	0	0	0	0	0	0	0	0	25.2677
H2481_006_0	2009	7																					1000											D	D			T			V	V					V	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	2000	427.594606	6.632979843	0	0	159.0588629	0	0	276.4392352	247.11783	0	0	0	0	444.0499302	3532.648235	3076.031196	140.9122325	468.4672602	0	1513.55096	0	0	0	1556.912342	371.843397	0	0	0	0	496.7664597											$100/Days 1-3 for IP Medical; $100/Days 1-3 for IP Surgical;	$100/Days 1-3 for IP Psych; $100/Days 1-3 for IP Substance Abuse;	No Cost-Sharing	No Cost-Sharing	$50/Run 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	$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/Visit for Prof - CORF; $10/Visit for Prof - CORF;	$10/Visit for PCP - Office Visits; $10/Consult for PCP - Consults;	$20/Visit for Speclst - Office Visits; $20/Consult for Speclst - Consults;	$10/Visit for OP Psych - Non-Physician; $20/Visit for OP Psych - Psychiatrist; $10/Visit for OP Substance Abuse;	$10/Visit for PT/ST (PCP); $10/Visit for Occ Therapy (PCP); $10/Visit for PT/ST (Specialist); $10/Visit for Occ Therapy (Specialist);	No Cost-Sharing	$10/Visit for Chiropractor; $20/Exam for Vistion Exams; $20/Service for Podiatrist; $20/Exam for Hearing/Speech Exams;	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$10/Procedure for Dental - Preventive;	$10/Exam for Vision (Refractions)	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$10/Visit for Acupunture; $10/Service for Care Coordination Counseling;											100	99.99999993	0	0	50	0	0	42.2407314	50	0	0	0	0	10	10	20	14.58367222	9.999999999	0	17.67625506	0	0	0	10	10	0	0	0	0	9.999999999											91.25131803	91.25131801	0	0	45.62565902	0	0	38.54522415	45.62565901	0	0	0	0	9.125131805	9.125131802	18.25026361	13.30779311	9.125131805	0	16.12981572	0	0	0	10	9.125131804	0	0	0	0	9.125131802											3.2515	0.050439013	0	0	0.604763787	0	0	0.887951024	0.939576154	0	0	0	0	0.337667845	2.686323396	4.678198348	0.156269236	0.356235458	0	2.034441506	0	0	0	1.297426952	0.282760001	0	0	0	0	0.377754952	0	0	0	0	0	0	0	0	0	0	17.9414	0	1.8773	3.2515	0.050439013	0	0	0.604763787	0	0	0.887951024	0.939576154	0	0	0	0	0.337667845	2.686323396	4.678198348	0.156269236	0.356235458	0	2.034441506	0	0	0	1.297426952	0.282760001	0	0	0	0	0.377754952	0	0	0	0	0	0	0	0	0	0	17.9414	3000	$200/Days Custom for IP Medical; $200/Days Custom for IP Surgical;	$200/Days Custom for IP Psych; $200/Days Custom for IP Substance Abuse;	$200/Days Custom for SNF	20% Coinsurance for Home Health	$50/Run 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;	$200/Case for OP Fac - Surgery; $200/Case for OP Fac - ASC	20% Coinsurance for OP Fac - Pathology	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	No Cost-Sharing	No Cost-Sharing	$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/Visit for Prof - CORF; $20/Visit for Prof - CORF;	$20/Visit for PCP - Office Visits; $20/Consult for PCP - Consults;	$40/Visit for Speclst - Office Visits; $20/Consult for Speclst - Consults;	$20/Visit for OP Psych - Non-Physician; $40/Visit for OP Psych - Psychiatrist; $20/Visit for OP Substance Abuse;	$20/Visit for PT/ST (PCP); $20/Visit for Occ Therapy (PCP); $20/Visit for PT/ST (Specialist); $20/Visit for Occ Therapy (Specialist);	No Cost-Sharing	$20/Visit for Chiropractor; $20/Exam for Vistion Exams; $40/Service for Podiatrist; $20/Exam for Hearing/Speech Exams;	20% Coinsurance for Part B Rx	No Cost-Sharing	No Cost-Sharing	$20/Procedure for Dental - Preventive;	$20/Exam for Vision (Refractions)	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$20/Visit for Acupunture; $20/Service for Care Coordination Counseling;											2.1243	0.0599	2.0506	0.57	0.092	0.2986	0.1675	0.1471	0.6564	0.1921	0.5214	0	0	0.1026	0.619	0.9829	0.0422	0.113	0	0.4908	0.1588	0	0	0	0	0	0	0	0	0											9.3893	0	37.9868176	5.3759	0.110300269	2.050634113	0.570001021	0.696801487	0.298568135	0.167501594	1.03509649	1.596008816	0.192125451	0.521402489	0	0	0.440303209	3.30533003	5.661074721	0.198425585	0.469274802	0	2.525198463	0.158821063	0	0	1.297426952	0.282760001	0	0	0	0	0.377754952	0	0	0	0	0	0	0	0	0	0	27.3307
H2486_002_0	2009	6	r.	s.	t.	u.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered							2500											D	D	D	V	T	Coin	Coin	V	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							0		1443.174248	117.283761	719.120943	13.578014	225.853738	3.17054	1.550428	330.635015	154.574383	92.56262	875.336115	0	13.110123	225.040324	4016.48793	3474.835751	2.256887	460.830915			21.957423			2.65	2.47		0.77		1.23	0.05	0.06	0.09	2.4	2.7							$125/Day(Days 1-5):1a	$125/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$40/Visit:9b. $0 Surgery ASC -- Physician,9b. $40 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $40 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $25 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $25 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$25-$50/Visit:9d. $25 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $35 Partial Hospitalization,8b. $50 Rad therapy,3. $25 Therapy (AT,PT,ST,OT) -- CORF"	$5/Visit:7a	"$15-$25/Visit:7b. $15 Chiropractic,7f. $25 Podiatry,7d. $25 Physician Services Spec,7d. $25 Spec Cap"	"$25-$50/Visit:7h. $50 Psych -- OP,7e. $25 Psych -- Other Provider"	"$25/Visit:7d, 9a"			20% Coins:15			"DEN 772 16a, 16b"	VIS 735		HER 722		$0: Health Education Materials 14a	$0 Additional Smoking Cessation 14a	$0: Nurse hotline 14a	$0: Nutritional benefit 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							76.637747	63.88424	43.132794	0	99.999974	0.2	0.2	50.000003	40.000004	46.352577	29.381924	0	0	39.285545	5.000001	24.985132	47.050649	24.999989			0.199999			0	0		0		0	0	0	0	0	0							55.214355	46.025976	31.07541	0	72.045881	0.144091	0.144091	36.022952	28.818363	33.395131	21.168472	0	0	28.303625	3.602295	18.000763	33.898064	18.011467			0.144091			0	0		0		0	0	0	0	0	0							6.6403	0.449841631	1.862248179	0	1.355985961	0.456846279	0.223402721	0.99253744	0.371215057	0.257595068	1.544127337	0	0	0.530788078	1.205714532	5.212474568	0.006375342	0.691686735	0	0	3.163867037	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.965	0	9.6865	6.6403	0.449841631	1.862248179	0	1.355985961	0.456846279	0.223402721	0.99253744	0.371215057	0.257595068	1.544127337	0	0	0.530788078	1.205714532	5.212474568	0.006375342	0.691686735	0	0	3.163867037	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.965	2500																																																																																	0	0	0	6.6403	0.449841631	1.862248179	0	1.355985961	0.456846279	0.223402721	0.99253744	0.371215057	0.257595068	1.544127337	0	0	0.530788078	1.205714532	5.212474568	0.006375342	0.691686735	0	0	3.163867037	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	24.965
H2486_801_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		293.770927	11.820092	719.120943	13.578014	8.344442	3.17054	1.550428	25.748238	25.888299	92.56262	20.967286	0	0.412543	6.647576	36.882921	81.621606	0.10762	3.800772			21.957423																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999982	1024.000151	43.132794	0	0.199999	0.2	0.2	0.2	0.2	0	0.2	0	0.2	0.2	0.199999	0.199999	0.5	0.199999			0.199999																				1023.999982	1024.000151	43.132794	0	0.199999	0.2	0.2	0.2	0.2	0	0.2	0	0.2	0.2	0.199999	0.199999	0.5	0.199999			0.199999																				25.0685	1.008647999	2.584807958	0	1.668880056	0.634108	0.3100856	5.1496476	5.1776598	0	4.1934572	0	0.0825086	1.3295152	7.376547317	16.32423958	0.05381	0.760150599	0	0	4.391462643	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.114	0	0	25.0685	1.008647999	2.584807958	0	1.668880056	0.634108	0.3100856	5.1496476	5.1776598	0	4.1934572	0	0.0825086	1.3295152	7.376547317	16.32423958	0.05381	0.760150599	0	0	4.391462643	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.114																																																																																		0	0	0	25.0685	1.008647999	2.584807958	0	1.668880056	0.634108	0.3100856	5.1496476	5.1776598	0	4.1934572	0	0.0825086	1.3295152	7.376547317	16.32423958	0.05381	0.760150599	0	0	4.391462643	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.114
H2486_802_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		293.770927	11.820092	719.120943	13.578014	8.344442	3.17054	1.550428	25.748238	25.888299	92.56262	20.967286	0	0.412543	6.647576	36.882921	81.621606	0.10762	3.800772			21.957423																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999982	1024.000151	43.132794	0	0.199999	0.2	0.2	0.2	0.2	0	0.2	0	0.2	0.2	0.199999	0.199999	0.5	0.199999			0.199999																				1023.999982	1024.000151	43.132794	0	0.199999	0.2	0.2	0.2	0.2	0	0.2	0	0.2	0.2	0.199999	0.199999	0.5	0.199999			0.199999																				25.0685	1.008647999	2.584807958	0	1.668880056	0.634108	0.3100856	5.1496476	5.1776598	0	4.1934572	0	0.0825086	1.3295152	7.376547317	16.32423958	0.05381	0.760150599	0	0	4.391462643	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.114	0	0	25.0685	1.008647999	2.584807958	0	1.668880056	0.634108	0.3100856	5.1496476	5.1776598	0	4.1934572	0	0.0825086	1.3295152	7.376547317	16.32423958	0.05381	0.760150599	0	0	4.391462643	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.114																																																																																		0	0	0	25.0685	1.008647999	2.584807958	0	1.668880056	0.634108	0.3100856	5.1496476	5.1776598	0	4.1934572	0	0.0825086	1.3295152	7.376547317	16.32423958	0.05381	0.760150599	0	0	4.391462643	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.114
H2486_803_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		293.770927	11.820092	719.120943	13.578014	8.344442	3.17054	1.550428	25.748238	25.888299	92.56262	20.967286	0	0.412543	6.647576	36.882921	81.621606	0.10762	3.800772			21.957423																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999982	1024.000151	43.132794	0	0.199999	0.2	0.2	0.2	0.2	0	0.2	0	0.2	0.2	0.199999	0.199999	0.5	0.199999			0.199999																				1023.999982	1024.000151	43.132794	0	0.199999	0.2	0.2	0.2	0.2	0	0.2	0	0.2	0.2	0.199999	0.199999	0.5	0.199999			0.199999																				25.0685	1.008647999	2.584807958	0	1.668880056	0.634108	0.3100856	5.1496476	5.1776598	0	4.1934572	0	0.0825086	1.3295152	7.376547317	16.32423958	0.05381	0.760150599	0	0	4.391462643	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.114	0	0	25.0685	1.008647999	2.584807958	0	1.668880056	0.634108	0.3100856	5.1496476	5.1776598	0	4.1934572	0	0.0825086	1.3295152	7.376547317	16.32423958	0.05381	0.760150599	0	0	4.391462643	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.114																																																																																		0	0	0	25.0685	1.008647999	2.584807958	0	1.668880056	0.634108	0.3100856	5.1496476	5.1776598	0	4.1934572	0	0.0825086	1.3295152	7.376547317	16.32423958	0.05381	0.760150599	0	0	4.391462643	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.114
H2486_804_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		293.770927	11.820092	719.120943	13.578014	8.344442	3.17054	1.550428	25.748238	25.888299	92.56262	20.967286	0	0.412543	6.647576	36.882921	81.621606	0.10762	3.800772			21.957423																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999982	1024.000151	43.132794	0	0.199999	0.2	0.2	0.2	0.2	0	0.2	0	0.2	0.2	0.199999	0.199999	0.5	0.199999			0.199999																				1023.999982	1024.000151	43.132794	0	0.199999	0.2	0.2	0.2	0.2	0	0.2	0	0.2	0.2	0.199999	0.199999	0.5	0.199999			0.199999																				25.0685	1.008647999	2.584807958	0	1.668880056	0.634108	0.3100856	5.1496476	5.1776598	0	4.1934572	0	0.0825086	1.3295152	7.376547317	16.32423958	0.05381	0.760150599	0	0	4.391462643	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.114	0	0	25.0685	1.008647999	2.584807958	0	1.668880056	0.634108	0.3100856	5.1496476	5.1776598	0	4.1934572	0	0.0825086	1.3295152	7.376547317	16.32423958	0.05381	0.760150599	0	0	4.391462643	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.114																																																																																		0	0	0	25.0685	1.008647999	2.584807958	0	1.668880056	0.634108	0.3100856	5.1496476	5.1776598	0	4.1934572	0	0.0825086	1.3295152	7.376547317	16.32423958	0.05381	0.760150599	0	0	4.391462643	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.114
H2491_001_0	2009	9																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	V	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	0	0	0											0		226.8743174	4.652903031	270.3566432	295.8499414	4.601675355	8.287081874	3.123206039	20.3688674	25.65967925	4245.25891	26.54538354	0.05571106	0.165948802	7.45917601	8841.56511	98.22099703	3.25916636	11.05996346	20.18520183	18.51354378	26.22453477	0.445559037	6000	1491.818182	368	118.2857143	65.6	13.34237288	3464	9242.424242											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS Cost Sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"Copay between $0.00 and $10.00, 20% coinsurance"	20% coinsurance	"$0.00 copayment, 20% coinsurance"	$0.00 copayment	"Copay between $0.00 and $195.00, $1,000 benefit limit"	$10.00 copayment	"$10.00 copayment, $150 benefit limit,"	$10.00 copayment	"$10.00 copayment, $1,000 benefit limit"	$0.00 copayment	$0.00 copayment											911.9176332	472.5837891	73.85248738	0	0.198624938	0.2	0.2	0.164728823	0.2	0	0.2	0.2	0.2	0.2	0	0.126240688	0.2	0.2	0.19999136	0.069747921	0.2	0.2	0	0	10	10	10	10	0	0											911.9176332	472.5837891	73.85248738	0	0.198624938	0.2	0.2	0.164728823	0.2	0	0.2	0.2	0.2	0.2	0	0.126240688	0.2	0.2	0.19999136	0.069747921	0.2	0.2	0	0	10	10	10	10	0	0											17.2409	0.183240545	1.663875882	0	0.914007483	1.657416375	0.624641208	3.355339563	5.131935851	0	5.309076708	0.011142212	0.03318976	1.491835202	0	12.39948628	0.651833272	2.211992691	4.036865969	1.29128118	5.244906954	0.089111807	0	0	0.306666667	0.098571429	0.054666667	0.011118644	0	0	0	0	0	0	0	0	0	0	0	0	64.0131	0	0	17.2409	0.183240545	1.663875882	0	0.914007483	1.657416375	0.624641208	3.355339563	5.131935851	0	5.309076708	0.011142212	0.03318976	1.491835202	0	12.39948628	0.651833272	2.211992691	4.036865969	1.29128118	5.244906954	0.089111807	0	0	0.306666667	0.098571429	0.054666667	0.011118644	0	0	0	0	0	0	0	0	0	0	0	0	64.0131	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.2409	0.183240545	1.663875882	0	0.914007483	1.657416375	0.624641208	3.355339563	5.131935851	0	5.309076708	0.011142212	0.03318976	1.491835202	0	12.39948628	0.651833272	2.211992691	4.036865969	1.29128118	5.244906954	0.089111807	0	0	0.306666667	0.098571429	0.054666667	0.011118644	0	0	0	0	0	0	0	0	0	0	0	0	64.0131
H2491_002_0	2009	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	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		1129.924955	16.34902002	225.0137087	230.0902577	212.2248727	8.221713499	2.723959106	2020.141213	289.5448441	3519.184373	1513.904293	1.755994216	0.137567234	541.443442	7418.622567	22174.60672	348.1123751	2076.809817	3302.6416	2655.738435	21.65425076	36.8956948	0	443.3333333	368	118.2857143	65.6	13.34237288	1664	7480											"$75 days 1 - 5, $0 after day 5, unlimited coverage"	"$75 days 1 - 5, $0 after day 5, unlimited coverage"	Medicare FFS Cost Sharing	Copay between $0.00 and $10.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $10.00	Copay between $5.00 and $10.00	$10.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$10.00 copayment	"$10.00 copayment, $150 benefit limit,"	$10.00 copayment	"$10.00 copayment, $1,000 benefit limit"	$0.00 copayment	Copay between $0.00 and $10.00											38.37021714	56.45863681	35.63	3.145387629	47.19767763	0.2	0.2	21.83928602	34.27736982	0	9.020278519	19.68691878	0.2	3.298329122	0	2.316035504	7.917060439	4.324597324	12.18504888	7.498268485	0.2	0	0	0	10	10	10	10	0	0											37.49221053	55.16672189	34.81469642	3.073413287	46.11767663	0.195423499	0.195423499	21.33954849	33.4930178	0	8.813871969	19.23643281	0.195423499	3.222855096	0	2.263038815	7.73589828	4.225639713	11.90622446	7.326689335	0.195423499	0	0	0	10	10	10	10	0	0											3.5303	0.075160153	0.65281533	0.058930205	0.815609838	1.606716023	0.532325621	3.592408448	0.808144218	0	1.111946551	0.002814922	0.02688387	0.145416146	0	4.181832977	0.224413494	0.731320836	3.276832684	1.621480873	4.231749462	0	0	0	0.306666667	0.098571429	0.054666667	0.011118644	0	0	0	0	0	0	0	0	0	0	0	0	27.6981	0	0.6376	3.5303	0.075160153	0.65281533	0.058930205	0.815609838	1.606716023	0.532325621	3.592408448	0.808144218	0	1.111946551	0.002814922	0.02688387	0.145416146	0	4.181832977	0.224413494	0.731320836	3.276832684	1.621480873	4.231749462	0	0	0	0.306666667	0.098571429	0.054666667	0.011118644	0	0	0	0	0	0	0	0	0	0	0	0	27.6981	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.5303	0.075160153	0.65281533	0.058930205	0.815609838	1.606716023	0.532325621	3.592408448	0.808144218	0	1.111946551	0.002814922	0.02688387	0.145416146	0	4.181832977	0.224413494	0.731320836	3.276832684	1.621480873	4.231749462	0	0	0	0.306666667	0.098571429	0.054666667	0.011118644	0	0	0	0	0	0	0	0	0	0	0	0	27.6981
H2542_001_0	2009	7	r.	s.	t.	u.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered							3700											D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			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		1357.997473	60.465273	473.960592	677.397066	134.734909	8.554736	3.089398	304.760254	330.350279	584.051355	866.857873	0	18.052849	663.139038	3245.596192	3912.279371	26.687984	843.248799			19.335155			4.77	2.69				1.32	0.09	0.06	0.05	1.23	2.7							$175/Day(Days 1-5):1a	$175/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $50 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$50/Visit:9a	"$0-$100/Proc:12. $0 Dialysis -- Dialysis Center,12. $100 Dialysis -- OP Hosp"	"$30-$100/Visit:9d. $50 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $30 Partial Hospitalization,8b. $100 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			"Dental 749 16a, 16b"	VIS752				$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0: Health Education Materials 14a	$0 Corp Health 14a							107.292853	89.438048	43.132801	0	100.000008	0.199999	0.199999	49.999984	127.313154	87.957402	83.490143	0	1.564739	71.76618	9.999998	30.000001	89.074244	39.70865			0.2			0	0				0	0	0	0	0	0							92.387408	77.013046	37.140663	0	86.107707	0.172215	0.172215	43.053836	109.626428	75.738096	71.891442	0	1.34736	61.796207	8.610768	25.832311	76.699782	34.192205			0.172215			0	0				0	0	0	0	0	0							10.4552	0.388051238	1.466934219	0	0.966809506	1.47325386	0.532040677	1.093424833	3.017926756	3.686244799	5.193305208	0	0.002026974	3.414956439	2.328922986	8.421934786	0.170580213	2.402711317	0	0	3.329803718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.3441	0	7.7997	10.4552	0.388051238	1.466934219	0	0.966809506	1.47325386	0.532040677	1.093424833	3.017926756	3.686244799	5.193305208	0	0.002026974	3.414956439	2.328922986	8.421934786	0.170580213	2.402711317	0	0	3.329803718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.3441		$975/Admit	$975/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$100/Proc	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins			"Dental 749 16a, 16b"	VIS752				0	0	0	0	0	0							1.8965	0.0611	0.3352	0.5086	0.6445	1.8681	0.6746	0.193	2.4212	0.3119	1.2974		0.0004	0.7328	1.4693	3.3546	0.0212	0.2833			1.0013			0	0				0	0	0	0	0	0							17.0749	0	0	12.3516	0.449156238	1.802174219	0.508593	1.611348506	3.34130486	1.206655677	1.286381833	5.439115756	3.998149799	6.490685208	0	0.002383974	4.147763439	3.798218986	11.77651079	0.191781213	2.685963317	0	0	4.331115718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.4189
H2542_002_0	2009	6	r.	s.	t.	u.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered							3700											D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			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		1365.433081	60.796347	476.555726	681.106101	135.47264	8.648679	3.123323	306.428945	332.159087	587.249282	871.604288	0	18.151698	666.770002	3263.3672	3933.70075	26.834112	847.865943			19.547482			6.57	2.69				1.32	0.09	0.06	0.05	1.23	2.7							$175/Day(Days 1-5):1a	$175/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $50 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$50/Visit:9a	"$0-$100/Proc:12. $0 Dialysis -- Dialysis Center,12. $100 Dialysis -- OP Hosp"	"$30-$100/Visit:9d. $50 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $30 Partial Hospitalization,8b. $100 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			"Dental 750 16a, 16b"	VIS752				$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0: Health Education Materials 14a	$0 Corp Health 14a							107.29285	89.437939	43.132802	0	100.000029	0.2	0.199999	49.999989	127.313175	87.9574	83.490139	0	1.564812	71.76618	10.000001	30	89.074384	39.708645			0.2			0	0				0	0	0	0	0	0							92.283117	76.926018	37.098739	0	86.010525	0.172021	0.17202	43.00524	109.502698	75.652599	71.810286	0	1.345902	61.72645	8.601051	25.80315	76.613323	34.153604			0.172021			0	0				0	0	0	0	0	0							10.5005	0.389735074	1.473301375	0	0.971006074	1.48775441	0.537274022	1.09817086	3.031026349	3.702244537	5.2158461	0	0.002035867	3.429778766	2.33903231	8.458489209	0.171320874	2.413139805	0	0	3.362577401	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.5833	0	7.902	10.5005	0.389735074	1.473301375	0	0.971006074	1.48775441	0.537274022	1.09817086	3.031026349	3.702244537	5.2158461	0	0.002035867	3.429778766	2.33903231	8.458489209	0.171320874	2.413139805	0	0	3.362577401	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.5833		$975/Admit	$975/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$100/Proc	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins			"Dental 750 16a, 16b"	VIS752				0	0	0	0	0	0							1.9047	0.0614	0.3385	0.5136	0.6473	1.8864	0.6813	0.1938	2.445	0.315	1.3101		0.0004	0.74	1.4838	3.3876	0.0214	0.286			1.0112			0	0				0	0	0	0	0	0							17.2275	0	0	12.4053	0.451104074	1.811839375	0.513599	1.618343074	3.37418841	1.218528022	1.29196586	5.476040349	4.017219537	6.5259911	0	0.002395867	4.169797766	3.82278631	11.84607421	0.192729874	2.699179805	0	0	4.373741401	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8108
H2542_801_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		245.300042	7.903525	476.555726	681.106101	4.382179	8.648679	3.123323	19.228569	49.42725	587.249282	26.726185	0	0.337248	15.22582	28.683414	65.487594	0.413862	5.529621			19.547482																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999987	1023.999797	43.132802	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.200001	0.2	0.2	0.2	0.5	0.199999			0.2																				1023.999987	1023.999797	43.132802	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.200001	0.2	0.2	0.2	0.5	0.199999			0.2																				20.9323	0.674434	1.712931981	0	0.8764358	1.7297358	0.624661477	3.8457138	9.88545	0	5.345237	0	0.067449937	3.045164	5.7366828	13.0975188	0.206931	1.10591867	0	0	3.9094964	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.796	0	0	20.9323	0.674434	1.712931981	0	0.8764358	1.7297358	0.624661477	3.8457138	9.88545	0	5.345237	0	0.067449937	3.045164	5.7366828	13.0975188	0.206931	1.10591867	0	0	3.9094964	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.796		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3258	0.0749	0.1903		0.5556	1.0966	0.396	0.7244	1.8951		1.0155		0.0127	0.5736	1.1501	2.6257	0.0415	0.2217			0.7838																				13.6834	0	0	23.2581	0.749371	1.903257981	0	1.4320848	2.8263658	1.020691477	4.5700928	11.780579	0	6.36073	0	0.080154937	3.618751	6.8867398	15.7232328	0.248416	1.32762767	0	0	4.6932494	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4794
H2542_802_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		245.300042	7.903525	476.555726	681.106101	4.382179	8.648679	3.123323	19.228569	49.42725	587.249282	26.726185	0	0.337248	15.22582	28.683414	65.487594	0.413862	5.529621			19.547482																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999987	1023.999797	43.132802	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.200001	0.2	0.2	0.2	0.5	0.199999			0.2																				1023.999987	1023.999797	43.132802	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.200001	0.2	0.2	0.2	0.5	0.199999			0.2																				20.9323	0.674434	1.712931981	0	0.8764358	1.7297358	0.624661477	3.8457138	9.88545	0	5.345237	0	0.067449937	3.045164	5.7366828	13.0975188	0.206931	1.10591867	0	0	3.9094964	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.796	0	0	20.9323	0.674434	1.712931981	0	0.8764358	1.7297358	0.624661477	3.8457138	9.88545	0	5.345237	0	0.067449937	3.045164	5.7366828	13.0975188	0.206931	1.10591867	0	0	3.9094964	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.796		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3258	0.0749	0.1903		0.5556	1.0966	0.396	0.7244	1.8951		1.0155		0.0127	0.5736	1.1501	2.6257	0.0415	0.2217			0.7838																				13.6834	0	0	23.2581	0.749371	1.903257981	0	1.4320848	2.8263658	1.020691477	4.5700928	11.780579	0	6.36073	0	0.080154937	3.618751	6.8867398	15.7232328	0.248416	1.32762767	0	0	4.6932494	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4794
H2542_803_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		245.300042	7.903525	476.555726	681.106101	4.382179	8.648679	3.123323	19.228569	49.42725	587.249282	26.726185	0	0.337248	15.22582	28.683414	65.487594	0.413862	5.529621			19.547482																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999987	1023.999797	43.132802	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.200001	0.2	0.2	0.2	0.5	0.199999			0.2																				1023.999987	1023.999797	43.132802	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.200001	0.2	0.2	0.2	0.5	0.199999			0.2																				20.9323	0.674434	1.712931981	0	0.8764358	1.7297358	0.624661477	3.8457138	9.88545	0	5.345237	0	0.067449937	3.045164	5.7366828	13.0975188	0.206931	1.10591867	0	0	3.9094964	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.796	0	0	20.9323	0.674434	1.712931981	0	0.8764358	1.7297358	0.624661477	3.8457138	9.88545	0	5.345237	0	0.067449937	3.045164	5.7366828	13.0975188	0.206931	1.10591867	0	0	3.9094964	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.796		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3258	0.0749	0.1903		0.5556	1.0966	0.396	0.7244	1.8951		1.0155		0.0127	0.5736	1.1501	2.6257	0.0415	0.2217			0.7838																				13.6834	0	0	23.2581	0.749371	1.903257981	0	1.4320848	2.8263658	1.020691477	4.5700928	11.780579	0	6.36073	0	0.080154937	3.618751	6.8867398	15.7232328	0.248416	1.32762767	0	0	4.6932494	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4794
H2542_804_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		245.300042	7.903525	476.555726	681.106101	4.382179	8.648679	3.123323	19.228569	49.42725	587.249282	26.726185	0	0.337248	15.22582	28.683414	65.487594	0.413862	5.529621			19.547482																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999987	1023.999797	43.132802	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.200001	0.2	0.2	0.2	0.5	0.199999			0.2																				1023.999987	1023.999797	43.132802	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.200001	0.2	0.2	0.2	0.5	0.199999			0.2																				20.9323	0.674434	1.712931981	0	0.8764358	1.7297358	0.624661477	3.8457138	9.88545	0	5.345237	0	0.067449937	3.045164	5.7366828	13.0975188	0.206931	1.10591867	0	0	3.9094964	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.796	0	0	20.9323	0.674434	1.712931981	0	0.8764358	1.7297358	0.624661477	3.8457138	9.88545	0	5.345237	0	0.067449937	3.045164	5.7366828	13.0975188	0.206931	1.10591867	0	0	3.9094964	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.796		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3258	0.0749	0.1903		0.5556	1.0966	0.396	0.7244	1.8951		1.0155		0.0127	0.5736	1.1501	2.6257	0.0415	0.2217			0.7838																				13.6834	0	0	23.2581	0.749371	1.903257981	0	1.4320848	2.8263658	1.020691477	4.5700928	11.780579	0	6.36073	0	0.080154937	3.618751	6.8867398	15.7232328	0.248416	1.32762767	0	0	4.6932494	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4794
H2610_005_0	2009	8																					800											D	D	D	V	T	Coin	Coin	V	V	Coin	V	V	Coin	Coin	V	V	V	V	Coin	V	Coin	Coin	T	V	V	V	V	V	Coin	Coin																																																			0	0	1240.976633	4.693475931	1528.158857	1096.465724	185.0800889	6.50724435	2.643093111	719.7436194	323.6442452	23.46194067	854.5466046	39.87183347	0	33.61054958	6541.870463	10256.6563	233.2948541	676.4896198	0	153.037758	17.8110911	0	216.3121958	343.4389331	0	3.967394978	0	0	0.100785942	0											1a: $100 Days 1-7	1b: $275	2: $75 Days 4-13	6: none	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4b: $25	9b: $75	8a: 20%; 8a: $40; 8a: 20%; 8a: $40; 8a: 20%	8b: $15	5: $100	12: 20%	9a: 20%; 9a: $40; 9a: 20%; 9d: $20	14c: $5; 7a: $5	7d: $20	7e: $35; 7h: $35	7c: $20; 7i: $20		7b: $20; 7f: $20	15: 20%		10b: none	16a: $20	17a: $20	17b: $20	18a. $20	18b. $0	14a: none												52.99881883	275	17.39703522	0	149.7859792	0.19999848	0.116734	14.85659474	53.48163686	0.09559572	5.7947058	32.26212909	0	0.157406902	3.229970674	5.765723966	35	18.20703555	0	19.78430834	0.196220735	0	0	19.58333333	0	18.24391581	0	0	0	0											45.88399706	275	6.171435309	0	88.56788174	0.130051904	0.097135495	13.4675528	50.99837711	0.086305878	5.197254807	19.91372001	0	0.065677041	3.222673383	5.75215943	35	15.30313065	0	19.78430834	0.071820734	0	0	19.58333333	0	18.24391581	0	0	0	0											4.7451	0.107558823	0.785911127	0	1.366012619	0.846279514	0.256738158	0.807765433	1.375444272	2.024903397	0.370108037	0.066166377	0	2.207441441	1.756859318	4.916493523	0.680443325	0.862700753	0	0.252312183	1.27920564	0	0	0.560473259	0	0.006031735	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2739	0	9.5464	4.7451	0.107558823	0.785911127	0	1.366012619	0.846279514	0.256738158	0.807765433	1.375444272	2.024903397	0.370108037	0.066166377	0	2.207441441	1.756859318	4.916493523	0.680443325	0.862700753	0	0.252312183	1.27920564	0	0	0.560473259	0	0.006031735	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2739	0																																																																																	0		0	4.7451	0.107558823	0.785911127	0	1.366012619	0.846279514	0.256738158	0.807765433	1.375444272	2.024903397	0.370108037	0.066166377	0	2.207441441	1.756859318	4.916493523	0.680443325	0.862700753	0	0.252312183	1.27920564	0	0	0.560473259	0	0.006031735	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2739
H2610_006_0	2009	8																					475											D	D	D	V	T	Coin	Coin	V	V	Coin	V	V	Coin	Coin	V	V	V	V	Coin	V	Coin	Coin	T	V	V	V	V	V	Coin	Coin																																																			0	0	2069.183244	2.414023087	2342.710424	2121.329968	272.0158851	14.692295	3.868621279	1023.9733	461.5794881	36.51556599	1288.23162	65.23586555	0	53.65959839	9035.438248	16108.25343	882.9967657	1052.060645	0	266.2410633	34.38930213	0	231.5096599	448.7711062	1.593978313	1.304938786	0	0	0.155506961	0											1a: $75 Days 1-6	1b: $275	2: $50 Days 4-9	6: none	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4b: $20	9b: $50	8a: 20%; 8a: $40; 8a: 20%; 8a: $40; 8a: 20%	8b: $15	5: $75	12: 20%	9a: 20%; 9a: $40; 9a: 20%; 9d: $15	14c: $5; 7a: $5	7d: $15; 7d: $20; 7d: $15	7e: $35; 7h: $35	7c: $15; 7i: $15		7b: $15; 7f: $15	15: 20%		10b: none	16a: $20	17a: $20	17b: $20	18a. $20	18b. $0	14a: none												32.62017912	275	5.768914484	0	149.9401977	0.202352982	0.157730041	14.99550572	36.08597099	0.105713389	5.609993327	19.64581613	0	0.151952362	3.263901312	4.446500015	35	13.53889527	0	14.67028039	0.194976746	0	0	19.13353066	0	17.57776088	0	0	0	0											22.572033	275	1.08218065	0	56.46918635	0.097510057	0.09392746	11.81819702	29.68124281	0.075965195	4.302083598	9.291622872	0	0.053188903	3.239892046	4.408290513	35	8.132091343	0	14.67028039	0.059645535	0	0	19.13353066	0	17.57776088	0	0	0	0											3.8921	0.055321362	0.211269657	0	1.280042975	1.432646522	0.363369769	1.00845985	1.141687739	2.773912104	0.46184001	0.050512255	0	2.854095189	2.439487043	5.917488397	2.575407233	0.712954439	0	0.325485921	2.05116832	0	0	0.715547976	0	0.001911492	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.2647	0	18.6376	3.8921	0.055321362	0.211269657	0	1.280042975	1.432646522	0.363369769	1.00845985	1.141687739	2.773912104	0.46184001	0.050512255	0	2.854095189	2.439487043	5.917488397	2.575407233	0.712954439	0	0.325485921	2.05116832	0	0	0.715547976	0	0.001911492	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.2647	0																																																																																	0		0	3.8921	0.055321362	0.211269657	0	1.280042975	1.432646522	0.363369769	1.00845985	1.141687739	2.773912104	0.46184001	0.050512255	0	2.854095189	2.439487043	5.917488397	2.575407233	0.712954439	0	0.325485921	2.05116832	0	0	0.715547976	0	0.001911492	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.2647
H2610_010_0	2009	8																					900											D	D	D	V	T	Coin	Coin	V	V	Coin	V	V	Coin	Coin	V	V	V	V	Coin	V	Coin	Coin	T	V	V	V	V	V	Coin	Coin																																																			0	0	1713.532777	6.481446053	2080.984492	1555.51767	250.3745302	9.519696476	31.51866474	949.8520773	435.8270282	31.99315324	1315.482355	35.46480029	0	171.7128142	8767.709982	13875.65273	392.1193168	909.4123216	0	200.38018	63.0135687	0	280.3832277	456.6688365	0	3.828929316	0	0	0.137241978	0											1a: $100 Days 1-8	1b: $275	2: $75 Days 4-14	6: none	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4b: $25	9b: $75	8a: 20%; 8a: $40; 8a: 20%; 8a: $40; 8a: 20%	8b: $15	5: $100	12: 20%	9a: 20%; 9a: $40; 9a: 20%; 9d: $20	7a: none	7d: $20	7e: $35; 7h: $35	7c: $20; 7i: $20		7b: $20; 7f: $20	15: 20%		10b: none	16a: $20	17a: $20	17b: $20	18a. $20	18b. $0	14a: none												49.99729121	275	14.46324366	0	149.7942373	0.200260338	0.013841002	13.97934436	53.3737653	0.104986731	6.710620277	44.77025741	0	0.0422959	0	5.54732828	35	18.41135233	0	19.79318349	0.078375825	0	0	19.61904762	0	17.80059035	0	0	0	0											40.14683038	275	4.459231295	0	83.46733812	0.122053353	0.010463555	12.56465914	50.15650487	0.091648404	6.022230629	29.06691772	0	0.016598624	0	5.535421669	35	14.80161354	0	19.79318349	0.025025136	0	0	19.61904762	0	17.80059035	0	0	0	0											5.7327	0.148533139	0.773299264	0	1.741507964	1.161910875	0.329797297	0.994547299	1.821630039	2.932121442	0.660178177	0.085904369	0	2.850196509	0	6.400632399	1.143681341	1.121730811	0	0.330513473	1.576923153	0	0	0.746617304	0	0.005679767	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.5581	0	14.2154	5.7327	0.148533139	0.773299264	0	1.741507964	1.161910875	0.329797297	0.994547299	1.821630039	2.932121442	0.660178177	0.085904369	0	2.850196509	0	6.400632399	1.143681341	1.121730811	0	0.330513473	1.576923153	0	0	0.746617304	0	0.005679767	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.5581	0																																																																																	0		0	5.7327	0.148533139	0.773299264	0	1.741507964	1.161910875	0.329797297	0.994547299	1.821630039	2.932121442	0.660178177	0.085904369	0	2.850196509	0	6.400632399	1.143681341	1.121730811	0	0.330513473	1.576923153	0	0	0.746617304	0	0.005679767	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.5581
H2610_803_0	2009	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																																																			0	0	203.3910941	0.476524771	47.64835606	6.703543287	6.430700292	7.069766697	2.520539877	9.451513008	28.36216305	23.75959464	2.281846297	2.530914609	0	34.18685381	169.5978622	88.71163278	3.650738686	4.056327777	0	1.041543671	19.49486861																				Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing											0.0799	0.0799	0.1906	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.0799	0.0799	0.1906	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				16.2509	0.038074329	9.081776665	0	1.485491768	1.633116107	0.582244712	2.183299505	6.551659664	5.488466361	0.527106495	0.584641275	0	7.897163231	39.17710617	20.49238717	0.843320636	0.937011716	0	0.240596588	4.503314649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.4977	0	0	16.2509	0.038074329	9.081776665	0	1.485491768	1.633116107	0.582244712	2.183299505	6.551659664	5.488466361	0.527106495	0.584641275	0	7.897163231	39.17710617	20.49238717	0.843320636	0.937011716	0	0.240596588	4.503314649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.4977	0																																																																																	0		0	16.2509	0.038074329	9.081776665	0	1.485491768	1.633116107	0.582244712	2.183299505	6.551659664	5.488466361	0.527106495	0.584641275	0	7.897163231	39.17710617	20.49238717	0.843320636	0.937011716	0	0.240596588	4.503314649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.4977
H2610_804_0	2009	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																																																			0	0	203.3910941	0.476524771	47.64835606	6.703543287	6.430700292	7.069766697	2.520539877	9.451513008	28.36216305	23.75959464	2.281846297	2.530914609	0	34.18685381	169.5978622	88.71163278	3.650738686	4.056327777	0	1.041543671	19.49486861																				Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing											0.0799	0.0799	0.1906	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.0799	0.0799	0.1906	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				16.2509	0.038074329	9.081776665	0	1.485491768	1.633116107	0.582244712	2.183299505	6.551659664	5.488466361	0.527106495	0.584641275	0	7.897163231	39.17710617	20.49238717	0.843320636	0.937011716	0	0.240596588	4.503314649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.4977	0	0	16.2509	0.038074329	9.081776665	0	1.485491768	1.633116107	0.582244712	2.183299505	6.551659664	5.488466361	0.527106495	0.584641275	0	7.897163231	39.17710617	20.49238717	0.843320636	0.937011716	0	0.240596588	4.503314649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.4977	0																																																																																	0		0	16.2509	0.038074329	9.081776665	0	1.485491768	1.633116107	0.582244712	2.183299505	6.551659664	5.488466361	0.527106495	0.584641275	0	7.897163231	39.17710617	20.49238717	0.843320636	0.937011716	0	0.240596588	4.503314649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.4977
H2611_001_0	2009	9																																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											34.3288	0.2618	3.3899	1.4708	0.7495	0.8764	0.8681	0.7922	5.8947	1.4886	2.9214	0.6311	1.3265	1.9256	9.2762	4.3489	0.323	0.4921	2.708	8.4882	6.2377	1.653			0.0879		0.169		0.0062	0.198											90.9136							5.734062168	5.676007845	387.0567555			19.11463157		158.4450479	13.4947498	5592.332956	1663.913778	237.4916229	768.3482269		0.074100432	40.81307283	4.901264809																			Full Coverage	Full Coverage	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$50 Copay for ER and $25 for Urgent Care	Full Coverage	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	$15 Copay	$30 Copay	$30 Copay	$30 Copay	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	$200 Limit	N/A																0.2	0.2	48.74221053			0.2		131.4704884	133.4436179	15	24.61390054	30	29.12498066		0.117092857	0.2	0.45093843																										48.74221053							13.84489745	15.69669726		29.12498066		0.117092857	0.2	0.45093843																			0	0	0	0	0	0	0	1.572166822	0	0	0	0	0	0	6.452106357	2.176495904	0	1.864843937	0	0.008676631	8.162614567	2.21016866	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.4471	900	10.3594	34.3288	0.261759315	3.38990494	1.470770955	0.749461853	0.876373711	0.86809971	2.364388895	5.894669038	1.488623974	2.921412449	0.631108733	1.326547021	1.925610143	15.72830072	6.525417244	0.323039444	2.356993194	2.707983202	8.496887032	14.40033977	3.863178799	0	0	0.087901975	0	0.168994307	0	0.006170997	0.197994187	0	0	0	0	0	0	0	0	0	0	113.3607	3350	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										1.5444	0.0118	0.1525	0.0662	0.0337	0.0394	0.0391		0.2652	0.067	0.1314	0.0284	0.0597	0.0866	0.4173	0.1957	0.0145	0.0221	0.1218	0.3819	0.2806	0.0744			0.004				0.0003												4.038	0	0.39980321	35.8732	0.273535754	3.542415307	1.536940309	0.78317982	0.915801388	0.907155143	2.364388895	6.159867666	1.555596527	3.052845541	0.659502044	1.386227802	2.012242516	16.14563272	6.721073347	0.33757285	2.379134778	2.829814203	8.878767972	14.68097235	3.937547015	0	0	0.091856647	0	0.168994307	0	0.006448628	0.197994187	0	0	0	0	0	0	0	0	0	0	117.3987
H2611_002_0	2009	7																																A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	P	P	P	P	P																																																			0			40.36658017				15.18210329	15.13631014	689.0419416			877.8928894	63.20664377	199.1606661	3.133695774		1225.032997	263.3022171				2650.027517	869.197081																			$0 copay	$100 for days 1-10; $0 for days 11-90	$0 copay	$0 copay	$0 copay	20% coins	20% coins	$40 copay	$0 copay	$0 copay	$0 copay	20% coins	20% coins	$0 copay; Urgent Care $0 copay	$0 copay	$5 copay	$5 copay for individual sessions; $0 copay for group sessions	$0 copay	20% coins	$5 copay for chiro; $5 copay for podiatry	20% coins	20% coins	N/A	$5 copay	$0 copay	$150 max benefit (every 2 years)	$0 copay	N/A	$0 copay (fitness benefit limited to $200 per year)	N/A												67.3				0.2	0.2	40			87.77959995	45.3227001	75.87078802	236.8687507		5	4.5				26.23089949	5																				67.3				0.2	0.2	40			87.77959995	45.3227001	75.87078802	236.8687507		5	4.5				26.23089949	5																			0	0.226389237	0	0	0	3.036420659	3.027262028	2.296806472	0	0	6.421757219	0.238724647	1.25920639	0.061856217	0	0.510430415	0.098738331	0	0	0	5.79271712	0.36216545	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.3325	0	0	0	0.226389237	0	0	0	3.036420659	3.027262028	2.296806472	0	0	6.421757219	0.238724647	1.25920639	0.061856217	0	0.510430415	0.098738331	0	0	0	5.79271712	0.36216545	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.3325	4800	$25/day (days 1-10)	$100/day (days 1-10)	$0 for days 1-20; $25 for days 21-30; $0 for days 31-100	$0 copay	$0 copay	20% coins	20% coins	$40 copay	$0 copay	$0 copay	20% coins	20% coins	20% coins	$0 copay; Urgent Care	$5 copay	$15 copay	$15 copay	$15 copay	20% coins	$15 copay for chiro; $15 copay for podiatry	20% coins	20% coins	N/A	$15 copay	$15 copay	$150 max benefit every 2 years (combined with IN allowance)	$15 copay	N/A	20% coins	N/A	N/A										0.0715	0.0068	0.0041			0.0995	0.0992				0.1873	0.0078	0.0413	0.0659	0.1003	0.0459	0.0099	0.0139		0.0001	0.1899	0.1427			0.0197				0.0075	0.0053											1.1186	0	0	0.0715	0.233180914	0.00406604	0	0	3.135939346	3.126480541	2.296806472	0	0	6.609056182	0.246548847	1.30047688	0.127756857	0.100310723	0.556369153	0.108612165	0.013908571	0	6.16E-05	5.982573424	0.504870917	0	0	0.01974686	0	0	0	0.007494274	0.005315648	0	0	0	0	0	0	0	0	0	0	24.4511
H2611_003_0	2009	8																																A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	P	P	P	P	P																																																			0			161.9635721				11.90084933	10.20388225	276.2084698			932.9932901		6.2390662	232.7486047		3313.934292	473.9553278	239.8737089			809.1479723	739.0856534								20.02560264											$0 copay	$100 copay (days 1-10); $0 copay (days 11-90)	$0 copay	$0 copay	$0 copay	20% coins	20% coins	$50 copay	$0 copay	$0 copay	0% coins	$0 copay	20% coins	$0 copay; Urgent Care $0 copay	$0 copay	$5 copay	$5 copay for individual session; $0 copay for group session	$0 copay	20% coins	$5 copay for chiro; $5 copay for podiatry	20% coins	20% coins	N/A	$5 copay	$0 copay (limit 1/year)	"$150 limit every 2 years (1 contact pair, 1 eyeglasses pair every 2 years)"	$0 copay (limit 1/year)	N/A	Fitness benefit limited to $200/year	N/A												67.3				0.2	0.2	50			38.17442361		92.92563264	15.49991815		5	4.5	15			52.51972758	5								5												67.3				0.2	0.2	50			38.17442361		92.92563264	15.49991815		5	4.5	15			52.51972758	5								5											0	0.9083457	0	0	0	2.380169866	2.040776449	1.150868624	0	0	2.968040091	0	0.048314098	0.300632027	0	1.380805955	0.177733248	0.299842136	0	0	3.54135259	0.307952356	0	0	0	0	0	0	0	0.008344001	0	0	0	0	0	0	0	0	0	0	15.5132	0	0	0	0.9083457	0	0	0	2.380169866	2.040776449	1.150868624	0	0	2.968040091	0	0.048314098	0.300632027	0	1.380805955	0.177733248	0.299842136	0	0	3.54135259	0.307952356	0	0	0	0	0	0	0	0.008344001	0	0	0	0	0	0	0	0	0	0	15.5132	4800	$25/day (days 1-10)	$100/day (days 1-10)	$0 copay for days 1-20; $25 copay for days 21-30; $0 copay for days 31-100)	$0 copay	$0 copay	20% coins	20% coins	$50 copay	$0 copay	$0 copay	20% coins	$0 copay	20% coins	$0 copay; Urgent Care 20% coins	$5 copay	$15 copay	$15 copay	$5 copay	20% coins	$15 copay for chiro; $15 copay for podiatry	20% coins	20% coins	N/A	$15 copay	$15 copay	$150 max benefit every 2 years (combined with IN allowance)	$15 copay	N/A	20% coins	N/A	N/A										0.0737	0.0321	0.0171			0.0918	0.0787				0.1019		0.0019	0.0107	0.0363	0.1473	0.0209	0.0101		0.0004	0.1365	0.0326			0.0056		0.0053		0.0111	0.0032											0.8171	0	0	0.0737	0.940400887	0.017092942	0	0	2.471934756	2.119456391	1.150868624	0	0	3.069964565	0	0.050176796	0.311320587	0.036269603	1.528155061	0.198640385	0.309907737	0	0.00036801	3.677885632	0.340533385	0	0	0.00561546	0	0.005344125	0	0.0111	0.01150103	0	0	0	0	0	0	0	0	0	0	16.3302
H2611_005_0	2009	5																																A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	P	P	P	P	P																																																			0			37.03275462				14.04802075	14.00564828	632.1348265			805.3888099	57.98648584	182.7122349	2.874887746		1123.859048	241.5564152				2431.165048	797.4111774																			$0 copay	$100/day days 1-10; $0 /day days 11-90	$0 copay	$0 copay	$0 copay	20% coins	20% coins	$50 copay	$0 copay	$0 copay	20% coins	20% coins	20% coins	$0 copay; Urgent Care $0 copay	$0 copay	$5 copay	$5 copay for individual sessions; $0 copay for group sessions	$0 copay	20% coins	$5 copay for chiro; $5 copay for podiatry	20% coins	20% coins	N/A	$5 copay	$0 copay (limit 1/yr)	"$150 limit every 2 years (1 contact pair, 1 eyeglasses pair every 2 years)"	$0 copay (limit 1/yr)	N/A	Fitness benefit limited to $200/year	N/A												67.3				0.2	0.2	50			88.5345401	45.7124937	76.52330756	238.905918		5	4.5				26.45649586	5																				67.3				0.2	0.2	50			88.5345401	45.7124937	76.52330756	238.905918		5	4.5				26.45649586	5																			0	0.207692032	0	0	0	2.80960415	2.801129657	2.63389511	0	0	5.942060657	0.220892239	1.165145379	0.057235641	0	0.468274603	0.090583656	0	0	0	5.360009002	0.332254657	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.0888	0	0	0	0.207692032	0	0	0	2.80960415	2.801129657	2.63389511	0	0	5.942060657	0.220892239	1.165145379	0.057235641	0	0.468274603	0.090583656	0	0	0	5.360009002	0.332254657	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.0888	4800	$25/day days 1-10	$100/day days 1-10	$0 copay for days 1-20; $25 copay for days 21-30; $0 copay for days 31-100)	$0 copay	$0 copay	20% coins	20% coins	$50 copay	$0 copay	$0 copay	20% coins	20% coins	20% coins	$0 copay; Urgent Care	$5 copay	$15 copay	$15 copay	$5 copay	20% coins	$15 copay for chiro; $15 copay for podiatry	20% coins	20% coins	N/A	$15 copay	$15 copay	$150 max benefit every 2 years (combined with IN allowance)	N/A	N/A	20% coins	N/A	N/A										0.0648	0.0062	0.0037			0.0921	0.0918				0.1733	0.0072	0.0382	0.0605	0.092	0.0421	0.0091	0.0128		0.0001	0.1757	0.1318			0.0181				0.0069	0.0049											1.0314	0	0	0.0648	0.213922793	0.003730231	0	0	2.901688926	2.892936681	2.63389511	0	0	6.115368642	0.228131982	1.203333019	0.117709626	0.092026185	0.510419318	0.099642021	0.012759879	0	5.65E-05	5.535683297	0.464055909	0	0	0.018115991	0	0	0	0.006934462	0.004876636	0	0	0	0	0	0	0	0	0	0	23.1201
H2611_006_0	2009	5																																A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	P	P	P	P	P																																																			0			150.5228522				11.04300265	9.468357726	256.6977632			867.0888726		5.798353465	214.4315763		3079.845888	440.4762555	206.6316984			751.9916922	686.9035163								18.6110419											$0 copay	$100/day days 1-10; $0/day days 11-90	$0 copay	$0 copay	$0 copay	20% coins	20% coins	$50 copay	$0 copay	$0 copay	$0 copay	$0 copay	20% coins	$0 copay; Urgent Care $0 copay	$0 copay	$5 copay	$5 for individual session; $0 for group session	$0 copay	20% coins	$5 copay for chiro; $5 copay for podiatry	20% coins	20% coins	N/A	$5 copay	$0 copay (limit 1/yr)	"$150 limit every 2 years (1 contact pair, 1 eyeglasses pair every 2 years)"	$0 copay (limit 1/yr)	N/A	Fitness benefit limited to $200/year	N/A												67.3				0.2	0.2	50			38.11506068		92.78112913	15.58908797		5	4.5	5			52.43805706	5								5												67.3				0.2	0.2	50			38.11506068		92.78112913	15.58908797		5	4.5	5			52.43805706	5								5											0	0.844182329	0	0	0	2.20860053	1.893671545	1.069574013	0	0	2.754095416	0	0.044831482	0.278566059	0	1.28326912	0.165178596	0.086096541	0	0	3.286081938	0.286209798	0	0	0	0	0	0	0	0.007754601	0	0	0	0	0	0	0	0	0	0	14.2081	0	0	0	0.844182329	0	0	0	2.20860053	1.893671545	1.069574013	0	0	2.754095416	0	0.044831482	0.278566059	0	1.28326912	0.165178596	0.086096541	0	0	3.286081938	0.286209798	0	0	0	0	0	0	0	0.007754601	0	0	0	0	0	0	0	0	0	0	14.2081	4800	$25/day days 1-10	$100/day days 1-10	$0 copay for days 1-20; $25 copay for days 21-30; $0 copay for days 31-100)	$0 copay	$0 copay	20% coins	20% coins	$50 copay	$0 copay	$0 copay	20% coins	$0 copay	20% coins	$0 copay; Urgent Care	$5 copay	$15 copay	$15 copay	$5 copay	20% coins	$15 copay for chiro; $15 copay for podiatry	20% coins	20% coins	N/A	$15 copay	$15 copay	$150 max benefit every 2 years (combined with IN allowance)	$15 copay	N/A	20% coins	N/A	N/A										0.0685	0.0298	0.0159			0.0852	0.073				0.0946		0.0017	0.0041	0.0337	0.1359	0.0194	0.0094		0.0003	0.1267	0.0336			0.0056				0.0111	0.003											0.7515	0	0	0.0685	0.873973215	0.015885538	0	0	2.293750749	1.966680016	1.069574013	0	0	2.848672887	0	0.046559911	0.282700968	0.033707605	1.419127412	0.184608903	0.095451132	0	0.000342015	3.412773295	0.31978064	0	0	0.005610807	0	0	0	0.0111	0.010785222	0	0	0	0	0	0	0	0	0	0	14.9596
H2611_008_0	2009	8																																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	P	P	V											30.3161	1.2671	4.5043	3.1277	1.0789	1.7704	1.3718	1.3077	4.0493	0.4431	1.4154	0.3063	0.0396	2.5401	3.4209	5.3084	0.2673	0.2849	2.7026	5.2967	2.8694	0.6199			0.1139		0.0387		0.1998	1.0779											75.7383							14.13283611	10.95124956	279.7641575			11.29922498	47.22303112	0.316239761	16.02074192	3439.869277	3721.373534	353.4507351			16.33548378	1217.15204	807.0438093								21.32881163											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	20% coins	20% coins	$50 copay	$0 copay	$0 copay	$0 copay	20% coins	20% coins	"20% coins, etc"	$15 copay	$30 copay	$30 copay	$0 copay	20% coins	$30 copay for chiro; $30 copay for podiatry	20% coins	20% coins	N/A	$30 copay	$0 copay (limit to 1/yr)	"$150 limit every 2 years (1 contact pair, 1 eyeglasses pair every 2 years)"	$0 copay (limit to 1/yr)	N/A	Fitness benefit limited to $200/year	N/A																0.2	0.2	50			0.2	124.2661493	0.2	22.34686249	14.78248205	28.32458239	30			15	45.16767935	30								30																		50							14.78248205	25.07614907				15	45.16767935	29.98804922																			0	0	0	0	0	0	0	1.16568399	0	0	0	0	0	0	4.237483819	7.776476457	0	0	0	0.020419355	4.581327757	2.01680579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.7982	800	9.8039	30.3161	1.267094486	4.504317847	3.127676522	1.078940457	1.770377888	1.371830107	2.473345794	4.049280903	0.443081995	1.415419942	0.306289503	0.039614404	2.540116955	7.658430045	13.08492438	0.267281391	0.284926889	2.702623577	5.317086698	7.450773527	2.636729619	0	0	0.113923455	0	0.038676596	0	0.199752533	1.077917184	0	0	0	0	0	0	0	0	0	0	95.5365	3350	20% coins	20% coins	20% coins	20% coins	20% coins	20% coins	20% coins	$50 copay	20% coins	20% coins	20% coins	20% coins	20% coins	20% coins; Urgent Care	20% coins	20% coins	20% coins	20% coins	20% coins	20% coins for chiro; 20% coins for podiatry	20% coins	20% coins	N/A	20% coins	20% coins	$150 max benefit every 2 years (combined with IN allowance)	20% coins	N/A	20% coins	N/A	N/A										1.942	0.0812	0.2887	0.2004	0.0691	0.1135	0.0879		0.2595	0.0284	0.0907	0.0196	0.0025	0.1628	0.2192	0.3402	0.0171	0.0183	0.1732	0.3395	0.1839	0.0397			0.0058		0.002		0.0101	0.0589											4.7543	0	0.4707213	32.2581	1.348300048	4.792990608	3.328123082	1.148087603	1.883837881	1.459747966	2.473345794	4.308791252	0.471478237	1.506131387	0.325918987	0.042153212	2.702907993	7.877671676	13.42513224	0.284410923	0.303187286	2.87582934	5.65653956	7.634670592	2.676443735	0	0	0.119684093	0	0.040632038	0	0.209851784	1.136838297	0	0	0	0	0	0	0	0	0	0	100.2908
H2611_010_0	2009	4																																A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	P	P	P	P	P																																																			0			172.7875331				14.76780722	11.44327587	297.4484133			713.0872698		9.135516107	19.27870996	662.0042418	3956.606389	375.7928151				1294.089802	857.7162811								135.3845											$0 copay	$100/day days 1-10; $0/day days 11-90	$0 copay	$0 copay	$0 copay	20% coins	20% coins	$50 copay	$0 copay	$0 copay	$0 copay	$0 copay	20% coins	$0 copay; Urgent Care $25 copay	$0/visit except for Immunization with $5 copay	$5 copay	$5 copay	$0 copay	20% coins	$5 copay for chiro; $5 copay for podiatry	20% coins	20% coins	N/A	$5 copay	$0 copay (limit 1/yr)	"$150 limit every 2 years (1 contact pair, 1 eyeglasses pair every 2 years)"	$0 copay	N/A	Fitness benefit limited to $200/year	N/A												67.29738379				0.2	0.2	50			39.73780793		86.81231116	19.98706347	5	5	5				44.39099568	5								5												67.29738379				0.2	0.2	50			39.73780793		86.81231116	19.98706347	5	5	5				44.39099568	5								5											0	0.969012411	0	0	0	2.953561444	2.288655173	1.239368389	0	0	2.36137708	0	0.066089606	0.0321104	0.275835101	1.648585995	0.15658034	0	0	0	4.787161233	0.357381784	0	0	0	0	0	0	0	0.056410208	0	0	0	0	0	0	0	0	0	0	17.1921	0	0	0	0.969012411	0	0	0	2.953561444	2.288655173	1.239368389	0	0	2.36137708	0	0.066089606	0.0321104	0.275835101	1.648585995	0.15658034	0	0	0	4.787161233	0.357381784	0	0	0	0	0	0	0	0.056410208	0	0	0	0	0	0	0	0	0	0	17.1921	4800	$25 copay days 1-10	$100/day days 1-10	$0 copay for days 1-20; $25 copay for days 21-30; $0 copay for days 31-100)	$0 copay	$0 copay	20% coins	20% coins	$50 copay	$0 copay	20% coins	20% coins	$0 copay	20% coins	$0 copay; Urgent Care	$5 copay	$15 copay	$15 copay	$15 copay	20% coins	$15 copay for chiro; $15 copay for podiatry	20% coins	20% coins	N/A	$15 copay	$15 copay	$150 max benefit every 2 years (combined with IN allowance)	N/A	N/A	20% coins	N/A	N/A										0.147	0.0603	0.0242			0.2007	0.1555				0.1457		0.0045	0.0152	0.0776	0.2743	0.0292	0.0222		0.0005	0.3254	0.0751			0.0093					0.0144											1.5812	0	0	0.147	1.029294448	0.024153956	0	0	3.154297801	2.444201726	1.239368389	0	0	2.507052931	0	0.070581331	0.047332555	0.353475578	1.922845865	0.185802819	0.022247605	0	0.000450193	5.112516681	0.432515016	0	0	0.009257595	0	0	0	0	0.070843862	0	0	0	0	0	0	0	0	0	0	18.7733
H2611_012_0	2009	6																																A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	P	P	P	P	P																																																			0		347.5508265	36.45045254				7.823842554	7.744630317	526.3865054			1573.809418		215.4808923	1367.074456	7605.105297	1969.048854	322.9820528	1044.932383			1653.947905	1202.307352																			$250 per stay	$100/day days 1-10; $0/day days 11-90	$0 copay	$0 copay	$0 copay	20% coins	20% coins	$50 copay	$0 copay	$0 copay	20% coins	$0 copay	20% coins	$0 copay; Urgent Care $25 copay	$10 copay	$20 copay	$5 copay	$20 copay	20% coins	$20 copay for chiro; $20 copay for podiatry	20% coins	20% coins	N/A	$20 copay	$0 copay (limit 1 per year)	"$150 limit every 2 years (1 contact pair, 1 eyeglasses pair every 2 years)"	$0 copay (limit 1/yr)	N/A	Fitness benefit limited to $200/year	N/A											160.6	67.3				0.2	0.2	48.74221053			39.77248607		131.9033683	21.52883861	9.614949961	13.88136531	5	20			80.80652197	20																			160.6	67.3				0.2	0.2	48.74221053			39.77248607		131.9033683	21.52883861	9.614949961	13.88136531	5	20			80.80652197	20																			4.6514	0.204426288	0	0	0	1.564768511	1.548926063	2.138103489	0	0	5.216192762	0	2.368554626	2.452627111	6.093558907	2.277757205	0.134575855	1.741553972	0	0	11.13748148	2.003845587	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5338	0	0	4.6514	0.204426288	0	0	0	1.564768511	1.548926063	2.138103489	0	0	5.216192762	0	2.368554626	2.452627111	6.093558907	2.277757205	0.134575855	1.741553972	0	0	11.13748148	2.003845587	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5338	4800	$250 per stay	$100/day days 1-10	$0 copay for days 1-20; $25 copay for days 21-30; $0 copay for days 31-100)	$0 copay	$0 copay	20% coins	20% coins	$50 copay	$0 copay	20% coins	20% coins	$0 copay	20% coins	$0 copay	$15 copay	$30 copay	$30 copay	$30 copay	20% coins	$30 copay for chiro; $30 copay for podiatry	20% coins	20% coins	N/A	$30 copay	20% coins	$150 max benefit every 2 years (combined with IN allowance)	N/A	N/A	20% coins	N/A	N/A										0.2426	0.0062	0.0058			0.0516	0.051			0.0876	0.1719		0.078	0.1084	0.2646	0.0881	0.0244	0.0788			0.367	0.1425			0.0237				0.0004	0.0065											1.799	0	0	4.894	0.210591699	0.005763292	0	0	1.616326606	1.59996216	2.138103489	0	0.087577497	5.388062888	0	2.446596945	2.561065952	6.35818798	2.365879116	0.158928365	1.820340782	0	0	11.50445418	2.146309579	0	0	0.023716127	0	0	0	0.000363047	0.006503306	0	0	0	0	0	0	0	0	0	0	45.3327
H2611_016_0	2009	7																																A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	P	P	P	P	P																																																			0			177.9421199				15.37256751	11.91189241	306.3218757			734.3600445	51.70586395	9.408046251	19.85383122	681.7531108	4074.639622	387.0034428				1332.695007	883.3036194								138.2347											$0 copay	$100/day days 1-10; $0/day days 11-90	$0 copay for days 1-20; $25 copay for days 21-30; $0 copay for days 31-100)	$0 copay	$0 copay	20% coins	20% coins	$50 copay	$0 copay	$0 copay	$0 copay	20% coins	20% coins	N/A	$0/Visit except Immunization $5/Visit	$5 copay	$5/day	$0 copay	20% coins	$5 copay for chiro; $5 copay for podiatry	20% coins	20% coins	N/A	$5 copay	$0 copay (limit 1/yr)	"$150 limit every 2 years (1 contact pair, 1 eyeglasses pair every 2 years)"	$0 copay (limit 1/yr)	N/A	Fitness benefit limited to $200/year	N/A												67.29738379				0.2	0.2	50			40.16686574	123.44798	87.7496427	20.19658074	5	5	5				44.87029499	5								5												67.29738379				0.2	0.2	50			40.16686574	123.44798	87.7496427	20.19658074	5	5	5				44.87029499	5								5											0	0.997919928	0	0	0	3.074513502	2.382378482	1.276341149	0	0	2.458078443	0.531915371	0.068796058	0.033414959	0.284063796	1.697766509	0.161251435	0	0	0	4.98320151	0.368043175	0	0	0	0	0	0	0	0.057597792	0	0	0	0	0	0	0	0	0	0	18.3753	0	0	0	0.997919928	0	0	0	3.074513502	2.382378482	1.276341149	0	0	2.458078443	0.531915371	0.068796058	0.033414959	0.284063796	1.697766509	0.161251435	0	0	0	4.98320151	0.368043175	0	0	0	0	0	0	0	0.057597792	0	0	0	0	0	0	0	0	0	0	18.3753	4800	$25/day days 1-10	$100/day days 1-10	$0 copay for days 1-20; $25 copay for days 21-30; $0 copay for days 31-100)	$0 copay	$0 copay	20% coins	20% coins	$50 copay	$0 copay	20% coins	20% coins	20% coins	20% coins	N/A	$5 copay	$15 copay	$15 copay	$15 copay	20% coins	$15 copay for chiro; $15 copay for podiatry	20% coins	20% coins	N/A	$15 copay	$15 copay	$150 max benefit every 2 years (combined with IN allowance)	$15 copay	N/A	20% coins	N/A	N/A										0.0161	0.0366	0.0146			0.1231	0.0954				0.0893	0.0213	0.0028	0.0092	0.0471	0.1663	0.0177	0.0135		0.0003	0.1995	0.0456			0.0056				0.0036	0.0087											0.9161	0	0	0.0161	1.034479786	0.014648894	0	0	3.197570595	2.477732941	1.276341149	0	0	2.547381881	0.553205231	0.071549613	0.042660768	0.331151203	1.864099671	0.178974288	0.013492731	0	0.000273033	5.182653648	0.413665224	0	0	0.005554611	0	0	0	0.003636231	0.066270474	0	0	0	0	0	0	0	0	0	0	19.2914
H2611_801_0	2009	3																																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											17.96	0.1369	1.7732	0.7693	0.392	0.4584	0.4541	0.4144	3.0834	0.7787	1.5281	0.3301	0.6939	1.0073	4.8522	2.2785	0.169	0.2574	1.4165	4.44	3.2628	0.8647			0.046				0.0315	0.1036											47.502							4.081444948	4.040122493	274.6951139			13.60559306		49.46228682		3968.728765	1036.314872	168.5483782	31.80978757	12.61161103		29.0503146	3.488668575																			Full Coverage	Full Coverage	Full Coverage	Full Coverage	Full Coverage	20% Coinsurance	20% Coinsurance	$50 Copay - Waived if Admitted	Full Coverage	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	$15 Copay	$30 Copay	$30 Copay	$30 Copay	Full Coverage	20% Coinsurance	20% Coinsurance	20% Coinsurance	Full Coverage	N/A	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	$200 Limit	N/A																0.2	0.2	48.74221053			0.2		259.6462937		15	23.98449613	30	15	0.2		0.2	0.449616236																										48.74221053							15	19.77876478			0.2																						0	0	0	0	0	0	0	1.115770589	0	0	0	0	0	0	4.960910956	1.708085675	0	0	2.522322206	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.3071	500	13.6186	17.96	0.136921623	1.773198729	0.769334018	0.39203011	0.458415436	0.454087454	1.530167806	3.083396093	0.778672613	1.528138675	0.330121707	0.693893054	1.007252274	9.813122554	3.986572287	0.168976164	0.257434486	3.938819854	4.440031259	3.262842645	0.864660081	0	0	0.045979953	0	0	0	0.031485526	0.103567223	0	0	0	0	0	0	0	0	0	0	57.8091	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										1.1659	0.0089	0.1151	0.0499	0.0254	0.0298	0.0295	0.0269	0.2002	0.0505	0.0992	0.0214	0.045	0.0654	0.315	0.1479	0.011	0.0167	0.092	0.2882	0.2118	0.0561			0.003				0.002	0.0067											3.0837	0	0	19.1259	0.145810113	1.888308813	0.819276589	0.417479383	0.488174221	0.483565281	1.557069077	3.283559773	0.829221415	1.627340286	0.351552095	0.738938252	1.072639696	10.12811177	4.134483957	0.179945527	0.274146265	4.030774106	4.728263121	3.474655391	0.920790898	0	0	0.048964816	0	0	0	0.03352946	0.110290458	0	0	0	0	0	0	0	0	0	0	60.8928
H2611_802_0	2009	5																					4800											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											12.5512	0.1179	0.74	0.5262	0.5347	0.6829	0.6847	0.5742	3.6281	0.2363	1.4443	0.0537	0.2832	0.6686	3.4114	1.9214	0.0969	0.1068	1.0608	4.5715	1.3028	1.0123			0.0717				0.0514	0.1951											36.5282		2.718703551					12.21317557	12.17633747	548.2040166			25.82977037		123.2062723		7624.184047	1881.366449	209.3831387	18.56391596	18.97214057		23.29962781	4.50444898								141.9571826											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 on Specialist Visits and Fullcoverage on rest of services	$30 Copay	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	$30 Copay	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit																0.2	0.2	49.98795085			0.2		84.63274705		15	21.80114937	30	15	0.2		0.2	0.383622247								19.67728162																0.138099457	0.138099457	49.98795085			0.138099457		58.43868208		15	21.1275445	20.71491856	10.35745928	0.2		0.138099457	0.265611178								19.67728162											0	0	0	0	0	1.686632915	1.681545593	2.283632953	0	0	3.567077264	0	0.600001015	0	9.530230059	3.312387781	0.361446222	0.016022917	3.794428113	0	3.217665949	1.196431999	0	0	0	0	0	0	0	0.232777622	0	0	0	0	0	0	0	0	0	0	31.4803	500	5.6262	12.5512	0.11791433	0.740048337	0.526194756	0.534703295	2.369533017	2.366208745	2.857793044	3.628103361	0.236315328	5.011349701	0.053689888	0.883200304	0.668645272	12.94163281	5.23376881	0.458378213	0.122849607	4.85525596	4.571481229	4.520465383	2.208684689	0	0	0.071734232	0	0	0	0.051425925	0.427855123	0	0	0	0	0	0	0	0	0	0	68.0085		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	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A										1.5549	0.0145	0.0913	0.0649	0.066	0.0843	0.0845	0.0708	0.4476	0.0292	0.1782	0.0066	0.0349	0.0825	0.4209	0.2371	0.012	0.0132	0.1309	0.564	0.1607	0.1249			0.0089				0.0016	0.0225											4.5068	0	0	14.1061	0.132462516	0.831354978	0.591116294	0.600674609	2.45378875	2.450682001	2.928632511	4.07573619	0.265471746	5.189543014	0.060314109	0.918141233	0.751142253	13.36252927	5.470827443	0.470337613	0.136029808	4.98614015	5.135507353	4.681203857	2.333575711	0	0	0.080584751	0	0	0	0.053031801	0.450317771	0	0	0	0	0	0	0	0	0	0	72.5153
H2611_807_0	2009	3																																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											18.7533	0.143	1.8515	0.8033	0.4093	0.4787	0.4741	0.4327	3.2196	0.8131	1.5956	0.3447	0.7245	1.0517	5.0665	2.3791	0.1764	0.2688	1.4791	4.6362	3.407	0.9029			0.048				0.0329	0.1081											49.6002							5.949412632	5.889178	399.8775526			19.83250742		72.00294872		5777.334453	1508.57818	245.3582519	46.30595653	18.38360652		42.34586301	5.085338441																			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 on Specialist Visits and Fullcoverage on rest of services	$30 Copay	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	$30 Copay	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit																0.2	0.2	48.74221053			0.2		259.9957118		15	23.98504152	30	15	0.2		0.2	0.44901198																										48.74221053							15	19.77927029			0.2																						0	0	0	0	0	0	0	1.624242988	0	0	0	0	0	0	7.221668066	2.486547964	0	0	3.676721305	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.0092	500	19.8468	18.7533	0.14296954	1.851522075	0.803316004	0.409346336	0.478663945	0.474144793	2.056944401	3.219591713	0.813067091	1.595637558	0.344703398	0.724542764	1.051743264	12.28820502	4.865676818	0.176439951	0.268805536	5.155786579	4.63615034	3.406964536	0.902852681	0	0	0.048010917	0	0	0	0.032876262	0.108141855	0	0	0	0	0	0	0	0	0	0	64.6094	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	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A										1.6508	0.0126	0.163	0.0707	0.036	0.0421	0.0417	0.0381	0.2834	0.0716	0.1405	0.0303	0.0638	0.0926	0.446	0.2094	0.0155	0.0237	0.1302	0.4081	0.2999	0.0795			0.0042				0.0029	0.0095											4.3662	0	0	20.4041	0.155554926	2.014508681	0.874030662	0.445380456	0.520799987	0.515883022	2.095034432	3.503007359	0.884640122	1.736099049	0.375047101	0.788323135	1.144326587	12.73420438	5.075107827	0.191971686	0.292468069	5.285986393	5.044263437	3.706874321	0.982329397	0	0	0.052237244	0	0	0	0.035770308	0.117661414	0	0	0	0	0	0	0	0	0	0	68.9756
H2611_809_0	2009	5																					4800											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											12.5512	0.1179	0.74	0.5262	0.5347	0.6829	0.6847	0.5742	3.6281	0.2363	1.4443	0.0537	0.2832	0.6686	3.4114	1.9214	0.0969	0.1068	1.0608	4.5715	1.3028	1.0123			0.0717				0.0514	0.1951											36.5282		2.718703551					12.21317557	12.17633747	548.2040166			25.82977037		123.2062723		7624.184047	1881.366449	209.3831387	18.56391596	18.97214057		23.29962781	4.50444898								141.9571826											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 on Specialist Visits and Fullcoverage on rest of services	$30 Copay	Full Coverage	20% Coinsurance	Full Coverage	20% Coinsurance	20% Coinsurance	Full Coverage	$30 Copay	Full Coverage	$150 Limit Every Two Years	Full Coverage	N/A	N/A	$200 Limit																0.2	0.2	49.98795085			0.2		84.63274705		15	21.80114937	30	15	0.2		0.2	0.383622247								19.67728162																0.138099457	0.138099457	49.98795085			0.138099457		58.43868208		15	21.1275445	20.71491856	10.35745928	0.2		0.138099457	0.265611178								19.67728162											0	0	0	0	0	1.686632915	1.681545593	2.283632953	0	0	3.567077264	0	0.600001015	0	9.530230059	3.312387781	0.361446222	0.016022917	3.794428113	0	3.217665949	1.196431999	0	0	0	0	0	0	0	0.232777622	0	0	0	0	0	0	0	0	0	0	31.4803	500	5.6262	12.5512	0.11791433	0.740048337	0.526194756	0.534703295	2.369533017	2.366208745	2.857793044	3.628103361	0.236315328	5.011349701	0.053689888	0.883200304	0.668645272	12.94163281	5.23376881	0.458378213	0.122849607	4.85525596	4.571481229	4.520465383	2.208684689	0	0	0.071734232	0	0	0	0.051425925	0.427855123	0	0	0	0	0	0	0	0	0	0	68.0085		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	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	N/A										1.5549	0.0145	0.0913	0.0649	0.066	0.0843	0.0845	0.0708	0.4476	0.0292	0.1782	0.0066	0.0349	0.0825	0.4209	0.2371	0.012	0.0132	0.1309	0.564	0.1607	0.1249			0.0089				0.0016	0.0225											4.5068	0	0	14.1061	0.132462516	0.831354978	0.591116294	0.600674609	2.45378875	2.450682001	2.928632511	4.07573619	0.265471746	5.189543014	0.060314109	0.918141233	0.751142253	13.36252927	5.470827443	0.470337613	0.136029808	4.98614015	5.135507353	4.681203857	2.333575711	0	0	0.080584751	0	0	0	0.053031801	0.450317771	0	0	0	0	0	0	0	0	0	0	72.5153
H2613_001_0	2009	6	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Ambulatory Surgical Center	Urgent Care	Radiology	Chiropractic	Podiatric	Vision Exam Diagnostic	Hearing Exam Diagnostic	Radiation-Chemotherapy	Radiology	Diabetes Supplies	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	Coin	V	V	0	Coin	0	0	0	V	V	V	0	0	0	V	V	V	V	V	V	V	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	0	0	0	0	0	0	0	0	0		1307.762807	58.95579047	388.1836711	45.42349534	90.96880881	13.61364328	0.247794638	403.4347825	348.1241924	4605.63924	467.0480444	98.94916068	0.191397693	1077.516906	3353.679154	2565.340495	1.537343318	1287.67189	230.7304604	0	54.32114198	0	0	0	421.945659	351.2071332	190.2861391	0	0	0	101.8073073	50.63845022	850.8696722	1272.621949	262.943629	661.4698859	0.29236352	15.37365339	1910.630049	2.148265485	$200/day (days 1-5); $1000 yrly max	$200/day (days 1-5); $1000 yrly max	$125/day (for days 21-100)	$0 copay	$100 copay	30% coinsurance	30% coinsurance	$50 copay	$175 copay	$15 copay	$100 copay/Higher Tier	$175 copay	20% coinsurance	$25 copay	$15 copay	$25 copay	50% coinsurance	$25 copay	$100 copay/Higher Tier	0	20% coinsurance	0	0	0	$25 copay	Covd up to $50/ Every 2 yrs.	$25 copay	0	0	0	$100 copay	$25 copay	$15 copay/Lower Tier	$25 copay	$25 copay	$25 copay	$25 copay	20% coinsurance	$15 copay/Lower Tier	20% coinsurance	200	200	125	0	100	0.3	0.3	50	175	15	100	175	0.2	25	15	25	0.5	25	100	0	0.2	0	0	0	25	0	25	0	0	0	100	25	15	25	25	25	25	0.2	15	0.2	101.7190534	56.33737043	120.1008241	0	96.08065932	0.288241978	0.288241978	48.04032966	168.1411538	14.4120989	96.08065932	168.1411538	0.192161319	24.02016483	14.4120989	24.02016483	0.480403297	24.02016483	96.08065932	0	0.192161319	0	0	0	24.02016483	0	24.02016483	0	0	0	96.08065932	24.02016483	14.4120989	24.02016483	24.02016483	24.02016483	24.02016483	0.192161319	14.4120989	0.192161319	11.0854	0.276784517	3.885098235	0	0.728361927	3.924023468	0.071424816	1.615094995	4.877833615	5.531410684	3.73952367	1.38645217	0.036779233	2.156844474	4.027796303	5.134991795	0.738544798	2.577507587	1.847394564	0	10.43842227	0	0	0	0.844600357	0	0.380892035	0	0	0	0.815142768	0.101361993	1.021901489	2.547382415	0.526329109	1.324051308	0.000585218	2.954221508	2.294682436	0.412813528	77.3036		3.1534	11.0854	0.276784517	3.885098235	0	0.728361927	3.924023468	0.071424816	1.615094995	4.877833615	5.531410684	3.73952367	1.38645217	0.036779233	2.156844474	4.027796303	5.134991795	0.738544798	2.577507587	1.847394564	0	10.43842227	0	0	0	0.844600357	0	0.380892035	0	0	0	0.815142768	0.101361993	1.021901489	2.547382415	0.526329109	1.324051308	0.000585218	2.954221508	2.294682436	0.412813528	77.3036	4000																																																																																	0		0	11.0854	0.276784517	3.885098235	0	0.728361927	3.924023468	0.071424816	1.615094995	4.877833615	5.531410684	3.73952367	1.38645217	0.036779233	2.156844474	4.027796303	5.134991795	0.738544798	2.577507587	1.847394564	0	10.43842227	0	0	0	0.844600357	0	0.380892035	0	0	0	0.815142768	0.101361993	1.021901489	2.547382415	0.526329109	1.324051308	0.000585218	2.954221508	2.294682436	0.412813528	77.3036
H2613_004_0	2009	8	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Ambulatory Surgical Center	Urgent Care	Radiology	Chiropractic	Podiatric	Vision Exam Diagnostic	Hearing Exam Diagnostic	Radiation-Chemotherapy	Radiology	Diabetes Supplies	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	Coin	V	V	0	Coin	0	0	0	V	V	V	0	0	0	V	V	V	V	V	V	V	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	0	0	0	0	0	0	0	0	0		1074.214016	108.6405969	271.9950462	40.69874388	77.7575732	9.152165626	0.528866768	293.4916529	248.4525493	3736.364091	353.7850712	50.38703982	0.383502555	621.9023041	3173.072309	2352.037654	0.180520257	687.6790813	238.4663136	0	26.50235267	0	0	0	412.2798991	364.7200047	197.6074942	0	0	0	111.0476306	27.76712991	614.7922139	601.9596169	177.2751367	596.25149	0.198626536	8.973297734	1839.554936	1.439883188	$275/day (days 1-5); $1375 yrly max	$275/day (days 1-5); $1375 yrly max	$125/day (for days 21-100)	$0 copay	$150 copay	30% coinsurance	30% coinsurance	$50 copay	$200 copay	$20 copay	$100 copay/Higher Tier	$200 copay	20% coinsurance	$30 copay	$20 copay	$30 copay	50% coinsurance	$30 copay	$100 copay/Higher Tier	0	20% coinsurance	0	0	0	$30 copay	Covd up to $50/ Every 2 yrs.	$30 copay	0	0	0	$100 copay	$30 copay	$30 copay/Lower Tier	$30 copay	$30 copay	$30 copay	$30 copay	20% coinsurance	$30 copay/Lower Tier	20% coinsurance	275	275	125	0	150	0.3	0.3	50	200	20	100	200	0.2	30	20	30	0.5	30	100	0	0.2	0	0	0	30	0	30	0	0	0	100	30	30	30	30	30	30	0.2	30	0.2	150.2874367	60.44228215	121.8432608	0	146.2119129	0.292423826	0.292423826	48.73730431	194.9492172	19.49492172	97.47460862	194.9492172	0.194949217	29.24238258	19.49492172	29.24238258	0.487373043	29.24238258	97.47460862	0	0.194949217	0	0	0	29.24238258	0	29.24238258	0	0	0	97.47460862	29.24238258	29.24238258	29.24238258	29.24238258	29.24238258	29.24238258	0.194949217	29.24238258	0.194949217	13.4534	0.547207134	2.761730278	0	0.947423627	2.676311287	0.154653244	1.191999333	4.0363025	6.070010458	2.873755112	0.818576164	0.074763523	1.515492092	5.15489969	5.731598744	0.087980707	1.675781233	1.937034215	0	5.166612907	0	0	0	1.004670545	0	0.481542829	0	0	0	0.902027027	0.067664753	1.498165761	1.466894451	0.431995614	1.452984516	0.000484026	1.749337369	4.482747436	0.2807041	70.6948		1.8316	13.4534	0.547207134	2.761730278	0	0.947423627	2.676311287	0.154653244	1.191999333	4.0363025	6.070010458	2.873755112	0.818576164	0.074763523	1.515492092	5.15489969	5.731598744	0.087980707	1.675781233	1.937034215	0	5.166612907	0	0	0	1.004670545	0	0.481542829	0	0	0	0.902027027	0.067664753	1.498165761	1.466894451	0.431995614	1.452984516	0.000484026	1.749337369	4.482747436	0.2807041	70.6948	4000																																																																																	0		0	13.4534	0.547207134	2.761730278	0	0.947423627	2.676311287	0.154653244	1.191999333	4.0363025	6.070010458	2.873755112	0.818576164	0.074763523	1.515492092	5.15489969	5.731598744	0.087980707	1.675781233	1.937034215	0	5.166612907	0	0	0	1.004670545	0	0.481542829	0	0	0	0.902027027	0.067664753	1.498165761	1.466894451	0.431995614	1.452984516	0.000484026	1.749337369	4.482747436	0.2807041	70.6948
H2613_803_0	2009	5																					none											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	V											0	0	0	0	0	0	0	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	309.2454689	3.363814701	54.60622737	41.1800017	8.354646688	16.62687111	4.703511773	10.44272545	40.73652521	7.501928981	23.50456759	0	0.255109465	31.51507797	42.83134553	123.8213262	1.294490499	6.173251441	32.46391376	38.5577642	9.117459833	0.98125761	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											22.8665	0.248729876	9.749343862	0	1.929923385	3.840807226	1.08651122	2.412269578	9.410137324	1.732945595	5.429555112	0	0.058930286	7.279983012	9.894040816	28.60272635	0.299027305	1.426021083	7.499164078	8.906843531	2.106133221	0.226670508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0062	0	0	22.8665	0.248729876	9.749343862	0	1.929923385	3.840807226	1.08651122	2.412269578	9.410137324	1.732945595	5.429555112	0	0.058930286	7.279983012	9.894040816	28.60272635	0.299027305	1.426021083	7.499164078	8.906843531	2.106133221	0.226670508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0062	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.8665	0.248729876	9.749343862	0	1.929923385	3.840807226	1.08651122	2.412269578	9.410137324	1.732945595	5.429555112	0	0.058930286	7.279983012	9.894040816	28.60272635	0.299027305	1.426021083	7.499164078	8.906843531	2.106133221	0.226670508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0062
H2613_804_0	2009	5																					none											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	V											0	0	0	0	0	0	0	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	309.2454689	3.363814701	54.60622737	41.1800017	8.354646688	16.62687111	4.703511773	10.44272545	40.73652521	7.501928981	23.50456759	0	0.255109465	31.51507797	42.83134553	123.8213262	1.294490499	6.173251441	32.46391376	38.5577642	9.117459833	0.98125761	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											22.8665	0.248729876	9.749343862	0	1.929923385	3.840807226	1.08651122	2.412269578	9.410137324	1.732945595	5.429555112	0	0.058930286	7.279983012	9.894040816	28.60272635	0.299027305	1.426021083	7.499164078	8.906843531	2.106133221	0.226670508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0062	0	0	22.8665	0.248729876	9.749343862	0	1.929923385	3.840807226	1.08651122	2.412269578	9.410137324	1.732945595	5.429555112	0	0.058930286	7.279983012	9.894040816	28.60272635	0.299027305	1.426021083	7.499164078	8.906843531	2.106133221	0.226670508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0062	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.8665	0.248729876	9.749343862	0	1.929923385	3.840807226	1.08651122	2.412269578	9.410137324	1.732945595	5.429555112	0	0.058930286	7.279983012	9.894040816	28.60272635	0.299027305	1.426021083	7.499164078	8.906843531	2.106133221	0.226670508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0062
H2613_806_0	2009	5																					none											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	V											0	0	0	0	0	0	0	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	309.2454689	3.363814701	54.60622737	41.1800017	8.354646688	16.62687111	4.703511773	10.44272545	40.73652521	7.501928981	23.50456759	0	0.255109465	31.51507797	42.83134553	123.8213262	1.294490499	6.173251441	32.46391376	38.5577642	9.117459833	0.98125761	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											22.8665	0.248729876	9.749343862	0	1.929923385	3.840807226	1.08651122	2.412269578	9.410137324	1.732945595	5.429555112	0	0.058930286	7.279983012	9.894040816	28.60272635	0.299027305	1.426021083	7.499164078	8.906843531	2.106133221	0.226670508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0062	0	0	22.8665	0.248729876	9.749343862	0	1.929923385	3.840807226	1.08651122	2.412269578	9.410137324	1.732945595	5.429555112	0	0.058930286	7.279983012	9.894040816	28.60272635	0.299027305	1.426021083	7.499164078	8.906843531	2.106133221	0.226670508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0062	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.8665	0.248729876	9.749343862	0	1.929923385	3.840807226	1.08651122	2.412269578	9.410137324	1.732945595	5.429555112	0	0.058930286	7.279983012	9.894040816	28.60272635	0.299027305	1.426021083	7.499164078	8.906843531	2.106133221	0.226670508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0062
H2643_001_0	2009	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											0	0	0	0	0	0	0	0	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	25.69	83.09	96.55	15.75	25.39	20.73	18.5	38.85	9.63	24.74	1.4	2.5	40.92	92.06	175.35	11.81	13.45	43.3	73.91	10.23	5.98	15.05	0	2.61	0.98	0	0	0	10.48											PBP: 1A IP Acute: Standard Medicare Cost Sharing	1B IP Psych: Standard Medicare Cost Sharing	2 SNF: Standard Medicare Cost Sharing	6 Home Health: Standard Medicare Cost Sharing	10A Ambulance: Standard Medicare Cost Sharing	11A DME: Standard Medicare Cost Sharing	"11B Prosthetic Medical Supplies, 11C Diabetes Monitoring Supplies: Standard Medicare Cost Sharing"	"4A ER, 4B Urgent Care: Standard Medicare Cost Sharing"	9B ASC Services: Standard Medicare Cost Sharing	8A OP C/D/T: Standard Medicare Cost Sharing	8B OP X-Ray: Standard Medicare Cost Sharing	9A OP Hospital: Standard Medicare Cost Sharing	12 Renal Dialysis: Standard Medicare Cost Sharing	"3 CORF, 5 Partial Hosp, 9C OP Substance Abuse, 9D Cardiac Rehab: Standard Medicare Cost Sharing"	"7A PCP, 14B Immunizations, 14C Routine Physical Exams, 14D Pap Smears, 14D Pelvic Exams, 14E Prostate Screening, 14F Colorectal Screening, 14G Bone Mass Measurement, 14H Mammography, 14I Diabetes Monitoring: Standard Medicare Cost Sharing"	"7B Chiropractic, 7D Physician Specialist (excl. Radiology), 7F Podiatry: Standard Medicare Cost Sharing"	"7E Mental Health, 7H Psychiatric: Standard Medicare Cost Sharing"	"7C Occupational Therapy, 7I Physical and Speech Therapy: Standard Medicare Cost Sharing"	7D Physician Specialist (Radiology): Standard Medicare Cost Sharing	"7G Other Health Care, 18A Medicare Covered Hearing Exams: Standard Medicare Cost Sharing"	15 Part B Drugs: Standard Medicare Cost Sharing	"13A Blood, 16B Medicare Covered Comprehensive Dental Services, 17A Medicare Covered Eye Exams: Standard Medicare Cost Sharing"	10B Transportation: 48 One-way trips per year	"16A Preventive Dental Services, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0 Annual Eye Exams	17B Eye Wear Medicare Covered: $0 Biennial Glasses or Contacts	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered; 7F Podiatry: 12 Visits for Routine Podiatry, $0"											0.0607	0.0607	0.1708	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0607	0.0607	0.1708	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											26.0403	1.559383	14.191772	0	3.63825	5.86509	4.78863	4.2735	8.97435	2.22453	5.71494	0.3234	0.5775	9.45252	21.26586	40.50585	2.72811	3.10695	10.0023	17.07321	2.36313	1.38138	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	186.051	0	0	26.0403	1.559383	14.191772	0	3.63825	5.86509	4.78863	4.2735	8.97435	2.22453	5.71494	0.3234	0.5775	9.45252	21.26586	40.50585	2.72811	3.10695	10.0023	17.07321	2.36313	1.38138	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	186.051	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	26.0403	1.559383	14.191772	0	3.63825	5.86509	4.78863	4.2735	8.97435	2.22453	5.71494	0.3234	0.5775	9.45252	21.26586	40.50585	2.72811	3.10695	10.0023	17.07321	2.36313	1.38138	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	186.051
H2648_001_0	2009	5	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded	V	T	Coin	Coin	V	Coin		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									V																																																		0		294.488777	1.349181472	4.197564655	0.228195196	182.8287541	11.13102097	1.511537613	238.8332195	36.63796728		833.9482712	0.097623129		2.385961067	4380.240157	6496.568689	2.780362856	1159.493929	937.4451464	2248.277401	0.869057557	50.3943757									29.46285726										$475 Copay	$475 Copay	$475 Copay	$30 Copay	$75 Copay	25% Coinsurance	25% Coinsurance	$50 Copay	20% Coinsurance		$35 Copay	50% Coinsurance		50% Coinsurance	$5 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	$0 Copay for blood and $35 Copay for other									$35 Copay										475	475	475	30	75	0.25	0.25	50	0.2		35	0.5		0.5	5	35	0.5	35	35	35	0.2	35									35										475	475	475	30	75	0.25	0.25	50	0.2		35	0.5		0.5	5	35	0.5	35	35	35	0.2	35									35										11.6568	0.0534051	0.166153601	0.000570488	1.142679713	2.782755243	0.377884403	0.995138414	7.327593456	0	2.432349124	0.048811564	0	1.192980533	1.825100065	18.94832534	1.390181428	3.381857294	2.73421501	6.557475752	0.173811511	0.146983596	0	0	0	0	0	0	0	0	0.085933334	0	0	0	0	0	0	0	0	0	63.4211	0		11.6568	0.0534051	0.166153601	0.000570488	1.142679713	2.782755243	0.377884403	0.995138414	7.327593456	0	2.432349124	0.048811564	0	1.192980533	1.825100065	18.94832534	1.390181428	3.381857294	2.73421501	6.557475752	0.173811511	0.146983596	0	0	0	0	0	0	0	0	0.085933334	0	0	0	0	0	0	0	0	0	63.4211																																																																																		0	0		11.6568	0.0534051	0.166153601	0.000570488	1.142679713	2.782755243	0.377884403	0.995138414	7.327593456	0	2.432349124	0.048811564	0	1.192980533	1.825100065	18.94832534	1.390181428	3.381857294	2.73421501	6.557475752	0.173811511	0.146983596	0	0	0	0	0	0	0	0	0.085933334	0	0	0	0	0	0	0	0	0	63.4211
H2648_002_0	2009	5	h.6.										OP Facility - Other											Cardiac Rehab and CORF										D	D	D	V	T	Coin	Coin	V	Coin		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									V																																																		0		299.6151847	0.424437501	17.34399398	0	215.5503667	14.59297112	1.651343116	257.0585481	27.14628498	0	674.1018491	0.055660991	0	1.82470096	4814.494134	6366.075378	3.041541752	1195.016469	1213.338562	2403.788728	1.317798288	30.00922437									17.67513685										$475 Copay	$475 Copay	$475 Copay	$30 Copay	$75 Copay	25% Coinsurance	25% Coinsurance	$75 Copay	20% Coinsurance	0% Coinsurance	$35 Copay	50% Coinsurance	0% Coinsurance	50% Coinsurance	$5 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	"$0 Copay for Blood, $35 Copay for other"									$35 Copay										475	475	475	30	75	0.25	0.25	75	0.2	0	35	0.5	0	0.5	5	35	0.5	35	35	35	0.2	35									35										475	475	475	30	75	0.25	0.25	75	0.2	0	35	0.5	0	0.5	5	35	0.5	35	35	35	0.2	35									35										11.8598	0.016800651	0.686533095	0	1.347189792	3.648242781	0.412835779	1.606615926	5.429256997	0	1.966130393	0.027830496	0	0.91235048	2.006039222	18.56771985	1.520770876	3.485464702	3.53890414	7.011050458	0.263559658	0.087526904	0	0	0	0	0	0	0	0	0.051552482	0	0	0	0	0	0	0	0	0	64.4461			11.8598	0.016800651	0.686533095	0	1.347189792	3.648242781	0.412835779	1.606615926	5.429256997	0	1.966130393	0.027830496	0	0.91235048	2.006039222	18.56771985	1.520770876	3.485464702	3.53890414	7.011050458	0.263559658	0.087526904	0	0	0	0	0	0	0	0	0.051552482	0	0	0	0	0	0	0	0	0	64.4461																																																																																		0			11.8598	0.016800651	0.686533095	0	1.347189792	3.648242781	0.412835779	1.606615926	5.429256997	0	1.966130393	0.027830496	0	0.91235048	2.006039222	18.56771985	1.520770876	3.485464702	3.53890414	7.011050458	0.263559658	0.087526904	0	0	0	0	0	0	0	0	0.051552482	0	0	0	0	0	0	0	0	0	64.4461
H2648_003_0	2009	5	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded	V	T	Coin	Coin	V	Coin		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									V																																																		0		294.488777	1.349181472	4.197564655	0.228195196	182.8287541	11.13102097	1.511537613	238.8332195	36.63796728		833.9482712	0.097623129		2.385961067	4380.240157	6496.568689	2.780362856	1159.493929	937.4451464	2248.277401	0.869057557	50.3943757									29.46285726										$475 Copay	$475 Copay	$475 Copay	$30 Copay	$75 Copay	25% Coinsurance	25% Coinsurance	$50 Copay	20% Coinsurance		$35 Copay	50% Coinsurance		50% Coinsurance	$5 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	$0 Copay for blood and $35 Copay for other									$35 Copay										475	475	475	30	75	0.25	0.25	50	0.2		35	0.5		0.5	5	35	0.5	35	35	35	0.2	35									35										475	475	475	30	75	0.25	0.25	50	0.2		35	0.5		0.5	5	35	0.5	35	35	35	0.2	35									35										11.6568	0.0534051	0.166153601	0.000570488	1.142679713	2.782755243	0.377884403	0.995138414	7.327593456	0	2.432349124	0.048811564	0	1.192980533	1.825100065	18.94832534	1.390181428	3.381857294	2.73421501	6.557475752	0.173811511	0.146983596	0	0	0	0	0	0	0	0	0.085933334	0	0	0	0	0	0	0	0	0	63.4211	0		11.6568	0.0534051	0.166153601	0.000570488	1.142679713	2.782755243	0.377884403	0.995138414	7.327593456	0	2.432349124	0.048811564	0	1.192980533	1.825100065	18.94832534	1.390181428	3.381857294	2.73421501	6.557475752	0.173811511	0.146983596	0	0	0	0	0	0	0	0	0.085933334	0	0	0	0	0	0	0	0	0	63.4211																																																																																		0	0		11.6568	0.0534051	0.166153601	0.000570488	1.142679713	2.782755243	0.377884403	0.995138414	7.327593456	0	2.432349124	0.048811564	0	1.192980533	1.825100065	18.94832534	1.390181428	3.381857294	2.73421501	6.557475752	0.173811511	0.146983596	0	0	0	0	0	0	0	0	0.085933334	0	0	0	0	0	0	0	0	0	63.4211
H2648_004_0	2009	5	h.6.										OP Facility - Other											Cardiac Rehab and CORF										D	D	D	V	T	Coin	Coin	V	Coin		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									V																																																		0		299.6151847	0.424437501	17.34399398	0	215.5503667	14.59297112	1.651343116	257.0585481	27.14628498		674.1018491	0.055660991		1.82470096	4814.494134	6366.075378	3.041541752	1195.016469	1213.338562	2403.788728	1.317798288	30.00922437									17.67513685										$475 Copay	$475 Copay	$475 Copay	$30 Copay	$75 Copay	25% Coinsurance	25% Coinsurance	$50 Copay	20% Coinsurance		$35 Copay	50% Coinsurance		50% Coinsurance	$5 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	"$0 Copay for Blood, $35 Copay for other"									$35 Copay										475	475	475	30	75	0.25	0.25	50	0.2		35	0.5		0.5	5	35	0.5	35	35	35	0.2	35									35										475	475	475	30	75	0.25	0.25	50	0.2		35	0.5		0.5	5	35	0.5	35	35	35	0.2	35									35										11.8598	0.016800651	0.686533095	0	1.347189792	3.648242781	0.412835779	1.071077284	5.429256997	0	1.966130393	0.027830496	0	0.91235048	2.006039222	18.56771985	1.520770876	3.485464702	3.53890414	7.011050458	0.263559658	0.087526904	0	0	0	0	0	0	0	0	0.051552482	0	0	0	0	0	0	0	0	0	63.9106			11.8598	0.016800651	0.686533095	0	1.347189792	3.648242781	0.412835779	1.071077284	5.429256997	0	1.966130393	0.027830496	0	0.91235048	2.006039222	18.56771985	1.520770876	3.485464702	3.53890414	7.011050458	0.263559658	0.087526904	0	0	0	0	0	0	0	0	0.051552482	0	0	0	0	0	0	0	0	0	63.9106																																																																																		0			11.8598	0.016800651	0.686533095	0	1.347189792	3.648242781	0.412835779	1.071077284	5.429256997	0	1.966130393	0.027830496	0	0.91235048	2.006039222	18.56771985	1.520770876	3.485464702	3.53890414	7.011050458	0.263559658	0.087526904	0	0	0	0	0	0	0	0	0.051552482	0	0	0	0	0	0	0	0	0	63.9106
H2648_801_0	2009	6	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded	V	T	Coin	Coin	V	Coin		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									Coin																																																		0		549.103192	4.006089244	33.86739943	1.080634004	143.9190051	10.90223406	1.419191392	258.0652215	15.14582094		886.04834	0.069092306		8.134326113	4919.910267	5143.321545	0.60681526	2889.073544	1232.879087	1978.852887	0.141217728	9.589002176									2.69227186										$600 Copay	$600 Copay	$600 Copay	$20 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	20% Coinsurance		$35 Copay	50% Coinsurance		50% Coinsurance	$20 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	"$0 Copay for Blood, $35 Copay for other"									50% Coinsurance										600	600	600	20	100	0.3	0.3	50	0.2		35	0.5		0.5	20	35	0.5	35	35	35	0.2	35									0.5										600	600	600	20	100	0.3	0.3	50	0.2		35	0.5		0.5	20	35	0.5	35	35	35	0.2	35									0.5										27.4552	0.200304462	1.693369971	0.001801057	1.199325042	3.270670217	0.425757418	1.075271756	3.029164188	0	2.584307658	0.034546153	0	4.067163057	8.199850445	15.00135451	0.30340763	8.426464504	3.595897338	5.771654254	0.028243546	0.027967923	0	0	0	0	0	0	0	0	1.34613593	0	0	0	0	0	0	0	0	0	87.7378			27.4552	0.200304462	1.693369971	0.001801057	1.199325042	3.270670217	0.425757418	1.075271756	3.029164188	0	2.584307658	0.034546153	0	4.067163057	8.199850445	15.00135451	0.30340763	8.426464504	3.595897338	5.771654254	0.028243546	0.027967923	0	0	0	0	0	0	0	0	1.34613593	0	0	0	0	0	0	0	0	0	87.7378																																																																																		0			27.4552	0.200304462	1.693369971	0.001801057	1.199325042	3.270670217	0.425757418	1.075271756	3.029164188	0	2.584307658	0.034546153	0	4.067163057	8.199850445	15.00135451	0.30340763	8.426464504	3.595897338	5.771654254	0.028243546	0.027967923	0	0	0	0	0	0	0	0	1.34613593	0	0	0	0	0	0	0	0	0	87.7378
H2648_802_0	2009	6	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded		T	Coin	Coin	V	Coin		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									Coin																																																		0		549.103192	4.006089244	33.86739943	1.080634004	143.9190051	10.90223406	1.419191392	258.0652215	15.14582094		886.04834	0.069092306		8.134326113	4919.910267	5143.321545	0.60681526	2889.073544	1232.879087	1978.852887	0.141217728	9.589002176									2.69227186										$600 Copay	$600 Copay	$600 Copay	$20 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	20% Coinsurance		$35 Copay	50% Coinsurance		50% Coinsurance	$20 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	"$0 Copay for Blood, $35 Copay for other"									50% Coinsurance										600	600	600	20	100	0.3	0.3	50	0.2		35	0.5		0.5	20	35	0.5	35	35	35	0.2	35									0.5										600	600	600	20	100	0.3	0.3	50	0.2		35	0.5		0.5	20	35	0.5	35	35	35	0.2	35									0.5										27.4552	0.200304462	1.693369971	0.001801057	1.199325042	3.270670217	0.425757418	1.075271756	3.029164188	0	2.584307658	0.034546153	0	4.067163057	8.199850445	15.00135451	0.30340763	8.426464504	3.595897338	5.771654254	0.028243546	0.027967923	0	0	0	0	0	0	0	0	1.34613593	0	0	0	0	0	0	0	0	0	87.7378			27.4552	0.200304462	1.693369971	0.001801057	1.199325042	3.270670217	0.425757418	1.075271756	3.029164188	0	2.584307658	0.034546153	0	4.067163057	8.199850445	15.00135451	0.30340763	8.426464504	3.595897338	5.771654254	0.028243546	0.027967923	0	0	0	0	0	0	0	0	1.34613593	0	0	0	0	0	0	0	0	0	87.7378																																																																																		0			27.4552	0.200304462	1.693369971	0.001801057	1.199325042	3.270670217	0.425757418	1.075271756	3.029164188	0	2.584307658	0.034546153	0	4.067163057	8.199850445	15.00135451	0.30340763	8.426464504	3.595897338	5.771654254	0.028243546	0.027967923	0	0	0	0	0	0	0	0	1.34613593	0	0	0	0	0	0	0	0	0	87.7378
H2649_004_0	2009	3	r.	s.	t.	u.	v.						Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered						2900											A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin	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		305.231683	8.07513	1162.4805	1250.015431	232.241604	11.37799	2.648131	344.045729	272.050357	213.77097	563.307103	0	14.499386	623.675347	4225.660873	3823.207763	11.123808	476.611372			25.060761			2.36	3.16				0.06	0.05	0.42	2.64	0.3	1.23	2.7						$550/Admit:1a	$550/Admit:1b	"$0/Day(Days 1-20) $100(Days 21-100):2. $0 SNF 1,2. $100 SNF 2"	$5/Visit:6	$100/Trip:10a	20% Coins:11a	"0%-20% Coins:11b. 0% Supplies,11b. 20% Prosthetics"	$50/Visit:4a	"$0-$175/Visit:9b. $0 Surgery ASC -- Physician,9b. $175 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $175 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$100/Visit:14h. $20 DMAM -- OP,8b. $20 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $20 Radiology OP -- Facility"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$0-$50/Visit:9d. $0 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $30 Partial Hospitalization,8b. $20 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$5/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$50/Visit:7h. $50 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30/Visit:7d, 9a"			"0%-20% Coins:15. 20% Part B Rx,15. 20% Part B Rx at Pharmacy,15. 0% Part B Rx - Chemo"			"DEN 756 16a, 16b"	VIS 993				$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0: Nutritional benefit 14a	$0: Membership in health club/fitness class 14a	NSP 002	$0: Health Education Materials 14a	$0 Corp Health 14a						549.999981	549.999814	33.697504	5.000002	100.000015	0.2	0.061864	50.000004	174.999998	0	37.677181	0	0	30.983927	4.999999	29.999998	43.087043	30.000014			0.095059			0	0				0	0	0	0	0	0	0						376.535487	376.535372	23.069648	3.423051	68.46101	0.136922	0.042352	34.230503	119.806748	0	25.794175	0	0	21.211906	3.423049	20.538299	29.49782	20.538309			0.065078			0	0				0	0	0	0	0	0	0						9.5775	0.253381007	2.234834662	0.356572214	1.324957898	1.557897147	0.112153644	0.981404863	2.71612238	0	1.210836833	0	0	1.102445236	1.205387019	6.543515348	0.027344007	0.815732636	0	0	1.630904204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.651	0	15.4597	9.5775	0.253381007	2.234834662	0.356572214	1.324957898	1.557897147	0.112153644	0.981404863	2.71612238	0	1.210836833	0	0	1.102445236	1.205387019	6.543515348	0.027344007	0.815732636	0	0	1.630904204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.651	2900																																																																																	0	0	0	9.5775	0.253381007	2.234834662	0.356572214	1.324957898	1.557897147	0.112153644	0.981404863	2.71612238	0	1.210836833	0	0	1.102445236	1.205387019	6.543515348	0.027344007	0.815732636	0	0	1.630904204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.651
H2649_011_0	2009	3	r.	s.	t.	u.	v.						Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)						2900											A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin	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		313.329712	8.289369	1193.321993	1283.179293	238.40315	11.989763	2.790517	353.173524	279.268059	219.442476	578.252068	0	14.884065	640.221929	4337.770876	3924.640377	11.418932	489.256232			26.408232			2.36	3.16				0.05	2.7	0.42	2.64	0.3	1.23	0.06						$550/Admit:1a	$550/Admit:1b	"$0/Day(Days 1-20) $100(Days 21-100):2. $0 SNF 1,2. $100 SNF 2"	$5/Visit:6	$100/Trip:10a	20% Coins:11a	"0%-20% Coins:11b. 0% Supplies,11b. 20% Prosthetics"	$50/Visit:4a	"$0-$175/Visit:9b. $0 Surgery ASC -- Physician,9b. $175 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $175 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$100/Visit:14h. $50 DMAM -- OP,8b. $20 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $20 Radiology OP -- Facility"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$0-$50/Visit:9d. $0 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $30 Partial Hospitalization,8b. $20 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$5/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$50/Visit:7h. $50 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30/Visit:7d, 9a"			"0%-20% Coins:15. 20% Part B Rx,15. 20% Part B Rx at Pharmacy,15. 0% Part B Rx - Chemo"			"DEN 756 16a, 16b"	VIS 993				$0 Additional Smoking Cessation 14a	$0 Corp Health 14a	$0: Nutritional benefit 14a	$0: Membership in health club/fitness class 14a	NSP 002	$0: Health Education Materials 14a	$0: Nurse hotline 14a						549.999994	549.999402	33.697496	4.999999	100.000004	0.2	0.061864	49.999988	174.999991	0	38.443151	0	0	30.983905	5.000001	30	43.087392	30.00001			0.095059			0	0				0	0	0	0	0	0	0						371.979296	371.978896	22.790493	3.381629	67.632602	0.135265	0.04184	33.816291	118.357044	0	26.000103	0	0	20.955221	3.38163	20.28978	29.141123	20.289786			0.06429			0	0				0	0	0	0	0	0	0						9.7127	0.256955861	2.266366377	0.361603026	1.343652113	1.621795292	0.116755231	0.995251555	2.754445162	0	1.252884444	0	0	1.117999334	1.222394677	6.635840819	0.027730042	0.827242021	0	0	1.697785235	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.2114	0	16.3243	9.7127	0.256955861	2.266366377	0.361603026	1.343652113	1.621795292	0.116755231	0.995251555	2.754445162	0	1.252884444	0	0	1.117999334	1.222394677	6.635840819	0.027730042	0.827242021	0	0	1.697785235	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.2114	2900																																																																																	0	0	0	9.7127	0.256955861	2.266366377	0.361603026	1.343652113	1.621795292	0.116755231	0.995251555	2.754445162	0	1.252884444	0	0	1.117999334	1.222394677	6.635840819	0.027730042	0.827242021	0	0	1.697785235	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.2114
H2649_012_0	2009	3	r.	s.	t.	u.	v.						Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)						4000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin	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		1439.949627	64.389733	1053.770327	1133.11937	210.523368	9.349462	2.176008	311.872052	246.609378	193.780028	510.629045	0	13.143465	565.351914	3830.49526	3465.677832	10.083558	432.040727			20.592797			2.36	3.16				0.05	2.7	0.42	2.64	0.3	1.23	0.06						$275/Day(Days 1-5):1a	$275/Day(Days 1-5):1b	"$0/Day(Days 1-20) $100(Days 21-100):2. $0 SNF 1,2. $100 SNF 2"	$5/Visit:6	$100/Trip:10a	20% Coins:11a	"0%-20% Coins:11b. 0% Supplies,11b. 20% Prosthetics"	$50/Visit:4a	"$0-$200/Visit:9b. $0 Surgery ASC -- Physician,9b. $200 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $200 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$150/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $150 Advanced Imaging -- FSR,8b. $0 Advanced Imaging -- Office,9a. $150 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$100/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$0-$100/Visit:9d. $0 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $50 OP Other,5. $35 Partial Hospitalization,8b. $50 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0-$50/Visit:7h. $50 Psych -- OP,7e. $0 Psych -- Other Provider"	"$0/Visit:7d, 9a"			"0%-20% Coins:15. 20% Part B Rx,15. 20% Part B Rx at Pharmacy,15. 0% Part B Rx - Chemo"			"DEN 756 16a, 16b"	VIS 993				$0 Additional Smoking Cessation 14a	$0 Corp Health 14a	$0: Nutritional benefit 14a	$0: Membership in health club/fitness class 14a	NSP 002	$0: Health Education Materials 14a	$0: Nurse hotline 14a						168.603047	140.545387	33.697502	4.999999	99.999977	0.199999	0.061864	50.000004	200.000034	0	47.045408	0	0	36.4557	0	0	32.718213	0			0.095059			0	0				0	0	0	0	0	0	0						135.864551	113.254987	27.154289	4.029124	80.582481	0.161164	0.049851	40.291253	161.165027	0	37.910366	0	0	29.376914	0	0	26.365154	0			0.0766			0	0				0	0	0	0	0	0	0						16.3032	0.607704864	2.384532	0.380456537	1.413707942	1.506796694	0.108476175	1.047142979	3.312067255	0	1.613177832	0	0	1.384024546	0	0	0.022154547	0	0	0	1.57740825	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6608	0	8.5067	16.3032	0.607704864	2.384532	0.380456537	1.413707942	1.506796694	0.108476175	1.047142979	3.312067255	0	1.613177832	0	0	1.384024546	0	0	0.022154547	0	0	0	1.57740825	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6608	4000																																																																																	0	0	0	16.3032	0.607704864	2.384532	0.380456537	1.413707942	1.506796694	0.108476175	1.047142979	3.312067255	0	1.613177832	0	0	1.384024546	0	0	0.022154547	0	0	0	1.57740825	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6608
H2649_015_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)																		D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin		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							0		1746.014085	78.075912	1277.751526	1373.966382	255.270574	13.746343	3.199346	378.161143	299.026746	234.968399	619.164369	0	15.937138	685.518704	4644.675445	4202.315269	12.22684	523.871933			30.277214		4.9	2.36	3.16				0.05	2.7	0.42	2.64	1.23	0.06							$0/Day(Days 1-5):1a	$0/Day(Days 1-5):1b	$0/Day(Days 1-100) $0(Days 101-100):2	$0/Visit:6	$0/Trip:10a	0% Coins:11a	0% Coins:11b	$25/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"$0/Visit:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			0% Coins:15		$0 Other - Transportation 10b	"DEN 756 16a, 16b"	VIS 993				$0 Additional Smoking Cessation 14a	$0 Corp Health 14a	$0: Nutritional benefit 14a	$0: Membership in health club/fitness class 14a	$0: Health Education Materials 14a	$0: Nurse hotline 14a							0	0	0	0	0	0	0	25.000009	0	0	0	0	0	0	0	0	0	0			0		0	0	0				0	0	0	0	0	0							0	0	0	0	0	0	0	25.000009	0	0	0	0	0	0	0	0	0	0			0		0	0	0				0	0	0	0	0	0							0	0	0	0	0	0	0	0.787835998	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7878	0	0	0	0	0	0	0	0	0	0.787835998	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7878																																																																																		0	0	0	0	0	0	0	0	0	0	0.787835998	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7878
H2649_016_0	2009	4	r.	s.	t.	u.	v.						Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)						2900											A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin	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		302.835588	8.01174	1153.354926	1240.202702	230.418487	11.200064	2.606721	341.34494	269.914739	212.092847	558.885091	0	14.385564	618.779441	4192.489065	3793.195247	11.036487	472.869931			24.668869			2.36	3.16				0.05	2.7	0.42	2.64	0.3	1.23	0.06						$550/Admit:1a	$550/Admit:1b	"$0/Day(Days 1-20) $100(Days 21-100):2. $0 SNF 1,2. $100 SNF 2"	$5/Visit:6	$100/Trip:10a	20% Coins:11a	"0%-20% Coins:11b. 0% Supplies,11b. 20% Prosthetics"	$50/Visit:4a	"$0-$175/Visit:9b. $0 Surgery ASC -- Physician,9b. $175 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $175 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$100/Visit:14h. $20 DMAM -- OP,8b. $20 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $20 Radiology OP -- Facility"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$0-$50/Visit:9d. $0 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $30 Partial Hospitalization,8b. $20 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$5/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$50/Visit:7h. $50 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30/Visit:7d, 9a"			"0%-20% Coins:15. 20% Part B Rx,15. 20% Part B Rx at Pharmacy,15. 0% Part B Rx - Chemo"			"DEN 756 16a, 16b"	VIS 993				$0 Additional Smoking Cessation 14a	$0 Corp Health 14a	$0: Nutritional benefit 14a	$0: Membership in health club/fitness class 14a	NSP 002	$0: Health Education Materials 14a	$0: Nurse hotline 14a						549.999982	550.000374	33.697502	4.999998	99.999996	0.2	0.061864	50.000014	175.000017	0	37.677161	0	0	30.983931	4.999998	29.999999	43.086536	30.000004			0.095059			0	0				0	0	0	0	0	0	0						377.894537	377.894807	23.152913	3.435404	68.708097	0.137416	0.042505	34.35406	120.239186	0	25.887262	0	0	21.28847	3.435404	20.612429	29.60394	20.612433			0.065313			0	0				0	0	0	0	0	0	0						9.5367	0.252299578	2.225293855	0.355049777	1.319301313	1.539067995	0.110798676	0.977215379	2.704527376	0	1.205667065	0	0	1.097738964	1.200241142	6.515580643	0.027226958	0.812249981	0	0	1.611197841	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.4901	0	15.2132	9.5367	0.252299578	2.225293855	0.355049777	1.319301313	1.539067995	0.110798676	0.977215379	2.704527376	0	1.205667065	0	0	1.097738964	1.200241142	6.515580643	0.027226958	0.812249981	0	0	1.611197841	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.4901	2900																																																																																	0	0	0	9.5367	0.252299578	2.225293855	0.355049777	1.319301313	1.539067995	0.110798676	0.977215379	2.704527376	0	1.205667065	0	0	1.097738964	1.200241142	6.515580643	0.027226958	0.812249981	0	0	1.611197841	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.4901
H2649_801_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		298.34483	7.892933	1136.251797	1221.811705	7.268347	10.87036	2.529985	20.5193	38.056877	208.947717	23.876638	0	0.523201	12.514437	43.545489	75.451344	0.294932	3.476386			23.942673																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000006	1023.99957	43.132795	0	0.199999	0.2	0.2	0.2	0.199999	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500003	0.2			0.2																				1024.000006	1023.99957	43.132795	0	0.199999	0.2	0.2	0.2	0.199999	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500003	0.2			0.2																				25.4588	0.67353	4.084142986	0	1.453662132	2.174072	0.505997	4.10386	7.611337343	0	4.7753276	0	0.104639677	2.502874886	8.7090978	15.09019335	0.147466885	0.6952772	0	0	4.7885346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.8788	0	0	25.4588	0.67353	4.084142986	0	1.453662132	2.174072	0.505997	4.10386	7.611337343	0	4.7753276	0	0.104639677	2.502874886	8.7090978	15.09019335	0.147466885	0.6952772	0	0	4.7885346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.8788																																																																																		0	0	0	25.4588	0.67353	4.084142986	0	1.453662132	2.174072	0.505997	4.10386	7.611337343	0	4.7753276	0	0.104639677	2.502874886	8.7090978	15.09019335	0.147466885	0.6952772	0	0	4.7885346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.8788
H2649_802_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		305.231683	8.07513	1162.4805	1250.015431	7.607768	11.37799	2.648131	21.477522	39.834079	213.77097	24.991643	0	0.547633	13.098843	45.579001	78.974814	0.308705	3.638728			25.060761																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000001	1024.000356	43.1328	0	0.2	0.2	0.199999	0.199999	0.2	0	0.199999	0	0.2	0.199999	0.199999	0.2	0.500001	0.2			0.2																				1024.000001	1024.000356	43.1328	0	0.2	0.2	0.199999	0.199999	0.2	0	0.199999	0	0.2	0.199999	0.199999	0.2	0.500001	0.2			0.2																				26.0464	0.689078	4.178419909	0	1.5215536	2.275598	0.529623552	4.295482922	7.9668158	0	4.998303608	0	0.1095266	2.619755501	9.115754621	15.7949628	0.154352809	0.7277456	0	0	5.0121522	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.0356	0	0	26.0464	0.689078	4.178419909	0	1.5215536	2.275598	0.529623552	4.295482922	7.9668158	0	4.998303608	0	0.1095266	2.619755501	9.115754621	15.7949628	0.154352809	0.7277456	0	0	5.0121522	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.0356																																																																																		0	0	0	26.0464	0.689078	4.178419909	0	1.5215536	2.275598	0.529623552	4.295482922	7.9668158	0	4.998303608	0	0.1095266	2.619755501	9.115754621	15.7949628	0.154352809	0.7277456	0	0	5.0121522	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.0356
H2649_803_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		298.34483	7.892933	1136.251797	1221.811705	7.268347	10.87036	2.529985	20.5193	38.056877	208.947717	23.876638	0	0.523201	12.514437	43.545489	75.451344	0.294932	3.476386			23.942673																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000006	1023.99957	43.132795	0	0.199999	0.2	0.2	0.2	0.199999	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500003	0.2			0.2																				1024.000006	1023.99957	43.132795	0	0.199999	0.2	0.2	0.2	0.199999	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500003	0.2			0.2																				25.4588	0.67353	4.084142986	0	1.453662132	2.174072	0.505997	4.10386	7.611337343	0	4.7753276	0	0.104639677	2.502874886	8.7090978	15.09019335	0.147466885	0.6952772	0	0	4.7885346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.8788	0	0	25.4588	0.67353	4.084142986	0	1.453662132	2.174072	0.505997	4.10386	7.611337343	0	4.7753276	0	0.104639677	2.502874886	8.7090978	15.09019335	0.147466885	0.6952772	0	0	4.7885346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.8788																																																																																		0	0	0	25.4588	0.67353	4.084142986	0	1.453662132	2.174072	0.505997	4.10386	7.611337343	0	4.7753276	0	0.104639677	2.502874886	8.7090978	15.09019335	0.147466885	0.6952772	0	0	4.7885346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.8788
H2649_804_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		298.34483	7.892933	1136.251797	1221.811705	7.268347	10.87036	2.529985	20.5193	38.056877	208.947717	23.876638	0	0.523201	12.514437	43.545489	75.451344	0.294932	3.476386			23.942673																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000006	1023.99957	43.132795	0	0.199999	0.2	0.2	0.2	0.199999	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500003	0.2			0.2																				1024.000006	1023.99957	43.132795	0	0.199999	0.2	0.2	0.2	0.199999	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500003	0.2			0.2																				25.4588	0.67353	4.084142986	0	1.453662132	2.174072	0.505997	4.10386	7.611337343	0	4.7753276	0	0.104639677	2.502874886	8.7090978	15.09019335	0.147466885	0.6952772	0	0	4.7885346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.8788	0	0	25.4588	0.67353	4.084142986	0	1.453662132	2.174072	0.505997	4.10386	7.611337343	0	4.7753276	0	0.104639677	2.502874886	8.7090978	15.09019335	0.147466885	0.6952772	0	0	4.7885346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.8788																																																																																		0	0	0	25.4588	0.67353	4.084142986	0	1.453662132	2.174072	0.505997	4.10386	7.611337343	0	4.7753276	0	0.104639677	2.502874886	8.7090978	15.09019335	0.147466885	0.6952772	0	0	4.7885346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.8788
H2654_004_0	2009	5																					4200											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1577.756855	131.5406278	935.1076978	1064.86281	172.0958693	10.09997656	4.466435664	359.4237103	32.83576063	6770.170479	40.52961633	0	0.245282401	25.99461117	5282.085231	3029.205027	618.4500141	139.8954108	0	0	20.10173871	2309.453605	389.5729932	0	292.3918341	283.2014125	18.89900156	11.22	113.0208403	0											"$245 Days 1-18 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$245 Days 1-18 (1b); $0 n/c (1b1, 1b2)"	"$85 Days 1-50 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 25% (9a); $40/$30 (9c)"	"$15 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$10 (17b1, 17b3); $0 n/c (17b2, 17b5); $5 (17b4)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											242.1144585	245	85	0	150	0.2	0.072871122	48.4341859	0.25	2.8	0.188483107	0	0.2	0.24674048	10.33356902	30	37.5	30	0	0	0.2	29.40398004	0	0	30	12.48137272	30	0	0	0											183.2008052	185.3681772	64.31140843	0	113.4907208	0.151320961	0.055134641	36.64553778	0.189151201	2.118493454	0.142607225	0	0.151320961	0.186907671	10.33356902	30	37.5	22.69814415	0	0	0.151320961	29.40398004	0	0	30	12.48137272	30	0	0	0											24.0872	2.031953867	5.011507757	0	1.62760702	1.52833816	0.246255326	1.097606263	6.210923568	1.195213487	5.779816097	0	0.037116369	4.858592241	4.548566025	7.573012567	1.932656294	0.26461385	0	0	3.041814419	5.65892731	0	0	0.730979585	0.294561865	0.047247504	0	0	0	0	0	0	0	0	0	0	0	0	0	77.8045	0	18.3321	24.0872	2.031953867	5.011507757	0	1.62760702	1.52833816	0.246255326	1.097606263	6.210923568	1.195213487	5.779816097	0	0.037116369	4.858592241	4.548566025	7.573012567	1.932656294	0.26461385	0	0	3.041814419	5.65892731	0	0	0.730979585	0.294561865	0.047247504	0	0	0	0	0	0	0	0	0	0	0	0	0	77.8045																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.0872	2.031953867	5.011507757	0	1.62760702	1.52833816	0.246255326	1.097606263	6.210923568	1.195213487	5.779816097	0	0.037116369	4.858592241	4.548566025	7.573012567	1.932656294	0.26461385	0	0	3.041814419	5.65892731	0	0	0.730979585	0.294561865	0.047247504	0	0	0	0	0	0	0	0	0	0	0	0	0	77.8045
H2654_010_0	2009	6																					2400											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2400	973.966241	103.4725524	542.8302686	933.1442517	11.74174101	10.16645414	3.992538214	597.9643688	34.23695376	6613.049385	32.83327784	0	0.016840621	38.02977553	4227.769563	3166.969879	579.3321411	210.7142456	0	0	4.599341503	586.7407929	329.0242767	0	128.4357708	286.4553818	17.95380801	0	468.0812494	0											"$150 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$150 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-24 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$15 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$10 (17b1, 17b3); $0 n/c (17b2, 17b5); $5 (17b4)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											148.2901508	150	100	0	150	0.2	0.059610497	46.78713408	0.2	2.8	0.19038125	0	0.2	0.198756088	9.661176471	30	37.5	30	0	0	0.2	29.62700864	0	0	22.32730784	12.29691901	30	0	0	0											107.9204451	109.1372121	72.75814138	0	109.1372121	0.145516283	0.043371489	34.04144916	0.145516283	2.037227959	0.138517859	0	0.145516283	0.144772557	9.661176471	30	37.5	21.82744241	0	0	0.145516283	29.62700864	0	0	22.32730784	12.29691901	30	0	0	0											8.7592	0.941058825	3.291276785	0	0.106788407	1.479384616	0.173162329	1.696297805	4.982034244	1.122690758	4.547995362	0	0.002450585	5.505667838	3.403768986	7.917424697	1.810412941	0.383279422	0	0	0.669279079	1.448614545	0	0	0.238968749	0.293543219	0.04488452	0	0	0	0	0	0	0	0	0	0	0	0	0	48.8182	0	12.5916	8.7592	0.941058825	3.291276785	0	0.106788407	1.479384616	0.173162329	1.696297805	4.982034244	1.122690758	4.547995362	0	0.002450585	5.505667838	3.403768986	7.917424697	1.810412941	0.383279422	0	0	0.669279079	1.448614545	0	0	0.238968749	0.293543219	0.04488452	0	0	0	0	0	0	0	0	0	0	0	0	0	48.8182		"$200 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$200 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-16 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.564	0.0577	0.2272	0.0895	0.0049	0.1021	0.0401	0.0781	0.3439	0.0517	0.3071	0	0.0001	0.3785	0.2647	0.4837	0.108	0.0206	0	0	0.0462	0.089	0	0	0.0126	0	0.0028	0	0	0											3.2723	0	1.320871366	9.3233	0.998796031	3.518449371	0.089509973	0.111702284	1.581495635	0.213263051	1.774353098	5.325907359	1.174351472	4.855094961	0	0.002563348	5.884191456	3.668460851	8.401102365	1.918402485	0.403855498	0	0	0.715474482	1.537564561	0	0	0.251546052	0.293543219	0.047640587	0	0	0	0	0	0	0	0	0	0	0	0	0	52.0905
H2654_013_0	2009	5																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1232.987566	113.7470752	544.8620562	820.1104564	140.2406367	7.060099269	3.644367336	346.5797281	26.19494994	6250.150969	35.986386	0	0.163801971	20.07387518	4655.203043	2622.091501	638.2480783	119.8946072	0	0	19.60521501	2299.458014	387.8033425	0	290.6948241	283.5707552	18.8131521	0	112.5074387	0											"$195 Days 1-15/$260 Days 1-12/$300 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$260 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$95 Days 1-28 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$10 (8a1); $10 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$10 (17b1, 17b3); $0 n/c (17b2, 17b5); $5 (17b4)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											251.4160822	260	75.92328607	0	150	0.2	0.065191659	48.89001009	0.2	4	0.229430523	0	0.2	0.197646003	6.856743312	29.99665228	37.5	30	0	0	0.2	29.40816896	0	0	30	12.46688375	30	0	0	0											173.2559858	179.1446754	52.31250939	0	103.3526974	0.137803596	0.044918225	33.68609612	0.137803596	2.75607193	0.158081756	0	0.137803596	0.136649926	6.856743312	29.99665228	37.5	20.67053947	0	0	0.137803596	29.40816896	0	0	30	12.46688375	30	0	0	0											17.8019	1.698098573	2.375258453	0	1.207854007	0.972907071	0.163698513	0.972909836	3.609758312	1.435488804	5.688791092	0	0.022572501	2.743093549	2.659961028	6.55449725	1.994525245	0.206523851	0	0	2.701669138	5.635237481	0	0	0.72673706	0.294603637	0.04703288	0	0	0	0	0	0	0	0	0	0	0	0	0	59.5131	0	18.7585	17.8019	1.698098573	2.375258453	0	1.207854007	0.972907071	0.163698513	0.972909836	3.609758312	1.435488804	5.688791092	0	0.022572501	2.743093549	2.659961028	6.55449725	1.994525245	0.206523851	0	0	2.701669138	5.635237481	0	0	0.72673706	0.294603637	0.04703288	0	0	0	0	0	0	0	0	0	0	0	0	0	59.5131	2900	"$350 Days 1-9 (1a); $0 (1a1); $0 n/c (1a2, 1a3, 13c)"	"$0 n/c (1b, 1b1, 1b2)"	"$0 n/c (2a, 2a1, 2a2)"	"$0 n/c (6a, 6a1, 6a2, 6a3)"	$0 n/c (10a)	$0 n/c (11a)	"$0 n/c (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	35% (9b)	35%/$10 (8a1); $10 (8a2)	"$20 (8b1); 35% (8b2, 8b3)"	Included in h.5.	$0 n/c (12)	"35% (3, 9a, 9d); $0 n/c (5); $45/$35 (9c)"	"$0 n/c (7a, 7a1, 14b, 14b1, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1)"	"$45/$35 (7e, 7h)"	"35% (7c, 7i)"	Included in h.2.	$0 n/c (7g)	"$0 n/c (15, 15a1, 15a2)"	"$0 n/c (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											5.7422	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											5.7422	0	2.591684052	23.5441	1.698098573	2.375258453	0	1.207854007	0.972907071	0.163698513	0.972909836	3.609758312	1.435488804	5.688791092	0	0.022572501	2.743093549	2.659961028	6.55449725	1.994525245	0.206523851	0	0	2.701669138	5.635237481	0	0	0.72673706	0.294603637	0.04703288	0	0	0	0	0	0	0	0	0	0	0	0	0	65.2553
H2654_020_0	2009	4																					3800											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1657.263607	129.5588683	901.3092748	905.324187	155.5754143	9.560398137	3.75155014	344.3591869	32.05599105	6531.548151	40.3881003	0	0.189598386	24.59707582	5207.879998	3007.334331	616.5291395	121.1284759	0	0	18.08636972	2295.233605	386.7885662	0	289.7261524	280.7282995	18.76392318	11.13955749	112.2130372	0											"$245 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$245 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$85 Days 1-45 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 25% (9a); $40/$30 (9c)"	"$15 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$10 (17b1, 17b3); $0 n/c (17b2, 17b5); $5 (17b4)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											242.1114753	245	85	0	150	0.2	0.078585786	48.41544853	0.25	2.8	0.188436971	0	0.2	0.247122141	10.08554379	30	37.5	30	0	0	0.2	29.40461267	0	0	30	12.48534114	30	0	0	0											177.8057233	179.9105043	62.41793008	0	110.1492884	0.146865718	0.057707789	35.55284801	0.183582147	2.05612005	0.138374655	0	0.146865718	0.18172384	10.08554379	30	37.5	22.02985767	0	0	0.146865718	29.40461267	0	0	30	12.48534114	30	0	0	0											24.5559	1.942416778	4.688154941	0	1.428043431	1.404094735	0.216493665	1.020245819	5.884907671	1.119137259	5.588689456	0	0.027845503	4.469875063	4.37702515	7.518335827	1.926653561	0.222370257	0	0	2.656267671	5.624204595	0	0	0.724315381	0.292082382	0.046909808	0	0	0	0	0	0	0	0	0	0	0	0	0	75.734	0	19.9679	24.5559	1.942416778	4.688154941	0	1.428043431	1.404094735	0.216493665	1.020245819	5.884907671	1.119137259	5.588689456	0	0.027845503	4.469875063	4.37702515	7.518335827	1.926653561	0.222370257	0	0	2.656267671	5.624204595	0	0	0.724315381	0.292082382	0.046909808	0	0	0	0	0	0	0	0	0	0	0	0	0	75.734																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.5559	1.942416778	4.688154941	0	1.428043431	1.404094735	0.216493665	1.020245819	5.884907671	1.119137259	5.588689456	0	0.027845503	4.469875063	4.37702515	7.518335827	1.926653561	0.222370257	0	0	2.656267671	5.624204595	0	0	0.724315381	0.292082382	0.046909808	0	0	0	0	0	0	0	0	0	0	0	0	0	75.734
H2654_022_0	2009	3																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1123.382039	111.797421	502.6680477	720.9981482	140.6021654	6.749376518	3.072494968	366.2084734	24.75785844	6093.167374	35.5069104	0	0.156857609	18.51564063	4459.023712	2524.504188	632.8684293	147.4172742	0	0	16.59093014	2293.894186	386.7253117	0	289.3956407	281.9891611	18.76085457	0	112.1946861	0											"$195 Days 1-11/$260 Days 1-9/$300 Days 1-7 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$260 Days 1-9 (1b); $0 n/c (1b1, 1b2)"	"$95 Days 1-23 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$10 (8a1); $10 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$10 (17b1, 17b3); $0 n/c (17b2, 17b5); $5 (17b4)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											251.4225927	260	95	0	150	0.2	0.065742784	48.91817906	0.2	4	0.228406985	0	0.2	0.198015685	6.770307729	29.99732591	37.5	30	0	0	0.2	29.40725624	0	0	30	12.47382378	30	0	0	0											156.009506	161.2962221	58.93515806	0	93.05551272	0.124074017	0.040784857	30.34737489	0.124074017	2.481480339	0.141696861	0	0.124074017	0.123432643	6.770307729	29.99732591	37.5	18.61110254	0	0	0.124074017	29.40725624	0	0	30	12.47382378	30	0	0	0											14.6049	1.50270847	2.46873507	0	1.090317216	0.837422257	0.125311266	0.926122153	3.071806947	1.260006254	5.031217734	0	0.019461954	2.285434465	2.515746892	6.310697907	1.977713842	0.228633167	0	0	2.058503348	5.621427842	0	0	0.723489102	0.293123592	0.046902136	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9996	0	21.7076	14.6049	1.50270847	2.46873507	0	1.090317216	0.837422257	0.125311266	0.926122153	3.071806947	1.260006254	5.031217734	0	0.019461954	2.285434465	2.515746892	6.310697907	1.977713842	0.228633167	0	0	2.058503348	5.621427842	0	0	0.723489102	0.293123592	0.046902136	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9996	2100	"$350 Days 1-6 (1a); $0 (1a1); $0 n/c (1a2, 1a3, 13c)"	"$0 n/c (1b, 1b1, 1b2)"	"$0 n/c (2a, 2a1, 2a2)"	"$0 n/c (6a, 6a1, 6a2, 6a3)"	$0 n/c (10a)	$0 n/c (11a)	"$0 n/c (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	35% (9b)	35%/$10 (8a1); $10 (8a2)	"$20 (8b1); 35% (8b2, 8b3)"	Included in h.5.	$0 n/c (12)	"35% (3, 9a, 9d); $0 n/c (5); $45/$35 (9c)"	"$0 n/c (7a, 7a1, 14b, 14b1, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1)"	"$45/$35 (7e, 7h)"	"35% (7c, 7i)"	Included in h.2.	$0 n/c (7g)	"$0 n/c (15, 15a1, 15a2)"	"$0 n/c (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											4.7105	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											4.7105	0	2.882529067	19.3153	1.50270847	2.46873507	0	1.090317216	0.837422257	0.125311266	0.926122153	3.071806947	1.260006254	5.031217734	0	0.019461954	2.285434465	2.515746892	6.310697907	1.977713842	0.228633167	0	0	2.058503348	5.621427842	0	0	0.723489102	0.293123592	0.046902136	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7101
H2654_023_0	2009	7																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		306.438905	23.22	31.08163909	3753.912512	10.17898566	33.53225961	11.02742058	34.28671548	43.78318544	13.32264915	27.93135242	0	1.823993275	52.52556299	41.34908345	124.1322974	14.57	3.864536868	0	0	21.74069479	6.569638571	365.1399043	0	272.2898029	308.8613942	0	0	20.2	0											"8% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"8% (1b); $0 n/c (1b1, 1b2)"	20.8% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.079291995	0.0803	0.2078	0	0.2	0.2	0.2	0.098590318	0.2	0.08	0.2	0	0.2	0.2	0	0.199673052	0.2	0.2	0	0	0.2	0.027225225	0	0	0	0	0	0	0	0											0.079291995	0.0803	0.2078	0	0.2	0.2	0.2	0.098590318	0.2	0.08	0.2	0	0.2	0.2	0	0.199673052	0.2	0.2	0	0	0.2	0.027225225	0	0	0	0	0	0	0	0											24.2982	1.864566	6.458764603	0	2.035797133	6.706451922	2.205484116	3.380338173	8.756637089	1.065811932	5.586270485	0	0.364798655	10.5051126	0	24.7858747	2.914	0.772907374	0	0	4.348138959	0.178859889	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.228	0	0	24.2982	1.864566	6.458764603	0	2.035797133	6.706451922	2.205484116	3.380338173	8.756637089	1.065811932	5.586270485	0	0.364798655	10.5051126	0	24.7858747	2.914	0.772907374	0	0	4.348138959	0.178859889	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.228																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.2982	1.864566	6.458764603	0	2.035797133	6.706451922	2.205484116	3.380338173	8.756637089	1.065811932	5.586270485	0	0.364798655	10.5051126	0	24.7858747	2.914	0.772907374	0	0	4.348138959	0.178859889	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.228
H2654_024_0	2009	6																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		386.9103972	23.21	39.62229517	2766.260921	15.3570126	22.35378907	9.213589993	27.98539716	35.87600471	12.93412595	38.73550319	0	1.715747938	47.23106507	29.17872109	116.5306118	14.57	3.089758669	0	0	18.46359987	3.290289099	365.1399043	0	356.6636621	412.2283099	0	0	20.2	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.078894404	0.079911785	0.19112431	0	0.2	0.2	0.2	0.103261376	0.2	0.08	0.2	0	0.2	0.2	0	0.199803669	0.2	0.2	0	0	0.2	0.019744549	0	0	0	0	0	0	0	0											0.078894404	0.079911785	0.19112431	0	0.2	0.2	0.2	0.103261376	0.2	0.08	0.2	0	0.2	0.2	0	0.199803669	0.2	0.2	0	0	0.2	0.019744549	0	0	0	0	0	0	0	0											30.5251	1.854752518	7.572783819	0	3.071402521	4.470757814	1.842717999	2.889810617	7.175200942	1.034730076	7.747100639	0	0.343149588	9.446213013	0	23.28324378	2.914	0.617951734	0	0	3.692719974	0.064965276	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.5466	0	0	30.5251	1.854752518	7.572783819	0	3.071402521	4.470757814	1.842717999	2.889810617	7.175200942	1.034730076	7.747100639	0	0.343149588	9.446213013	0	23.28324378	2.914	0.617951734	0	0	3.692719974	0.064965276	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.5466																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	30.5251	1.854752518	7.572783819	0	3.071402521	4.470757814	1.842717999	2.889810617	7.175200942	1.034730076	7.747100639	0	0.343149588	9.446213013	0	23.28324378	2.914	0.617951734	0	0	3.692719974	0.064965276	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.5466
H2654_026_0	2009	4																					2900											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1904.097678	277.1702726	43.52828684	51720.02335	90.05050004	21.79919534	9.638022811	367.9983762	385.8161055	6110.056836	467.274704	0	0.871757919	1488.850857	6022.402115	4461.848898	1301.980366	266.0610409	0	0	28.08060034	1126.573703	810.5086242	0	327.7093149	349.7142857	0	0	20.2	0											"$225 Days 1-13 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$225 Days 1-13 (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$75 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5, 9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											222.3	225	0.190699864	0	75	0.14	0.2	49.97282597	75	4.4	64.79010385	0	0.2	70.38039106	3.252634331	25	20	20	0	0	0.2	13.67894853	0	0	0	0	0	0	0	0											152.7879376	154.6436615	0.190699864	0	51.54788717	0.096222723	0.137461032	34.34658126	51.54788717	3.024142714	44.53057284	0	0.137461032	48.3728061	3.252634331	25	20	20	0	0	0.137461032	13.67894853	0	0	0	0	0	0	0	0											24.2436	3.571885485	8.300838389	0	0.386826085	2.097577928	1.324852566	1.053290511	1.657333756	1.539806988	1.734000853	0	0.119832744	6.001657816	1.632389323	9.295518537	2.169967277	0.443435068	0	0	3.859988315	1.284195309	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.717	0	21.6517	24.2436	3.571885485	8.300838389	0	0.386826085	2.097577928	1.324852566	1.053290511	1.657333756	1.539806988	1.734000853	0	0.119832744	6.001657816	1.632389323	9.295518537	2.169967277	0.443435068	0	0	3.859988315	1.284195309	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.717																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.2436	3.571885485	8.300838389	0	0.386826085	2.097577928	1.324852566	1.053290511	1.657333756	1.539806988	1.734000853	0	0.119832744	6.001657816	1.632389323	9.295518537	2.169967277	0.443435068	0	0	3.859988315	1.284195309	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.717
H2654_027_0	2009	4																					2500											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1769.212954	264.0889438	37.57970351	48056.21916	83.6713962	18.82011347	8.320888918	341.9438398	358.4852079	5677.225402	434.1733458	0	0.752623329	1384.584982	5601.042088	4145.775168	1301.980366	247.2134942	0	0	24.17477047	1046.768142	810.5086242	0	327.7093149	349.7142857	0	0	20.2	0											"$175 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	20.8% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$75 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5, 9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											172.9	175	0.2078	0	75	0.14	0.2	49.97075543	75	4.4	64.79010385	0	0.2	70.33226955	3.249578574	25	20	20	0	0	0.2	13.67894853	0	0	0	0	0	0	0	0											122.1287426	123.6120876	0.2078	0	52.97660899	0.09888967	0.141270957	35.29708229	52.97660899	3.107961061	45.76479997	0	0.141270957	49.67953524	3.249578574	25	20	20	0	0	0.141270957	13.67894853	0	0	0	0	0	0	0	0											18.006	2.720382139	7.809062389	0	0.36938557	1.861114813	1.175499943	1.005801654	1.582610891	1.470382957	1.65582136	0	0.106323818	5.732128199	1.516752197	8.6370316	2.169967277	0.41202249	0	0	3.415192968	1.193223962	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.8387	0	16.2549	18.006	2.720382139	7.809062389	0	0.36938557	1.861114813	1.175499943	1.005801654	1.582610891	1.470382957	1.65582136	0	0.106323818	5.732128199	1.516752197	8.6370316	2.169967277	0.41202249	0	0	3.415192968	1.193223962	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.8387																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.006	2.720382139	7.809062389	0	0.36938557	1.861114813	1.175499943	1.005801654	1.582610891	1.470382957	1.65582136	0	0.106323818	5.732128199	1.516752197	8.6370316	2.169967277	0.41202249	0	0	3.415192968	1.193223962	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.8387
H2654_801_0	2009	2																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1432.070146	149.8122991	598.0564385	1042.572205	116.3462115	10.21401967	6.098613224	297.612232	39.29114898	8203.647099	53.5561578	0	0.096981094	29.90859961	5873.665558	3616.469596	622.151217	174.9202042	0	0	22.03136355	4007.455584	0	0	0	0	0	0	0	0											"$335 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$335 (1b); $0 n/c (1b1, 1b2)"	"$150 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$50 (3, 9d); $60 (5); 25% (9a); $40/$30 (9c)"	"$40 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$50 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$50 (7c, 7i)"	Included in h.2.	$40 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $50 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											331.0356942	335	150	0	150	0.2	0.070977998	48.56349757	0.25	2.8	0.223020157	0	0.2	0.245819386	26.45709442	49.3684159	37.5	50	0	0	0.2	49.33634053	0	0	0	0	0	0	0	0											331.0356942	335	150	0	150	0.2	0.070977998	48.56349757	0.25	2.8	0.223020157	0	0.2	0.245819386	26.45709442	49.3684159	37.5	50	0	0	0.2	49.33634053	0	0	0	0	0	0	0	0											39.5055	4.182260015	7.475705481	0	1.454327643	2.042803933	0.432867357	1.204424242	9.822787244	1.914184323	11.94410274	0	0.019396219	7.352113588	12.95001036	14.87828126	1.944222553	0.728834184	0	0	4.40627271	16.47609944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.7342	0	0	39.5055	4.182260015	7.475705481	0	1.454327643	2.042803933	0.432867357	1.204424242	9.822787244	1.914184323	11.94410274	0	0.019396219	7.352113588	12.95001036	14.87828126	1.944222553	0.728834184	0	0	4.40627271	16.47609944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.7342																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	39.5055	4.182260015	7.475705481	0	1.454327643	2.042803933	0.432867357	1.204424242	9.822787244	1.914184323	11.94410274	0	0.019396219	7.352113588	12.95001036	14.87828126	1.944222553	0.728834184	0	0	4.40627271	16.47609944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.7342
H2654_802_0	2009	3																					6000											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1531.996313	152.3634961	587.527627	902.3848778	125.7049318	9.923071972	4.649427429	290.6441757	37.94482948	8505.368283	58.7533897	0	0.074318339	35.26347798	6062.131789	3758.656917	618.4528556	177.4157355	0	0	26.61627139	4016.156102	0	0	0	0	0	0	0	0											"$600 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$600 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-40 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$50 (3, 9d); $60 (5); 25% (9a); $40/$30 (9c)"	"$40 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$50 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$50 (7c, 7i)"	Included in h.2.	$40 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $50 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											592.8401583	600	150	0	150	0.2	0.086574119	48.88012765	0.25	2.8	0.223327155	0	0.2	0.245247882	26.34866714	49.29359239	37.5	50	0	0	0.2	49.30832225	0	0	0	0	0	0	0	0											416.2174429	421.2239954	105.3059989	0	105.3059989	0.140407998	0.060778494	34.31580444	0.175509998	1.965711979	0.156784594	0	0.140407998	0.172374422	26.34866714	49.29359239	37.5	35.10199962	0	0	0.140407998	49.30832225	0	0	0	0	0	0	0	0											53.137	5.348263382	5.155848635	0	1.103123617	1.393278674	0.282585197	0.831140725	6.65969695	1.393258693	9.211626371	0	0.010434889	6.078521633	13.31075772	15.4398085	1.932665174	0.51897059	0	0	3.737137393	16.50249327	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.0466	0	40.2472	53.137	5.348263382	5.155848635	0	1.103123617	1.393278674	0.282585197	0.831140725	6.65969695	1.393258693	9.211626371	0	0.010434889	6.078521633	13.31075772	15.4398085	1.932665174	0.51897059	0	0	3.737137393	16.50249327	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.0466																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	53.137	5.348263382	5.155848635	0	1.103123617	1.393278674	0.282585197	0.831140725	6.65969695	1.393258693	9.211626371	0	0.010434889	6.078521633	13.31075772	15.4398085	1.932665174	0.51897059	0	0	3.737137393	16.50249327	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.0466
H2654_803_0	2009	2																					5760											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	968.4957807	125.6595055	466.7487852	1029.801461	10.12328022	10.94564382	4.835987078	612.9702384	37.28657262	7613.605749	39.35017652	0	0.017155266	44.49705487	4978.080386	3650.035962	628.4667807	305.9943237	0	0	6.813025571	681.4613697	0	0	0	0	0	0	0	0											"$360 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$360 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-39 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 25% (9a); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											355.7630822	360	150	0	150	0.2	0.059640859	46.72878104	0.25	2.8	0.226893819	0	0.2	0.248209363	15.74688655	34.8277196	37.5	35	0	0	0.2	34.5128983	0	0	0	0	0	0	0	0											291.8369456	295.2926594	123.0386081	0	123.0386081	0.164051477	0.048920855	38.32962784	0.205064347	2.296720684	0.186111331	0	0.164051477	0.203694287	15.74688655	34.8277196	37.5	28.70900855	0	0	0.164051477	34.5128983	0	0	0	0	0	0	0	0											23.5536	3.092194131	4.785676739	0	0.103796192	1.79564904	0.236580622	1.957910093	7.646146659	1.457193817	7.32351373	0	0.002814347	9.06379587	6.532438923	10.59353575	1.96395869	0.732066138	0	0	1.117686911	1.959933912	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.9185	0	13.7691	23.5536	3.092194131	4.785676739	0	0.103796192	1.79564904	0.236580622	1.957910093	7.646146659	1.457193817	7.32351373	0	0.002814347	9.06379587	6.532438923	10.59353575	1.96395869	0.732066138	0	0	1.117686911	1.959933912	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.9185																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.5536	3.092194131	4.785676739	0	0.103796192	1.79564904	0.236580622	1.957910093	7.646146659	1.457193817	7.32351373	0	0.002814347	9.06379587	6.532438923	10.59353575	1.96395869	0.732066138	0	0	1.117686911	1.959933912	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.9185
H2654_804_0	2009	2																					5760											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	968.4957916	125.659507	466.7487905	1029.801473	10.12328034	10.94564406	4.835987187	612.9702452	37.28657346	7613.605834	39.3501774	0	0.017155266	44.49705587	4978.080442	3650.036003	628.4667878	305.9943272	0	0	6.813025724	681.4613774	0	0	0	0	0	0	0	0											"$360 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$360 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-39 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 25% (9a); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											355.7630822	360	150	0	150	0.2	0.059640859	46.72878104	0.25	2.8	0.226893819	0	0.2	0.248209363	15.74688655	34.82771963	37.5	35	0	0	0.2	34.5128983	0	0	0	0	0	0	0	0											291.8369443	295.2926582	123.0386076	0	123.0386076	0.164051477	0.048920855	38.32962768	0.205064346	2.296720675	0.18611133	0	0.164051477	0.203694286	15.74688655	34.82771963	37.5	28.70900843	0	0	0.164051477	34.5128983	0	0	0	0	0	0	0	0											23.5536	3.092194153	4.785676772	0	0.103796193	1.795649072	0.236580626	1.957910107	7.646146798	1.457193827	7.323513851	0	0.002814347	9.063796034	6.532438996	10.59353588	1.963958712	0.732066143	0	0	1.117686931	1.959933934	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.9185	0	13.7691	23.5536	3.092194153	4.785676772	0	0.103796193	1.795649072	0.236580626	1.957910107	7.646146798	1.457193827	7.323513851	0	0.002814347	9.063796034	6.532438996	10.59353588	1.963958712	0.732066143	0	0	1.117686931	1.959933934	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.9185																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.5536	3.092194153	4.785676772	0	0.103796193	1.795649072	0.236580626	1.957910107	7.646146798	1.457193827	7.323513851	0	0.002814347	9.063796034	6.532438996	10.59353588	1.963958712	0.732066143	0	0	1.117686931	1.959933934	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.9185
H2654_805_0	2009	2																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1432.070146	149.8122991	598.0564385	1042.572205	116.3462115	10.21401967	6.098613224	297.612232	39.29114898	8203.647099	53.5561578	0	0.096981094	29.90859962	5873.665558	3616.469596	622.151217	174.9202042	0	0	22.03136355	4007.455584	0	0	0	0	0	0	0	0											"$335 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$335 (1b); $0 n/c (1b1, 1b2)"	"$150 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$50 (3, 9d); $60 (5); 25% (9a); $40/$30 (9c)"	"$40 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$50 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$50 (7c, 7i)"	Included in h.2.	$40 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $50 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											331.0356942	335	150	0	150	0.2	0.070977998	48.56349757	0.25	2.8	0.223020157	0	0.2	0.245819386	26.45709442	49.3684159	37.5	50	0	0	0.2	49.33634053	0	0	0	0	0	0	0	0											331.0356942	335	150	0	150	0.2	0.070977998	48.56349757	0.25	2.8	0.223020157	0	0.2	0.245819386	26.45709442	49.3684159	37.5	50	0	0	0.2	49.33634053	0	0	0	0	0	0	0	0											39.5055	4.182260015	7.475705481	0	1.454327643	2.042803933	0.432867357	1.204424242	9.822787244	1.914184323	11.94410274	0	0.019396219	7.352113588	12.95001036	14.87828126	1.944222553	0.728834184	0	0	4.406272711	16.47609944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.7342	0	0	39.5055	4.182260015	7.475705481	0	1.454327643	2.042803933	0.432867357	1.204424242	9.822787244	1.914184323	11.94410274	0	0.019396219	7.352113588	12.95001036	14.87828126	1.944222553	0.728834184	0	0	4.406272711	16.47609944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.7342																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	39.5055	4.182260015	7.475705481	0	1.454327643	2.042803933	0.432867357	1.204424242	9.822787244	1.914184323	11.94410274	0	0.019396219	7.352113588	12.95001036	14.87828126	1.944222553	0.728834184	0	0	4.406272711	16.47609944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.7342
H2654_806_0	2009	2																					6100											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1538.280594	152.9884943	589.9376776	906.0864794	126.220576	10.00464824	4.687649761	291.7896326	38.25676893	8540.257482	59.23639359	0	0.0749293	35.55337439	6037.49491	3774.075007	620.9897622	178.1434986	0	0	26.83508026	4032.630459	0	0	0	0	0	0	0	0											"$610 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$610 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-41 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$50 (3, 9d); $60 (5); 25% (9a); $40/$30 (9c)"	"$40 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$50 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$50 (7c, 7i)"	Included in h.2.	$40 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $50 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											602.7197121	610	150	0	150	0.2	0.086574119	48.87994814	0.25	2.8	0.223225585	0	0.2	0.245233113	26.56471055	49.29946993	37.5	50	0	0	0.2	49.30894614	0	0	0	0	0	0	0	0											423.3225789	428.4157534	105.3481361	0	105.3481361	0.140464181	0.060802814	34.32940953	0.175580227	1.96649854	0.156775995	0	0.140464181	0.172431936	26.56471055	49.29946993	37.5	35.11604536	0	0	0.140464181	49.30894614	0	0	0	0	0	0	0	0											54.2657	5.461890089	5.179069562	0	1.108091868	1.405294726	0.285022296	0.834747149	6.717132166	1.399533656	9.286844566	0	0.010524883	6.130537172	13.36535873	15.50499144	1.940593007	0.521307931	0	0	3.769367582	16.57039651	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.7564	0	40.8349	54.2657	5.461890089	5.179069562	0	1.108091868	1.405294726	0.285022296	0.834747149	6.717132166	1.399533656	9.286844566	0	0.010524883	6.130537172	13.36535873	15.50499144	1.940593007	0.521307931	0	0	3.769367582	16.57039651	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.7564																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	54.2657	5.461890089	5.179069562	0	1.108091868	1.405294726	0.285022296	0.834747149	6.717132166	1.399533656	9.286844566	0	0.010524883	6.130537172	13.36535873	15.50499144	1.940593007	0.521307931	0	0	3.769367582	16.57039651	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.7564
H2654_807_0	2009	2																					5840											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	968.4957812	125.6595056	466.7487855	1029.801462	10.12328023	10.94564383	4.835987083	612.9702387	37.28657265	7613.605752	39.35017655	0	0.017155266	44.49705491	4978.080389	3650.035964	628.466781	305.9943239	0	0	6.813025577	681.46137	0	0	0	0	0	0	0	0											"$365 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$365 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-39 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $0 n/c (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 25% (9a); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											360.7027178	365	150	0	150	0.2	0.059640859	50	0.25	2.8	0.226893819	0	0.2	0.248209363	15.74688655	34.8277196	37.5	35	0	0	0.2	34.5128983	0	0	0	0	0	0	0	0											296.3434615	299.8542469	123.2277727	0	123.2277727	0.164303697	0.048996068	41.07592423	0.205379621	2.300251757	0.186397466	0	0.164303697	0.204006611	15.74688655	34.8277196	37.5	28.75314696	0	0	0.164303697	34.5128983	0	0	0	0	0	0	0	0											23.9173	3.139961368	4.793034437	0	0.103955773	1.798409746	0.236944351	2.098193257	7.657902166	1.459434167	7.334773207	0	0.002818674	9.077693355	6.532438926	10.59353576	1.963958691	0.733191647	0	0	1.11940529	1.959933913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.5229	0	13.7828	23.9173	3.139961368	4.793034437	0	0.103955773	1.798409746	0.236944351	2.098193257	7.657902166	1.459434167	7.334773207	0	0.002818674	9.077693355	6.532438926	10.59353576	1.963958691	0.733191647	0	0	1.11940529	1.959933913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.5229																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.9173	3.139961368	4.793034437	0	0.103955773	1.798409746	0.236944351	2.098193257	7.657902166	1.459434167	7.334773207	0	0.002818674	9.077693355	6.532438926	10.59353576	1.963958691	0.733191647	0	0	1.11940529	1.959933913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.5229
H2654_808_0	2009	2																					5840											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	968.3825768	125.6448177	466.6942287	1029.681091	10.12209695	10.94308517	4.834856622	612.8985905	37.27785655	7612.715822	39.34097806	0	0.017151256	44.48665328	4977.498517	3649.609323	628.3933215	305.9585572	0	0	6.811432964	681.3817162	0	0	0	0	0	0	0	0											"$365 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$365 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-39 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 25% (9a); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											360.7027178	365	150	0	150	0.2	0.059640859	46.72878104	0.25	2.8	0.22689774	0	0.2	0.248209809	15.74688655	34.82748988	37.5	35	0	0	0.2	34.5128983	0	0	0	0	0	0	0	0											296.528349	300.0413937	123.3046824	0	123.3046824	0.164406243	0.049026648	38.41251669	0.205507804	2.301687404	0.186517025	0	0.164406243	0.204133972	15.74688655	34.82748988	37.5	28.77109255	0	0	0.164406243	34.5128983	0	0	0	0	0	0	0	0											23.9294	3.141553851	4.795465302	0	0.104008496	1.799111522	0.237036811	1.961914778	7.660890434	1.460174343	7.337762197	0	0.002819774	9.081237213	6.53167537	10.59222765	1.96372913	0.733563497	0	0	1.119842104	1.959704823	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.4121	0	13.7112	23.9294	3.141553851	4.795465302	0	0.104008496	1.799111522	0.237036811	1.961914778	7.660890434	1.460174343	7.337762197	0	0.002819774	9.081237213	6.53167537	10.59222765	1.96372913	0.733563497	0	0	1.119842104	1.959704823	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.4121																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.9294	3.141553851	4.795465302	0	0.104008496	1.799111522	0.237036811	1.961914778	7.660890434	1.460174343	7.337762197	0	0.002819774	9.081237213	6.53167537	10.59222765	1.96372913	0.733563497	0	0	1.119842104	1.959704823	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.4121
H2663_002_0	2009	12																					1500											D	D	D	V	T	COIN	COIN	V	V	O	COIN	COIN	COIN	COIN	P	COIN	COIN	COIN	COIN	P	COIN	V	T	V	V	V	V	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	3122.481694	46.79486461	1223.725561	0	353.4527349	8.671944548	34.01224383	297.117325	447.1485202	0	57.08274668	1.817510956	0.126650755	22.85636766	4188.146662	94.8283501	1.633576757	6.94175444	41.50418452	1288.374633	20.6228737	0	0	0	100.65616	131.5855461	0	0	0	424.8421999											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 $0	"8a 20%, 8b $15"	9a 20%	12 20%	"9a 20%,9d 20%, 4b $50, 3 20%"	"14c $15,7a $15"	"17a $25,17b $15,18a $30,7b $30,7d $30,7f $30,8a 20%"	"7h $30,9c $30, 7e $30"	"7c 20%,7i 20%"	"8a 20%, 8b $15"	7g $30	0.2			16a $0	17a $25	17b $15	18a $30			7f $30											126.9422268	181.417719	42.59068121	0	100	0.2	0.2	50	250	0	0.203527897	0.2	0.2	0.20186513	15	0.143177787	0.212737469	0.2	0.194393519	0.049916637	0.129148679	0	0	0	25	15	0	0	0	22.77663555											59.55553226	181.417719	19.98161488	0	91.48084527	0.093830924	0.093830924	23.45773103	117.2886551	0	0.095486054	0.093830924	0.093830924	0.098497944	15	0.142524589	0.212737469	0.093830924	0.091200618	0.049916637	0.129148679	0	0	0	25	15	0	0	0	22.77663555											15.4968	0.707451467	2.03766774	0	2.694512913	0.813696571	3.191400269	0.580808191	4.370454048	0	5.450606204	0.170538733	0.011883757	2.251305215	5.235183327	13.51537158	0.347522984	0.651351234	3.785207261	0.005359277	2.663416906	0	0	0	0.209700333	0.164481933	0	0	0	0.806372996	0	0	0	0	0	0	0	0	0	0	65.161	0	44.0433	15.4968	0.707451467	2.03766774	0	2.694512913	0.813696571	3.191400269	0.580808191	4.370454048	0	5.450606204	0.170538733	0.011883757	2.251305215	5.235183327	13.51537158	0.347522984	0.651351234	3.785207261	0.005359277	2.663416906	0	0	0	0.209700333	0.164481933	0	0	0	0.806372996	0	0	0	0	0	0	0	0	0	0	65.161	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	15.4968	0.707451467	2.03766774	0	2.694512913	0.813696571	3.191400269	0.580808191	4.370454048	0	5.450606204	0.170538733	0.011883757	2.251305215	5.235183327	13.51537158	0.347522984	0.651351234	3.785207261	0.005359277	2.663416906	0	0	0	0.209700333	0.164481933	0	0	0	0.806372996	0	0	0	0	0	0	0	0	0	0	65.161
H2663_005_0	2009	11																					2800											D	D	D	V	T	COIN	COIN	V	V	O	COIN	COIN	COIN	COIN	P	COIN	COIN	COIN	COIN	P	COIN	V	T	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	2135.120137	43.24480063	780.3016729	0	227.4224237	7.649354081	16.53455143	276.162605	361.7290234	0	27.18840275	1.729305047	0.141826244	11.34240516	3298.694723	99.4972757	1.749752489	7.799354342	41.37308533	964.459038	13.56182524	0	0	0	102.395612	126.4025856	0	0	0	231.0189424											1a $285 days 1-7	1b $300 days 1-5	2 $100 days 6-30	6 0%	10a $150	11a 20%	11b 20%	4a $50	"9a $250,9b $150"	8a $0	"8a 20%, 8b $15"	9a 20%	12 20%	"9a 20%,9d 20%, 4b $25, 3 20%"	"14c $10,7a $10"	"17a $25,17b $15,18a $30,7b $30,7d $30,7f $30,8a 20%"	"7h $30,9c $30, 7e $30"	"7c 20%,7i 20%"	8a 20% 8b$15	7g $30	0.2			16a $0	17a $25	17b $15	18a $30			7f $30											201.3989396	212.1315614	61.49316109	0	150	0.2	0.2	49.95457325	168.6298649	0	0.200045136	0.2	0.189823318	0.195383564	10	0.072575996	0.036406533	0.121742806	0.144534366	0.104260337	0.167229419	0	0	0	15	15	0	0	0	16.88781714											133.514395	140.5239685	40.77151269	0	144.8540751	0.132919556	0.132827531	33.12644069	111.7934478	0	0.134801809	0.132711694	0.189823318	0.131014939	10	0.072402078	0.036406533	0.08079836	0.095982897	0.104260337	0.167229419	0	0	0	15	15	0	0	0	16.88781714											23.7558	0.506410917	2.651173297	0	2.745255404	1.016748748	2.196243638	0.762357013	3.369911223	0	3.665045882	0.229499003	0.026921928	1.486024514	2.748912269	7.203809547	0.063702421	0.630175041	3.971108578	0.008379569	2.26793615	0	0	0	0.127994515	0.158003232	0	0	0	0.325117138	0	0	0	0	0	0	0	0	0	0	59.9165	0	22.6762	23.7558	0.506410917	2.651173297	0	2.745255404	1.016748748	2.196243638	0.762357013	3.369911223	0	3.665045882	0.229499003	0.026921928	1.486024514	2.748912269	7.203809547	0.063702421	0.630175041	3.971108578	0.008379569	2.26793615	0	0	0	0.127994515	0.158003232	0	0	0	0.325117138	0	0	0	0	0	0	0	0	0	0	59.9165	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.7558	0.506410917	2.651173297	0	2.745255404	1.016748748	2.196243638	0.762357013	3.369911223	0	3.665045882	0.229499003	0.026921928	1.486024514	2.748912269	7.203809547	0.063702421	0.630175041	3.971108578	0.008379569	2.26793615	0	0	0	0.127994515	0.158003232	0	0	0	0.325117138	0	0	0	0	0	0	0	0	0	0	59.9165
H2663_006_0	2009	7																					3750											D	D	D	V	T	COIN	COIN	V	V	O	COIN	COIN	COIN	COIN	P	COIN	COIN	COIN	COIN	P	COIN	V	T	V	V	V	V	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	2241.154034	21.4667556	827.3972075	0	214.3084303	5.778722605	38.7755704	269.7721137	356.3822812	0	30.49562664	1.865064851	0.411560085	15.6042897	3249.866878	69.22815552	1.949865491	5.375064028	30.3454264	919.3725417	11.07359705	0	0	0	83.18423751	100.6408331	0	0	0	231.3591378											1a $255 days 1-5	1b $300 days 1-5	2 $100 days 6-30	6 0%	10a $100	11a 20%	11b 20%	4a $50	"9a $250,9b $250"	8a $0	8a 20% 8b$15	9a 20%	12 20%	"9a 20%,9d 20% 4b $50, 3 20%"	"14c $15,7a $15"	"17a $25,17b $15,18a $30,7b $30,7d $30,7f $30,8a 20%"	"7h $30,9c $30, 7e $30"	"7c 20%,7i 20%"	"8a 20%, 8b $15"	7g $30	0.2			16a $0	17a $25	17b $15	18a $30			7f $30											154.1212893	181.417719	62.30217242	0	100	0.2	0.2	50	250	0	0.203496214	0.2	0.2	0.201657465	15	0.147959629	0.161305427	0.2	0.192421339	0.034489676	0.202391128	0	0	0	25	15	0	0	0	25.532594											117.9196056	181.417719	47.66796093	0	96.18747215	0.153021826	0.153021826	38.2554565	191.2772825	0	0.155696811	0.153021826	0.153021826	0.156134878	15	0.147695623	0.161305427	0.153021826	0.147223324	0.034489676	0.202391128	0	0	0	25	15	0	0	0	25.532594											22.023	0.324537486	3.286694814	0	1.717815514	0.884270685	5.933508586	0.86002128	5.680652856	0	4.748071813	0.285395629	0.062977676	2.436373873	4.062333597	10.22469557	0.314523885	0.822502112	4.467554531	0.002642405	2.241197794	0	0	0	0.173300495	0.125801041	0	0	0	0.492266578	0	0	0	0	0	0	0	0	0	0	71.1701	0	15.8566	22.023	0.324537486	3.286694814	0	1.717815514	0.884270685	5.933508586	0.86002128	5.680652856	0	4.748071813	0.285395629	0.062977676	2.436373873	4.062333597	10.22469557	0.314523885	0.822502112	4.467554531	0.002642405	2.241197794	0	0	0	0.173300495	0.125801041	0	0	0	0.492266578	0	0	0	0	0	0	0	0	0	0	71.1701	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	22.023	0.324537486	3.286694814	0	1.717815514	0.884270685	5.933508586	0.86002128	5.680652856	0	4.748071813	0.285395629	0.062977676	2.436373873	4.062333597	10.22469557	0.314523885	0.822502112	4.467554531	0.002642405	2.241197794	0	0	0	0.173300495	0.125801041	0	0	0	0.492266578	0	0	0	0	0	0	0	0	0	0	71.1701
H2663_007_0	2009	10																					1800											D	D	D	V	T	COIN	COIN	V	V	O	COIN	COIN	COIN	COIN	P	COIN	COIN	COIN	COIN	P	COIN	V	T	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	2632.534641	35.45440164	1096.438743	0	189.5563892	7.032202068	18.76280579	236.0183718	418.2126081	0	36.71848542	1.483830358	0.008662815	12.83374903	3175.455949	104.4208963	1.414494701	10.19815221	51.91580115	1076.743636	24.33187611	0	0	0	88.00600738	118.3086886	0	0	0	286.8836828											1a $260 days 1-6	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 $0	"8a 20%, 8b $15"	9a 20%	12 20%	"9a 20%,9d 15%, 4b $25, 3 20%"	"14c $10,7a $10,8a $0"	"17a $25,17b $15,18a $25,7b $25,7d $25,7f $25,8a 20%"	"7h $30,9c $30, 7e $30"	"7c 15%,7i 15%"	"8a 20%, 8b $15"	7g $25	0.2			16a $0	17a $25	17b $15	18a $25			7f $25											173.2313298	199.9703022	53.24848024	0	150	0.2	0.2	49.95681735	162.4006631	0	0.199912144	0.2	0.124333753	0.195700537	10	0.075692608	0.040302643	0.114732384	0.161626249	0.100109597	0.210666792	0	0	0	15	15	0	0	0	17.93489155											89.4692515	102.7861421	27.5201886	0	144.0509476	0.104031887	0.103730437	25.86866734	84.02936169	0	0.119767721	0.103026406	0.124333753	0.101899456	10	0.075436016	0.040302643	0.059375141	0.084321532	0.100109597	0.210666792	0	0	0	15	15	0	0	0	17.93489155											19.6276	0.303685097	2.51451675	0	2.275481457	0.731573253	1.946274042	0.508790062	2.928511542	0	4.397689301	0.152873708	0.00107708	1.307752043	2.646213291	7.877096394	0.057007875	0.605516726	4.377619912	0.008982698	5.125918285	0	0	0	0.110007509	0.147885861	0	0	0	0.428768978	0	0	0	0	0	0	0	0	0	0	58.0808	0	36.5012	19.6276	0.303685097	2.51451675	0	2.275481457	0.731573253	1.946274042	0.508790062	2.928511542	0	4.397689301	0.152873708	0.00107708	1.307752043	2.646213291	7.877096394	0.057007875	0.605516726	4.377619912	0.008982698	5.125918285	0	0	0	0.110007509	0.147885861	0	0	0	0.428768978	0	0	0	0	0	0	0	0	0	0	58.0808	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.6276	0.303685097	2.51451675	0	2.275481457	0.731573253	1.946274042	0.508790062	2.928511542	0	4.397689301	0.152873708	0.00107708	1.307752043	2.646213291	7.877096394	0.057007875	0.605516726	4.377619912	0.008982698	5.125918285	0	0	0	0.110007509	0.147885861	0	0	0	0.428768978	0	0	0	0	0	0	0	0	0	0	58.0808
H2663_008_0	2009	8																					3900											D	D	D	V	T	COIN	COIN	V	V	O	COIN	COIN	COIN	COIN	P	COIN	COIN	COIN	COIN	P	COIN	V	T	V	V	V	V	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	3602.178398	22.81138774	1490.800686	0	320.8776693	10.20973163	29.7756186	380.5700748	403.038661	0	28.85359495	1.592122194	1.07773213	22.11245556	4031.791755	95.40399259	2.002491985	5.780325968	25.86587075	1104.599845	22.23169009	0	0	0	71.32835321	102.5157805	0	0	0	611.6811169											1a $255 days 1-5	1b $300 days 1-5	2 $100 days 6-30	6 0%	10a $100	11a 20%	11b 20%	4a $50	"9a $250,9b $250"	8a $0	8a 20% 8b$15	9a 20%	12 20%	"9a 20%,9d 20% 4b $50, 3 20%"	"14c $15,7a $15"	"17a $25,17b $15,18a $30,7b $30,7d $30,7f $10,8a 20%"	"7h $30,9c $30, 7e $30"	"7c 20%,7i 20%"	"8a 20%, 8b $15"	7g $30	0.2			16a $0	17a $25	17b $15	18a $30			7f $10											138.9812036	163.5606936	62.95302013	0	100	0.2	0.2	50	250	0	0.205411754	0.2	0.2	0.19986431	15	0.115013596	0.129110091	0.132118227	0.113315248	0.044319016	0.171773124	0	0	0	25	15	0	0	0	11.96423339											98.57230926	163.5606936	44.64937996	0	94.31756324	0.141849843	0.141849843	35.46246063	177.3123032	0	0.145688125	0.141849843	0.141849843	0.143037439	15	0.115013596	0.129110091	0.093704748	0.080368751	0.044319016	0.171773124	0	0	0	25	15	0	0	0	11.96423339											29.5896	0.310920533	5.546943858	0	2.522033322	1.448248824	4.223666809	1.124662608	5.955309437	0	4.203626145	0.225842282	0.152876133	3.162909011	5.039739694	10.97275624	0.258541922	0.54164399	2.078807719	0.004079565	3.81880686	0	0	0	0.148600736	0.128144726	0	0	0	0.60985797	0	0	0	0	0	0	0	0	0	0	82.0676	0	23.9927	29.5896	0.310920533	5.546943858	0	2.522033322	1.448248824	4.223666809	1.124662608	5.955309437	0	4.203626145	0.225842282	0.152876133	3.162909011	5.039739694	10.97275624	0.258541922	0.54164399	2.078807719	0.004079565	3.81880686	0	0	0	0.148600736	0.128144726	0	0	0	0.60985797	0	0	0	0	0	0	0	0	0	0	82.0676	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	29.5896	0.310920533	5.546943858	0	2.522033322	1.448248824	4.223666809	1.124662608	5.955309437	0	4.203626145	0.225842282	0.152876133	3.162909011	5.039739694	10.97275624	0.258541922	0.54164399	2.078807719	0.004079565	3.81880686	0	0	0	0.148600736	0.128144726	0	0	0	0.60985797	0	0	0	0	0	0	0	0	0	0	82.0676
H2663_009_0	2009	8																					1500											D	D	D	V	T	COIN	COIN	V	V	O	COIN	COIN	COIN	COIN	P	COIN	COIN	COIN	COIN	P	COIN	V	T	V	V	V	V	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	4154.035721	36.2741416	1857.876563	0	372.7072547	13.72605085	41.44180544	378.6853864	583.0098417	0	47.1838534	2.479695892	0.299707378	36.22684382	5438.616485	133.7620722	1.754544854	9.034496806	35.29395359	1444.624959	41.76928773	0	0	0	121.1178487	152.2357496	0	0	0	984.72724											1a $205 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 $0	"8a 20%, 8b $15"	9a 20%	12 20%	"9a 20%,9d 20%, 4b $50, 3 20%"	"14c $10,7a $10"	"17a $25,17b $15,18a $20,7b $20,7d $20,7f $10,8a 20%"	"7h $30,9c $30, 7e $30"	"7c 20%,7i 20%"	"8a 20%, 8b $15"	7g $20	0.2			16a $0	17a $25	17b $15	18a $20			7f $10											111.7322158	163.5606936	43.08724832	0	100	0.2	0.2	50	250	0	0.204731425	0.2	0.2	0.199959853	10	0.086367447	0.119929317	0.111355813	0.115172002	0.017540735	0.099929966	0	0	0	25	15	0	0	0	10											48.26466426	163.5606936	18.61228258	0	92.04649062	0.086393461	0.086393461	21.5983653	107.9918265	0	0.088437282	0.086393461	0.086393461	0.088834168	10	0.086367447	0.119929317	0.04810207	0.049750539	0.017540735	0.099929966	0	0	0	25	15	0	0	0	10											16.7078	0.494418647	2.8816103	0	2.858866236	1.185841042	3.580301011	0.681582109	5.246691473	0	4.172811747	0.214229511	0.025892758	3.218181548	4.532180404	11.55268868	0.210421367	0.434578001	1.755893226	0.002111649	4.174003504	0	0	0	0.252328852	0.190294687	0	0	0	0.820606033	0	0	0	0	0	0	0	0	0	0	65.1933	0	52.7791	16.7078	0.494418647	2.8816103	0	2.858866236	1.185841042	3.580301011	0.681582109	5.246691473	0	4.172811747	0.214229511	0.025892758	3.218181548	4.532180404	11.55268868	0.210421367	0.434578001	1.755893226	0.002111649	4.174003504	0	0	0	0.252328852	0.190294687	0	0	0	0.820606033	0	0	0	0	0	0	0	0	0	0	65.1933	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.7078	0.494418647	2.8816103	0	2.858866236	1.185841042	3.580301011	0.681582109	5.246691473	0	4.172811747	0.214229511	0.025892758	3.218181548	4.532180404	11.55268868	0.210421367	0.434578001	1.755893226	0.002111649	4.174003504	0	0	0	0.252328852	0.190294687	0	0	0	0.820606033	0	0	0	0	0	0	0	0	0	0	65.1933
H2663_010_0	2009	7																					3900											D	D	D	V	T	COIN	COIN	V	V	O	COIN	COIN	COIN	COIN	P	COIN	COIN	COIN	COIN	P	COIN	V	T	V	V	V	V	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	2335.834622	33.33829098	697.7574821	0	249.3091628	6.183848663	26.32869838	221.1157009	326.3794504	0	39.73349016	1.380266858	0.132450512	16.3466775	3045.630974	68.39843459	1.27581419	5.046578667	29.94232556	926.5586486	14.36215748	0	0	0	73.85148424	95.5006191	0	0	0	296.2850369											1a $255 days 1-5	1b $300 days 1-5	2 $100 days 6-30	6 0%	10a $100	11a 20%	11b 20%	4a $50	"9a $250,9b $250"	8a $0	8a 20% 8b$15	9a 20%	12 20%	"9a 20%,9d 20% 4b $50, 3 20%"	"14c $15,7a $15"	"17a $25,17b $15,18a $30,7b $30,7d $30,7f $30,8a 20%"	"7h $30,9C $30, 7e $30"	"7c 20%,7i 20%"	"8a 20%, 8b $15"	7g $30	0.2			16a $0	17a $25	17b $15	18a $30			7f $30											154.141096	181.417719	62.30217242	0	100	0.2	0.2	50	250	0	0.203524765	0.2	0.2	0.201839598	15	0.14398815	0.202613405	0.2	0.19413609	0.04794511	0.188267399	0	0	0	25	15	0	0	0	26.5510687											119.9442311	181.417719	48.48016762	0	96.43513076	0.15562914	0.15562914	38.90728504	194.5364252	0	0.158371921	0.15562914	0.15562914	0.158664781	15	0.143718242	0.202613405	0.15562914	0.151066163	0.04794511	0.188267399	0	0	0	25	15	0	0	0	26.5510687											23.3475	0.504013059	2.818949974	0	2.003513476	0.96238705	4.09751269	0.716917633	5.291057629	0	6.292669174	0.214809744	0.020613159	2.593642003	3.807038718	9.830102771	0.258497057	0.785394699	4.523272249	0.003701996	2.703926029	0	0	0	0.153857259	0.119375774	0	0	0	0.655557031	0	0	0	0	0	0	0	0	0	0	71.7043	0	14.7888	23.3475	0.504013059	2.818949974	0	2.003513476	0.96238705	4.09751269	0.716917633	5.291057629	0	6.292669174	0.214809744	0.020613159	2.593642003	3.807038718	9.830102771	0.258497057	0.785394699	4.523272249	0.003701996	2.703926029	0	0	0	0.153857259	0.119375774	0	0	0	0.655557031	0	0	0	0	0	0	0	0	0	0	71.7043	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.3475	0.504013059	2.818949974	0	2.003513476	0.96238705	4.09751269	0.716917633	5.291057629	0	6.292669174	0.214809744	0.020613159	2.593642003	3.807038718	9.830102771	0.258497057	0.785394699	4.523272249	0.003701996	2.703926029	0	0	0	0.153857259	0.119375774	0	0	0	0.655557031	0	0	0	0	0	0	0	0	0	0	71.7043
H2663_011_0	2009	6																					1500											D	D	D	V	T	COIN	COIN	V	V	O	COIN	COIN	COIN	COIN	P	COIN	COIN	COIN	COIN	P	COIN	V	T	V	V	V	V	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	3057.490636	43.63815466	1407.876409	0	343.4069194	8.517843451	36.26604455	304.5722862	449.5661547	0	54.73026062	1.901226511	0.18244184	22.51646951	4195.155681	94.21432992	1.757349853	6.951329082	41.24357752	1276.273393	19.78292415	0	0	0	101.725546	131.5458006	0	0	0	408.113086											1a $205 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 $0	"8a 20%, 8b $15"	9a 20%	12 20%	"9a 20%,9d 20%, 4b $50, 3 20%"	"14c $15,7a $15"	"17a $25,17b $15,18a $30,7b $30,7d $30,7f $30,8a 20%"	"7h $30,9c $30, 7e $30"	"7c 20%,7i 20%"	"8a 20%, 8b $15"	7g $30	0.2			16a $0	17a $25	17b $15	18a $30			7f $30											123.9173517	181.417719	42.59068121	0	100	0.2	0.2	50	250	0	0.203524765	0.2	0.2	0.201839598	15	0.143780104	0.202613405	0.2	0.19413609	0.04794511	0.131462112	0	0	0	25	15	0	0	0	22.70071247											58.46513167	181.417719	20.09460138	0	91.51273008	0.094361493	0.094361493	23.5903733	117.9518665	0	0.096024504	0.094361493	0.094361493	0.099048639	15	0.143137505	0.202613405	0.094361493	0.091594856	0.04794511	0.131462112	0	0	0	25	15	0	0	0	22.70071247											14.8964	0.659727873	2.357559602	0	2.61884206	0.803756427	3.422118115	0.598747827	4.418930587	0	5.255446121	0.179402572	0.017215484	2.230225661	5.243944601	13.48560415	0.356062638	0.655937792	3.777699564	0.005099256	2.600704981	0	0	0	0.211928221	0.164432251	0	0	0	0.772038152	0	0	0	0	0	0	0	0	0	0	64.7318	0	43.3492	14.8964	0.659727873	2.357559602	0	2.61884206	0.803756427	3.422118115	0.598747827	4.418930587	0	5.255446121	0.179402572	0.017215484	2.230225661	5.243944601	13.48560415	0.356062638	0.655937792	3.777699564	0.005099256	2.600704981	0	0	0	0.211928221	0.164432251	0	0	0	0.772038152	0	0	0	0	0	0	0	0	0	0	64.7318	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.8964	0.659727873	2.357559602	0	2.61884206	0.803756427	3.422118115	0.598747827	4.418930587	0	5.255446121	0.179402572	0.017215484	2.230225661	5.243944601	13.48560415	0.356062638	0.655937792	3.777699564	0.005099256	2.600704981	0	0	0	0.211928221	0.164432251	0	0	0	0.772038152	0	0	0	0	0	0	0	0	0	0	64.7318
H2663_012_0	2009	8																					0											COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	COIN	COIN	V	V	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	0	0	0	0	0	0	0	0											0	0	447.8786568	2.619380468	51.25461602	0	13.10645859	10.50411962	44.72292457	12.57972044	58.79313174	4.537585403	67.49281175	2.344573579	0.224985458	27.76708571	35.44931994	116.1841724	2.167146319	8.572309721	50.86116861	6.417925911	24.39610483	0	0	0	125.4469291	162.2209698	0	0	0	0											FFS Medicare 8.%	FFS Medicare 8.%	FFS Medicare 19.1%		FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%		16a $0	17a $25	17b $15	18a $30														0.079904799	0.079904799	0.190813631	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	25	15	0	0	0	0											0.079904799	0.079904799	0.190813631	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	25	15	0	0	0	0											35.7877	0.209301069	9.780079391	0	3.027591933	2.426451633	10.33099558	2.905915421	13.58121343	1.048182228	15.59083951	0.541596497	0.051971641	6.4141968	8.188792905	26.83854382	0.5006108	1.980203546	11.74892995	1.482540885	5.635500217	0	0	0	0.261347769	0.202776212	0	0	0	0	0	0	0	0	0	0	0	0	0	0	158.5352	0	0	35.7877	0.209301069	9.780079391	0	3.027591933	2.426451633	10.33099558	2.905915421	13.58121343	1.048182228	15.59083951	0.541596497	0.051971641	6.4141968	8.188792905	26.83854382	0.5006108	1.980203546	11.74892995	1.482540885	5.635500217	0	0	0	0.261347769	0.202776212	0	0	0	0	0	0	0	0	0	0	0	0	0	0	158.5352	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	35.7877	0.209301069	9.780079391	0	3.027591933	2.426451633	10.33099558	2.905915421	13.58121343	1.048182228	15.59083951	0.541596497	0.051971641	6.4141968	8.188792905	26.83854382	0.5006108	1.980203546	11.74892995	1.482540885	5.635500217	0	0	0	0.261347769	0.202776212	0	0	0	0	0	0	0	0	0	0	0	0	0	0	158.5352
H2663_802_0	2009	5																					0											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	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	305.6520055	1.142473487	28.92211376	0	7.551495842	7.621420474	32.16870943	8.020925915	45.29891023	3.336062327	41.33975189	1.602174601	0	22.12647981	27.56296111	95.9524918	2.031159958	7.827815191	40.54916804	5.736333037	16.01862332	0	0	0	0	0	0	0	0	0											FFS Medicare 8.%	FFS Medicare 8.%	FFS Medicare 19.1%		FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%																			0.079904491	0.079904491	0.190799946	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.079904491	0.079904491	0.190799946	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											24.423	0.091288763	5.518337753	0	1.744395539	1.76054813	7.430971877	1.852833886	10.46404826	0.770630397	9.549482685	0.370102333	0	5.111216837	6.367044016	22.16502561	0.46919795	1.808225309	9.366857817	1.325092932	3.700301986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2886	0	0	24.423	0.091288763	5.518337753	0	1.744395539	1.76054813	7.430971877	1.852833886	10.46404826	0.770630397	9.549482685	0.370102333	0	5.111216837	6.367044016	22.16502561	0.46919795	1.808225309	9.366857817	1.325092932	3.700301986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2886	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.423	0.091288763	5.518337753	0	1.744395539	1.76054813	7.430971877	1.852833886	10.46404826	0.770630397	9.549482685	0.370102333	0	5.111216837	6.367044016	22.16502561	0.46919795	1.808225309	9.366857817	1.325092932	3.700301986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2886
H2663_804_0	2009	5																					0											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	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	400.3644544	2.639389535	26.64471645	0	9.11566705	8.408389129	41.04388898	8.858909174	52.628465	3.404927849	43.17518268	1.559860173	2.940444079	17.8019364	29.02533498	106.8717717	1.683590118	7.348477002	50.1755189	5.355326122	15.857733	0	0	0	0	0	0	0	0	0											FFS Medicare 8.%	FFS Medicare 8.%	FFS Medicare 19.1%		FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%																			0.079904216	0.079904216	0.19078772	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.079904216	0.079904216	0.19078772	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											31.9908	0.210898353	5.0834847	0	2.105719089	1.942337889	9.481138353	2.046408019	12.15717541	0.786538333	9.9734672	0.3603277	0.679242582	4.112247309	6.704852381	24.68737925	0.388909317	1.697498187	11.59054487	1.237080334	3.663136322	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.8992	0	0	31.9908	0.210898353	5.0834847	0	2.105719089	1.942337889	9.481138353	2.046408019	12.15717541	0.786538333	9.9734672	0.3603277	0.679242582	4.112247309	6.704852381	24.68737925	0.388909317	1.697498187	11.59054487	1.237080334	3.663136322	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.8992	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	31.9908	0.210898353	5.0834847	0	2.105719089	1.942337889	9.481138353	2.046408019	12.15717541	0.786538333	9.9734672	0.3603277	0.679242582	4.112247309	6.704852381	24.68737925	0.388909317	1.697498187	11.59054487	1.237080334	3.663136322	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.8992
H2663_805_0	2009	5																					0											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	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	351.8372536	2.796106118	37.7737659	0	9.570291009	7.629819016	42.17786432	9.039623513	48.70091118	4.382892995	44.67669456	1.973212151	0.665115447	24.40941057	34.68881886	119.5627494	2.026651312	8.998696328	54.34358297	7.419521143	15.50565926	0	0	0	0	0	0	0	0	0											FFS Medicare 8.%	FFS Medicare 8.%	FFS Medicare 19.1%		FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%																			0.080149255	0.080149255	0.19100605	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.080149255	0.080149255	0.19100605	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											28.1995	0.224105823	7.215017814	0	2.210737223	1.762488193	9.743086659	2.088153032	11.24991048	1.012448282	10.32031644	0.455812007	0.153641668	5.638573841	8.013117156	27.6189951	0.468156453	2.078698852	12.55336767	1.713909384	3.581807288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.3018	0	0	28.1995	0.224105823	7.215017814	0	2.210737223	1.762488193	9.743086659	2.088153032	11.24991048	1.012448282	10.32031644	0.455812007	0.153641668	5.638573841	8.013117156	27.6189951	0.468156453	2.078698852	12.55336767	1.713909384	3.581807288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.3018	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	28.1995	0.224105823	7.215017814	0	2.210737223	1.762488193	9.743086659	2.088153032	11.24991048	1.012448282	10.32031644	0.455812007	0.153641668	5.638573841	8.013117156	27.6189951	0.468156453	2.078698852	12.55336767	1.713909384	3.581807288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.3018
H2667_001_0	2009	9																																A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	P	P	P	P	P																																																			0		317.0504259	6.465031572	392.3588079		226.4267381	12.90513271	12.86620749	579.0829248	892.4868471		737.4409785		167.297444	1433.415578	7233.221046	1525.918719	221.1771469	324.6296603			2226.056173	730.1363909																			$150/day days 1-90; maximum $750 per stay	$150/day days 1-90; maximum $750 per stay (covered under 1a)	$0 day days 1-20; $125/day days 21-100	$0 copay	$75/copay	20% coins	20% coins	"$50 copay for ER, $15 for Urgent Care"	$150/copay	$0 copay	20% coins; maximum $2400	$0 copay	20% coins	$0 copay;	$15 copay	$30 copay	$30/day	$30 copay	20% coins; maximum $2400	$30 copay for chiro; $15 copay for podiatry	20% coins	20% coins	N/A	N/A	$0 copay (limit 1 per year)	"$150 limit every 2 years (1 contact pair, 1 eyeglasses pair every 2 years)"	$0 copay (limit 1 per year)	N/A	Fitness benefit limited to $200/year; $10 copay for nutritional training and smoking cessation; $0 copay others	N/A											442.8108595	448.3487659	52.78		75	0.2	0.2	49.98313119	150		88.82565009		76.77492348	30.38508021	15.74078382	23.61304702	30	29.09391028			26.54348734	30																			442.8108595	448.3487659	52.78		75	0.2	0.2	49.98313119	150		88.82565009		76.77492348	30.38508021	15.74078382	23.61304702	30	29.09391028			26.54348734	30																			11.6994	0.241549077	1.725724823	0	1.415167113	2.581026542	2.573241497	2.412031483	11.15608559	0	5.458639527	0	1.070354038	3.629537276	9.488047403	3.002632539	0.552942867	0.787062184	0	0	4.923941152	1.825340977	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5428	0	0	11.6994	0.241549077	1.725724823	0	1.415167113	2.581026542	2.573241497	2.412031483	11.15608559	0	5.458639527	0	1.070354038	3.629537276	9.488047403	3.002632539	0.552942867	0.787062184	0	0	4.923941152	1.825340977	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5428																																																																																		0	0	0	11.6994	0.241549077	1.725724823	0	1.415167113	2.581026542	2.573241497	2.412031483	11.15608559	0	5.458639527	0	1.070354038	3.629537276	9.488047403	3.002632539	0.552942867	0.787062184	0	0	4.923941152	1.825340977	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5428
H2667_003_0	2009	15																					4000											A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	P	P	P	P	P																																																			0		2090.218047	36.4511309	658.5680921		275.6370079	7.82398816	7.74477445	526.3963018	860.891708		1573.838707		215.4849025	1367.099898	7662.79111	2084.523448	322.9880637	1044.95183		9.440158907	1653.978686	1202.329728																			$225/day days 1-17; $0/day days 18-90	$225/day days 1-12; $0/day days 13-90	$100/day days 1-30; $0/day days 31-100	$0 copay	$150 copay	20% coins	20% coins	$50 copay for ER and $35 for Urgent Care	$150 copay	0% coins	20% coins	$0 copay	20% coins	N/A	$15 copay	$30 copay	$30/day for individual; $15/day for group	20% coins	20% coins	$30 copay for chiro; $30 copay for podiatry	20% coins	20% coins	N/A	N/A	$0 copay (limit 1 per year)	"$150 limit every 2 years (1 contact pair, 1 eyeglasses pair every 2 years)"	$0 copay (limit 1 per year)	N/A	Fitness benefit limited to $200/year	N/A											187.39	163.8	71.01		150	0.2	0.2	49.24532632	150		39.77248607		131.9033683	11.14877631	14.98927014	25.4367599	28.5	29.12498066		15	80.80652197	30																			154.2672555	134.8469846	58.4583906		123.4862497	0.164648333	0.164648333	49.24532632	123.4862497		32.74236763		108.5883485	9.178137169	14.87247593	24.73353016	23.46238744	29.12498066		15	66.52329565	30																			26.871	0.409610424	3.208235897	0	2.836448365	1.288206607	1.275164202	2.160213138	8.859024033	0	4.294267129	0	1.949929141	1.045619199	9.49705636	4.296468633	0.631505924	2.536183487	0	0.011800199	9.169009429	3.005824319	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.3456	0	13.474	26.871	0.409610424	3.208235897	0	2.836448365	1.288206607	1.275164202	2.160213138	8.859024033	0	4.294267129	0	1.949929141	1.045619199	9.49705636	4.296468633	0.631505924	2.536183487	0	0.011800199	9.169009429	3.005824319	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.3456																																																																																		0	0	0	26.871	0.409610424	3.208235897	0	2.836448365	1.288206607	1.275164202	2.160213138	8.859024033	0	4.294267129	0	1.949929141	1.045619199	9.49705636	4.296468633	0.631505924	2.536183487	0	0.011800199	9.169009429	3.005824319	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.3456
H2667_012_0	2009	8																																A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	P	P	P	P	P																																																			0		314.2728818	5.765848185	433.3487154		244.4831044	10.86693982	12.36529445	528.3277265	790.5744705		661.588805		233.7806148	885.626782	6409.036189	1579.555676	93.74237341	177.2470169			2401.308075	651.7498164																			$150/day days 1-90; $750 max per stay	$150/day days 1-90; $750 max per stay	$0/day days 1-20; $125/day days 21-100	$0 copay	$75 copay	20% coins	20% coins	$50 copay for ER and $15 for urgent care	$150 copay	0% coins;	20% coins; $2400 max	$0 copay	20% coins	$150 copay;	$15 copay	$30 copay	$30/day	$30 copay	20% coins; $2400 max	$30 copay for chiro; $15 copay for podiatry	20% coins	20% coins	N/A	N/A	$0 copay (limit 1 per year)	"$150 limit every 2 years (1 contact pair, 1 eyeglasses pair every 2 years)"	$0 copay (limit 1 per year)	N/A	Fitness benefit limited to $200/year; $10 copay for nutritional training and smoking cessation; $0 copay others	N/A											433.1348658	277.8192255	52.78		75	0.2	0.2	49.99329594	150		92.49369497		98.40256362	30.22555422	15	22.85375215	30	29.09391028			21.66071584	30																			433.1348658	277.8192255	52.78		75	0.2	0.2	49.99329594	150		92.49369497		98.40256362	30.22555422	15	22.85375215	30	29.09391028			21.66071584	30																			11.3435	0.133488623	1.9060121	0	1.528019402	2.173387963	2.47305889	2.201070365	9.882180881	0	5.099399427	0	1.917050985	2.23071336	8.011295236	3.00823116	0.234355934	0.429734067	0	0	4.334504321	1.629374541	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5354	0	0	11.3435	0.133488623	1.9060121	0	1.528019402	2.173387963	2.47305889	2.201070365	9.882180881	0	5.099399427	0	1.917050985	2.23071336	8.011295236	3.00823116	0.234355934	0.429734067	0	0	4.334504321	1.629374541	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5354																																																																																		0	0	0	11.3435	0.133488623	1.9060121	0	1.528019402	2.173387963	2.47305889	2.201070365	9.882180881	0	5.099399427	0	1.917050985	2.23071336	8.011295236	3.00823116	0.234355934	0.429734067	0	0	4.334504321	1.629374541	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5354
H2667_013_0	2009	9																					4000											D	D	D	P	P	P	P	P	P	P	P	P	P	P	P	P	P	P	P	P	S	O	P	P	P	P	P	P	P	P																																																			0		2198.723874	40.0635348	597.7278332		246.3467927	593.4275164	1624.262846	498.4877943	785.6889447		1573.849904		157.6035535	1293.446438	7095.574686	2118.214908	324.8940873	1052.092114		10.20054265	1549.615513	1103.805897																			"$225/day for days 1-17, and $0 for days 18-90"	"$225/day for days 1-12, and $0 for days 13-90"	"$100/day for days 1-30, $0 for days 31-100"	Full coverage	$150 copay	20% coinsurance	20% coinsurance	$50 copay for ER and $35 for Urgent care	$150 copay	Full coverage	20% coinsurance	20% coinsurance	20% coinsurance	N/A	$15 copay	$30 copay	$30 copay for Individual and $15 for Group	20% coinsurance	20% coinsurance	Full coverage	20% coinsurance	20% coinsurance	Full coverage	N/A	Full coverage	$150 limit every 2 years	Full coverage	N/A	$200 limit	N/A											187.39	163.8	71.01		150	27.36333782	11.17801634	49.29804338	150		45.55424546		144.4592651	12.22965861	15.03521847	25.37387026	28.5	29.12498066		15	96.23526481	30																			153.4487751	134.1315404	58.14823374		122.831081	22.40712243	9.153385533	49.29804338	122.831081		37.30318142		118.293918	10.01454792	14.91995425	24.70028042	23.33790539	29.12498066		15	78.80454405	30																			28.116	0.447815303	2.89640148	0	2.521586904	1.108083584	1.23895867	2.047872743	8.042251868	0	4.892467375	0	1.553628486	1.079440111	8.822137473	4.360041853	0.631862289	2.55351354	0	0.012750678	10.17639533	2.759514743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.2607	0	14.0567	28.116	0.447815303	2.89640148	0	2.521586904	1.108083584	1.23895867	2.047872743	8.042251868	0	4.892467375	0	1.553628486	1.079440111	8.822137473	4.360041853	0.631862289	2.55351354	0	0.012750678	10.17639533	2.759514743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.2607																																																																																		0	0	0	28.116	0.447815303	2.89640148	0	2.521586904	1.108083584	1.23895867	2.047872743	8.042251868	0	4.892467375	0	1.553628486	1.079440111	8.822137473	4.360041853	0.631862289	2.55351354	0	0.012750678	10.17639533	2.759514743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.2607
H2667_803_0	2009	4																																A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	P	P	P	P	P																																																			0		226.227721	3.719141177	336.958214		558.219117	8.287598958	11.6790277	408.9860138	937.6180204		869.629409	44.37738286	91.6366248	1325.109735	4310.836672	2773.623686	126.6753695	167.8766144			571.9018503	585.6705308								12168.74098											$150/day days 1-90; $750 max per stay	$150/day days 1-90; $750 max per stay	$0/day days 1-5; $125/day days 6-100	$0 copay	$75 copay	20% coins	20% coins	$50 copay for ER and $15 for urgent care	$150 copay	0% coins;	20% coins; $2400 max	$0 copay	20% coins	N/A	$15 copay	$30 copay	$30/day	$30 copay	20% coins; $2400 max	$30 copay for chiro; $15 copay for podiatry	20% coins	20% coins	N/A	N/A	$0 copay (limit 1 per year)	"$150 limit every 2 years (1 contact pair, 1 eyeglasses pair every 2 years)"	$0 copay (limit 1 per year)	N/A	Fitness benefit limited to $200/year; $10 copay for nutritional training and smoking cessation; $0 copay others	N/A											564.7953797	520.0206016	100.0704374		75	0.2	0.2	49.98625993	150		74.71300045	42.85713865	76.60917159	30.23911811	15	28.8862627	30	25.15136295			110.6120912	30								5.612011531											564.7953797	520.0206016	100.0704374		75	0.2	0.2	49.98625993	150		74.71300045	42.85713865	76.60917159	30.23911811	15	28.8862627	30	25.15136295			110.6120912	30								5.612011531											10.6477	0.161169169	2.80996299	0	3.488869482	1.657519792	2.33580554	1.7036401	11.72022525	0	5.414385202	0.158490638	0.585017159	3.339179149	5.38854584	6.676635201	0.316688424	0.351860472	0	0	5.271604968	1.464176327	0	0	0	0	0	0	0	5.690926225	0	0	0	0	0	0	0	0	0	0	69.1824	0	0	10.6477	0.161169169	2.80996299	0	3.488869482	1.657519792	2.33580554	1.7036401	11.72022525	0	5.414385202	0.158490638	0.585017159	3.339179149	5.38854584	6.676635201	0.316688424	0.351860472	0	0	5.271604968	1.464176327	0	0	0	0	0	0	0	5.690926225	0	0	0	0	0	0	0	0	0	0	69.1824																																																																																		0	0	0	10.6477	0.161169169	2.80996299	0	3.488869482	1.657519792	2.33580554	1.7036401	11.72022525	0	5.414385202	0.158490638	0.585017159	3.339179149	5.38854584	6.676635201	0.316688424	0.351860472	0	0	5.271604968	1.464176327	0	0	0	0	0	0	0	5.690926225	0	0	0	0	0	0	0	0	0	0	69.1824
H2667_804_0	2009	4																																A	A	D	P	P	P	P	P	P	P	P	P	P	P	P	P	P	P	P	P	S	O	P	P	P	P	P	P	P	P																																																			0		315.2555319	4.052259369	520.1707914		29.86139411	782.2284596	929.1852409	202.3259461	569.1212692		1777.717622	134.3546738	51.67929666	2231.412334	3894.41682	5728.198295	225.3173748	1419.767286			571.0141137	1288.933966								162.6704751											$150/day days 1-90; maximum $750 per stay	$150/day days 1-90; maximum $750 per stay (covered under 1a)	$0 /day days 1-5; $125/day days 6-100	$0 copay	$75/copay	20% coins	20% coins	"$50 copay for ER, $15 for Urgent Care"	$150/copay	$0 copay	20% coins; maximum $2400	$0 copay	20% coins	N/A	$15 copay	$30 copay	$30/day	$30 copay	20% coins; maximum $2400	$30 copay for chiro; $15 copay for podiatry	20% coins	20% coins	N/A	N/A	$0 copay (limit 1 per year)	"$150 limit every 2 years (1 contact pair, 1 eyeglasses pair every 2 years)"	$0 copay (limit 1 per year)	N/A	Fitness benefit limited to $200/year; $10 copay for nutritional training and smoking cessation; $0 copay others	N/A											438.8945416	404.1006917	100.0704374		75	30.81672179	13.93753237	44.66364675	150		43.04755909	96.08486463	293.6144446	32.35212109	15	29.26892423	30	30			3.086288336	30								15											438.8945416	404.1006917	100.0704374		75	30.81672179	13.93753237	44.66364675	150		43.04755909	96.08486463	293.6144446	32.35212109	15	29.26892423	30	30			3.086288336	30								15											11.5303	0.136460068	4.337809887	0	0.186633713	2.008809735	1.079212448	0.753051215	7.114015865	0	6.377200364	1.075787554	1.264482332	6.01591017	4.868021025	13.97151682	0.563293437	3.549418214	0	0	0.146859517	3.222334914	0	0	0	0	0	0	0	0.203338094	0	0	0	0	0	0	0	0	0	0	68.4045	0	0	11.5303	0.136460068	4.337809887	0	0.186633713	2.008809735	1.079212448	0.753051215	7.114015865	0	6.377200364	1.075787554	1.264482332	6.01591017	4.868021025	13.97151682	0.563293437	3.549418214	0	0	0.146859517	3.222334914	0	0	0	0	0	0	0	0.203338094	0	0	0	0	0	0	0	0	0	0	68.4045																																																																																		0	0	0	11.5303	0.136460068	4.337809887	0	0.186633713	2.008809735	1.079212448	0.753051215	7.114015865	0	6.377200364	1.075787554	1.264482332	6.01591017	4.868021025	13.97151682	0.563293437	3.549418214	0	0	0.146859517	3.222334914	0	0	0	0	0	0	0	0.203338094	0	0	0	0	0	0	0	0	0	0	68.4045
H2667_807_0	2009	4																																A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	P	P	P	P	P																																																			0		301.3769497	7.188209995	490.4081962		525.5660854	13.78293961	14.11242316	530.8397877	1163.067303		1003.201089	50.73498333	85.50710576	1399.083444	6059.735204	3028.080074	160.2081324	193.7319115			1346.77816	773.3277847								12240.72089											$150/day days 1-90; maximum $750 per stay	$150/day days 1-90; maximum $750 per stay (covered under 1a)	$0 /day days 1-5; $125/day days 6-100	$0 copay	$75/copay	20% coins	20% coins	"$50 copay for ER, $15 for Urgent Care"	$150/copay	$0 copay	20% coins; maximum $2400	$0 copay	20% coins	$0 copay;	$15 copay	$30 copay	$30/day	$30 copay	20% coins; maximum $2400	$30 copay for chiro; $15 copay for podiatry	20% coins	20% coins	N/A	N/A	$0 copay (limit 1 per year)	"$150 limit every 2 years (1 contact pair, 1 eyeglasses pair every 2 years)"	$0 copay (limit 1 per year)	N/A	Fitness benefit limited to $200/year; $10 copay for nutritional training and smoking cessation; $0 copay others	N/A											446.8615346	740.8512681	100.0704374		75	0.2	0.2	49.99039405	150		82.16189769	41.78631082	77.50506257	30.20785029	15	27.53824781	30	29.35719013			73.44413451	30								5.667216335											446.8615346	740.8512681	100.0704374		75	0.2	0.2	49.99039405	150		82.16189769	41.78631082	77.50506257	30.20785029	15	27.53824781	30	29.35719013			73.44413451	30								5.667216335											11.2228	0.443782874	4.08961356	0	3.284788034	2.756587922	2.822484633	2.211407514	14.53834129	0	6.868742105	0.176668982	0.552269465	3.521941936	7.574669005	6.949001622	0.400520331	0.473952047	0	0	8.242746362	1.933319462	0	0	0	0	0	0	0	5.780901117	0	0	0	0	0	0	0	0	0	0	83.8446	0	0	11.2228	0.443782874	4.08961356	0	3.284788034	2.756587922	2.822484633	2.211407514	14.53834129	0	6.868742105	0.176668982	0.552269465	3.521941936	7.574669005	6.949001622	0.400520331	0.473952047	0	0	8.242746362	1.933319462	0	0	0	0	0	0	0	5.780901117	0	0	0	0	0	0	0	0	0	0	83.8446																																																																																		0	0	0	11.2228	0.443782874	4.08961356	0	3.284788034	2.756587922	2.822484633	2.211407514	14.53834129	0	6.868742105	0.176668982	0.552269465	3.521941936	7.574669005	6.949001622	0.400520331	0.473952047	0	0	8.242746362	1.933319462	0	0	0	0	0	0	0	5.780901117	0	0	0	0	0	0	0	0	0	0	83.8446
H2667_808_0	2009	4																																A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	P	P	P	P	P																																																			0		222.2087202	3.203039644	241.8049435		471.5622706	8.68576519	10.46129219	387.602227	805.275587		798.9806837	48.0511346	222.5928618	904.2802868	3917.991208	2679.516676	125.5166584	151.4468021			1187.659655	596.1297527							2.737490981	12156.17317											$150/day days 1-90; maximum $750 per stay	$150/day days 1-90; maximum $750 per stay (covered under 1a)	$0 /day days 1-5; $125/day days 6-100	$0 copay	$75/copay	20% coins	20% coins	"$50 copay for ER, $15 for Urgent Care"	$150/copay	$0 copay	20% coins; maximum $2400	$0 copay	20% coins	$0 copay;	$15 copay	$30 copay	$30/day	$30 copay	20% coins; maximum $2400	$30 copay for chiro; $15 copay for podiatry	20% coins	20% coins	N/A	N/A	$0 copay (limit 1 per year)	"$150 limit every 2 years (1 contact pair, 1 eyeglasses pair every 2 years)"	$0 copay (limit 1 per year)	N/A	Fitness benefit limited to $200/year; $10 copay for nutritional training and smoking cessation; $0 copay others	N/A											435.7940307	401.2459772	100.0704374		75	0.2	0.2	49.98751379	150		81.55076942	41.53137867	92.51424431	30.30614626	15	27.34376377	30	27.93186433			53.86713147	30							15	5.602305639											435.7940307	401.2459772	100.0704374		75	0.2	0.2	49.98751379	150		81.55076942	41.53137867	92.51424431	30.30614626	15	27.34376377	30	27.93186433			53.86713147	30							15	5.602305639											8.0698	0.107100564	2.016460539	0	2.947264191	1.737153038	2.092258439	1.614605972	10.06594484	0	5.429790792	0.166302489	1.7160842	2.283770886	4.89748901	6.105672585	0.313791646	0.352515961	0	0	5.331318232	1.490324382	0	0	0	0	0	0	0.003421864	5.675216456	0	0	0	0	0	0	0	0	0	0	62.4163	0	0	8.0698	0.107100564	2.016460539	0	2.947264191	1.737153038	2.092258439	1.614605972	10.06594484	0	5.429790792	0.166302489	1.7160842	2.283770886	4.89748901	6.105672585	0.313791646	0.352515961	0	0	5.331318232	1.490324382	0	0	0	0	0	0	0.003421864	5.675216456	0	0	0	0	0	0	0	0	0	0	62.4163																																																																																		0	0	0	8.0698	0.107100564	2.016460539	0	2.947264191	1.737153038	2.092258439	1.614605972	10.06594484	0	5.429790792	0.166302489	1.7160842	2.283770886	4.89748901	6.105672585	0.313791646	0.352515961	0	0	5.331318232	1.490324382	0	0	0	0	0	0	0.003421864	5.675216456	0	0	0	0	0	0	0	0	0	0	62.4163
H2667_809_0	2009	4																																A	A	D	P	P	P	P	P	P	P	P	P	P	P	P	P	P	P	P	P	S	O	P	P	P	P	P	P	P	P																																																			0		291.5803611	4.222402655	405.0339747		196.4130614	804.3924923	1601.125392	380.810724	911.1289555		1599.239953	237.9890237	69.16611366	2173.39908	7379.142089	1845.637936	204.827721	1547.687005			2969.171895	1269.13794								338.4959462											$150/day days 1-90; maximum $750 per stay	$150/day days 1-90; maximum $750 per stay (covered under 1a)	$0 /day days 1-5; $125/day days 6-100	$0 copay	$75/copay	20% coins	20% coins	"$50 copay for ER, $15 for Urgent Care"	$150/copay	$0 copay	20% coins; maximum $2400	$0 copay	20% coins	$0 copay;	$15 copay	$30 copay	$30/day	$30 copay	20% coins; maximum $2400	$30 copay for chiro; $15 copay for podiatry	20% coins	20% coins	N/A	N/A	$0 copay (limit 1 per year)	"$150 limit every 2 years (1 contact pair, 1 eyeglasses pair every 2 years)"	$0 copay (limit 1 per year)	N/A	Fitness benefit limited to $200/year; $10 copay for nutritional training and smoking cessation; $0 copay others	N/A											532.9327016	693.3608022	100.0704374		75	26.40470054	10.14353488	47.04573539	150		42.78230511	47.81822086	236.9393236	32.51630011	15	23.02174773	30	30			31.91677686	30								15											532.9327016	693.3608022	100.0704374		75	26.40470054	10.14353488	47.04573539	150		42.78230511	47.81822086	236.9393236	32.51630011	15	23.02174773	30	30			31.91677686	30								15											12.9494	0.243970708	3.377660586	0	1.227581634	1.769978573	1.353422605	1.492960046	11.38911194	0	5.701597633	0.948350975	1.365681016	5.889241395	9.223927611	3.540817581	0.512069302	3.869217513	0	0	7.897199735	3.17284485	0	0	0	0	0	0	0	0.423119933	0	0	0	0	0	0	0	0	0	0	76.3481	0	0	12.9494	0.243970708	3.377660586	0	1.227581634	1.769978573	1.353422605	1.492960046	11.38911194	0	5.701597633	0.948350975	1.365681016	5.889241395	9.223927611	3.540817581	0.512069302	3.869217513	0	0	7.897199735	3.17284485	0	0	0	0	0	0	0	0.423119933	0	0	0	0	0	0	0	0	0	0	76.3481																																																																																		0	0	0	12.9494	0.243970708	3.377660586	0	1.227581634	1.769978573	1.353422605	1.492960046	11.38911194	0	5.701597633	0.948350975	1.365681016	5.889241395	9.223927611	3.540817581	0.512069302	3.869217513	0	0	7.897199735	3.17284485	0	0	0	0	0	0	0	0.423119933	0	0	0	0	0	0	0	0	0	0	76.3481
H2667_810_0	2009	4																																A	A	D	V	T	Coin	Coin	V	P	P	P	P	P	P	P	P	P	P	P	P	S	P	T	V	V	P	P	P	P	P																																																			0		298.0599247	4.316233825	414.0347297		200.7777961	9.046557149	6.917493312	389.2731845	931.3762656		1634.778618	243.2776686	70.70313841	2221.696837	7543.123024	1886.652113	209.3794481	1582.08005			3035.153493	1297.341006								346.0180783											$150/day days 1-90; maximum $750 per stay	$150/day days 1-90; maximum $750 per stay (covered under 1a)	$0 /day days 1-5; $125/day days 6-100	$0 copay	$75/copay	20% coins	20% coins	"$50 copay for ER, $15 for Urgent Care"	$150/copay	$0 copay	20% coins; maximum $2400	$0 copay	20% coins	$0 copay;	$15 copay	$30 copay	$30/day	$30 copay	20% coins; maximum $2400	$30 copay for chiro; $15 copay for podiatry	20% coins	20% coins	N/A	N/A	$0 copay (limit 1 per year)	"$150 limit every 2 years (1 contact pair, 1 eyeglasses pair every 2 years)"	$0 copay (limit 1 per year)	N/A	Fitness benefit limited to $200/year; $10 copay for nutritional training and smoking cessation; $0 copay others	N/A											532.9327016	693.3608022	100.0704374		75	0.2	0.2	47.04573539	150		42.78230511	47.81822086	236.9393236	32.51630011	15	23.02174773	30	30			31.91677686	30								15											532.9327016	693.3608022	100.0704374		75	0.2	0.2	47.04573539	150		42.78230511	47.81822086	236.9393236	32.51630011	15	23.02174773	30	30			31.91677686	30								15											13.2372	0.249392279	3.45271971	0	1.254861225	1.80931143	1.383498662	1.526136936	11.64220332	0	5.828299802	0.969425441	1.396029483	6.020113426	9.42890378	3.619502416	0.52344862	3.955200124	0	0	8.072693062	3.243352514	0	0	0	0	0	0	0	0.432522598	0	0	0	0	0	0	0	0	0	0	78.0448	0	0	13.2372	0.249392279	3.45271971	0	1.254861225	1.80931143	1.383498662	1.526136936	11.64220332	0	5.828299802	0.969425441	1.396029483	6.020113426	9.42890378	3.619502416	0.52344862	3.955200124	0	0	8.072693062	3.243352514	0	0	0	0	0	0	0	0.432522598	0	0	0	0	0	0	0	0	0	0	78.0448																																																																																		0	0	0	13.2372	0.249392279	3.45271971	0	1.254861225	1.80931143	1.383498662	1.526136936	11.64220332	0	5.828299802	0.969425441	1.396029483	6.020113426	9.42890378	3.619502416	0.52344862	3.955200124	0	0	8.072693062	3.243352514	0	0	0	0	0	0	0	0.432522598	0	0	0	0	0	0	0	0	0	0	78.0448
H2672_001_0	2009	7																					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	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	1737.925454	44.8374663	1275.657492	0	274.7991871	11.37307951	2.217673845	494.2114011	554.4302616	0	20.93967215	0	0	634.1043928	6077.126188	13228.63482	198.9418319	707.7801985	3842.133071	896.557903	21.36206319	0	0	0	442.0169132	0	0.309969785	0	0	406.6803577											1a $165 days 1-5	1b $200 days 1-10	2 $150 days 8-23	6 $0	10a $100	11a 20%	"11b 20%, 11c $0"	"4a $50, 4b $10"	"9a $100, 9b $100"	8a $0	"8b 20% Ther., $100 Diag."	5 $0	12 $0	"3 $0, 4b $10, 9d $30, 13a $0, 14b $0"	"7a $5, 14c $5, 14d - 14g $0, 14i - 14j $0"	"17a $30, 18a $30, 7b $30,7d $30,7f $30, 14d - 14g $0, 14i - 14j $0"	"7e $30, 7h $30, 9c $30"	"7c $30,7i $30"	"8b $100, 14h $0"	7g $30	15 20%			"16a $0, 16b $30"	17a $5	17b $0	18a $5	18b $0	14a $0	"14c $5,7f $5"											111.536533	171.08	63.00940439	0	95.25248736	0.2	0.2	49.98084493	100	0	0.112115858	0	0	1.266881445	3.148718364	9.80390689	30	30	18.39278848	0.404613695	0.219871721	0	0	0	14.27244039	0	5	0	0	4.232088415											76.49033135	117.3244814	43.21104567	0	65.32294063	0.137157448	0.137157448	34.27622581	68.57872423	0	0.076887625	0	0	0.868811133	2.159350884	6.72339427	20.57361727	20.57361727	12.61353969	0.27747891	0.150785221	0	0	0	9.787857538	0	3.428936211	0	0	2.902312243											11.0779	0.438377707	4.593541179	0	1.495890915	1.559902566	0.304170486	1.411641798	3.168510001	0	1.610001657	0	0	0.045909746	1.093553984	7.411777295	0.341079426	1.213466576	4.038574833	0.020731326	3.221083425	0	0	0	0.360533215	0	8.86E-05	0	0	0.098359448	0	0	0	0	0	0	0	0	0	0	43.5051	0	19.9331	11.0779	0.438377707	4.593541179	0	1.495890915	1.559902566	0.304170486	1.411641798	3.168510001	0	1.610001657	0	0	0.045909746	1.093553984	7.411777295	0.341079426	1.213466576	4.038574833	0.020731326	3.221083425	0	0	0	0.360533215	0	8.86E-05	0	0	0.098359448	0	0	0	0	0	0	0	0	0	0	43.5051	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.0779	0.438377707	4.593541179	0	1.495890915	1.559902566	0.304170486	1.411641798	3.168510001	0	1.610001657	0	0	0.045909746	1.093553984	7.411777295	0.341079426	1.213466576	4.038574833	0.020731326	3.221083425	0	0	0	0.360533215	0	8.86E-05	0	0	0.098359448	0	0	0	0	0	0	0	0	0	0	43.5051
H2672_003_0	2009	7																					2250											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	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	1121.55033	27.98002974	637.5449634	0	142.4933054	7.046899071	1.876936112	329.0180178	408.094816	0	15.98800954	0	0	517.6278054	4956.359723	9093.05374	192.624822	567.4435684	2828.559399	744.3765295	13.57862515	0	0	0	353.8937062	0	0.196194478	0	0	279.8983219											1a $150 days 1-5	1b $200 days 1-10	2 $140 days 4-20	6 $0	10a $150	11a 20%	"11b 20%, 11c $0"	"4a $50, 4b $25"	"9a $100, 9b $100"	8a $0	"8b 20% Ther., $100 Diag."	5 $0	12 $0	"3 $0, 4b $25, 9d $25, 13a $0, 14b$0"	"7a $5, 14c $5, 14d - 14g $0, 14i - 14j $0"	"17a $25, 18a $25, 7b $25, 7d $25, 7f $25, 14d - 14g $0, 14i - 14j $0"	"7e $25, 7h $25, 9c $25"	"7c $25, 7i $25"	"8b $100, 14h $0"	7g $25	15 20%			"16a $0, 16b $25"	17a $5	17b $0	18a $5	18b $0	14a $0	"14c $5, 7f $5"											101.3968481	171.08	76.81347962	0	142.0744654	0.2	0.2	49.98274128	100	0	0.125363866	0	0	1.594067105	3.158029622	9.57381819	25	25	18.7446571	0.218780667	0.22286289	0	0	0	12.83650024	0	5	0	0	3.992145403											82.36618339	138.9708548	62.39674374	0	115.4092232	0.162463005	0.162463005	40.60173181	81.23150266	0	0.101834952	0	0	1.294884663	2.565314917	7.776956378	20.30787566	20.30787566	15.22656663	0.177718824	0.181034874	0	0	0	10.42728203	0	4.061575133	0	0	3.2428797											7.6982	0.324034054	3.315060809	0	1.37042014	1.144860401	0.304932682	1.11322511	2.762512928	0	1.628138185	0	0	0.055855692	1.059551961	5.893023523	0.325983411	0.960297786	3.589104015	0.011024143	2.458204699	0	0	0	0.307512457	0	6.64E-05	0	0	0.075639715	0	0	0	0	0	0	0	0	0	0	34.3976	0	7.9475	7.6982	0.324034054	3.315060809	0	1.37042014	1.144860401	0.304932682	1.11322511	2.762512928	0	1.628138185	0	0	0.055855692	1.059551961	5.893023523	0.325983411	0.960297786	3.589104015	0.011024143	2.458204699	0	0	0	0.307512457	0	6.64E-05	0	0	0.075639715	0	0	0	0	0	0	0	0	0	0	34.3976	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.6982	0.324034054	3.315060809	0	1.37042014	1.144860401	0.304932682	1.11322511	2.762512928	0	1.628138185	0	0	0.055855692	1.059551961	5.893023523	0.325983411	0.960297786	3.589104015	0.011024143	2.458204699	0	0	0	0.307512457	0	6.64E-05	0	0	0.075639715	0	0	0	0	0	0	0	0	0	0	34.3976
H2672_008_0	2009	7																					3000											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	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	1573.791907	41.52336778	900.6779671	0	186.8488402	10.00568916	2.053440715	437.9442148	516.9196387	0	18.55649202	0	0	565.1865822	5735.212509	11151.86077	155.6643733	496.8004674	3456.468277	842.7261842	40.94318579	0	0	0	486.2683965	0	0.169853768	0	0	353.6730093											1a $250 days 1-7	1b $250 days 1-7	2 $150 days 8-23	6 $0	10a $100	11a 20%	"11b 20%, 11c 20%"	"4a $50, 4b $30"	"9a $200, 9b $200"	8a $0	"8b 20% Ther., $150 Diag."	5 $0	12 $0	"3 $0, 4b $30, 9d $30, 13a $0, $14b $0"	"7a $15, 14c $15, 14d - 14g $0, 14i - 14j $0"	"17a $30, 18a $30, 7b $30, 7d $30, 7f $30, 14d - 14g $0, 14i - 14j $0"	"7e $30, 7h $30, 9c $30"	"7c $30, 7i $30"	"8b $150, 14h $0"	7g $30	15 20%			"16a $0, 16b $30"	17a $15	17b $0	18a $15	18b $0	14a $0	"14c $15, 7f $15"											194.9498567	194.9498567	63.00940439	0	96.51157197	0.2	0.2	49.99003768	200	0	0.159317572	0	0	1.222250879	9.729709085	10.83087081	30	30	28.26863467	0.268965467	0.209346119	0	0	0	20.73202725	0	15	0	0	12.07507411											140.7047546	140.7047546	45.47693921	0	69.65707633	0.144349688	0.144349688	36.08023162	144.3496876	0	0.114987209	0	0	0.882157663	7.022402336	7.817164092	21.65245315	21.65245315	20.40284292	0.194125406	0.151095234	0	0	0	14.96330829	0	10.82622657	0	0	8.715165882											18.4533	0.48687794	3.413339763	0	1.084611994	1.444318104	0.296413526	1.316760726	6.218099032	0	2.133759224	0	0	0.04154864	3.356247477	7.264660463	0.280876296	0.896412404	5.876814944	0.01363288	6.18632024	0	0	0	0.606348661	0	0.00015324	0	0	0.256859912	0	0	0	0	0	0	0	0	0	0	59.6274	0	22.9878	18.4533	0.48687794	3.413339763	0	1.084611994	1.444318104	0.296413526	1.316760726	6.218099032	0	2.133759224	0	0	0.04154864	3.356247477	7.264660463	0.280876296	0.896412404	5.876814944	0.01363288	6.18632024	0	0	0	0.606348661	0	0.00015324	0	0	0.256859912	0	0	0	0	0	0	0	0	0	0	59.6274	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.4533	0.48687794	3.413339763	0	1.084611994	1.444318104	0.296413526	1.316760726	6.218099032	0	2.133759224	0	0	0.04154864	3.356247477	7.264660463	0.280876296	0.896412404	5.876814944	0.01363288	6.18632024	0	0	0	0.606348661	0	0.00015324	0	0	0.256859912	0	0	0	0	0	0	0	0	0	0	59.6274
H2672_801_0	2009	3																					0											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	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	252.5285358	2.15875471	36.180083	0	8.54294876	11.85767776	3.403476559	14.1910622	67.24977067	3.689273008	22.04258985	0.57760663	0.048954526	10.95572215	36.31013356	139.3330353	1.352463107	9.229706196	49.94158727	3.362872111	23.13976495	0	0	0	0	0	0	0	0	0											FFS Medicare 8.4%	FFS Medicare 8.4%	FFS Medicare 18.5%		FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%																			0.08384508	0.08384508	0.18503968	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.08384508	0.08384508	0.18503968	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											21.1733	0.181000961	6.69475099	0	1.973421164	2.739123563	0.786203085	3.278135368	15.53469703	0.852222065	5.091838255	0.133427131	0.011308495	2.530771816	8.387640851	32.18593115	0.312418978	2.132062131	11.53650666	0.776823458	5.345285704	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.6568	0	0	21.1733	0.181000961	6.69475099	0	1.973421164	2.739123563	0.786203085	3.278135368	15.53469703	0.852222065	5.091838255	0.133427131	0.011308495	2.530771816	8.387640851	32.18593115	0.312418978	2.132062131	11.53650666	0.776823458	5.345285704	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.6568	0	FFS Medicare 8.4%	FFS Medicare 8.4%	FFS Medicare 18.5%		FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%																			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.1733	0.181000961	6.69475099	0	1.973421164	2.739123563	0.786203085	3.278135368	15.53469703	0.852222065	5.091838255	0.133427131	0.011308495	2.530771816	8.387640851	32.18593115	0.312418978	2.132062131	11.53650666	0.776823458	5.345285704	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.6568
H2672_802_0	2009	3																					0											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	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	287.8475474	3.744091495	45.96186956	0	9.621523526	15.03274082	2.841329936	16.14306487	58.96986584	5.94010215	25.18217611	0.469785397	0.180462691	8.771562817	39.34892835	129.4964129	4.260674226	8.322939113	49.07477996	3.594168992	30.62080261	0	0	0	0	0	0	0	0	0											FFS Medicare 8.4%	FFS Medicare 8.4%	FFS Medicare 18.5%		FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%																			0.08381883	0.08381883	0.185202165	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.08381883	0.08381883	0.185202165	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											24.127	0.31382537	8.512237742	0	2.222571935	3.472563129	0.656347215	3.729047984	13.62203901	1.372163597	5.81708268	0.108520427	0.041686882	2.026231011	9.089602449	29.91367138	0.984215746	1.922598935	11.33627417	0.830253037	7.073405404	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.1714	0	0	24.127	0.31382537	8.512237742	0	2.222571935	3.472563129	0.656347215	3.729047984	13.62203901	1.372163597	5.81708268	0.108520427	0.041686882	2.026231011	9.089602449	29.91367138	0.984215746	1.922598935	11.33627417	0.830253037	7.073405404	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.1714	0	FFS Medicare 8.4%	FFS Medicare 8.4%	FFS Medicare 18.5%		FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%																			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.127	0.31382537	8.512237742	0	2.222571935	3.472563129	0.656347215	3.729047984	13.62203901	1.372163597	5.81708268	0.108520427	0.041686882	2.026231011	9.089602449	29.91367138	0.984215746	1.922598935	11.33627417	0.830253037	7.073405404	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.1714
H2672_803_0	2009	5																					0											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	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	266.5482008	4.859712936	34.52767418	0	8.366917009	11.94282181	3.020773358	16.75924861	62.03826621	10.47442613	25.4440401	0.46464222	0.218443542	9.45491298	38.10049749	132.982615	2.776704431	6.900159418	45.50073964	3.454860809	22.19591545	0	0	0	0	0	0	0	0	0											FFS Medicare 8.4%	FFS Medicare 8.4%	FFS Medicare 18.5%		FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%																			0.08381883	0.08381883	0.185202165	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.08381883	0.08381883	0.185202165	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											22.3418	0.407335454	6.394600004	0	1.932757829	2.758791838	0.697798646	3.871386428	14.33083949	2.419592435	5.877573263	0.107332353	0.050460458	2.184084898	8.80121492	30.71898407	0.641418724	1.593936826	10.51067086	0.798072847	5.12725647	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.5659	0	0	22.3418	0.407335454	6.394600004	0	1.932757829	2.758791838	0.697798646	3.871386428	14.33083949	2.419592435	5.877573263	0.107332353	0.050460458	2.184084898	8.80121492	30.71898407	0.641418724	1.593936826	10.51067086	0.798072847	5.12725647	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.5659	0	FFS Medicare 8.4%	FFS Medicare 8.4%	FFS Medicare 18.5%		FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%																			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.3418	0.407335454	6.394600004	0	1.932757829	2.758791838	0.697798646	3.871386428	14.33083949	2.419592435	5.877573263	0.107332353	0.050460458	2.184084898	8.80121492	30.71898407	0.641418724	1.593936826	10.51067086	0.798072847	5.12725647	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.5659
H2701_001_0	2009	5																					0											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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	219.307326	0	697.9657422	0.985892341	74.31275759	9.984	6.656	203.3117448	96.89585685	1455.348944	295.9748148	32.23455879	4.659258724	626.0389553	3289.614214	2287.655834	164.2070053	617.0607579	661.6223982	1780.150237	39.56286475	0	0	0	406.704987	0	108.6969453	0	0	0											PBP: 1A IP Acute: $400 per admit	"1B IP Psych: $400 per admit, 190 day limit"	2 SNF: $0 per day (days 1-20) $75 per day (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: $30"	9B ASC Services: $50	8A OP C/D/T: $10	"8B OP Radiology - General: $10, CT/MRI/PET $50"	9A OP Hospital: $10	12 Renal Dialysis: 20%	"3 CORF: $10, 5 Partial Hosp: $10, 9C OP Substance Abuse: $10, 9D Cardiac Rehab: $10"	"7A PCP: $10, 14B Immunizations: $10, 14C Routine Physical Exams: $0"	7D Physician Specialist $10	"7E Mental Health: $10, 7H Psychiatric: $10"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	"8B OP Radiology - General: $10, CT/MRI/PET $50, 14G Bone Mass Measurement: $10, 14H Mammography: $10"	"7B Chiropractic: $10, 7F Podiatry: $10, 7G Other Health Care: $10, 18A Medicare Covered Hearing Exams: $10, 14D Pap Smears: $0, 14D Pelvic Exams: $0, 14E Prostate Screening: $10, 14F Colorectal Screening: $10, 14I Diabetes Monitoring: $10, 14J Nutrition Therapy $10"	15 Part B Drugs: 10%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $10, 17A Medicare Covered Eye Exams: $10"	10B Transportation: Not Covered	16A Preventive Dental Services and 16B Non Medicare Covered Comprehensive Dental $0 up to $200 per year	17A Routine Eye Exams: $10	17B Eye Wear: $100 per year max	18A Routine Hearing Exams: $10	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not covered	13B Acupuncture: Not Covered											400	400	75	0	100	0.2	0.19997156	49.11149757	50	10	17.2	10	0.199999991	10	10	10	10	10	17.2	10	0.1	0	0	0	10	0	10	0	0	0											400	400	75	0	100	0.2	0.19997156	49.11149757	50	10	17.2	10	0.199999991	10	10	10	10	10	17.2	10	0.1	0	0	0	10	0	10	0	0	0											7.3102	0	4.362285889	0	0.61927298	1.9968	1.331010702	0.832078688	0.403732737	1.212790786	0.424230568	0.026862132	0.931851703	0.521699129	2.741345178	1.906379862	0.136839171	0.514217298	0.948325437	1.483458531	3.956286475	0	0	0	0.338920822	0	0.090580788	0	0	0	0	0	0	0	0	0	0	0	0	0	32.0892	0	0	7.3102	0	4.362285889	0	0.61927298	1.9968	1.331010702	0.832078688	0.403732737	1.212790786	0.424230568	0.026862132	0.931851703	0.521699129	2.741345178	1.906379862	0.136839171	0.514217298	0.948325437	1.483458531	3.956286475	0	0	0	0.338920822	0	0.090580788	0	0	0	0	0	0	0	0	0	0	0	0	0	32.0892	0	PBP: 1A IP Acute: $600 per admit	"1B IP Psych: $600 per admit, 190 day limit"	2 SNF: $100 per day	6 Home Health: $30 per visit	10A Ambulance: $100	11A DME: 50%	"11B Prosthetic Medical Supplies: 50%, 11C Diabetes Monitoring Supplies: 50%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $150	8A OP C/D/T: $30	"8B OP Radiology - General: $30, CT/MRI/PET $150"	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: $30, 14B Immunizations: $30, 14C Routine Physical Exams: $30"	7D Physician Specialist $30	"7E Mental Health: $30, 7H Psychiatric: $30"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	"8B OP Radiology - General: $30, CT/MRI/PET $150, 14G Bone Mass Measurement: $30, 14H Mammography: $30"	"7B Chiropractic: $30, 7F Podiatry: $30, 7G Other Health Care: $30, 18A Medicare Covered Hearing Exams: $30, 14D Pap Smears: $30, 14D Pelvic Exams: $30, 14E Prostate Screening: $30, 14F Colorectal Screening: $30, 14I Diabetes Monitoring: $30, 14J Nutrition Therapy $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: $30	17B Eye Wear: Not Covered	18A Routine Hearing Exams: $30	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not covered	13B Acupuncture: Not Covered											0.7988	0	0	0.0001	0.3637	0	0	0.1207	0.0535	0.1508	0.4074	0.0026	0.3471	0.0504	2.7648	1.7189	0.4156	0.8799	1.5693	1.6046	1.2806	0	0	0	0.3034	0	0.0811	0	0	0											12.9132	0	0	8.109	0	4.362285889	7.78E-05	0.982972984	1.9968	1.331010702	0.952798223	0.457229327	1.363600222	0.831659925	0.029465987	1.278962001	0.572102761	5.50613318	3.625320112	0.552478859	1.39407152	2.517587003	3.088015717	5.236896922	0	0	0	0.642286202	0	0.171658943	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0024
H2701_003_0	2009	6																					0											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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	218.2395714	0	697.8264485	0.986269789	74.31275759	9.984	6.656	203.3117448	95.10597901	1449.331516	294.7510485	32.10127865	4.659258724	623.4504737	3219.616094	2216.588126	159.1057942	597.8913124	641.0686126	1724.848563	39.56286475	0	0	0	305.0287402	0	108.6969453	0	0	0											PBP: 1A IP Acute: $650 per admit	"1B IP Psych: $650 per admit, 190 day limit"	"2 SNF: $0, Days 1-20; $130/day, 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: $45"	9B ASC Services: $250	8A OP C/D/T: $25	"8B OP Radiology - General: $25, CT/MRI/PET $100"	9A OP Hospital: $25	12 Renal Dialysis: 20%	"3 CORF: $25, 5 Partial Hosp: $25, 9C OP Substance Abuse: $25, 9D Cardiac Rehab: $25"	"7A PCP: $25, 14B Immunizations: $25, 14C Routine Physical Exams: $25"	7D Physician Specialist $25	"7E Mental Health: $25, 7H Psychiatric: $25"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	"8B OP General: $25, CT/MRI/PET $100, 14G Bone Mass Measurement: $25, 14H Mammography: $25"	"7B Chiropractic: $25, 7F Podiatry: $25, 7G Other Health Care: $25, 18A Medicare Covered Hearing Exams: $25, 14D Pap Smears: $25, 14D Pelvic Exams: $25, 14E Prostate Screening: $25, 14F Colorectal Screening: $25, 14I Diabetes Monitoring: $25, 14J Nutrition Therapy $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: $25 copay 1 exam every 2 yrs.	17B Eye Wear: Not Covered	18A Routine Hearing Exams: $25	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											650	650	130	0	100	0.250000067	0.19997156	49.79569167	250	25	38.5	25	0.2	25	25	25	25	25	38.5	25	0.2	0	0	0	25	0	25	0	0	0											650	650	130	0	100	0.250000067	0.19997156	49.79569167	250	25	38.5	25	0.2	25	25	25	25	25	38.5	25	0.2	0	0	0	25	0	25	0	0	0											11.8213	0	7.559786525	0	0.61927298	2.496000668	1.331010702	0.843670746	1.981374563	3.019440659	0.945659614	0.066877664	0.931851745	1.298855154	6.707533529	4.617891929	0.331470404	1.245606901	2.056761799	3.593434506	7.912572949	0	0	0	0.635476542	0	0.226451969	0	0	0	0	0	0	0	0	0	0	0	0	0	60.2423	0	0	11.8213	0	7.559786525	0	0.61927298	2.496000668	1.331010702	0.843670746	1.981374563	3.019440659	0.945659614	0.066877664	0.931851745	1.298855154	6.707533529	4.617891929	0.331470404	1.245606901	2.056761799	3.593434506	7.912572949	0	0	0	0.635476542	0	0.226451969	0	0	0	0	0	0	0	0	0	0	0	0	0	60.2423	0	PBP: 1A IP Acute: $900 per admit	"1B IP Psych: $900 per admit, 190 day limit"	2 SNF: $130 per day	6 Home Health: $45	10A Ambulance: $100	11A DME: 50%	"11B Prosthetic Medical Supplies: 50%, 11C Diabetes Monitoring Supplies: 50%"	"4A ER : $50, 4B Urgent Care: $45"	9B ASC Services: $450	8A OP C/D/T: $45	"8B OP Radiology - General: $45, CT/MRI/PET $200"	9A OP Hospital: $45	12 Renal Dialysis: 20%	"3 CORF: $45, 5 Partial Hosp: $45, 9C OP Substance Abuse: $45, 9D Cardiac Rehab: $45"	"7A PCP: $45, 14B Immunizations: $45, 14C Routine Physical Exams: $45"	7D Physician Specialist $45	"7E Mental Health: $45, 7H Psychiatric: $45"	"7C Occupational Therapy: $45, 7I Physical and Speech Therapy: $45"	"8B OP General: $45, CT/MRI/PET $200, 14G Bone Mass Measurement: $45, 14H Mammography: $45"	"7B Chiropractic: $45, 7F Podiatry: $45, 7G Other Health Care: $45, 18A Medicare Covered Hearing Exams: $45, 14D Pap Smears: $45, 14D Pelvic Exams: $45, 14E Prostate Screening: $45, 14F Colorectal Screening: $45, 14I Diabetes Monitoring: $45, 14J Nutrition Therapy $45"	15 Part B Drugs: 30%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $45, 17A Medicare Covered Eye Exams: $45"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $45 copay 1 exam every 2 yrs.	17B Eye Wear: Not Covered	18A Routine Hearing Exams: $45	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											1.1923	0	0	0.0001	0.3637	0	0	0.1224	0.1575	0.2253	0.5732	0.0039	0.3471	0.0753	4.0589	2.4983	0.6041	1.2788	2.1482	2.3321	1.9209	0	0	0	0.3413	0	0.1216	0	0	0											18.3651	0	0	13.0137	0	7.559786525	0.000116747	0.982972984	2.496000668	1.331010702	0.966072079	2.138899737	3.244719485	1.518892037	0.070767297	1.278962043	1.374147996	10.76646964	7.116202093	0.935561708	2.524388257	4.204926023	5.925500165	9.83348862	0	0	0	0.976762594	0	0.348069202	0	0	0	0	0	0	0	0	0	0	0	0	0	78.6074
H2701_805_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	187.4280502	0	37.93206574	21.01259131	3.678858658	14.60310189	3.760167626	13.38321004	26.66844367	18.23746611	33.34441069	1.236696865	6.194146624	21.53627782	31.34496589	42.99739043	1.943872521	6.635498606	10.2524251	34.21211557	39.40224413	1.384839084	0	0	0	0	0	0	0	0											Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing											0.089501912	0.089572117	0.15970993	0	0.230938717	0.231000386	0.230969767	0.23099533	0.231000015	0.231079009	0.230946897	0.230999747	0.231000025	0.231014873	0.23099515	0.230999936	0.231011085	0.230956482	0.231004844	0.230992286	0.230996586	0.23100148	0	0	0	0	0	0	0	0											0.089501912	0.089572117	0.15970993	0	0.230938717	0.231000386	0.230969767	0.23099533	0.231000015	0.231079009	0.230946897	0.230999747	0.231000025	0.231014873	0.23099515	0.230999936	0.231011085	0.230956482	0.231004844	0.230992286	0.230996586	0.23100148	0	0	0	0	0	0	0	0											16.7752	0	6.058127576	0	0.849590897	3.373322173	0.868485041	3.091459026	6.160410896	4.214295603	7.700788186	0.285676662	1.430848024	4.975200496	7.240535101	9.932394453	0.4490561	1.532511411	2.368359864	7.902734794	9.101783895	0.319899878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.6306	0	0	16.7752	0	6.058127576	0	0.849590897	3.373322173	0.868485041	3.091459026	6.160410896	4.214295603	7.700788186	0.285676662	1.430848024	4.975200496	7.240535101	9.932394453	0.4490561	1.532511411	2.368359864	7.902734794	9.101783895	0.319899878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.6306	0	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing											1.222	0	0	0	0.499	0	0	0.4485	0.2721	0.1747	2.4653	0.0092	0.533	0.1602	2.4342	2.9853	0.4547	0.8741	1.3064	2.8493	1.4731	0	0	0	0	0	0	0	0	0											18.1609	0	0	17.9972	0	6.058127576	0	1.34855698	3.373322173	0.868485041	3.539973692	6.432505895	4.388976883	10.16605701	0.29490726	1.96383204	5.13542578	9.674686132	12.91766739	0.903715235	2.40658199	3.674724382	10.75202013	10.5748622	0.319899878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.7915
H2701_806_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	187.4280502	0	37.93206574	21.01259131	3.678858658	14.60310189	3.760167626	13.38321004	26.66844367	18.23746611	33.34441069	1.236696865	6.194146624	21.53627782	31.34496589	42.99739043	1.943872521	6.635498606	10.2524251	34.21211557	39.40224413	1.384839084	0	0	0	0	0	0	0	0											Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing											0.089501912	0.089572117	0.15970993	0	0.230938717	0.231000386	0.230969767	0.23099533	0.231000015	0.231079009	0.230946897	0.230999747	0.231000025	0.231014873	0.23099515	0.230999936	0.231011085	0.230956482	0.231004844	0.230992286	0.230996586	0.23100148	0	0	0	0	0	0	0	0											0.089501912	0.089572117	0.15970993	0	0.230938717	0.231000386	0.230969767	0.23099533	0.231000015	0.231079009	0.230946897	0.230999747	0.231000025	0.231014873	0.23099515	0.230999936	0.231011085	0.230956482	0.231004844	0.230992286	0.230996586	0.23100148	0	0	0	0	0	0	0	0											16.7752	0	6.058127576	0	0.849590897	3.373322173	0.868485041	3.091459026	6.160410896	4.214295603	7.700788186	0.285676662	1.430848024	4.975200496	7.240535101	9.932394453	0.4490561	1.532511411	2.368359864	7.902734794	9.101783895	0.319899878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.6306	0	0	16.7752	0	6.058127576	0	0.849590897	3.373322173	0.868485041	3.091459026	6.160410896	4.214295603	7.700788186	0.285676662	1.430848024	4.975200496	7.240535101	9.932394453	0.4490561	1.532511411	2.368359864	7.902734794	9.101783895	0.319899878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.6306	0	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing											1.222	0	0	0	0.499	0	0	0.4485	0.2721	0.1747	2.4653	0.0092	0.533	0.1602	2.4342	2.9853	0.4547	0.8741	1.3064	2.8493	1.4731	0	0	0	0	0	0	0	0	0											18.1609	0	0	17.9972	0	6.058127576	0	1.34855698	3.373322173	0.868485041	3.539973692	6.432505895	4.388976883	10.16605701	0.29490726	1.96383204	5.13542578	9.674686132	12.91766739	0.903715235	2.40658199	3.674724382	10.75202013	10.5748622	0.319899878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.7915
H2701_807_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	187.4280502	0	37.93206574	21.01259131	3.678858658	14.60310189	3.760167626	13.38321004	26.66844367	18.23746611	33.34441069	1.236696865	6.194146624	21.53627782	31.34496589	42.99739043	1.943872521	6.635498606	10.2524251	34.21211557	39.40224413	1.384839084	0	0	0	0	0	0	0	0											Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing											0.089501912	0.089572117	0.15970993	0	0.230938717	0.231000386	0.230969767	0.23099533	0.231000015	0.231079009	0.230946897	0.230999747	0.231000025	0.231014873	0.23099515	0.230999936	0.231011085	0.230956482	0.231004844	0.230992286	0.230996586	0.23100148	0	0	0	0	0	0	0	0											0.089501912	0.089572117	0.15970993	0	0.230938717	0.231000386	0.230969767	0.23099533	0.231000015	0.231079009	0.230946897	0.230999747	0.231000025	0.231014873	0.23099515	0.230999936	0.231011085	0.230956482	0.231004844	0.230992286	0.230996586	0.23100148	0	0	0	0	0	0	0	0											16.7752	0	6.058127576	0	0.849590897	3.373322173	0.868485041	3.091459026	6.160410896	4.214295603	7.700788186	0.285676662	1.430848024	4.975200496	7.240535101	9.932394453	0.4490561	1.532511411	2.368359864	7.902734794	9.101783895	0.319899878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.6306	0	0	16.7752	0	6.058127576	0	0.849590897	3.373322173	0.868485041	3.091459026	6.160410896	4.214295603	7.700788186	0.285676662	1.430848024	4.975200496	7.240535101	9.932394453	0.4490561	1.532511411	2.368359864	7.902734794	9.101783895	0.319899878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.6306	0	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing	Standared Medicare Cost Sharing											1.222	0	0	0	0.499	0	0	0.4485	0.2721	0.1747	2.4653	0.0092	0.533	0.1602	2.4342	2.9853	0.4547	0.8741	1.3064	2.8493	1.4731	0	0	0	0	0	0	0	0	0											18.1609	0	0	17.9972	0	6.058127576	0	1.34855698	3.373322173	0.868485041	3.539973692	6.432505895	4.388976883	10.16605701	0.29490726	1.96383204	5.13542578	9.674686132	12.91766739	0.903715235	2.40658199	3.674724382	10.75202013	10.5748622	0.319899878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.7915
H2762_012_0	2009	2																					3600											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1557.509054	40.22403062	1416.991741	2355.102813	292.8581313	13.59798572	8.373566129	284.2634782	361.5739572	6.772284291	19.82587081	1.012404814	40.49619255	120.822577	5228.387574	8196.093606	176.1175319	870.3678993	38.32217346	0	8.945344467	0	0	13.83271123	0	0	0	0	0	43.43988792											"$230 Copay/Day, up to 6 days; Unlimited"	"$230 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$40 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$250/Visit	15% Coinsurance	15% Coinsurance	$40 Copay	$40 Copay	$40 Copay	$15 Copay	$40 Copay	$15 Copay Group Session; $40 for Indiv.	$40 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"						$15/Routine Physical											140.5927273	131.2929032	28.10077519	0	150	0.15	0.15	49.56090468	250	0.15	0.15	40	40	40	15	40	27.5	40	0.15	0	0.2	0	0	0.25	0	0	0	0	0	15											103.2906137	96.45822236	20.64506729	0	110.2019454	0.110201945	0.110201945	36.41138741	183.669909	0.110201945	0.110201945	29.38718544	29.38718544	29.38718544	11.02019454	29.38718544	20.20368999	29.38718544	0.110201945	0	0.146935927	0	0	0.25	0	0	0	0	0	11.02019454											13.4063	0.323328207	2.437824153	0	2.689461316	1.49852448	0.922783277	0.862535636	5.534187984	0.746318904	2.184849533	0.002479311	0.099172427	0.29588629	4.80148735	20.07167689	0.296518668	2.131471905	4.223178068	0	1.314392483	0	0	3.458177807	0	0	0	0	0	0.039893001	0	0	0	0	0	0	0	0	0	0	67.3405	0	23.069	13.4063	0.323328207	2.437824153	0	2.689461316	1.49852448	0.922783277	0.862535636	5.534187984	0.746318904	2.184849533	0.002479311	0.099172427	0.29588629	4.80148735	20.07167689	0.296518668	2.131471905	4.223178068	0	1.314392483	0	0	3.458177807	0	0	0	0	0	0.039893001	0	0	0	0	0	0	0	0	0	0	67.3405	3600																																																																																	0	0	0	13.4063	0.323328207	2.437824153	0	2.689461316	1.49852448	0.922783277	0.862535636	5.534187984	0.746318904	2.184849533	0.002479311	0.099172427	0.29588629	4.80148735	20.07167689	0.296518668	2.131471905	4.223178068	0	1.314392483	0	0	3.458177807	0	0	0	0	0	0.039893001	0	0	0	0	0	0	0	0	0	0	67.3405
H2762_013_0	2009	2																					3600											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1757.059824	45.37760342	1384.949794	2759.175727	318.3429925	14.8044937	9.116527229	274.8148696	349.5093892	6.773131584	19.82835126	0.978624099	39.14496397	116.7911136	5546.478621	8741.391371	189.6437323	937.2140017	40.89926425	0	8.946463636	0	0	13.83271123	0	0	0	0	0	46.00924995											"$230 Copay/Day, up to 6 days; Unlimited"	"$230 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$40 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$250/Visit	15% Coinsurance	15% Coinsurance	$40 Copay	$40 Copay	$40 Copay	$15 Copay	$40 Copay	$15 Copay Group Session; $40 for Indiv.	$40 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"						$15/Routine Physical											140.5927273	131.2929032	28.10077519	0	150	0.15	0.15	49.56090468	250	0.15	0.15	40	40	40	15	40	27.5	40	0.15	0	0.2	0	0	0.25	0	0	0	0	0	15											100.9302307	94.25397224	20.17328903	0	107.6836256	0.107683626	0.107683626	35.57931936	179.4727093	0.107683626	0.107683626	28.71563349	28.71563349	28.71563349	10.76836256	28.71563349	19.74199803	28.71563349	0.107683626	0	0.143578167	0	0	0.25	0	0	0	0	0	10.76836256											14.7784	0.356418281	2.328249374	0	2.856693968	1.594201557	0.981700705	0.814810501	5.227283085	0.729355366	2.135188754	0.002341818	0.093672703	0.279477568	4.977207727	20.91788257	0.311995516	2.242724482	4.404181059	0	1.284516854	0	0	3.458177807	0	0	0	0	0	0.041287024	0	0	0	0	0	0	0	0	0	0	69.8157	0	26.0693	14.7784	0.356418281	2.328249374	0	2.856693968	1.594201557	0.981700705	0.814810501	5.227283085	0.729355366	2.135188754	0.002341818	0.093672703	0.279477568	4.977207727	20.91788257	0.311995516	2.242724482	4.404181059	0	1.284516854	0	0	3.458177807	0	0	0	0	0	0.041287024	0	0	0	0	0	0	0	0	0	0	69.8157	3600																																																																																	0	0	0	14.7784	0.356418281	2.328249374	0	2.856693968	1.594201557	0.981700705	0.814810501	5.227283085	0.729355366	2.135188754	0.002341818	0.093672703	0.279477568	4.977207727	20.91788257	0.311995516	2.242724482	4.404181059	0	1.284516854	0	0	3.458177807	0	0	0	0	0	0.041287024	0	0	0	0	0	0	0	0	0	0	69.8157
H2762_014_0	2009	2																					3600											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1701.137445	43.93335918	1335.04384	2359.72678	320.5072074	14.96777622	9.217075717	289.731108	368.554794	6.696288908	19.60339423	1.031951113	41.27804453	123.1552746	5483.424626	8724.324298	192.4476453	951.0708613	40.52824944	0	8.844964027	0	0	13.83271123	0	0	0	0	0	44.61323141											"$230 Copay/Day, up to 6 days; Unlimited"	"$230 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$40 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$250/Visit	15% Coinsurance	15% Coinsurance	$40 Copay	$40 Copay	$40 Copay	$15 Copay	$40 Copay	$15 Copay Group Session; $40 for Indiv.	$40 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"						$15/Routine Physical											140.5927273	131.2929032	28.10077519	0	150	0.15	0.15	49.56090468	250	0.15	0.15	40	40	40	15	40	27.5	40	0.15	0	0.2	0	0	0.25	0	0	0	0	0	15											101.1397865	94.44966644	20.2151737	0	107.907203	0.107907203	0.107907203	35.6531907	179.8453384	0.107907203	0.107907203	28.77525414	28.77525414	28.77525414	10.7907203	28.77525414	19.78298722	28.77525414	0.107907203	0	0.143876271	0	0	0.25	0	0	0	0	0	10.7907203											14.3377	0.345790927	2.249011926	0	2.882086359	1.615130867	0.994588861	0.86081987	5.523571804	0.722577807	2.115347441	0.002474555	0.098982185	0.295318694	4.930841787	20.92038741	0.317265776	2.280608812	4.373290042	0	1.272580439	0	0	3.458177807	0	0	0	0	0	0.040117409	0	0	0	0	0	0	0	0	0	0	69.6367	0	25.8136	14.3377	0.345790927	2.249011926	0	2.882086359	1.615130867	0.994588861	0.86081987	5.523571804	0.722577807	2.115347441	0.002474555	0.098982185	0.295318694	4.930841787	20.92038741	0.317265776	2.280608812	4.373290042	0	1.272580439	0	0	3.458177807	0	0	0	0	0	0.040117409	0	0	0	0	0	0	0	0	0	0	69.6367	3600																																																																																	0	0	0	14.3377	0.345790927	2.249011926	0	2.882086359	1.615130867	0.994588861	0.86081987	5.523571804	0.722577807	2.115347441	0.002474555	0.098982185	0.295318694	4.930841787	20.92038741	0.317265776	2.280608812	4.373290042	0	1.272580439	0	0	3.458177807	0	0	0	0	0	0.040117409	0	0	0	0	0	0	0	0	0	0	69.6367
H2762_015_0	2009	3																					3600											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1723.146694	44.50176725	1569.067387	2515.380265	310.0267642	14.60355053	8.99278751	310.0124842	394.450683	7.282588558	21.3197872	1.10445944	44.1783776	131.8085749	5422.299902	8487.416699	181.8867595	898.8792598	39.33700063	0	9.619392876	0	0	13.83271123	0	0	0	0	0	44.73940642											"$230 Copay/Day, up to 6 days; Unlimited"	"$230 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$40 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$250/Visit	15% Coinsurance	15% Coinsurance	$40 Copay	$40 Copay	$40 Copay	$15 Copay	$40 Copay	$15 Copay Group Session; $40 for Indiv.	$40 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"						$15/Routine Physical											140.5927273	131.2929032	28.10077519	0	150	0.15	0.15	49.56090468	250	0.15	0.15	40	40	40	15	40	27.5	40	0.15	0	0.2	0	0	0.25	0	0	0	0	0	15											100.9149646	94.23971589	20.17023773	0	107.667338	0.107667338	0.107667338	35.57393783	179.4455633	0.107667338	0.107667338	28.71129012	28.71129012	28.71129012	10.7667338	28.71129012	19.73901196	28.71129012	0.107667338	0	0.143556451	0	0	0.25	0	0	0	0	0	10.7667338											14.4909	0.349486159	2.637371851	0	2.781646367	1.572325411	0.968229492	0.919030403	5.898535416	0.784096924	2.295444733	0.002642538	0.105701518	0.315366186	4.865038301	20.30705694	0.299188743	2.150665268	4.235310141	0	1.380925898	0	0	3.458177807	0	0	0	0	0	0.04014144	0	0	0	0	0	0	0	0	0	0	69.8573	0	26.1002	14.4909	0.349486159	2.637371851	0	2.781646367	1.572325411	0.968229492	0.919030403	5.898535416	0.784096924	2.295444733	0.002642538	0.105701518	0.315366186	4.865038301	20.30705694	0.299188743	2.150665268	4.235310141	0	1.380925898	0	0	3.458177807	0	0	0	0	0	0.04014144	0	0	0	0	0	0	0	0	0	0	69.8573	3600																																																																																	0	0	0	14.4909	0.349486159	2.637371851	0	2.781646367	1.572325411	0.968229492	0.919030403	5.898535416	0.784096924	2.295444733	0.002642538	0.105701518	0.315366186	4.865038301	20.30705694	0.299188743	2.150665268	4.235310141	0	1.380925898	0	0	3.458177807	0	0	0	0	0	0.04014144	0	0	0	0	0	0	0	0	0	0	69.8573
H2762_016_0	2009	2																					3400											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1669.76804	43.12321692	1504.410146	2479.148554	308.273565	14.31412232	8.814559181	299.1724632	391.8976566	7.128814025	20.86961206	1.099618392	43.9847357	127.1830784	5679.970517	9105.277824	195.654267	958.4631243	40.34048954	0	9.715960243	0	0	13.83271123	409.5364599	1.889015625	175.5156257	0	0	43.44011735											"$100 Copay/Day, up to 6 days; Unlimited"	"$100 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $100 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$100/Trip	15% Coinsurance	15% Coinsurance	$20 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$100/Visit	15% Coinsurance	15% Coinsurance	$20 Copay	$20 Copay	$20 Copay	$10 Copay	$20 Copay	$10 Copay Group Session; $20 for Indiv.	$20 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"	$20/Exam	$75 Allowance	$20/Exam			$10 Copay											61.12727273	57.08387097	22.48062016	0	100	0.15	0.15	48.68271405	100	0.15	0.15	20	20	20	10	20	15	20	0.15	0	0.2	0	0	0.25	20	0	20	0	0	10											50.48794675	47.14830728	18.56782256	0	82.59479688	0.123892195	0.123892195	40.20938878	82.59479688	0.123892195	0.123892195	16.51895938	16.51895938	16.51895938	8.259479688	16.51895938	12.38921953	16.51895938	0.123892195	0	0.165189594	0	0	0.25	16.51895938	0	16.51895938	0	0	8.259479688											7.0253	0.169432224	2.327801719	0	2.12181604	1.773408039	1.092055088	1.002461824	2.697392279	0.88320442	2.585582053	0.001513713	0.060548505	0.175077675	3.90946676	12.53414287	0.202000306	1.319401118	4.99787181	0	1.604975526	0	0	3.458177807	0.563759679	0	0.241611291	0	0	0.029899397	0	0	0	0	0	0	0	0	0	0	50.7769	0	9.9734	7.0253	0.169432224	2.327801719	0	2.12181604	1.773408039	1.092055088	1.002461824	2.697392279	0.88320442	2.585582053	0.001513713	0.060548505	0.175077675	3.90946676	12.53414287	0.202000306	1.319401118	4.99787181	0	1.604975526	0	0	3.458177807	0.563759679	0	0.241611291	0	0	0.029899397	0	0	0	0	0	0	0	0	0	0	50.7769	3400																																																																																	0	0	0	7.0253	0.169432224	2.327801719	0	2.12181604	1.773408039	1.092055088	1.002461824	2.697392279	0.88320442	2.585582053	0.001513713	0.060548505	0.175077675	3.90946676	12.53414287	0.202000306	1.319401118	4.99787181	0	1.604975526	0	0	3.458177807	0.563759679	0	0.241611291	0	0	0.029899397	0	0	0	0	0	0	0	0	0	0	50.7769
H2762_017_0	2009	3																					3400											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1883.571079	48.64486699	1470.717827	2904.101187	335.0830917	15.58357744	9.596282782	289.2597605	378.8672952	7.130374097	20.87417917	1.063056742	42.52226968	122.9543175	6024.937269	9710.269398	210.6701728	1032.02243	43.04643651	0	9.718086486	0	0	13.83271123	433.7241947	1.889015625	185.8817977	0	0	46.00574494											"$100 Copay/Day, up to 6 days; Unlimited"	"$100 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $100 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$100/Trip	15% Coinsurance	15% Coinsurance	$20 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$100/Visit	15% Coinsurance	15% Coinsurance	$20 Copay	$20 Copay	$20 Copay	$10 Copay	$20 Copay	$10 Copay Group Session; $20 for Indiv.	$20 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"	$20/Exam	$75 Allowance	$20/Exam			$10 Copay											61.12727273	57.08387097	22.48062016	0	100	0.15	0.15	48.68271405	100	0.15	0.15	20	20	20	10	20	15	20	0.15	0	0.2	0	0	0.25	20	0	20	0	0	10											49.72056701	46.43168761	18.28560528	0	81.33941659	0.122009125	0.122009125	39.59823558	81.33941659	0.122009125	0.122009125	16.26788332	16.26788332	16.26788332	8.133941659	16.26788332	12.20091249	16.26788332	0.122009125	0	0.162678833	0	0	0.25	16.26788332	0	16.26788332	0	0	8.133941659											7.8044	0.188221939	2.241080473	0	2.271288599	1.901338646	1.170834064	0.954514678	2.568070396	0.869970704	2.546840333	0.00144114	0.05764561	0.166683874	4.083874021	13.16379413	0.214197362	1.399068372	5.252058048	0	1.58092697	0	0	3.458177807	0.587981216	0	0.25199195	0	0	0.031184004	0	0	0	0	0	0	0	0	0	0	52.7655	0	11.3072	7.8044	0.188221939	2.241080473	0	2.271288599	1.901338646	1.170834064	0.954514678	2.568070396	0.869970704	2.546840333	0.00144114	0.05764561	0.166683874	4.083874021	13.16379413	0.214197362	1.399068372	5.252058048	0	1.58092697	0	0	3.458177807	0.587981216	0	0.25199195	0	0	0.031184004	0	0	0	0	0	0	0	0	0	0	52.7655	3400																																																																																	0	0	0	7.8044	0.188221939	2.241080473	0	2.271288599	1.901338646	1.170834064	0.954514678	2.568070396	0.869970704	2.546840333	0.00144114	0.05764561	0.166683874	4.083874021	13.16379413	0.214197362	1.399068372	5.252058048	0	1.58092697	0	0	3.458177807	0.587981216	0	0.25199195	0	0	0.031184004	0	0	0	0	0	0	0	0	0	0	52.7655
H2762_018_0	2009	2																					3400											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1685.160907	43.52075115	1579.042742	2226.625411	303.9013328	14.56171369	8.967024607	315.0004163	412.7036773	7.464879439	21.85344398	1.157997621	46.31990485	133.9352845	5679.407506	9050.265729	192.3742438	942.3950807	41.2136328	0	10.17398849	0	0	13.83271123	412.9578268	1.889015625	176.9819258	0	0	43.80302663											"$100 Copay/Day, up to 6 days; Unlimited"	"$100 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $100 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$100/Trip	15% Coinsurance	15% Coinsurance	$20 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$100/Visit	15% Coinsurance	15% Coinsurance	$20 Copay	$20 Copay	$20 Copay	$10 Copay	$20 Copay	$10 Copay Group Session; $20 for Indiv.	$20 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"	$20/Exam	$75 Allowance	$20/Exam			$10 Copay											61.12727273	57.08387097	22.48062016	0	100	0.15	0.15	48.68271405	100	0.15	0.15	20	20	20	10	20	15	20	0.15	0	0.2	0	0	0.25	20	0	20	0	0	10											50.31373423	46.98561845	18.50375287	0	82.30979723	0.123464696	0.123464696	40.07064322	82.30979723	0.123464696	0.123464696	16.46195945	16.46195945	16.46195945	8.230979723	16.46195945	12.34646958	16.46195945	0.123464696	0	0.164619594	0	0	0.25	16.46195945	0	16.46195945	0	0	8.230979723											7.0656	0.170404117	2.434851388	0	2.084504757	1.797857552	1.107110966	1.051855775	2.830796333	0.921649069	2.698128814	0.001588576	0.063543033	0.183736435	3.895590668	12.41542562	0.197928563	1.2928058	5.088428638	0	1.674837859	0	0	3.458177807	0.566507916	0	0.242789107	0	0	0.030045152	0	0	0	0	0	0	0	0	0	0	51.2741	0	10.2785	7.0656	0.170404117	2.434851388	0	2.084504757	1.797857552	1.107110966	1.051855775	2.830796333	0.921649069	2.698128814	0.001588576	0.063543033	0.183736435	3.895590668	12.41542562	0.197928563	1.2928058	5.088428638	0	1.674837859	0	0	3.458177807	0.566507916	0	0.242789107	0	0	0.030045152	0	0	0	0	0	0	0	0	0	0	51.2741	3400																																																																																	0	0	0	7.0656	0.170404117	2.434851388	0	2.084504757	1.797857552	1.107110966	1.051855775	2.830796333	0.921649069	2.698128814	0.001588576	0.063543033	0.183736435	3.895590668	12.41542562	0.197928563	1.2928058	5.088428638	0	1.674837859	0	0	3.458177807	0.566507916	0	0.242789107	0	0	0.030045152	0	0	0	0	0	0	0	0	0	0	51.2741
H2762_019_0	2009	3																					3400											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1847.250977	47.70686867	1665.93069	2647.377897	326.2296313	15.36960985	9.464522698	326.2962819	427.5511371	7.666384315	22.44334976	1.199657834	47.98631338	138.7537508	5889.981707	9427.653605	202.0277145	989.6851082	41.40223954	0	10.4486223	0	0	13.83271123	421.7635868	1.889015625	180.7558229	0	0	44.73706617											"$100 Copay/Day, up to 6 days; Unlimited"	"$100 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $100 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$100/Trip	15% Coinsurance	15% Coinsurance	$20 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$100/Visit	15% Coinsurance	15% Coinsurance	$20 Copay	$20 Copay	$20 Copay	$10 Copay	$20 Copay	$10 Copay Group Session; $20 for Indiv.	$20 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"	$20/Exam	$75 Allowance	$20/Exam			$10 Copay											61.12727273	57.08387097	22.48062016	0	100	0.15	0.15	48.68271405	100	0.15	0.15	20	20	20	10	20	15	20	0.15	0	0.2	0	0	0.25	20	0	20	0	0	10											49.67963245	46.39346076	18.27055088	0	81.27245047	0.121908676	0.121908676	39.56563466	81.27245047	0.121908676	0.121908676	16.25449009	16.25449009	16.25449009	8.127245047	16.25449009	12.19086757	16.25449009	0.121908676	0	0.162544901	0	0	0.25	16.25449009	0	16.25449009	0	0	8.127245047											7.6476	0.184440562	2.536455953	0	2.209456796	1.873688783	1.153807428	1.07584329	2.895677385	0.934598759	2.736039048	0.001624986	0.064999421	0.187947622	3.989110388	12.77014185	0.205241093	1.340568899	5.047292193	0	1.698370277	0	0	3.458177807	0.571296004	0	0.244841144	0	0	0.030299092	0	0	0	0	0	0	0	0	0	0	52.8575	0	11.3807	7.6476	0.184440562	2.536455953	0	2.209456796	1.873688783	1.153807428	1.07584329	2.895677385	0.934598759	2.736039048	0.001624986	0.064999421	0.187947622	3.989110388	12.77014185	0.205241093	1.340568899	5.047292193	0	1.698370277	0	0	3.458177807	0.571296004	0	0.244841144	0	0	0.030299092	0	0	0	0	0	0	0	0	0	0	52.8575	3400																																																																																	0	0	0	7.6476	0.184440562	2.536455953	0	2.209456796	1.873688783	1.153807428	1.07584329	2.895677385	0.934598759	2.736039048	0.001624986	0.064999421	0.187947622	3.989110388	12.77014185	0.205241093	1.340568899	5.047292193	0	1.698370277	0	0	3.458177807	0.571296004	0	0.244841144	0	0	0.030299092	0	0	0	0	0	0	0	0	0	0	52.8575
H2762_020_0	2009	3																					3000											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1509.42041	38.98209943	1326.457719	2052.64282	209.4365957	11.79193074	7.261407232	267.5697206	344.1520926	6.161156489	18.0367934	0.958489451	38.33957803	113.6998769	5246.122102	7976.93008	168.4993895	831.2858767	34.44972412	0	8.187387844	0	0	13.83271123	0	0	0	0	0	43.92407434											"$175 Copay/Day, up to 6 days; Unlimited"	"$175 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$35 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$175/Visit	15% Coinsurance	15% Coinsurance	$35 Copay	$35 Copay	$35 Copay	$10 Copay	$35 Copay	$10 Copay Group Session; $35 for Indiv.	$35 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"						$10/Routine Physical											106.9727273	99.89677419	28.10077519	0	150	0.15	0.15	49.34135702	175	0.15	0.15	35	35	35	10	35	22.5	35	0.15	0	0.2	0	0	0.25	0	0	0	0	0	10											79.85234088	74.57032712	20.97649314	0	111.9710737	0.111971074	0.111971074	36.8320315	130.6329193	0.111971074	0.111971074	26.12658387	26.12658387	26.12658387	7.464738249	26.12658387	16.79566106	26.12658387	0.111971074	0	0.149294765	0	0	0.25	0	0	0	0	0	7.464738249											10.0442	0.242242326	2.318702603	0	1.954236708	1.320355146	0.813067565	0.821261365	3.746466047	0.689871307	2.019599123	0.002086838	0.083473517	0.247549114	3.263410693	17.3674944	0.23583822	1.809888348	3.8573726	0	1.222334144	0	0	3.458177807	0	0	0	0	0	0.027323476	0	0	0	0	0	0	0	0	0	0	55.545	0	17.6871	10.0442	0.242242326	2.318702603	0	1.954236708	1.320355146	0.813067565	0.821261365	3.746466047	0.689871307	2.019599123	0.002086838	0.083473517	0.247549114	3.263410693	17.3674944	0.23583822	1.809888348	3.8573726	0	1.222334144	0	0	3.458177807	0	0	0	0	0	0.027323476	0	0	0	0	0	0	0	0	0	0	55.545	3000																																																																																	0	0	0	10.0442	0.242242326	2.318702603	0	1.954236708	1.320355146	0.813067565	0.821261365	3.746466047	0.689871307	2.019599123	0.002086838	0.083473517	0.247549114	3.263410693	17.3674944	0.23583822	1.809888348	3.8573726	0	1.222334144	0	0	3.458177807	0	0	0	0	0	0.027323476	0	0	0	0	0	0	0	0	0	0	55.545
H2762_021_0	2009	2																					3000											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1590.411684	41.07376976	1202.04851	2255.496405	216.1309999	12.40546815	7.639220258	273.4630547	351.7704547	6.560479584	19.20581226	0.979707162	39.18828647	116.2168072	5181.809839	7972.287876	172.0467742	848.7867757	35.27963731	0	8.718037092	0	0	13.83271123	0	0	0	0	0	45.08547938											"$175 Copay/Day, up to 6 days; Unlimited"	"$175 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$35 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$175/Visit	15% Coinsurance	15% Coinsurance	$35 Copay	$35 Copay	$35 Copay	$10 Copay	$35 Copay	$10 Copay Group Session; $35 for Indiv.	$35 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"						$10/Routine Physical											106.9727273	99.89677419	28.10077519	0	150	0.15	0.15	49.34135702	175	0.15	0.15	35	35	35	10	35	22.5	35	0.15	0	0.2	0	0	0.25	0	0	0	0	0	10											79.37097801	74.12080509	20.85004344	0	111.2960939	0.111296094	0.111296094	36.61000204	129.8454429	0.111296094	0.111296094	25.96908858	25.96908858	25.96908858	7.419739595	25.96908858	16.69441409	25.96908858	0.111296094	0	0.148394792	0	0	0.25	0	0	0	0	0	7.419739595											10.5194	0.25370174	2.088563637	0	2.004544672	1.380680149	0.850215375	0.834290249	3.806315875	0.730155752	2.137531886	0.002120175	0.084807007	0.251503713	3.203973303	17.25275417	0.239351674	1.836851581	3.926485827	0	1.2937113	0	0	3.458177807	0	0	0	0	0	0.027876876	0	0	0	0	0	0	0	0	0	0	56.183	0	18.3377	10.5194	0.25370174	2.088563637	0	2.004544672	1.380680149	0.850215375	0.834290249	3.806315875	0.730155752	2.137531886	0.002120175	0.084807007	0.251503713	3.203973303	17.25275417	0.239351674	1.836851581	3.926485827	0	1.2937113	0	0	3.458177807	0	0	0	0	0	0.027876876	0	0	0	0	0	0	0	0	0	0	56.183	3000																																																																																	0	0	0	10.5194	0.25370174	2.088563637	0	2.004544672	1.380680149	0.850215375	0.834290249	3.806315875	0.730155752	2.137531886	0.002120175	0.084807007	0.251503713	3.203973303	17.25275417	0.239351674	1.836851581	3.926485827	0	1.2937113	0	0	3.458177807	0	0	0	0	0	0.027876876	0	0	0	0	0	0	0	0	0	0	56.183
H2762_022_0	2009	2																					3000											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1593.833235	41.1621343	1329.021942	2276.193855	234.9664036	12.81797341	7.893238763	305.5246986	393.1756441	6.902322553	20.20655799	1.095023727	43.80094908	129.8961223	5234.887091	7960.131537	168.1556912	829.5902531	32.96882182	0	9.172302615	0	0	13.83271123	0	0	0	0	0	43.79008827											"$175 Copay/Day, up to 6 days; Unlimited"	"$175 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$35 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$175/Visit	15% Coinsurance	15% Coinsurance	$35 Copay	$35 Copay	$35 Copay	$10 Copay	$35 Copay	$10 Copay Group Session; $35 for Indiv.	$35 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"						$10/Routine Physical											106.9727273	99.89677419	28.10077519	0	150	0.15	0.15	49.34135702	175	0.15	0.15	35	35	35	10	35	22.5	35	0.15	0	0.2	0	0	0.25	0	0	0	0	0	10											78.88443815	73.6664485	20.72223378	0	110.6138548	0.110613855	0.110613855	36.38558468	129.0494973	0.110613855	0.110613855	25.80989945	25.80989945	25.80989945	7.374256987	25.80989945	16.59207822	25.80989945	0.110613855	0	0.14748514	0	0	0.25	0	0	0	0	0	7.374256987											10.4774	0.252689021	2.295025281	0	2.165878304	1.417845449	0.873101566	0.926391233	4.228259934	0.763492505	2.235125271	0.002355204	0.094208174	0.279383821	3.216950226	17.12084955	0.232504365	1.784303418	3.64680847	0	1.352778333	0	0	3.458177807	0	0	0	0	0	0.026909947	0	0	0	0	0	0	0	0	0	0	56.8504	0	19.0093	10.4774	0.252689021	2.295025281	0	2.165878304	1.417845449	0.873101566	0.926391233	4.228259934	0.763492505	2.235125271	0.002355204	0.094208174	0.279383821	3.216950226	17.12084955	0.232504365	1.784303418	3.64680847	0	1.352778333	0	0	3.458177807	0	0	0	0	0	0.026909947	0	0	0	0	0	0	0	0	0	0	56.8504	3000																																																																																	0	0	0	10.4774	0.252689021	2.295025281	0	2.165878304	1.417845449	0.873101566	0.926391233	4.228259934	0.763492505	2.235125271	0.002355204	0.094208174	0.279383821	3.216950226	17.12084955	0.232504365	1.784303418	3.64680847	0	1.352778333	0	0	3.458177807	0	0	0	0	0	0.026909947	0	0	0	0	0	0	0	0	0	0	56.8504
H2762_023_0	2009	2																					3000											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1513.732358	39.09345925	1274.21761	2227.316606	208.9602218	13.12657028	8.083271053	259.6294512	333.8962294	6.576846503	19.25372644	0.9299261	37.19704402	110.3115773	5462.433914	8585.918861	192.324533	948.8263932	42.95298657	0	8.739786631	0	0	13.83271123	0	0	0	0	0	44.25028072											"$175 Copay/Day, up to 6 days; Unlimited"	"$175 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$35 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$175/Visit	15% Coinsurance	15% Coinsurance	$35 Copay	$35 Copay	$35 Copay	$10 Copay	$35 Copay	$10 Copay Group Session; $35 for Indiv.	$35 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"						$10/Routine Physical											106.9727273	99.89677419	28.10077519	0	150	0.15	0.15	49.34135702	175	0.15	0.15	35	35	35	10	35	22.5	35	0.15	0	0.2	0	0	0.25	0	0	0	0	0	10											78.39960284	73.21368373	20.5948719	0	109.9340059	0.109934006	0.109934006	36.16195355	128.2563402	0.109934006	0.109934006	25.65126803	25.65126803	25.65126803	7.328933724	25.65126803	16.49010088	25.65126803	0.109934006	0	0.146578674	0	0	0.25	0	0	0	0	0	7.328933724											9.8897	0.23851468	2.18686237	0	1.914319521	1.443056454	0.888626367	0.782392346	3.568692365	0.723019082	2.116639275	0.001987815	0.079512612	0.235802653	3.336151344	18.35330883	0.264287579	2.028216677	4.721993877	0	1.28106634	0	0	3.458177807	0	0	0	0	0	0.027025615	0	0	0	0	0	0	0	0	0	0	57.5393	0	19.7038	9.8897	0.23851468	2.18686237	0	1.914319521	1.443056454	0.888626367	0.782392346	3.568692365	0.723019082	2.116639275	0.001987815	0.079512612	0.235802653	3.336151344	18.35330883	0.264287579	2.028216677	4.721993877	0	1.28106634	0	0	3.458177807	0	0	0	0	0	0.027025615	0	0	0	0	0	0	0	0	0	0	57.5393	3000																																																																																	0	0	0	9.8897	0.23851468	2.18686237	0	1.914319521	1.443056454	0.888626367	0.782392346	3.568692365	0.723019082	2.116639275	0.001987815	0.079512612	0.235802653	3.336151344	18.35330883	0.264287579	2.028216677	4.721993877	0	1.28106634	0	0	3.458177807	0	0	0	0	0	0.027025615	0	0	0	0	0	0	0	0	0	0	57.5393
H2762_024_0	2009	2																					2500											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1617.577269	41.7753447	1428.438956	2160.667705	220.4571078	12.4124249	7.643504185	281.5946801	377.0350037	6.485436047	18.98612221	1.03478028	41.39121118	119.6838306	5522.23904	8769.936297	185.2501615	907.4959175	36.26305641	0	8.839091406	0	0	13.83271123	414.0979915	1.889015625	177.4705678	0	0	43.92396552											"$50 Copay/Day, up to 6 days; Unlimited"	"$50 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $50 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$100/Trip	15% Coinsurance	15% Coinsurance	$20 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$50/Visit	15% Coinsurance	15% Coinsurance	$20 Copay	$20 Copay	$20 Copay	$10 Copay	$20 Copay	$10 Copay Group Session; $20 for Indiv.	$20 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"	$20/Exam	$75 Allowance	$20/Exam			$10/Routine Physical											30.56363636	28.54193548	11.24031008	0	100	0.15	0.15	48.68271405	50	0.15	0.15	20	20	20	10	20	15	20	0.15	0	0.2	0	0	0.25	20	0	20	0	0	10											24.41690186	22.80179065	8.979741312	0	79.88873305	0.1198331	0.1198331	38.89200347	39.94436652	0.1198331	0.1198331	15.97774661	15.97774661	15.97774661	7.988873305	15.97774661	11.98330996	15.97774661	0.1198331	0	0.159777466	0	0	0.25	15.97774661	0	15.97774661	0	0	7.988873305											3.2914	0.079379389	1.068917692	0	1.467669919	1.487419349	0.915944798	0.91264844	1.255035365	0.777169904	2.275165874	0.001377788	0.055111524	0.159356493	3.676372337	11.676985	0.184992509	1.208311652	4.345514449	0	1.412287627	0	0	3.458177807	0.551362732	0	0.236298314	0	0	0.029241916	0	0	0	0	0	0	0	0	0	0	40.5261	0	9.327	3.2914	0.079379389	1.068917692	0	1.467669919	1.487419349	0.915944798	0.91264844	1.255035365	0.777169904	2.275165874	0.001377788	0.055111524	0.159356493	3.676372337	11.676985	0.184992509	1.208311652	4.345514449	0	1.412287627	0	0	3.458177807	0.551362732	0	0.236298314	0	0	0.029241916	0	0	0	0	0	0	0	0	0	0	40.5261	2500																																																																																	0	0	0	3.2914	0.079379389	1.068917692	0	1.467669919	1.487419349	0.915944798	0.91264844	1.255035365	0.777169904	2.275165874	0.001377788	0.055111524	0.159356493	3.676372337	11.676985	0.184992509	1.208311652	4.345514449	0	1.412287627	0	0	3.458177807	0.551362732	0	0.236298314	0	0	0.029241916	0	0	0	0	0	0	0	0	0	0	40.5261
H2762_025_0	2009	8																					2500											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1704.308545	44.0152556	1294.422581	2373.843845	227.4853662	13.05779499	8.040919597	287.7954488	385.3726081	6.905677413	20.21637934	1.057663005	42.30652022	122.330472	5454.381371	8764.683321	189.1511816	926.6060754	37.13694604	0	9.411844236	0	0	13.83271123	425.045719	1.889015625	182.162451	0	0	45.08520662											"$50 Copay/Day, up to 6 days; Unlimited"	"$50 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $50 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$100/Trip	15% Coinsurance	15% Coinsurance	$20 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$50/Visit	15% Coinsurance	15% Coinsurance	$20 Copay	$20 Copay	$20 Copay	$10 Copay	$20 Copay	$10 Copay Group Session; $20 for Indiv.	$20 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"	$20/Exam	$75 Allowance	$20/Exam			$10/Routine Physical											30.56363636	28.54193548	11.24031008	0	100	0.15	0.15	48.68271405	50	0.15	0.15	20	20	20	10	20	15	20	0.15	0	0.2	0	0	0.25	20	0	20	0	0	10											24.28575607	22.67931979	8.931510159	0	79.45964211	0.119189463	0.119189463	38.68311035	39.72982105	0.119189463	0.119189463	15.89192842	15.89192842	15.89192842	7.945964211	15.89192842	11.91894632	15.89192842	0.119189463	0	0.158919284	0	0	0.25	15.89192842	0	15.89192842	0	0	7.945964211											3.4492	0.083186338	0.963429036	0	1.506325482	1.556351575	0.95839289	0.927735259	1.27589873	0.823083984	2.409579401	0.001400692	0.056027683	0.162005592	3.611693263	11.60731	0.187873565	1.227129785	4.426332662	0	1.495723549	0	0	3.458177807	0.562899679	0	0.241242719	0	0	0.029853787	0	0	0	0	0	0	0	0	0	0	41.0209	0	9.7103	3.4492	0.083186338	0.963429036	0	1.506325482	1.556351575	0.95839289	0.927735259	1.27589873	0.823083984	2.409579401	0.001400692	0.056027683	0.162005592	3.611693263	11.60731	0.187873565	1.227129785	4.426332662	0	1.495723549	0	0	3.458177807	0.562899679	0	0.241242719	0	0	0.029853787	0	0	0	0	0	0	0	0	0	0	41.0209	2500																																																																																	0	0	0	3.4492	0.083186338	0.963429036	0	1.506325482	1.556351575	0.95839289	0.927735259	1.27589873	0.823083984	2.409579401	0.001400692	0.056027683	0.162005592	3.611693263	11.60731	0.187873565	1.227129785	4.426332662	0	1.495723549	0	0	3.458177807	0.562899679	0	0.241242719	0	0	0.029853787	0	0	0	0	0	0	0	0	0	0	41.0209
H2762_026_0	2009	2																					2500											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1708.033361	44.11145223	1431.242289	2395.882118	247.2979761	13.49156481	8.308032711	321.5583127	430.7475755	7.265447866	21.2696078	1.182195532	47.28782127	136.7340415	5510.472661	8751.54352	184.8731337	905.6489489	34.70285155	0	9.902180414	0	0	13.83271123	412.8468592	1.889015625	176.9343682	0	0	43.79125614											"$50 Copay/Day, up to 6 days; Unlimited"	"$50 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $50 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$100/Trip	15% Coinsurance	15% Coinsurance	$20 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$50/Visit	15% Coinsurance	15% Coinsurance	$20 Copay	$20 Copay	$20 Copay	$10 Copay	$20 Copay	$10 Copay Group Session; $20 for Indiv.	$20 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"	$20/Exam	$75 Allowance	$20/Exam			$10/Routine Physical											30.56363636	28.54193548	11.24031008	0	100	0.15	0.15	48.68271405	50	0.15	0.15	20	20	20	10	20	15	20	0.15	0	0.2	0	0	0.25	20	0	20	0	0	10											24.18872628	22.58870825	8.895825764	0	79.14217404	0.118713261	0.118713261	38.52855828	39.57108702	0.118713261	0.118713261	15.82843481	15.82843481	15.82843481	7.914217404	15.82843481	11.87132611	15.82843481	0.118713261	0	0.158284348	0	0	0.25	15.82843481	0	15.82843481	0	0	7.914217404											3.4429	0.08303506	1.061006835	0	1.630974955	1.601627656	0.986273656	1.032431516	1.420429149	0.862505009	2.524984503	0.001559359	0.06237435	0.180357155	3.634256553	11.54360301	0.182890771	1.194583779	4.119688676	0	1.567360171	0	0	3.458177807	0.544559966	0	0.233382843	0	0	0.028881127	0	0	0	0	0	0	0	0	0	0	41.3979	0	10.0003	3.4429	0.08303506	1.061006835	0	1.630974955	1.601627656	0.986273656	1.032431516	1.420429149	0.862505009	2.524984503	0.001559359	0.06237435	0.180357155	3.634256553	11.54360301	0.182890771	1.194583779	4.119688676	0	1.567360171	0	0	3.458177807	0.544559966	0	0.233382843	0	0	0.028881127	0	0	0	0	0	0	0	0	0	0	41.3979	2500																																																																																	0	0	0	3.4429	0.08303506	1.061006835	0	1.630974955	1.601627656	0.986273656	1.032431516	1.420429149	0.862505009	2.524984503	0.001559359	0.06237435	0.180357155	3.634256553	11.54360301	0.182890771	1.194583779	4.119688676	0	1.567360171	0	0	3.458177807	0.544559966	0	0.233382843	0	0	0.028881127	0	0	0	0	0	0	0	0	0	0	41.3979
H2762_027_0	2009	2																					2500											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1622.27588	41.89669043	1372.12341	2345.005118	219.966623	13.81794634	8.509016695	273.22907	365.7919617	6.922975376	20.26701915	1.003923521	40.15694084	116.1149038	5750.097045	9439.745836	211.4506524	1035.845811	45.21595084	0	9.435419871	0	0	13.83271123	417.1814235	1.889015625	178.7920387	0	0	44.25102957											"$50 Copay/Day, up to 6 days; Unlimited"	"$50 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $50 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$100/Trip	15% Coinsurance	15% Coinsurance	$20 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$50/Visit	15% Coinsurance	15% Coinsurance	$20 Copay	$20 Copay	$20 Copay	$10 Copay	$20 Copay	$10 Copay Group Session; $20 for Indiv.	$20 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"	$20/Exam	$75 Allowance	$20/Exam			$10/Routine Physical											30.56363636	28.54193548	11.24031008	0	100	0.15	0.15	48.68271405	50	0.15	0.15	20	20	20	10	20	15	20	0.15	0	0.2	0	0	0.25	20	0	20	0	0	10											23.91876773	22.33660672	8.796543799	0	78.2589069	0.11738836	0.11738836	38.09855986	39.12945345	0.11738836	0.11738836	15.65178138	15.65178138	15.65178138	7.82589069	15.65178138	11.73883603	15.65178138	0.11738836	0	0.156517814	0	0	0.25	15.65178138	0	15.65178138	0	0	7.82589069											3.2336	0.077985825	1.005828639	0	1.434528956	1.622066065	0.998859518	0.867469507	1.192769962	0.812676728	2.379112147	0.001309433	0.052377305	0.151450424	3.749969244	12.31240318	0.206848711	1.351069348	5.30782633	0	1.47681129	0	0	3.458177807	0.544136036	0	0.233201158	0	0	0.028858643	0	0	0	0	0	0	0	0	0	0	42.4993	0	10.8479	3.2336	0.077985825	1.005828639	0	1.434528956	1.622066065	0.998859518	0.867469507	1.192769962	0.812676728	2.379112147	0.001309433	0.052377305	0.151450424	3.749969244	12.31240318	0.206848711	1.351069348	5.30782633	0	1.47681129	0	0	3.458177807	0.544136036	0	0.233201158	0	0	0.028858643	0	0	0	0	0	0	0	0	0	0	42.4993	2500																																																																																	0	0	0	3.2336	0.077985825	1.005828639	0	1.434528956	1.622066065	0.998859518	0.867469507	1.192769962	0.812676728	2.379112147	0.001309433	0.052377305	0.151450424	3.749969244	12.31240318	0.206848711	1.351069348	5.30782633	0	1.47681129	0	0	3.458177807	0.544136036	0	0.233201158	0	0	0.028858643	0	0	0	0	0	0	0	0	0	0	42.4993
H2762_028_0	2009	3																					3800											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1794.265523	46.33847308	1345.398118	3071.258389	336.5568368	15.58705835	9.59842631	280.0485688	356.1929153	6.42089177	18.79716876	0.992042418	39.68169672	119.0244626	5547.585997	8767.06115	193.1843532	955.6908646	40.50376971	0	8.43616652	0	0	13.83271123	0	0	0	0	0	46.44432807											"$230 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$230 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$45 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$250/Visit	15% Coinsurance	15% Coinsurance	$45 Copay	$45 Copay	$45 Copay	$15 Copay	$45 Copay	$15 Copay Group Session; $45 for Indiv.	$45 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"						$15/Routine Physical											146.4372925	131.2929032	28.10077519	0	150	0.15	0.15	49.78045234	250	0.15	0.15	45	45	45	15	45	30	45	0.15	0	0.2	0	0	0.25	0	0	0	0	0	15											105.3322935	94.43893963	20.21287783	0	107.8949478	0.107894948	0.107894948	35.80706206	179.8249131	0.107894948	0.107894948	32.36848435	32.36848435	32.36848435	10.78949478	32.36848435	21.57898957	32.36848435	0.107894948	0	0.14385993	0	0	0.25	0	0	0	0	0	10.78949478											15.7495	0.364679688	2.266197315	0	3.026065196	1.681764848	1.035621706	0.83564304	5.337696669	0.692781783	2.028119543	0.002675909	0.107036365	0.321053455	4.987970848	23.64804014	0.347393595	2.5778554	4.37015212	0	1.213626329	0	0	3.458177807	0	0	0	0	0	0.041759236	0	0	0	0	0	0	0	0	0	0	74.0938	0	27.5661	15.7495	0.364679688	2.266197315	0	3.026065196	1.681764848	1.035621706	0.83564304	5.337696669	0.692781783	2.028119543	0.002675909	0.107036365	0.321053455	4.987970848	23.64804014	0.347393595	2.5778554	4.37015212	0	1.213626329	0	0	3.458177807	0	0	0	0	0	0.041759236	0	0	0	0	0	0	0	0	0	0	74.0938	3800																																																																																	0	0	0	15.7495	0.364679688	2.266197315	0	3.026065196	1.681764848	1.035621706	0.83564304	5.337696669	0.692781783	2.028119543	0.002675909	0.107036365	0.321053455	4.987970848	23.64804014	0.347393595	2.5778554	4.37015212	0	1.213626329	0	0	3.458177807	0	0	0	0	0	0.041759236	0	0	0	0	0	0	0	0	0	0	74.0938
H2762_029_0	2009	3																					3800											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1391.306615	35.93170758	1470.983726	1847.782367	262.1788578	12.20243402	7.514192934	287.8229693	366.1183495	7.036372934	20.59899064	1.01968601	40.78744041	122.3411189	5010.433181	7718.063048	162.4201182	803.4989409	36.83736564	0	9.244823912	0	0	13.83271123	0	0	0	0	0	41.36049065											"$230 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$230 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$45 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$250/Visit	15% Coinsurance	15% Coinsurance	$45 Copay	$45 Copay	$45 Copay	$15 Copay	$45 Copay	$15 Copay Group Session; $45 for Indiv.	$45 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"						$15/Routine Physical											147.2589119	131.2929032	28.10077519	0	150	0.15	0.15	49.78045234	250	0.15	0.15	45	45	45	15	45	30	45	0.15	0	0.2	0	0	0.25	0	0	0	0	0	15											110.7072916	98.70425863	21.12578909	0	112.7680052	0.112768005	0.112768005	37.42428206	187.9466754	0.112768005	0.112768005	33.83040156	33.83040156	33.83040156	11.27680052	33.83040156	22.55360104	33.83040156	0.112768005	0	0.15035734	0	0	0.25	0	0	0	0	0	11.27680052											12.8356	0.295551047	2.589640996	0	2.463782233	1.376044143	0.847360548	0.897630666	5.734227214	0.79347774	2.322907084	0.002874699	0.114987957	0.344904098	4.708471292	21.75876435	0.305263212	2.265224319	4.154076241	0	1.390027135	0	0	3.458177807	0	0	0	0	0	0.038867834	0	0	0	0	0	0	0	0	0	0	68.6979	0	21.5385	12.8356	0.295551047	2.589640996	0	2.463782233	1.376044143	0.847360548	0.897630666	5.734227214	0.79347774	2.322907084	0.002874699	0.114987957	0.344904098	4.708471292	21.75876435	0.305263212	2.265224319	4.154076241	0	1.390027135	0	0	3.458177807	0	0	0	0	0	0.038867834	0	0	0	0	0	0	0	0	0	0	68.6979	3800																																																																																	0	0	0	12.8356	0.295551047	2.589640996	0	2.463782233	1.376044143	0.847360548	0.897630666	5.734227214	0.79347774	2.322907084	0.002874699	0.114987957	0.344904098	4.708471292	21.75876435	0.305263212	2.265224319	4.154076241	0	1.390027135	0	0	3.458177807	0	0	0	0	0	0.038867834	0	0	0	0	0	0	0	0	0	0	68.6979
H2762_030_0	2009	3																					3800											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1962.583799	50.68543946	1261.21713	3413.514097	336.2118926	15.66680346	9.647532919	263.5910332	335.177925	6.492919344	19.00802957	0.933513006	37.34052026	112.0021502	5846.232294	9335.812159	209.4166316	1035.992607	46.25943468	0	8.530800822	0	0	13.83271123	0	0	0	0	0	47.88956456											"$230 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$230 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$45 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$250/Visit	15% Coinsurance	15% Coinsurance	$45 Copay	$45 Copay	$45 Copay	$15 Copay	$45 Copay	$15 Copay Group Session; $45 for Indiv.	$45 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"						$15/Routine Physical											146.5424433	131.2929032	28.10077519	0	150	0.15	0.15	49.78045234	250	0.15	0.15	45	45	45	15	45	30	45	0.15	0	0.2	0	0	0.25	0	0	0	0	0	15											103.3277538	92.57523267	19.81398642	0	105.765693	0.105765693	0.105765693	35.10042694	176.2761551	0.105765693	0.105765693	31.72970791	31.72970791	31.72970791	10.5765693	31.72970791	21.15313861	31.72970791	0.105765693	0	0.141020924	0	0	0.25	0	0	0	0	0	10.5765693											16.8991	0.391018029	2.082478257	0	2.963306986	1.657010326	1.020378005	0.77101315	4.923656324	0.686728114	2.010397421	0.002468341	0.09873365	0.296149626	5.152756752	24.68521608	0.369151586	2.739311902	4.892661168	0	1.203021415	0	0	3.458177807	0	0	0	0	0	0.042208942	0	0	0	0	0	0	0	0	0	0	76.345	0	30.487	16.8991	0.391018029	2.082478257	0	2.963306986	1.657010326	1.020378005	0.77101315	4.923656324	0.686728114	2.010397421	0.002468341	0.09873365	0.296149626	5.152756752	24.68521608	0.369151586	2.739311902	4.892661168	0	1.203021415	0	0	3.458177807	0	0	0	0	0	0.042208942	0	0	0	0	0	0	0	0	0	0	76.345	3800																																																																																	0	0	0	16.8991	0.391018029	2.082478257	0	2.963306986	1.657010326	1.020378005	0.77101315	4.923656324	0.686728114	2.010397421	0.002468341	0.09873365	0.296149626	5.152756752	24.68521608	0.369151586	2.739311902	4.892661168	0	1.203021415	0	0	3.458177807	0	0	0	0	0	0.042208942	0	0	0	0	0	0	0	0	0	0	76.345
H2762_031_0	2009	3																					3800											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1528.469161	39.47405006	1524.524517	2029.239648	298.602973	13.85172884	8.529819776	287.6008039	365.8352597	7.092284317	20.76267129	1.018897569	40.75590278	122.2465224	5215.423636	7969.805692	165.2070767	817.286138	34.93302647	0	9.318283761	0	0	13.83271123	0	0	0	0	0	43.91172129											"$230 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$230 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$45 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$250/Visit	15% Coinsurance	15% Coinsurance	$45 Copay	$45 Copay	$45 Copay	$15 Copay	$45 Copay	$15 Copay Group Session; $45 for Indiv.	$45 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"						$15/Routine Physical											146.9519171	131.2929032	28.10077519	0	150	0.15	0.15	49.78045234	250	0.15	0.15	45	45	45	15	45	30	45	0.15	0	0.2	0	0	0.25	0	0	0	0	0	15											108.9098828	97.30458088	20.82621441	0	111.1688962	0.111168896	0.111168896	36.89358626	185.2814937	0.111168896	0.111168896	33.35066886	33.35066886	33.35066886	11.11688962	33.35066886	22.23377924	33.35066886	0.111168896	0	0.148225195	0	0	0.25	0	0	0	0	0	11.11688962											13.8721	0.320083825	2.645839538	0	2.766280243	1.539881406	0.948250649	0.884218756	5.648541947	0.788441419	2.30816325	0.002831743	0.113269718	0.339750274	4.831607408	22.14986255	0.306098139	2.271419946	3.883465994	0	1.381204427	0	0	3.458177807	0	0	0	0	0	0.040680147	0	0	0	0	0	0	0	0	0	0	70.5002	0	23.4157	13.8721	0.320083825	2.645839538	0	2.766280243	1.539881406	0.948250649	0.884218756	5.648541947	0.788441419	2.30816325	0.002831743	0.113269718	0.339750274	4.831607408	22.14986255	0.306098139	2.271419946	3.883465994	0	1.381204427	0	0	3.458177807	0	0	0	0	0	0.040680147	0	0	0	0	0	0	0	0	0	0	70.5002	3800																																																																																	0	0	0	13.8721	0.320083825	2.645839538	0	2.766280243	1.539881406	0.948250649	0.884218756	5.648541947	0.788441419	2.30816325	0.002831743	0.113269718	0.339750274	4.831607408	22.14986255	0.306098139	2.271419946	3.883465994	0	1.381204427	0	0	3.458177807	0	0	0	0	0	0.040680147	0	0	0	0	0	0	0	0	0	0	70.5002
H2762_032_0	2009	3																					3800											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1701.137445	43.93335918	1335.04384	2359.72678	320.5072074	14.96777622	9.217075717	289.731108	368.554794	6.696288908	19.60339423	1.026471817	41.05887269	123.1552746	5483.424626	8670.995001	191.271268	946.226754	40.52824944	0	8.79800039	0	0	13.83271123	0	0	0	0	0	44.61323141											"$230 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$230 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$45 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$250/Visit	15% Coinsurance	15% Coinsurance	$45 Copay	$45 Copay	$45 Copay	$15 Copay	$45 Copay	$15 Copay Group Session; $45 for Indiv.	$45 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"						$15/Routine Physical											146.5444432	131.2929032	28.10077519	0	150	0.15	0.15	49.78045234	250	0.15	0.15	45	45	45	15	45	30	45	0.15	0	0.2	0	0	0.25	0	0	0	0	0	15											106.0506001	95.01343666	20.3358381	0	108.5513013	0.108551301	0.108551301	36.02488588	180.9188355	0.108551301	0.108551301	32.5653904	32.5653904	32.5653904	10.85513013	32.5653904	21.71026026	32.5653904	0.108551301	0	0.144735068	0	0	0.25	0	0	0	0	0	10.85513013											15.0339	0.347854953	2.262436282	0	2.899289537	1.624771586	1.000525563	0.869794175	5.556542013	0.726890875	2.127973954	0.002785621	0.111424852	0.334216633	4.96027399	23.53119478	0.346045751	2.567853637	4.399394217	0	1.273379189	0	0	3.458177807	0	0	0	0	0	0.040356869	0	0	0	0	0	0	0	0	0	0	73.4751	0	26.7309	15.0339	0.347854953	2.262436282	0	2.899289537	1.624771586	1.000525563	0.869794175	5.556542013	0.726890875	2.127973954	0.002785621	0.111424852	0.334216633	4.96027399	23.53119478	0.346045751	2.567853637	4.399394217	0	1.273379189	0	0	3.458177807	0	0	0	0	0	0.040356869	0	0	0	0	0	0	0	0	0	0	73.4751	3800																																																																																	0	0	0	15.0339	0.347854953	2.262436282	0	2.899289537	1.624771586	1.000525563	0.869794175	5.556542013	0.726890875	2.127973954	0.002785621	0.111424852	0.334216633	4.96027399	23.53119478	0.346045751	2.567853637	4.399394217	0	1.273379189	0	0	3.458177807	0	0	0	0	0	0.040356869	0	0	0	0	0	0	0	0	0	0	73.4751
H2762_033_0	2009	3																					3800											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1499.573552	38.72779572	1572.328501	1978.127129	271.12298	13.20312606	8.130413687	304.6928411	387.6613478	7.314143074	21.41216308	1.079685991	43.18743966	129.539869	5085.533211	7776.774189	161.4214204	798.5583422	38.38318964	0	9.609775579	0	0	13.83271123	0	0	0	0	0	43.33211957											"$230 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$230 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$45 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$250/Visit	15% Coinsurance	15% Coinsurance	$45 Copay	$45 Copay	$45 Copay	$15 Copay	$45 Copay	$15 Copay Group Session; $45 for Indiv.	$45 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"						$15/Routine Physical											147.073388	131.2929032	28.10077519	0	150	0.15	0.15	49.78045234	250	0.15	0.15	45	45	45	15	45	30	45	0.15	0	0.2	0	0	0.25	0	0	0	0	0	15											109.1850565	97.46986351	20.86159004	0	111.3577289	0.111357729	0.111357729	36.95625412	185.5962149	0.111357729	0.111357729	33.40731868	33.40731868	33.40731868	11.13577289	33.40731868	22.27154578	33.40731868	0.111357729	0	0.148476972	0	0	0.25	0	0	0	0	0	11.13577289											13.6443	0.31456608	2.733439384	0	2.515969943	1.470270133	0.905384403	0.938358838	5.995706567	0.814486362	2.384409852	0.003005784	0.12023138	0.36063164	4.719278573	21.6500978	0.299592046	2.223141085	4.274264827	0	1.426830379	0	0	3.458177807	0	0	0	0	0	0.040211387	0	0	0	0	0	0	0	0	0	0	70.2923	0	23.1961	13.6443	0.31456608	2.733439384	0	2.515969943	1.470270133	0.905384403	0.938358838	5.995706567	0.814486362	2.384409852	0.003005784	0.12023138	0.36063164	4.719278573	21.6500978	0.299592046	2.223141085	4.274264827	0	1.426830379	0	0	3.458177807	0	0	0	0	0	0.040211387	0	0	0	0	0	0	0	0	0	0	70.2923	3800																																																																																	0	0	0	13.6443	0.31456608	2.733439384	0	2.515969943	1.470270133	0.905384403	0.938358838	5.995706567	0.814486362	2.384409852	0.003005784	0.12023138	0.36063164	4.719278573	21.6500978	0.299592046	2.223141085	4.274264827	0	1.426830379	0	0	3.458177807	0	0	0	0	0	0.040211387	0	0	0	0	0	0	0	0	0	0	70.2923
H2762_034_0	2009	3																					3800											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1887.466422	48.74546762	1383.045702	2997.970718	363.1148742	15.94365121	9.818014267	303.2238688	385.7811576	6.894863856	20.18472264	1.074449423	42.97797693	128.9115897	5657.697438	8952.907774	197.7318526	978.1875292	41.16396541	0	9.058900494	0	0	13.83271123	0	0	0	0	0	45.21808862											"$230 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$230 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$45 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$250/Visit	15% Coinsurance	15% Coinsurance	$45 Copay	$45 Copay	$45 Copay	$15 Copay	$45 Copay	$15 Copay Group Session; $45 for Indiv.	$45 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"						$15/Routine Physical											146.4595237	131.2929032	28.10077519	0	150	0.15	0.15	49.78045234	250	0.15	0.15	45	45	45	15	45	30	45	0.15	0	0.2	0	0	0.25	0	0	0	0	0	15											103.777022	93.03038935	19.91140414	0	106.2857021	0.106285702	0.106285702	35.27300219	177.1428369	0.106285702	0.106285702	31.88571063	31.88571063	31.88571063	10.62857021	31.88571063	21.25714042	31.88571063	0.106285702	0	0.141714269	0	0	0.25	0	0	0	0	0	10.62857021											16.323	0.377900819	2.29486516	0	3.216159946	1.694582163	1.04351454	0.891301349	5.694864055	0.732825446	2.145347418	0.002854965	0.114198611	0.342536471	5.011102871	23.78915222	0.350267813	2.599183709	4.375140966	0	1.283775466	0	0	3.458177807	0	0	0	0	0	0.040050302	0	0	0	0	0	0	0	0	0	0	75.7808	0	29.7473	16.323	0.377900819	2.29486516	0	3.216159946	1.694582163	1.04351454	0.891301349	5.694864055	0.732825446	2.145347418	0.002854965	0.114198611	0.342536471	5.011102871	23.78915222	0.350267813	2.599183709	4.375140966	0	1.283775466	0	0	3.458177807	0	0	0	0	0	0.040050302	0	0	0	0	0	0	0	0	0	0	75.7808	3800																																																																																	0	0	0	16.323	0.377900819	2.29486516	0	3.216159946	1.694582163	1.04351454	0.891301349	5.694864055	0.732825446	2.145347418	0.002854965	0.114198611	0.342536471	5.011102871	23.78915222	0.350267813	2.599183709	4.375140966	0	1.283775466	0	0	3.458177807	0	0	0	0	0	0.040050302	0	0	0	0	0	0	0	0	0	0	75.7808
H2762_035_0	2009	3																					3800											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1606.915117	41.49998533	1700.765799	2173.497803	272.4813001	13.65523961	8.408822767	314.8631831	400.6467591	7.558212517	22.12667668	1.115852008	44.63408031	133.879039	5255.738387	8069.589949	168.7847329	834.9849491	38.04289833	0	9.930449177	0	0	13.83271123	0	0	0	0	0	44.38378236											"$230 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$230 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$45 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$250/Visit	15% Coinsurance	15% Coinsurance	$45 Copay	$45 Copay	$45 Copay	$15 Copay	$45 Copay	$15 Copay Group Session; $45 for Indiv.	$45 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"						$15/Routine Physical											147.1052083	131.2929032	28.10077519	0	150	0.15	0.15	49.78045234	250	0.15	0.15	45	45	45	15	45	30	45	0.15	0	0.2	0	0	0.25	0	0	0	0	0	15											107.7471065	96.16539476	20.58239306	0	109.8673947	0.109867395	0.109867395	36.46165736	183.1123244	0.109867395	0.109867395	32.9602184	32.9602184	32.9602184	10.98673947	32.9602184	21.97347893	32.9602184	0.109867395	0	0.14648986	0	0	0.25	0	0	0	0	0	10.98673947											14.4284	0.332571873	2.917152515	0	2.494734212	1.500265599	0.923855449	0.956702791	6.113613278	0.830401117	2.43100032	0.003064894	0.122595753	0.36772353	4.811952363	22.16462059	0.309065648	2.293440523	4.179674124	0	1.454710105	0	0	3.458177807	0	0	0	0	0	0.040636088	0	0	0	0	0	0	0	0	0	0	72.1343	0	25.08	14.4284	0.332571873	2.917152515	0	2.494734212	1.500265599	0.923855449	0.956702791	6.113613278	0.830401117	2.43100032	0.003064894	0.122595753	0.36772353	4.811952363	22.16462059	0.309065648	2.293440523	4.179674124	0	1.454710105	0	0	3.458177807	0	0	0	0	0	0.040636088	0	0	0	0	0	0	0	0	0	0	72.1343	3800																																																																																	0	0	0	14.4284	0.332571873	2.917152515	0	2.494734212	1.500265599	0.923855449	0.956702791	6.113613278	0.830401117	2.43100032	0.003064894	0.122595753	0.36772353	4.811952363	22.16462059	0.309065648	2.293440523	4.179674124	0	1.454710105	0	0	3.458177807	0	0	0	0	0	0.040636088	0	0	0	0	0	0	0	0	0	0	72.1343
H2762_036_0	2009	3																					3000											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	2033.524755	52.51755154	1521.167415	3394.847725	372.0174295	17.22840517	10.60915881	309.4221495	414.4346505	7.189731433	20.77661722	1.137424375	45.49697501	133.2738024	6327.699338	10288.7757	226.7132337	1112.925688	44.96569628	0	9.672665997	0	0	13.83271123	437.8594158	2.5186875	187.6540353	0	0	46.44437374											"$50 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$50 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $50 Copay Days 21-100; 100 day limit	$0/Visit; Unlimited Days	$100/Trip	10% Coinsurance	10% Coinsurance	$20 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$50/Visit	10% Coinsurance	10% Coinsurance	$20 Copay	$20 Copay	$20 Copay	$10 Copay	$20 Copay	$10 Copay Group Session; $20 for Indiv.	$20 Copay	10% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"	$20/Exam	$100 Allowance	$20/Exam			$10/Routine Physical											36.40816003	28.54193548	11.24031008	0	100	0.1	0.1	48.68271405	50	0.1	0.1	20	20	20	10	20	15	20	0.1	0	0.2	0	0	0.25	20	0	20	0	0	10											29.98025259	23.5028201	9.255818889	0	82.3448715	0.082344871	0.082344871	40.08771832	41.17243575	0.082344871	0.082344871	16.4689743	16.4689743	16.4689743	8.23448715	16.4689743	12.35173072	16.4689743	0.082344871	0	0.164689743	0	0	0.25	16.4689743	0	16.4689743	0	0	8.23448715											5.0805	0.102859214	1.173304174	0	2.552810619	1.41867081	0.873609819	1.033668998	1.421940335	0.592037511	1.710847875	0.001561018	0.062440709	0.182906902	4.34211324	14.12046522	0.233358401	1.52739538	3.702694482	0	1.592988877	0	0	3.458177807	0.600924622	0	0.257539124	0	0	0.031870467	0	0	0	0	0	0	0	0	0	0	46.0747	0	9.1377	5.0805	0.102859214	1.173304174	0	2.552810619	1.41867081	0.873609819	1.033668998	1.421940335	0.592037511	1.710847875	0.001561018	0.062440709	0.182906902	4.34211324	14.12046522	0.233358401	1.52739538	3.702694482	0	1.592988877	0	0	3.458177807	0.600924622	0	0.257539124	0	0	0.031870467	0	0	0	0	0	0	0	0	0	0	46.0747	3000																																																																																	0	0	0	5.0805	0.102859214	1.173304174	0	2.552810619	1.41867081	0.873609819	1.033668998	1.421940335	0.592037511	1.710847875	0.001561018	0.062440709	0.182906902	4.34211324	14.12046522	0.233358401	1.52739538	3.702694482	0	1.592988877	0	0	3.458177807	0.600924622	0	0.257539124	0	0	0.031870467	0	0	0	0	0	0	0	0	0	0	46.0747
H2762_037_0	2009	3																					3000											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1576.76052	40.72121654	1663.268332	2042.297127	289.7754509	13.48692406	8.305174959	318.0119068	425.9794281	7.878706996	22.76759306	1.169109254	46.76437015	136.9863694	5715.107459	9057.909292	190.615981	935.7257997	40.88835862	0	10.59957552	0	0	13.83271123	389.9298428	2.5186875	167.1127898	0	0	41.36041547											"$50 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$50 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $50 Copay Days 21-100; 100 day limit	$0/Visit; Unlimited Days	$100/Trip	10% Coinsurance	10% Coinsurance	$20 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$50/Visit	10% Coinsurance	10% Coinsurance	$20 Copay	$20 Copay	$20 Copay	$10 Copay	$20 Copay	$10 Copay Group Session; $20 for Indiv.	$20 Copay	10% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"	$20/Exam	$100 Allowance	$20/Exam			$10/Routine Physical											37.22985253	28.54193548	11.24031008	0	100	0.1	0.1	48.68271405	50	0.1	0.1	20	20	20	10	20	15	20	0.1	0	0.2	0	0	0.25	20	0	20	0	0	10											31.51607665	24.16152	9.515226356	0	84.65270344	0.084652703	0.084652703	41.21123355	42.32635172	0.084652703	0.084652703	16.93054069	16.93054069	16.93054069	8.465270344	16.93054069	12.69790552	16.93054069	0.084652703	0	0.169305407	0	0	0.25	16.93054069	0	16.93054069	0	0	8.465270344											4.1411	0.081990541	1.318864556	0	2.044189609	1.141704582	0.703055513	1.09213858	1.502512925	0.666953847	1.927338303	0.001649471	0.065978839	0.193271108	4.031660807	12.77960848	0.201701976	1.32019531	3.461310097	0	1.794565445	0	0	3.458177807	0.550143589	0	0.235775824	0	0	0.029177258	0	0	0	0	0	0	0	0	0	0	42.7431	0	7.123	4.1411	0.081990541	1.318864556	0	2.044189609	1.141704582	0.703055513	1.09213858	1.502512925	0.666953847	1.927338303	0.001649471	0.065978839	0.193271108	4.031660807	12.77960848	0.201701976	1.32019531	3.461310097	0	1.794565445	0	0	3.458177807	0.550143589	0	0.235775824	0	0	0.029177258	0	0	0	0	0	0	0	0	0	0	42.7431	3000																																																																																	0	0	0	4.1411	0.081990541	1.318864556	0	2.044189609	1.141704582	0.703055513	1.09213858	1.502512925	0.666953847	1.927338303	0.001649471	0.065978839	0.193271108	4.031660807	12.77960848	0.201701976	1.32019531	3.461310097	0	1.794565445	0	0	3.458177807	0.550143589	0	0.235775824	0	0	0.029177258	0	0	0	0	0	0	0	0	0	0	42.7431
H2762_038_0	2009	3																					3000											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	2224.224763	57.44254569	1426.070071	3772.707364	371.5931946	17.31569724	10.6629128	291.2164429	389.9732234	7.270188726	21.0091197	1.070289488	42.81157953	125.4075021	6668.616042	10956.72397	245.7746182	1206.49722	51.34166585	0	9.780908778	0	0	13.83271123	451.4848807	2.5186875	193.4935203	0	0	47.88964628											"$50 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$50 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $50 Copay Days 21-100; 100 day limit	$0/Visit; Unlimited Days	$100/Trip	10% Coinsurance	10% Coinsurance	$20 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$50/Visit	10% Coinsurance	10% Coinsurance	$20 Copay	$20 Copay	$20 Copay	$10 Copay	$20 Copay	$10 Copay Group Session; $20 for Indiv.	$20 Copay	10% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"	$20/Exam	$100 Allowance	$20/Exam			$10/Routine Physical											36.51343018	28.54193548	11.24031008	0	100	0.1	0.1	48.68271405	50	0.1	0.1	20	20	20	10	20	15	20	0.1	0	0.2	0	0	0.25	20	0	20	0	0	10											29.66429779	23.18808366	9.131870214	0	81.24215569	0.081242156	0.081242156	39.55088634	40.62107785	0.081242156	0.081242156	16.24843114	16.24843114	16.24843114	8.124215569	16.24843114	12.18632335	16.24843114	0.081242156	0	0.162484311	0	0	0.25	16.24843114	0	16.24843114	0	0	8.124215569											5.4983	0.110998546	1.0852239	0	2.515752681	1.406764571	0.866278022	0.95982237	1.320094389	0.590645804	1.706826174	0.00144921	0.057968417	0.169806264	4.514772856	14.83579791	0.249590747	1.633640583	4.17110761	0	1.589244227	0	0	3.458177807	0.61132675	0	0.261997178	0	0	0.032422151	0	0	0	0	0	0	0	0	0	0	47.648	0	10.2016	5.4983	0.110998546	1.0852239	0	2.515752681	1.406764571	0.866278022	0.95982237	1.320094389	0.590645804	1.706826174	0.00144921	0.057968417	0.169806264	4.514772856	14.83579791	0.249590747	1.633640583	4.17110761	0	1.589244227	0	0	3.458177807	0.61132675	0	0.261997178	0	0	0.032422151	0	0	0	0	0	0	0	0	0	0	47.648	3000																																																																																	0	0	0	5.4983	0.110998546	1.0852239	0	2.515752681	1.406764571	0.866278022	0.95982237	1.320094389	0.590645804	1.706826174	0.00144921	0.057968417	0.169806264	4.514772856	14.83579791	0.249590747	1.633640583	4.17110761	0	1.589244227	0	0	3.458177807	0.61132675	0	0.261997178	0	0	0.032422151	0	0	0	0	0	0	0	0	0	0	47.648
H2762_039_0	2009	3																					3000											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1732.199767	44.73557075	1723.831223	2242.812266	330.0340086	15.30941243	9.427453454	317.7669661	425.6488995	7.941261055	22.94835944	1.168202111	46.72808445	136.8800781	5948.834759	9353.199788	193.8832461	951.764666	38.77828849	0	10.68373228	0	0	13.83271123	413.9802397	2.5186875	177.4201027	0	0	43.91147542											"$50 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$50 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $50 Copay Days 21-100; 100 day limit	$0/Visit; Unlimited Days	$100/Trip	10% Coinsurance	10% Coinsurance	$20 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$50/Visit	10% Coinsurance	10% Coinsurance	$20 Copay	$20 Copay	$20 Copay	$10 Copay	$20 Copay	$10 Copay Group Session; $20 for Indiv.	$20 Copay	10% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"	$20/Exam	$100 Allowance	$20/Exam			$10/Routine Physical											36.92285142	28.54193548	11.24031008	0	100	0.1	0.1	48.68271405	50	0.1	0.1	20	20	20	10	20	15	20	0.1	0	0.2	0	0	0.25	20	0	20	0	0	10											30.96056362	23.93299475	9.425229143	0	83.85203858	0.083852039	0.083852039	40.82144817	41.92601929	0.083852039	0.083852039	16.77040772	16.77040772	16.77040772	8.385203858	16.77040772	12.57780579	16.77040772	0.083852039	0	0.167704077	0	0	0.25	16.77040772	0	16.77040772	0	0	8.385203858											4.4692	0.089221348	1.35395869	0	2.306168702	1.283725442	0.790511191	1.080975645	1.487146998	0.665890928	1.924266721	0.001632602	0.065304086	0.19129456	4.156849348	13.07141449	0.203218818	1.330123458	3.251638543	0	1.791705462	0	0	3.458177807	0.57855145	0	0.247950622	0	0	0.030683889	0	0	0	0	0	0	0	0	0	0	43.8296	0	7.773	4.4692	0.089221348	1.35395869	0	2.306168702	1.283725442	0.790511191	1.080975645	1.487146998	0.665890928	1.924266721	0.001632602	0.065304086	0.19129456	4.156849348	13.07141449	0.203218818	1.330123458	3.251638543	0	1.791705462	0	0	3.458177807	0.57855145	0	0.247950622	0	0	0.030683889	0	0	0	0	0	0	0	0	0	0	43.8296	3000																																																																																	0	0	0	4.4692	0.089221348	1.35395869	0	2.306168702	1.283725442	0.790511191	1.080975645	1.487146998	0.665890928	1.924266721	0.001632602	0.065304086	0.19129456	4.156849348	13.07141449	0.203218818	1.330123458	3.251638543	0	1.791705462	0	0	3.458177807	0.57855145	0	0.247950622	0	0	0.030683889	0	0	0	0	0	0	0	0	0	0	43.8296
H2762_040_0	2009	3																					3000											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1927.955706	49.79113874	1509.330945	2607.456344	354.3037943	16.5452979	10.18850505	320.1408912	428.8395329	7.497907764	21.66717367	1.17695887	47.07835478	137.9061212	6254.593941	10175.63859	224.4393429	1101.763255	44.97607976	0	10.08726934	0	0	13.83271123	420.6095236	2.5186875	180.2612244	0	0	44.61465304											"$50 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$50 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $50 Copay Days 21-100; 100 day limit	$0/Visit; Unlimited Days	$100/Trip	10% Coinsurance	10% Coinsurance	$20 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$50/Visit	10% Coinsurance	10% Coinsurance	$20 Copay	$20 Copay	$20 Copay	$10 Copay	$20 Copay	$10 Copay Group Session; $20 for Indiv.	$20 Copay	10% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"	$20/Exam	$100 Allowance	$20/Exam			$10/Routine Physical											36.51502546	28.54193548	11.24031008	0	100	0.1	0.1	48.68271405	50	0.1	0.1	20	20	20	10	20	15	20	0.1	0	0.2	0	0	0.25	20	0	20	0	0	10											30.14765589	23.56488702	9.280261921	0	82.56233019	0.08256233	0.08256233	40.19358312	41.2811651	0.08256233	0.08256233	16.51246604	16.51246604	16.51246604	8.256233019	16.51246604	12.38434953	16.51246604	0.08256233	0	0.16512466	0	0	0.25	16.51246604	0	16.51246604	0	0	8.256233019											4.8436	0.09777688	1.167248875	0	2.437678904	1.366018349	0.841186718	1.072300793	1.47524963	0.619044737	1.788892347	0.001619541	0.064781645	0.189764179	4.303282085	14.00207389	0.231627939	1.516069027	3.713329948	0	1.665656925	0	0	3.458177807	0.57877504	0	0.248046446	0	0	0.030695748	0	0	0	0	0	0	0	0	0	0	45.7129	0	8.9275	4.8436	0.09777688	1.167248875	0	2.437678904	1.366018349	0.841186718	1.072300793	1.47524963	0.619044737	1.788892347	0.001619541	0.064781645	0.189764179	4.303282085	14.00207389	0.231627939	1.516069027	3.713329948	0	1.665656925	0	0	3.458177807	0.57877504	0	0.248046446	0	0	0.030695748	0	0	0	0	0	0	0	0	0	0	45.7129	3000																																																																																	0	0	0	4.8436	0.09777688	1.167248875	0	2.437678904	1.366018349	0.841186718	1.072300793	1.47524963	0.619044737	1.788892347	0.001619541	0.064781645	0.189764179	4.303282085	14.00207389	0.231627939	1.516069027	3.713329948	0	1.665656925	0	0	3.458177807	0.57877504	0	0.248046446	0	0	0.030695748	0	0	0	0	0	0	0	0	0	0	45.7129
H2762_041_0	2009	3																					3000											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1699.481461	43.89059195	1777.874841	2186.356142	299.6621698	14.59281093	8.986174121	336.6587362	451.0333975	8.189566207	23.66590239	1.237870385	49.51481541	145.0432193	5800.623576	9126.504299	189.4344101	929.925518	42.59571406	0	11.01778826	0	0	13.83271123	408.5187357	2.5186875	175.0794582	0	0	43.3321659											"$50 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$50 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $50 Copay Days 21-100; 100 day limit	$0/Visit; Unlimited Days	$100/Trip	10% Coinsurance	10% Coinsurance	$20 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$50/Visit	10% Coinsurance	10% Coinsurance	$20 Copay	$20 Copay	$20 Copay	$10 Copay	$20 Copay	$10 Copay Group Session; $20 for Indiv.	$20 Copay	10% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"	$20/Exam	$100 Allowance	$20/Exam			$10/Routine Physical											37.04430615	28.54193548	11.24031008	0	100	0.1	0.1	48.68271405	50	0.1	0.1	20	20	20	10	20	15	20	0.1	0	0.2	0	0	0.25	20	0	20	0	0	10											31.09879436	23.96103138	9.436270454	0	83.95026818	0.083950268	0.083950268	40.869269	41.97513409	0.083950268	0.083950268	16.79005364	16.79005364	16.79005364	8.395026818	16.79005364	12.59254023	16.79005364	0.083950268	0	0.167900536	0	0	0.25	16.79005364	0	16.79005364	0	0	8.395026818											4.4043	0.087638654	1.39804232	0	2.096393293	1.225070391	0.754391727	1.146583038	1.577682278	0.687516279	1.986758852	0.001731993	0.069279701	0.202940286	4.05803254	12.76954139	0.198788369	1.301124944	3.575921618	0	1.849892559	0	0	3.458177807	0.571587624	0	0.244966124	0	0	0.030314558	0	0	0	0	0	0	0	0	0	0	43.6967	0	7.6879	4.4043	0.087638654	1.39804232	0	2.096393293	1.225070391	0.754391727	1.146583038	1.577682278	0.687516279	1.986758852	0.001731993	0.069279701	0.202940286	4.05803254	12.76954139	0.198788369	1.301124944	3.575921618	0	1.849892559	0	0	3.458177807	0.571587624	0	0.244966124	0	0	0.030314558	0	0	0	0	0	0	0	0	0	0	43.6967	3000																																																																																	0	0	0	4.4043	0.087638654	1.39804232	0	2.096393293	1.225070391	0.754391727	1.146583038	1.577682278	0.687516279	1.986758852	0.001731993	0.069279701	0.202940286	4.05803254	12.76954139	0.198788369	1.301124944	3.575921618	0	1.849892559	0	0	3.458177807	0.571587624	0	0.244966124	0	0	0.030314558	0	0	0	0	0	0	0	0	0	0	43.6967
H2762_042_0	2009	3																					3500											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1605.680675	41.4681048	1399.1333	2287.269087	225.6891559	12.17849872	7.499453707	274.3797819	348.9559605	6.132540821	17.95302099	0.977074502	39.08298009	116.6061813	5367.251583	8059.978808	169.5923935	838.1208486	33.58565892	0	8.100322985	0	0	13.83271123	0	0	0	0	0	45.42273071											"$230 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$230 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$40 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$250/Visit	15% Coinsurance	15% Coinsurance	$40 Copay	$40 Copay	$40 Copay	$10 Copay	$40 Copay	$10 Copay Group Session; $40 for Indiv.	$40 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"						$10/Routine Physical											146.345047	131.2929032	28.10077519	0	150	0.15	0.15	49.56090468	250	0.15	0.15	40	40	40	10	40	25	40	0.15	0	0.2	0	0	0.25	0	0	0	0	0	10											108.4846717	97.32661124	20.83092959	0	111.1940655	0.111194066	0.111194066	36.73918989	185.3234426	0.111194066	0.111194066	29.65175081	29.65175081	29.65175081	7.412937703	29.65175081	18.53234426	29.65175081	0.111194066	0	0.148258754	0	0	0.25	0	0	0	0	0	7.412937703											14.516	0.336329176	2.428770605	0	2.091274566	1.354176785	0.833894747	0.840040909	5.389143326	0.681902146	1.996269393	0.002414331	0.096573232	0.288131453	3.315591802	19.91604026	0.261912052	2.070979213	3.73452596	0	1.200943793	0	0	3.458177807	0	0	0	0	0	0.028059656	0	0	0	0	0	0	0	0	0	0	64.8411	0	21.4203	14.516	0.336329176	2.428770605	0	2.091274566	1.354176785	0.833894747	0.840040909	5.389143326	0.681902146	1.996269393	0.002414331	0.096573232	0.288131453	3.315591802	19.91604026	0.261912052	2.070979213	3.73452596	0	1.200943793	0	0	3.458177807	0	0	0	0	0	0.028059656	0	0	0	0	0	0	0	0	0	0	64.8411	3500																																																																																	0	0	0	14.516	0.336329176	2.428770605	0	2.091274566	1.354176785	0.833894747	0.840040909	5.389143326	0.681902146	1.996269393	0.002414331	0.096573232	0.288131453	3.315591802	19.91604026	0.261912052	2.070979213	3.73452596	0	1.200943793	0	0	3.458177807	0	0	0	0	0	0.028059656	0	0	0	0	0	0	0	0	0	0	64.8411
H2762_043_0	2009	3																					3500											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1068.229861	27.58796846	1035.752857	1101.880859	143.9538431	10.27161928	6.325207652	241.100929	306.4629663	6.312249791	18.47911923	0.858094385	34.32377539	102.4068371	4778.215429	7259.742154	156.0611395	771.2497707	38.18077708	0	8.337696162	0	0	13.83271123	0	0	0	0	0	38.08909367											"$230 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$230 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$40 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$250/Visit	15% Coinsurance	15% Coinsurance	$40 Copay	$40 Copay	$40 Copay	$10 Copay	$40 Copay	$10 Copay Group Session; $40 for Indiv.	$40 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"						$10/Routine Physical											149.0005887	131.2929032	28.10077519	0	150	0.15	0.15	49.56090468	250	0.15	0.15	40	40	40	10	40	25	40	0.15	0	0.2	0	0	0.25	0	0	0	0	0	10											116.848668	102.9620151	22.03708174	0	117.6324225	0.117632423	0.117632423	38.86646186	196.0540375	0.117632423	0.117632423	31.368646	31.368646	31.368646	7.8421615	31.368646	19.60540375	31.368646	0.117632423	0	0.15684323	0	0	0.25	0	0	0	0	0	7.8421615											10.4018	0.236709402	1.902080863	0	1.411136608	1.208275459	0.744049499	0.780895005	5.006941823	0.742525234	2.173743561	0.002243105	0.089724197	0.267696985	3.12262809	18.97735681	0.254970137	2.01608842	4.491297302	0	1.307711197	0	0	3.458177807	0	0	0	0	0	0.024891735	0	0	0	0	0	0	0	0	0	0	58.6209	0	15.1752	10.4018	0.236709402	1.902080863	0	1.411136608	1.208275459	0.744049499	0.780895005	5.006941823	0.742525234	2.173743561	0.002243105	0.089724197	0.267696985	3.12262809	18.97735681	0.254970137	2.01608842	4.491297302	0	1.307711197	0	0	3.458177807	0	0	0	0	0	0.024891735	0	0	0	0	0	0	0	0	0	0	58.6209	3500																																																																																	0	0	0	10.4018	0.236709402	1.902080863	0	1.411136608	1.208275459	0.744049499	0.780895005	5.006941823	0.742525234	2.173743561	0.002243105	0.089724197	0.267696985	3.12262809	18.97735681	0.254970137	2.01608842	4.491297302	0	1.307711197	0	0	3.458177807	0	0	0	0	0	0.024891735	0	0	0	0	0	0	0	0	0	0	58.6209
H2762_044_0	2009	3																					3500											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1724.163357	44.52802345	1236.118905	2506.267947	223.1785662	12.46708543	7.677163844	272.9590872	347.149037	6.433263281	18.83338637	0.972015128	38.88060511	116.0023847	5402.002308	8162.252694	173.7087777	858.4639034	35.67610696	0	8.497539917	0	0	13.83271123	0	0	0	0	0	47.72172534											"$230 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$230 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$40 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$250/Visit	15% Coinsurance	15% Coinsurance	$40 Copay	$40 Copay	$40 Copay	$10 Copay	$40 Copay	$10 Copay Group Session; $40 for Indiv.	$40 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"						$10/Routine Physical											146.734086	131.2929032	28.10077519	0	150	0.15	0.15	49.56090468	250	0.15	0.15	40	40	40	10	40	25	40	0.15	0	0.2	0	0	0.25	0	0	0	0	0	10											107.8583358	96.50814229	20.65575172	0	110.2589781	0.110258978	0.110258978	36.43023137	183.7649635	0.110258978	0.110258978	29.40239417	29.40239417	29.40239417	7.350598541	29.40239417	18.37649635	29.40239417	0.110258978	0	0.147011971	0	0	0.25	0	0	0	0	0	7.350598541											15.4971	0.358109735	2.127747099	0	2.050620054	1.3746081	0.84647624	0.828663558	5.316152511	0.709325035	2.076549936	0.002381631	0.09526524	0.284228986	3.308995857	19.99914758	0.266013227	2.103407839	3.933611097	0	1.24924009	0	0	3.458177807	0	0	0	0	0	0.029231937	0	0	0	0	0	0	0	0	0	0	65.9151	0	22.5044	15.4971	0.358109735	2.127747099	0	2.050620054	1.3746081	0.84647624	0.828663558	5.316152511	0.709325035	2.076549936	0.002381631	0.09526524	0.284228986	3.308995857	19.99914758	0.266013227	2.103407839	3.933611097	0	1.24924009	0	0	3.458177807	0	0	0	0	0	0.029231937	0	0	0	0	0	0	0	0	0	0	65.9151	3500																																																																																	0	0	0	15.4971	0.358109735	2.127747099	0	2.050620054	1.3746081	0.84647624	0.828663558	5.316152511	0.709325035	2.076549936	0.002381631	0.09526524	0.284228986	3.308995857	19.99914758	0.266013227	2.103407839	3.933611097	0	1.24924009	0	0	3.458177807	0	0	0	0	0	0.029231937	0	0	0	0	0	0	0	0	0	0	65.9151
H2762_045_0	2009	3																					3500											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	997.0094185	25.74863837	1069.541957	1246.769178	188.556727	12.21770791	7.523598514	276.892942	352.1647068	7.111275145	20.81826696	0.986058972	39.44235887	117.6784073	4312.320047	6822.456003	157.1489197	776.6255501	33.84565271	0	9.393109184	0	0	13.83271123	0	0	0	0	0	34.92262091											"$230 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$230 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$40 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$250/Visit	15% Coinsurance	15% Coinsurance	$40 Copay	$40 Copay	$40 Copay	$10 Copay	$40 Copay	$10 Copay Group Session; $40 for Indiv.	$40 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"						$10/Routine Physical											149.8947678	131.2929032	28.10077519	0	150	0.15	0.15	49.56090468	250	0.15	0.15	40	40	40	10	40	25	40	0.15	0	0.2	0	0	0.25	0	0	0	0	0	10											117.7640829	103.1496201	22.07723505	0	117.8467581	0.117846758	0.117846758	38.93727964	196.4112635	0.117846758	0.117846758	31.42580216	31.42580216	31.42580216	7.85645054	31.42580216	19.64112635	31.42580216	0.117846758	0	0.157129011	0	0	0.25	0	0	0	0	0	7.85645054											9.7843	0.221330189	1.967710765	0	1.851733249	1.439817269	0.886631694	0.898454826	5.764092919	0.838040722	2.453365271	0.002582308	0.103292314	0.308178196	2.823294097	17.86676272	0.257215149	2.033840074	3.988600448	0	1.475929954	0	0	3.458177807	0	0	0	0	0	0.022863987	0	0	0	0	0	0	0	0	0	0	58.4462	0	15.0072	9.7843	0.221330189	1.967710765	0	1.851733249	1.439817269	0.886631694	0.898454826	5.764092919	0.838040722	2.453365271	0.002582308	0.103292314	0.308178196	2.823294097	17.86676272	0.257215149	2.033840074	3.988600448	0	1.475929954	0	0	3.458177807	0	0	0	0	0	0.022863987	0	0	0	0	0	0	0	0	0	0	58.4462	3500																																																																																	0	0	0	9.7843	0.221330189	1.967710765	0	1.851733249	1.439817269	0.886631694	0.898454826	5.764092919	0.838040722	2.453365271	0.002582308	0.103292314	0.308178196	2.823294097	17.86676272	0.257215149	2.033840074	3.988600448	0	1.475929954	0	0	3.458177807	0	0	0	0	0	0.022863987	0	0	0	0	0	0	0	0	0	0	58.4462
H2762_046_0	2009	3																					3500											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1664.743171	42.99344528	1378.423957	2443.191224	236.3182629	12.78784808	7.874687752	300.5621125	382.3897334	6.681915588	19.56131632	1.070688857	42.82755427	127.7783206	5345.466468	7997.2026	167.092531	825.7665979	33.22029018	0	8.82597866	0	0	13.83271123	0	0	0	0	0	44.79338907											"$230 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$230 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$40 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$250/Visit	15% Coinsurance	15% Coinsurance	$40 Copay	$40 Copay	$40 Copay	$10 Copay	$40 Copay	$10 Copay Group Session; $40 for Indiv.	$40 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"						$10/Routine Physical											146.5949398	131.2929032	28.10077519	0	150	0.15	0.15	49.56090468	250	0.15	0.15	40	40	40	10	40	25	40	0.15	0	0.2	0	0	0.25	0	0	0	0	0	10											107.8289903	96.57346426	20.66973265	0	110.3336074	0.110333607	0.110333607	36.45488933	183.8893457	0.110333607	0.110333607	29.42229531	29.42229531	29.42229531	7.355573827	29.42229531	18.38893457	29.42229531	0.110333607	0	0.147111477	0	0	0.25	0	0	0	0	0	7.355573827											14.959	0.346002163	2.374304556	0	2.172820537	1.41092941	0.868842707	0.913079879	5.859783155	0.737239851	2.158270595	0.002625177	0.105007079	0.31329429	3.276581104	19.60800471	0.256054468	2.024662392	3.665314455	0	1.298402752	0	0	3.458177807	0	0	0	0	0	0.027456757	0	0	0	0	0	0	0	0	0	0	65.8358	0	22.4194	14.959	0.346002163	2.374304556	0	2.172820537	1.41092941	0.868842707	0.913079879	5.859783155	0.737239851	2.158270595	0.002625177	0.105007079	0.31329429	3.276581104	19.60800471	0.256054468	2.024662392	3.665314455	0	1.298402752	0	0	3.458177807	0	0	0	0	0	0.027456757	0	0	0	0	0	0	0	0	0	0	65.8358	3500																																																																																	0	0	0	14.959	0.346002163	2.374304556	0	2.172820537	1.41092941	0.868842707	0.913079879	5.859783155	0.737239851	2.158270595	0.002625177	0.105007079	0.31329429	3.276581104	19.60800471	0.256054468	2.024662392	3.665314455	0	1.298402752	0	0	3.458177807	0	0	0	0	0	0.027456757	0	0	0	0	0	0	0	0	0	0	65.8358
H2762_047_0	2009	3																					3500											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1091.889183	28.1989911	1035.496424	1276.980677	227.5602709	13.0399254	8.029915599	336.3895524	428.1464175	8.25233492	24.15872089	1.198807285	47.95229142	143.0682506	4584.996312	7184.25665	162.8918886	805.0071412	31.55730614	0	10.9003071	0	0	13.83271123	0	0	0	0	0	37.66509976											"$230 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$230 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$40 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$250/Visit	15% Coinsurance	15% Coinsurance	$40 Copay	$40 Copay	$40 Copay	$10 Copay	$40 Copay	$10 Copay Group Session; $40 for Indiv.	$40 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"						$10/Routine Physical											149.8761315	131.2929032	28.10077519	0	150	0.15	0.15	49.56090468	250	0.15	0.15	40	40	40	10	40	25	40	0.15	0	0.2	0	0	0.25	0	0	0	0	0	10											114.7128668	100.489552	21.50789754	0	114.8076738	0.114807674	0.114807674	37.93314784	191.3461229	0.114807674	0.114807674	30.61537967	30.61537967	30.61537967	7.653844918	30.61537967	19.13461229	30.61537967	0.114807674	0	0.153076898	0	0	0.25	0	0	0	0	0	7.653844918											10.4378	0.236141999	1.855945916	0	2.177138779	1.497083501	0.92189593	1.063359552	6.827013086	0.947431375	2.773606547	0.003058495	0.122339801	0.365007401	2.924404227	18.32906208	0.259739428	2.053799939	3.623020908	0	1.668585201	0	0	3.458177807	0	0	0	0	0	0.024023569	0	0	0	0	0	0	0	0	0	0	61.5686	0	17.8114	10.4378	0.236141999	1.855945916	0	2.177138779	1.497083501	0.92189593	1.063359552	6.827013086	0.947431375	2.773606547	0.003058495	0.122339801	0.365007401	2.924404227	18.32906208	0.259739428	2.053799939	3.623020908	0	1.668585201	0	0	3.458177807	0	0	0	0	0	0.024023569	0	0	0	0	0	0	0	0	0	0	61.5686	3500																																																																																	0	0	0	10.4378	0.236141999	1.855945916	0	2.177138779	1.497083501	0.92189593	1.063359552	6.827013086	0.947431375	2.773606547	0.003058495	0.122339801	0.365007401	2.924404227	18.32906208	0.259739428	2.053799939	3.623020908	0	1.668585201	0	0	3.458177807	0	0	0	0	0	0.024023569	0	0	0	0	0	0	0	0	0	0	61.5686
H2762_048_0	2009	3																					3500											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1906.036973	49.22506832	1378.099807	3368.170608	238.6949803	13.5926582	8.370285471	285.7785191	363.5176639	6.652289407	19.47458563	1.01784718	40.71388722	121.4720808	5643.075658	8509.108508	180.4124033	891.5930328	37.44628752	0	8.786846163	0	0	13.83271123	0	0	0	0	0	48.83560149											"$230 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$230 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$40 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$250/Visit	15% Coinsurance	15% Coinsurance	$40 Copay	$40 Copay	$40 Copay	$10 Copay	$40 Copay	$10 Copay Group Session; $40 for Indiv.	$40 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"						$10/Routine Physical											146.5597132	131.2929032	28.10077519	0	150	0.15	0.15	49.56090468	250	0.15	0.15	40	40	40	10	40	25	40	0.15	0	0.2	0	0	0.25	0	0	0	0	0	10											105.2781619	94.31156227	20.1856151	0	107.7494213	0.107749421	0.107749421	35.60105865	179.5823688	0.107749421	0.107749421	28.73317901	28.73317901	28.73317901	7.183294752	28.73317901	17.95823688	28.73317901	0.107749421	0	0.143665895	0	0	0.25	0	0	0	0	0	7.183294752											16.722	0.386874425	2.318149355	0	2.143270499	1.464601054	0.901893415	0.847834818	5.440113598	0.716780334	2.098375332	0.002437165	0.097486617	0.290856587	3.377989646	20.37447816	0.269990723	2.134858518	4.034815809	0	1.262370119	0	0	3.458177807	0	0	0	0	0	0.029233377	0	0	0	0	0	0	0	0	0	0	68.3726	0	25.4484	16.722	0.386874425	2.318149355	0	2.143270499	1.464601054	0.901893415	0.847834818	5.440113598	0.716780334	2.098375332	0.002437165	0.097486617	0.290856587	3.377989646	20.37447816	0.269990723	2.134858518	4.034815809	0	1.262370119	0	0	3.458177807	0	0	0	0	0	0.029233377	0	0	0	0	0	0	0	0	0	0	68.3726	3500																																																																																	0	0	0	16.722	0.386874425	2.318149355	0	2.143270499	1.464601054	0.901893415	0.847834818	5.440113598	0.716780334	2.098375332	0.002437165	0.097486617	0.290856587	3.377989646	20.37447816	0.269990723	2.134858518	4.034815809	0	1.262370119	0	0	3.458177807	0	0	0	0	0	0.029233377	0	0	0	0	0	0	0	0	0	0	68.3726
H2762_049_0	2009	3																					3500											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1240.470888	32.03624329	1208.07388	1480.985234	189.7596162	12.8428958	7.90858584	242.861888	308.7108292	6.538513181	19.14150559	0.864388387	34.57553547	103.1579769	5353.259848	8504.589289	197.2085507	974.599122	46.6527362	0	8.636561932	0	0	13.83271123	0	0	0	0	0	41.44859347											"$230 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$230 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$40 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$250/Visit	15% Coinsurance	15% Coinsurance	$40 Copay	$40 Copay	$40 Copay	$10 Copay	$40 Copay	$10 Copay Group Session; $40 for Indiv.	$40 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"						$10/Routine Physical											149.0342142	131.2929032	28.10077519	0	150	0.15	0.15	49.56090468	250	0.15	0.15	40	40	40	10	40	25	40	0.15	0	0.2	0	0	0.25	0	0	0	0	0	10											111.4857094	98.21424255	21.02091037	0	112.2081698	0.11220817	0.11220817	37.07425606	187.0136164	0.11220817	0.11220817	29.92217862	29.92217862	29.92217862	7.480544655	29.92217862	18.70136164	29.92217862	0.11220817	0	0.149610893	0	0	0.25	0	0	0	0	0	7.480544655											11.5246	0.262201281	2.116234396	0	1.774381603	1.441077833	0.887407943	0.750326985	4.811094049	0.733674597	2.14783331	0.002155365	0.086214612	0.257225951	3.337108279	21.20631998	0.307339035	2.430177418	5.234818146	0	1.292123744	0	0	3.458177807	0	0	0	0	0	0.025838171	0	0	0	0	0	0	0	0	0	0	64.0863	0	20.417	11.5246	0.262201281	2.116234396	0	1.774381603	1.441077833	0.887407943	0.750326985	4.811094049	0.733674597	2.14783331	0.002155365	0.086214612	0.257225951	3.337108279	21.20631998	0.307339035	2.430177418	5.234818146	0	1.292123744	0	0	3.458177807	0	0	0	0	0	0.025838171	0	0	0	0	0	0	0	0	0	0	64.0863	3500																																																																																	0	0	0	11.5246	0.262201281	2.116234396	0	1.774381603	1.441077833	0.887407943	0.750326985	4.811094049	0.733674597	2.14783331	0.002155365	0.086214612	0.257225951	3.337108279	21.20631998	0.307339035	2.430177418	5.234818146	0	1.292123744	0	0	3.458177807	0	0	0	0	0	0.025838171	0	0	0	0	0	0	0	0	0	0	64.0863
H2762_050_0	2009	3																					2000											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1819.715919	46.99575177	1582.037052	2528.045329	249.4451056	13.46045954	8.288878255	303.1516732	412.6775103	6.866578935	19.84278321	1.149759097	45.99036386	130.5637322	6260.515334	9921.630302	208.7648294	1016.157792	37.27610594	0	9.531922361	0	0	13.83271123	428.2287369	2.5186875	183.5266015	0	0	45.42283388											"$30 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$30 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $30 Copay Days 21-100; 100 day limit	$0/Visit; Unlimited Days	$100/Trip	10% Coinsurance	10% Coinsurance	$10 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$30/Visit	10% Coinsurance	10% Coinsurance	$10 Copay	$10 Copay	$10 Copay	$5 Copay	$10 Copay	$5 Copay Group Session; $10 for Indiv.	$10 Copay	10% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"	$10/Exam	$100 Allowance	$10/Exam			$5/Routine Physical											24.09049328	17.12516129	6.744186047	0	100	0.1	0.1	48.24361873	30	0.1	0.1	10	10	10	5	10	7.5	10	0.1	0	0.2	0	0	0.25	10	0	10	0	0	5											20.08037998	14.27449998	5.621546097	0	83.35395937	0.083353959	0.083353959	40.21296636	25.00618781	0.083353959	0.083353959	8.335395937	8.335395937	8.335395937	4.167697969	8.335395937	6.251546953	8.335395937	0.083353959	0	0.166707919	0	0	0.25	8.335395937	0	8.335395937	0	0	4.167697969											3.045	0.055903405	0.741124518	0	1.732686433	1.121982598	0.690910821	1.01588567	0.859957611	0.572356542	1.653974546	0.000798641	0.031945658	0.0906917	2.174328087	6.891726409	0.108758594	0.705839794	3.10711102	0	1.589046939	0	0	3.458177807	0.297454673	0	0.127480574	0	0	0.015775721	0	0	0	0	0	0	0	0	0	0	30.089	0	5.3139	3.045	0.055903405	0.741124518	0	1.732686433	1.121982598	0.690910821	1.01588567	0.859957611	0.572356542	1.653974546	0.000798641	0.031945658	0.0906917	2.174328087	6.891726409	0.108758594	0.705839794	3.10711102	0	1.589046939	0	0	3.458177807	0.297454673	0	0.127480574	0	0	0.015775721	0	0	0	0	0	0	0	0	0	0	30.089	2000																																																																																	0	0	0	3.045	0.055903405	0.741124518	0	1.732686433	1.121982598	0.690910821	1.01588567	0.859957611	0.572356542	1.653974546	0.000798641	0.031945658	0.0906917	2.174328087	6.891726409	0.108758594	0.705839794	3.10711102	0	1.589046939	0	0	3.458177807	0.297454673	0	0.127480574	0	0	0.015775721	0	0	0	0	0	0	0	0	0	0	30.089
H2762_051_0	2009	4																					2000											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1210.625786	31.2654675	1171.14177	1217.857731	159.107832	11.35288821	6.991047218	266.3494066	362.4219286	7.067768298	20.42417271	1.009742229	40.38968917	114.6637712	5573.424019	8936.469313	192.1040984	935.0620839	42.37960614	0	9.811205743	0	0	13.83271123	359.0892234	2.5186875	153.8953814	0	0	38.08910691											"$30 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$30 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $30 Copay Days 21-100; 100 day limit	$0/Visit; Unlimited Days	$100/Trip	10% Coinsurance	10% Coinsurance	$10 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$30/Visit	10% Coinsurance	10% Coinsurance	$10 Copay	$10 Copay	$10 Copay	$5 Copay	$10 Copay	$5 Copay Group Session; $10 for Indiv.	$10 Copay	10% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"	$10/Exam	$100 Allowance	$10/Exam			$5/Routine Physical											26.74597551	17.12516129	6.744186047	0	100	0.1	0.1	48.24361873	30	0.1	0.1	10	10	10	5	10	7.5	10	0.1	0	0.2	0	0	0.25	10	0	10	0	0	5											22.88277164	14.65159328	5.77005199	0	85.5559433	0.085555943	0.085555943	41.27528309	25.66678299	0.085555943	0.085555943	8.55559433	8.55559433	8.55559433	4.277797165	8.55559433	6.416695748	8.55559433	0.085555943	0	0.171111887	0	0	0.25	8.55559433	0	8.55559433	0	0	4.277797165											2.3085	0.038174076	0.563129075	0	1.134385054	0.97130706	0.598125639	0.916137263	0.775183749	0.604689584	1.747409363	0.000719912	0.028796483	0.081751393	1.986831456	6.371400516	0.102722796	0.666667655	3.625827181	0	1.678813925	0	0	3.458177807	0.256018477	0	0.109722204	0	0	0.013578123	0	0	0	0	0	0	0	0	0	0	28.0381	0	4.1492	2.3085	0.038174076	0.563129075	0	1.134385054	0.97130706	0.598125639	0.916137263	0.775183749	0.604689584	1.747409363	0.000719912	0.028796483	0.081751393	1.986831456	6.371400516	0.102722796	0.666667655	3.625827181	0	1.678813925	0	0	3.458177807	0.256018477	0	0.109722204	0	0	0.013578123	0	0	0	0	0	0	0	0	0	0	28.0381	2000																																																																																	0	0	0	2.3085	0.038174076	0.563129075	0	1.134385054	0.97130706	0.598125639	0.916137263	0.775183749	0.604689584	1.747409363	0.000719912	0.028796483	0.081751393	1.986831456	6.371400516	0.102722796	0.666667655	3.625827181	0	1.678813925	0	0	3.458177807	0.256018477	0	0.109722204	0	0	0.013578123	0	0	0	0	0	0	0	0	0	0	28.0381
H2762_052_0	2009	3																					2000											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1953.983905	50.46333967	1397.685467	2769.974773	246.6601108	13.77914995	8.485126083	301.5851136	410.5392884	7.203306925	20.81584717	1.143801805	45.75207222	129.8872373	6301.026862	10047.46761	213.82984	1040.811609	39.60220235	0	9.999355283	0	0	13.83271123	449.9013525	2.5186875	192.8148654	0	0	47.72167918											"$30 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$30 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $30 Copay Days 21-100; 100 day limit	$0/Visit; Unlimited Days	$100/Trip	10% Coinsurance	10% Coinsurance	$10 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$30/Visit	10% Coinsurance	10% Coinsurance	$10 Copay	$10 Copay	$10 Copay	$5 Copay	$10 Copay	$5 Copay Group Session; $10 for Indiv.	$10 Copay	10% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"	$10/Exam	$100 Allowance	$10/Exam			$5/Routine Physical											24.4795583	17.12516129	6.744186047	0	100	0.1	0.1	48.24361873	30	0.1	0.1	10	10	10	5	10	7.5	10	0.1	0	0.2	0	0	0.25	10	0	10	0	0	5											20.28673308	14.19198712	5.589051096	0	82.87213694	0.082872137	0.082872137	39.98051778	24.86164108	0.082872137	0.082872137	8.287213694	8.287213694	8.287213694	4.143606847	8.287213694	6.215410271	8.287213694	0.082872137	0	0.165744274	0	0	0.25	8.287213694	0	8.287213694	0	0	4.143606847											3.3033	0.059681256	0.650977958	0	1.70343754	1.141907601	0.703180531	1.004794083	0.850556703	0.596953438	1.725053737	0.000789911	0.031596433	0.089700274	2.175748171	6.938792595	0.110753349	0.718785685	3.281919136	0	1.657335881	0	0	3.458177807	0.310702387	0	0.133158166	0	0	0.016478323	0	0	0	0	0	0	0	0	0	0	30.6638	0	5.6251	3.3033	0.059681256	0.650977958	0	1.70343754	1.141907601	0.703180531	1.004794083	0.850556703	0.596953438	1.725053737	0.000789911	0.031596433	0.089700274	2.175748171	6.938792595	0.110753349	0.718785685	3.281919136	0	1.657335881	0	0	3.458177807	0.310702387	0	0.133158166	0	0	0.016478323	0	0	0	0	0	0	0	0	0	0	30.6638	2000																																																																																	0	0	0	3.3033	0.059681256	0.650977958	0	1.70343754	1.141907601	0.703180531	1.004794083	0.850556703	0.596953438	1.725053737	0.000789911	0.031596433	0.089700274	2.175748171	6.938792595	0.110753349	0.718785685	3.281919136	0	1.657335881	0	0	3.458177807	0.310702387	0	0.133158166	0	0	0.016478323	0	0	0	0	0	0	0	0	0	0	30.6638
H2762_053_0	2009	3																					2000											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1129.912652	29.18098037	1209.317817	1378.062487	208.4222738	13.50451557	8.316007716	305.9375134	416.4829286	7.962782838	23.01055228	1.160361357	46.41445427	131.767698	5029.863021	8398.131554	193.4479804	941.6033976	37.54857093	0	11.05363071	0	0	13.83271123	329.2273165	2.5186875	141.0974214	0	0	34.92161179											"$30 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$30 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $30 Copay Days 21-100; 100 day limit	$0/Visit; Unlimited Days	$100/Trip	10% Coinsurance	10% Coinsurance	$10 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$30/Visit	10% Coinsurance	10% Coinsurance	$10 Copay	$10 Copay	$10 Copay	$5 Copay	$10 Copay	$5 Copay Group Session; $10 for Indiv.	$10 Copay	10% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"	$10/Exam	$100 Allowance	$10/Exam			$5/Routine Physical											27.64028799	17.12516129	6.744186047	0	100	0.1	0.1	48.24361873	30	0.1	0.1	10	10	10	5	10	7.5	10	0.1	0	0.2	0	0	0.25	10	0	10	0	0	5											23.5837164	14.61182125	5.754389071	0	85.32370001	0.0853237	0.0853237	41.16324052	25.59711	0.0853237	0.0853237	8.532370001	8.532370001	8.532370001	4.266185001	8.532370001	6.399277501	8.532370001	0.0853237	0	0.1706474	0	0	0.25	8.532370001	0	8.532370001	0	0	4.266185001											2.2206	0.035532272	0.579907103	0	1.48194663	1.152255235	0.709552548	1.049448287	0.888396611	0.679414094	1.96334546	0.000825053	0.033002108	0.093690896	1.788193848	5.971330478	0.103160609	0.669509049	3.203783002	0	1.886273341	0	0	3.458177807	0.234090773	0	0.100324617	0	0	0.012415171	0	0	0	0	0	0	0	0	0	0	28.3152	0	4.2731	2.2206	0.035532272	0.579907103	0	1.48194663	1.152255235	0.709552548	1.049448287	0.888396611	0.679414094	1.96334546	0.000825053	0.033002108	0.093690896	1.788193848	5.971330478	0.103160609	0.669509049	3.203783002	0	1.886273341	0	0	3.458177807	0.234090773	0	0.100324617	0	0	0.012415171	0	0	0	0	0	0	0	0	0	0	28.3152	2000																																																																																	0	0	0	2.2206	0.035532272	0.579907103	0	1.48194663	1.152255235	0.709552548	1.049448287	0.888396611	0.679414094	1.96334546	0.000825053	0.033002108	0.093690896	1.788193848	5.971330478	0.103160609	0.669509049	3.203783002	0	1.886273341	0	0	3.458177807	0.234090773	0	0.100324617	0	0	0.012415171	0	0	0	0	0	0	0	0	0	0	28.3152
H2762_054_0	2009	3																					2000											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1886.714984	48.72606107	1558.67956	2700.685896	261.2103551	14.13448625	8.703940257	332.1122325	452.2345511	7.481988354	21.62117035	1.259968804	50.39875215	143.0788675	6235.175711	9844.403672	205.6861061	1001.17218	36.84562738	0	10.38621019	0	0	13.83271123	422.2981051	2.5186875	180.9849022	0	0	44.79376329											"$30 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$30 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $30 Copay Days 21-100; 100 day limit	$0/Visit; Unlimited Days	$100/Trip	10% Coinsurance	10% Coinsurance	$10 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$30/Visit	10% Coinsurance	10% Coinsurance	$10 Copay	$10 Copay	$10 Copay	$5 Copay	$10 Copay	$5 Copay Group Session; $10 for Indiv.	$10 Copay	10% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"	$10/Exam	$100 Allowance	$10/Exam			$5/Routine Physical											24.34029127	17.12516129	6.744186047	0	100	0.1	0.1	48.24361873	30	0.1	0.1	10	10	10	5	10	7.5	10	0.1	0	0.2	0	0	0.25	10	0	10	0	0	5											20.16414471	14.18693912	5.587063109	0	82.84265989	0.08284266	0.08284266	39.96629698	24.85279797	0.08284266	0.08284266	8.284265989	8.284265989	8.284265989	4.142132994	8.284265989	6.213199491	8.284265989	0.08284266	0	0.16568532	0	0	0.25	8.284265989	0	8.284265989	0	0	4.142132994											3.1703	0.057606139	0.725703422	0	1.80328005	1.170938437	0.721057562	1.10610801	0.936607828	0.619827816	1.791155262	0.000869826	0.034793056	0.098775283	2.15224392	6.79613821	0.106497401	0.69116472	3.052389777	0	1.720842556	0	0	3.458177807	0.291535819	0	0.124943922	0	0	0.01546181	0	0	0	0	0	0	0	0	0	0	30.6465	0	5.6242	3.1703	0.057606139	0.725703422	0	1.80328005	1.170938437	0.721057562	1.10610801	0.936607828	0.619827816	1.791155262	0.000869826	0.034793056	0.098775283	2.15224392	6.79613821	0.106497401	0.69116472	3.052389777	0	1.720842556	0	0	3.458177807	0.291535819	0	0.124943922	0	0	0.01546181	0	0	0	0	0	0	0	0	0	0	30.6465	2000																																																																																	0	0	0	3.1703	0.057606139	0.725703422	0	1.80328005	1.170938437	0.721057562	1.10610801	0.936607828	0.619827816	1.791155262	0.000869826	0.034793056	0.098775283	2.15224392	6.79613821	0.106497401	0.69116472	3.052389777	0	1.720842556	0	0	3.458177807	0.291535819	0	0.124943922	0	0	0.01546181	0	0	0	0	0	0	0	0	0	0	30.6465
H2762_055_0	2009	3																					2000											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1237.428995	31.95768376	1170.860646	1411.320651	251.486382	14.41125607	8.874373618	371.7266649	506.3464777	9.240247734	26.7021226	1.410729818	56.4291927	160.1989066	5348.190744	8843.802251	200.5189448	976.0211467	35.01299993	0	12.82695864	0	0	13.83271123	355.1087185	2.5186875	152.1894508	0	0	37.66688907											"$30 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$30 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $30 Copay Days 21-100; 100 day limit	$0/Visit; Unlimited Days	$100/Trip	10% Coinsurance	10% Coinsurance	$10 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$30/Visit	10% Coinsurance	10% Coinsurance	$10 Copay	$10 Copay	$10 Copay	$5 Copay	$10 Copay	$5 Copay Group Session; $10 for Indiv.	$10 Copay	10% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood		"25% Coinsurance; limited to semi-annual cleanings, exams, and annual x-rays"	$10/Exam	$100 Allowance	$10/Exam			$5/Routine Physical											27.6217199	17.12516129	6.744186047	0	100	0.1	0.1	48.24361873	30	0.1	0.1	10	10	10	5	10	7.5	10	0.1	0	0.2	0	0	0.25	10	0	10	0	0	5											23.11175876	14.32903519	5.643023007	0	83.6724101	0.08367241	0.08367241	40.36659851	25.10172303	0.08367241	0.08367241	8.36724101	8.36724101	8.36724101	4.183620505	8.36724101	6.275430758	8.36724101	0.08367241	0	0.16734482	0	0	0.25	8.36724101	0	8.36724101	0	0	4.183620505											2.3833	0.038160231	0.550599464	0	1.753539308	1.205824528	0.742540229	1.250445087	1.059180753	0.773153798	2.234230953	0.00098366	0.039346388	0.111701905	1.864566705	6.16651874	0.104861896	0.680550347	2.929622089	0	2.146525087	0	0	3.458177807	0.247606686	0	0.106117151	0	0	0.013131997	0	0	0	0	0	0	0	0	0	0	29.8606	0	5.1467	2.3833	0.038160231	0.550599464	0	1.753539308	1.205824528	0.742540229	1.250445087	1.059180753	0.773153798	2.234230953	0.00098366	0.039346388	0.111701905	1.864566705	6.16651874	0.104861896	0.680550347	2.929622089	0	2.146525087	0	0	3.458177807	0.247606686	0	0.106117151	0	0	0.013131997	0	0	0	0	0	0	0	0	0	0	29.8606	2000																																																																																	0	0	0	2.3833	0.038160231	0.550599464	0	1.753539308	1.205824528	0.742540229	1.250445087	1.059180753	0.773153798	2.234230953	0.00098366	0.039346388	0.111701905	1.864566705	6.16651874	0.104861896	0.680550347	2.929622089	0	2.146525087	0	0	3.458177807	0.247606686	0	0.106117151	0	0	0.013131997	0	0	0	0	0	0	0	0	0	0	29.8606
H2762_802_0	2009	3																					9999999											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	Coin	V	Coin	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	316.7538698	3.425453183	54.25226016	41.44914602	7.91350115	13.68907738	8.429659886	13.38541394	42.58786374	7.110522869	21.1056772	0.130320094	1.028080741	29.31749918	30.4987047	90.28545639	1.661077381	8.588762498	52.38582356	82.90190084	9.46096385	0.695733788	0	0	0	0	0	0	0	0											Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered																			0.07375485	0.07375485	0.179644673	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.07375485	0.07375485	0.179644673	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.3621	0.252643786	9.746129533	0	1.828018766	3.162176876	1.947251434	3.092030621	9.837796525	1.642530783	4.875411434	0.030103942	0.237486651	6.772342311	7.045200786	20.85594043	0.383708875	1.984004137	12.10112524	19.15033909	2.185482649	0.160714505	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.6526	0	0	23.3621	0.252643786	9.746129533	0	1.828018766	3.162176876	1.947251434	3.092030621	9.837796525	1.642530783	4.875411434	0.030103942	0.237486651	6.772342311	7.045200786	20.85594043	0.383708875	1.984004137	12.10112524	19.15033909	2.185482649	0.160714505	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.6526	9999999																																																																																	0	0	0	23.3621	0.252643786	9.746129533	0	1.828018766	3.162176876	1.947251434	3.092030621	9.837796525	1.642530783	4.875411434	0.030103942	0.237486651	6.772342311	7.045200786	20.85594043	0.383708875	1.984004137	12.10112524	19.15033909	2.185482649	0.160714505	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.6526
H2762_803_0	2009	3																					9999999											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	Coin	V	Coin	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	316.7539011	3.42545352	54.25228391	41.4491407	7.913495624	13.68906783	8.429654	13.38541452	42.5878656	7.110523179	21.10567812	0.1303201	1.028080785	29.31750046	30.49870882	90.28547696	1.661077873	8.588765038	52.38583664	82.9019077	9.460964262	0.695733819	0	0	0	0	0	0	0	0											Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered																			0.073754897	0.073754897	0.179644688	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.073754897	0.073754897	0.179644688	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.3622	0.252643971	9.746134633	0	1.828017489	3.162174668	1.947250074	3.092030754	9.837796953	1.642530854	4.875411646	0.030103943	0.237486661	6.772342606	7.045201737	20.85594518	0.383708989	1.984004724	12.10112826	19.15034068	2.185482745	0.160714512	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.6526	0	0	23.3622	0.252643971	9.746134633	0	1.828017489	3.162174668	1.947250074	3.092030754	9.837796953	1.642530854	4.875411646	0.030103943	0.237486661	6.772342606	7.045201737	20.85594518	0.383708989	1.984004724	12.10112826	19.15034068	2.185482745	0.160714512	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.6526	9999999																																																																																	0	0	0	23.3622	0.252643971	9.746134633	0	1.828017489	3.162174668	1.947250074	3.092030754	9.837796953	1.642530854	4.875411646	0.030103943	0.237486661	6.772342606	7.045201737	20.85594518	0.383708989	1.984004724	12.10112826	19.15034068	2.185482745	0.160714512	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.6526
H2762_804_0	2009	3																					9999999											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	Coin	V	Coin	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	316.7537644	3.425452043	54.25224208	41.44913185	7.913485775	13.68905079	8.429643509	13.38538943	42.58778501	7.110509724	21.10563819	0.130319853	1.02807884	29.31744498	30.49873687	90.28558626	1.661080237	8.588777264	52.38588909	82.90191745	9.46094636	0.695732502	0	0	0	0	0	0	0	0											Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered	Medicare Covered																			0.073754884	0.073754884	0.179644672	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.073754884	0.073754884	0.179644672	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.3621	0.252643818	9.746126253	0	1.828015214	3.162170732	1.947247651	3.092024959	9.837778338	1.642527746	4.875402421	0.030103886	0.237486212	6.772329791	7.045208218	20.85597043	0.383709535	1.984007548	12.10114038	19.15034293	2.185478609	0.160714208	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.6526	0	0	23.3621	0.252643818	9.746126253	0	1.828015214	3.162170732	1.947247651	3.092024959	9.837778338	1.642527746	4.875402421	0.030103886	0.237486212	6.772329791	7.045208218	20.85597043	0.383709535	1.984007548	12.10114038	19.15034293	2.185478609	0.160714208	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.6526	9999999																																																																																	0	0	0	23.3621	0.252643818	9.746126253	0	1.828015214	3.162170732	1.947247651	3.092024959	9.837778338	1.642527746	4.875402421	0.030103886	0.237486212	6.772329791	7.045208218	20.85597043	0.383709535	1.984007548	12.10114038	19.15034293	2.185478609	0.160714208	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.6526
H2775_001_0	2009	2																					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																																																			0		257.1126495	6.040621676	906.2047403	1531.988147	137.4449019	9.040715719	7.447660351	209.025732	379.8668066		4738.438018	9.223029315	4.287966331	85.66622667	4293.373317	3508.679569	299.565693	401.1033131			24.91831211	1279.576518					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	18.91854924	100	0.2	0.2	48.55089578	47.5		10.70945309	50	50	15.14237487	10	24.2384653	25.60028357	15			0.2	15					15														151.607061	130.2760853	53.33283104	15.5253572	82.06420586	0.164128412	0.164128412	39.84290706	38.98049778		8.788627627	41.03210293	41.03210293	12.42646969	8.206420586	19.89110406	21.00866941	12.30963088			0.164128412	12.30963088					12.30963088														3.2483	0.065579045	4.027538692	1.982055267	0.939942227	1.483838312	1.222372664	0.694016068	1.233949768	0	3.470363939	0.031536691	0.014662023	0.088710731	2.936102264	5.815959201	0.524456384	0.411452811	0	0	4.08980299	1.312592885	0	0	0	0	0.223125414	0	0	0	0	0	0	0	0	0	0	0	0	0	33.8164	0	7.3908	3.2483	0.065579045	4.027538692	1.982055267	0.939942227	1.483838312	1.222372664	0.694016068	1.233949768	0	3.470363939	0.031536691	0.014662023	0.088710731	2.936102264	5.815959201	0.524456384	0.411452811	0	0	4.08980299	1.312592885	0	0	0	0	0.223125414	0	0	0	0	0	0	0	0	0	0	0	0	0	33.8164		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										5.1033	0.108	1.7625	0.9706	0.2544	0.545	0.4489	0.2255	2.3226	1.0344	2.5491	0.0582	0.0056	1.4698	2.5288	2.5648	0.2003	0.2338			1.0817	0.7221					0.1173														24.3068	500	0	8.3516	0.173544202	5.790076769	2.952662868	1.194326164	2.028812298	1.671317336	0.919565629	3.556540447	1.034406515	6.019450156	0.089785619	0.020309424	1.55852417	5.464951514	8.3807375	0.72472594	0.645262923	0	0	5.171537056	2.034677534	0	0	0	0	0.340394202	0	0	0	0	0	0	0	0	0	0	0	0	0	58.1232
H2775_002_0	2009	2																					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																																																			0		267.8874527	7.549779376	876.5535555	2106.893047	137.9344553	7.019721892	6.267938428	217.613543	308.0466113		4284.675518	22.18688998	7.258598007	86.0459214	2984.420638	3384.227237	274.4942946	488.5178687			19.02295426	1128.901568					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	17.71497608	100	0.2	0.2	48.53901165	47.5		9.370358158	50	50	15.21738281	10	24.25913256	24.81634513	15			0.2	15					15														155.9999389	134.0508892	54.87817208	14.95888904	84.44205048	0.168884101	0.168884101	40.98733672	40.10997398		7.912522566	42.22102524	42.22102524	12.84987008	8.444205048	20.48490897	20.95543068	12.66630757			0.168884101	12.66630757					12.66630757														3.4825	0.084337887	4.008638071	2.626398276	0.970622353	1.185519421	1.058555146	0.743283297	1.02964513	0	2.825215977	0.07806277	0.025538787	0.092139909	2.100088318	5.777132239	0.479345514	0.515643132	0	0	3.212674529	1.19158454	0	0	0	0	0.229590566	0	0	0	0	0	0	0	0	0	0	0	0	0	31.7166	0	5.8436	3.4825	0.084337887	4.008638071	2.626398276	0.970622353	1.185519421	1.058555146	0.743283297	1.02964513	0	2.825215977	0.07806277	0.025538787	0.092139909	2.100088318	5.777132239	0.479345514	0.515643132	0	0	3.212674529	1.19158454	0	0	0	0	0.229590566	0	0	0	0	0	0	0	0	0	0	0	0	0	31.7166		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										5.2085	0.1368	1.5713	1.2746	0.2597	0.4315	0.3853	0.232	1.5452	0.7985	2.0565	0.0758	0.0091	1.2146	1.8052	2.4973	0.1795	0.2867			0.8517	0.6357					0.1182														21.5739	500	0	8.691	0.221126839	5.579904085	3.901037192	1.230361487	1.617035045	1.443857214	0.975298491	2.574851029	0.79850277	4.881736223	0.153908849	0.034649991	1.306758697	3.905336879	8.27442835	0.658853638	0.802317343	0	0	4.06439731	1.827326938	0	0	0	0	0.347794648	0	0	0	0	0	0	0	0	0	0	0	0	0	53.2905
H2775_003_0	2009	2																					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																																																			0		296.7954812	8.364484341	971.0796385	2334.250184	152.8191136	8.616476943	7.693687553	241.0403989	341.2882586		4747.039548	24.58110159	8.041881271	95.33123106	3306.472739	3749.422906	304.1152747	541.2343672			23.35004852	1250.722573					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35 : $	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	19.62661856	100	0.2	0.2	48.5405713	47.5		10.38152377	50	50	15.27990471	10	24.25913256	27.49430412	15			0.2	15					15														149.5260579	128.4878774	52.60076892	15.88534708	80.93776843	0.161875537	0.161875537	39.2876552	38.44544001		8.402573672	40.46888422	40.46888422	12.36721389	8.093776843	19.63480054	22.2532762	12.14066527			0.161875537	12.14066527					12.14066527														3.6982	0.089561237	4.256627972	3.090031196	1.030736502	1.394796831	1.245419803	0.78915934	1.093414773	0	3.323945794	0.08289748	0.027120497	0.098248477	2.230154374	6.134930908	0.563963434	0.547578773	0	0	3.779801641	1.265383675	0	0	0	0	0.220062729	0	0	0	0	0	0	0	0	0	0	0	0	0	34.9621	0	8.2342	3.6982	0.089561237	4.256627972	3.090031196	1.030736502	1.394796831	1.245419803	0.78915934	1.093414773	0	3.323945794	0.08289748	0.027120497	0.098248477	2.230154374	6.134930908	0.563963434	0.547578773	0	0	3.779801641	1.265383675	0	0	0	0	0.220062729	0	0	0	0	0	0	0	0	0	0	0	0	0	34.9621		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35 : $	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: $0.3	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										5.6125	0.148	1.8857	1.5298	0.2845	0.5179	0.4624	0.2515	1.8545	0.9583	2.4682	0.091	0.0098	1.4553	1.9881	2.7142	0.2181	0.3167			1.009	0.7048					0.1171														24.5974	500	0	9.3107	0.237569218	6.142299219	4.619820615	1.315212883	1.91269098	1.70784961	1.040621053	2.94793185	0.958342848	5.792129431	0.173926027	0.036920819	1.553596866	4.2182095	8.849133525	0.782036225	0.864324162	0	0	4.788789019	1.97016788	0	0	0	0	0.337194302	0	0	0	0	0	0	0	0	0	0	0	0	0	59.5595
H2775_004_0	2009	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																																																			0		257.1126495	6.040621676	906.2047403	1531.988147	137.4449019	9.040715719	7.447660351	209.025732	379.8668066		4738.438018	9.223029315	4.287966331	85.66622667	4293.373317	3508.679569	299.565693	401.1033131			24.91831211	1279.576518					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	18.91854924	100	0.2	0.2	48.55089578	47.5		10.70945309	50	50	15.14237487	10	24.2384653	25.60028357	15			0.2	15					15														151.607061	130.2760853	53.33283104	15.5253572	82.06420586	0.164128412	0.164128412	39.84290706	38.98049778		8.788627627	41.03210293	41.03210293	12.42646969	8.206420586	19.89110406	21.00866941	12.30963088			0.164128412	12.30963088					12.30963088														3.2483	0.065579045	4.027538692	1.982055267	0.939942227	1.483838312	1.222372664	0.694016068	1.233949768	0	3.470363939	0.031536691	0.014662023	0.088710731	2.936102264	5.815959201	0.524456384	0.411452811	0	0	4.08980299	1.312592885	0	0	0	0	0.223125414	0	0	0	0	0	0	0	0	0	0	0	0	0	33.8164	0	7.3908	3.2483	0.065579045	4.027538692	1.982055267	0.939942227	1.483838312	1.222372664	0.694016068	1.233949768	0	3.470363939	0.031536691	0.014662023	0.088710731	2.936102264	5.815959201	0.524456384	0.411452811	0	0	4.08980299	1.312592885	0	0	0	0	0.223125414	0	0	0	0	0	0	0	0	0	0	0	0	0	33.8164		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										5.1033	0.108	1.7625	0.9706	0.2544	0.545	0.4489	0.2255	2.3226	1.0344	2.5491	0.0582	0.0056	1.4698	2.5288	2.5648	0.2003	0.2338			1.0817	0.7221					0.1173														24.3068	500	0	8.3516	0.173544202	5.790076769	2.952662868	1.194326164	2.028812298	1.671317336	0.919565629	3.556540447	1.034406515	6.019450156	0.089785619	0.020309424	1.55852417	5.464951514	8.3807375	0.72472594	0.645262923	0	0	5.171537056	2.034677534	0	0	0	0	0.340394202	0	0	0	0	0	0	0	0	0	0	0	0	0	58.1232
H2775_005_0	2009	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																																																			0		267.8874527	7.549779376	876.5535555	2106.893047	137.9344553	7.019721892	6.267938428	217.613543	308.0466113		4284.675518	22.18688998	7.258598007	86.0459214	2984.420638	3384.227237	274.4942946	488.5178687			19.02295426	1128.901568					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	17.71497608	100	0.2	0.2	48.53901165	47.5		9.370358158	50	50	15.21738281	10	24.25913256	24.81634513	15			0.2	15					15														155.9999389	134.0508892	54.87817208	14.95888904	84.44205048	0.168884101	0.168884101	40.98733672	40.10997398		7.912522566	42.22102524	42.22102524	12.84987008	8.444205048	20.48490897	20.95543068	12.66630757			0.168884101	12.66630757					12.66630757														3.4825	0.084337887	4.008638071	2.626398276	0.970622353	1.185519421	1.058555146	0.743283297	1.02964513	0	2.825215977	0.07806277	0.025538787	0.092139909	2.100088318	5.777132239	0.479345514	0.515643132	0	0	3.212674529	1.19158454	0	0	0	0	0.229590566	0	0	0	0	0	0	0	0	0	0	0	0	0	31.7166	0	5.8436	3.4825	0.084337887	4.008638071	2.626398276	0.970622353	1.185519421	1.058555146	0.743283297	1.02964513	0	2.825215977	0.07806277	0.025538787	0.092139909	2.100088318	5.777132239	0.479345514	0.515643132	0	0	3.212674529	1.19158454	0	0	0	0	0.229590566	0	0	0	0	0	0	0	0	0	0	0	0	0	31.7166		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										5.2085	0.1368	1.5713	1.2746	0.2597	0.4315	0.3853	0.232	1.5452	0.7985	2.0565	0.0758	0.0091	1.2146	1.8052	2.4973	0.1795	0.2867			0.8517	0.6357					0.1182														21.5739	500	0	8.691	0.221126839	5.579904085	3.901037192	1.230361487	1.617035045	1.443857214	0.975298491	2.574851029	0.79850277	4.881736223	0.153908849	0.034649991	1.306758697	3.905336879	8.27442835	0.658853638	0.802317343	0	0	4.06439731	1.827326938	0	0	0	0	0.347794648	0	0	0	0	0	0	0	0	0	0	0	0	0	53.2905
H2775_006_0	2009	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																																																			0		296.7954812	8.364484341	971.0796385	2334.250184	152.8191136	8.616476943	7.693687553	241.0403989	341.2882586		4747.039548	24.58110159	8.041881271	95.33123106	3306.472739	3749.422906	304.1152747	541.2343672			23.35004852	1250.722573					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	19.62661856	100	0.2	0.2	48.5405713	47.5		10.38152377	50	50	15.27990471	10	24.25913256	27.49430412	15			0.2	15					15														149.5260579	128.4878774	52.60076892	15.88534708	80.93776843	0.161875537	0.161875537	39.2876552	38.44544001		8.402573672	40.46888422	40.46888422	12.36721389	8.093776843	19.63480054	22.2532762	12.14066527			0.161875537	12.14066527					12.14066527														3.6982	0.089561237	4.256627972	3.090031196	1.030736502	1.394796831	1.245419803	0.78915934	1.093414773	0	3.323945794	0.08289748	0.027120497	0.098248477	2.230154374	6.134930908	0.563963434	0.547578773	0	0	3.779801641	1.265383675	0	0	0	0	0.220062729	0	0	0	0	0	0	0	0	0	0	0	0	0	34.9621	0	8.2342	3.6982	0.089561237	4.256627972	3.090031196	1.030736502	1.394796831	1.245419803	0.78915934	1.093414773	0	3.323945794	0.08289748	0.027120497	0.098248477	2.230154374	6.134930908	0.563963434	0.547578773	0	0	3.779801641	1.265383675	0	0	0	0	0.220062729	0	0	0	0	0	0	0	0	0	0	0	0	0	34.9621		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										5.6125	0.148	1.8857	1.5298	0.2845	0.5179	0.4624	0.2515	1.8545	0.9583	2.4682	0.091	0.0098	1.4553	1.9881	2.7142	0.2181	0.3167			1.009	0.7048					0.1171														24.5974	500	0	9.3107	0.237569218	6.142299219	4.619820615	1.315212883	1.91269098	1.70784961	1.040621053	2.94793185	0.958342848	5.792129431	0.173926027	0.036920819	1.553596866	4.2182095	8.849133525	0.782036225	0.864324162	0	0	4.788789019	1.97016788	0	0	0	0	0.337194302	0	0	0	0	0	0	0	0	0	0	0	0	0	59.5595
H2775_007_0	2009	4																																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																																																			0		397.4749168	24.47023548	2170.092969		268.7980504	14.90822148	13.3389953	485.3808955	316.0611213	15434.1578	5951.823018	7.733945681	1.454237295	3113.800265	9019.64363	12783.09762	665.6807789	345.5692543			17.94096349	710.124675																			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	4a: Medicare FFS Ded/Coin  4b: $35	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																			732.2375806	864.0787018	71.64766793		110.8760946	0.231	0.231	87.91121508	297.2904128	3.079150403	23.45913707	250.4649091	171.9623013	27.06886764	13.76648728	18.96693865	19.47065271	22.57432344			0.231	17.96505229																			732.2375806	864.0787018	71.64766793		110.8760946	0.231	0.231	87.91121508	297.2904128	3.079150403	23.45913707	250.4649091	171.9623013	27.06886764	13.76648728	18.96693865	19.47065271	22.57432344			0.231	17.96505229																			24.2538	1.762017442	12.9568417	0	2.483606507	3.443799163	3.081307915	3.555868691	7.830161769	3.960341101	11.635386	0.1614235	0.020839499	7.023920601	10.34740077	20.2046857	1.080103272	0.650082677	0	0	4.144362566	1.06311891	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.6591	0	0	24.2538	1.762017442	12.9568417	0	2.483606507	3.443799163	3.081307915	3.555868691	7.830161769	3.960341101	11.635386	0.1614235	0.020839499	7.023920601	10.34740077	20.2046857	1.080103272	0.650082677	0	0	4.144362566	1.06311891	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.6591		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	4a: Medicare FFS Ded/Coin  4b: $35	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																			4.3259	0.3143	2.311		0.443	0.6142	0.5496	0.6347	1.3966	0.7061	2.0753	0.0288	0.0037	1.2537	1.8286	3.6037	0.4169	0.1159			0.7392	0.1926																			21.554	0	0	28.5798	2.076293018	15.26783653	0	2.926585586	4.058039373	3.630893745	4.190602769	9.226758952	4.666426193	13.71067235	0.190215192	0.024556458	8.277643885	12.17604937	23.80841804	1.497043014	0.765983229	0	0	4.883556118	1.255712623	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.2131
H2775_008_0	2009	4																					3000											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																																																			0		349.4421404	23.33949582	1284.006355		271.1246604	11.09164702	10.33180373	385.3037654	264.0902775			38.17249656	27.99381696	63.69949702	0.03630374	3142.122366	600.8741926	540.1187974			12.87838917	651.5025688					217.5130188														1a: $250 days 1-5	1b : $250 days 1-5	2a: $105 days 21 - 100  2a2: $105 days 21-100	6a: 0%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50  4b: $25	9a: $150 9b: $100	8a: 0%	8b1: 0% 8b2: 0% 8b3: 0%	9a: $150	12: $50	9a: $150 9c: 30% 9d: $25 3: $15 5: $25	"7a: $0, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $10, 14j: $10"	7b: $30 7d: $25 7f: $25	"7e: $35, 7h: $35"	7c: $25 7i: $25	8b1: 0% 8b2: 0% 8b3: 0%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $10 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $25 18a1: $25	18b: (n/c)		13c (: $											462.7102261	417.7604594	68.23860903		100	0.1	0.2	47.51922324	145			150	50	25.12846286	10	25.27802506	35	25			0.2	14.98945542					25														389.0661659	351.2705167	57.37788465		84.08419437	0.084084194	0.168168389	39.95615603	121.9220818			126.1262916	42.04209718	21.12906555	8.408419437	21.25482372	29.42946803	21.02104859			0.168168389	12.60376283					21.02104859														11.3297	0.683206396	6.139464046	0	1.899774887	0.932632204	1.737482785	1.282938114	2.683203036	0	0	0.401212952	0.098076564	0.112159237	2.54E-05	5.565438084	1.47361732	0.94615529	0	0	2.165737956	0.684281988	0	0	0	0	0.381029311	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5161	0	7.2905	11.3297	0.683206396	6.139464046	0	1.899774887	0.932632204	1.737482785	1.282938114	2.683203036	0	0	0.401212952	0.098076564	0.112159237	2.54E-05	5.565438084	1.47361732	0.94615529	0	0	2.165737956	0.684281988	0	0	0	0	0.381029311	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5161		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50  4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: 30% 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										6.3056	0.4001	2.223	2.2689	0.4866	0.6676	0.6219	0.3787	1.327	0.7452	1.8663	0.1326	0.0408	1.3931	1.8649	2.2664	0.3677	0.3103			0.5577	0.3769					0.1172														24.7185	500	0	17.6353	1.08335369	8.362466414	2.268945239	2.386397048	1.600234853	2.359350713	1.661599651	4.010164436	0.745196292	1.866257723	0.533828746	0.138847985	1.505217984	1.864940603	7.83186215	1.841340954	1.256485022	0	0	2.723475598	1.06116023	0	0	0	0	0.498227255	0	0	0	0	0	0	0	0	0	0	0	0	0	63.2346
H2775_009_0	2009	4																																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																																																			0		387.1508247	25.85808639	1422.500237		300.3820195	13.61463065	12.68194808	426.5481821	292.5885487	13163.50157	5054.947782	42.29173248	31.01466042	2531.011168	8255.941076	12878.37156	665.7151851	598.4036086			15.80779767	741.8718829																			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	4a: Medicare FFS Ded/Coin  4b: $35	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																			716.6608195	625.7557065	74.76266765		115.7981933	0.231	0.231	86.48861292	256.3787368	3.201397693	20.87236136	177.2641088	237.7754151	30.89566324	13.19188748	19.05431623	20.0050122	23.31515395			0.231	16.07252535																			716.6608195	625.7557065	74.76266765		115.7981933	0.231	0.231	86.48861292	256.3787368	3.201397693	20.87236136	177.2641088	237.7754151	30.89566324	13.19188748	19.05431623	20.0050122	23.31515395			0.231	16.07252535																			23.1213	1.34840376	8.862492707	0	2.898641262	3.144979679	2.929530007	3.074296718	6.251123544	3.511800298	8.792391395	0.624733856	0.614543646	6.516439058	9.075953806	20.44904702	1.109803367	1.162656021	0	0	3.651601261	0.99364622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.1334	0	0	23.1213	1.34840376	8.862492707	0	2.898641262	3.144979679	2.929530007	3.074296718	6.251123544	3.511800298	8.792391395	0.624733856	0.614543646	6.516439058	9.075953806	20.44904702	1.109803367	1.162656021	0	0	3.651601261	0.99364622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.1334		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	4a: Medicare FFS Ded/Coin  4b: $35	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																			4.1239	0.2405	1.5807		0.517	0.5609	0.5225	0.5488	1.115	0.6261	1.5681	0.1114	0.1096	1.1663	1.6042	3.6473	0.4284	0.207			0.6513	0.1804																			19.5097	0	0	27.2453	1.588906695	10.44321435	0	3.415646446	3.705922083	3.452044545	3.62307582	7.366081548	4.137939513	10.36048447	0.736162147	0.724153514	7.68277797	10.68013181	24.09636394	1.538244605	1.36965192	0	0	4.302905307	1.174080525	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.6431
H2775_801_0	2009	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																																																			0		225.0578112	5.367114161	30.55454767		6.722788317	8.394115802	7.495140379	8.618879619	30.05832588	15.539941	40.00810052	1.475406068	0.416250917	23.34164681	33.19447988	85.77893043	2.262682882	4.625570587			22.74746542	7.875666274																			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																			0.078328734	0.078328734	0.191530297		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.078328734	0.078328734	0.191530297		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			17.6285	0.420399259	5.852121588	0	1.552964101	1.93904075	1.731377428	1.990961192	6.943473279	3.58972637	9.241871221	0.340818802	0.096153962	5.391920412	7.667924853	19.81493293	0.522679746	1.068506806	0	0	5.254664512	1.819278909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.8673	0	0	17.6285	0.420399259	5.852121588	0	1.552964101	1.93904075	1.731377428	1.990961192	6.943473279	3.58972637	9.241871221	0.340818802	0.096153962	5.391920412	7.667924853	19.81493293	0.522679746	1.068506806	0	0	5.254664512	1.819278909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.8673		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																			3.1442	0.075	1.0438		0.277	0.3458	0.3088	0.3551	1.2384	0.64	1.6483	0.0608	0.0171	0.9617	1.3558	3.5342	0.0932	0.1905			0.9372	0.3245																			16.5515	0	0	20.7727	0.495382183	6.895913118	0	1.829952669	2.284890419	2.040188013	2.346071453	8.181919624	4.229707642	10.89012404	0.401607658	0.113303098	6.353629463	9.023679491	23.34914848	0.615903792	1.259008507	0	0	6.19189287	2.143767021	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.4188
H2775_802_0	2009	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																																																			0		225.0578112	5.367114161	30.55454767		6.722788317	8.394115802	7.495140379	8.618879619	30.05832588	15.539941	40.00810052	1.475406068	0.416250917	23.34164681	33.19447988	85.77893043	2.262682882	4.625570587			22.74746542	7.875666274																			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																			0.078328734	0.078328734	0.191530297		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.078328734	0.078328734	0.191530297		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			17.6285	0.420399259	5.852121588	0	1.552964101	1.93904075	1.731377428	1.990961192	6.943473279	3.58972637	9.241871221	0.340818802	0.096153962	5.391920412	7.667924853	19.81493293	0.522679746	1.068506806	0	0	5.254664512	1.819278909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.8673	0	0	17.6285	0.420399259	5.852121588	0	1.552964101	1.93904075	1.731377428	1.990961192	6.943473279	3.58972637	9.241871221	0.340818802	0.096153962	5.391920412	7.667924853	19.81493293	0.522679746	1.068506806	0	0	5.254664512	1.819278909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.8673		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																			3.1442	0.075	1.0438		0.277	0.3458	0.3088	0.3551	1.2384	0.64	1.6483	0.0608	0.0171	0.9617	1.3558	3.5342	0.0932	0.1905			0.9372	0.3245																			16.5515	0	0	20.7727	0.495382183	6.895913118	0	1.829952669	2.284890419	2.040188013	2.346071453	8.181919624	4.229707642	10.89012404	0.401607658	0.113303098	6.353629463	9.023679491	23.34914848	0.615903792	1.259008507	0	0	6.19189287	2.143767021	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.4188
H2775_803_0	2009	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																																																			0		225.0578112	5.367114161	30.55454767		6.722788317	8.394115802	7.495140379	8.618879619	30.05832588	15.539941	40.00810052	1.475406068	0.416250917	23.34164681	33.19447988	85.77893043	2.262682882	4.625570587			22.74746542	7.875666274																			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																			0.078328734	0.078328734	0.191530297		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.078328734	0.078328734	0.191530297		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			17.6285	0.420399259	5.852121588	0	1.552964101	1.93904075	1.731377428	1.990961192	6.943473279	3.58972637	9.241871221	0.340818802	0.096153962	5.391920412	7.667924853	19.81493293	0.522679746	1.068506806	0	0	5.254664512	1.819278909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.8673	0	0	17.6285	0.420399259	5.852121588	0	1.552964101	1.93904075	1.731377428	1.990961192	6.943473279	3.58972637	9.241871221	0.340818802	0.096153962	5.391920412	7.667924853	19.81493293	0.522679746	1.068506806	0	0	5.254664512	1.819278909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.8673		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																			3.1442	0.075	1.0438		0.277	0.3458	0.3088	0.3551	1.2384	0.64	1.6483	0.0608	0.0171	0.9617	1.3558	3.5342	0.0932	0.1905			0.9372	0.3245																			16.5515	0	0	20.7727	0.495382183	6.895913118	0	1.829952669	2.284890419	2.040188013	2.346071453	8.181919624	4.229707642	10.89012404	0.401607658	0.113303098	6.353629463	9.023679491	23.34914848	0.615903792	1.259008507	0	0	6.19189287	2.143767021	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.4188
H2788_801_0	2009	8																																Ded	Ded	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				21.0726	0.7566	0	0	0.2515	0.9272	0.0355	0.1009	0.1705	0.1376	0.2281	0.0109	0.0152	0.7018	1.3577	4.1569	0.1612	0.1992	1.0188	1.8632	0.085																				33.2503		2282.669146	192.6267205	2313.901114	30.46892806	7.860658264	28.97463446	1.108048231	11.20745389	18.94675141	15.28627696	25.3464731	1.211437935	1.68353074	77.97805455	42.42808839	129.904265	5.038101547	6.22400421	31.83634295	58.23317507	2.656966159																				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 7b, 7f, 7g"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	PBP 14d-i	PBP 15																				7.675256061	3.114779629	61.97329184	0	0.199	0.199	0.199	0.222	0.222	0.222	0.222	0.222	0.222	0.222	0.199	0.199	0.199	0.199	0.199	0.199	0.199																				7.675256061	3.114779629	61.97329184	0	0.199	0.199	0.199	0.222	0.222	0.222	0.222	0.222	0.222	0.222	0.199	0.199	0.199	0.199	0.199	0.199	0.199																				1.46	0.049999149	11.95000576	0	1.564270994	5.765952257	0.220501598	2.488054764	4.206178813	3.393553486	5.626917028	0.268939222	0.373743824	17.31112811	8.443189589	25.85094874	1.002582208	1.238576838	6.335432247	11.58840184	0.528736266	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.6671	Medicare levels		22.5326	0.806635695	11.95000576	0	1.815812059	6.69314056	0.255959141	2.588921849	4.376699576	3.531129979	5.855035286	0.279842163	0.388895601	18.0129306	9.800888418	30.00788522	1.163801457	1.437744973	7.354195222	13.45156568	0.613759183	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.9175																																																																																		0			22.5326	0.806635695	11.95000576	0	1.815812059	6.69314056	0.255959141	2.588921849	4.376699576	3.531129979	5.855035286	0.279842163	0.388895601	18.0129306	9.800888418	30.00788522	1.163801457	1.437744973	7.354195222	13.45156568	0.613759183	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.9175
H2788_802_0	2009	5																																Ded	Ded	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				21.0726	0.7566	0	0	0.2515	0.9272	0.0355	0.1009	0.1705	0.1376	0.2281	0.0109	0.0152	0.7018	1.3577	4.1569	0.1612	0.1992	1.0188	1.8632	0.085																				33.2503		2282.669146	192.6267205	2313.901114	30.46892806	7.860658264	28.97463446	1.108048231	11.20745389	18.94675141	15.28627696	25.3464731	1.211437935	1.68353074	77.97805455	42.42808839	129.904265	5.038101547	6.22400421	31.83634295	58.23317507	2.656966159																				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 7b, 7f, 7g"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	PBP 14d-i	PBP 15																				7.675256061	3.114779629	61.97329184	0	0.199	0.199	0.199	0.222	0.222	0.222	0.222	0.222	0.222	0.222	0.199	0.199	0.199	0.199	0.199	0.199	0.199																				7.675256061	3.114779629	61.97329184	0	0.199	0.199	0.199	0.222	0.222	0.222	0.222	0.222	0.222	0.222	0.199	0.199	0.199	0.199	0.199	0.199	0.199																				1.46	0.049999149	11.95000576	0	1.564270994	5.765952257	0.220501598	2.488054764	4.206178813	3.393553486	5.626917028	0.268939222	0.373743824	17.31112811	8.443189589	25.85094874	1.002582208	1.238576838	6.335432247	11.58840184	0.528736266	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.6671	Medicare levels		22.5326	0.806635695	11.95000576	0	1.815812059	6.69314056	0.255959141	2.588921849	4.376699576	3.531129979	5.855035286	0.279842163	0.388895601	18.0129306	9.800888418	30.00788522	1.163801457	1.437744973	7.354195222	13.45156568	0.613759183	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.9175																																																																																		0			22.5326	0.806635695	11.95000576	0	1.815812059	6.69314056	0.255959141	2.588921849	4.376699576	3.531129979	5.855035286	0.279842163	0.388895601	18.0129306	9.800888418	30.00788522	1.163801457	1.437744973	7.354195222	13.45156568	0.613759183	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.9175
H2788_803_0	2009	5																																Ded	Ded	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				21.0726	0.7566	0	0	0.2515	0.9272	0.0355	0.1009	0.1705	0.1376	0.2281	0.0109	0.0152	0.7018	1.3577	4.1569	0.1612	0.1992	1.0188	1.8632	0.085																				33.2503		2282.669146	192.6267205	2313.901114	30.46892806	7.860658264	28.97463446	1.108048231	11.20745389	18.94675141	15.28627696	25.3464731	1.211437935	1.68353074	77.97805455	42.42808839	129.904265	5.038101547	6.22400421	31.83634295	58.23317507	2.656966159																				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 7b, 7f, 7g"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	PBP 14d-i	PBP 15																				7.675256061	3.114779629	61.97329184	0	0.199	0.199	0.199	0.222	0.222	0.222	0.222	0.222	0.222	0.222	0.199	0.199	0.199	0.199	0.199	0.199	0.199																				7.675256061	3.114779629	61.97329184	0	0.199	0.199	0.199	0.222	0.222	0.222	0.222	0.222	0.222	0.222	0.199	0.199	0.199	0.199	0.199	0.199	0.199																				1.46	0.049999149	11.95000576	0	1.564270994	5.765952257	0.220501598	2.488054764	4.206178813	3.393553486	5.626917028	0.268939222	0.373743824	17.31112811	8.443189589	25.85094874	1.002582208	1.238576838	6.335432247	11.58840184	0.528736266	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.6671	Medicare levels		22.5326	0.806635695	11.95000576	0	1.815812059	6.69314056	0.255959141	2.588921849	4.376699576	3.531129979	5.855035286	0.279842163	0.388895601	18.0129306	9.800888418	30.00788522	1.163801457	1.437744973	7.354195222	13.45156568	0.613759183	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.9175																																																																																		0			22.5326	0.806635695	11.95000576	0	1.815812059	6.69314056	0.255959141	2.588921849	4.376699576	3.531129979	5.855035286	0.279842163	0.388895601	18.0129306	9.800888418	30.00788522	1.163801457	1.437744973	7.354195222	13.45156568	0.613759183	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.9175
H2788_804_0	2009	5																																Ded	Ded	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																				21.0726	0.7566	0	0	0.2515	0.9272	0.0355	0.1009	0.1705	0.1376	0.2281	0.0109	0.0152	0.7018	1.3577	4.1569	0.1612	0.1992	1.0188	1.8632	0.085																				33.2503		2282.669146	192.6267205	2313.901114	30.46892806	7.860658264	28.97463446	1.108048231	11.20745389	18.94675141	15.28627696	25.3464731	1.211437935	1.68353074	77.97805455	42.42808839	129.904265	5.038101547	6.22400421	31.83634295	58.23317507	2.656966159																				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 7b, 7f, 7g"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	PBP 14d-i	PBP 15																				7.675256061	3.114779629	61.97329184	0	0.199	0.199	0.199	0.222	0.222	0.222	0.222	0.222	0.222	0.222	0.199	0.199	0.199	0.199	0.199	0.199	0.199																				7.675256061	3.114779629	61.97329184	0	0.199	0.199	0.199	0.222	0.222	0.222	0.222	0.222	0.222	0.222	0.199	0.199	0.199	0.199	0.199	0.199	0.199																				1.46	0.049999149	11.95000576	0	1.564270994	5.765952257	0.220501598	2.488054764	4.206178813	3.393553486	5.626917028	0.268939222	0.373743824	17.31112811	8.443189589	25.85094874	1.002582208	1.238576838	6.335432247	11.58840184	0.528736266	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.6671	Medicare levels		22.5326	0.806635695	11.95000576	0	1.815812059	6.69314056	0.255959141	2.588921849	4.376699576	3.531129979	5.855035286	0.279842163	0.388895601	18.0129306	9.800888418	30.00788522	1.163801457	1.437744973	7.354195222	13.45156568	0.613759183	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.9175																																																																																		0			22.5326	0.806635695	11.95000576	0	1.815812059	6.69314056	0.255959141	2.588921849	4.376699576	3.531129979	5.855035286	0.279842163	0.388895601	18.0129306	9.800888418	30.00788522	1.163801457	1.437744973	7.354195222	13.45156568	0.613759183	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.9175
H2802_001_0	2009	6																					3500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2044.691177	146.5831684	1628.457748	1738.531774	104.6194968	12.24085686	6.634771855	279.1906004	33.33571635	8538.540585	42.57952218	0	0.013286526	21.79260932	5521.533649	4578.325895	643.6835334	279.5288519	0	0	43.14779702	1218.179439	0	0	298.2487182	280.9410896	18.8985499	13.99625137	113.0205014	0											"$245 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$245 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$15 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											242.1020211	245	85.36789939	0	150	0.2	0.079068657	49.88077796	0.2	2.8	0.188707736	0	0.2	0.197612843	6.955756446	29.99019481	37.5	30	0	0	0.2	29.53117369	0	0	25.54331539	15	30	0	0	0											160.64677	162.5526197	56.63990076	0	99.52201207	0.132696016	0.052460479	33.09490258	0.132696016	1.857744225	0.125203824	0	0.132696016	0.131506526	6.955756446	29.99019481	37.5	19.90440241	0	0	0.132696016	29.53117369	0	0	25.54331539	15	30	0	0	0											27.3728	1.985623169	7.686307101	0	0.867661902	1.62431294	0.348063308	0.769982143	4.423516754	1.321868705	5.331118987	0	0.001763069	2.865870336	3.200536939	11.44207379	2.011511042	0.463654563	0	0	5.725540767	2.997855717	0	0	0.634855089	0.351176362	0.047246375	0	0	0	0	0	0	0	0	0	0	0	0	0	81.4733	0	30.8147	27.3728	1.985623169	7.686307101	0	0.867661902	1.62431294	0.348063308	0.769982143	4.423516754	1.321868705	5.331118987	0	0.001763069	2.865870336	3.200536939	11.44207379	2.011511042	0.463654563	0	0	5.725540767	2.997855717	0	0	0.634855089	0.351176362	0.047246375	0	0	0	0	0	0	0	0	0	0	0	0	0	81.4733																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	27.3728	1.985623169	7.686307101	0	0.867661902	1.62431294	0.348063308	0.769982143	4.423516754	1.321868705	5.331118987	0	0.001763069	2.865870336	3.200536939	11.44207379	2.011511042	0.463654563	0	0	5.725540767	2.997855717	0	0	0.634855089	0.351176362	0.047246375	0	0	0	0	0	0	0	0	0	0	0	0	0	81.4733
H2802_005_0	2009	5																					2400											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1879.039932	495.1112349	7981.165813	77.22404142	518.8306823	14.57648885	11.16433936	209.5457373	130.2451661	11780.1859	1698.126556	0	4.596356297	355.0574753	232.0147237	7853.593622	1442.25144	30.67058894	0	0	2287.837881	950.0952018	1179.680808	0	179.579685	121.4941666	0	0	0	0											"$175 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $35 (4b)	$35 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$35 (3, 5, 9a, 9d); $35/$25 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $35 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$15 (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"$35/$25 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											173.4913277	175	0	0	75	0.2	0.2	49.88941129	35	0	0	0	0	34.85384304	0	14.5078762	32.5	0	0	0	0	14.75896058	0	0	0	0	0	0	0	0											144.5068184	145.7634428	0	0	62.47004691	0.166586792	0.166586792	41.55458484	29.15268856	0	0	0	0	29.03094946	0	12.08410275	27.07035366	0	0	0	0	12.29323946	0	0	0	0	0	0	0	0											22.6278	6.014093179	0	0	2.700948088	2.428250513	1.859831476	0.725632176	0.316416397	0	0	0	0	0.858971302	0	7.908636025	3.253521378	0	0	0	0	0.973312319	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.6675	0	9.9621	22.6278	6.014093179	0	0	2.700948088	2.428250513	1.859831476	0.725632176	0.316416397	0	0	0	0	0.858971302	0	7.908636025	3.253521378	0	0	0	0	0.973312319	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.6675																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.6278	6.014093179	0	0	2.700948088	2.428250513	1.859831476	0.725632176	0.316416397	0	0	0	0	0.858971302	0	7.908636025	3.253521378	0	0	0	0	0.973312319	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.6675
H2803_001_0	2009	4																					3500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	4500	1240.084997	125.6202081	955.0108298	970.6070945	55.67857673	8.655205226	4.59427179	239.3769075	26.74826047	5782.816488	30.46248933	0	0.033513166	16.38975548	4569.853506	4337.355985	545.5421735	314.098208	0	0	25.57453208	960.8315673	0	0	212.1450192	260.0150658	16.25252002	16.90801558	112.8799957	0											"$245 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$245 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$15 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											242.1181992	245	85.36789939	0	150	0.2	0.062277516	49.72876818	0.2	2.8	0.189633937	0	0.2	0.19662905	7.015120924	29.99995213	37.5	30	0	0	0.2	29.69453376	0	0	28.20488425	15	30	0	0	0											174.2115322	176.2653295	61.41796292	0	107.9175487	0.143890065	0.044805579	35.7773784	0.143890065	2.014460909	0.136432197	0	0.143890065	0.14177639	7.015120924	29.99995213	37.5	21.58350973	0	0	0.143890065	29.69453376	0	0	28.20488425	15	30	0	0	0											18.0031	1.84520728	4.887901644	0	0.500724626	1.245398042	0.205849009	0.71368985	3.848808935	0.97077148	4.156064353	0	0.004822212	2.323680365	2.671506246	10.84337266	1.704819292	0.564945144	0	0	3.679921081	2.377620451	0	0	0.498627142	0.325018832	0.0406313	0	0	0	0	0	0	0	0	0	0	0	0	0	61.4125	0	16.7388	18.0031	1.84520728	4.887901644	0	0.500724626	1.245398042	0.205849009	0.71368985	3.848808935	0.97077148	4.156064353	0	0.004822212	2.323680365	2.671506246	10.84337266	1.704819292	0.564945144	0	0	3.679921081	2.377620451	0	0	0.498627142	0.325018832	0.0406313	0	0	0	0	0	0	0	0	0	0	0	0	0	61.4125		"$325 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 25% (13c)"	"$325 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-30 (2a, 2a2); $0 n/c (2a1)"	"25% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	25%/$7 (8a1); $7 (8a2)	"$20 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 25% (9a); $45/$35 (9c)"	"$10 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 25% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$10 (7g)	"25% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 25% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											4.5911	0.4633	0.7929	0.475	0.1659	0.5157	0.2737	0.2364	1.5937	0.3216	1.7421	0	0.0016	0.9565	0.5016	1.7652	0.3145	0.0914	0	0	0.7442	0.3872	0	0	0.0812	0	0.0066	0	0	0											16.0214	0	5.170625308	22.5942	2.30853977	5.680780025	0.474955754	0.666594425	1.761085488	0.479581199	0.950106407	5.442502184	1.292348774	5.898210287	0	0.006419615	3.280175324	3.173101652	12.60857286	2.019351844	0.656340786	0	0	4.424083485	2.764820333	0	0	0.579799003	0.325018832	0.047245698	0	0	0	0	0	0	0	0	0	0	0	0	0	77.4338
H2803_002_0	2009	4																					3500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	4500	1298.243755	128.4125307	1160.750898	803.8851074	55.6817551	9.076547466	4.887822001	227.1100714	25.8724992	5885.611987	33.70576374	0	0.798219514	21.48032676	4336.273244	4138.725426	543.421939	345.3969883	0	0	30.52225915	903.6755377	0	0	167.5104684	286.2933984	16.04857457	14.03769567	105.842981	0											"$245 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$245 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$15 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											242.115565	245	85.36789939	0	150	0.2	0.061913756	49.7993352	0.2	2.8	0.187824898	0	0.2	0.197344958	6.897775485	30	37.5	30	0	0	0.2	29.40789634	0	0	30	15	30	0	0	0											168.8878573	170.8795653	59.54134507	0	104.620142	0.139493523	0.04318284	34.73342348	0.139493523	1.952909318	0.131001784	0	0.139493523	0.137897941	6.897775485	30	37.5	20.92402841	0	0	0.139493523	29.40789634	0	0	30	15	30	0	0	0											18.2715	1.828589785	5.759389149	0	0.485452761	1.26611958	0.211070034	0.65735919	3.609046056	0.957838874	4.415515172	0	0.111346452	2.962092823	2.492553273	10.34681356	1.69819356	0.602258033	0	0	4.25765745	2.214599711	0	0	0.418776171	0.357866748	0.040121436	0	0	0	0	0	0	0	0	0	0	0	0	0	62.9641	0	19.6795	18.2715	1.828589785	5.759389149	0	0.485452761	1.26611958	0.211070034	0.65735919	3.609046056	0.957838874	4.415515172	0	0.111346452	2.962092823	2.492553273	10.34681356	1.69819356	0.602258033	0	0	4.25765745	2.214599711	0	0	0.418776171	0.357866748	0.040121436	0	0	0	0	0	0	0	0	0	0	0	0	0	62.9641		"$325 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 25% (13c)"	"$325 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-30 (2a, 2a2); $0 n/c (2a1)"	"25% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	25% (11a)	"25% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	25%/$7 (8a1); $7 (8a2)	"$20 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 25% (9a); $45/$35 (9c)"	"$10 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 25% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$10 (7g)	"25% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 25% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											4.686	0.4619	0.9399	0.4157	0.1618	0.5274	0.284	0.2191	1.5034	0.3192	1.8603	0	0.0371	1.2287	0.4698	1.6844	0.3133	0.098	0	0	0.8662	0.3616	0	0	0.0682	0	0.0065	0	0	0											16.5124	0	5.907170637	22.9574	2.290504899	6.699239761	0.415708117	0.647228588	1.793533263	0.495088182	0.876422373	5.112427176	1.277036104	6.275861638	0	0.148452358	4.190744499	2.962384922	12.03117856	2.011503689	0.700274737	0	0	5.12381765	2.576241725	0	0	0.486949036	0.357866748	0.046652833	0	0	0	0	0	0	0	0	0	0	0	0	0	79.4765
H2803_010_0	2009	4																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		339.5335006	22.9632	44.53805076	5047.004102	14.72276743	32.33960257	10.99727194	23.10171857	35.96123329	6.678294561	16.15672229	0	2.693203072	38.29627152	51.88578472	139.1004955	13.3855	5.68189203	0	0	23.96389694	6.935553775	238.2271533	0	147.3499431	169.3372552	0	0	20.2	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.077751311	0.078695658	0.168151008	0	0.2	0.2	0.2	0.118063435	0.2	0.08	0.2	0	0.2	0.2	0	0.199600095	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											0.077751311	0.078695658	0.168151008	0	0.2	0.2	0.2	0.118063435	0.2	0.08	0.2	0	0.2	0.2	0	0.199600095	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											26.3992	1.807104143	7.489118137	0	2.944553485	6.467920515	2.199454388	2.727468245	7.192246659	0.534263565	3.231344458	0	0.538640614	7.659254303	0	27.76447205	2.6771	1.136378406	0	0	4.792779388	0.103126684	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.6644	0	0	26.3992	1.807104143	7.489118137	0	2.944553485	6.467920515	2.199454388	2.727468245	7.192246659	0.534263565	3.231344458	0	0.538640614	7.659254303	0	27.76447205	2.6771	1.136378406	0	0	4.792779388	0.103126684	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.6644		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											4.2442	0.287	0.7032	1.0415	0.2325	0.5106	0.1736	0.1437	0.5678	0.1054	0.2551	0	0.0283	0.6047	0.8192	2.1963	0.2114	0.0897	0	0	0.3784	0.0753	0.0261	0	0.0155	0	0	0	0.003	0											12.7125	0	0	30.6433	2.094144143	8.192350517	1.041485365	3.177018234	6.978545818	2.373095524	2.871128905	7.760055606	0.639710321	3.4864506	0	0.56699012	8.263932274	0.819249232	29.96079567	2.88845	1.226092491	0	0	5.171156708	0.178385317	0.0261	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	118.3769
H2803_011_0	2009	4																					2400											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1449.921673	743.8005083	6842.304837	91.20881478	527.6561981	10.52508558	12.02453971	149.2646222	97.70115583	11020.90606	1448.831057	0	5.42872663	248.2170287	152.1026828	7049.540203	5732.376103	36.2248338	0	0	1297.276524	829.856904	1498.037626	0	182.0000636	141.3063859	0	0	0	0											"$175 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $35 (4b)	$35 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$35 (3, 5, 9a, 9d); $35/$25 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $35 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$15 (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"$35/$25 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											173.6011825	175	0	0	75	0.2	0.2	49.81663475	35	0	0	0	0	34.80328127	0	14.47915846	32.5	0	0	0	0	14.67406104	0	0	0	0	0	0	0	0											141.184151	142.3217634	0	0	60.99504145	0.162653444	0.162653444	40.51423602	28.46435268	0	0	0	0	28.30436778	0	11.77542494	26.43118463	0	0	0	0	11.93393282	0	0	0	0	0	0	0	0											17.0588	8.82158333	0	0	2.682034306	1.711941416	1.955832795	0.503945178	0.231750013	0	0	0	0	0.585468839	0	6.917610961	12.62612426	0	0	0	0	0.825288045	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.9204	0	12.3806	17.0588	8.82158333	0	0	2.682034306	1.711941416	1.955832795	0.503945178	0.231750013	0	0	0	0	0.585468839	0	6.917610961	12.62612426	0	0	0	0	0.825288045	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.9204		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $35 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $35 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.1667	0.3718	0.8142	0.0396	0.3021	0.1662	0.1899	0.0326	0.0923	0.3793	0.3138	0	0	0.062	0.0156	1.7062	0.7439	0.0036	0	0	0.1123	0.084	0.1107	0	0.0089	0	0	0	0	0											7.7155	0	0	19.2255	9.19335833	0.814201933	0.039585002	2.984095456	1.878126978	2.145693948	0.536558604	0.324031658	0.379253789	0.313762152	0	0	0.647448028	0.01555529	8.623841153	13.36997426	0.003627693	0	0	0.1122986	0.909336172	0.110719388	0	0.008933819	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.6359
H2803_012_0	2009	4																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		292.415247	23.2032	38.35734941	4683.735365	12.67963741	27.85172261	9.471141982	19.89677629	30.97076695	5.751524225	13.91459733	0	2.319457845	32.99890226	44.77533138	119.8356302	13.3855	4.893395965	0	0	20.57242558	5.973082677	210.3134697	0	161.2971666	161.0206449	0	0	20.2	0											"8.8% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"8.8% (1b); $0 n/c (1b1, 1b2)"	12.2% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.0872404	0.0883	0.1218	0	0.2	0.2	0.2	0.127214225	0.2	0.08	0.2	0	0.2	0.2	0	0.199535805	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											0.0872404	0.0883	0.1218	0	0.2	0.2	0.2	0.127214225	0.2	0.08	0.2	0	0.2	0.2	0	0.199535805	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											25.5104	2.04884256	4.671925158	0	2.535927481	5.570344523	1.894228396	2.53115298	6.19415339	0.460121938	2.782919466	0	0.463891569	6.599780453	0	23.91149899	2.6771	0.978679193	0	0	4.114485117	0.088815432	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0343	0	0	25.5104	2.04884256	4.671925158	0	2.535927481	5.570344523	1.894228396	2.53115298	6.19415339	0.460121938	2.782919466	0	0.463891569	6.599780453	0	23.91149899	2.6771	0.978679193	0	0	4.114485117	0.088815432	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0343		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.6552	0.29	0.6056	0.897	0.2002	0.4398	0.1495	0.1333	0.489	0.0908	0.2197	0	0.0244	0.521	0.707	1.8921	0.2114	0.0773	0	0	0.3248	0.0648	0.0261	0	0.0155	0	0	0	0.003	0											11.0376	0	0	29.1656	2.33888256	5.277567517	0.896954792	2.736132282	6.010108564	2.043772743	2.664481258	6.6831655	0.550935478	3.002623634	0	0.488306915	7.120815752	0.706978916	25.80364051	2.88845	1.05594334	0	0	4.439312889	0.153630162	0.0261	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	104.0719
H2803_014_0	2009	3																					3350											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1816.690237	269.7770134	40.78347337	48979.03272	84.85172998	20.37351685	9.007691205	346.7547441	363.542279	5757.312759	440.2981326	0	0.791278977	1404.641692	5677.330795	4214.231198	1242.868229	251.2707484	0	0	26.23641451	1064.172783	769.983193	0	314.3760437	332.2285714	0	0	20.2	0											"$225 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$225 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$125 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$125 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5); $125 (9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											222.3	225	0.17069687	0	125	0.14	0.2	49.97260311	125	4.4	64.79010385	0	0.2	115.5162364	3.251137702	25	20	20	0	0	0.2	13.6791576	0	0	0	0	0	0	0	0											158.0461701	159.9657592	0.17069687	0	88.86986623	0.09953425	0.142191786	35.52846843	88.86986623	3.128219291	46.0631029	0	0.142191786	82.12729979	3.251137702	25	20	20	0	0	0.142191786	13.6791576	0	0	0	0	0	0	0	0											23.9267	3.596257064	6.961611253	0	0.628396824	2.027862723	1.2808197	1.026638748	2.692329475	1.500844737	1.690124849	0	0.112513371	9.613285776	1.538148683	8.77964833	2.071447048	0.418784581	0	0	3.730602636	1.213082267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.8091	0	21.0701	23.9267	3.596257064	6.961611253	0	0.628396824	2.027862723	1.2808197	1.026638748	2.692329475	1.500844737	1.690124849	0	0.112513371	9.613285776	1.538148683	8.77964833	2.071447048	0.418784581	0	0	3.730602636	1.213082267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.8091		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.646	0.2191	0.6439	0.5448	0.1402	0.3217	0.1422	0.0761	0.6366	0.1001	0.27	0	0.0083	0.5073	0.6916	2.1809	0.1512	0.0749	0	0	0.4143	0.086	0.0569	0	0.0155	0	0	0	0.003	0											10.9306	0	0	27.5727	3.815377064	7.605560833	0.544837509	0.768634064	2.349549831	1.423046403	1.102749489	3.328902449	1.600963799	1.960111804	0	0.120842623	10.12059152	2.22972116	10.96051878	2.222647048	0.493675867	0	0	4.144861813	1.299066861	0.056935837	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	83.7398
H2803_015_0	2009	3																					2100											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1676.659449	248.3544138	34.73858841	45203.72066	78.31134439	17.35377489	7.672580371	320.0414755	335.5203791	5313.538125	406.3598787	0	0.673996411	1297.739681	5245.160509	3889.39755	1242.868229	231.9027569	0	0	22.2772758	982.1461659	769.983193	0	314.3760437	332.2285714	0	0	20.2	0											"$150 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$150 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	12.2% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$75 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5, 9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											148.2	150	0.1218	0	75	0.14	0.2	49.97031635	75	4.4	64.79010385	0	0.2	70.25329472	3.247766215	25	20	20	0	0	0.2	13.6791576	0	0	0	0	0	0	0	0											103.4469967	104.703438	0.1218	0	52.35171899	0.097723209	0.139604584	34.88042612	52.35171899	3.071300847	45.22497746	0	0.139604584	49.03840991	3.247766215	25	20	20	0	0	0.139604584	13.6791576	0	0	0	0	0	0	0	0											14.4538	2.166963413	4.231160068	0	0.341644458	1.695866567	1.071127391	0.930265253	1.463755717	1.359956179	1.53146803	0	0.094092989	5.303257536	1.419587924	8.102911563	2.071447048	0.386504595	0	0	3.11000982	1.119577683	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8534	0	14.5023	14.4538	2.166963413	4.231160068	0	0.341644458	1.695866567	1.071127391	0.930265253	1.463755717	1.359956179	1.53146803	0	0.094092989	5.303257536	1.419587924	8.102911563	2.071447048	0.386504595	0	0	3.11000982	1.119577683	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8534		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.1056	0.2017	0.5485	0.4641	0.1195	0.274	0.1211	0.0703	0.5422	0.0853	0.23	0	0.0071	0.4324	0.5905	1.8576	0.1512	0.0638	0	0	0.3517	0.0732	0.0569	0	0.0155	0	0	0	0.003	0											9.3652	0	0	17.5593	2.368683413	4.779664095	0.464082247	0.461095876	1.969873539	1.192273396	1.000517821	2.005976492	1.445235696	1.761437792	0	0.101187688	5.735615499	2.010112153	9.96053561	2.222647048	0.450295571	0	0	3.46175628	1.192817728	0.056935837	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	60.2185
H2803_801_0	2009	4																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	Coin	V	V	Coin	O	T	V	P	P	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		1304.566064	132.1521192	1004.668811	1021.076039	58.57371219	9.122572392	4.84235508	285.879791	28.19262353	6083.507311	32.10741478	0	0.035322823	17.27477592	4779.414405	4562.394325	573.9088917	2.940042623	0	0	26.95551569	1010.792211	0	0	0	0	0	0	0	0											"$425 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$425 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$165 Days 1-30 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"25% (3, 9a, 9d); $60 (5); $40/$30 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											419.9498519	425	165	0	150	0.2	0.062277516	48.56784149	0.25	2.8	0.22820466	0	0.2	0.250599749	13.54162469	30	37.5	0.25	0	0	0.2	29.69453376	0	0	0	0	0	0	0	0											288.4730044	291.9200213	113.3336553	0	103.0305958	0.137374128	0.042776597	33.35982429	0.17171766	1.923237787	0.15674708	0	0.137374128	0.172476685	13.54162469	30	37.5	0.17171766	0	0	0.137374128	29.69453376	0	0	0	0	0	0	0	0											31.361	3.214820789	9.488565729	0	0.502907039	1.253205424	0.207139473	0.794741633	4.84117133	0.975002595	5.032743526	0	0.004852442	2.979496091	5.393419676	11.40598581	1.793465286	0.504857238	0	0	3.702990455	2.501250287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.9576	0	29.5577	31.361	3.214820789	9.488565729	0	0.502907039	1.253205424	0.207139473	0.794741633	4.84117133	0.975002595	5.032743526	0	0.004852442	2.979496091	5.393419676	11.40598581	1.793465286	0.504857238	0	0	3.702990455	2.501250287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.9576	4900	"$460 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 25% (13c)"	"$460 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$165 Days 1-30 (2a, 2a2); $0 n/c (2a1)"	"25% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	25%/$7 (8a1); $7 (8a2)	"$20 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 25% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 25% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											6.5401	0.6628	0.8815	0.4809	0.1676	0.6266	0.3326	0.2649	1.6137	0.325	1.7634	0	0.0016	0.9687	0.9762	1.8568	0.3309	0.0924	0	0	0.9042	0.4074	0	0	0	0	0	0	0	0											19.1974	0	7.130402608	37.9011	3.877596167	10.37001719	0.480925293	0.670542718	1.879808137	0.539746626	1.059655511	6.454895107	1.30000346	6.79613294	0	0.006469923	3.948245705	6.36961659	13.2627742	2.12435268	0.597225895	0	0	4.607209054	2.908607226	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.155
H2803_803_0	2009	4																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	Coin	V	V	Coin	O	T	V	P	P	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		1304.566037	132.1521166	1004.668791	1021.076019	58.573711	9.122572021	4.842354883	251.7675329	28.19262238	6083.507188	32.10741347	0	0.035322822	17.27477522	4779.41431	4562.394232	573.90888	2.940042504	0	0	26.9555146	1010.792191	0	0	0	0	0	0	0	0											"$425 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$425 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$165 Days 1-30 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"25% (3, 9a, 9d); $60 (5); $40/$30 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											419.9498519	425	165	0	150	0.2	0.062277516	49.7287075	0.25	2.8	0.228204661	0	0.2	0.250599749	13.54162468	30	37.5	0.25	0	0	0.2	29.69453376	0	0	0	0	0	0	0	0											288.6099034	292.0585896	113.3874524	0	103.0795022	0.137439336	0.042796902	34.17340277	0.17179917	1.924150708	0.156821485	0	0.137439336	0.17255803	13.54162468	30	37.5	0.17179917	0	0	0.137439336	29.69453376	0	0	0	0	0	0	0	0											31.3759	3.216346731	9.493069558	0	0.503145748	1.253800244	0.20723779	0.716979442	4.843469135	0.975465388	5.035132274	0	0.004854745	2.980901186	5.393419567	11.40598558	1.79346525	0.505096863	0	0	3.704748036	2.501250236	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.9103	0	29.4913	31.3759	3.216346731	9.493069558	0	0.503145748	1.253800244	0.20723779	0.716979442	4.843469135	0.975465388	5.035132274	0	0.004854745	2.980901186	5.393419567	11.40598558	1.79346525	0.505096863	0	0	3.704748036	2.501250236	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.9103	4900	"$460 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 25% (13c)"	"$460 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$165 Days 1-30 (2a, 2a2); $0 n/c (2a1)"	"25% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	25%/$7 (8a1); $7 (8a2)	"$20 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 25% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 25% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											6.5432	0.6631	0.8819	0.4812	0.1677	0.6269	0.3328	0.239	1.6145	0.3252	1.7642	0	0.0016	0.9692	0.9762	1.8568	0.3309	0.0924	0	0	0.9046	0.4074	0	0	0	0	0	0	0	0											19.1787	0	7.111121911	37.9191	3.879436702	10.37493941	0.481153559	0.670860997	1.880700366	0.54000281	0.955972589	6.457958847	1.300620518	6.799358668	0	0.006472994	3.950107172	6.369663073	13.26277393	2.124352637	0.597509363	0	0	4.609395812	2.908607251	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.089
H2803_804_0	2009	4																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	Coin	V	V	Coin	O	T	V	P	P	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		1304.566057	132.1521186	1004.668806	1021.076034	58.57371189	9.122572298	4.84235503	251.7675367	28.19262324	6083.50728	32.10741445	0	0.035322823	17.27477574	4779.414381	4562.394301	573.9088887	2.940042593	0	0	26.95551542	1010.792206	0	0	0	0	0	0	0	0											"$425 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$425 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$165 Days 1-30 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"25% (3, 9a, 9d); $60 (5); $40/$30 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											419.9498519	425	165	0	150	0.2	0.062277516	49.7287075	0.25	2.8	0.22820466	0	0.2	0.250599749	13.54162469	30	37.5	0.25	0	0	0.2	29.69453376	0	0	0	0	0	0	0	0											288.6099013	292.0585875	113.3874516	0	103.0795015	0.137439335	0.042796902	34.17340252	0.171799169	1.924150694	0.156821484	0	0.137439335	0.172558029	13.54162469	30	37.5	0.171799169	0	0	0.137439335	29.69453376	0	0	0	0	0	0	0	0											31.3759	3.216346757	9.493069634	0	0.503145752	1.253800273	0.207237794	0.716979448	4.843469248	0.975465396	5.035132379	0	0.004854745	2.980901255	5.393419649	11.40598575	1.793465277	0.505096875	0	0	3.704748121	2.501250274	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.9103	0	29.4913	31.3759	3.216346757	9.493069634	0	0.503145752	1.253800273	0.207237794	0.716979448	4.843469248	0.975465396	5.035132379	0	0.004854745	2.980901255	5.393419649	11.40598575	1.793465277	0.505096875	0	0	3.704748121	2.501250274	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.9103	4900	"$460 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 25% (13c)"	"$460 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$165 Days 1-30 (2a, 2a2); $0 n/c (2a1)"	"25% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	25%/$7 (8a1); $7 (8a2)	"$20 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 25% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 25% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											6.5432	0.6631	0.8819	0.4812	0.1677	0.6269	0.3328	0.239	1.6145	0.3252	1.7642	0	0.0016	0.9692	0.9762	1.8568	0.3309	0.0924	0	0	0.9046	0.4074	0	0	0	0	0	0	0	0											19.1787	0	7.111122176	37.9191	3.879436733	10.37493949	0.48115357	0.670861002	1.880700409	0.540002823	0.955972597	6.457958997	1.300620528	6.799358808	0	0.006472994	3.950107263	6.36966317	13.26277413	2.124352669	0.597509376	0	0	4.609395919	2.908607295	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.089
H2803_805_0	2009	4																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	Coin	V	V	Coin	O	T	V	P	P	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		1303.276685	132.0215056	1003.675838	1020.06685	58.51582037	9.104548563	4.832787846	251.5190928	28.13692224	6077.494626	32.04397888	0	0.035253035	17.24064546	4774.809843	4557.885044	573.341664	2.934233864	0	0	26.90225861	1009.793186	0	0	0	0	0	0	0	0											"$425 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$425 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$165 Days 1-30 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"25% (3, 9a, 9d); $60 (5); $40/$30 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											419.9498519	425	165	0	150	0.2	0.062277516	49.72870792	0.25	2.8	0.228239304	0	0.2	0.250600845	13.5412866	30	37.5	0.25	0	0	0.2	29.69453376	0	0	0	0	0	0	0	0											286.596475	290.0206109	112.5962372	0	102.3602156	0.136480287	0.042498267	33.93494177	0.170600359	1.910724025	0.155750829	0	0.136480287	0.171362755	13.5412866	30	37.5	0.170600359	0	0	0.136480287	29.69453376	0	0	0	0	0	0	0	0											31.1262	3.190746476	9.417510228	0	0.499140999	1.242591405	0.205385106	0.711273814	4.800169046	0.967701249	4.990876289	0	0.004811344	2.954404505	5.388089045	11.39471261	1.7916927	0.500581352	0	0	3.671627989	2.498778155	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.3563	0	29.9057	31.1262	3.190746476	9.417510228	0	0.499140999	1.242591405	0.205385106	0.711273814	4.800169046	0.967701249	4.990876289	0	0.004811344	2.954404505	5.388089045	11.39471261	1.7916927	0.500581352	0	0	3.671627989	2.498778155	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.3563	4800	"$460 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 25% (13c)"	"$460 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$165 Days 1-30 (2a, 2a2); $0 n/c (2a1)"	"25% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	25%/$7 (8a1); $7 (8a2)	"$20 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 25% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 25% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											6.4916	0.6578	0.8749	0.4769	0.1664	0.6213	0.3298	0.2371	1.6001	0.3226	1.7488	0	0.0016	0.9606	0.9745	1.855	0.3306	0.0917	0	0	0.8966	0.407	0	0	0	0	0	0	0	0											19.0445	0	7.210088662	37.6178	3.848558634	10.2923609	0.476852098	0.665521332	1.863887108	0.535175244	0.948365086	6.400225394	1.290268333	6.73966738	0	0.006415126	3.915023153	6.362630613	13.24966583	2.122253059	0.592258302	0	0	4.568188312	2.905731158	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.4008
H2869_001_0	2009	2																					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																																																			0		247.3601213	7.839766448	1121.097216	2278.513089	251.0311872	7.179806303	7.067368466	402.2731304	289.6840938		4211.076201	355.5354478	5.520524773	146.79241	2717.38302	2841.289292	370.624395	464.0521994			9.796204564	1414.056597					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	20.13870322	100	0.2	0.2	48.52475849	47.5		10.10130719	50	50	15.06392916	10	23.76877285	27.34639823	15			0.2	15					15														152.8888174	131.3774998	53.78373155	16.66639098	82.75801475	0.165516029	0.165516029	40.15812679	39.31005701		8.359641296	41.37900737	41.37900737	12.46660871	8.275801475	19.67056454	22.63133628	12.41370221			0.165516029	12.41370221					12.41370221														3.1515	0.085830743	5.024732643	3.164549166	1.731236891	1.188373032	1.169762768	1.346211281	0.948958187	0	2.933590542	1.225975326	0.019036153	0.152500295	1.874043534	4.657480368	0.69897711	0.480050485	0	0	1.621428884	1.462806459	0	0	0	0	0.22501182	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1621	0	6.9091	3.1515	0.085830743	5.024732643	3.164549166	1.731236891	1.188373032	1.169762768	1.346211281	0.948958187	0	2.933590542	1.225975326	0.019036153	0.152500295	1.874043534	4.657480368	0.69897711	0.480050485	0	0	1.621428884	1.462806459	0	0	0	0	0.22501182	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1621		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										4.8734	0.1283	2.5425	1.5667	0.46	0.4412	0.4343	0.4274	2.2186	1.0365	2.1785	0.5218	0.0091	2.6419	1.6462	2.0725	0.2699	0.2753			0.4334	0.7968					0.1172														25.0916	500	0	8.0249	0.214160965	7.567254342	4.731224801	2.191209109	1.629619552	1.60409924	1.773608473	3.167520777	1.036492419	5.112092717	1.747783817	0.028086608	2.794379431	3.520284953	6.729963449	0.968904315	0.755301652	0	0	2.054875107	2.259641526	0	0	0	0	0.342258334	0	0	0	0	0	0	0	0	0	0	0	0	0	58.2537
H2869_002_0	2009	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																																																			0		247.3601213	7.839766448	1121.097216	2278.513089	251.0311872	7.179806303	7.067368466	402.2731304	289.6840938		4211.076201	355.5354478	5.520524773	146.79241	2717.38302	2841.289292	370.624395	464.0521994			9.796204564	1414.056597					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	20.13870322	100	0.2	0.2	48.52475849	47.5		10.10130719	50	50	15.06392916	10	23.76877285	27.34639823	15			0.2	15					15														152.8888174	131.3774998	53.78373155	16.66639098	82.75801475	0.165516029	0.165516029	40.15812679	39.31005701		8.359641296	41.37900737	41.37900737	12.46660871	8.275801475	19.67056454	22.63133628	12.41370221			0.165516029	12.41370221					12.41370221														3.1515	0.085830743	5.024732643	3.164549166	1.731236891	1.188373032	1.169762768	1.346211281	0.948958187	0	2.933590542	1.225975326	0.019036153	0.152500295	1.874043534	4.657480368	0.69897711	0.480050485	0	0	1.621428884	1.462806459	0	0	0	0	0.22501182	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1621	0	6.9091	3.1515	0.085830743	5.024732643	3.164549166	1.731236891	1.188373032	1.169762768	1.346211281	0.948958187	0	2.933590542	1.225975326	0.019036153	0.152500295	1.874043534	4.657480368	0.69897711	0.480050485	0	0	1.621428884	1.462806459	0	0	0	0	0.22501182	0	0	0	0	0	0	0	0	0	0	0	0	0	33.1621		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										4.8734	0.1283	2.5425	1.5667	0.46	0.4412	0.4343	0.4274	2.2186	1.0365	2.1785	0.5218	0.0091	2.6419	1.6462	2.0725	0.2699	0.2753			0.4334	0.7968					0.1172														25.0916	500	0	8.0249	0.214160965	7.567254342	4.731224801	2.191209109	1.629619552	1.60409924	1.773608473	3.167520777	1.036492419	5.112092717	1.747783817	0.028086608	2.794379431	3.520284953	6.729963449	0.968904315	0.755301652	0	0	2.054875107	2.259641526	0	0	0	0	0.342258334	0	0	0	0	0	0	0	0	0	0	0	0	0	58.2537
H2869_003_0	2009	5																					3000											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																																																			0		315.1208667	23.24320909	1528.49069		414.6265046	11.75761488	11.72668311	679.4705451	292.078985			514.764241	2.629280939	141.7247648	2.956266635	2787.450199	909.179413	414.6779653			8.970536714	910.1197277					217.5130188														1a: $250 days 1-5	1b : $250 days 1-5	2a: $105 days 21 - 100  2a2: $105 days 21-100	6a: 0%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50  4b: $25	9a: $150 9b: $100	8a: 0%	8b1: 0% 8b2: 0% 8b3: 0%	9a: $150	12: $50	9a: $150 9c: 30% 9d: $25 3: $15 5: $25	"7a: $0, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $10, 14j: $10"	7b: $30 7d: $25 7f: $25	"7e: $35, 7h: $35"	7c: $25 7i: $25	8b1: 0% 8b2: 0% 8b3: 0%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $10 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $25 18a1: $25	18b: (n/c)		13c (: $											462.7102261	417.7604594	68.23860903		100	0.1	0.2	47.5139113	145			150	50	23.79920632	10	25.85928927	35	25			0.2	14.96623335					25														369.5039244	333.6086399	54.49292541		79.85644224	0.079856442	0.159712884	37.94291913	115.7918412			119.7846634	39.92822112	19.00519945	7.985644224	20.6503084	27.94975478	19.96411056			0.159712884	11.95150149					19.96411056														9.7032	0.646177948	6.940994095	0	2.759216459	0.938921294	1.872902384	2.148424662	2.818363622	0	0	5.13840511	0.008748543	0.224458952	0.001967308	4.796808854	2.117611804	0.689889729	0	0	1.432710294	0.90644144	0	0	0	0	0.361871163	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5071	0	10.9745	9.7032	0.646177948	6.940994095	0	2.759216459	0.938921294	1.872902384	2.148424662	2.818363622	0	0	5.13840511	0.008748543	0.224458952	0.001967308	4.796808854	2.117611804	0.689889729	0	0	1.432710294	0.90644144	0	0	0	0	0.361871163	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5071		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50  4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: 30% 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										5.6861	0.3777	3.3488	2.1278	0.7323	0.7105	0.7087	0.6758	2.1943	1.0411	2.2209	0.4605	0.0035	3.1339	1.6396	1.9728	0.6732	0.2427			0.3864	0.5271					0.1165														28.98	500	0	15.3893	1.023851238	10.28977482	2.127750331	3.491497773	1.649446644	2.581558494	2.824175525	5.012674121	1.041147768	2.220867196	5.598928653	0.012206656	3.358309178	1.641568749	6.769645341	2.790847027	0.9325841	0	0	1.819109997	1.433531874	0	0	0	0	0.478328742	0	0	0	0	0	0	0	0	0	0	0	0	0	72.4871
H2869_801_0	2009	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																																																			0		204.7443366	3.906096894	41.36222224		10.17179128	7.179806303	7.067368466	14.99759883	36.09966074	16.86543569	35.44781193	8.490682014	0.518197903	42.23298027	27.89426532	65.77086078	2.815345083	4.30628255			9.796204564	8.856947561																			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																			0.077071975	0.077071975	0.146826044		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.077071975	0.077071975	0.146826044		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			15.7801	0.301050601	6.07305148	0	2.349683785	1.658535256	1.632562116	3.46444533	8.33902163	3.895915644	8.188444555	1.961347545	0.119703716	9.755818443	6.443575289	15.19306884	0.650344714	0.994751269	0	0	2.262923254	2.045954887	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.1102	0	0	15.7801	0.301050601	6.07305148	0	2.349683785	1.658535256	1.632562116	3.46444533	8.33902163	3.895915644	8.188444555	1.961347545	0.119703716	9.755818443	6.443575289	15.19306884	0.650344714	0.994751269	0	0	2.262923254	2.045954887	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.1102		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																			2.8708	0.0548	1.1049		0.4275	0.3017	0.297	0.6303	1.5171	0.7088	1.4897	0.3568	0.0218	1.7749	1.1723	2.7641	0.1183	0.181			0.4117	0.3722																			16.5755	0	0	18.6509	0.355820268	7.177912271	0	2.777158094	1.96026999	1.929571597	4.094726469	9.856126839	4.604693505	9.678155511	2.318172447	0.141481226	11.53067929	7.615844899	17.95712018	0.768660914	1.175724817	0	0	2.674613355	2.418172271	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.6858
H2869_802_0	2009	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																																																			0		204.7443366	3.906096894	41.36222224		10.17179128	7.179806303	7.067368466	14.99759883	36.09966074	16.86543569	35.44781193	8.490682014	0.518197903	42.23298027	27.89426532	65.77086078	2.815345083	4.30628255			9.796204564	8.856947561																			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																			0.077071975	0.077071975	0.146826044		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.077071975	0.077071975	0.146826044		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			15.7801	0.301050601	6.07305148	0	2.349683785	1.658535256	1.632562116	3.46444533	8.33902163	3.895915644	8.188444555	1.961347545	0.119703716	9.755818443	6.443575289	15.19306884	0.650344714	0.994751269	0	0	2.262923254	2.045954887	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.1102	0	0	15.7801	0.301050601	6.07305148	0	2.349683785	1.658535256	1.632562116	3.46444533	8.33902163	3.895915644	8.188444555	1.961347545	0.119703716	9.755818443	6.443575289	15.19306884	0.650344714	0.994751269	0	0	2.262923254	2.045954887	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.1102		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																			2.8708	0.0548	1.1049		0.4275	0.3017	0.297	0.6303	1.5171	0.7088	1.4897	0.3568	0.0218	1.7749	1.1723	2.7641	0.1183	0.181			0.4117	0.3722																			16.5755	0	0	18.6509	0.355820268	7.177912271	0	2.777158094	1.96026999	1.929571597	4.094726469	9.856126839	4.604693505	9.678155511	2.318172447	0.141481226	11.53067929	7.615844899	17.95712018	0.768660914	1.175724817	0	0	2.674613355	2.418172271	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.6858
H2869_803_0	2009	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																																																			0		204.7443366	3.906096894	41.36222224		10.17179128	7.179806303	7.067368466	14.99759883	36.09966074	16.86543569	35.44781193	8.490682014	0.518197903	42.23298027	27.89426532	65.77086078	2.815345083	4.30628255			9.796204564	8.856947561																			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																			0.077071975	0.077071975	0.146826044		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.077071975	0.077071975	0.146826044		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			15.7801	0.301050601	6.07305148	0	2.349683785	1.658535256	1.632562116	3.46444533	8.33902163	3.895915644	8.188444555	1.961347545	0.119703716	9.755818443	6.443575289	15.19306884	0.650344714	0.994751269	0	0	2.262923254	2.045954887	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.1102	0	0	15.7801	0.301050601	6.07305148	0	2.349683785	1.658535256	1.632562116	3.46444533	8.33902163	3.895915644	8.188444555	1.961347545	0.119703716	9.755818443	6.443575289	15.19306884	0.650344714	0.994751269	0	0	2.262923254	2.045954887	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.1102		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																			2.8708	0.0548	1.1049		0.4275	0.3017	0.297	0.6303	1.5171	0.7088	1.4897	0.3568	0.0218	1.7749	1.1723	2.7641	0.1183	0.181			0.4117	0.3722																			16.5755	0	0	18.6509	0.355820268	7.177912271	0	2.777158094	1.96026999	1.929571597	4.094726469	9.856126839	4.604693505	9.678155511	2.318172447	0.141481226	11.53067929	7.615844899	17.95712018	0.768660914	1.175724817	0	0	2.674613355	2.418172271	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.6858
H2899_001_0	2009	17																					4450											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1724.752028	22.04656946	582.9143881	25.44018126	208.7548779	14.94491797	6.274932109	53.87515284	732.1648796	7.044651041	19.25486255	0.765034352	0.068881594	18.88405006	10801.42486	2644.55606	129.2002997	56.41968121	5241.011707	1741.542864	15.92165064	0	0	936	311.7481794	3.612163974	1.952496044	0	0	0											1a (IP Acute): 200 days 1-5	1b (IP Psych): 260 days 1-5	2a (SNF): 25 days 11-100	6a (Home Health): 15 copay	10a (Ambulance): 150 copay	11a (DME): 20% coin	11b (Medical Supplies): 15% coin	4a (ER): 50 copay	9b (OP Surg): 450 copay; 9b (OP ASC): 280 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 20% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 20% coin; 9c (OP SA): 50 copay; 3 (CORF): 50 copay; 5 (Partial Hosp): 55 copay; 9d (OP Cardiac Rehab): 34 copay	7a (PCP w/Copay): 15 copay	7b (Chiro): 18 copay; 7d (SPC w/Copay): 34 copay	7h (Psych): 50 copay; 7e (MH Non-Phys): 55 copay	7i (PT/ST): 25 copay; 7c (OT): 25 copay	7g (Prof. Other): 32 copay	7g (Prof. Other): 32 copay	15 (Part B Rx): 20% coin			16b (Comp. Dental): 34 copay	17a1 (Routine Eye Exam): 25 copay	17b1 (Non MCR Covered): 100 allowance	18a (Hearing Exam): 34 copay														107.5653302	124.5037627	13.27135307	15	150	0.2	0.15	50	449.537985	0	0.150412614	0.2	0.2	0.197324876	14.1660249	32.37204139	55	25	32	19.57502943	0.2	0	0	34	25	0	34	0	0	0											91.78110421	106.233977	11.32390369	12.79888753	127.9888753	0.170651834	0.127988875	42.66295842	383.5724073	0	0.128340942	0.170651834	0.170651834	0.16836926	12.08729062	27.62174111	46.92925426	21.33147921	27.30429339	16.70257333	0.170651834	0	0	29.01081172	25	0	34	0	0	0											13.1916	0.195174563	0.550072199	0.027133835	2.226525169	2.550377656	0.803121503	0.19153945	23.40318712	0	2.471187202	0.130554515	0.01175477	3.179493525	10.87999679	6.087270236	0.505272809	0.100292938	11.92517677	2.424020617	2.717058876	0	0	2.262843314	0.649475374	0	0.005532072	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4887		14.7614	13.1916	0.195174563	0.550072199	0.027133835	2.226525169	2.550377656	0.803121503	0.19153945	23.40318712	0	2.471187202	0.130554515	0.01175477	3.179493525	10.87999679	6.087270236	0.505272809	0.100292938	11.92517677	2.424020617	2.717058876	0	0	2.262843314	0.649475374	0	0.005532072	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4887																																																																																		0			13.1916	0.195174563	0.550072199	0.027133835	2.226525169	2.550377656	0.803121503	0.19153945	23.40318712	0	2.471187202	0.130554515	0.01175477	3.179493525	10.87999679	6.087270236	0.505272809	0.100292938	11.92517677	2.424020617	2.717058876	0	0	2.262843314	0.649475374	0	0.005532072	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4887
H2899_002_0	2009	14																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	V	V	Coin	Coin	Coin	Coin	V	V	Coin	Coin	Coin	Coin																																																			0		297.7950366	1.276558984	10.17980168	9.770601536	12.96148036	18.30393597	9.174817071	12.5002998	29.5271383	11.1178415	21.3934213	0.194251635	0	24.08399998	116.7415674	2508.974047	246.4721054	6.644808658	5312.540975	1236.373598	11.89710391	0	0	10.53	428.6605797	2.761815802	0.772962515	0	0	0											1a (IP Acute): MC CS;1a1 (Add'l Days): 0% coin	1b (IP Psych): MC CS;1a1 (Add'l Days): 0% coin	2a (SNF): MC CS;2a2 (Waiver 3 Day): 0% coin		10a (Ambulance): MC CS	11a (DME): MC CS	11b (Medical Supplies): MC CS	4a (ER): MC CS	9b (OP Surg): MC CS; 9b (OP ASC): MC CS	8a (OP Diag Proc/Test/Lab): MC CS	8b (OP Therap Rad): MC CS; 8b (OP Diag): MC CS	9a (OP Observation): MC CS	12 (Renal Dialysis): MC CS	9a (OP Other): MC CS; 9c (OP SA): MC CS; 3 (CORF): MC CS; 5 (Partial Hosp): MC CS; 9d (OP Cardiac Rehab): 10 copay		7b (Chiro): 10 copay; 7d (SPC w/Copay): 10 copay	7h (Psych): 10 copay; 7e (MH Non-Phys): 10 copay	7i (PT/ST): MC CS; 7c (OT): MC CS	7g (Prof. Other): 10 copay	7g (Prof. Other): 10 copay	15 (Part B Rx): MC CS		10b (Transportation): 20 trips/year	16b (Comp. Dental): MC CS	17a1 (Routine Eye Exam): 5 copay	17b1 (Non MCR Covered): 100 allowance	18a (Hearing Exam): MC CS														0.0769	0.0769	0.1934	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.230710159	0	10	10	0.231	10	10	0.231	0	0	0.231	5	0	0.231	0	0	0											0.0769	0.0769	0.1934	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.230710159	0	10	10	0.231	10	10	0.231	0	0	0.231	5	0	0.231	0	0	0											22.9004	0.098167386	1.968773646	0	2.994101964	4.228209209	2.119382743	2.887569253	6.820768946	2.568221386	4.941880321	0.044872128	0	5.556423458	0	2.090811705	0.205393421	1.5349508	4.427117479	1.030311332	2.748231004	0	0	2.43243	0.178608575	0	0.178554341	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9552		0	22.9004	0.098167386	1.968773646	0	2.994101964	4.228209209	2.119382743	2.887569253	6.820768946	2.568221386	4.941880321	0.044872128	0	5.556423458	0	2.090811705	0.205393421	1.5349508	4.427117479	1.030311332	2.748231004	0	0	2.43243	0.178608575	0	0.178554341	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9552																																																																																		0			22.9004	0.098167386	1.968773646	0	2.994101964	4.228209209	2.119382743	2.887569253	6.820768946	2.568221386	4.941880321	0.044872128	0	5.556423458	0	2.090811705	0.205393421	1.5349508	4.427117479	1.030311332	2.748231004	0	0	2.43243	0.178608575	0	0.178554341	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9552
H2899_801_0	2009	9																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		214.8898128	1.176611947	12.37645728	3.587638461	8.642871715	14.29405354	6.001653249	7.223174578	28.37368349	6.737850238	18.41629621	0.731716427	0.065881739	18.06163292	80.2719361	61.34346372	0.970874123	4.337546321	46.44583552	6.124241204	15.22824863	0																			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																			0.079105229	0.079105229	0.181771175	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.079105229	0.079105229	0.181771175	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			16.9989	0.093076158	2.249683182	0	1.996503366	3.301926367	1.3863819	1.668553328	6.554320887	1.556443405	4.254164424	0.169026495	0.015218682	4.172237206	18.54281724	14.17034012	0.224271922	1.0019732	10.728988	1.414699718	3.517725432	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.0173		0	16.9989	0.093076158	2.249683182	0	1.996503366	3.301926367	1.3863819	1.668553328	6.554320887	1.556443405	4.254164424	0.169026495	0.015218682	4.172237206	18.54281724	14.17034012	0.224271922	1.0019732	10.728988	1.414699718	3.517725432	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.0173																																																																																		0			16.9989	0.093076158	2.249683182	0	1.996503366	3.301926367	1.3863819	1.668553328	6.554320887	1.556443405	4.254164424	0.169026495	0.015218682	4.172237206	18.54281724	14.17034012	0.224271922	1.0019732	10.728988	1.414699718	3.517725432	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.0173
H2905_001_0	2009	9	h.5.	h.5.									OP Facility - Other	OP Facility - Other									3350	Complex diag	PET scans									A	A	D		T	Coin	Coin	V	V		Coin		V			V	V	V	V		Coin										P	V																																																	0	7500	386.4009286	7.274584278	244.8321199		165.9329992	7.715605802	2.727527148	82.14956415	192.5068051		18.43420012		0		16.25944135	12737.16926	94.97637549	630.3526654	2412.690048		11.1628622										45.288257	3.802524									$500/Stay	$500/Stay	$50/Day > 10	No cost sharing	$100 Trip	20 % Coins	20 % 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									500	500	50		100	0.2	0.2	50	50		0.2		25		5	25	25	25	25		0.25										44.2225	176.89									486.5650303	486.5650303	48.65650303		97.31300605	0.194626012	0.194626012	48.65650303	48.65650303		0.194626012		24.32825151		4.865650303	24.32825151	24.32825151	24.32825151	24.32825151		0.243282515										43.0342441	172.1369764									15.6674	0.294963193	0.992722899	0	1.345619913	1.501657588	0.530847732	0.333092543	0.780558995	0	3.587774856	0	0	0	0.00659273	25.82275478	0.192550763	1.277948182	4.891377526	0	2.715729192	0	0	0	0	0	0	0	0	0	0.162412159	0.054546249	0	0	0	0	0	0	0	0	60.1586	0	1.6611	15.6674	0.294963193	0.992722899	0	1.345619913	1.501657588	0.530847732	0.333092543	0.780558995	0	3.587774856	0	0	0	0.00659273	25.82275478	0.192550763	1.277948182	4.891377526	0	2.715729192	0	0	0	0	0	0	0	0	0	0.162412159	0.054546249	0	0	0	0	0	0	0	0	60.1586	7500	$912/Stay	$912/Stay	40% Coins	40% Coins	40% - not l.t. $100	50% Coins	50% Coins	$50/visit	$100/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									3.0542	0	2.717	0.2282	4.333	1.7692	0.1888	0.0681	0.2418	0	0.3058	0	0	0	0.0295	7.1983	0.5708	1.0548	1.9083	3.8614	0.0037	0									0	0									27.5329	500	0	18.7216	0.294963193	3.709731399	0.2281758	5.67859224	3.270809334	0.719641365	0.401143131	1.022315503	0	3.893587119	0	0	0	0.036106204	33.02108035	0.763360584	2.332766895	6.799678686	3.861419779	2.719458166	0	0	0	0	0	0	0	0	0	0.162412159	0.054546249	0	0	0	0	0	0	0	0	87.6914
H2905_801_0	2009	4	h.1.	h.2.									OP Facility - Other	OP Facility - Other									2500	Complex diag	PET scans									A	A	D		T	Coin	Coin	V	V		Coin					V	V	V	V	V	Coin										P	V																																																	0		524.0576629	0	1245.258423		67.94486502	6.538567818	8.188955289	255.1420855	248.2741396		17.48625308				5531.510224	9860.616214	123.7388177	1050.62172	1641.824686	5341.142427	6.601463001										43.02384415	3.6123978									$400/Stay	$400/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	$10/visit	$25/visit	$25/visit	$25/visit	$25/visit	None	20% coinsurance										$50/procedure	$200/visit									400	400	50		100	0.2	0.2	50	50		0.2				10	25	25	25	25		0.2										50	200									378.4	378.4	47.3		94.6	0.1892	0.1892	47.3	47.3		0.1892				9.46	23.65	23.65	23.65	23.65		0.1892										47.3	189.2									16.5253	0	4.908393618	0	0.535632019	1.237097031	1.549350341	1.005685054	0.9786139	0	3.308399083	0	0	0	4.360673893	19.43363112	0.243868587	2.070600307	3.235762818	0	1.2489968	0	0	0	0	0	0	0	0	0	0.169585652	0.056955472	0	0	0	0	0	0	0	0	60.8685	0	4.56	16.5253	0	4.908393618	0	0.535632019	1.237097031	1.549350341	1.005685054	0.9786139	0	3.308399083	0	0	0	4.360673893	19.43363112	0.243868587	2.070600307	3.235762818	0	1.2489968	0	0	0	0	0	0	0	0	0	0.169585652	0.056955472	0	0	0	0	0	0	0	0	60.8685	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/visit	$35/visit	$35/visit	$35/visit	$35/visit	None	20% coinsurance										40% Coins	40% Coins									1.9914	0	0.4198	0.3303	1.4867	0.2431	0.1116	0.2114	0.1487	0	0	0	0	0	1.6574	6.3035	0.0791	0.6716	1.0496	0	0.0001										0.0001	0.0001									14.7045	500	0	18.5167	0	5.328222763	0.330320674	2.022333449	1.480168241	1.660925909	1.217038201	1.127353563	0	3.30842976	0	0	0	6.018046226	25.73717962	0.322970503	2.74222618	4.285324155	0	1.24905488	0	0	0	0	0	0	0	0	0	0.169701814	0.057071633	0	0	0	0	0	0	0	0	75.5731
H2905_802_0	2009	4	h.1.	h.2.									OP Facility - Other	OP Facility - Other									2500	Complex diag	PET scans									A	A	D		T	Coin	Coin	V	V		Coin					V	V	V	V	V	Coin										P	V																																																	0		524.0576629	0	1245.258423		67.94486502	6.538567818	8.188955289	255.1420855	248.2741396		17.48625308				5531.510224	9860.616214	123.7388177	1050.62172	1641.824686	5341.142427	6.601463001										43.02384415	3.6123978									$400/Stay	$400/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	$10/visit	$25/visit	$25/visit	$25/visit	$25/visit	None	20% coinsurance										$50/procedure	$200/visit									400	400	50		100	0.2	0.2	50	50		0.2				10	25	25	25	25		0.2										50	200									378.4	378.4	47.3		94.6	0.1892	0.1892	47.3	47.3		0.1892				9.46	23.65	23.65	23.65	23.65		0.1892										47.3	189.2									16.5253	0	4.908393618	0	0.535632019	1.237097031	1.549350341	1.005685054	0.9786139	0	3.308399083	0	0	0	4.360673893	19.43363112	0.243868587	2.070600307	3.235762818	0	1.2489968	0	0	0	0	0	0	0	0	0	0.169585652	0.056955472	0	0	0	0	0	0	0	0	60.8685	0	4.56	16.5253	0	4.908393618	0	0.535632019	1.237097031	1.549350341	1.005685054	0.9786139	0	3.308399083	0	0	0	4.360673893	19.43363112	0.243868587	2.070600307	3.235762818	0	1.2489968	0	0	0	0	0	0	0	0	0	0.169585652	0.056955472	0	0	0	0	0	0	0	0	60.8685	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/visit	$35/visit	$35/visit	$35/visit	$35/visit	None	20% coinsurance										40% Coins	40% Coins									1.9914	0	0.4198	0.3303	1.4867	0.2431	0.1116	0.2114	0.1487	0	0	0	0	0	1.6574	6.3035	0.0791	0.6716	1.0496	0	0.0001										0.0001	0.0001									14.7045	500	0	18.5167	0	5.328222763	0.330320674	2.022333449	1.480168241	1.660925909	1.217038201	1.127353563	0	3.30842976	0	0	0	6.018046226	25.73717962	0.322970503	2.74222618	4.285324155	0	1.24905488	0	0	0	0	0	0	0	0	0	0.169701814	0.057071633	0	0	0	0	0	0	0	0	75.5731
H2905_803_0	2009	4	h.1.	h.2.									OP Facility - Other	OP Facility - Other									2500	Complex diag	PET scans									A	A	D		T	Coin	Coin	V	V		Coin					V	V	V	V	V	Coin										P	V																																																	0		524.0576629	0	1245.258423		67.94486502	6.538567818	8.188955289	255.1420855	248.2741396		17.48625308				5531.510224	9860.616214	123.7388177	1050.62172	1641.824686	5341.142427	6.601463001										43.02384415	3.6123978									$400/Stay	$400/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	$10/visit	$25/visit	$25/visit	$25/visit	$25/visit	None	20% coinsurance										$50/procedure	$200/visit									400	400	50		100	0.2	0.2	50	50		0.2				10	25	25	25	25		0.2										50	200									378.4	378.4	47.3		94.6	0.1892	0.1892	47.3	47.3		0.1892				9.46	23.65	23.65	23.65	23.65		0.1892										47.3	189.2									16.5253	0	4.908393618	0	0.535632019	1.237097031	1.549350341	1.005685054	0.9786139	0	3.308399083	0	0	0	4.360673893	19.43363112	0.243868587	2.070600307	3.235762818	0	1.2489968	0	0	0	0	0	0	0	0	0	0.169585652	0.056955472	0	0	0	0	0	0	0	0	60.8685	0	4.56	16.5253	0	4.908393618	0	0.535632019	1.237097031	1.549350341	1.005685054	0.9786139	0	3.308399083	0	0	0	4.360673893	19.43363112	0.243868587	2.070600307	3.235762818	0	1.2489968	0	0	0	0	0	0	0	0	0	0.169585652	0.056955472	0	0	0	0	0	0	0	0	60.8685	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/visit	$35/visit	$35/visit	$35/visit	$35/visit	None	20% coinsurance										40% Coins	40% Coins									1.9914	0	0.4198	0.3303	1.4867	0.2431	0.1116	0.2114	0.1487	0	0	0	0	0	1.6574	6.3035	0.0791	0.6716	1.0496	0	0.0001										0.0001	0.0001									14.7045	500	0	18.5167	0	5.328222763	0.330320674	2.022333449	1.480168241	1.660925909	1.217038201	1.127353563	0	3.30842976	0	0	0	6.018046226	25.73717962	0.322970503	2.74222618	4.285324155	0	1.24905488	0	0	0	0	0	0	0	0	0	0.169701814	0.057071633	0	0	0	0	0	0	0	0	75.5731
H2906_003_0	2009	7																					2500											D	D	A	V	Coin	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	Coin	V	V	Coin	V	T	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	296.6883504	0.430088995	96.64850312	1131.7773	12.00036707	14.93799021	10.57274321	599.7206458	313.7843519	379.6253101	2136.358173	34.95651073	1.475405	1165.094949	6565.566236	4100.522107	221.26054	3.087773164	319.0557658	1270.775596	0.898835628	2.283555025	0	0	423.0131994	149.0746039	0	0	0	24.55048655											PBP: 1A IP Acute: $150 per stay	1B IP Psych: $150 per stay	2 SNF: $0 per stay plus $0 per day for days 35-100 only	"6 Home Health: $0, 13C Custodial Care: $0 per episode"	10A Ambulance: 20%	11A DME: 10%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0-10%"	"4A ER: $50, 4B Urgent Care: $20"	"9B ASC Services: $50, 9A HOP - Surgery $50"	8A OP C/D/T: $0	"8B: $25 Routine Imaging, $75 CT, $100 PET, MRI, and Nuclear Medicine"	9A OP Hospital: $0	12 Renal Dialysis: 10%	"3 CORF: 10%, 5 Partial Hosp: $20,  9D Cardiac Rehab: $10"	"7A PCP: $10, 14B Immunizations: $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, 9C OP Substance Abuse: $20,"	"7C Occupational Therapy: 10%, 7I Physical and Speech Therapy: 10%"	7D Physician Specialist: $20	"7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $20"	15 Part B Drugs: 20%	"13A Blood: 10%, 16B Comprehensive Dental Services: $20 with $50 deductible, 17A Medicare Covered Eye Exams: $15"	10B Transportation: $0	"16A Preventive Dental Services: $0, 16B Additional Comprehensive Dental Coverage 20%-50% with $50 deductible"	17A Routine Eye Exams non-Medicare-covered: $15	17B Eye Wear: No member cost sharing	18A Routine Hearing Test (non-Medicare covered): Not Covered	18B Hearing Aids: Not Covered	19 POS: N/A	"14A Health Education/Wellness Programs: $0, Membership in Health Club $0"											150	150	0	0	0.2	0.1	0.1	44.8015423	50	0	39.29867506	0	0.1	15.34761098	9.9	20	20	0.1	20	19.95887038	0.2	15.64235529	0	0	15	0	0	0	0	0											142.5	142.5	0	0	0.19	0.095	0.095	42.56146518	47.5	0	37.3337413	0	0.095	14.58023043	9.405	19	19	0.095	19	18.96092686	0.19	14.86023753	0	0	14.25	0	0	0	0	0											3.5232	0.005107307	0	0	2.280069744	1.41910907	1.004410605	2.127082449	1.24206306	0	6.646520282	0	0.140163475	1.415612736	5.145762537	6.492493335	0.350329188	0.293338451	0.505171629	2.007923594	0.170778769	0.002827848	0	0	0.502328174	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2743	0	2.7226	3.5232	0.005107307	0	0	2.280069744	1.41910907	1.004410605	2.127082449	1.24206306	0	6.646520282	0	0.140163475	1.415612736	5.145762537	6.492493335	0.350329188	0.293338451	0.505171629	2.007923594	0.170778769	0.002827848	0	0	0.502328174	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2743	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	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											7.4978	0.0213	0.9706	0.2828	0.0005	0.3154	0.2232	0.427	0.7998	0.0929	0.2083	0.0222	0.0311	1.0535	1.0136	1.9822	0.051	0.0646	0.309	0.4206	0.019	0.0017	0	0.5051	0.0849	0	0	0	0.0091	0.0472											16.4542	500	0	11.0209	0.026449577	0.970601862	0.282778534	2.280562045	1.734466641	1.227612961	2.554090195	2.04183714	0.092943715	6.854776291	0.022160743	0.171310914	2.469140069	6.159343032	8.474648851	0.401285243	0.357982381	0.814138511	2.428489119	0.189754188	0.004563326	3.08E-05	0.505096	0.587258174	0	0	0	0.009086068	0.047156142	0	0	0	0	0	0	0	0	0	0	51.7285
H2914_001_0	2009	2																					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																																																			0		322.3034945	9.259234478	760.2497634	4515.06098	133.2155017	11.12513125	9.528359716	282.4957097	360.6854373		4710.915634	53.74005013	9.189789286	44.86027333	3236.627967	3153.516338	232.2227866	345.7306849			20.7601625	1095.316065					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	22.1772134	100	0.2	0.2	48.53522307	47.5		10.2797817	50	50	15.27715162	10	24.28775688	35.61663516	15			0.2	15					15														147.1598202	126.4545673	51.76836606	17.66568843	79.65693488	0.15931387	0.15931387	38.66167104	37.83704407		8.188559013	39.82846744	39.82846744	12.16931072	7.965693488	19.34688268	28.37111988	11.94854023			0.15931387	11.94854023					11.94854023														3.9525	0.097572707	3.279740671	6.646805044	0.884294879	1.772387711	1.517999859	0.91014635	1.137272566	0	3.214634222	0.17836532	0.030501269	0.045493217	2.14849886	5.084225887	0.549035043	0.344248083	0	0	3.307381824	1.090619006	0	0	0	0	0.216580255	0	0	0	0	0	0	0	0	0	0	0	0	0	36.4083	0	9.2981	3.9525	0.097572707	3.279740671	6.646805044	0.884294879	1.772387711	1.517999859	0.91014635	1.137272566	0	3.214634222	0.17836532	0.030501269	0.045493217	2.14849886	5.084225887	0.549035043	0.344248083	0	0	3.307381824	1.090619006	0	0	0	0	0.216580255	0	0	0	0	0	0	0	0	0	0	0	0	0	36.4083		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										6.0232	0.157	1.4746	3.3741	0.2587	0.7498	0.6422	0.2876	2.309	0.8926	2.427	0.199	0.0093	1.1734	1.9324	2.3059	0.2172	0.2032			0.9995	0.6179					0.1166														26.3701	500	0	9.9757	0.254546702	4.754312949	10.0209541	1.142972583	2.522159001	2.160157726	1.197700998	3.446306565	0.892643597	5.641642851	0.37731956	0.039848308	1.218844834	4.080859827	7.390091142	0.766284618	0.547446884	0	0	4.306871851	1.708528095	0	0	0	0	0.333210049	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7784
H2914_002_0	2009	2																					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																																																			0		312.8617137	8.987988079	737.994998	4382.793671	129.312995	10.48286407	8.978276074	274.2345333	350.1192695		4572.910823	52.16575205	8.920577262	43.54610555	3141.811956	3061.135057	225.4198922	335.6026118			19.5616534	1063.229121					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	21.52753882	100	0.2	0.2	48.53498758	47.5		9.978638685	50	50	15.26043567	10	24.28775688	34.57325689	15			0.2	15					15														148.9627708	128.0038443	52.40261392	17.35827103	80.63286371	0.161265727	0.161265727	39.13515039	38.30061026		8.046062131	40.31643185	40.31643185	12.30492629	8.063286371	19.58391391	27.87740711	12.09492956			0.161265727	12.09492956					12.09492956														3.8837	0.095874752	3.222738913	6.339810035	0.868906425	1.6905267	1.447888222	0.894350809	1.117481807	0	3.066160383	0.175261416	0.029970487	0.044652635	2.111110794	4.99575045	0.523676842	0.338257496	0	0	3.154624265	1.07164011	0	0	0	0	0.21923372	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2916	0	8.4767	3.8837	0.095874752	3.222738913	6.339810035	0.868906425	1.6905267	1.447888222	0.894350809	1.117481807	0	3.066160383	0.175261416	0.029970487	0.044652635	2.111110794	4.99575045	0.523676842	0.338257496	0	0	3.154624265	1.07164011	0	0	0	0	0.21923372	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2916		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										5.8946	0.1533	1.3974	3.1975	0.2522	0.7105	0.6085	0.2809	2.1882	0.8459	2.2999	0.1885	0.0091	1.1125	1.8792	2.2519	0.2052	0.1975			0.9504	0.5999					0.1169														25.3401	500	0	9.7783	0.249217456	4.620144943	9.537314764	1.121148978	2.40104577	2.056427675	1.175209909	3.305632662	0.845911689	5.366109629	0.363799952	0.039093849	1.157185774	3.990266981	7.247641716	0.728915566	0.535739254	0	0	4.105013419	1.671541312	0	0	0	0	0.336129882	0	0	0	0	0	0	0	0	0	0	0	0	0	60.6318
H2914_003_0	2009	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																																																			0		322.3034945	9.259234478	760.2497634	4515.06098	133.2155017	11.12513125	9.528359716	282.4957097	360.6854373		4710.915634	53.74005013	9.189789286	44.86027333	3236.627967	3153.516338	232.2227866	345.7306849			20.7601625	1095.316065					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	22.1772134	100	0.2	0.2	48.53522307	47.5		10.2797817	50	50	15.27715162	10	24.28775688	35.61663516	15			0.2	15					15														147.1598202	126.4545673	51.76836606	17.66568843	79.65693488	0.15931387	0.15931387	38.66167104	37.83704407		8.188559013	39.82846744	39.82846744	12.16931072	7.965693488	19.34688268	28.37111988	11.94854023			0.15931387	11.94854023					11.94854023														3.9525	0.097572707	3.279740671	6.646805044	0.884294879	1.772387711	1.517999859	0.91014635	1.137272566	0	3.214634222	0.17836532	0.030501269	0.045493217	2.14849886	5.084225887	0.549035043	0.344248083	0	0	3.307381824	1.090619006	0	0	0	0	0.216580255	0	0	0	0	0	0	0	0	0	0	0	0	0	36.4083	0	9.2981	3.9525	0.097572707	3.279740671	6.646805044	0.884294879	1.772387711	1.517999859	0.91014635	1.137272566	0	3.214634222	0.17836532	0.030501269	0.045493217	2.14849886	5.084225887	0.549035043	0.344248083	0	0	3.307381824	1.090619006	0	0	0	0	0.216580255	0	0	0	0	0	0	0	0	0	0	0	0	0	36.4083		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										6.0232	0.157	1.4746	3.3741	0.2587	0.7498	0.6422	0.2876	2.309	0.8926	2.427	0.199	0.0093	1.1734	1.9324	2.3059	0.2172	0.2032			0.9995	0.6179					0.1166														26.3701	500	0	9.9757	0.254546702	4.754312949	10.0209541	1.142972583	2.522159001	2.160157726	1.197700998	3.446306565	0.892643597	5.641642851	0.37731956	0.039848308	1.218844834	4.080859827	7.390091142	0.766284618	0.547446884	0	0	4.306871851	1.708528095	0	0	0	0	0.333210049	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7784
H2914_004_0	2009	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																																																			0		312.8617137	8.987988079	737.994998	4382.793671	129.312995	10.48286407	8.978276074	274.2345333	350.1192695		4572.910823	52.16575205	8.920577262	43.54610555	3141.811956	3061.135057	225.4198922	335.6026118			19.5616534	1063.229121					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	21.52753882	100	0.2	0.2	48.53498758	47.5		9.978638685	50	50	15.26043567	10	24.28775688	34.57325689	15			0.2	15					15														148.9627708	128.0038443	52.40261392	17.35827103	80.63286371	0.161265727	0.161265727	39.13515039	38.30061026		8.046062131	40.31643185	40.31643185	12.30492629	8.063286371	19.58391391	27.87740711	12.09492956			0.161265727	12.09492956					12.09492956														3.8837	0.095874752	3.222738913	6.339810035	0.868906425	1.6905267	1.447888222	0.894350809	1.117481807	0	3.066160383	0.175261416	0.029970487	0.044652635	2.111110794	4.99575045	0.523676842	0.338257496	0	0	3.154624265	1.07164011	0	0	0	0	0.21923372	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2916	0	8.4767	3.8837	0.095874752	3.222738913	6.339810035	0.868906425	1.6905267	1.447888222	0.894350809	1.117481807	0	3.066160383	0.175261416	0.029970487	0.044652635	2.111110794	4.99575045	0.523676842	0.338257496	0	0	3.154624265	1.07164011	0	0	0	0	0.21923372	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2916		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										5.8946	0.1533	1.3974	3.1975	0.2522	0.7105	0.6085	0.2809	2.1882	0.8459	2.2999	0.1885	0.0091	1.1125	1.8792	2.2519	0.2052	0.1975			0.9504	0.5999					0.1169														25.3401	500	0	9.7783	0.249217456	4.620144943	9.537314764	1.121148978	2.40104577	2.056427675	1.175209909	3.305632662	0.845911689	5.366109629	0.363799952	0.039093849	1.157185774	3.990266981	7.247641716	0.728915566	0.535739254	0	0	4.105013419	1.671541312	0	0	0	0	0.336129882	0	0	0	0	0	0	0	0	0	0	0	0	0	60.6318
H2914_801_0	2009	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																																																			0		257.4489186	5.665151975	23.88706199		6.771613859	10.7207408	9.182010757	10.13858803	37.4182937	14.29898893	38.88907609	3.224087736	0.306022058	19.05832462	33.03679866	78.89459435	2.213986008	3.179690247			20.00554566	7.171331621																			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																			0.079541869	0.079541869	0.207759063		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.079541869	0.079541869	0.207759063		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			20.478	0.450616774	4.962753604	0	1.564242801	2.476491125	2.121044485	2.342013834	8.643625844	3.303066442	8.983376577	0.744764267	0.070691095	4.402472987	7.63150049	18.22465129	0.511430768	0.734508447	0	0	4.621281047	1.656577604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.9231	0	0	20.478	0.450616774	4.962753604	0	1.564242801	2.476491125	2.121044485	2.342013834	8.643625844	3.303066442	8.983376577	0.744764267	0.070691095	4.402472987	7.63150049	18.22465129	0.511430768	0.734508447	0	0	4.621281047	1.656577604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.9231		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																			3.6525	0.0804	0.8852		0.3095	0.5006	0.4288	0.4177	1.5417	0.596	1.6205	0.1328	0.0127	0.7852	1.3515	3.3235	0.0923	0.133			0.9342	0.3006																			17.0986	0	0	24.1304	0.530989331	5.847916378	0	1.873789129	2.97709576	2.549798171	2.759738272	10.18531347	3.899063551	10.60383309	0.877601328	0.083349297	5.187709073	8.983030427	21.54811781	0.603746923	0.867465646	0	0	5.555439334	1.957207657	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.0216
H2914_802_0	2009	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																																																			0		257.4489186	5.665151975	23.88706199		6.771613859	10.7207408	9.182010757	10.13858803	37.4182937	14.29898893	38.88907609	3.224087736	0.306022058	19.05832462	33.03679866	78.89459435	2.213986008	3.179690247			20.00554566	7.171331621																			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																			0.079541869	0.079541869	0.207759063		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.079541869	0.079541869	0.207759063		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			20.478	0.450616774	4.962753604	0	1.564242801	2.476491125	2.121044485	2.342013834	8.643625844	3.303066442	8.983376577	0.744764267	0.070691095	4.402472987	7.63150049	18.22465129	0.511430768	0.734508447	0	0	4.621281047	1.656577604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.9231	0	0	20.478	0.450616774	4.962753604	0	1.564242801	2.476491125	2.121044485	2.342013834	8.643625844	3.303066442	8.983376577	0.744764267	0.070691095	4.402472987	7.63150049	18.22465129	0.511430768	0.734508447	0	0	4.621281047	1.656577604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.9231		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																			3.6525	0.0804	0.8852		0.3095	0.5006	0.4288	0.4177	1.5417	0.596	1.6205	0.1328	0.0127	0.7852	1.3515	3.3235	0.0923	0.133			0.9342	0.3006																			17.0986	0	0	24.1304	0.530989331	5.847916378	0	1.873789129	2.97709576	2.549798171	2.759738272	10.18531347	3.899063551	10.60383309	0.877601328	0.083349297	5.187709073	8.983030427	21.54811781	0.603746923	0.867465646	0	0	5.555439334	1.957207657	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.0216
H2914_803_0	2009	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																																																			0		257.4489186	5.665151975	23.88706199		6.771613859	10.7207408	9.182010757	10.13858803	37.4182937	14.29898893	38.88907609	3.224087736	0.306022058	19.05832462	33.03679866	78.89459435	2.213986008	3.179690247			20.00554566	7.171331621																			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																			0.079541869	0.079541869	0.207759063		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.079541869	0.079541869	0.207759063		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			20.478	0.450616774	4.962753604	0	1.564242801	2.476491125	2.121044485	2.342013834	8.643625844	3.303066442	8.983376577	0.744764267	0.070691095	4.402472987	7.63150049	18.22465129	0.511430768	0.734508447	0	0	4.621281047	1.656577604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.9231	0	0	20.478	0.450616774	4.962753604	0	1.564242801	2.476491125	2.121044485	2.342013834	8.643625844	3.303066442	8.983376577	0.744764267	0.070691095	4.402472987	7.63150049	18.22465129	0.511430768	0.734508447	0	0	4.621281047	1.656577604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.9231		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																			3.6525	0.0804	0.8852		0.3095	0.5006	0.4288	0.4177	1.5417	0.596	1.6205	0.1328	0.0127	0.7852	1.3515	3.3235	0.0923	0.133			0.9342	0.3006																			17.0986	0	0	24.1304	0.530989331	5.847916378	0	1.873789129	2.97709576	2.549798171	2.759738272	10.18531347	3.899063551	10.60383309	0.877601328	0.083349297	5.187709073	8.983030427	21.54811781	0.603746923	0.867465646	0	0	5.555439334	1.957207657	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.0216
H2926_001_0	2009	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																																																			0		486.7628189		245.7192945		27.15549016	46.3419238		38.89590087	45.35158981	168.9036454					308.5256109						4.877519628	0.632304474																			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											0.0793		0.1517		0.231	0.231		0.231	0.231	0.231					0.231						0.231	0.231																			0.0793		0.1517		0.231	0.231		0.231	0.231	0.231					0.231						0.231	0.231																			38.6003	0	37.27561698	0	6.272918227	10.7049844	0	8.984953102	10.47621725	39.01674209	0	0	0	0	71.26941612	0	0	0	0	0	1.126707034	0.146062333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	223.8739			38.6003	0	37.27561698	0	6.272918227	10.7049844	0	8.984953102	10.47621725	39.01674209	0	0	0	0	71.26941612	0	0	0	0	0	1.126707034	0.146062333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	223.8739																																																																																		0			38.6003	0	37.27561698	0	6.272918227	10.7049844	0	8.984953102	10.47621725	39.01674209	0	0	0	0	71.26941612	0	0	0	0	0	1.126707034	0.146062333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	223.8739
H2931_002_0	2009	8	h.5.	h.5.	f.	g.							OP Facility - Other	OP Facility - Other	OP Facility - Emergency	OP Facility - Surgery							3350	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		507.7018123	4.029172256	119.418871	0	41.79316953	32.93398266	1.453501763	133.4574366	323.367327	278.6610189	1448.990269	0	17.37428571	13049.12344	14355.26569	17489.46833	36.8914	0.019285714	3001.652672	0.655714286	18.65004449										45.288257	3.802524	547.751789	146.814774							$575/Admit	$575/Admit	$50/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	$14/visit	$30/visit	$10/visit	$10/visit	$30/visit	$20/visit	20% coins										$50/procedure	$200/visit	$25/visit	$25/visit							575	575	50	0	0.2	0.2	0.2	50	50	20	50	50	10	10	14	30	10	10	30	20	0.2										50	200	25	25							559.5497848	559.5497848	48.65650303	0	0.194626012	0.194626012	0.194626012	48.65650303	48.65650303	19.46260121	48.65650303	48.65650303	9.731300605	9.731300605	13.62382085	29.18	9.731300605	9.731300605	29.19390182	19.46260121	0.194626012										48	192	24	24							23.6737	0.187876872	0.484208722	0	8.13403792	6.409809708	0.282889252	0.541131014	1.311160277	0.45195569	5.875233285	0	0.014089533	10.58207857	16.29779733	42.52855716	0.029916775	1.56E-05	7.302496115	0.001063492	3.629783784	0	0	0	0	0	0	0	0	0	0.181153028	0.060840384	1.095503578	0.293629548	0	0	0	0	0	0	129.3689	0	3.5721	23.6737	0.187876872	0.484208722	0	8.13403792	6.409809708	0.282889252	0.541131014	1.311160277	0.45195569	5.875233285	0	0.014089533	10.58207857	16.29779733	42.52855716	0.029916775	1.56E-05	7.302496115	0.001063492	3.629783784	0	0	0	0	0	0	0	0	0	0.181153028	0.060840384	1.095503578	0.293629548	0	0	0	0	0	0	129.3689		$750/stay	$750/stay	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	$35/visit	$35/visit	$35/visit	$35/visit	$35/visit	$35/visit	20% Coins										20% Coins	20% Coins	20% Coins	20% Coins							0	0	0	0.0494	0	0.0728	0.0242	0	0.3911	0.0382	0.103	0	0	0.0635	0.0007	0.6734	0	0.0042	0.1302	0.1417	0																				1.6924			23.6737	0.187876872	0.484208722	0.049354048	8.13403792	6.482594708	0.307113299	0.541131014	1.702234563	0.490200214	5.978271142	0	0.014089533	10.64553405	16.29854073	43.20196582	0.029916775	0.004182306	7.43269249	0.142730159	3.629783784	0	0	0	0	0	0	0	0	0	0.181153028	0.060840384	1.095503578	0.293629548	0	0	0	0	0	0	131.0613
H2931_004_0	2009	8	g.										OP Facility - Surgery										2500	ASC										A	A			Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	V	V	V	V	V	V	Coin	Coin									V																																																		0		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	0.010957588									146.814774										$800/Stay	$800/Stay	No cost Sharing	No cost Sharing	20% of EME	20% of EME	20% of EME	"$50/visit-ER, $40/visit UC"	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	20% of EME	20% of EME									$25/visit										800	800			0.2	0.2	0.2	45	0.2	0.2	0.2	0.2	20	0.2	10	40	40	40	40	40	0.2	0.2									25										744.6993089	744.6993089			0.186174827	0.186174827	0.186174827	41.88933613	0.186174827	0.186174827	0.186174827	0.186174827	18.61748272	0.186174827	9.308741362	37.23496545	37.23496545	37.23496545	37.23496545	37.23496545	0.186174827	0.186174827									23.2718534										22.3549	0.010792026	0	0	2.221974052	4.22575776	0.62365906	0.827180107	3.919034853	0.157568341	4.451796444	0	0.897516239	5.559294022	4.411203626	22.82012599	0.667429708	1.304325771	8.751333857	6.249293041	0.327889864	0.002040027	0	0	0	0	0	0	0	0	0.284720992	0	0	0	0	0	0	0	0	0	90.0678		13.49	22.3549	0.010792026	0	0	2.221974052	4.22575776	0.62365906	0.827180107	3.919034853	0.157568341	4.451796444	0	0.897516239	5.559294022	4.411203626	22.82012599	0.667429708	1.304325771	8.751333857	6.249293041	0.327889864	0.002040027	0	0	0	0	0	0	0	0	0.284720992	0	0	0	0	0	0	0	0	0	90.0678																																																																																		0			22.3549	0.010792026	0	0	2.221974052	4.22575776	0.62365906	0.827180107	3.919034853	0.157568341	4.451796444	0	0.897516239	5.559294022	4.411203626	22.82012599	0.667429708	1.304325771	8.751333857	6.249293041	0.327889864	0.002040027	0	0	0	0	0	0	0	0	0.284720992	0	0	0	0	0	0	0	0	0	90.0678
H2931_006_0	2009	9																					3350											A	A	D	V	Coin	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin																																																												0		400.4156596	45.27094345	944.8529868		10.20014826	20.67526473	2.798853733	93.51853369	267.3511833	0.690927173	16.97929474	0	353.376539	3355.465255	5052.69545	7042.287166	207.4412179	426.5755493	2925.649616	2546.244591	3.768227644																				$200/Admit	$200/Admit	$50/day >20	No cost Sharing	20% coinsurance	20% coinsurance	20% coinsurance	"$50 per visit-ER, $25/viist UC"	"$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																				200	200	50		0.2	0.2	0.2	37.5	30	0.2	0.2	20	20	20	10	40	20	20	20	20	0.2																				189.1592252	189.1592252	47.2898063	0	0.189159225	0.189159225	0.189159225	35.46735472	28.37388378	0.189159225	0.189159225	18.91592252	18.91592252	18.91592252	9.45796126	37.83184504	18.91592252	18.91592252	18.91592252	18.91592252	0.189159225																				6.3119	0.713618049	3.723492894	0	1.929452141	3.910917058	0.529429003	0.276404584	0.632149284	0.130695249	3.211790238	0	0.557036936	5.289310066	3.982349819	22.20189307	0.326995167	0.672422503	4.611780121	4.013713783	0.712795021	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.7381	0	3.6529	6.3119	0.713618049	3.723492894	0	1.929452141	3.910917058	0.529429003	0.276404584	0.632149284	0.130695249	3.211790238	0	0.557036936	5.289310066	3.982349819	22.20189307	0.326995167	0.672422503	4.611780121	4.013713783	0.712795021	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.7381		$750/stay	$750/stay	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$35 copay/visit	$35 copay/visit	$35 copay/visit	$35 copay/visit	$35 copay/visit	$35 copay/visit	20% coinsurance																				3.5941	0	0.225	0.1034	0.0602	0.1257	0.073	0.3081	0.1614	0.0536	0.056	0	0.0004	0.0988	0.0044	1.17	0.2227	0.0686	0.3799	0.2906	0.0094																				7.0051			9.906	0.713618049	3.948466753	0.103352998	1.989642041	4.036623101	0.602455049	0.584464554	0.793529225	0.184269502	3.267768998	0	0.557440623	5.388068909	3.986730562	23.37186679	0.54971022	0.741052376	4.991682831	4.304320703	0.722162452	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.7432
H2931_015_0	2009	6																					3350											A	A			Coin	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	Coin	Coin	Coin	T	V	V	V	V	V		O																																																			0		554.3153538	0.88256493	662.5856211		39.61207517	19.06488418	6.114251172	2469.7697	579.9039965	8.447666253	9.980692686	0	821.3149237	6053.395178	1934.523488	5960	117.145785	1.264435671	0	6.63263667	9.616706542	0	0	0	0	0	0	0	0	11400	0										$1200/Stay	$1200/Stay	"$128 per day, days 21 - 100"	No cost sharing	20% coins	20% coins	20% coins	$50/visit	"$50/visit-hospital, $25/visit ASC"		20% coins	$50/visit	$15/visit	$50/visit	$10/visit	$40/visit	$20/visit	20% coins	20% coins	20% coins	20% coins	20% coins								$0/Script Generic-$3/s Brand											1200	1200	128		0.1982	0.1982	0.1982	50	35		0.1982	50	15	50	10	40	20	0.1982	0.1982	0.1982	0.2	0.1982								0.93											1167.72	1167.72	124.5568		0.19286842	0.19286842	0.19286842	48.655	34.0585		0.19286842	48.655	14.5965	48.655	9.731	38.924	19.462	0.19286842	0.19286842	0.19286842	0.19462	0.19286842								0.904983											53.9404	0.085882393	6.877462057	0	7.639918352	3.677014089	1.179245963	10.01388706	1.645888356	0	1.924960429	0	0.99902694	24.5439952	1.568737339	19.33225333	0.189990939	2.03E-05	0	1.279226155	1.871603427	0	0	0	0	0	0	0	0	0.85973385	0	0	0	0	0	0	0	0	0	0	137.6293		3.7022	53.9404	0.085882393	6.877462057	0	7.639918352	3.677014089	1.179245963	10.01388706	1.645888356	0	1.924960429	0	0.99902694	24.5439952	1.568737339	19.33225333	0.189990939	2.03E-05	0	1.279226155	1.871603427	0	0	0	0	0	0	0	0	0.85973385	0	0	0	0	0	0	0	0	0	0	137.6293																																																																																		0			53.9404	0.085882393	6.877462057	0	7.639918352	3.677014089	1.179245963	10.01388706	1.645888356	0	1.924960429	0	0.99902694	24.5439952	1.568737339	19.33225333	0.189990939	2.03E-05	0	1.279226155	1.871603427	0	0	0	0	0	0	0	0	0.85973385	0	0	0	0	0	0	0	0	0	0	137.6293
H2931_801_0	2009	5	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						6.500280375	28.43757558	1.100661985	101.1250739	131.553873		1.685302954	0	0	45.42915042	5801.7487	922.308336	35.06960584	59.90703855	903.4881504	725.1681207	15.88409221										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	$10/visit	$25/visit	$10/visit	$20/visit	$10/visit	$10/visit	$10/visit	$10/visit	20% Coinsurance										25	25													0.2	0.2	0.2	50	50		0.2	25	10	25	10	20	10	10	10	10	0.2										25	25													0.19632	0.19632	0.19632	49.08	49.08		0.19632	24.54	9.816	24.54	9.816	19.632	9.816	9.816	9.816	9.816	0.19632										24.54	24.54									0	0	0	0	1.276135043	5.582864838	0.216081961	0.413601552	0.53805534	0	0.330858676	0	0	0.092902613	4.745830436	1.508896438	0.028686938	0.049003958	0.739053307	0.593187523	3.118364982	0	0	0	0	0	0	0	0	0	0.237466146	0.286078138	0	0	0	0	0	0	0	0	19.7571	0	0.35	0	0	0	0	1.276135043	5.582864838	0.216081961	0.413601552	0.53805534	0	0.330858676	0	0	0.092902613	4.745830436	1.508896438	0.028686938	0.049003958	0.739053307	0.593187523	3.118364982	0	0	0	0	0	0	0	0	0	0.237466146	0.286078138	0	0	0	0	0	0	0	0	19.7571																																																																																		0			0	0	0	0	1.276135043	5.582864838	0.216081961	0.413601552	0.53805534	0	0.330858676	0	0	0.092902613	4.745830436	1.508896438	0.028686938	0.049003958	0.739053307	0.593187523	3.118364982	0	0	0	0	0	0	0	0	0	0.237466146	0.286078138	0	0	0	0	0	0	0	0	19.7571
H2931_803_0	2009	7	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						6.66339799	29.5179076	1.14247569	104.9667746	136.5515515		1.749326933	0	0	47.15498551	6017.247026	957.3464574	36.40188601	62.18288276	937.8113006	752.7169649	16.48752246										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	$10/visit	$25/visit	$10/visit	$20/visit	$10/visit	$10/visit	$10/visit	$10/visit	20% Coinsurance										25	25													0.2	0.2	0.2	50	50		0.2	25	10	25	10	20	10	10	10	10	0.2										25	25													0.19632	0.19632	0.19632	49.08	49.08		0.19632	24.54	9.816	24.54	9.816	19.632	9.816	9.816	9.816	9.816	0.19632										24.54	24.54									0	0	0	0	1.308158293	5.79495562	0.224290827	0.429314108	0.558495846	0	0.343427864	0	0	0.096431945	4.922108067	1.566218804	0.029776743	0.050865598	0.767129644	0.615722477	3.236830409	0	0	0	0	0	0	0	0	0	0.237466146	0.286078138	0	0	0	0	0	0	0	0	20.4673	0	0.35	0	0	0	0	1.308158293	5.79495562	0.224290827	0.429314108	0.558495846	0	0.343427864	0	0	0.096431945	4.922108067	1.566218804	0.029776743	0.050865598	0.767129644	0.615722477	3.236830409	0	0	0	0	0	0	0	0	0	0.237466146	0.286078138	0	0	0	0	0	0	0	0	20.4673																																																																																		0			0	0	0	0	1.308158293	5.79495562	0.224290827	0.429314108	0.558495846	0	0.343427864	0	0	0.096431945	4.922108067	1.566218804	0.029776743	0.050865598	0.767129644	0.615722477	3.236830409	0	0	0	0	0	0	0	0	0	0.237466146	0.286078138	0	0	0	0	0	0	0	0	20.4673
H2931_804_0	2009	5	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						2.647369188	10.49586882	0.406237296	37.32369894	48.55449752		0.622019225	0	0	16.76719599	2139.590526	340.4097258	12.9436485	22.11076033	333.4634867	267.6483248	5.862572483										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	$10/visit	$25/visit	$10/visit	$20/visit	$10/visit	$10/visit	$10/visit	$10/visit	20% Coinsurance										25	25													0.2	0.2	0.2	50	50		0.2	25	10	25	10	20	10	10	10	10	0.2										25	25													0.19632	0.19632	0.19632	49.08	49.08		0.19632	24.54	9.816	24.54	9.816	19.632	9.816	9.816	9.816	9.816	0.19632										24.54	24.54									0	0	0	0	0.519731519	2.060548966	0.079752506	0.152653929	0.198587895	0	0.122114814	0	0	0.034288916	1.75018505	0.556910311	0.010587904	0.018086602	0.272773132	0.21893633	1.15094023	0	0	0	0	0	0	0	0	0	0.237466146	0.286078138	0	0	0	0	0	0	0	0	7.6696	0	0.35	0	0	0	0	0.519731519	2.060548966	0.079752506	0.152653929	0.198587895	0	0.122114814	0	0	0.034288916	1.75018505	0.556910311	0.010587904	0.018086602	0.272773132	0.21893633	1.15094023	0	0	0	0	0	0	0	0	0	0.237466146	0.286078138	0	0	0	0	0	0	0	0	7.6696																																																																																		0			0	0	0	0	0.519731519	2.060548966	0.079752506	0.152653929	0.198587895	0	0.122114814	0	0	0.034288916	1.75018505	0.556910311	0.010587904	0.018086602	0.272773132	0.21893633	1.15094023	0	0	0	0	0	0	0	0	0	0.237466146	0.286078138	0	0	0	0	0	0	0	0	7.6696
H2947_001_0	2009	10																					2000											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	O	P																																																			0	4000	1349.238029	34.12808048	989.4601031		117.8807134	9.785980756	8.052609012	266.8443759	237.9860001	242.5602891	394.905692	7.904472339	0.623623232	462.7975898	3050.636797	4565.303813	163.608707	355.6898799	3138.787092	9373.676128	22.97435591				99.89258411		237.1062288			98.46											1a: Days 1 - 7: $150/day then $0;1a1: Days 1 - 7: $150/day then $0	1b: Days 1 - 7: $150/day then $0	"2: Days 1 - 7: $0/day, then $100/day"	6: $0	10a: $100/trip	11a: 20% (Oxygen 100% covered)	11b: 20% (Oxygen 100% covered);11c: 20%	4a: $50/visit;4a1: $50/visit;4b: $25/visit	9a: $250/visit;9b: $250/visit	8a: $10/visit;8a: $30/visit	8b: $10/visit;8b: $100/visit;8b: $50/visit	9a: $250/visit	12a: 20%	3: 20%;5: $150/day;9a: $50/visit;9c: $30/visit;9d: $30/visit; 7i: $30/visit; 7c: $30/visit; 7e: $30/visit	7a: $20/visit;14c: $10/visit	7b: $30/visit;7d: $30/visit;7f: $30/visit;16b: $30/visit;17a: $30/visit;18a: $30/visit	7e: $30/visit;7h: $30/visit	7c: $30/visit;7i: $30/visit	7a: $20; 7d: $30/visit; 8b: $10/visit; 8b: $100/visit; 8b: 50/visit; 14h: $0/visit	7g: $30/visit;14b: $10/visit;14i: 20%; 7a: $20/visit; 7d: $30/visit; 8a: $10/visit; 12: 20%	15: 20%	13a: $0		16a: $200 allowance	17a1: $30/visit	17b1: $100 every 2 yr	18a1: $30/visit		14a: $100 max	14c1: $10/visit;13a1: $0											118.5599514	114.9963673	52.50436424		100	0.1316	0.1316	50	232.2125766	10	59.92093417	250	0.2	42.65217848	19.99865878	30	29.77502781	29.78609204	8.027849639	7.674566308	0.2				30		30			10											93.68857966	90.87256025	41.49005845		79.02211379	0.103993102	0.103993102	39.51105689	183.4992865	7.902211379	47.35078878	197.5552845	0.158044228	33.93494529	19.99865878	30	29.77502781	29.78609204	8.027849639	7.674566308	0.158044228				30		30			10											10.534	0.258442171	3.421063126	0	0.776265262	1.017674492	0.837415788	0.87860861	3.639188436	0.159730223	1.558258001	0.130130857	0.098560052	1.308750908	5.084053697	11.41325953	0.405954483	0.882884292	2.099809235	5.99490825	3.630964334	0	0	0	0.24973146	0	0.592765572	0	0	0.08205	0	0	0	0	0	0	0	0	0	0	55.0545	0	7.488	10.534	0.258442171	3.421063126	0	0.776265262	1.017674492	0.837415788	0.87860861	3.639188436	0.159730223	1.558258001	0.130130857	0.098560052	1.308750908	5.084053697	11.41325953	0.405954483	0.882884292	2.099809235	5.99490825	3.630964334	0	0	0	0.24973146	0	0.592765572	0	0	0.08205	0	0	0	0	0	0	0	0	0	0	55.0545		OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: $100/trip	OON: 40%	OON: 40%	OON: $50/visit	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 40%;OON: 20%	OON: 20%	OON: 20%;OON: $30/visit	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%		OON: $200 allowance	OON: $30/visit	OON: $100 every 2 yr	OON: $30/visit		OON: 50%; $50 max	OON: 20%											3.2826	0.0437	0.5223	0.3021	0.0907	0.3511	0.2889	0.1036	0.4678	0.0155	0.2572	0.004	0.0189	0.3111	0.6003	2.037	0.0233	0.0619	0.3772	0.3074	0.4121				0.0562		0.0659		0.0908	0.0356											10.1272	0	1.756	13.8166	0.302108725	3.943347585	0.302066597	0.867009018	1.368735313	1.126293888	0.982200612	4.107037847	0.175274342	1.815450439	0.134133359	0.11741335	1.619837831	5.684373907	13.45026822	0.429260846	0.944826509	2.476981296	6.30231492	4.04305365	0	0	0	0.305935369	0	0.658628413	0	0.090827884	0.117662421	0	0	0	0	0	0	0	0	0	0	65.1817
H2947_002_0	2009	7																					1200											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	O	P																																																			0	2400	1486.672112	37.60438441	1090.218304		129.8881038	10.78284213	8.872898267	294.025282	262.2273772	267.2676056	435.13099	8.709625978	0.687149405	509.9383916	3361.376238	5030.32802	180.2739745	391.9206349	3458.505568	10328.48362	25.31466788				99.89258411		237.1062288			98.46											1a: Days 1 - 7: $100/day then $0;1a1: Days 1 - 7: $100/day then $0	1b: Days 1 - 7: $100/day then $0	"2: Days 1 - 7: $0/day, then $100/day"	6: $0	10a: $100/trip	11a: 20% (Oxygen 100% covered)	11b: 20% (Oxygen 100% covered);11c: 20%	4a: $50/visit;4a1: $50/visit;4b: $25/visit	9a: $150/visit;9b: $150/visit	8a: $5/visit;8a: $20/visit	8b: $5/visit;8b: $100/visit;8b: $50/visit	9a: $150/visit	12a: 20%	3: 20%;5: $100/day;9a: $50/visit;9c: $20/visit;9d: $20/visit; 7i: $20/visit; 7c: $20/visit; 7e: $20/visit	7a: $10/visit;14c: $5/visit	7b: $20/visit;7d: $20/visit;7f: $20/visit;16b: $20/visit;17a: $20 cpay;18a: $20/visit	7e: $20/visit;7h: $20/visit	7c: $20/visit;7i: $20/visit	7a: $10; 7d: $20/visit; 8b: $5/visit; 8b: $100/visit; 8b: $50/visit; 14h: $0/visit	7g: $20/visit;14b: $5/visit;14i: 20%; 7a: $10/visit; 7d: $20/visit; 8a: $5/visit; 12: 20%	15: 20%	13a: $0		16a: $200 allowance	17a1: $20/visit	17b1: $200 every 2 yr	18a1: $20/visit		14a: $100 max	14c1: $5/visit;13a1: $0											79.03996757	76.66424489	52.50436424		100	0.1316	0.1316	50	139.327546	5	58.01396228	150	0.2	38.55571892	9.999329389	20	19.85001854	19.78609204	5.296399405	4.851189537	0.2				20		20			5											54.76779287	53.12162459	36.38093782		69.29126434	0.091187304	0.091187304	34.64563217	96.54181818	3.464563217	40.19860796	103.9368965	0.138582529	27.05286306	9.999329389	20	19.85001854	19.78609204	5.296399405	4.851189537	0.138582529				20		20			5											6.7851	0.166467166	3.305263695	0	0.750009245	0.983258302	0.809095671	0.848890981	2.109658981	0.077163793	1.45763834	0.075437624	0.095226902	1.14960779	2.800959017	8.383880034	0.298203478	0.646214813	1.526468903	4.175452641	3.508170688	0	0	0	0.16648764	0	0.395177048	0	0	0.041025	0	0	0	0	0	0	0	0	0	0	40.5549	0	9.783	6.7851	0.166467166	3.305263695	0	0.750009245	0.983258302	0.809095671	0.848890981	2.109658981	0.077163793	1.45763834	0.075437624	0.095226902	1.14960779	2.800959017	8.383880034	0.298203478	0.646214813	1.526468903	4.175452641	3.508170688	0	0	0	0.16648764	0	0.395177048	0	0	0.041025	0	0	0	0	0	0	0	0	0	0	40.5549		"OON: Day 1-7: $250/day, then $0"	"OON: Day 1-7: $250/day, then $0"	"OON: Day 1-7: $0/day, then $100"	OON: 20%	OON: $100/trip	OON: 20%	OON: 20%	OON: $50/visit;OON: $25/visit	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 40%;OON: 20%	OON: $20/visit;OON: 20%	OON: $30/visit;OON: $20/visit;OON: $20 copay	OON: $30/visit	OON: $30/visit	OON: $20/visit	OON: $30/visit;OON: 20%	OON: 20%	OON: 20%		OON: $200 allowance	OON: $20/visit	OON: $200 every 2 yr	OON: $30/visit		OON: 50%; $50 max	OON: 20%											1.8666	0.0457	0.3731	0.2774	0.0833	0.1612	0.1327	0.0951	0.4297	0.0143	0.2362	0.0037	0.0087	0.2226	0.6552	1.4677	0.0523	0.1138	0.2654	0.7244	0.3785				0.0185	0.0317	0.0659		0.0757	0.033											7.8324	0	2.304	8.6517	0.21221391	3.678323327	0.277449879	0.833357462	1.144483977	0.941763755	0.943965215	2.539381312	0.091441154	1.693871049	0.079113945	0.103885333	1.372239026	3.456154109	9.851569239	0.350519878	0.759994385	1.791881643	4.899853376	3.886677057	0	0	0	0.184986267	0.031670958	0.461039889	0	0.075713294	0.074048498	0	0	0	0	0	0	0	0	0	0	48.3873
H2947_801_0	2009	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																																																			0		212.0446146	2.860083864	34.23559081		6.112083879	10.25469598	8.43830162	10.76265657	32.43317458	1.077579926	17.82959864	0.277469299	0.653492665	21.22587961	27.69967927	91.56099746	1.075390715	2.85810726	17.40328733	14.18420708	24.07474949																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.089682303	0.089682303	0.200311189		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.089682303	0.089682303	0.200311189		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				19.0166	0.256498907	6.857771896	0	1.411891376	2.368834772	1.949247674	2.486173668	7.492063327	0.248920963	4.118637286	0.064095408	0.150956806	4.90317819	6.398625912	21.15059041	0.248415255	0.660222777	4.020159372	3.276551835	5.561267132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.6408	0	0	19.0166	0.256498907	6.857771896	0	1.411891376	2.368834772	1.949247674	2.486173668	7.492063327	0.248920963	4.118637286	0.064095408	0.150956806	4.90317819	6.398625912	21.15059041	0.248415255	0.660222777	4.020159372	3.276551835	5.561267132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.6408		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				1.9268	0.026	0.6938		0.1603	0.269	0.2213	0.2379	0.7169	0.0238	0.3941	0.0061	0.0144	0.4692	0.7266	2.4017	0.0282	0.075	0.4565	0.3721	0.6315																				9.8513	0	0	20.9434	0.282477926	7.55158658	0	1.572190424	2.637821857	2.170589601	2.724085023	8.209007186	0.272741151	4.512765256	0.07022894	0.165402433	5.372381845	7.125205814	23.55229261	0.276623426	0.735192717	4.476658478	3.648612453	6.192762861	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.4921
H2947_802_0	2009	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																																																			0		212.0446146	2.860083864	34.23559081		6.112083879	10.25469598	8.43830162	10.76265657	32.43317458	1.077579926	17.82959864	0.277469299	0.653492665	21.22587961	27.69967927	91.56099746	1.075390715	2.85810726	17.40328733	14.18420708	24.07474949																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.089682303	0.089682303	0.200311189		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.089682303	0.089682303	0.200311189		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				19.0166	0.256498907	6.857771896	0	1.411891376	2.368834772	1.949247674	2.486173668	7.492063327	0.248920963	4.118637286	0.064095408	0.150956806	4.90317819	6.398625912	21.15059041	0.248415255	0.660222777	4.020159372	3.276551835	5.561267132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.6408	0	0	19.0166	0.256498907	6.857771896	0	1.411891376	2.368834772	1.949247674	2.486173668	7.492063327	0.248920963	4.118637286	0.064095408	0.150956806	4.90317819	6.398625912	21.15059041	0.248415255	0.660222777	4.020159372	3.276551835	5.561267132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.6408		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				1.9268	0.026	0.6938		0.1603	0.269	0.2213	0.2379	0.7169	0.0238	0.3941	0.0061	0.0144	0.4692	0.7266	2.4017	0.0282	0.075	0.4565	0.3721	0.6315																				9.8513	0	0	20.9434	0.282477926	7.55158658	0	1.572190424	2.637821857	2.170589601	2.724085023	8.209007186	0.272741151	4.512765256	0.07022894	0.165402433	5.372381845	7.125205814	23.55229261	0.276623426	0.735192717	4.476658478	3.648612453	6.192762861	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.4921
H2947_803_0	2009	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																																																			0		212.0446146	2.860083864	34.23559081		6.112083879	10.25469598	8.43830162	10.76265657	32.43317458	1.077579926	17.82959864	0.277469299	0.653492665	21.22587961	27.69967927	91.56099746	1.075390715	2.85810726	17.40328733	14.18420708	24.07474949																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.089682303	0.089682303	0.200311189		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.089682303	0.089682303	0.200311189		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				19.0166	0.256498907	6.857771896	0	1.411891376	2.368834772	1.949247674	2.486173668	7.492063327	0.248920963	4.118637286	0.064095408	0.150956806	4.90317819	6.398625912	21.15059041	0.248415255	0.660222777	4.020159372	3.276551835	5.561267132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.6408	0	0	19.0166	0.256498907	6.857771896	0	1.411891376	2.368834772	1.949247674	2.486173668	7.492063327	0.248920963	4.118637286	0.064095408	0.150956806	4.90317819	6.398625912	21.15059041	0.248415255	0.660222777	4.020159372	3.276551835	5.561267132	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.6408		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				1.9268	0.026	0.6938		0.1603	0.269	0.2213	0.2379	0.7169	0.0238	0.3941	0.0061	0.0144	0.4692	0.7266	2.4017	0.0282	0.075	0.4565	0.3721	0.6315																				9.8513	0	0	20.9434	0.282477926	7.55158658	0	1.572190424	2.637821857	2.170589601	2.724085023	8.209007186	0.272741151	4.512765256	0.07022894	0.165402433	5.372381845	7.125205814	23.55229261	0.276623426	0.735192717	4.476658478	3.648612453	6.192762861	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.4921
H2949_002_0	2009	8	r.	s.	t.	u.	v.	w.	x.				OP Facility - Other	OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered					Radiology	Other									D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	P	Coin	V	V	V	V			Coin		T		V				O	O	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	0	0				0		1919.56956	67.627679	836.71187	1441.434207	305.672488	11.431511	3.02448	350.638862	247.656326	141.232638	21.688005	0	20.656606	0.971703	5631.742508	5453.007179	3.863772	650.617103			37.475671		2.5		2.5				1.52	0.05	804.531677	235.32775	0.06	0.09	1.23	2.7	0.58				$195/Day(Days 1-5):1a	$195/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	"0%-20% Coins:11b. 0% Supplies,11b. 20% Prosthetics"	$50/Visit:4a	"$0-$175/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $175 Surgery OP -- Facility"	"$0-$175/Visit:8a. $0 Lab -- FSL,8. $175 Lab -- OP"	"20% Coins:14h, 8a, 8b, 9a"	$175/Visit:9a	"$0-$175/Proc:12. $0 Dialysis -- Dialysis Center,12. $175 Dialysis -- OP Hosp"	"20% Coins:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"			20% Coins:15		$0 Other - Transportation 10b		VIS 806				$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$175/Visit:14h. 20% DMAM -- OP,8b. $15 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. 20% Advanced Imaging -- Office,9a. 20% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $175 Radiology OP -- Facility"	"$30-$175/Visit:9d. $30 Cardiac Rehab,8b. 20% Nuclear Medicine,9a. $175 OP Other,5. $150 Partial Hospitalization,8b. 20% Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$0: Nurse hotline 14a	$0: Nutritional benefit 14a	$0: Health Education Materials 14a	$0 Corp Health 14a	OTC 001				119.55489	99.65949	43.132797	0	100.00001	0.199999	0.085423	49.999991	115.756946	99.763228	0.2	0	0	0.2	0	30	29.998664	30.000004			0.199999		0		0				0	0	20.089401	154.362534	0	0	0	0	0				119.55489	99.65949	43.132797	0	100.00001	0.199999	0.085423	49.999991	115.756946	99.763228	0.2	0	0	0.2	0	30	29.998664	30.000004			0.199999		0		0				0	0	20.089401	154.362534	0	0	0	0	0				19.1245	0.561645	3.007476936	0	2.547270988	2.286290768	0.258360155	1.460994995	2.388994996	1.174151989	4.337601	0	0	0.1943406	0	13.63251795	0.009659	1.626542974	0	0	7.495096724	0	0	0	0	0	0	0	0	0	1.346879956	3.027148984	0	0	0	0	0	0	0	0	64.4795	0	0	19.1245	0.561645	3.007476936	0	2.547270988	2.286290768	0.258360155	1.460994995	2.388994996	1.174151989	4.337601	0	0	0.1943406	0	13.63251795	0.009659	1.626542974	0	0	7.495096724	0	0	0	0	0	0	0	0	0	1.346879956	3.027148984	0	0	0	0	0	0	0	0	64.4795																																																																																		0	0	0	19.1245	0.561645	3.007476936	0	2.547270988	2.286290768	0.258360155	1.460994995	2.388994996	1.174151989	4.337601	0	0	0.1943406	0	13.63251795	0.009659	1.626542974	0	0	7.495096724	0	0	0	0	0	0	0	0	0	1.346879956	3.027148984	0	0	0	0	0	0	0	0	64.4795
H2949_007_0	2009	6	r.	s.	t.	u.	v.	w.	x.				OP Facility - Other	OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered					Radiology	Other									D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	P	Coin	V	V	V	V			Coin		T		V				O	O	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	0	0				0		1921.248934	67.686845	837.443886	1442.695277	305.939911	11.451538	3.029779	350.945625	247.872994	141.356198	21.726002	0	20.674679	0.973405	5636.669557	5457.777858	3.867151	651.18631			37.541328		2.5		2.5				1.52	0.05	805.235535	235.533632	0.06	0.09	1.23	2.7	0.58				$100/Day(Days 1-5):1a	$100/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	"0%-20% Coins:11b. 0% Supplies,11b. 20% Prosthetics"	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"20% Coins:14h, 8a, 8b, 9a"	$100/Visit:9a	$0/Proc:12	"20% Coins:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"			20% Coins:15		$0 Other - Transportation 10b		VIS 806				$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$100/Visit:14h. 20% DMAM -- OP,8b. $15 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. 20% Advanced Imaging -- Office,9a. 20% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	"$30-$150/Visit:9d. $30 Cardiac Rehab,8b. 20% Nuclear Medicine,9a. $100 OP Other,5. $150 Partial Hospitalization,8b. 20% Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$0: Nurse hotline 14a	$0: Nutritional benefit 14a	$0: Health Education Materials 14a	$0 Corp Health 14a	OTC 001				61.310199	51.107419	43.132795	0	99.999989	0.2	0.085423	49.999985	85.18924	57.00756	0.199999	0	0	0.2	0	30	30.00038	30.000004			0.199999		0		0				0	0	16.436905	130.049554	0	0	0	0	0				61.310199	51.107419	43.132795	0	99.999989	0.2	0.085423	49.999985	85.18924	57.00756	0.199999	0	0	0.2	0	30	30.00038	30.000004			0.199999		0		0				0	0	16.436905	130.049554	0	0	0	0	0				9.816	0.288274996	3.010107955	0	2.549498978	2.2903076	0.258812812	1.462272999	1.759675998	0.671530995	4.345178674	0	0	0.194681	0	13.64444465	0.009668	1.627965992	0	0	7.508228059	0	0	0	0	0	0	0	0	0	1.102964999	2.552586983	0	0	0	0	0	0	0	0	53.0922	0	0	9.816	0.288274996	3.010107955	0	2.549498978	2.2903076	0.258812812	1.462272999	1.759675998	0.671530995	4.345178674	0	0	0.194681	0	13.64444465	0.009668	1.627965992	0	0	7.508228059	0	0	0	0	0	0	0	0	0	1.102964999	2.552586983	0	0	0	0	0	0	0	0	53.0922																																																																																		0	0	0	9.816	0.288274996	3.010107955	0	2.549498978	2.2903076	0.258812812	1.462272999	1.759675998	0.671530995	4.345178674	0	0	0.194681	0	13.64444465	0.009668	1.627965992	0	0	7.508228059	0	0	0	0	0	0	0	0	0	1.102964999	2.552586983	0	0	0	0	0	0	0	0	53.0922
H2949_009_0	2009	6	r.	s.	t.	u.	v.	w.	x.				OP Facility - Other	OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered					Radiology	Other									D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	P	Coin	V	V	V	V			Coin		T	Coin	V		V		O	O	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	0	0	0	0				0		1951.926093	68.767622	850.815602	1465.731226	310.824946	11.82014	3.127302	356.549279	251.830857	143.613275	22.425319	0	21.004798	1.004737	5726.671951	5544.923836	3.9289	661.583997			38.749708		2.5	2.59	2.5		0.21		1.52	2.39	818.092974	239.294471	0.06	0.05	0.09	1.23	2.7				$50/Day(Days 1-5):1a	$50/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	"0%-20% Coins:11b. 0% Supplies,11b. 20% Prosthetics"	$50/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"20% Coins:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"			20% Coins:15		$0 Other - Transportation 10b	"DEN 813 16a, 16b"	VIS 806		HER 805		$0: Membership in health club/fitness class 14a	Chiro/Acupuncture	"$0-$15/Visit:14h. 20% DMAM -- OP,8b. $15 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. 20% Advanced Imaging -- Office,9a. 20% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $0 Radiology OP -- Facility"	"$0-$150/Visit:9d. $30 Cardiac Rehab,8b. 20% Nuclear Medicine,9a. $0 OP Other,5. $150 Partial Hospitalization,8b. 20% Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0: Nutritional benefit 14a	$0: Health Education Materials 14a	$0 Corp Health 14a				30.655099	25.553711	43.132805	0	100.000004	0.2	0.085423	50	0	0	0.2	0	0	0.2	0	29.999998	29.999236	30			0.2		0	0	0		0		0	0	11.566905	97.632209	0	0	0	0	0				30.655099	25.553711	43.132805	0	100.000004	0.2	0.085423	50	0	0	0.2	0	0	0.2	0	29.999998	29.999236	30			0.2		0	0	0		0		0	0	11.566905	97.632209	0	0	0	0	0				4.9864	0.146438995	3.058171954	0	2.590207987	2.364028	0.267143519	1.485621996	0	0	4.4850638	0	0	0.2009474	0	13.86230867	0.009822	1.653959993	0	0	7.7499416	0	0	0	0	0	0	0	0	0	0.788566976	1.946903984	0	0	0	0	0	0	0	0	45.5955	0	0	4.9864	0.146438995	3.058171954	0	2.590207987	2.364028	0.267143519	1.485621996	0	0	4.4850638	0	0	0.2009474	0	13.86230867	0.009822	1.653959993	0	0	7.7499416	0	0	0	0	0	0	0	0	0	0.788566976	1.946903984	0	0	0	0	0	0	0	0	45.5955																																																																																		0	0	0	4.9864	0.146438995	3.058171954	0	2.590207987	2.364028	0.267143519	1.485621996	0	0	4.4850638	0	0	0.2009474	0	13.86230867	0.009822	1.653959993	0	0	7.7499416	0	0	0	0	0	0	0	0	0	0.788566976	1.946903984	0	0	0	0	0	0	0	0	45.5955
H2949_011_0	2009	7	r.	s.	t.	u.	v.	w.					OP Facility - Other	OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered						Radiology	Other									D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	P	Coin	V	V	V	V			Coin		T	Coin	V		V		O	O	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	0	0	0	0					0		1976.058561	69.617824	861.334587	1483.852666	314.667803	12.114243	3.205114	360.957446	254.944345	145.388826	22.983295	0	21.264488	1.029737	5797.47316	5613.478016	3.977475	669.763433			39.71386		2.5	2.59	2.5		0.21		1.52	0.05	828.207397	242.252965	0.06	0.09	1.23	2.7					$50/Day(Days 1-5):1a	$50/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	"0%-20% Coins:11b. 0% Supplies,11b. 20% Prosthetics"	$50/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"20% Coins:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"			20% Coins:15		$0 Other - Transportation 10b	"DEN 813 16a, 16b"	VIS 806		HER 805		$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$15/Visit:14h. 20% DMAM -- OP,8b. $15 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. 20% Advanced Imaging -- Office,9a. 20% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $0 Radiology OP -- Facility"	"$0-$150/Visit:9d. $30 Cardiac Rehab,8b. 20% Nuclear Medicine,9a. $0 OP Other,5. $150 Partial Hospitalization,8b. 20% Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$0: Nurse hotline 14a	$0: Nutritional benefit 14a	$0: Health Education Materials 14a	$0 Corp Health 14a					30.655101	25.553628	43.132799	0	100.000011	0.2	0.085423	49.999988	0	0	0.2	0	0	0.2	0	29.999999	30.000942	30.000007			0.199999		0	0	0		0		0	0	11.566899	97.632241	0	0	0	0					30.655101	25.553628	43.132799	0	100.000011	0.2	0.085423	49.999988	0	0	0.2	0	0	0.2	0	29.999999	30.000942	30.000007			0.199999		0	0	0		0		0	0	11.566899	97.632241	0	0	0	0					5.048	0.148248998	3.095980968	0	2.62223198	2.4228486	0.273790453	1.503988997	0	0	4.596659	0	0	0.2059474	0	14.03369457	0.009944	1.674408973	0	0	7.942732286	0	0	0	0	0	0	0	0	0	0.798315943	1.970974988	0	0	0	0	0	0	0	0	46.3478	0	0	5.048	0.148248998	3.095980968	0	2.62223198	2.4228486	0.273790453	1.503988997	0	0	4.596659	0	0	0.2059474	0	14.03369457	0.009944	1.674408973	0	0	7.942732286	0	0	0	0	0	0	0	0	0	0.798315943	1.970974988	0	0	0	0	0	0	0	0	46.3478																																																																																		0	0	0	5.048	0.148248998	3.095980968	0	2.62223198	2.4228486	0.273790453	1.503988997	0	0	4.596659	0	0	0.2059474	0	14.03369457	0.009944	1.674408973	0	0	7.942732286	0	0	0	0	0	0	0	0	0	0.798315943	1.970974988	0	0	0	0	0	0	0	0	46.3478
H2949_012_0	2009	6	r.	s.	t.	u.	v.	w.	x.				OP Facility - Other	OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered					Radiology	Other									D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	P	Coin	V	V	V	V			Coin		T		Coin				O	O	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	0	0				0		1889.308814	66.561575	823.521661	1418.71095	300.853763	11.073939	2.929876	345.111272	243.752188	139.006197	21.009616	0	20.330968	0.941309	5542.961807	5367.044122	3.802861	640.360553			36.303452		2.5		2.5				1.52	0.05	791.848765	231.617965	0.06	0.09	1.23	2.7	0.58				$50/Day(Days 1-5):1a	$50/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	"0%-20% Coins:11b. 0% Supplies,11b. 20% Prosthetics"	$50/Visit:4a	"$0-$75/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $75 Surgery OP -- Facility"	"$0-$75/Visit:8a. $0 Lab -- FSL,8. $75 Lab -- OP"	"20% Coins:14h, 8a, 8b, 9a"	$75/Visit:9a	$0/Proc:12	"20% Coins:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"			20% Coins:15		$0 Other - Transportation 10b		"VIS 806 16a, 16b"				$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$75/Visit:14h. 20% DMAM -- OP,8b. $15 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. 20% Advanced Imaging -- Office,9a. 20% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $75 Radiology OP -- Facility"	"$30-$150/Visit:9d. $30 Cardiac Rehab,8b. 20% Nuclear Medicine,9a. $75 OP Other,5. $150 Partial Hospitalization,8b. 20% Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$0: Nurse hotline 14a	$0: Nutritional benefit 14a	$0: Health Education Materials 14a	$0 Corp Health 14a	OTC 001				30.655102	25.553662	43.132796	0	100.000012	0.2	0.085423	50.000012	75.00004	42.755647	0.2	0	0	0.2	0	29.999999	29.999518	29.999992			0.2		0		0				0	0	15.219406	121.945255	0	0	0	0	0				30.655102	25.553662	43.132796	0	100.000012	0.2	0.085423	50.000012	75.00004	42.755647	0.2	0	0	0.2	0	29.999999	29.999518	29.999992			0.2		0		0				0	0	15.219406	121.945255	0	0	0	0	0				4.8264	0.141740999	2.960065984	0	2.507114993	2.2147878	0.250278798	1.437963978	1.523451988	0.495274991	4.2019232	0	0	0.1882618	0	13.41760986	0.009507	1.600900956	0	0	7.2606904	0	0	0	0	0	0	0	0	0	1.004288987	2.353725984	0	0	0	0	0	0	0	0	46.394	0	0	4.8264	0.141740999	2.960065984	0	2.507114993	2.2147878	0.250278798	1.437963978	1.523451988	0.495274991	4.2019232	0	0	0.1882618	0	13.41760986	0.009507	1.600900956	0	0	7.2606904	0	0	0	0	0	0	0	0	0	1.004288987	2.353725984	0	0	0	0	0	0	0	0	46.394																																																																																		0	0	0	4.8264	0.141740999	2.960065984	0	2.507114993	2.2147878	0.250278798	1.437963978	1.523451988	0.495274991	4.2019232	0	0	0.1882618	0	13.41760986	0.009507	1.600900956	0	0	7.2606904	0	0	0	0	0	0	0	0	0	1.004288987	2.353725984	0	0	0	0	0	0	0	0	46.394
H2949_805_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		349.336816	11.685504	910.767267	1569.012155	9.31723	13.544604	3.58355	31.20434	50.695438	153.732807	36.884501	0	0.462589	6.387016	51.457065	113.168009	0.130474	6.464923			44.402981																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000001	1023.999991	43.132801	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.2	0.199999	0.2	0.2	0.5	0.199999			0.199999																				1024.000001	1023.999991	43.132801	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.2	0.199999	0.2	0.2	0.5	0.199999			0.199999																				29.8101	0.997162999	3.27366194	0	1.863446	2.7089208	0.71671	6.240868	10.1390876	0	7.3769002	0	0.0925178	1.277396813	10.291413	22.6336018	0.065237	1.292978135	0	0	8.880551797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.6605	0	0	29.8101	0.997162999	3.27366194	0	1.863446	2.7089208	0.71671	6.240868	10.1390876	0	7.3769002	0	0.0925178	1.277396813	10.291413	22.6336018	0.065237	1.292978135	0	0	8.880551797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.6605																																																																																		0	0	0	29.8101	0.997162999	3.27366194	0	1.863446	2.7089208	0.71671	6.240868	10.1390876	0	7.3769002	0	0.0925178	1.277396813	10.291413	22.6336018	0.065237	1.292978135	0	0	8.880551797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.6605
H2949_807_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		349.336816	11.685504	910.767267	1569.012155	9.31723	13.544604	3.58355	31.20434	50.695438	153.732807	36.884501	0	0.462589	6.387016	51.457065	113.168009	0.130474	6.464923			44.402981																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000001	1023.999991	43.132801	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.2	0.199999	0.2	0.2	0.5	0.199999			0.199999																				1024.000001	1023.999991	43.132801	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.2	0.199999	0.2	0.2	0.5	0.199999			0.199999																				29.8101	0.997162999	3.27366194	0	1.863446	2.7089208	0.71671	6.240868	10.1390876	0	7.3769002	0	0.0925178	1.277396813	10.291413	22.6336018	0.065237	1.292978135	0	0	8.880551797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.6605	0	0	29.8101	0.997162999	3.27366194	0	1.863446	2.7089208	0.71671	6.240868	10.1390876	0	7.3769002	0	0.0925178	1.277396813	10.291413	22.6336018	0.065237	1.292978135	0	0	8.880551797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.6605																																																																																		0	0	0	29.8101	0.997162999	3.27366194	0	1.863446	2.7089208	0.71671	6.240868	10.1390876	0	7.3769002	0	0.0925178	1.277396813	10.291413	22.6336018	0.065237	1.292978135	0	0	8.880551797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.6605
H2949_808_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		349.336816	11.685504	910.767267	1569.012155	9.31723	13.544604	3.58355	31.20434	50.695438	153.732807	36.884501	0	0.462589	6.387016	51.457065	113.168009	0.130474	6.464923			44.402981																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000001	1023.999991	43.132801	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.2	0.199999	0.2	0.2	0.5	0.199999			0.199999																				1024.000001	1023.999991	43.132801	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.2	0.199999	0.2	0.2	0.5	0.199999			0.199999																				29.8101	0.997162999	3.27366194	0	1.863446	2.7089208	0.71671	6.240868	10.1390876	0	7.3769002	0	0.0925178	1.277396813	10.291413	22.6336018	0.065237	1.292978135	0	0	8.880551797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.6605	0	0	29.8101	0.997162999	3.27366194	0	1.863446	2.7089208	0.71671	6.240868	10.1390876	0	7.3769002	0	0.0925178	1.277396813	10.291413	22.6336018	0.065237	1.292978135	0	0	8.880551797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.6605																																																																																		0	0	0	29.8101	0.997162999	3.27366194	0	1.863446	2.7089208	0.71671	6.240868	10.1390876	0	7.3769002	0	0.0925178	1.277396813	10.291413	22.6336018	0.065237	1.292978135	0	0	8.880551797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.6605
H2949_810_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		349.336816	11.685504	910.767267	1569.012155	9.31723	13.544604	3.58355	31.20434	50.695438	153.732807	36.884501	0	0.462589	6.387016	51.457065	113.168009	0.130474	6.464923			44.402981																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000001	1023.999991	43.132801	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.2	0.199999	0.2	0.2	0.5	0.199999			0.199999																				1024.000001	1023.999991	43.132801	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.2	0.199999	0.2	0.2	0.5	0.199999			0.199999																				29.8101	0.997162999	3.27366194	0	1.863446	2.7089208	0.71671	6.240868	10.1390876	0	7.3769002	0	0.0925178	1.277396813	10.291413	22.6336018	0.065237	1.292978135	0	0	8.880551797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.6605	0	0	29.8101	0.997162999	3.27366194	0	1.863446	2.7089208	0.71671	6.240868	10.1390876	0	7.3769002	0	0.0925178	1.277396813	10.291413	22.6336018	0.065237	1.292978135	0	0	8.880551797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.6605																																																																																		0	0	0	29.8101	0.997162999	3.27366194	0	1.863446	2.7089208	0.71671	6.240868	10.1390876	0	7.3769002	0	0.0925178	1.277396813	10.291413	22.6336018	0.065237	1.292978135	0	0	8.880551797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.6605
H2960_004_0	2009	7																					3500											D	D	A	V	Coin	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1312.141112	15.40841269	103.2822101	1205.580231	12.9563706	15.38618513	11.25795278	649.0354807	332.5395213	412.7385425	2322.704349	38.00563056	1.604021812	1255.486284	7138.254922	4210.517147	227.195775	404.1166891	339.2288199	1322.712278	0.998706253	2.475996957	0	0	459.9109877	162.0777991	0	0	0	26.69192956											PBP: 1A IP Acute: $200 per day (days 1-5)	1B IP Psych: $200 per day (days 1-5)	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: 30%	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0-20%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $200	8A OP C/D/T: $0	"8B: $50 Routine Imaging, $75 CT, $100 PET, MRI, and Nuclear Medicine"	9A OP Hospital: $0	12 Renal Dialysis: 20%	"3 CORF: $50, 5 Partial Hosp: $40, 9D Cardiac Rehab: $15"	"7A PCP: $10, 14B Immunizations: $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: $40, 7D Physician Specialist: $40, 7F Podiatry: $40"	"7E Mental Health: $40, 7H Psychiatric: $40, 9C OP Substance Abuse: $40,"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	7D Physician Specialist: $40	"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: $0, 16B Additional Comprehensive Dental Coverage: 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, Membership in Health Club $0"											200	200	440.032268	6.75	0.3	0.2	0.2	45.66795192	200	0	55.41069924	0	0.2	33.02141647	9.9	40	40	20	40	40	0.2	21.25864151	0	0	20	0	0	0	0	0											190	190	418.0306546	6.4125	0.285	0.19	0.19	43.38455432	190	0	52.64016428	0	0.19	31.37034565	9.405	38	38	19	38	38	0.19	20.19570944	0	0	19	0	0	0	0	0											20.7756	0.243966534	3.597927492	0.644231936	3.69256562	2.923375175	2.139011027	2.346509589	5.265209087	0	10.18896154	0	0.304764144	3.282086557	5.594607295	13.3333043	0.719453287	0.639851424	1.074224596	4.188588881	0.189754188	0.004167043	0	0	0.728192397	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.8763	0	4.3093	20.7756	0.243966534	3.597927492	0.644231936	3.69256562	2.923375175	2.139011027	2.346509589	5.265209087	0	10.18896154	0	0.304764144	3.282086557	5.594607295	13.3333043	0.719453287	0.639851424	1.074224596	4.188588881	0.189754188	0.004167043	0	0	0.728192397	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.8763	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.7756	0.243966534	3.597927492	0.644231936	3.69256562	2.923375175	2.139011027	2.346509589	5.265209087	0	10.18896154	0	0.304764144	3.282086557	5.594607295	13.3333043	0.719453287	0.639851424	1.074224596	4.188588881	0.189754188	0.004167043	0	0	0.728192397	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.8763
H2960_009_0	2009	5																					4000											D	D	A	V	Coin	Coin	Coin	V	Coin	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	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	793.2821887	8.272855593	69.00800654	805.5084063	8.656798747	10.28027928	7.522000915	433.6530431	15.52281399	275.7712486	1551.914863	25.39346128	1.071727141	838.8531346	4769.424879	2813.256945	151.8008524	270.0105575	226.655729	883.7701814	0.998706253	1.654337316	0	0	307.289517	108.2922781	0	0	0	17.83421218											PBP: 1A IP Acute: $250 per day (days 1-4)	1B IP Psych: $250 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: 30%	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0-20%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: 20%	8A OP C/D/T: $0	"8B: $50 Routine Imaging, $75 CT, $100 PET, MRI, and Nuclear Medicine"	9A OP Hospital: $0	12 Renal Dialysis: 20%	"3 CORF: $50, 5 Partial Hosp: $40, 9D Cardiac Rehab: $15"	"7A PCP: $10, 14B Immunizations: $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: $40, 7D Physician Specialist: $40, 7F Podiatry: $40"	"7E Mental Health: $40, 7H Psychiatric: $40, 9C OP Substance Abuse: $40,"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	7D Physician Specialist: $40	"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, 16B Additional Comprehensive Dental Coverage: 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											250	250	440.032268	6.75	0.3	0.2	0.2	45.66795192	0.2	0	55.41069924	0	0.2	33.02141647	9.9	40	40	20	40	40	0.2	21.25864151	0	0	20	0	0	0	0	0											237.5	237.5	418.0306546	6.4125	0.285	0.19	0.19	43.38455432	0.19	0	52.64016428	0	0.19	31.37034565	9.405	38	38	19	38	38	0.19	20.19570944	0	0	19	0	0	0	0	0											15.7004	0.1637336	2.403955179	0.430443555	2.467187643	1.953253063	1.429180174	1.567820334	2.949334659	0	6.807754443	0	0.203628157	2.192926065	3.738036749	8.908646992	0.480702699	0.427516716	0.717743142	2.798605574	0.189754188	0.00278421	0	0	0.486541735	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0199	0	2.9484	15.7004	0.1637336	2.403955179	0.430443555	2.467187643	1.953253063	1.429180174	1.567820334	2.949334659	0	6.807754443	0	0.203628157	2.192926065	3.738036749	8.908646992	0.480702699	0.427516716	0.717743142	2.798605574	0.189754188	0.00278421	0	0	0.486541735	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0199	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	15.7004	0.1637336	2.403955179	0.430443555	2.467187643	1.953253063	1.429180174	1.567820334	2.949334659	0	6.807754443	0	0.203628157	2.192926065	3.738036749	8.908646992	0.480702699	0.427516716	0.717743142	2.798605574	0.189754188	0.00278421	0	0	0.486541735	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0199
H2960_010_0	2009	7																					3000											D	D	A	V	Coin	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1083.308778	12.88240577	106.5777235	1244.047705	13.46341751	15.87713406	11.61716986	672.836872	345.8171128	425.9081424	2396.816853	39.21830856	1.655202701	1296.022211	7366.021297	4447.097835	239.9614593	417.0111842	353.9838526	1395.248678	0.998706253	2.561147467	0	0	474.585759	167.2493533	0	0	0	27.54361167											PBP: 1A IP Acute: $150 per day (days 1-3)	1B IP Psych: $150 per day (days 1-3)	2 SNF: $200 per stay plus $25 per day for days 35-100 only	"6 Home Health: $0, 13C Custodial Care: $150 per episode"	10A Ambulance: 20%	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0-20%"	"4A ER: $50, 4B Urgent Care: $20"	"9B ASC Services: $150, 9A HOP - Surgery $150"	8A OP C/D/T: $0	"8B: $25 Routine Imaging, $75 CT, $100 PET, MRI, and Nuclear Medicine"	9A OP Hospital: $0	12 Renal Dialysis: 20%	"3 CORF: $50, 5 Partial Hosp: $30, 9D Cardiac Rehab: $15"	"7A PCP: $10, 14B Immunizations: $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: $30, 7D Physician Specialist: $30, 7F Podiatry: $30"	"7E Mental Health: $30, 7H Psychiatric: $30,9C OP Substance Abuse: $30,"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	7D Physician Specialist: $30	"7G Other Health Care: $30, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: 20%	"13A Blood: 10%, 16B Comprehensive Dental Services: $30 , 17A Medicare Covered Eye Exams: $15"	10B Transportation: $0	"16A Preventive Dental Services: $0, 16B Additional Comprehensive Dental Coverage 20%-50%with $50 deductible"	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, Membership in Health Club $0"											150	150	320.7262887	6.75	0.2	0.2	0.2	44.8015423	150	0	39.29867506	0	0.2	32.32619451	9.9	30	30	20	30	30	0.2	16.29774512	0	0	15	0	0	0	0	0											142.5	142.5	304.6899742	6.4125	0.19	0.19	0.19	42.56146518	142.5	0	37.3337413	0	0.19	30.70988478	9.405	28.5	28.5	19	28.5	28.5	0.19	15.48285787	0	0	14.25	0	0	0	0	0											12.8643	0.152978569	2.706096985	0.664787992	2.558049327	3.016655471	2.207262273	2.386410259	4.106578214	0	7.456845029	0	0.314488513	3.316724399	5.773119191	10.56185736	0.569908466	0.660267708	0.84071165	3.313715609	0.189754188	0.00330449	0	0	0.563570589	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2274	0	3.3804	12.8643	0.152978569	2.706096985	0.664787992	2.558049327	3.016655471	2.207262273	2.386410259	4.106578214	0	7.456845029	0	0.314488513	3.316724399	5.773119191	10.56185736	0.569908466	0.660267708	0.84071165	3.313715609	0.189754188	0.00330449	0	0	0.563570589	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2274	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	12.8643	0.152978569	2.706096985	0.664787992	2.558049327	3.016655471	2.207262273	2.386410259	4.106578214	0	7.456845029	0	0.314488513	3.316724399	5.773119191	10.56185736	0.569908466	0.660267708	0.84071165	3.313715609	0.189754188	0.00330449	0	0	0.563570589	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.2274
H2960_012_0	2009	7																					4000											D	D	A	V	Coin	Coin	Coin	V	Coin	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	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	935.111398	9.754067955	80.66986322	943.3206114	10.17523429	12.03910383	8.808919245	497.9229065	17.93384291	322.9521888	1817.427684	29.73795833	1.255085973	983.0354409	5585.412589	3349.691969	180.746411	309.1791187	267.5605601	1051.332491	0.998706253	1.936498458	0	0	359.8628304	126.8197044	0	0	0	20.88541821											PBP: 1A IP Acute: $250 per day (days 1-4)	1B IP Psych: $250 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: 30%	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0-20%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: 20%	8A OP C/D/T: $0	"8B: $50 Routine Imaging, $75 CT, $100 PET, MRI, and Nuclear Medicine"	9A OP Hospital: $0	12 Renal Dialysis: 20%	"3 CORF: $50, 5 Partial Hosp: $40, 9D Cardiac Rehab: $15"	"7A PCP: $10, 14B Immunizations: $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: $40, 7D Physician Specialist: $40, 7F Podiatry: $40"	"7E Mental Health: $40, 7H Psychiatric: $40, 9C OP Substance Abuse: $40,"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	7D Physician Specialist: $40	"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, 16B Additional Comprehensive Dental Coverage: 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											250	250	440.032268	6.75	0.3	0.2	0.2	45.66795192	0.2	0	55.41069924	0	0.2	33.02141647	9.9	40	40	20	40	40	0.2	21.25864151	0	0	20	0	0	0	0	0											237.5	237.5	418.0306546	6.4125	0.285	0.19	0.19	43.38455432	0.19	0	52.64016428	0	0.19	31.37034565	9.405	38	38	19	38	38	0.19	20.19570944	0	0	19	0	0	0	0	0											18.5074	0.193049262	2.810206311	0.504086952	2.899941773	2.287429727	1.673694656	1.800180282	3.407430152	0	7.97247432	0	0.238466335	2.569846797	4.377567116	10.6073579	0.572363635	0.489533605	0.847275107	3.329219554	0.189754188	0.00325908	0	0	0.569782815	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8503	0	3.4658	18.5074	0.193049262	2.810206311	0.504086952	2.899941773	2.287429727	1.673694656	1.800180282	3.407430152	0	7.97247432	0	0.238466335	2.569846797	4.377567116	10.6073579	0.572363635	0.489533605	0.847275107	3.329219554	0.189754188	0.00325908	0	0	0.569782815	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8503	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.5074	0.193049262	2.810206311	0.504086952	2.899941773	2.287429727	1.673694656	1.800180282	3.407430152	0	7.97247432	0	0.238466335	2.569846797	4.377567116	10.6073579	0.572363635	0.489533605	0.847275107	3.329219554	0.189754188	0.00325908	0	0	0.569782815	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8503
H2960_803_0	2009	2																					4000											Coin	Coin	Coin	Coin	Coin	Coin	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	268.0908543	0.792722821	44.07389679	12.79945616	9.680924809	13.80238561	10.09904628	41.87159736	41.47085596	4.293879319	9.621158049	1.179048434	1.438902281	55.10292679	46.82610672	88.52058488	2.275633641	2.437027082	14.11555008	19.01452348	0.998706253	0.079977634	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											0.0704	0.0704	0.1632	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231											0.0704	0.0704	0.1632	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231											18.8736	0.055807687	7.192859957	0	2.236293631	3.188351076	2.332879691	9.672338989	9.579767727	0.991886123	2.222487509	0.272360188	0.332386427	12.72877609	10.81683065	20.44825511	0.525671371	0.562953256	3.260692068	4.392354924	0.230701144	0.018474834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.9357	0	5.7861	18.8736	0.055807687	7.192859957	0	2.236293631	3.188351076	2.332879691	9.672338989	9.579767727	0.991886123	2.222487509	0.272360188	0.332386427	12.72877609	10.81683065	20.44825511	0.525671371	0.562953256	3.260692068	4.392354924	0.230701144	0.018474834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.9357	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.8736	0.055807687	7.192859957	0	2.236293631	3.188351076	2.332879691	9.672338989	9.579767727	0.991886123	2.222487509	0.272360188	0.332386427	12.72877609	10.81683065	20.44825511	0.525671371	0.562953256	3.260692068	4.392354924	0.230701144	0.018474834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.9357
H2961_002_0	2009	12	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		326.8797417	6.223580103	110.8710494	0	42.56063933	30.75549715	0.828110808	218.6461255	182.0775356	576.7145688	153.1421721	0	0.286328795	92.99293088	11834.50229	4523.385139	100.1771953	59.83040624	12.99778458	30.04787537	21.59122895										45.288257	3.802524	547.751789	146.814774							$200/Admit	$200/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							200	200	50	0	0.2	0.2	0.2	50	50	20	50	50	10	10	10	20	10	10	20	20	0.2																				194.6260121	194.6260121	48.65650303	0	0.194626012	0.194626012	0.194626012	48.65650303	48.65650303	19.46260121	48.65650303	48.65650303	9.731300605	9.731300605	9.731300605	19.46260121	9.731300605	9.731300605	19.46260121	19.46260121	0.194626012										48	192	24	24							5.3016	0.100939215	0.449549796	0	8.283407505	5.985819762	0.161171904	0.886546322	0.738271347	0.935363805	0.62094688	0	0.000232196	0.075411847	9.597091611	7.336403424	0.081237867	0.048518972	0.021080891	0.048734151	4.202214787	0	0	0	0	0	0	0	0	0	0.181153028	0.060840384	1.095503578	0.293629548	0	0	0	0	0	0	46.5057	0	3.73	5.3016	0.100939215	0.449549796	0	8.283407505	5.985819762	0.161171904	0.886546322	0.738271347	0.935363805	0.62094688	0	0.000232196	0.075411847	9.597091611	7.336403424	0.081237867	0.048518972	0.021080891	0.048734151	4.202214787	0	0	0	0	0	0	0	0	0	0.181153028	0.060840384	1.095503578	0.293629548	0	0	0	0	0	0	46.5057		$750/stay	$750/stay	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	$35/visit	$35/visit	$35/visit	$35/visit	$35/visit	$35/visit	20% Coins										20% Coins	20% Coins	20% Coins	20% Coins							0.0303	0.0006	0.0131	0.0055	0.0015	0.0397	0.007	0	0.0942	0.0096	0.0287	0	0.0007	0.0351	0	0.0025	0	0.0003	0.0001	0.0013	0																				0.2704			5.3319	0.101516403	0.462647382	0.00552494	8.284919374	6.02555541	0.168205963	0.886552462	0.83244617	0.944951137	0.649634449	0	0.000923751	0.11047215	9.597093797	7.338952029	0.081287152	0.048856225	0.021212832	0.050065674	4.202214787	0	0	0	0	0	0	0	0	0	0.181153028	0.060840384	1.095503578	0.293629548	0	0	0	0	0	0	46.7761
H2961_011_0	2009	9	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										V																																																		0		400.4156596	155.6188681	1259.803982		10.20014826	20.67526473	2.798853733	93.51853369	267.3511833	0.690927173	16.97929474	0	353.376539	3355.465255	5052.69545	7042.287166	207.4412179	426.5755493	2925.649616	2546.244591	3.768227644										547.751789										$225/Admit	$225/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										$25/visit										225	225	50		0.2	0.2	0.2	50	30	0.2	0.2	20	20	20	10	40	20	20	20	20	0.2										25										209.4466806	209.4466806	46.54370681	0	0.186174827	0.186174827	0.186174827	46.54370681	27.92622409	0.186174827	0.186174827	18.61748272	18.61748272	18.61748272	9.308741362	37.23496545	18.61748272	18.61748272	18.61748272	18.61748272	0.186174827										23.2718534										6.9888	2.716154614	4.886328933	0	1.899010839	3.84921384	0.52107611	0.362724934	0.622175755	0.128633247	3.161117265	0	0.548248467	5.205859702	3.919519594	21.85160994	0.321836107	0.661813577	4.539019264	3.950388723	0.701549131	0	0	0	0	0	0	0	0	0	1.062266611	0	0	0	0	0	0	0	0	0	67.8974	0	4.876	6.9888	2.716154614	4.886328933	0	1.899010839	3.84921384	0.52107611	0.362724934	0.622175755	0.128633247	3.161117265	0	0.548248467	5.205859702	3.919519594	21.85160994	0.321836107	0.661813577	4.539019264	3.950388723	0.701549131	0	0	0	0	0	0	0	0	0	1.062266611	0	0	0	0	0	0	0	0	0	67.8974		$750/stay	$750/stay	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$35 copay/visit	$35 copay/visit	$35 copay/visit	$35 copay/visit	$35 copay/visit	$35 copay/visit	20% coinsurance										20% coinsurance										3.5941	0	0.225	0.1034	0.0602	0.1257	0.073	0.3081	0.1614	0.0536	0.056	0	0.0004	0.0988	0.0044	1.17	0.2227	0.0686	0.3799	0.2906	0.0094																				7.0051	0	0	10.5829	2.716154614	5.111302792	0.103352998	1.959200739	3.974919883	0.594102156	0.670784904	0.783555696	0.182207501	3.217096025	0	0.548652155	5.304618545	3.923900337	23.02158366	0.54455116	0.730443449	4.918921974	4.240995643	0.710916561	0	0	0	0	0	0	0	0	0	1.062266611	0	0	0	0	0	0	0	0	0	74.9025
H2961_801_0	2009	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					3994.298719	5.140361131	25.88605028	1.069789966	98.28865792	162.5673947		1.638032579	0	0	30.59387386	11824.6484	4346.662313	44.20187054	137.3240165	8.025389083	79.98600485	14.39480562											116.120365	139.89151								No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	20% coinsurance	20% coinsurance	20% coinsurance	$50/visit	$50/visit	No Cost Sharing	20% coinsurance	$25/visit	$10/visit	$25/visit	$10/visit	$20/visit	$10/visit	$10/visit	$10/visit	$10/visit	20% coinsurance											$25/visit	$25/visit											0	0.2	0.2	0.2	50	50		0.2	25	10	25	10	20	10	10	10	10	0.2											25	25											0	0.18468	0.18468	0.18468	46.17	46.17		0.18468	23.085	9.234	23.085	9.234	18.468	9.234	9.234	9.234	9.234	0.18468											23.085	23.085								0	0	0	0	0.949321894	4.780635766	0.197568811	0.378165611	0.625478051	0	0.302511857	0	0	0.058854965	9.099066944	6.689513299	0.034013339	0.105670831	0.006175537	0.061549231	2.658432701	0	0	0	0	0	0	0	0	0	0	0.223386552	0.269116292	0	0	0	0	0	0	0	26.4395	0	2.67	0	0	0	0	0.949321894	4.780635766	0.197568811	0.378165611	0.625478051	0	0.302511857	0	0	0.058854965	9.099066944	6.689513299	0.034013339	0.105670831	0.006175537	0.061549231	2.658432701	0	0	0	0	0	0	0	0	0	0	0.223386552	0.269116292	0	0	0	0	0	0	0	26.4395																																																																																		0			0	0	0	0	0.949321894	4.780635766	0.197568811	0.378165611	0.625478051	0	0.302511857	0	0	0.058854965	9.099066944	6.689513299	0.034013339	0.105670831	0.006175537	0.061549231	2.658432701	0	0	0	0	0	0	0	0	0	0	0.223386552	0.269116292	0	0	0	0	0	0	0	26.4395
H2961_805_0	2009	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					3994.298719	5.140361131	25.88605028	1.069789966	98.28865792	162.5673947		1.638032579	0	0	30.59387386	11824.6484	4346.662313	44.20187054	137.3240165	8.025389083	79.98600485	14.39480562											116.120365	139.89151								No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	20% coinsurance	20% coinsurance	20% coinsurance	$50/visit	$50/visit	No Cost Sharing	20% coinsurance	$25/visit	$10/visit	$25/visit	$10/visit	$20/visit	$10/visit	$10/visit	$10/visit	$10/visit	20% coinsurance											$25/visit	$25/visit											0	0.2	0.2	0.2	50	50		0.2	25	10	25	10	20	10	10	10	10	0.2											25	25											0	0.18468	0.18468	0.18468	46.17	46.17		0.18468	23.085	9.234	23.085	9.234	18.468	9.234	9.234	9.234	9.234	0.18468											23.085	23.085								0	0	0	0	0.949321894	4.780635766	0.197568811	0.378165611	0.625478051	0	0.302511857	0	0	0.058854965	9.099066944	6.689513299	0.034013339	0.105670831	0.006175537	0.061549231	2.658432701	0	0	0	0	0	0	0	0	0	0	0.223386552	0.269116292	0	0	0	0	0	0	0	26.4395	0	2.67	0	0	0	0	0.949321894	4.780635766	0.197568811	0.378165611	0.625478051	0	0.302511857	0	0	0.058854965	9.099066944	6.689513299	0.034013339	0.105670831	0.006175537	0.061549231	2.658432701	0	0	0	0	0	0	0	0	0	0	0.223386552	0.269116292	0	0	0	0	0	0	0	26.4395																																																																																		0			0	0	0	0	0.949321894	4.780635766	0.197568811	0.378165611	0.625478051	0	0.302511857	0	0	0.058854965	9.099066944	6.689513299	0.034013339	0.105670831	0.006175537	0.061549231	2.658432701	0	0	0	0	0	0	0	0	0	0	0.223386552	0.269116292	0	0	0	0	0	0	0	26.4395
H2961_806_0	2009	5																					2500														V	Coin	Coin	Coin	V	V		Coin	V	V	V	V	V	V	V	V	V	Coin																																																												0					2762.856424	3.555587794	17.90538098	0.739759762	67.96660695	112.4478669		1.133027135	0	0	21.16178255	8179.109299	3006.586322	30.57443385	94.98702222	5.551161629	55.32631955	9.956887045																				No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	20% coinsurance	20% coinsurance	20% coinsurance	"$50/visit-ER, $25/visit UCC"	"$50/visit-OH, $25/visit ASC"	No Cost Sharing	20% coinsurance	$25/visit	$10/visit	$25/visit	$10/visit	$20/visit	$10/visit	$10/visit	$10/visit	$10/visit	20% coinsurance																							0	0.2	0.2	0.2	35	37.5		0.2	25	10	25	10	20	10	10	10	10	0.2																							0	0.18468	0.18468	0.18468	32.319	34.6275		0.18468	23.085	9.234	23.085	9.234	18.468	9.234	9.234	9.234	9.234	0.18468																				0	0	0	0	0.656645954	3.306765759	0.136618833	0.183051064	0.324482376	0	0.209247451	0	0	0.040709979	6.293824605	4.627136349	0.023527027	0.073092514	0.004271619	0.042573603	1.838837899	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.7608	0	2.67	0	0	0	0	0.656645954	3.306765759	0.136618833	0.183051064	0.324482376	0	0.209247451	0	0	0.040709979	6.293824605	4.627136349	0.023527027	0.073092514	0.004271619	0.042573603	1.838837899	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.7608																																																																																		0			0	0	0	0	0.656645954	3.306765759	0.136618833	0.183051064	0.324482376	0	0.209247451	0	0	0.040709979	6.293824605	4.627136349	0.023527027	0.073092514	0.004271619	0.042573603	1.838837899	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.7608
H2997_001_0	2009	8	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Rehab Services	Urgent Care	ASC	Chiropractic/Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemo-Radiation	Blood	D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	0	Coin	0	0	V	V	V	V	0	V	0	V	V	V	V	V	Coin	V	V	Coin	Coin	4.0715	0.2706	0.9307	0.2402	0.2316	0.9841	0.1018	0.4598	1.0041	1.0866	2.4407	0.6461	0	0.1216	1.5302	2.7521	0.0472	1.0131	3.637	0	4.1152	0	0	0.1846	0.1779	0	0.1117	0	0	0	0.0682	0.0015	0.3805	0.524	0	0.0308	0.4823	0.0151	0.7486	0.1105	28.5197		1389.564493	90.54806222	408.8593271	3.29825833	76.31500823	13.51017341	1.397198492	302.9877466	264.6789511	14.91740607	33.50729596	170.3000093	0	160.2004178	3361.156436	3627.080496	62.18406708	1335.244745	49.93100724	0	56.49542427	0	0	312.1994172	293.0445979	271.7431874	147.2320949	0	0	0	89.85153866	1.393047111	125.37424	690.5779859	100.3227721	0.422413354	635.6066039	19.92712596	10.27736512	3.03497676	$150/day (days 1-5) w/$750 yrly max	"$200/day (days 1-5) w/$1,000 yrly max"	$75/day (for days 21-100)	20% coinsurance	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$125 copay	20% coinsurance	20% coinsurance	$125 copay	20% coinsurance	$25 copay	$15 coapy	$25 copay	$25 copay	$25 copay	20% coinsurance	0	20% coinsurance	0	0	$10/$20 copay; Exam/Cleaning 1/yr	$20 copay	"$0 copay / Covd up to $100/$80, glasses/lenses, /2yrs"	$25 copay	0	Forever Fit	0	$25 copay	$35 copay	$100 copay	$25 copay	$0 copay	20% coinsurance	$25 copay	$25 copay	20% coinsurance	10% coinsurance	150	200	75	0.2	100	0.2	0.2	50	125	0.2	0.2	125	0.2	25	15	25	25	25	0.2	0	0.2	0	0	19.47935514	20	0	25	0	0	0	25	35	100	25	0	0.2	25	25	0.2	0.1	85.94838844	87.65788191	66.77065224	0.178055073	89.02753631	0.178055073	0.178055073	44.51376816	111.2844204	0.178055073	0.178055073	111.2844204	0	22.25688408	13.35413045	22.25688408	22.25688408	22.25688408	0.178055073	0	0.178055073	0	0	17.34198997	17.80550726	0	22.25688408	0	0	0	22.25688408	31.15963771	89.02753631	22.25688408	0	0.178055073	22.25688408	22.25688408	0.178055073	0.089027536	9.9526	0.661437612	2.274983662	0.587271626	0.566178097	2.405554908	0.248778279	1.123927192	2.454553639	2.65611982	5.966144016	1.579311486	0	0.297130177	3.740443458	6.727292512	0.115335298	2.476532292	8.89046912	0	10.05929687	0	0	0.45117993	0.43481731	0	0.273077306	0	0	0	0.166651273	0.003617237	0.930146642	1.280842848	0	0.07521284	1.178885209	0.036959644	1.829936993	0.270196504	69.7149	500	8.5922	14.0241	0.932025842	3.205659193	0.827519212	0.797796509	3.389645972	0.350551255	1.583715785	3.458689646	3.742714756	8.406840337	2.225393733	0	0.418683484	5.270625525	9.479367895	0.16251794	3.48965957	12.52748077	0	14.17446553	0	0	0.635753617	0.612697194	0	0.384790797	0	0	0	0.234826823	0.005097016	1.31066134	1.804824237	0	0.105981743	1.661156636	0.052079505	2.5785479	0.380731484	98.2346	4000	$250/day (days 1-5)	$250/day (days 1-5)	20% Coinsurance	20% coinsurance	$100 copay	30% Coinsurance	30% Coinsurance	$50 copay	$225 copay	30% coinsurance	30% Coinsurance	$225 copay	20% coinsurance		$30 copay	$35 copay	$35 copay	$35 copay	30% Coinsurance	$35 copay	30% Coinsurance			50% Coinsurance	$40 copay	"$0 copay, covd up to $50 frame, $25/$35/$45/$45 sin/bif/trif/cont lenses /2yrs"	$35 copay		30% Coinsurance		$35 copay	$35 copay	$200 copay	$35 copay	$35 copay	30% Coinsurance	$35 copay	$35 copay	30% coinsurance	20% coinsurance	5.8126	0.3351	0.8352	0.1563	1.674	1.55	0.0457	0.3058	0.82	1.7115	2.1617	0.1885			2.1462	2.2551	0.0846	0.0111	6.2071	0.0001	2.2453			0.765	0.3508		0.1507		0.0081		0.1012	0.0044	0.7792	1.568	0.1172	0.414	0.3009	0.0217	0.5999	0.0963	33.8232	1000	2.571037552	19.8366	1.267164555	4.040826633	0.983779626	2.471810371	4.939613264	0.396251273	1.889529861	4.278732185	5.454249212	10.56850231	2.413909259	0	0.418683484	7.41679391	11.73443583	0.247164423	3.500766265	18.73457707	6.69E-05	16.41975452	0	0	1.400796736	0.963541184	0	0.535444739	0	0.008132157	0	0.335996822	0.009495712	2.089858847	3.372812462	0.117165172	0.519952708	1.962025225	0.073776759	3.17842612	0.477073878	132.0577
H3011_001_0	2009	5																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	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		1196.729425	50.34817229	1629.428257	1871.502169	297.9510309	943.9726186	140.4356576	215.4372447	272.6575546	3646.589245	934.1465592	112.3518008	4.822061072	1473.084104	3864.074866	4799.296432	232.1947298	379.0568155	1551.056471	49.98456381	708.1942918	0.153673535	0	219.4019012	287.6768575	141.3576988	1.580642074	12.1182559	31.70065493	240.1939896											"$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 - $25 per visit											89.77397714	47.09507956	4.963323429	0	29.75243148	0	0	43.86927385	92.91748492	0	0	0	0	5.82272933	18.20865356	19.89390924	23.65253619	18.6921719	0	5.393057958	0	0	0	24.65904543	14.27493513	21.3964715	0	0	0	15.04725473											89.77397714	47.09507956	4.963323429	0	29.75243148	0	0	43.86927385	92.91748492	0	0	0	0	5.82272933	18.20865356	19.89390924	23.65253619	18.6921719	0	5.393057958	0	0	0	24.65904543	14.27493513	21.3964715	0	0	0	15.04725473											8.9529	0.197595932	0.673948287	0	0.738730636	0	0	0.787589624	2.111221185	0	0	0	0	0.714780835	5.863300046	7.956397305	0.457666188	0.590449596	0	0.022464137	0	0	0	0.450853454	0.34221404	0.252046331	0	0	0	0.301188345	0	0	0	0	0	0	0	0	0	0	30.4134			8.9529	0.197595932	0.673948287	0	0.738730636	0	0	0.787589624	2.111221185	0	0	0	0	0.714780835	5.863300046	7.956397305	0.457666188	0.590449596	0	0.022464137	0	0	0	0.450853454	0.34221404	0.252046331	0	0	0	0.301188345	0	0	0	0	0	0	0	0	0	0	30.4134																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			8.9529	0.197595932	0.673948287	0	0.738730636	0	0	0.787589624	2.111221185	0	0	0	0	0.714780835	5.863300046	7.956397305	0.457666188	0.590449596	0	0.022464137	0	0	0	0.450853454	0.34221404	0.252046331	0	0	0	0.301188345	0	0	0	0	0	0	0	0	0	0	30.4134
H3011_801_0	2009	3																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	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		1196.729425	50.34817229	1629.428257	1871.502169	297.9510309	943.9726186	140.4356576	215.4372447	272.6575546	3646.589245	934.1465592	112.3518008	4.822061072	1473.084104	3864.074866	4799.296432	232.1947298	379.0568155	1551.056471	49.98456381	708.1942918	0.153673535	0	219.4019012	287.6768575	141.3576988	1.580642074	12.1182559	31.70065493	240.1939896											"$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 - $25 per visit											89.77397714	47.09507956	4.963323429	0	29.75243148	0	0	43.86927385	92.91748492	0	0	0	0	5.82272933	18.20865356	19.89390924	23.65253619	18.6921719	0	5.393057958	0	0	0	24.65904543	14.27493513	21.3964715	0	0	0	15.04725473											89.77397714	47.09507956	4.963323429	0	29.75243148	0	0	43.86927385	92.91748492	0	0	0	0	5.82272933	18.20865356	19.89390924	23.65253619	18.6921719	0	5.393057958	0	0	0	24.65904543	14.27493513	21.3964715	0	0	0	15.04725473											8.9529	0.197595932	0.673948287	0	0.738730636	0	0	0.787589624	2.111221185	0	0	0	0	0.714780835	5.863300046	7.956397305	0.457666188	0.590449596	0	0.022464137	0	0	0	0.450853454	0.34221404	0.252046331	0	0	0	0.301188345	0	0	0	0	0	0	0	0	0	0	30.4134			8.9529	0.197595932	0.673948287	0	0.738730636	0	0	0.787589624	2.111221185	0	0	0	0	0.714780835	5.863300046	7.956397305	0.457666188	0.590449596	0	0.022464137	0	0	0	0.450853454	0.34221404	0.252046331	0	0	0	0.301188345	0	0	0	0	0	0	0	0	0	0	30.4134																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			8.9529	0.197595932	0.673948287	0	0.738730636	0	0	0.787589624	2.111221185	0	0	0	0	0.714780835	5.863300046	7.956397305	0.457666188	0.590449596	0	0.022464137	0	0	0	0.450853454	0.34221404	0.252046331	0	0	0	0.301188345	0	0	0	0	0	0	0	0	0	0	30.4134
H3011_802_0	2009	3																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	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		1196.729425	50.34817229	1629.428257	1871.502169	297.9510309	943.9726186	140.4356576	215.4372447	272.6575546	3646.589245	934.1465592	112.3518008	4.822061072	1473.084104	3864.074866	4799.296432	232.1947298	379.0568155	1551.056471	49.98456381	708.1942918	0.153673535	0	219.4019012	287.6768575	141.3576988	1.580642074	12.1182559	31.70065493	240.1939896											"$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 - $25 per visit											89.77397714	47.09507956	4.963323429	0	29.75243148	0	0	43.86927385	92.91748492	0	0	0	0	5.82272933	18.20865356	19.89390924	23.65253619	18.6921719	0	5.393057958	0	0	0	24.65904543	14.27493513	21.3964715	0	0	0	15.04725473											89.77397714	47.09507956	4.963323429	0	29.75243148	0	0	43.86927385	92.91748492	0	0	0	0	5.82272933	18.20865356	19.89390924	23.65253619	18.6921719	0	5.393057958	0	0	0	24.65904543	14.27493513	21.3964715	0	0	0	15.04725473											8.9529	0.197595932	0.673948287	0	0.738730636	0	0	0.787589624	2.111221185	0	0	0	0	0.714780835	5.863300046	7.956397305	0.457666188	0.590449596	0	0.022464137	0	0	0	0.450853454	0.34221404	0.252046331	0	0	0	0.301188345	0	0	0	0	0	0	0	0	0	0	30.4134			8.9529	0.197595932	0.673948287	0	0.738730636	0	0	0.787589624	2.111221185	0	0	0	0	0.714780835	5.863300046	7.956397305	0.457666188	0.590449596	0	0.022464137	0	0	0	0.450853454	0.34221404	0.252046331	0	0	0	0.301188345	0	0	0	0	0	0	0	0	0	0	30.4134																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			8.9529	0.197595932	0.673948287	0	0.738730636	0	0	0.787589624	2.111221185	0	0	0	0	0.714780835	5.863300046	7.956397305	0.457666188	0.590449596	0	0.022464137	0	0	0	0.450853454	0.34221404	0.252046331	0	0	0	0.301188345	0	0	0	0	0	0	0	0	0	0	30.4134
H3028_001_0	2009	6	r.	s.	t.	u.	v.	w.					DME/Prosthetics/Supplies	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered					1500	Prosthetics/Supplies										D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin	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		1593.680609	56.146401	694.661716	1196.719199	253.777892	7.879494	0.890418	291.11024	205.611243	117.255306	992.227762	0	17.149694	201.419554	4675.630944	4527.239851	3.207811	540.160608			25.831173			4.78	2.47				1.36	0.48	6413.167226	0.06	0.09	0.05	1.23	2.7					$160/Day(Days 1-3):1a	$160/Day(Days 1-3):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$50/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$40/Visit:9b. $0 Surgery ASC -- Physician,9b. $30 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $40 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$100/Visit:14h. $40 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $40 Radiology OP -- Facility"	$50/Visit:9a	"$0-$40/Proc:12. $0 Dialysis -- Dialysis Center,12. $40 Dialysis -- OP Hosp"	"$15-$100/Visit:9d. $15 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $40 OP Other,5. $20 Partial Hospitalization,8b. $40 Rad therapy,3. $40 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$15/Visit:7b, 7d, 7f"	"$15-$50/Visit:7h. $50 Psych -- OP,7e. $15 Psych -- Other Provider"	"$15-$40/Visit:9a. $40 Therapy (AT,PT,ST,OT) -- OP,7d. $15 Therapy (AT,PT,ST,OT) - Specialist"			"0%-20% Coins:15. 20% Part B Rx,15. 0% Part B Rx at Pharmacy,15. 20% Part B Rx - Chemo"			"Dental 766 16a, 16b"	Vision Benefit				$0: Membership in health club/fitness class 14a	OTC Drugs OTC006 & NSP002	:11b	$0: Nurse hotline 14a	$0: Nutritional benefit 14a	$0 Additional Smoking Cessation 14a	$0 Health Education Materials 14a	$0 Corp Health 14a					72.304158	55.52712	43.132798	0	50.000005	0.2	0.2	49.999986	34.075685	0	33.868586	0	0	27.943642	0	15	48.103831	17.73468			0.163378			0	0				0	0	0	0	0	0	0	0					44.441317	34.129411	26.511315	0	30.732203	0.122928	0.122929	30.732191	20.944415	0	20.817123	0	0	17.175392	0	9.21966	29.566731	10.900515			0.100419			0	0				0	0	0	0	0	0	0	0					5.9021	0.159686966	1.534699631	0	0.649929474	0.968610438	0.109458194	0.745537958	0.358867267	0	1.72127728	0	0	0.288288316	0	3.478301014	0.007903707	0.490669067	0	0	2.593940561	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.0093	0	11.918	5.9021	0.159686966	1.534699631	0	0.649929474	0.968610438	0.109458194	0.745537958	0.358867267	0	1.72127728	0	0	0.288288316	0	3.478301014	0.007903707	0.490669067	0	0	2.593940561	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.0093	1500																																																																																	0	0	0	5.9021	0.159686966	1.534699631	0	0.649929474	0.968610438	0.109458194	0.745537958	0.358867267	0	1.72127728	0	0	0.288288316	0	3.478301014	0.007903707	0.490669067	0	0	2.593940561	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.0093
H3028_801_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		266.446677	8.912785	694.661716	1196.719199	5.420244	7.879494	2.084709	18.152942	29.491774	117.255306	21.457341	0	0.269108	3.715609	29.934846	65.834825	0.075902	3.760931			25.831173																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999995	1024.000466	43.132798	0	0.2	0.2	0.2	0.199999	0.199999	0	0.199999	0	0.200001	0.2	0.199999	0.2	0.5	0.199999			0.2																				1023.999995	1024.000466	43.132798	0	0.2	0.2	0.2	0.199999	0.199999	0	0.199999	0	0.200001	0.2	0.199999	0.2	0.5	0.199999			0.2																				22.7368	0.760557999	2.496891956	0	1.0840488	1.5758988	0.4169418	3.630570247	5.898325308	0	4.291446743	0	0.053821869	0.7431218	5.986939265	13.166965	0.037951	0.752182439	0	0	5.1662346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7987	0	0	22.7368	0.760557999	2.496891956	0	1.0840488	1.5758988	0.4169418	3.630570247	5.898325308	0	4.291446743	0	0.053821869	0.7431218	5.986939265	13.166965	0.037951	0.752182439	0	0	5.1662346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7987																																																																																		0	0	0	22.7368	0.760557999	2.496891956	0	1.0840488	1.5758988	0.4169418	3.630570247	5.898325308	0	4.291446743	0	0.053821869	0.7431218	5.986939265	13.166965	0.037951	0.752182439	0	0	5.1662346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7987
H3028_803_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		266.446677	8.912785	694.661716	1196.719199	5.420244	7.879494	2.084709	18.152942	29.491774	117.255306	21.457341	0	0.269108	3.715609	29.934846	65.834825	0.075902	3.760931			25.831173																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999995	1024.000466	43.132798	0	0.2	0.2	0.2	0.199999	0.199999	0	0.199999	0	0.200001	0.2	0.199999	0.2	0.5	0.199999			0.2																				1023.999995	1024.000466	43.132798	0	0.2	0.2	0.2	0.199999	0.199999	0	0.199999	0	0.200001	0.2	0.199999	0.2	0.5	0.199999			0.2																				22.7368	0.760557999	2.496891956	0	1.0840488	1.5758988	0.4169418	3.630570247	5.898325308	0	4.291446743	0	0.053821869	0.7431218	5.986939265	13.166965	0.037951	0.752182439	0	0	5.1662346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7987	0	0	22.7368	0.760557999	2.496891956	0	1.0840488	1.5758988	0.4169418	3.630570247	5.898325308	0	4.291446743	0	0.053821869	0.7431218	5.986939265	13.166965	0.037951	0.752182439	0	0	5.1662346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7987																																																																																		0	0	0	22.7368	0.760557999	2.496891956	0	1.0840488	1.5758988	0.4169418	3.630570247	5.898325308	0	4.291446743	0	0.053821869	0.7431218	5.986939265	13.166965	0.037951	0.752182439	0	0	5.1662346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7987
H3028_804_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		266.446677	8.912785	694.661716	1196.719199	5.420244	7.879494	2.084709	18.152942	29.491774	117.255306	21.457341	0	0.269108	3.715609	29.934846	65.834825	0.075902	3.760931			25.831173																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999995	1024.000466	43.132798	0	0.2	0.2	0.2	0.199999	0.199999	0	0.199999	0	0.200001	0.2	0.199999	0.2	0.5	0.199999			0.2																				1023.999995	1024.000466	43.132798	0	0.2	0.2	0.2	0.199999	0.199999	0	0.199999	0	0.200001	0.2	0.199999	0.2	0.5	0.199999			0.2																				22.7368	0.760557999	2.496891956	0	1.0840488	1.5758988	0.4169418	3.630570247	5.898325308	0	4.291446743	0	0.053821869	0.7431218	5.986939265	13.166965	0.037951	0.752182439	0	0	5.1662346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7987	0	0	22.7368	0.760557999	2.496891956	0	1.0840488	1.5758988	0.4169418	3.630570247	5.898325308	0	4.291446743	0	0.053821869	0.7431218	5.986939265	13.166965	0.037951	0.752182439	0	0	5.1662346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7987																																																																																		0	0	0	22.7368	0.760557999	2.496891956	0	1.0840488	1.5758988	0.4169418	3.630570247	5.898325308	0	4.291446743	0	0.053821869	0.7431218	5.986939265	13.166965	0.037951	0.752182439	0	0	5.1662346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7987
H3028_805_0	2009	1																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		266.446677	8.912785	694.661716	1196.719199	5.420244	7.879494	2.084709	18.152942	29.491774	117.255306	21.457341	0	0.269108	3.715609	29.934846	65.834825	0.075902	3.760931			25.831173																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999995	1024.000466	43.132798	0	0.2	0.2	0.2	0.199999	0.199999	0	0.199999	0	0.200001	0.2	0.199999	0.2	0.5	0.199999			0.2																				1023.999995	1024.000466	43.132798	0	0.2	0.2	0.2	0.199999	0.199999	0	0.199999	0	0.200001	0.2	0.199999	0.2	0.5	0.199999			0.2																				22.7368	0.760557999	2.496891956	0	1.0840488	1.5758988	0.4169418	3.630570247	5.898325308	0	4.291446743	0	0.053821869	0.7431218	5.986939265	13.166965	0.037951	0.752182439	0	0	5.1662346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7987	0	0	22.7368	0.760557999	2.496891956	0	1.0840488	1.5758988	0.4169418	3.630570247	5.898325308	0	4.291446743	0	0.053821869	0.7431218	5.986939265	13.166965	0.037951	0.752182439	0	0	5.1662346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7987																																																																																		0	0	0	22.7368	0.760557999	2.496891956	0	1.0840488	1.5758988	0.4169418	3.630570247	5.898325308	0	4.291446743	0	0.053821869	0.7431218	5.986939265	13.166965	0.037951	0.752182439	0	0	5.1662346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7987
H3044_001_0	2009	7																					4000											D	D	D		T	Coin	Coin	V	V	Coin	Coin			V	V	V	V	V	Coin	P	Coin	Coin			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		1013.594933	25.58584477	408.3141284	0	207.3214175	10.38515909	6.536378702	341.4645691	325.5032616	6.220657921	14.56460187	0	0	662.0115462	4167.233446	3752.141659	176.3817538	611.2678687	28.29951099	8968.603888	11.356279	1.266304409	0	0	389.34	308.2275	187.1967489	0	0	0											$100/Days 1-10 for IP Medical; $100/Days 1-10 for IP Surgical;	$100/Days 1-10 for IP Psych; $100/Days 1-10 for IP Substance Abuse;	$75/Days 21-100 for SNF		$100/Run 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; $50/Visit for Urgent Care; $50/Visit for Urgent Care - Worldwide;	$160/Case for OP Fac - Surgery; $160/Case for OP Fac - ASC	20% Coinsurance for OP Fac - Pathology	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET			$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/Visit for Prof - CORF; $30/Visit for Prof - CORF;	$10/Visit for PCP - Office Visits; $10/Consult for PCP - Consults; $5/Visit for PCP - Allergy Tx;	$25/Visit for Speclst - Office Visits; $5/Visit for Speclst - Allergy Tx; $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/Visit for PT/ST (PCP); $25/Visit for Occ Therapy (PCP); $25/Visit for PT/ST (Specialist); $25/Visit 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/Service for Podiatrist; $25/Exam for Hearing/Speech Exams; 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			$25/Exam for Vision (Refractions)	$25/Service for Vision Hardware	$25/Exam for Routine Hearing Exams														100	100	75	0	100	0.2	0.2	50	160	0.2	0.2	0	0	30	9.985028099	24.07576769	25	25	0.2	8.028029547	0.2	0.2	0	0	25	25	25	0	0	0											87.67818741	87.6781874	65.75864055	0	87.67818741	0.175356375	0.175356375	43.8390937	140.2850999	0.175356375	0.175356375	0	0	26.30345622	8.754691649	21.10919672	21.91954684	21.91954685	0.175356375	7.038830791	0.175356375	0.175356375	0	0	21.91954685	21.91954685	21.91954685	0	0	0											7.4058	0.186943374	2.237515167	0	1.514797175	1.82110385	1.146195674	1.247458103	3.805271464	1.090832022	2.553995784	0	0	1.451099311	3.040236987	6.600391367	0.32218401	1.116559557	4.962499657	5.2607071	1.991395916	0.222054551	0	0	0.711179698	0.563017261	0.341938992	0	0	0	0	0	0	0	0	0	0	0	0	0	49.5932	0	6.9694	7.4058	0.186943374	2.237515167	0	1.514797175	1.82110385	1.146195674	1.247458103	3.805271464	1.090832022	2.553995784	0	0	1.451099311	3.040236987	6.600391367	0.32218401	1.116559557	4.962499657	5.2607071	1.991395916	0.222054551	0	0	0.711179698	0.563017261	0.341938992	0	0	0	0	0	0	0	0	0	0	0	0	0	49.5932																																																																																		0	0	0	7.4058	0.186943374	2.237515167	0	1.514797175	1.82110385	1.146195674	1.247458103	3.805271464	1.090832022	2.553995784	0	0	1.451099311	3.040236987	6.600391367	0.32218401	1.116559557	4.962499657	5.2607071	1.991395916	0.222054551	0	0	0.711179698	0.563017261	0.341938992	0	0	0	0	0	0	0	0	0	0	0	0	0	49.5932
H3044_002_0	2009	5																					4000											D	D	D		T	Coin	Coin	V	V	Coin	Coin			V	V	V	V	V	Coin	P	Coin	Coin			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		994.6238226	25.12041875	400.334537	0	203.9379803	10.17525491	6.403338739	335.0147959	319.2869589	6.133549063	14.39934592	0	0	648.0990987	4075.435468	3669.239978	172.222092	596.7992733	27.61283494	8764.82736	11.12802952	1.240852999	0	0	389.34	308.2275	186.8256047	0	0	0											$100/Days 1-10 for IP Medical; $100/Days 1-10 for IP Surgical;	$100/Days 1-10 for IP Psych; $100/Days 1-10 for IP Substance Abuse;	$75/Days 21-100 for SNF		$100/Run 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; $50/Visit for Urgent Care; $50/Visit for Urgent Care - Worldwide;	$160/Case for OP Fac - Surgery; $160/Case for OP Fac - ASC	20% Coinsurance for OP Fac - Pathology	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET			$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/Visit for Prof - CORF; $30/Visit for Prof - CORF;	$10/Visit for PCP - Office Visits; $10/Consult for PCP - Consults; $5/Visit for PCP - Allergy Tx;	$25/Visit for Speclst - Office Visits; $5/Visit for Speclst - Allergy Tx; $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/Visit for PT/ST (PCP); $25/Visit for Occ Therapy (PCP); $25/Visit for PT/ST (Specialist); $25/Visit 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/Service for Podiatrist; $25/Exam for Hearing/Speech Exams; 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			$25/Exam for Vision (Refractions)	$25/Service for Vision Hardware	$25/Exam for Routine Hearing Exams														100	99.99999998	75	0	100	0.2	0.2	50	160	0.2	0.2	0	0	30	9.985051519	24.07714035	25	25	0.2	8.025643838	0.2	0.2	0	0	25	25	25	0	0	0											94.05708935	94.0570893	70.54281701	0	94.05708935	0.188114179	0.188114179	47.02854467	150.491343	0.188114179	0.188114179	0	0	28.21712681	9.391648829	22.64625741	23.51427233	23.51427234	0.188114179	7.548686995	0.188114179	0.188114179	0	0	23.51427234	23.51427234	23.51427234	0	0	0											7.796	0.196896123	2.353393832	0	1.598484403	1.914109721	1.204558808	1.312938191	4.00416027	1.153807544	2.708721131	0	0	1.523957871	3.189588228	6.924546088	0.337473098	1.16944172	5.194365766	5.513578192	2.093340134	0.233422043	0	0	0.762920566	0.603978781	0.366089012	0	0	0	0	0	0	0	0	0	0	0	0	0	52.1557	0	3.2954	7.796	0.196896123	2.353393832	0	1.598484403	1.914109721	1.204558808	1.312938191	4.00416027	1.153807544	2.708721131	0	0	1.523957871	3.189588228	6.924546088	0.337473098	1.16944172	5.194365766	5.513578192	2.093340134	0.233422043	0	0	0.762920566	0.603978781	0.366089012	0	0	0	0	0	0	0	0	0	0	0	0	0	52.1557																																																																																		0	0		7.796	0.196896123	2.353393832	0	1.598484403	1.914109721	1.204558808	1.312938191	4.00416027	1.153807544	2.708721131	0	0	1.523957871	3.189588228	6.924546088	0.337473098	1.16944172	5.194365766	5.513578192	2.093340134	0.233422043	0	0	0.762920566	0.603978781	0.366089012	0	0	0	0	0	0	0	0	0	0	0	0	0	52.1557
H3044_003_0	2009	7																					3350											A	A	D		T	Coin	O	V	V	Coin	Coin			V	V	V	V	V	Coin	P	Coin				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		276.9125289	4.306592455	432.0798935	0	218.2567602	10.9103067	32812.05366	363.4398363	342.1627508	6.55649715	15.37316161	0	0	697.8773677	4374.047586	3998.613109	188.2915562	653.0334652	29.92457351	9501.30203	11.93081455	0	0	0	389.34	308.2275	187.0043828	0	0	0											$250/Admit for IP Medical; $250/Admit for IP Surgical;	$250/Admit for IP Psych; $250/Admit for IP Substance Abuse;	$50/Days 21-100 for SNF		$75/Run for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; $5/Unit for Diabetes Monitoring 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;	$100/Case for OP Fac - Surgery; $100/Case 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/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/Visit for Prof - CORF; $20/Visit for Prof - CORF;	$10/Visit for PCP - Office Visits; $10/Consult for PCP - Consults; $5/Visit for PCP - Allergy Tx;	$20/Visit for Speclst - Office Visits; $5/Visit for Speclst - Allergy Tx; $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/Visit for PT/ST (PCP); $20/Visit for Occ Therapy (PCP); $20/Visit for PT/ST (Specialist); $20/Visit for Occ Therapy (Specialist);	20% Coinsurance for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	$20/Visit for Chiropractor; $25/Exam for Vistion Exams; $20/Service for Podiatrist; $20/Exam for Hearing/Speech Exams; 20% Coinsurance for Prof Path (IP); 20% Coinsurance for Prof Path (OP); 20% Coinsurance for Prof Path (Office); $15/Procedure for Prof Path (Labs)	20% Coinsurance for Part B Rx				$25/Exam for Vision (Refractions)	$25/Service for Vision Hardware	$20/Exam for Routine Hearing Exams														250	250.0000001	50	0	75	0.2	0.95825134	44.36744307	100	0.2	0.2	0	0	20	9.985040491	19.31216019	19.99999999	20	0.2	12.14152715	0.2	0	0	0	25	25	20	0	0	0											230.76619	230.76619	46.153238	0	69.229857	0.184612952	0.884528043	40.95402318	92.306476	0.184612952	0.184612952	0	0	18.4612952	9.216839004	17.82637451	18.46129519	18.4612952	0.184612952	11.20741584	0.184612952	0	0	0	23.076619	23.076619	18.4612952	0	0	0											5.3252	0.082817994	1.661823847	0	1.259157025	2.014183928	2.418598469	1.24036029	2.631986479	1.210414294	2.838084747	0	0	1.073643342	3.359574367	5.940064567	0.2896755	1.004653631	5.524463852	8.873753577	2.202582894	0	0	0	0.748720903	0.592737382	0.28769526	0	0	0	0	0	0	0	0	0	0	0	0	0	50.5802	0	4.2157	5.3252	0.082817994	1.661823847	0	1.259157025	2.014183928	2.418598469	1.24036029	2.631986479	1.210414294	2.838084747	0	0	1.073643342	3.359574367	5.940064567	0.2896755	1.004653631	5.524463852	8.873753577	2.202582894	0	0	0	0.748720903	0.592737382	0.28769526	0	0	0	0	0	0	0	0	0	0	0	0	0	50.5802																																																																																		0	0	0	5.3252	0.082817994	1.661823847	0	1.259157025	2.014183928	2.418598469	1.24036029	2.631986479	1.210414294	2.838084747	0	0	1.073643342	3.359574367	5.940064567	0.2896755	1.004653631	5.524463852	8.873753577	2.202582894	0	0	0	0.748720903	0.592737382	0.28769526	0	0	0	0	0	0	0	0	0	0	0	0	0	50.5802
H3057_001_1	2009	4																																Ded							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		201	0	0	0	0	0	0	239.4031386	311.6415332	0	0	0	0	0	2891.788023	3959.761824	71.953021	0	0	0	0	0	0	0	256.2078167	0	109.80335	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-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											200	0	0	0	0	0	0	50	50	0	0	0	0	0	15	15	15	0	0	0	0	0	0	0	15	0	15	0	0	0											200	0	0	0	0	0	0	50	50	0	0	0	0	0	15	15	15	0	0	0	0	0	0	0	15	0	15	0	0	0											3.35	0	0	0	0	0	0	0.997513078	1.298506388	0	0	0	0	0	3.614735029	4.94970228	0.089941276	0	0	0	0	0	0	0	0.320259771	0	0.137254187	0	0	0	0	0	0	0	0	0	0	0	0	0	14.7579	0	0	3.35	0	0	0	0	0	0	0.997513078	1.298506388	0	0	0	0	0	3.614735029	4.94970228	0.089941276	0	0	0	0	0	0	0	0.320259771	0	0.137254187	0	0	0	0	0	0	0	0	0	0	0	0	0	14.7579																																																																																		0	0	0	3.35	0	0	0	0	0	0	0.997513078	1.298506388	0	0	0	0	0	3.614735029	4.94970228	0.089941276	0	0	0	0	0	0	0	0.320259771	0	0.137254187	0	0	0	0	0	0	0	0	0	0	0	0	0	14.7579
H3057_001_2	2009	4																																Ded							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		201	0	0	0	0	0	0	259.7941497	291.3305957	0	0	0	0	0	3445.993259	4731.433704	87.23289099	0	0	0	0	0	0	0	305.3095186	0	130.8469365	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-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											200	0	0	0	0	0	0	50	50	0	0	0	0	0	15	15	15	0	0	0	0	0	0	0	15	0	15	0	0	0											200	0	0	0	0	0	0	50	50	0	0	0	0	0	15	15	15	0	0	0	0	0	0	0	15	0	15	0	0	0											3.35	0	0	0	0	0	0	1.082475624	1.213877482	0	0	0	0	0	4.307491574	5.91429213	0.109041114	0	0	0	0	0	0	0	0.381636898	0	0.163558671	0	0	0	0	0	0	0	0	0	0	0	0	0	16.5224	0	0	3.35	0	0	0	0	0	0	1.082475624	1.213877482	0	0	0	0	0	4.307491574	5.91429213	0.109041114	0	0	0	0	0	0	0	0.381636898	0	0.163558671	0	0	0	0	0	0	0	0	0	0	0	0	0	16.5224																																																																																		0	0	0	3.35	0	0	0	0	0	0	1.082475624	1.213877482	0	0	0	0	0	4.307491574	5.91429213	0.109041114	0	0	0	0	0	0	0	0.381636898	0	0.163558671	0	0	0	0	0	0	0	0	0	0	0	0	0	16.5224
H3057_002_1	2009	4																																Ded							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		201	0	0	0	0	0	0	239.4031386	311.6415332	0	0	0	0	0	2891.788023	3959.761824	71.953021	0	0	0	0	0	0	0	256.2078167	0	109.80335	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-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											200	0	0	0	0	0	0	50	50	0	0	0	0	0	15	15	15	0	0	0	0	0	0	0	15	0	15	0	0	0											200	0	0	0	0	0	0	50	50	0	0	0	0	0	15	15	15	0	0	0	0	0	0	0	15	0	15	0	0	0											3.35	0	0	0	0	0	0	0.997513078	1.298506388	0	0	0	0	0	3.614735029	4.94970228	0.089941276	0	0	0	0	0	0	0	0.320259771	0	0.137254187	0	0	0	0	0	0	0	0	0	0	0	0	0	14.7579	0	0	3.35	0	0	0	0	0	0	0.997513078	1.298506388	0	0	0	0	0	3.614735029	4.94970228	0.089941276	0	0	0	0	0	0	0	0.320259771	0	0.137254187	0	0	0	0	0	0	0	0	0	0	0	0	0	14.7579																																																																																		0	0	0	3.35	0	0	0	0	0	0	0.997513078	1.298506388	0	0	0	0	0	3.614735029	4.94970228	0.089941276	0	0	0	0	0	0	0	0.320259771	0	0.137254187	0	0	0	0	0	0	0	0	0	0	0	0	0	14.7579
H3057_002_2	2009	4																																Ded							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		201	0	0	0	0	0	0	259.7941497	291.3305957	0	0	0	0	0	3445.993259	4731.433704	87.23289099	0	0	0	0	0	0	0	305.3095186	0	130.8469365	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-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											200	0	0	0	0	0	0	50	50	0	0	0	0	0	15	15	15	0	0	0	0	0	0	0	15	0	15	0	0	0											200	0	0	0	0	0	0	50	50	0	0	0	0	0	15	15	15	0	0	0	0	0	0	0	15	0	15	0	0	0											3.35	0	0	0	0	0	0	1.082475624	1.213877482	0	0	0	0	0	4.307491574	5.91429213	0.109041114	0	0	0	0	0	0	0	0.381636898	0	0.163558671	0	0	0	0	0	0	0	0	0	0	0	0	0	16.5224	0	0	3.35	0	0	0	0	0	0	1.082475624	1.213877482	0	0	0	0	0	4.307491574	5.91429213	0.109041114	0	0	0	0	0	0	0	0.381636898	0	0.163558671	0	0	0	0	0	0	0	0	0	0	0	0	0	16.5224																																																																																		0	0	0	3.35	0	0	0	0	0	0	1.082475624	1.213877482	0	0	0	0	0	4.307491574	5.91429213	0.109041114	0	0	0	0	0	0	0	0.381636898	0	0.163558671	0	0	0	0	0	0	0	0	0	0	0	0	0	16.5224
H3057_003_1	2009	3																																Ded							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		201	0	0	0	0	0	0	239.4031386	311.6415332	0	0	0	0	0	2891.788023	3959.761824	71.953021	0	0	0	0	0	0	0	256.2078167	0	109.80335	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-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											200	0	0	0	0	0	0	50	50	0	0	0	0	0	15	15	15	0	0	0	0	0	0	0	15	0	15	0	0	0											200	0	0	0	0	0	0	50	50	0	0	0	0	0	15	15	15	0	0	0	0	0	0	0	15	0	15	0	0	0											3.35	0	0	0	0	0	0	0.997513078	1.298506388	0	0	0	0	0	3.614735029	4.94970228	0.089941276	0	0	0	0	0	0	0	0.320259771	0	0.137254187	0	0	0	0	0	0	0	0	0	0	0	0	0	14.7579	0	0	3.35	0	0	0	0	0	0	0.997513078	1.298506388	0	0	0	0	0	3.614735029	4.94970228	0.089941276	0	0	0	0	0	0	0	0.320259771	0	0.137254187	0	0	0	0	0	0	0	0	0	0	0	0	0	14.7579																																																																																		0	0	0	3.35	0	0	0	0	0	0	0.997513078	1.298506388	0	0	0	0	0	3.614735029	4.94970228	0.089941276	0	0	0	0	0	0	0	0.320259771	0	0.137254187	0	0	0	0	0	0	0	0	0	0	0	0	0	14.7579
H3057_003_2	2009	3																																Ded							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		201	0	0	0	0	0	0	259.7941497	291.3305957	0	0	0	0	0	3445.993259	4731.433704	87.23289099	0	0	0	0	0	0	0	305.3095186	0	130.8469365	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-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											200	0	0	0	0	0	0	50	50	0	0	0	0	0	15	15	15	0	0	0	0	0	0	0	15	0	15	0	0	0											200	0	0	0	0	0	0	50	50	0	0	0	0	0	15	15	15	0	0	0	0	0	0	0	15	0	15	0	0	0											3.35	0	0	0	0	0	0	1.082475624	1.213877482	0	0	0	0	0	4.307491574	5.91429213	0.109041114	0	0	0	0	0	0	0	0.381636898	0	0.163558671	0	0	0	0	0	0	0	0	0	0	0	0	0	16.5224	0	0	3.35	0	0	0	0	0	0	1.082475624	1.213877482	0	0	0	0	0	4.307491574	5.91429213	0.109041114	0	0	0	0	0	0	0	0.381636898	0	0.163558671	0	0	0	0	0	0	0	0	0	0	0	0	0	16.5224																																																																																		0	0	0	3.35	0	0	0	0	0	0	1.082475624	1.213877482	0	0	0	0	0	4.307491574	5.91429213	0.109041114	0	0	0	0	0	0	0	0.381636898	0	0.163558671	0	0	0	0	0	0	0	0	0	0	0	0	0	16.5224
H3057_007_0	2009	4																					3350											D		D		P	Coin	Coin	V	V		V			V	P	P	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		945.516308	0	1111.001684	0	126.0323527	15.1422671	0.782331032	254.6927703	292.0645093	0	864.5253259	0	0	485.549823	3119.060912	4293.500558	78.60884885	367.8373785	800.925304	0	0	0	0	0	276.3438329	0	118.4330712	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-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											200	0	100	0	50	0.15	0.15	50	150	0	50	0	0	25	25	25	25	25	50	0	0	0	0	0	25	0	25	0	0	0											183.7618416	0	91.88092078	0	45.94046039	0.137821381	0.137821381	45.94046039	137.8213812	0	45.94046039	0	0	22.97023019	22.97023019	22.97023019	22.97023019	22.97023019	45.94046039	0	0	0	0	0	22.97023019	0	22.97023019	0	0	0											14.4792	0	8.506654808	0	0.482498692	2.086928166	0.107821943	0.975058594	3.354394505	0	3.309724291	0	0	0.9294326	5.970462261	8.218558014	0.150471946	0.704109105	3.066239767	0	0	0	0	0	0.528973454	0	0.226702909	0	0	0	0	0	0	0	0	0	0	0	0	0	53.0972	0	4.6919	14.4792	0	8.506654808	0	0.482498692	2.086928166	0.107821943	0.975058594	3.354394505	0	3.309724291	0	0	0.9294326	5.970462261	8.218558014	0.150471946	0.704109105	3.066239767	0	0	0	0	0	0.528973454	0	0.226702909	0	0	0	0	0	0	0	0	0	0	0	0	0	53.0972																																																																																		0	0	0	14.4792	0	8.506654808	0	0.482498692	2.086928166	0.107821943	0.975058594	3.354394505	0	3.309724291	0	0	0.9294326	5.970462261	8.218558014	0.150471946	0.704109105	3.066239767	0	0	0	0	0	0.528973454	0	0.226702909	0	0	0	0	0	0	0	0	0	0	0	0	0	53.0972
H3057_008_0	2009	4																					3350											D		D		P	Coin	Coin	V	V		V			V	P	P	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		945.516308	0	1111.001684	0	126.0323527	15.1422671	0.782331032	254.6927703	292.0645093	0	864.5253259	0	0	485.549823	3119.060912	4293.500558	78.60884885	367.8373785	800.925304	0	0	0	0	0	276.3438329	0	118.4330712	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-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											200	0	100	0	50	0.15	0.15	50	150	0	50	0	0	25	25	25	25	25	50	0	0	0	0	0	25	0	25	0	0	0											183.7618416	0	91.88092078	0	45.94046039	0.137821381	0.137821381	45.94046039	137.8213812	0	45.94046039	0	0	22.97023019	22.97023019	22.97023019	22.97023019	22.97023019	45.94046039	0	0	0	0	0	22.97023019	0	22.97023019	0	0	0											14.4792	0	8.506654808	0	0.482498692	2.086928166	0.107821943	0.975058594	3.354394505	0	3.309724291	0	0	0.9294326	5.970462261	8.218558014	0.150471946	0.704109105	3.066239767	0	0	0	0	0	0.528973454	0	0.226702909	0	0	0	0	0	0	0	0	0	0	0	0	0	53.0972	0	4.6919	14.4792	0	8.506654808	0	0.482498692	2.086928166	0.107821943	0.975058594	3.354394505	0	3.309724291	0	0	0.9294326	5.970462261	8.218558014	0.150471946	0.704109105	3.066239767	0	0	0	0	0	0.528973454	0	0.226702909	0	0	0	0	0	0	0	0	0	0	0	0	0	53.0972																																																																																		0	0	0	14.4792	0	8.506654808	0	0.482498692	2.086928166	0.107821943	0.975058594	3.354394505	0	3.309724291	0	0	0.9294326	5.970462261	8.218558014	0.150471946	0.704109105	3.066239767	0	0	0	0	0	0.528973454	0	0.226702909	0	0	0	0	0	0	0	0	0	0	0	0	0	53.0972
H3057_009_0	2009	3																					3350											D		D		P	Coin	Coin	V	V		V			V	P	P	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		945.516308	0	1111.001684	0	126.0323527	15.1422671	0.782331032	254.6927703	292.0645093	0	864.5253259	0	0	485.549823	3119.060912	4293.500558	78.60884885	367.8373785	800.925304	0	0	0	0	0	276.3438329	0	118.4330712	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-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											200	0	100	0	50	0.15	0.15	50	150	0	50	0	0	25	25	25	25	25	50	0	0	0	0	0	25	0	25	0	0	0											183.7618416	0	91.88092078	0	45.94046039	0.137821381	0.137821381	45.94046039	137.8213812	0	45.94046039	0	0	22.97023019	22.97023019	22.97023019	22.97023019	22.97023019	45.94046039	0	0	0	0	0	22.97023019	0	22.97023019	0	0	0											14.4792	0	8.506654808	0	0.482498692	2.086928166	0.107821943	0.975058594	3.354394505	0	3.309724291	0	0	0.9294326	5.970462261	8.218558014	0.150471946	0.704109105	3.066239767	0	0	0	0	0	0.528973454	0	0.226702909	0	0	0	0	0	0	0	0	0	0	0	0	0	53.0972	0	4.6919	14.4792	0	8.506654808	0	0.482498692	2.086928166	0.107821943	0.975058594	3.354394505	0	3.309724291	0	0	0.9294326	5.970462261	8.218558014	0.150471946	0.704109105	3.066239767	0	0	0	0	0	0.528973454	0	0.226702909	0	0	0	0	0	0	0	0	0	0	0	0	0	53.0972																																																																																		0	0	0	14.4792	0	8.506654808	0	0.482498692	2.086928166	0.107821943	0.975058594	3.354394505	0	3.309724291	0	0	0.9294326	5.970462261	8.218558014	0.150471946	0.704109105	3.066239767	0	0	0	0	0	0.528973454	0	0.226702909	0	0	0	0	0	0	0	0	0	0	0	0	0	53.0972
H3057_801_0	2009	4																					3350											D		D		P	Coin	Coin	V	V		V			V	P	P	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		943.2678168	0	1094.694416	0	130.997709	15.21775812	0.786231304	251.8501112	290.3327615	0	847.185757	0	0	474.7048955	3129.506216	4320.004133	80.29356211	375.7207214	807.4836844	0	0	0	0	0	277.2692702	0	118.8296872	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-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											200	0	100	0	50	0.15	0.15	50	150	0	50	0	0	25	25	25	25	25	50	0	0	0	0	0	25	0	25	0	0	0											183.8206814	0	91.9103407	0	45.95517035	0.137865511	0.137865511	45.95517035	137.8655111	0	45.95517035	0	0	22.97758518	22.97758518	22.97758518	22.97758518	22.97758518	45.95517035	0	0	0	0	0	22.97758518	0	22.97758518	0	0	0											14.4493	0	8.384478064	0	0.501668503	2.098004	0.108394181	0.964484564	3.335572879	0	3.244380482	0	0	0.908964347	5.992374636	8.271938578	0.153746014	0.719429573	3.092337523	0	0	0	0	0	0.530914856	0	0.227534938	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9836	0	4.6634	14.4493	0	8.384478064	0	0.501668503	2.098004	0.108394181	0.964484564	3.335572879	0	3.244380482	0	0	0.908964347	5.992374636	8.271938578	0.153746014	0.719429573	3.092337523	0	0	0	0	0	0.530914856	0	0.227534938	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9836																																																																																		0	0	0	14.4493	0	8.384478064	0	0.501668503	2.098004	0.108394181	0.964484564	3.335572879	0	3.244380482	0	0	0.908964347	5.992374636	8.271938578	0.153746014	0.719429573	3.092337523	0	0	0	0	0	0.530914856	0	0.227534938	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9836
H3057_802_0	2009	4																					3350											D		D		P	Coin	Coin	V	V		V			V	P	P	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		943.2678168	0	1094.694416	0	130.997709	15.21775812	0.786231304	251.8501112	290.3327615	0	847.185757	0	0	474.7048955	3129.506216	4320.004133	80.29356211	375.7207214	807.4836844	0	0	0	0	0	277.2692702	0	118.8296872	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-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											200	0	100	0	50	0.15	0.15	50	150	0	50	0	0	25	25	25	25	25	50	0	0	0	0	0	25	0	25	0	0	0											183.8206814	0	91.9103407	0	45.95517035	0.137865511	0.137865511	45.95517035	137.8655111	0	45.95517035	0	0	22.97758518	22.97758518	22.97758518	22.97758518	22.97758518	45.95517035	0	0	0	0	0	22.97758518	0	22.97758518	0	0	0											14.4493	0	8.384478064	0	0.501668503	2.098004	0.108394181	0.964484564	3.335572879	0	3.244380482	0	0	0.908964347	5.992374636	8.271938578	0.153746014	0.719429573	3.092337523	0	0	0	0	0	0.530914856	0	0.227534938	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9836	0	4.6634	14.4493	0	8.384478064	0	0.501668503	2.098004	0.108394181	0.964484564	3.335572879	0	3.244380482	0	0	0.908964347	5.992374636	8.271938578	0.153746014	0.719429573	3.092337523	0	0	0	0	0	0.530914856	0	0.227534938	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9836																																																																																		0	0	0	14.4493	0	8.384478064	0	0.501668503	2.098004	0.108394181	0.964484564	3.335572879	0	3.244380482	0	0	0.908964347	5.992374636	8.271938578	0.153746014	0.719429573	3.092337523	0	0	0	0	0	0.530914856	0	0.227534938	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9836
H3057_803_0	2009	5																					3350											D		D		P	Coin	Coin	V	V		V			V	P	P	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		943.2678168	0	1094.694416	0	130.997709	15.21775812	0.786231304	251.8501112	290.3327615	0	847.185757	0	0	474.7048955	3129.506216	4320.004133	80.29356211	375.7207214	807.4836844	0	0	0	0	0	277.2692702	0	118.8296872	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-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											200	0	100	0	50	0.15	0.15	50	150	0	50	0	0	25	25	25	25	25	50	0	0	0	0	0	25	0	25	0	0	0											183.8206814	0	91.9103407	0	45.95517035	0.137865511	0.137865511	45.95517035	137.8655111	0	45.95517035	0	0	22.97758518	22.97758518	22.97758518	22.97758518	22.97758518	45.95517035	0	0	0	0	0	22.97758518	0	22.97758518	0	0	0											14.4493	0	8.384478064	0	0.501668503	2.098004	0.108394181	0.964484564	3.335572879	0	3.244380482	0	0	0.908964347	5.992374636	8.271938578	0.153746014	0.719429573	3.092337523	0	0	0	0	0	0.530914856	0	0.227534938	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9836	0	4.6634	14.4493	0	8.384478064	0	0.501668503	2.098004	0.108394181	0.964484564	3.335572879	0	3.244380482	0	0	0.908964347	5.992374636	8.271938578	0.153746014	0.719429573	3.092337523	0	0	0	0	0	0.530914856	0	0.227534938	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9836																																																																																		0	0	0	14.4493	0	8.384478064	0	0.501668503	2.098004	0.108394181	0.964484564	3.335572879	0	3.244380482	0	0	0.908964347	5.992374636	8.271938578	0.153746014	0.719429573	3.092337523	0	0	0	0	0	0.530914856	0	0.227534938	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9836
H3059_001_0	2009	3																					3450											D	A	D		T	Coin	Coin	V	V		Coin			V		V	V	V	Coin	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	583.064572	2.775213387	487.1100843	0	183.0292721	10.81085802	7.071074745	286.6060166	249.7003196	0	15.19436264	0	0	311.1412702	0	3394.531584	152.7451165	466.8431054	28.05838294	556.1171417	6.385216404	0	0	0	0	0	0	0	0	0											$50/Days 1-5 for IP Medical; $50/Days 1-5 for IP Surgical;	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	$75/Days Custom for SNF	No Cost Sharing	$100/Run 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;	$50/Case for OP Fac - Surgery; $50/Case for OP Fac - ASC	No Cost Sharing	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	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; $10/Visit for Prof - CORF; $10/Visit for Prof - CORF;	No Cost Sharing	$10/Visit for Speclst - Office Visits; $10/Consult for Speclst - Consults;	$10/Visit for OP Psych - Non-Physician; $10/Visit for OP Psych - Psychiatrist; $10/Visit for OP Substance Abuse;	$10/Visit for PT/ST (PCP); $10/Visit for Occ Therapy (PCP); $10/Visit for PT/ST (Specialist); $10/Visit for Occ Therapy (Specialist);	20% Coinsurance for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	$10/Service for Podiatrist;	20% Coinsurance for Part B Rx	No Cost Sharing	Not Covered	No Cost Sharing for Preventive Services	No Cost Sharing	Max Plan Benefit of $300 every two years	No Cost Sharing	Max Plan Benefit of $800 every three years	No Cost Sharing	No copay up to $100 every quarter											50	899.9999999	75	0	100	0.2	0.183541088	43.47883534	50	0	0.2	0	0	10	0	10	10	9.999999995	0.2	10	0.2	0	0	0	0	0	0	0	0	0											50	899.9999999	75	0	100	0.2	0.183541088	43.47883534	50	0	0.2	0	0	10	0	10	10	9.999999995	0.2	10	0.2	0	0	0	0	0	0	0	0	0											2.4294	0.208141004	3.044438027	0	1.525243934	2.162171603	1.297832753	1.038441317	1.040417998	0	3.038872528	0	0	0.259284392	0	2.82877632	0.127287597	0.389035921	5.611676587	0.463430951	1.277043281	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.7415	0	0	2.4294	0.208141004	3.044438027	0	1.525243934	2.162171603	1.297832753	1.038441317	1.040417998	0	3.038872528	0	0	0.259284392	0	2.82877632	0.127287597	0.389035921	5.611676587	0.463430951	1.277043281	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.7415	0																																																																																	0	0	0	2.4294	0.208141004	3.044438027	0	1.525243934	2.162171603	1.297832753	1.038441317	1.040417998	0	3.038872528	0	0	0.259284392	0	2.82877632	0.127287597	0.389035921	5.611676587	0.463430951	1.277043281	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.7415
H3059_002_0	2009	6																					3450											D	A	D		T	Coin	Coin	V	Coin		Coin			V		V	V	V	Coin	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	574.4632001	2.72012475	896.2297826	0	179.1149351	10.53791038	6.919757146	283.3012478	31.09958839	0	14.98504654	0	0	465.1793981	0	3268.552656	145.5788381	439.2197552	27.15824368	795.6865682	6.415110074	0	0	0	0	0	0	0	0	0											$150/Days 1-5 for IP Medical; $150/Days 1-5 for IP Surgical;	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	$87/Day for SNF	No Cost Sharing	$100/Run 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;	20% Coinsurance for OP Fac - Surgery; 20% Coinsurance for OP Fac - ASC	No Cost Sharing	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	No Cost Sharing	No Cost Sharing	$20/Case for OP Fac - Cardiovascular; $30/Case for OP Fac - Occ Therapy; $30/Case for OP Fac - Physical/Speech Therapy; $25/Case for OP Fac - CORF; $25/Visit for Prof - CORF; $25/Visit for Prof - CORF;	No Cost Sharing	$30/Visit for Speclst - Office Visits; $30/Consult for Speclst - Consults;	$30/Visit for OP Psych - Non-Physician; $30/Visit for OP Psych - Psychiatrist; $30/Visit for OP Substance Abuse;	$30/Visit for PT/ST (PCP); $30/Visit for Occ Therapy (PCP); $30/Visit for PT/ST (Specialist); $30/Visit 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; $30/Service for Podiatrist;	20% Coinsurance for Part B Rx	No Cost Sharing	Not Covered	No Cost Sharing for Preventive Services	No Cost Sharing	Not Covered	No Cost Sharing	Max Plan Benefit of $800 every three years	Not Covered	Not Covered											150	899.9999998	86.8	0	100	0.2	0.183605807	43.37041637	0.2	0	0.2	0	0	25.73209949	0	30	30	30	0.2	28.28779837	0.2	0	0	0	0	0	0	0	0	0											150	899.9999998	86.8	0	100	0.2	0.183605807	43.37041637	0.2	0	0.2	0	0	25.73209949	0	30	30	30	0.2	28.28779837	0.2	0	0	0	0	0	0	0	0	0											7.1808	0.204009356	6.482728761	0	1.492624459	2.107582076	1.270507598	1.023907756	6.219917677	0	2.997009308	0	0	0.997503546	0	8.17138164	0.363947095	1.098049388	5.431648736	1.875685101	1.283022015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.2003	0	0	7.1808	0.204009356	6.482728761	0	1.492624459	2.107582076	1.270507598	1.023907756	6.219917677	0	2.997009308	0	0	0.997503546	0	8.17138164	0.363947095	1.098049388	5.431648736	1.875685101	1.283022015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.2003	0																																																																																	0	0	0	7.1808	0.204009356	6.482728761	0	1.492624459	2.107582076	1.270507598	1.023907756	6.219917677	0	2.997009308	0	0	0.997503546	0	8.17138164	0.363947095	1.098049388	5.431648736	1.875685101	1.283022015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.2003
H3059_004_0	2009	3																					3450												A	D		T	Coin		V			Coin			V		V	V	V	Coin	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	33.46210104	940.8486886	0	483.3858081	28.06541315	0	543.0298078	0	0	16.59475856	0	0	305.5154764	0	5270.422931	1316.554559	670.1376274	25.60363075	725.3386849	7.143335742	0	0	0	0	0	0	0	0	0											No Cost Sharing	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	$75/Days Custom for SNF	No Cost Sharing	$100/Run for Ambulance	10% Coinsurance for DME	No Cost Sharing	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $30/Visit for Urgent Care; $30/Visit for Urgent Care - Worldwide;	No Cost Sharing	No Cost Sharing	10% Coinsurance for OP Fac - Radiology; 10% Coinsurance for OP Fac - CT/MRI/PET	No Cost Sharing	No Cost Sharing	$5/Case for OP Fac - Occ Therapy; $5/Case for OP Fac - Physical/Speech Therapy;	No Cost Sharing	$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);	10% Coinsurance for Prof Radiology (Office); 10% Coinsurance for Prof Radiology (OP); 10% Coinsurance for Prof Radiology (IP);	$5/Service for Podiatrist;	20% Coinsurance for Part B Rx	No Cost Sharing	Not Covered	No Cost Sharing for Preventive Services	No Cost Sharing	Max Plan Benefit of $300 every two years	No Cost Sharing	Max Plan Benefit of $800 every three years	No Cost Sharing	No copay up to $100 every quarter											0	900	75	0	100	0.1	0	44.66805899	0	0	0.1	0	0	5.000000001	0	5	5.000000001	5	0.1	5	0.2	0	0	0	0	0	0	0	0	0											0	900	75	0	100	0.1	0	44.66805899	0	0	0.1	0	0	5.000000001	0	5	5.000000001	5	0.1	5	0.2	0	0	0	0	0	0	0	0	0											0	2.509657578	5.880304304	0	4.028215068	2.806541315	0	2.021340624	0	0	1.659475856	0	0	0.127298115	0	2.196009555	0.5485644	0.279224011	2.560363075	0.302224452	1.428667148	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.3479	0	0	0	2.509657578	5.880304304	0	4.028215068	2.806541315	0	2.021340624	0	0	1.659475856	0	0	0.127298115	0	2.196009555	0.5485644	0.279224011	2.560363075	0.302224452	1.428667148	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.3479	0																																																																																	0	0	0	0	2.509657578	5.880304304	0	4.028215068	2.806541315	0	2.021340624	0	0	1.659475856	0	0	0.127298115	0	2.196009555	0.5485644	0.279224011	2.560363075	0.302224452	1.428667148	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.3479
H3107_004_0	2009	4																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1837.549506	143.0036905	1254.377596	555.8959339	125.7019043	8.23907206	9.489323281	253.6750149	672.8561322	7559.258401	45.65985312	0	0.158446199	692.498586	4523.804676	4423.934097	198.0056867	438.620192	0	0	39.86173865	1556.717581	0	614.9184625	39.45712748	97.55292207	18.89605242	2.7413762	7.636690843	0											"$100 Days 1-9 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$100 Days 1-9 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-5/$95 Days 6-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$100 (9b)	$0/$7 (8a1); $7 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); $100 (9a); $40/$40 (9c)"	"$15 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$40 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$25/$0 (18a1); $0 (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a3, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											78.30133686	64.03712297	70.6166421	0	150	0.2	0.101251337	49.81805493	100	2.8	0.189232807	0	0.2	35.79785991	10.01915906	25	40	25	0	0	0.2	24.47566972	0	0	0	0	25	0	0	0											78.30133686	64.03712297	70.6166421	0	150	0.2	0.101251337	49.81805493	100	2.8	0.189232807	0	0.2	35.79785991	10.01915906	25	40	25	0	0	0.2	24.47566972	0	0	0	0	25	0	0	0											11.9902	0.763128743	7.381661146	0	1.571273803	1.647814412	0.960806666	1.053132986	5.607134435	1.76382696	8.640342155	0	0.03168924	2.065830614	3.777059885	9.216529369	0.660018956	0.913792067	0	0	7.972347729	3.175142114	0	0	0	0	0.039366776	0	0	0	0	0	0	0	0	0	0	0	0	0	69.2311	0	0	11.9902	0.763128743	7.381661146	0	1.571273803	1.647814412	0.960806666	1.053132986	5.607134435	1.76382696	8.640342155	0	0.03168924	2.065830614	3.777059885	9.216529369	0.660018956	0.913792067	0	0	7.972347729	3.175142114	0	0	0	0	0.039366776	0	0	0	0	0	0	0	0	0	0	0	0	0	69.2311		"35% (1a, 1a1); $0 n/c (1a2, 1a3, 13c)"	"35% (1b); $0 n/c (1b1, 1b2)"	"$0 n/c (2a, 2a1, 2a2)"	"$0 n/c (6a, 6a1, 6a2, 6a3)"	$0 n/c (10a)	$0 n/c (11a)	"$0 n/c (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	$0 n/c (9b)	"$0 n/c (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"$0 n/c (3, 5, 9a, 9c, 9d)"	"30% (7a, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"50%/50% (7e, 7h)"	"$0 n/c (7c, 7i)"	Included in h.2.	30% (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 n/c (13a, 13a1); 30% (16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											4.8651	0.1673	0	0	0	0	0	0.0554	0	0	0.6821	0	0.0017	0	1.5382	7.9574	0.3349	0	0	0	2.9896	0.5204	0	0	0	0	0	0	0	0											19.1123	0	0	16.8553	0.930463134	7.381661146	0	1.571273803	1.647814412	0.960806666	1.108561037	5.607134435	1.76382696	9.322474431	0	0.033357095	2.065830614	5.315252487	17.17397412	0.994933864	0.913792067	0	0	10.96197813	3.695529261	0	0	0	0	0.039366776	0	0	0	0	0	0	0	0	0	0	0	0	0	88.3434
H3107_005_0	2009	6																																D	D	D	V	T	O	O	V	V	O	Coin	V	O	O	V	V	V	V	V	V	S	O	T	V	P	P	P	P	O	O											33.1293	1.0984	3.4952	0.5551	0.9459	0.7787	0.4721	0	5.6305	0	0	0	0.0207	1.6852	0	0	0	0	0	0	3.5272	0	0	0	0	0	0	0	0	0											51.3384		1815.368697	151.9237233	1363.085631	715.8140659	132.9206562	512.2067088	1190.893235	255.2632219	638.5530076	6410.882793	57.23647711	0	20.70922608	660.2763523	4602.041416	4367.125048	278.775697	421.5862591	0	0	941.3521827	1418.862363	0	614.9933696	45.13106143	97.5648056	18.89835426	2.275400794	10.01176349	0											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$0 (10a)	$0 (11a)	"$0 (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	$0 (9b)	$0/$7 (8a1); $7 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$20 (3, 9d); $0 (5, 9a); $40/$40 (9c)"	"$10 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$40 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$10 (7g)	"$0 (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$20/$0 (18a1); $0 (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a3, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											0	0	0	0	0	0	0	49.82238864	0	2.8	0.188466588	0	0	0.666434016	6.665432891	20	40	20	0	0	0	19.51104227	0	0	0	0	20	0	0	0											0	0	0	0	0	0	0	49.82238864	0	2.8	0.188466588	0	0	0.666434016	6.665432891	20	40	20	0	0	0	19.51104227	0	0	0	0	20	0	0	0											0	0	0	0	0	0	0	1.059818621	0	1.495872652	10.78716353	0	0	0.036669218	2.556216518	7.278541747	0.929252323	0.702643765	0	0	0	2.306956963	0	0	0	0	0.031497257	0	0	0	0	0	0	0	0	0	0	0	0	0	27.1846	1850	0	33.1293	1.098440876	3.495157882	0.555146479	0.945931174	0.778664959	0.472083298	1.059818621	5.630516663	1.495872652	10.78716353	0	0.020712243	1.721876005	2.556216518	7.278541747	0.929252323	0.702643765	0	0	3.527190243	2.306956963	0	0	0	0	0.031497257	0	0	0	0	0	0	0	0	0	0	0	0	0	78.523		"$0 n/c (1a, 1a1, 1a2, 1a3, 13c)"	"$0 n/c (1b, 1b1, 1b2)"	"$0 n/c (2a, 2a1, 2a2)"	"$0 n/c (6a, 6a1, 6a2, 6a3)"	$0 n/c (10a)	$0 n/c (11a)	"$0 n/c (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	$0 n/c (9b)	"$0 n/c (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 n/c (3, 5, 9a, 9c, 9d)"	"30% (7a, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"50%/50% (7e, 7h)"	"$0 n/c (7c, 7i)"	Included in h.2.	30% (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 n/c (13a, 13a1); 30% (16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0	0	0	0	0	0	0	0.0558	0	0	0.8516	0	0	0	1.5764	7.774	0.2758	0	0	0	2.0987	0.473	0	0	0	0	0	0	0	0											13.1052	0	0	33.1293	1.098440876	3.495157882	0.555146479	0.945931174	0.778664959	0.472083298	1.115598548	5.630516663	1.495872652	11.6387817	0	0.020712243	1.721876005	4.132596453	15.05251816	1.20500242	0.702643765	0	0	5.625938127	2.779951825	0	0	0	0	0.031497257	0	0	0	0	0	0	0	0	0	0	0	0	0	91.6283
H3107_008_0	2009	2																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1886.874248	116.9966168	1529.136649	482.4598578	139.6051015	6.909991705	7.191729428	242.5666669	638.7699176	7010.233422	45.95403485	0	0.100336827	643.8812235	4194.750699	4184.893725	273.9431118	362.0907787	0	0	28.57333036	1431.174719	0	613.6717284	36.53292991	97.3551356	18.85774107	9.895417063	8.140091188	0											"$80 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$80 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$75 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$50 (9b)	$0/$7 (8a1); $7 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); $50 (9a); $40/$40 (9c)"	"$10 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$40 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$20/$0 (18a1); $0 (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a3, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											64.62829608	53.83790703	41.33011473	0	150	0.2	0.113835741	49.8191908	50	2.8	0.188790649	0	0.2	18.2365665	6.689072814	19.99238002	40	20	0	0	0.2	19.5366809	0	0	0	0	20	0	0	0											64.62829608	53.83790703	41.33011473	0	150	0.2	0.113835741	49.8191908	50	2.8	0.188790649	0	0.2	18.2365665	6.689072814	19.99238002	40	20	0	0	0.2	19.5366809	0	0	0	0	20	0	0	0											10.1621	0.524904415	5.266616094	0	1.745063768	1.381998341	0.818675851	1.007039588	2.661541323	1.635721132	8.67569208	0	0.020067365	0.978515229	2.338249405	6.972165476	0.913143706	0.603484631	0	0	5.714666073	2.330033649	0	0	0	0	0.031429568	0	0	0	0	0	0	0	0	0	0	0	0	0	53.7811	0	0	10.1621	0.524904415	5.266616094	0	1.745063768	1.381998341	0.818675851	1.007039588	2.661541323	1.635721132	8.67569208	0	0.020067365	0.978515229	2.338249405	6.972165476	0.913143706	0.603484631	0	0	5.714666073	2.330033649	0	0	0	0	0.031429568	0	0	0	0	0	0	0	0	0	0	0	0	0	53.7811		"35% (1a, 1a1); $0 n/c (1a2, 1a3, 13c)"	"35% (1b); $0 n/c (1b1, 1b2)"	"$0 n/c (2a, 2a1, 2a2)"	"$0 n/c (6a, 6a1, 6a2, 6a3)"	$0 n/c (10a)	$0 n/c (11a)	"$0 n/c (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	$0 n/c (9b)	"$0 n/c (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"$0 n/c (3, 5, 9a, 9c, 9d)"	"30% (7a, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"50%/50% (7e, 7h)"	"$0 n/c (7c, 7i)"	Included in h.2.	30% (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 n/c (13a, 13a1); 30% (16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											4.8166	0	0	0	0	0	0	0.053	0	0	0.6849	0	0.0011	0	1.4356	7.5857	0.358	0	0	0	2.143	0.4775	0	0	0	0	0	0	0	0											17.5554	0	0	14.9787	0.524904415	5.266616094	0	1.745063768	1.381998341	0.818675851	1.060041672	2.661541323	1.635721132	9.360615139	0	0.021123543	0.978515229	3.773891751	14.55790061	1.27113165	0.603484631	0	0	7.85766585	2.807534065	0	0	0	0	0.031429568	0	0	0	0	0	0	0	0	0	0	0	0	0	71.3365
H3107_801_0	2009	3																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1869.075415	207.0605661	1300.807016	512.9293727	111.0478421	6.751216377	9.395432408	248.6671004	49.37131459	8278.650809	54.14718016	0	1.466763322	18.98161215	6139.859935	5763.930697	356.4127153	495.1457214	0	0	55.33696646	2149.005878	0	0	0	0	0	0	0	0											"$160 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$160 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $60 (5); 20% (9a); $40/$40 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$40 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											129.2563986	107.6758141	159.8131731	0	150	0.2	0.097981529	49.80007583	0.2	2.8	0.189175648	0	0.2	0.200353044	12.57352828	39.83689899	40	40	0	0	0.2	39.14685376	0	0	0	0	0	0	0	0											129.2563986	107.6758141	159.8131731	0	150	0.2	0.097981529	49.80007583	0.2	2.8	0.189175648	0	0.2	0.200353044	12.57352828	39.83689899	40	40	0	0	0.2	39.14685376	0	0	0	0	0	0	0	0											20.1325	1.857951251	17.3238414	0	1.388098026	1.350243275	0.920578828	1.031970038	9.874262919	1.931685189	10.24332792	0	0.293352664	3.803023767	6.433308541	19.13476041	1.188042384	1.650485738	0	0	11.06739329	7.010568236	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.6354	0	0	20.1325	1.857951251	17.3238414	0	1.388098026	1.350243275	0.920578828	1.031970038	9.874262919	1.931685189	10.24332792	0	0.293352664	3.803023767	6.433308541	19.13476041	1.188042384	1.650485738	0	0	11.06739329	7.010568236	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.6354																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.1325	1.857951251	17.3238414	0	1.388098026	1.350243275	0.920578828	1.031970038	9.874262919	1.931685189	10.24332792	0	0.293352664	3.803023767	6.433308541	19.13476041	1.188042384	1.650485738	0	0	11.06739329	7.010568236	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.6354
H3107_803_0	2009	3																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1869.259022	207.0809065	1300.9348	512.9797601	111.0587508	6.752542846	9.397278408	248.6915281	49.38101499	8279.464057	54.15781892	0	1.46705151	18.98534163	6140.46308	5764.496913	356.4477273	495.1943617	0	0	55.34783898	2149.216984	0	0	0	0	0	0	0	0											"$175 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$175 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $60 (5); 20% (9a); $40/$40 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$40 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											141.374186	117.7704216	159.8131731	0	150	0.2	0.097981529	49.80007583	0.2	2.8	0.189175648	0	0.2	0.075545617	12.57352828	39.83703272	40	40	0	0	0.2	39.14685376	0	0	0	0	0	0	0	0											141.374186	117.7704216	159.8131731	0	150	0.2	0.097981529	49.80007583	0.2	2.8	0.189175648	0	0.2	0.075545617	12.57352828	39.83703272	40	40	0	0	0.2	39.14685376	0	0	0	0	0	0	0	0											22.0221	2.032333806	17.32554319	0	1.388234385	1.350508569	0.920759702	1.032071413	9.876202999	1.931874947	10.24534051	0	0.293410302	1.434259354	6.433940514	19.13670435	1.188159091	1.650647872	0	0	11.0695678	7.011256915	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.3429	0	0	22.0221	2.032333806	17.32554319	0	1.388234385	1.350508569	0.920759702	1.032071413	9.876202999	1.931874947	10.24534051	0	0.293410302	1.434259354	6.433940514	19.13670435	1.188159091	1.650647872	0	0	11.0695678	7.011256915	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.3429																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.0221	2.032333806	17.32554319	0	1.388234385	1.350508569	0.920759702	1.032071413	9.876202999	1.931874947	10.24534051	0	0.293410302	1.434259354	6.433940514	19.13670435	1.188159091	1.650647872	0	0	11.0695678	7.011256915	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.3429
H3107_804_0	2009	3																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1869.075411	207.0605656	1300.807013	512.9293717	111.0478419	6.75121635	9.39543237	248.6670999	49.3713144	8278.650792	54.14717995	0	1.466763316	18.98161208	6139.859922	5763.930685	356.4127146	495.1457204	0	0	55.33696623	2149.005873	0	0	0	0	0	0	0	0											"$175 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$175 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $60 (5); 20% (9a); $40/$40 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$40 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											141.374186	117.7704216	159.8131731	0	150	0.2	0.097981529	49.80007583	0.2	2.8	0.189175648	0	0.2	0.075546137	12.57352828	39.83689899	40	40	0	0	0.2	39.14685376	0	0	0	0	0	0	0	0											141.374186	117.7704216	159.8131731	0	150	0.2	0.097981529	49.80007583	0.2	2.8	0.189175648	0	0.2	0.075546137	12.57352828	39.83689899	40	40	0	0	0.2	39.14685376	0	0	0	0	0	0	0	0											22.0199	2.032134177	17.32384136	0	1.388098023	1.35024327	0.920578825	1.031970036	9.874262879	1.931685185	10.24332788	0	0.293352663	1.433987465	6.433308528	19.13476038	1.188042382	1.650485735	0	0	11.06739325	7.010568222	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.328	0	0	22.0199	2.032134177	17.32384136	0	1.388098023	1.35024327	0.920578825	1.031970036	9.874262879	1.931685185	10.24332788	0	0.293352663	1.433987465	6.433308528	19.13476038	1.188042382	1.650485735	0	0	11.06739325	7.010568222	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.328																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.0199	2.032134177	17.32384136	0	1.388098023	1.35024327	0.920578825	1.031970036	9.874262879	1.931685185	10.24332788	0	0.293352663	1.433987465	6.433308528	19.13476038	1.188042382	1.650485735	0	0	11.06739325	7.010568222	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.328
H3107_805_0	2009	3																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1870.851077	207.2572781	1302.042811	513.4166668	111.15334	6.764050075	9.413292617	248.9033396	49.46516679	8286.515707	54.25011103	0	1.46955156	19.01769517	6145.692935	5769.406556	356.7513151	495.6161206	0	0	55.44215904	2151.04748	0	0	0	0	0	0	0	0											"$175 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$175 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $60 (5); 20% (9a); $40/$40 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$40 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											141.374186	117.7704216	159.8131731	0	150	0.2	0.097981529	49.80007583	0.2	2.8	0.189175648	0	0.2	0.075541117	12.57352828	39.83819227	40	40	0	0	0.2	39.14685376	0	0	0	0	0	0	0	0											141.374186	117.7704216	159.8131731	0	150	0.2	0.097981529	49.80007583	0.2	2.8	0.189175648	0	0.2	0.075541117	12.57352828	39.83819227	40	40	0	0	0.2	39.14685376	0	0	0	0	0	0	0	0											22.0408	2.034064752	17.34029942	0	1.389416749	1.352810015	0.922328799	1.032950432	9.893033359	1.933520332	10.26279993	0	0.293910312	1.436617932	6.439420324	19.15356064	1.18917105	1.652053735	0	0	11.08843181	7.017228427	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.4725	0	0	22.0408	2.034064752	17.34029942	0	1.389416749	1.352810015	0.922328799	1.032950432	9.893033359	1.933520332	10.26279993	0	0.293910312	1.436617932	6.439420324	19.15356064	1.18917105	1.652053735	0	0	11.08843181	7.017228427	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.4725																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.0408	2.034064752	17.34029942	0	1.389416749	1.352810015	0.922328799	1.032950432	9.893033359	1.933520332	10.26279993	0	0.293910312	1.436617932	6.439420324	19.15356064	1.18917105	1.652053735	0	0	11.08843181	7.017228427	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.4725
H3113_001_0	2009	9																																Coin	Coin	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		339.8220919	20.58	9436.1219	70.93178742	21.88201013	15.09955186	19.36643411	9.845020105	6.373343208	38.75844839	38.11945726	0	0.068577447	3.412091589	1.235778882	184.9342946	70.94	30.93962671	0	0	9.400399363	5.890522456	1056.145324	0	123.6214357	148.7435641	0	0	0	0											"6% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"6% (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.059634471	0.0604	0	0	0.2	0.2	0.2	0.068009367	0.2	0.08	0.14439729	0	0.2	0.2	0	0.19933041	0.2	0	0	0	0.2	0.021275959	0	0	0	0	0	0	0	0											0.059634471	0.0604	0	0	0.2	0.2	0.2	0.068009367	0.2	0.08	0.14439729	0	0.2	0.2	0	0.19933041	0.2	0	0	0	0.2	0.021275959	0	0	0	0	0	0	0	0											20.2651	1.243032	0	0	4.376402027	3.019910371	3.873286823	0.66955359	1.274668642	3.100675871	5.504346333	0	0.013715489	0.682418318	0	36.86302885	14.188	0	0	0	1.880079873	0.125326516	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.0796	0	0	20.2651	1.243032	0	0	4.376402027	3.019910371	3.873286823	0.66955359	1.274668642	3.100675871	5.504346333	0	0.013715489	0.682418318	0	36.86302885	14.188	0	0	0	1.880079873	0.125326516	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.0796																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.2651	1.243032	0	0	4.376402027	3.019910371	3.873286823	0.66955359	1.274668642	3.100675871	5.504346333	0	0.013715489	0.682418318	0	36.86302885	14.188	0	0	0	1.880079873	0.125326516	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.0796
H3113_002_0	2009	4																					3350											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2060.58594	276.5546807	50.97703743	55970.63333	97.45130014	25.52956887	11.28732338	398.2258847	417.5244011	6612.21184	505.6776743	0	0.991200915	1609.816264	6511.248419	4828.545938	1301.980366	287.9272668	0	0	26.04284996	1219.16116	810.5086242	0	327.7093149	349.7142857	0	0	20.2	0											"$225 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$225 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	16% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$125 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$125 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5); $125 (9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											222.3	225	0.1595	0	125	0.14	0.2	49.97488862	125	4.4	64.79010385	0	0.2	115.7285075	3.255683926	25	20	20	0	0	0.2	13.67894853	0	0	0	0	0	0	0	0											151.2083458	153.0448844	0.1595	0	85.02493578	0.095227928	0.136039897	33.99289357	85.02493578	2.99287774	44.07019535	0	0.136039897	78.71847136	3.255683926	25	20	20	0	0	0.136039897	13.67894853	0	0	0	0	0	0	0	0											25.9648	3.527106595	8.13083747	0	0.690482545	2.431127948	1.535526312	1.128070843	2.958332116	1.649128469	1.857109491	0	0.134842871	10.56018963	1.766547235	10.0594707	2.169967277	0.479878778	0	0	3.542866632	1.389736896	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.976	0	26.3192	25.9648	3.527106595	8.13083747	0	0.690482545	2.431127948	1.535526312	1.128070843	2.958332116	1.649128469	1.857109491	0	0.134842871	10.56018963	1.766547235	10.0594707	2.169967277	0.479878778	0	0	3.542866632	1.389736896	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.976																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	25.9648	3.527106595	8.13083747	0	0.690482545	2.431127948	1.535526312	1.128070843	2.958332116	1.649128469	1.857109491	0	0.134842871	10.56018963	1.766547235	10.0594707	2.169967277	0.479878778	0	0	3.542866632	1.389736896	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.976
H3113_003_0	2009	7																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		432.3196629	23.23	57.30614461	5873.63355	18.94346575	41.61066571	14.14995145	29.7228545	46.27053947	8.592816868	20.7885044	0	3.465286021	49.23607776	52.96185561	141.9382136	13.99	5.797438491	0	0	24.43588422	7.076594591	365.1399043	0	327.7093149	349.7142857	0	0	20.2	0											"6% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"6% (1b); $0 n/c (1b1, 1b2)"	16% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.0596752	0.0604	0.1595	0	0.2	0.2	0.2	0.106792899	0.2	0.08	0.2	0	0.2	0.2	0	0.199587463	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											0.0596752	0.0604	0.1595	0	0.2	0.2	0.2	0.106792899	0.2	0.08	0.2	0	0.2	0.2	0	0.199587463	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											25.7988	1.403092	9.140330065	0	3.78869315	8.322133142	2.829990291	3.174189809	9.254107893	0.687425349	4.157700879	0	0.693057204	9.847215553	0	28.32908793	2.798	1.159487698	0	0	4.887176843	0.105223859	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.3757	0	0	25.7988	1.403092	9.140330065	0	3.78869315	8.322133142	2.829990291	3.174189809	9.254107893	0.687425349	4.157700879	0	0.693057204	9.847215553	0	28.32908793	2.798	1.159487698	0	0	4.887176843	0.105223859	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.3757																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	25.7988	1.403092	9.140330065	0	3.78869315	8.322133142	2.829990291	3.174189809	9.254107893	0.687425349	4.157700879	0	0.693057204	9.847215553	0	28.32908793	2.798	1.159487698	0	0	4.887176843	0.105223859	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.3757
H3132_001_0	2009	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
H3152_022_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1618.8847	0	1210.0839	1200.785541	330.3652386	10.12841101	0	234.0857355	326.629215	743.7278639	3534.381269	0	73.10582304	485.4635055	5444.505539	8455.8973	0	731.9804591	0	0	262.2689455	0	0	0	660.1389897	0	49.28300916	0	0	0											$900 per stay	$900 per stay	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$35 per visit	$35 X-ray; $150 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$20 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											152.1692361	152.1692361	47.8866492	20	100	0.2	0.2	48.5	250	35	81	35	25	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											152.1692361	152.1692361	47.8866492	20	100	0.2	0.2	48.5	250	35	81	35	25	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											20.5287	0	4.828905267	2.001309235	2.753043655	2.025682202	0	0.946096514	6.804775313	2.16920627	23.85707357	0	0.152303798	1.415935224	9.074175898	24.66303379	0	2.134943006	0	0	0.983508545	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.3387			20.5287	0	4.828905267	2.001309235	2.753043655	2.025682202	0	0.946096514	6.804775313	2.16920627	23.85707357	0	0.152303798	1.415935224	9.074175898	24.66303379	0	2.134943006	0	0	0.983508545	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.3387																																																																																		0			20.5287	0	4.828905267	2.001309235	2.753043655	2.025682202	0	0.946096514	6.804775313	2.16920627	23.85707357	0	0.152303798	1.415935224	9.074175898	24.66303379	0	2.134943006	0	0	0.983508545	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.3387
H3152_041_0	2009	3																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1599.33764	0	1195.472863	1186.286777	326.3762768	10.00611653	0	231.2592909	322.6853634	734.7477967	3491.705739	0	72.22311414	479.6018252	5378.766405	8353.79742	0	723.1422348	0	0	259.1022055	0	0	0	652.1682079	0	48.68794642	0	0	0											$500 per stay	$500 per stay	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$35 per visit	$35 X-ray; $150 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$10 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											84.53846451	84.53846451	47.8866492	20	100	0.2	0.2	48.5	250	35	81	35	25	35	10	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											84.53846451	84.53846451	47.8866492	20	100	0.2	0.2	48.5	250	35	81	35	25	35	10	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											11.2671	0	4.770599137	1.977144628	2.719802307	2.001223306	0	0.934672967	6.722611738	2.143014407	23.56901374	0	0.150464821	1.398838657	4.482305338	24.36524247	0	2.109164851	0	0	0.971633271	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.5829			11.2671	0	4.770599137	1.977144628	2.719802307	2.001223306	0	0.934672967	6.722611738	2.143014407	23.56901374	0	0.150464821	1.398838657	4.482305338	24.36524247	0	2.109164851	0	0	0.971633271	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.5829																																																																																		0			11.2671	0	4.770599137	1.977144628	2.719802307	2.001223306	0	0.934672967	6.722611738	2.143014407	23.56901374	0	0.150464821	1.398838657	4.482305338	24.36524247	0	2.109164851	0	0	0.971633271	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.5829
H3152_045_0	2009	3																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1742.548497	0	1244.883879	687.0453721	248.0562783	10.21674391	0	242.8398935	412.151776	1314.738763	5399.81945	0	141.7180206	897.9836711	6659.265617	9677.346577	0	576.9685008	0	0	275.3434163	0	0	0	948.4401755	0	60.13023197	0	0	0											$75/day 1-10	$75/day 1-10	"$0 1-10, $75 11-100"	$25 per visit	$150 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$30 per visit	$30 X-ray; $150 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$10 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$1000 Every 3 Yrs	Fitness/Coaching	0											61.47355533	61.47355533	47.56208437	25	150	0.2	0.2	47.5	150	30	51.6	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											47.56086785	47.56086785	36.79783928	25	150	0.154736025	0.154736025	36.74980584	116.0520184	23.21040369	39.92189434	23.21040369	19.34200307	23.21040369	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											6.9064	0	3.817419741	1.431344525	3.100703479	1.580898338	0	0.743693245	3.985920459	2.54296812	17.9642518	0	0.228425866	1.736880293	5.549388014	24.19336644	0	1.442421252	0	0	1.032537811	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2566	0	11.5567	6.9064	0	3.817419741	1.431344525	3.100703479	1.580898338	0	0.743693245	3.985920459	2.54296812	17.9642518	0	0.228425866	1.736880293	5.549388014	24.19336644	0	1.442421252	0	0	1.032537811	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2566																																																																																		0			6.9064	0	3.817419741	1.431344525	3.100703479	1.580898338	0	0.743693245	3.985920459	2.54296812	17.9642518	0	0.228425866	1.736880293	5.549388014	24.19336644	0	1.442421252	0	0	1.032537811	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2566
H3152_046_0	2009	4																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1697.574664	0	1212.754386	669.313261	241.6541371	9.953057634	0	236.5723832	401.5144565	1280.80637	5260.454275	0	138.0603878	874.8074052	6487.395107	9493.552266	0	562.0773888	0	0	268.2370151	0	0	0	923.9616661	0	58.57831707	0	0	0											$150/day 1-10	$150/day 1-10	"$0 1-10, $75 11-100"	$25 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$35 per visit	$40 X-ray; $175 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$15 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$1000 Every 3 Yrs	Fitness/Coaching	0											122.9471107	122.9471107	47.56208437	25	100	0.2	0.2	47.5	150	35	64.3	35	25	35	15	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											92.05368003	92.05368003	36.79783928	25	100	0.14974517	0.14974517	35.56447791	116.0520184	26.20540478	49.74763191	26.20540478	19.34200307	26.20540478	15	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											13.0223	0	3.718895082	1.394402627	2.013784476	1.490422309	0	0.701131108	3.883046926	2.797004114	21.80792858	0	0.22253037	1.91039018	8.109243884	27.68952744	0	1.639392384	0	0	1.005888807	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.4059	0	15.3538	13.0223	0	3.718895082	1.394402627	2.013784476	1.490422309	0	0.701131108	3.883046926	2.797004114	21.80792858	0	0.22253037	1.91039018	8.109243884	27.68952744	0	1.639392384	0	0	1.005888807	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.4059																																																																																		0			13.0223	0	3.718895082	1.394402627	2.013784476	1.490422309	0	0.701131108	3.883046926	2.797004114	21.80792858	0	0.22253037	1.91039018	8.109243884	27.68952744	0	1.639392384	0	0	1.005888807	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.4059
H3152_047_0	2009	4																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1758.817294	0	1256.506375	693.4597713	250.3721836	10.31212957	0	245.1070975	415.9997111	1327.013439	5450.233293	0	143.0411297	906.3674344	6721.437912	9767.696308	0	582.3551993	0	0	277.91408	0	0	0	957.2950112	0	60.69162039	0	0	0											$75/day 1-10	$75/day 1-10	"$0 1-10, $75 11-100"	$25 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$100 per procedure	$30 per visit	$30 X-ray; $175 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$10 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$1000 Every 3 Yrs	Fitness/Coaching	0											61.47355533	61.47355533	47.56208437	25	100	0.2	0.2	47.5	100	30	56.1	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											49.82392997	49.82392997	37.28410174	25	100	0.162098742	0.162098742	38.49845126	81.04937106	24.31481132	45.46869717	24.31481132	19.59759661	24.31481132	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											7.3026	0	3.90397596	1.444707857	2.086434863	1.671583232	0	0.786353637	2.809709579	2.688840116	20.65125059	0	0.233605197	1.836512763	5.60119826	24.41924077	0	1.455887998	0	0	1.0421778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.9341	0	9.9664	7.3026	0	3.90397596	1.444707857	2.086434863	1.671583232	0	0.786353637	2.809709579	2.688840116	20.65125059	0	0.233605197	1.836512763	5.60119826	24.41924077	0	1.455887998	0	0	1.0421778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.9341																																																																																		0			7.3026	0	3.90397596	1.444707857	2.086434863	1.671583232	0	0.786353637	2.809709579	2.688840116	20.65125059	0	0.233605197	1.836512763	5.60119826	24.41924077	0	1.455887998	0	0	1.0421778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.9341
H3152_048_0	2009	4																					2500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1721.249186	0	1229.667563	678.6475611	245.0242664	10.09186383	0	239.8716419	407.1140116	1298.668606	5333.817021	0	139.9857898	887.0075443	6577.868876	9726.286016	0	569.9161683	0	0	271.9778715	0	0	0	936.8473147	0	59.3952553	0	0	0											$0 	$0 	"$0 1-10, $75 11-100"	$25 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$100 per procedure	$20 per visit	$20 X-ray; $175 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$10 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$1000 Every 3 Yrs	Fitness/Coaching	0											0	0	47.56208437	25	100	0.2	0.2	47.5	100	20	47.9	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											0	0	36.79621635	25	100	0.162103949	0.162103949	38.49968782	81.05197435	16.21039487	38.82389572	16.21039487	15.47292001	16.21039487	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											0	0	3.770592807	1.413849086	2.041868887	1.635930977	0	0.769581944	2.749782869	1.754327575	17.25662965	0	0.180499077	1.198228546	5.481557397	16.21047669	0	0.94986028	0	0	1.019917018	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.4331	0	7.0856	0	0	3.770592807	1.413849086	2.041868887	1.635930977	0	0.769581944	2.749782869	1.754327575	17.25662965	0	0.180499077	1.198228546	5.481557397	16.21047669	0	0.94986028	0	0	1.019917018	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.4331																																																																																		0			0	0	3.770592807	1.413849086	2.041868887	1.635930977	0	0.769581944	2.749782869	1.754327575	17.25662965	0	0.180499077	1.198228546	5.481557397	16.21047669	0	0.94986028	0	0	1.019917018	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.4331
H3152_053_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1594.575401	0	1191.913185	1182.754452	325.4044483	9.976321999	0	230.5706858	321.7245252	732.5599882	3481.308724	0	72.00806028	478.1737475	5362.750418	8328.922885	0	720.9889833	0	0	258.3306945	0	0	0	650.226291	0	48.54297164	0	0	0											$150/day 1-8	$150/day 1-8	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$35 per visit	$45 X-ray; $150 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$10 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											114.2747829	114.2747829	47.8866492	20	100	0.2	0.2	48.5	250	35	87	35	25	35	10	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											114.2747829	114.2747829	47.8866492	20	100	0.2	0.2	48.5	250	35	87	35	25	35	10	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											15.185	0	4.756394048	1.971257419	2.711703736	1.9952644	0	0.931889855	6.702594274	2.136633299	25.23948825	0	0.150016792	1.39467343	4.468958682	24.29269175	0	2.102884535	0	0	0.968740104	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.0082			15.185	0	4.756394048	1.971257419	2.711703736	1.9952644	0	0.931889855	6.702594274	2.136633299	25.23948825	0	0.150016792	1.39467343	4.468958682	24.29269175	0	2.102884535	0	0	0.968740104	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.0082																																																																																		0			15.185	0	4.756394048	1.971257419	2.711703736	1.9952644	0	0.931889855	6.702594274	2.136633299	25.23948825	0	0.150016792	1.39467343	4.468958682	24.29269175	0	2.102884535	0	0	0.968740104	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.0082
H3152_073_0	2009	7																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	v	T	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		2202.069498	0	1646.002859	1633.354873	449.3755578	13.77705586	0	318.4124589	444.2936742	1011.647367	4807.601917	0	99.44136418	660.346211	7405.826726	11502.03811	0	995.668093	0	0	356.7483497	0	0	3445	897.9465514	0	67.03665259	0	0	0											$950 per stay	$950 per stay	"$0/d 1-20, $100/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$200 per procedure	$0 per visit	$25 X-ray; $150 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$0 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	$0 per Trip/50 One Way Trips	0	$0 per visit	$150 Every 2 Years	$0 per visit	$1000 Every 3 Yrs	Fitness/Coaching	0											160.6230826	160.6230826	40.33133874	0	100	0.2	0.2	48.5	200	0	75	25	25	25	0	25	25	25	25	25	45	0	0	5	0	0	0	0	0	0											160.6230826	160.6230826	40.33133874	0	100	0.2	0.2	48.5	200	0	75	25	25	25	0	25	25	25	25	25	45	0	0	5	0	0	0	0	0	0											29.4753	0	5.532124907	0	3.744796315	2.755411173	0	1.286917021	7.40489457	0	30.04751198	0	0.207169509	1.375721273	0	23.9625794	0	2.074308527	0	0	1.337806311	0	0	1.435416667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.6399			29.4753	0	5.532124907	0	3.744796315	2.755411173	0	1.286917021	7.40489457	0	30.04751198	0	0.207169509	1.375721273	0	23.9625794	0	2.074308527	0	0	1.337806311	0	0	1.435416667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.6399																																																																																		0			29.4753	0	5.532124907	0	3.744796315	2.755411173	0	1.286917021	7.40489457	0	30.04751198	0	0.207169509	1.375721273	0	23.9625794	0	2.074308527	0	0	1.337806311	0	0	1.435416667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.6399
H3152_074_0	2009	6																					0											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		2262.91075	0	1616.632833	892.2118157	322.1311888	13.26768218	0	315.35708	535.229112	1707.34788	7012.321037	0	184.0380529	1166.140803	8647.864768	12787.06033	0	749.2636362	0	0	357.5668498	0	0	3445.512067	1231.664698	0	78.08640539	0	0	0											$100/day 1-7	$100/day 1-7	"$0/d 1-20, $100/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$100 per procedure	$0 per visit	$10 X-ray; $115 Complex Radiology	$10 per visit	$0 per visit	$10 per visit	$0 PCP visit; $10 if no PCP selected	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$45 per script	0	$0 per Trip/50 One Way Trips	$5 per visit	$0 per visit	$150 Every 2 Years	$0 per visit	$1000 Every 3 Yrs	Fitness/Coaching	0											72.2855078	72.2855078	40.33133874	0	100	0.2	0.2	47.5	100	0	28.9	10	0	10	0	10	10	10	10	10	45	0	0	5	0	0	0	0	0	0											72.2855078	72.2855078	40.33133874	0	100	0.2	0.2	47.5	100	0	28.9	10	0	10	0	10	10	10	10	10	45	0	0	5	0	0	0	0	0	0											13.6313	0	5.433413866	0	2.684426574	2.653536436	0	1.248288442	4.4602426	0	16.8880065	0	0	0.971784002	0	10.65588361	0	0.624386363	0	0	1.340875687	0	0	1.435630028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.0278	0	0	13.6313	0	5.433413866	0	2.684426574	2.653536436	0	1.248288442	4.4602426	0	16.8880065	0	0	0.971784002	0	10.65588361	0	0.624386363	0	0	1.340875687	0	0	1.435630028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.0278																																																																																		0			13.6313	0	5.433413866	0	2.684426574	2.653536436	0	1.248288442	4.4602426	0	16.8880065	0	0	0.971784002	0	10.65588361	0	0.624386363	0	0	1.340875687	0	0	1.435630028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.0278
H3152_801_0	2009	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																																																			0		375.385154	0	46.20064995	8.230238698	11.65943001	11.89493934	0	8.409775685	44.98890596	17.13691902	77.9452013	0	6.312938712	21.19953882	45.21285429	163.5988771	0	7.837179025	0	0	9.484880055	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.062692958	0.062692958	0.159120979	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.534	0	7.351492642	0	2.693328332	2.747730988	0	1.942658183	10.39243728	3.958628293	18.0053415	0	1.458288842	4.897093468	10.44416934	37.79134061	0	1.810388355	0	0	2.191007293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2179			23.534	0	7.351492642	0	2.693328332	2.747730988	0	1.942658183	10.39243728	3.958628293	18.0053415	0	1.458288842	4.897093468	10.44416934	37.79134061	0	1.810388355	0	0	2.191007293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2179																																																																																		0			23.534	0	7.351492642	0	2.693328332	2.747730988	0	1.942658183	10.39243728	3.958628293	18.0053415	0	1.458288842	4.897093468	10.44416934	37.79134061	0	1.810388355	0	0	2.191007293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2179
H3152_804_0	2009	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																																																			0		375.4630246	0	46.2102339	8.231945994	11.66184866	11.89740685	0	8.411520225	44.99823854	17.14047393	77.96137039	0	6.31424828	21.2039365	45.22223333	163.6328143	0	7.838804784	0	0	9.486847616	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.062697497	0.062697497	0.159121775	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.5406	0	7.353054424	0	2.693887041	2.748300982	0	1.943061172	10.3945931	3.959449479	18.00907656	0	1.458591353	4.898109331	10.4463359	37.79918011	0	1.810763905	0	0	2.191461799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2465			23.5406	0	7.353054424	0	2.693887041	2.748300982	0	1.943061172	10.3945931	3.959449479	18.00907656	0	1.458591353	4.898109331	10.4463359	37.79918011	0	1.810763905	0	0	2.191461799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2465																																																																																		0			23.5406	0	7.353054424	0	2.693887041	2.748300982	0	1.943061172	10.3945931	3.959449479	18.00907656	0	1.458591353	4.898109331	10.4463359	37.79918011	0	1.810763905	0	0	2.191461799	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2465
H3154_004_0	2009	6		r.	s.									OP Facility - Other	OP Facility - Other								10000		ASC	Chemo/Therapeutic XRay								D		D	V	T	coin	coin	V	V					V	V	V			V	V												P	V																																																0		2032.821962		1321.334275	126.9473174	353.1216528	10.76398211	0	247.7345683	119.4553446					1707.087632	8311.755427	3611.547126			642.7280249	2820.644527												149.8394566	210.6076807								$150/day for the first 10 days of each IP stay		$0 copay each days 1-15; $85 copay days 16-30; $110 copay each day 31+	$35 copay	$150 /Trip	20% Coinsurance	0	$50 copay per visit	$125 Copay					$125 Copay	$15 /PCP visit	$35 /visit			$35 /visit	$35 /visit												$75 Copay	$35 Copay								143.229448		68.72940244	35	150	0.2	0	50	125					125	15	35			35	35												75	35								135.7211194		65.12649154	33.16524112	142.1367477	0.189515664	0	47.37891589	118.4472897					118.4472897	14.21367477	33.16524112			33.16524112	33.16524112												71.06837383	33.16524112								22.9914	0	7.171155458	0.350853199	4.182630272	2.039943213	0	0.978116273	1.179096818	0	0	0	0	16.84999194	9.845049031	9.981485937	0	0	1.776352493	7.795612988	0	0	0	0	0	0	0	0	0	0	0	0.887403877	0.582071209	0	0	0	0	0	0	0	86.6112	0	4.7915	22.9914	0	7.171155458	0.350853199	4.182630272	2.039943213	0	0.978116273	1.179096818	0	0	0	0	16.84999194	9.845049031	9.981485937	0	0	1.776352493	7.795612988	0	0	0	0	0	0	0	0	0	0	0	0.887403877	0.582071209	0	0	0	0	0	0	0	86.6112																																																																																		0	0	0	22.9914	0	7.171155458	0.350853199	4.182630272	2.039943213	0	0.978116273	1.179096818	0	0	0	0	16.84999194	9.845049031	9.981485937	0	0	1.776352493	7.795612988	0	0	0	0	0	0	0	0	0	0	0	0.887403877	0.582071209	0	0	0	0	0	0	0	86.6112
H3154_005_0	2009	3		r.	s.									OP Facility - Other	OP Facility - Other										ASC	Chemo/Therapeutic XRay								D		D	V	T	coin		V	V					V	V	V			V	V												P	V								0		0	0	0	0		0	0					0	0	0			0	0												0	0								0	6200	2223.308987		1474.80531	121.7662985	352.9121615	19.7307179		238.0448035	159.9613414					1842.89514	8675.207573	4849.829683			852.08186	3850.612239												200.0692723	231.678963								$75/day for the first 10 days of each IP stay		$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	$125 Copay					$125 Copay	$15 /visit	$35 /visit			$35 /visit	$35 /visit												$75 Copay	$35 Copay								66.23159587		58.06082512	35	150	0.2		50	125					125	15	35			35	35												75	35								66.23159587		58.06082512	35	150	0.2		50	125					125	15	35			35	35												75	35								12.2711	0	7.135701098	0.355151704	4.411402019	3.946143581	0	0.991853348	1.666263973	0	0	0	0	19.19682438	10.84400947	14.14533658	0	0	2.485238758	11.23095236	0	0	0	0	0	0	0	0	0	0	0	1.250432952	0.675730309	0	0	0	0	0	0	0	90.6061	0	0	12.2711	0	7.135701098	0.355151704	4.411402019	3.946143581	0	0.991853348	1.666263973	0	0	0	0	19.19682438	10.84400947	14.14533658	0	0	2.485238758	11.23095236	0	0	0	0	0	0	0	0	0	0	0	1.250432952	0.675730309	0	0	0	0	0	0	0	90.6061		$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								0.0335	0.0002	0.0166	0.0001	0.0903	0.0202	0.0002	0.0007	0.0007	0.0231	0.0002	0.0002	0.0002	0.0063	0	0.0058	0.0002	0.0002	0.0049	0.0186	0.0002	0.0002	0	0.0002	0	0	0	0	0	0	0	0.0323	0.0002								0.2556	900	0.191462079	12.3046	0.000210187	7.152347636	0.355281002	4.501660963	3.966351925	0.000210187	0.99257367	1.667005558	0.023104507	0.000210187	0.000210187	0.000210187	19.203084	10.84405689	14.15111271	0.000210187	0.000210187	2.490185871	11.24957012	0.000210187	0.000210187	0	0.000210187	3.17E-05	3.24E-06	0	0	0	0	0	1.282731605	0.675940496	0	0	0	0	0	0	0	90.8617
H3154_006_0	2009	7		r.	s.									OP Facility - Other	OP Facility - Other										ASC	Chemo/Therapeutic XRay								D		D	V	T	coin		V	V					V	V	V			V	V												P	V																																																0	6200	2223.308987		1474.80531	121.7662985	352.9121615	19.7307179		238.0448035	159.9613414					1842.89514	8675.207573	4849.829683			852.08186	3850.612239												200.0692723	231.678963								$75/day for the first 10 days of each IP stay		$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	$125 Copay					$125 Copay	$15 /visit	$35 /visit			$35 /visit	$35 /visit												$75 Copay	$35 Copay								66.23159587		58.06082512	35	150	0.2		50	125					125	15	35			35	35												75	35								66.23159587		58.06082512	35	150	0.2		50	125					125	15	35			35	35												75	35								12.2711	0	7.135701098	0.355151704	4.411402019	3.946143581	0	0.991853348	1.666263973	0	0	0	0	19.19682438	10.84400947	14.14533658	0	0	2.485238758	11.23095236	0	0	0	0	0	0	0	0	0	0	0	1.250432952	0.675730309	0	0	0	0	0	0	0	90.6061	0	0	12.2711	0	7.135701098	0.355151704	4.411402019	3.946143581	0	0.991853348	1.666263973	0	0	0	0	19.19682438	10.84400947	14.14533658	0	0	2.485238758	11.23095236	0	0	0	0	0	0	0	0	0	0	0	1.250432952	0.675730309	0	0	0	0	0	0	0	90.6061		$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								0.0335	0.0002	0.0166	0.0001	0.0903	0.0202	0.0002	0.0007	0.0007	0.0231	0.0002	0.0002	0.0002	0.0063	0	0.0058	0.0002	0.0002	0.0049	0.0186	0.0002	0.0002	0	0.0002	0	0	0	0	0	0		0.0323	0.0002								0.2556	900	0.191462079	12.3046	0.000210187	7.152347636	0.355281002	4.501660963	3.966351925	0.000210187	0.99257367	1.667005558	0.023104507	0.000210187	0.000210187	0.000210187	19.203084	10.84405689	14.15111271	0.000210187	0.000210187	2.490185871	11.24957012	0.000210187	0.000210187	0	0.000210187	3.17E-05	3.24E-06	0	0	0	0	0	1.282731605	0.675940496	0	0	0	0	0	0	0	90.8617
H3154_012_0	2009	3		r.	s.									OP Facility - Other	OP Facility - Other										ASC	Chemo/Therapeutic XRay								D		D	V	T	coin		V	V					V	V	V			V	V												P	V								0		0	0	0	0		0	0					0	0	0			0	0												0	0								0	6200	2223.308987		1474.80531	121.7662985	352.9121615	19.7307179		238.0448035	159.9613414					1842.89514	8675.207573	4849.829683			852.08186	3850.612239												200.0692723	231.678963								$75/day for the first 10 days of each IP stay		$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	$125 Copay					$125 Copay	$15 /visit	$35 /visit			$35 /visit	$35 /visit												$75 Copay	$35 Copay								66.23159587		58.06082512	35	150	0.2		50	125					125	15	35			35	35												75	35								66.23159587		58.06082512	35	150	0.2		50	125					125	15	35			35	35												75	35								12.2711	0	7.135701098	0.355151704	4.411402019	3.946143581	0	0.991853348	1.666263973	0	0	0	0	19.19682438	10.84400947	14.14533658	0	0	2.485238758	11.23095236	0	0	0	0	0	0	0	0	0	0	0	1.250432952	0.675730309	0	0	0	0	0	0	0	90.6061	0	0	12.2711	0	7.135701098	0.355151704	4.411402019	3.946143581	0	0.991853348	1.666263973	0	0	0	0	19.19682438	10.84400947	14.14533658	0	0	2.485238758	11.23095236	0	0	0	0	0	0	0	0	0	0	0	1.250432952	0.675730309	0	0	0	0	0	0	0	90.6061		$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								0.0335	0.0002	0.0166	0.0001	0.0903	0.0202	0.0002	0.0007	0.0007	0.0231	0.0002	0.0002	0.0002	0.0063	0	0.0058	0.0002	0.0002	0.0049	0.0186	0.0002	0.0002	0	0.0002	0	0	0	0	0	0		0.0323	0.0002								0.2556	900	0.191462079	12.3046	0.000210187	7.152347636	0.355281002	4.501660963	3.966351925	0.000210187	0.99257367	1.667005558	0.023104507	0.000210187	0.000210187	0.000210187	19.203084	10.84405689	14.15111271	0.000210187	0.000210187	2.490185871	11.24957012	0.000210187	0.000210187	0	0.000210187	3.17E-05	3.24E-06	0	0	0	0	0	1.282731605	0.675940496	0	0	0	0	0	0	0	90.8617
H3154_013_0	2009	3		r.	s.									OP Facility - Other	OP Facility - Other								10000		ASC	Chemo/Therapeutic XRay								D		D	V	T	coin	coin	V	V					V	V	V			V	V												P	V								0		0	0	0	0	0	0	0					0	0	0			0	0												0	0								0		2032.821962		1321.334275	126.9473174	353.1216528	10.76398211	0	247.7345683	119.4553446					1707.087632	8311.755427	3611.547126			642.7280249	2820.644527												149.8394566	210.6076807								$150/day for the first 10 days of each IP stay		$0 copay each days 1-15; $85 copay days 16-30; $110 copay each day 31+	$35 copay	$150 /Trip	20% Coinsurance	0	$50 copay per visit	$125 Copay					$125 Copay	$15 /PCP visit	$35 /visit			$35 /visit	$35 /visit												$75 Copay	$35 Copay								143.229448		68.72940244	35	150	0.2	0	50	125					125	15	35			35	35												75	35								135.7211194		65.12649154	33.16524112	142.1367477	0.189515664	0	47.37891589	118.4472897					118.4472897	14.21367477	33.16524112			33.16524112	33.16524112												71.06837383	33.16524112								22.9914	0	7.171155458	0.350853199	4.182630272	2.039943213	0	0.978116273	1.179096818	0	0	0	0	16.84999194	9.845049031	9.981485937	0	0	1.776352493	7.795612988	0	0	0	0	0	0	0	0	0	0	0	0.887403877	0.582071209	0	0	0	0	0	0	0	86.6112	0	4.7915	22.9914	0	7.171155458	0.350853199	4.182630272	2.039943213	0	0.978116273	1.179096818	0	0	0	0	16.84999194	9.845049031	9.981485937	0	0	1.776352493	7.795612988	0	0	0	0	0	0	0	0	0	0	0	0.887403877	0.582071209	0	0	0	0	0	0	0	86.6112																																																																																		0	0	0	22.9914	0	7.171155458	0.350853199	4.182630272	2.039943213	0	0.978116273	1.179096818	0	0	0	0	16.84999194	9.845049031	9.981485937	0	0	1.776352493	7.795612988	0	0	0	0	0	0	0	0	0	0	0	0.887403877	0.582071209	0	0	0	0	0	0	0	86.6112
H3154_014_0	2009	4		r.	s.									OP Facility - Other	OP Facility - Other										ASC	Chemo/Therapeutic XRay								D		D	V	T	coin		V	V					V	V	V			V	V												P	V								0		0	0	0	0		0	0					0	0	0			0	0												0	0								0		2132.04166		1385.827079	133.1434698	370.357114	11.28935968		259.8262073	125.2858224					1790.408613	8346.484698	3787.822581			674.0988395	2958.316938												157.1529479	220.887199								$107/day for the first 10 days of each IP stay		$0 copay each days 1-5; $50 copay days 6-20; $100 copay each day 21+	$15 copay	$15 /Trip	20% Coinsurance		$15 copay per visit	$15 Copay					$15 Copay	$20 /PCP visit	$22 /visit			$22 /visit	$22 /visit												$15 Copay	$15 Copay								107		58.18445805	15	15	0.2		15	15					15	20	22			22	22												15	15								107		58.18445805	15	15	0.2		15	15					15	20	22			22	22												15	15								19.0107	0	6.719466463	0.166429337	0.462946392	2.257871937	0	0.324782759	0.156607278	0	0	0	0	2.238010766	13.91080783	6.944341399	0	0	1.235847872	5.423581052	0	0	0	0	0	0	0	0	0	0	0	0.196441185	0.276108999	0	0	0	0	0	0	0	59.3239			19.0107	0	6.719466463	0.166429337	0.462946392	2.257871937	0	0.324782759	0.156607278	0	0	0	0	2.238010766	13.91080783	6.944341399	0	0	1.235847872	5.423581052	0	0	0	0	0	0	0	0	0	0	0	0.196441185	0.276108999	0	0	0	0	0	0	0	59.3239																																																																																		0			19.0107	0	6.719466463	0.166429337	0.462946392	2.257871937	0	0.324782759	0.156607278	0	0	0	0	2.238010766	13.91080783	6.944341399	0	0	1.235847872	5.423581052	0	0	0	0	0	0	0	0	0	0	0	0.196441185	0.276108999	0	0	0	0	0	0	0	59.3239
H3154_015_0	2009	7		r.	s.									OP Facility - Other	OP Facility - Other										ASC	Chemo/Therapeutic XRay								D		D	V	T	coin		V	V					V	V	V			V	V												P	V								0		0	0	0	0		0	0					0	0	0			0	0												0	0								0	6200	2223.308987		1474.80531	121.7662985	352.9121615	19.7307179		238.0448035	159.9613414					1842.89514	8675.207573	4849.829683			852.08186	3850.612239												200.0692723	231.678963								$75/day for the first 10 days of each IP stay		$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	$125 Copay					$125 Copay	$15 /visit	$35 /visit			$35 /visit	$35 /visit												$75 Copay	$35 Copay								66.23159587		58.06082512	35	150	0.2		50	125					125	15	35			35	35												75	35								66.23159587		58.06082512	35	150	0.2		50	125					125	15	35			35	35												75	35								12.2711	0	7.135701098	0.355151704	4.411402019	3.946143581	0	0.991853348	1.666263973	0	0	0	0	19.19682438	10.84400947	14.14533658	0	0	2.485238758	11.23095236	0	0	0	0	0	0	0	0	0	0	0	1.250432952	0.675730309	0	0	0	0	0	0	0	90.6061	0	0	12.2711	0	7.135701098	0.355151704	4.411402019	3.946143581	0	0.991853348	1.666263973	0	0	0	0	19.19682438	10.84400947	14.14533658	0	0	2.485238758	11.23095236	0	0	0	0	0	0	0	0	0	0	0	1.250432952	0.675730309	0	0	0	0	0	0	0	90.6061		$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								0.0335	0.0002	0.0166	0.0001	0.0903	0.0202	0.0002	0.0007	0.0007	0.0231	0.0002	0.0002	0.0002	0.0063	0	0.0058	0.0002	0.0002	0.0049	0.0186	0.0002	0.0002	0	0.0002	0	0	0	0	0	0		0.0323	0.0002								0.2556	900	0.191462079	12.3046	0.000210187	7.152347636	0.355281002	4.501660963	3.966351925	0.000210187	0.99257367	1.667005558	0.023104507	0.000210187	0.000210187	0.000210187	19.203084	10.84405689	14.15111271	0.000210187	0.000210187	2.490185871	11.24957012	0.000210187	0.000210187	0	0.000210187	3.17E-05	3.24E-06	0	0	0	0	0	1.282731605	0.675940496	0	0	0	0	0	0	0	90.8617
H3154_016_0	2009	4		r.	s.									OP Facility - Other	OP Facility - Other								10000		ASC	Chemo/Therapeutic XRay								D		D	V	T	coin	coin	V	V					V	V	V			V	V												P	V								0		0	0	0	0	0	0	0					0	0	0			0	0												0	0								0		2032.821962		1321.334275	126.9473174	353.1216528	10.76398211	0	247.7345683	119.4553446					1707.087632	8311.755427	3611.547126			642.7280249	2820.644527												149.8394566	210.6076807								$150/day for the first 10 days of each IP stay		$0 copay each days 1-15; $85 copay days 16-30; $110 copay each day 31+	$35 copay	$150 /Trip	20% Coinsurance	0	$50 copay per visit	$125 Copay					$125 Copay	$15 /PCP visit	$35 /visit			$35 /visit	$35 /visit												$75 Copay	$35 Copay								143.229448		68.72940244	35	150	0.2	0	50	125					125	15	35			35	35												75	35								135.7211194		65.12649154	33.16524112	142.1367477	0.189515664	0	47.37891589	118.4472897					118.4472897	14.21367477	33.16524112			33.16524112	33.16524112												71.06837383	33.16524112								22.9914	0	7.171155458	0.350853199	4.182630272	2.039943213	0	0.978116273	1.179096818	0	0	0	0	16.84999194	9.845049031	9.981485937	0	0	1.776352493	7.795612988	0	0	0	0	0	0	0	0	0	0	0	0.887403877	0.582071209	0	0	0	0	0	0	0	86.6112	0	4.7915	22.9914	0	7.171155458	0.350853199	4.182630272	2.039943213	0	0.978116273	1.179096818	0	0	0	0	16.84999194	9.845049031	9.981485937	0	0	1.776352493	7.795612988	0	0	0	0	0	0	0	0	0	0	0	0.887403877	0.582071209	0	0	0	0	0	0	0	86.6112																																																																																		0	0	0	22.9914	0	7.171155458	0.350853199	4.182630272	2.039943213	0	0.978116273	1.179096818	0	0	0	0	16.84999194	9.845049031	9.981485937	0	0	1.776352493	7.795612988	0	0	0	0	0	0	0	0	0	0	0	0.887403877	0.582071209	0	0	0	0	0	0	0	86.6112
H3154_017_0	2009	8		r.	s.									OP Facility - Other	OP Facility - Other								10000		ASC	Chemo/Therapeutic XRay								D		D	V	T	coin	coin	V	V					V	V	V			V	V												P	V								0		0	0	0	0	0	0	0					0	0	0			0	0												0	0								0		2032.821962		1321.334275	126.9473174	353.1216528	10.76398211	0	247.7345683	119.4553446					1707.087632	8311.755427	3611.547126			642.7280249	2820.644527												149.8394566	210.6076807								$150/day for the first 10 days of each IP stay		$0 copay each days 1-15; $85 copay days 16-30; $110 copay each day 31+	$35 copay	$150 /Trip	20% Coinsurance	0	$50 copay per visit	$125 Copay					$125 Copay	$15 /PCP visit	$35 /visit			$35 /visit	$35 /visit												$75 Copay	$35 Copay								143.229448		68.72940244	35	150	0.2	0	50	125					125	15	35			35	35												75	35								135.7211194		65.12649154	33.16524112	142.1367477	0.189515664	0	47.37891589	118.4472897					118.4472897	14.21367477	33.16524112			33.16524112	33.16524112												71.06837383	33.16524112								22.9914	0	7.171155458	0.350853199	4.182630272	2.039943213	0	0.978116273	1.179096818	0	0	0	0	16.84999194	9.845049031	9.981485937	0	0	1.776352493	7.795612988	0	0	0	0	0	0	0	0	0	0	0	0.887403877	0.582071209	0	0	0	0	0	0	0	86.6112	0	4.7915	22.9914	0	7.171155458	0.350853199	4.182630272	2.039943213	0	0.978116273	1.179096818	0	0	0	0	16.84999194	9.845049031	9.981485937	0	0	1.776352493	7.795612988	0	0	0	0	0	0	0	0	0	0	0	0.887403877	0.582071209	0	0	0	0	0	0	0	86.6112																																																																																		0	0	0	22.9914	0	7.171155458	0.350853199	4.182630272	2.039943213	0	0.978116273	1.179096818	0	0	0	0	16.84999194	9.845049031	9.981485937	0	0	1.776352493	7.795612988	0	0	0	0	0	0	0	0	0	0	0	0.887403877	0.582071209	0	0	0	0	0	0	0	86.6112
H3154_801_0	2009	3		r.	s.									OP Facility - Other	OP Facility - Other										ASC	Chemo/Therapeutic XRay								D		D	V	T	coin		V	V					V	V	V			V	V												P	P																																																0	6200	2041.583871		1150.718604	201.3087468	296.6729464	18.71261008		206.105171	168.0159197					2377.333568	8876.316029	5895.228605			988.76875	5087.172192												246.4515632	300.7640141								$150/day for the first 10 days of each IP stay		$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	$35 Copay								139.5		54.5605205	35	150	0.2		50	200					200	15	35			35	35												100	35								139.5		54.5605205	35	150	0.2		50	200					200	15	35			35	35												100	35								23.7334	0	5.231983831	0.587150511	3.70841183	3.742522017	0	0.858771546	2.800265329	0	0	0	0	39.62222613	11.09539504	17.19441677	0	0	2.883908854	14.83758556	0	0	0	0	0	0	0	0	0	0	0	2.053763026	0.877228375	0	0	0	0	0	0	0	129.227			23.7334	0	5.231983831	0.587150511	3.70841183	3.742522017	0	0.858771546	2.800265329	0	0	0	0	39.62222613	11.09539504	17.19441677	0	0	2.883908854	14.83758556	0	0	0	0	0	0	0	0	0	0	0	2.053763026	0.877228375	0	0	0	0	0	0	0	129.227	N/A	$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								0.0071	0.0001	0.0066	0	0.0073	0.0125	0.0001	0.0016	0	0.0212	0.0001	0.0001	0.0001	0.007	0	0.007	0.0001	0.0001	0.006	0.0354	0.0001	0.0001	0	0	0.0001	0	0.0001	0.0001	0	0		0.0241	0.0001								0.1374	900	0.191462079	23.7405	0.000142443	5.238558981	0.587150511	3.715726464	3.755018665	0.000142443	0.860378579	2.800265329	0.021175835	0.000142443	0.000142443	0.000142443	39.62919871	11.09539504	17.20140749	0.000142443	0.000142443	2.889895133	14.87293761	0.000142443	0.000142443	0	0	0.000119981	0	0.000142443	0.000142443	0	0	0	2.077817426	0.877370817	0	0	0	0	0	0	0	129.3645
H3154_802_0	2009	3		r.	s.									OP Facility - Other	OP Facility - Other								0		ASC	Chemo/Therapeutic XRay								D		D	V	T	coin		V	V					V	V	V			V	V												P	P																																																0	6200	2041.583871		1150.718604	201.3087468	296.6729464	18.71261008		206.105171	168.0159197					2377.333568	8876.316029	5895.228605			988.76875	5087.172192												246.4515632	300.7640141								$150/day for the first 10 days of each IP stay		$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	$35 Copay								139.5		54.5605205	35	150	0.2		50	200					200	15	35			35	35												100	35								139.5		54.5605205	35	150	0.2		50	200					200	15	35			35	35												100	35								23.7334	0	5.231983831	0.587150511	3.70841183	3.742522017	0	0.858771546	2.800265329	0	0	0	0	39.62222613	11.09539504	17.19441677	0	0	2.883908854	14.83758556	0	0	0	0	0	0	0	0	0	0	0	2.053763026	0.877228375	0	0	0	0	0	0	0	129.227	0	0	23.7334	0	5.231983831	0.587150511	3.70841183	3.742522017	0	0.858771546	2.800265329	0	0	0	0	39.62222613	11.09539504	17.19441677	0	0	2.883908854	14.83758556	0	0	0	0	0	0	0	0	0	0	0	2.053763026	0.877228375	0	0	0	0	0	0	0	129.227	N/A	$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								0.0071	0.0001	0.0066	0	0.0073	0.0125	0.0001	0.0016	0	0.0212	0.0001	0.0001	0.0001	0.007	0	0.007	0.0001	0.0001	0.006	0.0354	0.0001	0.0001	0	0	0.0001	0	0.0001	0.0001	0	0		0.0241	0.0001								0.1374	900	0.102942611	23.7405	0.000142443	5.238558981	0.587150511	3.715726464	3.755018665	0.000142443	0.860378579	2.800265329	0.021175835	0.000142443	0.000142443	0.000142443	39.62919871	11.09539504	17.20140749	0.000142443	0.000142443	2.889895133	14.87293761	0.000142443	0.000142443	0	0	0.000119981	0	0.000142443	0.000142443	0	0	0	2.077817426	0.877370817	0	0	0	0	0	0	0	129.3645
H3154_805_0	2009	2		r.	s.									OP Facility - Other	OP Facility - Other										ASC	Chemo/Therapeutic XRay								D		D	V	T	coin		V	V					V	V	V			V	V												P	P								0		0	0	0	0		0	0					0	0	0			0	0												0	0								0	6200	2041.583871		1150.718604	201.3087468	296.6729464	18.71261008		206.105171	168.0159197					2377.333568	8876.316029	5895.228605			988.76875	5087.172192												246.4515632	300.7640141								$150/day for the first 10 days of each IP stay		$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	$35 Copay								139.5		54.5605205	35	150	0.2		50	200					200	15	35			35	35												100	35								139.5		54.5605205	35	150	0.2		50	200					200	15	35			35	35												100	35								23.7334	0	5.231983831	0.587150511	3.70841183	3.742522017	0	0.858771546	2.800265329	0	0	0	0	39.62222613	11.09539504	17.19441677	0	0	2.883908854	14.83758556	0	0	0	0	0	0	0	0	0	0	0	2.053763026	0.877228375	0	0	0	0	0	0	0	129.227			23.7334	0	5.231983831	0.587150511	3.70841183	3.742522017	0	0.858771546	2.800265329	0	0	0	0	39.62222613	11.09539504	17.19441677	0	0	2.883908854	14.83758556	0	0	0	0	0	0	0	0	0	0	0	2.053763026	0.877228375	0	0	0	0	0	0	0	129.227		$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								0.0071	0.0001	0.0066	0	0.0073	0.0125	0.0001	0.0016	0	0.0212	0.0001	0.0001	0.0001	0.007	0	0.007	0.0001	0.0001	0.006	0.0354	0.0001	0.0001	0	0	0.0001	0	0.0001	0.0001	0	0		0.0241	0.0001								0.1374	900	0.102942611	23.7405	0.000142443	5.238558981	0.587150511	3.715726464	3.755018665	0.000142443	0.860378579	2.800265329	0.021175835	0.000142443	0.000142443	0.000142443	39.62919871	11.09539504	17.20140749	0.000142443	0.000142443	2.889895133	14.87293761	0.000142443	0.000142443	0	0	0.000119981	0	0.000142443	0.000142443	0	0	0	2.077817426	0.877370817	0	0	0	0	0	0	0	129.3645
H3154_807_0	2009	2		r.										OP Facility - Other									4000		ASC									Coin		Coin	Coin	Coin	Coin		Coin	Coin	Coin				Coin	Coin	Coin			Coin	Coin					Coin	Coin	Coin	Coin				Coin									24.9383		4.0955	0.0678	1.108	1.4477		0.7415	2.2362	0.5959				8.8713	3.1216	3.558			4.5477	17.9376					0	0.0163	0	0				1.4669									74.7503	4000	296.8848622		48.75603555	0.806580022	13.19019972	17.2345096		8.8268394	26.62123319	7.094400733				105.6110344	37.16212617	42.35765787			54.13968639	213.5425499					0.000198962	0.193928841	0	0				17.4625322									$1000 Ded; 80% to 15k		$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k		$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k				$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k			$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k					$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k				$1000 Ded; 80% to 15k									0.2		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									0.087		0.087	0.087	0.087	0.087		0.087	0.087	0.087				0.087	0.087	0.087			0.087	0.087					0.087	0.087	0.087	0.087				0.087									25.829	0	4.241775092	0.070172462	1.147547376	1.499402335	0	0.767935028	2.316047288	0.617212864	0	0	0	9.188159995	3.233104977	3.685116235	0	0	4.710152716	18.57820184	0	0	0	0	1.73E-05	0.016871809	0	0	0	0	0	1.519240301	0	0	0	0	0	0	0	0	77.4199	1000	74.6529	50.7673	0	8.337282078	0.137925184	2.255524152	2.947101142	0	1.509389537	4.552230876	1.213142525	0	0	0	18.05948689	6.354723576	7.243159496	0	0	9.257886373	36.51577603	0	0	0	0	3.40E-05	0.033161832	0	0	0	0	0	2.986093006	0	0	0	0	0	0	0	0	152.1702		$1000 Ded; 80% to 15k		$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k		$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k				$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k			$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k					$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k				$1000 Ded; 80% to 15k									0		0	0	0	0		0	0	0				0	0	0			0	0					0	0	0	0				0									0	1000	0	50.7673	0	8.337282078	0.137925184	2.255524152	2.947101142	0	1.509389537	4.552230876	1.213142525	0	0	0	18.05948689	6.354723576	7.243159496	0	0	9.257886373	36.51577603	0	0	0	0	3.40E-05	0.033161832	0	0	0	0	0	2.986093006	0	0	0	0	0	0	0	0	152.1702
H3154_808_0	2009	1		r.										OP Facility - Other									4000		ASC									coin		coin	coin	coin	coin		coin	coin	coin				coin	coin	coin			coin	coin					coin	coin	coin	coin				coin									24.9383		4.0955	0.0678	1.108	1.4477		0.7415	2.2362	0.5959				8.8713	3.1216	3.558			4.5477	17.9376					0	0.0163	0	0				1.4669									74.7503	4000	296.8848622		48.75603555	0.806580022	13.19019972	17.2345096		8.8268394	26.62123319	7.094400733				105.6110344	37.16212617	42.35765787			54.13968639	213.5425499					0.000198962	0.193928841	0	0				17.4625322									$1000 Ded; 80% to 15k		$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k		$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k				$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k			$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k					$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k				$1000 Ded; 80% to 15k									0.2		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									0.087		0.087	0.087	0.087	0.087		0.087	0.087	0.087				0.087	0.087	0.087			0.087	0.087					0.087	0.087	0.087	0.087				0.087									25.829	0	4.241775092	0.070172462	1.147547376	1.499402335	0	0.767935028	2.316047288	0.617212864	0	0	0	9.188159995	3.233104977	3.685116235	0	0	4.710152716	18.57820184	0	0	0	0	1.73E-05	0.016871809	0	0	0	0	0	1.519240301	0	0	0	0	0	0	0	0	77.4199	1000	74.6529	50.7673	0	8.337282078	0.137925184	2.255524152	2.947101142	0	1.509389537	4.552230876	1.213142525	0	0	0	18.05948689	6.354723576	7.243159496	0	0	9.257886373	36.51577603	0	0	0	0	3.40E-05	0.033161832	0	0	0	0	0	2.986093006	0	0	0	0	0	0	0	0	152.1702		$1000 Ded; 80% to 15k		$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k		$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k				$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k			$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k					$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k				$1000 Ded; 80% to 15k									0		0	0	0	0		0	0	0				0	0	0			0	0					0	0	0	0				0									0	1000	0	50.7673	0	8.337282078	0.137925184	2.255524152	2.947101142	0	1.509389537	4.552230876	1.213142525	0	0	0	18.05948689	6.354723576	7.243159496	0	0	9.257886373	36.51577603	0	0	0	0	3.40E-05	0.033161832	0	0	0	0	0	2.986093006	0	0	0	0	0	0	0	0	152.1702
H3154_809_0	2009	1		r.										OP Facility - Other									4000		ASC									coin		coin	coin	coin	coin		coin	coin	coin				coin	coin	coin			coin	coin					coin	coin	coin	coin				coin									24.9383		4.0955	0.0678	1.108	1.4477		0.7415	2.2362	0.5959				8.8713	3.1216	3.558			4.5477	17.9376					0	0.0163	0	0				1.4669									74.7503	4000	296.8848622		48.75603555	0.806580022	13.19019972	17.2345096		8.8268394	26.62123319	7.094400733				105.6110344	37.16212617	42.35765787			54.13968639	213.5425499					0.000198962	0.193928841	0	0				17.4625322									$1000 Ded; 80% to 15k		$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k		$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k				$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k			$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k					$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k				$1000 Ded; 80% to 15k									0.2		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									0.087		0.087	0.087	0.087	0.087		0.087	0.087	0.087				0.087	0.087	0.087			0.087	0.087					0.087	0.087	0.087	0.087				0.087									25.829	0	4.241775092	0.070172462	1.147547376	1.499402335	0	0.767935028	2.316047288	0.617212864	0	0	0	9.188159995	3.233104977	3.685116235	0	0	4.710152716	18.57820184	0	0	0	0	1.73E-05	0.016871809	0	0	0	0	0	1.519240301	0	0	0	0	0	0	0	0	77.4199	1000	74.6529	50.7673	0	8.337282078	0.137925184	2.255524152	2.947101142	0	1.509389537	4.552230876	1.213142525	0	0	0	18.05948689	6.354723576	7.243159496	0	0	9.257886373	36.51577603	0	0	0	0	3.40E-05	0.033161832	0	0	0	0	0	2.986093006	0	0	0	0	0	0	0	0	152.1702		$1000 Ded; 80% to 15k		$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k		$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k				$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k			$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k					$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k	$1000 Ded; 80% to 15k				$1000 Ded; 80% to 15k									0		0	0	0	0		0	0	0				0	0	0			0	0					0	0	0	0				0									0	1000	0	50.7673	0	8.337282078	0.137925184	2.255524152	2.947101142	0	1.509389537	4.552230876	1.213142525	0	0	0	18.05948689	6.354723576	7.243159496	0	0	9.257886373	36.51577603	0	0	0	0	3.40E-05	0.033161832	0	0	0	0	0	2.986093006	0	0	0	0	0	0	0	0	152.1702
H3156_021_0	2009	3																					None											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	V	V	V	P	V	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	None	1493.296	42.71710031	1644.815193	0	202.762722	29799.09529	52.11150658	261.8127591	353.4373835	0	419.1708684	0	0	272.6131177	4687.33731	7769.248145	164.107065	767.9124356	1095.835127	135.0993191	1116.777327	0	0	546.7856137	341.5406633	0	68.43011146	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 14a												265	250	25	0	50	1.316277874	39.5519847	48.58852783	215	0	25	0	0	25	25	36.07952224	25	25	25	40	25	0	0	10	40	0	40	0	0	0											265	250	25	0	50	1.316277874	39.5519847	48.58852783	215	0	25	0	0	25	25	36.07952224	25	25	25	40	25	0	0	10	40	0	40	0	0	0											32.977	0.88993959	3.426698318	0	0.844844675	3.268657483	0.171759459	1.060091378	6.332419788	0	0.873272642	0	0	0.567943995	9.765286062	23.3592301	0.341889719	1.599817574	2.282989847	0.450331064	2.32661943	0	0	0.455654678	1.138468878	0	0.228100372	0	0	0	0	0	0	0	0	0	0	0	0	0	92.361	0	0	32.977	0.88993959	3.426698318	0	0.844844675	3.268657483	0.171759459	1.060091378	6.332419788	0	0.873272642	0	0	0.567943995	9.765286062	23.3592301	0.341889719	1.599817574	2.282989847	0.450331064	2.32661943	0	0	0.455654678	1.138468878	0	0.228100372	0	0	0	0	0	0	0	0	0	0	0	0	0	92.361	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 14a												1.0036	0.012	0.1798	0.1155	0.0215	0.052	0.0027	0.0109	0.1352	0.014	0.0368	0	0.0251	0.0399	0.092	0.1878	0.0063	0.0247	0.139	0.3096	0.0855	0.1021	0	0.0046	0	0	0.0013	0	0	0											2.6019	0	0	33.9806	0.901978807	3.606457992	0.115467084	0.866332585	3.320668355	0.174492495	1.07099053	6.467595736	0.013997156	0.910058786	0	0.025055819	0.607849001	9.85725151	23.54706471	0.348182464	1.624510482	2.421979525	0.759956307	2.412117069	0.102091081	0	0.460294377	1.138468878	0	0.229403317	0	0	0	0	0	0	0	0	0	0	0	0	0	94.9629
H3156_024_0	2009	2																					None											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	V	V	V	P	V	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	None	1493.296	42.71710031	1644.815193	0	202.762722	29799.09529	52.11150658	261.8127591	353.4373835	0	419.1708684	0	0	272.6131177	4687.33731	7769.248145	164.107065	767.9124356	1095.835127	135.0993191	1116.777327	0	0	546.7856137	341.5406633	0	68.43011146	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 14a												265	250	25	0	50	1.316277874	39.5519847	48.58852783	215	0	25	0	0	25	25	36.07952224	25	25	25	40	25	0	0	10	40	0	40	0	0	0											265	250	25	0	50	1.316277874	39.5519847	48.58852783	215	0	25	0	0	25	25	36.07952224	25	25	25	40	25	0	0	10	40	0	40	0	0	0											32.977	0.88993959	3.426698318	0	0.844844675	3.268657483	0.171759459	1.060091378	6.332419788	0	0.873272642	0	0	0.567943995	9.765286062	23.3592301	0.341889719	1.599817574	2.282989847	0.450331064	2.32661943	0	0	0.455654678	1.138468878	0	0.228100372	0	0	0	0	0	0	0	0	0	0	0	0	0	92.361	0	0	32.977	0.88993959	3.426698318	0	0.844844675	3.268657483	0.171759459	1.060091378	6.332419788	0	0.873272642	0	0	0.567943995	9.765286062	23.3592301	0.341889719	1.599817574	2.282989847	0.450331064	2.32661943	0	0	0.455654678	1.138468878	0	0.228100372	0	0	0	0	0	0	0	0	0	0	0	0	0	92.361	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 14a												1.0036	0.012	0.1798	0.1155	0.0215	0.052	0.0027	0.0109	0.1352	0.014	0.0368	0	0.0251	0.0399	0.092	0.1878	0.0063	0.0247	0.139	0.3096	0.0855	0.1021	0	0.0046	0	0	0.0013	0	0	0											2.6019	0	0	33.9806	0.901978807	3.606457992	0.115467084	0.866332585	3.320668355	0.174492495	1.07099053	6.467595736	0.013997156	0.910058786	0	0.025055819	0.607849001	9.85725151	23.54706471	0.348182464	1.624510482	2.421979525	0.759956307	2.412117069	0.102091081	0	0.460294377	1.138468878	0	0.229403317	0	0	0	0	0	0	0	0	0	0	0	0	0	94.9629
H3156_025_0	2009	2																					None											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	V	V	V	P	V	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	None	1362.555124	38.9914703	1401.255936	0	179.627905	26668.45707	46.63676741	232.9244156	315.3560004	0	377.5633118	0	0	242.2964403	4433.776779	6953.025204	146.8662782	687.2369655	993.8902695	120.9060328	999.4507518	0	0	495.9990265	306.7194782	0	62.0741801	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 14a												217.5	200	75	0	100	1.316277874	39.5519847	48.5801485	190	0	25	0	0	25	15	36.07952224	25	25	25	40	25	0	0	10	40	0	40	0	0	0											217.5	200	75	0	100	1.316277874	39.5519847	48.5801485	190	0	25	0	0	25	15	36.07952224	25	25	25	40	25	0	0	10	40	0	40	0	0	0											24.6963	0.649857838	8.757849602	0	1.496899209	2.925258331	0.153714726	0.942958558	4.993136672	0	0.786590233	0	0	0.504784251	5.542220974	20.90515229	0.305971413	1.431743678	2.070604728	0.403020109	2.082189066	0	0	0.413332522	1.022398261	0	0.206913934	0	0	0	0	0	0	0	0	0	0	0	0	0	80.2909	0	0	24.6963	0.649857838	8.757849602	0	1.496899209	2.925258331	0.153714726	0.942958558	4.993136672	0	0.786590233	0	0	0.504784251	5.542220974	20.90515229	0.305971413	1.431743678	2.070604728	0.403020109	2.082189066	0	0	0.413332522	1.022398261	0	0.206913934	0	0	0	0	0	0	0	0	0	0	0	0	0	80.2909	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 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	24.6963	0.649857838	8.757849602	0	1.496899209	2.925258331	0.153714726	0.942958558	4.993136672	0	0.786590233	0	0	0.504784251	5.542220974	20.90515229	0.305971413	1.431743678	2.070604728	0.403020109	2.082189066	0	0	0.413332522	1.022398261	0	0.206913934	0	0	0	0	0	0	0	0	0	0	0	0	0	80.2909
H3156_026_0	2009	3																					None											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	V	V	V	P	V	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	None	1362.555124	38.9914703	1401.255936	0	179.627905	26668.45707	46.63676741	232.9244156	315.3560004	0	377.5633118	0	0	242.2964403	4433.776779	6953.025204	146.8662782	687.2369655	993.8902695	120.9060328	999.4507518	0	0	495.9990265	306.7194782	0	62.0741801	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 14a												217.5	200	75	0	100	1.316277874	39.5519847	48.5801485	190	0	25	0	0	25	15	36.07952224	25	25	25	40	25	0	0	10	40	0	40	0	0	0											217.5	200	75	0	100	1.316277874	39.5519847	48.5801485	190	0	25	0	0	25	15	36.07952224	25	25	25	40	25	0	0	10	40	0	40	0	0	0											24.6963	0.649857838	8.757849602	0	1.496899209	2.925258331	0.153714726	0.942958558	4.993136672	0	0.786590233	0	0	0.504784251	5.542220974	20.90515229	0.305971413	1.431743678	2.070604728	0.403020109	2.082189066	0	0	0.413332522	1.022398261	0	0.206913934	0	0	0	0	0	0	0	0	0	0	0	0	0	80.2909	0	0	24.6963	0.649857838	8.757849602	0	1.496899209	2.925258331	0.153714726	0.942958558	4.993136672	0	0.786590233	0	0	0.504784251	5.542220974	20.90515229	0.305971413	1.431743678	2.070604728	0.403020109	2.082189066	0	0	0.413332522	1.022398261	0	0.206913934	0	0	0	0	0	0	0	0	0	0	0	0	0	80.2909	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 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	24.6963	0.649857838	8.757849602	0	1.496899209	2.925258331	0.153714726	0.942958558	4.993136672	0	0.786590233	0	0	0.504784251	5.542220974	20.90515229	0.305971413	1.431743678	2.070604728	0.403020109	2.082189066	0	0	0.413332522	1.022398261	0	0.206913934	0	0	0	0	0	0	0	0	0	0	0	0	0	80.2909
H3156_027_0	2009	2																					None											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	V	V	V	P	V	P	O	O											45.2894	0.542	8.0166	4.6653	0.8829	2.3507	0.117	0	7.0973	0	2.1442	0	1.2665	0.9992	0	0	0	0	6.4636	10.8938	0	0	0	0	0	0	0	0	0	0											90.7285	None	0	0	0	0	0	24547.30915	40.66804978	237.4950445	0	0	0	0	0	248.5443559	4638.510166	7087.237167	148.8644588	736.1659425	0	122.5510128	1013.048721	0	0	495.9990265	306.7194782	0	62.0741801	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 14a												0	0	0	0	0	0.658138937	19.77599235	48.58852783	0	0	0	0	0	15	10	33.36265836	25	15	0	40	25	0	0	10	40	0	40	0	0	0											0	0	0	0	0	0.658138937	19.77599235	48.58852783	0	0	0	0	0	15	10	33.36265836	25	15	0	40	25	0	0	10	40	0	40	0	0	0											0	0	0	0	0	1.346294996	0.06702092	0.961627881	0	0	0	0	0	0.310680445	3.865425139	19.70408936	0.310134289	0.920207428	0	0.408503376	2.110518169	0	0	0.413332522	1.022398261	0	0.206913934	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6471	1500	0	45.2894	0.542005697	8.016559382	4.665279263	0.882882657	3.696986447	0.184042453	0.961627881	7.097339369	0	2.144184516	0	1.266538169	1.309882312	3.865425139	19.70408936	0.310134289	0.920207428	6.463582025	11.30235308	2.110518169	0	0	0.413332522	1.022398261	0	0.206913934	0	0	0	0	0	0	0	0	0	0	0	0	0	122.3757	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 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	45.2894	0.542005697	8.016559382	4.665279263	0.882882657	3.696986447	0.184042453	0.961627881	7.097339369	0	2.144184516	0	1.266538169	1.309882312	3.865425139	19.70408936	0.310134289	0.920207428	6.463582025	11.30235308	2.110518169	0	0	0.413332522	1.022398261	0	0.206913934	0	0	0	0	0	0	0	0	0	0	0	0	0	122.3757
H3156_028_0	2009	3																					None											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	V	V	V	P	V	P	O	O											45.2894	0.542	8.0166	4.6653	0.8829	2.3507	0.117	0	7.0973	0	2.1442	0	1.2665	0.9992	0	0	0	0	6.4636	10.8938	0	0	0	0	0	0	0	0	0	0											90.7285	None	0	0	0	0	0	24547.30915	40.66804978	237.4950445	0	0	0	0	0	248.5443559	4638.510166	7087.237167	148.8644588	736.1659425	0	122.5510128	1013.048721	0	0	495.9990265	306.7194782	0	62.0741801	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 14a												0	0	0	0	0	0.658138937	19.77599235	48.58852783	0	0	0	0	0	15	10	33.36265836	25	15	0	40	25	0	0	10	40	0	40	0	0	0											0	0	0	0	0	0.658138937	19.77599235	48.58852783	0	0	0	0	0	15	10	33.36265836	25	15	0	40	25	0	0	10	40	0	40	0	0	0											0	0	0	0	0	1.346294996	0.06702092	0.961627881	0	0	0	0	0	0.310680445	3.865425139	19.70408936	0.310134289	0.920207428	0	0.408503376	2.110518169	0	0	0.413332522	1.022398261	0	0.206913934	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6471	1500	0	45.2894	0.542005697	8.016559382	4.665279263	0.882882657	3.696986447	0.184042453	0.961627881	7.097339369	0	2.144184516	0	1.266538169	1.309882312	3.865425139	19.70408936	0.310134289	0.920207428	6.463582025	11.30235308	2.110518169	0	0	0.413332522	1.022398261	0	0.206913934	0	0	0	0	0	0	0	0	0	0	0	0	0	122.3757	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 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	45.2894	0.542005697	8.016559382	4.665279263	0.882882657	3.696986447	0.184042453	0.961627881	7.097339369	0	2.144184516	0	1.266538169	1.309882312	3.865425139	19.70408936	0.310134289	0.920207428	6.463582025	11.30235308	2.110518169	0	0	0.413332522	1.022398261	0	0.206913934	0	0	0	0	0	0	0	0	0	0	0	0	0	122.3757
H3156_801_0	2009	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	N/A	348.0660322		41.98596432	12.57892638	13.99006405	18.46011141		8.11941511	59.80692918	67.57338234					277.2330982						79.40920507	0.275136222																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			0.069394857		0.157135739	0	0.231	0.231		0.231	0.231	0.231					0.231						0.231	0.231																			0.069394857		0.157135739	0	0.231	0.231		0.231	0.231	0.231					0.231						0.231	0.231																			24.154	0	6.597495542	0	3.231704796	4.264285736	0	1.87558489	13.81540064	15.60945132	0	0	0	0	64.04084569	0	0	0	0	0	18.34352637	0.063556467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.9958	Medicare FFS	0	24.154	0	6.597495542	0	3.231704796	4.264285736	0	1.87558489	13.81540064	15.60945132	0	0	0	0	64.04084569	0	0	0	0	0	18.34352637	0.063556467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.9958	None																																																																																	0	N/A	0	24.154	0	6.597495542	0	3.231704796	4.264285736	0	1.87558489	13.81540064	15.60945132	0	0	0	0	64.04084569	0	0	0	0	0	18.34352637	0.063556467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.9958
H3156_803_0	2009	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	N/A	348.0660322		41.98596432	12.57892638	13.99006405	18.46011141		8.11941511	59.80692918	67.57338234					277.2330982						79.40920507	0.275136222																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			0.068563497		0.155257332	0	0.231	0.231		0.231	0.231	0.231					0.231						0.231	0.231																			0.068563497		0.155257332	0	0.231	0.231		0.231	0.231	0.231					0.231						0.231	0.231																			23.8646	0	6.518628801	0	3.231704796	4.264285736	0	1.87558489	13.81540064	15.60945132	0	0	0	0	64.04084569	0	0	0	0	0	18.34352637	0.063556467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.6276	Medicare FFS	0	23.8646	0	6.518628801	0	3.231704796	4.264285736	0	1.87558489	13.81540064	15.60945132	0	0	0	0	64.04084569	0	0	0	0	0	18.34352637	0.063556467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.6276	None																																																																																	0	N/A	0	23.8646	0	6.518628801	0	3.231704796	4.264285736	0	1.87558489	13.81540064	15.60945132	0	0	0	0	64.04084569	0	0	0	0	0	18.34352637	0.063556467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.6276
H3164_003_0	2009	5																																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																																																			0		495.3984738	19.52833758	52.85189043		26.45396099	5.143136976	6.109404389	644.9205529	43.11368528	17.79886424	51.22008485	1.061583182	10.83825522	38.86883123	77.98070924	142.8000126	9.016458165	5.49130822			15.13051021	4.966645108																			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 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 (14a)	"$0 (13c, 13d, 13e)"											0.060115568	0.060115568	0.157282489		0.22869	0.22869	0.22869	52.01042284	0.22869	0.22869	0.22869	0.22869	0.22869	0.22869	0.2269292	0.22869	0.22869	0.22869			0.22869	0.22869																			0.060115568	0.060115568	0.157282489		0.22869	0.22869	0.22869	52.01042284	0.22869	0.22869	0.22869	0.22869	0.22869	0.22869	0.2269292	0.22869	0.22869	0.22869			0.22869	0.22869																			29.7812	1.173957112	8.312676884	0	6.049756339	1.176183995	1.39715969	2.795215888	9.859668686	4.070422264	11.7135212	0.242773458	2.478600586	8.888913013	17.6961	32.65693488	2.061973818	1.255807277	0	0	3.46019638	1.13582207	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	146.2068	135	0	29.7812	1.173957112	8.312676884	0	6.049756339	1.176183995	1.39715969	2.795215888	9.859668686	4.070422264	11.7135212	0.242773458	2.478600586	8.888913013	17.6961	32.65693488	2.061973818	1.255807277	0	0	3.46019638	1.13582207	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	146.2068																																																																																		0	0	0	29.7812	1.173957112	8.312676884	0	6.049756339	1.176183995	1.39715969	2.795215888	9.859668686	4.070422264	11.7135212	0.242773458	2.478600586	8.888913013	17.6961	32.65693488	2.061973818	1.255807277	0	0	3.46019638	1.13582207	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	146.2068
H3195_001_0	2009	7																					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	O	O											0	0	0	0	0	0	0	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	1087.714978	21.66174307	225.2063042	1981.166909	226.9947162	17440.52274	17522.37113	163.9158183	184.7797008	1595.971684	489.035603	0	74.01359389	427.2670144	10041.98493	17131.09671	155.0979078	528.5558221	3567.91795	8888.905353	134.0479123	750.2507743	0	4509.142379	383.6630411	291.7211285	153.8640523	19.74689343	0	387.8629936											"$0 copay, days 1-1"	"$0 copay, days 1-1"	"$0 copay, days 1-1"	$0 copay	$0 copay	$0 copay	$0 copay	$25 copay	$0 copay	$0 copay	0% coinsurance		$0 copay	Varies	$0 copay	$0 copay	"$0 copay Group, $0 copay Individual"	$0 copay	0% coinsurance	Varies		Varies	Not Covered	$0 copay	$10 copay	$10 copay; and $100 credit covered every 1years	$10 copay	$250 credit	Varies	Varies											0	0	0	0	0	0	0	20.25	0	0	0	0	0	0	0	0	0	0	0	0.090577059	0	0	0	0	9	18	9	0	0	0											0	0	0	0	0	0	0	20.25	0	0	0	0	0	0	0	0	0	0	0	0.090577059	0	0	0	0	9	18	9	0	0	0											0	0	0	0	0	0	0	0.276607943	0	0	0	0	0	0	0	0	0	0	0	0.067094242	0	0	0	0	0.287747281	0.437581693	0.115398039	0	0	0	0	0	0	0	0	0	0	0	0	0	1.1844		0	0	0	0	0	0	0	0	0.276607943	0	0	0	0	0	0	0	0	0	0	0	0.067094242	0	0	0	0	0.287747281	0.437581693	0.115398039	0	0	0	0	0	0	0	0	0	0	0	0	0	1.1844		"$250 copay, days 1-1"	"$250 copay, days 1-1"	"$0 copay, days 1-1"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance		25% coinsurance	Varies	20% coinsurance	20% coinsurance	"25% coinsurance Group, 25% coinsurance Individual"	25% coinsurance	20% coinsurance	Varies	0	Varies	Not Covered	$0 copay	20% coinsurance	Not Covered; and $100 credit covered every 1years	20% coinsurance	$250 credit	Varies	Varies											0.2444	0.004	0	0.4512	0.1329	0.1249	0.1486	0.106	0.2918	0.2226	0.201	0	0.022	0.2448	0.8706	1.8239	0.0352	0.1266	0.392	0.3623	0	0.135	0	0	0.0677	0	0.018	0	0	0											6.0254		0	0.2444	0.003964286	0	0.451244048	0.132936727	0.124890324	0.148552041	0.382574867	0.291765436	0.222611418	0.201005982	0	0.02197256	0.244770231	0.870622036	1.823863167	0.03519998	0.126616233	0.392037633	0.429428972	0	0.134979441	0	0	0.355447551	0.437581693	0.133355212	0	0	0	0	0	0	0	0	0	0	0	0	0	7.2098
H3204_001_0	2009	5																					0											A	A	D			O	O	V	V					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	166.960011	3.267850999	313.7470391	0	117.8718915	929.6635903	36.88913115	348.4489471	373.7889456	0	0	0	0	664.7882884	2706.681452	2452.259026	112.2840806	1259.66983	0	1321.88112	0	0	0	0	275.2132598	0	117.9485399	0	0	0											$550/benefit period for IP Medical; $550/benefit period for IP Surgical;	$550/benefit period for IP Psych; $550/benefit period for IP Substance Abuse;	$125/Days 21-100 for SNF		$50/Trip for Ambulance	$35/Unit for DME	$35/Unit for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care; $40/Visit for Urgent Care - Worldwide;	$275/Case for OP Fac - Surgery; $275/Case for OP Fac - ASC					$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/Visit for Prof - CORF; $20/Visit for Prof - CORF;	$20/Visit for PCP - Office Visits; $20/Consult for PCP - Consults;	$35/Visit for Speclst - Office Visits; $35/Consult for Speclst - Consults;	$35/Visit for OP Psych - Non-Physician; $35/Visit for OP Psych - Psychiatrist; $35/Visit for OP Substance Abuse;	$20/Visit for PT/ST (PCP); $20/Visit for Occ Therapy (PCP); $20/Visit for PT/ST (Specialist); $20/Visit for Occ Therapy (Specialist);		$35/Visit for Chiropractor; $35/Exam for Vistion Exams; $35/Service for Podiatrist; $35/Exam for Hearing/Speech Exams;		$20/Case for OP Fac - Cardiovascular;			$35/Exam for Vision (Refractions)		$35/Exam for Routine Hearing Exams														550	550.0000002	125	0	50	35	35.00000001	44.11319196	275	0	0	0	0	20	20	35	35	20	0	35	0	0	0	0	35	0	35	0	0	0											550	550.0000002	125	0	50	35	35.00000001	44.11319196	275	0	0	0	0	20	20	35	35	20	0	35	0	0	0	0	35	0	35	0	0	0											7.6523	0.149776504	3.268198324	0	0.491132881	2.711518805	0.107593299	1.280932941	8.56599667	0	0	0	0	1.107980481	4.511135754	7.15242216	0.327495235	2.099449716	0	3.855486601	0	0	0	0	0.802705341	0	0.344016575	0	0	0	0	0	0	0	0	0	0	0	0	0	44.4282	0	0	7.6523	0.149776504	3.268198324	0	0.491132881	2.711518805	0.107593299	1.280932941	8.56599667	0	0	0	0	1.107980481	4.511135754	7.15242216	0.327495235	2.099449716	0	3.855486601	0	0	0	0	0.802705341	0	0.344016575	0	0	0	0	0	0	0	0	0	0	0	0	0	44.4282	0																																																																																	0	0		7.6523	0.149776504	3.268198324	0	0.491132881	2.711518805	0.107593299	1.280932941	8.56599667	0	0	0	0	1.107980481	4.511135754	7.15242216	0.327495235	2.099449716	0	3.855486601	0	0	0	0	0.802705341	0	0.344016575	0	0	0	0	0	0	0	0	0	0	0	0	0	44.4282
H3204_007_0	2009	5																					0											A	A	D			O	O	V	V					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	189.5692431	3.71037374	412.2560451	0	151.0408032	1191.269043	47.26965799	446.5017755	478.9723983	0	0	0	0	857.8771294	3581.665748	3209.029009	147.306322	1667.942983	0	1734.616803	0	0	0	0	352.6577141	0	151.1390203	0	0	0											$250/benefit period for IP Medical; $250/benefit period for IP Surgical;	$250/benefit period for IP Psych; $250/benefit period for IP Substance Abuse;	$75/Days 21-100 for SNF		$50/Trip for Ambulance	$10/Unit for DME	$10/Unit for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care; $40/Visit for Urgent Care - Worldwide;	$175/Case for OP Fac - Surgery; $175/Case for OP Fac - ASC					$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;	$30/Visit for Speclst - Office Visits; $30/Consult for Speclst - Consults;	$30/Visit for OP Psych - Non-Physician; $30/Visit for OP Psych - Psychiatrist; $30/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);		$30/Visit for Chiropractor; $30/Exam for Vistion Exams; $30/Service for Podiatrist; $30/Exam for Hearing/Speech Exams;		$15/Case for OP Fac - Cardiovascular;			$30/Exam for Vision (Refractions)		$30/Exam for Routine Hearing Exams														250	249.9999999	75	0	50	10	10.00000001	44.11319196	175	0	0	0	0	15	15	30	30	15	0	30	0	0	0	0	30	0	30	0	0	0											250	249.9999999	75	0	50	10	10.00000001	44.11319196	175	0	0	0	0	15	15	30	30	15	0	30	0	0	0	0	30	0	30	0	0	0											3.9494	0.077299453	2.576600282	0	0.62933668	0.992724203	0.039391382	1.641384878	6.985014142	0	0	0	0	1.072346412	4.477082185	8.022572522	0.368265805	2.084928728	0	4.336542008	0	0	0	0	0.881644285	0	0.377847551	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5123	0	0	3.9494	0.077299453	2.576600282	0	0.62933668	0.992724203	0.039391382	1.641384878	6.985014142	0	0	0	0	1.072346412	4.477082185	8.022572522	0.368265805	2.084928728	0	4.336542008	0	0	0	0	0.881644285	0	0.377847551	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5123	0																																																																																	0	0		3.9494	0.077299453	2.576600282	0	0.62933668	0.992724203	0.039391382	1.641384878	6.985014142	0	0	0	0	1.072346412	4.477082185	8.022572522	0.368265805	2.084928728	0	4.336542008	0	0	0	0	0.881644285	0	0.377847551	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5123
H3204_008_0	2009	4																					0											A	A	D			O	O	V	V					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	172.1578172	3.369585876	340.0045866	0	124.5695884	982.4887792	38.98523918	368.2484548	395.0283185	0	0	0	0	707.526699	2953.947665	2646.618756	121.4896075	1375.621464	0	1430.610117	0	0	0	0	290.8513815	0	124.6505921	0	0	0											$250/benefit period for IP Medical; $250/benefit period for IP Surgical;	$250/benefit period for IP Psych; $250/benefit period for IP Substance Abuse;	$75/Days 21-100 for SNF		$50/Trip for Ambulance	$10/Unit for DME	$10/Unit for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care; $40/Visit for Urgent Care - Worldwide;	$150/Case for OP Fac - Surgery; $150/Case for OP Fac - ASC					$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;	$30/Visit for Speclst - Office Visits; $30/Consult for Speclst - Consults;	$30/Visit for OP Psych - Non-Physician; $30/Visit for OP Psych - Psychiatrist; $30/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);		$30/Visit for Chiropractor; $30/Exam for Vistion Exams; $30/Service for Podiatrist; $30/Exam for Hearing/Speech Exams;		$15/Case for OP Fac - Cardiovascular;			$30/Exam for Vision (Refractions)		$30/Exam for Routine Hearing Exams														250	250.0000002	75	0	50	10	9.999999995	44.11319196	150	0	0	0	0	15	15	30	29.99999999	15	0	30	0	0	0	0	30	0	30	0	0	0											250	250.0000002	75	0	50	10	9.999999995	44.11319196	150	0	0	0	0	15	15	30	29.99999999	15	0	30	0	0	0	0	30	0	30	0	0	0											3.5866	0.070199706	2.125028666	0	0.519039952	0.818740649	0.032487699	1.353717898	4.937853981	0	0	0	0	0.884408374	3.692434582	6.616546891	0.303724019	1.71952683	0	3.576525293	0	0	0	0	0.727128454	0	0.31162648	0	0	0	0	0	0	0	0	0	0	0	0	0	31.2756	0	0	3.5866	0.070199706	2.125028666	0	0.519039952	0.818740649	0.032487699	1.353717898	4.937853981	0	0	0	0	0.884408374	3.692434582	6.616546891	0.303724019	1.71952683	0	3.576525293	0	0	0	0	0.727128454	0	0.31162648	0	0	0	0	0	0	0	0	0	0	0	0	0	31.2756	0																																																																																	0	0		3.5866	0.070199706	2.125028666	0	0.519039952	0.818740649	0.032487699	1.353717898	4.937853981	0	0	0	0	0.884408374	3.692434582	6.616546891	0.303724019	1.71952683	0	3.576525293	0	0	0	0	0.727128454	0	0.31162648	0	0	0	0	0	0	0	0	0	0	0	0	0	31.2756
H3204_801_0	2009	4																					0											A	A	D			O	O	V	V					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	156.4070817	3.061302134	131.123537	0	107.8675447	850.7586296	33.75817552	240.147549	352.2592821	0	0	0	0	609.3335842	2505.744257	2265.069144	103.7648875	1166.304943	0	1221.647206	0	0	0	0	251.8546044	0	107.9376876	0	0	0											$550/benefit period for IP Medical; $550/benefit period for IP Surgical;	$550/benefit period for IP Psych; $550/benefit period for IP Substance Abuse;	$125/Days 21-100 for SNF		$50/Trip for Ambulance	$35/Unit for DME	$35/Unit for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care; $40/Visit for Urgent Care - Worldwide;	$250/Case for OP Fac - Surgery; $250/Case for OP Fac - ASC					$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/Visit for Prof - CORF; $20/Visit for Prof - CORF;	$20/Visit for PCP - Office Visits; $20/Consult for PCP - Consults;	$35/Visit for Speclst - Office Visits; $35/Consult for Speclst - Consults;	$35/Visit for OP Psych - Non-Physician; $35/Visit for OP Psych - Psychiatrist; $35/Visit for OP Substance Abuse;	$20/Visit for PT/ST (PCP); $20/Visit for Occ Therapy (PCP); $20/Visit for PT/ST (Specialist); $20/Visit for Occ Therapy (Specialist);		$35/Visit for Chiropractor; $35/Exam for Vistion Exams; $35/Service for Podiatrist; $35/Exam for Hearing/Speech Exams;		$20/Case for OP Fac - Cardiovascular;			$35/Exam for Vision (Refractions)		$35/Exam for Routine Hearing Exams														550	550.0000002	125	0	50	35	35.00000001	44.11319195	250	0	0	0	0	20	20	35	34.99999999	20	0	35	0	0	0	0	35	0	35	0	0	0											550	550.0000002	125	0	50	35	35.00000001	44.11319195	250	0	0	0	0	20	20	35	34.99999999	20	0	35	0	0	0	0	35	0	35	0	0	0											7.1687	0.140309681	1.365870177	0	0.449448103	2.481379336	0.098461345	0.882806244	7.338735043	0	0	0	0	1.015555974	4.176240428	6.606451669	0.302647589	1.943841572	0	3.563137685	0	0	0	0	0.734575929	0	0.314818256	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5829	0	0	7.1687	0.140309681	1.365870177	0	0.449448103	2.481379336	0.098461345	0.882806244	7.338735043	0	0	0	0	1.015555974	4.176240428	6.606451669	0.302647589	1.943841572	0	3.563137685	0	0	0	0	0.734575929	0	0.314818256	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5829	0																																																																																	0	0		7.1687	0.140309681	1.365870177	0	0.449448103	2.481379336	0.098461345	0.882806244	7.338735043	0	0	0	0	1.015555974	4.176240428	6.606451669	0.302647589	1.943841572	0	3.563137685	0	0	0	0	0.734575929	0	0.314818256	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5829
H3204_802_0	2009	4																					0											A	A	D			O	O	V	V					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	156.4070817	3.061302134	131.123537	0	107.8675447	850.7586296	33.75817552	240.147549	352.2592821	0	0	0	0	609.3335842	2505.744257	2265.069144	103.7648875	1166.304943	0	1221.647206	0	0	0	0	251.8546044	0	107.9376876	0	0	0											$550/benefit period for IP Medical; $550/benefit period for IP Surgical;	$550/benefit period for IP Psych; $550/benefit period for IP Substance Abuse;	$125/Days 21-100 for SNF		$50/Trip for Ambulance	$35/Unit for DME	$35/Unit for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care; $40/Visit for Urgent Care - Worldwide;	$250/Case for OP Fac - Surgery; $250/Case for OP Fac - ASC					$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/Visit for Prof - CORF; $20/Visit for Prof - CORF;	$20/Visit for PCP - Office Visits; $20/Consult for PCP - Consults;	$35/Visit for Speclst - Office Visits; $35/Consult for Speclst - Consults;	$35/Visit for OP Psych - Non-Physician; $35/Visit for OP Psych - Psychiatrist; $35/Visit for OP Substance Abuse;	$20/Visit for PT/ST (PCP); $20/Visit for Occ Therapy (PCP); $20/Visit for PT/ST (Specialist); $20/Visit for Occ Therapy (Specialist);		$35/Visit for Chiropractor; $35/Exam for Vistion Exams; $35/Service for Podiatrist; $35/Exam for Hearing/Speech Exams;		$20/Case for OP Fac - Cardiovascular;			$35/Exam for Vision (Refractions)		$35/Exam for Routine Hearing Exams														550	550.0000002	125	0	50	35	35.00000001	44.11319195	250	0	0	0	0	20	20	35	34.99999999	20	0	35	0	0	0	0	35	0	35	0	0	0											550	550.0000002	125	0	50	35	35.00000001	44.11319195	250	0	0	0	0	20	20	35	34.99999999	20	0	35	0	0	0	0	35	0	35	0	0	0											7.1687	0.140309681	1.365870177	0	0.449448103	2.481379336	0.098461345	0.882806244	7.338735043	0	0	0	0	1.015555974	4.176240428	6.606451669	0.302647589	1.943841572	0	3.563137685	0	0	0	0	0.734575929	0	0.314818256	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5829	0	0	7.1687	0.140309681	1.365870177	0	0.449448103	2.481379336	0.098461345	0.882806244	7.338735043	0	0	0	0	1.015555974	4.176240428	6.606451669	0.302647589	1.943841572	0	3.563137685	0	0	0	0	0.734575929	0	0.314818256	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5829	0																																																																																	0	0		7.1687	0.140309681	1.365870177	0	0.449448103	2.481379336	0.098461345	0.882806244	7.338735043	0	0	0	0	1.015555974	4.176240428	6.606451669	0.302647589	1.943841572	0	3.563137685	0	0	0	0	0.734575929	0	0.314818256	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5829
H3204_803_0	2009	4																					0											A	A	D			O	O	V	V					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	156.4070817	3.061302134	131.123537	0	107.8675447	850.7586296	33.75817552	240.147549	352.2592821	0	0	0	0	609.3335842	2505.744257	2265.069144	103.7648875	1166.304943	0	1221.647206	0	0	0	0	251.8546044	0	107.9376876	0	0	0											$550/benefit period for IP Medical; $550/benefit period for IP Surgical;	$550/benefit period for IP Psych; $550/benefit period for IP Substance Abuse;	$125/Days 21-100 for SNF		$50/Trip for Ambulance	$35/Unit for DME	$35/Unit for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care; $40/Visit for Urgent Care - Worldwide;	$250/Case for OP Fac - Surgery; $250/Case for OP Fac - ASC					$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/Visit for Prof - CORF; $20/Visit for Prof - CORF;	$20/Visit for PCP - Office Visits; $20/Consult for PCP - Consults;	$35/Visit for Speclst - Office Visits; $35/Consult for Speclst - Consults;	$35/Visit for OP Psych - Non-Physician; $35/Visit for OP Psych - Psychiatrist; $35/Visit for OP Substance Abuse;	$20/Visit for PT/ST (PCP); $20/Visit for Occ Therapy (PCP); $20/Visit for PT/ST (Specialist); $20/Visit for Occ Therapy (Specialist);		$35/Visit for Chiropractor; $35/Exam for Vistion Exams; $35/Service for Podiatrist; $35/Exam for Hearing/Speech Exams;		$20/Case for OP Fac - Cardiovascular;			$35/Exam for Vision (Refractions)		$35/Exam for Routine Hearing Exams														550	550.0000002	125	0	50	35	35.00000001	44.11319195	250	0	0	0	0	20	20	35	34.99999999	20	0	35	0	0	0	0	35	0	35	0	0	0											550	550.0000002	125	0	50	35	35.00000001	44.11319195	250	0	0	0	0	20	20	35	34.99999999	20	0	35	0	0	0	0	35	0	35	0	0	0											7.1687	0.140309681	1.365870177	0	0.449448103	2.481379336	0.098461345	0.882806244	7.338735043	0	0	0	0	1.015555974	4.176240428	6.606451669	0.302647589	1.943841572	0	3.563137685	0	0	0	0	0.734575929	0	0.314818256	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5829	0	0	7.1687	0.140309681	1.365870177	0	0.449448103	2.481379336	0.098461345	0.882806244	7.338735043	0	0	0	0	1.015555974	4.176240428	6.606451669	0.302647589	1.943841572	0	3.563137685	0	0	0	0	0.734575929	0	0.314818256	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5829	0																																																																																	0	0		7.1687	0.140309681	1.365870177	0	0.449448103	2.481379336	0.098461345	0.882806244	7.338735043	0	0	0	0	1.015555974	4.176240428	6.606451669	0.302647589	1.943841572	0	3.563137685	0	0	0	0	0.734575929	0	0.314818256	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5829
H3204_804_0	2009	4																					0											A	A	D			O	O	V	V					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	156.4070817	3.061302134	131.123537	0	107.8675447	850.7586296	33.75817552	240.147549	352.2592821	0	0	0	0	609.3335842	2505.744257	2265.069144	103.7648875	1166.304943	0	1221.647206	0	0	0	0	251.8546044	0	107.9376876	0	0	0											$550/benefit period for IP Medical; $550/benefit period for IP Surgical;	$550/benefit period for IP Psych; $550/benefit period for IP Substance Abuse;	$125/Days 21-100 for SNF		$50/Trip for Ambulance	$35/Unit for DME	$35/Unit for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $25/Visit for Urgent Care; $40/Visit for Urgent Care - Worldwide;	$250/Case for OP Fac - Surgery; $250/Case for OP Fac - ASC					$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/Visit for Prof - CORF; $20/Visit for Prof - CORF;	$20/Visit for PCP - Office Visits; $20/Consult for PCP - Consults;	$35/Visit for Speclst - Office Visits; $35/Consult for Speclst - Consults;	$35/Visit for OP Psych - Non-Physician; $35/Visit for OP Psych - Psychiatrist; $35/Visit for OP Substance Abuse;	$20/Visit for PT/ST (PCP); $20/Visit for Occ Therapy (PCP); $20/Visit for PT/ST (Specialist); $20/Visit for Occ Therapy (Specialist);		$35/Visit for Chiropractor; $35/Exam for Vistion Exams; $35/Service for Podiatrist; $35/Exam for Hearing/Speech Exams;		$20/Case for OP Fac - Cardiovascular;			$35/Exam for Vision (Refractions)		$35/Exam for Routine Hearing Exams														550	550.0000002	125	0	50	35	35.00000001	44.11319195	250	0	0	0	0	20	20	35	34.99999999	20	0	35	0	0	0	0	35	0	35	0	0	0											550	550.0000002	125	0	50	35	35.00000001	44.11319195	250	0	0	0	0	20	20	35	34.99999999	20	0	35	0	0	0	0	35	0	35	0	0	0											7.1687	0.140309681	1.365870177	0	0.449448103	2.481379336	0.098461345	0.882806244	7.338735043	0	0	0	0	1.015555974	4.176240428	6.606451669	0.302647589	1.943841572	0	3.563137685	0	0	0	0	0.734575929	0	0.314818256	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5829	0	0	7.1687	0.140309681	1.365870177	0	0.449448103	2.481379336	0.098461345	0.882806244	7.338735043	0	0	0	0	1.015555974	4.176240428	6.606451669	0.302647589	1.943841572	0	3.563137685	0	0	0	0	0.734575929	0	0.314818256	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5829	0																																																																																	0	0		7.1687	0.140309681	1.365870177	0	0.449448103	2.481379336	0.098461345	0.882806244	7.338735043	0	0	0	0	1.015555974	4.176240428	6.606451669	0.302647589	1.943841572	0	3.563137685	0	0	0	0	0.734575929	0	0.314818256	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5829
H3206_001_0	2009	5																					0											A	A	D			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	190.0199265	3.111453033	153.3131295	0	215.0840098	1738.225288	57.60566971	296.4597196	267.6228006	0	0	0	0	671.2005633	2438.232941	2226.998841	99.00324936	1191.264874	0	1270.365296	0	0	0	0	246.4133873	0	105.6057374	0	0	0											$550/Benefit Period for IP Medical; $550/Benefit Period for IP Surgical;	$550/Benefit Period for IP Psych; $550/Benefit Period for IP Substance Abuse;	$125/Days 21-100 for SNF		$75/Trip for Ambulance	$35/Unit for DME	$35/Unit for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $35/Visit for Urgent Care;	$275/Case for OP Fac - Surgery; $275/Case for OP Fac - ASC					$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;	$35/Visit for Speclst - Office Visits; $35/Consult for Speclst - Consults;	$35/Visit for OP Psych - Non-Physician; $35/Visit for OP Psych - Psychiatrist; $35/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);		$35/Visit for Chiropractor; $35/Exam for Vistion Exams; $35/Service for Podiatrist; $35/Exam for Hearing/Speech Exams;		$20/Case for OP Fac - Cardiovascular;			$35/Exam for Vision (Refractions)		$35/Exam for Routine Hearing Exams														550	550.0000003	125	0	75	35	35.00000001	47.19508766	275	0	0	0	0	20	20	35	35	20	0	35	0	0	0	0	35	0	35	0	0	0											550	550.0000003	125	0	75	35	35.00000001	47.19508766	275	0	0	0	0	20	20	35	35	20	0	35	0	0	0	0	35	0	35	0	0	0											8.7092	0.142608264	1.597011766	0	1.344275061	5.069823756	0.168016537	1.165953538	6.133022513	0	0	0	0	1.118667606	4.063721568	6.495413287	0.288759477	1.985441456	0	3.705232114	0	0	0	0	0.718705713	0	0.308016734	0	0	0	0	0	0	0	0	0	0	0	0	0	43.0139	0	0	8.7092	0.142608264	1.597011766	0	1.344275061	5.069823756	0.168016537	1.165953538	6.133022513	0	0	0	0	1.118667606	4.063721568	6.495413287	0.288759477	1.985441456	0	3.705232114	0	0	0	0	0.718705713	0	0.308016734	0	0	0	0	0	0	0	0	0	0	0	0	0	43.0139	0	$750/benefit period for IP Medical; $750/benefit period for IP Surgical;	$750/benefit period for IP Psych; $750/benefit period for IP Substance Abuse;	$125/Days 21-100 for SNF		$75/Trip for Ambulance	$50/Unit for DME	10% Coinsurance for Diabetes Monitoring Supplies; $50/Unit for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $40/Visit for Urgent Care;	20% Coinsurance for OP Fac - Surgery; 20% 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			$35/Case for OP Fac - Cardiovascular; $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;	$35/Visit for PCP - Office Visits; $35/Consult for PCP - Consults; $35/Exam for PCP - Routine Physicals;	$50/Visit for Speclst - Office Visits; $50/Consult for Speclst - Consults;	50% Coinsurance for OP Psych - Non-Physician; 50% Coinsurance for OP Psych - Psychiatrist; 50% Coinsurance 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);	10% Coinsurance for Prof Radiology (Office); 10% Coinsurance for Prof Radiology (OP); 10% Coinsurance for Prof Radiology (IP);	$50/Visit for Chiropractor; $50/Exam for Vistion Exams; $50/Service for Podiatrist; $50/Exam 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)		$35/Case for OP Fac - Cardiovascular;			$50/Exam for Vision (Refractions)		$50/Exam for Routine Hearing Exams														2.0958	0.0343	0.2818	0	0.2372	1.2781	0.0442	0.2098	0.7074	0.0133	0.2102	0	0	0.3455	1.257	1.6375	0.0635	0.6132	0.2068	0.9545	0	0	0	0	0.1812	0	0.0777	0	0	0											10.4491	0		10.8051	0.176925761	1.878837372	0	1.581500072	6.347930585	0.212188051	1.375786238	6.840436333	0.013336811	0.210209218	0	0	1.464138484	5.320748121	8.132912435	0.352296997	2.598592494	0.206812851	4.659742286	0	0	0	0	0.899892027	0	0.385668012	0	0	0	0	0	0	0	0	0	0	0	0	0	53.463
H3206_002_0	2009	5																					0											A	A	D			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	201.7878573	3.304145267	172.1940568	0	241.5721884	1952.292441	64.69996401	332.9695372	300.5812735	0	0	0	0	753.8607312	2738.507934	2553.688593	113.843286	1337.97237	0	1461.188851	0	0	0	0	276.7598636	0	118.6113701	0	0	0											$350/Benefit Period for IP Medical; $350/Benefit Period for IP Surgical;	$350/Benefit Period for IP Psych; $350/Benefit Period for IP Substance Abuse;	$125/Days 21-100 for SNF		$75/Trip for Ambulance	$20/Unit for DME	$20/Unit for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $35/Visit for Urgent Care;	$275/Case for OP Fac - Surgery; $275/Case for OP Fac - ASC					$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;	$30/Visit for Speclst - Office Visits; $30/Consult for Speclst - Consults;	$30/Visit for OP Psych - Non-Physician; $30/Visit for OP Psych - Psychiatrist; $30/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);		$30/Visit for Chiropractor; $30/Exam for Vistion Exams; $30/Service for Podiatrist; $30/Exam for Hearing/Speech Exams;		$20/Case for OP Fac - Cardiovascular;			$30/Exam for Vision (Refractions)		$30/Exam for Routine Hearing Exams														350	350	125	0	75	20	19.99999999	47.19508766	275	0	0	0	0	20	20	30	29.99999999	20	0	30	0	0	0	0	30	0	30	0	0	0											350	350	125	0	75	20	19.99999999	47.19508766	275	0	0	0	0	20	20	30	29.99999999	20	0	30	0	0	0	0	30	0	30	0	0	0											5.8855	0.096370904	1.793688092	0	1.509826177	3.253820736	0.107833273	1.309543875	6.888320852	0	0	0	0	1.256434552	4.564179889	6.384221482	0.284608215	2.229953951	0	3.652972128	0	0	0	0	0.691899659	0	0.296528425	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2057	0	0	5.8855	0.096370904	1.793688092	0	1.509826177	3.253820736	0.107833273	1.309543875	6.888320852	0	0	0	0	1.256434552	4.564179889	6.384221482	0.284608215	2.229953951	0	3.652972128	0	0	0	0	0.691899659	0	0.296528425	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2057	0	$750/benefit period for IP Medical; $750/benefit period for IP Surgical;	$750/benefit period for IP Psych; $750/benefit period for IP Substance Abuse;	$125/Days 21-100 for SNF		$75/Trip for Ambulance	$50/Unit for DME	10% Coinsurance for Diabetes Monitoring Supplies; $50/Unit for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $40/Visit for Urgent Care;	20% Coinsurance for OP Fac - Surgery; 20% 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			$35/Case for OP Fac - Cardiovascular; $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;	$35/Visit for PCP - Office Visits; $35/Consult for PCP - Consults; $35/Exam for PCP - Routine Physicals;	$50/Visit for Speclst - Office Visits; $50/Consult for Speclst - Consults;	50% Coinsurance for OP Psych - Non-Physician; 50% Coinsurance for OP Psych - Psychiatrist; 50% Coinsurance 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);	10% Coinsurance for Prof Radiology (Office); 10% Coinsurance for Prof Radiology (OP); 10% Coinsurance for Prof Radiology (IP);	$50/Visit for Chiropractor; $50/Exam for Vistion Exams; $50/Service for Podiatrist; $50/Exam 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)		$35/Case for OP Fac - Cardiovascular;			$50/Exam for Vision (Refractions)		$50/Exam for Routine Hearing Exams														2.2256	0.0364	0.3165	0	0.2664	1.4355	0.0496	0.2357	0.7945	0.015	0.0481	0	0	0.388	1.4118	1.8777	0.0731	0.6887	0.0561	1.0976	0	0	0	0	0.2035	0	0.0872	0	0	0											11.3071	0		8.1111	0.132813682	2.110221285	0	1.776266091	4.689329884	0.157444629	1.545218041	7.682854601	0.014979275	0.048080295	0	0	1.644451105	5.976012667	8.261933683	0.357669655	2.9186162	0.056074497	4.75056028	0	0	0	0	0.895399559	0	0.383742668	0	0	0	0	0	0	0	0	0	0	0	0	0	51.5127
H3206_003_0	2009	3																					0											A	A	D			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	179.4176822	2.93784816	136.1314857	0	190.9797673	1543.424178	51.1498619	263.2357855	237.6305901	0	0	0	0	595.9798105	2164.982697	2018.870039	90.00110661	1057.761052	0	1155.172326	0	0	0	0	218.7980939	0	93.77061167	0	0	0											$350/Benefit Period for IP Medical; $350/Benefit Period for IP Surgical;	$350/Benefit Period for IP Psych; $350/Benefit Period for IP Substance Abuse;	$125/Days 21-100 for SNF		$75/Trip for Ambulance	$20/Unit for DME	$20/Unit for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $35/Visit for Urgent Care;	$250/Case for OP Fac - Surgery; $250/Case for OP Fac - ASC					$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;	$30/Visit for Speclst - Office Visits; $30/Consult for Speclst - Consults;	$30/Visit for OP Psych - Non-Physician; $30/Visit for OP Psych - Psychiatrist; $30/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);		$30/Visit for Chiropractor; $30/Exam for Vistion Exams; $30/Service for Podiatrist; $30/Exam for Hearing/Speech Exams;		$20/Case for OP Fac - Cardiovascular;			$30/Exam for Vision (Refractions)		$30/Exam for Routine Hearing Exams														350	350.0000003	125	0	75	20	19.99999999	47.19508766	250	0	0	0	0	20	20	30	30.00000001	20	0	30	0	0	0	0	30	0	30	0	0	0											350	350.0000003	125	0	75	20	19.99999999	47.19508766	250	0	0	0	0	20	20	30	30.00000001	20	0	30	0	0	0	0	30	0	30	0	0	0											5.233	0.085687238	1.41803631	0	1.193623546	2.57237363	0.08524977	1.035286331	4.950637295	0	0	0	0	0.993299684	3.608304496	5.047175097	0.225002767	1.762935086	0	2.887930816	0	0	0	0	0.546995235	0	0.234426529	0	0	0	0	0	0	0	0	0	0	0	0	0	31.88	0	0	5.233	0.085687238	1.41803631	0	1.193623546	2.57237363	0.08524977	1.035286331	4.950637295	0	0	0	0	0.993299684	3.608304496	5.047175097	0.225002767	1.762935086	0	2.887930816	0	0	0	0	0.546995235	0	0.234426529	0	0	0	0	0	0	0	0	0	0	0	0	0	31.88	0	$750/benefit period for IP Medical; $750/benefit period for IP Surgical;	$750/benefit period for IP Psych; $750/benefit period for IP Substance Abuse;	$125/Days 21-100 for SNF		$75/Trip for Ambulance	$50/Unit for DME	10% Coinsurance for Diabetes Monitoring Supplies; $50/Unit for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $40/Visit for Urgent Care;	20% Coinsurance for OP Fac - Surgery; 20% 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			$35/Case for OP Fac - Cardiovascular; $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;	$35/Visit for PCP - Office Visits; $35/Consult for PCP - Consults; $35/Exam for PCP - Routine Physicals;	$50/Visit for Speclst - Office Visits; $50/Consult for Speclst - Consults;	50% Coinsurance for OP Psych - Non-Physician; 50% Coinsurance for OP Psych - Psychiatrist; 50% Coinsurance 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);	10% Coinsurance for Prof Radiology (Office); 10% Coinsurance for Prof Radiology (OP); 10% Coinsurance for Prof Radiology (IP);	$50/Visit for Chiropractor; $50/Exam for Vistion Exams; $50/Service for Podiatrist; $50/Exam 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)		$35/Case for OP Fac - Cardiovascular;			$50/Exam for Vision (Refractions)		$50/Exam for Routine Hearing Exams														1.9789	0.0324	0.2502	0	0.2106	1.1349	0.0392	0.1863	0.6281	0.0118	0.038	0	0	0.3068	1.1162	1.4845	0.0578	0.5444	0.0443	0.8677	0	0	0	0	0.1609	0	0.0689	0	0	0											9.162	0		7.2119	0.118089975	1.668278011	0	1.404262995	3.707244349	0.124471028	1.221603298	5.57877198	0.011842168	0.038010847	0	0	1.300053999	4.724457383	6.531638361	0.282762962	2.307370921	0.044330825	3.755651274	0	0	0	0	0.707876186	0	0.303375508	0	0	0	0	0	0	0	0	0	0	0	0	0	41.042
H3206_801_0	2009	3																					0											A	A	D			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	189.3165807	3.099936203	150.2572308	0	213.4947191	1725.381259	57.18001205	294.2691305	265.6452922	0	0	0	0	666.2409533	2420.216441	2210.543185	98.27169825	1182.462424	0	1260.978361	0	0	0	0	244.5925987	0	104.8253995	0	0	0											$550/Benefit Period for IP Medical; $550/Benefit Period for IP Surgical;	$550/Benefit Period for IP Psych; $550/Benefit Period for IP Substance Abuse;	$125/Days 21-100 for SNF		$75/Trip for Ambulance	$35/Unit for DME	$35/Unit for Prosthetics;	$50/Case for ER - Facility; $35/Visit for Urgent Care;	$250/Case for OP Fac - Surgery; $250/Case for OP Fac - ASC					$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;	$35/Visit for Speclst - Office Visits; $35/Consult for Speclst - Consults;	$35/Visit for OP Psych - Non-Physician; $35/Visit for OP Psych - Psychiatrist; $35/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);		$35/Visit for Chiropractor; $35/Exam for Vistion Exams; $35/Service for Podiatrist; $35/Exam for Hearing/Speech Exams;		$20/Case for OP Fac - Cardiovascular;			$35/Exam for Vision (Refractions)		$35/Exam for Routine Hearing Exams														550	550	125	0	75	35	35.00000001	47.19508766	250	0	0	0	0	20	20	35	34.99999999	20	0	35	0	0	0	0	35	0	35	0	0	0											550	550	125	0	75	35	35.00000001	47.19508766	250	0	0	0	0	20	20	35	34.99999999	20	0	35	0	0	0	0	35	0	35	0	0	0											8.677	0.142080409	1.565179488	0	1.334341994	5.032362004	0.166775035	1.157338117	5.53427692	0	0	0	0	1.110401589	4.033694069	6.447417622	0.286625787	1.970770706	0	3.677853552	0	0	0	0	0.71339508	0	0.305740748	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1553	0	0	8.677	0.142080409	1.565179488	0	1.334341994	5.032362004	0.166775035	1.157338117	5.53427692	0	0	0	0	1.110401589	4.033694069	6.447417622	0.286625787	1.970770706	0	3.677853552	0	0	0	0	0.71339508	0	0.305740748	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1553	0	$750/benefit period for IP Medical; $750/benefit period for IP Surgical;	$750/benefit period for IP Psych; $750/benefit period for IP Substance Abuse;	$125/Days 21-100 for SNF		$75/Trip for Ambulance	$50/Unit for DME	10% Coinsurance for Diabetes Monitoring Supplies; $50/Unit for Prosthetics;	$50/Case for ER - Facility; $40/Visit for Urgent Care;	20% Coinsurance for OP Fac - Surgery; 20% 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			$35/Case for OP Fac - Cardiovascular; $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;	$35/Visit for PCP - Office Visits; $35/Consult for PCP - Consults; $35/Exam for PCP - Routine Physicals;	$50/Visit for Speclst - Office Visits; $50/Consult for Speclst - Consults;	50% Coinsurance for OP Psych - Non-Physician; 50% Coinsurance for OP Psych - Psychiatrist; 50% Coinsurance 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);	10% Coinsurance for Prof Radiology (Office); 10% Coinsurance for Prof Radiology (OP); 10% Coinsurance for Prof Radiology (IP);	$50/Visit for Chiropractor; $50/Exam for Vistion Exams; $50/Service for Podiatrist; $50/Exam 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)		$35/Case for OP Fac - Cardiovascular;			$50/Exam for Vision (Refractions)		$50/Exam for Routine Hearing Exams														2.0881	0.0342	0.2762	0	0.2355	1.2687	0.0438	0.2083	0.7022	0.0132	0.2087	0	0	0.3429	1.2477	1.6254	0.0631	0.6086	0.2053	0.9475	0	0	0	0	0.1798	0	0.0771	0	0	0											10.3762	0		10.7651	0.176270882	1.841387633	0	1.569814111	6.301024694	0.210620159	1.36562033	6.236463545	0.013238263	0.208655947	0	0	1.453319727	5.281432248	8.072817023	0.349693817	2.579391071	0.205284677	4.625310692	0	0	0	0	0.893242579	0	0.382818248	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5315
H3206_802_0	2009	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	189.3165807	3.099936203	150.2572308	0	213.4947191	1725.381259	57.18001205	294.2691305	265.6452922	0	0	0	0	666.2409533	2420.216441	2210.543185	98.27169825	1182.462424	0	1260.978361	0	0	0	0	244.5925987	0	104.8253995	0	0	0											$550/Benefit Period for IP Medical; $550/Benefit Period for IP Surgical;	$550/Benefit Period for IP Psych; $550/Benefit Period for IP Substance Abuse;	$125/Days 21-100 for SNF		$75/Trip for Ambulance	$35/Unit for DME	$35/Unit for Prosthetics;	$50/Case for ER - Facility; $35/Visit for Urgent Care;	$250/Case for OP Fac - Surgery; $250/Case for OP Fac - ASC					$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;	$35/Visit for Speclst - Office Visits; $35/Consult for Speclst - Consults;	$35/Visit for OP Psych - Non-Physician; $35/Visit for OP Psych - Psychiatrist; $35/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);		$35/Visit for Chiropractor; $35/Exam for Vistion Exams; $35/Service for Podiatrist; $35/Exam for Hearing/Speech Exams;		$20/Case for OP Fac - Cardiovascular;			$35/Exam for Vision (Refractions)		$35/Exam for Routine Hearing Exams														550	550	125	0	75	35	35.00000001	47.19508766	250	0	0	0	0	20	20	35	34.99999999	20	0	35	0	0	0	0	35	0	35	0	0	0											550	550	125	0	75	35	35.00000001	47.19508766	250	0	0	0	0	20	20	35	34.99999999	20	0	35	0	0	0	0	35	0	35	0	0	0											8.677	0.142080409	1.565179488	0	1.334341994	5.032362004	0.166775035	1.157338117	5.53427692	0	0	0	0	1.110401589	4.033694069	6.447417622	0.286625787	1.970770706	0	3.677853552	0	0	0	0	0.71339508	0	0.305740748	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1553	0	0	8.677	0.142080409	1.565179488	0	1.334341994	5.032362004	0.166775035	1.157338117	5.53427692	0	0	0	0	1.110401589	4.033694069	6.447417622	0.286625787	1.970770706	0	3.677853552	0	0	0	0	0.71339508	0	0.305740748	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1553	0	$750/benefit period for IP Medical; $750/benefit period for IP Surgical;	$750/benefit period for IP Psych; $750/benefit period for IP Substance Abuse;	$125/Days 21-100 for SNF		$75/Trip for Ambulance	$50/Unit for DME	10% Coinsurance for Diabetes Monitoring Supplies; $50/Unit for Prosthetics;	$50/Case for ER - Facility; $40/Visit for Urgent Care;	20% Coinsurance for OP Fac - Surgery; 20% 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			$35/Case for OP Fac - Cardiovascular; $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;	$35/Visit for PCP - Office Visits; $35/Consult for PCP - Consults; $35/Exam for PCP - Routine Physicals;	$50/Visit for Speclst - Office Visits; $50/Consult for Speclst - Consults;	50% Coinsurance for OP Psych - Non-Physician; 50% Coinsurance for OP Psych - Psychiatrist; 50% Coinsurance 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);	10% Coinsurance for Prof Radiology (Office); 10% Coinsurance for Prof Radiology (OP); 10% Coinsurance for Prof Radiology (IP);	$50/Visit for Chiropractor; $50/Exam for Vistion Exams; $50/Service for Podiatrist; $50/Exam 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		$35/Case for OP Fac - Cardiovascular;			$50/Exam for Vision (Refractions)		$50/Exam for Routine Hearing Exams														2.0881	0.0342	0.2762	0	0.2355	1.2687	0.0438	0.2083	0.7022	0.0132	0.2087	0	0	0.3429	1.2477	1.6254	0.0631	0.6086	0.2053	0.9475	0	0	0	0	0.1798	0	0.0771	0	0	0											10.3762	0		10.7651	0.176270882	1.841387633	0	1.569814111	6.301024694	0.210620159	1.36562033	6.236463545	0.013238263	0.208655947	0	0	1.453319727	5.281432248	8.072817023	0.349693817	2.579391071	0.205284677	4.625310692	0	0	0	0	0.893242579	0	0.382818248	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5315
H3206_803_0	2009	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	189.3165807	3.099936203	150.2572308	0	213.4947191	1725.381259	57.18001205	294.2691305	265.6452922	0	0	0	0	666.2409533	2420.216441	2210.543185	98.27169825	1182.462424	0	1260.978361	0	0	0	0	244.5925987	0	104.8253995	0	0	0											$550/Benefit Period for IP Medical; $550/Benefit Period for IP Surgical;	$550/Benefit Period for IP Psych; $550/Benefit Period for IP Substance Abuse;	$125/Days 21-100 for SNF		$75/Trip for Ambulance	$35/Unit for DME	$35/Unit for Prosthetics;	$50/Case for ER - Facility; $35/Visit for Urgent Care;	$250/Case for OP Fac - Surgery; $250/Case for OP Fac - ASC					$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;	$35/Visit for Speclst - Office Visits; $35/Consult for Speclst - Consults;	$35/Visit for OP Psych - Non-Physician; $35/Visit for OP Psych - Psychiatrist; $35/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);		$35/Visit for Chiropractor; $35/Exam for Vistion Exams; $35/Service for Podiatrist; $35/Exam for Hearing/Speech Exams;		$20/Case for OP Fac - Cardiovascular;			$35/Exam for Vision (Refractions)		$35/Exam for Routine Hearing Exams														550	550	125	0	75	35	35.00000001	47.19508766	250	0	0	0	0	20	20	35	34.99999999	20	0	35	0	0	0	0	35	0	35	0	0	0											550	550	125	0	75	35	35.00000001	47.19508766	250	0	0	0	0	20	20	35	34.99999999	20	0	35	0	0	0	0	35	0	35	0	0	0											8.677	0.142080409	1.565179488	0	1.334341994	5.032362004	0.166775035	1.157338117	5.53427692	0	0	0	0	1.110401589	4.033694069	6.447417622	0.286625787	1.970770706	0	3.677853552	0	0	0	0	0.71339508	0	0.305740748	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1553	0	0	8.677	0.142080409	1.565179488	0	1.334341994	5.032362004	0.166775035	1.157338117	5.53427692	0	0	0	0	1.110401589	4.033694069	6.447417622	0.286625787	1.970770706	0	3.677853552	0	0	0	0	0.71339508	0	0.305740748	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1553	0	$750/benefit period for IP Medical; $750/benefit period for IP Surgical;	$750/benefit period for IP Psych; $750/benefit period for IP Substance Abuse;	$125/Days 21-100 for SNF		$75/Trip for Ambulance	$50/Unit for DME	10% Coinsurance for Diabetes Monitoring Supplies; $50/Unit for Prosthetics;	$50/Case for ER - Facility; $40/Visit for Urgent Care;	20% Coinsurance for OP Fac - Surgery; 20% 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			$35/Case for OP Fac - Cardiovascular; $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;	$35/Visit for PCP - Office Visits; $35/Consult for PCP - Consults; $35/Exam for PCP - Routine Physicals;	$50/Visit for Speclst - Office Visits; $50/Consult for Speclst - Consults;	50% Coinsurance for OP Psych - Non-Physician; 50% Coinsurance for OP Psych - Psychiatrist; 50% Coinsurance 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);	10% Coinsurance for Prof Radiology (Office); 10% Coinsurance for Prof Radiology (OP); 10% Coinsurance for Prof Radiology (IP);	$50/Visit for Chiropractor; $50/Exam for Vistion Exams; $50/Service for Podiatrist; $50/Exam 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		$35/Case for OP Fac - Cardiovascular;			$50/Exam for Vision (Refractions)		$50/Exam for Routine Hearing Exams														2.0881	0.0342	0.2762	0	0.2355	1.2687	0.0438	0.2083	0.7022	0.0132	0.2087	0	0	0.3429	1.2477	1.6254	0.0631	0.6086	0.2053	0.9475	0	0	0	0	0.1798	0	0.0771	0	0	0											10.3762	0		10.7651	0.176270882	1.841387633	0	1.569814111	6.301024694	0.210620159	1.36562033	6.236463545	0.013238263	0.208655947	0	0	1.453319727	5.281432248	8.072817023	0.349693817	2.579391071	0.205284677	4.625310692	0	0	0	0	0.893242579	0	0.382818248	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5315
H3206_804_0	2009	2																					0											A	A	D			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	189.3165807	3.099936203	150.2572308	0	213.4947191	1725.381259	57.18001205	294.2691305	265.6452922	0	0	0	0	666.2409533	2420.216441	2210.543185	98.27169825	1182.462424	0	1260.978361	0	0	0	0	244.5925987	0	104.8253995	0	0	0											$550/Benefit Period for IP Medical; $550/Benefit Period for IP Surgical;	$550/Benefit Period for IP Psych; $550/Benefit Period for IP Substance Abuse;	$125/Days 21-100 for SNF		$75/Trip for Ambulance	$35/Unit for DME	$35/Unit for Prosthetics;	$50/Case for ER - Facility; $35/Visit for Urgent Care;	$250/Case for OP Fac - Surgery; $250/Case for OP Fac - ASC					$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;	$35/Visit for Speclst - Office Visits; $35/Consult for Speclst - Consults;	$35/Visit for OP Psych - Non-Physician; $35/Visit for OP Psych - Psychiatrist; $35/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);		$35/Visit for Chiropractor; $35/Exam for Vistion Exams; $35/Service for Podiatrist; $35/Exam for Hearing/Speech Exams;		$20/Case for OP Fac - Cardiovascular;			$35/Exam for Vision (Refractions)		$35/Exam for Routine Hearing Exams														550	550	125	0	75	35	35.00000001	47.19508766	250	0	0	0	0	20	20	35	34.99999999	20	0	35	0	0	0	0	35	0	35	0	0	0											550	550	125	0	75	35	35.00000001	47.19508766	250	0	0	0	0	20	20	35	34.99999999	20	0	35	0	0	0	0	35	0	35	0	0	0											8.677	0.142080409	1.565179488	0	1.334341994	5.032362004	0.166775035	1.157338117	5.53427692	0	0	0	0	1.110401589	4.033694069	6.447417622	0.286625787	1.970770706	0	3.677853552	0	0	0	0	0.71339508	0	0.305740748	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1553	0	0	8.677	0.142080409	1.565179488	0	1.334341994	5.032362004	0.166775035	1.157338117	5.53427692	0	0	0	0	1.110401589	4.033694069	6.447417622	0.286625787	1.970770706	0	3.677853552	0	0	0	0	0.71339508	0	0.305740748	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1553	0	$750/benefit period for IP Medical; $750/benefit period for IP Surgical;	$750/benefit period for IP Psych; $750/benefit period for IP Substance Abuse;	$125/Days 21-100 for SNF		$75/Trip for Ambulance	$50/Unit for DME	10% Coinsurance for Diabetes Monitoring Supplies; $50/Unit for Prosthetics;	$50/Case for ER - Facility; $40/Visit for Urgent Care;	20% Coinsurance for OP Fac - Surgery; 20% 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			$35/Case for OP Fac - Cardiovascular; $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;	$35/Visit for PCP - Office Visits; $35/Consult for PCP - Consults; $35/Exam for PCP - Routine Physicals;	$50/Visit for Speclst - Office Visits; $50/Consult for Speclst - Consults;	50% Coinsurance for OP Psych - Non-Physician; 50% Coinsurance for OP Psych - Psychiatrist; 50% Coinsurance 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);	10% Coinsurance for Prof Radiology (Office); 10% Coinsurance for Prof Radiology (OP); 10% Coinsurance for Prof Radiology (IP);	$50/Visit for Chiropractor; $50/Exam for Vistion Exams; $50/Service for Podiatrist; $50/Exam 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		$35/Case for OP Fac - Cardiovascular;			$50/Exam for Vision (Refractions)		$50/Exam for Routine Hearing Exams														2.0881	0.0342	0.2762	0	0.2355	1.2687	0.0438	0.2083	0.7022	0.0132	0.2087	0	0	0.3429	1.2477	1.6254	0.0631	0.6086	0.2053	0.9475	0	0	0	0	0.1798	0	0.0771	0	0	0											10.3762	0		10.7651	0.176270882	1.841387633	0	1.569814111	6.301024694	0.210620159	1.36562033	6.236463545	0.013238263	0.208655947	0	0	1.453319727	5.281432248	8.072817023	0.349693817	2.579391071	0.205284677	4.625310692	0	0	0	0	0.893242579	0	0.382818248	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5315
H3207_001_0	2009	11																																D	D	D	V	T	Coin	O	V	P	P	P	V	P	V	V	V	V	V	P	V	Coin	Coin	T	V	V	P	V	P	V	V																																																			0		985.0359871	27.52552584			126.1496096	9.34540144	1169.148561	228.9361332	306.2151462		420.6549376		3.8224193	228.5795402	3041.93259	4965.418709	255.6169533	256.4044524							107.6857623		185.059095			13.10525994											"$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	No Cost Sharing	"Sleep Study - $50 for OP, $150 for IP"											22.61242049	45.31962557			50	0.1	13.82548939	50	75		35.08277103		7.5	5.409665626	10.00145198	18.5420278	10	5							30		20			100											22.61242049	45.31962557			50	0.1	13.82548939	50	75		35.08277103		7.5	5.409665626	10.00145198	18.5420278	10	5							30		20			100											1.8562	0.103953877	0	0	0.525623373	0.934540144	1.347004251	0.953900555	1.913844664	0	1.229811738	0	0.002389012	0.103044907	2.535311893	7.672410979	0.213014128	0.106835188	0	0	0	0	0	0	0.269214406	0	0.308431825	0	0	0.1092105	0	0	0	0	0	0	0	0	0	0	20.1847	0	0	1.8562	0.103953877	0	0	0.525623373	0.934540144	1.347004251	0.953900555	1.913844664	0	1.229811738	0	0.002389012	0.103044907	2.535311893	7.672410979	0.213014128	0.106835188	0	0	0	0	0	0	0.269214406	0	0.308431825	0	0	0.1092105	0	0	0	0	0	0	0	0	0	0	20.1847		"$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"	$75 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	Not Covered	Not Covered										1.1232	0.0374	0.3273		0.0814	0.3556	0.6036	0.2071	0.6694	0.1147	0.3105		0.0004	0.2353	0.7141	2.4134	0.0755	0.1108	0.3951						0.0274		0.0361														7.8384	0	0	2.9794	0.141392248	0.327290064	0	0.607032516	1.290157508	1.950649834	1.16095547	2.58324306	0.114696937	1.540353288	0	0.002819206	0.338304321	3.249451712	10.08577478	0.288488847	0.217612722	0.395088316	0	0	0	0	0	0.296655131	0	0.344507437	0	0	0.1092105	0	0	0	0	0	0	0	0	0	0	28.0231
H3207_002_0	2009	11																																D	D	D	V	T	Coin	O	V	P	P	P	V	P	V	V	V	V	V	P	V	Coin	Coin	T	V	V	P	V	P	V	V																																																			0		1147.42771	26.45224038			155.4083379	9.88971321	1011.544648	287.9483288	348.3170336		365.6900718		3.323538451	198.0371154	3343.632661	5071.539049	219.2438986	418.2938476							97.50514845		162.7514976			11.56270552											"$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	No Cost Sharing	"Sleep Study - $50 for OP, $150 for IP"											22.65822746	45.31962557			50	0.1	13.6935714	50	75		35.0801877		7.5	5.411133315	10.00114856	18.7329831	10	5							30		20			100											22.65822746	45.31962557			50	0.1	13.6935714	50	75		35.0801877		7.5	5.411133315	10.00114856	18.7329831	10	5							30		20			100											2.1666	0.099900469	0	0	0.647534741	0.988971321	1.154304906	1.199784703	2.17698146	0	1.069039696	0	0.002077212	0.089300436	2.786680581	7.917087942	0.182703249	0.174289103	0	0	0	0	0	0	0.243762871	0	0.271252496	0	0	0.096355879	0	0	0	0	0	0	0	0	0	0	21.2666	0	0	2.1666	0.099900469	0	0	0.647534741	0.988971321	1.154304906	1.199784703	2.17698146	0	1.069039696	0	0.002077212	0.089300436	2.786680581	7.917087942	0.182703249	0.174289103	0	0	0	0	0	0	0.243762871	0	0.271252496	0	0	0.096355879	0	0	0	0	0	0	0	0	0	0	21.2666		"$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	$75 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										1.0664	0.0324	0.2719		0.0703	0.3026	0.5225	0.1786	0.6169	0.1302	0.2781		0.0004	0.1999	0.7297	2.6213	0.065	0.1609	0.3555						0.0314		0.0317														7.6659	0	0	3.233	0.132313222	0.271881912	0	0.717807244	1.29160024	1.676809513	1.378372318	2.793924155	0.130246701	1.347117235	0	0.002451259	0.289243583	3.516415377	10.53837312	0.247713196	0.335211186	0.355535226	0	0	0	0	0	0.275196402	0	0.302979442	0	0	0.096355879	0	0	0	0	0	0	0	0	0	0	28.9325
H3207_003_0	2009	9																																D	D	D	V	T	Coin	O	V	P	P	P	V	P	V	V	V	V	V	P	V	Coin	Coin	T	V	V	P	V	P	V	V																																																			0		1427.493402	39.62935411			159.8997613	18.27667034	1701.742374	302.7265127	446.8457536		510.5584279		6.002944878	267.2090236	4003.254666	6303.702015	297.1161708	705.076232							112.0588137		178.9703766			12.70012524											"$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	No Cost Sharing	"Sleep Study - $50 for OP, $150 for IP"											22.13324482	45.31962557			50	0.1	14.06536439	50	75		34.50788208		7.5	5.585281617	10.00135235	18.81607982	10	5							30		20			100											22.13324482	45.31962557			50	0.1	14.06536439	50	75		34.50788208		7.5	5.585281617	10.00135235	18.81607982	10	5							30		20			100											2.6329	0.149665624	0	0	0.666249005	1.827667034	1.99463555	1.26136047	2.79278596	0	1.468190836	0	0.003751841	0.124369804	3.336496705	9.884246692	0.247596809	0.293781763	0	0	0	0	0	0	0.280147034	0	0.298283961	0	0	0.105834377	0	0	0	0	0	0	0	0	0	0	27.368	0	0	2.6329	0.149665624	0	0	0.666249005	1.827667034	1.99463555	1.26136047	2.79278596	0	1.468190836	0	0.003751841	0.124369804	3.336496705	9.884246692	0.247596809	0.293781763	0	0	0	0	0	0	0.280147034	0	0.298283961	0	0	0.105834377	0	0	0	0	0	0	0	0	0	0	27.368		"$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	$75 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										1.4527	0.0539	0.4055		0.2712	0.4746	0.8728	0.1922	0.8145	0.142	0.3583		0.0007	0.2491	0.8544	2.8976	0.0956	0.124	0.4348						0.0265		0.0349														9.7553	0	0	4.0856	0.203566809	0.405532726	0	0.937420476	2.302264274	2.867434955	1.453552781	3.607262855	0.141976853	1.826534375	0	0.004427442	0.373486458	4.190926484	12.78182385	0.343180143	0.417822561	0.434782851	0	0	0	0	0	0.306616778	0	0.333196734	0	0	0.105834377	0	0	0	0	0	0	0	0	0	0	37.1232
H3207_004_0	2009	10																																D	D	D	V	T	Coin	O	V	P	P	P	V	P	V	V	V	V	V	P	V	Coin	Coin	T	V	V	P	V	P	V	V																																																			0		1292.510205	41.24238268			265.2963884	16.20612711	1744.448137	297.9023194	369.7604143		531.3396228		6.247281981	278.0851985	3590.071554	6080.229883	309.2096525	304.3967617							107.0581178		184.3633084			13.08281936											"$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	No Cost Sharing	"Sleep Study - $50 for OP, $150 for IP"											22.13324482	45.31962557			50	0.1	14.02547585	50	75		34.50788208		7.5	5.585281617	10.00156937	18.74726271	10	5							30		20			100											22.13324482	45.31962557			50	0.1	14.02547585	50	75		34.50788208		7.5	5.585281617	10.00156937	18.74726271	10	5							30		20			100											2.384	0.155757445	0	0	1.105401618	1.620612711	2.038892936	1.241259664	2.311002589	0	1.527950421	0	0.003904551	0.129432012	2.992195808	9.498972245	0.25767471	0.126831984	0	0	0	0	0	0	0.267645294	0	0.307272181	0	0	0.109023495	0	0	0	0	0	0	0	0	0	0	26.0778	0	0	2.384	0.155757445	0	0	1.105401618	1.620612711	2.038892936	1.241259664	2.311002589	0	1.527950421	0	0.003904551	0.129432012	2.992195808	9.498972245	0.25767471	0.126831984	0	0	0	0	0	0	0.267645294	0	0.307272181	0	0	0.109023495	0	0	0	0	0	0	0	0	0	0	26.0778		"$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	$75 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										1.5118	0.0561	0.4264		0.1515	0.4876	0.9176	0.2128	0.7418	0.1356	0.3757		0.0007	0.2618	0.84	2.7764	0.0928	0.1304	0.4688						0.0273		0.036														9.651	0	0	3.8958	0.211852563	0.426369465	0	1.256892917	2.10816885	2.956537735	1.454094112	3.052783161	0.135629629	1.903636707	0	0.004607652	0.391212428	3.832150346	12.27537364	0.350474726	0.257246134	0.468809134	0	0	0	0	0	0.294916145	0	0.343236983	0	0	0.109023495	0	0	0	0	0	0	0	0	0	0	35.7288
H3208_001_0	2009	10																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V	0	V	V	V	V	V	Coin	Coin	Coin	Coin	0	0	V	0	V	0	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	5000	140.8726585	51.25137345	506.8517902	874.7843398	163.7387033	4.594277218	0.748284347	157.8216818	212.3646729	440.3008573	364.1513265	9.479549072	0	535.1158059	3408.957954	3226.340721	256.1458362	1294.8566	21.29787216	2.136133509	7.613500852	0.794655782	0	0	490.2044432	0	70.49242357	0	0	513.775575											$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/$30 Urgent	$50 per visit.	$0-50 per visit.	$50 per visit.	$50 per visit.	0	$50 per visit.	"$5 per visit.  $0 additional copay for colorectal screening, mammograms, bone mass measurements, and PSA's."	$20 per visit	$20 per visit	$20 per visit	10% coinsurance	"10% coinsurance except sustitute $0 copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	10% coinsurance.	10% coinsurance.	0	0	$20 per exam	0	$20 per exam	0	0	$0 PCP copay/$30 Specialist copay for routine physicals											100	60.51241082	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	3.135985833	13.53122664	20	20	0.05	0.05	0.1	0.095	0	0	30	0	30	0	0	8											100	60.51241082	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	3.135985833	13.53122664	20	20	0.05	0.05	0.1	0.095	0	0	30	0	30	0	0	8											1.1739	0.258445347	0.818707489	0.72898695	1.364489195	0.459427722	0.074828435	0.644438534	0.884852804	0.917293453	1.517297194	0.039498121	0	2.229649191	0.890870321	3.638028961	0.426909727	2.158094333	1.064893608	0.106806675	0.761350085	0.075492299	0	0	1.225511108	0	0.176231059	0	0	0.34251705	0	0	0	0	0	0	0	0	0	0	21.9786	0	0	1.1739	0.258445347	0.818707489	0.72898695	1.364489195	0.459427722	0.074828435	0.644438534	0.884852804	0.917293453	1.517297194	0.039498121	0	2.229649191	0.890870321	3.638028961	0.426909727	2.158094333	1.064893608	0.106806675	0.761350085	0.075492299	0	0	1.225511108	0	0.176231059	0	0	0.34251705	0	0	0	0	0	0	0	0	0	0	21.9786	7700	$250 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	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	0	$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	0	0	$50 per exam	0	$50 per exam	0	0	$20 PCP copay/$60 Specialist copay for routine physicals											5.1122	0.1874	1.3019	0.7044	0.2692	0.2281	0.0372	0.2812	0.6314	0.382	0.5676	0.0398	0.0136	0.6263	1.6371	3.4264	0.1621	0.6082	0.894	0.0897	0.3781	0.0389	0	0	0.3284	0	0.069	0	0	0.2679											18.2822	500	0	6.2861	0.445795477	2.120579999	1.433401773	1.63372726	0.68757666	0.111987768	0.925665013	1.516282421	1.29931566	2.08489031	0.079328979	0.013638803	2.855938001	2.527933531	7.064448746	0.589019707	2.766314134	1.958933739	0.196477093	1.139431783	0.114343997	0	0	1.553930642	0	0.245212743	0	0	0.61043284	0	0	0	0	0	0	0	0	0	0	40.2607
H3208_003_0	2009	7																					2700											D	D	D	V	T	Coin	Coin	V	V	V	V	V	0	V	V	V	V	V	Coin	Coin	Coin	Coin	0	0	V	0	V	0	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	5000	712.7660208	51.25137345	506.8517902	874.7843398	163.7387033	4.594277218	0.748284347	157.8216818	212.3646729	440.3008573	364.1513265	9.479549072	40.56659865	535.1158059	2138.08877	2182.817376	204.8944627	1294.8566	21.29787216	2.136133509	7.613500852	0.794655782	0	0	490.2044432	0	70.49242357	0	0	593.8378413											$250/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.	0	$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.	0	0	$40 per exam	0	$40 per exam	0	0	$0 PCP copay/$40 Specialist copay for routine physicals											154.5517313	133.9888561	48.4583958	40	150	0.2	0.2	49	100	0	100	100	0	100	10	40	40	40	0.1	0.1	0.2	0.19	0	0	40	0	40	0	0	0											131.530631	114.0306786	41.24032339	34.04183957	127.6568984	0.170209198	0.170209198	41.70125347	85.10459892	0	85.10459892	85.10459892	0	85.10459892	8.510459892	34.04183957	34.04183957	34.04183957	0.085104599	0.085104599	0.170209198	0.161698738	0	0	34.04183957	0	34.04183957	0	0	0											7.8125	0.487019075	1.741894312	2.481605679	1.741864584	0.78198824	0.127364878	0.54844683	1.506100859	0	2.582579382	0.067229435	0	3.795068003	1.516343227	6.192259911	0.581248702	3.673275054	1.812546868	0.181794786	1.295887873	0.128494837	0	0	1.390621751	0	0.199974315	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6462	0	7.12	7.8125	0.487019075	1.741894312	2.481605679	1.741864584	0.78198824	0.127364878	0.54844683	1.506100859	0	2.582579382	0.067229435	0	3.795068003	1.516343227	6.192259911	0.581248702	3.673275054	1.812546868	0.181794786	1.295887873	0.128494837	0	0	1.390621751	0	0.199974315	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6462	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	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	0	0	$50 per exam	0	$50 per exam	0	0	30% coinsurance											8.0522	0.1932	1.4815	0.9762	0.317	0.2596	0.0423	0.2772	0.9284	0.4102	0.7432	0.0606	0.0134	0.4676	1.9099	3.7102	0.0966	0.6922	0.9617	0.0965	0.4303	0.044	0	0	0.3237	0	0.068	0	0	0.219											22.7745	500	0.334027556	15.8648	0.680169421	3.223428696	3.457776775	2.058862613	1.041622339	0.169652299	0.825610691	2.434550849	0.410219333	3.325791654	0.12786198	0.013441774	4.262620344	3.426228129	9.902449916	0.677818407	4.365430807	2.774289465	0.278255623	1.726145852	0.172500432	0	0	1.71429698	0	0.267959492	0	0	0.218960202	0	0	0	0	0	0	0	0	0	0	63.4207
H3208_004_0	2009	10																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V	0	V	V	V	V	V	Coin	Coin	Coin	Coin	0	0	V	0	V	0	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	5000	140.8726585	51.25137345	506.8517902	874.7843398	163.7387033	4.594277218	0.748284347	157.8216818	212.3646729	440.3008573	364.1513265	9.479549072	0	535.1158059	3408.957954	3226.340721	256.1458362	1294.8566	21.29787216	2.136133509	7.613500852	0.794655782	0	0	490.2044432	0	70.49242357	0	0	80.06226626											"(1a) $50/admission, unlimited coverage."	(1b) $100/day-First seven days per stay.	(2) $20 per day.	(6) $10 per visit.	(10a) $100 per service.	(11a) 10% coinsurance.	(11b) 10% coinsurance.	"(4a) $50 copay emergency, (4b) $20 copay urgent."	(9a) $50 per visit.	(8b) $0 per visit.	$50 per visit.	$50 per visit.	0	$50 per visit.	"$0 per visit.  $0 additional copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	$15 per visit	$15 per visit	$15 per visit	10% coinsurance	"10% coinsurance except sustitute $0 copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	10% coinsurance.	10% coinsurance.	0	0	$15 per exam	0	$15 per exam	0	0	$0 PCP copay/$20 Specialist copay for routine physicals											50	60.51241082	19.38335832	10	100	0.1	0.1	49	50	0	50	50	0	50	6.271971665	10.14841998	15	15	0.05	0.05	0.1	0.095	0	0	20	0	30	0	0	4											50	60.51241082	19.38335832	10	100	0.1	0.1	49	50	0	50	50	0	50	6.271971665	10.14841998	15	15	0.05	0.05	0.1	0.095	0	0	20	0	30	0	0	4											0.587	0.258445347	0.818707489	0.72898695	1.364489195	0.459427722	0.074828435	0.644438534	0.884852804	0	1.517297194	0.039498121	0	2.229649191	1.781740642	2.728521721	0.320182295	1.61857075	1.064893608	0.106806675	0.761350085	0.075492299	0	0	0.817007405	0	0.176231059	0	0	0.026687422	0	0	0	0	0	0	0	0	0	0	19.0851	0	0	0.587	0.258445347	0.818707489	0.72898695	1.364489195	0.459427722	0.074828435	0.644438534	0.884852804	0	1.517297194	0.039498121	0	2.229649191	1.781740642	2.728521721	0.320182295	1.61857075	1.064893608	0.106806675	0.761350085	0.075492299	0	0	0.817007405	0	0.176231059	0	0	0.026687422	0	0	0	0	0	0	0	0	0	0	19.0851	7700	(1a) $100/admission.	(1b) $200/day-First seven days per stay	(2) 20% coinsurance	(6) $20 per visit.	(10a) $100 per service.	(11a) 20% coinsurance.	(11b) 20% coinsurance.	"(4a) $50 copay emergency, (4b) $20 copay urgent."	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	0	$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	0	0	$50 per exam	0	$50 per exam	0	0	$20 PCP copay/$40 Specialist copay for routine physicals											4.9769	0.1874	1.3019	0.7044	0.2692	0.2281	0.0372	0.2903	0.6314	0.4525	0.5676	0.0398	0.0136	0.6263	1.6371	3.147	0.1293	0.6082	0.894	0.0897	0.3781	0.0389	0	0	0.3284	0	0.069	0	0	0.2345											17.8808	500	0	5.5639	0.445795421	2.120579689	1.433401539	1.633727209	0.687576605	0.111987759	0.934757184	1.516282191	0.452483694	2.084890138	0.079328964	0.013638797	2.855937944	3.418803317	5.875486506	0.449499331	2.226790406	1.958933455	0.196477064	1.139431693	0.114343987	0	0	1.145426895	0	0.245212728	0	0	0.261146991	0	0	0	0	0	0	0	0	0	0	36.9658
H3208_801_0	2009	5																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	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	5000	140.8726585	51.25137345	506.8517902	874.7843398	163.7387033	4.594277218	0.748284347	157.8216818	212.3646729	440.3008573	364.1513265	9.479549072	0	535.1158059	3408.957954	3226.340721	256.1458362	1294.8566	21.29787216	2.136133509	7.613500852	0.794655782																			$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/$30 Urgent	$50 per visit.	$0-50 per visit.	$50 per visit.	$50 per visit.	0	$50 per visit.	"$5 per visit.  $0 additional copay for colorectal screening, mammograms, bone mass measurements, and PSA's."	$20 per visit	$20 per visit	$20 per visit	10% coinsurance	"10% coinsurance except sustitute $0 copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	10% coinsurance.	10% coinsurance.																			100	60.51241082	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	3.135985833	13.53122664	20	20	0.05	0.05	0.1	0.095																			100	60.51241082	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	3.135985833	13.53122664	20	20	0.05	0.05	0.1	0.095																			1.1739	0.258445347	0.818707489	0.72898695	1.364489195	0.459427722	0.074828435	0.644438534	0.884852804	0.917293453	1.517297194	0.039498121	0	2.229649191	0.890870321	3.638028961	0.426909727	2.158094333	1.064893608	0.106806675	0.761350085	0.075492299	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.2343	0	0	1.1739	0.258445347	0.818707489	0.72898695	1.364489195	0.459427722	0.074828435	0.644438534	0.884852804	0.917293453	1.517297194	0.039498121	0	2.229649191	0.890870321	3.638028961	0.426909727	2.158094333	1.064893608	0.106806675	0.761350085	0.075492299	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.2343	7700	$250 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	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$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																			5.1122	0.1874	1.3019	0.7044	0.2692	0.2281	0.0372	0.2812	0.6314	0.382	0.5676	0.0398	0.0136	0.6263	1.6371	3.4264	0.1621	0.6082	0.894	0.0897	0.3781	0.0389																			17.6169	500	0	6.2861	0.445795477	2.120579999	1.433401773	1.63372726	0.68757666	0.111987768	0.925665013	1.516282421	1.29931566	2.08489031	0.079328979	0.013638803	2.855938001	2.527933531	7.064448746	0.589019707	2.766314134	1.958933739	0.196477093	1.139431783	0.114343997	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.8512
H3208_802_0	2009	5																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	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	5000	140.8726585	51.25137345	506.8517902	874.7843398	163.7387033	4.594277218	0.748284347	157.8216818	212.3646729	440.3008573	364.1513265	9.479549072	0	535.1158059	3408.957954	3226.340721	256.1458362	1294.8566	21.29787216	2.136133509	7.613500852	0.794655782																			$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/$30 Urgent	$50 per visit.	$0-50 per visit.	$50 per visit.	$50 per visit.	0	$50 per visit.	"$5 per visit.  $0 additional copay for colorectal screening, mammograms, bone mass measurements, and PSA's."	$20 per visit	$20 per visit	$20 per visit	10% coinsurance	"10% coinsurance except sustitute $0 copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	10% coinsurance.	10% coinsurance.																			100	60.51241082	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	3.135985833	13.53122664	20	20	0.05	0.05	0.1	0.095																			100	60.51241082	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	3.135985833	13.53122664	20	20	0.05	0.05	0.1	0.095																			1.1739	0.258445347	0.818707489	0.72898695	1.364489195	0.459427722	0.074828435	0.644438534	0.884852804	0.917293453	1.517297194	0.039498121	0	2.229649191	0.890870321	3.638028961	0.426909727	2.158094333	1.064893608	0.106806675	0.761350085	0.075492299	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.2343	0	0	1.1739	0.258445347	0.818707489	0.72898695	1.364489195	0.459427722	0.074828435	0.644438534	0.884852804	0.917293453	1.517297194	0.039498121	0	2.229649191	0.890870321	3.638028961	0.426909727	2.158094333	1.064893608	0.106806675	0.761350085	0.075492299	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.2343	7700	$250 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	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$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																			5.1122	0.1874	1.3019	0.7044	0.2692	0.2281	0.0372	0.2812	0.6314	0.382	0.5676	0.0398	0.0136	0.6263	1.6371	3.4264	0.1621	0.6082	0.894	0.0897	0.3781	0.0389																			17.6169	500	0	6.2861	0.445795477	2.120579999	1.433401773	1.63372726	0.68757666	0.111987768	0.925665013	1.516282421	1.29931566	2.08489031	0.079328979	0.013638803	2.855938001	2.527933531	7.064448746	0.589019707	2.766314134	1.958933739	0.196477093	1.139431783	0.114343997	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.8512
H3208_803_0	2009	5																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	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	5000	140.8726585	51.25137345	506.8517902	874.7843398	163.7387033	4.594277218	0.748284347	157.8216818	212.3646729	440.3008573	364.1513265	9.479549072	0	535.1158059	3408.957954	3226.340721	256.1458362	1294.8566	21.29787216	2.136133509	7.613500852	0.794655782																			$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/$30 Urgent	$50 per visit.	$0-50 per visit.	$50 per visit.	$50 per visit.	0	$50 per visit.	"$5 per visit.  $0 additional copay for colorectal screening, mammograms, bone mass measurements, and PSA's."	$20 per visit	$20 per visit	$20 per visit	10% coinsurance	"10% coinsurance except sustitute $0 copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	10% coinsurance.	10% coinsurance.																			100	60.51241082	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	3.135985833	13.53122664	20	20	0.05	0.05	0.1	0.095																			100	60.51241082	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	3.135985833	13.53122664	20	20	0.05	0.05	0.1	0.095																			1.1739	0.258445347	0.818707489	0.72898695	1.364489195	0.459427722	0.074828435	0.644438534	0.884852804	0.917293453	1.517297194	0.039498121	0	2.229649191	0.890870321	3.638028961	0.426909727	2.158094333	1.064893608	0.106806675	0.761350085	0.075492299	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.2343	0	0	1.1739	0.258445347	0.818707489	0.72898695	1.364489195	0.459427722	0.074828435	0.644438534	0.884852804	0.917293453	1.517297194	0.039498121	0	2.229649191	0.890870321	3.638028961	0.426909727	2.158094333	1.064893608	0.106806675	0.761350085	0.075492299	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.2343	7700	$250 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	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$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																			5.1122	0.1874	1.3019	0.7044	0.2692	0.2281	0.0372	0.2812	0.6314	0.382	0.5676	0.0398	0.0136	0.6263	1.6371	3.4264	0.1621	0.6082	0.894	0.0897	0.3781	0.0389																			17.6169	500	0	6.2861	0.445795477	2.120579999	1.433401773	1.63372726	0.68757666	0.111987768	0.925665013	1.516282421	1.29931566	2.08489031	0.079328979	0.013638803	2.855938001	2.527933531	7.064448746	0.589019707	2.766314134	1.958933739	0.196477093	1.139431783	0.114343997	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.8512
H3208_804_0	2009	5																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	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	5000	140.8726585	51.25137345	506.8517902	874.7843398	163.7387033	4.594277218	0.748284347	157.8216818	212.3646729	440.3008573	364.1513265	9.479549072	0	535.1158059	3408.957954	3226.340721	256.1458362	1294.8566	21.29787216	2.136133509	7.613500852	0.794655782																			$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/$30 Urgent	$50 per visit.	$0-50 per visit.	$50 per visit.	$50 per visit.	0	$50 per visit.	"$5 per visit.  $0 additional copay for colorectal screening, mammograms, bone mass measurements, and PSA's."	$20 per visit	$20 per visit	$20 per visit	10% coinsurance	"10% coinsurance except sustitute $0 copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	10% coinsurance.	10% coinsurance.																			100	60.51241082	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	3.135985833	13.53122664	20	20	0.05	0.05	0.1	0.095																			100	60.51241082	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	3.135985833	13.53122664	20	20	0.05	0.05	0.1	0.095																			1.1739	0.258445347	0.818707489	0.72898695	1.364489195	0.459427722	0.074828435	0.644438534	0.884852804	0.917293453	1.517297194	0.039498121	0	2.229649191	0.890870321	3.638028961	0.426909727	2.158094333	1.064893608	0.106806675	0.761350085	0.075492299	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.2343	0	0	1.1739	0.258445347	0.818707489	0.72898695	1.364489195	0.459427722	0.074828435	0.644438534	0.884852804	0.917293453	1.517297194	0.039498121	0	2.229649191	0.890870321	3.638028961	0.426909727	2.158094333	1.064893608	0.106806675	0.761350085	0.075492299	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.2343	7700	$250 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	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$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																			5.1122	0.1874	1.3019	0.7044	0.2692	0.2281	0.0372	0.2812	0.6314	0.382	0.5676	0.0398	0.0136	0.6263	1.6371	3.4264	0.1621	0.6082	0.894	0.0897	0.3781	0.0389																			17.6169	500	0	6.2861	0.445795477	2.120579999	1.433401773	1.63372726	0.68757666	0.111987768	0.925665013	1.516282421	1.29931566	2.08489031	0.079328979	0.013638803	2.855938001	2.527933531	7.064448746	0.589019707	2.766314134	1.958933739	0.196477093	1.139431783	0.114343997	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.8512
H3208_805_0	2009	5																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	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	5000	140.8726585	51.25137345	506.8517902	874.7843398	163.7387033	4.594277218	0.748284347	157.8216818	212.3646729	440.3008573	364.1513265	9.479549072	0	535.1158059	3408.957954	3226.340721	256.1458362	1294.8566	21.29787216	2.136133509	7.613500852	0.794655782																			$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/$30 Urgent	$50 per visit.	$0-50 per visit.	$50 per visit.	$50 per visit.	0	$50 per visit.	"$5 per visit.  $0 additional copay for colorectal screening, mammograms, bone mass measurements, and PSA's."	$20 per visit	$20 per visit	$20 per visit	10% coinsurance	"10% coinsurance except sustitute $0 copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	10% coinsurance.	10% coinsurance.																			100	60.51241082	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	3.135985833	13.53122664	20	20	0.05	0.05	0.1	0.095																			100	60.51241082	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	3.135985833	13.53122664	20	20	0.05	0.05	0.1	0.095																			1.1739	0.258445347	0.818707489	0.72898695	1.364489195	0.459427722	0.074828435	0.644438534	0.884852804	0.917293453	1.517297194	0.039498121	0	2.229649191	0.890870321	3.638028961	0.426909727	2.158094333	1.064893608	0.106806675	0.761350085	0.075492299	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.2343	0	0	1.1739	0.258445347	0.818707489	0.72898695	1.364489195	0.459427722	0.074828435	0.644438534	0.884852804	0.917293453	1.517297194	0.039498121	0	2.229649191	0.890870321	3.638028961	0.426909727	2.158094333	1.064893608	0.106806675	0.761350085	0.075492299	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.2343	7700	$250 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	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$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																			5.1122	0.1874	1.3019	0.7044	0.2692	0.2281	0.0372	0.2812	0.6314	0.382	0.5676	0.0398	0.0136	0.6263	1.6371	3.4264	0.1621	0.6082	0.894	0.0897	0.3781	0.0389																			17.6169	500	0	6.2861	0.445795477	2.120579999	1.433401773	1.63372726	0.68757666	0.111987768	0.925665013	1.516282421	1.29931566	2.08489031	0.079328979	0.013638803	2.855938001	2.527933531	7.064448746	0.589019707	2.766314134	1.958933739	0.196477093	1.139431783	0.114343997	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.8512
H3208_806_0	2009	5																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	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	5000	140.8726585	51.25137345	506.8517902	874.7843398	163.7387033	4.594277218	0.748284347	157.8216818	212.3646729	440.3008573	364.1513265	9.479549072	0	535.1158059	3408.957954	3226.340721	256.1458362	1294.8566	21.29787216	2.136133509	7.613500852	0.794655782																			$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/$30 Urgent	$50 per visit.	$0-50 per visit.	$50 per visit.	$50 per visit.	0	$50 per visit.	"$5 per visit.  $0 additional copay for colorectal screening, mammograms, bone mass measurements, and PSA's."	$20 per visit	$20 per visit	$20 per visit	10% coinsurance	"10% coinsurance except sustitute $0 copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	10% coinsurance.	10% coinsurance.																			100	60.51241082	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	3.135985833	13.53122664	20	20	0.05	0.05	0.1	0.095																			100	60.51241082	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	3.135985833	13.53122664	20	20	0.05	0.05	0.1	0.095																			1.1739	0.258445347	0.818707489	0.72898695	1.364489195	0.459427722	0.074828435	0.644438534	0.884852804	0.917293453	1.517297194	0.039498121	0	2.229649191	0.890870321	3.638028961	0.426909727	2.158094333	1.064893608	0.106806675	0.761350085	0.075492299	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.2343	0	0	1.1739	0.258445347	0.818707489	0.72898695	1.364489195	0.459427722	0.074828435	0.644438534	0.884852804	0.917293453	1.517297194	0.039498121	0	2.229649191	0.890870321	3.638028961	0.426909727	2.158094333	1.064893608	0.106806675	0.761350085	0.075492299	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.2343	7700	$250 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	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$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																			5.1122	0.1874	1.3019	0.7044	0.2692	0.2281	0.0372	0.2812	0.6314	0.382	0.5676	0.0398	0.0136	0.6263	1.6371	3.4264	0.1621	0.6082	0.894	0.0897	0.3781	0.0389																			17.6169	500	0	6.2861	0.445795477	2.120579999	1.433401773	1.63372726	0.68757666	0.111987768	0.925665013	1.516282421	1.29931566	2.08489031	0.079328979	0.013638803	2.855938001	2.527933531	7.064448746	0.589019707	2.766314134	1.958933739	0.196477093	1.139431783	0.114343997	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.8512
H3208_807_0	2009	5																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	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	5000	140.8726585	51.25137345	506.8517902	874.7843398	163.7387033	4.594277218	0.748284347	157.8216818	212.3646729	440.3008573	364.1513265	9.479549072	0	535.1158059	3408.957954	3226.340721	256.1458362	1294.8566	21.29787216	2.136133509	7.613500852	0.794655782																			$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/$30 Urgent	$50 per visit.	$0-50 per visit.	$50 per visit.	$50 per visit.	0	$50 per visit.	"$5 per visit.  $0 additional copay for colorectal screening, mammograms, bone mass measurements, and PSA's."	$20 per visit	$20 per visit	$20 per visit	10% coinsurance	"10% coinsurance except sustitute $0 copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	10% coinsurance.	10% coinsurance.																			100	60.51241082	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	3.135985833	13.53122664	20	20	0.05	0.05	0.1	0.095																			100	60.51241082	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	3.135985833	13.53122664	20	20	0.05	0.05	0.1	0.095																			1.1739	0.258445347	0.818707489	0.72898695	1.364489195	0.459427722	0.074828435	0.644438534	0.884852804	0.917293453	1.517297194	0.039498121	0	2.229649191	0.890870321	3.638028961	0.426909727	2.158094333	1.064893608	0.106806675	0.761350085	0.075492299	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.2343	0	0	1.1739	0.258445347	0.818707489	0.72898695	1.364489195	0.459427722	0.074828435	0.644438534	0.884852804	0.917293453	1.517297194	0.039498121	0	2.229649191	0.890870321	3.638028961	0.426909727	2.158094333	1.064893608	0.106806675	0.761350085	0.075492299	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.2343	7700	$250 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	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$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																			5.1122	0.1874	1.3019	0.7044	0.2692	0.2281	0.0372	0.2812	0.6314	0.382	0.5676	0.0398	0.0136	0.6263	1.6371	3.4264	0.1621	0.6082	0.894	0.0897	0.3781	0.0389																			17.6169	500	0	6.2861	0.445795477	2.120579999	1.433401773	1.63372726	0.68757666	0.111987768	0.925665013	1.516282421	1.29931566	2.08489031	0.079328979	0.013638803	2.855938001	2.527933531	7.064448746	0.589019707	2.766314134	1.958933739	0.196477093	1.139431783	0.114343997	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.8512
H3209_001_0	2009	4																					800											D	D	D	V	T	P	P	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1390.171888	649.8688726	6822.754092	90.9482008	526.1485085	418.5059132	1170.029085	148.8381234	97.42199107	10989.41566	1444.691264	0	5.413214949	281.9083972	151.7602915	7030.096734	2708.831381	36.12132737	0	0	1293.569772	827.4857262	1498.037626	3510.266383	182.0000636	141.3063859	46.85749586	13.66333203	0	0											"$75 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $800 (13c)"	"$75 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0 (11a)	"$0 (11b, 11c)"	$50 (4a); $0 n/c (4a1); $10 (4b)	$25 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$25 (3, 5, 9a); $0 (9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $10 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$0 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a9, 14a10); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											74.48352753	75	0	0	75	0	0	49.511026	25	0	0	0	0	20.90334688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											57.16360677	57.55998206	0	0	57.55998206	0	0	37.99805024	19.18666069	0	0	0	0	16.04261695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											6.6223	3.117203387	0	0	2.523758225	0	0	0.471296541	0.15576689	0	0	0	0	0.376879036	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.2672	0	4.0198	6.6223	3.117203387	0	0	2.523758225	0	0	0.471296541	0.15576689	0	0	0	0	0.376879036	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.2672		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $10 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $10 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a9, 14a10); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											2.0715	0.3248	0.8096	0.0394	0.3003	0.1652	0.1888	0.0323	0.0918	0.3771	0.312	0	0	0.0613	0.0149	1.6029	0.5516	0.0034	0	0	0.1054	0.0789	0.1107	0	0.0089	0	0.004	0	0	0											7.2548	0	0	8.6937	3.442028387	0.809555688	0.03935911	2.824095663	0.165237223	0.18877771	0.503617279	0.24752193	0.377089577	0.311971667	0	0	0.438210532	0.014879517	1.602923113	0.55155	0.003406202	0	0	0.105442146	0.078916522	0.110719388	0	0.008933819	0	0.003969466	0	0	0	0	0	0	0	0	0	0	0	0	0	20.5219
H3209_002_0	2009	4																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		293.4545151	22.32	31.27261969	3809.780163	12.28137011	30.57546376	10.78884754	36.02628542	46.08905609	13.79216759	23.92811841	0	1.50567814	29.70116916	37.86766833	116.3890001	13.9175	4.282185824	0	0	17.25496806	7.00472604	62.75557261	2382.072524	160.8265407	193.6769327	30.83231456	10.73395894	20.2	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.071450565	0.072349843	0.18398085	0	0.2	0.2	0.2	0.076056671	0.2	0.08	0.2	0	0.2	0.2	0	0.19968644	0.2	0.2	0	0	0.2	0.036372961	0	0	0	0	0	0	0	0											0.071450565	0.072349843	0.18398085	0	0.2	0.2	0.2	0.076056671	0.2	0.08	0.2	0	0.2	0.2	0	0.19968644	0.2	0.2	0	0	0.2	0.036372961	0	0	0	0	0	0	0	0											20.9675	1.614848498	5.753563157	0	2.456274021	6.115092751	2.157769508	2.740039323	9.217811218	1.103373407	4.785623682	0	0.301135628	5.940233831	0	23.24130509	2.7835	0.856437165	0	0	3.450993613	0.254782629	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.7403	0	0	20.9675	1.614848498	5.753563157	0	2.456274021	6.115092751	2.157769508	2.740039323	9.217811218	1.103373407	4.785623682	0	0.301135628	5.940233831	0	23.24130509	2.7835	0.856437165	0	0	3.450993613	0.254782629	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.7403		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.6682	0.279	0.4938	0.6459	0.1939	0.4828	0.1704	0.1443	0.7277	0.2178	0.3778	0	0.0158	0.469	0.5979	1.8377	0.2198	0.0676	0	0	0.2724	0.0915	0.0261	0	0.0133	0	0.002	0	0.003	0											11.0176	0	0	24.6357	1.893848498	6.247341362	0.645885451	2.650190391	6.597863231	2.328119733	2.884361619	9.945533157	1.321144474	5.163436077	0	0.316984872	6.40919966	0.597910553	25.07902614	3.00325	0.924050625	0	0	3.723440477	0.346235496	0.0261	0	0.013276988	0	0.001978061	0	0.003	0	0	0	0	0	0	0	0	0	0	0	104.7578
H3209_003_0	2009	3																					2100											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1671.473283	248.3544138	34.52401717	45063.89859	78.06911534	17.24658513	7.625188835	319.0521256	334.4825629	5297.102533	405.102945	0	0.66983331	1293.780469	5229.154695	3877.367045	1242.868229	231.185446	0	0	22.1367409	979.1082366	769.983193	0	314.3760437	332.2285714	0	0	20.2	0											"$150 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$150 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$75 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5, 9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											148.2	150	0.184002269	0	75	0.14	0.2	49.9702243	75	4.4	64.79010385	0	0.2	70.25095025	3.247630647	25	20	20	0	0	0.2	13.6791576	0	0	0	0	0	0	0	0											103.5773874	104.8354123	0.184002269	0	52.41770617	0.097846385	0.13978055	34.92432713	52.41770617	3.075172095	45.28198168	0	0.13978055	49.09858225	3.247630647	25	20	20	0	0	0.13978055	13.6791576	0	0	0	0	0	0	0	0											14.4272	2.169694781	6.352497495	0	0.341016996	1.687516006	1.065853087	0.928556734	1.461067392	1.357458491	1.528655345	0	0.093629668	5.293565565	1.41519692	8.07784801	2.071447048	0.385309077	0	0	3.094285814	1.116114656	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.8669	0	14.4101	14.4272	2.169694781	6.352497495	0	0.341016996	1.687516006	1.065853087	0.928556734	1.461067392	1.357458491	1.528655345	0	0.093629668	5.293565565	1.41519692	8.07784801	2.071447048	0.385309077	0	0	3.094285814	1.116114656	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.8669		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.0864	0.2017	0.5451	0.4612	0.1187	0.2723	0.1204	0.07	0.5389	0.0848	0.2285	0	0.0071	0.4297	0.5869	1.8461	0.1512	0.0634	0	0	0.3495	0.0728	0.0569	0	0.0155	0	0	0	0.003	0											9.3102	0	0	17.5136	2.371414781	6.897613555	0.461215732	0.459730594	1.959830508	1.186250806	0.998592339	1.99993901	1.442211259	1.757204644	0	0.100680545	5.723263156	2.002134307	9.923997996	2.222647048	0.448706032	0	0	3.443813302	1.188902317	0.056935837	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	62.1772
H3214_002_0	2009	10																					N/A											D		D		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	0	0	0	0	0											0	N/A	39.03879482	0	489.6414572	0	488.1198829	0	0	149.4680517	69.83307122	0	0	0	0	0	0	67.45074642	0	0	0	0	38.28965703	0	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	PBP 4a	"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	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a												50	0	50	0	50	0	0	50	50	0	0	0	0	0	0	25	0	0	0	0	0.2	0	0	0	0	0	0	0	0	0											50	0	50	0	50	0	0	50	50	0	0	0	0	0	0	25	0	0	0	0	0.2	0	0	0	0	0	0	0	0	0											0.1627	0	2.040172738	0	2.033832846	0	0	0.622783549	0.29097113	0	0	0	0	0	0	0.140522388	0	0	0	0	7.657931406	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.9489	0	0	0.1627	0	2.040172738	0	2.033832846	0	0	0.622783549	0.29097113	0	0	0	0	0	0	0.140522388	0	0	0	0	7.657931406	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.9489	N/A	"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	PBP 4a	"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	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	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	0.1627	0	2.040172738	0	2.033832846	0	0	0.622783549	0.29097113	0	0	0	0	0	0	0.140522388	0	0	0	0	7.657931406	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.9489
H3214_003_0	2009	10																					N/A											D		D		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	0	0	0	0	0											0	N/A	382.1548624	0	489.6414572	0	488.1198829	0	0	149.4680517	69.83307122	0	0	0	0	0	0	67.45074642	0	0	0	0	38.28965703	0	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	PBP 4a	"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	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a												94.87695604	0	50	0	50	0	0	50	50	0	0	0	0	0	0	25	0	0	0	0	0.2	0	0	0	0	0	0	0	0	0											94.87695604	0	50	0	50	0	0	50	50	0	0	0	0	0	0	25	0	0	0	0	0.2	0	0	0	0	0	0	0	0	0											3.0215	0	2.040172738	0	2.033832846	0	0	0.622783549	0.29097113	0	0	0	0	0	0	0.140522388	0	0	0	0	7.657931406	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.8077	0	0	3.0215	0	2.040172738	0	2.033832846	0	0	0.622783549	0.29097113	0	0	0	0	0	0	0.140522388	0	0	0	0	7.657931406	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.8077	N/A	"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	PBP 4a	"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	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	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	3.0215	0	2.040172738	0	2.033832846	0	0	0.622783549	0.29097113	0	0	0	0	0	0	0.140522388	0	0	0	0	7.657931406	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.8077
H3214_801_0	2009	9																					N/A											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	N/A	160.3448576	0	24.81412773	0	12.23848907	32.58520417	1.622148468	9.020271138	37.77098339	3.176023618	19.42556575	0	0	35.86810526	40.12563436	51.661426	2.909650939	11.41755149	48.61662452	127.5946822	39.14640204	45.1526648	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	PBP 4a	"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	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a												0.0718	0	0.1737	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0718	0	0.1737	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											11.5128	0	4.310213986	0	2.827090976	7.527182163	0.374716296	2.083682633	8.725097163	0.733661456	4.487305689	0	0	8.285532315	9.269021537	11.93378941	0.672129367	2.637454394	11.23044026	29.47437158	9.042818871	10.43026557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.5575	0	0	11.5128	0	4.310213986	0	2.827090976	7.527182163	0.374716296	2.083682633	8.725097163	0.733661456	4.487305689	0	0	8.285532315	9.269021537	11.93378941	0.672129367	2.637454394	11.23044026	29.47437158	9.042818871	10.43026557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.5575	N/A	"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	PBP 4a	"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	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	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	11.5128	0	4.310213986	0	2.827090976	7.527182163	0.374716296	2.083682633	8.725097163	0.733661456	4.487305689	0	0	8.285532315	9.269021537	11.93378941	0.672129367	2.637454394	11.23044026	29.47437158	9.042818871	10.43026557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.5575
H3214_802_0	2009	10																					N/A											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	N/A	160.3448576	0	24.81412773	0	12.23848907	32.58520417	1.622148468	9.020271138	37.77098339	3.176023618	19.42556575	0	0	35.86810526	40.12563436	51.661426	2.909650939	11.41755149	48.61662452	127.5946822	39.14640204	45.1526648	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	PBP 4a	"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	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a												0.0718	0	0.1737	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0718	0	0.1737	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											11.5128	0	4.310213986	0	2.827090976	7.527182163	0.374716296	2.083682633	8.725097163	0.733661456	4.487305689	0	0	8.285532315	9.269021537	11.93378941	0.672129367	2.637454394	11.23044026	29.47437158	9.042818871	10.43026557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.5575	0	0	11.5128	0	4.310213986	0	2.827090976	7.527182163	0.374716296	2.083682633	8.725097163	0.733661456	4.487305689	0	0	8.285532315	9.269021537	11.93378941	0.672129367	2.637454394	11.23044026	29.47437158	9.042818871	10.43026557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.5575	N/A	"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	PBP 4a	"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	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	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	11.5128	0	4.310213986	0	2.827090976	7.527182163	0.374716296	2.083682633	8.725097163	0.733661456	4.487305689	0	0	8.285532315	9.269021537	11.93378941	0.672129367	2.637454394	11.23044026	29.47437158	9.042818871	10.43026557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.5575
H3214_803_0	2009	10																					N/A											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	N/A	160.3448576	0	24.81412773	0	12.23848907	32.58520417	1.622148468	9.020271138	37.77098339	3.176023618	19.42556575	0	0	35.86810526	40.12563436	51.661426	2.909650939	11.41755149	48.61662452	127.5946822	39.14640204	45.1526648	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	PBP 4a	"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	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a												0.0718	0	0.1737	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0718	0	0.1737	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											11.5128	0	4.310213986	0	2.827090976	7.527182163	0.374716296	2.083682633	8.725097163	0.733661456	4.487305689	0	0	8.285532315	9.269021537	11.93378941	0.672129367	2.637454394	11.23044026	29.47437158	9.042818871	10.43026557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.5575	0	0	11.5128	0	4.310213986	0	2.827090976	7.527182163	0.374716296	2.083682633	8.725097163	0.733661456	4.487305689	0	0	8.285532315	9.269021537	11.93378941	0.672129367	2.637454394	11.23044026	29.47437158	9.042818871	10.43026557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.5575	N/A	"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	PBP 4a	"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	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	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	11.5128	0	4.310213986	0	2.827090976	7.527182163	0.374716296	2.083682633	8.725097163	0.733661456	4.487305689	0	0	8.285532315	9.269021537	11.93378941	0.672129367	2.637454394	11.23044026	29.47437158	9.042818871	10.43026557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.5575
H3240_008_0	2009	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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1057.46	22.47	645.86	0	151.84	8.51	6.1	201.95	255.59	0	465.7	34.69	0.18	976.1	6254.52	7936.63	198.56	869.47	1779.82	1876.82	7.19	769.83	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $100 per day for the first 10 days	1B IP Psych: $100 per day for the first 10 days	2 SNF: $125 per day for 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: $50,4A Non Covered Foreign Travel: $50,  4B Urgent Care: $30"	9B ASC Services: $250	8A OP Lab Services: $0	8B OP X-Ray: $100	"9A OP Hospital: $250, 5 Partial Hosp: $250"	12 Renal Dialysis: 20%	"3 CORF: $250, 8A OP Diagnostic Procedures/Tests: $250, 9A OP Hospital: $250, 9D Cardiac Rehab: $250"	"7A PCP: $15, 14B Immunizations: $0, 14C Routine Physical Exams: $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"	"8B Physician Specialist Services - Radiology: $100, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7B Chiropractic: $30, 7F Podiatry: $30, 7F Non Medicare Covered Podiatry: $0,  7G Other Health Care: $30, 14D Pap Smears & Pelvic Exams: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $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, 17B Medicare Covered Eyewear: $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	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: Over-the-Counter Drugs: $0, 13D Other: PERS: $0, 13E Other: Assistive Devices: Not Covered"											100	100	125	0	100	0.199999978	0.200048515	48.33226046	250	0	100	250	0.2	171.2093023	15	30	30	30	100	30	0.200001812	30	0	0	0	0	0	0	0	0											100	100	125	0	100	0.199999978	0.200048515	48.33226046	250	0	100	250	0.2	171.2093023	15	30	30	30	100	30	0.200001812	30	0	0	0	0	0	0	0	0											8.8122	0.18725	6.727708333	0	1.265333333	1.701999814	1.220295939	0.813391667	5.324791667	0	3.880833333	0.722708333	0.036	13.92645	7.81815	19.841575	0.4964	2.173675	14.83183333	4.69205	1.438013025	1.924575	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.8352	0	0	8.8122	0.18725	6.727708333	0	1.265333333	1.701999814	1.220295939	0.813391667	5.324791667	0	3.880833333	0.722708333	0.036	13.92645	7.81815	19.841575	0.4964	2.173675	14.83183333	4.69205	1.438013025	1.924575	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.8352	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.8122	0.18725	6.727708333	0	1.265333333	1.701999814	1.220295939	0.813391667	5.324791667	0	3.880833333	0.722708333	0.036	13.92645	7.81815	19.841575	0.4964	2.173675	14.83183333	4.69205	1.438013025	1.924575	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.8352
H3240_009_0	2009	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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1012.42	22.82	641.36	0	155.88	9.14	6.54	205.16	277.09	0	482.19	27.49	0.15	865.85	6296.22	8063.36	204.38	907.79	1822.67	1956.01	8.35	759.33	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $100 per day for the first 10 days	1B IP Psych: $100 per day for the first 10 days	2 SNF: $130 per day for 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: $50,4A Non Covered Foreign Travel: $50,  4B Urgent Care: $35"	9B ASC Services: $200	8A OP Lab Services: $0	8B OP X-Ray: $50	"9A OP Hospital: $200, 5 Partial Hosp: $200"	12 Renal Dialysis: 20%	"3 CORF: $200, 8A OP Diagnostic Procedures/Tests: $200, 9A OP Hospital: $200, 9D Cardiac Rehab: $200"	"7A PCP: $15, 14B Immunizations: $0, 14C Routine Physical Exams: $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"	"8B Physician Specialist Services - Radiology: $50, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7B Chiropractic: $35, 7F Podiatry: $35, 7F Non Medicare Covered Podiatry: $0,  7G Other Health Care: $35, 14D Pap Smears & Pelvic Exams: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $35, 18A Medicare Covered Hearing Exams: $35"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $35, 17A Medicare Covered Eye Exams: $35, 17B Medicare Covered Eyewear: $35"	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: $0	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: Over-the-Counter Drugs: $0, 13D Other: PERS: $0, 13E Other: Assistive Devices: Not Covered"											100	100	130	0	100	0.199999996	0.199914688	48.77242152	200	0	50	200	0.200000018	135.9570942	15	35	35	35	50	35	0.199998977	35	0	0	0	0	0	0	0	0											100	100	130	0	100	0.199999996	0.199914688	48.77242152	200	0	50	200	0.200000018	135.9570942	15	35	35	35	50	35	0.199998977	35	0	0	0	0	0	0	0	0											8.4368	0.190166667	6.948066667	0	1.299	1.827999962	1.307442059	0.833845833	4.618166667	0	2.009125	0.458166667	0.030000003	9.809870833	7.870275	23.51813333	0.596108333	2.647720833	7.594458333	5.705029167	1.669991458	2.2147125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.5851	0	0	8.4368	0.190166667	6.948066667	0	1.299	1.827999962	1.307442059	0.833845833	4.618166667	0	2.009125	0.458166667	0.030000003	9.809870833	7.870275	23.51813333	0.596108333	2.647720833	7.594458333	5.705029167	1.669991458	2.2147125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.5851	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.4368	0.190166667	6.948066667	0	1.299	1.827999962	1.307442059	0.833845833	4.618166667	0	2.009125	0.458166667	0.030000003	9.809870833	7.870275	23.51813333	0.596108333	2.647720833	7.594458333	5.705029167	1.669991458	2.2147125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.5851
H3240_010_0	2009	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	O	V											49.7874	0.4935	9.8605	6.5412	0	1.5743	1.1201	0	6.6539	0.9681	3.0256	0.1759	0.0307	3.2288	0	0	0	0	0	0	1.2328	0.0973	0	0	0	0	0	0	0	0											84.79	0	0	0	0	0	155.47	0	0	217.69	0	0	0	0	0	351.59	0	8656.61	222.26	1003.9	0	2207.03	0	873.74	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, 4A Non Medicare Covered Foreign Travel: $50,  4B Urgent Care: $10"	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, 9A Outpatient Hospital Services $0,  9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $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"	"8B Physician Specialist Services - Radiology: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7G Other Health Care: $10, 18A Medicare Covered Hearing Exams: $10, 7B Chiropractic: $10, 7F Medicare Covered Podiatry: $10, 7F Non Medicare Covered Podiatry (Routine): $0, 14D Pap Smears & Pelvic Exams: $0, , 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $10"	15 Part B Drugs: 0%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $10, 17A Medicare Covered Eye Exams: $10, 17B Medicare Covered Eyewear: $10"	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: $0	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: Over-the-Counter Drugs: $0, 13D Other: PERS: $0, 13E Other: Assistive Devices: Not Covered"											0	0	0	0	100	0	0	46.5620837	0	0	0	0	0	10	0	10	10	10	0	10	0	10	0	0	0	0	0	0	0	0											0	0	0	0	100	0	0	46.5620837	0	0	0	0	0	10	0	10	10	10	0	10	0	10	0	0	0	0	0	0	0	0											0	0	0	0	1.295583333	0	0	0.844675	0	0	0	0	0	0.292991667	0	7.213841667	0.185216667	0.836583333	0	1.839191667	0	0.728116667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.2362	1500	0	49.7874	0.493451539	9.860493566	6.541220927	1.295583333	1.574264081	1.120083771	0.844675	6.653912282	0.968121186	3.025592138	0.175866812	0.030734006	3.521769733	0	7.213841667	0.185216667	0.836583333	0	1.839191667	1.232775126	0.825441019	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.0262	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	49.7874	0.493451539	9.860493566	6.541220927	1.295583333	1.574264081	1.120083771	0.844675	6.653912282	0.968121186	3.025592138	0.175866812	0.030734006	3.521769733	0	7.213841667	0.185216667	0.836583333	0	1.839191667	1.232775126	0.825441019	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.0262
H3240_013_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	471.67	33.05	154.64	67.86	16.54	20.73	19.3	20.25	33.99	9.05	18.08	1.21	2.14	53.05	101.36	168.14	10.88	10.6	45.11	65.2	7.48	6.27	7.96	23.48	2.76	2.67	0.63	1.77	3.03	12.63											PBP: 1A IP Acute: Standard Medicare	1B IP Psych: Standard Medicare	2 SNF: Standard Medicare	6 Home Health: Standard Medicare	10A Ambulance: Standard Medicare	11A DME: Standard Medicare	"11B Prosthetic Medical Supplies: Standard Medicare, 11C Diabetes Monitoring Supplies: $0"	"4A ER, 4B Urgent Care: Standard Medicare, 4A Worldwide Coverage: $0"	9B ASC Services: Standard Medicare	8A OP C/D/T: Standard Medicare	8B OP X-Ray: Standard Medicare	"9A OP Hospital, 5 Partial Hosp: Standard Medicare"	12 Renal Dialysis: Standard Medicare	"3 CORF, 9A OP Hospital, 9D Cardiac Rehab: Standard Medicare"	"7A PCP, 14B Immunizations, 14C Routine Physical Exams: Standard Medicare"	7D Physician Specialist (excl. Radiology): Standard Medicare	"7E Mental Health, 7H Psychiatric, 9C OP Substance Abuse,: Standard Medicare"	"7C Occupational Therapy, 7I Physical and Speech Therapy: Standard Medicare"	"8B Physician Specialist (Radiology), 14G Bone Mass Measurement, 14H Mammography: Standard Medicare"	"7B Chiropractic, 7F Podiatry - Medicare Covered, 7G Other Health Care, 14D Pap Smears/Pelvic Exams, 14E Prostate Screening, 14F Colorectal Screening, 14I Diabetes Monitoring, 14J Nutrition Therapy, 18A Medicare Covered Hearing Exams: Standard Medicare, 7F Podiatry - Routine: $0"	15 Part B Drugs: Standard Medicare	"13A Blood, 16B Medicare Covered Comprehensive Dental Services, 17A Medicare Covered Eye Exams, 17B Medicare Covered Eyewear: Standard Medicare"	10B Transportation: $0 for 24 one-way trips	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental: $0"	17A Routine Eye Exams: $0	17B Eye Wear - Non-Covered: $0	18A Hearing - Routine: $0	18B Hearing Aids: $0	"14A Medical Nutrition: $0, 14A Health Education/Wellness Programs: $0"	"6 Respite Care: $0, 13B Acupuncture: Not Covered, 13C Other: OTC Drugs: $0, 13D Other: Assistive Devices: $0 13E Other: PERS: $0"											0.059675419	0.0596748	0.159503037	0	0.231062906	0.231000243	0.182371623	0.229717854	0.231000011	0.231058009	0.230926396	0.230999868	0.231000006	0.231010043	0.228896413	0.230996721	0.23099309	0.230988842	0.230995788	0.222761682	0.231002611	0.230992084	0	0	0	0	0	0	0	0											0.059675419	0.0596748	0.159503037	0	0.231062906	0.231000243	0.182371623	0.229717854	0.231000011	0.231058009	0.230926396	0.230999868	0.231000006	0.231010043	0.228896413	0.230996721	0.23099309	0.230988842	0.230995788	0.222761682	0.231002611	0.230992084	0	0	0	0	0	0	0	0											28.1471	1.972252133	24.66554965	0	3.821780457	4.788635032	3.519772332	4.651786551	7.85169036	2.091074979	4.175149243	0.279509841	0.494340014	12.25508277	23.2009404	38.83978866	2.513204823	2.448481723	10.42022001	14.52406166	1.727899529	1.448320366	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	193.8366	0	0	28.1471	1.972252133	24.66554965	0	3.821780457	4.788635032	3.519772332	4.651786551	7.85169036	2.091074979	4.175149243	0.279509841	0.494340014	12.25508277	23.2009404	38.83978866	2.513204823	2.448481723	10.42022001	14.52406166	1.727899529	1.448320366	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	193.8366	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	28.1471	1.972252133	24.66554965	0	3.821780457	4.788635032	3.519772332	4.651786551	7.85169036	2.091074979	4.175149243	0.279509841	0.494340014	12.25508277	23.2009404	38.83978866	2.513204823	2.448481723	10.42022001	14.52406166	1.727899529	1.448320366	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	193.8366
H3240_014_0	2009	3																					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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	741.559	15.778	646.75	0	151.84	8.51	6.1	141.484	179.193	0	325.99	34.69	0.18	976.1	6254.52	5555.641	139.16	608.629	1245.874	1313.774	7.19	538.971	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $100 per day for the first 10 days	1B IP Psych: $100 per day for the first 10 days	2 SNF: $125 per day for 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/Worldwide Coverage: $50, 4B Urgent Care: $30"	9B ASC Services: $250	8A OP Lab Services: $0	8B OP X-Ray: $100	"9A OP Hospital: $250,  5 Partial Hosp: $250"	12 Renal Dialysis: 20%	"3 CORF: $250, 8A OP Diagnostic Procedures/Tests: $250, 9A OP Hospital: $250, 9D Cardiac Rehab: $250"	"7A PCP: $15, 14B Immunizations: $0, 14C Routine Physical Exams: $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"	"8B Physician Specialist Services - Radiology: $100, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7B Chiropractic: $30, 7F Podiatry - Medicare Covered: $30, 7F Podiatry - Routine: $0, 7G Other Health Care: $30, 14D Pap Smears/Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutritional Therapy: $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, 17B Medicare Covered Eyewear: $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	14A Health Education/Wellness Programs: $0	"13B Acupuncture: Not Covered, 13C Other: OTC drugs: $0, 13D Other: PERS: $0"											100	100	125	0	100	0.199999978	0.200048515	48.33366317	250	0	100	250	0.2	171.2093023	15	30	30	30	100	30	0.200001812	30	0	0	0	0	0	0	0	0											100	100	125	0	100	0.199999978	0.200048515	48.33366317	250	0	100	250	0.2	171.2093023	15	30	30	30	100	30	0.200001812	30	0	0	0	0	0	0	0	0											6.1797	0.131483333	6.736979167	0	1.265333333	1.701999814	1.220295939	0.56987	3.7331875	0	2.716583333	0.722708333	0.036	13.92645	7.81815	13.8891025	0.3479	1.5215725	10.38228333	3.284435	1.438013025	1.3474275	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.9694	0	0	6.1797	0.131483333	6.736979167	0	1.265333333	1.701999814	1.220295939	0.56987	3.7331875	0	2.716583333	0.722708333	0.036	13.92645	7.81815	13.8891025	0.3479	1.5215725	10.38228333	3.284435	1.438013025	1.3474275	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.9694	0	PBP: 1A IP Acute: $150 per day for the first 10 days	1B IP Psych: $150 per day for the first 10 days	2 SNF: Not Covered	6 Home Health: Not Covered	10A Ambulance: Not Covered	11A DME: Not Covered	"11B Prosthetic Medical Supplies, 11C Diabetes Monitoring Supplies: Not Covered"	"4A ER/Worldwide Coverage: $50, 4B Urgent Care: $40"	9B ASC Services: $275	8A OP Lab Services: Not Covered	8B OP X-Ray: $150	"9A OP Hospital, 5 Partial Hosp: Not Covered"	12 Renal Dialysis: Not Covered	"3 CORF, 8A OP Diagnostic Procedures/Tests, 9A OP Hospital, 9D Cardiac Rehab: Not Covered"	"7A PCP, 14B Immunizations, 14C Routine Physical Exams, 14I Diabetes Monitoring: Not Covered"	7D Physician Specialist: $40	"7E Mental Health: $40,  7H Psychiatric: $40, 9C OP Substance Abuse: $40"	"7C Occupational Therapy: $40,  7I Physical and Speech Therapy: $40"	"7D Physician Specialist Services - Radiology: $150, 14H Mammography: $0, 14G Bone Mass Measurement:$0"	"7B Chiropractic: $40, 7F Podiatry: $40, 7G Other Health Care: $40, 14D Pap Smears:$0, 14D Pelvic Exams:$0, 14E Prostate Screening:$0, 14F Colorectal Screening:$0, 14I Diabetes Monitoring:$0, 14J Nutrition Therapy:$0, 18A Medicare Covered Hearing Exams: $40"	15 Part B Drugs: Not Covered	"13A Blood: Not Covered, 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: Not Covered	17B Eye Wear: Not Covered	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: OTC drugs: Not Covered, 13D Other: PERS: Not Covered"											4.6731	0.1123	0	0	0	0	0	0.2803	2.1516	0	1.8119	0	0	0	0	9.1736	0.2565	1.1082	8.1829	2.494	0	0.9344	0	0	0	0	0	0	0	0											31.1787	0	0	10.8528	0.243795833	6.736979167	0	1.265333333	1.701999814	1.220295939	0.8502125	5.8847875	0	4.528433333	0.722708333	0.036	13.92645	7.81815	23.0626525	0.60439	2.6297525	18.56515833	5.778415	1.438013025	2.2817975	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.1481
H3240_015_0	2009	3																					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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	706.069	15.918	640.95	0	155.88	9.14	6.54	143.549	193.774	0	337.533	27.49	0.15	865.85	6296.22	5644.352	142.989	635.453	1275.869	1369.207	8.35	531.621	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $125 per day for the first 10 days	1B IP Psych: $125 per day for the first 10 days	2 SNF: $130 per day for 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/Worldwide Coverage: $50, 4B Urgent Care: $35"	9B ASC Services: $250	8A OP Lab Services: $0	8B OP X-Ray: $100	"9A OP Hospital: $250,  5 Partial Hosp: $250"	12 Renal Dialysis: 20%	"3 CORF: $250, 8A OP Diagnostic Procedures/Tests: $250, 9A OP Hospital: $250, 9D Cardiac Rehab: $250"	"7A PCP: $15, 14B Immunizations: $0, 14C Routine Physical Exams: $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"	"8B Physician Specialist Services - Radiology: $100, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7B Chiropractic: $35, 7F Podiatry - Medicare Covered: $35, 7F Podiatry - Routine: $0, 7G Other Health Care: $35, 14D Pap Smears/Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutritional Therapy: $35, 18A Medicare Covered Hearing Exams: $35"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $35, 17A Medicare Covered Eye Exams: $35, 17B Medicare Covered Eyewear: $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	14A Health Education/Wellness Programs: $0	"13B Acupuncture: Not Covered, 13C Other: OTC drugs: $0, 13D Other: PERS: $0"											125	125	130	0	100	0.199999996	0.199914688	48.77188277	250	0	100	250	0.200000018	166.550153	15	35	35	35	100	35	0.199998977	35	0	0	0	0	0	0	0	0											125	125	130	0	100	0.199999996	0.199914688	48.77188277	250	0	100	250	0.200000018	166.550153	15	35	35	35	100	35	0.199998977	35	0	0	0	0	0	0	0	0											7.3549	0.1658125	6.943625	0	1.299	1.827999962	1.307442059	0.583429583	4.036958333	0	2.812775	0.572708333	0.030000003	12.0172875	7.870275	16.46269333	0.41705125	1.853404583	10.63224167	3.993520417	1.669991458	1.55056125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.4017	0	0	7.3549	0.1658125	6.943625	0	1.299	1.827999962	1.307442059	0.583429583	4.036958333	0	2.812775	0.572708333	0.030000003	12.0172875	7.870275	16.46269333	0.41705125	1.853404583	10.63224167	3.993520417	1.669991458	1.55056125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.4017	0	PBP: 1A IP Acute: $175 per day for the first 10 days	1B IP Psych: $175 per day for the first 10 days	2 SNF: Not Covered	6 Home Health: Not Covered	10A Ambulance: Not Covered	11A DME: Not Covered	"11B Prosthetic Medical Supplies, 11C Diabetes Monitoring Supplies: Not Covered"	"4A ER/Worldwide Coverage: $50, 4B Urgent Care: $45"	9B ASC Services: $275	8A OP Lab Services: Not Covered	8B OP X-Ray: $150	"9A OP Hospital, 5 Partial Hosp: Not Covered"	12 Renal Dialysis: Not Covered	"3 CORF, 8A OP Diagnostic Procedures/Tests, 9A OP Hospital, 9D Cardiac Rehab: Not Covered"	"7A PCP, 14B Immunizations, 14C Routine Physical Exams, 14I Diabetes Monitoring: Not Covered"	7D Physician Specialist: $45	"7E Mental Health: $45,  7H Psychiatric: $45, 9C OP Substance Abuse: $45"	"7C Occupational Therapy: $45,  7I Physical and Speech Therapy: $45"	"7D Physician Specialist Services - Radiology: $150, 14H Mammography: $0, 14G Bone Mass Measurement:$0"	"7B Chiropractic: $45, 7F Podiatry: $45, 7G Other Health Care: $45, 14D Pap Smears:$0, 14D Pelvic Exams:$0, 14E Prostate Screening:$0, 14F Colorectal Screening:$0, 14I Diabetes Monitoring:$0, 14J Nutrition Therapy:$0, 18A Medicare Covered Hearing Exams: $45"	15 Part B Drugs: Not Covered	"13A Blood: Not Covered, 16B Medicare Covered Comprehensive Dental Services: $45, 17A Medicare Covered Eye Exams: $45"	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: Not Covered	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: OTC drugs: Not Covered, 13D Other: PERS: Not Covered"											5.271	0.1326	0	0	0	0	0	0.2908	2.4665	0	1.8888	0	0	0	0	10.5805	0.3049	1.3226	8.4162	2.9675	0	1.0487	0	0	0	0	0	0	0	0											34.69	0	0	12.6258	0.29841875	6.943625	0	1.299	1.827999962	1.307442059	0.874199583	6.503502083	0	4.7015375	0.572708333	0.030000003	12.0172875	7.870275	27.04316083	0.72190375	3.176044583	19.04840417	6.961022917	1.669991458	2.59926375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.0916
H3251_002_0	2009	8																																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		1115.614048	36.16101419	921.0860107	369.6764566	317.7021823	1725.218065	139.1530318	393.4370716	246.4222866	5069.083762	715.768953	2.445878775	7.512341953	676.6348926	5685.847543	6243.144141	26.64843368	313.0442406	1554.891192	1514.544266	2270.535108		0	0.436764067	5.765285685	184.8385532	1.747056268	0	17.38320987	173.7447459											$250 Copay / Adm	$250 Copay / Adm	Various Copays	0	$75 Copay	0	0	$50 Copay	$75 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 Copay	Various Copays	$15 Copay	Various Copays	Various Copays	"$50 Outpatient, + Other Copays"											55.39136407	41.68683448	0.066874318	0	75	0	0	50	75	0.126136648	17.66535782	10.93716964	0	21.3883646	5	15	20	10	0.856896525	16.16668815	0.21611621		0	1.134225	15	0	15	0	0	17.46387161											55.39136407	41.68683448	0.066874318	0	75	0	0	50	75	0.126136648	17.66535782	10.93716964	0	21.3883646	5	15	20	10	0.856896525	16.16668815	0.21611621	0	0	1.134225	15	0	15	0	0	17.46387161											5.1496	0.125619851	0.005133083	0	1.98563864	0	0	1.639321132	1.540139291	0.053283103	1.053692889	0.002229249	0	1.206009482	2.369103143	7.803930176	0.044414056	0.2608702	0.111031738	2.040430403	0.04089162	0	0	4.13E-05	0.007206607	0	0.00218382	0	0	0.252854661	0	0	0	0	0	0	0	0	0	0	25.6936			5.1496	0.125619851	0.005133083	0	1.98563864	0	0	1.639321132	1.540139291	0.053283103	1.053692889	0.002229249	0	1.206009482	2.369103143	7.803930176	0.044414056	0.2608702	0.111031738	2.040430403	0.04089162	0	0	4.13E-05	0.007206607	0	0.00218382	0	0	0.252854661	0	0	0	0	0	0	0	0	0	0	25.6936																																																																																		0			5.1496	0.125619851	0.005133083	0	1.98563864	0	0	1.639321132	1.540139291	0.053283103	1.053692889	0.002229249	0	1.206009482	2.369103143	7.803930176	0.044414056	0.2608702	0.111031738	2.040430403	0.04089162	0	0	4.13E-05	0.007206607	0	0.00218382	0	0	0.252854661	0	0	0	0	0	0	0	0	0	0	25.6936
H3251_021_0	2009	8																																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		1651.747796	44.2466356	1239.99296	603.8072033	441.1241645	2714.982958	163.1250915	442.7392644	269.7216859	6602.124681	791.1970712	3.8358623	8.883049537	923.4333768	7660.780865	8796.207103	59.46742335	312.6342031	2263.012718	1982.311183	3503.91936		0	0	3.8358623	183.5157279	0.807549958	0	30.28312342	118.7098438											$250 Copay / Adm	$250 Copay / Adm	Various Copays	0	$75 Copay	0	0	$50 Copay	$75 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 Copay	Various Copays	$15 Copay	Various Copays	Various Copays	$50 Outpatient; $150 InPatient											46.12623592	33.36480687	0.135353482	0	75	0	0	50	75	0.11819511	16.81137566	20.23659227	0	20.03146477	5	15	20	10	0.689807878	15.37459485	0.063746148		0	0	15	0	15	0	0	16.27689503											46.12623592	33.36480687	0.135353482	0	75	0	0	50	75	0.11819511	16.81137566	20.23659227	0	20.03146477	5	15	20	10	0.689807878	15.37459485	0.063746148		0	0	15	0	15	0	0	16.27689503											6.3491	0.123023371	0.013986447	0	2.757026028	0	0	1.844746935	1.685760537	0.065028237	1.108425932	0.006468732	0	1.54147693	3.191992027	10.99525888	0.099112372	0.260528503	0.130087	2.539769276	0.018613447	0	0	0	0.004794828	0	0.001009437	0	0	0.161018972	0	0	0	0	0	0	0	0	0	0	32.8972			6.3491	0.123023371	0.013986447	0	2.757026028	0	0	1.844746935	1.685760537	0.065028237	1.108425932	0.006468732	0	1.54147693	3.191992027	10.99525888	0.099112372	0.260528503	0.130087	2.539769276	0.018613447	0	0	0	0.004794828	0	0.001009437	0	0	0.161018972	0	0	0	0	0	0	0	0	0	0	32.8972																																																																																		0			6.3491	0.123023371	0.013986447	0	2.757026028	0	0	1.844746935	1.685760537	0.065028237	1.108425932	0.006468732	0	1.54147693	3.191992027	10.99525888	0.099112372	0.260528503	0.130087	2.539769276	0.018613447	0	0	0	0.004794828	0	0.001009437	0	0	0.161018972	0	0	0	0	0	0	0	0	0	0	32.8972
H3251_023_0	2009	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		1283.826778	38.88355558	1052.44816	450.2427706	363.8708575	2074.851379	150.0607916	418.5577349	259.8095422	5670.685442	757.0538813	2.937466559	8.124907502	769.9912341	6274.460578	6998.212159	36.07130721	314.5828996	1763.383979	1654.845578	2706.651156		0	0.312496442	5.312439521	189.0603476	1.499982924	0	21.81225168	161.0606664											$0 Copay / Adm	$200 Copay / Adm	Various Copays	0	$50 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	$5 Copay	Various Copays	Various Copays	Various Copays		Various Copays	Various Copays	$15 Copay	Various Copays	$15 Copay	Various Copays	Various Copays	"$50 Outpatient, + Other Copays"											0	32.09039739	0.096204501	0	50	0	0	50	50	0.125972947	17.71807666	15.29928988	0	21.36170038	5	15	20	5	0.79939882	15.96091005	0.15785941		0	1.123541601	15	0	15	0	0	17.36759009											0	32.09039739	0.096204501	0	50	0	0	50	50	0.125972947	17.71807666	15.29928988	0	21.36170038	5	15	20	5	0.79939882	15.96091005	0.15785941	0	0	1.123541601	15	0	15	0	0	17.36759009											0	0.103982396	0.008437521	0	1.516128573	0	0	1.743990562	1.082539759	0.059529413	1.117794892	0.003745096	0	1.370693503	2.614358574	8.747765198	0.060118845	0.131076208	0.117470589	2.201070118	0.035605863	0	0	2.93E-05	0.006640549	0	0.001874979	0	0	0.233102969	0	0	0	0	0	0	0	0	0	0	21.156			0	0.103982396	0.008437521	0	1.516128573	0	0	1.743990562	1.082539759	0.059529413	1.117794892	0.003745096	0	1.370693503	2.614358574	8.747765198	0.060118845	0.131076208	0.117470589	2.201070118	0.035605863	0	0	2.93E-05	0.006640549	0	0.001874979	0	0	0.233102969	0	0	0	0	0	0	0	0	0	0	21.156																																																																																		0			0	0.103982396	0.008437521	0	1.516128573	0	0	1.743990562	1.082539759	0.059529413	1.117794892	0.003745096	0	1.370693503	2.614358574	8.747765198	0.060118845	0.131076208	0.117470589	2.201070118	0.035605863	0	0	2.93E-05	0.006640549	0	0.001874979	0	0	0.233102969	0	0	0	0	0	0	0	0	0	0	21.156
H3251_804_0	2009	4																																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		1104.905734	24.38572823	571.0174966	340.4438144	230.5157526	1507.965829	146.9925562	286.1289701	224.9337568	5500.126532	652.4732872	1.653924682	4.548292877	637.7947057	6052.09047	6985.545854	19.06599158	318.8689816	1666.912407	1688.702111	2695.786629		1.033702927	0	3.51458995	230.5157526	0.413481171	0	36.5930836	162.2913595											$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	$15 Copay	Various Copays	$15 Copay	Various Copays	Various Copays	$50 Outpatient; $150 InPatient											37.69489248	27.25831111	0	0	100	8.438331395	0.007287792	50	100	0.090771839	19.7183955	20.72648	0	23.51003955	20	40	40	40	1.213632005	19.70814785	0.129737327	0	2.760767136	0	15	0	15	0	0	18.92446438											37.69489248	27.25831111	0	0	100	8.438331395	0.007287792	50	100	0.090771839	19.7183955	20.72648	0	23.51003955	20	40	40	40	1.213632005	19.70814785	0.129737327		2.760767136	0	15	0	15	0	0	18.92446438											3.4708	0.055392814	0	0	1.920964605	1.06039295	8.93E-05	1.192204042	1.874447973	0.041604717	1.072143861	0.00285667	0	1.249548229	10.08681745	23.28515285	0.063553305	1.062896605	0.168584854	2.773432574	0.029145346	0	0.000237818	0	0.004393237	0	0.000516851	0	0	0.255939754	0	0	0	0	0	0	0	0	0	0	49.6711			3.4708	0.055392814	0	0	1.920964605	1.06039295	8.93E-05	1.192204042	1.874447973	0.041604717	1.072143861	0.00285667	0	1.249548229	10.08681745	23.28515285	0.063553305	1.062896605	0.168584854	2.773432574	0.029145346	0	0.000237818	0	0.004393237	0	0.000516851	0	0	0.255939754	0	0	0	0	0	0	0	0	0	0	49.6711																																																																																		0			3.4708	0.055392814	0	0	1.920964605	1.06039295	8.93E-05	1.192204042	1.874447973	0.041604717	1.072143861	0.00285667	0	1.249548229	10.08681745	23.28515285	0.063553305	1.062896605	0.168584854	2.773432574	0.029145346	0	0.000237818	0	0.004393237	0	0.000516851	0	0	0.255939754	0	0	0	0	0	0	0	0	0	0	49.6711
H3251_805_0	2009	4																																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		1104.905734	24.38572823	571.0174966	340.4438144	230.5157526	1507.965829	146.9925562	286.1289701	224.9337568	5500.126532	652.4732872	1.653924682	4.548292877	637.7947057	6052.09047	6985.545854	19.06599158	318.8689816	1666.912407	1688.702111	2695.786629		1.033702927	0	3.51458995	230.5157526	0.413481171	0	36.5930836	162.2913595											$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	$15 Copay	Various Copays	$15 Copay	Various Copays	Various Copays	$50 Outpatient; $150 InPatient											37.69489248	27.25831111	0	0	100	8.438331395	0.007287792	50	100	0.090771839	19.7183955	20.72648	0	23.51003955	20	40	40	40	1.213632005	19.70814785	0.129737327	0	2.760767136	0	15	0	15	0	0	18.92446438											37.69489248	27.25831111	0	0	100	8.438331395	0.007287792	50	100	0.090771839	19.7183955	20.72648	0	23.51003955	20	40	40	40	1.213632005	19.70814785	0.129737327		2.760767136	0	15	0	15	0	0	18.92446438											3.4708	0.055392814	0	0	1.920964605	1.06039295	8.93E-05	1.192204042	1.874447973	0.041604717	1.072143861	0.00285667	0	1.249548229	10.08681745	23.28515285	0.063553305	1.062896605	0.168584854	2.773432574	0.029145346	0	0.000237818	0	0.004393237	0	0.000516851	0	0	0.255939754	0	0	0	0	0	0	0	0	0	0	49.6711			3.4708	0.055392814	0	0	1.920964605	1.06039295	8.93E-05	1.192204042	1.874447973	0.041604717	1.072143861	0.00285667	0	1.249548229	10.08681745	23.28515285	0.063553305	1.062896605	0.168584854	2.773432574	0.029145346	0	0.000237818	0	0.004393237	0	0.000516851	0	0	0.255939754	0	0	0	0	0	0	0	0	0	0	49.6711																																																																																		0			3.4708	0.055392814	0	0	1.920964605	1.06039295	8.93E-05	1.192204042	1.874447973	0.041604717	1.072143861	0.00285667	0	1.249548229	10.08681745	23.28515285	0.063553305	1.062896605	0.168584854	2.773432574	0.029145346	0	0.000237818	0	0.004393237	0	0.000516851	0	0	0.255939754	0	0	0	0	0	0	0	0	0	0	49.6711
H3305_007_0	2009	8	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	V	Coin	V																																																		0		301.8566251	5.975129376	2038.755317	75.98253688	524.1452332	8.175611171	2.918453799	301.9595115	287.0210353		428.9365594			558.636767	4178.037405	4295.761183	95.12378808				26.63658144	11.05094756			3.250994115		3.099785087			1											"$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"	$10 per Visit	"$100 MAB, no cost sharing prior to MAB"	$20 per Visit	"$600 Max Benefit, Every 3 Years"	Check with PBP	50% Coinsurance	$20 per Visit MH; 50% Coinsurance Sub Abuse										93.88897862	94.93670886	34.26621634	4.162909687	50	0.2	0.2	48.46946663	75		20			20	15.00053253	20	20				0.2	0.144457845			10		20			0.5											93.88897862	94.93670886	34.26621634	4.162909687	50	0.2	0.2	48.46946663	75		20			20	15.00053253	20	20				0.2	0.144457845			10		20			0.5											2.3618	0.047271593	5.821702563	0.026359037	2.183938472	1.635122234	0.58369076	1.219651372	1.793881471	0	0.714894266	0	0	0.931061278	5.222732168	7.159601972	0.158539647	0	0	0	5.327316288	1.596396065	0	0	0.002709162	0	0.005166308	0	0	0.5	0	0	0	0	0	0	0	0	0	0	37.2918	0	0	2.3618	0.047271593	5.821702563	0.026359037	2.183938472	1.635122234	0.58369076	1.219651372	1.793881471	0	0.714894266	0	0	0.931061278	5.222732168	7.159601972	0.158539647	0	0	0	5.327316288	1.596396065	0	0	0.002709162	0	0.005166308	0	0	0.5	0	0	0	0	0	0	0	0	0	0	37.2918																							"30% Travel Benefit with $3,000 MAB"																																								0.3521																			0.3521	0	0	2.3618	0.047271593	5.821702563	0.026359037	2.183938472	1.635122234	0.58369076	1.219651372	1.793881471	0	0.714894266	0	0	0.931061278	5.222732168	7.159601972	0.158539647	0	0	0	5.327316288	1.948539572	0	0	0.002709162	0	0.005166308	0	0	0.5	0	0	0	0	0	0	0	0	0	0	37.6439
H3305_011_0	2009	10	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	V	Coin	V																																																		0		262.5585548	5.132665623	2265.819798	86.1648236	545.4190525	9.950658596	4.125745417	285.0116924	275.0938571		402.4287772			601.7940778	3922.293135	5030.53816	223.6653329				23.45717081	4.552760857			4.00196811		2.940221469			1											"$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"	Check with PBP	50% Coinsurance	$20 per Visit MH; 50% Coinsurance Sub Abuse										93.88897862	94.93670886	34.26621634	4.162909687	50	0.2	0.2	48.01828369	75		20			20	15.00162616	20	20				0.2	0.118633972			15		20			0.5											93.88897862	94.93670886	34.26621634	4.162909687	50	0.2	0.2	48.01828369	75		20			20	15.00162616	20	20				0.2	0.118633972			15		20			0.5											2.0543	0.040606532	6.470089284	0.029891365	2.272579386	1.990131719	0.825149083	1.140481025	1.719336607	0	0.670714629	0	0	1.00299013	4.903397941	8.384230266	0.372775555	0	0	0	4.691434162	0.540112105	0	0	0.00500246	0	0.004900369	0	0	0.5	0	0	0	0	0	0	0	0	0	0	37.6181	0	0	2.0543	0.040606532	6.470089284	0.029891365	2.272579386	1.990131719	0.825149083	1.140481025	1.719336607	0	0.670714629	0	0	1.00299013	4.903397941	8.384230266	0.372775555	0	0	0	4.691434162	0.540112105	0	0	0.00500246	0	0.004900369	0	0	0.5	0	0	0	0	0	0	0	0	0	0	37.6181																							"30% Travel Benefit with $3,000 MAB"																																								0.5498																			0.5498	0	0	2.0543	0.040606532	6.470089284	0.029891365	2.272579386	1.990131719	0.825149083	1.140481025	1.719336607	0	0.670714629	0	0	1.00299013	4.903397941	8.384230266	0.372775555	0	0	0	4.691434162	1.089960779	0	0	0.00500246	0	0.004900369	0	0	0.5	0	0	0	0	0	0	0	0	0	0	38.168
H3305_801_0	2009	10	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	V	Coin	V																																																		0		268.9520768	4.209179831	1818.306479	82.21200733	472.2444387	9.245953051	4.06925813	266.7284874			266.7807769			586.5830567	4391.848389	5900.600717	179.3238737				23.37386002	2.016639118			3.963248808		1.16865029			1											"$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"	Check with PBP		$20 per Visit MH; 50% Coinsurance Sub Abuse										93.88897862	94.93670886	34.26621634	4.162909687	50	0.2	0.2	48.13565967			20			20	15.00215437	20	20				0.2	0.090400544			15		20			0.5											93.88897862	94.93670886	34.26621634	4.162909687	50	0.2	0.2	48.13565967			20			20	15.00215437	20	20				0.2	0.090400544			15		20			0.5											2.1043	0.033300473	5.192206931	0.028520097	1.967685161	1.84919061	0.813851626	1.069929308	0	0	0.444634628	0	0	0.977638428	5.49059896	9.834334528	0.298873123	0	0	0	4.674772005	0.182305274	0	0	0.004954061	0	0.00194775	0	0	0.5	0	0	0	0	0	0	0	0	0	0	35.469	0	0	2.1043	0.033300473	5.192206931	0.028520097	1.967685161	1.84919061	0.813851626	1.069929308	0	0	0.444634628	0	0	0.977638428	5.49059896	9.834334528	0.298873123	0	0	0	4.674772005	0.182305274	0	0	0.004954061	0	0.00194775	0	0	0.5	0	0	0	0	0	0	0	0	0	0	35.469																							"30% Travel Benefit - $3,000 MAB"																																								0.4237																			0.4237	0	0	2.1043	0.033300473	5.192206931	0.028520097	1.967685161	1.84919061	0.813851626	1.069929308	0	0	0.444634628	0	0	0.977638428	5.49059896	9.834334528	0.298873123	0	0	0	4.674772005	0.605997497	0	0	0.004954061	0	0.00194775	0	0	0.5	0	0	0	0	0	0	0	0	0	0	35.8927
H3305_803_0	2009	13	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	V	Coin	V																																																		0		242.4377749	3.554371776	1456.049211	80.17865865	387.717135	8.691451985	4.176288958	246.1749146			310.0395381			589.3472273	4310.531717	5855.234278	157.4656703				27.48848156	5.404921798			4.821607019		2.410803509			1											"$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"	Check with PBP	50% Coinsurance	$20 per Visit MH; 50% Coinsurance Sub Abuse										93.88897862	94.93670886	34.26621634	4.162909687	50	0.2	0.2	48.0396619			20			20	15.00088145	20	20				0.2	0.111944668			15		20			0.5											93.88897862	94.93670886	34.26621634	4.162909687	50	0.2	0.2	48.0396619			20			20	15.00088145	20	20				0.2	0.111944668			15		20			0.5											1.8969	0.02812003	4.157774773	0.02781471	1.615488063	1.738290397	0.835257792	0.985513305	0	0	0.516732564	0	0	0.982245379	5.388481273	9.758723797	0.262442784	0	0	0	5.497696312	0.605052176	0	0	0.006027009	0	0.004018006	0	0	0.5	0	0	0	0	0	0	0	0	0	0	34.8065	0	0	1.8969	0.02812003	4.157774773	0.02781471	1.615488063	1.738290397	0.835257792	0.985513305	0	0	0.516732564	0	0	0.982245379	5.388481273	9.758723797	0.262442784	0	0	0	5.497696312	0.605052176	0	0	0.006027009	0	0.004018006	0	0	0.5	0	0	0	0	0	0	0	0	0	0	34.8065																							"30% Travel Benefit - $3,000 MAB"																																								0.5533																			0.5533	0	0	1.8969	0.02812003	4.157774773	0.02781471	1.615488063	1.738290397	0.835257792	0.985513305	0	0	0.516732564	0	0	0.982245379	5.388481273	9.758723797	0.262442784	0	0	0	5.497696312	1.158303714	0	0	0.006027009	0	0.004018006	0	0	0.5	0	0	0	0	0	0	0	0	0	0	35.3598
H3307_002_0	2009	7																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2209.912654	119.3053887	1965.247916	1419.413861	162.4522802	7.204261624	8.761360943	196.84002	468.3677965	6545.907035	57.43312414	0	0.472107598	583.7201276	6198.302154	6939.183205	1346.412072	1066.515657	0	0	53.7429917	2974.628537	0	736.2539145	43.50364212	124.813013	18.89863947	4.034675686	14.93829382	0											"$110 Days 1-6 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$110 Days 1-6 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-14/$95 Days 15-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$75 (9b)	$0/$7 (8a1); $7 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); $75 (9a); $40/$40 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$40 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$30/$0 (18a1); $0 (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a3, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											73.66406035	56.21889751	41.37652798	0	150	0.2	0.098505306	49.71313876	75	2.8	0.184044564	0	0.2	29.95721561	6.837428118	30	40	30	0	0	0.2	29.47845009	0	0	0	0	30	0	0	0											73.66406035	56.21889751	41.37652798	0	150	0.2	0.098505306	49.71313876	75	2.8	0.184044564	0	0.2	29.95721561	6.837428118	30	40	30	0	0	0.2	29.47845009	0	0	0	0	30	0	0	0											13.5659	0.558934785	6.776261281	0	2.030653502	1.440852325	0.863040537	0.815461269	2.927298728	1.527378308	10.57025427	0	0.09442152	1.457219143	3.531703786	17.34795801	4.48804024	2.666289144	0	0	10.74859834	7.307286572	0	0	0	0	0.047246599	0	0	0	0	0	0	0	0	0	0	0	0	0	88.7648	0	0	13.5659	0.558934785	6.776261281	0	2.030653502	1.440852325	0.863040537	0.815461269	2.927298728	1.527378308	10.57025427	0	0.09442152	1.457219143	3.531703786	17.34795801	4.48804024	2.666289144	0	0	10.74859834	7.307286572	0	0	0	0	0.047246599	0	0	0	0	0	0	0	0	0	0	0	0	0	88.7648																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	13.5659	0.558934785	6.776261281	0	2.030653502	1.440852325	0.863040537	0.815461269	2.927298728	1.527378308	10.57025427	0	0.09442152	1.457219143	3.531703786	17.34795801	4.48804024	2.666289144	0	0	10.74859834	7.307286572	0	0	0	0	0.047246599	0	0	0	0	0	0	0	0	0	0	0	0	0	88.7648
H3307_011_0	2009	5																																D	D	D	V	T	O	O	V	V	O	Coin	V	O	O	V	V	V	V	V	V	S	O	T	V	P	P	P	P	O	O											37.3357	0.7835	3.2481	0.6564	0.7274	0.7245	0.4212	0	6.4958	0	0	0	0.0046	1.3792	0	0	0	0	0	0	6.7542	0	0	0	0	0	0	0	0	0											58.5307	0	1554.018707	122.2839444	1219.298443	910.4564183	106.395413	510.9088173	1061.127524	198.8329562	527.9010078	6782.851381	65.93636024	0	2.670958579	591.5325528	6512.190572	7191.234675	888.9991792	1387.804239	0	0	1520.604195	3058.717935	0	735.5604881	41.75152356	124.8124409	18.89855286	2.657523881	30.12285765	0											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$0 (10a)	$0 (11a)	"$0 (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	$0 (9b)	$0/$7 (8a1); $7 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$30 (3, 9d); $0 (5, 9a); $40/$40 (9c)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$40 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$10 (7g)	"$0 (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$30/$0 (18a1); $0 (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a3, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											0	0	0	0	0	0	0	49.71492655	0	2.8	0.184660777	0	0	2.756094832	6.487677029	30	40	30	0	0	0	29.43162943	0	0	0	0	30	0	0	0											0	0	0	0	0	0	0	49.71492655	0	2.8	0.184660777	0	0	2.756094832	6.487677029	30	40	30	0	0	0	29.43162943	0	0	0	0	30	0	0	0											0	0	0	0	0	0	0	0.823747151	0	1.582665322	12.17585951	0	0	0.135859984	3.520749098	17.97808669	2.963330597	3.469510598	0	0	0	7.501921065	0	0	0	0	0.047246382	0	0	0	0	0	0	0	0	0	0	0	0	0	50.199	2050	0	37.3357	0.783519765	3.248105691	0.656425819	0.727415824	0.724454899	0.421226576	0.823747151	6.495821819	1.582665322	12.17585951	0	0.004628882	1.51509207	3.520749098	17.97808669	2.963330597	3.469510598	0	0	6.754236832	7.501921065	0	0	0	0	0.047246382	0	0	0	0	0	0	0	0	0	0	0	0	0	108.7297																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	37.3357	0.783519765	3.248105691	0.656425819	0.727415824	0.724454899	0.421226576	0.823747151	6.495821819	1.582665322	12.17585951	0	0.004628882	1.51509207	3.520749098	17.97808669	2.963330597	3.469510598	0	0	6.754236832	7.501921065	0	0	0	0	0.047246382	0	0	0	0	0	0	0	0	0	0	0	0	0	108.7297
H3307_012_0	2009	6																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2060.893902	105.9803116	1433.854102	865.1572388	137.8284689	7.060468465	7.84822686	277.8374032	673.8019446	6790.890925	43.400904	0	0.31724282	498.3772815	5832.303954	5902.628922	2861.051659	706.5860679	0	0	34.88682565	2337.252908	0	646.780892	87.17771236	196.9571424	18.64215876	7.077209243	207.5655995	0											"$130 Days 1-12 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$130 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-5/$95 Days 6-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$120 (9b)	$0/$7 (8a1); $7 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); $120 (9a); $40/$40 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$40 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$30/$0 (18a1); $0 (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a3, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											110.0465173	94.63717097	70.6166421	0	150	0.2	0.093743851	49.81294255	120	2.8	0.184611624	0	0.2	42.26051091	10.17298529	30	40	30	0	0	0.2	29.46065212	0	0	0	0	30	0	0	0											110.0465173	94.63717097	70.6166421	0	150	0.2	0.093743851	49.81294255	120	2.8	0.184611624	0	0.2	42.26051091	10.17298529	30	40	30	0	0	0.2	29.46065212	0	0	0	0	30	0	0	0											18.8995	0.835806406	8.437830162	0	1.722855862	1.412093693	0.735723013	1.153324884	6.738019446	1.584541216	8.012311378	0	0.063448564	1.755139878	4.944328527	14.75657231	9.536838864	1.76646517	0	0	6.97736513	5.738082903	0	0	0	0	0.046605397	0	0	0	0	0	0	0	0	0	0	0	0	0	95.1169	0	0	18.8995	0.835806406	8.437830162	0	1.722855862	1.412093693	0.735723013	1.153324884	6.738019446	1.584541216	8.012311378	0	0.063448564	1.755139878	4.944328527	14.75657231	9.536838864	1.76646517	0	0	6.97736513	5.738082903	0	0	0	0	0.046605397	0	0	0	0	0	0	0	0	0	0	0	0	0	95.1169																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.8995	0.835806406	8.437830162	0	1.722855862	1.412093693	0.735723013	1.153324884	6.738019446	1.584541216	8.012311378	0	0.063448564	1.755139878	4.944328527	14.75657231	9.536838864	1.76646517	0	0	6.97736513	5.738082903	0	0	0	0	0.046605397	0	0	0	0	0	0	0	0	0	0	0	0	0	95.1169
H3307_013_0	2009	5																																D	D	D	V	T	O	O	V	V	O	Coin	V	O	O	V	V	V	V	V	V	S	O	T	V	P	P	P	P	O	O											39.9055	1.1527	3.0341	0.6966	0.8306	1.1156	0.4932	0	8.4524	0	0	0	0.0122	1.6394	0	0	0	0	0	0	6.1598	0	0	0	0	0	0	0	0	0											63.492	0	1298.732389	138.7447376	1045.135038	772.4112687	102.4911072	538.601329	989.2831525	219.194941	631.8666122	6835.284321	56.13911049	0	7.027837391	521.6814383	6026.628043	6058.414315	733.5239243	964.4184608	0	0	1364.108585	2476.779516	0	651.147385	89.76381484	197.2769144	18.73824177	4.466996661	210.6900576	0											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$0 (10a)	$0 (11a)	"$0 (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	$0 (9b)	$0/$7 (8a1); $7 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$22 (3, 9d); $0 (5, 9a); $40/$40 (9c)"	"$10 (7a); $22 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$22 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$40 (7e, 7h)"	"$22 (7c, 7i)"	Included in h.2.	$10 (7g)	"$0 (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $22 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$22/$0 (18a1); $0 (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a3, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											0	0	0	0	0	0	0	49.77562799	0	2.8	0.1845681	0	0	2.156665824	6.572094766	22	40	22	0	0	0	21.63264241	0	0	0	0	22	0	0	0											0	0	0	0	0	0	0	49.77562799	0	2.8	0.1845681	0	0	2.156665824	6.572094766	22	40	22	0	0	0	21.63264241	0	0	0	0	22	0	0	0											0	0	0	0	0	0	0	0.90921382	0	1.594899675	10.36148895	0	0	0.093757711	3.300630885	11.10709291	2.445079748	1.768100511	0	0	0	4.464940466	0	0	0	0	0.034353443	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0796	2400	0	39.9055	1.152663185	3.034092975	0.696576608	0.83062666	1.11564442	0.493233984	0.90921382	8.452393592	1.594899675	10.36148895	0	0.012166349	1.733160502	3.300630885	11.10709291	2.445079748	1.768100511	0	0	6.159783911	4.464940466	0	0	0	0	0.034353443	0	0	0	0	0	0	0	0	0	0	0	0	0	99.5716																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	39.9055	1.152663185	3.034092975	0.696576608	0.83062666	1.11564442	0.493233984	0.90921382	8.452393592	1.594899675	10.36148895	0	0.012166349	1.733160502	3.300630885	11.10709291	2.445079748	1.768100511	0	0	6.159783911	4.464940466	0	0	0	0	0.034353443	0	0	0	0	0	0	0	0	0	0	0	0	0	99.5716
H3307_015_0	2009	6																																D	D	D	V	T	O	O	V	V	O	O	V	O	O	V	V	Coin	V	V	V	S	O	T	Coin	P	P	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	915.2595726	60.29367449	730.9602813	479.6575835	64.15770304	468.837745	1203.140424	77.94177055	308.5756681	6077.935499	3515.608316	0	47.58385969	195.4584961	8618.611703	8079.410311	2.357321452	6029.128716	0	0	1593.532159	3138.563598	0	6.410291718	30.34058297	124.8135019	18.8987135	11.7302392	363.0908463	461.5384615											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$0 (10a)	$0 (11a)	"$0 (11b, 11c)"	"$50 (4a, 4a1); $5 (4b)"	$0 (9b)	$0/$0 (8a1); $0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$5 (3, 9d); $0 (5, 9a); $5/$5 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $5 (7a1); $0 n/c (14b1, 14e1, 14h1)"	"$5 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"50%/50% (7e, 7h)"	"$5 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $5 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b2, 16b3, 16b4, 16b5); 70% (16b1)"	$0 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$5/$0 (18a1); $0 (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a3, 14a4, 14a6, 14a7)"	"$5 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0	0	46.5242306	0	0	0	0	0	0.455096334	0.017442723	5	0.5	5	0	0	0	4.717250684	0	0.40117725	0	0	5	0	0	5											0	0	0	0	0	0	0	46.5242306	0	0	0	0	0	0.455096334	0.017442723	5	0.5	5	0	0	0	4.717250684	0	0.40117725	0	0	5	0	0	5											0	0	0	0	0	0	0	0.302181742	0	0	0	0	0	0.007412704	0.012527671	3.366420963	1.178660726	2.512136965	0	0	0	1.233782607	0	2.571663203	0	0	0.007874464	0	0	0.192307692	0	0	0	0	0	0	0	0	0	0	11.385	0	0	0	0	0	0	0	0	0	0.302181742	0	0	0	0	0	0.007412704	0.012527671	3.366420963	1.178660726	2.512136965	0	0	0	1.233782607	0	2.571663203	0	0	0.007874464	0	0	0.192307692	0	0	0	0	0	0	0	0	0	0	11.385																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0.302181742	0	0	0	0	0	0.007412704	0.012527671	3.366420963	1.178660726	2.512136965	0	0	0	1.233782607	0	2.571663203	0	0	0.007874464	0	0	0.192307692	0	0	0	0	0	0	0	0	0	0	11.385
H3307_018_0	2009	5																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2349.790763	127.7195906	2056.555204	1291.035916	151.5010771	8.39852773	4.818809947	191.9701376	667.7630981	7219.09796	73.24582072	0	2.530212896	646.1111577	7265.070961	9005.693398	880.662705	1629.582348	0	0	77.0586028	3630.949928	0	738.5467898	45.72914862	124.8144074	18.89885061	2.462631704	19.8228698	0											"$110 Days 1-6 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$110 Days 1-6 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$95 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$75 (9b)	$0/$7 (8a1); $7 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); $75 (9a); $40/$40 (9c)"	"$10 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$40 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$25/$0 (18a1); $0 (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a3, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											73.66419783	56.21889751	52.35147866	0	150	0.2	0.175757983	49.63776769	75	2.8	0.184546285	0	0.2	27.14107079	6.745549398	25	40	25	0	0	0.2	24.54233244	0	0	0	0	25	0	0	0											73.66419783	56.21889751	52.35147866	0	150	0.2	0.175757983	49.63776769	75	2.8	0.184546285	0	0.2	27.14107079	6.745549398	25	40	25	0	0	0.2	24.54233244	0	0	0	0	25	0	0	0											14.4246	0.598354548	8.97197549	0	1.893763464	1.679705546	0.846944316	0.794080758	4.173519363	1.684456191	13.5172441	0	0.506042579	1.461345723	4.08390792	18.76186125	2.93554235	3.394963226	0	0	15.41172056	7.425998351	0	0	0	0	0.039372605	0	0	0	0	0	0	0	0	0	0	0	0	0	102.6054	0	0	14.4246	0.598354548	8.97197549	0	1.893763464	1.679705546	0.846944316	0.794080758	4.173519363	1.684456191	13.5172441	0	0.506042579	1.461345723	4.08390792	18.76186125	2.93554235	3.394963226	0	0	15.41172056	7.425998351	0	0	0	0	0.039372605	0	0	0	0	0	0	0	0	0	0	0	0	0	102.6054																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.4246	0.598354548	8.97197549	0	1.893763464	1.679705546	0.846944316	0.794080758	4.173519363	1.684456191	13.5172441	0	0.506042579	1.461345723	4.08390792	18.76186125	2.93554235	3.394963226	0	0	15.41172056	7.425998351	0	0	0	0	0.039372605	0	0	0	0	0	0	0	0	0	0	0	0	0	102.6054
H3307_019_0	2009	4																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2056.905164	93.69642576	1836.91284	1241.933619	150.3755727	6.448411795	6.253814839	200.5557453	618.7284801	6535.650877	52.91478534	0	0.615421828	530.4935812	5743.969201	6481.282203	1208.033714	939.0714011	0	0	46.13804905	2763.491899	0	586.6710131	119.7050043	248.6586634	18.549772	9.36	353.5284855	0											"$80 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$80 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$75 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$50 (9b)	$0/$7 (8a1); $7 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); $50 (9a); $40/$40 (9c)"	"$10 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$40 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$20/$0 (18a1); $0 (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a3, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											64.62856673	53.83790703	41.33011473	0	150	0.2	0.103913292	49.73522736	50	2.8	0.184041402	0	0.2	21.83121009	6.848510326	20	40	20	0	0	0.2	19.65294934	0	0	0	0	20	0	0	0											64.62856673	53.83790703	41.33011473	0	150	0.2	0.103913292	49.73522736	50	2.8	0.184041402	0	0.2	21.83121009	6.848510326	20	40	20	0	0	0.2	19.65294934	0	0	0	0	20	0	0	0											11.0779	0.420368288	6.326651538	0	1.879694659	1.289682359	0.649854486	0.831223799	2.578035334	1.524985205	9.738511291	0	0.123084366	0.965109735	3.278136032	10.80213701	4.026779047	1.565119002	0	0	9.227609809	4.52589719	0	0	0	0	0.030916287	0	0	0	0	0	0	0	0	0	0	0	0	0	70.8617	0	0	11.0779	0.420368288	6.326651538	0	1.879694659	1.289682359	0.649854486	0.831223799	2.578035334	1.524985205	9.738511291	0	0.123084366	0.965109735	3.278136032	10.80213701	4.026779047	1.565119002	0	0	9.227609809	4.52589719	0	0	0	0	0.030916287	0	0	0	0	0	0	0	0	0	0	0	0	0	70.8617																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.0779	0.420368288	6.326651538	0	1.879694659	1.289682359	0.649854486	0.831223799	2.578035334	1.524985205	9.738511291	0	0.123084366	0.965109735	3.278136032	10.80213701	4.026779047	1.565119002	0	0	9.227609809	4.52589719	0	0	0	0	0.030916287	0	0	0	0	0	0	0	0	0	0	0	0	0	70.8617
H3307_020_0	2009	7																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		558.9578789	23.23	54.3860734	2971.146821	14.4709162	13.88175212	14.58699978	11.14117379	62.92387914	14.43757433	68.16307191	0	0.420362164	17.34540609	35.48260038	205.6627008	13.99	16.15847335	0	0	59.41086072	14.3687991	833.1550791	0	62.33977439	144.4177865	0	0	2.374928176	0											"6% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"6% (1b); $0 n/c (1b1, 1b2)"	16% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.05963877	0.0604	0.1595	0	0.2	0.2	0.2	0.108644166	0.2	0.08	0.184645372	0	0.2	0.2	0.001122165	0.199939716	0.2	0.2	0	0	0.2	0.01380126	0	0	0	0	0	0	0	0											0.05963877	0.0604	0.1595	0	0.2	0.2	0.2	0.108644166	0.2	0.08	0.184645372	0	0.2	0.2	0.001122165	0.199939716	0.2	0.2	0	0	0.2	0.01380126	0	0	0	0	0	0	0	0											33.3356	1.403092	8.674578707	0	2.89418324	2.776350425	2.917399955	1.210423535	12.58477583	1.155005946	12.58599574	0	0.084072433	3.469081219	0.039817319	41.12014205	2.798	3.231694671	0	0	11.88217214	0.198307536	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.3607	0	0	33.3356	1.403092	8.674578707	0	2.89418324	2.776350425	2.917399955	1.210423535	12.58477583	1.155005946	12.58599574	0	0.084072433	3.469081219	0.039817319	41.12014205	2.798	3.231694671	0	0	11.88217214	0.198307536	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.3607																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	33.3356	1.403092	8.674578707	0	2.89418324	2.776350425	2.917399955	1.210423535	12.58477583	1.155005946	12.58599574	0	0.084072433	3.469081219	0.039817319	41.12014205	2.798	3.231694671	0	0	11.88217214	0.198307536	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.3607
H3307_021_0	2009	7																																D	D	D	V	T	Coin	Coin	V	V	O	O	V	Coin	O	V	V	Coin	V	V	V	Coin	O	T	V	P	P	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	2252.554362	121.6074641	2003.168658	1446.802378	165.586903	7.484965798	9.102735357	200.5818172	477.4052591	6672.214587	4578.408263	0	0.490502623	594.9833887	6142.966332	7072.160059	11.19201249	1087.094774	0	0	55.83701367	3032.025938	0	0	0	0	0	0	492.269714	0											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$100 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	10% (11a)	10% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$100 (9b)	$0/$0 (8a1); $0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $0 (5); $100 (9a); $20/$20 (9c)"	"$5 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"50%/50% (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$5 (7g)	"10% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a3, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											0	0	55.10681964	0	75	0.1	0.049252653	49.71305816	100	0	0	0	0.2	31.79019976	3.539466833	20	0.5	20	0	0	0.1	19.65230006	0	0	0	0	0	0	0	0											0	0	55.10681964	0	75	0.1	0.049252653	49.71305816	100	0	0	0	0.2	31.79019976	3.539466833	20	0.5	20	0	0	0.1	19.65230006	0	0	0	0	0	0	0	0											0	0	9.199021163	0	1.034918144	0.74849658	0.448333864	0.830961295	3.978377159	0	0	0	0.098100525	1.576220065	1.811902132	11.78693343	5.596006243	1.811824623	0	0	5.583701367	4.965523626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.4703	0	0	0	0	9.199021163	0	1.034918144	0.74849658	0.448333864	0.830961295	3.978377159	0	0	0	0.098100525	1.576220065	1.811902132	11.78693343	5.596006243	1.811824623	0	0	5.583701367	4.965523626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.4703																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	9.199021163	0	1.034918144	0.74849658	0.448333864	0.830961295	3.978377159	0	0	0	0.098100525	1.576220065	1.811902132	11.78693343	5.596006243	1.811824623	0	0	5.583701367	4.965523626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.4703
H3307_802_0	2009	3																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1926.229879	102.9031939	1650.9074	1266.68149	132.7420181	5.292054929	7.985328877	173.8684935	51.63553946	6588.927482	61.32016188	0	0.207889326	13.48394449	6165.213011	7038.167545	1369.414619	1405.643115	0	0	53.58063459	3248.474016	0	0	0	0	0	0	0	0											"$130 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$130 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $60 (5); 20% (9a); $40/$40 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$40 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											105.0209886	87.48659893	159.8131731	0	150	0.2	0.094242125	49.67884724	0.2	2.8	0.188704826	0	0.2	0.105952248	12.6875572	39.87477751	40	40	0	0	0.2	39.32751426	0	0	0	0	0	0	0	0											105.0209886	87.48659893	159.8131731	0	150	0.2	0.094242125	49.67884724	0.2	2.8	0.188704826	0	0.2	0.105952248	12.6875572	39.87477751	40	40	0	0	0.2	39.32751426	0	0	0	0	0	0	0	0											16.8579	0.750220871	21.98639583	0	1.659275227	1.058410986	0.752554366	0.719798861	10.32710789	1.537416412	11.5714105	0	0.041577865	1.428654225	6.518457726	23.38711375	4.564715396	4.68547705	0	0	10.71612692	10.64620068	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2088	0	0	16.8579	0.750220871	21.98639583	0	1.659275227	1.058410986	0.752554366	0.719798861	10.32710789	1.537416412	11.5714105	0	0.041577865	1.428654225	6.518457726	23.38711375	4.564715396	4.68547705	0	0	10.71612692	10.64620068	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2088																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.8579	0.750220871	21.98639583	0	1.659275227	1.058410986	0.752554366	0.719798861	10.32710789	1.537416412	11.5714105	0	0.041577865	1.428654225	6.518457726	23.38711375	4.564715396	4.68547705	0	0	10.71612692	10.64620068	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2088
H3307_804_0	2009	3																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1928.294933	103.0135134	1652.677289	1268.039462	132.884327	5.303407924	8.002459728	174.0548928	51.7463127	6595.991277	61.45171144	0	0.208335309	13.51287146	6171.822555	7045.712957	1370.882728	1407.150064	0	0	53.69558062	3251.956609	0	0	0	0	0	0	0	0											"$130 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$130 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $60 (5); 20% (9a); $40/$40 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$40 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											105.0209886	87.48659893	159.8131731	0	150	0.2	0.094242125	49.67884724	0.2	2.8	0.188704826	0	0.2	0.105908782	12.6875572	39.87633234	40	40	0	0	0.2	39.32751426	0	0	0	0	0	0	0	0											105.0209886	87.48659893	159.8131731	0	150	0.2	0.094242125	49.67884724	0.2	2.8	0.188704826	0	0.2	0.105908782	12.6875572	39.87633234	40	40	0	0	0.2	39.32751426	0	0	0	0	0	0	0	0											16.876	0.751025161	22.0099668	0	1.661054087	1.060681585	0.754168814	0.720570536	10.34926254	1.539064631	11.59623454	0	0.041667062	1.431131753	6.525445973	23.41309929	4.569609093	4.690500212	0	0	10.73911612	10.65761416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.3862	0	0	16.876	0.751025161	22.0099668	0	1.661054087	1.060681585	0.754168814	0.720570536	10.34926254	1.539064631	11.59623454	0	0.041667062	1.431131753	6.525445973	23.41309929	4.569609093	4.690500212	0	0	10.73911612	10.65761416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.3862																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.876	0.751025161	22.0099668	0	1.661054087	1.060681585	0.754168814	0.720570536	10.34926254	1.539064631	11.59623454	0	0.041667062	1.431131753	6.525445973	23.41309929	4.569609093	4.690500212	0	0	10.73911612	10.65761416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.3862
H3307_805_0	2009	3																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1926.229878	102.9031939	1650.907399	1266.68149	132.7420181	5.292054924	7.985328871	173.8684935	51.63553942	6588.927479	61.32016183	0	0.207889326	13.48394447	6165.213008	7038.167542	1369.414618	1405.643114	0	0	53.58063455	3248.474014	0	0	0	0	0	0	0	0											"$130 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$130 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $60 (5); 20% (9a); $40/$40 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$40 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											105.0209886	87.48659893	159.8131731	0	150	0.2	0.094242125	49.67884724	0.2	2.8	0.188704826	0	0.2	0.105952248	12.6875572	39.87477751	40	40	0	0	0.2	39.32751426	0	0	0	0	0	0	0	0											105.0209886	87.48659893	159.8131731	0	150	0.2	0.094242125	49.67884724	0.2	2.8	0.188704826	0	0.2	0.105952248	12.6875572	39.87477751	40	40	0	0	0.2	39.32751426	0	0	0	0	0	0	0	0											16.8579	0.750220871	21.98639583	0	1.659275226	1.058410985	0.752554365	0.719798861	10.32710788	1.537416412	11.57141049	0	0.041577865	1.428654224	6.518457724	23.38711374	4.564715394	4.685477048	0	0	10.71612691	10.64620068	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2088	0	0	16.8579	0.750220871	21.98639583	0	1.659275226	1.058410985	0.752554365	0.719798861	10.32710788	1.537416412	11.57141049	0	0.041577865	1.428654224	6.518457724	23.38711374	4.564715394	4.685477048	0	0	10.71612691	10.64620068	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2088																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.8579	0.750220871	21.98639583	0	1.659275226	1.058410985	0.752554365	0.719798861	10.32710788	1.537416412	11.57141049	0	0.041577865	1.428654224	6.518457724	23.38711374	4.564715394	4.685477048	0	0	10.71612691	10.64620068	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2088
H3307_806_0	2009	3																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1931.584196	103.1892326	1655.496407	1270.202469	133.1109995	5.321516338	8.029784018	174.3517936	51.92299978	6607.242642	61.66153747	0	0.209046667	13.55901098	6182.350377	7057.731452	1373.221164	1409.550364	0	0	53.87892345	3257.503759	0	0	0	0	0	0	0	0											"$130 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$130 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $60 (5); 20% (9a); $40/$40 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$40 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											105.0209886	87.48659893	159.8131731	0	150	0.2	0.094242125	49.67884724	0.2	2.8	0.188704826	0	0.2	0.10583974	12.6875572	39.87880891	40	40	0	0	0.2	39.32751426	0	0	0	0	0	0	0	0											105.0209886	87.48659893	159.8131731	0	150	0.2	0.094242125	49.67884724	0.2	2.8	0.188704826	0	0.2	0.10583974	12.6875572	39.87880891	40	40	0	0	0.2	39.32751426	0	0	0	0	0	0	0	0											16.9047	0.752306251	22.04751115	0	1.663887494	1.064303268	0.756743913	0.721799677	10.38459996	1.54168995	11.63582972	0	0.041809333	1.435082195	6.536577003	23.45449366	4.577403879	4.698501212	0	0	10.77578469	10.67579379	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.6689	0	0	16.9047	0.752306251	22.04751115	0	1.663887494	1.064303268	0.756743913	0.721799677	10.38459996	1.54168995	11.63582972	0	0.041809333	1.435082195	6.536577003	23.45449366	4.577403879	4.698501212	0	0	10.77578469	10.67579379	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.6689																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.9047	0.752306251	22.04751115	0	1.663887494	1.064303268	0.756743913	0.721799677	10.38459996	1.54168995	11.63582972	0	0.041809333	1.435082195	6.536577003	23.45449366	4.577403879	4.698501212	0	0	10.77578469	10.67579379	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.6689
H3312_002_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1992.419551	0	1454.492269	586.5890582	280.6114926	8.480380564	0	176.2023629	255.3108161	1597.259515	4540.00786	0	157.945589	491.6223552	9548.60538	8465.296419	0	596.1037767	0	0	271.3858771	0	0	0	1108.464087	0	101.3230904	0	0	0											$50/day 1-5	$50/day 1-5	"$0/d 1-20, $50/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$0 per procedure	$5 per visit	$20 X-ray; $125 Complex Radiology	$15 per visit	$15 per visit	$15 per visit	$0 PCP visit; $15 if no PCP selected	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$750 Every 3 Yrs	Fitness/Coaching	0											30.64193704	30.64193704	20.16566937	0	100	0.2	0.2	47.5	0	5	38.9	15	15	15	0	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											28.35642778	28.35642778	18.66156002	0	100	0.185082475	0.185082475	43.95708789	0	5	35.99854145	0	13.88118565	13.88118565	0	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											4.7082	0	2.261924564	0	2.338429105	1.569569827	0	0.64544523	0	0.665524798	13.61947176	0	0.182706004	0.568691765	0	10.58162052	0	0.745129721	0	0	1.017697039	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.9044	0	1.7829	4.7082	0	2.261924564	0	2.338429105	1.569569827	0	0.64544523	0	0.665524798	13.61947176	0	0.182706004	0.568691765	0	10.58162052	0	0.745129721	0	0	1.017697039	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.9044																																																																																		0			4.7082	0	2.261924564	0	2.338429105	1.569569827	0	0.64544523	0	0.665524798	13.61947176	0	0.182706004	0.568691765	0	10.58162052	0	0.745129721	0	0	1.017697039	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.9044
H3312_018_0	2009	5																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		2038.704181	0	1489.888406	904.7760309	309.6112911	8.711230817	0	276.4047357	247.670653	1498.243148	5646.791502	0	35.44771016	638.5206834	7839.874331	8644.82334	0	642.8099953	0	0	263.2646686	0	0	0	1097.947568	0	90.78067269	0	0	0											$150/day 1-5	$150/day 1-5	"$0 1-10, $75 11-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$30 per visit	$30 X-ray; $125 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$5 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$750 Every 3 Yrs	Fitness/Coaching	0											91.92581111	91.92581111	47.56208437	20	100	0.2	0.2	47.5	150	30	47.1	30	25	30	5	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											77.16504094	77.16504094	39.92491492	20	100	0.167885472	0.167885472	39.8727996	125.914104	25.1828208	39.53702866	25.1828208	20.985684	25.1828208	5	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											13.1097	0	4.95697232	1.507960052	2.580094093	1.462489097	0	0.918419219	2.59876903	3.144165726	18.60477979	0	0.061991204	1.339979329	3.266614304	21.61205835	0	1.607024988	0	0	0.987242507	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.7583	0	8.837	13.1097	0	4.95697232	1.507960052	2.580094093	1.462489097	0	0.918419219	2.59876903	3.144165726	18.60477979	0	0.061991204	1.339979329	3.266614304	21.61205835	0	1.607024988	0	0	0.987242507	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.7583																																																																																		0			13.1097	0	4.95697232	1.507960052	2.580094093	1.462489097	0	0.918419219	2.59876903	3.144165726	18.60477979	0	0.061991204	1.339979329	3.266614304	21.61205835	0	1.607024988	0	0	0.987242507	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.7583
H3312_025_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		2338.532764	0	1877.560836	1034.744182	319.8855061	10.45231729	0	222.5619195	262.2444827	1504.030215	5527.526287	0	94.08063074	514.8647164	9438.439984	9579.665976	0	832.1593364	0	0	278.7561062	0	0	0	1165.263515	0	105.0194448	0	0	0											$100/day 1-5	$100/day 1-5	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$20 X-ray; $125 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$10 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$750 Every 3 Yrs	Fitness/Coaching	0											61.28387407	61.28387407	47.8866492	20	100	0.2	0.2	47.5	150	0	38.9	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											52.18759624	52.18759624	40.77890231	20	100	0.170314286	0.170314286	40.4496429	127.7357144	0	33.1261286	0	17.03142859	17.03142859	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											10.1702	0	6.380405825	1.724573637	2.665712551	1.780178954	0	0.750212514	2.791498863	0	15.25879555	0	0.133527295	0.730740138	7.865366653	15.96610996	0	1.386932227	0	0	1.045335398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.6496	0	6.6226	10.1702	0	6.380405825	1.724573637	2.665712551	1.780178954	0	0.750212514	2.791498863	0	15.25879555	0	0.133527295	0.730740138	7.865366653	15.96610996	0	1.386932227	0	0	1.045335398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.6496																																																																																		0			10.1702	0	6.380405825	1.724573637	2.665712551	1.780178954	0	0.750212514	2.791498863	0	15.25879555	0	0.133527295	0.730740138	7.865366653	15.96610996	0	1.386932227	0	0	1.045335398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.6496
H3312_028_0	2009	4																					2500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		2013.467413	0	1469.857483	592.7857681	283.5758643	8.56996706	0	178.0637596	258.0079122	1614.132919	4587.968372	0	159.6141217	496.8158395	9649.476571	8554.723566	0	602.4009998	0	0	274.2527897	0	0	0	1120.17387	0	102.3934646	0	0	0											$0 	$0 	"$0/d 1-20, $50/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $0 Urgent Care Ctr	$0 per procedure	$0 per visit	$15 X-ray; $125 Complex Radiology	$15 per visit	$15 per visit	$15 per visit	$0 PCP visit; $15 if no PCP selected	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$750 Every 3 Yrs	Fitness/Coaching	0											0	0	20.16566937	0	100	0.2	0.2	45	0	0	34.8	15	15	15	0	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											0	0	18.14375315	0	100	0.179946947	0.179946947	40.48806299	0	0	31.31076871	0	13.496021	13.496021	0	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											0	0	2.222394278	0	2.363132203	1.542139405	0	0.60078806	0	0	11.97106805	0	0.179512961	0.558753084	0	10.69340446	0	0.75300125	0	0	1.028447961	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9126	0	1.9028	0	0	2.222394278	0	2.363132203	1.542139405	0	0.60078806	0	0	11.97106805	0	0.179512961	0.558753084	0	10.69340446	0	0.75300125	0	0	1.028447961	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9126																																																																																		0			0	0	2.222394278	0	2.363132203	1.542139405	0	0.60078806	0	0	11.97106805	0	0.179512961	0.558753084	0	10.69340446	0	0.75300125	0	0	1.028447961	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9126
H3312_036_0	2009	2																					2500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		2031.553412	0	1483.060498	598.1104744	286.1230884	8.646946906	0	179.6632198	260.3254718	1628.63189	4629.17986	0	161.0478577	501.2784946	9736.153126	8720.835155	0	607.812075	0	0	276.7162691	0	0	0	1130.235847	0	103.3132153	0	0	0											$0 	$0 	"$0/d 1-20, $50/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $0 Urgent Care Ctr	$0 per procedure	$0 per visit	$10 X-ray; $125 Complex Radiology	$10 per visit	$10 per visit	$10 per visit	$0 PCP visit; $10 if no PCP selected	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$750 Every 3 Yrs	Fitness/Coaching	0											0	0	20.16566937	0	100	0.2	0.2	45	0	0	30.7	10	10	10	0	10	10	10	10	10	45	0	0	0	0	0	0	0	0	0											0	0	18.91333572	0	100	0.187579548	0.187579548	42.20539828	0	0	28.7934606	0	9.378977395	9.378977395	0	10	10	10	10	10	45	0	0	0	0	0	0	0	0	0											0	0	2.337468424	0	2.38435907	1.621990391	0	0.631896479	0	0	11.10750899	0	0.125872018	0.391789972	0	7.267362629	0	0.506510063	0	0	1.037686009	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.4124	0	1.0738	0	0	2.337468424	0	2.38435907	1.621990391	0	0.631896479	0	0	11.10750899	0	0.125872018	0.391789972	0	7.267362629	0	0.506510063	0	0	1.037686009	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.4124																																																																																		0			0	0	2.337468424	0	2.38435907	1.621990391	0	0.631896479	0	0	11.10750899	0	0.125872018	0.391789972	0	7.267362629	0	0.506510063	0	0	1.037686009	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.4124
H3312_037_0	2009	4																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1963.347989	0	1433.269649	578.0300878	276.5170667	8.356642616	0	173.6313794	251.5855544	1573.953767	4473.764222	0	155.6409916	484.4490519	9409.280873	8341.778565	0	587.4059762	0	0	267.4260629	0	0	0	1092.290394	0	99.84467667	0	0	0											$0 	$0 	"$0/d 1-20, $50/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $0 Urgent Care Ctr	$0 per procedure	$0 per visit	$15 X-ray; $125 Complex Radiology	$15 per visit	$15 per visit	$15 per visit	$0 PCP visit; $15 if no PCP selected	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$750 Every 3 Yrs	Fitness/Coaching	0											0	0	20.16566937	0	100	0.2	0.2	45	0	0	34.8	15	15	15	0	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											0	0	18.95403804	0	100	0.187983227	0.187983227	42.29622614	0	0	32.70908155	0	14.09874205	14.09874205	0	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											0	0	2.263853955	0	2.304308889	1.570908648	0	0.611996007	0	0	12.19439323	0	0.182861849	0.569176852	0	10.42722321	0	0.73425747	0	0	1.002847736	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.8618	0	1.1119	0	0	2.263853955	0	2.304308889	1.570908648	0	0.611996007	0	0	12.19439323	0	0.182861849	0.569176852	0	10.42722321	0	0.73425747	0	0	1.002847736	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.8618																																																																																		0			0	0	2.263853955	0	2.304308889	1.570908648	0	0.611996007	0	0	12.19439323	0	0.182861849	0.569176852	0	10.42722321	0	0.73425747	0	0	1.002847736	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.8618
H3312_040_0	2009	2																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		2015.844382	0	1473.182427	894.6308621	306.1396487	8.613552602	0	273.3054353	244.8935451	1481.443488	5583.474558	0	35.05023831	631.3610108	7751.966555	8726.543955	0	635.6022271	0	0	260.3127066	0	0	0	1085.636385	0	89.76275752	0	0	0											$150/day 1-5	$150/day 1-5	"$0 1-10, $75 11-100"	$20 per visit	$150 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$175 per procedure	$30 per visit	$30 X-ray; $125 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$20 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$750 Every 3 Yrs	Fitness/Coaching	0											91.92581111	91.92581111	47.56208437	20	150	0.2	0.2	47.5	175	30	47.1	30	25	30	20	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											74.91565429	74.91565429	38.76109035	20	150	0.162991555	0.162991555	38.71049421	142.6176102	24.44873319	38.3845111	24.44873319	20.37394432	24.44873319	20	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											12.5849	0	4.758513095	1.491051437	3.826745609	1.403936329	0	0.881649039	2.910511014	3.018284714	17.85991176	0	0.0595093	1.286331408	12.91994426	21.81635989	0	1.589005568	0	0	0.97617265	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.3828	0	10.1639	12.5849	0	4.758513095	1.491051437	3.826745609	1.403936329	0	0.881649039	2.910511014	3.018284714	17.85991176	0	0.0595093	1.286331408	12.91994426	21.81635989	0	1.589005568	0	0	0.97617265	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.3828																																																																																		0			12.5849	0	4.758513095	1.491051437	3.826745609	1.403936329	0	0.881649039	2.910511014	3.018284714	17.85991176	0	0.0595093	1.286331408	12.91994426	21.81635989	0	1.589005568	0	0	0.97617265	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.3828
H3312_043_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		2339.195478	0	1878.092916	1035.037417	319.9761581	10.45527936	0	222.624991	262.3187999	1504.456441	5529.092727	0	94.10729214	515.0106234	9441.114733	9582.380747	0	832.3951612	0	0	278.8351026	0	0	0	1165.593737	0	105.0492062	0	0	0											$150/day 1-5	$150/day 1-5	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$30 per visit	$30 X-ray; $125 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$15 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$750 Every 3 Yrs	Fitness/Coaching	0											91.92581111	91.92581111	47.8866492	20	100	0.2	0.2	47.5	150	30	47.1	25	25	25	15	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											73.70028866	73.70028866	38.39248005	20	100	0.160347323	0.160347323	38.08248923	120.2604923	24.05209846	37.76179458	20.04341538	20.04341538	20.04341538	15	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											14.3666	0	6.0087204	1.725062362	2.666467984	1.676476057	0	0.706509485	2.628882335	3.015444537	17.39903865	0	0.157185962	0.860214321	11.80139342	19.96329322	0	1.734156586	0	0	1.045631635	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.7551	0	11.578	14.3666	0	6.0087204	1.725062362	2.666467984	1.676476057	0	0.706509485	2.628882335	3.015444537	17.39903865	0	0.157185962	0.860214321	11.80139342	19.96329322	0	1.734156586	0	0	1.045631635	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.7551																																																																																		0			14.3666	0	6.0087204	1.725062362	2.666467984	1.676476057	0	0.706509485	2.628882335	3.015444537	17.39903865	0	0.157185962	0.860214321	11.80139342	19.96329322	0	1.734156586	0	0	1.045631635	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.7551
H3312_044_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		2311.333873	0	1855.723395	1022.709331	316.1649977	10.33074899	0	219.9733574	259.1943827	1486.537216	5463.237009	0	92.98640242	508.8764535	9328.663846	9468.247274	0	822.480699	0	0	275.5139636	0	0	0	1151.710626	0	103.7979899	0	0	0											$0 	$0 	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$20 X-ray; $125 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$10 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$750 Every 3 Yrs	Fitness/Coaching	0											0	0	47.8866492	20	100	0.2	0.2	47.5	150	0	38.9	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											0	0	40.0119835	20	100	0.167111227	0.167111227	39.68891639	125.3334202	0	32.50313363	0	16.71112269	16.71112269	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											0	0	6.18759782	1.704515552	2.634708314	1.726384139	0	0.727542016	2.707143206	0	14.79769355	0	0.129492265	0.708658071	7.773886538	15.78041212	0	1.370801165	0	0	1.033177363	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.282	0	5.3108	0	0	6.18759782	1.704515552	2.634708314	1.726384139	0	0.727542016	2.707143206	0	14.79769355	0	0.129492265	0.708658071	7.773886538	15.78041212	0	1.370801165	0	0	1.033177363	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.282																																																																																		0			0	0	6.18759782	1.704515552	2.634708314	1.726384139	0	0.727542016	2.707143206	0	14.79769355	0	0.129492265	0.708658071	7.773886538	15.78041212	0	1.370801165	0	0	1.033177363	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.282
H3312_048_0	2009	5																					2500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	10087.38831	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$0 	$0 	"$0/d 1-20, $100/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$0 per procedure	$5 per visit	$10 X-ray; $100 Complex Radiology	$5 per visit	$10 per visit	$5 per visit	$0 PCP visit; $5 if no PCP selected	$5 per visit	$5 per visit	$5 per visit	$5 per visit	$5 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											0	0	40.33133874	0	100	0.2	0.2	47.5	0	5	26.2	5	10	5	0	5	5	5	5	5	45	0	0	0	0	0	0	0	0	0											0	0	40.12099266	0	100	0.19895691	0.19895691	47.25226613	0	5	26.06335521	0	9.947845501	4.973922751	0	5	5	5	5	5	45	0	0	0	0	0	0	0	0	0											0	0	4.50925822	0	2.276793099	1.567917912	0	1.001823543	0	0.43716534	10.23931322	0	0.055397582	0.326210823	0	4.203078464	0	0.280024353	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.9358	0	0.0844	0	0	4.50925822	0	2.276793099	1.567917912	0	1.001823543	0	0.43716534	10.23931322	0	0.055397582	0.326210823	0	4.203078464	0	0.280024353	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.9358																																																																																		0			0	0	4.50925822	0	2.276793099	1.567917912	0	1.001823543	0	0.43716534	10.23931322	0	0.055397582	0.326210823	0	4.203078464	0	0.280024353	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.9358
H3312_050_0	2009	7																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9965.057534	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$0 	$0 	"$0/d 1-20, $100/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$0 per procedure	$0 per visit	$10 X-ray; $100 Complex Radiology	$10 per visit	$10 per visit	$10 per visit	$0 PCP visit; $10 if no PCP selected	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											0	0	40.33133874	0	100	0.2	0.2	47.5	0	0	26.2	10	10	10	0	10	10	10	10	10	45	0	0	0	0	0	0	0	0	0											0	0	39.52049918	0	100	0.195979109	0.195979109	46.54503841	0	0	25.67326329	0	9.798955455	9.798955455	0	10	10	10	10	10	45	0	0	0	0	0	0	0	0	0											0	0	4.44176786	0	2.276793099	1.544450784	0	0.986829186	0	0	10.08606075	0	0.054568443	0.642656809	0	8.304214612	0	0.560048705	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9362	0	0.3643	0	0	4.44176786	0	2.276793099	1.544450784	0	0.986829186	0	0	10.08606075	0	0.054568443	0.642656809	0	8.304214612	0	0.560048705	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9362																																																																																		0			0	0	4.44176786	0	2.276793099	1.544450784	0	0.986829186	0	0	10.08606075	0	0.054568443	0.642656809	0	8.304214612	0	0.560048705	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9362
H3312_052_0	2009	7																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		2070.265629	0	1512.953565	918.7829881	314.4044244	8.846090531	0	280.6837939	251.504875	1521.437648	5734.210227	0	35.99648084	648.4057064	7961.24446	8870.393637	0	652.7614217	0	0	267.3403037	0	0	0	1114.94504	0	92.18606027	0	0	0											$100/day 1-5	$100/day 1-5	"$0 1-10, $75 11-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$25 X-ray; $125 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$750 Every 3 Yrs	Fitness/Coaching	0											61.28387407	61.28387407	47.56208437	20	100	0.2	0.2	47.5	150	0	43	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											48.7343393	48.7343393	37.82245807	20	100	0.159044578	0.159044578	37.77308716	119.2834331	0	34.19458417	0	19.88057219	19.88057219	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											8.4078	0	4.768635231	1.53130498	2.62003687	1.406922731	0	0.883524451	2.500030412	0	16.33991119	0	0.059635886	1.074223038	6.634370384	18.47998674	0	1.359919629	0	0	1.002526139	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.0688	0	9.1263	8.4078	0	4.768635231	1.53130498	2.62003687	1.406922731	0	0.883524451	2.500030412	0	16.33991119	0	0.059635886	1.074223038	6.634370384	18.47998674	0	1.359919629	0	0	1.002526139	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.0688																																																																																		0			8.4078	0	4.768635231	1.53130498	2.62003687	1.406922731	0	0.883524451	2.500030412	0	16.33991119	0	0.059635886	1.074223038	6.634370384	18.47998674	0	1.359919629	0	0	1.002526139	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.0688
H3312_053_0	2009	3																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		2317.697773	0	1860.832841	1025.525203	317.035509	10.35919311	0	220.5790199	259.9080342	1490.630165	5478.279185	0	93.24242606	510.2775659	9354.348875	9494.316625	0	824.7452721	0	0	276.2725486	0	0	0	1154.881682	0	104.0837816	0	0	0											$100/day 1-5	$100/day 1-5	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$20 per visit	$20 X-ray; $125 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$10 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$750 Every 3 Yrs	Fitness/Coaching	0											61.28387407	61.28387407	47.8866492	20	100	0.2	0.2	47.5	150	20	38.9	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											54.22286643	54.22286643	42.3692435	20	100	0.176956393	0.176956393	42.02714326	132.7172945	17.69563927	34.41801838	17.69563927	17.69563927	17.69563927	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											10.4727	0	6.570173314	1.709208671	2.641962575	1.833125444	0	0.772525506	2.87452426	2.198137807	15.71262614	0	0.137498695	0.752473978	7.795290729	15.82386104	0	1.374575454	0	0	1.036022057	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7047	0	5.3813	10.4727	0	6.570173314	1.709208671	2.641962575	1.833125444	0	0.772525506	2.87452426	2.198137807	15.71262614	0	0.137498695	0.752473978	7.795290729	15.82386104	0	1.374575454	0	0	1.036022057	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7047																																																																																		0			10.4727	0	6.570173314	1.709208671	2.641962575	1.833125444	0	0.772525506	2.87452426	2.198137807	15.71262614	0	0.137498695	0.752473978	7.795290729	15.82386104	0	1.374575454	0	0	1.036022057	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7047
H3312_054_0	2009	3																					2500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	10087.38831	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$0 	$0 	"$0/d 1-20, $100/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$0 per procedure	$0 per visit	$5 X-ray; $100 Complex Radiology	$5 per visit	$5 per visit	$5 per visit	$0 PCP visit; $5 if no PCP selected	$5 per visit	$5 per visit	$5 per visit	$5 per visit	$5 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											0	0	40.33133874	0	100	0.2	0.2	47.5	0	0	22.1	5	5	5	0	5	5	5	5	5	45	0	0	0	0	0	0	0	0	0											0	0	40.12033826	0	100	0.198953665	0.198953665	47.25149541	0	0	21.98437997	0	4.973841622	4.973841622	0	5	5	5	5	5	45	0	0	0	0	0	0	0	0	0											0	0	4.50918467	0	2.276793099	1.567892338	0	1.001807203	0	0	8.636837066	0	0.027698339	0.326205502	0	4.203078464	0	0.280024353	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.8684	0	0.0845	0	0	4.50918467	0	2.276793099	1.567892338	0	1.001807203	0	0	8.636837066	0	0.027698339	0.326205502	0	4.203078464	0	0.280024353	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.8684																																																																																		0			0	0	4.50918467	0	2.276793099	1.567892338	0	1.001807203	0	0	8.636837066	0	0.027698339	0.326205502	0	4.203078464	0	0.280024353	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.8684
H3312_055_0	2009	8																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9965.057534	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$0 	$0 	"$0/d 1-20, $100/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$0 per procedure	$0 per visit	$10 X-ray; $100 Complex Radiology	$10 per visit	$10 per visit	$10 per visit	$0 PCP visit; $10 if no PCP selected	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											0	0	40.33133874	0	100	0.2	0.2	47.5	0	0	26.2	10	10	10	0	10	10	10	10	10	45	0	0	0	0	0	0	0	0	0											0	0	39.5405811	0	100	0.196078694	0.196078694	46.56868978	0	0	25.68630889	0	9.803934691	9.803934691	0	10	10	10	10	10	45	0	0	0	0	0	0	0	0	0											0	0	4.444024898	0	2.276793099	1.54523558	0	0.987330633	0	0	10.09118588	0	0.054596171	0.642983369	0	8.304214612	0	0.560048705	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9452	0	0.3553	0	0	4.444024898	0	2.276793099	1.54523558	0	0.987330633	0	0	10.09118588	0	0.054596171	0.642983369	0	8.304214612	0	0.560048705	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9452																																																																																		0			0	0	4.444024898	0	2.276793099	1.54523558	0	0.987330633	0	0	10.09118588	0	0.054596171	0.642983369	0	8.304214612	0	0.560048705	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9452
H3312_056_0	2009	2																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9742.031502	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$150/day 1-5	$150/day 1-5	"$0 1-10, $75 11-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$200 per procedure	$0 per visit	$30 X-ray; $125 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$15 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$750 Every 3 Yrs	Fitness/Coaching	0											91.92581111	91.92581111	47.56208437	20	100	0.2	0.2	47.5	200	0	47.1	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											77.87967719	77.87967719	40.29466515	20	100	0.169440283	0.169440283	40.24206718	169.4402829	0	39.90318662	0	21.18003536	25.41604243	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											12.6812	0	4.528777529	1.711889696	2.276793099	1.335306497	0	0.853196125	5.429001365	0	15.6764631	0	0.117947424	1.666891212	9.133424332	24.35507876	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.485	0	7.6271	12.6812	0	4.528777529	1.711889696	2.276793099	1.335306497	0	0.853196125	5.429001365	0	15.6764631	0	0.117947424	1.666891212	9.133424332	24.35507876	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.485																																																																																		0			12.6812	0	4.528777529	1.711889696	2.276793099	1.335306497	0	0.853196125	5.429001365	0	15.6764631	0	0.117947424	1.666891212	9.133424332	24.35507876	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.485
H3312_057_0	2009	5																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9742.031502	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$150/day 1-5	$150/day 1-5	"$0 1-10, $75 11-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$35 X-ray; $125 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$20 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$750 Every 3 Yrs	Fitness/Coaching	0											91.92581111	91.92581111	47.56208437	20	100	0.2	0.2	47.5	150	0	51.2	35	25	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											76.49030799	76.49030799	39.57581052	20	100	0.166417477	0.166417477	39.5241509	124.8131081	0	42.60287423	0	20.80218468	29.12305856	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											12.455	0	4.447984385	1.711889696	2.276793099	1.311484702	0	0.837975152	3.999111207	0	16.73706895	0	0.115843248	1.910012958	12.17789911	28.41425855	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.3943	0	8.438	12.455	0	4.447984385	1.711889696	2.276793099	1.311484702	0	0.837975152	3.999111207	0	16.73706895	0	0.115843248	1.910012958	12.17789911	28.41425855	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.3943																																																																																		0			12.455	0	4.447984385	1.711889696	2.276793099	1.311484702	0	0.837975152	3.999111207	0	16.73706895	0	0.115843248	1.910012958	12.17789911	28.41425855	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.3943
H3312_058_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9742.031502	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$100/day 1-5	$100/day 1-5	"$0 1-10, $75 11-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$25 X-ray; $125 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$750 Every 3 Yrs	Fitness/Coaching	0											61.28387407	61.28387407	47.56208437	20	100	0.2	0.2	47.5	150	0	43	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											49.89792809	49.89792809	38.72551306	20	100	0.162841951	0.162841951	38.67496336	122.1314632	0	35.01101946	0	20.35524387	20.35524387	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											8.1249	0	4.352418185	1.711889696	2.276793099	1.283307083	0	0.81997102	3.913189174	0	13.75451439	0	0.113354323	1.334982707	6.088949555	20.29589896	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.5091	0	7.6891	8.1249	0	4.352418185	1.711889696	2.276793099	1.283307083	0	0.81997102	3.913189174	0	13.75451439	0	0.113354323	1.334982707	6.088949555	20.29589896	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.5091																																																																																		0			8.1249	0	4.352418185	1.711889696	2.276793099	1.283307083	0	0.81997102	3.913189174	0	13.75451439	0	0.113354323	1.334982707	6.088949555	20.29589896	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.5091
H3312_801_0	2009	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																																																			0		364.2135092	0	48.69350108	5.715896014	7.120950013	8.543663694	0	7.857145194	38.08377058	20.85451578	81.70538359	0	0.740975545	16.2591423	51.66788954	264.19287	0	6.093238323	0	0	9.560593862	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.061157837	0.061157837	0.161797426	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											22.2745	0	7.878483115	0	1.644939453	1.973586313	0	1.81500054	8.797351003	4.817393146	18.87394361	0	0.171165351	3.75586187	11.93528248	61.02855298	0	1.407538053	0	0	2.208497182	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.5821			22.2745	0	7.878483115	0	1.644939453	1.973586313	0	1.81500054	8.797351003	4.817393146	18.87394361	0	0.171165351	3.75586187	11.93528248	61.02855298	0	1.407538053	0	0	2.208497182	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.5821																																																																																		0			22.2745	0	7.878483115	0	1.644939453	1.973586313	0	1.81500054	8.797351003	4.817393146	18.87394361	0	0.171165351	3.75586187	11.93528248	61.02855298	0	1.407538053	0	0	2.208497182	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.5821
H3312_804_0	2009	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																																																			0		363.9099974	0	48.6529231	5.711132759	7.115015878	8.536543962	0	7.850597562	38.05203405	20.83713699	81.63729566	0	0.740358064	16.24559299	51.6248329	263.9727089	0	6.088160615	0	0	9.552626687	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.061143037	0.061143037	0.161765594	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											22.2506	0	7.87036899	0	1.643568668	1.971941655	0	1.813488037	8.790019865	4.813378645	18.8582153	0	0.171022713	3.75273198	11.9253364	60.97769576	0	1.406365102	0	0	2.206656765	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.4514			22.2506	0	7.87036899	0	1.643568668	1.971941655	0	1.813488037	8.790019865	4.813378645	18.8582153	0	0.171022713	3.75273198	11.9253364	60.97769576	0	1.406365102	0	0	2.206656765	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.4514																																																																																		0			22.2506	0	7.87036899	0	1.643568668	1.971941655	0	1.813488037	8.790019865	4.813378645	18.8582153	0	0.171022713	3.75273198	11.9253364	60.97769576	0	1.406365102	0	0	2.206656765	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.4514
H3327_001_0	2009	13																																D	D	D	V	T	Coin	Coin	V	P	P	P	P	V	V	V	V	V	V	P	V	S	V	T	V	V	V	V	V	O	V																																																			0									320.5745517						8.67018533		4149.984688	236.5154931	1052.352396				395.6491241																			PBP: 1A IP Acute: $0 copay	"1B IP Psych: $0 copay, 190-day lifetime limit"	2 SNF: $0 copay days 1-100	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: $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	9A OP Observation $0 Copay	12 Renal Dialysis: $0 copay	"3 CORF: $5 copay,  5  Partial Hosp:  $0 copay, 9C OP SA: $15 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 Mammography:  $0 copay, 14I Diabetes Monitoring:  $0 copay, 14J Nutrition Therapy: $0 copay"	"7D Physician Specialist: $15 copay, 7B Chiropractic: $15 copay, 7B1 Routine Chiropractic: $15 copay, 7F Podiatry:  $15 copay"	"7E Mental Health: $15 copay, 7H Psychiatric: $15 copay"	"7C Occupational Therapy:  $15 copay, 7I Physical and Speech Therapy:  $15 copay"	7D Physician Specialist: $0 copay for radiology services	7G Other Health Care:  $15 copay	15 Part B Drugs: $0 copay	"13A Blood: $0 copay, 14A Health Ed/Wellness: $0 copay, 14j (Nutrition Therapy Diabetes) $0, 17A Medicare Covered Eye Exams: $15 copay"	10B Transportation: Not Covered	"16A Preventive Dental: $0 copay, 16B Comp Dental: Not Covered"	17A Eye Exams: $15 copay	17B Eye Wear:  $0 copay for eye wear	"18A Medicare Covered Hearing Exams:  $0 copay, 18A Routine Hearing Exams: $0 copay"	18B Hearing Aids: $0 copay		"13B Acupuncture: Not Covered, 13C Other1: Not Covered"																		49.62998692						9.095664131		15	15	15				15																										49.62998692						9.095664131		15	15	15				15																			0	0	0	0	0	0	0	1.325842567	0	0	0	0	0	0.006571758	0	5.18748086	0.295644366	1.315440495	0	0	0	0.494561405	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.6255	0	0	0	0	0	0	0	0	0	1.325842567	0	0	0	0	0	0.006571758	0	5.18748086	0.295644366	1.315440495	0	0	0	0.494561405	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.6255																																																																																		0	0	0	0	0	0	0	0	0	0	1.325842567	0	0	0	0	0	0.006571758	0	5.18748086	0.295644366	1.315440495	0	0	0	0.494561405	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.6255
H3327_002_0	2009	15																																D	D	D	V	T	Coin	Coin	V	P	P	P	P	V	V	V	V	V	V	P	V	S	O	T	V	V	V	V	V	O	V																																																			0									318.3863361						11.1916165		5643.730922	424.2593609	1382.354817				1157.469993																			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	9A OP Observation	12 Renal Dialysis: $0 copay	"3 CORF: $5 copay,  5  Partial Hosp:  $0 copay, 9C OP SA: $5 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: $5 copay, 7B Chiropractic:  $5 copay, 7B1 Routine Chiro.:  $5 copay, 7F Podiatry:  $5 copay for medically necessary services,"	"7E Mental Health: $5 copay, 7H Psychiatric: $5 copay"	"7C Occupational Therapy:  $5 copay, 7I Physical and Speech Therapy:  $5 copay"	7D Physician Specialist: $0 copay for radiology services	7G Other Health Care:  $5 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"	17A1 Routine Eye Exams: $0 copay	17B Eye Wear:  $0 copay for eye wear	"18A Medicare Covered Hearing Exams:  $0 copay, 18A1 Routine Hearing Exams: $0 copay"	18B Hearing Aids: $0 copay	14A Health Ed/Wellness: $0 copay	"13B Acupuncture: Not Covered, 13C Other1: $0 copay"																		48.76916622						5		5	5	5				5																										48.76916622						5		5	5	5				5																			0	0	0	0	0	0	0	1.293953012	0	0	0	0	0	0.004663174	0	2.351554551	0.176774734	0.575981174	0	0	0	0.482279164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.8852	0	0	0	0	0	0	0	0	0	1.293953012	0	0	0	0	0	0.004663174	0	2.351554551	0.176774734	0.575981174	0	0	0	0.482279164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.8852																																																																																		0	0	0	0	0	0	0	0	0	0	1.293953012	0	0	0	0	0	0.004663174	0	2.351554551	0.176774734	0.575981174	0	0	0	0.482279164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.8852
H3327_003_0	2009	14																																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	V																																																			0	3500								218.8136176						43.76512522		4795.745069	1390.56859	2256.522766				821.0423635																			PBP: 1A IP Acute: $0 copay	"1B IP Psych: $0 copay, 190-day lifetime limit"	2 SNF: $0 copay days 1-100	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: $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	9A OP Observation $0 Copay	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 Mamm"	"7D Physician Specialist: $15 copay, 7B Chiropractic:  $15 copay, 7F Podiatry:  $15 copay for medically necessary services,"	"7E Mental Health: $15 copay, 7H Psychiatric: $15 copay,   9C OP Substance Abuse: $15 copay"	"7C Occupational Therapy:  $20 copay, 7I Physical and Speech Therapy:  $20 copay"	7D Physician Specialist: $0 copay for radiology services	7G Other Health Care:  $15 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"	17A1 Routine Eye Exams: $0 copay	17B1 Eye Wear:  $0 copay for eye wear	18A Routine Hearing Exams: $0 copay	18B Hearing Aids: $0 copay	14A Health Ed/Wellness: $0 copay	"13B Acupuncture: Not Covered, 13C Other1: Not Covered"																		47.5						15		15	15	15				15																										47.5						15		15	15	15				15																			0	0	0	0	0	0	0	0.866137236	0	0	0	0	0	0.054706407	0	5.994681336	1.738210738	2.820653458	0	0	0	1.026302954	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.5007	0	0	0	0	0	0	0	0	0	0.866137236	0	0	0	0	0	0.054706407	0	5.994681336	1.738210738	2.820653458	0	0	0	1.026302954	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.5007		PBP: 1A IP Acute: 10% coins	1B IP Psych: 10% coins	2 SNF: 10% coins	6 Home Health: 10% coins	10A Ambulance: 0% coins	11A DME:  10% coins	"11B Prosthetic Medical Supplies: 10% coins, 11C Diabetes Monitoring Supplies: 10% coins"	"4A ER: $50 copay,  4B Urgent Care: $25 copay"	"9A Outpatient Hospital: 10% coins,   9B ASC Services: 10% coins"	8A OP C/D/T: 10% coins	8B OP X-Ray: 10% coins	9A OP Observation 10% coins	12 Renal Dialysis: Not Covered	"3 CORF: 10% coins,  5  Partial Hosp:  10% coins, 9D Cardiac Rehab: 10% coins"	"7A PCP: $15 copay, 14B Immunizations: 10% coins, 14C Routine Physical:  10% coins,  14D Pap Smears:  10% coins, 14D Pelvic Exams:  10% coins, 14E Prostate Screening:  10% coins, 14F Colorectal Screening:  10% coins, 14G Bone Mass Measurement:  10% coins, 14H Mammography:  10% coins, 14I Diabetes Monitoring:  10% coins"	"7D Physician Specialist: $30 copay;7B Chiropractic:  10% coins, 7F Podiatry:  10% coins for medically necessary services"	"7E Mental Health: 10% coins, 7H Psychiatric: 10% coins,   9C OP Substance Abuse: 10% coins"	"7C Occupational Therapy:  10% coins, 7I Physical and Speech Therapy:  10% coins"	7D Physician Specialist: 0% coins for radiology services	7G Other Health Care:  10% coins	15 Part B Drugs: Not Covered	"13A Blood: 10% coins, 17A Medicare Covered Eye Exams: 10% coins, 14J Nutrition Therapy: 10% coins"	10B Transportation: Not Covered	"16A Preventive Dental: Not Covered, 16B Comp Dental: Not Covered"	17A1 Routine Eye Exams: 10% coins	17B1 Eye Wear:  10% coins	18A Routine Hearing Exams: 10% coins	18B Hearing Aids: 10% coins	14A Health Ed/Wellness: Not Covered	"13B Acupuncture: Not Covered, 13C Other1: Not Covered"											1.6796	0.1023	0.3118	0.1978		0.041	0.0311	0.0421	0.1132	0.5086	0.0709	0.0089	0.0135	0.102	0.4479	1.0453	0.1116	0.1739				0.0707																			5.0724	0	2.258213415	1.6796	0.102293183	0.311801806	0.197778887	0	0.041032503	0.03112027	0.908194799	0.113244421	0.508630133	0.070938102	0.008930327	0.013504094	0.156663245	0.447859992	7.040010849	1.849801119	2.994556807	0	0	0	1.097051776	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.5731
H3327_014_0	2009	10																																D	D	D	V	T	Coin	Coin	V	V	P	P	P	V	V	V	V	V	V	P	V	S	O	T	V	V	V	V	V	O	V																																																			0									205.5632547		11495.12129	592.6916387			23.60326047		4694.401527	657.2766784	1415.483092				834.6498045																			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: $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	9A OP Observation $0 Copay	12 Renal Dialysis: $0 copay	"3 CORF: $5 copay,  5  Partial Hosp:  $0 copay, 9C OP SA: $5 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: $5 copay, 7B Chiropractic:  $5 copay, 7B1 Routine Chiro.:  $5 copay, 7F Podiatry:  $10 copay for medically necessary services,"	"7E Mental Health: $5 copay, 7H Psychiatric: $5 copay"	"7C Occupational Therapy:  $5 copay, 7I Physical and Speech Therapy:  $5 copay"	7D Physician Specialist: $0 copay for radiology services	7G Other Health Care:  $5 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	14A Health Ed/Wellness: $0 copay	"13B Acupuncture: Not Covered, 13C Other1: $0 copay"																		48.60041512		5	5			5		5	5	5				5																										48.60041512		5	5			5		5	5	5				5																			0	0	0	0	0	0	0	0.832538292	0	4.789633872	0.246954849	0	0	0.009834692	0	1.956000636	0.273865283	0.589784622	0	0	0	0.347770752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.0464	0	0	0	0	0	0	0	0	0	0.832538292	0	4.789633872	0.246954849	0	0	0.009834692	0	1.956000636	0.273865283	0.589784622	0	0	0	0.347770752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.0464																																																																																		0	0	0	0	0	0	0	0	0	0	0.832538292	0	4.789633872	0.246954849	0	0	0.009834692	0	1.956000636	0.273865283	0.589784622	0	0	0	0.347770752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.0464
H3327_021_0	2009	13																																D	D	D	V	T	Coin	O	V	P	P	P	P	V	V	V	V	V	V	P	P	S	V	T	V	V	V	V	V	O	V																																																			0		1360.351033	185.9397891			166.6039214			327.6969923			1017.223388			78.17956583		3479.731396	767.8244253	994.1115027				767.920391																			"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	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: $15 copay	9A OP Observation: $0 copay	12 Renal Dialysis: $0 copay	"3 CORF: $20 copay,  5  Partial Hosp:  $0 copay, 9C OP SA: $20 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 Mammography:  $0 copay, 14I Diabetes Monitoring:  $0 copay, 14J Nutrition Therapy: $0 copay"	"7D Physician Specialist: $20 copay, 7B Chiropractic:  $20 copay, 7B1 Routine Chiro:  $20 copay, 7F Podiatry:  $20 copay for medically necessary services,"	"7E Mental Health: $20 copay, 7H Psychiatric: $20 copay"	"7C Occupational Therapy:  $20 copay, 7I Physical and Speech Therapy:  $20 copay"	7D Physician Specialist: $0 copay	7G Other Health Care:  $20 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	14A Health Ed/Wellness: $0 copay	"13B Acupuncture: Not Covered, 13C Other1: Not Covered"											27.60257	27.60257			50			47.5			15			20		20	20	20				20																			27.60257	27.60257			50			47.5			15			20		20	20	20				20																			3.1291	0.427701337	0	0	0.694183006	0	0	1.297133928	0	0	1.271529235	0	0	0.130299276	0	5.799552327	1.279707375	1.656852505	0	0	0	1.279867318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.9659	0	0	3.1291	0.427701337	0	0	0.694183006	0	0	1.297133928	0	0	1.271529235	0	0	0.130299276	0	5.799552327	1.279707375	1.656852505	0	0	0	1.279867318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.9659																																																																																		0	0	0	3.1291	0.427701337	0	0	0.694183006	0	0	1.297133928	0	0	1.271529235	0	0	0.130299276	0	5.799552327	1.279707375	1.656852505	0	0	0	1.279867318	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.9659
H3327_022_0	2009	9																																D	D	D	V	T	Coin	Coin	V	P	P	P	P	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	Coin	O	V																																																			0	2000	1491.324533	148.0605284						380.866244			1227.801606			62.93958731		3719.981919	620.3063169	921.7501734				718.4967449																			"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 copay	"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: $15 copay	9A OP Observation $0 copay	12 Renal Dialysis: $0 copay	"3 CORF: $15 copay,  5  Partial Hosp:  $0 copay, 9C OP SA: $15 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"	"7B Chiropractic:  $15 copay, 7B1 Routine Chiro.: $15 copay, 7D Physician Specialist: $15 copay, 7F Podiatry:  $15 copay for medically necessary services, $0 copay for 4 routine exams,"	"7E Mental Health: $15 copay, 7H Psychiatric: $15 copay"	"7C Occupational Therapy:  $15 copay, 7I Physical and Speech Therapy:  $15 copay"	7D Physician Specialist: $0 copay	7G Other Health Care:  $15 copay	15 Part B Drugs: $0 copay	"13A Blood: $0 copay, 17A Medicare Covered Eye Exams: $15 copay; 14J Nutritional Therapy: $15 copay"	10B Transportation: Not Covered	"16A Preventive Dental: OPTIONAL SUPPLEMENTAL, 16B Comp Dental: Not Covered"	17A1 Routine Eye Exams: $0 copay	17B Eye Wear:  $0 copay for eye wear	18A Hearing Exams: $0 copay	18B Hearing Aids: $0 copay	14A Health Ed/Wellness: $0 copay	"13B Acupuncture: Not Covered, 13C Other1: $0 copay"											27.60257	27.60257						48.26615268			15			15		15	15	15				15																			27.60257	27.60257						48.26615268			15			15		15	15	15				15																			3.4304	0.340570925	0	0	0	0	0	1.531912357	0	0	1.534752008	0	0	0.078674484	0	4.649977398	0.775382896	1.152187717	0	0	0	0.898120931	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.3919	0	0	3.4304	0.340570925	0	0	0	0	0	1.531912357	0	0	1.534752008	0	0	0.078674484	0	4.649977398	0.775382896	1.152187717	0	0	0	0.898120931	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.3919		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: $0 copay,  4B Urgent Care: $0 copay"	"9A Outpatient Hospital: 15% coins,   9B ASC Services: 15% coins"	8A OP C/D/T: 15% coins	8B OP X-Ray: 15% coins	9A OP Observation 15% coins	12 Renal Dialysis: Not Covered	"3 CORF: 15% coins,  5  Partial Hosp:  15% coins, 9C OP SA: 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, 7B Chiropractic:  15% coins, 7F Podiatry:  15% coins for medically necessary services, 15% coins for 4 routine exams,"	"7E Mental Health: 15% coins, 7H Psychiatric: 15% coins"	"7C Occupational Therapy:  15% coins, 7I Physical and Speech Therapy:  15% coins"	7D Physician Specialist: 0% coins	7G Other Health Care:  15% coins	15 Part B Drugs: Not Covered	"13A Blood: 15% coins, 17A Medicare Covered Eye Exams: 15% coins; 14J Nutritional Therapy: 15% coin"	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 Hearing Exams: 15% coins	18B Hearing Aids: 15% coins	14A Health Ed/Wellness: Not Covered	"13B Acupuncture: Not Covered, 13C Other1: Not Covered"											1.8494	0.0968	1.1893	0.2434		0.0961	0.1014	0.0912	0.3465	0.5999	0.1133	0.0225		0.1827	0.4738	0.4112	0.0772	0.1292				0.1003						0.0253													6.1492	0	3.864833179	5.2798	0.437378997	1.189266548	0.243414353	0	0.096088958	0.101378385	1.623122961	0.346454933	0.599874561	1.648039205	0.022496794	0	0.261350212	0.473792753	5.061154278	0.852576002	1.281368954	0	0	0	0.998399204	0	0	0	0	0	0.025283925	0	0	0	0	0	0	0	0	0	0	0	0	20.5412
H3327_023_0	2009	12																																D	D	D	V	T	Coin	O	V	P	P	P	P	V	V	P	P	P	P	P	V	S	V	T	V	V	V	V	Coin	O	V																																																			0	3500	1205.607739	130.3412974			123.1941595			359.2459334			1367.68511			55.11912291	3466.179712	4033.520422	516.200953	673.19745				716.2993808																			"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 days 1-100	6 Home Health: $0 copay	10A Ambulance: $50 copay	11A DME:  $0 copay	"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: $15 copay	9A OP Observation: $0 copay	12 Renal Dialysis: $0 copay	"3 CORF: $20 copay,  5  Partial Hosp:  $0 copay, 9C OP SA: $20 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, 7B Chiropractic:  $20 copay, 7B1 Routine Chiro: $0 copay, 7F Podiatry:  $20 copay for medically necessary services,"	"7E Mental Health: $20 copay, 7H Psychiatric: $20 copay"	"7C Occupational Therapy:  $20 copay, 7I Physical and Speech Therapy:  $20 copay"	7D Physician Specialist: $0 copay	7G Other Health Care:  $20 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"	17A1 Routine Eye Exams: $0 copay	17B Eye Wear:  $0 copay for eye wear	18A Routine Hearing Exams: $0 copay	18B Hearing Aids: $0 copay	14A Health Ed/Wellness: $0 copay	"13B Acupuncture: Not Covered, 13C Other1: Not Covered"											27.60257	27.60257			50			48.38179247			15			20	10	20	20	20				20																			27.60257	27.60257			50			48.38179247			15			20	10	20	20	20				20																			2.7732	0.299812899	0	0	0.513308998	0	0	1.448413516	0	0	1.709606387	0	0	0.091865205	2.888483093	6.722534037	0.860334922	1.12199575	0	0	0	1.193832301	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.6233	0	0	2.7732	0.299812899	0	0	0.513308998	0	0	1.448413516	0	0	1.709606387	0	0	0.091865205	2.888483093	6.722534037	0.860334922	1.12199575	0	0	0	1.193832301	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.6233		PBP: 1A IP Acute: 15% coins	1B IP Psych: 15% coins	2 SNF: 15% coins	6 Home Health: 15% coins	10A Ambulance: 0% 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	9A OP Observation: 15% coins	12 Renal Dialysis: Not Covered	"3 CORF: 15% coins,  5  Partial Hosp:  15% coins, 9C OP SA: 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, 7B Chiropractic:  15% coins, 7B1 Routine Chiro.: 15% coins, 7F Podiatry:  15% coins for medically necessary services, 15% coins for 4 routine exams,"	"7E Mental Health: 15% coins, 7H Psychiatric: 15% coins"	"7C Occupational Therapy:  15% coins, 7I Physical and Speech Therapy:  15% coins"	7D Physician Specialist: 0% coins	7G Other Health Care:  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"	17A1 Routine Eye Exams: 15% coins	17B Eye Wear:  15% coins	18A Routine Hearing Exams: 15% coins	18B Hearing Aids: 15% coins	14A Health Ed/Wellness: Not Covered	"13B Acupuncture: Not Covered, 13C Other1: Not Covered"											2.5117	0.1051	0.6982	0.2642		0.3412	0.1348	0.1468	0.7201	0.8725	0.1829	0.0244		0.2221	0.9679	0.7974	0.108	0.3956			0.525	0.221			0.067		0.0217	0.0414													9.369	0	3.04309933	5.2849	0.404884161	0.698189633	0.264191329	0.513308998	0.341195071	0.134787895	1.595187474	0.720117274	0.872468257	1.892508806	0.02441704	0	0.313941733	3.856371956	7.519968412	0.96833686	1.517590567	0	0	0.52501586	1.414823024	0	0	0.067028808	0	0.021739073	0.041440107	0	0	0	0	0	0	0	0	0	0	0	0	28.9924
H3327_026_0	2009	13																																D	D	D	V	T	O	O	V	P	P	P	P	P	V	V	V	V	V	V	V	S	V	T	V	V	V	V	Coin	O	V																																																			0									319.4986585						74.63014718		4699.179958	2231.565506	4911.93734																							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	9A OP Observation: $0 copay	12 Renal Dialysis: $0 copay	"3 CORF: $10 copay,  5  Partial Hosp:  $0 copay, 9C OP SA: $20 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,7B Chiropractic:  $0 copay, 7F Podiatry:  $10 copay for medically necessary services,"	"7E Mental Health: $20 copay, 7H Psychiatric: $20 copay"	"7C Occupational Therapy:  $10 copay, 7I Physical and Speech Therapy:  $10 copay"	7D Physician Specialist: $0 copay for radiology services	"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"	17A1 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	14A Health Ed/Wellness: $0 copay	"13B Acupuncture: Not Covered, 13C Other1: $0 copay"																		46						18.34871583		10	20	10																														46						18.34871583		10	20	10																							0	0	0	0	0	0	0	1.224744857	0	0	0	0	0	0.114113947	0	3.915983298	3.719275844	4.093281117	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.0674	0	0	0	0	0	0	0	0	0	1.224744857	0	0	0	0	0	0.114113947	0	3.915983298	3.719275844	4.093281117	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.0674																																																																																		0	0	0	0	0	0	0	0	0	0	1.224744857	0	0	0	0	0	0.114113947	0	3.915983298	3.719275844	4.093281117	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.0674
H3327_027_0	2009	9																																D	D	D	V	T	O	O	V	P	P	P	P	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	O	V																																																			0									740.1956791						86.91777117		2746.239879	2774.446758	912.6762201																							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	9A OP Observation: $0 copay	12 Renal Dialysis: $0 copay	"3 CORF: $10 copay,  5  Partial Hosp:  $0 copay, 9C OP SA: $20 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, 7B Chiropractic:  $0 copay, 7B1 Routine Chiro: $0 copay, 7F Podiatry:  $10 copay for medically necessary services, $0 copay for 4 routine exams,"	"7E Mental Health: $20 copay, 7H Psychiatric: $20 copay"	"7C Occupational Therapy:  $10 copay, 7I Physical and Speech Therapy:  $10 copay"	7D Physician Specialist: $0 copay for radiology services	7G Other Health Care:  $10 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"	17A1 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	14A Health Ed/Wellness: $0 copay	"13B Acupuncture: Not Covered, 13C Other1: $0 copay"																		46						18.34867894		10	20	10																														46						18.34867894		10	20	10																							0	0	0	0	0	0	0	2.83741677	0	0	0	0	0	0.13290219	0	2.288533233	4.62407793	0.760563517	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.6435	0	0	0	0	0	0	0	0	0	2.83741677	0	0	0	0	0	0.13290219	0	2.288533233	4.62407793	0.760563517	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.6435																																																																																		0	0	0	0	0	0	0	0	0	0	2.83741677	0	0	0	0	0	0.13290219	0	2.288533233	4.62407793	0.760563517	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.6435
H3327_028_0	2009	13																																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	V	O																																																			0									149.5099602						13.69670189			931.1760154																								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	9A OP Observation: $0 copay	12 Renal Dialysis: $0 copay	"3 CORF: $0 copay,  5  Partial Hosp:  $0 copay, 9C OP SA: $50 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, 7B Chiropractic:  $0 copay, 7F Podiatry:  $0 copay for medically necessary services, $0 copay for 4 routine exams,"	"7E Mental Health: $50 copay, 7H Psychiatric: $50 copay"	"7C Occupational Therapy:  $0 copay, 7I Physical and Speech Therapy:  $0copay"	7D Physician Specialist: $0 copay for radiology services	7G Other Health Care:  $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"	17A1 Routine Eye Exams: $0 copay	17B Eye Wear:  $0 copay for eye wear	18A Routine Hearing Exams: $0 copay	18B Hearing Aids: $0 copay	14A Health Ed/Wellness: $0 copay	"13B Acupuncture: Not Covered, 13C Other1: $0 copay"																		45.84525715						50			50																															45.84525715						50			50																								0	0	0	0	0	0	0	0.571193548	0	0	0	0	0	0.057069591	0	0	3.879900064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.5082	0	0	0	0	0	0	0	0	0	0.571193548	0	0	0	0	0	0.057069591	0	0	3.879900064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.5082																																																																																		0	0	0	0	0	0	0	0	0	0	0.571193548	0	0	0	0	0	0.057069591	0	0	3.879900064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.5082
H3327_029_0	2009	13																																D	D	D	V	T	O	O	V	P	P	P	P	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O																																																			0									329.3420475						72.5616191		4599.578225	2096.776532	4784.900777																							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	9A OP Observation: $0 copay	12 Renal Dialysis: $0 copay	"3 CORF: $0 copay,  5  Partial Hosp:  $0 copay, 9C OP SA: $20 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 Mammography:  $0 copay, 14I Diabetes Monitoring:  $0 copay, 14J Nutrition Therapy: $0 copay"	"7D Physician Specialist: $10 copay, 7B Chiropractic:  $0 copay, 7F Podiatry:  $10 copay for medically necessary services, $0 copay for 4 routine exams,"	"7E Mental Health: $20 copay, 7H Psychiatric: $20 copay"	"7C Occupational Therapy:  $10 copay, 7I Physical and Speech Therapy:  $10 copay"	7D Physician Specialist: $0 copay for radiology services	7G Other Health Care:  $10 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	14A Health Ed/Wellness: $0 copay	"13B Acupuncture: Not Covered, 13C Other1: $0 copay"																		46						18.37174753		10	20	10																														46						18.37174753		10	20	10																							0	0	0	0	0	0	0	1.262477849	0	0	0	0	0	0.111090312	0	3.832981854	3.494627553	3.987417315	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.6886	0	0	0	0	0	0	0	0	0	1.262477849	0	0	0	0	0	0.111090312	0	3.832981854	3.494627553	3.987417315	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.6886																																																																																		0	0	0	0	0	0	0	0	0	0	1.262477849	0	0	0	0	0	0.111090312	0	3.832981854	3.494627553	3.987417315	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.6886
H3327_030_0	2009	11																																D	D	D	V	T	O	O	V	P	P	P	P	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O																																																			0									540.9497238						204.8302273		4216.791031	3638.951665	1361.889421																							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	9A OP Observation: $0 copay	12 Renal Dialysis: $0 copay	"3 CORF: $10 copay,  5  Partial Hosp:  $0 copay, 9C OP SA: $20 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, 7B Chiropractic:  $0 copay, 7F Podiatry:  $10 copay for medically necessary services, $0 copay for 4 routine exams,"	"7E Mental Health: $20 copay, 7H Psychiatric: $20 copay"	"7C Occupational Therapy:  $10 copay, 7I Physical and Speech Therapy:  $10 copay"	7D Physician Specialist: $0 copay for radiology services	7G Other Health Care:  $10 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"	17A1 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	14A Health Ed/Wellness: $0 copay	"13B Acupuncture: Not Covered, 13C Other1: $0 copay"																		46						19.28043553		10	20	10																														46						19.28043553		10	20	10																							0	0	0	0	0	0	0	2.073640608	0	0	0	0	0	0.329101333	0	3.513992526	6.064919441	1.134907851	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.1166	0	0	0	0	0	0	0	0	0	2.073640608	0	0	0	0	0	0.329101333	0	3.513992526	6.064919441	1.134907851	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.1166																																																																																		0	0	0	0	0	0	0	0	0	0	2.073640608	0	0	0	0	0	0.329101333	0	3.513992526	6.064919441	1.134907851	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.1166
H3327_801_0	2009	12																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		198.5531464	4.406503205	49.79285761		6.747155477	8.363020239	7.062567254	9.537160507	28.55674338	32.89466959	13.28706753	2.357133401	0.242681839	14.75088022	36.71225432	69.76165621	2.601149497	10.56788375			17.91718172	6.375749853																			Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing																			0.083679819	0.083679819	0.192849895		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.083679819	0.083679819	0.192849895		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			16.6149	0.368735392	9.602547361	0	1.558592915	1.931857675	1.631453036	2.203084077	6.596607721	7.598668674	3.069312599	0.544497816	0.056059505	3.40745333	8.480530749	16.11494259	0.600865534	2.441181145	0	0	4.138868976	1.472798216	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.4329	0	0	16.6149	0.368735392	9.602547361	0	1.558592915	1.931857675	1.631453036	2.203084077	6.596607721	7.598668674	3.069312599	0.544497816	0.056059505	3.40745333	8.480530749	16.11494259	0.600865534	2.441181145	0	0	4.138868976	1.472798216	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.4329																																																																																		0	0	0	16.6149	0.368735392	9.602547361	0	1.558592915	1.931857675	1.631453036	2.203084077	6.596607721	7.598668674	3.069312599	0.544497816	0.056059505	3.40745333	8.480530749	16.11494259	0.600865534	2.441181145	0	0	4.138868976	1.472798216	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.4329
H3327_802_0	2009	11																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		198.5531464	4.406503205	49.79285761		6.747155477	8.363020239	7.062567254	9.537160507	28.55674338	32.89466959	13.28706753	2.357133401	0.242681839	14.75088022	36.71225432	69.76165621	2.601149497	10.56788375			17.91718172	6.375749853																			Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing																			0.083679819	0.083679819	0.192849895		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.083679819	0.083679819	0.192849895		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			16.6149	0.368735392	9.602547361	0	1.558592915	1.931857675	1.631453036	2.203084077	6.596607721	7.598668674	3.069312599	0.544497816	0.056059505	3.40745333	8.480530749	16.11494259	0.600865534	2.441181145	0	0	4.138868976	1.472798216	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.4329	0	0	16.6149	0.368735392	9.602547361	0	1.558592915	1.931857675	1.631453036	2.203084077	6.596607721	7.598668674	3.069312599	0.544497816	0.056059505	3.40745333	8.480530749	16.11494259	0.600865534	2.441181145	0	0	4.138868976	1.472798216	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.4329																																																																																		0	0	0	16.6149	0.368735392	9.602547361	0	1.558592915	1.931857675	1.631453036	2.203084077	6.596607721	7.598668674	3.069312599	0.544497816	0.056059505	3.40745333	8.480530749	16.11494259	0.600865534	2.441181145	0	0	4.138868976	1.472798216	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.4329
H3327_803_0	2009	13																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		198.5531464	4.406503205	49.79285761		6.747155477	8.363020239	7.062567254	9.537160507	28.55674338	32.89466959	13.28706753	2.357133401	0.242681839	14.75088022	36.71225432	69.76165621	2.601149497	10.56788375			17.91718172	6.375749853																			Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing																			0.083679819	0.083679819	0.192849895		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.083679819	0.083679819	0.192849895		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			16.6149	0.368735392	9.602547361	0	1.558592915	1.931857675	1.631453036	2.203084077	6.596607721	7.598668674	3.069312599	0.544497816	0.056059505	3.40745333	8.480530749	16.11494259	0.600865534	2.441181145	0	0	4.138868976	1.472798216	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.4329	0	0	16.6149	0.368735392	9.602547361	0	1.558592915	1.931857675	1.631453036	2.203084077	6.596607721	7.598668674	3.069312599	0.544497816	0.056059505	3.40745333	8.480530749	16.11494259	0.600865534	2.441181145	0	0	4.138868976	1.472798216	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.4329																																																																																		0	0	0	16.6149	0.368735392	9.602547361	0	1.558592915	1.931857675	1.631453036	2.203084077	6.596607721	7.598668674	3.069312599	0.544497816	0.056059505	3.40745333	8.480530749	16.11494259	0.600865534	2.441181145	0	0	4.138868976	1.472798216	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.4329
H3327_805_0	2009	11																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		144.9437969	3.21674734	36.34878606		4.925423498	6.105004774	5.155674095	6.96212717	20.84642267	24.0131088	9.699559294	1.720707382	0.177157743	10.76814256	26.79994566	50.92600904	1.898839133	7.714555134			13.07954265	4.654297393																			Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing																			0.061086268	0.061086268	0.140780423		0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863			0.16863	0.16863																			0.061086268	0.061086268	0.140780423		0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863			0.16863	0.16863																			8.8541	0.196499091	5.117197489	0	0.830574165	1.029486955	0.869401323	1.174023505	3.515332254	4.049330537	1.635636684	0.290162886	0.02987411	1.81583188	4.519274836	8.587652904	0.320201243	1.300905432	0	0	2.205603277	0.784854169	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1259	0	0	8.8541	0.196499091	5.117197489	0	0.830574165	1.029486955	0.869401323	1.174023505	3.515332254	4.049330537	1.635636684	0.290162886	0.02987411	1.81583188	4.519274836	8.587652904	0.320201243	1.300905432	0	0	2.205603277	0.784854169	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1259		Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing																			1.7033	0.0378	0.9844		0.1547	0.1917	0.1619	0.2186	0.6546	0.7888	0.2995	0.054	0.0056	0.3382	0.6932	1.7031	0.0625	0.2463			0.4107	0.1551																			8.8642	0	0	10.5574	0.23430023	6.101608633	0	0.985241327	1.221195093	1.031298769	1.392646828	4.169947446	4.838144298	1.935166052	0.344196195	0.035464279	2.153984077	5.212518129	10.29079317	0.382736358	1.547225317	0	0	2.616324458	0.939934591	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.9901
H3327_806_0	2009	12																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		144.9437969	3.21674734	36.34878606		4.925423498	6.105004774	5.155674095	6.96212717	20.84642267	24.0131088	9.699559294	1.720707382	0.177157743	10.76814256	26.79994566	50.92600904	1.898839133	7.714555134			13.07954265	4.654297393																			Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing																			0.061086268	0.061086268	0.140780423		0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863			0.16863	0.16863																			0.061086268	0.061086268	0.140780423		0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863			0.16863	0.16863																			8.8541	0.196499091	5.117197489	0	0.830574165	1.029486955	0.869401323	1.174023505	3.515332254	4.049330537	1.635636684	0.290162886	0.02987411	1.81583188	4.519274836	8.587652904	0.320201243	1.300905432	0	0	2.205603277	0.784854169	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1259	0	0	8.8541	0.196499091	5.117197489	0	0.830574165	1.029486955	0.869401323	1.174023505	3.515332254	4.049330537	1.635636684	0.290162886	0.02987411	1.81583188	4.519274836	8.587652904	0.320201243	1.300905432	0	0	2.205603277	0.784854169	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1259		Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing																			1.7033	0.0378	0.9844		0.1547	0.1917	0.1619	0.2186	0.6546	0.7888	0.2995	0.054	0.0056	0.3382	0.6932	1.7031	0.0625	0.2463			0.4107	0.1551																			8.8642	0	0	10.5574	0.23430023	6.101608633	0	0.985241327	1.221195093	1.031298769	1.392646828	4.169947446	4.838144298	1.935166052	0.344196195	0.035464279	2.153984077	5.212518129	10.29079317	0.382736358	1.547225317	0	0	2.616324458	0.939934591	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.9901
H3327_807_0	2009	12																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		144.9437969	3.21674734	36.34878606		4.925423498	6.105004774	5.155674095	6.96212717	20.84642267	24.0131088	9.699559294	1.720707382	0.177157743	10.76814256	26.79994566	50.92600904	1.898839133	7.714555134			13.07954265	4.654297393																			Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing																			0.061086268	0.061086268	0.140780423		0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863			0.16863	0.16863																			0.061086268	0.061086268	0.140780423		0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863	0.16863			0.16863	0.16863																			8.8541	0.196499091	5.117197489	0	0.830574165	1.029486955	0.869401323	1.174023505	3.515332254	4.049330537	1.635636684	0.290162886	0.02987411	1.81583188	4.519274836	8.587652904	0.320201243	1.300905432	0	0	2.205603277	0.784854169	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1259	0	0	8.8541	0.196499091	5.117197489	0	0.830574165	1.029486955	0.869401323	1.174023505	3.515332254	4.049330537	1.635636684	0.290162886	0.02987411	1.81583188	4.519274836	8.587652904	0.320201243	1.300905432	0	0	2.205603277	0.784854169	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1259		Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing																			1.7033	0.0378	0.9844		0.1547	0.1917	0.1619	0.2186	0.6546	0.7888	0.2995	0.054	0.0056	0.3382	0.6932	1.7031	0.0625	0.2463			0.4107	0.1551																			8.8642	0	0	10.5574	0.23430023	6.101608633	0	0.985241327	1.221195093	1.031298769	1.392646828	4.169947446	4.838144298	1.935166052	0.344196195	0.035464279	2.153984077	5.212518129	10.29079317	0.382736358	1.547225317	0	0	2.616324458	0.939934591	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.9901
H3328_001_0	2009	11																					3350											A	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																																																			0	6700	269.0289364	92.58066805	624.3169046		81.01519145	9.222177486	0.405571983	261.0182719	22.94244301		24.37399762	1.03244787	0.387375487	11.46268466							14.62081304																				$300 per admit	$75/day days 1-10	$50 per days 1-40		$50 per trip	0.1	0.1	$50(ER & WW)	0.1		0%xrays/20%TherRad/10%OthDxRad	0.1	0.2	10%/20% Chemotherapy	$0 per visit	$0 per visit	$0 per visit	$0 per visit			0.2																				300	46.575	44.5		50	0.1	0.1	50	0.1		0.133206367	0.1	0.2	0.103595652							0.2																				235.5796294	36.57373747	34.9443117		39.26327157	0.078526543	0.078526543	39.26327157	0.078526543		0.104602355	0.078526543	0.157053086	0.081350085							0.157053086																				5.2815	0.282168421	1.818027043	0	0.265076789	0.724185718	0.031848166	0.854035941	1.801590741	0	2.549577554	0.081074562	0.060838516	0.932490368	0	0	0	0	0	0	2.296243812	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.9786	0	4.6429	5.2815	0.282168421	1.818027043	0	0.265076789	0.724185718	0.031848166	0.854035941	1.801590741	0	2.549577554	0.081074562	0.060838516	0.932490368	0	0	0	0	0	0	2.296243812	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.9786		$600 per admit	$150/day days 1-10	$100 per days 1-40		$50 per trip	0.2	0.2	$50 per visit	0.2	0.2	20% xrays/ 30% other	0.2		20%/30%Chemotherapy	$10 per visit	$30 per visit	$30 per visit	$30 per visit																							0.6259	0.0566	0.2772		0.2557	0.2704	0.0707	0.0785	0.3736	0.3666	0.8159	0.027	0.0009	0.4982	0.0377	1.5111	0.1418	0.277																							5.6847	0	1.507465518	5.9073	0.338794388	2.095236895	0	0.520771304	0.994617093	0.102556461	0.932572079	2.175151304	0.366638411	3.365485014	0.108043549	0.061694619	1.430666994	0.03767439	1.51109007	0.141756908	0.276964977	0	0	2.296243812	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.6633
H3328_002_0	2009	8																																D	D	D	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V	Coin	P	T	V	V	P	V	P	V	P																																																			0									471.2974743						34.7742182		3229.437399	2968.272278	3496.637689																														$50ER/$10UC						$20 per MHSA visit	$0 per visit	$10 per visit	$20 per visit	$10 per visit												$1100 flex; $62.50 per qtr OTC																		50						17.66628658		10	20	10																														50						17.66628658		10	20	10																							0	0	0	0	0	0	0	1.963739476	0	0	0	0	0	0.051194275	0	2.691197833	4.947120463	2.913864741	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.5671	0	0	0	0	0	0	0	0	0	1.963739476	0	0	0	0	0	0.051194275	0	2.691197833	4.947120463	2.913864741	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.5671																																																																																		0	0	0	0	0	0	0	0	0	0	1.963739476	0	0	0	0	0	0.051194275	0	2.691197833	4.947120463	2.913864741	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.5671
H3328_003_0	2009	14																					3350											A	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	P	T	V	V	P	V	P	V	P																																																			0	6700	292.7368196	277.6789703	534.3854101		67.20737756	6.23092565	2.923358589	244.4185214			20.79824114		0.400201566								16.00063688																				$300 per admit	$75/day days 1-10	$50 per days 1-40		$50 per trip	0.1	0.1	$50(ER & WW)			0%Diag/20%TherRad		0.2	20% Chemotherapy	$0 per visit	$0 per visit	$0 per visit	$0 per visit			0.2		$630 non mcr benefit limit	$630 non mcr benefit limit	$630 non mcr benefit limit	$630 non mcr benefit limit	$630 non mcr benefit limit	$630 non mcr benefit limit	$630 non mcr benefit limit	$630 non mcr: $50 per qtr OTC											300	39.6	44.5		50	0.1	0.1	50			0.095325153		0.2								0.2																				230.4217595	30.41567226	34.17922766		38.40362659	0.076807253	0.076807253	38.40362659			0.073216632		0.153614506								0.153614506																				5.6211	0.703816046	1.522073383	0	0.215083919	0.478580284	0.224535143	0.782213136	0	0	1.522777167	0	0.061476766	0	0	0	0	0	0	0	2.457929935	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.5896	0	4.1035	5.6211	0.703816046	1.522073383	0	0.215083919	0.478580284	0.224535143	0.782213136	0	0	1.522777167	0	0.061476766	0	0	0	0	0	0	0	2.457929935	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.5896		$600 per admit	$150/day days 1-10	$100 per 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	20%/30%Chemotherapy	$10 per visit	$30 per visit	$30 per visit	$30 per visit			0.3																				0.433	0.0394	0.2003		0.4447	0.1478	0.0479	0.1156	0.4461	0.3237	0.4311	0.0126	0.0054	0.13	0.0378	1.4047	0.1464	0.2683			0.6038																				5.2385	0	2.034492682	6.0541	0.743222127	1.722327022	0	0.659773619	0.626367157	0.27241469	0.897794496	0.446131206	0.323691583	1.953891076	0.01263825	0.066878287	0.129953143	0.037755147	1.404704547	0.146360455	0.268323368	0	0	3.061736682	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.8281
H3328_012_0	2009	13																					3350											A	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																																																			0	6700	222.4909298	112.8748957	1347.588574		135.2625594	4.520086662	4.368101816	265.5083924	18.50735597		33.05704434	1.539365443	0.448903264	14.88786747							17.15337822																				$300 per admit	$75/day days 1-10	$50 per days 1-40		$50 per trip	0.1	0.1	$50(ER & WW)	0.1		0%xrays/20%TherRad/10%OthDxRad	0.1	0.2	10%/20% Chemotherapy	$0 per visit	$0 per visit	$0 per visit	$0 per visit			0.2		$250 non mcr benefit limit	$250 non mcr benefit limit	$250 non mcr benefit limit	$250 non mcr benefit limit	$250 non mcr benefit limit	$250 non mcr benefit limit	$250 non mcr benefit limit	$250 non mcr benefit limit											300	48.225	44.5		50	0.1	0.1	50	0.1		0.133206367	0.1	0.2	0.113689094							0.2																				235.1501394	37.8003849	34.88060401		39.1916899	0.07838338	0.07838338	39.1916899	0.07838338		0.104411652	0.07838338	0.15676676	0.089113355							0.15676676																				4.3599	0.355559542	3.917058617	0	0.441764024	0.35429967	0.342386584	0.867143548	1.450669112	0	3.451540622	0.120660666	0.07037311	1.326707812	0	0	0	0	0	0	2.68907952	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.7471	0	5.4459	4.3599	0.355559542	3.917058617	0	0.441764024	0.35429967	0.342386584	0.867143548	1.450669112	0	3.451540622	0.120660666	0.07037311	1.326707812	0	0	0	0	0	0	2.68907952	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.7471		$600 per admit	$150/day days 1-10	$100 per days 1-40		$50 per trip	0.2	0.2	$50 per visit	0.2	0.2	20% xrays/ 30% other	0.2		20%/30%Chemotherapy	$10 per visit	$30 per visit	$30 per visit	$30 per visit																							1.2788	0.1043	1.1489		0.0731	0.1975	0.1047	0.0704	0.4195	0.3313	0.9677	0.0348	0.0017	0.3599	0.0412	1.3043	0.2263	0.3327																							6.9971	0	0.803673373	5.6387	0.459851899	5.066006203	0	0.514883419	0.551790225	0.447054097	0.937499291	1.870133522	0.331258537	4.419230888	0.155488116	0.072083543	1.686593687	0.041232107	1.304345559	0.226332237	0.332685518	0	0	2.68907952	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.7443
H3328_013_0	2009	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																																																			0		534.6742944		77.17649687		19.30945212	27.10192574		16.76906494	23.7621209	22.37435733	48.31344294	1.766580807	9.844169104	35.29008107	43.21124158	177.4691333	24.8346854	22.61498062			16.43546188	0.027733206																			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	$3000 non-mcr benefit limit	$3000 non-mcr benefit limit	$3000 non-mcr benefit limit	$3000 non-mcr benefit limit	$3000 non-mcr benefit limit	$3000 non-mcr benefit limit	$3000 non-mcr benefit limit	$3000 non-mcr; $125/qtr OTC											0.06566914		0.172164762		0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.06566914		0.172164762		0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			35.1116	0	13.28707323	0	4.46048344	6.260544845	0	3.873654002	5.489049928	5.168476543	11.16040532	0.408080166	2.274003063	8.152008727	9.981796805	40.9953698	5.736812327	5.224060523	0	0	3.796591693	0.006406371	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	161.3864	0	0	35.1116	0	13.28707323	0	4.46048344	6.260544845	0	3.873654002	5.489049928	5.168476543	11.16040532	0.408080166	2.274003063	8.152008727	9.981796805	40.9953698	5.736812327	5.224060523	0	0	3.796591693	0.006406371	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	161.3864																																																																																		0	0	0	35.1116	0	13.28707323	0	4.46048344	6.260544845	0	3.873654002	5.489049928	5.168476543	11.16040532	0.408080166	2.274003063	8.152008727	9.981796805	40.9953698	5.736812327	5.224060523	0	0	3.796591693	0.006406371	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	161.3864
H3328_014_0	2009	10																					3350											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																																																			0	6700	238.5546585	8.030051681	1483.074617		148.3041358	8.068370684	4.944896363	147.5398638	19.81324064		32.00572625	1.739456842	0.445445529	9.690316089	3210.037189	1407.318155	833.2148199	1288.944791			17.6142038																				$900 per admit	$900 per admit	$75 per days 1-25		$50 per trip	0.2	0.2	$50(ER & WW)	0.2		0%xrays/20%Other	0.2	0.2	0.2	$5 per visit	$20 per visit	$20 per visit	$20 per visit			0.2																				900	900	60.75		50	0.2	0.2	50	0.2		0.17108758	0.2	0.2	0.198104437	5	20	20	20			0.2																				803.2010592	803.2010592	54.2160715		44.62228107	0.178489124	0.178489124	44.62228107	0.178489124		0.152686362	0.178489124	0.178489124	0.176797437	4.462228107	17.84891243	17.84891243	17.84891243			0.178489124																				15.9673	0.537478835	6.700539955	0	0.551472402	1.440116418	0.882610222	0.548630439	3.536447971	0	4.886837895	0.310474128	0.079507182	1.713223052	1.193659847	2.093258209	1.239331529	1.917188559	0	0	3.143943811	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.742	0	5.6332	15.9673	0.537478835	6.700539955	0	0.551472402	1.440116418	0.882610222	0.548630439	3.536447971	0	4.886837895	0.310474128	0.079507182	1.713223052	1.193659847	2.093258209	1.239331529	1.917188559	0	0	3.143943811	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.742		$2000 per admit	$2000 per admit	$150 per days 1-25		$50 per trip	0.3	0.3	$50 per visit	0.3	0.2	20% xrays/ 30% other	0.3		0.3	$20 per visit	$40 per visit	$40 per visit	$40 per visit																							4.0778	0.1373	1.7112		0.076	0.3237	0.1762	0.0775	0.6678	0.3365	1.1248	0.0585	0.0026	0.324	0.0778	0.5343	0.311	0.459			0.0216																				10.4976	0	1.001754956	20.0451	0.674742218	8.411749263	0	0.627432317	1.763839207	1.058799132	0.62614219	4.20423588	0.336467413	6.011605374	0.368992984	0.082133333	2.037258269	1.271502797	2.627576387	1.550366864	2.376193297	0	0	3.165530094	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2396
H3330_021_1	2009	6																					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	O	O																																																			0	n/a	2147.791558	97.99392174	1677.006829	232.8485888	516.5761665	7.423225623	7.423225623	226.774156	77.35779874	0	0	0	0	617.7540479	5330.905905	8994.170617	137.2723044	23.54442829	372.663535	4291.544505	29.37592745	0	0	79.60450886	1604.268021	0	109.0476324	0	0	0											$0 -$150 Copay	$0 Copay	$25 (days 21-100) Copay	$0 Copay	$75 Copay	20%Coinsurance	20%Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	0 Copay	$0-$5 Copay	$25 Copay	5 Copay	$0 Copay	$0-$5 Copay	10%Coinsurance	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay											17.18591819	0	6.261788712	0	75	0.2	0.2	50	75	0	0	0	0	75	0	2.737566559	25	2.737566559	0	2.737566559	0.1	0	0	10	15	0	15	0	0	0											17.18591819	0	6.261788712	0	75	0.2	0.2	50	75	0	0	0	0	75	0	2.737566559	25	2.737566559	0	2.737566559	0.1	0	0	10	15	0	15	0	0	0											3.076	0	0.875088536	0	3.228601041	1.484645125	1.484645125	0.944892317	0.483486242	0	0	0	0	3.8609628	0	2.051845059	0.285983968	0.005371203	0	0.979032394	2.937592745	0	0	0.066337091	2.005335027	0	0.13630954	0	0	0	0	0	0	0	0	0	0	0	0	0	23.9061	0	0	3.076	0	0.875088536	0	3.228601041	1.484645125	1.484645125	0.944892317	0.483486242	0	0	0	0	3.8609628	0	2.051845059	0.285983968	0.005371203	0	0.979032394	2.937592745	0	0	0.066337091	2.005335027	0	0.13630954	0	0	0	0	0	0	0	0	0	0	0	0	0	23.9061	none																																																																																	0	0	0	3.076	0	0.875088536	0	3.228601041	1.484645125	1.484645125	0.944892317	0.483486242	0	0	0	0	3.8609628	0	2.051845059	0.285983968	0.005371203	0	0.979032394	2.937592745	0	0	0.066337091	2.005335027	0	0.13630954	0	0	0	0	0	0	0	0	0	0	0	0	0	23.9061
H3330_021_2	2009	7																					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	O	O																																																			0	n/a	1980.074871	97.99392174	1701.479969	287.3018898	263.459436	7.33170977	7.33170977	243.1974201	164.1682255	0	0	0	0	308.2660102	4941.226579	8336.71344	127.2379538	21.82337428	345.4225223	3977.840568	42.13529466	0	0	79.60450886	1630.431278	0	143.1434714	0	0	0											$0 -$250 (day 1) /$0 - $50 day (days 2-10) Copay	$0 Copay	$25 (days 21-100) Copay	$0 Copay	$75 Copay	20%Coinsurance	20%Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$5 Copay	$5-$10 Copay	$30 Copay	10 Copay	$0 Copay	$5-$10 Copay	10%Coinsurance	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay											30.45756534	0	6.261788712	0	75	0.2	0.2	50	75	0	0	0	0	75	5	8.407116579	30	8.407116579	0	8.407116579	0.1	0	0	10	15	0	15	0	0	0											30.45756534	0	6.261788712	0	75	0.2	0.2	50	75	0	0	0	0	75	5	8.407116579	30	8.407116579	0	8.407116579	0.1	0	0	10	15	0	15	0	0	0											5.0257	0	0.887859005	0	1.646621475	1.466341954	1.466341954	1.013322584	1.026051409	0	0	0	0	1.926662564	2.058844408	5.840643481	0.318094884	0.015289304	0	2.786847449	4.213529466	0	0	0.066337091	2.038039098	0	0.178929339	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9754	0	0	5.0257	0	0.887859005	0	1.646621475	1.466341954	1.466341954	1.013322584	1.026051409	0	0	0	0	1.926662564	2.058844408	5.840643481	0.318094884	0.015289304	0	2.786847449	4.213529466	0	0	0.066337091	2.038039098	0	0.178929339	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9754	none																																																																																	0	0	0	5.0257	0	0.887859005	0	1.646621475	1.466341954	1.466341954	1.013322584	1.026051409	0	0	0	0	1.926662564	2.058844408	5.840643481	0.318094884	0.015289304	0	2.786847449	4.213529466	0	0	0.066337091	2.038039098	0	0.178929339	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9754
H3330_021_3	2009	6																					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	O	O																																																			0	n/a	2277.937252	97.99392174	1792.260348	276.4077193	167.6886923	6.429967821	6.429967821	282.2846249	125.1504839	0	0	0	0	1058.480238	5612.695161	9469.598376	144.5284559	24.78897604	392.3623596	4518.393591	42.52035101	0	0	79.60450886	1522.098296	0	80.44537115	0	0	0											$0 - $250 (day 1) /$0 - $50 day (days 2-10) Copay	$0 Copay	$25 (days 21-100) Copay	$0 Copay	$75 Copay	20%Coinsurance	20%Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$5 Copay	$5-$10 Copay	$30 Copay	10 Copay	$0 Copay	$5-$10 Copay	10%Coinsurance	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay											30.45756534	0	6.261788712	0	75	0.2	0.2	50	75	0	0	0	0	75	5	9.94802448	30	9.94802448	0	9.94802448	0.1	0	0	10	15	0	15	0	0	0											30.45756534	0	6.261788712	0	75	0.2	0.2	50	75	0	0	0	0	75	5	9.94802448	30	9.94802448	0	9.94802448	0.1	0	0	10	15	0	15	0	0	0											5.7817	0	0.935229635	0	1.048054327	1.285993564	1.285993564	1.176185937	0.782190525	0	0	0	0	6.615501488	2.338622984	7.850316372	0.36132114	0.020550112	0	3.745757505	4.252035101	0	0	0.066337091	1.90262287	0	0.100556714	0	0	0	0	0	0	0	0	0	0	0	0	0	39.549	0	0	5.7817	0	0.935229635	0	1.048054327	1.285993564	1.285993564	1.176185937	0.782190525	0	0	0	0	6.615501488	2.338622984	7.850316372	0.36132114	0.020550112	0	3.745757505	4.252035101	0	0	0.066337091	1.90262287	0	0.100556714	0	0	0	0	0	0	0	0	0	0	0	0	0	39.549	none																																																																																	0	0	0	5.7817	0	0.935229635	0	1.048054327	1.285993564	1.285993564	1.176185937	0.782190525	0	0	0	0	6.615501488	2.338622984	7.850316372	0.36132114	0.020550112	0	3.745757505	4.252035101	0	0	0.066337091	1.90262287	0	0.100556714	0	0	0	0	0	0	0	0	0	0	0	0	0	39.549
H3330_023_1	2009	4																					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	O	O																																																			0	n/a	1972.699798	97.99392174	1496.943773	219.5957401	541.7504852	7.361688516	7.361688516	223.0641697	71.11210815	0	0	0	0	699.2762682	5344.175402	9016.558578	137.6139977	23.60303422	373.5911555	4302.226861	27.30296565	0	0	41.004	1649.453156	0	108.8036138	0	0	0											$300 Copay	$0 Copay	$25 (days 21-100) Copay	$0 Copay	$75 Copay	20%Coinsurance	20%Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$0 Copay	$10 Copay	$25 Copay	$10 Copay	$0 Copay	$10 Copay	10%Coinsurance	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay											45.82911518	0	6.261788712	0	75	0.2	0.2	50	75	0	0	0	0	75	0	10	25	10	0	10	0.1	0	0	10	15	0	15	0	0	0											45.82911518	0	6.261788712	0	75	0.2	0.2	50	75	0	0	0	0	75	0	10	25	10	0	10	0.1	0	0	10	15	0	15	0	0	0											7.5339	0	0.781128802	0	3.385940533	1.472337703	1.472337703	0.92943404	0.444450676	0	0	0	0	4.370476676	0	7.513798815	0.286695828	0.019669195	0	3.585189051	2.730296565	0	0	0.03417	2.061816446	0	0.136004517	0	0	0	0	0	0	0	0	0	0	0	0	0	36.7577	0	0	7.5339	0	0.781128802	0	3.385940533	1.472337703	1.472337703	0.92943404	0.444450676	0	0	0	0	4.370476676	0	7.513798815	0.286695828	0.019669195	0	3.585189051	2.730296565	0	0	0.03417	2.061816446	0	0.136004517	0	0	0	0	0	0	0	0	0	0	0	0	0	36.7577	none																																																																																	0	0	0	7.5339	0	0.781128802	0	3.385940533	1.472337703	1.472337703	0.92943404	0.444450676	0	0	0	0	4.370476676	0	7.513798815	0.286695828	0.019669195	0	3.585189051	2.730296565	0	0	0.03417	2.061816446	0	0.136004517	0	0	0	0	0	0	0	0	0	0	0	0	0	36.7577
H3330_023_2	2009	5																					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	O	O																																																			0	n/a	1831.200582	97.99392174	1571.853978	272.4045497	277.7821118	7.2692137	7.2692137	240.859466	151.9487225	0	0	0	0	351.339784	4980.122541	8402.33773	128.2395356	21.99516182	348.1415924	4009.153023	39.1526954	0	0	40.8	1685.353982	0	143.5900009	0	0	0											$300 (day 1) /$50 day (days 2-10) Copay	$0 Copay	$25 (days 21-100) Copay	$0 Copay	$75 Copay	20%Coinsurance	20%Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$5 Copay	$15 Copay	$30 Copay	$15 Copay	$0 Copay	$15 Copay	10%Coinsurance	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay											47.71536238	0	6.261788712	0	75	0.2	0.2	50	75	0	0	0	0	75	5	15	30	15	0	15	0.1	0	0	10	15	0	15	0	0	0											47.71536238	0	6.261788712	0	75	0.2	0.2	50	75	0	0	0	0	75	5	15	30	15	0	15	0.1	0	0	10	15	0	15	0	0	0											7.2814	0	0.820218125	0	1.736138199	1.45384274	1.45384274	1.003581108	0.949679516	0	0	0	0	2.19587365	2.075051059	10.50292216	0.320598839	0.027493952	0	5.011441278	3.91526954	0	0	0.034	2.106692477	0	0.179487501	0	0	0	0	0	0	0	0	0	0	0	0	0	41.0675	0	0	7.2814	0	0.820218125	0	1.736138199	1.45384274	1.45384274	1.003581108	0.949679516	0	0	0	0	2.19587365	2.075051059	10.50292216	0.320598839	0.027493952	0	5.011441278	3.91526954	0	0	0.034	2.106692477	0	0.179487501	0	0	0	0	0	0	0	0	0	0	0	0	0	41.0675	none																																																																																	0	0	0	7.2814	0	0.820218125	0	1.736138199	1.45384274	1.45384274	1.003581108	0.949679516	0	0	0	0	2.19587365	2.075051059	10.50292216	0.320598839	0.027493952	0	5.011441278	3.91526954	0	0	0.034	2.106692477	0	0.179487501	0	0	0	0	0	0	0	0	0	0	0	0	0	41.0675
H3330_023_3	2009	4																					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	O	O																																																			0	n/a	2082.769722	97.99392174	1636.757858	259.0741143	183.1030851	6.2447775	6.2447775	276.4080116	114.5246912	0	0	0	0	1192.732599	5592.097	9434.845675	143.9980475	24.69800239	390.9224198	4501.811433	38.702451	0	0	40.8	1555.354226	0	79.77222271	0	0	0											$300 (day 1) /$50 day (days 2-10) Copay	$0 Copay	$25 (days 21-100) Copay	$0 Copay	$75 Copay	20%Coinsurance	20%Coinsurance	$50 Copay	$75 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$75 Copay	$5 Copay	$15 Copay	$30 Copay	$15 Copay	$0 Copay	$15 Copay	10%Coinsurance	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay											47.71536238	0	6.261788712	0	75	0.2	0.2	50	75	0	0	0	0	75	5	15	30	15	0	15	0.1	0	0	10	15	0	15	0	0	0											47.71536238	0	6.261788712	0	75	0.2	0.2	50	75	0	0	0	0	75	5	15	30	15	0	15	0.1	0	0	10	15	0	15	0	0	0											8.2817	0	0.85408599	0	1.144394282	1.2489555	1.2489555	1.151700048	0.71577932	0	0	0	0	7.454578747	2.330040417	11.79355709	0.359995119	0.030872503	0	5.627264291	3.8702451	0	0	0.034	1.944192782	0	0.099715278	0	0	0	0	0	0	0	0	0	0	0	0	0	48.19	0	0	8.2817	0	0.85408599	0	1.144394282	1.2489555	1.2489555	1.151700048	0.71577932	0	0	0	0	7.454578747	2.330040417	11.79355709	0.359995119	0.030872503	0	5.627264291	3.8702451	0	0	0.034	1.944192782	0	0.099715278	0	0	0	0	0	0	0	0	0	0	0	0	0	48.19	none																																																																																	0	0	0	8.2817	0	0.85408599	0	1.144394282	1.2489555	1.2489555	1.151700048	0.71577932	0	0	0	0	7.454578747	2.330040417	11.79355709	0.359995119	0.030872503	0	5.627264291	3.8702451	0	0	0.034	1.944192782	0	0.099715278	0	0	0	0	0	0	0	0	0	0	0	0	0	48.19
H3330_025_1	2009	2																					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	O	O																																																			0	n/a	2072.997546	97.99392174	1518.702102	227.2433529	533.92135	7.94976	7.94976	233.8686811	74.5565501	0	0	0	0	733.1469629	5530.290963	9330.568081	142.4065249	24.42503044	386.6017928	4452.055657	29.484	0	0	42.432	1706.896799	0	112.5927943	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%Coinsurance	$0 Copay	$0 Copay	$10 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	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	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	0.03536	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.0354	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.03536	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.0354	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	0.03536	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.0354
H3330_025_2	2009	2																					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	O	O																																																			0	n/a	2009.718461	97.99392174	1631.734129	296.9209592	288.3642875	8.710735	8.710735	263.1473799	166.009287	0	0	0	0	383.8509863	5428.333569	9158.548126	139.7810938	23.97472638	379.4743357	4369.976795	46.91687	0	0	44.472	1837.03584	0	156.513101	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%Coinsurance	$0 Copay	$0 Copay	$10 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	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	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	0.03706	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.0371	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.03706	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.0371	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	0.03706	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.0371
H3330_025_3	2009	3																					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	O	O																																																			0	n/a	2158.716714	97.99392174	1622.728505	269.696153	173.2821015	6.685302	6.685302	286.0341613	118.5131133	0	0	0	0	1234.270551	5821.372977	9821.674347	149.9019675	25.71062049	406.950239	4686.385702	41.4326328	0	0	42.4728	1619.123749	0	83.04288384	0	0	0											$250 (day 1) /$50 day (days 2-10) Copay	$0 Copay	$25 (days 21-100) Copay	$0 Copay	$100 Copay	0%Coinsurance	0%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	10%Coinsurance	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay											40.61008712	0	6.261788712	0	100	0	0	50	75	0	0	0	0	75	5	10	30	10	0	10	0.1	0	0	10	15	0	15	0	0	0											40.61008712	0	6.261788712	0	100	0	0	50	75	0	0	0	0	75	5	10	30	10	0	10	0.1	0	0	10	15	0	15	0	0	0											7.3055	0	0.846765253	0	1.444017512	0	0	1.191809005	0.740706958	0	0	0	0	7.714190942	2.425572074	8.184728623	0.374754919	0.021425517	0	3.905321418	4.14326328	0	0	0.035394	2.023904686	0	0.103803605	0	0	0	0	0	0	0	0	0	0	0	0	0	40.4611	0	0	7.3055	0	0.846765253	0	1.444017512	0	0	1.191809005	0.740706958	0	0	0	0	7.714190942	2.425572074	8.184728623	0.374754919	0.021425517	0	3.905321418	4.14326328	0	0	0.035394	2.023904686	0	0.103803605	0	0	0	0	0	0	0	0	0	0	0	0	0	40.4611	none																																																																																	0	0	0	7.3055	0	0.846765253	0	1.444017512	0	0	1.191809005	0.740706958	0	0	0	0	7.714190942	2.425572074	8.184728623	0.374754919	0.021425517	0	3.905321418	4.14326328	0	0	0.035394	2.023904686	0	0.103803605	0	0	0	0	0	0	0	0	0	0	0	0	0	40.4611
H3330_029_0	2009	7																					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	O	O																																																			0	n/a	2094.140287	97.99392174	1596.875294	251.6468003	470.6232226	8.394737733	8.394737733	246.8829028	97.0043575	0	0	0	0	717.8481005	5706.535842	9627.924016	146.9448794	25.20343189	398.9224078	4593.938248	35.4627066	0	0	0	325.2244303	0	122.0924021	0	0	455											$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%Coinsurance	$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	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
H3330_030_1	2009	8																					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	O	O																																																			0	n/a	2062.708487	97.99392174	1589.292544	233.1429399	575.1719082	8.2726644	8.2726644	232.7602987	74.20320152	0	0	0	0	729.6723328	5673.865825	9572.803983	146.1036174	25.05914181	396.6385701	4567.637872	30.681585	0	0	43.5336	1751.210466	0	115.5158765	0	0	0											$300 Copay	$0 Copay	$25 (days 21-100) Copay	$0 Copay	$75 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	10%Coinsurance	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay											45.82911518	0	6.261788712	0	75	0.2	0.2	50	75	0	0	0	0	75	0	5	25	5	0	5	0.1	0	0	10	15	0	15	0	0	0											45.82911518	0	6.261788712	0	75	0.2	0.2	50	75	0	0	0	0	75	0	5	25	5	0	5	0.1	0	0	10	15	0	15	0	0	0											7.8777	0	0.829317842	0	3.594824426	1.65453288	1.65453288	0.969834578	0.463770009	0	0	0	0	4.56045208	0	3.988668326	0.304382536	0.010441309	0	1.903182447	3.0681585	0	0	0.036278	2.189013082	0	0.144394846	0	0	0	0	0	0	0	0	0	0	0	0	0	33.2495	0	0	7.8777	0	0.829317842	0	3.594824426	1.65453288	1.65453288	0.969834578	0.463770009	0	0	0	0	4.56045208	0	3.988668326	0.304382536	0.010441309	0	1.903182447	3.0681585	0	0	0.036278	2.189013082	0	0.144394846	0	0	0	0	0	0	0	0	0	0	0	0	0	33.2495	none																																																																																	0	0	0	7.8777	0	0.829317842	0	3.594824426	1.65453288	1.65453288	0.969834578	0.463770009	0	0	0	0	4.56045208	0	3.988668326	0.304382536	0.010441309	0	1.903182447	3.0681585	0	0	0.036278	2.189013082	0	0.144394846	0	0	0	0	0	0	0	0	0	0	0	0	0	33.2495
H3330_030_2	2009	9																					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	O	O																																																			0	n/a	2520.050093	97.99392174	2041.164666	367.7461421	375.0058509	13.4366175	13.4366175	326.8621604	206.2044251	0	0	0	0	476.791229	6723.16543	11343.15594	173.123373	29.69346846	469.9911497	5412.356581	72.370935	0	0	55.08	2275.227876	0	193.8465012	0	0	0											$300 (day 1) /$50 day (days 2-10) Copay	$0 Copay	$25 (days 21-100) Copay	$0 Copay	$75 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	10%Coinsurance	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay											47.71536238	0	6.261788712	0	75	0.2	0.2	50	75	0	0	0	0	75	5	10	30	10	0	10	0.1	0	0	10	15	0	15	0	0	0											47.71536238	0	6.261788712	0	75	0.2	0.2	50	75	0	0	0	0	75	5	10	30	10	0	10	0.1	0	0	10	15	0	15	0	0	0											10.0204	0	1.065111822	0	2.343786568	2.6873235	2.6873235	1.361925668	1.288777657	0	0	0	0	2.979945181	2.801318929	9.452629946	0.432808433	0.024744557	0	4.510297151	7.2370935	0	0	0.0459	2.844034845	0	0.242308126	0	0	0	0	0	0	0	0	0	0	0	0	0	52.0258	0	0	10.0204	0	1.065111822	0	2.343786568	2.6873235	2.6873235	1.361925668	1.288777657	0	0	0	0	2.979945181	2.801318929	9.452629946	0.432808433	0.024744557	0	4.510297151	7.2370935	0	0	0.0459	2.844034845	0	0.242308126	0	0	0	0	0	0	0	0	0	0	0	0	0	52.0258	none																																																																																	0	0	0	10.0204	0	1.065111822	0	2.343786568	2.6873235	2.6873235	1.361925668	1.288777657	0	0	0	0	2.979945181	2.801318929	9.452629946	0.432808433	0.024744557	0	4.510297151	7.2370935	0	0	0.0459	2.844034845	0	0.242308126	0	0	0	0	0	0	0	0	0	0	0	0	0	52.0258
H3330_030_3	2009	8																					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	O	O																																																			0	n/a	2614.39867	97.99392174	1958.809452	316.0704195	213.2318655	9.416875	9.416875	343.7910592	142.4436458	0	0	0	0	1483.498258	6822.35834	11510.51172	175.677618	30.13156292	476.9253521	5492.209948	58.36175	0	0	49.776	1897.532155	0	97.3221117	0	0	0											$300 (day 1) /$50 day (days 2-10) Copay	$0 Copay	$25 (days 21-100) Copay	$0 Copay	$75 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	10%Coinsurance	$0 Copay	$0 Copay	$10 Copay	$15 Copay	$0 Copay	$15 Copay	$0 Copay	$0 Copay	$0 Copay											47.71536238	0	6.261788712	0	75	0.2	0.2	50	75	0	0	0	0	75	5	10	30	10	0	10	0.1	0	0	10	15	0	15	0	0	0											47.71536238	0	6.261788712	0	75	0.2	0.2	50	75	0	0	0	0	75	5	10	30	10	0	10	0.1	0	0	10	15	0	15	0	0	0											10.3956	0	1.022137576	0	1.332699159	1.883375	1.883375	1.432462747	0.890272786	0	0	0	0	9.271864113	2.842649308	9.592093103	0.439194045	0.025109636	0	4.576841623	5.836175	0	0	0.04148	2.371915194	0	0.12165264	0	0	0	0	0	0	0	0	0	0	0	0	0	53.9589	0	0	10.3956	0	1.022137576	0	1.332699159	1.883375	1.883375	1.432462747	0.890272786	0	0	0	0	9.271864113	2.842649308	9.592093103	0.439194045	0.025109636	0	4.576841623	5.836175	0	0	0.04148	2.371915194	0	0.12165264	0	0	0	0	0	0	0	0	0	0	0	0	0	53.9589	none																																																																																	0	0	0	10.3956	0	1.022137576	0	1.332699159	1.883375	1.883375	1.432462747	0.890272786	0	0	0	0	9.271864113	2.842649308	9.592093103	0.439194045	0.025109636	0	4.576841623	5.836175	0	0	0.04148	2.371915194	0	0.12165264	0	0	0	0	0	0	0	0	0	0	0	0	0	53.9589
H3330_031_1	2009	6																					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	O	O																																																			0	n/a	2157.54988	95.75406067	1620.922435	242.5385786	569.858364	8.80564776	8.80564776	242.7357401	77.38333873	0	0	0	0	760.9440042	514.8502534	8994.373915	74.94197298	514.8502534	203.4506573	10901.03904	32.658309	0	0	0	302.6241644	0	120.1711555	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%Coinsurance	$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	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	1.011398917	0	0	0	0	0	0	0	7.495311596	0.124903288	0.429041878	0	9.0841992	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.1449	0	0	0	0	0	0	0	0	0	1.011398917	0	0	0	0	0	0	0	7.495311596	0.124903288	0.429041878	0	9.0841992	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.1449	none																																																																																	0	0	0	0	0	0	0	0	0	0	1.011398917	0	0	0	0	0	0	0	7.495311596	0.124903288	0.429041878	0	9.0841992	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.1449
H3330_031_2	2009	8																					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	O	O																																																			0	n/a	2070.392749	97.99392174	1648.860456	292.0370651	255.9043832	8.228979728	8.228979728	272.0597916	152.3007789	0	0	0	0	651.8641935	5617.57231	9477.826978	144.6540438	24.8105164	392.7033027	4522.319847	46.09992391	0	0	0	381.7654012	0	156.2259209	0	0	1006											$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%Coinsurance	$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	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	1.133582465	0	0	0	0	0	0	0	7.898189148	0.241090073	0.02067543	0	3.768599873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.0621	0	0	0	0	0	0	0	0	0	1.133582465	0	0	0	0	0	0	0	7.898189148	0.241090073	0.02067543	0	3.768599873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.0621	none																																																																																	0	0	0	0	0	0	0	0	0	0	1.133582465	0	0	0	0	0	0	0	7.898189148	0.241090073	0.02067543	0	3.768599873	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.0621
H3330_802_1	2009	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																																																			0	n/a	350.0056933	16.62786125	42.98919235	8.64660542	18.34940101	8.33072418	8.33072418	8.118185704	9.142747868	0	0	0	0	36.61757277	120.0563876	202.5561233	3.091485253	0.530239899	8.392689461	96.64911363	27.54476369	0	0	0	0	0	0	0	0	0											Medicare Defined Cost Sharing	Medicare Defined Cost Sharing	Medicare Defined Cost Sharing	0%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	0%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	50%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											21.1403	1.004322819	6.856776179	0	4.238711633	1.924397286	1.924397286	1.875300898	2.111974757	0	0	0	0	8.45865931	27.73302554	46.79046448	0.714133093	0.122485417	1.938711265	22.32594525	6.362840411	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	155.5225	0	0	21.1403	1.004322819	6.856776179	0	4.238711633	1.924397286	1.924397286	1.875300898	2.111974757	0	0	0	0	8.45865931	27.73302554	46.79046448	0.714133093	0.122485417	1.938711265	22.32594525	6.362840411	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	155.5225	none																																																																																	0	0	0	21.1403	1.004322819	6.856776179	0	4.238711633	1.924397286	1.924397286	1.875300898	2.111974757	0	0	0	0	8.45865931	27.73302554	46.79046448	0.714133093	0.122485417	1.938711265	22.32594525	6.362840411	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	155.5225
H3330_802_2	2009	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																																																			0	n/a	319.4650917	16.27436013	41.09320927	10.05146298	8.816983926	7.752006429	7.752006429	8.615944696	19.20172567	0	0	0	0	18.08331767	0	260.3022305	3.972827351	0.681404374	10.78533569	100.8820764	37.2230764	0	0	0	0	0	0	0	0	0											Medicare Defined Cost Sharing	Medicare Defined Cost Sharing	Medicare Defined Cost Sharing	0%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	0%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	50%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											19.2957	0.982971352	6.554366879	0	2.036723287	1.790713485	1.790713485	1.990283225	4.435598631	0	0	0	0	4.177246383	0	60.12981524	0.917723118	0.15740441	2.491412545	23.30375964	8.598530648	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.653	0	0	19.2957	0.982971352	6.554366879	0	2.036723287	1.790713485	1.790713485	1.990283225	4.435598631	0	0	0	0	4.177246383	0	60.12981524	0.917723118	0.15740441	2.491412545	23.30375964	8.598530648	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.653	none																																																																																	0	0	0	19.2957	0.982971352	6.554366879	0	2.036723287	1.790713485	1.790713485	1.990283225	4.435598631	0	0	0	0	4.177246383	0	60.12981524	0.917723118	0.15740441	2.491412545	23.30375964	8.598530648	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.653
H3330_802_3	2009	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																																																			0	n/a	405.2775599	18.21429495	48.75704695	10.89266233	6.321252632	7.507763186	7.507763186	11.03315991	16.14925305	0	0	0	0	68.50211395	134.1428573	226.3224613	3.454215751	0.592454067	9.377421453	107.9891584	41.48164552	0	0	0	0	0	0	0	0	0											Medicare Defined Cost Sharing	Medicare Defined Cost Sharing	Medicare Defined Cost Sharing	0%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	0%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	50%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											24.4788	1.100143415	7.776748989	0	1.460209358	1.734293296	1.734293296	2.54865994	3.730477454	0	0	0	0	15.82398832	30.98700004	52.28048857	0.797923839	0.136856889	2.166184356	24.94549559	9.582260114	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	181.2838	0	0	24.4788	1.100143415	7.776748989	0	1.460209358	1.734293296	1.734293296	2.54865994	3.730477454	0	0	0	0	15.82398832	30.98700004	52.28048857	0.797923839	0.136856889	2.166184356	24.94549559	9.582260114	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	181.2838	none																																																																																	0	0	0	24.4788	1.100143415	7.776748989	0	1.460209358	1.734293296	1.734293296	2.54865994	3.730477454	0	0	0	0	15.82398832	30.98700004	52.28048857	0.797923839	0.136856889	2.166184356	24.94549559	9.582260114	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	181.2838
H3330_806_1	2009	3																					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																																																			0	n/a	420.4467285	19.97433184	49.7445219	9.6222087	19.1678481	9.2904084	9.2904084	10.424804	12.41664	0	0	0	0	38.61164682	125.727165	212.1237165	3.237509341	0.5552854	8.789112127	101.2142652	34.456185	0	0	0	0	0	0	0	0	0											Medicare Defined Cost Sharing	Medicare Defined Cost Sharing	Medicare Defined Cost Sharing	0%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	0%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	50%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											25.395	1.206449643	7.934251243	0	4.427772911	2.14608434	2.14608434	2.408129724	2.86824384	0	0	0	0	8.919290416	29.0429751	49.0005785	0.747864658	0.128270927	2.030284901	23.38049525	7.959378735	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	169.7411	0	0	25.395	1.206449643	7.934251243	0	4.427772911	2.14608434	2.14608434	2.408129724	2.86824384	0	0	0	0	8.919290416	29.0429751	49.0005785	0.747864658	0.128270927	2.030284901	23.38049525	7.959378735	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	169.7411	none																																																																																	0	0	0	25.395	1.206449643	7.934251243	0	4.427772911	2.14608434	2.14608434	2.408129724	2.86824384	0	0	0	0	8.919290416	29.0429751	49.0005785	0.747864658	0.128270927	2.030284901	23.38049525	7.959378735	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	169.7411
H3330_806_2	2009	3																					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																																																			0	n/a	386.1058053	19.6692067	53.30664	12.5396	10.32516	9.69151	9.69151	11.13163283	26.23702932	0	0	0	0	19.18465249	0	305.595542	4.664110352	0.799970629	12.66201408	118.435838	52.19942	0	0	0	0	0	0	0	0	0											Medicare Defined Cost Sharing	Medicare Defined Cost Sharing	Medicare Defined Cost Sharing	0%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	0%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	50%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.3208	1.188020085	8.50240908	0	2.38511196	2.23873881	2.23873881	2.571407183	6.060753773	0	0	0	0	4.431654726	0	70.59257021	1.077409491	0.184793215	2.924925252	27.35867858	12.05806602	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	167.1341	0	0	23.3208	1.188020085	8.50240908	0	2.38511196	2.23873881	2.23873881	2.571407183	6.060753773	0	0	0	0	4.431654726	0	70.59257021	1.077409491	0.184793215	2.924925252	27.35867858	12.05806602	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	167.1341	none																																																																																	0	0	0	23.3208	1.188020085	8.50240908	0	2.38511196	2.23873881	2.23873881	2.571407183	6.060753773	0	0	0	0	4.431654726	0	70.59257021	1.077409491	0.184793215	2.924925252	27.35867858	12.05806602	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	167.1341
H3330_806_3	2009	3																					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																																																			0	n/a	372.553802	16.74359872	44.144049	9.484446	5.166583	6.5510575	6.5510575	10.842	16.783416	0	0	0	0	55.27558135	109.9158189	185.4472103	2.830362797	0.48545316	7.683800529	88.48564144	40.600643	0	0	0	0	0	0	0	0	0											Medicare Defined Cost Sharing	Medicare Defined Cost Sharing	Medicare Defined Cost Sharing	0%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	0%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	50%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											22.5022	1.011313363	7.040975816	0	1.193480673	1.513294283	1.513294283	2.504502	3.876969096	0	0	0	0	12.76865929	25.39055416	42.83830558	0.653813806	0.11213968	1.774957922	20.44018317	9.378748533	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	154.5134	0	0	22.5022	1.011313363	7.040975816	0	1.193480673	1.513294283	1.513294283	2.504502	3.876969096	0	0	0	0	12.76865929	25.39055416	42.83830558	0.653813806	0.11213968	1.774957922	20.44018317	9.378748533	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	154.5134	none																																																																																	0	0	0	22.5022	1.011313363	7.040975816	0	1.193480673	1.513294283	1.513294283	2.504502	3.876969096	0	0	0	0	12.76865929	25.39055416	42.83830558	0.653813806	0.11213968	1.774957922	20.44018317	9.378748533	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	154.5134
H3330_808_0	2009	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																																																			0	n/a	374.1954576	17.92964224	45.84451214	9.339393691	14.80856962	8.359824314	8.359824314	9.703633575	14.24482344	0	0	0	0	33.33553137	66.68855089	112.5152489	1.717248667	66.68855089	4.661945186	156.2052936	35.31521845	0	0	0	0	0	0	0	0	0											Medicare Defined Cost Sharing	Medicare Defined Cost Sharing	Medicare Defined Cost Sharing	0%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	0%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	50%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0	0	0	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0	0	0	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0	0	0	0	3.420779582	1.931119417	1.931119417	2.241539356	3.290554214	0	0	0	0	7.700507746	15.40505526	25.9910225	0.396684442	15.40505526	1.076909338	36.08342281	8.157815462	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.0316	0	0	0	0	0	0	3.420779582	1.931119417	1.931119417	2.241539356	3.290554214	0	0	0	0	7.700507746	15.40505526	25.9910225	0.396684442	15.40505526	1.076909338	36.08342281	8.157815462	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.0316	none																																																																																	0	0	0	0	0	0	0	3.420779582	1.931119417	1.931119417	2.241539356	3.290554214	0	0	0	0	7.700507746	15.40505526	25.9910225	0.396684442	15.40505526	1.076909338	36.08342281	8.157815462	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.0316
H3330_810_0	2009	3																					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																																																			0	n/a	436.0139296	0	51.63958624	10.51995983	16.68047869	9.416565877	9.416565877	10.7897184	15.83918358	0	0	0	0	37.0666301	0	210.5102933	1.753991647	0	4.761694139	243.0852518	39.77931455	0	0	0	0	0	0	0	0	0											Medicare Defined Cost Sharing	Medicare Defined Cost Sharing	Medicare Defined Cost Sharing	0%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	0%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	50%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											26.3352	0	8.236514006	0	3.853190578	2.175226718	2.175226718	2.492424951	3.658851407	0	0	0	0	8.562391553	0	48.62787776	0.40517207	0	1.099951346	56.15269317	9.189021661	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	172.9638	0	0	26.3352	0	8.236514006	0	3.853190578	2.175226718	2.175226718	2.492424951	3.658851407	0	0	0	0	8.562391553	0	48.62787776	0.40517207	0	1.099951346	56.15269317	9.189021661	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	172.9638	none																																																																																	0	0	0	26.3352	0	8.236514006	0	3.853190578	2.175226718	2.175226718	2.492424951	3.658851407	0	0	0	0	8.562391553	0	48.62787776	0.40517207	0	1.099951346	56.15269317	9.189021661	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	172.9638
H3330_811_1	2009	3																					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																																																			0	n/a	473.9696556	22.51706706	56.80754588	10.98842729	21.88941352	10.60951601	10.60951601	11.751883	13.99728	0	0	0	0	43.52691484	143.5786579	242.2423072	3.697190231	0.634128134	10.0370427	115.5852704	39.3484797	0	0	0	0	0	0	0	0	0											Medicare Defined Cost Sharing	Medicare Defined Cost Sharing	Medicare Defined Cost Sharing	0%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	0%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	50%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											28.6278	1.360030851	9.060803568	0	5.056454524	2.450798198	2.450798198	2.714684973	3.23337168	0	0	0	0	10.05471733	33.16666997	55.95797296	0.854050943	0.146483599	2.318556864	26.70019745	9.089498811	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	193.2429	0	0	28.6278	1.360030851	9.060803568	0	5.056454524	2.450798198	2.450798198	2.714684973	3.23337168	0	0	0	0	10.05471733	33.16666997	55.95797296	0.854050943	0.146483599	2.318556864	26.70019745	9.089498811	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	193.2429	none																																																																																	0	0	0	28.6278	1.360030851	9.060803568	0	5.056454524	2.450798198	2.450798198	2.714684973	3.23337168	0	0	0	0	10.05471733	33.16666997	55.95797296	0.854050943	0.146483599	2.318556864	26.70019745	9.089498811	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	193.2429
H3330_811_2	2009	3																					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																																																			0	n/a	390.4583856	19.89093816	53.79427188	12.6543082	10.41961122	9.780164795	9.780164795	11.25712	26.5328	0	0	0	0	19.40092156	0	308.3910311	4.706776123	0.807288501	12.77784208	119.5192507	52.67692339	0	0	0	0	0	0	0	0	0											Medicare Defined Cost Sharing	Medicare Defined Cost Sharing	Medicare Defined Cost Sharing	0%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	0%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	50%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.5837	1.201412665	8.580186365	0	2.406930192	2.259218068	2.259218068	2.60039472	6.1290768	0	0	0	0	4.481612879	0	71.23832818	1.087265284	0.186483644	2.951681521	27.60894691	12.1683693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	168.7428	0	0	23.5837	1.201412665	8.580186365	0	2.406930192	2.259218068	2.259218068	2.60039472	6.1290768	0	0	0	0	4.481612879	0	71.23832818	1.087265284	0.186483644	2.951681521	27.60894691	12.1683693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	168.7428	none																																																																																	0	0	0	23.5837	1.201412665	8.580186365	0	2.406930192	2.259218068	2.259218068	2.60039472	6.1290768	0	0	0	0	4.481612879	0	71.23832818	1.087265284	0.186483644	2.951681521	27.60894691	12.1683693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	168.7428
H3330_811_3	2009	3																					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																																																			0	n/a	460.3833092	20.6908998	56.3116452	12.0986808	6.5906684	8.356751	8.356751	13.398	20.740104	0	0	0	0	68.30679201	140.2123442	236.5627473	3.610506722	0.619260505	9.801716403	112.8752835	51.7915564	0	0	0	0	0	0	0	0	0											Medicare Defined Cost Sharing	Medicare Defined Cost Sharing	Medicare Defined Cost Sharing	0%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	0%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	50%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											27.8072	1.249730348	8.981707409	0	1.5224444	1.930409481	1.930409481	3.094938	4.790964024	0	0	0	0	15.77886895	32.38905152	54.64599463	0.834027053	0.143049177	2.264196489	26.07419049	11.96384953	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	195.401	0	0	27.8072	1.249730348	8.981707409	0	1.5224444	1.930409481	1.930409481	3.094938	4.790964024	0	0	0	0	15.77886895	32.38905152	54.64599463	0.834027053	0.143049177	2.264196489	26.07419049	11.96384953	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	195.401	none																																																																																	0	0	0	27.8072	1.249730348	8.981707409	0	1.5224444	1.930409481	1.930409481	3.094938	4.790964024	0	0	0	0	15.77886895	32.38905152	54.64599463	0.834027053	0.143049177	2.264196489	26.07419049	11.96384953	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	195.401
H3330_812_0	2009	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																																																			0	n/a	440.1814906	21.09137481	55.31912344	11.2695511	17.86903279	10.08753571	10.08753571	11.41478285	16.75677106	0	0	0	0	39.21395515	80.47096603	135.7685937	2.072149677	80.47096603	5.62542187	188.4879894	42.61375762	0	0	0	0	0	0	0	0	0											Medicare Defined Cost Sharing	Medicare Defined Cost Sharing	Medicare Defined Cost Sharing	0%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	0%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	50%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											26.587	1.273919038	8.823400188	0	4.127746575	2.330220748	2.330220748	2.636814838	3.870814115	0	0	0	0	9.058423639	18.58879315	31.36254516	0.478666575	18.58879315	1.299472452	43.54072554	9.843778011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	184.7413	0	0	26.587	1.273919038	8.823400188	0	4.127746575	2.330220748	2.330220748	2.636814838	3.870814115	0	0	0	0	9.058423639	18.58879315	31.36254516	0.478666575	18.58879315	1.299472452	43.54072554	9.843778011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	184.7413	none																																																																																	0	0	0	26.587	1.273919038	8.823400188	0	4.127746575	2.330220748	2.330220748	2.636814838	3.870814115	0	0	0	0	9.058423639	18.58879315	31.36254516	0.478666575	18.58879315	1.299472452	43.54072554	9.843778011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	184.7413
H3330_813_0	2009	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																																																			0	n/a	428.7293692	20.54264436	54.36575299	11.07533152	17.56107766	9.913686993	9.913686993	11.11780653	16.32081321	0	0	0	0	38.19373284	79.08412841	133.4287561	2.036438224	79.08412841	5.52847328	185.239585	41.8793516	0	0	0	0	0	0	0	0	0											Medicare Defined Cost Sharing	Medicare Defined Cost Sharing	Medicare Defined Cost Sharing	0%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	0%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	50%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											25.8953	1.240775719	8.671337601	0	4.05660894	2.290061695	2.290061695	2.568213308	3.770107851	0	0	0	0	8.822752286	18.26843366	30.82204267	0.47041723	18.26843366	1.277077328	42.79034414	9.67413022	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	181.1761	0	0	25.8953	1.240775719	8.671337601	0	4.05660894	2.290061695	2.290061695	2.568213308	3.770107851	0	0	0	0	8.822752286	18.26843366	30.82204267	0.47041723	18.26843366	1.277077328	42.79034414	9.67413022	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	181.1761	none																																																																																	0	0	0	25.8953	1.240775719	8.671337601	0	4.05660894	2.290061695	2.290061695	2.568213308	3.770107851	0	0	0	0	8.822752286	18.26843366	30.82204267	0.47041723	18.26843366	1.277077328	42.79034414	9.67413022	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	181.1761
H3333_031_0	2009	2																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		313.6148538	49.77880308	363.4073159	11.97588151	195.0936753	20.07273618	1.007100668	625.5779301	1360.319866		13.48923548		3.367738332	4.729838489	4084.283633	3985.3339	1.298563023	719.3358121		64.46102882	1.487558475	742.3153033			113.2222995		19.32087123														1a: $350 per admit $875 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.13616328		0.1		50	0.329488928	10	25	0.5	15		30.04458599	0.2	15			15		15														285.257787	90.58972292	24.99673236	0.122253337	81.50222485	0.16300445	0.16300445	40.75111243	77.53808971		0.081502225		40.75111243	0.268540807	8.150222485	20.37555621	0.407511124	12.22533373		24.48700603	0.16300445	12.22533373			12.22533373		12.22533373														7.4551	0.375787332	0.756999618	1.464091481	1.325047383	3.271945315	0.16416189	2.12441638	8.789716984	0	1.099402703	0	0.01143659	1.270154643	2.773985025	6.766949576	0.529178877	0.732843364	0	0.131538133	0.242478651	0.75625436	0	0	0.115348366	0	0.019683675	0	0	0	0	0	0	0	0	0	0	0	0	0	40.1765	0	9.1185	7.4551	0.375787332	0.756999618	1.464091481	1.325047383	3.271945315	0.16416189	2.12441638	8.789716984	0	1.099402703	0	0.01143659	1.270154643	2.773985025	6.766949576	0.529178877	0.732843364	0	0.131538133	0.242478651	0.75625436	0	0	0.115348366	0	0.019683675	0	0	0	0	0	0	0	0	0	0	0	0	0	40.1765																																																																																		0	0	0	7.4551	0.375787332	0.756999618	1.464091481	1.325047383	3.271945315	0.16416189	2.12441638	8.789716984	0	1.099402703	0	0.01143659	1.270154643	2.773985025	6.766949576	0.529178877	0.732843364	0	0.131538133	0.242478651	0.75625436	0	0	0.115348366	0	0.019683675	0	0	0	0	0	0	0	0	0	0	0	0	0	40.1765
H3333_032_0	2009	2																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		337.8765719	16.45791622	199.2627656	10.40447418	182.9500992	19.14677655	1.15447544	709.8912302	1430.228438		18.28670046		4.526590309	3.332371101	4308.490034	3529.882905	0.971150187	606.6469536		39.16097104	1.084520582	722.0628541			111.2840035		25.13691081														1a: $350 per admit $875 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	94.9558734		0.1		50	0.289250861	10	25	0.5	15		27.8	0.2	15			15		15														286.9389893	91.12362475	25.14405372	0.122973853	81.98256838	0.163965137	0.163965137	40.99128419	77.84726384		0.081982568		40.99128419	0.237135285	8.198256838	20.49564209	0.409912842	12.29738526		22.79115401	0.163965137	12.29738526			12.29738526		12.29738526														8.0792	0.124975415	0.417522807	1.279478274	1.249893251	3.139403835	0.189293723	2.424946097	9.27828088	0	1.499190671	0	0.015462562	0.79022277	2.94350899	6.028934721	0.398086933	0.621680942	0	0.074376977	0.177823566	0.739957091	0	0	0.114041855	0	0.025759856	0	0	0	0	0	0	0	0	0	0	0	0	0	39.612	0	8.7056	8.0792	0.124975415	0.417522807	1.279478274	1.249893251	3.139403835	0.189293723	2.424946097	9.27828088	0	1.499190671	0	0.015462562	0.79022277	2.94350899	6.028934721	0.398086933	0.621680942	0	0.074376977	0.177823566	0.739957091	0	0	0.114041855	0	0.025759856	0	0	0	0	0	0	0	0	0	0	0	0	0	39.612																																																																																		0	0	0	8.0792	0.124975415	0.417522807	1.279478274	1.249893251	3.139403835	0.189293723	2.424946097	9.27828088	0	1.499190671	0	0.015462562	0.79022277	2.94350899	6.028934721	0.398086933	0.621680942	0	0.074376977	0.177823566	0.739957091	0	0	0.114041855	0	0.025759856	0	0	0	0	0	0	0	0	0	0	0	0	0	39.612
H3333_033_0	2009	2																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		333.9237965	50.65461205	398.9900462	12.44708746	184.8587183	17.39069205	0.125141186	729.1778653	1347.984497		15.54511341		7.034650064	5.082416148	3933.645489	3634.396458	1.471537132	691.6193166		37.1029998	0.906061361	781.1484023			117.1675524		15.3082502														1a: $350 per admit $875 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	94.96580889		0.1		50	0.312219904	10	25	0.5	15		26.17647059	0.2	15			15		15														285.9807619	90.81931911	25.06008562	0.122563184	81.70878912	0.163417578	0.163417578	40.85439456	77.59541252		0.081708789		40.85439456	0.255111103	8.170878912	20.42719728	0.408543946	12.25631837		21.38847715	0.163417578	12.25631837			12.25631837		12.25631837														7.958	0.383368115	0.83322706	1.525554667	1.258715169	2.841944778	0.02045027	2.482510018	8.716451092	0	1.270172393	0	0.023949697	1.296580789	2.678445081	6.18671112	0.601187586	0.706392211	0	0.066131389	0.148066353	0.797833626	0	0	0.119670235	0	0.015635232	0	0	0	0	0	0	0	0	0	0	0	0	0	39.931	0	8.9389	7.958	0.383368115	0.83322706	1.525554667	1.258715169	2.841944778	0.02045027	2.482510018	8.716451092	0	1.270172393	0	0.023949697	1.296580789	2.678445081	6.18671112	0.601187586	0.706392211	0	0.066131389	0.148066353	0.797833626	0	0	0.119670235	0	0.015635232	0	0	0	0	0	0	0	0	0	0	0	0	0	39.931																																																																																		0	0	0	7.958	0.383368115	0.83322706	1.525554667	1.258715169	2.841944778	0.02045027	2.482510018	8.716451092	0	1.270172393	0	0.023949697	1.296580789	2.678445081	6.18671112	0.601187586	0.706392211	0	0.066131389	0.148066353	0.797833626	0	0	0.119670235	0	0.015635232	0	0	0	0	0	0	0	0	0	0	0	0	0	39.931
H3333_034_0	2009	2																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		377.3940865	72.66133689	356.5450938	11.64830787	215.7444041	21.52957479	0.391681692	757.0673011	1577.616527		23.10957342		5.441307866	3.929304392	3589.488628	4167.549335	2.528174171	776.0664442		35.90213924	2.161536347	786.3417617			110.6277381		18.38336562														1a: $350 per admit $875 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	94.65969188		0.1		50	0.282687005	10	25	0.5	15		27.52525253	0.2	15			15		15														276.4596434	87.79568391	24.22576361	0.118482704	78.98846956	0.157976939	0.157976939	39.49423478	74.77024191		0.07898847		39.49423478	0.223290139	7.898846956	19.74711739	0.394942348	11.84827043		21.74177571	0.157976939	11.84827043			11.84827043		11.84827043														8.6945	0.531612647	0.719798097	1.380123017	1.420110024	3.401176325	0.061876675	2.491649478	9.829897449	0	1.825389836	0	0.017908358	0.877374925	2.36273511	6.858090495	0.998483043	0.766253759	0	0.065048022	0.341472896	0.776399154	0	0	0.109228947	0	0.018150924	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5473	0	11.5839	8.6945	0.531612647	0.719798097	1.380123017	1.420110024	3.401176325	0.061876675	2.491649478	9.829897449	0	1.825389836	0	0.017908358	0.877374925	2.36273511	6.858090495	0.998483043	0.766253759	0	0.065048022	0.341472896	0.776399154	0	0	0.109228947	0	0.018150924	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5473																																																																																		0	0	0	8.6945	0.531612647	0.719798097	1.380123017	1.420110024	3.401176325	0.061876675	2.491649478	9.829897449	0	1.825389836	0	0.017908358	0.877374925	2.36273511	6.858090495	0.998483043	0.766253759	0	0.065048022	0.341472896	0.776399154	0	0	0.109228947	0	0.018150924	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5473
H3333_035_0	2009	2																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		377.3940865	72.66133689	356.5450938	11.88899542	215.7444041	21.97443774	0.399774963	757.0673011	1577.616527		23.58708368		5.441307866	4.010495125	3589.488628	4167.549335	2.580413522	776.0664442		35.90213924	2.206199906	786.3417617			110.6277381		18.38336562														1a: $350 per admit $875 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	94.65969188		0.1		50	0.27696413	10	25	0.5	15		27.52525253	0.2	15			15		15														276.178326	87.70634554	24.20111217	0.11836214	78.90809315	0.157816186	0.157816186	39.45404658	74.69415785		0.078908093		39.45404658	0.218547114	7.890809315	19.72702329	0.394540466	11.83621397		21.7196519	0.157816186	11.83621397			11.83621397		11.83621397														8.6857	0.531071693	0.719065651	1.407206937	1.418664961	3.46792196	0.06309096	2.489114047	9.819894827	0	1.861211796	0	0.017890134	0.876482133	2.360330859	6.851111899	1.018077553	0.765474041	0	0.064981831	0.348174055	0.775609112	0	0	0.109117798	0	0.018132454	0	0	0	0	0	0	0	0	0	0	0	0	0	43.6683	0	11.6724	8.6857	0.531071693	0.719065651	1.407206937	1.418664961	3.46792196	0.06309096	2.489114047	9.819894827	0	1.861211796	0	0.017890134	0.876482133	2.360330859	6.851111899	1.018077553	0.765474041	0	0.064981831	0.348174055	0.775609112	0	0	0.109117798	0	0.018132454	0	0	0	0	0	0	0	0	0	0	0	0	0	43.6683																																																																																		0	0	0	8.6857	0.531071693	0.719065651	1.407206937	1.418664961	3.46792196	0.06309096	2.489114047	9.819894827	0	1.861211796	0	0.017890134	0.876482133	2.360330859	6.851111899	1.018077553	0.765474041	0	0.064981831	0.348174055	0.775609112	0	0	0.109117798	0	0.018132454	0	0	0	0	0	0	0	0	0	0	0	0	0	43.6683
H3333_036_0	2009	2																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		377.3940865	72.66133689	356.5450938	13.07670599	215.7444041	24.16968393	0.439712479	757.0673011	1577.616527		25.9434332		5.441307866	4.411143563	3589.488628	4167.549335	2.838196817	776.0664442		35.90213924	2.426599263	786.3417617			110.6277381		18.38336562														1a: $350 per admit $875 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	94.65969188		0.1		50	0.251808466	10	25	0.5	15		27.52525253	0.2	15			15		15														274.8207369	87.27521401	24.08214857	0.117780316	78.52021054	0.157040421	0.157040421	39.26010527	74.32698936		0.078520211		39.26010527	0.197720537	7.852021054	19.63005263	0.392601053	11.77803158		21.61288623	0.157040421	11.77803158			11.77803158		11.77803158														8.643	0.528461144	0.715530993	1.540178561	1.411691336	3.795617342	0.069052633	2.476878495	9.771623904	0	2.037083837	0	0.017802193	0.872173676	2.348728357	6.8174344	1.114279058	0.761711257	0	0.064662404	0.38107417	0.771796509	0	0	0.108581416	0	0.018043322	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2654	0	12.1091	8.643	0.528461144	0.715530993	1.540178561	1.411691336	3.795617342	0.069052633	2.476878495	9.771623904	0	2.037083837	0	0.017802193	0.872173676	2.348728357	6.8174344	1.114279058	0.761711257	0	0.064662404	0.38107417	0.771796509	0	0	0.108581416	0	0.018043322	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2654																																																																																		0	0	0	8.643	0.528461144	0.715530993	1.540178561	1.411691336	3.795617342	0.069052633	2.476878495	9.771623904	0	2.037083837	0	0.017802193	0.872173676	2.348728357	6.8174344	1.114279058	0.761711257	0	0.064662404	0.38107417	0.771796509	0	0	0.108581416	0	0.018043322	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2654
H3333_037_0	2009	2																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		315.4690355	32.54121856	569.1494021	9.288319368	179.0134341	18.31255236	0.960308701	633.2993761	1161.933353		16.54357748		2.063824783	3.860005461	3629.501875	2788.886368	1.238305452	463.6354108		45.68562535	1.748855231	627.2689193			98.08787758		15.78701151														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	181.3245369		0.2		50	0.442018336	20	35	0.5	35		35	0.2	34.8172293			35		35														110.7908003	138.2572494	25.21766185	0.164445138	123.3338532	0.164445138	0.164445138	41.1112844	149.0896921		0.164445138		41.1112844	0.36343883	16.44451376	28.77789908	0.411112844	28.77789908		28.77789908	0.164445138	28.76570716			28.77789908		28.77789908														2.9126	0.374921614	1.19605143	1.527418956	1.83986805	3.011410192	0.157918097	2.169645897	14.43602382	0	2.720510875	0	0.007070541	1.402875869	4.973782793	6.68819087	0.509083276	1.111871088	0	0.10956136	0.287590739	1.503652837	0	0	0.235230253	0	0.037859752	0	0	0	0	0	0	0	0	0	0	0	0	0	47.2131	0	10.1992	2.9126	0.374921614	1.19605143	1.527418956	1.83986805	3.011410192	0.157918097	2.169645897	14.43602382	0	2.720510875	0	0.007070541	1.402875869	4.973782793	6.68819087	0.509083276	1.111871088	0	0.10956136	0.287590739	1.503652837	0	0	0.235230253	0	0.037859752	0	0	0	0	0	0	0	0	0	0	0	0	0	47.2131																																																																																		0	0	0	2.9126	0.374921614	1.19605143	1.527418956	1.83986805	3.011410192	0.157918097	2.169645897	14.43602382	0	2.720510875	0	0.007070541	1.402875869	4.973782793	6.68819087	0.509083276	1.111871088	0	0.10956136	0.287590739	1.503652837	0	0	0.235230253	0	0.037859752	0	0	0	0	0	0	0	0	0	0	0	0	0	47.2131
H3333_038_0	2009	2																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		315.4690355	32.54121856	569.1494021	9.208573555	179.0134341	18.15532807	0.952063873	633.2993761	1161.933353		16.40154091		2.063824783	3.82686499	3629.501875	2788.886368	1.227673854	463.6354108		45.68562535	1.733840257	627.2689193			98.08787758		15.78701151														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	181.3245369		0.2		50	0.445846194	20	35	0.5	35		35	0.2	34.8105604			35		35														110.8403247	138.3190515	25.22893434	0.164518646	123.3889844	0.164518646	0.164518646	41.12966147	149.1563364		0.164518646		41.12966147	0.36675006	16.45186459	28.79076303	0.411296615	28.79076303		28.79076303	0.164518646	28.77154954			28.79076303		28.79076303														2.9139	0.375089207	1.196586075	1.514982052	1.840690486	2.98688999	0.156632259	2.170615746	14.44247683	0	2.6983593	0	0.007073701	1.403502966	4.976006113	6.691180545	0.5049381	1.112368104	0	0.109610334	0.285249051	1.503958232	0	0	0.235335403	0	0.037876676	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1633	0	10.1629	2.9139	0.375089207	1.196586075	1.514982052	1.840690486	2.98688999	0.156632259	2.170615746	14.44247683	0	2.6983593	0	0.007073701	1.403502966	4.976006113	6.691180545	0.5049381	1.112368104	0	0.109610334	0.285249051	1.503958232	0	0	0.235335403	0	0.037876676	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1633																																																																																		0	0	0	2.9139	0.375089207	1.196586075	1.514982052	1.840690486	2.98688999	0.156632259	2.170615746	14.44247683	0	2.6983593	0	0.007073701	1.403502966	4.976006113	6.691180545	0.5049381	1.112368104	0	0.109610334	0.285249051	1.503958232	0	0	0.235335403	0	0.037876676	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1633
H3333_039_0	2009	2																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		315.4690355	32.54121856	569.1494021	8.794444844	179.0134341	17.3388452	0.90924758	633.2993761	1161.933353		15.66392949		2.063824783	3.65476291	3629.501875	2788.886368	1.172462807	463.6354108		45.68562535	1.655865853	627.2689193			98.08787758		15.78701151														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	181.3245369		0.2		50	0.466841005	20	35	0.5	35		35	0.2	34.77592808			35		35														111.0999217	138.6430059	25.28802254	0.164903962	123.6779713	0.164903962	0.164903962	41.22599045	149.5056725		0.164903962		41.22599045	0.384919656	16.49039618	28.85819331	0.412259904	28.85819331		28.85819331	0.164903962	28.80249892			28.85819331		28.85819331														2.9207	0.375967696	1.199388576	1.450238797	1.845001531	2.859244266	0.149938528	2.175699503	14.47630228	0	2.58304403	0	0.007090268	1.406790083	4.98766032	6.706851828	0.483359405	1.114973359	0	0.109867051	0.273058839	1.505576031	0	0	0.235886578	0	0.037965386	0	0	0	0	0	0	0	0	0	0	0	0	0	46.9046	0	9.9744	2.9207	0.375967696	1.199388576	1.450238797	1.845001531	2.859244266	0.149938528	2.175699503	14.47630228	0	2.58304403	0	0.007090268	1.406790083	4.98766032	6.706851828	0.483359405	1.114973359	0	0.109867051	0.273058839	1.505576031	0	0	0.235886578	0	0.037965386	0	0	0	0	0	0	0	0	0	0	0	0	0	46.9046																																																																																		0	0	0	2.9207	0.375967696	1.199388576	1.450238797	1.845001531	2.859244266	0.149938528	2.175699503	14.47630228	0	2.58304403	0	0.007090268	1.406790083	4.98766032	6.706851828	0.483359405	1.114973359	0	0.109867051	0.273058839	1.505576031	0	0	0.235886578	0	0.037965386	0	0	0	0	0	0	0	0	0	0	0	0	0	46.9046
H3333_040_0	2009	2																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		315.4690355	32.54121856	569.1494021	8.839912467	179.0134341	17.42848771	0.913948426	633.2993761	1161.933353		15.74491262		2.063824783	3.673658177	3629.501875	2788.886368	1.178524485	463.6354108		45.68562535	1.664426744	627.2689193			98.08787758		15.78701151														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	181.3245369		0.2		50	0.464439833	20	35	0.5	35		35	0.2	34.7797304			35		35														111.0712209	138.6071899	25.28148982	0.164861362	123.6460213	0.164861362	0.164861362	41.21534043	149.4670503		0.164861362		41.21534043	0.382840916	16.48613617	28.8507383	0.412153404	28.8507383		28.8507383	0.164861362	28.7990506			28.8507383		28.8507383														2.92	0.375870572	1.199078734	1.457360007	1.844524907	2.873284215	0.150674782	2.175137448	14.47256257	0	2.595727734	0	0.007088437	1.406426663	4.986371845	6.705119229	0.485732879	1.114685325	0	0.109838668	0.274399659	1.505395779	0	0	0.235825641	0	0.037955578	0	0	0	0	0	0	0	0	0	0	0	0	0	46.933	0	9.9951	2.92	0.375870572	1.199078734	1.457360007	1.844524907	2.873284215	0.150674782	2.175137448	14.47256257	0	2.595727734	0	0.007088437	1.406426663	4.986371845	6.705119229	0.485732879	1.114685325	0	0.109838668	0.274399659	1.505395779	0	0	0.235825641	0	0.037955578	0	0	0	0	0	0	0	0	0	0	0	0	0	46.933																																																																																		0	0	0	2.92	0.375870572	1.199078734	1.457360007	1.844524907	2.873284215	0.150674782	2.175137448	14.47256257	0	2.595727734	0	0.007088437	1.406426663	4.986371845	6.705119229	0.485732879	1.114685325	0	0.109838668	0.274399659	1.505395779	0	0	0.235825641	0	0.037955578	0	0	0	0	0	0	0	0	0	0	0	0	0	46.933
H3333_041_0	2009	2																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		315.4690355	32.54121856	569.1494021	10.85691965	179.0134341	21.40515433	1.122484488	633.2993761	1161.933353		19.33743709		2.063824783	4.511878573	3629.501875	2788.886368	1.447428998	463.6354108		45.68562535	2.044199814	627.2689193			98.08787758		15.78701151														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	181.3245369		0.2		50	0.378155831	20	35	0.5	35		35	0.2	34.94840653			35		35														109.8459935	137.0782129	25.00260952	0.163042775	122.2820811	0.163042775	0.163042775	40.7606937	147.8182782		0.163042775		40.7606937	0.30827788	16.30427748	28.53248559	0.407606937	28.53248559		28.53248559	0.163042775	28.53248559			28.53248559		28.53248559														2.8878	0.371724341	1.185851688	1.770142306	1.824177939	3.489955757	0.183012986	2.151143491	14.31291563	0	3.1528294	0	0.007010244	1.39091236	4.93136714	6.63115501	0.5899821	1.102389223	0	0.108627037	0.33329201	1.491461783	0	0	0.233224246	0	0.03753689	0	0	0	0	0	0	0	0	0	0	0	0	0	48.1865	0	10.9198	2.8878	0.371724341	1.185851688	1.770142306	1.824177939	3.489955757	0.183012986	2.151143491	14.31291563	0	3.1528294	0	0.007010244	1.39091236	4.93136714	6.63115501	0.5899821	1.102389223	0	0.108627037	0.33329201	1.491461783	0	0	0.233224246	0	0.03753689	0	0	0	0	0	0	0	0	0	0	0	0	0	48.1865																																																																																		0	0	0	2.8878	0.371724341	1.185851688	1.770142306	1.824177939	3.489955757	0.183012986	2.151143491	14.31291563	0	3.1528294	0	0.007010244	1.39091236	4.93136714	6.63115501	0.5899821	1.102389223	0	0.108627037	0.33329201	1.491461783	0	0	0.233224246	0	0.03753689	0	0	0	0	0	0	0	0	0	0	0	0	0	48.1865
H3333_042_0	2009	2																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		315.4690355	32.54121856	569.1494021	11.85551225	179.0134341	23.37394744	1.225727833	633.2993761	1161.933353		21.11604669		2.063824783	4.926869996	3629.501875	2788.886368	1.580559934	463.6354108		45.68562535	2.232220253	627.2689193			98.08787758		15.78701151														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	181.3245369		0.2		50	0.346303676	20	35	0.5	35		35	0.2	35			35		35														109.2730943	136.3632848	24.872209	0.162192429	121.6443218	0.162192429	0.162192429	40.54810728	147.0473355		0.162192429		40.54810728	0.280839172	16.21924291	28.38367509	0.405481073	28.38367509		28.38367509	0.162192429	28.38367509			28.38367509		28.38367509														2.8727	0.369785621	1.179666907	1.922874329	1.814663983	3.791077314	0.198803775	2.139924253	14.23826696	0	3.424862905	0	0.006973682	1.38365809	4.905647712	6.596570379	0.640887138	1.096639739	0	0.108060496	0.362049225	1.4836831	0	0	0.232007871	0	0.037341117	0	0	0	0	0	0	0	0	0	0	0	0	0	48.8061	0	11.3769	2.8727	0.369785621	1.179666907	1.922874329	1.814663983	3.791077314	0.198803775	2.139924253	14.23826696	0	3.424862905	0	0.006973682	1.38365809	4.905647712	6.596570379	0.640887138	1.096639739	0	0.108060496	0.362049225	1.4836831	0	0	0.232007871	0	0.037341117	0	0	0	0	0	0	0	0	0	0	0	0	0	48.8061																																																																																		0	0	0	2.8727	0.369785621	1.179666907	1.922874329	1.814663983	3.791077314	0.198803775	2.139924253	14.23826696	0	3.424862905	0	0.006973682	1.38365809	4.905647712	6.596570379	0.640887138	1.096639739	0	0.108060496	0.362049225	1.4836831	0	0	0.232007871	0	0.037341117	0	0	0	0	0	0	0	0	0	0	0	0	0	48.8061
H3333_049_0	2009	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		305.4044081	23.96003052	426.2281389	9.422222981	140.941305	17.12766964	0.434420441	626.9601205	1589.10665		13.43517685		3.701857931	3.483611105	3976.652406	4220.230777	1.503812481	856.2250738		45.08218463	1.143167675	756.4210277			110.7863169		23.8120013														1a: $350 per admit $875 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.10800508		0.1		50	0.289318237	10	25	0.5	15		27.46268657	0.2	15			15		15														285.3052338	90.60479067	25.00089006	0.122273672	81.51578108	0.163031562	0.163031562	40.75789054	77.52803321		0.081515781		40.75789054	0.235840021	8.151578108	20.37894527	0.407578905	12.22736716		22.38642346	0.163031562	12.22736716			12.22736716		12.22736716														7.2611	0.180907796	0.888006903	1.152089799	0.957411714	2.792350738	0.070824243	2.12946433	10.26669276	0	1.095178935	0	0.012573327	0.821574915	2.701332724	7.166987668	0.612922245	0.872448196	0	0.084102406	0.186372412	0.770753136	0	0	0.112885414	0	0.024263174	0	0	0	0	0	0	0	0	0	0	0	0	0	40.1603	0	9.1066	7.2611	0.180907796	0.888006903	1.152089799	0.957411714	2.792350738	0.070824243	2.12946433	10.26669276	0	1.095178935	0	0.012573327	0.821574915	2.701332724	7.166987668	0.612922245	0.872448196	0	0.084102406	0.186372412	0.770753136	0	0	0.112885414	0	0.024263174	0	0	0	0	0	0	0	0	0	0	0	0	0	40.1603																																																																																		0	0	0	7.2611	0.180907796	0.888006903	1.152089799	0.957411714	2.792350738	0.070824243	2.12946433	10.26669276	0	1.095178935	0	0.012573327	0.821574915	2.701332724	7.166987668	0.612922245	0.872448196	0	0.084102406	0.186372412	0.770753136	0	0	0.112885414	0	0.024263174	0	0	0	0	0	0	0	0	0	0	0	0	0	40.1603
H3333_050_0	2009	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		305.4044081	23.96003052	426.2281389	10.36112374	140.941305	18.83439873	0.477709343	626.9601205	1589.10665		14.77395834		3.701857931	3.830744168	3976.652406	4220.230777	1.653663603	856.2250738		45.08218463	1.257081451	756.4210277			110.7863169		23.8120013														1a: $350 per admit $875 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.10800508		0.1		50	0.263100896	10	25	0.5	15		27.46268657	0.2	15			15		15														284.1034663	90.22314366	24.89558089	0.121758628	81.17241894	0.162344838	0.162344838	40.58620947	77.20146833		0.081172419		40.58620947	0.213565362	8.117241894	20.29310474	0.405862095	12.17586284		22.29212699	0.162344838	12.17586284			12.17586284		12.17586284														7.2305	0.180145773	0.884266426	1.261556216	0.953378888	3.057667409	0.077553646	2.120494565	10.22344723	0	1.199237936	0	0.012520365	0.818114264	2.689954126	7.136798763	0.671159374	0.868773255	0	0.083748149	0.204080684	0.767506557	0	0	0.112409917	0	0.024160972	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5775	0	9.4118	7.2305	0.180145773	0.884266426	1.261556216	0.953378888	3.057667409	0.077553646	2.120494565	10.22344723	0	1.199237936	0	0.012520365	0.818114264	2.689954126	7.136798763	0.671159374	0.868773255	0	0.083748149	0.204080684	0.767506557	0	0	0.112409917	0	0.024160972	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5775																																																																																		0	0	0	7.2305	0.180145773	0.884266426	1.261556216	0.953378888	3.057667409	0.077553646	2.120494565	10.22344723	0	1.199237936	0	0.012520365	0.818114264	2.689954126	7.136798763	0.671159374	0.868773255	0	0.083748149	0.204080684	0.767506557	0	0	0.112409917	0	0.024160972	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5775
H3333_051_0	2009	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		305.4044081	23.96003052	426.2281389	10.05801779	140.941305	18.28341425	0.463734358	626.9601205	1589.10665		14.34175862		3.701857931	3.718678971	3976.652406	4220.230777	1.605287066	856.2250738		45.08218463	1.220306591	756.4210277			110.7863169		23.8120013														1a: $350 per admit $875 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.10800508		0.1		50	0.27102964	10	25	0.5	15		27.46268657	0.2	15			15		15														284.4876192	90.34513963	24.92924366	0.121923265	81.28217691	0.162564354	0.162564354	40.64108845	77.30585694		0.081282177		40.64108845	0.220298792	8.128217691	20.32054423	0.406410885	12.19232654		22.32226948	0.162564354	12.19232654			12.19232654		12.19232654														7.2403	0.180389359	0.885462094	1.226306372	0.954668007	2.972231423	0.075386676	2.123361809	10.23727095	0	1.165729362	0	0.012537295	0.819220484	2.69359137	7.146448845	0.652406136	0.869947974	0	0.08386139	0.198378352	0.768544347	0	0	0.112561913	0	0.024193641	0	0	0	0	0	0	0	0	0	0	0	0	0	40.4428	0	9.3133	7.2403	0.180389359	0.885462094	1.226306372	0.954668007	2.972231423	0.075386676	2.123361809	10.23727095	0	1.165729362	0	0.012537295	0.819220484	2.69359137	7.146448845	0.652406136	0.869947974	0	0.08386139	0.198378352	0.768544347	0	0	0.112561913	0	0.024193641	0	0	0	0	0	0	0	0	0	0	0	0	0	40.4428																																																																																		0	0	0	7.2403	0.180389359	0.885462094	1.226306372	0.954668007	2.972231423	0.075386676	2.123361809	10.23727095	0	1.165729362	0	0.012537295	0.819220484	2.69359137	7.146448845	0.652406136	0.869947974	0	0.08386139	0.198378352	0.768544347	0	0	0.112561913	0	0.024193641	0	0	0	0	0	0	0	0	0	0	0	0	0	40.4428
H3333_052_0	2009	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		305.4044081	23.96003052	426.2281389	11.31869109	140.941305	20.57505986	0.521858885	626.9601205	1589.10665		16.13935659		3.701857931	4.184778695	3976.652406	4220.230777	1.806493963	856.2250738		45.08218463	1.373259984	756.4210277			110.7863169		23.8120013														1a: $350 per admit $875 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.10800508		0.1		50	0.240842419	10	25	0.5	15		27.46268657	0.2	15			15		15														282.9130641	89.84510593	24.79126765	0.121248456	80.83230403	0.161664608	0.161664608	40.41615201	76.87799182		0.080832304		40.41615201	0.194678476	8.083230403	20.20807601	0.40416152	12.1248456		22.1987223	0.161664608	12.1248456			12.1248456		12.1248456														7.2002	0.179390957	0.880561322	1.37237382	0.949384201	3.326258988	0.084366112	2.111609628	10.18061067	0	1.304581378	0	0.012467904	0.81468634	2.678683136	7.106895358	0.730115346	0.865133069	0	0.083397241	0.222007537	0.764290681	0	0	0.111938916	0	0.024059737	0	0	0	0	0	0	0	0	0	0	0	0	0	41.0031	0	9.723	7.2002	0.179390957	0.880561322	1.37237382	0.949384201	3.326258988	0.084366112	2.111609628	10.18061067	0	1.304581378	0	0.012467904	0.81468634	2.678683136	7.106895358	0.730115346	0.865133069	0	0.083397241	0.222007537	0.764290681	0	0	0.111938916	0	0.024059737	0	0	0	0	0	0	0	0	0	0	0	0	0	41.0031																																																																																		0	0	0	7.2002	0.179390957	0.880561322	1.37237382	0.949384201	3.326258988	0.084366112	2.111609628	10.18061067	0	1.304581378	0	0.012467904	0.81468634	2.678683136	7.106895358	0.730115346	0.865133069	0	0.083397241	0.222007537	0.764290681	0	0	0.111938916	0	0.024059737	0	0	0	0	0	0	0	0	0	0	0	0	0	41.0031
H3333_053_0	2009	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		305.4044081	23.96003052	426.2281389	12.422712	140.941305	22.58194351	0.572760806	626.9601205	1589.10665		17.7135834		3.701857931	4.592960446	3976.652406	4220.230777	1.98269871	856.2250738		45.08218463	1.50720725	756.4210277			110.7863169		23.8120013														1a: $350 per admit $875 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.10800508		0.1		50	0.219438472	10	25	0.5	15		27.46268657	0.2	15			15		15														281.5828095	89.42265508	24.67469934	0.120678347	80.45223129	0.160904463	0.160904463	40.22611564	76.51651222		0.080452231		40.22611564	0.176543147	8.045223129	20.11305782	0.402261156	12.06783469		22.09434411	0.160904463	12.06783469			12.06783469		12.06783469														7.1664	0.178547462	0.876420931	1.499152348	0.944920206	3.633535485	0.09215977	2.101680859	10.13274153	0	1.425097309	0	0.01240928	0.810855692	2.666087993	7.073478803	0.797562676	0.861065221	0	0.083005108	0.242516373	0.760696993	0	0	0.11141258	0	0.023946608	0	0	0	0	0	0	0	0	0	0	0	0	0	41.4937	0	10.0819	7.1664	0.178547462	0.876420931	1.499152348	0.944920206	3.633535485	0.09215977	2.101680859	10.13274153	0	1.425097309	0	0.01240928	0.810855692	2.666087993	7.073478803	0.797562676	0.861065221	0	0.083005108	0.242516373	0.760696993	0	0	0.11141258	0	0.023946608	0	0	0	0	0	0	0	0	0	0	0	0	0	41.4937																																																																																		0	0	0	7.1664	0.178547462	0.876420931	1.499152348	0.944920206	3.633535485	0.09215977	2.101680859	10.13274153	0	1.425097309	0	0.01240928	0.810855692	2.666087993	7.073478803	0.797562676	0.861065221	0	0.083005108	0.242516373	0.760696993	0	0	0.11141258	0	0.023946608	0	0	0	0	0	0	0	0	0	0	0	0	0	41.4937
H3333_054_0	2009	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		305.4044081	23.96003052	426.2281389	12.84980449	140.941305	23.3583101	0.592452306	626.9601205	1589.10665		18.3225759		3.701857931	4.750866297	3976.652406	4220.230777	2.050863835	856.2250738		45.08218463	1.559024993	756.4210277			110.7863169		23.8120013														1a: $350 per admit $875 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.10800508		0.1		50	0.212144935	10	25	0.5	15		27.46268657	0.2	15			15		15														281.0798785	89.26293856	24.63062821	0.120462805	80.30853672	0.160617073	0.160617073	40.15426836	76.37984718		0.080308537		40.15426836	0.170370493	8.030853672	20.07713418	0.401542684	12.04628051		22.05488173	0.160617073	12.04628051			12.04628051		12.04628051														7.1536	0.178228561	0.874855569	1.547923493	0.943232497	3.751743408	0.095157956	2.097927077	10.11464359	0	1.471459259	0	0.012387116	0.809407435	2.661326131	7.060844964	0.823509368	0.859527285	0	0.082856854	0.250406032	0.759338323	0	0	0.111213587	0	0.023903837	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6835	0	10.2207	7.1536	0.178228561	0.874855569	1.547923493	0.943232497	3.751743408	0.095157956	2.097927077	10.11464359	0	1.471459259	0	0.012387116	0.809407435	2.661326131	7.060844964	0.823509368	0.859527285	0	0.082856854	0.250406032	0.759338323	0	0	0.111213587	0	0.023903837	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6835																																																																																		0	0	0	7.1536	0.178228561	0.874855569	1.547923493	0.943232497	3.751743408	0.095157956	2.097927077	10.11464359	0	1.471459259	0	0.012387116	0.809407435	2.661326131	7.060844964	0.823509368	0.859527285	0	0.082856854	0.250406032	0.759338323	0	0	0.111213587	0	0.023903837	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6835
H3333_055_0	2009	4																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		252.526156	131.4297051	182.8802065	7.366291162	152.3532836	11.85671273	0.11457955	566.6237085	1099.164788		13.1658891		1.704131454	2.906138113	3269.27279	2633.817474	2.281177433	327.9494591		51.9608234	0.430394785	566.9002409			89.76685331		16.29446884														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	180.9302326		0.2		50	0.448387793	20	35	0.5	35		35	0.2	34.91268696			35		35														114.4944094	142.8790303	26.0606593	0.169942349	127.4567621	0.169942349	0.169942349	42.48558737	153.7385441		0.169942349		42.48558737	0.381000375	16.99423495	29.73991116	0.424855874	29.73991116		29.73991116	0.169942349	29.73991116			29.73991116		29.73991116														2.4094	1.564879069	0.397164896	1.251844827	1.618204686	2.014957619	0.019471918	2.006111756	14.08199952	0	2.237442127	0	0.006033419	1.107239712	4.629899159	6.527458142	0.969171632	0.812765648	0	0.128775856	0.073142301	1.404963567	0	0	0.22247152	0	0.040383005	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5238	0	7.6939	2.4094	1.564879069	0.397164896	1.251844827	1.618204686	2.014957619	0.019471918	2.006111756	14.08199952	0	2.237442127	0	0.006033419	1.107239712	4.629899159	6.527458142	0.969171632	0.812765648	0	0.128775856	0.073142301	1.404963567	0	0	0.22247152	0	0.040383005	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5238																																																																																		0	0	0	2.4094	1.564879069	0.397164896	1.251844827	1.618204686	2.014957619	0.019471918	2.006111756	14.08199952	0	2.237442127	0	0.006033419	1.107239712	4.629899159	6.527458142	0.969171632	0.812765648	0	0.128775856	0.073142301	1.404963567	0	0	0.22247152	0	0.040383005	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5238
H3333_056_0	2009	4																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		252.526156	131.4297051	182.8802065	7.689902417	152.3532836	12.37759435	0.119613186	566.6237085	1099.164788		13.74428463		1.704131454	3.033808739	3269.27279	2633.817474	2.381392681	327.9494591		51.9608234	0.449302617	566.9002409			89.76685331		16.29446884														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	180.9302326		0.2		50	0.429518459	20	35	0.5	35		35	0.2	34.95304651			35		35														114.3364475	142.6819077	26.02470478	0.169707889	127.2809168	0.169707889	0.169707889	42.42697226	153.5264391		0.169707889		42.42697226	0.364463355	16.9707889	29.69888058	0.424269723	29.69888058		29.69888058	0.169707889	29.69888058			29.69888058		29.69888058														2.4061	1.562720088	0.396616949	1.305037106	1.615972134	2.100575409	0.020299301	2.00334403	14.06257133	0	2.332513532	0	0.006025095	1.105712112	4.623511532	6.518452554	1.010352812	0.811644319	0	0.128598191	0.076250199	1.403025213	0	0	0.222164588	0	0.04032729	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7518	0	7.8073	2.4061	1.562720088	0.396616949	1.305037106	1.615972134	2.100575409	0.020299301	2.00334403	14.06257133	0	2.332513532	0	0.006025095	1.105712112	4.623511532	6.518452554	1.010352812	0.811644319	0	0.128598191	0.076250199	1.403025213	0	0	0.222164588	0	0.04032729	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7518																																																																																		0	0	0	2.4061	1.562720088	0.396616949	1.305037106	1.615972134	2.100575409	0.020299301	2.00334403	14.06257133	0	2.332513532	0	0.006025095	1.105712112	4.623511532	6.518452554	1.010352812	0.811644319	0	0.128598191	0.076250199	1.403025213	0	0	0.222164588	0	0.04032729	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7518
H3333_057_0	2009	4																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		252.526156	131.4297051	182.8802065	7.471327232	152.3532836	12.0257778	0.116213341	566.6237085	1099.164788		13.35362174		1.704131454	2.947576786	3269.27279	2633.817474	2.313704781	327.9494591		51.9608234	0.436531792	566.9002409			89.76685331		16.29446884														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	180.9302326		0.2		50	0.442084108	20	35	0.5	35		35	0.2	34.92578666			35		35														114.4429086	142.8147619	26.04893694	0.169865908	127.3994308	0.169865908	0.169865908	42.46647692	153.6693909		0.169865908		42.46647692	0.375475092	16.98659077	29.72653384	0.424664769	29.72653384		29.72653384	0.169865908	29.72653384			29.72653384		29.72653384														2.4083	1.56417517	0.396986247	1.269123782	1.617476801	2.042769661	0.019740685	2.005209386	14.07566529	0	2.268325077	0	0.006030705	1.106741664	4.627816583	6.524522024	0.982548907	0.812400058	0	0.128717931	0.074151869	1.4043316	0	0	0.22237145	0	0.04036484	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5978	0	7.7307	2.4083	1.56417517	0.396986247	1.269123782	1.617476801	2.042769661	0.019740685	2.005209386	14.07566529	0	2.268325077	0	0.006030705	1.106741664	4.627816583	6.524522024	0.982548907	0.812400058	0	0.128717931	0.074151869	1.4043316	0	0	0.22237145	0	0.04036484	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5978																																																																																		0	0	0	2.4083	1.56417517	0.396986247	1.269123782	1.617476801	2.042769661	0.019740685	2.005209386	14.07566529	0	2.268325077	0	0.006030705	1.106741664	4.627816583	6.524522024	0.982548907	0.812400058	0	0.128717931	0.074151869	1.4043316	0	0	0.22237145	0	0.04036484	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5978
H3333_058_0	2009	4																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		252.526156	131.4297051	182.8802065	8.087734673	152.3532836	13.0179414	0.125801299	566.6237085	1099.164788		14.45533654		1.704131454	3.190760923	3269.27279	2633.817474	2.504592531	327.9494591		51.9608234	0.472547005	566.9002409			89.76685331		16.29446884														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	180.9302326		0.2		50	0.408390627	20	35	0.5	35		35	0.2	35			35		35														114.1451569	142.4431937	25.98116414	0.169423959	127.0679694	0.169423959	0.169423959	42.35598979	153.2695817		0.169423959		42.35598979	0.345955785	16.94239592	29.64919285	0.423559898	29.64919285		29.64919285	0.169423959	29.64919285			29.64919285		29.64919285														2.4021	1.560105578	0.395953389	1.370256029	1.613268532	2.205551172	0.021313754	1.999992334	14.03904393	0	2.449080348	0	0.006015015	1.1038622	4.615776164	6.507546854	1.060844957	0.810286397	0	0.128383039	0.080060784	1.400677881	0	0	0.221792895	0	0.040259821	0	0	0	0	0	0	0	0	0	0	0	0	0	44.0321	0	7.9465	2.4021	1.560105578	0.395953389	1.370256029	1.613268532	2.205551172	0.021313754	1.999992334	14.03904393	0	2.449080348	0	0.006015015	1.1038622	4.615776164	6.507546854	1.060844957	0.810286397	0	0.128383039	0.080060784	1.400677881	0	0	0.221792895	0	0.040259821	0	0	0	0	0	0	0	0	0	0	0	0	0	44.0321																																																																																		0	0	0	2.4021	1.560105578	0.395953389	1.370256029	1.613268532	2.205551172	0.021313754	1.999992334	14.03904393	0	2.449080348	0	0.006015015	1.1038622	4.615776164	6.507546854	1.060844957	0.810286397	0	0.128383039	0.080060784	1.400677881	0	0	0.221792895	0	0.040259821	0	0	0	0	0	0	0	0	0	0	0	0	0	44.0321
H3333_059_0	2009	4																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		252.526156	131.4297051	182.8802065	8.812446545	152.3532836	14.18443079	0.137073886	566.6237085	1099.164788		15.75062557		1.704131454	3.476673161	3269.27279	2633.817474	2.729019767	327.9494591		51.9608234	0.514890187	566.9002409			89.76685331		16.29446884														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	180.9302326		0.2		50	0.374805682	20	35	0.5	35		35	0.2	35			35		35														113.7121953	141.9028955	25.88261554	0.168781321	126.5859906	0.168781321	0.168781321	42.1953302	152.6882181		0.168781321		42.1953302	0.31630099	16.87813208	29.53673114	0.421953302	29.53673114		29.53673114	0.168781321	29.53673114			29.53673114		29.53673114														2.3929	1.554187975	0.394451506	1.487376367	1.607149277	2.394066963	0.023135512	1.992406206	13.98579274	0	2.658411387	0	0.005992199	1.099675164	4.598268163	6.482863218	1.151518902	0.807212917	0	0.127896073	0.086903846	1.395365	0	0	0.220951618	0	0.040107112	0	0	0	0	0	0	0	0	0	0	0	0	0	44.5067	0	8.2322	2.3929	1.554187975	0.394451506	1.487376367	1.607149277	2.394066963	0.023135512	1.992406206	13.98579274	0	2.658411387	0	0.005992199	1.099675164	4.598268163	6.482863218	1.151518902	0.807212917	0	0.127896073	0.086903846	1.395365	0	0	0.220951618	0	0.040107112	0	0	0	0	0	0	0	0	0	0	0	0	0	44.5067																																																																																		0	0	0	2.3929	1.554187975	0.394451506	1.487376367	1.607149277	2.394066963	0.023135512	1.992406206	13.98579274	0	2.658411387	0	0.005992199	1.099675164	4.598268163	6.482863218	1.151518902	0.807212917	0	0.127896073	0.086903846	1.395365	0	0	0.220951618	0	0.040107112	0	0	0	0	0	0	0	0	0	0	0	0	0	44.5067
H3333_060_0	2009	4																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		252.526156	131.4297051	182.8802065	10.08562681	152.3532836	16.23372973	0.156877668	566.6237085	1099.164788		18.02620087		1.704131454	3.978966325	3269.27279	2633.817474	3.123295534	327.9494591		51.9608234	0.589279067	566.9002409			89.76685331		16.29446884														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	180.9302326		0.2		50	0.3274913	20	35	0.5	35		35	0.2	35			35		35														112.8257853	140.7967331	25.68085521	0.167465636	125.5992267	0.167465636	0.167465636	41.86640889	151.4979819		0.167465636		41.86640889	0.274217694	16.74656355	29.30648622	0.418664089	29.30648622		29.30648622	0.167465636	29.30648622			29.30648622		29.30648622														2.3743	1.542072759	0.391376675	1.688995904	1.594621217	2.718591867	0.026271618	1.976874989	13.8767706	0	3.018769185	0	0.005945489	1.091102969	4.562423713	6.43232796	1.307611679	0.800920525	0	0.126899096	0.098683993	1.384487841	0	0	0.219229254	0	0.039794469	0	0	0	0	0	0	0	0	0	0	0	0	0	45.2781	0	8.7964	2.3743	1.542072759	0.391376675	1.688995904	1.594621217	2.718591867	0.026271618	1.976874989	13.8767706	0	3.018769185	0	0.005945489	1.091102969	4.562423713	6.43232796	1.307611679	0.800920525	0	0.126899096	0.098683993	1.384487841	0	0	0.219229254	0	0.039794469	0	0	0	0	0	0	0	0	0	0	0	0	0	45.2781																																																																																		0	0	0	2.3743	1.542072759	0.391376675	1.688995904	1.594621217	2.718591867	0.026271618	1.976874989	13.8767706	0	3.018769185	0	0.005945489	1.091102969	4.562423713	6.43232796	1.307611679	0.800920525	0	0.126899096	0.098683993	1.384487841	0	0	0.219229254	0	0.039794469	0	0	0	0	0	0	0	0	0	0	0	0	0	45.2781
H3333_100_0	2009	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																																																			0		288.556369	3.038555794	32.88864226		8.507189762	21.1804431	1.114139925	11.31242871	57.7054134	15.5738655	16.81702305	1.341719103	0.053581037	17.28081867	32.13449402	24.59187052	1.191819246	8.421348375	47.85816575	67.28445295	1.380369397	13.35254351		1000	500		40														Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	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: $0	17a: $0	17b: $200 Allowance	18a: $0	18b: $500 Allowance													0.083236699	0.083236699	0.202040626		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.083236699	0.083236699	0.202040626		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			24.0185	0.252919353	6.644841867	0	1.965160835	4.892682357	0.257366323	2.613171033	13.3299505	3.59756293	3.884732325	0.309937113	0.01237722	3.991869113	7.423068119	5.680722091	0.275310246	1.945331475	11.05523629	15.54270863	0.318865331	3.084437551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.0967	0	0	24.0185	0.252919353	6.644841867	0	1.965160835	4.892682357	0.257366323	2.613171033	13.3299505	3.59756293	3.884732325	0.309937113	0.01237722	3.991869113	7.423068119	5.680722091	0.275310246	1.945331475	11.05523629	15.54270863	0.318865331	3.084437551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.0967																																																																																		0	0	0	24.0185	0.252919353	6.644841867	0	1.965160835	4.892682357	0.257366323	2.613171033	13.3299505	3.59756293	3.884732325	0.309937113	0.01237722	3.991869113	7.423068119	5.680722091	0.275310246	1.945331475	11.05523629	15.54270863	0.318865331	3.084437551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.0967
H3333_801_0	2009	7																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		283.5271706	3.585729364	30.70444319		8.367535012	21.4380959	1.075604268	10.70835683	57.86511365	14.0421792	14.40678148	1.382312375	0.043836561	17.73819282	31.60825693	25.70703407	1.38689207	8.795639239	48.18322964	69.56413935	1.588743107	12.76456182																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																			0.079386524	0.079386524	0.197535381		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.079386524	0.079386524	0.197535381		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			22.5082	0.284658589	6.065213869	0	1.932900588	4.952200153	0.248464586	2.473630427	13.36684125	3.243743395	3.327966521	0.319314159	0.010126246	4.097522541	7.301507351	5.938324871	0.320372068	2.031792664	11.13032605	16.06931619	0.366999658	2.948613781	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.9381	0	0	22.5082	0.284658589	6.065213869	0	1.932900588	4.952200153	0.248464586	2.473630427	13.36684125	3.243743395	3.327966521	0.319314159	0.010126246	4.097522541	7.301507351	5.938324871	0.320372068	2.031792664	11.13032605	16.06931619	0.366999658	2.948613781	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.9381																																																																																		0	0	0	22.5082	0.284658589	6.065213869	0	1.932900588	4.952200153	0.248464586	2.473630427	13.36684125	3.243743395	3.327966521	0.319314159	0.010126246	4.097522541	7.301507351	5.938324871	0.320372068	2.031792664	11.13032605	16.06931619	0.366999658	2.948613781	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.9381
H3333_805_0	2009	7																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		232.28497	2.937676258	25.15519288		6.85526052	17.56356349	0.881209037	8.773022843	47.40708328	11.50431956	11.80302683	1.132485426	0.035913928	14.53234827	25.8956593	21.06097142	1.136237427	7.205992965	39.4750176	56.99173023	1.301607688	10.45760748																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																			0.082803064	0.082803064	0.194615338		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.082803064	0.082803064	0.194615338		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			19.2339	0.243248596	4.895586359	0	1.58356518	4.057183167	0.203559288	2.026568277	10.95103624	2.657497817	2.726499199	0.261604133	0.008296117	3.35697245	5.981897298	4.865084399	0.262470846	1.664584375	9.118729067	13.16508968	0.300671376	2.415707328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.9798	0	0	19.2339	0.243248596	4.895586359	0	1.58356518	4.057183167	0.203559288	2.026568277	10.95103624	2.657497817	2.726499199	0.261604133	0.008296117	3.35697245	5.981897298	4.865084399	0.262470846	1.664584375	9.118729067	13.16508968	0.300671376	2.415707328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.9798																																																																																		0	0	0	19.2339	0.243248596	4.895586359	0	1.58356518	4.057183167	0.203559288	2.026568277	10.95103624	2.657497817	2.726499199	0.261604133	0.008296117	3.35697245	5.981897298	4.865084399	0.262470846	1.664584375	9.118729067	13.16508968	0.300671376	2.415707328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.9798
H3333_806_0	2009	7																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		278.9319619	3.527614388	30.2068072		8.231919898	21.09064234	1.058171632	10.53480332	56.92727664	13.81459345	14.17328651	1.35990883	0.043126089	17.45070468	31.09597256	25.29039257	1.3644143	8.653085713	47.40230979	68.43669277	1.562993877	12.5576828																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																			0.082803064	0.082803064	0.194615338		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.082803064	0.082803064	0.194615338		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			23.0964	0.29209728	5.878707985	0	1.901573496	4.871938381	0.244437647	2.433539567	13.1502009	3.191171086	3.274029183	0.31413894	0.009962127	4.031112782	7.183169662	5.842080683	0.315179703	1.9988628	10.94993356	15.80887603	0.361051586	2.900824726	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.0493	0	0	23.0964	0.29209728	5.878707985	0	1.901573496	4.871938381	0.244437647	2.433539567	13.1502009	3.191171086	3.274029183	0.31413894	0.009962127	4.031112782	7.183169662	5.842080683	0.315179703	1.9988628	10.94993356	15.80887603	0.361051586	2.900824726	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.0493																																																																																		0	0	0	23.0964	0.29209728	5.878707985	0	1.901573496	4.871938381	0.244437647	2.433539567	13.1502009	3.191171086	3.274029183	0.31413894	0.009962127	4.031112782	7.183169662	5.842080683	0.315179703	1.9988628	10.94993356	15.80887603	0.361051586	2.900824726	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.0493
H3333_807_0	2009	7																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		278.9319619	3.527614388	30.2068072		8.231919898	21.09064234	1.058171632	10.53480332	56.92727664	13.81459345	14.17328651	1.35990883	0.043126089	17.45070468	31.09597256	25.29039257	1.3644143	8.653085713	47.40230979	68.43669277	1.562993877	12.5576828																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																			0.079386524	0.079386524	0.197535381		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.079386524	0.079386524	0.197535381		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			22.1434	0.280045043	5.966913154	0	1.901573496	4.871938381	0.244437647	2.433539567	13.1502009	3.191171086	3.274029183	0.31413894	0.009962127	4.031112782	7.183169662	5.842080683	0.315179703	1.9988628	10.94993356	15.80887603	0.361051586	2.900824726	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.1725	0	0	22.1434	0.280045043	5.966913154	0	1.901573496	4.871938381	0.244437647	2.433539567	13.1502009	3.191171086	3.274029183	0.31413894	0.009962127	4.031112782	7.183169662	5.842080683	0.315179703	1.9988628	10.94993356	15.80887603	0.361051586	2.900824726	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.1725																																																																																		0	0	0	22.1434	0.280045043	5.966913154	0	1.901573496	4.871938381	0.244437647	2.433539567	13.1502009	3.191171086	3.274029183	0.31413894	0.009962127	4.031112782	7.183169662	5.842080683	0.315179703	1.9988628	10.94993356	15.80887603	0.361051586	2.900824726	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.1725
H3333_808_0	2009	7																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		278.9319619	3.527614388	30.2068072		8.231919898	21.09064234	1.058171632	10.53480332	56.92727664	13.81459345	14.17328651	1.35990883	0.043126089	17.45070468	31.09597256	25.29039257	1.3644143	8.653085713	47.40230979	68.43669277	1.562993877	12.5576828																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																			0.082803064	0.082803064	0.194615338		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.082803064	0.082803064	0.194615338		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			23.0964	0.29209728	5.878707985	0	1.901573496	4.871938381	0.244437647	2.433539567	13.1502009	3.191171086	3.274029183	0.31413894	0.009962127	4.031112782	7.183169662	5.842080683	0.315179703	1.9988628	10.94993356	15.80887603	0.361051586	2.900824726	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.0493	0	0	23.0964	0.29209728	5.878707985	0	1.901573496	4.871938381	0.244437647	2.433539567	13.1502009	3.191171086	3.274029183	0.31413894	0.009962127	4.031112782	7.183169662	5.842080683	0.315179703	1.9988628	10.94993356	15.80887603	0.361051586	2.900824726	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.0493																																																																																		0	0	0	23.0964	0.29209728	5.878707985	0	1.901573496	4.871938381	0.244437647	2.433539567	13.1502009	3.191171086	3.274029183	0.31413894	0.009962127	4.031112782	7.183169662	5.842080683	0.315179703	1.9988628	10.94993356	15.80887603	0.361051586	2.900824726	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.0493
H3333_809_0	2009	7																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		278.9319619	3.527614388	30.2068072		8.231919898	21.09064234	1.058171632	10.53480332	56.92727664	13.81459345	14.17328651	1.35990883	0.043126089	17.45070468	31.09597256	25.29039257	1.3644143	8.653085713	47.40230979	68.43669277	1.562993877	12.5576828																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																			0.082803064	0.082803064	0.194615338		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.082803064	0.082803064	0.194615338		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			23.0964	0.29209728	5.878707985	0	1.901573496	4.871938381	0.244437647	2.433539567	13.1502009	3.191171086	3.274029183	0.31413894	0.009962127	4.031112782	7.183169662	5.842080683	0.315179703	1.9988628	10.94993356	15.80887603	0.361051586	2.900824726	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.0493	0	0	23.0964	0.29209728	5.878707985	0	1.901573496	4.871938381	0.244437647	2.433539567	13.1502009	3.191171086	3.274029183	0.31413894	0.009962127	4.031112782	7.183169662	5.842080683	0.315179703	1.9988628	10.94993356	15.80887603	0.361051586	2.900824726	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.0493																																																																																		0	0	0	23.0964	0.29209728	5.878707985	0	1.901573496	4.871938381	0.244437647	2.433539567	13.1502009	3.191171086	3.274029183	0.31413894	0.009962127	4.031112782	7.183169662	5.842080683	0.315179703	1.9988628	10.94993356	15.80887603	0.361051586	2.900824726	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.0493
H3335_002_0	2009	7																					4000											A	A	D		T	Coin	Coin	V	P		Coin	P		P	V	V	Coin	V	Coin	V	Coin				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		271.7387039	5.204470698	2118.808046	0	258.5606595	6.226178822	12.03935341	271.9450552	344.349156	0	23.38910302	0	0	525.0314649	3559.611274	4659.700467	2.091202828	777.1746283	30.53901414	75.83626797	51.19203992	0	0	0	866.6422775	0	48.11882419	0	0	0											"$500 Copay per admit, 3 per year"	"$500 Copay per admit, 3 per year"	$50 Copay per day	$0 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $40 Urgent Care"	$125 Copay	$0 Copay	10% Coinsurance	$125 Copay	$0 Copay	$40 Copay	"$20 PCP, $0 Physical Exams"	"$40 Specialist, $20 Chiropractic"	50% coinsurance	$40 Copay	10% Coinsurance	$40 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$40 Copay	Not Covered	$40 Copay	Not Covered	Not Covered	$0 Copay											500	500	50	0	100	0.299995341	0.085430313	50	125	0	0.1	0	0	40	20	38.0232833	0.5	40	0.1	40	0.1	0	0	0	40	0	40	0	0	0											470.6303899	470.6303899	47.06303899	0	94.12607799	0.282373849	0.080412203	47.06303899	117.6575975	0	0.094126078	0	0	37.6504312	18.8252156	35.78982529	0.47063039	37.6504312	0.094126078	37.6504312	0.094126078	0	0	0	40	0	40	0	0	0											10.6574	0.204115173	8.309795474	0	2.0281084	1.758110078	0.968110936	1.066546728	3.376274533	0	2.201524535	0	0	1.647305087	5.58420414	13.8974888	0.984183602	2.438413322	2.874517627	0.237939016	4.818505942	0	0	0	2.888807592	0	0.160396081	0	0	0	0	0	0	0	0	0	0	0	0	0	66.1017		3.9348	10.6574	0.204115173	8.309795474	0	2.0281084	1.758110078	0.968110936	1.066546728	3.376274533	0	2.201524535	0	0	1.647305087	5.58420414	13.8974888	0.984183602	2.438413322	2.874517627	0.237939016	4.818505942	0	0	0	2.888807592	0	0.160396081	0	0	0	0	0	0	0	0	0	0	0	0	0	66.1017		30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	40% Coinsurance	40% Coinsurance	"$50 ER, $40 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	"$25 PCP, 30% Physical Exams"	"$45 Specialist, 30% Chiropractic"	50% Coinsurance	30% Coinsurance	30% Coinsurance	$45 Copay	30% Coinsurance	$45 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											5.4389	0.081	1.1548	0.5173	0.2925	0.1932	0.3736	0.0879	0.9314	0.3401	0.5443	0	0	0.2274	0.7363	1.1842	0.0811	0.0846	0.7107	0.1217	1.1914	0	0	0	0.1518	0	0.0131	0	0	0											14.4572		0	16.0963	0.285134548	9.464585875	0.517339018	2.320614514	1.9513057	1.341686838	1.15444607	4.307647441	0.340112656	2.745839808	0	0	1.874713363	6.320472641	15.08168414	1.065294996	2.522977311	3.585226874	0.35963618	6.009855997	0	0	0	3.040560392	0	0.173469048	0	0	0	0	0	0	0	0	0	0	0	0	0	80.5589
H3335_005_0	2009	7																					3500											A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	V	V	V	V	Coin				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	236.3414238	6.883266163	602.8152245	0	129.5142289	8.84339086	1.715951198	206.4420272	376.7384481	0	1034.935312	0.085989535	0	867.5036535	4372.712281	5515.454419	352.183424	1154.852263	834.1664563	784.9925915	40.96124294	0	0	0	655.7117844	0	0	0	0	0											"$300 Copay per admit, 3 per year"	"$300 Copay per admit, 3 per year"	$25 Copay per day	$0 Copay	$100 Copay	20% Coinsurance	20% Coinsurance	"$50 ER, $30 Urgent Care"	$50 Copay	$0 Copay	$30 Copay	$50 Copay	$0 Copay	$30 Copay	"$15 PCP, $0 Physical Exams"	"$30 Specialist, $15 Chiropractic"	$30 Copay	$30 Copay	$30 Copay	$30 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$30 Copay	Not Covered	$30 Copay	Not Covered	Not Covered	$0 Copay											300	300	25	0	100	0.229507581	0.086756509	47.42364922	50	0	30	50	0	30	15	27.77130982	30	30	30	30	0.1	0	0	0	30	0	0	0	0	0											286.8954655	286.8954655	23.90795546	0	95.63182182	0.219482281	0.08296683	45.35209973	47.81591091	0	28.68954655	47.81591091	0	28.68954655	14.34477327	26.55820953	28.68954655	28.68954655	28.68954655	28.68954655	0.095631822	0	0	0	30	0	0	0	0	0											5.6504	0.164564821	1.201006628	0	1.032140139	1.940967595	0.142367031	0.78021495	1.501174339	0	2.474318735	0.000342639	0	2.074023871	5.227130521	12.20671617	0.841998561	2.761015645	1.994321448	1.876756791	3.917198286	0	0	0	1.639279461	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.426	0	2.0914	5.6504	0.164564821	1.201006628	0	1.032140139	1.940967595	0.142367031	0.78021495	1.501174339	0	2.474318735	0.000342639	0	2.074023871	5.227130521	12.20671617	0.841998561	2.761015645	1.994321448	1.876756791	3.917198286	0	0	0	1.639279461	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.426	0	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $30 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	30% Coinsurance	30% Coinsurance	50% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											2.8261	0.0132	1.062	0.0291	0.9798	0.6614	0.3445	0.0405	0.3577	0.1296	0.1369	0.0002	0	0.1948	0.5324	1.5772	0.4227	0.1103	0.3902	2.6946	0.2764	0	0	0	0.0709	0	0	0	0	0											12.8502	0	0	8.4765	0.177813194	2.262990096	0.029114656	2.011943768	2.602319514	0.486913941	0.82067913	1.858852801	0.129550865	2.611186184	0.000506493	0	2.26879024	5.759532905	13.78393337	1.264717644	2.871279848	2.38447393	4.571340278	4.19360833	0	0	0	1.710132036	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.2762
H3335_006_0	2009	7																					3500											A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	V	V	V	V	Coin				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	233.1245644	8.696671339	864.18004	0	173.4575345	6.051578399	1.697656489	168.6626601	368.9311049	0	848.3737651	0	0	866.6385189	4269.765175	5648.01266	255.460189	1030.204583	998.5734532	705.8463008	42.59839318	0	0	0	765.2536413	0	0	0	0	0											"$100 Copay per admit, 3 per year"	"$100 Copay per admit, 3 per year"	$25 Copay per day	$0 Copay	$100 Copay	20% Coinsurance	20% Coinsurance	"$50 ER, $25 Urgent Care"	$35 Copay	$0 Copay	$25 Copay	$35 Copay	$0 Copay	$25 Copay	"$10 PCP, $0 Physical Exams"	"$25 Specialist, $10 Chiropractic"	$25 Copay	$25 Copay	$25 Copay	$25 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$25 Copay	Not Covered	$25 Copay	Not Covered	Not Covered	$0 Copay											100	100	25	0	100	0.228372531	0.051347319	46.50701081	35	0	25	0	0	25	10	22.4565521	25	25	25	25	0.1	0	0	0	25	0	0	0	0	0											97.33489676	97.33489676	24.33372419	0	97.33489676	0.222286167	0.04997886	45.26755096	34.06721387	0	24.33372419	0	0	24.33372419	9.733489676	21.8580618	24.33372419	24.33372419	24.33372419	24.33372419	0.097334897	0	0	0	25	0	0	0	0	0											1.8909	0.070540801	1.752393229	0	1.406955934	1.345182169	0.084846936	0.636245463	1.047371238	0	1.720341101	0	0	1.757378558	3.463309604	10.28788415	0.518024815	2.089059515	2.024917583	1.431322434	4.146310202	0	0	0	1.594278419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.2673	0	0.9768	1.8909	0.070540801	1.752393229	0	1.406955934	1.345182169	0.084846936	0.636245463	1.047371238	0	1.720341101	0	0	1.757378558	3.463309604	10.28788415	0.518024815	2.089059515	2.024917583	1.431322434	4.146310202	0	0	0	1.594278419	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.2673	0	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $25 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	30% Coinsurance	30% Coinsurance	50% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											2.2343	0	0.1566	0.0041	0.6464	0.6191	0.2758	0.0442	0.4038	0.1081	0.1202	0	0	0.0857	0.4292	1.3538	0.055	0.1126	0.2361	2.1741	0.1709	0	0	0	0.0289	0	0	0	0	0											9.2588	0	0	4.1252	0.070540801	1.908964256	0.004093847	2.053349915	1.964283169	0.360599086	0.680436768	1.451125842	0.108086655	1.840577217	0	0	1.84304426	3.892494871	11.64172784	0.573036351	2.201618128	2.261063345	3.605424108	4.317218053	0	0	0	1.623187365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.5261
H3335_008_0	2009	7																					3500											A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	V	V	V	V	Coin				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	233.4193031	5.812816921	369.1020168	0	120.8928664	11.44409965	1.536122376	201.1230254	371.7131788	0	1398.46988	0.661789412	0	1034.813503	4286.415718	5104.390151	411.8953209	698.9517813	521.5827384	899.3117861	38.13984187	0	0	0	457.4142749	0	0	0	0	0											"$300 Copay per admit, 3 per year"	"$300 Copay per admit, 3 per year"	$25 Copay per day	$0 Copay	$100 Copay	20% Coinsurance	20% Coinsurance	"$50 ER, $30 Urgent Care"	$50 Copay	$0 Copay	$30 Copay	$50 Copay	$0 Copay	$30 Copay	"$15 PCP, $0 Physical Exams"	"$30 Specialist, $15 Chiropractic"	$30 Copay	$30 Copay	$30 Copay	$30 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$30 Copay	Not Covered	$30 Copay	Not Covered	Not Covered	$0 Copay											300	300	25	0	100	0.212707413	0.097206006	49.06276971	50	0	30	50	0	30	15	27.93578021	30	30	30	30	0.1	0	0	0	30	0	0	0	0	0											287.8496418	287.8496418	23.98747015	0	95.94988061	0.204092509	0.093269047	47.07566896	47.9749403	0	28.78496418	47.9749403	0	28.78496418	14.39248209	26.80434776	28.78496418	28.78496418	28.78496418	28.78496418	0.095949881	0	0	0	30	0	0	0	0	0											5.5991	0.139434772	0.737818634	0	0.966638008	2.33565501	0.14327267	0.78900008	1.486076463	0	3.35457545	0.002645776	0	2.482255801	5.141013454	11.40165406	0.988032672	1.676608499	1.251145037	2.157221463	3.659513274	0	0	0	1.143535687	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4552	0	1.8704	5.5991	0.139434772	0.737818634	0	0.966638008	2.33565501	0.14327267	0.78900008	1.486076463	0	3.35457545	0.002645776	0	2.482255801	5.141013454	11.40165406	0.988032672	1.676608499	1.251145037	2.157221463	3.659513274	0	0	0	1.143535687	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4552	0	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $30 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	30% Coinsurance	30% Coinsurance	50% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											1.4208	0	1.8798	0.0012	0.4754	0.7998	0.2898	0.028	0.2068	0.1576	0.2305	0.0011	0	0.8091	0.2258	1.1975	0.337	0.046	0.3492	2.1178	0.0664	0	0	0	0.0556	0	0	0	0	0											10.6952	0	0	7.0199	0.139434772	2.617619186	0.001178468	1.442059392	3.135480289	0.43304188	0.816955817	1.692861898	0.157643893	3.585068495	0.003711822	0	3.291368211	5.366837426	12.59915135	1.325019506	1.722605602	1.600327078	4.275025254	3.725910136	0	0	0	1.199173197	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1504
H3335_009_0	2009	7																					3500											A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	V	V	V	V	Coin				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	219.3947131	4.673687571	367.8452094	0	141.6645476	7.904476881	1.319778079	176.7611251	393.4054619	0	1319.771986	0	0	957.6595535	4099.47484	5192.84866	286.7173231	956.8519186	664.4721358	789.0422855	45.05776409	0	0	0	488.2659521	0	0	0	0	0											"$100 Copay per admit, 3 per year"	"$100 Copay per admit, 3 per year"	$25 Copay per day	$0 Copay	$100 Copay	20% Coinsurance	20% Coinsurance	"$50 ER, $25 Urgent Care"	$35 Copay	$0 Copay	$25 Copay	$35 Copay	$0 Copay	$25 Copay	"$10 PCP, $0 Physical Exams"	"$25 Specialist, $10 Chiropractic"	$25 Copay	$25 Copay	$25 Copay	$25 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$25 Copay	Not Covered	$25 Copay	Not Covered	Not Covered	$0 Copay											100	100	25	0	100	0.23791133	0.117512341	49.33876789	35	0	25	0	0	25	10	22.80600015	25	25	25	25	0.1	0	0	0	25	0	0	0	0	0											97.38118699	97.38118699	24.34529675	0	97.38118699	0.231680877	0.114434913	48.04667782	34.08341545	0	24.34529675	0	0	24.34529675	9.738118699	22.20875366	24.34529675	24.34529675	24.34529675	24.34529675	0.097381187	0	0	0	25	0	0	0	0	0											1.7804	0.037927437	0.746275065	0	1.149621816	1.83131614	0.151028689	0.707732069	1.117383483	0	2.677520054	0	0	1.942875501	3.326764383	9.610558055	0.581684859	1.941236992	1.348064277	1.600789049	4.38777855	0	0	0	1.017220733	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.9562	0	0.9396	1.7804	0.037927437	0.746275065	0	1.149621816	1.83131614	0.151028689	0.707732069	1.117383483	0	2.677520054	0	0	1.942875501	3.326764383	9.610558055	0.581684859	1.941236992	1.348064277	1.600789049	4.38777855	0	0	0	1.017220733	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.9562	0	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $25 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	30% Coinsurance	30% Coinsurance	50% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											2.2304	0.0596	1.8816	0.0124	0.4517	0.6722	0.3845	0.0291	0.4838	0.1103	0.1751	0	0	0.0304	0.2458	1.0262	0.2587	0.0507	0.4428	2.1286	0.1138	0	0	0	0.0469	0	0	0	0	0											10.8345	0	0	4.0108	0.097523744	2.62788118	0.012355247	1.601338889	2.503516474	0.535541518	0.736850728	1.60117263	0.11034368	2.852625926	0	0	1.973237095	3.572584883	10.63673052	0.840373542	1.991897625	1.790837008	3.729420084	4.501564517	0	0	0	1.064087222	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7907
H3335_014_0	2009	7																					3500											A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	V	V	V	V	Coin				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	207.3570924	9.597929931	445.2143461	0	88.03922933	9.615005401	1.62939993	202.9229078	288.991894	0	667.5522397	0	0	602.9261174	4151.722768	5435.59174	475.2456844	1514.096735	988.7226561	704.3667084	33.99578888	0	0	0	610.1219701	0	0	0	0	0											"$300 Copay per admit, 3 per year"	"$300 Copay per admit, 3 per year"	$25 Copay per day	$0 Copay	$100 Copay	20% Coinsurance	20% Coinsurance	"$50 ER, $30 Urgent Care"	$50 Copay	$0 Copay	$30 Copay	$50 Copay	$0 Copay	$30 Copay	"$15 PCP, $0 Physical Exams"	"$30 Specialist, $15 Chiropractic"	$30 Copay	$30 Copay	$30 Copay	$30 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$30 Copay	Not Covered	$30 Copay	Not Covered	Not Covered	$0 Copay											300	300	25	0	100	0.222538233	0.060347459	45.61668167	50	0	30	0	0	30	15	28.05428366	30	30	30	30	0.1	0	0	0	30	0	0	0	0	0											288.3176413	288.3176413	24.02647011	0	96.10588043	0.213872328	0.057997457	43.84031354	48.05294022	0	28.83176413	0	0	28.83176413	14.41588206	26.96181631	28.83176413	28.83176413	28.83176413	28.83176413	0.09610588	0	0	0	30	0	0	0	0	0											4.9821	0.230604377	0.891410765	0	0.705090637	2.056383587	0.094501052	0.741350325	1.157242517	0	1.603892393	0	0	1.448618634	4.987562149	12.2127855	1.141847623	3.637839995	2.375551534	1.692344566	3.267195222	0	0	0	1.525304925	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7516	0	1.7515	4.9821	0.230604377	0.891410765	0	0.705090637	2.056383587	0.094501052	0.741350325	1.157242517	0	1.603892393	0	0	1.448618634	4.987562149	12.2127855	1.141847623	3.637839995	2.375551534	1.692344566	3.267195222	0	0	0	1.525304925	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7516	0	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $30 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	30% Coinsurance	30% Coinsurance	50% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											1.2987	0	1.3856	0.0162	1.4979	0.6528	0.2019	0.0214	0.1047	0.0601	0.0291	0	0	0.0877	0.8223	1.6403	0.8241	0.1321	0.361	2.5435	0.0877	0	0	0	0.0904	0	0	0	0	0											11.8576	0	0	6.2808	0.230604377	2.276999152	0.016191899	2.202980303	2.709151337	0.296395681	0.762759483	1.26195244	0.060147415	1.63300827	0	0	1.536350811	5.809833664	13.85313079	1.965958419	3.769927173	2.736551863	4.23586829	3.354884054	0	0	0	1.61573733	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.6092
H3335_015_0	2009	7																					3500											A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	V	V	V	V	Coin				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	204.9905085	3.041891318	617.8148004	0	65.94320466	7.604566536	1.534708743	186.3880154	293.8381608	0	562.9625543	0	0	457.0317105	4019.430471	5432.686369	276.946539	1613.091927	849.6840661	713.1350714	31.69971043	0	0	0	700.3590878	0	0	0	0	0											"$100 Copay per admit, 3 per year"	"$100 Copay per admit, 3 per year"	$25 Copay per day	$0 Copay	$100 Copay	20% Coinsurance	20% Coinsurance	"$50 ER, $25 Urgent Care"	$35 Copay	$0 Copay	$25 Copay	$35 Copay	$0 Copay	$25 Copay	"$10 PCP, $0 Physical Exams"	"$25 Specialist, $10 Chiropractic"	$25 Copay	$25 Copay	$25 Copay	$25 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$25 Copay	Not Covered	$25 Copay	Not Covered	Not Covered	$0 Copay											100	100	25	0	100	0.230990306	0.072284837	43.61566577	35	0	25	0	0	25	10	22.96897576	25	25	25	25	0.1	0	0	0	25	0	0	0	0	0											97.68360296	97.68360296	24.42090074	0	97.68360296	0.225639653	0.070610433	42.60535377	34.18926104	0	24.42090074	0	0	24.42090074	9.768360296	22.43692309	24.42090074	24.42090074	24.42090074	24.42090074	0.097683603	0	0	0	25	0	0	0	0	0											1.6687	0.024761909	1.257299493	0	0.536797485	1.715891757	0.108366449	0.661760611	0.837175798	0	1.145671055	0	0	0.930093836	3.271937085	10.15773052	0.563606995	3.282763153	1.729170853	1.451283399	3.096541928	0	0	0	1.459081433	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.8986	0	0.7692	1.6687	0.024761909	1.257299493	0	0.536797485	1.715891757	0.108366449	0.661760611	0.837175798	0	1.145671055	0	0	0.930093836	3.271937085	10.15773052	0.563606995	3.282763153	1.729170853	1.451283399	3.096541928	0	0	0	1.459081433	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.8986	0	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $25 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	30% Coinsurance	30% Coinsurance	50% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											1.4726	0	0.5023	0.0197	1.4829	0.4059	0.3735	0.0586	0.3665	0.0934	0.0724	0.0002	0	0.1392	0.6674	1.6888	0.7229	0.1002	0.4108	2.4869	0.2327	0	0	0	0.0895	0	0	0	0	0											11.3862	0	0	3.1413	0.024761909	1.75957811	0.019710434	2.019680618	2.1217779	0.481914004	0.720311919	1.203693524	0.093381022	1.218038055	0.000185599	0	1.069283797	3.939317156	11.84655272	1.286485214	3.382965762	2.139938536	3.938149302	3.329193347	0	0	0	1.548555941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.2848
H3335_017_0	2009	7																					3500											A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	V	V	V	V	Coin				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	224.8005307	6.547146335	573.3788864	0	123.1898621	8.411555312	1.632158823	196.3611648	358.3417655	0	984.3979263	0.081790542	0	825.1421972	4159.186425	5246.126814	334.9857987	1098.459159	793.4329035	746.6602695	38.96104628	0	0	0	623.6924309	0	0	0	0	0											"$300 Copay per admit, 3 per year"	"$300 Copay per admit, 3 per year"	$25 Copay per day	$0 Copay	$100 Copay	20% Coinsurance	20% Coinsurance	"$50 ER, $30 Urgent Care"	$50 Copay	$0 Copay	$30 Copay	$50 Copay	$0 Copay	$30 Copay	"$15 PCP, $0 Physical Exams"	"$30 Specialist, $15 Chiropractic"	$30 Copay	$30 Copay	$30 Copay	$30 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$30 Copay	Not Covered	$30 Copay	Not Covered	Not Covered	$0 Copay											300	300	25	0	100	0.229507581	0.086756509	47.42364922	50	0	30	50	0	30	15	27.77130982	30	30	30	30	0.1	0	0	0	30	0	0	0	0	0											287.9717911	287.9717911	23.99764926	0	95.99059703	0.220305697	0.083278091	45.52224402	47.99529851	0	28.79717911	47.99529851	0	28.79717911	14.39858955	26.6578461	28.79717911	28.79717911	28.79717911	28.79717911	0.095990597	0	0	0	30	0	0	0	0	0											5.3947	0.157116121	1.146645451	0	0.985422367	1.853113555	0.135923071	0.744900072	1.433226667	0	2.362323616	0.00032713	0	1.980147303	4.99053485	11.65420344	0.80388717	2.636043761	1.904052453	1.791809126	3.739894093	0	0	0	1.559231077	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.2735	0	1.8259	5.3947	0.157116121	1.146645451	0	0.985422367	1.853113555	0.135923071	0.744900072	1.433226667	0	2.362323616	0.00032713	0	1.980147303	4.99053485	11.65420344	0.80388717	2.636043761	1.904052453	1.791809126	3.739894093	0	0	0	1.559231077	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.2735	0	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $30 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	30% Coinsurance	30% Coinsurance	50% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											2.6881	0.0126	1.0101	0.0277	0.932	0.6291	0.3277	0.0385	0.3402	0.1232	0.1302	0.0002	0	0.1853	0.5064	1.5002	0.4021	0.1049	0.3711	2.563	0.2629	0	0	0	0.0674	0	0	0	0	0											12.2227	0	0	8.0828	0.169717558	2.156770732	0.027692945	1.91738077	2.482170705	0.463645257	0.783388327	1.773439173	0.123224709	2.492507631	0.000482983	0	2.165402949	5.496939256	13.15440284	1.20596427	2.740923603	2.275153225	4.35481221	4.002806636	0	0	0	1.626623819	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.4962
H3335_018_0	2009	7																					3500											A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	V	V	V	V	Coin				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	225.7051606	6.573493	573.3788864	0	123.1898621	8.411555312	1.632158823	196.9494151	359.4276496	0	1005.471609	0.0824197	0	827.2364667	4293.353729	5375.699329	342.7761661	1124.004721	810.418467	754.776142	38.96104628	0	0	0	638.196906	0	0	0	0	0											"$100 Copay per admit, 3 per year"	"$100 Copay per admit, 3 per year"	$25 Copay per day	$0 Copay	$100 Copay	20% Coinsurance	20% Coinsurance	"$50 ER, $25 Urgent Care"	$35 Copay	$0 Copay	$25 Copay	$35 Copay	$0 Copay	$25 Copay	"$10 PCP, $0 Physical Exams"	"$25 Specialist, $10 Chiropractic"	$25 Copay	$25 Copay	$25 Copay	$25 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$25 Copay	Not Covered	$25 Copay	Not Covered	Not Covered	$0 Copay											100	100	25	0	100	0.229507581	0.086756509	46.71451014	35	0	25	35	0	25	10	22.75332644	25	25	25	25	0.1	0	0	0	25	0	0	0	0	0											97.36277652	97.36277652	24.34069413	0	97.36277652	0.223454953	0.084468546	45.48254411	34.07697178	0	24.34069413	34.07697178	0	24.34069413	9.736277652	22.15327037	24.34069413	24.34069413	24.34069413	24.34069413	0.097362777	0	0	0	25	0	0	0	0	0											1.8313	0.053334461	1.163036675	0	0.999508918	1.879603696	0.137866082	0.746480038	1.020683823	0	2.039489742	0.000234051	0	1.677959151	3.48344033	9.924110055	0.695284151	2.279921259	1.643845669	1.530981267	3.793355642	0	0	0	1.329576887	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.23	0	0.9453	1.8313	0.053334461	1.163036675	0	0.999508918	1.879603696	0.137866082	0.746480038	1.020683823	0	2.039489742	0.000234051	0	1.677959151	3.48344033	9.924110055	0.695284151	2.279921259	1.643845669	1.530981267	3.793355642	0	0	0	1.329576887	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.23	0	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $25 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	30% Coinsurance	30% Coinsurance	50% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											2.6989	0.0127	1.0101	0.0277	0.932	0.6291	0.3277	0.0381	0.3412	0.1249	0.133	0.0002	0	0.1857	0.521	1.5379	0.4114	0.1073	0.379	2.5925	0.2629	0	0	0	0.069	0	0	0	0	0											12.3423	0	0	4.5302	0.065986607	2.173161956	0.027692945	1.931467321	2.508660846	0.465588269	0.784614188	1.361927275	0.124850365	2.172460695	0.000391103	0	1.863684989	4.004436036	11.46202787	1.106711881	2.387240167	2.02289085	4.123518649	4.056268184	0	0	0	1.398536902	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.5723
H3335_020_0	2009	7																					3500											A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	V	V	V	V	Coin				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	208.6086384	6.075569653	532.0796549	0	114.3167648	7.805689315	1.51459798	182.2176981	332.5311891	0	913.4938891	0.075899347	0	765.7090031	3859.609291	4868.259733	310.8575017	1019.33954	736.2836607	692.8799576	36.15476703	0	0	0	578.7692244	0	0	0	0	0											"$300 Copay per admit, 3 per year"	"$300 Copay per admit, 3 per year"	$25 Copay per day	$0 Copay	$100 Copay	20% Coinsurance	20% Coinsurance	"$50 ER, $30 Urgent Care"	$50 Copay	$0 Copay	$30 Copay	$50 Copay	$0 Copay	$30 Copay	"$15 PCP, $0 Physical Exams"	"$30 Specialist, $15 Chiropractic"	$30 Copay	$30 Copay	$30 Copay	$30 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$30 Copay	Not Covered	$30 Copay	Not Covered	Not Covered	$0 Copay											300	300	25	0	100	0.229507581	0.086756509	47.42364922	50	0	30	50	0	30	15	27.77130982	30	30	30	30	0.1	0	0	0	30	0	0	0	0	0											289.3914529	289.3914529	24.11595441	0	96.46381765	0.221391774	0.08368864	45.74666251	48.23190882	0	28.93914529	48.23190882	0	28.93914529	14.46957265	26.78926566	28.93914529	28.93914529	28.93914529	28.93914529	0.096463818	0	0	0	30	0	0	0	0	0											5.0308	0.146518161	1.069300725	0	0.918952629	1.728115406	0.126754646	0.694654295	1.336551166	0	2.202977699	0.000305064	0	1.846580341	4.653908086	10.86809194	0.749662534	2.458234587	1.77561832	1.670946147	3.487626854	0	0	0	1.446923061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.2125	0	1.4944	5.0308	0.146518161	1.069300725	0	0.918952629	1.728115406	0.126754646	0.694654295	1.336551166	0	2.202977699	0.000305064	0	1.846580341	4.653908086	10.86809194	0.749662534	2.458234587	1.77561832	1.670946147	3.487626854	0	0	0	1.446923061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.2125	0	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $30 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	30% Coinsurance	30% Coinsurance	50% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											2.4945	0.0117	0.9374	0.0257	0.8648	0.5837	0.3041	0.0357	0.3157	0.1143	0.1208	0.0001	0	0.1719	0.4699	1.3921	0.3731	0.0973	0.3444	2.3784	0.244	0	0	0	0.0625	0	0	0	0	0											11.3424	0	0	7.5253	0.158211943	2.006668884	0.025698283	1.7837841	2.31186294	0.430871717	0.730370325	1.652258907	0.114349102	2.323784842	0.000449691	0	2.018492427	5.123837286	12.26023525	1.122778897	2.555560162	2.119989512	4.049341705	3.731602379	0	0	0	1.50946165	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.5549
H3335_021_0	2009	7																					3500											A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	V	V	V	V	Coin				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	209.4481098	6.100018626	532.0796549	0	114.3167648	7.805689315	1.51459798	182.763578	333.5388594	0	933.0496807	0.076483189	0	767.6524269	3984.112817	4988.499422	318.0867459	1043.04511	752.0457911	700.4112615	36.15476703	0	0	0	592.2289738	0	0	0	0	0											"$100 Copay per admit, 3 per year"	"$100 Copay per admit, 3 per year"	$25 Copay per day	$0 Copay	$100 Copay	20% Coinsurance	20% Coinsurance	"$50 ER, $25 Urgent Care"	$35 Copay	$0 Copay	$25 Copay	$35 Copay	$0 Copay	$25 Copay	"$10 PCP, $0 Physical Exams"	"$25 Specialist, $10 Chiropractic"	$25 Copay	$25 Copay	$25 Copay	$25 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$25 Copay	Not Covered	$25 Copay	Not Covered	Not Covered	$0 Copay											100	100	25	0	100	0.229507581	0.086756509	46.71451014	35	0	25	35	0	25	10	22.75332644	25	25	25	25	0.1	0	0	0	25	0	0	0	0	0											97.66919954	97.66919954	24.41729988	0	97.66919954	0.224158217	0.084734388	45.62568812	34.18421984	0	24.41729988	34.18421984	0	24.41729988	9.766919954	22.2229918	24.41729988	24.41729988	24.41729988	24.41729988	0.0976692	0	0	0	25	0	0	0	0	0											1.7047	0.049648661	1.082662375	0	0.930435576	1.749709399	0.128338532	0.694892834	0.950147141	0	1.898546155	0.000217877	0	1.56199996	3.242709247	9.238281812	0.647234955	2.122362104	1.530243967	1.425179318	3.531207155	0	0	0	1.233810362	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.7223	0	0.7753	1.7047	0.049648661	1.082662375	0	0.930435576	1.749709399	0.128338532	0.694892834	0.950147141	0	1.898546155	0.000217877	0	1.56199996	3.242709247	9.238281812	0.647234955	2.122362104	1.530243967	1.425179318	3.531207155	0	0	0	1.233810362	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.7223	0	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $25 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	30% Coinsurance	30% Coinsurance	50% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											2.5045	0.0117	0.9374	0.0257	0.8648	0.5837	0.3041	0.0354	0.3167	0.1159	0.1234	0.0001	0	0.1723	0.4835	1.4271	0.3818	0.0996	0.3517	2.4058	0.244	0	0	0	0.064	0	0	0	0	0											11.4533	0	0	4.2092	0.061389501	2.020030534	0.025698283	1.795267046	2.333456933	0.432455604	0.730280264	1.266811572	0.115857665	2.0219395	0.000363616	0	1.73434837	3.726178768	10.66542676	1.029028443	2.221951065	1.881987351	3.830981882	3.77518268	0	0	0	1.297803337	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.1757
H3335_032_0	2009	8																					4000											A	A	D		T	Coin	Coin	V	P		Coin	P		P	V	V	Coin	V	Coin	V	Coin				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		232.234444	4.327647461	941.0737147	0	232.383874	11.56413015	3.192865032	176.992295	284.5284124	0	19.50113335	0	0	1096.426528	3972.491947	4867.839046	5.071101109	602.3206839	28.71140906	823.8219751	41.07781279	0	0	0	669.2899745	0	33.77344747	0	0	0											"$500 Copay per admit, 3 per year"	"$500 Copay per admit, 3 per year"	$50 Copay per day	$0 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $40 Urgent Care"	$125 Copay	$0 Copay	10% Coinsurance	$125 Copay	$0 Copay	$40 Copay	"$20 PCP, $0 Physical Exams"	"$40 Specialist, $20 Chiropractic"	50% coinsurance	$40 Copay	10% Coinsurance	$40 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$40 Copay	Not Covered	$40 Copay	Not Covered	Not Covered	$0 Copay											500	500	50	0	100	0.25929032	0.175551673	47.89978827	125	0	0.1	0	0	40	20	37.99526613	0.5	40	0.1	40	0.1	0	0	0	40	0	40	0	0	0											471.818848	471.818848	47.1818848	0	94.36376959	0.24467612	0.165657176	45.20004583	117.954712	0	0.09436377	0	0	37.74550784	18.87275392	35.85376539	0.471818848	37.74550784	0.09436377	37.74550784	0.09436377	0	0	0	40	0	40	0	0	0											9.131	0.17015547	3.700135966	0	1.827384862	2.829466496	0.528921004	0.666671654	2.796788912	0	1.840200454	0	0	3.448764676	6.247655246	14.54419659	2.392641083	1.894575008	2.709316789	2.591298235	3.876257261	0	0	0	2.230966582	0	0.112578158	0	0	0	0	0	0	0	0	0	0	0	0	0	63.539		3.6551	9.131	0.17015547	3.700135966	0	1.827384862	2.829466496	0.528921004	0.666671654	2.796788912	0	1.840200454	0	0	3.448764676	6.247655246	14.54419659	2.392641083	1.894575008	2.709316789	2.591298235	3.876257261	0	0	0	2.230966582	0	0.112578158	0	0	0	0	0	0	0	0	0	0	0	0	0	63.539		30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	40% Coinsurance	40% Coinsurance	"$50 ER, $40 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	"$25 PCP, 30% Physical Exams"	"$45 Specialist, 30% Chiropractic"	50% Coinsurance	30% Coinsurance	30% Coinsurance	$45 Copay	30% Coinsurance	$0 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											4.5475	0.1883	0.7368	0.6735	0.2629	0.3588	0.0991	0.0548	0.9203	0.1416	0.4538	0.0855	0	0.4291	0.8807	1.1867	0.1967	0.0891	0.6682	0.6738	0.956	0	0	0	0.0942	0	0.0121	0	0	0											13.7092		0	13.6786	0.358407813	4.436927655	0.673452848	2.090277539	3.188296426	0.627994217	0.721476935	3.717059839	0.141596418	2.29403422	0.085452732	0	3.877820003	7.128388277	15.73087154	2.589333661	1.983654379	3.377493694	3.265059539	4.832227264	0	0	0	2.325150181	0	0.12468228	0	0	0	0	0	0	0	0	0	0	0	0	0	77.2482
H3335_036_0	2009	9																					4000											A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	Coin	V	V	V	Coin				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	234.9148156	6.841717273	590.512873	0	129.5142289	8.84339086	1.715951198	205.8235771	372.9330092	0	1010.240928	0.083784675	0	863.1000817	4231.657046	5377.028736	2.418884986	1141.423748	814.2625773	767.9275352	40.96124294	0	0	0	648.0872287	0	0	0	0	0											"$600 Copay per admit, 3 per year"	"$600 Copay per admit, 3 per year"	$50 Copay per day	$0 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $40 Urgent Care"	$100 Copay	$0 Copay	$40 Copay	$100 Copay	$0 Copay	$40 Copay	"$20 PCP, $0 Physical Exams"	"$40 Specialist, $20 Chiropractic"	50% Coinsurance	$40 Copay	$40 Copay	$40 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$40 Copay	Not Covered	$40 Copay	Not Covered	Not Covered	$0 Copay											600	600	50	0	100	0.344261371	0.130134763	48.73800154	100	0	40	100	0	40	20	37.08589471	0.5	40	40	40	0.1	0	0	0	40	0	0	0	0	0											564.8733366	564.8733366	47.07277805	0	94.1455561	0.324106782	0.122516096	45.88466258	94.1455561	0	37.65822244	94.1455561	0	37.65822244	18.82911122	34.91472181	0.47072778	37.65822244	37.65822244	37.65822244	0.094145556	0	0	0	40	0	0	0	0	0											11.0581	0.322058639	2.31642345	0	1.016099092	2.866202956	0.210231642	0.787012115	2.925832128	0	3.170323131	0.00065733	0	2.708567905	6.639861763	15.64478854	1.138636361	3.581999117	2.555306772	2.409898828	3.856318995	0	0	0	2.160290762	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.3686	0	3.9306	11.0581	0.322058639	2.31642345	0	1.016099092	2.866202956	0.210231642	0.787012115	2.925832128	0	3.170323131	0.00065733	0	2.708567905	6.639861763	15.64478854	1.138636361	3.581999117	2.555306772	2.409898828	3.856318995	0	0	0	2.160290762	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.3686	0	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	40% Coinsurance	40% Coinsurance	"$50 ER, $40 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	30% Coinsurance	30% Coinsurance	50% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											2.809	0.0132	1.0403	0.0291	0.9798	0.8818	0.4594	0.0412	0.3541	0.1278	0.1336	0.0002	0	0.1938	0.5174	1.5345	0.4178	0.109	0.3808	2.6425	0.2764	0	0	0	0.07	0	0	0	0	0											13.0117	0	0	13.8671	0.335227042	3.356733787	0.029114656	1.995902722	3.748005515	0.669627522	0.828240456	3.279897676	0.127841751	3.303924814	0.000816982	0	2.902345613	7.157227185	17.17932053	1.556440106	3.690981177	2.936149903	5.052385322	4.132729039	0	0	0	2.23031947	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.3803
H3335_037_0	2009	9																					4000											A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	Coin	V	V	V	Coin				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	206.8785199	6.025181253	520.0371413	0	114.0571399	7.787961808	1.511158175	181.2592232	328.4247048	0	889.6720598	0.073785255	0	760.0919804	3726.622964	4735.298382	2.130199172	1005.19865	717.0830684	676.2779583	36.07265591	0	0	0	570.7401906	0	0	0	0	0											"$600 Copay per admit, 3 per year"	"$600 Copay per admit, 3 per year"	$50 Copay per day	$0 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $40 Urgent Care"	$100 Copay	$0 Copay	$40 Copay	$100 Copay	$0 Copay	$40 Copay	"$20 PCP, $0 Physical Exams"	"$40 Specialist, $20 Chiropractic"	50% Coinsurance	$40 Copay	$40 Copay	$40 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$40 Copay	Not Covered	$40 Copay	Not Covered	Not Covered	$0 Copay											600	600	50	0	100	0.344261371	0.130134763	48.73800154	100	0	40	100	0	40	20	37.08589471	0.5	40	40	40	0.1	0	0	0	40	0	0	0	0	0											570.6670525	570.6670525	47.55558771	0	95.11117542	0.327431037	0.123772703	46.35528614	95.11117542	0	38.04447017	95.11117542	0	38.04447017	19.02223508	35.27283038	0.475555877	38.04447017	38.04447017	38.04447017	0.095111175	0	0	0	40	0	0	0	0	0											9.8382	0.286531036	2.060889324	0	0.904009053	2.550020407	0.187040132	0.700193596	2.603071642	0	2.820591845	0.000584817	0	2.409774723	5.907391508	13.91894805	1.013028736	3.186854172	2.27342045	2.144053051	3.430912704	0	0	0	1.902467302	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.138	0	2.8906	9.8382	0.286531036	2.060889324	0	0.904009053	2.550020407	0.187040132	0.700193596	2.603071642	0	2.820591845	0.000584817	0	2.409774723	5.907391508	13.91894805	1.013028736	3.186854172	2.27342045	2.144053051	3.430912704	0	0	0	1.902467302	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.138	0	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	40% Coinsurance	40% Coinsurance	"$50 ER, $40 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	30% Coinsurance	30% Coinsurance	50% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											2.4738	0.0116	0.9162	0.0256	0.8629	0.7766	0.4046	0.0363	0.3118	0.1126	0.1177	0.0001	0	0.1707	0.4556	1.3514	0.3679	0.096	0.3354	2.3271	0.2434	0	0	0	0.0617	0	0	0	0	0											11.4588	0	0	12.312	0.298127834	2.977042109	0.02563992	1.766876405	3.326582787	0.591608653	0.736501473	2.914880654	0.112584266	2.938248615	0.000725416	0	2.580425711	6.3630111	15.2703388	1.380969004	3.282829589	2.608811231	4.471167641	3.674334136	0	0	0	1.964138319	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.5968
H3335_038_0	2009	9																					4000											A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	Coin	V	V	V	Coin				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	217.1922547	6.325561021	545.9631059	0	119.7433518	8.17622335	1.586495551	190.295732	344.7980108	0	934.0258272	0.07746375	0	797.9856543	3912.410262	4971.372248	2.236398257	1055.311888	752.8325732	709.9931626	37.87102439	0	0	0	599.1939083	0	0	0	0	0											"$600 Copay per admit, 3 per year"	"$600 Copay per admit, 3 per year"	$50 Copay per day	$0 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $40 Urgent Care"	$100 Copay	$0 Copay	$40 Copay	$100 Copay	$0 Copay	$40 Copay	"$20 PCP, $0 Physical Exams"	"$40 Specialist, $20 Chiropractic"	50% Coinsurance	$40 Copay	$40 Copay	$40 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$40 Copay	Not Covered	$40 Copay	Not Covered	Not Covered	$0 Copay											600	600	50	0	100	0.344261371	0.130134763	48.73800154	100	0	40	100	0	40	20	37.08589471	0.5	40	40	40	0.1	0	0	0	40	0	0	0	0	0											568.4148636	568.4148636	47.3679053	0	94.7358106	0.3261388	0.123284223	46.17234083	94.7358106	0	37.89432424	94.7358106	0	37.89432424	18.94716212	35.13362297	0.473679053	37.89432424	37.89432424	37.89432424	0.094735811	0	0	0	40	0	0	0	0	0											10.2879	0.299628575	2.155094058	0	0.945331958	2.666583676	0.195589871	0.73219995	2.722059921	0	2.949523128	0.000611549	0	2.51992726	6.177422625	14.55519319	1.059335008	3.33252757	2.377340136	2.242059259	3.587742194	0	0	0	1.997313028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.8034	0	3.2677	10.2879	0.299628575	2.155094058	0	0.945331958	2.666583676	0.195589871	0.73219995	2.722059921	0	2.949523128	0.000611549	0	2.51992726	6.177422625	14.55519319	1.059335008	3.33252757	2.377340136	2.242059259	3.587742194	0	0	0	1.997313028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.8034	0	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	40% Coinsurance	40% Coinsurance	"$50 ER, $40 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	30% Coinsurance	30% Coinsurance	50% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											2.5971	0.0122	0.9618	0.0269	0.9059	0.8153	0.4247	0.0381	0.3274	0.1182	0.1235	0.0001	0	0.1792	0.4783	1.4188	0.3863	0.1008	0.3521	2.4431	0.2556	0	0	0	0.0647	0	0	0	0	0											12.0301	0	0	12.885	0.311803522	3.116920782	0.026918174	1.851216753	3.481860846	0.620327777	0.770317922	3.049413879	0.11819705	3.073045566	0.000759157	0	2.699085893	6.655756706	15.97395625	1.445618595	3.433287751	2.729451509	4.685189968	3.843299173	0	0	0	2.062058595	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.8335
H3335_039_0	2009	9																					4000											A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	Coin	V	V	V	Coin				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	223.4435858	6.507626337	561.6772765	0	123.1898621	8.411555312	1.632158823	195.7729145	354.7221517	0	960.9094041	0.079693348	0	820.9536581	4025.01912	5114.460656	2.300767338	1085.686378	774.5009596	730.4285245	38.96104628	0	0	0	616.4401933	0	0	0	0	0											"$600 Copay per admit, 3 per year"	"$600 Copay per admit, 3 per year"	$50 Copay per day	$0 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $40 Urgent Care"	$100 Copay	$0 Copay	$40 Copay	$100 Copay	$0 Copay	$40 Copay	"$20 PCP, $0 Physical Exams"	"$40 Specialist, $20 Chiropractic"	50% Coinsurance	$40 Copay	$40 Copay	$40 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$40 Copay	Not Covered	$40 Copay	Not Covered	Not Covered	$0 Copay											600	600	50	0	100	0.344261371	0.130134763	48.73800154	100	0	40	100	0	40	20	37.08589471	0.5	40	40	40	0.1	0	0	0	40	0	0	0	0	0											567.1015178	567.1015178	47.25845981	0	94.51691963	0.325385243	0.12299937	46.06565774	94.51691963	0	37.80676785	94.51691963	0	37.80676785	18.90338393	35.0524453	0.472584598	37.80676785	37.80676785	37.80676785	0.09451692	0	0	0	40	0	0	0	0	0											10.5596	0.307540398	2.21200025	0	0.970293858	2.736995972	0.200754506	0.751534006	2.793937092	0	3.027406564	0.000627697	0	2.586467031	6.340540145	14.93952937	1.087307208	3.420524404	2.440114831	2.301261805	3.68247808	0	0	0	2.054800644	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.4137	0	3.5015	10.5596	0.307540398	2.21200025	0	0.970293858	2.736995972	0.200754506	0.751534006	2.793937092	0	3.027406564	0.000627697	0	2.586467031	6.340540145	14.93952937	1.087307208	3.420524404	2.440114831	2.301261805	3.68247808	0	0	0	2.054800644	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.4137	0	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	40% Coinsurance	40% Coinsurance	"$50 ER, $40 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	30% Coinsurance	30% Coinsurance	50% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											2.6719	0.0125	0.9895	0.0277	0.932	0.8387	0.437	0.0392	0.3368	0.1216	0.1271	0.0002	0	0.1843	0.4921	1.4596	0.3974	0.1037	0.3622	2.5135	0.2629	0	0	0	0.0666	0	0	0	0	0											12.3764	0	0	13.2315	0.320065769	3.20151073	0.027692945	1.902252261	3.575738839	0.637717421	0.790749108	3.130713108	0.121599053	3.154484283	0.000779554	0	2.770782293	6.832641866	16.39912795	1.484708993	3.524184713	2.802360842	4.814711867	3.945390622	0	0	0	2.121409749	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.7901
H3335_040_0	2009	10																					4000											A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	Coin	V	V	V	Coin				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	207.3494313	6.038896195	521.2208864	0	114.3167648	7.805689315	1.51459798	181.6718182	329.1722882	0	891.697194	0.07395321	0	761.8221553	3735.105765	4746.077202	2.135048081	1007.486754	718.7153434	677.8173498	36.15476703	0	0	0	572.0393497	0	0	0	0	0											"$600 Copay per admit, 3 per year"	"$600 Copay per admit, 3 per year"	$50 Copay per day	$0 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $40 Urgent Care"	$100 Copay	$0 Copay	$40 Copay	$100 Copay	$0 Copay	$40 Copay	"$20 PCP, $0 Physical Exams"	"$40 Specialist, $20 Chiropractic"	50% Coinsurance	$40 Copay	$40 Copay	$40 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$40 Copay	Not Covered	$40 Copay	Not Covered	Not Covered	$0 Copay											600	600	50	0	100	0.344261371	0.130134763	48.73800154	100	0	40	100	0	40	20	37.08589471	0.5	40	40	40	0.1	0	0	0	40	0	0	0	0	0											570.5789185	570.5789185	47.5482432	0	95.09648641	0.327380468	0.123753587	46.34812701	95.09648641	0	38.03859456	95.09648641	0	38.03859456	19.01929728	35.26738283	0.475482432	38.03859456	38.03859456	38.03859456	0.095096486	0	0	0	40	0	0	0	0	0											9.8591	0.287138905	2.065261456	0	0.905926889	2.555430221	0.187436933	0.701679042	2.608594003	0	2.82657567	0.000586058	0	2.414887008	5.919923911	13.9484768	1.015177854	3.193615014	2.278243463	2.148601613	3.438191311	0	0	0	1.906797832	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.2616	0	2.9059	9.8591	0.287138905	2.065261456	0	0.905926889	2.555430221	0.187436933	0.701679042	2.608594003	0	2.82657567	0.000586058	0	2.414887008	5.919923911	13.9484768	1.015177854	3.193615014	2.278243463	2.148601613	3.438191311	0	0	0	1.906797832	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.2616	0	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	40% Coinsurance	40% Coinsurance	"$50 ER, $40 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	30% Coinsurance	30% Coinsurance	50% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											2.4794	0.0116	0.9182	0.0257	0.8648	0.7783	0.4055	0.0364	0.3125	0.1128	0.1179	0.0001	0	0.171	0.4567	1.3545	0.3688	0.0962	0.3362	2.3324	0.244	0	0	0	0.0618	0	0	0	0	0											11.4849	0	0	12.3385	0.298762101	2.983499653	0.025698283	1.77075836	3.333760267	0.592926362	0.738069565	2.921112776	0.112840539	2.944500258	0.000726976	0	2.585926443	6.376580617	15.30294367	1.383955654	3.289808897	2.614397683	4.481013345	3.682166837	0	0	0	1.968609229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.7466
H3335_041_0	2009	4																					4000											A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	Coin	V	V	V	Coin				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	235.8658877	6.869416533	590.512873	0	129.5142289	8.84339086	1.715951198	206.4420272	372.9330092	0	1026.743212	0.083784675	0	867.5036535	4231.657046	5479.433206	2.418884986	1154.852263	827.5635556	784.9925915	40.96124294	0	0	0	655.7117844	0	0	0	0	0											"$400 Copay per admit, 3 per year"	"$400 Copay per admit, 3 per year"	$50 Copay per day	$0 Copay	$100 Copay	20% Coinsurance	20% Coinsurance	"$50 ER, $30 Urgent Care"	$100 Copay	$0 Copay	$30 Copay	$100 Copay	$0 Copay	$30 Copay	"$20 PCP, $0 Physical Exams"	"$30 Specialist, $20 Chiropractic"	50% Coinsurance	$30 Copay	$30 Copay	$30 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$30 Copay	Not Covered	$30 Copay	Not Covered	Not Covered	$0 Copay											400	400	50	0	100	0.229507581	0.086756509	47.42364922	100	0	30	100	0	30	20	28.57017804	0.5	30	30	30	0.1	0	0	0	30	0	0	0	0	0											382.4907952	382.4907952	47.8113494	0	95.6226988	0.219461343	0.082958915	45.34777326	95.6226988	0	28.68680964	95.6226988	0	28.68680964	19.12453976	27.31957529	0.478113494	28.68680964	28.68680964	28.68680964	0.095622699	0	0	0	30	0	0	0	0	0											7.518	0.218957383	2.352768108	0	1.032041675	1.940782432	0.14235345	0.78014052	2.971738401	0	2.454498923	0.000667643	0	2.073826014	6.744041119	12.474649	1.156501552	2.760752252	1.978346516	1.876577754	3.916824596	0	0	0	1.639279461	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0328	0	2.3984	7.518	0.218957383	2.352768108	0	1.032041675	1.940782432	0.14235345	0.78014052	2.971738401	0	2.454498923	0.000667643	0	2.073826014	6.744041119	12.474649	1.156501552	2.760752252	1.978346516	1.876577754	3.916824596	0	0	0	1.639279461	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0328	0	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $30 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	30% Coinsurance	$35 Copay	50% Coinsurance	30% Coinsurance	30% Coinsurance	$35 Copay	30% Coinsurance	$0 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											2.8204	0.0132	1.0403	0.0291	0.9798	0.6614	0.3445	0.0405	0.3541	0.1285	0.1358	0.0002	0	0.1948	0.4604	1.2223	0.4178	0.1103	0.3871	1.0105	0.2764	0	0	0	0.0709	0	0	0	0	0											10.6981	0	0	10.3384	0.2321791	3.393078444	0.029114656	2.011845305	2.602134351	0.486900359	0.820604699	3.325803949	0.128525397	2.590282989	0.000827296	0	2.268592383	7.204448986	13.69689964	1.574305297	2.871016454	2.365410719	2.887064911	4.19323464	0	0	0	1.710132036	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.7308
H3335_042_0	2009	5																					4000											A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	Coin	V	V	V	Coin				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	207.7160847	6.049574699	520.0371413	0	114.0571399	7.787961808	1.511158175	181.8038633	328.4247048	0	904.204852	0.073785255	0	763.9700007	3726.622964	4825.481222	2.130199172	1017.024517	728.7966196	691.3063574	36.07265591	0	0	0	577.4547811	0	0	0	0	0											"$400 Copay per admit, 3 per year"	"$400 Copay per admit, 3 per year"	$50 Copay per day	$0 Copay	$100 Copay	20% Coinsurance	20% Coinsurance	"$50 ER, $30 Urgent Care"	$100 Copay	$0 Copay	$30 Copay	$100 Copay	$0 Copay	$30 Copay	"$20 PCP, $0 Physical Exams"	"$30 Specialist, $20 Chiropractic"	50% Coinsurance	$30 Copay	$30 Copay	$30 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$30 Copay	Not Covered	$30 Copay	Not Covered	Not Covered	$0 Copay											400	400	50	0	100	0.229507581	0.086756509	47.42364922	100	0	30	100	0	30	20	28.57017804	0.5	30	30	30	0.1	0	0	0	30	0	0	0	0	0											385.8747162	385.8747162	48.23433952	0	96.46867904	0.221402931	0.083692858	45.74896796	96.46867904	0	28.94060371	96.46867904	0	28.94060371	19.29373581	27.56127335	0.482343395	28.94060371	28.94060371	28.94060371	0.096468679	0	0	0	30	0	0	0	0	0											6.6794	0.194531493	2.090304003	0	0.916911802	1.724277574	0.126473147	0.693111593	2.640224786	0	2.180686191	0.000593164	0	1.84247942	5.991706577	11.08303392	1.027487501	2.452775292	1.75765118	1.667235278	3.479881465	0	0	0	1.443636953	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.9924	0	1.704	6.6794	0.194531493	2.090304003	0	0.916911802	1.724277574	0.126473147	0.693111593	2.640224786	0	2.180686191	0.000593164	0	1.84247942	5.991706577	11.08303392	1.027487501	2.452775292	1.75765118	1.667235278	3.479881465	0	0	0	1.443636953	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.9924	0	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $30 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	30% Coinsurance	$35 Copay	50% Coinsurance	30% Coinsurance	30% Coinsurance	$35 Copay	30% Coinsurance	$0 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											2.4838	0.0116	0.9162	0.0256	0.8629	0.5824	0.3034	0.0356	0.3118	0.1132	0.1196	0.0001	0	0.1715	0.4055	1.0764	0.3679	0.0971	0.3409	0.8899	0.2434	0	0	0	0.0624	0	0	0	0	0											9.4213	0	0	9.1632	0.206175243	3.006456788	0.02563992	1.779779153	2.306699359	0.429899538	0.728746508	2.952033798	0.113186321	2.300264884	0.000733763	0	2.014001076	6.397166308	12.15941304	1.39542777	2.549879831	2.098520568	2.557124181	3.723302897	0	0	0	1.506033511	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.4136
H3335_043_0	2009	5																					4000											A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	Coin	V	V	V	Coin				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	218.0715756	6.35117058	545.9631059	0	119.7433518	8.17622335	1.586495551	190.8675246	344.7980108	0	949.2831381	0.07746375	0	802.0570097	3912.410262	5066.051069	2.236398257	1067.727322	765.1300926	725.7707884	37.87102439	0	0	0	606.2432484	0	0	0	0	0											"$400 Copay per admit, 3 per year"	"$400 Copay per admit, 3 per year"	$50 Copay per day	$0 Copay	$100 Copay	20% Coinsurance	20% Coinsurance	"$50 ER, $30 Urgent Care"	$100 Copay	$0 Copay	$30 Copay	$100 Copay	$0 Copay	$30 Copay	"$20 PCP, $0 Physical Exams"	"$30 Specialist, $20 Chiropractic"	50% Coinsurance	$30 Copay	$30 Copay	$30 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$30 Copay	Not Covered	$30 Copay	Not Covered	Not Covered	$0 Copay											400	400	50	0	100	0.229507581	0.086756509	47.42364922	100	0	30	100	0	30	20	28.57017804	0.5	30	30	30	0.1	0	0	0	30	0	0	0	0	0											384.7688027	384.7688027	48.09610034	0	96.19220068	0.220768393	0.083452995	45.61785183	96.19220068	0	28.8576602	96.19220068	0	28.8576602	19.23844014	27.48228299	0.480961003	28.8576602	28.8576602	28.8576602	0.096192201	0	0	0	30	0	0	0	0	0											6.9923	0.203644358	2.188224694	0	0.959864711	1.805051687	0.132397805	0.725580538	2.763906621	0	2.282840853	0.000620951	0	1.928790721	6.272389217	11.60222076	1.07562035	2.56767602	1.839988685	1.745337233	3.642897178	0	0	0	1.515608121	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2449	0	1.929	6.9923	0.203644358	2.188224694	0	0.959864711	1.805051687	0.132397805	0.725580538	2.763906621	0	2.282840853	0.000620951	0	1.928790721	6.272389217	11.60222076	1.07562035	2.56767602	1.839988685	1.745337233	3.642897178	0	0	0	1.515608121	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2449	0	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $30 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	30% Coinsurance	$35 Copay	50% Coinsurance	30% Coinsurance	30% Coinsurance	$35 Copay	30% Coinsurance	$0 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											2.6076	0.0122	0.9618	0.0269	0.9059	0.6115	0.3186	0.0374	0.3274	0.1188	0.1255	0.0001	0	0.1801	0.4257	1.13	0.3863	0.1019	0.3579	0.9343	0.2556	0	0	0	0.0655	0	0	0	0	0											9.891	0	0	9.5999	0.215868596	3.150051418	0.026918174	1.865749505	2.416509564	0.450951235	0.762991999	3.091260579	0.118829119	2.40838103	0.000768559	0	2.108863428	6.698062764	12.73226176	1.461903936	2.669621615	2.197851798	2.679590714	3.898454157	0	0	0	1.581115401	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1359
H3335_044_0	2009	5																					4000											A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	Coin	V	V	V	Coin				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	224.3482157	6.533973002	561.6772765	0	123.1898621	8.411555312	1.632158823	196.3611648	354.7221517	0	976.6058583	0.079693348	0	825.1421972	4025.01912	5211.864568	2.300767338	1098.459159	787.1524319	746.6602695	38.96104628	0	0	0	623.6924309	0	0	0	0	0											"$400 Copay per admit, 3 per year"	"$400 Copay per admit, 3 per year"	$50 Copay per day	$0 Copay	$100 Copay	20% Coinsurance	20% Coinsurance	"$50 ER, $30 Urgent Care"	$100 Copay	$0 Copay	$30 Copay	$100 Copay	$0 Copay	$30 Copay	"$20 PCP, $0 Physical Exams"	"$30 Specialist, $20 Chiropractic"	50% Coinsurance	$30 Copay	$30 Copay	$30 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$30 Copay	Not Covered	$30 Copay	Not Covered	Not Covered	$0 Copay											400	400	50	0	100	0.229507581	0.086756509	47.42364922	100	0	30	100	0	30	20	28.57017804	0.5	30	30	30	0.1	0	0	0	30	0	0	0	0	0											383.9240226	383.9240226	47.99050282	0	95.98100565	0.220283684	0.08326977	45.51769544	95.98100565	0	28.79430169	95.98100565	0	28.79430169	19.19620113	27.4219442	0.479905028	28.79430169	28.79430169	28.79430169	0.095981006	0	0	0	30	0	0	0	0	0											7.1777	0.209045767	2.246264577	0	0.985323904	1.852928392	0.135909489	0.744825641	2.837215737	0	2.34339031	0.000637421	0	1.979949447	6.438756382	11.90995495	1.104149814	2.635780368	1.88879205	1.791630089	3.739520403	0	0	0	1.559231077	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.581	0	2.0946	7.1777	0.209045767	2.246264577	0	0.985323904	1.852928392	0.135909489	0.744825641	2.837215737	0	2.34339031	0.000637421	0	1.979949447	6.438756382	11.90995495	1.104149814	2.635780368	1.88879205	1.791630089	3.739520403	0	0	0	1.559231077	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.581	0	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $30 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	30% Coinsurance	$35 Copay	50% Coinsurance	30% Coinsurance	30% Coinsurance	$35 Copay	30% Coinsurance	$0 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											2.6827	0.0126	0.9895	0.0277	0.932	0.6291	0.3277	0.0385	0.3368	0.1222	0.1292	0.0002	0	0.1853	0.4379	1.1626	0.3974	0.1049	0.3682	0.9611	0.2629	0	0	0	0.0674	0	0	0	0	0											10.1757	0	0	9.8604	0.221621848	3.235775057	0.027692945	1.917282307	2.481985542	0.463631676	0.783313896	3.173991753	0.122249316	2.472543844	0.000789277	0	2.165205093	6.876681868	13.07252132	1.501551599	2.74066021	2.25695535	2.752773699	4.002432946	0	0	0	1.626623819	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.7567
H3335_045_0	2009	5																					4000											A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	Coin	V	V	V	Coin				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	208.1889027	6.063345167	521.2208864	0	114.3167648	7.805689315	1.51459798	182.2176981	329.1722882	0	906.2630668	0.07395321	0	765.7090031	3735.105765	4836.465322	2.135048081	1019.33954	730.4555578	692.8799576	36.15476703	0	0	0	578.7692244	0	0	0	0	0											"$400 Copay per admit, 3 per year"	"$400 Copay per admit, 3 per year"	$50 Copay per day	$0 Copay	$100 Copay	20% Coinsurance	20% Coinsurance	"$50 ER, $30 Urgent Care"	$100 Copay	$0 Copay	$30 Copay	$100 Copay	$0 Copay	$30 Copay	"$20 PCP, $0 Physical Exams"	"$30 Specialist, $20 Chiropractic"	50% Coinsurance	$30 Copay	$30 Copay	$30 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$30 Copay	Not Covered	$30 Copay	Not Covered	Not Covered	$0 Copay											400	400	50	0	100	0.229507581	0.086756509	47.42364922	100	0	30	100	0	30	20	28.57017804	0.5	30	30	30	0.1	0	0	0	30	0	0	0	0	0											385.8290424	385.8290424	48.2286303	0	96.4572606	0.221376725	0.083682952	45.74355292	96.4572606	0	28.93717818	96.4572606	0	28.93717818	19.29145212	27.55801108	0.482286303	28.93717818	28.93717818	28.93717818	0.096457261	0	0	0	30	0	0	0	0	0											6.6938	0.194951222	2.09481412	0	0.918890164	1.727997939	0.12674603	0.694607076	2.645921432	0	2.18539132	0.000594444	0	1.846454821	6.004634503	11.10694708	1.029704446	2.45806749	1.761443552	1.670832566	3.487389785	0	0	0	1.446923061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.0961	0	1.7134	6.6938	0.194951222	2.09481412	0	0.918890164	1.727997939	0.12674603	0.694607076	2.645921432	0	2.18539132	0.000594444	0	1.846454821	6.004634503	11.10694708	1.029704446	2.45806749	1.761443552	1.670832566	3.487389785	0	0	0	1.446923061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.0961	0	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $30 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	30% Coinsurance	$35 Copay	50% Coinsurance	30% Coinsurance	30% Coinsurance	$35 Copay	30% Coinsurance	$0 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											2.4894	0.0117	0.9182	0.0257	0.8648	0.5837	0.3041	0.0357	0.3125	0.1134	0.1199	0.0001	0	0.1719	0.4064	1.0788	0.3688	0.0973	0.3416	0.8919	0.244	0	0	0	0.0625	0	0	0	0	0											9.4427	0	0	9.1832	0.206621475	3.013052316	0.025698283	1.783721635	2.311745473	0.430863101	0.730323106	2.958440205	0.113443964	2.305242206	0.000735363	0	2.018366907	6.41101717	12.18577633	1.398482246	2.555393066	2.103088851	2.562747096	3.73136531	0	0	0	1.50946165	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.5388
H3335_046_0	2009	8																					4000											A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	Coin	V	V	V	Coin				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	235.8658877	6.869416533	590.512873	0	129.5142289	8.84339086	1.715951198	206.4420272	372.9330092	0	1026.743212	0.083784675	0	867.5036535	4231.657046	5479.433206	2.418884986	1154.852263	827.5635556	784.9925915	40.96124294	0	0	0	655.7117844	0	0	0	0	0											"$400 Copay per admit, 3 per year"	"$400 Copay per admit, 3 per year"	$50 Copay per day	$0 Copay	$100 Copay	20% Coinsurance	20% Coinsurance	"$50 ER, $30 Urgent Care"	$100 Copay	$0 Copay	$30 Copay	$100 Copay	$0 Copay	$30 Copay	"$20 PCP, $0 Physical Exams"	"$30 Specialist, $20 Chiropractic"	50% Coinsurance	$30 Copay	$30 Copay	$30 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$30 Copay	Not Covered	$30 Copay	Not Covered	Not Covered	$0 Copay											400	400	50	0	100	0.229507581	0.086756509	47.42364922	100	0	30	100	0	30	20	28.57017804	0.5	30	30	30	0.1	0	0	0	30	0	0	0	0	0											382.4907952	382.4907952	47.8113494	0	95.6226988	0.219461343	0.082958915	45.34777326	95.6226988	0	28.68680964	95.6226988	0	28.68680964	19.12453976	27.31957529	0.478113494	28.68680964	28.68680964	28.68680964	0.095622699	0	0	0	30	0	0	0	0	0											7.518	0.218957383	2.352768108	0	1.032041675	1.940782432	0.14235345	0.78014052	2.971738401	0	2.454498923	0.000667643	0	2.073826014	6.744041119	12.474649	1.156501552	2.760752252	1.978346516	1.876577754	3.916824596	0	0	0	1.639279461	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0328	0	2.3984	7.518	0.218957383	2.352768108	0	1.032041675	1.940782432	0.14235345	0.78014052	2.971738401	0	2.454498923	0.000667643	0	2.073826014	6.744041119	12.474649	1.156501552	2.760752252	1.978346516	1.876577754	3.916824596	0	0	0	1.639279461	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0328	0	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $30 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	30% Coinsurance	$35 Copay	50% Coinsurance	30% Coinsurance	30% Coinsurance	$35 Copay	30% Coinsurance	$0 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											2.8204	0.0132	1.0403	0.0291	0.9798	0.6614	0.3445	0.0405	0.3541	0.1285	0.1358	0.0002	0	0.1948	0.4604	1.2223	0.4178	0.1103	0.3871	1.0105	0.2764	0	0	0	0.0709	0	0	0	0	0											10.6981	0	0	10.3384	0.2321791	3.393078444	0.029114656	2.011845305	2.602134351	0.486900359	0.820604699	3.325803949	0.128525397	2.590282989	0.000827296	0	2.268592383	7.204448986	13.69689964	1.574305297	2.871016454	2.365410719	2.887064911	4.19323464	0	0	0	1.710132036	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.7308
H3335_047_0	2009	9																					4000											A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	Coin	V	V	V	Coin				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	207.7160847	6.049574699	520.0371413	0	114.0571399	7.787961808	1.511158175	181.8038633	328.4247048	0	904.204852	0.073785255	0	763.9700007	3726.622964	4825.481222	2.130199172	1017.024517	728.7966196	691.3063574	36.07265591	0	0	0	577.4547811	0	0	0	0	0											"$400 Copay per admit, 3 per year"	"$400 Copay per admit, 3 per year"	$50 Copay per day	$0 Copay	$100 Copay	20% Coinsurance	20% Coinsurance	"$50 ER, $30 Urgent Care"	$100 Copay	$0 Copay	$30 Copay	$100 Copay	$0 Copay	$30 Copay	"$20 PCP, $0 Physical Exams"	"$30 Specialist, $20 Chiropractic"	50% Coinsurance	$30 Copay	$30 Copay	$30 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$30 Copay	Not Covered	$30 Copay	Not Covered	Not Covered	$0 Copay											400	400	50	0	100	0.229507581	0.086756509	47.42364922	100	0	30	100	0	30	20	28.57017804	0.5	30	30	30	0.1	0	0	0	30	0	0	0	0	0											385.8747162	385.8747162	48.23433952	0	96.46867904	0.221402931	0.083692858	45.74896796	96.46867904	0	28.94060371	96.46867904	0	28.94060371	19.29373581	27.56127335	0.482343395	28.94060371	28.94060371	28.94060371	0.096468679	0	0	0	30	0	0	0	0	0											6.6794	0.194531493	2.090304003	0	0.916911802	1.724277574	0.126473147	0.693111593	2.640224786	0	2.180686191	0.000593164	0	1.84247942	5.991706577	11.08303392	1.027487501	2.452775292	1.75765118	1.667235278	3.479881465	0	0	0	1.443636953	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.9924	0	1.704	6.6794	0.194531493	2.090304003	0	0.916911802	1.724277574	0.126473147	0.693111593	2.640224786	0	2.180686191	0.000593164	0	1.84247942	5.991706577	11.08303392	1.027487501	2.452775292	1.75765118	1.667235278	3.479881465	0	0	0	1.443636953	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.9924	0	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $30 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	30% Coinsurance	$35 Copay	50% Coinsurance	30% Coinsurance	30% Coinsurance	$35 Copay	30% Coinsurance	$0 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											2.4838	0.0116	0.9162	0.0256	0.8629	0.5824	0.3034	0.0356	0.3118	0.1132	0.1196	0.0001	0	0.1715	0.4055	1.0764	0.3679	0.0971	0.3409	0.8899	0.2434	0	0	0	0.0624	0	0	0	0	0											9.4213	0	0	9.1632	0.206175243	3.006456788	0.02563992	1.779779153	2.306699359	0.429899538	0.728746508	2.952033798	0.113186321	2.300264884	0.000733763	0	2.014001076	6.397166308	12.15941304	1.39542777	2.549879831	2.098520568	2.557124181	3.723302897	0	0	0	1.506033511	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.4136
H3335_048_0	2009	9																					4000											A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	Coin	V	V	V	Coin				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	218.0715756	6.35117058	545.9631059	0	119.7433518	8.17622335	1.586495551	190.8675246	344.7980108	0	949.2831381	0.07746375	0	802.0570097	3912.410262	5066.051069	2.236398257	1067.727322	765.1300926	725.7707884	37.87102439	0	0	0	606.2432484	0	0	0	0	0											"$400 Copay per admit, 3 per year"	"$400 Copay per admit, 3 per year"	$50 Copay per day	$0 Copay	$100 Copay	20% Coinsurance	20% Coinsurance	"$50 ER, $30 Urgent Care"	$100 Copay	$0 Copay	$30 Copay	$100 Copay	$0 Copay	$30 Copay	"$20 PCP, $0 Physical Exams"	"$30 Specialist, $20 Chiropractic"	50% Coinsurance	$30 Copay	$30 Copay	$30 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$30 Copay	Not Covered	$30 Copay	Not Covered	Not Covered	$0 Copay											400	400	50	0	100	0.229507581	0.086756509	47.42364922	100	0	30	100	0	30	20	28.57017804	0.5	30	30	30	0.1	0	0	0	30	0	0	0	0	0											384.7688027	384.7688027	48.09610034	0	96.19220068	0.220768393	0.083452995	45.61785183	96.19220068	0	28.8576602	96.19220068	0	28.8576602	19.23844014	27.48228299	0.480961003	28.8576602	28.8576602	28.8576602	0.096192201	0	0	0	30	0	0	0	0	0											6.9923	0.203644358	2.188224694	0	0.959864711	1.805051687	0.132397805	0.725580538	2.763906621	0	2.282840853	0.000620951	0	1.928790721	6.272389217	11.60222076	1.07562035	2.56767602	1.839988685	1.745337233	3.642897178	0	0	0	1.515608121	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2449	0	1.929	6.9923	0.203644358	2.188224694	0	0.959864711	1.805051687	0.132397805	0.725580538	2.763906621	0	2.282840853	0.000620951	0	1.928790721	6.272389217	11.60222076	1.07562035	2.56767602	1.839988685	1.745337233	3.642897178	0	0	0	1.515608121	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.2449	0	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $30 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	30% Coinsurance	$35 Copay	50% Coinsurance	30% Coinsurance	30% Coinsurance	$35 Copay	30% Coinsurance	$0 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											2.6076	0.0122	0.9618	0.0269	0.9059	0.6115	0.3186	0.0374	0.3274	0.1188	0.1255	0.0001	0	0.1801	0.4257	1.13	0.3863	0.1019	0.3579	0.9343	0.2556	0	0	0	0.0655	0	0	0	0	0											9.891	0	0	9.5999	0.215868596	3.150051418	0.026918174	1.865749505	2.416509564	0.450951235	0.762991999	3.091260579	0.118829119	2.40838103	0.000768559	0	2.108863428	6.698062764	12.73226176	1.461903936	2.669621615	2.197851798	2.679590714	3.898454157	0	0	0	1.581115401	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1359
H3335_049_0	2009	9																					4000											A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	Coin	V	V	V	Coin				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	224.3482157	6.533973002	561.6772765	0	123.1898621	8.411555312	1.632158823	196.3611648	354.7221517	0	976.6058583	0.079693348	0	825.1421972	4025.01912	5211.864568	2.300767338	1098.459159	787.1524319	746.6602695	38.96104628	0	0	0	623.6924309	0	0	0	0	0											"$400 Copay per admit, 3 per year"	"$400 Copay per admit, 3 per year"	$50 Copay per day	$0 Copay	$100 Copay	20% Coinsurance	20% Coinsurance	"$50 ER, $30 Urgent Care"	$100 Copay	$0 Copay	$30 Copay	$100 Copay	$0 Copay	$30 Copay	"$20 PCP, $0 Physical Exams"	"$30 Specialist, $20 Chiropractic"	50% Coinsurance	$30 Copay	$30 Copay	$30 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$30 Copay	Not Covered	$30 Copay	Not Covered	Not Covered	$0 Copay											400	400	50	0	100	0.229507581	0.086756509	47.42364922	100	0	30	100	0	30	20	28.57017804	0.5	30	30	30	0.1	0	0	0	30	0	0	0	0	0											383.9240226	383.9240226	47.99050282	0	95.98100565	0.220283684	0.08326977	45.51769544	95.98100565	0	28.79430169	95.98100565	0	28.79430169	19.19620113	27.4219442	0.479905028	28.79430169	28.79430169	28.79430169	0.095981006	0	0	0	30	0	0	0	0	0											7.1777	0.209045767	2.246264577	0	0.985323904	1.852928392	0.135909489	0.744825641	2.837215737	0	2.34339031	0.000637421	0	1.979949447	6.438756382	11.90995495	1.104149814	2.635780368	1.88879205	1.791630089	3.739520403	0	0	0	1.559231077	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.581	0	2.0946	7.1777	0.209045767	2.246264577	0	0.985323904	1.852928392	0.135909489	0.744825641	2.837215737	0	2.34339031	0.000637421	0	1.979949447	6.438756382	11.90995495	1.104149814	2.635780368	1.88879205	1.791630089	3.739520403	0	0	0	1.559231077	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.581	0	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $30 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	30% Coinsurance	$35 Copay	50% Coinsurance	30% Coinsurance	30% Coinsurance	$35 Copay	30% Coinsurance	$0 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											2.6827	0.0126	0.9895	0.0277	0.932	0.6291	0.3277	0.0385	0.3368	0.1222	0.1292	0.0002	0	0.1853	0.4379	1.1626	0.3974	0.1049	0.3682	0.9611	0.2629	0	0	0	0.0674	0	0	0	0	0											10.1757	0	0	9.8604	0.221621848	3.235775057	0.027692945	1.917282307	2.481985542	0.463631676	0.783313896	3.173991753	0.122249316	2.472543844	0.000789277	0	2.165205093	6.876681868	13.07252132	1.501551599	2.74066021	2.25695535	2.752773699	4.002432946	0	0	0	1.626623819	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.7567
H3335_050_0	2009	9																					4000											A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	Coin	V	V	V	Coin				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	208.1889027	6.063345167	521.2208864	0	114.3167648	7.805689315	1.51459798	182.2176981	329.1722882	0	906.2630668	0.07395321	0	765.7090031	3735.105765	4836.465322	2.135048081	1019.33954	730.4555578	692.8799576	36.15476703	0	0	0	578.7692244	0	0	0	0	0											"$400 Copay per admit, 3 per year"	"$400 Copay per admit, 3 per year"	$50 Copay per day	$0 Copay	$100 Copay	20% Coinsurance	20% Coinsurance	"$50 ER, $30 Urgent Care"	$100 Copay	$0 Copay	$30 Copay	$100 Copay	$0 Copay	$30 Copay	"$20 PCP, $0 Physical Exams"	"$30 Specialist, $20 Chiropractic"	50% Coinsurance	$30 Copay	$30 Copay	$30 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$30 Copay	Not Covered	$30 Copay	Not Covered	Not Covered	$0 Copay											400	400	50	0	100	0.229507581	0.086756509	47.42364922	100	0	30	100	0	30	20	28.57017804	0.5	30	30	30	0.1	0	0	0	30	0	0	0	0	0											385.8290424	385.8290424	48.2286303	0	96.4572606	0.221376725	0.083682952	45.74355292	96.4572606	0	28.93717818	96.4572606	0	28.93717818	19.29145212	27.55801108	0.482286303	28.93717818	28.93717818	28.93717818	0.096457261	0	0	0	30	0	0	0	0	0											6.6938	0.194951222	2.09481412	0	0.918890164	1.727997939	0.12674603	0.694607076	2.645921432	0	2.18539132	0.000594444	0	1.846454821	6.004634503	11.10694708	1.029704446	2.45806749	1.761443552	1.670832566	3.487389785	0	0	0	1.446923061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.0961	0	1.7134	6.6938	0.194951222	2.09481412	0	0.918890164	1.727997939	0.12674603	0.694607076	2.645921432	0	2.18539132	0.000594444	0	1.846454821	6.004634503	11.10694708	1.029704446	2.45806749	1.761443552	1.670832566	3.487389785	0	0	0	1.446923061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.0961	0	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$175 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $30 Urgent Care"	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$0 Copay	30% Coinsurance	30% Coinsurance	$35 Copay	50% Coinsurance	30% Coinsurance	30% Coinsurance	$35 Copay	30% Coinsurance	$0 Copay	Not Covered	Not Covered	30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	Not Covered	$0 Copay											2.4894	0.0117	0.9182	0.0257	0.8648	0.5837	0.3041	0.0357	0.3125	0.1134	0.1199	0.0001	0	0.1719	0.4064	1.0788	0.3688	0.0973	0.3416	0.8919	0.244	0	0	0	0.0625	0	0	0	0	0											9.4427	0	0	9.1832	0.206621475	3.013052316	0.025698283	1.783721635	2.311745473	0.430863101	0.730323106	2.958440205	0.113443964	2.305242206	0.000735363	0	2.018366907	6.41101717	12.18577633	1.398482246	2.555393066	2.103088851	2.562747096	3.73136531	0	0	0	1.50946165	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.5388
H3335_801_0	2009	4																																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		1488.479222	35.59246078	1826.54461	1597.817216	205.1216093	6.595149816	14.83965654	456.0084728	631.6556252	14438.5249	2140.136632	0	112.4340453	1396.406836	6693.025886	9158.181949	242.6249542	1237.147853	3101.035505	2361.321823	2511.813136	43.58703365																			FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																			161.5026285	92.82898332	51.11513155	0	135.8984636	0.231	0.231	106.3797087	223.5970474	3.266519293	34.39526023	0	42.63709139	24.18989803	18.88729679	35.30628256	18.9211717	12.4417926	32.66673001	18.19966835	72.05203844	100.4470916																			161.5026285	92.82898332	51.11513155	0	135.8984636	0.231	0.231	106.3797087	223.5970474	3.266519293	34.39526023	0	42.63709139	24.18989803	18.88729679	35.30628256	18.9211717	12.4417926	32.66673001	18.19966835	72.05203844	100.4470916																			20.0328	0.275334329	7.780339002	0	2.322975964	1.523479608	3.42796066	4.042504042	11.76969439	3.930310013	6.134213032	0	0.399488389	2.814911581	10.53443053	26.9451133	0.382562368	1.282694751	8.441724134	3.581272837	15.08177139	0.36484923	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.0684	135		20.0328	0.275334329	7.780339002	0	2.322975964	1.523479608	3.42796066	4.042504042	11.76969439	3.930310013	6.134213032	0	0.399488389	2.814911581	10.53443053	26.9451133	0.382562368	1.282694751	8.441724134	3.581272837	15.08177139	0.36484923	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.0684		FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																			1.554	0.0214	0.6036	0	0.1802	0.1182	0.2659	0.3136	0.913	0.3049	0.4759	0	0.031	0.2184	0.8172	2.0902	0.0297	0.0995	0.6549	0.2778	1.17	0.0283																			10.1675	135		21.5868	0.29669309	8.383890342	0	2.503178299	1.641661882	3.693880982	4.356096899	12.68271564	4.23519954	6.61006794	0	0.430478266	3.033275287	11.35162752	29.03535118	0.412239228	1.382198402	9.096581707	3.859086184	16.25172341	0.393152013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.2359
H3335_811_0	2009	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		1034.023316	78.19135425	1004.117217	2590.377174	318.1814734	10.19715386	2.375533582	551.6954447	1000.899398	1092.646423	1108.648087	59.22578363	69.05223272	2082.83551	11239.40511	19475.74088	682.7443726	1232.755018	4302.760464	15664.50391	2676.44929	1.334319794																			FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																			179.3826027	81.57521045	71.86867585	0	53.06531826	0.231	0.231	59.96521528	113.7788341	17.40874498	39.08025861	129.6011783	28.59916979	21.29091552	7.820007731	9.60590065	10.64333362	9.402336378	18.69417764	12.73526857	38.80627513	1278.623551																			179.3826027	81.57521045	71.86867585	0	53.06531826	0.231	0.231	59.96521528	113.7788341	17.40874498	39.08025861	129.6011783	28.59916979	21.29091552	7.820007731	9.60590065	10.64333362	9.402336378	18.69417764	12.73526857	38.80627513	1278.623551																			15.4571	0.531539681	6.013714563	0	1.407033429	2.355542542	0.548748257	2.756878009	9.49009722	1.585133578	3.610521163	0.639644279	0.164569711	3.695456241	7.324352902	15.59016933	0.605556344	0.965898113	6.703047373	16.62430536	8.655252295	0.142174393	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.8668	135		15.4571	0.531539681	6.013714563	0	1.407033429	2.355542542	0.548748257	2.756878009	9.49009722	1.585133578	3.610521163	0.639644279	0.164569711	3.695456241	7.324352902	15.59016933	0.605556344	0.965898113	6.703047373	16.62430536	8.655252295	0.142174393	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.8668		FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																			1.1991	0.0412	0.4665	0	0.1091	0.1827	0.0426	0.2139	0.7362	0.123	0.2801	0.0496	0.0128	0.2867	0.5682	1.2094	0.047	0.0749	0.52	1.2896	0.6714	0.011																			8.1349	135		16.6562	0.572773294	6.480221933	0	1.516182518	2.538271195	0.591316807	2.970739824	10.2262812	1.708098592	3.890603418	0.689263988	0.177336027	3.982127242	7.892531617	16.79955977	0.652531719	1.040826609	7.223028986	17.91391778	9.326674083	0.153203417	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.0017
H3335_813_0	2009	4																																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		1488.479222	35.59246078	1826.54461	1597.817216	205.1216093	6.595149816	14.83965654	456.0084728	631.6556252	14438.5249	2140.136632	0	112.4340453	1396.406836	6693.025886	9158.181949	242.6249542	1237.147853	3101.035505	2361.321823	2511.813136	43.58703365																			FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																			161.5026285	92.82898332	51.11513155	0	135.8984636	0.231	0.231	106.3797087	223.5970474	3.266519293	34.39526023	0	42.63709139	24.18989803	18.88729679	35.30628256	18.9211717	12.4417926	32.66673001	18.19966835	72.05203844	100.4470916																			161.5026285	92.82898332	51.11513155	0	135.8984636	0.231	0.231	106.3797087	223.5970474	3.266519293	34.39526023	0	42.63709139	24.18989803	18.88729679	35.30628256	18.9211717	12.4417926	32.66673001	18.19966835	72.05203844	100.4470916																			20.0328	0.275334329	7.780339002	0	2.322975964	1.523479608	3.42796066	4.042504042	11.76969439	3.930310013	6.134213032	0	0.399488389	2.814911581	10.53443053	26.9451133	0.382562368	1.282694751	8.441724134	3.581272837	15.08177139	0.36484923	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.0684	135		20.0328	0.275334329	7.780339002	0	2.322975964	1.523479608	3.42796066	4.042504042	11.76969439	3.930310013	6.134213032	0	0.399488389	2.814911581	10.53443053	26.9451133	0.382562368	1.282694751	8.441724134	3.581272837	15.08177139	0.36484923	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.0684		FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																			1.554	0.0214	0.6036	0	0.1802	0.1182	0.2659	0.3136	0.913	0.3049	0.4759	0	0.031	0.2184	0.8172	2.0902	0.0297	0.0995	0.6549	0.2778	1.17	0.0283																			10.1675	135		21.5868	0.29669309	8.383890342	0	2.503178299	1.641661882	3.693880982	4.356096899	12.68271564	4.23519954	6.61006794	0	0.430478266	3.033275287	11.35162752	29.03535118	0.412239228	1.382198402	9.096581707	3.859086184	16.25172341	0.393152013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.2359
H3335_819_0	2009	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		1034.023316	78.19135425	1004.117217	2590.377174	318.1814734	10.19715386	2.375533582	551.6954447	1000.899398	1092.646423	1108.648087	59.22578363	69.05223272	2082.83551	11239.40511	19475.74088	682.7443726	1232.755018	4302.760464	15664.50391	2676.44929	1.334319794																			FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																			179.3826027	81.57521045	71.86867585	0	53.06531826	0.231	0.231	59.96521528	113.7788341	17.40874498	39.08025861	129.6011783	28.59916979	21.29091552	7.820007731	9.60590065	10.64333362	9.402336378	18.69417764	12.73526857	38.80627513	1278.623551																			179.3826027	81.57521045	71.86867585	0	53.06531826	0.231	0.231	59.96521528	113.7788341	17.40874498	39.08025861	129.6011783	28.59916979	21.29091552	7.820007731	9.60590065	10.64333362	9.402336378	18.69417764	12.73526857	38.80627513	1278.623551																			15.4571	0.531539681	6.013714563	0	1.407033429	2.355542542	0.548748257	2.756878009	9.49009722	1.585133578	3.610521163	0.639644279	0.164569711	3.695456241	7.324352902	15.59016933	0.605556344	0.965898113	6.703047373	16.62430536	8.655252295	0.142174393	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.8668	135		15.4571	0.531539681	6.013714563	0	1.407033429	2.355542542	0.548748257	2.756878009	9.49009722	1.585133578	3.610521163	0.639644279	0.164569711	3.695456241	7.324352902	15.59016933	0.605556344	0.965898113	6.703047373	16.62430536	8.655252295	0.142174393	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.8668		FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																			1.1991	0.0412	0.4665	0	0.1091	0.1827	0.0426	0.2139	0.7362	0.123	0.2801	0.0496	0.0128	0.2867	0.5682	1.2094	0.047	0.0749	0.52	1.2896	0.6714	0.011																			8.1349	135		16.6562	0.572773294	6.480221933	0	1.516182518	2.538271195	0.591316807	2.970739824	10.2262812	1.708098592	3.890603418	0.689263988	0.177336027	3.982127242	7.892531617	16.79955977	0.652531719	1.040826609	7.223028986	17.91391778	9.326674083	0.153203417	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.0017
H3335_820_0	2009	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		1034.023316	78.19135425	1004.117217	2590.377174	318.1814734	10.19715386	2.375533582	551.6954447	1000.899398	1092.646423	1108.648087	59.22578363	69.05223272	2082.83551	11239.40511	19475.74088	682.7443726	1232.755018	4302.760464	15664.50391	2676.44929	1.334319794																			FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																			179.3826027	81.57521045	71.86867585	0	53.06531826	0.231	0.231	59.96521528	113.7788341	17.40874498	39.08025861	129.6011783	28.59916979	21.29091552	7.820007731	9.60590065	10.64333362	9.402336378	18.69417764	12.73526857	38.80627513	1278.623551																			179.3826027	81.57521045	71.86867585	0	53.06531826	0.231	0.231	59.96521528	113.7788341	17.40874498	39.08025861	129.6011783	28.59916979	21.29091552	7.820007731	9.60590065	10.64333362	9.402336378	18.69417764	12.73526857	38.80627513	1278.623551																			15.4571	0.531539681	6.013714563	0	1.407033429	2.355542542	0.548748257	2.756878009	9.49009722	1.585133578	3.610521163	0.639644279	0.164569711	3.695456241	7.324352902	15.59016933	0.605556344	0.965898113	6.703047373	16.62430536	8.655252295	0.142174393	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.8668	135		15.4571	0.531539681	6.013714563	0	1.407033429	2.355542542	0.548748257	2.756878009	9.49009722	1.585133578	3.610521163	0.639644279	0.164569711	3.695456241	7.324352902	15.59016933	0.605556344	0.965898113	6.703047373	16.62430536	8.655252295	0.142174393	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.8668		FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																			1.1991	0.0412	0.4665	0	0.1091	0.1827	0.0426	0.2139	0.7362	0.123	0.2801	0.0496	0.0128	0.2867	0.5682	1.2094	0.047	0.0749	0.52	1.2896	0.6714	0.011																			8.1349	135		16.6562	0.572773294	6.480221933	0	1.516182518	2.538271195	0.591316807	2.970739824	10.2262812	1.708098592	3.890603418	0.689263988	0.177336027	3.982127242	7.892531617	16.79955977	0.652531719	1.040826609	7.223028986	17.91391778	9.326674083	0.153203417	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.0017
H3335_822_0	2009	4																																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		1488.479222	35.59246078	1826.54461	1597.817216	205.1216093	6.595149816	14.83965654	456.0084728	631.6556252	14438.5249	2140.136632	0	112.4340453	1396.406836	6693.025886	9158.181949	242.6249542	1237.147853	3101.035505	2361.321823	2511.813136	43.58703365																			FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																			161.5026285	92.82898332	51.11513155	0	135.8984636	0.231	0.231	106.3797087	223.5970474	3.266519293	34.39526023	0	42.63709139	24.18989803	18.88729679	35.30628256	18.9211717	12.4417926	32.66673001	18.19966835	72.05203844	100.4470916																			161.5026285	92.82898332	51.11513155	0	135.8984636	0.231	0.231	106.3797087	223.5970474	3.266519293	34.39526023	0	42.63709139	24.18989803	18.88729679	35.30628256	18.9211717	12.4417926	32.66673001	18.19966835	72.05203844	100.4470916																			20.0328	0.275334329	7.780339002	0	2.322975964	1.523479608	3.42796066	4.042504042	11.76969439	3.930310013	6.134213032	0	0.399488389	2.814911581	10.53443053	26.9451133	0.382562368	1.282694751	8.441724134	3.581272837	15.08177139	0.36484923	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.0684	135		20.0328	0.275334329	7.780339002	0	2.322975964	1.523479608	3.42796066	4.042504042	11.76969439	3.930310013	6.134213032	0	0.399488389	2.814911581	10.53443053	26.9451133	0.382562368	1.282694751	8.441724134	3.581272837	15.08177139	0.36484923	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.0684		FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																			1.554	0.0214	0.6036	0	0.1802	0.1182	0.2659	0.3136	0.913	0.3049	0.4759	0	0.031	0.2184	0.8172	2.0902	0.0297	0.0995	0.6549	0.2778	1.17	0.0283																			10.1675	135		21.5868	0.29669309	8.383890342	0	2.503178299	1.641661882	3.693880982	4.356096899	12.68271564	4.23519954	6.61006794	0	0.430478266	3.033275287	11.35162752	29.03535118	0.412239228	1.382198402	9.096581707	3.859086184	16.25172341	0.393152013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.2359
H3336_001_0	2009	6																																D	D	D		T	COIN		V		P	P			V		V	COIN	V		V							P																																																						0		2312.30824	366.7831647	1213.308884		657.9035053	5.72		1106.542083		7835.467762	3217.34194			62.418		7623.823709	13.61	733.8185887		654.252189							111.9347812														$50 days 1-20	$50 days 1-20	$70 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																																																						45.22524723	45.22524723	69.93653672		40	0.1		49.55979607		5	5			25		10	0.5	10		11.18834621							15														8.7146	1.382321609	7.071218445	0	2.193011684	0.572	0	4.57	0	3.264778234	1.340559142	0	0	0.1300375	0	6.353186424	6.805	0.611515491	0	0.61	0	0	0	0	0	0	0.139918477	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7581			8.7146	1.382321609	7.071218445	0	2.193011684	0.572	0	4.57	0	3.264778234	1.340559142	0	0	0.1300375	0	6.353186424	6.805	0.611515491	0	0.61	0	0	0	0	0	0	0.139918477	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7581																																																																																		0			8.7146	1.382321609	7.071218445	0	2.193011684	0.572	0	4.57	0	3.264778234	1.340559142	0	0	0.1300375	0	6.353186424	6.805	0.611515491	0	0.61	0	0	0	0	0	0	0.139918477	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7581
H3336_003_0	2009	6																																							V						V		V	V	V		V																																																													0									1710.827949						349.5408		9372.345752	2843.499986	1907.853825		911.0841154																												$50 COPAY ER/ $10 UR						$20 Copay Substance Abuse		$10 copay	$20 copay	$10 copay		$10 chiro copay/ $10 podiatry																																																																				49.02889275						20		10	20	10		10																					0	0	0	0	0	0	0	6.99	0	0	0	0	0	0.582568	0	7.810288127	4.739166643	1.589878188	0	0.759236763	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.4711		0	0	0	0	0	0	0	0	6.99	0	0	0	0	0	0.582568	0	7.810288127	4.739166643	1.589878188	0	0.759236763	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.4711																																																																																		0		0	0	0	0	0	0	0	0	6.99	0	0	0	0	0	0.582568	0	7.810288127	4.739166643	1.589878188	0	0.759236763	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.4711
H3336_004_0	2009	7																																D	D	D		T	COIN		V		P	P			V		V	COIN	V		V							P																																																						0		2306.626503	165.4046778	1352.207211		803.5777296	5.66		844.7646773		5332.955731	2548.053355			68.6598		4905.281773	6.32	777.301698		663.1648978							57.66108486														$50 days 1-20	$50 days 1-20	$70 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																																																						48.75512254	48.75512254	70		40	0.1		49.14978232		5	5			25		10	0.5	10		11.39987962							15														9.3717	0.672027111	7.8878754	0	2.678592432	0.566	0	3.46	0	2.222064888	1.061688898	0	0	0.14304125	0	4.087734811	3.16	0.647751415	0	0.63	0	0	0	0	0	0	0.072076356	0	0	0	0	0	0	0	0	0	0	0	0	0	36.6605			9.3717	0.672027111	7.8878754	0	2.678592432	0.566	0	3.46	0	2.222064888	1.061688898	0	0	0.14304125	0	4.087734811	3.16	0.647751415	0	0.63	0	0	0	0	0	0	0.072076356	0	0	0	0	0	0	0	0	0	0	0	0	0	36.6605																																																																																		0			9.3717	0.672027111	7.8878754	0	2.678592432	0.566	0	3.46	0	2.222064888	1.061688898	0	0	0.14304125	0	4.087734811	3.16	0.647751415	0	0.63	0	0	0	0	0	0	0.072076356	0	0	0	0	0	0	0	0	0	0	0	0	0	36.6605
H3336_006_0	2009	6																																D	D	D		COIN			V	COIN	V	V	COIN	COIN			V																																																																	0		3125.248531	151.6313678	856.3384562		18.93			1464.767232	19.43	8543.668249	3924.857052	21.05	1.63			7587.601913																									Same as Medicare Covered	Same as Medicare Covered	Same as Medicare Covered		20% coinsurance			$50 ER/ 20% coinsurance UR	20% coinsurance	$5 copay	$5 copay	20% coinsurance	20% coinsurance			$10 copay																																																																	100.1900221	100.1900221	79.27741935		0.2			48.49917343	0.2	5	5	0.2	0.2			15																									26.0932	1.265995841	5.657358575	0	3.786	0	0	5.92	3.886	3.55986177	1.635357105	4.21	0.326	0	0	9.484502392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8243			26.0932	1.265995841	5.657358575	0	3.786	0	0	5.92	3.886	3.55986177	1.635357105	4.21	0.326	0	0	9.484502392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8243																																																																																		0			26.0932	1.265995841	5.657358575	0	3.786	0	0	5.92	3.886	3.55986177	1.635357105	4.21	0.326	0	0	9.484502392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8243
H3336_010_0	2009	4																																							V						0		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	0	0	0	0	0	0	293.3554401	0	0	0	0	0	11.27226916	0	681.5893724	1260.028257	100.8000992	0	3708.358562	0	0	0	0	0	0	0	0	0	0																		$50/Case for ER - Facility;						$10/Visit for Prof - CORF; $10/Visit for Prof - CORF;		$10/Visit for Speclst - Office Visits;	$20/Visit for OP Psych - Non-Physician; $20/Visit for OP Psych - Psychiatrist; $20/Visit for OP Substance Abuse;	$10/Visit for PT/ST (PCP); $10/Visit for Occ Therapy (PCP); $10/Visit for PT/ST (Specialist); $10/Visit for Occ Therapy (Specialist);		$10/Visit for Chiropractor; $10/Service for Podiatrist;																					0	0	0	0	0	0	0	50	0	0	0	0	0	9.999999966	0	10	20	10.00000002	0	10	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	50	0	0	0	0	0	9.999999966	0	10	20	10.00000002	0	10	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.222314334	0	0	0	0	0	0.009393558	0	0.567991144	2.100047095	0.084000083	0	3.090298802	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.074	0	0	0	0	0	0	0	0	0	1.222314334	0	0	0	0	0	0.009393558	0	0.567991144	2.100047095	0.084000083	0	3.090298802	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.074																																																																																		0	0		0	0	0	0	0	0	0	1.222314334	0	0	0	0	0	0.009393558	0	0.567991144	2.100047095	0.084000083	0	3.090298802	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.074
H3337_001_0	2009	7	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			A		T	Coin	Coin	V					Coin	V			V	V			Coin						V																0		0	0	0	0					0	0			0	0			0						0														0	none			115.6094239		812.4118835	3.413584965	0.532419606	194.7712142					0.246522324	90.7289653			272.1868959	946.718459			21.21054277						98.8036																"1-20 days:$0, 21-100:$25/day"		$50 copay/trip	20% coinsurance	20% coinsurance	$50 copay/visit					20% coinsurance	$20 copay/visit			$20 copay/visit	$20 copay/visit			20% coinsurance						$20 copay/visit																25		50	0.2	0.2	50					0.2	20			20	20			0.2						20																25		50	0.2	0.2	50					0.2	20			20	20			0.2						20														0	0	0.240852966	0	3.385049514	0.682716993	0.106483921	0.811546726	0	0	0	0	0.049304465	0.151214942	0	0	0.453644827	1.577864098	0	0	4.242108553	0	0	0	0	0	0.164672667	0	0	0	0	0	0	0	0	0	0	0	0	0	11.8655	0	0	0	0	0.240852966	0	3.385049514	0.682716993	0.106483921	0.811546726	0	0	0	0	0.049304465	0.151214942	0	0	0.453644827	1.577864098	0	0	4.242108553	0	0	0	0	0	0.164672667	0	0	0	0	0	0	0	0	0	0	0	0	0	11.8655	none																																																																																	0	0	0	0	0	0.240852966	0	3.385049514	0.682716993	0.106483921	0.811546726	0	0	0	0	0.049304465	0.151214942	0	0	0.453644827	1.577864098	0	0	4.242108553	0	0	0	0	0	0.164672667	0	0	0	0	0	0	0	0	0	0	0	0	0	11.8655
H3337_002_0	2009	7																					None											BP							V						V		V	V	V		V	Coin																											0						0		0	0	0		0	0																				0	None	12000							468.9124048						279.7211367		14977.62176	839.1634101	1697.235708		221.912221	53.70805237																				Medicaid COB							$50 copay/visit						$20 copay/visit		$10 copay/visit	$20 copay/visit	$10 copay/visit		$10 copay/visit	20% coinsurance																				30							50						20		10	20	10		10	0.2																				30							50						20		10	20	10		10	0.2																				30	0	0	0	0	0	0	1.953801687	0	0	0	0	0	0.466201895	0	12.48135147	1.398605684	1.41436309	0	0.184926851	10.74161047	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.6409	0	0	30	0	0	0	0	0	0	1.953801687	0	0	0	0	0	0.466201895	0	12.48135147	1.398605684	1.41436309	0	0.184926851	10.74161047	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.6409	None																																																																																	0	0	0	30	0	0	0	0	0	0	1.953801687	0	0	0	0	0	0.466201895	0	12.48135147	1.398605684	1.41436309	0	0.184926851	10.74161047	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.6409
H3337_003_0	2009	7	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								V						V		V	V	V		V	Coin																											0						0		0	0	0		0	0																				0	None								227.3750739						62.56378537		8572.603935	187.6913561	758.0994969		77.72707538	6.40411713																											$50 copay/visit						$20 copay/visit		$10 copay/visit	$20 copay/visit	$10 copay/visit		$10 copay/visit	20% coinsurance																											50						20		10	20	10		10	0.2																											50						20		10	20	10		10	0.2																				0	0	0	0	0	0	0	0.947396141	0	0	0	0	0	0.104272976	0	7.143836613	0.312818927	0.631749581	0	0.064772563	1.280823426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.4857	0	0	0	0	0	0	0	0	0	0.947396141	0	0	0	0	0	0.104272976	0	7.143836613	0.312818927	0.631749581	0	0.064772563	1.280823426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.4857	None																																																																																	0	0	0	0	0	0	0	0	0	0	0.947396141	0	0	0	0	0	0.104272976	0	7.143836613	0.312818927	0.631749581	0	0.064772563	1.280823426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.4857
H3337_004_0	2009	8																					None											D				T	Coin	Coin	V					Coin	V			V	V			Coin						V														0				0	0	0	0					0	0			0	0			0						0														0	None	748.8230889				1057.668129	0	0.958765638	304.8082624					0.443930183	163.3820641			490.1461924	519.4904048			6.11121368						177.9226299														"$150/day for days 0-9, $0 after"				$50 copay/trip	10% coinsurance	20% coinsurance	$50 copay/visit					20% coinsurance	$20 copay/visit			$20 copay/visit	$20 copay/visit			20% coinsurance						$20 copay/visit														150				50	0.1	0.2	50					0.2	20			20	20			0.2						20														150				50	0.1	0.2	50					0.2	20			20	20			0.2						20														9.3603	0	0	0	4.406950536	0	0.191753128	1.270034426	0	0	0	0	0.088786037	0.27230344	0	0	0.816910321	0.865817341	0	0	1.222242736	0	0	0	0	0	0.296537716	0	0	0	0	0	0	0	0	0	0	0	0	0	18.7916	0	0	9.3603	0	0	0	4.406950536	0	0.191753128	1.270034426	0	0	0	0	0.088786037	0.27230344	0	0	0.816910321	0.865817341	0	0	1.222242736	0	0	0	0	0	0.296537716	0	0	0	0	0	0	0	0	0	0	0	0	0	18.7916	None																																																																																	0	0	0	9.3603	0	0	0	4.406950536	0	0.191753128	1.270034426	0	0	0	0	0.088786037	0.27230344	0	0	0.816910321	0.865817341	0	0	1.222242736	0	0	0	0	0	0.296537716	0	0	0	0	0	0	0	0	0	0	0	0	0	18.7916
H3342_001_0	2009	7	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		CORF/Cardiac Rehab	Therapy (PT/OT/ST)	Urgent Care	Chiropractic	Podiatric	Physical Exam	Diabetes Education/Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemotherapy/Radiation	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V		V	V	V	V	V	V		V	V	V	V	V	V	Coin	V	V	Coin																																									0		1503.46815	101.6681041	716.4507821	1338.661657	140.3287587	8.752111158	1.38991828	187.1336266	266.4547695	1328.688566	179.6146955	4.643511105	0	164.6821667	3785.601874	4784.848192	899.6590964	1223.539843	1196.953473	0	70.67720466	0	0	0	436.4613071	306.3838279	186.5182769	24.17829515	0	0	17.4884197	201.2413219	3.160154107	750.314425	821.5913027	120.2592903	2.89115488	1120.980063	29.56063336	16.25976676	$75/day (days 1-7)	$75/day (days 1-7)	$30/day (for days 1-100)	$0 copay	$50 copay	20% coinsurance	20% coinsurance	$50 copay	$75 copay	$0 copay	$75 copay - Tier 2	$75 copay	10% coinsurance	$25 copay	$10 coapy	$25 copay	$25 copay	$25 copay	$25 copay - Tier 1	$0 copay	20% coinsurance	$0 copay	n/c	Preventive n/c; comp 0 copay	$10 copay	$0 copay/1 pr glasses; $45/1 pr contact lenses; per 2 years	$0 copay	$1000/ 3 yrs	Silver Sneakers		$0 copay	$50 copay	$25 copay	$25 copay	$25 copay	$0 copay	10% coinsurance	$25 copay	$0 copay	20% coinsurance	75	75	30	0	50	0.2	0.2	50	75	0	75	75	0.1	25	10	25	25	25	25	0	0.2	0	0	0	10	0	0	0	0	0	0	50	25	25	25	0	0.1	25	0	0.2	49.28129415	45.80959774	27.98419277	0	46.64032129	0.186561285	0.186561285	46.64032129	69.96048194	0	69.96048194	69.96048194	0	23.32016065	9.328064258	23.32016065	23.32016065	23.32016065	23.32016065	0	0.186561285	0	0	0	9.328064258	0	0	0	0	0	0	46.64032129	23.32016065	23.32016065	23.32016065	0	0.093280643	23.32016065	0	0.186561285	6.1744	0.388114579	1.670774733	0	0.545414866	1.632805106	0.25930494	0.727331039	1.553442008	0	1.047160888	0.027071856	0	0.320034548	2.942694795	9.298619041	1.748349554	2.377762142	2.326095607	0	13.18563013	0	0	0	0.33927826	0	0	0	0	0	0	0.782163326	0.006141275	1.458121077	1.596636764	0	0.269688785	2.17845293	0	3.033442983	55.8889		4.0259	6.1744	0.388114579	1.670774733	0	0.545414866	1.632805106	0.25930494	0.727331039	1.553442008	0	1.047160888	0.027071856	0	0.320034548	2.942694795	9.298619041	1.748349554	2.377762142	2.326095607	0	13.18563013	0	0	0	0.33927826	0	0	0	0	0	0	0.782163326	0.006141275	1.458121077	1.596636764	0	0.269688785	2.17845293	0	3.033442983	55.8889	4000	$250/day (days 1-7)	$250/day (days 1-7)	$150/day (for days 1-100)	$50 copay	$100 copay	20% Coinsurance	20% Coinsurance	$50 copay	$250 copay	$50 copay	$50/$150 copay - Tier 2	$250 copay	10% coinsurance	$50 copay	$30 copay	$50 copay	$100 copay	$50 copay	$50 copay - Tier 1	$25-$100 copay	20% Coinsurance	$50 copay	n/c	Preventive n/c; comp 20%	50% Coinsurance up to $45 max	"50% Coin up to $ max ($50 frames, $25 lenses)"	50% Coinsurance	50% Coinsurance; $1000 every 3 yrs	Silver Sneakers		$50/$100 copay	$100 copay	$25 copay	$50 copay	$50 copay	$30 copay	20% coinsurance	20% coinsurance	50% Coinsurance	20% coinsurance	5.1453	0.3234	2.0885	1.3007	0.2727	0.4082	0.0648	0.1818	1.2945	1.2911	0.6876	0.0226	0	0.16	2.207	4.6493	1.7483	1.1889	1.987	0.0001	3.0538	0	0	0	0.0005	0	0	0	0	0	0.034	0.3911	0.0015	0.7291	0.7983	0.0701	0.1348	0.7307	0.0531	0.7584	31.7773		2.289041818	11.3197	0.711543396	3.75924315	1.300741871	0.818122299	2.041006382	0.324131176	0.909163799	2.847977014	1.291051284	1.734772703	0.049631736	0	0.480051823	5.149715891	13.94792856	3.496699109	3.566643213	4.313095377	7.19E-05	16.23938791	0	0	0	0.339811718	0	0	0	0	0	0.033986063	1.173244989	0.007676594	2.187181616	2.394955145	0.070111649	0.404533178	2.909189128	0.053059524	3.791803729	87.6663
H3342_002_0	2009	9	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		CORF/Cardiac Rehab	Therapy (PT/OT/ST)	Urgent Care	Chiropractic	Podiatric	Physical Exam	Diabetes Education/Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemotherapy/Radiation	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V		V	V	V	V	V	V		V	V	V	V	V	V	Coin	V	V	Coin																																									0		1460.673043	88.0748471	723.4827271	1578.162253	143.2523871	9.94072172	1.172016924	185.3004481	340.5997217	1296.942726	235.0975351	3.695170298	0	94.98868181	3792.715579	4710.034047	886.4057107	1174.650307	1057.830014	0	126.6664335	0	0	0	435.7430315	306.3838279	186.5182769	24.17829515	0	0	7.939792019	361.7814799	10.67201265	587.2311122	824.4788804	168.3241558	2.825191693	1065.5268	30.01343751	13.86419664	$150/day (days 1-7)	$150/day (days 1-7)	$60/day (for days 1-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$300 copay	$0 copay	$90 copay - Tier 2	$300 copay	10% coinsurance	$30 copay	$15 coapy	$30 copay	$25 copay	$30 copay	$30 copay - Tier 1	$0 copay	20% coinsurance	$0 copay	n/c	Preventive n/c; comp 0 copay	$10 copay	1 pair / 2 yrs	$0 copay	$1000/ 3 yrs	Silver Sneakers		$0 copay	$50 copay	$30 copay	$30 copay	$30 copay	$0 copay	10% coinsurance	$30 copay	$0 copay	20% coinsurance	150	150	60	0	100	0.2	0.2	50	300	0	90	300	0.1	30	15	30	25	30	30	0	0.2	0	0	0	10	0	0	0	0	0	0	50	30	30	30	0	0.1	30	0	0.2	93.55241173	77.15790204	54.52313548	0	90.87189247	0.181743785	0.181743785	45.43594623	272.6156774	0	81.78470322	272.6156774	0	27.26156774	13.63078387	27.26156774	22.71797312	27.26156774	27.26156774	0	0.181743785	0	0	0	9.087189247	0	0	0	0	0	0	45.43594623	27.26156774	27.26156774	27.26156774	0	0.090871892	27.26156774	0	0.181743785	11.3875	0.566305869	3.287212229	0	1.084801293	1.80666439	0.213006792	0.701608433	7.73773532	0	1.602281845	0.083946779	0	0.215795032	4.308140528	10.70024269	1.678111759	2.668567411	2.403175383	0	23.02083704	0	0	0	0.329973282	0	0	0	0	0	0	1.369823656	0.02424465	1.334070062	1.873048904	0	0.256730516	2.420660921	0	2.519731572	83.5942		8.3971	11.3875	0.566305869	3.287212229	0	1.084801293	1.80666439	0.213006792	0.701608433	7.73773532	0	1.602281845	0.083946779	0	0.215795032	4.308140528	10.70024269	1.678111759	2.668567411	2.403175383	0	23.02083704	0	0	0	0.329973282	0	0	0	0	0	0	1.369823656	0.02424465	1.334070062	1.873048904	0	0.256730516	2.420660921	0	2.519731572	83.5942	4000	$250/day (days 1-7)	$250/day (days 1-7)	$200/day (for days 1-100)	$50 copay	$200 copay	20% Coinsurance	20% Coinsurance	$50 copay	$500 copay	$50 copay	$50/$150 copay - Tier 2	$500 copay	10% coinsurance	$50 copay	$30 copay	$50 copay	$100 copay	$50 copay	$50 copay - Tier 1	$30-$100 copay	20% Coinsurance	$50 copay	n/c	Preventive n/c; comp 20%	50% Coinsurance up to $45 max	"50% Coin up to $ max ($50 frames, $25 lenses)"	50% Coinsurance	50% Coinsurance	Silver Sneakers	0	$50/$100 copay	$100 copay	$30 copay	$50 copay	$50 copay	$30 copay	20% coinsurance	20% coinsurance	50% Coinsurance	20% coinsurance	4.7448	0.236	2.7393	1.4939	0.5424	0.4517	0.0533	0.1754	3.2241	1.2277	0.7466	0.035	0	0.0899	2.1541	4.4584	1.6781	1.1119	1.7471	0.0001	5.5772	0	0	0	0.0002	0	0	0	0	0	0.0092	0.6849	0.0061	0.5559	0.7804	0.0956	0.1284	0.658	0.0571	0.6299	36.0924		3.62548988	16.1322	0.802266647	6.026555753	1.493860318	1.62720194	2.258330488	0.26625849	0.877010541	10.9617917	1.227662916	2.348910086	0.118924604	0	0.305709629	6.462210792	15.15867714	3.356223518	3.780470498	4.150243156	6.09E-05	28.5980116	0	0	0	0.330194821	0	0	0	0	0	0.009243781	2.054735484	0.030305812	1.889932588	2.653485947	0.095599591	0.385095774	3.078626914	0.057056733	3.149664466	119.6866
H3342_004_0	2009	8	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		CORF/Cardiac Rehab	Therapy (PT/OT/ST)	Urgent Care	Chiropractic	Podiatric	Physical Exam	Diabetes Education/Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemotherapy/Radiation	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V		V	V	V	V	V	V		V	V	V	V	V	V	Coin	V	V	Coin																																									0		1736.618895	131.372005	734.8145412	1759.793879	123.9683717	12.61627579	1.624043459	198.4518865	278.6307315	1319.950932	223.9173206	2.400140744	0	78.06607311	4063.96769	4738.14162	822.5295828	1256.835647	1154.579169	0	98.0628304	0	0	0	435.7291836	306.3838279	186.5182769	24.17829515	0	0	7.73378684	196.9367042	3.200187658	591.5940072	768.594127	143.2063969	2.644211184	1025.352002	31.389593	17.98248502	$125/day (days 1-7)	$125/day (days 1-7)	$60/day (for days 1-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$200 copay	$0 copay	$75 copay - Tier 2	$200 copay	10% coinsurance	$25 copay	$10 coapy	$25 copay	$25 copay	$25 copay	$25 copay - Tier 1	$0 copay	20% coinsurance	$0 copay	n/c	Preventive n/c; comp 0 copay	$10 copay	$0 copay/1 pr glasses; $45/1 pr contact lenses; per 2 years	$0 copay	$1000/ 3 yrs	Silver Sneakers		$0 copay	$50 copay	$25 copay	$25 copay	$25 copay	$0 copay	10% coinsurance	$25 copay	$0 copay	20% coinsurance	125	125	60	0	100	0.2	0.2	50	200	0	75	200	0.1	25	10	25	25	25	25	0	0.2	0	0	0	10	0	0	0	0	0	0	50	25	25	25	0	0.1	25	0	0.2	76.99076895	67.01595253	55.14455523	0	91.90759205	0.183815184	0.183815184	45.95379602	183.8151841	0	68.93069403	183.8151841	0	22.97689801	9.190759205	22.97689801	22.97689801	22.97689801	22.97689801	0	0.183815184	0	0	0	9.190759205	0	0	0	0	0	0	45.95379602	22.97689801	22.97689801	22.97689801	0	0.091907592	22.97689801	0	0.183815184	11.142	0.733668337	3.376751754	0	0.949469545	2.319063058	0.298523847	0.759968126	4.268046601	0	1.28623136	0.036765193	0	0.14947635	3.112579038	9.072316397	1.574931528	2.406515372	2.210720652	0	18.02543722	0	0	0	0.3337235	0	0	0	0	0	0	0.754165761	0.006127532	1.132749597	1.471659072	0	0.243023083	1.963284032	0	3.305453794	70.9326		6.2456	11.142	0.733668337	3.376751754	0	0.949469545	2.319063058	0.298523847	0.759968126	4.268046601	0	1.28623136	0.036765193	0	0.14947635	3.112579038	9.072316397	1.574931528	2.406515372	2.210720652	0	18.02543722	0	0	0	0.3337235	0	0	0	0	0	0	0.754165761	0.006127532	1.132749597	1.471659072	0	0.243023083	1.963284032	0	3.305453794	70.9326	4000	$250/day (days 1-7)	$250/day (days 1-7)	$250/day (for days 1-100)	$50 copay	$200 copay	20% Coinsurance	20% Coinsurance	$50 copay	$450 copay	$50 copay	$50/$150 copay - Tier 2	$450 copay	10% coinsurance	$50 copay	$25 copay	$50 copay	$100 copay	$50 copay	$50 copay - Tier 1	$25-$100 copay	20% Coinsurance	$50 copay	n/c	Preventive n/c; comp 20%	50% Coinsurance up to $45 max	"50% Coin up to $ max ($50 frames, $25 lenses)"	50% Coinsurance	50% Coinsurance	Silver Sneakers		$50/$100 copay	$100 copay	$25 copay	$50 copay	$50 copay	$25 copay	20% coinsurance	20% coinsurance	50% Coinsurance	20% coinsurance	5.571	0.3668	3.5174	1.6848	0.4747	0.5798	0.0746	0.19	2.4008	1.2637	0.787	0.0207	0.0081	0.0747	1.9454	4.5362	1.5749	1.2033	1.9258	0.0001	4.213	0	0	0	0.0002	0	0	0	0	0	0.0089	0.3771	0.0015	0.5664	0.7358	0.0686	0.1215	0.6721	0.0643	0.8264	35.8556		3.157059988	16.713	1.100502506	6.894201498	1.684775187	1.424204317	2.898828822	0.373154809	0.949960158	6.668822814	1.263682415	2.073249478	0.057445614	0.008145414	0.224214525	5.057940936	13.6084746	3.149863056	3.609773059	4.136510912	6.67E-05	22.23840711	0	0	0	0.33394175	0	0	0	0	0	0.008870286	1.131248642	0.007659415	1.699124396	2.207488609	0.068550808	0.364534624	2.635427781	0.064334328	4.131817243	106.7882
H3342_012_0	2009	9	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		CORF/Cardiac Rehab	Therapy (PT/OT/ST)	Urgent Care	Chiropractic	Podiatric	Physical Exam	Diabetes Education/Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemotherapy/Radiation	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V		V	V	V	V	V	V		V	V	V	V	V	V	Coin	V	V	Coin																																									0		1574.947476	116.679591	747.7481962	1487.940939	139.2326853	9.869202416	1.404857725	189.2116487	283.5948711	1317.026728	202.1225612	4.006834913	0	122.4310668	3843.412052	4743.838834	863.3651135	1203.751274	1150.376578	0	89.607793	0	0	0	436.0771939	306.3838279	186.5182769	24.17829515	0	0	12.9109125	239.9648909	5.342446551	685.6261761	807.9974304	137.1252352	2.809301665	1073.135148	31.24372448	15.63982977	$215/day (days 1-6)	$215/day (days 1-6)	$60/day (for days 1-100)	$0 copay	$75 copay	20% coinsurance	20% coinsurance	$50 copay	$300 copay	$0 copay	$45 copay - Tier 2	$300 copay	10% coinsurance	$15 copay	$5 coapy	$15 copay	$25 copay	$15 copay	$15 copay - Tier 1	$0 copay	20% coinsurance	$0 copay	n/c	Preventive n/c; comp 0 copay	$10 copay	$0 copay/1 pr glasses; $45/1 pr contact lenses; per 2 years	$0 copay	$1000/ 3 yrs	Silver Sneakers		$0 copay	$30 copay	$15 copay	$15 copay	$15 copay	$0 copay	10% coinsurance	$25 copay	$0 copay	20% coinsurance	215	215	60	0	75	0.2	0.2	50	300	0	45	300	0.1	15	5	15	25	15	15	0	0.2	0	0	0	10	0	0	0	0	0	0	30	15	15	15	0	0.1	25	0	0.2	125.3085801	98.62354841	55.04570144	0	68.80712679	0.183485671	0.183485671	45.87141786	275.2285072	0	41.28427608	275.2285072	0	13.76142536	4.587141786	13.76142536	22.93570893	13.76142536	13.76142536	0	0.183485671	0	0	0	9.174283573	0	0	0	0	0	0	27.52285072	13.76142536	13.76142536	13.76142536	0	0.091742836	22.93570893	0	0.183485671	16.4462	0.958946274	3.430026996	0	0.798350086	1.810857232	0.257771263	0.723283883	6.504449418	0	0.695373635	0.091899599	0	0.140402166	1.469189669	5.440165336	1.650157579	1.380444442	1.319235118	0	16.44174607	0	0	0	0.33339132	0	0	0	0	0	0	0.550376489	0.00612664	0.786266121	0.926599694	0	0.257733301	2.05109295	0	2.869684666	67.3398		6.0608	16.4462	0.958946274	3.430026996	0	0.798350086	1.810857232	0.257771263	0.723283883	6.504449418	0	0.695373635	0.091899599	0	0.140402166	1.469189669	5.440165336	1.650157579	1.380444442	1.319235118	0	16.44174607	0	0	0	0.33339132	0	0	0	0	0	0	0.550376489	0.00612664	0.786266121	0.926599694	0	0.257733301	2.05109295	0	2.869684666	67.3398	4000	$250/day (days 1-6)	$250/day (days 1-6)	$250/day (for days 1-100)	$50 copay	$200 copay	20% Coinsurance	20% Coinsurance	$50 copay	$500 copay	$50 copay	$50/$150 copay - Tier 2	$500 copay	10% coinsurance	$50 copay	$30 copay	$50 copay	$100 copay	$50 copay	$50 copay - Tier 1	$30-$100 copay	20% Coinsurance	$50 copay	n/c	Preventive n/c; comp 20%	50% Coinsurance up to $45 max	"50% Coin up to $ max ($50 frames, $25 lenses)"	50% Coinsurance	50% Coinsurance	Silver Sneakers		$50/$100 copay	$100 copay	$15 copay	$50 copay	$50 copay	$30 copay	20% coinsurance	20% coinsurance	50% Coinsurance	20% coinsurance	4.7809	0.2788	3.5729	1.422	0.5322	0.4527	0.0644	0.1808	0.271	1.2586	0.7051	0.0383	0	0.117	2.2038	4.5335	1.6502	1.1504	1.9022	0.0001	3.8809	0	0	0	0.0004	0	0	0	0	0	0.0247	0.4586	0.0015	0.6552	0.7722	0.0786	0.1289	0.6829	0.0565	0.7174	32.5727		2.931652298	21.2271	1.237709726	7.002971784	1.421957512	1.330583477	2.26357154	0.322214079	0.904104854	6.775468143	1.25862257	1.40043241	0.130191099	0	0.25740397	3.672974172	9.973636449	3.300315158	2.530814811	3.221451729	6.73E-05	20.32262849	0	0	0	0.333755016	0	0	0	0	0	0.024676744	1.009023564	0.0076583	1.441487888	1.698766106	0.078626612	0.386599952	2.734028272	0.05654477	3.587105833	99.9125
H3344_001_0	2009	9																					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	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	163.7023934	4.198560395	70.30186687	1181.740647	298.3962466	8.427228708	2.800607197	255.3220447	480.5687947	0	570.0446624	17.5635	0	1229.610772	5588.08013	2648.583187	409.7745617	1028.093341	872.0115856	1424.747937	18.90648106	531.4697859	0	0	424.8	424.8	23.64291	0	0	0											PBP: 1A IP Acute: $200 per admit	1B IP Psych: $200 per admit	2 SNF: $200	6 Home Health: $10	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: $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: $25, 9D Cardiac Rehab: $15"	"7A PCP: $10, 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, 14J Nutrition therapy $25"	7D Physician Specialist: $25	"7E Mental Health: 2500%, 7H Psychiatric: 2500%"	"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: $25"	17A Routine Eye Exams: $5	17B Eye Wear: Medicare Covered: Various Cost Sharing	18A Routine Hearing Exams: $25	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											200	200	200	10	100	0.15597851	0.166891948	48.73125408	50	0	25	25	0	15	10	25	25	15	25	25	0.2000011	25	0	0	5	27.3458	25	0	0	0											200	200	200	10	100	0.15597851	0.166891948	48.73125408	50	0	25	25	0	15	10	25	25	15	25	25	0.2000011	25	0	0	5	27.3458	25	0	0	0											2.7284	0.069976007	1.171697781	0.984783872	2.486635388	1.314466578	0.467398791	1.036846953	2.002369978	0	1.187593047	0.036590625	0	1.537013465	4.656733441	5.517881639	0.853697004	1.285116677	1.816690803	2.968224869	3.78131701	1.107228721	0	0	0.177	0.96804132	0.049256062	0	0	0	0	0	0	0	0	0	0	0	0	0	38.2049	0	0	2.7284	0.069976007	1.171697781	0.984783872	2.486635388	1.314466578	0.467398791	1.036846953	2.002369978	0	1.187593047	0.036590625	0	1.537013465	4.656733441	5.517881639	0.853697004	1.285116677	1.816690803	2.968224869	3.78131701	1.107228721	0	0	0.177	0.96804132	0.049256062	0	0	0	0	0	0	0	0	0	0	0	0	0	38.2049	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	"14A Health Education/Wellness Programs: $250 Deductible, 20% Coinsurance"	13B Acupuncture: Not Covered											3.0535	0.1472	0.537	0.2979	0.1394	0.3372	0.0992	0.1005	0.6943	0.1226	0.2583	0.007	0.0012	0.3102	1.6364	1.3215	0.112	0.384	0.4142	0.5087	0.1768	0.1342	0	0	0	0.1113	0.0068	0	0.0229	0											10.9341	250	7.049	5.7818	0.217213629	1.708733671	1.282644885	2.626028741	1.65163261	0.566629691	1.137320801	2.696661434	0.122596976	1.445855993	0.043575388	0.001202295	1.847199485	6.293130301	6.839344635	0.965665255	1.669083592	2.230850668	3.476939569	3.958136861	1.24147294	0	0	0.177	1.079366593	0.056033234	0	0.022900861	0	0	0	0	0	0	0	0	0	0	0	49.1391
H3344_003_0	2009	9																					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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	1252.865072	316.3431813	8.944478076	2.962808605	271.4495657	507.0998814	0	604.5264261	18.69485037	0	1308.011449	0	3095.898843	474.625206	1091.083755	1032.630401	1651.780183	20.04520248	587.9254137	0	0	424.8	424.8	27.26273149	6.627838818	0	0											PBP: 1A IP Acute: $0 per admit	1B IP Psych: $0 per admit	2 SNF: 0%	6 Home Health: $10	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 C/D/T: $0	8B OP X-Ray: $10	9A OP Hospital: $10	12 Renal Dialysis: $0	"3 CORF: $15, 5 Partial Hosp: $10, 9C OP Substance Abuse: $10, 9D Cardiac Rehab: $15"	"7A PCP: $0, 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, 14J Nutrition therapy $10"	7D Physician Specialist: $10	"7E Mental Health: 1000%, 7H Psychiatric: 1000%"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	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: $10, 17A Medicare Covered Eye Exams: $10"	10B Transportation: Not Covered	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: $10"	17A Routine Eye Exams: $5	17B Eye Wear: Medicare Covered: $60	18A Routine Hearing Exams: $10	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											0	0	0	10	100	0.15597851	0.166891948	48.60215441	75	0	10	10	0	14.9995621	0	10	10	15	10	10	0.2000011	10	0	0	5	27.3458	10	0.500012031	0	0											0	0	0	10	100	0.15597851	0.166891948	48.60215441	75	0	10	10	0	14.9995621	0	10	10	15	10	10	0.2000011	10	0	0	5	27.3458	10	0.500012031	0	0											0	0	0	1.044054227	2.636193178	1.395146364	0.4944689	1.099419475	3.169374259	0	0.503772022	0.015579042	0	1.634966579	0	2.579915703	0.395521005	1.363854693	0.860525334	1.376483486	4.009062546	0.489937845	0	0	0.177	0.96804132	0.022718943	3.313999151	0	0	0	0	0	0	0	0	0	0	0	0	27.55	0	0	0	0	0	1.044054227	2.636193178	1.395146364	0.4944689	1.099419475	3.169374259	0	0.503772022	0.015579042	0	1.634966579	0	2.579915703	0.395521005	1.363854693	0.860525334	1.376483486	4.009062546	0.489937845	0	0	0.177	0.96804132	0.022718943	3.313999151	0	0	0	0	0	0	0	0	0	0	0	0	27.55	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	"14A Health Education/Wellness Programs: $250 Deductible, 20% Coinsurance"	13B Acupuncture: Not Covered											2.8134	0.1537	0.4921	0.2722	0.111	0.3469	0.1022	0.1064	0.6286	0.1117	0.2354	0.0063	0.0011	0.3295	1.5552	1.2476	0.1251	0.4072	0.4029	0.4915	0.1606	0.1324	0	0.3028	0	0.1403	0.0117	0.206	0.0206	0											10.9143	0	7.05	2.8134	0.153727459	0.492099764	1.316279127	2.747164145	1.742072414	0.596692125	1.205808577	3.797971084	0.11169909	0.739142019	0.02185159	0.001079701	1.964453	1.555179595	3.827488867	0.520619912	1.771025427	1.2634472	1.867943555	4.169677863	0.622308008	0	0.302771743	0.177	1.108379589	0.034430591	3.520000321	0.02056573	0	0	0	0	0	0	0	0	0	0	0	38.4643
H3344_801_0	2009	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	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	210.2963958	3.825625374	26.72923896	11.98627581	10.60865611	8.679228708	2.976107197	10.93031208	64.71482539	8.632723261	16.48860016	0.8505	0.1485	26.026722	58.53400344	87.41529285	2.723324441	3.795909908	37.39884053	46.85879199	18.71748106	4.20836533	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	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits											0.087265221	0.08700945	0.18531416	0	0.230905375	0.230999984	0.230962218	0.230994336	0.230999981	0.230957114	0.230973723	0.231000162	0.231	0.231025056	0.230992832	0.230998289	0.231012975	0.230997468	0.231008538	0.231019347	0.231015237	0.231015237	0	0	0	0	0	0	0	0											0.087265221	0.08700945	0.18531416	0	0.230905375	0.230999984	0.230962218	0.230994336	0.230999981	0.230957114	0.230973723	0.231000162	0.231	0.231025056	0.230992832	0.230998289	0.231012975	0.230997468	0.231008538	0.231019347	0.231015237	0.231015237	0	0	0	0	0	0	0	0											18.3516	0.332865558	4.953306464	0	2.449595713	2.004901695	0.687368321	2.524840177	14.94912341	1.993788849	3.808433362	0.196465638	0.0343035	6.012824903	13.5209352	20.19278305	0.629123281	0.876845579	8.639451458	10.82528755	4.324023317	0.972196513	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.28	0	0	18.3516	0.332865558	4.953306464	0	2.449595713	2.004901695	0.687368321	2.524840177	14.94912341	1.993788849	3.808433362	0.196465638	0.0343035	6.012824903	13.5209352	20.19278305	0.629123281	0.876845579	8.639451458	10.82528755	4.324023317	0.972196513	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.28	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	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits											2.4274	0.0397	0.9034	0	0.1953	0.2481	0.085	0.3035	1.4351	0.2562	0.5398	0.0141	0.0024	0.7656	1.5205	2.0562	0.0642	0.1223	0.9225	1.1336	0.3642	0.1157	0	0	0	0	0	0	0	0											13.5148	0	0	20.779	0.372578108	5.856697537	0	2.64494229	2.252960342	0.772325717	2.828302102	16.38421992	2.249987777	4.348235235	0.210556627	0.036729	6.77845792	15.04139256	22.24896981	0.693364996	0.999102287	9.561953678	11.95890923	4.688260581	1.087905157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.7948
H3344_803_0	2009	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	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	210.2963958	3.825625374	26.72923896	11.98627581	10.60865611	8.679228708	2.976107197	10.93031208	64.71482539	8.632723261	16.48860016	0.8505	0.1485	26.026722	58.53400344	87.41529285	2.723324441	3.795909908	37.39884053	46.85879199	18.71748106	4.20836533	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	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits											0.087265221	0.08700945	0.18531416	0	0.230905375	0.230999984	0.230962218	0.230994336	0.230999981	0.230957114	0.230973723	0.231000162	0.231	0.231025056	0.230992832	0.230998289	0.231012975	0.230997468	0.231008538	0.231019347	0.231015237	0.231015237	0	0	0	0	0	0	0	0											0.087265221	0.08700945	0.18531416	0	0.230905375	0.230999984	0.230962218	0.230994336	0.230999981	0.230957114	0.230973723	0.231000162	0.231	0.231025056	0.230992832	0.230998289	0.231012975	0.230997468	0.231008538	0.231019347	0.231015237	0.231015237	0	0	0	0	0	0	0	0											18.3516	0.332865558	4.953306464	0	2.449595713	2.004901695	0.687368321	2.524840177	14.94912341	1.993788849	3.808433362	0.196465638	0.0343035	6.012824903	13.5209352	20.19278305	0.629123281	0.876845579	8.639451458	10.82528755	4.324023317	0.972196513	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.28	0	0	18.3516	0.332865558	4.953306464	0	2.449595713	2.004901695	0.687368321	2.524840177	14.94912341	1.993788849	3.808433362	0.196465638	0.0343035	6.012824903	13.5209352	20.19278305	0.629123281	0.876845579	8.639451458	10.82528755	4.324023317	0.972196513	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.28	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	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits											2.4274	0.0397	0.9034	0	0.1953	0.2481	0.085	0.3035	1.4351	0.2562	0.5398	0.0141	0.0024	0.7656	1.5205	2.0562	0.0642	0.1223	0.9225	1.1336	0.3642	0.1157	0	0	0	0	0	0	0	0											13.5148	0	0	20.779	0.372578108	5.856697537	0	2.64494229	2.252960342	0.772325717	2.828302102	16.38421992	2.249987777	4.348235235	0.210556627	0.036729	6.77845792	15.04139256	22.24896981	0.693364996	0.999102287	9.561953678	11.95890923	4.688260581	1.087905157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.7948
H3344_804_0	2009	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	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	210.2963958	3.825625374	26.72923896	11.98627581	10.60865611	8.679228708	2.976107197	10.93031208	64.71482539	8.632723261	16.48860016	0.8505	0.1485	26.026722	58.53400344	87.41529285	2.723324441	3.795909908	37.39884053	46.85879199	18.71748106	4.20836533	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	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits											0.087265221	0.08700945	0.18531416	0	0.230905375	0.230999984	0.230962218	0.230994336	0.230999981	0.230957114	0.230973723	0.231000162	0.231	0.231025056	0.230992832	0.230998289	0.231012975	0.230997468	0.231008538	0.231019347	0.231015237	0.231015237	0	0	0	0	0	0	0	0											0.087265221	0.08700945	0.18531416	0	0.230905375	0.230999984	0.230962218	0.230994336	0.230999981	0.230957114	0.230973723	0.231000162	0.231	0.231025056	0.230992832	0.230998289	0.231012975	0.230997468	0.231008538	0.231019347	0.231015237	0.231015237	0	0	0	0	0	0	0	0											18.3516	0.332865558	4.953306464	0	2.449595713	2.004901695	0.687368321	2.524840177	14.94912341	1.993788849	3.808433362	0.196465638	0.0343035	6.012824903	13.5209352	20.19278305	0.629123281	0.876845579	8.639451458	10.82528755	4.324023317	0.972196513	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.28	0	0	18.3516	0.332865558	4.953306464	0	2.449595713	2.004901695	0.687368321	2.524840177	14.94912341	1.993788849	3.808433362	0.196465638	0.0343035	6.012824903	13.5209352	20.19278305	0.629123281	0.876845579	8.639451458	10.82528755	4.324023317	0.972196513	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.28	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	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits											2.4274	0.0397	0.9034	0	0.1953	0.2481	0.085	0.3035	1.4351	0.2562	0.5398	0.0141	0.0024	0.7656	1.5205	2.0562	0.0642	0.1223	0.9225	1.1336	0.3642	0.1157	0	0	0	0	0	0	0	0											13.5148	0	0	20.779	0.372578108	5.856697537	0	2.64494229	2.252960342	0.772325717	2.828302102	16.38421992	2.249987777	4.348235235	0.210556627	0.036729	6.77845792	15.04139256	22.24896981	0.693364996	0.999102287	9.561953678	11.95890923	4.688260581	1.087905157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.7948
H3346_001_0	2009	8																																A	A	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	P	P	P	P	P	O	O																																																			0	3000			1864.805911	69.47350847	451.7837707	825.3867574	229.2472645	276.1959109			330.2110349			299.6807474	3819.719822	3632.138281	114.7298351	870.0162619		11.63656724	1388.149735	1167.712899			2.972498372		2.834242634			516.6347867											No cost sharing	No cost sharing (190 day limit)	"$0(day 1-15), $65(days 16-100)"	"$0(day 1-20), $15(days 21+)"	$35 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER visit, $20 per Urgently Needed Care"	No cost sharing	No cost sharing	$15 Copay per visit	No cost sharing	No cost sharing	"$15 copay for OT/PT/ST, Cardiac Rehab $50 copay"	$10 Copay per visit	$15 Copay per visit	$15 Copay per visit	$15 Copay per visit	No cost sharing	$15 Copay per visit	20% Coinsurance	$15 copay for Ophthalmology visit	No cost sharing	$300 for any services	$10 Copay per routine exam	$100 allowance per year	$15 Copay for 1 exam per year	$600 every 3 years	No cost sharing	"50% Coinsurance for Acupuncture, others $0,"													34.26621634	3.122182265	35	21.52315775	24.854157	48.46946663			15			16.7786749	10	15	15	15		15	32.20604795	19.61930951			10		15			19.27381209													34.26621634	3.122182265	35	21.52315775	24.854157	48.46946663			15			16.7786749	10	15	15	15		15	32.20604795	19.61930951			10		15			19.27381209											0	0	5.324986898	0.018075746	1.317702664	1.480410782	0.474812292	1.115589041	0	0	0.412763794	0	0	0.419020486	3.183099851	4.540172851	0.143412294	1.087520327	0	0.014545709	3.725568078	1.909143399	0	0	0.002477082	0	0.003542803	0	0	0.829793483	0	0	0	0	0	0	0	0	0	0	26.0026	0	0	0	0	5.324986898	0.018075746	1.317702664	1.480410782	0.474812292	1.115589041	0	0	0.412763794	0	0	0.419020486	3.183099851	4.540172851	0.143412294	1.087520327	0	0.014545709	3.725568078	1.909143399	0	0	0.002477082	0	0.003542803	0	0	0.829793483	0	0	0	0	0	0	0	0	0	0	26.0026		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$35 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER visit, $20 per Urgently needed Care"	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	"$25 copay for OT/PT/ST, Cardiac Rehab 50% coinsurance"	$25 Copay per visit	$25 Copay per visit	"50% Coinsurance for MH, $25 Copay per visit for Substance Abuse"	$25 Copay per visit	20% Coinsurance	20% Coinsurance	20% Coinsurance	$25 copay for Ophthalmology visit	No cost sharing	$300 for any services	$25 Copay per visit	$100 Allowance	$25 copay for 1 exam every year	$600 every 3 years	No cost sharing	"50% Coinsurance for Acupuncture, others $25 copay per visit,"											2.631	0.0385	0.5006	0.0103	0.0638	0.0896	0.0287	0.0547	0.5298	0.3167	0.3175		0.0055	0.09	0.504	0.4271	0.0319	0.0878	0.3663	0.6585	0.2255	0.137			0.0003		0.0003			0.0521											7.1677	0	5.703494382	2.631	0.038499948	5.825624829	0.028346493	1.381511657	1.570020832	0.503552932	1.170322197	0.529793791	0.316727233	0.730258977	0	0.005536592	0.509009424	3.687135058	4.967248171	0.175318534	1.175291237	0.366303432	0.673087986	3.951078689	2.046171302	0	0	0.00277696	0	0.003828734	0	0	0.881913779	0	0	0	0	0	0	0	0	0	0	33.1704
H3346_002_0	2009	10																																A	A	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	P	P	P	P	P	O	O																																																			0	3000			2078.979639	79.02996392	471.5828869	898.0950118	333.9610213	261.5095454			307.7807713			330.4536721	3596.338471	3534.092318	252.0329488	1002.521682		12.32165655	1334.893222	1037.613183			3.670586002		2.696757063			560.7624305											No cost sharing	No cost sharing (190 day limit)	"$0(day 1-15), $65(days 16-100)"	"$0(day 1-20), $20(days 21+)"	$35 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER visit, $20 per Urgently Needed Care"	No cost sharing	No cost sharing	$15 Copay per visit	No cost sharing	No cost sharing	"$15 copay for OT/PT/ST, Cardiac Rehab $50 copay"	$10 Copay per visit	$15 Copay per visit	$15 Copay per visit	$15 Copay per visit	No cost sharing	$15 Copay per visit	20% Coinsurance	$15 copay for Ophthalmology visit	No cost sharing	$300 for any services	$10 Copay per routine exam	$100 allowance per year	$15 Copay for 1 exam per year	$600 every 3 years	No cost sharing	"50% Coinsurance for Acupuncture, others $0,"													34.26621634	3.122182265	35	24.21633555	25.01127727	48.01828369			15			16.54375729	10	15	15	15		15	29.01562753	20.29311693			10		15			18.93749631													34.26621634	3.122182265	35	24.21633555	25.01127727	48.01828369			15			16.54375729	10	15	15	15		15	29.01562753	20.29311693			10		15			18.93749631											0	0	5.93656384	0.020562163	1.375450087	1.812380847	0.696065975	1.046436628	0	0	0.384725964	0	0	0.455578779	2.996948726	4.417615398	0.315041186	1.253152103	0	0.015402071	3.227730378	1.754700471	0	0	0.003058822	0	0.003370946	0	0	0.884953038	0	0	0	0	0	0	0	0	0	0	26.5997	0	0	0	0	5.93656384	0.020562163	1.375450087	1.812380847	0.696065975	1.046436628	0	0	0.384725964	0	0	0.455578779	2.996948726	4.417615398	0.315041186	1.253152103	0	0.015402071	3.227730378	1.754700471	0	0	0.003058822	0	0.003370946	0	0	0.884953038	0	0	0	0	0	0	0	0	0	0	26.5997		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$35 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER visit, $20 per Urgently needed Care"	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	"$25 copay for OT/PT/ST, Cardiac Rehab 50% coinsurance"	$25 Copay per visit	$25 Copay per visit	"50% Coinsurance for MH, $25 Copay per visit for Substance Abuse"	$25 Copay per visit	20% Coinsurance	20% Coinsurance	20% Coinsurance	$25 copay for Ophthalmology visit	No cost sharing	$300 for any services	$25 Copay per visit	$100 Allowance	$25 copay for 1 exam every year	$600 every 3 years	No cost sharing	"50% Coinsurance for Acupuncture, others $25 copay per visit,"											2.423	0.0289	0.529	0.0145	0.0678	0.1117	0.0429	0.0523	0.5163	0.3405	0.2739		0.0036	0.1131	0.509	0.4277	0.0691	0.103	0.3891	0.615	0.1989	0.1272			0.0004		0.0003			0.0576											7.0147	0	5.355941586	2.423	0.028888727	6.465554589	0.035036669	1.443271107	1.924087479	0.738968209	1.098758958	0.516287836	0.340523813	0.658633485	0	0.003578849	0.568663079	3.505937903	4.845274062	0.384110395	1.356136639	0.389092066	0.630448065	3.4266725	1.881865939	0	0	0.003435884	0	0.003647972	0	0	0.942557637	0	0	0	0	0	0	0	0	0	0	33.6145
H3346_802_0	2009	8																																A	A	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	P	P	P	P	P	O	O																																																			0	3000				35.07138135	342.0341815	833.0723773	299.2899822	229.9389289			248.2533104			332.6489706	4024.087673	4182.839171	174.2350459	1500.983165		15.99465542	1398.400143	1238.573033			4.501916447		2.250958223			605.6495692											No cost sharing	No cost sharing (190 day limit)	$0(day 1-100)	"$0(day 1-20), $20(days 21+)"	$35 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER visit, $20 per Urgently Needed Care"	No cost sharing	No cost sharing	$15 Copay per visit	No cost sharing	No cost sharing	"$15 copay for OT/PT/ST, Cardiac Rehab $50 copay"	$10 Copay per visit	$15 Copay per visit	$15 Copay per visit	$15 Copay per visit	No cost sharing	$15 Copay per visit	20% Coinsurance	$15 copay for Ophthalmology visit	No cost sharing	$300 for any services	$10 Copay per routine exam	$100 allowance per year	$15 Copay for 1 exam per year	$600 every 3 years	No cost sharing	"50% Coinsurance for Acupuncture, others $0,"														3.122182265	35	23.22498113	27.95435101	48.0396619			15			17.02921348	10	15	15	15		15	30.68016673	20.60928755			10		15			18.64567253														3.122182265	35	23.22498113	27.95435101	48.0396619			15			17.02921348	10	15	15	15		15	30.68016673	20.60928755			10		15			18.64567253											0	0	0	0.009124937	0.997599696	1.612340854	0.697204768	0.9205157	0	0	0.310316638	0	0	0.472062528	3.353406394	5.228548964	0.217793807	1.876228957	0	0.019993319	3.575262462	2.127175648	0	0	0.003751597	0	0.002813698	0	0	0.941061961	0	0	0	0	0	0	0	0	0	0	22.3652	0	0	0	0	0	0.009124937	0.997599696	1.612340854	0.697204768	0.9205157	0	0	0.310316638	0	0	0.472062528	3.353406394	5.228548964	0.217793807	1.876228957	0	0.019993319	3.575262462	2.127175648	0	0	0.003751597	0	0.002813698	0	0	0.941061961	0	0	0	0	0	0	0	0	0	0	22.3652		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$35 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER visit, $20 per Urgently needed Care"	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	"$25 copay for OT/PT/ST, Cardiac Rehab 50% coinsurance"	$25 Copay per visit	$25 Copay per visit	"50% Coinsurance for MH, $25 Copay per visit for Substance Abuse"	$25 Copay per visit	20% Coinsurance	20% Coinsurance	20% Coinsurance	$25 copay for Ophthalmology visit	No cost sharing	$300 for any services	$25 Copay per visit	$100 Allowance	$25 copay for 1 exam every year	$600 every 3 years	No cost sharing	"50% Coinsurance for Acupuncture, others $25 copay per visit,"											2.3457	0.0247	0.3728	0.0075	0.0487	0.0985	0.0426	0.045	0.5377	0.3662	0.3063		0.0014	0.1367	0.5077	0.4838	0.047	0.1528	0.4243	0.7058	0.2183	0.1528			0.0005		0.0002			0.0616											7.0887	0	5.524956814	2.3457	0.024744374	0.372800145	0.016629695	1.046335231	1.710800054	0.739780272	0.965485466	0.537700843	0.366180357	0.616600096	0	0.001427057	0.608772271	3.861093604	5.712333271	0.264811259	2.02899401	0.424311074	0.725835431	3.793589425	2.279963625	0	0	0.004209787	0	0.003042793	0	0	1.00271004	0	0	0	0	0	0	0	0	0	0	29.4539
H3347_001_0	2009	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																																																			0		2741.44737		1578.980004		663.9346029	10.56385076		242.2969258	174.8915189		291.6425175				19459.00022		300.2206604	3382.426797		64.3281105	6.019077786					80.41013812															"1A: $200/day day 1, $85/day days 2-7; 1B: $200/day day 1, $85/day days 2-7"	"1A: $200/day day 1, $85/day days 2-7; 1B: $200/day day 1, $85/day days 2-7"	"2: $0/day days 1-7, $100/day days 8-39, $0/day days 40-100"	6: $0	10A: $50	11A: 20%; 11B: 20%; 11C: $0	11A: 20%; 11B: 20%; 11C: $0	4A: $50; $4B: $50	9A: $200; 9B: $200	8A: $0	"8B: $45 Diag Rad, $0 x-rays, 20% Ther Rad"			9C: $20; 9D: $0; 12: 20%	7A: $0; 7D: $20; 7F: $20; 7G: $20; 8A: $0; 11A: 20%; 11B: 20%; 11C: $0; 14B: $0; 17A: $0 routine; $20 MC Benefits	14C: $0	5: $20/day; 7E: $20; 7H: $20; 9C: $20	3: $25; 7C: $25; 7I: $25	"8B: $45 Diag Rad, $0 x-rays, 20% Ther Rad"	7B: $20; 8A: $0	15: 20%		10B: n/a	16A: $0; 16B: $0	17A: $0 routine; $20 MC Benefits	"17B: $0 contacts and glasses, $10 MC Eyewear"	"18A: $0 routine hearing test, hearing aid eval, MC benefits"	18B: $0													65.57640574		45.14077426		50	0.176		50	192.7030825		97.92841951				1.246372827		8.242534762	9.978338516		18.53544681	0.17877033					1.996844695															65.57640574		45.14077426		50	0.176		50	192.7030825		97.92841951				1.246372827		8.242534762	9.978338516		18.53544681	0.17877033					1.996844695															14.9812	0	5.939698328	0	2.766394179	1.859237733	0	1.009570524	2.808511234	0	2.380007567	0	0	0	2.021097426	0	0.206214936	2.812583299	0	0.099362523	1.076032522	0	0	0	0	0.013380546	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.9733	0	0	14.9812	0	5.939698328	0	2.766394179	1.859237733	0	1.009570524	2.808511234	0	2.380007567	0	0	0	2.021097426	0	0.206214936	2.812583299	0	0.099362523	1.076032522	0	0	0	0	0.013380546	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.9733																																																																																		0	0	0	14.9812	0	5.939698328	0	2.766394179	1.859237733	0	1.009570524	2.808511234	0	2.380007567	0	0	0	2.021097426	0	0.206214936	2.812583299	0	0.099362523	1.076032522	0	0	0	0	0.013380546	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.9733
H3347_002_0	2009	6																																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																																																			0		2926.547714	758.5261573	992.5415147			12.25829463	685.3631614	307.6631919	178.4324221	979.1644141	162.1465425		88.98797106								10.02481756																				1A: MC defined cost share	1B: MC defined cost share	2: MC defined cost share	6: $0	10A: $0; 10B: $0	11A: MC defined cost share	11B: MC defined cost share; 11C: $0	4A: MC defined cost share; 4B: $0	9A: MC defined cost share; 9B: MC defined cost share	"8A: Lab-MC defined cost share, X-ray-$0"	"8A: Lab-MC defined cost share, X-ray-$0; 8B: MC defined cost share"		12: MC defined cost share	3: $0; 5: MC defined cost share; 7C: $0; 7I: $0; 9C: $0; 9D: $0; 13A: $0	7A: $0; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0	7B: $0; 7D: $0; 7F: $0; 14B: $0; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0	7E: $0; 7H: $0	7I: $0			15: MC defined cost share	13A: $0; 16A: $0; 16B: $0; 17A: $0; 17B: $0; 18A: $0	10B: $0	16A: $0; 16B: $0	17A: $0	17B: $0	18A: $0	18B: $0 n/c	14A: $0	13B: $0											106.4740618	47.94055884	76.11028836			0.231	36.51628983	71.94312562	327.6610908	13.84950378	147.7061395		228.1736603								0.231																				106.4740618	47.94055884	76.11028836			0.231	36.51628983	71.94312562	327.6610908	13.84950378	147.7061395		228.1736603								0.231																				25.9668	3.030347323	6.295218407	0	0	2.831666059	2.085576654	1.844520972	4.872113503	1.130078438	1.995836652	0	1.692059257	0	0	0	0	0	0	0	2.315732856	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0599	0	0	25.9668	3.030347323	6.295218407	0	0	2.831666059	2.085576654	1.844520972	4.872113503	1.130078438	1.995836652	0	1.692059257	0	0	0	0	0	0	0	2.315732856	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0599																																																																																		0	0	0	25.9668	3.030347323	6.295218407	0	0	2.831666059	2.085576654	1.844520972	4.872113503	1.130078438	1.995836652	0	1.692059257	0	0	0	0	0	0	0	2.315732856	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0599
H3347_003_0	2009	6																																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																																																			0		4101.493605	481.2622388	8864.256558			3.567897337	1306.299314	235.7604322	84.3722367	3142.71848	97.47257181		45.38568831								42.23267557																				1A: MC defined cost share	1B: MC defined cost share	2: MC defined cost share	6: $0	10A: $0; 10B: $0	11A: MC defined cost share	11B: MC defined cost share; 11C: $0	4A: MC defined cost share; 4B: $0	9A: MC defined cost share; 9B: MC defined cost share	"8A: Lab-MC defined cost share, X-ray-$0"	"8A: Lab-MC defined cost share, X-ray-$0; 8B: MC defined cost share"		12: MC defined cost share	3: $0; 5: MC defined cost share; 7C: $0; 7I: $0; 9C: $0; 9D: $0; 13A: $0	7A: $0; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0	7B: $0; 7D: $0; 7F: $0; 14B: $0; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0	7E: $0; 7H: $0	7I: $0			15: MC defined cost share	13A: $0; 16A: $0; 16B: $0; 17A: $0; 17B: $0; 18A: $0	10B: $0	16A: $0; 16B: $0	17A: $0	17B: $0	18A: $0	18B: $0 n/c	14A: $0	13B: $0											85.289687	50.55727725	68.01893605			0.231	35.69346885	103.7882665	279.9045777	9.545341191	111.9237897		197.9233719								0.231																				85.289687	50.55727725	68.01893605			0.231	35.69346885	103.7882665	279.9045777	9.545341191	111.9237897		197.9233719								0.231																				29.1513	2.027609037	50.244775	0	0	0.824184285	3.885529489	2.039097213	1.968014607	2.499860013	0.909124969	0	0.748574039	0	0	0	0	0	0	0	9.755748056	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.0538	0	0	29.1513	2.027609037	50.244775	0	0	0.824184285	3.885529489	2.039097213	1.968014607	2.499860013	0.909124969	0	0.748574039	0	0	0	0	0	0	0	9.755748056	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.0538																																																																																		0	0	0	29.1513	2.027609037	50.244775	0	0	0.824184285	3.885529489	2.039097213	1.968014607	2.499860013	0.909124969	0	0.748574039	0	0	0	0	0	0	0	9.755748056	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.0538
H3347_004_0	2009	4																																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																																																			0		1773.464228	148.3881496	792.4306744		161.7905474	7.537613933	351.2822204	168.2067178	163.7404017		208.9137484		15.27610757	87.12462289	2875.265383	5726.071281	1140.094292	1973.822941			17.65891196	1605.983327	11.02011548		147.9890135		255.8976692														"1A: $200/day day 1, $85/day days 2-10"	"1B: $200/day day 1, $85/day days 2-10"	"2: $0/day days 1-7, $100/day days 8-39, $0/day days 40-100"	6: $0	10A: $50; 10B: $0	11A: 20%	11B: 20%; 11C: $0	4A: $50; 4B: $50	9A: $200; 9B: $200	8A: $0	"8A: $0; 8B: $250 Diag Rad, $20 x-rays, 20% Ther Rad"		12: 20%	3: $30; 5: $30/day; 7C: $30; 7I: $30; 9C: $30; 9D: $30; 13A: $0	7A: $20; 14C: $0; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $25	7B: $30; 7D: $30; 7F: $30; 14B: $0; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $25	7E: $30; 7H: $30	7I: $30			15: 20%	"13A: $0; 16A: $0; 16B: $0; 17A: $30; 17B: $10 MC benefits, $0 contact lenses and glasses; 18A: $30"	10B: $0	16A: $0; 16B: $0	17A: $30	"17B: $10 MC benefits, $0 contact lenses and glasses"	18A: $30	18B: $0	14A: $0	13B: $30											100.8757226	100.8757226	53.82238443		50	0.2	31.70485296	50	200		145.4852359		92.45535321	30	20	29.99673732	30	30			0.2	30	39.85958904		30		30														100.8757226	100.8757226	53.82238443		50	0.2	31.70485296	50	200		145.4852359		92.45535321	30	20	29.99673732	30	30			0.2	30	39.85958904		30		30														14.9083	1.247396817	3.554209033	0	0.674127281	1.507522787	0.928112596	0.700861324	2.729006695	0	2.532822164	0	0.117696493	0.217811557	4.792108972	14.31362134	2.85023573	4.934557352	0	0	3.531782392	4.014958318	0.036604773	0	0.369972534	0	0.639744173	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6014	0	0	14.9083	1.247396817	3.554209033	0	0.674127281	1.507522787	0.928112596	0.700861324	2.729006695	0	2.532822164	0	0.117696493	0.217811557	4.792108972	14.31362134	2.85023573	4.934557352	0	0	3.531782392	4.014958318	0.036604773	0	0.369972534	0	0.639744173	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6014																																																																																		0	0	0	14.9083	1.247396817	3.554209033	0	0.674127281	1.507522787	0.928112596	0.700861324	2.729006695	0	2.532822164	0	0.117696493	0.217811557	4.792108972	14.31362134	2.85023573	4.934557352	0	0	3.531782392	4.014958318	0.036604773	0	0.369972534	0	0.639744173	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6014
H3347_005_0	2009	6																																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																																																			0		3291.7209		1895.918753		638.9185612	10.165821		237.6730967	171.5540086		286.0770108				18725.81481		288.9088045	3254.982122		61.90432555	5.944064243					77.38040694															"1A: $200/day day 1, $85/day days 2-7; 1B: $200/day day 1, $85/day days 2-7"	"1A: $200/day day 1, $85/day days 2-7; 1B: $200/day day 1, $85/day days 2-7"	"2: $0/day days 1-7, $100/day days 8-39, $0/day days 40-100"	6: $0	10A: $50	11A: 20%; 11B: 20%; 11C: $0	11A: 20%; 11B: 20%; 11C: $0	4A: $50; $4B: $50	9A: $200; 9B: $200	8A: $0	"8B: $45 Diag Rad, $0 x-rays, 20% Ther Rad"			9C: $20; 9D: $0; 12: 20%	7A: $0; 7D: $20; 7F: $20; 7G: $20; 8A: $0; 11A: 20%; 11B: 20%; 11C: $0; 14B: $0; 17A: $0 routine; $20 MC benefits	14C: $0	5: $20/day; 7E: $20; 7H: $20; 9C: $20	3: $25; 7C: $25; 7I: $25	"8B: $45 Diag Rad, $0 x-rays, 20% Ther Rad"	7B: $20; 8A: $0	15: 20%		10B: n/a	16A: $0; 16B: $0	17A: $0 routine; $20 MC benefits	17B: $10 MC Benefits	18A: $0	18B: $0													65.57640574		45.14077426		50	0.176		50	192.7030825		97.92841951				1.425874621		8.242534762	9.978338516		18.53544681	0.17931241					2.499560127															65.57640574		45.14077426		50	0.176		50	192.7030825		97.92841951				1.425874621		8.242534762	9.978338516		18.53544681	0.17931241					2.499560127															17.9883	0	7.131936705	0	2.662160672	1.789184495	0	0.99030457	2.754915523	0	2.334589127	0	0	0	2.225055341	0	0.198445072	2.706609456	0	0.095618694	1.065844483	0	0	0	0	0.016118082	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.9591	0	0	17.9883	0	7.131936705	0	2.662160672	1.789184495	0	0.99030457	2.754915523	0	2.334589127	0	0	0	2.225055341	0	0.198445072	2.706609456	0	0.095618694	1.065844483	0	0	0	0	0.016118082	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.9591																																																																																		0	0	0	17.9883	0	7.131936705	0	2.662160672	1.789184495	0	0.99030457	2.754915523	0	2.334589127	0	0	0	2.225055341	0	0.198445072	2.706609456	0	0.095618694	1.065844483	0	0	0	0	0.016118082	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.9591
H3347_006_0	2009	8																																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																																																			0		3291.7209		1895.918753		638.9185612	10.165821		237.6730967	171.5540086		286.0770108				18725.81481		288.9088045	3254.982122		61.90432555	5.944064243					77.38040694															"1A: $200/day day 1, $75/day days 2-7; 1B: $200/day day 1, $75/day days 2-7"	"1A: $200/day day 1, $75/day days 2-7; 1B: $200/day day 1, $75/day days 2-7"	"2: $0/day days 1-7, $100/day days 8-39, $0/day days 40-100"	6: $0	10A: $50	11A: 20%; 11B: 20%; 11C: $0	11A: 20%; 11B: 20%; 11C: $0	4A: $50; $4B: $50	9A: $200; 9B: $200	8A: $0	"8B: $45 Diag Rad, $0 x-rays, 20% Ther Rad"			9C: $20; 9D: $0; 12: 20%	7A: $0; 7D: $20; 7F: $20; 7G: $20; 8A: $0; 11A: 20%; 11B: 20%; 11C: $0; 14B: $0; 17A: $0 routine; $20 MC benefits	14C: $0	5: $20/day; 7E: $20; 7H: $20; 9C: $20	3: $25; 7C: $25; 7I: $25	"8B: $45 Diag Rad, $0 x-rays, 20% Ther Rad"	7B: $20; 8A: $0	15: 20%		10B: n/a	16A: $0; 16B: $0	17A: $0 routine; $20 MC benefits	17B: $10 MC Benefits	18A: $0	18B: $0													60.89273285		45.14077426		50	0.176		50	192.7030825		97.92841951				1.425874621		8.242534762	9.978338516		18.53544681	0.17931241					2.499560127															60.89273285		45.14077426		50	0.176		50	192.7030825		97.92841951				1.425874621		8.242534762	9.978338516		18.53544681	0.17931241					2.499560127															16.7035	0	7.131936705	0	2.662160672	1.789184495	0	0.99030457	2.754915523	0	2.334589127	0	0	0	2.225055341	0	0.198445072	2.706609456	0	0.095618694	1.065844483	0	0	0	0	0.016118082	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6743	0	0	16.7035	0	7.131936705	0	2.662160672	1.789184495	0	0.99030457	2.754915523	0	2.334589127	0	0	0	2.225055341	0	0.198445072	2.706609456	0	0.095618694	1.065844483	0	0	0	0	0.016118082	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6743																																																																																		0	0	0	16.7035	0	7.131936705	0	2.662160672	1.789184495	0	0.99030457	2.754915523	0	2.334589127	0	0	0	2.225055341	0	0.198445072	2.706609456	0	0.095618694	1.065844483	0	0	0	0	0.016118082	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6743
H3347_802_0	2009	6																																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																																																			0		1751.8594	148.4127	792.2961888		161.8173152	7.540108292	351.3403391	167.8832748	163.7674921	650.7042212	208.9483125	19.28565649	15.27863496	764.7424461	5649.933211	11161.58372	1140.282917	1974.149504	3321.252813	18848.88049	17.66475568	1610.061522																			1A: MC defined cost share	1B: MC defined cost share	2: MC defined cost share	6: $0	10A: MC defined cost share; 10B: MC defined cost share	11A: MC defined cost share	11B: MC defined cost share; 11C: MC defined cost share	4A: MC defined cost share; 4B: $0	9A: MC defined cost share; 9B: MC defined cost share	8A: MC defined cost share	8A: MC defined cost share; 8B: MC defined cost share	MC Defined Cost Share	12: MC defined cost share	3: MC defined cost share; 5: MC defined cost share; 7C: MC defined cost share; 7I: MC defined cost share; 9C: MC defined cost share; 9D: MC defined cost share; 13A: MC defined cost share	7A: MC defined cost share; 14D: MC defined cost share; 14E: MC defined cost share; 14F: MC defined cost share; 14G: MC defined cost share; 14H: MC defined cost share; 14I: MC defined cost share; 14J: MC defined cost share	7B: MC defined cost share; 7D: MC defined cost share; 7F: MC defined cost share; 14B: $0; 14D: MC defined cost share; 14E: MC defined cost share; 14F: MC defined cost share; 14G: MC defined cost share; 14H: MC defined cost share; 14I: MC defined cost share; 14J: MC defined cost share	7E: MC defined cost share; 7H: MC defined cost share	7I: MC defined cost share	MC Defined Cost Share	MC Defined Cost Share	15: MC defined cost share	13A: MC defined cost share; 16A: MC defined cost share; 16B: MC defined cost share; 17A: MC defined cost share; 17B: MC defined cost share; 18A: MC defined cost share	10B: MC defined cost share	16A: MC defined cost share; 16B: MC defined cost share	17A: MC defined cost share	17B: MC defined cost share	18A: MC defined cost share	18B: $0 n/c	14A: $0	13B: $0											113.2683502	48.3290268	76.81805378		121.3113935	0.231	36.62516369	84.09470358	353.4804219	13.16368494	118.80696	289.2258795	106.8036004	70.28095754	13.48686542	16.02672772	21.62642171	16.95576021	26.38046542	8.721437113	0.231	17.17421999																			113.2683502	48.3290268	76.81805378		121.3113935	0.231	36.62516369	84.09470358	353.4804219	13.16368494	118.80696	289.2258795	106.8036004	70.28095754	13.48686542	16.02672772	21.62642171	16.95576021	26.38046542	8.721437113	0.231	17.17421999																			16.5359	0.597720113	5.071887603	0	1.635857	1.741765015	1.072324786	1.176507852	4.824050183	0.713805446	2.068709484	0.464825913	0.135984435	4.478902615	6.349990737	14.90697194	2.055019937	2.789433801	7.301349582	13.69911048	4.080558561	2.304295898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.0049	0	0	16.5359	0.597720113	5.071887603	0	1.635857	1.741765015	1.072324786	1.176507852	4.824050183	0.713805446	2.068709484	0.464825913	0.135984435	4.478902615	6.349990737	14.90697194	2.055019937	2.789433801	7.301349582	13.69911048	4.080558561	2.304295898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.0049																																																																																		0	0	0	16.5359	0.597720113	5.071887603	0	1.635857	1.741765015	1.072324786	1.176507852	4.824050183	0.713805446	2.068709484	0.464825913	0.135984435	4.478902615	6.349990737	14.90697194	2.055019937	2.789433801	7.301349582	13.69911048	4.080558561	2.304295898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.0049
H3347_805_0	2009	6																																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																																																			0		1751.8594	148.4127	792.2961888		161.8173152	7.540108292	351.3403391	167.8832748	163.7674921	650.7042212	208.9483125	19.28565649	15.27863496	764.7424461	5649.933211	11161.58372	1140.282917	1974.149504	3321.252813	18848.88049	17.66475568	1610.061522																			1A: MC defined cost share	1B: MC defined cost share	2: MC defined cost share	6: $0	10A: MC defined cost share; 10B: MC defined cost share	11A: MC defined cost share	11B: MC defined cost share; 11C: MC defined cost share	4A: MC defined cost share; 4B: $0	9A: MC defined cost share; 9B: MC defined cost share	8A: MC defined cost share	8A: MC defined cost share; 8B: MC defined cost share	MC Defined Cost Share	12: MC defined cost share	3: MC defined cost share; 5: MC defined cost share; 7C: MC defined cost share; 7I: MC defined cost share; 9C: MC defined cost share; 9D: MC defined cost share; 13A: MC defined cost share	7A: MC defined cost share; 14D: MC defined cost share; 14E: MC defined cost share; 14F: MC defined cost share; 14G: MC defined cost share; 14H: MC defined cost share; 14I: MC defined cost share; 14J: MC defined cost share	7B: MC defined cost share; 7D: MC defined cost share; 7F: MC defined cost share; 14B: $0; 14D: MC defined cost share; 14E: MC defined cost share; 14F: MC defined cost share; 14G: MC defined cost share; 14H: MC defined cost share; 14I: MC defined cost share; 14J: MC defined cost share	7E: MC defined cost share; 7H: MC defined cost share	7I: MC defined cost share	MC Defined Cost Share	MC Defined Cost Share	15: MC defined cost share	13A: MC defined cost share; 16A: MC defined cost share; 16B: MC defined cost share; 17A: MC defined cost share; 17B: MC defined cost share; 18A: MC defined cost share	10B: MC defined cost share	16A: MC defined cost share; 16B: MC defined cost share	17A: MC defined cost share	17B: MC defined cost share	18A: MC defined cost share	18B: $0 n/c	14A: $0	13B: $0											113.2683502	48.3290268	76.81805378		121.3113935	0.231	36.62516369	84.09470358	353.4804219	13.16368494	118.80696	289.2258795	106.8036004	70.28095754	13.48686542	16.02672772	21.62642171	16.95576021	26.38046542	8.721437113	0.231	17.17421999																			113.2683502	48.3290268	76.81805378		121.3113935	0.231	36.62516369	84.09470358	353.4804219	13.16368494	118.80696	289.2258795	106.8036004	70.28095754	13.48686542	16.02672772	21.62642171	16.95576021	26.38046542	8.721437113	0.231	17.17421999																			16.5359	0.597720113	5.071887603	0	1.635857	1.741765015	1.072324786	1.176507852	4.824050183	0.713805446	2.068709484	0.464825913	0.135984435	4.478902615	6.349990737	14.90697194	2.055019937	2.789433801	7.301349582	13.69911048	4.080558561	2.304295898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.0049	0	0	16.5359	0.597720113	5.071887603	0	1.635857	1.741765015	1.072324786	1.176507852	4.824050183	0.713805446	2.068709484	0.464825913	0.135984435	4.478902615	6.349990737	14.90697194	2.055019937	2.789433801	7.301349582	13.69911048	4.080558561	2.304295898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.0049																																																																																		0	0	0	16.5359	0.597720113	5.071887603	0	1.635857	1.741765015	1.072324786	1.176507852	4.824050183	0.713805446	2.068709484	0.464825913	0.135984435	4.478902615	6.349990737	14.90697194	2.055019937	2.789433801	7.301349582	13.69911048	4.080558561	2.304295898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.0049
H3347_806_0	2009	6																																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																																																			0		1751.8594	148.4127	792.2961888		161.8173152	7.540108292	351.3403391	167.8832748	163.7674921	650.7042212	208.9483125	19.28565649	15.27863496	764.7424461	5649.933211	11161.58372	1140.282917	1974.149504	3321.252813	18848.88049	17.66475568	1610.061522																			1A: MC defined cost share	1B: MC defined cost share	2: MC defined cost share	6: $0	10A: MC defined cost share; 10B: MC defined cost share	11A: MC defined cost share	11B: MC defined cost share; 11C: MC defined cost share	4A: MC defined cost share; 4B: $0	9A: MC defined cost share; 9B: MC defined cost share	8A: MC defined cost share	8A: MC defined cost share; 8B: MC defined cost share	MC Defined Cost Share	12: MC defined cost share	3: MC defined cost share; 5: MC defined cost share; 7C: MC defined cost share; 7I: MC defined cost share; 9C: MC defined cost share; 9D: MC defined cost share; 13A: MC defined cost share	7A: MC defined cost share; 14D: MC defined cost share; 14E: MC defined cost share; 14F: MC defined cost share; 14G: MC defined cost share; 14H: MC defined cost share; 14I: MC defined cost share; 14J: MC defined cost share	7B: MC defined cost share; 7D: MC defined cost share; 7F: MC defined cost share; 14B: $0; 14D: MC defined cost share; 14E: MC defined cost share; 14F: MC defined cost share; 14G: MC defined cost share; 14H: MC defined cost share; 14I: MC defined cost share; 14J: MC defined cost share	7E: MC defined cost share; 7H: MC defined cost share	7I: MC defined cost share	MC Defined Cost Share	MC Defined Cost Share	15: MC defined cost share	13A: MC defined cost share; 16A: MC defined cost share; 16B: MC defined cost share; 17A: MC defined cost share; 17B: MC defined cost share; 18A: MC defined cost share	10B: MC defined cost share	16A: MC defined cost share; 16B: MC defined cost share	17A: MC defined cost share	17B: MC defined cost share	18A: MC defined cost share	18B: $0 n/c	14A: $0	13B: $0											113.2683502	48.3290268	76.81805378		121.3113935	0.231	36.62516369	84.09470358	353.4804219	13.16368494	118.80696	289.2258795	106.8036004	70.28095754	13.48686542	16.02672772	21.62642171	16.95576021	26.38046542	8.721437113	0.231	17.17421999																			113.2683502	48.3290268	76.81805378		121.3113935	0.231	36.62516369	84.09470358	353.4804219	13.16368494	118.80696	289.2258795	106.8036004	70.28095754	13.48686542	16.02672772	21.62642171	16.95576021	26.38046542	8.721437113	0.231	17.17421999																			16.5359	0.597720113	5.071887603	0	1.635857	1.741765015	1.072324786	1.176507852	4.824050183	0.713805446	2.068709484	0.464825913	0.135984435	4.478902615	6.349990737	14.90697194	2.055019937	2.789433801	7.301349582	13.69911048	4.080558561	2.304295898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.0049	0	0	16.5359	0.597720113	5.071887603	0	1.635857	1.741765015	1.072324786	1.176507852	4.824050183	0.713805446	2.068709484	0.464825913	0.135984435	4.478902615	6.349990737	14.90697194	2.055019937	2.789433801	7.301349582	13.69911048	4.080558561	2.304295898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.0049																																																																																		0	0	0	16.5359	0.597720113	5.071887603	0	1.635857	1.741765015	1.072324786	1.176507852	4.824050183	0.713805446	2.068709484	0.464825913	0.135984435	4.478902615	6.349990737	14.90697194	2.055019937	2.789433801	7.301349582	13.69911048	4.080558561	2.304295898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.0049
H3351_001_0	2009	4																																A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	V	V	P	V	Coin				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		314.648744	4.431739406	2247.076699	0	270.3868001	6.456295233	13.91847724	302.5075919	405.6532119	0	903.0109157	0	0	524.061575	4256.59788	5278.248564	178.3966049	843.933509	655.6676973	76.87579633	47.58358071	0	0	0	989.0125764	0	56.98609249	0	0	34.35113543											"$100 Copay per admit, 3 per year"	"$100 Copay per admit, 3 per year"	$25 Copay per day	$0 Copay	$100 Copay	20% Coinsurance	20% Coinsurance	"$50 ER, $25 Urgent Care"	$35 Copay	$0 Copay	$25 Copay	$35 Copay	$0 Copay	$25 Copay	"$10 Copay, $0 Physical Exams"	"$25 Specialist, $10 Chiropractic"	$25 Copay	$25 Copay	$25 Copay	$25 Copay	20% Coinsurance	$0 Copay	Not Covered	$0 Copay	$25 Copay	$0 Copay	$25 Copay	Not Covered	Not Covered	"30% Coins, $1,500 max Travel Benefit"											100	100	25	0	100	0.199720133	0.046468397	50	35	0	25	0	0	25	10	23.51145209	25	25	25	25	0.1	0	0	0	25	0	25	0	0	47.64917126											100	100	25	0	100	0.199720133	0.046468397	50	35	0	25	0	0	25	10	23.51145209	25	25	25	25	0.1	0	0	0	25	0	25	0	0	47.64917126											2.6221	0.036931162	4.68140979	0	2.253223334	1.289452144	0.646769328	1.2604483	1.183155201	0	1.881272741	0	0	1.091794948	3.5471649	10.34160735	0.371659594	1.75819481	1.365974369	0.160157909	4.758358071	0	0	0	2.060442867	0	0.118721026	0	0	0.136400261	0	0	0	0	0	0	0	0	0	0	41.5652			2.6221	0.036931162	4.68140979	0	2.253223334	1.289452144	0.646769328	1.2604483	1.183155201	0	1.881272741	0	0	1.091794948	3.5471649	10.34160735	0.371659594	1.75819481	1.365974369	0.160157909	4.758358071	0	0	0	2.060442867	0	0.118721026	0	0	0.136400261	0	0	0	0	0	0	0	0	0	0	41.5652																																																																																		0			2.6221	0.036931162	4.68140979	0	2.253223334	1.289452144	0.646769328	1.2604483	1.183155201	0	1.881272741	0	0	1.091794948	3.5471649	10.34160735	0.371659594	1.75819481	1.365974369	0.160157909	4.758358071	0	0	0	2.060442867	0	0.118721026	0	0	0.136400261	0	0	0	0	0	0	0	0	0	0	41.5652
H3351_002_0	2009	7																																A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	V	V	P	V	Coin				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		293.7671635	6.029138229	2470.965286	0	292.2620019	6.872799666	12.93211874	293.1380921	366.2152267	0	895.3652256	0	0	585.4288825	3919.014257	5174.948284	279.2932867	857.2400905	645.7990293	85.95531811	59.26243742	0	0	0	951.2586958	0	53.44075083	0	0	37.39200256											"$250 Copay per admit, 3 per year"	"$250 Copay per admit, 3 per year"	$25 Copay per day	$0 Copay	$100 Copay	25% Coinsurance	25% Coinsurance	"$50 ER, $30 Urgent Care"	$50 Copay	$0 Copay	$30 Copay	$50 Copay	$0 Copay	$30 Copay	"$15 PCP, $0 Physical Exams"	"$30 Specialist, $15 Chiropractic"	$30 Copay	$30 Copay	$30 Copay	$30 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$30 Copay	$0 Copay	$30 Copay	Not Covered	Not Covered	"30% Coins, $1,500 max Travel Benefit"											250	250	25	0	100	0.249861413	0.076246909	50	50	0	30	0	0	30	15	28.49357194	30	30	30	30	0.1	0	0	0	30	0	30	0	0	37.51394592											250	250	25	0	100	0.249861413	0.076246909	50	50	0	30	0	0	30	15	28.49357194	30	30	30	30	0.1	0	0	0	30	0	30	0	0	37.51394592											6.1201	0.125607046	5.147844345	0	2.435516682	1.717247437	0.986034076	1.221408717	1.525896778	0	2.238413064	0	0	1.463572206	4.898767822	12.2877301	0.698233217	2.143100226	1.614497573	0.214888295	5.926243742	0	0	0	2.37814674	0	0.133601877	0	0	0.116893464	0	0	0	0	0	0	0	0	0	0	53.3938			6.1201	0.125607046	5.147844345	0	2.435516682	1.717247437	0.986034076	1.221408717	1.525896778	0	2.238413064	0	0	1.463572206	4.898767822	12.2877301	0.698233217	2.143100226	1.614497573	0.214888295	5.926243742	0	0	0	2.37814674	0	0.133601877	0	0	0.116893464	0	0	0	0	0	0	0	0	0	0	53.3938																																																																																		0			6.1201	0.125607046	5.147844345	0	2.435516682	1.717247437	0.986034076	1.221408717	1.525896778	0	2.238413064	0	0	1.463572206	4.898767822	12.2877301	0.698233217	2.143100226	1.614497573	0.214888295	5.926243742	0	0	0	2.37814674	0	0.133601877	0	0	0.116893464	0	0	0	0	0	0	0	0	0	0	53.3938
H3351_006_0	2009	7																																A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	V	V	P	V	Coin				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		233.3769611	4.407520561	932.2488188	0	228.8653756	12.43767731	3.331208312	179.204779	320.2900134	0	598.6115443	0	0	1088.216964	4484.341939	5391.481386	883.6455796	706.4655873	773.7231344	930.8062607	48.31731512	0	0	0	742.3809729	0	32.91055039	0	0	260.4025456											"$250 Copay per admit, 3 per year"	"$250 Copay per admit, 3 per year"	$25 Copay per day	$0 Copay	$100 Copay	25% Coinsurance	25% Coinsurance	"$50 ER, $30 Urgent Care"	$50 Copay	$0 Copay	$30 Copay	$50 Copay	$0 Copay	$30 Copay	"$15 PCP, $0 Physical Exams"	"$30 Specialist, $15 Chiropractic"	$30 Copay	$30 Copay	$30 Copay	$30 Copay	20% Coinsurance	$0 Copay	Not Covered	$0 Copay	$30 Copay	$0 Copay	$30 Copay	Not Covered	Not Covered	"30% Coins, $3,000 max Travel Benefit"											250	250	25	0	100	0.212983576	0.147954935	46.46327591	50	0	30	0	0	30	15	28.4817997	30	30	30	30	0.1	0	0	0	30	0	30	0	0	43.13675539											250	250	25	0	100	0.212983576	0.147954935	46.46327591	50	0	30	0	0	30	15	28.4817997	30	30	30	30	0.1	0	0	0	30	0	30	0	0	43.13675539											4.862	0.091823345	1.942185039	0	1.907211463	2.649020987	0.492868709	0.693870091	1.334541723	0	1.496528861	0	0	2.72054241	5.605427423	12.79659108	2.209113949	1.766163968	1.934307836	2.327015652	4.831731512	0	0	0	1.855952432	0	0.082276376	0	0	0.936076743	0	0	0	0	0	0	0	0	0	0	52.5353			4.862	0.091823345	1.942185039	0	1.907211463	2.649020987	0.492868709	0.693870091	1.334541723	0	1.496528861	0	0	2.72054241	5.605427423	12.79659108	2.209113949	1.766163968	1.934307836	2.327015652	4.831731512	0	0	0	1.855952432	0	0.082276376	0	0	0.936076743	0	0	0	0	0	0	0	0	0	0	52.5353																																																																																		0			4.862	0.091823345	1.942185039	0	1.907211463	2.649020987	0.492868709	0.693870091	1.334541723	0	1.496528861	0	0	2.72054241	5.605427423	12.79659108	2.209113949	1.766163968	1.934307836	2.327015652	4.831731512	0	0	0	1.855952432	0	0.082276376	0	0	0.936076743	0	0	0	0	0	0	0	0	0	0	52.5353
H3351_007_0	2009	4																																A	A	D		T	Coin	Coin	V	P		P	P		P	V	V	V	V	P	V	Coin				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		317.7793642	5.893052195	1460.649741	0	328.9414888	12.6283103	3.290040631	229.4205833	298.7230241	0	786.617061	0	0	1558.873292	4607.147682	5765.873745	393.7803708	557.531104	758.9909402	910.5070992	37.30020456	0	0	0	742.9559312	0	51.75539581	0	0	202.5799626											"$100 Copay per admit, 3 per year"	"$100 Copay per admit, 3 per year"	$25 Copay per day	$0 Copay	$100 Copay	20% Coinsurance	20% Coinsurance	"$50 ER, $25 Urgent Care"	$35 Copay	$0 Copay	$25 Copay	$35 Copay	$0 Copay	$25 Copay	"$10 Copay, $0 Physical Exams"	"$25 Specialist, $10 Chiropractic"	$25 Copay	$25 Copay	$25 Copay	$25 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$25 Copay	$0 Copay	$25 Copay	Not Covered	Not Covered	"30% Coins, $3,000 max Travel Benefit"											100	100	25	0	100	0.17697865	0.122810308	42.52135338	35	0	25	0	0	25	10	23.38038504	25	25	25	25	0.1	0	0	0	25	0	25	0	0	30.16879653											100	100	25	0	100	0.17697865	0.122810308	42.52135338	35	0	25	0	0	25	10	23.38038504	25	25	25	25	0.1	0	0	0	25	0	25	0	0	30.16879653											2.6482	0.049108768	3.043020294	0	2.741179074	2.23494131	0.404050902	0.812939474	0.871275487	0	1.638785544	0	0	3.247652691	3.839289735	11.23402902	0.820375772	1.161523133	1.581231125	1.89688979	3.730020456	0	0	0	1.547824857	0	0.107823741	0	0	0.509299473	0	0	0	0	0	0	0	0	0	0	44.1194			2.6482	0.049108768	3.043020294	0	2.741179074	2.23494131	0.404050902	0.812939474	0.871275487	0	1.638785544	0	0	3.247652691	3.839289735	11.23402902	0.820375772	1.161523133	1.581231125	1.89688979	3.730020456	0	0	0	1.547824857	0	0.107823741	0	0	0.509299473	0	0	0	0	0	0	0	0	0	0	44.1194																																																																																		0			2.6482	0.049108768	3.043020294	0	2.741179074	2.23494131	0.404050902	0.812939474	0.871275487	0	1.638785544	0	0	3.247652691	3.839289735	11.23402902	0.820375772	1.161523133	1.581231125	1.89688979	3.730020456	0	0	0	1.547824857	0	0.107823741	0	0	0.509299473	0	0	0	0	0	0	0	0	0	0	44.1194
H3351_010_0	2009	6																																A	A	D		T	Coin	Coin	V	P		Coin	P		P	V	V	Coin	V	Coin	V	Coin				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		292.8185385	5.608201855	2283.172277	0	278.6182216	6.709167876	12.97329316	293.0408972	371.0616675	0	25.20348727	0	0	565.76021	3835.744249	5021.171665	2.253425614	837.4631052	32.90804497	81.71918402	55.16320677	0	0	0	933.8711101	0	51.85158967	0	0	0											"$500 Copay per admit, 3 per year"	"$500 Copay per admit, 3 per year"	$50 Copay per day	$0 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $40 Urgent Care"	$125 Copay	$0 Copay	10% Coinsurance	$125 Copay	$0 Copay	$40 Copay	"$20 Copay, $0 Physical Exams"	"$40 Specialist, $20 Chiropractic"	50% Coinsurance	$40 Copay	10% Coinsurance	$40 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$40 Copay	$0 Copay	$40 Copay	Not Covered	Not Covered	$0 Copay											500	500	50	0	100	0.299995341	0.085430313	50	125	0	0.1	0	0	40	20	38.0232833	0.5	40	0.1	40	0.1	0	0	0	40	0	40	0	0	0											500	500	50	0	100	0.299995341	0.085430313	50	125	0	0.1	0	0	40	20	38.0232833	0.5	40	0.1	40	0.1	0	0	0	40	0	40	0	0	0											12.2008	0.233675077	9.51321782	0	2.321818513	2.012719107	1.108312502	1.221003738	3.865225703	0	2.520348727	0	0	1.885867367	6.392907082	15.91011939	1.126712807	2.791543684	3.290804497	0.27239728	5.516320677	0	0	0	3.1129037	0	0.172838632	0	0	0	0	0	0	0	0	0	0	0	0	0	75.4695			12.2008	0.233675077	9.51321782	0	2.321818513	2.012719107	1.108312502	1.221003738	3.865225703	0	2.520348727	0	0	1.885867367	6.392907082	15.91011939	1.126712807	2.791543684	3.290804497	0.27239728	5.516320677	0	0	0	3.1129037	0	0.172838632	0	0	0	0	0	0	0	0	0	0	0	0	0	75.4695																																																																																		0			12.2008	0.233675077	9.51321782	0	2.321818513	2.012719107	1.108312502	1.221003738	3.865225703	0	2.520348727	0	0	1.885867367	6.392907082	15.91011939	1.126712807	2.791543684	3.290804497	0.27239728	5.516320677	0	0	0	3.1129037	0	0.172838632	0	0	0	0	0	0	0	0	0	0	0	0	0	75.4695
H3351_011_0	2009	6																																A	A	D		T	Coin	Coin	V	P		Coin	P		P	V	V	Coin	V	Coin	V	Coin				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		250.2497785	4.663360008	1014.076485	0	250.4108004	12.46120497	3.440548066	190.7222799	306.6003948	0	20.56680805	0	0	1181.480624	4280.653691	5245.456369	5.464486265	649.0450562	30.28732509	887.7290692	44.26437946	0	0	0	721.2094167	0	36.39338594	0	0	0											"$500 Copay per admit, 3 per year"	"$500 Copay per admit, 3 per year"	$50 Copay per day	$0 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $40 Urgent Care"	$125 Copay	$0 Copay	20% Coinsurance	$125 Copay	$0 Copay	$40 Copay	"$20 Copay, $0 Physical Exams"	"$40 Specialist, $20 Chiropractic"	50% Coinsurance	$40 Copay	20% Coinsurance	$40 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$40 Copay	$0 Copay	$40 Copay	Not Covered	Not Covered	$0 Copay											500	500	50	0	100	0.25929032	0.175551673	47.89978827	125	0	0.2	0	0	40	20	37.99526613	0.5	40	0.2	40	0.1	0	0	0	40	0	40	0	0	0											500	500	50	0	100	0.25929032	0.175551673	47.89978827	125	0	0.2	0	0	40	20	37.99526613	0.5	40	0.2	40	0.1	0	0	0	40	0	40	0	0	0											10.4271	0.194306667	4.225318688	0	2.08675667	3.231069824	0.603993967	0.761296402	3.193754112	0	4.113361609	0	0	3.938268747	7.134422819	16.60854256	2.732243133	2.163483521	6.057465017	2.959096897	4.426437946	0	0	0	2.404031389	0	0.121311286	0	0	0	0	0	0	0	0	0	0	0	0	0	77.3822			10.4271	0.194306667	4.225318688	0	2.08675667	3.231069824	0.603993967	0.761296402	3.193754112	0	4.113361609	0	0	3.938268747	7.134422819	16.60854256	2.732243133	2.163483521	6.057465017	2.959096897	4.426437946	0	0	0	2.404031389	0	0.121311286	0	0	0	0	0	0	0	0	0	0	0	0	0	77.3822																																																																																		0			10.4271	0.194306667	4.225318688	0	2.08675667	3.231069824	0.603993967	0.761296402	3.193754112	0	4.113361609	0	0	3.938268747	7.134422819	16.60854256	2.732243133	2.163483521	6.057465017	2.959096897	4.426437946	0	0	0	2.404031389	0	0.121311286	0	0	0	0	0	0	0	0	0	0	0	0	0	77.3822
H3351_012_0	2009	6																																A	A	D		T	Coin	Coin	V	P		Coin	P		P	V	V	Coin	V	Coin	V	Coin				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		293.7058674	5.625196406	2283.172277	0	278.6182216	6.709167876	12.97329316	293.0408972	372.4870004	0	25.20348727	0	0	567.2034759	3835.744249	5071.558589	2.253425614	842.3893588	32.90804497	82.62717496	55.16320677	0	0	0	939.3644696	0	52.15659903	0	0	0											"$350 Copay per admit, 3 per year"	"$350 Copay per admit, 3 per year"	$50 Copay per day	$0 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $35 Urgent Care"	$100 Copay	$0 Copay	10% Coinsurance	$100 Copay	$0 Copay	$35 Copay	"$20 Copay, $0 Physical Exams"	"$35 Specialist, $20 Chiropractic"	50% Coinsurance	$35 Copay	10% Coinsurance	$35 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$35 Copay	$0 Copay	$35 Copay	Not Covered	Not Covered	$0 Copay											350	350	50	0	100	0.299995341	0.085430313	50	100	0	0.1	0	0	35	20	33.53219177	0.5	35	0.1	35	0.1	0	0	0	35	0	35	0	0	0											350	350	50	0	100	0.299995341	0.085430313	50	100	0	0.1	0	0	35	20	33.53219177	0.5	35	0.1	35	0.1	0	0	0	35	0	35	0	0	0											8.5664	0.164068229	9.51321782	0	2.321818513	2.012719107	1.108312502	1.221003738	3.104058337	0	2.520348727	0	0	1.654343471	6.392907082	14.17170627	1.126712807	2.456968963	3.290804497	0.240995927	5.516320677	0	0	0	2.739813036	0	0.152123414	0	0	0	0	0	0	0	0	0	0	0	0	0	68.2747			8.5664	0.164068229	9.51321782	0	2.321818513	2.012719107	1.108312502	1.221003738	3.104058337	0	2.520348727	0	0	1.654343471	6.392907082	14.17170627	1.126712807	2.456968963	3.290804497	0.240995927	5.516320677	0	0	0	2.739813036	0	0.152123414	0	0	0	0	0	0	0	0	0	0	0	0	0	68.2747																																																																																		0			8.5664	0.164068229	9.51321782	0	2.321818513	2.012719107	1.108312502	1.221003738	3.104058337	0	2.520348727	0	0	1.654343471	6.392907082	14.17170627	1.126712807	2.456968963	3.290804497	0.240995927	5.516320677	0	0	0	2.739813036	0	0.152123414	0	0	0	0	0	0	0	0	0	0	0	0	0	68.2747
H3351_013_0	2009	6																																A	A	D		T	Coin	Coin	V	P		Coin	P		P	V	V	Coin	V	Coin	V	Coin				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		251.0081112	4.677491402	1014.076485	0	250.4108004	12.46120497	3.440548066	191.1991337	307.7781171	0	21.01391257	0	0	1184.494605	4280.653691	5297.000122	5.464486265	652.8629683	30.93866541	897.5927256	44.26437946	0	0	0	725.451825	0	36.60746468	0	0	0											"$350 Copay per admit, 3 per year"	"$350 Copay per admit, 3 per year"	$50 Copay per day	$0 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	"$50 ER, $35 Urgent Care"	$100 Copay	$0 Copay	10% Coinsurance	$100 Copay	$0 Copay	$35 Copay	"$20 Copay, $0 Physical Exams"	"$35 Specialist, $20 Chiropractic"	50% Coinsurance	$35 Copay	10% Coinsurance	$35 Copay	20% Coinsurance	$0 Copay	Not Covered	Not Covered	$35 Copay	$0 Copay	$35 Copay	Not Covered	Not Covered	$0 Copay											350	350	50	0	100	0.25929032	0.175551673	46.8201291	100	0	0.1	0	0	35	20	33.51108026	0.5	35	0.1	35	0.1	0	0	0	35	0	35	0	0	0											350	350	50	0	100	0.25929032	0.175551673	46.8201291	100	0	0.1	0	0	35	20	33.51108026	0.5	35	0.1	35	0.1	0	0	0	35	0	35	0	0	0											7.3211	0.136426833	4.225318688	0	2.08675667	3.231069824	0.603993967	0.745997343	2.564817643	0	2.101391257	0	0	3.454775932	7.134422819	14.79234969	2.732243133	1.904183657	3.093866541	2.617978783	4.426437946	0	0	0	2.115901156	0	0.106771772	0	0	0	0	0	0	0	0	0	0	0	0	0	65.3958			7.3211	0.136426833	4.225318688	0	2.08675667	3.231069824	0.603993967	0.745997343	2.564817643	0	2.101391257	0	0	3.454775932	7.134422819	14.79234969	2.732243133	1.904183657	3.093866541	2.617978783	4.426437946	0	0	0	2.115901156	0	0.106771772	0	0	0	0	0	0	0	0	0	0	0	0	0	65.3958																																																																																		0			7.3211	0.136426833	4.225318688	0	2.08675667	3.231069824	0.603993967	0.745997343	2.564817643	0	2.101391257	0	0	3.454775932	7.134422819	14.79234969	2.732243133	1.904183657	3.093866541	2.617978783	4.426437946	0	0	0	2.115901156	0	0.106771772	0	0	0	0	0	0	0	0	0	0	0	0	0	65.3958
H3351_801_0	2009	5																																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		1603.94638	38.35350723	1968.236822	1721.76615	221.0336952	7.106761394	15.99082676	491.3828344	680.6556237	15558.57778	2306.155405	0	121.1559942	1504.731579	7212.230094	9868.617959	261.4463213	1333.118253	3341.594963	2544.498797	2706.66431	46.96825041																			FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																			161.5026285	92.82898332	51.11513155	0	135.8984636	0.231	0.231	106.3797087	223.5970474	3.266519293	34.39526023	0	42.63709139	24.18989803	18.88729679	35.30628256	18.9211717	12.4417926	32.66673001	18.19966835	72.05203844	100.4470916																			161.5026285	92.82898332	51.11513155	0	135.8984636	0.231	0.231	106.3797087	223.5970474	3.266519293	34.39526023	0	42.63709139	24.18989803	18.88729679	35.30628256	18.9211717	12.4417926	32.66673001	18.19966835	72.05203844	100.4470916																			21.5868	0.29669309	8.383890342	0	2.503178299	1.641661882	3.693880982	4.356096899	12.68271564	4.23519954	6.61006794	0	0.430478266	3.033275287	11.35162752	29.03535118	0.412239228	1.382198402	9.096581707	3.859086184	16.25172341	0.393152013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.2359	135		21.5868	0.29669309	8.383890342	0	2.503178299	1.641661882	3.693880982	4.356096899	12.68271564	4.23519954	6.61006794	0	0.430478266	3.033275287	11.35162752	29.03535118	0.412239228	1.382198402	9.096581707	3.859086184	16.25172341	0.393152013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.2359																																																																																		0			21.5868	0.29669309	8.383890342	0	2.503178299	1.641661882	3.693880982	4.356096899	12.68271564	4.23519954	6.61006794	0	0.430478266	3.033275287	11.35162752	29.03535118	0.412239228	1.382198402	9.096581707	3.859086184	16.25172341	0.393152013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.2359
H3351_802_0	2009	5																																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		1024.907427	62.37016357	1031.663614	3192.645364	359.2681139	10.50028954	2.101017462	635.765667	1182.495393	896.8590068	1161.310477	73.19176428	89.15886017	2394.540029	12921.81327	22940.42485	826.0050388	1457.647193	4923.047208	18364.92134	3084.230638	1.722847																			FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																			187.9705617	91.9925865	76.33276468	0	47.9235926	0.231	0.231	61.31700077	109.0382894	16.4098905	33.99173384	132.0734445	28.59916979	19.14026232	7.050953313	8.90949332	10.18756086	8.773075711	17.95060019	11.69278002	36.59791512	1278.623551																			187.9705617	91.9925865	76.33276468	0	47.9235926	0.231	0.231	61.31700077	109.0382894	16.4098905	33.99173384	132.0734445	28.59916979	19.14026232	7.050953313	8.90949332	10.18756086	8.773075711	17.95060019	11.69278002	36.59791512	1278.623551																			16.0544	0.478132722	6.562477989	0	1.434784894	2.425566883	0.485335034	3.248603658	10.74477291	1.226446508	3.28957972	0.805557368	0.212489115	3.81934369	7.592591838	17.03229683	0.701248051	1.065670765	7.364304347	17.89474877	9.406367592	0.183572729	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.0283	135		16.0544	0.478132722	6.562477989	0	1.434784894	2.425566883	0.485335034	3.248603658	10.74477291	1.226446508	3.28957972	0.805557368	0.212489115	3.81934369	7.592591838	17.03229683	0.701248051	1.065670765	7.364304347	17.89474877	9.406367592	0.183572729	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.0283																																																																																		0			16.0544	0.478132722	6.562477989	0	1.434784894	2.425566883	0.485335034	3.248603658	10.74477291	1.226446508	3.28957972	0.805557368	0.212489115	3.81934369	7.592591838	17.03229683	0.701248051	1.065670765	7.364304347	17.89474877	9.406367592	0.183572729	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.0283
H3351_803_0	2009	5																																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		1603.94638	38.35350723	1968.236822	1721.76615	221.0336952	7.106761394	15.99082676	491.3828344	680.6556237	15558.57778	2306.155405	0	121.1559942	1504.731579	7212.230094	9868.617959	261.4463213	1333.118253	3341.594963	2544.498797	2706.66431	46.96825041																			FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																			161.5026285	92.82898332	51.11513155	0	135.8984636	0.231	0.231	106.3797087	223.5970474	3.266519293	34.39526023	0	42.63709139	24.18989803	18.88729679	35.30628256	18.9211717	12.4417926	32.66673001	18.19966835	72.05203844	100.4470916																			161.5026285	92.82898332	51.11513155	0	135.8984636	0.231	0.231	106.3797087	223.5970474	3.266519293	34.39526023	0	42.63709139	24.18989803	18.88729679	35.30628256	18.9211717	12.4417926	32.66673001	18.19966835	72.05203844	100.4470916																			21.5868	0.29669309	8.383890342	0	2.503178299	1.641661882	3.693880982	4.356096899	12.68271564	4.23519954	6.61006794	0	0.430478266	3.033275287	11.35162752	29.03535118	0.412239228	1.382198402	9.096581707	3.859086184	16.25172341	0.393152013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.2359	135		21.5868	0.29669309	8.383890342	0	2.503178299	1.641661882	3.693880982	4.356096899	12.68271564	4.23519954	6.61006794	0	0.430478266	3.033275287	11.35162752	29.03535118	0.412239228	1.382198402	9.096581707	3.859086184	16.25172341	0.393152013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.2359																																																																																		0			21.5868	0.29669309	8.383890342	0	2.503178299	1.641661882	3.693880982	4.356096899	12.68271564	4.23519954	6.61006794	0	0.430478266	3.033275287	11.35162752	29.03535118	0.412239228	1.382198402	9.096581707	3.859086184	16.25172341	0.393152013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.2359
H3351_804_0	2009	5																																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		1024.907427	62.37016357	1031.663614	3192.645364	359.2681139	10.50028954	2.101017462	635.765667	1182.495393	896.8590068	1161.310477	73.19176428	89.15886017	2394.540029	12921.81327	22940.42485	826.0050388	1457.647193	4923.047208	18364.92134	3084.230638	1.722847																			FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																			187.9705617	91.9925865	76.33276468	0	47.9235926	0.231	0.231	61.31700077	109.0382894	16.4098905	33.99173384	132.0734445	28.59916979	19.14026232	7.050953313	8.90949332	10.18756086	8.773075711	17.95060019	11.69278002	36.59791512	1278.623551																			187.9705617	91.9925865	76.33276468	0	47.9235926	0.231	0.231	61.31700077	109.0382894	16.4098905	33.99173384	132.0734445	28.59916979	19.14026232	7.050953313	8.90949332	10.18756086	8.773075711	17.95060019	11.69278002	36.59791512	1278.623551																			16.0544	0.478132722	6.562477989	0	1.434784894	2.425566883	0.485335034	3.248603658	10.74477291	1.226446508	3.28957972	0.805557368	0.212489115	3.81934369	7.592591838	17.03229683	0.701248051	1.065670765	7.364304347	17.89474877	9.406367592	0.183572729	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.0283	135		16.0544	0.478132722	6.562477989	0	1.434784894	2.425566883	0.485335034	3.248603658	10.74477291	1.226446508	3.28957972	0.805557368	0.212489115	3.81934369	7.592591838	17.03229683	0.701248051	1.065670765	7.364304347	17.89474877	9.406367592	0.183572729	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.0283																																																																																		0			16.0544	0.478132722	6.562477989	0	1.434784894	2.425566883	0.485335034	3.248603658	10.74477291	1.226446508	3.28957972	0.805557368	0.212489115	3.81934369	7.592591838	17.03229683	0.701248051	1.065670765	7.364304347	17.89474877	9.406367592	0.183572729	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.0283
H3351_805_0	2009	5																																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		1603.94638	38.35350723	1968.236822	1721.76615	221.0336952	7.106761394	15.99082676	491.3828344	680.6556237	15558.57778	2306.155405	0	121.1559942	1504.731579	7212.230094	9868.617959	261.4463213	1333.118253	3341.594963	2544.498797	2706.66431	46.96825041																			FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																			161.5026285	92.82898332	51.11513155	0	135.8984636	0.231	0.231	106.3797087	223.5970474	3.266519293	34.39526023	0	42.63709139	24.18989803	18.88729679	35.30628256	18.9211717	12.4417926	32.66673001	18.19966835	72.05203844	100.4470916																			161.5026285	92.82898332	51.11513155	0	135.8984636	0.231	0.231	106.3797087	223.5970474	3.266519293	34.39526023	0	42.63709139	24.18989803	18.88729679	35.30628256	18.9211717	12.4417926	32.66673001	18.19966835	72.05203844	100.4470916																			21.5868	0.29669309	8.383890342	0	2.503178299	1.641661882	3.693880982	4.356096899	12.68271564	4.23519954	6.61006794	0	0.430478266	3.033275287	11.35162752	29.03535118	0.412239228	1.382198402	9.096581707	3.859086184	16.25172341	0.393152013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.2359	135		21.5868	0.29669309	8.383890342	0	2.503178299	1.641661882	3.693880982	4.356096899	12.68271564	4.23519954	6.61006794	0	0.430478266	3.033275287	11.35162752	29.03535118	0.412239228	1.382198402	9.096581707	3.859086184	16.25172341	0.393152013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.2359																																																																																		0			21.5868	0.29669309	8.383890342	0	2.503178299	1.641661882	3.693880982	4.356096899	12.68271564	4.23519954	6.61006794	0	0.430478266	3.033275287	11.35162752	29.03535118	0.412239228	1.382198402	9.096581707	3.859086184	16.25172341	0.393152013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.2359
H3351_806_0	2009	5																																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		1024.907427	62.37016357	1031.663614	3192.645364	359.2681139	10.50028954	2.101017462	635.765667	1182.495393	896.8590068	1161.310477	73.19176428	89.15886017	2394.540029	12921.81327	22940.42485	826.0050388	1457.647193	4923.047208	18364.92134	3084.230638	1.722847																			FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																			187.9705617	91.9925865	76.33276468	0	47.9235926	0.231	0.231	61.31700077	109.0382894	16.4098905	33.99173384	132.0734445	28.59916979	19.14026232	7.050953313	8.90949332	10.18756086	8.773075711	17.95060019	11.69278002	36.59791512	1278.623551																			187.9705617	91.9925865	76.33276468	0	47.9235926	0.231	0.231	61.31700077	109.0382894	16.4098905	33.99173384	132.0734445	28.59916979	19.14026232	7.050953313	8.90949332	10.18756086	8.773075711	17.95060019	11.69278002	36.59791512	1278.623551																			16.0544	0.478132722	6.562477989	0	1.434784894	2.425566883	0.485335034	3.248603658	10.74477291	1.226446508	3.28957972	0.805557368	0.212489115	3.81934369	7.592591838	17.03229683	0.701248051	1.065670765	7.364304347	17.89474877	9.406367592	0.183572729	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.0283	135		16.0544	0.478132722	6.562477989	0	1.434784894	2.425566883	0.485335034	3.248603658	10.74477291	1.226446508	3.28957972	0.805557368	0.212489115	3.81934369	7.592591838	17.03229683	0.701248051	1.065670765	7.364304347	17.89474877	9.406367592	0.183572729	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.0283																																																																																		0			16.0544	0.478132722	6.562477989	0	1.434784894	2.425566883	0.485335034	3.248603658	10.74477291	1.226446508	3.28957972	0.805557368	0.212489115	3.81934369	7.592591838	17.03229683	0.701248051	1.065670765	7.364304347	17.89474877	9.406367592	0.183572729	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.0283
H3359_001_0	2009	7																																D	D	D	0	P	Coin	Coin	P	P	0	P	Coin	Coin	Coin	0	V	Coin	V	P	P	Coin	P	0	P	0	0	V	0	0	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		1398.982456	80.49427901	588.4585686	0	402.6147583	9.937924068	0	278.5434582	341.8631007	0	669.9204927	0	0.058394993	5.726864826	0	5388.095324	4.812098453	836.3578544	1259.816887	0	12.62473979	0	0	639.6517905	0	0	11.55818538	0	0	0											"$100 copay for days 1-8, $0 copay 9+, unlimited coverage"	"$100 copay for days 1-8, $0 copay 9, 190 day lifetime limit"	"$50 copay for days 1-30, CIF days 31-100"	$0 copay	$50 copay	10% coinsurance	10% coinsurance	"$50 ER, $0 Urgent Care"	$50 copay	$0 copay	$0 - $15 copay	10% coinsurance	20% coinsurance	10% coinsurance	$0 copay	"$15 Specialist OV, $10 - $20 copay other specialists"	50% coinsurance	$20 copay	$0 - $15 copay	$0 - $20 copay	"20% coinsurance, $2,000 OOP Maximum"	$0 - $20 copay	"12 round trips, $0 copay"	$0 - $150 copays	$0 copay	$125 per year	$10 copay	$500 every three years	Not Covered	0											100	100	50	0	50	0.1	0	50	50	0	15	0	0.2	0.01159404	0	15	0.332039212	20	15	0	0.18	0	0	16.52232502	0	0	10	0	0	0											100	100	50	0	50	0.1	0	50	50	0	15	0	0.2	0.01159404	0	15	0.332039212	20	15	0	0.18	0	0	16.52232502	0	0	10	0	0	0											11.6582	0.670785658	2.451910703	0	1.677561493	0.993792407	0	1.160597742	1.424429586	0	0.837400616	0	0.011678999	0.066397501	0	6.735119155	1.597805379	1.393929757	1.574771109	0	2.272453162	0	0	0.880711232	0	0	0.009631821	0	0	0	0	0	0	0	0	0	0	0	0	0	35.4172	0	0	11.6582	0.670785658	2.451910703	0	1.677561493	0.993792407	0	1.160597742	1.424429586	0	0.837400616	0	0.011678999	0.066397501	0	6.735119155	1.597805379	1.393929757	1.574771109	0	2.272453162	0	0	0.880711232	0	0	0.009631821	0	0	0	0	0	0	0	0	0	0	0	0	0	35.4172																																																																																		0			11.6582	0.670785658	2.451910703	0	1.677561493	0.993792407	0	1.160597742	1.424429586	0	0.837400616	0	0.011678999	0.066397501	0	6.735119155	1.597805379	1.393929757	1.574771109	0	2.272453162	0	0	0.880711232	0	0	0.009631821	0	0	0	0	0	0	0	0	0	0	0	0	0	35.4172
H3359_019_0	2009	8																																D	D	D		P	Coin	Coin	P	P		Coin	Coin	Coin	Coin		V	Coin	V	Coin	P	Coin	P		P			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		1387.121606	98.97976981	546.7521785	0	414.2591786	9.082199026	0	347.9819368	358.1379183	0	18.70590192	0	0.180395804	9.901683911	0	5869.213777	5.069477539	791.0695056	31.04950083	0	11.76824911	0	0	703.5802187	0	0	10.21321639	0	0	10.98231046											"$100 copay for days 1-8, $0 copay 9+, unlimited coverage"	"$100 copay for days 1-8, $0 copay 9, 190 day lifetime limit"	"$50 copay for days 1-30, CIF days 31-100"	$0 copay	$50 copay	10% coinsurance	10% coinsurance	"$50 ER, $0 Urgent Care"	$50 copay	$0 copay	"20% coinsurance, $500 Radiology OOP Max"	10% coinsurance	20% coinsurance	10% coinsurance	$0 copay	"$15 Specialist OV, $10 - $20 copay other specialists"	50% coinsurance	$20 copay	"20% coinsurance, $500 Radiology OOP Max"	$0 - $20 copay	"20% coinsurance, $2,000 OOP Maximum"	$0 - $20 copay	"8 round trips, $0 copay"	$0 - $150 copays	$0 copay	$125 per year	$10 copay	$500 every three years	Not Covered	0											100	100	50	0	50	0.1	0	50	50	0	0.151354972	0	0.2	0.000115138	0	15	0.340219349	20	0.151354972	0	0.18	0	0	17.98658868	0	0	10	0	0	0											100	100	50	0	50	0.1	0	50	50	0	0.151354972	0	0.2	0.000115138	0	15	0.340219349	20	0.151354972	0	0.18	0	0	17.98658868	0	0	10	0	0	0											11.5593	0.824831415	2.278134077	0	1.726079911	0.908219903	0	1.449924737	1.492241326	0	2.831231267	0	0.036079161	0.001140058	0	7.336517222	1.724734351	1.318449176	4.699496339	0	2.118284839	0	0	1.054584	0	0	0.008511014	0	0	0	0	0	0	0	0	0	0	0	0	0	41.3678	0	0	11.5593	0.824831415	2.278134077	0	1.726079911	0.908219903	0	1.449924737	1.492241326	0	2.831231267	0	0.036079161	0.001140058	0	7.336517222	1.724734351	1.318449176	4.699496339	0	2.118284839	0	0	1.054584	0	0	0.008511014	0	0	0	0	0	0	0	0	0	0	0	0	0	41.3678																																																																																		0			11.5593	0.824831415	2.278134077	0	1.726079911	0.908219903	0	1.449924737	1.492241326	0	2.831231267	0	0.036079161	0.001140058	0	7.336517222	1.724734351	1.318449176	4.699496339	0	2.118284839	0	0	1.054584	0	0	0.008511014	0	0	0	0	0	0	0	0	0	0	0	0	0	41.3678
H3359_021_0	2009	8																																Coin	Coin	Coin	0	Coin	Coin	0	Coin	Coin	Coin	Coin	0	Coin	Coin	0	0	0	0	Coin	0	Coin	0	0	0	0	0	0	0	0	0											0	0	0	0	0.3709	0.4217	0	0.3932	0.8467	0.6208	0.579	0	0	0.0002	0	2.885	0.2641	0.1337	0.5886	2.364	1.1913	0.0029	0	0	0	0	0	0	0	0											10.6623		571.3122191	26.13307928	31.21911523	0	20.1487104	13.06745269	0	8.668442529	25.88070534	5.744044683	24.64241475	0	0.023852491	6.432548579	0	0	0	0	37.65785453	0	16.37098519	0	0	0	0	0	0	0	0	0											Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	0	20% coinsurance	10% coinsurance	10% coinsurance	"20% up to $50 copay for ER, 0-20% coinsurance"	0 - 20% coinsurance	0 - 20% coinsurance	20% coinsurance	0 - 20% coinsurance	20% coinsurance	0 - 20% coinsurance	$0 copay	$0 copay	$0 copay	$0 copay	20% coinsurance	$0 copay	"20% coinsurance, $2,000 OOP Maximum"	$0 copay	"16 round trips, $0 copay"	$0 copay	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	0											0.058712691	0.067179148	0.157522459	0	0.2	0.1	0	0.157225417	0.122167265	0	0.2	0	0.2	0	0	0	0	0	0.2	0	0.2	0	0	0	0	0	0	0	0	0											0.058712691	0.067179148	0.157522459	0	0.2	0.1	0	0.157225417	0.122167265	0	0.2	0	0.2	0	0	0	0	0	0.2	0	0.2	0	0	0	0	0	0	0	0	0											33.5433	1.755597997	4.917711786	0	4.029742079	1.306745269	0	1.362899491	3.161774977	0	4.92848295	0	0.004770498	0	0	0	0	0	7.531570906	0	3.274197039	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8168	135		33.5433	1.755597997	4.917711786	0	4.400676714	1.728395503	0	1.756052788	4.008514491	0.620849707	5.507461724	0	0.004770498	0.000195084	0	2.885020851	0.264144171	0.133744648	8.120178795	2.364043016	4.465515582	0.002931757	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.4791																																																																																		0			33.5433	1.755597997	4.917711786	0	4.400676714	1.728395503	0	1.756052788	4.008514491	0.620849707	5.507461724	0	0.004770498	0.000195084	0	2.885020851	0.264144171	0.133744648	8.120178795	2.364043016	4.465515582	0.002931757	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.4791
H3359_026_0	2009	8																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	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	0	0	0	0	0	0	624.8964072	0	0	0	0	0	1060.353156	0	7942.455344	961.4023816	5192.328364	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	"$50 ER, $10 Urgent Care"	0	0	0	0	0	$10 copay	0	$10 copay	$20 copay	$10 copay	0	0	0	0			0	0	0	0													0	0	0	0	0	0	0	46.70996637	0	0	0	0	0	10	0	10	19.58629167	10	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	46.70996637	0	0	0	0	0	10	0	10	19.58629167	10	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	2.432407514	0	0	0	0	0	0.88362763	0	6.618712787	1.569192288	4.326940303	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.8309	0	0	0	0	0	0	0	0	0	2.432407514	0	0	0	0	0	0.88362763	0	6.618712787	1.569192288	4.326940303	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.8309																																																																																		0	0	0	0	0	0	0	0	0	0	2.432407514	0	0	0	0	0	0.88362763	0	6.618712787	1.569192288	4.326940303	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.8309
H3359_027_0	2009	6																																D	D	D		P	Coin	Coin	P	P		P	Coin	Coin	Coin		V	Coin	V	P	P	Coin	P		P			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		1233.252554	94.5475749	567.6929302	0	376.043789	7.543515095	0	282.5114864	314.977494	0	632.4645257	0	0.090438745	12.26556866	0	5543.101375	4.407302238	665.2738303	930.5293769	0	11.5180682	0	0	722.3347799	0	0	9.780374659	0	0	10.72142293											"$100 copay for days 1-8, $0 copay 9+, unlimited coverage"	"$100 copay for days 1-8, $0 copay 9, 190 day lifetime limit"	"$50 copay for days 1-30, CIF days 31-100"	$0 copay	$50 copay	10% coinsurance	10% coinsurance	"$50 ER, $0 Urgent Care"	$50 copay	$0 copay	$0 - $15 copay	10% coinsurance	20% coinsurance	10% coinsurance	$0 copay	"$15 Specialist OV, $10 - $20 copay other specialists"	50% coinsurance	$20 copay	$0 - $15 copay	$0 - $20 copay	"20% coinsurance, $2,000 OOP Maximum"	$0 - $20 copay	"8 round trips, $0 copay"	$0 - $150 copays	$0 copay	$125 per year	$10 copay	$500 every three years	Not Covered	0											100	100	50	0	50	0.1	0	50	50	0	15	0	0.2	0	0	15	0.33372289	20	15	0	0.18	0	0	15.07334113	0	0	10	0	0	0											100	100	50	0	50	0.1	0	50	50	0	15	0	0.2	0	0	15	0.33372289	20	15	0	0.18	0	0	15.07334113	0	0	10	0	0	0											10.2771	0.787896458	2.365387209	0	1.566849121	0.754351509	0	1.177131193	1.312406225	0	0.790580657	0	0.018087749	0	0	6.928876719	1.47081764	1.108789717	1.163161721	0	2.073252276	0	0	0.907333212	0	0	0.008150312	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7102	0	0	10.2771	0.787896458	2.365387209	0	1.566849121	0.754351509	0	1.177131193	1.312406225	0	0.790580657	0	0.018087749	0	0	6.928876719	1.47081764	1.108789717	1.163161721	0	2.073252276	0	0	0.907333212	0	0	0.008150312	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7102																																																																																		0			10.2771	0.787896458	2.365387209	0	1.566849121	0.754351509	0	1.177131193	1.312406225	0	0.790580657	0	0.018087749	0	0	6.928876719	1.47081764	1.108789717	1.163161721	0	2.073252276	0	0	0.907333212	0	0	0.008150312	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7102
H3359_031_0	2009	7																																D	D	D	V	T	Coin	Coin	V	Coin	V	V	Coin	Coin	V	P	P	Coin	P	P	P	Coin	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		1308.81523	37.35278942	1002.437205	0	141.4976793	10.21651223	0.519303133	189.9954163	34.46519164	0	365.4916591	0	14.47069113	439.2497875	5054.241183	5851.89399	1.961955352	711.0701255	0	0	29.92718753	0	0	2293.529317	0	0	93.82618261	0	0	0											"$150 copay for days 1-8, $0 copay 9+, unlimited coverage"	"$150 copay for days 1-8, $0 copay 9, 190 day lifetime limit"	"$50 copay for days 1-30, CIF days 31-100"	$0 copay	$50 copay	10% coinsurance	10% coinsurance	"$50 ER, $0 Urgent Care"	20% coinsurance	$0 copay	$0 - $25 copay	20% coinsurance	20% coinsurance	$25 copay or 20% coinsurance	"$10 PCP, $0 Physical Exam & Immun"	$25 copay	50% coinsurance	$25 copay	$0 copay	$0 - $25 copay	"20% coinsurance, $2,000 OOP Maximum"	$0 - $25 copay	"8 round trips, $0 copay"	$0 - $150 copays	$0 - $25 copay	$125 per year	$25 copay	$500 every three years	Not Covered												150	150	50	0	50	0.1	0.1	50	0.2	0	25	0	0.2	56.63112848	10	25	0.5	25	0	0	0.2	0	0	10.41645102	0	0	25	0	0	0											150	150	50	0	50	0.1	0.1	50	0.2	0	25	0	0.2	56.63112848	10	25	0.5	25	0	0	0.18	0	0	10.41645102	0	0	25	0	0	0											16.3602	0.466909868	4.176821686	0	0.589573664	1.021651223	0.051930313	0.791647568	6.893038329	0	0.761440957	0	2.894138225	2.072934262	4.211867652	12.19144581	0.980977676	1.481396095	0	0	5.386893755	0	0	1.990869649	0	0	0.195471214	0	0	0	0	0	0	0	0	0	0	0	0	0	62.5192	0		16.3602	0.466909868	4.176821686	0	0.589573664	1.021651223	0.051930313	0.791647568	6.893038329	0	0.761440957	0	2.894138225	2.072934262	4.211867652	12.19144581	0.980977676	1.481396095	0	0	5.386893755	0	0	1.990869649	0	0	0.195471214	0	0	0	0	0	0	0	0	0	0	0	0	0	62.5192																																																																																		0			16.3602	0.466909868	4.176821686	0	0.589573664	1.021651223	0.051930313	0.791647568	6.893038329	0	0.761440957	0	2.894138225	2.072934262	4.211867652	12.19144581	0.980977676	1.481396095	0	0	5.386893755	0	0	1.990869649	0	0	0.195471214	0	0	0	0	0	0	0	0	0	0	0	0	0	62.5192
H3359_804_0	2009	6																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	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		1933.941975	55.19352596	1379.328925	0	129.8016497	20983.97999	34.76460648	231.4707814	211.7857849	886.9637753	474.8664425	0	594.9793712	372.2491297	6166.859611	10806.80015	274.3498516	3423.401875	4717.946345	23877.96222	1324.700088	11190.99091	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered												113.2661727	47.49661892	76.77855003	0	101.5751193	1.61218383	48.44347189	136.5004465	409.8906741	15.07827592	94.053351	0	49.87238882	97.8075455	15.12835365	18.69803847	25.27112357	7.947004965	30.20786974	12.78182476	67.23388461	9.746721803	0	0	0	0	0	0	0	0											113.2661727	47.49661892	76.77855003	0	101.5751193	1.61218383	48.44347189	136.5004465	409.8906741	15.07827592	94.053351	0	49.87238882	97.8075455	15.12835365	18.69803847	25.27112357	7.947004965	30.20786974	12.78182476	67.23388461	9.746721803	0	0	0	0	0	0	0	0											18.2542	0.218458822	8.82523957	0	1.098718172	2.819169436	0.140343186	2.632988752	7.234084843	1.114490378	3.72189835	0	2.472753545	3.034064474	7.774536093	16.83883042	0.57776075	2.267149308	11.87659238	25.43366073	7.422061073	9.089622924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.8466	135	0	18.2542	0.218458822	8.82523957	0	1.098718172	2.819169436	0.140343186	2.632988752	7.234084843	1.114490378	3.72189835	0	2.472753545	3.034064474	7.774536093	16.83883042	0.57776075	2.267149308	11.87659238	25.43366073	7.422061073	9.089622924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.8466		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 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 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	18.2542	0.218458822	8.82523957	0	1.098718172	2.819169436	0.140343186	2.632988752	7.234084843	1.114490378	3.72189835	0	2.472753545	3.034064474	7.774536093	16.83883042	0.57776075	2.267149308	11.87659238	25.43366073	7.422061073	9.089622924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.8466
H3359_805_0	2009	7																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	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		1933.941975	55.19352596	1379.328925	0	129.8016497	20983.97999	34.76460648	231.4707814	211.7857849	886.9637753	474.8664425	0	594.9793712	372.2491297	6166.859611	10806.80015	274.3498516	3423.401875	4717.946345	23877.96222	1324.700088	11190.99091	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered												113.2661727	47.49661892	76.77855003	0	101.5751193	1.61218383	48.44347189	136.5004465	409.8906741	15.07827592	94.053351	0	49.87238882	97.8075455	15.12835365	18.69803847	25.27112357	7.947004965	30.20786974	12.78182476	67.23388461	9.746721803	0	0	0	0	0	0	0	0											113.2661727	47.49661892	76.77855003	0	101.5751193	1.61218383	48.44347189	136.5004465	409.8906741	15.07827592	94.053351	0	49.87238882	97.8075455	15.12835365	18.69803847	25.27112357	7.947004965	30.20786974	12.78182476	67.23388461	9.746721803	0	0	0	0	0	0	0	0											18.2542	0.218458822	8.82523957	0	1.098718172	2.819169436	0.140343186	2.632988752	7.234084843	1.114490378	3.72189835	0	2.472753545	3.034064474	7.774536093	16.83883042	0.57776075	2.267149308	11.87659238	25.43366073	7.422061073	9.089622924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.8466	135	0	18.2542	0.218458822	8.82523957	0	1.098718172	2.819169436	0.140343186	2.632988752	7.234084843	1.114490378	3.72189835	0	2.472753545	3.034064474	7.774536093	16.83883042	0.57776075	2.267149308	11.87659238	25.43366073	7.422061073	9.089622924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.8466		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 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 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	18.2542	0.218458822	8.82523957	0	1.098718172	2.819169436	0.140343186	2.632988752	7.234084843	1.114490378	3.72189835	0	2.472753545	3.034064474	7.774536093	16.83883042	0.57776075	2.267149308	11.87659238	25.43366073	7.422061073	9.089622924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.8466
H3359_806_0	2009	7																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	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		1933.941975	55.19352596	1379.328925	0	129.8016497	20983.97999	34.76460648	231.4707814	211.7857849	886.9637753	474.8664425	0	594.9793712	372.2491297	6166.859611	10806.80015	274.3498516	3423.401875	4717.946345	23877.96222	1324.700088	11190.99091	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered												113.2661727	47.49661892	76.77855003	0	101.5751193	1.61218383	48.44347189	136.5004465	409.8906741	15.07827592	94.053351	0	49.87238882	97.8075455	15.12835365	18.69803847	25.27112357	7.947004965	30.20786974	12.78182476	67.23388461	9.746721803	0	0	0	0	0	0	0	0											113.2661727	47.49661892	76.77855003	0	101.5751193	1.61218383	48.44347189	136.5004465	409.8906741	15.07827592	94.053351	0	49.87238882	97.8075455	15.12835365	18.69803847	25.27112357	7.947004965	30.20786974	12.78182476	67.23388461	9.746721803	0	0	0	0	0	0	0	0											18.2542	0.218458822	8.82523957	0	1.098718172	2.819169436	0.140343186	2.632988752	7.234084843	1.114490378	3.72189835	0	2.472753545	3.034064474	7.774536093	16.83883042	0.57776075	2.267149308	11.87659238	25.43366073	7.422061073	9.089622924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.8466	0	0	18.2542	0.218458822	8.82523957	0	1.098718172	2.819169436	0.140343186	2.632988752	7.234084843	1.114490378	3.72189835	0	2.472753545	3.034064474	7.774536093	16.83883042	0.57776075	2.267149308	11.87659238	25.43366073	7.422061073	9.089622924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.8466		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 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 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	18.2542	0.218458822	8.82523957	0	1.098718172	2.819169436	0.140343186	2.632988752	7.234084843	1.114490378	3.72189835	0	2.472753545	3.034064474	7.774536093	16.83883042	0.57776075	2.267149308	11.87659238	25.43366073	7.422061073	9.089622924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.8466
H3359_807_0	2009	6																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	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		1933.941975	55.19352596	1379.328925	0	129.8016497	20983.97999	34.76460648	231.4707814	211.7857849	886.9637753	474.8664425	0	594.9793712	372.2491297	6166.859611	10806.80015	274.3498516	3423.401875	4717.946345	23877.96222	1324.700088	11190.99091	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered												113.2661727	47.49661892	76.77855003	0	101.5751193	1.61218383	48.44347189	136.5004465	409.8906741	15.07827592	94.053351	0	49.87238882	97.8075455	15.12835365	18.69803847	25.27112357	7.947004965	30.20786974	12.78182476	67.23388461	9.746721803	0	0	0	0	0	0	0	0											113.2661727	47.49661892	76.77855003	0	101.5751193	1.61218383	48.44347189	136.5004465	409.8906741	15.07827592	94.053351	0	49.87238882	97.8075455	15.12835365	18.69803847	25.27112357	7.947004965	30.20786974	12.78182476	67.23388461	9.746721803	0	0	0	0	0	0	0	0											18.2542	0.218458822	8.82523957	0	1.098718172	2.819169436	0.140343186	2.632988752	7.234084843	1.114490378	3.72189835	0	2.472753545	3.034064474	7.774536093	16.83883042	0.57776075	2.267149308	11.87659238	25.43366073	7.422061073	9.089622924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.8466	0	0	18.2542	0.218458822	8.82523957	0	1.098718172	2.819169436	0.140343186	2.632988752	7.234084843	1.114490378	3.72189835	0	2.472753545	3.034064474	7.774536093	16.83883042	0.57776075	2.267149308	11.87659238	25.43366073	7.422061073	9.089622924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.8466		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 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 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	18.2542	0.218458822	8.82523957	0	1.098718172	2.819169436	0.140343186	2.632988752	7.234084843	1.114490378	3.72189835	0	2.472753545	3.034064474	7.774536093	16.83883042	0.57776075	2.267149308	11.87659238	25.43366073	7.422061073	9.089622924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.8466
H3361_020_0	2009	6																					0											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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		304.3598263	21.84015968	1030.834445	791.4055008	731.9099661	5.602897674	2.901364004	1151.797394	112.7623621	2396.10075	441.7125809	3.74840686	0.040681387	164.6360167	8289.131607	10503.0821	532.9963088	2413.416193	3314.434374	1358.442848	8.909894939	2.131596631	5400	526.6666667	438.5564788	201	36.91211583	14.23448276	1664	10950											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	"$0 days 1 - 7, $75 days 8 - 100"	Copay between $0.00 and $10.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $10.00	Copay between $5.00 and $10.00	$10.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"Copay between $0.00 and $50.00, No benefit limit"	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	Copay between $0.00 and $15.00											0	0	49.53	0.6995172	44.02750942	0.2	0.067487993	13.74367264	0	0	4.689692299	0	0.2	1.428468346	0	2.43250532	6.997976541	4.46719044	7.716744082	0.857723428	0.2	0	0	50	0	0	9.633540987	10	0	0											0	0	49.53	0.6995172	44.02750942	0.2	0.067487993	13.74367264	0	0	4.689692299	0	0.2	1.428468346	0	2.43250532	6.997976541	4.46719044	7.716744082	0.857723428	0.2	0	0	50	0	0	9.633540987	10	0	0											0	0	4.254769172	0.04613348	2.685347744	1.120579535	0.195807235	1.319160528	0	0	0.172624674	0	0.008136277	0.019598112	0	2.129066924	0.310824639	0.898432479	2.13138682	0.097097355	1.781978988	0	0	2.194444444	0	0	0.029632865	0.011862069	0	0	0	0	0	0	0	0	0	0	0	0	19.4069	0	0	0	0	4.254769172	0.04613348	2.685347744	1.120579535	0.195807235	1.319160528	0	0	0.172624674	0	0.008136277	0.019598112	0	2.129066924	0.310824639	0.898432479	2.13138682	0.097097355	1.781978988	0	0	2.194444444	0	0	0.029632865	0.011862069	0	0	0	0	0	0	0	0	0	0	0	0	19.4069	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	20% coinsurance											8.1447	0.3097	0.377	0.1824	0.2766	0.1352	0.0706	0	0.2299	0.0583	0.1693	0.0018	0	0.0457	0.2776	1.3871	0.1017	0.1803	0.5469	0.2477	0.1414	0.0008	0	0	0	0	0	0	0	0											12.885	0	0	8.1447	0.309742857	4.631791768	0.228529666	2.961986977	1.25577592	0.266405595	1.319160528	0.229929236	0.058344429	0.341882505	0.001816333	0.008136277	0.065288651	0.277629723	3.516166001	0.412573094	1.078768193	2.678268842	0.344800152	1.923393284	0.00079098	0	2.194444444	0	0	0.029632865	0.011862069	0	0	0	0	0	0	0	0	0	0	0	0	32.2919
H3361_021_0	2009	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	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		1506.605633	149.7286651	552.4636594	516.4470581	448.1899326	12.62174071	5.02478718	1157.659221	323.9859934	2736.486418	970.2282807	21.91004671	0.035193254	1268.444033	8772.687991	17325.99138	977.8513339	2344.004881	4064.906461	2176.917722	28.37900328	17.34632884	0	526.6666667	427.8975139	201	28.8	21.58229138	0	15318.46895											"$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	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $35.00	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $0.00 and $75.00	Copay between $0.00 and $75.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $50.00, No benefit limit"	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	Not Covered	Copay between $0.00 and $30.00											121.217183	63.18507396	33.02	4.859173489	44.30235522	0.2	0.106749914	14.71340879	78.57081108	0	16.95793956	65.62306262	0.2	10.92839343	5.39022782	9.661560722	26.39073541	15.0286424	16.65822394	3.74935121	0.2	0	0	50	0	0	10	8.063519439	0	0.096972274											121.217183	63.18507396	33.02	4.859173489	44.30235522	0.2	0.106749914	14.71340879	78.57081108	0	16.95793956	65.62306262	0.2	10.92839343	5.39022782	9.661560722	26.39073541	15.0286424	16.65822394	3.74935121	0.2	0	0	50	0	0	10	8.063519439	0	0.096972274											15.2189	0.788384731	1.520195836	0.209125488	1.6546558	2.524348141	0.5363956	1.419426113	2.12132019	0	1.371089378	0.119817031	0.007038651	1.155171287	3.940565572	13.94967648	2.150517985	2.935600928	5.642843508	0.680169091	5.675800657	0	0	2.194444444	0	0	0.024	0.014502436	0	0.123788898	0	0	0	0	0	0	0	0	0	0	65.9778	0	0	15.2189	0.788384731	1.520195836	0.209125488	1.6546558	2.524348141	0.5363956	1.419426113	2.12132019	0	1.371089378	0.119817031	0.007038651	1.155171287	3.940565572	13.94967648	2.150517985	2.935600928	5.642843508	0.680169091	5.675800657	0	0	2.194444444	0	0	0.024	0.014502436	0	0.123788898	0	0	0	0	0	0	0	0	0	0	65.9778	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	20% coinsurance											5.5084	0.1688	0.2111	0.1396	0.1797	0.3069	0.1223	0	0.5972	0.0836	0.421	0.0083	0	0.2494	0.1845	2.4196	0.1607	0.2084	0.8179	0.3797	0.6693	0.0094	0	0	0	0	0	0	0	0.0094											12.8553	0	0	20.7273	0.957173488	1.731288648	0.348762017	1.834371445	2.831283833	0.658703219	1.419426113	2.718488644	0.083589427	1.792112912	0.128112347	0.007038651	1.404528613	4.125096263	16.3692791	2.3112492	3.144034255	6.460713014	1.05986352	6.345107957	0.009381654	0	2.194444444	0	0	0.024	0.014502436	0	0.133194249	0	0	0	0	0	0	0	0	0	0	78.833
H3361_024_0	2009	6																					0											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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		202.1160247	10.65285866	402.7636986	676.1968804	435.7338565	8.943322346	4.828902066	701.8254678	154.4599334	1492.816667	417.5409925	17.19462135	0.198760682	168.6248522	9316.110555	15588.71169	591.2645652	3390.699229	4911.933373	2680.314759	12.00148659	3.74256157	5400	526.6666667	431.7006119	201	34.4	15.58014391	1664	10987.87636											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	"$0 days 1 - 7, $75 days 8 - 100"	Copay between $0.00 and $10.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $10.00	Copay between $5.00 and $10.00	$10.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"Copay between $0.00 and $50.00, No benefit limit"	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	Copay between $0.00 and $15.00											0	0	49.53	0.854368341	39.08653327	0.2	0.1106025	14.17238141	0	0	4.730351247	0	0.2	1.094887517	0	2.965931268	6.870267654	4.571922115	10.19570568	0.691527136	0.2	0	0	50	0	0	10	9.160974575	0	0.015197341											0	0	49.53	0.854368341	39.08653327	0.2	0.1106025	14.17238141	0	0	4.730351247	0	0.2	1.094887517	0	2.965931268	6.870267654	4.571922115	10.19570568	0.691527136	0.2	0	0	50	0	0	10	9.160974575	0	0.015197341											0	0	1.662407166	0.048143434	1.419277156	1.788664469	0.534088642	0.828878184	0	0	0.164592963	0	0.039752136	0.015385437	0	3.85292062	0.338512151	1.291834399	4.173385584	0.154459199	2.400297319	0	0	2.194444444	0	0	0.028666667	0.011894109	0	0.013915542	0	0	0	0	0	0	0	0	0	0	20.9615	0	0	0	0	1.662407166	0.048143434	1.419277156	1.788664469	0.534088642	0.828878184	0	0	0.164592963	0	0.039752136	0.015385437	0	3.85292062	0.338512151	1.291834399	4.173385584	0.154459199	2.400297319	0	0	2.194444444	0	0	0.028666667	0.011894109	0	0.013915542	0	0	0	0	0	0	0	0	0	0	20.9615	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	20% coinsurance											4.8922	0.1781	0.1378	0.1563	0.1484	0.2169	0.1177	0	0.3555	0.0389	0.1616	0.0067	0	0.0561	0.1589	2.3547	0.1138	0.2227	1.3177	0.4428	0.2414	0.0016	0	0	0	0	0	0	0	0.0026											11.3224	0	0	4.8922	0.178146919	1.800174761	0.204398472	1.567670756	2.00559507	0.65182963	0.828878184	0.355510513	0.038911032	0.326161884	0.006685983	0.039752136	0.071435981	0.15887324	6.207585531	0.452275728	1.514558125	5.491134712	0.597278412	2.641709035	0.001626395	0	2.194444444	0	0	0.028666667	0.011894109	0	0.016495935	0	0	0	0	0	0	0	0	0	0	32.2839
H3361_027_0	2009	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	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		2129.947344	276.3192735	492.0283791	701.6329725	674.3249423	10.27381127	4.632647519	1164.194817	245.082928	3595.14344	1128.488724	18.73012946	0.155767877	269.2645954	9492.782297	21355.74308	706.0913721	3478.781065	4808.392629	2064.670996	19.45156964	9.036806111	0	526.6666667	442.1226639	201	28.8	17.28	0	15192.68516											"$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	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $30.00	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $50.00, No benefit limit"	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	Not Covered	$0.00 copayment											30.19348917	21.27295347	16.51	5.421771237	39.69019547	0.2	0.153600164	15.3463966	30.23707603	0	6.599591023	19.68691878	0.2	5.837672009	2.349514102	7.136728438	23.85495477	13.27898726	12.44842745	2.616521047	0.2	0	0	50	0	0	10	10	0	0											30.19348917	21.27295347	16.51	5.421771237	39.69019547	0.2	0.153600164	15.3463966	30.23707603	0	6.599591023	19.68691878	0.2	5.837672009	2.349514102	7.136728438	23.85495477	13.27898726	12.44842745	2.616521047	0.2	0	0	50	0	0	10	10	0	0											5.3592	0.489843921	0.676949045	0.317007789	2.230340731	2.054762254	0.711575418	1.488849615	0.617549261	0	0.620630338	0.030728211	0.031153575	0.130989866	1.858618823	12.70084491	1.403648145	3.849557452	4.988077233	0.450187926	3.890313928	0	0	2.194444444	0	0	0.024	0.0144	0	0	0	0	0	0	0	0	0	0	0	0	46.1337	0	0	5.3592	0.489843921	0.676949045	0.317007789	2.230340731	2.054762254	0.711575418	1.488849615	0.617549261	0	0.620630338	0.030728211	0.031153575	0.130989866	1.858618823	12.70084491	1.403648145	3.849557452	4.988077233	0.450187926	3.890313928	0	0	2.194444444	0	0	0.024	0.0144	0	0	0	0	0	0	0	0	0	0	0	0	46.1337	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	20% coinsurance											7.7797	0.3555	0.1906	0.185	0.253	0.2501	0.113	0	0.5118	0.0891	0.4153	0.0073	0	0.1343	0.2857	2.7912	0.1215	0.2645	1.1691	0.3633	0.4438	0.005	0	0	0	0	0	0	0	0.003											15.7318	0	0	13.1389	0.845312237	0.86756903	0.502039595	2.483374824	2.304816987	0.824535988	1.488849615	1.129352572	0.089065659	1.035967535	0.037995283	0.031153575	0.26524291	2.144368047	15.49207922	1.525152587	4.114062703	6.157208071	0.813537422	4.334083753	0.005005701	0	2.194444444	0	0	0.024	0.0144	0	0.0030283	0	0	0	0	0	0	0	0	0	0	61.8655
H3361_031_0	2009	7																					0											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	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		335.8897211	31.69048312	199.2305514	1948.572604	15.49243068	10.20536681	3.781032853	15.07071182	10.08443603	2737.028452	7.662542709	0.016138229	0.321837053	1.621599577	8626.752663	71.03771755	6.574314349	12.10827468	35.86467222	12.22797123	7.399003536	0.021109388	7200	1145.454545	0.151702603	0	0	0	1664	10613.73626											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	$0.00 copayment	"$0.00 copayment, No benefit limit"	$0.00 copayment	Not Covered	Not Covered	Not Covered	$0.00 copayment	$0.00 copayment											704.9066282	445.4820178	62.51603741	0	0.168983617	0.17	0.17	0.120783948	0.17	0	0.131662253	0.17	0.17	0.17	0	0.113650118	0.17	0.17	0.155281509	0.122861089	0.17	0.17	0	0	0	0	0	0	0	0											704.9066282	445.4820178	62.51603741	0	0.168983617	0.17	0.17	0.120783948	0.17	0	0.131662253	0.17	0.17	0.17	0	0.113650118	0.17	0.17	0.155281509	0.122861089	0.17	0.17	0	0	0	0	0	0	0	0											19.7309	1.176461697	1.037925384	0	2.617966967	1.734912358	0.642775585	1.820300077	1.714354124	0	1.008867633	0.002743499	0.054712299	0.275671928	0	8.073444993	1.117633439	2.058406696	5.569120438	1.502341863	1.257830601	0.003588596	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.4	0	0	19.7309	1.176461697	1.037925384	0	2.617966967	1.734912358	0.642775585	1.820300077	1.714354124	0	1.008867633	0.002743499	0.054712299	0.275671928	0	8.073444993	1.117633439	2.058406696	5.569120438	1.502341863	1.257830601	0.003588596	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.4	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.7309	1.176461697	1.037925384	0	2.617966967	1.734912358	0.642775585	1.820300077	1.714354124	0	1.008867633	0.002743499	0.054712299	0.275671928	0	8.073444993	1.117633439	2.058406696	5.569120438	1.502341863	1.257830601	0.003588596	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.4
H3361_039_0	2009	5																																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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1135.262851	383.3727215	311.6239961	600.4177973	613.6968179	9.053099841	2.11861185	886.9882501	137.0482912	2284.634064	523.943323	11.66525465	0.251285133	186.5024307	5958.162434	14841.67865	901.2760241	2676.396903	2814.53284	1595.439157	14.89046197	7.752742861	0	0	14.69384726	0	3.995288382	3.673461815	1664	0.005719236											"$200 days 1 - 5, $0 after day 5, unlimited coverage"	"$200 days 1 - 5, $0 after day 5, unlimited coverage"	Medicare FFS Cost Sharing	Copay between $0.00 and $15.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $15.00	Copay between $5.00 and $15.00	$15.00 copayment	Copay between $0.00 and $75.00	Copay between $0.00 and $75.00	20% coinsurance	$0.00 copayment	Not Covered	Not Covered	$0.00 copayment	Not Covered	$0.00 copayment	"$0.00 copayment,  benefit limit"	$0.00 copayment	$0.00 copayment											96.50762342	36.35281146	35.63	2.161577589	36.39487489	0.2	0.180456246	18.14186717	85.84361735	0	15.27199542	52.49845009	0.2	7.851475627	2.141426036	3.404815712	10.66088694	6.748401364	16.81981538	5.310954885	0.2	0	0	0	0	0	0	0	0	0											96.50762342	36.35281146	35.63	2.161577589	36.39487489	0.2	0.180456246	18.14186717	85.84361735	0	15.27199542	52.49845009	0.2	7.851475627	2.141426036	3.404815712	10.66088694	6.748401364	16.81981538	5.310954885	0.2	0	0	0	0	0	0	0	0	0											9.1301	1.161389689	0.925263582	0.108154138	1.861284909	1.810619968	0.382316741	1.340968584	0.980393423	0	0.666805002	0.051033982	0.050257027	0.122026607	1.063247013	4.21109839	0.80070015	1.505116709	3.944993563	0.706108782	2.978092395	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.8	0	0	9.1301	1.161389689	0.925263582	0.108154138	1.861284909	1.810619968	0.382316741	1.340968584	0.980393423	0	0.666805002	0.051033982	0.050257027	0.122026607	1.063247013	4.21109839	0.80070015	1.505116709	3.944993563	0.706108782	2.978092395	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.8	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	9.1301	1.161389689	0.925263582	0.108154138	1.861284909	1.810619968	0.382316741	1.340968584	0.980393423	0	0.666805002	0.051033982	0.050257027	0.122026607	1.063247013	4.21109839	0.80070015	1.505116709	3.944993563	0.706108782	2.978092395	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.8
H3361_043_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		311.9081897	44.920287	460.1559849	1838.119673	959.6485042	10.82560372	3.619281637	2055.289193	112.7793937	2909.624985	628.260214	4.610407186	0.69032486	169.9029557	9796.258515	15706.40493	1420.818292	6392.253414	4189.604748	2104.340331	9.593811382	7.241349901	3750	671.25	428.2369098	201	0	0	1664	10750											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"Copay between $0.00 and $195.00, No benefit limit"	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	Not Covered	Not Covered	$0.00 copayment	$0.00 copayment											0	0	0	0	39.29717952	0.2	0.098972297	17.59530252	0	0	4.049134121	0	0.2	0	0	0	0	0	8.362130858	0.729479662	0.2	0	0	20	0	0	0	0	0	0											0	0	0	0	39.29717952	0.2	0.098972297	17.59530252	0	0	4.049134121	0	0.2	0	0	0	0	0	8.362130858	0.729479662	0.2	0	0	20	0	0	0	0	0	0											0	0	0	0	3.142623295	2.165120745	0.358208616	3.013619593	0	0	0.211992489	0	0.138064972	0	0	0	0	0	2.919501929	0.12792279	1.918762276	0	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.1146	0	0	0	0	0	0	3.142623295	2.165120745	0.358208616	3.013619593	0	0	0.211992489	0	0.138064972	0	0	0	0	0	2.919501929	0.12792279	1.918762276	0	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.1146	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	20% coinsurance											8.6395	0.7525	0.1804	0.3833	0.3263	0.2633	0.0883	0	0.2628	0.0755	0.2309	0.0016	0	0.0781	0.2412	2.1569	0.2707	0.4197	0.8924	0.3675	0.1823	0.0014	0	0	0	0	0	0	0	0											15.8147	0	0	8.6395	0.752486067	0.180371248	0.383313711	3.468918315	2.428375264	0.446497921	3.013619593	0.262777382	0.075540211	0.442884369	0.00163814	0.138064972	0.078141091	0.241222135	2.156867527	0.270736088	0.419733239	3.81192711	0.495401643	2.101056321	0.00140146	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.9293
H3361_047_0	2009	7																																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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		338.1462214	52.79880177	857.8016476	2397.679848	1311.850678	2991.301901	391.1356369	3295.882829	308.7651247	13927.3417	1862.842134	62.37264254	10.73640396	620.6742103	8663.566091	22407.65849	3920.906375	4049.331813	5249.623679	1757.549442	34.78615924	10.14175991	0	0	402	201	195	41.6	1664	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 $0.00 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	Not Covered	Not Covered	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$0.00 copayment	"$0.00 copayment, $1,250 benefit limit"	$0.00 copayment	Not Covered											0	0	0	0	0	0	0	11.13812678	0	0	0	0	0	0.320430213	0	1.900723761	12.1726811	3.552241042	3.464377727	0	0.17	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	11.13812678	0	0	0	0	0	0.320430213	0	1.900723761	12.1726811	3.552241042	3.464377727	0	0.17	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	3.059163401	0	0	0	0	0	0.016573564	0	3.549230743	3.977328578	1.198683555	1.515556612	0	5.91364707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.2302	0	0	0	0	0	0	0	0	0	3.059163401	0	0	0	0	0	0.016573564	0	3.549230743	3.977328578	1.198683555	1.515556612	0	5.91364707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.2302	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	3.059163401	0	0	0	0	0	0.016573564	0	3.549230743	3.977328578	1.198683555	1.515556612	0	5.91364707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.2302
H3361_050_0	2009	7																																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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		323.3759532	63.65768058	275.0595397	4214.586658	1115.231658	1697.568454	347.8975023	4832.449366	203.4396344	6687.008678	1164.207403	15.34709491	56.83586033	340.6464167	7003.772873	19580.80107	4428.800747	6062.040771	4377.756758	2219.489696	17.55748162	15.00118098	0	0	402	201	195	41.6	1664	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 $0.00 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	Not Covered	Not Covered	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$0.00 copayment	"$0.00 copayment, $1,250 benefit limit"	$0.00 copayment	Not Covered											0	0	0	0	0	0	0	7.127511176	0	0	0	0	0	0.140529138	0	1.816958131	11.01226456	3.816192966	3.333130174	0	0.17	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	7.127511176	0	0	0	0	0	0.140529138	0	1.816958131	11.01226456	3.816192966	3.333130174	0	0.17	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	2.870278072	0	0	0	0	0	0.003989229	0	2.96479131	4.064260461	1.927826446	1.215969429	0	2.984771876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.0319	0	0	0	0	0	0	0	0	0	2.870278072	0	0	0	0	0	0.003989229	0	2.96479131	4.064260461	1.927826446	1.215969429	0	2.984771876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.0319	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	2.870278072	0	0	0	0	0	0.003989229	0	2.96479131	4.064260461	1.927826446	1.215969429	0	2.984771876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.0319
H3361_051_0	2009	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	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		1985.89611	229.9641815	582.6901556	488.3103605	578.0206234	4.37973294	3.185613754	800.0028822	94.97603795	1195.566638	408.4840598	2.589131964	0.102135289	90.05441266	9138.614838	8547.098032	380.8101461	2223.773861	3643.978816	1355.436254	5.184961448	3.574941466	3750	1145.454545	446.0951044	201	29.46841783	19.21907994	1664	11550.00143											"$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	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $10.00	Copay between $5.00 and $10.00	$10.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"$0.00 copayment, No benefit limit"	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											25.12175795	26.05321168	33.02	0.452007846	47.92976087	0.2	0.055515721	10.62547143	33.92690875	0	4.762104614	26.24922505	0.2	4.616973194	0	2.621173264	7.287695072	4.546077492	7.135095138	0.517578469	0.2	0	0	0	0	0	9.877863381	9.019891865	0	0											25.12175795	26.05321168	33.02	0.452007846	47.92976087	0.2	0.055515721	10.62547143	33.92690875	0	4.762104614	26.24922505	0.2	4.616973194	0	2.621173264	7.287695072	4.546077492	7.135095138	0.517578469	0.2	0	0	0	0	0	9.877863381	9.019891865	0	0											4.1574	0.499275458	1.603369078	0.018393343	2.308699188	0.875946588	0.176851644	0.708367314	0.268520281	0	0.162103652	0.005663559	0.020427058	0.034648234	0	1.866952071	0.231269019	0.842454025	2.166677961	0.058462052	1.03699229	0	0	0	0	0	0.024257084	0.014446169	0	0	0	0	0	0	0	0	0	0	0	0	17.0812	0	0	4.1574	0.499275458	1.603369078	0.018393343	2.308699188	0.875946588	0.176851644	0.708367314	0.268520281	0	0.162103652	0.005663559	0.020427058	0.034648234	0	1.866952071	0.231269019	0.842454025	2.166677961	0.058462052	1.03699229	0	0	0	0	0	0.024257084	0.014446169	0	0	0	0	0	0	0	0	0	0	0	0	17.0812	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	20% coinsurance											6.0649	0.2792	0.2113	0.099	0.2408	0.1047	0.0774	0	0.2236	0.028	0.1429	0.0008	0	0.0221	0.2046	1.2993	0.0679	0.1506	0.6759	0.2328	0.0568	0.0006	0	0	0	0	0	0	0	0											10.1831	0	0	10.2224	0.778434174	1.814649795	0.117343813	2.549518017	0.980660201	0.25429345	0.708367314	0.492122998	0.028024219	0.30496889	0.006477405	0.020427058	0.056700505	0.204563009	3.166276928	0.299161177	0.993028718	2.842582552	0.29126704	1.093820959	0.000561535	0	0	0	0	0.024257084	0.014446169	0	2.93E-11	0	0	0	0	0	0	0	0	0	0	27.2643
H3361_056_0	2009	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	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		1271.769204	186.1374755	340.4770164	806.1567249	516.4831442	11.55365513	4.148825998	935.369743	258.3053234	4477.872216	998.9056982	34.27534688	0.611986742	389.1761512	7760.258811	26836.49273	1388.532875	5018.466107	4126.192249	2700.192436	27.74201744	10.9095531	0	1145.454545	430.0785021	201	28.8	17.28	1664	13779.34597											"$75 days 1 - 10, $0 after day 10, unlimited coverage"	"$75 days 1 - 10, $0 after day 10, unlimited coverage"	"$0 days 1 - 7, $75 days 8 - 100"	Copay between $0.00 and $15.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $15.00	Copay between $5.00 and $15.00	$15.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	Copay between $0.00 and $10.00											53.21563203	20.607265	49.53	2.901172155	33.7732491	0.2	0.2	20.71691676	33.73448038	0	8.602078768	19.68691878	0.2	3.990563705	0	3.562943975	9.314175727	6.597953332	13.98461277	1.585888852	0.2	0	0	0	0	0	10	10	0	5.57E-07											53.21563203	20.607265	49.53	2.901172155	33.7732491	0.2	0.2	20.71691676	33.73448038	0	8.602078768	19.68691878	0.2	3.990563705	0	3.562943975	9.314175727	6.597953332	13.98461277	1.585888852	0.2	0	0	0	0	0	10	10	0	5.57E-07											5.6398	0.31964869	1.405318885	0.194899954	1.45360949	2.310731026	0.8297652	1.614831426	0.726149655	0	0.716055458	0.056231331	0.122397348	0.129419352	0	7.968076674	1.077753267	2.759300431	4.808600068	0.356850423	5.548403487	0	0	0	0	0	0.024	0.0144	0	6.40E-07	0	0	0	0	0	0	0	0	0	0	38.0763	0	0	5.6398	0.31964869	1.405318885	0.194899954	1.45360949	2.310731026	0.8297652	1.614831426	0.726149655	0	0.716055458	0.056231331	0.122397348	0.129419352	0	7.968076674	1.077753267	2.759300431	4.808600068	0.356850423	5.548403487	0	0	0	0	0	0.024	0.0144	0	6.40E-07	0	0	0	0	0	0	0	0	0	0	38.0763	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	5.6398	0.31964869	1.405318885	0.194899954	1.45360949	2.310731026	0.8297652	1.614831426	0.726149655	0	0.716055458	0.056231331	0.122397348	0.129419352	0	7.968076674	1.077753267	2.759300431	4.808600068	0.356850423	5.548403487	0	0	0	0	0	0.024	0.0144	0	6.40E-07	0	0	0	0	0	0	0	0	0	0	38.0763
H3361_059_0	2009	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	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		1645.629942	162.7793176	337.6314859	612.9817979	599.0321447	16.11847661	4.068051763	1075.522695	295.102492	5656.742249	1210.399603	19.57453785	0.043989494	369.9943461	7625.461577	17878.49613	646.2529323	2289.411221	3788.024017	2048.621424	18.43033001	8.662172164	0	1145.454545	434.9972632	201	28.8	21.39131668	1664	0											"$100 days 1 - 10, $0 after day 10, unlimited coverage"	"$100 days 1 - 10, $0 after day 10, unlimited coverage"	Medicare FFS Cost Sharing	Copay between $0.00 and $20.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $20.00	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	Not Covered											64.66150278	30.25443368	35.63	4.075733037	42.77017979	0.2	0.14490677	16.00948985	40.25412696	0	6.8221349	26.24922505	0.2	3.034637341	4.26457301	5.023538679	14.8241343	8.78269625	11.27523781	2.972711959	0.2	0	0	0	0	0	10	8.132957148	0	0											64.66150278	30.25443368	35.63	4.075733037	42.77017979	0.2	0.14490677	16.00948985	40.25412696	0	6.8221349	26.24922505	0.2	3.034637341	4.26457301	5.023538679	14.8241343	8.78269625	11.27523781	2.972711959	0.2	0	0	0	0	0	10	8.132957148	0	0											8.8674	0.410399672	1.002484153	0.208195847	2.135059378	3.223695322	0.589488242	1.434880807	0.989924432	0	0.688125781	0.042818037	0.008797899	0.093566555	2.709944802	7.484443068	0.798345022	1.675600279	3.559239301	0.507496784	3.686066003	0	0	0	0	0	0.024	0.014497888	0	0	0	0	0	0	0	0	0	0	0	0	40.1545	0	0	8.8674	0.410399672	1.002484153	0.208195847	2.135059378	3.223695322	0.589488242	1.434880807	0.989924432	0	0.688125781	0.042818037	0.008797899	0.093566555	2.709944802	7.484443068	0.798345022	1.675600279	3.559239301	0.507496784	3.686066003	0	0	0	0	0	0.024	0.014497888	0	0	0	0	0	0	0	0	0	0	0	0	40.1545	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.8674	0.410399672	1.002484153	0.208195847	2.135059378	3.223695322	0.589488242	1.434880807	0.989924432	0	0.688125781	0.042818037	0.008797899	0.093566555	2.709944802	7.484443068	0.798345022	1.675600279	3.559239301	0.507496784	3.686066003	0	0	0	0	0	0.024	0.014497888	0	0	0	0	0	0	0	0	0	0	0	0	40.1545
H3361_065_0	2009	6																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	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		351.3513853	72.10556234	708.2950574	1656.216246	20.40187797	18.69943066	3.612803258	31.01949545	14.17768094	8311.665697	22.40705188	0.678358869	0.158186729	5.653479384	8145.204709	86.58781256	21.9409191	6.622576009	26.49218191	9.601113557	19.28730763	0.259274567	4500	0	0.140199795	0	0.006902255	0.036011763	1664	11124.19355											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	$0.00 copayment	Not Covered	$0.00 copayment	Not Covered	$0.00 copayment	"$0.00 copayment,  benefit limit"	$0.00 copayment	$0.00 copayment											703.3546177	563.8100554	77.58466241	0	0.167843621	0.17	0.17	0.115165923	0.17	0	0.125661563	0.17	0.17	0.17	0	0.089102228	0.17	0.17	0.140860276	0.085820647	0.17	0.16892384	0	0	0	0	0	0	0	0											703.3546177	563.8100554	77.58466241	0	0.167843621	0.17	0.17	0.115165923	0.17	0	0.125661563	0.17	0.17	0.17	0	0.089102228	0.17	0.17	0.140860276	0.085820647	0.17	0.16892384	0	0	0	0	0	0	0	0											20.5937	3.387820092	4.579402743	0	3.42432507	3.178903213	0.614176554	3.572388827	2.41020576	0	2.815705158	0.115321008	0.026891744	0.961091495	0	7.715167004	3.729956248	1.125837922	3.731696057	0.823973779	3.278842297	0.043797655	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.1292	0	0	20.5937	3.387820092	4.579402743	0	3.42432507	3.178903213	0.614176554	3.572388827	2.41020576	0	2.815705158	0.115321008	0.026891744	0.961091495	0	7.715167004	3.729956248	1.125837922	3.731696057	0.823973779	3.278842297	0.043797655	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.1292	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.5937	3.387820092	4.579402743	0	3.42432507	3.178903213	0.614176554	3.572388827	2.41020576	0	2.815705158	0.115321008	0.026891744	0.961091495	0	7.715167004	3.729956248	1.125837922	3.731696057	0.823973779	3.278842297	0.043797655	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.1292
H3361_077_0	2009	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	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		1969.094184	160.1660721	558.195466	936.6292359	598.9670507	17.64139022	3.964097117	1068.674579	288.3627984	4215.272298	1149.448807	28.4174119	0.019458449	305.1495495	10001.27951	18509.20207	590.1382059	2267.901128	4011.000143	2232.701763	18.24179384	9.610097559	0	1145.454545	421.4658151	201	28.8	31.83213966	1664	13806.58575											"$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	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $20.00	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	Copay between $0.00 and $15.00											35.56583341	18.61505688	49.53	3.71590848	43.84432336	0.2	0.159289227	15.61506169	26.81047429	0	6.710316267	19.68691878	0.2	3.037217748	0	4.768981876	15.2425081	8.523438536	11.93196491	2.861346782	0.2	0	0	0	0	0	10	5.559090783	0	0.008945547											35.56583341	18.61505688	49.53	3.71590848	43.84432336	0.2	0.159289227	15.61506169	26.81047429	0	6.710316267	19.68691878	0.2	3.037217748	0	4.768981876	15.2425081	8.523438536	11.93196491	2.861346782	0.2	0	0	0	0	0	10	5.559090783	0	0.008945547											5.836	0.248458378	2.303951786	0.29003571	2.188442088	3.528278043	0.631437964	1.390618289	0.64426195	0	0.642763752	0.04662094	0.00389169	0.077233802	0	7.355837435	0.749598865	1.610859656	3.988259413	0.532377834	3.648358768	0	0	0	0	0	0.024	0.01474648	0	0.010292288	0	0	0	0	0	0	0	0	0	0	35.7664	0	0	5.836	0.248458378	2.303951786	0.29003571	2.188442088	3.528278043	0.631437964	1.390618289	0.64426195	0	0.642763752	0.04662094	0.00389169	0.077233802	0	7.355837435	0.749598865	1.610859656	3.988259413	0.532377834	3.648358768	0	0	0	0	0	0.024	0.01474648	0	0.010292288	0	0	0	0	0	0	0	0	0	0	35.7664	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	5.836	0.248458378	2.303951786	0.29003571	2.188442088	3.528278043	0.631437964	1.390618289	0.64426195	0	0.642763752	0.04662094	0.00389169	0.077233802	0	7.355837435	0.749598865	1.610859656	3.988259413	0.532377834	3.648358768	0	0	0	0	0	0.024	0.01474648	0	0.010292288	0	0	0	0	0	0	0	0	0	0	35.7664
H3361_084_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		244.1282027	39.2210048	501.3893958	1924.753008	1081.297522	20.52845682	3.519615071	3194.877904	162.5413337	10235.714	1270.526168	34.75537093	0.012799159	504.742998	5886.475122	10137.0508	2673.893721	730.2746816	3260.558285	1126.138456	8.348575779	14.5255877	0	671.25	419.2896502	201	28.8	17.28	1664	15150											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	$0.00 copayment	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $195.00, No benefit limit"	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											0	0	0	0	48.35578117	0.2	0.122662809	20.0334965	0	0	3.944698305	0	0.2	0	0	0	0	0	7.871314091	2.32093317	0.2	0	0	20	0	0	10	10	0	0											0	0	0	0	48.35578117	0.2	0.122662809	20.0334965	0	0	3.944698305	0	0.2	0	0	0	0	0	7.871314091	2.32093317	0.2	0	0	20	0	0	10	10	0	0											0	0	0	0	4.357248863	4.105691365	0.431725872	5.333714608	0	0	0.417653535	0	0.002559832	0	0	0	0	0	2.138739864	0.217807675	1.669715156	0	0	1.11875	0	0	0.024	0.0144	0	0	0	0	0	0	0	0	0	0	0	0	19.832	0	0	0	0	0	0	4.357248863	4.105691365	0.431725872	5.333714608	0	0	0.417653535	0	0.002559832	0	0	0	0	0	2.138739864	0.217807675	1.669715156	0	0	1.11875	0	0	0.024	0.0144	0	0	0	0	0	0	0	0	0	0	0	0	19.832	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	20% coinsurance											4.4291	0.6624	0.1657	0.3719	0.4294	0.501	0.0858	0	0.2893	0.2516	0.3344	0.0173	0	0.2732	0.1768	1.2796	0.5796	0.0722	0.4508	0.1309	0.2019	0.0059	0	0	0	0	0	0	0	0											10.7085	0	0	4.4291	0.662351059	0.16565039	0.371861528	4.786607719	4.606694052	0.517540596	5.333714608	0.289320395	0.25155532	0.752012261	0.017250307	0.002559832	0.273175233	0.176818477	1.279591837	0.579601801	0.072203331	2.589573304	0.348712681	1.871604466	0.005920275	0	1.11875	0	0	0.024	0.0144	0	0	0	0	0	0	0	0	0	0	0	0	30.5406
H3361_098_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2016.006669	497.752426	668.5998225	1477.253511	1298.661899	21.71898076	4.021358403	3181.411392	235.6462443	7264.834281	1414.508658	14.9086014	0.206482121	434.409088	8927.997954	17072.12058	2946.360676	2348.673261	4557.407839	1781.533061	21.32606572	22.69695928	0	526.6666667	449.0442	201	28.8	26.6584071	1664	14382.35675											"$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	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $15.00	Copay between $5.00 and $15.00	$15.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $50.00, No benefit limit"	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	Copay between $0.00 and $10.00											37.68585527	18.86279638	51.96	1.752656197	40.06656808	0.2	0.128255833	18.22029372	27.53663202	0	5.602206664	19.68691878	0.2	2.782830615	0	3.547706075	10.01234192	6.294279512	9.848584803	3.645259854	0.2	0	0	50	0	0	10	6.582521762	0	0.006612363											37.68585527	18.86279638	51.96	1.752656197	40.06656808	0.2	0.128255833	18.22029372	27.53663202	0	5.602206664	19.68691878	0.2	2.782830615	0	3.547706075	10.01234192	6.294279512	9.848584803	3.645259854	0.2	0	0	50	0	0	10	6.582521762	0	0.006612363											6.3312	0.782416888	2.895037231	0.215759793	4.336077116	4.343796151	0.515762673	4.830520834	0.540741993	0	0.660364153	0.024458702	0.041296424	0.100740576	0	5.047238824	2.458330876	1.231933833	3.740334798	0.541179246	4.265213144	0	0	2.194444444	0	0	0.024	0.014623295	0	0.007925114	0	0	0	0	0	0	0	0	0	0	45.1434	0	0	6.3312	0.782416888	2.895037231	0.215759793	4.336077116	4.343796151	0.515762673	4.830520834	0.540741993	0	0.660364153	0.024458702	0.041296424	0.100740576	0	5.047238824	2.458330876	1.231933833	3.740334798	0.541179246	4.265213144	0	0	2.194444444	0	0	0.024	0.014623295	0	0.007925114	0	0	0	0	0	0	0	0	0	0	45.1434	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	20% coinsurance											5.741	0.6447	0.2346	0.3208	0.448	0.53	0.0981	0	0.3965	0.1878	0.479	0.0111	0	0.1274	0.2942	2.0743	0.4856	0.1981	0.7054	0.2549	0.514	0.0126	0	0	0	0	0	0	0	0.0027											13.7608	0	0	12.0723	1.427120943	3.129603146	0.536526812	4.784113614	4.873822635	0.613864774	4.830520834	0.937239569	0.187789879	1.139390533	0.035556149	0.041296424	0.2281683	0.294235091	7.121495694	2.94394079	1.430067741	4.445703387	0.796076365	4.779175387	0.012573033	0	2.194444444	0	0	0.024	0.014623295	0	0.010578847	0	0	0	0	0	0	0	0	0	0	58.9042
H3361_099_0	2009	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	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		1799.182599	411.8365867	459.284267	465.4170883	576.1493226	15.08452434	4.2152237	1633.263977	263.8962821	6736.945369	1460.644346	19.30315704	0.057592199	426.337881	8828.919331	12693.19871	618.9792307	1184.755671	3745.080834	1772.92063	21.48480187	8.226036193	0	526.6666667	427.4050673	202.1045681	31.14182791	18.38099541	0	15150											"$100 days 1 - 5, $0 after day 5, unlimited coverage"	"$100 days 1 - 5, $0 after day 5, unlimited coverage"	Medicare FFS Cost Sharing	Copay between $0.00 and $30.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $30.00	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $50.00, No benefit limit"	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	Not Covered	Copay between $0.00 and $30.00											44.89480588	26.14899381	35.63	4.953726335	48.08183467	0.2	0.077474002	12.68222189	34.35578343	0	5.342030527	26.24922505	0.2	4.811210829	0	8.025539773	22.16531979	12.7880961	8.283198743	3.89277565	0.2	0	0	50	0	0	9.595083415	9.418128138	0	0											44.89480588	26.14899381	35.63	4.953726335	48.08183467	0.2	0.077474002	12.68222189	34.35578343	0	5.342030527	26.24922505	0.2	4.811210829	0	8.025539773	22.16531979	12.7880961	8.283198743	3.89277565	0.2	0	0	50	0	0	9.595083415	9.418128138	0	0											6.7312	0.89742603	1.363691536	0.192129074	2.308526373	3.016904868	0.326570248	1.726118013	0.755530293	0	0.65023389	0.042224409	0.01151844	0.170933452	0	8.489147593	1.143322716	1.262564114	2.585104071	0.575131855	4.296960375	0	0	2.194444444	0	0	0.024900703	0.014426214	0	0	0	0	0	0	0	0	0	0	0	0	38.779	0	0	6.7312	0.89742603	1.363691536	0.192129074	2.308526373	3.016904868	0.326570248	1.726118013	0.755530293	0	0.65023389	0.042224409	0.01151844	0.170933452	0	8.489147593	1.143322716	1.262564114	2.585104071	0.575131855	4.296960375	0	0	2.194444444	0	0	0.024900703	0.014426214	0	0	0	0	0	0	0	0	0	0	0	0	38.779	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	20% coinsurance											4.3548	0.3919	0.1496	0.1256	0.2415	0.3669	0.1024	0	0.3802	0.2017	0.6272	0.0154	0	0.1257	0.1559	1.767	0.0928	0.1057	0.5099	0.2657	0.5138	0.0036	0	0	0	0	0	0	0	0											10.4971	0	0	11.0859	1.289323629	1.51328144	0.317769134	2.54998173	3.383783777	0.428953662	1.726118013	1.135702603	0.201667286	1.277431335	0.057594373	0.01151844	0.296588899	0.155915988	10.25614271	1.236076346	1.368295462	3.095029544	0.840825239	4.810738415	0.003596033	0	2.194444444	0	0	0.024900703	0.014426214	0	0	0	0	0	0	0	0	0	0	0	0	49.2761
H3361_101_0	2009	5																					0											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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		198.9431978	15.32640172	458.8499835	1211.464475	423.4127212	16.43772855	3.220469582	1756.34869	235.9693347	11672.20464	966.1670117	42.77138337	1.205285219	517.5490079	5343.809673	13580.56859	1243.201691	1845.262882	3265.280532	1479.731514	17.57470916	21.08259866	0	671.25	429.8664568	201	28.8	17.28	1664	15150											"$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	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $10.00	Copay between $5.00 and $10.00	$10.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $195.00, No benefit limit"	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	Copay between $0.00 and $15.00											70	70	33.02	1.931528994	45.52061175	0.2	0.2	21.5743232	49.42621922	0	9.655836263	26.24922505	0.2	5.547335288	0	2.80926615	5.08549114	4.197424546	12.00012545	1.698622231	0.2	0	0	20	0	0	10	10	0	0											70	70	33.02	1.931528994	45.52061175	0.2	0.2	21.5743232	49.42621922	0	9.655836263	26.24922505	0.2	5.547335288	0	2.80926615	5.08549114	4.197424546	12.00012545	1.698622231	0.2	0	0	20	0	0	10	10	0	0											1.1605	0.08940401	1.262602205	0.19499823	1.606167174	3.287545711	0.644093916	3.157669524	0.971922672	0	0.777429206	0.093559639	0.241057044	0.23925149	0	3.17928597	0.526857599	0.645445976	3.265314669	0.209458737	3.514941833	0	0	1.11875	0	0	0.024	0.0144	0	0	0	0	0	0	0	0	0	0	0	0	26.2247	0	0	1.1605	0.08940401	1.262602205	0.19499823	1.606167174	3.287545711	0.644093916	3.157669524	0.971922672	0	0.777429206	0.093559639	0.241057044	0.23925149	0	3.17928597	0.526857599	0.645445976	3.265314669	0.209458737	3.514941833	0	0	1.11875	0	0	0.024	0.0144	0	0	0	0	0	0	0	0	0	0	0	0	26.2247	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	1.1605	0.08940401	1.262602205	0.19499823	1.606167174	3.287545711	0.644093916	3.157669524	0.971922672	0	0.777429206	0.093559639	0.241057044	0.23925149	0	3.17928597	0.526857599	0.645445976	3.265314669	0.209458737	3.514941833	0	0	1.11875	0	0	0.024	0.0144	0	0	0	0	0	0	0	0	0	0	0	0	26.2247
H3361_102_0	2009	6																					0											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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		258.3781185	15.47130593	443.3301245	1266.450086	563.6813387	10.87830462	4.010596697	1311.958152	165.4532594	7596.694611	841.1605408	20.53087209	0.73308659	353.2786553	7452.713865	10324.39154	634.1764671	1129.516934	3384.164048	1399.264684	11.2290414	18.07881498	0	526.6666667	428.9055484	202.9218249	28.8	21.11121749	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	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $30.00	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $50.00, No benefit limit"	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	Not Covered	Not Covered											0	0	16.51	3.318912422	48.4125137	0.2	0.099468761	19.48620779	0	0	5.813689329	0	0.2	2.221486857	0	7.740685272	16.16001023	12.15717833	11.59126525	2.619961516	0.2	0	0	50	0	0	10	8.237072716	0	0											0	0	16.51	3.318912422	48.4125137	0.2	0.099468761	19.48620779	0	0	5.813689329	0	0.2	2.221486857	0	7.740685272	16.16001023	12.15717833	11.59126525	2.619961516	0.2	0	0	50	0	0	10	8.237072716	0	0											0	0	0.609948363	0.350269743	2.274102544	2.175660924	0.398929084	2.130424098	0	0	0.407520505	0	0.146617318	0.065400324	0	6.659822125	0.85402485	1.144311566	3.26889526	0.305501635	2.245808281	0	0	2.194444444	0	0	0.024	0.014491219	0	0	0	0	0	0	0	0	0	0	0	0	25.2702	0	0	0	0	0.609948363	0.350269743	2.274102544	2.175660924	0.398929084	2.130424098	0	0	0.407520505	0	0.146617318	0.065400324	0	6.659822125	0.85402485	1.144311566	3.26889526	0.305501635	2.245808281	0	0	2.194444444	0	0	0.024	0.014491219	0	0	0	0	0	0	0	0	0	0	0	0	25.2702	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	20% coinsurance											4.8248	0.1521	0.1558	0.2916	0.2301	0.2645	0.0976	0	0.3122	0.1726	0.2339	0.0134	0	0.1134	0.1748	1.4083	0.1097	0.1153	0.6037	0.2106	0.2666	0.0088	0	0	0	0	0	0	0	0											9.7597	0	0	4.8248	0.15207834	0.765699957	0.641867592	2.504157367	2.440183925	0.496500219	2.130424098	0.312162633	0.172588294	0.64143893	0.013375517	0.146617318	0.178760955	0.17484198	8.068144328	0.963742624	1.259594808	3.872584778	0.516106253	2.512389417	0.008830744	0	2.194444444	0	0	0.024	0.014491219	0	0	0	0	0	0	0	0	0	0	0	0	35.0299
H3361_104_0	2009	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	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		1823.609367	91.89414945	491.0881092	489.2547514	449.433766	10.65131494	3.902057587	1019.370235	255.2498577	2438.095616	1131.585303	13.94935677	0.042294142	274.5909916	10586.28014	14798.42578	748.3420402	1849.534124	3989.081469	1961.897372	16.08734138	6.695990542	0	526.6666667	425.5635767	201	30.93567655	27.49189579	0	15250.28945											"$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	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $25.00	Copay between $15.00 and $25.00	$25.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $50.00, No benefit limit"	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	Not Covered	Copay between $0.00 and $30.00											22.73455758	16.83780038	49.53	3.756567728	44.97389927	0.2	0.085640516	12.03835475	13.1201168	0	4.158129713	13.12461252	0.2	4.833809747	0	6.346051643	19.90336148	10.63038455	8.908339281	3.530393069	0.2	0	0	50	0	0	9.628267487	6.391617582	0	0.057985608											22.73455758	16.83780038	49.53	3.756567728	44.97389927	0.2	0.085640516	12.03835475	13.1201168	0	4.158129713	13.12461252	0.2	4.833809747	0	6.346051643	19.90336148	10.63038455	8.908339281	3.530393069	0.2	0	0	50	0	0	9.628267487	6.391617582	0	0.057985608											3.4549	0.128941279	2.026966171	0.153159884	1.684399077	2.130262989	0.334174227	1.022628377	0.279075662	0	0.392106539	0.015256659	0.008458828	0.110610051	0	7.825964521	1.241210178	1.638438248	2.961340929	0.577189074	3.217468276	0	0	2.194444444	0	0	0.024821414	0.01464314	0	0.073691442	0	0	0	0	0	0	0	0	0	0	31.5102	0	0	3.4549	0.128941279	2.026966171	0.153159884	1.684399077	2.130262989	0.334174227	1.022628377	0.279075662	0	0.392106539	0.015256659	0.008458828	0.110610051	0	7.825964521	1.241210178	1.638438248	2.961340929	0.577189074	3.217468276	0	0	2.194444444	0	0	0.024821414	0.01464314	0	0.073691442	0	0	0	0	0	0	0	0	0	0	31.5102	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	20% coinsurance											4.6829	0.1157	0.1763	0.114	0.197	0.2585	0.0948	0	0.4175	0.0638	0.3744	0.0046	0	0.0966	0.214	2.1007	0.1225	0.1678	0.7198	0.3182	0.3736	0.0029	0	0	0	0	0	0	0	0.0062											10.6217	0	0	8.1378	0.244648127	2.203223676	0.267130466	1.881411892	2.38873704	0.429007966	1.022628377	0.696594066	0.063753207	0.766520285	0.019879608	0.008458828	0.207239108	0.214040055	9.926644386	1.363683884	1.806278866	3.68109829	0.895374598	3.591036058	0.002853256	0	2.194444444	0	0	0.024821414	0.01464314	0	0.07990624	0	0	0	0	0	0	0	0	0	0	42.1319
H3361_105_0	2009	7																																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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		559.7287036	92.93510754	1537.304215	26943.01904	2630.468123	3988.834397	691.777344	6735.876088	305.6986234	10096.45396	1771.168048	30.5926547	175.6880862	645.2744062	19551.89359	45362.72507	7091.85468	18924.3005	8467.054008	4936.606819	34.11049397	19.43570083	0	0	402	201	195	41.6	1664	10820.58824											"$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 $0.00 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	Not Covered	Not Covered	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$0.00 copayment	"$0.00 copayment, $1,250 benefit limit"	$0.00 copayment	$0.00 copayment											0	0	0	0	0	0	0	11.6201658	0	0	0	0	0	0.133093708	0	1.913632742	13.23758197	4.562658973	3.723797173	0	0.2	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	11.6201658	0	0	0	0	0	0.133093708	0	1.913632742	13.23758197	4.562658973	3.723797173	0	0.2	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	6.522666414	0	0	0	0	0	0.00715683	0	7.233966328	7.823250638	7.195427456	2.627465982	0	6.822098794	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.232	0	0	0	0	0	0	0	0	0	6.522666414	0	0	0	0	0	0.00715683	0	7.233966328	7.823250638	7.195427456	2.627465982	0	6.822098794	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.232	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	6.522666414	0	0	0	0	0	0.00715683	0	7.233966328	7.823250638	7.195427456	2.627465982	0	6.822098794	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.232
H3361_106_0	2009	6																					0											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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		252.0370438	28.04011032	479.6689487	643.0380926	634.8696462	5.808006266	3.447956655	807.1290462	132.7210007	1749.638945	511.7170124	3.338486827	0.278802852	172.6490709	8790.161083	11762.17671	487.8101263	3390.14751	3323.585689	1559.021003	13.7390266	1.662898167	5400	526.6666667	435.6131102	201	34.4	15.31526949	1664	10950.71855											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	"$0 days 1 - 7, $75 days 8 - 100"	Copay between $0.00 and $10.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $10.00	Copay between $5.00 and $10.00	$10.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"Copay between $0.00 and $50.00, No benefit limit"	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	Copay between $0.00 and $15.00											0	0	49.53	0.728579728	42.55821434	0.2	0.070346417	14.46403294	0	0	4.186008684	0	0.2	1.195959912	0	2.513603089	7.505586346	4.566613251	8.52834357	0.834067968	0.2	0	0	50	0	0	10	9.314470367	0	0.000289285											0	0	49.53	0.728579728	42.55821434	0.2	0.070346417	14.46403294	0	0	4.186008684	0	0.2	1.195959912	0	2.513603089	7.505586346	4.566613251	8.52834357	0.834067968	0.2	0	0	50	0	0	10	9.314470367	0	0.000289285											0	0	1.979833586	0.039042043	2.25157654	1.161601253	0.242551397	0.972861759	0	0	0.178504321	0	0.05576057	0.017206781	0	2.463786975	0.305108419	1.290124379	2.36205672	0.10836079	2.74780532	0	0	2.194444444	0	0	0.028666667	0.011887802	0	0.00026399	0	0	0	0	0	0	0	0	0	0	18.4114	0	0	0	0	1.979833586	0.039042043	2.25157654	1.161601253	0.242551397	0.972861759	0	0	0.178504321	0	0.05576057	0.017206781	0	2.463786975	0.305108419	1.290124379	2.36205672	0.10836079	2.74780532	0	0	2.194444444	0	0	0.028666667	0.011887802	0	0.00026399	0	0	0	0	0	0	0	0	0	0	18.4114	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	20% coinsurance											6.5225	0.434	0.167	0.1405	0.2252	0.1401	0.0838	0	0.2978	0.0462	0.2095	0.0017	0	0.0717	0.1907	1.6884	0.0913	0.2658	0.684	0.3012	0.1976	0.0005	0	0	0	0	0	0	0	0.0001											11.7595	0	0	6.5225	0.434034575	2.146793384	0.179528127	2.476755276	1.30170531	0.326367993	0.972861759	0.297838523	0.046242702	0.388008432	0.001682723	0.05576057	0.088936436	0.190673959	4.152227933	0.396410186	1.555956987	3.046034136	0.409515282	2.94536435	0.000465069	0	2.194444444	0	0	0.028666667	0.011887802	0	0.000323241	0	0	0	0	0	0	0	0	0	0	30.1709
H3361_107_0	2009	6																					0											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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		230.4020883	16.8867201	470.1897757	709.8831248	485.8022139	4.993560646	3.256931032	813.1840912	118.3003935	1942.242657	537.8230042	2.707899702	0.349803053	107.4157703	7642.495527	10669.50616	709.3104739	2733.45318	3445.308422	1596.814628	8.45240189	8.704063232	5400	526.6666667	435.3950869	201	34.4	14.23448276	1664	10950.02369											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	"$0 days 1 - 7, $75 days 8 - 100"	Copay between $0.00 and $10.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $10.00	Copay between $5.00 and $10.00	$10.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"Copay between $0.00 and $50.00, No benefit limit"	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	Copay between $0.00 and $15.00											0	0	49.53	0.985861685	44.32770615	0.2	0.06215452	14.67681306	0	0	4.534294863	0	0.2	0.779103226	0	2.921376515	7.295201519	4.51208621	8.468075263	0.618672289	0.2	0	0	50	0	0	10	10	0	2.17E-08											0	0	49.53	0.985861685	44.32770615	0.2	0.06215452	14.67681306	0	0	4.534294863	0	0.2	0.779103226	0	2.921376515	7.295201519	4.51208621	8.468075263	0.618672289	0.2	0	0	50	0	0	10	10	0	2.17E-08											0	0	1.940708299	0.058320548	1.794541482	0.998712129	0.202432984	0.994579241	0	0	0.203220674	0	0.069960611	0.006973998	0	2.597470394	0.431213571	1.027798033	2.431260919	0.082325413	1.690480378	0	0	2.194444444	0	0	0.028666667	0.011862069	0	1.98E-08	0	0	0	0	0	0	0	0	0	0	16.765	0	0	0	0	1.940708299	0.058320548	1.794541482	0.998712129	0.202432984	0.994579241	0	0	0.203220674	0	0.069960611	0.006973998	0	2.597470394	0.431213571	1.027798033	2.431260919	0.082325413	1.690480378	0	0	2.194444444	0	0	0.028666667	0.011862069	0	1.98E-08	0	0	0	0	0	0	0	0	0	0	16.765	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	20% coinsurance											6.6803	0.2686	0.1465	0.1494	0.1774	0.1201	0.0794	0	0.2617	0.0536	0.2259	0.0009	0	0.0463	0.1519	1.656	0.1439	0.1908	0.6637	0.301	0.1643	0.0035	0	0	0	0	0	0	0	0											11.4852	0	0	6.6803	0.268597037	2.087235382	0.207753395	1.971969783	1.118850556	0.281841473	0.994579241	0.26174068	0.053591649	0.429122958	0.000855342	0.069960611	0.053300779	0.151852849	4.253499422	0.575137816	1.218567886	3.094936683	0.383298821	1.854771594	0.003495296	0	2.194444444	0	0	0.028666667	0.011862069	0	1.98E-08	0	0	0	0	0	0	0	0	0	0	28.2502
H3361_109_0	2009	8																					0											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	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		293.619231	26.74032282	416.310124	988.4866935	12.68763452	5.855127325	3.970032984	8.110241987	10.13027901	1809.814441	7.525193279	0.021716623	0.154164777	0.753495913	8812.229786	67.95407161	1.234989622	5.614565122	37.7644194	13.01937832	4.981792017	0.013158688	7200	1145.454545	427.3402749	201	0.008366422	0	1664	10629.06977											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	$0.00 copayment	"$0.00 copayment, No benefit limit"	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$0.00 copayment	Not Covered	$0.00 copayment	$0.00 copayment											797.6387534	363.9705458	58.75880748	0	0.169023336	0.17	0.17	0.101819269	0.17	0	0.123305776	0.17	0.17	0.17	0	0.126344124	0.17	0.17	0.149696793	0.029900949	0.17	0.168894954	0	0	0	0	0	0	0	0											797.6387534	363.9705458	58.75880748	0	0.169023336	0.17	0.17	0.101819269	0.17	0	0.123305776	0.17	0.17	0.17	0	0.126344124	0.17	0.17	0.149696793	0.029900949	0.17	0.168894954	0	0	0	0	0	0	0	0											19.5168	0.811057491	2.038490536	0	2.144506313	0.995371645	0.674905607	0.82577891	1.722147432	0	0.927899797	0.003691826	0.026208012	0.128094305	0	8.585597643	0.209948236	0.954476071	5.653212456	0.389291772	0.846904643	0.002222436	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.4566	0	0	19.5168	0.811057491	2.038490536	0	2.144506313	0.995371645	0.674905607	0.82577891	1.722147432	0	0.927899797	0.003691826	0.026208012	0.128094305	0	8.585597643	0.209948236	0.954476071	5.653212456	0.389291772	0.846904643	0.002222436	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.4566	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.5168	0.811057491	2.038490536	0	2.144506313	0.995371645	0.674905607	0.82577891	1.722147432	0	0.927899797	0.003691826	0.026208012	0.128094305	0	8.585597643	0.209948236	0.954476071	5.653212456	0.389291772	0.846904643	0.002222436	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.4566
H3361_110_0	2009	8																					0											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	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		305.4110387	33.68213993	309.1615565	1708.490589	16.5916293	8.636851386	3.626103752	10.60882991	14.26757728	1729.989508	7.149986898	0.006904079	0.424615801	2.703420649	11616.4699	84.99071462	3.653556542	18.64284783	41.19546776	16.74014162	11.41341941	0.091311231	7200	1145.454545	430.2799063	201	0.008180973	0	1664	10711.16166											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	$0.00 copayment	"$0.00 copayment, No benefit limit"	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$0.00 copayment	Not Covered	$0.00 copayment	$0.00 copayment											896.9825703	380.1001464	58.53956201	0	0.169064099	0.17	0.17	0.115473952	0.17	0	0.129386353	0.17	0.17	0.17	0	0.107568271	0.17	0.17	0.152791261	0.02382874	0.17	0.17	0	0	0	0	0	0	0	0											896.9825703	380.1001464	58.53956201	0	0.169064099	0.17	0.17	0.115473952	0.17	0	0.129386353	0.17	0.17	0.17	0	0.107568271	0.17	0.17	0.152791261	0.02382874	0.17	0.17	0	0	0	0	0	0	0	0											22.829	1.066882193	1.508181842	0	2.805048858	1.468264736	0.616437638	1.225043514	2.425488138	0	0.925110728	0.001173693	0.072184686	0.45958151	0	9.142304258	0.621104612	3.169284131	6.294307457	0.398896486	1.9402813	0.015522909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.9841	0	0	22.829	1.066882193	1.508181842	0	2.805048858	1.468264736	0.616437638	1.225043514	2.425488138	0	0.925110728	0.001173693	0.072184686	0.45958151	0	9.142304258	0.621104612	3.169284131	6.294307457	0.398896486	1.9402813	0.015522909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.9841	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.829	1.066882193	1.508181842	0	2.805048858	1.468264736	0.616437638	1.225043514	2.425488138	0	0.925110728	0.001173693	0.072184686	0.45958151	0	9.142304258	0.621104612	3.169284131	6.294307457	0.398896486	1.9402813	0.015522909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.9841
H3361_111_0	2009	9																					0											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	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		235.5560408	25.36296001	348.1332414	1532.25885	10.458143	11.18388854	5.383440821	10.32560252	14.91435511	1760.534421	5.765595193	0.084929716	0.938974213	2.345985021	11102.9354	99.80368012	7.113564954	22.09243252	54.20963972	18.61231055	13.41027593	0.035007789	7200	1145.454545	448.792645	201	0	0	1664	10643.44141											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	$0.00 copayment	"$0.00 copayment, No benefit limit"	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	Not Covered	Not Covered	$0.00 copayment	$0.00 copayment											647.7150699	659.3762831	59.40202582	0	0.167936578	0.17	0.17	0.124589015	0.17	0	0.137868791	0.17	0.17	0.17	0	0.120239992	0.17	0.17	0.163736393	0.034827716	0.17	0.130082432	0	0	0	0	0	0	0	0											647.7150699	659.3762831	59.40202582	0	0.167936578	0.17	0.17	0.124589015	0.17	0	0.137868791	0.17	0.17	0.17	0	0.120239992	0.17	0.17	0.163736393	0.034827716	0.17	0.130082432	0	0	0	0	0	0	0	0											12.7144	1.393644525	1.723318316	0	1.756304748	1.901261051	0.91518494	1.286456647	2.535440368	0	0.794895639	0.014438052	0.159625616	0.398817454	0	12.00039373	1.209306042	3.755713529	8.876090873	0.648224263	2.279746908	0.004553898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.3678	0	0	12.7144	1.393644525	1.723318316	0	1.756304748	1.901261051	0.91518494	1.286456647	2.535440368	0	0.794895639	0.014438052	0.159625616	0.398817454	0	12.00039373	1.209306042	3.755713529	8.876090873	0.648224263	2.279746908	0.004553898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.3678	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.7144	1.393644525	1.723318316	0	1.756304748	1.901261051	0.91518494	1.286456647	2.535440368	0	0.794895639	0.014438052	0.159625616	0.398817454	0	12.00039373	1.209306042	3.755713529	8.876090873	0.648224263	2.279746908	0.004553898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.3678
H3361_112_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1237.035285	171.9281217	348.7391056	1192.61975	661.9376425	12.01914791	3.381769303	796.9464072	153.4695642	2448.143519	623.4124918	56.33843403	0.224290999	240.7682265	8055.144707	28416.02066	1236.491071	5934.633137	4233.231899	3120.457188	24.57087917	21.44193041	3750	526.6666667	402	201	28.8	17.28	1664	11683.33333											"$25 days 1 - 5, $0 after day 5, unlimited coverage"	"$25 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	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $10.00	Copay between $5.00 and $10.00	$10.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"Copay between $0.00 and $50.00, No benefit limit"	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											12.741922	4.659090122	56.13	1.304254007	23.24851373	0.2	0.2	19.08431613	18.05619019	0	7.130878616	6.562306262	0.2	2.199992522	0	2.277776321	7.193974145	4.543671718	12.58374229	0.932372754	0.2	0	0	50	0	0	10	10	0	0											12.54526687	4.587183075	55.26370585	1.284124528	22.88970291	0.196913258	0.196913258	18.78977433	17.77751618	0	7.020822703	6.461025529	0.196913258	2.166038475	0	2.242621781	7.082944433	4.473546005	12.38952846	0.917982783	0.196913258	0	0	50	0	0	10	10	0	0											1.2932	0.065722147	1.606051279	0.127622689	1.262629665	2.366729572	0.665915211	1.247870262	0.227358972	0	0.364739048	0.030333672	0.044165871	0.043459437	0	5.310532239	0.729833129	2.21240453	4.370645592	0.238710498	4.838331869	0	0	2.194444444	0	0	0.024	0.0144	0	0	0	0	0	0	0	0	0	0	0	0	29.2791	0	0.424	1.2932	0.065722147	1.606051279	0.127622689	1.262629665	2.366729572	0.665915211	1.247870262	0.227358972	0	0.364739048	0.030333672	0.044165871	0.043459437	0	5.310532239	0.729833129	2.21240453	4.370645592	0.238710498	4.838331869	0	0	2.194444444	0	0	0.024	0.0144	0	0	0	0	0	0	0	0	0	0	0	0	29.2791	0	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	Not covered OON	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	Not covered OON	25% coinsurance	Not covered OON	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	25% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	25% coinsurance											4.684	0.2231	0.1091	0.2774	0.1169	0.2488	0.07	0	0.2928	0.0533	0.2334	0.0175	0	0.1064	0.1768	2.7811	0.2126	0.3775	1.0868	0.4887	0.4707	0.0107	0	0	0	0	0	0	0	0											12.0377	0	0	5.9773	0.288832076	1.715197236	0.405032217	1.379506523	2.61551301	0.735914199	1.247870262	0.52013095	0.053254057	0.59809893	0.047832449	0.044165871	0.149860217	0.176844781	8.091617809	0.942467393	2.589922111	5.457450317	0.727429609	5.309037725	0.010747266	0	2.194444444	0	0	0.024	0.0144	0	0	0	0	0	0	0	0	0	0	0	0	41.3168
H3361_113_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1314.011537	86.08893796	682.8067003	1180.445133	411.5203157	15.31911656	3.989692394	1199.645362	287.5753076	8683.672303	1078.114443	7.596959217	0.201207677	509.2121318	6708.377034	16896.6059	515.3753712	2563.994168	4061.203144	2152.691637	25.40672848	41.17647322	0	526.6666667	402	201	28.8	17.28	0	15150											"$150 days 1 - 3, $0 after day 3, unlimited coverage"	"$150 days 1 - 3, $0 after day 3, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $20.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $20.00	Copay between $10.00 and $20.00	$20.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $50.00, No benefit limit"	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	Not Covered	$0.00 copayment											55.8069436	30.72888633	56.13	3.389449985	40.40853669	0.2	0.2	20.22281498	56.88618825	0	7.447347131	39.37383757	0.2	2.067607365	2.572341682	4.890242863	15.57350482	8.634970712	14.02705579	3.400767235	0.2	0	0	50	0	0	10	10	0	0											53.86406001	29.65907951	54.17586941	3.271448419	39.00173894	0.193037126	0.193037126	19.51877042	54.90573144	0	7.188072432	38.00306222	0.193037126	1.995624917	2.482787227	4.719992138	15.03132306	8.334349646	13.53871267	3.282371666	0.193037126	0	0	50	0	0	10	10	0	0											5.8982	0.212776555	3.082637219	0.32181378	1.33750066	2.957158234	0.770158753	1.9513002	1.315794384	0	0.645797059	0.024058976	0.038840552	0.084683035	1.387956068	6.645987251	0.645564475	1.780768657	4.581955207	0.588827836	4.904441847	0	0	2.194444444	0	0	0.024	0.0144	0	0	0	0	0	0	0	0	0	0	0	0	41.409	0	1.4131	5.8982	0.212776555	3.082637219	0.32181378	1.33750066	2.957158234	0.770158753	1.9513002	1.315794384	0	0.645797059	0.024058976	0.038840552	0.084683035	1.387956068	6.645987251	0.645564475	1.780768657	4.581955207	0.588827836	4.904441847	0	0	2.194444444	0	0	0.024	0.0144	0	0	0	0	0	0	0	0	0	0	0	0	41.409	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	20% coinsurance											4.6159	0.1002	0.2638	0.3294	0.1478	0.3745	0.0975	0	0.5064	0.2018	0.3441	0.0038	0	0.2308	0.1718	2.0708	0.0808	0.1898	0.6841	0.3288	0.5686	0.0306	0	0	0	0	0	0	0	0											11.341	0	0	10.514	0.312929428	3.346400714	0.651204829	1.485330567	3.331625528	0.867684567	1.9513002	1.822160533	0.201773369	0.989875173	0.027816531	0.038840552	0.31545748	1.559716094	8.7168005	0.726386238	1.970581754	5.266059358	0.917645224	5.473030041	0.030560789	0	2.194444444	0	0	0.024	0.0144	0	0	0	0	0	0	0	0	0	0	0	0	52.7501
H3361_115_0	2009	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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		962.0482529	154.082375	646.0703656	1523.242408	688.2349813	14.04774164	4.563956875	1381.883967	275.183443	2751.906883	748.737907	11.46193233	0.347862509	399.7787866	12732.18558	22957.43261	682.6551386	3999.417445	4699.379985	2154.826251	26.87292514	46.72871917	0	526.6666667	402	201	28.8	17.28	1664	13350											"$100 days 1 - 3, $0 after day 3, unlimited coverage"	"$100 days 1 - 3, $0 after day 3, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $30.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $30.00	Copay between $20.00 and $30.00	$30.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $50.00, No benefit limit"	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											44.2696843	15.62729361	56.13	4.379251399	22.87679052	0.2	0.2	20.78599899	47.00771312	0	8.97031598	26.24922505	0.2	4.46869177	0	6.378901483	21.76334239	13.442457	16.53978973	3.914771806	0.2	0	0	50	0	0	10	10	0	0											42.09115246	14.8582672	53.36781649	4.163746393	21.75101298	0.190157907	0.190157907	19.76311028	44.6944416	0	8.528882541	24.95748842	0.190157907	4.248785361	0	6.064992762	20.69235815	12.78094741	15.72585895	3.722124057	0.190157907	0	0	50	0	0	10	10	0	0											3.3745	0.190783092	2.873280392	0.528532924	1.247484001	2.671289143	0.867872485	2.275860436	1.02493086	0	0.532158139	0.02383842	0.066148806	0.141547855	0	11.60305522	1.177145385	4.259695337	6.158482233	0.668377552	5.110099189	0	0	2.194444444	0	0	0.024	0.0144	0	0	0	0	0	0	0	0	0	0	0	0	47.0279	0	2.3185	3.3745	0.190783092	2.873280392	0.528532924	1.247484001	2.671289143	0.867872485	2.275860436	1.02493086	0	0.532158139	0.02383842	0.066148806	0.141547855	0	11.60305522	1.177145385	4.259695337	6.158482233	0.668377552	5.110099189	0	0	2.194444444	0	0	0.024	0.0144	0	0	0	0	0	0	0	0	0	0	0	0	47.0279	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	20% coinsurance											3.9584	0.1688	0.2273	0.3407	0.1438	0.3434	0.1116	0	0.4965	0.0813	0.2643	0.0065	0	0.1824	0.1863	2.3309	0.1149	0.3009	0.9949	0.3629	0.6248	0.0183	0	0	0	0	0	0	0	0											11.2589	0	0	7.3329	0.35954651	3.100625772	0.869189423	1.39124171	3.014678383	0.979435875	2.275860436	1.521440691	0.08134834	0.796447945	0.030314817	0.066148806	0.323978846	0.186279337	13.93395368	1.292048709	4.560630795	7.153397076	1.031271155	5.734871377	0.01832637	0	2.194444444	0	0	0.024	0.0144	0	0	0	0	0	0	0	0	0	0	0	0	58.2868
H3361_116_0	2009	6																					0											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	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		270.3985877	59.66129782	376.4608761	2960.718468	13.34240498	19.11212377	3.11979281	19.82260106	11.89856142	4763.349078	11.56843417	0.791565721	4.610555176	6.964382304	8784.496667	113.8568386	29.6785284	25.12225865	40.36096851	16.07125731	22.67974315	0.15363268	5400	671.25	0	0	0	0	1664	10871.73913											Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	$0.00 copayment	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance	Coin between 20% and 50%	$0.00 copayment	"$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% coinsurance"	$0.00 copayment	"Copay between $0.00 and $195.00, No benefit limit"	Not Covered	Not Covered	Not Covered	Not Covered	$0.00 copayment	$0.00 copayment											790.4336127	809.8903235	67.63310561	0	0.163436819	0.17	0.17	0.147060799	0.17	0	0.17	0.17	0.17	0.17	0	0.100056513	0.17	0.17	0.17	0.142371953	0.17	0.161554708	0	20	0	0	0	0	0	0											790.4336127	809.8903235	67.63310561	0	0.163436819	0.17	0.17	0.147060799	0.17	0	0.17	0.17	0.17	0.17	0	0.100056513	0.17	0.17	0.17	0.142371953	0.17	0.161554708	0	20	0	0	0	0	0	0											17.811	4.026592316	2.121768183	0	2.180640222	3.24906104	0.530364778	2.915127544	2.022755441	0	1.966633809	0.134566173	0.78379438	1.183944992	0	11.39211822	5.045349829	4.27078397	6.861364647	2.288096294	3.855556336	0.024820083	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.7831	0	0	17.811	4.026592316	2.121768183	0	2.180640222	3.24906104	0.530364778	2.915127544	2.022755441	0	1.966633809	0.134566173	0.78379438	1.183944992	0	11.39211822	5.045349829	4.27078397	6.861364647	2.288096294	3.855556336	0.024820083	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.7831	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.811	4.026592316	2.121768183	0	2.180640222	3.24906104	0.530364778	2.915127544	2.022755441	0	1.966633809	0.134566173	0.78379438	1.183944992	0	11.39211822	5.045349829	4.27078397	6.861364647	2.288096294	3.855556336	0.024820083	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.7831
H3361_117_0	2009	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	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		1701.179325	869.3759885	366.7606863	2591.294852	1265.720568	17.989886	2.915718939	2569.864829	151.0604598	4457.766185	728.9604927	61.18298856	4.749854416	313.0530598	10109.75356	23494.31527	4355.539091	9769.544508	3972.737573	2500.953462	21.5426904	14.35153685	0	526.6666667	402	201	28.8	17.28	1664	13350											"$25 days 1 - 5, $0 after day 5, unlimited coverage"	"$25 days 1 - 5, $0 after day 5, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $5.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $5.00	$5.00 copayment	$5.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $50.00, No benefit limit"	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											11.39783427	5.200419671	58.89	0.282321859	27.13962513	0.2	0.2	21.13535413	18.26819213	0	7.060094681	6.562306262	0.2	1.39064368	0	1.035191388	3.549332483	2.276540984	11.42325951	1.191647424	0.2	0	0	50	0	0	10	10	0	0											10.86720621	4.958313276	56.14836634	0.269178318	25.87613541	0.190688967	0.190688967	20.15139423	17.41771344	0	6.73141081	6.256797012	0.190688967	1.325902034	0	0.986997882	3.384092724	2.170556244	10.89144778	1.136170081	0.190688967	0	0	50	0	0	10	10	0	0											1.5406	0.359219875	1.716084448	0.058126699	2.729329734	3.430472778	0.555995433	4.315529941	0.21926065	0	0.408911045	0.031900795	0.905744832	0.034589807	0	1.932403284	1.228295679	1.767112152	3.605738653	0.236792375	4.107953379	0	0	2.194444444	0	0	0.024	0.0144	0	0	0	0	0	0	0	0	0	0	0	0	31.4169	0	1.425	1.5406	0.359219875	1.716084448	0.058126699	2.729329734	3.430472778	0.555995433	4.315529941	0.21926065	0	0.408911045	0.031900795	0.905744832	0.034589807	0	1.932403284	1.228295679	1.767112152	3.605738653	0.236792375	4.107953379	0	0	2.194444444	0	0	0.024	0.0144	0	0	0	0	0	0	0	0	0	0	0	0	31.4169	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	20% coinsurance											6.6835	1.5114	0.149	0.5281	0.3042	0.4398	0.0713	0	0.2804	0.1121	0.2781	0.0179	0	0.1815	0.2976	2.7945	0.8105	0.6159	0.9511	0.4419	0.3884	0.0037	0	0	0	0	0	0	0	0											16.8608	0	0	8.224	1.870669805	1.865128676	0.586218058	3.033481229	3.870225547	0.627268562	4.315529941	0.499644814	0.112112562	0.687056349	0.049841386	0.905744832	0.216087516	0.297641393	4.726886837	2.038750349	2.3830037	4.556866136	0.678685254	4.49632085	0.003656501	0	2.194444444	0	0	0.024	0.0144	0	0	0	0	0	0	0	0	0	0	0	0	48.2777
H3361_119_0	2009	5																					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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		886.7125965	141.8843707	567.1313756	1171.346628	736.9005469	14.82855433	4.213229971	1180.418878	255.741498	2536.116814	692.2748671	10.55454302	0.283372844	376.2697838	11198.47084	22015.19537	686.6607492	3918.962509	4413.206994	2206.717356	24.22477274	43.54014922	0	1145.454545	402	201	28.8	17.28	1664	11550											"$50 days 1 - 3, $0 after day 3, unlimited coverage"	"$50 days 1 - 3, $0 after day 3, unlimited coverage"	"$0 days 1 - 7, $85 days 8 - 100"	Copay between $0.00 and $15.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $15.00	Copay between $5.00 and $15.00	$15.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	Not Covered	"$0.00 copayment, No benefit limit"	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$10.00 copayment	"$10.00 copayment, $350 benefit limit"	$0.00 copayment	$0.00 copayment											22.13636721	7.813646807	56.13	2.752810703	22.87679052	0.2	0.2	20.76711147	18.44451713	0	8.027079905	13.12461252	0.2	2.25466766	0	3.327459655	10.60981822	6.722522721	13.12081724	2.88410401	0.2	0	0	0	0	0	10	10	0	0											21.67792198	7.651825805	54.96754499	2.695799861	22.40301109	0.19585799	0.19585799	20.33702359	18.06253029	0	7.860838693	12.85280117	0.19585799	2.207973384	0	3.258547805	10.39008837	6.583298952	12.84908449	2.824374077	0.19585799	0	0	0	0	0	10	10	0	0											1.6018	0.090472874	2.597818284	0.263143006	1.375732594	2.90429085	0.825194755	2.000517214	0.38494488	0	0.453488422	0.01130462	0.055500836	0.069232806	0	5.978130545	0.594538822	2.149975148	4.725472459	0.519382941	4.744615306	0	0	0	0	0	0.024	0.0144	0	0	0	0	0	0	0	0	0	0	0	0	31.384	0	0.6629	1.6018	0.090472874	2.597818284	0.263143006	1.375732594	2.90429085	0.825194755	2.000517214	0.38494488	0	0.453488422	0.01130462	0.055500836	0.069232806	0	5.978130545	0.594538822	2.149975148	4.725472459	0.519382941	4.744615306	0	0	0	0	0	0.024	0.0144	0	0	0	0	0	0	0	0	0	0	0	0	31.384	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	1.6018	0.090472874	2.597818284	0.263143006	1.375732594	2.90429085	0.825194755	2.000517214	0.38494488	0	0.453488422	0.01130462	0.055500836	0.069232806	0	5.978130545	0.594538822	2.149975148	4.725472459	0.519382941	4.744615306	0	0	0	0	0	0.024	0.0144	0	0	0	0	0	0	0	0	0	0	0	0	31.384
H3361_120_0	2009	5																																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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1408.0727	165.8413123	315.8943812	1354.930787	845.5272734	14.04739437	2.983332825	1280.323688	174.0181416	3678.636611	688.3488769	24.86161819	0.523662475	313.3826662	6778.177289	25373.25607	1605.304269	5762.232538	3893.678699	2757.754946	23.96774426	15.02641199	3750	1145.454545	0	0	0	0	1664	0.047079137											"$200 days 1 - 5, $0 after day 5, unlimited coverage"	"$200 days 1 - 5, $0 after day 5, unlimited coverage"	Medicare FFS Cost Sharing	Copay between $0.00 and $15.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $15.00	Copay between $5.00 and $15.00	$15.00 copayment	Copay between $0.00 and $75.00	Copay between $0.00 and $75.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"$0.00 copayment, No benefit limit"	Not Covered	Not Covered	Not Covered	Not Covered	$0.00 copayment	$0.00 copayment											94.94057703	40.33875653	35.63	2.341059444	27.07973954	0.2	0.2	20.58037078	102.8078297	0	20.23068771	52.49845009	0.2	7.531132693	2.070185323	3.41000749	10.63703319	6.736951061	19.22996648	5.880955279	0.2	0	0	0	0	0	0	0	0	0											94.94057703	40.33875653	35.63	2.341059444	27.07973954	0.2	0.2	20.58037078	102.8078297	0	20.23068771	52.49845009	0.2	7.531132693	2.070185323	3.41000749	10.63703319	6.736951061	19.22996648	5.880955279	0.2	0	0	0	0	0	0	0	0	0											11.1403	0.557486027	0.937943067	0.264331126	1.908054862	2.809478874	0.596666565	2.195794685	1.490868956	0	1.16048093	0.108766368	0.104732495	0.196677204	1.169340262	7.210249438	1.4229729	3.234989884	6.239609239	1.351519459	4.793548851	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.8938	0	0	11.1403	0.557486027	0.937943067	0.264331126	1.908054862	2.809478874	0.596666565	2.195794685	1.490868956	0	1.16048093	0.108766368	0.104732495	0.196677204	1.169340262	7.210249438	1.4229729	3.234989884	6.239609239	1.351519459	4.793548851	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.8938	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.1403	0.557486027	0.937943067	0.264331126	1.908054862	2.809478874	0.596666565	2.195794685	1.490868956	0	1.16048093	0.108766368	0.104732495	0.196677204	1.169340262	7.210249438	1.4229729	3.234989884	6.239609239	1.351519459	4.793548851	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.8938
H3361_124_0	2009	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	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		1197.02027	80.06944198	595.0723109	828.339556	455.2905394	16.19228174	3.645520508	1007.743793	274.1034976	7837.726975	959.4786642	8.126233267	0.152837458	464.5157119	5631.419522	15103.81866	436.4920887	2327.881513	3691.25105	1962.901435	21.88591141	35.1633611	0	671.25	0	0	0	0	1664	0											"$200 days 1 - 5, $0 after day 5, unlimited coverage"	"$200 days 1 - 5, $0 after day 5, unlimited coverage"	Medicare FFS Cost Sharing	Copay between $0.00 and $35.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 and $50.00	Copay between $35.00 and $150.00	$0.00 copayment	Copay between $0.00 and $75.00	$200.00 copayment	20% coinsurance	Copay between $25.00 and $35.00	Copay between $0.00 and $15.00	Copay between $0.00 and $35.00	Copay between $25.00 and $35.00	$35.00 copayment	Copay between $0.00 and $75.00	Copay between $0.00 and $75.00	20% coinsurance	$0.00 copayment	Not Covered	"Copay between $0.00 and $195.00, No benefit limit"	Not Covered	Not Covered	Not Covered	Not Covered	$0.00 copayment	Not Covered											107.8067295	65.0074526	35.63	6.8078883	40.08078766	0.2	0.2	20.15852888	93.30593457	0	11.29219789	52.49845009	0.2	3.645311559	7.127718109	8.364681284	27.51862163	15.12457396	22.36670491	12.66249489	0.2	0	0	20	0	0	0	0	0	0											107.8067295	65.0074526	35.63	6.8078883	40.08078766	0.2	0.2	20.15852888	93.30593457	0	11.29219789	52.49845009	0.2	3.645311559	7.127718109	8.364681284	27.51862163	15.12457396	22.36670491	12.66249489	0.2	0	0	20	0	0	0	0	0	0											10.7539	0.433759204	1.76686887	0.469936931	1.520700286	3.238456349	0.729104102	1.692886029	2.131290251	0	0.902885245	0.035551221	0.030567492	0.141108708	3.344930909	10.5282191	1.000971719	2.934018009	6.880093583	2.071269116	4.377182282	0	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1025	0	0	10.7539	0.433759204	1.76686887	0.469936931	1.520700286	3.238456349	0.729104102	1.692886029	2.131290251	0	0.902885245	0.035551221	0.030567492	0.141108708	3.344930909	10.5282191	1.000971719	2.934018009	6.880093583	2.071269116	4.377182282	0	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1025	0	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.7539	0.433759204	1.76686887	0.469936931	1.520700286	3.238456349	0.729104102	1.692886029	2.131290251	0	0.902885245	0.035551221	0.030567492	0.141108708	3.344930909	10.5282191	1.000971719	2.934018009	6.880093583	2.071269116	4.377182282	0	0	1.11875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1025
H3361_125_0	2009	7																					0											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	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		134.1148243	7.676452362	136.9548286	353.6054079	367.0807522	8.119234735	2.934126092	866.727782	130.2733266	2046.587549	454.0351512	14.04644393	0.20425367	231.3609101	8482.44563	16640.14737	839.097688	5201.085617	3001.277856	2273.673437	19.89742829	7.61888877	3750	671.25	476.4622259	201	40.2809668	20.41959757	1664	11683.34712											"$0 per admission, unlimited coverage"	"$0 per admission, unlimited coverage"	$0 days 1 - 100	Copay between $0.00 and $5.00	Copay between $0.00 and $100.00	20% coinsurance	20% coinsurance	Copay between $0.00 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	Copay between $0.00 and $5.00	$5.00 copayment	$5.00 copayment	Copay between $0.00 and $50.00	Copay between $0.00 and $50.00	20% coinsurance	$0.00 copayment	$0.00 copayment	"Copay between $0.00 and $195.00, No benefit limit"	$0.00 copayment	"$0.00 copayment, $120 benefit limit,"	$10.00 copayment	"$10.00 copayment, $500 benefit limit"	$0.00 copayment	$0.00 copayment											0	0	0	1.188388429	31.34291623	0.2	0.151535833	19.81766735	0	0	6.622599187	0	0.2	0.516945752	0	1.300212516	3.847649994	2.279459135	11.55163854	0.537176676	0.2	0	0	20	0	0	9.213853419	7.057533958	0	0											0	0	0	1.188388429	31.34291623	0.2	0.151535833	19.81766735	0	0	6.622599187	0	0.2	0.516945752	0	1.300212516	3.847649994	2.279459135	11.55163854	0.537176676	0.2	0	0	20	0	0	9.213853419	7.057533958	0	0											0	0	0	0.035018381	0.958781772	1.623846947	0.444625241	1.431376906	0	0	0.250574402	0	0.040850734	0.009966753	0	1.802977324	0.269046185	0.987971844	2.889139747	0.101780362	3.979485658	0	0	1.11875	0	0	0.030928577	0.012009334	0	0	0	0	0	0	0	0	0	0	0	0	15.9871	0	0	0	0	0	0.035018381	0.958781772	1.623846947	0.444625241	1.431376906	0	0	0.250574402	0	0.040850734	0.009966753	0	1.802977324	0.269046185	0.987971844	2.889139747	0.101780362	3.979485658	0	0	1.11875	0	0	0.030928577	0.012009334	0	0	0	0	0	0	0	0	0	0	0	0	15.9871	0	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	20% coinsurance	Not covered OON	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	Not covered OON	20% coinsurance											4.1203	0.1628	0.0564	0.0976	0.0958	0.1977	0.0716	0	0.2977	0.0527	0.2017	0.005	0	0.0955	0.1193	2.1346	0.1614	0.3336	0.8743	0.411	0.3903	0.0029	0	0	0	0	0	0	0	0											9.8824	0	0	4.1203	0.162840319	0.056435323	0.132652208	1.054541373	1.821546002	0.516227425	1.431376906	0.297722709	0.052676241	0.452270056	0.005034314	0.040850734	0.105435727	0.119329083	3.937617414	0.430451377	1.321588314	3.763422557	0.512775838	4.369767302	0.002912196	0	1.11875	0	0	0.030928577	0.012009334	0	2.72E-10	0	0	0	0	0	0	0	0	0	0	25.8695
H3361_801_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.3292	0.4184	0.1735	0.468	0.5837	0	0.5022	0.0189	0.0123	0.3416	1.1083	4.2583	0.3377	0.5573	1.7781	0.2048	0	0.0002	0	0	0	0	0	0	0	0											11.0926		260.3287279	9.445809555	1146.138161	2491.848912	8.207703551	10.43018495	4.325580098	11.66795333	14.55185595	5161.42335	12.52087707	0.471577269	0.307650317	8.516901486	28.83341014	120.0032603	8.419584405	13.89335442	44.32930479	5.106914211	23.98392805	0.004347464	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											757.76	757.76	70.95675	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.19970126	0.197823019	0.5	0.2	0.2	0.195689513	0.2	0.2	0	0	0	0	0	0	0	0											757.76	757.76	70.95675	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.19970126	0.197823019	0.5	0.2	0.2	0.195689513	0.2	0.2	0	0	0	0	0	0	0	0											16.4389	0.596471387	6.777186577	0	1.64154071	2.08603699	0.86511602	2.333590667	2.91037119	0	2.504175414	0.094315454	0.061530063	1.703380297	5.758068334	23.73940723	4.209792203	2.778670884	8.865860959	0.999369557	4.79678561	0.000869493	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.1614	135	0	16.4389	0.596471387	6.777186577	0	1.970760745	2.504403203	1.038619804	2.801605134	3.494062169	0	3.006401592	0.113230938	0.073870257	2.045002602	6.866374834	27.99773445	4.547511012	3.335948641	10.64395823	1.204213514	4.79678561	0.001043874	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2541		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			16.4389	0.596471387	6.777186577	0	1.970760745	2.504403203	1.038619804	2.801605134	3.494062169	0	3.006401592	0.113230938	0.073870257	2.045002602	6.866374834	27.99773445	4.547511012	3.335948641	10.64395823	1.204213514	4.79678561	0.001043874	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2541
H3361_802_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.3292	0.4184	0.1735	0.468	0.5837	0	0.5022	0.0189	0.0123	0.3416	1.1083	4.2583	0.3377	0.5573	1.7781	0.2048	0	0.0002	0	0	0	0	0	0	0	0											11.0926		260.3287279	9.445809555	1146.138161	2491.848912	8.207703551	10.43018495	4.325580098	11.66795333	14.55185595	5161.42335	12.52087707	0.471577269	0.307650317	8.516901486	28.83341014	120.0032603	8.419584405	13.89335442	44.32930479	5.106914211	23.98392805	0.004347464	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											757.76	757.76	70.95675	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.19970126	0.197823019	0.5	0.2	0.2	0.195689513	0.2	0.2	0	0	0	0	0	0	0	0											757.76	757.76	70.95675	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.19970126	0.197823019	0.5	0.2	0.2	0.195689513	0.2	0.2	0	0	0	0	0	0	0	0											16.4389	0.596471387	6.777186577	0	1.64154071	2.08603699	0.86511602	2.333590667	2.91037119	0	2.504175414	0.094315454	0.061530063	1.703380297	5.758068334	23.73940723	4.209792203	2.778670884	8.865860959	0.999369557	4.79678561	0.000869493	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.1614	135	0	16.4389	0.596471387	6.777186577	0	1.970760745	2.504403203	1.038619804	2.801605134	3.494062169	0	3.006401592	0.113230938	0.073870257	2.045002602	6.866374834	27.99773445	4.547511012	3.335948641	10.64395823	1.204213514	4.79678561	0.001043874	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2541		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			16.4389	0.596471387	6.777186577	0	1.970760745	2.504403203	1.038619804	2.801605134	3.494062169	0	3.006401592	0.113230938	0.073870257	2.045002602	6.866374834	27.99773445	4.547511012	3.335948641	10.64395823	1.204213514	4.79678561	0.001043874	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2541
H3361_803_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.3292	0.4184	0.1735	0.468	0.5837	0	0.5022	0.0189	0.0123	0.3416	1.1083	4.2583	0.3377	0.5573	1.7781	0.2048	0	0.0002	0	0	0	0	0	0	0	0											11.0926		260.3287279	9.445809555	1146.138161	2491.848912	8.207703551	10.43018495	4.325580098	11.66795333	14.55185595	5161.42335	12.52087707	0.471577269	0.307650317	8.516901486	28.83341014	120.0032603	8.419584405	13.89335442	44.32930479	5.106914211	23.98392805	0.004347464	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											757.76	757.76	70.95675	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.19970126	0.197823019	0.5	0.2	0.2	0.195689513	0.2	0.2	0	0	0	0	0	0	0	0											757.76	757.76	70.95675	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.19970126	0.197823019	0.5	0.2	0.2	0.195689513	0.2	0.2	0	0	0	0	0	0	0	0											16.4389	0.596471387	6.777186577	0	1.64154071	2.08603699	0.86511602	2.333590667	2.91037119	0	2.504175414	0.094315454	0.061530063	1.703380297	5.758068334	23.73940723	4.209792203	2.778670884	8.865860959	0.999369557	4.79678561	0.000869493	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.1614	135	0	16.4389	0.596471387	6.777186577	0	1.970760745	2.504403203	1.038619804	2.801605134	3.494062169	0	3.006401592	0.113230938	0.073870257	2.045002602	6.866374834	27.99773445	4.547511012	3.335948641	10.64395823	1.204213514	4.79678561	0.001043874	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2541		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			16.4389	0.596471387	6.777186577	0	1.970760745	2.504403203	1.038619804	2.801605134	3.494062169	0	3.006401592	0.113230938	0.073870257	2.045002602	6.866374834	27.99773445	4.547511012	3.335948641	10.64395823	1.204213514	4.79678561	0.001043874	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2541
H3361_804_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.3292	0.4184	0.1735	0.468	0.5837	0	0.5022	0.0189	0.0123	0.3416	1.1083	4.2583	0.3377	0.5573	1.7781	0.2048	0	0.0002	0	0	0	0	0	0	0	0											11.0926		260.3287279	9.445809555	1146.138161	2491.848912	8.207703551	10.43018495	4.325580098	11.66795333	14.55185595	5161.42335	12.52087707	0.471577269	0.307650317	8.516901486	28.83341014	120.0032603	8.419584405	13.89335442	44.32930479	5.106914211	23.98392805	0.004347464	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											757.76	757.76	70.95675	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.19970126	0.197823019	0.5	0.2	0.2	0.195689513	0.2	0.2	0	0	0	0	0	0	0	0											757.76	757.76	70.95675	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.19970126	0.197823019	0.5	0.2	0.2	0.195689513	0.2	0.2	0	0	0	0	0	0	0	0											16.4389	0.596471387	6.777186577	0	1.64154071	2.08603699	0.86511602	2.333590667	2.91037119	0	2.504175414	0.094315454	0.061530063	1.703380297	5.758068334	23.73940723	4.209792203	2.778670884	8.865860959	0.999369557	4.79678561	0.000869493	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.1614	135	0	16.4389	0.596471387	6.777186577	0	1.970760745	2.504403203	1.038619804	2.801605134	3.494062169	0	3.006401592	0.113230938	0.073870257	2.045002602	6.866374834	27.99773445	4.547511012	3.335948641	10.64395823	1.204213514	4.79678561	0.001043874	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2541		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			16.4389	0.596471387	6.777186577	0	1.970760745	2.504403203	1.038619804	2.801605134	3.494062169	0	3.006401592	0.113230938	0.073870257	2.045002602	6.866374834	27.99773445	4.547511012	3.335948641	10.64395823	1.204213514	4.79678561	0.001043874	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2541
H3362_003_0	2009	8																					3350											A	A	D	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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	191.5889346	3.949623435	92.75175469	1394.002419	355.079733	6.557662823	5.50586093	287.0131247	501.6880376	0	614.1771768	40.6446303	0	945.172793	6773.808112	3268.388521	1.642098874	810.6924081	1012.509579	1381.842301	19.43123957	634.4189969	0	0	451	451	24.15924552	0	0	0											PBP: 1A IP Acute: $375 per admit	1B IP Psych: $375 per admit	2 SNF: $375	6 Home Health: $10	10A Ambulance: $125	11A DME: 20%	"11B Prosthetic Medical Supplies: 0%, 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: $75	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 $20"	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: $0"	17A Routine Eye Exams: $5	17B Eye Wear: Medicare Covered: Various Cost Sharing	18A Routine Hearing Exams: $20	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											375	375	375	10	125	0.156012935	0.115556115	48.46196993	75	0	20	20	0	20	10	20	0.5005125	20	20	20	0.199988661	20	0	0	5	27.3471	20	0	0	0											375	375	375	10	125	0.156012935	0.115556115	48.46196993	75	0	20	20	0	20	10	20	0.5005125	20	20	20	0.199988661	20	0	0	5	27.3471	20	0	0	0											5.9872	0.123425732	2.898492334	1.161668683	3.698747218	1.023080224	0.636235898	1.159101785	3.135550235	0	1.023628628	0.06774105	0	1.575287988	5.644840093	5.447314202	0.821891013	1.351154013	1.687515966	2.303070502	3.88602758	1.057364995	0	0	0.187916667	1.027795175	0.040265409	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9453	0	0	5.9872	0.123425732	2.898492334	1.161668683	3.698747218	1.023080224	0.636235898	1.159101785	3.135550235	0	1.023628628	0.06774105	0	1.575287988	5.644840093	5.447314202	0.821891013	1.351154013	1.687515966	2.303070502	3.88602758	1.057364995	0	0	0.187916667	1.027795175	0.040265409	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9453	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	5.9872	0.123425732	2.898492334	1.161668683	3.698747218	1.023080224	0.636235898	1.159101785	3.135550235	0	1.023628628	0.06774105	0	1.575287988	5.644840093	5.447314202	0.821891013	1.351154013	1.687515966	2.303070502	3.88602758	1.057364995	0	0	0.187916667	1.027795175	0.040265409	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9453
H3362_004_0	2009	7																					3350											A	A	D	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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	172.7487045	3.557643028	83.5466061	1255.654639	320.825928	5.906847527	4.959431721	258.528505	455.5716577	0	553.2231583	36.61085366	0	851.369112	6101.541475	2944.017278	1.479128759	730.2352339	912.0230587	1244.701352	19.04406102	571.4560788	0	0	451	451	21.76156102	0	0	0											PBP: 1A IP Acute: $250 per admit	1B IP Psych: $250 per admit	2 SNF: $250	6 Home Health: $10	10A Ambulance: $100	11A DME: 20%	"11B Prosthetic Medical Supplies: 0%, 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: $35	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 $20"	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: $0"	17A Routine Eye Exams: $5	17B Eye Wear: Medicare Covered: Various Cost Sharing	18A Routine Hearing Exams: $20	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											250	250	250	10	100	0.156012935	0.115556115	48.46196993	35	0	20	20	0	20	10	20	0.5005125	20	20	20	0.199988661	20	0	0	5	27.3471	20	0	0	0											250	250	250	10	100	0.156012935	0.115556115	48.46196993	35	0	20	20	0	20	10	20	0.5005125	20	20	20	0.199988661	20	0	0	5	27.3471	20	0	0	0											3.5989	0.074117563	1.740554294	1.046378865	2.6735494	0.921544619	0.573092662	1.04406672	1.328750668	0	0.922038597	0.061018089	0	1.41894852	5.084617896	4.906695463	0.740322433	1.217058723	1.520038431	2.074502253	3.80859626	0.952426798	0	0	0.187916667	1.027795175	0.036269268	0	0	0	0	0	0	0	0	0	0	0	0	0	36.9592	0	0	3.5989	0.074117563	1.740554294	1.046378865	2.6735494	0.921544619	0.573092662	1.04406672	1.328750668	0	0.922038597	0.061018089	0	1.41894852	5.084617896	4.906695463	0.740322433	1.217058723	1.520038431	2.074502253	3.80859626	0.952426798	0	0	0.187916667	1.027795175	0.036269268	0	0	0	0	0	0	0	0	0	0	0	0	0	36.9592	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.5989	0.074117563	1.740554294	1.046378865	2.6735494	0.921544619	0.573092662	1.04406672	1.328750668	0	0.922038597	0.061018089	0	1.41894852	5.084617896	4.906695463	0.740322433	1.217058723	1.520038431	2.074502253	3.80859626	0.952426798	0	0	0.187916667	1.027795175	0.036269268	0	0	0	0	0	0	0	0	0	0	0	0	0	36.9592
H3362_016_0	2009	4																					3350											A	A	D	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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	180.0449533	3.707904349	87.07529724	1328.931055	336.0792108	6.156330319	5.168899269	269.7399656	474.8132732	0	576.5892021	38.15715698	0	887.3277079	6467.965573	3114.96208	1.541601536	761.0775951	963.2087613	1297.272807	19.18127097	595.5922119	0	0	451	451	22.68068666	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: $75	11A DME: 20%	"11B Prosthetic Medical Supplies: 0%, 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: $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 $20"	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: $0"	17A Routine Eye Exams: $5	17B Eye Wear: Medicare Covered: Various Cost Sharing	18A Routine Hearing Exams: $20	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											250	250	250	5	75	0.156012935	0.115556115	48.43113817	35	0	20	20	0	20	5	20	0.5005125	20	20	20	0.199988661	20	0	0	5	27.3471	20	0	0	0											250	250	250	5	75	0.156012935	0.115556115	48.43113817	35	0	20	20	0	20	5	20	0.5005125	20	20	20	0.199988661	20	0	0	5	27.3471	20	0	0	0											3.7509	0.077248007	1.814068692	0.553721273	2.100495067	0.960467162	0.597297918	1.088651129	1.384872047	0	0.960982003	0.063595262	0	1.478879513	2.694985655	5.191603466	0.771590839	1.268462659	1.605347935	2.162121344	3.836036693	0.992653686	0	0	0.187916667	1.027795175	0.037801144	0	0	0	0	0	0	0	0	0	0	0	0	0	34.6075	0	0	3.7509	0.077248007	1.814068692	0.553721273	2.100495067	0.960467162	0.597297918	1.088651129	1.384872047	0	0.960982003	0.063595262	0	1.478879513	2.694985655	5.191603466	0.771590839	1.268462659	1.605347935	2.162121344	3.836036693	0.992653686	0	0	0.187916667	1.027795175	0.037801144	0	0	0	0	0	0	0	0	0	0	0	0	0	34.6075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.7509	0.077248007	1.814068692	0.553721273	2.100495067	0.960467162	0.597297918	1.088651129	1.384872047	0	0.960982003	0.063595262	0	1.478879513	2.694985655	5.191603466	0.771590839	1.268462659	1.605347935	2.162121344	3.836036693	0.992653686	0	0	0.187916667	1.027795175	0.037801144	0	0	0	0	0	0	0	0	0	0	0	0	0	34.6075
H3362_017_0	2009	8																					3350											A	A	D	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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	135.5291133	2.796765194	65.67838262	941.3166852	252.2104612	4.643542211	3.853152047	202.6818776	355.2499789	0	434.9045876	28.62884371	0	668.1988842	4593.276436	2221.73355	1.162785529	593.1954176	697.8765148	952.8305419	18.21443869	434.2737954	0	0	451	451	16.53739419	0	0	0											PBP: 1A IP Acute: $500 per admit	1B IP Psych: $500 per admit	2 SNF: $500	6 Home Health: $25	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: $75	8A OP C/D/T: $0	8B OP X-Ray: $30	9A OP Hospital: $75	12 Renal Dialysis: $0	"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 $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: $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: $0"	17A Routine Eye Exams: $5	17B Eye Wear: Medicare Covered: Various Cost Sharing	18A Routine Hearing Exams: $30	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											500	500	500	25	100	0.156012935	0.16684898	49.02658517	75	0	30	30	0	15	20	30	0.5005125	15	30	28.57813422	0.199988661	30	0	0	5	27.3471	30	0	0	0											500	500	500	25	100	0.156012935	0.16684898	49.02658517	75	0	30	30	0	15	20	30	0.5005125	15	30	28.57813422	0.199988661	30	0	0	5	27.3471	30	0	0	0											5.647	0.116531883	2.736599276	1.961076427	2.101753843	0.724452649	0.642894488	0.828066695	2.220312368	0	1.087261469	0.071572109	0	0.835248605	7.655460727	5.554333876	0.581988692	0.741494272	1.744691287	2.269176593	3.642681201	1.085684489	0	0	0.187916667	1.027795175	0.041343485	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5054	0	0	5.647	0.116531883	2.736599276	1.961076427	2.101753843	0.724452649	0.642894488	0.828066695	2.220312368	0	1.087261469	0.071572109	0	0.835248605	7.655460727	5.554333876	0.581988692	0.741494272	1.744691287	2.269176593	3.642681201	1.085684489	0	0	0.187916667	1.027795175	0.041343485	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5054	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	5.647	0.116531883	2.736599276	1.961076427	2.101753843	0.724452649	0.642894488	0.828066695	2.220312368	0	1.087261469	0.071572109	0	0.835248605	7.655460727	5.554333876	0.581988692	0.741494272	1.744691287	2.269176593	3.642681201	1.085684489	0	0	0.187916667	1.027795175	0.041343485	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5054
H3362_018_0	2009	4																					3350											A	A	D	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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	178.33	3.68	86.42	1278.76	333.55	6.11	5.07	266.69	467.44	0	572.25	37.67	0	879.22	6043.86	2923.37	1.53	780.53	918.27	1253.74	20.52	571.42	0	0	449.96	449.96	21.76	0	0	0											PBP: 1A IP Acute: $500 per admit	1B IP Psych: $500 per admit	2 SNF: $500	6 Home Health: $15	10A Ambulance: $75	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $75	8A OP C/D/T: $0	8B OP X-Ray: $30	9A OP Hospital: $30	12 Renal Dialysis: $0	"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 $30"	7D Physician Specialist: $30	"7E Mental Health: 50%, 7H Psychiatric: 50%"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	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: $0"	17A Routine Eye Exams: $5	17B Eye Wear: Medicare Covered: Various Cost Sharing	18A Routine Hearing Exams: $30	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											500	500	500	15	75	0.156012935	0.16684898	49.02658517	75	0	30	30	0	15	20	30	0.5005125	15	30	28.57813422	0.199988661	30	0	0	5	27.3471	30	0	0	0											500	500	500	15	75	0.156012935	0.16684898	49.02658517	75	0	30	30	0	15	20	30	0.5005125	15	30	28.57813422	0.199988661	30	0	0	5	27.3471	30	0	0	0											7.4304	0.153333333	3.600833333	1.59845	2.0846875	0.953239033	0.845924328	1.089575	2.9215	0	1.430625	0.094175	0	1.099025	10.0731	7.308425	0.765784125	0.9756625	2.295675	2.985795833	4.10376732	1.42855	0	0	0.187483333	1.025425093	0.0544	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5059	0	0	7.4304	0.153333333	3.600833333	1.59845	2.0846875	0.953239033	0.845924328	1.089575	2.9215	0	1.430625	0.094175	0	1.099025	10.0731	7.308425	0.765784125	0.9756625	2.295675	2.985795833	4.10376732	1.42855	0	0	0.187483333	1.025425093	0.0544	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.4304	0.153333333	3.600833333	1.59845	2.0846875	0.953239033	0.845924328	1.089575	2.9215	0	1.430625	0.094175	0	1.099025	10.0731	7.308425	0.765784125	0.9756625	2.295675	2.985795833	4.10376732	1.42855	0	0	0.187483333	1.025425093	0.0544	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5059
H3362_020_0	2009	8																					3350											A	A	D	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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	328.1662378	15.2279621	0	0	1013.114949	12.75228419	10.81655741	259.5996239	186.9852047	0	344.695931	13.49876252	1.894563161	472.9404402	0	1550.926545	3.708731558	0	1703.643391	4696.003456	28.32723331	297.6544879	0	0	450	450	64.58696461	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%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $5"	9B ASC Services: $75	8A OP C/D/T: $0	8B OP X-Ray: $5	9A OP Hospital: $5	12 Renal Dialysis: $5	"3 CORF: $5, 5 Partial Hosp: $5, 9C OP Substance Abuse: $33.59, 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, 14J Nutrition therapy $25"	7D Physician Specialist: $5	"7E Mental Health: 50%, 7H Psychiatric: 50%"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	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: $0	"16A Preventive Dental Services: Not Covered, 16B Non Medicare Covered Comprehensive Dental: $5"	17A Routine Eye Exams: $5	17B Eye Wear: Medicare Covered: Various Cost Sharing	18A Routine Hearing Exams: $5	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											250	250	0	0	50	0.199999902	0.2000087	49.61585366	75	0	5	5	5	5.69918407	0	5	0.499978329	0	5	5	0.200001233	5	0	0	5	27.3471	5	0	0	0											250	250	0	0	50	0.199999902	0.2000087	49.61585366	75	0	5	5	5	5.69918407	0	5	0.499978329	0	5	5	0.200001233	5	0	0	5	27.3471	5	0	0	0											6.8368	0.317249211	0	0	4.221312288	2.550455582	2.163405582	1.073354746	1.168657529	0	0.143623305	0.005624484	0.000789401	0.224614552	0	0.646219394	1.854285408	0	0.709851413	1.956668107	5.665481586	0.124022703	0	0	0.1875	1.02551625	0.026911235	0	0	0	0	0	0	0	0	0	0	0	0	0	30.9023	0	0	6.8368	0.317249211	0	0	4.221312288	2.550455582	2.163405582	1.073354746	1.168657529	0	0.143623305	0.005624484	0.000789401	0.224614552	0	0.646219394	1.854285408	0	0.709851413	1.956668107	5.665481586	0.124022703	0	0	0.1875	1.02551625	0.026911235	0	0	0	0	0	0	0	0	0	0	0	0	0	30.9023	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.8368	0.317249211	0	0	4.221312288	2.550455582	2.163405582	1.073354746	1.168657529	0	0.143623305	0.005624484	0.000789401	0.224614552	0	0.646219394	1.854285408	0	0.709851413	1.956668107	5.665481586	0.124022703	0	0	0.1875	1.02551625	0.026911235	0	0	0	0	0	0	0	0	0	0	0	0	0	30.9023
H3362_801_0	2009	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	V	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	227.4202949	3.177529071	36.15672831	13.76600327	11.84172325	6.700441737	5.476797001	12.20684305	62.04076171	9.404301878	16.25276516	1.845335206	0.315779287	19.48950284	58.32048699	95.69099193	1.756522281	2.960430812	40.40001247	40.61711073	20.24934675	19.50253394	0	0	0	0	0	0	0	0											Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits	Standared Medicare Benefits											0.087263996	0.087008422	0.185348299	0	0.231061126	0.230999998	0.231084464	0.231073203	0.230999986	0.230946036	0.230998821	0.231000058	0.231000007	0.231084712	0.231001667	0.231000284	0.231008622	0.230975459	0.230995997	0.231012973	0.230987352	0.23098399	0	0	0	0	0	0	0	0											0.087263996	0.087008422	0.185348299	0	0.231061126	0.230999998	0.231084464	0.231073203	0.230999986	0.230946036	0.230998821	0.231000058	0.231000007	0.231084712	0.231001667	0.231000284	0.231008622	0.230975459	0.230995997	0.231012973	0.230987352	0.23098399	0	0	0	0	0	0	0	0											19.8456	0.27647179	6.701588086	0	2.736161908	1.547802028	1.265602699	2.820674325	14.33141507	2.17188624	3.754369588	0.42627254	0.072945017	4.503726161	13.47212974	22.10464635	0.405771792	0.683786866	9.332241177	9.383079518	4.677342983	4.504773112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0183	0	0	19.8456	0.27647179	6.701588086	0	2.736161908	1.547802028	1.265602699	2.820674325	14.33141507	2.17188624	3.754369588	0.42627254	0.072945017	4.503726161	13.47212974	22.10464635	0.405771792	0.683786866	9.332241177	9.383079518	4.677342983	4.504773112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0183	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.8456	0.27647179	6.701588086	0	2.736161908	1.547802028	1.265602699	2.820674325	14.33141507	2.17188624	3.754369588	0.42627254	0.072945017	4.503726161	13.47212974	22.10464635	0.405771792	0.683786866	9.332241177	9.383079518	4.677342983	4.504773112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0183
H3362_807_0	2009	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	V	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	211.3473766	2.948479497	33.60534086	12.79200577	11.00643589	6.226602665	5.091163356	11.34523633	57.65101527	8.735557269	15.09951146	1.712315733	0.293016596	18.12124511	54.20807026	88.92138012	1.639061584	2.747030588	37.54275136	37.77167058	18.82631629	3.699334525	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	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits											0.087262331	0.087120886	0.185323593	0	0.231025273	0.231000001	0.231173595	0.231050304	0.23099997	0.231050347	0.231065004	0.230999842	0.231000007	0.231001709	0.230994738	0.230996085	0.23099945	0.231024144	0.231004188	0.231020788	0.230987324	0.231013418	0	0	0	0	0	0	0	0											0.087262331	0.087120886	0.185323593	0	0.231025273	0.231000001	0.231173595	0.231050304	0.23099997	0.231050347	0.231065004	0.230999842	0.231000007	0.231001709	0.230994738	0.230996085	0.23099945	0.231024144	0.231004188	0.231020788	0.230987324	0.231013418	0	0	0	0	0	0	0	0											18.4427	0.256874145	6.227862521	0	2.542764856	1.438345222	1.176942536	2.621320308	13.3173828	2.01835354	3.488968679	0.395544665	0.067686836	4.186038593	12.52177901	20.54049072	0.378622325	0.63463039	8.672532798	8.726041105	4.348640415	0.854595912	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8581	0	0	18.4427	0.256874145	6.227862521	0	2.542764856	1.438345222	1.176942536	2.621320308	13.3173828	2.01835354	3.488968679	0.395544665	0.067686836	4.186038593	12.52177901	20.54049072	0.378622325	0.63463039	8.672532798	8.726041105	4.348640415	0.854595912	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8581	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	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits											2.8623	0.0344	1.4179	0	0.1293	0.2129	0.1498	0.3411	1.0367	0.2974	0.6296	0.0287	0.0049	0.6686	1.4435	1.926	0.031	0.1218	0.8983	0.8393	0.2519	0.1354	0	0	0	0	0	0	0	0											13.4607	0	0	21.3049	0.291265852	7.645771276	0	2.672042049	1.651276721	1.326765157	2.962414001	14.35407233	2.315723355	4.118539336	0.42421754	0.072622334	4.854686047	13.96526186	22.46647753	0.409645383	0.756385406	9.570809772	9.565386366	4.600572026	0.989977443	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.3188
H3362_817_0	2009	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	V	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	207.729	2.898	33.03	12.573	10.818	6.12	5.004	11.151	56.664	8.586	14.841	1.683	0.288	17.811	53.28	87.399	1.611	2.7	36.9	37.125	18.504	3.636	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	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits											0.087262331	0.087120886	0.185323593	0	0.231025273	0.231000001	0.231173595	0.231050304	0.23099997	0.231050347	0.231065004	0.230999842	0.231000007	0.231001709	0.230994738	0.230996085	0.23099945	0.231024144	0.231004188	0.231020788	0.230987324	0.231013418	0	0	0	0	0	0	0	0											0.087262331	0.087120886	0.185323593	0	0.231025273	0.231000001	0.231173595	0.231050304	0.23099997	0.231050347	0.231065004	0.230999842	0.231000007	0.231001709	0.230994738	0.230996085	0.23099945	0.231024144	0.231004188	0.231020788	0.230987324	0.231013418	0	0	0	0	0	0	0	0											18.1269	0.252476326	6.121238286	0	2.499231404	1.413720006	1.15679267	2.576441945	13.0893823	1.983798282	3.429235726	0.388772735	0.066528002	4.114371442	12.30739966	20.18882687	0.372140114	0.623765189	8.52405454	8.576646758	4.274189437	0.839964787	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.9259	0	0	18.1269	0.252476326	6.121238286	0	2.499231404	1.413720006	1.15679267	2.576441945	13.0893823	1.983798282	3.429235726	0.388772735	0.066528002	4.114371442	12.30739966	20.18882687	0.372140114	0.623765189	8.52405454	8.576646758	4.274189437	0.839964787	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.9259	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	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits											2.8133	0.0338	1.3936	0	0.1271	0.2093	0.1473	0.3353	1.0189	0.2923	0.6188	0.0282	0.0049	0.6572	1.4188	1.893	0.0305	0.1197	0.8829	0.825	0.2476	0.1331	0	0	0	0	0	0	0	0											13.2303	0	0	20.9402	0.28627923	7.514871708	0	2.626295304	1.623006007	1.30405025	2.911695937	14.10832317	2.276076971	4.048027807	0.416954716	0.071379002	4.771571305	13.72616934	22.08183979	0.402632042	0.743435695	9.406952547	9.401621992	4.521807848	0.973028516	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.1562
H3362_819_0	2009	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	V	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	207.729	2.898	33.03	12.573	10.818	6.12	5.004	11.151	56.664	8.586	14.841	1.683	0.288	17.811	53.28	87.399	1.611	2.7	36.9	37.125	18.504	3.636	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	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits											0.087262331	0.087120886	0.185323593	0	0.231025273	0.231000001	0.231173595	0.231050304	0.23099997	0.231050347	0.231065004	0.230999842	0.231000007	0.231001709	0.230994738	0.230996085	0.23099945	0.231024144	0.231004188	0.231020788	0.230987324	0.231013418	0	0	0	0	0	0	0	0											0.087262331	0.087120886	0.185323593	0	0.231025273	0.231000001	0.231173595	0.231050304	0.23099997	0.231050347	0.231065004	0.230999842	0.231000007	0.231001709	0.230994738	0.230996085	0.23099945	0.231024144	0.231004188	0.231020788	0.230987324	0.231013418	0	0	0	0	0	0	0	0											18.1269	0.252476326	6.121238286	0	2.499231404	1.413720006	1.15679267	2.576441945	13.0893823	1.983798282	3.429235726	0.388772735	0.066528002	4.114371442	12.30739966	20.18882687	0.372140114	0.623765189	8.52405454	8.576646758	4.274189437	0.839964787	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.9259	0	0	18.1269	0.252476326	6.121238286	0	2.499231404	1.413720006	1.15679267	2.576441945	13.0893823	1.983798282	3.429235726	0.388772735	0.066528002	4.114371442	12.30739966	20.18882687	0.372140114	0.623765189	8.52405454	8.576646758	4.274189437	0.839964787	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.9259	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	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits											2.8133	0.0338	1.3936	0	0.1271	0.2093	0.1473	0.3353	1.0189	0.2923	0.6188	0.0282	0.0049	0.6572	1.4188	1.893	0.0305	0.1197	0.8829	0.825	0.2476	0.1331	0	0	0	0	0	0	0	0											13.2303	0	0	20.9402	0.28627923	7.514871708	0	2.626295304	1.623006007	1.30405025	2.911695937	14.10832317	2.276076971	4.048027807	0.416954716	0.071379002	4.771571305	13.72616934	22.08183979	0.402632042	0.743435695	9.406952547	9.401621992	4.521807848	0.973028516	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.1562
H3366_022_0	2009	12																																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	V																																																			0									352.767047	17.1015753					37.33465629		3613.279076	1529.164508	2848.978855				940.2730472																										$25 ER / $10 UC	$20 OP Surg/ASC					$20 OP SA/$20 OP Therapy	$0 PCP	$5 Spec Copay	$5 Copay	$5 Copay		$0 Hearing / $0 Preventive		5		$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																								23.77765376	0.058131188					20		5	5	5				5																										23.77765376	0.058131188					20		5	5	5				5																			0	0	0	0	0	0	0	0.698997725	0.99413488	0	0	0	0	0.062224427	0	1.505532948	0.637151878	1.187074523	0	0	0	0.391780436	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.4769	0	0	0	0	0	0	0	0	0	0.698997725	0.99413488	0	0	0	0	0.062224427	0	1.505532948	0.637151878	1.187074523	0	0	0	0.391780436	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.4769																																																																																		0	0	0	0	0	0	0	0	0	0	0.698997725	0.99413488	0	0	0	0	0.062224427	0	1.505532948	0.637151878	1.187074523	0	0	0	0.391780436	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.4769
H3370_001_0	2009	11	h.6	h.7	i.7	i.8	i.9	i.10	i.11	i.12	i.13		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional			Urgent Care	Therapy (PT/OT/ST)	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemo-Radiation		D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V		V	V	V	V	V	V		V	V	V	V	V	Coin	V	V	Coin																																										0		2285.907458	84.52103293	1398.916558	2044.492439	266.4427708	9.178170743	1.866025026	199.2206646	219.5644934	477.3730349	222.4424009	25.70269098	0.221019207	0	5384.205569	4852.247689	442.3450917	902.1547629	1267.499786	0	52.98909218	0	0	2589.404459	1.358520671	306.3838279	186.5182769	24.17829515	0	0	3.225241146	160.2200563	309.0149341	1027.866444	109.2638768	4.080476768	1271.672385	31.6826428	22.56178534	0	$85/day (days 1-7)	$85/day (days 1-7)	$25/day (for days 1-100)	$0 copay	$75 copay	20% coinsurance	20% coinsurance	$50 copay	$100 copay	$0 copay	$45 copay Tier 2 - Radiology	$100 copay	10% coinsurance	$15 copay	$5 coapy	$15 copay	$25 copay	$15 copay	$15 copay Tier 1 - Radiology	$0 copay	20% coinsurance	$0 copay	n/c	$0 copay	$10 copay	$0 copay/1 pr glasses; $45/1 pr contact lenses; per 2 years	$0 copay	$1000/3yrs Hearing Aids	Silver Sneakers		$15 copay	$30 copay	$15 copay	$15 copay	$0 copay	10% coinsurance	$15 copay	$0 copay (1/yr)	20% coinsurance		85	85	25	0	75	0.2	0.2	50	100	0	45	100	0.1	15	5	15	25	15	15	0	0.2	0	0	0	10	0	0	0	0	0	15	30	15	15	0	0.1	15	0	0.2	0	53.70704694	62.32791482	24.16456591	0	72.49369772	0.193316527	0.193316527	48.32913181	96.65826362	0	43.49621863	96.65826362	0.096658264	0	4.832913181	14.49873954	24.16456591	14.49873954	14.49873954	0	0.193316527	0	0	0	9.665826362	0	0	0	0	0	14.49873954	28.99747909	14.49873954	14.49873954	0	0.096658264	14.49873954	0	0.193316527	0	10.2308	0.439001645	2.817017614	0	1.609618474	1.774292095	0.360733478	0.802346813	1.768560224	0	0.806283609	0.207031457	0.021363333	0	2.168449839	5.862622953	0.890756427	1.090008911	1.531429106	0	10.24366728	0	0	0	0.001094269	0	0	0	0	0	0.003896828	0.387164811	0.373360587	1.241897321	0	0.394411799	1.536470558	0	4.36156599	0	50.9238		1.7606	10.2308	0.439001645	2.817017614	0	1.609618474	1.774292095	0.360733478	0.802346813	1.768560224	0	0.806283609	0.207031457	0.021363333	0	2.168449839	5.862622953	0.890756427	1.090008911	1.531429106	0	10.24366728	0	0	0	0.001094269	0	0	0	0	0	0.003896828	0.387164811	0.373360587	1.241897321	0	0.394411799	1.536470558	0	4.36156599	0	50.9238	3400																																																																																	0			10.2308	0.439001645	2.817017614	0	1.609618474	1.774292095	0.360733478	0.802346813	1.768560224	0	0.806283609	0.207031457	0.021363333	0	2.168449839	5.862622953	0.890756427	1.090008911	1.531429106	0	10.24366728	0	0	0	0.001094269	0	0	0	0	0	0.003896828	0.387164811	0.373360587	1.241897321	0	0.394411799	1.536470558	0	4.36156599	0	50.9238
H3370_002_0	2009	13	h.6	h.7	i.7	i.8	i.9	i.10	i.11	i.12	i.13		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional			Urgent Care	Therapy (PT/OT/ST)	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemo/Radiation		D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V			V	V	V	V	V		V	V	V	V	V	Coin	V	V	Coin																																										0		2272.998237	46.42386588	1479.597589	2028.651134	301.5331792	9.304883531	0.973171885	221.7512512	300.124113	776.7696589	377.3982897	2.288927036	0.064725208	17.48740255	5012.227381	5033.534674	310.3116835	681.38575	1184.792933	0	54.54350811	0	0	0	435.9255242	306.3838279	186.5182769	24.17829515	0	0	34.97480511	472.2514261	292.2143067	998.1303017	242.3480785	4.010273693	1435.73555	27.39509125	18.26616715		$175/day (days 1-7)	$175/day (days 1-7)	$50/day (for days 1-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$300 copay	$0 copay	$75 copay Tier 2 - Radiology	$300 copay	10% coinsurance	$25 copay	$10 coapy	$25 copay	$25 copay	$25 copay	$25 copay Tier 1 - Radiology	$0 copay	20% coinsurance	$0 copay	n/c	n/c	$10 copay	$0 copay/1 pr glasses; $45/1 pr contact lenses; per 2 years	$0 copay	$1000/3yrs Hearing Aids	Silver Sneakers		$25 copay	$50 copay	$25 copay	$25 copay	$0 copay	10% coinsurance	$25 copay	$0 copay (1/yr)	20% coinsurance		175	175	50	0	100	0.2	0.2	50	300	0	75	300	0.1	25	10	25	25	25	25	0	0.2	0	0	0	10	0	0	0	0	0	25	50	25	25	0	0.1	25	0	0.2	0	111.3146585	84.62980074	46.63274735	0	93.2654947	0.186530989	0.186530989	46.63274735	279.7964841	0	69.94912102	279.7964841	0.093265495	23.31637367	9.32654947	23.31637367	23.31637367	23.31637367	23.31637367	0	0.186530989	0	0	0	9.32654947	0	0	0	0	0	23.31637367	46.63274735	23.31637367	23.31637367	0	0.093265495	23.31637367	0	0.186530989	0	21.0848	0.327403543	5.749808378	0	2.343553427	1.735649131	0.181526715	0.861739173	6.997805966	0	2.199889887	0.053369478	0.006036629	0.033978568	3.895565552	9.780314614	0.602945264	1.32395373	2.302089563	0	10.17405453	0	0	0	0.338806747	0	0	0	0	0	0.067957135	1.835198453	0.567781497	1.939398258	0	0.37402016	2.789678882	0	3.407206232	0	80.9746		5.847	21.0848	0.327403543	5.749808378	0	2.343553427	1.735649131	0.181526715	0.861739173	6.997805966	0	2.199889887	0.053369478	0.006036629	0.033978568	3.895565552	9.780314614	0.602945264	1.32395373	2.302089563	0	10.17405453	0	0	0	0.338806747	0	0	0	0	0	0.067957135	1.835198453	0.567781497	1.939398258	0	0.37402016	2.789678882	0	3.407206232	0	80.9746	4000																																																																																	0			21.0848	0.327403543	5.749808378	0	2.343553427	1.735649131	0.181526715	0.861739173	6.997805966	0	2.199889887	0.053369478	0.006036629	0.033978568	3.895565552	9.780314614	0.602945264	1.32395373	2.302089563	0	10.17405453	0	0	0	0.338806747	0	0	0	0	0	0.067957135	1.835198453	0.567781497	1.939398258	0	0.37402016	2.789678882	0	3.407206232	0	80.9746
H3370_003_0	2009	8	h.6	h.7	i.7	i.8	i.9	i.10	i.11	i.12	i.13		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional			Urgent Care	Therapy (PT/OT/ST)	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemo/Radiation		D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V			V	V	V	V	V		V	V	V	V	V	Coin	V	V	Coin																																										0		2728.353795	31.3208498	1560.97322	2255.711656	228.4652692	12.20946013	1.986614728	214.444406	305.8411097	552.2000138	116.4685621	2.489404381	0.105083062	65.7914015	5127.625488	5790.24733	405.4239417	919.2552289	1476.163589	0	55.87654966	0	0	0	435.7309253	306.3838279	186.5182769	24.17829515	0	0	0	68.28080588	401.9894248	1198.839569	179.9563385	4.486269003	1421.394268	35.81739685	36.67957627		$160/day (days 1-7)	$160/day (days 1-7)	$50/day (for days 1-100)	$0 copay	$75 copay	20% coinsurance	20% coinsurance	$50 copay	$200 copay	$0 copay	$90 copay Tier 2 - Radiology	$200 copay	10% coinsurance	$30 copay	$15 coapy	$30 copay	$25 copay	$30 copay	$30 copay Tier 1 - Radiology	$0 copay	20% coinsurance	$0 copay	n/c	n/c	$10 copay	$0 copay/1 pr glasses; $45/1 pr contact lenses; per 2 years	$0 copay	$1000/3yrs Hearing Aids	Silver Sneakers		$30 copay	$50 copay	$30 copay	$30 copay	$0 copay	10% coinsurance	$30 copay	$0 copay (1/yr)	20% coinsurance		160	160	50	0	75	0.2	0.2	50	200	0	90	200	0.1	30	15	30	25	30	30	0	0.2	0	0	0	10	0	0	0	0	0	30	50	30	30	0	0.1	30	0	0.2	0	96.83743472	58.9797603	46.69231024	0	70.03846536	0.186769241	0.186769241	46.69231024	186.769241	0	84.04615843	186.769241	0.09338462	28.01538614	14.00769307	28.01538614	23.34615512	28.01538614	28.01538614	0	0.186769241	0	0	0	9.338462048	0	0	0	0	0	0	46.69231024	28.01538614	28.01538614	0	0.09338462	28.01538614	0	0.186769241	0	22.0172	0.153941351	6.073787154	0	1.333446404	2.280351601	0.371038525	0.834408728	4.760142659	0	0.815727935	0.038745347	0.009813142	0.153597627	5.985517002	13.51800123	0.788757519	2.146107517	3.446274412	0	10.43602077	0	0	0	0.339088059	0	0	0	0	0	0	0.265682381	0.938490747	2.798829455	0	0.418948528	3.318409107	0	6.850616619	0	90.093		6.3822	22.0172	0.153941351	6.073787154	0	1.333446404	2.280351601	0.371038525	0.834408728	4.760142659	0	0.815727935	0.038745347	0.009813142	0.153597627	5.985517002	13.51800123	0.788757519	2.146107517	3.446274412	0	10.43602077	0	0	0	0.339088059	0	0	0	0	0	0	0.265682381	0.938490747	2.798829455	0	0.418948528	3.318409107	0	6.850616619	0	90.093	4000																																																																																	0			22.0172	0.153941351	6.073787154	0	1.333446404	2.280351601	0.371038525	0.834408728	4.760142659	0	0.815727935	0.038745347	0.009813142	0.153597627	5.985517002	13.51800123	0.788757519	2.146107517	3.446274412	0	10.43602077	0	0	0	0.339088059	0	0	0	0	0	0	0.265682381	0.938490747	2.798829455	0	0.418948528	3.318409107	0	6.850616619	0	90.093
H3370_004_0	2009	5	h.6	h.7	i.7	i.8	i.9	i.10	i.11	i.12	i.13		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional			Urgent Care	Therapy (PT/OT/ST)	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemo/Radiation		D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V			V	V	V	V	V		V	V	V	V	V	Coin	V	V	Coin																																										0		2443.581137	38.08158	1451.889682	2179.531916	163.072439	13.79539906	2.444927305	248.3956152	317.9556416	495.0925289	287.8797987	2.930466743	0.768137904	7.788872133	6570.150451	5313.867164	335.8868357	841.3930922	1354.237188	0	67.5311932	0	0	0	435.8879771	306.3838279	186.5182769	24.17829515	0	0	0.539822821	187.9354593	437.6631571	1244.067327	165.1416806	4.999774043	1292.478724	25.94006307	37.62418946		$150/day (days 1-7)	$150/day (days 1-7)	$50/day (for days 1-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$200 copay	$0 copay	$75 copay Tier 2 - Radiology	$200 copay	10% coinsurance	$25 copay	$10 coapy	$25 copay	$25 copay	$25 copay	$25 copay Tier 1 - Radiology	$0 copay	20% coinsurance	$0 copay	n/c	n/c	$10 copay	$0 copay/1 pr glasses; $45/1 pr contact lenses; per 2 years	$0 copay	$1000/3yrs Hearing Aids	Silver Sneakers		$25 copay	$50 copay	$25 copay	$25 copay	$0 copay	10% coinsurance	$25 copay	$0 copay (1/yr)	20% coinsurance		150	150	50	0	100	0.2	0.2	50	200	0	75	200	0.1	25	10	25	25	25	25	0	0.2	0	0	0	10	0	0	0	0	0	25	50	25	25	0	0.1	25	0	0.2	0	98.16746493	101.6335832	46.58205898	0	93.16411797	0.186328236	0.186328236	46.58205898	186.3282359	0	69.87308848	186.3282359	0.093164118	23.29102949	9.316411797	23.29102949	23.29102949	23.29102949	23.29102949	0	0.186328236	0	0	0	9.316411797	0	0	0	0	0	23.29102949	46.58205898	23.29102949	23.29102949	0	0.093164118	23.29102949	0	0.186328236	0	19.99	0.322530619	5.636000901	0	1.266041662	2.570472372	0.455558992	0.9642316	4.937009484	0	1.676254221	0.045502392	0.07156289	0.015117571	5.100852264	10.3137864	0.651929183	1.633075944	2.628464857	0	12.5829681	0	0	0	0.338409324	0	0	0	0	0	0.001047752	0.729535054	0.849468792	2.414634067	0	0.465799539	2.508596673	0	7.01044885	0	85.1793		6.25	19.99	0.322530619	5.636000901	0	1.266041662	2.570472372	0.455558992	0.9642316	4.937009484	0	1.676254221	0.045502392	0.07156289	0.015117571	5.100852264	10.3137864	0.651929183	1.633075944	2.628464857	0	12.5829681	0	0	0	0.338409324	0	0	0	0	0	0.001047752	0.729535054	0.849468792	2.414634067	0	0.465799539	2.508596673	0	7.01044885	0	85.1793	4000																																																																																	0			19.99	0.322530619	5.636000901	0	1.266041662	2.570472372	0.455558992	0.9642316	4.937009484	0	1.676254221	0.045502392	0.07156289	0.015117571	5.100852264	10.3137864	0.651929183	1.633075944	2.628464857	0	12.5829681	0	0	0	0.338409324	0	0	0	0	0	0.001047752	0.729535054	0.849468792	2.414634067	0	0.465799539	2.508596673	0	7.01044885	0	85.1793
H3370_009_0	2009	4	h.6	h.7	i.7	i.8	i.9	i.10	i.11	i.12	i.13		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional			Urgent Care	Therapy (PT/OT/ST)	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemo/Radiation		D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V			V	0	V	V	V		V	V	V	V	V	Coin	V	V	Coin																																										0		2633.014485	25.94102941	1782.599869	2460.602558	159.1888327	13.19190023	2.824148015	270.289501	331.2154131	525.1366982	315.7069991	1.107743857	0	6.092591211	6955.068388	5449.996355	191.3401304	691.0658202	1417.334837	0	63.50816077	0	0	0	436.292488	306.3838279	186.5182769	24.17829515	0	0	0	301.8602009	331.4516316	1415.168486	165.7258158	5.269009913	1431.957703	30.32890747	37.80871793		$150/day (days 1-7)	$150/day (days 1-7)	$50/day (for days 1-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$200 copay	$0 copay	$75 copay Tier 2 - Radiology	$200 copay	10% coinsurance	$25 copay	$10 coapy	$25 copay	$25 copay	$25 copay	$25 copay Tier 1 - Radiology	$0 copay	20% coinsurance	$0 copay	n/c	n/c	$10 copay	$0 copay/1 pr glasses; $45/1 pr contact lenses; per 2 years	$0 copay	$1000/3yrs Hearing Aids	Silver Sneakers		$25 copay	$50 copay	$25 copay	$25 copay	$0 copay	10% coinsurance	$25 copay	$0 copay (1/yr)	20% coinsurance		150	150	50	0	100	0.2	0.2	50	200	0	75	200	0.1	25	10	25	25	25	25	0	0.2	0	0	0	10	0	0	0	0	0	25	50	25	25	0	0.1	25	0	0.2	0	98.32257438	86.10840978	45.10440512	0	90.20881025	0.18041762	0.18041762	45.10440512	180.4176205	0	67.65660769	180.4176205	0	22.55220256	9.020881025	22.55220256	22.55220256	22.55220256	22.55220256	0	0.18041762	0	0	0	9.020881025	0	0	0	0	0	0	45.10440512	22.55220256	22.55220256	0	0.09020881	22.55220256	0	0.18041762	0	21.5737	0.186145066	6.700258888	0	1.196686267	2.380051249	0.509526065	1.015937263	4.979758059	0	1.779972049	0.016654709	0	0.011450113	5.228403704	10.24245181	0.359595115	1.298754697	2.663668528	0	11.45799125	0	0	0	0.327978552	0	0	0	0	0	0	1.134602066	0.622913695	2.659597196	0	0.475311115	2.691150014	0	6.821358923	0	86.3339		9.3706	21.5737	0.186145066	6.700258888	0	1.196686267	2.380051249	0.509526065	1.015937263	4.979758059	0	1.779972049	0.016654709	0	0.011450113	5.228403704	10.24245181	0.359595115	1.298754697	2.663668528	0	11.45799125	0	0	0	0.327978552	0	0	0	0	0	0	1.134602066	0.622913695	2.659597196	0	0.475311115	2.691150014	0	6.821358923	0	86.3339	4000																																																																																	0			21.5737	0.186145066	6.700258888	0	1.196686267	2.380051249	0.509526065	1.015937263	4.979758059	0	1.779972049	0.016654709	0	0.011450113	5.228403704	10.24245181	0.359595115	1.298754697	2.663668528	0	11.45799125	0	0	0	0.327978552	0	0	0	0	0	0	1.134602066	0.622913695	2.659597196	0	0.475311115	2.691150014	0	6.821358923	0	86.3339
H3370_010_0	2009	5	h.6.	h.7.	i.7.	i.8.	i.9.	i.10.	i.11.	i.12.	i.13.		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional			Urgent Care	Therapy (PT/OT/ST)	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemo/Radiation		D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V			V	V	V	V	V		V	V	V	V	V	Coin	V	V	Coin																																										0		2312.935511	20.89087904	1405.67275	1553.759274	275.9209819	9.267695627	1.435120374	264.6948534	325.7147302	637.7394014	350.5947555	1.346285905	0.191863115	18.21544026	5230.793241	5064.52172	282.5086234	768.080984	1169.04442	0	42.68084523	0	0	0	435.5759125	306.3838279	186.5182769	24.17829515	0	0	28.88884664	291.8230472	376.3705049	1036.402847	193.2574633	4.254239957	1315.957895	33.22506931	22.76604902		$200/day (days 1-7)	$200/day (days 1-7)	$50/day (for days 1-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$300 copay	$0 copay	$75 copay Tier 2 - Radiology	$300 copay	10% coinsurance	$25 copay	$10 coapy	$25 copay	$25 copay	$25 copay	$25 copay Tier 1 - Radiology	$0 copay	20% coinsurance	$0 copay	n/c	n/c	$10 copay	$0 copay/1 pr glasses; $45/1 pr contact lenses; per 2 years	$0 copay	$1000/3yrs Hearing Aids	Silver Sneakers		$25 copay	$50 copay	$25 copay	$25 copay	$0 copay	10% coinsurance	$25 copay	$0 copay (1/yr)	20% coinsurance		200	200	50	0	100	0.2	0.2	50	300	0	75	300	0.1	25	10	25	25	25	25	0	0.2	0	0	0	10	0	0	0	0	0	25	50	25	25	0	0.1	25	0	0.2	0	127.4150244	57.06990909	46.3044289	0	92.6088578	0.185217716	0.185217716	46.3044289	277.8265734	0	69.45664335	277.8265734	0.092608858	23.15221445	9.26088578	23.15221445	23.15221445	23.15221445	23.15221445	0	0.185217716	0	0	0	9.26088578	0	0	0	0	0	23.15221445	46.3044289	23.15221445	23.15221445	0	0.092608858	23.15221445	0	0.185217716	0	24.5586	0.099353381	5.424072825	0	2.129393914	1.716541413	0.265809717	1.021378668	7.541017284	0	2.029261241	0.0311695	0.017768224	0.035143982	4.036814896	9.771241079	0.545058353	1.481897971	2.25549726	0	7.905248653	0	0	0	0.336151565	0	0	0	0	0	0.055736731	1.126058295	0.726150887	1.999585081	0	0.393980303	2.53894495	0	4.216675593	0	82.2585		6.5651	24.5586	0.099353381	5.424072825	0	2.129393914	1.716541413	0.265809717	1.021378668	7.541017284	0	2.029261241	0.0311695	0.017768224	0.035143982	4.036814896	9.771241079	0.545058353	1.481897971	2.25549726	0	7.905248653	0	0	0	0.336151565	0	0	0	0	0	0.055736731	1.126058295	0.726150887	1.999585081	0	0.393980303	2.53894495	0	4.216675593	0	82.2585	4000																																																																																	0			24.5586	0.099353381	5.424072825	0	2.129393914	1.716541413	0.265809717	1.021378668	7.541017284	0	2.029261241	0.0311695	0.017768224	0.035143982	4.036814896	9.771241079	0.545058353	1.481897971	2.25549726	0	7.905248653	0	0	0	0.336151565	0	0	0	0	0	0.055736731	1.126058295	0.726150887	1.999585081	0	0.393980303	2.53894495	0	4.216675593	0	82.2585
H3370_014_0	2009	8	H.6	H.7	I.7	I.8	I.9	I.10	I.11	I.12	I.13		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional			Urgent Care	Therapy (PT/OT/ST)	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemo/Radiation		D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V		V	V	V	V	V	V		V	V	V	V	V	Coin	V	V	Coin																																										0		2173.675608	27.34574659	1201.222669	1794.445087	238.2462343	10.79007458	1.194867182	237.8195544	360.3192132	703.7158732	389.9504148	1.554505055	0.221537031	32.57520906	5439.927753	4915.401818	279.6559429	914.0117819	1182.56929	0	55.73330233	0	0	963.6620984	435.6326116	306.3838279	186.5182769	24.17829515	0	0	9.591809829	294.9343953	352.4860485	990.5664993	224.7159574	4.569991339	1284.634584	28.78803154	23.33210813		$75/day (days 1-7)	$75/day (days 1-7)	$25/day (for days 1-100)	$0 copay	$50 copay	20% coinsurance	20% coinsurance	$50 copay	$100 copay	$0 copay	$45 copay Tier 2 - Radiology	$100 copay	10% coinsurance	$15 copay	$5 coapy	$15 copay	$25 copay	$15 copay	$15 copay Tier 1 - Radiology	$0 copay	20% coinsurance	$0 copay	n/c	$0 copay	$10 copay	$0 copay/1 pr glasses; $45/1 pr contact lenses; per 2 years	$0 copay	$1000/3yrs Hearing Aids	Silver Sneakers		$15 copay	$30 copay	$15 copay	$15 copay	$0 copay	10% coinsurance	$15 copay	$0 copay (1/yr)	20% coinsurance		75	75	25	0	50	0.2	0.2	50	100	0	45	100	0.1	15	5	15	25	15	15	0	0.2	0	0	0	10	0	0	0	0	0	15	30	15	15	0	0.1	15	0	0.2	0	49.36970389	52.85132447	24.20151133	0	48.40302265	0.193612091	0.193612091	48.40302265	96.80604531	0	43.56272039	96.80604531	0.096806045	14.5209068	4.840302265	14.5209068	24.20151133	14.5209068	14.5209068	0	0.193612091	0	0	0	9.680604531	0	0	0	0	0	14.5209068	29.04181359	14.5209068	14.5209068	0	0.096806045	14.5209068	0	0.193612091	0	8.9428	0.120438244	2.422617003	0	0.960986489	2.089088898	0.231340733	0.95926544	2.906756506	0	1.415608407	0.012540457	0.021446124	0.039418465	2.194241219	5.948007639	0.564008039	1.106023325	1.430998203	0	10.79064118	0	0	0	0.351432253	0	0	0	0	0	0.011606815	0.713785811	0.426534755	1.198660318	0	0.442402789	1.554504922	0	4.517378234	0	51.3725		1.695	8.9428	0.120438244	2.422617003	0	0.960986489	2.089088898	0.231340733	0.95926544	2.906756506	0	1.415608407	0.012540457	0.021446124	0.039418465	2.194241219	5.948007639	0.564008039	1.106023325	1.430998203	0	10.79064118	0	0	0	0.351432253	0	0	0	0	0	0.011606815	0.713785811	0.426534755	1.198660318	0	0.442402789	1.554504922	0	4.517378234	0	51.3725	4000																																																																																	0			8.9428	0.120438244	2.422617003	0	0.960986489	2.089088898	0.231340733	0.95926544	2.906756506	0	1.415608407	0.012540457	0.021446124	0.039418465	2.194241219	5.948007639	0.564008039	1.106023325	1.430998203	0	10.79064118	0	0	0	0.351432253	0	0	0	0	0	0.011606815	0.713785811	0.426534755	1.198660318	0	0.442402789	1.554504922	0	4.517378234	0	51.3725
H3370_018_0	2009	7	6	7	8	7	8	9	10	11	12	13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Urgent Care	Therapy (PT/OT/ST)	Ambulatory Surgery	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemotherapy	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		V	V	V	V	V	V	Coin	V	V	Coin																																									0		2727.958191	62.53933324	1858.587096	2694.893963	303.1807193	14.77487714	2.590384169	291.7638824	269.0960672	594.8481306	405.8602682	29.8705796	5.860975116	122.2791547	6137.616146	5696.6528	723.1104322	932.0850676	2541.137011	0	812.0316744	0	0	2589.404459	435.7217302	306.7558685	186.5587309	24.17829515	0	0	13.04730782	290.7281259	51.95185881	425.0445451	1209.91489	161.4215428	5.848582882	1374.711045	34.25393096	23.65609322	$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% coinsurance	$0 copay	Max $40 coverage/1-way trip.  Limit 12 trips/yr max	$0 copay	$0 copay	$0 copay	$0 copay	$1000/3yrs Hearing Aids	Forever Fit		$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	0% coinsurance	$0 copay	$0 copay	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																		0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	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	2009	4	H.6	H.7	I.7	I.8	I.9	I.10	I.11	I.12	I.13		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional			Urgent Care	Therapy (PT/OT/ST)	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemo/Radiation		D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V		V	V	V	V	V	V		V	V	V	V	V	Coin	V	V	Coin																																										0		2415.580905	47.56940744	1192.167623	2206.597754	237.4283542	9.479419028	2.427578602	198.3401953	279.811872	553.3782787	261.3393654	12.40214295	0.095004185	48.93438203	5327.68198	5188.606565	357.1797524	877.1676957	1327.063984	0	45.33681917	0	0	2589.404459	435.559153	306.3838279	186.5182769	24.17829515	0	0	6.011664492	130.3056107	274.3196563	1090.257746	125.8551929	4.393711123	1353.949366	32.26619274	21.4684616		$75/day (days 1-7)	$75/day (days 1-7)	$25/day (for days 1-100)	$0 copay	$50 copay	20% coinsurance	20% coinsurance	$50 copay	$100 copay	$0 copay	$45 copay Tier 2 - Radiology	$100 copay	10% coinsurance	$15 copay	$5 coapy	$15 copay	$25 copay	$15 copay	$15 copay Tier 1 - Radiology	$0 copay	20% coinsurance	$0 copay	n/c	$0 copay	$10 copay	$0 copay/1 pr glasses; $45/1 pr contact lenses; per 2 years	$0 copay	$1000/3yrs Hearing Aids	Silver Sneakers		$15 copay	$30 copay	$15 copay	$15 copay	$0 copay	10% coinsurance	$15 copay	$0 copay (1/yr)	20% coinsurance		75	75	25	0	50	0.2	0.2	50	100	0	45	100	0.1	15	5	15	25	15	15	0	0.2	0	0	0	10	0	0	0	0	0	15	30	15	15	0	0.1	15	0	0.2	0	47.47202383	58.84735281	24.27368787	0	48.54737573	0.194189503	0.194189503	48.54737573	97.09475147	0	43.69263816	97.09475147	0.097094751	14.56421272	4.854737573	14.56421272	24.27368787	14.56421272	14.56421272	0	0.194189503	0	0	0	9.709475147	0	0	0	0	0	14.56421272	29.12842544	14.56421272	14.56421272	0	0.097094751	14.56421272	0	0.194189503	0	9.556	0.233277809	2.411525397	0	0.960543627	1.840803669	0.471410282	0.802407999	2.264022014	0	0.951550527	0.100348582	0.009224408	0.059390896	2.155374824	6.297330811	0.722505818	1.064604743	1.610636847	0	8.803934379	0	0	0	0.352420898	0	0	0	0	0	0.007296263	0.316299772	0.332937486	1.323228811	0	0.426606289	1.643267215	0	4.168949886	0	48.8859		1.4628	9.556	0.233277809	2.411525397	0	0.960543627	1.840803669	0.471410282	0.802407999	2.264022014	0	0.951550527	0.100348582	0.009224408	0.059390896	2.155374824	6.297330811	0.722505818	1.064604743	1.610636847	0	8.803934379	0	0	0	0.352420898	0	0	0	0	0	0.007296263	0.316299772	0.332937486	1.323228811	0	0.426606289	1.643267215	0	4.168949886	0	48.8859	4000																																																																																	0			9.556	0.233277809	2.411525397	0	0.960543627	1.840803669	0.471410282	0.802407999	2.264022014	0	0.951550527	0.100348582	0.009224408	0.059390896	2.155374824	6.297330811	0.722505818	1.064604743	1.610636847	0	8.803934379	0	0	0	0.352420898	0	0	0	0	0	0.007296263	0.316299772	0.332937486	1.323228811	0	0.426606289	1.643267215	0	4.168949886	0	48.8859
H3370_801_0	2009	4																																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	V																																																			0		307.7031131	3.684223351	27.87412543	13.81510481	7.164748024	7.03628752	5.220500749	9.83908778	39.97014726	8.820852528	23.8270055	0	0.199873677	23.44671029	58.45955077	158.448915	1.802649217	6.06647082	39.39635773	52.16822149	65.88335168	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.061735401	0.061735401	0.163372084	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.061735401	0.061735401	0.163372084	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			18.9962	0.227447005	4.553853948	0	1.655056794	1.625382417	1.205935673	2.272829277	9.233104018	2.037616934	5.504038271	0	0.046170819	5.416190077	13.50415623	36.60169936	0.416411969	1.40135476	9.100558637	12.05085916	15.21905424	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.0679			18.9962	0.227447005	4.553853948	0	1.655056794	1.625382417	1.205935673	2.272829277	9.233104018	2.037616934	5.504038271	0	0.046170819	5.416190077	13.50415623	36.60169936	0.416411969	1.40135476	9.100558637	12.05085916	15.21905424	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.0679																																																																																		0			18.9962	0.227447005	4.553853948	0	1.655056794	1.625382417	1.205935673	2.272829277	9.233104018	2.037616934	5.504038271	0	0.046170819	5.416190077	13.50415623	36.60169936	0.416411969	1.40135476	9.100558637	12.05085916	15.21905424	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.0679
H3370_803_0	2009	4																																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	V																																																			0		307.7031131	3.684223351	27.87412543	13.81510481	7.164748024	7.03628752	5.220500749	9.83908778	39.97014726	8.820852528	23.8270055	0	0.199873677	23.44671029	58.45955077	158.448915	1.802649217	6.06647082	39.39635773	52.16822149	65.88335168	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.061735401	0.061735401	0.163372084	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.061735401	0.061735401	0.163372084	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			18.9962	0.227447005	4.553853948	0	1.655056794	1.625382417	1.205935673	2.272829277	9.233104018	2.037616934	5.504038271	0	0.046170819	5.416190077	13.50415623	36.60169936	0.416411969	1.40135476	9.100558637	12.05085916	15.21905424	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.0679			18.9962	0.227447005	4.553853948	0	1.655056794	1.625382417	1.205935673	2.272829277	9.233104018	2.037616934	5.504038271	0	0.046170819	5.416190077	13.50415623	36.60169936	0.416411969	1.40135476	9.100558637	12.05085916	15.21905424	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.0679																																																																																		0			18.9962	0.227447005	4.553853948	0	1.655056794	1.625382417	1.205935673	2.272829277	9.233104018	2.037616934	5.504038271	0	0.046170819	5.416190077	13.50415623	36.60169936	0.416411969	1.40135476	9.100558637	12.05085916	15.21905424	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.0679
H3370_805_0	2009	4																																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	V																																																			0		307.7031131	3.684223351	27.87412543	13.81510481	7.164748024	7.03628752	5.220500749	9.83908778	39.97014726	8.820852528	23.8270055	0	0.199873677	23.44671029	58.45955077	158.448915	1.802649217	6.06647082	39.39635773	52.16822149	65.88335168	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.061735401	0.061735401	0.163372084	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.061735401	0.061735401	0.163372084	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			18.9962	0.227447005	4.553853948	0	1.655056794	1.625382417	1.205935673	2.272829277	9.233104018	2.037616934	5.504038271	0	0.046170819	5.416190077	13.50415623	36.60169936	0.416411969	1.40135476	9.100558637	12.05085916	15.21905424	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.0679			18.9962	0.227447005	4.553853948	0	1.655056794	1.625382417	1.205935673	2.272829277	9.233104018	2.037616934	5.504038271	0	0.046170819	5.416190077	13.50415623	36.60169936	0.416411969	1.40135476	9.100558637	12.05085916	15.21905424	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.0679																																																																																		0			18.9962	0.227447005	4.553853948	0	1.655056794	1.625382417	1.205935673	2.272829277	9.233104018	2.037616934	5.504038271	0	0.046170819	5.416190077	13.50415623	36.60169936	0.416411969	1.40135476	9.100558637	12.05085916	15.21905424	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.0679
H3379_001_0	2009	5																					2400											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2026.852315	184.1787883	1395.567733	1386.678102	167.2918622	6.156653381	4.135606201	181.0495323	24.3401298	16001.03194	62.75037901	0	0.026749336	17.17644075	7818.525558	7267.451729	1061.668835	2491.655637	0	0	17.64228236	2156.979145	0	0	147.9890135	0	18.41008798	0	98.4	0											"$200 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$200 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-24 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$21 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$5 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$21 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$21 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $21 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$21 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$21 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											197.6446294	200	100	0	150	0.2	0.071233402	49.64996162	0.2	2.8	0.160788499	0	0.2	0.199671171	3.596109478	21	37.5	21	0	0	0.2	19.53287875	0	0	21	0	21	0	0	0											117.1155847	118.4900375	59.24501877	0	88.86752816	0.118490038	0.042202242	29.41512908	0.118490038	1.658860526	0.095259176	0	0.118490038	0.119181366	3.596109478	21	37.5	12.44145394	0	0	0.118490038	19.53287875	0	0	21	0	21	0	0	0											19.7813	1.818612628	6.890036378	0	1.23890119	0.72950209	0.174531856	0.443799614	2.884062894	2.211956687	5.977549415	0	0.00316953	2.047111674	2.343022822	12.71804053	3.317715109	2.583318238	0	0	2.090434699	3.51100101	0	0	0.258980774	0	0.032217654	0	0	0	0	0	0	0	0	0	0	0	0	0	71.0553	0	33.5892	19.7813	1.818612628	6.890036378	0	1.23890119	0.72950209	0.174531856	0.443799614	2.884062894	2.211956687	5.977549415	0	0.00316953	2.047111674	2.343022822	12.71804053	3.317715109	2.583318238	0	0	2.090434699	3.51100101	0	0	0.258980774	0	0.032217654	0	0	0	0	0	0	0	0	0	0	0	0	0	71.0553																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.7813	1.818612628	6.890036378	0	1.23890119	0.72950209	0.174531856	0.443799614	2.884062894	2.211956687	5.977549415	0	0.00316953	2.047111674	2.343022822	12.71804053	3.317715109	2.583318238	0	0	2.090434699	3.51100101	0	0	0.258980774	0	0.032217654	0	0	0	0	0	0	0	0	0	0	0	0	0	71.0553
H3379_002_0	2009	6																																Coin	Coin	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin	T	V	V	P	V	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		639.3978595	42.45	10121.11148	9.305491951	32.61683831	19.67508532	38.09873464	5.807603727	10.7797095	33.07939137	62.58026932	0	0.830688728	7.814817493	0.900854334	265.646057	45.27	3.06775714	0	0	4.496703082	8.652136886	202.91976	0	51.62460062	53.49401512	0	0	0	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.060041328	0.060789069	0	0	0.2	0.2	0.2	0.107241302	0.2	0.08	0.148265923	0	0.2	0.2	0	0.199988474	0.2	0	0	0	0.2	0.017224881	0	0	0	0	0	0	0	0											0.060041328	0.060789069	0	0	0.2	0.2	0.2	0.107241302	0.2	0.08	0.148265923	0	0.2	0.2	0	0.199988474	0.2	0	0	0	0.2	0.017224881	0	0	0	0	0	0	0	0											38.3903	2.580495977	0	0	6.523367662	3.935017064	7.619746929	0.622814985	2.1559419	2.646351309	9.278521366	0	0.166137746	1.562963499	0	53.12614961	9.054	0	0	0	0.899340616	0.149032027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.7102	0	0	38.3903	2.580495977	0	0	6.523367662	3.935017064	7.619746929	0.622814985	2.1559419	2.646351309	9.278521366	0	0.166137746	1.562963499	0	53.12614961	9.054	0	0	0	0.899340616	0.149032027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.7102																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	38.3903	2.580495977	0	0	6.523367662	3.935017064	7.619746929	0.622814985	2.1559419	2.646351309	9.278521366	0	0.166137746	1.562963499	0	53.12614961	9.054	0	0	0	0.899340616	0.149032027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.7102
H3379_005_0	2009	5																					3250											D	D	D	V	T	Coin	Coin	V	V	O	O	V	Coin	Coin	V	V	Coin	V	V	V	Coin	O	T	V	P	P	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	2015.675387	183.1631478	1387.871977	1379.031367	166.3693435	6.08893977	4.090120966	180.0540595	154.1683863	15912.79542	4151.880692	0	0.026455135	16.98752662	7776.184275	7227.430549	8.747682014	2477.915585	0	0	17.44824469	2145.084642	0	0	147.9890135	292.8	18.41008798	0	98.4	0											"$0 (1a, 1a1); $0 n/c (1a2, 1a3); $950 (13c)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$0 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$0 (9b)	$0/$7 (8a1); $7 (8a2)	"$5 (8b1); $0 (8b2, 8b3)"	Included in h.5.	20% (12)	"$0 (3, 9a, 9d); $60 (5); 50%/50% (9c)"	"$4 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$10 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"50%/50% (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$4 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $10 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$10 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$10 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											0.032613758	0	0	0	0	0.2	0.071233402	49.64996728	0	2.8	1.251884624	0	0.2	0.002217107	2.876601453	10	0.5	0	0	0	0.2	9.301370835	0	0	10	0	10	0	0	0											0.032613758	0	0	0	0	0.195909868	0.069776632	48.63459279	0	2.742738158	1.22628276	0	0.195909868	0.002215923	2.876601453	10	0.5	0	0	0	0.195909868	9.301370835	0	0	10	0	10	0	0	0											0.0055	0	0	0	0	1.192883389	0.285394866	0.729737989	0	3.6370526	0.424281643	0	0.005182822	0.037643055	1.864081915	6.022858791	4.373841007	0	0	0	3.418283322	1.662685644	0	0	0.123324178	0	0.01534174	0	0	0	0	0	0	0	0	0	0	0	0	0	23.7981	0	0.2024	0.0055	0	0	0	0	1.192883389	0.285394866	0.729737989	0	3.6370526	0.424281643	0	0.005182822	0.037643055	1.864081915	6.022858791	4.373841007	0	0	0	3.418283322	1.662685644	0	0	0.123324178	0	0.01534174	0	0	0	0	0	0	0	0	0	0	0	0	0	23.7981																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.0055	0	0	0	0	1.192883389	0.285394866	0.729737989	0	3.6370526	0.424281643	0	0.005182822	0.037643055	1.864081915	6.022858791	4.373841007	0	0	0	3.418283322	1.662685644	0	0	0.123324178	0	0.01534174	0	0	0	0	0	0	0	0	0	0	0	0	0	23.7981
H3379_007_0	2009	5																					3250											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1734.507548	178.1527995	1233.716594	831.4396448	159.980805	10.45076988	4.36045647	402.3289443	36.23988606	11442.05912	43.54334855	0	0.206899883	23.38848725	5610.747079	4227.004614	709.6167646	299.2503401	0	0	16.56255394	877.2555076	0	0	139.3864903	0	18.56071364	0	139.7277862	0											"$250 Days 1-13 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$250 Days 1-13 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											247.0481518	250	85.36789939	0	150	0.2	0.064773281	47.83412242	0.2	2.8	0.166206097	0	0.2	0.197810482	7.067768505	29.96306319	37.5	30	0	0	0.2	28.81545378	0	0	30	0	30	0	0	0											167.9090251	169.8965461	58.01484503	0	101.9379277	0.135917237	0.044019027	32.50740875	0.135917237	1.902841317	0.112951367	0	0.135917237	0.134801259	7.067768505	29.96306319	37.5	20.38758554	0	0	0.135917237	28.81545378	0	0	30	0	30	0	0	0											24.27	2.522295443	5.964489752	0	1.359009311	1.420439766	0.19194305	1.089889287	4.92562518	1.81436857	4.918280755	0	0.02812126	3.152797516	3.304621791	10.55450053	2.217552389	0.508415992	0	0	2.251136567	2.106542961	0	0	0.348466226	0	0.046401784	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9949	0	25.6399	24.27	2.522295443	5.964489752	0	1.359009311	1.420439766	0.19194305	1.089889287	4.92562518	1.81436857	4.918280755	0	0.02812126	3.152797516	3.304621791	10.55450053	2.217552389	0.508415992	0	0	2.251136567	2.106542961	0	0	0.348466226	0	0.046401784	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9949																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.27	2.522295443	5.964489752	0	1.359009311	1.420439766	0.19194305	1.089889287	4.92562518	1.81436857	4.918280755	0	0.02812126	3.152797516	3.304621791	10.55450053	2.217552389	0.508415992	0	0	2.251136567	2.106542961	0	0	0.348466226	0	0.046401784	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9949
H3379_022_0	2009	6																																Coin	Coin	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		303.4922847	21.18	6897.579985	37.31331885	26.45564759	5.14340939	9.904572413	6.876100334	8.115423848	28.71251646	28.57597381	0	0.027995424	4.391036479	1.184052155	115.5110046	70.94	19.19927726	0	0	13.68771714	5.72494307	2068.176582	0	62.80040951	110.980046	0	0	0	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.086031355	0.08727546	0	0	0.2	0.2	0.2	0.123782796	0.2	0.08	0.150758323	0	0.2	0.2	0	0.199448773	0.2	0	0	0	0.2	0.040626599	0	0	0	0	0	0	0	0											0.086031355	0.08727546	0	0	0.2	0.2	0.2	0.123782796	0.2	0.08	0.150758323	0	0.2	0.2	0	0.199448773	0.2	0	0	0	0.2	0.040626599	0	0	0	0	0	0	0	0											26.1099	1.84849424	0	0	5.291129519	1.028681878	1.980914483	0.851142928	1.62308477	2.297001317	4.308065876	0	0.005599085	0.878207296	0	23.03852808	14.188	0	0	0	2.737543428	0.232584967	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4188	0	0	26.1099	1.84849424	0	0	5.291129519	1.028681878	1.980914483	0.851142928	1.62308477	2.297001317	4.308065876	0	0.005599085	0.878207296	0	23.03852808	14.188	0	0	0	2.737543428	0.232584967	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4188																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	26.1099	1.84849424	0	0	5.291129519	1.028681878	1.980914483	0.851142928	1.62308477	2.297001317	4.308065876	0	0.005599085	0.878207296	0	23.03852808	14.188	0	0	0	2.737543428	0.232584967	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4188
H3379_036_0	2009	5																					3350											Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		493.013436	23.23	63.88212057	6201.488093	21.11726014	46.38555921	15.77368205	36.41218203	56.68659724	10.52716382	25.46824804	0	4.245363794	60.28270061	65.94277055	177.108345	12.88	7.236924816	0	0	30.62738834	8.833691481	832.7304653	0	327.7093149	349.7142857	0	0	20.2	0											"6% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"6% (1b); $0 n/c (1b1, 1b2)"	16% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.0596752	0.0604	0.1595	0	0.2	0.2	0.2	0.092039713	0.2	0.08	0.2	0	0.2	0.2	0	0.199669384	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											0.0596752	0.0604	0.1595	0	0.131032974	0.131032974	0.131032974	0.060301186	0.131032974	0.05241319	0.131032974	0	0.131032974	0.131032974	0	0.130816366	0.131032974	0.131032974	0	0	0.131032974	0.009741829	0	0	0	0	0	0	0	0											29.4207	1.403092	10.18919823	0	2.767057399	6.078037775	2.066872471	2.195697776	7.427813424	0.551762233	3.337180283	0	0.556282644	7.899021543	0	23.16867013	1.687704706	0.948275781	0	0	4.013197781	0.086056314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.7966	0	33.0451	29.4207	1.403092	10.18919823	0	2.767057399	6.078037775	2.066872471	2.195697776	7.427813424	0.551762233	3.337180283	0	0.556282644	7.899021543	0	23.16867013	1.687704706	0.948275781	0	0	4.013197781	0.086056314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.7966																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	29.4207	1.403092	10.18919823	0	2.767057399	6.078037775	2.066872471	2.195697776	7.427813424	0.551762233	3.337180283	0	0.556282644	7.899021543	0	23.16867013	1.687704706	0.948275781	0	0	4.013197781	0.086056314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.7966
H3384_013_0	2009	8	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									V																																																		0		239.7777491	0.860446468	8.592992062		314.8569333	14.43179363	0.60077067	277.7139448	329.3503733		554.6440919	0.143676977		2.224754576	4965.988406	3995.354711	0.808415418	487.1919351	1146.198811	1380.681144	6.528911808	0									20.95843133										$250 Copay	$250 Copay	$250 Copay		$100 Copay	25% Coinsurance	25% Coinsurance	$50 Copay	$100 Copay		$75 Copay	50% Coinsurance		50% Coinsurance	$10 Copay	$25 Copay	50% Coinsurance	$25 Copay	$25 Copay	$25 Copay	20% Coinsurance	$0 Copay for blood and $25 Copay for other									$25 Copay										250	250	250		100	0.25	0.25	50	100		75	0.5		0.5	10	25	0.5	25	25	25	0.2	25									25										250	250	250		100	0.25	0.25	50	100		75	0.5		0.5	10	25	0.5	25	25	25	0.2	25									25										4.9954	0.017925968	0.179020668	0	2.623807777	3.607948406	0.150192668	1.157141437	2.744586444	0	3.466525574	0.071838489	0	1.112377288	4.138323672	8.323655647	0.404207709	1.014983198	2.387914189	2.87641905	1.305782362	0	0	0	0	0	0	0	0	0	0.043663399	0	0	0	0	0	0	0	0	0	40.6217	0		4.9954	0.017925968	0.179020668	0	2.623807777	3.607948406	0.150192668	1.157141437	2.744586444	0	3.466525574	0.071838489	0	1.112377288	4.138323672	8.323655647	0.404207709	1.014983198	2.387914189	2.87641905	1.305782362	0	0	0	0	0	0	0	0	0	0.043663399	0	0	0	0	0	0	0	0	0	40.6217																																																																																		0	0		4.9954	0.017925968	0.179020668	0	2.623807777	3.607948406	0.150192668	1.157141437	2.744586444	0	3.466525574	0.071838489	0	1.112377288	4.138323672	8.323655647	0.404207709	1.014983198	2.387914189	2.87641905	1.305782362	0	0	0	0	0	0	0	0	0	0.043663399	0	0	0	0	0	0	0	0	0	40.6217
H3384_015_0	2009	5	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									V																																																		0		257.813905	1.544131902	11.50860349		296.5114701	12.11065631	0.304273312	258.3300718	334.8296042		533.4203045	0.152796026		1.81809298	4831.465066	4216.525713	0.233113299	491.9876305	1147.833612	1580.466995	6.447559715	0									18.35929132										$500 Copay	$500 Copay	$500 Copay		$100 Copay	25% Coinsurance	25% Coinsurance	$50 Copay	$100 Copay		$75 Copay	50% Coinsurance		50% Coinsurance	$15 Copay	$25 Copay	50% Coinsurance	$25 Copay	$25 Copay	$25 Copay	20% Coinsurance	$0 Copay for blood and $25 Copay for other									$25 Copay										500	500	500		100	0.25	0.25	50	100		75	0.5		0.5	15	25	0.5	25	25	25	0.2	25									25										500	500	500		100	0.25	0.25	50	100		75	0.5		0.5	15	25	0.5	25	25	25	0.2	25									25										10.7422	0.064338829	0.479525145	0	2.470928918	3.027664078	0.076068328	1.076375299	2.790246702	0	3.333876903	0.076398013	0	0.90904649	6.039331332	8.784428569	0.116556649	1.02497423	2.391320024	3.292639573	1.289511943	0	0	0	0	0	0	0	0	0	0.038248524	0	0	0	0	0	0	0	0	0	48.0237	0		10.7422	0.064338829	0.479525145	0	2.470928918	3.027664078	0.076068328	1.076375299	2.790246702	0	3.333876903	0.076398013	0	0.90904649	6.039331332	8.784428569	0.116556649	1.02497423	2.391320024	3.292639573	1.289511943	0	0	0	0	0	0	0	0	0	0.038248524	0	0	0	0	0	0	0	0	0	48.0237																																																																																		0	0		10.7422	0.064338829	0.479525145	0	2.470928918	3.027664078	0.076068328	1.076375299	2.790246702	0	3.333876903	0.076398013	0	0.90904649	6.039331332	8.784428569	0.116556649	1.02497423	2.391320024	3.292639573	1.289511943	0	0	0	0	0	0	0	0	0	0.038248524	0	0	0	0	0	0	0	0	0	48.0237
H3384_019_0	2009	7	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V																																																											0		181.6193156	1.448936827	10.49042207		234.8531144	13.70436256	1.386370138	279.9474063	300.8078346		493.2896988	0		3.107026578	3810.344909	2860.258955	1.048715596	218.1140208	766.2654663	1202.772514	4.721350113	11.3140059									41.45244655										$550 Copay	$550 Copay	$550 Copay		$75 Copay	25% Coinsurance	25% Coinsurance	$50 Copay	$125 Copay		$35 Copay	50% Coinsurance		50% Coinsurance	$20 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	"$0 Copay for Blood, $35 Copay for other"									$35 Copay										550	550	550		75	0.25	0.25	50	125		35	0.5		0.5	20	35	0.5	35	35	35	0.2	35									35										550	550	550		75	0.25	0.25	50	125		35	0.5		0.5	20	35	0.5	35	35	35	0.2	35									35										8.3242	0.066409605	0.480811012	0	1.467831965	3.426090639	0.346592534	1.166447526	3.133414943	0	1.438761622	0	0	1.553513289	6.350574848	8.342421953	0.524357798	0.636165894	2.234940943	3.508086498	0.944270023	0.032999184	0	0	0	0	0	0	0	0	0.120902969	0	0	0	0	0	0	0	0	0	44.0988			8.3242	0.066409605	0.480811012	0	1.467831965	3.426090639	0.346592534	1.166447526	3.133414943	0	1.438761622	0	0	1.553513289	6.350574848	8.342421953	0.524357798	0.636165894	2.234940943	3.508086498	0.944270023	0.032999184	0	0	0	0	0	0	0	0	0.120902969	0	0	0	0	0	0	0	0	0	44.0988																																																																																		0			8.3242	0.066409605	0.480811012	0	1.467831965	3.426090639	0.346592534	1.166447526	3.133414943	0	1.438761622	0	0	1.553513289	6.350574848	8.342421953	0.524357798	0.636165894	2.234940943	3.508086498	0.944270023	0.032999184	0	0	0	0	0	0	0	0	0.120902969	0	0	0	0	0	0	0	0	0	44.0988
H3384_022_0	2009	8	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									V																																																		0		201.7218294	1.801388038	10.11637361		229.2684657	13.58903093	0.506453124	256.4407491	354.008607		482.5850128	0.026210665		1.959000536	5568.96387	3370.328184	0.514159978	330.7571445	783.2627921	1578.011181	4.723667706	13.66966535									23.6469426										$350 Copay	$350 Copay	$350 Copay		$50 Copay	25% Coinsurance	25% Coinsurance	$50 Copay	$75 Copay		$30 Copay	50% Coinsurance		50% Coinsurance	$5 Copay	$30 Copay	50% Coinsurance	$30 Copay	$30 Copay	$30 Copay	20% Coinsurance	"$0 Copay for Blood, $30 Copay for other"									$30 Copay										350	350	350		50	0.25	0.25	50	75		30	0.5		0.5	5	30	0.5	30	30	30	0.2	30									30										350	350	350		50	0.25	0.25	50	75		30	0.5		0.5	5	30	0.5	30	30	30	0.2	30									30										5.8836	0.052540484	0.295060897	0	0.955285274	3.397257733	0.126613281	1.068503121	2.212553793	0	1.206462532	0.013105333	0	0.979500268	2.320401612	8.425820459	0.257079989	0.826892861	1.95815698	3.945027953	0.944733541	0.034174163	0	0	0	0	0	0	0	0	0.059117356	0	0	0	0	0	0	0	0	0	34.9618			5.8836	0.052540484	0.295060897	0	0.955285274	3.397257733	0.126613281	1.068503121	2.212553793	0	1.206462532	0.013105333	0	0.979500268	2.320401612	8.425820459	0.257079989	0.826892861	1.95815698	3.945027953	0.944733541	0.034174163	0	0	0	0	0	0	0	0	0.059117356	0	0	0	0	0	0	0	0	0	34.9618																																																																																		0			5.8836	0.052540484	0.295060897	0	0.955285274	3.397257733	0.126613281	1.068503121	2.212553793	0	1.206462532	0.013105333	0	0.979500268	2.320401612	8.425820459	0.257079989	0.826892861	1.95815698	3.945027953	0.944733541	0.034174163	0	0	0	0	0	0	0	0	0.059117356	0	0	0	0	0	0	0	0	0	34.9618
H3384_040_0	2009	5	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									V																																																		0		248.7029091	1.402341964	10.33808736		297.4002548	13.19352996	0.4450975	265.7192991	332.6051598		543.9924561	0.15132386		1.989851484	4998.443018	4227.822625	0.620122268	530.4929214	1187.794048	1523.245197	6.473008453	0									19.64810869										$400 Copay	$400 Copay	$400 Copay		$100 Copay	25% Coinsurance	25% Coinsurance	$50 Copay	$125 Copay		$75 Copay	50% Coinsurance		50% Coinsurance	$10 Copay	$25 Copay	50% Coinsurance	$25 Copay	$25 Copay	$25 Copay	20% Coinsurance	$0 Copay for blood and $25 Copay for other									$25 Copay										400	400	400		100	0.25	0.25	50	125		75	0.5		0.5	10	25	0.5	25	25	25	0.2	25									25										400	400	400		100	0.25	0.25	50	125		75	0.5		0.5	10	25	0.5	25	25	25	0.2	25									25										8.2901	0.046744732	0.344602912	0	2.478335457	3.29838249	0.111274375	1.107163746	3.464637081	0	3.39995285	0.07566193	0	0.994925742	4.165369182	8.807963801	0.310061134	1.105193586	2.474570934	3.173427494	1.294601691	0	0	0	0	0	0	0	0	0	0.04093356	0	0	0	0	0	0	0	0	0	44.9839	0		8.2901	0.046744732	0.344602912	0	2.478335457	3.29838249	0.111274375	1.107163746	3.464637081	0	3.39995285	0.07566193	0	0.994925742	4.165369182	8.807963801	0.310061134	1.105193586	2.474570934	3.173427494	1.294601691	0	0	0	0	0	0	0	0	0	0.04093356	0	0	0	0	0	0	0	0	0	44.9839																																																																																		0	0		8.2901	0.046744732	0.344602912	0	2.478335457	3.29838249	0.111274375	1.107163746	3.464637081	0	3.39995285	0.07566193	0	0.994925742	4.165369182	8.807963801	0.310061134	1.105193586	2.474570934	3.173427494	1.294601691	0	0	0	0	0	0	0	0	0	0.04093356	0	0	0	0	0	0	0	0	0	44.9839
H3384_041_0	2009	7	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									V																																																		0		195.9556362	0.519060655	4.671465182		156.2985832	15.06637361	2.086946411	254.316147	427.6049456		610.5196188	0.045622535		2.434457017	5525.151627	4151.15217	1.277226014	550.4022252	970.9632139	1633.740062	4.729730864	27.69840805									23.86783287										$350 Copay	$350 Copay	$350 Copay		$50 Copay	25% Coinsurance	25% Coinsurance	$50 Copay	$50 Copay		$25 Copay	50% Coinsurance		50% Coinsurance	$5 Copay	$25 Copay	50% Coinsurance	$25 Copay	$25 Copay	$25 Copay	20% Coinsurance	"$0 Copay for Blood, $25 Copay for other"									$25 Copay										350	350	350		50	0.25	0.25	50	50		25	0.5		0.5	5	25	0.5	25	25	25	0.2	25									25										350	350	350		50	0.25	0.25	50	50		25	0.5		0.5	5	25	0.5	25	25	25	0.2	25									25										5.7154	0.015139269	0.136251068	0	0.651244097	3.766593404	0.521736603	1.059650612	1.781687273	0	1.271915872	0.022811268	0	1.217228508	2.302146511	8.648233687	0.638613007	1.146671302	2.022840029	3.403625129	0.945946173	0.057705017	0	0	0	0	0	0	0	0	0.049724652	0	0	0	0	0	0	0	0	0	35.3751			5.7154	0.015139269	0.136251068	0	0.651244097	3.766593404	0.521736603	1.059650612	1.781687273	0	1.271915872	0.022811268	0	1.217228508	2.302146511	8.648233687	0.638613007	1.146671302	2.022840029	3.403625129	0.945946173	0.057705017	0	0	0	0	0	0	0	0	0.049724652	0	0	0	0	0	0	0	0	0	35.3751																																																																																		0			5.7154	0.015139269	0.136251068	0	0.651244097	3.766593404	0.521736603	1.059650612	1.781687273	0	1.271915872	0.022811268	0	1.217228508	2.302146511	8.648233687	0.638613007	1.146671302	2.022840029	3.403625129	0.945946173	0.057705017	0	0	0	0	0	0	0	0	0.049724652	0	0	0	0	0	0	0	0	0	35.3751
H3384_044_0	2009	4																																							V						V		V		V		V		V																																																											0									389.0155064						987.485893		9433.531048		940.796051		2378.147338		18.72242614																										$50 Copay						$20 Copay		$10 Copay		$10 Copay		$10 Copay		$10 Copay																										50						20		10		10		10		10																										50						20		10		10		10		10																			0	0	0	0	0	0	0	1.620897943	0	0	0	0	0	1.645809822	0	7.861275873	0	0.783996709	0	1.981789448	0	0.015602022	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.9094			0	0	0	0	0	0	0	1.620897943	0	0	0	0	0	1.645809822	0	7.861275873	0	0.783996709	0	1.981789448	0	0.015602022	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.9094																																																																																		0			0	0	0	0	0	0	0	1.620897943	0	0	0	0	0	1.645809822	0	7.861275873	0	0.783996709	0	1.981789448	0	0.015602022	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.9094
H3384_045_0	2009	4																																							V						V		V		V		V		V																																																											0									389.0155064						987.485893		9433.531048		940.796051		2378.147338		18.72242614																										$50 Copay						$20 Copay		$10 Copay		$10 Copay		$10 Copay		$10 Copay																										50						20		10		10		10		10																										50						20		10		10		10		10																			0	0	0	0	0	0	0	1.620897943	0	0	0	0	0	1.645809822	0	7.861275873	0	0.783996709	0	1.981789448	0	0.015602022	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.9094			0	0	0	0	0	0	0	1.620897943	0	0	0	0	0	1.645809822	0	7.861275873	0	0.783996709	0	1.981789448	0	0.015602022	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.9094																																																																																		0			0	0	0	0	0	0	0	1.620897943	0	0	0	0	0	1.645809822	0	7.861275873	0	0.783996709	0	1.981789448	0	0.015602022	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.9094
H3384_051_0	2009	8	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V																																																											0		200.2958439	1.57861047	10.30044199		223.1554848	13.85846704	1.217823383	262.3084409	359.5113708		545.3974772	0.025010267	0	2.271309395	5294.604632	3602.848584	0.837155966	437.7714228	845.7426585	1612.423972	4.722443843	80.99166977									30.5436041										$100 Copay	$100 Copay	$100 Copay		$50 Copay	25% Coinsurance	25% Coinsurance	$50 Copay	$75 Copay		$15 Copay	50% Coinsurance	0% Coinsurance	50% Coinsurance	$5 Copay	$15 Copay	50% Coinsurance	$15 Copay	$15 Copay	$15 Copay	20% Coinsurance	"$0 Copay for Blood, $15 Copay for other"									$15 Copay										100	100	100		50	0.25	0.25	50	75		15	0.5	0	0.5	5	15	0.5	15	15	15	0.2	15									15										100	100	100		50	0.25	0.25	50	75		15	0.5	0	0.5	5	15	0.5	15	15	15	0.2	15									15										1.6691	0.013155087	0.085837017	0	0.92981452	3.46461676	0.304455846	1.092951837	2.246946068	0	0.681746847	0.012505133	0	1.135654698	2.206085263	4.50356073	0.418577983	0.547214279	1.057178323	2.015529965	0.944488769	0.101239587	0	0	0	0	0	0	0	0	0.038179505	0	0	0	0	0	0	0	0	0	23.4689			1.6691	0.013155087	0.085837017	0	0.92981452	3.46461676	0.304455846	1.092951837	2.246946068	0	0.681746847	0.012505133	0	1.135654698	2.206085263	4.50356073	0.418577983	0.547214279	1.057178323	2.015529965	0.944488769	0.101239587	0	0	0	0	0	0	0	0	0.038179505	0	0	0	0	0	0	0	0	0	23.4689																																																																																		0			1.6691	0.013155087	0.085837017	0	0.92981452	3.46461676	0.304455846	1.092951837	2.246946068	0	0.681746847	0.012505133	0	1.135654698	2.206085263	4.50356073	0.418577983	0.547214279	1.057178323	2.015529965	0.944488769	0.101239587	0	0	0	0	0	0	0	0	0.038179505	0	0	0	0	0	0	0	0	0	23.4689
H3384_052_0	2009	8	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V																																																											0		199.5279361	1.57861047	10.29972629		223.1554848	13.85846704	1.217823383	262.3084409	359.5113708		531.8634817	0.025010267		2.271309395	5109.238961	3534.16755	0.837155966	417.9108729	838.9378825	1582.302055	4.722443843	79.01246296									30.21944623										$350 Copay	$350 Copay	$350 Copay		$50 Copay	25% Coinsurance	25% Coinsurance	$50 Copay	$75 Copay		$25 Copay	50% Coinsurance		50% Coinsurance	$10 Copay	$25 Copay	50% Coinsurance	$25 Copay	$25 Copay	$25 Copay	20% Coinsurance	"$0 Copay for Blood, $25 Copay for other"									$25 Copay										350	350	350		50	0.25	0.25	50	75		25	0.5		0.5	10	25	0.5	25	25	25	0.2	25									25										350	350	350		50	0.25	0.25	50	75		25	0.5		0.5	10	25	0.5	25	25	25	0.2	25									25										5.8196	0.046042805	0.300408683	0	0.92981452	3.46461676	0.304455846	1.092951837	2.246946068	0	1.10804892	0.012505133	0	1.135654698	4.257699134	7.362849063	0.418577983	0.870647652	1.747787255	3.296462615	0.944488769	0.164609298	0	0	0	0	0	0	0	0	0.06295718	0	0	0	0	0	0	0	0	0	35.5871			5.8196	0.046042805	0.300408683	0	0.92981452	3.46461676	0.304455846	1.092951837	2.246946068	0	1.10804892	0.012505133	0	1.135654698	4.257699134	7.362849063	0.418577983	0.870647652	1.747787255	3.296462615	0.944488769	0.164609298	0	0	0	0	0	0	0	0	0.06295718	0	0	0	0	0	0	0	0	0	35.5871																																																																																		0			5.8196	0.046042805	0.300408683	0	0.92981452	3.46461676	0.304455846	1.092951837	2.246946068	0	1.10804892	0.012505133	0	1.135654698	4.257699134	7.362849063	0.418577983	0.870647652	1.747787255	3.296462615	0.944488769	0.164609298	0	0	0	0	0	0	0	0	0.06295718	0	0	0	0	0	0	0	0	0	35.5871
H3384_053_0	2009	4	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									V																																																		0		974.3882026	5.441165003	10.33798696		297.4002548	13.19352996	0.4450975	265.7192991	337.9795602		543.9924561	0.15132386		1.989851484	4868.527526	4192.759091	0.620122268	518.5794849	1185.266138	1513.611804	6.473008453	0									19.59195086										$300 Copay per day for 5 days	$300 Copay per day for 5 days	$500 Copay		$100 Copay	25% Coinsurance	25% Coinsurance	$50 Copay	$100 Copay		$75 Copay	50% Coinsurance		50% Coinsurance	$15 Copay	$30 Copay	50% Coinsurance	$30 Copay	$30 Copay	$30 Copay	20% Coinsurance	$0 Copay for blood and $30 Copay for other									$30 Copay										300	300	500		100	0.25	0.25	50	100		75	0.5		0.5	15	30	0.5	30	30	30	0.2	30									30										300	300	500		100	0.25	0.25	50	100		75	0.5		0.5	15	30	0.5	30	30	30	0.2	30									30										24.3597	0.136029125	0.430749457	0	2.478335457	3.29838249	0.111274375	1.107163746	2.816496335	0	3.39995285	0.07566193	0	0.994925742	6.085659407	10.48189773	0.310061134	1.296448712	2.963165345	3.78402951	1.294601691	0	0	0	0	0	0	0	0	0	0.048979877	0	0	0	0	0	0	0	0	0	65.4735	0		24.3597	0.136029125	0.430749457	0	2.478335457	3.29838249	0.111274375	1.107163746	2.816496335	0	3.39995285	0.07566193	0	0.994925742	6.085659407	10.48189773	0.310061134	1.296448712	2.963165345	3.78402951	1.294601691	0	0	0	0	0	0	0	0	0	0.048979877	0	0	0	0	0	0	0	0	0	65.4735																																																																																		0	0		24.3597	0.136029125	0.430749457	0	2.478335457	3.29838249	0.111274375	1.107163746	2.816496335	0	3.39995285	0.07566193	0	0.994925742	6.085659407	10.48189773	0.310061134	1.296448712	2.963165345	3.78402951	1.294601691	0	0	0	0	0	0	0	0	0	0.048979877	0	0	0	0	0	0	0	0	0	65.4735
H3384_054_0	2009	10	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									V																																																		0		200.2958439	1.57861047	10.30044199		223.1554848	13.85846704	1.217823383	262.3084409	386.9703479		545.3974772	0.025010267		2.271309395	5294.604632	3602.848584	0.837155966	437.7714228	845.7426585	1612.423972	4.722443843	80.99166977									30.5436041										$100 Copay	$100 Copay	$100 Copay		$50 Copay	25% Coinsurance	25% 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	"$0 Copay for Blood, $15 Copay for other"									$15 Copay										100	100	100		50	0.25	0.25	50	50		15	0.5		0.5	5	15	0.5	15	15	15	0.2	15									15										100	100	100		50	0.25	0.25	50	50		15	0.5		0.5	5	15	0.5	15	15	15	0.2	15									15										1.6691	0.013155087	0.085837017	0	0.92981452	3.46461676	0.304455846	1.092951837	1.612376449	0	0.681746847	0.012505133	0	1.135654698	2.206085263	4.50356073	0.418577983	0.547214279	1.057178323	2.015529965	0.944488769	0.101239587	0	0	0	0	0	0	0	0	0.038179505	0	0	0	0	0	0	0	0	0	22.8343			1.6691	0.013155087	0.085837017	0	0.92981452	3.46461676	0.304455846	1.092951837	1.612376449	0	0.681746847	0.012505133	0	1.135654698	2.206085263	4.50356073	0.418577983	0.547214279	1.057178323	2.015529965	0.944488769	0.101239587	0	0	0	0	0	0	0	0	0.038179505	0	0	0	0	0	0	0	0	0	22.8343																																																																																		0			1.6691	0.013155087	0.085837017	0	0.92981452	3.46461676	0.304455846	1.092951837	1.612376449	0	0.681746847	0.012505133	0	1.135654698	2.206085263	4.50356073	0.418577983	0.547214279	1.057178323	2.015529965	0.944488769	0.101239587	0	0	0	0	0	0	0	0	0.038179505	0	0	0	0	0	0	0	0	0	22.8343
H3384_801_0	2009	6	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded	V	T	Coin	Coin	V	Coin		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									Coin																																																		0		507.5040478	3.694563638	31.2355001	0.996600638	132.7274283	10.39976356	1.353782614	237.99729	13.96803613		817.1465435	0.063719479		7.501776333	4537.323176	4743.361318	0.578847894	2664.410455	1137.006684	1824.971306	0.130757155	8.843332389									2.339381122										$550 Copay	$550 Copay	$550 Copay	$20 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	20% Coinsurance		$35 Copay	50% Coinsurance		50% Coinsurance	$20 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	"$0 Copay for Blood, $35 Copay for other"									50% Coinsurance										550	550	550	20	100	0.3	0.3	50	0.2		35	0.5		0.5	20	35	0.5	35	35	35	0.2	35									0.5										550	550	550	20	100	0.3	0.3	50	0.2		35	0.5		0.5	20	35	0.5	35	35	35	0.2	35									0.5										23.2606	0.169334167	1.431627088	0.001661001	1.106061903	3.119929068	0.406134784	0.991655375	2.793607227	0	2.383344085	0.03185974	0	3.750888167	7.562205294	13.83480384	0.289423947	7.77119716	3.316269495	5.322832977	0.026151431	0.025793053	0	0	0	0	0	0	0	0	1.169690561	0	0	0	0	0	0	0	0	0	78.7651			23.2606	0.169334167	1.431627088	0.001661001	1.106061903	3.119929068	0.406134784	0.991655375	2.793607227	0	2.383344085	0.03185974	0	3.750888167	7.562205294	13.83480384	0.289423947	7.77119716	3.316269495	5.322832977	0.026151431	0.025793053	0	0	0	0	0	0	0	0	1.169690561	0	0	0	0	0	0	0	0	0	78.7651																																																																																		0			23.2606	0.169334167	1.431627088	0.001661001	1.106061903	3.119929068	0.406134784	0.991655375	2.793607227	0	2.383344085	0.03185974	0	3.750888167	7.562205294	13.83480384	0.289423947	7.77119716	3.316269495	5.322832977	0.026151431	0.025793053	0	0	0	0	0	0	0	0	1.169690561	0	0	0	0	0	0	0	0	0	78.7651
H3384_802_0	2009	7	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded	V	T	Coin	Coin	V	Coin		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									Coin																																																		0		507.5040478	3.694563638	31.2355001	0.996600638	132.7274283	10.39976356	1.353782614	237.99729	13.96803613		817.1465435	0.063719479		7.501776333	4537.323176	4743.361318	0.578847894	2664.410455	1137.006684	1824.971306	0.130757155	8.843332389									2.339381122										$550 Copay	$550 Copay	$550 Copay	$20 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	20% Coinsurance		$35 Copay	50% Coinsurance		50% Coinsurance	$20 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	"$0 Copay for Blood, $35 Copay for other"									50% Coinsurance										550	550	550	20	100	0.3	0.3	50	0.2		35	0.5		0.5	20	35	0.5	35	35	35	0.2	35									0.5										550	550	550	20	100	0.3	0.3	50	0.2		35	0.5		0.5	20	35	0.5	35	35	35	0.2	35									0.5										23.2606	0.169334167	1.431627088	0.001661001	1.106061903	3.119929068	0.406134784	0.991655375	2.793607227	0	2.383344085	0.03185974	0	3.750888167	7.562205294	13.83480384	0.289423947	7.77119716	3.316269495	5.322832977	0.026151431	0.025793053	0	0	0	0	0	0	0	0	1.169690561	0	0	0	0	0	0	0	0	0	78.7651			23.2606	0.169334167	1.431627088	0.001661001	1.106061903	3.119929068	0.406134784	0.991655375	2.793607227	0	2.383344085	0.03185974	0	3.750888167	7.562205294	13.83480384	0.289423947	7.77119716	3.316269495	5.322832977	0.026151431	0.025793053	0	0	0	0	0	0	0	0	1.169690561	0	0	0	0	0	0	0	0	0	78.7651																																																																																		0			23.2606	0.169334167	1.431627088	0.001661001	1.106061903	3.119929068	0.406134784	0.991655375	2.793607227	0	2.383344085	0.03185974	0	3.750888167	7.562205294	13.83480384	0.289423947	7.77119716	3.316269495	5.322832977	0.026151431	0.025793053	0	0	0	0	0	0	0	0	1.169690561	0	0	0	0	0	0	0	0	0	78.7651
H3384_803_0	2009	7	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded	V	T	Coin	Coin	V	Coin		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									Coin																																																		0		582.5598612	4.738021075	36.55680915	1.24741676	158.7913142	10.8414675	0.158599008	246.6258029	12.52388413		843.6462549	0.07207362		8.759242994	4863.040261	4506.706628	0.634753987	696.0357105	1189.261295	1635.6051	0.013572295	5.461079391									2.988397963										$550 Copay	$550 Copay	$550 Copay	$20 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	20% Coinsurance		$35 Copay	50% Coinsurance		50% Coinsurance	$20 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	"$0 Copay for Blood, $35 Copay for other"									50% Coinsurance										550	550	550	20	100	0.3	0.3	50	0.2		35	0.5		0.5	20	35	0.5	35	35	35	0.2	35									0.5										550	550	550	20	100	0.3	0.3	50	0.2		35	0.5		0.5	20	35	0.5	35	35	35	0.2	35									0.5										26.7007	0.217159299	1.675520419	0.002079028	1.323260952	3.25244025	0.047579702	1.027607512	2.504776825	0	2.46063491	0.03603681	0	4.379621497	8.105067101	13.144561	0.317376994	2.030104156	3.468678778	4.770514874	0.002714459	0.015928148	0	0	0	0	0	0	0	0	1.494198981	0	0	0	0	0	0	0	0	0	76.9765			26.7007	0.217159299	1.675520419	0.002079028	1.323260952	3.25244025	0.047579702	1.027607512	2.504776825	0	2.46063491	0.03603681	0	4.379621497	8.105067101	13.144561	0.317376994	2.030104156	3.468678778	4.770514874	0.002714459	0.015928148	0	0	0	0	0	0	0	0	1.494198981	0	0	0	0	0	0	0	0	0	76.9765																																																																																		0			26.7007	0.217159299	1.675520419	0.002079028	1.323260952	3.25244025	0.047579702	1.027607512	2.504776825	0	2.46063491	0.03603681	0	4.379621497	8.105067101	13.144561	0.317376994	2.030104156	3.468678778	4.770514874	0.002714459	0.015928148	0	0	0	0	0	0	0	0	1.494198981	0	0	0	0	0	0	0	0	0	76.9765
H3384_804_0	2009	7	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded	V	T	Coin	Coin	V	Coin		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									Coin																																																		0		516.2349494	3.758123469	31.77286346	1.020910352	136.5281854	10.8512294	1.412551893	243.8026706	14.82737432		837.0788992	0.067639614		7.963298824	4667.253091	4879.191302	0.603976355	2740.708001	1169.565789	1877.230834	0.130757155	9.059044551									2.440936379										$550 Copay	$550 Copay	$550 Copay	$20 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	20% Coinsurance		$35 Copay	50% Coinsurance		50% Coinsurance	$20 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	"$0 Copay for Blood, $35 Copay for other"									50% Coinsurance										550	550	550	20	100	0.3	0.3	50	0.2		35	0.5		0.5	20	35	0.5	35	35	35	0.2	35									0.5										550	550	550	20	100	0.3	0.3	50	0.2		35	0.5		0.5	20	35	0.5	35	35	35	0.2	35									0.5										23.6608	0.172247326	1.456256242	0.001701517	1.137734879	3.255368819	0.423765568	1.015844461	2.965474863	0	2.441480123	0.033819807	0	3.981649412	7.778755152	14.23097463	0.301988178	7.993731668	3.411233551	5.4752566	0.026151431	0.026422213	0	0	0	0	0	0	0	0	1.220468189	0	0	0	0	0	0	0	0	0	81.0111			23.6608	0.172247326	1.456256242	0.001701517	1.137734879	3.255368819	0.423765568	1.015844461	2.965474863	0	2.441480123	0.033819807	0	3.981649412	7.778755152	14.23097463	0.301988178	7.993731668	3.411233551	5.4752566	0.026151431	0.026422213	0	0	0	0	0	0	0	0	1.220468189	0	0	0	0	0	0	0	0	0	81.0111																																																																																		0			23.6608	0.172247326	1.456256242	0.001701517	1.137734879	3.255368819	0.423765568	1.015844461	2.965474863	0	2.441480123	0.033819807	0	3.981649412	7.778755152	14.23097463	0.301988178	7.993731668	3.411233551	5.4752566	0.026151431	0.026422213	0	0	0	0	0	0	0	0	1.220468189	0	0	0	0	0	0	0	0	0	81.0111
H3387_005_0	2009	6																																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																																																			0		572.5610552	28.44592366	22.59756984		21.58009645	6.399089459	5.239074091	314.2879333	17.71558896	15.99089549	49.1973632	1.175364848	5.667809778	24.59492497	65.33603339	125.7510988	14.41312595	16.55848943			15.88488545	5.920240443																			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 (14a)	$0 (13c)											0.059303579	0.059796	0.157905		0.22869	0.22869	0.22869	53.24875839	0.22869	0.22869	0.22869	0.22869	0.22869	0.22869	0.22663203	0.228848914	0.22869	0.22869			0.22869	0.22869																			0.059303579	0.059796	0.157905		0.22869	0.22869	0.22869	53.24875839	0.22869	0.22869	0.22869	0.22869	0.22869	0.22869	0.22663203	0.228848914	0.22869	0.22869			0.22869	0.22869																			33.9549	1.700952451	3.568269266	0	4.935152257	1.463407768	1.198123854	1.394620185	4.05137804	3.656957891	11.25094499	0.268794187	1.296171418	5.624613391	14.80723788	28.77800241	3.296137774	3.786760949	0	0	3.632714455	1.353899787	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.0191	135	0	33.9549	1.700952451	3.568269266	0	4.935152257	1.463407768	1.198123854	1.394620185	4.05137804	3.656957891	11.25094499	0.268794187	1.296171418	5.624613391	14.80723788	28.77800241	3.296137774	3.786760949	0	0	3.632714455	1.353899787	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.0191																																																																																		0	0	0	33.9549	1.700952451	3.568269266	0	4.935152257	1.463407768	1.198123854	1.394620185	4.05137804	3.656957891	11.25094499	0.268794187	1.296171418	5.624613391	14.80723788	28.77800241	3.296137774	3.786760949	0	0	3.632714455	1.353899787	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.0191
H3388_001_0	2009	7																					2500											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	S	P	P	P	P	P	P	P	P	P																																																			0		323.9035035	31.93733846			541.0780452	12.20280393	3.405675457	956.0453521	374.1878236		852.9945666			1345.049539	5996.218158	11337.21818		958.6352321		626.1686811					711.6214385		63.98025437														1A: $250/admit - $750 annual max	1B: $250/admit - $750 annual max	2: $0	6: $0	10A: $50	11A: 20%	11B: 20%	4A: $50; 4B: $35	9A: $100	"8A: $0-$12 for labs,& x-rays"	"8A: $0-$12 for labs,& x-rays; 8B: $12"		12: $0	"7I: $12; 9C: Ind - $10/visits 1-10, $25/visits 11+, Group - $5/visits 1-10, $10/visits 11+"	7A: $12; 9A: $100; 14B: $0	7D: $12; 15: $0	"7E: Ind - $10/visits 1-10, $25/visits 11+, Group - $5/visits 1-10, $10/visits 11+; 9C: Ind - $10/visits 1-10, $25/visits 11+, Group - $5/visits 1-10, $10/visits 11+"	7C: $12; 7I: $12	"8A: $0-$12 for labs,& x-rays"	6: $0; 7B: $12; 7D: $12; 14C: $0	15: $0			16A: $0	17A: $12	17B: $0	18A: $12	18B: $0	14A: $0												250	247.4574723			50	0.2	0.2	42.46801113	100		12			11.94022805	48.4263791	12		12		12					12		12														193.2709472	193.2709472			38.65418945	0.154616758	0.154616758	32.83133095	77.30837889		9.277005467			9.230796741	37.43764863	9.277005467		9.277005467		9.277005467					9.277005467		9.277005467														5.2168	0.514379971	0	0	1.742911105	1.88675798	0.526574497	2.61568678	2.410654504	0	0.659436271	0	0	1.034656575	18.70702571	8.764619585	0	0.741105357	0	0.484080857	0	0	0	0	0.550142998	0	0.049462097	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9043	0	13.4671	5.2168	0.514379971	0	0	1.742911105	1.88675798	0.526574497	2.61568678	2.410654504	0	0.659436271	0	0	1.034656575	18.70702571	8.764619585	0	0.741105357	0	0.484080857	0	0	0	0	0.550142998	0	0.049462097	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9043																																																																																		0	0	0	5.2168	0.514379971	0	0	1.742911105	1.88675798	0.526574497	2.61568678	2.410654504	0	0.659436271	0	0	1.034656575	18.70702571	8.764619585	0	0.741105357	0	0.484080857	0	0	0	0	0.550142998	0	0.049462097	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9043
H3388_002_0	2009	9																					2500											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	S	P	P	P	P	P	P	P	P	P																																																			0		302.1858828	172.3829755			520.355211	11.50892696	3.211417582	951.7059329	395.8915002		845.0318356			1698.713927	5694.449965	10461.787	4.901242308	1249.190548		714.6531018					625.6389454		73.31275748														1A: $250/admit - $750 annual max	1B: $250/admit - $750 annual max	2: $0	6: $0	10A: $50	11A: 20%	11B: 20%	4A: $50; 4B: $35	9A: $100	"8A: $0-$12 for labs,& x-rays"	"8A: $0-$12 for labs,& x-rays; 8B: $12"		12: $0	"7I: $12; 9C: Ind - $10/visits 1-10, $25/visits 11+, Group - $5/visits 1-10, $10/visits 11+"	7A: $12; 9A: $100; 14B: $0	7D: $12; 15: $0	"7E: Ind - $10/visits 1-10, $25/visits 11+, Group - $5/visits 1-10, $10/visits 11+; 9C: Ind - $10/visits 1-10, $25/visits 11+, Group - $5/visits 1-10, $10/visits 11+"	7C: $12; 7I: $12	"8A: $0-$12 for labs,& x-rays"	6: $0; 7B: $12; 7D: $12; 14C: $0	15: $0			16A: $0	17A: $12	17B: $0	18A: $12	18B: $0	14A: $0												250	250			50	0.2	0.2	42.50469555	100		12			11.89305314	47.80227273	12	11.7375	12		12					12		12														192.5344393	192.5344393			38.50688786	0.154027551	0.154027551	32.7344709	77.01377572		9.241653087			9.159289274	36.81433511	9.241653087	9.039491925	9.241653087		9.241653087					9.241653087		9.241653087														4.8484	2.765804962	0	0	1.669771647	1.772691839	0.494646787	2.596132514	2.540758267	0	0.650790923	0	0	1.296584355	17.46978244	8.057017179	0.003692062	0.962048807	0	0.550381337	0	0	0	0	0.481828174	0	0.056460923	0	0	0	0	0	0	0	0	0	0	0	0	0	46.2168	0	13.7943	4.8484	2.765804962	0	0	1.669771647	1.772691839	0.494646787	2.596132514	2.540758267	0	0.650790923	0	0	1.296584355	17.46978244	8.057017179	0.003692062	0.962048807	0	0.550381337	0	0	0	0	0.481828174	0	0.056460923	0	0	0	0	0	0	0	0	0	0	0	0	0	46.2168																																																																																		0	0	0	4.8484	2.765804962	0	0	1.669771647	1.772691839	0.494646787	2.596132514	2.540758267	0	0.650790923	0	0	1.296584355	17.46978244	8.057017179	0.003692062	0.962048807	0	0.550381337	0	0	0	0	0.481828174	0	0.056460923	0	0	0	0	0	0	0	0	0	0	0	0	0	46.2168
H3388_003_0	2009	6																					3350											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	S	P	P	P	P	P	P	P	P	P																																																			0		323.9035035	31.93733846	1039.0993		541.0780452	12.20280393	3.405675457	956.0453521	374.1878236		852.9945666			1345.049539	5996.218158	11337.21818		958.6352321		626.1686811					711.6214385		63.98025437														1A: $500/admit - $1500 annual max	1B: $500/admit - $1500 annual max	"2: $0/day days 1-20, $65/day days 21-100"	"6: $0/day days 1-20, $25/day days 21+"	10A: $100	11A: 20%	11B: 20%	4A: $50; 4B: $35	9A: $125	"8A: $0-$25 for labs,& x-rays"	"8A: $0-$25 for labs,& x-rays; 8B: $25"		12: $0	"7I: $25; 9C: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+"	7A: $10; 9A: $125; 14B: $0	7D: $25; 15: $0	"7E: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+; 9C: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+"	7C: $25; 7I: $25	"8A: $0-$25 for labs,& x-rays"	"6: $0/day days 1-20, $25/day days 21+; 7B: $25; 7D: $25; 14C: $0"	15: $0			16A: $0	17A: $25	17B: n/c	18A: $25	18B: n/c	14A: $0												500	465.5425787	33.28916668		100	0.2	0.2	43.97774687	125		25			26.88746536	57.6026545	25		25		25					25		25														364.1461432	347.0317674	24.24424331		72.82922863	0.145658457	0.145658457	32.02865382	91.03653579		18.20730716			19.58193362	41.95156895	18.20730716		18.20730716		18.20730716					18.20730716		18.20730716														9.829	0.923605918	2.09934802	0	3.283858055	1.777441595	0.496065433	2.551737135	2.838730267	0	1.29422784	0	0	2.194889233	20.96256329	17.20168448	0	1.454513844	0	0.950070459	0	0	0	0	1.079725843	0	0.097075679	0	0	0	0	0	0	0	0	0	0	0	0	0	69.0346	0	25.7259	9.829	0.923605918	2.09934802	0	3.283858055	1.777441595	0.496065433	2.551737135	2.838730267	0	1.29422784	0	0	2.194889233	20.96256329	17.20168448	0	1.454513844	0	0.950070459	0	0	0	0	1.079725843	0	0.097075679	0	0	0	0	0	0	0	0	0	0	0	0	0	69.0346																																																																																		0	0	0	9.829	0.923605918	2.09934802	0	3.283858055	1.777441595	0.496065433	2.551737135	2.838730267	0	1.29422784	0	0	2.194889233	20.96256329	17.20168448	0	1.454513844	0	0.950070459	0	0	0	0	1.079725843	0	0.097075679	0	0	0	0	0	0	0	0	0	0	0	0	0	69.0346
H3388_004_0	2009	8																					3350											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	S	P	P	P	P	P	P	P	P	P																																																			0		302.1858828	172.3829755	922.1271217		520.355211	11.50892696	3.211417582	951.7059329	395.8915002		845.0318356			1698.713927	5694.449965	10461.787	4.901242308	1249.190548		714.6531018					625.6389454		73.31275748														1A: $500/admit - $1500 annual max	1B: $500/admit - $1500 annual max	"2: $0/day days 1-20, $65/day days 21-100"	"6: $0/day days 1-20, $25/day days 21+"	10A: $100	11A: 20%	11B: 20%	4A: $50; 4B: $35	9A: $125	"8A: $0-$25 for labs,& x-rays"	"8A: $0-$25 for labs,& x-rays; 8B: $25"		12: $0	"7I: $25; 9C: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+"	7A: $10; 9A: $125; 14B: $0	7D: $25; 15: $0	"7E: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+; 9C: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+"	7C: $25; 7I: $25	"8A: $0-$25 for labs,& x-rays"	"6: $0/day days 1-20, $25/day days 21+; 7B: $25; 7D: $25; 14C: $0"	15: $0			16A: $0	17A: $25	17B: n/c	18A: $25	18B: n/c	14A: $0												500	500	33.28916668		100	0.2	0.2	43.97758255	125		25			28.37714407	56.78706095	25	21.195	25		25					25		25														360.4645224	360.4645224	23.99912714		72.09290449	0.144185809	0.144185809	31.70471658	90.11613061		18.02322612			20.45790737	40.93944161	18.02322612	15.28009111	18.02322612		18.02322612					18.02322612		18.02322612														9.0773	5.178162246	1.844187169	0	3.126159877	1.659423943	0.463040842	2.514463906	2.973017512	0	1.269183321	0	0	2.896011014	19.42730016	15.7129294	0.006240952	1.876203642	0	1.073362871	0	0	0	0	0.939669349	0	0.110111034	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1467	0	27.1537	9.0773	5.178162246	1.844187169	0	3.126159877	1.659423943	0.463040842	2.514463906	2.973017512	0	1.269183321	0	0	2.896011014	19.42730016	15.7129294	0.006240952	1.876203642	0	1.073362871	0	0	0	0	0.939669349	0	0.110111034	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1467																																																																																		0	0	0	9.0773	5.178162246	1.844187169	0	3.126159877	1.659423943	0.463040842	2.514463906	2.973017512	0	1.269183321	0	0	2.896011014	19.42730016	15.7129294	0.006240952	1.876203642	0	1.073362871	0	0	0	0	0.939669349	0	0.110111034	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1467
H3388_009_0	2009	5																					2500											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	S	P	P	P	P	P	P	P	P	P																																																			0		391.3153904	38.58424478	1255.360142		653.6890283	14.74249254	4.114476091	1155.020727	452.0650523					1624.985774	2998.624186	13696.75817		1158.149622		756.4890136					859.7264864		77.29604015														1A: $100/admit - $300 annual max	1B: $100/admit - $300 annual max	"2: $0/day days 1-20, $30/day days 21-100"	"6: $0/day days 1-20, $10/day days 21+"	10A: $50	11A: 20%	11B: 20%	4A: $50; 4B: $35	9A: $50	"8A: $0 lab, $0 x-rays"	"8A: $0 lab, $0 x-rays; 8B: $0"		12: $0	"7I: $10; 9C: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+"	7A: $0; 9A: $50; 14B: $0	7D: $10; 15: $0	"7E: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+; 9C: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+"	7C: $10; 7I: $10	"8A: $0 lab, $0 x-rays"	"6: $0/day days 1-20, $10/day days 21+; 7B: $10; 7D: $10; 14C: $0"	15: $0			16A: $0	17A: $10	17B: $0	18A: $10	18B: $0	14A: $0												100	100	15.36423077		50	0.2	0.2	42.23574409	50					11.22144965	50	10		10		10					10		10														83.51791897	83.51791897	12.83188581		41.75895949	0.167035838	0.167035838	35.27441453	41.75895949					9.371921228	41.75895949	8.351791897		8.351791897		8.351791897					8.351791897		8.351791897														2.7235	0.268539652	1.342386499	0	2.274781138	2.462524595	0.687264961	3.395223326	1.573147184	0	0	0	0	1.269103223	10.43495216	9.532706157	0	0.806052052	0	0.526503235	0	0	0	0	0.598354725	0	0.053796703	0	0	0	0	0	0	0	0	0	0	0	0	0	37.9488	0	7.4891	2.7235	0.268539652	1.342386499	0	2.274781138	2.462524595	0.687264961	3.395223326	1.573147184	0	0	0	0	1.269103223	10.43495216	9.532706157	0	0.806052052	0	0.526503235	0	0	0	0	0.598354725	0	0.053796703	0	0	0	0	0	0	0	0	0	0	0	0	0	37.9488																																																																																		0	0	0	2.7235	0.268539652	1.342386499	0	2.274781138	2.462524595	0.687264961	3.395223326	1.573147184	0	0	0	0	1.269103223	10.43495216	9.532706157	0	0.806052052	0	0.526503235	0	0	0	0	0.598354725	0	0.053796703	0	0	0	0	0	0	0	0	0	0	0	0	0	37.9488
H3388_010_0	2009	6																					2500											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	S	P	P	P	P	P	P	P	P	P																																																			0		337.5258905	192.5428044	1029.967962		581.209666	12.85487192	3.58698616	1063.005954	442.1901842					1897.374973	2587.692255	11685.27114	5.474432358	1395.280773		798.2302892					698.8061132		81.88653133														1A: $100/admit - $300 annual max	1B: $100/admit - $300 annual max	"2: $0/day days 1-20, $30/day days 21-100"	"6: $0/day days 1-20, $10/day days 21+"	10A: $50	11A: 20%	11B: 20%	4A: $50; 4B: $35	9A: $50	"8A: $0 lab, $0 x-rays"	"8A: $0 lab, $0 x-rays; 8B: $0"		12: $0	"7I: $10; 9C: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+"	7A: $0; 9A: $50; 14B: $0	7D: $10; 15: $0	"7E: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+; 9C: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+"	7C: $10; 7I: $10	"8A: $0 lab, $0 x-rays"	"6: $0/day days 1-20, $10/day days 21+; 7B: $10; 7D: $10; 14C: $0"	15: $0			16A: $0	17A: $10	17B: $0	18A: $10	18B: $0	14A: $0												100	100	15.36423077		50	0.2	0.2	42.27809755	50					12.18547664	50	10	21.195	10		10					10		10														85.272018	85.272018	13.10138963		42.636009	0.170544036	0.170544036	36.05138695	42.636009					10.39080183	42.636009	8.5272018	18.07340422	8.5272018		8.5272018					8.5272018		8.5272018														2.3985	1.368209457	1.124500965	0	2.065038379	2.19232174	0.611739097	3.193569914	1.571102056	0	0	0	0	1.642937279	9.194072523	8.303555425	0.008245136	0.991486727	0	0.567222563	0	0	0	0	0.496571729	0	0.058188581	0	0	0	0	0	0	0	0	0	0	0	0	0	35.7872	0	6.1811	2.3985	1.368209457	1.124500965	0	2.065038379	2.19232174	0.611739097	3.193569914	1.571102056	0	0	0	0	1.642937279	9.194072523	8.303555425	0.008245136	0.991486727	0	0.567222563	0	0	0	0	0.496571729	0	0.058188581	0	0	0	0	0	0	0	0	0	0	0	0	0	35.7872																																																																																		0	0	0	2.3985	1.368209457	1.124500965	0	2.065038379	2.19232174	0.611739097	3.193569914	1.571102056	0	0	0	0	1.642937279	9.194072523	8.303555425	0.008245136	0.991486727	0	0.567222563	0	0	0	0	0.496571729	0	0.058188581	0	0	0	0	0	0	0	0	0	0	0	0	0	35.7872
H3388_801_0	2009	5																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	S	P	P	P	P	P	P	P	P	P																																																			0		302.1858828	172.3829755	922.1271217		520.355211	11.97035742	3.340173799	951.7059329	395.8915002	8172.595127	4596.067898	12.68556833	26.38021595	2277.204674	12862.95654	12766.33326	4.901242308	1249.190548	2076.738842	1510.581904	232.7143991																				1A: Medicare defined cost share	1B: Medicare defined cost share	2: Medicare defined cost share	6: Medicare defined cost share	10A: Medicare defined cost share	11A: Medicare defined cost share	11B: Medicare defined cost share	4A: Medicare defined cost share; 4B: Medicare defined cost share	9A: Medicare defined cost share	8A: Medicare defined cost share	8A: Medicare defined cost share; 8B: Medicare defined cost share	Medicare defined cost share	12: Medicare defined cost share	7I: Medicare defined cost share; 9C: Medicare defined cost share	7A: Medicare defined cost share; 9A: Medicare defined cost share; 14B: Medicare defined cost share	7D: Medicare defined cost share; 15: Medicare defined cost share	7E: Medicare defined cost share; 9C: Medicare defined cost share	7C: Medicare defined cost share; 7I: Medicare defined cost share	8A: Medicare defined cost share	6: Medicare defined cost share; 7B: Medicare defined cost share; 7D: Medicare defined cost share; 14C: Medicare defined cost share	15: Medicare defined cost share																				927.7456471	58.99221291	76.61529804		62.95216283	0.231	0.231	37.40135349	362.5641941	4.769853851	23.26835828	34.98827246	67.67170948	34.95072122	23.64264812	25.24930695	21.29213513	10.92516029	36.25484424	15.92776013	60.02992023																				927.7456471	58.99221291	76.61529804		62.95216283	0.231	0.231	37.40135349	362.5641941	4.769853851	23.26835828	34.98827246	67.67170948	34.95072122	23.64264812	25.24930695	21.29213513	10.92516029	36.25484424	15.92776013	60.02992023																				23.3626	0.847437766	5.887420355	0	2.729790498	2.765152563	0.771580148	2.966257501	11.96134023	3.248507029	8.911912875	0.036987177	0.148766192	6.632495478	25.34286294	26.86175558	0.008696493	1.137300581	6.27432027	2.005015518	1.164152234	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.0644	0	0	23.3626	0.847437766	5.887420355	0	2.729790498	2.765152563	0.771580148	2.966257501	11.96134023	3.248507029	8.911912875	0.036987177	0.148766192	6.632495478	25.34286294	26.86175558	0.008696493	1.137300581	6.27432027	2.005015518	1.164152234	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.0644																																																																																		0	0	0	23.3626	0.847437766	5.887420355	0	2.729790498	2.765152563	0.771580148	2.966257501	11.96134023	3.248507029	8.911912875	0.036987177	0.148766192	6.632495478	25.34286294	26.86175558	0.008696493	1.137300581	6.27432027	2.005015518	1.164152234	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.0644
H3388_803_0	2009	5																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	S	P	P	P	P	P	P	P	P	P																																																			0		302.1858828	172.3829755	922.1271217		520.355211	11.97035742	3.340173799	951.7059329	395.8915002	8172.595127	4596.067898	12.68556833	26.38021595	2277.204674	12862.95654	12766.33326	4.901242308	1249.190548	2076.738842	1510.581904	232.7143991																				1A: Medicare defined cost share	1B: Medicare defined cost share	2: Medicare defined cost share	6: Medicare defined cost share	10A: Medicare defined cost share	11A: Medicare defined cost share	11B: Medicare defined cost share	4A: Medicare defined cost share; 4B: Medicare defined cost share	9A: Medicare defined cost share	8A: Medicare defined cost share	8A: Medicare defined cost share; 8B: Medicare defined cost share	Medicare defined cost share	12: Medicare defined cost share	7I: Medicare defined cost share; 9C: Medicare defined cost share	7A: Medicare defined cost share; 9A: Medicare defined cost share; 14B: Medicare defined cost share	7D: Medicare defined cost share; 15: Medicare defined cost share	7E: Medicare defined cost share; 9C: Medicare defined cost share	7C: Medicare defined cost share; 7I: Medicare defined cost share	8A: Medicare defined cost share	6: Medicare defined cost share; 7B: Medicare defined cost share; 7D: Medicare defined cost share; 14C: Medicare defined cost share	15: Medicare defined cost share																				927.8685199	59.00002598	76.61660476		62.95216283	0.231	0.231	37.40135349	362.5641941	4.769853851	23.26835828	34.98827246	67.67170948	34.95072122	23.64264812	25.24930695	21.29213513	10.92516029	36.25484424	15.92776013	60.02992023																				927.8685199	59.00002598	76.61660476		62.95216283	0.231	0.231	37.40135349	362.5641941	4.769853851	23.26835828	34.98827246	67.67170948	34.95072122	23.64264812	25.24930695	21.29213513	10.92516029	36.25484424	15.92776013	60.02992023																				23.3657	0.847550003	5.887520768	0	2.729790498	2.765152563	0.771580148	2.966257501	11.96134023	3.248507029	8.911912875	0.036987177	0.148766192	6.632495478	25.34286294	26.86175558	0.008696493	1.137300581	6.27432027	2.005015518	1.164152234	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.0677	0	0	23.3657	0.847550003	5.887520768	0	2.729790498	2.765152563	0.771580148	2.966257501	11.96134023	3.248507029	8.911912875	0.036987177	0.148766192	6.632495478	25.34286294	26.86175558	0.008696493	1.137300581	6.27432027	2.005015518	1.164152234	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.0677																																																																																		0	0	0	23.3657	0.847550003	5.887520768	0	2.729790498	2.765152563	0.771580148	2.966257501	11.96134023	3.248507029	8.911912875	0.036987177	0.148766192	6.632495478	25.34286294	26.86175558	0.008696493	1.137300581	6.27432027	2.005015518	1.164152234	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.0677
H3388_804_0	2009	5																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	S	P	P	P	P	P	P	P	P	P																																																			0		323.9035035	31.93733846	1039.0993		541.0780452	11.73420185	3.274893496	956.0453521	374.1878236	7964.201453	4684.932486	14.8481777	62.49531509	1966.456857	11658.72273	13563.55807		958.6352321	2068.526825	1430.834434	149.5697337																				1A: Medicare defined cost share	1B: Medicare defined cost share	2: Medicare defined cost share	6: Medicare defined cost share	10A: Medicare defined cost share	11A: Medicare defined cost share	11B: Medicare defined cost share	4A: Medicare defined cost share; 4B: Medicare defined cost share	9A: Medicare defined cost share	8A: Medicare defined cost share	8A: Medicare defined cost share; 8B: Medicare defined cost share	Medicare Defined Cost Share	12: Medicare defined cost share	7I: Medicare defined cost share; 9C: Medicare defined cost share	7A: Medicare defined cost share; 9A: Medicare defined cost share; 14B: Medicare defined cost share	7D: Medicare defined cost share; 15: Medicare defined cost share	7E: Medicare defined cost share; 9C: Medicare defined cost share	7C: Medicare defined cost share; 7I: Medicare defined cost share	8A: Medicare defined cost share	6: Medicare defined cost share; 7B: Medicare defined cost share; 7D: Medicare defined cost share; 14C: Medicare defined cost share	15: Medicare defined cost share																				845.6134323	202.8513407	72.74251521		59.57845888	0.231	0.231	35.06593168	356.2585231	4.16459959	21.20502493	33.47796045	80.84153184	33.34659258	22.45699141	22.57558259		10.24630063	31.92223577	14.73839794	71.89839527																				845.6134323	202.8513407	72.74251521		59.57845888	0.231	0.231	35.06593168	356.2585231	4.16459959	21.20502493	33.47796045	80.84153184	33.34659258	22.45699141	22.57558259		10.24630063	31.92223577	14.73839794	71.89839527																				22.8248	0.53987766	6.298891384	0	2.686383006	2.710600627	0.756500398	2.793718416	11.10896678	2.763975842	8.278675846	0.041423892	0.421018084	5.464552968	21.81831968	25.51710211	0	0.818538732	5.502666751	1.757350605	0.896151986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.9995	0	0	22.8248	0.53987766	6.298891384	0	2.686383006	2.710600627	0.756500398	2.793718416	11.10896678	2.763975842	8.278675846	0.041423892	0.421018084	5.464552968	21.81831968	25.51710211	0	0.818538732	5.502666751	1.757350605	0.896151986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.9995																																																																																		0	0	0	22.8248	0.53987766	6.298891384	0	2.686383006	2.710600627	0.756500398	2.793718416	11.10896678	2.763975842	8.278675846	0.041423892	0.421018084	5.464552968	21.81831968	25.51710211	0	0.818538732	5.502666751	1.757350605	0.896151986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.9995
H3404_001_0	2009	4																					3350											A	A	D	Coin	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	O	V	V	V	V	Coin	V	Coin	Coin	Coin	V	V	Coin	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		176.7684482	0	732.6648966	8.632029827	144.9750887	21.70195213	0.002154709	1163.573125	1324.206604	14.66727985	37.92424429	0	0.000289793	1551.67918	5266.334264	4917.714997	314.7402086	381.0877081	0	2122.096606	1.799386317	0	0	0	57.43975427	0	0	0	0	0											"(1a) $350 copay per admission, unlimited days"	(1b) $350 copay per admission	"(2) $0 copay for days 1-10, $100 after day 10"	(6) 0% coinsurance	(10a) $100 copay	(11a) 20% coinsurance	"(11b) 20% coinsurance, (11c) 20% coinsurance"	"(4a) $50 copay, includes worldwide coverage and waived copay if admitted to hospital, (4b) $30 copay"	"(9a  - surgery) $100 copay, (9b) $100 copay"	(8a) 10% coinsurance	(8b) 10% coinsurance	(5) 0% coinsurance	(12) 0% coinsurance	"(3) $30 copay for physician services, 20% coinsurance for supplies, (9a - non-surgery) 0% coinsurance, (9c) $30 copay, (9d) 0% coinsurance"	"(7a) $15 copay, $30 copay for Urgent Care services, (14b) 0% coinsurance, (14c) 0% coinsurance"	(7d) $30 copay	"(7e) $30 copay, (7h) $30 copay"	"(7c) $30 copay, (7i) $30 copay"	0	"(7b) $30 copay, (7f) $30 copay, (7g) 0% coinsurance, (14d - j) 0% coinsurance"	(15) 20% coinsurance	"(13a) 0% coinsurance, 3 pint deductible waived"	0	(16b) $30 copay	(17a) $30 copay	(17b) 20% coinsurance	(18a) $30 copay	0	(14a) 0% coinsurance	0											350	0	64.81086177	0	100	0.18	0.063092344	48.94256506	100	0.09	0.09	0	0	0.080108663	12.16172907	30	30	30	0	8.584425023	0.18	0	0	0	15	0	0	0	0	0											306.0034675	0	56.70770015	0	87.42956215	0.157373212	0.055108994	42.7899575	87.42956215	0.078686606	0.078686606	0	0	0.069991168	10.63285658	26.22886865	26.22886865	26.22886865	0	7.506059647	0.157373212	0	0	0	13.11443432	0	0	0	0	0											4.5076	0	3.462311772	0	1.056259044	3.415305911	0.000118744	4.149103713	9.647900301	1.15411847	2.984130066	0	0	0.00905032	4.666348078	10.74884172	0.687939966	0.832958287	0	1.327381975	0.283175204	0	0	0	0.062774157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9954	0	7.2157	4.5076	0	3.462311772	0	1.056259044	3.415305911	0.000118744	4.149103713	9.647900301	1.15411847	2.984130066	0	0	0.00905032	4.666348078	10.74884172	0.687939966	0.832958287	0	1.327381975	0.283175204	0	0	0	0.062774157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9954		20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$100 copay	20% coinsurance	20% coinsurance	"(4a) $50 copay, (4b) $30 copay"	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	0% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	100% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	0% coinsurance												4.7457	0	0.7576	0.1775	0.1385	0.4449	0	0.5406	1.6015	0.3006	0.7767	0	0	0.2032	0.9777	1.8219	0.1333	0.0808	0	0.2725	0.0361	0	0	0	0.0057	0	0	0	0	0											13.0147			9.2533	0	4.219880561	0.177515242	1.194804158	3.860160343	0.000165	4.689708741	11.24935875	1.454745301	3.760788835	0	0	0.212264433	5.644092563	12.57078326	0.821195236	0.913764534	0	1.599881278	0.319240614	0	0	0	0.068446834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.0101
H3404_002_0	2009	4																																A	A	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	O	V	V	V	V	Coin	V	Coin	Coin	Coin	V	V	Coin	V	Coin	O	Coin																																																			0		200.80135	0	922.0887223	8.381192794	177.8044585	18.59537771	0.005437079	1114.620909	1074.627759	12.51894842	31.24716113	0	0.000706651	1772.333525	5518.152482	4134.828369	90.61983941	293.6477211	0	1818.64912	0.13356419	0	0	0	56.12009732	0	0	0	0	0											"(1a) $350 copay per admission, unlimited days"	(1b) $350 copay per admission	"(2) $0 copay for days 1-10, $100 after day 10"	(6) 0% coinsurance	(10a) $100 copay	(11a) 20% coinsurance	"(11b) 20% coinsurance, (11c) 20% coinsurance"	"(4a) $50 copay, includes worldwide coverage and waived copay if admitted to hospital, (4b) $20 copay"	"(9a  - surgery) 0% coinsurance, (9b) 0% coinsurance"	(8a) 0% coinsurance	(8b) 0% coinsurance	(5) 0% coinsurance	(12) 0% coinsurance	"(3) $20 copay for physician services, 20% coinsurance for supplies, (9a - non-surgery) 0% coinsurance, (9c) $20 copay, (9d) 0% coinsurance"	"(7a) $10 copay, $20 copay for Urgent Care services, (14b) 0% coinsurance, (14c) 0% coinsurance"	(7d) $20 copay	"(7e) $20 copay, (7h) $20 copay"	"(7c) $20 copay, (7i) $20 copay"	0	"(7b) $20 copay, (7f) $20 copay, (7g) 0% coinsurance, (14d - j) 0% coinsurance"	(15) 20% coinsurance	"(13a) 0% coinsurance, 3 pint deductible waived"	0	(16b) $20 copay	(17a) $20 copay	(17b) 20% coinsurance	(18a) $20 copay	0	(14a) 0% coinsurance	0											350	0	67.77525836	0	100	0.2	0.070102605	48.41384758	0	0	0	0	0	0.053405776	8.107819382	20	20	20	0	5.722950016	0.2	0	0	0	20	0	0	0	0	0											326.2147735	0	63.18935864	0	93.204221	0.186408442	0.065017195	45.12115754	0	0	0	0	0	0.049601575	7.556498853	18.6408442	18.6408442	18.6408442	0	5.336735479	0.186408442	0	0	0	18.6408442	0	0	0	0	0											5.4587	0	4.855516247	0	1.381010504	3.466335387	0.000353504	4.191082136	0	0	0	0	0	0.007325878	3.474826075	6.423057619	0.140769192	0.456153452	0	0.808804107	0.024897493	0	0	0	0.087177166	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.776	0	2.5974	5.4587	0	4.855516247	0	1.381010504	3.466335387	0.000353504	4.191082136	0	0	0	0	0	0.007325878	3.474826075	6.423057619	0.140769192	0.456153452	0	0.808804107	0.024897493	0	0	0	0.087177166	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.776	3350	"(1a) $350 copay per admission, unlimited days"	(1b) $350 copay per admission	"(2) $100 copay for days 1-32, $0 after day 32"	(6) 0% coinsurance	(10a) $100 copay	(11a) 20% coinsurance	"(11b) 20% coinsurance, (11c) 20% coinsurance"	"(4a) $50 copay, includes worldwide coverage and waived copay if admitted to hospital, (4b) $20 copay"	"(9a  - surgery) 0% coinsurance, (9b) 0% coinsurance"	(8a) 0% coinsurance	(8b) 0% coinsurance	(5) 0% coinsurance	(12) 0% coinsurance	"(3) $20 copay for physician services, 20% coinsurance for supplies, (9a - non-surgery) 0% coinsurance, (9c) $20 copay, (9d) 0% coinsurance"	"(7a) $10 copay, $20 copay for Urgent Care services, (14b) 0% coinsurance, (14c) 0% coinsurance"	(7d) $20 copay	"(7e) $20 copay, (7h) $20 copay"	"(7c) $20 copay, (7i) $20 copay"		"(7b) $20 copay, (7f) $20 copay, (7g) 0% coinsurance, (14d - j) 0% coinsurance"	(15) 20% coinsurance	"(13a) 0% coinsurance, 3 pint deductible waived"		(16b) $20 copay	(17a) $20 copay	(17b) 20% coinsurance	(18a) $20 copay		(14a) 0% coinsurance												1.3647	0	1.2139	0	0.3453	0.8666	0.0001	1.0478	0	0	0	0	0	0.0018	0.8687	1.6058	0.0352	0.114	0	0.2022	0.0062	0	0	0	0.0218	0	0	0	0	0											7.694	0	0.649357169	6.8234	0	6.069395309	0	1.72626313	4.332919234	0.00044188	5.238852669	0	0	0	0	0	0.009157347	4.343532594	8.028822024	0.17596149	0.570191814	0	1.011005134	0.031121866	0	0	0	0.108971457	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.47
H3404_801_0	2009	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		215.5681005	0	31.55811286	6.550616153	4.117293885	15.81063421	0	14.33352602	81.22152545	16.53240066	40.48480454	0	0	10.94606178	60.89619964	94.16161925	1.50422435	6.559801071	0	11.67954443	1.994501569	2.18912704																			FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																			0.078600764	0	0.202742873	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231																			0.078600764	0	0.202742873	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231																			16.9438	0	6.398182458	0	0.951094888	3.652256502	0	3.311044511	18.76217238	3.818984552	9.351989848	0	0	2.528540272	14.06702212	21.75133405	0.347475825	1.515314047	0	2.697974764	0.460729863	0.505688346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.0636			16.9438	0	6.398182458	0	0.951094888	3.652256502	0	3.311044511	18.76217238	3.818984552	9.351989848	0	0	2.528540272	14.06702212	21.75133405	0.347475825	1.515314047	0	2.697974764	0.460729863	0.505688346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.0636																																																																																		0			16.9438	0	6.398182458	0	0.951094888	3.652256502	0	3.311044511	18.76217238	3.818984552	9.351989848	0	0	2.528540272	14.06702212	21.75133405	0.347475825	1.515314047	0	2.697974764	0.460729863	0.505688346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.0636
H3404_803_0	2009	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		215.5681005	0	31.55811286	6.550616153	4.117293885	15.81063421	0	14.33352602	81.22152545	16.53240066	40.48480454	0	0	10.94606178	60.89619964	94.16161925	1.50422435	6.559801071	0	11.67954443	1.994501569	2.18912704																			FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																			0.078600764	0	0.202742873	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231																			0.078600764	0	0.202742873	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231																			16.9438	0	6.398182458	0	0.951094888	3.652256502	0	3.311044511	18.76217238	3.818984552	9.351989848	0	0	2.528540272	14.06702212	21.75133405	0.347475825	1.515314047	0	2.697974764	0.460729863	0.505688346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.0636			16.9438	0	6.398182458	0	0.951094888	3.652256502	0	3.311044511	18.76217238	3.818984552	9.351989848	0	0	2.528540272	14.06702212	21.75133405	0.347475825	1.515314047	0	2.697974764	0.460729863	0.505688346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.0636																																																																																		0			16.9438	0	6.398182458	0	0.951094888	3.652256502	0	3.311044511	18.76217238	3.818984552	9.351989848	0	0	2.528540272	14.06702212	21.75133405	0.347475825	1.515314047	0	2.697974764	0.460729863	0.505688346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.0636
H3404_807_0	2009	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		215.5681005	0	31.55811286	6.550616153	4.117293885	15.81063421	0	14.33352602	81.22152545	16.53240066	40.48480454	0	0	10.94606178	60.89619964	94.16161925	1.50422435	6.559801071	0	11.67954443	1.994501569	2.18912704																			FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																			0.078600764	0	0.202742873	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231																			0.078600764	0	0.202742873	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231																			16.9438	0	6.398182458	0	0.951094888	3.652256502	0	3.311044511	18.76217238	3.818984552	9.351989848	0	0	2.528540272	14.06702212	21.75133405	0.347475825	1.515314047	0	2.697974764	0.460729863	0.505688346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.0636			16.9438	0	6.398182458	0	0.951094888	3.652256502	0	3.311044511	18.76217238	3.818984552	9.351989848	0	0	2.528540272	14.06702212	21.75133405	0.347475825	1.515314047	0	2.697974764	0.460729863	0.505688346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.0636																																																																																		0			16.9438	0	6.398182458	0	0.951094888	3.652256502	0	3.311044511	18.76217238	3.818984552	9.351989848	0	0	2.528540272	14.06702212	21.75133405	0.347475825	1.515314047	0	2.697974764	0.460729863	0.505688346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.0636
H3404_808_0	2009	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		215.5681005	0	31.55811286	6.550616153	4.117293885	15.81063421	0	14.33352602	81.22152545	16.53240066	40.48480454	0	0	10.94606178	60.89619964	94.16161925	1.50422435	6.559801071	0	11.67954443	1.994501569	2.18912704																			FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																			0.078600764	0	0.202742873	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231																			0.078600764	0	0.202742873	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231																			16.9438	0	6.398182458	0	0.951094888	3.652256502	0	3.311044511	18.76217238	3.818984552	9.351989848	0	0	2.528540272	14.06702212	21.75133405	0.347475825	1.515314047	0	2.697974764	0.460729863	0.505688346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.0636			16.9438	0	6.398182458	0	0.951094888	3.652256502	0	3.311044511	18.76217238	3.818984552	9.351989848	0	0	2.528540272	14.06702212	21.75133405	0.347475825	1.515314047	0	2.697974764	0.460729863	0.505688346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.0636																																																																																		0			16.9438	0	6.398182458	0	0.951094888	3.652256502	0	3.311044511	18.76217238	3.818984552	9.351989848	0	0	2.528540272	14.06702212	21.75133405	0.347475825	1.515314047	0	2.697974764	0.460729863	0.505688346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.0636
H3405_001_0	2009	4	r.	s.	t.								Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered								4000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin				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		1378.760007	61.389734	481.207014	687.753846	136.794883	8.818326	3.184589	309.419757	335.401031	592.980965	880.111334	0	18.328862	673.277824	3295.218378	3972.09453	27.096019	856.1413			19.930914				2.47				1.65	0.05	0.06	1.23	2.7								$195/Day(Days 1-5):1a	$195/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$125/Visit:9b. $0 Surgery ASC -- Physician,9b. $125 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $125 Surgery OP -- Facility"	"$0-$75/Visit:8a. $0 Lab -- FSL,8. $75 Lab -- OP"	"$0-$100/Visit:14h. $75 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $75 Radiology OP -- Facility"	$50/Visit:9a	"$0-$75/Proc:12. $0 Dialysis -- Dialysis Center,12. $75 Dialysis -- OP Hosp"	"$30-$100/Visit:9d. $75 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $75 OP Other,5. $30 Partial Hospitalization,8b. $75 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$5/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$75/Visit:7h. $75 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15				Vision 743				Silver Sneakers	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit								119.554886	99.659464	43.132787	0	99.999968	0.199999	0.2	50	125.000009	65.96806	68.319901	0	1.173886	60.069811	5.000001	29.999999	67.97648	39.708636			0.2				0				0	0	0	0	0								101.5767	84.673072	36.646651	0	84.962373	0.169924	0.169924	42.4812	106.203007	56.048047	58.046228	0	0.997361	51.036753	4.248121	25.488719	57.754449	33.73741			0.169924				0				0	0	0	0	0								11.6708	0.433171447	1.469552125	0	0.968534823	1.498445227	0.541138101	1.095376882	2.96838317	2.76961875	4.25726193	0	0.001523374	2.863492834	1.166540533	8.436966776	0.130409637	2.406999171	0	0	3.386740631	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.065	0	8.1531	11.6708	0.433171447	1.469552125	0	0.968534823	1.498445227	0.541138101	1.095376882	2.96838317	2.76961875	4.25726193	0	0.001523374	2.863492834	1.166540533	8.436966776	0.130409637	2.406999171	0	0	3.386740631	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.065	6000	$950/Admit:1a	$950/Admit:1b	"30% Coins(Days 1-20) 30%(Days 21-100):2. 30% SNF 1,2. 30% SNF 2"	30% Coins:6	$100/Trip:10a	40% Coins:11a	40% Coins:11b	$50/Visit:4a	"30% Coins:9b. 30% Surgery ASC -- Physician,9b. 30% Surgery ASC -- Facility,9a. 30% Surgery OP -- Physician,9a. 30% Surgery OP -- Facility"	"30% Coins:8a. 30% Lab -- FSL,8. 30% Lab -- OP"	"30% Coins:14h. 30% DMAM -- OP,8b. 30% Radiology -- FSR,14h. 30% SMAM -- FSR,14h. 30% SMAM -- OP,8b. 30% Advanced Imaging -- FSR,8b. 30% Advanced Imaging -- Office,9a. 30% Advanced Imaging -- OP,8a. 30% Radiology OP -- Physician,8a. 30% Radiology OP -- Facility"		"$0-$75/Proc:12. $0 Dialysis -- Dialysis Center,12. $75 Dialysis -- OP Hosp"	"30% Coins:9d. 30% Cardiac Rehab,8b. 30% Nuclear Medicine,9a. 30% OP Other,5. 30% Partial Hospitalization,8b. 30% Rad therapy,3. 30% Therapy (AT,PT,ST,OT) -- CORF"	30% Coins:7a	"30% Coins:7b, 7d, 7f"	"30% Coins:7h. 30% Psych -- OP,7e. 30% Psych -- Other Provider"	"30% Coins:9a. 30% Therapy (AT,PT,ST,OT) -- OP,7d. 30% Therapy (AT,PT,ST,OT) - Specialist"			30% Coins:15				Vision 743				Silver Sneakers	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit								1.8512	0.0596	0.341	0.5173	0.6457	1.9	0.6862	0.1933	2.4626	0.3172	1.3196		0.0003	0.7453	1.4944	3.4119	0.0216	0.2881			1.0184				0				0	0	0	0	0								17.2737	0	3.057289644	13.522	0.492815447	1.810524125	0.517292	1.614224823	3.398444227	1.227290101	1.288678882	5.43097817	3.08685775	5.57682893	0	0.001791374	3.608832834	2.660964533	11.84891078	0.151972637	2.695095171	0	0	4.405177631	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.3387
H3405_002_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered							4000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			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		1399.961003	62.333713	488.606464	698.329338	138.898358	9.091605	3.283278	314.177662	340.558445	602.099147	893.644679	0	18.610701	683.630718	3345.888479	4033.172861	27.51267	869.306061			20.548571				2.47				1.65	0.09	0.06	0.05	1.23	2.7							$250/Day(Days 1-5):1a	$250/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$125/Visit:9b. $0 Surgery ASC -- Physician,9b. $125 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $125 Surgery OP -- Facility"	"$0-$75/Visit:8a. $0 Lab -- FSL,8. $75 Lab -- OP"	"$0-$100/Visit:14h. $75 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $75 Radiology OP -- Facility"	$50/Visit:9a	"$0-$75/Proc:12. $0 Dialysis -- Dialysis Center,12. $75 Dialysis -- OP Hosp"	"$30-$100/Visit:9d. $75 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $75 OP Other,5. $30 Partial Hospitalization,8b. $75 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$5/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$75/Visit:7h. $75 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15				Vision 743				Silver Sneakers	Meals on Wheels	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit							153.28	127.77	43.132798	0	99.999972	0.2	0.2	50.000015	124.999971	65.968045	68.319905	0	1.173518	60.069851	4.999999	30.000002	67.97639	39.708638			0.199999				0				0	0	0	0	0	0							128.12	106.8	35.451795	0	82.192177	0.164384	0.164384	41.096112	102.740226	54.220587	56.153633	0	0.98	49.372732	4.109609	24.657662	55.87129	32.637403			0.164384				0				0	0	0	0	0	0							14.9469	0.554770046	1.443498016	0	0.951363202	1.494514396	0.539718371	1.075956699	2.9157543	2.720514099	4.181782945	0	0.001519874	2.812726352	1.145857784	8.287384433	0.128097364	2.364324354	0	0	3.377856295	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9426	0	9.72	14.9469	0.554770046	1.443498016	0	0.951363202	1.494514396	0.539718371	1.075956699	2.9157543	2.720514099	4.181782945	0	0.001519874	2.812726352	1.145857784	8.287384433	0.128097364	2.364324354	0	0	3.377856295	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9426	6000	$950/Admit:1a	$950/Admit:1b	"30% Coins(Days 1-20) 30%(Days 21-100):2. 30% SNF 1,2. 30% SNF 2"	30% Coins:6	$100/Trip:10a	40% Coins:11a	40% Coins:11b	$50/Visit:4a	"30% Coins:9b. 30% Surgery ASC -- Physician,9b. 30% Surgery ASC -- Facility,9a. 30% Surgery OP -- Physician,9a. 30% Surgery OP -- Facility"	"30% Coins:8a. 30% Lab -- FSL,8. 30% Lab -- OP"	"30% Coins:14h. 30% DMAM -- OP,8b. 30% Radiology -- FSR,14h. 30% SMAM -- FSR,14h. 30% SMAM -- OP,8b. 30% Advanced Imaging -- FSR,8b. 30% Advanced Imaging -- Office,9a. 30% Advanced Imaging -- OP,8a. 30% Radiology OP -- Physician,8a. 30% Radiology OP -- Facility"		"$0-$75/Proc:12. $0 Dialysis -- Dialysis Center,12. $75 Dialysis -- OP Hosp"	"30% Coins:9d. 30% Cardiac Rehab,8b. 30% Nuclear Medicine,9a. 30% OP Other,5. 30% Partial Hospitalization,8b. 30% Rad therapy,3. 30% Therapy (AT,PT,ST,OT) -- CORF"	30% Coins:7a	"30% Coins:7b, 7d, 7f"	"30% Coins:7h. 30% Psych -- OP,7e. 30% Psych -- Other Provider"	"30% Coins:9a. 30% Therapy (AT,PT,ST,OT) -- OP,7d. 30% Therapy (AT,PT,ST,OT) - Specialist"			30% Coins:15				Vision 747				Silver Sneakers	Meals on Wheels	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit							1.8183	0.0586	0.3401	0.5159	0.6342	1.895	0.6844	0.1899	2.4561	0.3164	1.3161		0.0003	0.7434	1.4905	3.403	0.0215	0.2873			1.0158				0				0	0	0	0	0	0							17.1868	0	3.72369717	16.7653	0.613357046	1.783575016	0.515934	1.585606202	3.389524396	1.224068371	1.265831699	5.3718843	3.036920099	5.497883945	0	0.001783874	3.556108352	2.636357784	11.69037043	0.149603364	2.651665354	0	0	4.393618295	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.1293
H3405_801_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		247.694227	7.980665	481.207017	687.75385	4.468136	8.818325	3.184588	19.605742	50.396779	592.980967	27.250424	0	0.343863	15.524479	29.246046	66.772149	0.42198	5.638086			19.930911																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999998	1024.00038	43.132812	0	0.199999	0.2	0.2	0.199999	0.2	0	0.199999	0	0.200001	0.2	0.199999	0.2	0.500002	0.2			0.2																				1023.999998	1024.00038	43.132812	0	0.199999	0.2	0.2	0.199999	0.2	0	0.199999	0	0.200001	0.2	0.199999	0.2	0.500002	0.2			0.2																				21.1366	0.681016999	1.729650983	0	0.893622732	1.763665	0.6369176	3.921128794	10.0793558	0	5.45005755	0	0.068772944	3.1048958	5.849179954	13.3544298	0.210990844	1.1276172	0	0	3.9861822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.9941	0	0	21.1366	0.681016999	1.729650983	0	0.893622732	1.763665	0.6369176	3.921128794	10.0793558	0	5.45005755	0	0.068772944	3.1048958	5.849179954	13.3544298	0.210990844	1.1276172	0	0	3.9861822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.9941		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3485	0.0757	0.1922		0.5665	1.1181	0.4038	0.7386	1.9323		1.0354		0.013	0.5848	1.1726	2.6772	0.0423	0.2261			0.7991																				13.9263	0	0	23.4851	0.756684999	1.921833983	0	1.460170732	2.881806	1.0407146	4.659716794	12.0116578	0	6.48546955	0	0.081726944	3.6897338	7.021795954	16.0316478	0.253289844	1.3536752	0	0	4.7853092	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.9203
H3405_802_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		247.694227	7.980665	481.207017	687.75385	4.468136	8.818325	3.184588	19.605742	50.396779	592.980967	27.250424	0	0.343863	15.524479	29.246046	66.772149	0.42198	5.638086			19.930911																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999998	1024.00038	43.132812	0	0.199999	0.2	0.2	0.199999	0.2	0	0.199999	0	0.200001	0.2	0.199999	0.2	0.500002	0.2			0.2																				1023.999998	1024.00038	43.132812	0	0.199999	0.2	0.2	0.199999	0.2	0	0.199999	0	0.200001	0.2	0.199999	0.2	0.500002	0.2			0.2																				21.1366	0.681016999	1.729650983	0	0.893622732	1.763665	0.6369176	3.921128794	10.0793558	0	5.45005755	0	0.068772944	3.1048958	5.849179954	13.3544298	0.210990844	1.1276172	0	0	3.9861822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.9941	0	0	21.1366	0.681016999	1.729650983	0	0.893622732	1.763665	0.6369176	3.921128794	10.0793558	0	5.45005755	0	0.068772944	3.1048958	5.849179954	13.3544298	0.210990844	1.1276172	0	0	3.9861822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.9941		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3485	0.0757	0.1922		0.5665	1.1181	0.4038	0.7386	1.9323		1.0354		0.013	0.5848	1.1726	2.6772	0.0423	0.2261			0.7991																				13.9263	0	0	23.4851	0.756684999	1.921833983	0	1.460170732	2.881806	1.0407146	4.659716794	12.0116578	0	6.48546955	0	0.081726944	3.6897338	7.021795954	16.0316478	0.253289844	1.3536752	0	0	4.7853092	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.9203
H3405_803_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		247.694227	7.980665	481.207017	687.75385	4.468136	8.818325	3.184588	19.605742	50.396779	592.980967	27.250424	0	0.343863	15.524479	29.246046	66.772149	0.42198	5.638086			19.930911																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999998	1024.00038	43.132812	0	0.199999	0.2	0.2	0.199999	0.2	0	0.199999	0	0.200001	0.2	0.199999	0.2	0.500002	0.2			0.2																				1023.999998	1024.00038	43.132812	0	0.199999	0.2	0.2	0.199999	0.2	0	0.199999	0	0.200001	0.2	0.199999	0.2	0.500002	0.2			0.2																				21.1366	0.681016999	1.729650983	0	0.893622732	1.763665	0.6369176	3.921128794	10.0793558	0	5.45005755	0	0.068772944	3.1048958	5.849179954	13.3544298	0.210990844	1.1276172	0	0	3.9861822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.9941	0	0	21.1366	0.681016999	1.729650983	0	0.893622732	1.763665	0.6369176	3.921128794	10.0793558	0	5.45005755	0	0.068772944	3.1048958	5.849179954	13.3544298	0.210990844	1.1276172	0	0	3.9861822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.9941		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3485	0.0757	0.1922		0.5665	1.1181	0.4038	0.7386	1.9323		1.0354		0.013	0.5848	1.1726	2.6772	0.0423	0.2261			0.7991																				13.9263	0	0	23.4851	0.756684999	1.921833983	0	1.460170732	2.881806	1.0407146	4.659716794	12.0116578	0	6.48546955	0	0.081726944	3.6897338	7.021795954	16.0316478	0.253289844	1.3536752	0	0	4.7853092	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.9203
H3405_804_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		247.694227	7.980665	481.207017	687.75385	4.468136	8.818325	3.184588	19.605742	50.396779	592.980967	27.250424	0	0.343863	15.524479	29.246046	66.772149	0.42198	5.638086			19.930911																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999998	1024.00038	43.132812	0	0.199999	0.2	0.2	0.199999	0.2	0	0.199999	0	0.200001	0.2	0.199999	0.2	0.500002	0.2			0.2																				1023.999998	1024.00038	43.132812	0	0.199999	0.2	0.2	0.199999	0.2	0	0.199999	0	0.200001	0.2	0.199999	0.2	0.500002	0.2			0.2																				21.1366	0.681016999	1.729650983	0	0.893622732	1.763665	0.6369176	3.921128794	10.0793558	0	5.45005755	0	0.068772944	3.1048958	5.849179954	13.3544298	0.210990844	1.1276172	0	0	3.9861822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.9941	0	0	21.1366	0.681016999	1.729650983	0	0.893622732	1.763665	0.6369176	3.921128794	10.0793558	0	5.45005755	0	0.068772944	3.1048958	5.849179954	13.3544298	0.210990844	1.1276172	0	0	3.9861822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.9941		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3485	0.0757	0.1922		0.5665	1.1181	0.4038	0.7386	1.9323		1.0354		0.013	0.5848	1.1726	2.6772	0.0423	0.2261			0.7991																				13.9263	0	0	23.4851	0.756684999	1.921833983	0	1.460170732	2.881806	1.0407146	4.659716794	12.0116578	0	6.48546955	0	0.081726944	3.6897338	7.021795954	16.0316478	0.253289844	1.3536752	0	0	4.7853092	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.9203
H3435_001_0	2009	4																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1735.704908	44.2563036	2692.715841	5088.628571	266.568833	16.84230637	9.290869809	379.6721208	386.2845611	6574.286417	483.3204528	0	7.696304949	1462.951637	6873.56511	5627.418064	236.4649545	688.4325641	0	0	1422.67061	1676.159947	2759.542995	523.0549861	205.2567597	154.1150788	49.27524142	14.09480567	932.1	115.5175384											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b, 7d); $0 n/c (7b1); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0.2	0.2	49.97366148	50	8	16.62123034	0	0	46.77659972	1.305839824	17.57541035	20	0	0	0	0	0.001757725	0	20	20	0	20	0	0	20											0	0	0	0	0	0.163544734	0.163544734	40.86464581	40.88618344	6.54178935	13.59157345	0	0	38.25033273	1.067816132	14.37182903	16.35447338	0	0	0	0	0.001437334	0	20	20	0	20	0	0	20											0	0	0	0	0	2.754470511	1.519472829	1.292930562	1.316141785	3.583966406	0.547423786	0	0	4.663198907	0.611641976	6.739690859	0.32227165	0	0	0	0	0.000200767	0	0.87175831	0.342094599	0	0.082125402	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	24.8399	0	5.2052	0	0	0	0	0	2.754470511	1.519472829	1.292930562	1.316141785	3.583966406	0.547423786	0	0	4.663198907	0.611641976	6.739690859	0.32227165	0	0	0	0	0.000200767	0	0.87175831	0.342094599	0	0.082125402	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	24.8399		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.6082	0.0202	0.6184	0.4049	0.0812	0.1031	0.0569	0.0323	0.258	0.0451	0.1094	0	0	0.2058	0.3473	1.0706	0.0137	0.0349	0	0	0.1804	0.079	0	0	0.0039	0.0039	0.0016	0.0006	0	0											5.2793	0	0	1.6082	0.020189043	0.618395968	0.404866222	0.081244778	2.857586672	1.576355706	1.325198599	1.574119261	3.629054219	0.65682099	0	0	4.869044498	0.958939067	7.810283611	0.335922519	0.034890009	0	0	0.180418126	0.079152878	0	0.87175831	0.346006016	0.003931507	0.083745916	0.000575298	0	0.192529231	0	0	0	0	0	0	0	0	0	0	30.1192
H3435_002_0	2009	2																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1734.379857	44.22251799	2690.660201	5084.849563	266.3653323	16.81660109	9.276689781	379.3824289	385.9896685	6569.267556	482.9514822	0	7.69042953	1461.834808	6868.374484	5623.318559	236.2844353	687.9070094	0	0	1421.584532	1674.880354	2759.542995	523.0549861	205.2567597	154.1150788	49.27524142	14.09480567	932.1	115.5175384											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b, 7d); $0 n/c (7b1); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0.2	0.2	49.97364137	50	8	16.62123034	0	0	46.77659972	1.305829043	17.57479617	20	0	0	0	0	0.001757725	0	20	20	0	20	0	0	20											0	0	0	0	0	0.163567345	0.163567345	40.87027916	40.89183621	6.542693794	13.59345257	0	0	38.25562108	1.067954947	14.37331373	16.35673448	0	0	0	0	0.001437532	0	20	20	0	20	0	0	20											0	0	0	0	0	2.75064679	1.517363517	1.292122148	1.315318859	3.581725506	0.547081506	0	0	4.660283209	0.611259542	6.73547682	0.322070148	0	0	0	0	0.000200641	0	0.87175831	0.342094599	0	0.082125402	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	24.8221	0	5.1973	0	0	0	0	0	2.75064679	1.517363517	1.292122148	1.315318859	3.581725506	0.547081506	0	0	4.660283209	0.611259542	6.73547682	0.322070148	0	0	0	0	0.000200641	0	0.87175831	0.342094599	0	0.082125402	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	24.8221		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.6058	0.0202	0.6175	0.4042	0.0811	0.103	0.0568	0.0322	0.2576	0.045	0.1092	0	0	0.2055	0.3468	1.069	0.0136	0.0348	0	0	0.1831	0.0788	0	0	0.0039	0.0039	0.0016	0.0006	0	0											5.2743	0	0	1.6058	0.02015823	0.617452152	0.404248302	0.081120779	2.853605572	1.574159576	1.324365552	1.5729026	3.626744504	0.656311744	0	0	4.865814632	0.958026577	7.804444454	0.335700182	0.034836758	0	0	0.183138187	0.079032253	0	0.87175831	0.346006016	0.003931507	0.083745916	0.000575298	0	0.192529231	0	0	0	0	0	0	0	0	0	0	30.0964
H3435_003_0	2009	4																					1500											D	D	D	V	T	P	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2864.549071	61.96086847	2631.075576	87766.64764	158.8421632	3218.752374	17.2420966	453.8123922	436.1649234	8428.848557	549.1468963	0	12.31904607	1680.176335	7690.55003	6269.221007	250.1036203	287.2631435	0	0	1875.620039	1680.458168	1418.390092	523.0549861	205.2567597	154.1150788	37.56409609	10.74492219	932.1	115.5175384											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	$0 (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b, 7d); $0 n/c (7b1); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0	0.2	49.97796446	50	3.2	16.87836848	0	0	45.70445279	1.385889324	17.95100824	20	0	0	0	0	0.001602202	0	20	0	0	20	0	0	20											0	0	0	0	0	0	0.158470195	39.60008884	39.61754872	2.535523118	13.37359171	0	0	36.2139677	1.098110756	14.22349887	15.84701949	0	0	0	0	0.001269506	0	20	0	0	20	0	0	20											0	0	0	0	0	0	2.732358408	1.497584254	1.439982092	1.780961698	0.612005532	0	0	5.070487626	0.703756309	7.430854825	0.330283079	0	0	0	0	0.000177779	0	0.87175831	0	0	0.062606827	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	22.7253	0	5.6602	0	0	0	0	0	0	2.732358408	1.497584254	1.439982092	1.780961698	0.612005532	0	0	5.070487626	0.703756309	7.430854825	0.330283079	0	0	0	0	0.000177779	0	0.87175831	0	0	0.062606827	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	22.7253		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a3); $0 (6a2)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.5682	0.0283	0.5907	0.3979	0.0993	0.1636	0.1056	0.0386	0.3048	0.0561	0.1266	0	0	0.2459	0.4166	1.2425	0.0149	0.0365	0	0	0.2283	0.0827	0	0	0.0039	0.0039	0.0009	0.0004	0	0											6.7566	0	0	2.5682	0.028323688	0.590740182	0.397908629	0.099313215	0.163633656	2.837922265	1.536156736	1.744831416	1.837084778	0.738648294	0	0	5.31643477	1.120377976	8.673359698	0.345177943	0.036535976	0	0	0.22826555	0.082892083	0	0.87175831	0.003911416	0.003931507	0.063548589	0.000438568	0	0.192529231	0	0	0	0	0	0	0	0	0	0	29.482
H3437_001_0	2009	2																					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																																																			0		286.4984832	7.565220071	943.0382587	1272.168418	129.1176299	11.03710525	9.980359806	305.9014644	344.4472577		4558.05134	127.3510267	7.087027891	183.7166155	3122.183807	3551.967791	278.8768783	373.7228842			22.40149508	1305.946375					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	20.71018681	100	0.2	0.2	48.54428187	47.5		11.5407653	50	50	15.61835313	10	23.52438243	26.80958699	15			0.2	15					15														150.8416258	129.6183462	53.06356375	16.90984254	81.64987934	0.163299759	0.163299759	39.63634757	38.78369269		9.423020944	40.82493967	40.82493967	12.75236649	8.164987934	19.20762987	21.88999543	12.2474819			0.163299759	12.2474819					12.2474819														3.6013	0.081715943	4.170080897	1.792680636	0.878536575	1.802356624	1.629790348	1.010401397	1.113244716	0	3.57921777	0.433258165	0.024110624	0.195235134	2.124382759	5.685406885	0.508717799	0.381430355	0	0	3.65815874	1.332879549	0	0	0	0	0.221998897	0	0	0	0	0	0	0	0	0	0	0	0	0	34.2249	0	7.6918	3.6013	0.081715943	4.170080897	1.792680636	0.878536575	1.802356624	1.629790348	1.010401397	1.113244716	0	3.57921777	0.433258165	0.024110624	0.195235134	2.124382759	5.685406885	0.508717799	0.381430355	0	0	3.65815874	1.332879549	0	0	0	0	0.221998897	0	0	0	0	0	0	0	0	0	0	0	0	0	34.2249		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										5.4533	0.1248	2.3271	0.8899	0.2426	0.6711	0.6068	0.3571	2.5602	1.0822	2.613	0.5527	0.0077	2.3235	1.8745	2.5144	0.1943	0.2183			0.9744	0.7354					0.1167														26.44	500	0	9.0546	0.206551295	6.497133486	2.682611391	1.121161329	2.473407239	2.236591356	1.367509505	3.673487228	1.082236721	6.19217619	0.985930924	0.031772918	2.518720459	3.998872104	8.199853745	0.702977958	0.599780282	0	0	4.63252027	2.068230119	0	0	0	0	0.33873991	0	0	0	0	0	0	0	0	0	0	0	0	0	60.6649
H3437_002_0	2009	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																																																			0		286.4984832	7.565220071	943.0382587	1272.168418	129.1176299	11.03710525	9.980359806	305.9014644	344.4472577		4558.05134	127.3510267	7.087027891	183.7166155	3122.183807	3551.967791	278.8768783	373.7228842			22.40149508	1305.946375					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	20.71018681	100	0.2	0.2	48.54428187	47.5		11.5407653	50	50	15.61835313	10	23.52438243	26.80958699	15			0.2	15					15														150.8416258	129.6183462	53.06356375	16.90984254	81.64987934	0.163299759	0.163299759	39.63634757	38.78369269		9.423020944	40.82493967	40.82493967	12.75236649	8.164987934	19.20762987	21.88999543	12.2474819			0.163299759	12.2474819					12.2474819														3.6013	0.081715943	4.170080897	1.792680636	0.878536575	1.802356624	1.629790348	1.010401397	1.113244716	0	3.57921777	0.433258165	0.024110624	0.195235134	2.124382759	5.685406885	0.508717799	0.381430355	0	0	3.65815874	1.332879549	0	0	0	0	0.221998897	0	0	0	0	0	0	0	0	0	0	0	0	0	34.2249	0	7.6918	3.6013	0.081715943	4.170080897	1.792680636	0.878536575	1.802356624	1.629790348	1.010401397	1.113244716	0	3.57921777	0.433258165	0.024110624	0.195235134	2.124382759	5.685406885	0.508717799	0.381430355	0	0	3.65815874	1.332879549	0	0	0	0	0.221998897	0	0	0	0	0	0	0	0	0	0	0	0	0	34.2249		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										5.4533	0.1248	2.3271	0.8899	0.2426	0.6711	0.6068	0.3571	2.5602	1.0822	2.613	0.5527	0.0077	2.3235	1.8745	2.5144	0.1943	0.2183			0.9744	0.7354					0.1167														26.44	500	0	9.0546	0.206551295	6.497133486	2.682611391	1.121161329	2.473407239	2.236591356	1.367509505	3.673487228	1.082236721	6.19217619	0.985930924	0.031772918	2.518720459	3.998872104	8.199853745	0.702977958	0.599780282	0	0	4.63252027	2.068230119	0	0	0	0	0.33873991	0	0	0	0	0	0	0	0	0	0	0	0	0	60.6649
H3437_003_0	2009	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	V																																																			0		319.4365802	11.85873826	68.1974007		11.274314	20.49398663	18.41755224	555.611689	41.78371534	20.11169616	44.2261041	11.44492761	1.555218895	44.93293187	40.44293069	86.81730042	6.085390197	3.203123957			21.27244483	6.608160778																			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	4a: Medicare FFS Ded/Coin  4b: $35	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																			0.0773	0.0773	0.1766		0.231	0.231	0.231	121.945062	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.205983845																			0.0773	0.0773	0.1766		0.231	0.231	0.231	121.945062	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.205983845																			24.6924	0.916680468	12.04366096	0	2.604366535	4.734110911	4.254454568	5.646175154	9.652038244	4.645801814	10.21623005	2.643778277	0.359255565	10.37950726	9.342316988	20.0547964	1.405725135	0.739921634	0	0	4.913934755	1.361174365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.6064	0	0	24.6924	0.916680468	12.04366096	0	2.604366535	4.734110911	4.254454568	5.646175154	9.652038244	4.645801814	10.21623005	2.643778277	0.359255565	10.37950726	9.342316988	20.0547964	1.405725135	0.739921634	0	0	4.913934755	1.361174365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.6064		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	4a: Medicare FFS Ded/Coin  4b: $35	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														4.4042	0.1635	2.1481		0.4704	0.8613	0.774	1.0076	1.7215	0.8286	1.8222	0.4715	0.0641	1.8548	1.6659	3.581	0.5427	0.132			0.894	0.2466																			23.6541	0	0	29.0966	1.080180712	14.19177997	0	3.074814996	5.595380331	5.028460857	6.653811907	11.37358753	5.47443268	12.03840927	3.115325788	0.423332824	12.23431371	11.00825177	23.63577533	1.948423937	0.871894957	0	0	5.807919247	1.60773749	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	154.2605
H3437_801_0	2009	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																																																			0		243.6607725	4.311135239	39.03072078		6.396544155	11.03710525	9.980359806	16.40152827	42.95178146	18.15609065	43.83616729	9.271887109	0.292958718	38.2505089	33.44064705	82.72781606	2.076826092	3.412260807			22.40149508	8.749628063																			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																			0.0773	0.0773	0.1766		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.0773	0.0773	0.1766		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			18.835	0.333250754	6.89282529	0	1.4776017	2.549571313	2.305463115	3.788753032	9.921861518	4.19405694	10.12615464	2.141805922	0.067673464	8.835867556	7.724789468	19.11012551	0.479746827	0.788232246	0	0	5.174745363	2.021164083	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.7687	0	0	18.835	0.333250754	6.89282529	0	1.4776017	2.549571313	2.305463115	3.788753032	9.921861518	4.19405694	10.12615464	2.141805922	0.067673464	8.835867556	7.724789468	19.11012551	0.479746827	0.788232246	0	0	5.174745363	2.021164083	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.7687		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																			3.3594	0.0594	1.2294		0.2669	0.4638	0.4194	0.6758	1.7697	0.7481	1.8061	0.382	0.0121	1.576	1.3778	3.413	0.0856	0.1406			0.9414	0.3605																			19.087	0	0	22.1944	0.392689764	8.122237999	0	1.744475394	3.013410848	2.724892427	4.464519634	11.69153681	4.94211404	11.93226791	2.523821033	0.079743785	10.41184365	9.10259232	22.52316732	0.565315055	0.928822309	0	0	6.116178722	2.381661946	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.8557
H3437_802_0	2009	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																																																			0		243.6607725	4.311135239	39.03072078		6.396544155	11.03710525	9.980359806	16.40152827	42.95178146	18.15609065	43.83616729	9.271887109	0.292958718	38.2505089	33.44064705	82.72781606	2.076826092	3.412260807			22.40149508	8.749628063																			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																			0.0773	0.0773	0.1766		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.0773	0.0773	0.1766		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			18.835	0.333250754	6.89282529	0	1.4776017	2.549571313	2.305463115	3.788753032	9.921861518	4.19405694	10.12615464	2.141805922	0.067673464	8.835867556	7.724789468	19.11012551	0.479746827	0.788232246	0	0	5.174745363	2.021164083	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.7687	0	0	18.835	0.333250754	6.89282529	0	1.4776017	2.549571313	2.305463115	3.788753032	9.921861518	4.19405694	10.12615464	2.141805922	0.067673464	8.835867556	7.724789468	19.11012551	0.479746827	0.788232246	0	0	5.174745363	2.021164083	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.7687		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																			3.3594	0.0594	1.2294		0.2669	0.4638	0.4194	0.6758	1.7697	0.7481	1.8061	0.382	0.0121	1.576	1.3778	3.413	0.0856	0.1406			0.9414	0.3605																			19.087	0	0	22.1944	0.392689764	8.122237999	0	1.744475394	3.013410848	2.724892427	4.464519634	11.69153681	4.94211404	11.93226791	2.523821033	0.079743785	10.41184365	9.10259232	22.52316732	0.565315055	0.928822309	0	0	6.116178722	2.381661946	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.8557
H3437_803_0	2009	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																																																			0		243.6607725	4.311135239	39.03072078		6.396544155	11.03710525	9.980359806	16.40152827	42.95178146	18.15609065	43.83616729	9.271887109	0.292958718	38.2505089	33.44064705	82.72781606	2.076826092	3.412260807			22.40149508	8.749628063																			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																			0.0773	0.0773	0.1766		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.0773	0.0773	0.1766		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			18.835	0.333250754	6.89282529	0	1.4776017	2.549571313	2.305463115	3.788753032	9.921861518	4.19405694	10.12615464	2.141805922	0.067673464	8.835867556	7.724789468	19.11012551	0.479746827	0.788232246	0	0	5.174745363	2.021164083	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.7687	0	0	18.835	0.333250754	6.89282529	0	1.4776017	2.549571313	2.305463115	3.788753032	9.921861518	4.19405694	10.12615464	2.141805922	0.067673464	8.835867556	7.724789468	19.11012551	0.479746827	0.788232246	0	0	5.174745363	2.021164083	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.7687		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																			3.3594	0.0594	1.2294		0.2669	0.4638	0.4194	0.6758	1.7697	0.7481	1.8061	0.382	0.0121	1.576	1.3778	3.413	0.0856	0.1406			0.9414	0.3605																			19.087	0	0	22.1944	0.392689764	8.122237999	0	1.744475394	3.013410848	2.724892427	4.464519634	11.69153681	4.94211404	11.93226791	2.523821033	0.079743785	10.41184365	9.10259232	22.52316732	0.565315055	0.928822309	0	0	6.116178722	2.381661946	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.8557
H3449_005_0	2009	5																					3350											A	A	D	Coin	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	O	V	V	V	V	Coin	V	Coin	Coin	Coin	V	V	Coin	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		243.6909588	0	1119.039712	10.17135048	215.7821099	22.56720596	0.006598397	1352.695278	1304.159902	15.19289857	37.92131205	0	0.000857587	2150.890201	6696.786993	5017.995594	109.9755333	356.3685936	0	2207.098447	0.162092464	0	0	0	68.10691422	0	0	0	0	0											"(1a) $350 copay per admission, unlimited days"	(1b) $350 copay per admission	"(2) $0 copay for days 1-10, $100 after day 10"	(6) 0% coinsurance	(10a) $100 copay	(11a) 20% coinsurance	"(11b) 20% coinsurance, (11c) 20% coinsurance"	"(4a) $50 copay, includes worldwide coverage and waived copay if admitted to hospital, (4b) $30 copay"	"(9a  - surgery) $100 copay, (9b) $100 copay"	(8a) 10% coinsurance	(8b) 10% coinsurance	(5) 0% coinsurance	(12) 0% coinsurance	"(3) $30 copay for physician services, 20% coinsurance for supplies, (9a - non-surgery) no cost sharing, (9c) $30 copay, (9d) 0% coinsurance"	"(7a) $15 copay, $30 copay for Urgent Care services, (14b) 0% coinsurance, (14c) 0% coinsurance"	(7d) $30 copay	"(7e) $30 copay, (7h) $30 copay"	"(7c) $30 copay, (7i) $30 copay"		"(7b) $30 copay, (7f) $30 copay, (7g) 0% coinsurance, (14d - j) 0% coinsurance"	(15) 20% coinsurance	"(13a) 0% coinsurance, 3 pint deductible waived"	(10b) 0	"(16a) 0, (16b) $30 copay"	(17a) $30 copay	(17b) 20% coinsurance	(18a) $30 copay	(18b) 0	(14a) 0% coinsurance	(13b) 0											350	0	70.14331876	0	100	0.2	0.2	49.6409618	100	0.1	0.1	0	0	0.186119798	12.36242568	30	30	30	0	6.944803072	0.2	0	0	0	30	0	0	0	0	0											298.4237299	0	59.95656066	0	85.26392283	0.170527846	0.170527846	42.32583136	85.26392283	0.085263923	0.085263923	0	0	0.158693041	10.54068909	25.57917685	25.57917685	25.57917685	0	5.921411532	0.170527846	0	0	0	25.57917685	0	0	0	0	0											6.0603	0	5.591147696	0	1.53320243	3.848337014	0.00112521	4.771162685	9.266482437	1.295406131	3.233319824	0	0	0.028444276	5.8823958	10.69634973	0.234423635	0.759634607	0	1.08909485	0.027641279	0	0	0	0.145176567	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.4636	0	9.3965	6.0603	0	5.591147696	0	1.53320243	3.848337014	0.00112521	4.771162685	9.266482437	1.295406131	3.233319824	0	0	0.028444276	5.8823958	10.69634973	0.234423635	0.759634607	0	1.08909485	0.027641279	0	0	0	0.145176567	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.4636																																																																																		0			6.0603	0	5.591147696	0	1.53320243	3.848337014	0.00112521	4.771162685	9.266482437	1.295406131	3.233319824	0	0	0.028444276	5.8823958	10.69634973	0.234423635	0.759634607	0	1.08909485	0.027641279	0	0	0	0.145176567	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.4636
H3449_012_0	2009	2																					3350											A	A	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	O	V	V	V	V	Coin	V	Coin	Coin	Coin	V	V	Coin	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		200.4765637	0	660.0144527	6.21465505	138.5164965	13.8906148	0	1038.189804	66.32467837	12.64799572	30.1977762	0	0.029281111	1709.414147	5322.329367	4432.230002	48.25736006	290.7357001	0	1862.151144	0.01958336	0	0	0	59.33083874	0	0	0	0	0											"(1a) $350 copay per admission, unlimited days"	(1b) $350 copay per admission	"(2) $0 copay for days 1-10, $100 after day 10"	(6) 0% coinsurance	(10a) $100 copay	(11a) 10% coinsurance	"(11b) 10% coinsurance, (11c) 10% coinsurance"	"(4a) $50 copay, includes worldwide coverage and waived copay if admitted to hospital, (4b) $10 copay"	"(9a  - surgery) 0% coinsurance, (9b) 0% coinsurance"	(8a) 0% coinsurance	(8b) 0% coinsurance	(5) 0% coinsurance	(12) 0% coinsurance	"(3) $10 copay for physician services, 10% coinsurance for supplies, (9a - non-surgery) 0% coinsurance, (9c) $10 copay, (9d) 0% coinsurance"	"(7a) $5 copay, $10 copay for Urgent Care services, (14b) 0% coinsurance, (14c) 0% coinsurance"	(7d) $10 copay	"(7e) $10 copay, (7h) $10 copay"	"(7c) $10 copay, (7i) $10 copay"		"(7b) $10 copay, (7f) $10 copay, (7g) 0% coinsurance, (14d - j) 0% coinsurance"	(15) 10% coinsurance	"(13a) 0% coinsurance, 3 pint deductible waived"	(10b) 0	"(16a) 0, (16b) $10 copay"	(17a) $10 copay	(17b) 10% coinsurance	(18a) $10 copay	(18b) 0	(14a) 0% coinsurance	(13b) 0											350	0	68.81208307	0	100	0.1	0	49.30171278	0	0	0	0	0	0.32660408	4.023044782	10	10	10	0	3.001003149	0.1	0	0	0	10	0	0	0	0	0											342.5833845	0	67.43497214	0	97.88096701	0.097880967	0	48.25699322	0	0	0	0	0	0.319683231	3.937795136	9.788096701	9.788096701	9.788096701	0	2.937410902	0.097880967	0	0	0	9.788096701	0	0	0	0	0											5.7233	0	3.709004686	0	1.129844052	1.359626809	0	4.174993194	0	0	0	0	0	0.045539253	1.746520224	3.615257988	0.039362309	0.237145762	0	0.455825256	0.001916838	0	0	0	0.048394666	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2868	0	0.4779	5.7233	0	3.709004686	0	1.129844052	1.359626809	0	4.174993194	0	0	0	0	0	0.045539253	1.746520224	3.615257988	0.039362309	0.237145762	0	0.455825256	0.001916838	0	0	0	0.048394666	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2868																																																																																		0			5.7233	0	3.709004686	0	1.129844052	1.359626809	0	4.174993194	0	0	0	0	0	0.045539253	1.746520224	3.615257988	0.039362309	0.237145762	0	0.455825256	0.001916838	0	0	0	0.048394666	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2868
H3449_013_0	2009	5																					4000											A	A	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	O	V	V	V	V	Coin	V	Coin	Coin	Coin	V	V	Coin	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		233.4363951	0	1323.277201	10.27086417	300.2223449	16.90722776	0.002032339	1402.616805	59.26720222	13.1852888	28.22404933	0	0.147786786	1579.393398	4868.683137	3880.125631	68.13756092	223.2170306	0	1937.229242	0.092275992	0	0	0	66.60878923	0	0	0	0	0											"(1a) $650 copay per admission, unlimited days"	(1b) $650 copay per admission	"(2) $0 copay for days 1-10, $100 after day 10"	(6) 0% coinsurance	(10a) $100 copay	(11a) 20% coinsurance	"(11b) 20% coinsurance, (11c) 20% coinsurance"	"(4a) $50 copay, includes worldwide coverage and waived copay if admitted to hospital, (4b) $30 copay"	"(9a  - surgery) 20% coinsurance, (9b) 20% coinsurance"	(8a) 20% coinsurance	(8b) 20% coinsurance	(5) 0% coinsurance	(12) 0% coinsurance	"(3) $30 copay for physician services, 20% coinsurance for supplies, (9a - non-surgery) 0% coinsurance, (9c) $30 copay, (9d) 0% coinsurance"	"(7a) $15 copay, $30 copay for Urgent Care services, (14b) 0% coinsurance, (14c) 0% coinsurance"	(7d) $30 copay	"(7e) $30 copay, (7h) $30 copay"	"(7c) $30 copay, (7i) $30 copay"	0	"(7b) $30 copay, (7f) $30 copay, (7g) 0% coinsurance, (14d - j) 0% coinsurance"	(15) 20% coinsurance	"(13a) 0% coinsurance, 3 pint deductible waived"	0	(16b) $30 copay	(17a) $30 copay	(17b) 20% coinsurance	(18a) $30 copay	0	(14a) 0% coinsurance	0											700	0	70.82549705	0	100	0.2	0.063771026	49.65605513	0.145380614	0.2	0.2	0	0	0.183029146	12.08738931	30	30	30	0	6.706134336	0.2	0	0	0	30	0	0	0	0	0											602.8768066	0	61.03074239	0	86.12525809	0.172250516	0.055836072	42.76630447	0.124427356	0.172250516	0.172250516	0	0	0.15765504	10.41213874	25.83757743	25.83757743	25.83757743	0	5.777275246	0.172250516	0	0	0	25.83757743	0	0	0	0	0											11.7278	0	6.730049165	0	2.154727245	2.912278709	0.000113478	4.998728112	7.374461291	2.271172802	4.861607066	0	0	0.020749944	4.224450361	8.354420534	0.146709126	0.480615609	0	0.932658879	0.015894587	0	0	0	0.143417479	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3498	0	9.2368	11.7278	0	6.730049165	0	2.154727245	2.912278709	0.000113478	4.998728112	7.374461291	2.271172802	4.861607066	0	0	0.020749944	4.224450361	8.354420534	0.146709126	0.480615609	0	0.932658879	0.015894587	0	0	0	0.143417479	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3498																																																																																		0			11.7278	0	6.730049165	0	2.154727245	2.912278709	0.000113478	4.998728112	7.374461291	2.271172802	4.861607066	0	0	0.020749944	4.224450361	8.354420534	0.146709126	0.480615609	0	0.932658879	0.015894587	0	0	0	0.143417479	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.3498
H3449_801_0	2009	2																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		209.2894179	0	30.63894453	6.359821508	3.997372704	15.3501303	0	13.91604468	78.85584995	16.05087442	39.30563547	0	0	10.62724445	59.12252393	91.41904781	1.46041199	6.368738904	0	11.33936353	1.936409291	2.125366058																			FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																			0.078600764	0	0.202742873	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231																			0.078600764	0	0.202742873	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231																			16.4503	0	6.211827629	0	0.923393095	3.545880099	0	3.214606321	18.21570134	3.707751992	9.079601794	0	0	2.454893468	13.65730303	21.11780005	0.33735517	1.471178687	0	2.619392975	0.447310546	0.490959559	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.9453			16.4503	0	6.211827629	0	0.923393095	3.545880099	0	3.214606321	18.21570134	3.707751992	9.079601794	0	0	2.454893468	13.65730303	21.11780005	0.33735517	1.471178687	0	2.619392975	0.447310546	0.490959559	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.9453																																																																																		0			16.4503	0	6.211827629	0	0.923393095	3.545880099	0	3.214606321	18.21570134	3.707751992	9.079601794	0	0	2.454893468	13.65730303	21.11780005	0.33735517	1.471178687	0	2.619392975	0.447310546	0.490959559	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.9453
H3449_805_0	2009	2																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		209.2894179	0	30.63894453	6.359821508	3.997372704	15.3501303	0	13.91604468	78.85584995	16.05087442	39.30563547	0	0	10.62724445	59.12252393	91.41904781	1.46041199	6.368738904	0	11.33936353	1.936409291	2.125366058																			FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																			0.078600764	0	0.202742873	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231																			0.078600764	0	0.202742873	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231																			16.4503	0	6.211827629	0	0.923393095	3.545880099	0	3.214606321	18.21570134	3.707751992	9.079601794	0	0	2.454893468	13.65730303	21.11780005	0.33735517	1.471178687	0	2.619392975	0.447310546	0.490959559	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.9453			16.4503	0	6.211827629	0	0.923393095	3.545880099	0	3.214606321	18.21570134	3.707751992	9.079601794	0	0	2.454893468	13.65730303	21.11780005	0.33735517	1.471178687	0	2.619392975	0.447310546	0.490959559	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.9453																																																																																		0			16.4503	0	6.211827629	0	0.923393095	3.545880099	0	3.214606321	18.21570134	3.707751992	9.079601794	0	0	2.454893468	13.65730303	21.11780005	0.33735517	1.471178687	0	2.619392975	0.447310546	0.490959559	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.9453
H3449_810_0	2009	2																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		220.634436	0	34.66024158	7.212651405	5.888074929	17.07098219	0	14.89916089	63.44459374	20.43960007	32.7919018	0	0	2.336599154	59.40044665	75.9945857	2.16622971	4.880562948	0	12.81380982	0.018599162	1.834915847																			FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																			0.077281371	0	0.203133756	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231																			0.077281371	0	0.203133756	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231																			17.0509	0	7.040665073	0	1.360145309	3.943396886	0	3.441706165	14.65570115	4.721547617	7.574929316	0	0	0.539754405	13.72150318	17.5547493	0.500399063	1.127410041	0	2.959990068	0.004296407	0.423865561	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.621			17.0509	0	7.040665073	0	1.360145309	3.943396886	0	3.441706165	14.65570115	4.721547617	7.574929316	0	0	0.539754405	13.72150318	17.5547493	0.500399063	1.127410041	0	2.959990068	0.004296407	0.423865561	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.621																																																																																		0			17.0509	0	7.040665073	0	1.360145309	3.943396886	0	3.441706165	14.65570115	4.721547617	7.574929316	0	0	0.539754405	13.72150318	17.5547493	0.500399063	1.127410041	0	2.959990068	0.004296407	0.423865561	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.621
H3449_811_0	2009	2																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		220.634436	0	34.66024158	7.212651405	5.888074929	17.07098219	0	14.89916089	63.44459374	20.43960007	32.7919018	0	0	2.336599154	59.40044665	75.9945857	2.16622971	4.880562948	0	12.81380982	0.018599162	1.834915847																			FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare	FFS Medicare																			0.077281371	0	0.203133756	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231																			0.077281371	0	0.203133756	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231																			17.0509	0	7.040665073	0	1.360145309	3.943396886	0	3.441706165	14.65570115	4.721547617	7.574929316	0	0	0.539754405	13.72150318	17.5547493	0.500399063	1.127410041	0	2.959990068	0.004296407	0.423865561	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.621			17.0509	0	7.040665073	0	1.360145309	3.943396886	0	3.441706165	14.65570115	4.721547617	7.574929316	0	0	0.539754405	13.72150318	17.5547493	0.500399063	1.127410041	0	2.959990068	0.004296407	0.423865561	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.621																																																																																		0			17.0509	0	7.040665073	0	1.360145309	3.943396886	0	3.441706165	14.65570115	4.721547617	7.574929316	0	0	0.539754405	13.72150318	17.5547493	0.500399063	1.127410041	0	2.959990068	0.004296407	0.423865561	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.621
H3456_001_0	2009	4																					3500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	3500	1528.647217	157.3383421	875.5927198	848.9565422	128.1278662	13.10053824	4.838998698	364.4479671	39.79768014	11347.07246	46.31486992	0	0.241063896	30.11364945	5877.926854	4491.009492	707.4876484	254.4792093	0	0	19.96258685	975.4128916	0	0	194.681395	0	17.95347582	11.22	468.1280585	0											"$245 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$245 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											242.1133959	245	85.36789939	0	150	0.2	0.076056143	49.51700137	0.2	2.8	0.173863341	0	0.2	0.197304868	10.91787271	29.99990139	37.5	30	0	0	0.2	28.55424374	0	0	30	0	30	0	0	0											169.2550318	171.2535407	59.67165318	0	104.8491065	0.139798809	0.053162791	34.61208901	0.139798809	1.957183322	0.12152944	0	0.139798809	0.138189861	10.91787271	29.99990139	37.5	20.9698213	0	0	0.139798809	28.55424374	0	0	30	0	30	0	0	0											21.5609	2.245395681	4.354005425	0	1.119507691	1.83143964	0.257254676	1.051192123	5.563668272	1.850691748	5.628620193	0	0.033700445	4.161401046	5.347871431	11.22748683	2.210898901	0.444698629	0	0	2.79074586	2.321014788	0	0	0.486703487	0	0.04488369	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5321	0	22.7619	21.5609	2.245395681	4.354005425	0	1.119507691	1.83143964	0.257254676	1.051192123	5.563668272	1.850691748	5.628620193	0	0.033700445	4.161401046	5.347871431	11.22748683	2.210898901	0.444698629	0	0	2.79074586	2.321014788	0	0	0.486703487	0	0.04488369	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5321		"$325 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$325 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$190 Days 1-19 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.3267	0.1355	0.4407	0.0709	0.0509	0.1249	0.0461	0.0478	0.3795	0.0842	0.3768	0	0.0015	0.2832	0.3964	0.6851	0.1319	0.0236	0	0	0.1904	0.1443	0	0	0.0299	0	0.0028	0	0	0											4.973	0	2.356483877	22.8876	2.380851013	4.79469616	0.0709489	1.170418855	1.956370525	0.303400902	1.098996542	5.943191564	1.934854521	6.005464161	0	0.03523302	4.44455428	5.74428929	11.91258056	2.342777081	0.468292463	0	0	2.981115416	2.465272704	0	0	0.516588789	0	0.047639706	0	0	0	0	0	0	0	0	0	0	0	0	0	79.5051
H3456_010_0	2009	6																																Coin	Coin	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		421.4712864	21.03	8081.1192	197.1011589	21.26690822	8.45349102	13.30608836	13.70868196	14.5944573	30.65824903	30.21023248	0	0.107602306	7.652874452	1.243345213	148.8858858	70.94	12.63193038	0	0	13.63446805	8.212158927	1971.10214	0	75.87301024	112.4593703	0	0	0	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.079473286	0.080554714	0	0	0.2	0.2	0.2	0.085512742	0.2	0.08	0.151746509	0	0.2	0.2	0	0.199275485	0.2	0	0	0	0.2	0.012933592	0	0	0	0	0	0	0	0											0.079473286	0.080554714	0	0	0.2	0.2	0.2	0.085512742	0.2	0.08	0.151746509	0	0.2	0.2	0	0.199275485	0.2	0	0	0	0.2	0.012933592	0	0	0	0	0	0	0	0											33.4957	1.694065638	0	0	4.253381644	1.690698204	2.661217671	1.172266982	2.918891459	2.452659923	4.584297301	0	0.021520461	1.53057489	0	29.66930714	14.188	0	0	0	2.72689361	0.106212711	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.1657	0	0	33.4957	1.694065638	0	0	4.253381644	1.690698204	2.661217671	1.172266982	2.918891459	2.452659923	4.584297301	0	0.021520461	1.53057489	0	29.66930714	14.188	0	0	0	2.72689361	0.106212711	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.1657																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	33.4957	1.694065638	0	0	4.253381644	1.690698204	2.661217671	1.172266982	2.918891459	2.452659923	4.584297301	0	0.021520461	1.53057489	0	29.66930714	14.188	0	0	0	2.72689361	0.106212711	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.1657
H3456_016_0	2009	8																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		349.4315385	23.71	30.70596519	1176.711525	11.67222799	25.23380141	9.26449013	39.27177644	36.62142256	16.43691963	48.63717799	0	0.34108654	28.94030824	34.75913296	129.1715895	13.99	2.064301342	0	0	33.01072032	5.792335543	146.5376362	3695.017245	160.4613263	182.1314926	18.19531739	6.204735726	20.2	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.078388132	0.079450479	0.200530372	0	0.2	0.2	0.2	0.090461511	0.2	0.08	0.2	0	0.2	0.2	0	0.199921771	0.2	0.2	0	0	0.2	0.015698102	0	0	0	0	0	0	0	0											0.078388132	0.079450479	0.200530372	0	0.2	0.2	0.2	0.090461511	0.2	0.08	0.2	0	0.2	0.2	0	0.199921771	0.2	0.2	0	0	0.2	0.015698102	0	0	0	0	0	0	0	0											27.3913	1.88377086	6.15747861	0	2.334445598	5.046760281	1.852898026	3.552584247	7.324284511	1.314953571	9.727435598	0	0.068217308	5.788061648	0	25.82421294	2.798	0.412860268	0	0	6.602144064	0.090928675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.1703	0	0	27.3913	1.88377086	6.15747861	0	2.334445598	5.046760281	1.852898026	3.552584247	7.324284511	1.314953571	9.727435598	0	0.068217308	5.788061648	0	25.82421294	2.798	0.412860268	0	0	6.602144064	0.090928675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.1703																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	27.3913	1.88377086	6.15747861	0	2.334445598	5.046760281	1.852898026	3.552584247	7.324284511	1.314953571	9.727435598	0	0.068217308	5.788061648	0	25.82421294	2.798	0.412860268	0	0	6.602144064	0.090928675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.1703
H3456_020_0	2009	3																					3000											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	3000	1374.305638	154.4772823	663.827226	747.4229799	111.5473904	10.9455926	3.819035098	356.876203	40.74419658	10946.79551	47.73148846	0	0.161438721	34.89403128	5811.594945	4490.17654	708.2462281	342.2147679	0	0	21.01672487	1024.624324	0	0	199.9274549	0	17.96839172	0	468.22188	0											"$260 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$260 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-28 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											256.9387315	260	110	0	150	0.2	0.080457074	49.56441694	0.2	2.8	0.172465284	0	0.2	0.196857701	10.63580215	30	37.5	30	0	0	0.2	28.48791967	0	0	30	0	30	0	0	0											169.9316019	171.9318818	72.74041151	0	99.19147024	0.132255294	0.05320437	32.77578259	0.132255294	1.851574111	0.114047234	0	0.132255294	0.130444195	10.63580215	30	37.5	19.83829405	0	0	0.132255294	28.48791967	0	0	30	0	30	0	0	0											19.4615	2.213297487	4.023922132	0	0.922045805	1.447612563	0.203189355	0.974741403	5.388635684	1.68906693	5.443644244	0	0.021351125	4.551723816	5.150914499	11.22544135	2.213269463	0.565746433	0	0	2.77957312	2.432451287	0	0	0.499818637	0	0.044920979	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2529	0	25.4323	19.4615	2.213297487	4.023922132	0	0.922045805	1.447612563	0.203189355	0.974741403	5.388635684	1.68906693	5.443644244	0	0.021351125	4.551723816	5.150914499	11.22544135	2.213269463	0.565746433	0	0	2.77957312	2.432451287	0	0	0.499818637	0	0.044920979	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2529		"$325 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$325 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$190 Days 1-16 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.1458	0.1273	0.3199	0.059	0.0424	0.0999	0.0349	0.0449	0.372	0.0777	0.3689	0	0.001	0.3134	0.3866	0.6851	0.132	0.0304	0	0	0.1919	0.1511	0	0	0.0307	0	0.0028	0	0	0											4.6179	0	2.364444593	20.6073	2.340640687	4.343838485	0.05898629	0.964486105	1.547559517	0.238061923	1.019607199	5.760681168	1.766811993	5.812582307	0	0.022333884	4.865104825	5.53753245	11.91057862	2.345289045	0.596126908	0	0	2.971482109	2.583596181	0	0	0.530509255	0	0.047679285	0	0	0	0	0	0	0	0	0	0	0	0	0	75.8708
H3456_022_0	2009	4																					2900											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1830.372119	266.0896177	40.22276407	49717.45401	86.56379685	20.14377212	8.906114754	353.7574362	370.8775294	5873.478975	449.1820982	0	0.897844034	1433.559367	5792.094319	4289.088694	1301.980366	255.7593115	0	0	25.91019962	1082.953422	810.5086242	0	327.7093149	349.7142857	0	0	20.2	0											"$175 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$75 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5, 9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											172.9	175	0.207577783	0	75	0.14	0.2	49.97173204	75	4.4	64.79010385	0	0.2	70.28937733	3.251019201	25	20	20	0	0	0.2	13.67894853	0	0	0	0	0	0	0	0											126.8389214	128.3794751	0.207577783	0	55.01977503	0.10270358	0.1467194	36.65911273	55.01977503	3.227826802	47.52982584	0	0.1467194	51.56407637	3.251019201	25	20	20	0	0	0.1467194	13.67894853	0	0	0	0	0	0	0	0											19.3469	2.846703787	8.349352185	0	0.396893386	2.068837513	1.306699814	1.080702811	1.700466519	1.579881071	1.779128908	0	0.131731138	6.160013722	1.569184154	8.935601445	2.169967277	0.426265519	0	0	3.801528944	1.23447201	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.8843	0	15.3246	19.3469	2.846703787	8.349352185	0	0.396893386	2.068837513	1.306699814	1.080702811	1.700466519	1.579881071	1.779128908	0	0.131731138	6.160013722	1.569184154	8.935601445	2.169967277	0.426265519	0	0	3.801528944	1.23447201	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.8843																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.3469	2.846703787	8.349352185	0	0.396893386	2.068837513	1.306699814	1.080702811	1.700466519	1.579881071	1.779128908	0	0.131731138	6.160013722	1.569184154	8.935601445	2.169967277	0.426265519	0	0	3.801528944	1.23447201	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.8843
H3456_801_0	2009	3																					4180											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	Coin	V	V	Coin	O	T	V	P	P	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	1284.099004	184.1098262	515.6974071	658.0082789	105.0391455	11.22847446	4.228304452	347.0902128	42.4895562	12227.55684	47.09808796	0	0.11554482	28.25878601	6613.323083	5041.364109	743.6907564	2.7250072	0	0	25.2352241	1147.984635	0	0	0	0	0	0	0	0											"$380 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$380 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$165 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 9a, 9d); $60 (5); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											375.4997349	380	165	0	150	0.2	0.069602405	47.59732547	0.3	2.8	0.242415403	0	0.2	0.300408312	21.94135809	34.59958516	37.5	0.3	0	0	0.2	34.16718182	0	0	0	0	0	0	0	0											258.2138368	261.2831682	113.451902	0	103.1380927	0.137517457	0.047857729	32.72731578	0.206276185	1.925244397	0.166681749	0	0.137517457	0.206876371	21.94135809	34.59958516	37.5	0.206276185	0	0	0.137517457	34.16718182	0	0	0	0	0	0	0	0											27.631	4.008733223	4.875570973	0	0.902794761	1.544111253	0.202357048	0.946610917	8.764583571	1.961752942	7.85039167	0	0.01588943	5.846075094	12.09210749	14.5357589	2.324033614	0.56210409	0	0	3.470283843	3.268616644	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.8028	0	31.1441	27.631	4.008733223	4.875570973	0	0.902794761	1.544111253	0.202357048	0.946610917	8.764583571	1.961752942	7.85039167	0	0.01588943	5.846075094	12.09210749	14.5357589	2.324033614	0.56210409	0	0	3.470283843	3.268616644	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.8028																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	27.631	4.008733223	4.875570973	0	0.902794761	1.544111253	0.202357048	0.946610917	8.764583571	1.961752942	7.85039167	0	0.01588943	5.846075094	12.09210749	14.5357589	2.324033614	0.56210409	0	0	3.470283843	3.268616644	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.8028
H3456_803_0	2009	3																					4180											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	Coin	V	V	Coin	O	T	V	P	P	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	1284.104744	184.1106492	515.6997124	658.0112203	105.0396151	11.22857485	4.228342254	347.0643566	42.48993607	12227.6115	47.09850903	0	0.115545853	28.25903865	6394.411755	5041.386644	743.6940808	2.725031563	0	0	25.23544971	1147.989766	0	0	0	0	0	0	0	0											"$380 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$380 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$165 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 9a, 9d); $60 (5); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											375.4997349	380	165	0	150	0.2	0.069602405	47.59713573	0.3	2.8	0.242415267	0	0.2	0.300408308	22.69261726	34.59959308	37.5	0.3	0	0	0.2	34.16718182	0	0	0	0	0	0	0	0											258.2133705	261.2826962	113.451697	0	103.1379064	0.137517209	0.047857642	32.7271262	0.206275813	1.925240919	0.166681354	0	0.137517209	0.206875994	22.69261726	34.59959308	37.5	0.206275813	0	0	0.137517209	34.16718182	0	0	0	0	0	0	0	0											27.6311	4.008743901	4.875583961	0	0.902797166	1.544122269	0.202358491	0.946534916	8.764646098	1.961758167	7.850443276	0	0.015889543	5.846116723	12.09216155	14.5358272	2.324044002	0.562108101	0	0	3.4703086	3.268631255	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.8032	0	31.1444	27.6311	4.008743901	4.875583961	0	0.902797166	1.544122269	0.202358491	0.946534916	8.764646098	1.961758167	7.850443276	0	0.015889543	5.846116723	12.09216155	14.5358272	2.324044002	0.562108101	0	0	3.4703086	3.268631255	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.8032																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	27.6311	4.008743901	4.875583961	0	0.902797166	1.544122269	0.202358491	0.946534916	8.764646098	1.961758167	7.850443276	0	0.015889543	5.846116723	12.09216155	14.5358272	2.324044002	0.562108101	0	0	3.4703086	3.268631255	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.8032
H3518_001_0	2009	6	e.3.	i.7.	g.1.	h.6.	h.7.	i.8.					DME/Prosthetics/Supplies	Professional	OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional					3300	Electric Wheelchairs	Urgent Care	Ambulatory Surgical Center	Cardiac Rehab	Chemotherapy	Advanced Imaging					A	A	D		T	O		V	V					V	V	V	V	V			Coin									V	O	V	V	V	V	O																																													0		283.8840766	3.008657252	662.5001456	0	238.8558208	0	0	327.2955422	150.3779424	0	0	0	0	477.4898142	4060.345613	5937.866356	272.0570258	0	0	0	33.225591	0	0	0	0	0	0	0	0	1349.018361	0.013674489	403.79535	164.8358918	517.6746005	11.57067946	371.0976654					$200 for days 1-7	$200 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	$0 copay	$50 copay	$150 copay	$0 copay	$0 copay	$0 copay	$0 copay	"$150 copay on OP Facility, $75 copay on IDTF"	$15 copay	$35 copay	$35 copay	with Cardiac Rehab	$0 copay	$0 copay	20% coinsurance	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	"$50 worldwide ER, $35 worldwide urgent care/specialist, $35 podiatrist, $15 annual physical, $6 allergy injections"	$500 copay	$35 copay	$100 copay	$35 copay for Cardiac Rehab and PT/OT/ST	$150 copay	$100 copay					994.7044511	994.7044511	100	0	100	0	0	50	150	0	0	0	0	150	15	35	35	0	0	0	0.2	0	0	0	0	0	0	0	0	23.57948175	500	35	100	35	150	100					705.88	705.88	70.96	0	70.96	0	0	35.48	106.45	0	0	0	0	106.45	10.64	24.84	24.84	0	0	0	0.141927831	0	0	0	0	0	0	0	0	17.40144021	354.82	24.84	70.96	24.84	106.45	70.96					16.699	0.176979248	3.917584194	0	1.412434087	0	0	0.96770382	1.333977664	0	0	0	0	4.23573256	3.60017311	12.29138336	0.563158043	0	0	0	4.715636079	0	0	0	0	0	0	0	0	1.95623853	0.000404332	0.835856374	0.974729573	1.071586423	0.102641569	2.194424195	0	0	0	0	57.0497		23.2374	16.699	0.176979248	3.917584194	0	1.412434087	0	0	0.96770382	1.333977664	0	0	0	0	4.23573256	3.60017311	12.29138336	0.563158043	0	0	0	4.715636079	0	0	0	0	0	0	0	0	1.95623853	0.000404332	0.835856374	0.974729573	1.071586423	0.102641569	2.194424195	0	0	0	0	57.0497																																																																																		0			16.699	0.176979248	3.917584194	0	1.412434087	0	0	0.96770382	1.333977664	0	0	0	0	4.23573256	3.60017311	12.29138336	0.563158043	0	0	0	4.715636079	0	0	0	0	0	0	0	0	1.95623853	0.000404332	0.835856374	0.974729573	1.071586423	0.102641569	2.194424195	0	0	0	0	57.0497
H3518_801_0	2009	4																																Coin		Coin		Coin	Coin		Coin	Coin					Coin		Coin					Coin	Coin																																																											0		329.3922481		61.56376901		9.398490536	69.56921285		5.004002396	13.83776322					63.03630936		337.43792					36.18136367	0																			7.9% coinsurance		17.3% coinsurance	0% coinsurance	23.1% coinsurance	23.1% coinsurance		23.1% coinsurance	23.1% coinsurance					23.1% coinsurance		23.1% coinsurance					23.1% coinsurance	23.1% coinsurance																																																											0.078855731		0.172687542		0.231	0.231		0.231	0.231					0.231		0.231					0.231	0.231																			25.9745	0	10.63129592	0	2.171051314	16.07048817	0	1.155924553	3.196523304	0	0	0	0	14.56138746	0	77.94815952	0	0	0	0	8.357895009	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.0672	0	0	25.9745	0	10.63129592	0	2.171051314	16.07048817	0	1.155924553	3.196523304	0	0	0	0	14.56138746	0	77.94815952	0	0	0	0	8.357895009	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.0672																																																																																		0	0	0	25.9745	0	10.63129592	0	2.171051314	16.07048817	0	1.155924553	3.196523304	0	0	0	0	14.56138746	0	77.94815952	0	0	0	0	8.357895009	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.0672
H3518_802_0	2009	3																																Coin		Coin		Coin	Coin		Coin	Coin					Coin		Coin					Coin	Coin																																																											0		329.3922481		61.56376901		9.398490536	69.56921285		5.004002396	13.83776322					63.03630936		337.43792					36.18136367	0																			7.9% coinsurance		17.3% coinsurance	0% coinsurance	23.1% coinsurance	23.1% coinsurance		23.1% coinsurance	23.1% coinsurance					23.1% coinsurance		23.1% coinsurance					23.1% coinsurance	23.1% coinsurance																																																											0.078855731		0.172687542		0.231	0.231		0.231	0.231					0.231		0.231					0.231	0.231																			25.9745	0	10.63129592	0	2.171051314	16.07048817	0	1.155924553	3.196523304	0	0	0	0	14.56138746	0	77.94815952	0	0	0	0	8.357895009	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.0672	0	0	25.9745	0	10.63129592	0	2.171051314	16.07048817	0	1.155924553	3.196523304	0	0	0	0	14.56138746	0	77.94815952	0	0	0	0	8.357895009	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.0672																																																																																		0	0	0	25.9745	0	10.63129592	0	2.171051314	16.07048817	0	1.155924553	3.196523304	0	0	0	0	14.56138746	0	77.94815952	0	0	0	0	8.357895009	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.0672
H3518_803_0	2009	3																																Coin		Coin		Coin	Coin		Coin	Coin					Coin		Coin					Coin	Coin																																																											0		329.3922481		61.56376901		9.398490536	69.56921285		5.004002396	13.83776322					63.03630936		337.43792					36.18136367	0																			7.9% coinsurance		17.3% coinsurance	0% coinsurance	23.1% coinsurance	23.1% coinsurance		23.1% coinsurance	23.1% coinsurance					23.1% coinsurance		23.1% coinsurance					23.1% coinsurance	23.1% coinsurance																																																											0.078855731		0.172687542		0.231	0.231		0.231	0.231					0.231		0.231					0.231	0.231																			25.9745	0	10.63129592	0	2.171051314	16.07048817	0	1.155924553	3.196523304	0	0	0	0	14.56138746	0	77.94815952	0	0	0	0	8.357895009	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.0672	0	0	25.9745	0	10.63129592	0	2.171051314	16.07048817	0	1.155924553	3.196523304	0	0	0	0	14.56138746	0	77.94815952	0	0	0	0	8.357895009	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.0672																																																																																		0	0	0	25.9745	0	10.63129592	0	2.171051314	16.07048817	0	1.155924553	3.196523304	0	0	0	0	14.56138746	0	77.94815952	0	0	0	0	8.357895009	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.0672
H3528_001_0	2009	6																																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																																																			0		1940.8496	74.70552732	1666.466504	192.5869216	549.1957389	10.61631747	10.61631747	333.9348217	50.77396785	0	0	0	0	3224.282852	9178.811787	12259.8068	137.6821768	229.4702947	321.2584125	0	10.91818475	0	0	344.485824	1449.53851	353.0979696	69.50426041	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, colorectal exempt"	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											104.9758582	208.125	63	0	100	0.2	0.2	50	90	0	0	0	0	175	15	30	30	30	20	0	0	0	0	11.875	30	1.697777778	30	0	0	0											104.9758582	208.125	63	0	100	0.2	0.2	50	90	0	0	0	0	175	15	30	30	30	20	0	0	0	0	11.875	30	1.697777778	30	0	0	0											16.9785	1.295673989	8.748949145	0	4.576631157	2.123263495	2.123263495	1.39139509	0.380804759	0	0	0	0	47.02079159	11.47351473	30.64951699	0.344205442	0.573675737	0.535430688	0	0	0	0	0.34089743	3.623846274	0.049956824	0.173760651	0	0	0	0	0	0	0	0	0	0	0	0	0	132.4041		0	16.9785	1.295673989	8.748949145	0	4.576631157	2.123263495	2.123263495	1.39139509	0.380804759	0	0	0	0	47.02079159	11.47351473	30.64951699	0.344205442	0.573675737	0.535430688	0	0	0	0	0.34089743	3.623846274	0.049956824	0.173760651	0	0	0	0	0	0	0	0	0	0	0	0	0	132.4041																																																																																		0			16.9785	1.295673989	8.748949145	0	4.576631157	2.123263495	2.123263495	1.39139509	0.380804759	0	0	0	0	47.02079159	11.47351473	30.64951699	0.344205442	0.573675737	0.535430688	0	0	0	0	0.34089743	3.623846274	0.049956824	0.173760651	0	0	0	0	0	0	0	0	0	0	0	0	0	132.4041
H3528_002_0	2009	5																					1500											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	O	O																																																			0		1989.889623	76.59313408	1913.627068	197.4530726	563.0724308	10.88456312	10.88456312	342.372452	52.05688878	0	0	0	0	3831.201255	9410.735552	13410.29816	141.1610333	235.2683888	329.3757443	0	11.19405777	0	0	344.485824	1449.53851	353.0979696	69.5	0	0	0											0	$50 days 1-7 copay	$80 days 21-100 copay	0	$75 copay	20% coinsurance	20% coinsurance	$50 copay	0	0	0	0	0	$60 copay	$0 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	0	0	0											0	46.25	33.6	0	75	0.2	0.2	50	0	0	0	0	0	60	0	15	25	15	20	0	0	0	0	11.875	15	4.244444444	15	0	0	0											0	45.55625	26.88	0	73.875	0.16	0.16	49.25	0	0	0	0	0	59.1	0	14.775	24.625	14.775	19.7	0	0	0	0	11.696875	14.775	4.180777778	14.775	0	0	0											0	0.290774664	4.286524631	0	3.466414652	1.7415301	1.7415301	1.405153605	0	0	0	0	0	18.86866618	0	16.51142961	0.289674204	0.289674204	0.54072518	0	0	0	0	0.335783969	1.78474429	0.123018679	0.085571875	0	0	0	0	0	0	0	0	0	0	0	0	0	51.7612	0	2.26	0	0.290774664	4.286524631	0	3.466414652	1.7415301	1.7415301	1.405153605	0	0	0	0	0	18.86866618	0	16.51142961	0.289674204	0.289674204	0.54072518	0	0	0	0	0.335783969	1.78474429	0.123018679	0.085571875	0	0	0	0	0	0	0	0	0	0	0	0	0	51.7612																																																																																		0			0	0.290774664	4.286524631	0	3.466414652	1.7415301	1.7415301	1.405153605	0	0	0	0	0	18.86866618	0	16.51142961	0.289674204	0.289674204	0.54072518	0	0	0	0	0.335783969	1.78474429	0.123018679	0.085571875	0	0	0	0	0	0	0	0	0	0	0	0	0	51.7612
H3528_003_0	2009	3																																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																																																			0		2026.800695	78.01388357	1949.123522	201.11569	573.5170337	11.08646422	11.08646422	348.7232235	53.02250795	0	0	0	0	3902.26738	9585.298166	13659.04989	143.7794725	239.6324542	335.4854358	0	11.40169977	0	0	344.485824	1449.53851	353.0979696	69.50426041	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, colorectal exempt"	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											43.42627648	92.5	63	0	75	0.2	0.2	50	90	0	0	0	0	175	10	20	25	20	20	0	0	0	0	11.875	20	0	20	0	0	0											43.42627648	92.5	63	0	75	0.2	0.2	50	90	0	0	0	0	175	10	20	25	20	20	0	0	0	0	11.875	20	0	20	0	0	0											7.3347	0.601357019	10.23289849	0	3.584481461	2.217292843	2.217292843	1.453013431	0.39766881	0	0	0	0	56.90806595	7.987748472	22.76508314	0.299540568	0.399387424	0.559142393	0	0	0	0	0.34089743	2.415897516	0	0.115840434	0	0	0	0	0	0	0	0	0	0	0	0	0	119.8303		0	7.3347	0.601357019	10.23289849	0	3.584481461	2.217292843	2.217292843	1.453013431	0.39766881	0	0	0	0	56.90806595	7.987748472	22.76508314	0.299540568	0.399387424	0.559142393	0	0	0	0	0.34089743	2.415897516	0	0.115840434	0	0	0	0	0	0	0	0	0	0	0	0	0	119.8303																																																																																		0			7.3347	0.601357019	10.23289849	0	3.584481461	2.217292843	2.217292843	1.453013431	0.39766881	0	0	0	0	56.90806595	7.987748472	22.76508314	0.299540568	0.399387424	0.559142393	0	0	0	0	0.34089743	2.415897516	0	0.115840434	0	0	0	0	0	0	0	0	0	0	0	0	0	119.8303
H3528_004_0	2009	5																					1500											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																																																			0		2773.290752	106.7471421	2667.004334	275.1885199	784.7488358	15.16971489	15.16971489	477.1613179	72.55120413	0	0	0	0	5339.509733	13115.65505	15966.46166	196.7348257	327.8913762	459.0479266	0	15.60105472	0	0	344.485824	1449.53851	353.0979696	69.5	0	0	0											0	0	$75 days 21-100 copay	0	$75 copay	20% coinsurance	20% coinsurance	$50 copay	0	0	0	0	0	$60 copay	$0 copay	"$15 copay, $0 Podiatry"	$25 copay	$15 copay	$20 copay	0	0% coinsurance	0	0	$150 max benefit	$0 copay	$100 1 year max benefit	$15 copay	0	0	0											0	0	31.5	0	75	0.2	0.2	50	0	0	0	0	0	60	0	13.5	25	15	20	0	0	0	0	11.875	0	0	15	0	0	0											0	0	25.2	0	73.875	0.16	0.16	49.25	0	0	0	0	0	59.1	0	13.2975	24.625	14.775	19.7	0	0	0	0	11.696875	0	0	14.775	0	0	0											0	0	5.600709102	0	4.831110021	2.427154383	2.427154383	1.958349576	0	0	0	0	0	26.29708543	0	17.69283532	0.403716257	0.403716257	0.75360368	0	0	0	0	0.335783969	0	0	0.085571875	0	0	0	0	0	0	0	0	0	0	0	0	0	63.2168		2.97	0	0	5.600709102	0	4.831110021	2.427154383	2.427154383	1.958349576	0	0	0	0	0	26.29708543	0	17.69283532	0.403716257	0.403716257	0.75360368	0	0	0	0	0.335783969	0	0	0.085571875	0	0	0	0	0	0	0	0	0	0	0	0	0	63.2168																																																																																		0			0	0	5.600709102	0	4.831110021	2.427154383	2.427154383	1.958349576	0	0	0	0	0	26.29708543	0	17.69283532	0.403716257	0.403716257	0.75360368	0	0	0	0	0.335783969	0	0	0.085571875	0	0	0	0	0	0	0	0	0	0	0	0	0	63.2168
H3528_005_0	2009	5																					3000											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	O	O																																																			0		2061.579674	79.35256637	1982.569596	204.5667439	583.3583255	11.27670291	11.27670291	354.7071556	53.9323501	0	0	0	0	3969.228515	9749.777529	13893.43298	146.2466629	243.7444382	341.2422135	0	11.59734776	0	0	344.485824	1449.53851	353.0979696	69.50426041	0	0	0											$75 days 1-7 copay	$125 days 1-7 copay	$90 days 21-100 copay	0	$100 copay	20% coinsurance	20% coinsurance	$50 copay	"$75 copay, colorectal exempt"	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											39.36594681	115.625	75.6	0	100	0.2	0.2	50	67.5	0	0	0	0	175	15	25	25	25	20	0	0	0	0	11.875	25	1.697777778	25	0	0	0											38.77545761	113.890625	60.48	0	98.5	0.16	0.16	49.25	66.4875	0	0	0	0	172.375	14.775	24.625	24.625	24.625	19.7	0	0	0	0	11.696875	24.625	1.672311111	24.625	0	0	0											6.6616	0.753126115	9.992150764	0	4.788399588	1.804272465	1.804272465	1.455777284	0.298818927	0	0	0	0	57.01631378	12.00441358	28.51048226	0.30011034	0.500183899	0.560205967	0	0	0	0	0.335783969	2.974573816	0.049207471	0.142628534	0	0	0	0	0	0	0	0	0	0	0	0	0	129.9523		4.76	6.6616	0.753126115	9.992150764	0	4.788399588	1.804272465	1.804272465	1.455777284	0.298818927	0	0	0	0	57.01631378	12.00441358	28.51048226	0.30011034	0.500183899	0.560205967	0	0	0	0	0.335783969	2.974573816	0.049207471	0.142628534	0	0	0	0	0	0	0	0	0	0	0	0	0	129.9523																																																																																		0			6.6616	0.753126115	9.992150764	0	4.788399588	1.804272465	1.804272465	1.455777284	0.298818927	0	0	0	0	57.01631378	12.00441358	28.51048226	0.30011034	0.500183899	0.560205967	0	0	0	0	0.335783969	2.974573816	0.049207471	0.142628534	0	0	0	0	0	0	0	0	0	0	0	0	0	129.9523
H3528_006_0	2009	4																					1500											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	O	O																																																			0		1951.832984	79.08241094	1975.819947	203.8702974	552.3036706	10.67639585	10.67639585	335.8245789	51.06130078	0	0	0	0	3757.929531	9230.755234	13153.82621	145.7487669	230.7688809	323.0764332	0	11.55786465	0	0	337.8975326	1421.816086	346.3449709	66.025	0	0	0											0	$50 days 1-7 copay	$50 days 21-100 copay	0	$75 copay	20% coinsurance	20% coinsurance	$50 copay	0	0	0	0	0	$60 copay	$0 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	0	0	0											0	46.25	21	0	75	0.2	0.2	50	0	0	0	0	0	60	0	15	25	15	20	0	0	0	0	11.875	15	4.244444444	15	0	0	0											0	45.55625	16.8	0	73.875	0.16	0.16	49.25	0	0	0	0	0	59.1	0	14.775	24.625	14.775	19.7	0	0	0	0	11.696875	14.775	4.180777778	14.775	0	0	0											0	0.30022484	2.766147926	0	3.400119472	1.708223337	1.708223337	1.378280043	0	0	0	0	0	18.50780294	0	16.19564852	0.299088615	0.284134185	0.530383811	0	0	0	0	0.3293621	1.750611055	0.120665946	0.081293281	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3602		2.26	0	0.30022484	2.766147926	0	3.400119472	1.708223337	1.708223337	1.378280043	0	0	0	0	0	18.50780294	0	16.19564852	0.299088615	0.284134185	0.530383811	0	0	0	0	0.3293621	1.750611055	0.120665946	0.081293281	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3602		$100 days 1-7 copay	0	0	0	$75 copay	20% coinsurance	20% coinsurance	$50 copay	20% coinsurance	0	0	0	0	20% coinsurance	$25 copay	$25 copay	0	$25 copay	20% coinsurance	0	0% coinsurance	0	0	$150 max benefit	$25 copay	$100 1 year max benefit	$25 copay	0	0	0											0.542	0	0	0	0.1817	0.1124	0.1124	0.0736	0.0158	0	0	0	0	1.0236	1.0121	1.4423	0	0.0253	0.0725	0	0	0	0	0.0173	0.1559	0.0064	0.0072	0	0	0											4.8006			0.542	0.30022484	2.766147926	0	3.581798311	1.820606451	1.820606451	1.451925784	0.015838883	0	0	0	0	19.53137639	1.012144214	17.63795403	0.299088615	0.30943779	0.602901928	0	0	0	0	0.346696948	1.906511942	0.127016786	0.088532865	0	0	0	0	0	0	0	0	0	0	0	0	0	54.1608
H3528_007_0	2009	2																					1500											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	O	O																																																			0		1951.832984	79.08241094	1975.819947	203.8702974	552.3036706	10.67639585	10.67639585	335.8245789	51.06130078	0	0	0	0	3757.929531	9230.755234	13153.82621	145.7487669	230.7688809	323.0764332	0	11.55786465	0	0	337.8975326	1421.816086	346.3449709	66.025	0	0	0											0	$50 days 1-7 copay	$50 days 21-100 copay	0	$75 copay	20% coinsurance	20% coinsurance	$50 copay	0	0	0	0	0	$60 copay	$0 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	0	0	0											0	46.25	21	0	75	0.2	0.2	50	0	0	0	0	0	60	0	15	25	15	20	0	0	0	0	11.875	15	4.244444444	15	0	0	0											0	45.55625	16.8	0	73.875	0.16	0.16	49.25	0	0	0	0	0	59.1	0	14.775	24.625	14.775	19.7	0	0	0	0	11.696875	14.775	4.180777778	14.775	0	0	0											0	0.30022484	2.766147926	0	3.400119472	1.708223337	1.708223337	1.378280043	0	0	0	0	0	18.50780294	0	16.19564852	0.299088615	0.284134185	0.530383811	0	0	0	0	0.3293621	1.750611055	0.120665946	0.081293281	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3602		2.26	0	0.30022484	2.766147926	0	3.400119472	1.708223337	1.708223337	1.378280043	0	0	0	0	0	18.50780294	0	16.19564852	0.299088615	0.284134185	0.530383811	0	0	0	0	0.3293621	1.750611055	0.120665946	0.081293281	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3602		$100 days 1-7 copay	0	0	0	$75 copay	20% coinsurance	20% coinsurance	$50 copay	20% coinsurance	0	0	0	0	20% coinsurance	$25 copay	$25 copay	0	$25 copay	20% coinsurance	0	0% coinsurance	0	0	$150 max benefit	$25 copay	$100 1 year max benefit	$25 copay	0	0	0											0.542	0	0	0	0.1817	0.1124	0.1124	0.0736	0.0158	0	0	0	0	1.0236	1.0121	1.4423	0	0.0253	0.0725	0	0	0	0	0.0173	0.1559	0.0064	0.0072	0	0	0											4.8006			0.542	0.30022484	2.766147926	0	3.581798311	1.820606451	1.820606451	1.451925784	0.015838883	0	0	0	0	19.53137639	1.012144214	17.63795403	0.299088615	0.30943779	0.602901928	0	0	0	0	0.346696948	1.906511942	0.127016786	0.088532865	0	0	0	0	0	0	0	0	0	0	0	0	0	54.1608
H3528_801_0	2009	3																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	Coin	Coin	V	Coin	V	Coin	O																																																			0		1940.8496	74.70552732	1866.466504	192.5869216	19.57171337	10.61631747	10.61631747	11.8248886	1.496226695	0	0	0	0	96.69229064	96.68941069	129.1445474	1.45034116	2.417235267	3.384129374	8.637862787	10.91818475	0	0	0.177988152	7.927193122	0	0.776541367	0	0	0											2008 Mcare defined cost share	2008 Mcare defined cost share	$128/day (Days 21 - 100)	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	50% Days 1 - 999	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	0											148	148	45.34	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.5	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0	0.231	0	0.231	0											148	148	45.34	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.5	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0	0.231	0	0.231	0											23.9371	0.92136817	7.052132607	0	4.521065789	2.452369337	2.452369337	2.731549267	0.345628367	0	0	0	0	22.33591914	22.33525387	29.83239046	0.72517058	0.558381347	0.781733885	1.995346304	2.522100678	0	0	0.041115263	1.831181611	0	0.179381056	0	0	0	0	0	0	0	0	0	0	0	0	0	127.5516			23.9371	0.92136817	7.052132607	0	4.521065789	2.452369337	2.452369337	2.731549267	0.345628367	0	0	0	0	22.33591914	22.33525387	29.83239046	0.72517058	0.558381347	0.781733885	1.995346304	2.522100678	0	0	0.041115263	1.831181611	0	0.179381056	0	0	0	0	0	0	0	0	0	0	0	0	0	127.5516																																																																																		0			23.9371	0.92136817	7.052132607	0	4.521065789	2.452369337	2.452369337	2.731549267	0.345628367	0	0	0	0	22.33591914	22.33525387	29.83239046	0.72517058	0.558381347	0.781733885	1.995346304	2.522100678	0	0	0.041115263	1.831181611	0	0.179381056	0	0	0	0	0	0	0	0	0	0	0	0	0	127.5516
H3528_805_0	2009	3																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	Coin	Coin	V	Coin	V	Coin	O																																																			0		1940.8496	74.70552732	1866.466504	192.5869216	19.57171337	10.61631747	10.61631747	11.8248886	1.496226695	0	0	0	0	96.69229064	96.68941069	129.1445474	1.45034116	2.417235267	3.384129374	8.637862787	10.91818475	0	0	0.177988152	7.927193122	0	0.776541367	0	0	0											2008 Mcare defined cost share	2008 Mcare defined cost share	$128/day (Days 21 - 100)	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	50% Days 1 - 999	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	0											148	148	45.34	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.5	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0	0.231	0	0.231	0											148	148	45.34	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.5	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0	0.231	0	0.231	0											23.9371	0.92136817	7.052132607	0	4.521065789	2.452369337	2.452369337	2.731549267	0.345628367	0	0	0	0	22.33591914	22.33525387	29.83239046	0.72517058	0.558381347	0.781733885	1.995346304	2.522100678	0	0	0.041115263	1.831181611	0	0.179381056	0	0	0	0	0	0	0	0	0	0	0	0	0	127.5516			23.9371	0.92136817	7.052132607	0	4.521065789	2.452369337	2.452369337	2.731549267	0.345628367	0	0	0	0	22.33591914	22.33525387	29.83239046	0.72517058	0.558381347	0.781733885	1.995346304	2.522100678	0	0	0.041115263	1.831181611	0	0.179381056	0	0	0	0	0	0	0	0	0	0	0	0	0	127.5516																																																																																		0			23.9371	0.92136817	7.052132607	0	4.521065789	2.452369337	2.452369337	2.731549267	0.345628367	0	0	0	0	22.33591914	22.33525387	29.83239046	0.72517058	0.558381347	0.781733885	1.995346304	2.522100678	0	0	0.041115263	1.831181611	0	0.179381056	0	0	0	0	0	0	0	0	0	0	0	0	0	127.5516
H3528_806_0	2009	3																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	Coin	Coin	V	Coin	V	Coin	O																																																			0		1903.730851	77.13345696	1927.126665	188.9036967	19.19740435	10.4132804	10.4132804	11.59873761	1.467611359	0	0	0	0	94.84305058	94.84022571	126.674658	1.497477248	2.371005643	3.3194079	8.397789799	10.70937447	0	0	0.174584129	7.775585554	0	0.761690013	0	0	0											2008 Mcare defined cost share	2008 Mcare defined cost share	$128/day (Days 21 - 100)	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	50% Days 1 - 999	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	0											148	148	45.34	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.5	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0	0.231	0	0.231	0											148	148	45.34	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.5	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0	0.231	0	0.231	0											23.4793	0.951312636	7.281326916	0	4.434600406	2.405467773	2.405467773	2.679308387	0.339018224	0	0	0	0	21.90874468	21.90809214	29.26184599	0.748738624	0.547702303	0.766783225	1.939889444	2.473865502	0	0	0.040328934	1.796160263	0	0.175950393	0	0	0	0	0	0	0	0	0	0	0	0	0	125.544			23.4793	0.951312636	7.281326916	0	4.434600406	2.405467773	2.405467773	2.679308387	0.339018224	0	0	0	0	21.90874468	21.90809214	29.26184599	0.748738624	0.547702303	0.766783225	1.939889444	2.473865502	0	0	0.040328934	1.796160263	0	0.175950393	0	0	0	0	0	0	0	0	0	0	0	0	0	125.544		20% Coinsurance	0	0	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	0	0	0											3.5699	0	0	0	0.2334	0.1266	0.1266	0.141	0.0178	0	0	0	0	1.1531	1.1531	1.5401	0	0.0288	0.0404	0.1021	0.1302	0	0	0.0021	0.0945	0	0.0093														8.469			27.0493	0.951312636	7.281326916	0	4.668000427	2.53207134	2.53207134	2.820324618	0.356861288	0	0	0	0	23.06183651	23.06114962	30.80194315	0.748738624	0.57652874	0.807140237	2.041988888	2.60406895	0	0	0.042451509	1.890695014	0	0.18521094	0	0	0	0	0	0	0	0	0	0	0	0	0	134.013
H3528_807_0	2009	3																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	Coin	Coin	V	Coin	V	Coin	O																																																			0		1903.730851	77.13345696	1927.126665	188.9036967	19.19740435	10.4132804	10.4132804	11.59873761	1.467611359	0	0	0	0	94.84305058	94.84022571	126.674658	1.497477248	2.371005643	3.3194079	8.397789799	10.70937447	0	0	0.174584129	7.775585554	0	0.761690013	0	0	0											2008 Mcare defined cost share	2008 Mcare defined cost share	$128/day (Days 21 - 100)	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	50% Days 1 - 999	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	0											148	148	45.34	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.5	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0	0.231	0	0.231	0											148	148	45.34	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.5	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0	0.231	0	0.231	0											23.4793	0.951312636	7.281326916	0	4.434600406	2.405467773	2.405467773	2.679308387	0.339018224	0	0	0	0	21.90874468	21.90809214	29.26184599	0.748738624	0.547702303	0.766783225	1.939889444	2.473865502	0	0	0.040328934	1.796160263	0	0.175950393	0	0	0	0	0	0	0	0	0	0	0	0	0	125.544			23.4793	0.951312636	7.281326916	0	4.434600406	2.405467773	2.405467773	2.679308387	0.339018224	0	0	0	0	21.90874468	21.90809214	29.26184599	0.748738624	0.547702303	0.766783225	1.939889444	2.473865502	0	0	0.040328934	1.796160263	0	0.175950393	0	0	0	0	0	0	0	0	0	0	0	0	0	125.544		20% Coinsurance	0	0	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	0	0	0											3.5699	0	0	0	0.2334	0.1266	0.1266	0.141	0.0178	0	0	0	0	1.1531	1.1531	1.5401	0	0.0288	0.0404	0.1021	0.1302	0	0	0.0021	0.0945	0	0.0093														8.469			27.0493	0.951312636	7.281326916	0	4.668000427	2.53207134	2.53207134	2.820324618	0.356861288	0	0	0	0	23.06183651	23.06114962	30.80194315	0.748738624	0.57652874	0.807140237	2.041988888	2.60406895	0	0	0.042451509	1.890695014	0	0.18521094	0	0	0	0	0	0	0	0	0	0	0	0	0	134.013
H3533_001_0	2009	9																					3200											D	D	D	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1724.752028	22.04656946	582.9143881	25.44018126	208.7548779	13.16097785	5.525908047	53.87515284	26.12452926	6.203747419	16.95645436	0.673713979	0.060659358	16.62990489	10801.42486	2644.55606	129.2002997	56.41968121	5241.011707	1741.542864	14.0211202	0	0	936	403.7524018	4.678198548	1.952496044	0	0	0											1a (IP Acute): 100 days 1-5	1b (IP Psych): $150 days 1-5	2a (SNF): 25 days 11-100		10a (Ambulance): 100 copay	11a (DME): 10% coin	11b (Medical Supplies): 10% coin	4a (ER): 50 copay	9b (OP Surg): 15% coin; 9b (OP ASC): 10% coin		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 15% coin; 9c (OP SA): $35 copay; 3 (CORF): 25 copay; 5 (Partial Hosp): 40 copay; 9d (OP Cardiac Rehab): $10 copay		7b (Chiro): $10 copay; 7d (SPC w/Copay): $10 copay	7h (Psych): 35 copay; 7e (MH Non-Phys): 35 copay	7i (PT/ST): 10 copay; 7c (OT): $10 copay	7g (Prof. Other): $10 copay	7g (Prof. Other): $10 copay	15 (Part B Rx): 20% coin			16b (Comp. Dental): $10 copay	17a1 (Routine Eye Exam): 5 copay	17b1 (Non MCR Covered): 100 allowance	18a (Hearing Exam): $10 copay														50.06352091	66.86201464	12.50140768	0	100	0.1	0.1	50	0.149836186	0	0.150412614	0.15	0.2	0.147473768	0	10	35	10	10	10	0.2	0	0	10	5	0	10	0	0	0											46.05503249	61.50850362	11.50044436	0	91.99319516	0.091993195	0.091993195	45.99659758	0.137839095	0	0.13836937	0.137989793	0.18398639	0.135665831	0	9.199319516	32.1976183	9.199319516	9.199319516	9.199319516	0.18398639	0	0	9.199319516	5	0	10	0	0	0											6.6195	0.113004291	0.558647874	0	1.600335685	1.210720404	0.508345937	0.206506144	3.600981466	0	2.346253905	0.092965652	0.011160496	2.256109873	0	2.027343014	0.346661828	0.04325189	4.017811773	1.335084105	2.579695294	0	0	0.717546922	0.168230167	0	0.00162708	0	0	0	0	0	0	0	0	0	0	0	0	0	30.3617		2.6278	6.6195	0.113004291	0.558647874	0	1.600335685	1.210720404	0.508345937	0.206506144	3.600981466	0	2.346253905	0.092965652	0.011160496	2.256109873	0	2.027343014	0.346661828	0.04325189	4.017811773	1.335084105	2.579695294	0	0	0.717546922	0.168230167	0	0.00162708	0	0	0	0	0	0	0	0	0	0	0	0	0	30.3617																																																																																		0			6.6195	0.113004291	0.558647874	0	1.600335685	1.210720404	0.508345937	0.206506144	3.600981466	0	2.346253905	0.092965652	0.011160496	2.256109873	0	2.027343014	0.346661828	0.04325189	4.017811773	1.335084105	2.579695294	0	0	0.717546922	0.168230167	0	0.00162708	0	0	0	0	0	0	0	0	0	0	0	0	0	30.3617
H3533_801_0	2009	10																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		227.9169668	1.247941084	13.12674885	3.805130011	9.166824056	15.16059455	6.365488369	7.661061354	30.09376663	7.146315448	19.5327378	0.776074894	0.069875654	19.15657395	85.13822015	65.06225678	1.029730922	4.600499148	49.26149738	6.49550791	16.15142286	0																			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																			0.0824	0.0824	0.187	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.0824	0.0824	0.187	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			18.7804	0.102830345	2.454702034	0	2.117536357	3.502097341	1.470427813	1.769705173	6.951660091	1.650798868	4.512062433	0.1792733	0.016141276	4.425168583	19.66692885	15.02938132	0.237867843	1.062715303	11.37940589	1.500462327	3.730978682	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.5405		0	18.7804	0.102830345	2.454702034	0	2.117536357	3.502097341	1.470427813	1.769705173	6.951660091	1.650798868	4.512062433	0.1792733	0.016141276	4.425168583	19.66692885	15.02938132	0.237867843	1.062715303	11.37940589	1.500462327	3.730978682	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.5405																																																																																		0			18.7804	0.102830345	2.454702034	0	2.117536357	3.502097341	1.470427813	1.769705173	6.951660091	1.650798868	4.512062433	0.1792733	0.016141276	4.425168583	19.66692885	15.02938132	0.237867843	1.062715303	11.37940589	1.500462327	3.730978682	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.5405
H3597_001_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9965.057534	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$125/day 1-7	$125/day 1-7	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$5 per visit	$25 X-ray; $175 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	10 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$750 Every 3 Yrs	Fitness/Coaching	0											90.35688474	90.35688474	47.56208437	0	100	0.2	0.2	47.5	150	5	52	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											80.47128006	80.47128006	42.35849678	0	100	0.178118757	0.178118757	42.30320483	139.0593786	5	46.31087686	0	17.81187572	17.81187572	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											13.1032	0	4.760734645	0	2.276793099	1.40369887	0	0.896895536	4.455573039	0.43716534	18.19380389	0	0.09919081	1.168177901	6.088949555	16.60842922	0	1.12009741	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.6516	0	5.2184	13.1032	0	4.760734645	0	2.276793099	1.40369887	0	0.896895536	4.455573039	0.43716534	18.19380389	0	0.09919081	1.168177901	6.088949555	16.60842922	0	1.12009741	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.6516																																																																					0	0	0											0			13.1032	0	4.760734645	0	2.276793099	1.40369887	0	0.896895536	4.455573039	0.43716534	18.19380389	0	0.09919081	1.168177901	6.088949555	16.60842922	0	1.12009741	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.6516
H3597_002_0	2009	4																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9965.057534	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$0 	$0 	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$100 per procedure	$0 per visit	$15 X-ray; $175 Complex Radiology	$15 per visit	$15 per visit	$15 per visit	5 PCP visit; $15 if no PCP selected	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$750 Every 3 Yrs	Fitness/Coaching	0											0	0	47.56208437	0	100	0.2	0.2	47.5	100	0	43.8	15	15	15	5	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											0	0	44.55705878	0	100	0.187363777	0.187363777	44.49889697	93.68188836	0	41.0326671	0	14.05228325	14.05228325	5	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											0	0	5.007834308	0	2.276793099	1.476556012	0	0.943447718	3.001642178	0	16.12019355	0	0.078254384	0.921607978	3.044474777	12.45632192	0	0.840073058	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.206	0	1.858	0	0	5.007834308	0	2.276793099	1.476556012	0	0.943447718	3.001642178	0	16.12019355	0	0.078254384	0.921607978	3.044474777	12.45632192	0	0.840073058	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.206																																																																																		0			0	0	5.007834308	0	2.276793099	1.476556012	0	0.943447718	3.001642178	0	16.12019355	0	0.078254384	0.921607978	3.044474777	12.45632192	0	0.840073058	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.206
H3597_003_0	2009	3																					2500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9965.057534	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$0 	$0 	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$15 X-ray; $175 Complex Radiology	$15 per visit	$15 per visit	$15 per visit	5 PCP visit; $15 if no PCP selected	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$750 Every 3 Yrs	Fitness/Coaching	0											0	0	47.56208437	0	100	0.2	0.2	47.5	150	0	43.8	15	15	15	5	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											0	0	43.03713801	0	100	0.180972464	0.180972464	42.98096021	140.486232	0	39.63296962	0	13.5729348	13.5729348	5	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											0	0	4.837008146	0	2.276793099	1.426188052	0	0.911265033	4.501290557	0	15.57030499	0	0.075584987	0.890170286	3.044474777	12.45632192	0	0.840073058	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.8683	0	2.7978	0	0	4.837008146	0	2.276793099	1.426188052	0	0.911265033	4.501290557	0	15.57030499	0	0.075584987	0.890170286	3.044474777	12.45632192	0	0.840073058	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.8683																																																																					0	0	0											0			0	0	4.837008146	0	2.276793099	1.426188052	0	0.911265033	4.501290557	0	15.57030499	0	0.075584987	0.890170286	3.044474777	12.45632192	0	0.840073058	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.8683
H3597_004_0	2009	6																					2500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9965.057534	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$0 	$0 	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$100 per procedure	$0 per visit	$15 X-ray; $175 Complex Radiology	$15 per visit	$15 per visit	$15 per visit	5 PCP visit; $15 if no PCP selected	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$750 Every 3 Yrs	Fitness/Coaching	0											0	0	47.56208437	0	100	0.2	0.2	47.5	100	0	43.8	15	15	15	5	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											0	0	42.92339347	0	100	0.180494165	0.180494165	42.86736414	90.24708241	0	39.52822209	0	13.53706236	13.53706236	5	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											0	0	4.824224227	0	2.276793099	1.422418724	0	0.908856615	2.891588265	0	15.52915362	0	0.07538522	0.88781762	3.044474777	12.45632192	0	0.840073058	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.1959	0	2.8681	0	0	4.824224227	0	2.276793099	1.422418724	0	0.908856615	2.891588265	0	15.52915362	0	0.07538522	0.88781762	3.044474777	12.45632192	0	0.840073058	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.1959																																																																					0	0	0											0		0	0	0	4.824224227	0	2.276793099	1.422418724	0	0.908856615	2.891588265	0	15.52915362	0	0.07538522	0.88781762	3.044474777	12.45632192	0	0.840073058	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.1959
H3597_801_0	2009	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																																																			0		277.6111528	0	34.27949559	5.197182685	6.129682017	8.160151073	0	7.212877713	37.27703524	12.70646701	51.7924748	0	2.826257215	10.74298494	37.94594565	164.8275281	0	4.885106398	0	0	7.37168648	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.076870157	0.076870157	0.147147286	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											21.34	0	5.044134744	0	1.415956546	1.884994898	0	1.666174752	8.610995139	2.935193879	11.96406168	0	0.652865417	2.481629521	8.765513445	38.075159	0	1.128459578	0	0	1.702859577	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.668			21.34	0	5.044134744	0	1.415956546	1.884994898	0	1.666174752	8.610995139	2.935193879	11.96406168	0	0.652865417	2.481629521	8.765513445	38.075159	0	1.128459578	0	0	1.702859577	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.668																																																																																		0			21.34	0	5.044134744	0	1.415956546	1.884994898	0	1.666174752	8.610995139	2.935193879	11.96406168	0	0.652865417	2.481629521	8.765513445	38.075159	0	1.128459578	0	0	1.702859577	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.668
H3597_802_0	2009	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																																																			0		277.6111528	0	34.27949559	5.197182685	6.129682017	8.160151073	0	7.212877713	37.27703524	12.70646701	51.7924748	0	2.826257215	10.74298494	37.94594565	164.8275281	0	4.885106398	0	0	7.37168648	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.076870157	0.076870157	0.147147286	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											21.34	0	5.044134744	0	1.415956546	1.884994898	0	1.666174752	8.610995139	2.935193879	11.96406168	0	0.652865417	2.481629521	8.765513445	38.075159	0	1.128459578	0	0	1.702859577	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.668			21.34	0	5.044134744	0	1.415956546	1.884994898	0	1.666174752	8.610995139	2.935193879	11.96406168	0	0.652865417	2.481629521	8.765513445	38.075159	0	1.128459578	0	0	1.702859577	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.668																																																																																		0			21.34	0	5.044134744	0	1.415956546	1.884994898	0	1.666174752	8.610995139	2.935193879	11.96406168	0	0.652865417	2.481629521	8.765513445	38.075159	0	1.128459578	0	0	1.702859577	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.668
H3619_001_0	2009	6	r.	s.	t.	u.	v.						OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered						4700	Renal Dialysis										D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin					O	O	P	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		1412.103477	62.874362	492.844362	704.386254	140.103083	9.25	3.34048	316.902662	343.512258	607.321416	901.395652	0	0	689.560146	3374.908834	4068.154331	27.7513	876.845933			20.906569			3.13					2.42	0.09	18.47838	0.06	0.05	1.23	2.7						$175/Day(Days 1-5):1a	$175/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$175/Visit:9b. $0 Surgery ASC -- Physician,9b. $125 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $175 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $50 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$35-$100/Visit:9d. $50 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $35 Partial Hospitalization,8b. $100 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$100/Visit:7h. $100 Psych -- OP,7e. $35 Psych -- Other Provider"	"$35-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			"Dental 767 16a, 16b"					$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	$0/Proc:12	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0: Health Education Materials 14a	$0 Corp Health 14a						107.292848	89.437981	43.132805	0	100.000026	0.2	0.2	50.000009	152.313167	87.957411	83.490143	0	0	73.563659	14.999999	34.999999	89.854385	43.629908			0.2			0					0	0	0	0	0	0	0						93.811072	78.199741	37.712995	0	87.434623	0.174869	0.174869	43.717308	133.174408	76.905211	72.999272	0	0	64.320091	13.115189	30.602109	78.563822	38.147636			0.174869			0					0	0	0	0	0	0	0						11.0392	0.409729902	1.548886413	0	1.020821687	1.61753825	0.584146397	1.15451094	3.812253467	3.892181804	5.483435532	0	0	3.696047612	3.688547268	10.37450852	0.181687349	2.787466623	0	0	3.655910814	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.9469	0	7.8965	11.0392	0.409729902	1.548886413	0	1.020821687	1.61753825	0.584146397	1.15451094	3.812253467	3.892181804	5.483435532	0	0	3.696047612	3.688547268	10.37450852	0.181687349	2.787466623	0	0	3.655910814	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.9469		30% Coins	30% Coins	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins			30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins			"Dental 767 16a, 16b"					0	0		0	0	0	0						6.9722	0.0998	0.437	0.6631	0.8081	1.8265	0.6596	0.2419	3.1565	0.4066	1.6914			0.9554	1.9155	4.3733	0.0276	0.3693			1.3054			0					0	0		0	0	0	0						25.9093	500	0	18.0114	0.509506902	1.985936413	0.663052	1.828908687	3.44406725	1.243765397	1.39642994	6.968748467	4.298811804	7.174824532	0	0	4.651404612	5.604062268	14.74785552	0.209326349	3.156741623	0	0	4.961317814	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.8562
H3619_004_0	2009	6	r.	s.	t.	u.	v.						OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered						4600	Renal Dialysis										A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin								O	O	P	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		277.791383	8.95039	539.678072	771.32207	153.416681	11.040601	3.987125	347.017221	376.155507	665.033846	987.053333	0	0	755.087464	3695.511729	4454.638391	30.388447	960.170223			24.953671								2.42	0.09	20.234344	0.06	0.05	1.23	2.7						$750/Admit:1a	$750/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$10/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $50 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $50 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$35-$100/Visit:9d. $50 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $35 Partial Hospitalization,8b. $100 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$100/Visit:7h. $100 Psych -- OP,7e. $35 Psych -- Other Provider"	"$35-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	$0/Proc:12	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0: Health Education Materials 14a	$0 Corp Health 14a						749.999981	749.999465	43.132803	9.999993	99.999973	0.199999	0.199999	49.999996	127.313175	87.9574	77.613411	0	0	73.563668	15.000001	35.000001	89.854542	43.629913			0.199999								0	0	0	0	0	0	0						617.498234	617.49781	35.512573	8.233304	82.333078	0.164666	0.164666	41.166547	104.820884	72.418054	63.901527	0	0	60.567248	12.349965	28.816586	73.980029	35.92186			0.164666								0	0	0	0	0	0	0						14.2946	0.460570519	1.597113077	0.529210757	1.05260563	1.818011604	0.656543925	1.190458395	3.285746064	4.013371414	5.256184601	0	0	3.811130808	3.803286709	10.69728919	0.187344849	2.874258361	0	0	4.109021189	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.6368	0	12.7968	14.2946	0.460570519	1.597113077	0.529210757	1.05260563	1.818011604	0.656543925	1.190458395	3.285746064	4.013371414	5.256184601	0	0	3.811130808	3.803286709	10.69728919	0.187344849	2.874258361	0	0	4.109021189	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.6368		30% Coins	30% Coins	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins			30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins								0	0		0	0	0	0						7.7351	0.1107	0.4849	0.7356	0.8225	2.0264	0.7318	0.2462	3.5019	0.4511	1.8765			1.0599	2.1251	4.8519	0.0307	0.4097			1.4483								0	0		0	0	0	0						28.6483	500	0	22.0298	0.571265519	2.081990077	1.264819757	1.87509763	3.844415604	1.388345925	1.436690395	6.787659064	4.464499414	7.132662601	0	0	4.871032808	5.928418709	15.54921519	0.218007849	3.283943361	0	0	5.557280189	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.2851
H3619_012_0	2009	7	r.	s.	t.	u.	v.						OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered						4700	Renal Dialysis										D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin					O	O	P	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		1460.524778	65.030336	509.744091	728.539794	144.907246	9.895242	3.573498	327.769316	355.291359	628.146586	932.304684	0	0	713.205299	3490.63511	4207.652131	28.702898	906.91315			22.364926			3.13					2.42	0.09	19.112006	0.06	0.05	1.23	2.7						$195/Day(Days 1-5):1a	$195/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$175/Visit:9b. $0 Surgery ASC -- Physician,9b. $125 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $175 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $50 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$30-$100/Visit:9d. $50 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $30 Partial Hospitalization,8b. $100 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			"Dental 767 16a, 16b"					$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	$0/Proc:12	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0: Health Education Materials 14a	$0 Corp Health 14a						119.554887	99.659457	43.132796	0	99.999968	0.199999	0.199999	49.999982	152.313155	87.957392	83.490156	0	0	71.766163	15	30.000001	89.074489	39.70864			0.199999			0					0	0	0	0	0	0	0						104.624156	87.213386	37.746113	0	87.511372	0.175022	0.175022	43.755684	133.291374	76.972745	73.063404	0	0	62.803574	13.12671	26.253421	77.950333	34.749586			0.175022			0					0	0	0	0	0	0	0						12.7338	0.472626316	1.603404838	0	1.056752659	1.731885045	0.625440767	1.195147551	3.946439451	4.029180582	5.676446148	0	0	3.732653481	3.818379567	9.205438568	0.186450038	2.626238042	0	0	3.914354078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.5547	0	8.0708	12.7338	0.472626316	1.603404838	0	1.056752659	1.731885045	0.625440767	1.195147551	3.946439451	4.029180582	5.676446148	0	0	3.732653481	3.818379567	9.205438568	0.186450038	2.626238042	0	0	3.914354078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.5547		$975/Admit	$975/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	30% Coins	30% Coins	30% Coins			30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins			"Dental 767 16a, 16b"					0	0		0	0	0	0						2.5048	0.0807	0.4762	0.7224	0.8513	2.6535	0.9583	0.2548	3.4392	0.443	1.8429			1.0409	2.0871	4.765	0.0301	0.4023			1.4223			0					0	0		0	0	0	0						23.9749	500	0	15.2386	0.553329316	2.079597838	0.722436	1.908023659	4.385373045	1.583703767	1.449994551	7.385636451	4.472228582	7.519318148	0	0	4.773575481	5.905452567	13.97046957	0.216564038	3.028587042	0	0	5.336675078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.5296
H3619_801_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		253.684047	8.173656	492.843718	704.385332	4.686857	9.249993	3.340478	20.565467	52.863763	607.320621	28.584368	0	0.360696	16.28442	30.677676	70.040727	0.442637	5.914077			20.906553																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999983	1023.999541	43.132788	0	0.199999	0.2	0.199999	0.199999	0.2	0	0.2	0	0.199999	0.199999	0.199999	0.2	0.500001	0.2			0.199999																				1023.999983	1023.999541	43.132788	0	0.199999	0.2	0.199999	0.199999	0.2	0	0.2	0	0.199999	0.199999	0.199999	0.2	0.500001	0.2			0.199999																				21.6477	0.697484999	1.771476967	0	0.937366713	1.8499986	0.66809226	4.113072835	10.5727526	0	5.7168736	0	0.072138839	3.256867716	6.135504522	14.0081454	0.221318943	1.1828154	0	0	4.181289693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.0329	0	0	21.6477	0.697484999	1.771476967	0	0.937366713	1.8499986	0.66809226	4.113072835	10.5727526	0	5.7168736	0	0.072138839	3.256867716	6.135504522	14.0081454	0.221318943	1.1828154	0	0	4.181289693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.0329		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4053	0.0775	0.1968		0.5943	1.1729	0.4236	0.7747	2.0269		1.0861		0.0136	0.6135	1.23	2.8083	0.0444	0.2371			0.8382																				14.5432	0	0	24.053	0.774982999	1.968307967	0	1.531647713	3.0228736	1.09165626	4.887815835	12.5996436	0	6.8029706	0	0.085726839	3.870334716	7.365520522	16.8164164	0.265687943	1.4199394	0	0	5.019533693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.5761
H3619_804_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		253.684047	8.173656	492.843718	704.385332	4.686857	9.249993	3.340478	20.565467	52.863763	607.320621	28.584368	0	0.360696	16.28442	30.677676	70.040727	0.442637	5.914077			20.906553																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999983	1023.999541	43.132788	0	0.199999	0.2	0.199999	0.199999	0.2	0	0.2	0	0.199999	0.199999	0.199999	0.2	0.500001	0.2			0.199999																				1023.999983	1023.999541	43.132788	0	0.199999	0.2	0.199999	0.199999	0.2	0	0.2	0	0.199999	0.199999	0.199999	0.2	0.500001	0.2			0.199999																				21.6477	0.697484999	1.771476967	0	0.937366713	1.8499986	0.66809226	4.113072835	10.5727526	0	5.7168736	0	0.072138839	3.256867716	6.135504522	14.0081454	0.221318943	1.1828154	0	0	4.181289693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.0329	0	0	21.6477	0.697484999	1.771476967	0	0.937366713	1.8499986	0.66809226	4.113072835	10.5727526	0	5.7168736	0	0.072138839	3.256867716	6.135504522	14.0081454	0.221318943	1.1828154	0	0	4.181289693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.0329		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4053	0.0775	0.1968		0.5943	1.1729	0.4236	0.7747	2.0269		1.0861		0.0136	0.6135	1.23	2.8083	0.0444	0.2371			0.8382																				14.5432	0	0	24.053	0.774982999	1.968307967	0	1.531647713	3.0228736	1.09165626	4.887815835	12.5996436	0	6.8029706	0	0.085726839	3.870334716	7.365520522	16.8164164	0.265687943	1.4199394	0	0	5.019533693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.5761
H3619_806_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		253.684047	8.173656	492.843718	704.385332	4.686857	9.249993	3.340478	20.565467	52.863763	607.320621	28.584368	0	0.360696	16.28442	30.677676	70.040727	0.442637	5.914077			20.906553																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999983	1023.999541	43.132788	0	0.199999	0.2	0.199999	0.199999	0.2	0	0.2	0	0.199999	0.199999	0.199999	0.2	0.500001	0.2			0.199999																				1023.999983	1023.999541	43.132788	0	0.199999	0.2	0.199999	0.199999	0.2	0	0.2	0	0.199999	0.199999	0.199999	0.2	0.500001	0.2			0.199999																				21.6477	0.697484999	1.771476967	0	0.937366713	1.8499986	0.66809226	4.113072835	10.5727526	0	5.7168736	0	0.072138839	3.256867716	6.135504522	14.0081454	0.221318943	1.1828154	0	0	4.181289693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.0329	0	0	21.6477	0.697484999	1.771476967	0	0.937366713	1.8499986	0.66809226	4.113072835	10.5727526	0	5.7168736	0	0.072138839	3.256867716	6.135504522	14.0081454	0.221318943	1.1828154	0	0	4.181289693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.0329		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4053	0.0775	0.1968		0.5943	1.1729	0.4236	0.7747	2.0269		1.0861		0.0136	0.6135	1.23	2.8083	0.0444	0.2371			0.8382																				14.5432	0	0	24.053	0.774982999	1.968307967	0	1.531647713	3.0228736	1.09165626	4.887815835	12.5996436	0	6.8029706	0	0.085726839	3.870334716	7.365520522	16.8164164	0.265687943	1.4199394	0	0	5.019533693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.5761
H3619_807_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		253.684047	8.173656	492.843718	704.385332	4.686857	9.249993	3.340478	20.565467	52.863763	607.320621	28.584368	0	0.360696	16.28442	30.677676	70.040727	0.442637	5.914077			20.906553																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999983	1023.999541	43.132788	0	0.199999	0.2	0.199999	0.199999	0.2	0	0.2	0	0.199999	0.199999	0.199999	0.2	0.500001	0.2			0.199999																				1023.999983	1023.999541	43.132788	0	0.199999	0.2	0.199999	0.199999	0.2	0	0.2	0	0.199999	0.199999	0.199999	0.2	0.500001	0.2			0.199999																				21.6477	0.697484999	1.771476967	0	0.937366713	1.8499986	0.66809226	4.113072835	10.5727526	0	5.7168736	0	0.072138839	3.256867716	6.135504522	14.0081454	0.221318943	1.1828154	0	0	4.181289693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.0329	0	0	21.6477	0.697484999	1.771476967	0	0.937366713	1.8499986	0.66809226	4.113072835	10.5727526	0	5.7168736	0	0.072138839	3.256867716	6.135504522	14.0081454	0.221318943	1.1828154	0	0	4.181289693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.0329		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4053	0.0775	0.1968		0.5943	1.1729	0.4236	0.7747	2.0269		1.0861		0.0136	0.6135	1.23	2.8083	0.0444	0.2371			0.8382																				14.5432	0	0	24.053	0.774982999	1.968307967	0	1.531647713	3.0228736	1.09165626	4.887815835	12.5996436	0	6.8029706	0	0.085726839	3.870334716	7.365520522	16.8164164	0.265687943	1.4199394	0	0	5.019533693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.5761
H3620_001_0	2009	8																					3500											D	D	D		T	Coin	Coin	V	V	V	Coin			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	884.3503368	21.52920697	553.662222	0	209.5021718	7.959236251	5.04729999	286.7002447	281.7334946	1701.560389	28.12461274	0	0	398.6376819	3443.860934	2960.021824	134.362546	1000.748824	1103.941282	3197.353056	0	0	0	0	302.7749056	0	123.7069859	0	0	0											$150/Days 1-10 for IP Medical; $150/Days 1-10 for IP Surgical;	$150/Days 1-10 for IP Psych; $150/Days 1-10 for IP Substance Abuse;	$50/Days 11-30; $75/Days 31-100		$125/Run 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; $40/Visit for Urgent Care; $40/Visit for Urgent Care - Worldwide;	$150/Case for OP Fac - Surgery; $150/Case for OP Fac - ASC	$15/Case for OP Fac - Pathology	$15/Case for OP Fac - Radiology; $15/Case for OP Fac - CT/MRI/PET;15% Coinsurance for Chemo/Radiation Therapy			$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;	$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 OP Psych - Non-Physician; $30/Visit for OP Psych - Psychiatrist; $30/Visit for OP Substance Abuse;	$5/Visit for PT/ST (PCP); $5/Case for Occ Therapy (PCP); $5/Visit for PT/ST (Specialist); $5/Visit for Occ Therapy (Specialist);	$15/Procedure for Prof Radiology (Office);	$30/Visit for Chiropractor; $30/Exam for Vision Exams; $30/Service for Podiatrist; $30/Exam for Hearing/Speech Exams; $15/Procedure for Prof Path (Labs)					$30/Exam for Vision (Refractions)		$30/Exam for Routine Hearing Exams														150	150	57.90719697	0	125	0.2	0.2	47.26190779	150	15	0.077978742	0	0	4.999999999	15	30	30.00000001	5	15	22.12965249	0	0	0	0	30	0	30	0	0	0											143.4531712	143.4531712	55.37980693	0	119.5443093	0.191270895	0.191270895	45.19913699	143.4531712	14.34531712	0.074575319	0	0	4.781772372	14.34531712	28.69063424	28.69063425	4.781772372	14.34531712	21.16379218	0	0	0	0	28.69063424	0	28.69063424	0	0	0											10.5719	0.257369418	2.555142247	0	2.087066035	1.522370241	0.965401586	1.079883636	3.367963603	2.034118614	2.097401973	0	0	0.158849555	4.116939767	7.077075291	0.321245555	0.398779423	1.319698981	5.639009634	0	0	0	0	0.723900339	0	0.295769324	0	0	0	0	0	0	0	0	0	0	0	0	0	46.5899	0	2.025	10.5719	0.257369418	2.555142247	0	2.087066035	1.522370241	0.965401586	1.079883636	3.367963603	2.034118614	2.097401973	0	0	0.158849555	4.116939767	7.077075291	0.321245555	0.398779423	1.319698981	5.639009634	0	0	0	0	0.723900339	0	0.295769324	0	0	0	0	0	0	0	0	0	0	0	0	0	46.5899	0	$250/Days 1-10 for IP Medical; $250/Days 1-10 for IP Surgical;	$250/Days 1-10 for IP Psych; $250/Days 1-10 for IP Substance Abuse;	$100/Day for SNF	20% Coinsurance for Home Health	$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;	$200/Case for OP Fac - Surgery; $200/Case 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 Chemo/Radiation Therapy			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 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 Vision 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 Vision (Refractions)		20% Coinsurance for Routine Hearing Exams														2.4239	0.0677	1.3066	0.4322	0.2589	0.2208	0.1361	0.1711	0.5403	0.208	0.6507	0	0	0.2078	0.5299	0.8033	0.0255	0.0898	0.4915	0.8022	0	0	0	0	0.0856	0	0.0224	0	0	0											9.4742	0	0	12.9958	0.325060905	3.86169894	0.432160741	2.345978291	1.743129999	1.101495349	1.251012818	3.908231477	2.242168091	2.748081374	0	0	0.36666244	4.646816726	7.880342613	0.346793666	0.488578782	1.811216548	6.441239322	0	0	0	0	0.809514344	0	0.318140646	0	0	0	0	0	0	0	0	0	0	0	0	0	56.0641
H3620_801_0	2009	5																					0											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	292.2720837	2.044956874	47.15460673	0	6.816217281	15.90167827	0	17.69756445	35.76360551	15.33430336	46.66558707	0	0	17.16927035	50.49240774	143.1550739	0.726988267	10.09940526	13.95452291	14.82027329	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 Speclst - Office Visits; 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 - 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 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 Chiropractor; 23% Coinsurance for Vistion Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical (PCP); 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 Part B Rx	23% Coinsurance for Blood Products																			0.079174647	0.079174647	0.189947663	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0											0.079174647	0.079174647	0.189947663	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0											23.1405	0.161908738	8.956907339	0	1.574546192	3.673287681	0	4.088137387	8.261392872	3.542224076	10.77975061	0	0	3.96610145	11.66374619	33.06882207	0.16793429	2.332962615	3.223494791	3.42348313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.0252	0	0	23.1405	0.161908738	8.956907339	0	1.574546192	3.673287681	0	4.088137387	8.261392872	3.542224076	10.77975061	0	0	3.96610145	11.66374619	33.06882207	0.16793429	2.332962615	3.223494791	3.42348313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.0252	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 Speclst - Office Visits; 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 - 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 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 Chiropractor; 23% Coinsurance for Vision Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical (PCP); 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 Part B Rx	23% Coinsurance for Blood Products																			2.5712	0.018	0.9952	0	0.1749	0.4081	0	0.4542	0.9179	0.3936	1.1978	0	0	0.4407	1.296	3.6743	0.0187	0.2592	0.3582	0.3804	0	0	0	0	0	0	0	0	0	0											13.5584	0	0	25.7117	0.179898598	9.952119266	0	1.749495769	4.081430756	0	4.542374874	9.179325414	3.935804528	11.97750068	0	0	4.406779389	12.95971799	36.74313564	0.186593655	2.592180684	3.581660879	3.803870144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.5836
H3620_802_0	2009	5																					0											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	292.2720837	2.044956874	47.15460673	0	6.816217281	15.90167827	0	17.69756445	35.76360551	15.33430336	46.66558707	0	0	17.16927035	50.49240774	143.1550739	0.726988267	10.09940526	13.95452291	14.82027329	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 Speclst - Office Visits; 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 - 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 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 Chiropractor; 23% Coinsurance for Vistion Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical (PCP); 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 Part B Rx	23% Coinsurance for Blood Products																			0.079174647	0.079174647	0.189947663	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0											0.079174647	0.079174647	0.189947663	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0											23.1405	0.161908738	8.956907339	0	1.574546192	3.673287681	0	4.088137387	8.261392872	3.542224076	10.77975061	0	0	3.96610145	11.66374619	33.06882207	0.16793429	2.332962615	3.223494791	3.42348313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.0252	0	0	23.1405	0.161908738	8.956907339	0	1.574546192	3.673287681	0	4.088137387	8.261392872	3.542224076	10.77975061	0	0	3.96610145	11.66374619	33.06882207	0.16793429	2.332962615	3.223494791	3.42348313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.0252	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 Speclst - Office Visits; 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 - 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 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 Chiropractor; 23% Coinsurance for Vision Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical (PCP); 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 Part B Rx	23% Coinsurance for Blood Products																			2.5712	0.018	0.9952	0	0.1749	0.4081	0	0.4542	0.9179	0.3936	1.1978	0	0	0.4407	1.296	3.6743	0.0187	0.2592	0.3582	0.3804	0	0	0	0	0	0	0	0	0	0											13.5584	0	0	25.7117	0.179898598	9.952119266	0	1.749495769	4.081430756	0	4.542374874	9.179325414	3.935804528	11.97750068	0	0	4.406779389	12.95971799	36.74313564	0.186593655	2.592180684	3.581660879	3.803870144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.5836
H3620_803_0	2009	5																					0											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	292.2720837	2.044956874	47.15460673	0	6.816217281	15.90167827	0	17.69756445	35.76360551	15.33430336	46.66558707	0	0	17.16927035	50.49240774	143.1550739	0.726988267	10.09940526	13.95452291	14.82027329	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 Speclst - Office Visits; 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 - 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 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 Chiropractor; 23% Coinsurance for Vistion Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical (PCP); 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 Part B Rx	23% Coinsurance for Blood Products																			0.079174647	0.079174647	0.189947663	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0											0.079174647	0.079174647	0.189947663	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0											23.1405	0.161908738	8.956907339	0	1.574546192	3.673287681	0	4.088137387	8.261392872	3.542224076	10.77975061	0	0	3.96610145	11.66374619	33.06882207	0.16793429	2.332962615	3.223494791	3.42348313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.0252	0	0	23.1405	0.161908738	8.956907339	0	1.574546192	3.673287681	0	4.088137387	8.261392872	3.542224076	10.77975061	0	0	3.96610145	11.66374619	33.06882207	0.16793429	2.332962615	3.223494791	3.42348313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.0252	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 Speclst - Office Visits; 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 - 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 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 Chiropractor; 23% Coinsurance for Vision Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical (PCP); 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 Part B Rx	23% Coinsurance for Blood Products																			2.5712	0.018	0.9952	0	0.1749	0.4081	0	0.4542	0.9179	0.3936	1.1978	0	0	0.4407	1.296	3.6743	0.0187	0.2592	0.3582	0.3804	0	0	0	0	0	0	0	0	0	0											13.5584	0	0	25.7117	0.179898598	9.952119266	0	1.749495769	4.081430756	0	4.542374874	9.179325414	3.935804528	11.97750068	0	0	4.406779389	12.95971799	36.74313564	0.186593655	2.592180684	3.581660879	3.803870144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.5836
H3620_804_0	2009	5																					0											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	292.2720837	2.044956874	47.15460673	0	6.816217281	15.90167827	0	17.69756445	35.76360551	15.33430336	46.66558707	0	0	17.16927035	50.49240774	143.1550739	0.726988267	10.09940526	13.95452291	14.82027329	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 Speclst - Office Visits; 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 - 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 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 Chiropractor; 23% Coinsurance for Vistion Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical (PCP); 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 Part B Rx	23% Coinsurance for Blood Products																			0.079174647	0.079174647	0.189947663	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0											0.079174647	0.079174647	0.189947663	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0											23.1405	0.161908738	8.956907339	0	1.574546192	3.673287681	0	4.088137387	8.261392872	3.542224076	10.77975061	0	0	3.96610145	11.66374619	33.06882207	0.16793429	2.332962615	3.223494791	3.42348313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.0252	0	0	23.1405	0.161908738	8.956907339	0	1.574546192	3.673287681	0	4.088137387	8.261392872	3.542224076	10.77975061	0	0	3.96610145	11.66374619	33.06882207	0.16793429	2.332962615	3.223494791	3.42348313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.0252	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 Speclst - Office Visits; 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 - 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 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 Chiropractor; 23% Coinsurance for Vision Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical (PCP); 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 Part B Rx	23% Coinsurance for Blood Products																			2.5712	0.018	0.9952	0	0.1749	0.4081	0	0.4542	0.9179	0.3936	1.1978	0	0	0.4407	1.296	3.6743	0.0187	0.2592	0.3582	0.3804	0	0	0	0	0	0	0	0	0	0											13.5584	0	0	25.7117	0.179898598	9.952119266	0	1.749495769	4.081430756	0	4.542374874	9.179325414	3.935804528	11.97750068	0	0	4.406779389	12.95971799	36.74313564	0.186593655	2.592180684	3.581660879	3.803870144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.5836
H3623_001_0	2009	5																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$900/stay	$900/stay	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$200 per procedure	$40 per visit	$40 X-ray; $175 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	15 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											152.1692361	152.1692361	47.56	0	100	0.2	0.2	47.5	200	40	67	35	25	35	15	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											133.4343718	133.4343718	41.70447908	0	100	0.175376279	0.175376279	41.6518662	181.5322091	35.07525575	58.75105338	30.69084878	21.92203484	30.69084878	15	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											21.7272	0	4.687228621	0	2.276793099	1.382086246	0	0.883086116	5.816436292	3.06673722	23.08108194	0	0.122079472	2.01283525	9.133424332	27.04289519	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.2309	0	8.5895	21.7272	0	4.687228621	0	2.276793099	1.382086246	0	0.883086116	5.816436292	3.06673722	23.08108194	0	0.122079472	2.01283525	9.133424332	27.04289519	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.2309																																																																																		0			21.7272	0	4.687228621	0	2.276793099	1.382086246	0	0.883086116	5.816436292	3.06673722	23.08108194	0	0.122079472	2.01283525	9.133424332	27.04289519	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.2309
H3623_002_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$500/stay	$500/stay	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$25 X-ray; $175 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											84.53846451	84.53846451	47.56	0	100	0.2	0.2	47.5	150	0	55	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											75.07311048	75.07311048	42.23494187	0	100	0.177606989	0.177606989	42.18165977	133.2052414	0	48.84192184	0	22.20087357	22.20087357	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											12.2242	0	4.746848124	0	2.276793099	1.39966578	0	0.894318587	4.268001829	0	19.18815639	0	0.12363227	1.456026883	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4219	0	5.5855	12.2242	0	4.746848124	0	2.276793099	1.39966578	0	0.894318587	4.268001829	0	19.18815639	0	0.12363227	1.456026883	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4219																																																																																		0			12.2242	0	4.746848124	0	2.276793099	1.39966578	0	0.894318587	4.268001829	0	19.18815639	0	0.12363227	1.456026883	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4219
H3623_003_0	2009	6																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$0 	$0 	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$25 X-ray; $175 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	0 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											0	0	47.56	0	100	0.2	0.2	47.5	150	0	55	20	20	20	0	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											0	0	43.77490559	0	100	0.184082866	0.184082866	43.71968073	138.0621497	0	50.62278822	0	18.40828662	18.40828662	0	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											0	0	4.919926945	0	2.276793099	1.450700171	0	0.926927088	4.423621032	0	19.88779189	0	0.102512104	1.207293043	0	15.45308296	0	1.12009741	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.8076	0	3.0054	0	0	4.919926945	0	2.276793099	1.450700171	0	0.926927088	4.423621032	0	19.88779189	0	0.102512104	1.207293043	0	15.45308296	0	1.12009741	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.8076																																																																																		0			0	0	4.919926945	0	2.276793099	1.450700171	0	0.926927088	4.423621032	0	19.88779189	0	0.102512104	1.207293043	0	15.45308296	0	1.12009741	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.8076
H3623_004_0	2009	5																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1522.958952	0	1169.853076	248.6004626	171.5539971	15.08263255	0	500.7465198	209.9411832	2512.717983	3634.318888	0	0	531.824123	5613.937841	7798.158809	0	599.3471778	0	0	267.1371886	0	0	0	553.7946474	0	41.11549433	0	0	0											$500/stay	$500/stay	"$0/d 1-10, $75/d 11-100"	$0 per visit	$150 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$175 per procedure	$35 per visit	$35 X-ray; $125 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	15 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											84.53846451	84.53846451	47.56	0	150	0.2	0.2	47.5	175	35	53	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											74.0142445	74.0142445	41.63924066	0	150	0.175101937	0.175101937	41.58671007	156.3264529	30.642839	46.40201335	26.26529057	0	26.26529057	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											9.3934	0	4.059316149	0	2.144424963	2.640998178	0	1.735366695	2.734946707	6.416401051	14.05330946	0	0	1.164042927	7.017422301	19.49539702	0	1.498367944	0	0	1.001764457	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3551	0	5.938	9.3934	0	4.059316149	0	2.144424963	2.640998178	0	1.735366695	2.734946707	6.416401051	14.05330946	0	0	1.164042927	7.017422301	19.49539702	0	1.498367944	0	0	1.001764457	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3551																																																																																		0			9.3934	0	4.059316149	0	2.144424963	2.640998178	0	1.735366695	2.734946707	6.416401051	14.05330946	0	0	1.164042927	7.017422301	19.49539702	0	1.498367944	0	0	1.001764457	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3551
H3623_005_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1549.800527	0	1190.471294	252.9819517	174.5775713	15.34845825	0	509.5719877	213.6413171	2557.003686	3698.372383	0	0	541.1973219	5712.881371	7935.598406	0	609.910445	0	0	271.8453805	0	0	0	563.5550685	0	41.84013936	0	0	0											$250/stay	$250/stay	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$20 X-ray; $125 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	10 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											42.26923225	42.26923225	47.56	0	100	0.2	0.2	47.5	150	0	41	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											37.13109288	37.13109288	41.77872848	0	100	0.175688513	0.175688513	41.72602193	131.766385	0	36.01614524	0	0	17.56885134	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											4.7955	0	4.14469808	0	1.454813095	2.696547812	0	1.771867661	2.345895337	0	11.10009308	0	0	0.792351274	4.760734475	13.22599734	0	1.016517408	0	0	1.019420177	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.1244	0	3.8257	4.7955	0	4.14469808	0	1.454813095	2.696547812	0	1.771867661	2.345895337	0	11.10009308	0	0	0.792351274	4.760734475	13.22599734	0	1.016517408	0	0	1.019420177	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.1244																																																																																		0			4.7955	0	4.14469808	0	1.454813095	2.696547812	0	1.771867661	2.345895337	0	11.10009308	0	0	0.792351274	4.760734475	13.22599734	0	1.016517408	0	0	1.019420177	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.1244
H3623_006_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1551.799967	0	1192.007153	253.3083305	174.8027986	15.3682597	0	510.2294003	213.9169415	2560.302546	3703.143753	0	0	541.8955351	5720.251713	7945.836335	0	610.6973069	0	0	272.1960955	0	0	0	564.2821261	0	41.89411845	0	0	0											$0 	$0 	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$20 X-ray; $125 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	0 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											0	0	47.56	0	100	0.2	0.2	47.5	150	0	41	20	20	20	0	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											0	0	43.6504045	0	100	0.183559312	0.183559312	43.5953367	137.6694843	0	37.62965905	0	0	18.35593124	0	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											0	0	4.3359662	0	1.456689988	2.820987185	0	1.853635208	2.454152919	0	11.6123364	0	0	0.828916432	0	13.24306056	0	1.017828845	0	0	1.020735358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6443	0	2.1412	0	0	4.3359662	0	1.456689988	2.820987185	0	1.853635208	2.454152919	0	11.6123364	0	0	0.828916432	0	13.24306056	0	1.017828845	0	0	1.020735358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6443																																																																																		0			0	0	4.3359662	0	1.456689988	2.820987185	0	1.853635208	2.454152919	0	11.6123364	0	0	0.828916432	0	13.24306056	0	1.017828845	0	0	1.020735358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6443
H3623_013_0	2009	2																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$900/stay	$900/stay	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$200 per procedure	$30 per visit	$30 X-ray; $175 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	15 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											152.1692361	152.1692361	47.56	0	100	0.2	0.2	47.5	200	30	59	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											135.1132261	135.1132261	42.22919953	0	100	0.177582841	0.177582841	42.17592468	183.1871306	26.63742611	52.38693802	26.63742611	22.19785509	26.63742611	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											22.0006	0	4.746202734	0	2.276793099	1.399475479	0	0.894196993	5.869461293	2.328991888	20.58086008	0	0.12361546	1.746994703	9.133424332	23.17962445	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.9992	0	7.3328	22.0006	0	4.746202734	0	2.276793099	1.399475479	0	0.894196993	5.869461293	2.328991888	20.58086008	0	0.12361546	1.746994703	9.133424332	23.17962445	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.9992																																																																					0	0	0											0			22.0006	0	4.746202734	0	2.276793099	1.399475479	0	0.894196993	5.869461293	2.328991888	20.58086008	0	0.12361546	1.746994703	9.133424332	23.17962445	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.9992
H3623_014_0	2009	2																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1518.081679	0	1166.106624	247.8043201	171.0045957	15.03433045	0	499.14288	209.2688469	2504.671008	3622.679989	0	0	530.1209572	5595.959215	7773.185219	0	597.4277695	0	0	266.2816823	0	0	0	552.0211211	0	40.98382204	0	0	0											$500/stay	$500/stay	"$0/d 1-10, $75/d 11-100"	$0 per visit	$150 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$175 per procedure	$0 per visit	$30 X-ray; $125 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	15 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											84.53846451	84.53846451	47.56	0	150	0.2	0.2	47.5	175	0	49	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											72.2854687	72.2854687	40.66665879	0	150	0.171012022	0.171012022	40.61535519	153.2590164	0	41.89794535	0	0	25.65180328	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											9.1446	0	3.951805017	0	2.137557446	2.571051247	0	1.689405447	2.672694803	0	12.64857068	0	0	1.133213209	6.994949019	19.43296305	0	1.493569424	0	0	0.998556309	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.8689	0	5.6574	9.1446	0	3.951805017	0	2.137557446	2.571051247	0	1.689405447	2.672694803	0	12.64857068	0	0	1.133213209	6.994949019	19.43296305	0	1.493569424	0	0	0.998556309	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.8689																																																																																		0			9.1446	0	3.951805017	0	2.137557446	2.571051247	0	1.689405447	2.672694803	0	12.64857068	0	0	1.133213209	6.994949019	19.43296305	0	1.493569424	0	0	0.998556309	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.8689
H3623_801_0	2009	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																																																			0		300.4756926	0	37.10281478	5.625231737	6.634533344	8.832235381	0	7.806942931	40.34723703	13.75299385	56.05819357	0	3.059032701	11.62779596	41.07124007	178.4030115	0	5.287452301	0	0	7.978831466	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.075368108	0.075368108	0.172547517	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											22.6463	0	6.401998553	0	1.532577202	2.040246373	0	1.803403817	9.320211753	3.176941578	12.94944271	0	0.706636554	2.686020867	9.487456457	41.21109566	0	1.221401482	0	0	1.843110069	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.0268			22.6463	0	6.401998553	0	1.532577202	2.040246373	0	1.803403817	9.320211753	3.176941578	12.94944271	0	0.706636554	2.686020867	9.487456457	41.21109566	0	1.221401482	0	0	1.843110069	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.0268																																																																																		0			22.6463	0	6.401998553	0	1.532577202	2.040246373	0	1.803403817	9.320211753	3.176941578	12.94944271	0	0.706636554	2.686020867	9.487456457	41.21109566	0	1.221401482	0	0	1.843110069	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.0268
H3623_802_0	2009	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																																																			0		301.1699352	0	37.18854002	5.638228712	6.649862288	8.852642068	0	7.824980702	40.44045844	13.78476984	56.1877148	0	3.066100529	11.65466173	41.16613427	178.8152078	0	5.299668844	0	0	7.997266382	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.075350984	0.075350984	0.172490027	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											22.6935	0	6.414652284	0	1.536118189	2.044960318	0	1.807570542	9.341745899	3.184281832	12.97936212	0	0.708269222	2.692226859	9.509377017	41.30631299	0	1.224223503	0	0	1.847368534	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.2899			22.6935	0	6.414652284	0	1.536118189	2.044960318	0	1.807570542	9.341745899	3.184281832	12.97936212	0	0.708269222	2.692226859	9.509377017	41.30631299	0	1.224223503	0	0	1.847368534	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.2899																																																																																		0			22.6935	0	6.414652284	0	1.536118189	2.044960318	0	1.807570542	9.341745899	3.184281832	12.97936212	0	0.708269222	2.692226859	9.509377017	41.30631299	0	1.224223503	0	0	1.847368534	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.2899
H3624_001_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3500	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$0 	$0 	"$0/d 1-10, $75/d 11-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$25 X-ray; $175 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											0	0	47.56	20	100	0.2	0.2	47.5	150	0	55	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											0	0	36.96804026	20	100	0.155458538	0.155458538	36.92140269	116.5939032	0	42.75109786	0	19.43231721	19.43231721	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											0	0	3.656306011	1.506462933	2.003577927	1.078106202	0	0.688857604	3.287469987	0	14.77986439	0	0.09522896	1.121518891	5.358275608	16.99839126	0	1.232107151	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.7203	0	7.0791	0	0	3.656306011	1.506462933	2.003577927	1.078106202	0	0.688857604	3.287469987	0	14.77986439	0	0.09522896	1.121518891	5.358275608	16.99839126	0	1.232107151	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.7203	0	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$100 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$50 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$25 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP		$Not Covered copay		$500 ded; 30% coinsurance; $3500 max OOP	0	$500 ded; 30% coinsurance; $3500 max OOP	0	Not Covered												5.2917	0	0.6534	0.0991	0.1436	0.1555	0	0.0824	0.7106	0.2422	0.9872	0	0.0175	0.2048	0.7233	3.1419	0	0.0931	0	0	0.1405	0	0	0	0.0655	0	0.0042	0	0	0											12.7565	500	10.08805796	5.2917	0	4.309722601	1.605528725	2.147220091	1.233650442	0	0.771246803	3.998024003	0.242203574	15.7671036	0	0.112734645	1.326295667	6.081580021	20.1402415	0	1.32522432	0	0	1.054688261	0	0	0	0.065534855	0	0.004183258	0	0	0	0	0	0	0	0	0	0	0	0	0	65.4769
H3624_002_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3500	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$250/stay	$250/stay	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$20 X-ray; $125 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	10 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											42.26923225	42.26923225	47.56	0	100	0.2	0.2	47.5	150	0	41	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											33.51895293	33.51895293	37.71446313	0	100	0.158597406	0.158597406	37.66688391	118.9480544	0	32.51246821	0	15.85974059	15.85974059	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											4.803	0	3.730130602	0	2.003577927	1.099874279	0	0.702766349	3.353847398	0	11.24017617	0	0.077721385	0.915330812	5.358275608	13.59871301	0	0.985685721	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.7832	0	6.7673	4.803	0	3.730130602	0	2.003577927	1.099874279	0	0.702766349	3.353847398	0	11.24017617	0	0.077721385	0.915330812	5.358275608	13.59871301	0	0.985685721	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.7832	0	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$100 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$50 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$20 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP		$Not Covered copay		$500 ded; 30% coinsurance; $3500 max OOP	0	$500 ded; 30% coinsurance; $3500 max OOP	0	Not Covered												5.2917	0	0.6534	0.0991	0.1436	0.1555	0	0.0824	0.7106	0.2422	0.9872	0	0.016	0.2048	0.7233	3.1419	0	0.0931	0	0	0.1405	0	0	0	0.0655	0	0.0042	0	0	0											12.755	500	10.08660758	10.0946	0	4.383547192	0.099065792	2.147220091	1.255418519	0	0.785155549	4.064401414	0.242203574	12.22741538	0	0.093737121	1.120107588	6.081580021	16.74056325	0	1.078802889	0	0	1.054688261	0	0	0	0.065534855	0	0.004183258	0	0	0	0	0	0	0	0	0	0	0	0	0	61.5383
H3624_801_0	2009	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																																																			0	Unlimited	284.3354286	0	35.10981088	5.323068441	6.2781547	8.35780562	0	7.387587478	38.1799567	13.01424207	53.04698811	0	2.894714599	11.00320069	38.86506941	168.8199677	0	5.003433067	0	0	7.550242899	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.076461657	0.076461657	0.178223257	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											21.7408	0	6.257384863	0	1.450253736	1.930653098	0	1.706532708	8.819569997	3.006289918	12.25385425	0	0.668679072	2.541739359	8.977831033	38.99741255	0	1.155793038	0	0	1.74410611	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.2509			21.7408	0	6.257384863	0	1.450253736	1.930653098	0	1.706532708	8.819569997	3.006289918	12.25385425	0	0.668679072	2.541739359	8.977831033	38.99741255	0	1.155793038	0	0	1.74410611	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.2509		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											2.9646	0	0.8533	0	0.1978	0.2633	0	0.2327	1.2027	0.4099	1.671	0	0.0912	0.3466	1.2242	5.3178	0	0.1576	0	0	0.2378	0	0	0	0	0	0	0	0	0											15.1706		0	24.7054	0	7.110664617	0	1.648015609	2.193923975	0	1.939241713	10.02223863	3.416238543	13.92483438	0	0.759862582	2.888340181	10.20208072	44.31524153	0	1.31340118	0	0	1.981938761	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.4214
H3624_802_0	2009	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																																																			0	Unlimited	285.0428633	0	35.19716509	5.336312388	6.293774928	8.378600079	0	7.405968007	38.27494952	13.04662188	53.17897053	0	2.901916731	11.03057697	38.96176681	169.2399966	0	5.015881751	0	0	7.569028119	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.076277927	0.076277927	0.177728963	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											21.7425	0	6.255555639	0	1.453862008	1.935456618	0	1.71077861	8.841513339	3.013769653	12.28434219	0	0.670342765	2.548063279	9.000168133	39.09443923	0	1.158668685	0	0	1.748445496	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.4579			21.7425	0	6.255555639	0	1.453862008	1.935456618	0	1.71077861	8.841513339	3.013769653	12.28434219	0	0.670342765	2.548063279	9.000168133	39.09443923	0	1.158668685	0	0	1.748445496	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.4579		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											2.9649	0	0.853	0	0.1983	0.2639	0	0.2333	1.2057	0.411	1.6751	0	0.0914	0.3475	1.2273	5.3311	0	0.158	0	0	0.2384	0	0	0	0	0	0	0	0	0											15.1988		0	24.7074	0	7.108585953	0	1.652115919	2.199382521	0	1.944066602	10.04717425	3.424738242	13.95947976	0	0.761753142	2.895526453	10.22746379	44.42549912	0	1.31666896	0	0	1.986869881	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.6567
H3653_004_0	2009	7																					3350											A	A	D		T	Coin	Coin	V	V				V		V	V	V			V					V		V																																																						0		402.8613543	19.21968409	1102.405332		264.2865095	0.01022212	7.317274752	412.2650546	438.5895021				0		4841.467288	5686.603599	167.6514424	2094.160755		4822.177444					231.4072151		27.23272161														$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/$25 if UC	$100 per visit				5% Coinsurance		$10 per visit	$20 per visit	$25 per visit	$25 per visit		$20 per visit					$20 per visit		$20 per visit														325	325	75		50	0.2	0.2	50	100				0.05		10	20	25	25		20					20		20														307.1067103	307.1067103	70.87077931		47.24718621	0.188988745	0.188988745	47.24718621	94.49437241				0.047247186		9.449437241	18.89887448	23.6235931	23.6235931		18.89887448					18.89887448		18.89887448														10.3101	0.491874496	6.510693751	0	1.040566161	0.001931866	1.382882571	1.623196983	3.453686646	0	0	0	0	0	3.812428441	8.955867304	0.330044122	4.122633464	0	7.594477187	0	0	0	0	0.364444659	0	0.042888982	0	0	0	0	0	0	0	0	0	0	0	0	0	50.0377		2.9154	10.3101	0.491874496	6.510693751	0	1.040566161	0.001931866	1.382882571	1.623196983	3.453686646	0	0	0	0	0	3.812428441	8.955867304	0.330044122	4.122633464	0	7.594477187	0	0	0	0	0.364444659	0	0.042888982	0	0	0	0	0	0	0	0	0	0	0	0	0	50.0377																																																																																		0			10.3101	0.491874496	6.510693751	0	1.040566161	0.001931866	1.382882571	1.623196983	3.453686646	0	0	0	0	0	3.812428441	8.955867304	0.330044122	4.122633464	0	7.594477187	0	0	0	0	0.364444659	0	0.042888982	0	0	0	0	0	0	0	0	0	0	0	0	0	50.0377
H3653_015_0	2009	7																					3350											A	A	D		T	Coin	Coin	V	V	V	V		V		V	V	V	V		V							V														18.3329	0.2168	3.1206	0.0087	0.4242	0.0006	0.4076	1.1531	1.8981	1.1187	1.9041	0.4733	0	2.1414	2.5524	8.4309	0.1071	0.7336	0	2.9121	0.0625	1.2994			0.1182		0.019														47.4351	N/A	438.5614074	20.92285998	1297.15762		269.2873294	0.010415542	7.455731964	420.0659193	446.8884771	7219.276012	1705.467632		0		4933.07736	5794.20531	170.823737	2133.78639		4913.422513					235.7858942		27.74801819														$340 per Admission	$340 per Admission	$95 per day after 10 days		$175 per trip	20% Coinsurance	20% Coinsurance	$50 per visit if ER/$25 if UC	$150 per visit	$2 per visit	$5 or $50 per visit routine or advanced respectively.		5% Coinsurance		$15 per visit	$35 per visit	$35 per visit	$35 per visit		$35 per visit					$35 per visit		$35 per visit														340	340	95		175	0.2	0.2	50	150	2	5		0.05		15	35	35	35		35					35		35														296.7533478	296.7533478	82.91637658		152.7406937	0.174560793	0.174560793	43.6401982	130.9205946	1.745607928	4.36401982		0.043640198		13.09205946	30.54813874	30.54813874	30.54813874		30.54813874					30.54813874		30.54813874														10.8454	0.517410729	8.962967478	0	3.427594459	0.001818145	1.301478482	1.527646665	4.875575428	1.050168787	0.620224546	0	0	0	5.382011843	14.75018231	0.434862268	5.431933558	0	12.50799272	0	0	0	0	0.600235017	0	0.070637526	0	0	0	0	0	0	0	0	0	0	0	0	0	72.3081	600	10.5377	29.1783	0.734189245	12.08352481	0.008704168	3.85176688	0.002387609	1.709116227	2.680733858	6.773714225	2.168822086	2.524292583	0.473258463	0	2.141438874	7.934388259	23.18110441	0.542000646	6.165503497	0	15.42009507	0.06245124	1.299413929	0	0	0.718433437	0	0.089639113	0	0	0	0	0	0	0	0	0	0	0	0	0	119.7432																																																																																		0			29.1783	0.734189245	12.08352481	0.008704168	3.85176688	0.002387609	1.709116227	2.680733858	6.773714225	2.168822086	2.524292583	0.473258463	0	2.141438874	7.934388259	23.18110441	0.542000646	6.165503497	0	15.42009507	0.06245124	1.299413929	0	0	0.718433437	0	0.089639113	0	0	0	0	0	0	0	0	0	0	0	0	0	119.7432
H3653_018_0	2009	5																					3350											A	A	D		T	Coin	Coin	V	V						V	V	V			V					V		V																																																						0		386.1298104	18.42145666	1056.620491		253.3102238	0.009797577	7.013375403	395.1429585	420.3741052				0		4640.392598	5450.428904	160.6885818	2007.186559		4621.903895					221.7964646		26.10169856														$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/$25 if UC	$100 per visit				5% Coinsurance		$10 per visit	$20 per visit	$25 per visit	$25 per visit		$20 per visit					$20 per visit		$20 per visit														325	325	75		50	0.2	0.2	50	100				0.05		10	20	25	25		20					20		20														307.1067103	307.1067103	70.87077931		47.24718621	0.188988745	0.188988745	47.24718621	94.49437241				0.047247186		9.449437241	18.89887448	23.6235931	23.6235931		18.89887448					18.89887448		18.89887448														9.8819	0.471446079	6.240293136	0	0.997349609	0.001851632	1.325449014	1.555782745	3.310248937	0	0	0	0	0	3.654091552	8.583914312	0.316336806	3.951413213	0	7.279065131	0	0	0	0	0.349308629	0	0.041107727	0	0	0	0	0	0	0	0	0	0	0	0	0	47.9596		2.7943	9.8819	0.471446079	6.240293136	0	0.997349609	0.001851632	1.325449014	1.555782745	3.310248937	0	0	0	0	0	3.654091552	8.583914312	0.316336806	3.951413213	0	7.279065131	0	0	0	0	0.349308629	0	0.041107727	0	0	0	0	0	0	0	0	0	0	0	0	0	47.9596																																																																																		0			9.8819	0.471446079	6.240293136	0	0.997349609	0.001851632	1.325449014	1.555782745	3.310248937	0	0	0	0	0	3.654091552	8.583914312	0.316336806	3.951413213	0	7.279065131	0	0	0	0	0.349308629	0	0.041107727	0	0	0	0	0	0	0	0	0	0	0	0	0	47.9596
H3653_020_0	2009	7																																A	A	D		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin		Coin																																																						0		872.2576418	41.61361259	3144.525845		15.43024055	0.02071554	14.8287539	41.94618008	69.04913369	40.69356852	69.26482334	17.2158574	0	77.89972965	92.84852123	306.6940461	3.897403157	26.68528189	0	105.9343736	2.271806497	47.26914927	0		4.299737437		0.691226135														$698 per admit	$698 per admit	$70 per day after 5 days		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														698	698	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		0.2														698	698	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		0.2														50.7363	2.420525132	18.34306743	0	3.086048109	0.004143108	2.96575078	8.389236015	13.80982674	8.138713705	13.85296467	3.44317148	0	15.57994593	18.56970425	61.33880921	0.779480631	5.337056377	0	21.18687471	0.454361299	9.453829854	0	0	0.859947487	0	0.138245227	0	0	0	0	0	0	0	0	0	0	0	0	0	258.888			50.7363	2.420525132	18.34306743	0	3.086048109	0.004143108	2.96575078	8.389236015	13.80982674	8.138713705	13.85296467	3.44317148	0	15.57994593	18.56970425	61.33880921	0.779480631	5.337056377	0	21.18687471	0.454361299	9.453829854	0	0	0.859947487	0	0.138245227	0	0	0	0	0	0	0	0	0	0	0	0	0	258.888																																																																																		0			50.7363	2.420525132	18.34306743	0	3.086048109	0.004143108	2.96575078	8.389236015	13.80982674	8.138713705	13.85296467	3.44317148	0	15.57994593	18.56970425	61.33880921	0.779480631	5.337056377	0	21.18687471	0.454361299	9.453829854	0	0	0.859947487	0	0.138245227	0	0	0	0	0	0	0	0	0	0	0	0	0	258.888
H3653_021_0	2009	5																					3350											A	A	D		T	Coin	Coin	V	V	V	V				V	V	V	V		V							V																																																						0		439.2475883	20.95559625	1299.187176		269.7086612	0.010431839	7.467397334	420.7231619	447.5876867	7230.571419	1708.136037		0		4940.79574	5803.271026	171.0910109	2137.12495		4921.110141					236.154809		27.79143324														$300 per Admission	$300 per Admission	$95 per day after 10 days		$175 per trip	20% Coinsurance	20% Coinsurance	$50 per visit if ER/$25 if UC	$150 per visit	$2 per visit	$5 or $50 per visit routine or advanced respectively.		5% Coinsurance		$15 per visit	$35 per visit	$35 per visit	$35 per visit		$35 per visit					$35 per visit		$35 per visit														300	300	95		175	0.2	0.2	50	150	2	5		0.05		15	35	35	35		35					35		35														283.4831172	283.4831172	89.76965379		165.3651517	0.188988745	0.188988745	47.24718621	141.7415586	1.889887448	4.724718621		0.047247186		14.17415586	33.07303034	33.07303034	33.07303034		33.07303034					33.07303034		33.07303034														10.3766	0.495046479	9.718965252	0	3.716701139	0.0019715	1.411254049	1.656498797	5.286814694	1.138747181	0.672538512	0	0	0	5.835967408	15.99431323	0.471541516	5.890099861	0	13.56300209	0	0	0	0	0.65086293	0	0.076595576	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9575		4.4839	10.3766	0.495046479	9.718965252	0	3.716701139	0.0019715	1.411254049	1.656498797	5.286814694	1.138747181	0.672538512	0	0	0	5.835967408	15.99431323	0.471541516	5.890099861	0	13.56300209	0	0	0	0	0.65086293	0	0.076595576	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9575																																																																																		0			10.3766	0.495046479	9.718965252	0	3.716701139	0.0019715	1.411254049	1.656498797	5.286814694	1.138747181	0.672538512	0	0	0	5.835967408	15.99431323	0.471541516	5.890099861	0	13.56300209	0	0	0	0	0.65086293	0	0.076595576	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9575
H3653_803_0	2009	4																					3350											A	A	D		T	Coin	Coin	V	V						V	V	V	V		V					V		V																																																						0		374.275338	17.85590423	1296.598253		229.8141254	0.008888791	6.362841221	358.4909919	381.3817928	6161.04592	1455.473427		0		4209.967328	4944.86773	145.7837166	1821.007524		4193.193567					201.2234633		23.68060371														$300 per Admission	$300 per Admission	$95 per day after 5 days		$175 per trip	20% Coinsurance	20% Coinsurance	$50 per visit if ER	$150 per visit	$2 per visit	$5 or $50 per visit routine or advanced respectively.		5% Coinsurance		$20 per visit	$35 per visit	$35 per visit	$35 per visit		$35 per visit					$35 per visit		$35 per visit														300	300	95		175	0.2	0.2	50	150	2	5		0.05		20	35	35	35		35					35		35														269.3989161	269.3989161	85.30965676		157.1493677	0.179599277	0.179599277	44.89981935	134.699458	1.795992774	4.489981935		0.044899819		17.95992774	31.42987354	31.42987354	31.42987354		31.42987354					31.42987354		31.42987354														8.4024	0.400863437	9.217695993	0	3.009595374	0.00159642	1.142761685	1.341348398	4.2809934	0.922099496	0.544587449	0	0	0	6.300892416	12.95138062	0.381830315	4.769503016	0	10.98262863	0	0	0	0	0.527035667	0	0.062023198	0	0	0	0	0	0	0	0	0	0	0	0	0	65.2393		7.4105	8.4024	0.400863437	9.217695993	0	3.009595374	0.00159642	1.142761685	1.341348398	4.2809934	0.922099496	0.544587449	0	0	0	6.300892416	12.95138062	0.381830315	4.769503016	0	10.98262863	0	0	0	0	0.527035667	0	0.062023198	0	0	0	0	0	0	0	0	0	0	0	0	0	65.2393																																																																																		0			8.4024	0.400863437	9.217695993	0	3.009595374	0.00159642	1.142761685	1.341348398	4.2809934	0.922099496	0.544587449	0	0	0	6.300892416	12.95138062	0.381830315	4.769503016	0	10.98262863	0	0	0	0	0.527035667	0	0.062023198	0	0	0	0	0	0	0	0	0	0	0	0	0	65.2393
H3653_806_0	2009	4																					3350											A	A	D		T	Coin	Coin	V	V	V	V				V	V	V	V		V							V																																																						0		378.2590841	18.04596054	1310.399104		232.260242	0.008983402	6.430566613	362.3067311	385.4411793	6226.623425	1470.965328		0		4254.777764	4997.500366	147.3354226	1840.39013		4237.825464							23.93265749														$300 per Admission	$300 per Admission	$95 per day after 5 days		$175 per trip	20% Coinsurance	20% Coinsurance	$50 per visit if ER	$150 per visit	$2 per visit	$5 or $50 per visit routine or advanced respectively.		5% Coinsurance		$20 per visit	$35 per visit	$35 per visit	$35 per visit		$35 per visit							$35 per visit														300	300	95		175	0.2	0.2	50	150	2	5		0.05		20	35	35	35		35							35														269.3989161	269.3989161	85.30965676		157.1493677	0.179599277	0.179599277	44.89981935	134.699458	1.795992774	4.489981935		0.044899819		17.95992774	31.42987354	31.42987354	31.42987354		31.42987354							31.42987354														8.4919	0.405130184	9.31580815	0	3.041629181	0.001613413	1.154925117	1.355625565	4.32655983	0.931914223	0.550383979	0	0	0	6.367958432	13.08923371	0.385894475	4.820269089	0	11.09952654	0	0	0	0	0	0	0.062683367	0	0	0	0	0	0	0	0	0	0	0	0	0	65.401			8.4919	0.405130184	9.31580815	0	3.041629181	0.001613413	1.154925117	1.355625565	4.32655983	0.931914223	0.550383979	0	0	0	6.367958432	13.08923371	0.385894475	4.820269089	0	11.09952654	0	0	0	0	0	0	0.062683367	0	0	0	0	0	0	0	0	0	0	0	0	0	65.401																																																																																		0			8.4919	0.405130184	9.31580815	0	3.041629181	0.001613413	1.154925117	1.355625565	4.32655983	0.931914223	0.550383979	0	0	0	6.367958432	13.08923371	0.385894475	4.820269089	0	11.09952654	0	0	0	0	0	0	0.062683367	0	0	0	0	0	0	0	0	0	0	0	0	0	65.401
H3653_809_0	2009	4																					3350											A	A	D		T	Coin	Coin	V	V						V	V	V	V		V					V		V																																																						0		378.2590841	18.04596054	1310.399104		232.260242	0.008983402	6.430566613	362.3067311	385.4411793	6226.623425	1470.965328		0		4254.777764	4997.500366	147.3354226	1840.39013		4237.825464					203.365264		23.93265749														$300 per Admission	$300 per Admission	$95 per day after 5 days		$175 per trip	20% Coinsurance	20% Coinsurance	$50 per visit if ER	$150 per visit	$2 per visit	$5 or $50 per visit routine or advanced respectively.		5% Coinsurance		$20 per visit	$35 per visit	$35 per visit	$35 per visit		$35 per visit					$35 per visit		$35 per visit														300	300	95		175	0.2	0.2	50	150	2	5		0.05		20	35	35	35		35					35		35														269.3989161	269.3989161	85.30965676		157.1493677	0.179599277	0.179599277	44.89981935	134.699458	1.795992774	4.489981935		0.044899819		17.95992774	31.42987354	31.42987354	31.42987354		31.42987354					31.42987354		31.42987354														8.4919	0.405130184	9.31580815	0	3.041629181	0.001613413	1.154925117	1.355625565	4.32655983	0.931914223	0.550383979	0	0	0	6.367958432	13.08923371	0.385894475	4.820269089	0	11.09952654	0	0	0	0	0.532645378	0	0.062683367	0	0	0	0	0	0	0	0	0	0	0	0	0	65.9337		7.4894	8.4919	0.405130184	9.31580815	0	3.041629181	0.001613413	1.154925117	1.355625565	4.32655983	0.931914223	0.550383979	0	0	0	6.367958432	13.08923371	0.385894475	4.820269089	0	11.09952654	0	0	0	0	0.532645378	0	0.062683367	0	0	0	0	0	0	0	0	0	0	0	0	0	65.9337																																																																																		0			8.4919	0.405130184	9.31580815	0	3.041629181	0.001613413	1.154925117	1.355625565	4.32655983	0.931914223	0.550383979	0	0	0	6.367958432	13.08923371	0.385894475	4.820269089	0	11.09952654	0	0	0	0	0.532645378	0	0.062683367	0	0	0	0	0	0	0	0	0	0	0	0	0	65.9337
H3653_810_0	2009	3																					3350											A	A	D		T	Coin	Coin	V	V	V	V				V	V	V	V		V							V																																																						0		378.2590841	18.04596054	1310.399104		232.260242	0.008983402	6.430566613	362.3067311	385.4411793	6226.623425	1470.965328		0		4254.777764	4997.500366	147.3354226	1840.39013		4237.825464							23.93265749														$300 per Admission	$300 per Admission	$95 per day after 5 days		$175 per trip	20% Coinsurance	20% Coinsurance	$50 per visit if ER	$150 per visit	$2 per visit	$5 or $50 per visit routine or advanced respectively.		5% Coinsurance		$20 per visit	$35 per visit	$35 per visit	$35 per visit		$35 per visit							$35 per visit														300	300	95		175	0.2	0.2	50	150	2	5		0.05		20	35	35	35		35							35														269.3989161	269.3989161	85.30965676		157.1493677	0.179599277	0.179599277	44.89981935	134.699458	1.795992774	4.489981935		0.044899819		17.95992774	31.42987354	31.42987354	31.42987354		31.42987354							31.42987354														8.4919	0.405130184	9.31580815	0	3.041629181	0.001613413	1.154925117	1.355625565	4.32655983	0.931914223	0.550383979	0	0	0	6.367958432	13.08923371	0.385894475	4.820269089	0	11.09952654	0	0	0	0	0	0	0.062683367	0	0	0	0	0	0	0	0	0	0	0	0	0	65.401			8.4919	0.405130184	9.31580815	0	3.041629181	0.001613413	1.154925117	1.355625565	4.32655983	0.931914223	0.550383979	0	0	0	6.367958432	13.08923371	0.385894475	4.820269089	0	11.09952654	0	0	0	0	0	0	0.062683367	0	0	0	0	0	0	0	0	0	0	0	0	0	65.401																																																																																		0			8.4919	0.405130184	9.31580815	0	3.041629181	0.001613413	1.154925117	1.355625565	4.32655983	0.931914223	0.550383979	0	0	0	6.367958432	13.08923371	0.385894475	4.820269089	0	11.09952654	0	0	0	0	0	0	0.062683367	0	0	0	0	0	0	0	0	0	0	0	0	0	65.401
H3655_013_0	2009	8	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		CORF	Partial Hospitalization	Ambulatory Surgical Center	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemo/Radiation	A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	0	Coin	0	0	0	V	V	V	V	0	0	V	V	V	V	V	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		403.5282975	9.014730303	920.3982464	761.4111847	371.6462061	13.07373151	1.492507911	374.6354198	274.6919828	5464.815844	930.0990872	148.1617619	0.069587533	184.0872727	4315.004303	4024.996893	20.59833503	1601.202126	2934.936637	0	46.44693629	0	0	0	375.425447	343.1752547	185.934419	0	0	0	0	0.247762144	146.4464855	91.35675082	571.0313757	80.15563511	0.495930401	857.7122802	33.09591405	15.37140303	$750/admt w/$1400 yrly max	$750/admt w/$1400 yrly max	$100/day (for days 21-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$200 copay	$0 copay	$75/$125 copay for Lower/Higher Tier	$200 copay	20% coinsurance	$30 copay	$15 coapy	$30 copay	$35 copay	$30 copay	$75/$125 copay for Lower/Higher Tier	0	20% coinsurance	0	0	0	$30 copay 1/yr $50 limit	"$30 Copay, Covd up to $75"	$30 copay 1/yr $50 limit	Silver Sneakers	0	0	$30 copay	$35 copay	$200 copay	$30 copay	$30 copay	$0 copay	20% coinsurance	$30 copay	$30 copay	20% coinsurance	750	750	100	0	100	0.2	0.2	50	200	0	91.89684849	200	0.2	30	15	30	35	30	79.44882016	0	0.2	0	0	0	30	30	30	0	0	0	30	35	200	30	30	0	0.2	30	30	0.2	558.8076813	523.758408	88.55682823	0	88.55682823	0.177113656	0.177113656	44.27841412	177.1136565	0	81.38093427	177.1136565	0.177113656	26.56704847	13.28352424	26.56704847	30.99488988	26.56704847	70.3573552	0	0.177113656	0	0	0	26.56704847	26.56704847	26.56704847	0	0	0	0	30.99488988	177.1136565	26.56704847	26.56704847	0	0.177113656	26.56704847	26.56704847	0.177113656	18.7912	0.393461733	6.792295784	0	2.74265077	2.315536392	0.264343533	1.382355188	4.054308456	0	6.30769439	2.186789283	0.012324903	0.407554625	4.776538687	8.911023963	0.053203594	3.544934542	17.20786496	0	8.226386718	0	0	0	0.831162171	0.759762802	0.41164406	0	0	0	0	0.000639947	2.161472711	0.202256602	1.264218186	0	0.087836047	1.898906977	0.073271729	2.722485396	98.7842		12.7647	18.7912	0.393461733	6.792295784	0	2.74265077	2.315536392	0.264343533	1.382355188	4.054308456	0	6.30769439	2.186789283	0.012324903	0.407554625	4.776538687	8.911023963	0.053203594	3.544934542	17.20786496	0	8.226386718	0	0	0	0.831162171	0.759762802	0.41164406	0	0	0	0	0.000639947	2.161472711	0.202256602	1.264218186	0	0.087836047	1.898906977	0.073271729	2.722485396	98.7842	3500																																																																																	0		0	18.7912	0.393461733	6.792295784	0	2.74265077	2.315536392	0.264343533	1.382355188	4.054308456	0	6.30769439	2.186789283	0.012324903	0.407554625	4.776538687	8.911023963	0.053203594	3.544934542	17.20786496	0	8.226386718	0	0	0	0.831162171	0.759762802	0.41164406	0	0	0	0	0.000639947	2.161472711	0.202256602	1.264218186	0	0.087836047	1.898906977	0.073271729	2.722485396	98.7842
H3655_023_0	2009	9	H.6	H.7	I.7	I.8	I.9	I.10	I.11	I.12	I.13		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional	0		CORF	Partial Hospitalization	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemo/Radiation	0	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	0	Coin	0	0	0	V	V	V	0	V	0	V	V	V	V	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1559.800346	44.47463428	486.0328313	412.3866627	232.7045877	10.11771513	1.198856279	358.6664055	453.3543365	4916.922164	1021.481923	130.3951643	0	201.0125944	4143.592274	3511.993118	24.01506607	1358.599363	2828.206077	0	34.84766042	0	0	0	357.5272364	343.1752547	185.934419	0	0	0	0	0.318814583	160.3362716	490.7547451	123.710437	0.553616918	862.200441	27.50867405	10.08653931	0	$240/day w/$2250 yrly max	$240/day w/$2250 yrly max	$100/day (for days 21-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$200 copay	$0 copay	$75/$125 copay for Lower/Higher Tier	$200 copay	20% coinsurance	$30 copay	$15 coapy	$30 copay	$35 copay	$30 copay	$75/$125 copay for Lower/Higher Tier	0	20% coinsurance	0	0	0	$30 copay	"$30 Copay, Covd up to $75"	$30 copay	0	Silver Sneakers	0	$30 copay	$35 copay	$30 copay	$30 copay	$0 copay	20% coinsurance	$30 copay	$30 copay	20% coinsurance	0	240	240	75	0	100	0.2	0.2	50	200	0	89.90324594	200	0.2	30	15	30	35	30	80.15506892	0	0.2	0	0	0	30	30	30	0	0	0	30	35	30	30	0	0.2	30	30	0.2	0	142.5273362	140.1353401	67.13214266	0	89.50952355	0.179019047	0.179019047	44.75476178	179.0190471	0	80.4719671	179.0190471	0	26.85285707	13.42642853	26.85285707	31.32833324	26.85285707	71.74642029	0	0.179019047	0	0	0	26.85285707	26.85285707	26.85285707	0	0	0	0	31.32833324	26.85285707	26.85285707	0	0.179019047	26.85285707	26.85285707	0.179019047	0	18.5262	0.519372333	2.719035447	0	1.735773065	1.811263722	0.214618109	1.337669128	6.763255111	0	6.850054974	1.945268172	0	0.449813539	4.636137128	7.858920768	0.062695999	3.040189543	16.90947183	0	6.238394962	0	0	0	0.800052315	0.767936339	0.416072531	0	0	0	0	0.000832327	0.358790582	1.098180585	0	0.099107973	1.929378767	0.061557208	1.805682655	0	88.9557		10.4256	18.5262	0.519372333	2.719035447	0	1.735773065	1.811263722	0.214618109	1.337669128	6.763255111	0	6.850054974	1.945268172	0	0.449813539	4.636137128	7.858920768	0.062695999	3.040189543	16.90947183	0	6.238394962	0	0	0	0.800052315	0.767936339	0.416072531	0	0	0	0	0.000832327	0.358790582	1.098180585	0	0.099107973	1.929378767	0.061557208	1.805682655	0	88.9557	3500																																																																																	0		0	18.5262	0.519372333	2.719035447	0	1.735773065	1.811263722	0.214618109	1.337669128	6.763255111	0	6.850054974	1.945268172	0	0.449813539	4.636137128	7.858920768	0.062695999	3.040189543	16.90947183	0	6.238394962	0	0	0	0.800052315	0.767936339	0.416072531	0	0	0	0	0.000832327	0.358790582	1.098180585	0	0.099107973	1.929378767	0.061557208	1.805682655	0	88.9557
H3655_801_0	2009	4																																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	V																																																			0		308.3943005	3.692499149	39.35250907	6.250680111	10.10243713	14.38609809	1.7146553	14.1507028	46.0831073	10.79429669	29.15769942	0	0.244590392	28.6923227	47.65993109	129.1775984	1.469633897	4.94577152	32.11840786	42.5308407	61.18264019	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.077320593	0.077320593	0.185086255	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.077320593	0.077320593	0.185086255	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			23.8452	0.285506225	7.283608524	0	2.333662976	3.32318866	0.396085374	3.268812347	10.64519779	2.493482535	6.735428565	0	0.05650038	6.627926544	11.00944408	29.84002522	0.33948543	1.142473221	7.419352215	9.824624202	14.13318988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.0032			23.8452	0.285506225	7.283608524	0	2.333662976	3.32318866	0.396085374	3.268812347	10.64519779	2.493482535	6.735428565	0	0.05650038	6.627926544	11.00944408	29.84002522	0.33948543	1.142473221	7.419352215	9.824624202	14.13318988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.0032																																																																																		0			23.8452	0.285506225	7.283608524	0	2.333662976	3.32318866	0.396085374	3.268812347	10.64519779	2.493482535	6.735428565	0	0.05650038	6.627926544	11.00944408	29.84002522	0.33948543	1.142473221	7.419352215	9.824624202	14.13318988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.0032
H3655_803_0	2009	4																																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	V																																																			0		279.8698525	3.350967222	5.724221699	9.434823196	10.43296876	15.68938778	0.548046884	14.85051135	40.03192535	9.509129317	25.68618802	0	0.215469496	25.27621899	43.22332087	117.1525988	1.332827305	4.485375125	29.12854083	38.57169183	48.70698265	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.0788	0.0788	0.1802	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.0788	0.0788	0.1802	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			22.0537	0.264056217	1.03150475	0	2.410015784	3.624248577	0.12659883	3.430468123	9.247374755	2.196608872	5.933509434	0	0.049773453	5.838806587	9.984587121	27.06225031	0.307883107	1.036121654	6.728692932	8.910060812	11.25131299	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.4876			22.0537	0.264056217	1.03150475	0	2.410015784	3.624248577	0.12659883	3.430468123	9.247374755	2.196608872	5.933509434	0	0.049773453	5.838806587	9.984587121	27.06225031	0.307883107	1.036121654	6.728692932	8.910060812	11.25131299	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.4876																																																																																		0			22.0537	0.264056217	1.03150475	0	2.410015784	3.624248577	0.12659883	3.430468123	9.247374755	2.196608872	5.933509434	0	0.049773453	5.838806587	9.984587121	27.06225031	0.307883107	1.036121654	6.728692932	8.910060812	11.25131299	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.4876
H3655_804_0	2009	4																																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	V																																																			0		308.3943005	3.692499149	39.35250907	6.250680111	10.10243713	14.38609809	1.7146553	14.1507028	46.0831073	10.79429669	29.15769942	0	0.244590392	28.6923227	47.65993109	129.1775984	1.469633897	4.94577152	32.11840786	42.5308407	61.18264019	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.077320593	0.077320593	0.185086255	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.077320593	0.077320593	0.185086255	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			23.8452	0.285506225	7.283608524	0	2.333662976	3.32318866	0.396085374	3.268812347	10.64519779	2.493482535	6.735428565	0	0.05650038	6.627926544	11.00944408	29.84002522	0.33948543	1.142473221	7.419352215	9.824624202	14.13318988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.0032			23.8452	0.285506225	7.283608524	0	2.333662976	3.32318866	0.396085374	3.268812347	10.64519779	2.493482535	6.735428565	0	0.05650038	6.627926544	11.00944408	29.84002522	0.33948543	1.142473221	7.419352215	9.824624202	14.13318988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.0032																																																																																		0			23.8452	0.285506225	7.283608524	0	2.333662976	3.32318866	0.396085374	3.268812347	10.64519779	2.493482535	6.735428565	0	0.05650038	6.627926544	11.00944408	29.84002522	0.33948543	1.142473221	7.419352215	9.824624202	14.13318988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.0032
H3659_001_0	2009	4																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1912.719629	163.2405021	1585.910946	1899.089693	249.1157754	13.34450719	5.403534709	368.3528839	39.87578073	10156.10507	46.96468663	0	0.310043711	21.35202731	5558.934825	4863.548417	746.7641701	281.0347715	0	0	30.7375923	782.5508961	0	0	232.651489	0	54.42393236	10.7712	468.1164166	0											"$255 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$255 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	"$115 Days 1-25 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$20 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											252.0696677	255	87.8078022	0	149.9897987	0.2	0.070295793	49.62057302	0.2	2.8	0.187928923	0	0.2	0.199214955	14.59354825	30	37.5	30	0	0	0.2	29.18574414	0	0	30	0	30	0	0	0											174.4247555	176.4037469	60.74362869	0	103.7598529	0.13835588	0.048629182	34.32649021	0.13835588	1.936982319	0.130005358	0	0.13835588	0.138231371	14.59354825	30	37.5	20.75338199	0	0	0.13835588	29.18574414	0	0	30	0	30	0	0	0											27.8021	2.399686351	8.027832135	0	2.154018017	1.846291034	0.262769472	1.053688472	5.517048731	1.639349663	6.105660885	0	0.04289637	2.951520013	6.760381965	12.15887104	2.333638031	0.486035164	0	0	4.252726629	1.90327752	0	0	0.581628723	0	0.136059831	0	0	0	0	0	0	0	0	0	0	0	0	0	88.4155	0	28.7324	27.8021	2.399686351	8.027832135	0	2.154018017	1.846291034	0.262769472	1.053688472	5.517048731	1.639349663	6.105660885	0	0.04289637	2.951520013	6.760381965	12.15887104	2.333638031	0.486035164	0	0	4.252726629	1.90327752	0	0	0.581628723	0	0.136059831	0	0	0	0	0	0	0	0	0	0	0	0	0	88.4155	4200	"$325 Days 1-13 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$325 Days 1-13 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-24 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$38 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$38 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$38 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $38 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$38 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$38 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.1432	0.0946	0.6987	0.1001	0.0781	0.1004	0.0407	0.0382	0.3002	0.0595	0.3255	0	0.0016	0.1598	0.3669	0.6417	0.1102	0.0257	0	0	0.2658	0.1007	0	0	0.0276	0	0.0072	0	0	0											4.6862	0	1.517952881	28.9453	2.494276777	8.726533633	0.100101487	2.232143023	1.946736919	0.303442598	1.091905152	5.817199051	1.698807941	6.431112025	0	0.044452197	3.111307216	7.127321447	12.80058924	2.443837605	0.51168702	0	0	4.518522043	2.003981225	0	0	0.609194081	0	0.143240766	0	0	0	0	0	0	0	0	0	0	0	0	0	93.1017
H3659_003_0	2009	5																					2550											D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1957.637208	151.3188465	1720.20651	1349.292879	261.2403378	10.37877303	4.232262858	385.2803869	337.204402	10167.46127	42.25028034	0	1.210958807	886.0560312	5823.220582	5144.500688	702.5297916	399.3367243	0	0	17.84534806	1091.05753	0	0	155.0869431	0	18.89819965	11.22	468.1223974	0											"$100 Days 1-26 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$100 Days 1-26 (1b); $0 n/c (1b1, 1b2)"	"$75 Days 1-34 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$100 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$15 (3, 9d); $60 (5); $100 (9a); $40/$30 (9c)"	"$5 (7a); $15 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$15 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$15 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$15 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$15 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											98.84895978	100	75	0	149.8763869	0.2	0.07693156	49.85005952	100	2.8	0.184350792	0	0.2	35.58045388	3.857970695	15	37.5	15	0	0	0.2	14.60724774	0	0	15	0	15	0	0	0											70.39353634	71.19794465	53.39845849	0	106.708907	0.142395889	0.05477369	35.49221778	71.19794465	1.99354245	0.131253975	0	0.142395889	25.43868447	3.857970695	15	37.5	10.6796917	0	0	0.142395889	14.60724774	0	0	15	0	15	0	0	0											11.4838	0.897799238	7.654697993	0	2.323055909	1.477894615	0.231816652	1.13953795	2.000688363	1.689105471	5.545517235	0	0.172435556	1.87834165	1.872151197	6.430625859	2.195405599	0.355399425	0	0	2.541104206	1.328112304	0	0	0.193858679	0	0.02362275	0	0	0	0	0	0	0	0	0	0	0	0	0	51.4349	0	15.9206	11.4838	0.897799238	7.654697993	0	2.323055909	1.477894615	0.231816652	1.13953795	2.000688363	1.689105471	5.545517235	0	0.172435556	1.87834165	1.872151197	6.430625859	2.195405599	0.355399425	0	0	2.541104206	1.328112304	0	0	0.193858679	0	0.02362275	0	0	0	0	0	0	0	0	0	0	0	0	0	51.4349																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.4838	0.897799238	7.654697993	0	2.323055909	1.477894615	0.231816652	1.13953795	2.000688363	1.689105471	5.545517235	0	0.172435556	1.87834165	1.872151197	6.430625859	2.195405599	0.355399425	0	0	2.541104206	1.328112304	0	0	0.193858679	0	0.02362275	0	0	0	0	0	0	0	0	0	0	0	0	0	51.4349
H3659_031_0	2009	5																					2950											D	D	D	V	T	Coin	Coin	V	V	O	O	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1794.678356	138.258278	1317.445388	1665.076534	221.1144609	12.88159078	5.21136124	365.0056928	352.1526137	9580.035304	4955.459549	0	0.688321812	877.6275743	5818.030759	4594.513869	714.2293095	251.2640893	0	0	22.9711519	786.0257836	0	0	191.9399804	0	75.59282138	0	468.1224314	0											"$195 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$195 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$150/$50 (9b)	$0/$25 (8a1); $25 (8a2)	"$25 (8b1); $100 (8b2, 8b3)"	Included in h.5.	20% (12)	"$50 (3, 9d); $60 (5); $150/$50 (9a); $35/$35 (9c)"	"$15 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$35/$35 (7e, 7h)"	"$50 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											192.8591258	195	77.60718127	0	150	0.2	0.071555683	49.6634926	150	10	49.47320651	0	0.2	53.55680897	11.09595714	25	35	50	0	0	0.2	24.49606363	0	0	25	0	25	0	0	0											120.7109961	121.9642975	48.5400274	0	93.81869038	0.125091587	0.04475507	31.06242557	93.81869038	6.254579359	30.94340963	0	0.125091587	33.62600662	11.09595714	25	35	31.27289679	0	0	0.125091587	24.49606363	0	0	25	0	25	0	0	0											18.0531	1.405214479	5.329069604	0	1.728722429	1.611378636	0.233234836	0.94483018	2.753208086	4.993257589	12.77823456	0	0.086103268	2.459259219	5.379718327	9.571903894	2.083168819	0.654812994	0	0	2.873497851	1.604544801	0	0	0.399874959	0	0.157485045	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1006	0	33.4414	18.0531	1.405214479	5.329069604	0	1.728722429	1.611378636	0.233234836	0.94483018	2.753208086	4.993257589	12.77823456	0	0.086103268	2.459259219	5.379718327	9.571903894	2.083168819	0.654812994	0	0	2.873497851	1.604544801	0	0	0.399874959	0	0.157485045	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1006																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.0531	1.405214479	5.329069604	0	1.728722429	1.611378636	0.233234836	0.94483018	2.753208086	4.993257589	12.77823456	0	0.086103268	2.459259219	5.379718327	9.571903894	2.083168819	0.654812994	0	0	2.873497851	1.604544801	0	0	0.399874959	0	0.157485045	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1006
H3659_054_0	2009	4																					2350											D	D	D	V	T	Coin	Coin	V	V	O	O	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1774.256887	140.6248363	1236.231931	1456.031635	214.7231288	12.55645738	4.614339203	352.8072264	385.2619557	9552.104061	4968.647834	0	0.426386644	882.9079528	5750.368658	4813.112731	716.1883613	247.5521736	0	0	26.87274881	786.7924356	0	0	195.2946355	0	75.72511924	0	468.9455284	0											"$195 Days 1-13 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$195 Days 1-13 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-24 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$150/$50 (9b)	$0/$25 (8a1); $25 (8a2)	"$25 (8b1); $100 (8b2, 8b3)"	Included in h.5.	20% (12)	"$50 (3, 9d); $60 (5); $150/$50 (9a); $35/$35 (9c)"	"$10 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$35/$35 (7e, 7h)"	"$50 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											192.8617703	195	100	0	150	0.2	0.085477138	49.63002658	150	10	50.35186165	0	0.2	53.55857857	7.440478064	25	35	50	0	0	0.2	24.44847073	0	0	25	0	25	0	0	0											107.8709426	108.9634311	55.87868263	0	83.81802395	0.111757365	0.047763499	27.73260504	83.81802395	5.587868263	28.13595697	0	0.111757365	30.07818157	7.440478064	25	35	27.93934132	0	0	0.111757365	24.44847073	0	0	25	0	25	0	0	0											15.9492	1.276913722	5.756584313	0	1.499805696	1.403276594	0.220396985	0.815355289	2.690991319	4.447991594	11.64980514	0	0.047651848	2.213022143	3.565457655	10.02731819	2.08888272	0.576370389	0	0	3.003227604	1.602989319	0	0	0.406863824	0	0.157760665	0	0	0	0	0	0	0	0	0	0	0	0	0	69.3999	0	40.657	15.9492	1.276913722	5.756584313	0	1.499805696	1.403276594	0.220396985	0.815355289	2.690991319	4.447991594	11.64980514	0	0.047651848	2.213022143	3.565457655	10.02731819	2.08888272	0.576370389	0	0	3.003227604	1.602989319	0	0	0.406863824	0	0.157760665	0	0	0	0	0	0	0	0	0	0	0	0	0	69.3999																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	15.9492	1.276913722	5.756584313	0	1.499805696	1.403276594	0.220396985	0.815355289	2.690991319	4.447991594	11.64980514	0	0.047651848	2.213022143	3.565457655	10.02731819	2.08888272	0.576370389	0	0	3.003227604	1.602989319	0	0	0.406863824	0	0.157760665	0	0	0	0	0	0	0	0	0	0	0	0	0	69.3999
H3659_056_0	2009	8																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		432.3491833	23.65	56.92239549	2280.209273	18.32451739	22.96644847	12.55809951	32.70638647	40.1218777	17.24220677	54.3710646	0	0.694190226	36.3552988	34.13371467	147.431788	13.99	2.063755047	0	0	25.89005854	4.066444894	631.6667079	3695.017245	163.2604543	184.3514798	18.14307564	6.393994731	20.2	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.075990989	0.076985567	0.185524407	0	0.2	0.2	0.2	0.115065046	0.2	0.08	0.2	0	0.2	0.2	0	0.199993771	0.2	0.2	0	0	0.2	0.007332319	0	0	0	0	0	0	0	0											0.075990989	0.076985567	0.185524407	0	0.2	0.2	0.2	0.115065046	0.2	0.08	0.2	0	0.2	0.2	0	0.199993771	0.2	0.2	0	0	0.2	0.007332319	0	0	0	0	0	0	0	0											32.8546	1.820708664	10.56049368	0	3.664903478	4.593289695	2.511619902	3.76336188	8.02437554	1.379376542	10.87421292	0	0.138838045	7.271059759	0	29.4854392	2.798	0.412751009	0	0	5.178011708	0.02981647	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.3609	0	0	32.8546	1.820708664	10.56049368	0	3.664903478	4.593289695	2.511619902	3.76336188	8.02437554	1.379376542	10.87421292	0	0.138838045	7.271059759	0	29.4854392	2.798	0.412751009	0	0	5.178011708	0.02981647	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.3609																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	32.8546	1.820708664	10.56049368	0	3.664903478	4.593289695	2.511619902	3.76336188	8.02437554	1.379376542	10.87421292	0	0.138838045	7.271059759	0	29.4854392	2.798	0.412751009	0	0	5.178011708	0.02981647	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.3609
H3659_057_0	2009	5																					2400											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1591.431851	748.7137015	7692.166631	106.8549551	618.1713851	13.72350196	15.67861783	174.8697704	114.4610052	12911.45407	1697.3664	0	6.359981125	289.4536845	174.3569977	8229.725426	4666.963198	42.43891337	0	0	1519.813902	972.2121973	1971.10214	0	191.5790143	267.7384154	0	0	0	0											"$175 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $35 (4b)	$35 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$35 (3, 5, 9a, 9d); $35/$25 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $35 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$15 (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"$35/$25 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											173.6011825	175	0	0	75	0.2	0.2	49.81663475	35	0	0	0	0	34.82030501	0	14.53036825	32.5	0	0	0	0	14.67406104	0	0	0	0	0	0	0	0											139.6438245	140.7690255	0	0	60.32958237	0.160878886	0.160878886	40.07222359	28.1538051	0	0	0	0	28.00925946	0	11.68814731	26.14281903	0	0	0	0	11.80373299	0	0	0	0	0	0	0	0											18.5195	8.782974847	0	0	3.107835124	2.207821712	2.522358575	0.583951712	0.268542736	0	0	0	0	0.675615279	0	8.01585359	10.16729786	0	0	0	0	0.956311099	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.808	0	13.5709	18.5195	8.782974847	0	0	3.107835124	2.207821712	2.522358575	0.583951712	0.268542736	0	0	0	0	0.675615279	0	8.01585359	10.16729786	0	0	0	0	0.956311099	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.808																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.5195	8.782974847	0	0	3.107835124	2.207821712	2.522358575	0.583951712	0.268542736	0	0	0	0	0.675615279	0	8.01585359	10.16729786	0	0	0	0	0.956311099	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.808
H3659_058_0	2009	5																					2400											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1514.672401	757.7936827	7321.150755	101.7010256	588.3551566	12.43157863	14.20264091	166.4352858	108.9402134	12288.69657	1615.497414	0	6.053220484	276.0658976	167.5858312	7845.209336	96.36248203	40.39195946	0	0	1446.508797	925.3195366	1971.10214	0	191.5790143	267.7384154	0	0	0	0											"$175 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $35 (4b)	$35 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$35 (3, 5, 9a, 9d); $35/$25 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $35 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$15 (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"$35/$25 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											173.6011825	175	0	0	75	0.2	0.2	49.81663475	35	0	0	0	0	34.81424985	0	14.50735026	32.5	0	0	0	0	14.67406104	0	0	0	0	0	0	0	0											147.2360274	148.4224037	0	0	63.6096016	0.169625604	0.169625604	42.25088386	29.68448075	0	0	0	0	29.52694084	0	12.30409027	27.56416069	0	0	0	0	12.44548235	0	0	0	0	0	0	0	0											18.5845	9.37279666	0	0	3.118753092	2.108714038	2.409131546	0.586003161	0.269486139	0	0	0	0	0.679281786	0	8.044013653	0.221345912	0	0	0	0	0.959670664	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3537	0	8.3004	18.5845	9.37279666	0	0	3.118753092	2.108714038	2.409131546	0.586003161	0.269486139	0	0	0	0	0.679281786	0	8.044013653	0.221345912	0	0	0	0	0.959670664	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3537																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.5845	9.37279666	0	0	3.118753092	2.108714038	2.409131546	0.586003161	0.269486139	0	0	0	0	0.679281786	0	8.044013653	0.221345912	0	0	0	0	0.959670664	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3537
H3659_059_0	2009	4																					3350											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1886.532349	267.7824955	42.72889296	51242.90538	89.21978285	21.39885467	9.46102121	364.6054307	382.2569462	6053.691472	462.964088	0	0.991172368	1476.971218	5967.530612	4420.688276	1301.980366	263.6066239	0	0	28.39739125	1116.181044	810.5086242	0	327.7093149	349.7142857	0	0	20.2	0											"$175 Days 1-20 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-20 (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$75 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5, 9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											172.9	175	0.185621914	0	75	0.14	0.2	49.97257309	75	4.4	64.79010385	0	0.2	70.31083493	3.252260834	25	20	20	0	0	0.2	13.67894853	0	0	0	0	0	0	0	0											131.0753326	132.6673407	0.185621914	0	56.85743172	0.106133873	0.151619818	37.88416217	56.85743172	3.335635995	49.11731874	0	0.151619818	53.30257995	3.252260834	25	20	20	0	0	0.151619818	13.67894853	0	0	0	0	0	0	0	0											20.6065	2.960499297	7.931418885	0	0.422733976	2.271143315	1.434478313	1.151064272	1.811179019	1.682742598	1.89496289	0	0.150281374	6.560531367	1.617330507	9.209767242	2.169967277	0.439344373	0	0	4.305607291	1.272348588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.8919	0	14.4393	20.6065	2.960499297	7.931418885	0	0.422733976	2.271143315	1.434478313	1.151064272	1.811179019	1.682742598	1.89496289	0	0.150281374	6.560531367	1.617330507	9.209767242	2.169967277	0.439344373	0	0	4.305607291	1.272348588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.8919																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.6065	2.960499297	7.931418885	0	0.422733976	2.271143315	1.434478313	1.151064272	1.811179019	1.682742598	1.89496289	0	0.150281374	6.560531367	1.617330507	9.209767242	2.169967277	0.439344373	0	0	4.305607291	1.272348588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.8919
H3659_060_0	2009	6																					2950											D	D	D	V	T	Coin	Coin	V	V	O	O	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1782.347025	137.308298	1308.39315	1653.635704	219.5951716	12.70517874	5.139992191	360.7483771	349.7329542	9514.210369	4921.410321	0	0.678895316	871.5973483	5822.158005	4571.472791	709.3218017	249.5376403	0	0	22.65656437	780.6249583	0	0	147.9890135	0	18.41008798	0	453.6	0											"$195 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$195 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$150/$50 (9b)	$0/$25 (8a1); $25 (8a2)	"$25 (8b1); $100 (8b2, 8b3)"	Included in h.5.	20% (12)	"$50 (3, 9d); $60 (5); $150/$50 (9a); $35/$35 (9c)"	"$15 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$35/$35 (7e, 7h)"	"$50 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											192.8591258	195	77.60718127	0	150	0.2	0.071555683	49.6618608	150	10	49.47320651	0	0.2	53.55644575	11.0119045	25	35	50	0	0	0.2	24.49606363	0	0	25	0	25	0	0	0											121.0898001	122.3477617	48.6926406	0	94.11366282	0.125484884	0.044895783	31.15906415	94.11366282	6.274244188	31.04069784	0	0.125484884	33.73042273	11.0119045	25	35	31.37122094	0	0	0.125484884	24.49606363	0	0	25	0	25	0	0	0											17.9853	1.39994691	5.30909312	0	1.722242161	1.594307877	0.230763974	0.936715152	2.742887444	4.974539926	12.73033423	0	0.0851911	2.449945584	5.342753995	9.523901649	2.068855255	0.65235837	0	0	2.843056346	1.593519888	0	0	0.308310445	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5324	0	33.015	17.9853	1.39994691	5.30909312	0	1.722242161	1.594307877	0.230763974	0.936715152	2.742887444	4.974539926	12.73033423	0	0.0851911	2.449945584	5.342753995	9.523901649	2.068855255	0.65235837	0	0	2.843056346	1.593519888	0	0	0.308310445	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5324																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.9853	1.39994691	5.30909312	0	1.722242161	1.594307877	0.230763974	0.936715152	2.742887444	4.974539926	12.73033423	0	0.0851911	2.449945584	5.342753995	9.523901649	2.068855255	0.65235837	0	0	2.843056346	1.593519888	0	0	0.308310445	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5324
H3659_801_0	2009	3																					5160											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	Coin	V	V	Coin	O	T	V	P	P	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	1620.252414	191.0945724	1236.739201	1550.331711	186.6199493	12.87260152	6.499109771	290.324825	48.51289496	11467.433	60.89982077	0	0.132817939	44.85511466	6309.440481	5649.93989	772.2081852	4.581286068	0	0	35.50274485	1075.082836	0	0	0	0	0	0	0	0											"$430 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$430 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-30 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"25% (3, 9a, 9d); $60 (5); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											425.0216912	430	175	0	150	0.2	0.069771679	49.66040647	0.25	2.8	0.222708402	0	0.2	0.250401692	23.96859707	39.7081281	37.5	0.25	0	0	0.2	39.60093329	0	0	0	0	0	0	0	0											280.7659846	283.9671016	115.5680065	0	99.05829126	0.132077722	0.046076422	32.79516672	0.165097152	1.849088103	0.147074092	0	0.132077722	0.165588172	23.96859707	39.7081281	37.5	0.165097152	0	0	0.132077722	39.60093329	0	0	0	0	0	0	0	0											37.9093	4.522047655	11.91062366	0	1.540521108	1.70018388	0.299455726	0.793437586	8.009340798	1.767024494	8.956785823	0	0.017542291	7.427476431	12.60236972	18.69571141	2.413150579	0.756357283	0	0	4.689121654	3.547856972	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.5583	0	46.4043	37.9093	4.522047655	11.91062366	0	1.540521108	1.70018388	0.299455726	0.793437586	8.009340798	1.767024494	8.956785823	0	0.017542291	7.427476431	12.60236972	18.69571141	2.413150579	0.756357283	0	0	4.689121654	3.547856972	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.5583																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	37.9093	4.522047655	11.91062366	0	1.540521108	1.70018388	0.299455726	0.793437586	8.009340798	1.767024494	8.956785823	0	0.017542291	7.427476431	12.60236972	18.69571141	2.413150579	0.756357283	0	0	4.689121654	3.547856972	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.5583
H3659_802_0	2009	3																					5160											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	Coin	V	V	Coin	O	T	V	P	P	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	1620.252409	191.0945717	1236.739196	1550.331705	186.6199487	12.87260143	6.499109725	290.3248239	48.51289462	11467.43295	60.89982034	0	0.132817938	44.85511435	6309.440459	5649.939871	772.2081825	4.581286036	0	0	35.50274461	1075.082832	0	0	0	0	0	0	0	0											"$430 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$430 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-30 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"25% (3, 9a, 9d); $60 (5); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											425.0216912	430	175	0	150	0.2	0.069771679	49.66040647	0.25	2.8	0.222708402	0	0.2	0.250401692	23.96859707	39.70812809	37.5	0.25	0	0	0.2	39.60093329	0	0	0	0	0	0	0	0											280.7659852	283.9671021	115.5680067	0	99.05829144	0.132077722	0.046076422	32.79516678	0.165097152	1.849088107	0.147074092	0	0.132077722	0.165588172	23.96859707	39.70812809	37.5	0.165097152	0	0	0.132077722	39.60093329	0	0	0	0	0	0	0	0											37.9093	4.522047647	11.91062364	0	1.540521105	1.700183872	0.299455724	0.793437585	8.009340757	1.767024491	8.95678578	0	0.017542291	7.427476392	12.60236967	18.69571134	2.41315057	0.756357279	0	0	4.689121629	3.54785696	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.5583	0	46.4043	37.9093	4.522047647	11.91062364	0	1.540521105	1.700183872	0.299455724	0.793437585	8.009340757	1.767024491	8.95678578	0	0.017542291	7.427476392	12.60236967	18.69571134	2.41315057	0.756357279	0	0	4.689121629	3.54785696	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.5583																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	37.9093	4.522047647	11.91062364	0	1.540521105	1.700183872	0.299455724	0.793437585	8.009340757	1.767024491	8.95678578	0	0.017542291	7.427476392	12.60236967	18.69571134	2.41315057	0.756357279	0	0	4.689121629	3.54785696	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.5583
H3659_803_0	2009	3																					5160											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	Coin	V	V	Coin	O	T	V	P	P	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	1620.252395	191.0945701	1236.739186	1550.331692	186.6199471	12.87260121	6.499109613	290.3248214	48.51289379	11467.43286	60.89981929	0	0.132817936	44.85511358	6309.440404	5649.939822	772.2081759	4.581285957	0	0	35.50274399	1075.082823	0	0	0	0	0	0	0	0											"$430 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$430 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-30 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"25% (3, 9a, 9d); $60 (5); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											425.0216912	430	175	0	150	0.2	0.069771679	49.66040647	0.25	2.8	0.222708402	0	0.2	0.250401692	23.96859707	39.70812808	37.5	0.25	0	0	0.2	39.60093329	0	0	0	0	0	0	0	0											280.7659864	283.9671034	115.5680072	0	99.05829188	0.132077723	0.046076423	32.79516693	0.165097153	1.849088115	0.147074093	0	0.132077723	0.165588173	23.96859707	39.70812808	37.5	0.165097153	0	0	0.132077723	39.60093329	0	0	0	0	0	0	0	0											37.9093	4.522047628	11.91062359	0	1.540521099	1.70018385	0.299455721	0.793437582	8.009340654	1.767024484	8.956785675	0	0.01754229	7.427476297	12.60236956	18.69571118	2.41315055	0.756357269	0	0	4.689121569	3.547856929	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.5583	0	46.4043	37.9093	4.522047628	11.91062359	0	1.540521099	1.70018385	0.299455721	0.793437582	8.009340654	1.767024484	8.956785675	0	0.01754229	7.427476297	12.60236956	18.69571118	2.41315055	0.756357269	0	0	4.689121569	3.547856929	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.5583																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	37.9093	4.522047628	11.91062359	0	1.540521099	1.70018385	0.299455721	0.793437582	8.009340654	1.767024484	8.956785675	0	0.01754229	7.427476297	12.60236956	18.69571118	2.41315055	0.756357269	0	0	4.689121569	3.547856929	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.5583
H3659_804_0	2009	3																					5160											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	Coin	V	V	Coin	O	T	V	P	P	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	1620.252396	191.0945702	1236.739187	1550.331693	186.6199472	12.87260122	6.499109623	290.3248216	48.51289386	11467.43286	60.89981938	0	0.132817936	44.85511364	6309.440409	5649.939826	772.2081764	4.581285963	0	0	35.50274405	1075.082824	0	0	0	0	0	0	0	0											"$430 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$430 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-30 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"25% (3, 9a, 9d); $60 (5); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											425.0216912	430	175	0	150	0.2	0.069771679	49.66040647	0.25	2.8	0.222708402	0	0.2	0.250401692	23.96859707	39.70812808	37.5	0.25	0	0	0.2	39.60093329	0	0	0	0	0	0	0	0											280.7659863	283.9671033	115.5680071	0	99.05829184	0.132077722	0.046076423	32.79516692	0.165097153	1.849088114	0.147074093	0	0.132077722	0.165588173	23.96859707	39.70812808	37.5	0.165097153	0	0	0.132077722	39.60093329	0	0	0	0	0	0	0	0											37.9093	4.52204763	11.9106236	0	1.540521099	1.700183852	0.299455721	0.793437582	8.009340663	1.767024484	8.956785683	0	0.01754229	7.427476305	12.60236957	18.69571119	2.413150551	0.75635727	0	0	4.689121574	3.547856932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.5583	0	46.4043	37.9093	4.52204763	11.9106236	0	1.540521099	1.700183852	0.299455721	0.793437582	8.009340663	1.767024484	8.956785683	0	0.01754229	7.427476305	12.60236957	18.69571119	2.413150551	0.75635727	0	0	4.689121574	3.547856932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.5583																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	37.9093	4.52204763	11.9106236	0	1.540521099	1.700183852	0.299455721	0.793437582	8.009340663	1.767024484	8.956785683	0	0.01754229	7.427476305	12.60236957	18.69571119	2.413150551	0.75635727	0	0	4.689121574	3.547856932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.5583
H3659_805_0	2009	3																					5000											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	Coin	V	V	Coin	O	T	V	P	P	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	1609.231719	189.794778	1228.327101	1539.786605	185.3505906	12.69808236	6.410998665	288.3500824	47.85518568	11389.43337	60.07417683	0	0.131017271	44.24699541	6266.524687	5611.509913	766.95575	4.519175687	0	0	35.02141953	1067.770296	0	0	0	0	0	0	0	0											"$425 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$425 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-29 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"25% (3, 9a, 9d); $60 (5); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"25% (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											420.0825402	425	175	0	150	0.2	0.069771679	49.66040647	0.25	2.8	0.222891552	0	0.2	0.250406244	23.96859707	39.70027705	37.5	0.25	0	0	0.2	39.6006604	0	0	0	0	0	0	0	0											275.7189596	278.8578985	114.8238406	0	98.42043477	0.131227246	0.045779727	32.58399197	0.164034058	1.837181449	0.146247223	0	0.131227246	0.164530748	23.96859707	39.70027705	37.5	0.164034058	0	0	0.131227246	39.6006604	0	0	0	0	0	0	0	0											36.9746	4.410481079	11.75343626	0	1.520190476	1.666334382	0.293493767	0.782966398	7.849880301	1.743704642	8.785681549	0	0.017193036	7.27999127	12.51665044	18.56487485	2.396736719	0.741298727	0	0	4.595764449	3.523700741	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.417	0	46.3026	36.9746	4.410481079	11.75343626	0	1.520190476	1.666334382	0.293493767	0.782966398	7.849880301	1.743704642	8.785681549	0	0.017193036	7.27999127	12.51665044	18.56487485	2.396736719	0.741298727	0	0	4.595764449	3.523700741	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.417																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	36.9746	4.410481079	11.75343626	0	1.520190476	1.666334382	0.293493767	0.782966398	7.849880301	1.743704642	8.785681549	0	0.017193036	7.27999127	12.51665044	18.56487485	2.396736719	0.741298727	0	0	4.595764449	3.523700741	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.417
H3660_028_0	2009	7																					2000											D	D	D	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1481.087728	47.19609851	187.9003562	0	237.1119273	20.34178441	0.7479791	332.9399833	281.5529931	0	896.2416984	0	0	1233.219586	0	3486.231537	226.1965542	404.4067829	0	0	0	0	0	0	655.4855207	0	51.28932221	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	12 ESRD: $0	3 CORF: $25; 5 Partial Hosp: $25; Part B Rx: $50; 9D Cardiac Rehab: $0	7A PCP: $0; 14A through 14J Diabetes Monitoring: $0	7B Chiropractic: $25; 7D Physician Specialist: $25; 7F Podiatry: $25; 7G Other Health Care: $25; 16B Comp Dental: $0; 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.	13 Blood: $0	0	0	17A Routine Eye Exams: $25	0	18A Routine Hearing Exams: $25	0	0	0											100	0	75	0	75	0.2	0.2	49.01172635	150	0	82.54015889	0	0	36.01990198	0	25	25	25	0	0	0	0	0	0	25	0	25	0	0	0											92.54601885	0	75	0	75	0.2	0.2	49.01172635	150	0	82.54015889	0	0	36.01990198	0	25	25	25	0	0	0	0	0	0	25	0	25	0	0	0											11.4224	0	1.174377226	0	1.481949546	4.068356883	0.14959582	1.359830279	3.519412414	0	6.164661016	0	0	3.701704051	0	7.26298237	0.471242821	0.842514131	0	0	0	0	0	0	1.365594835	0	0.106852755	0	0	0	0	0	0	0	0	0	0	0	0	0	43.0915	0	0.92	11.4224	0	1.174377226	0	1.481949546	4.068356883	0.14959582	1.359830279	3.519412414	0	6.164661016	0	0	3.701704051	0	7.26298237	0.471242821	0.842514131	0	0	0	0	0	0	1.365594835	0	0.106852755	0	0	0	0	0	0	0	0	0	0	0	0	0	43.0915	0	20% coinsurance	20% 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											6.5872	0.0884	0.5154	0.061	0.1647	0.6781	0.0249	0.1516	0.7722	0	0.841	0	0	0.431	0.7986	1.2912	0.0839	0.1498	0	0	0	0	0	0	0.2428	0	0.019	0	0	0											12.9008	0	0	18.0095	0.088402077	1.689798342	0.061034616	1.646610606	4.746416363	0.174528457	1.511439934	4.291654919	0	7.005670523	0	0	4.132741057	0.798596145	8.554179235	0.555185631	0.992294421	0	0	0	0	0	0	1.60836725	0	0.1258488	0	0	0	0	0	0	0	0	0	0	0	0	0	55.9923
H3660_029_0	2009	8																					3000											D	D	D	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1055.806272	30.29323907	133.9464036	0	175.5820184	14.50081799	0.533203408	237.6530786	204.943509	0	633.3141772	0	0	848.6442484	0	2575.116519	183.6149387	314.8983839	0	0	0	0	0	0	467.2685559	0	36.56203954	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	12 ESRD: $0	3 CORF: $30; 5 Partial Hosp: $30; Part B Rx: $50; 9D Cardiac Rehab: $0	7A PCP: $0; 14A through 14J Diabetes Monitoring: $0	7B Chiropractic: $30; 7D Physician Specialist: $30; 7F Podiatry: $30; 7G Other Health Care: $30; 16B Comp Dental: $0; 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.	13 Blood: $0	0	0	17A Routine Eye Exams: $30	0	18A Routine Hearing Exams: $30	0	0	0											175	0	100	0	75	0.2	0.2	49.13441917	250	0	83.80067568	0	0	40.44932068	0	30	30	30	0	0	0	0	0	0	30	0	30	0	0	0											162.838678	0	100	0	75	0.2	0.2	49.13441917	250	0	83.80067568	0	0	40.44932068	0	30	30	30	0	0	0	0	0	0	30	0	30	0	0	0											14.3272	0	1.11622003	0	1.097387615	2.900163597	0.106640682	0.973078832	4.269656437	0	4.422679664	0	0	2.860590279	0	6.437791297	0.459037347	0.78724596	0	0	0	0	0	0	1.16817139	0	0.091405099	0	0	0	0	0	0	0	0	0	0	0	0	0	41.0172	0	1.07	14.3272	0	1.11622003	0	1.097387615	2.900163597	0.106640682	0.973078832	4.269656437	0	4.422679664	0	0	2.860590279	0	6.437791297	0.459037347	0.78724596	0	0	0	0	0	0	1.16817139	0	0.091405099	0	0	0	0	0	0	0	0	0	0	0	0	0	41.0172	0	25% coinsurance	25% 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											5.8696	0.0788	0.4899	0.0435	0.1219	0.4834	0.0178	0.1085	0.5505	0.2851	0.5995	0	0	0.2891	0.5693	1.073	0.0766	0.1312	0	0	0	0	0	0	0.1947	0	0.0152	0	0	0											10.9976	0	0	20.1968	0.078772737	1.606116598	0.043509057	1.219319572	3.383524197	0.124414129	1.081567536	4.820156225	0.28505619	5.022200607	0	0	3.149699609	0.56928621	7.510756513	0.535662125	0.91845362	0	0	0	0	0	0	1.362866621	0	0.106639282	0	0	0	0	0	0	0	0	0	0	0	0	0	52.0148
H3660_032_0	2009	7																					0											D	D	D	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1789.413645	51.34193344	227.0165736	0	297.5819219	24.57644197	0.903689891	402.7819051	347.3446987	0	827.4358865	0	0	1438.308938	0	4364.388391	311.1963677	533.6996757	0	0	0	0	0	0	791.941431	0	61.96649346	0	0	0											1A IP Acute: $0 per day (days 1-10); 1B IP Psych: $0 per day (days 1-10)	0	2 SNF: $0 per day for days 11-100 only	0	10A Ambulance: $0	11A DME: 0%	11B Prosthetic Medical Supplies: 0%; 11C Diabetes Monitoring Supplies: 0%	4A ER: $50; 4B Urgent Care: $35	9A OP Hospital: $0; 9B ASC Services: $0	0	8A OP C/D/T: $0; 8B OP X-Ray: $0	0	12 ESRD: $0	3 CORF: $0; 5 Partial Hosp: $0; Part B Rx: $0; 9D Cardiac Rehab: $0	7A PCP: $0; 14A through 14J Diabetes Monitoring: $0	7B Chiropractic: $0; 7D Physician Specialist: $0; 7F Podiatry: $0; 7G Other Health Care: $0; 16B Comp Dental: $0; 17A Medicare Covered Vision Exams: $0; 18A Medicare Covered Hearing Exams: $0	7E Mental Health: $0; 7H Psychiatric: $0; 9C OP Substance Abuse: $0	7C Occupational Therapy: $0; 7I Physical and Speech Therapy: $0	0	0	included in h.5.	13 Blood: $0	0	0	17A Routine Eye Exams: $0	0	18A Routine Hearing Exams: $0	0	0	0											0	0	0	0	0	0	0	47.11473057	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	47.11473057	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.581413412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.5814	0	0	0	0	0	0	0	0	0	1.581413412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.5814	0	15% coinsurance	15% coinsurance	$50 copay	20% coinsurance	$75 copay	20% coinsurance	20% coinsurance	$50 copay for ER; $35 copay for UC	$150 copay	0	20% coinsurance	0	0	Combination of 20% coinsurance and $40 copay	$15 copay	$35 copay	$35 copay	$35 copay	0	0	0	0	0	0	$35 copay	0	$35 copay	0	0	0											6.2175	0.0834	0.4151	0.0737	0.2067	0.5461	0.0201	0.1839	0.6623	0	1.0161	0	0	0.3995	0.9648	1.4144	0.1011	0.173	0	0	0	0	0	0	0.2568	0	0.0207	0	0	0											12.7553	0	0	6.2175	0.083441568	0.415146049	0.073740517	0.206654112	0.546143155	0.020081998	1.765283477	0.662327308	0	1.016086933	0	0	0.399530261	0.964844156	1.414385127	0.101051604	0.172958228	0	0	0	0	0	0	0.256831871	0	0.020667777	0	0	0	0	0	0	0	0	0	0	0	0	0	14.3367
H3660_801_0	2009	4																					0											D	D	D	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	296.8450342	1.736743822	8.642312827	0	298.0650452	19.2743601	0.248021726	226.3287113	118.7825718	0	430.25342	0	0	342.6272385	2499.26594	2110.084382	67.24407226	276.7518269	0	0	0	0	0	0	0	0	0	0	0	0											1A IP Acute: $250 per day (days 1-10); 1B IP Psych: $250 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	12 ESRD: $0	3 CORF: $40; 5 Partial Hosp: $40; Part B Rx: $50	7A PCP: $20; 14A through 14J 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.	13 Blood: $0	0	0	0	0	0	0	0	0											250	0	100	0	75	0.2	0.20000145	49.52366249	250	0	73.04417243	0	0	40.98327293	20	40	40	40	0	0	0	0	0	0	0	0	0	0	0	0											250	0	100	0	75	0.2	0.20000145	49.52366249	250	0	73.04417243	0	0	40.98327293	20	40	40	40	0	0	0	0	0	0	0	0	0	0	0	0											6.1843	0	0.072019274	0	1.862906533	3.854872021	0.049604705	0.934052226	2.474636913	0	2.61895875	0	0	1.170165469	4.165443233	7.033614606	0.224146908	0.92250609	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.5672	0	0	6.1843	0	0.072019274	0	1.862906533	3.854872021	0.049604705	0.934052226	2.474636913	0	2.61895875	0	0	1.170165469	4.165443233	7.033614606	0.224146908	0.92250609	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.5672	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.1843	0	0.072019274	0	1.862906533	3.854872021	0.049604705	0.934052226	2.474636913	0	2.61895875	0	0	1.170165469	4.165443233	7.033614606	0.224146908	0.92250609	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.5672
H3660_802_0	2009	3																					0											D	D	D	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	296.8450342	1.736743822	8.642312827	0	298.0650452	19.2743601	0.248021726	226.3287113	118.7825718	0	430.25342	0	0	342.6272385	2499.26594	2110.084382	67.24407226	276.7518269	0	0	0	0	0	0	0	0	0	0	0	0											1A IP Acute: $250 per day (days 1-10); 1B IP Psych: $250 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	12 ESRD: $0	3 CORF: $40; 5 Partial Hosp: $40; Part B Rx: $50	7A PCP: $20; 14A through 14J 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.	13 Blood: $0	0	0	0	0	0	0	0	0											250	0	100	0	75	0.2	0.20000145	49.52366249	250	0	73.04417243	0	0	40.98327293	20	40	40	40	0	0	0	0	0	0	0	0	0	0	0	0											250	0	100	0	75	0.2	0.20000145	49.52366249	250	0	73.04417243	0	0	40.98327293	20	40	40	40	0	0	0	0	0	0	0	0	0	0	0	0											6.1843	0	0.072019274	0	1.862906533	3.854872021	0.049604705	0.934052226	2.474636913	0	2.61895875	0	0	1.170165469	4.165443233	7.033614606	0.224146908	0.92250609	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.5672	0	0	6.1843	0	0.072019274	0	1.862906533	3.854872021	0.049604705	0.934052226	2.474636913	0	2.61895875	0	0	1.170165469	4.165443233	7.033614606	0.224146908	0.92250609	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.5672	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.1843	0	0.072019274	0	1.862906533	3.854872021	0.049604705	0.934052226	2.474636913	0	2.61895875	0	0	1.170165469	4.165443233	7.033614606	0.224146908	0.92250609	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.5672
H3660_805_0	2009	4																					0											D	D	D	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	267.1605307	1.56306944	7.778081544	0	268.2585407	17.34692409	0.223219553	203.6958402	106.9043147	0	387.228078	0	0	308.3645147	2249.339346	1899.075944	60.51966504	249.0766442	0	0	0	0	0	0	0	0	0	0	0	0											1A IP Acute: $250 per day (days 1-10); 1B IP Psych: $250 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	0	0	0	0	0	0											250	0	100	0	75	0.2	0.20000145	49.52366249	250	0	73.04417243	0	0	40.98327293	20	40	40	40	0	0	0	0	0	0	0	0	0	0	0	0											250	0	100	0	75	0.2	0.20000145	49.52366249	250	0	73.04417243	0	0	40.98327293	20	40	40	40	0	0	0	0	0	0	0	0	0	0	0	0											5.5658	0	0.064817346	0	1.676615879	3.469384819	0.044644234	0.840647003	2.227173222	0	2.357062875	0	0	1.053148922	3.748898909	6.330253145	0.201732217	0.830255481	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.4105	0	0	5.5658	0	0.064817346	0	1.676615879	3.469384819	0.044644234	0.840647003	2.227173222	0	2.357062875	0	0	1.053148922	3.748898909	6.330253145	0.201732217	0.830255481	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.4105	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	0	0	0	0	0	0											4.4731	0.0206	0.0658	0.0725	0.1863	0.5782	0.0074	0.1002	0.6722	0.3637	0.6851	0	0	0.4	1.5981	3.3607	0.059	0.8515	0	0	0	0	0	0	0	0	0	0	0	0											13.4946	0	0	10.0389	0.020640914	0.13061468	0.072539694	1.862906533	4.047615622	0.052084886	0.940804013	2.899399433	0.363705366	3.042210474	0	0	1.453116474	5.347036407	9.690946392	0.260735332	1.681763601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.905
H3660_806_0	2009	3																					0											D	D	D	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	267.1605307	1.56306944	7.778081544	0	268.2585407	17.34692409	0.223219553	203.6958402	106.9043147	0	387.228078	0	0	308.3645147	2249.339346	1899.075944	60.51966504	249.0766442	0	0	0	0	0	0	0	0	0	0	0	0											1A IP Acute: $250 per day (days 1-10); 1B IP Psych: $250 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	12 ESRD: $0	3 CORF: $40; 5 Partial Hosp: $40; Part B Rx: $50	7A PCP: $20; 14A through 14J 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.	13 Blood: $0	0	0	0	0	0	0	0	0											250	0	100	0	75	0.2	0.20000145	49.52366249	250	0	73.04417243	0	0	40.98327293	20	40	40	40	0	0	0	0	0	0	0	0	0	0	0	0											250	0	100	0	75	0.2	0.20000145	49.52366249	250	0	73.04417243	0	0	40.98327293	20	40	40	40	0	0	0	0	0	0	0	0	0	0	0	0											5.5658	0	0.064817346	0	1.676615879	3.469384819	0.044644234	0.840647003	2.227173222	0	2.357062875	0	0	1.053148922	3.748898909	6.330253145	0.201732217	0.830255481	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.4105	0	0	5.5658	0	0.064817346	0	1.676615879	3.469384819	0.044644234	0.840647003	2.227173222	0	2.357062875	0	0	1.053148922	3.748898909	6.330253145	0.201732217	0.830255481	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.4105	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	0	0	0	0	0	0											4.4731	0.0206	0.0658	0.0725	0.1863	0.5782	0.0074	0.1002	0.6722	0.3637	0.6851	0	0	0.4	1.5981	3.3607	0.059	0.8515	0	0	0	0	0	0	0	0	0	0	0	0											13.4946	0	0	10.0389	0.020640914	0.13061468	0.072539694	1.862906533	4.047615622	0.052084886	0.940804013	2.899399433	0.363705366	3.042210474	0	0	1.453116474	5.347036407	9.690946392	0.260735332	1.681763601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.905
H3664_001_0	2009	5																					3500											D	D	D		T	Coin	Coin	V	V	V	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	1418.766068	38.66921542	966.9896041	0	259.6643644	15.42686612	0.01840752	332.5176808	360.8193913	2954.482787	1073.639888	0	0	254.2808297	4751.103587	4163.737969	180.2221183	418.9136877	950.9986928	1031.345098	0	0	0	0	181.0381649	0	3.450229341	0	0	0											$150/Days 1-10 for IP Medical; $150/Days 1-10 for IP Surgical;	$150/Days 1-10 for IP Psych; $150/Days 1-10 for IP Substance Abuse;	$50/Days 11-30; $75/Days 31-100		$125/Run 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; $40/Visit for Urgent Care; $40/Visit for Urgent Care - Worldwide;	$150/Case for OP Fac - Surgery; $150/Case for OP Fac - ASC	$15/Case for OP Fac - Pathology	$15/Case for OP Fac - Radiology; $15/Case for OP Fac - CT/MRI/PET;15% Coinsurance for Chemo/Radiation Therapy			$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;	$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 OP Psych - Non-Physician; $30/Visit for OP Psych - Psychiatrist; $30/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);	$15/Procedure for Prof Radiology (Office);	$30/Visit for Chiropractor; $30/Exam for Vision Exams; $30/Service for Podiatrist; $30/Exam for Hearing/Speech Exams; $15/Procedure for Prof Path (Labs)	No Cost Sharing				$30/Exam for Vision (Refractions)		$30/Exam for Routine Hearing Exams														150	150	57.90719697	0	125	0.2	0.2	50	150	15	28.23918585	0	0	5	15.03320668	29.4957016	30	5	15	24.50871336	0	0	0	0	30	0	30	0	0	0											142.9425958	142.9425958	55.18270032	0	119.1188298	0.190590128	0.190590128	47.64753192	142.9425958	14.29425958	26.91055018	0	0	4.764753192	14.32590391	28.10794767	28.58851915	4.764753192	14.29425958	23.35559404	0	0	0	0	28.58851915	0	28.58851915	0	0	0											16.9002	0.460623169	4.446758128	0	2.577576269	2.940208383	0.003508292	1.320303901	4.298038366	3.519345323	2.407686673	0	0	0.10096545	5.671987786	9.752844079	0.429356957	0.166335028	1.132818514	2.007306453	0	0	0	0	0.431301087	0	0.008219746	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5754	0	2.892	16.9002	0.460623169	4.446758128	0	2.577576269	2.940208383	0.003508292	1.320303901	4.298038366	3.519345323	2.407686673	0	0	0.10096545	5.671987786	9.752844079	0.429356957	0.166335028	1.132818514	2.007306453	0	0	0	0	0.431301087	0	0.008219746	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5754	0																																																																																	0	0	0	16.9002	0.460623169	4.446758128	0	2.577576269	2.940208383	0.003508292	1.320303901	4.298038366	3.519345323	2.407686673	0	0	0.10096545	5.671987786	9.752844079	0.429356957	0.166335028	1.132818514	2.007306453	0	0	0	0	0.431301087	0	0.008219746	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5754
H3664_011_0	2009	6																					3500											D	D	D		T	Coin	Coin	V	V	V	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	1184.719727	32.33694758	809.9247565	0	217.4879608	12.92113248	0.015417649	275.3874223	302.2127191	2474.59615	899.2521957	0	0	212.9788554	3860.555109	3435.709191	149.214201	350.8709557	793.6659747	856.3417511	0	0	0	0	149.8898435	0	2.856603945	0	0	0											$175/Days 1-10 for IP Medical; $175/Days 1-10 for IP Surgical;	$175/Days 1-10 for IP Psych; $175/Days 1-10 for IP Substance Abuse;	$50/Days 11-30; $75/Days 31-100		$125/Run 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; $40/Visit for Urgent Care; $40/Visit for Urgent Care - Worldwide;	$175/Case for OP Fac - Surgery; $175/Case for OP Fac - ASC	$20/Case for OP Fac - Pathology	$20/Case for OP Fac - Radiology; $20/Case for OP Fac - CT/MRI/PET;15% Coinsurance for Chemo/Radiation Therapy			$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;	$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 OP Psych - Non-Physician; $35/Visit for OP Psych - Psychiatrist; $35/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);	$20/Procedure for Prof Radiology (Office);	$35/Visit for Chiropractor; $35/Exam for Vision Exams; $35/Service for Podiatrist; $35/Exam for Hearing/Speech Exams; $20/Procedure for Prof Path (Labs)	No Cost Sharing				$35/Exam for Vision (Refractions)		$35/Exam for Routine Hearing Exams														175	175	57.90719697	0	125	0.2	0.2	50	175	20	33.20210129	0	0	5	20.03064207	34.50462166	35	5	20	29.48063842	0	0	0	0	35	0	35	0	0	0											167.1291363	167.1291363	55.3027418	0	119.3779545	0.191004727	0.191004727	47.7511818	167.1291363	19.10047272	31.7087915	0	0	4.77511818	19.12973662	32.95272923	33.42582726	4.77511818	19.10047272	28.1547065	0	0	0	0	33.42582726	0	33.42582726	0	0	0											16.5001	0.45037051	3.732588307	0	2.163605657	2.467997385	0.002944844	1.095839572	4.209045893	3.938829689	2.376183365	0	0	0.084749934	6.154283536	9.434666224	0.415634009	0.139620857	1.263282941	2.009170889	0	0	0	0	0.417516001	0	0.007957029	0	0	0	0	0	0	0	0	0	0	0	0	0	56.8644	0	2.678	16.5001	0.45037051	3.732588307	0	2.163605657	2.467997385	0.002944844	1.095839572	4.209045893	3.938829689	2.376183365	0	0	0.084749934	6.154283536	9.434666224	0.415634009	0.139620857	1.263282941	2.009170889	0	0	0	0	0.417516001	0	0.007957029	0	0	0	0	0	0	0	0	0	0	0	0	0	56.8644	0																																																																																	0	0	0	16.5001	0.45037051	3.732588307	0	2.163605657	2.467997385	0.002944844	1.095839572	4.209045893	3.938829689	2.376183365	0	0	0.084749934	6.154283536	9.434666224	0.415634009	0.139620857	1.263282941	2.009170889	0	0	0	0	0.417516001	0	0.007957029	0	0	0	0	0	0	0	0	0	0	0	0	0	56.8644
H3664_012_0	2009	5																					3500											D	D	D		T	Coin	Coin	V	V	V	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	1718.24759	46.88111953	1167.569393	0	313.5257742	18.62681525	0.022225738	396.9923413	435.6630886	3567.322398	1296.341829	0	0	307.0255489	5736.610928	5096.525875	220.106266	505.8077129	1152.391971	1256.06482	0	0	0	0	221.1029081	0	4.213784101	0	0	0											$100/Days 1-10 for IP Medical; $100/Days 1-10 for IP Surgical;	$100/Days 1-10 for IP Psych; $100/Days 1-10 for IP Substance Abuse;	$25/Days 11-30; $75/Days 31-100		$75/Run 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; $40/Visit for Urgent Care; $40/Visit for Urgent Care - Worldwide;	$100/Case for OP Fac - Surgery; $100/Case for OP Fac - ASC	$15/Case for OP Fac - Pathology	$15/Case for OP Fac - Radiology; $15/Case for OP Fac - CT/MRI/PET;15% Coinsurance for Chemo/Radiation Therapy			$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;	$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 OP Psych - Non-Physician; $25/Visit for OP Psych - Psychiatrist; $25/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);	$15/Procedure for Prof Radiology (Office);	$25/Visit for Chiropractor; $25/Exam for Vision Exams; $25/Service for Podiatrist; $25/Exam for Hearing/Speech Exams; $15/Procedure for Prof Path (Labs)	No Cost Sharing				$25/Exam for Vision (Refractions)		$25/Exam for Routine Hearing Exams														100	100	40.81439394	0	75	0.2	0.2	50	100	15	28.23918585	0	0	5	15.01981797	24.6683604	25	5	15	21.35753728	0	0	0	0	25	0	25	0	0	0											95.51905343	95.51905343	38.98552275	0	71.63929007	0.191038107	0.191038107	47.75952672	95.51905343	14.32785801	26.97380302	0	0	4.775952672	14.34678795	23.56298435	23.87976336	4.775952672	14.32785801	20.40051745	0	0	0	0	23.87976336	0	23.87976336	0	0	0											13.6771	0.373170013	3.793191927	0	1.871730323	3.558431523	0.004245963	1.580013861	3.46784382	4.259340735	2.913939094	0	0	0.122194958	6.858495046	10.00744662	0.438007129	0.201309475	1.375942379	2.135364356	0	0	0	0	0.439990427	0	0.008385347	0	0	0	0	0	0	0	0	0	0	0	0	0	57.0862	0	2.678	13.6771	0.373170013	3.793191927	0	1.871730323	3.558431523	0.004245963	1.580013861	3.46784382	4.259340735	2.913939094	0	0	0.122194958	6.858495046	10.00744662	0.438007129	0.201309475	1.375942379	2.135364356	0	0	0	0	0.439990427	0	0.008385347	0	0	0	0	0	0	0	0	0	0	0	0	0	57.0862	0																																																																																	0	0	0	13.6771	0.373170013	3.793191927	0	1.871730323	3.558431523	0.004245963	1.580013861	3.46784382	4.259340735	2.913939094	0	0	0.122194958	6.858495046	10.00744662	0.438007129	0.201309475	1.375942379	2.135364356	0	0	0	0	0.439990427	0	0.008385347	0	0	0	0	0	0	0	0	0	0	0	0	0	57.0862
H3664_014_0	2009	2																					3900											D	D	D		T	Coin	Coin	V	V	V	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	1283.232913	35.0260064	1294.723858	0	236.2909812	14.03823486	0.016750589	299.196167	328.340657	2688.538485	976.9974528	0	0	231.3920391	4107.926452	3730.005551	162.1145825	365.957437	862.2827271	930.3771663	0	0	0	0	162.8486381	0	3.103572936	0	0	0											$200/Days 1-10 for IP Medical; $200/Days 1-10 for IP Surgical;	$200/Days 1-10 for IP Psych; $200/Days 1-10 for IP Substance Abuse;	$75/Days 5-100		$125/Run 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; $40/Visit for Urgent Care; $40/Visit for Urgent Care - Worldwide;	$200/Case for OP Fac - Surgery; $200/Case for OP Fac - ASC	$25/Case for OP Fac - Pathology	$25/Case for OP Fac - Radiology; $25/Case for OP Fac - CT/MRI/PET;15% Coinsurance for Chemo/Radiation Therapy			$10/Case for OP Fac - Occ Therapy; $10/Case for OP Fac - Physical/Speech Therapy; $10/Case for OP Fac - CORF; $10/Visit for Prof - CORF; $10/Visit for Prof - CORF;	$25/Visit for PCP - Office Visits; $25/Consult for PCP - Consults; $25/Exam for PCP - Routine Physicals;	$35/Visit for Speclst - Office Visits; $35/Consult for Speclst - Consults;	$35/Visit for OP Psych - Non-Physician; $35/Visit for OP Psych - Psychiatrist; $35/Visit for OP Substance Abuse;	$10/Visit for PT/ST (PCP); $10/Visit for Occ Therapy (PCP); $10/Visit for PT/ST (Specialist); $10/Visit for Occ Therapy (Specialist);	$25/Procedure for Prof Radiology (Office);	$35/Visit for Chiropractor; $35/Exam for Vision Exams; $35/Service for Podiatrist; $35/Exam for Hearing/Speech Exams; $25/Procedure for Prof Path (Labs)	No Cost Sharing				$35/Exam for Vision (Refractions)		$35/Exam for Routine Hearing Exams														200	200	75	0	125	0.2	0.2	50	200	25	38.16501674	0	0	10	25.01763486	34.67684955	35	10	25	31.32042561	0	0	0	0	35	0	35	0	0	0											192.5842934	192.5842934	72.21911002	0	120.3651834	0.192584293	0.192584293	48.14607335	192.5842934	24.07303667	36.7499139	0	0	9.62921467	24.09001766	33.39108284	33.70225134	9.62921467	24.07303667	30.15911018	0	0	0	0	33.70225134	0	33.70225134	0	0	0											20.5942	0.562121558	7.791983729	0	2.370100607	2.703543541	0.0032259	1.200426717	5.269437786	5.393440462	2.992047689	0	0	0.185676968	8.246668398	10.37907703	0.4553022	0.293656893	1.729813643	2.338278955	0	0	0	0	0.457363811	0	0.00871645	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9751	0	2.81	20.5942	0.562121558	7.791983729	0	2.370100607	2.703543541	0.0032259	1.200426717	5.269437786	5.393440462	2.992047689	0	0	0.185676968	8.246668398	10.37907703	0.4553022	0.293656893	1.729813643	2.338278955	0	0	0	0	0.457363811	0	0.00871645	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9751	0																																																																																	0	0	0	20.5942	0.562121558	7.791983729	0	2.370100607	2.703543541	0.0032259	1.200426717	5.269437786	5.393440462	2.992047689	0	0	0.185676968	8.246668398	10.37907703	0.4553022	0.293656893	1.729813643	2.338278955	0	0	0	0	0.457363811	0	0.00871645	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9751
H3664_016_0	2009	6																					5000											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	192.4637797	1.638235023	35.94357578	0	6.441897617	10.46966345	0.012492527	12.16244027	29.30230129	10.89930467	33.2335996	0.045628062	0	17.44829797	47.83676875	117.2900701	1.014198753	2.687271409	12.30985975	12.16721957	0	0	0	0	1.39209902	0	0.149119079	0	0	0											10% Coinsurance for IP Medical; 10% Coinsurance for IP Surgical;	10% Coinsurance for IP Psych; 10% Coinsurance for IP Substance Abuse;	10% Coinsurance		10% Coinsurance for Ambulance	10% Coinsurance for DME	10% Coinsurance for Prosthetics/Supplies; 10% Coinsurance for Prosthetics;	10% Coinsurance for ER - Facility; 10% Coinsurance for ER - Worldwide; 10% Coinsurance for Urgent Care; 10% Coinsurance for Urgent Care - Worldwide;	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/PET10% Coinsurance for Chemo/Radiation Therapy	10% Coinsurance for OP Fac - Observation		10% Coinsurance for OP Fac - Cardiovascular; 10% Coinsurance for OP Fac - Occ Therapy; 10% Coinsurance for OP Fac - Physical/Speech Therapy; 10% Coinsurance for OP Fac - CORF; 10% Coinsurance for OP Fac - Other; 10% Coinsurance for Prof - CORF; 10% Coinsurance for Prof - CORF;	10% Coinsurance for PCP - Office Visits; 10% Coinsurance for PCP - Consults; 10% Coinsurance for PCP - Primary Surgeon (IP); 10% Coinsurance for PCP - Asst Surgeon (IP); 10% Coinsurance for PCP - Primary Surgeon (OP); 10% Coinsurance for PCP - Asst Surgeon (OP); 10% Coinsurance for PCP - IP Visits; 10% Coinsurance for PCP - Tx Injections; 10% Coinsurance for PCP - Allergy Testing; 10% Coinsurance for PCP - Allergy Tx; 10% Coinsurance for PCP - ER Visits; 10% Coinsurance for PCP - Cardio;	10% Coinsurance for Speclst - Office Visits; 10% Coinsurance for Speclst - Primary Surgeon (IP); 10% Coinsurance for Speclst - Asst Surgeon (IP); 10% Coinsurance for Speclst - Anesthesia (IP); 10% Coinsurance for Speclst - Primary Surgeon (OP); 10% Coinsurance for Speclst - Asst Surgeon (OP); 10% Coinsurance for Speclst - Anesthesia (OP); 10% Coinsurance for Speclst - IP Visits; 10% Coinsurance for Speclst - Tx Injections; 10% Coinsurance for Speclst - Allergy Testing; 10% Coinsurance for Speclst - Allergy Tx; 10% Coinsurance for Speclst - ER Visits; 10% Coinsurance for Speclst - Consults; 10% Coinsurance for Speclst - Cardio;	10% Coinsurance for OP Psych - Non-Physician; 10% Coinsurance for OP Psych - Psychiatrist; 10% Coinsurance for OP Substance Abuse;	10% Coinsurance for PT/ST (PCP); 10% Coinsurance for Occ Therapy (PCP); 10% Coinsurance for PT/ST (Specialist); 10% Coinsurance for Occ Therapy (Specialist);	10% Coinsurance for Prof Radiology (Office); 10% Coinsurance for Prof Radiology (OP); 10% Coinsurance for Prof Radiology (IP);	10% Coinsurance for Chiropractor; 10% Coinsurance for Vision Exams; 10% Coinsurance for Podiatrist; 10% Coinsurance for Hearing/Speech Exams; 10% Coinsurance for Misc. Medical (PCP); 10% Coinsurance for Misc. Medical; 10% Coinsurance for Prof Path (IP); 10% Coinsurance for Prof Path (OP); 10% Coinsurance for Prof Path (Office); 10% Coinsurance for Prof Path (Labs)	No Cost Sharing				10% Coinsurance for Vision (Refractions)		10% Coinsurance for Routine Hearing Exams														0.1	0.1	0.1	0	0.1	0.1	0.1	0.1	0.1	0.1	0.1	0.1	0	0.1	0.095774874	0.0995402	0.1	0.1	0.1	0.1	0	0	0	0	0.1	0	0.1	0	0	0											0.092177078	0.092177078	0.092177078	0	0.092177078	0.092177078	0.092177078	0.092177078	0.092177078	0.092177078	0.092177078	0.092177078	0	0.092177078	0.088179987	0.091728948	0.092177078	0.092177078	0.092177078	0.092177078	0	0	0	0	0.092177078	0	0.092177078	0	0	0											17.7407	0.151007718	3.313173791	0	0.5937953	0.965062985	0.001151525	1.121098206	2.701000514	1.004666057	3.063376105	3.50E-07	0	1.608333124	4.218245661	10.75889469	0.093485878	0.247704826	1.134686903	1.121538748	0	0	0	0	0.12831962	0	0.013745361	0	0	0	0	0	0	0	0	0	0	0	0	0	49.98	0	4.2577	17.7407	0.151007718	3.313173791	0	0.5937953	0.965062985	0.001151525	1.121098206	2.701000514	1.004666057	3.063376105	3.50E-07	0	1.608333124	4.218245661	10.75889469	0.093485878	0.247704826	1.134686903	1.121538748	0	0	0	0	0.12831962	0	0.013745361	0	0	0	0	0	0	0	0	0	0	0	0	0	49.98	0																																																																																	0	0	0	17.7407	0.151007718	3.313173791	0	0.5937953	0.965062985	0.001151525	1.121098206	2.701000514	1.004666057	3.063376105	3.50E-07	0	1.608333124	4.218245661	10.75889469	0.093485878	0.247704826	1.134686903	1.121538748	0	0	0	0	0.12831962	0	0.013745361	0	0	0	0	0	0	0	0	0	0	0	0	0	49.98
H3664_801_0	2009	1																					0											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	230.5595135	1.650043383	31.21050545	5.097023987	5.331094311	15.53643941	0.014694914	9.718892708	41.29700591	14.09619813	47.82517881	0.045025839	0.08262916	21.57745717	61.73771216	163.9117369	1.054973909	3.868000754	15.39652789	15.12622367	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/PET23% Coinsurance for Chemo/Radiation Therapy	23% Coinsurance for Observation	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 Speclst - Office Visits; 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 - 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 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 Chiropractor; 23% Coinsurance for Vision Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical (PCP); 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)	No Cost Sharing	23% Coinsurance for Blood Products																			0.079180363	0.079180363	0.189728204	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0											0.079180363	0.079180363	0.189728204	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0											18.2558	0.130651034	5.921513152	0	1.231482786	3.588917504	0.003394525	2.245064216	9.539608366	3.256221768	11.04761631	0.010400969	0.019087336	4.984392605	14.26141151	37.86361122	0.243698973	0.893508174	3.556597942	3.494157667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.5471	0	0	18.2558	0.130651034	5.921513152	0	1.231482786	3.588917504	0.003394525	2.245064216	9.539608366	3.256221768	11.04761631	0.010400969	0.019087336	4.984392605	14.26141151	37.86361122	0.243698973	0.893508174	3.556597942	3.494157667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.5471	0																																																																																	0	0	0	18.2558	0.130651034	5.921513152	0	1.231482786	3.588917504	0.003394525	2.245064216	9.539608366	3.256221768	11.04761631	0.010400969	0.019087336	4.984392605	14.26141151	37.86361122	0.243698973	0.893508174	3.556597942	3.494157667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.5471
H3664_802_0	2009	1																					0											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	274.2670929	1.967577505	37.21665082	6.077894583	6.357009367	18.52626968	0.017522802	11.58919508	49.24419606	16.80886856	57.02864965	0.053690605	0.098530305	25.72982006	73.28787813	195.454889	1.257992943	4.612358288	18.3594336	18.03711207	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/PET23% Coinsurance for Chemo/Radiation Therapy	23% Coinsurance for Observation	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 Speclst - Office Visits; 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 - 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 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 Chiropractor; 23% Coinsurance for Vision Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical (PCP); 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)	No Cost Sharing	23% Coinsurance for Blood Products																			0.079360399	0.079360399	0.190523686	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0											0.079360399	0.079360399	0.190523686	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0											21.7659	0.156147736	7.090653477	0	1.468469164	4.279568295	0.004047767	2.677104065	11.37540929	3.882848637	13.17361807	0.01240253	0.0227605	5.943588433	16.92949985	45.15007936	0.29059637	1.065454765	4.241029161	4.166572888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.6958	0	0	21.7659	0.156147736	7.090653477	0	1.468469164	4.279568295	0.004047767	2.677104065	11.37540929	3.882848637	13.17361807	0.01240253	0.0227605	5.943588433	16.92949985	45.15007936	0.29059637	1.065454765	4.241029161	4.166572888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.6958	0																																																																																	0	0	0	21.7659	0.156147736	7.090653477	0	1.468469164	4.279568295	0.004047767	2.677104065	11.37540929	3.882848637	13.17361807	0.01240253	0.0227605	5.943588433	16.92949985	45.15007936	0.29059637	1.065454765	4.241029161	4.166572888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.6958
H3664_803_0	2009	1																					0											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	230.5595135	1.650043383	31.21050545	5.097023987	5.331094311	15.53643941	0.014694914	9.718892708	41.29700591	14.09619813	47.82517881	0.045025839	0.08262916	21.57745717	61.73771216	163.9117369	1.054973909	3.868000754	15.39652789	15.12622367	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/PET23% Coinsurance for Chemo/Radiation Therapy	23% Coinsurance for Observation	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 Speclst - Office Visits; 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 - 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 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 Chiropractor; 23% Coinsurance for Vision Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical (PCP); 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)	No Cost Sharing	23% Coinsurance for Blood Products																			0.079180363	0.079180363	0.189728204	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0											0.079180363	0.079180363	0.189728204	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0											18.2558	0.130651034	5.921513152	0	1.231482786	3.588917504	0.003394525	2.245064216	9.539608366	3.256221768	11.04761631	0.010400969	0.019087336	4.984392605	14.26141151	37.86361122	0.243698973	0.893508174	3.556597942	3.494157667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.5471	0	0	18.2558	0.130651034	5.921513152	0	1.231482786	3.588917504	0.003394525	2.245064216	9.539608366	3.256221768	11.04761631	0.010400969	0.019087336	4.984392605	14.26141151	37.86361122	0.243698973	0.893508174	3.556597942	3.494157667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.5471	0																																																																																	0	0	0	18.2558	0.130651034	5.921513152	0	1.231482786	3.588917504	0.003394525	2.245064216	9.539608366	3.256221768	11.04761631	0.010400969	0.019087336	4.984392605	14.26141151	37.86361122	0.243698973	0.893508174	3.556597942	3.494157667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.5471
H3664_804_0	2009	1																					0											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	230.5595135	1.650043383	31.21050545	5.097023987	5.331094311	15.53643941	0.014694914	9.718892708	41.29700591	14.09619813	47.82517881	0.045025839	0.08262916	21.57745717	61.73771216	163.9117369	1.054973909	3.868000754	15.39652789	15.12622367	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/PET23% Coinsurance for Chemo/Radiation Therapy	23% Coinsurance for Observation	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 Speclst - Office Visits; 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 - 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 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 Chiropractor; 23% Coinsurance for Vision Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical (PCP); 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)	No Cost Sharing	23% Coinsurance for Blood Products																			0.079180363	0.079180363	0.189728204	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0											0.079180363	0.079180363	0.189728204	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0											18.2558	0.130651034	5.921513152	0	1.231482786	3.588917504	0.003394525	2.245064216	9.539608366	3.256221768	11.04761631	0.010400969	0.019087336	4.984392605	14.26141151	37.86361122	0.243698973	0.893508174	3.556597942	3.494157667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.5471	0	0	18.2558	0.130651034	5.921513152	0	1.231482786	3.588917504	0.003394525	2.245064216	9.539608366	3.256221768	11.04761631	0.010400969	0.019087336	4.984392605	14.26141151	37.86361122	0.243698973	0.893508174	3.556597942	3.494157667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.5471	0																																																																																	0	0	0	18.2558	0.130651034	5.921513152	0	1.231482786	3.588917504	0.003394525	2.245064216	9.539608366	3.256221768	11.04761631	0.010400969	0.019087336	4.984392605	14.26141151	37.86361122	0.243698973	0.893508174	3.556597942	3.494157667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.5471
H3668_005_0	2009	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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	57.1	0	250	8.98	6.344718627	359.63	426.73	0	1187.88	175.15	0.25	602.97	3962.2	3657.77	131.58	507.94	465.86	1151.95	655.67	595.3	0	0	331	0	141.29	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 Lab: $0	8B OP X-Ray: $25	9A OP Hospital: $0	12 Renal Dialysis: $15	"3 CORF: $15, 5 Partial Hosp: $15, 9C OP Substance Abuse: $15, 9D Cardiac Rehab: $15"	"7A PCP: $10, 14B Immunizations: $10, 14C Routine Physical Exams: $0, 14D Pap Smears: $25, 14D Pelvic Exams: $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, Nutrition Therapy: $10-$25"	7D Physician Specialist: $25	"7E Mental Health: $25, 7H Psychiatric: $25"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	8B OP X-Rays: $25	"7B Chiropractic: $25, 7F Podiatry: $25, 7G Other Health Care: $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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0	0	200	0	50	0.199999572	0.200101556	43.8429775	15	0	15	15	15	15	10	25	25	25	15	25	20.1	25	0	0	25	0	25	0	0	0											0	0	200	0	50	0.199999572	0.200101556	43.8429775	15	0	15	15	15	15	10	25	25	25	15	25	20.1	25	0	0	25	0	25	0	0	0											0	0	0.951666667	0	1.041666667	1.79599616	1.269588072	1.3139375	0.5334125	0	1.48485	0.2189375	0.0003125	0.7537125	3.301833333	7.620354167	0.274125	1.058208333	0.582325	2.399895833	1.09824725	1.240208333	0	0	0.689583333	0	0.294354167	0	0	0	0	0	0	0	0	0	0	0	0	0	27.9232	0	0	0	0	0.951666667	0	1.041666667	1.79599616	1.269588072	1.3139375	0.5334125	0	1.48485	0.2189375	0.0003125	0.7537125	3.301833333	7.620354167	0.274125	1.058208333	0.582325	2.399895833	1.09824725	1.240208333	0	0	0.689583333	0	0.294354167	0	0	0	0	0	0	0	0	0	0	0	0	0	27.9232	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0.951666667	0	1.041666667	1.79599616	1.269588072	1.3139375	0.5334125	0	1.48485	0.2189375	0.0003125	0.7537125	3.301833333	7.620354167	0.274125	1.058208333	0.582325	2.399895833	1.09824725	1.240208333	0	0	0.689583333	0	0.294354167	0	0	0	0	0	0	0	0	0	0	0	0	0	27.9232
H3668_011_0	2009	5																					3000											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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	229.31	2.59	57.1	0	247.47	8.98	6.344718627	360.59	413.02	0	1187.88	173.74	0.25	598.11	4001.52	3692.39	130.08	502.17	453.5	1138.63	21.95	588.54	0	0	327.24	0	139.69	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 Lab: $0	8B OP X-Ray: $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: $30, 14D Pelvic Exams: $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, Nutrition Therapy: $10-$30"	7D Physician Specialist: $30	"7E Mental Health: $30, 7H Psychiatric: $30"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	8B OP X-Rays: $30	"7B Chiropractic: $30, 7F Podiatry: $30, 7G Other Health Care: $30, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: 15%	"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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											600	600	400	0	100	0.199999572	0.200101556	45.03424942	200	0	30	30	30	30	10	30	30	30	30	30	0.15010213	30	0	0	30	0	30	0	0	0											584.2653513	584.2653513	389.5102342	0	97.37755855	0.194754701	0.19485401	43.8532526	194.7551171	0	29.21326756	29.21326756	29.21326756	29.21326756	9.737755855	29.21326756	29.21326756	29.21326756	29.21326756	29.21326756	0.146165789	29.21326756	0	0	29.21326756	0	29.21326756	0	0	0											11.1648	0.126103938	1.853419531	0	2.008168701	1.748897212	1.236293868	1.317753696	6.703146539	0	2.891821356	0.422959426	0.00060861	1.456062289	3.247152067	8.988898085	0.31667182	1.222502214	1.10401807	2.771925237	3.208339077	1.432764708	0	0	0.796645806	0	0.340066779	0	0	0	0	0	0	0	0	0	0	0	0	0	54.359	0	1.4639	11.1648	0.126103938	1.853419531	0	2.008168701	1.748897212	1.236293868	1.317753696	6.703146539	0	2.891821356	0.422959426	0.00060861	1.456062289	3.247152067	8.988898085	0.31667182	1.222502214	1.10401807	2.771925237	3.208339077	1.432764708	0	0	0.796645806	0	0.340066779	0	0	0	0	0	0	0	0	0	0	0	0	0	54.359	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.1648	0.126103938	1.853419531	0	2.008168701	1.748897212	1.236293868	1.317753696	6.703146539	0	2.891821356	0.422959426	0.00060861	1.456062289	3.247152067	8.988898085	0.31667182	1.222502214	1.10401807	2.771925237	3.208339077	1.432764708	0	0	0.796645806	0	0.340066779	0	0	0	0	0	0	0	0	0	0	0	0	0	54.359
H3668_013_0	2009	3																					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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	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	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	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	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	213.2	1.13	24.91	21.12	7.01	9.98	7.008150022	14.66	48.62220438	7.05	41.67	46.45	0.08	15.28116207	41.71122404	108.5035915	0.7015	3.99256	19.13738364	30.0057093	21.95	7.066116509	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	0	0	0	0	0	0	0											0.075265953	0.07527222	0.17223818	0	0.231158165	0.23099956	0.231003914	0.231001706	0.231002099	0.231007889	0.231019622	0.230999762	0.231000142	0.231108652	0.231002698	0.230680284	0.230999341	0.230987843	0.231005116	0.231005144	0.23115728	0.231001133	0	0	0	0	0	0	0	0											0.075265953	0.07527222	0.17223818	0	0.231158165	0.23099956	0.231003914	0.231001706	0.231002099	0.231007889	0.231019622	0.230999762	0.231000142	0.231108652	0.231002698	0.230680284	0.230999341	0.230987843	0.231005116	0.231005144	0.23115728	0.231001133	0	0	0	0	0	0	0	0											16.0467	0.085057609	4.290453056	0	1.620418736	2.305375611	1.618910087	3.386485003	11.23183129	1.628605615	9.626587665	10.72993893	0.018480011	3.531608762	9.635405273	25.02963935	0.162046038	0.922232823	4.420833536	6.931473199	5.073902295	1.632280916	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.9283	0	0	16.0467	0.085057609	4.290453056	0	1.620418736	2.305375611	1.618910087	3.386485003	11.23183129	1.628605615	9.626587665	10.72993893	0.018480011	3.531608762	9.635405273	25.02963935	0.162046038	0.922232823	4.420833536	6.931473199	5.073902295	1.632280916	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.9283	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.0467	0.085057609	4.290453056	0	1.620418736	2.305375611	1.618910087	3.386485003	11.23183129	1.628605615	9.626587665	10.72993893	0.018480011	3.531608762	9.635405273	25.02963935	0.162046038	0.922232823	4.420833536	6.931473199	5.073902295	1.632280916	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.9283
H3668_802_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	213.2	1.13	24.91	21.12	7.01	9.98	7.008150022	14.66	48.62220438	7.05	41.67	46.45	0.08	15.28116207	41.71122404	108.5035915	0.7015	3.99256	19.13738364	30.0057093	21.95	7.066116509	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	0	0	0	0	0	0	0											0.075265953	0.07527222	0.17223818	0	0.231158165	0.23099956	0.231003914	0.231001706	0.231002099	0.231007889	0.231019622	0.230999762	0.231000142	0.231108652	0.231002698	0.230680284	0.230999341	0.230987843	0.231005116	0.231005144	0.23115728	0.231001133	0	0	0	0	0	0	0	0											0.075265953	0.07527222	0.17223818	0	0.231158165	0.23099956	0.231003914	0.231001706	0.231002099	0.231007889	0.231019622	0.230999762	0.231000142	0.231108652	0.231002698	0.230680284	0.230999341	0.230987843	0.231005116	0.231005144	0.23115728	0.231001133	0	0	0	0	0	0	0	0											16.0467	0.085057609	4.290453056	0	1.620418736	2.305375611	1.618910087	3.386485003	11.23183129	1.628605615	9.626587665	10.72993893	0.018480011	3.531608762	9.635405273	25.02963935	0.162046038	0.922232823	4.420833536	6.931473199	5.073902295	1.632280916	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.9283	0	0	16.0467	0.085057609	4.290453056	0	1.620418736	2.305375611	1.618910087	3.386485003	11.23183129	1.628605615	9.626587665	10.72993893	0.018480011	3.531608762	9.635405273	25.02963935	0.162046038	0.922232823	4.420833536	6.931473199	5.073902295	1.632280916	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.9283	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.0467	0.085057609	4.290453056	0	1.620418736	2.305375611	1.618910087	3.386485003	11.23183129	1.628605615	9.626587665	10.72993893	0.018480011	3.531608762	9.635405273	25.02963935	0.162046038	0.922232823	4.420833536	6.931473199	5.073902295	1.632280916	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.9283
H3672_013_0	2009	5																					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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1606.5	59.5	1830.7	378.3	318.7	13.46793711	0	376.1	419.2	7505.4	636.5	159	43.5	4643.9	4153.1	3389.4	166.2	275.7	51.4	0	18.31435387	0	0	0	174.3	689	0.3	0	0	0											$50 / days 1-10	$50 / days 1-10	$25 / days 21-100	$0.00 	$50.00 	20%	20%	$50.00 	$100.00 	$0.00 	$50 Scans	$0.00 	$0.00 	"$25 Rad Ther, CORF"	"$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 	$25.00 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											39.83471074	39.83471074	6.30926889	$0.00 	$50.00 	20%	20%	$50.00 	$100.00 	$0.00 	5	$0.00 	$0.00 	2.5	15	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	0.18	$0.00 	$0.00 	$0.00 	$25.00 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											36.29450566	36.29450566	5.748549221	0	45.55638158	0.182225526	0.182225526	45.55638158	91.11276317	0	4.555638158	0	0	2.277819079	13.66691448	22.77819079	22.77819079	22.77819079	0	0	0.164002974	0	0	0	22.77819079	13.66691448	22.77819079	0	0	0											4.8589	0.179960257	0.876989088	0	1.209901568	2.454201929	0	1.427812926	3.182872527	0	0.241638641	0	0	0.881497002	4.730005209	6.433699989	0.315477942	0.523328933	0	0	3.003608497	0	0	0	0.330853221	0.784708673	0.000569455	0	0	0	0	0	0	0	0	0	0	0	0	0	31.4361		3.0663	4.8589	0.179960257	0.876989088	0	1.209901568	2.454201929	0	1.427812926	3.182872527	0	0.241638641	0	0	0.881497002	4.730005209	6.433699989	0.315477942	0.523328933	0	0	3.003608497	0	0	0	0.330853221	0.784708673	0.000569455	0	0	0	0	0	0	0	0	0	0	0	0	0	31.4361	0																																																																																	0		0	4.8589	0.179960257	0.876989088	0	1.209901568	2.454201929	0	1.427812926	3.182872527	0	0.241638641	0	0	0.881497002	4.730005209	6.433699989	0.315477942	0.523328933	0	0	3.003608497	0	0	0	0.330853221	0.784708673	0.000569455	0	0	0	0	0	0	0	0	0	0	0	0	0	31.4361
H3672_014_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1536.4	28.6	1413.8	479.5	242.5	9.319785243	0	349.6	412.2	6391.5	612.8	174.6	104.4	4365.1	3765.1	3240.9	88.8	179.4	34.8	0	8.503444116	0	0	0	155.6	669.5	0.1	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	$0.00 	$0.00 	"$25 Rad Ther, CORF"	"$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 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											39.83471074	39.83471074	6.30926889	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	5	$0.00 	$0.00 	2.5	15	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	0.18	$0.00 	$0.00 	$0.00 	$15.00 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											36.29450566	36.29450566	5.748549221	0	22.77819079	0.182225526	0.182225526	45.55638158	91.11276317	0	4.555638158	0	0	2.277819079	13.66691448	22.77819079	22.77819079	22.77819079	0	0	0.164002974	0	0	0	13.66691448	13.66691448	22.77819079	0	0	0											4.6469	0.086501905	0.677274907	0	0.460309272	1.698302771	0	1.32720925	3.129723415	0	0.232641255	0	0	0.828575672	4.288108308	6.151819878	0.168558612	0.340533952	0	0	1.394590122	0	0	0	0.177214324	0.762499937	0.000189818	0	0	0	0	0	0	0	0	0	0	0	0	0	26.371		2.5723	4.6469	0.086501905	0.677274907	0	0.460309272	1.698302771	0	1.32720925	3.129723415	0	0.232641255	0	0	0.828575672	4.288108308	6.151819878	0.168558612	0.340533952	0	0	1.394590122	0	0	0	0.177214324	0.762499937	0.000189818	0	0	0	0	0	0	0	0	0	0	0	0	0	26.371	0																																																																																	0		0	4.6469	0.086501905	0.677274907	0	0.460309272	1.698302771	0	1.32720925	3.129723415	0	0.232641255	0	0	0.828575672	4.288108308	6.151819878	0.168558612	0.340533952	0	0	1.394590122	0	0	0	0.177214324	0.762499937	0.000189818	0	0	0	0	0	0	0	0	0	0	0	0	0	26.371
H3672_804_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1606.5	59.5	1830.7	378.3	318.7	13.46793711	0	376.1	419.2	7505.4	636.5	159	43.5	4643.9	4153.1	3389.4	166.2	275.7	51.4	0	18.31435387	0	0	0	174.3	689	0.3	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	$0.00 	$0.00 	"$25 Rad Ther, CORF"	"$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 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											39.83471074	39.83471074	6.30926889	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	5	$0.00 	$0.00 	2.5	15	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	0.18	$0.00 	$0.00 	$0.00 	$15.00 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											36.29450566	36.29450566	5.748549221	0	22.77819079	0.182225526	0.182225526	45.55638158	91.11276317	0	4.555638158	0	0	2.277819079	13.66691448	22.77819079	22.77819079	22.77819079	0	0	0.164002974	0	0	0	13.66691448	13.66691448	22.77819079	0	0	0											4.8589	0.179960257	0.876989088	0	0.604950784	2.454201929	0	1.427812926	3.182872527	0	0.241638641	0	0	0.881497002	4.730005209	6.433699989	0.315477942	0.523328933	0	0	3.003608497	0	0	0	0.198511933	0.784708673	0.000569455	0	0	0	0	0	0	0	0	0	0	0	0	0	30.6988		2.9944	4.8589	0.179960257	0.876989088	0	0.604950784	2.454201929	0	1.427812926	3.182872527	0	0.241638641	0	0	0.881497002	4.730005209	6.433699989	0.315477942	0.523328933	0	0	3.003608497	0	0	0	0.198511933	0.784708673	0.000569455	0	0	0	0	0	0	0	0	0	0	0	0	0	30.6988	0																																																																																	0		0	4.8589	0.179960257	0.876989088	0	0.604950784	2.454201929	0	1.427812926	3.182872527	0	0.241638641	0	0	0.881497002	4.730005209	6.433699989	0.315477942	0.523328933	0	0	3.003608497	0	0	0	0.198511933	0.784708673	0.000569455	0	0	0	0	0	0	0	0	0	0	0	0	0	30.6988
H3672_805_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1473.3	50.1	1325.3	342.7	274.7	12.28069028	0	322.4	379.4	6827.6	622.1	164.4	18.7	4654.2	3848	3234.3	94.8	222.9	48.2	0	23.46759441	0	0	0	176.2	695.8	1	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	$0.00 	$0.00 	"$25 Rad Ther, CORF"	"$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 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											39.83471074	39.83471074	6.30926889	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	5	$0.00 	$0.00 	2.5	15	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	0.18	$0.00 	$0.00 	$0.00 	$15.00 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											36.29450566	36.29450566	5.748549221	0	22.77819079	0.182225526	0.182225526	45.55638158	91.11276317	0	4.555638158	0	0	2.277819079	13.66691448	22.77819079	22.77819079	22.77819079	0	0	0.164002974	0	0	0	13.66691448	13.66691448	22.77819079	0	0	0											4.4561	0.151529561	0.634879357	0	0.521430751	2.23785525	0	1.223948119	2.880681862	0	0.236171875	0	0	0.88345213	4.382523908	6.139291873	0.179947707	0.423104894	0	0	3.848755269	0	0	0	0.200675861	0.792453258	0.001898183	0	0	0	0	0	0	0	0	0	0	0	0	0	29.1947		2.8477	4.4561	0.151529561	0.634879357	0	0.521430751	2.23785525	0	1.223948119	2.880681862	0	0.236171875	0	0	0.88345213	4.382523908	6.139291873	0.179947707	0.423104894	0	0	3.848755269	0	0	0	0.200675861	0.792453258	0.001898183	0	0	0	0	0	0	0	0	0	0	0	0	0	29.1947	0																																																																																	0		0	4.4561	0.151529561	0.634879357	0	0.521430751	2.23785525	0	1.223948119	2.880681862	0	0.236171875	0	0	0.88345213	4.382523908	6.139291873	0.179947707	0.423104894	0	0	3.848755269	0	0	0	0.200675861	0.792453258	0.001898183	0	0	0	0	0	0	0	0	0	0	0	0	0	29.1947
H3706_001_0	2009	3																					3000											A	A	D			Coin	Coin	V	V	Coin	Coin		Coin	V		V	V	V	Coin	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	280.8499464	4.438307224	281.3872378	0	220.2141931	7.408262871	4.703326745	328.353379	350.2557948	2.610421782	14.27604608	0	0.329193439	476.1035301	0	3667.050883	169.2018439	547.6500666	30.53580201	8825.884745	4.281907915	0	0	0	0	0	0	0	0	0											$195/Admit for IP Medical/Surgical	$195/Admit for IP Psych/Substance Abuse	$105/Days 21-100 for SNF	No cost sharing for this service.	$100/Trip for Ambulance	25% Coinsurance for DME	25% Coinsurance for Prosthetics/Supplies; 0-20% Coinsurance for Diabetes Monitoring Supplies	$50/Case for ER; $25/Visit for Urgent Care	$250/Case for OP Surgery (Hospital or ASC)	20% Coinsurance for OP Fac - Pathology	20% Coinsurance for OP Fac - Radiology (including CT/MRI/PET)	No cost sharing for this service.	20% Coinsurance for Renal Dialysis	"$25/Case for OP Cardiovascular, PT/OT/ST, CORF"	No cost sharing for this service.	$25/Visit for Specialist Office Visits/Consults	$25/Visit for OP Psych/Substance Abuse;	$25/Visit for PT/ST/OT	20% Coinsurance for Prof Radiology	$30/Visit for Chiropractor; $25/Exam for Vision Exams; $25/Service for Podiatrist; $25/Exam for Hearing/Speech Exams; 20% Coinsurance for Prof Path	No cost sharing for this service.	$25/Case for Pharmacy and Blood																			195	195	105	0	100	0.25	0.237282584	42.26293088	250	0.2	0.2	0	0.2	25	0	25	25	25	0.2	6.652936873	0.2	0	0	0	0	0	0	0	0	0											194.2011438	194.2011438	104.5698466	0	99.59033014	0.248956239	0.236291919	42.08979239	248.9758253	0.19918066	0.19918066	0	0.19918066	24.89758253	0	24.89758253	24.89758252	24.89758253	0.19918066	6.625681796	0.19918066	0	0	0	0	0	0	0	0	0											4.5451	0.071827028	2.452051692	0	1.827600349	1.844333262	1.111358101	1.151693796	7.267102132	0.519945534	2.843512284	0	0.065568967	0.987818911	0	7.608391834	0.351059739	1.136263561	6.082141206	4.873125324	0.852873246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.5918	0	0.1851	4.5451	0.071827028	2.452051692	0	1.827600349	1.844333262	1.111358101	1.151693796	7.267102132	0.519945534	2.843512284	0	0.065568967	0.987818911	0	7.608391834	0.351059739	1.136263561	6.082141206	4.873125324	0.852873246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.5918	0																																																																																	0	0		4.5451	0.071827028	2.452051692	0	1.827600349	1.844333262	1.111358101	1.151693796	7.267102132	0.519945534	2.843512284	0	0.065568967	0.987818911	0	7.608391834	0.351059739	1.136263561	6.082141206	4.873125324	0.852873246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.5918
H3706_006_0	2009	3																					3000											D	D	D			Coin	Coin	V	V	Coin	Coin		Coin	V	V	V	V	V	Coin	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	758.4742251	27.86608722	278.4529008	0	220.7419179	10.60210888	6.778977031	303.8434385	276.0111638	1.802451749	17.91405336	0	0.463924608	532.2084603	4144.688067	3587.805217	166.9524693	543.7376229	23.56792815	9759.063606	8.029531531	0	0	872	413.7890047	0	0	0	0	0											$250/Days 1-5 for IP Medical/Surgical	$250/Days 1-5 for IP Psych/Substance Abuse	$105/Days 21-100 for SNF	No cost sharing for this service.	$100/Trip for Ambulance	25% Coinsurance for DME	25% Coinsurance for Prosthetics/Supplies; 0-20% Coinsurance for Diabetes Monitoring Supplies	$50/Case for ER; $25/Visit for Urgent Care	$200/Case for OP Surgery (Hospital or ASC)	10% Coinsurance for OP Fac - Pathology	10% Coinsurance for OP Fac - Radiology (including CT/MRI/PET)	No cost sharing for this service.	20% Coinsurance for Renal Dialysis	"$25/Case for OP Cardiovascular, PT/OT/ST, CORF"	$15/Visit for PCP - Office Visits/Consults/Routine Physicals	$25/Visit for Specialist Office Visits/Consults	$25/Visit for OP Psych/Substance Abuse;	$25/Visit for PT/ST/OT	20% Coinsurance for Prof Radiology	$30/Visit for Chiropractor; $25/Exam for Vision Exams; $25/Service for Podiatrist; $25/Exam for Hearing/Speech Exams; 10% Coinsurance for Prof Path	No cost sharing for this service.	$25/Case for Pharmacy and Blood		$15/Office Visit	$25/Exam	No cost sharing for this service.															250	250	105	0	100	0.25	0.237372547	41.75338812	200	0.1	0.2	0	0.2	25	15	25	25	25	0.2	5.547968809	0.2	0	0	15	25	0	0	0	0	0											248.4373542	248.4373541	104.3436887	0	99.37494166	0.248412928	0.235865638	41.49240509	198.7498833	0.099374942	0.198749883	0	0.198749883	24.84373541	14.90624125	24.84373542	24.84373542	24.84373541	0.198749883	5.513290767	0.198749883	0	0	14.90624125	24.84373542	0	0	0	0	0											15.7028	0.576914748	2.421233568	0	1.828017935	2.633700907	1.598927742	1.050599586	4.571432216	0.179118537	3.560416016	0	0.092204962	1.101837181	5.148476686	7.427873628	0.345643581	1.125706137	4.684122969	4.48371294	1.595868455	0	0	1.083186864	0.856672046	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.0684	0	0.385	15.7028	0.576914748	2.421233568	0	1.828017935	2.633700907	1.598927742	1.050599586	4.571432216	0.179118537	3.560416016	0	0.092204962	1.101837181	5.148476686	7.427873628	0.345643581	1.125706137	4.684122969	4.48371294	1.595868455	0	0	1.083186864	0.856672046	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.0684	0																																																																																	0	0		15.7028	0.576914748	2.421233568	0	1.828017935	2.633700907	1.598927742	1.050599586	4.571432216	0.179118537	3.560416016	0	0.092204962	1.101837181	5.148476686	7.427873628	0.345643581	1.125706137	4.684122969	4.48371294	1.595868455	0	0	1.083186864	0.856672046	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.0684
H3706_009_0	2009	3																					3000											A	A	D			Coin	Coin	V	V	Coin	Coin		Coin	V		V	V	V	Coin	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	280.8499464	4.438307224	281.3872378	0	220.2141931	7.408262871	4.703326745	328.353379	350.2557948	2.610421782	14.27604608	0	0.329193439	476.1035301	0	3667.050883	169.2018439	547.6500666	30.53580201	8825.884745	4.281907915	0	0	0	0	0	0	0	0	0											$195/Admit for IP Medical/Surgical	$195/Admit for IP Psych/Substance Abuse	$105/Days 21-100 for SNF	No cost sharing for this service.	$100/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 0-20% Coinsurance for Diabetes Monitoring Supplies	$50/Case for ER; $25/Visit for Urgent Care	$250/Case for OP Surgery (Hospital or ASC)	20% Coinsurance for OP Fac - Pathology	20% Coinsurance for OP Fac - Radiology (including CT/MRI/PET)	No cost sharing for this service.	20% Coinsurance for Renal Dialysis	"$25/Case for OP Cardiovascular, PT/OT/ST, CORF"	No cost sharing for this service.	$25/Visit for Specialist Office Visits/Consults	$25/Visit for OP Psych/Substance Abuse;	$25/Visit for PT/ST/OT	20% Coinsurance for Prof Radiology	$30/Visit for Chiropractor; $25/Exam for Vision Exams; $25/Service for Podiatrist; $25/Exam for Hearing/Speech Exams; 20% Coinsurance for Prof Path	No cost sharing for this service.	$25/Case for Pharmacy and Blood																			195	195	105	0	100	0.2	0.191521723	42.26293088	250	0.2	0.2	0	0.2	25	0	25	25	25	0.2	6.652936873	0.2	0	0	0	0	0	0	0	0	0											194.2011438	194.2011438	104.5698466	0	99.59033014	0.19918066	0.190737116	42.08979239	248.9758253	0.19918066	0.19918066	0	0.19918066	24.89758253	0	24.89758253	24.89758252	24.89758253	0.19918066	6.625681796	0.19918066	0	0	0	0	0	0	0	0	0											4.5451	0.071827028	2.452051692	0	1.827600349	1.47558269	0.897098978	1.151693796	7.267102132	0.519945534	2.843512284	0	0.065568967	0.987818911	0	7.608391834	0.351059739	1.136263561	6.082141206	4.873125324	0.852873246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0088	0	0.1851	4.5451	0.071827028	2.452051692	0	1.827600349	1.47558269	0.897098978	1.151693796	7.267102132	0.519945534	2.843512284	0	0.065568967	0.987818911	0	7.608391834	0.351059739	1.136263561	6.082141206	4.873125324	0.852873246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0088	0																																																																																	0	0		4.5451	0.071827028	2.452051692	0	1.827600349	1.47558269	0.897098978	1.151693796	7.267102132	0.519945534	2.843512284	0	0.065568967	0.987818911	0	7.608391834	0.351059739	1.136263561	6.082141206	4.873125324	0.852873246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0088
H3706_010_0	2009	3																					3000											D	D	D			Coin	Coin	V	V	Coin	Coin		Coin	V	V	V	V	V	Coin	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	758.4742251	27.86608722	278.4529008	0	220.7419179	10.60210882	6.778976993	303.8434385	276.0111638	1.802451739	17.91405326	0	0.463924606	532.2084603	4144.688067	3587.805217	166.9524693	543.7376229	23.56792802	9759.063606	8.029531485	0	0	872	413.7890047	0	0	0	0	0											$250/Days 1-5 for IP Medical/Surgical	$250/Days 1-5 for IP Psych/Substance Abuse	$105/Days 21-100 for SNF	No cost sharing for this service.	$100/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 0-20% Coinsurance for Diabetes Monitoring Supplies	$50/Case for ER; $25/Visit for Urgent Care	$200/Case for OP Surgery (Hospital or ASC)	10% Coinsurance for OP Fac - Pathology	10% Coinsurance for OP Fac - Radiology (including CT/MRI/PET)	No cost sharing for this service.	20% Coinsurance for Renal Dialysis	"$25/Case for OP Cardiovascular, PT/OT/ST, CORF"	$15/Visit for PCP - Office Visits/Consults/Routine Physicals	$25/Visit for Specialist Office Visits/Consults	$25/Visit for OP Psych/Substance Abuse;	$25/Visit for PT/ST/OT	20% Coinsurance for Prof Radiology	$30/Visit for Chiropractor; $25/Exam for Vision Exams; $25/Service for Podiatrist; $25/Exam for Hearing/Speech Exams; 10% Coinsurance for Prof Path	No cost sharing for this service.	$25/Case for Pharmacy and Blood		$15/Office Visit	$25/Exam	No cost sharing for this service.															250	250	105	0	100	0.2	0.191581698	41.75338812	200	0.1	0.2	0	0.2	25	15	25	25	25	0.2	5.547968805	0.2	0	0	15	25	0	0	0	0	0											248.4373542	248.4373541	104.3436887	0	99.37494166	0.198749883	0.190384201	41.49240509	198.7498833	0.099374942	0.198749883	0	0.198749883	24.84373541	14.90624125	24.84373542	24.84373542	24.84373541	0.198749883	5.513290763	0.198749883	0	0	14.90624125	24.84373542	0	0	0	0	0											15.7028	0.576914748	2.421233568	0	1.828017935	2.10716789	1.290610118	1.050599586	4.571432216	0.179118536	3.560415996	0	0.092204961	1.101837181	5.148476686	7.427873628	0.345643581	1.125706137	4.684122944	4.483712937	1.595868446	0	0	1.083186864	0.856672046	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.2336	0	0.385	15.7028	0.576914748	2.421233568	0	1.828017935	2.10716789	1.290610118	1.050599586	4.571432216	0.179118536	3.560415996	0	0.092204961	1.101837181	5.148476686	7.427873628	0.345643581	1.125706137	4.684122944	4.483712937	1.595868446	0	0	1.083186864	0.856672046	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.2336	0																																																																																	0	0		15.7028	0.576914748	2.421233568	0	1.828017935	2.10716789	1.290610118	1.050599586	4.571432216	0.179118536	3.560415996	0	0.092204961	1.101837181	5.148476686	7.427873628	0.345643581	1.125706137	4.684122944	4.483712937	1.595868446	0	0	1.083186864	0.856672046	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.2336
H3706_014_0	2009	3																					2500											A	A				Coin	Coin	V	V	Coin	Coin		Coin	V		V	V	V	Coin	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	259.9038978	3.803781756	0	0	220.48294	10.56001677	6.753044315	311.9106559	275.7779848	1.798791971	17.85375136	0	0.457827342	532.6991254	0	3629.541276	169.15302	551.2849724	22.45149229	9816.597547	8.00616557	0	0	1090	413.6949701	314.5299413	0	0	0	0											$175/Admit for IP Medical/Surgical	$175/Admit for IP Psych/Substance Abuse	0	No cost sharing for this service.	$50/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 0-20% Coinsurance for Diabetes Monitoring Supplies	$40/Case for ER; $15/Visit for Urgent Care	"$125/Case for OP Surgery Hospital, $75/Case for OP Surgery ASC"	20% Coinsurance for OP Fac - Pathology	20% Coinsurance for OP Fac - Radiology (including CT/MRI/PET)	No cost sharing for this service.	20% Coinsurance for Renal Dialysis	"$20/Case for OP Cardiovascular, PT/OT/ST, CORF"	No cost sharing for this service.	$20/Visit for Specialist Office Visits/Consults	$20/Visit for OP Psych/Substance Abuse;	$20/Visit for PT/ST/OT	20% Coinsurance for Prof Radiology	$25/Visit for Chiropractor; $10/Exam for Vision Exams; $20/Service for Podiatrist; $20/Exam for Hearing/Speech Exams; 20% Coinsurance for Prof Path	No cost sharing for this service.	$20/Case for Pharmacy and Blood		$15/Office Visit	$10/Exam	$20/Service for Glasses/Contacts															175	174.9999998	0	0	50	0.2	0.191582921	33.49242249	100	0.2	0.2	0	0.2	20	0	20	20	20	0.2	4.677504657	0.2	0	0	15	10	20	0	0	0	0											174.34361	174.3436098	0	0	49.81245999	0.19924984	0.190864332	33.3667991	99.62491997	0.19924984	0.19924984	0	0.19924984	19.92498399	0	19.92498399	19.924984	19.924984	0.19924984	4.659960271	0.19924984	0	0	14.943738	9.962491997	19.92498399	0	0	0	0											3.776	0.055263754	0	0	0.915233136	2.104081651	1.288915291	0.86728835	2.289529972	0.358409012	3.557357102	0	0.091222025	0.884501796	0	6.026545986	0.280864268	0.915362021	4.473456244	3.812079547	1.595227208	0	0	1.357389535	0.343452736	0.522250337	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.5145	0	0.134	3.776	0.055263754	0	0	0.915233136	2.104081651	1.288915291	0.86728835	2.289529972	0.358409012	3.557357102	0	0.091222025	0.884501796	0	6.026545986	0.280864268	0.915362021	4.473456244	3.812079547	1.595227208	0	0	1.357389535	0.343452736	0.522250337	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.5145	0																																																																																	0	0		3.776	0.055263754	0	0	0.915233136	2.104081651	1.288915291	0.86728835	2.289529972	0.358409012	3.557357102	0	0.091222025	0.884501796	0	6.026545986	0.280864268	0.915362021	4.473456244	3.812079547	1.595227208	0	0	1.357389535	0.343452736	0.522250337	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.5145
H3706_015_0	2009	4																					0											Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	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	216.2818998	4.933120192	32.00308201	0	6.661656472	7.324274066	4.650004286	6.867247959	27.57614223	2.610421782	14.86876472	0	0.355656918	11.05697952	41.73435364	108.0524971	1.495715251	3.599950355	37.82796399	48.4279479	4.233363157	0.472049554	0	1090	428.1066262	316.33875	0	0	0	0											FFS Medicare Cost Sharing	FFS Medicare Cost Sharing	FFS Medicare Cost Sharing	No cost sharing for this service.	FFS Medicare Cost Sharing	25% Coinsurance for DME	25% Coinsurance for Prosthetics/Supplies; 0-20% Coinsurance for Diabetes Monitoring Supplies	FFS Medicare Cost Sharing for ER; $35/Visit for Urgent Care	FFS Medicare Cost Sharing	FFS Medicare Cost Sharing	FFS Medicare Cost Sharing	No cost sharing for this service.	FFS Medicare Cost Sharing	FFS Medicare Cost Sharing	FFS Medicare Cost Sharing	FFS Medicare Cost Sharing	50% Coinsurance for OP Psych/Substance Abuse	FFS Medicare Cost Sharing	FFS Medicare Cost Sharing	FFS Medicare Cost Sharing	FFS Medicare Cost Sharing	FFS Medicare Cost Sharing		$15/Office Visit	$10/Exam	$20/Service for Glasses/Contacts															0.0783823	0.0783823	0.200736137	0	0.231	0.281	0.265654318	0.24949723	0.231	0.231	0.231	0	0.231	0.231	0.229827501	0.231	0.531	0.231	0.231	0.208179389	0.231	0.231	0	15	9.999999999	20	0	0	0	0											0.0783823	0.0783823	0.200736137	0	0.231	0.281	0.265654318	0.24949723	0.231	0.231	0.231	0	0.231	0.231	0.229827501	0.231	0.531	0.231	0.231	0.208179389	0.231	0.231	0	15	9.999999999	20	0	0	0	0											16.9527	0.386669308	6.424175044	0	1.538842645	2.058121013	1.235293717	1.713359342	6.370088854	0.603007432	3.43468465	0	0.082156748	2.55416227	9.591702217	24.96012684	0.794224798	0.831588532	8.738259682	10.08170059	0.977906889	0.109043447	0	1.3625	0.356755522	0.52723125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.6843	0	0	16.9527	0.386669308	6.424175044	0	1.538842645	2.058121013	1.235293717	1.713359342	6.370088854	0.603007432	3.43468465	0	0.082156748	2.55416227	9.591702217	24.96012684	0.794224798	0.831588532	8.738259682	10.08170059	0.977906889	0.109043447	0	1.3625	0.356755522	0.52723125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.6843	0																																																																																	0	0		16.9527	0.386669308	6.424175044	0	1.538842645	2.058121013	1.235293717	1.713359342	6.370088854	0.603007432	3.43468465	0	0.082156748	2.55416227	9.591702217	24.96012684	0.794224798	0.831588532	8.738259682	10.08170059	0.977906889	0.109043447	0	1.3625	0.356755522	0.52723125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.6843
H3706_016_0	2009	4																					0											Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	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	230.5698012	4.944105521	34.72477722	0	6.377897673	10.61379409	6.786448548	12.18592763	36.39824679	1.804438339	17.93379751	0	0.474245396	16.59141229	32.75443378	82.19925623	1.533958729	4.043466237	25.84744553	39.91849634	8.038381359	0.896335654	0	1090	413.7890047	314.554275	0	0	0	0											FFS Medicare Cost Sharing	FFS Medicare Cost Sharing	FFS Medicare Cost Sharing	No cost sharing for this service.	FFS Medicare Cost Sharing	25% Coinsurance for DME	25% Coinsurance for Prosthetics/Supplies; 0-20% Coinsurance for Diabetes Monitoring Supplies	FFS Medicare Cost Sharing for ER; $35/Visit for Urgent Care	FFS Medicare Cost Sharing	FFS Medicare Cost Sharing	FFS Medicare Cost Sharing	No cost sharing for this service.	FFS Medicare Cost Sharing	FFS Medicare Cost Sharing	FFS Medicare Cost Sharing	FFS Medicare Cost Sharing	50% Coinsurance for OP Psych/Substance Abuse	FFS Medicare Cost Sharing	FFS Medicare Cost Sharing	FFS Medicare Cost Sharing	FFS Medicare Cost Sharing	FFS Medicare Cost Sharing		$15/Office Visit	$10/Exam	$20/Service for Glasses/Contacts															0.080494438	0.080494438	0.210354889	0	0.231	0.281	0.265762874	0.244124286	0.231	0.231	0.231	0	0.231	0.231	0.229742876	0.231	0.531	0.231	0.231	0.212899138	0.231	0.231	0	15	10	20	0	0	0	0											0.080494438	0.080494438	0.210354889	0	0.231	0.281	0.265762874	0.244124286	0.231	0.231	0.231	0	0.231	0.231	0.229742876	0.231	0.531	0.231	0.231	0.212899138	0.231	0.231	0	15	10	20	0	0	0	0											18.5596	0.397972994	7.304526667	0	1.473294363	2.982476141	1.80358607	2.97488088	8.407995008	0.416825256	4.142707226	0	0.109550687	3.832616239	7.525097825	18.98802819	0.814532085	0.934040701	5.970759917	8.498613478	1.856866094	0.207053536	0	1.3625	0.344824171	0.524257125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.4326	0	0	18.5596	0.397972994	7.304526667	0	1.473294363	2.982476141	1.80358607	2.97488088	8.407995008	0.416825256	4.142707226	0	0.109550687	3.832616239	7.525097825	18.98802819	0.814532085	0.934040701	5.970759917	8.498613478	1.856866094	0.207053536	0	1.3625	0.344824171	0.524257125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.4326	0																																																																																	0	0		18.5596	0.397972994	7.304526667	0	1.473294363	2.982476141	1.80358607	2.97488088	8.407995008	0.416825256	4.142707226	0	0.109550687	3.832616239	7.525097825	18.98802819	0.814532085	0.934040701	5.970759917	8.498613478	1.856866094	0.207053536	0	1.3625	0.344824171	0.524257125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.4326
H3706_017_0	2009	3																					2500											A	A				Coin	Coin	V	V	Coin	Coin		Coin	V		V	0	V	Coin	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	281.0100462	4.44115559	0	0	220.2141931	7.324274066	4.650004286	332.0814045	350.2557948	2.610421782	14.08218093	0	0.331365065	478.4868096	0	3789.912301	175.7316532	568.9620854	31.6929434	8969.807151	4.233363157	0	0	1090	428.1066262	316.33875	0	0	0	0											$150/Admit for IP Medical/Surgical	$150/Admit for IP Psych/Substance Abuse	0	No cost sharing for this service.	$50/Trip for Ambulance	10% Coinsurance for DME	10% Coinsurance for Prosthetics/Supplies; 0-20% Coinsurance for Diabetes Monitoring Supplies	$50/Case for ER; $15/Visit for Urgent Care	"$200/Case for OP Surgery Hospital, $150/Case for OP Surgery ASC"	20% Coinsurance for OP Fac - Pathology	20% Coinsurance for OP Fac - Radiology (including CT/MRI/PET)	No cost sharing for this service.	20% Coinsurance for Renal Dialysis	"$15/Case for OP Cardiovascular, PT/OT/ST, CORF"	No cost sharing for this service.	$15/Visit for Specialist Office Visits/Consults	$15/Visit for OP Psych/Substance Abuse;	$15/Visit for PT/ST/OT	20% Coinsurance for Prof Radiology	$20/Visit for Chiropractor; $10/Exam for Vision Exams; $15/Service for Podiatrist; $15/Exam for Hearing/Speech Exams; 20% Coinsurance for Prof Path	No cost sharing for this service.	$15/Case for Pharmacy and Blood		$15/Office Visit	$10/Exam	$20/Service for Glasses/Contacts															150	150.0000001	0	0	50	0.1	0.1	38.8967863	175	0.2	0.2	0	0.2	15	0	15	15	15	0.2	4.598287745	0.2	0	0	15	9.999999999	20	0	0	0	0											149.4723761	149.4723763	0	0	49.82412537	0.099648251	0.099648251	38.75996714	174.3844388	0.199296502	0.199296502	0	0.199296502	14.94723761	0	14.94723761	14.94723761	14.94723761	0.199296502	4.582113302	0.199296502	0	0	14.94723761	9.964825073	19.92965015	0	0	0	0											3.5003	0.055319173	0	0	0.914331631	0.729851099	0.463364793	1.072622027	5.089930018	0.520247929	2.806529393	0	0.066039898	0.59600467	0	4.720726642	0.218891898	0.708700957	6.316292742	3.425056056	0.843694467	0	0	1.357707417	0.355500637	0.525376718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.2865	0	0.121	3.5003	0.055319173	0	0	0.914331631	0.729851099	0.463364793	1.072622027	5.089930018	0.520247929	2.806529393	0	0.066039898	0.59600467	0	4.720726642	0.218891898	0.708700957	6.316292742	3.425056056	0.843694467	0	0	1.357707417	0.355500637	0.525376718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.2865	0																																																																																	0	0		3.5003	0.055319173	0	0	0.914331631	0.729851099	0.463364793	1.072622027	5.089930018	0.520247929	2.806529393	0	0.066039898	0.59600467	0	4.720726642	0.218891898	0.708700957	6.316292742	3.425056056	0.843694467	0	0	1.357707417	0.355500637	0.525376718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.2865
H3706_803_0	2009	3																					0											A	A	D			Coin	Coin	V	V		Coin		Coin	V	V	V	V	P	Coin	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	275.0402206	4.232682907	261.2199809	0	194.9689466	6.762944964	1.021901362	289.7993779	322.7183911	0	13.41036249	0	0.313727127	438.205831	3737.832549	3356.17901	155.5049296	514.5288451	33.83719024	1753.131558	3.701793285	0	0	0	0	0	0	0	0	0											$100/Admit for IP Medical/Surgical	$100/Admit for IP Psych/Substance Abuse	$105/Days 21-100 for SNF	No cost sharing for this service.	$50/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 0-20% Coinsurance for Diabetes Monitoring Supplies	$50/Case for ER; $50/Visit for Urgent Care	$150/Case for OP Surgery (Hospital or ASC)	No cost sharing for this service.	20% Coinsurance for OP Fac - Radiology (including CT/MRI/PET)	No cost sharing for this service.	20% Coinsurance for Renal Dialysis	"$15/Case for OP Fac - Cardiovascular; $25/Case for OP Cardiovascular, PT/OT/ST, CORF"	$25/Visit for PCP - Office Visits/Consults/Routine Physicals	$25/Visit for Specialist Office Visits/Consults	$25/Visit for OP Psych/Substance Abuse;	$25/Visit for PT/ST/OT	20% Coinsurance for Prof Radiology	"$25/Visit for Chiropractor, Vision Exams, Podiatrist, Hearing/Speech Exams"	No cost sharing for this service.	$15/Case for Pharmacy and Blood																			100	100.0000001	105	0	50	0.2	0.164377593	50	150	0	0.2	0	0.2	21.49484269	25	25	25	25	0.2	24.28323036	0.2	0	0	0	0	0	0	0	0	0											100	100.0000001	105	0	50	0.2	0.164377593	50	150	0	0.2	0	0.2	21.49484269	25	25	25	25	0.2	24.28323036	0.2	0	0	0	0	0	0	0	0	0											2.292	0.035272358	2.285674833	0	0.812370611	1.352588993	0.167977686	1.207497408	4.033979889	0	2.682072498	0	0.062745425	0.78493045	7.787151144	6.992039604	0.323968603	1.071935094	6.767438049	3.547641457	0.740358657	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.9476	0	0	2.292	0.035272358	2.285674833	0	0.812370611	1.352588993	0.167977686	1.207497408	4.033979889	0	2.682072498	0	0.062745425	0.78493045	7.787151144	6.992039604	0.323968603	1.071935094	6.767438049	3.547641457	0.740358657	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.9476	0																																																																																	0	0		2.292	0.035272358	2.285674833	0	0.812370611	1.352588993	0.167977686	1.207497408	4.033979889	0	2.682072498	0	0.062745425	0.78493045	7.787151144	6.992039604	0.323968603	1.071935094	6.767438049	3.547641457	0.740358657	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.9476
H3706_804_0	2009	3																					0											A	A	D			Coin	Coin	V	V		Coin		Coin	V	V	V	V	P	Coin	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	275.0402206	4.232682907	261.2199809	0	194.9689466	6.762944964	1.021901362	289.7993779	322.7183911	0	13.41036249	0	0.313727127	438.205831	3737.832549	3356.17901	155.5049296	514.5288451	33.83719024	1753.131558	3.701793285	0	0	0	0	0	0	0	0	0											$100/Admit for IP Medical/Surgical	$100/Admit for IP Psych/Substance Abuse	$105/Days 21-100 for SNF	No cost sharing for this service.	$50/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 0-20% Coinsurance for Diabetes Monitoring Supplies	$50/Case for ER; $50/Visit for Urgent Care	$150/Case for OP Surgery (Hospital or ASC)	No cost sharing for this service.	20% Coinsurance for OP Fac - Radiology (including CT/MRI/PET)	No cost sharing for this service.	20% Coinsurance for Renal Dialysis	"$15/Case for OP Fac - Cardiovascular; $25/Case for OP Cardiovascular, PT/OT/ST, CORF"	$25/Visit for PCP - Office Visits/Consults/Routine Physicals	$25/Visit for Specialist Office Visits/Consults	$25/Visit for OP Psych/Substance Abuse;	$25/Visit for PT/ST/OT	20% Coinsurance for Prof Radiology	"$25/Visit for Chiropractor, Vision Exams, Podiatrist, Hearing/Speech Exams"	No cost sharing for this service.	$15/Case for Pharmacy and Blood																			100	100.0000001	105	0	50	0.2	0.164377593	50	150	0	0.2	0	0.2	21.49484269	25	25	25	25	0.2	24.28323036	0.2	0	0	0	0	0	0	0	0	0											100	100.0000001	105	0	50	0.2	0.164377593	50	150	0	0.2	0	0.2	21.49484269	25	25	25	25	0.2	24.28323036	0.2	0	0	0	0	0	0	0	0	0											2.292	0.035272358	2.285674833	0	0.812370611	1.352588993	0.167977686	1.207497408	4.033979889	0	2.682072498	0	0.062745425	0.78493045	7.787151144	6.992039604	0.323968603	1.071935094	6.767438049	3.547641457	0.740358657	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.9476	0	0	2.292	0.035272358	2.285674833	0	0.812370611	1.352588993	0.167977686	1.207497408	4.033979889	0	2.682072498	0	0.062745425	0.78493045	7.787151144	6.992039604	0.323968603	1.071935094	6.767438049	3.547641457	0.740358657	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.9476	0																																																																																	0	0		2.292	0.035272358	2.285674833	0	0.812370611	1.352588993	0.167977686	1.207497408	4.033979889	0	2.682072498	0	0.062745425	0.78493045	7.787151144	6.992039604	0.323968603	1.071935094	6.767438049	3.547641457	0.740358657	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.9476
H3706_807_0	2009	3																					0											A	A	D			Coin	Coin	V	V		Coin		Coin	V	V	V	V	P	Coin	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	275.0402206	4.232682907	261.2199809	0	194.9689466	6.762944964	1.021901362	289.7993779	322.7183911	0	13.41036249	0	0.313727127	438.205831	3737.832549	3356.17901	155.5049296	514.5288451	33.83719024	1753.131558	3.701793285	0	0	0	0	0	0	0	0	0											$100/Admit for IP Medical/Surgical	$100/Admit for IP Psych/Substance Abuse	$105/Days 21-100 for SNF	No cost sharing for this service.	$50/Trip for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 0-20% Coinsurance for Diabetes Monitoring Supplies	$50/Case for ER; $50/Visit for Urgent Care	$150/Case for OP Surgery (Hospital or ASC)	No cost sharing for this service.	20% Coinsurance for OP Fac - Radiology (including CT/MRI/PET)	No cost sharing for this service.	20% Coinsurance for Renal Dialysis	"$15/Case for OP Fac - Cardiovascular; $25/Case for OP Cardiovascular, PT/OT/ST, CORF"	$25/Visit for PCP - Office Visits/Consults/Routine Physicals	$25/Visit for Specialist Office Visits/Consults	$25/Visit for OP Psych/Substance Abuse;	$25/Visit for PT/ST/OT	20% Coinsurance for Prof Radiology	"$25/Visit for Chiropractor, Vision Exams, Podiatrist, Hearing/Speech Exams"	No cost sharing for this service.	$15/Case for Pharmacy and Blood																			100	100.0000001	105	0	50	0.2	0.164377593	50	150	0	0.2	0	0.2	21.49484269	25	25	25	25	0.2	24.28323036	0.2	0	0	0	0	0	0	0	0	0											100	100.0000001	105	0	50	0.2	0.164377593	50	150	0	0.2	0	0.2	21.49484269	25	25	25	25	0.2	24.28323036	0.2	0	0	0	0	0	0	0	0	0											2.292	0.035272358	2.285674833	0	0.812370611	1.352588993	0.167977686	1.207497408	4.033979889	0	2.682072498	0	0.062745425	0.78493045	7.787151144	6.992039604	0.323968603	1.071935094	6.767438049	3.547641457	0.740358657	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.9476	0	0	2.292	0.035272358	2.285674833	0	0.812370611	1.352588993	0.167977686	1.207497408	4.033979889	0	2.682072498	0	0.062745425	0.78493045	7.787151144	6.992039604	0.323968603	1.071935094	6.767438049	3.547641457	0.740358657	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.9476	0																																																																																	0	0		2.292	0.035272358	2.285674833	0	0.812370611	1.352588993	0.167977686	1.207497408	4.033979889	0	2.682072498	0	0.062745425	0.78493045	7.787151144	6.992039604	0.323968603	1.071935094	6.767438049	3.547641457	0.740358657	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.9476
H3708_001_0	2009	7																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		667.0787927	32.12465265	422.5505594		46.41461302	48.71148587	10.76386681	25.36521919	17.01983173	47.64453679	46.23431675	2.176865829	3.658339262	78.30570851	110.7246409	197.2695717	77.77704247	12.47902065			24.19741829	6.272921793																			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																			0.080365351	0.080365351	0.194318179		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.080365351	0.080365351	0.194318179		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			53.61	2.581708971	82.1092554	0	10.72177561	11.25235324	2.486453234	5.859365633	3.93158113	11.005888	10.68012717	0.502856006	0.84507637	18.08861867	25.57739204	45.56927105	17.96649681	2.882653771	0	0	5.589603625	1.449044934	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	312.7095	0	0	53.61	2.581708971	82.1092554	0	10.72177561	11.25235324	2.486453234	5.859365633	3.93158113	11.005888	10.68012717	0.502856006	0.84507637	18.08861867	25.57739204	45.56927105	17.96649681	2.882653771	0	0	5.589603625	1.449044934	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	312.7095																																																																																		0	0	0	53.61	2.581708971	82.1092554	0	10.72177561	11.25235324	2.486453234	5.859365633	3.93158113	11.005888	10.68012717	0.502856006	0.84507637	18.08861867	25.57739204	45.56927105	17.96649681	2.882653771	0	0	5.589603625	1.449044934	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	312.7095
H3709_001_0	2009	8																					2500											D	D	D	0	T	Coin	Coin	P	P	0	V	0	P	Coin	V	V	V	Coin	0	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	0	0	0	0	0	0											0	2500	1258.450563	90.48876897	805.7969149	2819.323019	181.4492333	5.783236954	0.94193395	174.8922069	235.3347517	487.925282	403.5391613	10.50488905	44.95441869	10.41452561	3777.682336	3575.312607	283.8514331	15.41746923	26.80957971	2.688946632	9.583809898	1.000305917	0	0	0	0	0	0	0	0											$100 / day up to 5 days.	$200 / day up to 5 days.	$100/day for days 21 to 100.	0	$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	0	"$100 copay for CT, MRI, PET, and nuclear medicine studies. $0 copay for all other lab plus 0% for Hospital Based physician costs"	0	$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	0	$20 copay for Office Visits and 20% coinsurance for other services	20% coinsurance	$20 copay for Vision Exams and 0% Coinsurance for OP Blood	0	0	0	0	0	0	0	0											61.82069251	46.87478736	42.71645621	0	100	0.2	0.2	42.5	150	0	50	50	35	0.2	20	20	40	0.2	0	0.2	0.2	0	0	0	0	0	0	0	0	0											57.48049535	43.5838857	39.71749527	0	92.97937796	0.185958756	0.185958756	39.51623563	139.4690669	0	46.48968898	46.48968898	32.54278229	0.185958756	18.59587559	18.59587559	37.19175118	0.185958756	0	0.185958756	0.185958756	0	0	0	0	0	0	0	0	0											6.028	0.328654347	2.667019596	0	1.405919737	1.075443549	0.175160866	0.575923471	2.735159853	0	1.563367508	0.040697419	0.121911822	1.936672225	5.854109229	5.540505704	0.879744323	2.867013397	0	0.50003317	1.782193366	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0776	0	2.7241	6.028	0.328654347	2.667019596	0	1.405919737	1.075443549	0.175160866	0.575923471	2.735159853	0	1.563367508	0.040697419	0.121911822	1.936672225	5.854109229	5.540505704	0.879744323	2.867013397	0	0.50003317	1.782193366	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0776	5000	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	$100 copay	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	0	0	0	0	0	0	0	0											4.2219	0.1276	0.7859	0.4576	0.1086	0.1127	0.0184	0.0961	0.403	0.2228	0.3226	0.0263	0.0098	0.203	0.9751	1.8511	0.0456	0.3004	0.5225	0.0524	0.1868	0.0195	0	0	0	0	0	0	0	0											11.0697	500	0.313784709	10.25	0.456213085	3.452956787	0.457585502	1.514541369	1.188144814	0.193516874	0.672006774	3.138178905	0.222846123	1.885979075	0.067016629	0.13166708	2.139626077	6.829245473	7.391633937	0.925328547	3.167462489	0.522453702	0.55243422	1.968958582	0.019493537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1472
H3709_003_0	2009	5																					2500											D	D	D	0	T	Coin	Coin	P	P	0	V	0	P	Coin	V	V	V	Coin	0	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	0	0	0	0	0	0											0	2500	1284.272779	92.34551294	822.3311055	2877.172861	185.1724	5.901906467	0.961262026	178.4808296	240.1635982	497.9370474	411.8194033	10.72043944	45.87684085	10.62822715	3855.196805	3648.674641	289.6757961	15.73382901	27.35970066	2.74412265	9.780465518	1.02083176	0	0	0	0	0	0	0	0											$100 / day up to 5 days.	$200 / day up to 5 days.	$100/day for days 21 to 100.	0	$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	0	"$100 copay for CT, MRI, PET, and nuclear medicine studies. $0 copay for all other lab plus 0% for Hospital Based physician costs"	0	$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	0	$20 copay for Office Visits and 20% coinsurance for other services	20% coinsurance	$20 copay for Vision Exams and 0% Coinsurance for OP Blood	0	0	0	0	0	0	0	0											61.82069251	46.87478736	42.71645621	0	100	0.2	0.2	42.5	150	0	50	50	35	0.2	20	20	40	0.2	0	0.2	0.2	0	0	0	0	0	0	0	0	0											56.92285686	43.16106311	39.33218189	0	92.07735234	0.184154705	0.184154705	39.13287474	138.1160285	0	46.03867617	46.03867617	32.22707332	0.184154705	18.41547047	18.41547047	36.83094094	0.184154705	0	0.184154705	0.184154705	0	0	0	0	0	0	0	0	0											6.092	0.332144209	2.695339718	0	1.420848693	1.086863843	0.177020925	0.582038996	2.764203531	0	1.579968346	0.04112957	0.123206359	1.957238033	5.916271909	5.599338341	0.889086011	2.897458634	0	0.505343096	1.801118739	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.4607	0	3.1372	6.092	0.332144209	2.695339718	0	1.420848693	1.086863843	0.177020925	0.582038996	2.764203531	0	1.579968346	0.04112957	0.123206359	1.957238033	5.916271909	5.599338341	0.889086011	2.897458634	0	0.505343096	1.801118739	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.4607	5000	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	$100 copay	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	0	0	0	0	0	0	0	0											4.2772	0.1292	0.7962	0.4636	0.1099	0.1142	0.0186	0.0922	0.4083	0.2258	0.3268	0.0267	0.0099	0.2056	0.9879	1.8754	0.0462	0.3044	0.5293	0.0531	0.1892	0.0197	0	0	0	0	0	0	0	0											11.2095	500	0.331802596	10.3692	0.461372466	3.491546973	0.463585754	1.530787916	1.201043947	0.195617796	0.674207377	3.172510905	0.225770257	1.906813145	0.067794135	0.133089624	2.162854997	6.90420366	7.474756641	0.935268381	3.201850148	0.529309216	0.55843174	1.990334645	0.019749326	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.6701
H3709_801_0	2009	5																					2500											D	D	D	0	T	Coin	Coin	P	P	0	V	0	P	Coin	V	V	V	Coin	0	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	0	0	0	0	0	0											0	2500	1256.347714	90.33756379	804.450442	2814.611978	181.1460348	5.773563755	0.940358446	174.599965	234.9415113	487.1099672	402.8648543	10.48733556	44.87930062	10.39710599	3771.369894	3569.338321	283.3771222	15.39168155	26.76473728	2.684449026	9.567779756	0.998632778	0	0	0	0	0	0	0	0											$100 / day up to 5 days.	$200 / day up to 5 days.	$100/day for days 21 to 100.	0	$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	0	"$100 copay for CT, MRI, PET, and nuclear medicine studies. $0 copay for all other lab plus 0% for Hospital Based physician costs"	0	$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	0	$20 copay for Office Visits and 20% coinsurance for other services	20% coinsurance	$20 copay for Vision Exams and 0% Coinsurance for OP Blood	0	0	0	0	0	0	0	0											61.82069251	46.87478736	42.71645621	0	100	0.2	0.2	42.5	150	0	50	50	35	0.2	20	20	40	0.2	0	0.2	0.2	0	0	0	0	0	0	0	0	0											57.52702704	43.61916779	39.74964744	0	93.05464676	0.186109294	0.186109294	39.54822487	139.5819701	0	46.52732338	46.52732338	32.56912637	0.186109294	18.61092935	18.61092935	37.2218587	0.186109294	0	0.186109294	0.186109294	0	0	0	0	0	0	0	0	0											6.0228	0.328370779	2.664718454	0	1.40470669	1.074513871	0.175009446	0.575426556	2.732799918	0	1.562018613	0.040662304	0.121806634	1.93499805	5.849058221	5.535725277	0.878985267	2.864534979	0	0.499600912	1.780652731	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0464	0	2.6904	6.0228	0.328370779	2.664718454	0	1.40470669	1.074513871	0.175009446	0.575426556	2.732799918	0	1.562018613	0.040662304	0.121806634	1.93499805	5.849058221	5.535725277	0.878985267	2.864534979	0	0.499600912	1.780652731	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0464	5000	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	$100 copay	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	0	0	0	0	0	0	0	0											4.2158	0.1274	0.7848	0.4569	0.1085	0.1125	0.0183	0.0928	0.4024	0.2225	0.3221	0.0263	0.0097	0.2027	0.9737	1.8484	0.0455	0.3	0.5217	0.0523	0.1865	0.0195	0	0	0	0	0	0	0	0											11.0504	500	0.312610464	10.2386	0.455743884	3.449517695	0.456914347	1.513171504	1.187050063	0.193338569	0.668205929	3.135228668	0.22251972	1.884157649	0.066942965	0.131547604	2.137654634	6.822766181	7.384142159	0.924502724	3.164544002	0.521688463	0.55192521	1.967144392	0.019464985	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.0968
H3709_802_0	2009	4																					2500											D	D	D	0	T	Coin	Coin	P	P	0	V	0	P	Coin	V	V	V	Coin	0	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	0	0	0	0	0	0											0	2500	1256.347714	90.33756379	804.450442	2814.611978	181.1460348	5.773563755	0.940358446	174.599965	234.9415113	487.1099672	402.8648543	10.48733556	44.87930062	10.39710599	3771.369894	3569.338321	283.3771222	15.39168155	26.76473728	2.684449026	9.567779756	0.998632778	0	0	0	0	0	0	0	0											$100 / day up to 5 days.	$200 / day up to 5 days.	$100/day for days 21 to 100.	0	$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	0	"$100 copay for CT, MRI, PET, and nuclear medicine studies. $0 copay for all other lab plus 0% for Hospital Based physician costs"	0	$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	0	$20 copay for Office Visits and 20% coinsurance for other services	20% coinsurance	$20 copay for Vision Exams and 0% Coinsurance for OP Blood	0	0	0	0	0	0	0	0											61.82069251	46.87478736	42.71645621	0	100	0.2	0.2	42.5	150	0	50	50	35	0.2	20	20	40	0.2	0	0.2	0.2	0	0	0	0	0	0	0	0	0											57.52702704	43.61916779	39.74964744	0	93.05464676	0.186109294	0.186109294	39.54822487	139.5819701	0	46.52732338	46.52732338	32.56912637	0.186109294	18.61092935	18.61092935	37.2218587	0.186109294	0	0.186109294	0.186109294	0	0	0	0	0	0	0	0	0											6.0228	0.328370779	2.664718454	0	1.40470669	1.074513871	0.175009446	0.575426556	2.732799918	0	1.562018613	0.040662304	0.121806634	1.93499805	5.849058221	5.535725277	0.878985267	2.864534979	0	0.499600912	1.780652731	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0464	0	2.6904	6.0228	0.328370779	2.664718454	0	1.40470669	1.074513871	0.175009446	0.575426556	2.732799918	0	1.562018613	0.040662304	0.121806634	1.93499805	5.849058221	5.535725277	0.878985267	2.864534979	0	0.499600912	1.780652731	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0464	5000	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	$100 copay	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	0	0	0	0	0	0	0	0											4.2158	0.1274	0.7848	0.4569	0.1085	0.1125	0.0183	0.0928	0.4024	0.2225	0.3221	0.0263	0.0097	0.2027	0.9737	1.8484	0.0455	0.3	0.5217	0.0523	0.1865	0.0195	0	0	0	0	0	0	0	0											11.0504	500	0.312610464	10.2386	0.455743884	3.449517695	0.456914347	1.513171504	1.187050063	0.193338569	0.668205929	3.135228668	0.22251972	1.884157649	0.066942965	0.131547604	2.137654634	6.822766181	7.384142159	0.924502724	3.164544002	0.521688463	0.55192521	1.967144392	0.019464985	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.0968
H3709_803_0	2009	4																					2500											D	D	D	0	T	Coin	Coin	P	P	0	V	0	P	Coin	V	V	V	Coin	0	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	0	0	0	0	0	0											0	2500	1256.347714	90.33756379	804.450442	2814.611978	181.1460348	5.773563755	0.940358446	174.599965	234.9415113	487.1099672	402.8648543	10.48733556	44.87930062	10.39710599	3771.369894	3569.338321	283.3771222	15.39168155	26.76473728	2.684449026	9.567779756	0.998632778	0	0	0	0	0	0	0	0											$100 / day up to 5 days.	$200 / day up to 5 days.	$100/day for days 21 to 100.	0	$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	0	"$100 copay for CT, MRI, PET, and nuclear medicine studies. $0 copay for all other lab plus 0% for Hospital Based physician costs"	0	$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	0	$20 copay for Office Visits and 20% coinsurance for other services	20% coinsurance	$20 copay for Vision Exams and 0% Coinsurance for OP Blood	0	0	0	0	0	0	0	0											61.82069251	46.87478736	42.71645621	0	100	0.2	0.2	42.5	150	0	50	50	35	0.2	20	20	40	0.2	0	0.2	0.2	0	0	0	0	0	0	0	0	0											57.52702704	43.61916779	39.74964744	0	93.05464676	0.186109294	0.186109294	39.54822487	139.5819701	0	46.52732338	46.52732338	32.56912637	0.186109294	18.61092935	18.61092935	37.2218587	0.186109294	0	0.186109294	0.186109294	0	0	0	0	0	0	0	0	0											6.0228	0.328370779	2.664718454	0	1.40470669	1.074513871	0.175009446	0.575426556	2.732799918	0	1.562018613	0.040662304	0.121806634	1.93499805	5.849058221	5.535725277	0.878985267	2.864534979	0	0.499600912	1.780652731	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0464	0	2.6904	6.0228	0.328370779	2.664718454	0	1.40470669	1.074513871	0.175009446	0.575426556	2.732799918	0	1.562018613	0.040662304	0.121806634	1.93499805	5.849058221	5.535725277	0.878985267	2.864534979	0	0.499600912	1.780652731	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0464	5000	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	$100 copay	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	0	0	0	0	0	0	0	0											4.2158	0.1274	0.7848	0.4569	0.1085	0.1125	0.0183	0.0928	0.4024	0.2225	0.3221	0.0263	0.0097	0.2027	0.9737	1.8484	0.0455	0.3	0.5217	0.0523	0.1865	0.0195	0	0	0	0	0	0	0	0											11.0504	500	0.312610464	10.2386	0.455743884	3.449517695	0.456914347	1.513171504	1.187050063	0.193338569	0.668205929	3.135228668	0.22251972	1.884157649	0.066942965	0.131547604	2.137654634	6.822766181	7.384142159	0.924502724	3.164544002	0.521688463	0.55192521	1.967144392	0.019464985	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.0968
H3709_804_0	2009	4																					2500											D	D	D	0	T	Coin	Coin	P	P	0	V	0	P	Coin	V	V	V	Coin	0	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	0	0	0	0	0	0											0	2500	1256.347714	90.33756379	804.450442	2814.611978	181.1460348	5.773563755	0.940358446	174.599965	234.9415113	487.1099672	402.8648543	10.48733556	44.87930062	10.39710599	3771.369894	3569.338321	283.3771222	15.39168155	26.76473728	2.684449026	9.567779756	0.998632778	0	0	0	0	0	0	0	0											$100 / day up to 5 days.	$200 / day up to 5 days.	$100/day for days 21 to 100.	0	$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	0	"$100 copay for CT, MRI, PET, and nuclear medicine studies. $0 copay for all other lab plus 0% for Hospital Based physician costs"	0	$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	0	$20 copay for Office Visits and 20% coinsurance for other services	20% coinsurance	$20 copay for Vision Exams and 0% Coinsurance for OP Blood	0	0	0	0	0	0	0	0											61.82069251	46.87478736	42.71645621	0	100	0.2	0.2	42.5	150	0	50	50	35	0.2	20	20	40	0.2	0	0.2	0.2	0	0	0	0	0	0	0	0	0											57.52702704	43.61916779	39.74964744	0	93.05464676	0.186109294	0.186109294	39.54822487	139.5819701	0	46.52732338	46.52732338	32.56912637	0.186109294	18.61092935	18.61092935	37.2218587	0.186109294	0	0.186109294	0.186109294	0	0	0	0	0	0	0	0	0											6.0228	0.328370779	2.664718454	0	1.40470669	1.074513871	0.175009446	0.575426556	2.732799918	0	1.562018613	0.040662304	0.121806634	1.93499805	5.849058221	5.535725277	0.878985267	2.864534979	0	0.499600912	1.780652731	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0464	0	2.6904	6.0228	0.328370779	2.664718454	0	1.40470669	1.074513871	0.175009446	0.575426556	2.732799918	0	1.562018613	0.040662304	0.121806634	1.93499805	5.849058221	5.535725277	0.878985267	2.864534979	0	0.499600912	1.780652731	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0464	5000	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	$100 copay	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	0	0	0	0	0	0	0	0											4.2158	0.1274	0.7848	0.4569	0.1085	0.1125	0.0183	0.0928	0.4024	0.2225	0.3221	0.0263	0.0097	0.2027	0.9737	1.8484	0.0455	0.3	0.5217	0.0523	0.1865	0.0195	0	0	0	0	0	0	0	0											11.0504	500	0.312610464	10.2386	0.455743884	3.449517695	0.456914347	1.513171504	1.187050063	0.193338569	0.668205929	3.135228668	0.22251972	1.884157649	0.066942965	0.131547604	2.137654634	6.822766181	7.384142159	0.924502724	3.164544002	0.521688463	0.55192521	1.967144392	0.019464985	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.0968
H3709_805_0	2009	4																					2500											D	D	D	0	T	Coin	Coin	P	P	0	V	0	P	Coin	V	V	V	Coin	0	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	2500	1242.783346	89.36221916	795.7650581	2784.223549	179.1902613	5.711228507	0.930205708	172.7148672	232.404926	481.8508029	398.5152564	10.37410728	44.39475374	10.28485189	3730.651667	3530.801362	280.3175937	15.22550268	26.47576731	2.655465923	9.46447962	0.987850872																			$100 / day up to 5 days.	$200 / day up to 5 days.	$100/day for days 21 to 100.	0	$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	0	"$100 copay for CT, MRI, PET, and nuclear medicine studies. $0 copay for all other lab plus 0% for Hospital Based physician costs"	0	$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	0	$20 copay for Office Visits and 20% coinsurance for other services	20% coinsurance	$20 copay for Vision Exams and 0% Coinsurance for OP Blood																			61.82069251	46.87478736	42.71645621	0	100	0.2	0.2	42.5	150	0	50	50	35	0.2	20	20	40	0.2	0	0.2	0.2	0																			57.83029432	43.84911651	39.95919707	0	93.54520625	0.187090413	0.187090413	39.75671266	140.3178094	0	46.77260313	46.77260313	32.74082219	0.187090413	18.70904125	18.70904125	37.4180825	0.187090413	0	0.187090413	0.187090413	0																			5.9892	0.326537863	2.649844398	0	1.396865829	1.068516097	0.17403257	0.572214612	2.717545842	0	1.553299661	0.040435334	0.121126728	1.924197183	5.816409661	5.504825695	0.874078904	2.848545577	0	0.496812215	1.770713396	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.8452	0	2.4734	5.9892	0.326537863	2.649844398	0	1.396865829	1.068516097	0.17403257	0.572214612	2.717545842	0	1.553299661	0.040435334	0.121126728	1.924197183	5.816409661	5.504825695	0.874078904	2.848545577	0	0.496812215	1.770713396	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.8452	5000	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	$100 copay	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																			4.1936	0.1267	0.7807	0.4545	0.1079	0.1119	0.0182	0.093	0.4003	0.2214	0.3204	0.0261	0.0097	0.2016	0.9686	1.8387	0.0453	0.2984	0.5189	0.052	0.1855	0.0194																			10.993	500	0.269903348	10.1828	0.453241425	3.430518305	0.454512555	1.504813697	1.180460737	0.192265344	0.665204797	3.117859206	0.221350034	1.873745358	0.066577849	0.130816494	2.125788494	6.784999279	7.343526286	0.919357097	3.146977589	0.518946183	0.548861468	1.956224755	0.019362666	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.8382
H3709_806_0	2009	4																					2500											D	D	D	0	T	Coin	Coin	P	P	0	V	0	P	Coin	V	V	V	Coin	0	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	2500	1242.783346	89.36221916	795.7650581	2784.223549	179.1902613	5.711228507	0.930205708	172.7148672	232.404926	481.8508029	398.5152564	10.37410728	44.39475374	10.28485189	3730.651667	3530.801362	280.3175937	15.22550268	26.47576731	2.655465923	9.46447962	0.987850872																			$100 / day up to 5 days.	$200 / day up to 5 days.	$100/day for days 21 to 100.	0	$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	0	"$100 copay for CT, MRI, PET, and nuclear medicine studies. $0 copay for all other lab plus 0% for Hospital Based physician costs"	0	$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	0	$20 copay for Office Visits and 20% coinsurance for other services	20% coinsurance	$20 copay for Vision Exams and 0% Coinsurance for OP Blood																			61.82069251	46.87478736	42.71645621	0	100	0.2	0.2	42.5	150	0	50	50	35	0.2	20	20	40	0.2	0	0.2	0.2	0																			57.83029432	43.84911651	39.95919707	0	93.54520625	0.187090413	0.187090413	39.75671266	140.3178094	0	46.77260313	46.77260313	32.74082219	0.187090413	18.70904125	18.70904125	37.4180825	0.187090413	0	0.187090413	0.187090413	0																			5.9892	0.326537863	2.649844398	0	1.396865829	1.068516097	0.17403257	0.572214612	2.717545842	0	1.553299661	0.040435334	0.121126728	1.924197183	5.816409661	5.504825695	0.874078904	2.848545577	0	0.496812215	1.770713396	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.8452	0	2.4734	5.9892	0.326537863	2.649844398	0	1.396865829	1.068516097	0.17403257	0.572214612	2.717545842	0	1.553299661	0.040435334	0.121126728	1.924197183	5.816409661	5.504825695	0.874078904	2.848545577	0	0.496812215	1.770713396	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.8452	5000	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	$100 copay	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																			4.1936	0.1267	0.7807	0.4545	0.1079	0.1119	0.0182	0.093	0.4003	0.2214	0.3204	0.0261	0.0097	0.2016	0.9686	1.8387	0.0453	0.2984	0.5189	0.052	0.1855	0.0194																			10.993	500	0.269903348	10.1828	0.453241425	3.430518305	0.454512555	1.504813697	1.180460737	0.192265344	0.665204797	3.117859206	0.221350034	1.873745358	0.066577849	0.130816494	2.125788494	6.784999279	7.343526286	0.919357097	3.146977589	0.518946183	0.548861468	1.956224755	0.019362666	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.8382
H3709_807_0	2009	4																					2500											D	D	D	0	T	Coin	Coin	P	P	0	V	0	P	Coin	V	V	V	Coin	0	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	2500	1242.783346	89.36221916	795.7650581	2784.223549	179.1902613	5.711228507	0.930205708	172.7148672	232.404926	481.8508029	398.5152564	10.37410728	44.39475374	10.28485189	3730.651667	3530.801362	280.3175937	15.22550268	26.47576731	2.655465923	9.46447962	0.987850872																			$100 / day up to 5 days.	$200 / day up to 5 days.	$100/day for days 21 to 100.	0	$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	0	"$100 copay for CT, MRI, PET, and nuclear medicine studies. $0 copay for all other lab plus 0% for Hospital Based physician costs"	0	$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	0	$20 copay for Office Visits and 20% coinsurance for other services	20% coinsurance	$20 copay for Vision Exams and 0% Coinsurance for OP Blood																			61.82069251	46.87478736	42.71645621	0	100	0.2	0.2	42.5	150	0	50	50	35	0.2	20	20	40	0.2	0	0.2	0.2	0																			57.83029432	43.84911651	39.95919707	0	93.54520625	0.187090413	0.187090413	39.75671266	140.3178094	0	46.77260313	46.77260313	32.74082219	0.187090413	18.70904125	18.70904125	37.4180825	0.187090413	0	0.187090413	0.187090413	0																			5.9892	0.326537863	2.649844398	0	1.396865829	1.068516097	0.17403257	0.572214612	2.717545842	0	1.553299661	0.040435334	0.121126728	1.924197183	5.816409661	5.504825695	0.874078904	2.848545577	0	0.496812215	1.770713396	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.8452	0	2.4734	5.9892	0.326537863	2.649844398	0	1.396865829	1.068516097	0.17403257	0.572214612	2.717545842	0	1.553299661	0.040435334	0.121126728	1.924197183	5.816409661	5.504825695	0.874078904	2.848545577	0	0.496812215	1.770713396	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.8452	5000	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	$100 copay	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																			4.1936	0.1267	0.7807	0.4545	0.1079	0.1119	0.0182	0.093	0.4003	0.2214	0.3204	0.0261	0.0097	0.2016	0.9686	1.8387	0.0453	0.2984	0.5189	0.052	0.1855	0.0194																			10.993	500	0.269903348	10.1828	0.453241425	3.430518305	0.454512555	1.504813697	1.180460737	0.192265344	0.665204797	3.117859206	0.221350034	1.873745358	0.066577849	0.130816494	2.125788494	6.784999279	7.343526286	0.919357097	3.146977589	0.518946183	0.548861468	1.956224755	0.019362666	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.8382
H3749_001_0	2009	6																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	319.6037997	7.014448512	595.2813295	381.5533038	143.6337297	18.27408588	8.483368947	353.0386672	278.6369904	10506.4732	45.72772243	0	0.127941759	1822.962799	6104.748224	4801.008848	323.057715	457.6335891	0	0	25.32606713	836.0390624	0	0	86.78858978	33.49941556	0	0	419.8843015	0											"$250 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$250 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-14/$95 Days 15-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$200 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); $200 (9a); $40/$30 (9c)"	"$5 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											249.9464479	250	41.37652798	0	150	0.2	0.091752821	49.99843667	200	2.8	0.195207488	0	0.2	69.86895152	3.078528669	30	37.5	25	0	0	0.2	29.44288484	0	0	30	30	0	0	0	0											249.9464479	250	41.37652798	0	150	0.2	0.091752821	49.99843667	200	2.8	0.195207488	0	0.2	69.86895152	3.078528669	30	37.5	25	0	0	0.2	29.44288484	0	0	30	30	0	0	0	0											6.657	0.146134344	2.052556216	0	1.795421621	3.654817175	0.778373036	1.470948454	4.64394984	2.451510414	8.926393836	0	0.025588352	10.61404162	1.566136869	12.00252212	1.009555359	0.953403311	0	0	5.065213426	2.051283486	0	0	0.216971474	0.083748539	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.1656	0	0	6.657	0.146134344	2.052556216	0	1.795421621	3.654817175	0.778373036	1.470948454	4.64394984	2.451510414	8.926393836	0	0.025588352	10.61404162	1.566136869	12.00252212	1.009555359	0.953403311	0	0	5.065213426	2.051283486	0	0	0.216971474	0.083748539	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.1656																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.657	0.146134344	2.052556216	0	1.795421621	3.654817175	0.778373036	1.470948454	4.64394984	2.451510414	8.926393836	0	0.025588352	10.61404162	1.566136869	12.00252212	1.009555359	0.953403311	0	0	5.065213426	2.051283486	0	0	0.216971474	0.083748539	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.1656
H3749_004_0	2009	5																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1949.715524	70.42235108	1022.186761	1158.527156	204.4528167	16.35730698	7.085131152	333.2202018	266.315706	11434.66493	47.67036395	0	0.195865673	1438.8815	5396.000302	5122.402221	326.6600668	524.0716382	0	0	43.08719929	814.7879545	0	0	105.2556147	99.08403738	0	0	98.4	0											"$150 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$150 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$95 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$140 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); $140 (9a); $40/$30 (9c)"	"$10 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											91.7256503	67.97943836	52.35147866	0	150	0.2	0.07115182	49.9995518	140	2.8	0.199063011	0	0.2	49.25458792	6.472918268	25	37.5	20	0	0	0.2	24.60085947	0	0	25	30	0	0	0	0											91.7256503	67.97943836	52.35147866	0	150	0.2	0.07115182	49.9995518	140	2.8	0.199063011	0	0.2	49.25458792	6.472918268	25	37.5	20	0	0	0.2	24.60085947	0	0	25	30	0	0	0	0											14.9032	0.398939323	4.459415701	0	2.555660209	3.271461397	0.504119976	1.388405062	3.10701657	2.668088484	9.489406188	0	0.039173135	5.905959611	2.910655744	10.67167129	1.020812709	0.87345273	0	0	8.617439858	1.670373664	0	0	0.219282531	0.247710093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.9223	0	0	14.9032	0.398939323	4.459415701	0	2.555660209	3.271461397	0.504119976	1.388405062	3.10701657	2.668088484	9.489406188	0	0.039173135	5.905959611	2.910655744	10.67167129	1.020812709	0.87345273	0	0	8.617439858	1.670373664	0	0	0.219282531	0.247710093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.9223																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.9032	0.398939323	4.459415701	0	2.555660209	3.271461397	0.504119976	1.388405062	3.10701657	2.668088484	9.489406188	0	0.039173135	5.905959611	2.910655744	10.67167129	1.020812709	0.87345273	0	0	8.617439858	1.670373664	0	0	0.219282531	0.247710093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.9223
H3749_011_0	2009	7																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		419.9683722	23.67	41.06499456	3997.02884	17.39207474	35.12763972	12.66647541	27.93524755	39.99926524	10.83360438	23.76173424	0	2.138505171	34.81626441	50.62975652	154.2620481	13.99	4.921800415	0	0	24.20721942	7.241489637	659.2362572	0	306.0448965	92.17420499	0	0	21.45084695	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.077095723	0.078063009	0.201709716	0	0.2	0.2	0.2	0.127428852	0.2	0.08	0.2	0	0.2	0.2	0	0.19962042	0.2	0.2	0	0	0.2	0.018820445	0	0	0	0	0	0	0	0											0.077095723	0.078063009	0.201709716	0	0.2	0.2	0.2	0.127428852	0.2	0.08	0.2	0	0.2	0.2	0	0.19962042	0.2	0.2	0	0	0.2	0.018820445	0	0	0	0	0	0	0	0											32.3778	1.847751426	8.283208384	0	3.478414949	7.025527945	2.533295081	3.559756518	7.999853049	0.86668835	4.752346848	0	0.427701034	6.963252881	0	30.79385483	2.798	0.984360083	0	0	4.841443885	0.13628806	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.6695	0	0	32.3778	1.847751426	8.283208384	0	3.478414949	7.025527945	2.533295081	3.559756518	7.999853049	0.86668835	4.752346848	0	0.427701034	6.963252881	0	30.79385483	2.798	0.984360083	0	0	4.841443885	0.13628806	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.6695																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	32.3778	1.847751426	8.283208384	0	3.478414949	7.025527945	2.533295081	3.559756518	7.999853049	0.86668835	4.752346848	0	0.427701034	6.963252881	0	30.79385483	2.798	0.984360083	0	0	4.841443885	0.13628806	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.6695
H3749_012_0	2009	9																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		391.4703179	23.74	51.89135857	5589.253053	17.15352133	37.67892587	12.81294021	26.91507013	41.89849398	7.780892333	18.82422458	0	3.137855472	44.59516091	60.37934046	162.0349416	13.99	6.619982052	0	0	27.97380032	8.08062548	365.1399043	0	327.7093149	349.7142857	0	0	20.2	0											"8.1% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"8.1% (1b); $0 n/c (1b1, 1b2)"	21.1% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.079534	0.0805	0.2112	0	0.2	0.2	0.2	0.112223627	0.2	0.08	0.2	0	0.2	0.2	0	0.199638629	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											0.079534	0.0805	0.2112	0	0.2	0.2	0.2	0.112223627	0.2	0.08	0.2	0	0.2	0.2	0	0.199638629	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											31.1352	1.91107	10.95945493	0	3.430704266	7.535785175	2.562588043	3.020506801	8.379698795	0.622471387	3.764844915	0	0.627571094	8.919032183	0	32.34843354	2.798	1.32399641	0	0	5.594760065	0.120153074	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0543	0	0	31.1352	1.91107	10.95945493	0	3.430704266	7.535785175	2.562588043	3.020506801	8.379698795	0.622471387	3.764844915	0	0.627571094	8.919032183	0	32.34843354	2.798	1.32399641	0	0	5.594760065	0.120153074	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0543																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	31.1352	1.91107	10.95945493	0	3.430704266	7.535785175	2.562588043	3.020506801	8.379698795	0.622471387	3.764844915	0	0.627571094	8.919032183	0	32.34843354	2.798	1.32399641	0	0	5.594760065	0.120153074	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0543
H3749_013_0	2009	6																																Coin	Coin	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		410.4402288	43.25	8010.224776	111.2732277	27.04945817	14.88185223	17.00199222	11.81343288	8.26378527	33.96202889	28.0972783	0	0.106156456	5.516185097	1.295307636	153.2338052	45.27	44.19369102	0	0	10.1071868	7.573660861	1576.881712	0	191.5790143	148.7435641	0	0	0	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.077089067	0.078160373	0	0	0.2	0.2	0.2	0.063811822	0.2	0.08	0.15003742	0	0.2	0.2	0	0.198763326	0.2	0	0	0	0.2	0.022666282	0	0	0	0	0	0	0	0											0.077089067	0.078160373	0	0	0.2	0.2	0.2	0.063811822	0.2	0.08	0.15003742	0	0.2	0.2	0	0.198763326	0.2	0	0	0	0.2	0.022666282	0	0	0	0	0	0	0	0											31.6405	3.380436116	0	0	5.409891634	2.976370445	3.400398444	0.75383668	1.652757054	2.716962312	4.215643132	0	0.021231291	1.103237019	0	30.4572608	9.054	0	0	0	2.021437361	0.17166673	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.9756	0	0	31.6405	3.380436116	0	0	5.409891634	2.976370445	3.400398444	0.75383668	1.652757054	2.716962312	4.215643132	0	0.021231291	1.103237019	0	30.4572608	9.054	0	0	0	2.021437361	0.17166673	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.9756																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	31.6405	3.380436116	0	0	5.409891634	2.976370445	3.400398444	0.75383668	1.652757054	2.716962312	4.215643132	0	0.021231291	1.103237019	0	30.4572608	9.054	0	0	0	2.021437361	0.17166673	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.9756
H3749_014_0	2009	6																																D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	O	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	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 Only	2026.381488	251.469309	1326.329873	55041.55544	95.83366884	24.68905317	10.91570831	391.6189013	410.5937543	6502.453214	20.72113589	0	16.99852382	1591.868019	6404.398744	4748.395062	1512.926942	283.1478523	0	0	31.86944991	1198.923839	810.5086242	0	327.7093149	349.7142857	0	0	98.17983361	0											"$200 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$200 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	$0 Days 1-20/$120 Days 21-100 (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $30 (4b)	$100 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); $0/20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-99 (3, 9d); $150 (5); $100 (9a); $30 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $30 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7f); $0 n/c (7b1, 7f1); $10 (7d)"	"$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-99 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											122.3052789	90.63925114	37.21990109	0	75	0.14	0.2	49.97446497	100	0	0.095212815	0	0	91.27422103	0	8.884666847	30	8.303264072	0	0	0.2	0	0	0	0	0	0	0	0	0											122.3052789	90.63925114	37.21990109	0	75	0.14	0.2	49.97446497	100	0	0.095212815	0	0	91.27422103	0	8.884666847	30	8.303264072	0	0	0.2	0	0	0	0	0	0	0	0	0											20.6531	1.899415821	4.113822225	0	0.59896043	3.456467444	2.183141661	1.630912089	3.421614619	0	1.972917679	0	0	12.10804278	0	3.515659015	3.782317355	0.195920949	0	0	6.373889982	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.9062	0	0	20.6531	1.899415821	4.113822225	0	0.59896043	3.456467444	2.183141661	1.630912089	3.421614619	0	1.972917679	0	0	12.10804278	0	3.515659015	3.782317355	0.195920949	0	0	6.373889982	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.9062																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.6531	1.899415821	4.113822225	0	0.59896043	3.456467444	2.183141661	1.630912089	3.421614619	0	1.972917679	0	0	12.10804278	0	3.515659015	3.782317355	0.195920949	0	0	6.373889982	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.9062
H3749_015_0	2009	6																																Coin	Coin	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		393.8988116	43.36	7847.15223	109.0079219	25.95932045	14.28208907	16.31678393	11.33733208	7.930741112	32.59330319	26.9649117	0	0.101878176	5.29629185	1.255160476	147.0964163	45.27	43.29399371	0	0	9.699850528	7.268429854	1576.881712	0	191.5790143	148.7435641	0	0	0	0											"8.1% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"8.1% (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.079393942	0.0805	0	0	0.2	0.2	0.2	0.065130232	0.2	0.08	0.15003742	0	0.2	0.2	0	0.198711728	0.2	0	0	0	0.2	0.022666282	0	0	0	0	0	0	0	0											0.079393942	0.0805	0	0	0.2	0.2	0.2	0.065130232	0.2	0.08	0.15003742	0	0.2	0.2	0	0.198711728	0.2	0	0	0	0.2	0.022666282	0	0	0	0	0	0	0	0											31.2732	3.49048	0	0	5.19186409	2.856417814	3.263356786	0.738403072	1.586148222	2.607464255	4.04574577	0	0.020375635	1.05925837	0	29.22978302	9.054	0	0	0	1.939970106	0.164748278	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.5212	0	0	31.2732	3.49048	0	0	5.19186409	2.856417814	3.263356786	0.738403072	1.586148222	2.607464255	4.04574577	0	0.020375635	1.05925837	0	29.22978302	9.054	0	0	0	1.939970106	0.164748278	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.5212																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	31.2732	3.49048	0	0	5.19186409	2.856417814	3.263356786	0.738403072	1.586148222	2.607464255	4.04574577	0	0.020375635	1.05925837	0	29.22978302	9.054	0	0	0	1.939970106	0.164748278	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.5212
H3749_016_0	2009	6																																D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	O	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	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 Only	1978.944187	251.469309	1295.28068	53753.0405	93.59021635	23.54664889	10.41062001	382.4558407	400.9818132	6350.231714	19.76233386	0	16.60059081	1555.198991	6256.211597	4637.235812	1512.926942	276.5194015	0	0	30.37166067	1170.857203	810.5086242	0	327.7093149	349.7142857	0	0	98.17983361	0											"$200 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$200 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	$0 Days 1-20/$120 Days 21-100 (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $30 (4b)	$100 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); $0/20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-99 (3, 9d); $150 (5); $100 (9a); $30 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $30 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7f); $0 n/c (7b1, 7f1); $10 (7d)"	"$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-99 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											122.3052789	90.63925114	37.21990109	0	75	0.14	0.2	49.97385319	100	0	0.095212815	0	0	91.25072409	0	8.884666847	30	8.303264072	0	0	0.2	0	0	0	0	0	0	0	0	0											122.3052789	90.63925114	37.21990109	0	75	0.14	0.2	49.97385319	100	0	0.095212815	0	0	91.25072409	0	8.884666847	30	8.303264072	0	0	0.2	0	0	0	0	0	0	0	0	0											20.1696	1.899415821	4.017518235	0	0.584938852	3.296530845	2.082124001	1.59273267	3.34151511	0	1.881627438	0	0	11.82608617	0	3.43335794	3.782317355	0.191334468	0	0	6.074332134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1734	0	0	20.1696	1.899415821	4.017518235	0	0.584938852	3.296530845	2.082124001	1.59273267	3.34151511	0	1.881627438	0	0	11.82608617	0	3.43335794	3.782317355	0.191334468	0	0	6.074332134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1734																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.1696	1.899415821	4.017518235	0	0.584938852	3.296530845	2.082124001	1.59273267	3.34151511	0	1.881627438	0	0	11.82608617	0	3.43335794	3.782317355	0.191334468	0	0	6.074332134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1734
H3749_017_0	2009	5																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1543.888291	65.597793	579.3052343	371.313218	139.7789034	17.30637236	8.034127827	343.5339488	271.1589613	10224.50162	43.30618762	0	0.121166538	1774.038323	5898.559807	4672.42587	314.3875273	445.3516689	0	0	23.98491236	813.6015375	0	0	147.9890135	292.8	0	0	98.4	0											"$250 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$250 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$95 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$240 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); $240 (9a); $40/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											152.8750013	113.2990639	52.35147866	0	150	0.2	0.091752821	49.99843653	240	2.8	0.195941568	0	0.2	60.70826642	9.299166101	30	37.5	25	0	0	0.2	29.44288484	0	0	30	30	0	0	0	0											152.8750013	113.2990639	52.35147866	0	150	0.2	0.091752821	49.99843653	240	2.8	0.195941568	0	0.2	60.70826642	9.299166101	30	37.5	25	0	0	0.2	29.44288484	0	0	30	30	0	0	0	0											19.6685	0.619347379	2.527290468	0	1.747236292	3.461274472	0.737153896	1.431346695	5.423179227	2.385717045	8.485482316	0	0.024233308	8.974899261	4.57097395	11.68106467	0.982461023	0.927815977	0	0	4.796982471	1.996231364	0	0	0.369972534	0.732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.5432	0	0	19.6685	0.619347379	2.527290468	0	1.747236292	3.461274472	0.737153896	1.431346695	5.423179227	2.385717045	8.485482316	0	0.024233308	8.974899261	4.57097395	11.68106467	0.982461023	0.927815977	0	0	4.796982471	1.996231364	0	0	0.369972534	0.732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.5432																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.6685	0.619347379	2.527290468	0	1.747236292	3.461274472	0.737153896	1.431346695	5.423179227	2.385717045	8.485482316	0	0.024233308	8.974899261	4.57097395	11.68106467	0.982461023	0.927815977	0	0	4.796982471	1.996231364	0	0	0.369972534	0.732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.5432
H3749_801_0	2009	3																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1612.596509	66.89002691	651.8667121	829.9416037	162.656801	18.85342877	6.954771109	314.3645265	37.56568546	13186.73992	63.29391126	0	0.093234469	25.35068229	6464.277843	5496.794707	324.3152838	770.7180864	0	0	34.59710938	968.5835673	0	0	0	0	0	0	0	0											"$340 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$340 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											274.6684308	228.8111049	159.8131731	0	150	0.2	0.101782226	49.99914243	0.2	2.8	0.1933411	0	0.2	0.203429649	12.4419946	40	37.5	35	0	0	0.2	39.52901159	0	0	0	0	0	0	0	0											274.6684308	228.8111049	159.8131731	0	150	0.2	0.101782226	49.99914243	0.2	2.8	0.1933411	0	0.2	0.203429649	12.4419946	40	37.5	35	0	0	0.2	39.52901159	0	0	0	0	0	0	0	0											36.9108	1.275431747	8.681407307	0	2.033210012	3.770685754	0.707872082	1.309829728	7.513137092	3.07690598	12.23731441	0	0.018646894	5.157080405	6.702375833	18.32264902	1.013485262	2.247927752	0	0	6.919421876	3.190595922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.0888	0	0	36.9108	1.275431747	8.681407307	0	2.033210012	3.770685754	0.707872082	1.309829728	7.513137092	3.07690598	12.23731441	0	0.018646894	5.157080405	6.702375833	18.32264902	1.013485262	2.247927752	0	0	6.919421876	3.190595922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.0888																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	36.9108	1.275431747	8.681407307	0	2.033210012	3.770685754	0.707872082	1.309829728	7.513137092	3.07690598	12.23731441	0	0.018646894	5.157080405	6.702375833	18.32264902	1.013485262	2.247927752	0	0	6.919421876	3.190595922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.0888
H3749_802_0	2009	4																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1638.00266	67.94386652	662.1367478	843.0171754	165.2194278	19.4521728	7.175639565	319.2848144	38.75869021	13394.49449	65.30398869	0	0.096195394	26.15576501	6540.489975	5583.395659	329.4248092	782.8606029	0	0	35.69583859	983.8434166	0	0	0	0	0	0	0	0											"$340 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$340 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											274.6684308	228.8111049	159.8131731	0	150	0.2	0.101782226	49.99914234	0.2	2.8	0.193009412	0	0.2	0.203328159	12.49075316	40	37.5	35	0	0	0.2	39.52901159	0	0	0	0	0	0	0	0											274.6684308	228.8111049	159.8131731	0	150	0.2	0.101782226	49.99914234	0.2	2.8	0.193009412	0	0.2	0.203328159	12.49075316	40	37.5	35	0	0	0.2	39.52901159	0	0	0	0	0	0	0	0											37.4923	1.295525931	8.818181223	0	2.065242848	3.89043456	0.730352565	1.330330574	7.751738041	3.125382047	12.60428446	0	0.019239079	5.318203548	6.807970485	18.61131886	1.029452529	2.283343425	0	0	7.139167717	3.240863152	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.5533	0	0	37.4923	1.295525931	8.818181223	0	2.065242848	3.89043456	0.730352565	1.330330574	7.751738041	3.125382047	12.60428446	0	0.019239079	5.318203548	6.807970485	18.61131886	1.029452529	2.283343425	0	0	7.139167717	3.240863152	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.5533																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	37.4923	1.295525931	8.818181223	0	2.065242848	3.89043456	0.730352565	1.330330574	7.751738041	3.125382047	12.60428446	0	0.019239079	5.318203548	6.807970485	18.61131886	1.029452529	2.283343425	0	0	7.139167717	3.240863152	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.5533
H3749_803_0	2009	3																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1474.71291	67.21268935	613.1260757	442.9807424	118.6671855	15.50543688	9.289104314	298.6109694	38.89368476	12005.02687	57.5199414	0	0.060953269	23.52381864	6704.094882	5426.293118	332.5911439	630.2132818	0	0	45.21768651	955.743165	0	0	0	0	0	0	0	0											"$345 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$345 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											278.7064839	232.1759741	159.8131731	0	150	0.2	0.087941409	49.99412636	0.2	2.8	0.192231128	0	0.2	0.205494633	12.05689561	40	37.5	35	0	0	0.2	38.93048923	0	0	0	0	0	0	0	0											278.7064839	232.1759741	159.8131731	0	150	0.2	0.087941409	49.99412636	0.2	2.8	0.192231128	0	0.2	0.205494633	12.05689561	40	37.5	35	0	0	0.2	38.93048923	0	0	0	0	0	0	0	0											34.251	1.300430968	8.165468637	0	1.483339819	3.101087376	0.816896917	1.244066211	7.778736952	2.801172935	11.05712323	0	0.012190654	4.834018468	6.735881014	18.08764373	1.039347325	1.838122072	0	0	9.043537302	3.100629083	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.6907	0	0	34.251	1.300430968	8.165468637	0	1.483339819	3.101087376	0.816896917	1.244066211	7.778736952	2.801172935	11.05712323	0	0.012190654	4.834018468	6.735881014	18.08764373	1.039347325	1.838122072	0	0	9.043537302	3.100629083	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.6907																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	34.251	1.300430968	8.165468637	0	1.483339819	3.101087376	0.816896917	1.244066211	7.778736952	2.801172935	11.05712323	0	0.012190654	4.834018468	6.735881014	18.08764373	1.039347325	1.838122072	0	0	9.043537302	3.100629083	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.6907
H3749_804_0	2009	3																																D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1476.756493	67.3058293	613.9757149	443.5946027	118.8316285	15.54843996	9.314866895	298.9959136	39.00155326	12021.66283	57.67946832	0	0.061122318	23.58906005	6643.938206	5433.812601	333.0520319	631.0865996	0	0	45.34309411	957.0675856	0	0	0	0	0	0	0	0											"$345 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$345 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											278.7064839	232.1759741	159.8131731	0	150	0.2	0.087941409	49.99412579	0.2	2.8	0.192201563	0	0.2	0.205482277	12.18292232	40	37.5	35	0	0	0.2	38.93048923	0	0	0	0	0	0	0	0											278.7064839	232.1759741	159.8131731	0	150	0.2	0.087941409	49.99412579	0.2	2.8	0.192201563	0	0.2	0.205482277	12.18292232	40	37.5	35	0	0	0.2	38.93048923	0	0	0	0	0	0	0	0											34.2985	1.30223304	8.176783931	0	1.485395356	3.109687991	0.819162515	1.245669943	7.800310651	2.805054659	11.08608396	0	0.012224464	4.847133773	6.745215258	18.11270867	1.0407876	1.840669249	0	0	9.068618822	3.104925778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.9011	0	0	34.2985	1.30223304	8.176783931	0	1.485395356	3.109687991	0.819162515	1.245669943	7.800310651	2.805054659	11.08608396	0	0.012224464	4.847133773	6.745215258	18.11270867	1.0407876	1.840669249	0	0	9.068618822	3.104925778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.9011																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	34.2985	1.30223304	8.176783931	0	1.485395356	3.109687991	0.819162515	1.245669943	7.800310651	2.805054659	11.08608396	0	0.012224464	4.847133773	6.745215258	18.11270867	1.0407876	1.840669249	0	0	9.068618822	3.104925778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.9011
H3755_001_0	2009	5																																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	V																																																			0		1085.7	37.9	45.8	0	99.6	82.3	0	226.1	372.9	0.2	303.5	0	0	93.9	3125.1	3920.7	133.1	68.2	529.2	300.5	0	273.5	0	0	283.4	149.6	60.47617778	0	0	0											1a. $200 copay day (1st 5 days)	1b. $200 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., 11c. No copay"	"4a. $50 copay, 4b. $50 copay if at ER"	9a/9b. $100 copay	8a. No copay	8b/14g $100 copay for MRI/CT/Endo/PET/Nuclear	no copay	12. no copay	"3/5. $50 copay, 9d no copay"	"7a/7g/14b/14f/14i $20 copay, 14c/14d/14h/14i/14j no copay"	"7d/7g/16b $35 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. $35 copay	15. no copay	"13a. no copay, 17a $35 copay"	no copay	no copay	17a1. $35 copay	17b1. $35 copay	18a1. $20 copay	no copay	14a/14j no copay	13c no copay																																																			200	200	50	0	50	76	0	50	100	0	100	0	0	50	20	35	24	20	20	35	0	35	0	0	35	35	20	0	0	0											18.095	0.631666667	0.190833333	0	0.415	0.521233333	0	0.942083333	3.1075	0	2.529166667	0	0	0.39125	5.2085	11.435375	0.2662	0.113666667	0.882	0.876458333	0	0.797708333	0	0	0.826583333	0.436333333	0.10079363	0	0	0	0	0	0	0	0	0	0	0	0	0	47.7674			18.095	0.631666667	0.190833333	0	0.415	0.521233333	0	0.942083333	3.1075	0	2.529166667	0	0	0.39125	5.2085	11.435375	0.2662	0.113666667	0.882	0.876458333	0	0.797708333	0	0	0.826583333	0.436333333	0.10079363	0	0	0	0	0	0	0	0	0	0	0	0	0	47.7674																																																																																		0			18.095	0.631666667	0.190833333	0	0.415	0.521233333	0	0.942083333	3.1075	0	2.529166667	0	0	0.39125	5.2085	11.435375	0.2662	0.113666667	0.882	0.876458333	0	0.797708333	0	0	0.826583333	0.436333333	0.10079363	0	0	0	0	0	0	0	0	0	0	0	0	0	47.7674
H3755_002_0	2009	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	V																																																			0		680.3	11.2	0	0	63	89.1	0	208.4	0	0	292.1	0	0	0	2207.6	3502.8	52.2	75	510.8	440.2	0	359.6	0	0	216.5	179.8	75.92355538	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. No copay	8a. No copay	8b/14g $100 copay for MRI/CT/Endo/PET/Nuclear	no copay	no copay	3/5/9d. no copay	"7a/7g/14b/14f $10 copay, 14c/14d/14h/14i/14j no copay"	"7d/7g $25 copay, 16b 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. $25 copay	15. no copay	"13a. no copay, 17a $25 copay"	no copay	no copay	17a1. $20 copay	17b1. $20 copay	18a1. $10 copay	no copay	14a/14j no copay	13c no copay																																																			100	100	0	0	50	76	0	50	0	0	100	0	0	0	10	25	20	20	20	25	0	25	0	0	20	20	10	0	0	0											5.6692	0.093333333	0	0	0.2625	0.5643	0	0.868333333	0	0	2.434166667	0	0	0	1.839666667	7.2975	0.087	0.125	0.851333333	0.917083333	0	0.749166667	0	0	0.360833333	0.299666667	0.063269629	0	0	0	0	0	0	0	0	0	0	0	0	0	22.4823			5.6692	0.093333333	0	0	0.2625	0.5643	0	0.868333333	0	0	2.434166667	0	0	0	1.839666667	7.2975	0.087	0.125	0.851333333	0.917083333	0	0.749166667	0	0	0.360833333	0.299666667	0.063269629	0	0	0	0	0	0	0	0	0	0	0	0	0	22.4823																																																																																		0			5.6692	0.093333333	0	0	0.2625	0.5643	0	0.868333333	0	0	2.434166667	0	0	0	1.839666667	7.2975	0.087	0.125	0.851333333	0.917083333	0	0.749166667	0	0	0.360833333	0.299666667	0.063269629	0	0	0	0	0	0	0	0	0	0	0	0	0	22.4823
H3755_004_0	2009	5																																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	V																																																			0		932.5	24	0	0	79.9	0.4	0	244.9	0	0	429.6	0	0	0	3203.9	5083.7	154.5	173.2	653.8	760.2	0	424.9	0	0	255.9	207.4	73.05713608	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. No copay	8a. No copay	8b/14g $100 copay for MRI/CT/Endo/PET/Nuclear	no copay	no copay	3/5/9d. no copay	"7a/7g/14b/14f $10 copay, 14c/14d/14h/14i/14j no copay"	"7d/7g $25 copay, 16b 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. $25 copay	15. no copay	"13a. no copay, 17a $25 copay"	no copay	no copay	17a1. $20 copay	17b1. $20 copay	18a1. $10 copay	no copay	14a/14j no copay	13c no copay																																																			100	100	0	0	50	76	0	50	0	0	100	0	0	0	10	25	20	20	20	25	0	25	0	0	20	20	10	0	0	0											7.7708	0.2	0	0	0.332916667	0.002533333	0	1.020416667	0	0	3.58	0	0	0	2.669916667	10.59104167	0.2575	0.288666667	1.089666667	1.58375	0	0.885208333	0	0	0.4265	0.345666667	0.060880947	0	0	0	0	0	0	0	0	0	0	0	0	0	31.1055			7.7708	0.2	0	0	0.332916667	0.002533333	0	1.020416667	0	0	3.58	0	0	0	2.669916667	10.59104167	0.2575	0.288666667	1.089666667	1.58375	0	0.885208333	0	0	0.4265	0.345666667	0.060880947	0	0	0	0	0	0	0	0	0	0	0	0	0	31.1055																																																																																		0			7.7708	0.2	0	0	0.332916667	0.002533333	0	1.020416667	0	0	3.58	0	0	0	2.669916667	10.59104167	0.2575	0.288666667	1.089666667	1.58375	0	0.885208333	0	0	0.4265	0.345666667	0.060880947	0	0	0	0	0	0	0	0	0	0	0	0	0	31.1055
H3755_801_0	2009	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	V																																																			0		525.2	17	38	0	65.2	0.3	0	172	331.4	0	337.1	0	0	271.2	2257.7	3664.4	142.4	103.2	608	309.4	0	290.1	0	0	273.7	127.8	77.06793055	0	0	0											1a. $200 copay day (1st 5 days)	1b. $200 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., 11c. No copay"	"4a. $50 copay, 4b. $50 copay if at ER"	9a/9b. $100 copay	8a. No copay	8b/14g $100 copay for MRI/CT/Endo/PET/Nuclear	no copay	12. no copay	"3/5. $50 copay, 9d no copay"	"7a/7g/14b/14f/14i $20 copay, 14c/14d/14h/14i/14j no copay"	"7d/7g/16b $35 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. $35 copay	15. no copay	"13a. no copay, 17a $35 copay"	no copay	no copay	17a1. $20 copay	17b1. $25 copay	18a1. $20 copay	no copay	14a/14j no copay	13c no copay																																																			200	200	50	0	50	76	0	50	100	0	100	0	0	50	20	35	24	20	20	35	0	35	0	0	20	25	20	0	0	0											8.7533	0.283333333	0.158333333	0	0.271666667	0.0019	0	0.716666667	2.761666667	0	2.809166667	0	0	1.13	3.762833333	10.68783333	0.2848	0.172	1.013333333	0.902416667	0	0.846125	0	0	0.456166667	0.26625	0.128446551	0	0	0	0	0	0	0	0	0	0	0	0	0	35.4063			8.7533	0.283333333	0.158333333	0	0.271666667	0.0019	0	0.716666667	2.761666667	0	2.809166667	0	0	1.13	3.762833333	10.68783333	0.2848	0.172	1.013333333	0.902416667	0	0.846125	0	0	0.456166667	0.26625	0.128446551	0	0	0	0	0	0	0	0	0	0	0	0	0	35.4063																																																																																		0			8.7533	0.283333333	0.158333333	0	0.271666667	0.0019	0	0.716666667	2.761666667	0	2.809166667	0	0	1.13	3.762833333	10.68783333	0.2848	0.172	1.013333333	0.902416667	0	0.846125	0	0	0.456166667	0.26625	0.128446551	0	0	0	0	0	0	0	0	0	0	0	0	0	35.4063
H3805_001_0	2009	5																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1210.650185	80.38529221	1059.228799	361.9947684	238.0830182	15.21009831	8.198774332	357.497088	198.1162508	13446.99655	51.45939409	0	0.050398277	1768.817952	5927.531453	4404.737115	369.3463886	250.4489129	0	0	30.54859956	958.4617271	0	0	147.2517547	29.2875852	0	0	737.8524342	0											"$200 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$200 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-14/$95 Days 15-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$150 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $60 (5); $150 (9a); $40/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											122.2982786	90.63925114	41.37652798	0	150	0.2	0.083188206	49.99864666	150	2.8	0.191322707	0	0.2	52.33883723	9.185028686	30	37.5	8.334199101	0	0	0.2	29.17275161	0	0	30	30	0	0	0	0											122.2982786	90.63925114	41.37652798	0	150	0.2	0.083188206	49.99864666	150	2.8	0.191322707	0	0.2	52.33883723	9.185028686	30	37.5	8.334199101	0	0	0.2	29.17275161	0	0	30	30	0	0	0	0											12.3384	0.607171891	3.652267503	0	2.976037728	3.042019661	0.682041329	1.489530882	2.476453135	3.137632529	9.845350602	0	0.010079655	7.714822909	4.537045536	11.01184279	1.154207464	0.173940925	0	0	6.109719911	2.330080491	0	0	0.368129387	0.073218963	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.73	0	0	12.3384	0.607171891	3.652267503	0	2.976037728	3.042019661	0.682041329	1.489530882	2.476453135	3.137632529	9.845350602	0	0.010079655	7.714822909	4.537045536	11.01184279	1.154207464	0.173940925	0	0	6.109719911	2.330080491	0	0	0.368129387	0.073218963	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.73																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.3384	0.607171891	3.652267503	0	2.976037728	3.042019661	0.682041329	1.489530882	2.476453135	3.137632529	9.845350602	0	0.010079655	7.714822909	4.537045536	11.01184279	1.154207464	0.173940925	0	0	6.109719911	2.330080491	0	0	0.368129387	0.073218963	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.73
H3805_007_0	2009	6																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	963.6813463	87.28843799	911.649446	233.6289199	164.8397839	13.93646234	7.974997976	321.0754298	114.9517053	11764.81077	38.93021014	0	0.134643543	1575.635085	5786.285059	4220.570251	368.6675003	296.7674875	0	0	18.3667608	636.8137597	0	0	203.4288177	26.00367781	0	0	737.8450119	0											"$150 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$150 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-14/$95 Days 15-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$100 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $60 (5); $100 (9a); $40/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											91.7223635	67.97943836	41.37652798	0	150	0.2	0.069968063	49.99680488	100	2.8	0.191840544	0	0.2	34.72954907	9.249743684	30	37.5	8.334199101	0	0	0.2	28.46782525	0	0	30	30	0	0	0	0											91.7223635	67.97943836	41.37652798	0	150	0.2	0.069968063	49.99680488	100	2.8	0.191840544	0	0.2	34.72954907	9.249743684	30	37.5	8.334199101	0	0	0.2	28.46782525	0	0	30	30	0	0	0	0											7.3659	0.494484916	3.143407401	0	2.060497299	2.787292469	0.557995161	1.337728801	0.957930878	2.745122512	7.46839269	0	0.026928709	4.560091335	4.460137806	10.55142563	1.152085939	0.206109944	0	0	3.673352161	1.510725236	0	0	0.508572044	0.065009195	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6332	0	0	7.3659	0.494484916	3.143407401	0	2.060497299	2.787292469	0.557995161	1.337728801	0.957930878	2.745122512	7.46839269	0	0.026928709	4.560091335	4.460137806	10.55142563	1.152085939	0.206109944	0	0	3.673352161	1.510725236	0	0	0.508572044	0.065009195	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6332																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.3659	0.494484916	3.143407401	0	2.060497299	2.787292469	0.557995161	1.337728801	0.957930878	2.745122512	7.46839269	0	0.026928709	4.560091335	4.460137806	10.55142563	1.152085939	0.206109944	0	0	3.673352161	1.510725236	0	0	0.508572044	0.065009195	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6332
H3805_011_0	2009	5																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1202.686417	82.04228944	1000.75213	363.2409315	221.5174533	13.9780915	7.635531223	350.4730961	193.6334251	13416.97827	50.81437856	0	0.041742611	1919.621605	6043.06334	4534.004805	384.7466047	236.2010431	0	0	33.23893848	939.6120098	0	0	163.4348261	30.5149429	0	0	768.9143509	0											"$150 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$150 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$95 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$100 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $60 (5); $100 (9a); $40/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											91.72345169	67.97943836	52.35147866	0	150	0.2	0.086041454	49.99881258	100	2.8	0.192249811	0	0.2	34.97987078	9.146394371	30	37.5	8.334199101	0	0	0.2	29.23020337	0	0	30	30	0	0	0	0											91.72345169	67.97943836	52.35147866	0	150	0.2	0.086041454	49.99881258	100	2.8	0.192249811	0	0.2	34.97987078	9.146394371	30	37.5	8.334199101	0	0	0.2	29.23020337	0	0	30	30	0	0	0	0											9.1929	0.46476573	4.365904481	0	2.768968166	2.7956183	0.656972208	1.460269887	1.613611876	3.130628262	9.769054667	0	0.008348522	5.595676307	4.606020043	11.33501201	1.20233314	0.164045543	0	0	6.647787697	2.288754178	0	0	0.408587065	0.076287357	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5515	0	0	9.1929	0.46476573	4.365904481	0	2.768968166	2.7956183	0.656972208	1.460269887	1.613611876	3.130628262	9.769054667	0	0.008348522	5.595676307	4.606020043	11.33501201	1.20233314	0.164045543	0	0	6.647787697	2.288754178	0	0	0.408587065	0.076287357	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5515																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	9.1929	0.46476573	4.365904481	0	2.768968166	2.7956183	0.656972208	1.460269887	1.613611876	3.130628262	9.769054667	0	0.008348522	5.595676307	4.606020043	11.33501201	1.20233314	0.164045543	0	0	6.647787697	2.288754178	0	0	0.408587065	0.076287357	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5515
H3805_801_0	2009	2																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1260.167479	90.15875135	1065.650413	341.0731	243.625429	16.53116195	11.183508	359.9459503	224.0327311	14158.60207	57.37479087	0	0.049576131	2138.977954	6250.632847	4714.937961	387.8579882	342.7668738	0	0	31.52621182	1029.744148	0	0	0	0	0	0	0	0											"$525 Days 1-4 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$525 Days 1-4 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$300 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); $300 (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											282.3471285	202.4351948	159.8131731	0	150	0.2	0.069804176	49.9988447	300	7	0.275687472	0	0.2	105.4889776	12.53912188	39.99906296	37.5	35	0	0	0.2	39.04579551	0	0	0	0	0	0	0	0											282.3471285	202.4351948	159.8131731	0	150	0.2	0.069804176	49.9988447	300	7	0.275687472	0	0.2	105.4889776	12.53912188	39.99906296	37.5	35	0	0	0.2	39.04579551	0	0	0	0	0	0	0	0											29.6504	1.520942033	14.19208115	0	3.045317862	3.306232389	0.780655556	1.499740139	5.600818277	8.25918454	15.81751105	0	0.009915226	18.80321645	6.531453925	15.7160917	1.212056213	0.999736715	0	0	6.305242364	3.350598286	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.6012	0	0	29.6504	1.520942033	14.19208115	0	3.045317862	3.306232389	0.780655556	1.499740139	5.600818277	8.25918454	15.81751105	0	0.009915226	18.80321645	6.531453925	15.7160917	1.212056213	0.999736715	0	0	6.305242364	3.350598286	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.6012																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	29.6504	1.520942033	14.19208115	0	3.045317862	3.306232389	0.780655556	1.499740139	5.600818277	8.25918454	15.81751105	0	0.009915226	18.80321645	6.531453925	15.7160917	1.212056213	0.999736715	0	0	6.305242364	3.350598286	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.6012
H3805_802_0	2009	2																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1266.152632	90.58695941	1070.711708	342.6930232	244.7825254	16.68856402	11.28999218	361.6402502	225.0967722	14225.8482	57.92108706	0	0.050048172	2149.137007	6231.899695	4737.33151	389.7001157	344.3948415	0	0	31.82638981	1034.634907	0	0	0	0	0	0	0	0											"$525 Days 1-4 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$525 Days 1-4 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$300 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); $300 (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											282.3471285	202.4351948	159.8131731	0	150	0.2	0.069804176	49.99884465	300	7	0.275591714	0	0.2	105.4890047	12.63654806	39.99910116	37.5	35	0	0	0.2	39.04610743	0	0	0	0	0	0	0	0											282.3471285	202.4351948	159.8131731	0	150	0.2	0.069804176	49.99884465	300	7	0.275591714	0	0.2	105.4890047	12.63654806	39.99910116	37.5	35	0	0	0.2	39.04610743	0	0	0	0	0	0	0	0											29.7912	1.528165731	14.25948629	0	3.059781568	3.337712803	0.788088597	1.506799557	5.627419305	8.298411452	15.96257165	0	0.010009634	18.892527	6.562474998	15.79075019	1.217812862	1.004484954	0	0	6.365277962	3.366538812	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.3695	0	0	29.7912	1.528165731	14.25948629	0	3.059781568	3.337712803	0.788088597	1.506799557	5.627419305	8.298411452	15.96257165	0	0.010009634	18.892527	6.562474998	15.79075019	1.217812862	1.004484954	0	0	6.365277962	3.366538812	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.3695																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	29.7912	1.528165731	14.25948629	0	3.059781568	3.337712803	0.788088597	1.506799557	5.627419305	8.298411452	15.96257165	0	0.010009634	18.892527	6.562474998	15.79075019	1.217812862	1.004484954	0	0	6.365277962	3.366538812	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.3695
H3805_803_0	2009	2																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1220.768952	81.42080632	922.1427624	343.1314136	222.762294	15.46127782	9.364712617	354.9809818	183.5343944	13968.81296	51.49697299	0	0.030544535	2305.761926	6188.579426	4584.306789	382.3620045	340.5318901	0	0	36.33939099	917.7946669	0	0	0	0	0	0	0	0											"$425 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$425 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$300 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); $300 (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											259.8834374	192.6084087	159.8131731	0	150	0.2	0.081689717	49.99636553	300	7	0.276496073	0	0.2	105.0382809	12.38658345	39.99919702	37.5	35	0	0	0.2	38.73342184	0	0	0	0	0	0	0	0											259.8834374	192.6084087	159.8131731	0	150	0.2	0.081689717	49.99636553	300	7	0.276496073	0	0.2	105.0382809	12.38658345	39.99919702	37.5	35	0	0	0.2	38.73342184	0	0	0	0	0	0	0	0											26.4381	1.306860995	12.28088007	0	2.784528675	3.092255563	0.765000728	1.47897991	4.58835986	8.148474226	14.23871079	0	0.006108907	20.18277241	6.387946291	15.28071587	1.194881264	0.993218013	0	0	7.267878199	2.962444	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.3982	0	0	26.4381	1.306860995	12.28088007	0	2.784528675	3.092255563	0.765000728	1.47897991	4.58835986	8.148474226	14.23871079	0	0.006108907	20.18277241	6.387946291	15.28071587	1.194881264	0.993218013	0	0	7.267878199	2.962444	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.3982																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	26.4381	1.306860995	12.28088007	0	2.784528675	3.092255563	0.765000728	1.47897991	4.58835986	8.148474226	14.23871079	0	0.006108907	20.18277241	6.387946291	15.28071587	1.194881264	0.993218013	0	0	7.267878199	2.962444	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.3982
H3805_804_0	2009	2																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1220.768952	81.42080632	922.1427624	343.1314136	222.762294	15.46127782	9.364712617	354.9809818	183.5343944	13968.81296	51.49697299	0	0.030544535	2305.761926	6188.579426	4584.306789	382.3620045	340.5318901	0	0	36.33939099	917.7946669	0	0	0	0	0	0	0	0											"$425 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$425 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$300 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); $300 (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											259.8834374	192.6084087	159.8131731	0	150	0.2	0.081689717	49.99636553	300	7	0.276496073	0	0.2	105.0382809	12.38658345	39.99919702	37.5	35	0	0	0.2	38.73342184	0	0	0	0	0	0	0	0											259.8834374	192.6084087	159.8131731	0	150	0.2	0.081689717	49.99636553	300	7	0.276496073	0	0.2	105.0382809	12.38658345	39.99919702	37.5	35	0	0	0.2	38.73342184	0	0	0	0	0	0	0	0											26.4381	1.306860995	12.28088007	0	2.784528675	3.092255563	0.765000728	1.47897991	4.58835986	8.148474226	14.23871079	0	0.006108907	20.18277241	6.387946291	15.28071587	1.194881264	0.993218013	0	0	7.267878199	2.962444	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.3982	0	0	26.4381	1.306860995	12.28088007	0	2.784528675	3.092255563	0.765000728	1.47897991	4.58835986	8.148474226	14.23871079	0	0.006108907	20.18277241	6.387946291	15.28071587	1.194881264	0.993218013	0	0	7.267878199	2.962444	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.3982																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	26.4381	1.306860995	12.28088007	0	2.784528675	3.092255563	0.765000728	1.47897991	4.58835986	8.148474226	14.23871079	0	0.006108907	20.18277241	6.387946291	15.28071587	1.194881264	0.993218013	0	0	7.267878199	2.962444	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.3982
H3810_001_0	2009	3																					2000											D	D			T			V	V					V	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		477.3447184	3.988078534	0	0	140.6311843	0	0	253.8831203	293.2971756	0	0	0	0	510.5777658	3472.033197	2920.959363	92.09906086	558.0924768	0	1028.439268	0	0	0	2055.800294	283.2376439	0	0	0	0	568.3399415											$100/Days 1-3 for IP Medical; $100/Days 1-3 for IP Surgical;	$100/Days 1-3 for IP Psych; $100/Days 1-3 for IP Substance Abuse;	No Cost-Sharing	No Cost-Sharing	$50/Run 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/Exam for PCP - Routine Physicals;	$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	$15/Procedure for Dental - Preventive;	$15/Exam for Vision (Refractions)	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$15/Visit for Acupunture; $15/Service for Care Coordination Counseling;											100	100.0000001	0	0	50	0	0	45.02078239	50	0	0	0	0	15	15	15	15	15	0	15	0	0	0	15	15	0	0	0	0	15											98.84771349	98.84771373	0	0	49.42385674	0	0	44.50201399	49.42385674	0	0	0	0	14.82715702	14.82715702	14.82715702	14.82715703	14.82715703	0	14.82715702	0	0	0	15	14.82715702	0	0	0	0	14.82715702											3.932	0.032851037	0	0	0.579211292	0	0	0.941525848	1.207989799	0	0	0	0	0.630868059	4.290031783	3.609126927	0.11379727	0.689577066	0	1.270735877	0	0	0	2.569750367	0.349967418	0	0	0	0	0.702238796	0	0	0	0	0	0	0	0	0	0	20.9197	0	0.2139	3.932	0.032851037	0	0	0.579211292	0	0	0.941525848	1.207989799	0	0	0	0	0.630868059	4.290031783	3.609126927	0.11379727	0.689577066	0	1.270735877	0	0	0	2.569750367	0.349967418	0	0	0	0	0.702238796	0	0	0	0	0	0	0	0	0	0	20.9197	2000	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	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	3.932	0.032851037	0	0	0.579211292	0	0	0.941525848	1.207989799	0	0	0	0	0.630868059	4.290031783	3.609126927	0.11379727	0.689577066	0	1.270735876	0	0	0	2.569750367	0.349967418	0	0	0	0	0.702238796	0	0	0	0	0	0	0	0	0	0	20.9197
H3810_002_0	2009	5																					0											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		25.35716542	1.700301021	5.667890179	0	4.148200634	6.890262542	5.218880465	7.037408484	8.004682163	2.760718778	5.922237777	0	1.529880281	12.90739695	12.73295286	26.84398271	2.147073988	1.319099532	4.901527076	9.35884572	2.453622705	0.186682479	0	0	0	0	0	0	0	0											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	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing											0.891534287	0.977820926	1.138730852	0	1.206919525	1.49619939	0.747423784	1.337845282	1.019106955	0.769852707	0.929302185	0	0.6	0.807769942	1.025127405	1.105324251	0.834201573	0.939049598	1.02376335	0.981365252	0.715611198	0.665120762	0	0	0	0	0	0	0	0											0.891534287	0.977820926	1.138730852	0	1.206919525	1.49619939	0.747423784	1.337845282	1.019106955	0.769852707	0.929302185	0	0.6	0.807769942	1.025127405	1.105324251	0.834201573	0.939049598	1.02376335	0.981365252	0.715611198	0.665120762	0	0	0	0	0	0	0	0											22.6068	1.662589918	6.454201414	0	5.006544337	10.30920661	3.900715385	9.414963738	8.157627268	2.125346824	5.503548506	0	0.917928169	10.42620729	13.05289892	29.67130508	1.791092497	1.238699885	5.018003777	9.184445986	1.755839883	0.124166393	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.3221	0	0	22.6068	1.662589918	6.454201414	0	5.006544337	10.30920661	3.900715385	9.414963738	8.157627268	2.125346824	5.503548506	0	0.917928169	10.42620729	13.05289892	29.67130508	1.791092497	1.238699885	5.018003777	9.184445986	1.755839883	0.124166393	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.3221		No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	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	22.6068	1.662589918	6.454201414	0	5.006544337	10.30920661	3.900715385	9.414963738	8.157627268	2.125346824	5.503548506	0	0.917928169	10.42620729	13.05289892	29.67130508	1.791092497	1.238699885	5.018003777	9.184445986	1.755839883	0.124166393	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.3221
H3810_003_0	2009	6																					2000											D	D			T			V	V					V	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		469.7051479	5.32425801	0	0	186.970259	0	0	304.3848172	342.179717	0	0	0	0	518.6132186	4355.562085	3561.974658	194.4602703	793.796537	0	903.925294	0	0	0	2055.800294	287.5467409	0	0	0	0	858.9820339											$100/Days 1-3 for IP Medical; $100/Days 1-3 for IP Surgical;	$100/Days 1-3 for IP Psych; $100/Days 1-3 for IP Substance Abuse;	No Cost-Sharing	No Cost-Sharing	$50/Run 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/Exam for PCP - Routine Physicals;	$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	$15/Procedure for Dental - Preventive;	$15/Exam for Vision (Refractions)	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$15/Visit for Acupunture; $15/Service for Care Coordination Counseling;											100	100.0000001	0	0	50	0	0	46.97784421	50	0	0	0	0	15	15	15	15	15	0	15	0	0	0	15	15	0	0	0	0	15											98.44896054	98.44896056	0	0	49.22448027	0	0	46.2491993	49.22448027	0	0	0	0	14.76734408	14.76734408	14.76734408	14.76734409	14.76734408	0	14.76734408	0	0	0	15	14.76734408	0	0	0	0	14.76734408											3.8535	0.043680639	0	0	0.766959486	0	0	1.173129506	1.403634894	0	0	0	0	0.638211654	5.360006998	4.383408782	0.239305144	0.976855549	0	1.11238132	0	0	0	2.569750367	0.353858472	0	0	0	0	1.057073605	0	0	0	0	0	0	0	0	0	0	23.9318	0	0.3366	3.8535	0.043680639	0	0	0.766959486	0	0	1.173129506	1.403634894	0	0	0	0	0.638211654	5.360006998	4.383408782	0.239305144	0.976855549	0	1.11238132	0	0	0	2.569750367	0.353858472	0	0	0	0	1.057073605	0	0	0	0	0	0	0	0	0	0	23.9318	2000	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	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	3.8535	0.043680639	0	0	0.766959486	0	0	1.173129506	1.403634894	0	0	0	0	0.638211654	5.360006998	4.383408782	0.239305144	0.976855549	0	1.11238132	0	0	0	2.569750367	0.353858472	0	0	0	0	1.057073604	0	0	0	0	0	0	0	0	0	0	23.9318
H3810_004_0	2009	3																					500											D	D			T			V	V					V	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	1000	487.3105663	7.023174444	0	0	195.6007176	0	0	338.602937	278.8688903	0	0	0	0	475.3797821	3494.553013	3062.736174	133.5238987	542.5122294	0	1407.561854	0	0	0	1651.592607	336.8972975	0	0	0	0	468.6103936											$100/Days 1-3 for IP Medical; $100/Days 1-3 for IP Surgical;	$100/Days 1-3 for IP Psych; $100/Days 1-3 for IP Substance Abuse;	No Cost-Sharing	No Cost-Sharing	$50/Run 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/Exam for PCP - Routine Physicals;	$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	$5/Procedure for Dental - Preventive;	$5/Exam for Vision (Refractions)	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$5/Visit for Acupunture; $5/Service for Care Coordination Counseling;											100	99.99999999	0	0	50	0	0	44.23883157	50	0	0	0	0	4.999999997	5	5	5.00000001	5.000000001	0	5	0	0	0	5	5.000000001	0	0	0	0	4.999999998											95.06541798	95.06541808	0	0	47.53270899	0	0	42.05583014	47.53270899	0	0	0	0	4.753270895	4.753270899	4.753270899	4.753270909	4.753270901	0	4.753270899	0	0	0	5	4.753270898	0	0	0	0	4.753270897											3.8605	0.055638418	0	0	0.774785999	0	0	1.186685633	1.104616151	0	0	0	0	0.18830074	1.384213095	1.213167894	0.052889605	0.214892299	0	0.557543567	0	0	0	0.688163586	0.13344701	0	0	0	0	0.185619346	0	0	0	0	0	0	0	0	0	0	11.6005	0	0.587	3.8605	0.055638418	0	0	0.774785999	0	0	1.186685633	1.104616151	0	0	0	0	0.18830074	1.384213095	1.213167894	0.052889605	0.214892299	0	0.557543567	0	0	0	0.688163586	0.13344701	0	0	0	0	0.185619346	0	0	0	0	0	0	0	0	0	0	11.6005	1500	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$25/Visit for Urgent Care;	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	20% Coinsurance for Renal Dialysis - Prof	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 - Primary Surgeon (Office); 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 - Office Visits; 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 - Primary Surgeon (Office); 20% Coinsurance for Speclst - Anesthesia (OP); 20% Coinsurance for Speclst - IP 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 (IP); 20% Coinsurance for Prof Radiology (OP); 020% Coinsurance for Prof Radiology (Office);	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)	No Cost-Sharing	No Cost-Sharing	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	0.023	0	0	0	0	0.0022	0.0123	0.7472	2.3323	0.0285	0.1064	0.5226	0.9563	0	0	0	0	0	0	0	0	0	0											4.7308	0	0	3.8605	0.055638418	0	0	0.774785999	0	0	1.209720366	1.104616151	0	0	0	0.002247952	0.200552914	2.131383401	3.545501472	0.081416124	0.32130355	0.522596066	1.513795536	0	0	0	0.688163586	0.13344701	0	0	0	0	0.185619346	0	0	0	0	0	0	0	0	0	0	16.3313
H3810_005_0	2009	6																					500											D	D			T			V	V					V	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	1000	566.682799	6.696865456	0	0	212.9671333	0	0	346.4185956	349.7244157	0	0	0	0	944.9094707	4134.782256	3591.690903	463.2066311	647.1717843	0	1481.273158	0	0	0	1651.592607	374.0005163	0	0	0	0	678.7301122											$100/Days 1-3 for IP Medical; $100/Days 1-3 for IP Surgical;	$100/Days 1-3 for IP Psych; $100/Days 1-3 for IP Substance Abuse;	No Cost-Sharing	No Cost-Sharing	$50/Run 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/Exam for PCP - Routine Physicals;	$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	$5/Procedure for Dental - Preventive;	$5/Exam for Vision (Refractions)	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$5/Visit for Acupunture; $5/Service for Care Coordination Counseling;											100	100.0000001	0	0	50	0	0	44.4405123	50	0	0	0	0	5.000000002	5	5	5	4.999999997	0	5	0	0	0	5	5.000000001	0	0	0	0	5											94.16864723	94.16864737	0	0	47.08432361	0	0	41.84902926	47.08432361	0	0	0	0	4.708432364	4.708432361	4.708432361	4.708432364	4.708432358	0	4.708432361	0	0	0	5	4.708432361	0	0	0	0	4.708432362											4.447	0.052552897	0	0	0.835617785	0	0	1.208106828	1.372211464	0	0	0	0	0.370753528	1.622361882	1.409269473	0.181748091	0.253930381	0	0.581206206	0	0	0	0.688163586	0.146746345	0	0	0	0	0.266312902	0	0	0	0	0	0	0	0	0	0	13.436	0	0.8181	4.447	0.052552897	0	0	0.835617785	0	0	1.208106828	1.372211464	0	0	0	0	0.370753528	1.622361882	1.409269473	0.181748091	0.253930381	0	0.581206206	0	0	0	0.688163586	0.146746345	0	0	0	0	0.266312902	0	0	0	0	0	0	0	0	0	0	13.436	1500	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$25/Visit for Urgent Care;	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	20% Coinsurance for Renal Dialysis - Prof	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 - Primary Surgeon (Office); 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 - Office Visits; 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 - Primary Surgeon (Office); 20% Coinsurance for Speclst - Anesthesia (OP); 20% Coinsurance for Speclst - IP 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 (IP); 20% Coinsurance for Prof Radiology (OP); 020% Coinsurance for Prof Radiology (Office);	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)	No Cost-Sharing	No Cost-Sharing	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	0.0227	0	0	0	0	0.0022	0.0127	0.7663	2.3296	0.0435	0.1102	0.5161	0.9486	0	0	0	0	0	0	0	0	0	0											4.752	0	0	4.447	0.052552897	0	0	0.835617785	0	0	1.230854705	1.372211464	0	0	0	0.002219958	0.383430287	2.388683784	3.738848532	0.225261006	0.36417908	0.516088064	1.529788602	0	0	0	0.688163586	0.146746344	0	0	0	0	0.266312902	0	0	0	0	0	0	0	0	0	0	18.1879
H3810_006_0	2009	5																					3250											D	D	D		T	Coin	Coin	V	V				Coin	V	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		518.2218073	9.869605061	148.9533245	0	130.0588504	1.404124866	0.837768834	221.1814279	181.1130133	0	0	0	0.085505015	331.834711	2600.436235	2249.377299	102.598367	320.6750695	0	1036.904395	0	0	0	2721.970188	246.3160869	0	0	0	0	326.7659805											$250/Days Custom for IP Medical; $250/Days Custom for IP Surgical;	$250/Days Custom for IP Psych; $250/Days Custom for IP Substance Abuse;	$250/Days Custom for SNF	No Cost-Sharing	$50/Run 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;	$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/Exam for PCP - Routine Physicals;	$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	$25/Procedure for Dental - Preventive;	$25/Exam for Vision (Refractions)	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$25/Visit for Acupunture; $15/Service for Care Coordination Counseling;											250	250	250	0	50	1	1	42.7996656	200	0	0	0	1	15	15.10181529	25	19.46252478	15	0	25	0	0	0	25	25	0	0	0	0	23.12130389											246.521835	246.5218351	246.521835	0	49.30436699	0.98608734	0.98608734	42.2042084	197.217468	0	0	0	0.98608734	14.7913101	14.89170887	24.6521835	19.19174929	14.7913101	0	24.6521835	0	0	0	25	24.6521835	0	0	0	0	22.79962504											10.6461	0.202756096	3.060020573	0	0.534372441	1.384589754	0.826113241	0.777898923	2.976554159	0	0	0	0.084315413	0.409022509	3.227078278	4.621005161	0.164086845	0.395267033	0	2.130163118	0	0	0	5.670771225	0.506019115	0	0	0	0	0.620845153	0	0	0	0	0	0	0	0	0	0	38.237	0	0.4595	10.6461	0.202756096	3.060020573	0	0.534372441	1.384589754	0.826113241	0.777898923	2.976554159	0	0	0	0.084315413	0.409022509	3.227078278	4.621005161	0.164086845	0.395267033	0	2.130163118	0	0	0	5.670771225	0.506019115	0	0	0	0	0.620845153	0	0	0	0	0	0	0	0	0	0	38.237	3250	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	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	10.6461	0.202756096	3.060020573	0	0.534372441	1.384589754	0.826113241	0.777898923	2.976554159	0	0	0	0.084315413	0.409022509	3.227078278	4.621005161	0.164086845	0.395267033	0	2.130163118	0	0	0	5.670771225	0.506019115	0	0	0	0	0.620845153	0	0	0	0	0	0	0	0	0	0	38.237
H3810_007_0	2009	8																					3250											D	D	D		T	Coin	Coin	V	V				Coin	V	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		566.1501763	10.97610653	165.6572852	0	144.6571331	1.561677223	0.931805754	246.006804	201.4432469	0	0	0	0.095107551	369.1094879	2892.926535	2502.395078	114.1339683	356.6994402	0	1153.393345	0	0	0	2721.970188	273.7247224	0	0	0	0	363.1266168											$250/Days Custom for IP Medical; $250/Days Custom for IP Surgical;	$250/Days Custom for IP Psych; $250/Days Custom for IP Substance Abuse;	$250/Days Custom for SNF	No Cost-Sharing	$50/Run 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;	$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/Exam for PCP - Routine Physicals;	$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	$25/Procedure for Dental - Preventive;	$25/Exam for Vision (Refractions)	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$25/Visit for Acupunture; $15/Service for Care Coordination Counseling;											250	250	250	0	50	1	1	42.79795206	200	0	0	0	1	15	15.10170518	25	19.46255429	15	0	25	0	0	0	25	25	0	0	0	0	23.12130389											245.8425865	245.8425866	245.8425865	0	49.1685173	0.983370346	0.983370346	42.08623692	196.6740692	0	0	0	0.983370347	14.75055518	14.85056904	24.58425865	19.13889874	14.75055519	0	24.58425865	0	0	0	25	24.58425865	0	0	0	0	22.7368046											11.5987	0.224866202	3.393801289	0	0.592714729	1.535707071	0.916310146	0.86279172	3.301555256	0	0	0	0.093525945	0.453714156	3.580133771	5.12662732	0.182033205	0.438459565	0	2.362943359	0	0	0	5.670771225	0.560776615	0	0	0	0	0.688028244	0	0	0	0	0	0	0	0	0	0	41.5834	0	0.6073	11.5987	0.224866202	3.393801289	0	0.592714729	1.535707071	0.916310146	0.86279172	3.301555256	0	0	0	0.093525945	0.453714156	3.580133771	5.12662732	0.182033205	0.438459565	0	2.362943359	0	0	0	5.670771225	0.560776615	0	0	0	0	0.688028244	0	0	0	0	0	0	0	0	0	0	41.5834	3250	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	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	11.5987	0.224866202	3.393801289	0	0.592714729	1.535707071	0.916310146	0.86279172	3.301555256	0	0	0	0.093525945	0.453714156	3.580133771	5.12662732	0.182033205	0.438459565	0	2.362943359	0	0	0	5.670771225	0.560776615	0	0	0	0	0.688028244	0	0	0	0	0	0	0	0	0	0	41.5834
H3810_008_0	2009	4																					2000											D	D			T			V	V					V	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		473.0659939	7.325927986	0	0	169.0164144	0	0	293.9626329	263.3277658	0	0	0	0	470.8819414	3724.781391	3305.145987	154.1278477	489.6643925	0	1624.358623	0	0	0	2055.800294	393.1222834	0	0	0	0	525.194118											$100/Days 1-3 for IP Medical; $100/Days 1-3 for IP Surgical;	$100/Days 1-3 for IP Psych; $100/Days 1-3 for IP Substance Abuse;	No Cost-Sharing	No Cost-Sharing	$50/Run 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/Exam for PCP - Routine Physicals;	$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	$15/Procedure for Dental - Preventive;	$15/Exam for Vision (Refractions)	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$15/Visit for Acupunture; $15/Service for Care Coordination Counseling;											100	100	0	0	50	0	0	42.28103239	50	0	0	0	0	15	15	15	15.00000001	15	0	15	0	0	0	15	15	0	0	0	0	15											98.62420322	98.62420322	0	0	49.31210161	0	0	41.69933131	49.31210161	0	0	0	0	14.79363048	14.79363048	14.79363048	14.79363049	14.79363048	0	14.79363048	0	0	0	15	14.79363048	0	0	0	0	14.79363049											3.888	0.060209484	0	0	0.694546217	0	0	1.021503768	1.082103796	0	0	0	0	0.580504453	4.591919961	4.074592368	0.190009202	0.603659507	0	2.002513437	0	0	0	2.569750367	0.48464215	0	0	0	0	0.647460643	0	0	0	0	0	0	0	0	0	0	22.4914	0	0.2779	3.888	0.060209484	0	0	0.694546217	0	0	1.021503768	1.082103796	0	0	0	0	0.580504453	4.591919961	4.074592368	0.190009202	0.603659507	0	2.002513437	0	0	0	2.569750367	0.48464215	0	0	0	0	0.647460643	0	0	0	0	0	0	0	0	0	0	22.4914	2000	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	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	3.888	0.060209484	0	0	0.694546217	0	0	1.021503768	1.082103796	0	0	0	0	0.580504453	4.591919961	4.074592368	0.190009202	0.603659507	0	2.002513437	0	0	0	2.569750367	0.48464215	0	0	0	0	0.647460643	0	0	0	0	0	0	0	0	0	0	22.4914
H3810_010_0	2009	6																					2000											D	D			T			V	V					V	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		500.7432387	7.728763418	0	0	186.1762544	0	0	323.3263759	288.4250294	0	0	0	0	518.592732	4135.617119	3665.133183	170.1820926	537.3727162	0	1781.885507	0	0	0	2055.800294	437.46282	0	0	0	0	584.431129											$100/Days 1-3 for IP Medical; $100/Days 1-3 for IP Surgical;	$100/Days 1-3 for IP Psych; $100/Days 1-3 for IP Substance Abuse;	No Cost-Sharing	No Cost-Sharing	$50/Run 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/Exam for PCP - Routine Physicals;	$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	$15/Procedure for Dental - Preventive;	$15/Exam for Vision (Refractions)	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$15/Visit for Acupunture; $15/Service for Care Coordination Counseling;											100	99.99999997	0	0	50	0	0	42.19995769	50	0	0	0	0	15	15	15	14.99999999	15	0	15	0	0	0	15	15	0	0	0	0	15											98.38936726	98.38936715	0	0	49.19468363	0	0	41.52027136	49.19468363	0	0	0	0	14.75840509	14.75840509	14.75840509	14.75840508	14.75840509	0	14.75840509	0	0	0	15	14.75840509	0	0	0	0	14.75840509											4.1057	0.063369012	0	0	0.763240161	0	0	1.118716572	1.182414839	0	0	0	0	0.637800135	5.086259395	4.507626685	0.209301355	0.660897019	0	2.191482344	0	0	0	2.569750367	0.538021126	0	0	0	0	0.718772612	0	0	0	0	0	0	0	0	0	0	24.3533	0	0.3566	4.1057	0.063369012	0	0	0.763240161	0	0	1.118716572	1.182414839	0	0	0	0	0.637800135	5.086259395	4.507626685	0.209301355	0.660897019	0	2.191482344	0	0	0	2.569750367	0.538021126	0	0	0	0	0.718772612	0	0	0	0	0	0	0	0	0	0	24.3533	2000	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	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	4.1057	0.063369012	0	0	0.763240161	0	0	1.118716572	1.182414839	0	0	0	0	0.637800135	5.086259395	4.507626685	0.209301355	0.660897019	0	2.191482344	0	0	0	2.569750367	0.538021126	0	0	0	0	0.718772612	0	0	0	0	0	0	0	0	0	0	24.3533
H3810_011_0	2009	4																					500											D	D			T			V	V					V	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	1000	489.5166523	7.623631728	0	0	179.0394808	0	0	301.7806997	278.9437148	0	0	0	0	495.2846337	3682.541909	3255.945556	152.8238489	487.2104881	0	1622.774687	0	0	0	1651.592607	416.435349	0	0	0	0	556.3393506											$100/Days 1-3 for IP Medical; $100/Days 1-3 for IP Surgical;	$100/Days 1-3 for IP Psych; $100/Days 1-3 for IP Substance Abuse;	No Cost-Sharing	No Cost-Sharing	$50/Run 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/Exam for PCP - Routine Physicals;	$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	$5/Procedure for Dental - Preventive;	$5/Exam for Vision (Refractions)	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$5/Visit for Acupunture; $5/Service for Care Coordination Counseling;											100	100	0	0	50	0	0	42.83159851	50	0	0	0	0	5	5	5	5.000000001	5.000000001	0	5	0	0	0	5	5.000000001	0	0	0	0	5.000000001											95.01018701	95.01018699	0	0	47.5050935	0	0	40.69438184	47.50509351	0	0	0	0	4.750509354	4.750509351	4.750509351	4.750509344	4.750509349	0	4.75050935	0	0	0	5	4.750509351	0	0	0	0	4.750509352											3.8758	0.060360223	0	0	0.70877394	0	0	1.023398252	1.104270604	0	0	0	0	0.19607119	1.457829148	1.288949984	0.06049926	0.192874832	0	0.642417194	0	0	0	0.688163586	0.164856668	0	0	0	0	0.220241274	0	0	0	0	0	0	0	0	0	0	11.6845	0	0.5998	3.8758	0.060360223	0	0	0.70877394	0	0	1.023398252	1.104270604	0	0	0	0	0.19607119	1.457829148	1.288949984	0.06049926	0.192874832	0	0.642417194	0	0	0	0.688163586	0.164856668	0	0	0	0	0.220241274	0	0	0	0	0	0	0	0	0	0	11.6845	1500	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$25/Visit for Urgent Care;	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	20% Coinsurance for Renal Dialysis - Prof	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 - Primary Surgeon (Office); 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 - Office Visits; 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 - Primary Surgeon (Office); 20% Coinsurance for Speclst - Anesthesia (OP); 20% Coinsurance for Speclst - IP 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 (IP); 20% Coinsurance for Prof Radiology (OP); 020% Coinsurance for Prof Radiology (Office);	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)	No Cost-Sharing	No Cost-Sharing	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	0.0285	0	0	0	0	0.0035	0.0183	1.0908	3.3622	0.045	0.1588	0.8819	1.4846	0	0	0	0	0	0	0	0	0	0											7.0737	0	0	3.8758	0.060360223	0	0	0.70877394	0	0	1.051871253	1.104270604	0	0	0	0.003544324	0.214390278	2.548646491	4.651189021	0.105476733	0.351718404	0.881882188	2.126988829	0	0	0	0.688163586	0.164856668	0	0	0	0	0.220241274	0	0	0	0	0	0	0	0	0	0	18.7581
H3810_012_0	2009	6																					500											D	D			T			V	V					V	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	1000	523.8945586	8.175252795	0	0	199.0856137	0	0	335.5695376	310.1756126	0	0	0	0	550.7391152	4094.857249	3620.497089	169.9347518	541.7609489	0	1804.46845	0	0	0	1651.592607	463.0614803	0	0	0	0	618.6298158											$100/Days 1-3 for IP Medical; $100/Days 1-3 for IP Surgical;	$100/Days 1-3 for IP Psych; $100/Days 1-3 for IP Substance Abuse;	No Cost-Sharing	No Cost-Sharing	$50/Run 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/Exam for PCP - Routine Physicals;	$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	$5/Procedure for Dental - Preventive;	$5/Exam for Vision (Refractions)	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$5/Visit for Acupunture; $5/Service for Care Coordination Counseling;											100	99.99999997	0	0	50	0	0	42.83159852	50	0	0	0	0	4.999999996	5	5	4.999999993	5.000000001	0	5	0	0	0	5	5.000000001	0	0	0	0	4.999999999											94.52503143	94.52503136	0	0	47.26251572	0	0	40.48658195	47.26251571	0	0	0	0	4.726251568	4.726251571	4.726251571	4.726251563	4.726251575	0	4.726251571	0	0	0	5	4.726251572	0	0	0	0	4.72625157											4.1268	0.064397169	0	0	0.784107246	0	0	1.132171965	1.22163998	0	0	0	0	0.216910967	1.612777126	1.425948338	0.066929532	0.213374878	0	0.710697654	0	0	0	0.688163586	0.182378754	0	0	0	0	0.243650012	0	0	0	0	0	0	0	0	0	0	12.6899	0	0.7223	4.1268	0.064397169	0	0	0.784107246	0	0	1.132171965	1.22163998	0	0	0	0	0.216910967	1.612777126	1.425948338	0.066929532	0.213374878	0	0.710697654	0	0	0	0.688163586	0.182378754	0	0	0	0	0.243650012	0	0	0	0	0	0	0	0	0	0	12.6899	1500	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$25/Visit for Urgent Care;	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	20% Coinsurance for Renal Dialysis - Prof	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 - Primary Surgeon (Office); 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 - Office Visits; 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 - Primary Surgeon (Office); 20% Coinsurance for Speclst - Anesthesia (OP); 20% Coinsurance for Speclst - IP 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 (IP); 20% Coinsurance for Prof Radiology (OP); 020% Coinsurance for Prof Radiology (Office);	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)	No Cost-Sharing	No Cost-Sharing	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	0.0317	0	0	0	0	0.0039	0.0204	1.213	3.7387	0.05	0.1766	0.9806	1.6508	0	0	0	0	0	0	0	0	0	0											7.8657	0	0	4.1268	0.064397169	0	0	0.784107246	0	0	1.163832942	1.22163998	0	0	0	0.003941163	0.23728115	2.825727694	5.164640044	0.116942902	0.390003352	0.980622016	2.361489165	0	0	0	0.688163586	0.182378754	0	0	0	0	0.243650012	0	0	0	0	0	0	0	0	0	0	20.5556
H3810_013_0	2009	4																					3250											D	D	D		T	Coin	Coin	V	V				Coin	V	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		633.211413	13.06660482	215.4772128	0	149.3633429	1.909910869	1.138247789	259.7809314	232.7082582	0	0	0	0.075544137	416.1282273	3291.667276	2848.935755	134.4190264	432.7266724	0	1386.977303	0	0	0	2721.970188	347.4103899	0	0	0	0	464.1250345											$250/Days Custom for IP Medical; $250/Days Custom for IP Surgical;	$250/Days Custom for IP Psych; $250/Days Custom for IP Substance Abuse;	$250/Days Custom for SNF	No Cost-Sharing	$50/Run 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;	$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/Exam for PCP - Routine Physicals;	$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	$25/Procedure for Dental - Preventive;	$25/Exam for Vision (Refractions)	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$25/Visit for Acupunture; $15/Service for Care Coordination Counseling;											250	250	250	0	50	1	1	42.28103238	200	0	0	0	1	15	15.11344708	25	19.45221486	15	0	25	0	0	0	25	25	0	0	0	0	23.51920854											244.6429211	244.6429211	244.6429211	0	48.92858423	0.978571685	0.978571684	41.37502108	195.7143369	0	0	0	0.978571685	14.67857526	14.78959137	24.46429211	19.03538666	14.67857527	0	24.46429211	0	0	0	25	24.46429211	0	0	0	0	23.01523152											12.9092	0.266387698	4.392914564	0	0.609011409	1.868984696	1.113857057	0.895703459	3.79536187	0	0	0	0.073925354	0.509014125	4.056867827	5.808099711	0.213226512	0.529317586	0	2.827618157	0	0	0	5.670771225	0.708262439	0	0	0	0	0.890162094	0	0	0	0	0	0	0	0	0	0	47.1387	0	0.908	12.9092	0.266387698	4.392914564	0	0.609011409	1.868984696	1.113857057	0.895703459	3.79536187	0	0	0	0.073925354	0.509014125	4.056867827	5.808099711	0.213226512	0.529317586	0	2.827618157	0	0	0	5.670771225	0.708262439	0	0	0	0	0.890162094	0	0	0	0	0	0	0	0	0	0	47.1387	3250	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	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	12.9092	0.266387698	4.392914564	0	0.609011409	1.868984696	1.113857057	0.895703459	3.79536187	0	0	0	0.073925354	0.509014125	4.056867827	5.808099711	0.213226512	0.529317586	0	2.827618157	0	0	0	5.670771225	0.708262439	0	0	0	0	0.890162094	0	0	0	0	0	0	0	0	0	0	47.1387
H3810_014_0	2009	6																					3250											D	D	D		T	Coin	Coin	V	V				Coin	V	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		691.0828791	14.41323731	239.5766379	0	166.0684537	2.123519321	1.265551819	288.8353776	258.7348397	0	0	0	0.083993153	462.6688843	3659.814274	3167.566728	149.4527333	481.1237344	0	1542.099764	0	0	0	2721.970188	386.2654993	0	0	0	0	516.0337555											$250/Days Custom for IP Medical; $250/Days Custom for IP Surgical;	$250/Days Custom for IP Psych; $250/Days Custom for IP Substance Abuse;	$250/Days Custom for SNF	No Cost-Sharing	$50/Run 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;	$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/Exam for PCP - Routine Physicals;	$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	$25/Procedure for Dental - Preventive;	$25/Exam for Vision (Refractions)	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$25/Visit for Acupunture; $15/Service for Care Coordination Counseling;											250	250	250	0	50	1	1	42.28103239	200	0	0	0	1	15	15.11344708	25	19.45221486	15	0	25	0	0	0	25	25	0	0	0	0	23.51920854											243.6334219	243.6334219	243.6334219	0	48.72668437	0.974533687	0.974533687	41.20429041	194.9067375	0	0	0	0.974533687	14.61800531	14.72856331	24.36334219	18.95683867	14.61800531	0	24.36334219	0	0	0	25	24.36334219	0	0	0	0	22.92026102											14.0309	0.292628861	4.864073007	0	0.674330427	2.069441115	1.23332288	0.991771398	4.20243029	0	0	0	0.081854157	0.563608017	4.491983853	6.431042674	0.236095946	0.586089109	0	3.13089202	0	0	0	5.670771225	0.784226545	0	0	0	0	0.985635698	0	0	0	0	0	0	0	0	0	0	51.3211	0	1.1929	14.0309	0.292628861	4.864073007	0	0.674330427	2.069441115	1.23332288	0.991771398	4.20243029	0	0	0	0.081854157	0.563608017	4.491983853	6.431042674	0.236095946	0.586089109	0	3.13089202	0	0	0	5.670771225	0.784226545	0	0	0	0	0.985635698	0	0	0	0	0	0	0	0	0	0	51.3211	3250	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	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	14.0309	0.292628861	4.864073007	0	0.674330427	2.069441115	1.23332288	0.991771398	4.20243029	0	0	0	0.081854157	0.563608017	4.491983853	6.431042674	0.236095946	0.586089109	0	3.13089202	0	0	0	5.670771225	0.784226545	0	0	0	0	0.985635698	0	0	0	0	0	0	0	0	0	0	51.3211
H3810_015_0	2009	4																					3250											D	D	D		T	Coin	Coin	V	V				Coin	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		529.2362358	10.48724094	46.84121993	0	135.3074212	1.469529164	0.871126254	230.2489322	188.1780565	0	0	0	0.08764319	340.4260505	2597.452321	2249.08348	0	328.4458234	0	835.7429415	0	0	0	0	247.1415641	0	0	0	0	0											$250/Days Custom for IP Medical; $250/Days Custom for IP Surgical;	$250/Days Custom for IP Psych; $250/Days Custom for IP Substance Abuse;	$250/Days Custom for SNF	No Cost-Sharing	$50/Run 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;	$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/Exam for PCP - Routine Physicals;	$25/Visit for Speclst - Office Visits; $25/Consult for Speclst - Consults;	No Cost-Sharing	$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/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											250	250	250	0	50	1	1	43.10875766	200	0	0	0	1	15	15.10227386	25	0	15	0	25	0	0	0	0	25	0	0	0	0	0											247.1065012	247.1065012	247.1065012	0	49.42130023	0.988426005	0.988426005	42.60981711	197.685201	0	0	0	0.988426004	14.82639007	14.92748021	24.71065012	0	14.82639007	0	24.71065012	0	0	0	0	24.71065012	0	0	0	0	0											10.8981	0.215955451	0.964564164	0	0.557255724	1.452520841	0.861043843	0.817572074	3.10000141	0	0	0	0.086628808	0.420607451	3.231118178	4.63135958	0	0.405805491	0	1.720979285	0	0	0	0	0.50891906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.8725	0	0.3498	10.8981	0.215955451	0.964564164	0	0.557255724	1.452520841	0.861043843	0.817572074	3.10000141	0	0	0	0.086628808	0.420607451	3.231118178	4.63135958	0	0.405805491	0	1.720979285	0	0	0	0	0.50891906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.8725	3250	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	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	10.8981	0.215955451	0.964564164	0	0.557255724	1.452520841	0.861043843	0.817572074	3.10000141	0	0	0	0.086628808	0.420607451	3.231118178	4.63135958	0	0.405805491	0	1.720979285	0	0	0	0	0.50891906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.8725
H3810_016_0	2009	6																					3250											D	D	D		T	Coin	Coin	V	V				Coin	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		578.3742053	11.67101536	52.12854364	0	150.5805959	1.635406065	0.96945688	256.2388753	209.4191408	0	0	0	0.097536142	378.8525204	2890.646462	2502.954588	0	365.5199942	0	930.0795852	0	0	0	0	275.0383067	0	0	0	0	0											$250/Days Custom for IP Medical; $250/Days Custom for IP Surgical;	$250/Days Custom for IP Psych; $250/Days Custom for IP Substance Abuse;	$250/Days Custom for SNF	No Cost-Sharing	$50/Run 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;	$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/Exam for PCP - Routine Physicals;	$25/Visit for Speclst - Office Visits; $25/Consult for Speclst - Consults;	No Cost-Sharing	$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/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											250	250	250	0	50	1	1	43.10875766	200	0	0	0	1	15	15.10227386	25	0	15	0	25	0	0	0	0	25	0	0	0	0	0											246.4487996	246.4487997	246.4487997	0	49.28975993	0.985795199	0.985795199	42.49640632	197.1590397	0	0	0	0.985795199	14.78692798	14.88774906	24.64487996	0	14.78692798	0	24.64487997	0	0	0	0	24.64487997	0	0	0	0	0											11.8783	0.239692311	1.070584751	0	0.618506785	1.612175447	0.955685938	0.907435947	3.440739725	0	0	0	0.09615066	0.466838745	3.586268262	5.140417948	0	0.450409819	0	1.910141645	0	0	0	0	0.564857171	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.9382	0	0.4746	11.8783	0.239692311	1.070584751	0	0.618506785	1.612175447	0.955685938	0.907435947	3.440739725	0	0	0	0.09615066	0.466838745	3.586268262	5.140417948	0	0.450409819	0	1.910141645	0	0	0	0	0.564857171	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.9382	3250	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	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	11.8783	0.239692311	1.070584751	0	0.618506785	1.612175447	0.955685938	0.907435947	3.440739725	0	0	0	0.09615066	0.466838745	3.586268262	5.140417948	0	0.450409819	0	1.910141645	0	0	0	0	0.564857171	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.9382
H3811_001_0	2009	5																																					coin	coin																																																																										0		1040.582747	7.138930205	2209.138394	1218.941889	299.0209762	8.040523857	0.56116546	374.2239444	938.5315015	9093.044333	2148.441436	0	0	4079.386667	0	0	298.8222033	0	2693.200802	19735.66464	0	1760.663894	0	0.035436535	248.7894339	214.4953085	36.24733463	0	0	11.69405646											"$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"		$50 copay	20% coinsurance	20% coinsurance	$50 copay	$30 copay					"$15 copay for therapy and rehab, $0 other"			"$15, $20, $30, $40 Copays"			"$15 PCP, $20 SCP"		"Copays ($25, $0)"		$15 copay	$15 copay					$25 copay											35.989921	25.32909616	0.809477937	0	50	0.2	0.2	50	30	0	0	0	0	7.347837725	0	0	22.59	0	0	4.991767428	0	1.250933027	0	15	15	0	0	0	0	25											35.989921	25.32909616	0.809477937	0	50	0.2	0.2	50	30	0	0	0	0	7.347837725	0	0	22.59	0	0	4.991767428	0	1.250933027	0	15	15	0	0	0	0	25											3.1209	0.015068554	0.149020732	0	1.245920734	1.608104771	0.112233092	1.559266435	2.346328754	0	0	0	0	2.49788927	0	0	0.562532798	0	0	8.209653992	0	0.183539385	0	4.43E-05	0.310986792	0	0	0	0	0.024362618	0	0	0	0	0	0	0	0	0	0	21.9458			3.1209	0.015068554	0.149020732	0	1.245920734	1.608104771	0.112233092	1.559266435	2.346328754	0	0	0	0	2.49788927	0	0	0.562532798	0	0	8.209653992	0	0.183539385	0	4.43E-05	0.310986792	0	0	0	0	0.024362618	0	0	0	0	0	0	0	0	0	0	21.9458																																																																																		0			3.1209	0.015068554	0.149020732	0	1.245920734	1.608104771	0.112233092	1.559266435	2.346328754	0	0	0	0	2.49788927	0	0	0.562532798	0	0	8.209653992	0	0.183539385	0	4.43E-05	0.310986792	0	0	0	0	0.024362618	0	0	0	0	0	0	0	0	0	0	21.9458
H3811_002_0	2009	6																																					coin	coin														coin																																																												0		1344.500508	8.661554106	3325.207866	1849.497317	391.7142524	12.18079664	0.850124006	473.8390326	941.6135379	11160.15282	2735.96104	0	0	4494.211458	0	0	440.330364	0	3201.115693	21851.52168	37.51176644	172.7296996	0	0.010799326	257.3208274	221.8507007	41.75306131	0	0	3.559845633											"$100 days 1-5, $0 days 6-90"	$500 per admission	"$0 days 1-10, $50 days 11-20, $80 days 21-100"		$75 copay	20% coinsurance	20% coinsurance	$50 copay	$35 copay					"$15 copay for therapy and rehab, $0 other"			"$15, $20, $30, $40 Copays"			"$15 PCP, $20 SCP"	20% coinsurance	"Copays ($25, $0)"		$15 copay	$15 copay					$25 copay											50.384	100.3287017	0.072314325	0	50	0.2	0.2	50	35	0	0	1	1	7.903613267	1	1	22.59	1	0	5.043917429	0.2	12.4099376	1	15	15	0	0	1	1	25											50.384	100.3287017	0.072314325	0	50	0.2	0.2	50	35	0	0	1	1	7.903613267	1	1	22.59	1	0	5.043917429	0.2	12.4099376	1	15	15	0	0	1	1	25											5.6451	0.072416873	0.020038347	0	1.632142718	2.436159328	0.170024801	1.974329303	2.746372819	0	0	0	0	2.960042442	0	0	0.82892191	0	0	9.184772588	7.502353288	0.1786304	0	1.35E-05	0.321651034	0	0	0	0	0.007416345	0	0	0	0	0	0	0	0	0	0	35.6804			5.6451	0.072416873	0.020038347	0	1.632142718	2.436159328	0.170024801	1.974329303	2.746372819	0	0	0	0	2.960042442	0	0	0.82892191	0	0	9.184772588	7.502353288	0.1786304	0	1.35E-05	0.321651034	0	0	0	0	0.007416345	0	0	0	0	0	0	0	0	0	0	35.6804																																																																																		0			5.6451	0.072416873	0.020038347	0	1.632142718	2.436159328	0.170024801	1.974329303	2.746372819	0	0	0	0	2.960042442	0	0	0.82892191	0	0	9.184772588	7.502353288	0.1786304	0	1.35E-05	0.321651034	0	0	0	0	0.007416345	0	0	0	0	0	0	0	0	0	0	35.6804
H3811_003_0	2009	3																																					coin	coin														coin																																																												0		2330.604429	48.94662097	8041.55577	3601.049659	953.590001	22.33202299	1.559235612	1017.088876	838.9977092	13205.72835	2504.947609	0	0	5305.036939	0	0	2838.56752	0	3602.153	23972.10448	30.20321596	165.5182329	0	0.048279445	488.9800806	421.6296224	0	0	0	19.65003681											"$100 days 1-5, $0 days 6-90"	$500 per admission	"$0 days 1-10, $50 days 11-20, $80 days 21-100"		$75 copay	20% coinsurance	20% coinsurance	$50 copay	$35 copay					"$15 copay for therapy and rehab, $0 other"			"$15, $20, $30, $40 Copays"			"$15 PCP, $20 SCP"	20% coinsurance	"Copays ($25, $22.50, $0)"		$15 copay	$15 copay					$25 copay											50.384	34.50275927	0.863637827	0	50	0.2	0.2	50	35	0	0	1	1	7.313308302	1	1	22.59	1	0	4.659543835	0.2	5.240093287	1	15	15	0	1	1	1	25											50.384	34.50275927	0.863637827	0	50	0.2	0.2	50	35	0	0	1	1	7.313308302	1	1	22.59	1	0	4.659543835	0.2	5.240093287	1	15	15	0	1	1	1	25											9.7854	0.14073279	0.578749313	0	3.973291671	4.466404598	0.311847122	4.237870315	2.447076652	0	0	0	0	3.233114224	0	0	5.343603357	0	0	9.30825597	6.040643193	0.072277582	0	6.03E-05	0.611225101	0	0	0	0	0.040937577	0	0	0	0	0	0	0	0	0	0	50.5915			9.7854	0.14073279	0.578749313	0	3.973291671	4.466404598	0.311847122	4.237870315	2.447076652	0	0	0	0	3.233114224	0	0	5.343603357	0	0	9.30825597	6.040643193	0.072277582	0	6.03E-05	0.611225101	0	0	0	0	0.040937577	0	0	0	0	0	0	0	0	0	0	50.5915																																																																																		0			9.7854	0.14073279	0.578749313	0	3.973291671	4.466404598	0.311847122	4.237870315	2.447076652	0	0	0	0	3.233114224	0	0	5.343603357	0	0	9.30825597	6.040643193	0.072277582	0	6.03E-05	0.611225101	0	0	0	0	0.040937577	0	0	0	0	0	0	0	0	0	0	50.5915
H3811_009_0	2009	5																																					coin	coin														coin																																																												0		1081.759467	7.1394157	2470.889593	1849.047145	302.6880187	11.71899706	0.792789779	418.2295554	961.032353	11344.21514	2710.770978	0	0	4539.467476	0	0	428.9661164	0	3280.335508	23190.31204	28.24647875	262.3825863	0	16.37081972	281.8770517	243.0219974	52.21038643	0	0	6.28859977											"$100 days 1-5, $0 days 6-90"	$500 per admission	"$0 days 1-10, $50 days 11-20, $80 days 21-100"		$75 copay	20% coinsurance	20% coinsurance	$50 copay	$35 copay					"$15 copay for therapy and rehab, $0 other"			"$15, $20, $30, $40 Copays"			"$15 PCP, $20 SCP"	20% coinsurance	"Copays ($25, $0)"		$15 copay for Medicare-covered & $0 copay for 1 oral exam and 1 cleaning per year	$15 copay					$25 copay											50.384	103.4879323	0.258177219	0	50	0.2	0.2	50	35	0	0	0	0	7.939382005	0	0	22.59	0	0	5.151197458	0.2	12.6572824	0	15	15	0	0	0	0	25											50.384	103.4879323	0.258177219	0	50	0.2	0.2	50	35	0	0	0	0	7.939382005	0	0	22.59	0	0	5.151197458	0.2	12.6572824	0	15	15	0	0	0	0	25											4.5419	0.061570281	0.053160617	0	1.261200078	2.343799412	0.158557956	1.742623147	2.803011029	0	0	0	0	3.003380533	0	0	0.807528714	0	0	9.954823037	5.64929575	0.276754208	0	0.020463525	0.352346315	0	0	0	0	0.01310125	0	0	0	0	0	0	0	0	0	0	33.0436			4.5419	0.061570281	0.053160617	0	1.261200078	2.343799412	0.158557956	1.742623147	2.803011029	0	0	0	0	3.003380533	0	0	0.807528714	0	0	9.954823037	5.64929575	0.276754208	0	0.020463525	0.352346315	0	0	0	0	0.01310125	0	0	0	0	0	0	0	0	0	0	33.0436																																																																																		0			4.5419	0.061570281	0.053160617	0	1.261200078	2.343799412	0.158557956	1.742623147	2.803011029	0	0	0	0	3.003380533	0	0	0.807528714	0	0	9.954823037	5.64929575	0.276754208	0	0.020463525	0.352346315	0	0	0	0	0.01310125	0	0	0	0	0	0	0	0	0	0	33.0436
H3812_001_0	2009	4																					2900											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	3600	1104.61535	134.9576434	468.6399275	300.1425019	97.47499292	9.671970887	4.707000549	321.5330399	31.24936661	7351.300024	33.81358571	0	0.055593308	17.33178369	4544.235959	3313.095431	544.4391763	205.0684469	0	0	16.70585022	701.390509	0	0	157.7737478	0	15.03064817	0	393.8298715	0											"$225 Days 1-13 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$225 Days 1-13 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-27 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											222.3751052	225	110	0	150	0.2	0.069876065	48.68399431	0.2	2.8	0.184691989	0	0.2	0.198812616	7.045555703	20	37.5	20	0	0	0.2	18.78353703	0	0	20	0	20	0	0	0											160.3539738	162.2218326	79.30845148	0	108.1478884	0.144197185	0.050379659	35.10047455	0.144197185	2.018760583	0.133160324	0	0.144197185	0.143700596	7.045555703	20	37.5	14.41971845	0	0	0.144197185	18.78353703	0	0	20	0	20	0	0	0											14.7608	1.824423019	3.097258913	0	0.878476221	1.394670971	0.237137083	0.940496857	4.506070683	1.23670956	4.502628031	0	0.008016398	2.490587638	2.668055631	5.521825719	1.701372426	0.246419106	0	0	2.408936566	1.097882883	0	0	0.262956246	0	0.02505108	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8098	0	14.8999	14.7608	1.824423019	3.097258913	0	0.878476221	1.394670971	0.237137083	0.940496857	4.506070683	1.23670956	4.502628031	0	0.008016398	2.490587638	2.668055631	5.521825719	1.701372426	0.246419106	0	0	2.408936566	1.097882883	0	0	0.262956246	0	0.02505108	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8098		"$375 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$375 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-21 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a7, 14a8, 14a9, 14a10); $0 (14a6)"	"$0 n/c (13b, 13d, 13e)"											1.3916	0.1681	1.8289	0.0792	0.1343	0.3197	0.1556	0.1437	1.033	0.189	1.0127	0	0.0012	0.5711	1.4941	2.4042	0.4821	0.0934	0	0	0.7823	0.4902	0	0	0.115	0	0.011	0	0	0											12.9003	0	4.834329636	16.1524	1.992512459	4.926154161	0.079176608	1.01273574	1.714397075	0.392736285	1.08423513	5.539080228	1.425718695	5.515280331	0	0.009241563	3.061645258	4.162185971	7.926026914	2.183427947	0.339786487	0	0	3.19128348	1.5880505	0	0	0.377999604	0	0.036010928	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7101
H3812_005_0	2009	4																					800											D	D	D	V	T	P	P	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1583.657617	25.74665385	8317.643073	75.30430087	505.5337733	544.4931655	1935.075892	167.2135714	127.0775725	11705.3231	1419.321745	0	4.118391922	230.5781794	190.3090409	6887.284207	16.81993138	34.94006392	0	0	1129.892233	714.6143945	1134.079423	0	158.189216	121.6100082	39.13190007	13.66333203	0	0											"$75 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $800 (13c)"	"$75 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0 (11a)	"$0 (11b, 11c)"	$50 (4a); $0 n/c (4a1); $10 (4b)	$25 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$25 (3, 5, 9a); $0 (9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $10 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$0 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a9, 14a10); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											74.46509442	75	0	0	75	0	0	48.45074394	25	0	0	0	0	24.06958686	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											59.8069131	60.23652448	0	0	60.23652448	0	0	38.91339231	20.07884149	0	0	0	0	19.33157677	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											7.8928	0.129240745	0	0	2.537633126	0	0	0.542237275	0.21263087	0	0	0	0	0.371453315	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.686	0	2.8641	7.8928	0.129240745	0	0	2.537633126	0	0	0.542237275	0.21263087	0	0	0	0	0.371453315	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.686		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $10 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $10 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a9, 14a10); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											2.3611	0.1471	0.9919	0.0316	0.3094	0.2041	0.225	0.0355	0.1329	0.453	0.3568	0	0	0.0611	0.0217	2.0525	0.8642	0.0048	0	0	0.1169	0.0867	0.0832	0	0.0135	0	0.0032	0	0	0											8.5561	0	0	10.2539	0.276315745	0.991872131	0.031561378	2.847017836	0.204094201	0.225040928	0.577770705	0.34557714	0.453019627	0.356789012	0	0	0.432526702	0.021702094	2.05249882	0.86415	0.004806879	0	0	0.116923599	0.086663558	0.083184283	0	0.013476749	0	0.00323086	0	0	0	0	0	0	0	0	0	0	0	0	0	20.2421
H3812_007_0	2009	3																					2900											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1739.682487	269.7770134	37.39921	46902.85867	81.25494682	18.68289707	8.26022178	332.0641982	348.1320717	5513.265813	421.6343186	0	0.731422604	1345.852596	5439.665479	4035.593994	1242.868229	240.6196232	0	0	24.01986809	1019.063523	769.983193	0	314.3760437	332.2285714	0	0	20.2	0											"$225 Days 1-13 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$225 Days 1-13 (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$75 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5, 9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											222.3	225	0.139192445	0	75	0.14	0.2	49.97139107	75	4.4	64.79010385	0	0.2	70.28068275	3.249349902	25	20	20	0	0	0.2	13.6791576	0	0	0	0	0	0	0	0											158.3656843	160.2891542	0.139192445	0	53.42971805	0.099735474	0.142479248	35.59943114	53.42971805	3.134543459	46.15622641	0	0.142479248	50.06769419	3.249349902	25	20	20	0	0	0.142479248	13.6791576	0	0	0	0	0	0	0	0											22.9588	3.603527441	5.20568748	0	0.361785742	1.863347589	1.176910189	0.985108047	1.55004987	1.440130941	1.62175409	0	0.104212543	5.615311351	1.472948041	8.407487488	2.071447048	0.401032705	0	0	3.422332746	1.161660878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4236	0	18.0473	22.9588	3.603527441	5.20568748	0	0.361785742	1.863347589	1.176910189	0.985108047	1.55004987	1.440130941	1.62175409	0	0.104212543	5.615311351	1.472948041	8.407487488	2.071447048	0.401032705	0	0	3.422332746	1.161660878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4236		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.3702	0.2191	0.5905	0.4996	0.1286	0.295	0.1304	0.0729	0.5884	0.0925	0.2496	0	0.0077	0.4691	0.635	1.9999	0.1512	0.0687	0	0	0.3793	0.0788	0.0569	0	0.0155	0	0	0	0.003	0											10.1019	0	0	26.329	3.822647441	5.796201322	0.499626215	0.490385921	2.158340701	1.307334743	1.057997176	2.138469221	1.532676488	1.871317856	0	0.111911728	6.084366718	2.107948079	10.40738659	2.222647048	0.469709419	0	0	3.801593822	1.240510363	0.056935837	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	73.5255
H3812_801_0	2009	2																					3575											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	4100	1159.845143	141.7054065	492.0715104	315.1493622	102.3486566	10.15555236	4.942342271	337.5567265	32.8117798	7718.85854	35.50420533	0	0.058372875	18.19834229	4752.125645	3475.427302	571.6606548	215.3216884	0	0	17.54111325	736.4594156	0	0	0	0	0	0	0	0											"$325 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$325 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-24 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											321.1692146	325	150	0	150	0.2	0.069876065	48.68378892	0.3	7	0.261282405	0	0.2	0.297966112	24.75968929	34.83714197	37.5	35	0	0	0.2	32.86356526	0	0	0	0	0	0	0	0											216.5850218	219.1392422	101.1411887	0	101.1411887	0.134854918	0.047115655	32.82624188	0.202282377	4.71992214	0.176176087	0	0.134854918	0.201330662	24.75968929	34.83714197	37.5	23.5996107	0	0	0.134854918	32.86356526	0	0	0	0	0	0	0	0											20.9338	2.587767949	4.147391458	0	0.862638732	1.369526184	0.232861694	0.923393229	6.637244826	3.036034277	6.254991956	0	0.007871869	3.663884305	9.805096205	10.08949619	1.786439546	0.423459002	0	0	2.365505394	2.016890172	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.1443	0	25.8031	20.9338	2.587767949	4.147391458	0	0.862638732	1.369526184	0.232861694	0.923393229	6.637244826	3.036034277	6.254991956	0	0.007871869	3.663884305	9.805096205	10.08949619	1.786439546	0.423459002	0	0	2.365505394	2.016890172	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.1443		"$405 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 40% (13c)"	"$405 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-24 (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 40% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.5414	0.185	1.864	0.1076	0.1368	0.3259	0.1586	0.1465	1.4037	0.4816	1.3229	0	0.0012	0.7735	3.0314	2.8641	0.5062	0.1088	0	0	0.7973	0.5864	0	0	0	0	0	0	0	0											16.3429	0	6.203775014	22.4752	2.772784518	6.011345782	0.107592426	0.999471944	1.695381016	0.391443527	1.069863422	8.040992793	3.517615157	7.577895128	0	0.009120518	4.437402076	12.83649917	12.95359116	2.292597418	0.532210076	0	0	3.162848866	2.603268321	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.4871
H3812_803_0	2009	2																					3575											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	4100	1159.845143	141.7054065	492.0715104	315.1493622	102.3486566	10.15555236	4.942342271	337.5567265	32.8117798	7718.85854	35.50420533	0	0.058372875	18.19834229	4752.125645	3475.427302	571.6606548	215.3216884	0	0	17.54111325	736.4594156	0	0	0	0	0	0	0	0											"$325 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$325 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-24 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											321.1692146	325	150	0	150	0.2	0.069876065	48.68378892	0.3	7	0.261282405	0	0.2	0.297966112	24.75968929	34.83714197	37.5	35	0	0	0.2	32.86356526	0	0	0	0	0	0	0	0											216.5850218	219.1392422	101.1411887	0	101.1411887	0.134854918	0.047115655	32.82624188	0.202282377	4.71992214	0.176176087	0	0.134854918	0.201330662	24.75968929	34.83714197	37.5	23.5996107	0	0	0.134854918	32.86356526	0	0	0	0	0	0	0	0											20.9338	2.587767949	4.147391458	0	0.862638732	1.369526184	0.232861694	0.923393229	6.637244826	3.036034277	6.254991956	0	0.007871869	3.663884305	9.805096205	10.08949619	1.786439546	0.423459002	0	0	2.365505394	2.016890172	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.1443	0	25.8031	20.9338	2.587767949	4.147391458	0	0.862638732	1.369526184	0.232861694	0.923393229	6.637244826	3.036034277	6.254991956	0	0.007871869	3.663884305	9.805096205	10.08949619	1.786439546	0.423459002	0	0	2.365505394	2.016890172	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.1443		"$405 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 40% (13c)"	"$405 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-24 (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 40% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.5414	0.185	1.864	0.1076	0.1368	0.3259	0.1586	0.1465	1.4037	0.4816	1.3229	0	0.0012	0.7735	3.0314	2.8641	0.5062	0.1088	0	0	0.7973	0.5864	0	0	0	0	0	0	0	0											16.3429	0	6.203775014	22.4752	2.772784518	6.011345782	0.107592426	0.999471944	1.695381016	0.391443527	1.069863422	8.040992793	3.517615157	7.577895128	0	0.009120518	4.437402076	12.83649917	12.95359116	2.292597418	0.532210076	0	0	3.162848866	2.603268321	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.4871
H3813_001_0	2009	9	e.2.	i.3.	h.2.	h.2.	f.	i.1.	i.6.	i.6.			DME/Prosthetics/Supplies	Professional	OP Facility - Other	OP Facility - Other	OP Facility - Emergency	Professional	Professional	Professional			1500	Prosthetics/Supplies	Mental Health (MH)	Radiology	Radiology		Routine Physical	Other	Other			A	A	D	v	T	Coin	Coin	V	Coin	P	P	V	Coin	P	V	V	V	V	P	P	Coin	V	T	V	V	P	V	P	O	O	O	V	Coin	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	1500	318.9973943	0	181.2574504	393.9928167	845.6834247	0	15.91774254	140.3015048	28.57503743	10478.06057	6772.901424	0	0.452733577	0	5657.859689	3786.203908	10.37733494	2371.012676	241.445993	759.5857936	17.62	9.927642471	0	0	160.5373477	29.92127596	0	0	94.26075262	0	38.05022813	243.1755489	15.08164645	0	15.91191358	188.9020632	0	4543.888106			$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	$50 ER copay	$400 or 10% copay	$0 copay	X-Ray $10 copay	"$50 ER copay, $20 Primary Care and $30 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"	"$30 O/P Surgery, PCP, specialist, Chiro and Podiatrist visits, $30 inpatient visits"	$20 copay for Group Visits	$20 copay per visit	$20 copay per visit	$20 copay per visit	10% coinsurance	$20 copay per visit	N/A	N/A	"$30 copay, one exam per two years"	N/A	N/A	N/A	N/A	N/A	Equipment $10 copay	$30 copay for Individual Visits	Diagnostic 10% to $100	Radiation Therapy $30 copay	$20 Urgent Care Copay	$0 copay per visit	$30 copay per visit	$0 copay per visit			400	400	24	0	50	0.1	0.1	50	0.1	0	10	0	0.1	0	20	30	20	20	20	20	0.1	20	0	0	30	0	0	0	0	0	10	30	0.1	30	20	0	30	0			182.8574063	182.8574063	10.97144438	0	22.85717579	0.045714352	0.045714352	22.85717579	0.045714352	0	4.571435158	0	0.045714352	0	9.142870316	13.71430547	9.142870316	9.142870316	9.142870316	9.142870316	0.045714352	9.142870316	0	0	13.71430547	0	0	0	0	0	4.571435158	13.71430547	0.045714352	13.71430547	9.142870316	0	13.71430547	0			4.8609	0	0.165721336	0	1.610827892	0	0.727669279	0.267241347	1.306289307	0	2.580156641	0	0.020696422	0	4.31075645	4.327096416	0.007906552	1.806488451	0.183959117	0.578732867	0.805486875	0.007563929	0	0	0.183471519	0	0	0	0	0	0.014495346	0.277915313	0.689447688	0	0.01212338	0	0	0	0	0	24.745	0	36.731	4.8609	0	0.165721336	0	1.610827892	0	0.727669279	0.267241347	1.306289307	0	2.580156641	0	0.020696422	0	4.31075645	4.327096416	0.007906552	1.806488451	0.183959117	0.578732867	0.805486875	0.007563929	0	0	0.183471519	0	0	0	0	0	0.014495346	0.277915313	0.689447688	0	0.01212338	0	0	0	0	0	24.745	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 $30 Specialist copay"	$400 or 10% copay	$0 copay	"O/P Diag 10% to $100, O/P Radiation Therapy $30 O/P X-Ray $10"	"$50 ER copay, $20 Primary Care and $30 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"	"$30 O/P Surgery, PCP, specialist, Chiro and Podiatrist visits, $30 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	"$30 copay, one exam per two years"	N/A	N/A	N/A	N/A	N/A	Equipment $10 copay	$30 copay for Individual Visits	Diagnostic 10% to $100	Radiation Therapy $30 copay	$20 Urgent Care Copay	$0 copay per visit	$30 copay per visit	$0 copay per visit			1.2152	0	0.0414	0	0.4027	0	0.1819	0.0668	0.3266	0	0.645	0	0.0052	0	1.0777	1.0818	0.002	0.4516	0.046	0.1447	0.2014	0.0019	0	0	0.0459	0	0	0	0	0	0.0036	0.0695	0.1724	0	0.003	0	0	0			6.1862	0	9.182756716	6.0761	0	0.20715167	0	2.013534865	0	0.909586599	0.334051683	1.632861634	0	3.225195801	0	0.025870527	0	5.388445562	5.408870519	0.00988319	2.258110564	0.229948896	0.723416084	1.006858594	0.009454911	0	0	0.229339399	0	0	0	0	0	0.018119182	0.347394142	0.86180961	0	0.015154225	0	0	0	0	0	30.9312
H3813_002_0	2009	10	e.2.	i.3.	h.2.	h.2.	f.	i.1.	i.6.	i.6.			DME/Prosthetics/Supplies	Professional	OP Facility - Other	OP Facility - Other	OP Facility - Emergency	Professional	Professional	Professional			1500	Prosthetics/Supplies	Mental Health (MH)	Radiology	Radiology	0	Routine Physical	Other	Other			A	A	D	v	T	Coin	Coin	V	Coin	P	P	V	Coin	P	V	V	V	V	P	P	Coin	V	T	V	V	P	V	P	O	O	O	V	Coin	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	1500	318.4137486	0	344.0414705	4768.387024	1021.708924	0	22.92468874	144.8599635	32.5044215	10913.2591	5100.764259	0	0.388164432	0	5917.458249	3773.061202	8.897312968	2511.744092	208.5697826	546.9438559	22.83717448	7.490509505	0	0	140.813542	18.98868536	0	0	119.362084	0	32.62348088	259.9396289	16.91268371	0	13.64254655	169.8097667	0	5873.215641			$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	$50 ER copay	$400 or 10% copay	$0 copay	X-Ray $10 copay	"$50 ER copay, $20 Primary Care and $30 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"	"$30 O/P Surgery, PCP, specialist, Chiro and Podiatrist visits, $30 inpatient visits"	$20 copay for Group Visits	$20 copay per visit	$20 copay per visit	$20 copay per visit	10% coinsurance	$20 copay per visit	N/A	N/A	"$30 copay, one exam per two years"	N/A	N/A	N/A	N/A	N/A	Equipment $10 copay	$30 copay for Individual Visits	Diagnostic 10% to $100	Radiation Therapy $30 copay	$20 Urgent Care Copay	$0 copay per visit	$30 copay per visit	$0 copay per visit			400	400	24	0	50	0.1	0.1	50	0.1	0	10	0	0.1	0	20	30	20	20	20	20	0.1	20	0	0	30	0	0	0	0	0	10	30	0.1	30	20	0	30	0			182.2119746	182.2119746	10.93271848	0	22.77649682	0.045552994	0.045552994	22.77649682	0.045552994	0	4.555299365	0	0.045552994	0	9.11059873	13.66589809	9.11059873	9.11059873	9.11059873	9.11059873	0.045552994	9.11059873	0	0	13.66589809	0	0	0	0	0	4.555299365	13.66589809	0.045552994	13.66589809	9.11059873	0	13.66589809	0			4.8349	0	0.313442378	0	1.939245839	0	1.0442882	0.274950208	1.480673706	0	1.936292349	0	0.017682052	0	4.492632301	4.296855825	0.006754987	1.906957711	0.158349633	0.415248833	1.040301664	0.005686919	0	0	0.16036196	0	0	0	0	0	0.012384143	0.296025707	0.770423374	0	0.010357647	0	0	0	0	0	25.4138	0	37.97	4.8349	0	0.313442378	0	1.939245839	0	1.0442882	0.274950208	1.480673706	0	1.936292349	0	0.017682052	0	4.492632301	4.296855825	0.006754987	1.906957711	0.158349633	0.415248833	1.040301664	0.005686919	0	0	0.16036196	0	0	0	0	0	0.012384143	0.296025707	0.770423374	0	0.010357647	0	0	0	0	0	25.4138	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 $30 Specialist copay"	$400 or 10% copay	$0 copay	"O/P Diag 10% to $100, O/P Radiation Therapy $30 O/P X-Ray $10"	"$50 ER copay, $20 Primary Care and $30 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"	"$30 O/P Surgery, PCP, specialist, Chiro and Podiatrist visits, $30 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	"$30 copay, one exam per two years"	N/A	N/A	N/A	N/A	N/A	Equipment $10 copay	$30 copay for Individual Visits	Diagnostic 10% to $100	Radiation Therapy $30 copay	$20 Urgent Care Copay	$0 copay per visit	$30 copay per visit	$0 copay per visit			1.2087	0	0.0784	0	0.4848	0	0.2611	0.0687	0.3702	0	0.4841	0	0.0044	0	1.1232	1.0742	0.0017	0.4767	0.0396	0.1038	0.2601	0.0014	0	0	0.0401	0	0	0	0	0	0.0031	0.074	0.1926	0	0.0026	0	0	0			6.3535	0	9.492495263	6.0436	0	0.391802973	0	2.424057299	0	1.305360251	0.34368776	1.850842133	0	2.420365436	0	0.022102565	0	5.615790376	5.371069781	0.008443734	2.383697139	0.197937041	0.519061042	1.30037708	0.007108649	0	0	0.20045245	0	0	0	0	0	0.015480179	0.370032133	0.963029217	0	0.012947059	0	0	0	0	0	31.7673
H3813_003_0	2009	9	e.2.	i.3.	h.2.	h.2.	f.	i.1.	i.6.	i.6.			DME/Prosthetics/Supplies	Professional	OP Facility - Other	OP Facility - Other	OP Facility - Emergency	Professional	Professional	Professional			1500	Prosthetics/Supplies	Mental Health (MH)	Radiology	Radiology	0	Routine Physical	Other	Other			A	A	D	v	T	Coin	Coin	V	Coin	P	P	V	Coin	P	V	V	V	V	P	P	Coin	V	T	V	V	P	V	P	O	O	O	V	Coin	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	1500	303.9234382	0	295.6902297	2706.760073	928.6076843	0	13.53413459	187.1160612	24.2960584	10931.75968	5745.223251	0	0.384938828	0	6018.82327	4019.393711	8.823377275	2540.483975	377.3121061	530.7292179	14.38544069	7.404565925	0	0	140.9998235	14.16915517	0	0	70.39640868	0	32.35238334	413.7959004	17.43259251	0	16.57380731	195.5633429	0	5262.923719			$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	$50 ER copay	$400 or 10% copay	$0 copay	X-Ray $10 copay	"$50 ER copay, $20 Primary Care and $30 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"	"$30 O/P Surgery, PCP, specialist, Chiro and Podiatrist visits, $30 inpatient visits"	$20 copay for Group Visits	$20 copay per visit	$20 copay per visit	$20 copay per visit	10% coinsurance	$20 copay per visit	N/A	N/A	"$30 copay, one exam per two years"	N/A	N/A	N/A	N/A	N/A	Equipment $10 copay	$30 copay for Individual Visits	Diagnostic 10% to $100	Radiation Therapy $30 copay	$20 Urgent Care Copay	$0 copay per visit	$30 copay per visit	$0 copay per visit			400	400	24	0	50	0.1	0.1	50	0.1	0	10	0	0.1	0	20	30	20	20	20	20	0.1	20	0	0	30	0	20	0	0	0	10	30	0.1	30	20	0	30	0			201.0973067	201.0973067	12.0658384	0	25.13716334	0.050274327	0.050274327	25.13716334	0.050274327	0	5.027432668	0	0.050274327	0	10.05486534	15.08229801	10.05486534	10.05486534	10.05486534	10.05486534	0.050274327	10.05486534	0	0	15.08229801	0	10.05486534	0	0	0	5.027432668	15.08229801	0.050274327	15.08229801	10.05486534	0	15.08229801	0			5.0932	0	0.297312544	0	1.945213587	0	0.680419504	0.391963916	1.221467977	0	2.406976922	0	0.01935254	0	5.043204789	5.051807813	0.007393156	2.128685355	0.316151868	0.444700901	0.723218345	0.006204326	0	0	0.17721678	0	0	0	0	0	0.013554119	0.520082757	0.876411851	0	0.013887283	0	0	0	0	0	27.3784	0	33.8508	5.0932	0	0.297312544	0	1.945213587	0	0.680419504	0.391963916	1.221467977	0	2.406976922	0	0.01935254	0	5.043204789	5.051807813	0.007393156	2.128685355	0.316151868	0.444700901	0.723218345	0.006204326	0	0	0.17721678	0	0	0	0	0	0.013554119	0.520082757	0.876411851	0	0.013887283	0	0	0	0	0	27.3784	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 $30 Specialist copay"	$400 or 10% copay	$0 copay	"O/P Diag 10% to $100, O/P Radiation Therapy $30 O/P X-Ray $10"	"$50 ER copay, $20 Primary Care and $30 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"	"$30 O/P Surgery, PCP, specialist, Chiro and Podiatrist visits, $30 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	N/A	N/A	N/A	N/A	Equipment $10 copay	$30 copay for Individual Visits	Diagnostic 10% to $100	Radiation Therapy $30 copay	$20 Urgent Care Copay	$0 copay per visit	$30 copay per visit	$0 copay per visit			1.2733	0	0.0743	0	0.4863	0	0.1701	0.098	0.3054	0	0.6017	0	0.0048	0	1.2608	1.263	0.0018	0.5322	0.079	0.1112	0.1808	0.0016	0	0	0.0443	0	0	0	0	0	0.0034	0.13	0.2191	0	0.0035	0	0	0			6.8446	0	8.462688027	6.3665	0	0.37164068	0	2.431516983	0	0.85052438	0.489954895	1.526834972	0	3.008721152	0	0.024190676	0	6.304005987	6.314759766	0.009241445	2.660856694	0.395189835	0.555876127	0.904022931	0.007755408	0	0	0.221520975	0	0	0	0	0	0.016942649	0.650103446	1.095514814	0	0.017359104	0	0	0	0	0	34.223
H3813_801_0	2009	3	e.2.	i.3.	h.2.	h.2.	f.						DME/Prosthetics/Supplies	Professional	OP Facility - Other	OP Facility - Other	OP Facility - Emergency						1500	Prosthetics/Supplies	Mental Health (MH)	Radiology	Radiology	0						A	A	D	v	T	Coin	Coin	V	Coin	P	P	V	Coin	P	V	V	V	V	P	P	Coin	V	T	V	V	P	V	P	O	O	O	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	0	0	0						0	1500	259.7074468	0	209.0425532	454.3882979	892.0212766	0	0	134.0425532	0	10466.8883	5808.510638	0	0	0	5996.808511	3783.510638	11.96808511	2380.452128	278.4574468	595.212766	0.005285073	7.978723404	0	4823.93617	174.7340426	17.15425532	47.07446809	1.196808511	91.35638298	0	43.88297872	280.4521277	1.279406998	0	18.35106383						$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	$50 ER copay	$400 or 10% copay	$0 copay	X-Ray $10 copay	"$50 ER copay, $20 Primary Care and $30 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"	"$30 O/P Surgery, PCP, specialist, Chiro and Podiatrist visits, $30 inpatient visits"	$20 copay for Group Visits	$20 copay per visit	$20 copay per visit	$20 copay per visit	10% coinsurance	$20 copay per visit	N/A	N/A	"$30 copay, one exam per two years"	N/A	$20 copay per visit	N/A	N/A	N/A	Equipment $10 copay	$30 copay for Individual Visits	Diagnostic 10% to $100	Radiation Therapy $30 copay	$20 Urgent Care Copay						400	400	24	0	50	0.1	0.1	50	0.1	0	10	0	0.1	0	20	30	20	20	20	20	0.1	20	0	0	30	0	20	0	0	0	10	30	0.1	30	20						185.5230393	185.5230393	11.13138236	0	23.19037992	0.04638076	0.04638076	23.19037992	0.04638076	0	4.638075983	0	0.04638076	0	9.276151966	13.91422795	9.276151966	9.276151966	9.276151966	9.276151966	0.04638076	9.276151966	0	0	13.91422795	0	9.276151966	0	0	0	4.638075983	13.91422795	0.04638076	13.91422795	9.276151966						4.0151	0	0.193911049	0	1.723859358	0	0	0.259041478	0	0	2.245026141	0	0	0	4.635608921	4.387052456	0.009251481	1.84011964	0.215251133	0.460107006	0.000245126	0.006167654	0	0	0.202607442	0	0.03638916	0	0	0	0.016961049	0.325189569	0.059339869	0	0.014185605	0	0	0	0	0	20.6455	0	29.8324	4.0151	0	0.193911049	0	1.723859358	0	0	0.259041478	0	0	2.245026141	0	0	0	4.635608921	4.387052456	0.009251481	1.84011964	0.215251133	0.460107006	0.000245126	0.006167654	0	0	0.202607442	0	0.03638916	0	0	0	0.016961049	0.325189569	0.059339869	0	0.014185605	0	0	0	0	0	20.6455	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 $30 Specialist copay"	$400 or 10% copay	$0 copay	"O/P Diag 10% to $100, O/P Radiation Therapy $30 O/P X-Ray $10"	"$50 ER copay, $20 Primary Care and $30 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"	"$30 O/P Surgery, PCP, specialist, Chiro and Podiatrist visits, $30 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	Equipment $10 copay	$30 copay for Individual Visits	Diagnostic 10% to $100	Radiation Therapy $30 copay	$20 Urgent Care Copay						1.0038	0	0.0485	0	0.431	0	0	0.0648	0	0	0.5613	0	0	0	1.1589	1.0968	0.0023	0.46	0.0538	0.115	0.0001	0.0015	0	0	0.0507	0	0.0091	0	0	0	0.0042	0.0813	0.0148	0	0.0035						5.1614	0	7.458101187	5.0189	0	0.242388811	0	2.154824198	0	0	0.323801847	0	0	2.806282676	0	0	0	5.794511152	5.48381557	0.011564352	2.30014955	0.269063916	0.575133757	0.000306407	0.007709568	0	0	0.253259302	0	0.04548645	0	0	0	0.021201311	0.406486962	0.074174836	0	0.017732006	0	0	0	0	0	25.8068
H3813_802_0	2009	3	e.2.	i.3.	h.2.	h.2.	f.						DME/Prosthetics/Supplies	Professional	OP Facility - Other	OP Facility - Other	OP Facility - Emergency						1500	Prosthetics/Supplies	Mental Health (MH)	Radiology	Radiology	0						A	A	D	v	T	Coin	Coin	V	Coin	P	P	V	Coin	P	V	V	V	V	P	P	Coin	V	T	V	V	P	V	P	O	O	O	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	0	0	0						0	1500	259.7074468	0	209.0425532	454.3882979	892.0212766	0	0	134.0425532	0	10466.8883	5808.510638	0	0	0	5996.808511	3783.510638	11.96808511	2380.452128	278.4574468	595.212766	0.005285073	7.978723404	0	4823.93617	174.7340426	17.15425532	47.07446809	1.196808511	91.35638298	0	43.88297872	280.4521277	1.279406998	0	18.35106383						$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	$50 ER copay	$400 or 10% copay	$0 copay	X-Ray $10 copay	"$50 ER copay, $20 Primary Care and $30 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"	"$30 O/P Surgery, PCP, specialist, Chiro and Podiatrist visits, $30 inpatient visits"	$20 copay for Group Visits	$20 copay per visit	$20 copay per visit	$20 copay per visit	10% coinsurance	$20 copay per visit	N/A	N/A	"$30 copay, one exam per two years"	N/A	$20 copay per visit	N/A	N/A	N/A	Equipment $10 copay	$30 copay for Individual Visits	Diagnostic 10% to $100	Radiation Therapy $30 copay	$20 Urgent Care Copay						400	400	24	0	50	0.1	0.1	50	0.1	0	10	0	0.1	0	20	30	20	20	20	20	0.1	20	0	0	30	0	20	0	0	0	10	30	0.1	30	20						185.5230393	185.5230393	11.13138236	0	23.19037992	0.04638076	0.04638076	23.19037992	0.04638076	0	4.638075983	0	0.04638076	0	9.276151966	13.91422795	9.276151966	9.276151966	9.276151966	9.276151966	0.04638076	9.276151966	0	0	13.91422795	0	9.276151966	0	0	0	4.638075983	13.91422795	0.04638076	13.91422795	9.276151966						4.0151	0	0.193911049	0	1.723859358	0	0	0.259041478	0	0	2.245026141	0	0	0	4.635608921	4.387052456	0.009251481	1.84011964	0.215251133	0.460107006	0.000245126	0.006167654	0	0	0.202607442	0	0.03638916	0	0	0	0.016961049	0.325189569	0.059339869	0	0.014185605	0	0	0	0	0	20.6455	0	29.8324	4.0151	0	0.193911049	0	1.723859358	0	0	0.259041478	0	0	2.245026141	0	0	0	4.635608921	4.387052456	0.009251481	1.84011964	0.215251133	0.460107006	0.000245126	0.006167654	0	0	0.202607442	0	0.03638916	0	0	0	0.016961049	0.325189569	0.059339869	0	0.014185605	0	0	0	0	0	20.6455	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 $30 Specialist copay"	$400 or 10% copay	$0 copay	"O/P Diag 10% to $100, O/P Radiation Therapy $30 O/P X-Ray $10"	"$50 ER copay, $20 Primary Care and $30 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"	"$30 O/P Surgery, PCP, specialist, Chiro and Podiatrist visits, $30 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	Equipment $10 copay	$30 copay for Individual Visits	Diagnostic 10% to $100	Radiation Therapy $30 copay	$20 Urgent Care Copay						1.0038	0	0.0485	0	0.431	0	0	0.0648	0	0	0.5613	0	0	0	1.1589	1.0968	0.0023	0.46	0.0538	0.115	0.0001	0.0015	0	0	0.0507	0	0.0091	0	0	0	0.0042	0.0813	0.0148	0	0.0035						5.1614	0	7.458101187	5.0189	0	0.242388811	0	2.154824198	0	0	0.323801847	0	0	2.806282676	0	0	0	5.794511152	5.48381557	0.011564352	2.30014955	0.269063916	0.575133757	0.000306407	0.007709568	0	0	0.253259302	0	0.04548645	0	0	0	0.021201311	0.406486962	0.074174836	0	0.017732006	0	0	0	0	0	25.8068
H3814_004_0	2009	8																					2000											D	D	D	V	T	Coin	Coin	V	V		Coin			V	V	V		V			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		929.8543837	103.3171537	1199.342244	0	273.4042364	9.997143842	16.2504237	474.5781681	65.89046698		10.9172302			31.4832649	1482.743769	4902.679676		561.2416932			14.22252503			300	7.469167565		20.26417635			630											$150 (1-5)	$150 (1-5)	$15 (1-100)		$50 waived	15% Coins	15% Coins Prosth and $0 copay Supplies	$50 waived - WW	$150 ASC/OPV		$0 lab/ 0% diag & ther ad/15% MRI&CT&PET			$150 ASC/OPV	$15 PCP / $20 Specialist	$15 PCP / $20 Specialist		$20 OT/PT/ST			15% Part B Rx & Chemo Rx			$20 Copay to $200 Max Benefit	$20 routine copay/ $150 2 yr. hardware limit		$20 routine & Fitting copay/ $150 2 yr. aids limit			$20 Chiro to $200 and Podiatry to $200											150	150	15	0	50	0.15	0.15	50	150		0.15			150	15	20		20			0.15			20	20		20			20											144	144	14.4	0	48	0.144	0.144	48	144		0.144			144	14.4	19.2		19.2			0.144			19.2	19.2		19.2			19.2											11.1583	1.239805845	1.439210692	0	1.093616946	1.439588713	2.340061013	1.898312672	0.790685604	0	1.572081149	0	0	0.377799179	1.779292522	7.844287482	0	0.897986709	0	0	2.048043604	0	0	0.48	0.011950668	0	0.032422682	0	0	1.008	0	0	0	0	0	0	0	0	0	0	37.4514		1.5605	11.1583	1.239805845	1.439210692	0	1.093616946	1.439588713	2.340061013	1.898312672	0.790685604	0	1.572081149	0	0	0.377799179	1.779292522	7.844287482	0	0.897986709	0	0	2.048043604	0	0	0.48	0.011950668	0	0.032422682	0	0	1.008	0	0	0	0	0	0	0	0	0	0	37.4514																																																																																		0			11.1583	1.239805845	1.439210692	0	1.093616946	1.439588713	2.340061013	1.898312672	0.790685604	0	1.572081149	0	0	0.377799179	1.779292522	7.844287482	0	0.897986709	0	0	2.048043604	0	0	0.48	0.011950668	0	0.032422682	0	0	1.008	0	0	0	0	0	0	0	0	0	0	37.4514
H3814_005_0	2009	6																					1200											D	D	D	V	T	Coin	Coin	V	V		Coin			V	V	V		V			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		1113.655422	123.7394913	1442.150463	0	327.1196409	12.02198789	19.44312508	567.8179752	80.44478419		13.06212541			37.66874443	1809.850495	5984.255289		685.0567023			17.01680757			550	9.026894965		24.49035851			750											$100 (1-5)	$100 (1-5)	$10 (1-100)		$50 waived	10% Coins	10% Coins Prosth and $0 copay Supplies	$50 waived - WW	$100 ASC/OPV		$0 lab/ 0% diag & ther ad/10% MRI&CT&PET			$100 ASC/OPV	$10 PCP / $15 Specialist	$10 PCP / $15 Specialist		$15 OT/PT/ST			10% Part B Rx & Chemo Rx			$15 Copay to $500 Max Benefit	$15 routine copay/ $200 2 yr. hardware limit		$15 routine & Fitting copay/ $250 2 yr. aids limit			$15 Chiro to $500 and Podiatry to $500											100	100	10	0	50	0.1	0.1	50	100		0.1			100	10	15		15			0.1			15	15		15			15											94	94	9.4	0	47	0.094	0.094	47	94		0.094			94	9.4	14.1		14.1			0.094			14.1	14.1		14.1			14.1											8.7236	0.969292682	1.129684529	0	1.281218594	1.130066862	1.827653757	2.223953736	0.630150809	0	1.227839789	0	0	0.295071831	1.417716221	7.031499964	0	0.804941625	0	0	1.599579911	0	0	0.64625	0.010606602	0	0.028776171	0	0	0.88125	0	0	0	0	0	0	0	0	0	0	31.8592		2.0336	8.7236	0.969292682	1.129684529	0	1.281218594	1.130066862	1.827653757	2.223953736	0.630150809	0	1.227839789	0	0	0.295071831	1.417716221	7.031499964	0	0.804941625	0	0	1.599579911	0	0	0.64625	0.010606602	0	0.028776171	0	0	0.88125	0	0	0	0	0	0	0	0	0	0	31.8592																																																																																		0			8.7236	0.969292682	1.129684529	0	1.281218594	1.130066862	1.827653757	2.223953736	0.630150809	0	1.227839789	0	0	0.295071831	1.417716221	7.031499964	0	0.804941625	0	0	1.599579911	0	0	0.64625	0.010606602	0	0.028776171	0	0	0.88125	0	0	0	0	0	0	0	0	0	0	31.8592
H3814_006_0	2009	9																					1200											D	D	D		T	Coin	Coin	V	V		Coin			V	V	V		V			Coin			V	V		V			V											0	0	0		0	0	0	0	0		0			0	0	0		0			0			0	0		0			0											0		1113.655422	123.7394913	1442.150463		327.1196409	12.02198789	19.44312508	567.8179752	80.44478419		13.06212541			37.66874443	1809.850495	5984.255289		685.0567023			17.01680757			550	9.026894965		24.49035851			750											$100 (1-5)	$100 (1-5)	$10 (1-100)		$50 waived	10% Coins	10% Coins Prosth and $0 copay Supplies	$50 waived - WW	$100 ASC/OPV		$0 lab/ 0% diag & ther ad/10% MRI&CT&PET			$100 ASC/OPV	$10 PCP / $15 Specialist	$10 PCP / $15 Specialist		$15 OT/PT/ST			10% Part B Rx & Chemo Rx			$15 Copay to $500 Max Benefit	$15 routine copay/ $200 2 yr. hardware limit		$15 routine & Fitting copay/ $250 2 yr. aids limit			$15 Chiro to $500 and Podiatry to $500											100	100	10		50	0.1	0.1	50	100		0.1			100	10	15		15			0.1			15	15		15			15											94	94	9.4		47	0.094	0.094	47	94		0.094			94	9.4	14.1		14.1			0.094			14.1	14.1		14.1			14.1											8.7236	0.969292682	1.129684529	0	1.281218594	1.130066862	1.827653757	2.223953736	0.630150809	0	1.227839789	0	0	0.295071831	1.417716221	7.031499964	0	0.804941625	0	0	1.599579911	0	0	0.64625	0.010606602	0	0.028776171	0	0	0.88125	0	0	0	0	0	0	0	0	0	0	31.8592		2.0336	8.7236	0.969292682	1.129684529	0	1.281218594	1.130066862	1.827653757	2.223953736	0.630150809	0	1.227839789	0	0	0.295071831	1.417716221	7.031499964	0	0.804941625	0	0	1.599579911	0	0	0.64625	0.010606602	0	0.028776171	0	0	0.88125	0	0	0	0	0	0	0	0	0	0	31.8592																																																																																		0			8.7236	0.969292682	1.129684529	0	1.281218594	1.130066862	1.827653757	2.223953736	0.630150809	0	1.227839789	0	0	0.295071831	1.417716221	7.031499964	0	0.804941625	0	0	1.599579911	0	0	0.64625	0.010606602	0	0.028776171	0	0	0.88125	0	0	0	0	0	0	0	0	0	0	31.8592
H3814_007_0	2009	9																																Coin	Coin	Coin	V	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		387.0661424	43.00734915	59.28602175	29.93187975	28.31894543	17.30921869	28.24135681	35.29284643	13.81040024	0	37.80312133	0	0	33.90266276					0	131.0958238	20.16650036	0																			Medicare	Medicare	Medicare	Medicare	Medicare	Medicare	Medicare Prosth and Medicare Supplies	Medicare	"Prof ASC 10%, Other Medicare"	Medicare	Medicare	"Prof ASC 10%, Other Medicare"	Medicare	"Prof ASC 10%, Other Medicare"					Medicare	Medicare	Medicare	"Prof ASC 10%, Other Medicare"																			0.0744	0.0744	0.1306	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.17598					0.231	0.231	0.231	0.231																			0.0744	0.0744	0.1306	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.17598					0.231	0.231	0.231	0.231																			28.7977	3.199746777	7.742754441	0	6.541676393	3.998429517	6.523753422	8.152647524	3.190202455	0	8.732521027	0	0	5.966190592	0	0	0	0	0	30.2831353	4.658461582	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.7872		0	28.7977	3.199746777	7.742754441	0	6.541676393	3.998429517	6.523753422	8.152647524	3.190202455	0	8.732521027	0	0	5.966190592	0	0	0	0	0	30.2831353	4.658461582	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.7872																																																																																		0			28.7977	3.199746777	7.742754441	0	6.541676393	3.998429517	6.523753422	8.152647524	3.190202455	0	8.732521027	0	0	5.966190592	0	0	0	0	0	30.2831353	4.658461582	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.7872
H3814_008_0	2009	9																					1200											D	D	D		T	Coin	Coin	V	V		Coin			V	V	V		V			Coin			V	V		V			V											0	0	0		0	0	0	0	0		0			0	0	0		0			0			0	0		0			0											0		1113.655422	123.7394913	1442.150463		327.1196409	12.02198789	19.44312508	567.8179752	80.44478419		13.06212541			37.66874443	1809.850495	5984.255289		685.0567023			17.01680757			550	9.026894965		24.49035851			750											$100 (1-5)	$100 (1-5)	$10 (1-100)		$50 waived	10% Coins	10% Coins Prosth and $0 copay Supplies	$50 waived - WW	$100 ASC/OPV		$0 lab/ 0% diag & ther ad/10% MRI&CT&PET			$100 ASC/OPV	$10 PCP / $15 Specialist	$10 PCP / $15 Specialist		$15 OT/PT/ST			10% Part B Rx & Chemo Rx			$15 Copay to $500 Max Benefit	$15 routine copay/ $200 2 yr. hardware limit		$15 routine & Fitting copay/ $250 2 yr. aids limit			$15 Chiro to $500 and Podiatry to $500											100	100	10		50	0.1	0.1	50	100		0.1			100	10	15		15			0.1			15	15		15			15											94	94	9.4		47	0.094	0.094	47	94		0.094			94	9.4	14.1		14.1			0.094			14.1	14.1		14.1			14.1											8.7236	0.969292682	1.129684529	0	1.281218594	1.130066862	1.827653757	2.223953736	0.630150809	0	1.227839789	0	0	0.295071831	1.417716221	7.031499964	0	0.804941625	0	0	1.599579911	0	0	0.64625	0.010606602	0	0.028776171	0	0	0.88125	0	0	0	0	0	0	0	0	0	0	31.8592		2.0336	8.7236	0.969292682	1.129684529	0	1.281218594	1.130066862	1.827653757	2.223953736	0.630150809	0	1.227839789	0	0	0.295071831	1.417716221	7.031499964	0	0.804941625	0	0	1.599579911	0	0	0.64625	0.010606602	0	0.028776171	0	0	0.88125	0	0	0	0	0	0	0	0	0	0	31.8592																																																																																		0			8.7236	0.969292682	1.129684529	0	1.281218594	1.130066862	1.827653757	2.223953736	0.630150809	0	1.227839789	0	0	0.295071831	1.417716221	7.031499964	0	0.804941625	0	0	1.599579911	0	0	0.64625	0.010606602	0	0.028776171	0	0	0.88125	0	0	0	0	0	0	0	0	0	0	31.8592
H3814_011_0	2009	5																					3000											D	D	D		T	Coin	Coin	V	V		Coin			V	V	V		V	Coin		Coin	V			V		V														0	0	0		0	0	0	0	0		0			0	0	0		0	0		0	0			0		0														0		1169.854791	129.9838657	1199.342244		273.4042364	11.18738986	18.46639057	474.5781681	65.89046698		29.36559718			31.4832649	1460.465732	4829.017536		552.809108	0		14.22252503	0			7.393721428		20.0594877														$165 (1-10)	$165 (1-10)	$25 (1-100)		$150 waived	25% Coins	25% Coins Prosth and 25% Coins Supplies	$50 waived - WW	$200 Copay		$0 lab/ 25% diag & ther ad			$200 Copay	$20 PCP / $25 Specialist	$20 PCP / $25 Specialist		$25 OT/PT/ST	$0 lab/ 25% diag & ther ad		25% Part B Rx & Chemo Rx	$200 Copay			$25 routine copay/ $100 2 yr. hardware limit		$25 routine & Fitting copay/ $100 2 yr. aids limit														165	165	25		150	0.25	0.25	50	200		0.25			200	20	25		25	0.25		0.25	200			25		25														162.525	162.525	24.625		147.75	0.24625	0.24625	49.25	197		0.24625			197	19.7	24.625		24.625	0.24625		0.24625	197			24.625		24.625														15.8442	1.760468981	2.461150229	0	3.366289661	2.754894752	4.547348677	1.947747898	1.081701833	0	7.231278305	0	0	0.516850265	2.397597909	9.909546402	0	1.134410357	0	0	3.502296788	0	0	0	0.015172533	0	0.04116374	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5121		0.891	15.8442	1.760468981	2.461150229	0	3.366289661	2.754894752	4.547348677	1.947747898	1.081701833	0	7.231278305	0	0	0.516850265	2.397597909	9.909546402	0	1.134410357	0	0	3.502296788	0	0	0	0.015172533	0	0.04116374	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5121																																																																																		0			15.8442	1.760468981	2.461150229	0	3.366289661	2.754894752	4.547348677	1.947747898	1.081701833	0	7.231278305	0	0	0.516850265	2.397597909	9.909546402	0	1.134410357	0	0	3.502296788	0	0	0	0.015172533	0	0.04116374	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5121
H3814_012_0	2009	8																					3000											D	D	D		T	Coin	Coin	V	V		Coin			V	V	V		V	Coin		Coin	V			V		V														0	0	0		0	0	0	0	0		0			0	0	0		0	0		0	0			0		0														0		1169.854791	129.9838657	1199.342244		273.4042364	11.18738986	18.46639057	474.5781681	65.89046698		29.36559718			31.4832649	1460.465732	4829.017536		552.809108	0		14.22252503	0			7.393721428		20.0594877														$165 (1-10)	$165 (1-10)	$25 (1-100)		$150 waived	25% Coins	25% Coins Prosth and 25% Coins Supplies	$50 waived - WW	$200 Copay		$0 lab/ 25% diag & ther ad			$200 Copay	$20 PCP / $25 Specialist	$20 PCP / $25 Specialist		$25 OT/PT/ST	$0 lab/ 25% diag & ther ad		25% Part B Rx & Chemo Rx	$200 Copay			$25 routine copay/ $100 2 yr. hardware limit		$25 routine & Fitting copay/ $100 2 yr. aids limit														165	165	25		150	0.25	0.25	50	200		0.25			200	20	25		25	0.25		0.25	200			25		25														162.525	162.525	24.625		147.75	0.24625	0.24625	49.25	197		0.24625			197	19.7	24.625		24.625	0.24625		0.24625	197			24.625		24.625														15.8442	1.760468981	2.461150229	0	3.366289661	2.754894752	4.547348677	1.947747898	1.081701833	0	7.231278305	0	0	0.516850265	2.397597909	9.909546402	0	1.134410357	0	0	3.502296788	0	0	0	0.015172533	0	0.04116374	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5121		0.891	15.8442	1.760468981	2.461150229	0	3.366289661	2.754894752	4.547348677	1.947747898	1.081701833	0	7.231278305	0	0	0.516850265	2.397597909	9.909546402	0	1.134410357	0	0	3.502296788	0	0	0	0.015172533	0	0.04116374	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5121																																																																																		0			15.8442	1.760468981	2.461150229	0	3.366289661	2.754894752	4.547348677	1.947747898	1.081701833	0	7.231278305	0	0	0.516850265	2.397597909	9.909546402	0	1.134410357	0	0	3.502296788	0	0	0	0.015172533	0	0.04116374	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5121
H3814_015_0	2009	8																					1200											D	D	D		T	Coin	Coin	V	V					V	V	V		V			Coin			V	V		V			V											0	0	0		0	0	0	0	0					0	0	0		0			0			0	0		0			0											0	2500	785.0949785	87.23277539	1363.226806		310.7636588	11.42088849	18.47096882	539.4270764	76.80465771					35.78530721	1727.869643	5713.186299		654.0256685			16.16596719			522.5	8.661305719		23.49849899			807.267069											$100 (1-3)	$100 (1-3)	$10 (1-100)		$50 waived	10% Coins	10% Coins Prosth and $0 copay Supplies	$50 waived - WW	$50 copay					$50 copay	$10 PCP / $10 Specialist	$10 PCP / $10 Specialist		$10 OT/PT/ST			10% Part B Rx & Chemo Rx			$10 copay	$10 for Medicare Covered/$200 Hardware Limit		$10 for Medicare Covered/$300 Aids Limit			$10 Chiro to $600 and Podiatry to $600											100	100	10		50	0.1	0.1	50	50					50	10	10		10			0.1			10	10		10			10											94	94	9.4		47	0.094	0.094	47	47					47	9.4	9.4		9.4			0.094			9.4	9.4		9.4			9.4											6.1499	0.683323407	1.067860998	0	1.217157664	1.073563518	1.736271069	2.112756049	0.300818243	0	0	0	0	0.14015912	1.353497887	4.475329268	0	0.512320107	0	0	1.519600916	0	0	0.409291667	0.006784689	0	0.018407158	0	0	0.632359204	0	0	0	0	0	0	0	0	0	0	23.4094		1.4942	6.1499	0.683323407	1.067860998	0	1.217157664	1.073563518	1.736271069	2.112756049	0.300818243	0	0	0	0	0.14015912	1.353497887	4.475329268	0	0.512320107	0	0	1.519600916	0	0	0.409291667	0.006784689	0	0.018407158	0	0	0.632359204	0	0	0	0	0	0	0	0	0	0	23.4094		$200 (1-5)	$200 (1-5)	$25 (1-100)	0	$50 Waived	25% DME/Prosthetics	25% DME/Prosthetics	$50 Copay- waived	$200 OP Surg/Visits	0	0	0	0	$200 OP Surg/Visits	$20 PCP/Spec	$20 PCP/Spec	$20 PCP/Spec	$20 PCP/Spec	0	0	0	0	0	0	$20 Copay	0	$20 Copay	0	0	$20 Copay											0.9002	0.1	0.145	0	0.0661	0.1458	0.2357	0.1147	0.0654	0	0	0	0	0.0304	0.147	0.4861	0	0.0556	0	0	0	0	0	0	0.0007	0	0.002	0	0	0											2.4949		0.07716232	7.0501	0.783346163	1.212853322	0	1.283263091	1.219330122	1.972018961	2.227502599	0.366169574	0	0	0	0	0.170608022	1.500518375	4.96145126	0	0.567969659	0	0	1.519600916	0	0	0.409291667	0.00752166	0	0.020406591	0	0	0.632359204	0	0	0	0	0	0	0	0	0	0	25.9043
H3814_016_0	2009	9																					1200											D	D	D		T	Coin	Coin	V	V					V	V	V		V			Coin			V	V		V			V											0	0	0		0	0	0	0	0					0	0	0		0			0			0	0		0			0											0	2500	785.0949785	87.23277539	1363.226806		310.7636588	11.42088849	18.47096882	539.4270764	76.80465771					35.78530721	1727.869643	5713.186299		654.0256685			16.16596719			522.5	8.661305719		23.49849899			807.267069											$100 (1-3)	$100 (1-3)	$10 (1-100)		$50 waived	10% Coins	10% Coins Prosth and $0 copay Supplies	$50 waived - WW	$50 copay					$50 copay	$10 PCP / $10 Specialist	$10 PCP / $10 Specialist		$10 OT/PT/ST			10% Part B Rx & Chemo Rx			$10 copay	$10 for Medicare Covered/$200 Hardware Limit		$10 for Medicare Covered/$300 Aids Limit			$10 Chiro to $600 and Podiatry to $600											100	100	10		50	0.1	0.1	50	50					50	10	10		10			0.1			10	10		10			10											94	94	9.4		47	0.094	0.094	47	47					47	9.4	9.4		9.4			0.094			9.4	9.4		9.4			9.4											6.1499	0.683323407	1.067860998	0	1.217157664	1.073563518	1.736271069	2.112756049	0.300818243	0	0	0	0	0.14015912	1.353497887	4.475329268	0	0.512320107	0	0	1.519600916	0	0	0.409291667	0.006784689	0	0.018407158	0	0	0.632359204	0	0	0	0	0	0	0	0	0	0	23.4094		1.4942	6.1499	0.683323407	1.067860998	0	1.217157664	1.073563518	1.736271069	2.112756049	0.300818243	0	0	0	0	0.14015912	1.353497887	4.475329268	0	0.512320107	0	0	1.519600916	0	0	0.409291667	0.006784689	0	0.018407158	0	0	0.632359204	0	0	0	0	0	0	0	0	0	0	23.4094		$200 (1-5)	$200 (1-5)	$25 (1-100)	0	$50 Waived	25% DME/Prosthetics	25% DME/Prosthetics	$50 Copay- waived	$200 OP Surg/Visits	0	0	0	0	$200 OP Surg/Visits	$20 PCP/Spec	$20 PCP/Spec	$20 PCP/Spec	$20 PCP/Spec	0	0	0	0	0	0	$20 Copay	0	$20 Copay	0	0	$20 Copay											0.9002	0.1	0.145	0	0.0661	0.1458	0.2357	0.1147	0.0654	0	0	0	0	0.0304	0.147	0.4861	0	0.0556	0	0	0	0	0	0	0.0007	0	0.002	0	0	0											2.4949		0.07716232	7.0501	0.783346163	1.212853322	0	1.283263091	1.219330122	1.972018961	2.227502599	0.366169574	0	0	0	0	0.170608022	1.500518375	4.96145126	0	0.567969659	0	0	1.519600916	0	0	0.409291667	0.00752166	0	0.020406591	0	0	0.632359204	0	0	0	0	0	0	0	0	0	0	25.9043
H3814_018_0	2009	5																					1200											D	D	D		T	Coin	Coin	V	V		Coin			V	V	V		V			Coin			V	V		V			V											0	0	0		0	0	0	0	0		0			0	0	0		0			0			0	0		0			0											0		1141.808808	126.8676453	1478.608256		335.3892775	12.32590565	19.93465037	582.172504	82.47844113		13.39233802			38.62101628	1855.603803	6135.538215		702.3750447			17.44699517			550	9.255096306		25.10947867			750											$100 (1-5)	$100 (1-5)	$10 (1-100)		$50 waived	10% Coins	10% Coins Prosth and $0 copay Supplies	$50 waived - WW	$100 ASC/OPV		$0 lab/ 0% diag & ther ad/10% MRI&CT&PET			$100 ASC/OPV	$10 PCP / $15 Specialist	$10 PCP / $15 Specialist		$15 OT/PT/ST			10% Part B Rx & Chemo Rx			$15 Copay to $500 Max Benefit	$15 routine copay/ $200 2 yr. hardware limit		$15 routine & Fitting copay/ $250 2 yr. aids limit			$15 Chiro to $500 and Podiatry to $500											100	100	10		50	0.1	0.1	50	100		0.1			100	10	15		15			0.1			15	15		15			15											94	94	9.4		47	0.094	0.094	47	94		0.094			94	9.4	14.1		14.1			0.094			14.1	14.1		14.1			14.1											8.9442	0.993796555	1.158243134	0	1.313608003	1.158635132	1.873857135	2.28017564	0.646081122	0	1.258879774	0	0	0.302531294	1.453556313	7.209257402	0	0.825290677	0	0	1.640017546	0	0	0.64625	0.010874738	0	0.029503637	0	0	0.88125	0	0	0	0	0	0	0	0	0	0	32.626		2.0825	8.9442	0.993796555	1.158243134	0	1.313608003	1.158635132	1.873857135	2.28017564	0.646081122	0	1.258879774	0	0	0.302531294	1.453556313	7.209257402	0	0.825290677	0	0	1.640017546	0	0	0.64625	0.010874738	0	0.029503637	0	0	0.88125	0	0	0	0	0	0	0	0	0	0	32.626																																																																																		0			8.9442	0.993796555	1.158243134	0	1.313608003	1.158635132	1.873857135	2.28017564	0.646081122	0	1.258879774	0	0	0.302531294	1.453556313	7.209257402	0	0.825290677	0	0	1.640017546	0	0	0.64625	0.010874738	0	0.029503637	0	0	0.88125	0	0	0	0	0	0	0	0	0	0	32.626
H3814_019_0	2009	8																					1200											D	D	D		T	Coin	Coin	V	V		Coin			V	V	V		V			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		1141.808808	126.8676453	1478.608256		335.3892775	12.32590565	19.93465037	582.172504	82.47844113		13.39233802			38.62101628	1855.603803	6135.538215	0	702.3750447			17.44699517			550	9.255096306		25.10947867			750											$100 (1-5)	$100 (1-5)	$10 (1-100)		$50 waived	10% Coins	10% Coins Prosth and $0 copay Supplies	$50 waived - WW	$100 ASC/OPV		$0 lab/ 0% diag & ther ad/10% MRI&CT&PET			$100 ASC/OPV	$10 PCP / $15 Specialist	$10 PCP / $15 Specialist		$15 OT/PT/ST			10% Part B Rx & Chemo Rx			$15 Copay to $500 Max Benefit	$15 routine copay/ $200 2 yr. hardware limit		$15 routine & Fitting copay/ $250 2 yr. aids limit			$15 Chiro to $500 and Podiatry to $500											100	100	10		50	0.1	0.1	50	100		0.1			100	10	15	0	15			0.1			15	15		15			15											94	94	9.4		47	0.094	0.094	47	94		0.094			94	9.4	14.1	0	14.1			0.094			14.1	14.1		14.1			14.1											8.9442	0.993796555	1.158243134	0	1.313608003	1.158635132	1.873857135	2.28017564	0.646081122	0	1.258879774	0	0	0.302531294	1.453556313	7.209257402	0	0.825290677	0	0	1.640017546	0	0	0.64625	0.010874738	0	0.029503637	0	0	0.88125	0	0	0	0	0	0	0	0	0	0	32.626		2.0825	8.9442	0.993796555	1.158243134	0	1.313608003	1.158635132	1.873857135	2.28017564	0.646081122	0	1.258879774	0	0	0.302531294	1.453556313	7.209257402	0	0.825290677	0	0	1.640017546	0	0	0.64625	0.010874738	0	0.029503637	0	0	0.88125	0	0	0	0	0	0	0	0	0	0	32.626																																																																																		0			8.9442	0.993796555	1.158243134	0	1.313608003	1.158635132	1.873857135	2.28017564	0.646081122	0	1.258879774	0	0	0.302531294	1.453556313	7.209257402	0	0.825290677	0	0	1.640017546	0	0	0.64625	0.010874738	0	0.029503637	0	0	0.88125	0	0	0	0	0	0	0	0	0	0	32.626
H3814_021_0	2009	8																					1200											D	D	D		T	Coin	Coin	V	V					V	V	V		V			Coin			V	V		V			V											0	0	0		0	0	0	0	0					0	0	0		0			0			0	0		0			0											0	2500	804.9423045	89.43803383	1397.689396		318.6198136	11.70961037	18.93791785	553.0638788	78.74629167					36.68996547	1771.550463	5857.616558		670.5595414			16.57464541			522.5	8.880264905		24.09254479			807.267069											$100 (1-3)	$100 (1-3)	$10 (1-100)		$50 waived	10% Coins	10% Coins Prosth and $0 copay Supplies	$50 waived - WW	$50 copay					$50 copay	$10 PCP / $10 Specialist	$10 PCP / $10 Specialist		$10 OT/PT/ST			10% Part B Rx & Chemo Rx			$10 copay	$10 for Medicare Covered/$200 Hardware Limit		$10 for Medicare Covered/$300 Aids Limit			$10 Chiro to $600 and Podiatry to $600											100	100	10		50	0.1	0.1	50	50					50	10	10		10			0.1			10	10		10			10											94	94	9.4		47	0.094	0.094	47	47					47	9.4	9.4		9.4			0.094			9.4	9.4		9.4			9.4											6.3054	0.700597932	1.094856694	0	1.247927603	1.100703375	1.780164278	2.166166858	0.308422976	0	0	0	0	0.143702365	1.387714529	4.588466304	0	0.525271641	0	0	1.558016669	0	0	0.409291667	0.006956208	0	0.018872493	0	0	0.632359204	0	0	0	0	0	0	0	0	0	0	23.9749		1.5303	6.3054	0.700597932	1.094856694	0	1.247927603	1.100703375	1.780164278	2.166166858	0.308422976	0	0	0	0	0.143702365	1.387714529	4.588466304	0	0.525271641	0	0	1.558016669	0	0	0.409291667	0.006956208	0	0.018872493	0	0	0.632359204	0	0	0	0	0	0	0	0	0	0	23.9749		$200 (1-5)	$200 (1-5)	$25 (1-100)	0	$50 Waived	25% DME/Prosthetics	25% DME/Prosthetics	$50 Copay- waived	$200 OP Surg/Visits	0	0	0	0	$200 OP Surg/Visits	$20 PCP/Spec	$20 PCP/Spec	$20 PCP/Spec	$20 PCP/Spec	0	0	0	0	0	0	$20 Copay	0	$20 Copay	0	0	$20 Copay											0.923	0.1026	0.1487	0	0.0678	0.1495	0.2417	0.1176	0.067	0	0	0	0	0.0312	0.1507	0.4984	0	0.0571	0	0	0	0	0	0	0.0008	0	0.002	0	0	0											2.558		0.079112996	7.2283	0.803149278	1.243514447	0	1.315704186	1.250154981	2.021871914	2.283814219	0.375426399	0	0	0	0	0.17492102	1.538451718	5.086877537	0	0.582328023	0	0	1.558016669	0	0	0.409291667	0.007711809	0	0.020922473	0	0	0.632359204	0	0	0	0	0	0	0	0	0	0	26.5329
H3814_023_0	2009	5																					3000											D	D	D		T	Coin	Coin	V	V		Coin			V	V	V		V	Coin		Coin	V			V		V														0	0	0		0	0	0	0	0		0			0	0	0		0	0		0	0			0		0														0		1203.41688	133.7129866	1233.7503		281.2479596	11.50834607	18.99617481	488.1933915	67.78080558		30.20806991			32.38649163	1502.365188	4967.557733		568.6687072	0		14.63055656	0			7.605840687		20.63497647														$165 (1-10)	$165 (1-10)	$25 (1-100)		$150 waived	25% Coins	25% Coins Prosth and 25% Coins Supplies	$50 waived - WW	$200 Copay		$0 lab/ 25% diag & ther ad			$200 Copay	$20 PCP / $25 Specialist	$20 PCP / $25 Specialist		$25 OT/PT/ST	$0 lab/ 25% diag & ther ad		25% Part B Rx & Chemo Rx	$200 Copay			$25 routine copay/ $100 2 yr. hardware limit		$25 routine & Fitting copay/ $100 2 yr. aids limit														165	165	25		150	0.25	0.25	50	200		0.25			200	20	25		25	0.25		0.25	200			25		25														162.525	162.525	24.625		147.75	0.24625	0.24625	49.25	197		0.24625			197	19.7	24.625		24.625	0.24625		0.24625	197			24.625		24.625														16.2988	1.810975262	2.531758429	0	3.462865502	2.83393022	4.677808046	2.003627044	1.112734892	0	7.438737216	0	0	0.531678238	2.46638285	10.19384243	0	1.166955576	0	0	3.602774552	0	0	0	0.015607819	0	0.042344691	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1908		0.9166	16.2988	1.810975262	2.531758429	0	3.462865502	2.83393022	4.677808046	2.003627044	1.112734892	0	7.438737216	0	0	0.531678238	2.46638285	10.19384243	0	1.166955576	0	0	3.602774552	0	0	0	0.015607819	0	0.042344691	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1908																																																																																		0			16.2988	1.810975262	2.531758429	0	3.462865502	2.83393022	4.677808046	2.003627044	1.112734892	0	7.438737216	0	0	0.531678238	2.46638285	10.19384243	0	1.166955576	0	0	3.602774552	0	0	0	0.015607819	0	0.042344691	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1908
H3814_024_0	2009	8																					3000											D	D	D		T	Coin	Coin	V	V		Coin			V	V	V		V	Coin		Coin	V			V		V														0	0	0		0	0	0	0	0		0			0	0	0		0	0		0	0			0		0														0		1203.41688	133.7129866	1233.7503		281.2479596	11.50834607	18.99617481	488.1933915	67.78080558		30.20806991			32.38649163	1502.365188	4967.557733		568.6687072	0		14.63055656	0			7.605840687		20.63497647														$165 (1-10)	$165 (1-10)	$25 (1-100)		$150 waived	25% Coins	25% Coins Prosth and 25% Coins Supplies	$50 waived - WW	$200 Copay		$0 lab/ 25% diag & ther ad			$200 Copay	$20 PCP / $25 Specialist	$20 PCP / $25 Specialist		$25 OT/PT/ST	$0 lab/ 25% diag & ther ad		25% Part B Rx & Chemo Rx	$200 Copay			$25 routine copay/ $100 2 yr. hardware limit		$25 routine & Fitting copay/ $100 2 yr. aids limit														165	165	25		150	0.25	0.25	50	200		0.25			200	20	25		25	0.25		0.25	200			25		25														162.525	162.525	24.625		147.75	0.24625	0.24625	49.25	197		0.24625			197	19.7	24.625		24.625	0.24625		0.24625	197			24.625		24.625														16.2988	1.810975262	2.531758429	0	3.462865502	2.83393022	4.677808046	2.003627044	1.112734892	0	7.438737216	0	0	0.531678238	2.46638285	10.19384243	0	1.166955576	0	0	3.602774552	0	0	0	0.015607819	0	0.042344691	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1908		0.9166	16.2988	1.810975262	2.531758429	0	3.462865502	2.83393022	4.677808046	2.003627044	1.112734892	0	7.438737216	0	0	0.531678238	2.46638285	10.19384243	0	1.166955576	0	0	3.602774552	0	0	0	0.015607819	0	0.042344691	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1908																																																																																		0			16.2988	1.810975262	2.531758429	0	3.462865502	2.83393022	4.677808046	2.003627044	1.112734892	0	7.438737216	0	0	0.531678238	2.46638285	10.19384243	0	1.166955576	0	0	3.602774552	0	0	0	0.015607819	0	0.042344691	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1908
H3814_025_0	2009	10																																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		399.7937517	44.42152797	61.2354801		29.25013634	17.87838491	29.16999643	36.45335496	14.2645174	0	39.04617338	0	0	35.01745891					0	135.4065507	20.82962045	0																			Medicare	Medicare	Medicare		Medicare	Medicare	Medicare Prosth and Medicare Supplies	Medicare	"Prof ASC and OP Hospital Surgery 0%, Other Medicare"	Medicare	Medicare	"Prof ASC and OP Hospital Surgery 0%, Other Medicare"	Medicare	"Prof ASC and OP Hospital Surgery 0%, Other Medicare"					Medicare	Medicare	Medicare	"Prof ASC and OP Hospital Surgery 0%, Other Medicare"																			0.0739	0.0739	0.1421		0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.13398					0.231	0.231	0.231	0.231																			0.0739	0.0739	0.1421		0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.13398					0.231	0.231	0.231	0.231																			29.5448	3.282750917	8.701561723	0	6.756781494	4.129906914	6.738269175	8.420724996	0	0	9.01966605	0	0	4.691639145	0	0	0	0	0	31.27891321	4.811642325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.3766		0	29.5448	3.282750917	8.701561723	0	6.756781494	4.129906914	6.738269175	8.420724996	0	0	9.01966605	0	0	4.691639145	0	0	0	0	0	31.27891321	4.811642325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.3766																																																																																		0			29.5448	3.282750917	8.701561723	0	6.756781494	4.129906914	6.738269175	8.420724996	0	0	9.01966605	0	0	4.691639145	0	0	0	0	0	31.27891321	4.811642325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.3766
H3815_001_0	2009	9																					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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.593457035	0	0	177.1140823	4.981488662	0.744831638	444.7295486	0	0	0	0	1.333073956	0	2.462296765	0	433.9969378	0	0	0	7.284914156	0	0	654.2641859	0	0	0	0	0	2.602410704											$0 copay	1B - $200 per admit	$0 copay	$0 copay	10A - $50 copay	11A - 20% coinsurance on items >$150	11B - 20% coinsurance on items >$150	4A - $50 copay	$0 copay	$0 copay	$0 copay	$0 copay	12 - $25 copay	$0 copay	4B- $25 copay	$0 copay	7E & 7H & 9C- $30 copay	$0 copay	$0 copay	$0 copay	15 - 20% coinsurance	$0 copay	$0 copay	16A - $20 copay	$0 copay	17B - $250 max	$0 copay	18B - $500 max	$0 copay	4A - $50 worldwide emerg.											0	200	0	0	50	0.04	0.2	50	0	0	0	0	25	0	25	0	30	0	0	0	0.2	0	0	20	0	0	0	0	0	50											0	200	0	0	50	0.04	0.2	50	0	0	0	0	25	0	25	0	30	0	0	0	0.2	0	0	20	0	0	0	0	0	50											0	0.109890951	0	0	0.737975343	0.199259546	0.148966328	1.853039786	0	0	0	0	0.002777237	0	0.005129785	0	1.084992345	0	0	0	1.456982831	0	0	1.09044031	0	0	0	0	0	0.010843378	0	0	0	0	0	0	0	0	0	0	6.7003			0	0.109890951	0	0	0.737975343	0.199259546	0.148966328	1.853039786	0	0	0	0	0.002777237	0	0.005129785	0	1.084992345	0	0	0	1.456982831	0	0	1.09044031	0	0	0	0	0	0.010843378	0	0	0	0	0	0	0	0	0	0	6.7003	0	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			0	0.109890951	0	0	0.737975343	0.199259546	0.148966328	1.853039786	0	0	0	0	0.002777237	0	0.005129785	0	1.084992345	0	0	0	1.456982831	0	0	1.09044031	0	0	0	0	0	0.010843378	0	0	0	0	0	0	0	0	0	0	6.7003
H3817_001_0	2009	6	h.6.										OP Facility - Other										1500	Urgent Care										D	D	D		T	Coin	Coin	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	3000	632.9392874	6.256050714			4.745883997	14.12028481	0.92013701	323.095911							8564.227795	8.362838726	427.0866719	1660.257286		245.1935691	5.282542576				148.574393						9.648310085										$100/day (days 1-5)	$100/day (days 1-5)			$100 	10%	10%	$50 							$10 	$10 	$10 	$10 		$10 chiro	10%				$10 						$10 										100	100			100	0.1	0.1	50	0	0	0	0	0	0	10	10	10	10	0	10	0.1	0	0	0	10	0					10										99.20135606	99.20135606	0	0	99.20135606	0.099201356	0.099201356	49.60067803	0	0	0	0	0	0	9.920135606	9.920135606	9.920135606	9.920135606	0	9.920135606	0.099201356	0	0	0	9.920135606	0					9.920135606										5.2324	0.051717393	0	0	0.039233177	1.400751401	0.091278839	1.335481354	0	0	0	0	0	0	7.079858424	0.006913375	0.353063142	1.372498118	0	0.202696121	0.524035387	0	0	0	0.122823177	0	0	0	0	0	0.007976045	0	0	0	0	0	0	0	0	0	17.8207	0	0.1435	5.2324	0.051717393	0	0	0.039233177	1.400751401	0.091278839	1.335481354	0	0	0	0	0	0	7.079858424	0.006913375	0.353063142	1.372498118	0	0.202696121	0.524035387	0	0	0	0.122823177	0	0	0	0	0	0.007976045	0	0	0	0	0	0	0	0	0	17.8207	N/A	$250/day (days 1-5)	$250/day (days 1-5)	$25/day (days 1-100)	20%	$100 	20%	20%	$50 	$100 	No cost sharing	20%	No cost sharing	No cost sharing	No cost sharing	$25 	$25 	$25 	$25 	No cost sharing	$25 	10%	No cost sharing	No cost sharing	No cost sharing	$25 	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$25 										3.2222	0.0228	0.1239	0.0324	1.1955	0.3564	0.0102	0.0757	0.1292	0	0	0	0	0	0.9313	0.122	0.3188	0.2185	0	1.3028	0.0313	0	0	0	0.0137	0	0	0	0	0	0.0049										8.1115	0	0.127329645	8.4546	0.074505875	0.123874225	0.032360371	1.234715545	1.757109284	0.101437789	1.411184016	0.12920176	0	0	0	0	0	8.011135255	0.128937259	0.671856522	1.59099265	0	1.505528391	0.5553623	0	0	0	0.136540034	0	0	0	0	0	0.012857001	0	0	0	0	0	0	0	0	0	25.9322
H3817_002_0	2009	6	h.6.										OP Facility - Other										1500	Urgent Care										D	D	D		T	Coin	Coin	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	3000	632.9392874	6.256050714			4.745883997	14.12028481	0.92013701	323.095911							8564.227795	8.362838726	427.0866719	1660.257286		245.1935691	5.282542576				148.574393						9.648310085										$100/day (days 1-5)	$100/day (days 1-5)			$100 	10%	10%	$50 							$10 	$10 	$10 	$10 		$10 chiro	10%				$10 						$10 										100	100			100	0.1	0.1	50	0	0	0	0	0	0	10	10	10	10	0	10	0.1	0	0	0	10	0					10										99.20135606	99.20135606	0	0	99.20135606	0.099201356	0.099201356	49.60067803	0	0	0	0	0	0	9.920135606	9.920135606	9.920135606	9.920135606	0	9.920135606	0.099201356	0	0	0	9.920135606	0					9.920135606										5.2324	0.051717393	0	0	0.039233177	1.400751401	0.091278839	1.335481354	0	0	0	0	0	0	7.079858424	0.006913375	0.353063142	1.372498118	0	0.202696121	0.524035387	0	0	0	0.122823177	0	0	0	0	0	0.007976045	0	0	0	0	0	0	0	0	0	17.8207	0	0.1435	5.2324	0.051717393	0	0	0.039233177	1.400751401	0.091278839	1.335481354	0	0	0	0	0	0	7.079858424	0.006913375	0.353063142	1.372498118	0	0.202696121	0.524035387	0	0	0	0.122823177	0	0	0	0	0	0.007976045	0	0	0	0	0	0	0	0	0	17.8207	N/A	$250/day (days 1-5)	$250/day (days 1-5)	$25/day (days 1-100)	20%	$100 	20%	20%	$50 	$100 	No cost sharing	20%	No cost sharing	No cost sharing	No cost sharing	$25 	$25 	$25 	$25 	No cost sharing	$25 	10%	No cost sharing	No cost sharing	No cost sharing	$25 	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$25 										3.2222	0.0228	0.1239	0.0324	1.1955	0.3564	0.0102	0.0757	0.1292	0	0	0	0	0	0.9313	0.122	0.3188	0.2185	0	1.3028	0.0313	0	0	0	0.0137	0	0	0	0	0	0.0049										8.1115	0	0.127329645	8.4546	0.074505875	0.123874225	0.032360371	1.234715545	1.757109284	0.101437789	1.411184016	0.12920176	0	0	0	0	0	8.011135255	0.128937259	0.671856522	1.59099265	0	1.505528391	0.5553623	0	0	0	0.136540034	0	0	0	0	0	0.012857001	0	0	0	0	0	0	0	0	0	25.9322
H3817_003_0	2009	9	h.6.										OP Facility - Other										1500	Urgent Care										D	D	D		T	Coin	Coin	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	3000	632.9392874	6.256050714			4.745883997	14.12028481	0.92013701	323.095911							8564.227795	8.362838726	427.0866719	1660.257286		245.1935691	5.282542576				148.574393						9.648310085										$100/day (days 1-5)	$100/day (days 1-5)			$100 	10%	10%	$50 							$10 	$10 	$10 	$10 		$10 chiro	10%				$10 						$10 										100	100			100	0.1	0.1	50	0	0	0	0	0	0	10	10	10	10	0	10	0.1	0	0	0	10	0					10										99.20135606	99.20135606	0	0	99.20135606	0.099201356	0.099201356	49.60067803	0	0	0	0	0	0	9.920135606	9.920135606	9.920135606	9.920135606	0	9.920135606	0.099201356	0	0	0	9.920135606	0					9.920135606										5.2324	0.051717393	0	0	0.039233177	1.400751401	0.091278839	1.335481354	0	0	0	0	0	0	7.079858424	0.006913375	0.353063142	1.372498118	0	0.202696121	0.524035387	0	0	0	0.122823177	0	0	0	0	0	0.007976045	0	0	0	0	0	0	0	0	0	17.8207	0	0.1435	5.2324	0.051717393	0	0	0.039233177	1.400751401	0.091278839	1.335481354	0	0	0	0	0	0	7.079858424	0.006913375	0.353063142	1.372498118	0	0.202696121	0.524035387	0	0	0	0.122823177	0	0	0	0	0	0.007976045	0	0	0	0	0	0	0	0	0	17.8207	N/A	$250/day (days 1-5)	$250/day (days 1-5)	$25/day (days 1-100)	20%	$100 	20%	20%	$50 	$100 	No cost sharing	20%	No cost sharing	No cost sharing	No cost sharing	$25 	$25 	$25 	$25 	No cost sharing	$25 	10%	No cost sharing	No cost sharing	No cost sharing	$25 	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$25 										3.2222	0.0228	0.1239	0.0324	1.1955	0.3564	0.0102	0.0757	0.1292	0	0	0	0	0	0.9313	0.122	0.3188	0.2185	0	1.3028	0.0313	0	0	0	0.0137	0	0	0	0	0	0.0049										8.1115	0	0.127329645	8.4546	0.074505875	0.123874225	0.032360371	1.234715545	1.757109284	0.101437789	1.411184016	0.12920176	0	0	0	0	0	8.011135255	0.128937259	0.671856522	1.59099265	0	1.505528391	0.5553623	0	0	0	0.136540034	0	0	0	0	0	0.012857001	0	0	0	0	0	0	0	0	0	25.9322
H3817_006_0	2009	6	h.6.										OP Facility - Other										2500	Urgent Care										D	D	D	Coin	T	Coin	Coin	V	V		Coin				V	V	V	V	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	5000	632.9392874	6.256050714	893.9976684	11.46802123	3.990856998	13.80970416	0.882945714	323.095911	962.4272657	0	15.79792991	0	0	0	7536.520459	8.028325177	375.8362713	1461.026411	14.92432837	208.4145338	5.271786927										8.490512875										$250/day (days 1-5)	$250/day (days 1-5)	$25/day	10%	$100 	20%	20%	$50 	$250 		20%				$25 	$25 	$25 	$25 	20%	$25 chiro	20%										$25 										250	250	25	0.1	100	0.2	0.2	50	250	0	0.2	0	0	0	25	25	25	25	0.2	25	0.2	0	0	0	0	0	0	0	0	0	25										241.1849058	241.1849058	24.11849058	0.096473962	96.47396233	0.192947925	0.192947925	48.23698116	241.1849058	0	0.192947925	0	0	0	24.11849058	24.11849058	24.11849058	24.11849058	0.192947925	24.11849058	0.192947925	0	0	0	0	0	0	0	0	0	24.11849058										12.7213	0.12573875	1.796822862	1.106365448	0.032084482	2.664553758	0.170362543	1.298764281	19.34357745	0	3.04817779	0	0	0	15.14745814	0.016135924	0.755383631	2.936479312	2.879618186	0.418886998	1.017180347	0	0	0	0	0	0	0	0	0	0.017064863	0	0	0	0	0	0	0	0	0	65.4959	0	2.3938	12.7213	0.12573875	1.796822862	1.106365448	0.032084482	2.664553758	0.170362543	1.298764281	19.34357745	0	3.04817779	0	0	0	15.14745814	0.016135924	0.755383631	2.936479312	2.879618186	0.418886998	1.017180347	0	0	0	0	0	0	0	0	0	0.017064863	0	0	0	0	0	0	0	0	0	65.4959	N/A	$500/day (days 1-5)	$500/day (days 1-5)	$35/day (days 1-100)	40%	$100 	40%	40%	$50 	$500 	No cost sharing	40%	No cost sharing	No cost sharing	No cost sharing	$35 	$35 	$35 	$35 	40%	$35 	20%	No cost sharing	Not covered	Not covered	Not covered	Not covered	Not covered	Not covered	Not covered	Not covered	$35 										8.034	0.0568	0.173	0.0645	1.1923	0.7094	0	0.0755	0.6443	0	0.1813	0	0	0	1.3003	0.1704	0.4451	0.3051	0.1479	1.8191	0.0624	0	0	0	0	0	0	0	0	0	0.0068										15.3881	0	0.303735487	20.7553	0.182557775	1.969783531	1.17091331	1.224373502	3.373918466	0.170362543	1.374264727	19.98786065	0	3.229463895	0	0	0	16.44776306	0.186513036	1.200502188	3.241554564	3.027477273	2.237980037	1.079539586	0	0	0	0	0	0	0	0	0	0.023879947	0	0	0	0	0	0	0	0	0	80.884
H3818_001_0	2009	7																					1500											D	D	D	V	T	Coin	Coin	V	V	P	P	P	P	P	V	V	V	V	P	P	Coin	P	T	V	V	P	V	O	O	O																																																			0		977.7750184	82.42106264		1491.473364	103.2950245	9.813162754	8.502430037	289.4111296						155.3998075	3745.189595	5263.173612	191.7803504	478.6308507			16.33887847			1629.06186	144.9690383		381.0933515			386.31											"#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 0% or 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 $0, #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	#14A $0	"#13B $15, #13C $15, #13D $15"											76.98761809	76.98761809		20	50	0.2	0.193355649	43.99243156						25	14.88863052	23.69419761	25	25			0.2			20.44351254	25		20			15											60.01084641	60.01084641		15.58973973	38.97434932	0.155897397	0.150718212	34.2915279						19.48717466	11.60549373	18.47061602	19.48717466	19.48717466			0.155897397			20.44351254	25		15.58973973			11.69230479											4.8898	0.412179811	0	1.93764013	0.335488031	1.529846532	1.281471054	0.827029152	0	0	0	0	0	0.252358599	3.622064531	8.101171569	0.311438099	0.777263582	0	0	2.547188627	0	0	2.775312214	0.30201883	0	0.495095513	0	0	0.376404522	0	0	0	0	0	0	0	0	0	0	30.7737	0	7.8344	4.8898	0.412179811	0	1.93764013	0.335488031	1.529846532	1.281471054	0.827029152	0	0	0	0	0	0.252358599	3.622064531	8.101171569	0.311438099	0.777263582	0	0	2.547188627	0	0	2.775312214	0.30201883	0	0.495095513	0	0	0.376404522	0	0	0	0	0	0	0	0	0	0	30.7737																																																																																		0	0	0	4.8898	0.412179811	0	1.93764013	0.335488031	1.529846532	1.281471054	0.827029152	0	0	0	0	0	0.252358599	3.622064531	8.101171569	0.311438099	0.777263582	0	0	2.547188627	0	0	2.775312214	0.30201883	0	0.495095513	0	0	0.376404522	0	0	0	0	0	0	0	0	0	0	30.7737
H3818_002_0	2009	5																																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	O	V	O	O	O																																																			0		299.678245	11.62978441	60.37179309		22.71770013	31.7633435	8.555420503	1.378666911	27.31636831	18.40730979	34.90127708	3.596991654	0.423165612	68.11767114	60.70274206	31.21189607	4.634763328	2.942701053	13.1718999	25.69427415	4.608412971	13.20928447																			1/2 FFS Medicare Ded & Coin	1/2 FFS Medicare Ded & Coin	FFS Medicare Ded & Coin		20% Coins	20% Coins	20% Coins	20% Coins on Urgent Care	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																			0.037031373	0.037031373	0.138633165		0.2	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																			0.037031373	0.037031373	0.138633165		0.2	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																			11.0975	0.430666887	8.369532751	0	4.543540027	6.352668701	1.711084101	0.275733382	5.463273662	3.681461958	6.980255416	0.719398331	0.084633122	13.62353423	12.14054841	6.242379214	0.926952666	0.588540211	2.634379979	5.138854831	0.921682594	2.641856893	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.5685	0	0	11.0975	0.430666887	8.369532751	0	4.543540027	6.352668701	1.711084101	0.275733382	5.463273662	3.681461958	6.980255416	0.719398331	0.084633122	13.62353423	12.14054841	6.242379214	0.926952666	0.588540211	2.634379979	5.138854831	0.921682594	2.641856893	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.5685																																																																																		0	0	0	11.0975	0.430666887	8.369532751	0	4.543540027	6.352668701	1.711084101	0.275733382	5.463273662	3.681461958	6.980255416	0.719398331	0.084633122	13.62353423	12.14054841	6.242379214	0.926952666	0.588540211	2.634379979	5.138854831	0.921682594	2.641856893	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.5685
H3818_003_0	2009	7																					3500											D	D	D	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	P	P	Coin	P	T	V	V	P	V	O	O	O																																																			0		1023.714039	251.5227916	797.0335483	1839.316638	170.0249181	12.80283351	10.65985051	412.4241658	24.29728654		13.50625858		0.475561889	4.835516971	2942.26961	3493.628941	2.347669644	2.619850764			12.42930115									386.31											"#1A $250/day days 1-5, $0/day days 6-90"	"#1B $250/day days 1-5, $0/day days 6-90"	"#2 $0/day days 1-20, $25/day days 21-100"	#6 $20	#10A $50	#11A 20%	"#11B 20%, #11C 0% or 20%"	"#4A $50, #4B $20"	"#9A 20%, #9B 20%"	#8A 20%	"#8A 20%, #8B 20%"	#9A 20%	#12 20%	"#3 $0, #5 20%, #9C 20%, #9D 20%"	"#7A $15, #14B $0, #14C $0, #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 20%, #7H 20%"	"#7C 20%, #7I 20%"	$0 (incl in h2)		#15 20%	"#13A $0, #16B $0"	#10B $0 n/c	"#16A n/c, #16B n/c"	#17A n/c	#17B n/c	#18A n/c	#18B n/c	#14A $0	"#13B $15, #13C $15, #13D $15"											159.2758647	159.2758647	10.75307874	20	50	0.2	0.19524272	43.99337576	0.2		0.2		0.2	0.2	14.87825063	27.92565455	0.2	0.2			0.2									15											139.9466677	139.9466677	9.44812034	17.57286554	43.93216385	0.175728655	0.171548703	38.65448384	0.175728655		0.175728655		0.175728655	0.175728655	13.07267489	24.53668863	0.175728655	0.175728655			0.175728655									13.17964916											11.9388	2.933314712	0.627539073	2.693505331	0.622463547	2.249824718	1.828683528	1.328503604	4.269729495	0	2.373436661	0	0.083569851	0.849738896	3.205277838	7.143507127	0.41255283	0.460382852	0	0	2.18418438	0	0	0	0	0	0	0	0	0.424285855	0	0	0	0	0	0	0	0	0	0	45.6293	0	6.3022	11.9388	2.933314712	0.627539073	2.693505331	0.622463547	2.249824718	1.828683528	1.328503604	4.269729495	0	2.373436661	0	0.083569851	0.849738896	3.205277838	7.143507127	0.41255283	0.460382852	0	0	2.18418438	0	0	0	0	0	0	0	0	0.424285855	0	0	0	0	0	0	0	0	0	0	45.6293																																																																																		0	0	0	11.9388	2.933314712	0.627539073	2.693505331	0.622463547	2.249824718	1.828683528	1.328503604	4.269729495	0	2.373436661	0	0.083569851	0.849738896	3.205277838	7.143507127	0.41255283	0.460382852	0	0	2.18418438	0	0	0	0	0	0	0	0	0.424285855	0	0	0	0	0	0	0	0	0	0	45.6293
H3818_004_0	2009	2																					3500											D	D	D	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	P	P	Coin	P	T	V	V	P	V	O	O	O																																																			0		715.7971716	30.34021154	478.9136599	1183.174903	91.42020264	7.108334639	7.859867306	251.0815747	25.30408907		11.00234801		0.025152626	4.238803233	2905.196925	3954.555934	1.26060113	4.092668002			16.83488476									386.31											"#1A $250/day days 1-5, $0/day days 6-90"	"#1B $250/day days 1-5, $0/day days 6-90"	"#2 $0/day days 1-20, $25/day days 21-100"	#6 $20	#10A $50	#11A 20%	"#11B 20%, #11C 0% or 20%"	"#4A $50, #4B $20"	"#9A 20%, #9B 20%"	#8A 20%	"#8A 20%, #8B 20%"	#9A 20%	#12 20%	"#3 $0, #5 20%, #9C 20%, #9D 20%"	"#7A $15, #14B $0, #14C $0, #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 20%, #7H 20%"	"#7C 20%, #7I 20%"	$0 (incl in h2)		#15 20%	"#13A $0, #16B $0"	#10B $0 n/c	"#16A n/c, #16B n/c"	#17A n/c	#17B n/c	#18A n/c	#18B n/c	#14A $0	"#13B $15, #13C $15, #13D $15"											184.5036234	184.5036234	11.55056328	20	50	0.2	0.198428687	43.98963129	0.2		0.2		0.2	0.2	14.88481418	28.1263745	0.2	0.2			0.2									15											167.3255119	167.3255119	10.47515425	18.13791066	45.34477666	0.181379107	0.17995409	39.89400012	0.181379107		0.181379107		0.181379107	0.181379107	13.49897149	25.5076834	0.181379107	0.181379107			0.181379107									13.603433											9.9809	0.423057619	0.418057872	1.788360058	0.345452389	1.289303386	1.414415267	0.834720698	4.58963307	0	1.995596053	0	0.004562161	0.768830344	3.268097538	8.405963394	0.228646707	0.742324466	0	0	3.053496358	0	0	0	0	0	0	0	0	0.437928517	0	0	0	0	0	0	0	0	0	0	39.9894	0	4.1054	9.9809	0.423057619	0.418057872	1.788360058	0.345452389	1.289303386	1.414415267	0.834720698	4.58963307	0	1.995596053	0	0.004562161	0.768830344	3.268097538	8.405963394	0.228646707	0.742324466	0	0	3.053496358	0	0	0	0	0	0	0	0	0.437928517	0	0	0	0	0	0	0	0	0	0	39.9894																																																																																		0	0	0	9.9809	0.423057619	0.418057872	1.788360058	0.345452389	1.289303386	1.414415267	0.834720698	4.58963307	0	1.995596053	0	0.004562161	0.768830344	3.268097538	8.405963394	0.228646707	0.742324466	0	0	3.053496358	0	0	0	0	0	0	0	0	0.437928517	0	0	0	0	0	0	0	0	0	0	39.9894
H3864_001_0	2009	3																																D	D	D		T	Coin	Coin	V	V		V				V	V		V			Coin						V																																																						0		510.1116257	56.67906952	28.01417323		86.44173296	3.443935457	5.676389859	249.3196262	110.6482078		647.5080717				2596.746239	5344.373757		1943.796536			54.70262474						27.86061147														$125 (1-4)	$125 (1-4)	$25 (21-100)		$50 copay	20% to $500	20% to $500 Prosth and $0 copay Supplies	$50 waived - WW	$125 ASC / $0 OPV		$50 CT/$100 MRI/$200 PET				$10 PCP / $25 Specialist	$10 PCP / $25 Specialist		$25 copay			20% Part B Rx						$25 Med-Cov/$25 routine/Aids to $250 per 2 yrs														125	125	25		50	0.2	0.2	50	125		65				10	25		25			0.2						25														125	125	25		50	0.2	0.2	50	125		65				10	25		25			0.2						25														5.3137	0.590406974	0.058362861	0	0.360173887	0.688787091	1.135277972	1.038831776	1.152585498	0	3.507335388	0	0	0	2.163955199	11.13411199	0	4.049576117	0	0	10.94052495	0	0	0	0	0	0.058042941	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1916		0	5.3137	0.590406974	0.058362861	0	0.360173887	0.688787091	1.135277972	1.038831776	1.152585498	0	3.507335388	0	0	0	2.163955199	11.13411199	0	4.049576117	0	0	10.94052495	0	0	0	0	0	0.058042941	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1916																																																																																		0			5.3137	0.590406974	0.058362861	0	0.360173887	0.688787091	1.135277972	1.038831776	1.152585498	0	3.507335388	0	0	0	2.163955199	11.13411199	0	4.049576117	0	0	10.94052495	0	0	0	0	0	0.058042941	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1916
H3864_002_0	2009	3																																D	D	D		T	Coin	Coin	V	V		V				V	V		V			Coin						V																																																						0		333.2825048	37.03138943	15.04452498		50.9523312	2.32605657	3.836572627	187.3325368	94.43610449		517.7653111				1989.82016	4095.256781		1476.500763			34.02807919						27.46395714														$200 (1-4)	$200 (1-4)	$50 (21-100)		$50 copay	20% to $500	20% to $500 Prosth and $0 copay Supplies	$50 waived - WW	$200 ASC/ $0 OPV		$100 CT/$200 MRI/$300 PET				$15 PCP / $25 Specialist	$15 PCP / $25 Specialist		$25 copay			20% Part B Rx						$25 Med-Cov/$25 routine/Aids to $250 per 2 yrs														200	200	50		50	0.2	0.2	50	200		128.9				15	25		25			0.2						25														200	200	50		50	0.2	0.2	50	200		128.9				15	25		25			0.2						25														5.5547	0.617189824	0.062685521	0	0.21230138	0.465211314	0.767314525	0.780552237	1.573935075	0	5.561662384	0	0	0	2.487275199	8.53178496	0	3.076043257	0	0	6.805615839	0	0	0	0	0	0.057216577	0	0	0	0	0	0	0	0	0	0	0	0	0	36.5535		0	5.5547	0.617189824	0.062685521	0	0.21230138	0.465211314	0.767314525	0.780552237	1.573935075	0	5.561662384	0	0	0	2.487275199	8.53178496	0	3.076043257	0	0	6.805615839	0	0	0	0	0	0.057216577	0	0	0	0	0	0	0	0	0	0	0	0	0	36.5535																																																																																		0			5.5547	0.617189824	0.062685521	0	0.21230138	0.465211314	0.767314525	0.780552237	1.573935075	0	5.561662384	0	0	0	2.487275199	8.53178496	0	3.076043257	0	0	6.805615839	0	0	0	0	0	0.057216577	0	0	0	0	0	0	0	0	0	0	0	0	0	36.5535
H3864_006_0	2009	6																																D	D	D		T	Coin	Coin	V	V		V				V	V		V			Coin						V																																																						0		826.2256057	91.80284508	48.18530737		171.6911433	6.385162104	10.52420113	551.7291327	102.5180182		663.0228664				2456.305095	5055.331282		1802.274493			36.4581355						23.37482092														$200 (1-4)	$200 (1-4)	$50 (21-100)		$50 copay	20% to $500	20% to $500 Prosth and $0 copay Supplies	$50 waived - WW	$200 ASC/ $0 OPV		$100 CT/$200 MRI/$300 PET				$15 PCP / $25 Specialist	$15 PCP / $25 Specialist		$25 copay			20% Part B Rx						$25 Med-Cov/$25 routine/Aids to $250 per 2 yrs														200	200	50		50	0.2	0.2	50	200		128.9				15	25		25			0.2						25														200	200	50		50	0.2	0.2	50	200		128.9				15	25		25			0.2						25														13.7704	1.530047418	0.200772114	0	0.715379764	1.277032421	2.104840225	2.298871386	1.708633637	0	7.121970623	0	0	0	3.070381369	10.53194017	0	3.754738528	0	0	7.291627099	0	0	0	0	0	0.048697544	0	0	0	0	0	0	0	0	0	0	0	0	0	55.4254		0	13.7704	1.530047418	0.200772114	0	0.715379764	1.277032421	2.104840225	2.298871386	1.708633637	0	7.121970623	0	0	0	3.070381369	10.53194017	0	3.754738528	0	0	7.291627099	0	0	0	0	0	0.048697544	0	0	0	0	0	0	0	0	0	0	0	0	0	55.4254																																																																																		0			13.7704	1.530047418	0.200772114	0	0.715379764	1.277032421	2.104840225	2.298871386	1.708633637	0	7.121970623	0	0	0	3.070381369	10.53194017	0	3.754738528	0	0	7.291627099	0	0	0	0	0	0.048697544	0	0	0	0	0	0	0	0	0	0	0	0	0	55.4254
H3864_007_0	2009	7																																D	D	D		T	Coin	Coin	V	V		V				V	V		V			Coin						V																																																						0		466.4202734	51.82447483	31.65472058		82.1857901	4.529389207	7.465464809	283.4618852	115.5193553		762.7734219				2873.122311	5913.184451		2369.823351			49.21074706						32.25885258														$125 (1-4)	$125 (1-4)	$25 (21-100)		$50 copay	20% to $500	20% to $500 Prosth and $0 copay Supplies	$50 waived - WW	$125 ASC / $0 OPV		$50 CT/$100 MRI/$200 PET				$10 PCP / $25 Specialist	$10 PCP / $25 Specialist		$25 copay			20% Part B Rx						$25 Med-Cov/$25 routine/Aids to $250 per 2 yrs														125	125	25		50	0.2	0.2	50	125		65				10	25		25			0.2						25														125	125	25		50	0.2	0.2	50	125		65				10	25		25			0.2						25														4.8585	0.539838279	0.065947335	0	0.342440792	0.905877841	1.493092962	1.181091188	1.203326618	0	4.131689369	0	0	0	2.394268593	12.31913427	0	4.937131981	0	0	9.842149412	0	0	0	0	0	0.067205943	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2817		0	4.8585	0.539838279	0.065947335	0	0.342440792	0.905877841	1.493092962	1.181091188	1.203326618	0	4.131689369	0	0	0	2.394268593	12.31913427	0	4.937131981	0	0	9.842149412	0	0	0	0	0	0.067205943	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2817																10% Coins POS Prof Visits Benefit	10% Coins POS Prof Visits Benefit																																							0.116	0.2388																									0.3549		0	4.8585	0.539838279	0.065947335	0	0.342440792	0.905877841	1.493092962	1.181091188	1.203326618	0	4.131689369	0	0	0	2.510313564	12.55796689	0	4.937131981	0	0	9.842149412	0	0	0	0	0	0.067205943	0	0	0	0	0	0	0	0	0	0	0	0	0	44.6366
H3864_801_0	2009	3																																D	D	D		T			V	V						V	V		V			Coin						V																																																						0		317.6411011	35.29345568	0		50.92349782			189.5613291	115.6742146						2516.134411	5178.466234		2583.913775			34.90194621						30.07538241														$125 (1-4)	$125 (1-4)			$50 copay			$50 WW	$125 ASC / $0 OPV						$10 PCP / $15 Specialist	$10 PCP / $15 Specialist		$15 copay			20% Part B Rx						$15 Med-Cov/$15 routine/Aids to $250 per 2 yrs														125	125	0		50			50	125						10	15		15			0.2						15														125	125	0		50			50	125						10	15		15			0.2						15														3.3088	0.367640163	0	0	0.212181241	0	0	0.789838871	1.204939735	0	0	0	0	0	2.096778676	6.473082792	0	3.229892219	0	0	6.980389242	0	0	0	0	0	0.037594228	0	0	0	0	0	0	0	0	0	0	0	0	0	24.7011		0	3.3088	0.367640163	0	0	0.212181241	0	0	0.789838871	1.204939735	0	0	0	0	0	2.096778676	6.473082792	0	3.229892219	0	0	6.980389242	0	0	0	0	0	0.037594228	0	0	0	0	0	0	0	0	0	0	0	0	0	24.7011																																																																																		0			3.3088	0.367640163	0	0	0.212181241	0	0	0.789838871	1.204939735	0	0	0	0	0	2.096778676	6.473082792	0	3.229892219	0	0	6.980389242	0	0	0	0	0	0.037594228	0	0	0	0	0	0	0	0	0	0	0	0	0	24.7011
H3887_001_0	2009	7																																Coin	Coin	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		407.8618608	42.042	8117.33802	108.2051732	26.92462371	14.81317181	16.92352726	11.75891336	8.22564753	33.80529261	27.9676081	0	0.105666539	5.488004558	1.280745917	153.2468645	43.282	42.97517103	0	0	10.11119782	7.57666645	1498.037626	0	182.0000636	141.3063859	0	0	0	0											"7% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"7% (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.068769641	0.0697	0	0	0.2	0.2	0.2	0.062348601	0.2	0.08	0.15003742	0	0.2	0.2	0	0.19882526	0.2	0	0	0	0.2	0.022666282	0	0	0	0	0	0	0	0											0.068769641	0.0697	0	0	0.2	0.2	0.2	0.062348601	0.2	0.08	0.15003742	0	0.2	0.2	0	0.19882526	0.2	0	0	0	0.2	0.022666282	0	0	0	0	0	0	0	0											28.0485	2.9303274	0	0	5.384924741	2.962634362	3.384705453	0.733151803	1.645129506	2.704423409	4.19618775	0	0.021133308	1.097600912	0	30.46934769	8.6564	0	0	0	2.022239563	0.171734856	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.4285	0	0	28.0485	2.9303274	0	0	5.384924741	2.962634362	3.384705453	0.733151803	1.645129506	2.704423409	4.19618775	0	0.021133308	1.097600912	0	30.46934769	8.6564	0	0	0	2.022239563	0.171734856	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.4285		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											3.1374	0.3234	0.8815	0.0557	0.4251	0.2339	0.2672	0.0386	0.1299	0.5338	0.4416	0	0.0011	0.0867	0.0202	2.4197	0.6834	0.0052	0	0	0.1597	0.1195	0.1107	0	0.0089	0	0	0	0	0											10.0831	0	0	31.1859	3.2537274	0.881477439	0.055712557	5.810050379	3.196526549	3.651919041	0.77173874	1.775008151	3.238191187	4.637781562	0	0.022245587	1.184253615	0.020222304	32.88903502	9.3398	0.005157347	0	0	2.181890055	0.291222764	0.110719388	0	0.008933819	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.5115
H3887_002_0	2009	6																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		416.0510734	22.752	54.57518564	5586.832689	18.04070344	39.62768428	13.47562696	28.30637676	44.06548893	8.183320985	19.79781565	0	3.30014572	46.88942138	63.43278807	170.3856265	13.376	6.96236829	0	0	29.47146857	8.498556365	145.6678154	0	186.6288954	332.2285714	0	0	20.2	0											"7% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"7% (1b); $0 n/c (1b1, 1b2)"	17.6% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.0688636	0.0697	0.1755	0	0.2	0.2	0.2	0.106661436	0.2	0.08	0.2	0	0.2	0.2	0	0.199673523	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											0.0688636	0.0697	0.1755	0	0.2	0.2	0.2	0.106661436	0.2	0.08	0.2	0	0.2	0.2	0	0.199673523	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											28.6508	1.5858144	9.57794508	0	3.608140688	7.925536856	2.695125393	3.019198804	8.813097787	0.654665679	3.95956313	0	0.660029144	9.377884276	0	34.02149826	2.6752	1.392473658	0	0	5.894293714	0.126367405	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.6376	0	0	28.6508	1.5858144	9.57794508	0	3.608140688	7.925536856	2.695125393	3.019198804	8.813097787	0.654665679	3.95956313	0	0.660029144	9.377884276	0	34.02149826	2.6752	1.392473658	0	0	5.894293714	0.126367405	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.6376		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											5.2006	0.2844	0.8617	1.2762	0.2849	0.6257	0.2128	0.159	0.6958	0.1292	0.3126	0	0.0347	0.7404	1.0016	2.6903	0.2112	0.1099	0	0	0.4653	0.0922	0.0261	0	0.0155	0	0	0	0.003	0											15.4331	0	0	33.8514	1.8702144	10.43965854	1.276195437	3.8929939	8.551237134	2.90789845	3.178213704	9.508868664	0.78387601	4.272160219	0	0.69476752	10.11824356	1.001570338	36.71179763	2.8864	1.502405789	0	0	6.359632692	0.218586392	0.0261	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	140.0707
H3887_003_0	2009	4																					3600											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1676.10282	172.5154346	714.0895343	757.2757532	114.2910403	12.5747502	4.644786246	325.0005755	38.2004065	10121.67575	44.45602989	0	0.231388834	28.90504286	4746.133132	3740.560002	589.0121196	211.8642478	0	0	17.88396546	812.0707352	0	0	103.5923094	0	12.88706159	0	453.6	0											"$195 Days 1-19 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$195 Days 1-19 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$28 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$8 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$28 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$28 (7c, 7i)"	Included in h.2.	$8 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $28 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$28 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$28 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											192.7155233	195	85.36789939	0	150	0.2	0.076056143	49.5168679	0.2	2.8	0.172763969	0	0.2	0.197047433	5.744075889	28	37.5	28	0	0	0.2	26.65325159	0	0	28	0	28	0	0	0											132.9893997	134.5458546	58.90203578	0	103.4968112	0.137995748	0.052477122	34.16558619	0.137995748	1.931940476	0.119203466	0	0.137995748	0.13622169	5.744075889	28	37.5	19.31940476	0	0	0.137995748	26.65325159	0	0	28	0	28	0	0	0											18.5753	1.934269715	3.505110608	0	0.985729852	1.735262063	0.243745014	0.925319598	5.271493679	1.629539589	5.299312851	0	0.031930675	3.93749378	2.271845741	8.727973339	1.840662874	0.34109093	0	0	2.467911196	1.803693801	0	0	0.241715389	0	0.03006981	0	0	0	0	0	0	0	0	0	0	0	0	0	61.7995	0	21.0507	18.5753	1.934269715	3.505110608	0	0.985729852	1.735262063	0.243745014	0.925319598	5.271493679	1.629539589	5.299312851	0	0.031930675	3.93749378	2.271845741	8.727973339	1.840662874	0.34109093	0	0	2.467911196	1.803693801	0	0	0.241715389	0	0.03006981	0	0	0	0	0	0	0	0	0	0	0	0	0	61.7995		"$295 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$295 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$40 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$40 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											5.632	0.576	6.9344	0.7141	0.4762	1.2575	0.4645	0.447	3.82	0.7872	3.7721	0	0.0154	2.8438	2.8259	5.2953	0.894	0.3027	0	0	2.2994	1.1252	0	0	0.148	0	0.0184	0	0	0											40.6493	0	0	24.2073	2.510298176	10.43954117	0.714126609	1.46194252	2.992737083	0.708223638	1.372347669	9.091534329	2.416781036	9.071393165	0	0.047356598	6.781303733	5.097789151	14.02326875	2.734699127	0.643754141	0	0	4.767278183	2.928918577	0	0	0.389704402	0	0.048479898	0	0	0	0	0	0	0	0	0	0	0	0	0	102.4488
H3887_004_0	2009	3																					3250											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1691.66032	174.116714	720.7176765	764.3047477	115.3518838	12.80926994	4.731411748	328.0135385	38.91284604	10215.62462	45.28513714	0	0.235704248	29.44412339	4789.275235	3775.215296	594.4792997	213.8307608	0	0	18.21750233	819.6083339	0	0	103.5923094	0	12.88706159	0	98.4	0											"$195 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$195 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$5 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											192.7155233	195	85.36789939	0	150	0.2	0.076056143	49.51686249	0.2	2.8	0.172510315	0	0.2	0.196894156	3.590730513	25	37.5	25	0	0	0.2	23.79984922	0	0	25	0	25	0	0	0											127.2981545	128.7852368	56.38012893	0	99.06556679	0.132087422	0.050230299	32.70277365	0.132087422	1.849223913	0.113932214	0	0.132087422	0.130321782	3.590730513	25	37.5	16.5109278	0	0	0.132087422	23.79984922	0	0	25	0	25	0	0	0											17.9454	1.868638521	3.386179627	0	0.952283313	1.691943449	0.237660229	0.893912709	5.139897532	1.574248112	5.159435953	0	0.031133567	3.837210641	1.43308306	7.865031867	1.857747812	0.294212021	0	0	2.406302926	1.625546231	0	0	0.215817311	0	0.026848045	0	0	0	0	0	0	0	0	0	0	0	0	0	58.4426	0	23.3345	17.9454	1.868638521	3.386179627	0	0.952283313	1.691943449	0.237660229	0.893912709	5.139897532	1.574248112	5.159435953	0	0.031133567	3.837210641	1.43308306	7.865031867	1.857747812	0.294212021	0	0	2.406302926	1.625546231	0	0	0.215817311	0	0.026848045	0	0	0	0	0	0	0	0	0	0	0	0	0	58.4426		"$295 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$295 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$15 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$15 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$40 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$40 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											5.685	0.5814	6.9988	0.7274	0.4806	1.2809	0.4731	0.4512	3.8913	0.7945	3.8373	0	0.0157	2.8966	2.2228	5.3463	0.9023	0.3055	0	0	2.3423	1.1359	0	0	0.148	0	0.0184	0	0	0											40.5354	0	0	23.6305	2.450013648	10.38497521	0.727445106	1.432916162	2.972870443	0.710801404	1.345084967	9.031182136	2.368796694	8.996760535	0	0.046847183	6.733808355	3.655909723	13.21129213	2.760082463	0.599684536	0	0	4.748553226	2.761418967	0	0	0.363806325	0	0.045258133	0	0	0	0	0	0	0	0	0	0	0	0	0	98.978
H3887_005_0	2009	3																					3350											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1993.53286	267.2653983	49.10992182	53746.81339	93.11147738	24.53302127	10.84672232	380.4904999	398.9306841	6317.748581	483.1582058	0	0.952828327	1538.033075	6223.111673	4624.45837	1242.868229	275.7302722	0	0	31.68987881	1167.762873	769.983193	0	314.3760437	332.2285714	0	0	20.2	0											"$225 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$225 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	17.6% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$125 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$125 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5); $125 (9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											222.3	225	0.1755	0	125	0.14	0.2	49.97503223	125	4.4	64.79010385	0	0.2	115.7345881	3.254726395	25	20	20	0	0	0.2	13.6791576	0	0	0	0	0	0	0	0											152.4148458	154.2660382	0.1755	0	85.70335456	0.095987757	0.137125367	34.26422325	85.70335456	3.016758081	44.42183394	0	0.137125367	79.35073952	3.254726395	25	20	20	0	0	0.137125367	13.6791576	0	0	0	0	0	0	0	0											25.3203	3.435831179	8.61879128	0	0.664997163	2.354869687	1.487360782	1.086434286	2.849141488	1.588259924	1.788564465	0	0.130656934	10.17033849	1.687877151	9.63428827	2.071447048	0.459550454	0	0	4.345486271	1.331167698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.0254	0	25.3205	25.3203	3.435831179	8.61879128	0	0.664997163	2.354869687	1.487360782	1.086434286	2.849141488	1.588259924	1.788564465	0	0.130656934	10.17033849	1.687877151	9.63428827	2.071447048	0.459550454	0	0	4.345486271	1.331167698	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.0254		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											4.3903	0.2171	0.7754	0.6561	0.1689	0.3874	0.1713	0.0835	0.7665	0.1206	0.3251	0	0.01	0.6104	0.8308	2.6261	0.1512	0.0902	0	0	0.5004	0.1035	0.0569	0	0.0155	0	0	0	0.003	0											13.0601	0	0	29.7107	3.652911179	9.394211098	0.656072798	0.833865563	2.74223318	1.658624818	1.169943219	3.615678677	1.708819526	2.113672582	0	0.140686706	10.78073008	2.518637229	12.26041028	2.222647048	0.549731718	0	0	4.845852778	1.434707106	0.056935837	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	92.0855
H3887_801_0	2009	2																					5040											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1766.240695	181.7930126	752.492019	798.0007171	120.4374123	13.29867974	4.912187023	342.4572417	40.39960746	10666.00175	47.01536768	0	0.244709911	30.56910887	4996.092152	3934.410475	620.68816	223.257936	0	0	18.91354702	855.7424773	0	0	0	0	0	0	0	0											"$315 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$315 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-34 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 25% (9a); $40/$30 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											311.2704177	315	150	0	150	0.2	0.076056143	49.51683786	0.25	2.8	0.208960741	0	0.2	0.245855928	14.37536511	30	37.5	30	0	0	0.2	28.55571343	0	0	0	0	0	0	0	0											210.6052469	213.1077875	101.4798988	0	101.4798988	0.135306532	0.051454465	33.49975796	0.169133165	1.894291444	0.141368765	0	0.135306532	0.166603144	14.37536511	30	37.5	20.29597976	0	0	0.135306532	28.55571343	0	0	0	0	0	0	0	0											30.9983	3.228458892	6.363567828	0	1.018498034	1.799398233	0.252753953	0.956019559	6.832913461	1.683709655	6.646504488	0	0.033110849	5.092909639	5.985054066	9.836026187	1.9396505	0.377603213	0	0	2.55912645	2.036361413	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.64	0	32.4205	30.9983	3.228458892	6.363567828	0	1.018498034	1.799398233	0.252753953	0.956019559	6.832913461	1.683709655	6.646504488	0	0.033110849	5.092909639	5.985054066	9.836026187	1.9396505	0.377603213	0	0	2.55912645	2.036361413	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.64		"$365 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 40% (13c)"	"$365 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 40% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											7.3517	0.751	7.3074	1.007	0.5018	1.3299	0.4912	0.471	5.3866	0.8296	5.1248	0	0.0163	3.9982	3.7476	4.9029	0.9421	0.2791	0	0	2.4317	1.0405	0	0	0	0	0	0	0	0											47.9104	0	0	38.35	3.979500539	13.67091992	1.006985259	1.520320586	3.129266207	0.743972656	1.42705844	12.21952779	2.513287568	11.77131336	0	0.049424843	9.091063786	9.732613424	14.73894915	2.881766457	0.656675633	0	0	4.990868209	3.076827991	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.5504
H3887_802_0	2009	2																					5040											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1766.239318	181.7928708	752.4914321	798.0000948	120.4373184	13.298659	4.912179361	342.4569749	40.39954445	10665.99343	47.01529434	0	0.24470953	30.56906119	4996.088332	3934.407406	620.6876759	223.2577619	0	0	18.91351752	855.7418099	0	0	0	0	0	0	0	0											"$315 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$315 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-34 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 25% (9a); $40/$30 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											311.2704177	315	150	0	150	0.2	0.076056143	49.51683786	0.25	2.8	0.208960762	0	0.2	0.24585593	14.37536489	30	37.5	30	0	0	0.2	28.55571342	0	0	0	0	0	0	0	0											210.605334	213.1078757	101.4799408	0	101.4799408	0.135306588	0.051454486	33.49977183	0.169133235	1.894292228	0.141368839	0	0.135306588	0.166603214	14.37536489	30	37.5	20.29598816	0	0	0.135306588	28.55571342	0	0	0	0	0	0	0	0											30.9983	3.22845771	6.363565499	0	1.018497662	1.799396171	0.252753664	0.95601921	6.832905631	1.683709038	6.646497553	0	0.033110811	5.092903834	5.985049399	9.836018516	1.939648987	0.377603074	0	0	2.559123517	2.036359824	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.6399	0	32.4205	30.9983	3.22845771	6.363565499	0	1.018497662	1.799396171	0.252753664	0.95601921	6.832905631	1.683709038	6.646497553	0	0.033110811	5.092903834	5.985049399	9.836018516	1.939648987	0.377603074	0	0	2.559123517	2.036359824	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.6399		"$365 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 40% (13c)"	"$365 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 40% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											7.3517	0.751	7.3073	1.007	0.5018	1.3299	0.4912	0.471	5.3866	0.8296	5.1248	0	0.0163	3.9981	3.7476	4.9029	0.9421	0.2791	0	0	2.4317	1.0405	0	0	0	0	0	0	0	0											47.9104	0	0	38.35	3.979498772	13.67091189	1.006983688	1.520319821	3.12926207	0.7439716	1.427057724	12.21951156	2.513286305	11.77129888	0	0.04942478	9.091051765	9.732605548	14.73893749	2.881764209	0.656675277	0	0	4.990861483	3.076825573	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.5503
H3887_803_0	2009	2																					5040											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1766.240351	181.7929772	752.4918723	798.0005615	120.4373888	13.29867456	4.912185107	342.457175	40.39959171	10665.99967	47.01534935	0	0.244709816	30.56909695	4996.091197	3934.409708	620.6880389	223.2578925	0	0	18.91353964	855.7423105	0	0	0	0	0	0	0	0											"$315 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$315 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-34 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 25% (9a); $40/$30 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											311.2704177	315	150	0	150	0.2	0.076056143	49.51683786	0.25	2.8	0.208960746	0	0.2	0.245855929	14.37536505	30	37.5	30	0	0	0.2	28.55571343	0	0	0	0	0	0	0	0											210.6052686	213.1078095	101.4799093	0	101.4799093	0.135306546	0.05145447	33.49976143	0.169133182	1.89429164	0.141368784	0	0.135306546	0.166603161	14.37536505	30	37.5	20.29598186	0	0	0.135306546	28.55571343	0	0	0	0	0	0	0	0											30.9983	3.228458596	6.363567245	0	1.018497941	1.799397717	0.252753881	0.956019472	6.832911504	1.683709501	6.646502755	0	0.03311084	5.092908188	5.9850529	9.836024269	1.939650122	0.377603178	0	0	2.559125717	2.036361016	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.6399	0	32.4205	30.9983	3.228458596	6.363567245	0	1.018497941	1.799397717	0.252753881	0.956019472	6.832911504	1.683709501	6.646502755	0	0.03311084	5.092908188	5.9850529	9.836024269	1.939650122	0.377603178	0	0	2.559125717	2.036361016	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.6399		"$365 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 40% (13c)"	"$365 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 40% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											7.3517	0.751	7.3074	1.007	0.5018	1.3299	0.4912	0.471	5.3866	0.8296	5.1248	0	0.0163	3.9982	3.7476	4.9029	0.9421	0.2791	0	0	2.4317	1.0405	0	0	0	0	0	0	0	0											47.9104	0	0	38.35	3.979500097	13.67091791	1.006984866	1.520320395	3.129265173	0.743972392	1.427058261	12.21952373	2.513287253	11.77130974	0	0.049424828	9.091060781	9.732611455	14.73894624	2.881765895	0.656675544	0	0	4.990866528	3.076827387	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.5503
H3887_804_0	2009	2																					5040											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1766.236218	181.7925518	752.4901117	797.9986945	120.437107	13.29861233	4.912162121	342.4563747	40.39940266	10665.97471	47.01512934	0	0.244708671	30.56895391	4996.079737	3934.400502	620.6865867	223.2573701	0	0	18.91345114	855.7403083	0	0	0	0	0	0	0	0											"$315 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$315 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-34 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 25% (9a); $40/$30 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											311.2704177	315	150	0	150	0.2	0.076056143	49.51683786	0.25	2.8	0.20896081	0	0.2	0.245855934	14.37536439	30	37.5	30	0	0	0.2	28.55571338	0	0	0	0	0	0	0	0											210.6055301	213.1080741	101.4800353	0	101.4800353	0.135306714	0.051454534	33.49980303	0.169133392	1.894293992	0.141369003	0	0.135306714	0.166603371	14.37536439	30	37.5	20.29600706	0	0	0.135306714	28.55571338	0	0	0	0	0	0	0	0											30.9983	3.228455051	6.363560258	0	1.018496823	1.799391531	0.252753012	0.956018425	6.832888014	1.683707652	6.646481951	0	0.033110726	5.092890773	5.985038896	9.836001256	1.939645583	0.377602763	0	0	2.559116919	2.036356248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.6398	0	32.4203	30.9983	3.228455051	6.363560258	0	1.018496823	1.799391531	0.252753012	0.956018425	6.832888014	1.683707652	6.646481951	0	0.033110726	5.092890773	5.985038896	9.836001256	1.939645583	0.377602763	0	0	2.559116919	2.036356248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.6398		"$365 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 40% (13c)"	"$365 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 40% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											7.3517	0.751	7.3073	1.007	0.5018	1.3299	0.4912	0.471	5.3866	0.8296	5.1248	0	0.0163	3.9981	3.7475	4.9029	0.9421	0.2791	0	0	2.4317	1.0405	0	0	0	0	0	0	0	0											47.9102	0	0	38.35	3.979494795	13.67089383	1.006980154	1.520318102	3.129252764	0.743969224	1.427056113	12.21947504	2.513283463	11.7712663	0	0.049424637	9.091024718	9.732587828	14.73891125	2.881759153	0.656674476	0	0	4.990846351	3.076820131	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.55
H3907_002_0	2009	2																					3100											A	A	D		T	coin	coin	V	V		P	V		V	V	V	V	V			S	P	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		330.0570683	6.026081059	1433.604684	0	221.119186	15.24731486	1.788874244	279.1685114	246.909039	0	2135.860675	194.3544589	0	11657.89979	15556.41735	5958.260475	43.09743171	648.6534403	0	0	196.73413	92.16332101	38.28596728	0.698133664																	"1a:  $250 per Admit, max 3"	"1b:  $250 per Admit, max 3"	"2:  $60 per day, day 16 - 65"		10a:  $100 per Trip	11a:  20% Coinsurance	"11b:  20% Coinsurance, supplies paid 100%"	"4a,b:  $50 Copay"	"9a,b:  $150 Copay, max 2x"		8b:  $15/$50 Copay depending on type of Service	"9a:  $250 Observation copay- no PBP code, 3x Max"		"7c,i:  $30 Copay"	"7a, 14c:  $15"	"7a,b,d,f,g 16b, 17a, 18a:  $30 Copay"	"7e,h 9c:  $30 Copay"	"7c,i:  $30 Copay"			15:  $32/$96 Copay per 31/90 day supply	11c:  $20/$60 Copay per 31/90 day supply	10a:  $100 per Trip																		199.4201895	250	29.41510231	0	100	0.042598957	0.2	50	128.0840593	0	27.96701245	201.7353579	0	0.264554287	4.952181052	20.32950387	5.254582485	30	0	0	0	265.4000881	74.95313615	0																	194.9871357	244.4425715	28.761213	0	97.77702861	0.041651995	0.195554057	48.88851431	125.2367873	0	27.34531376	197.2508386	0	0.258673321	4.842095484	19.87758481	5.13777462	29.33310858	0	0	0	259.5003201	73.28694938	0																	5.3631	0.122752563	3.436017473	0	1.801698082	0.635081076	0.349821616	1.13734448	2.576841234	0	4.867148359	3.194715001	0	0.251298971	6.277138184	9.869652328	0.018452074	1.58558515	0	0	0	1.993034275	0.233821812	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7135	0	0.9938	5.3631	0.122752563	3.436017473	0	1.801698082	0.635081076	0.349821616	1.13734448	2.576841234	0	4.867148359	3.194715001	0	0.251298971	6.277138184	9.869652328	0.018452074	1.58558515	0	0	0	1.993034275	0.233821812	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7135																																																																																		0			5.3631	0.122752563	3.436017473	0	1.801698082	0.635081076	0.349821616	1.13734448	2.576841234	0	4.867148359	3.194715001	0	0.251298971	6.277138184	9.869652328	0.018452074	1.58558515	0	0	0	1.993034275	0.233821812	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7135
H3907_006_0	2009	4																					3100											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	0	0	0	0	0	0	0	0											0		324.2272034	13.70492292	1251.011119	956.1572179	225.3020416	19.05244106	3.506034023	310.8202188	280.5147739	14252.74542	2589.032036	225.5861551	20.07735722	14017.30999	18001.90777	7208.401637	96.31449192	1010.391246	0	0	230.0365257	95.84010137	51.14043819	0	0	222.6015116	0.377377982	24.00985628	91.99070427	120.1800297											"1a:  $100 per Admit, max 2"	"1b:  $100 per Admit, max 2"	"2:  $60 per day, day 16 - 50"		10a:  $100 per Trip	11a:  20% Coinsurance	"11b:  20% Coinsurance, Medical Supplies 100%"	"4a,b:  $50 Copay"	"9a,b:  $60 Copay, max 2x"		"8b:  $15/$50 Copay depending on type of Service, $200 Max"	"9a:  $100 Observation copay- no PBP code, 2x Max"		"7c,i:  $15 Copay"		"7a,b,d,f,g 16b, 17a, 18a:  $25 Copay"	"7e,h 9c:  $25 Copay"	"7c,i:  $15 Copay"			15:  $25/$75 Copay per 31/90 day supply	11c:  $15/$45 Copay per 31/90 day supply	10a:  $100 per Trip				18a:  $25 copay														67.2562392	100	24.00441664	0	100	0.043951975	0.2	50	51.98299069	0	23.1524388	67.81414278	0	0.653667633	0	17.01025704	3.859390364	15	0	0	0	154.6048314	65.51082185	0	0	0	25	0	0	0											66.18322783	98.40459208	23.62144827	0	98.40459208	0.043250762	0.196809184	49.20229604	51.15364994	0	22.78306295	66.73223058	0	0.643238968	0	16.73887406	3.797817344	14.76068881	0	0	0	152.1382537	64.46565701	0	0	0	24.60114802	0	0	0											1.7882	0.112385612	2.462557869	0	1.847562958	0.82403259	0.690019696	1.274422368	1.195779546	0	4.915506655	1.254488943	0	0.751373334	0	10.05504393	0.030482071	1.24283923	0	0	0	1.215078804	0.274733496	0	0	0	0.000773661	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9353	0	0.4853	1.7882	0.112385612	2.462557869	0	1.847562958	0.82403259	0.690019696	1.274422368	1.195779546	0	4.915506655	1.254488943	0	0.751373334	0	10.05504393	0.030482071	1.24283923	0	0	0	1.215078804	0.274733496	0	0	0	0.000773661	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9353																																																																																		0			1.7882	0.112385612	2.462557869	0	1.847562958	0.82403259	0.690019696	1.274422368	1.195779546	0	4.915506655	1.254488943	0	0.751373334	0	10.05504393	0.030482071	1.24283923	0	0	0	1.215078804	0.274733496	0	0	0	0.000773661	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9353
H3907_020_0	2009	5																					N/A											Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		329.0225275	45.49176622	60.41377442	36.69943818	23.67573988	35.28194225	4.483920402	42.28098816	23.68279884	44.7367442	37.70030811	16.48283146	1.590780773	59.81361918	105.3242838	51.60062003	2.161897065	9.944727032	0	0	53.09319693	19.42459674	0.682032869	4.237509309	0	6.379835362	0.003031749	3.990433371	1.199532246	0.258604804											Medicare Cost Sharing	Medicare Cost Sharing		Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																			0.077821204	0.077821204	0	0	0.231	0.231	0.231	0.231	0.231	0.231	0.230970158	0.231	0.231	0.231	0.229682167	0.211460204	0.231	0.231	0.23	0.23	0.231	0.231	0	0	0	0	0	0	0	0											0.077821204	0.077821204	0	0	0.231	0.231	0.231	0.231	0.231	0.231	0.230970158	0.231	0.231	0.231	0.229682167	0.211460204	0.231	0.231	0.23	0.23	0.231	0.231	0	0	0	0	0	0	0	0											25.6049	3.540224009	0	0	5.469095913	8.150128659	1.035785613	9.766908264	5.470726532	10.33418791	8.707646124	3.807534067	0.367470359	13.81694603	24.19110974	10.91147766	0.499398222	2.297231945	0	0	12.26452849	4.487081847	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.7224	0	0	25.6049	3.540224009	0	0	5.469095913	8.150128659	1.035785613	9.766908264	5.470726532	10.33418791	8.707646124	3.807534067	0.367470359	13.81694603	24.19110974	10.91147766	0.499398222	2.297231945	0	0	12.26452849	4.487081847	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.7224	N/A																																																																																	0			25.6049	3.540224009	0	0	5.469095913	8.150128659	1.035785613	9.766908264	5.470726532	10.33418791	8.707646124	3.807534067	0.367470359	13.81694603	24.19110974	10.91147766	0.499398222	2.297231945	0	0	12.26452849	4.487081847	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.7224
H3907_029_0	2009	5																					3100											A	A	D		T	coin	coin	V	V		P	V		V	V	V	V	V			S	P	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		306.8660154	9.717189105	1291.400349		222.5770078	17.0355233	2.219393667	329.8779757	256.9423178		2426.016884	212.7169188		13654.19317	16369.19766	6393.421471	54.3754905	706.3935009			227.6561504	83.51674822	33.06029823				0.144450085	12.25376481	71.21599784	102.0809208											"1a:  $250 per Admit, max 3"	"1b:  $250 per Admit, max 3"	"2:  $60 per day, day 16 - 65"		10a:  $100 per Trip	11a:  20% Coinsurance	"11b:  20% Coinsurance, Medical Supplies 100%"	"4a,b:  $50 Copay"	"9a,b:  $150 Copay, max 2x"		8b:  $15/$50 Copay depending on type of Service	"9a:  $250 Observation copay- no PBP code, 3x Max"		"7c,i:  $30 Copay"	"7a, 14c:  $15"	"7a,b,d,f,g 16b, 17a, 18a:  $30 Copay"	"7e,h 9c:  $30 Copay"	"7c,i:  $30 Copay"			15:  $32/$96 Copay per 31/90 day supply	11c:  $20/$60 Copay per 31/90 day supply	10a:  $100 per Trip				18a:  $30 copay														203.5977379	250	30.18702833	0	100	0.040954858	0.2	50	129.1124736	0	26.67055167	208.3792723	0	0.495720324	5.044379484	20.11728766	5.52	30	0	0	0	209.2820771	76.05019546	0	0	0	30	0	0	0											199.4460881	244.9021416	29.57147154	0	97.96085662	0.040119729	0.195921713	48.98042831	126.4796852	0	26.12670088	204.1301202	0	0.485611876	4.941517354	19.70706732	5.407439286	29.38825699	0	0	0	205.0145155	74.49942293	0	0	0	29.38825699	0	0	0											5.1003	0.198313368	3.182384056	0	1.816986196	0.683460586	0.43482741	1.346463712	2.708165288	0	5.281984789	3.618494184	0	0.552553196	6.74072286	10.49963228	0.02450268	1.729972811	0	0	0	1.426845472	0.205247762	0	0	0	0.000353761	0	0	0	0	0	0	0	0	0	0	0	0	0	45.5512	0	0.9482	5.1003	0.198313368	3.182384056	0	1.816986196	0.683460586	0.43482741	1.346463712	2.708165288	0	5.281984789	3.618494184	0	0.552553196	6.74072286	10.49963228	0.02450268	1.729972811	0	0	0	1.426845472	0.205247762	0	0	0	0.000353761	0	0	0	0	0	0	0	0	0	0	0	0	0	45.5512																																																																																		0			5.1003	0.198313368	3.182384056	0	1.816986196	0.683460586	0.43482741	1.346463712	2.708165288	0	5.281984789	3.618494184	0	0.552553196	6.74072286	10.49963228	0.02450268	1.729972811	0	0	0	1.426845472	0.205247762	0	0	0	0.000353761	0	0	0	0	0	0	0	0	0	0	0	0	0	45.5512
H3907_801_0	2009	2																					3100											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	0	0	0	0	0	0	0	0											0		339.9032851	4.207030103	1406.756625	745.6753546	244.2300911	19.34891749	2.619304005	555.3463574	335.4500938	17568.38648	2598.496055	219.5140568	29.55731932	11412.81992	19456.10544	10560.2369	71.72746025	1353.919461	0	0	253.3233418	97.20226813	53.25413567	0	0	251.2255503	0.126917918	26.0929375	92.84551135	145.6207585											1a:  $100 per Admit	1b:  $100 per Admit	"2:  $30 per day, day 21 - 100"		10a:  $75 per Trip	11a:  15% Coinsurance	"11b:  15% Coinsurance, Medical Supplies 100%"	"4a,b:  $50 Copay"	"9a,b:  $100 Copay"		8b:  $5/$40 Copay depending on type of Service	9a:  $100 Observation copay- no PBP code		"7c,i:  $25 Copay"	"7a, 14c:  $5 Copay"	"7a,b,d,f,g 16b, 17a, 18a:  $25 Copay"	"7e,h 9c:  $25 Copay"	"7c,i:  $25 Copay"			15:  $20/$60 Copay per 31/90 day supply	11c:  $20/$60 Copay per 31/90 day supply	10a:  $75 per Trip	"16a:  $25 Copay, 16b:  20% coinsurance"			18a:  $25 copay														98.54386604	100	30	0	75	0.031837695	0.15	50	100	0	18.10820749	100	0	0.531641754	1.481331116	18.4644568	2.531083481	25	0	0	0	170.7929016	5.208147083	0	0	0	25	0	0	0											96.97168939	98.40459208	29.52137762	0	73.80344406	0.031329754	0.147606888	49.20229604	98.40459208	0	17.81930772	98.40459208	0	0.5231599	1.457697842	18.1698734	2.490702375	24.60114802	0	0	0	168.0680581	5.125055892	0	0	0	24.60114802	0	0	0											2.7467	0.034499257	3.460782795	0	1.502085156	0.606196819	0.386627313	2.277026323	2.750819137	0	3.858616734	1.800099268	0	0.497560811	2.363426909	15.98984728	0.014887646	2.775664422	0	0	0	1.361383038	0.022744202	0	0	0	0.000260194	0	0	0	0	0	0	0	0	0	0	0	0	0	42.4493	0	0.4978	2.7467	0.034499257	3.460782795	0	1.502085156	0.606196819	0.386627313	2.277026323	2.750819137	0	3.858616734	1.800099268	0	0.497560811	2.363426909	15.98984728	0.014887646	2.775664422	0	0	0	1.361383038	0.022744202	0	0	0	0.000260194	0	0	0	0	0	0	0	0	0	0	0	0	0	42.4493																																																																																		0			2.7467	0.034499257	3.460782795	0	1.502085156	0.606196819	0.386627313	2.277026323	2.750819137	0	3.858616734	1.800099268	0	0.497560811	2.363426909	15.98984728	0.014887646	2.775664422	0	0	0	1.361383038	0.022744202	0	0	0	0.000260194	0	0	0	0	0	0	0	0	0	0	0	0	0	42.4493
H3907_802_0	2009	2																					3100											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	0	0	0	0	0	0	0	0											0		339.9032851	4.207030103	1406.756625	745.6753546	244.2300911	19.34891749	2.619304005	555.3463574	335.4500938	17568.38648	2598.496055	219.5140568	29.55731932	11412.81992	19456.10544	10560.2369	71.72746025	1353.919461	0	0	253.3233418	97.20226813	53.25413567	0	0	251.2255503	0.126917918	26.0929375	92.84551135	145.6207585											1a:  $100 per Admit	1b:  $100 per Admit	"2:  $30 per day, day 21 - 100"		10a:  $75 per Trip	11a:  15% Coinsurance	"11b:  15% Coinsurance, Medical Supplies 100%"	"4a,b:  $50 Copay"	"9a,b:  $100 Copay"		8b:  $5/$40 Copay depending on type of Service	9a:  $100 Observation copay- no PBP code		"7c,i:  $25 Copay"	"7a, 14c:  $5 Copay"	"7a,b,d,f,g 16b, 17a, 18a:  $25 Copay"	"7e,h 9c:  $25 Copay"	"7c,i:  $25 Copay"			15:  $20/$60 Copay per 31/90 day supply	11c:  $20/$60 Copay per 31/90 day supply	10a:  $75 per Trip	"16a:  $25 Copay, 16b:  20% coinsurance"			18a:  $25 copay														98.54386604	100	30	0	75	0.031837695	0.15	50	100	0	18.10820749	100	0	0.531641754	1.481331116	18.4644568	2.531083481	25	0	0	0	170.7929016	5.208147083	0	0	0	25	0	0	0											96.97168939	98.40459208	29.52137762	0	73.80344406	0.031329754	0.147606888	49.20229604	98.40459208	0	17.81930772	98.40459208	0	0.5231599	1.457697842	18.1698734	2.490702375	24.60114802	0	0	0	168.0680581	5.125055892	0	0	0	24.60114802	0	0	0											2.7467	0.034499257	3.460782795	0	1.502085156	0.606196819	0.386627313	2.277026323	2.750819137	0	3.858616734	1.800099268	0	0.497560811	2.363426909	15.98984728	0.014887646	2.775664422	0	0	0	1.361383038	0.022744202	0	0	0	0.000260194	0	0	0	0	0	0	0	0	0	0	0	0	0	42.4493	0	0.4978	2.7467	0.034499257	3.460782795	0	1.502085156	0.606196819	0.386627313	2.277026323	2.750819137	0	3.858616734	1.800099268	0	0.497560811	2.363426909	15.98984728	0.014887646	2.775664422	0	0	0	1.361383038	0.022744202	0	0	0	0.000260194	0	0	0	0	0	0	0	0	0	0	0	0	0	42.4493																																																																																		0			2.7467	0.034499257	3.460782795	0	1.502085156	0.606196819	0.386627313	2.277026323	2.750819137	0	3.858616734	1.800099268	0	0.497560811	2.363426909	15.98984728	0.014887646	2.775664422	0	0	0	1.361383038	0.022744202	0	0	0	0.000260194	0	0	0	0	0	0	0	0	0	0	0	0	0	42.4493
H3907_803_0	2009	2																					3100											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	0	0	0	0	0	0	0	0											0		339.9032851	4.207030103	1406.756625	745.6753546	244.2300911	19.34891749	2.619304005	555.3463574	335.4500938	17568.38648	2598.496055	219.5140568	29.55731932	11412.81992	19456.10544	10560.2369	71.72746025	1353.919461	0	0	253.3233418	97.20226813	53.25413567	0	0	251.2255503	0.126917918	26.0929375	92.84551135	145.6207585											1a:  $100 per Admit	1b:  $100 per Admit	"2:  $30 per day, day 21 - 100"		10a:  $75 per Trip	11a:  15% Coinsurance	"11b:  15% Coinsurance, Medical Supplies 100%"	"4a,b:  $50 Copay"	"9a,b:  $100 Copay"		8b:  $5/$40 Copay depending on type of Service	9a:  $100 Observation copay- no PBP code		"7c,i:  $25 Copay"	"7a, 14c:  $5 Copay"	"7a,b,d,f,g 16b, 17a, 18a:  $25 Copay"	"7e,h 9c:  $25 Copay"	"7c,i:  $25 Copay"			15:  $20/$60 Copay per 31/90 day supply	11c:  $20/$60 Copay per 31/90 day supply	10a:  $75 per Trip	"16a:  $25 Copay, 16b:  20% coinsurance"			18a:  $25 copay														98.54386604	100	30	0	75	0.031837695	0.15	50	100	0	18.10820749	100	0	0.531641754	1.481331116	18.4644568	2.531083481	25	0	0	0	170.7929016	5.208147083	0	0	0	25	0	0	0											96.97168939	98.40459208	29.52137762	0	73.80344406	0.031329754	0.147606888	49.20229604	98.40459208	0	17.81930772	98.40459208	0	0.5231599	1.457697842	18.1698734	2.490702375	24.60114802	0	0	0	168.0680581	5.125055892	0	0	0	24.60114802	0	0	0											2.7467	0.034499257	3.460782795	0	1.502085156	0.606196819	0.386627313	2.277026323	2.750819137	0	3.858616734	1.800099268	0	0.497560811	2.363426909	15.98984728	0.014887646	2.775664422	0	0	0	1.361383038	0.022744202	0	0	0	0.000260194	0	0	0	0	0	0	0	0	0	0	0	0	0	42.4493	0	0.4978	2.7467	0.034499257	3.460782795	0	1.502085156	0.606196819	0.386627313	2.277026323	2.750819137	0	3.858616734	1.800099268	0	0.497560811	2.363426909	15.98984728	0.014887646	2.775664422	0	0	0	1.361383038	0.022744202	0	0	0	0.000260194	0	0	0	0	0	0	0	0	0	0	0	0	0	42.4493																																																																																		0			2.7467	0.034499257	3.460782795	0	1.502085156	0.606196819	0.386627313	2.277026323	2.750819137	0	3.858616734	1.800099268	0	0.497560811	2.363426909	15.98984728	0.014887646	2.775664422	0	0	0	1.361383038	0.022744202	0	0	0	0.000260194	0	0	0	0	0	0	0	0	0	0	0	0	0	42.4493
H3909_001_0	2009	8																																a	a	d		t	coin	coin	v	v		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		419.3555717	4.135032459	1228.168903		262.2719196	8.269125666	21.27474694	303.5494321	529.5292729		999.6565594			507.0663851	3901.219988	6763.968601	217.8997825	943.5308417	193.4073673	127.0356273	12.38279913																				$850/stay	$850/stay	$50 per day 100 day max (PBP category 2)		$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)"	$250 per visit (PBP categories 9A and 9B)		$45 per visit (PBP category 8B)			"$45 per visit (PBP categories 3, 5, 9C, and 9D)"	$25 per visit (PBP category 7A)	"$45 per visit (PBP categories 4B, 7B, 7D, and 7F)"	"$45 per visit (PBP categories 7E, 7H and 9C)"	$45 per visit (PBP categories 7C and 7I)	$45 per visit (per note in PBP category 8B)	"$45 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)																				850	850	50		100	0.2	0.2	50	250		45			45	25	45	45	45	45	45	50																				850	850	50		100	0.2	0.2	50	250		45			45	25	45	45	45	45	45	50																				29.7044	0.292898133	5.117370429	0	2.18559933	1.653825133	4.254949388	1.2647893	11.03185985	0	3.748712098	0	0	1.901498944	8.127541641	25.36488225	0.817124184	3.538240656	0.725277627	0.476383602	0.051594996	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2569			29.7044	0.292898133	5.117370429	0	2.18559933	1.653825133	4.254949388	1.2647893	11.03185985	0	3.748712098	0	0	1.901498944	8.127541641	25.36488225	0.817124184	3.538240656	0.725277627	0.476383602	0.051594996	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.2569		$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																				0	0	0.0272		1.1242	0.079	0.0984	0.0015	0.1837		0.0097			0.0285	0.2903	0.5872	0.5598	0.311	0.3777	0.9718	0																				4.6501			29.7044	0.292898133	5.144591642	0	3.30984571	1.732839736	4.353383501	1.266262305	11.21556206	0	3.758390773	0	0	1.92999793	8.417881451	25.95208438	1.376909029	3.849275705	1.103009875	1.448167499	0.051594996	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.907
H3909_007_0	2009	6																																a	a	d		t	coin	coin	v	v		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		419.3555717	4.135032459	1450.863747		280.2936161	10.07042243	10.41820882	409.1891107	621.6899091		1181.906482			548.8709688	4740.038935	7944.929806	220.6216518	720.2960831	201.1977162	124.8584109	133.2126709																				$850/stay	$850/stay	$50 per day 100 day max (PBP category 2)		$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)"	$250 per visit (PBP categories 9A and 9B)		$45 per visit (PBP category 8B)			"$45 per visit (PBP categories 3, 5, 9C, and 9D)"	$25 per visit (PBP category 7A)	"$45 per visit (PBP categories 4B, 7B, 7D, and 7F)"	"$45 per visit (PBP categories 7E, 7H and 9C)"	$45 per visit (PBP categories 7C and 7I)	$45 per visit (per note in PBP category 8B)	"$45 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)																				850	850	50		100	0.2	0.2	50	250		45			45	25	45	45	45	45	45	50																				850	850	50		100	0.2	0.2	50	250		45			45	25	45	45	45	45	45	50																				29.7044	0.292898133	6.045265612	0	2.335780134	2.014084486	2.083641764	1.704954628	12.95187311	0	4.432149308	0	0	2.058266133	9.875081115	29.79348677	0.827331194	2.701110312	0.754491436	0.468219041	0.555052795	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.598			29.7044	0.292898133	6.045265612	0	2.335780134	2.014084486	2.083641764	1.704954628	12.95187311	0	4.432149308	0	0	2.058266133	9.875081115	29.79348677	0.827331194	2.701110312	0.754491436	0.468219041	0.555052795	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.598		$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																				0.3357	0	0		1.0042	0.0594	0.0739	0	0.0634		0			0.0428	0.2575	0.6877	0.3311	0.3053	0.4878	0.9222	0																				4.571			30.0401	0.292898133	6.045265612	0	3.340009748	2.073459486	2.157511226	1.704954628	13.01525817	0	4.432149308	0	0	2.101041079	10.13257739	30.48113745	1.158447136	3.006428269	1.242301723	1.390445766	0.555052795	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.169
H3909_801_0	2009	7																																coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin																																																											0		311.3686314	4.379226533	22.35142589	9.642964911	2.209462671	7.265986608	11.77656355	7.55281688	58.55594123	14.92355359	40.47185153	0	1.313277963	193.8707996	20.61983586	44.35267443	1.373965845	10.22205954	25.50690524	263.2346952	5.588961249	6.587949608																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			0.0702	0.0702	0.1592	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.0702	0.0702	0.1592	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			21.8581	0.307421703	3.558347002	0	0.510385877	1.678442906	2.720386179	1.744700699	13.52642242	3.447340879	9.348997703	0	0.303367209	44.7841547	4.763182084	10.24546779	0.31738611	2.361295753	5.892095111	60.80721459	1.291050049	1.521816359	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	190.9876			21.8581	0.307421703	3.558347002	0	0.510385877	1.678442906	2.720386179	1.744700699	13.52642242	3.447340879	9.348997703	0	0.303367209	44.7841547	4.763182084	10.24546779	0.31738611	2.361295753	5.892095111	60.80721459	1.291050049	1.521816359	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	190.9876		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	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	0	0.024	0	0.6726	0.0171	0.0378	0.0104	0.0713	0	0	0	0	0.0043	0.1932	0.3043	0.3193	0.3092	0.2988	1.2407	0	0																			3.503			21.8581	0.307421703	3.582299884	0	1.182939116	1.695590369	2.758234536	1.755099427	13.5976991	3.447340879	9.348997703	0	0.303367209	44.78843107	4.956336258	10.54975678	0.6367184	2.670503874	6.190938012	62.04789939	1.291050049	1.521816359	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	194.4905
H3909_802_0	2009	6																																coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin																																																											0		311.3686314	4.379226533	22.35142589	9.642964911	2.209462671	7.265986608	11.77656355	7.55281688	58.55594123	14.92355359	40.47185153	0	1.313277963	193.8707996	20.61983586	44.35267443	1.373965845	10.22205954	25.50690524	263.2346952	5.588961249	6.587949608																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			0.0702	0.0702	0.1592	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.0702	0.0702	0.1592	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			21.8581	0.307421703	3.558347002	0	0.510385877	1.678442906	2.720386179	1.744700699	13.52642242	3.447340879	9.348997703	0	0.303367209	44.7841547	4.763182084	10.24546779	0.31738611	2.361295753	5.892095111	60.80721459	1.291050049	1.521816359	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	190.9876			21.8581	0.307421703	3.558347002	0	0.510385877	1.678442906	2.720386179	1.744700699	13.52642242	3.447340879	9.348997703	0	0.303367209	44.7841547	4.763182084	10.24546779	0.31738611	2.361295753	5.892095111	60.80721459	1.291050049	1.521816359	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	190.9876		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	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	0	0.024	0	0.6726	0.0171	0.0378	0.0104	0.0713	0	0	0	0	0.0043	0.1932	0.3043	0.3193	0.3092	0.2988	1.2407	0	0																			3.503			21.8581	0.307421703	3.582299884	0	1.182939116	1.695590369	2.758234536	1.755099427	13.5976991	3.447340879	9.348997703	0	0.303367209	44.78843107	4.956336258	10.54975678	0.6367184	2.670503874	6.190938012	62.04789939	1.291050049	1.521816359	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	194.4905
H3912_001_0	2009	4																					2400											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1697.193232	61.43608497	8121.09481	38.05895389	702.2060647	8.422515591	14.85269458	161.0448685	100.5363982	10049.87693	1490.063591	0	1.990107095	309.4069648	158.0508958	7398.705932	2613.739573	16.10102677	0	0	1478.915315	957.1819711	1188.626131	0	65.04380354	122.143627	0	0	0	0											"$175 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $35 (4b)	$35 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$35 (3, 5, 9a, 9d); $35/$25 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $35 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$15 (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"$35/$25 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											173.5380794	175	0	0	75	0.2	0.2	49.9376975	35	0	0	0	0	34.84206423	0	14.81872991	32.5	0	0	0	0	14.79029353	0	0	0	0	0	0	0	0											147.6609854	148.904912	0	0	63.81639084	0.170177042	0.170177042	42.49124828	29.78098239	0	0	0	0	29.64659718	0	12.60903813	27.65376936	0	0	0	0	12.58484203	0	0	0	0	0	0	0	0											20.8841	0.762344569	0	0	3.734354723	1.433318791	2.527587632	0.570249791	0.249506059	0	0	0	0	0.764405304	0	7.774213769	6.023312611	0	0	0	0	1.003831992	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.7272	0	8.0135	20.8841	0.762344569	0	0	3.734354723	1.433318791	2.527587632	0.570249791	0.249506059	0	0	0	0	0.764405304	0	7.774213769	6.023312611	0	0	0	0	1.003831992	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.7272		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $35 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $35 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.7511	0.1519	1.0689	0.0166	0.3487	0.133	0.2345	0.0353	0.2016	0.4137	0.4212	0	0	0.1171	0.0164	2.698	0.956	0.0019	0	0	0.1676	0.1168	0.0827	0	0.0033	0	0	0	0	0											9.9363	0	0	23.6353	0.914219569	1.068925982	0.016553786	4.083062072	1.56630588	2.762103862	0.605522642	0.451129331	0.413728905	0.421216507	0	0	0.881526419	0.016370389	10.47221245	6.979262611	0.001942738	0	0	0.167563725	1.120619871	0.082718466	0	0.003317966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6636
H3912_005_0	2009	4																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		346.0318464	22.464	89.56189065	2491.462611	17.94304868	31.53938742	12.51872428	26.98368469	38.09615007	15.07099966	31.90852823	0	1.565892963	39.66616507	48.338609	131.62934	13.9175	3.315749004	0	0	25.95047824	4.456297326	417.0708014	0	156.0802334	174.9598934	0	0	20.2	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.077544206	0.078530988	0.186631012	0	0.2	0.2	0.2	0.102227808	0.2	0.08	0.2	0	0.2	0.2	0	0.199750944	0.2	0.2	0	0	0.2	0.011240812	0	0	0	0	0	0	0	0											0.077544206	0.078530988	0.186631012	0	0.2	0.2	0.2	0.102227808	0.2	0.08	0.2	0	0.2	0.2	0	0.199750944	0.2	0.2	0	0	0.2	0.011240812	0	0	0	0	0	0	0	0											26.8328	1.764120114	16.71502626	0	3.588609736	6.307877484	2.503744856	2.758482933	7.619230014	1.205679973	6.381705647	0	0.313178593	7.933233014	0	26.29308495	2.7835	0.663149801	0	0	5.190095648	0.050092399	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.9036	0	0	26.8328	1.764120114	16.71502626	0	3.588609736	6.307877484	2.503744856	2.758482933	7.619230014	1.205679973	6.381705647	0	0.313178593	7.933233014	0	26.29308495	2.7835	0.663149801	0	0	5.190095648	0.050092399	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.9036		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											4.3254	0.2808	1.4141	0.4837	0.2833	0.498	0.1977	0.1453	0.6015	0.238	0.5038	0	0.0165	0.6263	0.7632	2.0784	0.2198	0.0524	0	0	0.4097	0.056	0.0261	0	0.0155	0	0	0	0.003	0											13.2384	0	0	31.1582	2.044920114	18.12916138	0.483669906	3.871921031	6.805867812	2.701408924	2.903775945	8.220748173	1.443643125	6.885524513	0	0.329661676	8.559540883	0.763241195	28.37144295	3.00325	0.715503732	0	0	5.599840041	0.106139623	0.0261	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	132.142
H3912_006_0	2009	5																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		450.6348804	22.272	70.817433	3387.453353	16.39831962	31.61375584	11.64569407	42.93451892	42.9022629	14.52839585	35.06685884	0	2.786039103	68.32894983	44.50828278	146.8176162	13.9175	3.798949328	0	0	17.61552435	6.152721215	786.5747324	0	135.3098303	165.4919797	0	0	20.2	0											"7% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"7% (1b); $0 n/c (1b1, 1b2)"	15.9% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.069340342	0.0702	0.1592	0	0.2	0.2	0.2	0.062717724	0.2	0.08	0.2	0	0.2	0.2	0	0.199621115	0.2	0.2	0	0	0.2	0.011678152	0	0	0	0	0	0	0	0											0.069340342	0.0702	0.1592	0	0.2	0.2	0.2	0.062717724	0.2	0.08	0.2	0	0.2	0.2	0	0.199621115	0.2	0.2	0	0	0.2	0.011678152	0	0	0	0	0	0	0	0											31.2472	1.5634944	11.27413533	0	3.279663925	6.322751168	2.329138813	2.692755309	8.58045258	1.162271668	7.013371767	0	0.557207821	13.66578997	0	29.30789619	2.7835	0.759789866	0	0	3.523104869	0.071852412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.1344	0	0	31.2472	1.5634944	11.27413533	0	3.279663925	6.322751168	2.329138813	2.692755309	8.58045258	1.162271668	7.013371767	0	0.557207821	13.66578997	0	29.30789619	2.7835	0.759789866	0	0	3.523104869	0.071852412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.1344		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											5.6329	0.2784	1.1182	0.7525	0.2589	0.4992	0.1839	0.1418	0.6774	0.2294	0.5537	0	0.0293	1.0789	0.7028	2.3182	0.2198	0.06	0	0	0.2781	0.0752	0.0261	0	0.0155	0	0	0	0.003	0											15.133	0	0	36.8801	1.8418944	12.39230533	0.752466251	3.538584761	6.821915734	2.513018193	2.834588973	9.257856732	1.391667392	7.567059012	0	0.586534548	14.74466812	0.70276236	31.62606908	3.00325	0.819773276	0	0	3.801244727	0.147016561	0.0261	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	141.2673
H3912_007_0	2009	5																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		336.3845953	22.848	44.12499549	5023.546097	14.58622538	32.03967828	10.89528092	28.60767908	44.53465155	8.270448312	20.0086018	0	3.335282174	47.38743649	46.33433022	124.0595384	13.376	5.066277269	0	0	21.31602091	6.184108789	352.9685741	0	314.3760437	332.2285714	0	0	20.2	0											"7.4% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"7.4% (1b); $0 n/c (1b1, 1b2)"	18.1% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.073112	0.074	0.1807	0	0.2	0.2	0.2	0.09489729	0.2	0.08	0.2	0	0.2	0.2	0	0.19955161	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											0.073112	0.074	0.1807	0	0.2	0.2	0.2	0.09489729	0.2	0.08	0.2	0	0.2	0.2	0	0.19955161	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											24.5938	1.690752	7.973386686	0	2.917245076	6.407935657	2.179056185	2.714791227	8.90693031	0.661635865	4.001720361	0	0.667056435	9.477487297	0	24.75628064	2.6752	1.013255454	0	0	4.263204183	0.091953238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.9916	0	0	24.5938	1.690752	7.973386686	0	2.917245076	6.407935657	2.179056185	2.714791227	8.90693031	0.661635865	4.001720361	0	0.667056435	9.477487297	0	24.75628064	2.6752	1.013255454	0	0	4.263204183	0.091953238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.9916		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											4.2048	0.2856	0.6967	1.0318	0.2303	0.5059	0.172	0.143	0.7032	0.1306	0.3159	0	0.0351	0.7482	0.7316	1.9588	0.2112	0.08	0	0	0.3366	0.0671	0.0261	0	0.0155	0	0	0	0.003	0											12.633	0	0	28.7986	1.976352	8.670097141	1.03182641	3.147553898	6.913825314	2.351086936	2.857784675	9.610109018	0.792221891	4.317645653	0	0.702164668	10.22570998	0.731594688	26.71511546	2.8864	1.093249306	0	0	4.599772934	0.159057841	0.0261	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	117.6247
H3912_008_0	2009	3																					3350											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1733.011574	270.9589499	37.11294103	46723.00694	80.94337001	18.53989047	8.196994637	330.7916073	346.7971391	5492.124875	420.0175374	0	0.892158659	1340.759902	5419.07736	4020.119275	1242.868229	239.6969533	0	0	21.40163685	1015.155864	769.983193	0	314.3760437	332.2285714	0	0	20.2	0											"$225 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$225 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$125 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$125 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5); $125 (9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											222.3	225	0.188513645	0	125	0.14	0.2	49.97128101	125	4.4	64.79010385	0	0.2	115.4549499	3.24918765	25	20	20	0	0	0.2	13.6791576	0	0	0	0	0	0	0	0											161.0724879	163.028834	0.188513645	0	90.57157442	0.101440163	0.144914519	36.20782078	90.57157442	3.18811942	46.9451337	0	0.144914519	83.65549269	3.24918765	25	20	20	0	0	0.144914519	13.6791576	0	0	0	0	0	0	0	0											23.2617	3.681176805	6.996295779	0	0.610930705	1.880689518	1.187863536	0.998103603	2.617496907	1.459129164	1.643148287	0	0.129286743	9.346827513	1.467299936	8.375248489	2.071447048	0.399494922	0	0	3.101407911	1.157206422	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.3848	0	18.9749	23.2617	3.681176805	6.996295779	0	0.610930705	1.880689518	1.187863536	0.998103603	2.617496907	1.459129164	1.643148287	0	0.129286743	9.346827513	1.467299936	8.375248489	2.071447048	0.399494922	0	0	3.101407911	1.157206422	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.3848		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.3178	0.2201	0.586	0.4958	0.1276	0.2927	0.1294	0.0726	0.7177	0.1129	0.3044	0	0.0094	0.5718	0.5682	1.7861	0.1512	0.0613	0	0	0.3379	0.0704	0.0569	0	0.0155	0	0	0	0.003	0											10.0088	0	0	26.5795	3.901256805	7.582289584	0.495801869	0.738546525	2.173424631	1.317289767	1.070713655	3.335226189	1.572012346	1.947555717	0	0.138677887	9.918599003	2.035475419	10.16138044	2.222647048	0.460830853	0	0	3.439328493	1.227627767	0.056935837	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	80.3936
H3912_009_0	2009	3																					3350											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1946.8457	268.1518507	46.83661609	52488.10022	90.93087102	23.39738399	10.3446259	371.5841254	389.5880035	6169.791282	471.842975	0	1.125906259	1504.004702	6079.023338	4516.156755	1242.868229	269.27286	0	0	27.13336552	1140.414675	769.983193	0	314.3760437	332.2285714	0	0	20.2	0											"$225 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$225 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	15.9% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$125 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$125 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5); $125 (9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											222.3	225	0.1592	0	125	0.14	0.2	49.97443378	125	4.4	64.79010385	0	0.2	115.6012159	3.25384157	25	20	20	0	0	0.2	13.6791576	0	0	0	0	0	0	0	0											154.2069682	156.0799273	0.1592	0	86.71107072	0.097116399	0.138737713	34.6666933	86.71107072	3.052229689	44.94415421	0	0.138737713	80.19124164	3.25384157	25	20	20	0	0	0.138737713	13.6791576	0	0	0	0	0	0	0	0											25.0181	3.487760113	7.456389281	0	0.657059432	2.272269684	1.43518974	1.073466076	2.815132744	1.569301677	1.767215286	0	0.15620566	10.05066704	1.648348237	9.408659907	2.071447048	0.4487881	0	0	3.764421082	1.299992672	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.4004	0	23.8742	25.0181	3.487760113	7.456389281	0	0.657059432	2.272269684	1.43518974	1.073466076	2.815132744	1.569301677	1.767215286	0	0.15620566	10.05066704	1.648348237	9.408659907	2.071447048	0.4487881	0	0	3.764421082	1.299992672	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.4004		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											4.1871	0.2178	0.7395	0.6257	0.1611	0.3694	0.1633	0.0816	0.9058	0.1425	0.3842	0	0.0119	0.7211	0.7145	2.2541	0.1512	0.0774	0	0	0.4284	0.0889	0.0569	0	0.0155	0	0	0	0.003	0											12.5008	0	0	29.2052	3.705560113	8.195914798	0.625703088	0.818110888	2.641702063	1.598525939	1.155021856	3.720908731	1.71176051	2.151378156	0	0.168057304	10.77181166	2.362813402	11.66276249	2.222647048	0.526194184	0	0	4.192842643	1.38886457	0.056935837	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	88.9012
H3912_011_0	2009	3																					3350											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1801.534332	270.0724975	40.10583208	48570.42063	84.1438466	20.03499894	8.858023141	343.8634958	360.509394	5709.281846	436.6249049	0	0.964104821	1393.071402	5630.555852	4179.073586	1242.868229	249.174499	0	0	23.16582984	1055.294823	769.983193	0	314.3760437	332.2285714	0	0	20.2	0											"$225 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$225 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	18.1% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$125 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$125 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5); $125 (9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											222.3	225	0.1807	0	125	0.14	0.2	49.97237276	125	4.4	64.79010385	0	0.2	115.505553	3.250797774	25	20	20	0	0	0.2	13.6791576	0	0	0	0	0	0	0	0											158.8893232	160.819153	0.1807	0	89.34397389	0.100065251	0.142950358	35.71784293	89.34397389	3.144907881	46.30884277	0	0.142950358	82.55780087	3.250797774	25	20	20	0	0	0.142950358	13.6791576	0	0	0	0	0	0	0	0											23.8537	3.619402525	7.247123857	0	0.626478803	2.004807192	1.266257581	1.023505194	2.684111824	1.496263789	1.684966172	0	0.13781913	9.58407595	1.525316536	8.706403304	2.071447048	0.415290832	0	0	3.311563675	1.202962017	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.4615	0	20.4704	23.8537	3.619402525	7.247123857	0	0.626478803	2.004807192	1.266257581	1.023505194	2.684111824	1.496263789	1.684966172	0	0.13781913	9.58407595	1.525316536	8.706403304	2.071447048	0.415290832	0	0	3.311563675	1.202962017	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.4615		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.5854	0.2194	0.6332	0.5358	0.1379	0.3163	0.1399	0.0755	0.7756	0.122	0.329	0	0.0101	0.6177	0.6132	1.9302	0.1512	0.0663	0	0	0.3658	0.0761	0.0569	0	0.0155	0	0	0	0.003	0											10.7759	0	0	27.4391	3.838762525	7.880373837	0.535784715	0.764385919	2.321149281	1.406121104	1.098981889	3.459720795	1.618250186	2.013921866	0	0.147967601	10.20182363	2.138519139	10.63657391	2.222647048	0.481573063	0	0	3.677339935	1.279062335	0.056935837	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	83.2374
H3916_001_0	2009	7																																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		396.9348708	0	781.4917788	0	498.1433151	31.06724592	0	221.2594225	0	0	0	0	0	1039.185212	4238.796317	6043.551971	0	0	0	0	1274.966656	0	0	9.741571429	407.4091473	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											92.81502165	0	25	0	50	0.096979208	0	50	0	0	0	0	0	15	15	15	0	0	0	0	2.1	0	0	0.3	15	0	15	0	0	0											91.71803897	0	24.70452448	0	50	0.060773637	0	49.40904895	0	0	0	0	0	14.82271469	14.82271469	14.82271469	0	0	0	0	2.075180056	0	0	0.3	15	0	15	0	0	0											3.0338	0	1.608865231	0	2.075597146	1.888069517	0	0.911018136	0	0	0	0	0	1.283628825	5.235872368	7.465153879	0	0	0	0	0.220482115	0	0	2.922471429	0.509261434	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.1543	0	1.3611	3.0338	0	1.608865231	0	2.075597146	1.888069517	0	0.911018136	0	0	0	0	0	1.283628825	5.235872368	7.465153879	0	0	0	0	0.220482115	0	0	2.922471429	0.509261434	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.1543	3350	"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											1.1949	0	0.2368	0.0799	0.0945	0.4765	0	0.0153	0.1218	0	0	0	0	0.3531	0.1825	0.7314	0	0	0	0	0.2048	0	0	0.1537	0.023	0	0.0056	0	0	0											3.8738	250	2.288888038	4.2287	0	1.845660838	0.079935347	2.170126074	2.364569145	0	0.926313521	0.121770036	0	0	0	0	1.63673035	5.418377373	8.196530889	0	0	0	0	0.425278669	0	0	3.076127143	0.532303306	0	0.005638745	0	0	0	0	0	0	0	0	0	0	0	0	0	31.0281
H3916_002_0	2009	7																																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		293.9377825	0	590.3092272	0	345.2939514	26.45572608	0	215.3903333	0	0	0	0	0	1304.699587	3590.079092	5449.342763	0	0	0	0	1119.054611	0	0	9.540714286	360.3324976	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											92.81502165	0	25	0	50	0.096979208	0	50	0	0	0	0	0	15	15	15	0	0	0	0	2.1	0	0	0.3	15	0	15	0	0	0											91.95185938	0	24.76750469	0	50	0.060773637	0	49.53500939	0	0	0	0	0	14.86050282	14.86050282	14.86050282	0	0	0	0	2.080470394	0	0	0.3	15	0	15	0	0	0											2.2523	0	1.21837388	0	1.438724797	1.607810686	0	0.889113515	0	0	0	0	0	1.615707658	4.445865038	6.748331122	0	0	0	0	0.194013332	0	0	2.862214286	0.450415622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.7229	0	1.1208	2.2523	0	1.21837388	0	1.438724797	1.607810686	0	0.889113515	0	0	0	0	0	1.615707658	4.445865038	6.748331122	0	0	0	0	0.194013332	0	0	2.862214286	0.450415622	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.7229	3350	"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											1.7212	0	0.3455	0.1036	0.132	0.6905	0	0.0283	0.2152	0	0	0	0	0.7097	0.2592	1.0393	0	0	0	0	0.2601	0	0	0.2561	0.0379	0	0.009	0	0	0											5.8075	250	2.618127024	3.9736	0	1.563896598	0.103552571	1.570687875	2.298330866	0	0.917413002	0.215189866	0	0	0	0	2.325436171	4.705066352	7.787641995	0	0	0	0	0.454095465	0	0	3.118307143	0.488299663	0	0.00897221	0	0	0	0	0	0	0	0	0	0	0	0	0	29.5304
H3916_003_0	2009	7																																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		329.5304473	0	864.7222429	0	360.8649418	29.98158515	0	219.6724932	0	0	0	0	0	1250.962338	4115.500814	5925.03002	0	0	0	0	729.9927371	0	0	9.741571429	407.4741545	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											92.81502165	0	25	0	50	0.096979208	0	50	0	0	0	0	0	15	15	15	0	0	0	0	2.1	0	0	0.3	15	0	15	0	0	0											91.78897713	0	24.72363188	0	50	0.060773637	0	49.44726376	0	0	0	0	0	14.83417913	14.83417913	14.83417913	0	0	0	0	2.076785078	0	0	0.3	15	0	15	0	0	0											2.5206	0	1.781589534	0	1.503603924	1.822089964	0	0.905183643	0	0	0	0	0	1.546416618	5.087506357	7.324413055	0	0	0	0	0.126336502	0	0	2.922471429	0.509342693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.0496	0	1.3012	2.5206	0	1.781589534	0	1.503603924	1.822089964	0	0.905183643	0	0	0	0	0	1.546416618	5.087506357	7.324413055	0	0	0	0	0.126336502	0	0	2.922471429	0.509342693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.0496	3350	"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											1.0754	0	0.2688	0.0608	0.0767	0.4598	0	0.0157	0.1141	0	0	0	0	0.5744	0.1669	0.6694	0	0	0	0	0.0872	0	0	0.1537	0.023	0	0.007	0	0	0											3.753	250	2.070157157	3.596	0	2.050437881	0.06076691	1.580343984	2.28193807	0	0.920841947	0.114081324	0	0	0	0	2.120831364	5.254456323	7.993815607	0	0	0	0	0.213503623	0	0	3.076127143	0.532385078	0	0.007017053	0	0	0	0	0	0	0	0	0	0	0	0	0	29.8025
H3916_005_0	2009	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	0	166.8060416	0	135.6350102	20.80601236	0	156.7133034	0	0	0	0	0	643.9354926	2751.967734	7467.346737	0	0	0	0	1083.716045	0	0	9.239428571	382.4806837	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											0	0	25	0	50	0.096979208	0	50	0	0	0	0	0	15	15	15	0	0	0	0	2.1	0	0	0.3	15	0	15	0	0	0											0	0	24.84172246	0	50	0.060773637	0	49.68344491	0	0	0	0	0	14.90503347	14.90503347	14.90503347	0	0	0	0	2.086704686	0	0	0.3	15	0	15	0	0	0											0	0	0.345312449	0	0.565145876	1.264457037	0	0.648838065	0	0	0	0	0	0.799823339	3.418180933	9.275087757	0	0	0	0	0.188449612	0	0	2.771828571	0.478100855	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.7552	0	0.8468	0	0	0.345312449	0	0.565145876	1.264457037	0	0.648838065	0	0	0	0	0	0.799823339	3.418180933	9.275087757	0	0	0	0	0.188449612	0	0	2.771828571	0.478100855	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.7552	3350	"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											2.7613	0	0.1993	0.0926	0.0972	0.8972	0	0.0354	0.3674	0	0	0	0	0.9388	0.4674	1.8764	0	0	0	0	0.4511	0	0	0.4097	0.0614	0	0.0175	0	0	0											8.6728	250	3.592203331	2.7613	0	0.544650947	0.092613904	0.662336527	2.161681904	0	0.684281304	0.367356661	0	0	0	0	1.738636389	3.885602718	11.15151973	0	0	0	0	0.639509613	0	0	3.181577143	0.539458748	0	0.01752157	0	0	0	0	0	0	0	0	0	0	0	0	0	28.4281
H3916_012_0	2009	5																					3350											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	3350	263.4135577	0	165.8242775	0	134.8367082	20.68355518	0	155.7909417	33.43797017	0	0	0	0	5240.145505	2735.77058	7381.015543	0	0	0	0	1083.716045	0	0	0	380.2295313	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											210.3650293	0	25	0	50	0.096979208	0	50	50	0	0	0	0	15	15	15	0	0	0	0	2.1	0	0	0	15	0	15	0	0	0											205.6487684	0	24.43951462	0	50	0.060773637	0	48.87902924	48.87902924	0	0	0	0	14.66370877	14.66370877	14.66370877	0	0	0	0	2.052919228	0	0	0	15	0	15	0	0	0											4.5142	0	0.337722071	0	0.561819618	1.257014869	0	0.634575833	0.136201293	0	0	0	0	6.403330634	3.343045254	9.019421863	0	0	0	0	0.185398459	0	0	0	0.475286914	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.868	0	1.3124	4.5142	0	0.337722071	0	0.561819618	1.257014869	0	0.634575833	0.136201293	0	0	0	0	6.403330634	3.343045254	9.019421863	0	0	0	0	0.185398459	0	0	0	0.475286914	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.868	3350	"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											3.2563	0	0.2351	0.1092	0.1381	0.8919	0	0.029	0.4332	0	0	0	0	1.1071	0.5512	2.2001	0	0	0	0	0.5319	0	0	0	0.092	0	0.0157	0	0	0											9.5908	250	6.822940521	7.7705	0	0.572790049	0.109214042	0.699948746	2.148958973	0	0.663586214	0.569403049	0	0	0	0	7.510416756	3.89424783	11.21955306	0	0	0	0	0.71730656	0	0	0	0.567248879	0	0.015676599	0	0	0	0	0	0	0	0	0	0	0	0	0	36.4588
H3916_015_0	2009	7																																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		264.6987153	0	166.6333107	0	135.4945575	20.78446733	0	156.5510237	0	0	0	0	0	643.2686849	2749.118018	7417.026475	0	0	0	0	1083.716045	0	0	0	382.0846175	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											84.14601174	0	25	0	50	0.096979208	0	50	0	0	0	0	0	15	15	15	0	0	0	0	2.1	0	0	0	15	0	15	0	0	0											83.40840125	0	24.780854	0	50	0.060773637	0	49.56170799	0	0	0	0	0	14.8685124	14.8685124	14.8685124	0	0	0	0	2.081591736	0	0	0	15	0	15	0	0	0											1.8398	0	0.344109645	0	0.564560656	1.263147667	0	0.64657801	0	0	0	0	0	0.797037368	3.406274611	9.190012509	0	0	0	0	0.187987864	0	0	0	0.477605772	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.7172	0	0.8976	1.8398	0	0.344109645	0	0.564560656	1.263147667	0	0.64657801	0	0	0	0	0	0.797037368	3.406274611	9.190012509	0	0	0	0	0.187987864	0	0	0	0.477605772	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.7172	3350	"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											2.7623	0	0.1994	0.0926	0.0971	0.8963	0	0.0354	0.3675	0	0	0	0	0.9391	0.4676	1.8664	0	0	0	0	0.4512	0	0	0	0.0613	0	0.0105	0	0	0											8.2469	250	3.576127479	4.6021	0	0.543517604	0.092646175	0.661677099	2.159443441	0	0.68202674	0.367484669	0	0	0	0	1.736177552	3.873859272	11.05638187	0	0	0	0	0.639205038	0	0	0	0.538954883	0	0.010502056	0	0	0	0	0	0	0	0	0	0	0	0	0	26.964
H3916_018_0	2009	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		262.0828501	0	164.9865695	0	134.1555426	20.57906638	0	155.0039199	33.26904886	0	0	0	0	5236.91163	2721.950065	7343.728267	0	0	0	0	1083.716045	0	0	0	378.3086949	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											232.0375541	0	50	0	50	0.096979208	0	50	100	0	0	0	0	15	25	25	0	0	0	0	2.1	0	0	0	25	0	25	0	0	0											222.5360278	0	47.95258868	0	50	0.060773637	0	47.95258868	95.90517737	0	0	0	0	14.3857766	23.97629434	23.97629434	0	0	0	0	2.014008725	0	0	0	25	0	25	0	0	0											4.8602	0	0.659294425	0	0.558981428	1.250664705	0	0.619403268	0.265889503	0	0	0	0	6.278086734	5.438522995	14.67294921	0	0	0	0	0.181884464	0	0	0	0.788143114	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.5741	0	2.1531	4.8602	0	0.659294425	0	0.558981428	1.250664705	0	0.619403268	0.265889503	0	0	0	0	6.278086734	5.438522995	14.67294921	0	0	0	0	0.181884464	0	0	0	0.788143114	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.5741	3350	"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											3.2493	0	0.2346	0.109	0.1375	0.8874	0	0.0289	0.4323	0	0	0	0	1.1047	0.55	2.1954	0	0	0	0	0.5308	0	0	0	0.1003	0	0.0156	0	0	0											9.5758	250	6.768993507	8.1095	0	0.89385885	0.108980088	0.696459128	2.138102902	0	0.648344109	0.698163272	0	0	0	0	7.382801303	5.988544808	16.86836737	0	0	0	0	0.712653134	0	0	0	0.888429775	0	0.015597405	0	0	0	0	0	0	0	0	0	0	0	0	0	45.1498
H3916_019_0	2009	7																																					Ded		V							V	V								Coin	V		V														32.1414	0	6.3695	2.1502	1.4675	0	0	0	3.2754	0	0	0	0	9.498	2.761	16.3583	0	0	0	0	5.5087	0	0	0	0	0	0	0	0	0											79.53		0	0	0	0	0	8111.849619	0	214.2406859	0	0	0	0	0	0	4104.334271	5824.305388	0	0	0	0	0	0	0	9.741571429	394.4854153	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											0	0	0	0	0	11.06732353	0	50	0	0	0	0	0	0	15	15	0	0	0	0	0	0	0	0.3	15	0	15	0	0	0											0	0	0	0	0	11.06732353	0	49.15668725	0	0	0	0	0	0	14.74700617	14.74700617	0	0	0	0	0	0	0	0.3	15	0	15	0	0	0											0	0	0	0	0	7.481372017	0	0.877613533	0	0	0	0	0	0	5.043886903	7.15758896	0	0	0	0	0	0	0	2.922471429	0.493106769	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.976	1250	0.2244	32.1414	0	6.369479374	2.15015199	1.467497486	7.481372017	0	0.877613533	3.275448147	0	0	0	0	9.497950215	7.804924874	23.51592026	0	0	0	0	5.508748444	0	0	2.922471429	0.493106769	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.506	3350	"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											1.7223	0	0.3413	0.1152	0.1557	0.4782	0	0.0089	0.1755	0	0	0	0	0.5089	0.2631	1.0492	0	0	0	0	0.2952	0	0	0.1537	0.0344	0	0.0082	0	0	0											5.3096	1250	4.39993205	33.8636	0	6.710783318	2.265366329	1.623183256	7.959527961	0	0.886480281	3.450960666	0	0	0	0	10.00689101	8.067977383	24.56512604	0	0	0	0	5.803930744	0	0	3.076127143	0.527516691	0	0.008189812	0	0	0	0	0	0	0	0	0	0	0	0	0	108.8157
H3916_020_0	2009	7																																					Ded		V							V	V								Coin	V		V														24.5033	0	4.9189	1.4742	1.2056	0	0	0	3.0635	0	0	0	0	10.1038	1.5386	11.4849	0	0	0	0	3.7026	0	0	0	0	0	0	0	0	0											61.9952		0	0	0	0	0	6807.710568	0	208.5564092	0	0	0	0	0	0	3476.172736	5246.588198	0	0	0	0	0	0	0	9.540714286	348.8998354	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											0	0	0	0	0	11.22988996	0	50	0	0	0	0	0	0	15	15	0	0	0	0	0	0	0	0.3	15	0	15	0	0	0											0	0	0	0	0	11.22988996	0	49.48699436	0	0	0	0	0	0	14.84609831	14.84609831	0	0	0	0	0	0	0	0.3	15	0	15	0	0	0											0	0	0	0	0	6.370820046	0	0.860069154	0	0	0	0	0	0	4.300633515	6.490947014	0	0	0	0	0	0	0	2.862214286	0.436124794	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.3208	1000	0.1208	24.5033	0	4.918890893	1.474183241	1.205563707	6.370820046	0	0.860069154	3.063461287	0	0	0	0	10.10375566	5.839227193	17.97581463	0	0	0	0	3.702551429	0	0	2.862214286	0.436124794	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.316	3350	"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											2.4343	0	0.4887	0.1465	0.2132	0.6929	0	0.0183	0.3043	0	0	0	0	1.0038	0.3666	1.4616	0	0	0	0	0.3678	0	0	0.2561	0.0566	0	0.013	0	0	0											7.8235	1000	5.153974622	26.9376	0	5.407554636	1.620634934	1.418716634	7.063735942	0	0.878357728	3.367798686	0	0	0	0	11.10750613	6.205808832	19.4373674	0	0	0	0	4.070378786	0	0	3.118307143	0.492720673	0	0.013031308	0	0	0	0	0	0	0	0	0	0	0	0	0	91.1395
H3916_021_0	2009	7																																					Ded		V							V	V								Coin	V		V														24.6847	0	6.1713	1.3949	1.0474	0	0	0	2.6187	0	0	0	0	13.1855	1.9409	12.447	0	0	0	0	2.0009	0	0	0	0	0	0	0	0	0											65.4914		0	0	0	0	0	5837.953198	0	213.5621727	0	0	0	0	0	0	4001.025723	5729.539886	0	0	0	0	0	0	0	9.741571429	396.1400197	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											0	0	0	0	0	14.90054657	0	50	0	0	0	0	0	0	15	15	0	0	0	0	0	0	0	0.3	15	0	15	0	0	0											0	0	0	0	0	14.90054657	0	49.41351689	0	0	0	0	0	0	14.82405507	14.82405507	0	0	0	0	0	0	0	0.3	15	0	15	0	0	0											0	0	0	0	0	7.249057793	0	0.879404836	0	0	0	0	0	0	4.942618804	7.077917899	0	0	0	0	0	0	0	2.922471429	0.495175025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.5666	1000	0.1531	24.6847	0	6.171330612	1.394885626	1.047426053	7.249057793	0	0.879404836	2.618701499	0	0	0	0	13.18551276	6.88351105	19.52491061	0	0	0	0	2.000894298	0	0	2.922471429	0.495175025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.058	3350	"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											1.501	0	0.3753	0.0848	0.1231	0.4633	0	0.01	0.1592	0	0	0	0	0.8018	0.233	0.9294	0	0	0	0	0.1217	0	0	0.1537	0.0344	0	0.0102	0	0	0											5.001	1000	3.943028647	26.1857	0	6.546594652	1.479705326	1.170550722	7.712365869	0	0.889436308	2.777938553	0	0	0	0	13.98729265	7.116543239	20.45429951	0	0	0	0	2.122563955	0	0	3.076127143	0.52960452	0	0.010232804	0	0	0	0	0	0	0	0	0	0	0	0	0	94.059
H3916_022_0	2009	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		394.604556	0	776.9038174	0	495.2188283	30.88485714	0	219.9604584	43.77963903	0	0	0	0	5883.08439	4213.911302	5979.802005	0	0	0	0	1274.966656	0	0	0	405.0173403	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											185.6300433	0	35	0	50	0.096979208	0	50	100	0	0	0	0	18	20	20	0	0	0	0	2.1	0	0	0	20	0	20	0	0	0											178.2854063	0	33.61519025	0	50	0.060773637	0	48.02170036	96.04340072	0	0	0	0	17.28781213	19.20868014	19.20868014	0	0	0	0	2.016911415	0	0	0	20	0	20	0	0	0											5.8627	0	2.176314136	0	2.063411785	1.876985088	0	0.880239602	0.350395451	0	0	0	0	8.475471473	6.745306197	9.57200867	0	0	0	0	0.214291233	0	0	0	0.675028901	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.8921	0	2.5303	5.8627	0	2.176314136	0	2.063411785	1.876985088	0	0.880239602	0.350395451	0	0	0	0	8.475471473	6.745306197	9.57200867	0	0	0	0	0.214291233	0	0	0	0.675028901	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.8921	3350	"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											1.3972	0	0.2769	0.0935	0.1359	0.4737	0	0.0123	0.1424	0	0	0	0	0.4129	0.2134	0.8512	0	0	0	0	0.2395	0	0	0	0.0361	0	0.0084	0	0	0											4.2934	250	4.117991361	7.2599	0	2.453201379	0.093469124	2.199344736	2.350687295	0	0.89256045	0.492782255	0	0	0	0	8.888356279	6.95871095	10.42319044	0	0	0	0	0.453761696	0	0	0	0.711160518	0	0.008408463	0	0	0	0	0	0	0	0	0	0	0	0	0	43.1855
H3916_023_0	2009	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		327.5318854	0	859.4778081	0	358.67634	29.7997505	0	218.3402063	38.54964526	0	0	0	0	6093.375405	4090.540805	5857.727073	0	0	0	0	729.9927371	0	0	0	405.0028736	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											185.6300433	0	35	0	50	0.096979208	0	50	100	0	0	0	0	18	20	20	0	0	0	0	2.1	0	0	0	20	0	20	0	0	0											178.6224428	0	33.6787375	0	50	0.060773637	0	48.11248214	96.22496427	0	0	0	0	17.32049357	19.24499285	19.24499285	0	0	0	0	2.02072425	0	0	0	20	0	20	0	0	0											4.8754	0	2.41217729	0	1.49448475	1.811039211	0	0.87540744	0.309119853	0	0	0	0	8.795022459	6.56020238	9.394326305	0	0	0	0	0.122926169	0	0	0	0.675004789	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.3251	0	2.3871	4.8754	0	2.41217729	0	1.49448475	1.811039211	0	0.87540744	0.309119853	0	0	0	0	8.795022459	6.56020238	9.394326305	0	0	0	0	0.122926169	0	0	0	0.675004789	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.3251	3350	"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											1.26	0	0.315	0.0712	0.1101	0.4571	0	0.0127	0.1337	0	0	0	0	0.673	0.1956	0.7801	0	0	0	0	0.1021	0	0	0	0.0361	0	0.0105	0	0	0											4.1572	250	3.75605208	6.1354	0	2.727181749	0.071199425	1.604580897	2.268098394	0	0.88806479	0.442786756	0	0	0	0	9.468053215	6.755814458	10.17447473	0	0	0	0	0.225058215	0	0	0	0.711136179	0	0.010461742	0	0	0	0	0	0	0	0	0	0	0	0	0	41.4823
H3916_024_0	2009	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		291.9306516	0	586.2783472	0	342.9361388	26.27507524	0	213.9195574	34.15390959	0	0	0	0	6045.790549	3565.56452	5381.507235	0	0	0	0	1119.054611	0	0	0	357.8719956	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											185.6300433	0	35	0	50	0.096979208	0	50	100	0	0	0	0	18	20	20	0	0	0	0	2.1	0	0	0	20	0	20	0	0	0											179.4557084	0	33.83584727	0	50	0.060773637	0	48.33692467	96.67384935	0	0	0	0	17.40129288	19.33476987	19.33476987	0	0	0	0	2.030150836	0	0	0	20	0	20	0	0	0											4.3657	0	1.653102051	0	1.428900579	1.596831878	0	0.861684461	0.275149159	0	0	0	0	8.767047671	5.744947454	8.670850328	0	0	0	0	0.189320805	0	0	0	0.596453326	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.15	0	2.0016	4.3657	0	1.653102051	0	1.428900579	1.596831878	0	0.861684461	0.275149159	0	0	0	0	8.767047671	5.744947454	8.670850328	0	0	0	0	0.189320805	0	0	0	0.596453326	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.15	3350	"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											2.024	0	0.4063	0.1218	0.1881	0.6858	0	0.023	0.253	0	0	0	0	0.8346	0.3048	1.2152	0	0	0	0	0.3058	0	0	0	0.0592	0	0.0134	0	0	0											6.435	250	4.880818027	6.3897	0	2.059403511	0.121767857	1.616955404	2.282636894	0	0.884727954	0.528191729	0	0	0	0	9.601620091	6.049743251	9.886064332	0	0	0	0	0.49515236	0	0	0	0.655631364	0	0.013366415	0	0	0	0	0	0	0	0	0	0	0	0	0	40.585
H3916_025_0	2009	7																																					Ded		V							V	V								Coin	V		V														24.6719	0	1.781	0.8275	0.5793	0	0	0	3.2823	0	0	0	0	8.3881	1.8991	13.254	0	0	0	0	4.0301	0	0	0	0	0	0	0	0	0											58.7134		0	0	0	0	0	5534.205576	0	151.0685531	0	0	0	0	0	0	2503.545132	6452.997353	0	0	0	0	0	0	0	9.239428571	368.703883	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											0	0	0	0	0	10.81586692	0	50	0	0	0	0	0	0	15	15	0	0	0	0	0	0	0	0.3	15	0	15	0	0	0											0	0	0	0	0	10.81586692	0	49.39972747	0	0	0	0	0	0	14.81991824	14.81991824	0	0	0	0	0	0	0	0.3	15	0	15	0	0	0											0	0	0	0	0	4.988102585	0	0.621895446	0	0	0	0	0	0	3.09186118	7.969407766	0	0	0	0	0	0	0	2.771828571	0.460879854	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.904	1000	0.142	24.6719	0	1.781048268	0.827486081	0.579321105	4.988102585	0	0.621895446	3.282255818	0	0	0	0	8.388100496	4.990986965	21.22343659	0	0	0	0	4.030127844	0	0	2.771828571	0.460879854	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.6173	3350	"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											3.9513	0	0.2852	0.1325	0.1574	0.8963	0	0.0232	0.5257	0	0	0	0	1.3434	0.6689	2.6698	0	0	0	0	0.6454	0	0	0.4097	0.0916	0	0.0152	0	0	0											11.8157	1000	7.155692999	28.6232	0	2.066292831	0.960012476	0.736754048	5.884449904	0	0.645049708	3.807926932	0	0	0	0	9.731500394	5.659846839	23.8931982	0	0	0	0	4.675574729	0	0	3.181577143	0.552458498	0	0.015201405	0	0	0	0	0	0	0	0	0	0	0	0	0	90.4331
H3916_026_0	2009	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	0	786.1393539	0	0	31.25200455	0	0	0	0	0	0	0	0	0	6079.49331	0	0	0	0	1274.966656	0	0	9.741571429	409.8320321	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											0	0	25	0	0	0.096979208	0	0	0	0	0	0	0	0	0	10	0	0	0	0	2.1	0	0	0.3	10	0	10	0	0	0											0	0	24.98619951	0	0	0.060773637	0	0	0	0	0	0	0	0	0	9.994479803	0	0	0	0	2.098840759	0	0	0.3	10	0	10	0	0	0											0	0	1.636886228	0	0	1.899297972	0	0	0	0	0	0	0	0	0	5.063447759	0	0	0	0	0.222995999	0	0	2.922471429	0.341526693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.0866	0	1.1353	0	0	1.636886228	0	0	1.899297972	0	0	0	0	0	0	0	0	0	5.063447759	0	0	0	0	0.222995999	0	0	2.922471429	0.341526693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.0866	3350	"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											1.201	0	0.238	0.0803	0.095	0.4793	0	0	0.1224	0	0	0	0	0.3549	0.1834	0.7351	0	0	0	0	0.2058	0	0	0.1537	0.022	0	0.0095	0	0	0											3.8804	250	2.288610388	1.201	0	1.874885976	0.08034183	0.095043721	2.378631369	0	0	0.122389255	0	0	0	0	0.3548971	0.183433071	5.798543931	0	0	0	0	0.428833974	0	0	3.076127143	0.36351028	0	0.009453799	0	0	0	0	0	0	0	0	0	0	0	0	0	15.9671
H3916_027_0	2009	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	0	594.1679966	0	0	26.62866349	0	0	0	0	0	0	0	0	0	5484.964359	0	0	0	0	1119.054611	0	0	9.540714286	362.6879411	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											0	0	25	0	0	0.096979208	0	0	0	0	0	0	0	0	0	10	0	0	0	0	2.1	0	0	0.3	10	0	10	0	0	0											0	0	24.99124553	0	0	0.060773637	0	0	0	0	0	0	0	0	0	9.996498211	0	0	0	0	2.099264624	0	0	0.3	10	0	10	0	0	0											0	0	1.237416524	0	0	1.618320721	0	0	0	0	0	0	0	0	0	4.569203034	0	0	0	0	0.19576598	0	0	2.862214286	0.302239951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.7852	0	0.9662	0	0	1.237416524	0	0	1.618320721	0	0	0	0	0	0	0	0	0	4.569203034	0	0	0	0	0.19576598	0	0	2.862214286	0.302239951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.7852	3350	"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											1.7314	0	0.3476	0.1042	0.1327	0.695	0	0	0.2165	0	0	0	0	0.7139	0.2607	1.0454	0	0	0	0	0.2616	0	0	0.2561	0.0363	0	0.0151	0	0	0											5.8164	250	2.61352053	1.7314	0	1.584975131	0.104162724	0.132739976	2.313354735	0	0	0.216457808	0	0	0	0	0.713910376	0.260728579	5.614637734	0	0	0	0	0.457380569	0	0	3.118307143	0.338533054	0	0.015051433	0	0	0	0	0	0	0	0	0	0	0	0	0	16.6016
H3916_028_0	2009	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	0	869.8333034	0	0	30.15879546	0	0	0	0	0	0	0	0	0	5960.050731	0	0	0	0	729.9927371	0	0	9.741571429	409.8825869	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											0	0	25	0	0	0.096979208	0	0	0	0	0	0	0	0	0	10	0	0	0	0	2.1	0	0	0.3	10	0	10	0	0	0											0	0	24.98632602	0	0	0.060773637	0	0	0	0	0	0	0	0	0	9.994530407	0	0	0	0	2.098851385	0	0	0.3	10	0	10	0	0	0											0	0	1.811161542	0	0	1.832859679	0	0	0	0	0	0	0	0	0	4.963992354	0	0	0	0	0.127678856	0	0	2.922471429	0.341568822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.9997	0	1.0957	0	0	1.811161542	0	0	1.832859679	0	0	0	0	0	0	0	0	0	4.963992354	0	0	0	0	0.127678856	0	0	2.922471429	0.341568822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.9997	3350	"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											1.081	0	0.2702	0.0611	0.0772	0.4626	0	0	0.1147	0	0	0	0	0.5774	0.1678	0.6729	0	0	0	0	0.0876	0	0	0.1537	0.022	0	0.0118	0	0	0											3.7598	250	2.0685869	1.081	0	2.081405937	0.061082455	0.07715314	2.29542578	0	0	0.114673714	0	0	0	0	0.57739751	0.167816888	5.636870913	0	0	0	0	0.21529861	0	0	3.076127143	0.363552675	0	0.011764213	0	0	0	0	0	0	0	0	0	0	0	0	0	15.7595
H3916_801_0	2009	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		265.8371186	0	44.03617628	0	10.48511037	28.23760802	0	4.383362642	31.5837927	0	0	0	0	93.4208047	43.91250538	175.6500215	0	0	0	0	47.16786065	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											0.077589425	0	0.186572744	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0.231	0	0	0	0	0.231	0	0	0	0	0	0	0	0	0											0.077589425	0	0.186572744	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0.231	0	0	0	0	0.231	0	0	0	0	0	0	0	0	0											20.6261	0	8.215950247	0	2.422060496	6.522887452	0	1.01255677	7.295856114	0	0	0	0	21.58020589	10.14378874	40.57515497	0	0	0	0	10.89577581	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2904	0	0	20.6261	0	8.215950247	0	2.422060496	6.522887452	0	1.01255677	7.295856114	0	0	0	0	21.58020589	10.14378874	40.57515497	0	0	0	0	10.89577581	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2904		"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											1.1073	0	0.4411	0	0.13	0.3502	0	0.0544	0.3917	0	0	0	0	1.1585	0.5446	2.1782	0	0	0	0	0.5849	0	0	0	0	0	0	0	0	0											6.9409	0	0	21.7334	0	8.65701705	0	2.552086901	6.873063515	0	1.066915081	7.68752839	0	0	0	0	22.7387222	10.68835003	42.75340013	0	0	0	0	11.48070693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.2312
H3916_802_0	2009	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		265.8371186	0	44.03617628	0	10.48511037	28.23760802	0	4.383362642	31.5837927	0	0	0	0	93.4208047	43.91250538	175.6500215	0	0	0	0	47.16786065	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											0.077589425	0	0.186572744	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0.231	0	0	0	0	0.231	0	0	0	0	0	0	0	0	0											0.077589425	0	0.186572744	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0.231	0	0	0	0	0.231	0	0	0	0	0	0	0	0	0											20.6261	0	8.215950247	0	2.422060496	6.522887452	0	1.01255677	7.295856114	0	0	0	0	21.58020589	10.14378874	40.57515497	0	0	0	0	10.89577581	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2904	0	0	20.6261	0	8.215950247	0	2.422060496	6.522887452	0	1.01255677	7.295856114	0	0	0	0	21.58020589	10.14378874	40.57515497	0	0	0	0	10.89577581	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2904		"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											1.1073	0	0.4411	0	0.13	0.3502	0	0.0544	0.3917	0	0	0	0	1.1585	0.5446	2.1782	0	0	0	0	0.5849	0	0	0	0	0	0	0	0	0											6.9409	0	0	21.7334	0	8.65701705	0	2.552086901	6.873063515	0	1.066915081	7.68752839	0	0	0	0	22.7387222	10.68835003	42.75340013	0	0	0	0	11.48070693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.2312
H3916_804_0	2009	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		265.8371186	0	44.03617628	0	10.48511037	28.23760802	0	4.383362642	31.5837927	0	0	0	0	93.4208047	43.91250538	175.6500215	0	0	0	0	47.16786065	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											0.077589425	0	0.186572744	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0.231	0	0	0	0	0.231	0	0	0	0	0	0	0	0	0											0.077589425	0	0.186572744	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0.231	0	0	0	0	0.231	0	0	0	0	0	0	0	0	0											20.6261	0	8.215950247	0	2.422060496	6.522887452	0	1.01255677	7.295856114	0	0	0	0	21.58020589	10.14378874	40.57515497	0	0	0	0	10.89577581	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2904	0	0	20.6261	0	8.215950247	0	2.422060496	6.522887452	0	1.01255677	7.295856114	0	0	0	0	21.58020589	10.14378874	40.57515497	0	0	0	0	10.89577581	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2904		"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											1.1073	0	0.4411	0	0.13	0.3502	0	0.0544	0.3917	0	0	0	0	1.1585	0.5446	2.1782	0	0	0	0	0.5849	0	0	0	0	0	0	0	0	0											6.9409	0	0	21.7334	0	8.65701705	0	2.552086901	6.873063515	0	1.066915081	7.68752839	0	0	0	0	22.7387222	10.68835003	42.75340013	0	0	0	0	11.48070693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.2312
H3920_001_0	2009	10																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	Coin	T	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		1415.558726	481.2946821	918.1540788	235.0194701	309.7469998	14.97379624	5.275533757	884.8008824	2999.421794	3147.551917	951.6593337	0	1.056561365	180.5085731	4432.184599	7417.729954	1055.69917	158.2010484	1808.372703	0	17.11702646	0.618072128	1.440735228	1087.147591	661.7926614	747.8627923	27.38397489	3.979644026	2.569721501	5231.443285											$50/day - 1st 5 days	$50/day - 1st 5 days	$0/Day 1-5; $50/Day 6-100	Zero Cost Sharing	$150 Per Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $30 visit Urgent Care	$100/visit	$0 Lab / $35 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$35/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	$20/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$0/visit preventitive  / $10/visit Comprehensive	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											28.63574966	28.63574966	40.66337511	0	124.5225926	0.2	0.122529278	46.93826705	33	0	0	0	0.2	0	3.900068624	10	19.65402757	20	0.025080991	0	0.2	0	0	9.36738806	0	0	0	0	0	0											18.46304381	18.46304381	40.66337511	0	124.5225926	0.2	0.122529278	46.93826705	33	0	0	0	0.2	0	3.900068624	10	19.65402757	20	0.025080991	0	0.2	0	0	9.36738806	0	0	0	0	0	0											2.178	0.740513733	3.11127031	0	3.214208289	2.994759248	0.646407343	3.460918342	8.248409934	0	0	0	0.211312273	0	1.440485341	6.181441629	1.729061715	0.263668414	0.003779648	0	3.423405292	0	0	0.848644447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.6962	0	0	2.178	0.740513733	3.11127031	0	3.214208289	2.994759248	0.646407343	3.460918342	8.248409934	0	0	0	0.211312273	0	1.440485341	6.181441629	1.729061715	0.263668414	0.003779648	0	3.423405292	0	0	0.848644447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.6962		$50/day - 1st 5 days	$50/day - 1st 5 days	$0/Day 1-5; $50/Day 6-100	Zero Cost Sharing	$150 Per Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $30 visit Urgent Care	$100/visit	$0 Lab / $35 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$35/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	$20/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$0/visit preventitive  / $10/visit Comprehensive	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											0.3432	0.1167	0.2079	0	2.0491	0	0.0866	0.5185	0.5897	0	0	0	0	0	0.3661	1.571	0.4394	0.067	0.001	0	0.9176	0	0	0.0655	0	0	0	0	0	0											7.3394	0	0	2.5212	0.857199531	3.319185346	0	5.26331631	2.994786994	0.733046162	3.97945274	8.838139619	0	0	0	0.211316654	0	1.80658214	7.752444073	2.168499689	0.330679275	0.004740239	0	4.341024714	0	0	0.914114855	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.0357
H3920_002_0	2009	8																																D	D	D	V	P	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	Coin	T	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		2145.558738	491.2277604	1074.668862	407.3579674	296.4368015	21.88151183	7.14178385	905.5488188	3719.838503	4054.256619	1011.419085	0	0.850699889	202.3780382	5288.031504	8940.374137	889.5264666	251.688925	2759.579544	0	18.86678883	0.554486006	1.653392096	1271.094452	743.5126876	674.8304136	24.40699761	1.429690764	2.924312603	8022.840209											$50/day - 1st 5 days	$50/day - 1st 5 days	$0/Day 1-5; $50/Day 6-20; $100/day 21-100	Zero Cost Sharing	$150 Per Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $20 visit Urgent Care	$100/visit	$0 Lab / $20 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$20/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	$20/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$5/visit preventitive  / $20/visit Comprehensive	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											28.63574966	28.63574966	63.45106976	0	125	0.2	0.122529278	47.06367526	33	0	0	0	0.2	0	3.863636364	10	20	20	0	0	0.2	0	0	18.04400978	0	0	0	0	0	0											18.46304381	18.46304381	63.45106976	0	125	0.2	0.122529278	47.06367526	33	0	0	0	0.2	0	3.863636364	10	20	20	0	0	0.2	0	0	18.04400978	0	0	0	0	0	0											3.3011	0.755796638	5.682407412	0	3.087883349	4.376302367	0.875077619	3.551537962	10.22955588	0	0	0	0.170139978	0	1.702585901	7.450311781	1.482544111	0.419481542	0	0	3.773357765	0	0	1.911303394	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.7694	0	0	3.3011	0.755796638	5.682407412	0	3.087883349	4.376302367	0.875077619	3.551537962	10.22955588	0	0	0	0.170139978	0	1.702585901	7.450311781	1.482544111	0.419481542	0	0	3.773357765	0	0	1.911303394	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.7694		$50/day - 1st 5 days	$50/day - 1st 5 days	$0/Day 1-5; $50/Day 6-20; $100/day 21-100	Zero Cost Sharing	$150 Per Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $20 visit Urgent Care	$100/visit	$0 Lab / $20 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$20/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	$20/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$5/visit preventitive  / $20/visit Comprehensive	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											0.5202	0.1191	0.3797	0	1.9686	0	0.1112	0.5321	0.7314	0	0	0	0	0	0.4327	1.8935	0.3768	0.1066	0	0	1.1781	0	0	0.1475	0	0	0	0	0	0											8.4975	0	0	3.8213	0.874890627	6.06214232	0	5.056457248	4.376342914	0.986312514	4.083649505	10.96092991	0	0	0	0.17014295	0	2.135295093	9.343795328	1.859330072	0.526092033	0	0	4.951482081	0	0	2.058754796	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.2669
H3920_003_0	2009	8																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0.2239	0.713	0.2148	0.9612	1.5226	0.4625	0.4596	0	0.0401	0.0464	0.9222	2.5335	0.231	0.0596	0.2985	0	0.7826	0.0169	0	0	0	0	0	0	0	0											9.4882		308.9735691	51.45595236	1236.418045	20.84641876	7.222002335	22.99851588	6.92897669	31.00535688	49.11677713	14.91970447	14.82636552	0	1.292076402	1.495250042	29.74914007	81.72465803	7.450252189	1.922085418	9.628305817	0	25.2453034	0.544777862	1.222808936	1.934838661	2.97552008	2.352475388	0.07157475	1.051993199	0.003928622	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	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											705.0509047	485.6115204	67.5430257	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											705.0509047	485.6115204	67.5430257	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											18.1535	2.082300272	6.95928465	0	1.444400467	4.599703175	1.385795338	6.201071375	9.823355427	2.983940893	2.965273104	0	0.25841528	0.299050008	5.949828013	16.34493161	1.490050438	0.384417084	1.925661163	0	5.049060681	0.108955572	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.409	135	0	18.1535	2.082300272	6.95928465	0	1.668282539	5.312657167	1.600593615	7.162237438	11.34597552	3.446451732	3.424890435	0	0.298469649	0.34540276	6.872051355	18.878396	1.721008256	0.444001732	2.224138644	0	5.831665086	0.125843686	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.8972		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											3.3956	0.3895	0.4984	0	2.9341	0.6646	0.2002	1.2622	0.8737	0.914	0.9083	0	0.0792	0.0916	2.3416	6.4328	0.5864	0.1513	0.7579	0	1.5058	0.0346	0	0	0	0	0	0	0	0											24.0217	135	0	21.5491	2.471790475	7.457652843	0	4.602357167	5.977208279	1.800809107	8.424433858	12.21963238	4.360491764	4.333212154	0	0.377627353	0.437007684	9.213695839	25.31119017	2.307440062	0.595294868	2.982011616	0	7.337422401	0.160484271	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.9188
H3920_007_0	2009	8																																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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1460.563702	379.9401702	969.3725448	301.5509964	177.4248023	18.0898482	5.652701539	784.4604655	2766.858717	2684.701494	715.2024856	0	0.991062303	131.8974377	3708.650904	5979.647488	797.1373876	166.359107	1819.466803	0	17.76929487	0.446437995	1.912983534	1152.081426	553.700847	522.4089108	18.03590166	1.665584586	3.406813639	12000											$50/day - 1st 5 days	$50/day - 1st 5 days	$ 50/Day 6-14; $100/Day 15-100	Zero Cost Sharing	$150 Per Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $30 visit Urgent Care	$100/visit	$0 Lab / $20 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$30/visit	$5/visit	$15/visit	$15/visit	$15/visit	$15/visit	$15/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$0/visit preventitive  / $35/visit Comprehensive	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											28.63574966	28.63574966	69.89808837	0	125	0.2	0.122529278	47.06367526	33	0	0	0	0	0	3.863636364	7.5	15	15	0	0	0.2	0	0	31.57701711	0	0	0	0	0	0											18.46304381	18.46304381	69.89808837	0	125	0.2	0.122529278	47.06367526	33	0	0	0	0	0	3.863636364	7.5	15	15	0	0	0.2	0	0	31.57701711	0	0	0	0	0	0											2.2472	0.584571	5.646440649	0	1.848175024	3.61796964	0.692621439	3.076632717	7.60886147	0	0	0	0	0	1.194073208	3.73727968	0.996421734	0.207948884	0	0	3.553858974	0	0	3.03160791	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0437	0	0	2.2472	0.584571	5.646440649	0	1.848175024	3.61796964	0.692621439	3.076632717	7.60886147	0	0	0	0	0	1.194073208	3.73727968	0.996421734	0.207948884	0	0	3.553858974	0	0	3.03160791	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0437		$50/day - 1st 5 days	$50/day - 1st 5 days	$ 50/Day 6-14; $100/Day 15-100	Zero Cost Sharing	$150 Per Service	20% Coinsurance	"20%, except 10% for Diabetic Supplies"	$50 visit ER / $30 visit Urgent Care	$100/visit	$0 Lab / $20 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$30/visit	$5/visit	$15/visit	$15/visit	$15/visit	$15/visit	$15/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$0/visit preventitive  / $35/visit Comprehensive	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											0.4203	0.1093	0.4044	0	3.2505	0.0314	0.0866	0.5422	0.5859	0	0	0	0	0	0.4069	1.2735	0.3395	0.0709	0	0	0.9176	0	0	0.2534	0	0	0	0	0	0											8.6924	0	0	2.6675	0.693913866	6.050793477	0	5.098633695	3.649357797	0.779260258	3.618825689	8.194755036	0	0	0	0	0	1.600952434	5.010753915	1.335951423	0.278807254	0	0	4.471478397	0	0	3.285038944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7361
H3920_801_0	2009	2																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																							0.2052	0.633	0.1978	0.8794	1.4131	0.4253	0.4234	0	0.0347	0.0425	0.8565	2.3392	0.2062	0.0538	0.2786	0	0.6218	0.0156																			8.6261		217.7919555	24.72978845	32.55076382	18.83862427	6.619573033	20.4197406	6.380744485	28.36617218	45.58494715	13.71905035	13.65930859	0	1.118706743	1.371855523	27.62885093	75.45676774	6.650586904	1.736134225	8.988442499	0	20.05790142	0.503937233																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			0.076513151	0.076513151	0.189087361	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																			0.076513151	0.076513151	0.189087361	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																			16.6639	1.892154038	6.154938018	0	1.323914607	4.08394812	1.276148897	5.673234436	9.116989431	2.74381007	2.731861717	0	0.223741349	0.274371105	5.525770185	15.09135355	1.330117381	0.347226845	1.7976885	0	4.011580285	0.100787447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.3636	135	0	16.6639	1.892154038	6.154938018	0	1.529121371	4.716960079	1.473951976	6.552585774	10.53012279	3.169100631	3.155300284	0	0.258421258	0.316898626	6.382264564	17.43051335	1.536285575	0.401047006	2.076330217	0	4.633375229	0.116409501	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.9897		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			3.117	0.3539	0.4408	0	2.3284	0.5109	0.1596	0.9998	0.702	0.7277	0.7245	0	0.0593	0.0728	1.8829	5.1424	0.4532	0.1183	0.6126	0	1.0358	0.0277																			19.4696	135	0	19.7809	2.246077759	6.595705352	0	3.857542465	5.227814097	1.633583238	7.552376168	11.23214444	3.896791729	3.879822536	0	0.317760127	0.389665109	8.265165113	22.57287666	1.989521714	0.519364199	2.688890738	0	5.669179972	0.144152936	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.4593
H3920_802_0	2009	2																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																							0.2052	0.633	0.1978	0.8794	1.4131	0.4253	0.4234	0	0.0347	0.0425	0.8565	2.3392	0.2062	0.0538	0.2786	0	0.6218	0.0156																			8.6261		217.7919555	24.72978845	32.55076382	18.83862427	6.619573033	20.4197406	6.380744485	28.36617218	45.58494715	13.71905035	13.65930859	0	1.118706743	1.371855523	27.62885093	75.45676774	6.650586904	1.736134225	8.988442499	0	20.05790142	0.503937233																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			0.076513151	0.076513151	0.189087361	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																			0.076513151	0.076513151	0.189087361	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																			16.6639	1.892154038	6.154938018	0	1.323914607	4.08394812	1.276148897	5.673234436	9.116989431	2.74381007	2.731861717	0	0.223741349	0.274371105	5.525770185	15.09135355	1.330117381	0.347226845	1.7976885	0	4.011580285	0.100787447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.3636	135	0	16.6639	1.892154038	6.154938018	0	1.529121371	4.716960079	1.473951976	6.552585774	10.53012279	3.169100631	3.155300284	0	0.258421258	0.316898626	6.382264564	17.43051335	1.536285575	0.401047006	2.076330217	0	4.633375229	0.116409501	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.9897		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			3.117	0.3539	0.4408	0	2.3284	0.5109	0.1596	0.9998	0.702	0.7277	0.7245	0	0.0593	0.0728	1.8829	5.1424	0.4532	0.1183	0.6126	0	1.0358	0.0218																			19.4636	135	0	19.7809	2.246077759	6.595705352	0	3.857542465	5.227814097	1.633583238	7.552376168	11.23214444	3.896791729	3.879822536	0	0.317760127	0.389665109	8.265165113	22.57287666	1.989521714	0.519364199	2.688890738	0	5.669179972	0.138164506	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.4534
H3921_001_0	2009	5																					2750											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1530.913359	157.5715883	652.2327834	691.6780719	104.3907798	10.49057465	3.874945908	296.8822738	31.86896039	9244.903377	37.08775862	0	0.193037778	24.11423726	4343.511976	3417.141491	537.9899799	193.5118797	0	0	14.91982518	741.7265349	0	0	103.5923094	0	12.88706159	7.854	98.4	0											"$275 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$275 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$125 Days 1-22 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											271.7521195	275	125	0	150	0.2	0.076056143	49.51692372	0.2	2.8	0.175534234	0	0.2	0.196853052	7.16603675	20	37.5	20	0	0	0.2	19.04197535	0	0	20	0	20	0	0	0											163.3375666	165.2639455	75.11997522	0	90.14397027	0.12019196	0.045706685	29.75768067	0.12019196	1.682687445	0.105489018	0	0.12019196	0.118671605	7.16603675	20	37.5	12.01919604	0	0	0.12019196	19.04197535	0	0	20	0	20	0	0	0											20.838	2.170075198	4.082975877	0	0.784183279	1.260882732	0.177110931	0.736210658	3.830392823	1.296356904	3.912351251	0	0.023201589	2.861675228	2.59381387	5.695235818	1.681218687	0.193821435	0	0	1.793243036	1.176994866	0	0	0.172653849	0	0.021478436	0	0	0	0	0	0	0	0	0	0	0	0	0	55.3018	0	29.1697	20.838	2.170075198	4.082975877	0	0.784183279	1.260882732	0.177110931	0.736210658	3.830392823	1.296356904	3.912351251	0	0.023201589	2.861675228	2.59381387	5.695235818	1.681218687	0.193821435	0	0	1.793243036	1.176994866	0	0	0.172653849	0	0.021478436	0	0	0	0	0	0	0	0	0	0	0	0	0	55.3018		"30% Days 1-999 (1a); 30% (1a1, 13c); $0 n/c (1a2, 1a3)"	"30% Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"30% Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											8.6727	0.4129	3.3658	0.5958	0.435	1.0491	0.3875	0.4084	3.1869	0.719	3.1921	0	0.0129	2.3726	2.5618	4.2406	0.8166	0.2419	0	0	1.9183	0.9	0	0	0.1295	0	0.0161	0	0	0											35.6353	0	0	29.5107	2.582979705	7.448785806	0.595765194	1.219144862	2.309940197	0.564605521	1.14456335	7.017288862	2.015404944	7.104439525	0	0.036070774	5.234268782	5.155586787	9.935806397	2.497810621	0.435711284	0	0	3.711506274	2.077041867	0	0	0.302144236	0	0.037587263	0	0	0	0	0	0	0	0	0	0	0	0	0	90.9371
H3921_003_0	2009	4																					1900											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1549.767472	159.5121766	660.2654198	700.1965007	105.6764146	10.2386297	3.781883986	300.5336795	31.10358539	9358.759886	36.19704733	0	0.188401722	23.53510214	4395.795831	3459.140194	544.615648	195.8950941	0	0	14.56150596	750.8613405	0	0	103.5923094	0	12.88706159	0	98.4	0											"$200 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$200 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-19 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$15 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$5 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$15 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$15 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$15 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$15 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											197.6553105	200	100	0	150	0.2	0.076056143	49.51691588	0.2	2.8	0.176672411	0	0.2	0.196668631	3.584003906	15	37.5	15	0	0	0.2	14.28535021	0	0	15	0	15	0	0	0											108.9429356	110.2062801	55.10314003	0	82.65471004	0.11020628	0.041909323	27.2853755	0.11020628	1.542887921	0.097352046	0	0.11020628	0.108803356	3.584003906	15	37.5	8.265471004	0	0	0.11020628	14.28535021	0	0	15	0	15	0	0	0											14.0697	1.464936967	3.03189149	0	0.727887784	1.128361292	0.158496197	0.683347858	3.427810442	1.203293132	3.523856627	0	0.020763053	2.560698086	1.312879119	4.323925243	1.7019239	0.134930435	0	0	1.604769403	0.893859768	0	0	0.129490387	0	0.016108827	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1189	0	27.466	14.0697	1.464936967	3.03189149	0	0.727887784	1.128361292	0.158496197	0.683347858	3.427810442	1.203293132	3.523856627	0	0.020763053	2.560698086	1.312879119	4.323925243	1.7019239	0.134930435	0	0	1.604769403	0.893859768	0	0	0.129490387	0	0.016108827	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1189		"30% Days 1-999 (1a); 30% (1a1, 13c); $0 n/c (1a2, 1a3)"	"30% Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"30% Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$15 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$15 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											8.4644	0.403	3.285	0.5815	0.4403	1.0239	0.3782	0.4134	3.1104	0.7279	3.1337	0	0.0126	2.3144	2.0025	3.6987	0.8266	0.2099	0	0	1.8722	0.7829	0	0	0.111	0	0.0138	0	0	0											33.8062	0	0	22.5341	1.867925029	6.316867067	0.58145711	1.168206178	2.152224263	0.536684596	1.096722884	6.538168981	1.931196679	6.657593224	0	0.033323168	4.875116088	3.315393631	8.022584203	2.528572651	0.344818036	0	0	3.476963026	1.676793844	0	0	0.240482147	0	0.029916393	0	0	0	0	0	0	0	0	0	0	0	0	0	75.9251
H3921_008_0	2009	3																					2750											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1546.4262	159.168271	658.8418988	698.686889	105.4485781	10.70425511	3.953873921	299.8865878	32.51809299	9338.58256	37.8431919	0	0.196969727	24.60541543	4386.530235	3451.697303	543.4414659	195.4727476	0	0	15.22372417	749.2424962	0	0	103.5923094	0	12.88706159	7.854	98.4	0											"$275 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$275 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$125 Days 1-22 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											271.7521195	275	125	0	150	0.2	0.076056143	49.51691726	0.2	2.8	0.175227525	0	0.2	0.196833837	7.167661932	20	37.5	20	0	0	0.2	19.04215844	0	0	20	0	20	0	0	0											162.3562062	164.270623	74.66846499	0	89.60215799	0.119469544	0.045431964	29.57881762	0.119469544	1.672573616	0.104671762	0	0.119469544	0.11794868	7.167661932	20	37.5	11.9469544	0	0	0.119469544	19.04215844	0	0	20	0	20	0	0	0											20.9227	2.178889253	4.099559438	0	0.787368346	1.278832476	0.179632256	0.739190891	3.88492174	1.301622233	3.961113592	0	0.023531883	2.902176273	2.620097148	5.752828839	1.698254581	0.194608667	0	0	1.818771384	1.18893286	0	0	0.172653849	0	0.021478436	0	0	0	0	0	0	0	0	0	0	0	0	0	55.7271	0	29.8221	20.9227	2.178889253	4.099559438	0	0.787368346	1.278832476	0.179632256	0.739190891	3.88492174	1.301622233	3.961113592	0	0.023531883	2.902176273	2.620097148	5.752828839	1.698254581	0.194608667	0	0	1.818771384	1.18893286	0	0	0.172653849	0	0.021478436	0	0	0	0	0	0	0	0	0	0	0	0	0	55.7271		"30% Days 1-999 (1a); 30% (1a1, 13c); $0 n/c (1a2, 1a3)"	"30% Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"30% Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											8.8494	0.4213	3.4344	0.6079	0.4394	1.0704	0.3954	0.4125	3.2518	0.7263	3.2519	0	0.0131	2.4207	2.5898	4.2852	0.8249	0.2443	0	0	1.9573	0.9094	0	0	0.1295	0	0.0161	0	0	0											36.251	0	0	29.772	2.600204131	7.533926889	0.607900219	1.226737421	2.349257987	0.575019648	1.151675873	7.136731039	2.027956432	7.213062288	0	0.036663199	5.322868069	5.209865137	10.03801059	2.523121092	0.438949601	0	0	3.776107349	2.098285754	0	0	0.302144236	0	0.037587263	0	0	0	0	0	0	0	0	0	0	0	0	0	91.9781
H3921_801_0	2009	2																					3200											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	Coin	V	V	Coin	O	T	V	P	P	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		1607.460904	165.4503609	684.8452221	726.2628235	109.6104468	11.0151291	4.068702705	311.7069514	33.46248654	9707.159879	38.94223749	0	0.20269014	25.32000825	4555.784001	3580.718662	564.8901384	1.626892554	0	0	15.66585302	778.813771	0	0	0	0	0	0	0	0											"$320 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$320 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-22 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 9a, 9d); $60 (5); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											316.2102049	320	150	0	150	0.2	0.076056143	49.51689304	0.2	2.8	0.175534198	0	0.2	0.200573383	17.93439555	29.9880886	37.5	0.2	0	0	0.2	28.55392865	0	0	0	0	0	0	0	0											190.2893588	192.5442622	90.25512291	0	90.25512291	0.120340164	0.045763044	29.79435511	0.120340164	1.684762294	0.105619071	0	0.120340164	0.121055313	17.93439555	29.9880886	37.5	0.120340164	0	0	0.120340164	28.55392865	0	0	0	0	0	0	0	0											25.4902	2.654709806	5.150899141	0	0.824408695	1.325562441	0.186196219	0.773925634	4.026881114	1.362854746	4.11304294	0	0.024391765	3.065121535	6.808769359	8.948242373	1.765281683	0.195780517	0	0	1.88523132	1.853182738	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.4547	0	33.7909	25.4902	2.654709806	5.150899141	0	0.824408695	1.325562441	0.186196219	0.773925634	4.026881114	1.362854746	4.11304294	0	0.024391765	3.065121535	6.808769359	8.948242373	1.765281683	0.195780517	0	0	1.88523132	1.853182738	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.4547		"30% Days 1-999 (1a); 30% (1a1, 13c); $0 n/c (1a2, 1a3)"	"30% Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"30% Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 9a, 9d); $75 (5); $45/$35 (9c)"	"30% (7a, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	30% (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); 30% (16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											9.1064	0.4336	3.5341	0.6256	0.4567	1.1015	0.4069	0.4287	3.3462	0.755	3.3517	0	0.0135	2.5362	2.9336	10.298	0.8574	0.2092	0	0	2.0142	0.5372	0	0	0	0	0	0	0	0											42.9457	0	0	34.5966	3.08826055	8.685007819	0.625554915	1.28111889	2.427075352	0.59306649	1.202668961	7.373129769	2.11785607	7.464742837	0	0.037904441	5.601369115	9.742345787	19.24624752	2.622704214	0.404952416	0	0	3.899412422	2.390400467	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.4004
H3921_803_0	2009	2																					3200											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	Coin	V	V	Coin	O	T	V	P	P	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		1607.474042	165.4517131	684.8508192	726.2687591	109.6113426	11.01530915	4.06876921	311.7094957	33.46303351	9707.239214	38.94287403	0	0.202693454	25.32042212	4555.820432	3580.747927	564.8947552	1.626919147	0	0	15.66610909	778.8201361	0	0	0	0	0	0	0	0											"$320 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$320 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-22 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 9a, 9d); $60 (5); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											316.2102049	320	150	0	150	0.2	0.076056143	49.51689303	0.2	2.8	0.175533948	0	0.2	0.200573376	17.93439871	29.98809985	37.5	0.2	0	0	0.2	28.5539288	0	0	0	0	0	0	0	0											190.288442	192.5433342	90.25468792	0	90.25468792	0.120339584	0.045762823	29.79421152	0.120339584	1.684754175	0.105618411	0	0.120339584	0.121054727	17.93439871	29.98809985	37.5	0.120339584	0	0	0.120339584	28.5539288	0	0	0	0	0	0	0	0											25.4903	2.654718708	5.150916413	0	0.82441146	1.32557772	0.186198365	0.773928221	4.026927529	1.362859316	4.113084492	0	0.024392046	3.065156785	6.808825006	8.948318864	1.76529611	0.195782773	0	0	1.885253049	1.853197893	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.4552	0	33.7915	25.4903	2.654718708	5.150916413	0	0.82441146	1.32557772	0.186198365	0.773928221	4.026927529	1.362859316	4.113084492	0	0.024392046	3.065156785	6.808825006	8.948318864	1.76529611	0.195782773	0	0	1.885253049	1.853197893	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.4552		"30% Days 1-999 (1a); 30% (1a1, 13c); $0 n/c (1a2, 1a3)"	"30% Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"30% Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 9a, 9d); $75 (5); $45/$35 (9c)"	"30% (7a, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	30% (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); 30% (16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											9.1065	0.4336	3.5342	0.6256	0.4567	1.1015	0.4069	0.4287	3.3463	0.755	3.3518	0	0.0135	2.5363	2.9336	10.2982	0.8574	0.2092	0	0	2.0142	0.5372	0	0	0	0	0	0	0	0											42.9464	0	0	34.5968	3.088276539	8.685082859	0.62556514	1.281125387	2.427108635	0.593075286	1.202675047	7.37323088	2.11786681	7.46483485	0	0.037904943	5.601445749	9.742447485	19.24649234	2.622725649	0.404958092	0	0	3.899467075	2.390424404	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.4015
H3921_804_0	2009	2																					3200											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	Coin	V	V	Coin	O	T	V	P	P	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		1607.464032	165.4506828	684.8465548	726.2642367	109.61066	11.01517197	4.068718539	311.7075572	33.46261677	9707.178769	38.94238905	0	0.202690929	25.32010679	4555.792675	3580.72563	564.8912376	1.626898886	0	0	15.66591399	778.8152865	0	0	0	0	0	0	0	0											"$320 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$320 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-22 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 9a, 9d); $60 (5); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											316.2102049	320	150	0	150	0.2	0.076056143	49.51689304	0.2	2.8	0.175534139	0	0.2	0.200573381	17.9343963	29.98809128	37.5	0.2	0	0	0.2	28.55392869	0	0	0	0	0	0	0	0											190.2891405	192.5440413	90.25501934	0	90.25501934	0.120340026	0.045762991	29.79432092	0.120340026	1.684760361	0.105618914	0	0.120340026	0.121055174	17.9343963	29.98809128	37.5	0.120340026	0	0	0.120340026	28.55392869	0	0	0	0	0	0	0	0											25.4902	2.654711925	5.150903254	0	0.824409354	1.325566079	0.18619673	0.773926249	4.026892165	1.362855834	4.113052834	0	0.024391832	3.065129927	6.808782608	8.948260585	1.765285118	0.195781054	0	0	1.885236493	1.853186346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.4548	0	33.7911	25.4902	2.654711925	5.150903254	0	0.824409354	1.325566079	0.18619673	0.773926249	4.026892165	1.362855834	4.113052834	0	0.024391832	3.065129927	6.808782608	8.948260585	1.765285118	0.195781054	0	0	1.885236493	1.853186346	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.4548		"30% Days 1-999 (1a); 30% (1a1, 13c); $0 n/c (1a2, 1a3)"	"30% Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"30% Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 9a, 9d); $75 (5); $45/$35 (9c)"	"30% (7a, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	30% (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); 30% (16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											9.1064	0.4336	3.5341	0.6256	0.4567	1.1015	0.4069	0.4287	3.3463	0.755	3.3517	0	0.0135	2.5363	2.9336	10.298	0.8574	0.2092	0	0	2.0142	0.5372	0	0	0	0	0	0	0	0											42.9459	0	0	34.5966	3.088264357	8.685025685	0.625557349	1.281120437	2.427083276	0.593068584	1.20267041	7.373153843	2.117858627	7.464764745	0	0.03790456	5.601387361	9.742370001	19.24630581	2.622709318	0.404953768	0	0	3.899425435	2.390406166	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.4007
H3921_805_0	2009	2																					3200											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	Coin	V	V	Coin	O	T	V	P	P	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		1607.474042	165.4517131	684.8508192	726.2687591	109.6113426	11.01530915	4.06876921	311.7094957	33.46303351	9707.239214	38.94287403	0	0.202693454	25.32042212	4555.820432	3580.747927	564.8947552	1.626919147	0	0	15.66610909	778.8201361	0	0	0	0	0	0	0	0											"$320 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$320 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-22 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 9a, 9d); $60 (5); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											316.2102049	320	150	0	150	0.2	0.076056143	49.51689303	0.2	2.8	0.175533948	0	0.2	0.200573376	17.93439871	29.98809985	37.5	0.2	0	0	0.2	28.5539288	0	0	0	0	0	0	0	0											190.288442	192.5433342	90.25468792	0	90.25468792	0.120339584	0.045762823	29.79421152	0.120339584	1.684754175	0.105618411	0	0.120339584	0.121054727	17.93439871	29.98809985	37.5	0.120339584	0	0	0.120339584	28.5539288	0	0	0	0	0	0	0	0											25.4903	2.654718708	5.150916413	0	0.82441146	1.32557772	0.186198365	0.773928221	4.026927529	1.362859316	4.113084492	0	0.024392046	3.065156785	6.808825006	8.948318864	1.76529611	0.195782773	0	0	1.885253049	1.853197893	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.4552	0	33.7915	25.4903	2.654718708	5.150916413	0	0.82441146	1.32557772	0.186198365	0.773928221	4.026927529	1.362859316	4.113084492	0	0.024392046	3.065156785	6.808825006	8.948318864	1.76529611	0.195782773	0	0	1.885253049	1.853197893	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.4552		"30% Days 1-999 (1a); 30% (1a1, 13c); $0 n/c (1a2, 1a3)"	"30% Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"30% Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 9a, 9d); $75 (5); $45/$35 (9c)"	"30% (7a, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	30% (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); 30% (16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											9.1065	0.4336	3.5342	0.6256	0.4567	1.1015	0.4069	0.4287	3.3463	0.755	3.3518	0	0.0135	2.5363	2.9336	10.2982	0.8574	0.2092	0	0	2.0142	0.5372	0	0	0	0	0	0	0	0											42.9464	0	0	34.5968	3.088276539	8.685082859	0.62556514	1.281125387	2.427108635	0.593075286	1.202675047	7.37323088	2.11786681	7.46483485	0	0.037904943	5.601445749	9.742447485	19.24649234	2.622725649	0.404958092	0	0	3.899467075	2.390424404	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.4015
H3923_009_0	2009	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	V	V	P	V	P	O	V											0	0	0	0	0	0	0	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	239.6746688	35.5047543	836.7218062	488.7469979	171.4586881	17.2728516	0	221.7304794	492.103239	2340.880307	864.6860258	0	4.750069759	916.2436407	4247.21011	6497.452603	204.6762785	762.8895513	2768.097115	17608.96234	6.358150285	361.7046092	9.525482673	828.1244658	515.3013721	13.7573229	27.67729823	10.49900959	0	4.508043017											"1a - $250 copay/admit, $500 max"	"1b - $250 copay/admit, $500 max"	2 - $0 copay Days 1-14/ $50 copay Days 15-100	6 - $0 copay	10a - $50 copay/trip	"11a - 0% coinsurance for diabetic supplies, 15% coinsurance for all other"	"11b,11c - 0% coinsurance for diabetic supplies, 15% coinsurance for all other"	4a - $50 ER copay (WIA); 4b - $30 Urgent Care copay	"9a,9b - $100 copay"	8a - $0 copay	8b - $100 copay (High Tech Imaging Only)	5 - $0 copay	12 - $0 copay	3 - $30 CORF copay; 9c - $30 SA Ind/Grp Session copay; 9d - $30 Cardiac Rehab copay	7a - $20 OV copay	7d - $30 Specialist OV copay (excluding MH and Radiology); 18a - $30 Hearing Exam copay	"7e,7h - $30 MH/Psych Ind/Grp Session copay"	"7c,7i -  $30 OT/PT/ST copay"	7d - $30 OV copay (Radiology only); 14h - $0 Mammography Screening copay	"7b,7f,7g - $30 Chiro/Pod/Other OV copay; 14b - $0 Immunization copay; 14c - $20 Physical Exam copay; 14d - $0 Pap Smear copay, $0 Pelvic Exam copay; 14e - $0 Prostate Screening copay; 14f - $0 Colorectal Screening copay; 14g - $0 Bone Mass Meas copay; 14i - $0 Diabetes Monitoring copay; 14j - $0 Nutrition Therapy copay"	15 - $0 Copay	13a - $0 copay; 17a - $30 Eye Exam copay	10b - $50 copay/trip	"16a,16b - $5 Preventive OV copay"	17a - $20 Routine Eye Exam copay	17b - $40 allowance every 2 years	18a - $25 Routine Hearing Exam/Fitting copay	18b - $400 allowance every 3 years	0	4a - $50 ER copay worldwide coverage											208.9305665	250	33.40787979	0	50	0.330230199	0	42.21582508	100	0	22.19827586	0	0	8.531392906	20	27.39799139	31.52950451	30	0	2.170156256	0	32.72204109	50	5	20	0	8.62821435	0	0	42.56325401											156.2986923	187.0222903	24.99207277	0	49.75557818	24.70%	0.00%	31.36320729	79.63860022	0	16.60628957	0	0	6.382242564	14.96178323	20.4961404	23.58688058	25.42235488	0	1.623470373	0.00%	24.47900427	49.75557818	3.740445807	15.55604298	0	6.454673637	0	0	31.62132105											3.1217	0.553348372	1.742617689	0	0.710918847	4.266394346	0	0.579514916	3.26586776	0	1.196602211	0	0	0.48730743	5.295486415	11.09772507	0.402306245	1.616204075	0	2.382302388	0	0.73784739	0.039495491	0.258129557	0.668004191	0	0.014887327	0	0	0.01187919	0	0	0	0	0	0	0	0	0	0	38.4486	0	20.11	3.1217	0.553348372	1.742617689	0	0.710918847	4.266394346	0	0.579514916	3.26586776	0	1.196602211	0	0	0.48730743	5.295486415	11.09772507	0.402306245	1.616204075	0	2.382302388	0	0.73784739	0.039495491	0.258129557	0.668004191	0	0.014887327	0	0	0.01187919	0	0	0	0	0	0	0	0	0	0	38.4486	3350	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max, $100 Preventive Dental OON allowance"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max, $40 Glasses/Contacts OON allowance"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max, $400 Hearing Aid OON allowance"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"											3.3853	0.0474	0.3011	0.0591	0.0833	0.2539	0	0.0707	0.5861	0.1921	0.4093	0	0.0029	0.4648	0.0509	0.66	0.0326	0.0881	0.3621	1.9513	0.0935	0.0459	0	0.0513	0.0661	0.0007	0.002	0.0051	0	0											9.2653	350	0	6.5071	0.600727283	2.043704764	0.059052727	0.794226875	4.520269915	0	0.650167558	3.852011637	0.192081287	1.605897313	0	0.002938718	0.952078546	5.34633884	11.75770362	0.434878272	1.704347584	0.362061442	4.333594261	0.093451797	0.783726026	0.039495491	0.309453706	0.734068836	0.000674015	0.016848659	0.005143798	0	0.01187919	0	0	0	0	0	0	0	0	0	0	47.7139
H3923_013_0	2009	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	V	V	P	V	P	O	V											0	0	0	0	0	0	0	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	232.6188541	33.70429104	469.5347907	336.1688541	171.163064	14.40739357	0	241.4007372	464.7862399	2276.75801	815.1527517	0	4.668028913	859.4740109	4247.21011	6205.746447	205.0945864	685.3968944	2675.415019	17032.66925	6.449452449	362.9032581	9.50905911	950	585.0906172	15.56328964	19.31330411	9.209943527	0	4.907962633											"1a - $250 copay/admit, $500 max"	"1b - $250 copay/admit, $500 max"	2 - $0 copay Days 1-14/ $50 copay Days 15-100	6 - $0 copay	10a - $50 copay/trip	"11a - 0% coinsurance for diabetic supplies, 15% coinsurance for all other"	"11b,11c - 0% coinsurance for diabetic supplies, 15% coinsurance for all other"	4a - $50 ER copay (WIA); 4b - $30 Urgent Care copay	"9a,9b - $100 copay"	8a - $0 copay	8b - $100 copay (High Tech Imaging Only)	5 - $0 copay	12 - $0 copay	3 - $30 CORF copay; 9c - $30 SA Ind/Grp Session copay; 9d - $30 Cardiac Rehab copay	7a - $20 OV copay	7d - $30 Specialist OV copay (excluding MH and Radiology); 18a - $30 Hearing Exam copay	"7e,7h - $30 MH/Psych Ind/Grp Session copay"	"7c,7i -  $30 OT/PT/ST copay"	7d - $30 OV copay (Radiology only); 14h - $0 Mammography Screening copay	"7b,7f,7g - $30 Chiro/Pod/Other OV copay; 14b - $0 Immunization copay; 14c - $20 Physical Exam copay; 14d - $0 Pap Smear copay, $0 Pelvic Exam copay; 14e - $0 Prostate Screening copay; 14f - $0 Colorectal Screening copay; 14g - $0 Bone Mass Meas copay; 14i - $0 Diabetes Monitoring copay; 14j - $0 Nutrition Therapy copay"	15 - $0 Copay	13a - $0 copay; 17a - $30 Eye Exam copay	10b - $50 copay/trip	"16a,16b - $5 Preventive OV copay"	17a - $20 Routine Eye Exam copay	17b - $40 allowance every 2 years	18a - $25 Routine Hearing Exam/Fitting copay	18b - $400 allowance every 3 years	0	4a - $50 ER copay worldwide coverage											235.9763404	250	31.01169332	0	50	0.427993178	0	41.32026707	100	0	22.19827586	0	0	8.272309288	20	27.49485963	31.73092318	30	0	2.067716032	0	33.81965611	50	5	20	0	12.98921802	0	0	41.66032571											176.2985874	186.7757029	23.16892327	0	37.09593986	32.00%	0.00%	30.65628285	86.59852946	0	16.58439431	0	0	6.180265528	14.94205623	20.54148693	23.70626192	25.60687128	0	1.544796461	0.00%	25.26676017	37.09593986	3.735514058	15.83169397	0	9.704281301	0	0	30.90857874											3.4175	0.524595221	0.906551295	0	0.529121227	4.610365942	0	0.616704107	3.354150407	0	1.126567888	0	0	0.442648133	5.288504357	10.6229383	0.405168832	1.462572504	0	2.192667265	0	0.764115799	0.029395624	0.295728196	0.771914633	0	0.015618478	0	0	0.012641512	0	0	0	0	0	0	0	0	0	0	37.3895	0	20.27	3.4175	0.524595221	0.906551295	0	0.529121227	4.610365942	0	0.616704107	3.354150407	0	1.126567888	0	0	0.442648133	5.288504357	10.6229383	0.405168832	1.462572504	0	2.192667265	0	0.764115799	0.029395624	0.295728196	0.771914633	0	0.015618478	0	0	0.012641512	0	0	0	0	0	0	0	0	0	0	37.3895	3350	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max, $100 Preventive Dental OON allowance"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max, $40 Glasses/Contacts OON allowance"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max, $400 Hearing Aid OON allowance"	"$350 deductible, 25% coinsurance, no separate OOP Max"	"$350 deductible, 25% coinsurance, no separate OOP Max"											3.2769	0.0457	0.1506	0.0405	0.087	0.2128	0	0.078	0.5788	0.1866	0.4219	0	0.0036	0.3928	0.0511	0.6374	0.0324	0.0798	0.3686	1.9259	0.0953	0.0464	0	0.0592	0.076	0.0008	0.0014	0.0045	0	0											8.8538	350	0	6.6944	0.570343542	1.057200665	0.040542199	0.616145727	4.823152009	0	0.694691736	3.93299392	0.186612518	1.548443303	0	0.0035659	0.83542473	5.339556602	11.26030321	0.437563846	1.542372227	0.368550875	4.118550999	0.095253428	0.810503794	0.029395624	0.354891258	0.847878342	0.000766193	0.017034999	0.004534125	0	0.012641512	0	0	0	0	0	0	0	0	0	0	46.2433
H3923_017_0	2009	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	V	V	P	V	P	O	V											0	0	0	0	0	0	0	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	277.457412	39.70593742	705.0843048	748.190158	189.4158846	23.53828375	0	237.2677234	571.6644137	2664.057362	1026.874007	0	5.354892129	1156.507774	4247.21011	7284.07518	205.1742746	1033.33549	3161.528178	19182.50325	8.165059537	383.6840485	10.5231047	950	597.6254061	16.2650643	31.51776886	14.5092722	0	4.823933572											1a - $0 copay/admit	1b - $0 copay/admit	2 - $0 copay Days 1-14/ $25 copay Days 15-100	6 - $0 copay	10a - $25 copay/trip	"11a - 0% coinsurance for diabetic supplies, 5% coinsurance for all other"	"11b,11c - 0% coinsurance for diabetic supplies, 5% coinsurance for all other"	4a - $50 ER copay (WIA); 4b - $20 Urgent Care copay	"9a,9b - $50 copay"	8a - $0 copay	8b - $50 copay (High Tech Imaging Only)	5 - $0 copay	12 - $0 copay	3 - $20 CORF copay; 9c - $20 SA Ind/Grp Session copay; 9d - $20 Cardiac Rehab copay	7a - $15 OV copay	7d - $20 Specialist OV copay (excluding MH and Radiology); 18a - $20 Hearing Exam copay	"7e,7h - $20 MH/Psych Ind/Grp Session copay"	"7c,7i -  $20 OT/PT/ST copay"	7d - $20 OV copay (Radiology only); 14h - $0 Mammography Screening copay	"7b,7f,7g - $20 Chiro/Pod/Other OV copay; 14b - $0 Immunization copay; 14c - $15 Physical Exam copay; 14d - $0 Pap Smear copay, $0 Pelvic Exam copay; 14e - $0 Prostate Screening copay; 14f - $0 Colorectal Screening copay; 14g - $0 Bone Mass Meas copay; 14i - $0 Diabetes Monitoring copay; 14j - $0 Nutrition Therapy copay"	15 - $0 Copay	13a - $0 copay; 17a - $20 Eye Exam copay	10b - $25 copay/trip	"16a,16b - $5 Preventive OV copay"	17a - $20 Routine Eye Exam copay	17b - $40 allowance every 2 years	18a - $15 Routine Hearing Exam/Fittinig copay	18b - $400 allowance every 3 years	0	4a - $50 ER copay worldwide coverage											0	0	12.70176239	0	25	0.068486293	0	41.56414059	50	0	11.09913793	0	0	4.816705994	15	16.73441167	21.20043166	20	0	1.40550584	0	17.79142019	25	5	19.81003021	0	3.231738833	0	0	42.07935918											0	0	12.18098076	0	23.97498156	6.60%	0.00%	39.82490309	47.94996312	0	10.64406509	0	0	4.619217495	14.38498894	16.04828845	20.33119833	19.47944003	0	1.347879064	0.00%	17.06195884	23.97498156	4.794996312	18.21888037	0	3.099235157	0	0	40.31856252											0	0	0.715718196	0	0.378436862	1.553526727	0	0.787430341	2.284273963	0	0.910842814	0	0	0.445180079	5.091339203	9.741411631	0.347619906	1.677399726	0	2.15464121	0	0.545533453	0.02102427	0.379603875	0.907338815	0	0.008140081	0	0	0.016207839	0	0	0	0	0	0	0	0	0	0	27.9657	0	1.26	0	0	0.715718196	0	0.378436862	1.553526727	0	0.787430341	2.284273963	0	0.910842814	0	0	0.445180079	5.091339203	9.741411631	0.347619906	1.677399726	0	2.15464121	0	0.545533453	0.02102427	0.379603875	0.907338815	0	0.008140081	0	0	0.016207839	0	0	0	0	0	0	0	0	0	0	27.9657	2500	"$250 deductible, 20% coinsurance, no separate OOP Max"	"$250 deductible, 20% coinsurance, no separate OOP Max"	"$250 deductible, 20% coinsurance, no separate OOP Max"	"$250 deductible, 20% coinsurance, no separate OOP Max"	"$250 deductible, 20% coinsurance, no separate OOP Max"	"$250 deductible, 20% coinsurance, no separate OOP Max"	"$250 deductible, 20% coinsurance, no separate OOP Max"	"$250 deductible, 20% coinsurance, no separate OOP Max"	"$250 deductible, 20% coinsurance, no separate OOP Max"	"$250 deductible, 20% coinsurance, no separate OOP Max"	"$250 deductible, 20% coinsurance, no separate OOP Max"	"$250 deductible, 20% coinsurance, no separate OOP Max"	"$250 deductible, 20% coinsurance, no separate OOP Max"	"$250 deductible, 20% coinsurance, no separate OOP Max"	"$250 deductible, 20% coinsurance, no separate OOP Max"	"$250 deductible, 20% coinsurance, no separate OOP Max"	"$250 deductible, 20% coinsurance, no separate OOP Max"	"$250 deductible, 20% coinsurance, no separate OOP Max"	"$250 deductible, 20% coinsurance, no separate OOP Max"	"$250 deductible, 20% coinsurance, no separate OOP Max"	"$250 deductible, 20% coinsurance, no separate OOP Max"	"$250 deductible, 20% coinsurance, no separate OOP Max"	"$250 deductible, 20% coinsurance, no separate OOP Max"	"$250 deductible, 20% coinsurance, no separate OOP Max, $100 Preventive Dental OON allowance"	"$250 deductible, 20% coinsurance, no separate OOP Max"	"$250 deductible, 20% coinsurance, no separate OOP Max, $40 Glasses/Contacts OON allowance"	"$250 deductible, 20% coinsurance, no separate OOP Max"	"$250 deductible, 20% coinsurance, no separate OOP Max, $400 Hearing Aid OON allowance"	"$250 deductible, 20% coinsurance, no separate OOP Max"	"$250 deductible, 20% coinsurance, no separate OOP Max"											3.0828	0.0403	0.1641	0.0713	0.0737	0.2723	0	0.0675	0.4955	0.1761	0.3748	0	0.0025	0.51	0.0412	0.601	0.0261	0.0971	0.3359	1.7545	0.0944	0.0404	0	0.0463	0.0603	0.0006	0.0019	0.0056	0	0											8.4362	250	0	3.0828	0.040252602	0.879778575	0.071303573	0.452173964	1.825802038	0	0.854933251	2.779750225	0.176109386	1.285609646	0	0.002530168	0.955140009	5.13256963	10.34244432	0.373713278	1.774539553	0.335867542	3.90918826	0.094448013	0.585906257	0.02102427	0.425940707	0.967629895	0.000627145	0.010000946	0.005594456	0	0.016207839	0	0	0	0	0	0	0	0	0	0	36.4019
H3923_021_0	2009	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	V	V	P	V	P	O	V											0	0	0	0	0	0	0	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	208.9803996	36.94110273	620.0663048	560.6761631	180.5967431	16.13943128	0	237.7114009	522.0518052	2481.511166	928.2305366	0	5.028642209	1017.108091	4247.21011	6784.792759	205.1025254	870.9169733	2933.374622	18186.67994	6.1006452	372.4623371	10.03315239	0	0	15.7819957	0	12.04415461	0	4.832954061											"1a - $500 copay/admit, $1,000 max"	"1b - $500 copay/admit, $1,000 max"	2 - $0 copay Days 1-14/ $100 copay Days 15-100	6 - $0 copay	10a - $100 copay/trip	"11a - 0% coinsurance for diabetic supplies, 20% coinsurance for all other"	"11b,11c - 0% coinsurance for diabetic supplies, 20% coinsurance for all other"	4a - $50 ER copay (WIA); 4b - $40 Urgent Care copay	"9a,9b - $250 copay"	8a - $0 copay	8b - $150 copay (High Tech Imaging Only)	5 - $0 copay	12 - $0 copay	3 - $50 CORF copay; 9c - $50 SA Ind/Grp Session copay; 9d - $50 Cardiac Rehab copay	7a - $35 OV copay	7d - $50 Specialist OV copay (excluding MH and Radiology); 18a - $50 Hearing Exam copay	"7e,7h - $50 MH/Psych Ind/Grp Session copay"	"7c,7i -  $50 OT/PT/ST copay"	7d - $50 OV copay (Radiology only); 14h - $0 Mammography Screening copay	"7b,7f,7g - $50 Chiro/Pod/Other OV copay; 14b - $0 Immunization copay; 14c - $35 Physical Exam copay; 14d - $0 Pap Smear copay, $10 Pelvic Exam copay; 14e - $10 Prostate Screening copay; 14f - $10 Colorectal Screening copay; 14g - $10 Bone Mass Meas copay; 14i - $0 Diabetes Monitoring copay; 14j - $0 Nutrition Therapy copay"	15 - $0 Copay	13a - $0 copay; 17a - $50 Eye Exam copay	10b - $100 copay/trip	0	0	0	0	0	0	4a - $50 ER copay worldwide coverage											500	500	69.88640186	0	100	0.367417652	0	41.79582174	250	0	33.29741379	0	0	13.79029483	35	47.27956724	52.91826015	50	0	3.790492723	0	52.97454036	100	0	0	0	0	0	0	41.96710311											328.7963208	286.2909452	40.01568809	0	57.25818904	21.00%	0.00%	23.56684003	143.1454726	0	19.06549614	0	0	7.896073082	20.04036617	27.07142399	30.30003743	32.44674299	0	2.170367489	0.00%	30.33226246	57.25818904	0	0	0	0	0	0	23.66341812											5.726	0.881325268	2.067698321	0	0.861720205	3.38928057	0	0.466842213	6.227446031	0	1.474764642	0	0	0.669263318	7.092970482	15.30616679	0.517884516	2.354868267	0	3.289314906	0	0.941468781	0.047873345	0	0	0	0	0	0	0.009530351	0	0	0	0	0	0	0	0	0	0	51.3244	0	64.55	5.726	0.881325268	2.067698321	0	0.861720205	3.38928057	0	0.466842213	6.227446031	0	1.474764642	0	0	0.669263318	7.092970482	15.30616679	0.517884516	2.354868267	0	3.289314906	0	0.941468781	0.047873345	0	0	0	0	0	0	0.009530351	0	0	0	0	0	0	0	0	0	0	51.3244	3350	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"	"$1000 deductible, 30% coinsurance, no separate OOP Max"											4.0135	0.0095	0.2098	0.0768	0.1014	0.3216	0	0.1089	0.6814	0.2322	0.5053	0	0.0037	0.5988	0.058	0.7658	0.0036	0.1114	0.4408	2.3307	0.1216	0.0544	0	0	0	0	0	0	0	0											10.7492	1000	0	9.7395	0.8908672	2.277531194	0.076815584	0.963164818	3.710875726	0	0.575764144	6.908797212	0.232239725	1.980030804	0	0.003686037	1.268089701	7.151012577	16.07194246	0.521496827	2.46622994	0.440767699	5.620031956	0.121561777	0.995849954	0.047873345	0	0	0	0	0	0	0.009530351	0	0	0	0	0	0	0	0	0	0	62.0736
H3923_801_0	2009	11																					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											0	0	0	0	0	0	0	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	208.691679	3.134532857	12.92863243	4.219448095	5.623018609	17.02902952	0	11.98470419	46.44108688	13.43669893	24.47077588	0	0.222526514	35.29064917	0	53.90241443	2.213827427	8.234987378	32.22308551	154.670094	6.722590219	5.373380729	0	0	0	0	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																			0.075687947	0.075687947	0.192523473	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.075687947	0.075687947	0.192523473	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											15.7954	0.237246356	2.489065213	0	1.298917299	3.933705819	0	2.768466668	10.72789107	3.103877454	5.652749227	0	0.051403625	8.152139958	0	12.45145773	0.511394136	1.902282084	7.443532752	35.72879172	1.552918341	1.241250948	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.0425	0	0	15.7954	0.237246356	2.489065213	0	1.298917299	3.933705819	0	2.768466668	10.72789107	3.103877454	5.652749227	0	0.051403625	8.152139958	0	12.45145773	0.511394136	1.902282084	7.443532752	35.72879172	1.552918341	1.241250948	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.0425	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	NA	NA	NA	NA	NA	NA	NA	NA											0.8313	0.0125	0.131	0	0.0684	0.207	0	0.1457	0.5646	0.1634	0.2975	0	0.0027	0.4291	0	0.6553	0.0269	0.1001	0.3918	1.8805	0.0817	0.0653	0	0	0	0	0	0	0	0											6.0549	0	0	16.6268	0.249733006	2.620068645	0	1.367281367	4.140742967	0	2.91417544	11.29251691	3.267239425	5.950262344	0	0.054109079	8.581199955	0	13.10679761	0.538309616	2.002402194	7.835297634	37.60925444	1.634650885	1.306579946	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.0974
H3923_802_0	2009	10																					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											0	0	0	0	0	0	0	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	188.7916752	2.952594778	11.69281129	3.81611981	5.085525932	15.40125994	0	10.83911119	42.00187979	12.15231277	22.13166521	0	0.201255666	31.91728927	0	48.74999452	2.088944471	7.447822029	29.14294765	139.8859917	6.079991774	4.859750419	0	0	0	0	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																			0.075912021	0.075912021	0.188504422	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.075912021	0.075912021	0.188504422	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											14.3316	0.224137436	2.204146635	0	1.17475649	3.557691045	0	2.503834686	9.70243423	2.807184251	5.112414662	0	0.046490059	7.372893821	0	11.26124873	0.482546173	1.720446889	6.732020908	32.31366408	1.4044781	1.122602347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.0745	0	0	14.3316	0.224137436	2.204146635	0	1.17475649	3.557691045	0	2.503834686	9.70243423	2.807184251	5.112414662	0	0.046490059	7.372893821	0	11.26124873	0.482546173	1.720446889	6.732020908	32.31366408	1.4044781	1.122602347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.0745	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	NA	NA	NA	NA	NA	NA	NA	NA											0.7543	0.0118	0.116	0	0.0618	0.1872	0	0.1318	0.5107	0.1477	0.2691	0	0.0024	0.388	0	0.5927	0.0254	0.0905	0.3543	1.7007	0.0739	0.0591	0	0	0	0	0	0	0	0											5.4776	0	0	15.0859	0.235934144	2.320154353	0	1.236585779	3.744937942	0	2.635615459	10.21308866	2.95493079	5.381489118	0	0.048936904	7.760940864	0	11.85394604	0.50794334	1.810996725	7.086337798	34.01438324	1.478398	1.181686681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.5522
H3923_803_0	2009	10																					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											0	0	0	0	0	0	0	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	188.7916752	2.952594778	11.69281129	3.81611981	5.085525932	15.40125994	0	10.83911119	42.00187979	12.15231277	22.13166521	0	0.201255666	31.91728927	0	48.74999452	2.088944471	7.447822029	29.14294765	139.8859917	6.079991774	4.859750419	0	0	0	0	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																			0.074484826	0.074484826	0.179409604	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.074484826	0.074484826	0.179409604	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											14.0621	0.219923507	2.097802639	0	1.17475649	3.557691045	0	2.503834686	9.70243423	2.807184251	5.112414662	0	0.046490059	7.372893821	0	11.26124873	0.482546173	1.720446889	6.732020908	32.31366408	1.4044781	1.122602347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.6945	0	0	14.0621	0.219923507	2.097802639	0	1.17475649	3.557691045	0	2.503834686	9.70243423	2.807184251	5.112414662	0	0.046490059	7.372893821	0	11.26124873	0.482546173	1.720446889	6.732020908	32.31366408	1.4044781	1.122602347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.6945	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	NA	NA	NA	NA	NA	NA	NA	NA											0.7401	0.0116	0.1104	0	0.0618	0.1872	0	0.1318	0.5107	0.1477	0.2691	0	0.0024	0.388	0	0.5927	0.0254	0.0905	0.3543	1.7007	0.0739	0.0591	0	0	0	0	0	0	0	0											5.4576	0	0	14.8022	0.231498428	2.208213304	0	1.236585779	3.744937942	0	2.635615459	10.21308866	2.95493079	5.381489118	0	0.048936904	7.760940864	0	11.85394604	0.50794334	1.810996725	7.086337798	34.01438324	1.478398	1.181686681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.1522
H3924_001_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	140.4024768	1.174203903	947.2752702	10.77892955	123.056977	10.11335088	9.406539013	289.7239205	300.434271	47.82386517	1125.4505	31.56660105	0.797198193	912.2084179	4379.178725	2596.021347	118.5952596	0	608.0964536	5.233464716	3.278945654	0.906293617	0	863.8778595	830.7821281	4.013395142	0.991582426	1.138147529	3.05095349	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	2.706839084	0	0.390705902	1.541274674	1.433556546	0.919873448	2.246384599	0	2.143983203	0.050111979	0	1.158504691	2.780778491	3.296947111	0.15061598	0	0.810896621	0	0.499711318	0	0	1.097124882	1.055093303	0	0.00125931	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2837	None	6.96	0	0	2.706839084	0	0.390705902	1.541274674	1.433556546	0.919873448	2.246384599	0	2.143983203	0.050111979	0	1.158504691	2.780778491	3.296947111	0.15061598	0	0.810896621	0	0.499711318	0	0	1.097124882	1.055093303	0	0.00125931	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2837		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.3296	0.0137	0.2047	0.0623	0.0844	0.0585	0.0544	0.6676	0.2934	0.2764	0.2437	0.0226	0.0046	0.1544	0.5157	1.4337	0.0073	0	0.0945	0.0302	0.0627	0.0052	0	0.0457	0.1301	0.0232	0.0039	0.0066	0.0176	0											5.8469	None	4.803189168	1.3296	0.013690036	2.91152309	0.062290867	0.475152034	1.59981316	1.488003836	1.58744607	2.539822746	0.2763716	2.38772663	0.07270551	0.004606966	1.312941227	3.296461684	4.730646784	0.1579001	0	0.90538308	0.030243917	0.562450791	0.005237423	0	1.142802612	1.185151441	0.023193199	0.005169399	0.006577295	0.0176313	0	0	0	0	0	0	0	0	0	0	0	28.1306
H3924_002_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	140.4024768	1.174203903	947.2752702	10.77892955	123.056977	10.11335088	9.406539013	289.7239205	300.434271	47.82386517	1125.4505	31.56660105	0.797198193	912.2084179	4379.178725	2596.021347	118.5952596	0	608.0964536	5.233464716	3.278945654	0.906293617	0	863.8778595	830.7821281	4.013395142	0.991582426	1.138147529	3.05095349	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	2.706839084	0	0.390705902	1.541274674	1.433556546	0.919873448	2.246384599	0	2.143983203	0.050111979	0	1.158504691	2.780778491	3.296947111	0.15061598	0	0.810896621	0	0.499711318	0	0	1.097124882	1.055093303	0	0.00125931	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2837	None	6.96	0	0	2.706839084	0	0.390705902	1.541274674	1.433556546	0.919873448	2.246384599	0	2.143983203	0.050111979	0	1.158504691	2.780778491	3.296947111	0.15061598	0	0.810896621	0	0.499711318	0	0	1.097124882	1.055093303	0	0.00125931	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2837		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.3296	0.0137	0.2047	0.0623	0.0844	0.0585	0.0544	0.6676	0.2934	0.2764	0.2437	0.0226	0.0046	0.1544	0.5157	1.4337	0.0073	0	0.0945	0.0302	0.0627	0.0052	0	0.0457	0.1301	0.0232	0.0039	0.0066	0.0176	0											5.8469	None	4.803189168	1.3296	0.013690036	2.91152309	0.062290867	0.475152034	1.59981316	1.488003836	1.58744607	2.539822746	0.2763716	2.38772663	0.07270551	0.004606966	1.312941227	3.296461684	4.730646784	0.1579001	0	0.90538308	0.030243917	0.562450791	0.005237423	0	1.142802612	1.185151441	0.023193199	0.005169399	0.006577295	0.0176313	0	0	0	0	0	0	0	0	0	0	0	28.1306
H3924_003_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	140.4024768	1.174203903	947.2752702	10.77892955	123.056977	10.11335088	9.406539013	289.7239205	300.434271	47.82386517	1125.4505	31.56660105	0.797198193	912.2084179	4379.178725	2596.021347	118.5952596	0	608.0964536	5.233464716	3.278945654	0.906293617	0	863.8778595	830.7821281	4.013395142	0.991582426	1.138147529	3.05095349	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	2.706839084	0	0.390705902	1.541274674	1.433556546	0.919873448	2.246384599	0	2.143983203	0.050111979	0	1.158504691	2.780778491	3.296947111	0.15061598	0	0.810896621	0	0.499711318	0	0	1.097124882	1.055093303	0	0.00125931	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2837	None	6.96	0	0	2.706839084	0	0.390705902	1.541274674	1.433556546	0.919873448	2.246384599	0	2.143983203	0.050111979	0	1.158504691	2.780778491	3.296947111	0.15061598	0	0.810896621	0	0.499711318	0	0	1.097124882	1.055093303	0	0.00125931	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2837		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.3296	0.0137	0.2047	0.0623	0.0844	0.0585	0.0544	0.6676	0.2934	0.2764	0.2437	0.0226	0.0046	0.1544	0.5157	1.4337	0.0073	0	0.0945	0.0302	0.0627	0.0052	0	0.0457	0.1301	0.0232	0.0039	0.0066	0.0176	0											5.8469	None	4.803189168	1.3296	0.013690036	2.91152309	0.062290867	0.475152034	1.59981316	1.488003836	1.58744607	2.539822746	0.2763716	2.38772663	0.07270551	0.004606966	1.312941227	3.296461684	4.730646784	0.1579001	0	0.90538308	0.030243917	0.562450791	0.005237423	0	1.142802612	1.185151441	0.023193199	0.005169399	0.006577295	0.0176313	0	0	0	0	0	0	0	0	0	0	0	28.1306
H3924_005_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	161.4022484	1.174203903	1477.678762	13.9103318	206.8362911	11.3604911	1.884295354	215.8905729	209.9279436	41.04413232	620.2541567	3.623763808	1.691057528	459.0355856	4541.104784	3695.760821	118.5952596	0	693.7855202	4.8543909	1.893053663	1.031160166	0	861.65	703.4241157	3.831870821	1.731326455	1.013045989	3.560192805	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	4.222467063	0	0.656705224	1.731338844	0.287166612	0.685452569	1.569657476	0	1.181584169	0.005752725	0	0.582975194	2.883601538	4.693616243	0.15061598	0	0.925162991	0	0.288501378	0	0	1.0942955	0.893348627	0	0.002198785	0	0	0	0	0	0	0	0	0	0	0	0	0	21.8544	None	6.8259	0	0	4.222467063	0	0.656705224	1.731338844	0.287166612	0.685452569	1.569657476	0	1.181584169	0.005752725	0	0.582975194	2.883601538	4.693616243	0.15061598	0	0.925162991	0	0.288501378	0	0	1.0942955	0.893348627	0	0.002198785	0	0	0	0	0	0	0	0	0	0	0	0	0	21.8544		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.5285	0.0137	0.333	0.0804	0.0858	0.0658	0.0109	0.4974	0.2702	0.2372	0.2542	0.0042	0.0098	0.1263	0.5348	2.0411	0.0073	0	0.1619	0.0281	0.0362	0.006	0	0.0456	0.1101	0.0221	0.0068	0.0059	0.0206	0											6.5436	None	5.375548356	1.5285	0.013690036	4.555424163	0.080387075	0.742522246	1.797096074	0.298073363	1.182900745	1.839812004	0.23719188	1.435807114	0.01000185	0.009772532	0.709260016	3.418352816	6.734666901	0.1579001	0	1.087050405	0.02805327	0.32472314	0.00595902	0	1.13987165	1.003468992	0.02214418	0.009025893	0.005854339	0.020574167	0	0	0	0	0	0	0	0	0	0	0	28.3981
H3924_006_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	161.4022484	1.174203903	1477.678762	13.9103318	206.8362911	11.3604911	1.884295354	215.8905729	209.9279436	41.04413232	620.2541567	3.623763808	1.691057528	459.0355856	4541.104784	3695.760821	118.5952596	0	693.7855202	4.8543909	1.893053663	1.031160166	0	861.65	703.4241157	3.831870821	1.731326455	1.013045989	3.560192805	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	4.222467063	0	0.656705224	1.731338844	0.287166612	0.685452569	1.569657476	0	1.181584169	0.005752725	0	0.582975194	2.883601538	4.693616243	0.15061598	0	0.925162991	0	0.288501378	0	0	1.0942955	0.893348627	0	0.002198785	0	0	0	0	0	0	0	0	0	0	0	0	0	21.8544	None	6.8259	0	0	4.222467063	0	0.656705224	1.731338844	0.287166612	0.685452569	1.569657476	0	1.181584169	0.005752725	0	0.582975194	2.883601538	4.693616243	0.15061598	0	0.925162991	0	0.288501378	0	0	1.0942955	0.893348627	0	0.002198785	0	0	0	0	0	0	0	0	0	0	0	0	0	21.8544		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.5285	0.0137	0.333	0.0804	0.0858	0.0658	0.0109	0.4974	0.2702	0.2372	0.2542	0.0042	0.0098	0.1263	0.5348	2.0411	0.0073	0	0.1619	0.0281	0.0362	0.006	0	0.0456	0.1101	0.0221	0.0068	0.0059	0.0206	0											6.5436	None	5.375548356	1.5285	0.013690036	4.555424163	0.080387075	0.742522246	1.797096074	0.298073363	1.182900745	1.839812004	0.23719188	1.435807114	0.01000185	0.009772532	0.709260016	3.418352816	6.734666901	0.1579001	0	1.087050405	0.02805327	0.32472314	0.00595902	0	1.13987165	1.003468992	0.02214418	0.009025893	0.005854339	0.020574167	0	0	0	0	0	0	0	0	0	0	0	28.3981
H3924_007_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	161.4022484	1.174203903	1477.678762	13.9103318	206.8362911	11.3604911	1.884295354	215.8905729	209.9279436	41.04413232	620.2541567	3.623763808	1.691057528	459.0355856	4541.104784	3695.760821	118.5952596	0	693.7855202	4.8543909	1.893053663	1.031160166	0	861.65	703.4241157	3.831870821	1.731326455	1.013045989	3.560192805	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	4.222467063	0	0.656705224	1.731338844	0.287166612	0.685452569	1.569657476	0	1.181584169	0.005752725	0	0.582975194	2.883601538	4.693616243	0.15061598	0	0.925162991	0	0.288501378	0	0	1.0942955	0.893348627	0	0.002198785	0	0	0	0	0	0	0	0	0	0	0	0	0	21.8544	None	6.8259	0	0	4.222467063	0	0.656705224	1.731338844	0.287166612	0.685452569	1.569657476	0	1.181584169	0.005752725	0	0.582975194	2.883601538	4.693616243	0.15061598	0	0.925162991	0	0.288501378	0	0	1.0942955	0.893348627	0	0.002198785	0	0	0	0	0	0	0	0	0	0	0	0	0	21.8544		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.5285	0.0137	0.333	0.0804	0.0858	0.0658	0.0109	0.4974	0.2702	0.2372	0.2542	0.0042	0.0098	0.1263	0.5348	2.0411	0.0073	0	0.1619	0.0281	0.0362	0.006	0	0.0456	0.1101	0.0221	0.0068	0.0059	0.0206	0											6.5436	None	5.375548356	1.5285	0.013690036	4.555424163	0.080387075	0.742522246	1.797096074	0.298073363	1.182900745	1.839812004	0.23719188	1.435807114	0.01000185	0.009772532	0.709260016	3.418352816	6.734666901	0.1579001	0	1.087050405	0.02805327	0.32472314	0.00595902	0	1.13987165	1.003468992	0.02214418	0.009025893	0.005854339	0.020574167	0	0	0	0	0	0	0	0	0	0	0	28.3981
H3924_009_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	151.435594	1.174203903	950.8421935	15.29263966	90.35463146	10.63475474	7.615912401	191.8163686	227.2588913	37.90979583	835.6023599	8.151622258	0.738876098	487.4267571	4045.983811	4883.315127	118.5952596	0	851.8475895	8.141380285	2.215841102	1.279202168	0	867.3736367	656.7468456	3.209335832	1.626780757	1.297230809	3.75721855	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	2.717031568	0	0.286875955	1.620736623	1.16066505	0.60901697	1.699243138	0	1.591822496	0.0129407	0	0.619031982	2.56919972	6.201810211	0.15061598	0	1.135938761	0	0.337694184	0	0	1.101564519	0.834068494	0	0.002066012	0	0	0	0	0	0	0	0	0	0	0	0	0	22.6503	None	7.0745	0	0	2.717031568	0	0.286875955	1.620736623	1.16066505	0.60901697	1.699243138	0	1.591822496	0.0129407	0	0.619031982	2.56919972	6.201810211	0.15061598	0	1.135938761	0	0.337694184	0	0	1.101564519	0.834068494	0	0.002066012	0	0	0	0	0	0	0	0	0	0	0	0	0	22.6503		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.4341	0.0137	0.2185	0.0884	0.0522	0.0616	0.0441	0.442	0.206	0.2191	0.1585	0.0065	0.0043	0.1032	0.4764	2.6969	0.0073	0	0.1876	0.047	0.0424	0.0074	0	0.0459	0.1028	0.0185	0.0064	0.0075	0.0217	0											6.72	None	5.520417187	1.4341	0.013690036	2.935498681	0.08837536	0.339055105	1.682293119	1.204747766	1.050994133	1.905272259	0.219078715	1.75035197	0.019464343	0.004269926	0.722214283	3.045646557	8.898709181	0.1579001	0	1.323503039	0.047048608	0.380092173	0.007392442	0	1.147481829	0.936881578	0.018546583	0.008480866	0.007496629	0.021712768	0	0	0	0	0	0	0	0	0	0	0	29.3703
H3924_010_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	151.435594	1.174203903	950.8421935	15.29263966	90.35463146	10.63475474	7.615912401	191.8163686	227.2588913	37.90979583	835.6023599	8.151622258	0.738876098	487.4267571	4045.983811	4883.315127	118.5952596	0	851.8475895	8.141380285	2.215841102	1.279202168	0	867.3736367	656.7468456	3.209335832	1.626780757	1.297230809	3.75721855	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	2.717031568	0	0.286875955	1.620736623	1.16066505	0.60901697	1.699243138	0	1.591822496	0.0129407	0	0.619031982	2.56919972	6.201810211	0.15061598	0	1.135938761	0	0.337694184	0	0	1.101564519	0.834068494	0	0.002066012	0	0	0	0	0	0	0	0	0	0	0	0	0	22.6503	None	7.0745	0	0	2.717031568	0	0.286875955	1.620736623	1.16066505	0.60901697	1.699243138	0	1.591822496	0.0129407	0	0.619031982	2.56919972	6.201810211	0.15061598	0	1.135938761	0	0.337694184	0	0	1.101564519	0.834068494	0	0.002066012	0	0	0	0	0	0	0	0	0	0	0	0	0	22.6503		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.4341	0.0137	0.2185	0.0884	0.0522	0.0616	0.0441	0.442	0.206	0.2191	0.1585	0.0065	0.0043	0.1032	0.4764	2.6969	0.0073	0	0.1876	0.047	0.0424	0.0074	0	0.0459	0.1028	0.0185	0.0064	0.0075	0.0217	0											6.72	None	5.520417187	1.4341	0.013690036	2.935498681	0.08837536	0.339055105	1.682293119	1.204747766	1.050994133	1.905272259	0.219078715	1.75035197	0.019464343	0.004269926	0.722214283	3.045646557	8.898709181	0.1579001	0	1.323503039	0.047048608	0.380092173	0.007392442	0	1.147481829	0.936881578	0.018546583	0.008480866	0.007496629	0.021712768	0	0	0	0	0	0	0	0	0	0	0	29.3703
H3924_011_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	151.435594	1.174203903	950.8421935	15.29263966	90.35463146	10.63475474	7.615912401	191.8163686	227.2588913	37.90979583	835.6023599	8.151622258	0.738876098	487.4267571	4045.983811	4883.315127	118.5952596	0	851.8475895	8.141380285	2.215841102	1.279202168	0	867.3736367	656.7468456	3.209335832	1.626780757	1.297230809	3.75721855	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	2.717031568	0	0.286875955	1.620736623	1.16066505	0.60901697	1.699243138	0	1.591822496	0.0129407	0	0.619031982	2.56919972	6.201810211	0.15061598	0	1.135938761	0	0.337694184	0	0	1.101564519	0.834068494	0	0.002066012	0	0	0	0	0	0	0	0	0	0	0	0	0	22.6503	None	7.0745	0	0	2.717031568	0	0.286875955	1.620736623	1.16066505	0.60901697	1.699243138	0	1.591822496	0.0129407	0	0.619031982	2.56919972	6.201810211	0.15061598	0	1.135938761	0	0.337694184	0	0	1.101564519	0.834068494	0	0.002066012	0	0	0	0	0	0	0	0	0	0	0	0	0	22.6503		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.4341	0.0137	0.2185	0.0884	0.0522	0.0616	0.0441	0.442	0.206	0.2191	0.1585	0.0065	0.0043	0.1032	0.4764	2.6969	0.0073	0	0.1876	0.047	0.0424	0.0074	0	0.0459	0.1028	0.0185	0.0064	0.0075	0.0217	0											6.72	None	5.520417187	1.4341	0.013690036	2.935498681	0.08837536	0.339055105	1.682293119	1.204747766	1.050994133	1.905272259	0.219078715	1.75035197	0.019464343	0.004269926	0.722214283	3.045646557	8.898709181	0.1579001	0	1.323503039	0.047048608	0.380092173	0.007392442	0	1.147481829	0.936881578	0.018546583	0.008480866	0.007496629	0.021712768	0	0	0	0	0	0	0	0	0	0	0	29.3703
H3924_013_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	143.4710326	1.174203903	1136.009648	18.70903278	123.1430908	9.435736006	9.496316351	269.8407467	269.1600392	65.09770594	903.623285	26.55587761	1.370855023	1379.214911	4076.022749	2290.139026	118.5952596	0	711.0373558	5.469686113	3.3365385	0.978654553	0	868.0225251	721.2780407	3.703357196	1.780255526	1.177913181	2.817021657	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	3.246147568	0	0.390979313	1.438006167	1.447238612	0.856744371	2.012543258	0	1.721402358	0.042157456	0	1.751602937	2.588274446	2.908476563	0.15061598	0	0.948168314	0	0.508488467	0	0	1.102388607	0.916023112	0	0.002260925	0	0	0	0	0	0	0	0	0	0	0	0	0	22.0315	None	6.8812	0	0	3.246147568	0	0.390979313	1.438006167	1.447238612	0.856744371	2.012543258	0	1.721402358	0.042157456	0	1.751602937	2.588274446	2.908476563	0.15061598	0	0.948168314	0	0.508488467	0	0	1.102388607	0.916023112	0	0.002260925	0	0	0	0	0	0	0	0	0	0	0	0	0	22.0315		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.3587	0.0137	0.2481	0.1081	0.0784	0.0546	0.055	0.6218	0.2984	0.3762	0.3723	0.0243	0.0079	0.1807	0.48	1.2648	0.0073	0	0.137	0.0316	0.0638	0.0057	0	0.0459	0.1129	0.0214	0.007	0.0068	0.0163	0											5.9987	None	4.927930687	1.3587	0.013690036	3.494243968	0.108118516	0.469394275	1.492622457	1.502205555	1.478502818	2.310962457	0.376196216	2.093737882	0.06647895	0.007922099	1.932342539	3.068258607	4.1732472	0.1579001	1.09E-05	1.085199979	0.031609028	0.572329924	0.005655593	0	1.148251393	1.028938492	0.021401506	0.009280974	0.006807098	0.01627942	0	0	0	0	0	0	0	0	0	0	0	28.0303
H3924_014_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	143.4710326	1.174203903	1136.009648	18.70903278	123.1430908	9.435736006	9.496316351	269.8407467	269.1600392	65.09770594	903.623285	26.55587761	1.370855023	1379.214911	4076.022749	2290.139026	118.5952596	0	711.0373558	5.469686113	3.3365385	0.978654553	0	868.0225251	721.2780407	3.703357196	1.780255526	1.177913181	2.817021657	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	3.246147568	0	0.390979313	1.438006167	1.447238612	0.856744371	2.012543258	0	1.721402358	0.042157456	0	1.751602937	2.588274446	2.908476563	0.15061598	0	0.948168314	0	0.508488467	0	0	1.102388607	0.916023112	0	0.002260925	0	0	0	0	0	0	0	0	0	0	0	0	0	22.0315	None	6.8812	0	0	3.246147568	0	0.390979313	1.438006167	1.447238612	0.856744371	2.012543258	0	1.721402358	0.042157456	0	1.751602937	2.588274446	2.908476563	0.15061598	0	0.948168314	0	0.508488467	0	0	1.102388607	0.916023112	0	0.002260925	0	0	0	0	0	0	0	0	0	0	0	0	0	22.0315		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.3587	0.0137	0.2481	0.1081	0.0784	0.0546	0.055	0.6218	0.2984	0.3762	0.3723	0.0243	0.0079	0.1807	0.48	1.2648	0.0073	0	0.137	0.0316	0.0638	0.0057	0	0.0459	0.1129	0.0214	0.007	0.0068	0.0163	0											5.9987	None	4.927930687	1.3587	0.013690036	3.494243968	0.108118516	0.469394275	1.492622457	1.502205555	1.478502818	2.310962457	0.376196216	2.093737882	0.06647895	0.007922099	1.932342539	3.068258607	4.1732472	0.1579001	1.09E-05	1.085199979	0.031609028	0.572329924	0.005655593	0	1.148251393	1.028938492	0.021401506	0.009280974	0.006807098	0.01627942	0	0	0	0	0	0	0	0	0	0	0	28.0303
H3924_015_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	143.4710326	1.174203903	1136.009648	18.70903278	123.1430908	9.435736006	9.496316351	269.8407467	269.1600392	65.09770594	903.623285	26.55587761	1.370855023	1379.214911	4076.022749	2290.139026	118.5952596	0	711.0373558	5.469686113	3.3365385	0.978654553	0	868.0225251	721.2780407	3.703357196	1.780255526	1.177913181	2.817021657	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	3.246147568	0	0.390979313	1.438006167	1.447238612	0.856744371	2.012543258	0	1.721402358	0.042157456	0	1.751602937	2.588274446	2.908476563	0.15061598	0	0.948168314	0	0.508488467	0	0	1.102388607	0.916023112	0	0.002260925	0	0	0	0	0	0	0	0	0	0	0	0	0	22.0315	None	6.8812	0	0	3.246147568	0	0.390979313	1.438006167	1.447238612	0.856744371	2.012543258	0	1.721402358	0.042157456	0	1.751602937	2.588274446	2.908476563	0.15061598	0	0.948168314	0	0.508488467	0	0	1.102388607	0.916023112	0	0.002260925	0	0	0	0	0	0	0	0	0	0	0	0	0	22.0315		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.3587	0.0137	0.2481	0.1081	0.0784	0.0546	0.055	0.6218	0.2984	0.3762	0.3723	0.0243	0.0079	0.1807	0.48	1.2648	0.0073	0	0.137	0.0316	0.0638	0.0057	0	0.0459	0.1129	0.0214	0.007	0.0068	0.0163	0											5.9987	None	4.927930687	1.3587	0.013690036	3.494243968	0.108118516	0.469394275	1.492622457	1.502205555	1.478502818	2.310962457	0.376196216	2.093737882	0.06647895	0.007922099	1.932342539	3.068258607	4.1732472	0.1579001	1.09E-05	1.085199979	0.031609028	0.572329924	0.005655593	0	1.148251393	1.028938492	0.021401506	0.009280974	0.006807098	0.01627942	0	0	0	0	0	0	0	0	0	0	0	28.0303
H3924_017_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	135.3979961	1.174203903	997.9822974	13.35169863	196.2988496	11.3755269	8.384913349	326.9373052	297.4061608	37.79986525	876.0750026	63.83495152	1.319588129	569.1334281	3081.174669	3700.086752	118.5952596	0	624.6987043	8.683540929	3.208023071	0.880717413	0	861.65	626.6305296	3.484663134	1.327121769	1.194591452	3.4768584	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	2.851734415	0	0.623248847	1.733630299	1.277860794	1.038025944	2.22374304	0	1.66892288	0.101337986	0	0.722799454	1.956545915	4.699110176	0.15061598	0	0.833035722	0	0.488902716	0	0	1.0942955	0.795820773	0	0.001685445	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2613	None	6.953	0	0	2.851734415	0	0.623248847	1.733630299	1.277860794	1.038025944	2.22374304	0	1.66892288	0.101337986	0	0.722799454	1.956545915	4.699110176	0.15061598	0	0.833035722	0	0.488902716	0	0	1.0942955	0.795820773	0	0.001685445	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2613		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.2822	0.0137	0.2137	0.0772	0.1101	0.0658	0.0485	0.7533	0.2758	0.2184	0.2483	0.0332	0.0076	0.1331	0.3628	2.0434	0.0073	0	0.1144	0.0502	0.0614	0.0051	0	0.0456	0.0981	0.0201	0.0052	0.0069	0.0201	0											6.3217	None	5.193272852	1.2822	0.013690036	3.065467562	0.077158764	0.73332817	1.799474561	1.326394672	1.791344461	2.499559164	0.218443432	1.917193599	0.134557179	0.00762583	0.855888511	2.319378787	6.742549907	0.1579001	0	0.947482547	0.050181726	0.550285154	0.00508962	0	1.13987165	0.893919176	0.020137685	0.00691866	0.006903481	0.020092582	0	0	0	0	0	0	0	0	0	0	0	28.5831
H3924_018_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	135.3979961	1.174203903	997.9822974	13.35169863	196.2988496	11.3755269	8.384913349	326.9373052	297.4061608	37.79986525	876.0750026	63.83495152	1.319588129	569.1334281	3081.174669	3700.086752	118.5952596	0	624.6987043	8.683540929	3.208023071	0.880717413	0	861.65	626.6305296	3.484663134	1.327121769	1.194591452	3.4768584	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	2.851734415	0	0.623248847	1.733630299	1.277860794	1.038025944	2.22374304	0	1.66892288	0.101337986	0	0.722799454	1.956545915	4.699110176	0.15061598	0	0.833035722	0	0.488902716	0	0	1.0942955	0.795820773	0	0.001685445	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2613	None	6.953	0	0	2.851734415	0	0.623248847	1.733630299	1.277860794	1.038025944	2.22374304	0	1.66892288	0.101337986	0	0.722799454	1.956545915	4.699110176	0.15061598	0	0.833035722	0	0.488902716	0	0	1.0942955	0.795820773	0	0.001685445	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2613		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.2822	0.0137	0.2137	0.0772	0.1101	0.0658	0.0485	0.7533	0.2758	0.2184	0.2483	0.0332	0.0076	0.1331	0.3628	2.0434	0.0073	0	0.1144	0.0502	0.0614	0.0051	0	0.0456	0.0981	0.0201	0.0052	0.0069	0.0201	0											6.3217	None	5.193272852	1.2822	0.013690036	3.065467562	0.077158764	0.73332817	1.799474561	1.326394672	1.791344461	2.499559164	0.218443432	1.917193599	0.134557179	0.00762583	0.855888511	2.319378787	6.742549907	0.1579001	0	0.947482547	0.050181726	0.550285154	0.00508962	0	1.13987165	0.893919176	0.020137685	0.00691866	0.006903481	0.020092582	0	0	0	0	0	0	0	0	0	0	0	28.5831
H3924_019_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	135.3979961	1.174203903	997.9822974	13.35169863	196.2988496	11.3755269	8.384913349	326.9373052	297.4061608	37.79986525	876.0750026	63.83495152	1.319588129	569.1334281	3081.174669	3700.086752	118.5952596	0	624.6987043	8.683540929	3.208023071	0.880717413	0	861.65	626.6305296	3.484663134	1.327121769	1.194591452	3.4768584	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	2.851734415	0	0.623248847	1.733630299	1.277860794	1.038025944	2.22374304	0	1.66892288	0.101337986	0	0.722799454	1.956545915	4.699110176	0.15061598	0	0.833035722	0	0.488902716	0	0	1.0942955	0.795820773	0	0.001685445	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2613	None	6.953	0	0	2.851734415	0	0.623248847	1.733630299	1.277860794	1.038025944	2.22374304	0	1.66892288	0.101337986	0	0.722799454	1.956545915	4.699110176	0.15061598	0	0.833035722	0	0.488902716	0	0	1.0942955	0.795820773	0	0.001685445	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2613		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.2822	0.0137	0.2137	0.0772	0.1101	0.0658	0.0485	0.7533	0.2758	0.2184	0.2483	0.0332	0.0076	0.1331	0.3628	2.0434	0.0073	0	0.1144	0.0502	0.0614	0.0051	0	0.0456	0.0981	0.0201	0.0052	0.0069	0.0201	0											6.3217	None	5.193272852	1.2822	0.013690036	3.065467562	0.077158764	0.73332817	1.799474561	1.326394672	1.791344461	2.499559164	0.218443432	1.917193599	0.134557179	0.00762583	0.855888511	2.319378787	6.742549907	0.1579001	0	0.947482547	0.050181726	0.550285154	0.00508962	0	1.13987165	0.893919176	0.020137685	0.00691866	0.006903481	0.020092582	0	0	0	0	0	0	0	0	0	0	0	28.5831
H3924_021_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	151.8428262	1.174203903	473.2077823	7.552291132	83.87131595	8.464899296	4.809647887	125.2502559	147.1991536	25.90126281	277.1703455	24.70501269	1.807519244	296.5597207	4976.611194	2238.978626	118.5952596	0	510.886061	25.93245162	2.239694758	1.477209026	0	861.65	561.369898	3.044463204	0.798599278	1.000674122	4.270440396	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	1.352191238	0	0.266291428	1.290050653	0.732990338	0.397669562	1.100626472	0	0.528009508	0.039219208	0	0.376630845	3.160148108	2.843502855	0.15061598	0	0.681266562	0	0.341329481	0	0	1.0942955	0.71293977	0	0.001014221	0	0	0	0	0	0	0	0	0	0	0	0	0	15.0688	None	4.7065	0	0	1.352191238	0	0.266291428	1.290050653	0.732990338	0.397669562	1.100626472	0	0.528009508	0.039219208	0	0.376630845	3.160148108	2.843502855	0.15061598	0	0.681266562	0	0.341329481	0	0	1.0942955	0.71293977	0	0.001014221	0	0	0	0	0	0	0	0	0	0	0	0	0	15.0688		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.438	0.0137	0.0981	0.0436	0.0463	0.049	0.0278	0.2886	0.2394	0.1497	0.1393	0.0105	0.0104	0.0874	0.586	1.2365	0.0073	0	0.1252	0.1499	0.0429	0.0085	0	0.0456	0.0879	0.0176	0.0031	0.0058	0.0247	0											4.9828	None	4.093323	1.438	0.013690036	1.450281652	0.043644293	0.312600699	1.339047508	0.760829726	0.68626721	1.340073427	0.149682035	0.667317988	0.049691459	0.010445559	0.464021888	3.746183736	4.080019237	0.1579001	0	0.806425068	0.149862273	0.384183887	0.008536713	0	1.13987165	0.800821685	0.017593793	0.004163323	0.005782843	0.02467865	0	0	0	0	0	0	0	0	0	0	0	20.0516
H3924_022_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	151.8428262	1.174203903	473.2077823	7.552291132	83.87131595	8.464899296	4.809647887	125.2502559	147.1991536	25.90126281	277.1703455	24.70501269	1.807519244	296.5597207	4976.611194	2238.978626	118.5952596	0	510.886061	25.93245162	2.239694758	1.477209026	0	861.65	561.369898	3.044463204	0.798599278	1.000674122	4.270440396	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	1.352191238	0	0.266291428	1.290050653	0.732990338	0.397669562	1.100626472	0	0.528009508	0.039219208	0	0.376630845	3.160148108	2.843502855	0.15061598	0	0.681266562	0	0.341329481	0	0	1.0942955	0.71293977	0	0.001014221	0	0	0	0	0	0	0	0	0	0	0	0	0	15.0688	None	4.7065	0	0	1.352191238	0	0.266291428	1.290050653	0.732990338	0.397669562	1.100626472	0	0.528009508	0.039219208	0	0.376630845	3.160148108	2.843502855	0.15061598	0	0.681266562	0	0.341329481	0	0	1.0942955	0.71293977	0	0.001014221	0	0	0	0	0	0	0	0	0	0	0	0	0	15.0688		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.438	0.0137	0.0981	0.0436	0.0463	0.049	0.0278	0.2886	0.2394	0.1497	0.1393	0.0105	0.0104	0.0874	0.586	1.2365	0.0073	0	0.1252	0.1499	0.0429	0.0085	0	0.0456	0.0879	0.0176	0.0031	0.0058	0.0247	0											4.9828	None	4.093323	1.438	0.013690036	1.450281652	0.043644293	0.312600699	1.339047508	0.760829726	0.68626721	1.340073427	0.149682035	0.667317988	0.049691459	0.010445559	0.464021888	3.746183736	4.080019237	0.1579001	0	0.806425068	0.149862273	0.384183887	0.008536713	0	1.13987165	0.800821685	0.017593793	0.004163323	0.005782843	0.02467865	0	0	0	0	0	0	0	0	0	0	0	20.0516
H3924_023_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	151.8428262	1.174203903	473.2077823	7.552291132	83.87131595	8.464899296	4.809647887	125.2502559	147.1991536	25.90126281	277.1703455	24.70501269	1.807519244	296.5597207	4976.611194	2238.978626	118.5952596	0	510.886061	25.93245162	2.239694758	1.477209026	0	861.65	561.369898	3.044463204	0.798599278	1.000674122	4.270440396	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	1.352191238	0	0.266291428	1.290050653	0.732990338	0.397669562	1.100626472	0	0.528009508	0.039219208	0	0.376630845	3.160148108	2.843502855	0.15061598	0	0.681266562	0	0.341329481	0	0	1.0942955	0.71293977	0	0.001014221	0	0	0	0	0	0	0	0	0	0	0	0	0	15.0688	None	4.7065	0	0	1.352191238	0	0.266291428	1.290050653	0.732990338	0.397669562	1.100626472	0	0.528009508	0.039219208	0	0.376630845	3.160148108	2.843502855	0.15061598	0	0.681266562	0	0.341329481	0	0	1.0942955	0.71293977	0	0.001014221	0	0	0	0	0	0	0	0	0	0	0	0	0	15.0688		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.438	0.0137	0.0981	0.0436	0.0463	0.049	0.0278	0.2886	0.2394	0.1497	0.1393	0.0105	0.0104	0.0874	0.586	1.2365	0.0073	0	0.1252	0.1499	0.0429	0.0085	0	0.0456	0.0879	0.0176	0.0031	0.0058	0.0247	0											4.9828	None	4.093323	1.438	0.013690036	1.450281652	0.043644293	0.312600699	1.339047508	0.760829726	0.68626721	1.340073427	0.149682035	0.667317988	0.049691459	0.010445559	0.464021888	3.746183736	4.080019237	0.1579001	0	0.806425068	0.149862273	0.384183887	0.008536713	0	1.13987165	0.800821685	0.017593793	0.004163323	0.005782843	0.02467865	0	0	0	0	0	0	0	0	0	0	0	20.0516
H3924_025_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	125.9591402	1.174203903	736.1112308	8.427166411	198.8072057	10.77433399	10.2368959	234.3966742	254.4263595	30.53188132	840.937367	48.7673005	0.32229567	780.8657183	4493.218154	3036.060281	118.5952596	0	531.3920431	5.528580198	2.830585908	0.600347203	0	861.65	730.7332503	3.549946666	1.002569516	1.276245016	3.082948583	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	2.103437842	0	0.631212878	1.642008501	1.560102934	0.744209441	1.902377693	0	1.601985684	0.07741809	0	0.991699462	2.853193528	3.855796557	0.15061598	0	0.708611289	0	0.431381292	0	0	1.0942955	0.928031228	0	0.001273263	0	0	0	0	0	0	0	0	0	0	0	0	0	21.2777	None	6.6458	0	0	2.103437842	0	0.631212878	1.642008501	1.560102934	0.744209441	1.902377693	0	1.601985684	0.07741809	0	0.991699462	2.853193528	3.855796557	0.15061598	0	0.708611289	0	0.431381292	0	0	1.0942955	0.928031228	0	0.001273263	0	0	0	0	0	0	0	0	0	0	0	0	0	21.2777		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.1928	0.0137	0.1541	0.0487	0.1094	0.0624	0.0593	0.5401	0.2636	0.1764	0.2687	0.0284	0.0019	0.1106	0.5291	1.6767	0.0073	0	0.0863	0.0319	0.0542	0.0035	0	0.0456	0.1144	0.0205	0.004	0.0074	0.0178	0											5.6286	None	4.623899075	1.1928	0.013690036	2.257565581	0.048700151	0.740646194	1.704372914	1.619356528	1.284298786	2.165944291	0.176442135	1.870680201	0.105777214	0.00186253	1.102316064	3.382305773	5.532515678	0.1579001	0	0.79489637	0.031949374	0.485541833	0.003469375	0	1.13987165	1.042426812	0.020514955	0.005226677	0.007375353	0.017816198	0	0	0	0	0	0	0	0	0	0	0	26.9063
H3924_026_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	125.9591402	1.174203903	736.1112308	8.427166411	198.8072057	10.77433399	10.2368959	234.3966742	254.4263595	30.53188132	840.937367	48.7673005	0.32229567	780.8657183	4493.218154	3036.060281	118.5952596	0	531.3920431	5.528580198	2.830585908	0.600347203	0	861.65	730.7332503	3.549946666	1.002569516	1.276245016	3.082948583	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	2.103437842	0	0.631212878	1.642008501	1.560102934	0.744209441	1.902377693	0	1.601985684	0.07741809	0	0.991699462	2.853193528	3.855796557	0.15061598	0	0.708611289	0	0.431381292	0	0	1.0942955	0.928031228	0	0.001273263	0	0	0	0	0	0	0	0	0	0	0	0	0	21.2777	None	6.6458	0	0	2.103437842	0	0.631212878	1.642008501	1.560102934	0.744209441	1.902377693	0	1.601985684	0.07741809	0	0.991699462	2.853193528	3.855796557	0.15061598	0	0.708611289	0	0.431381292	0	0	1.0942955	0.928031228	0	0.001273263	0	0	0	0	0	0	0	0	0	0	0	0	0	21.2777		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.1928	0.0137	0.1541	0.0487	0.1094	0.0624	0.0593	0.5401	0.2636	0.1764	0.2687	0.0284	0.0019	0.1106	0.5291	1.6767	0.0073	0	0.0863	0.0319	0.0542	0.0035	0	0.0456	0.1144	0.0205	0.004	0.0074	0.0178	0											5.6286	None	4.623899075	1.1928	0.013690036	2.257565581	0.048700151	0.740646194	1.704372914	1.619356528	1.284298786	2.165944291	0.176442135	1.870680201	0.105777214	0.00186253	1.102316064	3.382305773	5.532515678	0.1579001	0	0.79489637	0.031949374	0.485541833	0.003469375	0	1.13987165	1.042426812	0.020514955	0.005226677	0.007375353	0.017816198	0	0	0	0	0	0	0	0	0	0	0	26.9063
H3924_027_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	125.9591402	1.174203903	736.1112308	8.427166411	198.8072057	10.77433399	10.2368959	234.3966742	254.4263595	30.53188132	840.937367	48.7673005	0.32229567	780.8657183	4493.218154	3036.060281	118.5952596	0	531.3920431	5.528580198	2.830585908	0.600347203	0	861.65	730.7332503	3.549946666	1.002569516	1.276245016	3.082948583	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	2.103437842	0	0.631212878	1.642008501	1.560102934	0.744209441	1.902377693	0	1.601985684	0.07741809	0	0.991699462	2.853193528	3.855796557	0.15061598	0	0.708611289	0	0.431381292	0	0	1.0942955	0.928031228	0	0.001273263	0	0	0	0	0	0	0	0	0	0	0	0	0	21.2777	None	6.6458	0	0	2.103437842	0	0.631212878	1.642008501	1.560102934	0.744209441	1.902377693	0	1.601985684	0.07741809	0	0.991699462	2.853193528	3.855796557	0.15061598	0	0.708611289	0	0.431381292	0	0	1.0942955	0.928031228	0	0.001273263	0	0	0	0	0	0	0	0	0	0	0	0	0	21.2777		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.1928	0.0137	0.1541	0.0487	0.1094	0.0624	0.0593	0.5401	0.2636	0.1764	0.2687	0.0284	0.0019	0.1106	0.5291	1.6767	0.0073	0	0.0863	0.0319	0.0542	0.0035	0	0.0456	0.1144	0.0205	0.004	0.0074	0.0178	0											5.6286	None	4.623899075	1.1928	0.013690036	2.257565581	0.048700151	0.740646194	1.704372914	1.619356528	1.284298786	2.165944291	0.176442135	1.870680201	0.105777214	0.00186253	1.102316064	3.382305773	5.532515678	0.1579001	0	0.79489637	0.031949374	0.485541833	0.003469375	0	1.13987165	1.042426812	0.020514955	0.005226677	0.007375353	0.017816198	0	0	0	0	0	0	0	0	0	0	0	26.9063
H3924_029_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	145.143471	1.174203903	449.8497257	8.588709262	136.9764519	9.727803483	6.570852155	210.4320606	133.5130063	66.4237491	706.4113559	11.79632317	0	631.1456091	3283.91257	3087.726582	118.5952596	0	619.7591782	11.50151507	2.856920128	0.86419549	0	865.1530313	1009.719433	3.579787673	1.433172656	1.077568682	3.529877203	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	1.285445591	0	0.434900235	1.482517251	1.001397868	0.668121792	0.998293437	0	1.345713633	0.018726663	0	0.801554924	2.085284482	3.921412759	0.15061598	0	0.826448864	0	0.435394627	0	0	1.09874435	1.28234368	0	0.001820129	0	0	0	0	0	0	0	0	0	0	0	0	0	17.8387	None	5.5717	0	0	1.285445591	0	0.434900235	1.482517251	1.001397868	0.668121792	0.998293437	0	1.345713633	0.018726663	0	0.801554924	2.085284482	3.921412759	0.15061598	0	0.826448864	0	0.435394627	0	0	1.09874435	1.28234368	0	0.001820129	0	0	0	0	0	0	0	0	0	0	0	0	0	17.8387		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.3745	0.0137	0.0984	0.0496	0.0526	0.0563	0.038	0.4849	0.2859	0.3839	0.2715	0.0095	0	0.1177	0.3867	1.7053	0.0073	0	0.1525	0.0665	0.0547	0.005	0	0.0457	0.1581	0.0207	0.0057	0.0062	0.0204	0											5.8712	None	4.823112321	1.3745	0.013690036	1.383840241	0.049633699	0.487473331	1.538824096	1.039431527	1.152992638	1.284192663	0.38385935	1.617226325	0.028235016	0	0.919256119	2.471991357	5.626665528	0.1579001	0	0.97898446	0.06646665	0.490059048	0.00499414	0	1.144457173	1.440414281	0.020687405	0.007471533	0.006227213	0.020398975	0	0	0	0	0	0	0	0	0	0	0	23.7099
H3924_030_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	145.143471	1.174203903	449.8497257	8.588709262	136.9764519	9.727803483	6.570852155	210.4320606	133.5130063	66.4237491	706.4113559	11.79632317	0	631.1456091	3283.91257	3087.726582	118.5952596	0	619.7591782	11.50151507	2.856920128	0.86419549	0	865.1530313	1009.719433	3.579787673	1.433172656	1.077568682	3.529877203	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	1.285445591	0	0.434900235	1.482517251	1.001397868	0.668121792	0.998293437	0	1.345713633	0.018726663	0	0.801554924	2.085284482	3.921412759	0.15061598	0	0.826448864	0	0.435394627	0	0	1.09874435	1.28234368	0	0.001820129	0	0	0	0	0	0	0	0	0	0	0	0	0	17.8387	None	5.5717	0	0	1.285445591	0	0.434900235	1.482517251	1.001397868	0.668121792	0.998293437	0	1.345713633	0.018726663	0	0.801554924	2.085284482	3.921412759	0.15061598	0	0.826448864	0	0.435394627	0	0	1.09874435	1.28234368	0	0.001820129	0	0	0	0	0	0	0	0	0	0	0	0	0	17.8387		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.3745	0.0137	0.0984	0.0496	0.0526	0.0563	0.038	0.4849	0.2859	0.3839	0.2715	0.0095	0	0.1177	0.3867	1.7053	0.0073	0	0.1525	0.0665	0.0547	0.005	0	0.0457	0.1581	0.0207	0.0057	0.0062	0.0204	0											5.8712	None	4.823112321	1.3745	0.013690036	1.383840241	0.049633699	0.487473331	1.538824096	1.039431527	1.152992638	1.284192663	0.38385935	1.617226325	0.028235016	0	0.919256119	2.471991357	5.626665528	0.1579001	0	0.97898446	0.06646665	0.490059048	0.00499414	0	1.144457173	1.440414281	0.020687405	0.007471533	0.006227213	0.020398975	0	0	0	0	0	0	0	0	0	0	0	23.7099
H3924_031_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	145.143471	1.174203903	449.8497257	8.588709262	136.9764519	9.727803483	6.570852155	210.4320606	133.5130063	66.4237491	706.4113559	11.79632317	0	631.1456091	3283.91257	3087.726582	118.5952596	0	619.7591782	11.50151507	2.856920128	0.86419549	0	865.1530313	1009.719433	3.579787673	1.433172656	1.077568682	3.529877203	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	1.285445591	0	0.434900235	1.482517251	1.001397868	0.668121792	0.998293437	0	1.345713633	0.018726663	0	0.801554924	2.085284482	3.921412759	0.15061598	0	0.826448864	0	0.435394627	0	0	1.09874435	1.28234368	0	0.001820129	0	0	0	0	0	0	0	0	0	0	0	0	0	17.8387	None	5.5717	0	0	1.285445591	0	0.434900235	1.482517251	1.001397868	0.668121792	0.998293437	0	1.345713633	0.018726663	0	0.801554924	2.085284482	3.921412759	0.15061598	0	0.826448864	0	0.435394627	0	0	1.09874435	1.28234368	0	0.001820129	0	0	0	0	0	0	0	0	0	0	0	0	0	17.8387		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.3745	0.0137	0.0984	0.0496	0.0526	0.0563	0.038	0.4849	0.2859	0.3839	0.2715	0.0095	0	0.1177	0.3867	1.7053	0.0073	0	0.1525	0.0665	0.0547	0.005	0	0.0457	0.1581	0.0207	0.0057	0.0062	0.0204	0											5.8712	None	4.823112321	1.3745	0.013690036	1.383840241	0.049633699	0.487473331	1.538824096	1.039431527	1.152992638	1.284192663	0.38385935	1.617226325	0.028235016	0	0.919256119	2.471991357	5.626665528	0.1579001	0	0.97898446	0.06646665	0.490059048	0.00499414	0	1.144457173	1.440414281	0.020687405	0.007471533	0.006227213	0.020398975	0	0	0	0	0	0	0	0	0	0	0	23.7099
H3924_033_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	131.5895448	1.174203903	908.1843508	9.646598131	90.6727676	9.000048559	5.455324651	371.5916758	264.8357136	54.30729452	1197.586404	17.22682616	0.378670551	703.0719729	4234.221247	1751.36805	118.5952596	0	622.6808362	4.405366744	2.804454797	0.922266209	0	863.7192389	721.2032201	3.386092891	0.922387044	1.447862707	3.405883291	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	2.595136782	0	0.287886037	1.3716074	0.831391477	1.179803571	1.980209735	0	2.2814021	0.027347587	0	0.892901406	2.688730492	2.224237423	0.15061598	0	0.830344895	0	0.427398911	0	0	1.096923433	0.91592809	0	0.001171432	0	0	0	0	0	0	0	0	0	0	0	0	0	19.783	None	6.179	0	0	2.595136782	0	0.287886037	1.3716074	0.831391477	1.179803571	1.980209735	0	2.2814021	0.027347587	0	0.892901406	2.688730492	2.224237423	0.15061598	0	0.830344895	0	0.427398911	0	0	1.096923433	0.91592809	0	0.001171432	0	0	0	0	0	0	0	0	0	0	0	0	0	19.783		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.2462	0.0137	0.1957	0.0557	0.0694	0.0521	0.0316	0.8562	0.2702	0.3138	0.2774	0.0092	0.0022	0.1346	0.4986	0.9672	0.0073	0	0.0939	0.0255	0.0537	0.0053	0	0.0457	0.1129	0.0196	0.0036	0.0084	0.0197	0											5.3893	None	4.427239566	1.2462	0.013690036	2.790805368	0.055747183	0.357265236	1.423701827	0.862968196	2.036013265	2.250405944	0.313838997	2.558788665	0.036578122	0.002188317	1.027452791	3.187343787	3.191462058	0.1579001	0	0.924272123	0.025458383	0.481059458	0.005329728	0	1.142608026	1.028831756	0.019568053	0.004808664	0.008367122	0.01968242	0	0	0	0	0	0	0	0	0	0	0	25.1723
H3924_034_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	131.5895448	1.174203903	908.1843508	9.646598131	90.6727676	9.000048559	5.455324651	371.5916758	264.8357136	54.30729452	1197.586404	17.22682616	0.378670551	703.0719729	4234.221247	1751.36805	118.5952596	0	622.6808362	4.405366744	2.804454797	0.922266209	0	863.7192389	721.2032201	3.386092891	0.922387044	1.447862707	3.405883291	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	2.595136782	0	0.287886037	1.3716074	0.831391477	1.179803571	1.980209735	0	2.2814021	0.027347587	0	0.892901406	2.688730492	2.224237423	0.15061598	0	0.830344895	0	0.427398911	0	0	1.096923433	0.91592809	0	0.001171432	0	0	0	0	0	0	0	0	0	0	0	0	0	19.783	None	6.179	0	0	2.595136782	0	0.287886037	1.3716074	0.831391477	1.179803571	1.980209735	0	2.2814021	0.027347587	0	0.892901406	2.688730492	2.224237423	0.15061598	0	0.830344895	0	0.427398911	0	0	1.096923433	0.91592809	0	0.001171432	0	0	0	0	0	0	0	0	0	0	0	0	0	19.783		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.2462	0.0137	0.1957	0.0557	0.0694	0.0521	0.0316	0.8562	0.2702	0.3138	0.2774	0.0092	0.0022	0.1346	0.4986	0.9672	0.0073	0	0.0939	0.0255	0.0537	0.0053	0	0.0457	0.1129	0.0196	0.0036	0.0084	0.0197	0											5.3893	None	4.427239566	1.2462	0.013690036	2.790805368	0.055747183	0.357265236	1.423701827	0.862968196	2.036013265	2.250405944	0.313838997	2.558788665	0.036578122	0.002188317	1.027452791	3.187343787	3.191462058	0.1579001	0	0.924272123	0.025458383	0.481059458	0.005329728	0	1.142608026	1.028831756	0.019568053	0.004808664	0.008367122	0.01968242	0	0	0	0	0	0	0	0	0	0	0	25.1723
H3924_035_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	3000	131.5895448	1.174203903	908.1843508	9.646598131	90.6727676	9.000048559	5.455324651	371.5916758	264.8357136	54.30729452	1197.586404	17.22682616	0.378670551	703.0719729	4234.221247	1751.36805	118.5952596	0	622.6808362	4.405366744	2.804454797	0.922266209	0	863.7192389	721.2032201	3.386092891	0.922387044	1.447862707	3.405883291	0											CIF (PBP 1a)	CIF (PBP 1b)	$45 Copay Days 14-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	20% Coinsurance (PBP 11a)	"20% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$75 ASC, $150 OP Hospital (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $20 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$20 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"20% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0	0	45	0	50	0.2	0.2	50	117.75	0	30	25	0	20	10	20	20	20	21	0	0.2	0	0	20	20	0	20	0	0	0											0	0	34.29	0	38.1	0.1524	0.1524	38.1	89.7255	0	22.86	19.05	0	15.24	7.62	15.24	15.24	15.24	16.002	0	0.1524	0	0	15.24	15.24	0	15.24	0	0	0											0	0	2.595136782	0	0.287886037	1.3716074	0.831391477	1.179803571	1.980209735	0	2.2814021	0.027347587	0	0.892901406	2.688730492	2.224237423	0.15061598	0	0.830344895	0	0.427398911	0	0	1.096923433	0.91592809	0	0.001171432	0	0	0	0	0	0	0	0	0	0	0	0	0	19.783	None	6.179	0	0	2.595136782	0	0.287886037	1.3716074	0.831391477	1.179803571	1.980209735	0	2.2814021	0.027347587	0	0.892901406	2.688730492	2.224237423	0.15061598	0	0.830344895	0	0.427398911	0	0	1.096923433	0.91592809	0	0.001171432	0	0	0	0	0	0	0	0	0	0	0	0	0	19.783		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$20 Copay	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	$30 Copay	20% Coinsurance	$30 Copay	20% Coinsurance	20% Coinsurance	20% Coinsurance											1.2462	0.0137	0.1957	0.0557	0.0694	0.0521	0.0316	0.8562	0.2702	0.3138	0.2774	0.0092	0.0022	0.1346	0.4986	0.9672	0.0073	0	0.0939	0.0255	0.0537	0.0053	0	0.0457	0.1129	0.0196	0.0036	0.0084	0.0197	0											5.3893	None	4.427239566	1.2462	0.013690036	2.790805368	0.055747183	0.357265236	1.423701827	0.862968196	2.036013265	2.250405944	0.313838997	2.558788665	0.036578122	0.002188317	1.027452791	3.187343787	3.191462058	0.1579001	0	0.924272123	0.025458383	0.481059458	0.005329728	0	1.142608026	1.028831756	0.019568053	0.004808664	0.008367122	0.01968242	0	0	0	0	0	0	0	0	0	0	0	25.1723
H3924_036_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	T	V	V	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	0	0											0	3000	0	0	711.260909	0	102.8209335	13.67455585	0.718562385	228.0770982	326.686671	0	533.4418846	0	0	467.4367928	4271.417982	4967.615004	125.3669297	586.6342461	1255.52997	0	24.48543214	0	0	0	341.9560821	0	73.27630331	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 14a												0	0	45	0	50	0.2	0.2	46.43784171	117.75	0	28.10735706	0	0	20	10	19.62316217	20	20	22.39138219	0	0.2	0	0	0	20	0	20	0	0	0											0	0	34.550599	0	38.38955445	0.153558218	0.153558218	35.65456105	90.40740072	0	21.58057828	0	0	15.35582178	7.677910889	15.06648905	15.35582178	15.35582178	17.19190371	0	0.153558218	0	0	0	15.35582178	0	15.35582178	0	0	0											0	0	2.047874205	0	0.328937485	2.099840425	0.110341159	0.677665735	2.461241065	0	0.959332029	0	0	0.59815634	2.732963887	6.23704309	0.160426019	0.750687578	1.798745863	0	3.759939321	0	0	0	0.437584721	0	0.093768155	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2545	0	7.6379	0	0	2.047874205	0	0.328937485	2.099840425	0.110341159	0.677665735	2.461241065	0	0.959332029	0	0	0.59815634	2.732963887	6.23704309	0.160426019	0.750687578	1.798745863	0	3.759939321	0	0	0	0.437584721	0	0.093768155	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2545		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 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 14a												1.4877	0.0178	0.2338	0.1074	0.0333	0.0806	0.0042	0.0255	0.1996	0.0416	0.0739	0	0.0636	0.0931	0.2238	0.4458	0.0083	0.0327	0.1841	0.4864	0.1443	0.1394	0	0.0679	0.0247	0.0193	0.0053	0.0065	0.02	0											4.2706	0	3.432632106	1.4877	0.017803958	2.281694683	0.10739382	0.36222967	2.180423205	0.114575575	0.703180568	2.660833798	0.04162697	1.033206734	0	0.063553697	0.691221675	2.956758692	6.682840947	0.168761928	0.783397916	1.982853179	0.486426128	3.904229505	0.139417969	0	0.067948924	0.462297618	0.019269454	0.099063775	0.006485622	0.02	0	0	0	0	0	0	0	0	0	0	0	29.5252
H3924_037_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	T	V	V	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	0	0											0	3000	0	0	711.260909	0	102.8209335	13.67455585	0.718562385	228.0770982	326.686671	0	533.4418846	0	0	467.4367928	4271.417982	4967.615004	125.3669297	586.6342461	1255.52997	0	24.48543214	0	0	0	341.9560821	0	73.27630331	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 14a												0	0	45	0	50	0.2	0.2	46.43784171	117.75	0	28.10735706	0	0	20	10	19.62316217	20	20	22.39138219	0	0.2	0	0	0	20	0	20	0	0	0											0	0	34.550599	0	38.38955445	0.153558218	0.153558218	35.65456105	90.40740072	0	21.58057828	0	0	15.35582178	7.677910889	15.06648905	15.35582178	15.35582178	17.19190371	0	0.153558218	0	0	0	15.35582178	0	15.35582178	0	0	0											0	0	2.047874205	0	0.328937485	2.099840425	0.110341159	0.677665735	2.461241065	0	0.959332029	0	0	0.59815634	2.732963887	6.23704309	0.160426019	0.750687578	1.798745863	0	3.759939321	0	0	0	0.437584721	0	0.093768155	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2545	0	7.6379	0	0	2.047874205	0	0.328937485	2.099840425	0.110341159	0.677665735	2.461241065	0	0.959332029	0	0	0.59815634	2.732963887	6.23704309	0.160426019	0.750687578	1.798745863	0	3.759939321	0	0	0	0.437584721	0	0.093768155	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2545		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 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 14a												1.4877	0.0178	0.2338	0.1074	0.0333	0.0806	0.0042	0.0255	0.1996	0.0416	0.0739	0	0.0636	0.0931	0.2238	0.4458	0.0083	0.0327	0.1841	0.4864	0.1443	0.1394	0	0.0679	0.0247	0.0193	0.0053	0.0065	0.02	0											4.2706	0	3.432632106	1.4877	0.017803958	2.281694683	0.10739382	0.36222967	2.180423205	0.114575575	0.703180568	2.660833798	0.04162697	1.033206734	0	0.063553697	0.691221675	2.956758692	6.682840947	0.168761928	0.783397916	1.982853179	0.486426128	3.904229505	0.139417969	0	0.067948924	0.462297618	0.019269454	0.099063775	0.006485622	0.02	0	0	0	0	0	0	0	0	0	0	0	29.5252
H3924_038_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	T	V	V	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	0	0											0	3000	0	0	711.260909	0	102.8209335	13.67455585	0.718562385	228.0770982	326.686671	0	533.4418846	0	0	467.4367928	4271.417982	4967.615004	125.3669297	586.6342461	1255.52997	0	24.48543214	0	0	0	341.9560821	0	73.27630331	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 14a												0	0	45	0	50	0.2	0.2	46.43784171	117.75	0	28.10735706	0	0	20	10	19.62316217	20	20	22.39138219	0	0.2	0	0	0	20	0	20	0	0	0											0	0	34.550599	0	38.38955445	0.153558218	0.153558218	35.65456105	90.40740072	0	21.58057828	0	0	15.35582178	7.677910889	15.06648905	15.35582178	15.35582178	17.19190371	0	0.153558218	0	0	0	15.35582178	0	15.35582178	0	0	0											0	0	2.047874205	0	0.328937485	2.099840425	0.110341159	0.677665735	2.461241065	0	0.959332029	0	0	0.59815634	2.732963887	6.23704309	0.160426019	0.750687578	1.798745863	0	3.759939321	0	0	0	0.437584721	0	0.093768155	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2545	0	7.6379	0	0	2.047874205	0	0.328937485	2.099840425	0.110341159	0.677665735	2.461241065	0	0.959332029	0	0	0.59815634	2.732963887	6.23704309	0.160426019	0.750687578	1.798745863	0	3.759939321	0	0	0	0.437584721	0	0.093768155	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2545		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 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 14a												1.4877	0.0178	0.2338	0.1074	0.0333	0.0806	0.0042	0.0255	0.1996	0.0416	0.0739	0	0.0636	0.0931	0.2238	0.4458	0.0083	0.0327	0.1841	0.4864	0.1443	0.1394	0	0.0679	0.0247	0.0193	0.0053	0.0065	0.02	0											4.2706	0	3.432632106	1.4877	0.017803958	2.281694683	0.10739382	0.36222967	2.180423205	0.114575575	0.703180568	2.660833798	0.04162697	1.033206734	0	0.063553697	0.691221675	2.956758692	6.682840947	0.168761928	0.783397916	1.982853179	0.486426128	3.904229505	0.139417969	0	0.067948924	0.462297618	0.019269454	0.099063775	0.006485622	0.02	0	0	0	0	0	0	0	0	0	0	0	29.5252
H3924_039_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	T	V	V	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	0	0											0	3000	0	0	907.9035627	0	179.9583704	15.61562887	0.82056073	231.0759344	343.1163043	0	861.0035121	0	0	307.6396354	4659.943165	5316.80135	124.7392341	583.6970461	1039.989445	0	24.78166013	0	0	0	373.0601674	0	79.94146445	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 14a												0	0	45	0	50	0.2	0.2	46.16426387	117.75	0	28.10735706	0	0	20	10	19.61588565	20	20	22.39138219	0	0.2	0	0	0	20	0	20	0	0	0											0	0	33.57373316	0	37.30414795	0.149216592	0.149216592	34.44237059	87.85126843	0	20.97042013	0	0	14.92165918	7.460829591	14.63507801	14.92165918	14.92165918	16.70582868	0	0.149216592	0	0	0	14.92165918	0	14.92165918	0	0	0											0	0	2.540142662	0	0.559432806	2.330110919	0.122441276	0.663233581	2.511933546	0	1.504633782	0	0	0.382541149	2.897253488	6.484316876	0.155109695	0.725810699	1.447823792	0	3.697834864	0	0	0	0.463889723	0	0.099404941	0	0	0	0	0	0	0	0	0	0	0	0	0	26.5859	0	9.0481	0	0	2.540142662	0	0.559432806	2.330110919	0.122441276	0.663233581	2.511933546	0	1.504633782	0	0	0.382541149	2.897253488	6.484316876	0.155109695	0.725810699	1.447823792	0	3.697834864	0	0	0	0.463889723	0	0.099404941	0	0	0	0	0	0	0	0	0	0	0	0	0	26.5859		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 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 14a												1.5193	0.0182	0.2951	0.1575	0.0345	0.0836	0.0044	0.0247	0.2211	0.056	0.1258	0	0.0358	0.0873	0.2358	0.4569	0.008	0.0314	0.1648	0.4624	0.1327	0.134	0	0.0679	0.026	0.0186	0.0056	0.0063	0.02	0											4.4337	0	3.846313088	1.5193	0.018182889	2.83528411	0.157470022	0.593967607	2.413701416	0.126833739	0.687977119	2.733050243	0.056006985	1.63040476	0	0.035826086	0.469799112	3.133043493	6.941184958	0.163106116	0.757188878	1.612652543	0.462392697	3.830491148	0.133952635	0	0.067948924	0.489929426	0.018611151	0.104984877	0.006264053	0.02	0	0	0	0	0	0	0	0	0	0	0	31.0196
H3924_040_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	T	V	V	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	0	0											0	3000	0	0	907.9035627	0	179.9583704	15.61562887	0.82056073	231.0759344	343.1163043	0	861.0035121	0	0	307.6396354	4659.943165	5316.80135	124.7392341	583.6970461	1039.989445	0	24.78166013	0	0	0	373.0601674	0	79.94146445	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 14a												0	0	45	0	50	0.2	0.2	46.16426387	117.75	0	28.10735706	0	0	20	10	19.61588565	20	20	22.39138219	0	0.2	0	0	0	20	0	20	0	0	0											0	0	33.57373316	0	37.30414795	0.149216592	0.149216592	34.44237059	87.85126843	0	20.97042013	0	0	14.92165918	7.460829591	14.63507801	14.92165918	14.92165918	16.70582868	0	0.149216592	0	0	0	14.92165918	0	14.92165918	0	0	0											0	0	2.540142662	0	0.559432806	2.330110919	0.122441276	0.663233581	2.511933546	0	1.504633782	0	0	0.382541149	2.897253488	6.484316876	0.155109695	0.725810699	1.447823792	0	3.697834864	0	0	0	0.463889723	0	0.099404941	0	0	0	0	0	0	0	0	0	0	0	0	0	26.5859	0	9.0481	0	0	2.540142662	0	0.559432806	2.330110919	0.122441276	0.663233581	2.511933546	0	1.504633782	0	0	0.382541149	2.897253488	6.484316876	0.155109695	0.725810699	1.447823792	0	3.697834864	0	0	0	0.463889723	0	0.099404941	0	0	0	0	0	0	0	0	0	0	0	0	0	26.5859		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 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 14a												1.5193	0.0182	0.2951	0.1575	0.0345	0.0836	0.0044	0.0247	0.2211	0.056	0.1258	0	0.0358	0.0873	0.2358	0.4569	0.008	0.0314	0.1648	0.4624	0.1327	0.134	0	0.0679	0.026	0.0186	0.0056	0.0063	0.02	0											4.4337	0	3.846313088	1.5193	0.018182889	2.83528411	0.157470022	0.593967607	2.413701416	0.126833739	0.687977119	2.733050243	0.056006985	1.63040476	0	0.035826086	0.469799112	3.133043493	6.941184958	0.163106116	0.757188878	1.612652543	0.462392697	3.830491148	0.133952635	0	0.067948924	0.489929426	0.018611151	0.104984877	0.006264053	0.02	0	0	0	0	0	0	0	0	0	0	0	31.0196
H3924_041_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	T	V	V	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	0	0											0	3000	0	0	907.9035627	0	179.9583704	15.61562887	0.82056073	231.0759344	343.1163043	0	861.0035121	0	0	307.6396354	4659.943165	5316.80135	124.7392341	583.6970461	1039.989445	0	24.78166013	0	0	0	373.0601674	0	79.94146445	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 14a												0	0	45	0	50	0.2	0.2	46.16426387	117.75	0	28.10735706	0	0	20	10	19.61588565	20	20	22.39138219	0	0.2	0	0	0	20	0	20	0	0	0											0	0	33.57373316	0	37.30414795	0.149216592	0.149216592	34.44237059	87.85126843	0	20.97042013	0	0	14.92165918	7.460829591	14.63507801	14.92165918	14.92165918	16.70582868	0	0.149216592	0	0	0	14.92165918	0	14.92165918	0	0	0											0	0	2.540142662	0	0.559432806	2.330110919	0.122441276	0.663233581	2.511933546	0	1.504633782	0	0	0.382541149	2.897253488	6.484316876	0.155109695	0.725810699	1.447823792	0	3.697834864	0	0	0	0.463889723	0	0.099404941	0	0	0	0	0	0	0	0	0	0	0	0	0	26.5859	0	9.0481	0	0	2.540142662	0	0.559432806	2.330110919	0.122441276	0.663233581	2.511933546	0	1.504633782	0	0	0.382541149	2.897253488	6.484316876	0.155109695	0.725810699	1.447823792	0	3.697834864	0	0	0	0.463889723	0	0.099404941	0	0	0	0	0	0	0	0	0	0	0	0	0	26.5859		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 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 14a												1.5193	0.0182	0.2951	0.1575	0.0345	0.0836	0.0044	0.0247	0.2211	0.056	0.1258	0	0.0358	0.0873	0.2358	0.4569	0.008	0.0314	0.1648	0.4624	0.1327	0.134	0	0.0679	0.026	0.0186	0.0056	0.0063	0.02	0											4.4337	0	3.846313088	1.5193	0.018182889	2.83528411	0.157470022	0.593967607	2.413701416	0.126833739	0.687977119	2.733050243	0.056006985	1.63040476	0	0.035826086	0.469799112	3.133043493	6.941184958	0.163106116	0.757188878	1.612652543	0.462392697	3.830491148	0.133952635	0	0.067948924	0.489929426	0.018611151	0.104984877	0.006264053	0.02	0	0	0	0	0	0	0	0	0	0	0	31.0196
H3924_042_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	T	V	V	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	0	0											0	3000	0	0	678.2856588	0	184.8088523	15.66052352	0.822919828	294.3408141	294.2089158	0	1006.73946	0	0	353.1412099	3481.897379	3964.621928	92.25816978	431.7071655	847.3066555	0	19.87350658	0	0	0	278.7495841	0	59.73205373	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 14a												0	0	45	0	50	0.2	0.2	47.74997003	117.75	0	28.10735706	0	0	20	10	19.61510299	20	20	22.39138219	0	0.2	0	0	0	20	0	20	0	0	0											0	0	35.57790729	0	39.5310081	0.158124032	0.158124032	37.75208904	93.09552407	0	22.22224319	0	0	15.81240324	7.90620162	15.5080959	15.81240324	15.81240324	17.70307821	0	0.158124032	0	0	0	15.81240324	0	15.81240324	0	0	0											0	0	2.01099869	0	0.608806687	2.476305129	0.130123401	0.925998385	2.2824611	0	1.864334093	0	0	0.465334268	2.294048558	5.123644757	0.121568615	0.568860648	1.249994666	0	3.142478998	0	0	0	0.367308402	0	0.078708943	0	0	0	0	0	0	0	0	0	0	0	0	0	23.711	0	6.2794	0	0	2.01099869	0	0.608806687	2.476305129	0.130123401	0.925998385	2.2824611	0	1.864334093	0	0	0.465334268	2.294048558	5.123644757	0.121568615	0.568860648	1.249994666	0	3.142478998	0	0	0	0.367308402	0	0.078708943	0	0	0	0	0	0	0	0	0	0	0	0	0	23.711		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 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 14a												1.3429	0.0161	0.2298	0.1487	0.0415	0.1005	0.0053	0.0368	0.1854	0.0662	0.1438	0	0.0877	0.1113	0.1953	0.3714	0.0061	0.0239	0.1168	0.3607	0.1275	0.1021	0	0.0679	0.0216	0.0207	0.0046	0.007	0.02	0											3.9615	0	2.690363833	1.3429	0.016071836	2.240761545	0.148745657	0.65031842	2.576783092	0.135403257	0.962809155	2.467821924	0.066207053	2.008106171	0	0.087687298	0.576640795	2.489351967	5.495017203	0.1276597	0.592762236	1.366776394	0.360650423	3.269987472	0.102054149	0	0.067948924	0.388952889	0.020703757	0.083347048	0.006968372	0.02	0	0	0	0	0	0	0	0	0	0	0	27.6725
H3924_043_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	T	V	V	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	0	0											0	3000	0	0	678.2856588	0	184.8088523	15.66052352	0.822919828	294.3408141	294.2089158	0	1006.73946	0	0	353.1412099	3481.897379	3964.621928	92.25816978	431.7071655	847.3066555	0	19.87350658	0	0	0	278.7495841	0	59.73205373	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 14a												0	0	45	0	50	0.2	0.2	47.74997003	117.75	0	28.10735706	0	0	20	10	19.61510299	20	20	22.39138219	0	0.2	0	0	0	20	0	20	0	0	0											0	0	35.57790729	0	39.5310081	0.158124032	0.158124032	37.75208904	93.09552407	0	22.22224319	0	0	15.81240324	7.90620162	15.5080959	15.81240324	15.81240324	17.70307821	0	0.158124032	0	0	0	15.81240324	0	15.81240324	0	0	0											0	0	2.01099869	0	0.608806687	2.476305129	0.130123401	0.925998385	2.2824611	0	1.864334093	0	0	0.465334268	2.294048558	5.123644757	0.121568615	0.568860648	1.249994666	0	3.142478998	0	0	0	0.367308402	0	0.078708943	0	0	0	0	0	0	0	0	0	0	0	0	0	23.711	0	6.2794	0	0	2.01099869	0	0.608806687	2.476305129	0.130123401	0.925998385	2.2824611	0	1.864334093	0	0	0.465334268	2.294048558	5.123644757	0.121568615	0.568860648	1.249994666	0	3.142478998	0	0	0	0.367308402	0	0.078708943	0	0	0	0	0	0	0	0	0	0	0	0	0	23.711		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 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 14a												1.3429	0.0161	0.2298	0.1487	0.0415	0.1005	0.0053	0.0368	0.1854	0.0662	0.1438	0	0.0877	0.1113	0.1953	0.3714	0.0061	0.0239	0.1168	0.3607	0.1275	0.1021	0	0.0679	0.0216	0.0207	0.0046	0.007	0.02	0											3.9615	0	2.690363833	1.3429	0.016071836	2.240761545	0.148745657	0.65031842	2.576783092	0.135403257	0.962809155	2.467821924	0.066207053	2.008106171	0	0.087687298	0.576640795	2.489351967	5.495017203	0.1276597	0.592762236	1.366776394	0.360650423	3.269987472	0.102054149	0	0.067948924	0.388952889	0.020703757	0.083347048	0.006968372	0.02	0	0	0	0	0	0	0	0	0	0	0	27.6725
H3924_044_0	2009	3																					1500											D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	T	V	V	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	0	0											0	3000	0	0	678.2856588	0	184.8088523	15.66052352	0.822919828	294.3408141	294.2089158	0	1006.73946	0	0	353.1412099	3481.897379	3964.621928	92.25816978	431.7071655	847.3066555	0	19.87350658	0	0	0	278.7495841	0	59.73205373	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 14a												0	0	45	0	50	0.2	0.2	47.74997003	117.75	0	28.10735706	0	0	20	10	19.61510299	20	20	22.39138219	0	0.2	0	0	0	20	0	20	0	0	0											0	0	35.57790729	0	39.5310081	0.158124032	0.158124032	37.75208904	93.09552407	0	22.22224319	0	0	15.81240324	7.90620162	15.5080959	15.81240324	15.81240324	17.70307821	0	0.158124032	0	0	0	15.81240324	0	15.81240324	0	0	0											0	0	2.01099869	0	0.608806687	2.476305129	0.130123401	0.925998385	2.2824611	0	1.864334093	0	0	0.465334268	2.294048558	5.123644757	0.121568615	0.568860648	1.249994666	0	3.142478998	0	0	0	0.367308402	0	0.078708943	0	0	0	0	0	0	0	0	0	0	0	0	0	23.711	0	6.2794	0	0	2.01099869	0	0.608806687	2.476305129	0.130123401	0.925998385	2.2824611	0	1.864334093	0	0	0.465334268	2.294048558	5.123644757	0.121568615	0.568860648	1.249994666	0	3.142478998	0	0	0	0.367308402	0	0.078708943	0	0	0	0	0	0	0	0	0	0	0	0	0	23.711		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 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 14a												1.3429	0.0161	0.2298	0.1487	0.0415	0.1005	0.0053	0.0368	0.1854	0.0662	0.1438	0	0.0877	0.1113	0.1953	0.3714	0.0061	0.0239	0.1168	0.3607	0.1275	0.1021	0	0.0679	0.0216	0.0207	0.0046	0.007	0.02	0											3.9615	0	2.690363833	1.3429	0.016071836	2.240761545	0.148745657	0.65031842	2.576783092	0.135403257	0.962809155	2.467821924	0.066207053	2.008106171	0	0.087687298	0.576640795	2.489351967	5.495017203	0.1276597	0.592762236	1.366776394	0.360650423	3.269987472	0.102054149	0	0.067948924	0.388952889	0.020703757	0.083347048	0.006968372	0.02	0	0	0	0	0	0	0	0	0	0	0	27.6725
H3924_801_0	2009	2																					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	N/A	232.9439373	2.368949784	35.52713788	12.56282416	13.69573105	10.25818852	8.360298436	14.91835219	46.91428765	46.34986792	42.43043309	3.38036873	0.897289796	23.87025401	37.39275158	125.5322143	1.255467723	0.000218176	21.36669744	7.145334377	9.793925317	0.983578887	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																			0.077898125	0.077898125	0.196929779	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.077898125	0.077898125	0.196929779	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											18.1459	0.184536746	6.996351396	0	3.163713874	2.369641548	1.931228939	3.446139357	10.83720045	10.70681949	9.801430043	0.780865177	0.207273943	5.514028675	8.637725615	28.99794151	0.290013044	5.04E-05	4.935707109	1.650572241	2.262396748	0.227206723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.0867	None	0	18.1459	0.184536746	6.996351396	0	3.163713874	2.369641548	1.931228939	3.446139357	10.83720045	10.70681949	9.801430043	0.780865177	0.207273943	5.514028675	8.637725615	28.99794151	0.290013044	5.04E-05	4.935707109	1.650572241	2.262396748	0.227206723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.0867	None	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																			0.955	0.0097	0.3682	0	0.1665	0.1247	0.1016	0.1814	0.5704	0.5635	0.5159	0.0411	0.0109	0.2902	0.4546	1.5262	0.0153	0	0.2598	0.0869	0.1191	0.012	0	0	0	0	0	0	0	0											6.373	N/A	0	19.1009	0.194249207	7.364580416	0	3.33022513	2.494359524	2.032872567	3.627515112	11.40757942	11.27033631	10.31729478	0.821963344	0.218183098	5.804240711	9.092342753	30.52414896	0.305276888	5.31E-05	5.195481167	1.737444464	2.381470261	0.239164971	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.4597
H3924_802_0	2009	2																					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	N/A	232.9439373	2.368949784	35.52713788	12.56282416	13.69573105	10.25818852	8.360298436	14.91835219	46.91428765	46.34986792	42.43043309	3.38036873	0.897289796	23.87025401	37.39275158	125.5322143	1.255467723	0.000218176	21.36669744	7.145334377	9.793925317	0.983578887	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																			0.077898125	0.077898125	0.196929779	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.077898125	0.077898125	0.196929779	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											18.1459	0.184536746	6.996351396	0	3.163713874	2.369641548	1.931228939	3.446139357	10.83720045	10.70681949	9.801430043	0.780865177	0.207273943	5.514028675	8.637725615	28.99794151	0.290013044	5.04E-05	4.935707109	1.650572241	2.262396748	0.227206723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.0867	None	0	18.1459	0.184536746	6.996351396	0	3.163713874	2.369641548	1.931228939	3.446139357	10.83720045	10.70681949	9.801430043	0.780865177	0.207273943	5.514028675	8.637725615	28.99794151	0.290013044	5.04E-05	4.935707109	1.650572241	2.262396748	0.227206723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.0867	None	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																			0.955	0.0097	0.3682	0	0.1665	0.1247	0.1016	0.1814	0.5704	0.5635	0.5159	0.0411	0.0109	0.2902	0.4546	1.5262	0.0153	0	0.2598	0.0869	0.1191	0.012	0	0	0	0	0	0	0	0											6.373	N/A	0	19.1009	0.194249207	7.364580416	0	3.33022513	2.494359524	2.032872567	3.627515112	11.40757942	11.27033631	10.31729478	0.821963344	0.218183098	5.804240711	9.092342753	30.52414896	0.305276888	5.31E-05	5.195481167	1.737444464	2.381470261	0.239164971	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.4597
H3931_004_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1623.018216	0	1050.791322	949.9829626	209.0743974	10.67237216	0	230.2363103	405.5853145	583.4890973	3565.168229	0	2.358240039	834.8618955	6238.357692	8756.866782	0	411.0484415	0	0	262.409811	0	0	0	721.1345776	0	65.6044277	0	0	0											$185/day 1-8	$185/day 1-8	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$30 per visit	$40 X-ray; $150 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$15 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											140.9388989	140.9388989	47.8866492	20	100	0.2	0.2	48.5	250	30	84	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											140.9388989	140.9388989	47.8866492	20	100	0.2	0.2	48.5	250	30	84	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											19.0622	0	4.193239619	1.583304938	1.742286645	2.134474431	0	0.930538421	8.449694053	1.458722743	24.9561776	0	0.004913	2.087154739	7.797947114	21.89216695	0	1.027621104	0	0	0.984036791	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.3045			19.0622	0	4.193239619	1.583304938	1.742286645	2.134474431	0	0.930538421	8.449694053	1.458722743	24.9561776	0	0.004913	2.087154739	7.797947114	21.89216695	0	1.027621104	0	0	0.984036791	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.3045																																																																																		0			19.0622	0	4.193239619	1.583304938	1.742286645	2.134474431	0	0.930538421	8.449694053	1.458722743	24.9561776	0	0.004913	2.087154739	7.797947114	21.89216695	0	1.027621104	0	0	0.984036791	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.3045
H3931_054_0	2009	4																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		2194.595305	0	1159.211832	1198.429812	247.929225	13.37206739	0	277.993396	395.5055737	600.903162	3193.317341	0	1.238556141	645.8300595	7654.129217	9357.536447	0	432.6451767	0	0	255.8959287	0	0	0	636.7677652	0	77.48062975	0	0	0											$200/day 1-10	$200/day 1-10	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$35 per visit	$35 X-ray; $125 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$10 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											163.9294809	163.9294809	47.8866492	20	100	0.2	0.2	48.5	250	35	71	35	25	35	10	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											163.9294809	163.9294809	47.8866492	20	100	0.2	0.2	48.5	250	35	71	35	25	35	10	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											29.9799	0	4.625897531	1.997383019	2.066076875	2.674413477	0	1.123556642	8.239699452	1.752634222	18.89379427	0	0.002580325	1.883671007	6.378441014	27.29281464	0	1.261881765	0	0	0.959609733	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.1324			29.9799	0	4.625897531	1.997383019	2.066076875	2.674413477	0	1.123556642	8.239699452	1.752634222	18.89379427	0	0.002580325	1.883671007	6.378441014	27.29281464	0	1.261881765	0	0	0.959609733	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.1324																																																																																		0			29.9799	0	4.625897531	1.997383019	2.066076875	2.674413477	0	1.123556642	8.239699452	1.752634222	18.89379427	0	0.002580325	1.883671007	6.378441014	27.29281464	0	1.261881765	0	0	0.959609733	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.1324
H3931_055_0	2009	4																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1583.31049	0	1025.083334	926.7412871	203.9593169	10.41126873	0	224.603496	395.6625237	569.2138263	3477.945104	0	2.300544847	814.4366984	6085.734023	8542.626881	0	400.9919932	0	0	255.9898604	0	0	0	703.4917604	0	63.99939174	0	0	0											$200/day 1-10	$200/day 1-10	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$35 per visit	$35 X-ray; $150 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$20 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											163.9294809	163.9294809	47.8866492	20	100	0.2	0.2	48.5	250	35	81	35	25	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											163.9294809	163.9294809	47.8866492	20	100	0.2	0.2	48.5	250	35	81	35	25	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											21.6293	0	4.090650501	1.544568812	1.699660974	2.082253745	0	0.907772463	8.242969243	1.660206993	23.47612945	0	0.004792802	2.37544037	10.14289004	24.91599507	0	1.16955998	0	0	0.959961977	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.9021			21.6293	0	4.090650501	1.544568812	1.699660974	2.082253745	0	0.907772463	8.242969243	1.660206993	23.47612945	0	0.004792802	2.37544037	10.14289004	24.91599507	0	1.16955998	0	0	0.959961977	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.9021																																																																																		0			21.6293	0	4.090650501	1.544568812	1.699660974	2.082253745	0	0.907772463	8.242969243	1.660206993	23.47612945	0	0.004792802	2.37544037	10.14289004	24.91599507	0	1.16955998	0	0	0.959961977	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.9021
H3931_058_0	2009	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		2220.792483	0	1173.049499	1212.735629	250.8887894	13.53169155	0	281.3118404	400.2267768	608.0762236	3231.436398	0	1.253340952	653.5394195	7745.497583	9469.238614	0	437.8097201	0	0	258.9505927	0	0	0	644.3689473	0	78.40552642	0	0	0											$150/day 1-8	$150/day 1-8	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$200 per procedure	$20 per visit	$30 X-ray; $125 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$10 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											114.2747829	114.2747829	47.8866492	20	100	0.2	0.2	48.5	200	20	68	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											114.2747829	114.2747829	47.8866492	20	100	0.2	0.2	48.5	200	20	68	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											21.1484	0	4.68111749	2.021226048	2.090739911	2.70633831	0	1.136968688	6.670446279	1.013460373	18.31147292	0	0.002088902	1.089232366	6.45458132	15.78206436	0	0.729682867	0	0	0.971064723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.8089			21.1484	0	4.68111749	2.021226048	2.090739911	2.70633831	0	1.136968688	6.670446279	1.013460373	18.31147292	0	0.002088902	1.089232366	6.45458132	15.78206436	0	0.729682867	0	0	0.971064723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.8089																																																																																		0			21.1484	0	4.68111749	2.021226048	2.090739911	2.70633831	0	1.136968688	6.670446279	1.013460373	18.31147292	0	0.002088902	1.089232366	6.45458132	15.78206436	0	0.729682867	0	0	0.971064723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.8089
H3931_064_0	2009	7																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1555.612348	0	1007.150715	910.5290458	200.3912902	10.22913591	0	220.6743239	388.7408764	559.2561045	3417.102573	0	2.260299539	800.1890928	5979.271313	8393.18374	0	393.9771132	0	0	251.511621	0	0	0	691.1850051	0	62.87979817	0	0	0											$200/day 1-10	$200/day 1-10	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$35 per visit	$35 X-ray; $150 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$20 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											163.9294809	163.9294809	47.8866492	20	100	0.2	0.2	48.5	250	35	81	35	25	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											163.9294809	163.9294809	47.8866492	20	100	0.2	0.2	48.5	250	35	81	35	25	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											21.2509	0	4.019089415	1.51754841	1.669927418	2.045827182	0	0.891892059	8.098768258	1.631163638	23.06544237	0	0.004708957	2.333884854	9.965452189	24.48011924	0	1.149099913	0	0	0.943168579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.067			21.2509	0	4.019089415	1.51754841	1.669927418	2.045827182	0	0.891892059	8.098768258	1.631163638	23.06544237	0	0.004708957	2.333884854	9.965452189	24.48011924	0	1.149099913	0	0	0.943168579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.067																																																																																		0			21.2509	0	4.019089415	1.51754841	1.669927418	2.045827182	0	0.891892059	8.098768258	1.631163638	23.06544237	0	0.004708957	2.333884854	9.965452189	24.48011924	0	1.149099913	0	0	0.943168579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.067
H3931_065_0	2009	7																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		2200.101417	0	1162.120228	1201.436603	248.551265	13.40561713	0	278.6908653	396.4978743	602.4107932	3201.329189	0	1.241663607	647.4504097	7673.332984	9381.013964	0	433.7306583	0	0	256.5379567	0	0	0	638.3653786	0	77.67502416	0	0	0											$175/day 1-10	$175/day 1-10	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$35 per visit	$45 X-ray; $125 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$10 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											143.44	143.44	47.8866492	20	100	0.2	0.2	48.5	250	35	77	35	25	35	10	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											143.44	143.44	47.8866492	20	100	0.2	0.2	48.5	250	35	77	35	25	35	10	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											26.2985	0	4.63750364	2.002394338	2.071260542	2.681123426	0	1.12637558	8.260372381	1.75703148	20.5418623	0	0.002586799	1.888397028	6.394444153	27.36129073	0	1.265047753	0	0	0.962017338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.2503			26.2985	0	4.63750364	2.002394338	2.071260542	2.681123426	0	1.12637558	8.260372381	1.75703148	20.5418623	0	0.002586799	1.888397028	6.394444153	27.36129073	0	1.265047753	0	0	0.962017338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.2503																																																																																		0			26.2985	0	4.63750364	2.002394338	2.071260542	2.681123426	0	1.12637558	8.260372381	1.75703148	20.5418623	0	0.002586799	1.888397028	6.394444153	27.36129073	0	1.265047753	0	0	0.962017338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.2503
H3931_069_0	2009	7																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		2521.242468	0	1506.553141	1420.291351	310.9761464	15.3831258	0	344.8836438	552.9867454	815.7982631	4740.231037	0	2.651758529	1055.163313	9282.33182	12316.87929	0	580.5831296	0	0	357.7877688	0	0	3445.512067	947.3433994	0	95.05829729	0	0	0											$950 per stay	$950 per stay	"$0/d 1-20, $100/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$250 per procedure	$0 per visit	$25 X-ray; $150 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$0 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	$0 per Trip/50 One Way Trips	$5 per visit	$0 per visit	$150 Every 2 Years	$0 per visit	$1000 Every 3 Yrs	Not Covered	0											160.6230826	160.6230826	40.33133874	0	100	0.2	0.2	47.5	250	0	50	25	25	25	0	25	25	25	25	25	45	0	0	5	0	0	0	0	0	0											160.6230826	160.6230826	40.33133874	0	100	0.2	0.2	47.5	250	0	50	25	25	25	0	25	25	25	25	25	45	0	0	5	0	0	0	0	0	0											33.7475	0	5.06344209	0	2.591467886	3.07662516	0	1.365164423	11.5205572	0	19.75096266	0	0.005524497	2.198256902	0	25.66016518	0	1.209548187	0	0	1.341704133	0	0	1.435630028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.9665	0	0	33.7475	0	5.06344209	0	2.591467886	3.07662516	0	1.365164423	11.5205572	0	19.75096266	0	0.005524497	2.198256902	0	25.66016518	0	1.209548187	0	0	1.341704133	0	0	1.435630028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.9665																								0	0		0		0	0																																							0	0	0											0			33.7475	0	5.06344209	0	2.591467886	3.07662516	0	1.365164423	11.5205572	0	19.75096266	0	0.005524497	2.198256902	0	25.66016518	0	1.209548187	0	0	1.341704133	0	0	1.435630028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.9665
H3931_070_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1579.307313	0	1114.504959	980.2297408	232.563038	13.19676374	0	268.2461457	367.9447748	1744.231669	4059.834474	0	0	751.2406767	6013.95856	8493.624782	0	726.8198925	0	0	236.5888693	0	0	0	537.4632084	0	41.78871958	0	0	0											$75/day 1-5	$75/day 1-5	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$135 per procedure	$25 per visit	$35 X-ray; $125 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											45.96290555	45.96290555	47.8866492	20	100	0.2	0.2	48.5	135	25	71	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											45.96290555	45.96290555	47.8866492	20	100	0.2	0.2	48.5	135	25	71	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											6.0491	0	4.447492332	1.633716235	1.938025317	2.639352747	0	1.084161506	4.139378717	3.633815977	24.0206873	0	0	1.565084743	5.011632134	17.69505163	0	1.514208109	0	0	0.88720826	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2589			6.0491	0	4.447492332	1.633716235	1.938025317	2.639352747	0	1.084161506	4.139378717	3.633815977	24.0206873	0	0	1.565084743	5.011632134	17.69505163	0	1.514208109	0	0	0.88720826	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2589																																																																																		0			6.0491	0	4.447492332	1.633716235	1.938025317	2.639352747	0	1.084161506	4.139378717	3.633815977	24.0206873	0	0	1.565084743	5.011632134	17.69505163	0	1.514208109	0	0	0.88720826	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2589
H3931_071_0	2009	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1652.063556	0	1165.848477	1025.387408	243.2768572	13.80471821	0	280.6038304	384.8954211	1824.585722	4246.864764	0	0	785.8491719	6291.012322	8884.912929	0	760.3033599	0	0	247.4881523	0	0	0	562.2233065	0	43.7138612	0	0	0											$50/day 1-7	$50/day 1-7	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$135 per procedure	$20 per visit	$20 X-ray; $125 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$10 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											36.1427539	36.1427539	47.8866492	20	100	0.2	0.2	48.5	135	20	62	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											36.1427539	36.1427539	47.8866492	20	100	0.2	0.2	48.5	135	20	62	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											4.9758	0	4.65238142	1.708979013	2.027307143	2.760943643	0	1.134107148	4.330073487	3.040976204	21.94213461	0	0	1.30974862	5.242510269	14.80818821	0	1.267172266	0	0	0.928080571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1284			4.9758	0	4.65238142	1.708979013	2.027307143	2.760943643	0	1.134107148	4.330073487	3.040976204	21.94213461	0	0	1.30974862	5.242510269	14.80818821	0	1.267172266	0	0	0.928080571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1284																																																																																		0			4.9758	0	4.65238142	1.708979013	2.027307143	2.760943643	0	1.134107148	4.330073487	3.040976204	21.94213461	0	0	1.30974862	5.242510269	14.80818821	0	1.267172266	0	0	0.928080571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1284
H3931_074_0	2009	4																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1954.053053	0	1348.910759	1027.155625	273.2236478	8.015977228	0	254.4364303	385.2538831	1049.265596	4714.637071	0	66.82277183	788.3021666	7307.177077	9272.285824	0	672.1334747	0	0	277.0435882	0	0	0	886.0288901	0	75.20564196	0	0	0											$250 per stay	$250 per stay	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$125 per procedure	$30 per visit	$30 X-ray; $50 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$10 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											42.26923225	42.26923225	47.8866492	20	100	0.2	0.2	48.5	125	30	38	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											42.26923225	42.26923225	47.8866492	20	100	0.2	0.2	48.5	125	30	38	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											6.883	0	5.382901362	1.711926042	2.276863731	1.603195446	0	1.028347239	4.013061282	2.623163991	14.92968406	0	0.139214108	1.970755417	6.08931423	23.18071456	0	1.680333687	0	0	1.038913456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5514			6.883	0	5.382901362	1.711926042	2.276863731	1.603195446	0	1.028347239	4.013061282	2.623163991	14.92968406	0	0.139214108	1.970755417	6.08931423	23.18071456	0	1.680333687	0	0	1.038913456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5514																																																																																		0			6.883	0	5.382901362	1.711926042	2.276863731	1.603195446	0	1.028347239	4.013061282	2.623163991	14.92968406	0	0.139214108	1.970755417	6.08931423	23.18071456	0	1.680333687	0	0	1.038913456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5514
H3931_075_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1954.053053	0	1348.910759	1027.155625	273.2236478	8.015977228	0	254.4364303	385.2538831	1049.265596	4714.637071	0	66.82277183	788.3021666	7307.177077	9272.285824	0	672.1334747	0	0	277.0435882	0	0	0	886.0288901	0	75.20564196	0	0	0											$250 per stay	$250 per stay	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$125 per procedure	$30 per visit	$30 X-ray; $50 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$10 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											42.26923225	42.26923225	47.8866492	20	100	0.2	0.2	48.5	125	30	38	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											42.26923225	42.26923225	47.8866492	20	100	0.2	0.2	48.5	125	30	38	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											6.883	0	5.382901362	1.711926042	2.276863731	1.603195446	0	1.028347239	4.013061282	2.623163991	14.92968406	0	0.139214108	1.970755417	6.08931423	23.18071456	0	1.680333687	0	0	1.038913456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5514			6.883	0	5.382901362	1.711926042	2.276863731	1.603195446	0	1.028347239	4.013061282	2.623163991	14.92968406	0	0.139214108	1.970755417	6.08931423	23.18071456	0	1.680333687	0	0	1.038913456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5514																																																																																		0			6.883	0	5.382901362	1.711926042	2.276863731	1.603195446	0	1.028347239	4.013061282	2.623163991	14.92968406	0	0.139214108	1.970755417	6.08931423	23.18071456	0	1.680333687	0	0	1.038913456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5514
H3931_076_0	2009	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1954.053053	0	1348.910759	1027.155625	273.2236478	8.015977228	0	254.4364303	385.2538831	1049.265596	4714.637071	0	66.82277183	788.3021666	7307.177077	9272.285824	0	672.1334747	0	0	277.0435882	0	0	0	886.0288901	0	75.20564196	0	0	0											$100 per stay	$100 per stay	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$50 per procedure	$20 per visit	$20 X-ray; $50 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$10 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											16.9076929	16.9076929	47.8866492	20	100	0.2	0.2	48.5	50	20	32	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											16.9076929	16.9076929	47.8866492	20	100	0.2	0.2	48.5	50	20	32	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											2.7532	0	5.382901362	1.711926042	2.276863731	1.603195446	0	1.028347239	1.605224513	1.748775994	12.57236552	0	0.111371286	1.313836944	6.08931423	15.45380971	0	1.120222458	0	0	1.038913456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.8103			2.7532	0	5.382901362	1.711926042	2.276863731	1.603195446	0	1.028347239	1.605224513	1.748775994	12.57236552	0	0.111371286	1.313836944	6.08931423	15.45380971	0	1.120222458	0	0	1.038913456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.8103																																																																																		0			2.7532	0	5.382901362	1.711926042	2.276863731	1.603195446	0	1.028347239	1.605224513	1.748775994	12.57236552	0	0.111371286	1.313836944	6.08931423	15.45380971	0	1.120222458	0	0	1.038913456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.8103
H3931_077_0	2009	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1619.677686	0	1142.994019	1005.286448	238.507832	13.53410041	0	275.103074	377.3502071	1788.817851	4163.61227	0	0	770.4439478	6167.687825	8710.739463	0	745.3989176	0	0	242.6365719	0	0	0	551.2018837	0	42.85692599	0	0	0											$50/day 1-7	$50/day 1-7	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$135 per procedure	$20 per visit	$20 X-ray; $125 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$10 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											36.1427539	36.1427539	47.8866492	20	100	0.2	0.2	48.5	135	20	62	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											36.1427539	36.1427539	47.8866492	20	100	0.2	0.2	48.5	135	20	62	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											4.8783	0	4.561179468	1.675477413	1.987565267	2.706820082	0	1.111874924	4.245189829	2.981363086	21.51199673	0	0	1.284073246	5.139739854	14.5178991	0	1.242331529	0	0	0.909887144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7537			4.8783	0	4.561179468	1.675477413	1.987565267	2.706820082	0	1.111874924	4.245189829	2.981363086	21.51199673	0	0	1.284073246	5.139739854	14.5178991	0	1.242331529	0	0	0.909887144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7537																																																																																		0			4.8783	0	4.561179468	1.675477413	1.987565267	2.706820082	0	1.111874924	4.245189829	2.981363086	21.51199673	0	0	1.284073246	5.139739854	14.5178991	0	1.242331529	0	0	0.909887144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7537
H3931_078_0	2009	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1954.053053	0	1348.910759	1027.155625	273.2236478	8.015977228	0	254.4364303	385.2538831	1049.265596	4714.637071	0	66.82277183	788.3021666	7307.177077	9272.285824	0	672.1334747	0	0	277.0435882	0	0	0	886.0288901	0	75.20564196	0	0	0											$100 per stay	$100 per stay	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$50 per procedure	$20 per visit	$20 X-ray; $50 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$10 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											16.9076929	16.9076929	47.8866492	20	100	0.2	0.2	48.5	50	20	32	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											16.9076929	16.9076929	47.8866492	20	100	0.2	0.2	48.5	50	20	32	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											2.7532	0	5.382901362	1.711926042	2.276863731	1.603195446	0	1.028347239	1.605224513	1.748775994	12.57236552	0	0.111371286	1.313836944	6.08931423	15.45380971	0	1.120222458	0	0	1.038913456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.8103	0	0	2.7532	0	5.382901362	1.711926042	2.276863731	1.603195446	0	1.028347239	1.605224513	1.748775994	12.57236552	0	0.111371286	1.313836944	6.08931423	15.45380971	0	1.120222458	0	0	1.038913456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.8103																																																																																		0			2.7532	0	5.382901362	1.711926042	2.276863731	1.603195446	0	1.028347239	1.605224513	1.748775994	12.57236552	0	0.111371286	1.313836944	6.08931423	15.45380971	0	1.120222458	0	0	1.038913456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.8103
H3931_079_0	2009	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1690.624162	0	1193.060398	1049.320845	248.9551514	14.12693239	0	287.1533688	393.8792162	1867.173146	4345.990295	0	0	804.1915775	6437.850041	9092.294552	0	778.049504	0	0	253.2647418	0	0	0	575.3460892	0	44.73418088	0	0	0											$75/day 1-7	$75/day 1-7	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$135 per procedure	$25 per visit	$25 X-ray; $125 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											54.21413085	54.21413085	47.8866492	20	100	0.2	0.2	48.5	135	25	65	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											54.21413085	54.21413085	47.8866492	20	100	0.2	0.2	48.5	135	25	65	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											7.638	0	4.760972063	1.748868075	2.074626262	2.825386477	0	1.160578199	4.431141182	3.889944054	23.54078076	0	0	1.67539912	5.364875034	18.94228032	0	1.620936467	0	0	0.949742782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6235			7.638	0	4.760972063	1.748868075	2.074626262	2.825386477	0	1.160578199	4.431141182	3.889944054	23.54078076	0	0	1.67539912	5.364875034	18.94228032	0	1.620936467	0	0	0.949742782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6235																																																																																		0			7.638	0	4.760972063	1.748868075	2.074626262	2.825386477	0	1.160578199	4.431141182	3.889944054	23.54078076	0	0	1.67539912	5.364875034	18.94228032	0	1.620936467	0	0	0.949742782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6235
H3931_801_0	2009	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																																																			0		420.4504154	0	55.19401504	10.74759003	9.722612742	13.67530126	0	10.71154487	63.24287318	16.33491574	74.8691382	0	1.697881204	30.73156955	50.92932111	215.9029326	0	8.312700749	0	0	9.911663703	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.071256223	0.071256223	0.164003094	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											29.9597	0	9.051989238	0	2.245923543	3.15899459	0	2.474366864	14.6091037	3.773365535	17.29477092	0	0.392210558	7.098992566	11.76467318	49.87357744	0	1.920233873	0	0	2.289594315	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	155.9075			29.9597	0	9.051989238	0	2.245923543	3.15899459	0	2.474366864	14.6091037	3.773365535	17.29477092	0	0.392210558	7.098992566	11.76467318	49.87357744	0	1.920233873	0	0	2.289594315	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	155.9075																																																																																		0			29.9597	0	9.051989238	0	2.245923543	3.15899459	0	2.474366864	14.6091037	3.773365535	17.29477092	0	0.392210558	7.098992566	11.76467318	49.87357744	0	1.920233873	0	0	2.289594315	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	155.9075
H3931_804_0	2009	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																																																			0		420.4504154	0	55.19401504	10.74759003	9.722612742	13.67530126	0	10.71154487	63.24287318	16.33491574	74.8691382	0	1.697881204	30.73156955	50.92932111	215.9029326	0	8.312700749	0	0	9.911663703	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.071256223	0.071256223	0.164003094	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											29.9597	0	9.051989238	0	2.245923543	3.15899459	0	2.474366864	14.6091037	3.773365535	17.29477092	0	0.392210558	7.098992566	11.76467318	49.87357744	0	1.920233873	0	0	2.289594315	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	155.9075			29.9597	0	9.051989238	0	2.245923543	3.15899459	0	2.474366864	14.6091037	3.773365535	17.29477092	0	0.392210558	7.098992566	11.76467318	49.87357744	0	1.920233873	0	0	2.289594315	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	155.9075																																																																																		0			29.9597	0	9.051989238	0	2.245923543	3.15899459	0	2.474366864	14.6091037	3.773365535	17.29477092	0	0.392210558	7.098992566	11.76467318	49.87357744	0	1.920233873	0	0	2.289594315	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	155.9075
H3949_002_0	2009	2																																D	coin	D	coin	T	coin	coin	V	coin	coin	P	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2033.297314	9.189246244	1007.702342	22.71852086	178.3114653	15.06744069	5.031836289	463.1991194	40.50086601	1.086018717	1551.864405	0	0.325232397	17.13128544	2.846280404	5073.00023	429.0328125	294.2768955	22.07684447	4169.077119	27.05416426	0	0	0	313.1728213	0	0	0	1029.266039	483.0075269											1a:  Acute - $150/$0/day for 1-7/8-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - MC Cost Shares for 1-/1-190	2:  Skilled Nursing Services - $0/$85/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$85/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $35/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - 20.0%	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $150/visit/8b:  Outpatient Therapeutic Radiological Services - $150/visit/8b:  Outpatient X-Ray Services - $20/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $35/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $0/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - 0.0%/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $35/visit/7b:  Chiropractic Services - $35/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14d:  Pap Smears and Pelvic Exams Screening - 0.0%/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $35/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $35/visit/7h:  Psychiatric Services - Individual - $35/visit/7h:  Psychiatric Services - Group - $35/visit	7c:  Occupational Therapy Services - $35/visit/7i:  Physical/Speech Therapy - $35/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $35/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service			14a:  Written health education materials - $0/service/14a:  Membership in Health Club/Fitness Classes - $0/service/14c:  Routine Exams - $0/visit/	13d:  Other: Over the Counter Benefit - $0/visit											149.6154635	0.0702	85	0	100	0.2	0.2	44.66769624	0.2	0	91.93287868	0	0.2	0.199786683	33.29442592	34.82051711	34.98155539	35	0	0.270705175	0.2	0	0	0	0	0	0	0	0	0											123.2714447	0.06901951	69.99915472	0	82.35194673	0.164703893	0.164703893	36.78471741	0.164703893	0	75.70851527	0	0.164703893	0.164528223	27.41860789	28.6753737	34.96139886	28.82318135	0	0.270156114	0.164703893	0	0	0	0	0	0	0	0	0											20.8873	0.634237272	5.87819268	0	1.223691358	2.481666147	0.828763028	1.419887393	6.670650321	0	9.790779166	0	0.053567042	2.818579951	0.006503421	12.12251478	1.249965607	0.706833027	0	0.093858473	4.455926188	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.3229	0	14.86	20.8873	0.634237272	5.87819268	0	1.223691358	2.481666147	0.828763028	1.419887393	6.670650321	0	9.790779166	0	0.053567042	2.818579951	0.006503421	12.12251478	1.249965607	0.706833027	0	0.093858473	4.455926188	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.3229	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	20.8873	0.634237272	5.87819268	0	1.223691358	2.481666147	0.828763028	1.419887393	6.670650321	0	9.790779166	0	0.053567042	2.818579951	0.006503421	12.12251478	1.249965607	0.706833027	0	0.093858473	4.455926188	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.3229
H3949_009_0	2009	2																																coin	coin	coin	coin	coin	coin	coin	V	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		513.5403618	9.154657387	59.53178256	26.48520573	13.35075245	22.59732188	7.053245761	613.4374455	36.00707596	1.535029907	51.48690198	0	1.022206348	19.0586846	75.58160349	142.0241667	7.089472667	2.858392615	24.59369082	17.57171468	21.26105917	0.129407258	1632.328318	518.5055259	316.3576297	0	0	0.716680219	1029.266039	2484.03871											1a:  Acute - MC Cost Shares for 1-/1-90	1b:  Psych - MC Cost Shares for 1-/1-190	2:  Skilled Nursing Services - MC Cost Shares for 1-100/2:  Non-Medicare Covered Stay - MC Cost Shares for 1-100	6:  Home Health Services - $0/visit	10a:  Ambulance - 20.0%	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - 20.0%/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - 20.0%	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - 20.0%/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - 20.0%	9d:  Cardiac Rehabilitation Services - 20.0%/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $0/visit/17a:  Vision Exams - 20.0%/18a:  Hearing Exams - 20.0%/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - 0%/20%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%	7d:  Physician Specialist Services - 20.0%/7b:  Chiropractic Services - 20.0%/7f:  Podiatry Services - 20.0%/7-12 Additional Visits/17a:  Vision Exams - 20.0%/18a:  Hearing Exams - 20.0%/14d:  Pap Smears and Pelvic Exams Screening - 0%/20%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%	7e:  Mental Hlth Spec-Non-Physician - Individual - 50.0%/7e:  Mental Hlth Spec-Non-Physician - Group - 50.0%/7h:  Psychiatric Services - Individual - 50.0%/7h:  Psychiatric Services - Group - 50.0%	7c:  Occupational Therapy Services - 20.0%/7i:  Physical/Speech Therapy - 20.0%	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%	9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - 20.0%	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%	10b:  Transportation - $0/trip	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Emergency Svcs - $0/visit/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $0/visit/18a:  Fitting for Hearing Aid - $0/visit	18b:  Hearing Aids - $0/service	14a:  Written health education materials - $0/service/14a:  Membership in Health Club/Fitness Classes - $0/service/14c:  Routine Exams - $0/visit/	13d:  Other: Over the Counter Benefit - $0/visit											0.070254778	0.070256076	0.159384313	0	0.2	0.2	0.2	60.83802636	0.2	0	0.2	0	0.2	0.2	0.011427534	0.199545894	0.5	0.2	0.194901131	0.192868548	0.2	0.2	0	0	0	0	0	0	0	0											0.070254778	0.070256076	0.159384313	0	0.2	0.2	0.2	60.83802636	0.2	0	0.2	0	0.2	0.2	0.011427534	0.199545894	0.5	0.2	0.194901131	0.192868548	0.2	0.2	0	0	0	0	0	0	0	0											36.0787	0.643170304	9.488432281	0	2.670150489	4.519464377	1.410649152	3.110026956	7.201415192	0	10.2973804	0	0.20444127	3.811736921	0.863711316	28.3403393	3.544736333	0.571678523	4.793338164	3.389031094	4.252211834	0.025881452	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.2165	0	0	36.0787	0.643170304	9.488432281	0	2.670150489	4.519464377	1.410649152	3.110026956	7.201415192	0	10.2973804	0	0.20444127	3.811736921	0.863711316	28.3403393	3.544736333	0.571678523	4.793338164	3.389031094	4.252211834	0.025881452	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.2165																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	36.0787	0.643170304	9.488432281	0	2.670150489	4.519464377	1.410649152	3.110026956	7.201415192	0	10.2973804	0	0.20444127	3.811736921	0.863711316	28.3403393	3.544736333	0.571678523	4.793338164	3.389031094	4.252211834	0.025881452	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.2165
H3949_012_0	2009	2																																D	coin	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2118.055419	8.994227441	1392.143065	35.21063549	286.6528754	16.07668578	4.265766774	364.0626519	318.2874494	7.535919253	1394.20626	0	0.175418973	1095.083828	3407.112488	5162.219406	521.3861325	647.6345169	24.15989416	4795.961716	15.50509131	0	0	0	313.1728213	0	0	0	310.5048387	0											1a:  Acute - $150/day for 1-12	1b:  Psych - MC Cost Shares for 1-/1-190	2:  Skilled Nursing Services - $0/$85/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$85/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $35/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $200/visit/9b:  Ambulatory Surgical Center Services - $175/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $150/visit/8b:  Outpatient Therapeutic Radiological Services - $150/visit/8b:  Outpatient X-Ray Services - $20/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $35/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $15/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - 0.0%/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $35/visit/7b:  Chiropractic Services - $35/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14d:  Pap Smears and Pelvic Exams Screening - 0.0%/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $35/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $35/visit/7h:  Psychiatric Services - Individual - $35/visit/7h:  Psychiatric Services - Group - $35/visit	7c:  Occupational Therapy Services - $35/visit/7i:  Physical/Speech Therapy - $35/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $35/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service			14a:  Written health education materials - $0/service/14c:  Routine Exams - $0/visit/												149.5412241	0.0777	85	0	50	0.2	0.2	44.66768101	180.0037607	0	78.7798682	0	0.2	35	15.00822749	34.58781933	34.64500788	35	0	0.233238469	0.2	0	0	0	0	0	0	0	0	0											149.5412241	0.0777	85	0	50	0.2	0.2	44.66768101	180.0037607	0	78.7798682	0	0.2	35	15.00822749	34.58781933	34.64500788	35	0	0.233238469	0.2	0	0	0	0	0	0	0	0	0											26.3947	0.698851472	9.861013376	0	1.194386981	3.215337155	0.853153355	1.355152867	4.774411489	0	9.152948787	0	0.035083795	3.193994497	4.26122661	14.87915935	1.505285556	1.888934008	0	0.093216897	3.101018263	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4579	0	0	26.3947	0.698851472	9.861013376	0	1.194386981	3.215337155	0.853153355	1.355152867	4.774411489	0	9.152948787	0	0.035083795	3.193994497	4.26122661	14.87915935	1.505285556	1.888934008	0	0.093216897	3.101018263	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4579																																										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	26.3947	0.698851472	9.861013376	0	1.194386981	3.215337155	0.853153355	1.355152867	4.774411489	0	9.152948787	0	0.035083795	3.193994497	4.26122661	14.87915935	1.505285556	1.888934008	0	0.093216897	3.101018263	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4579
H3949_013_0	2009	2																																D	coin	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1098.656639	8.691945679	738.2706191	25.83135874	129.6949056	10.59576252	2.752198736	358.6788956	279.2005193	3.507318642	1402.585054	0	0.123091137	616.4141936	2.879235415	5773.760345	443.4312559	528.8004895	24.49675257	4323.102412	10.41044807	0	0	79.10076672	321.3099935	0	0	0	1029.266039	483.0075269											1a:  Acute - $100/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - MC Cost Shares for 1-/1-190	2:  Skilled Nursing Services - $0/$85/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$85/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $20/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $50/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $50/visit/8b:  Outpatient Therapeutic Radiological Services - $50/visit/8b:  Outpatient X-Ray Services - $10/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $0/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - 0.0%/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - 0.0%/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $20/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $20/visit/7h:  Psychiatric Services - Individual - $20/visit/7h:  Psychiatric Services - Group - $20/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service	17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service			14a:  Written health education materials - $0/service/14a:  Membership in Health Club/Fitness Classes - $0/service/14c:  Routine Exams - $0/visit/	13d:  Other: Over the Counter Benefit - $0/visit											99.76076047	0.0702	85	0	50	0.2	0.2	38.77670249	60.04978863	0	23.13384805	0	0.2	20	20	20	20	20	0	0.258060055	0.2	0	0	0	0	0	0	0	0	0											95.19120175	0.070059158	81.08176601	0	47.69515648	0.190780626	0.190780626	36.98921786	57.2816813	0	22.06745005	0	0.190780626	19.07806259	19.07806259	19.07806259	20	19.07806259	0	0.258060055	0.190780626	0	0	0	0	0	0	0	0	0											8.7152	0.608950393	4.988357132	0	0.515484901	2.021466205	0.525066198	1.105604318	1.332756264	0	2.579289635	0	0.023483404	0.979999047	0.004577519	9.17934677	0.739052093	0.840707403	0	0.092968337	1.986111798	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.2384	0	1.68	8.7152	0.608950393	4.988357132	0	0.515484901	2.021466205	0.525066198	1.105604318	1.332756264	0	2.579289635	0	0.023483404	0.979999047	0.004577519	9.17934677	0.739052093	0.840707403	0	0.092968337	1.986111798	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.2384	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	8.7152	0.608950393	4.988357132	0	0.515484901	2.021466205	0.525066198	1.105604318	1.332756264	0	2.579289635	0	0.023483404	0.979999047	0.004577519	9.17934677	0.739052093	0.840707403	0	0.092968337	1.986111798	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.2384
H3949_015_0	2009	2																																A	coin	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		518.7563254	8.988276622	1379.416676	34.90426266	284.0189925	15.93066512	4.22724759	367.3300091	316.4343926	7.470089299	1381.540622	0	0.17386855	1090.796483	3624.442556	5116.833121	521.455486	641.9432467	24.06974139	4797.578599	15.35745518	0	0	656.2726946	313.1728213	0	0	0	1029.266039	0											1a:  Acute - $150/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - MC Cost Shares for 1-190	2:  Skilled Nursing Services - $0/$85/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$85/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $25/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $125/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $50/visit/8b:  Outpatient Therapeutic Radiological Services - $50/visit/8b:  Outpatient X-Ray Services - $10/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $5/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - 0.0%/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $25/visit/7b:  Chiropractic Services - $25/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14d:  Pap Smears and Pelvic Exams Screening - 0.0%/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $25/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Emergency Svcs - $0/visit/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $0/visit/18a:  Fitting for Hearing Aid - $0/visit	18b:  Hearing Aids - $0/service	14a:  Written health education materials - $0/service/14a:  Membership in Health Club/Fitness Classes - $0/service/14c:  Routine Exams - $0/visit/												148.1257016	0.0777	85	0	50	0.2	0.2	40.83242842	105.0657789	0	28.07916996	0	0.2	25	5.012384876	25	24.84542264	25	0	0.233153651	0.2	0	0	0	0	0	0	0	0	0											134.6036851	0.077216093	77.16162338	0	45.38919022	0.181556761	0.181556761	37.06701721	95.37701253	0	25.48981573	0	0.181556761	22.69459511	4.550161812	22.69459511	24.81430335	22.69459511	0	0.233096891	0.181556761	0	0	0	0	0	0	0	0	0											5.8189	0.694039601	8.869835835	0	1.074282673	2.892319959	0.76748538	1.134652314	2.515047252	0	2.934601322	0	0.031567011	2.062932044	1.374316676	9.677037995	1.078296218	1.214053506	0	0.093191721	2.788249818	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0208	0	4.4981	5.8189	0.694039601	8.869835835	0	1.074282673	2.892319959	0.76748538	1.134652314	2.515047252	0	2.934601322	0	0.031567011	2.062932044	1.374316676	9.677037995	1.078296218	1.214053506	0	0.093191721	2.788249818	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0208	4000	1a:  Acute - 20.0% for 1-90/1a:  Additional Days - 20.0% for 91-999		2:  Skilled Nursing Services - 20.0% for 1-100/2:  Non-Medicare Covered Stay - 20.0% for 1-100	6:  Home Health Services - 20.0%	10a:  Ambulance - 20.0%			4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $25/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - 20.0%	8a:  Outpatient Diagnostic Procedures/Tests - 20.0%/8a:  Outpatient Lab Services - 20.0%	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - 20.0%/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - 20.0%	7a:  Primary Care - 20.0%/17a:  Vision Exams - 20.0%/18a:  Hearing Exams - 20.0%/14c:  Physical Exams (Initial Exam) - 20.0%/14d:  Pap Smears and Pelvic Exams Screening - 20.0%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%	7d:  Physician Specialist Services - 20.0%/7b:  Chiropractic Services - 20.0%/17a:  Vision Exams - 20.0%/18a:  Hearing Exams - 20.0%/14d:  Pap Smears and Pelvic Exams Screening - 20.0%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%		7c:  Occupational Therapy Services - 20.0%/7i:  Physical/Speech Therapy - 20.0%	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%	7a:  Primary Care - 20.0%/17a:  Vision Exams - 20.0%/18a:  Hearing Exams - 20.0%/14c:  Physical Exams (Initial Exam) - 20.0%/14d:  Pap Smears and Pelvic Exams Screening - 20.0%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%/7d:  Physician Specialist Services - 20.0%/7b:  Chiropractic Services - 20.0%/17a:  Vision Exams - 20.0%/18a:  Hearing Exams - 20.0%/14d:  Pap Smears and Pelvic Exams Screening - 20.0%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%							14c:  Routine Exams - $0/visit/												9.197	0.0143	1.5993	0.7123	0.2736	0.1809	0.0454	0.1508	0.8809	0.1582	0.6601	0	0.0049	0.4942	0.7533	2.1643	0.0004	0.1191	0.6265	0.6087	0.3973	0.0225	0	0	0	0	0	0	0	0											19.0639	0	0.115	15.0159	0.708372447	10.46910925	0.71229101	1.347908137	3.073267026	0.81291046	1.285438538	3.395980415	0.158188676	3.594699419	0	0.036417766	2.557082223	2.127569572	11.84132745	1.078657507	1.333145804	0.626506442	0.70193401	3.185560836	0.022453608	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.0847
H3949_016_0	2009	2																																coin	coin	coin	coin	coin	coin	coin	V	coin	coin	coin	O	coin	P	V	V	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		719.0984521	8.313641055	182.80841	1.580044253	25.8058974	48.78486119	13.68427192	108.3563218	24.88455889	5.499125079	22.45933257	0	0.39961111	436.0214224	30287.99376	0	7.085165907	10.5254661	43.54749877	4548.055599	4.703008585	0.502749928	5387.592185	518.9489695	321.3099935	0	0	0	310.5048387	1794.027957											1a:  Acute - MC Cost Shares for 1-/1-90	1b:  Psych - MC Cost Shares for 1-/1-190	2:  Skilled Nursing Services - 0/day for 1-100/2:  Non-Medicare Covered Stay - $0/day for 1-100	6:  Home Health Services - $0/visit	10a:  Ambulance - 20.0%	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $0/visit/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - 20.0%	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $0/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $0/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - $0/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - 0%/0%/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $0/visit/7b:  Chiropractic Services - $0/visit/7f:  Podiatry Services - $0/visit/7-12 Additional Visits/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - 0%/0%/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - 50.0%/7e:  Mental Hlth Spec-Non-Physician - Group - 50.0%/7h:  Psychiatric Services - Individual - 50.0%/7h:  Psychiatric Services - Group - 50.0%	7c:  Occupational Therapy Services - $0/visit/7i:  Physical/Speech Therapy - $0/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%	10b:  Transportation - $0/trip	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Emergency Svcs - $0/visit/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $0/visit/18a:  Fitting for Hearing Aid - $0/visit	18b:  Hearing Aids - $0/service	14a:  Written health education materials - $0/service/14c:  Routine Exams - $0/visit/	13d:  Other: Over the Counter Benefit - $0/visit											0.070198703	0.0702	0	0	0.2	0.2	0.2	50	0.2	0	0.2	0	0.2	33.88190947	0	0	0.5	0	0	0.245296044	0.2	0.2	0	0	0	0	0	0	0	0											0.070198703	0.0702	0	0	0.2	0.2	0.2	50	0.2	0	0.2	0	0.2	33.88190947	0	0	0.5	0	0	0.245296044	0.2	0.2	0	0	0	0	0	0	0	0											50.4798	0.583617602	0	0	5.16117948	9.756972239	2.736854384	0.451484674	4.976911777	0	4.491866513	0	0.079922222	1.231103197	0	0	3.542582954	0	0	0.092968337	0.940601717	0.100549986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.6264	0	0	50.4798	0.583617602	0	0	5.16117948	9.756972239	2.736854384	0.451484674	4.976911777	0	4.491866513	0	0.079922222	1.231103197	0	0	3.542582954	0	0	0.092968337	0.940601717	0.100549986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.6264																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	50.4798	0.583617602	0	0	5.16117948	9.756972239	2.736854384	0.451484674	4.976911777	0	4.491866513	0	0.079922222	1.231103197	0	0	3.542582954	0	0	0.092968337	0.940601717	0.100549986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.6264
H3949_017_0	2009	2																																D	coin	D	coin	T	coin	coin	V	coin	coin	P	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1372.046986	8.313641055	1186.340901	45.1180042	187.7500592	13.50943911	3.789430446	243.8626788	38.40821284	8.487655636	1224.554811	0	0.327509084	29.09254569	3.146477652	7029.377201	446.7810243	937.7330749	32.43063291	4355.759993	7.236547429	0	0	0	321.3099935	0	0	0	1029.266039	1748.02724											1a:  Acute - $150/$0/day for 1-7/8-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - MC Cost Shares for 1-190	2:  Skilled Nursing Services - $0/$85/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$85/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $35/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - 20.0%	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $150/visit/8b:  Outpatient Therapeutic Radiological Services - $150/visit/8b:  Outpatient X-Ray Services - $20/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $35/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $0/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - 0.0%/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $35/visit/7b:  Chiropractic Services - $35/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14d:  Pap Smears and Pelvic Exams Screening - 0.0%/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $35/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $35/visit/7h:  Psychiatric Services - Individual - $35/visit/7h:  Psychiatric Services - Group - $35/visit	7c:  Occupational Therapy Services - $35/visit/7i:  Physical/Speech Therapy - $35/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $35/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service			14a:  Written health education materials - $0/service/14a:  Membership in Health Club/Fitness Classes - $0/service/14a:  Nutritional Training - $0/service/14c:  Routine Exams - $0/visit/	13d:  Other: Over the Counter Benefit - $0/visit											149.4520001	0.0702	85	0	100	0.2	0.2	44.6719435	0.2	0	54.5872795	0	0.2	0.133655352	29.69826158	35	35	35	0	0.256125234	0.2	0	0	0	0	0	0	0	0	0											127.8004361	0.0702	72.64400053	0	85.46353003	0.17092706	0.17092706	38.17821985	0.17092706	0	46.65221601	0	0.17092706	0.114226582	25.3811827	29.91223551	35	29.91223551	0	0.256125234	0.17092706	0	0	0	0	0	0	0	0	0											14.6124	0.583617602	7.181712421	0	1.337148569	2.309128711	0.647716206	0.77585358	6.565002903	0	4.760682964	0	0.055980165	3.323142056	0.00665511	17.5220322	1.303111321	2.337474382	0	0.092968337	1.236921777	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6515	0	10.65	14.6124	0.583617602	7.181712421	0	1.337148569	2.309128711	0.647716206	0.77585358	6.565002903	0	4.760682964	0	0.055980165	3.323142056	0.00665511	17.5220322	1.303111321	2.337474382	0	0.092968337	1.236921777	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6515	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	14.6124	0.583617602	7.181712421	0	1.337148569	2.309128711	0.647716206	0.77585358	6.565002903	0	4.760682964	0	0.055980165	3.323142056	0.00665511	17.5220322	1.303111321	2.337474382	0	0.092968337	1.236921777	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6515
H3949_019_0	2009	2																																D	coin	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2138.247699	8.994192699	1398.702727	35.4614485	287.9297513	16.1575169	4.288453919	365.7564072	320.2005676	7.588178054	1401.213421	0	0.176536315	1100.147093	3430.283017	5196.466556	522.3278811	651.946109	24.28594357	4804.804261	15.54567267	0	0	656.2726946	313.1728213	0	0	0	1029.266039	0											1a:  Acute - $150/day for 1-12/1a:  Additional Days - $0/day for 91-999	1b:  Psych - MC Cost Shares for 1-190	2:  Skilled Nursing Services - $0/$85/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$85/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $35/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $200/visit/9b:  Ambulatory Surgical Center Services - $175/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $150/visit/8b:  Outpatient Therapeutic Radiological Services - $150/visit/8b:  Outpatient X-Ray Services - $20/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $35/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $15/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - 0.0%/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $35/visit/7b:  Chiropractic Services - $35/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14d:  Pap Smears and Pelvic Exams Screening - 0.0%/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $35/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $35/visit/7h:  Psychiatric Services - Individual - $35/visit/7h:  Psychiatric Services - Group - $35/visit	7c:  Occupational Therapy Services - $35/visit/7i:  Physical/Speech Therapy - $35/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $35/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Emergency Svcs - $0/visit/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $0/visit/18a:  Fitting for Hearing Aid - $0/visit	18b:  Hearing Aids - $0/service	14a:  Written health education materials - $0/service/14a:  Membership in Health Club/Fitness Classes - $0/service/14c:  Routine Exams - $0/visit/												149.5440511	0.0777	85	0	50	0.2	0.2	44.66769365	180.0037607	0	78.65752206	0	0.2	35	15.00820391	34.5843927	34.64566801	35	0	0.23280925	0.2	0	0	0	0	0	0	0	0	0											149.5440511	0.0777	85	0	50	0.2	0.2	44.66769365	180.0037607	0	78.65752206	0	0.2	35	15.00820391	34.5843927	34.64566801	35	0	0.23280925	0.2	0	0	0	0	0	0	0	0	0											26.6469	0.698848773	9.907477648	0	1.199707297	3.231503381	0.857690784	1.361457929	4.803108861	0	9.18466463	0	0.035307263	3.208762356	4.290198917	14.97638667	1.508033197	1.901509485	0	0.093216906	3.109134534	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.0139	0	0	26.6469	0.698848773	9.907477648	0	1.199707297	3.231503381	0.857690784	1.361457929	4.803108861	0	9.18466463	0	0.035307263	3.208762356	4.290198917	14.97638667	1.508033197	1.901509485	0	0.093216906	3.109134534	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.0139																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	26.6469	0.698848773	9.907477648	0	1.199707297	3.231503381	0.857690784	1.361457929	4.803108861	0	9.18466463	0	0.035307263	3.208762356	4.290198917	14.97638667	1.508033197	1.901509485	0	0.093216906	3.109134534	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.0139
H3949_020_0	2009	2																																D	coin	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1562.971739	8.381246289	1228.575285	55.1669027	239.3135581	17.83748397	5.00345753	317.1146015	358.5043235	11.49691214	1311.413854	0	0.245991491	948.5267765	4460.717813	6392.143346	510.4646196	804.7238912	28.4240559	4790.002236	8.924234132	0	0	0	313.1728213	0	0	0	1029.266039	2783.043369											1a:  Acute - $150/$0/day for 1-7/8-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - MC Cost Shares for 1-190	2:  Skilled Nursing Services - $0/$85/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$85/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $35/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $150/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $150/visit/8b:  Outpatient Therapeutic Radiological Services - $150/visit/8b:  Outpatient X-Ray Services - $20/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $35/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $10/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - 0.0%/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $35/visit/7b:  Chiropractic Services - $35/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14d:  Pap Smears and Pelvic Exams Screening - 0.0%/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $35/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $35/visit/7h:  Psychiatric Services - Individual - $35/visit/7h:  Psychiatric Services - Group - $35/visit	7c:  Occupational Therapy Services - $35/visit/7i:  Physical/Speech Therapy - $35/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $35/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service			14a:  Written health education materials - $0/service/14a:  Membership in Health Club/Fitness Classes - $0/service/14a:  Nutritional Training - $0/service/14c:  Routine Exams - $0/visit/	13d:  Other: Over the Counter Benefit - $0/visit											149.3795039	0.0777	85	0	50	0.2	0.2	44.66766738	110.1315579	0	54.5872795	0	0.2	35	10.01048702	34.66817631	35	35	0	0.232905955	0.2	0	0	0	0	0	0	0	0	0											149.3795039	0.0777	85	0	50	0.2	0.2	44.66766738	110.1315579	0	54.5872795	0	0.2	35	10.01048702	34.66817631	35	35	0	0.232905955	0.2	0	0	0	0	0	0	0	0	0											19.4563	0.651222837	8.702408269	0	0.997139826	3.567496795	1.000691506	1.180397462	3.290219972	0	5.965542881	0	0.049198298	2.766536432	3.721163145	18.46699605	1.488855141	2.347111349	0	0.092968337	1.784846826	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5291	0	0	19.4563	0.651222837	8.702408269	0	0.997139826	3.567496795	1.000691506	1.180397462	3.290219972	0	5.965542881	0	0.049198298	2.766536432	3.721163145	18.46699605	1.488855141	2.347111349	0	0.092968337	1.784846826	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5291																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.4563	0.651222837	8.702408269	0	0.997139826	3.567496795	1.000691506	1.180397462	3.290219972	0	5.965542881	0	0.049198298	2.766536432	3.721163145	18.46699605	1.488855141	2.347111349	0	0.092968337	1.784846826	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5291
H3949_021_0	2009	2																																coin	coin	coin	coin	coin	coin	coin	V	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		345.4909743	8.381246289	56.28287939	52.24994536	8.924686501	16.89432463	4.738899045	285.1047966	32.07863331	10.88901138	26.94598997	0	0.232984658	28.2673388	50.84844911	125.5351936	7.085165907	5.672038299	26.57655009	12721.32778	8.453823434	0.896850289	1632.328318	518.5055259	313.1728213	0	0	0.716680219	1029.266039	3243.050538											1a:  Acute - MC Cost Shares for 1-90	1b:  Psych - MC Cost Shares for 1-190	2:  Skilled Nursing Services - MC Cost Shares for 1--1/-100/2:  Non-Medicare Covered Stay - MC Cost Shares for 1--1/-100	6:  Home Health Services - $0/visit	10a:  Ambulance - 20.0%	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - 20.0%/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - 20.0%	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - 20.0%/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - 20.0%	9d:  Cardiac Rehabilitation Services - 20.0%/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $0/visit/17a:  Vision Exams - 20.0%/18a:  Hearing Exams - 20.0%/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - 0%/20%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%	7d:  Physician Specialist Services - 20.0%/7b:  Chiropractic Services - 20.0%/7f:  Podiatry Services - 20.0%/7-12 Additional Visits/17a:  Vision Exams - 20.0%/18a:  Hearing Exams - 20.0%/14d:  Pap Smears and Pelvic Exams Screening - 0%/20%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%	7e:  Mental Hlth Spec-Non-Physician - Individual - 50.0%/7e:  Mental Hlth Spec-Non-Physician - Group - 50.0%/7h:  Psychiatric Services - Individual - 50.0%/7h:  Psychiatric Services - Group - 50.0%	7c:  Occupational Therapy Services - 20.0%/7i:  Physical/Speech Therapy - 20.0%	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%	9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - 20.0%	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%	10b:  Transportation - $0/trip	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Emergency Svcs - $0/visit/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $0/visit/18a:  Fitting for Hearing Aid - $0/visit	18b:  Hearing Aids - $0/service	14a:  Written health education materials - $0/service/14a:  Membership in Health Club/Fitness Classes - $0/service/14c:  Routine Exams - $0/visit/	13d:  Other: Over the Counter Benefit - $0/visit											0.0777	0.0777	0.189811858	0	0.2	0.2	0.2	55.91028936	0.2	0	0.2	0	0.2	0.2	0.01187639	0.113371341	0.5	0.2	0.139107025	5.14838109	0.2	0.2	0	0	0	0	0	0	0	0											0.0777	0.0777	0.189811858	0	0.2	0.2	0.2	55.91028936	0.2	0	0.2	0	0.2	0.2	0.01187639	0.113371341	0.5	0.2	0.139107025	5.14838109	0.2	0.2	0	0	0	0	0	0	0	0											26.8446	0.651222837	10.68315793	0	1.7849373	3.378864926	0.947779809	1.32835764	6.415726662	0	5.389197993	0	0.046596932	5.653467759	0.603896006	14.23209325	3.542582954	1.13440766	3.69698481	5.457853616	1.690764687	0.179370058	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.6619	0	0	26.8446	0.651222837	10.68315793	0	1.7849373	3.378864926	0.947779809	1.32835764	6.415726662	0	5.389197993	0	0.046596932	5.653467759	0.603896006	14.23209325	3.542582954	1.13440766	3.69698481	5.457853616	1.690764687	0.179370058	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.6619																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	26.8446	0.651222837	10.68315793	0	1.7849373	3.378864926	0.947779809	1.32835764	6.415726662	0	5.389197993	0	0.046596932	5.653467759	0.603896006	14.23209325	3.542582954	1.13440766	3.69698481	5.457853616	1.690764687	0.179370058	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.6619
H3949_801_0	2009	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	V											0	0	0	0	0	0	0	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	322.0216299	3.502787273	53.69264529	41.05236732	6.429728717	12.2036392	3.423150402	8.197296085	31.19372719	8.233072072	27.44630463	0	0.253672381	24.71273747	46.65871983	120.6129628	1.280413206	6.110639171	25.30040047	36.16774194	6.683368002	0.717914108	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.072846916	0.072846916	0.167727879	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.072846916	0.072846916	0.167727879	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.4583	0.255167249	9.005753516	0	1.485267334	2.819040655	0.790747743	1.893575396	7.205750981	1.901839649	6.340096369	0	0.05859832	5.708642356	10.77816428	27.8615944	0.295775451	1.411557648	5.844392509	8.354748388	1.543858009	0.165838159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.1787	0	0	23.4583	0.255167249	9.005753516	0	1.485267334	2.819040655	0.790747743	1.893575396	7.205750981	1.901839649	6.340096369	0	0.05859832	5.708642356	10.77816428	27.8615944	0.295775451	1.411557648	5.844392509	8.354748388	1.543858009	0.165838159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.1787	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	23.4583	0.255167249	9.005753516	0	1.485267334	2.819040655	0.790747743	1.893575396	7.205750981	1.901839649	6.340096369	0	0.05859832	5.708642356	10.77816428	27.8615944	0.295775451	1.411557648	5.844392509	8.354748388	1.543858009	0.165838159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.1787
H3949_802_0	2009	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	V											0	0	0	0	0	0	0	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	322.0216299	3.502787273	53.69264529	41.05236732	6.429728717	12.2036392	3.423150402	8.197296085	31.19372719	8.233072072	27.44630463	0	0.253672381	24.71273747	46.65871983	120.6129628	1.280413206	6.110639171	25.30040047	36.16774194	6.683368002	0.717914108	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.072846916	0.072846916	0.167727879	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.072846916	0.072846916	0.167727879	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.4583	0.255167249	9.005753516	0	1.485267334	2.819040655	0.790747743	1.893575396	7.205750981	1.901839649	6.340096369	0	0.05859832	5.708642356	10.77816428	27.8615944	0.295775451	1.411557648	5.844392509	8.354748388	1.543858009	0.165838159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.1787	0	0	23.4583	0.255167249	9.005753516	0	1.485267334	2.819040655	0.790747743	1.893575396	7.205750981	1.901839649	6.340096369	0	0.05859832	5.708642356	10.77816428	27.8615944	0.295775451	1.411557648	5.844392509	8.354748388	1.543858009	0.165838159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.1787	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	23.4583	0.255167249	9.005753516	0	1.485267334	2.819040655	0.790747743	1.893575396	7.205750981	1.901839649	6.340096369	0	0.05859832	5.708642356	10.77816428	27.8615944	0.295775451	1.411557648	5.844392509	8.354748388	1.543858009	0.165838159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.1787
H3952_008_0	2009	6																																A	A	D		T	Coin	Coin	V	V		V			V	V	V	V	V	V	V	S			V	V		V																																																						0		1627.815616	92.39363678	1420.45261		341.4070561	9.152012252	10.5969369	304.4936151	372.7086231		1124.769576			474.2571875	16729.32673	5560.052983	203.5353714	529.4860928	39.56306171	136.3114279	30.3807016			725.277	309.3520021		0.00001														$150 per day; 10 days max	$150 per day; 10 days max	$0 Days 1-7; $60 Days 8-20; $120 Days 21-100 (PBP 2)		$50 copay per trip	20% coinsurance	20% coinsurance	$50 copay per visit	$225 copay per visit		$30 copay per visit			$30 copay per visit	$5 copay per visit	$30 copay per visit	$30 copay per visit	$30 copay per visit	$30 copay per visit	$30 copay per visit	$25 per script for certain injectible drugs			$15 per visit	$30 copay per visit		$30 copay per visit														150	150	65.56185672		50	0.2	0.2	50	225		30			30	5	30	30	30	30	30	25			15	30		30														150	150	65.56185672		50	0.2	0.2	50	225		30			30	5	30	30	30	30	30	25			15	30		30														20.3477	1.15492046	7.760625876	0	1.4225294	1.83040245	2.11938738	1.268723396	6.988286683	0	2.81192394	0	0	1.185642969	6.970552803	13.90013246	0.508838428	1.323715232	0.098907654	0.34077857	0.063293128	0	0	0.90659625	0.773380005	0	0.000000025	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7763			20.3477	1.15492046	7.760625876	0	1.4225294	1.83040245	2.11938738	1.268723396	6.988286683	0	2.81192394	0	0	1.185642969	6.970552803	13.90013246	0.508838428	1.323715232	0.098907654	0.34077857	0.063293128	0	0	0.90659625	0.773380005	0	0.000000025	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7763																																																																																		0			20.3477	1.15492046	7.760625876	0	1.4225294	1.83040245	2.11938738	1.268723396	6.988286683	0	2.81192394	0	0	1.185642969	6.970552803	13.90013246	0.508838428	1.323715232	0.098907654	0.34077857	0.063293128	0	0	0.90659625	0.773380005	0	0.000000025	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7763
H3952_018_0	2009	5		a.1.	a.2.	i.2.	h.5.							Inpatient Facility	Inpatient Facility	Professional	Professional								IP Copays days 61-150	IPMH Copays days 61-150	podiatry visits	op mh						bp	bp	d		coin	coin	coin	coin	coin		v	coin	coin	coin		coin	coin	v	coin	coin	coin						coin					d	d	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		317.0306427	3.038475445	685.5873004		19.52409568	17.08822438	18.24108606	22.88164377	43.58403482		1015.29327	0	3.338846288	96.41986213		30.65238417	13.86665037	809.0451273	12.82483574	186.5219478	5.25400766						0.001					241.656528	160.1513446	449.0719429	1.396830178						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"	"PBP 4a - 20% coinsurance to maximum $50, PBP 4b - 0%-20%"	"PBP 9a, 9b"		PBP 8b (Radiology)	20% coinsurance	PBP 12	"PBP 3, 8b (Radiation Therapy) 9a, 9d, 13a, 13b"		"PBP 4b, 7b, 7d, 7f, 7g, 17a (non-routine)"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g, 18a (non-routine)"	PBP 15						PBP 18a - routine					PBP  1a - Medicare FFS level desired per benefit period	PBP 1b - Medicare FFS level desired per benefit period	PBP 7f	"PBP 5, 9c"						1056	1056	132		0.1997	0.199496089	0.2	0.153776335	0.2		20	0.2	0.2	0.2		0.2	0.33	20	0.2	0.2	0.2						0.2					264	264	20	0.43						1056	1056	132		0.1997	0.199496089	0.2	0.153776335	0.2		20	0.2	0.2	0.2		0.2	0.33	20	0.2	0.2	0.2						0.2					264	264	20	0.43						27.8987	0.267385839	7.541460304	0	3.898961907	3.409033936	3.648217213	3.518655311	8.716806964	0	1.69215545	0	0.667769258	19.28397243	0	6.130476834	4.575994624	1.348408546	2.564967148	37.30438957	1.050801532	0	0	0	0	0	0.0002	0	0	0	0	5.316443617	3.523329581	0.748453238	0.600636977	0	0	0	0	0	143.7072			27.8987	0.267385839	7.541460304	0	3.898961907	3.409033936	3.648217213	3.518655311	8.716806964	0	1.69215545	0	0.667769258	19.28397243	0	6.130476834	4.575994624	1.348408546	2.564967148	37.30438957	1.050801532	0	0	0	0	0	0.0002	0	0	0	0	5.316443617	3.523329581	0.748453238	0.600636977	0	0	0	0	0	143.7072																																																																																		0			27.8987	0.267385839	7.541460304	0	3.898961907	3.409033936	3.648217213	3.518655311	8.716806964	0	1.69215545	0	0.667769258	19.28397243	0	6.130476834	4.575994624	1.348408546	2.564967148	37.30438957	1.050801532	0	0	0	0	0	0.0002	0	0	0	0	5.316443617	3.523329581	0.748453238	0.600636977	0	0	0	0	0	143.7072
H3952_020_0	2009	6																																A	A	D		T	Coin	Coin	V	V		V			V	V	V	V	V	V	V	S			V	V		V																																																						0		1440.237851	95.60994424	1420.45261		281.1218107	9.05666279	10.70596898	283.9601308	397.1644402		1141.916412			522.6158067	16744.60849	5625.250228	202.1699304	569.6227129	42.97499759	190.6661761	20.28730649			725.277	309.3520021		0.00001														$150 per day; 10 days max	$150 per day; 10 days max	$0 Days 1-7; $60 Days 8-20; $120 Days 21-100 (PBP 2)		$50 copay per trip	20% coinsurance	20% coinsurance	$50 copay per visit	$225 copay per visit		$30 copay per visit			$30 copay per visit	$5 copay per visit	$30 copay per visit	$30 copay per visit	$30 copay per visit	$30 copay per visit	$30 copay per visit	$25 per script for certain injectible drugs			$15 per visit	$30 copay per visit		$30 copay per visit														150	150	65.56185672		50	0.2	0.2	50	225		30			30	5	30	30	30	30	30	25			15	30		30														150	150	65.56185672		50	0.2	0.2	50	225		30			30	5	30	30	30	30	30	25			15	30		30														18.003	1.195124303	7.760625876	0	1.171340878	1.811332558	2.141193795	1.183167212	7.446833254	0	2.85479103	0	0	1.306539517	6.976920204	14.06312557	0.505424826	1.424056782	0.107437494	0.47666544	0.042265222	0	0	0.90659625	0.773380005	0	0.000000025	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1498			18.003	1.195124303	7.760625876	0	1.171340878	1.811332558	2.141193795	1.183167212	7.446833254	0	2.85479103	0	0	1.306539517	6.976920204	14.06312557	0.505424826	1.424056782	0.107437494	0.47666544	0.042265222	0	0	0.90659625	0.773380005	0	0.000000025	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1498																																																																																		0			18.003	1.195124303	7.760625876	0	1.171340878	1.811332558	2.141193795	1.183167212	7.446833254	0	2.85479103	0	0	1.306539517	6.976920204	14.06312557	0.505424826	1.424056782	0.107437494	0.47666544	0.042265222	0	0	0.90659625	0.773380005	0	0.000000025	0	0	0	0	0	0	0	0	0	0	0	0	0	70.1498
H3952_026_0	2009	7																																D	D	D		T	coin	coin	V	V		V			V	V	V	V	V	V	V	S			V	V		V																																																						0		1614.641861	92.96401516	1077.732821		229.9764395	6.071725975	7.676259148	260.4322354	404.8272027		1099.836129			261.931206	15926.11813	4222.873918	138.2726746	467.7789934	29.10200905	118.5949375	37.0039002			789.9255	277.4700329	0	0.00001														$225 per day; 10 days max	$225 per day; 10 days max	$0 Days 1-7; $60 Days 8-20; $120 Days 21-100 (PBP 2)		$100 copay per trip	20% coinsurance	20% coinsurance	$50 copay per visit	$275 Copay per visit		$40 copay per visit			$40 copay per visit	$5 copay per visit	$40 copay per visit	$40 copay per visit	$40 copay per visit	$40 copay per visit	$40 copay per visit	$25 per script			$15 per visit (PBP category 16A)	$40 copay per visit	$0 Copay	$40 copay per visit														225	225	65.56185672		100	0.2	0.2	50	275		40			40	5	40	40	40	40	40	25			15	40	0	40														225	225	65.56185672		100	0.2	0.2	50	275		40			40	5	40	40	40	40	40	25			15	40	0	40														30.2745	1.743075284	5.888180397	0	1.916470329	1.214345195	1.53525183	1.085134314	9.277290061	0	3.666120429	0	0	0.87310402	6.635882555	14.07624639	0.460908915	1.559263311	0.097006697	0.395316458	0.077091459	0	0	0.987406875	0.92490011	0	3.33E-08	0	0	0	0	0	0	0	0	0	0	0	0	0	82.6875			30.2745	1.743075284	5.888180397	0	1.916470329	1.214345195	1.53525183	1.085134314	9.277290061	0	3.666120429	0	0	0.87310402	6.635882555	14.07624639	0.460908915	1.559263311	0.097006697	0.395316458	0.077091459	0	0	0.987406875	0.92490011	0	3.33E-08	0	0	0	0	0	0	0	0	0	0	0	0	0	82.6875																																																																																		0			30.2745	1.743075284	5.888180397	0	1.916470329	1.214345195	1.53525183	1.085134314	9.277290061	0	3.666120429	0	0	0.87310402	6.635882555	14.07624639	0.460908915	1.559263311	0.097006697	0.395316458	0.077091459	0	0	0.987406875	0.92490011	0	3.33E-08	0	0	0	0	0	0	0	0	0	0	0	0	0	82.6875
H3952_040_0	2009	7																																D	D	D		T	coin	coin	V	V		V			V	V	V	V	V	V	V	S			V	V		V																																																						0		2108.073106	92.21866794	1332.630213		267.4602703	8.93770927	9.588054249	306.7154838	407.6766855		1132.581948			330.9750769	16068.14432	4452.934276	138.2726746	488.0668856	28.37385149	130.9947153	15.27136273			789.9255	277.4700329		0.00001														$225 per day; 10 days max	$225 per day; 10 days max	$0 Days 1-7; $60 Days 8-20; $120 Days 21-100 (PBP 2)		$100 copay per trip	20% coinsurance	20% coinsurance	$50 copay per visit	$275 Copay per visit		$40 copay per visit			$40 copay per visit	$5 copay per visit	$40 copay per visit	$40 copay per visit	$40 copay per visit	$40 copay per visit	$40 copay per visit	$25 per script			$15 per visit (PBP category 16A)	$40 copay per visit		$40 copay per visit														225	225	65.56185672		100	0.2	0.2	50	275		40			40	5	40	40	40	40	40	25			15	40		40														225	225	65.56185672		100	0.2	0.2	50	275		40			40	5	40	40	40	40	40	25			15	40		40														39.5264	1.729100024	7.280809258	0	2.228835586	1.787541854	1.91761085	1.277981182	9.34259071	0	3.77527316	0	0	1.103250256	6.695060135	14.84311425	0.460908915	1.626889619	0.094579505	0.436649051	0.031815339	0	0	0.987406875	0.92490011	0	3.33E-08	0	0	0	0	0	0	0	0	0	0	0	0	0	96.0707			39.5264	1.729100024	7.280809258	0	2.228835586	1.787541854	1.91761085	1.277981182	9.34259071	0	3.77527316	0	0	1.103250256	6.695060135	14.84311425	0.460908915	1.626889619	0.094579505	0.436649051	0.031815339	0	0	0.987406875	0.92490011	0	3.33E-08	0	0	0	0	0	0	0	0	0	0	0	0	0	96.0707																																																																																		0			39.5264	1.729100024	7.280809258	0	2.228835586	1.787541854	1.91761085	1.277981182	9.34259071	0	3.77527316	0	0	1.103250256	6.695060135	14.84311425	0.460908915	1.626889619	0.094579505	0.436649051	0.031815339	0	0	0.987406875	0.92490011	0	3.33E-08	0	0	0	0	0	0	0	0	0	0	0	0	0	96.0707
H3952_042_0	2009	5																																D	D	D		T	Coin	Coin	V	V		V			V	V	V	V	V	V	V	S			V	V		V																																																						0		1370.92822	79.27595691	1164.099057		244.2877192	7.382268198	8.549827943	244.9020815	328.3840882		955.3007807			377.8192054	13964.86379	4415.363151	156.8351602	450.8549267	31.84824374	131.8096808	9.858268284			627.5937872	254.3046829		8.45E-06														"$200/day, 10 day max  (PBP 1a)"	"$200/day, 10 day max  (PBP 1b)"	$0 Days 1-7; $60 Days 8-20; $120 Days 21-100 (PBP 2)		50 per trip (PBP category 10)	20% coinsurance (PBP category 11A)	20% coinsurance (PBP category 11B)	$50 per visit (PBP category 4A)	$250/visit (PBP categories 9A and 9B)		$30 per visit (PBP category 8B)			"$30 per visit (PBP categories3,5,9C,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 )"	$30 per visit (PBP categories 7C and 7I)	$30 per visit (PBP 7D)	$30 per visit (PBP category 7D)	$25 per script for certain injectible drugs (PBP category 15)	$0 Copay		$15 per visit (PBP category 16A)	$30 per visit (PBP category 17A)		$30 per visit (PBP category 18A)														200	200	65.56185672		50	0.2	0.2	50	250		30			30	10	30	30	30	30	30	25	0	0	15	30		30														200	200	65.56185672		50	0.2	0.2	50	250		30			30	10	30	30	30	30	30	25	0	0	15	30		30														22.8488	1.321265949	6.3600413	0	1.017865497	1.47645364	1.709965589	1.02042534	6.841335172	0	2.388251952	0	0	0.944548013	11.63738649	11.03840788	0.392087901	1.127137317	0.079620609	0.329524202	0.020538059	0	0	0.784492234	0.635761707	0	2.11E-08	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9739			22.8488	1.321265949	6.3600413	0	1.017865497	1.47645364	1.709965589	1.02042534	6.841335172	0	2.388251952	0	0	0.944548013	11.63738649	11.03840788	0.392087901	1.127137317	0.079620609	0.329524202	0.020538059	0	0	0.784492234	0.635761707	0	2.11E-08	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9739																																																																																		0			22.8488	1.321265949	6.3600413	0	1.017865497	1.47645364	1.709965589	1.02042534	6.841335172	0	2.388251952	0	0	0.944548013	11.63738649	11.03840788	0.392087901	1.127137317	0.079620609	0.329524202	0.020538059	0	0	0.784492234	0.635761707	0	2.11E-08	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9739
H3952_043_0	2009	6																																D	D	D		T	Coin	Coin	V	V		V			V	V	V	V	V	V	V	S			V	V		V																																																						0		1370.92822	79.27595691	1164.099057		244.2877192	7.382268198	8.549827943	244.9020815	328.3840882		955.3007807			377.8192054	13964.86379	4415.363151	156.8351602	450.8549267	31.84824374	131.8096808	9.858268284			627.5937872	254.3046829		8.45E-06														"$200/day, 10 day max  (PBP 1a)"	"$200/day, 10 day max  (PBP 1b)"	$0 Days 1-7; $60 Days 8-20; $120 Days 21-100 (PBP 2)		50 per trip (PBP category 10)	20% coinsurance (PBP category 11A)	20% coinsurance (PBP category 11B)	$50 per visit (PBP category 4A)	$250/visit (PBP categories 9A and 9B)		$30 per visit (PBP category 8B)			"$30 per visit (PBP categories 3,5,9C,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)"	$30 per visit (PBP categories 7C and 7I)	$30 per visit (PBP category 7D)	$30 per visit (PBP category 7D)	$25 per script for certain injectible drugs (PBP category 15)			$15 per visit (PBP category 16A)	$30 per visit (PBP category 17A)		$30 per visit (PBP category 18A)														200	200	65.56185672		50	0.2	0.2	50	250		30			30	10	30	30	30	30	30	25			15	30		30														200	200	65.56185672		50	0.2	0.2	50	250		30			30	10	30	30	30	30	30	25			15	30		30														22.8488	1.321265949	6.3600413	0	1.017865497	1.47645364	1.709965589	1.02042534	6.841335172	0	2.388251952	0	0	0.944548013	11.63738649	11.03840788	0.392087901	1.127137317	0.079620609	0.329524202	0.020538059	0	0	0.784492234	0.635761707	0	2.11E-08	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9739			22.8488	1.321265949	6.3600413	0	1.017865497	1.47645364	1.709965589	1.02042534	6.841335172	0	2.388251952	0	0	0.944548013	11.63738649	11.03840788	0.392087901	1.127137317	0.079620609	0.329524202	0.020538059	0	0	0.784492234	0.635761707	0	2.11E-08	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9739																																																																																		0			22.8488	1.321265949	6.3600413	0	1.017865497	1.47645364	1.709965589	1.02042534	6.841335172	0	2.388251952	0	0	0.944548013	11.63738649	11.03840788	0.392087901	1.127137317	0.079620609	0.329524202	0.020538059	0	0	0.784492234	0.635761707	0	2.11E-08	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9739
H3952_802_0	2009	5																																coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin																																																											0		347.7139721	6.41496887	36.84894285	13.91170551	8.506765549	9.801071895	11.161265	7.577386969	55.0119007	1.214940855	25.12859968	0	1.258529063	99.84531715	51.77283714	38.87009167	2.41427697	2.413415904	15.35705586	242.7328181	4.760314337	1.954156569																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			0.0702	0.0702	0.1592	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.0702	0.0702	0.1592	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			24.4095	0.450330815	5.866351702	0	1.965062842	2.264047608	2.578252214	1.75037639	12.70774906	0.280651338	5.804706525	0	0.290720214	23.06426826	11.95952538	8.978991177	0.55769798	0.557499074	3.547479903	56.07128097	1.099632612	0.451410167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	164.6556			24.4095	0.450330815	5.866351702	0	1.965062842	2.264047608	2.578252214	1.75037639	12.70774906	0.280651338	5.804706525	0	0.290720214	23.06426826	11.95952538	8.978991177	0.55769798	0.557499074	3.547479903	56.07128097	1.099632612	0.451410167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	164.6556																																																																																		0			24.4095	0.450330815	5.866351702	0	1.965062842	2.264047608	2.578252214	1.75037639	12.70774906	0.280651338	5.804706525	0	0.290720214	23.06426826	11.95952538	8.978991177	0.55769798	0.557499074	3.547479903	56.07128097	1.099632612	0.451410167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	164.6556
H3952_804_0	2009	5																																coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin																																																											0		347.7139721	6.41496887	36.84894285	13.91170551	8.506765549	9.801071895	11.161265	7.577386969	55.0119007	1.214940855	25.12859968	0	1.258529063	99.84531715	51.77283714	38.87009167	2.41427697	2.413415904	15.35705586	242.7328181	4.760314337	1.954156569																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			0.0702	0.0702	0.1592	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.0702	0.0702	0.1592	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			24.4095	0.450330815	5.866351702	0	1.965062842	2.264047608	2.578252214	1.75037639	12.70774906	0.280651338	5.804706525	0	0.290720214	23.06426826	11.95952538	8.978991177	0.55769798	0.557499074	3.547479903	56.07128097	1.099632612	0.451410167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	164.6556			24.4095	0.450330815	5.866351702	0	1.965062842	2.264047608	2.578252214	1.75037639	12.70774906	0.280651338	5.804706525	0	0.290720214	23.06426826	11.95952538	8.978991177	0.55769798	0.557499074	3.547479903	56.07128097	1.099632612	0.451410167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	164.6556																																																																																		0			24.4095	0.450330815	5.866351702	0	1.965062842	2.264047608	2.578252214	1.75037639	12.70774906	0.280651338	5.804706525	0	0.290720214	23.06426826	11.95952538	8.978991177	0.55769798	0.557499074	3.547479903	56.07128097	1.099632612	0.451410167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	164.6556
H3954_003_0	2009	3																					None											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	N/A	1180.541147	28.21569972	1112.979605	10.52284493	138.2749695	10.50722032	7.427871491	319.9742632	301.4398846	50.12413926	1179.583403	33.08491904	0.835542528	958.0154001	4703.016994	2787.987155	127.3645471	0	652.7864322	5.632480741	2.737644324	0.894006361	0	909.3044836	812.6159257	3.935139265	1.089527484	1.260140122	3.043536225	0											$50 Copay Days 1-5 (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	$25 Copay Days 11-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	10% Coinsurance (PBP 11a)	"CIF (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$50 Copay (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"10% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											4.9189	0.117565415	2.31870751	0	0.576145706	1.050722032	0	1.333226097	1.255999519	0	2.948958506	0.068926915	0	0.798346167	3.919180828	4.646645258	0.212274245	0	1.142376256	0	0.273764432	0	0	1.515507473	1.354359876	0	0.001815879	0	0	0	0	0	0	0	0	0	0	0	0	0	28.4534	None	0	4.9189	0.117565415	2.31870751	0	0.576145706	1.050722032	0	1.333226097	1.255999519	0	2.948958506	0.068926915	0	0.798346167	3.919180828	4.646645258	0.212274245	0	1.142376256	0	0.273764432	0	0	1.515507473	1.354359876	0	0.001815879	0	0	0	0	0	0	0	0	0	0	0	0	0	28.4534	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											0	0	0	0	0	0	0	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	4.9189	0.117565415	2.31870751	0	0.576145706	1.050722032	0	1.333226097	1.255999519	0	2.948958506	0.068926915	0	0.798346167	3.919180828	4.646645258	0.212274245	0	1.142376256	0	0.273764432	0	0	1.515507473	1.354359876	0	0.001815879	0	0	0	0	0	0	0	0	0	0	0	0	0	28.4534
H3954_004_0	2009	2																					None											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	N/A	1404.573678	24.69001293	1635.653425	14.38875801	213.950133	12.40406464	2.054985964	223.315824	219.9615152	42.45578725	641.5869219	3.748398043	1.749219061	475.7823574	4697.318356	3822.882593	122.674176	0	717.3456586	5.032105688	2.059699844	1.066625463	0	907	727.6173941	3.973711736	1.790872982	1.056897842	3.703431916	0											$50 Copay Days 1-5 (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	$25 Copay Days 11-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	10% Coinsurance (PBP 11a)	"CIF (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$50 Copay (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"10% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											5.8524	0.102875054	3.407611301	0	0.891458887	1.240406464	0	0.9304826	0.916506313	0	1.603967305	0.007809163	0	0.396485298	3.914431963	6.371470989	0.20445696	0	1.255354903	0	0.205969984	0	0	1.511666667	1.212695657	0	0.002984788	0	0	0	0	0	0	0	0	0	0	0	0	0	30.029	None	0	5.8524	0.102875054	3.407611301	0	0.891458887	1.240406464	0	0.9304826	0.916506313	0	1.603967305	0.007809163	0	0.396485298	3.914431963	6.371470989	0.20445696	0	1.255354903	0	0.205969984	0	0	1.511666667	1.212695657	0	0.002984788	0	0	0	0	0	0	0	0	0	0	0	0	0	30.029	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											0	0	0	0	0	0	0	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	5.8524	0.102875054	3.407611301	0	0.891458887	1.240406464	0	0.9304826	0.916506313	0	1.603967305	0.007809163	0	0.396485298	3.914431963	6.371470989	0.20445696	0	1.255354903	0	0.205969984	0	0	1.511666667	1.212695657	0	0.002984788	0	0	0	0	0	0	0	0	0	0	0	0	0	30.029
H3954_005_0	2009	3																					None											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	N/A	1489.042318	27.79508763	1271.227407	18.71739989	99.91059551	12.02626329	8.684992272	208.1876862	263.2754379	45.33999732	840.6687739	13.50100184	0.914188394	746.4507571	4104.067006	4042.842387	119.9921393	0	812.7775209	7.327741698	2.109869904	1.139120809	0	913.1511358	659.3914362	3.288739661	1.648868173	1.245737963	3.017253549	0											$50 Copay Days 1-5 (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	$25 Copay Days 11-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	10% Coinsurance (PBP 11a)	"CIF (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$50 Copay (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"10% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											6.2043	0.115812865	2.648390431	0	0.416294148	1.202626329	0	0.867448692	1.096980991	0	2.101671935	0.028127087	0	0.622042298	3.420055838	6.738070645	0.199986899	0	1.422360662	0	0.21098699	0	0	1.52191856	1.098985727	0	0.002748114	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9189	None	0	6.2043	0.115812865	2.648390431	0	0.416294148	1.202626329	0	0.867448692	1.096980991	0	2.101671935	0.028127087	0	0.622042298	3.420055838	6.738070645	0.199986899	0	1.422360662	0	0.21098699	0	0	1.52191856	1.098985727	0	0.002748114	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9189	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											0	0	0	0	0	0	0	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	6.2043	0.115812865	2.648390431	0	0.416294148	1.202626329	0	0.867448692	1.096980991	0	2.101671935	0.028127087	0	0.622042298	3.420055838	6.738070645	0.199986899	0	1.422360662	0	0.21098699	0	0	1.52191856	1.098985727	0	0.002748114	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9189
H3954_007_0	2009	3																					None											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	N/A	1085.689301	25.82123971	929.673844	12.50413351	205.0294726	12.89361362	9.100219464	319.88567	326.105122	36.87741932	793.9701739	58.69978224	1.457141596	538.7739024	3563.705692	3573.383186	123.3824417	0	628.1465235	12.31950351	2.243226146	0.958999517	0	907	606.4799393	3.368343197	1.016680976	0.964612962	3.676859485	0											$50 Copay Days 1-5 (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	$25 Copay Days 11-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	10% Coinsurance (PBP 11a)	"CIF (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$50 Copay (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"10% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											4.5237	0.107588499	1.936820508	0	0.854289469	1.289361362	0	1.332856958	1.358771342	0	1.984925435	0.122291213	0	0.448978252	2.969754743	5.955638643	0.205637403	0	1.099256416	0	0.224322615	0	0	1.511666667	1.010799899	0	0.001694468	0	0	0	0	0	0	0	0	0	0	0	0	0	26.9384	None	0	4.5237	0.107588499	1.936820508	0	0.854289469	1.289361362	0	1.332856958	1.358771342	0	1.984925435	0.122291213	0	0.448978252	2.969754743	5.955638643	0.205637403	0	1.099256416	0	0.224322615	0	0	1.511666667	1.010799899	0	0.001694468	0	0	0	0	0	0	0	0	0	0	0	0	0	26.9384	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											0	0	0	0	0	0	0	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	4.5237	0.107588499	1.936820508	0	0.854289469	1.289361362	0	1.332856958	1.358771342	0	1.984925435	0.122291213	0	0.448978252	2.969754743	5.955638643	0.205637403	0	1.099256416	0	0.224322615	0	0	1.511666667	1.010799899	0	0.001694468	0	0	0	0	0	0	0	0	0	0	0	0	0	26.9384
H3954_009_0	2009	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	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	0	0											0	N/A	185.8899907	24.69001293	19.51128654	11.1496556	110.1559653	10.76905974	7.994293466	301.842148	52.39787878	39.19292076	43.63609451	2.897537681	0.029875141	27.45010084	5321.644602	8299.651489	122.674176	0	15.20923191	2.676524567	5.333718139	0.909827426	0	909.3044836	1012.909383	4.16147933	16.01395025	1.186302073	3.176678035	0											15% Coinsurance (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	15% Coinsurance (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	15% Coinsurance (PBP 11a)	"15% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"15% Coinsurance (PBP 9a, 9b)"	15% Coinsurance (PBP 8a)	"$15 General, 15% CT/MRI/PT (PBP 8b)"	15% Coinsurance (PBP 5)	15% Coinsurance (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit), Other Services 15% Coinsurance (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, 15% Office CT/MRI/PT (PBP 7d)"	"Inpatient Professional CIF, Other Professional 15% Coinsurance (PBP 7g)"	"15% Coinsurance, $1000 OOP Max (PBP 15)"	15% Coinsurance (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0.15	50	0.15	0	50	0.15	0.15	50	0.15	0.15	0.11	0.15	0.15	0.15	10	20	20	10	0.15	0.15	0.15	0.15	0	20	20	0	20	0	0	0											0.10185	50	0.10185	0	50	0.116005018	0.10185	50	0.109422171	0.10185	0.095599053	0.10185	0.10185	0.112225909	10	20	20	10	0.10185	0.106840391	0.10185	0.121076599	0	20	20	0	20	0	0	0											18.9329	0.102875054	1.987224534	0	0.458983189	1.249264967	0.81421879	1.257675617	5.733489668	3.99179898	4.171569313	0.295114213	0.003042783	3.080612513	4.434703835	13.83275248	0.20445696	0	1.54906027	0.285960932	0.543239192	0.110158811	0	1.515507473	1.688182305	0	0.026689917	0	0	0	0	0	0	0	0	0	0	0	0	0	66.2695	None	17.5917	18.9329	0.102875054	1.987224534	0	0.458983189	1.249264967	0.81421879	1.257675617	5.733489668	3.99179898	4.171569313	0.295114213	0.003042783	3.080612513	4.434703835	13.83275248	0.20445696	0	1.54906027	0.285960932	0.543239192	0.110158811	0	1.515507473	1.688182305	0	0.026689917	0	0	0	0	0	0	0	0	0	0	0	0	0	66.2695		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	N/A	0	18.9329	0.102875054	1.987224534	0	0.458983189	1.249264967	0.81421879	1.257675617	5.733489668	3.99179898	4.171569313	0.295114213	0.003042783	3.080612513	4.434703835	13.83275248	0.20445696	0	1.54906027	0.285960932	0.543239192	0.110158811	0	1.515507473	1.688182305	0	0.026689917	0	0	0	0	0	0	0	0	0	0	0	0	0	66.2695
H3954_010_0	2009	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	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	0	0											0	N/A	213.6917906	24.69001293	31.7387838	14.38875801	185.1520481	12.0970595	1.60139771	224.920587	48.24023159	33.63675061	45.51185938	0.544934758	0.063372676	22.4463149	5518.419613	11815.59113	122.674176	0	26.0585829	2.482656749	3.079347975	1.035180853	0	907	857.6314573	3.973711736	27.96073729	1.056897842	3.703431916	0											15% Coinsurance (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	15% Coinsurance (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	15% Coinsurance (PBP 11a)	"15% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"15% Coinsurance (PBP 9a, 9b)"	15% Coinsurance (PBP 8a)	"$15 General, 15% CT/MRI/PT (PBP 8b)"	15% Coinsurance (PBP 5)	15% Coinsurance (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit), Other Services 15% Coinsurance (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, 15% Office CT/MRI/PT (PBP 7d)"	"Inpatient Professional CIF, Other Professional 15% Coinsurance (PBP 7g)"	"15% Coinsurance, $1000 OOP Max (PBP 15)"	15% Coinsurance (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0.15	50	0.15	0	50	0.15	0.15	50	0.15	0.15	0.11	0.15	0.15	0.15	10	20	20	10	0.15	0.15	0.15	0.15	0	20	20	0	20	0	0	0											0.10185	50	0.10185	0	50	0.116005018	0.10185	50	0.109422171	0.10185	0.095599053	0.10185	0.10185	0.112225909	10	20	20	10	0.10185	0.106840391	0.10185	0.121076599	0	20	20	0	20	0	0	0											21.7645	0.102875054	3.23259513	0	0.771466867	1.403319602	0.163102357	0.937169112	5.278550885	3.42590305	4.350890659	0.055501605	0.006454507	2.519058089	4.598683011	19.69265188	0.20445696	0	2.654066668	0.265248019	0.313631591	0.125336177	0	1.511666667	1.429385762	0	0.046601229	0	0	0	0	0	0	0	0	0	0	0	0	0	74.8531	None	18.9556	21.7645	0.102875054	3.23259513	0	0.771466867	1.403319602	0.163102357	0.937169112	5.278550885	3.42590305	4.350890659	0.055501605	0.006454507	2.519058089	4.598683011	19.69265188	0.20445696	0	2.654066668	0.265248019	0.313631591	0.125336177	0	1.511666667	1.429385762	0	0.046601229	0	0	0	0	0	0	0	0	0	0	0	0	0	74.8531		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	N/A	0	21.7645	0.102875054	3.23259513	0	0.771466867	1.403319602	0.163102357	0.937169112	5.278550885	3.42590305	4.350890659	0.055501605	0.006454507	2.519058089	4.598683011	19.69265188	0.20445696	0	2.654066668	0.265248019	0.313631591	0.125336177	0	1.511666667	1.429385762	0	0.046601229	0	0	0	0	0	0	0	0	0	0	0	0	0	74.8531
H3954_011_0	2009	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	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	0	0											0	N/A	200.4968408	24.69001293	20.82514671	15.81860839	80.88205885	11.32426933	6.472501593	199.8394355	36.7896574	31.06807906	28.38335718	0.836633285	0.027689511	18.33999032	4916.741074	15612.28058	122.674176	0	30.19171896	4.163705217	3.604412248	1.284190017	0	912.9204931	800.7214164	3.329765536	26.27233543	1.350856797	3.907234083	0											15% Coinsurance (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	15% Coinsurance (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	15% Coinsurance (PBP 11a)	"15% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"15% Coinsurance (PBP 9a, 9b)"	15% Coinsurance (PBP 8a)	"$15 General, 15% CT/MRI/PT (PBP 8b)"	15% Coinsurance (PBP 5)	15% Coinsurance (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit), Other Services 15% Coinsurance (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, 15% Office CT/MRI/PT (PBP 7d)"	"Inpatient Professional CIF, Other Professional 15% Coinsurance (PBP 7g)"	"15% Coinsurance, $1000 OOP Max (PBP 15)"	15% Coinsurance (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0.15	50	0.15	0	50	0.15	0.15	50	0.15	0.15	0.11	0.15	0.15	0.15	10	20	20	10	0.15	0.15	0.15	0.15	0	20	20	0	20	0	0	0											0.10185	50	0.10185	0	50	0.116005018	0.10185	50	0.109422171	0.10185	0.095599053	0.10185	0.10185	0.112225909	10	20	20	10	0.10185	0.106840391	0.10185	0.121076599	0	20	20	0	20	0	0	0											20.4206	0.102875054	2.121041193	0	0.337008579	1.313672065	0.659224287	0.832664315	4.025604194	3.164283853	2.713422069	0.0852111	0.002820177	2.058222081	4.097284228	26.02046763	0.20445696	0	3.075026576	0.444851895	0.367109387	0.15548536	0	1.521534155	1.334535694	0	0.043787226	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1012	None	17.3293	20.4206	0.102875054	2.121041193	0	0.337008579	1.313672065	0.659224287	0.832664315	4.025604194	3.164283853	2.713422069	0.0852111	0.002820177	2.058222081	4.097284228	26.02046763	0.20445696	0	3.075026576	0.444851895	0.367109387	0.15548536	0	1.521534155	1.334535694	0	0.043787226	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1012		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	N/A	0	20.4206	0.102875054	2.121041193	0	0.337008579	1.313672065	0.659224287	0.832664315	4.025604194	3.164283853	2.713422069	0.0852111	0.002820177	2.058222081	4.097284228	26.02046763	0.20445696	0	3.075026576	0.444851895	0.367109387	0.15548536	0	1.521534155	1.334535694	0	0.043787226	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1012
H3954_012_0	2009	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	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	0	0											0	N/A	189.9524812	24.69001293	23.64952717	19.35250352	110.2330512	10.04751106	8.070592133	281.1273245	53.28732179	53.34928956	66.65323448	3.11914266	0.051373031	32.12530173	4953.244849	7321.725531	122.674176	0.274654128	22.05761969	2.797334089	5.427401914	0.98247051	0	913.5916991	879.3993884	3.840778067	28.75093656	1.227435408	2.934700447	0											15% Coinsurance (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	15% Coinsurance (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	15% Coinsurance (PBP 11a)	"15% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"15% Coinsurance (PBP 9a, 9b)"	15% Coinsurance (PBP 8a)	"$15 General, 15% CT/MRI/PT (PBP 8b)"	15% Coinsurance (PBP 5)	15% Coinsurance (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit), Other Services 15% Coinsurance (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, 15% Office CT/MRI/PT (PBP 7d)"	"Inpatient Professional CIF, Other Professional 15% Coinsurance (PBP 7g)"	"15% Coinsurance, $1000 OOP Max (PBP 15)"	15% Coinsurance (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0.15	50	0.15	0	50	0.15	0.15	50	0.15	0.15	0.11	0.15	0.15	0.15	10	20	20	10	0.15	0.15	0.15	0.15	0	20	20	0	20	0	0	0											0.10185	50	0.10185	0	50	0.116005018	0.10185	50	0.109422171	0.10185	0.095599053	0.10185	0.10185	0.112225909	10	20	20	10	0.10185	0.106840391	0.10185	0.121076599	0	20	20	0	20	0	0	0											19.3467	0.102875054	2.408704342	0	0.45930438	1.165561698	0.821989809	1.171363852	5.830814453	5.433625142	6.371986099	0.31768468	0.005232343	3.605291182	4.127704041	12.20287589	0.20445696	0.000228878	2.246568565	0.298868269	0.552780885	0.118954188	0	1.522652832	1.465665647	0	0.047918228	0	0	0	0	0	0	0	0	0	0	0	0	0	69.8298	None	19.5447	19.3467	0.102875054	2.408704342	0	0.45930438	1.165561698	0.821989809	1.171363852	5.830814453	5.433625142	6.371986099	0.31768468	0.005232343	3.605291182	4.127704041	12.20287589	0.20445696	0.000228878	2.246568565	0.298868269	0.552780885	0.118954188	0	1.522652832	1.465665647	0	0.047918228	0	0	0	0	0	0	0	0	0	0	0	0	0	69.8298		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	N/A	0	19.3467	0.102875054	2.408704342	0	0.45930438	1.165561698	0.821989809	1.171363852	5.830814453	5.433625142	6.371986099	0.31768468	0.005232343	3.605291182	4.127704041	12.20287589	0.20445696	0.000228878	2.246568565	0.298868269	0.552780885	0.118954188	0	1.522652832	1.465665647	0	0.047918228	0	0	0	0	0	0	0	0	0	0	0	0	0	69.8298
H3954_013_0	2009	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	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	0	0											0	N/A	183.2185386	24.69001293	18.37184819	12.72142588	157.4414194	11.55018294	6.574212342	302.4505377	48.07173815	29.20701911	40.90431474	3.730430217	0.052772683	22.18054983	4162.615961	10981.05008	122.674176	0	18.73534491	6.04310192	4.932282652	0.992905805	0	907	749.5522566	3.5318657	19.88268398	1.208257699	3.766314869	0											15% Coinsurance (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	15% Coinsurance (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	15% Coinsurance (PBP 11a)	"15% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"15% Coinsurance (PBP 9a, 9b)"	15% Coinsurance (PBP 8a)	"$15 General, 15% CT/MRI/PT (PBP 8b)"	15% Coinsurance (PBP 5)	15% Coinsurance (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit), Other Services 15% Coinsurance (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, 15% Office CT/MRI/PT (PBP 7d)"	"Inpatient Professional CIF, Other Professional 15% Coinsurance (PBP 7g)"	"15% Coinsurance, $1000 OOP Max (PBP 15)"	15% Coinsurance (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0.15	50	0.15	0	50	0.15	0.15	50	0.15	0.15	0.11	0.15	0.15	0.15	10	20	20	10	0.15	0.15	0.15	0.15	0	20	20	0	20	0	0	0											0.10185	50	0.10185	0	50	0.116005018	0.10185	50	0.109422171	0.10185	0.095599053	0.10185	0.10185	0.112225909	10	20	20	10	0.10185	0.106840391	0.10185	0.121076599	0	20	20	0	20	0	0	0											18.6608	0.102875054	1.871172738	0	0.656005914	1.339879177	0.669583527	1.260210574	5.260113967	2.974734897	3.910413755	0.379944318	0.005374898	2.489232362	3.468846634	18.30175013	0.20445696	0	1.908194879	0.645647374	0.502352988	0.120217658	0	1.511666667	1.249253761	0	0.033137807	0	0	0	0	0	0	0	0	0	0	0	0	0	67.5259	None	16.8109	18.6608	0.102875054	1.871172738	0	0.656005914	1.339879177	0.669583527	1.260210574	5.260113967	2.974734897	3.910413755	0.379944318	0.005374898	2.489232362	3.468846634	18.30175013	0.20445696	0	1.908194879	0.645647374	0.502352988	0.120217658	0	1.511666667	1.249253761	0	0.033137807	0	0	0	0	0	0	0	0	0	0	0	0	0	67.5259		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	N/A	0	18.6608	0.102875054	1.871172738	0	0.656005914	1.339879177	0.669583527	1.260210574	5.260113967	2.974734897	3.910413755	0.379944318	0.005374898	2.489232362	3.468846634	18.30175013	0.20445696	0	1.908194879	0.645647374	0.502352988	0.120217658	0	1.511666667	1.249253761	0	0.033137807	0	0	0	0	0	0	0	0	0	0	0	0	0	67.5259
H3954_015_0	2009	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	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	0	0											0	N/A	166.7683181	24.69001293	14.69206384	8.71700689	177.9647136	11.47289834	8.699985176	244.2007395	47.06385569	25.02168324	48.10217547	3.636953936	0.012078086	19.6613894	5460.227051	9706.484986	122.674176	0	13.88907806	2.827453995	4.60439086	0.602688069	0	907	890.9274055	3.682091198	16.19139059	1.329149228	3.209773554	0											15% Coinsurance (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	15% Coinsurance (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	15% Coinsurance (PBP 11a)	"15% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"15% Coinsurance (PBP 9a, 9b)"	15% Coinsurance (PBP 8a)	"$15 General, 15% CT/MRI/PT (PBP 8b)"	15% Coinsurance (PBP 5)	15% Coinsurance (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit), Other Services 15% Coinsurance (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, 15% Office CT/MRI/PT (PBP 7d)"	"Inpatient Professional CIF, Other Professional 15% Coinsurance (PBP 7g)"	"15% Coinsurance, $1000 OOP Max (PBP 15)"	15% Coinsurance (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0.15	50	0.15	0	50	0.15	0.15	50	0.15	0.15	0.11	0.15	0.15	0.15	10	20	20	10	0.15	0.15	0.15	0.15	0	20	20	0	20	0	0	0											0.10185	50	0.10185	0	50	0.116005018	0.10185	50	0.109422171	0.10185	0.095599053	0.10185	0.10185	0.112225909	10	20	20	10	0.10185	0.106840391	0.10185	0.121076599	0	20	20	0	20	0	0	0											16.9854	0.102875054	1.496386702	0	0.74151964	1.330913775	0.88609349	1.017503081	5.149829279	2.548458438	4.598522424	0.370423758	0.001230153	2.206517293	4.550189209	16.17747498	0.20445696	0	1.414602601	0.302086291	0.468957209	0.072971422	0	1.511666667	1.484879009	0	0.026985651	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6499	None	15.3018	16.9854	0.102875054	1.496386702	0	0.74151964	1.330913775	0.88609349	1.017503081	5.149829279	2.548458438	4.598522424	0.370423758	0.001230153	2.206517293	4.550189209	16.17747498	0.20445696	0	1.414602601	0.302086291	0.468957209	0.072971422	0	1.511666667	1.484879009	0	0.026985651	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6499		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	N/A	0	16.9854	0.102875054	1.496386702	0	0.74151964	1.330913775	0.88609349	1.017503081	5.149829279	2.548458438	4.598522424	0.370423758	0.001230153	2.206517293	4.550189209	16.17747498	0.20445696	0	1.414602601	0.302086291	0.468957209	0.072971422	0	1.511666667	1.484879009	0	0.026985651	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6499
H3954_018_0	2009	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	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	0	0											0	N/A	192.1666386	24.69001293	9.379366082	8.884105779	122.6161544	10.35851501	5.584340891	219.2337625	51.05168864	54.43601696	48.6066103	1.219411518	0	20.92063036	3990.66051	9871.665559	122.674176	0	24.55324594	5.882162066	4.647227589	0.86756515	0	910.6235131	1231.074012	3.712958545	23.14558528	1.123639702	3.672073652	0											15% Coinsurance (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	15% Coinsurance (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	15% Coinsurance (PBP 11a)	"15% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"15% Coinsurance (PBP 9a, 9b)"	15% Coinsurance (PBP 8a)	"$15 General, 15% CT/MRI/PT (PBP 8b)"	15% Coinsurance (PBP 5)	15% Coinsurance (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit), Other Services 15% Coinsurance (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, 15% Office CT/MRI/PT (PBP 7d)"	"Inpatient Professional CIF, Other Professional 15% Coinsurance (PBP 7g)"	"15% Coinsurance, $1000 OOP Max (PBP 15)"	15% Coinsurance (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0.15	50	0.15	0	50	0.15	0.15	50	0.15	0.15	0.11	0.15	0.15	0.15	10	20	20	10	0.15	0.15	0.15	0.15	0	20	20	0	20	0	0	0											0.10185	50	0.10185	0	50	0.116005018	0.10185	50	0.109422171	0.10185	0.095599053	0.10185	0.10185	0.112225909	10	20	20	10	0.10185	0.106840391	0.10185	0.121076599	0	20	20	0	20	0	0	0											19.5722	0.102875054	0.955288435	0	0.510900643	1.201639717	0.56876512	0.91347401	5.58618662	5.544308327	4.646745916	0.124197063	0	2.347836755	3.325550425	16.45277593	0.20445696	0	2.500748099	0.628452497	0.47332013	0.105041838	0	1.517705855	2.051790021	0	0.038575975	0	0	0	0	0	0	0	0	0	0	0	0	0	69.3728	None	18.252	19.5722	0.102875054	0.955288435	0	0.510900643	1.201639717	0.56876512	0.91347401	5.58618662	5.544308327	4.646745916	0.124197063	0	2.347836755	3.325550425	16.45277593	0.20445696	0	2.500748099	0.628452497	0.47332013	0.105041838	0	1.517705855	2.051790021	0	0.038575975	0	0	0	0	0	0	0	0	0	0	0	0	0	69.3728		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	N/A	0	19.5722	0.102875054	0.955288435	0	0.510900643	1.201639717	0.56876512	0.91347401	5.58618662	5.544308327	4.646745916	0.124197063	0	2.347836755	3.325550425	16.45277593	0.20445696	0	2.500748099	0.628452497	0.47332013	0.105041838	0	1.517705855	2.051790021	0	0.038575975	0	0	0	0	0	0	0	0	0	0	0	0	0	69.3728
H3954_019_0	2009	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	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	0	0											0	N/A	174.2224651	24.69001293	18.65190116	9.978379241	81.16684232	9.583575393	4.636292494	387.1341704	48.24767432	44.50626238	49.657995	1.183782457	0.014190745	23.91564319	5145.490069	5599.23918	122.674176	0	15.11921407	2.253014581	4.56188452	0.925862298	0	909.1404075	879.3081654	3.512601905	14.89645223	1.506669466	3.543815144	0											15% Coinsurance (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	15% Coinsurance (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	15% Coinsurance (PBP 11a)	"15% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"15% Coinsurance (PBP 9a, 9b)"	15% Coinsurance (PBP 8a)	"$15 General, 15% CT/MRI/PT (PBP 8b)"	15% Coinsurance (PBP 5)	15% Coinsurance (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit), Other Services 15% Coinsurance (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, 15% Office CT/MRI/PT (PBP 7d)"	"Inpatient Professional CIF, Other Professional 15% Coinsurance (PBP 7g)"	"15% Coinsurance, $1000 OOP Max (PBP 15)"	15% Coinsurance (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0.15	50	0.15	0	50	0.15	0.15	50	0.15	0.15	0.11	0.15	0.15	0.15	10	20	20	10	0.15	0.15	0.15	0.15	0	20	20	0	20	0	0	0											0.10185	50	0.10185	0	50	0.116005018	0.10185	50	0.109422171	0.10185	0.095599053	0.10185	0.10185	0.112225909	10	20	20	10	0.10185	0.106840391	0.10185	0.121076599	0	20	20	0	20	0	0	0											17.7446	0.102875054	1.899696133	0	0.338195176	1.111742834	0.47220639	1.613059043	5.279365285	4.532962823	4.747257298	0.120568243	0.001445327	2.683954791	4.287908391	9.332065301	0.20445696	0	1.539891953	0.24071296	0.464627938	0.112100258	0	1.515234012	1.465513609	0	0.02482742	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8352	None	16.6846	17.7446	0.102875054	1.899696133	0	0.338195176	1.111742834	0.47220639	1.613059043	5.279365285	4.532962823	4.747257298	0.120568243	0.001445327	2.683954791	4.287908391	9.332065301	0.20445696	0	1.539891953	0.24071296	0.464627938	0.112100258	0	1.515234012	1.465513609	0	0.02482742	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8352		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	N/A	0	17.7446	0.102875054	1.899696133	0	0.338195176	1.111742834	0.47220639	1.613059043	5.279365285	4.532962823	4.747257298	0.120568243	0.001445327	2.683954791	4.287908391	9.332065301	0.20445696	0	1.539891953	0.24071296	0.464627938	0.112100258	0	1.515234012	1.465513609	0	0.02482742	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8352
H3954_020_0	2009	3																					None											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	N/A	1033.026877	24.69001293	1048.545922	11.1496556	127.2893478	11.04236225	10.25863891	299.6885653	314.7936208	49.46869942	1164.15878	32.65228968	0.824616698	945.4880736	4529.822056	2685.315771	122.674176	0	628.7466923	5.425057048	3.567592394	0.937464305	0	909.3044836	859.3557053	4.16147933	1.025686502	1.186302073	3.176678035	0											$50 Copay Days 1-5 (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	$25 Copay Days 11-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	10% Coinsurance (PBP 11a)	"CIF (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$50 Copay (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"10% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											4.3043	0.102875054	2.18447067	0	0.530372282	1.104236225	0	1.248702356	1.311640087	0	2.910396949	0.068025604	0	0.787906728	3.774851713	4.475526285	0.20445696	0	1.100306711	0	0.356759239	0	0	1.515507473	1.432259509	0	0.001709478	0	0	0	0	0	0	0	0	0	0	0	0	0	27.4143	None	0	4.3043	0.102875054	2.18447067	0	0.530372282	1.104236225	0	1.248702356	1.311640087	0	2.910396949	0.068025604	0	0.787906728	3.774851713	4.475526285	0.20445696	0	1.100306711	0	0.356759239	0	0	1.515507473	1.432259509	0	0.001709478	0	0	0	0	0	0	0	0	0	0	0	0	0	27.4143	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											0	0	0	0	0	0	0	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	4.3043	0.102875054	2.18447067	0	0.530372282	1.104236225	0	1.248702356	1.311640087	0	2.910396949	0.068025604	0	0.787906728	3.774851713	4.475526285	0.20445696	0	1.100306711	0	0.356759239	0	0	1.515507473	1.432259509	0	0.001709478	0	0	0	0	0	0	0	0	0	0	0	0	0	27.4143
H3954_021_0	2009	5																					None											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	N/A	890.8495502	21.29188251	746.5314456	10.28939765	108.7314142	11.6638716	12.0497867	286.8747534	345.6489744	50.33837014	1184.624949	33.22632419	0.839113642	962.1099639	4523.527206	2681.584133	122.5037023	0	627.8729569	5.417518139	4.254039554	0.896462897	0	909.3044836	928.0078885	4.493931468	1.023027369	0.82815263	3.390206137	0											$50 Copay Days 1-5 (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	$25 Copay Days 11-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	10% Coinsurance (PBP 11a)	"CIF (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$50 Copay (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"10% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											3.7119	0.088716177	1.555273845	0	0.453047559	1.16638716	0	1.195311473	1.44020406	0	2.961562374	0.069221509	0	0.801758303	3.769606005	4.469306888	0.204172837	0	1.098777675	0	0.425403955	0	0	1.515507473	1.546679814	0	0.001705046	0	0	0	0	0	0	0	0	0	0	0	0	0	26.4745	None	0	3.7119	0.088716177	1.555273845	0	0.453047559	1.16638716	0	1.195311473	1.44020406	0	2.961562374	0.069221509	0	0.801758303	3.769606005	4.469306888	0.204172837	0	1.098777675	0	0.425403955	0	0	1.515507473	1.546679814	0	0.001705046	0	0	0	0	0	0	0	0	0	0	0	0	0	26.4745	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											0	0	0	0	0	0	0	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	3.7119	0.088716177	1.555273845	0	0.453047559	1.16638716	0	1.195311473	1.44020406	0	2.961562374	0.069221509	0	0.801758303	3.769606005	4.469306888	0.204172837	0	1.098777675	0	0.425403955	0	0	1.515507473	1.546679814	0	0.001705046	0	0	0	0	0	0	0	0	0	0	0	0	0	26.4745
H3954_023_0	2009	3																					None											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	N/A	1404.573678	24.69001293	1635.653425	14.38875801	213.950133	12.40406464	2.054985964	223.315824	219.9615152	42.45578725	641.5869219	3.748398043	1.749219061	475.7823574	4697.318356	3822.882593	122.674176	0	717.3456586	5.032105688	2.059699844	1.066625463	0	907	727.6173941	3.973711736	1.790872982	1.056897842	3.703431916	0											$50 Copay Days 1-5 (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	$25 Copay Days 11-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	10% Coinsurance (PBP 11a)	"CIF (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$50 Copay (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"10% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											5.8524	0.102875054	3.407611301	0	0.891458887	1.240406464	0	0.9304826	0.916506313	0	1.603967305	0.007809163	0	0.396485298	3.914431963	6.371470989	0.20445696	0	1.255354903	0	0.205969984	0	0	1.511666667	1.212695657	0	0.002984788	0	0	0	0	0	0	0	0	0	0	0	0	0	30.029	None	0	5.8524	0.102875054	3.407611301	0	0.891458887	1.240406464	0	0.9304826	0.916506313	0	1.603967305	0.007809163	0	0.396485298	3.914431963	6.371470989	0.20445696	0	1.255354903	0	0.205969984	0	0	1.511666667	1.212695657	0	0.002984788	0	0	0	0	0	0	0	0	0	0	0	0	0	30.029	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											0	0	0	0	0	0	0	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	5.8524	0.102875054	3.407611301	0	0.891458887	1.240406464	0	0.9304826	0.916506313	0	1.603967305	0.007809163	0	0.396485298	3.914431963	6.371470989	0.20445696	0	1.255354903	0	0.205969984	0	0	1.511666667	1.212695657	0	0.002984788	0	0	0	0	0	0	0	0	0	0	0	0	0	30.029
H3954_024_0	2009	3																					None											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	N/A	1404.573678	24.69001293	1635.653425	14.38875801	213.950133	12.40406464	2.054985964	223.315824	219.9615152	42.45578725	641.5869219	3.748398043	1.749219061	475.7823574	4697.318356	3822.882593	122.674176	0	717.3456586	5.032105688	2.059699844	1.066625463	0	907	727.6173941	3.973711736	1.790872982	0.700900998	3.703431916	0											$50 Copay Days 1-5 (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	$25 Copay Days 11-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	10% Coinsurance (PBP 11a)	"CIF (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$50 Copay (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"10% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											5.8524	0.102875054	3.407611301	0	0.891458887	1.240406464	0	0.9304826	0.916506313	0	1.603967305	0.007809163	0	0.396485298	3.914431963	6.371470989	0.20445696	0	1.255354903	0	0.205969984	0	0	1.511666667	1.212695657	0	0.002984788	0	0	0	0	0	0	0	0	0	0	0	0	0	30.029	None	0	5.8524	0.102875054	3.407611301	0	0.891458887	1.240406464	0	0.9304826	0.916506313	0	1.603967305	0.007809163	0	0.396485298	3.914431963	6.371470989	0.20445696	0	1.255354903	0	0.205969984	0	0	1.511666667	1.212695657	0	0.002984788	0	0	0	0	0	0	0	0	0	0	0	0	0	30.029	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											0	0	0	0	0	0	0	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	5.8524	0.102875054	3.407611301	0	0.891458887	1.240406464	0	0.9304826	0.916506313	0	1.603967305	0.007809163	0	0.396485298	3.914431963	6.371470989	0.20445696	0	1.255354903	0	0.205969984	0	0	1.511666667	1.212695657	0	0.002984788	0	0	0	0	0	0	0	0	0	0	0	0	0	30.029
H3954_026_0	2009	5																					None											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	N/A	1323.959558	24.69001293	1123.084519	17.03569937	105.1431489	11.16078087	9.012092475	226.2098276	253.2414961	48.89935008	888.5741953	14.98850678	0.989431362	823.5506687	4195.866713	4127.462357	122.674176	0	830.6327294	7.485598379	2.830853511	1.216128349	0	913.1516598	702.3239811	3.505760782	1.73740701	1.30834986	3.572288683	0											$50 Copay Days 1-5 (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	$25 Copay Days 11-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	10% Coinsurance (PBP 11a)	"CIF (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$50 Copay (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"10% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											5.5165	0.102875054	2.339759415	0	0.438096454	1.116078087	0	0.942540948	1.055172901	0	2.221435488	0.031226056	0	0.686292224	3.496555594	6.879103928	0.20445696	0	1.453607277	0	0.283085351	0	0	1.521919433	1.170539968	0	0.002895678	0	0	0	0	0	0	0	0	0	0	0	0	0	29.4621	None	0	5.5165	0.102875054	2.339759415	0	0.438096454	1.116078087	0	0.942540948	1.055172901	0	2.221435488	0.031226056	0	0.686292224	3.496555594	6.879103928	0.20445696	0	1.453607277	0	0.283085351	0	0	1.521919433	1.170539968	0	0.002895678	0	0	0	0	0	0	0	0	0	0	0	0	0	29.4621	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											0	0	0	0	0	0	0	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	5.5165	0.102875054	2.339759415	0	0.438096454	1.116078087	0	0.942540948	1.055172901	0	2.221435488	0.031226056	0	0.686292224	3.496555594	6.879103928	0.20445696	0	1.453607277	0	0.283085351	0	0	1.521919433	1.170539968	0	0.002895678	0	0	0	0	0	0	0	0	0	0	0	0	0	29.4621
H3954_027_0	2009	5																					None											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	N/A	1186.136548	22.14451782	877.2791897	15.27881468	103.0668519	10.81648776	9.99218525	240.5060489	258.100822	56.21496264	972.9861411	18.37790985	1.146779251	996.3838031	4364.360463	4062.880864	127.5232846	0	851.1055245	7.546361171	3.3141308	1.206795438	0	913.2069698	775.6624196	3.889649024	1.888711236	1.012143005	4.098325479	0											$50 Copay Days 1-5 (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	$25 Copay Days 11-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	10% Coinsurance (PBP 11a)	"CIF (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$50 Copay (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"10% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											4.9422	0.092268824	1.827664979	0	0.429445216	1.081648776	0	1.002108537	1.075420092	0	2.432465353	0.038287312	0	0.830319836	3.636967053	6.771468107	0.212538808	0	1.489434668	0	0.33141308	0	0	1.522011616	1.292770699	0	0.003147852	0	0	0	0	0	0	0	0	0	0	0	0	0	29.0116	None	0	4.9422	0.092268824	1.827664979	0	0.429445216	1.081648776	0	1.002108537	1.075420092	0	2.432465353	0.038287312	0	0.830319836	3.636967053	6.771468107	0.212538808	0	1.489434668	0	0.33141308	0	0	1.522011616	1.292770699	0	0.003147852	0	0	0	0	0	0	0	0	0	0	0	0	0	29.0116	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											0	0	0	0	0	0	0	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	4.9422	0.092268824	1.827664979	0	0.429445216	1.081648776	0	1.002108537	1.075420092	0	2.432465353	0.038287312	0	0.830319836	3.636967053	6.771468107	0.212538808	0	1.489434668	0	0.33141308	0	0	1.522011616	1.292770699	0	0.003147852	0	0	0	0	0	0	0	0	0	0	0	0	0	29.0116
H3954_032_0	2009	3																					None											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	N/A	1038.125325	24.69001293	999.1778929	12.72142588	181.9294627	11.84330918	8.43632659	300.2926142	283.0370657	36.86464855	793.6952195	58.67945432	1.456636983	538.5873232	3543.248563	3552.870503	122.674176	0	624.5407053	12.24878451	3.299082107	1.02306627	0	907	635.922639	3.5318657	1.273477204	1.208257699	3.766314869	0											$50 Copay Days 1-5 (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	$25 Copay Days 11-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	10% Coinsurance (PBP 11a)	"CIF (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$50 Copay (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"10% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											4.3255	0.102875054	2.08162061	0	0.758039428	1.184330918	0	1.251219226	1.179321107	0	1.984238049	0.122248863	0	0.448822769	2.952707136	5.921450839	0.20445696	0	1.092946234	0	0.329908211	0	0	1.511666667	1.059871065	0	0.002122462	0	0	0	0	0	0	0	0	0	0	0	0	0	26.5134	None	0	4.3255	0.102875054	2.08162061	0	0.758039428	1.184330918	0	1.251219226	1.179321107	0	1.984238049	0.122248863	0	0.448822769	2.952707136	5.921450839	0.20445696	0	1.092946234	0	0.329908211	0	0	1.511666667	1.059871065	0	0.002122462	0	0	0	0	0	0	0	0	0	0	0	0	0	26.5134	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											0	0	0	0	0	0	0	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	4.3255	0.102875054	2.08162061	0	0.758039428	1.184330918	0	1.251219226	1.179321107	0	1.984238049	0.122248863	0	0.448822769	2.952707136	5.921450839	0.20445696	0	1.092946234	0	0.329908211	0	0	1.511666667	1.059871065	0	0.002122462	0	0	0	0	0	0	0	0	0	0	0	0	0	26.5134
H3954_033_0	2009	5																					None											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	N/A	961.595033	22.86987247	911.5372203	6.467808325	148.891455	11.44818777	7.741502938	281.8209684	276.0655432	37.17321989	800.3387549	59.17062401	1.468829597	543.095507	3540.175131	3549.788726	122.5677678	0	623.9989756	12.23815986	4.388846991	1.03338668	0	907	666.8874314	3.703841788	1.565965873	1.048005736	3.931322056	0											$50 Copay Days 1-5 (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	$25 Copay Days 11-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	10% Coinsurance (PBP 11a)	"CIF (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$50 Copay (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"10% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											4.0066	0.095291135	1.899035876	0	0.620381063	1.144818777	0	1.174254035	1.150273097	0	2.000846887	0.123272133	0	0.452579589	2.950145942	5.916314543	0.204279613	0	1.091998207	0	0.438884699	0	0	1.511666667	1.111479052	0	0.002609943	0	0	0	0	0	0	0	0	0	0	0	0	0	25.8948	None	0	4.0066	0.095291135	1.899035876	0	0.620381063	1.144818777	0	1.174254035	1.150273097	0	2.000846887	0.123272133	0	0.452579589	2.950145942	5.916314543	0.204279613	0	1.091998207	0	0.438884699	0	0	1.511666667	1.111479052	0	0.002609943	0	0	0	0	0	0	0	0	0	0	0	0	0	25.8948	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											0	0	0	0	0	0	0	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	4.0066	0.095291135	1.899035876	0	0.620381063	1.144818777	0	1.174254035	1.150273097	0	2.000846887	0.123272133	0	0.452579589	2.950145942	5.916314543	0.204279613	0	1.091998207	0	0.438884699	0	0	1.511666667	1.111479052	0	0.002609943	0	0	0	0	0	0	0	0	0	0	0	0	0	25.8948
H3954_038_0	2009	5																					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	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	0	0											0	N/A	185.8899907	24.69001293	19.51128654	11.1496556	110.1559653	10.76905974	7.994293466	301.842148	52.39787878	39.19292076	43.63609451	2.897537681	0.029875141	27.45010084	5321.644602	8299.651489	122.674176	0	15.20923191	2.676524567	5.333718139	0.909827426	0	909.3044836	1012.909383	4.16147933	16.01395025	1.186302073	3.176678035	0											15% Coinsurance (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	15% Coinsurance (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	15% Coinsurance (PBP 11a)	"15% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"15% Coinsurance (PBP 9a, 9b)"	15% Coinsurance (PBP 8a)	"$15 General, 15% CT/MRI/PT (PBP 8b)"	15% Coinsurance (PBP 5)	15% Coinsurance (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit), Other Services 15% Coinsurance (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, 15% Office CT/MRI/PT (PBP 7d)"	"Inpatient Professional CIF, Other Professional 15% Coinsurance (PBP 7g)"	"15% Coinsurance, $1000 OOP Max (PBP 15)"	15% Coinsurance (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0.15	50	0.15	0	50	0.15	0.15	50	0.15	0.15	0.11	0.15	0.15	0.15	10	20	20	10	0.15	0.15	0.15	0.15	0	20	20	0	20	0	0	0											0.10185	50	0.10185	0	50	0.116005018	0.10185	50	0.109422171	0.10185	0.095599053	0.10185	0.10185	0.112225909	10	20	20	10	0.10185	0.106840391	0.10185	0.121076599	0	20	20	0	20	0	0	0											18.9329	0.102875054	1.987224534	0	0.458983189	1.249264967	0.81421879	1.257675617	5.733489668	3.99179898	4.171569313	0.295114213	0.003042783	3.080612513	4.434703835	13.83275248	0.20445696	0	1.54906027	0.285960932	0.543239192	0.110158811	0	1.515507473	1.688182305	0	0.026689917	0	0	0	0	0	0	0	0	0	0	0	0	0	66.2695	None	17.5917	18.9329	0.102875054	1.987224534	0	0.458983189	1.249264967	0.81421879	1.257675617	5.733489668	3.99179898	4.171569313	0.295114213	0.003042783	3.080612513	4.434703835	13.83275248	0.20445696	0	1.54906027	0.285960932	0.543239192	0.110158811	0	1.515507473	1.688182305	0	0.026689917	0	0	0	0	0	0	0	0	0	0	0	0	0	66.2695		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	N/A	0	18.9329	0.102875054	1.987224534	0	0.458983189	1.249264967	0.81421879	1.257675617	5.733489668	3.99179898	4.171569313	0.295114213	0.003042783	3.080612513	4.434703835	13.83275248	0.20445696	0	1.54906027	0.285960932	0.543239192	0.110158811	0	1.515507473	1.688182305	0	0.026689917	0	0	0	0	0	0	0	0	0	0	0	0	0	66.2695
H3954_039_0	2009	5																					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	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	0	0											0	N/A	185.8899907	24.69001293	19.51128654	11.1496556	110.1559653	10.76905974	7.994293466	301.842148	52.39787878	39.19292076	43.63609451	2.897537681	0.029875141	27.45010084	5321.644602	8299.651489	122.674176	0	15.20923191	2.676524567	5.333718139	0.909827426	0	909.3044836	1012.909383	4.16147933	16.01395025	0.83030523	3.176678035	0											15% Coinsurance (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	15% Coinsurance (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	15% Coinsurance (PBP 11a)	"15% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"15% Coinsurance (PBP 9a, 9b)"	15% Coinsurance (PBP 8a)	"$15 General, 15% CT/MRI/PT (PBP 8b)"	15% Coinsurance (PBP 5)	15% Coinsurance (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit), Other Services 15% Coinsurance (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, 15% Office CT/MRI/PT (PBP 7d)"	"Inpatient Professional CIF, Other Professional 15% Coinsurance (PBP 7g)"	"15% Coinsurance, $1000 OOP Max (PBP 15)"	15% Coinsurance (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0.15	50	0.15	0	50	0.15	0.15	50	0.15	0.15	0.11	0.15	0.15	0.15	10	20	20	10	0.15	0.15	0.15	0.15	0	20	20	0	20	0	0	0											0.10185	50	0.10185	0	50	0.116005018	0.10185	50	0.109422171	0.10185	0.095599053	0.10185	0.10185	0.112225909	10	20	20	10	0.10185	0.106840391	0.10185	0.121076599	0	20	20	0	20	0	0	0											18.9329	0.102875054	1.987224534	0	0.458983189	1.249264967	0.81421879	1.257675617	5.733489668	3.99179898	4.171569313	0.295114213	0.003042783	3.080612513	4.434703835	13.83275248	0.20445696	0	1.54906027	0.285960932	0.543239192	0.110158811	0	1.515507473	1.688182305	0	0.026689917	0	0	0	0	0	0	0	0	0	0	0	0	0	66.2695	None	17.5917	18.9329	0.102875054	1.987224534	0	0.458983189	1.249264967	0.81421879	1.257675617	5.733489668	3.99179898	4.171569313	0.295114213	0.003042783	3.080612513	4.434703835	13.83275248	0.20445696	0	1.54906027	0.285960932	0.543239192	0.110158811	0	1.515507473	1.688182305	0	0.026689917	0	0	0	0	0	0	0	0	0	0	0	0	0	66.2695		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	N/A	0	18.9329	0.102875054	1.987224534	0	0.458983189	1.249264967	0.81421879	1.257675617	5.733489668	3.99179898	4.171569313	0.295114213	0.003042783	3.080612513	4.434703835	13.83275248	0.20445696	0	1.54906027	0.285960932	0.543239192	0.110158811	0	1.515507473	1.688182305	0	0.026689917	0	0	0	0	0	0	0	0	0	0	0	0	0	66.2695
H3954_041_0	2009	5																					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	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	0	0											0	N/A	213.6917906	24.69001293	31.7387838	14.38875801	185.1520481	12.0970595	1.60139771	224.920587	48.24023159	33.63675061	45.51185938	0.544934758	0.063372676	22.4463149	5518.419613	11815.59113	122.674176	0	26.0585829	2.482656749	3.079347975	1.035180853	0	907	857.6314573	3.973711736	27.96073729	1.056897842	3.703431916	0											15% Coinsurance (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	15% Coinsurance (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	15% Coinsurance (PBP 11a)	"15% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"15% Coinsurance (PBP 9a, 9b)"	15% Coinsurance (PBP 8a)	"$15 General, 15% CT/MRI/PT (PBP 8b)"	15% Coinsurance (PBP 5)	15% Coinsurance (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit), Other Services 15% Coinsurance (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, 15% Office CT/MRI/PT (PBP 7d)"	"Inpatient Professional CIF, Other Professional 15% Coinsurance (PBP 7g)"	"15% Coinsurance, $1000 OOP Max (PBP 15)"	15% Coinsurance (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0.15	50	0.15	0	50	0.15	0.15	50	0.15	0.15	0.11	0.15	0.15	0.15	10	20	20	10	0.15	0.15	0.15	0.15	0	20	20	0	20	0	0	0											0.10185	50	0.10185	0	50	0.116005018	0.10185	50	0.109422171	0.10185	0.095599053	0.10185	0.10185	0.112225909	10	20	20	10	0.10185	0.106840391	0.10185	0.121076599	0	20	20	0	20	0	0	0											21.7645	0.102875054	3.23259513	0	0.771466867	1.403319602	0.163102357	0.937169112	5.278550885	3.42590305	4.350890659	0.055501605	0.006454507	2.519058089	4.598683011	19.69265188	0.20445696	0	2.654066668	0.265248019	0.313631591	0.125336177	0	1.511666667	1.429385762	0	0.046601229	0	0	0	0	0	0	0	0	0	0	0	0	0	74.8531	None	18.9556	21.7645	0.102875054	3.23259513	0	0.771466867	1.403319602	0.163102357	0.937169112	5.278550885	3.42590305	4.350890659	0.055501605	0.006454507	2.519058089	4.598683011	19.69265188	0.20445696	0	2.654066668	0.265248019	0.313631591	0.125336177	0	1.511666667	1.429385762	0	0.046601229	0	0	0	0	0	0	0	0	0	0	0	0	0	74.8531		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	N/A	0	21.7645	0.102875054	3.23259513	0	0.771466867	1.403319602	0.163102357	0.937169112	5.278550885	3.42590305	4.350890659	0.055501605	0.006454507	2.519058089	4.598683011	19.69265188	0.20445696	0	2.654066668	0.265248019	0.313631591	0.125336177	0	1.511666667	1.429385762	0	0.046601229	0	0	0	0	0	0	0	0	0	0	0	0	0	74.8531
H3954_042_0	2009	5																					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	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	0	0											0	N/A	213.6917906	24.69001293	31.7387838	14.38875801	185.1520481	12.0970595	1.60139771	224.920587	48.24023159	33.63675061	45.51185938	0.544934758	0.063372676	22.4463149	5518.419613	11815.59113	122.674176	0	26.0585829	2.482656749	3.079347975	1.035180853	0	907	857.6314573	3.973711736	27.96073729	0.700900998	3.703431916	0											15% Coinsurance (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	15% Coinsurance (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	15% Coinsurance (PBP 11a)	"15% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"15% Coinsurance (PBP 9a, 9b)"	15% Coinsurance (PBP 8a)	"$15 General, 15% CT/MRI/PT (PBP 8b)"	15% Coinsurance (PBP 5)	15% Coinsurance (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit), Other Services 15% Coinsurance (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, 15% Office CT/MRI/PT (PBP 7d)"	"Inpatient Professional CIF, Other Professional 15% Coinsurance (PBP 7g)"	"15% Coinsurance, $1000 OOP Max (PBP 15)"	15% Coinsurance (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0.15	50	0.15	0	50	0.15	0.15	50	0.15	0.15	0.11	0.15	0.15	0.15	10	20	20	10	0.15	0.15	0.15	0.15	0	20	20	0	20	0	0	0											0.10185	50	0.10185	0	50	0.116005018	0.10185	50	0.109422171	0.10185	0.095599053	0.10185	0.10185	0.112225909	10	20	20	10	0.10185	0.106840391	0.10185	0.121076599	0	20	20	0	20	0	0	0											21.7645	0.102875054	3.23259513	0	0.771466867	1.403319602	0.163102357	0.937169112	5.278550885	3.42590305	4.350890659	0.055501605	0.006454507	2.519058089	4.598683011	19.69265188	0.20445696	0	2.654066668	0.265248019	0.313631591	0.125336177	0	1.511666667	1.429385762	0	0.046601229	0	0	0	0	0	0	0	0	0	0	0	0	0	74.8531	None	18.9556	21.7645	0.102875054	3.23259513	0	0.771466867	1.403319602	0.163102357	0.937169112	5.278550885	3.42590305	4.350890659	0.055501605	0.006454507	2.519058089	4.598683011	19.69265188	0.20445696	0	2.654066668	0.265248019	0.313631591	0.125336177	0	1.511666667	1.429385762	0	0.046601229	0	0	0	0	0	0	0	0	0	0	0	0	0	74.8531		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	N/A	0	21.7645	0.102875054	3.23259513	0	0.771466867	1.403319602	0.163102357	0.937169112	5.278550885	3.42590305	4.350890659	0.055501605	0.006454507	2.519058089	4.598683011	19.69265188	0.20445696	0	2.654066668	0.265248019	0.313631591	0.125336177	0	1.511666667	1.429385762	0	0.046601229	0	0	0	0	0	0	0	0	0	0	0	0	0	74.8531
H3954_044_0	2009	5																					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	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	0	0											0	N/A	200.4968408	24.69001293	20.82514671	15.81860839	80.88205885	11.32426933	6.472501593	199.8394355	36.7896574	31.06807906	28.38335718	0.836633285	0.027689511	18.33999032	4916.741074	15612.28058	122.674176	0	30.19171896	4.163705217	3.604412248	1.284190017	0	912.9204931	800.7214164	3.329765536	26.27233543	1.350856797	3.907234083	0											15% Coinsurance (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	15% Coinsurance (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	15% Coinsurance (PBP 11a)	"15% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"15% Coinsurance (PBP 9a, 9b)"	15% Coinsurance (PBP 8a)	"$15 General, 15% CT/MRI/PT (PBP 8b)"	15% Coinsurance (PBP 5)	15% Coinsurance (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit), Other Services 15% Coinsurance (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, 15% Office CT/MRI/PT (PBP 7d)"	"Inpatient Professional CIF, Other Professional 15% Coinsurance (PBP 7g)"	"15% Coinsurance, $1000 OOP Max (PBP 15)"	15% Coinsurance (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0.15	50	0.15	0	50	0.15	0.15	50	0.15	0.15	0.11	0.15	0.15	0.15	10	20	20	10	0.15	0.15	0.15	0.15	0	20	20	0	20	0	0	0											0.10185	50	0.10185	0	50	0.116005018	0.10185	50	0.109422171	0.10185	0.095599053	0.10185	0.10185	0.112225909	10	20	20	10	0.10185	0.106840391	0.10185	0.121076599	0	20	20	0	20	0	0	0											20.4206	0.102875054	2.121041193	0	0.337008579	1.313672065	0.659224287	0.832664315	4.025604194	3.164283853	2.713422069	0.0852111	0.002820177	2.058222081	4.097284228	26.02046763	0.20445696	0	3.075026576	0.444851895	0.367109387	0.15548536	0	1.521534155	1.334535694	0	0.043787226	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1012	None	17.3293	20.4206	0.102875054	2.121041193	0	0.337008579	1.313672065	0.659224287	0.832664315	4.025604194	3.164283853	2.713422069	0.0852111	0.002820177	2.058222081	4.097284228	26.02046763	0.20445696	0	3.075026576	0.444851895	0.367109387	0.15548536	0	1.521534155	1.334535694	0	0.043787226	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1012		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	N/A	0	20.4206	0.102875054	2.121041193	0	0.337008579	1.313672065	0.659224287	0.832664315	4.025604194	3.164283853	2.713422069	0.0852111	0.002820177	2.058222081	4.097284228	26.02046763	0.20445696	0	3.075026576	0.444851895	0.367109387	0.15548536	0	1.521534155	1.334535694	0	0.043787226	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1012
H3954_045_0	2009	5																					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	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	0	0											0	N/A	200.4968408	24.69001293	20.82514671	15.81860839	80.88205885	11.32426933	6.472501593	199.8394355	36.7896574	31.06807906	28.38335718	0.836633285	0.027689511	18.33999032	4916.741074	15612.28058	122.674176	0	30.19171896	4.163705217	3.604412248	1.284190017	0	912.9204931	800.7214164	3.329765536	26.27233543	0.994859954	3.907234083	0											15% Coinsurance (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	15% Coinsurance (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	15% Coinsurance (PBP 11a)	"15% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"15% Coinsurance (PBP 9a, 9b)"	15% Coinsurance (PBP 8a)	"$15 General, 15% CT/MRI/PT (PBP 8b)"	15% Coinsurance (PBP 5)	15% Coinsurance (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit), Other Services 15% Coinsurance (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, 15% Office CT/MRI/PT (PBP 7d)"	"Inpatient Professional CIF, Other Professional 15% Coinsurance (PBP 7g)"	"15% Coinsurance, $1000 OOP Max (PBP 15)"	15% Coinsurance (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0.15	50	0.15	0	50	0.15	0.15	50	0.15	0.15	0.11	0.15	0.15	0.15	10	20	20	10	0.15	0.15	0.15	0.15	0	20	20	0	20	0	0	0											0.10185	50	0.10185	0	50	0.116005018	0.10185	50	0.109422171	0.10185	0.095599053	0.10185	0.10185	0.112225909	10	20	20	10	0.10185	0.106840391	0.10185	0.121076599	0	20	20	0	20	0	0	0											20.4206	0.102875054	2.121041193	0	0.337008579	1.313672065	0.659224287	0.832664315	4.025604194	3.164283853	2.713422069	0.0852111	0.002820177	2.058222081	4.097284228	26.02046763	0.20445696	0	3.075026576	0.444851895	0.367109387	0.15548536	0	1.521534155	1.334535694	0	0.043787226	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1012	None	17.3293	20.4206	0.102875054	2.121041193	0	0.337008579	1.313672065	0.659224287	0.832664315	4.025604194	3.164283853	2.713422069	0.0852111	0.002820177	2.058222081	4.097284228	26.02046763	0.20445696	0	3.075026576	0.444851895	0.367109387	0.15548536	0	1.521534155	1.334535694	0	0.043787226	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1012		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	N/A	0	20.4206	0.102875054	2.121041193	0	0.337008579	1.313672065	0.659224287	0.832664315	4.025604194	3.164283853	2.713422069	0.0852111	0.002820177	2.058222081	4.097284228	26.02046763	0.20445696	0	3.075026576	0.444851895	0.367109387	0.15548536	0	1.521534155	1.334535694	0	0.043787226	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1012
H3954_047_0	2009	5																					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	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	0	0											0	N/A	189.9524812	24.69001293	23.64952717	19.35250352	110.2330512	10.04751106	8.070592133	281.1273245	53.28732179	53.34928956	66.65323448	3.11914266	0.051373031	32.12530173	4953.244849	7321.725531	122.674176	0.274654128	22.05761969	2.797334089	5.427401914	0.98247051	0	913.5916991	879.3993884	3.840778067	28.75093656	1.227435408	2.934700447	0											15% Coinsurance (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	15% Coinsurance (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	15% Coinsurance (PBP 11a)	"15% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"15% Coinsurance (PBP 9a, 9b)"	15% Coinsurance (PBP 8a)	"$15 General, 15% CT/MRI/PT (PBP 8b)"	15% Coinsurance (PBP 5)	15% Coinsurance (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit), Other Services 15% Coinsurance (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, 15% Office CT/MRI/PT (PBP 7d)"	"Inpatient Professional CIF, Other Professional 15% Coinsurance (PBP 7g)"	"15% Coinsurance, $1000 OOP Max (PBP 15)"	15% Coinsurance (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0.15	50	0.15	0	50	0.15	0.15	50	0.15	0.15	0.11	0.15	0.15	0.15	10	20	20	10	0.15	0.15	0.15	0.15	0	20	20	0	20	0	0	0											0.10185	50	0.10185	0	50	0.116005018	0.10185	50	0.109422171	0.10185	0.095599053	0.10185	0.10185	0.112225909	10	20	20	10	0.10185	0.106840391	0.10185	0.121076599	0	20	20	0	20	0	0	0											19.3467	0.102875054	2.408704342	0	0.45930438	1.165561698	0.821989809	1.171363852	5.830814453	5.433625142	6.371986099	0.31768468	0.005232343	3.605291182	4.127704041	12.20287589	0.20445696	0.000228878	2.246568565	0.298868269	0.552780885	0.118954188	0	1.522652832	1.465665647	0	0.047918228	0	0	0	0	0	0	0	0	0	0	0	0	0	69.8298	None	19.5447	19.3467	0.102875054	2.408704342	0	0.45930438	1.165561698	0.821989809	1.171363852	5.830814453	5.433625142	6.371986099	0.31768468	0.005232343	3.605291182	4.127704041	12.20287589	0.20445696	0.000228878	2.246568565	0.298868269	0.552780885	0.118954188	0	1.522652832	1.465665647	0	0.047918228	0	0	0	0	0	0	0	0	0	0	0	0	0	69.8298		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	N/A	0	19.3467	0.102875054	2.408704342	0	0.45930438	1.165561698	0.821989809	1.171363852	5.830814453	5.433625142	6.371986099	0.31768468	0.005232343	3.605291182	4.127704041	12.20287589	0.20445696	0.000228878	2.246568565	0.298868269	0.552780885	0.118954188	0	1.522652832	1.465665647	0	0.047918228	0	0	0	0	0	0	0	0	0	0	0	0	0	69.8298
H3954_048_0	2009	5																					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	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	0	0											0	N/A	189.9524812	24.69001293	23.64952717	19.35250352	110.2330512	10.04751106	8.070592133	281.1273245	53.28732179	53.34928956	66.65323448	3.11914266	0.051373031	32.12530173	4953.244849	7321.725531	122.674176	0.274654128	22.05761969	2.797334089	5.427401914	0.98247051	0	913.5916991	879.3993884	3.840778067	28.75093656	0.871438564	2.934700447	0											15% Coinsurance (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	15% Coinsurance (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	15% Coinsurance (PBP 11a)	"15% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"15% Coinsurance (PBP 9a, 9b)"	15% Coinsurance (PBP 8a)	"$15 General, 15% CT/MRI/PT (PBP 8b)"	15% Coinsurance (PBP 5)	15% Coinsurance (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit), Other Services 15% Coinsurance (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, 15% Office CT/MRI/PT (PBP 7d)"	"Inpatient Professional CIF, Other Professional 15% Coinsurance (PBP 7g)"	"15% Coinsurance, $1000 OOP Max (PBP 15)"	15% Coinsurance (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0.15	50	0.15	0	50	0.15	0.15	50	0.15	0.15	0.11	0.15	0.15	0.15	10	20	20	10	0.15	0.15	0.15	0.15	0	20	20	0	20	0	0	0											0.10185	50	0.10185	0	50	0.116005018	0.10185	50	0.109422171	0.10185	0.095599053	0.10185	0.10185	0.112225909	10	20	20	10	0.10185	0.106840391	0.10185	0.121076599	0	20	20	0	20	0	0	0											19.3467	0.102875054	2.408704342	0	0.45930438	1.165561698	0.821989809	1.171363852	5.830814453	5.433625142	6.371986099	0.31768468	0.005232343	3.605291182	4.127704041	12.20287589	0.20445696	0.000228878	2.246568565	0.298868269	0.552780885	0.118954188	0	1.522652832	1.465665647	0	0.047918228	0	0	0	0	0	0	0	0	0	0	0	0	0	69.8298	None	19.5447	19.3467	0.102875054	2.408704342	0	0.45930438	1.165561698	0.821989809	1.171363852	5.830814453	5.433625142	6.371986099	0.31768468	0.005232343	3.605291182	4.127704041	12.20287589	0.20445696	0.000228878	2.246568565	0.298868269	0.552780885	0.118954188	0	1.522652832	1.465665647	0	0.047918228	0	0	0	0	0	0	0	0	0	0	0	0	0	69.8298		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	N/A	0	19.3467	0.102875054	2.408704342	0	0.45930438	1.165561698	0.821989809	1.171363852	5.830814453	5.433625142	6.371986099	0.31768468	0.005232343	3.605291182	4.127704041	12.20287589	0.20445696	0.000228878	2.246568565	0.298868269	0.552780885	0.118954188	0	1.522652832	1.465665647	0	0.047918228	0	0	0	0	0	0	0	0	0	0	0	0	0	69.8298
H3954_050_0	2009	5																					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	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	0	0											0	N/A	183.2185386	24.69001293	18.37184819	12.72142588	157.4414194	11.55018294	6.574212342	302.4505377	48.07173815	29.20701911	40.90431474	3.730430217	0.052772683	22.18054983	4162.615961	10981.05008	122.674176	0	18.73534491	6.04310192	4.932282652	0.992905805	0	907	749.5522566	3.5318657	19.88268398	1.208257699	3.766314869	0											15% Coinsurance (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	15% Coinsurance (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	15% Coinsurance (PBP 11a)	"15% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"15% Coinsurance (PBP 9a, 9b)"	15% Coinsurance (PBP 8a)	"$15 General, 15% CT/MRI/PT (PBP 8b)"	15% Coinsurance (PBP 5)	15% Coinsurance (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit), Other Services 15% Coinsurance (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, 15% Office CT/MRI/PT (PBP 7d)"	"Inpatient Professional CIF, Other Professional 15% Coinsurance (PBP 7g)"	"15% Coinsurance, $1000 OOP Max (PBP 15)"	15% Coinsurance (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0.15	50	0.15	0	50	0.15	0.15	50	0.15	0.15	0.11	0.15	0.15	0.15	10	20	20	10	0.15	0.15	0.15	0.15	0	20	20	0	20	0	0	0											0.10185	50	0.10185	0	50	0.116005018	0.10185	50	0.109422171	0.10185	0.095599053	0.10185	0.10185	0.112225909	10	20	20	10	0.10185	0.106840391	0.10185	0.121076599	0	20	20	0	20	0	0	0											18.6608	0.102875054	1.871172738	0	0.656005914	1.339879177	0.669583527	1.260210574	5.260113967	2.974734897	3.910413755	0.379944318	0.005374898	2.489232362	3.468846634	18.30175013	0.20445696	0	1.908194879	0.645647374	0.502352988	0.120217658	0	1.511666667	1.249253761	0	0.033137807	0	0	0	0	0	0	0	0	0	0	0	0	0	67.5259	None	16.8109	18.6608	0.102875054	1.871172738	0	0.656005914	1.339879177	0.669583527	1.260210574	5.260113967	2.974734897	3.910413755	0.379944318	0.005374898	2.489232362	3.468846634	18.30175013	0.20445696	0	1.908194879	0.645647374	0.502352988	0.120217658	0	1.511666667	1.249253761	0	0.033137807	0	0	0	0	0	0	0	0	0	0	0	0	0	67.5259		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	N/A	0	18.6608	0.102875054	1.871172738	0	0.656005914	1.339879177	0.669583527	1.260210574	5.260113967	2.974734897	3.910413755	0.379944318	0.005374898	2.489232362	3.468846634	18.30175013	0.20445696	0	1.908194879	0.645647374	0.502352988	0.120217658	0	1.511666667	1.249253761	0	0.033137807	0	0	0	0	0	0	0	0	0	0	0	0	0	67.5259
H3954_051_0	2009	5																					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	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	0	0											0	N/A	183.2185386	24.69001293	18.37184819	12.72142588	157.4414194	11.55018294	6.574212342	302.4505377	48.07173815	29.20701911	40.90431474	3.730430217	0.052772683	22.18054983	4162.615961	10981.05008	122.674176	0	18.73534491	6.04310192	4.932282652	0.992905805	0	907	749.5522566	3.5318657	19.88268398	0.852260855	3.766314869	0											15% Coinsurance (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	15% Coinsurance (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	15% Coinsurance (PBP 11a)	"15% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"15% Coinsurance (PBP 9a, 9b)"	15% Coinsurance (PBP 8a)	"$15 General, 15% CT/MRI/PT (PBP 8b)"	15% Coinsurance (PBP 5)	15% Coinsurance (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit), Other Services 15% Coinsurance (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, 15% Office CT/MRI/PT (PBP 7d)"	"Inpatient Professional CIF, Other Professional 15% Coinsurance (PBP 7g)"	"15% Coinsurance, $1000 OOP Max (PBP 15)"	15% Coinsurance (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0.15	50	0.15	0	50	0.15	0.15	50	0.15	0.15	0.11	0.15	0.15	0.15	10	20	20	10	0.15	0.15	0.15	0.15	0	20	20	0	20	0	0	0											0.10185	50	0.10185	0	50	0.116005018	0.10185	50	0.109422171	0.10185	0.095599053	0.10185	0.10185	0.112225909	10	20	20	10	0.10185	0.106840391	0.10185	0.121076599	0	20	20	0	20	0	0	0											18.6608	0.102875054	1.871172738	0	0.656005914	1.339879177	0.669583527	1.260210574	5.260113967	2.974734897	3.910413755	0.379944318	0.005374898	2.489232362	3.468846634	18.30175013	0.20445696	0	1.908194879	0.645647374	0.502352988	0.120217658	0	1.511666667	1.249253761	0	0.033137807	0	0	0	0	0	0	0	0	0	0	0	0	0	67.5259	None	16.8109	18.6608	0.102875054	1.871172738	0	0.656005914	1.339879177	0.669583527	1.260210574	5.260113967	2.974734897	3.910413755	0.379944318	0.005374898	2.489232362	3.468846634	18.30175013	0.20445696	0	1.908194879	0.645647374	0.502352988	0.120217658	0	1.511666667	1.249253761	0	0.033137807	0	0	0	0	0	0	0	0	0	0	0	0	0	67.5259		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	N/A	0	18.6608	0.102875054	1.871172738	0	0.656005914	1.339879177	0.669583527	1.260210574	5.260113967	2.974734897	3.910413755	0.379944318	0.005374898	2.489232362	3.468846634	18.30175013	0.20445696	0	1.908194879	0.645647374	0.502352988	0.120217658	0	1.511666667	1.249253761	0	0.033137807	0	0	0	0	0	0	0	0	0	0	0	0	0	67.5259
H3954_056_0	2009	5																					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	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	0	0											0	N/A	166.7683181	24.69001293	14.69206384	8.71700689	177.9647136	11.47289834	8.699985176	244.2007395	47.06385569	25.02168324	48.10217547	3.636953936	0.012078086	19.6613894	5460.227051	9706.484986	122.674176	0	13.88907806	2.827453995	4.60439086	0.602688069	0	907	890.9274055	3.682091198	16.19139059	1.329149228	3.209773554	0											15% Coinsurance (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	15% Coinsurance (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	15% Coinsurance (PBP 11a)	"15% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"15% Coinsurance (PBP 9a, 9b)"	15% Coinsurance (PBP 8a)	"$15 General, 15% CT/MRI/PT (PBP 8b)"	15% Coinsurance (PBP 5)	15% Coinsurance (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit), Other Services 15% Coinsurance (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, 15% Office CT/MRI/PT (PBP 7d)"	"Inpatient Professional CIF, Other Professional 15% Coinsurance (PBP 7g)"	"15% Coinsurance, $1000 OOP Max (PBP 15)"	15% Coinsurance (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0.15	50	0.15	0	50	0.15	0.15	50	0.15	0.15	0.11	0.15	0.15	0.15	10	20	20	10	0.15	0.15	0.15	0.15	0	20	20	0	20	0	0	0											0.10185	50	0.10185	0	50	0.116005018	0.10185	50	0.109422171	0.10185	0.095599053	0.10185	0.10185	0.112225909	10	20	20	10	0.10185	0.106840391	0.10185	0.121076599	0	20	20	0	20	0	0	0											16.9854	0.102875054	1.496386702	0	0.74151964	1.330913775	0.88609349	1.017503081	5.149829279	2.548458438	4.598522424	0.370423758	0.001230153	2.206517293	4.550189209	16.17747498	0.20445696	0	1.414602601	0.302086291	0.468957209	0.072971422	0	1.511666667	1.484879009	0	0.026985651	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6499	None	15.3018	16.9854	0.102875054	1.496386702	0	0.74151964	1.330913775	0.88609349	1.017503081	5.149829279	2.548458438	4.598522424	0.370423758	0.001230153	2.206517293	4.550189209	16.17747498	0.20445696	0	1.414602601	0.302086291	0.468957209	0.072971422	0	1.511666667	1.484879009	0	0.026985651	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6499		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	N/A	0	16.9854	0.102875054	1.496386702	0	0.74151964	1.330913775	0.88609349	1.017503081	5.149829279	2.548458438	4.598522424	0.370423758	0.001230153	2.206517293	4.550189209	16.17747498	0.20445696	0	1.414602601	0.302086291	0.468957209	0.072971422	0	1.511666667	1.484879009	0	0.026985651	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6499
H3954_057_0	2009	8																					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	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	0	0											0	N/A	166.7683181	24.69001293	14.69206384	8.71700689	177.9647136	11.47289834	8.699985176	244.2007395	47.06385569	25.02168324	48.10217547	3.636953936	0.012078086	19.6613894	5460.227051	9706.484986	122.674176	0	13.88907806	2.827453995	4.60439086	0.602688069	0	907	890.9274055	3.682091198	16.19139059	0.973152384	3.209773554	0											15% Coinsurance (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	15% Coinsurance (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	15% Coinsurance (PBP 11a)	"15% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"15% Coinsurance (PBP 9a, 9b)"	15% Coinsurance (PBP 8a)	"$15 General, 15% CT/MRI/PT (PBP 8b)"	15% Coinsurance (PBP 5)	15% Coinsurance (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit), Other Services 15% Coinsurance (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, 15% Office CT/MRI/PT (PBP 7d)"	"Inpatient Professional CIF, Other Professional 15% Coinsurance (PBP 7g)"	"15% Coinsurance, $1000 OOP Max (PBP 15)"	15% Coinsurance (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0.15	50	0.15	0	50	0.15	0.15	50	0.15	0.15	0.11	0.15	0.15	0.15	10	20	20	10	0.15	0.15	0.15	0.15	0	20	20	0	20	0	0	0											0.10185	50	0.10185	0	50	0.116005018	0.10185	50	0.109422171	0.10185	0.095599053	0.10185	0.10185	0.112225909	10	20	20	10	0.10185	0.106840391	0.10185	0.121076599	0	20	20	0	20	0	0	0											16.9854	0.102875054	1.496386702	0	0.74151964	1.330913775	0.88609349	1.017503081	5.149829279	2.548458438	4.598522424	0.370423758	0.001230153	2.206517293	4.550189209	16.17747498	0.20445696	0	1.414602601	0.302086291	0.468957209	0.072971422	0	1.511666667	1.484879009	0	0.026985651	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6499	None	15.3018	16.9854	0.102875054	1.496386702	0	0.74151964	1.330913775	0.88609349	1.017503081	5.149829279	2.548458438	4.598522424	0.370423758	0.001230153	2.206517293	4.550189209	16.17747498	0.20445696	0	1.414602601	0.302086291	0.468957209	0.072971422	0	1.511666667	1.484879009	0	0.026985651	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6499		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	N/A	0	16.9854	0.102875054	1.496386702	0	0.74151964	1.330913775	0.88609349	1.017503081	5.149829279	2.548458438	4.598522424	0.370423758	0.001230153	2.206517293	4.550189209	16.17747498	0.20445696	0	1.414602601	0.302086291	0.468957209	0.072971422	0	1.511666667	1.484879009	0	0.026985651	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6499
H3954_059_0	2009	5																					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	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	0	0											0	N/A	192.1666386	24.69001293	9.379366082	8.884105779	122.6161544	10.35851501	5.584340891	219.2337625	51.05168864	54.43601696	48.6066103	1.219411518	0	20.92063036	3990.66051	9871.665559	122.674176	0	24.55324594	5.882162066	4.647227589	0.86756515	0	910.6235131	1231.074012	3.712958545	23.14558528	1.123639702	3.672073652	0											15% Coinsurance (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	15% Coinsurance (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	15% Coinsurance (PBP 11a)	"15% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"15% Coinsurance (PBP 9a, 9b)"	15% Coinsurance (PBP 8a)	"$15 General, 15% CT/MRI/PT (PBP 8b)"	15% Coinsurance (PBP 5)	15% Coinsurance (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit), Other Services 15% Coinsurance (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, 15% Office CT/MRI/PT (PBP 7d)"	"Inpatient Professional CIF, Other Professional 15% Coinsurance (PBP 7g)"	"15% Coinsurance, $1000 OOP Max (PBP 15)"	15% Coinsurance (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0.15	50	0.15	0	50	0.15	0.15	50	0.15	0.15	0.11	0.15	0.15	0.15	10	20	20	10	0.15	0.15	0.15	0.15	0	20	20	0	20	0	0	0											0.10185	50	0.10185	0	50	0.116005018	0.10185	50	0.109422171	0.10185	0.095599053	0.10185	0.10185	0.112225909	10	20	20	10	0.10185	0.106840391	0.10185	0.121076599	0	20	20	0	20	0	0	0											19.5722	0.102875054	0.955288435	0	0.510900643	1.201639717	0.56876512	0.91347401	5.58618662	5.544308327	4.646745916	0.124197063	0	2.347836755	3.325550425	16.45277593	0.20445696	0	2.500748099	0.628452497	0.47332013	0.105041838	0	1.517705855	2.051790021	0	0.038575975	0	0	0	0	0	0	0	0	0	0	0	0	0	69.3728	None	18.252	19.5722	0.102875054	0.955288435	0	0.510900643	1.201639717	0.56876512	0.91347401	5.58618662	5.544308327	4.646745916	0.124197063	0	2.347836755	3.325550425	16.45277593	0.20445696	0	2.500748099	0.628452497	0.47332013	0.105041838	0	1.517705855	2.051790021	0	0.038575975	0	0	0	0	0	0	0	0	0	0	0	0	0	69.3728		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	N/A	0	19.5722	0.102875054	0.955288435	0	0.510900643	1.201639717	0.56876512	0.91347401	5.58618662	5.544308327	4.646745916	0.124197063	0	2.347836755	3.325550425	16.45277593	0.20445696	0	2.500748099	0.628452497	0.47332013	0.105041838	0	1.517705855	2.051790021	0	0.038575975	0	0	0	0	0	0	0	0	0	0	0	0	0	69.3728
H3954_060_0	2009	7																					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	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	0	0											0	N/A	192.1666386	24.69001293	9.379366082	8.884105779	122.6161544	10.35851501	5.584340891	219.2337625	51.05168864	54.43601696	48.6066103	1.219411518	0	20.92063036	3990.66051	9871.665559	122.674176	0	24.55324594	5.882162066	4.647227589	0.86756515	0	910.6235131	1231.074012	3.712958545	23.14558528	0.767642859	3.672073652	0											15% Coinsurance (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	15% Coinsurance (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	15% Coinsurance (PBP 11a)	"15% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"15% Coinsurance (PBP 9a, 9b)"	15% Coinsurance (PBP 8a)	"$15 General, 15% CT/MRI/PT (PBP 8b)"	15% Coinsurance (PBP 5)	15% Coinsurance (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit), Other Services 15% Coinsurance (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, 15% Office CT/MRI/PT (PBP 7d)"	"Inpatient Professional CIF, Other Professional 15% Coinsurance (PBP 7g)"	"15% Coinsurance, $1000 OOP Max (PBP 15)"	15% Coinsurance (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0.15	50	0.15	0	50	0.15	0.15	50	0.15	0.15	0.11	0.15	0.15	0.15	10	20	20	10	0.15	0.15	0.15	0.15	0	20	20	0	20	0	0	0											0.10185	50	0.10185	0	50	0.116005018	0.10185	50	0.109422171	0.10185	0.095599053	0.10185	0.10185	0.112225909	10	20	20	10	0.10185	0.106840391	0.10185	0.121076599	0	20	20	0	20	0	0	0											19.5722	0.102875054	0.955288435	0	0.510900643	1.201639717	0.56876512	0.91347401	5.58618662	5.544308327	4.646745916	0.124197063	0	2.347836755	3.325550425	16.45277593	0.20445696	0	2.500748099	0.628452497	0.47332013	0.105041838	0	1.517705855	2.051790021	0	0.038575975	0	0	0	0	0	0	0	0	0	0	0	0	0	69.3728	None	18.252	19.5722	0.102875054	0.955288435	0	0.510900643	1.201639717	0.56876512	0.91347401	5.58618662	5.544308327	4.646745916	0.124197063	0	2.347836755	3.325550425	16.45277593	0.20445696	0	2.500748099	0.628452497	0.47332013	0.105041838	0	1.517705855	2.051790021	0	0.038575975	0	0	0	0	0	0	0	0	0	0	0	0	0	69.3728		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	N/A	0	19.5722	0.102875054	0.955288435	0	0.510900643	1.201639717	0.56876512	0.91347401	5.58618662	5.544308327	4.646745916	0.124197063	0	2.347836755	3.325550425	16.45277593	0.20445696	0	2.500748099	0.628452497	0.47332013	0.105041838	0	1.517705855	2.051790021	0	0.038575975	0	0	0	0	0	0	0	0	0	0	0	0	0	69.3728
H3954_062_0	2009	5																					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	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	0	0											0	N/A	174.2224651	24.69001293	18.65190116	9.978379241	81.16684232	9.583575393	4.636292494	387.1341704	48.24767432	44.50626238	49.657995	1.183782457	0.014190745	23.91564319	5145.490069	5599.23918	122.674176	0	15.11921407	2.253014581	4.56188452	0.925862298	0	909.1404075	879.3081654	3.512601905	14.89645223	1.506669466	3.543815144	0											15% Coinsurance (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	15% Coinsurance (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	15% Coinsurance (PBP 11a)	"15% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"15% Coinsurance (PBP 9a, 9b)"	15% Coinsurance (PBP 8a)	"$15 General, 15% CT/MRI/PT (PBP 8b)"	15% Coinsurance (PBP 5)	15% Coinsurance (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit), Other Services 15% Coinsurance (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, 15% Office CT/MRI/PT (PBP 7d)"	"Inpatient Professional CIF, Other Professional 15% Coinsurance (PBP 7g)"	"15% Coinsurance, $1000 OOP Max (PBP 15)"	15% Coinsurance (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0.15	50	0.15	0	50	0.15	0.15	50	0.15	0.15	0.11	0.15	0.15	0.15	10	20	20	10	0.15	0.15	0.15	0.15	0	20	20	0	20	0	0	0											0.10185	50	0.10185	0	50	0.116005018	0.10185	50	0.109422171	0.10185	0.095599053	0.10185	0.10185	0.112225909	10	20	20	10	0.10185	0.106840391	0.10185	0.121076599	0	20	20	0	20	0	0	0											17.7446	0.102875054	1.899696133	0	0.338195176	1.111742834	0.47220639	1.613059043	5.279365285	4.532962823	4.747257298	0.120568243	0.001445327	2.683954791	4.287908391	9.332065301	0.20445696	0	1.539891953	0.24071296	0.464627938	0.112100258	0	1.515234012	1.465513609	0	0.02482742	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8352	None	16.6846	17.7446	0.102875054	1.899696133	0	0.338195176	1.111742834	0.47220639	1.613059043	5.279365285	4.532962823	4.747257298	0.120568243	0.001445327	2.683954791	4.287908391	9.332065301	0.20445696	0	1.539891953	0.24071296	0.464627938	0.112100258	0	1.515234012	1.465513609	0	0.02482742	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8352		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	N/A	0	17.7446	0.102875054	1.899696133	0	0.338195176	1.111742834	0.47220639	1.613059043	5.279365285	4.532962823	4.747257298	0.120568243	0.001445327	2.683954791	4.287908391	9.332065301	0.20445696	0	1.539891953	0.24071296	0.464627938	0.112100258	0	1.515234012	1.465513609	0	0.02482742	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8352
H3954_063_0	2009	7																					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	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	0	0											0	N/A	174.2224651	24.69001293	18.65190116	9.978379241	81.16684232	9.583575393	4.636292494	387.1341704	48.24767432	44.50626238	49.657995	1.183782457	0.014190745	23.91564319	5145.490069	5599.23918	122.674176	0	15.11921407	2.253014581	4.56188452	0.925862298	0	909.1404075	879.3081654	3.512601905	14.89645223	1.150672623	3.543815144	0											15% Coinsurance (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	15% Coinsurance (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	15% Coinsurance (PBP 11a)	"15% Coinsurance (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"15% Coinsurance (PBP 9a, 9b)"	15% Coinsurance (PBP 8a)	"$15 General, 15% CT/MRI/PT (PBP 8b)"	15% Coinsurance (PBP 5)	15% Coinsurance (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit), Other Services 15% Coinsurance (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, 15% Office CT/MRI/PT (PBP 7d)"	"Inpatient Professional CIF, Other Professional 15% Coinsurance (PBP 7g)"	"15% Coinsurance, $1000 OOP Max (PBP 15)"	15% Coinsurance (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												0.15	50	0.15	0	50	0.15	0.15	50	0.15	0.15	0.11	0.15	0.15	0.15	10	20	20	10	0.15	0.15	0.15	0.15	0	20	20	0	20	0	0	0											0.10185	50	0.10185	0	50	0.116005018	0.10185	50	0.109422171	0.10185	0.095599053	0.10185	0.10185	0.112225909	10	20	20	10	0.10185	0.106840391	0.10185	0.121076599	0	20	20	0	20	0	0	0											17.7446	0.102875054	1.899696133	0	0.338195176	1.111742834	0.47220639	1.613059043	5.279365285	4.532962823	4.747257298	0.120568243	0.001445327	2.683954791	4.287908391	9.332065301	0.20445696	0	1.539891953	0.24071296	0.464627938	0.112100258	0	1.515234012	1.465513609	0	0.02482742	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8352	None	16.6846	17.7446	0.102875054	1.899696133	0	0.338195176	1.111742834	0.47220639	1.613059043	5.279365285	4.532962823	4.747257298	0.120568243	0.001445327	2.683954791	4.287908391	9.332065301	0.20445696	0	1.539891953	0.24071296	0.464627938	0.112100258	0	1.515234012	1.465513609	0	0.02482742	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8352		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	N/A	0	17.7446	0.102875054	1.899696133	0	0.338195176	1.111742834	0.47220639	1.613059043	5.279365285	4.532962823	4.747257298	0.120568243	0.001445327	2.683954791	4.287908391	9.332065301	0.20445696	0	1.539891953	0.24071296	0.464627938	0.112100258	0	1.515234012	1.465513609	0	0.02482742	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8352
H3954_065_0	2009	4																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	V	V	V	Coin	P	P	P	P	P	Coin	Coin	Coin	T	V	V	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	0	0											0	N/A	253.7697956	30.21985877	40.94826885	0	106.5501902	14.56465733	0.752488602	235.131029	35.37489812	7.472097263	569.3697045	0	872.6584287	16.31515721	4426.979322	7606.882725	129.9139168	648.438545	1851.921002	88.19811153	26.47710199	24.92199652	0	0	359.9537707	0	77.13295085	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 14a												0.14925	50	0.15	0	50	0.15	0.15	46.43784171	0.15	0.15	31.08957687	0	22.70722518	0.085234322	10	15.64052665	20	10	21.72995236	0.0756655	0.046383192	0.15	0	0	20	0	20	0	0	0											0.101351991	50	0.101861298	0	50	0.101861298	0.101861298	46.43784171	0.101861298	0.101861298	24.76485821	0	15.41991613	0.06586073	10	14.88282636	20	10	17.72163367	0.051382574	0.046383192	0.101861298	0	0	20	0	20	0	0	0											25.7201	0.125916078	4.171043796	0	0.443959126	1.483574894	0.076649465	0.909914792	3.603333022	0.761117523	1.17503	0	1.121359982	1.074528162	3.689149435	9.434326228	0.216523195	0.540365454	2.734922132	4.531845951	1.228092509	2.538586903	0	0	0.599922951	0	0.128554918	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3088	0	22.5127	25.7201	0.125916078	4.171043796	0	0.443959126	1.483574894	0.076649465	0.909914792	3.603333022	0.761117523	1.17503	0	1.121359982	1.074528162	3.689149435	9.434326228	0.216523195	0.540365454	2.734922132	4.531845951	1.228092509	2.538586903	0	0	0.599922951	0	0.128554918	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3088																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	25.7201	0.125916078	4.171043796	0	0.443959126	1.483574894	0.076649465	0.909914792	3.603333022	0.761117523	1.17503	0	1.121359982	1.074528162	3.689149435	9.434326228	0.216523195	0.540365454	2.734922132	4.531845951	1.228092509	2.538586903	0	0	0.599922951	0	0.128554918	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3088
H3954_066_0	2009	5																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	V	V	V	Coin	P	P	P	P	P	Coin	Coin	Coin	T	V	V	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	0	0											0	N/A	253.7697956	30.21985877	40.94826885	0	106.5501902	14.56465733	0.752488602	235.131029	35.37489812	7.472097263	569.3697045	0	872.6584287	16.31515721	4426.979322	7606.882725	129.9139168	648.438545	1851.921002	88.19811153	26.47710199	24.92199652	0	0	359.9537707	0	77.13295085	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 14a												0.14925	50	0.15	0	50	0.15	0.15	46.43784171	0.15	0.15	31.08957687	0	22.70722518	0.085234322	10	15.64052665	20	10	21.72995236	0.0756655	0.046383192	0.15	0	0	20	0	20	0	0	0											0.101351991	50	0.101861298	0	50	0.101861298	0.101861298	46.43784171	0.101861298	0.101861298	24.76485821	0	15.41991613	0.06586073	10	14.88282636	20	10	17.72163367	0.051382574	0.046383192	0.101861298	0	0	20	0	20	0	0	0											25.7201	0.125916078	4.171043796	0	0.443959126	1.483574894	0.076649465	0.909914792	3.603333022	0.761117523	1.17503	0	1.121359982	1.074528162	3.689149435	9.434326228	0.216523195	0.540365454	2.734922132	4.531845951	1.228092509	2.538586903	0	0	0.599922951	0	0.128554918	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3088	0	22.5127	25.7201	0.125916078	4.171043796	0	0.443959126	1.483574894	0.076649465	0.909914792	3.603333022	0.761117523	1.17503	0	1.121359982	1.074528162	3.689149435	9.434326228	0.216523195	0.540365454	2.734922132	4.531845951	1.228092509	2.538586903	0	0	0.599922951	0	0.128554918	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3088																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	25.7201	0.125916078	4.171043796	0	0.443959126	1.483574894	0.076649465	0.909914792	3.603333022	0.761117523	1.17503	0	1.121359982	1.074528162	3.689149435	9.434326228	0.216523195	0.540365454	2.734922132	4.531845951	1.228092509	2.538586903	0	0	0.599922951	0	0.128554918	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3088
H3954_067_0	2009	4																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	V	V	V	Coin	P	P	P	P	P	Coin	Coin	Coin	T	V	V	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	0	0											0	N/A	253.7697956	30.21985877	40.94826885	0	106.5501902	14.56465733	0.752488602	235.131029	35.37489812	7.472097263	569.3697045	0	872.6584287	16.31515721	4426.979322	7606.882725	129.9139168	648.438545	1851.921002	88.19811153	26.47710199	24.92199652	0	0	359.9537707	0	77.13295085	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 14a												0.14925	50	0.15	0	50	0.15	0.15	46.43784171	0.15	0.15	31.08957687	0	22.70722518	0.085234322	10	15.64052665	20	10	21.72995236	0.0756655	0.046383192	0.15	0	0	20	0	20	0	0	0											0.101351991	50	0.101861298	0	50	0.101861298	0.101861298	46.43784171	0.101861298	0.101861298	24.76485821	0	15.41991613	0.06586073	10	14.88282636	20	10	17.72163367	0.051382574	0.046383192	0.101861298	0	0	20	0	20	0	0	0											25.7201	0.125916078	4.171043796	0	0.443959126	1.483574894	0.076649465	0.909914792	3.603333022	0.761117523	1.17503	0	1.121359982	1.074528162	3.689149435	9.434326228	0.216523195	0.540365454	2.734922132	4.531845951	1.228092509	2.538586903	0	0	0.599922951	0	0.128554918	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3088	0	22.5127	25.7201	0.125916078	4.171043796	0	0.443959126	1.483574894	0.076649465	0.909914792	3.603333022	0.761117523	1.17503	0	1.121359982	1.074528162	3.689149435	9.434326228	0.216523195	0.540365454	2.734922132	4.531845951	1.228092509	2.538586903	0	0	0.599922951	0	0.128554918	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3088																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	25.7201	0.125916078	4.171043796	0	0.443959126	1.483574894	0.076649465	0.909914792	3.603333022	0.761117523	1.17503	0	1.121359982	1.074528162	3.689149435	9.434326228	0.216523195	0.540365454	2.734922132	4.531845951	1.228092509	2.538586903	0	0	0.599922951	0	0.128554918	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3088
H3954_077_0	2009	4																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	V	V	V	Coin	P	P	P	P	P	Coin	Coin	Coin	T	V	V	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	0	0											0	N/A	285.3083854	31.17712779	56.89989891	0	186.485358	16.63195206	0.859296176	238.2226128	43.14200235	11.06721128	918.9929201	0	466.3757512	16.7876778	4829.654255	7956.421497	129.263455	645.191899	1533.996274	92.42395405	26.82291344	26.35921335	0	0	392.6949131	0	84.14890995	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 14a												0.14925	50	0.15	0	50	0.15	0.15	46.16426387	0.15	0.15	34.26584852	0	26.3669094	0.09933497	10	15.96726379	20	10	24.10102901	0.073014616	0.046383192	0.15	0	0	20	0	20	0	0	0											0.096448499	50	0.096933165	0	50	0.096933165	0.096933165	46.16426387	0.096933165	0.096933165	26.16994776	0	17.03885324	0.069819172	10	15.12395586	20	10	18.84352743	0.047183586	0.046383192	0.096933165	0	0	20	0	20	0	0	0											27.5176	0.129904699	5.515487306	0	0.777022325	1.612187758	0.083294298	0.91644763	4.181890844	1.07277982	2.004166392	0	0.662208998	1.172101767	4.02471188	10.02771396	0.215439092	0.537659916	2.408825071	4.360893564	1.244132348	2.555081985	0	0	0.654491522	0	0.140248183	0	0	0	0	0	0	0	0	0	0	0	0	0	71.8143	0	28.3846	27.5176	0.129904699	5.515487306	0	0.777022325	1.612187758	0.083294298	0.91644763	4.181890844	1.07277982	2.004166392	0	0.662208998	1.172101767	4.02471188	10.02771396	0.215439092	0.537659916	2.408825071	4.360893564	1.244132348	2.555081985	0	0	0.654491522	0	0.140248183	0	0	0	0	0	0	0	0	0	0	0	0	0	71.8143																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	27.5176	0.129904699	5.515487306	0	0.777022325	1.612187758	0.083294298	0.91644763	4.181890844	1.07277982	2.004166392	0	0.662208998	1.172101767	4.02471188	10.02771396	0.215439092	0.537659916	2.408825071	4.360893564	1.244132348	2.555081985	0	0	0.654491522	0	0.140248183	0	0	0	0	0	0	0	0	0	0	0	0	0	71.8143
H3954_078_0	2009	3																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	V	V	V	Coin	P	P	P	P	P	Coin	Coin	Coin	T	V	V	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	0	0											0	N/A	285.3083854	31.17712779	56.89989891	0	186.485358	16.63195206	0.859296176	238.2226128	43.14200235	11.06721128	918.9929201	0	466.3757512	16.7876778	4829.654255	7956.421497	129.263455	645.191899	1533.996274	92.42395405	26.82291344	26.35921335	0	0	392.6949131	0	84.14890995	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 14a												0.14925	50	0.15	0	50	0.15	0.15	46.16426387	0.15	0.15	34.26584852	0	26.3669094	0.09933497	10	15.96726379	20	10	24.10102901	0.073014616	0.046383192	0.15	0	0	20	0	20	0	0	0											0.096448499	50	0.096933165	0	50	0.096933165	0.096933165	46.16426387	0.096933165	0.096933165	26.16994776	0	17.03885324	0.069819172	10	15.12395586	20	10	18.84352743	0.047183586	0.046383192	0.096933165	0	0	20	0	20	0	0	0											27.5176	0.129904699	5.515487306	0	0.777022325	1.612187758	0.083294298	0.91644763	4.181890844	1.07277982	2.004166392	0	0.662208998	1.172101767	4.02471188	10.02771396	0.215439092	0.537659916	2.408825071	4.360893564	1.244132348	2.555081985	0	0	0.654491522	0	0.140248183	0	0	0	0	0	0	0	0	0	0	0	0	0	71.8143	0	28.3846	27.5176	0.129904699	5.515487306	0	0.777022325	1.612187758	0.083294298	0.91644763	4.181890844	1.07277982	2.004166392	0	0.662208998	1.172101767	4.02471188	10.02771396	0.215439092	0.537659916	2.408825071	4.360893564	1.244132348	2.555081985	0	0	0.654491522	0	0.140248183	0	0	0	0	0	0	0	0	0	0	0	0	0	71.8143																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	27.5176	0.129904699	5.515487306	0	0.777022325	1.612187758	0.083294298	0.91644763	4.181890844	1.07277982	2.004166392	0	0.662208998	1.172101767	4.02471188	10.02771396	0.215439092	0.537659916	2.408825071	4.360893564	1.244132348	2.555081985	0	0	0.654491522	0	0.140248183	0	0	0	0	0	0	0	0	0	0	0	0	0	71.8143
H3954_079_0	2009	3																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	V	V	V	Coin	P	P	P	P	P	Coin	Coin	Coin	T	V	V	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	0	0											0	N/A	285.3083854	31.17712779	56.89989891	0	186.485358	16.63195206	0.859296176	238.2226128	43.14200235	11.06721128	918.9929201	0	466.3757512	16.7876778	4829.654255	7956.421497	129.263455	645.191899	1533.996274	92.42395405	26.82291344	26.35921335	0	0	392.6949131	0	84.14890995	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 14a												0.14925	50	0.15	0	50	0.15	0.15	46.16426387	0.15	0.15	34.26584852	0	26.3669094	0.09933497	10	15.96726379	20	10	24.10102901	0.073014616	0.046383192	0.15	0	0	20	0	20	0	0	0											0.096448499	50	0.096933165	0	50	0.096933165	0.096933165	46.16426387	0.096933165	0.096933165	26.16994776	0	17.03885324	0.069819172	10	15.12395586	20	10	18.84352743	0.047183586	0.046383192	0.096933165	0	0	20	0	20	0	0	0											27.5176	0.129904699	5.515487306	0	0.777022325	1.612187758	0.083294298	0.91644763	4.181890844	1.07277982	2.004166392	0	0.662208998	1.172101767	4.02471188	10.02771396	0.215439092	0.537659916	2.408825071	4.360893564	1.244132348	2.555081985	0	0	0.654491522	0	0.140248183	0	0	0	0	0	0	0	0	0	0	0	0	0	71.8143	0	28.3846	27.5176	0.129904699	5.515487306	0	0.777022325	1.612187758	0.083294298	0.91644763	4.181890844	1.07277982	2.004166392	0	0.662208998	1.172101767	4.02471188	10.02771396	0.215439092	0.537659916	2.408825071	4.360893564	1.244132348	2.555081985	0	0	0.654491522	0	0.140248183	0	0	0	0	0	0	0	0	0	0	0	0	0	71.8143																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	27.5176	0.129904699	5.515487306	0	0.777022325	1.612187758	0.083294298	0.91644763	4.181890844	1.07277982	2.004166392	0	0.662208998	1.172101767	4.02471188	10.02771396	0.215439092	0.537659916	2.408825071	4.360893564	1.244132348	2.555081985	0	0	0.654491522	0	0.140248183	0	0	0	0	0	0	0	0	0	0	0	0	0	71.8143
H3954_089_0	2009	4																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	V	V	V	Coin	P	P	P	P	P	Coin	Coin	Coin	T	V	V	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	0	0											0	N/A	210.4072034	24.29289647	36.95766843	0	191.5117641	16.68017457	0.861787611	303.4441382	30.17450584	10.91550227	1074.544324	0	1167.59264	17.84790006	3608.705063	5918.077307	95.60432102	477.1892675	1249.786965	61.2209544	21.40821238	16.75536913	0	0	293.4206148	0	62.87584604	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 14a												0.14925	50	0.15	0	50	0.15	0.15	47.74997003	0.15	0.15	30.04809675	0	21.50723702	0.108543694	10	15.65382555	20	10	20.02259038	0.071568203	0.046383192	0.15	0	0	20	0	20	0	0	0											0.107671672	50	0.108212736	0	50	0.108212736	0.108212736	47.74997003	0.108212736	0.108212736	24.84800119	0	15.51571305	0.083089424	10	15.08642919	20	10	17.01877065	0.051630607	0.046383192	0.108212736	0	0	20	0	20	0	0	0											22.6549	0.101220402	3.99929041	0	0.797965684	1.805007324	0.093256395	1.207454042	3.265265828	1.181196363	2.225023219	0	1.509669364	1.482971736	3.007254219	7.440221186	0.159340535	0.397657723	1.772486477	3.160875056	0.992981229	1.813144333	0	0	0.489034358	0	0.104793077	0	0	0	0	0	0	0	0	0	0	0	0	0	59.661	0	16.7592	22.6549	0.101220402	3.99929041	0	0.797965684	1.805007324	0.093256395	1.207454042	3.265265828	1.181196363	2.225023219	0	1.509669364	1.482971736	3.007254219	7.440221186	0.159340535	0.397657723	1.772486477	3.160875056	0.992981229	1.813144333	0	0	0.489034358	0	0.104793077	0	0	0	0	0	0	0	0	0	0	0	0	0	59.661																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.6549	0.101220402	3.99929041	0	0.797965684	1.805007324	0.093256395	1.207454042	3.265265828	1.181196363	2.225023219	0	1.509669364	1.482971736	3.007254219	7.440221186	0.159340535	0.397657723	1.772486477	3.160875056	0.992981229	1.813144333	0	0	0.489034358	0	0.104793077	0	0	0	0	0	0	0	0	0	0	0	0	0	59.661
H3954_090_0	2009	3																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	V	V	V	Coin	P	P	P	P	P	Coin	Coin	Coin	T	V	V	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	0	0											0	N/A	210.4072034	24.29289647	36.95766843	0	191.5117641	16.68017457	0.861787611	303.4441382	30.17450584	10.91550227	1074.544324	0	1167.59264	17.84790006	3608.705063	5918.077307	95.60432102	477.1892675	1249.786965	61.2209544	21.40821238	16.75536913	0	0	293.4206148	0	62.87584604	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 14a												0.14925	50	0.15	0	50	0.15	0.15	47.74997003	0.15	0.15	30.04809675	0	21.50723702	0.108543694	10	15.65382555	20	10	20.02259038	0.071568203	0.046383192	0.15	0	0	20	0	20	0	0	0											0.107671672	50	0.108212736	0	50	0.108212736	0.108212736	47.74997003	0.108212736	0.108212736	24.84800119	0	15.51571305	0.083089424	10	15.08642919	20	10	17.01877065	0.051630607	0.046383192	0.108212736	0	0	20	0	20	0	0	0											22.6549	0.101220402	3.99929041	0	0.797965684	1.805007324	0.093256395	1.207454042	3.265265828	1.181196363	2.225023219	0	1.509669364	1.482971736	3.007254219	7.440221186	0.159340535	0.397657723	1.772486477	3.160875056	0.992981229	1.813144333	0	0	0.489034358	0	0.104793077	0	0	0	0	0	0	0	0	0	0	0	0	0	59.661	0	16.7592	22.6549	0.101220402	3.99929041	0	0.797965684	1.805007324	0.093256395	1.207454042	3.265265828	1.181196363	2.225023219	0	1.509669364	1.482971736	3.007254219	7.440221186	0.159340535	0.397657723	1.772486477	3.160875056	0.992981229	1.813144333	0	0	0.489034358	0	0.104793077	0	0	0	0	0	0	0	0	0	0	0	0	0	59.661																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.6549	0.101220402	3.99929041	0	0.797965684	1.805007324	0.093256395	1.207454042	3.265265828	1.181196363	2.225023219	0	1.509669364	1.482971736	3.007254219	7.440221186	0.159340535	0.397657723	1.772486477	3.160875056	0.992981229	1.813144333	0	0	0.489034358	0	0.104793077	0	0	0	0	0	0	0	0	0	0	0	0	0	59.661
H3954_091_0	2009	3																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	V	V	V	Coin	P	P	P	P	P	Coin	Coin	Coin	T	V	V	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	0	0											0	N/A	210.4072034	24.29289647	36.95766843	0	191.5117641	16.68017457	0.861787611	303.4441382	30.17450584	10.91550227	1074.544324	0	1167.59264	17.84790006	3608.705063	5918.077307	95.60432102	477.1892675	1249.786965	61.2209544	21.40821238	16.75536913	0	0	293.4206148	0	62.87584604	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 14a												0.14925	50	0.15	0	50	0.15	0.15	47.74997003	0.15	0.15	30.04809675	0	21.50723702	0.108543694	10	15.65382555	20	10	20.02259038	0.071568203	0.046383192	0.15	0	0	20	0	20	0	0	0											0.107671672	50	0.108212736	0	50	0.108212736	0.108212736	47.74997003	0.108212736	0.108212736	24.84800119	0	15.51571305	0.083089424	10	15.08642919	20	10	17.01877065	0.051630607	0.046383192	0.108212736	0	0	20	0	20	0	0	0											22.6549	0.101220402	3.99929041	0	0.797965684	1.805007324	0.093256395	1.207454042	3.265265828	1.181196363	2.225023219	0	1.509669364	1.482971736	3.007254219	7.440221186	0.159340535	0.397657723	1.772486477	3.160875056	0.992981229	1.813144333	0	0	0.489034358	0	0.104793077	0	0	0	0	0	0	0	0	0	0	0	0	0	59.661	0	16.7592	22.6549	0.101220402	3.99929041	0	0.797965684	1.805007324	0.093256395	1.207454042	3.265265828	1.181196363	2.225023219	0	1.509669364	1.482971736	3.007254219	7.440221186	0.159340535	0.397657723	1.772486477	3.160875056	0.992981229	1.813144333	0	0	0.489034358	0	0.104793077	0	0	0	0	0	0	0	0	0	0	0	0	0	59.661																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.6549	0.101220402	3.99929041	0	0.797965684	1.805007324	0.093256395	1.207454042	3.265265828	1.181196363	2.225023219	0	1.509669364	1.482971736	3.007254219	7.440221186	0.159340535	0.397657723	1.772486477	3.160875056	0.992981229	1.813144333	0	0	0.489034358	0	0.104793077	0	0	0	0	0	0	0	0	0	0	0	0	0	59.661
H3954_097_0	2009	4																					N/A											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	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	0	0											0	N/A	342.3189951	24.23459068	127.9385005	44.7572519	15.44921183	45.66687667	3.685253122	900.6622857	33.01702131	15.97354068	27.43471975	0	34.93263055	24.3372197	22.8474084	43.82887337	5.585498953	6.358085985	23.66242632	80.39404606	26.29426246	20.16641182	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 14a												0.07763191	0.07763191	0.196795874	0	0.231	0.231	0.231	48.56001649	0.231	0.231	0.231	0	0.231	0.231	0.005169672	0.231	0.231	0.231	0.231	0.207664263	0.231	0.231	0	0	0	0	0	0	0	0											0.07763191	0.07763191	0.196795874	0	0.231	0.231	0.231	48.56001649	0.231	0.231	0.231	0	0.231	0.231	0.005169672	0.231	0.231	0.231	0.231	0.207664263	0.231	0.231	0	0	0	0	0	0	0	0											26.5749	1.881377552	25.17776902	0	3.568767934	10.54904851	0.851293471	3.644681287	7.626931924	3.689887896	6.337420263	0	8.069437658	5.62189775	0.118113613	10.12446975	1.290250258	1.468717862	5.466020481	16.69497035	6.073974629	4.658441131	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	149.4883	0	0	26.5749	1.881377552	25.17776902	0	3.568767934	10.54904851	0.851293471	3.644681287	7.626931924	3.689887896	6.337420263	0	8.069437658	5.62189775	0.118113613	10.12446975	1.290250258	1.468717862	5.466020481	16.69497035	6.073974629	4.658441131	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	149.4883	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	26.5749	1.881377552	25.17776902	0	3.568767934	10.54904851	0.851293471	3.644681287	7.626931924	3.689887896	6.337420263	0	8.069437658	5.62189775	0.118113613	10.12446975	1.290250258	1.468717862	5.466020481	16.69497035	6.073974629	4.658441131	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	149.4883
H3954_098_0	2009	3																					N/A											Coin	D	Coin	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	T	V	V	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	0	0											0	N/A	224.5443398	26.35059126	39.02187123	0	5.846420499	14.57510836	0.748641222	233.350358	31.51011344	9.986388444	21.93499616	0	9.016635586	15.74019217	3803.838776	6280.779294	101.8161764	508.1944634	26.63867656	69.19683682	21.30817127	19.58977243	0	0	309.2867643	0	66.27573521	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 14a												0.15194885	50	0.132294136	0	0.132294136	0.132294136	0.132294136	46.91589401	0.132294136	0.132294136	0.132294136	0	0.132294136	0.091335843	10	15.53237865	20	10	0.122312452	0.063921446	0.132294136	0.132294136	0	0	20	0	20	0	0	0											0.15194885	50	0.132294136	0	0.132294136	0.132294136	0.132294136	46.91589401	0.132294136	0.132294136	0.132294136	0	0.132294136	0.091335843	10	15.53237865	20	10	0.122312452	0.063921446	0.132294136	0.132294136	0	0	20	0	20	0	0	0											34.1193	0.10979413	5.162364739	0	0.773447149	1.928201368	0.099040844	0.912320055	4.168603233	1.321140631	2.901871365	0	1.192848014	1.437643717	3.169865646	8.129620186	0.169693627	0.423495386	3.258241855	4.423161839	2.818946108	2.591612018	0	0	0.515477941	0	0.110459559	0	0	0	0	0	0	0	0	0	0	0	0	0	79.7371	0	0	34.1193	0.10979413	5.162364739	0	0.773447149	1.928201368	0.099040844	0.912320055	4.168603233	1.321140631	2.901871365	0	1.192848014	1.437643717	3.169865646	8.129620186	0.169693627	0.423495386	3.258241855	4.423161839	2.818946108	2.591612018	0	0	0.515477941	0	0.110459559	0	0	0	0	0	0	0	0	0	0	0	0	0	79.7371	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	34.1193	0.10979413	5.162364739	0	0.773447149	1.928201368	0.099040844	0.912320055	4.168603233	1.321140631	2.901871365	0	1.192848014	1.437643717	3.169865646	8.129620186	0.169693627	0.423495386	3.258241855	4.423161839	2.818946108	2.591612018	0	0	0.515477941	0	0.110459559	0	0	0	0	0	0	0	0	0	0	0	0	0	79.7371
H3954_099_0	2009	2																					N/A											Coin	D	Coin	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	T	V	V	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	0	0											0	N/A	224.5443398	26.35059126	39.02187123	0	5.846420499	14.57510836	0.748641222	233.350358	31.51011344	9.986388444	21.93499616	0	9.016635586	15.74019217	3803.838776	6280.779294	101.8161764	508.1944634	26.63867656	69.19683682	21.30817127	19.58977243	0	0	309.2867643	0	66.27573521	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 14a												0.15194885	50	0.132294136	0	0.132294136	0.132294136	0.132294136	46.91589401	0.132294136	0.132294136	0.132294136	0	0.132294136	0.091335843	10	15.53237865	20	10	0.122312452	0.063921446	0.132294136	0.132294136	0	0	20	0	20	0	0	0											0.15194885	50	0.132294136	0	0.132294136	0.132294136	0.132294136	46.91589401	0.132294136	0.132294136	0.132294136	0	0.132294136	0.091335843	10	15.53237865	20	10	0.122312452	0.063921446	0.132294136	0.132294136	0	0	20	0	20	0	0	0											34.1193	0.10979413	5.162364739	0	0.773447149	1.928201368	0.099040844	0.912320055	4.168603233	1.321140631	2.901871365	0	1.192848014	1.437643717	3.169865646	8.129620186	0.169693627	0.423495386	3.258241855	4.423161839	2.818946108	2.591612018	0	0	0.515477941	0	0.110459559	0	0	0	0	0	0	0	0	0	0	0	0	0	79.7371	0	0	34.1193	0.10979413	5.162364739	0	0.773447149	1.928201368	0.099040844	0.912320055	4.168603233	1.321140631	2.901871365	0	1.192848014	1.437643717	3.169865646	8.129620186	0.169693627	0.423495386	3.258241855	4.423161839	2.818946108	2.591612018	0	0	0.515477941	0	0.110459559	0	0	0	0	0	0	0	0	0	0	0	0	0	79.7371	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	34.1193	0.10979413	5.162364739	0	0.773447149	1.928201368	0.099040844	0.912320055	4.168603233	1.321140631	2.901871365	0	1.192848014	1.437643717	3.169865646	8.129620186	0.169693627	0.423495386	3.258241855	4.423161839	2.818946108	2.591612018	0	0	0.515477941	0	0.110459559	0	0	0	0	0	0	0	0	0	0	0	0	0	79.7371
H3954_100_0	2009	2																					N/A											Coin	D	Coin	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	Coin	Coin	T	V	V	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	0	0											0	N/A	224.6913994	26.35059126	39.04742761	0	5.850249463	14.58465396	0.749131526	233.350358	31.53075019	9.992928775	21.94936193	0	9.022540801	15.7505008	3803.838776	6280.779294	101.8161764	508.1944634	26.65612288	69.24215552	21.32212651	19.60260225	0	0	309.2867643	0	66.27573521	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 14a												0.15194885	50	0.132294136	0	0.132294136	0.132294136	0.132294136	46.91589401	0.132294136	0.132294136	0.132294136	0	0.132294136	0.091324189	10	15.5336751	20	10	0.122312452	0.063921446	0.132294136	0.132294136	0	0	20	0	20	0	0	0											0.15194885	50	0.132294136	0	0.132294136	0.132294136	0.132294136	46.91589401	0.132294136	0.132294136	0.132294136	0	0.132294136	0.091324189	10	15.5336751	20	10	0.122312452	0.063921446	0.132294136	0.132294136	0	0	20	0	20	0	0	0											34.1416	0.10979413	5.165745699	0	0.773953698	1.929464194	0.099105708	0.912320055	4.171333353	1.322005878	2.903771872	0	1.19362924	1.438401705	3.169865646	8.130298741	0.169693627	0.423495386	3.260375757	4.426058676	2.820792304	2.593309329	0	0	0.515477941	0	0.110459559	0	0	0	0	0	0	0	0	0	0	0	0	0	79.781	0	0	34.1416	0.10979413	5.165745699	0	0.773953698	1.929464194	0.099105708	0.912320055	4.171333353	1.322005878	2.903771872	0	1.19362924	1.438401705	3.169865646	8.130298741	0.169693627	0.423495386	3.260375757	4.426058676	2.820792304	2.593309329	0	0	0.515477941	0	0.110459559	0	0	0	0	0	0	0	0	0	0	0	0	0	79.781	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	34.1416	0.10979413	5.165745699	0	0.773953698	1.929464194	0.099105708	0.912320055	4.171333353	1.322005878	2.903771872	0	1.19362924	1.438401705	3.169865646	8.130298741	0.169693627	0.423495386	3.260375757	4.426058676	2.820792304	2.593309329	0	0	0.515477941	0	0.110459559	0	0	0	0	0	0	0	0	0	0	0	0	0	79.781
H3954_106_0	2009	2																					N/A											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	T	V	V	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	0	0											0	N/A	2200.132218	239.3699	0	0	1256.392397	39.69317073	0	581.8374611	0	0	0	0	0	0	0	5368.457482	1156.000846	0	547.9286567	3446.888605	8.904763678	0	0	0	344.8694426	0	78.00618343	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 14a												50	50	0	0	50	0.1	0	50	0	0	0	0	0	0	0	9.382426284	20	0	10	10	0.1	0	0	0	10	0	10	0	0	0											50	50	0	0	50	0.1	0	50	0	0	0	0	0	0	0	9.382426284	20	0	10	10	0.1	0	0	0	10	0	10	0	0	0											9.1672	0.997374583	0	0	5.23496832	3.969317073	0	2.424322755	0	0	0	0	0	0	0	4.197429716	1.926668076	0	0.456607214	2.87240717	0.890476368	0	0	0	0.287391202	0	0.065005153	0	0	0	0	0	0	0	0	0	0	0	0	0	32.4892	0	0	9.1672	0.997374583	0	0	5.23496832	3.969317073	0	2.424322755	0	0	0	0	0	0	0	4.197429716	1.926668076	0	0.456607214	2.87240717	0.890476368	0	0	0	0.287391202	0	0.065005153	0	0	0	0	0	0	0	0	0	0	0	0	0	32.4892	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	9.1672	0.997374583	0	0	5.23496832	3.969317073	0	2.424322755	0	0	0	0	0	0	0	4.197429716	1.926668076	0	0.456607214	2.87240717	0.890476368	0	0	0	0.287391202	0	0.065005153	0	0	0	0	0	0	0	0	0	0	0	0	0	32.4892
H3954_107_0	2009	3																					N/A											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	T	V	V	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	0	0											0	N/A	1058.882402	30.21985877	859.4255874	0	106.5501902	14.95606182	0	235.131029	342.9215151	0	552.7895177	0	0	486.8368753	4426.979322	5147.787569	129.9139168	648.438545	1301.067327	0	26.79828604	0	0	0	359.9537707	0	77.13295085	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 14a												50	50	25	0	50	0.1	0	46.43784171	50	0	28.10735706	0	0	10	10	19.62316217	20	10	22.39138219	0	0.030188489	0	0	0	20	0	20	0	0	0											50	50	25	0	50	0.1	0	46.43784171	50	0	28.10735706	0	0	10	10	19.62316217	20	10	22.39138219	0	0.030188489	0	0	0	20	0	20	0	0	0											4.412	0.125916078	1.790469974	0	0.443959126	1.495606182	0	0.909914792	1.428839646	0	1.294787696	0	0	0.405697396	3.689149435	8.417989191	0.216523195	0.540365454	2.427724647	0	0.808999752	0	0	0	0.599922951	0	0.128554918	0	0	0	0	0	0	0	0	0	0	0	0	0	29.1364	0	0	4.412	0.125916078	1.790469974	0	0.443959126	1.495606182	0	0.909914792	1.428839646	0	1.294787696	0	0	0.405697396	3.689149435	8.417989191	0.216523195	0.540365454	2.427724647	0	0.808999752	0	0	0	0.599922951	0	0.128554918	0	0	0	0	0	0	0	0	0	0	0	0	0	29.1364	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	4.412	0.125916078	1.790469974	0	0.443959126	1.495606182	0	0.909914792	1.428839646	0	1.294787696	0	0	0.405697396	3.689149435	8.417989191	0.216523195	0.540365454	2.427724647	0	0.808999752	0	0	0	0.599922951	0	0.128554918	0	0	0	0	0	0	0	0	0	0	0	0	0	29.1364
H3954_108_0	2009	3																					N/A											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	T	V	V	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	0	0											0	N/A	1058.882402	30.21985877	859.4255874	0	106.5501902	14.95606182	0	235.131029	342.9215151	0	552.7895177	0	0	486.8368753	4426.979322	5147.787569	129.9139168	648.438545	1301.067327	0	26.79828604	0	0	0	359.9537707	0	77.13295085	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 14a												50	50	25	0	50	0.1	0	46.43784171	50	0	28.10735706	0	0	10	10	19.62316217	20	10	22.39138219	0	0.030188489	0	0	0	20	0	20	0	0	0											50	50	25	0	50	0.1	0	46.43784171	50	0	28.10735706	0	0	10	10	19.62316217	20	10	22.39138219	0	0.030188489	0	0	0	20	0	20	0	0	0											4.412	0.125916078	1.790469974	0	0.443959126	1.495606182	0	0.909914792	1.428839646	0	1.294787696	0	0	0.405697396	3.689149435	8.417989191	0.216523195	0.540365454	2.427724647	0	0.808999752	0	0	0	0.599922951	0	0.128554918	0	0	0	0	0	0	0	0	0	0	0	0	0	29.1364	0	0	4.412	0.125916078	1.790469974	0	0.443959126	1.495606182	0	0.909914792	1.428839646	0	1.294787696	0	0	0.405697396	3.689149435	8.417989191	0.216523195	0.540365454	2.427724647	0	0.808999752	0	0	0	0.599922951	0	0.128554918	0	0	0	0	0	0	0	0	0	0	0	0	0	29.1364	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	4.412	0.125916078	1.790469974	0	0.443959126	1.495606182	0	0.909914792	1.428839646	0	1.294787696	0	0	0.405697396	3.689149435	8.417989191	0.216523195	0.540365454	2.427724647	0	0.808999752	0	0	0	0.599922951	0	0.128554918	0	0	0	0	0	0	0	0	0	0	0	0	0	29.1364
H3954_109_0	2009	3																					N/A											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	T	V	V	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	0	0											0	N/A	1058.882402	30.21985877	859.4255874	0	106.5501902	14.95606182	0	235.131029	342.9215151	0	552.7895177	0	0	486.8368753	4426.979322	5147.787569	129.9139168	648.438545	1301.067327	0	26.79828604	0	0	0	359.9537707	0	77.13295085	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 14a												50	50	25	0	50	0.1	0	46.43784171	50	0	28.10735706	0	0	10	10	19.62316217	20	10	22.39138219	0	0.030188489	0	0	0	20	0	20	0	0	0											50	50	25	0	50	0.1	0	46.43784171	50	0	28.10735706	0	0	10	10	19.62316217	20	10	22.39138219	0	0.030188489	0	0	0	20	0	20	0	0	0											4.412	0.125916078	1.790469974	0	0.443959126	1.495606182	0	0.909914792	1.428839646	0	1.294787696	0	0	0.405697396	3.689149435	8.417989191	0.216523195	0.540365454	2.427724647	0	0.808999752	0	0	0	0.599922951	0	0.128554918	0	0	0	0	0	0	0	0	0	0	0	0	0	29.1364	0	0	4.412	0.125916078	1.790469974	0	0.443959126	1.495606182	0	0.909914792	1.428839646	0	1.294787696	0	0	0.405697396	3.689149435	8.417989191	0.216523195	0.540365454	2.427724647	0	0.808999752	0	0	0	0.599922951	0	0.128554918	0	0	0	0	0	0	0	0	0	0	0	0	0	29.1364	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	4.412	0.125916078	1.790469974	0	0.443959126	1.495606182	0	0.909914792	1.428839646	0	1.294787696	0	0	0.405697396	3.689149435	8.417989191	0.216523195	0.540365454	2.427724647	0	0.808999752	0	0	0	0.599922951	0	0.128554918	0	0	0	0	0	0	0	0	0	0	0	0	0	29.1364
H3954_110_0	2009	3																					N/A											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	T	V	V	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	0	0											0	N/A	851.2058501	24.29289647	819.5811739	0	191.5117641	17.12776256	0	303.4441382	308.8297629	0	1043.253327	0	0	367.7976698	3608.705063	4108.416506	95.60432102	477.1892675	878.0379849	0	21.62238508	0	0	0	293.4206148	0	62.87584604	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 14a												50	50	25	0	50	0.1	0	47.74997003	50	0	28.10735706	0	0	10	10	19.61510299	20	10	22.39138219	0	0.030188489	0	0	0	20	0	20	0	0	0											50	50	25	0	50	0.1	0	47.74997003	50	0	28.10735706	0	0	10	10	19.61510299	20	10	22.39138219	0	0.030188489	0	0	0	20	0	20	0	0	0											3.5467	0.101220402	1.707460779	0	0.797965684	1.712776256	0	1.207454042	1.286790679	0	2.443591147	0	0	0.306498058	3.007254219	6.715584407	0.159340535	0.397657723	1.638373675	0	0.652747125	0	0	0	0.489034358	0	0.104793077	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2752	0	0	3.5467	0.101220402	1.707460779	0	0.797965684	1.712776256	0	1.207454042	1.286790679	0	2.443591147	0	0	0.306498058	3.007254219	6.715584407	0.159340535	0.397657723	1.638373675	0	0.652747125	0	0	0	0.489034358	0	0.104793077	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2752	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	3.5467	0.101220402	1.707460779	0	0.797965684	1.712776256	0	1.207454042	1.286790679	0	2.443591147	0	0	0.306498058	3.007254219	6.715584407	0.159340535	0.397657723	1.638373675	0	0.652747125	0	0	0	0.489034358	0	0.104793077	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2752
H3954_111_0	2009	3																					N/A											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	T	V	V	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	0	0											0	N/A	851.2058501	24.29289647	819.5811739	0	191.5117641	17.12776256	0	303.4441382	308.8297629	0	1043.253327	0	0	367.7976698	3608.705063	4108.416506	95.60432102	477.1892675	878.0379849	0	21.62238508	0	0	0	293.4206148	0	62.87584604	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 14a												50	50	25	0	50	0.1	0	47.74997003	50	0	28.10735706	0	0	10	10	19.61510299	20	10	22.39138219	0	0.030188489	0	0	0	20	0	20	0	0	0											50	50	25	0	50	0.1	0	47.74997003	50	0	28.10735706	0	0	10	10	19.61510299	20	10	22.39138219	0	0.030188489	0	0	0	20	0	20	0	0	0											3.5467	0.101220402	1.707460779	0	0.797965684	1.712776256	0	1.207454042	1.286790679	0	2.443591147	0	0	0.306498058	3.007254219	6.715584407	0.159340535	0.397657723	1.638373675	0	0.652747125	0	0	0	0.489034358	0	0.104793077	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2752	0	0	3.5467	0.101220402	1.707460779	0	0.797965684	1.712776256	0	1.207454042	1.286790679	0	2.443591147	0	0	0.306498058	3.007254219	6.715584407	0.159340535	0.397657723	1.638373675	0	0.652747125	0	0	0	0.489034358	0	0.104793077	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2752	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	3.5467	0.101220402	1.707460779	0	0.797965684	1.712776256	0	1.207454042	1.286790679	0	2.443591147	0	0	0.306498058	3.007254219	6.715584407	0.159340535	0.397657723	1.638373675	0	0.652747125	0	0	0	0.489034358	0	0.104793077	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2752
H3954_112_0	2009	3																					N/A											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	T	V	V	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	0	0											0	N/A	851.2058501	24.29289647	819.5811739	0	191.5117641	17.12776256	0	303.4441382	308.8297629	0	1043.253327	0	0	367.7976698	3608.705063	4108.416506	95.60432102	477.1892675	878.0379849	0	21.62238508	0	0	0	293.4206148	0	62.87584604	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 14a												50	50	25	0	50	0.1	0	47.74997003	50	0	28.10735706	0	0	10	10	19.61510299	20	10	22.39138219	0	0.030188489	0	0	0	20	0	20	0	0	0											50	50	25	0	50	0.1	0	47.74997003	50	0	28.10735706	0	0	10	10	19.61510299	20	10	22.39138219	0	0.030188489	0	0	0	20	0	20	0	0	0											3.5467	0.101220402	1.707460779	0	0.797965684	1.712776256	0	1.207454042	1.286790679	0	2.443591147	0	0	0.306498058	3.007254219	6.715584407	0.159340535	0.397657723	1.638373675	0	0.652747125	0	0	0	0.489034358	0	0.104793077	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2752	0	0	3.5467	0.101220402	1.707460779	0	0.797965684	1.712776256	0	1.207454042	1.286790679	0	2.443591147	0	0	0.306498058	3.007254219	6.715584407	0.159340535	0.397657723	1.638373675	0	0.652747125	0	0	0	0.489034358	0	0.104793077	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2752	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	3.5467	0.101220402	1.707460779	0	0.797965684	1.712776256	0	1.207454042	1.286790679	0	2.443591147	0	0	0.306498058	3.007254219	6.715584407	0.159340535	0.397657723	1.638373675	0	0.652747125	0	0	0	0.489034358	0	0.104793077	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2752
H3954_113_0	2009	2																					None											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	N/A	982.8587556	24.69001293	1005.275897	9.978379241	93.7913293	9.826792094	5.9495002	384.3720463	277.4936192	56.17511717	1238.775696	17.8193185	0.391694389	728.7218055	4379.878054	1811.609234	122.674176	0	643.8263433	4.56664317	3.051331941	0.953986252	0	909.1404075	746.0079857	3.512601905	0.954111243	1.506669466	3.543815144	0											$50 Copay Days 1-5 (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	$25 Copay Days 11-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	10% Coinsurance (PBP 11a)	"CIF (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$50 Copay (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"10% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											4.0952	0.102875054	2.094324786	0	0.390797205	0.982679209	0	1.601550193	1.156223413	0	3.09693924	0.03712358	0	0.607268171	3.649898378	3.019348724	0.20445696	0	1.126696101	0	0.305133194	0	0	1.515234012	1.243346643	0	0.001590185	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2307	None	0	4.0952	0.102875054	2.094324786	0	0.390797205	0.982679209	0	1.601550193	1.156223413	0	3.09693924	0.03712358	0	0.607268171	3.649898378	3.019348724	0.20445696	0	1.126696101	0	0.305133194	0	0	1.515234012	1.243346643	0	0.001590185	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2307	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											0	0	0	0	0	0	0	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	4.0952	0.102875054	2.094324786	0	0.390797205	0.982679209	0	1.601550193	1.156223413	0	3.09693924	0.03712358	0	0.607268171	3.649898378	3.019348724	0.20445696	0	1.126696101	0	0.305133194	0	0	1.515234012	1.243346643	0	0.001590185	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2307
H3954_114_0	2009	2																					None											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	N/A	982.8587556	24.69001293	1005.275897	9.978379241	93.7913293	9.826792094	5.9495002	384.3720463	277.4936192	56.17511717	1238.775696	17.8193185	0.391694389	728.7218055	4379.878054	1811.609234	122.674176	0	643.8263433	4.56664317	3.051331941	0.953986252	0	909.1404075	746.0079857	3.512601905	0.954111243	1.506669466	3.543815144	0											$50 Copay Days 1-5 (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	$25 Copay Days 11-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	10% Coinsurance (PBP 11a)	"CIF (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$50 Copay (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"10% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											4.0952	0.102875054	2.094324786	0	0.390797205	0.982679209	0	1.601550193	1.156223413	0	3.09693924	0.03712358	0	0.607268171	3.649898378	3.019348724	0.20445696	0	1.126696101	0	0.305133194	0	0	1.515234012	1.243346643	0	0.001590185	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2307	None	0	4.0952	0.102875054	2.094324786	0	0.390797205	0.982679209	0	1.601550193	1.156223413	0	3.09693924	0.03712358	0	0.607268171	3.649898378	3.019348724	0.20445696	0	1.126696101	0	0.305133194	0	0	1.515234012	1.243346643	0	0.001590185	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2307	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											0	0	0	0	0	0	0	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	4.0952	0.102875054	2.094324786	0	0.390797205	0.982679209	0	1.601550193	1.156223413	0	3.09693924	0.03712358	0	0.607268171	3.649898378	3.019348724	0.20445696	0	1.126696101	0	0.305133194	0	0	1.515234012	1.243346643	0	0.001590185	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2307
H3954_115_0	2009	2																					None											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	N/A	982.8587556	24.69001293	1005.275897	9.978379241	93.7913293	9.826792094	5.9495002	384.3720463	277.4936192	56.17511717	1238.775696	17.8193185	0.391694389	728.7218055	4379.878054	1811.609234	122.674176	0	643.8263433	4.56664317	3.051331941	0.953986252	0	909.1404075	746.0079857	3.512601905	0.954111243	1.150672623	3.543815144	0											$50 Copay Days 1-5 (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	$25 Copay Days 11-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	10% Coinsurance (PBP 11a)	"CIF (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$50 Copay (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"10% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											4.0952	0.102875054	2.094324786	0	0.390797205	0.982679209	0	1.601550193	1.156223413	0	3.09693924	0.03712358	0	0.607268171	3.649898378	3.019348724	0.20445696	0	1.126696101	0	0.305133194	0	0	1.515234012	1.243346643	0	0.001590185	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2307	None	0	4.0952	0.102875054	2.094324786	0	0.390797205	0.982679209	0	1.601550193	1.156223413	0	3.09693924	0.03712358	0	0.607268171	3.649898378	3.019348724	0.20445696	0	1.126696101	0	0.305133194	0	0	1.515234012	1.243346643	0	0.001590185	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2307	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											0	0	0	0	0	0	0	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	4.0952	0.102875054	2.094324786	0	0.390797205	0.982679209	0	1.601550193	1.156223413	0	3.09693924	0.03712358	0	0.607268171	3.649898378	3.019348724	0.20445696	0	1.126696101	0	0.305133194	0	0	1.515234012	1.243346643	0	0.001590185	0	0	0	0	0	0	0	0	0	0	0	0	0	25.2307
H3954_119_0	2009	3																					N/A											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	T	V	V	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	0	0											0	N/A	1092.42443	31.17712779	1097.031403	0	186.485358	17.07930093	0	238.2226128	360.1676266	0	892.2316187	0	0	320.4076383	4829.654255	5509.638705	129.263455	645.191899	1077.70927	0	27.16287755	0	0	0	392.6949131	0	84.14890995	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 14a												50	50	25	0	50	0.1	0	46.16426387	50	0	28.10735706	0	0	10	10	19.61588565	20	10	22.39138219	0	0.030188489	0	0	0	20	0	20	0	0	0											50	50	25	0	50	0.1	0	46.16426387	50	0	28.10735706	0	0	10	10	19.61588565	20	10	22.39138219	0	0.030188489	0	0	0	20	0	20	0	0	0											4.5518	0.129904699	2.285482089	0	0.777022325	1.707930093	0	0.91644763	1.500698444	0	2.089856057	0	0	0.267006365	4.02471188	9.006370233	0.215439092	0.537659916	2.010950012	0	0.820006219	0	0	0	0.654491522	0	0.140248183	0	0	0	0	0	0	0	0	0	0	0	0	0	31.636	0	0	4.5518	0.129904699	2.285482089	0	0.777022325	1.707930093	0	0.91644763	1.500698444	0	2.089856057	0	0	0.267006365	4.02471188	9.006370233	0.215439092	0.537659916	2.010950012	0	0.820006219	0	0	0	0.654491522	0	0.140248183	0	0	0	0	0	0	0	0	0	0	0	0	0	31.636	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	4.5518	0.129904699	2.285482089	0	0.777022325	1.707930093	0	0.91644763	1.500698444	0	2.089856057	0	0	0.267006365	4.02471188	9.006370233	0.215439092	0.537659916	2.010950012	0	0.820006219	0	0	0	0.654491522	0	0.140248183	0	0	0	0	0	0	0	0	0	0	0	0	0	31.636
H3954_120_0	2009	3																					N/A											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	T	V	V	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	0	0											0	N/A	1092.42443	31.17712779	1097.031403	0	186.485358	17.07930093	0	238.2226128	360.1676266	0	892.2316187	0	0	320.4076383	4829.654255	5509.638705	129.263455	645.191899	1077.70927	0	27.16287755	0	0	0	392.6949131	0	84.14890995	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 14a												50	50	25	0	50	0.1	0	46.16426387	50	0	28.10735706	0	0	10	10	19.61588565	20	10	22.39138219	0	0.030188489	0	0	0	20	0	20	0	0	0											50	50	25	0	50	0.1	0	46.16426387	50	0	28.10735706	0	0	10	10	19.61588565	20	10	22.39138219	0	0.030188489	0	0	0	20	0	20	0	0	0											4.5518	0.129904699	2.285482089	0	0.777022325	1.707930093	0	0.91644763	1.500698444	0	2.089856057	0	0	0.267006365	4.02471188	9.006370233	0.215439092	0.537659916	2.010950012	0	0.820006219	0	0	0	0.654491522	0	0.140248183	0	0	0	0	0	0	0	0	0	0	0	0	0	31.636	0	0	4.5518	0.129904699	2.285482089	0	0.777022325	1.707930093	0	0.91644763	1.500698444	0	2.089856057	0	0	0.267006365	4.02471188	9.006370233	0.215439092	0.537659916	2.010950012	0	0.820006219	0	0	0	0.654491522	0	0.140248183	0	0	0	0	0	0	0	0	0	0	0	0	0	31.636	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	4.5518	0.129904699	2.285482089	0	0.777022325	1.707930093	0	0.91644763	1.500698444	0	2.089856057	0	0	0.267006365	4.02471188	9.006370233	0.215439092	0.537659916	2.010950012	0	0.820006219	0	0	0	0.654491522	0	0.140248183	0	0	0	0	0	0	0	0	0	0	0	0	0	31.636
H3954_121_0	2009	2																					N/A											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	T	V	V	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	0	0											0	N/A	1092.42443	31.17712779	1097.031403	0	186.485358	17.07930093	0	238.2226128	360.1676266	0	892.2316187	0	0	320.4076383	4829.654255	5509.638705	129.263455	645.191899	1077.70927	0	27.16287755	0	0	0	392.6949131	0	84.14890995	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 14a												50	50	25	0	50	0.1	0	46.16426387	50	0	28.10735706	0	0	10	10	19.61588565	20	10	22.39138219	0	0.030188489	0	0	0	20	0	20	0	0	0											50	50	25	0	50	0.1	0	46.16426387	50	0	28.10735706	0	0	10	10	19.61588565	20	10	22.39138219	0	0.030188489	0	0	0	20	0	20	0	0	0											4.5518	0.129904699	2.285482089	0	0.777022325	1.707930093	0	0.91644763	1.500698444	0	2.089856057	0	0	0.267006365	4.02471188	9.006370233	0.215439092	0.537659916	2.010950012	0	0.820006219	0	0	0	0.654491522	0	0.140248183	0	0	0	0	0	0	0	0	0	0	0	0	0	31.636	0	0	4.5518	0.129904699	2.285482089	0	0.777022325	1.707930093	0	0.91644763	1.500698444	0	2.089856057	0	0	0.267006365	4.02471188	9.006370233	0.215439092	0.537659916	2.010950012	0	0.820006219	0	0	0	0.654491522	0	0.140248183	0	0	0	0	0	0	0	0	0	0	0	0	0	31.636	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	4.5518	0.129904699	2.285482089	0	0.777022325	1.707930093	0	0.91644763	1.500698444	0	2.089856057	0	0	0.267006365	4.02471188	9.006370233	0.215439092	0.537659916	2.010950012	0	0.820006219	0	0	0	0.654491522	0	0.140248183	0	0	0	0	0	0	0	0	0	0	0	0	0	31.636
H3954_122_0	2009	2																					None											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	N/A	959.1953526	24.69001293	814.8069028	8.71700689	205.6448985	11.76406321	11.16421443	242.4584166	266.5867468	31.58198223	869.8602193	50.44458288	0.333380574	809.3536622	4647.78443	3140.490568	122.674176	0	549.4374904	5.730976436	3.079763382	0.620995296	0	907	755.8657878	3.682091198	1.037051478	1.329149228	3.209773554	0											$50 Copay Days 1-5 (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	$25 Copay Days 11-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	10% Coinsurance (PBP 11a)	"CIF (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$50 Copay (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"10% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											3.9966	0.102875054	1.697514381	0	0.856853744	1.176406321	0	1.010243402	1.110778112	0	2.174650548	0.105092881	0	0.674461385	3.873153691	5.234150946	0.20445696	0	0.961515608	0	0.307976338	0	0	1.511666667	1.259776313	0	0.001728419	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2599	None	0	3.9966	0.102875054	1.697514381	0	0.856853744	1.176406321	0	1.010243402	1.110778112	0	2.174650548	0.105092881	0	0.674461385	3.873153691	5.234150946	0.20445696	0	0.961515608	0	0.307976338	0	0	1.511666667	1.259776313	0	0.001728419	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2599	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											0	0	0	0	0	0	0	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	3.9966	0.102875054	1.697514381	0	0.856853744	1.176406321	0	1.010243402	1.110778112	0	2.174650548	0.105092881	0	0.674461385	3.873153691	5.234150946	0.20445696	0	0.961515608	0	0.307976338	0	0	1.511666667	1.259776313	0	0.001728419	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2599
H3954_123_0	2009	2																					None											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	N/A	959.1953526	24.69001293	814.8069028	8.71700689	205.6448985	11.76406321	11.16421443	242.4584166	266.5867468	31.58198223	869.8602193	50.44458288	0.333380574	809.3536622	4647.78443	3140.490568	122.674176	0	549.4374904	5.730976436	3.079763382	0.620995296	0	907	755.8657878	3.682091198	1.037051478	1.329149228	3.209773554	0											$50 Copay Days 1-5 (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	$25 Copay Days 11-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	10% Coinsurance (PBP 11a)	"CIF (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$50 Copay (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"10% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											3.9966	0.102875054	1.697514381	0	0.856853744	1.176406321	0	1.010243402	1.110778112	0	2.174650548	0.105092881	0	0.674461385	3.873153691	5.234150946	0.20445696	0	0.961515608	0	0.307976338	0	0	1.511666667	1.259776313	0	0.001728419	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2599	None	0	3.9966	0.102875054	1.697514381	0	0.856853744	1.176406321	0	1.010243402	1.110778112	0	2.174650548	0.105092881	0	0.674461385	3.873153691	5.234150946	0.20445696	0	0.961515608	0	0.307976338	0	0	1.511666667	1.259776313	0	0.001728419	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2599	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											0	0	0	0	0	0	0	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	3.9966	0.102875054	1.697514381	0	0.856853744	1.176406321	0	1.010243402	1.110778112	0	2.174650548	0.105092881	0	0.674461385	3.873153691	5.234150946	0.20445696	0	0.961515608	0	0.307976338	0	0	1.511666667	1.259776313	0	0.001728419	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2599
H3954_124_0	2009	2																					None											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	N/A	959.1953526	24.69001293	814.8069028	8.71700689	205.6448985	11.76406321	11.16421443	242.4584166	266.5867468	31.58198223	869.8602193	50.44458288	0.333380574	809.3536622	4647.78443	3140.490568	122.674176	0	549.4374904	5.730976436	3.079763382	0.620995296	0	907	755.8657878	3.682091198	1.037051478	0.973152384	3.209773554	0											$50 Copay Days 1-5 (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	$25 Copay Days 11-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	10% Coinsurance (PBP 11a)	"CIF (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$50 Copay (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"10% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											3.9966	0.102875054	1.697514381	0	0.856853744	1.176406321	0	1.010243402	1.110778112	0	2.174650548	0.105092881	0	0.674461385	3.873153691	5.234150946	0.20445696	0	0.961515608	0	0.307976338	0	0	1.511666667	1.259776313	0	0.001728419	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2599	None	0	3.9966	0.102875054	1.697514381	0	0.856853744	1.176406321	0	1.010243402	1.110778112	0	2.174650548	0.105092881	0	0.674461385	3.873153691	5.234150946	0.20445696	0	0.961515608	0	0.307976338	0	0	1.511666667	1.259776313	0	0.001728419	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2599	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											0	0	0	0	0	0	0	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	3.9966	0.102875054	1.697514381	0	0.856853744	1.176406321	0	1.010243402	1.110778112	0	2.174650548	0.105092881	0	0.674461385	3.873153691	5.234150946	0.20445696	0	0.961515608	0	0.307976338	0	0	1.511666667	1.259776313	0	0.001728419	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2599
H3954_125_0	2009	2																					None											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	N/A	936.2489237	24.69001293	497.94195	8.884105779	141.6875633	10.62139851	7.166078778	217.6695739	139.8943021	68.70830008	730.7073762	12.20204104	0	654.1713872	3396.87885	3193.934016	122.674176	0	640.8054693	11.92257496	3.108415813	0.893918272	0	910.6235131	1044.447306	3.712958545	1.482464604	1.123639702	3.672073652	0											$50 Copay Days 1-5 (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	$25 Copay Days 11-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	10% Coinsurance (PBP 11a)	"CIF (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$50 Copay (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"10% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											3.901	0.102875054	1.037379063	0	0.590364847	1.062139851	0	0.906956558	0.582892926	0	1.82676844	0.025420919	0	0.545142823	2.830732375	5.323223361	0.20445696	0	1.121409571	0	0.310841581	0	0	1.517705855	1.74074551	0	0.002470774	0	0	0	0	0	0	0	0	0	0	0	0	0	23.6326	None	0	3.901	0.102875054	1.037379063	0	0.590364847	1.062139851	0	0.906956558	0.582892926	0	1.82676844	0.025420919	0	0.545142823	2.830732375	5.323223361	0.20445696	0	1.121409571	0	0.310841581	0	0	1.517705855	1.74074551	0	0.002470774	0	0	0	0	0	0	0	0	0	0	0	0	0	23.6326	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											0	0	0	0	0	0	0	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	3.901	0.102875054	1.037379063	0	0.590364847	1.062139851	0	0.906956558	0.582892926	0	1.82676844	0.025420919	0	0.545142823	2.830732375	5.323223361	0.20445696	0	1.121409571	0	0.310841581	0	0	1.517705855	1.74074551	0	0.002470774	0	0	0	0	0	0	0	0	0	0	0	0	0	23.6326
H3954_126_0	2009	2																					None											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	N/A	936.2489237	24.69001293	497.94195	8.884105779	141.6875633	10.62139851	7.166078778	217.6695739	139.8943021	68.70830008	730.7073762	12.20204104	0	654.1713872	3396.87885	3193.934016	122.674176	0	640.8054693	11.92257496	3.108415813	0.893918272	0	910.6235131	1044.447306	3.712958545	1.482464604	1.123639702	3.672073652	0											$50 Copay Days 1-5 (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	$25 Copay Days 11-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	10% Coinsurance (PBP 11a)	"CIF (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$50 Copay (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"10% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											3.901	0.102875054	1.037379063	0	0.590364847	1.062139851	0	0.906956558	0.582892926	0	1.82676844	0.025420919	0	0.545142823	2.830732375	5.323223361	0.20445696	0	1.121409571	0	0.310841581	0	0	1.517705855	1.74074551	0	0.002470774	0	0	0	0	0	0	0	0	0	0	0	0	0	23.6326	None	0	3.901	0.102875054	1.037379063	0	0.590364847	1.062139851	0	0.906956558	0.582892926	0	1.82676844	0.025420919	0	0.545142823	2.830732375	5.323223361	0.20445696	0	1.121409571	0	0.310841581	0	0	1.517705855	1.74074551	0	0.002470774	0	0	0	0	0	0	0	0	0	0	0	0	0	23.6326	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											0	0	0	0	0	0	0	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	3.901	0.102875054	1.037379063	0	0.590364847	1.062139851	0	0.906956558	0.582892926	0	1.82676844	0.025420919	0	0.545142823	2.830732375	5.323223361	0.20445696	0	1.121409571	0	0.310841581	0	0	1.517705855	1.74074551	0	0.002470774	0	0	0	0	0	0	0	0	0	0	0	0	0	23.6326
H3954_127_0	2009	2																					None											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	O	O	V	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	0	0											0	N/A	936.2489237	24.69001293	497.94195	8.884105779	141.6875633	10.62139851	7.166078778	217.6695739	139.8943021	68.70830008	730.7073762	12.20204104	0	654.1713872	3396.87885	3193.934016	122.674176	0	640.8054693	11.92257496	3.108415813	0.893918272	0	910.6235131	1044.447306	3.712958545	1.482464604	0.767642859	3.672073652	0											$50 Copay Days 1-5 (PBP 1a)	$50 Copay Days 1-5 (PBP 1b)	$25 Copay Days 11-100 (PBP 2)	CIF (PBP 6)	$50 Copay (PBP 10a)	10% Coinsurance (PBP 11a)	"CIF (PBP 11b, 11c)"	"$50 Copay (PBP 4a, 4b)"	"$50 Copay (PBP 9a, 9b)"	CIF (PBP 8a)	"$15 General, $75 CT/MRI/PT (PBP 8b)"	$25 Copay (PBP 5)	CIF (PBP 12)	"CORF $10 Copay, OP Facility SA $25/$10 Copay (Indiv/Grp Visit) (PBP 3, 9a, 9c, 9d)"	"$10 Copay (PBP 7a, 14b-i)"	"$20 Copay (PBP 7b, 7d, 7f, 7g, 14d-i)"	"OP MH/SA $25/$10 Copay (Indiv/Grp Visit) (PBP 7e, 7h)"	"$10 Copay (PBP 7c, 7i)"	"$15 Office General, $75 Office CT/MRI/PT (PBP 7d)"	CIF (PBP 7g)	"10% Coinsurance, $1000 OOP Max (PBP 15)"	CIF (PBP 13a)	N/A (PBP 10b)	"$20 Copay (PBP 16a, 16b)"	$20 Copay (PBP 17a)	$200 Max per 2 Years (PBP 17b)	$20 Copay (PBP 18a)	$800 Max per 3 Years (PBP 18b)	CIF (PBP 14a)												50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											50	50	25	0	50	0.1	0	50	50	0	30	25	0	10	10	20	20	10	21	0	0.1	0	0	20	20	0	20	0	0	0											3.901	0.102875054	1.037379063	0	0.590364847	1.062139851	0	0.906956558	0.582892926	0	1.82676844	0.025420919	0	0.545142823	2.830732375	5.323223361	0.20445696	0	1.121409571	0	0.310841581	0	0	1.517705855	1.74074551	0	0.002470774	0	0	0	0	0	0	0	0	0	0	0	0	0	23.6326	None	0	3.901	0.102875054	1.037379063	0	0.590364847	1.062139851	0	0.906956558	0.582892926	0	1.82676844	0.025420919	0	0.545142823	2.830732375	5.323223361	0.20445696	0	1.121409571	0	0.310841581	0	0	1.517705855	1.74074551	0	0.002470774	0	0	0	0	0	0	0	0	0	0	0	0	0	23.6326	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											0	0	0	0	0	0	0	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	3.901	0.102875054	1.037379063	0	0.590364847	1.062139851	0	0.906956558	0.582892926	0	1.82676844	0.025420919	0	0.545142823	2.830732375	5.323223361	0.20445696	0	1.121409571	0	0.310841581	0	0	1.517705855	1.74074551	0	0.002470774	0	0	0	0	0	0	0	0	0	0	0	0	0	23.6326
H3954_128_0	2009	3																					N/A											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	T	V	V	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	0	0											0	N/A	915.9993886	26.14206459	841.6608911	0	225.883765	17.47117232	0	247.0366177	327.9843748	0	1094.070989	0	0	406.2150718	4343.379272	4917.798357	111.9007641	558.5296053	1275.416423	0	26.51531591	0	0	0	353.1563245	0	75.67635526	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 14a												50	50	25	0	50	0.1	0	46.67354167	50	0	28.10735706	0	0	10	10	19.6129878	20	10	22.39138219	0	0.030188489	0	0	0	20	0	20	0	0	0											50	50	25	0	50	0.1	0	46.67354167	50	0	28.10735706	0	0	10	10	19.6129878	20	10	22.39138219	0	0.030188489	0	0	0	20	0	20	0	0	0											3.8167	0.108925269	1.75346019	0	0.941182354	1.747117232	0	0.960839489	1.366601562	0	2.562620328	0	0	0.33851256	3.619482726	8.037726599	0.186501274	0.465441338	2.379861381	0	0.800457312	0	0	0	0.588593874	0	0.126127259	0	0	0	0	0	0	0	0	0	0	0	0	0	29.8001	0	0	3.8167	0.108925269	1.75346019	0	0.941182354	1.747117232	0	0.960839489	1.366601562	0	2.562620328	0	0	0.33851256	3.619482726	8.037726599	0.186501274	0.465441338	2.379861381	0	0.800457312	0	0	0	0.588593874	0	0.126127259	0	0	0	0	0	0	0	0	0	0	0	0	0	29.8001	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	3.8167	0.108925269	1.75346019	0	0.941182354	1.747117232	0	0.960839489	1.366601562	0	2.562620328	0	0	0.33851256	3.619482726	8.037726599	0.186501274	0.465441338	2.379861381	0	0.800457312	0	0	0	0.588593874	0	0.126127259	0	0	0	0	0	0	0	0	0	0	0	0	0	29.8001
H3954_129_0	2009	3																					N/A											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	T	V	V	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	0	0											0	N/A	915.9993886	26.14206459	841.6608911	0	225.883765	17.47117232	0	247.0366177	327.9843748	0	1094.070989	0	0	406.2150718	4343.379272	4917.798357	111.9007641	558.5296053	1275.416423	0	26.51531591	0	0	0	353.1563245	0	75.67635526	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 14a												50	50	25	0	50	0.1	0	46.67354167	50	0	28.10735706	0	0	10	10	19.6129878	20	10	22.39138219	0	0.030188489	0	0	0	20	0	20	0	0	0											50	50	25	0	50	0.1	0	46.67354167	50	0	28.10735706	0	0	10	10	19.6129878	20	10	22.39138219	0	0.030188489	0	0	0	20	0	20	0	0	0											3.8167	0.108925269	1.75346019	0	0.941182354	1.747117232	0	0.960839489	1.366601562	0	2.562620328	0	0	0.33851256	3.619482726	8.037726599	0.186501274	0.465441338	2.379861381	0	0.800457312	0	0	0	0.588593874	0	0.126127259	0	0	0	0	0	0	0	0	0	0	0	0	0	29.8001	0	0	3.8167	0.108925269	1.75346019	0	0.941182354	1.747117232	0	0.960839489	1.366601562	0	2.562620328	0	0	0.33851256	3.619482726	8.037726599	0.186501274	0.465441338	2.379861381	0	0.800457312	0	0	0	0.588593874	0	0.126127259	0	0	0	0	0	0	0	0	0	0	0	0	0	29.8001	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	3.8167	0.108925269	1.75346019	0	0.941182354	1.747117232	0	0.960839489	1.366601562	0	2.562620328	0	0	0.33851256	3.619482726	8.037726599	0.186501274	0.465441338	2.379861381	0	0.800457312	0	0	0	0.588593874	0	0.126127259	0	0	0	0	0	0	0	0	0	0	0	0	0	29.8001
H3954_130_0	2009	3																					N/A											D	D	D	V	P	Coin	O	V	V	V	V	V	V	V	P	P	P	P	P	P	Coin	O	T	V	V	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	0	0											0	N/A	915.9993886	26.14206459	841.6608911	0	225.883765	17.47117232	0	247.0366177	327.9843748	0	1094.070989	0	0	406.2150718	4343.379272	4917.798357	111.9007641	558.5296053	1275.416423	0	26.51531591	0	0	0	353.1563245	0	75.67635526	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 14a												50	50	25	0	50	0.1	0	46.67354167	50	0	28.10735706	0	0	10	10	19.6129878	20	10	22.39138219	0	0.030188489	0	0	0	20	0	20	0	0	0											50	50	25	0	50	0.1	0	46.67354167	50	0	28.10735706	0	0	10	10	19.6129878	20	10	22.39138219	0	0.030188489	0	0	0	20	0	20	0	0	0											3.8167	0.108925269	1.75346019	0	0.941182354	1.747117232	0	0.960839489	1.366601562	0	2.562620328	0	0	0.33851256	3.619482726	8.037726599	0.186501274	0.465441338	2.379861381	0	0.800457312	0	0	0	0.588593874	0	0.126127259	0	0	0	0	0	0	0	0	0	0	0	0	0	29.8001	0	0	3.8167	0.108925269	1.75346019	0	0.941182354	1.747117232	0	0.960839489	1.366601562	0	2.562620328	0	0	0.33851256	3.619482726	8.037726599	0.186501274	0.465441338	2.379861381	0	0.800457312	0	0	0	0.588593874	0	0.126127259	0	0	0	0	0	0	0	0	0	0	0	0	0	29.8001	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	3.8167	0.108925269	1.75346019	0	0.941182354	1.747117232	0	0.960839489	1.366601562	0	2.562620328	0	0	0.33851256	3.619482726	8.037726599	0.186501274	0.465441338	2.379861381	0	0.800457312	0	0	0	0.588593874	0	0.126127259	0	0	0	0	0	0	0	0	0	0	0	0	0	29.8001
H3954_131_0	2009	4																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	V	V	V	Coin	P	P	P	P	P	Coin	Coin	Coin	T	V	V	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	0	0											0	N/A	229.5550144	26.14206459	39.66207504	0	225.883765	17.01410672	0.879040343	247.0366177	34.53408847	14.82980579	1126.886194	0	744.5829942	18.15964768	4343.379272	7035.928838	111.9007641	558.5296053	1815.409865	75.78096877	26.21986829	23.01724872	0	0	353.1563245	0	75.67635526	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 14a												0.14925	50	0.15	0	50	0.15	0.15	46.67354167	0.15	0.15	31.49735525	0	23.17706537	0.100058358	10	16.06078656	20	10	19.78903123	0.080268861	0.046383192	0.15	0	0	20	0	20	0	0	0											0.102848106	50	0.103364931	0	50	0.103364931	0.103364931	46.67354167	0.103364931	0.103364931	25.24341345	0	15.97130507	0.074745639	10	15.32949002	20	10	16.5093474	0.055313235	0.046383192	0.103364931	0	0	20	0	20	0	0	0											23.6093	0.108925269	4.099667645	0	0.941182354	1.758661965	0.090861944	0.960839489	3.569613669	1.532881851	2.370537842	0	0.990996846	1.357354478	3.619482726	8.988100074	0.186501274	0.465441338	2.497602678	4.191690534	1.216161189	2.379176324	0	0	0.588593874	0	0.126127259	0	0	0	0	0	0	0	0	0	0	0	0	0	65.6497	0	21.0216	23.6093	0.108925269	4.099667645	0	0.941182354	1.758661965	0.090861944	0.960839489	3.569613669	1.532881851	2.370537842	0	0.990996846	1.357354478	3.619482726	8.988100074	0.186501274	0.465441338	2.497602678	4.191690534	1.216161189	2.379176324	0	0	0.588593874	0	0.126127259	0	0	0	0	0	0	0	0	0	0	0	0	0	65.6497																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.6093	0.108925269	4.099667645	0	0.941182354	1.758661965	0.090861944	0.960839489	3.569613669	1.532881851	2.370537842	0	0.990996846	1.357354478	3.619482726	8.988100074	0.186501274	0.465441338	2.497602678	4.191690534	1.216161189	2.379176324	0	0	0.588593874	0	0.126127259	0	0	0	0	0	0	0	0	0	0	0	0	0	65.6497
H3954_132_0	2009	4																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	V	V	V	Coin	P	P	P	P	P	Coin	Coin	Coin	T	V	V	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	0	0											0	N/A	229.5550144	26.14206459	39.66207504	0	225.883765	17.01410672	0.879040343	247.0366177	34.53408847	14.82980579	1126.886194	0	744.5829942	18.15964768	4343.379272	7035.928838	111.9007641	558.5296053	1815.409865	75.78096877	26.21986829	23.01724872	0	0	353.1563245	0	75.67635526	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 14a												0.14925	50	0.15	0	50	0.15	0.15	46.67354167	0.15	0.15	31.49735525	0	23.17706537	0.100058358	10	16.06078656	20	10	19.78903123	0.080268861	0.046383192	0.15	0	0	20	0	20	0	0	0											0.102848106	50	0.103364931	0	50	0.103364931	0.103364931	46.67354167	0.103364931	0.103364931	25.24341345	0	15.97130507	0.074745639	10	15.32949002	20	10	16.5093474	0.055313235	0.046383192	0.103364931	0	0	20	0	20	0	0	0											23.6093	0.108925269	4.099667645	0	0.941182354	1.758661965	0.090861944	0.960839489	3.569613669	1.532881851	2.370537842	0	0.990996846	1.357354478	3.619482726	8.988100074	0.186501274	0.465441338	2.497602678	4.191690534	1.216161189	2.379176324	0	0	0.588593874	0	0.126127259	0	0	0	0	0	0	0	0	0	0	0	0	0	65.6497	0	21.0216	23.6093	0.108925269	4.099667645	0	0.941182354	1.758661965	0.090861944	0.960839489	3.569613669	1.532881851	2.370537842	0	0.990996846	1.357354478	3.619482726	8.988100074	0.186501274	0.465441338	2.497602678	4.191690534	1.216161189	2.379176324	0	0	0.588593874	0	0.126127259	0	0	0	0	0	0	0	0	0	0	0	0	0	65.6497																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.6093	0.108925269	4.099667645	0	0.941182354	1.758661965	0.090861944	0.960839489	3.569613669	1.532881851	2.370537842	0	0.990996846	1.357354478	3.619482726	8.988100074	0.186501274	0.465441338	2.497602678	4.191690534	1.216161189	2.379176324	0	0	0.588593874	0	0.126127259	0	0	0	0	0	0	0	0	0	0	0	0	0	65.6497
H3954_133_0	2009	4																					2000											Coin	D	Coin	V	P	Coin	Coin	V	Coin	Coin	V	V	V	Coin	P	P	P	P	P	Coin	Coin	Coin	T	V	V	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	0	0											0	N/A	229.5550144	26.14206459	39.66207504	0	225.883765	17.01410672	0.879040343	247.0366177	34.53408847	14.82980579	1126.886194	0	744.5829942	18.15964768	4343.379272	7035.928838	111.9007641	558.5296053	1815.409865	75.78096877	26.21986829	23.01724872	0	0	353.1563245	0	75.67635526	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 14a												0.14925	50	0.15	0	50	0.15	0.15	46.67354167	0.15	0.15	31.49735525	0	23.17706537	0.100058358	10	16.06078656	20	10	19.78903123	0.080268861	0.046383192	0.15	0	0	20	0	20	0	0	0											0.102848106	50	0.103364931	0	50	0.103364931	0.103364931	46.67354167	0.103364931	0.103364931	25.24341345	0	15.97130507	0.074745639	10	15.32949002	20	10	16.5093474	0.055313235	0.046383192	0.103364931	0	0	20	0	20	0	0	0											23.6093	0.108925269	4.099667645	0	0.941182354	1.758661965	0.090861944	0.960839489	3.569613669	1.532881851	2.370537842	0	0.990996846	1.357354478	3.619482726	8.988100074	0.186501274	0.465441338	2.497602678	4.191690534	1.216161189	2.379176324	0	0	0.588593874	0	0.126127259	0	0	0	0	0	0	0	0	0	0	0	0	0	65.6497	0	21.0216	23.6093	0.108925269	4.099667645	0	0.941182354	1.758661965	0.090861944	0.960839489	3.569613669	1.532881851	2.370537842	0	0.990996846	1.357354478	3.619482726	8.988100074	0.186501274	0.465441338	2.497602678	4.191690534	1.216161189	2.379176324	0	0	0.588593874	0	0.126127259	0	0	0	0	0	0	0	0	0	0	0	0	0	65.6497																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.6093	0.108925269	4.099667645	0	0.941182354	1.758661965	0.090861944	0.960839489	3.569613669	1.532881851	2.370537842	0	0.990996846	1.357354478	3.619482726	8.988100074	0.186501274	0.465441338	2.497602678	4.191690534	1.216161189	2.379176324	0	0	0.588593874	0	0.126127259	0	0	0	0	0	0	0	0	0	0	0	0	0	65.6497
H3954_801_0	2009	2																					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	N/A	239.7567185	2.493724388	37.35898621	12.99490474	14.16677637	11.20050466	9.102988511	15.43144783	49.15657067	47.94400613	43.89738836	3.496631736	0.92815081	24.74110086	38.67905867	129.8501013	1.321581959	0.000240725	22.0922853	7.4069185	10.65608801	1.017407693	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																			0.077898125	0.077898125	0.196929779	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.077898125	0.077898125	0.196929779	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											18.6766	0.194256454	7.357096882	0	3.272525341	2.587316577	2.102790346	3.56466445	11.35516783	11.07506541	10.14029671	0.807721931	0.214402837	5.7151943	8.934862553	29.9953734	0.305285432	5.56E-05	5.103317903	1.710998173	2.46155633	0.235021177	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.8096	None	0	18.6766	0.194256454	7.357096882	0	3.272525341	2.587316577	2.102790346	3.56466445	11.35516783	11.07506541	10.14029671	0.807721931	0.214402837	5.7151943	8.934862553	29.9953734	0.305285432	5.56E-05	5.103317903	1.710998173	2.46155633	0.235021177	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.8096	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											0	0	0	0	0	0	0	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	18.6766	0.194256454	7.357096882	0	3.272525341	2.587316577	2.102790346	3.56466445	11.35516783	11.07506541	10.14029671	0.807721931	0.214402837	5.7151943	8.934862553	29.9953734	0.305285432	5.56E-05	5.103317903	1.710998173	2.46155633	0.235021177	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.8096
H3954_802_0	2009	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	N/A	205.2808342	2.135138593	27.51709184	10.13274164	9.14752272	9.301673543	7.559751096	14.54425293	57.56500661	52.49121722	48.06080122	3.828266989	1.016180535	27.08765088	36.8082054	123.5694291	1.257658843	0.000229081	21.02371161	7.048655962	13.52855085	0.898654346	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																			0.078196345	0.078196345	0.196459795	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.078196345	0.078196345	0.196459795	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											16.0522	0.166960034	5.406002212	0	2.113077748	2.148686588	1.746302503	3.359722426	13.29751653	12.12547118	11.10204508	0.884329674	0.234737704	6.257247354	8.502695447	28.54453813	0.290519193	5.29E-05	4.856477382	1.628239527	3.125095247	0.207589154	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.0495	None	0	16.0522	0.166960034	5.406002212	0	2.113077748	2.148686588	1.746302503	3.359722426	13.29751653	12.12547118	11.10204508	0.884329674	0.234737704	6.257247354	8.502695447	28.54453813	0.290519193	5.29E-05	4.856477382	1.628239527	3.125095247	0.207589154	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.0495	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											0	0	0	0	0	0	0	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	16.0522	0.166960034	5.406002212	0	2.113077748	2.148686588	1.746302503	3.359722426	13.29751653	12.12547118	11.10204508	0.884329674	0.234737704	6.257247354	8.502695447	28.54453813	0.290519193	5.29E-05	4.856477382	1.628239527	3.125095247	0.207589154	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.0495
H3957_003_0	2009	9																					3350											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		398.9703093	0	785.499183	0	500.6977394	31.22655535	0	222.3940165	44.26400015	0	0	0	0	1044.514039	4260.5324	6045.960239	0	0	0	0	1286.381506	0	0	0	418.4170802	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											126.2190176	0	50	0	50	0.096979208	0	50	100	0	0	0	0	30	10	30	0	0	0	0	2.1	0	0	0	30	0	30	0	0	0											122.8212301	0	48.65401127	0	50	0.060773637	0	48.65401127	97.30802254	0	0	0	0	29.19240676	9.730802254	29.19240676	0	0	0	0	2.043468473	0	0	0	30	0	30	0	0	0											4.0835	0	3.184807175	0	2.086240581	1.897751331	0	0.901696749	0.35893686	0	0	0	0	2.540989892	3.454866523	14.70801088	0	0	0	0	0.219056671	0	0	0	1.0460427	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.4819	0	1.9453	4.0835	0	3.184807175	0	2.086240581	1.897751331	0	0.901696749	0.35893686	0	0	0	0	2.540989892	3.454866523	14.70801088	0	0	0	0	0.219056671	0	0	0	1.0460427	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.4819																																																																																		0	0	0	4.0835	0	3.184807175	0	2.086240581	1.897751331	0	0.901696749	0.35893686	0	0	0	0	2.540989892	3.454866523	14.70801088	0	0	0	0	0.219056671	0	0	0	1.0460427	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.4819
H3957_006_0	2009	8																					3350											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		360.8078852	0	724.6030844	0	423.8474526	32.4743369	0	264.3910898	42.21207956	0	0	0	0	1601.515446	4406.813012	6651.20375	0	0	0	0	1219.207037	0	0	0	427.3406969	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											126.2190176	0	50	0	50	0.096979208	0	50	100	0	0	0	0	30	10	30	0	0	0	0	2.1	0	0	0	30	0	30	0	0	0											122.1338604	0	48.38171884	0	50	0.060773637	0	48.38171884	96.76343767	0	0	0	0	29.0290313	9.676343767	29.0290313	0	0	0	0	2.032032191	0	0	0	30	0	30	0	0	0											3.6722	0	2.921461892	0	1.766031053	1.973583554	0	1.065974614	0.340382161	0	0	0	0	3.874203501	3.553486469	16.08983349	0	0	0	0	0.206455662	0	0	0	1.068351742	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.532	0	2.2369	3.6722	0	2.921461892	0	1.766031053	1.973583554	0	1.065974614	0.340382161	0	0	0	0	3.874203501	3.553486469	16.08983349	0	0	0	0	0.206455662	0	0	0	1.068351742	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.532																																																																																		0	0	0	3.6722	0	2.921461892	0	1.766031053	1.973583554	0	1.065974614	0.340382161	0	0	0	0	3.874203501	3.553486469	16.08983349	0	0	0	0	0.206455662	0	0	0	1.068351742	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.532
H3957_016_0	2009	8																					3350											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		340.9652951	0	894.7284753	0	373.3871099	31.021959	0	227.2952228	40.13072241	0	0	0	0	1294.371268	4258.310456	6097.976194	0	0	0	0	758.4293343	0	0	0	418.3563633	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											126.2190176	0	50	0	50	0.096979208	0	50	100	0	0	0	0	30	10	30	0	0	0	0	2.1	0	0	0	30	0	30	0	0	0											122.6782667	0	48.59737821	0	50	0.060773637	0	48.59737821	97.19475642	0	0	0	0	29.15842693	9.719475642	29.15842693	0	0	0	0	2.041089885	0	0	0	30	0	30	0	0	0											3.4858	0	3.623454842	0	1.555779625	1.885317267	0	0.920495992	0.325041316	0	0	0	0	3.145152502	3.449045396	14.81728277	0	0	0	0	0.12900187	0	0	0	1.045890908	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.3822	0	1.986	3.4858	0	3.623454842	0	1.555779625	1.885317267	0	0.920495992	0.325041316	0	0	0	0	3.145152502	3.449045396	14.81728277	0	0	0	0	0.12900187	0	0	0	1.045890908	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.3822																																																																																		0	0	0	3.4858	0	3.623454842	0	1.555779625	1.885317267	0	0.920495992	0.325041316	0	0	0	0	3.145152502	3.449045396	14.81728277	0	0	0	0	0.12900187	0	0	0	1.045890908	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.3822
H3957_020_0	2009	7																					3350											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		427.8988375	0	842.454136	0	537.0023172	33.49072956	0	238.5193557	0	0	0	0	0	1120.249635	4569.454965	6514.995413	0	0	0	0	1376.021192	0	0	9.183333333	419.521863	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											84.14601174	0	40	0	50	0.096979208	0	50	0	0	0	0	0	25	5	25	0	0	0	0	2.1	0	0	0.4	25	0	25	0	0	0											82.62922354	0	39.27897322	0	50	0.060773637	0	49.09871653	0	0	0	0	0	24.54935826	4.909871653	24.54935826	0	0	0	0	2.062146094	0	0	0.4	25	0	25	0	0	0											2.9464	0	2.757561121	0	2.237509655	2.035353432	0	0.975916186	0	0	0	0	0	2.291784135	1.869619783	13.32824637	0	0	0	0	0.236463061	0	0	3.673333333	0.874003881	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.2262	0	1.6606	2.9464	0	2.757561121	0	2.237509655	2.035353432	0	0.975916186	0	0	0	0	0	2.291784135	1.869619783	13.32824637	0	0	0	0	0.236463061	0	0	3.673333333	0.874003881	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.2262																																																																																		0	0	0	2.9464	0	2.757561121	0	2.237509655	2.035353432	0	0.975916186	0	0	0	0	0	2.291784135	1.869619783	13.32824637	0	0	0	0	0.236463061	0	0	3.673333333	0.874003881	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.2262
H3957_021_0	2009	7																					3350											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		342.7668866	0	688.3717167	0	402.6543702	30.85056567	0	251.1710925	0	0	0	0	0	1521.436992	4186.464981	6354.590542	0	0	0	0	1154.917117	0	0	9.183333333	428.571943	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											84.14601174	0	40	0	50	0.096979208	0	50	0	0	0	0	0	25	5	25	0	0	0	0	2.1	0	0	0.4	25	0	25	0	0	0											82.72847619	0	39.32615438	0	50	0.060773637	0	49.15769297	0	0	0	0	0	24.57884649	4.915769297	24.57884649	0	0	0	0	2.064623105	0	0	0.4	25	0	25	0	0	0											2.363	0	2.2559177	0	1.677726542	1.874901071	0	1.028915954	0	0	0	0	0	3.116263854	1.714974668	13.01570878	0	0	0	0	0.198705714	0	0	3.673333333	0.892858215	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.8124	0	1.5229	2.363	0	2.2559177	0	1.677726542	1.874901071	0	1.028915954	0	0	0	0	0	3.116263854	1.714974668	13.01570878	0	0	0	0	0.198705714	0	0	3.673333333	0.892858215	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.8124																																																																																		0	0	0	2.363	0	2.2559177	0	1.677726542	1.874901071	0	1.028915954	0	0	0	0	0	3.116263854	1.714974668	13.01570878	0	0	0	0	0.198705714	0	0	3.673333333	0.892858215	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.8124
H3957_022_0	2009	7																					3350											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		362.6331278	0	951.587127	0	397.1153003	32.99335794	0	241.7394931	0	0	0	0	0	1376.626619	4528.919694	6520.223506	0	0	0	0	804.4285693	0	0	9.183333333	419.4993711	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											84.14601174	0	40	0	50	0.096979208	0	50	0	0	0	0	0	25	5	25	0	0	0	0	2.1	0	0	0.4	25	0	25	0	0	0											82.57279327	0	39.25214829	0	50	0.060773637	0	49.06518536	0	0	0	0	0	24.53259268	4.906518536	24.53259268	0	0	0	0	2.060737785	0	0	0.4	25	0	25	0	0	0											2.4953	0	3.112653251	0	1.654647085	2.005126349	0	0.988416086	0	0	0	0	0	2.814351676	1.851769036	13.32983229	0	0	0	0	0.138143029	0	0	3.673333333	0.873957023	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.9375	0	1.6657	2.4953	0	3.112653251	0	1.654647085	2.005126349	0	0.988416086	0	0	0	0	0	2.814351676	1.851769036	13.32983229	0	0	0	0	0.138143029	0	0	3.673333333	0.873957023	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.9375																																																																																		0	0	0	2.4953	0	3.112653251	0	1.654647085	2.005126349	0	0.988416086	0	0	0	0	0	2.814351676	1.851769036	13.32983229	0	0	0	0	0.138143029	0	0	3.673333333	0.873957023	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.9375
H3957_024_0	2009	4																					3350											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		407.0380701	0	801.3831205	0	510.8225769	31.85800178	0	226.8911474	45.1590827	0	0	0	0	6065.635635	0	6168.218361	0	0	0	0	1314.398614	0	0	0	417.7789487	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											168.2920235	0	50	0	50	0.096979208	0	50	125	0	0	0	0	18	0	30	0	0	0	0	2.1	0	0	0	30	0	30	0	0	0											162.0859424	0	48.15615708	0	50	0.060773637	0	48.15615708	120.3903927	0	0	0	0	17.33621655	0	28.89369425	0	0	0	0	2.022558598	0	0	0	30	0	30	0	0	0											5.4979	0	3.215960953	0	2.128427404	1.936126627	0	0.910517145	0.453059975	0	0	0	0	8.762931073	0	14.85188462	0	0	0	0	0.221537351	0	0	0	1.044447372	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.0228	0	2.452	5.4979	0	3.215960953	0	2.128427404	1.936126627	0	0.910517145	0.453059975	0	0	0	0	8.762931073	0	14.85188462	0	0	0	0	0.221537351	0	0	0	1.044447372	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.0228																																																																																		0	0	0	5.4979	0	3.215960953	0	2.128427404	1.936126627	0	0.910517145	0.453059975	0	0	0	0	8.762931073	0	14.85188462	0	0	0	0	0.221537351	0	0	0	1.044447372	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.0228
H3957_025_0	2009	4																					3350											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		348.0932269	0	699.0684967	0	408.911317	31.32996032	0	255.0741028	40.72455063	0	0	0	0	6545.078981	0	6416.819231	0	0	0	0	1177.952222	0	0	0	426.7205827	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											168.2920235	0	50	0	50	0.096979208	0	50	125	0	0	0	0	18	0	30	0	0	0	0	2.1	0	0	0	30	0	30	0	0	0											162.0467614	0	48.14451632	0	50	0.060773637	0	48.14451632	120.3612908	0	0	0	0	17.33202588	0	28.88670979	0	0	0	0	2.022069685	0	0	0	30	0	30	0	0	0											4.7006	0	2.804692887	0	1.703797154	1.904035627	0	1.023368276	0.408471623	0	0	0	0	9.453289855	0	15.44673291	0	0	0	0	0.19849179	0	0	0	1.066801457	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.7103	0	2.446	4.7006	0	2.804692887	0	1.703797154	1.904035627	0	1.023368276	0.408471623	0	0	0	0	9.453289855	0	15.44673291	0	0	0	0	0.19849179	0	0	0	1.066801457	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.7103																																																																																		0	0	0	4.7006	0	2.804692887	0	1.703797154	1.904035627	0	1.023368276	0.408471623	0	0	0	0	9.453289855	0	15.44673291	0	0	0	0	0.19849179	0	0	0	1.066801457	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.7103
H3957_026_0	2009	4																					3350											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		337.82667	0	886.4923959	0	369.9500383	30.73639827	0	225.2029439	39.76131445	0	0	0	0	6282.45643	0	6041.843616	0	0	0	0	752.5698321	0	0	0	417.7326795	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											168.2920235	0	50	0	50	0.096979208	0	50	125	0	0	0	0	18	0	30	0	0	0	0	2.1	0	0	0	30	0	30	0	0	0											162.3146884	0	48.22411812	0	50	0.060773637	0	48.22411812	120.5602953	0	0	0	0	17.36068252	0	28.93447087	0	0	0	0	2.025412961	0	0	0	30	0	30	0	0	0											4.5695	0	3.562526168	0	1.541458493	1.867962703	0	0.905017781	0.399469651	0	0	0	0	9.088977629	0	14.56812901	0	0	0	0	0.127022058	0	0	0	1.044331699	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.6744	0	2.3362	4.5695	0	3.562526168	0	1.541458493	1.867962703	0	0.905017781	0.399469651	0	0	0	0	9.088977629	0	14.56812901	0	0	0	0	0.127022058	0	0	0	1.044331699	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.6744																																																																																		0	0	0	4.5695	0	3.562526168	0	1.541458493	1.867962703	0	0.905017781	0.399469651	0	0	0	0	9.088977629	0	14.56812901	0	0	0	0	0.127022058	0	0	0	1.044331699	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.6744
H3957_030_0	2009	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		406.8987588	0	84.80940733	0	19.00384175	43.04728049	0	6.757445291	41.4792172	0	0	0	0	127.1548051	52.89740703	210.9238403	0	0	0	0	66.45314151	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											0.078018658	0	0.186653143	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0.231	0	0	0	0	0.231	0	0	0	0	0	0	0	0	0											0.078018658	0	0.186653143	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0.231	0	0	0	0	0.231	0	0	0	0	0	0	0	0	0											31.7457	0	15.82994242	0	4.389887444	9.943921792	0	1.560969862	9.581699173	0	0	0	0	29.37275997	12.21930102	48.72340712	0	0	0	0	15.35067569	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	178.7183	0	0	31.7457	0	15.82994242	0	4.389887444	9.943921792	0	1.560969862	9.581699173	0	0	0	0	29.37275997	12.21930102	48.72340712	0	0	0	0	15.35067569	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	178.7183																																																																																		0	0	0	31.7457	0	15.82994242	0	4.389887444	9.943921792	0	1.560969862	9.581699173	0	0	0	0	29.37275997	12.21930102	48.72340712	0	0	0	0	15.35067569	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	178.7183
H3957_031_0	2009	9																					3350											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		405.7703185	0	798.8871508	0	509.2315804	31.75877756	0	226.1844774	45.01843124	0	0	0	0	6062.31663	0	6149.006967	0	0	0	0	1314.398614	0	0	0	416.4777438	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											232.0375541	0	75	0	50	0.096979208	0	50	150	0	0	0	0	18	0	40	0	0	0	0	2.1	0	0	0	40	0	40	0	0	0											219.416599	0	70.92061018	0	50	0.060773637	0	47.28040679	141.8412204	0	0	0	0	17.02094644	0	37.82432543	0	0	0	0	1.985777085	0	0	0	40	0	40	0	0	0											7.4194	0	4.721463683	0	2.121798252	1.93009641	0	0.891174508	0.532122436	0	0	0	0	8.59886389	0	19.38183672	0	0	0	0	0.217508554	0	0	0	1.388259146	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.2025	0	3.552	7.4194	0	4.721463683	0	2.121798252	1.93009641	0	0.891174508	0.532122436	0	0	0	0	8.59886389	0	19.38183672	0	0	0	0	0.217508554	0	0	0	1.388259146	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.2025																																																																																		0	0	0	7.4194	0	4.721463683	0	2.121798252	1.93009641	0	0.891174508	0.532122436	0	0	0	0	8.59886389	0	19.38183672	0	0	0	0	0.217508554	0	0	0	1.388259146	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.2025
H3957_032_0	2009	10																					3350											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		346.9343485	0	696.7411449	0	407.5499618	31.22565603	0	254.2249054	40.5889697	0	0	0	0	6539.935075	0	6395.456237	0	0	0	0	1177.952222	0	0	0	425.2999367	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											232.0375541	0	75	0	50	0.096979208	0	50	150	0	0	0	0	18	0	40	0	0	0	0	2.1	0	0	0	40	0	40	0	0	0											219.494931	0	70.94592893	0	50	0.060773637	0	47.29728595	141.8918579	0	0	0	0	17.02702294	0	37.83782876	0	0	0	0	1.98648601	0	0	0	40	0	40	0	0	0											6.3459	0	4.119245646	0	1.698124841	1.897696676	0	1.002012337	0.479937027	0	0	0	0	9.279635381	0	20.16584816	0	0	0	0	0.194998801	0	0	0	1.417666456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.601	0	3.507	6.3459	0	4.119245646	0	1.698124841	1.897696676	0	1.002012337	0.479937027	0	0	0	0	9.279635381	0	20.16584816	0	0	0	0	0.194998801	0	0	0	1.417666456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.601																																																																																		0	0	0	6.3459	0	4.119245646	0	1.698124841	1.897696676	0	1.002012337	0.479937027	0	0	0	0	9.279635381	0	20.16584816	0	0	0	0	0.194998801	0	0	0	1.417666456	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.601
H3957_033_0	2009	10																					3350											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		336.7380124	0	883.6356449	0	368.7578621	30.63734921	0	224.47722	39.6331823	0	0	0	0	6278.323672	0	6022.373575	0	0	0	0	752.5698321	0	0	0	416.3865221	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											232.0375541	0	75	0	50	0.096979208	0	50	150	0	0	0	0	18	0	40	0	0	0	0	2.1	0	0	0	40	0	40	0	0	0											219.845353	0	71.05919357	0	50	0.060773637	0	47.37279571	142.1183871	0	0	0	0	17.05420646	0	37.89823657	0	0	0	0	1.98965742	0	0	0	40	0	40	0	0	0											6.1692	0	5.232536361	0	1.536491092	1.861943131	0	0.886176124	0.469383662	0	0	0	0	8.922652342	0	19.0197782	0	0	0	0	0.124779679	0	0	0	1.387955074	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.6109	0	3.3733	6.1692	0	5.232536361	0	1.536491092	1.861943131	0	0.886176124	0.469383662	0	0	0	0	8.922652342	0	19.0197782	0	0	0	0	0.124779679	0	0	0	1.387955074	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.6109																																																																																		0	0	0	6.1692	0	5.232536361	0	1.536491092	1.861943131	0	0.886176124	0.469383662	0	0	0	0	8.922652342	0	19.0197782	0	0	0	0	0.124779679	0	0	0	1.387955074	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.6109
H3957_805_0	2009	2																																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		288.1574094	0	47.73355407	0	11.36546415	30.60850199	0	4.751399766	34.23563997	0	0	0	0	101.2646285	47.59949948	190.3979979	0	0	0	0	51.12818181	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											0.078004569	0	0.185759344	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0.231	0	0	0	0	0.231	0	0	0	0	0	0	0	0	0											0.078004569	0	0.185759344	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0.231	0	0	0	0	0.231	0	0	0	0	0	0	0	0	0											22.4776	0	8.866953671	0	2.625422219	7.070563959	0	1.097573346	7.908432832	0	0	0	0	23.39212919	10.99548438	43.98193752	0	0	0	0	11.81061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.2267	0	0	22.4776	0	8.866953671	0	2.625422219	7.070563959	0	1.097573346	7.908432832	0	0	0	0	23.39212919	10.99548438	43.98193752	0	0	0	0	11.81061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.2267																																																																																		0	0	0	22.4776	0	8.866953671	0	2.625422219	7.070563959	0	1.097573346	7.908432832	0	0	0	0	23.39212919	10.99548438	43.98193752	0	0	0	0	11.81061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.2267
H3957_806_0	2009	3																																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		296.4410547	0	49.10574795	0	11.69218653	31.48840292	0	4.887987996	35.21981004	0	0	0	0	104.1756773	48.96783969	195.8713588	0	0	0	0	52.59796085	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											0.078004569	0	0.185759344	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0.231	0	0	0	0	0.231	0	0	0	0	0	0	0	0	0											0.078004569	0	0.185759344	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0.231	0	0	0	0	0.231	0	0	0	0	0	0	0	0	0											23.1238	0	9.121851504	0	2.700895088	7.273821074	0	1.129125227	8.135776119	0	0	0	0	24.06458145	11.31157097	45.24628387	0	0	0	0	12.15012896	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	144.2578	0	0	23.1238	0	9.121851504	0	2.700895088	7.273821074	0	1.129125227	8.135776119	0	0	0	0	24.06458145	11.31157097	45.24628387	0	0	0	0	12.15012896	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	144.2578																																																																																		0	0	0	23.1238	0	9.121851504	0	2.700895088	7.273821074	0	1.129125227	8.135776119	0	0	0	0	24.06458145	11.31157097	45.24628387	0	0	0	0	12.15012896	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	144.2578
H3957_808_0	2009	2																																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		288.1574094	0	47.73355407	0	11.36546415	30.60850199	0	4.751399766	34.23563997	0	0	0	0	101.2646285	47.59949948	190.3979979	0	0	0	0	51.12818181	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											0.078004569	0	0.185759344	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0.231	0	0	0	0	0.231	0	0	0	0	0	0	0	0	0											0.078004569	0	0.185759344	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0.231	0	0	0	0	0.231	0	0	0	0	0	0	0	0	0											22.4776	0	8.866953671	0	2.625422219	7.070563959	0	1.097573346	7.908432832	0	0	0	0	23.39212919	10.99548438	43.98193752	0	0	0	0	11.81061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.2267	0	0	22.4776	0	8.866953671	0	2.625422219	7.070563959	0	1.097573346	7.908432832	0	0	0	0	23.39212919	10.99548438	43.98193752	0	0	0	0	11.81061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.2267																																																																																		0	0	0	22.4776	0	8.866953671	0	2.625422219	7.070563959	0	1.097573346	7.908432832	0	0	0	0	23.39212919	10.99548438	43.98193752	0	0	0	0	11.81061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.2267
H3959_001_0	2009	8																					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	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	2365.806364	56.56200888	1495.04084	0	332.8083859	12.14402689	10.10007455	128.7744444	712.8682738	1963.513387	1161.434098	0	0	401.1994597	7342.487423	28247.56919	202.2803303	2163.468896	6254.164973	2057.840027	2134.382372	0	0	0	281.4450532	0	288.6341964	0	0	590.1561429											"1a $150 per admit, with a max of 2/yr"	"1b $150 per admit, with a max of 2/yr"	2 $50 days 6-100	6 $0	10a $100	11a 15%	11b 15%	4a $50	"9a $75, 9b $75"	8a $10	8b $25	5 $0	12 $0	4b $50	7a $10	"16b $25, 17a $25, 18a $25, 7b $25, 7d $25, 7f $25"	"7e $30, 7h $30, 9c $30"	"7c $20, 7i $20"	8b $25	7g $25	"15 $50/$100, 11c DS $20/$40, Nebulizers $10/$30"		10b $0	16a $15	17a $25	17b $150 Allowance every two years	18a $25	"18b $750 Allowance every 3 yrs ($500 for 1st aid, $250 for 2nd aid)"		14a $0											14.99370325	15.0227475	38.21942755	0	98.18514766	0.149120047	0.15	45.88541521	74.18664379	10	14.72205861	0	0	0.13551126	5.290911113	3.445534667	27.00753949	2.972884568	1.87027868	0.766309973	7.761387929	0	0	0	11.01901344	0	24.8424355	0	0	3.020847358											13.15424676	15.0227475	33.53059433	0	86.13960402	0.130825711	0.13159771	40.25610381	65.08528298	8.773180677	12.91592801	0	0	0.118886477	4.641811914	3.022829817	27.00753949	2.608165345	1.640829277	0.672297585	7.761387929	0	0	0	9.667179578	0	21.79471751	0	0	2.650243967											2.5934	0.070809731	4.177467325	0	2.388998548	1.588750955	1.329146683	0.43199645	3.86643611	1.435521475	1.250083266	0	0	0.003974766	2.8402038	7.115632865	0.455257834	0.470223717	0.855168083	0.115290073	1.380480799	0	0	0	0.226731656	0	0.524225065	0	0	0.130338146	0	0	0	0	0	0	0	0	0	0	33.2501	0	4.383	2.5934	0.070809731	4.177467325	0	2.388998548	1.588750955	1.329146683	0.43199645	3.86643611	1.435521475	1.250083266	0	0	0.003974766	2.8402038	7.115632865	0.455257834	0.470223717	0.855168083	0.115290073	1.380480799	0	0	0	0.226731656	0	0.524225065	0	0	0.130338146	0	0	0	0	0	0	0	0	0	0	33.2501	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	2.5934	0.070809731	4.177467325	0	2.388998548	1.588750955	1.329146683	0.43199645	3.86643611	1.435521475	1.250083266	0	0	0.003974766	2.8402038	7.115632865	0.455257834	0.470223717	0.855168083	0.115290073	1.380480799	0	0	0	0.226731656	0	0.524225065	0	0	0.130338146	0	0	0	0	0	0	0	0	0	0	33.2501
H3959_002_0	2009	8																					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	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	0	0	1166.532504	0	279.671402	12.776984	6.945849565	154.2199296	690.5948604	0	1130.328855	0	0	431.533612	6893.67269	27211.27385	175.2162669	1809.931167	6020.539871	1717.09202	2175.168526	0	0	0	243.9283793	0	278.282847	0	0	379.2812035											1a $0	1b $0	2 $50 days 11-100	6 $0	10a $75	11a 15%	11b 15%	4a $50	"9a $75, 9b $75"	8a $0	8b $25	5 $0	12 $0	4b $50	7a $10	"16b $25, 17a $25, 18a $25, 7b $25, 7d $25, 7f $25"	"7e $30, 7h $30, 9c $30"	"7c $20, 7i $20"	8b $25	7g $25	"15 $50/$100, 11c DS $20/$40, Nebulizers $10/$30"		10b $0	16a $15	17a $25	17b $150 Allowance every two years	18a $25	"18b $750 Allowance every 3 yrs ($500 for 1st aid, $250 for 2nd aid)"		14a $0											0	0	28.51080645	0	73.74894724	0.149168924	0.15	45.88541521	74.42603258	0	16.84477657	0	0	0.160144323	5.91790619	3.456495666	27.28253385	2.78847294	1.872926385	0.531685973	8.467495652	0	0	0	8.920386505	0	24.79003356	0	0	2.40602222											0	0	26.27706202	0	67.97091708	0.137481943	0.138247906	42.29041728	68.59495462	0	15.52503397	0	0	0.147597449	5.454254277	3.185688598	27.28253385	2.570003642	1.726187679	0.490029818	8.467495652	0	0	0	8.221498396	0	22.84780161	0	0	2.217516899											0	0	2.554420581	0	1.584126806	1.756604585	0.960249161	0.543502098	3.947610259	0	1.462366156	0	0	0.005307772	3.133320313	7.223887069	0.398361978	0.387627474	0.866048479	0.070118857	1.534852503	0	0	0	0.167121398	0	0.52984594	0	0	0.07008854	0	0	0	0	0	0	0	0	0	0	27.1955	0	2.1475	0	0	2.554420581	0	1.584126806	1.756604585	0.960249161	0.543502098	3.947610259	0	1.462366156	0	0	0.005307772	3.133320313	7.223887069	0.398361978	0.387627474	0.866048479	0.070118857	1.534852503	0	0	0	0.167121398	0	0.52984594	0	0	0.07008854	0	0	0	0	0	0	0	0	0	0	27.1955	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	2.554420581	0	1.584126806	1.756604585	0.960249161	0.543502098	3.947610259	0	1.462366156	0	0	0.005307772	3.133320313	7.223887069	0.398361978	0.387627474	0.866048479	0.070118857	1.534852503	0	0	0	0.167121398	0	0.52984594	0	0	0.07008854	0	0	0	0	0	0	0	0	0	0	27.1955
H3959_006_0	2009	7																					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	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	2150.509925	25.22398488	1075.185113	0	230.3658848	9.645343213	6.279219886	88.22774716	767.1923017	0	976.9736372	0	0	444.7342211	7096.933058	20297.68743	236.7748132	1818.871364	4862.961479	1656.11317	2088.925148	0	0	0	256.7260259	0	261.6078748	0	0	881.9870573											"1a $100 per admit, with a max of 4/yr"	"1b $100 per admit, with a max of 4/yr"	2 $45 days 6-100	6 $0	10a $75	11a 20% with $250 OOP Max	11b 20% with $250 OOP Max	4a $50	"9a $100, 9b $100"	8a $0	8b $0	5 $0	12 $0	4b $50	7a $10	"16b $25, 17a $25, 18a $20, 7b $25, 7d $25, 7f $25"	"7e $25, 7h $25, 9c $25"	"7c $25, 7i $25"	8b $0	7g $25	"15 $50/$100, 11c DS Covered in Full, Nebulizers $10/$30"		10b $0	16a N/A	17a $25	17b $150 Allowance every two years	18a $20	"18b $750 Allowance every 3 yrs ($500 for 1st aid, $250 for 2nd aid)"		14a $0											12.43129945	12.45033777	34.3974848	0	72.92220555	0.199604119	0.2	50	99.09113514	0	1.447497413	0	0	0.165298399	5.720550353	4.66872889	23.15153913	4.886130206	0.004482667	0.837134373	2.17759736	0	0	0	11.06076481	0	19.914214	0	0	1.958147489											11.51644514	12.45033777	31.86607711	0	67.55565527	0.101319828	0.15075664	46.32035932	91.7987397	0	1.340972005	0	0	0.153133625	5.299558957	4.325143995	23.15153913	4.526546136	0.004152775	0.775527299	2.17759736	0	0	0	10.246772	0	18.44867096	0	0	1.814041906											2.0639	0.026170594	2.855160977	0	1.296876525	0.977264511	0.946634093	0.340561746	5.868940534	0	0.109174525	0	0	0.005675314	3.13421793	7.315868409	0.456808446	0.686100429	0.001682899	0.107030081	0.379069824	0	0	0	0.219217755	0	0.402193134	0	0	0.133330124	0	0	0	0	0	0	0	0	0	0	27.3258	0	1.9494	2.0639	0.026170594	2.855160977	0	1.296876525	0.977264511	0.946634093	0.340561746	5.868940534	0	0.109174525	0	0	0.005675314	3.13421793	7.315868409	0.456808446	0.686100429	0.001682899	0.107030081	0.379069824	0	0	0	0.219217755	0	0.402193134	0	0	0.133330124	0	0	0	0	0	0	0	0	0	0	27.3258	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	2.0639	0.026170594	2.855160977	0	1.296876525	0.977264511	0.946634093	0.340561746	5.868940534	0	0.109174525	0	0	0.005675314	3.13421793	7.315868409	0.456808446	0.686100429	0.001682899	0.107030081	0.379069824	0	0	0	0.219217755	0	0.402193134	0	0	0.133330124	0	0	0	0	0	0	0	0	0	0	27.3258
H3959_010_0	2009	8																					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	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	2026.97969	20.0039388	1457.715154	0	301.031181	10.79579267	7.851308571	125.1904739	556.9120715	2050.156905	1125.155822	0	0	286.8607311	6458.210963	25003.50592	335.9748032	1683.471661	5428.442538	1671.510478	1932.117674	0	0	0	231.9901143	0	0	0	0	501.2888125											1a $225 per admit	1b $225 per admit	2 20% days 11-100	6 $0	10a $100	11a 15%	11b 15%	4a $50	"9a $100, 9b $100"	8a $10	8b $25	5 $0	12 $0	4b $50	7a $15	"16b $30, 17a $30, 18a $30, 7b $30, 7d $30, 7f $30"	"7e $30, 7h $30, 9c $30"	"7c $35, 7i $35"	8b $25	7g $30	"15 $50/$100, 11c DS $20/$40, Nebulizers $10/$30"		10b $0	16a $0	17a $30	17b $150 Allowance every two years	18a $30	18b N/A		14a $0											42.5981017	42.63055101	44.60706587	0	98.12286372	0.149023246	0.15	50	98.96176897	10	14.68296437	0	0	0.00272969	7.819570402	4.729509494	11.50607954	14.70323305	1.987511103	0.717589888	5.114745909	0	0	0	10.00390252	0	0	0	0	3.326330497											35.6468865	42.63055101	37.32802521	0	82.11104361	0.124705433	0.125522799	41.84093314	82.81305517	8.368186628	12.28697861	0	0	0.002284255	6.543562447	3.95774181	11.50607954	12.30393982	1.663186384	0.600492611	5.114745909	0	0	0	8.371452327	0	0	0	0	2.783535438											6.0213	0.071064911	4.534469001	0	2.059832036	1.346294001	0.985518231	0.436507187	3.843299176	1.429674633	1.152063793	0	0	5.46E-05	3.521642228	8.246451734	0.322146067	1.726111168	0.752375976	0.083644141	0.823524248	0	0	0	0.161841182	0	0	0	0	0.116279598	0	0	0	0	0	0	0	0	0	0	37.6341	0	7.1015	6.0213	0.071064911	4.534469001	0	2.059832036	1.346294001	0.985518231	0.436507187	3.843299176	1.429674633	1.152063793	0	0	5.46E-05	3.521642228	8.246451734	0.322146067	1.726111168	0.752375976	0.083644141	0.823524248	0	0	0	0.161841182	0	0	0	0	0.116279598	0	0	0	0	0	0	0	0	0	0	37.6341	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.0213	0.071064911	4.534469001	0	2.059832036	1.346294001	0.985518231	0.436507187	3.843299176	1.429674633	1.152063793	0	0	5.46E-05	3.521642228	8.246451734	0.322146067	1.726111168	0.752375976	0.083644141	0.823524248	0	0	0	0.161841182	0	0	0	0	0.116279598	0	0	0	0	0	0	0	0	0	0	37.6341
H3959_011_0	2009	8																					3350											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	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	1781.919011	34.98563611	1008.522342	0	269.715084	11.22859516	5.154247591	138.2915435	615.5189238	0	916.0469943	0	0	339.9865174	5784.160998	23641.11381	174.9528456	1411.153171	4622.870863	1332.368047	1656.802244	0	0	0	226.4124517	0	240.6779052	0	0	313.8293514											1a $120 days 1-5	1b $120 days 1-5	2 20% days 11-100	6 $0	10a $100	11a 20%	11b 20%	4a $50	"9a $100, 9b $100"	8a $0	8b $25	5 $0	12 $0	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	"15 $50/$100, 11c DS $20/$40, Nebulizers $10/$30"		10b $0	16a $0	17a $30	17b $150 Allowance every two years	18a $30	"18b $750 Allowance every 3 yrs ($500 for 1st aid, $250 for 2nd aid)"		14a $0											80.61081583	80.64471582	40.40087564	0	98.53952492	0.198869347	0.2	50	99.33192899	0	17.02390193	0	0	0.000275176	8.570922694	4.221087505	10.10672728	14.51440852	2.240612788	0.512876729	6.080320275	0	0	0	9.880260662	0	29.80367716	0	0	2.88502288											68.93084101	80.64471582	34.54705558	0	84.26179856	0.170054492	0.171021321	42.75533022	84.93938851	0	14.55725098	0	0	0.000235305	7.329052602	3.609479803	10.10672728	12.41136658	1.915962793	0.438564278	5.199322024	0	0	0	8.448676146	0	25.48532118	0	0	2.467002119											10.2358	0.235117223	2.903456451	0	1.893889839	1.909473045	0.881486231	0.492725051	4.35681675	0	1.1112605	0	0	6.67E-06	3.532701684	7.111010237	0.147350058	1.459528276	0.738104048	0.048694086	0.717854033	0	0	0	0.159407123	0	0.511146143	0	0	0.06451814	0	0	0	0	0	0	0	0	0	0	38.5103	0	6.4606	10.2358	0.235117223	2.903456451	0	1.893889839	1.909473045	0.881486231	0.492725051	4.35681675	0	1.1112605	0	0	6.67E-06	3.532701684	7.111010237	0.147350058	1.459528276	0.738104048	0.048694086	0.717854033	0	0	0	0.159407123	0	0.511146143	0	0	0.06451814	0	0	0	0	0	0	0	0	0	0	38.5103	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.2358	0.235117223	2.903456451	0	1.893889839	1.909473045	0.881486231	0.492725051	4.35681675	0	1.1112605	0	0	6.67E-06	3.532701684	7.111010237	0.147350058	1.459528276	0.738104048	0.048694086	0.717854033	0	0	0	0.159407123	0	0.511146143	0	0	0.06451814	0	0	0	0	0	0	0	0	0	0	38.5103
H3959_013_0	2009	5																					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	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	1978.290547	54.43229208	1046.985847	0	259.7135656	13.16052785	7.073375273	124.5159774	626.8080426	504.572823	1005.393062	0	0	387.2642646	6551.340847	17680.35117	193.4733884	1749.229159	5470.526633	1890.055462	2031.693681	0	0	0	251.6101209	0	0	0	0	466.1527236											1a $250 per admit	1b $250 per admit	2 20% days 11-100	6 $0	10a $100	11a 15%	11b 15%	4a $50	"9a $100, 9b $100"	8a $10	8b $25	5 $0	12 $0	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	"15 $50/$100, 11c DS $20/$40, Nebulizers $10/$30"		10b $0	16a $0	17a $30	17b $150 Allowance every two years	18a $30	18b N/A		14a $0											47.30027142	47.3672789	38.80571951	0	98.432954	0.14918896	0.15	45.88541521	69.41010757	10	15.88067725	0	0	0.224117296	8.480096838	6.105970847	22.94106975	5.055259471	1.909586945	1.053417989	8.66401874	0	0	0	11.46139292	0	0	0	0	4.259773605											40.92373486	47.3672789	33.57433115	0	85.16323459	0.129076837	0.129778541	39.69961503	60.0529501	8.651902755	13.73980753	0	0	0.193904105	7.33689732	5.282826599	22.94106975	4.373761335	1.652156055	0.911407	8.66401874	0	0	0	9.916285701	0	0	0	0	3.685514699											6.7466	0.21485913	2.929320794	0	1.84317061	1.698719314	0.917972325	0.411936364	3.136806008	0.363792916	1.15115893	0	0	0.006257678	4.005542925	7.783519123	0.369873875	0.637559238	0.753180308	0.143550815	1.46688601	0	0	0	0.20791982	0	0	0	0	0.143167726	0	0	0	0	0	0	0	0	0	0	34.9318	0	5.1232	6.7466	0.21485913	2.929320794	0	1.84317061	1.698719314	0.917972325	0.411936364	3.136806008	0.363792916	1.15115893	0	0	0.006257678	4.005542925	7.783519123	0.369873875	0.637559238	0.753180308	0.143550815	1.46688601	0	0	0	0.20791982	0	0	0	0	0.143167726	0	0	0	0	0	0	0	0	0	0	34.9318	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.7466	0.21485913	2.929320794	0	1.84317061	1.698719314	0.917972325	0.411936364	3.136806008	0.363792916	1.15115893	0	0	0.006257678	4.005542925	7.783519123	0.369873875	0.637559238	0.753180308	0.143550815	1.46688601	0	0	0	0.20791982	0	0	0	0	0.143167726	0	0	0	0	0	0	0	0	0	0	34.9318
H3959_023_0	2009	6																					3350											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	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	1709.39879	297.980388	824.6610692	0	258.2181674	8.785703352	8.029194344	130.2187834	593.6523961	0	1052.845251	0	0	317.8699836	6270.896196	26762.77346	230.8025747	1380.777715	5231.97659	1792.48952	1698.217328	0	0	0	273.6140758	0	0	0	0	527.4003051											1a $185 days 1-5	1b $185 days 1-5	2 20% days 11-100	6 $0	10a $100	11a 15%	11b 15%	4a $50	"9a $100, 9b $100"	8a $0	8b $25	5 $0	12 $0	4b $50	7a $20	"16b $40, 17a $40, 18a $40, 7b $40, 7d $40, 7f $40"	"7e $30, 7h $30, 9c $30"	"7c $35, 7i $35"	8b $25	7g $40	"15 $50/$100, 11c DS $20/$40, Nebulizers $10/$30"		10b $0	16a $0	17a $40	17b $150 Allowance every two years	18a $40	18b N/A		14a $0											124.0565584	124.3272702	41.19038579	0	97.03638486	0.148584245	0.15	45.88541521	69.12036309	0	15.275272	0	0	0.209723246	11.72256546	4.772640677	25.89163487	4.992090886	1.85407398	1.052383102	7.823977504	0	0	0	13.47601791	0	0	0	0	5.426965121											102.8492068	124.3272702	34.14892819	0	80.44810639	0.123183908	0.124357641	38.04134676	57.30430222	0	12.66397866	0	0	0.173871255	9.71860395	3.956762255	25.89163487	4.138697658	1.537121782	0.872479204	6.48647593	0	0	0	11.17230536	0	0	0	0	4.499230552											14.6509	3.087257352	2.346774303	0	1.731096884	1.082257275	0.998491672	0.412808158	2.834903026	0	1.111100816	0	0	0.004605704	5.078696378	8.82449432	0.497987999	0.476218458	0.670182098	0.130325819	0.917953818	0	0	0	0.254741667	0	0	0	0	0.197741297	0	0	0	0	0	0	0	0	0	0	45.3085	0	8.6033	14.6509	3.087257352	2.346774303	0	1.731096884	1.082257275	0.998491672	0.412808158	2.834903026	0	1.111100816	0	0	0.004605704	5.078696378	8.82449432	0.497987999	0.476218458	0.670182098	0.130325819	0.917953818	0	0	0	0.254741667	0	0	0	0	0.197741297	0	0	0	0	0	0	0	0	0	0	45.3085	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.6509	3.087257352	2.346774303	0	1.731096884	1.082257275	0.998491672	0.412808158	2.834903026	0	1.111100816	0	0	0.004605704	5.078696378	8.82449432	0.497987999	0.476218458	0.670182098	0.130325819	0.917953818	0	0	0	0.254741667	0	0	0	0	0.197741297	0	0	0	0	0	0	0	0	0	0	45.3085
H3959_026_0	2009	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	Coin	V	V	Coin	Coin	Coin	V	V	Coin	V	Coin	Coin	Coin																																																			0		363.7625457	57.46693489	39.63011546		13.26918459	16.99746816	15.33966122	858.8940736	31.13045982	10.13497073	19.33523054	5.573650789	1.940724343	30.43701799		14170.5569	2316.366577	9.706903897	5369.16181	5125.93135	15.12530332																				1a: Medicare FFS	1b: Medicare FFS	2a1: Medicare FFS	6: Medicare FFS	10a: Medicare FFS	11a: Medicare FFS	11b: Medicare FFS;11c: Medicare FFS	4a: $50/visit	9a: Medicare FFS;9b: Medicare FFS	8a: $0/visit;8a: Medicare FFS	8b: Medicare FFS	9a: Medicare FFS	12a: Medicare FFS	3: Medicare FFS;5: Medicare FFS;9c: Medicare FFS;9d: Medicare FFS	7a: $0/visit;14f: Medicare FFS;14g: Medicare FFS;14h: Medicare FFS	7b: Medicare FFS;7d: $0/visit;7f: Medicare FFS;16b: Medicare FFS;17a: Medicare FFS	7a: $0/visit;7d: Medicare FFS;7e: Medicare FFS;7h: Medicare FFS	7c: Medicare FFS;7i: Medicare FFS	7a: $0/visit;7d: Medicare FFS	7g: $0/visit;14b: Medicare FFS;14i: Medicare FFS	15: Medicare FFS	13a: Medicare FFS			17a1: 1 routine exam	17b1: $150 every two years	18a1: $0/visit	18b: $1200 every three years													0.076610682	0.076610682	0.18962106		0.231	0.231	0.231	50	0.231	0.231	0.231	0.231	0.231	0.231		20.44925871	21.03104723	0.231	14.48499635	5.470610867	0.231																				0.076610682	0.076610682	0.18962106		0.231	0.231	0.231	50	0.231	0.231	0.231	0.231	0.231	0.231		20.44925871	21.03104723	0.231	14.48499635	5.470610867	0.231																				27.8681	4.402581061	7.51470449	0	3.065181639	3.926415145	3.543461742	3.578725307	7.191136218	2.341178239	4.466438255	1.287513332	0.448307323	7.030951155	0	24.14811534	4.059634574	2.2422948	6.4810241	2.336831313	3.493945066	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.4265	0	0	27.8681	4.402581061	7.51470449	0	3.065181639	3.926415145	3.543461742	3.578725307	7.191136218	2.341178239	4.466438255	1.287513332	0.448307323	7.030951155	0	24.14811534	4.059634574	2.2422948	6.4810241	2.336831313	3.493945066	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.4265																																																																																		0	0	0	27.8681	4.402581061	7.51470449	0	3.065181639	3.926415145	3.543461742	3.578725307	7.191136218	2.341178239	4.466438255	1.287513332	0.448307323	7.030951155	0	24.14811534	4.059634574	2.2422948	6.4810241	2.336831313	3.493945066	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.4265
H3959_027_0	2009	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	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	2444.57339	53.54034343	1254.585224	0	322.4910961	13.19022349	9.355042187	145.7161358	749.7310876	2411.329099	1233.971379	0	0	596.8869109	8205.928331	30240.97045	148.5745318	2127.358184	6690.470476	2156.72412	2354.581885	0	0	0	280.9974331	0	286.9411421	0	0	549.2177248											"1a $225 per admit, with a max of 3/yr"	"1b $225 per admit, with a max of 3/yr"	2 $75 days 6-25	6 $0	10a $100	11a 20%	11b 20%	4a $50	"9a $100, 9b $100"	8a $10	8b $25	5 $0	12 $0	4b $50	7a $15	"16b $25, 17a $25, 18a $25, 7b $25, 7d $25, 7f $25"	"7e $30, 7h $30, 9c $30"	"7c $25, 7i $25"	8b $25	7g $25	"15 $50/$100, 11c DS $20/$40, Nebulizers $10/$30"		10b $0	16a N/A	17a $25	17b $150 Allowance every two years	18a $25	"18b $750 Allowance every 3 yrs ($500 for 1st aid, $250 for 2nd aid)"		14a $0											26.01621423	26.02520398	40.6842134	0	98.38921898	0.198891972	0.2	45.88541521	69.24433705	10	16.08813303	0	0	0.167525208	8.38213616	3.46909284	27.33378187	3.530509999	1.933311834	0.733948381	9.954186105	0	0	0	10.8131811	0	24.83160911	0	0	3.534706968											17.9236528	26.02520398	28.02904793	0	67.78442801	0.137024958	0.137788324	31.61237234	47.70530581	6.88941621	11.08378445	0	0	0.115415089	5.774802473	2.390002445	27.33378187	2.432315282	1.331938989	0.505647587	9.954186105	0	0	0	7.449650517	0	17.10752903	0	0	2.435206748											3.6513	0.11611653	2.930402449	0	1.821656207	1.807389819	1.289015586	0.383869395	2.980512567	1.384387482	1.139756064	0	0	0.005740813	3.948967935	6.022999443	0.33842532	0.431200485	0.742608207	0.090878529	1.95316219	0	0	0	0.174444389	0	0.40907116	0	0	0.111454892	0	0	0	0	0	0	0	0	0	0	31.7334	0	13.2406	3.6513	0.11611653	2.930402449	0	1.821656207	1.807389819	1.289015586	0.383869395	2.980512567	1.384387482	1.139756064	0	0	0.005740813	3.948967935	6.022999443	0.33842532	0.431200485	0.742608207	0.090878529	1.95316219	0	0	0	0.174444389	0	0.40907116	0	0	0.111454892	0	0	0	0	0	0	0	0	0	0	31.7334	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.6513	0.11611653	2.930402449	0	1.821656207	1.807389819	1.289015586	0.383869395	2.980512567	1.384387482	1.139756064	0	0	0.005740813	3.948967935	6.022999443	0.33842532	0.431200485	0.742608207	0.090878529	1.95316219	0	0	0	0.174444389	0	0.40907116	0	0	0.111454892	0	0	0	0	0	0	0	0	0	0	31.7334
H3959_028_0	2009	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	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	2396.244364	52.48185499	1229.782172	0	316.1154721	12.57923829	8.921706669	142.8353391	734.9089621	2363.65731	1209.57586	0	0	585.086503	8043.697764	29643.10881	145.6372248	2085.300478	6558.200394	2114.085851	2308.031983	0	0	0	275.4421357	0	281.2683379	0	0	538.359733											"1a $225 per admit, with a max of 3/yr"	"1b $225 per admit, with a max of 3/yr"	2 $75 days 6-25	6 $0	10a $100	11a 20%	11b 20%	4a $50	"9a $100, 9b $100"	8a $10	8b $25	5 $0	12 $0	4b $50	7a $15	"16b $25, 17a $25, 18a $25, 7b $25, 7d $25, 7f $25"	"7e $30, 7h $30, 9c $30"	"7c $25, 7i $25"	8b $25	7g $25	"15 $50/$100, 11c DS $20/$40, Nebulizers $10/$30"		10b $0	16a N/A	17a $25	17b $150 Allowance every two years	18a $25	"18b $750 Allowance every 3 yrs ($500 for 1st aid, $250 for 2nd aid)"		14a $0											26.01621423	26.02520398	40.6842134	0	98.38921898	0.198891972	0.2	45.88541521	69.24433705	10	16.08813303	0	0	0.167525208	8.38213616	3.46909284	27.33378187	3.530509999	1.933311834	0.733948381	9.954186105	0	0	0	10.8131811	0	24.83160911	0	0	3.534706968											18.0797427	26.02520398	28.27314166	0	68.37473538	0.138218253	0.138988267	31.8876718	48.12075217	6.94941337	11.18030867	0	0	0.116420192	5.82509291	2.410816017	27.33378187	2.453497339	1.343538311	0.510051069	9.954186105	0	0	0	7.514526533	0	17.25651163	0	0	2.456413986											3.6103	0.113820915	2.897483796	0	1.801192646	1.738680344	1.240012552	0.379557201	2.947031003	1.368835976	1.126952624	0	0	0.005676324	3.904607235	5.955340126	0.331734678	0.426356598	0.734266123	0.089857646	1.914548325	0	0	0	0.17248477	0	0.404475862	0	0	0.110202865	0	0	0	0	0	0	0	0	0	0	31.2734	0	12.6921	3.6103	0.113820915	2.897483796	0	1.801192646	1.738680344	1.240012552	0.379557201	2.947031003	1.368835976	1.126952624	0	0	0.005676324	3.904607235	5.955340126	0.331734678	0.426356598	0.734266123	0.089857646	1.914548325	0	0	0	0.17248477	0	0.404475862	0	0	0.110202865	0	0	0	0	0	0	0	0	0	0	31.2734	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.6103	0.113820915	2.897483796	0	1.801192646	1.738680344	1.240012552	0.379557201	2.947031003	1.368835976	1.126952624	0	0	0.005676324	3.904607235	5.955340126	0.331734678	0.426356598	0.734266123	0.089857646	1.914548325	0	0	0	0.17248477	0	0.404475862	0	0	0.110202865	0	0	0	0	0	0	0	0	0	0	31.2734
H3959_029_0	2009	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	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	3105.982049	59.75848151	1806.217439	0	426.4971897	22.22117669	15.4105677	187.7622032	881.0018077	2919.705389	1323.970199	0	0	644.8303467	10489.57703	37236.86429	172.3876416	2722.383531	7690.372234	2519.93861	4297.872331	0	0	0	0	0	327.9899584	0	0	531.6063847											"1a $225 per admit, with a max of 3/yr"	"1b $225 per admit, with a max of 3/yr"	2 $75 days 6-25	6 $0	10a $100	11a 20%	11b 20%	4a $50	"9a $100, 9b $100"	8a $10	8b $25	5 $0	12 $0	4b $50	7a $15	"16b $25, 17a $0, 18a $25, 7b $25, 7d $25, 7f $0"	"7e $30, 7h $30, 9c $30"	"7c $25, 7i $25"	8b $25	7g $25	"15 $50/$100, 11c DS Covered in Full, Nebulizers $10/$30"		10b $0	16a $15	17a $0	17b $150 Allowance every two years	18a $25	"18b $750 Allowance every 3 yrs ($500 for 1st aid, $250 for 2nd aid)"		14a $0											26.00148912	26.02520398	40.6842134	0	98.57694201	0.199241694	0.2	45.88541521	69.29258913	10	16.46939059	0	0	0.168497693	8.21830172	3.223330065	26.92274619	3.085048464	1.936762822	0.826268467	4.175050278	0	0	0	0	0	24.75691596	0	0	1.868510905											16.25565018	26.02520398	25.43501788	0	61.62848125	0.124562222	0.125036302	28.68671307	43.32044536	6.251815079	10.29635844	0	0	0.105341642	5.137930262	2.015166351	26.92274619	1.92871525	1.210828302	0.516567766	4.175050278	0	0	0	0	0	15.47756605	0	0	1.168158465											4.2075	0.129602223	3.828431072	0	2.190364505	2.767919153	1.926880391	0.448856704	3.180449223	1.521121515	1.136005978	0	0	0.005660624	4.491226273	6.253206327	0.386762393	0.437558553	0.775976696	0.108476588	1.495319422	0	0	0	0	0	0.423040521	0	0	0.051750042	0	0	0	0	0	0	0	0	0	0	35.7661	0	20.237	4.2075	0.129602223	3.828431072	0	2.190364505	2.767919153	1.926880391	0.448856704	3.180449223	1.521121515	1.136005978	0	0	0.005660624	4.491226273	6.253206327	0.386762393	0.437558553	0.775976696	0.108476588	1.495319422	0	0	0	0	0	0.423040521	0	0	0.051750042	0	0	0	0	0	0	0	0	0	0	35.7661	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.2075	0.129602223	3.828431072	0	2.190364505	2.767919153	1.926880391	0.448856704	3.180449223	1.521121515	1.136005978	0	0	0.005660624	4.491226273	6.253206327	0.386762393	0.437558553	0.775976696	0.108476588	1.495319422	0	0	0	0	0	0.423040521	0	0	0.051750042	0	0	0	0	0	0	0	0	0	0	35.7661
H3959_030_0	2009	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	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	3033.507272	57.83062462	1764.071282	0	412.3484293	20.90207439	14.49575947	181.5333171	851.7751592	2822.846106	1280.048369	0	0	623.4385291	10141.5923	36001.5561	166.6687963	2632.070269	7435.249254	2436.341324	4155.293277	0	0	0	0	0	317.1091098	0	0	524.3950316											"1a $225 per admit, with a max of 3/yr"	"1b $225 per admit, with a max of 3/yr"	2 $75 days 6-25	6 $0	10a $100	11a 20%	11b 20%	4a $50	"9a $100, 9b $100"	8a $10	8b $25	5 $0	12 $0	4b $50	7a $15	"16b $25, 17a $0, 18a $25, 7b $25, 7d $25, 7f $0"	"7e $30, 7h $30, 9c $30"	"7c $25, 7i $25"	8b $25	7g $25	"15 $50/$100, 11c DS Covered in Full, Nebulizers $10/$30"		10b $0	16a $15	17a $0	17b $150 Allowance every two years	18a $25	"18b $750 Allowance every 3 yrs ($500 for 1st aid, $250 for 2nd aid)"		14a $0											26.00148912	26.02520398	40.6842134	0	98.57694201	0.199241694	0.2	45.88541521	69.29258913	10	16.46939059	0	0	0.168497693	8.21830172	3.223330065	26.92274619	3.085048464	1.936762822	0.826268467	4.175050278	0	0	0	0	0	24.75691596	0	0	1.868510905											16.50656521	26.02520398	25.82762159	0	62.57975128	0.12648491	0.126966307	29.12950851	43.98912063	6.348315337	10.45528849	0	0	0.106967649	5.217237085	2.046271569	26.92274619	1.958486048	1.229518113	0.524541278	4.175050278	0	0	0	0	0	15.71647093	0	0	1.186189644											4.1727	0.12542115	3.796813795	0	2.150388512	2.643796996	1.840473043	0.440664692	3.122403352	1.493359769	1.115272915	0	0	0.005557313	4.409257619	6.139080057	0.373931808	0.429572741	0.761814469	0.106496799	1.445713196	0	0	0	0	0	0.415319676	0	0	0.051835996	0	0	0	0	0	0	0	0	0	0	35.0399	0	19.0368	4.1727	0.12542115	3.796813795	0	2.150388512	2.643796996	1.840473043	0.440664692	3.122403352	1.493359769	1.115272915	0	0	0.005557313	4.409257619	6.139080057	0.373931808	0.429572741	0.761814469	0.106496799	1.445713196	0	0	0	0	0	0.415319676	0	0	0.051835996	0	0	0	0	0	0	0	0	0	0	35.0399	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.1727	0.12542115	3.796813795	0	2.150388512	2.643796996	1.840473043	0.440664692	3.122403352	1.493359769	1.115272915	0	0	0.005557313	4.409257619	6.139080057	0.373931808	0.429572741	0.761814469	0.106496799	1.445713196	0	0	0	0	0	0.415319676	0	0	0.051835996	0	0	0	0	0	0	0	0	0	0	35.0399
H3959_803_0	2009	2																					0											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	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	231.3733932	1.591327591	36.73759682	0	8.477399373	10.69913013	7.864374489	2.412054807	43.89474317	6.321923678	27.99271469	3.078026569	0.627999332	7.466435987	33.67896879	106.4344923	1.791007023	11.83609072	52.05139814	9.09793864	87.97903005	0	0	0	0	0	0	0	0	0											FFS 7.8%	FFS 7.8%	FFS 18.4%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%		FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%			FFS 23.1%											0.077871521	0.077871521	0.183916916	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.077871521	0.077871521	0.183916916	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											18.0174	0.1239191	6.756665492	0	1.958279255	2.471499059	1.816670507	0.557184661	10.13968567	1.46036437	6.466317094	0.711024137	0.145067846	1.724746713	7.77984179	24.58636772	0.413722622	2.734136956	12.02387297	2.101623826	20.32315594	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.3115	0	0	18.0174	0.1239191	6.756665492	0	1.958279255	2.471499059	1.816670507	0.557184661	10.13968567	1.46036437	6.466317094	0.711024137	0.145067846	1.724746713	7.77984179	24.58636772	0.413722622	2.734136956	12.02387297	2.101623826	20.32315594	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.3115	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.0174	0.1239191	6.756665492	0	1.958279255	2.471499059	1.816670507	0.557184661	10.13968567	1.46036437	6.466317094	0.711024137	0.145067846	1.724746713	7.77984179	24.58636772	0.413722622	2.734136956	12.02387297	2.101623826	20.32315594	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.3115
H3959_804_0	2009	2																					0											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	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	313.7736867	2.127940138	48.31837768	0	12.12685622	13.83013097	9.10595834	3.578577363	55.71544017	9.164694114	39.88450086	2.618625406	0.011790117	7.474309205	45.98462044	136.3449434	2.671827032	16.91322272	62.01228191	10.62817725	44.4605955	0	0	0	0	0	0	0	0	0											FFS 7.8%	FFS 7.8%	FFS 18.4%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%		FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%			FFS 23.1%											0.077858186	0.077858186	0.184191637	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.077858186	0.077858186	0.184191637	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											24.4299	0.165677559	8.8998411	0	2.801303786	3.194760255	2.103476376	0.826651371	12.87026668	2.11704434	9.213319698	0.604902469	0.002723517	1.726565426	10.62244732	31.49568193	0.617192044	3.906954449	14.32483712	2.455108945	10.27039756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.649	0	0	24.4299	0.165677559	8.8998411	0	2.801303786	3.194760255	2.103476376	0.826651371	12.87026668	2.11704434	9.213319698	0.604902469	0.002723517	1.726565426	10.62244732	31.49568193	0.617192044	3.906954449	14.32483712	2.455108945	10.27039756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.649	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.4299	0.165677559	8.8998411	0	2.801303786	3.194760255	2.103476376	0.826651371	12.87026668	2.11704434	9.213319698	0.604902469	0.002723517	1.726565426	10.62244732	31.49568193	0.617192044	3.906954449	14.32483712	2.455108945	10.27039756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.649
H3959_806_0	2009	2																					0											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	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	317.1533976	2.194041046	47.2127999	0	12.66495407	13.65579306	10.11503611	3.499763582	54.14889373	8.953661829	37.78810107	3.928525428	0.104413725	9.29484733	44.80008224	138.1132745	2.393886497	16.39614001	64.89760771	11.32753925	51.55233797	0	0	0	0	0	0	0	0	0											FFS 7.8%	FFS 7.8%	FFS 18.4%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%		FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%			FFS 23.1%											0.077891934	0.077891934	0.18408516	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.077891934	0.077891934	0.18408516	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											24.7037	0.1708981	8.691175846	0	2.925604391	3.154488197	2.33657334	0.808445388	12.50839445	2.068295882	8.729051347	0.907489374	0.02411957	2.147109733	10.348819	31.9041664	0.552987781	3.787508342	14.99134738	2.616661567	11.90859007	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.2854	0	0	24.7037	0.1708981	8.691175846	0	2.925604391	3.154488197	2.33657334	0.808445388	12.50839445	2.068295882	8.729051347	0.907489374	0.02411957	2.147109733	10.348819	31.9041664	0.552987781	3.787508342	14.99134738	2.616661567	11.90859007	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.2854	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.7037	0.1708981	8.691175846	0	2.925604391	3.154488197	2.33657334	0.808445388	12.50839445	2.068295882	8.729051347	0.907489374	0.02411957	2.147109733	10.348819	31.9041664	0.552987781	3.787508342	14.99134738	2.616661567	11.90859007	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.2854
H3962_001_0	2009	9																					1500											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	P	V	P	O	V											0	0	0	0	0	0	0	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	346.6490899	34.82582004	1768.489169	769.186253	329.8654496	19.5889405	0	267.8378065	557.535742	1985.348082	904.1312096	0	3.171443227	993.0686167	4470.747484	4536.640747	212.9524063	1000.802304	3416.632689	17212.09178	7.793404556	487.3909221	17.36133945	1000	664.7880575	24.22696006	31.11895647	16.65110284	0	5.445459534											1a - $0 copay/admit	1b - $0 copay/admit	2 - $0 copay Days 1-100	6 - $0 copay	10a - $25 copay/trip	"11a - 0% coinsurance for diabetic supplies, 0% coinsurance for all other"	"11b,11c - 0% coinsurance for diabetic supplies, 0% coinsurance for all other"	4a - $50 ER copay (WIA); 4b - $10 Urgent Care copay	"9a,9b - $25 copay"	8a - $0 copay	8b - $50 copay (High Tech Imaging Only)	5 - $0 copay	12 - $0 copay	"3 - $10 CORF copay; 9c - $0 SA Ind/Grp copay initial visit, $25 SA Ind/Grp Session copay thereafter; 9d - $10 Cardiac Rehab copay"	7a - $10 OV copay	7d - $10 Specialist OV copay (excluding MH and Radiology); 18a - $10 Hearing Exam copay	"7e,7h - $10 MH/Psych Ind/Grp Session copay"	"7c,7i -  $10 OT/PT/ST copay"	7d - $10 OV copay (Radiology only); 14h - $0 Mammography Screening copay	"7b,7f,7g - $10 Chiro/Pod/Other OV copay; 14b - $0 Immunization copay; 14c - $10 Physical Exam copay; 14d - $0 Pap Smear copay, $0 Pelvic Exam copay; 14e - $0 Prostate Screening copay; 14f - $0 Colorectal Screening copay; 14g - $0 Bone Mass Meas copay; 14i - $0 Diabetes Monitoring copay; 14j - $0 Nutrition Therapy copay"	15 - $0 Copay	13a - $0 copay; 17a - $10 Eye Exam copay	10b - $25 copay/trip	"16a,16b - $5 Preventive OV copay"	17a - $20 Routine Eye Exam copay	17b - $40 allowance every 2 years	"18a - $0 Routine Hearing Exam copay, $10 Hearing Aid Fitting copay"	18b - $400 allowance every 3 years	0	4a - $50 ER copay worldwide coverage											0	0	0	0	25	0	0	46.94371304	25	0	9.733437868	0	0	6.879259837	10	7.575106025	11.41414819	10	0	0.34016562	0	5.485560595	25	5	10.8648884	0	0.467922839	0	0	47.72280205											0	0	0	0	24.43094728	0.00%	0.00%	45.85308994	24.43094728	0	9.511884294	0	0	6.722673375	9.77237891	7.402680636	11.15433811	9.838475754	0	0.332422733	0.00%	5.360697667	24.43094728	4.886189455	10.3759021	0	0.457271928	0	0	46.61407871											0	0	0	0	0.671577117	0	0	1.023432586	1.13509386	0	0.716665954	0	0	0.556339662	3.640819869	2.798608551	0.197945262	0.820530767	0	0.476807549	0	0.217729615	0.035346164	0.407182455	0.57481465	0	0.001185819	0	0	0.021152923	0	0	0	0	0	0	0	0	0	0	13.2952	0	0.31	0	0	0	0	0.671577117	0	0	1.023432586	1.13509386	0	0.716665954	0	0	0.556339662	3.640819869	2.798608551	0.197945262	0.820530767	0	0.476807549	0	0.217729615	0.035346164	0.407182455	0.57481465	0	0.001185819	0	0	0.021152923	0	0	0	0	0	0	0	0	0	0	13.2952	none	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	0.671577117	0	0	1.023432586	1.13509386	0	0.716665954	0	0	0.556339662	3.640819869	2.798608551	0.197945262	0.820530767	0	0.476807549	0	0.217729615	0.035346164	0.407182455	0.57481465	0	0.001185819	0	0	0.021152923	0	0	0	0	0	0	0	0	0	0	13.2952
H3962_004_0	2009	9																					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	P	V	P	O	V											0	0	0	0	0	0	0	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	246.2510118	52.08525217	1051.995177	506.6827317	236.2910934	10.95442578	0	262.9442266	504.8836059	1854.999323	885.3932669	0	2.661363272	853.3901236	4470.747484	3729.540195	212.6512519	880.7535038	2929.715584	15388.89911	5.437246651	395.333714	12.43637334	1000	617.7878179	21.10782267	24.80844618	17.66208167	0	5.345967264											1a - $0 copay/admit	"1b - $100 copay/admit, $300 max"	2 - $0 copay Days 1-14/ $25 copay Days 15-100	6 - $0 copay	10a - $50 copay/trip	"11a - 0% coinsurance for diabetic supplies, 0% coinsurance for all other"	"11b,11c - 0% coinsurance for diabetic supplies, 0% coinsurance for all other"	4a - $50 ER copay (WIA); 4b - $20 Urgent Care copay	"9a,9b - $100 copay"	8a - $0 copay	8b - $100 copay (High Tech Imaging Only)	5 - $0 copay	12 - $0 copay	"3 - $20 CORF copay; 9c - $0 SA Ind/Grp copay initial visit, $25 SA Ind/Grp Session copay thereafter; 9d - $20 Cardiac Rehab copay"	7a - $10 OV copay	7d - $20 Specialist OV copay (excluding MH and Radiology); 18a - $20 Hearing Exam copay	"7e,7h - $10 MH/Psych Ind/Grp Session copay"	"7c,7i -  $20 OT/PT/ST copay"	7d - $20 OV copay (Radiology only); 14h - $0 Mammography Screening copay	"7b,7f,7g - $20 Chiro/Pod/Other OV copay; 14b - $0 Immunization copay; 14c - $10 Physical Exam copay; 14d - $0 Pap Smear copay, $0 Pelvic Exam copay; 14e - $0 Prostate Screening copay; 14f - $0 Colorectal Screening copay; 14g - $0 Bone Mass Meas copay; 14i - $0 Diabetes Monitoring copay; 14j - $0 Nutrition Therapy copay"	15 - $0 Copay	13a - $0 copay; 17a - $20 Eye Exam copay	10b - $50 copay/trip	"16a,16b - $5 Preventive OV copay"	17a - $20 Routine Eye Exam copay	17b - $40 allowance every 2 years	18a - $10 Routine Hearing Exam/Fitting copay	18b - $400 allowance every 3 years	0	4a - $50 ER copay worldwide coverage											0	100	11.65363854	0	49.87857082	0	0	48.32642397	100	0	19.46687574	0	0	9.759481194	10	11.93136535	11.42005726	20	0	0.630274991	0	12.70326364	49.87857082	5	18.1923476	0	0.26696268	0	0	48.92546611											0	97.9341035	11.41288643	0	48.84813117	0.00%	0.00%	47.30750033	97.9341035	0	19.06471023	0	0	9.557860414	9.79341035	11.68487569	11.1841307	19.74480422	0	0.617254162	0.00%	12.44082737	48.84813117	4.896705175	17.44844182	0	0.261447508	0	0	47.89391216											0	0.425076873	1.000525123	0	0.96186486	0	0	1.036602841	4.12044361	0	1.406647173	0	0	0.679715307	3.64865539	3.631601132	0.198193283	1.449192125	0	0.791571835	0	0.409856541	0.050624466	0.408058765	0.898286233	0	0.000540509	0	0	0.021336607	0	0	0	0	0	0	0	0	0	0	21.1388	0	0.45	0	0.425076873	1.000525123	0	0.96186486	0	0	1.036602841	4.12044361	0	1.406647173	0	0	0.679715307	3.64865539	3.631601132	0.198193283	1.449192125	0	0.791571835	0	0.409856541	0.050624466	0.408058765	0.898286233	0	0.000540509	0	0	0.021336607	0	0	0	0	0	0	0	0	0	0	21.1388	none	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	0.425076873	1.000525123	0	0.96186486	0	0	1.036602841	4.12044361	0	1.406647173	0	0	0.679715307	3.64865539	3.631601132	0.198193283	1.449192125	0	0.791571835	0	0.409856541	0.050624466	0.408058765	0.898286233	0	0.000540509	0	0	0.021336607	0	0	0	0	0	0	0	0	0	0	21.1388
H3962_007_0	2009	9																					3350											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	P	V	P	O	V											0	0	0	0	0	0	0	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	241.7545075	32.74498165	1360.859614	602.8582503	272.7657221	12.39894319	0	250.2824154	515.0438774	1905.446061	890.8125663	0	2.773939976	898.2469431	4470.747484	4070.739673	212.8036236	786.943213	3203.707888	15930.18351	5.504456556	448.1976267	14.35609064	0	0	26.9838772	26.33186687	12.16636803	0	5.088537661											"1a - $500 copay/admit, $1,000 max"	"1b - $500 copay/admit, $1,000 max"	2 - $0 copay Days 1-14/ $50 copay Days 15-100	6 - $0 copay	10a - $75 copay/trip	"11a - 0% coinsurance for diabetic supplies, 20% coinsurance for all other"	"11b,11c - 0% coinsurance for diabetic supplies, 20% coinsurance for all other"	4a - $50 ER copay (WIA); 4b - $40 Urgent Care copay	"9a,9b - $150 copay"	8a - $0 copay	8b - $150 copay (High Tech Imaging Only)	5 - $0 copay	12 - $0 copay	3 - $40 CORF copay; 9c - $40 SA Ind/Grp Session copay; 9d - $40 Cardiac Rehab copay	7a - $30 OV copay	7d - $40 Specialist OV copay (excluding MH and Radiology); 18a - $40 Hearing Exam copay	"7e,7h - $40 MH/Psych Ind/Grp Session copay"	"7c,7i -  $40 OT/PT/ST copay"	7d - $40 OV copay (Radiology only); 14h - $0 Mammography Screening copay	"7b,7f,7g - $40 Chiro/Pod/Other OV copay; 14b - $0 Immunization copay; 14c - $30 Physical Exam copay; 14d - $0 Pap Smear copay, $10 Pelvic Exam copay; 14e - $10 Prostate Screening copay; 14f - $10 Colorectal Screening copay; 14g - $10 Bone Mass Meas copay; 14i - $0 Diabetes Monitoring copay; 14j - $0 Nutrition Therapy copay"	15 - $0 Copay	13a - $0 copay; 17a - $40 Eye Exam copay	10b - $75 copay/trip	0	0	0	18a - $10 Routine Hearing Exam/Fitting copay	18b - $400 allowance every 3 years	0	4a - $50 ER copay worldwide coverage											500	500	27.18568618	0	66.2714155	0.164963388	0	49.36515341	143.2841771	0	29.2003136	0	0	24.06107961	30	27.11842688	39.97222032	40	0	1.2300874	0	24.4891252	66.2714155	0	0	0	0.404050421	0	0	49.56745429											343.8187257	324.4760275	17.64220691	0	43.00697127	10.70%	0.00%	31.68184392	92.98456115	0	18.94960352	0	0	15.61448705	19.46856165	17.59855885	25.94005452	26.1466322	0	0.798267746	0.00%	15.89226812	43.00697127	0	0	0	0.262209351	0	0	31.8116777											6.9266	0.885413464	2.000713907	0	0.977568965	1.326686921	0	0.660784035	3.990927409	0	1.406712078	0	0	1.168805439	7.253251917	5.969929308	0.460011466	1.714659563	0	1.05971264	0	0.593573071	0.051450998	0	0	0	0.000575372	0	0	0.013489577	0	0	0	0	0	0	0	0	0	0	36.4609	0	40.15	6.9266	0.885413464	2.000713907	0	0.977568965	1.326686921	0	0.660784035	3.990927409	0	1.406712078	0	0	1.168805439	7.253251917	5.969929308	0.460011466	1.714659563	0	1.05971264	0	0.593573071	0.051450998	0	0	0	0.000575372	0	0	0.013489577	0	0	0	0	0	0	0	0	0	0	36.4609	none	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	6.9266	0.885413464	2.000713907	0	0.977568965	1.326686921	0	0.660784035	3.990927409	0	1.406712078	0	0	1.168805439	7.253251917	5.969929308	0.460011466	1.714659563	0	1.05971264	0	0.593573071	0.051450998	0	0	0	0.000575372	0	0	0.013489577	0	0	0	0	0	0	0	0	0	0	36.4609
H3962_010_0	2009	8																					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	P	V	P	O	V											0	0	0	0	0	0	0	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	306.5032681	32.78115193	1368.465047	707.3126532	292.8196049	15.52651121	0	256.2051655	521.4481046	1903.894184	878.3357923	0	2.859212116	947.5140915	4470.747484	4063.859942	212.8062098	781.2783534	3349.349908	16144.07796	4.755042942	483.0922034	15.41155815	735.346138	488.8493307	23.48298202	27.76045456	12.24432417	0	5.208954177											1a - $0 copay/admit	"1b - $100 copay/admit, $300 max"	2 - $0 copay Days 1-14/ $25 copay Days 15-100	6 - $0 copay	10a - $50 copay/trip	"11a - 0% coinsurance for diabetic supplies, 0% coinsurance for all other"	"11b,11c - 0% coinsurance for diabetic supplies, 0% coinsurance for all other"	4a - $50 ER copay (WIA); 4b - $20 Urgent Care copay	"9a,9b - $100 copay"	8a - $0 copay	8b - $100 copay (High Tech Imaging Only)	5 - $0 copay	12 - $0 copay	"3 - $20 CORF copay; 9c - $0 SA Ind/Grp copay initial visit, $25 SA Ind/Grp Session copay thereafter; 9d - $20 Cardiac Rehab copay"	7a - $10 OV copay	7d - $20 Specialist OV copay (excluding MH and Radiology); 18a - $20 Hearing Exam copay	"7e,7h - $10 MH/Psych Ind/Grp Session copay"	"7c,7i -  $20 OT/PT/ST copay"	7d - $20 OV copay (Radiology only); 14h - $0 Mammography Screening copay	"7b,7f,7g - $20 Chiro/Pod/Other OV copay; 14b - $0 Immunization copay; 14c - $10 Physical Exam copay; 14d - $0 Pap Smear copay, $0 Pelvic Exam copay; 14e - $0 Prostate Screening copay; 14f - $0 Colorectal Screening copay; 14g - $0 Bone Mass Meas copay; 14i - $0 Diabetes Monitoring copay; 14j - $0 Nutrition Therapy copay"	15 - $0 Copay	13a - $0 copay; 17a - $20 Eye Exam copay	10b - $50 copay/trip	"16a,16b - $5 Preventive OV copay"	17a - $20 Routine Eye Exam copay	17b - $40 allowance every 2 years	18a - $10 Routine Hearing Exam/Fitting copay	18b - $400 allowance every 3 years	0	4a - $50 ER copay worldwide coverage											0	100	13.6470038	0	41.41889415	0	0	47.41775181	91.84039855	0	19.46687574	0	0	13.157866	10	11.47284196	11.41701468	20	0	0.556198985	0	12.18350218	41.41889415	5	17.18269142	0	0.385713208	0	0	48.00553028											0	97.89548255	13.35980022	0	40.5472263	0.00%	0.00%	46.39929666	89.90760134	0	19.05719194	0	0	12.88095642	9.789548255	11.231394	11.17674162	19.62503791	0	0.54449368	0.00%	11.92709825	40.5472263	4.894774127	16.46707615	0	0.377595806	0	0	46.97445062											0	0.267427224	1.523534969	0	0.989418565	0	0	0.990644957	3.906845693	0	1.394884482	0	0	1.017073977	3.647216519	3.803567681	0.198206668	1.277718109	0	0.732529035	0	0.480157348	0.052074661	0.299946104	0.670826596	0	0.000873519	0	0	0.020390647	0	0	0	0	0	0	0	0	0	0	21.2733	0	0.46	0	0.267427224	1.523534969	0	0.989418565	0	0	0.990644957	3.906845693	0	1.394884482	0	0	1.017073977	3.647216519	3.803567681	0.198206668	1.277718109	0	0.732529035	0	0.480157348	0.052074661	0.299946104	0.670826596	0	0.000873519	0	0	0.020390647	0	0	0	0	0	0	0	0	0	0	21.2733	none	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	0.267427224	1.523534969	0	0.989418565	0	0	0.990644957	3.906845693	0	1.394884482	0	0	1.017073977	3.647216519	3.803567681	0.198206668	1.277718109	0	0.732529035	0	0.480157348	0.052074661	0.299946104	0.670826596	0	0.000873519	0	0	0.020390647	0	0	0	0	0	0	0	0	0	0	21.2733
H3962_801_0	2009	10																					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											0	0	0	0	0	0	0	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	218.7876778	3.096833549	13.18414966	4.712961402	5.583467693	17.17727344	0	14.71969583	51.97242076	11.99972013	33.38013287	0	0.254913979	34.06387728	21.76996359	34.74879966	2.149681944	11.03746929	30.31456245	152.1801348	5.64890018	5.909204701	0	0	0	0	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																			0.074475509	0.074475509	0.189882067	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.074475509	0.074475509	0.189882067	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											16.2943	0.230638255	2.503433595	0	1.289781037	3.967950166	0	3.400249736	12.0056292	2.771935349	7.710810693	0	0.058885129	7.868755652	5.02886159	8.026972721	0.496576529	2.549655406	7.002663925	35.15361114	1.304895942	1.365026286	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.0307	0	0	16.2943	0.230638255	2.503433595	0	1.289781037	3.967950166	0	3.400249736	12.0056292	2.771935349	7.710810693	0	0.058885129	7.868755652	5.02886159	8.026972721	0.496576529	2.549655406	7.002663925	35.15361114	1.304895942	1.365026286	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.0307	none	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	16.2943	0.230638255	2.503433595	0	1.289781037	3.967950166	0	3.400249736	12.0056292	2.771935349	7.710810693	0	0.058885129	7.868755652	5.02886159	8.026972721	0.496576529	2.549655406	7.002663925	35.15361114	1.304895942	1.365026286	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.0307
H3962_802_0	2009	10																					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											0	0	0	0	0	0	0	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	236.898612	3.022549066	13.08731779	3.759488685	5.667509144	13.56988273	0	13.68516834	49.12174973	8.895054624	28.50985517	0	0.352822374	30.51928468	21.10365661	31.75217621	2.056476397	11.86548929	32.90145008	150.8529634	1.39878275	5.123392655	0	0	0	0	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																			0.074059426	0.074059426	0.188087346	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.074059426	0.074059426	0.188087346	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											17.5446	0.223848249	2.461558867	0	1.309194612	3.13464291	0	3.161273886	11.34712419	2.054757618	6.585776545	0	0.081501968	7.049954762	4.874944678	7.334752705	0.475046048	2.740928027	7.600234968	34.84703454	0.323118815	1.183503703	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.3338	0	0	17.5446	0.223848249	2.461558867	0	1.309194612	3.13464291	0	3.161273886	11.34712419	2.054757618	6.585776545	0	0.081501968	7.049954762	4.874944678	7.334752705	0.475046048	2.740928027	7.600234968	34.84703454	0.323118815	1.183503703	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.3338	none	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	17.5446	0.223848249	2.461558867	0	1.309194612	3.13464291	0	3.161273886	11.34712419	2.054757618	6.585776545	0	0.081501968	7.049954762	4.874944678	7.334752705	0.475046048	2.740928027	7.600234968	34.84703454	0.323118815	1.183503703	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.3338
H3962_803_0	2009	10																					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											0	0	0	0	0	0	0	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	226.9769447	3.121136634	13.35718192	4.526957212	5.690478238	16.46366415	0	14.66298348	51.98852937	11.3435098	32.57061599	0	0.285174969	33.62228699	21.83842039	34.46536793	2.15521524	11.42755017	31.47027977	153.9257511	4.587776824	5.78649609	0	0	0	0	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																			0.074484826	0.074484826	0.179409604	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.074484826	0.074484826	0.179409604	0	0.231	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											16.9063	0.232477318	2.396406714	0	1.314500473	3.803106419	0	3.387149184	12.00935029	2.620350763	7.523812293	0	0.065875418	7.766748295	5.044675109	7.961499993	0.49785472	2.63976409	7.269634627	35.55684849	1.059776446	1.336680597	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.3928	0	0	16.9063	0.232477318	2.396406714	0	1.314500473	3.803106419	0	3.387149184	12.00935029	2.620350763	7.523812293	0	0.065875418	7.766748295	5.044675109	7.961499993	0.49785472	2.63976409	7.269634627	35.55684849	1.059776446	1.336680597	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.3928	none	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	16.9063	0.232477318	2.396406714	0	1.314500473	3.803106419	0	3.387149184	12.00935029	2.620350763	7.523812293	0	0.065875418	7.766748295	5.044675109	7.961499993	0.49785472	2.63976409	7.269634627	35.55684849	1.059776446	1.336680597	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.3928
H3964_001_0	2009	2																																D	D	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1938.223247	106.4423027	968.046391	20.04010038	183.5623462	6.914734787	4.592175504	206.7833247	381.035346	0.594129879	1250.063469	0	1.174461596	497.4745892	0.025011296	4730.349182	420.0423711	287.3111312	23.2933505	4131.363531	40.45560963	0	123.9651806	466.2151251	347.2343467	0	0	0	1033.942959	178.4744352											1a:  Acute - $150/$0/day for 1-7/8-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $150/$0/day for 1-7/8-190/1b:  Additional Days - $0/day for 91-999/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - $0/$85/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$85/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $40/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $150/visit/9b:  Ambulatory Surgical Center Services - $150/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $150/visit/8b:  Outpatient Therapeutic Radiological Services - $150/visit/8b:  Outpatient X-Ray Services - $20/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $0/visit/3:  Rehab Services (CORF) - $0/day/5:  Partial Hospitalization - $0/day/7c:  Occupational Therapy Services - $10/visit/7i:  Physical/Speech Therapy - $10/visit	7a:  Primary Care - $0/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - 0.0%/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $40/visit/7b:  Chiropractic Services - $40/visit/7f:  Podiatry Services - $40/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14d:  Pap Smears and Pelvic Exams Screening - 0.0%/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $20/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $20/visit/7h:  Psychiatric Services - Individual - $20/visit/7h:  Psychiatric Services - Group - $20/visit	7c:  Occupational Therapy Services - $10/visit/7i:  Physical/Speech Therapy - $10/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $20/visit/9c:  Outpatient Substance Abuse Svcs - Group - $20/visit/7g:  Other Health Care Professional Services - $40/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service	10b:  Transportation - $0/trip	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $0/visit/18a:  Fitting for Hearing Aid - $0/visit	18b:  Hearing Aids - $0/service	14a:  Written health education materials - $0/service/14a:  Membership in Health Club/Fitness Classes - $0/service/14c:  Routine Exams - $0/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit/14e:   Additional Prostate Screening - $0/visit/14g:   Additional Mammography Screening - $0/visit/	13c:  Other: Over the Counter Benefit - $0/visit											150	150	85	0	100	0.2	0.2	49.87731511	150	0	61.89834879	0	0.2	10	40	39.79466453	20	10	0	0.224952471	0.2	0	0	0	0	0	0	0	0	0											150	150	85	0	100	0.2	0.2	49.87731511	150	0	61.89834879	0	0.2	10	40	39.79466453	20	10	0	0.224952471	0.2	0	0	0	0	0	0	0	0	0											24.2278	1.330528784	6.85699527	0	1.529686219	1.382946957	0.918435101	0.859483087	4.762941825	0	6.448072052	0	0.234892319	0.414562158	8.34E-05	15.68688823	0.700070618	0.239425943	0	0.077446703	8.091121926	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.7614	0	0	24.2278	1.330528784	6.85699527	0	1.529686219	1.382946957	0.918435101	0.859483087	4.762941825	0	6.448072052	0	0.234892319	0.414562158	8.34E-05	15.68688823	0.700070618	0.239425943	0	0.077446703	8.091121926	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.7614																																										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	24.2278	1.330528784	6.85699527	0	1.529686219	1.382946957	0.918435101	0.859483087	4.762941825	0	6.448072052	0	0.234892319	0.414562158	8.34E-05	15.68688823	0.700070618	0.239425943	0	0.077446703	8.091121926	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.7614
H3964_002_0	2009	2																																coin	coin	coin	coin	coin	coin	coin	V	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	T	P	V	P	V	P	O	V											11.3044	0.0356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											11.34		454.0724877	9.075912872	26.86505124	24.45586781	10.50175225	12.46685094	7.356890563	340.4182011	25.39056428	0.979427271	33.92393661	0	1.357634479	19.92127789	65.92437325	125.6577655	7.01835287	3.016031185	20.15453876	19.88906745	52.9747819	0.145484943	1639.290569	466.2151251	347.2343467	0	0	0	1033.942959	7838.00934											1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $0/admit for 1-190/1b:  Additional Days - $0/day for 91-999/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - 0/day for 1-100/2:  Non-Medicare Covered Stay - $0/day for 1-100	6:  Home Health Services - $0/visit	10a:  Ambulance - 20.0%	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - 20.0%	8a:  Outpatient Diagnostic Procedures/Tests - 20.0%/8a:  Outpatient Lab Services - 20.0%	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - 20.0%/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - 20.0%	9d:  Cardiac Rehabilitation Services - 20.0%/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - $0/day/7c:  Occupational Therapy Services - 20.0%/7i:  Physical/Speech Therapy - 20.0%	7a:  Primary Care - $0/visit/17a:  Vision Exams - 20.0%/18a:  Hearing Exams - 20.0%/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - 0%/20%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%	7d:  Physician Specialist Services - 20.0%/7b:  Chiropractic Services - 20.0%/7f:  Podiatry Services - 20.0%/1-6 Additional Visits/17a:  Vision Exams - 20.0%/18a:  Hearing Exams - 20.0%/14d:  Pap Smears and Pelvic Exams Screening - 0%/20%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%	7e:  Mental Hlth Spec-Non-Physician - Individual - 50.0%/7e:  Mental Hlth Spec-Non-Physician - Group - 50.0%/7h:  Psychiatric Services - Individual - 50.0%/7h:  Psychiatric Services - Group - 50.0%	7c:  Occupational Therapy Services - 20.0%/7i:  Physical/Speech Therapy - 20.0%	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%	9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - 20.0%	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%	10b:  Transportation - $0/trip	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Emergency Svcs - $0/visit/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service	/18a:  Fitting for Hearing Aid - $0/visit	18b:  Hearing Aids - $0/service	14a:  Written health education materials - $0/service/14a:  Membership in Health Club/Fitness Classes - $0/service/14c:  Routine Exams - $0/visit/	13c:  Other: Over the Counter Benefit - $0/visit/13e:  Other: Home Safety - $0/visit											0	0	0	0	0.2	0.2	0.2	50	0.2	0.2	0.2	0	0.2	0.2	0.019432263	0.200103667	0.5	0.2	0.2	0.192624528	0.2	0.2	0	0	0	0	0	0	0	0											0	0	0	0	0.2	0.2	0.2	50	0.2	0.2	0.2	0	0.2	0.2	0.019432263	0.200103667	0.5	0.2	0.2	0.192624528	0.2	0.2	0	0	0	0	0	0	0	0											0	0	0	0	2.10035045	2.493370187	1.471378113	1.418409171	5.078112855	0.195885454	6.784787322	0	0.271526896	3.984255578	1.281059773	25.1445796	3.509176435	0.603206237	4.030907753	3.831122232	10.59495638	0.029096989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.8222	650	0	11.3044	0.035582046	0	0	2.10035045	2.493370187	1.471378113	1.418409171	5.078112855	0.195885454	6.784787322	0	0.271526896	3.984255578	1.281059773	25.1445796	3.509176435	0.603206237	4.030907753	3.831122232	10.59495638	0.029096989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.1622																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.3044	0.035582046	0	0	2.10035045	2.493370187	1.471378113	1.418409171	5.078112855	0.195885454	6.784787322	0	0.271526896	3.984255578	1.281059773	25.1445796	3.509176435	0.603206237	4.030907753	3.831122232	10.59495638	0.029096989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.1622
H3964_003_0	2009	3																																D	D	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1826.551583	106.947246	854.9057978	19.20534102	155.0008292	6.968678193	4.734365707	207.7328363	402.6638739	0.769150608	1282.605982	0	1.792775267	540.5245622	0.060782413	5391.975539	421.9017555	375.5695427	24.10491199	4130.803075	40.51599542	0	219.4126528	466.2151251	347.2343467	0	0	0	1033.942959	206.3161153											1a:  Acute - $150/$0/day for 1-7/8-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $150/$0/day for 1-7/8-190/1b:  Additional Days - $0/day for 91-999/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - $0/$85/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$85/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $40/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $150/visit/9b:  Ambulatory Surgical Center Services - $150/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $150/visit/8b:  Outpatient Therapeutic Radiological Services - $150/visit/8b:  Outpatient X-Ray Services - $20/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $0/visit/3:  Rehab Services (CORF) - $0/day/5:  Partial Hospitalization - $0/day/7c:  Occupational Therapy Services - $10/visit/7i:  Physical/Speech Therapy - $10/visit	7a:  Primary Care - $0/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - 0.0%/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $40/visit/7b:  Chiropractic Services - $40/visit/7f:  Podiatry Services - $40/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14d:  Pap Smears and Pelvic Exams Screening - 0.0%/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $20/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $20/visit/7h:  Psychiatric Services - Individual - $20/visit/7h:  Psychiatric Services - Group - $20/visit	7c:  Occupational Therapy Services - $10/visit/7i:  Physical/Speech Therapy - $10/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $20/visit/9c:  Outpatient Substance Abuse Svcs - Group - $20/visit/7g:  Other Health Care Professional Services - $40/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service	10b:  Transportation - $0/trip	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $0/visit/18a:  Fitting for Hearing Aid - $0/visit	18b:  Hearing Aids - $0/service	14a:  Written health education materials - $0/service/14a:  Membership in Health Club/Fitness Classes - $0/service/14c:  Routine Exams - $0/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit/14e:   Additional Prostate Screening - $0/visit/14g:   Additional Mammography Screening - $0/visit/	13c:  Other: Over the Counter Benefit - $0/visit											150	150	85	0	100	0.2	0.2	49.9190756	150	0	59.71318944	0	0.2	10	40	39.73501994	20	10	0	0.223600198	0.2	0	0	0	0	0	0	0	0	0											128.1316058	148.6941336	72.54210373	0	85.34365144	0.170687303	0.170687303	42.60276189	128.0154772	0	50.96141626	0	0.170687303	8.534365144	34.13746058	33.91131692	19.98152603	8.534365144	0	0.222057849	0.170687303	0	0	0	0	0	0	0	0	0											19.5032	1.325202341	5.168055422	0	1.102361395	1.189464885	0.808096113	0.73749938	4.295600663	0	5.446951446	0	0.306003975	0.384419499	0.000172913	15.23741594	0.702520076	0.267103968	0	0.07643977	6.915565982	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4661	0	10.53	19.5032	1.325202341	5.168055422	0	1.102361395	1.189464885	0.808096113	0.73749938	4.295600663	0	5.446951446	0	0.306003975	0.384419499	0.000172913	15.23741594	0.702520076	0.267103968	0	0.07643977	6.915565982	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4661	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	19.5032	1.325202341	5.168055422	0	1.102361395	1.189464885	0.808096113	0.73749938	4.295600663	0	5.446951446	0	0.306003975	0.384419499	0.000172913	15.23741594	0.702520076	0.267103968	0	0.07643977	6.915565982	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4661
H4003_001_0	2009	3																																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																																																			0							25.75829025		344.5831499	74.20354769		122.6900962	1.855088692		90.13273299		7008.035702	520.6064529							730.0582279						300											"$0 per Day - (1a, 1b)"		$0 per Day - (2)	$0 per Visit - (6)	$0 per Trip - (10a)	"20% Coins - (11b), 0% Coinsurance (11a, 11c)"		"$25 per Visit - (4a), $50 WWC - (4a)"	"$25 per Visit - (9a, 9b)"	$0 per Visit - (8a)	"$30 / $15 per Visit - (8a, 8b)"	$25 per Visit - (9a)	$0 per Visit - (12)	$25 per Visit - (9a)	$0 per Visit - (7a)	"$10 per Visit - (7b, 7d, 7f, 17a, 18a), $0 per Visit (14c)"	"$10 per Visit - (7e, 7h, 9c)"	"$0 per Visit - (7c, 7i)"		$0 per Visit (7g)	$0 per Script (15)		$0 per Trip (10b)	"$5 per Visit - (16a), 50% Coins (16b)"	$0 per Visit - (17a)	MAB $250 per 2 years (17b)	$0 per Visit - (18a)	MAB $200 per 3 years (18b)		"$15 per Visit (13c), $0 (14a, 13d)"																0.012		25.04898933	25		25.02577293	25		25		10	10							40.63869519						15																0.012		25.04898933	25		25.02577293	25		25		10	10							40.63869519						15											0	0	0	0	0	0.309099483	0	0.719288304	0.154590724	0	0.255867874	0.003864768	0	0.187776527	0	5.840029752	0.433838711	0	0	0	0	0	0	2.472384483	0	0	0	0	0	0.375	0	0	0	0	0	0	0	0	0	0	10.7517	0	0	0	0	0	0	0	0.309099483	0	0.719288304	0.154590724	0	0.255867874	0.003864768	0	0.187776527	0	5.840029752	0.433838711	0	0	0	0	0	0	2.472384483	0	0	0	0	0	0.375	0	0	0	0	0	0	0	0	0	0	10.7517		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	20% Coinsurance											0.0614			0.0652	0.0202	0.1722		0.0382	0.0556	0.0068	0.0299	0.0003	0.0002	0.0225	0.553	0.7555	0.031	0.0266		0.0842			0.0095	0.0535	0.0045	0.0205		0.0004		0.0341											2.0452	0	0	0.0614	0	0	0.065226859	0.020227969	0.481282656	0	0.757520379	0.210143937	0.006787345	0.285806199	0.00414544	0.000163644	0.210253458	0.553019323	6.595558859	0.464797616	0.026625919	0	0.084154725	0	0	0.009525029	2.52583925	0.004480521	0.02047117	0	0.000380368	0	0.409107154	0	0	0	0	0	0	0	0	0	0	12.797
H4003_009_0	2009	4																																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																																																			0							41.04914281		448.9857808	102.7036249		161.6686624	3.82334805		131.0397666										745.8013055																	"$0 per Day - (1a, 1b)"		$0 per Day - (2)	$0 per Visit - (6)	$0 per Trip - (10a)	"20% Coins - (11b), 0% Coinsurance (11a, 11c)"		"$25 per Visit - (4a), $50 WWC - (4a)"	"$25 per Visit - (9a, 9b)"	$0 per Visit - (8a)	"$30 / $15 per Visit - (8a, 8b)"	$25 per Visit - (9a)	$0 per Visit - (12)	$25 per Visit - (9a)	$0 per Visit - (7a)	"$0 - $10 per Visit - (7b, 7d, 7f, 17a, 18a), $0 per Visit (14c)"	"$0 - $10 per Visit - (7e, 7h, 9c)"	"$0 per Visit - (7c, 7i)"		$0 per Visit (7g)	$0 per Script (15)			"$5 per Visit - (16a), 50% Coins (16b)"	$0 per Visit - (17a)	MAB $200 per 2 years (17b)	$0 per Visit - (18a)	MAB $200 per 3 years (18b)		"$0 per Visit (13c, 13d, 14a)"																0.012		25.03340863	25		25.14713519	25		25										37.1705252																						0.012		25.03340863	25		25.14713519	25		25										37.1705252																	0	0	0	0	0	0.492589714	0	0.936637043	0.213965885	0	0.338791976	0.007965308	0	0.272999514	0	0	0	0	0	0	0	0	0	2.310152185	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.5731	0	0	0	0	0	0	0	0.492589714	0	0.936637043	0.213965885	0	0.338791976	0.007965308	0	0.272999514	0	0	0	0	0	0	0	0	0	2.310152185	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.5731																																																																																		0	0	0	0	0	0	0	0	0.492589714	0	0.936637043	0.213965885	0	0.338791976	0.007965308	0	0.272999514	0	0	0	0	0	0	0	0	0	2.310152185	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.5731
H4003_010_0	2009	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																																																			0		357.6498514		0.064498723			38.97250778		638.9937269	112.7205334		259.405498	2.896459104		175.3530863		10170.51574	1005.63311	105.4785726						767.6412019																	"$525 per admit (1a, 1b)"		$200 per admit (2)	$0 per Visit - (6)	$0 per Trip - (10a)	"20% Coinsurance - (11a, 11b, 11c)"		"$50 per Visit - (4a), $50 WWC - (4a)"	"$25 per Visit (9a, 9b)"		"$0 - $25 per Visit (8a, 8b, 14h)"	$25 per Visit (9a)	$0 per Visit - (12)	"$25 per Visit (5, 9a, 9d, 13a)"	$0 per Visit - (7a)	"$25 per Visit (7b, 7d, 7f, 17a, 18a), $0 per Visit (14c)"	"$25 per Visit (7e, 7h, 9c)"	"$25 per Visit (7c, 7i)"		$0 per Visit (7g)	$0 per Script (15)			"$5 per Visit - (16a), 50% Coins (16b)"	$0 per Visit	MAB $200 per 2 years (17b)		MAB $200 per 3 years (18b)		$0 per visit (14a)											525		200			0.2		50	25		22.42788781	25		25		24.97828735	25	25						33.57251671																	516.9206349		196.9221466			0.2		50	25		22.42788781	25		25		24.97828735	25	25						33.57251671																	15.4064	0	0.001058436	0	0	7.794501555	0	2.662473862	0.234834445	0	0.484826451	0.00603429	0	0.36531893	0	21.17017205	2.095068979	0.219747026	0	0	0	0	0	2.147637256	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5881	0	0.2408	15.4064	0	0.001058436	0	0	7.794501555	0	2.662473862	0.234834445	0	0.484826451	0.00603429	0	0.36531893	0	21.17017205	2.095068979	0.219747026	0	0	0	0	0	2.147637256	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5881																																																																																		0	0	0	15.4064	0	0.001058436	0	0	7.794501555	0	2.662473862	0.234834445	0	0.484826451	0.00603429	0	0.36531893	0	21.17017205	2.095068979	0.219747026	0	0	0	0	0	2.147637256	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5881
H4003_015_0	2009	5																																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																																																			0							27.64473174		369.259843	79.51749928		131.4763234	1.987937482		96.5422437										782.340015						180											"$0 per Day - (1a, 1b)"		$0 per Day - (2)	$0 per Visit - (6)	$0 per Trip - (10a)	"20% Coinsurance - (11b), 0% Coinsurance (11a, 11c)"		"$25 per Visit - (4a), $50 WWC - (4a)"	"$25 per Visit - (9a, 9b)"	$0 per Visit - (8a)	"$30 / $15 per Visit - (8a, 8b)"	$25 per Visit - (9a)	$0 per Visit - (12)	$25 per Visit - (9a)	$0 per Visit - (7a)	"$0 per Visit - (7b, 7d, 7f, 17a, 18a), $0 per Visit (14c)"	"$0 per Visit - (7e, 7h, 9c)"	"$0 per Visit - (7c, 7i)"		$0 per Visit (7g)	$0 per Script (15)			"$5 per Visit - (16a), 50% Coins (16b)"	$0 per Visit - (17a)	MAB $200 per 2 years (17b)	$0 per Visit - (18a)	MAB $200 per 3 years (18b)		"$15 per Visit (13c), $0 per Visit (14a, 13d)"																0.012		25.04898933	25		25.02577293	25		25										40.70024828						15																0.012		25.04898933	25		25.02577293	25		25										40.70024828						15											0	0	0	0	0	0.331736781	0	0.770798822	0.165661457	0	0.274191385	0.004141536	0	0.201129674	0	0	0	0	0	0	0	0	0	2.653452738	0	0	0	0	0	0.225	0	0	0	0	0	0	0	0	0	0	4.6261	0	0	0	0	0	0	0	0.331736781	0	0.770798822	0.165661457	0	0.274191385	0.004141536	0	0.201129674	0	0	0	0	0	0	0	0	0	2.653452738	0	0	0	0	0	0.225	0	0	0	0	0	0	0	0	0	0	4.6261																																																																																		0	0	0	0	0	0	0	0	0.331736781	0	0.770798822	0.165661457	0	0.274191385	0.004141536	0	0.201129674	0	0	0	0	0	0	0	0	0	2.653452738	0	0	0	0	0	0.225	0	0	0	0	0	0	0	0	0	0	4.6261
H4003_016_0	2009	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																																																			0		348.6401661		0.062873912			37.95293695		622.9117223	109.8809502		252.8707214	2.823493367		170.935704		9914.306637	980.2998465	102.8214241						748.3032779																	"$525 per admit (1a, 1b)"		$200 per admit (2)	$0 per Visit - (6)	$0 per Trip - (10a)	"20% Coinsurance - (11a, 11b, 11c)"		"$50 per Visit - (4a), $50 WWC - (4a)"	"$25 per Visit (9a, 9b)"		"$0 - $25 per Visit (8a, 8b, 14h)"	$25 per Visit (9a)	$0 per Visit - (12)	"$25 per Visit (5, 9a, 9d, 13a)"	$0 per Visit - (7a)	"$25 per Visit (7b, 7d, 7f, 17a, 18a), $0 per Visit (14c)"	"$25 per Visit (7e, 7h, 9c)"	"$25 per Visit (7c, 7i)"		$0 per Visit (7g)	$0 per Script (15)			"$5 per Visit - (16a), 50% Coins (16b)"	$0 per Visit	MAB $200 per 2 years (17b)		MAB $200 per 3 years (18b)		$0 per Visit (14a)											525		200			0.2		50	25		22.42788781	25		25		24.97789165	25	25						33.53911235																	517.4260499		197.1146857			0.2		50	25		22.42788781	25		25		24.97789165	25	25						33.53911235																	15.033	0	0.001032781	0	0	7.590587391	0	2.595465509	0.228918646	0	0.472613014	0.005882278	0	0.35611605	0	20.63653974	2.042291347	0.2142113	0	0	0	0	0	2.091452309	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.2681	0	0.2201	15.033	0	0.001032781	0	0	7.590587391	0	2.595465509	0.228918646	0	0.472613014	0.005882278	0	0.35611605	0	20.63653974	2.042291347	0.2142113	0	0	0	0	0	2.091452309	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.2681																																																																																		0	0	0	15.033	0	0.001032781	0	0	7.590587391	0	2.595465509	0.228918646	0	0.472613014	0.005882278	0	0.35611605	0	20.63653974	2.042291347	0.2142113	0	0	0	0	0	2.091452309	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.2681
H4003_017_0	2009	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																																																			0		348.6401661		0.062873912			37.95293695		622.9117223	109.8809502		252.8707214	2.823493367		170.935704		9914.306637	980.2998465	102.8214241						748.3032779																	"$525 per admit (1a, 1b)"		$200 per admit (2)	$0 per Visit - (6)	$0 per Trip - (10a)	"20% Coinsurance - (11a, 11b, 11c)"		"$50 per Visit - (4a), $50 WWC - (4a)"	"$25 per Visit (9a, 9b)"		"$0 - $25 per Visit (8a, 8b, 14h)"	$25 per Visit (9a)	$0 per Visit - (12)	"$25 per Visit (5, 9a, 9d, 13a)"	$0 per Visit - (7a)	"$25 per Visit (7b, 7d, 7f, 17a, 18a), $0 per Visit (14c)"	"$25 per Visit (7e, 7h, 9c)"	"$25 per Visit (7c, 7i)"		$0 per Visit (7g)	$0 per Script (15)			"$5 per Visit - (16a), 50% Coins (16b)"	$0 per Visit	MAB $200 per 2 years (17b)		MAB $200 per 3 years (18b)		$0 per Visit (14a)											525		200			0.2		50	25		22.42788781	25		25		24.97789165	25	25						33.53911235																	517.4260499		197.1146857			0.2		50	25		22.42788781	25		25		24.97789165	25	25						33.53911235																	15.033	0	0.001032781	0	0	7.590587391	0	2.595465509	0.228918646	0	0.472613014	0.005882278	0	0.35611605	0	20.63653974	2.042291347	0.2142113	0	0	0	0	0	2.091452309	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.2681	0	0.2201	15.033	0	0.001032781	0	0	7.590587391	0	2.595465509	0.228918646	0	0.472613014	0.005882278	0	0.35611605	0	20.63653974	2.042291347	0.2142113	0	0	0	0	0	2.091452309	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.2681																																																																																		0	0	0	15.033	0	0.001032781	0	0	7.590587391	0	2.595465509	0.228918646	0	0.472613014	0.005882278	0	0.35611605	0	20.63653974	2.042291347	0.2142113	0	0	0	0	0	2.091452309	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.2681
H4003_018_0	2009	2																																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																																																			0							32.72871815		376.8100781	98.530211		168.5139051	2.632787835		129.8336908		9388.55585	615.6349708							907.2566296																	"$0 per Day - (1a, 1b)"		$0 per Day - (2)	$0 per Visit - (6)	$0 per Trip - (10a)	"20% Coins - (11b), 0% Coinsurance (11a, 11c)"		"$25 per Visit (4a), $50 WWC (4a)"	"$25 per Visit - (9a, 9b)"	$0 per Visit - (8a)	"$30 / $15 per Visit - (8a, 8b)"	$25 per Visit - (9a)	$0 per Visit - (12)	$25 per Visit - (9a)	$0 per Visit - (7a)	"$10 per Visit - (7b, 7d, 7f, 17a, 18a), $0 per Visit (14c)"	"$10 per Visit - (7e, 7h, 9c)"	"$0 per Visit - (7c, 7i)"		$0 per Visit (7g)	$0 per Script (15)			"$5 per Visit - (16a), 50% Coins (16b)"	$0 per Visit - (17a)	MAB $200 per 2 years (17b)	$0 per Visit - (18a)	MAB $200 per 3 years (18b)		"$0 per visit (14a, 13c)"																0.012		25.05257252	25		25.33484666	25		25		10	10							41.9176049																						0.012		25.05257252	25		25.33484666	25		25		10	10							41.9176049																	0	0	0	0	0	0.392744618	0	0.786671817	0.205271273	0	0.355772829	0.005484975	0	0.270486856	0	7.823796542	0.513029142	0	0	0	0	0	0	3.169168745	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.5224	0	0	0	0	0	0	0	0.392744618	0	0.786671817	0.205271273	0	0.355772829	0.005484975	0	0.270486856	0	7.823796542	0.513029142	0	0	0	0	0	0	3.169168745	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.5224																																																																																		0	0	0	0	0	0	0	0	0.392744618	0	0.786671817	0.205271273	0	0.355772829	0.005484975	0	0.270486856	0	7.823796542	0.513029142	0	0	0	0	0	0	3.169168745	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.5224
H4003_801_0	2009	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin										Coin																																																			0		125.5751006				2.765332219	32.98657047		7.741484633	13.22454408	2.057310049	6.742890856	0.259161079		7.931304378	96.06688517	187.0290373	4.031898752	8.047993552		19.51578352										9.689474771											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	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins										"Visitor/Travel Benefit - 35% Coin, $7,500 MAB"											0.151914876				0.231	0.231		0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231		0.231										0.35											0.151914876				0.231	0.231		0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231		0.231										0.35											19.0767	0	0	0	0.638791743	7.619897779	0	1.78828295	3.054869682	0.475238621	1.557607788	0.059866209	0	1.832131311	22.19145048	43.20370761	0.931368612	1.859086511	0	4.508145994	0	0	0	0	0	0	0	0	0	3.39131617	0	0	0	0	0	0	0	0	0	0	112.1885	0	0	19.0767	0	0	0	0.638791743	7.619897779	0	1.78828295	3.054869682	0.475238621	1.557607788	0.059866209	0	1.832131311	22.19145048	43.20370761	0.931368612	1.859086511	0	4.508145994	0	0	0	0	0	0	0	0	0	3.39131617	0	0	0	0	0	0	0	0	0	0	112.1885																																																																																		0	0	0	19.0767	0	0	0	0.638791743	7.619897779	0	1.78828295	3.054869682	0.475238621	1.557607788	0.059866209	0	1.832131311	22.19145048	43.20370761	0.931368612	1.859086511	0	4.508145994	0	0	0	0	0	0	0	0	0	3.39131617	0	0	0	0	0	0	0	0	0	0	112.1885
H4003_803_0	2009	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin										Coin																																																			0		124.3069964				2.92495808	31.00290254		7.899041216	14.85269387	2.090310013	7.849475389	0.049730369		8.612613318	95.98157797	186.9920439	3.194099589	8.134386998		21.68143598										9.759508705											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	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins										"Visitor/Travel Benefit - 35% Coin, $7,500 MAB"											0.151658176				0.231	0.231		0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231		0.231										0.35											0.151658176				0.231	0.231		0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231		0.231										0.35											18.8522	0	0	0	0.675665316	7.161670486	0	1.824678521	3.430972284	0.482861613	1.813228815	0.011487715	0	1.989513677	22.17174451	43.19516214	0.737837005	1.879043397	0	5.008411712	0	0	0	0	0	0	0	0	0	3.415828047	0	0	0	0	0	0	0	0	0	0	112.6503	0	0	18.8522	0	0	0	0.675665316	7.161670486	0	1.824678521	3.430972284	0.482861613	1.813228815	0.011487715	0	1.989513677	22.17174451	43.19516214	0.737837005	1.879043397	0	5.008411712	0	0	0	0	0	0	0	0	0	3.415828047	0	0	0	0	0	0	0	0	0	0	112.6503																																																																																		0	0	0	18.8522	0	0	0	0.675665316	7.161670486	0	1.824678521	3.430972284	0.482861613	1.813228815	0.011487715	0	1.989513677	22.17174451	43.19516214	0.737837005	1.879043397	0	5.008411712	0	0	0	0	0	0	0	0	0	3.415828047	0	0	0	0	0	0	0	0	0	0	112.6503
H4003_804_0	2009	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin										Coin																																																			0		107.4528944				2.5283791	26.79938948		6.828053659	12.83889879	1.806896374	6.785208189	0.042987702		7.444876444	86.44696652	161.638821	2.761029192	7.031490201		18.74176932										9.759508705											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	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins										"Visitor/Travel Benefit - 35% Coin, $7,500 MAB"											0.1537				0.231	0.231		0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231		0.231										0.35											0.1537				0.231	0.231		0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231		0.231										0.35											16.5155	0	0	0	0.584055572	6.19065897	0	1.577280395	2.965785621	0.417393062	1.567383092	0.009930159	0	1.719766459	19.96924927	37.33856766	0.637797743	1.624274236	0	4.329348712	0	0	0	0	0	0	0	0	0	3.415828047	0	0	0	0	0	0	0	0	0	0	98.8628	0	0	16.5155	0	0	0	0.584055572	6.19065897	0	1.577280395	2.965785621	0.417393062	1.567383092	0.009930159	0	1.719766459	19.96924927	37.33856766	0.637797743	1.624274236	0	4.329348712	0	0	0	0	0	0	0	0	0	3.415828047	0	0	0	0	0	0	0	0	0	0	98.8628																																																																																		0	0	0	16.5155	0	0	0	0.584055572	6.19065897	0	1.577280395	2.965785621	0.417393062	1.567383092	0.009930159	0	1.719766459	19.96924927	37.33856766	0.637797743	1.624274236	0	4.329348712	0	0	0	0	0	0	0	0	0	3.415828047	0	0	0	0	0	0	0	0	0	0	98.8628
H4003_805_0	2009	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin										Coin																																																			0		125.5751006				2.765332219	32.98657047		7.741484633	13.22454408	2.057310049	6.742890856	0.259161079		7.931304378	96.06688517	187.0290373	4.031898752	8.047993552		19.51578352										9.689474771											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	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins										"Visitor/Travel Benefit - 35% Coin, $7,500 MAB"											0.151914876				0.231	0.231		0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231		0.231										0.35											0.151914876				0.231	0.231		0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231		0.231										0.35											19.0767	0	0	0	0.638791743	7.619897779	0	1.78828295	3.054869682	0.475238621	1.557607788	0.059866209	0	1.832131311	22.19145048	43.20370761	0.931368612	1.859086511	0	4.508145994	0	0	0	0	0	0	0	0	0	3.39131617	0	0	0	0	0	0	0	0	0	0	112.1885	0	0	19.0767	0	0	0	0.638791743	7.619897779	0	1.78828295	3.054869682	0.475238621	1.557607788	0.059866209	0	1.832131311	22.19145048	43.20370761	0.931368612	1.859086511	0	4.508145994	0	0	0	0	0	0	0	0	0	3.39131617	0	0	0	0	0	0	0	0	0	0	112.1885																																																																																		0	0	0	19.0767	0	0	0	0.638791743	7.619897779	0	1.78828295	3.054869682	0.475238621	1.557607788	0.059866209	0	1.832131311	22.19145048	43.20370761	0.931368612	1.859086511	0	4.508145994	0	0	0	0	0	0	0	0	0	3.39131617	0	0	0	0	0	0	0	0	0	0	112.1885
H4003_806_0	2009	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin										Coin																																																			0		124.3069964				2.92495808	31.06151298		7.899041216	14.85269387	2.090310013	7.849475389	0.049730369		8.612613318	95.93025937	186.9938571	3.194099589	8.134386998		21.68143598										9.759508705											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	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins										"Visitor/Travel Benefit - 35% Coin, $7,500 MAB"											0.151658176				0.231	0.231		0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231		0.231										0.35											0.151658176				0.231	0.231		0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231		0.231										0.35											18.8522	0	0	0	0.675665316	7.175209498	0	1.824678521	3.430972284	0.482861613	1.813228815	0.011487715	0	1.989513677	22.15988992	43.19558098	0.737837005	1.879043397	0	5.008411712	0	0	0	0	0	0	0	0	0	3.415828047	0	0	0	0	0	0	0	0	0	0	112.6524	0	0	18.8522	0	0	0	0.675665316	7.175209498	0	1.824678521	3.430972284	0.482861613	1.813228815	0.011487715	0	1.989513677	22.15988992	43.19558098	0.737837005	1.879043397	0	5.008411712	0	0	0	0	0	0	0	0	0	3.415828047	0	0	0	0	0	0	0	0	0	0	112.6524																																																																																		0	0	0	18.8522	0	0	0	0.675665316	7.175209498	0	1.824678521	3.430972284	0.482861613	1.813228815	0.011487715	0	1.989513677	22.15988992	43.19558098	0.737837005	1.879043397	0	5.008411712	0	0	0	0	0	0	0	0	0	3.415828047	0	0	0	0	0	0	0	0	0	0	112.6524
H4003_807_0	2009	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin										Coin																																																			0		107.4528944				2.5283791	26.79938948		6.828053659	12.83889879	1.806896374	6.785208189	0.042987702		7.444876444	86.44696652	161.638821	2.761029192	7.031490201		18.74176932										9.759508705											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	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins	FFS Medicare Ded & Coins										"Visitor/Travel Benefit - 35% Coin, $7,500 MAB"											0.1537				0.231	0.231		0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231		0.231										0.35											0.1537				0.231	0.231		0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231		0.231										0.35											16.5155	0	0	0	0.584055572	6.19065897	0	1.577280395	2.965785621	0.417393062	1.567383092	0.009930159	0	1.719766459	19.96924927	37.33856766	0.637797743	1.624274236	0	4.329348712	0	0	0	0	0	0	0	0	0	3.415828047	0	0	0	0	0	0	0	0	0	0	98.8628	0	0	16.5155	0	0	0	0.584055572	6.19065897	0	1.577280395	2.965785621	0.417393062	1.567383092	0.009930159	0	1.719766459	19.96924927	37.33856766	0.637797743	1.624274236	0	4.329348712	0	0	0	0	0	0	0	0	0	3.415828047	0	0	0	0	0	0	0	0	0	0	98.8628																																																																																		0	0	0	16.5155	0	0	0	0.584055572	6.19065897	0	1.577280395	2.965785621	0.417393062	1.567383092	0.009930159	0	1.719766459	19.96924927	37.33856766	0.637797743	1.624274236	0	4.329348712	0	0	0	0	0	0	0	0	0	3.415828047	0	0	0	0	0	0	0	0	0	0	98.8628
H4004_001_0	2009	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																																																			0		371.4374559		0.77845132			31.36116508		742.4946206	133.3756133		257.6650313	1.85057098		213.867222		10480.52279	235.6774524	71.56065119						879.026923																	"$525 per admit (1a, 1b)"		$200 per admit (2)	$0 per Visit - (6)	$0 per Trip - (10a)	"20% Coinsurance - (11a, 11b, 11c)"		"$50 per Visit - (4a), $50 WWC - (4a)"	"$25 per Visit (9a, 9b)"		"$0 - $25 per Visit (8a, 8b, 14h)"	$25 per Visit (9a)	$0 per Visit - (12)	"$25 per Visit (5, 9a, 9d, 13a)"	$0 per Visit - (7a)	"$25 per Visit (7b, 7d, 7f, 17a, 18a), $0 per Visit (14c)"	"$25 per Visit (7e, 7h, 9c)"	"$25 per Visit (7c, 7i)"		$0 per Visit (7g)	$0 per Script (15)			"$5 per Visit - (16a), 50% Coins (16b)"	$0 per Visit	MAB $200 per 2 years (17b)		MAB $200 per 3 years (18b)		$0 per Visit (14a)											525		200			0.2		50	25		22.4502305	25		25		24.97556715	25	25						44.56248615																	516.1809339		196.6403558			0.2		50	25		22.4502305	25		25		24.97556715	25	25						44.56248615																	15.9774	0	0.012756245	0	0	6.272233017	0	3.093727586	0.277865861	0	0.482053279	0.003855356	0	0.445556713	0	21.81308338	0.490994693	0.14908469	0	0	0	0	0	3.26430209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.2829	0	0.2732	15.9774	0	0.012756245	0	0	6.272233017	0	3.093727586	0.277865861	0	0.482053279	0.003855356	0	0.445556713	0	21.81308338	0.490994693	0.14908469	0	0	0	0	0	3.26430209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.2829																																																																																		0	0	0	15.9774	0	0.012756245	0	0	6.272233017	0	3.093727586	0.277865861	0	0.482053279	0.003855356	0	0.445556713	0	21.81308338	0.490994693	0.14908469	0	0	0	0	0	3.26430209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.2829
H4004_015_0	2009	3																																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																																																			0							16.94898831		393.4610729	102.1195861		169.6248626	1.374352884		158.2489227		8311.095605	103.7656038							793.2482925						300											"$0 per Day - (1a, 1b)"		$0 per Day - (2)	$0 per Visit - (6)	$0 per Trip - (10a)	"20% Coins - (11b), 0% Coins (11a,11c)"		"$25 per Visit (4a), $50 WWC (4a)"	"$25 per Visit - (9a, 9b)"	$0 per Visit - (8a)	"$30 / $15 per Visit - (8a, 8b)"	$25 per Visit - (9a)	$0 per Visit - (12)	$25 per Visit - (9a)	$0 per Visit (7a)	"$10 per Visit - (7b, 7d, 7f, 17a, 18a), $0 per Visit (14c)"	"$10 per Visit - (7e, 7h, 9c)"	"$0 per Visit - (7c, 7i)"		$0 per Visit (7g)	$0 per Script (15)		$0 per Trip	"$5 per Visit - (16a), 20%-50% Coins (16b)"	$0 per Visit - (17a)	MAB $250 per 2 years (17b)	$0 per Visit - (18a)	MAB $200 per 3 years (18b)		"$15 per Visit (13c), $0 (13d, 14a)"																0.011460358		25.04394818	25		25.60378071	25		25		10	10							44.30123352						15																0.011460358		25.04394818	25		25.60378071	25		25		10	10							44.30123352						15											0	0	0	0	0	0.19424147	0	0.82115156	0.212749138	0	0.361919815	0.002863235	0	0.329685256	0	6.925913004	0.086471337	0	0	0	0	0	0	2.92848982	0	0	0	0	0	0.375	0	0	0	0	0	0	0	0	0	0	12.2385	0	0	0	0	0	0	0	0.19424147	0	0.82115156	0.212749138	0	0.361919815	0.002863235	0	0.329685256	0	6.925913004	0.086471337	0	0	0	0	0	0	2.92848982	0	0	0	0	0	0.375	0	0	0	0	0	0	0	0	0	0	12.2385		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	20% Coinsurance											0.022			0.0943	0.0358	0.1496		0.0456	0.0785	0.0098	0.0475	0.0003	0.0046	0.0432	0.4942	0.9343	0.073	0.0365		0.1227			0.0105	0.0701	0.0048	0.0209		0.0005		0.0466											2.3453	0	0	0.022	0	0	0.094301327	0.035805153	0.34388271	0	0.866720583	0.291234211	0.009821473	0.409406811	0.003212389	0.004574088	0.372894777	0.494197447	7.860237991	0.159478774	0.036453826	0	0.122702216	0	0	0.010547701	2.99860397	0.004758712	0.020936895	0	0.000473263	0	0.421597832	0	0	0	0	0	0	0	0	0	0	14.5838
H4004_025_0	2009	2																																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																																																			0							14.34872235		339.438606	99.51462252		212.5688262	1.403562143		112.3719616		7893.153109	131.4007864							780.5080988																	"$0 per Day - (1a, 1b)"		$0 per Day - (2)	$0 per Visit - (6)	$0 per Trip - (10a)	"20% Coins - (11b), 0% Coins (11a,11c)"		"$25 per Visit (4a), $50 WWC (4a)"	"$25 per Visit - (9a, 9b)"	$0 per Visit - (8a)	"$30 / $15 per Visit - (8a, 8b)"	$25 per Visit - (9a)	$0 per Visit - (12)	$25 per Visit - (9a)	$0 per Visit (7a)	"$10 per Visit - (7b, 7d, 7f, 17a, 18a), $0 per Visit (14c)"	"$10 per Visit - (7e, 7h, 9c)"	"$0 per Visit - (7c, 7i)"		$0 per Visit (7g)	$0 per Script (15)			"$5 per Visit - (16a), 50% Coins (16b)"	$0 per Visit - (17a)	MAB $200 per 2 years (17b)	$0 per Visit - (18a)	MAB $200 per 3 years (18b)		"$0 per Visit (13c, 14a)"																0.011460358		25.04945421	25		25.79298192	25		25		10	10							46.49303048																						0.011460358		25.04945421	25		25.79298192	25		25		10	10							46.49303048																	0	0	0	0	0	0.164441492	0	0.708562651	0.20732213	0	0.456898658	0.002924088	0	0.234108253	0	6.577627591	0.109500655	0	0	0	0	0	0	3.024015569	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.4854	0	0	0	0	0	0	0	0.164441492	0	0.708562651	0.20732213	0	0.456898658	0.002924088	0	0.234108253	0	6.577627591	0.109500655	0	0	0	0	0	0	3.024015569	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.4854																																																																																		0	0	0	0	0	0	0	0	0.164441492	0	0.708562651	0.20732213	0	0.456898658	0.002924088	0	0.234108253	0	6.577627591	0.109500655	0	0	0	0	0	0	3.024015569	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.4854
H4004_035_0	2009	3																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	V	Coin	V	V	V	V	V	V																																																			0							72.71553069		425.4731985	18.55646349		38.43838865	1.325461678		138.6426364		4439.386968	475.0008625							3.272490672																	"$0 per Day - (1a, 1b)"		$0 per Day - (2)	$0 per Visit - (6)	$0 per Trip - (10a)	"20% Coins - (11b), 0% Coins (11a,11c)"		"$25 per Visit (4a), $50 WWC (4a)"	"$25 per Visit - (9a, 9b)"	$0 per Visit - (8a)	"$20 / $15 per Visit - (8a, 8b)"	$25 per Visit - (9a)	$0 per Visit - (12)	$25 per Visit - (9a)	$0 per Visit (7a)	"$5 per Visit - (7b, 7d, 7f, 17a, 18a), $0 per Visit (14c)"	"$5 per Visit - (7e, 7h, 9c)"	"$0 per Visit - (7c, 7i)"		$0 per Visit (7g)	$0 per Script (15)			"$5 per Visit - (16a), 50% Coins (16b)"	$0 per Visit - (17a)	MAB $100 per 2 years (17b)	$0 per Visit - (18a)	MAB $200 per 3 years (18b)		"$0 per Visit (13c, 13d, 14a)"																0.011460358		25.04034413	25		17.24137931	25		25		5	5							0.309158369																						0.011460358		25.04034413	25		17.24137931	25		25		5	5							0.309158369																	0	0	0	0	0	0.833345999	0	0.887832943	0.038659299	0	0.05522757	0.002761378	0	0.288838826	0	1.84974457	0.197917026	0	0	0	0	0	0	1.011717879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.166	0	0	0	0	0	0	0	0.833345999	0	0.887832943	0.038659299	0	0.05522757	0.002761378	0	0.288838826	0	1.84974457	0.197917026	0	0	0	0	0	0	1.011717879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.166																																																																																		0	0	0	0	0	0	0	0	0.833345999	0	0.887832943	0.038659299	0	0.05522757	0.002761378	0	0.288838826	0	1.84974457	0.197917026	0	0	0	0	0	0	1.011717879	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.166
H4004_047_0	2009	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																																																			0		364.6914462		0.407555668			35.60541492		689.149824	122.7749551		258.872598	2.397401964		194.0601772		10331.33081	636.9232629	89.30775678						822.0479934																	"$525 per admit (1a, 1b)"		$200 per admit (2)	$0 per Visit - (6)	$0 per Trip - (10a)	"20% Coinsurance - (11a, 11b, 11c)"		"$50 per Visit - (4a), $50 WWC - (4a)"	"$25 per Visit (9a, 9b)"		"$0 - $25 per Visit (8a, 8b, 14h)"	$25 per Visit (9a)	$0 per Visit - (12)	"$25 per Visit (5, 9a, 9d, 13a)"	$0 per Visit - (7a)	"$25 per Visit (7b, 7d, 7f, 17a, 18a), $0 per Visit (14c)"	"$25 per Visit (7e, 7h, 9c)"	"$25 per Visit (7c, 7i)"		$0 per Visit (7g)	$0 per Script (15)			"$5 per Visit - (16a), 50% Coins (16b)"	$0 per Visit	MAB $200 per 2 years (17b)		MAB $200 per 3 years (18b)		$0 per Visit (14a)											525		200			0.2		50	25		22.43857113	25		25		24.97658935	25	25						39.18084407																	516.5361645		196.7756817			0.2		50	25		22.43857113	25		25		24.97658935	25	25						39.18084407																	15.698	0	0.006683087	0	0	7.121082984	0	2.8714576	0.255781156	0	0.484060934	0.004994587	0	0.404292036	0	21.50345058	1.326923464	0.186057827	0	0	0	0	0	2.684044521	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5469	0	0.2573	15.698	0	0.006683087	0	0	7.121082984	0	2.8714576	0.255781156	0	0.484060934	0.004994587	0	0.404292036	0	21.50345058	1.326923464	0.186057827	0	0	0	0	0	2.684044521	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5469																																																																																		0	0	0	15.698	0	0.006683087	0	0	7.121082984	0	2.8714576	0.255781156	0	0.484060934	0.004994587	0	0.404292036	0	21.50345058	1.326923464	0.186057827	0	0	0	0	0	2.684044521	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5469
H4004_048_0	2009	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																																																			0		364.6914462		0.407555668			35.60541492		689.149824	122.7749551		258.872598	2.397401964		194.0601772		10331.33081	636.9232629	89.30775678						822.0479934																	"$525 per admit (1a, 1b)"		$200 per admit (2)	$0 per Visit - (6)	$0 per Trip - (10a)	"20% Coinsurance - (11a, 11b, 11c)"		"$50 per Visit - (4a), $50 WWC - (4a)"	"$25 per Visit (9a, 9b)"		"$0 - $25 per Visit (8a, 8b, 14h)"	$25 per Visit (9a)	$0 per Visit - (12)	"$25 per Visit (5, 9a, 9d, 13a)"	$0 per Visit - (7a)	"$25 per Visit (7b, 7d, 7f, 17a, 18a), $0 per Visit (14c)"	"$25 per Visit (7e, 7h, 9c)"	"$25 per Visit (7c, 7i)"		$0 per Visit (7g)	$0 per Script (15)			"$5 per Visit - (16a), 50% Coins (16b)"	$0 per Visit	MAB $200 per 2 years (17b)		MAB $200 per 3 years (18b)		$0 per Visit (14a)											525		200			0.2		50	25		22.43857113	25		25		24.97658935	25	25						39.18084407																	516.5361645		196.7756817			0.2		50	25		22.43857113	25		25		24.97658935	25	25						39.18084407																	15.698	0	0.006683087	0	0	7.121082984	0	2.8714576	0.255781156	0	0.484060934	0.004994587	0	0.404292036	0	21.50345058	1.326923464	0.186057827	0	0	0	0	0	2.684044521	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5469	0	0.2573	15.698	0	0.006683087	0	0	7.121082984	0	2.8714576	0.255781156	0	0.484060934	0.004994587	0	0.404292036	0	21.50345058	1.326923464	0.186057827	0	0	0	0	0	2.684044521	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5469																																																																																		0	0	0	15.698	0	0.006683087	0	0	7.121082984	0	2.8714576	0.255781156	0	0.484060934	0.004994587	0	0.404292036	0	21.50345058	1.326923464	0.186057827	0	0	0	0	0	2.684044521	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.5469
H4004_049_0	2009	5																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	V	Coin	V	V	V	V	V	V																																																			0							17.54789122		407.1307392	105.6674355		175.5179876	1.422100798		163.7468235										9.807173636						180											"$0 per Day - (1a, 1b)"		$0 per Day - (2)	$0 per Visit - (6)	$0 per Trip - (10a)	"20% Coins - (11b), 0% Coins (11a,11c)"		"$25 per Visit (4a), $50 WWC (4a)"	"$25 per Visit - (9a, 9b)"	$0 per Visit - (8a)	"$30 / $15 per Visit - (8a, 8b)"	$25 per Visit - (9a)	$0 per Visit - (12)	$25 per Visit - (9a)	$0 per Visit (7a)	"$0 per Visit - (7b, 7d, 7f, 17a, 18a), $0 per Visit (14c)"	"$0 per Visit - (7e, 7h, 9c)"	"$0 per Visit - (7c, 7i)"		$0 per Visit (7g)	$0 per Script (15)			"$5 per Visit - (16a), 50% Coins (16b)"	$0 per Visit - (17a)	MAB $200 per 2 years (17b)	$0 per Visit - (18a)	MAB $200 per 3 years (18b)		"$15 per Visit (13d), $0 per Visit (14a, 13c)"																0.011460358		25.04394818	25		25.60378071	25		25										0.309158369						15																0.011460358		25.04394818	25		25.60378071	25		25										0.309158369						15											0	0	0	0	0	0.201105112	0	0.849680095	0.220140491	0	0.374493672	0.00296271	0	0.341139216	0	0	0	0	0	0	0	0	0	3.031969806	0	0	0	0	0	0.225	0	0	0	0	0	0	0	0	0	0	5.2465	0	0	0	0	0	0	0	0.201105112	0	0.849680095	0.220140491	0	0.374493672	0.00296271	0	0.341139216	0	0	0	0	0	0	0	0	0	3.031969806	0	0	0	0	0	0.225	0	0	0	0	0	0	0	0	0	0	5.2465																																																																																		0	0	0	0	0	0	0	0	0.201105112	0	0.849680095	0.220140491	0	0.374493672	0.00296271	0	0.341139216	0	0	0	0	0	0	0	0	0	3.031969806	0	0	0	0	0	0.225	0	0	0	0	0	0	0	0	0	0	5.2465
H4005_001_0	2009	3																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	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	0	0	0											0		0	0	0	0	0	0	0	366.0351261	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	$25/Case for ER - Facility; $25/Visit for Urgent Care;	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -											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	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	0.762573179	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7626	0		0	0	0	0	0	0	0	0.762573179	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7626		$250/Admit for IP Medical; $250/Admit for IP Surgical;	$250/Admit for IP Psych; $250/Admit for IP Substance Abuse;	20% Coinsurance for SNF	20% Coinsurance for Home Health	20% Coinsurance for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	- zero -	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	- zero -	- zero -	20% 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;	20% Coinsurance for PCP - Routine Physicals; 20% Coinsurance for PCP - Immunizations;	20% Coinsurance for Speclst - Immunizations;	25% Coinsurance for OP Psych - Non-Physician; 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);	20% Coinsurance for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	25% Coinsurance for Chiropractor; 20% Coinsurance for Vistion Exams; 25% Coinsurance for Podiatrist; 20% Coinsurance for Hearing/Speech Exams; 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	- zero -	- zero -	20% Coinsurance for Vision (Refractions)	- zero -	20% Coinsurance for Routine Hearing Exams	- zero -	- zero -	- zero -											0.4831	0.0279	0.0419	0.2186	0.0273	0.1973	0.0397	0	0.2042	0.0378	0.0614	0	0	0.1046	0.0399	0.0049	0.0647	0.1408	0.6696	0.3209	0.2792	0	0	0	0	0	0	0	0	0											2.9639	0		0.4831	0.027853015	0.041885684	0.218592027	0.027288324	0.197336845	0.039741657	0.762573179	0.204202491	0.037834912	0.061419068	0	0	0.104564438	0.039905288	0.004882112	0.06472177	0.140830989	0.669620788	0.320863977	0.279208838	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.7264
H4005_003_0	2009	7																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	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	0	0	0											0		0	0	0	0	0	0	0	440.3028759	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	$25/Case for ER - Facility; $25/Visit for Urgent Care;	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -											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	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	0.917297658	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.9173	0		0	0	0	0	0	0	0	0.917297658	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.9173		$250/Admit for IP Medical; $250/Admit for IP Surgical;	$250/Admit for IP Psych; $250/Admit for IP Substance Abuse;	20% Coinsurance for SNF	20% Coinsurance for Home Health	20% Coinsurance for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	- zero -	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	- zero -	- zero -	20% 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;	20% Coinsurance for PCP - Routine Physicals; 20% Coinsurance for PCP - Immunizations;	20% Coinsurance for Speclst - Immunizations;	25% Coinsurance for OP Psych - Non-Physician; 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);	20% Coinsurance for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	25% Coinsurance for Chiropractor; 20% Coinsurance for Vistion Exams; 25% Coinsurance for Podiatrist; 20% Coinsurance for Hearing/Speech Exams; 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	- zero -	- zero -	20% Coinsurance for Vision (Refractions)	- zero -	20% Coinsurance for Routine Hearing Exams	- zero -	- zero -	- zero -											0.4569	0.013	0.0767	0.2304	0.0331	0.2382	0.0721	0	0.2434	0.0404	0.0805	0	0	0.1694	0.0408	0.0057	0.0539	0.1896	0.7559	0.3596	0.4003	0	0	0	0	0	0	0	0	0											3.4598	0		0.4569	0.013037938	0.076684922	0.230382976	0.033057879	0.238196286	0.072132637	0.917297658	0.243351029	0.040415893	0.080545184	0	0	0.169387862	0.040760329	0.0057338	0.053913975	0.189572321	0.755873539	0.35964477	0.400282223	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.3771
H4005_004_0	2009	6																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	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	0	0	0											0		0	0	0	0	0	0	0	391.6681743	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	$25/Case for ER - Facility; $25/Visit for Urgent Care;	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -											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	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	0.815975363	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.816	0		0	0	0	0	0	0	0	0.815975363	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.816		$250/Admit for IP Medical; $250/Admit for IP Surgical;	$250/Admit for IP Psych; $250/Admit for IP Substance Abuse;	20% Coinsurance for SNF	20% Coinsurance for Home Health	20% Coinsurance for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	- zero -	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	- zero -	- zero -	20% 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;	20% Coinsurance for PCP - Routine Physicals; 20% Coinsurance for PCP - Immunizations;	20% Coinsurance for Speclst - Immunizations;	25% Coinsurance for OP Psych - Non-Physician; 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);	20% Coinsurance for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	25% Coinsurance for Chiropractor; 20% Coinsurance for Vistion Exams; 25% Coinsurance for Podiatrist; 20% Coinsurance for Hearing/Speech Exams; 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	- zero -	- zero -	20% Coinsurance for Vision (Refractions)	- zero -	20% Coinsurance for Routine Hearing Exams	- zero -	- zero -	- zero -											0.3636	0.0146	0.074	0.1968	0.0248	0.1779	0.0647	0	0.2283	0.0405	0.0687	0	0	0.1422	0.0357	0.0047	0.066	0.1578	0.6471	0.3068	0.3242	0	0	0	0	0	0	0	0	0											2.9383	0		0.3636	0.014554908	0.074010722	0.196795136	0.024764745	0.177856019	0.064743084	0.815975363	0.228334204	0.040476711	0.068686913	0	0	0.142154959	0.035746222	0.004706004	0.065959842	0.157840985	0.647103439	0.306812666	0.324205238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.7543
H4005_801_0	2009	5																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	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	0	0	0											0		0	0	0	0	0	0	0	411.1077809	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	$25/Case for ER - Facility; $25/Visit for Urgent Care;	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -											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	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	0.856474544	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.8565	0		0	0	0	0	0	0	0	0.856474544	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.8565		$250/Admit for IP Medical; $250/Admit for IP Surgical;	$250/Admit for IP Psych; $250/Admit for IP Substance Abuse;	20% Coinsurance for SNF	20% Coinsurance for Home Health	20% Coinsurance for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	- zero -	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	- zero -	- zero -	20% 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;	20% Coinsurance for PCP - Routine Physicals; 20% Coinsurance for PCP - Immunizations;	20% Coinsurance for Speclst - Immunizations;	25% Coinsurance for OP Psych - Non-Physician; 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);	20% Coinsurance for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	25% Coinsurance for Chiropractor; 20% Coinsurance for Vistion Exams; 25% Coinsurance for Podiatrist; 20% Coinsurance for Hearing/Speech Exams; 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	- zero -	- zero -	20% Coinsurance for Vision (Refractions)	- zero -	20% Coinsurance for Routine Hearing Exams	- zero -	- zero -	- zero -											0.3032	0.0079	0.0568	0.1707	0.0223	0.172	0.0556	0	0.226	0.0356	0.0634	0	0	0.1435	0.0326	0.0052	0.0436	0.1986	0.6338	0.3274	0.3437	0	0	0	0	0	0	0	0	0											2.8418	0		0.3032	0.007949215	0.056848915	0.170666127	0.02234649	0.171954228	0.055593376	0.856474544	0.225986872	0.035581749	0.06338473	0	0	0.143533941	0.032604767	0.005205313	0.043587994	0.198593964	0.633790803	0.327367416	0.34367616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.6983
H4005_802_0	2009	4																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	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	0	0	0											0		0	0	0	0	0	0	0	411.1077809	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	$25/Case for ER - Facility; $25/Visit for Urgent Care;	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -											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	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	0.856474544	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.8565	0		0	0	0	0	0	0	0	0.856474544	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.8565		$250/Admit for IP Medical; $250/Admit for IP Surgical;	$250/Admit for IP Psych; $250/Admit for IP Substance Abuse;	20% Coinsurance for SNF	20% Coinsurance for Home Health	20% Coinsurance for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	- zero -	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	- zero -	- zero -	20% 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;	20% Coinsurance for PCP - Routine Physicals; 20% Coinsurance for PCP - Immunizations;	20% Coinsurance for Speclst - Immunizations;	25% Coinsurance for OP Psych - Non-Physician; 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);	20% Coinsurance for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	25% Coinsurance for Chiropractor; 20% Coinsurance for Vistion Exams; 25% Coinsurance for Podiatrist; 20% Coinsurance for Hearing/Speech Exams; 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	- zero -	- zero -	20% Coinsurance for Vision (Refractions)	- zero -	20% Coinsurance for Routine Hearing Exams	- zero -	- zero -	- zero -											0.3032	0.0079	0.0568	0.1707	0.0223	0.172	0.0556	0	0.226	0.0356	0.0634	0	0	0.1435	0.0326	0.0052	0.0436	0.1986	0.6338	0.3274	0.3437	0	0	0	0	0	0	0	0	0											2.8418	0		0.3032	0.007949215	0.056848915	0.170666127	0.02234649	0.171954228	0.055593376	0.856474544	0.225986872	0.035581749	0.06338473	0	0	0.143533941	0.032604767	0.005205313	0.043587994	0.198593964	0.633790803	0.327367416	0.34367616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.6983
H4005_804_0	2009	4																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	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	0	0	0											0		0	0	0	0	0	0	0	411.1077809	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	$25/Case for ER - Facility; $25/Visit for Urgent Care;	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -											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	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	0.856474544	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.8565	0		0	0	0	0	0	0	0	0.856474544	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.8565		$250/Admit for IP Medical; $250/Admit for IP Surgical;	$250/Admit for IP Psych; $250/Admit for IP Substance Abuse;	20% Coinsurance for SNF	20% Coinsurance for Home Health	20% Coinsurance for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	- zero -	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	- zero -	- zero -	20% 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;	20% Coinsurance for PCP - Routine Physicals; 20% Coinsurance for PCP - Immunizations;	20% Coinsurance for Speclst - Immunizations;	25% Coinsurance for OP Psych - Non-Physician; 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);	20% Coinsurance for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	25% Coinsurance for Chiropractor; 20% Coinsurance for Vistion Exams; 25% Coinsurance for Podiatrist; 20% Coinsurance for Hearing/Speech Exams; 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	- zero -	- zero -	20% Coinsurance for Vision (Refractions)	- zero -	20% Coinsurance for Routine Hearing Exams	- zero -	- zero -	- zero -											0.3032	0.0079	0.0568	0.1707	0.0223	0.172	0.0556	0	0.226	0.0356	0.0634	0	0	0.1435	0.0326	0.0052	0.0436	0.1986	0.6338	0.3274	0.3437	0	0	0	0	0	0	0	0	0											2.8418	0		0.3032	0.007949215	0.056848915	0.170666127	0.02234649	0.171954228	0.055593376	0.856474544	0.225986872	0.035581749	0.06338473	0	0	0.143533941	0.032604767	0.005205313	0.043587994	0.198593964	0.633790803	0.327367416	0.34367616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.6983
H4006_001_0	2009	4																																D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	P	P	P	P	P	P	Coin	O		P	P	P	P	P																																																					0							9.073086851	8.29505244	453.64762						12.94017209			702.1352054																								1a (IP Acute) - $0	1b (IP Psych) - $0	2 (SNF) - $0; 2a2 (Waiver 3 Day) - $0	6a (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) - $0, 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Radiology) - 0%	9a (OP Observation) - $0	12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA) - $10, 9d (Cardiac Rehab) - $0, 3 (CORF)- $0; 5 (Partial Hospitalization) - $0, 9a (OP Other excluding Surgery) - $0"	"7a (PCP) - $0, 14c (Routine Physical) - $0"	"7b (Chiro) - $0, 7d (Spec) - $0, 7f (Pod) - $0; 17a (MCR Eye Exam) - $0; 18a (MCR Hearing Exam) - $0, 16b (Comp Dental) - $0, 14j (Nutrition Therap) - $0; 14i (Diab Mon.) - $0;"	"7e (MH), 7h (Psychiatric) - $10"	"7c (OT), 7i (PT/ST) - $0"	8b (Prof Radiology) - 0%	"7g (Prof. Other - allergy visits)  - $0; 14b (Immun), 14d (Pap/Pelvic), 14e (Prostate), 14f (Colorectal), 14g (Bone Mass) - $0, 13b (Accupuncture) - $15"	15 (Part B Rx) - 0%	13a (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	14a (Health Ed & Wellness) - $0	13C OTC - $60/Qtr																0.1	0.1	25						10			10																													0.1	0.1	25						10			10																								0	0	0	0	0	0.907308685	0.829505244	0.945099208	0	0	0	0	0	0.010783477	0	0	0.585112671	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.2778	0	0	0	0	0	0	0	0.907308685	0.829505244	0.945099208	0	0	0	0	0	0.010783477	0	0	0.585112671	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.2778																																																																																		0	0	0	0	0	0	0	0	0.907308685	0.829505244	0.945099208	0	0	0	0	0	0.010783477	0	0	0.585112671	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.2778
H4006_007_0	2009	6																																D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	P	P	P	P	P	P	Coin	O		P	P	P	P	P																																																					0							9.867991461	9.939185447	421.8978134						14.17494181			636.4770682																								1a (IP Acute) - $0	1b (IP Psych) - $0	2 (SNF) - $0; 2a2 (Waiver 3 Day) - $0	6a (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) - $0, 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Radiology) - 0%	9a (OP Observation) - $0	12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA) - $10, 9d (Cardiac Rehab) - $0, 3 (CORF)- $0; 5 (Partial Hospitalization) - $0, 9a (OP Other excluding Surgery) - $0"	"7a (PCP) - $0, 14c (Routine Physical) - $0"	"7b (Chiro) - $0, 7d (Spec) - $0, 7f (Pod) - $0; 17a (MCR Eye Exam) - $0; 18a (MCR Hearing Exam) - $0, 16b (Comp Dental) - $0, 14j (Nutrition Therap) - $0; 14i (Diab Mon.) - $0;"	"7e (MH), 7h (Psychiatric) - $10"	"7c (OT), 7i (PT/ST) - $0"	8b (Prof Radiology) - 0%	"7g (Prof. Other - allergy visits)  - $0; 14b (Immun), 14d (Pap/Pelvic), 14e (Prostate), 14f (Colorectal), 14g (Bone Mass) - $0, 13b (Accupuncture) - $15"	15 (Part B Rx) - 0%	13a (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	14a (Health Ed & Wellness) - $0	13C OTC - $55/Qtr																0.1	0.1	25						10			10																													0.1	0.1	25						10			10																								0	0	0	0	0	0.986799146	0.993918545	0.878953778	0	0	0	0	0	0.011812452	0	0	0.530397557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.4019	0	0	0	0	0	0	0	0.986799146	0.993918545	0.878953778	0	0	0	0	0	0.011812452	0	0	0.530397557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.4019																																																																																		0	0	0	0	0	0	0	0	0.986799146	0.993918545	0.878953778	0	0	0	0	0	0.011812452	0	0	0.530397557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.4019
H4006_008_0	2009	6																																D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	P	P	P	P	P	P	Coin	O		Coin	P	P	P	P																																																					0							10.7702597	12.40558011	378.3876369						9.279260851			684.7641867			0.631119066				9.204838078																	1a (IP Acute) - $0	1b (IP Psych) - $0	2 (SNF) - $0; 2a2 (Waiver 3 Day) - $0	6a (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) - $0, 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Radiology) - 0%	9a (OP Observation) - $0	12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA) - $10, 9d (Cardiac Rehab) - $0, 3 (CORF)- $0; 5 (Partial Hospitalization), 9a (OP Other excluding Surgery) - $0"	"7a (PCP) - $0, 14c (Routine Physical) - $0"	"7b (Chiro) - $0, 7d (Spec) - $0, 7f (Pod) - $0; 17a (MCR Eye Exam) - $0; 18a (MCR Hearing Exam) - $0, 16b (Comp Dental) - $0, 14j (Nutrition Therap) - $0; 14i (Diab Mon.) - $0;"	"7e (MH), 7h (Psychiatric) - $10"	"7c (OT), 7i (PT/ST) - $0"	8b (Prof Radiology) - 0%	"7g (Prof. Other - allergy visits)  - $0; 14b (Immun), 14d (Pap/Pelvic), 14e (Prostate), 14f (Colorectal), 14g (Bone Mass) - $0, 13b (Accupuncture) - $15"	15 (Part B Rx) - 0%	13a (Blood) - $0		16a (Preventive); 16b (Comp. Dental) - $0; 25% Prosthodontics	17a1 (Rountine Eye Exam) - $0	17b1 (Non MCR Covered) - $300 limit	18a1 (Hearing Exam Non-covered) - $0	18b (Hearing Aids) - $500 limit	14a (Health Ed & Wellness) - $0	13C OTC - $75/Qtr																0.1	0.1	25						10			10			15				0.052653859																						0.1	0.1	25						10			10			15				0.052653859																	0	0	0	0	0	1.07702597	1.240558011	0.788307577	0	0	0	0	0	0.007732717	0	0	0.570636822	0	0	0.000788899	0	0	0	0.484670246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1697	0	0	0	0	0	0	0	1.07702597	1.240558011	0.788307577	0	0	0	0	0	0.007732717	0	0	0.570636822	0	0	0.000788899	0	0	0	0.484670246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1697				2 (SNF) - 20%	6a (Home Health) - 20%	10a (Ambulance) - 20%	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"		"9a (OP Surgery) , 9b (ASC) - 20%"	8a (OP Diag Proc/Test/Lab) - 20%	8b (OP Radiology) - 20%	9a (OP Observation) - 20%		"7i, 7c (OP PT/ST/OT), 9c (OP SA) - $10, 9d (Cardiac Rehab), 3 (CORF),  5 (Partial Hospitalization), 9a (OP Other excluding Surgery) - 20%"	"7a (PCP), 14c (Routine Physical) - 20%"	"7b (Chiro) , 7d (Spec), 7f (Pod), 17a (MCR Eye Exam), 18a (MCR Hearing Exam), 16b (Comp Dental), 14j (Nutrition Therap); 14i (Diab Mon.) - 20%"	"7e (MH), 7h (Psychiatric) - 20%"	"7c (OT), 7i (PT/ST) - 20%"	8b (Prof Radiology) - 20%	"7g (Prof. Other - allergy visits), 14b (Immun), 14d (Pap/Pelvic), 14e (Prostate), 14f (Colorectal), 14g (Bone Mass) - 20%"		13a (Blood) - 20%		16a (Preventive); 16b (Comp. Dental) - 20%; 25% Prosthodontics	17a1 (Rountine Eye Exam) - 20%	17b1 (Non MCR Covered) - $300 limit	18a1 (Hearing Exam Non-covered) - 20%	18b (Hearing Aids) - $500 limit															0.0212	0.0961	0.0192	0.0898	0.1034		0.1159	0.0175	0.0608			0.0609	0.3911	0.6276	0.0372	0.0719	0.2646	0.5224		0.0005		0.0808	0.0046																2.5855	0	0	0	0	0.021246063	0.096098948	0.019184307	1.166778134	1.343937845	0.788307577	0.115936657	0.017523977	0.060804651	0	0	0.068616709	0.391092373	0.62759445	0.607821244	0.0718958	0.264628224	0.523163115	0	0.00046927	0	0.565485993	0.004649058	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.7552
H4006_013_0	2009	7																																D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	P	P	P	P	P	P	Coin	O		P	P	P	P	P																																																					0							12.80151158	14.14663134																																		"1a (IP Acute) - $0, 1a (additional days)"	1b (IP Psych) - $0	2 (SNF) - $0; 2a2 (Waiver 3 Day) - $0	6a (Home Health) - $0	10a (Ambulance) - $0	11a (Medical Equip) - 10%	"11b (Med Supp), 11c (Diab Supp) - 10%"	"4a (ER) $25 (WW coverage), 4b (UC) - $0 (WW coverage)"	"9a (OP Surgery) - $0, 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - $0	"8b (OP Therap Rad, CT scans, PET, scans, & MRI) - $0, 8b (OP x-rays) - 0%"	9a (OP Observation) - $0	12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA) - $0, 9d (Cardiac Rehab) - $0, 3 (CORF)- $0; 5 (Partial Hospitalization) - $0, 9a (OP Other excluding Surgery) - $0"	"7a (PCP) - $0, 14c (Routine Physical) - $0"	"7b (Chiro) - $0, 7d (Spec) - $0, 7f (Pod) - $0; 17a (MCR Eye Exam) - $0; 18a (MCR Hearing Exam) - $0, 16b (Comp Dental) - $0, 14j (Nutrition Therap) - $0; 14i (Diab Mon.) - $0;"	"7e (MH), 7h (Psychiatric) - $0"	"7c (OT), 7i (PT/ST) - $0"	"8b (OP Therap Rad, CT scans, PET, scans, & MRI) - 0%, 8b (OP x-rays) - 0%"	"7g (Prof. Other - allergy visits)  - $0; 14b (Immun), 14d (Pap/Pelvic), 14e (Prostate), 14f (Colorectal), 14g (Bone Mass) - $0"	15 (Part B Rx) - 0%	13a (Blood) - $0	1 Round trip per year	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	14a (Health Ed & Wellness) - $0	13C OTC - $23/Qtr																0.1	0.1																																							0.1	0.1																																		0	0	0	0	0	1.280151158	1.414663134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.6948	0	0	0	0	0	0	0	1.280151158	1.414663134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.6948																																																																																		0	0	0	0	0	0	0	0	1.280151158	1.414663134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.6948
H4006_015_0	2009	7																																D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	P	P	P	P	P	P	Coin	O		P	P	P	P	P																																																					0							15.50181076	17.13066466																																		"1a (IP Acute) - $0, 1a (additional days)"	1b (IP Psych) - $0	2 (SNF) - $0; 2a2 (Waiver 3 Day) - $0	6a (Home Health) - $0	10a (Ambulance) - $0	11a (Medical Equip) - 10%	"11b (Med Supp), 11c (Diab Supp) - 10%"	"4a (ER) $25 (WW coverage), 4b (UC) - $0 (WW coverage)"	"9a (OP Surgery) - $0, 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - $0	"8b (OP Therap Rad, CT scans, PET, scans, & MRI) - $0, 8b (OP x-rays) - 0%"	9a (OP Observation) - $0	12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA) - $0, 9d (Cardiac Rehab) - $0, 3 (CORF)- $0; 5 (Partial Hospitalization) - $0, 9a (OP Other excluding Surgery) - $0"	"7a (PCP) - $0, 14c (Routine Physical) - $0"	"7b (Chiro) - $0, 7d (Spec) - $0, 7f (Pod) - $0; 17a (MCR Eye Exam) - $0; 18a (MCR Hearing Exam) - $0, 16b (Comp Dental) - $0, 14j (Nutrition Therap) - $0; 14i (Diab Mon.) - $0;"	"7e (MH), 7h (Psychiatric) - $0"	"7c (OT), 7i (PT/ST) - $0"	"8b (OP Therap Rad, CT scans, PET, scans, & MRI) - 0%, 8b (OP x-rays) - 0%"	"7g (Prof. Other - allergy visits)  - $0; 14b (Immun), 14d (Pap/Pelvic), 14e (Prostate), 14f (Colorectal), 14g (Bone Mass) - $0"	15 (Part B Rx) - 0%	13a (Blood) - $0	1 Round trip per year	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	14a (Health Ed & Wellness) - $0	13C OTC - $25/Qtr																0.1	0.1																																							0.1	0.1																																		0	0	0	0	0	1.550181076	1.713066466	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.2632	0	0	0	0	0	0	0	1.550181076	1.713066466	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.2632																																																																																		0	0	0	0	0	0	0	0	1.550181076	1.713066466	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.2632
H4006_018_0	2009	7																																D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	P	P	P	P	P	P	Coin	O		P	P	P	P	P																																																					0							16.98415294	18.76876405																																		"1a (IP Acute) - $0, 1a (additional days)"	1b (IP Psych) - $0	2 (SNF) - $0; 2a2 (Waiver 3 Day) - $0	6a (Home Health) - $0	10a (Ambulance) - $0	11a (Medical Equip) - 10%	"11b (Med Supp), 11c (Diab Supp) - 10%"	"4a (ER) $25 (WW coverage), 4b (UC) - $0 (WW coverage)"	"9a (OP Surgery) - $0, 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - $0	"8b (OP Therap Rad, CT scans, PET, scans, & MRI) - $0, 8b (OP x-rays) - 0%"	9a (OP Observation) - $0	12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA) - $0, 9d (Cardiac Rehab) - $0, 3 (CORF)- $0; 5 (Partial Hospitalization) - $0, 9a (OP Other excluding Surgery) - $0"	"7a (PCP) - $0, 14c (Routine Physical) - $0"	"7b (Chiro) - $0, 7d (Spec) - $0, 7f (Pod) - $0; 17a (MCR Eye Exam) - $0; 18a (MCR Hearing Exam) - $0, 16b (Comp Dental) - $0, 14j (Nutrition Therap) - $0; 14i (Diab Mon.) - $0;"	"7e (MH), 7h (Psychiatric) - $0"	"7c (OT), 7i (PT/ST) - $0"	"8b (OP Therap Rad, CT scans, PET, scans, & MRI) - 0%, 8b (OP x-rays) - 0%"	"7g (Prof. Other - allergy visits)  - $0; 14b (Immun), 14d (Pap/Pelvic), 14e (Prostate), 14f (Colorectal), 14g (Bone Mass) - $0"	15 (Part B Rx) - 0%	13a (Blood) - $0	1 Round trip per year	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	14a (Health Ed & Wellness) - $0	13C OTC - $22/Qtr																0.1	0.1																																							0.1	0.1																																		0	0	0	0	0	1.698415294	1.876876405	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.5753	0	0	0	0	0	0	0	1.698415294	1.876876405	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.5753																																																																																		0	0	0	0	0	0	0	0	1.698415294	1.876876405	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.5753
H4006_020_0	2009	6																																D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	P	P	P	P	P	P	Coin	O		P	P	P	P	P																																																					0							8.346173773	8.406388396	356.8337568						11.98891669			538.3211199																								1a (IP Acute) - $0	1b (IP Psych) - $0	2 (SNF) - $0; 2a2 (Waiver 3 Day) - $0	6a (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) - $0, 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Radiology) - 0%	9a (OP Observation) - $0	12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA) - $10, 9d (Cardiac Rehab) - $0, 3 (CORF)- $0; 5 (Partial Hospitalization) - $0, 9a (OP Other excluding Surgery) - $0"	"7a (PCP) - $0, 14c (Routine Physical) - $0"	"7b (Chiro) - $0, 7d (Spec) - $0, 7f (Pod) - $0; 17a (MCR Eye Exam) - $0; 18a (MCR Hearing Exam) - $0, 16b (Comp Dental) - $0, 14j (Nutrition Therap) - $0; 14i (Diab Mon.) - $0;"	"7e (MH), 7h (Psychiatric) - $10"	"7c (OT), 7i (PT/ST) - $0"	8b (Prof Radiology) - 0%	"7g (Prof. Other - allergy visits)  - $0; 14b (Immun), 14d (Pap/Pelvic), 14e (Prostate), 14f (Colorectal), 14g (Bone Mass) - $0, 13b (Accupuncture) - $15"	15 (Part B Rx) - 0%	13a (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	14a (Health Ed & Wellness) - $0	13C OTC - $50/Qtr																0.1	0.1	25						10			10																													0.1	0.1	25						10			10																								0	0	0	0	0	0.834617377	0.84063884	0.74340366	0	0	0	0	0	0.009990764	0	0	0.448600933	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.8773	0	0	0	0	0	0	0	0.834617377	0.84063884	0.74340366	0	0	0	0	0	0.009990764	0	0	0.448600933	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.8773																																																																																		0	0	0	0	0	0	0	0	0.834617377	0.84063884	0.74340366	0	0	0	0	0	0.009990764	0	0	0.448600933	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.8773
H4006_022_0	2009	6																					3350											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	P	P	P	P	Coin	Coin	P	O		P	P	P	P	P																																																					0		269.7365548					9.867991461	9.939185447	421.8978134		1.762635459	7.022282945			290.6786589	6109.975878	5050.107162	620.5651415	4516.980117	23.43579747	15.84255817				2191.071816	190.0316138																1a (IP Acute) - $50 per admit	1b (IP Psych) - $50 per admit	2 (SNF) - $0; 2a2 (Waiver 3 Day) - $0	6a (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) - $0, 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - 10%	8b (Radiology) - 10%	9a (OP Observation) - $0	12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA) - $15, 9d (Cardiac Rehab) - $0, 3 (CORF)- $0; 5 (Partial Hospitalization) - $0, 9a (OP Other excluding Surgery) - $0"	"7a (PCP) - $10, 14c (Routine Physical) - $0"	"7b (Chiro) - $15, 7d (Spec) - $15, 7f (Pod) - $15; 17a (MCR Eye Exam) - $15; 18a (MCR Hearing Exam) - $15, 16b (Comp Dental) - $15, 14j (Nutrition Therap) - $0; 14i (Diab Mon.) - $0;"	"7e (MH), 7h (Psychiatric) - $15"	"7c (OT), 7i (PT/ST) - $15"	8b (Prof Radiology) - 10%	"7g (Prof. Other - allergy visits)  - $0; 14b (Immun), 14d (Pap/Pelvic), 14e (Prostate), 14f (Colorectal), 14g (Bone Mass) - $0, Labs/Pathology - 10%"	15 (Part B Rx) - 0%	13a (Blood) - $0		16a (Preventive); 16b (Comp. Dental) - $15	17a1 (Rountine Eye Exam) - $15	17b1 (Non MCR Covered) - $200 limit	18a1 (Hearing Exam Non-covered) - $15	18b (Hearing Aids) - $200 limit	14a (Health Ed & Wellness) - $0	13C OTC - $50/Qtr											50					0.1	0.1	25		0.1	0.1			15	10.00378158	15	15	15	0.1	0.100022871				15	15																47.42591468					0.094851829	0.094851829	23.71295734		0.094851829	0.094851829			14.2277744	9.488769836	14.2277744	14.2277744	14.2277744	0.094851829	0.094873523				14.2277744	14.2277744																1.066	0	0	0	0	0.935997042	0.942749922	0.833703738	0	0.167189198	0.666076384	0	0	0.344642532	4.831346234	5.987648784	0.735771736	5.35554784	2.222928263	1.5030393	0	0	0	2.597839625	0.225310578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.4158	0	1.5423	1.066	0	0	0	0	0.935997042	0.942749922	0.833703738	0	0.167189198	0.666076384	0	0	0.344642532	4.831346234	5.987648784	0.735771736	5.35554784	2.222928263	1.5030393	0	0	0	2.597839625	0.225310578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.4158																																																																																		0	0	0	1.066	0	0	0	0	0.935997042	0.942749922	0.833703738	0	0.167189198	0.666076384	0	0	0.344642532	4.831346234	5.987648784	0.735771736	5.35554784	2.222928263	1.5030393	0	0	0	2.597839625	0.225310578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.4158
H4006_803_0	2009	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																																																					0		112.1941963		1.883096493		3.266886615	10.53512905	11.92692526	6.056896531	15.4254173	2.45029016	8.158979719		0.336289499	8.860891361	56.30651358	74.9791354	3.605293022	9.803102079	31.64229011	64.70437577	14.44557591	0.137132941																			Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share																			0.152022424		0.188757067		0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.152022424		0.188757067		0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			17.056	0	0.35544777	0	0.754650808	2.43361481	2.755119734	1.399143099	3.563271397	0.566017027	1.884724315	0	0.077682874	2.046865904	13.00680464	17.32018028	0.832822688	2.26451658	7.309369016	14.9467108	3.336928036	0.031677709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.9416	0	0	17.056	0	0.35544777	0	0.754650808	2.43361481	2.755119734	1.399143099	3.563271397	0.566017027	1.884724315	0	0.077682874	2.046865904	13.00680464	17.32018028	0.832822688	2.26451658	7.309369016	14.9467108	3.336928036	0.031677709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.9416																																																																																		0	0	0	17.056	0	0.35544777	0	0.754650808	2.43361481	2.755119734	1.399143099	3.563271397	0.566017027	1.884724315	0	0.077682874	2.046865904	13.00680464	17.32018028	0.832822688	2.26451658	7.309369016	14.9467108	3.336928036	0.031677709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.9416
H4006_807_0	2009	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																																																					0		112.1941963		1.883096493		3.266886615	10.53512905	11.92692526	6.056896531	15.4254173	2.45029016	8.158979719		0.336289499	8.860891361	56.30651358	74.9791354	3.605293022	9.803102079	31.64229011	64.70437577	14.44557591	0.137132941																			Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share																			0.152022424		0.188757067		0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.152022424		0.188757067		0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			17.056	0	0.35544777	0	0.754650808	2.43361481	2.755119734	1.399143099	3.563271397	0.566017027	1.884724315	0	0.077682874	2.046865904	13.00680464	17.32018028	0.832822688	2.26451658	7.309369016	14.9467108	3.336928036	0.031677709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.9416	0	0	17.056	0	0.35544777	0	0.754650808	2.43361481	2.755119734	1.399143099	3.563271397	0.566017027	1.884724315	0	0.077682874	2.046865904	13.00680464	17.32018028	0.832822688	2.26451658	7.309369016	14.9467108	3.336928036	0.031677709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.9416																																																																																		0	0	0	17.056	0	0.35544777	0	0.754650808	2.43361481	2.755119734	1.399143099	3.563271397	0.566017027	1.884724315	0	0.077682874	2.046865904	13.00680464	17.32018028	0.832822688	2.26451658	7.309369016	14.9467108	3.336928036	0.031677709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.9416
H4006_809_0	2009	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																																																					0		112.1941963		1.883096493		3.266886615	10.53512905	11.92692526	6.056896531	15.4254173	2.45029016	8.158979719		0.336289499	8.860891361	56.30651358	74.9791354	3.605293022	9.803102079	31.64229011	64.70437577	14.44557591	0.137132941																			Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share																			0.152022424		0.188757067		0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.152022424		0.188757067		0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			17.056	0	0.35544777	0	0.754650808	2.43361481	2.755119734	1.399143099	3.563271397	0.566017027	1.884724315	0	0.077682874	2.046865904	13.00680464	17.32018028	0.832822688	2.26451658	7.309369016	14.9467108	3.336928036	0.031677709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.9416	0	0	17.056	0	0.35544777	0	0.754650808	2.43361481	2.755119734	1.399143099	3.563271397	0.566017027	1.884724315	0	0.077682874	2.046865904	13.00680464	17.32018028	0.832822688	2.26451658	7.309369016	14.9467108	3.336928036	0.031677709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.9416																																																																																		0	0	0	17.056	0	0.35544777	0	0.754650808	2.43361481	2.755119734	1.399143099	3.563271397	0.566017027	1.884724315	0	0.077682874	2.046865904	13.00680464	17.32018028	0.832822688	2.26451658	7.309369016	14.9467108	3.336928036	0.031677709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.9416
H4006_811_0	2009	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																																																					0		112.1941963		1.883096493		3.266886615	10.53512905	11.92692526	6.056896531	15.4254173	2.45029016	8.158979719		0.336289499	8.860891361	56.30651358	74.9791354	3.605293022	9.803102079	31.64229011	64.70437577	14.44557591	0.137132941																			Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share																			0.152022424		0.188757067		0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.152022424		0.188757067		0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			17.056	0	0.35544777	0	0.754650808	2.43361481	2.755119734	1.399143099	3.563271397	0.566017027	1.884724315	0	0.077682874	2.046865904	13.00680464	17.32018028	0.832822688	2.26451658	7.309369016	14.9467108	3.336928036	0.031677709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.9416	0	0	17.056	0	0.35544777	0	0.754650808	2.43361481	2.755119734	1.399143099	3.563271397	0.566017027	1.884724315	0	0.077682874	2.046865904	13.00680464	17.32018028	0.832822688	2.26451658	7.309369016	14.9467108	3.336928036	0.031677709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.9416																																																																																		0	0	0	17.056	0	0.35544777	0	0.754650808	2.43361481	2.755119734	1.399143099	3.563271397	0.566017027	1.884724315	0	0.077682874	2.046865904	13.00680464	17.32018028	0.832822688	2.26451658	7.309369016	14.9467108	3.336928036	0.031677709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.9416
H4006_813_0	2009	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																																																					0		112.1941963		1.883096493		3.266886615	10.53512905	11.92692526	6.056896531	15.4254173	2.45029016	8.158979719		0.336289499	8.860891361	56.30651358	74.9791354	3.605293022	9.803102079	31.64229011	64.70437577	14.44557591	0.137132941																			Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share																			0.152022424		0.188757067		0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.152022424		0.188757067		0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			17.056	0	0.35544777	0	0.754650808	2.43361481	2.755119734	1.399143099	3.563271397	0.566017027	1.884724315	0	0.077682874	2.046865904	13.00680464	17.32018028	0.832822688	2.26451658	7.309369016	14.9467108	3.336928036	0.031677709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.9416	0	0	17.056	0	0.35544777	0	0.754650808	2.43361481	2.755119734	1.399143099	3.563271397	0.566017027	1.884724315	0	0.077682874	2.046865904	13.00680464	17.32018028	0.832822688	2.26451658	7.309369016	14.9467108	3.336928036	0.031677709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.9416																																																																																		0	0	0	17.056	0	0.35544777	0	0.754650808	2.43361481	2.755119734	1.399143099	3.563271397	0.566017027	1.884724315	0	0.077682874	2.046865904	13.00680464	17.32018028	0.832822688	2.26451658	7.309369016	14.9467108	3.336928036	0.031677709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.9416
H4006_815_0	2009	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																																																					0		112.1941963		1.883096493		3.266886615	10.53512905	11.92692526	6.056896531	15.4254173	2.45029016	8.158979719		0.336289499	8.860891361	56.30651358	74.9791354	3.605293022	9.803102079	31.64229011	64.70437577	14.44557591	0.137132941																			Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share																			0.152022424		0.188757067		0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.152022424		0.188757067		0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			17.056	0	0.35544777	0	0.754650808	2.43361481	2.755119734	1.399143099	3.563271397	0.566017027	1.884724315	0	0.077682874	2.046865904	13.00680464	17.32018028	0.832822688	2.26451658	7.309369016	14.9467108	3.336928036	0.031677709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.9416	0	0	17.056	0	0.35544777	0	0.754650808	2.43361481	2.755119734	1.399143099	3.563271397	0.566017027	1.884724315	0	0.077682874	2.046865904	13.00680464	17.32018028	0.832822688	2.26451658	7.309369016	14.9467108	3.336928036	0.031677709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.9416																																																																																		0	0	0	17.056	0	0.35544777	0	0.754650808	2.43361481	2.755119734	1.399143099	3.563271397	0.566017027	1.884724315	0	0.077682874	2.046865904	13.00680464	17.32018028	0.832822688	2.26451658	7.309369016	14.9467108	3.336928036	0.031677709	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.9416
H4007_002_0	2009	3	r.	s.	t.								Part B Rx	Health & Education (Non-Covered)	Other Non-Covered																			A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin	V		V		O	O	S	O	O								0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0			0	0		0		0	0	0	0	0								0		248.260742	0	8.993198	125.131704	167.487469	11.004582	7.438065	752.614774	124.111247	3188.07626	1207.607887	0	10.807718	214.949535	6029.665002	4165.211257	1.452484	848.720453			1.643276			7.38	2.47		0.33		1.3	0.05	955.68552	0.06	1.23								$40/Admit:1a	$40/Admit:1b	$0/Day(Days 1-100) $0(Days 100-100):2	$0/Visit:6	$0/Trip:10a	0% Coins:11a	0% Coins:11b	$25/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$10/Visit:14h. $0 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $0 Advanced Imaging -- FSR,8b. $10 Advanced Imaging -- Office,9a. $0 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $0 Radiology OP -- Facility"	$0/Visit:9a	$0/Proc:12	"$0-$10/Visit:9d. $0 Cardiac Rehab,8b. $0 Nuclear Medicine,9a. $0 OP Other,5. $10 Partial Hospitalization,8b. $0 Rad therapy,3. $0 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$10/Visit:7b, 7d, 7f"	"$0-$10/Visit:7h. $0 Psych -- OP,7e. $10 Psych -- Other Provider"	"$0-$10/Visit:9a. $0 Therapy (AT,PT,ST,OT) -- OP,7d. $10 Therapy (AT,PT,ST,OT) - Specialist"			0% Coins:15			"Dental PR 002 16a, 16b"	Vision Benefit		Hearing PR 002		$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	$0/Script:15	$0: Nurse hotline 14a	$0 Health Education Materials 14a								40.000009	0	0	0	0	0	0	24.999992	0	0	0.440238	0	0	0	0	9.999998	0	8.8894			0			0	0		0		0	0	0	0	0								40.000009	0	0	0	0	0	0	24.999992	0	0	0.440238	0	0	0	0	9.999998	0	8.8894			0			0	0		0		0	0	0	0	0								0.8275	0	0	0	0	0	0	1.567946944	0	0	0.044302907	0	0	0	0	3.471008687	0	0.628717966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5395	0	0	0.8275	0	0	0	0	0	0	1.567946944	0	0	0.044302907	0	0	0	0	3.471008687	0	0.628717966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5395																																																																																		0	0	0	0.8275	0	0	0	0	0	0	1.567946944	0	0	0.044302907	0	0	0	0	3.471008687	0	0.628717966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5395
H4007_005_0	2009	3	r.	s.									Health & Education (Non-Covered)	Other Non-Covered																				D	D	A	V	T	Coin	Coin	V	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									0		1872.439941	0	0.609036	148.768251	199.124739	15.554609	10.513457	894.778702	147.555036	3790.282671	1435.716988	0	12.849224	255.552075	7168.628636	4951.991974	1.726848	1009.038103			17.25446			7.38	1.5		0.33		1.3	0.05	0.06	1.23									$90/Day(Days 1-5):1a	$90/Day(Days 1-5):1b	$0/Admit(Days 1-100) $0(Days 100-100):2	$0/Visit:6	$0/Trip:10a	0% Coins:11a	0% Coins:11b	$50/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"$0/Visit:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			0% Coins:15			"Dental PR 005 16a, 16b"	Vision PR 005		Hearing PR 005		$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	$0: Nurse hotline 14a	$0 Health Education Materials 14a									55.179179	0	0	0	0	0	0	50.000005	0	0	0	0	0	0	0	0	0	0			0			0	0		0		0	0	0	0									55.179179	0	0	0	0	0	0	50.000005	0	0	0	0	0	0	0	0	0	0			0			0	0		0		0	0	0	0									8.61	0	0	0	0	0	0	3.728244964	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.3382	0	0	8.61	0	0	0	0	0	0	3.728244964	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.3382																																																																																		0	0	0	8.61	0	0	0	0	0	0	3.728244964	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.3382
H4007_008_0	2009	4	r.	s.									Health & Education (Non-Covered)	Other Non-Covered																				A	A	D	V	T	Coin	Coin	V	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									0		251.442733	0	9.108465	126.735535	169.634177	11.288505	7.629971	762.26114	125.701996	3228.938262	1223.085962	0	10.94624	217.704572	6106.948032	4218.597334	1.471101	859.598618			12.522145			1.27	2.47		0.33		1.3	0.05	0.06	1.23									$60/Admit:1a	$60/Admit:1b	$0/Day(Days 1-100) $0(Days 100-100):2	$0/Visit:6	$0/Trip:10a	0% Coins:11a	0% Coins:11b	$25/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$10/Visit:14h. $0 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $0 Advanced Imaging -- FSR,8b. $10 Advanced Imaging -- Office,9a. $0 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $0 Radiology OP -- Facility"	$0/Visit:9a	$0/Proc:12	"$0-$10/Visit:9d. $0 Cardiac Rehab,8b. $0 Nuclear Medicine,9a. $0 OP Other,5. $10 Partial Hospitalization,8b. $0 Rad therapy,3. $0 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$10/Visit:7b, 7d, 7f"	"$0-$10/Visit:7h. $0 Psych -- OP,7e. $10 Psych -- Other Provider"	"$0-$10/Visit:9a. $0 Therapy (AT,PT,ST,OT) -- OP,7d. $10 Therapy (AT,PT,ST,OT) - Specialist"			0% Coins:15			"Dental PR 008 16a, 16b"	Vision Benefit		Hearing PR 008		$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	$0: Nurse hotline 14a	$0 Health Education Materials 14a									60.000015	0	0	0	0	0	0	24.999999	0	0	0.44023	0	0	0	0	10	0	8.889395			0			0	0		0		0	0	0	0									60.000015	0	0	0	0	0	0	24.999999	0	0	0.44023	0	0	0	0	10	0	8.889395			0			0	0		0		0	0	0	0									1.2572	0	0	0	0	0	0	1.588043978	0	0	0.044869928	0	0	0	0	3.515497778	0	0.636775971	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.0424	0	0	1.2572	0	0	0	0	0	0	1.588043978	0	0	0.044869928	0	0	0	0	3.515497778	0	0.636775971	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.0424																																																																																		0	0	0	1.2572	0	0	0	0	0	0	1.588043978	0	0	0.044869928	0	0	0	0	3.515497778	0	0.636775971	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.0424
H4007_010_0	2009	4	r.	s.	t.	u.	v.						DME/Prosthetics/Supplies	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	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						0		1641.651504	0	9.374112	130.431753	174.581528	11.956546	4.690841	784.492346	129.368072	3323.109654	1258.757035	0	11.265486	224.053886	6285.056051	4341.631949	1.514004	884.668652			13.263192			7.38	2.47		0.33		1.3	0.25	95.697312	0.06	0.16	0.05	1.23						$50/Day(Days 1-5):1a	$50/Day(Days 1-5):1b	$0/Day(Days 1-100) $0(Days 100-100):2	$0/Visit:6	$10/Trip:10a	0% Coins:11a	0% Coins:11b	$25/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$15/Visit:14h. $0 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $0 Advanced Imaging -- FSR,8b. $10 Advanced Imaging -- Office,9a. $15 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $0 Radiology OP -- Facility"	$0/Visit:9a	$0/Proc:12	"$0-$10/Visit:9d. $0 Cardiac Rehab,8b. $0 Nuclear Medicine,9a. $0 OP Other,5. $10 Partial Hospitalization,8b. $0 Rad therapy,3. $0 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$10/Visit:7b, 7d, 7f"	"$0-$10/Visit:7h. $0 Psych -- OP,7e. $10 Psych -- Other Provider"	"$0-$10/Visit:9a. $0 Therapy (AT,PT,ST,OT) -- OP,7d. $10 Therapy (AT,PT,ST,OT) - Specialist"			0% Coins:15			"Dental PR 010 16a, 16b"	Vision Benefit		Hearing PR 010		$0: Membership in health club/fitness class 14a	Assist America AAM001	:11b	$0: Nurse hotline 14a	HumanaMail NSP002	$0 Additional Smoking Cessation 14a	$0 Health Education Materials 14a						30.655098	0	0	0	10.000027	0	0	24.999999	0	0	1.498096	0	0	0	0	9.999998	0	8.889402			0			0	0		0		0	0	0	0	0	0	0						30.655098	0	0	0	10.000027	0	0	24.999999	0	0	1.498096	0	0	0	0	9.999998	0	8.889402			0			0	0		0		0	0	0	0	0	0	0						4.1937	0	0	0	0.145484999	0	0	1.634358989	0	0	0.157144907	0	0	0	0	3.618025901	0	0.65534794	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.4041	0	0	4.1937	0	0	0	0.145484999	0	0	1.634358989	0	0	0.157144907	0	0	0	0	3.618025901	0	0.65534794	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.4041																																																																																		0	0	0	4.1937	0	0	0	0.145484999	0	0	1.634358989	0	0	0.157144907	0	0	0	0	3.618025901	0	0.65534794	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.4041
H4007_012_0	2009	3	r.	s.	t.	u.	v.						DME/Prosthetics/Supplies	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	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						0		1554.672825	0	8.877449	123.521162	165.331775	10.723122	4.206939	742.928039	122.513838	3147.043247	1192.065039	0	10.668614	212.18297	5952.058538	4111.60176	1.433789	837.796762			11.894975			7.38	2.47		0.33		1.3	0.25	90.627037	0.06	0.16	0.05	1.23						$0/Day(Days 1-1):1a	$0/Day(Days 1-1):1b	$0/Day(Days 1-100) $0(Days 100-100):2	$0/Visit:6	$0/Trip:10a	0% Coins:11a	0% Coins:11b	$10/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"$0/Visit:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			0% Coins:15			"Dental PR DEN735 16a, 16b"	Vision Benefit		Hearing PR new010		$0: Membership in health club/fitness class 14a	Assist America AAM001	:11b	$0: Nurse hotline 14a	HumanaMail NSP002	$0 Additional Smoking Cessation 14a	$0: Health Education Materials 14a						0	0	0	0	0	0	0	10.000004	0	0	0	0	0	0	0	0	0	0			0			0	0		0		0	0	0	0	0	0	0						0	0	0	0	0	0	0	10.000004	0	0	0	0	0	0	0	0	0	0			0			0	0		0		0	0	0	0	0	0	0						0	0	0	0	0	0	0	0.619106947	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.6191	0	0	0	0	0	0	0	0	0	0.619106947	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.6191																																																																																		0	0	0	0	0	0	0	0	0	0	0.619106947	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.6191
H4007_801_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		248.260716	0	8.993198	125.131691	3.754226	11.004574	7.43806	16.346672	16.296653	3188.07593	17.745534	0	0.298988	5.62626	45.694443	62.775281	0.00861	3.738758			12.207185																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999979	0	43.132598	0	0.199999	0.2	0.2	0.199999	0.2	0	0.2	0	0.200001	0.2	0.2	0.199999	0.5	0.2			0.2																				1023.999979	0	43.132598	0	0.199999	0.2	0.2	0.199999	0.2	0	0.2	0	0.200001	0.2	0.2	0.199999	0.5	0.2			0.2																				21.1849	0	0.032325	0	0.750841446	2.2009148	1.487612	3.269318053	3.2593306	0	3.5491068	0	0.059797899	1.125252	9.1388886	12.55499342	0.004305	0.7477516	0	0	2.441437	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8068	0	0	21.1849	0	0.032325	0	0.750841446	2.2009148	1.487612	3.269318053	3.2593306	0	3.5491068	0	0.059797899	1.125252	9.1388886	12.55499342	0.004305	0.7477516	0	0	2.441437	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8068																																																																																		0	0	0	21.1849	0	0.032325	0	0.750841446	2.2009148	1.487612	3.269318053	3.2593306	0	3.5491068	0	0.059797899	1.125252	9.1388886	12.55499342	0.004305	0.7477516	0	0	2.441437	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8068
H4007_802_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		248.260716	0	8.993198	125.131691	3.754226	11.004574	7.43806	16.346672	16.296653	3188.07593	17.745534	0	0.298988	5.62626	45.694443	62.775281	0.00861	3.738758			12.207185																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999979	0	43.132598	0	0.199999	0.2	0.2	0.199999	0.2	0	0.2	0	0.200001	0.2	0.2	0.199999	0.5	0.2			0.2																				1023.999979	0	43.132598	0	0.199999	0.2	0.2	0.199999	0.2	0	0.2	0	0.200001	0.2	0.2	0.199999	0.5	0.2			0.2																				21.1849	0	0.032325	0	0.750841446	2.2009148	1.487612	3.269318053	3.2593306	0	3.5491068	0	0.059797899	1.125252	9.1388886	12.55499342	0.004305	0.7477516	0	0	2.441437	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8068	0	0	21.1849	0	0.032325	0	0.750841446	2.2009148	1.487612	3.269318053	3.2593306	0	3.5491068	0	0.059797899	1.125252	9.1388886	12.55499342	0.004305	0.7477516	0	0	2.441437	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8068																																																																																		0	0	0	21.1849	0	0.032325	0	0.750841446	2.2009148	1.487612	3.269318053	3.2593306	0	3.5491068	0	0.059797899	1.125252	9.1388886	12.55499342	0.004305	0.7477516	0	0	2.441437	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8068
H4007_803_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		248.260716	0	8.993198	125.131691	3.754226	11.004574	7.43806	16.346672	16.296653	3188.07593	17.745534	0	0.298988	5.62626	45.694443	62.775281	0.00861	3.738758			12.207185																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999979	0	43.132598	0	0.199999	0.2	0.2	0.199999	0.2	0	0.2	0	0.200001	0.2	0.2	0.199999	0.5	0.2			0.2																				1023.999979	0	43.132598	0	0.199999	0.2	0.2	0.199999	0.2	0	0.2	0	0.200001	0.2	0.2	0.199999	0.5	0.2			0.2																				21.1849	0	0.032325	0	0.750841446	2.2009148	1.487612	3.269318053	3.2593306	0	3.5491068	0	0.059797899	1.125252	9.1388886	12.55499342	0.004305	0.7477516	0	0	2.441437	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8068	0	0	21.1849	0	0.032325	0	0.750841446	2.2009148	1.487612	3.269318053	3.2593306	0	3.5491068	0	0.059797899	1.125252	9.1388886	12.55499342	0.004305	0.7477516	0	0	2.441437	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8068																																																																																		0	0	0	21.1849	0	0.032325	0	0.750841446	2.2009148	1.487612	3.269318053	3.2593306	0	3.5491068	0	0.059797899	1.125252	9.1388886	12.55499342	0.004305	0.7477516	0	0	2.441437	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8068
H4007_804_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		248.260716	0	8.993198	125.131691	3.754226	11.004574	7.43806	16.346672	16.296653	3188.07593	17.745534	0	0.298988	5.62626	45.694443	62.775281	0.00861	3.738758			12.207185																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999979	0	43.132598	0	0.199999	0.2	0.2	0.199999	0.2	0	0.2	0	0.200001	0.2	0.2	0.199999	0.5	0.2			0.2																				1023.999979	0	43.132598	0	0.199999	0.2	0.2	0.199999	0.2	0	0.2	0	0.200001	0.2	0.2	0.199999	0.5	0.2			0.2																				21.1849	0	0.032325	0	0.750841446	2.2009148	1.487612	3.269318053	3.2593306	0	3.5491068	0	0.059797899	1.125252	9.1388886	12.55499342	0.004305	0.7477516	0	0	2.441437	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8068	0	0	21.1849	0	0.032325	0	0.750841446	2.2009148	1.487612	3.269318053	3.2593306	0	3.5491068	0	0.059797899	1.125252	9.1388886	12.55499342	0.004305	0.7477516	0	0	2.441437	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8068																																																																																		0	0	0	21.1849	0	0.032325	0	0.750841446	2.2009148	1.487612	3.269318053	3.2593306	0	3.5491068	0	0.059797899	1.125252	9.1388886	12.55499342	0.004305	0.7477516	0	0	2.441437	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8068
H4008_001_0	2009	4	r.	s.	t.	u.							Part B Rx	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)																		A	A	A	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin						V		O		S	O	O	O							0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0						0		0		0	0	0	0							0		225.917008	5.232621	22.750241	183.320045	177.546988	13.51383	6.819286	417.344998	293.400899	1500.991431	801.855632	0	4.900791	893.862785	4414.339303	4557.502578	43.300658	772.318085			6.509424						0.33		0.05		139.761567	1.23	1.3	0.06							$175/Admit:1a	$175/Admit:1b	$0/Admit(Days 1-100) $0(Days 100-100):2	$0/Visit:6	$15/Trip:10a	0% Coins:11a	0% Coins:11b	$35/Visit:4a	"$0-$10/Visit:9b. $0 Surgery ASC -- Physician,9b. $0 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $10 Surgery OP -- Facility"	"$0-$10/Visit:8a. $0 Lab -- FSL,8. $10 Lab -- OP"	"$0-$15/Visit:14h. $0 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $0 Advanced Imaging -- FSR,8b. $10 Advanced Imaging -- Office,9a. $15 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $10 Radiology OP -- Facility"	$10/Visit:9a	$0/Proc:12	"$10/Visit:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$10/Visit:7b, 7d, 7f"	"$10/Visit:7e, 7h"	"$10/Visit:7d, 9a"			0% Coins:15						Hearing 300		$0 Additional Smoking Cessation 14a		$0/Script:15	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0: Nurse hotline 14a							174.999997	174.999873	0	0	15.000017	0	0	34.999992	6.406074	7.741946	8.226343	0	0	9.999991	0	9.999997	9.999755	9.999993			0						0		0		0	0	0	0							174.999997	174.999873	0	0	15.000017	0	0	34.999992	6.406074	7.741946	8.226343	0	0	9.999991	0	9.999997	9.999755	9.999993			0						0		0		0	0	0	0							3.2946	0.076309001	0	0	0.221933987	0	0	1.217255966	0.156628989	0.968382884	0.549694955	0	0	0.744884984	0	3.797917676	0.036082998	0.643597954	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.7073	0	0	3.2946	0.076309001	0	0	0.221933987	0	0	1.217255966	0.156628989	0.968382884	0.549694955	0	0	0.744884984	0	3.797917676	0.036082998	0.643597954	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.7073																																																																																		0	0	0	3.2946	0.076309001	0	0	0.221933987	0	0	1.217255966	0.156628989	0.968382884	0.549694955	0	0	0.744884984	0	3.797917676	0.036082998	0.643597954	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.7073
H4008_801_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		312.656608	7.241657	761.549395	253.704772	12.120629	25.881764	13.060336	35.367165	75.3488	2077.28888	36.540335	0	0.281561	29.311393	55.158423	77.356267	0.891894	8.297967			29.704664																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000017	1024.000446	43.132797	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				1024.000017	1024.000446	43.132797	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167	0	0	26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167																																																																																		0	0	0	26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167
H4008_802_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		312.656608	7.241657	761.549395	253.704772	12.120629	25.881764	13.060336	35.367165	75.3488	2077.28888	36.540335	0	0.281561	29.311393	55.158423	77.356267	0.891894	8.297967			29.704664																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000017	1024.000446	43.132797	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				1024.000017	1024.000446	43.132797	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167	0	0	26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167																																																																																		0	0	0	26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167
H4008_803_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		312.656608	7.241657	761.549395	253.704772	12.120629	25.881764	13.060336	35.367165	75.3488	2077.28888	36.540335	0	0.281561	29.311393	55.158423	77.356267	0.891894	8.297967			29.704664																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000017	1024.000446	43.132797	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				1024.000017	1024.000446	43.132797	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167	0	0	26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167																																																																																		0	0	0	26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167
H4008_804_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		312.656608	7.241657	761.549395	253.704772	12.120629	25.881764	13.060336	35.367165	75.3488	2077.28888	36.540335	0	0.281561	29.311393	55.158423	77.356267	0.891894	8.297967			29.704664																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000017	1024.000446	43.132797	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				1024.000017	1024.000446	43.132797	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167	0	0	26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167																																																																																		0	0	0	26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167
H4008_805_0	2009	4																																			V	Coin	Coin	Coin	Coin	Coin	V	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					253.704772	12.120629	25.881764	13.060336	35.367165	75.3488	2077.28888	36.540335	0	0.281561	29.311393	55.158423	77.356267	0.891894	8.297967			29.704664																							$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																							0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																							0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317	0	0	0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317																																																																																		0	0	0	0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317
H4008_806_0	2009	4																																			V	Coin	Coin	Coin	Coin	Coin	V	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					253.704772	12.120629	25.881764	13.060336	35.367165	75.3488	2077.28888	36.540335	0	0.281561	29.311393	55.158423	77.356267	0.891894	8.297967			29.704664																							$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																							0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																							0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317	0	0	0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317																																																																																		0	0	0	0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317
H4008_807_0	2009	4																																			V	Coin	Coin	Coin	Coin	Coin	V	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					253.704772	12.120629	25.881764	13.060336	35.367165	75.3488	2077.28888	36.540335	0	0.281561	29.311393	55.158423	77.356267	0.891894	8.297967			29.704664																							$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																							0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																							0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317	0	0	0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317																																																																																		0	0	0	0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317
H4008_808_0	2009	4																																			V	Coin	Coin	Coin	Coin	Coin	V	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					253.704772	12.120629	25.881764	13.060336	35.367165	75.3488	2077.28888	36.540335	0	0.281561	29.311393	55.158423	77.356267	0.891894	8.297967			29.704664																							$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																							0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																							0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317	0	0	0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317																																																																																		0	0	0	0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317
H4009_002_0	2009	9																					3250											Coin	Coin	Coin	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V	V	S	O	T	V	V	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	0	0	0	0	0											0		93.26972918	0.804932846	4.923913195	1913.836977	248.9058663	4.000883963	4.53613506	195.6541391	148.817749	1264.277083	390.1293898	0	57.71426484	335.1640365	11423.71903	19194.12265	1.096913744	585.3158057	3967.799975	10720.18889	173.9329732	1572.209586	4000	2339.730736	476.3318547	9.756303906	151.9320839	17.78632914	0	27410.15866											"$0 copay, days 1-1"	"$0 copay, days 1-1"	"$0 copay, days 1-1"	$0 copay	$0 copay	10% coinsurance	10% coinsurance	$25 copay	$0 copay	$0 copay	$0 copay		$0 copay	Varies	$0 copay	$0 copay	"20% coinsurance Group, 20% coinsurance Individual"	$10 copay	$0 copay	Varies		Varies	$0 Copay	$0 copay	$0 copay	$0 copay; and $350 credit covered every 1years	$0 copay	$500 credit	Varies	Varies											0	0	0	0	0	0.1	0.1	22.5	0	0	0	0	0	6.107422535	0.11540971	0.097059768	0.2	10	0	0.533444201	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0.1	0.1	22.5	0	0	0	0	0	6.107422535	0.11540971	0.097059768	0.2	10	0	0.533444201	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0.400088396	0.453613506	0.366851511	0	0	0	0	0	0.170582366	0.109867342	0.15524809	0.219382749	0.487763171	0	0.476551883	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.8399		0	0	0	0	0	0	0.400088396	0.453613506	0.366851511	0	0	0	0	0	0.170582366	0.109867342	0.15524809	0.219382749	0.487763171	0	0.476551883	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.8399																																																																																		0			0	0	0	0	0	0.400088396	0.453613506	0.366851511	0	0	0	0	0	0.170582366	0.109867342	0.15524809	0.219382749	0.487763171	0	0.476551883	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.8399
H4009_003_0	2009	12																					3250											D	D	D	V	Coin	Coin	Coin	V	Coin	V	V	V	V	V	V	V	Coin	Coin	V	V	S	O	T	V	V	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	0	0	0	0	0											0		1019.435122	19.22408791	217.2593149	2058.893116	2.553308192	3.037059651	3.502069091	171.6718592	13.73063962	1653.746874	496.9162364	0	78.72174055	449.2270827	7594.424538	10396.51257	1.040687564	3.699157208	3617.586474	8976.320803	142.1537575	767.5453403	4000	1555.522479	426.6644066	2.604086452	182.8561743	22.08292297	0	30461.50519											"$25 copay, days 1-5"	"$25 copay, days 1-5"	"$5 copay, days 8-100"	$0 copay	20% coinsurance	20% coinsurance	20% coinsurance	$25 copay	20% coinsurance	$5 copay to 20% coinsurance	$5 copay to 20% coinsurance		$0 copay	Varies	$5 copay	$10 copay	"50% coinsurance Group, 50% coinsurance Individual"	20% coinsurance	$5 copay	Varies		Varies	$0 Copay	$0 copay	$0 copay	$0 copay; and $100 credit covered every 1years	$0 copay	$100 credit	Varies	Varies											14.15909091	12.15432099	3.202107622	0	0.2	0.2	0.2	22.5	0.2	11.7645514	18.64406641	0	0	45.32699735	4.646410987	9.399071367	0.5	0.2	2.41930417	4.733597986	0	0	0	0	0	0	0	0	0	0											13.66429028	12.15432099	3.140257543	0	0.2	0.189817441	0.191169495	22.5	0.19549547	11.7645514	18.64406641	0	0	45.32699735	4.541977126	9.256104912	0.5	0.2	2.295604012	4.671747907	0	0	0	0	0	0	0	0	0	0											1.1608	0.019471311	0.056854184	0	0.510661638	0.576486891	0.669488779	0.321884736	2.684277845	1.621299176	0.772044943	0	0	1.696842899	2.874475211	8.019267589	0.520343782	0.739831442	0.692045502	3.494592327	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.4307		1.237	1.1608	0.019471311	0.056854184	0	0.510661638	0.576486891	0.669488779	0.321884736	2.684277845	1.621299176	0.772044943	0	0	1.696842899	2.874475211	8.019267589	0.520343782	0.739831442	0.692045502	3.494592327	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.4307																																																																																		0			1.1608	0.019471311	0.056854184	0	0.510661638	0.576486891	0.669488779	0.321884736	2.684277845	1.621299176	0.772044943	0	0	1.696842899	2.874475211	8.019267589	0.520343782	0.739831442	0.692045502	3.494592327	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.4307
H4009_004_0	2009	8																					3250											Coin	Coin	Coin	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	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	0	0	0	0	0											0		84.07360492	0.629331366	4.889726672	2093.403126	219.1044008	16679.3299	16761.92745	174.677668	198.0163458	1710.973792	521.7329533	0	80.20004383	460.4139999	10530.44464	18230.02363	157.9867569	537.1289003	3765.07816	8976.384167	144.7888646	778.9250632	4000	2339.730736	433.1334045	13.63706	185.6286019	22.43364148	0	42474.97339											"$0 copay, days 1-7"	"$0 copay, days 1-7"	"$0 copay, days 1-7"	$0 copay	$0 copay	$0 copay	$0 copay	$25 copay	$0 copay	$0 copay	$0 copay		$0 copay	Varies	$0 copay	$0 copay	"$10 copay Group, $10 copay Individual"	$5 copay	$0 copay	Varies		Varies	$0 Copay	$0 copay	$0 copay	$0 copay; and $500 credit covered every 1years	$0 copay	$500 credit	Varies	Varies											0	0	0	0	0	0	0	22.5	0	0	0	0	0	4.761064865	0	0	10	5	0	0	0	0	0	0	0	0	0	0	0	0.00057482											0	0	0	0	0	0	0	22.5	0	0	0	0	0	4.761064865	0	0	10	5	0	0	0	0	0	0	0	0	0	0	0	0.00057482											0	0	0	0	0	0	0	0.327520627	0	0	0	0	0	0.182671743	0	0	0.131655631	0.223803708	0	0	0	0	0	0	0	0	0	0	0	0.002034623	0	0	0	0	0	0	0	0	0	0	0.8677		0	0	0	0	0	0	0	0	0.327520627	0	0	0	0	0	0.182671743	0	0	0.131655631	0.223803708	0	0	0	0	0	0	0	0	0	0	0	0.002034623	0	0	0	0	0	0	0	0	0	0	0.8677																																																																																		0			0	0	0	0	0	0	0	0.327520627	0	0	0	0	0	0.182671743	0	0	0.131655631	0.223803708	0	0	0	0	0	0	0	0	0	0	0	0.002034623	0	0	0	0	0	0	0	0	0	0	0.8677
H4009_006_0	2009	15																					3250											Coin	Coin	Coin	V	T	P	P	V	V	V	V	V	V	V	V	V	Coin	V	V	V	S	O	T	V	V	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	0	0	0	0	0											0		130.3389873	0.976917867	0.053714906	2681.402658	280.4697959	21350.77267	21456.50363	234.9570647	254.2139953	2196.508971	669.9561167	0	102.902815	591.3308017	13466.33157	23265.34836	1.381583991	701.4525366	4833.565994	11447.49884	185.8054179	998.1155844	4000	2339.730736	554.8905382	6.323430587	237.8102307	28.71671599	0	36605.33746											"$0 copay, days 1-7"	"$0 copay, days 1-7"	"$0 copay, days 1-7"	$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 Group, $0 copay Individual"	$0 copay	$0 copay	Varies		Varies	$0 Copay	$0 copay	$0 copay	$0 copay; and $300 credit covered every 1years	$0 copay	$300 credit	Varies	Varies											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.105169122	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.105169122	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.10032695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.1003		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.10032695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.1003																																																																																		0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.10032695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.1003
H4009_007_0	2009	15																					3250											Coin	Coin	Coin	V	T	P	P	V	V	V	V	V	V	V	V	V	Coin	V	V	V	S	O	T	V	V	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	0	0	0	0	0											0		130.3402782	0.975626923	0.053714906	2797.057715	292.8204501	22290.96664	22401.35353	244.53205	264.7115206	2287.253558	697.4766422	0	107.2069023	615.9278646	14068.94126	24350.95201	1.382816806	739.2345303	5031.970318	11986.77264	193.5486274	1041.010872	4000	2339.730736	578.8575277	6.327919814	248.0817976	29.98127365	0	36633.11651											"$0 copay, days 1-7"	"$0 copay, days 1-7"	"$0 copay, days 1-7"	$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 Group, $0 copay Individual"	$0 copay	$0 copay	Varies		Varies	$0 Copay	$0 copay	$0 copay	$0 copay; and $200 credit covered every 1years	$0 copay	$200 credit	Varies	Varies											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.105802407	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.105802407	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.105685783	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.1057		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.105685783	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.1057																																																																																		0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.105685783	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.1057
H4009_008_0	2009	7																					3250											Coin	Coin	Coin	V	T	P	P	V	V	V	V	V	V	V	V	V	Coin	V	V	V	S	O	T	V	V	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	0	0	0	0	0											0		91.70615579	0.791474845	4.823396492	2087.756218	272.6084106	21187.6879	21280.35743	168.9374246	188.9172453	1630.77768	503.2042318	0	74.4515866	432.8609549	10788.47681	18134.1398	1.160317667	588.9753457	3744.045835	10173.72176	135.4800927	811.7237126	6000	2339.730736	446.8984886	9.602336916	191.5279237	22.434051	0	36481.51556											"$0 copay, days 1-7"	"$0 copay, days 1-7"	"$0 copay, days 1-7"	$0 copay	$0 copay	$0 copay	$0 copay	$25 copay	$0 copay	$0 copay	$0 copay		$0 copay	Varies	$0 copay	$0 copay	"$0 copay Group, $0 copay Individual"	$0 copay	$0 copay	Varies		Varies	$0 Copay	$0 copay	$0 copay	$0 copay; and $350 credit covered every 1years	$0 copay	$500 credit	Varies	Varies											0	0	0	0	0	0	0	22.5	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	22.5	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	0.316757671	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.3168		0	0	0	0	0	0	0	0	0.316757671	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.3168																																																																																		0			0	0	0	0	0	0	0	0.316757671	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.3168
H4009_009_0	2009	14																					3250											Coin	Coin	D	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	V	V	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	0	0	0	0	0											0		88.04094123	0.659885199	255.5619939	2412.768231	253.2009244	14902.6037	14997.51274	207.3840341	229.4978623	1979.73375	603.2475571	0	92.89801708	533.5989516	9112.675235	12451.42607	183.8011318	614.4071482	4357.91061	10287.52083	167.7403566	901.0344435	4000	2339.730736	500.9409187	7.801945098	201.8814151	25.92471325	0	36544.08246											"$0 copay, days 1-7"	"$0 copay, days 1-7"	"$3 copay, days 8-100"	$3 copay	$0 copay	$3 copay	$3 copay	$12.5 copay	$0 copay	$2 copay	$2 copay		$0 copay	Varies	$0 copay	$2 copay	"$3 copay Group, $3 copay Individual"	$3 copay	$2 copay	Varies		Varies	$0 Copay	$0 copay	$0 copay	$0 copay; and $250 credit covered every 1 year(s)	$0 copay	$250 credit	Varies	Varies											0	0	1.921264573	3	0	1.866758066	1.131951731	11.25	0	2	2	0	0	2.856635237	0.044860124	1.395269009	3	3	0.969345165	1.842968565	0	0.274949736	0	0	0	0	0	0	0	0.00038604											0	0	1.920166972	2.997804797	0	1.866209265	1.13140293	11.25	0	2	2	0	0	2.856635237	0.043004802	1.392733925	3	3	0.967149962	1.841870963	0	0.274949736	0	0	0	0	0	0	0	0.00038604											0	0	0.040893475	0.602750681	0	2.317614759	1.414019155	0.194422532	0	0.329955625	0.10054126	0	0	0.127024797	0.0326574	1.445126958	0.045950283	0.153601787	0.351229423	1.579023825	0	0.020644932	0	0	0	0	0	0	0	0.001175623	0	0	0	0	0	0	0	0	0	0	8.7566		0.022	0	0	0.040893475	0.602750681	0	2.317614759	1.414019155	0.194422532	0	0.329955625	0.10054126	0	0	0.127024797	0.0326574	1.445126958	0.045950283	0.153601787	0.351229423	1.579023825	0	0.020644932	0	0	0	0	0	0	0	0.001175623	0	0	0	0	0	0	0	0	0	0	8.7566																																																																																		0			0	0	0.040893475	0.602750681	0	2.317614759	1.414019155	0.194422532	0	0.329955625	0.10054126	0	0	0.127024797	0.0326574	1.445126958	0.045950283	0.153601787	0.351229423	1.579023825	0	0.020644932	0	0	0	0	0	0	0	0.001175623	0	0	0	0	0	0	0	0	0	0	8.7566
H4009_010_0	2009	7																					3250											Coin	Coin	Coin	V	T	P	P	V	V	V	V	V	V	V	V	V	Coin	V	V	V	S	O	T	V	V	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	0	0	0	0	0											0		93.32506789	0.806841753	4.885195289	2085.805697	271.5768419	21107.51225	21199.83111	169.5704214	189.5145934	1635.866065	505.030711	0	74.59782473	433.9390506	10724.58723	17939.26414	1.142526535	573.4287259	3750.782874	10072.8061	135.7936965	810.9614731	4000	2670.427462	446.2656981	8.146512648	191.2567278	22.34915903	0	42478.71173											"$0 copay, days 1-7"	"$0 copay, days 1-7"	"$0 copay, days 1-7"	$0 copay	$0 copay	$0 copay	$0 copay	$25 copay	$0 copay	$0 copay	$0 copay		$0 copay	Varies	$0 copay	$0 copay	"$0 copay Group, $0 copay Individual"	$0 copay	$0 copay	Varies		Varies	$0 Copay	$0 copay	$0 copay	$0 copay; and $300 credit covered every 1years	$0 copay	$800 credit	Varies	Varies											0	0	0	0	0	0	0	22.5	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.000571501											0	0	0	0	0	0	0	22.5	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.000571501											0	0	0	0	0	0	0	0.31794454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.002023052	0	0	0	0	0	0	0	0	0	0	0.32		0	0	0	0	0	0	0	0	0.31794454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.002023052	0	0	0	0	0	0	0	0	0	0	0.32																																																																																		0			0	0	0	0	0	0	0	0.31794454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.002023052	0	0	0	0	0	0	0	0	0	0	0.32
H4009_011_0	2009	7																					3250											Coin	Coin	Coin	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V	V	S	O	T	V	V	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	0	0	0	0	0											0		82.78799968	0.620513307	4.805053604	2048.643763	214.284377	3.086470861	3.552189782	171.3819993	194.2244349	1678.175559	511.8594986	0	78.61975135	451.3554745	10283.31202	17767.79231	1.056224834	511.8126034	3692.938395	8719.162706	141.9589517	762.5797121	4000	2339.730736	423.9471596	9.335943173	181.6916398	21.94012933	0	36458.73854											"$0 copay, days 1-1"	"$0 copay, days 1-1"	"$0 copay, days 1-1"	$0 copay	$0 copay	10% coinsurance	10% coinsurance	$25 copay	$0 copay	$0 copay	$0 copay		$0 copay	Varies	$0 copay	$0 copay	"20% coinsurance Group, 20% coinsurance Individual"	$10 copay	$0 copay	Varies		Varies	$0 Copay	$0 copay	$0 copay	$0 copay; and $350 credit covered every 1years	$0 copay	$500 credit	Varies	Varies											0	0	0	0	0	0.1	0.1	22.5	0	0	0	0	0	6.132420354	0.115734838	0.094650149	0.2	10	0	0.510219472	0	0	0	0	0	0	0	0	0	0.000654942											0	0	0	0	0	0.1	0.1	22.5	0	0	0	0	0	6.132420354	0.115734838	0.094650149	0.2	10	0	0.510219472	0	0	0	0	0	0	0	0	0	0.000654942											0	0	0	0	0	0.308647086	0.355218978	0.321341249	0	0	0	0	0	0.230658458	0.099178121	0.140143683	0.211244967	0.426510503	0	0.370723883	0	0	0	0	0	0	0	0	0	0.001989864	0	0	0	0	0	0	0	0	0	0	2.4657		0	0	0	0	0	0	0.308647086	0.355218978	0.321341249	0	0	0	0	0	0.230658458	0.099178121	0.140143683	0.211244967	0.426510503	0	0.370723883	0	0	0	0	0	0	0	0	0	0.001989864	0	0	0	0	0	0	0	0	0	0	2.4657																																																																																		0			0	0	0	0	0	0.308647086	0.355218978	0.321341249	0	0	0	0	0	0.230658458	0.099178121	0.140143683	0.211244967	0.426510503	0	0.370723883	0	0	0	0	0	0	0	0	0	0.001989864	0	0	0	0	0	0	0	0	0	0	2.4657
H4009_012_0	2009	6																					3250											Coin	Coin	Coin	V	T	P	P	V	V	V	V	V	V	V	V	V	Coin	V	V	V	S	O	T	V	V	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	0	0	0	0	0											0		92.71091442	0.902093491	7.556327255	2077.908973	333.0665609	26294.4976	26398.2587	163.1684672	179.1592833	1544.508116	484.2554169	0	67.93773357	401.8077278	10975.95858	17685.97581	1.03208033	603.782303	3725.877741	11395.28907	125.0478754	848.3349724	6000	2339.730736	461.700396	9.600848905	197.8715983	22.27747116	0	36484.80364											"$0 copay, days 1-7"	"$0 copay, days 1-7"	"$0 copay, days 1-7"	$0 copay	$0 copay	$0 copay	$0 copay	$25 copay	$0 copay	$0 copay	$0 copay		$0 copay	Varies	$0 copay	$0 copay	"$0 copay Group, $0 copay Individual"	$0 copay	$0 copay	Varies		Varies	$0 Copay	$0 copay	$0 copay	$0 copay; and $350 credit covered every 1years	$0 copay	$500 credit	Varies	Varies											0	0	0	0	0	0	0	22.5	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.000661751											0	0	0	0	0	0	0	22.5	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.000661751											0	0	0	0	0	0	0	0.305940876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.002011989	0	0	0	0	0	0	0	0	0	0	0.308		0	0	0	0	0	0	0	0	0.305940876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.002011989	0	0	0	0	0	0	0	0	0	0	0.308																																																																																		0			0	0	0	0	0	0	0	0.305940876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.002011989	0	0	0	0	0	0	0	0	0	0	0.308
H4011_001_0	2009	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	302.374969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											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	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	0.629947852	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.6299	0	0	0	0	0	0	0	0	0	0.629947852	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.6299		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.4464	0	0	0.5323	0.667	1.1348	0.1617	0.2099	0	0.1481	0.3764	0	0	0	1.1646	0.5932	0	0.1713	0	1.442	0.0438	0.0243	0	0.011	0.02	0	0	0.0063	0	0											7.1531	0	0	0.4464	0	0	0.53232937	0.666967851	1.134799289	0.161713887	0.839879167	0	0.148141471	0.376385284	0	0	0	1.164574732	0.593226904	0	0.171266624	0	1.441956291	0.043836414	0.024304721	0	0.011033386	0.019979666	0	0	0.006250544	0	0	0	0	0	0	0	0	0	0	0	0	7.783
H4011_003_0	2009	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	302.374969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											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	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	0.629947852	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.6299	0	0	0	0	0	0	0	0	0	0.629947852	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.6299		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.4464	0	0	0.5323	0.667	1.1348	0.1617	0.2099	0	0.1481	0.3764	0	0	0	1.1646	0.5936	0	0.1713	0	1.442	0.0438	0.0243	0	0.0263	0.02	0	0	0.0083	0	0											7.1708	0	0	0.4464	0	0	0.53232937	0.666967851	1.134799289	0.161713887	0.839879167	0	0.148141471	0.376385284	0	0	0	1.164574732	0.593560205	0	0.171266624	0	1.441956291	0.043836414	0.024304721	0	0.026314695	0.019979666	0	0	0.008334059	0	0	0	0	0	0	0	0	0	0	0	0	7.8007
H4011_004_0	2009	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	302.374969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											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	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	0.629947852	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.6299	0	0	0	0	0	0	0	0	0	0.629947852	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.6299		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.4464	0	0	0.5323	0.667	1.1348	0.1617	0.2099	0	0.1481	0.3764	0	0	0	1.1646	0.5936	0	0.1713	0	1.442	0.0438	0.0243	0	0.0319	0.02	0	0	0.0104	0	0											7.1784	0	0	0.4464	0	0	0.53232937	0.666967851	1.134799289	0.161713887	0.839879167	0	0.148141471	0.376385284	0	0	0	1.164574732	0.593560205	0	0.171266624	0	1.441956291	0.043836414	0.024304721	0	0.031880456	0.019979666	0	0	0.010417574	0	0	0	0	0	0	0	0	0	0	0	0	7.8084
H4011_801_0	2009	5																																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		76.44376679	0	0	3.288413409	0.667215292	12.85201525	1.030350278	3.483985555	3.927317424	16.01009844	21.00556134	0	0	0	63.42725725	19.12607318	0.994404777	5.629964749	0	77.55399229	3.045947174	0.390794145	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307	0	0	11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.8843	0	0	0	0.7703	1.3107	0.1868	0.1959	0	0.1711	0.4347	0	0	0	1.3451	0.6833	0	0.1978	0	1.6655	0.0506	0.0281	0	0	0	0	0	0	0	0											7.9242	0	0	12.3826	0	0	0	0.9244746	4.279508701	0.424790453	1.000672268	0.907210325	3.869436139	5.287009673	0	0	0	15.99678024	5.101375163	0.229707504	1.498334808	0	19.58043173	0.754244855	0.1183454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.3549
H4011_802_0	2009	5																																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		76.44376679	0	0	3.288413409	0.667215292	12.85201525	1.030350278	3.483985555	3.927317424	16.01009844	21.00556134	0	0	0	63.42725725	19.12607318	0.994404777	5.629964749	0	77.55399229	3.045947174	0.390794145	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307	0	0	11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.8843	0	0	0	0.7703	1.3107	0.1868	0.1959	0	0.1711	0.4347	0	0	0	1.3451	0.6833	0	0.1978	0	1.6655	0.0506	0.0281	0	0	0	0	0	0	0	0											7.9242	0	0	12.3826	0	0	0	0.9244746	4.279508701	0.424790453	1.000672268	0.907210325	3.869436139	5.287009673	0	0	0	15.99678024	5.101375163	0.229707504	1.498334808	0	19.58043173	0.754244855	0.1183454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.3549
H4011_803_0	2009	6																																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		76.44376679	0	0	3.288413409	0.667215292	12.85201525	1.030350278	3.483985555	3.927317424	16.01009844	21.00556134	0	0	0	63.42725725	19.12607318	0.994404777	5.629964749	0	77.55399229	3.045947174	0.390794145	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307	0	0	11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.8843	0	0	0	0.7703	1.3107	0.1868	0.1959	0	0.1711	0.4347	0	0	0	1.3451	0.6833	0	0.1978	0	1.6655	0.0506	0.0281	0	0	0	0	0	0	0	0											7.9242	0	0	12.3826	0	0	0	0.9244746	4.279508701	0.424790453	1.000672268	0.907210325	3.869436139	5.287009673	0	0	0	15.99678024	5.101375163	0.229707504	1.498334808	0	19.58043173	0.754244855	0.1183454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.3549
H4011_805_0	2009	6																																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		76.44376679	0	0	3.288413409	0.667215292	12.85201525	1.030350278	3.483985555	3.927317424	16.01009844	21.00556134	0	0	0	63.42725725	19.12607318	0.994404777	5.629964749	0	77.55399229	3.045947174	0.390794145	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307	0	0	11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.8843	0	0	0	0.7703	1.3107	0.1868	0.1959	0	0.1711	0.4347	0	0	0	1.3451	0.6833	0	0.1978	0	1.6655	0.0506	0.0281	0	0	0	0	0	0	0	0											7.9242	0	0	12.3826	0	0	0	0.9244746	4.279508701	0.424790453	1.000672268	0.907210325	3.869436139	5.287009673	0	0	0	15.99678024	5.101375163	0.229707504	1.498334808	0	19.58043173	0.754244855	0.1183454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.3549
H4011_806_0	2009	5																																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		76.44376679	0	0	3.288413409	0.667215292	12.85201525	1.030350278	3.483985555	3.927317424	16.01009844	21.00556134	0	0	0	63.42725725	19.12607318	0.994404777	5.629964749	0	77.55399229	3.045947174	0.390794145	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307	0	0	11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.8843	0	0	0	0.7703	1.3107	0.1868	0.1959	0	0.1711	0.4347	0	0	0	1.3451	0.6833	0	0.1978	0	1.6655	0.0506	0.0281	0	0	0	0	0	0	0	0											7.9242	0	0	12.3826	0	0	0	0.9244746	4.279508701	0.424790453	1.000672268	0.907210325	3.869436139	5.287009673	0	0	0	15.99678024	5.101375163	0.229707504	1.498334808	0	19.58043173	0.754244855	0.1183454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.3549
H4011_807_0	2009	5																																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		76.44376679	0	0	3.288413409	0.667215292	12.85201525	1.030350278	3.483985555	3.927317424	16.01009844	21.00556134	0	0	0	63.42725725	19.12607318	0.994404777	5.629964749	0	77.55399229	3.045947174	0.390794145	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307	0	0	11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.8843	0	0	0	0.7703	1.3107	0.1868	0.1959	0	0.1711	0.4347	0	0	0	1.3451	0.6833	0	0.1978	0	1.6655	0.0506	0.0281	0	0	0	0	0	0	0	0											7.9242	0	0	12.3826	0	0	0	0.9244746	4.279508701	0.424790453	1.000672268	0.907210325	3.869436139	5.287009673	0	0	0	15.99678024	5.101375163	0.229707504	1.498334808	0	19.58043173	0.754244855	0.1183454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.3549
H4011_809_0	2009	5																																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		76.44376679	0	0	3.288413409	0.667215292	12.85201525	1.030350278	3.483985555	3.927317424	16.01009844	21.00556134	0	0	0	63.42725725	19.12607318	0.994404777	5.629964749	0	77.55399229	3.045947174	0.390794145	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307	0	0	11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.8843	0	0	0	0.7703	1.3107	0.1868	0.1959	0	0.1711	0.4347	0	0	0	1.3451	0.6833	0	0.1978	0	1.6655	0.0506	0.0281	0	0	0	0	0	0	0	0											7.9242	0	0	12.3826	0	0	0	0.9244746	4.279508701	0.424790453	1.000672268	0.907210325	3.869436139	5.287009673	0	0	0	15.99678024	5.101375163	0.229707504	1.498334808	0	19.58043173	0.754244855	0.1183454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.3549
H4011_810_0	2009	5																																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		76.44376679	0	0	3.288413409	0.667215292	12.85201525	1.030350278	3.483985555	3.927317424	16.01009844	21.00556134	0	0	0	63.42725725	19.12607318	0.994404777	5.629964749	0	77.55399229	3.045947174	0.390794145	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307	0	0	11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.8843	0	0	0	0.7703	1.3107	0.1868	0.1959	0	0.1711	0.4347	0	0	0	1.3451	0.6833	0	0.1978	0	1.6655	0.0506	0.0281	0	0	0	0	0	0	0	0											7.9242	0	0	12.3826	0	0	0	0.9244746	4.279508701	0.424790453	1.000672268	0.907210325	3.869436139	5.287009673	0	0	0	15.99678024	5.101375163	0.229707504	1.498334808	0	19.58043173	0.754244855	0.1183454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.3549
H4011_811_0	2009	5																																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		76.44376679	0	0	3.288413409	0.667215292	12.85201525	1.030350278	3.483985555	3.927317424	16.01009844	21.00556134	0	0	0	63.42725725	19.12607318	0.994404777	5.629964749	0	77.55399229	3.045947174	0.390794145	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307	0	0	11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.8843	0	0	0	0.7703	1.3107	0.1868	0.1959	0	0.1711	0.4347	0	0	0	1.3451	0.6833	0	0.1978	0	1.6655	0.0506	0.0281	0	0	0	0	0	0	0	0											7.9242	0	0	12.3826	0	0	0	0.9244746	4.279508701	0.424790453	1.000672268	0.907210325	3.869436139	5.287009673	0	0	0	15.99678024	5.101375163	0.229707504	1.498334808	0	19.58043173	0.754244855	0.1183454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.3549
H4011_813_0	2009	5																																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		76.44376679	0	0	3.288413409	0.667215292	12.85201525	1.030350278	3.483985555	3.927317424	16.01009844	21.00556134	0	0	0	63.42725725	19.12607318	0.994404777	5.629964749	0	77.55399229	3.045947174	0.390794145	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307	0	0	11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.8843	0	0	0	0.7703	1.3107	0.1868	0.1959	0	0.1711	0.4347	0	0	0	1.3451	0.6833	0	0.1978	0	1.6655	0.0506	0.0281	0	0	0	0	0	0	0	0											7.9242	0	0	12.3826	0	0	0	0.9244746	4.279508701	0.424790453	1.000672268	0.907210325	3.869436139	5.287009673	0	0	0	15.99678024	5.101375163	0.229707504	1.498334808	0	19.58043173	0.754244855	0.1183454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.3549
H4011_814_0	2009	5																																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		76.44376679	0	0	3.288413409	0.667215292	12.85201525	1.030350278	3.483985555	3.927317424	16.01009844	21.00556134	0	0	0	63.42725725	19.12607318	0.994404777	5.629964749	0	77.55399229	3.045947174	0.390794145	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307	0	0	11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.8843	0	0	0	0.7703	1.3107	0.1868	0.1959	0	0.1711	0.4347	0	0	0	1.3451	0.6833	0	0.1978	0	1.6655	0.0506	0.0281	0	0	0	0	0	0	0	0											7.9242	0	0	12.3826	0	0	0	0.9244746	4.279508701	0.424790453	1.000672268	0.907210325	3.869436139	5.287009673	0	0	0	15.99678024	5.101375163	0.229707504	1.498334808	0	19.58043173	0.754244855	0.1183454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.3549
H4011_815_0	2009	5																																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		76.44376679	0	0	3.288413409	0.667215292	12.85201525	1.030350278	3.483985555	3.927317424	16.01009844	21.00556134	0	0	0	63.42725725	19.12607318	0.994404777	5.629964749	0	77.55399229	3.045947174	0.390794145	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307	0	0	11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.8843	0	0	0	0.7703	1.3107	0.1868	0.1959	0	0.1711	0.4347	0	0	0	1.3451	0.6833	0	0.1978	0	1.6655	0.0506	0.0281	0	0	0	0	0	0	0	0											7.9242	0	0	12.3826	0	0	0	0.9244746	4.279508701	0.424790453	1.000672268	0.907210325	3.869436139	5.287009673	0	0	0	15.99678024	5.101375163	0.229707504	1.498334808	0	19.58043173	0.754244855	0.1183454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.3549
H4011_817_0	2009	5																																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		76.44376679	0	0	3.288413409	0.667215292	12.85201525	1.030350278	3.483985555	3.927317424	16.01009844	21.00556134	0	0	0	63.42725725	19.12607318	0.994404777	5.629964749	0	77.55399229	3.045947174	0.390794145	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307	0	0	11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.8843	0	0	0	0.7703	1.3107	0.1868	0.1959	0	0.1711	0.4347	0	0	0	1.3451	0.6833	0	0.1978	0	1.6655	0.0506	0.0281	0	0	0	0	0	0	0	0											7.9242	0	0	12.3826	0	0	0	0.9244746	4.279508701	0.424790453	1.000672268	0.907210325	3.869436139	5.287009673	0	0	0	15.99678024	5.101375163	0.229707504	1.498334808	0	19.58043173	0.754244855	0.1183454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.3549
H4011_818_0	2009	5																																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		76.44376679	0	0	3.288413409	0.667215292	12.85201525	1.030350278	3.483985555	3.927317424	16.01009844	21.00556134	0	0	0	63.42725725	19.12607318	0.994404777	5.629964749	0	77.55399229	3.045947174	0.390794145	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307	0	0	11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.8843	0	0	0	0.7703	1.3107	0.1868	0.1959	0	0.1711	0.4347	0	0	0	1.3451	0.6833	0	0.1978	0	1.6655	0.0506	0.0281	0	0	0	0	0	0	0	0											7.9242	0	0	12.3826	0	0	0	0.9244746	4.279508701	0.424790453	1.000672268	0.907210325	3.869436139	5.287009673	0	0	0	15.99678024	5.101375163	0.229707504	1.498334808	0	19.58043173	0.754244855	0.1183454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.3549
H4011_819_0	2009	5																																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		76.44376679	0	0	3.288413409	0.667215292	12.85201525	1.030350278	3.483985555	3.927317424	16.01009844	21.00556134	0	0	0	63.42725725	19.12607318	0.994404777	5.629964749	0	77.55399229	3.045947174	0.390794145	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.150414263	0	0.180348378	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0	0	0	0	0											11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307	0	0	11.4982	0	0	0	0.154126732	2.968815522	0.238010914	0.804800663	0.907210325	3.69833274	4.85228467	0	0	0	14.65169643	4.418122904	0.229707504	1.300521857	0	17.91497222	0.703613797	0.090273448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4307		"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.8843	0	0	0	0.7703	1.3107	0.1868	0.1959	0	0.1711	0.4347	0	0	0	1.3451	0.6833	0	0.1978	0	1.6655	0.0506	0.0281	0	0	0	0	0	0	0	0											7.9242	0	0	12.3826	0	0	0	0.9244746	4.279508701	0.424790453	1.000672268	0.907210325	3.869436139	5.287009673	0	0	0	15.99678024	5.101375163	0.229707504	1.498334808	0	19.58043173	0.754244855	0.1183454	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.3549
H4012_001_0	2009	6																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	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	0	0	0											0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																		0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H4012_003_0	2009	7																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	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	0	0	0											0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																		0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H4012_004_0	2009	6																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	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	0	0	0											0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																		0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H4012_005_0	2009	7																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	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	0	0	0											0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																		0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H4036_001_0	2009	10	H.6	H.7	I.7	I.8	I.9	I.10	I.11	I.12	I.13	I.14	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional	Professional		CORF	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies\Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Partial Hosp	Chemo/Radiation	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	0	Coin	0	0	0	V	V	V	0	V	0	V	V	V	V	V	Coin	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	0	0	0	0	0	0	0	0	0		1181.001995	72.2147061	519.4076377	385.0703428	91.6513137	9.097331198	1.789022323	279.4395149	369.1472243	4276.110187	765.2067615	118.6384457	0.023798246	96.8843262	3059.42638	2923.800956	25.45493425	1102.057441	2002.521562	0	33.96151299	0	0	0	301.0780768	276.076979	149.5801692	0	0	0	0	0.004931279	161.9540143	338.2891911	99.11939675	0.4603431	636.7536247	26.32858976	1.345615642	16.27136311	$220/day (days 1-10) w/$2200 yrly max	$220/day (days 1-10) w/$2200 yrly max	$100/day (for days 21-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$200 copay	$0 copay	$75/$125 copay for Lower/Higher Tier	$200 copay	20% coinsurance	$0 copay	$15 coapy	$30 copay	$35 copay	$30 copay	$75/$125 copay for Lower/Higher Tier	0	20% coinsurance	0	0	0	$30 copay/ $50 limit	$30 copay / Covd up to $50	$30 copay/ $50 limit	0	Silver Sneakers	0	$30 copay	$0 copay	$30 copay	$30 copay	$0 copay	20% coinsurance	$30 copay	$30 copay	$35 copay	20% coinsurance	220	220	100	0	100	0.2	0.2	50	200	0	92.27725674	200	0.2	0	15	30	35	30	80.68445476	0	0.2	0	0	0	30	30	30	0	0	0	30	0	30	30	0	0.2	30	30	35	0.2	134.8043367	88.45790077	91.17619734	0	91.17619734	0.182352395	0.182352395	45.58809867	182.3523947	0	84.1348937	182.3523947	0.182352395	0	13.6764296	27.3528592	31.91166907	27.3528592	73.56501769	0	0.182352395	0	0	0	27.3528592	27.3528592	27.3528592	0	0	0	0	0	27.3528592	27.3528592	0	0.182352395	27.3528592	27.3528592	31.91166907	0.182352395	13.267	0.532330109	3.946467772	0	0.696368189	1.658920129	0.326232505	1.061593015	5.609573362	0	5.365049129	1.802833723	0.004339667	0	3.486835792	6.664526322	0.067692453	2.512035168	12.27629451	0	6.192963221	0	0	0	0.686278854	0.629291228	0.340953776	0	0	0	0	0	0.369158779	0.771098051	0	0.083944667	1.451419353	0.060013517	0.003578403	2.967122027	72.8339		7.0487	13.267	0.532330109	3.946467772	0	0.696368189	1.658920129	0.326232505	1.061593015	5.609573362	0	5.365049129	1.802833723	0.004339667	0	3.486835792	6.664526322	0.067692453	2.512035168	12.27629451	0	6.192963221	0	0	0	0.686278854	0.629291228	0.340953776	0	0	0	0	0	0.369158779	0.771098051	0	0.083944667	1.451419353	0.060013517	0.003578403	2.967122027	72.8339	4500	$300/day (Days 1-10)	$300/day (Days 1-10)	25% Coinsurance	$0 copay	$100 copay	30% Coinsurance	30% Coinsurance	$50 copay	$275 copay	$0 copay	25% Coinsurance	$275 copay	20% Coinsurance	$0 copay	$20 copay	$40 copay	$45 copay	$40 copay	25% Coinsurance		20% Coinsurance				$40 copay / $50 limit	$40 copay / Covd up to $50	$40 copay / $50 limit		Silver Sneakers		$40 copay	$40 copay	$40 copay	$40 copay	$0 copay	30% Coinsurance	$40 copay	$40 copay	$45 copay	20% coinsurance	5.6028	0.1227	0.8453		0.8845	0.3635	0.0117	0.1994	1.1059		1.0178	0.403			0.973	1.3912	0.0235	0.367	2.8738		0.7914				0.2342	0.2039						0	0.8694	0.3012		0.2153	0.2078	0.0161		0.3183	19.3428		1.871946982	18.8698	0.655018226	4.791782108	0	1.580876375	2.02241172	0.337916135	1.260961205	6.715470419	0	6.38289248	2.205830109	0.004339667	0	4.459828057	8.055764053	0.091153441	2.879029945	15.15014151	0	6.984389694	0	0	0	0.920463291	0.833216749	0.340953776	0	0	0	0	2.02E-06	1.238598309	1.072342374	0	0.299204049	1.659197246	0.076151606	0.003578403	3.285438562	92.1767
H4036_801_0	2009	3																					none											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	V											0	0	0	0	0	0	0	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	214.32843	2.331355497	51.47501788	14.53838428	4.713988332	9.258404553	2.613991362	8.104399907	29.73697303	6.025054579	18.928279	0	0.156334377	33.5650951	24.17065015	83.41475483	0.805220859	3.792370817	17.11020215	24.3979258	8.973162583	0.965391134	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.078797282	0.078797282	0.161888228	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.078797282	0.078797282	0.161888228	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											16.8885	0.183704477	8.333199456	0	1.088931305	2.138691452	0.603832005	1.872116378	6.869240771	1.391787608	4.37243245	0	0.036113241	7.753536968	5.583420184	19.26880837	0.186006018	0.876037659	3.952456698	5.635920861	2.072800557	0.223005352	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.3305	0	0	16.8885	0.183704477	8.333199456	0	1.088931305	2.138691452	0.603832005	1.872116378	6.869240771	1.391787608	4.37243245	0	0.036113241	7.753536968	5.583420184	19.26880837	0.186006018	0.876037659	3.952456698	5.635920861	2.072800557	0.223005352	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.3305	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											5.2797	0.0574	1.9978	0	0.4051	0.796	0.2247	0.5309	2.0578	0.3793	1.179	0	0.0132	1.5873	2.2118	6.322	0.0665	0.3176	1.6749	1.9845	0.4582	0.0493	0	0	0	0	0	0	0	0											27.593	0	0	22.1682	0.241134907	10.3309858	0	1.494049044	2.9346493	0.828560458	2.403009197	8.926998819	1.771094815	5.551432615	0	0.049329096	9.34085666	7.795224875	25.59078244	0.252516435	1.193598915	5.627331972	7.620459324	2.530951624	0.272295146	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.9235
H4036_802_0	2009	3																					none											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	V											0	0	0	0	0	0	0	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	214.32843	2.331355497	51.47501788	14.53838428	4.713988332	9.258404553	2.613991362	8.104399907	29.73697303	6.025054579	18.928279	0	0.156334377	33.5650951	24.17065015	83.41475483	0.805220859	3.792370817	17.11020215	24.3979258	8.973162583	0.965391134	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.078797282	0.078797282	0.161888228	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.078797282	0.078797282	0.161888228	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											16.8885	0.183704477	8.333199456	0	1.088931305	2.138691452	0.603832005	1.872116378	6.869240771	1.391787608	4.37243245	0	0.036113241	7.753536968	5.583420184	19.26880837	0.186006018	0.876037659	3.952456698	5.635920861	2.072800557	0.223005352	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.3305	0	0	16.8885	0.183704477	8.333199456	0	1.088931305	2.138691452	0.603832005	1.872116378	6.869240771	1.391787608	4.37243245	0	0.036113241	7.753536968	5.583420184	19.26880837	0.186006018	0.876037659	3.952456698	5.635920861	2.072800557	0.223005352	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.3305	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											5.2797	0.0574	1.9978	0	0.4051	0.796	0.2247	0.5309	2.0578	0.3793	1.179	0	0.0132	1.5873	2.2118	6.322	0.0665	0.3176	1.6749	1.9845	0.4582	0.0493	0	0	0	0	0	0	0	0											27.593	0	0	22.1682	0.241134907	10.3309858	0	1.494049044	2.9346493	0.828560458	2.403009197	8.926998819	1.771094815	5.551432615	0	0.049329096	9.34085666	7.795224875	25.59078244	0.252516435	1.193598915	5.627331972	7.620459324	2.530951624	0.272295146	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.9235
H4036_803_0	2009	3																					none											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	V											0	0	0	0	0	0	0	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	214.32843	2.331355497	51.47501788	14.53838428	4.713988332	9.258404553	2.613991362	8.104399907	29.73697303	6.025054579	18.928279	0	0.156334377	33.5650951	24.17065015	83.41475483	0.805220859	3.792370817	17.11020215	24.3979258	8.973162583	0.965391134	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.078797282	0.078797282	0.161888228	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.078797282	0.078797282	0.161888228	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											16.8885	0.183704477	8.333199456	0	1.088931305	2.138691452	0.603832005	1.872116378	6.869240771	1.391787608	4.37243245	0	0.036113241	7.753536968	5.583420184	19.26880837	0.186006018	0.876037659	3.952456698	5.635920861	2.072800557	0.223005352	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.3305	0	0	16.8885	0.183704477	8.333199456	0	1.088931305	2.138691452	0.603832005	1.872116378	6.869240771	1.391787608	4.37243245	0	0.036113241	7.753536968	5.583420184	19.26880837	0.186006018	0.876037659	3.952456698	5.635920861	2.072800557	0.223005352	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.3305	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											5.2797	0.0574	1.9978	0	0.4051	0.796	0.2247	0.5309	2.0578	0.3793	1.179	0	0.0132	1.5873	2.2118	6.322	0.0665	0.3176	1.6749	1.9845	0.4582	0.0493	0	0	0	0	0	0	0	0											27.593	0	0	22.1682	0.241134907	10.3309858	0	1.494049044	2.9346493	0.828560458	2.403009197	8.926998819	1.771094815	5.551432615	0	0.049329096	9.34085666	7.795224875	25.59078244	0.252516435	1.193598915	5.627331972	7.620459324	2.530951624	0.272295146	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.9235
H4102_001_0	2009	5																					3800											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2013.703026	147.5379392	1687.111704	2561.144837	336.8874004	8.920458999	4.78651138	414.0643973	33.92377433	12970.97716	57.75756201	0	0.073681868	38.56993553	5745.089607	6591.022678	724.2003015	868.6558089	0	0	12.5201055	1687.839637	0	0	255.7476656	0	18.89839441	0	789.719594	0											"$245 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$245 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$115 Days 1-25 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$15 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$0 n/c (13b, 13d, 13e)"											242.1026674	245	87.8078022	0	150	0.2	0.073510203	48.47425962	0.2	2.8	0.172644065	0	0.2	0.197540301	10.6388358	29.91726878	37.5	30	0	0	0.2	27.84810127	0	0	30	0	30	0	0	0											162.8254098	164.7570995	59.04881143	0	100.8716935	0.134495591	0.049433991	32.59787108	0.134495591	1.88293828	0.116099328	0	0.134495591	0.133080346	10.6388358	29.91726878	37.5	20.17433871	0	0	0.134495591	27.84810127	0	0	30	0	30	0	0	0											27.3235	2.025660244	8.301828406	0	2.831866884	1.199762409	0.23661636	1.124801487	4.562598091	2.035295785	6.705614156	0	0.009909886	5.13290035	5.093422082	16.43211642	2.263125942	1.460379709	0	0	1.683898994	3.916927429	0	0	0.639369164	0	0.047245986	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0268	0	31.4616	27.3235	2.025660244	8.301828406	0	2.831866884	1.199762409	0.23661636	1.124801487	4.562598091	2.035295785	6.705614156	0	0.009909886	5.13290035	5.093422082	16.43211642	2.263125942	1.460379709	0	0	1.683898994	3.916927429	0	0	0.639369164	0	0.047245986	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0268																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	27.3235	2.025660244	8.301828406	0	2.831866884	1.199762409	0.23661636	1.124801487	4.562598091	2.035295785	6.705614156	0	0.009909886	5.13290035	5.093422082	16.43211642	2.263125942	1.460379709	0	0	1.683898994	3.916927429	0	0	0.639369164	0	0.047245986	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0268
H4102_025_0	2009	5																					3300											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1734.127457	143.918888	1458.063866	2202.008126	290.5531687	7.13968068	3.748489044	467.3116998	31.02432079	11930.93744	50.92950037	0	0.057193206	29.76074275	5277.042486	6179.824354	723.1324979	779.9519766	0	0	12.31082733	1628.713267	0	0	250.5351592	0	18.87823156	0	788.8736113	0											"$245 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$245 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$115 Days 1-25 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$15 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$0 n/c (13b, 13d, 13e)"											242.1094934	245	87.8078022	0	150	0.2	0.076081235	48.76082398	0.2	2.8	0.172030054	0	0.2	0.196459917	10.56829536	25	37.5	25	0	0	0.2	23.18175917	0	0	25	0	25	0	0	0											162.77282	164.6965179	59.02709905	0	100.8346028	0.134446137	0.051144141	32.77852212	0.134446137	1.882245919	0.115643881	0	0.134446137	0.132374889	10.56829536	25	37.5	16.80576713	0	0	0.134446137	23.18175917	0	0	25	0	25	0	0	0											23.5224	1.975244976	7.172106689	0	2.441484446	0.959902487	0.191713252	1.276482241	4.171100085	1.871413192	5.889685098	0	0.007689406	3.939575009	4.647445303	12.87463407	2.259789056	1.092307608	0	0	1.655143178	3.146369892	0	0	0.521948248	0	0.039329649	0	0	0	0	0	0	0	0	0	0	0	0	0	79.6558	0	27.368	23.5224	1.975244976	7.172106689	0	2.441484446	0.959902487	0.191713252	1.276482241	4.171100085	1.871413192	5.889685098	0	0.007689406	3.939575009	4.647445303	12.87463407	2.259789056	1.092307608	0	0	1.655143178	3.146369892	0	0	0.521948248	0	0.039329649	0	0	0	0	0	0	0	0	0	0	0	0	0	79.6558																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.5224	1.975244976	7.172106689	0	2.441484446	0.959902487	0.191713252	1.276482241	4.171100085	1.871413192	5.889685098	0	0.007689406	3.939575009	4.647445303	12.87463407	2.259789056	1.092307608	0	0	1.655143178	3.146369892	0	0	0.521948248	0	0.039329649	0	0	0	0	0	0	0	0	0	0	0	0	0	79.6558
H4102_801_0	2009	2																					5740											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	Coin	V	V	Coin	O	T	V	P	P	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	1468.476941	152.3392373	1060.837611	1753.607223	237.9734536	6.587642685	4.830517271	361.0046022	41.7944185	14619.54006	53.35559946	0	0.034122292	44.14690313	6276.549896	7027.403022	718.0918734	6.846232337	0	0	16.29578173	1991.234161	0	0	0	0	0	0	0	0											"$410 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$410 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$140 Days 1-41 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 9a, 9d); $60 (5); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											405.1308165	410	140	0	150	0.2	0.079331311	47.83205353	0.2	2.8	0.166869522	0	0.2	0.20041106	16.09331471	34.64045712	37.5	0.2	0	0	0.2	31.19829492	0	0	0	0	0	0	0	0											302.6396098	306.2590656	104.5762663	0	112.0459996	0.149394666	0.059258373	35.72926835	0.149394666	2.091525326	0.124647083	0	0.149394666	0.149867046	16.09331471	34.64045712	37.5	0.149394666	0	0	0.149394666	31.19829492	0	0	0	0	0	0	0	0											37.0349	3.887939372	9.244869706	0	2.221997791	0.98415868	0.286248596	1.074869192	6.2438632	2.548094858	6.650619817	0	0.005097688	6.616165977	8.417541066	20.28603775	2.244037104	1.022790595	0	0	2.434502871	5.176925883	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.3807	0	27.173	37.0349	3.887939372	9.244869706	0	2.221997791	0.98415868	0.286248596	1.074869192	6.2438632	2.548094858	6.650619817	0	0.005097688	6.616165977	8.417541066	20.28603775	2.244037104	1.022790595	0	0	2.434502871	5.176925883	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.3807																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	37.0349	3.887939372	9.244869706	0	2.221997791	0.98415868	0.286248596	1.074869192	6.2438632	2.548094858	6.650619817	0	0.005097688	6.616165977	8.417541066	20.28603775	2.244037104	1.022790595	0	0	2.434502871	5.176925883	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.3807
H4102_802_0	2009	2																					5740											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	Coin	V	V	Coin	O	T	V	P	P	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	1468.476941	152.3392373	1060.837611	1753.607223	237.9734536	6.587642685	4.830517271	361.0046022	41.7944185	14619.54006	53.35559946	0	0.034122292	44.14690313	6276.549896	7027.403022	718.0918734	6.846232337	0	0	16.29578173	1991.234161	0	0	0	0	0	0	0	0											"$410 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$410 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$140 Days 1-41 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 9a, 9d); $60 (5); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											405.1308165	410	140	0	150	0.2	0.079331311	47.83205353	0.2	2.8	0.166869522	0	0.2	0.20041106	16.09331471	34.64045712	37.5	0.2	0	0	0.2	31.19829492	0	0	0	0	0	0	0	0											302.6396098	306.2590656	104.5762663	0	112.0459996	0.149394666	0.059258373	35.72926835	0.149394666	2.091525326	0.124647083	0	0.149394666	0.149867046	16.09331471	34.64045712	37.5	0.149394666	0	0	0.149394666	31.19829492	0	0	0	0	0	0	0	0											37.0349	3.887939372	9.244869706	0	2.221997791	0.98415868	0.286248596	1.074869192	6.2438632	2.548094858	6.650619817	0	0.005097688	6.616165977	8.417541066	20.28603775	2.244037104	1.022790595	0	0	2.434502871	5.176925883	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.3807	0	27.173	37.0349	3.887939372	9.244869706	0	2.221997791	0.98415868	0.286248596	1.074869192	6.2438632	2.548094858	6.650619817	0	0.005097688	6.616165977	8.417541066	20.28603775	2.244037104	1.022790595	0	0	2.434502871	5.176925883	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.3807																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	37.0349	3.887939372	9.244869706	0	2.221997791	0.98415868	0.286248596	1.074869192	6.2438632	2.548094858	6.650619817	0	0.005097688	6.616165977	8.417541066	20.28603775	2.244037104	1.022790595	0	0	2.434502871	5.176925883	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.3807
H4102_803_0	2009	2																					5740											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	Coin	V	V	Coin	O	T	V	P	P	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	1468.476941	152.3392373	1060.837611	1753.607223	237.9734536	6.587642685	4.830517271	360.9593157	41.7944185	14619.54006	53.35559946	0	0.034122292	44.14690313	5735.870286	7027.403022	718.0918734	6.846232337	0	0	16.29578173	1991.234161	0	0	0	0	0	0	0	0											"$410 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$410 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$140 Days 1-41 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 9a, 9d); $60 (5); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											405.1308165	410	140	0	150	0.2	0.079331311	47.83178154	0.2	2.8	0.166869522	0	0.2	0.20041106	17.61031679	34.64045712	37.5	0.2	0	0	0.2	31.19829492	0	0	0	0	0	0	0	0											302.6397681	306.2592259	104.576321	0	112.0460583	0.149394744	0.059258404	35.72908387	0.149394744	2.091526421	0.124647148	0	0.149394744	0.149867124	17.61031679	34.64045712	37.5	0.149394744	0	0	0.149394744	31.19829492	0	0	0	0	0	0	0	0											37.035	3.887941407	9.244874544	0	2.221998954	0.984159195	0.286248746	1.074728805	6.243866467	2.548096191	6.650623297	0	0.005097691	6.616169424	8.417541066	20.28603775	2.244037104	1.02279113	0	0	2.434504145	5.176925883	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.3806	0	27.1729	37.035	3.887941407	9.244874544	0	2.221998954	0.984159195	0.286248746	1.074728805	6.243866467	2.548096191	6.650623297	0	0.005097691	6.616169424	8.417541066	20.28603775	2.244037104	1.02279113	0	0	2.434504145	5.176925883	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.3806																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	37.035	3.887941407	9.244874544	0	2.221998954	0.984159195	0.286248746	1.074728805	6.243866467	2.548096191	6.650623297	0	0.005097691	6.616169424	8.417541066	20.28603775	2.244037104	1.02279113	0	0	2.434504145	5.176925883	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.3806
H4102_804_0	2009	2																					5740											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	Coin	V	V	Coin	O	T	V	P	P	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	1468.476941	152.3392373	1060.837611	1753.607223	237.9734536	6.587642685	4.830517271	361.0046022	41.7944185	14619.54006	53.35559946	0	0.034122292	44.14690313	6276.549896	7027.403022	718.0918734	6.846232337	0	0	16.29578173	1991.234161	0	0	0	0	0	0	0	0											"$410 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$410 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$140 Days 1-41 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 9a, 9d); $60 (5); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											405.1308165	410	140	0	150	0.2	0.079331311	47.83205353	0.2	2.8	0.166869522	0	0.2	0.20041106	16.09331471	34.64045712	37.5	0.2	0	0	0.2	31.19829492	0	0	0	0	0	0	0	0											302.6396098	306.2590656	104.5762663	0	112.0459996	0.149394666	0.059258373	35.72926835	0.149394666	2.091525326	0.124647083	0	0.149394666	0.149867046	16.09331471	34.64045712	37.5	0.149394666	0	0	0.149394666	31.19829492	0	0	0	0	0	0	0	0											37.0349	3.887939372	9.244869706	0	2.221997791	0.98415868	0.286248596	1.074869192	6.2438632	2.548094858	6.650619817	0	0.005097688	6.616165977	8.417541066	20.28603775	2.244037104	1.022790595	0	0	2.434502871	5.176925883	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.3807	0	27.173	37.0349	3.887939372	9.244869706	0	2.221997791	0.98415868	0.286248596	1.074869192	6.2438632	2.548094858	6.650619817	0	0.005097688	6.616165977	8.417541066	20.28603775	2.244037104	1.022790595	0	0	2.434502871	5.176925883	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.3807																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	37.0349	3.887939372	9.244869706	0	2.221997791	0.98415868	0.286248596	1.074869192	6.2438632	2.548094858	6.650619817	0	0.005097688	6.616165977	8.417541066	20.28603775	2.244037104	1.022790595	0	0	2.434502871	5.176925883	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.3807
H4106_001_0	2009	8																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		438.2442623	23.1	57.4340853	4241.771202	21.92106038	30.46922169	11.81219254	47.68983056	44.98355839	17.4690246	32.40049029	0	2.00811165	110.4725745	41.86037824	144.6918629	14.57	4.338526175	0	0	22.78477822	5.815346683	412.9428895	0	191.3284333	218.4479186	0	0	20.2	0											"7.6% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"7.6% (1b); $0 n/c (1b1, 1b2)"	16.9% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.074577879	0.0755	0.1689	0	0.2	0.2	0.2	0.079788644	0.2	0.08	0.2	0	0.2	0.2	0	0.199564743	0.2	0.2	0	0	0.2	0.012815454	0	0	0	0	0	0	0	0											0.074577879	0.0755	0.1689	0	0.2	0.2	0.2	0.079788644	0.2	0.08	0.2	0	0.2	0.2	0	0.199564743	0.2	0.2	0	0	0.2	0.012815454	0	0	0	0	0	0	0	0											32.6833	1.74405	9.700617007	0	4.384212077	6.093844339	2.362438508	3.805106893	8.996711677	1.397521968	6.480098058	0	0.40162233	22.0945149	0	28.87539444	2.914	0.867705235	0	0	4.556955645	0.074526307	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.4326	0	0	32.6833	1.74405	9.700617007	0	4.384212077	6.093844339	2.362438508	3.805106893	8.996711677	1.397521968	6.480098058	0	0.40162233	22.0945149	0	28.87539444	2.914	0.867705235	0	0	4.556955645	0.074526307	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.4326																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	32.6833	1.74405	9.700617007	0	4.384212077	6.093844339	2.362438508	3.805106893	8.996711677	1.397521968	6.480098058	0	0.40162233	22.0945149	0	28.87539444	2.914	0.867705235	0	0	4.556955645	0.074526307	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.4326
H4106_002_0	2009	4																					3350											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1864.682741	285.3268659	41.74486208	50649.41576	88.18644927	20.90604682	9.243137328	360.3849277	377.8296889	5983.578292	457.6020895	0	0.896917319	1458.383115	5899.275654	4369.488358	1301.980366	260.5535613	0	0	23.62045383	1103.25356	810.5086242	0	327.7093149	349.7142857	0	0	20.2	0											"$250 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$250 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	16.9% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$125 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5); $125 (9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											247	250	0.1689	0	150	0.14	0.2	49.97225189	125	4.4	64.79010385	0	0.2	115.6169854	3.251786543	25	20	20	0	0	0.2	13.67894853	0	0	0	0	0	0	0	0											170.315799	172.3844119	0.1689	0	103.4306471	0.096535271	0.13790753	34.45774902	86.19220595	3.033965649	44.67521579	0	0.13790753	79.72226416	3.251786543	25	20	20	0	0	0.13790753	13.67894853	0	0	0	0	0	0	0	0											26.4654	4.098825332	7.050707205	0	0.76009846	2.018170888	1.274698234	1.034837782	2.713831197	1.512830917	1.703622675	0	0.123691652	9.688800332	1.598598766	9.103100745	2.169967277	0.434255936	0	0	3.257438434	1.257612388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2665	0	24.607	26.4654	4.098825332	7.050707205	0	0.76009846	2.018170888	1.274698234	1.034837782	2.713831197	1.512830917	1.703622675	0	0.123691652	9.688800332	1.598598766	9.103100745	2.169967277	0.434255936	0	0	3.257438434	1.257612388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2665																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	26.4654	4.098825332	7.050707205	0	0.76009846	2.018170888	1.274698234	1.034837782	2.713831197	1.512830917	1.703622675	0	0.123691652	9.688800332	1.598598766	9.103100745	2.169967277	0.434255936	0	0	3.257438434	1.257612388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.2665
H4125_001_0	2009	9																					3420											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1724.752028	22.04656946	582.9143881	25.44018126	208.7548779	14.78320908	6.207035294	53.87515284	732.1648796	6.968425615	19.04651865	0.75675643	0.068136272	18.67971847	10801.42486	2644.55606	129.2002997	56.41968121	5241.011707	1741.542864	15.74937317	0	0	936	427.0510449	4.948155278	1.952496044	0	0	0											1a (IP Acute): 150 days 1-5	1b (IP Psych): 260 days 1-5	2a (SNF): 25 days 11-100	6a (Home Health): 10 copay	10a (Ambulance): 110 copay	11a (DME): 20% coin	11b (Medical Supplies): 10% coin	4a (ER): 50 copay	9b (OP Surg): 450 copay; 9b (OP ASC): 125 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 15% coin; 9c (OP SA): 50 copay; 3 (CORF): 35 copay; 5 (Partial Hosp): 50 copay; 9d (OP Cardiac Rehab): 35 copay		7b (Chiro): 10 copay; 7d (SPC w/Copay): 25 copay	7h (Psych): 50 copay; 7e (MH Non-Phys): 50 copay	7i (PT/ST): 25 copay; 7c (OT): 25 copay	7g (Prof. Other): 25 copay	7g (Prof. Other): 25 copay	15 (Part B Rx): 20% coin			16b (Comp. Dental): 25 copay	17a1 (Routine Eye Exam): 5 copay	17b1 (Non MCR Covered): 150 allowance	18a (Hearing Exam): 25 copay														79.58897824	122.8292578	13.24949112	10	110	0.2	0.1	50	449.1167361	0	0.150412614	0.15	0.2	0.148472055	0	23.4737888	50	25	25	18.1028975	0.2	0	0	25	5	0	25	0	0	0											68.00857534	104.957282	11.32165578	8.544974046	93.99471451	0.170899481	0.08544974	42.72487023	383.7690854	0	0.128527189	0.128174611	0.170899481	0.126868985	0	20.05829161	42.72487023	21.36243512	21.36243512	15.46887893	0.170899481	0	0	21.36243512	5	0	25	0	0	0											9.7748	0.192829001	0.549963004	0.018115474	1.635154596	2.526442758	0.530389555	0.191817409	23.41518718	0	2.447995494	0.096996961	0.011644454	2.369876931	0	4.420439718	0.460005503	0.100438482	9.330064377	2.24497631	2.6915597	0	0	1.666269939	0.177937935	0	0.0040677	0	0	0	0	0	0	0	0	0	0	0	0	0	64.857		11.0128	9.7748	0.192829001	0.549963004	0.018115474	1.635154596	2.526442758	0.530389555	0.191817409	23.41518718	0	2.447995494	0.096996961	0.011644454	2.369876931	0	4.420439718	0.460005503	0.100438482	9.330064377	2.24497631	2.6915597	0	0	1.666269939	0.177937935	0	0.0040677	0	0	0	0	0	0	0	0	0	0	0	0	0	64.857																																																																																		0			9.7748	0.192829001	0.549963004	0.018115474	1.635154596	2.526442758	0.530389555	0.191817409	23.41518718	0	2.447995494	0.096996961	0.011644454	2.369876931	0	4.420439718	0.460005503	0.100438482	9.330064377	2.24497631	2.6915597	0	0	1.666269939	0.177937935	0	0.0040677	0	0	0	0	0	0	0	0	0	0	0	0	0	64.857
H4125_002_0	2009	8																					3500											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1724.752028	22.04656946	582.9143881	25.44018126	208.7548779	15.9587671	6.70061758	53.87515284	732.1648796	7.522553518	20.56109425	0.81693356	0.073554456	20.16512619	10801.42486	2644.55606	129.2002997	56.41968121	5241.011707	1741.542864	17.00176039	0	0	936	411.0214433	4.762423482	1.952496044	0	0	0											1a (IP Acute): 135 days 1-5	1b (IP Psych): 200 days 1-5	2a (SNF): 25 days 11-100	6a (Home Health): 5 copay	10a (Ambulance): 100 copay	11a (DME): 20% coin	11b (Medical Supplies): 10% coin	4a (ER): 50 copay	9b (OP Surg): 380 copay; 9b (OP ASC): 100 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 15% coin	9a (OP Other): 15% coin; 9c (OP SA): 30 copay; 3 (CORF): 20 copay; 5 (Partial Hosp): 50 copay; 9d (OP Cardiac Rehab): 20 copay		7b (Chiro): 8 copay; 7d (SPC w/Copay): 25 copay	7h (Psych): 30 copay; 7e (MH Non-Phys): 30 copay	7i (PT/ST): 10 copay; 7c (OT): 10 copay	7g (Prof. Other): 25 copay	7g (Prof. Other): 25 copay	15 (Part B Rx): 20% coin			16b (Comp. Dental): 25 copay	17a1 (Routine Eye Exam): 5 copay	17b1 (Non MCR Covered): 150 allowance	18a (Hearing Exam): 25 copay														74.42361264	98.16886826	13.76621371	5	100	0.2	0.1	50	379.2390342	0	0.150412614	0.15	0.15	0.14766223	0	23.27029398	30	10	25	19.16587928	0.2	0	0	25	5	0	25	0	0	0											64.8131704	85.49216251	11.98856012	4.354341861	87.08683723	0.174173674	0.087086837	43.54341861	330.2672804	0	0.130989589	0.130630256	0.130630256	0.128594366	0	20.26536304	26.12605117	8.708683723	21.77170931	16.69095809	0.174173674	0	0	21.77170931	5	0	25	0	0	0											9.3156	0.157067408	0.582358682	0.009231271	1.514983506	2.779597106	0.583535593	0.195492361	20.15084197	0	2.693289278	0.10671624	0.009608437	2.593121612	0	4.466074051	0.281291137	0.040945097	9.50881528	2.422334913	2.961259079	0	0	1.698193326	0.171258935	0	0.0040677	0	0	0	0	0	0	0	0	0	0	0	0	0	62.2456		9.2037	9.3156	0.157067408	0.582358682	0.009231271	1.514983506	2.779597106	0.583535593	0.195492361	20.15084197	0	2.693289278	0.10671624	0.009608437	2.593121612	0	4.466074051	0.281291137	0.040945097	9.50881528	2.422334913	2.961259079	0	0	1.698193326	0.171258935	0	0.0040677	0	0	0	0	0	0	0	0	0	0	0	0	0	62.2456																																																																																		0			9.3156	0.157067408	0.582358682	0.009231271	1.514983506	2.779597106	0.583535593	0.195492361	20.15084197	0	2.693289278	0.10671624	0.009608437	2.593121612	0	4.466074051	0.281291137	0.040945097	9.50881528	2.422334913	2.961259079	0	0	1.698193326	0.171258935	0	0.0040677	0	0	0	0	0	0	0	0	0	0	0	0	0	62.2456
H4125_003_0	2009	8																					4950											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	S	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1724.752028	22.04656946	582.9143881	25.44018126	208.7548779	14.26553173	5.989677781	53.87515284	732.1648796	6.724405791	18.37954904	0.730256388	0.065750281	18.02559344	10801.42486	2644.55606	129.2002997	56.41968121	5241.011707	1741.542864	517.0331895	0	0	936	374.7159883	4.341759417	1.952496044	0	0	0											1a (IP Acute): 200 days 1-5	1b (IP Psych): 250 days 1-5	2a (SNF): 25 days 11-100	6a (Home Health): 15 copay	10a (Ambulance): 125 copay	11a (DME): 15% coin	11b (Medical Supplies): 10% coin	4a (ER): 50 copay	9b (OP Surg): 450 copay; 9b (OP ASC): 175 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 15% coin; 9c (OP SA): 55 copay; 3 (CORF): 50 copay; 5 (Partial Hosp): 55 copay; 9d (OP Cardiac Rehab): 50 copay	7a (PCP w/Copay): 9 copay	7b (Chiro): 18 copay; 7d (SPC w/Copay): 30 copay	7h (Psych): 55 copay; 7e (MH Non-Phys): 55 copay	7i (PT/ST): 25 copay; 7c (OT): 25 copay	7g (Prof. Other): 30 copay	7g (Prof. Other): 30 copay	15 (Part B Rx): 0.2			16b (Comp. Dental): 30 copay	17a1 (Routine Eye Exam): 10 copay	17b1 (Non MCR Covered): 100 allowance	18a (Hearing Exam): 30 copay														104.244053	116.018731	13.015439	15	125	0.15	0.1	50	449.2526229	0	0.150412614	0.15	0.2	0.149173809	8.499614939	28.77903104	55	25	30	30	0.2	0	0	30	10	0	30	0	0	0											91.00610427	101.2855163	11.36260884	13.09515051	109.1262543	0.130951505	0.087301003	43.6505017	392.2020476	0	0.131311722	0.130951505	0.174602007	0.130230232	7.420249127	25.12438287	48.01555188	21.82525085	26.19030102	26.19030102	0.174602007	0	0	26.19030102	10	0	30	0	0	0											13.0802	0.186083181	0.551952348	0.027761917	1.89838649	1.868092851	0.52290488	0.195973121	23.92971375	0	2.413450226	0.095628173	0.011480131	2.347477216	6.679105283	5.536903247	0.516968641	0.102614475	11.43863952	3.800960988	0.007522919	0	0	2.04284348	0.312263324	0	0.00488124	0	0	0	0	0	0	0	0	0	0	0	0	0	77.5719		11.2376	13.0802	0.186083181	0.551952348	0.027761917	1.89838649	1.868092851	0.52290488	0.195973121	23.92971375	0	2.413450226	0.095628173	0.011480131	2.347477216	6.679105283	5.536903247	0.516968641	0.102614475	11.43863952	3.800960988	0.007522919	0	0	2.04284348	0.312263324	0	0.00488124	0	0	0	0	0	0	0	0	0	0	0	0	0	77.5719																																																																																		0			13.0802	0.186083181	0.551952348	0.027761917	1.89838649	1.868092851	0.52290488	0.195973121	23.92971375	0	2.413450226	0.095628173	0.011480131	2.347477216	6.679105283	5.536903247	0.516968641	0.102614475	11.43863952	3.800960988	0.007522919	0	0	2.04284348	0.312263324	0	0.00488124	0	0	0	0	0	0	0	0	0	0	0	0	0	77.5719
H4125_005_0	2009	11																					0											D	D	Coin	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		2741.621403	28.81080409	13.1880377	50.65531965	14.37096633	24.05718985	9.011640878	13.14152308	31.66593803	1413.266372	21.98048436	0.169664479	0	32.33967756	12222.02616	2689.49514	214.0223706	73.97648972	5280.669982	1427.943947	14.33656501	0	0	2670.222222	465.3129737	2.534792566	10.71734791	0	0	0											1a (IP Acute): $250 days 1-4;1a1 (Add'l Days): 1a1 $0 coin	1b (IP Psych): $250 days 1-4;1a1 (Add'l Days): 1a1 $0 coin	2a (SNF): MC CS;2a2 (Waiver 3 Day): 0% coin		10a (Ambulance): MC CS	11a (DME): MC CS	11b (Medical Supplies): MC CS	4a (ER): MC CS	9b (OP Surg): MC CS; 9b (OP ASC): 100		8b (OP Therap Rad): MC CS; 8b (OP Diag): MC CS	9a (OP Observation): MC CS	12 (Renal Dialysis): MC CS	9a (OP Other): MC CS; 9c (OP SA): 8 copay; 3 (CORF): MC CS; 5 (Partial Hosp): MC CS; 9d (OP Cardiac Rehab): 8 copay		; 7d (SPC w/Copay): 8 copay	7h (Psych): 8 copay; 7e (MH Non-Phys): 8 copay	7i (PT/ST): 5; 7c (OT): 5	7g (Prof. Other): 8 copay	7g (Prof. Other): 8 copay	15 (Part B Rx): MC CS		10b (Transportation): 20 trips/year	16b (Comp. Dental): 8 copay	17a1 (Routine Eye Exam): 5 copay	17b1 (Non MCR Covered): 150 allowance	18a (Hearing Exam): 8 copay														144.5298069	116.7026555	0.1942	0	0.231	0.231	0.231	0.231	0.230658577	0	0.231	0.231	0	0.230034435	0	7.656712402	8	5	8	8	0.231	0	0	8	5	0	8	0	0	0											144.5298069	116.7026555	0.1942	0	0.231	0.231	0.231	0.231	0.230658577	0	0.231	0.231	0	0.230034435	0	7.656712402	8	5	8	8	0.231	0	0	8	5	0	8	0	0	0											33.0205	0.280191445	2.561116921	0	3.319693222	5.557210856	2.081689043	3.035691831	7.304020199	0	5.077491886	0.039192495	0	7.439239445	0	1.716057566	0.14268158	0.030823537	3.520446654	0.951962631	3.311746516	0	0	1.780148148	0.193880406	0	0.007144899	0	0	0	0	0	0	0	0	0	0	0	0	0	81.3709		0	33.0205	0.280191445	2.561116921	0	3.319693222	5.557210856	2.081689043	3.035691831	7.304020199	0	5.077491886	0.039192495	0	7.439239445	0	1.716057566	0.14268158	0.030823537	3.520446654	0.951962631	3.311746516	0	0	1.780148148	0.193880406	0	0.007144899	0	0	0	0	0	0	0	0	0	0	0	0	0	81.3709																																																																																		0			33.0205	0.280191445	2.561116921	0	3.319693222	5.557210856	2.081689043	3.035691831	7.304020199	0	5.077491886	0.039192495	0	7.439239445	0	1.716057566	0.14268158	0.030823537	3.520446654	0.951962631	3.311746516	0	0	1.780148148	0.193880406	0	0.007144899	0	0	0	0	0	0	0	0	0	0	0	0	0	81.3709
H4152_004_0	2009	4	f.2.	I.7.									OP Facility - Emergency	Professional										Urgent Care	Routine Exams									D	D	D		T	Coin		V	V		O		Coin		V	V	V	V				V			V		V		O		V	V																																																	0		1483.433228	145.8974781	1640.991128	0	431.1671229	4.039056969	0	222.1118025	324.390402	0	342.8271648	0	1.023112171	0	3226.598602	3858.810742	157.5957938	1050.435407	0	0	0	513.7678624	0	0	600.2070824	0	0	0	856.2818258	0	146.718923	431.6356751									$250 per day subject to an Inpatient OOP Maximum of $2500	$250 per day subject to an Inpatient OOP Maximum of $2500	$100 per day subject to an Inpatient OOP Maximum of $2500	No Copay	$150 Copay per day	20% Coinsurance for non-capitated services	Grouped in Line e.1.	$50 Copay per visit	$175 Copay per visit	No Copay	$125 Copay per MRI or CAT Scan	No Copay	20% Coinsurance	No Copay	"$10 Copay per visit; Includes PCP, Nutrition Therapy, Nutrition Training and Smoking Cessation"	$25 Copay per visit	$25 Copay per visit	$15 Copay per visit	No Copay	No Copay	No Copay	$25 Copay per visit	Not Covered	Not Covered	$25 Copay per visit	Not Covered	$25 Copay per visit	Not Covered	$15 Monthly	Not Covered	$35 Copay per visit	$10 Copay per visit									250	250	100	0	150	0.2	0	50	175	0	125	0	0.2	0	10	25	25	15	0	0	0	25	0	0	25	0	25	0	15	0	35	10									132.2784793	77.09198138	38.82331295	0	150	0.2	0	50	175	0	125	0	0.2	0	10	25	25	15	0	0	0	25	0	0	25	0	25	0	15	0	35	10									16.3522	0.937293805	5.309059342	0	5.389589037	0.807811394	0	0.925465844	4.730693362	0	3.5711163	0	0.204622434	0	2.688832169	8.039189046	0.32832457	1.313044259	0	0	0	1.070349713	0	0	1.250431422	0	0	0	1.070352282	0	0.427930192	0.359696396	0	0	0	0	0	0	0	0	54.776	0	25.0208	16.3522	0.937293805	5.309059342	0	5.389589037	0.807811394	0	0.925465844	4.730693362	0	3.5711163	0	0.204622434	0	2.688832169	8.039189046	0.32832457	1.313044259	0	0	0	1.070349713	0	0	1.250431422	0	0	0	1.070352282	0	0.427930192	0.359696396	0	0	0	0	0	0	0	0	54.776																																																																																		0			16.3522	0.937293805	5.309059342	0	5.389589037	0.807811394	0	0.925465844	4.730693362	0	3.5711163	0	0.204622434	0	2.688832169	8.039189046	0.32832457	1.313044259	0	0	0	1.070349713	0	0	1.250431422	0	0	0	1.070352282	0	0.427930192	0.359696396	0	0	0	0	0	0	0	0	54.776
H4152_005_0	2009	6	f.2.	I.7.									OP Facility - Emergency	Professional										Urgent Care	Routine Exams									D	D	D		T	Coin		V	V		O		Coin		V	V	V	V				V			V		V		O		V	V																																																	0		1767.447123	138.1809478	2178.464942	0	481.0325402	4.409872382	0	231.659993	379.6443725	0	410.3415257	0	0.971463503	0	4006.573475	4438.902183	331.3544039	1215.847744	0	0	0	611.7194842	0	0	696.8902021	0	0	0	731.4803867	0	173.7934592	447.0639663									$200 per day subject to an Inpatient OOP Maximum of $2000	$200 per day subject to an Inpatient OOP Maximum of $2000	$100 per day subject to an Inpatient OOP Maximum of $2000	No Copay	$150 Copay per day	20% Coinsurance for non-capitated services	Grouped in Line e.1.	$50 Copay per visit	$150 Copay per visit	No Copay	$125 Copay per MRI or CAT Scan	No Copay	20% Coinsurance	No Copay	"$10 Copay per visit; Includes PCP, Nutrition Therapy, Nutrition Training and Smoking Cessation"	$25 Copay per visit	$25 Copay per visit	$15 Copay per visit	No Copay	No Copay	No Copay	$25 Copay per visit	Not Covered	No Copay	$25 Copay per visit	"Benefit Allowance, No Copay"	$25 Copay per visit	Not Covered	$15 Monthly	Not Covered	$35 Copay per visit	$10 Copay per visit									200	200	100	0	150	0.2	0	50	150	0	125	0	0.2	0	10	25	25	15	0	0	0	25	0	0	25	0	25	0	15	0	35	10									103.0289204	48.77208034	36.05844809	0	150	0.2	0	50	150	0	125	0	0.2	0	10	25	25	15	0	0	0	25	0	0	25	0	25	0	15	0	35	10									15.1748	0.561614357	6.546005419	0	6.012906752	0.881974476	0	0.965249971	4.745554656	0	4.274390893	0	0.194292701	0	3.338811229	9.247712881	0.690321675	1.519809681	0	0	0	1.274415592	0	0	1.451854588	0	0	0	0.914350483	0	0.506897589	0.372553305	0	0	0	0	0	0	0	0	58.6736	0	27.6319	15.1748	0.561614357	6.546005419	0	6.012906752	0.881974476	0	0.965249971	4.745554656	0	4.274390893	0	0.194292701	0	3.338811229	9.247712881	0.690321675	1.519809681	0	0	0	1.274415592	0	0	1.451854588	0	0	0	0.914350483	0	0.506897589	0.372553305	0	0	0	0	0	0	0	0	58.6736																																																																																		0			15.1748	0.561614357	6.546005419	0	6.012906752	0.881974476	0	0.965249971	4.745554656	0	4.274390893	0	0.194292701	0	3.338811229	9.247712881	0.690321675	1.519809681	0	0	0	1.274415592	0	0	1.451854588	0	0	0	0.914350483	0	0.506897589	0.372553305	0	0	0	0	0	0	0	0	58.6736
H4152_007_0	2009	6	f.2.	I.7.									OP Facility - Emergency	Professional										Urgent Care	Routine Exams									D	D	D		T	Coin		V	V		O		Coin		V	V	V	V				V			V		V		O		V	V																																																	0	3000	2313.548088	124.4189051	2444.295196	0	595.8588602	8.233261223	0	276.1950902	459.2173219	0	498.3388866	0	1.875577203	0	4468.602046	5437.506596	602.8764981	1794.595735	0	0	0	622.7835831	0	0	760.8040217	0	1.616030391	0	804.3563426	0	194.1978293	417.2167637									$95 per day subject to an Inpatient OOP Maximum of $950	$95 per day subject to an Inpatient OOP Maximum of $950	$75 per day subject to an Inpatient OOP Maximum of $950	No Copay	$150 Copay per day	20% Coinsurance for non-capitated services	Grouped in Line e.1.	$50 Copay per visit	$95 Copay per visit	No Copay	$125 Copay per MRI or CAT Scan	No Copay	20% Coinsurance	No Copay	"$10 Copay per visit; Includes PCP, Nutrition Therapy, Nutrition Training and Smoking Cessation"	$25 Copay per visit	$25 Copay per visit	$15 Copay per visit	No Copay	No Copay	No Copay	$25 Copay per visit	Not Covered	No Copay	$25 Copay per visit	"Benefit Allowance, No Copay"	$25 Copay per visit	"Benefit Allowance, No Copay"	$15 Monthly	Not Covered	$35 Copay per visit	$10 Copay per visit									95	95	75	0	150	0.2	0	50	95	0	125	0	0.2	0	10	25	25	15	0	0	0	25	0	0	25	0	25	0	15	0	35	10									45.33467426	34.9089162	19.46136721	0	150	0.2	0	50	95	0	125	0	0.2	0	10	25	25	15	0	0	0	25	0	0	25	0	25	0	15	0	35	10									8.7403	0.361944094	3.964110532	0	7.448235752	1.646652245	0	1.150812876	3.635470465	0	5.191030069	0	0.375115441	0	3.723835038	11.32813874	1.255992704	2.243244669	0	0	0	1.297465798	0	0	1.585008379	0	0.00336673	0	1.005445428	0	0.566410335	0.347680636	0	0	0	0	0	0	0	0	55.8703	0	21.511	8.7403	0.361944094	3.964110532	0	7.448235752	1.646652245	0	1.150812876	3.635470465	0	5.191030069	0	0.375115441	0	3.723835038	11.32813874	1.255992704	2.243244669	0	0	0	1.297465798	0	0	1.585008379	0	0.00336673	0	1.005445428	0	0.566410335	0.347680636	0	0	0	0	0	0	0	0	55.8703		20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max									0	0	0.0047	0.0004	0	0	0	0	0.0171	0	0.0062	0	0	0.012	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0									0.0405	0	0	8.7403	0.361944094	3.968835035	0.000388826	7.448235752	1.646652245	0	1.150812876	3.652616535	0	5.197245022	0	0.375115441	0.012044842	3.723835038	11.32813874	1.255992704	2.243244669	0	0	0	1.297465798	0	0	1.585008379	0	0.00336673	0	1.005445428	0	0.566410335	0.347680636	0	0	0	0	0	0	0	0	55.9108
H4152_012_0	2009	6	f.2.	I.7.									OP Facility - Emergency	Professional										Urgent Care	Routine Exams									D	D	D		T	Coin		V	Coin				Coin	Coin	V	V	V	Coin		Coin		Coin			V				O		V	V																																																	0		2731.301711	680.9327291	413.0155379	0	1230.702085	15.11359648	0	722.5698985	38.94534868	0	0	0	0.093105279	91.79194354	3892.945789	4662.959183	2624.635335	8.388375153	0	153.2599339	0	5.26551725	0	0	578.9410765	0	0	0	323.4606886	0	395.7260609	241.926834									$190 per day for days 1-30	$190 per day for days 1-30	$133 per day for days 21-100	No Copay	$150 Copay per day	20% Coinsurance for non-capitated services	Grouped into Line e.1.	$50 Copay per visit	23% Coinsurance	Grouped into Line h.5.	Grouped into Line h.5.	Grouped into Line h.5.	20% Coinsurance on all non Emergency Room / Urgent Care Services	"23% Coinsurance for all Outpatient services excluding ER, Urget Care and Renal Dialysis"	"$5 Copay per visit; Includes PCP, Nutrition Therapy, Nutrition Training and Smoking Cessation"	$25 Copay per visit	$25 Copay per visit	23% Coinsurance	No Copay	23% Coinsurance	No Copay	23% Coinsurance	No Copay	Not Covered	$25 Copay per visit	Not Covered	Not Covered	Not Covered	$15 Monthly	Not Covered	$35 Copay per visit	$5 Copay per visit									190	190	133	0	150	0.2	0	50	0.23	0	0	0	0.2	0.23	5	25	25	0.23	0	0.23	0	0.23	0	0	25	0	0	0	15	0	35	5									190	190	133	0	150	0.2	0	50	0.23	0	0	0	0.2	0.23	5	25	25	0.23	0	0.23	0	0.2	0	0	25	0	0	0	15	0	35	5									43.2456	10.78143488	4.577588878	0	15.38377607	3.022719297	0	3.010707911	8.957430196	0	0	0	0.018621056	21.11214701	1.622060746	9.714498297	5.467990282	1.929326285	0	35.2497848	0	1.05310345	0	0	1.206127243	0	0	0	0.404325861	0	1.154201011	0.100802847	0	0	0	0	0	0	0	0	168.0123			43.2456	10.78143488	4.577588878	0	15.38377607	3.022719297	0	3.010707911	8.957430196	0	0	0	0.018621056	21.11214701	1.622060746	9.714498297	5.467990282	1.929326285	0	35.2497848	0	1.05310345	0	0	1.206127243	0	0	0	0.404325861	0	1.154201011	0.100802847	0	0	0	0	0	0	0	0	168.0123																																																																																		0			43.2456	10.78143488	4.577588878	0	15.38377607	3.022719297	0	3.010707911	8.957430196	0	0	0	0.018621056	21.11214701	1.622060746	9.714498297	5.467990282	1.929326285	0	35.2497848	0	1.05310345	0	0	1.206127243	0	0	0	0.404325861	0	1.154201011	0.100802847	0	0	0	0	0	0	0	0	168.0123
H4152_013_0	2009	6	f.2.	I.7.									OP Facility - Emergency	Professional										Urgent Care	Routine Exams									D	D	D		T	Coin		V	V		O		Coin		V	V	V	V				V			V		V		O		V	V																																																	0		1611.280369	114.4282002	1675.997958	0	421.9321517	4.799802131	0	250.0594174	331.426369	0	396.6849462	0	0.356965629	0	3841.747497	4136.153149	457.8414968	1010.065686	0	0	0	564.6918538	0	0	666.5114827	0	0	0	866.5680061	0	172.0705892	419.4451298									$300 per day subject to an Inpatient OOP Maximum of $3000	$300 per day subject to an Inpatient OOP Maximum of $3000	$100 per day subject to an Inpatient OOP Maximum of $3000	No Copay	$150 Copay per day	20% Coinsurance for non-capitated services	Grouped in Line e.1.	$50 Copay per visit	$175 Copay per visit	No Copay	$125 Copay per MRI or CAT Scan	No Copay	20% Coinsurance	No Copay	"$10 Copay per visit; Includes PCP, Nutrition Therapy, Nutrition Training and Smoking Cessation"	$25 Copay per visit	$25 Copay per visit	$15 Copay per visit	No Copay	No Copay	No Copay	$25 Copay per visit	Not Covered	Not Covered	$25 Copay per visit	Not Covered	$25 Copay per visit	Not Covered	$15 Monthly	Not Covered	$35 Copay per visit	$10 Copay per visit									300	300	100	0	150	0.2	0	50	175	0	125	0	0.2	0	10	25	25	15	0	0	0	25	0	0	25	0	25	0	15	0	35	10									170.2548612	124.5085365	44.76830963	0	150	0.2	0	50	175	0	125	0	0.2	0	10	25	25	15	0	0	0	25	0	0	25	0	25	0	15	0	35	10									22.8607	1.187273979	6.252632961	0	5.274151896	0.959960426	0	1.041914239	4.833301214	0	4.132134856	0	0.071393126	0	3.201456248	8.616985728	0.953836452	1.262582108	0	0	0	1.176441362	0	0	1.388565589	0	0	0	1.083210008	0	0.501872552	0.349537608	0	0	0	0	0	0	0	0	65.1479	0	26.8088	22.8607	1.187273979	6.252632961	0	5.274151896	0.959960426	0	1.041914239	4.833301214	0	4.132134856	0	0.071393126	0	3.201456248	8.616985728	0.953836452	1.262582108	0	0	0	1.176441362	0	0	1.388565589	0	0	0	1.083210008	0	0.501872552	0.349537608	0	0	0	0	0	0	0	0	65.1479																																																																																		0			22.8607	1.187273979	6.252632961	0	5.274151896	0.959960426	0	1.041914239	4.833301214	0	4.132134856	0	0.071393126	0	3.201456248	8.616985728	0.953836452	1.262582108	0	0	0	1.176441362	0	0	1.388565589	0	0	0	1.083210008	0	0.501872552	0.349537608	0	0	0	0	0	0	0	0	65.1479
H4152_815_0	2009	3	f.2.	I.7.									OP Facility - Emergency	Professional										Urgent Care	Routine Exams									D	D	D	V	T	O	O	V	V	O	O	O	V	P	V	V	V	V	V	V	O	V	T	Coin	V	V	V	V	O	O	V	V																																																	0	3000	1485.086327	58.79170639	410.5024573	0	390.3995494	0	0	185.7595253	0	0	0	0	0	0	3628.280338	4854.91123	292.9167758	0	0	0	0	640.6527486	0	9.218688616	687.2378274	0	0.673102671	0	1061.534471	0	133.4716589	477.2465547									$100 copay per stay per benefit period	$100 copay per stay per benefit period	$0 for days 1-29 and $50 for days 30-100	No Copay	$50 Copay per day	No Copay	No Copay	$50 Copay per visit	No Copay	No Copay	No Copay	No Copay	No Copay	No Copay	$10 Copay per visit	$20 Copay per visit	$20 Copay per visit	No Copay	No Copay	No Copay	No Copay	$20 Copay per visit	Not Covered	"20% Coinsurance for comprehensive services up to a $1,500 allowance"	$20 Copay per visit	"No Copay, Benefit Allowance"	$20 Copay per visit	"No Copay, Benefit Allowance"	$15 Monthly	Not Covered	$25 Copay per visit	$10 Copay per visit									100	100	50	0	50	0	0	50	0	0	0	0	0	0	10	20	20	0	0	0	0	20	0	0.2	20	0	20	0	15	0	25	10									100	100	50	0	50	0	0	50	0	0	0	0	0	0	10	20	20	0	0	0	0	20	0	0.2	20	0	20	0	15	0	25	10									12.3757	0.489930887	1.710426906	0	1.626664789	0	0	0.773998022	0	0	0	0	0	0	3.023566948	8.091518716	0.488194626	0	0	0	0	1.067754581	0	1.843737723	1.145396379	0	0.001121838	0	1.326918088	0	0.278065956	0.397705462	0	0	0	0	0	0	0	0	34.6407	0	0	12.3757	0.489930887	1.710426906	0	1.626664789	0	0	0.773998022	0	0	0	0	0	0	3.023566948	8.091518716	0.488194626	0	0	0	0	1.067754581	0	1.843737723	1.145396379	0	0.001121838	0	1.326918088	0	0.278065956	0.397705462	0	0	0	0	0	0	0	0	34.6407		20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max									0	0	0	0	0	0	0	0	0.0286	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0									0.0286	0	0	12.3757	0.489930887	1.710426906	0	1.626664789	0	0	0.773998022	0.028581359	0	0	0	0	0	3.023566948	8.091518716	0.488194626	0	0	0	0	1.067754581	0	1.843737723	1.145396379	0	0.001121838	0	1.326918088	0	0.278065956	0.397705462	0	0	0	0	0	0	0	0	34.6693
H4152_817_0	2009	3	f.2.	I.7.									OP Facility - Emergency	Professional										Urgent Care	Routine Exams									D	D	D	V	T	O	O	V	V	O	O	O	V	P	V	V	V	V	V	V	O	V	T	V	V	V	V	V	O	O	V	V																																																	0		1580.442643	62.56667922	436.8605224	0	415.6750488	0	0	197.6550698	0	0	0	0	0	0	3857.683492	5161.869857	311.4368532	0	0	0	0	680.0003464	0	0	731.3648699	0	0.716322106	0	1061.534471	0	142.018828	507.4211429									$100 copay per stay per benefit period	$100 copay per stay per benefit period	$0 for days 1-29 and $50 for days 30-100	No Copay	$50 Copay per day	No Copay	No Copay	$50 Copay per visit	No Copay	No Copay	No Copay	No Copay	No Copay	No Copay	$10 Copay per visit	$20 Copay per visit	$20 Copay per visit	No Copay	No Copay	No Copay	No Copay	$20 Copay per visit	Not Covered	No Copay	$20 Copay per visit	"No Copay, Benefit Allowance"	$20 Copay per visit	Not Covered	$15 Monthly	Not Covered	$25 Copay per visit	$10 Copay per visit									100	100	50	0	50	0	0	50	0	0	0	0	0	0	10	20	20	0	0	0	0	20	0	0	20	0	20	0	15	0	25	10									100	100	50	0	50	0	0	50	0	0	0	0	0	0	10	20	20	0	0	0	0	20	0	0	20	0	20	0	15	0	25	10									13.1704	0.521388993	1.820252177	0	1.73197937	0	0	0.823562791	0	0	0	0	0	0	3.214736244	8.603116428	0.519061422	0	0	0	0	1.133333911	0	0	1.21894145	0	0.00119387	0	1.326918088	0	0.295872558	0.422850952	0	0	0	0	0	0	0	0	34.8036	0	0	13.1704	0.521388993	1.820252177	0	1.73197937	0	0	0.823562791	0	0	0	0	0	0	3.214736244	8.603116428	0.519061422	0	0	0	0	1.133333911	0	0	1.21894145	0	0.00119387	0	1.326918088	0	0.295872558	0.422850952	0	0	0	0	0	0	0	0	34.8036																																																																																		0			13.1704	0.521388993	1.820252177	0	1.73197937	0	0	0.823562791	0	0	0	0	0	0	3.214736244	8.603116428	0.519061422	0	0	0	0	1.133333911	0	0	1.21894145	0	0.00119387	0	1.326918088	0	0.295872558	0.422850952	0	0	0	0	0	0	0	0	34.8036
H4152_818_0	2009	3	f.2.	I.7.									OP Facility - Emergency	Professional										Urgent Care	Routine Exams									D	D	D		T	Coin		V	V		O		Coin		V	V	V	V				V			V		V		O		V	V																																																	0		1483.433228	145.8974781	1640.991128	0	431.1671229	4.039056969	0	222.1118025	324.390402	0	342.8271648	0	1.023112171	0	3226.598602	3858.810742	157.5957938	1050.435407	0	0	0	513.7678624	0	0	600.2070824	0	0	0	856.2818258	0	146.718923	431.6356751									$250 per day subject to an Inpatient OOP Maximum of $2500	$250 per day subject to an Inpatient OOP Maximum of $2500	$100 per day subject to an Inpatient OOP Maximum of $2500	No Copay	$150 Copay per day	20% Coinsurance for non-capitated services	Grouped in Line e.1.	$50 Copay per visit	$175 Copay per visit	No Copay	$125 Copay per MRI or CAT Scan	No Copay	20% Coinsurance	No Copay	"$10 Copay per visit; Includes PCP, Nutrition Therapy, Nutrition Training and Smoking Cessation"	$25 Copay per visit	$25 Copay per visit	$15 Copay per visit	No Copay	No Copay	No Copay	$25 Copay per visit	Not Covered	Not Covered	$25 Copay per visit	Not Covered	$25 Copay per visit	Not Covered	$15 Monthly	Not Covered	$35 Copay per visit	$10 Copay per visit									250	250	100	0	150	0.2	0	50	175	0	125	0	0.2	0	10	25	25	15	0	0	0	25	0	0	25	0	25	0	15	0	35	10									132.2784793	77.09198138	38.82331295	0	150	0.2	0	50	175	0	125	0	0.2	0	10	25	25	15	0	0	0	25	0	0	25	0	25	0	15	0	35	10									16.3522	0.937293805	5.309059342	0	5.389589037	0.807811394	0	0.925465844	4.730693362	0	3.5711163	0	0.204622434	0	2.688832169	8.039189046	0.32832457	1.313044259	0	0	0	1.070349713	0	0	1.250431422	0	0	0	1.070352282	0	0.427930192	0.359696396	0	0	0	0	0	0	0	0	54.776	0	25.0208	16.3522	0.937293805	5.309059342	0	5.389589037	0.807811394	0	0.925465844	4.730693362	0	3.5711163	0	0.204622434	0	2.688832169	8.039189046	0.32832457	1.313044259	0	0	0	1.070349713	0	0	1.250431422	0	0	0	1.070352282	0	0.427930192	0.359696396	0	0	0	0	0	0	0	0	54.776																																																																																		0			16.3522	0.937293805	5.309059342	0	5.389589037	0.807811394	0	0.925465844	4.730693362	0	3.5711163	0	0.204622434	0	2.688832169	8.039189046	0.32832457	1.313044259	0	0	0	1.070349713	0	0	1.250431422	0	0	0	1.070352282	0	0.427930192	0.359696396	0	0	0	0	0	0	0	0	54.776
H4152_819_0	2009	3	f.2.	I.7.									OP Facility - Emergency	Professional										Urgent Care	Routine Exams									D	D	D	V	T	O	O	V	V	O	O	O	V	P	V	V	V	V	V	V	O	V	T	V	V	V	V	V	O	O	V	V																																																	0		1580.442643	62.56667922	436.8605224	0	415.6750488	0	0	197.6550698	0	0	0	0	0	0	3857.683492	5161.869857	311.4368532	0	0	0	0	680.0003464	0	0	731.3648699	0	0.716322106	0	1061.534471	0	142.018828	507.4211429									$100 copay per stay per benefit period	$100 copay per stay per benefit period	$0 for days 1-29 and $50 for days 30-100	No Copay	$50 Copay per day	No Copay	No Copay	$50 Copay per visit	No Copay	No Copay	No Copay	No Copay	No Copay	No Copay	$10 Copay per visit	$20 Copay per visit	$20 Copay per visit	No Copay	No Copay	No Copay	No Copay	$20 Copay per visit	Not Covered	No Copay	$20 Copay per visit	"No Copay, Benefit Allowance"	$20 Copay per visit	Not Covered	$15 Monthly	Not Covered	$25 Copay per visit	$10 Copay per visit									100	100	50	0	50	0	0	50	0	0	0	0	0	0	10	20	20	0	0	0	0	20	0	0	20	0	20	0	15	0	25	10									100	100	50	0	50	0	0	50	0	0	0	0	0	0	10	20	20	0	0	0	0	20	0	0	20	0	20	0	15	0	25	10									13.1704	0.521388993	1.820252177	0	1.73197937	0	0	0.823562791	0	0	0	0	0	0	3.214736244	8.603116428	0.519061422	0	0	0	0	1.133333911	0	0	1.21894145	0	0.00119387	0	1.326918088	0	0.295872558	0.422850952	0	0	0	0	0	0	0	0	34.8036	0	0	13.1704	0.521388993	1.820252177	0	1.73197937	0	0	0.823562791	0	0	0	0	0	0	3.214736244	8.603116428	0.519061422	0	0	0	0	1.133333911	0	0	1.21894145	0	0.00119387	0	1.326918088	0	0.295872558	0.422850952	0	0	0	0	0	0	0	0	34.8036																																																																																		0	0	0	13.1704	0.521388993	1.820252177	0	1.73197937	0	0	0.823562791	0	0	0	0	0	0	3.214736244	8.603116428	0.519061422	0	0	0	0	1.133333911	0	0	1.21894145	0	0.00119387	0	1.326918088	0	0.295872558	0.422850952	0	0	0	0	0	0	0	0	34.8036
H4152_820_0	2009	3	f.2.	I.7.									OP Facility - Emergency	Professional										Urgent Care	Routine Exams									D	D	D	V	T	Coin	O	V	V	O	O	O	V	P	V	V	V	V	V	V	O	V	T	Coin	V	V	V	V	O	O	V	V																																																	0	3000	1485.086327	58.79170639	410.5024573	0	390.3995494	0	0	185.7595253	0	0	0	0	0	0	3628.280338	4854.91123	292.9167758	0	0	0	0	640.6527486	0	9.218688616	687.2378274	0	0.673102671	0	1061.534471	0	133.4716589	477.2465547									$100 copay per stay per benefit period	$100 copay per stay per benefit period	$0 for days 1-29 and $50 for days 30-100	No Copay	$50 Copay per day	No Copay	No Copay	$50 Copay per visit	No Copay	No Copay	No Copay	No Copay	No Copay	No Copay	$10 Copay per visit	$20 Copay per visit	$20 Copay per visit	No Copay	No Copay	No Copay	No Copay	$20 Copay per visit	Not Covered	"20% Coinsurance for comprehensive services up to a $1,500 allowance"	$20 Copay per visit	"No Copay, Benefit Allowance"	$20 Copay per visit	"No Copay, Benefit Allowance"	$15 Monthly	Not Covered	$25 Copay per visit	$10 Copay per visit									100	100	50	0	50	0	0	50	0	0	0	0	0	0	10	20	20	0	0	0	0	20	0	0.2	20	0	20	0	15	0	25	10									100	100	50	0	50	0	0	50	0	0	0	0	0	0	10	20	20	0	0	0	0	20	0	0.2	20	0	20	0	15	0	25	10									12.3757	0.489930887	1.710426906	0	1.626664789	0	0	0.773998022	0	0	0	0	0	0	3.023566948	8.091518716	0.488194626	0	0	0	0	1.067754581	0	1.843737723	1.145396379	0	0.001121838	0	1.326918088	0	0.278065956	0.397705462	0	0	0	0	0	0	0	0	34.6407	0	0	12.3757	0.489930887	1.710426906	0	1.626664789	0	0	0.773998022	0	0	0	0	0	0	3.023566948	8.091518716	0.488194626	0	0	0	0	1.067754581	0	1.843737723	1.145396379	0	0.001121838	0	1.326918088	0	0.278065956	0.397705462	0	0	0	0	0	0	0	0	34.6407		20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max	20% Coinsurance on OON Benefits Subject to a $3000 OOP OON Max									0	0	0	0	0	0	0	0	0.0286	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0									0.0286	0	0	12.3757	0.489930887	1.710426906	0	1.626664789	0	0	0.773998022	0.028581359	0	0	0	0	0	3.023566948	8.091518716	0.488194626	0	0	0	0	1.067754581	0	1.843737723	1.145396379	0	0.001121838	0	1.326918088	0	0.278065956	0.397705462	0	0	0	0	0	0	0	0	34.6693
H4204_002_0	2009	4																					3350											D	D	D	coin	T	coin	coin	V	coin	P	P	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1459.313556	92.02879492	541.6401783	34.57186648	346.454985	22.15264077	7.056594408	499.554008	38.51348174	2214.030205	1184.354359	0	0.169121379	27.63076794	4083.741157	6990.042838	236.2499942	521.0509898	27.50021314	4622.668448	9.851933422	17.59647671	0	50	465	0	0	0	0	0											1a:  Acute - $100/$0/day for 1-10/11-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $100/$0/day for 1-10/11-190	2:  Skilled Nursing Services - $0/$100/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-20/21-100	6:  Home Health Services - 20.0%	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50 to $50/visit/4a:  Worldwide Coverage - 39.5%	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - 20.0%	8a:  Outpatient Diagnostic Procedures/Tests - $30/visit/8a:  Outpatient Lab Services - $30/visit	8b:  Outpatient Diagnostic Radiological Services - $30/visit/8b:  Outpatient Therapeutic Radiological Services - $30/visit/8b:  Outpatient X-Ray Services - $30/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $30/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $30/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $30/visit/7f:  Podiatry Services - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $30/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $30/visit/7h:  Psychiatric Services - Individual - $30/visit/7h:  Psychiatric Services - Group - $30/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit	7a: Other Healthcare 20%	9c:  Outpatient Substance Abuse Svcs - Individual - $30/visit/9c:  Outpatient Substance Abuse Svcs - Group - $30/visit/7g:  Other Health Care Professional Services - $20 to $30/visit	15:  Medicare Part B Rx Drugs - $0/service	13a:  Blood - $30/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - X-Rays - $0/service	17a:  Routine Eye Exams - $15/visit				14b:  Other Immunizations - $0/visit/14a:  Alternative Medicine Program - $0/service/14a:  Written health education materials - $0/service/14a:  Nursing Hotline - $0/service/14a:  Nutritional Training - $0/service/14a:  Smoking Cessation - $0/service/14a:  Other - $0/service/14c:  Routine Exams - $0/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												100	100	100	0.2	50	0.3	0.231107603	51.5902924	0.2	30	30	0	0.2	0.167726448	20.02559597	31.97927572	30	30	0.039961205	3.652976402	0.2	30	0	0	15	0	0	0	0	0											78.81881818	78.81881818	78.81881818	0.157637636	39.40940909	0.236456455	0.182156281	40.66285877	0.157637636	23.64564545	23.64564545	0	0.157637636	0.132200004	15.78427575	25.20568718	23.64564545	23.64564545	0.03149695	2.879232828	0.157637636	23.64564545	0	0	15	0	0	0	0	0											9.5851	0.604466738	3.557619894	5.449827317	1.137798853	5.238134895	1.285402996	1.692774506	6.071174229	4.362681104	2.333735272	0	0.026659894	3.652787629	5.371574709	14.68240276	0.465523633	1.026715581	0.866172826	1.109144896	1.553035498	0.034673337	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.6887	0	18.84	9.5851	0.604466738	3.557619894	5.449827317	1.137798853	5.238134895	1.285402996	1.692774506	6.071174229	4.362681104	2.333735272	0	0.026659894	3.652787629	5.371574709	14.68240276	0.465523633	1.026715581	0.866172826	1.109144896	1.553035498	0.034673337	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.6887																																																																																		0			9.5851	0.604466738	3.557619894	5.449827317	1.137798853	5.238134895	1.285402996	1.692774506	6.071174229	4.362681104	2.333735272	0	0.026659894	3.652787629	5.371574709	14.68240276	0.465523633	1.026715581	0.866172826	1.109144896	1.553035498	0.034673337	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.6887
H4204_022_0	2009	4																					3350											D	D	D	coin	T	coin	coin	V	coin	P	P	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1475.346372	32.04133742	455.3196363	44.44780905	408.5173798	20.1847359	5.601391209	393.2641451	51.75164827	2055.30694	1368.059959	0	0.23801989	35.90816712	4854.798694	8594.507706	188.7840861	910.4113376	31.33972551	6333.953697	9.835109714	18.59324318	0	50	465	0	0	0	0	0											1a:  Acute - $100/$0/day for 1-10/11-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $100/$0/day for 1-10/11-190	2:  Skilled Nursing Services - $0/$100/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-20/21-100	6:  Home Health Services - 20.0%	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50 to $50/visit/4a:  Worldwide Coverage - 39.5%	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - 20.0%	8a:  Outpatient Diagnostic Procedures/Tests - $30/visit/8a:  Outpatient Lab Services - $30/visit	8b:  Outpatient Diagnostic Radiological Services - $30/visit/8b:  Outpatient Therapeutic Radiological Services - $30/visit/8b:  Outpatient X-Ray Services - $30/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $30/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $30/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $30/visit/7f:  Podiatry Services - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $30/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $30/visit/7h:  Psychiatric Services - Individual - $30/visit/7h:  Psychiatric Services - Group - $30/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit	7a: Other Healthcare 20%	9c:  Outpatient Substance Abuse Svcs - Individual - $30/visit/9c:  Outpatient Substance Abuse Svcs - Group - $30/visit/7g:  Other Health Care Professional Services - $20 to $30/visit	15:  Medicare Part B Rx Drugs - $0/service	13a:  Blood - $30/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - X-Rays - $0/service	17a:  Routine Eye Exams - $15/visit				14b:  Other Immunizations - $0/visit/14a:  Alternative Medicine Program - $0/service/14a:  Written health education materials - $0/service/14a:  Nursing Hotline - $0/service/14a:  Nutritional Training - $0/service/14a:  Smoking Cessation - $0/service/14a:  Other - $0/service/14c:  Routine Exams - $0/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												100	100	100	0.2	50	0.3	0.220919735	51.69811164	0.2	30	30	0	0.2	0.150225604	20.02742949	32.29078453	30	30	0.039665989	3.986095782	0.2	30	0	0	15	0	0	0	0	0											76.06955948	76.06955948	76.06955948	0.152139119	38.03477974	0.228208678	0.16805267	39.32652579	0.152139119	22.82086784	22.82086784	0	0.152139119	0.114275956	15.23555895	24.56345754	22.82086784	22.82086784	0.030173743	3.032205501	0.152139119	22.82086784	0	0	15	0	0	0	0	0											9.3524	0.203114202	2.886330346	6.762250508	1.29482238	4.606331904	0.941328746	1.288809379	7.873450172	3.908657338	2.601692961	0	0.036212136	4.103440109	6.16379764	17.59256876	0.359018057	1.731364735	0.945636819	1.600487437	1.496304927	0.035359495	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.3646	0	23.84	9.3524	0.203114202	2.886330346	6.762250508	1.29482238	4.606331904	0.941328746	1.288809379	7.873450172	3.908657338	2.601692961	0	0.036212136	4.103440109	6.16379764	17.59256876	0.359018057	1.731364735	0.945636819	1.600487437	1.496304927	0.035359495	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.3646																																																																																		0			9.3524	0.203114202	2.886330346	6.762250508	1.29482238	4.606331904	0.941328746	1.288809379	7.873450172	3.908657338	2.601692961	0	0.036212136	4.103440109	6.16379764	17.59256876	0.359018057	1.731364735	0.945636819	1.600487437	1.496304927	0.035359495	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.3646
H4204_023_0	2009	4																					2500											coin	coin	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	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		286.0491936	3.095939946	456.9528455	31.80537413	329.4285423	17.27598886	5.330173456	326.9097592	434.3168741	1401.039928	1005.012232	0	0.232024538	26.43226523	4493.511735	6487.555489	181.2738373	830.993658	32.32491712	19.02874535	7.940636634	15.00187318	0	50	465	0	0	0	0	0											1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $0/admit for 1-190	2:  Skilled Nursing Services - $0/$100/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-20/21-100	6:  Home Health Services - 20.0%	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50 to $50/visit/4a:  Worldwide Coverage - 35.5%	9a:  Outpatient Hospital Services (Hospital Surgery) - $50/visit/9b:  Ambulatory Surgical Center Services - $25/visit	8a:  Outpatient Diagnostic Procedures/Tests - $10/visit/8a:  Outpatient Lab Services - $10/visit	8b:  Outpatient Diagnostic Radiological Services - $10/visit/8b:  Outpatient Therapeutic Radiological Services - $10/visit/8b:  Outpatient X-Ray Services - $10/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $20/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $20/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $20/visit/7h:  Psychiatric Services - Individual - $20/visit/7h:  Psychiatric Services - Group - $20/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $20/visit/9c:  Outpatient Substance Abuse Svcs - Group - $20/visit/7g:  Other Health Care Professional Services - $10 to $20/visit	15:  Medicare Part B Rx Drugs - $0/service	13a:  Blood - $20/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - X-Rays - $0/service	17a:  Routine Eye Exams - $15/visit				14b:  Other Immunizations - $0/visit/14a:  Alternative Medicine Program - $0/service/14a:  Written health education materials - $0/service/14a:  Nursing Hotline - $0/service/14a:  Nutritional Training - $0/service/14a:  Smoking Cessation - $0/service/14a:  Other - $0/service/14c:  Routine Exams - $0/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												0	0	100	0.2	50	0.2	0.041937078	51.63578867	30.0454603	10	10	0	0.2	0.129783582	10.0065946	20	20	20	0	20	0.2	20	0	0	15	0	0	0	0	0											0	0	86.49241418	0.172984828	43.24620709	0.172984828	0.036272391	44.6610402	25.98704396	8.649241418	8.649241418	0	0.172984828	0.112252953	8.654945247	17.29848284	17.29848284	17.29848284	0	17.29848284	0.172984828	17.29848284	0	0	15	0	0	0	0	0											0	0	3.293579564	5.501847184	1.187211247	2.988483968	0.193338136	1.216677492	0.940550975	1.009827715	0.724382785	0	0.040136725	2.96709983	3.240924836	9.352072273	0.26131353	1.197910794	0	0.027430702	1.373609665	0.021625804	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.1193	0	5.55	0	0	3.293579564	5.501847184	1.187211247	2.988483968	0.193338136	1.216677492	0.940550975	1.009827715	0.724382785	0	0.040136725	2.96709983	3.240924836	9.352072273	0.26131353	1.197910794	0	0.027430702	1.373609665	0.021625804	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.1193																																																																																		0			0	0	3.293579564	5.501847184	1.187211247	2.988483968	0.193338136	1.216677492	0.940550975	1.009827715	0.724382785	0	0.040136725	2.96709983	3.240924836	9.352072273	0.26131353	1.197910794	0	0.027430702	1.373609665	0.021625804	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.1193
H4204_024_0	2009	4																					2500											coin	coin	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	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		309.4409604	3.349111452	592.2425169	29.23751286	353.4924059	18.43996831	5.694419751	297.4952406	440.1857175	1624.942448	974.5180601	0	0.226241031	28.09674994	4879.711124	6910.719911	182.4798037	838.1144082	33.32616659	19.15533851	7.843022834	15.56038253	0	50	465	0	0	0	0	0											1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $0/admit for 1-190	2:  Skilled Nursing Services - $0/$100/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-20/21-100	6:  Home Health Services - 20.0%	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50 to $50/visit/4a:  Worldwide Coverage - 35.5%	9a:  Outpatient Hospital Services (Hospital Surgery) - $50/visit/9b:  Ambulatory Surgical Center Services - $25/visit	8a:  Outpatient Diagnostic Procedures/Tests - $10/visit/8a:  Outpatient Lab Services - $10/visit	8b:  Outpatient Diagnostic Radiological Services - $10/visit/8b:  Outpatient Therapeutic Radiological Services - $10/visit/8b:  Outpatient X-Ray Services - $10/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $20/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $20/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $20/visit/7h:  Psychiatric Services - Individual - $20/visit/7h:  Psychiatric Services - Group - $20/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $20/visit/9c:  Outpatient Substance Abuse Svcs - Group - $20/visit/7g:  Other Health Care Professional Services - $10 to $20/visit	15:  Medicare Part B Rx Drugs - $0/service	13a:  Blood - $20/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - X-Rays - $0/service	17a:  Routine Eye Exams - $15/visit				14b:  Other Immunizations - $0/visit/14a:  Alternative Medicine Program - $0/service/14a:  Written health education materials - $0/service/14a:  Nursing Hotline - $0/service/14a:  Nutritional Training - $0/service/14a:  Smoking Cessation - $0/service/14a:  Other - $0/service/14c:  Routine Exams - $0/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												0	0	100	0.2	50	0.2	0.042079276	51.94729893	30.0454603	10	10	0	0.2	0.13580144	10.00658622	20	20	20	0	20	0.2	20	0	0	15	0	0	0	0	0											0	0	85.3383195	0.170676639	42.66915975	0.170676639	0.035909747	44.33095193	25.6402909	8.53383195	8.53383195	0	0.170676639	0.115890666	8.539452517	17.0676639	17.0676639	17.0676639	0	17.0676639	0.170676639	17.0676639	0	0	15	0	0	0	0	0											0	0	4.211748427	4.990160427	1.256935328	3.147271815	0.204485171	1.099020601	0.940540821	1.155582148	0.693031113	0	0.038614059	3.256151075	3.47250512	9.829153729	0.259541997	1.192054586	0	0.02724474	1.338620777	0.022131615	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.716	0	6.38	0	0	4.211748427	4.990160427	1.256935328	3.147271815	0.204485171	1.099020601	0.940540821	1.155582148	0.693031113	0	0.038614059	3.256151075	3.47250512	9.829153729	0.259541997	1.192054586	0	0.02724474	1.338620777	0.022131615	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.716																																																																																		0			0	0	4.211748427	4.990160427	1.256935328	3.147271815	0.204485171	1.099020601	0.940540821	1.155582148	0.693031113	0	0.038614059	3.256151075	3.47250512	9.829153729	0.259541997	1.192054586	0	0.02724474	1.338620777	0.022131615	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.716
H4204_026_0	2009	4																					3350											coin	coin	D	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											17.6787	0.1913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											17.87		254.1123286	2.750283959	496.4615801	31.20995852	8.48147671	17.40059493	5.369723331	10.82663937	42.05773117	5.414383438	22.4753737	0	0.228429423	25.8035066	45.56698416	123.7678305	1.229197516	5.748684793	31.78042768	19620.29293	7.844268126	0.83415051	0	50	465	0	0	0	0	0											1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $0/admit for 1-190	2:  Skilled Nursing Services - $0/$100/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-20/21-100	6:  Home Health Services - 20.0%	10a:  Ambulance - 20.0%	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - 20.0%/4b:  Urgently Needed Care / Urgent Care Centers - 20.0%/4a:  Worldwide Coverage - 39.5%	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - 20.0%	8a:  Outpatient Diagnostic Procedures/Tests - 20.0%/8a:  Outpatient Lab Services - 20.0%	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - 20.0%/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $0/visit/17a:  Vision Exams - 20.0%/18a:  Hearing Exams - 20.0%/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - 20.0%/7b:  Chiropractic Services - 20.0%/7f:  Podiatry Services - 20.0%/17a:  Vision Exams - 20.0%/18a:  Hearing Exams - 20.0%/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - 20.0%/7e:  Mental Hlth Spec-Non-Physician - Group - 20.0%/7h:  Psychiatric Services - Individual - 20.0%/7h:  Psychiatric Services - Group - 20.0%	7c:  Occupational Therapy Services - 20.0%/7i:  Physical/Speech Therapy - 20.0%	7a: Other Healthcare 20%	9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - 20.0%	15:  Medicare Part B Rx Drugs - $0/service	13a:  Blood - 20.0%/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - X-Rays - $0/service	17a:  Routine Eye Exams - $15/visit				14b:  Other Immunizations - $0/visit/14a:  Alternative Medicine Program - $0/service/14a:  Written health education materials - $0/service/14a:  Nursing Hotline - $0/service/14a:  Nutritional Training - $0/service/14a:  Smoking Cessation - $0/service/14a:  Other - $0/service/14c:  Routine Exams - $0/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												0	0	100	0.2	0.2	0.2	0.06295441	0.202570418	0.2	0.2	0.2	0	0.2	0.2	0.009087662	0.159711418	0.2	0.2	0.184278334	4.408870072	0.2	0.2	0	0	15	0	0	0	0	0											0	0	84.75432257	0.169508645	0.169508645	0.169508645	0.053356584	0.171687186	0.169508645	0.169508645	0.169508645	0	0.169508645	0.169508645	0.007702186	0.13536233	0.169508645	0.169508645	0.156183853	3.736707963	0.169508645	0.169508645	0	0	15	0	0	0	0	0											0	0	3.506438742	5.290357784	1.437683626	2.949551271	0.286510092	1.858795243	7.129149029	0.917784801	3.809770145	0	0.038720762	4.373917444	0.350965385	16.75350196	0.208359606	0.974451771	4.96358966	6.109608736	1.329671262	0.141395723	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.0115	1024	11.23	17.6787	0.191337984	3.506438742	5.290357784	1.437683626	2.949551271	0.286510092	1.858795243	7.129149029	0.917784801	3.809770145	0	0.038720762	4.373917444	0.350965385	16.75350196	0.208359606	0.974451771	4.96358966	6.109608736	1.329671262	0.141395723	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.8815																																																																																		0			17.6787	0.191337984	3.506438742	5.290357784	1.437683626	2.949551271	0.286510092	1.858795243	7.129149029	0.917784801	3.809770145	0	0.038720762	4.373917444	0.350965385	16.75350196	0.208359606	0.974451771	4.96358966	6.109608736	1.329671262	0.141395723	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.8815
H4204_028_0	2009	6																					3350											D	D	D	coin	T	coin	coin	V	coin	P	P	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1465.752245	75.50629819	549.124239	35.57413946	331.9055397	21.9106283	6.980108956	491.6904546	38.67344681	2149.231794	1174.58545	0	0.182530928	26.22086447	4135.591404	7140.610428	250.4593825	553.5558162	28.83740238	4779.529866	9.107656125	16.21504213	0	50	465	0	0	0	0	100											1a:  Acute - $200/$0/day for 1-10/11-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $200/$0/day for 1-7/8-190	2:  Skilled Nursing Services - $0/$100/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-20/21-100	6:  Home Health Services - 20.0%	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50 to $50/visit/4a:  Worldwide Coverage - 39.5%	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - 20.0%	8a:  Outpatient Diagnostic Procedures/Tests - $30/visit/8a:  Outpatient Lab Services - $30/visit	8b:  Outpatient Diagnostic Radiological Services - $30/visit/8b:  Outpatient Therapeutic Radiological Services - $30/visit/8b:  Outpatient X-Ray Services - $30/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $35/visit/3:  Rehab Services (CORF) - $35/day/5:  Partial Hospitalization - $35/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $35/visit/7b:  Chiropractic Services - $35/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $35/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $35/visit/7h:  Psychiatric Services - Individual - $35/visit/7h:  Psychiatric Services - Group - $35/visit	7c:  Occupational Therapy Services - $35/visit/7i:  Physical/Speech Therapy - $35/visit	7a: Other Healthcare 20%	9c:  Outpatient Substance Abuse Svcs - Individual - $35/visit/9c:  Outpatient Substance Abuse Svcs - Group - $35/visit/7g:  Other Health Care Professional Services - $20 to $35/visit	15:  Medicare Part B Rx Drugs - $0/service	13a:  Blood - $35/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - X-Rays - $0/service	17a:  Routine Eye Exams - $15/visit				14b:  Other Immunizations - $0/visit/14a:  Alternative Medicine Program - $0/service/14a:  Written health education materials - $0/service/14a:  Nursing Hotline - $0/service/14a:  Nutritional Training - $0/service/14a:  Smoking Cessation - $0/service/14a:  Other - $0/service/14c:  Routine Exams - $0/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												200	200	100	0.2	50	0.3	0.231113586	51.62481291	0.2	30	30	0	0.2	0.179524806	20.04184871	35.90528911	35	35	0.040172619	3.674393892	0.2	35	0	0	15	0	0	0	0	0											152.1308743	152.1308743	76.06543716	0.152130874	38.03271858	0.228196311	0.17579756	39.26863962	0.152130874	22.81963115	22.81963115	0	0.152130874	0.136556329	15.24590158	27.38086559	26.62290301	26.62290301	0.030557479	2.794943777	0.152130874	26.62290301	0	0	15	0	0	0	0	0											18.5822	0.957236597	3.480781275	5.411924939	1.051939166	4.999924561	1.22708612	1.609001272	5.883425277	4.087056398	2.233633893	0	0.02776859	3.58062499	5.25423496	16.29300786	0.555662987	1.228105234	0.881198304	1.113209771	1.385555689	0.035974291	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.4608	0	25.08	18.5822	0.957236597	3.480781275	5.411924939	1.051939166	4.999924561	1.22708612	1.609001272	5.883425277	4.087056398	2.233633893	0	0.02776859	3.58062499	5.25423496	16.29300786	0.555662987	1.228105234	0.881198304	1.113209771	1.385555689	0.035974291	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.4608																																																																																		0			18.5822	0.957236597	3.480781275	5.411924939	1.051939166	4.999924561	1.22708612	1.609001272	5.883425277	4.087056398	2.233633893	0	0.02776859	3.58062499	5.25423496	16.29300786	0.555662987	1.228105234	0.881198304	1.113209771	1.385555689	0.035974291	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.4608
H4204_029_0	2009	6																					3350											D	D	D	coin	T	coin	coin	V	coin	P	P	O	coin	coin	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1411.202107	24.90779077	432.8909461	43.09887504	391.2451829	19.36692661	5.368821237	377.521618	49.56785132	1974.782614	1313.444671	0	0.226955029	34.23090566	4642.199027	8210.627015	179.790114	869.038249	29.8125272	6028.19854	9.407640284	17.69093197	0	50	465	0	0	0	0	100											1a:  Acute - $200/$0/day for 1-10/11-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $200/$0/day for 1-7/8-190	2:  Skilled Nursing Services - $0/$100/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-20/21-100	6:  Home Health Services - 20.0%	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50 to $50/visit/4a:  Worldwide Coverage - 39.5%	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - 20.0%	8a:  Outpatient Diagnostic Procedures/Tests - $30/visit/8a:  Outpatient Lab Services - $30/visit	8b:  Outpatient Diagnostic Radiological Services - $30/visit/8b:  Outpatient Therapeutic Radiological Services - $30/visit/8b:  Outpatient X-Ray Services - $30/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $35/visit/3:  Rehab Services (CORF) - $35/day/5:  Partial Hospitalization - $35/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $35/visit/7b:  Chiropractic Services - $35/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $35/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $35/visit/7h:  Psychiatric Services - Individual - $35/visit/7h:  Psychiatric Services - Group - $35/visit	7c:  Occupational Therapy Services - $35/visit/7i:  Physical/Speech Therapy - $35/visit	7a: Other Healthcare 20%	9c:  Outpatient Substance Abuse Svcs - Individual - $35/visit/9c:  Outpatient Substance Abuse Svcs - Group - $35/visit/7g:  Other Health Care Professional Services - $20 to $35/visit	15:  Medicare Part B Rx Drugs - $0/service	13a:  Blood - $35/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - X-Rays - $0/service	17a:  Routine Eye Exams - $15/visit				14b:  Other Immunizations - $0/visit/14a:  Alternative Medicine Program - $0/service/14a:  Written health education materials - $0/service/14a:  Nursing Hotline - $0/service/14a:  Nutritional Training - $0/service/14a:  Smoking Cessation - $0/service/14a:  Other - $0/service/14c:  Routine Exams - $0/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												200	200	100	0.2	50	0.3	0.220836915	51.69231159	0.2	30	30	0	0.2	0.160095814	20.03245102	36.358007	35	35	0.039877709	4.010496515	0.2	35	0	0	15	0	0	0	0	0											149.0802241	149.0802241	74.54011205	0.149080224	37.27005603	0.223620336	0.164612084	38.53150698	0.149080224	22.36203362	22.36203362	0	0.149080224	0.119335599	14.93378938	27.20870123	26.08903922	26.08903922	0.029724889	2.989428596	0.149080224	26.08903922	0	0	15	0	0	0	0	0											17.5319	0.309438253	2.688978302	6.425189949	1.215144157	4.330838638	0.883772852	1.212206405	7.389586383	3.680012932	2.447607824	0	0.033834507	4.084965636	5.777135211	18.61670812	0.390879278	1.889364413	0.886174061	1.501739091	1.402493122	0.038461618	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.3176	0	28.16	17.5319	0.309438253	2.688978302	6.425189949	1.215144157	4.330838638	0.883772852	1.212206405	7.389586383	3.680012932	2.447607824	0	0.033834507	4.084965636	5.777135211	18.61670812	0.390879278	1.889364413	0.886174061	1.501739091	1.402493122	0.038461618	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.3176																																																																																		0			17.5319	0.309438253	2.688978302	6.425189949	1.215144157	4.330838638	0.883772852	1.212206405	7.389586383	3.680012932	2.447607824	0	0.033834507	4.084965636	5.777135211	18.61670812	0.390879278	1.889364413	0.886174061	1.501739091	1.402493122	0.038461618	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.3176
H4204_030_0	2009	5																					2500											coin	coin	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	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		285.2841679	3.087659994	456.8627545	31.68380265	329.111327	17.20947539	5.309725628	325.5248635	434.0053324	1398.115243	1003.981377	0	0.232298139	26.42014592	4489.701014	6487.827947	181.7342679	833.1286969	32.30786952	19.07707784	7.871380078	14.90303048	0	50	465	0	0	0	0	0											1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $0/admit for 1-190	2:  Skilled Nursing Services - $0/$100/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-20/21-100	6:  Home Health Services - 20.0%	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50 to $50/visit/4a:  Worldwide Coverage - 35.5%	9a:  Outpatient Hospital Services (Hospital Surgery) - $50/visit/9b:  Ambulatory Surgical Center Services - $25/visit	8a:  Outpatient Diagnostic Procedures/Tests - $10/visit/8a:  Outpatient Lab Services - $10/visit	8b:  Outpatient Diagnostic Radiological Services - $10/visit/8b:  Outpatient Therapeutic Radiological Services - $10/visit/8b:  Outpatient X-Ray Services - $10/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $20/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $20/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $20/visit/7h:  Psychiatric Services - Individual - $20/visit/7h:  Psychiatric Services - Group - $20/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $20/visit/9c:  Outpatient Substance Abuse Svcs - Group - $20/visit/7g:  Other Health Care Professional Services - $10 to $20/visit	15:  Medicare Part B Rx Drugs - $0/service	13a:  Blood - $20/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - X-Rays - $0/service	17a:  Routine Eye Exams - $15/visit				14b:  Other Immunizations - $0/visit/14a:  Alternative Medicine Program - $0/service/14a:  Written health education materials - $0/service/14a:  Nursing Hotline - $0/service/14a:  Nutritional Training - $0/service/14a:  Smoking Cessation - $0/service/14a:  Other - $0/service/14c:  Routine Exams - $0/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												0	0	100	0.2	50	0.2	0.041939269	51.64221309	30.0454603	10	10	0	0.2	0.129743961	10.00659446	20	20	20	0	20	0.2	20	0	0	15	0	0	0	0	0											0	0	86.51966793	0.173039336	43.25983397	0.173039336	0.036285717	44.68067128	25.99523248	8.651966793	8.651966793	0	0.173039336	0.112254044	8.6576723	17.30393359	17.30393359	17.30393359	0	17.30393359	0.173039336	17.30393359	0	0	15	0	0	0	0	0											0	0	3.293967817	5.482544168	1.18644178	2.977916193	0.192667199	1.212055785	0.940172459	1.008037222	0.723867795	0	0.040196716	2.965768233	3.239196675	9.355411993	0.262059808	1.20136697	0	0.027509041	1.362058381	0.021490087	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.074	0	5.53	0	0	3.293967817	5.482544168	1.18644178	2.977916193	0.192667199	1.212055785	0.940172459	1.008037222	0.723867795	0	0.040196716	2.965768233	3.239196675	9.355411993	0.262059808	1.20136697	0	0.027509041	1.362058381	0.021490087	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.074																																																																																		0			0	0	3.293967817	5.482544168	1.18644178	2.977916193	0.192667199	1.212055785	0.940172459	1.008037222	0.723867795	0	0.040196716	2.965768233	3.239196675	9.355411993	0.262059808	1.20136697	0	0.027509041	1.362058381	0.021490087	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.074
H4204_031_0	2009	5																					2500											coin	coin	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	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		308.5670728	3.339653276	597.6748711	29.39915394	359.3537778	18.59991592	5.74381294	296.4164336	437.0143882	1616.595789	966.4751957	0	0.226741617	27.28598797	4896.095919	6935.76529	183.2884601	841.8284988	32.95734782	19.24022509	7.851671972	15.52398744	0	50	465	0	0	0	0	0											1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $0/admit for 1-190	2:  Skilled Nursing Services - $0/$100/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-20/21-100	6:  Home Health Services - 20.0%	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50 to $50/visit/4a:  Worldwide Coverage - 35.5%	9a:  Outpatient Hospital Services (Hospital Surgery) - $50/visit/9b:  Ambulatory Surgical Center Services - $25/visit	8a:  Outpatient Diagnostic Procedures/Tests - $10/visit/8a:  Outpatient Lab Services - $10/visit	8b:  Outpatient Diagnostic Radiological Services - $10/visit/8b:  Outpatient Therapeutic Radiological Services - $10/visit/8b:  Outpatient X-Ray Services - $10/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $20/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $20/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $20/visit/7h:  Psychiatric Services - Individual - $20/visit/7h:  Psychiatric Services - Group - $20/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $20/visit/9c:  Outpatient Substance Abuse Svcs - Group - $20/visit/7g:  Other Health Care Professional Services - $10 to $20/visit	15:  Medicare Part B Rx Drugs - $0/service	13a:  Blood - $20/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - X-Rays - $0/service	17a:  Routine Eye Exams - $15/visit				14b:  Other Immunizations - $0/visit/14a:  Alternative Medicine Program - $0/service/14a:  Written health education materials - $0/service/14a:  Nursing Hotline - $0/service/14a:  Nutritional Training - $0/service/14a:  Smoking Cessation - $0/service/14a:  Other - $0/service/14c:  Routine Exams - $0/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												0	0	100	0.2	50	0.2	0.042079276	51.9624867	30.0454603	10	10	0	0.2	0.134315159	10.00658622	20	20	20	0	20	0.2	20	0	0	15	0	0	0	0	0											0	0	85.32356549	0.170647131	42.66178275	0.170647131	0.035903538	44.33624637	25.63585799	8.532356549	8.532356549	0	0.170647131	0.114602482	8.537976143	17.0647131	17.0647131	17.0647131	0	17.0647131	0.170647131	17.0647131	0	0	15	0	0	0	0	0											0	0	4.249645917	5.016881273	1.277556066	3.174022289	0.206223208	1.095166002	0.933603233	1.149447639	0.68719258	0	0.038692806	3.127041956	3.483562513	9.863070399	0.260647082	1.197130151	0	0.027360743	1.339865296	0.022076033	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.7304	0	6.39	0	0	4.249645917	5.016881273	1.277556066	3.174022289	0.206223208	1.095166002	0.933603233	1.149447639	0.68719258	0	0.038692806	3.127041956	3.483562513	9.863070399	0.260647082	1.197130151	0	0.027360743	1.339865296	0.022076033	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.7304																																																																																		0			0	0	4.249645917	5.016881273	1.277556066	3.174022289	0.206223208	1.095166002	0.933603233	1.149447639	0.68719258	0	0.038692806	3.127041956	3.483562513	9.863070399	0.260647082	1.197130151	0	0.027360743	1.339865296	0.022076033	0	0	0.58125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.7304
H4204_801_0	2009	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	344.2036641	3.744072143	60.81747073	45.87411639	9.296330528	18.49816128	5.232734586	11.61393269	45.32715618	8.346413673	26.14819372	0	0.284110859	35.04993546	47.70449638	137.8518474	1.441718375	6.875271937	36.14765979	20599.3291	10.14631826	1.091944677	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.073974322	0.073974322	0.178587086	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.77695873	0.231	0.231	0	0	0	0	0	0	0	0											0.073974322	0.073974322	0.178587086	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.77695873	0.231	0.231	0	0	0	0	0	0	0	0											25.4622	0.276965199	10.86121488	0	2.147452352	4.273075255	1.208761689	2.682818452	10.47057308	1.928021558	6.04023275	0	0.065629609	8.09653509	11.01973866	31.84377676	0.333036945	1.588187817	8.350109411	9.916789508	2.343799519	0.25223922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1612	0	0	25.4622	0.276965199	10.86121488	0	2.147452352	4.273075255	1.208761689	2.682818452	10.47057308	1.928021558	6.04023275	0	0.065629609	8.09653509	11.01973866	31.84377676	0.333036945	1.588187817	8.350109411	9.916789508	2.343799519	0.25223922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1612	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	25.4622	0.276965199	10.86121488	0	2.147452352	4.273075255	1.208761689	2.682818452	10.47057308	1.928021558	6.04023275	0	0.065629609	8.09653509	11.01973866	31.84377676	0.333036945	1.588187817	8.350109411	9.916789508	2.343799519	0.25223922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1612
H4204_802_0	2009	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	344.2036641	3.744072143	60.81747073	45.87411639	9.296330528	18.49816128	5.232734586	11.61393269	45.32715618	8.346413673	26.14819372	0	0.284110859	35.04993546	47.70449638	137.8518474	1.441718375	6.875271937	36.14765979	20599.3291	10.14631826	1.091944677	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.073974322	0.073974322	0.178587086	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.77695873	0.231	0.231	0	0	0	0	0	0	0	0											0.073974322	0.073974322	0.178587086	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.77695873	0.231	0.231	0	0	0	0	0	0	0	0											25.4622	0.276965199	10.86121488	0	2.147452352	4.273075255	1.208761689	2.682818452	10.47057308	1.928021558	6.04023275	0	0.065629609	8.09653509	11.01973866	31.84377676	0.333036945	1.588187817	8.350109411	9.916789508	2.343799519	0.25223922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1612	0	0	25.4622	0.276965199	10.86121488	0	2.147452352	4.273075255	1.208761689	2.682818452	10.47057308	1.928021558	6.04023275	0	0.065629609	8.09653509	11.01973866	31.84377676	0.333036945	1.588187817	8.350109411	9.916789508	2.343799519	0.25223922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1612	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	25.4622	0.276965199	10.86121488	0	2.147452352	4.273075255	1.208761689	2.682818452	10.47057308	1.928021558	6.04023275	0	0.065629609	8.09653509	11.01973866	31.84377676	0.333036945	1.588187817	8.350109411	9.916789508	2.343799519	0.25223922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1612
H4204_803_0	2009	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	344.2036641	3.744072143	60.81747073	45.87411639	9.296330528	18.49816128	5.232734586	11.61393269	45.32715618	8.346413673	26.14819372	0	0.284110859	35.04993546	47.70449638	137.8518474	1.441718375	6.875271937	36.14765979	20599.3291	10.14631826	1.091944677	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.073974322	0.073974322	0.178587086	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.77695873	0.231	0.231	0	0	0	0	0	0	0	0											0.073974322	0.073974322	0.178587086	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.77695873	0.231	0.231	0	0	0	0	0	0	0	0											25.4622	0.276965199	10.86121488	0	2.147452352	4.273075255	1.208761689	2.682818452	10.47057308	1.928021558	6.04023275	0	0.065629609	8.09653509	11.01973866	31.84377676	0.333036945	1.588187817	8.350109411	9.916789508	2.343799519	0.25223922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1612	0	0	25.4622	0.276965199	10.86121488	0	2.147452352	4.273075255	1.208761689	2.682818452	10.47057308	1.928021558	6.04023275	0	0.065629609	8.09653509	11.01973866	31.84377676	0.333036945	1.588187817	8.350109411	9.916789508	2.343799519	0.25223922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1612	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	25.4622	0.276965199	10.86121488	0	2.147452352	4.273075255	1.208761689	2.682818452	10.47057308	1.928021558	6.04023275	0	0.065629609	8.09653509	11.01973866	31.84377676	0.333036945	1.588187817	8.350109411	9.916789508	2.343799519	0.25223922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1612
H4204_804_0	2009	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	344.2036641	3.744072143	60.81747073	45.87411639	9.296330528	18.49816128	5.232734586	11.61393269	45.32715618	8.346413673	26.14819372	0	0.284110859	35.04993546	47.70449638	137.8518474	1.441718375	6.875271937	36.14765979	20599.3291	10.14631826	1.091944677	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.073974322	0.073974322	0.178587086	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.77695873	0.231	0.231	0	0	0	0	0	0	0	0											0.073974322	0.073974322	0.178587086	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.77695873	0.231	0.231	0	0	0	0	0	0	0	0											25.4622	0.276965199	10.86121488	0	2.147452352	4.273075255	1.208761689	2.682818452	10.47057308	1.928021558	6.04023275	0	0.065629609	8.09653509	11.01973866	31.84377676	0.333036945	1.588187817	8.350109411	9.916789508	2.343799519	0.25223922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1612	0	0	25.4622	0.276965199	10.86121488	0	2.147452352	4.273075255	1.208761689	2.682818452	10.47057308	1.928021558	6.04023275	0	0.065629609	8.09653509	11.01973866	31.84377676	0.333036945	1.588187817	8.350109411	9.916789508	2.343799519	0.25223922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1612	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	25.4622	0.276965199	10.86121488	0	2.147452352	4.273075255	1.208761689	2.682818452	10.47057308	1.928021558	6.04023275	0	0.065629609	8.09653509	11.01973866	31.84377676	0.333036945	1.588187817	8.350109411	9.916789508	2.343799519	0.25223922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1612
H4205_002_0	2009	5																					3350											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	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		793.0242345	109.6798785	131.5814407	4.732819003	209.7667723	16.44606961	7.142532314	406.5287495	396.177935	5930.534604	1264.287115	0	0.144844661	32.40213713	3644.921702	4946.614558	519.6862994	512.4761574	29.51667622	54.55270546	15.60445307	14.80098799	0	0	409	0	40.57895664	0	90.02657084	0											1a:  Acute - $175/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $175/$0/day for 1-5/6-190	2:  Skilled Nursing Services - $0/$128/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$128/day for 1-20/21-100	6:  Home Health Services - 10.0%	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50 to $50/visit/4a:  Worldwide Coverage - 35.5%	9a:  Outpatient Hospital Services (Hospital Surgery) - $200/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $15 to $30/visit	8b:  Outpatient Diagnostic Radiological Services - $100/visit/8b:  Outpatient Therapeutic Radiological Services - $100/visit/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $30/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $30/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $30/visit/7f:  Podiatry Services - $30/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $30/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $30/visit/7h:  Psychiatric Services - Individual - $30/visit/7h:  Psychiatric Services - Group - $30/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $30/visit/9c:  Outpatient Substance Abuse Svcs - Group - $30/visit/7g:  Other Health Care Professional Services - $20 to $30/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $30/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $25/visit		18a:  Routine Hearing Test - $20/visit	18b:  Hearing Aids - $250/Every Other Year	14b:  Other Immunizations - $0/visit/14a:  Alternative Medicine Program - $0/service/14a:  Written health education materials - $0/service/14a:  Nursing Hotline - $0/service/14a:  Nutritional Training - $0/service/14a:  Smoking Cessation - $0/service/14a:  Other - $0/service/14c:  Routine Exams - $20/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												175	175	128	0.1	150	0.25	0.109638385	51.30429487	169.1701525	22.5	37.61475967	0	0.2	0.21534389	20	29.43180584	30	30	0	30	0.2	30	0	0	25	0	20	0	20	0											143.3820571	143.3820571	104.8737332	0.081932604	122.8989061	0.20483151	0.089829584	42.03494477	138.6055112	18.43483591	30.8187521	0	0.163865208	0.176436857	16.38652081	24.11424494	24.57978121	24.57978121	0	24.57978121	0.163865208	24.57978121	0	0	25	0	16.38652081	0	16.38652081	0											9.4755	1.31051055	1.149953075	0.387772185	2.148342237	3.368673274	0.641610704	1.424034461	4.5760371	9.110702689	3.246979265	0	0.023735001	5.716931238	4.977298775	9.940322923	1.064481295	1.049712652	0	0.11174113	2.55702695	0.030317087	0	0	0.852083333	0	0.055412326	0	0.12293519	0	0	0	0	0	0	0	0	0	0	0	63.3421	0	13.78	9.4755	1.31051055	1.149953075	0.387772185	2.148342237	3.368673274	0.641610704	1.424034461	4.5760371	9.110702689	3.246979265	0	0.023735001	5.716931238	4.977298775	9.940322923	1.064481295	1.049712652	0	0.11174113	2.55702695	0.030317087	0	0	0.852083333	0	0.055412326	0	0.12293519	0	0	0	0	0	0	0	0	0	0	0	63.3421																																																																																		0			9.4755	1.31051055	1.149953075	0.387772185	2.148342237	3.368673274	0.641610704	1.424034461	4.5760371	9.110702689	3.246979265	0	0.023735001	5.716931238	4.977298775	9.940322923	1.064481295	1.049712652	0	0.11174113	2.55702695	0.030317087	0	0	0.852083333	0	0.055412326	0	0.12293519	0	0	0	0	0	0	0	0	0	0	0	63.3421
H4205_004_0	2009	5																					3350											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	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		762.4406626	110.3674714	130.2273476	4.642486523	234.2694502	17.35587103	7.65654878	511.2883925	539.2177279	7065.555135	1782.886328	0	0.18757687	38.53637173	3789.54537	5706.218538	703.7543407	701.0522452	32.42378911	73.87476504	19.97647185	21.28697555	0	0	409	0	43.16552521	0	96.86019133	0											1a:  Acute - $275/$0/day for 1-6/7-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $275/$0/day for 1-6/7-190	2:  Skilled Nursing Services - $0/$128/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$128/day for 1-20/21-100	6:  Home Health Services - 10.0%	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50 to $50/visit/4a:  Worldwide Coverage - 35.5%	9a:  Outpatient Hospital Services (Hospital Surgery) - $200/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $15 to $35/visit	8b:  Outpatient Diagnostic Radiological Services - $100/visit/8b:  Outpatient Therapeutic Radiological Services - $100/visit/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $35/visit/3:  Rehab Services (CORF) - $35/day/5:  Partial Hospitalization - $35/day	7a:  Primary Care - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $25/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $35/visit/7b:  Chiropractic Services - $35/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $35/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $35/visit/7h:  Psychiatric Services - Individual - $35/visit/7h:  Psychiatric Services - Group - $35/visit	7c:  Occupational Therapy Services - $35/visit/7i:  Physical/Speech Therapy - $35/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $35/visit/9c:  Outpatient Substance Abuse Svcs - Group - $35/visit/7g:  Other Health Care Professional Services - $25 to $35/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $35/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $25/visit		18a:  Routine Hearing Test - $20/visit	18b:  Hearing Aids - $250/Every Other Year	14b:  Other Immunizations - $0/visit/14a:  Alternative Medicine Program - $0/service/14a:  Written health education materials - $0/service/14a:  Nursing Hotline - $0/service/14a:  Nutritional Training - $0/service/14a:  Smoking Cessation - $0/service/14a:  Other - $0/service/14c:  Routine Exams - $25/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												275	275	128	0.1	150	0.25	0.111817894	51.06587426	168.4926381	25	37.61475967	0	0.2	0.250202355	24.99896946	33.93451728	35	35	0	35	0.2	35	0	0	25	0	20	0	25	0											212.5108593	212.5108593	98.91414542	0.077276676	115.9150142	0.19319169	0.086409152	39.46201025	130.2055102	19.31916903	29.067436	0	0.154553352	0.193348063	19.31837266	26.23623156	27.04683664	27.04683664	0	27.04683664	0.154553352	27.04683664	0	0	25	0	15.45533522	0	19.31916903	0											13.5022	1.954523849	1.073443899	0.358755927	2.262945553	3.35301006	0.661595886	1.681372316	5.850759946	11.37505449	4.318661187	0	0.028990634	7.450932834	6.100654141	12.47580591	1.586194057	1.580103796	0	0.166506558	3.087430691	0.047978779	0	0	0.852083333	0	0.055594805	0	0.155938201	0	0	0	0	0	0	0	0	0	0	0	79.9806	0	23.26	13.5022	1.954523849	1.073443899	0.358755927	2.262945553	3.35301006	0.661595886	1.681372316	5.850759946	11.37505449	4.318661187	0	0.028990634	7.450932834	6.100654141	12.47580591	1.586194057	1.580103796	0	0.166506558	3.087430691	0.047978779	0	0	0.852083333	0	0.055594805	0	0.155938201	0	0	0	0	0	0	0	0	0	0	0	79.9806																																																																																		0			13.5022	1.954523849	1.073443899	0.358755927	2.262945553	3.35301006	0.661595886	1.681372316	5.850759946	11.37505449	4.318661187	0	0.028990634	7.450932834	6.100654141	12.47580591	1.586194057	1.580103796	0	0.166506558	3.087430691	0.047978779	0	0	0.852083333	0	0.055594805	0	0.155938201	0	0	0	0	0	0	0	0	0	0	0	79.9806
H4205_005_0	2009	6																					3350											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	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		793.0242345	109.6798785	131.5814407	4.732819003	209.7667723	16.44606961	7.142532314	406.5287495	396.177935	5930.534604	1264.287115	0	0.144844661	32.40213713	3644.921702	4946.614558	519.6862994	512.4761574	29.51667622	54.55270546	15.60445307	14.80098799	0	0	409	0	40.57895664	0	90.02657084	0											1a:  Acute - $175/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $175/$0/day for 1-5/6-190	2:  Skilled Nursing Services - $0/$128/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$128/day for 1-20/21-100	6:  Home Health Services - 10.0%	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50 to $50/visit/4a:  Worldwide Coverage - 35.5%	9a:  Outpatient Hospital Services (Hospital Surgery) - $200/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $15 to $30/visit	8b:  Outpatient Diagnostic Radiological Services - $100/visit/8b:  Outpatient Therapeutic Radiological Services - $100/visit/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $30/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $30/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $30/visit/7f:  Podiatry Services - $30/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $30/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $30/visit/7h:  Psychiatric Services - Individual - $30/visit/7h:  Psychiatric Services - Group - $30/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $30/visit/9c:  Outpatient Substance Abuse Svcs - Group - $30/visit/7g:  Other Health Care Professional Services - $20 to $30/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $30/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $25/visit		18a:  Routine Hearing Test - $20/visit	18b:  Hearing Aids - $250/Every Other Year	14b:  Other Immunizations - $0/visit/14a:  Alternative Medicine Program - $0/service/14a:  Written health education materials - $0/service/14a:  Nursing Hotline - $0/service/14a:  Nutritional Training - $0/service/14a:  Smoking Cessation - $0/service/14a:  Other - $0/service/14c:  Routine Exams - $20/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												175	175	128	0.1	150	0.25	0.109638385	51.30429487	169.1701525	22.5	37.61475967	0	0.2	0.21534389	20	29.43180584	30	30	0	30	0.2	30	0	0	25	0	20	0	20	0											143.3820571	143.3820571	104.8737332	0.081932604	122.8989061	0.20483151	0.089829584	42.03494477	138.6055112	18.43483591	30.8187521	0	0.163865208	0.176436857	16.38652081	24.11424494	24.57978121	24.57978121	0	24.57978121	0.163865208	24.57978121	0	0	25	0	16.38652081	0	16.38652081	0											9.4755	1.31051055	1.149953075	0.387772185	2.148342237	3.368673274	0.641610704	1.424034461	4.5760371	9.110702689	3.246979265	0	0.023735001	5.716931238	4.977298775	9.940322923	1.064481295	1.049712652	0	0.11174113	2.55702695	0.030317087	0	0	0.852083333	0	0.055412326	0	0.12293519	0	0	0	0	0	0	0	0	0	0	0	63.3421	0	13.78	9.4755	1.31051055	1.149953075	0.387772185	2.148342237	3.368673274	0.641610704	1.424034461	4.5760371	9.110702689	3.246979265	0	0.023735001	5.716931238	4.977298775	9.940322923	1.064481295	1.049712652	0	0.11174113	2.55702695	0.030317087	0	0	0.852083333	0	0.055412326	0	0.12293519	0	0	0	0	0	0	0	0	0	0	0	63.3421																																																																																		0			9.4755	1.31051055	1.149953075	0.387772185	2.148342237	3.368673274	0.641610704	1.424034461	4.5760371	9.110702689	3.246979265	0	0.023735001	5.716931238	4.977298775	9.940322923	1.064481295	1.049712652	0	0.11174113	2.55702695	0.030317087	0	0	0.852083333	0	0.055412326	0	0.12293519	0	0	0	0	0	0	0	0	0	0	0	63.3421
H4205_006_0	2009	6																					3350											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	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		762.4406626	110.3674714	130.2273476	4.642486523	234.2694502	17.35587103	7.65654878	511.2883925	539.2177279	7065.555135	1782.886328	0	0.18757687	38.53637173	3789.54537	5706.218538	703.7543407	701.0522452	32.42378911	73.87476504	19.97647185	21.28697555	0	0	409	0	43.16552521	0	96.86019133	0											1a:  Acute - $275/$0/day for 1-6/7-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $275/$0/day for 1-6/7-190	2:  Skilled Nursing Services - $0/$128/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$128/day for 1-20/21-100	6:  Home Health Services - 10.0%	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50 to $50/visit/4a:  Worldwide Coverage - 35.5%	9a:  Outpatient Hospital Services (Hospital Surgery) - $200/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $15 to $35/visit	8b:  Outpatient Diagnostic Radiological Services - $100/visit/8b:  Outpatient Therapeutic Radiological Services - $100/visit/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $35/visit/3:  Rehab Services (CORF) - $35/day/5:  Partial Hospitalization - $35/day	7a:  Primary Care - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $25/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $35/visit/7b:  Chiropractic Services - $35/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $35/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $35/visit/7h:  Psychiatric Services - Individual - $35/visit/7h:  Psychiatric Services - Group - $35/visit	7c:  Occupational Therapy Services - $35/visit/7i:  Physical/Speech Therapy - $35/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $35/visit/9c:  Outpatient Substance Abuse Svcs - Group - $35/visit/7g:  Other Health Care Professional Services - $25 to $35/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $35/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $25/visit		18a:  Routine Hearing Test - $20/visit	18b:  Hearing Aids - $250/Every Other Year	14b:  Other Immunizations - $0/visit/14a:  Alternative Medicine Program - $0/service/14a:  Written health education materials - $0/service/14a:  Nursing Hotline - $0/service/14a:  Nutritional Training - $0/service/14a:  Smoking Cessation - $0/service/14a:  Other - $0/service/14c:  Routine Exams - $25/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												275	275	128	0.1	150	0.25	0.111817894	51.06587426	168.4926381	25	37.61475967	0	0.2	0.250202355	24.99896946	33.93451728	35	35	0	35	0.2	35	0	0	25	0	20	0	25	0											212.5108593	212.5108593	98.91414542	0.077276676	115.9150142	0.19319169	0.086409152	39.46201025	130.2055102	19.31916903	29.067436	0	0.154553352	0.193348063	19.31837266	26.23623156	27.04683664	27.04683664	0	27.04683664	0.154553352	27.04683664	0	0	25	0	15.45533522	0	19.31916903	0											13.5022	1.954523849	1.073443899	0.358755927	2.262945553	3.35301006	0.661595886	1.681372316	5.850759946	11.37505449	4.318661187	0	0.028990634	7.450932834	6.100654141	12.47580591	1.586194057	1.580103796	0	0.166506558	3.087430691	0.047978779	0	0	0.852083333	0	0.055594805	0	0.155938201	0	0	0	0	0	0	0	0	0	0	0	79.9806	0	23.26	13.5022	1.954523849	1.073443899	0.358755927	2.262945553	3.35301006	0.661595886	1.681372316	5.850759946	11.37505449	4.318661187	0	0.028990634	7.450932834	6.100654141	12.47580591	1.586194057	1.580103796	0	0.166506558	3.087430691	0.047978779	0	0	0.852083333	0	0.055594805	0	0.155938201	0	0	0	0	0	0	0	0	0	0	0	79.9806																																																																																		0			13.5022	1.954523849	1.073443899	0.358755927	2.262945553	3.35301006	0.661595886	1.681372316	5.850759946	11.37505449	4.318661187	0	0.028990634	7.450932834	6.100654141	12.47580591	1.586194057	1.580103796	0	0.166506558	3.087430691	0.047978779	0	0	0.852083333	0	0.055594805	0	0.155938201	0	0	0	0	0	0	0	0	0	0	0	79.9806
H4205_007_0	2009	6																					3350											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	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		716.2257287	92.56044895	131.5814407	4.732819003	209.7667723	16.44606961	7.142532314	406.5287496	396.177935	5930.534604	1264.287115	0	0.144844661	32.44941018	3884.184895	5040.574637	531.4973516	524.1233428	29.74511994	55.79253967	15.60445307	14.87608941	0	2000	409	0	40.57895664	0	96.02834223	0											1a:  Acute - $150/$0/day for 1-4/5-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $150/$0/day for 1-4/5-190	2:  Skilled Nursing Services - $0/$128/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$128/day for 1-20/21-100	6:  Home Health Services - 10.0%	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $10 to $10/visit/4a:  Worldwide Coverage - 35.5%	9a:  Outpatient Hospital Services (Hospital Surgery) - $200/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $15 to $20/visit	8b:  Outpatient Diagnostic Radiological Services - $100/visit/8b:  Outpatient Therapeutic Radiological Services - $100/visit/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $20/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $10/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $20/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $20/visit/7h:  Psychiatric Services - Individual - $20/visit/7h:  Psychiatric Services - Group - $20/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $20/visit/9c:  Outpatient Substance Abuse Svcs - Group - $20/visit/7g:  Other Health Care Professional Services - $10 to $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $20/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $10/service/16a:  Preventive Dental - Prophylaxis - $10/service/16a:  Preventive Dental - X-Rays - $10/service	17a:  Routine Eye Exams - $25/visit		18a:  Routine Hearing Test - $20/visit	18b:  Hearing Aids - $250/Every Other Year	14b:  Other Immunizations - $0/visit/14a:  Alternative Medicine Program - $0/service/14a:  Written health education materials - $0/service/14a:  Nursing Hotline - $0/service/14a:  Nutritional Training - $0/service/14a:  Smoking Cessation - $0/service/14a:  Other - $0/service/14c:  Routine Exams - $10/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												150	150	128	0.1	150	0.25	0.109638385	51.30429482	169.1701525	17.5	37.61475967	0	0.2	0.191028351	10.00189036	20.51008331	20	20	0	20	0.2	20	0	10	25	0	20	0	10	0											127.7624498	127.7624498	109.0239571	0.085174967	127.7624498	0.212937416	0.093384458	43.69841593	144.0906207	14.90561914	32.03835895	0	0.170349933	0.162708334	8.519106763	17.46945659	17.0349933	17.0349933	0	17.0349933	0.170349933	17.0349933	0	10	25	0	17.0349933	0	8.517496651	0											7.6256	0.985479142	1.195460779	0.4031177	2.233359725	3.501983571	0.667001506	1.480388532	4.757127047	7.366524174	3.375473701	0	0.024674278	5.279789465	2.757482151	7.338008318	0.754504485	0.744036469	0	0.079202128	2.658217536	0.02111784	0	1.666666667	0.852083333	0	0.057605188	0	0.06816009	0	0	0	0	0	0	0	0	0	0	0	55.893	0	9.29	7.6256	0.985479142	1.195460779	0.4031177	2.233359725	3.501983571	0.667001506	1.480388532	4.757127047	7.366524174	3.375473701	0	0.024674278	5.279789465	2.757482151	7.338008318	0.754504485	0.744036469	0	0.079202128	2.658217536	0.02111784	0	1.666666667	0.852083333	0	0.057605188	0	0.06816009	0	0	0	0	0	0	0	0	0	0	0	55.893																																																																																		0			7.6256	0.985479142	1.195460779	0.4031177	2.233359725	3.501983571	0.667001506	1.480388532	4.757127047	7.366524174	3.375473701	0	0.024674278	5.279789465	2.757482151	7.338008318	0.754504485	0.744036469	0	0.079202128	2.658217536	0.02111784	0	1.666666667	0.852083333	0	0.057605188	0	0.06816009	0	0	0	0	0	0	0	0	0	0	0	55.893
H4205_008_0	2009	6																					3350											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	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		778.1610887	112.6430894	130.2273476	4.642486523	234.2694502	17.35587103	7.65654878	511.2883926	539.2177279	7065.555135	1782.886328	0	0.18757687	38.60374407	4001.71879	5706.218538	703.7543407	701.0522452	32.59195228	73.87476504	19.97647185	21.39960505	0	2000	409	0	43.16552521	0	102.3636113	0											1a:  Acute - $225/$0/day for 1-6/7-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $225/$0/day for 1-6/7-190	2:  Skilled Nursing Services - $0/$128/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$128/day for 1-20/21-100	6:  Home Health Services - 10.0%	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $15 to $15/visit/4a:  Worldwide Coverage - 35.5%	9a:  Outpatient Hospital Services (Hospital Surgery) - $200/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $15 to $25/visit	8b:  Outpatient Diagnostic Radiological Services - $100/visit/8b:  Outpatient Therapeutic Radiological Services - $100/visit/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - $25/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $15/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $15/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $25/visit/7b:  Chiropractic Services - $25/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $15 to $25/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $25/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $10/service/16a:  Preventive Dental - Prophylaxis - $10/service/16a:  Preventive Dental - X-Rays - $10/service	17a:  Routine Eye Exams - $25/visit		18a:  Routine Hearing Test - $20/visit	18b:  Hearing Aids - $250/Every Other Year	14b:  Other Immunizations - $0/visit/14a:  Alternative Medicine Program - $0/service/14a:  Written health education materials - $0/service/14a:  Nursing Hotline - $0/service/14a:  Nutritional Training - $0/service/14a:  Smoking Cessation - $0/service/14a:  Other - $0/service/14c:  Routine Exams - $15/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												225	225	128	0.1	150	0.25	0.111817894	51.06587421	168.4926381	20	37.61475967	0	0.2	0.21703745	15.0009759	24.97767417	25	25	0	25	0.2	25	0	10	25	0	20	0	15	0											179.3526581	179.3526581	102.0317344	0.079712292	119.5684387	0.199280731	0.089132607	40.70577901	134.3093444	15.94245849	29.98358724	0	0.159424585	0.173005527	11.95762178	19.91027668	19.92807312	19.92807312	0	19.92807312	0.159424585	19.92807312	0	10	25	0	15.94245849	0	11.95684387	0											11.6304	1.683569791	1.107276844	0.370063244	2.334269367	3.458690669	0.682448151	1.734366027	6.035164962	9.386859956	4.454777314	0	0.029904365	6.678661096	3.987586647	9.467699159	1.168705663	1.164218367	0	0.12268181	3.184740734	0.035537741	0	1.666666667	0.852083333	0	0.057347049	0	0.101995477	0	0	0	0	0	0	0	0	0	0	0	71.3958	0	17.53	11.6304	1.683569791	1.107276844	0.370063244	2.334269367	3.458690669	0.682448151	1.734366027	6.035164962	9.386859956	4.454777314	0	0.029904365	6.678661096	3.987586647	9.467699159	1.168705663	1.164218367	0	0.12268181	3.184740734	0.035537741	0	1.666666667	0.852083333	0	0.057347049	0	0.101995477	0	0	0	0	0	0	0	0	0	0	0	71.3958																																																																																		0			11.6304	1.683569791	1.107276844	0.370063244	2.334269367	3.458690669	0.682448151	1.734366027	6.035164962	9.386859956	4.454777314	0	0.029904365	6.678661096	3.987586647	9.467699159	1.168705663	1.164218367	0	0.12268181	3.184740734	0.035537741	0	1.666666667	0.852083333	0	0.057347049	0	0.101995477	0	0	0	0	0	0	0	0	0	0	0	71.3958
H4205_801_0	2009	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	344.2036641	3.744072143	60.81747073	45.87411639	9.296330528	18.49816128	5.232734586	11.61393269	45.32715618	8.346413673	26.14819372	0	0.284110859	35.04993546	47.70449638	137.8518474	1.441718375	6.875271937	36.14765979	20599.3291	10.14631826	1.091944677	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.073974322	0.073974322	0.178587086	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.77695873	0.231	0.231	0	0	0	0	0	0	0	0											0.073974322	0.073974322	0.178587086	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.77695873	0.231	0.231	0	0	0	0	0	0	0	0											25.4622	0.276965199	10.86121488	0	2.147452352	4.273075255	1.208761689	2.682818452	10.47057308	1.928021558	6.04023275	0	0.065629609	8.09653509	11.01973866	31.84377676	0.333036945	1.588187817	8.350109411	9.916789508	2.343799519	0.25223922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1612	0	0	25.4622	0.276965199	10.86121488	0	2.147452352	4.273075255	1.208761689	2.682818452	10.47057308	1.928021558	6.04023275	0	0.065629609	8.09653509	11.01973866	31.84377676	0.333036945	1.588187817	8.350109411	9.916789508	2.343799519	0.25223922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1612	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	25.4622	0.276965199	10.86121488	0	2.147452352	4.273075255	1.208761689	2.682818452	10.47057308	1.928021558	6.04023275	0	0.065629609	8.09653509	11.01973866	31.84377676	0.333036945	1.588187817	8.350109411	9.916789508	2.343799519	0.25223922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1612
H4205_802_0	2009	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	344.2036641	3.744072143	60.81747073	45.87411639	9.296330528	18.49816128	5.232734586	11.61393269	45.32715618	8.346413673	26.14819372	0	0.284110859	35.04993546	47.70449638	137.8518474	1.441718375	6.875271937	36.14765979	20599.3291	10.14631826	1.091944677	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.073974322	0.073974322	0.178587086	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.77695873	0.231	0.231	0	0	0	0	0	0	0	0											0.073974322	0.073974322	0.178587086	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.77695873	0.231	0.231	0	0	0	0	0	0	0	0											25.4622	0.276965199	10.86121488	0	2.147452352	4.273075255	1.208761689	2.682818452	10.47057308	1.928021558	6.04023275	0	0.065629609	8.09653509	11.01973866	31.84377676	0.333036945	1.588187817	8.350109411	9.916789508	2.343799519	0.25223922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1612	0	0	25.4622	0.276965199	10.86121488	0	2.147452352	4.273075255	1.208761689	2.682818452	10.47057308	1.928021558	6.04023275	0	0.065629609	8.09653509	11.01973866	31.84377676	0.333036945	1.588187817	8.350109411	9.916789508	2.343799519	0.25223922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1612	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	25.4622	0.276965199	10.86121488	0	2.147452352	4.273075255	1.208761689	2.682818452	10.47057308	1.928021558	6.04023275	0	0.065629609	8.09653509	11.01973866	31.84377676	0.333036945	1.588187817	8.350109411	9.916789508	2.343799519	0.25223922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1612
H4205_803_0	2009	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	344.2036641	3.744072143	60.81747073	45.87411639	9.296330528	18.49816128	5.232734586	11.61393269	45.32715618	8.346413673	26.14819372	0	0.284110859	35.04993546	47.70449638	137.8518474	1.441718375	6.875271937	36.14765979	20599.3291	10.14631826	1.091944677	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.073974322	0.073974322	0.178587086	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.77695873	0.231	0.231	0	0	0	0	0	0	0	0											0.073974322	0.073974322	0.178587086	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.77695873	0.231	0.231	0	0	0	0	0	0	0	0											25.4622	0.276965199	10.86121488	0	2.147452352	4.273075255	1.208761689	2.682818452	10.47057308	1.928021558	6.04023275	0	0.065629609	8.09653509	11.01973866	31.84377676	0.333036945	1.588187817	8.350109411	9.916789508	2.343799519	0.25223922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1612	0	0	25.4622	0.276965199	10.86121488	0	2.147452352	4.273075255	1.208761689	2.682818452	10.47057308	1.928021558	6.04023275	0	0.065629609	8.09653509	11.01973866	31.84377676	0.333036945	1.588187817	8.350109411	9.916789508	2.343799519	0.25223922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1612	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	25.4622	0.276965199	10.86121488	0	2.147452352	4.273075255	1.208761689	2.682818452	10.47057308	1.928021558	6.04023275	0	0.065629609	8.09653509	11.01973866	31.84377676	0.333036945	1.588187817	8.350109411	9.916789508	2.343799519	0.25223922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1612
H4205_804_0	2009	3																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	344.2036641	3.744072143	60.81747073	45.87411639	9.296330528	18.49816128	5.232734586	11.61393269	45.32715618	8.346413673	26.14819372	0	0.284110859	35.04993546	47.70449638	137.8518474	1.441718375	6.875271937	36.14765979	20599.3291	10.14631826	1.091944677	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.073974322	0.073974322	0.178587086	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.77695873	0.231	0.231	0	0	0	0	0	0	0	0											0.073974322	0.073974322	0.178587086	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.77695873	0.231	0.231	0	0	0	0	0	0	0	0											25.4622	0.276965199	10.86121488	0	2.147452352	4.273075255	1.208761689	2.682818452	10.47057308	1.928021558	6.04023275	0	0.065629609	8.09653509	11.01973866	31.84377676	0.333036945	1.588187817	8.350109411	9.916789508	2.343799519	0.25223922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1612	0	0	25.4622	0.276965199	10.86121488	0	2.147452352	4.273075255	1.208761689	2.682818452	10.47057308	1.928021558	6.04023275	0	0.065629609	8.09653509	11.01973866	31.84377676	0.333036945	1.588187817	8.350109411	9.916789508	2.343799519	0.25223922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1612	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	25.4622	0.276965199	10.86121488	0	2.147452352	4.273075255	1.208761689	2.682818452	10.47057308	1.928021558	6.04023275	0	0.065629609	8.09653509	11.01973866	31.84377676	0.333036945	1.588187817	8.350109411	9.916789508	2.343799519	0.25223922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1612
H4209_001_0	2009	5																																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	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		648.2284457	85.55993377	129.5739146	3.779816235	198.1016019	15.44212465	6.589953934	381.1681459	364.120821	5338.06662	1269.274317	0	0.123868456	1598.407706	3323.506776	4650.30587	451.7454586	445.4854358	28.64831519	47.420794	13.34397548	13.34213517	0	0	401.229	0	35.86215381	0	84.065883	0											1a:  Acute - $275/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $275/$0/day for 1-5/6-190	2:  Skilled Nursing Services - $0/$128/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$128/day for 1-20/21-100	6:  Home Health Services - 10.0%	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $35 to $0.3/visit/4a:  Worldwide Coverage - 35.5%	9a:  Outpatient Hospital Services (Hospital Surgery) - $200/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $15 to $30/visit	8b:  Outpatient Diagnostic Radiological Services - $100/visit/8b:  Outpatient Therapeutic Radiological Services - $100/visit/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $30/visit/3:  Rehab Services (CORF) - $35/day/5:  Partial Hospitalization - $35/day	7a:  Primary Care - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $25/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $35/visit/7b:  Chiropractic Services - $35/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $35/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $35/visit/7h:  Psychiatric Services - Individual - $35/visit/7h:  Psychiatric Services - Group - $35/visit	7c:  Occupational Therapy Services - $35/visit/7i:  Physical/Speech Therapy - $35/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $35/visit/9c:  Outpatient Substance Abuse Svcs - Group - $35/visit/7g:  Other Health Care Professional Services - $25 to $35/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $30/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $25/visit		18a:  Routine Hearing Test - $20/visit	18b:  Hearing Aids - $250/Every Other Year	14b:  Other Immunizations - $0/visit/14a:  Alternative Medicine Program - $0/service/14a:  Written health education materials - $0/service/14a:  Nursing Hotline - $0/service/14a:  Nutritional Training - $0/service/14a:  Smoking Cessation - $0/service/14a:  Other - $0/service/14c:  Routine Exams - $25/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												275	275	128	0.1	150	0.25	0.107155632	51.2852449	169.2968047	22.5	37.61475967	0	0.2	33.97018155	24.99902377	33.8658033	35	35	0	35	0.2	30	0	0	25	0	20	0	25	0											226.0856935	226.0856935	105.2326137	0.082212979	123.3194692	0.205532449	0.088095838	42.16312785	139.1839472	18.49792038	30.92421464	0	0.164425959	27.92789838	20.55244227	27.84208591	28.77454281	28.77454281	0	28.77454281	0.164425959	24.66389384	0	0	25	0	16.44259589	0	20.55324486	0											12.2129	1.611989747	1.136283475	0.310749954	2.035815366	3.173857691	0.580547513	1.339270106	4.223314428	8.228594276	3.270942617	0	0.02036719	3.720013999	5.692181763	10.78951796	1.083230753	1.068219979	0	0.113709306	2.194095964	0.027422417	0	0	0.83589375	0	0.049138909	0	0.143985557	0	0	0	0	0	0	0	0	0	0	0	63.8621	0	14.3216	12.2129	1.611989747	1.136283475	0.310749954	2.035815366	3.173857691	0.580547513	1.339270106	4.223314428	8.228594276	3.270942617	0	0.02036719	3.720013999	5.692181763	10.78951796	1.083230753	1.068219979	0	0.113709306	2.194095964	0.027422417	0	0	0.83589375	0	0.049138909	0	0.143985557	0	0	0	0	0	0	0	0	0	0	0	63.8621	3350	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	10a:  Ambulance - $150/trip	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$35 Copay	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	18b:  Hearing Aids - $250/Every Other Year	30% Coinsurance	30% Coinsurance											1.1984	0.0724	0.0617	0.0237	0.0459	0.0993	0.0399	0.0728	0.2469	0.0978	0.1161	0	0.0008	0.1898	0.2371	0.5914	0.0183	0.026	0.1767	0.1177	0.0832	0.0088	0	0	0.0162	0	0.0011	0.0017	0.0054	0											3.5492	2000	0.68571	13.4113	1.684376059	1.197943026	0.334453515	2.081669352	3.273185524	0.62047535	1.412068346	4.470255647	8.32642995	3.387032183	0	0.021153457	3.909835889	5.929287666	11.38092738	1.101551791	1.094203725	0.176710195	0.231446772	2.277275342	0.036266669	0	0	0.852083333	0	0.050257733	0.001681639	0.149432544	0	0	0	0	0	0	0	0	0	0	0	67.4113
H4209_003_0	2009	5																																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	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		641.8395176	87.69308541	117.7350153	4.135559842	211.7966603	15.61944751	6.889118678	462.2419811	488.9049444	6387.776891	1615.13763	0	0.168733117	2213.808654	3427.701893	5160.98681	636.2452248	633.8023334	29.16653331	66.78817277	17.97272926	19.34670005	0	0	388.959	0	39.20946778	0	87.56867366	0											1a:  Acute - $275/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $275/$0/day for 1-5/6-190	2:  Skilled Nursing Services - $0/$128/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$128/day for 1-20/21-100	6:  Home Health Services - 10.0%	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $35 to $0.3/visit/4a:  Worldwide Coverage - 35.5%	9a:  Outpatient Hospital Services (Hospital Surgery) - $200/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $15 to $30/visit	8b:  Outpatient Diagnostic Radiological Services - $100/visit/8b:  Outpatient Therapeutic Radiological Services - $100/visit/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $30/visit/3:  Rehab Services (CORF) - $35/day/5:  Partial Hospitalization - $35/day	7a:  Primary Care - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $25/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $35/visit/7b:  Chiropractic Services - $35/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $35/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $35/visit/7h:  Psychiatric Services - Individual - $35/visit/7h:  Psychiatric Services - Group - $35/visit	7c:  Occupational Therapy Services - $35/visit/7i:  Physical/Speech Therapy - $35/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $35/visit/9c:  Outpatient Substance Abuse Svcs - Group - $35/visit/7g:  Other Health Care Professional Services - $25 to $35/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $30/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $25/visit		18a:  Routine Hearing Test - $20/visit	18b:  Hearing Aids - $250/Every Other Year	14b:  Other Immunizations - $0/visit/14a:  Alternative Medicine Program - $0/service/14a:  Written health education materials - $0/service/14a:  Nursing Hotline - $0/service/14a:  Nutritional Training - $0/service/14a:  Smoking Cessation - $0/service/14a:  Other - $0/service/14c:  Routine Exams - $25/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												275	275	128	0.1	150	0.25	0.111789688	51.05986024	168.5836864	22.5	37.61475967	0	0.2	34.1117989	24.99896997	33.934961	35	35	0	35	0.2	30	0	0	25	0	20	0	25	0											223.896489	223.896489	104.2136385	0.081416905	122.1253576	0.203542263	0.091015704	41.57135795	137.2556199	18.31880364	30.62477318	0	0.16283381	27.77277093	20.35338765	27.64166959	28.49591678	28.49591678	-4.76E-19	28.49591678	0.16283381	24.42507152	0	0	25	0	16.28338102	0	20.35422627	0											11.9755	1.636181161	1.022466194	0.336704483	2.155478574	3.179217689	0.627017986	1.601335571	5.592079269	9.751369215	4.121935299	0	0.027475456	5.123633387	5.813778781	11.88819101	1.510865915	1.505064879	-1.39E-17	0.158599184	2.926567984	0.039378711	0	0	0.81033125	0	0.053205225	0	0.148532716	0	0	0	0	0	0	0	0	0	0	0	72.0049	0	18.1257	11.9755	1.636181161	1.022466194	0.336704483	2.155478574	3.179217689	0.627017986	1.601335571	5.592079269	9.751369215	4.121935299	0	0.027475456	5.123633387	5.813778781	11.88819101	1.510865915	1.505064879	-1.39E-17	0.158599184	2.926567984	0.039378711	0	0	0.81033125	0	0.053205225	0	0.148532716	0	0	0	0	0	0	0	0	0	0	0	72.0049	3350	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	10a:  Ambulance - $150/trip	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	$35 Copay	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	30% Coinsurance	18b:  Hearing Aids - $250/Every Other Year	30% Coinsurance	30% Coinsurance											3.1754	0.1993	0.1576	0.0623	0.1147	0.2532	0.1055	0.1897	0.6536	0.2422	0.2855	0	0.0021	0.4299	0.6178	1.5607	0.049	0.0692	0.4467	0.3141	0.2232	0.0241	0	0	0.0418	0	0.0031	0.0043	0.0144	0											9.2392	2000	1.88258	15.1508	1.835521111	1.180026846	0.398979475	2.270215016	3.43238632	0.732503761	1.791051421	6.24566166	9.993609244	4.407446633	0	0.029577548	5.553494126	6.431610747	13.44887047	1.559827192	1.574256855	0.446712392	0.472689258	3.14975165	0.063489966	0	0	0.852083333	0	0.05626902	0.004267819	0.162902719	0	0	0	0	0	0	0	0	0	0	0	81.244
H4209_004_0	2009	5																																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	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		666.0428029	89.44379919	121.7659817	4.05620045	199.0208739	15.03739478	7.248051306	383.8096789	357.1312274	5224.599484	1169.411489	0	0.121946492	1544.176102	3630.360511	4720.463315	456.800176	459.9800022	28.35113399	47.95139969	12.91494001	13.05144975	0	1962	401.229	0	36.38679052	0	90.92724451	0											1a:  Acute - $150/$0/day for 1-4/5-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $150/$0/day for 1-4/5-190	2:  Skilled Nursing Services - $0/$128/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$128/day for 1-20/21-100	6:  Home Health Services - 10.0%	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $20 to $0.2/visit/4a:  Worldwide Coverage - 35.5%	9a:  Outpatient Hospital Services (Hospital Surgery) - $200/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $15 to $20/visit	8b:  Outpatient Diagnostic Radiological Services - $100/visit/8b:  Outpatient Therapeutic Radiological Services - $100/visit/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $20/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $10/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $20/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $20/visit/7h:  Psychiatric Services - Individual - $20/visit/7h:  Psychiatric Services - Group - $20/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $20/visit/9c:  Outpatient Substance Abuse Svcs - Group - $20/visit/7g:  Other Health Care Professional Services - $10 to $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $20/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $10/service/16a:  Preventive Dental - Prophylaxis - $10/service/16a:  Preventive Dental - X-Rays - $10/service	17a:  Routine Eye Exams - $25/visit		18a:  Routine Hearing Test - $20/visit	18b:  Hearing Aids - $250/Every Other Year	14b:  Other Immunizations - $0/visit/14a:  Alternative Medicine Program - $0/service/14a:  Written health education materials - $0/service/14a:  Nursing Hotline - $0/service/14a:  Nutritional Training - $0/service/14a:  Smoking Cessation - $0/service/14a:  Other - $0/service/14c:  Routine Exams - $10/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												150	150	128	0.1	150	0.25	0.123529339	51.31454492	168.5011313	17.5	37.61475967	0	0.2	20	10.00181358	20.51534922	20	20	0	20	0.2	20	0	10	25	0	20	0	10	0											131.1569909	131.1569909	111.9206323	0.087437994	131.1569909	0.218594985	0.108011576	44.86840868	147.334009	15.30164894	32.88959129	0	0.174875988	17.48759879	8.745385156	17.93820981	17.48759879	17.48759879	-1.22E-19	17.48759879	0.174875988	17.48759879	0	10	25	0	17.48759879	0	8.743799396	0											7.2797	0.977598297	1.135677138	0.35466603	2.175248246	3.287099084	0.782873443	1.435077461	4.384797957	6.662082264	3.205122159	0	0.021325513	2.250327679	2.645741743	7.056388446	0.665694851	0.670328811	-3.47E-18	0.06987957	2.258512893	0.019019876	0	1.635	0.83589375	0	0.053026466	0	0.066254132	0	0	0	0	0	0	0	0	0	0	0	49.9273	0	7.2103	7.2797	0.977598297	1.135677138	0.35466603	2.175248246	3.287099084	0.782873443	1.435077461	4.384797957	6.662082264	3.205122159	0	0.021325513	2.250327679	2.645741743	7.056388446	0.665694851	0.670328811	-3.47E-18	0.06987957	2.258512893	0.019019876	0	1.635	0.83589375	0	0.053026466	0	0.066254132	0	0	0	0	0	0	0	0	0	0	0	49.9273	3350	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	10a:  Ambulance - $150/trip	30% Coinsurance	30% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$35 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	18b:  Hearing Aids - $250/Every Other Year	20% Coinsurance	20% Coinsurance											0.8856	0.0549	0.041	0.0183	0.0435	0.0866	0.0358	0.0563	0.1763	0.0654	0.0754	0	0.0005	0.117	0.2131	0.4306	0.0133	0.019	0.1248	0.0844	0.0571	0.0061	0	0.0317	0.0162	0	0.0008	0.001	0.0039	0											2.6586	1000	0.39235	8.1653	1.032524581	1.176708747	0.372952659	2.218758994	3.373704979	0.818632143	1.491404964	4.561060774	6.727509011	3.280539997	0	0.021874422	2.367352851	2.858844865	7.486987097	0.678996819	0.689311593	0.124811742	0.154254914	2.315589358	0.025088672	0	1.666666667	0.852083333	0	0.053850037	0.000993242	0.070120665	0	0	0	0	0	0	0	0	0	0	0	52.5859
H4209_006_0	2009	5																																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	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		615.3379584	78.51855487	113.5944493	3.990118335	204.3480857	15.06325842	6.645161901	446.3318431	475.6046395	6194.361867	1572.007655	0	0.163318649	2155.647655	3607.114022	5080.14811	627.8210013	625.4104551	28.51307528	65.90386201	18.31733884	19.1228299	0	1902	388.959	0	37.65233767	0	92.16983264	0											1a:  Acute - $150/$0/day for 1-4/5-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $150/$0/day for 1-4/5-190	2:  Skilled Nursing Services - $0/$128/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$128/day for 1-20/21-100	6:  Home Health Services - 10.0%	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $20 to $0.2/visit/4a:  Worldwide Coverage - 35.5%	9a:  Outpatient Hospital Services (Hospital Surgery) - $200/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $15 to $20/visit	8b:  Outpatient Diagnostic Radiological Services - $100/visit/8b:  Outpatient Therapeutic Radiological Services - $100/visit/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $20/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $10/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $20/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $20/visit/7h:  Psychiatric Services - Individual - $20/visit/7h:  Psychiatric Services - Group - $20/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $20/visit/9c:  Outpatient Substance Abuse Svcs - Group - $20/visit/7g:  Other Health Care Professional Services - $10 to $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $20/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $10/service/16a:  Preventive Dental - Prophylaxis - $10/service/16a:  Preventive Dental - X-Rays - $10/service	17a:  Routine Eye Exams - $25/visit		18a:  Routine Hearing Test - $20/visit	18b:  Hearing Aids - $250/Every Other Year	14b:  Other Immunizations - $0/visit/14a:  Alternative Medicine Program - $0/service/14a:  Written health education materials - $0/service/14a:  Nursing Hotline - $0/service/14a:  Nutritional Training - $0/service/14a:  Smoking Cessation - $0/service/14a:  Other - $0/service/14c:  Routine Exams - $10/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												150	150	128	0.1	150	0.25	0.111817894	51.05922325	168.8408905	17.5	37.61475967	0	0.2	20	10.00188875	20.4894017	20	20	0	20	0.2	20	0	10	25	0	20	0	10	0											129.5477122	129.5477122	110.5473811	0.086365141	129.5477122	0.215912854	0.096571682	44.0973704	145.8196739	15.11389976	32.48604041	0	0.172730283	17.2730283	8.638145374	17.69570077	17.2730283	17.2730283	2.43E-19	17.2730283	0.172730283	17.2730283	0	10	25	0	17.2730283	0	8.636514149	0											6.643	0.847658263	1.046464073	0.344607135	2.206068917	3.252351113	0.641734465	1.640171717	5.779376122	7.801747028	4.255692017	0	0.028210076	3.102880246	2.596564608	7.491398401	0.903697493	0.900227708	6.94E-18	0.094863273	3.163959121	0.027525765	0	1.585	0.81033125	0	0.054197491	0	0.066335505	0	0	0	0	0	0	0	0	0	0	0	55.284	0	9.3655	6.643	0.847658263	1.046464073	0.344607135	2.206068917	3.252351113	0.641734465	1.640171717	5.779376122	7.801747028	4.255692017	0	0.028210076	3.102880246	2.596564608	7.491398401	0.903697493	0.900227708	6.94E-18	0.094863273	3.163959121	0.027525765	0	1.585	0.81033125	0	0.054197491	0	0.066335505	0	0	0	0	0	0	0	0	0	0	0	55.284	3350	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	10a:  Ambulance - $150/trip	30% Coinsurance	30% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$35 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	18b:  Hearing Aids - $250/Every Other Year	20% Coinsurance	20% Coinsurance											2.2079	0.1385	0.1095	0.0433	0.1049	0.2216	0.0823	0.1402	0.4556	0.1687	0.1998	0	0.0015	0.3021	0.5376	1.1023	0.0355	0.0494	0.3162	0.223	0.1707	0.0181	0	0.0817	0.0418	0	0.0022	0.0025	0.01	0											6.7669	1000	1.01577	8.8509	0.98613312	1.155916237	0.387867508	2.310997119	3.473981376	0.724039436	1.780404212	6.234980517	7.970496994	4.455462906	0	0.029673178	3.405018016	3.134193364	8.59367066	0.939240577	0.949627679	0.316202539	0.317851768	3.334620991	0.045671807	0	1.666666667	0.852083333	0	0.056390164	0.002517218	0.07635142	0	0	0	0	0	0	0	0	0	0	0	62.0509
H4209_809_0	2009	4																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	333.9234472	3.632249179	58.96383783	44.46619111	9.021352622	17.95370563	5.078854899	11.27606135	43.98732493	8.100587518	25.38024651	0	0.275467357	34.03000054	46.24931319	133.702344	1.397791635	6.665880696	35.054554	19972.18967	9.845038724	1.05956257	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.778604311	0.231	0.231	0	0	0	0	0	0	0	0											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.778604311	0.231	0.231	0	0	0	0	0	0	0	0											24.6912	0.268578673	10.52734749	0	2.083932456	4.147306	1.173215482	2.604770171	10.16107206	1.871235717	5.862836943	0	0.063632959	7.860930124	10.68359135	30.88524147	0.322889868	1.539818441	8.097601975	9.617615112	2.274203945	0.244758954	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.9818	0	0	24.6912	0.268578673	10.52734749	0	2.083932456	4.147306	1.173215482	2.604770171	10.16107206	1.871235717	5.862836943	0	0.063632959	7.860930124	10.68359135	30.88524147	0.322889868	1.539818441	8.097601975	9.617615112	2.274203945	0.244758954	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.9818	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.7588	0.0083	0.3313	0	0.0615	0.1223	0.0346	0.0816	0.3185	0.0585	0.1827	0	0.002	0.2451	0.3404	0.9749	0.0103	0.0492	0.2594	0.3063	0.071	0.0076	0	0	0	0	0	0	0	0											4.2243	0	0	25.45	0.276832671	10.85863398	0	2.145466679	4.26964087	1.207822324	2.686338871	10.47959193	1.929730551	6.045498871	0	0.065670235	8.106007219	11.02397141	31.86016536	0.333206427	1.589059891	8.356997449	9.923871818	2.345204604	0.252398449	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.2062
H4209_810_0	2009	4																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	333.9234472	3.632249179	58.96383783	44.46619111	9.021352622	17.95370563	5.078854899	11.27606135	43.98732493	8.100587518	25.38024651	0	0.275467357	34.03000054	46.24931319	133.702344	1.397791635	6.665880696	35.054554	19972.18967	9.845038724	1.05956257	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.778604311	0.231	0.231	0	0	0	0	0	0	0	0											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.778604311	0.231	0.231	0	0	0	0	0	0	0	0											24.6912	0.268578673	10.52734749	0	2.083932456	4.147306	1.173215482	2.604770171	10.16107206	1.871235717	5.862836943	0	0.063632959	7.860930124	10.68359135	30.88524147	0.322889868	1.539818441	8.097601975	9.617615112	2.274203945	0.244758954	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.9818	0	0	24.6912	0.268578673	10.52734749	0	2.083932456	4.147306	1.173215482	2.604770171	10.16107206	1.871235717	5.862836943	0	0.063632959	7.860930124	10.68359135	30.88524147	0.322889868	1.539818441	8.097601975	9.617615112	2.274203945	0.244758954	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.9818	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.7588	0.0083	0.3313	0	0.0615	0.1223	0.0346	0.0816	0.3185	0.0585	0.1827	0	0.002	0.2451	0.3404	0.9749	0.0103	0.0492	0.2594	0.3063	0.071	0.0076	0	0	0	0	0	0	0	0											4.2243	0	0	25.45	0.276832671	10.85863398	0	2.145466679	4.26964087	1.207822324	2.686338871	10.47959193	1.929730551	6.045498871	0	0.065670235	8.106007219	11.02397141	31.86016536	0.333206427	1.589059891	8.356997449	9.923871818	2.345204604	0.252398449	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.2062
H4209_811_0	2009	4																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	333.9234472	3.632249179	58.96383783	44.46619111	9.021352622	17.95370563	5.078854899	11.27606135	43.98732493	8.100587518	25.38024651	0	0.275467357	34.03000054	46.24931319	133.702344	1.397791635	6.665880696	35.054554	19972.18967	9.845038724	1.05956257	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.778604311	0.231	0.231	0	0	0	0	0	0	0	0											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.778604311	0.231	0.231	0	0	0	0	0	0	0	0											24.6912	0.268578673	10.52734749	0	2.083932456	4.147306	1.173215482	2.604770171	10.16107206	1.871235717	5.862836943	0	0.063632959	7.860930124	10.68359135	30.88524147	0.322889868	1.539818441	8.097601975	9.617615112	2.274203945	0.244758954	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.9818	0	0	24.6912	0.268578673	10.52734749	0	2.083932456	4.147306	1.173215482	2.604770171	10.16107206	1.871235717	5.862836943	0	0.063632959	7.860930124	10.68359135	30.88524147	0.322889868	1.539818441	8.097601975	9.617615112	2.274203945	0.244758954	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.9818	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.7588	0.0083	0.3313	0	0.0615	0.1223	0.0346	0.0816	0.3185	0.0585	0.1827	0	0.002	0.2451	0.3404	0.9749	0.0103	0.0492	0.2594	0.3063	0.071	0.0076	0	0	0	0	0	0	0	0											4.2243	0	0	25.45	0.276832671	10.85863398	0	2.145466679	4.26964087	1.207822324	2.686338871	10.47959193	1.929730551	6.045498871	0	0.065670235	8.106007219	11.02397141	31.86016536	0.333206427	1.589059891	8.356997449	9.923871818	2.345204604	0.252398449	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.2062
H4209_812_0	2009	4																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	333.9234472	3.632249179	58.96383783	44.46619111	9.021352622	17.95370563	5.078854899	11.27606135	43.98732493	8.100587518	25.38024651	0	0.275467357	34.03000054	46.24931319	133.702344	1.397791635	6.665880696	35.054554	19972.18967	9.845038724	1.05956257	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.778604311	0.231	0.231	0	0	0	0	0	0	0	0											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.778604311	0.231	0.231	0	0	0	0	0	0	0	0											24.6912	0.268578673	10.52734749	0	2.083932456	4.147306	1.173215482	2.604770171	10.16107206	1.871235717	5.862836943	0	0.063632959	7.860930124	10.68359135	30.88524147	0.322889868	1.539818441	8.097601975	9.617615112	2.274203945	0.244758954	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.9818	0	0	24.6912	0.268578673	10.52734749	0	2.083932456	4.147306	1.173215482	2.604770171	10.16107206	1.871235717	5.862836943	0	0.063632959	7.860930124	10.68359135	30.88524147	0.322889868	1.539818441	8.097601975	9.617615112	2.274203945	0.244758954	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.9818	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.7588	0.0083	0.3313	0	0.0615	0.1223	0.0346	0.0816	0.3185	0.0585	0.1827	0	0.002	0.2451	0.3404	0.9749	0.0103	0.0492	0.2594	0.3063	0.071	0.0076	0	0	0	0	0	0	0	0											4.2243	0	0	25.45	0.276832671	10.85863398	0	2.145466679	4.26964087	1.207822324	2.686338871	10.47959193	1.929730551	6.045498871	0	0.065670235	8.106007219	11.02397141	31.86016536	0.333206427	1.589059891	8.356997449	9.923871818	2.345204604	0.252398449	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.2062
H4270_001_0	2009	2																					3350											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	P	P	Coin	P	T	P	V	P	V	P	P	P																																																			0		246.34592	7.644430476	977.9050826		126.1097911	7.208631598	6.478364512	304.7375586	232.3193099	1625.999936	353.2813981	24.70086821		1335.070692		1771.221128	192.3937067	201.9078087																							#1A $250	#1B $250	"#2 $0/day days 1-20, $75/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, #14I $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 $0, #17B $0, #18A $0"	#10B $0 n/c	"#16A $0 n/c, #16B $0 n/c"	#17A $0	#17B $0 n/c	#18A $0	#18B $0 n/c	#14A $0	#13B $0 n/c											250	250	39.60368412		100	0.2	0.124698443	47.48517724	100	25	25	25		25		25	25	25																							249.5212387	249.5212387	39.52786442		99.80849548	0.199616991	0.12445964	47.39434742	99.80849548	24.95212387	24.95212387	24.95212387		24.95212387		24.95212387	24.95212387	24.95212387																							5.1224	0.15895398	3.221208293	0	1.048902377	1.438965349	0.806294914	1.20356981	1.932286732	3.381012652	0.734593434	0.051361594	0	2.776070773	0	3.682977416	0.400052634	0.419835721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.3785	0	0.0506	5.1224	0.15895398	3.221208293	0	1.048902377	1.438965349	0.806294914	1.20356981	1.932286732	3.381012652	0.734593434	0.051361594	0	2.776070773	0	3.682977416	0.400052634	0.419835721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.3785		#1A 20%	#1B 20%	#2 20%	#6 20%	#10A 20%	#11A 20%	#11B 20%	"#4A $50, #4B $25"	"#9A 20%, #9B 20%"	#8A 20%	#8B 20%	#9A 20%	#12 20%	"#3 20%, #5 20%, #9A 20%, #9C 20%, #9D 20%"	"#7A 20%, #14B 20%, #14C 20%, #14D 20%, #14E 20%, #14F 20%, #14G 20%, #14H 20%, #14I 20%"	"#7B 0% n/c, #7D 20%, #7F 20%"	"#7E 20%, #7H 20%"	"#7C 20%, #7I 20%"	#7D 20%	#7G 20%	#15 20%	"#13A 20%, #14J 20%, #16B 0% n/c, #17A 20%, #17B 20%, #18A 20%"	#10B $0 n/c	"#16A $0 n/c, #16B $0 n/c"	#17A 20%	#17B 0% n/c	#18A 20%	#18B 0% n/c	#14A 20%	#13B $0 n/c											0.3764	0.0066	0.0759	0.0177	0.0122	0.0154	0.0138	0.0137	0.0606	0.0162	0.033	0.0023	0.0001	0.0543	0.0567	0.1155	0.0028	0.0044	0.0261	0.0023	0.0265	0.0137			0.0038				0.0048												0.9547	0	0	5.4987	0.165559255	3.297134908	0.017704559	1.061135364	1.454324057	0.820097715	1.217228911	1.992867864	3.397233847	0.767548253	0.053705172	0.000109819	2.830344302	0.056672186	3.798516666	0.402882826	0.424236789	0.026103693	0.002291609	0.026492379	0.013653788	0	0	0.0038	0	0	0	0.0048	0	0	0	0	0	0	0	0	0	0	0	27.3332
H4270_002_0	2009	5																					3350											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	P	P	Coin	P	T	P	V	P	V	P	P	P																																																			0		303.8551118	9.429014603	1206.101973		155.5499871	9.689450608	8.707865302	375.7359589								2184.710808	237.307812	249.0429709																							#1A $100	#1B $100	"#2 $0/day days 1-20, $50/day days 21-100"	#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 $0"	"#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 $0, #17B $0, #18A $0"	#10B $0 n/c	"#16A $0, #16B opt.supp"	#17A $0	#17B $0	#18A $0	#18B $0	#14A $0	#13B $0 n/c											100	100	27.94302608		100	0.2	0.1	46.98674926								10	10	10																							100	100	27.94302608		100	0.2	0.1	46.98674926								10	10	10																							2.5321	0.078575122	2.808511575	0	1.296249893	1.937890122	0.87078653	1.471217607	0	0	0	0	0	0	0	1.82059234	0.19775651	0.207535809	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.2212	0	0	2.5321	0.078575122	2.808511575	0	1.296249893	1.937890122	0.87078653	1.471217607	0	0	0	0	0	0	0	1.82059234	0.19775651	0.207535809	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.2212		#1A 20%	#1B 20%	#2 20%	#6 20%	#10A 20%	#11A 20%	#11B 20%	"#4A $50, #4B $25"	"#9A 20%, #9B 20%"	#8A 20%	#8B 20%	#9A 20%	#12 20%	"#3 20%, #5 20%, #9A 20%, #9C 20%, #9D 20%"	"#7A 20%, #14B 20%, #14C 20%, #14D 20%, #14E 20%, #14F 20%, #14G 20%, #14H 20%, #14I 20%"	"#7B 0% n/c, #7D 20%, #7F 20%"	"#7E 20%, #7H 20%"	"#7C 20%, #7I 20%"	#7D 20%	#7G 20%	#15 20%	"#13A 20%, #14J 20%, #16B 0% n/c, #17A 20%, #17B 20%, #18A 20%"	#10B $0 n/c	"#16A $0 n/c, #16B $0 n/c"	#17A 20%	#17B 20%	#18A 20%	#18B 0% n/c	#14A 20%	#13B $0 n/c											0.4672	0.0082	0.0942	0.022	0.0152	0.019	0.0171	0.015	0.0751	0.0201	0.0409	0.0029	0.0001	0.0673	0.0698	0.1433	0.0035	0.0055	0.0324	0.0028	0.0329	0.0164			0.0051			0.002	0.0048												1.183	0	0	2.9994	0.086767777	2.902679762	0.021959321	1.311422713	1.956939837	0.887906423	1.486266315	0.075139997	0.020119474	0.040874526	0.002906787	0.00013621	0.06731655	0.069824889	1.963897998	0.201266855	0.212994542	0.032376936	0.002842329	0.032859031	0.016443519	0	0	0.00512	0	0	0.00202	0.0048	0	0	0	0	0	0	0	0	0	0	0	14.4042
H4270_003_0	2009	5																					3350											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	P	P	Coin	P	T	P	V	P	V	P	P	P																																																			0		256.5339355	7.960577689	1018.325379		131.3252561	7.772309277	6.984939085	317.3064374	241.9272333	1693.245672	367.8918952	25.72241071		1390.2846		1844.47271	200.3504452	210.2580176																							#1A $250	#1B $250	"#2 $0/day days 1-20, $75/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, #14I $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 $0, #17B $0, #18A $0"	#10B $0 n/c	"#16A $0 n/c, #16B $0 n/c"	#17A $0	#17B $0 n/c	#18A $0	#18B $0 n/c	#14A $0	#13B $0 n/c											250	250	40.63161205		100	0.2	0.124698443	47.48624757	100	25	25	25		25		25	25	25																							249.5212387	249.5212387	40.55382271		99.80849548	0.199616991	0.12445964	47.39540802	99.80849548	24.95212387	24.95212387	24.95212387		24.95212387		24.95212387	24.95212387	24.95212387																							5.3342	0.165527767	3.441415573	0	1.092281352	1.551484991	0.869343002	1.253239006	2.01219943	3.520839645	0.764973678	0.053485732	0	2.890879462	0	3.835292628	0.416597427	0.437198675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.639	0	0.053	5.3342	0.165527767	3.441415573	0	1.092281352	1.551484991	0.869343002	1.253239006	2.01219943	3.520839645	0.764973678	0.053485732	0	2.890879462	0	3.835292628	0.416597427	0.437198675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.639		#1A 20%	#1B 20%	#2 20%	#6 20%	#10A 20%	#11A 20%	#11B 20%	"#4A $50, #4B $25"	"#9A 20%, #9B 20%"	#8A 20%	#8B 20%	#9A 20%	#12 20%	"#3 20%, #5 20%, #9A 20%, #9C 20%, #9D 20%"	"#7A 20%, #14B 20%, #14C 20%, #14D 20%, #14E 20%, #14F 20%, #14G 20%, #14H 20%, #14I 20%"	"#7B 0% n/c, #7D 20%, #7F 20%"	"#7E 20%, #7H 20%"	"#7C 20%, #7I 20%"	#7D 20%	#7G 20%	#15 20%	"#13A 20%, #14J 20%, #16B 0% n/c, #17A 20%, #17B 20%, #18A 20%"	#10B $0 n/c	"#16A $0 n/c, #16B $0 n/c"	#17A 20%	#17B 0% n/c	#18A 20%	#18B 0% n/c	#14A 20%	#13B $0 n/c											0.4081	0.0072	0.0823	0.0192	0.0133	0.0167	0.015	0.0142	0.0657	0.0176	0.0357	0.0025	0.0001	0.0589	0.0613	0.1253	0.0031	0.0048	0.0283	0.0025	0.0287	0.0146			0.0041				0.0048												1.034	0	0	5.7423	0.172690682	3.523750375	0.019199239	1.105547091	1.568140334	0.884311084	1.267461678	2.07789503	3.538430289	0.800710657	0.056027163	0.00011909	2.949734949	0.061285649	3.9605861	0.419666555	0.441971296	0.028307456	0.002485075	0.028728957	0.014633809	0	0	0.00412	0	0	0	0.0048	0	0	0	0	0	0	0	0	0	0	0	28.6729
H4270_801_0	2009	2																					3350											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	P	P	Coin	P	T	P	V	P	V	P	P	P																																																			0		326.0223025	10.11689102	1294.055217		166.8978503	11.07503466	9.953083399	403.0931971	307.4590248	2151.901859	467.5442355	32.68994237		1766.876517	3162.762614	2344.092366	254.6201669	267.2114427																							#1A $250	#1B $250	"#2 $0/day days 1-20, $75/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, #14I $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 $0, #17B $0, #18A $0"	#10B $0 n/c	"#16A $0 n/c, #16B $0 n/c"	#17A $0	#17B $0 n/c	#18A $0	#18B $0 n/c	#14A $0	#13B $0 n/c											250	250	44.53293815		100	0.2	0.124698443	47.49029309	100	25	25	25		25	25	25	25	25																							250	250	44.53293815		100	0.2	0.124698443	47.49029309	100	25	25	25		25	25	25	25	25																							6.7921	0.210768563	4.802340077	0	1.390815419	2.215006931	1.241134002	1.595251173	2.56215854	4.483128872	0.974050491	0.068104047	0	3.680992743	6.58908878	4.883525763	0.530458681	0.556690506	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.5756	0	0	6.7921	0.210768563	4.802340077	0	1.390815419	2.215006931	1.241134002	1.595251173	2.56215854	4.483128872	0.974050491	0.068104047	0	3.680992743	6.58908878	4.883525763	0.530458681	0.556690506	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.5756		#1A 20%	#1B 20%	#2 20%	#6 20%	#10A 20%	#11A 20%	#11B 20%	"#4A $50, #4B $25"	"#9A 20%, #9B 20%"	#8A 20%	#8B 20%	#9A 20%	#12 20%	"#3 20%, #5 20%, #9A 20%, #9C 20%, #9D 20%"	"#7A 20%, #14B 20%, #14C 20%, #14D 20%, #14E 20%, #14F 20%, #14G 20%, #14H 20%, #14I 20%"	"#7B 0% n/c, #7D 20%, #7F 20%"	"#7E 20%, #7H 20%"	"#7C 20%, #7I 20%"	#7D 20%	#7G 20%	#15 20%	"#13A 20%, #14J 20%, #16B 0% n/c, #17A 20%, #17B 20%, #18A 20%"	#10B $0 n/c	"#16A $0 n/c, #16B $0 n/c"	#17A 20%	#17B 0% n/c	#18A 20%	#18B 0% n/c	#14A 20%	#13B $0 n/c											0.5277	0.0093	0.1063	0.0248	0.0171	0.0215	0.0193	0.0162	0.0848	0.0227	0.0462	0.0033	0.0002	0.076	0.0786	0.1618	0.004	0.0062	0.0366	0.0032	0.0371	0.0183			0.0038				0.0048												1.3296	0	0	7.3198	0.220019676	4.908671655	0.024796376	1.407948506	2.236517792	1.260465715	1.611410233	2.647006318	4.505847701	1.020205838	0.071386379	0.000153808	3.757006317	6.667650491	5.045345926	0.534422548	0.562854484	0.036559903	0.003209546	0.037104283	0.018303698	0	0	0.0038	0	0	0	0.0048	0	0	0	0	0	0	0	0	0	0	0	43.9053
H4270_802_0	2009	2																					3350											A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	P	P	Coin	P	T	P	V	P	V	P	P	P																																																			0		322.5474018	10.00906038	1280.26762		165.1189737	10.81142275	9.716176577	398.8043206	304.1819803	2128.965866	462.5609268	32.34151742		1748.044307	3129.052387	2319.107916	251.9063041	264.3633762																							#1A $250	#1B $250	"#2 $0/day days 1-20, $75/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, #14I $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 $0, #17B $0, #18A $0"	#10B $0 n/c	"#16A $0 n/c, #16B $0 n/c"	#17A $0	#17B $0 n/c	#18A $0	#18B $0 n/c	#14A $0	#13B $0 n/c											250	250	44.90103412		100	0.2	0.124698443	47.49010565	100	25	25	25		25	25	25	25	25																							250	250	44.90103412		100	0.2	0.124698443	47.49010565	100	25	25	25		25	25	25	25	25																							6.7197	0.208522091	4.790445008	0	1.375991447	2.162284551	1.211592091	1.57827161	2.534849836	4.435345554	0.963668597	0.067378161	0	3.641758973	6.518859139	4.831474824	0.5248048	0.550757034	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1157	0	0	6.7197	0.208522091	4.790445008	0	1.375991447	2.162284551	1.211592091	1.57827161	2.534849836	4.435345554	0.963668597	0.067378161	0	3.641758973	6.518859139	4.831474824	0.5248048	0.550757034	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1157		#1A 20%	#1B 20%	#2 20%	#6 20%	#10A 20%	#11A 20%	#11B 20%	"#4A $50, #4B $25"	"#9A 20%, #9B 20%"	#8A 20%	#8B 20%	#9A 20%	#12 20%	"#3 20%, #5 20%, #9A 20%, #9C 20%, #9D 20%"	"#7A 20%, #14B 20%, #14C 20%, #14D 20%, #14E 20%, #14F 20%, #14G 20%, #14H 20%, #14I 20%"	"#7B 0% n/c, #7D 20%, #7F 20%"	"#7E 20%, #7H 20%"	"#7C 20%, #7I 20%"	#7D 20%	#7G 20%	#15 20%	"#13A 20%, #14J 20%, #16B 0% n/c, #17A 20%, #17B 20%, #18A 20%"	#10B $0 n/c	"#16A $0 n/c, #16B $0 n/c"	#17A 20%	#17B 0% n/c	#18A 20%	#18B 0% n/c	#14A 20%	#13B $0 n/c											0.5165	0.0091	0.1041	0.0243	0.0168	0.0211	0.0189	0.016	0.083	0.0222	0.0452	0.0032	0.0002	0.0744	0.0769	0.1584	0.0039	0.006	0.0358	0.0031	0.0363	0.018			0.0038				0.0048												1.3019	0	0	7.2362	0.21757705	4.894522453	0.024270609	1.392761256	2.183339309	1.230513906	1.594258779	2.617898557	4.457582667	1.008845297	0.070590897	0.000150547	3.716160804	6.595798026	4.989863858	0.52868462	0.556790315	0.035784711	0.003141493	0.036317548	0.017958968	0	0	0.0038	0	0	0	0.0048	0	0	0	0	0	0	0	0	0	0	0	43.4176
H4362_001_0	2009	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3000	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	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	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$35 X-ray; $150 Complex Radiology	$35 per visit	$20 per visit	$35 per visit	$10 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	Not Covered	$0 per visit	$300 Every 3 Yrs	Fitness/Coaching	0											91.92581111	91.92581111	40.33133874	0	100	0.2	0.2	47.5	150	0	81	35	20	35	10	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											91.92581111	91.92581111	40.33133874	0	100	0.2	0.2	47.5	150	0	81	35	20	35	10	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											13.1722	0	3.988951409	0	2.003577927	1.3870016	0	0.88622679	4.229384937	0	28.00323443	0	0.098010916	2.019993848	5.358275608	23.79774777	0	1.724950012	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.5837	0	0	13.1722	0	3.988951409	0	2.003577927	1.3870016	0	0.88622679	4.229384937	0	28.00323443	0	0.098010916	2.019993848	5.358275608	23.79774777	0	1.724950012	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.5837		$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$100 copay	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$50 copay	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$20 copay	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP		0	0	$500 ded; 20% coinsurance; $3000 max OOP	0	$500 ded; 20% coinsurance; $3000 max OOP	0	Not Covered												4.5026	0	0.556	0.0843	0.1668	0.1324	0	0.0964	0.6046	0.2061	0.84	0	0.019	0.1742	0.6155	2.6734	0	0.0792	0	0	0.1196	0	0	0	0.0558	0	0.0036	0	0	0											10.9295	500	2.893288696	17.6748	0	4.544938531	0.084294316	2.17042691	1.519352991	0	0.982661775	4.833989852	0.206089147	28.84326864	0	0.117040154	2.194236822	5.973729737	26.47112383	0	1.80418269	0	0	1.033736393	0	0	0	0.055763101	0	0.003559502	0	0	0	0	0	0	0	0	0	0	0	0	0	98.5132
H4362_002_0	2009	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3000	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	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	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$35 X-ray; $150 Complex Radiology	$35 per visit	$20 per visit	$35 per visit	$10 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	Not Covered	$0 per visit	$300 Every 3 Yrs	Fitness/Coaching	0											91.92581111	91.92581111	40.33133874	0	100	0.2	0.2	47.5	150	0	81	35	20	35	10	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											91.92581111	91.92581111	40.33133874	0	100	0.2	0.2	47.5	150	0	81	35	20	35	10	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											13.1722	0	3.988951409	0	2.003577927	1.3870016	0	0.88622679	4.229384937	0	28.00323443	0	0.098010916	2.019993848	5.358275608	23.79774777	0	1.724950012	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.5837	0	0	13.1722	0	3.988951409	0	2.003577927	1.3870016	0	0.88622679	4.229384937	0	28.00323443	0	0.098010916	2.019993848	5.358275608	23.79774777	0	1.724950012	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.5837		$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$100 copay	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$50 copay	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$20 copay	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP	$500 ded; 20% coinsurance; $3000 max OOP		0	0	$500 ded; 20% coinsurance; $3000 max OOP	0	$500 ded; 20% coinsurance; $3000 max OOP	0	Not Covered												4.5026	0	0.556	0.0843	0.1668	0.1324	0	0.0964	0.6046	0.2061	0.84	0	0.019	0.1742	0.6155	2.6734	0	0.0792	0	0	0.1196	0	0	0	0.0558	0	0.0036	0	0	0											10.9295	500	2.893288696	17.6748	0	4.544938531	0.084294316	2.17042691	1.519352991	0	0.982661775	4.833989852	0.206089147	28.84326864	0	0.117040154	2.194236822	5.973729737	26.47112383	0	1.80418269	0	0	1.033736393	0	0	0	0.055763101	0	0.003559502	0	0	0	0	0	0	0	0	0	0	0	0	0	98.5132
H4362_801_0	2009	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																																																			0		330.8114989	0	40.84868783	6.19315102	7.30435098	9.723931408	0	8.595126182	44.42066458	15.14148605	61.7177878	0	3.367870405	12.80172974	45.21776244	196.4144491	0	5.82126962	0	0	8.784368458	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.0681	0.0681	0.1579	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											22.5283	0	6.450007808	0	1.687305076	2.246228155	0	1.985474148	10.26117352	3.497683277	14.25680898	0	0.777978064	2.95719957	10.44530312	45.37173774	0	1.344713282	0	0	2.029189114	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.8391			22.5283	0	6.450007808	0	1.687305076	2.246228155	0	1.985474148	10.26117352	3.497683277	14.25680898	0	0.777978064	2.95719957	10.44530312	45.37173774	0	1.344713282	0	0	2.029189114	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.8391		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.072	0	0.8795	0	0.2301	0.3063	0	0.2707	1.3993	0.477	1.9441	0	0.1061	0.4033	1.4244	6.1871	0	0.1834	0	0	0.2767	0	0	0	0	0	0	0	0	0											17.1599			25.6003	0	7.329554328	0	1.917392132	2.552531995	0	2.256220623	11.66042445	3.974640088	16.2009193	0	0.884065981	3.360454056	11.86966264	51.55879289	0	1.528083275	0	0	2.30589672	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.9989
H4362_802_0	2009	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																																																			0		330.8114989	0	40.84868783	6.19315102	7.30435098	9.723931408	0	8.595126182	44.42066458	15.14148605	61.7177878	0	3.367870405	12.80172974	45.21776244	196.4144491	0	5.82126962	0	0	8.784368458	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.0681	0.0681	0.1579	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											22.5283	0	6.450007808	0	1.687305076	2.246228155	0	1.985474148	10.26117352	3.497683277	14.25680898	0	0.777978064	2.95719957	10.44530312	45.37173774	0	1.344713282	0	0	2.029189114	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.8391			22.5283	0	6.450007808	0	1.687305076	2.246228155	0	1.985474148	10.26117352	3.497683277	14.25680898	0	0.777978064	2.95719957	10.44530312	45.37173774	0	1.344713282	0	0	2.029189114	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.8391		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.072	0	0.8795	0	0.2301	0.3063	0	0.2707	1.3993	0.477	1.9441	0	0.1061	0.4033	1.4244	6.1871	0	0.1834	0	0	0.2767	0	0	0	0	0	0	0	0	0											17.1599			25.6003	0	7.329554328	0	1.917392132	2.552531995	0	2.256220623	11.66042445	3.974640088	16.2009193	0	0.884065981	3.360454056	11.86966264	51.55879289	0	1.528083275	0	0	2.30589672	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.9989
H4406_001_0	2009	7																					3600											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	5000	1985.024145	141.9580086	894.1592168	1005.895873	196.2946959	12.62450654	5.437659356	408.9295427	34.28643998	9802.598782	38.30988005	0	0.123302139	19.95404884	4735.862042	3998.0221	575.9291503	196.6731104	0	0	22.70248819	706.8720756	783.329477	0	130.1903043	288.9055492	16.61235762	8.976	462.5734516	0											"$245 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$245 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$115 Days 1-25 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$15 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											242.1030943	245	87.8078022	0	150	0.2	0.063593031	49.44767153	0.2	2.8	0.175617597	0	0.2	0.197118371	7.296213571	25	37.5	25	0	0	0.2	24.25662649	0	0	25	15	25	0	0	0											162.1388729	164.0617403	58.79959527	0	100.4459634	0.133927951	0.042584422	33.11212671	0.133927951	1.874991318	0.117600525	0	0.133927951	0.132390472	7.296213571	25	37.5	16.74099391	0	0	0.133927951	24.25662649	0	0	25	15	25	0	0	0											26.8208	1.940823161	4.381350004	0	1.643084154	1.690774297	0.231559581	1.128377236	4.591912663	1.531648967	4.505262	0	0.016513603	2.641725935	2.879488408	8.329212708	1.799778595	0.274375279	0	0	3.040497731	1.428860993	0	0	0.271229801	0.361131937	0.034609078	0	0	0	0	0	0	0	0	0	0	0	0	0	69.543	0	26.8409	26.8208	1.940823161	4.381350004	0	1.643084154	1.690774297	0.231559581	1.128377236	4.591912663	1.531648967	4.505262	0	0.016513603	2.641725935	2.879488408	8.329212708	1.799778595	0.274375279	0	0	3.040497731	1.428860993	0	0	0.271229801	0.361131937	0.034609078	0	0	0	0	0	0	0	0	0	0	0	0	0	69.543		"$290 Days 1-18 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$290 Days 1-18 (1b); $0 n/c (1b1, 1b2)"	"$0 n/c (2a, 2a1, 2a2)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$40 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$40 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.2032	0.1569	0	0.2687	0.3103	0.479	0.2063	0.2131	1.301	0.2893	1.2488	0	0.0031	0.7469	1.5967	3.301	0.5099	0.1175	0	0	1.2204	0.5746	0	0	0.1085	0	0.0138	0	0	0											14.8692	0	3.511705472	29.024	2.097772784	4.381350004	0.26865842	1.953433719	2.169810381	0.437891213	1.341507758	5.892909411	1.820950394	5.754059015	0	0.019632731	3.388587123	4.476233151	11.63023427	2.309715863	0.391844467	0	0	4.260877364	2.003509167	0	0	0.379721721	0.361131937	0.04845271	0	0	0	0	0	0	0	0	0	0	0	0	0	84.4122
H4406_801_0	2009	2																					4800											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2217.313934	158.5700967	1341.238662	1242.577104	242.4816537	15.59497488	6.717106982	505.0914781	42.35382733	12109.09114	47.32395796	0	0.15231437	24.64911316	6208.452511	5242.643462	755.9069178	258.133426	0	0	29.7970085	927.7694864	0	0	0	0	0	0	0	0											"$400 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$400 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											395.2377719	400	150	0	150	0.2	0.063593031	49.44760951	0.2	2.8	0.175617601	0	0.2	0.19779675	21.91460924	34.83559084	37.5	35	0	0	0.2	33.92914965	0	0	0	0	0	0	0	0											255.0719578	258.1268363	96.7975636	0	96.7975636	0.129063418	0.04103767	31.90938751	0.129063418	1.806887854	0.113329039	0	0.129063418	0.128062671	21.91460924	34.83559084	37.5	22.58609817	0	0	0.129063418	33.92914965	0	0	0	0	0	0	0	0											47.1312	3.410933115	10.81905289	0	1.955969441	2.012740763	0.275654419	1.343096642	5.466329726	1.823314142	5.363178698	0	0.019658213	3.156631266	11.33798423	15.21921521	2.362209118	0.485852242	0	0	3.845703767	2.623202479	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6519	0	47.8562	47.1312	3.410933115	10.81905289	0	1.955969441	2.012740763	0.275654419	1.343096642	5.466329726	1.823314142	5.363178698	0	0.019658213	3.156631266	11.33798423	15.21921521	2.362209118	0.485852242	0	0	3.845703767	2.623202479	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6519																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	47.1312	3.410933115	10.81905289	0	1.955969441	2.012740763	0.275654419	1.343096642	5.466329726	1.823314142	5.363178698	0	0.019658213	3.156631266	11.33798423	15.21921521	2.362209118	0.485852242	0	0	3.845703767	2.623202479	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6519
H4406_803_0	2009	2																					4800											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2217.313934	158.5700967	1341.238662	1242.577104	242.4816537	15.59497488	6.717106982	505.0914781	42.35382733	12109.09114	47.32395796	0	0.15231437	24.64911316	6208.452511	5242.643462	755.9069178	258.133426	0	0	29.7970085	927.7694864	0	0	0	0	0	0	0	0											"$400 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$400 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											395.2377719	400	150	0	150	0.2	0.063593031	49.44760951	0.2	2.8	0.175617601	0	0.2	0.19779675	21.91460924	34.83559084	37.5	35	0	0	0.2	33.92914965	0	0	0	0	0	0	0	0											255.0719578	258.1268363	96.7975636	0	96.7975636	0.129063418	0.04103767	31.90938751	0.129063418	1.806887854	0.113329039	0	0.129063418	0.128062671	21.91460924	34.83559084	37.5	22.58609817	0	0	0.129063418	33.92914965	0	0	0	0	0	0	0	0											47.1312	3.410933115	10.81905289	0	1.955969441	2.012740763	0.275654419	1.343096642	5.466329726	1.823314142	5.363178698	0	0.019658213	3.156631266	11.33798423	15.21921521	2.362209118	0.485852242	0	0	3.845703767	2.623202479	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6519	0	47.8562	47.1312	3.410933115	10.81905289	0	1.955969441	2.012740763	0.275654419	1.343096642	5.466329726	1.823314142	5.363178698	0	0.019658213	3.156631266	11.33798423	15.21921521	2.362209118	0.485852242	0	0	3.845703767	2.623202479	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6519																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	47.1312	3.410933115	10.81905289	0	1.955969441	2.012740763	0.275654419	1.343096642	5.466329726	1.823314142	5.363178698	0	0.019658213	3.156631266	11.33798423	15.21921521	2.362209118	0.485852242	0	0	3.845703767	2.623202479	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6519
H4406_804_0	2009	2																					4800											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2217.313934	158.5700967	1341.238662	1242.577104	242.4816537	15.59497488	6.717106982	505.0914781	42.35382733	12109.09114	47.32395796	0	0.15231437	24.64911316	6208.452511	5242.643462	755.9069178	258.133426	0	0	29.7970085	927.7694864	0	0	0	0	0	0	0	0											"$400 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$400 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											395.2377719	400	150	0	150	0.2	0.063593031	49.44760951	0.2	2.8	0.175617601	0	0.2	0.19779675	21.91460924	34.83559084	37.5	35	0	0	0.2	33.92914965	0	0	0	0	0	0	0	0											255.0719578	258.1268363	96.7975636	0	96.7975636	0.129063418	0.04103767	31.90938751	0.129063418	1.806887854	0.113329039	0	0.129063418	0.128062671	21.91460924	34.83559084	37.5	22.58609817	0	0	0.129063418	33.92914965	0	0	0	0	0	0	0	0											47.1312	3.410933115	10.81905289	0	1.955969441	2.012740763	0.275654419	1.343096642	5.466329726	1.823314142	5.363178698	0	0.019658213	3.156631266	11.33798423	15.21921521	2.362209118	0.485852242	0	0	3.845703767	2.623202479	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6519	0	47.8562	47.1312	3.410933115	10.81905289	0	1.955969441	2.012740763	0.275654419	1.343096642	5.466329726	1.823314142	5.363178698	0	0.019658213	3.156631266	11.33798423	15.21921521	2.362209118	0.485852242	0	0	3.845703767	2.623202479	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6519																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	47.1312	3.410933115	10.81905289	0	1.955969441	2.012740763	0.275654419	1.343096642	5.466329726	1.823314142	5.363178698	0	0.019658213	3.156631266	11.33798423	15.21921521	2.362209118	0.485852242	0	0	3.845703767	2.623202479	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6519
H4406_805_0	2009	2																					4800											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2217.313934	158.5700967	1341.238662	1242.577104	242.4816537	15.59497488	6.717106982	505.0914781	42.35382733	12109.09114	47.32395796	0	0.15231437	24.64911316	6208.452511	5242.643462	755.9069178	258.133426	0	0	29.7970085	927.7694864	0	0	0	0	0	0	0	0											"$400 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$400 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											395.2377719	400	150	0	150	0.2	0.063593031	49.44760951	0.2	2.8	0.175617601	0	0.2	0.19779675	21.91460924	34.83559084	37.5	35	0	0	0.2	33.92914965	0	0	0	0	0	0	0	0											255.0719578	258.1268363	96.7975636	0	96.7975636	0.129063418	0.04103767	31.90938751	0.129063418	1.806887854	0.113329039	0	0.129063418	0.128062671	21.91460924	34.83559084	37.5	22.58609817	0	0	0.129063418	33.92914965	0	0	0	0	0	0	0	0											47.1312	3.410933115	10.81905289	0	1.955969441	2.012740763	0.275654419	1.343096642	5.466329726	1.823314142	5.363178698	0	0.019658213	3.156631266	11.33798423	15.21921521	2.362209118	0.485852242	0	0	3.845703767	2.623202479	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6519	0	47.8562	47.1312	3.410933115	10.81905289	0	1.955969441	2.012740763	0.275654419	1.343096642	5.466329726	1.823314142	5.363178698	0	0.019658213	3.156631266	11.33798423	15.21921521	2.362209118	0.485852242	0	0	3.845703767	2.623202479	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6519																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	47.1312	3.410933115	10.81905289	0	1.955969441	2.012740763	0.275654419	1.343096642	5.466329726	1.823314142	5.363178698	0	0.019658213	3.156631266	11.33798423	15.21921521	2.362209118	0.485852242	0	0	3.845703767	2.623202479	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6519
H4407_001_0	2009	5																					2000											D	D	D	P	T	COIN	COIN	V	V	V	V	V	V	V	V	V	V	V	P		COIN		T	COIN	COIN																																																								0		1206.65	55.517	147.17	868	196	6.661445102	2.049043798	306.54	271	178.8831776	254.2001524	17.04212873	9.455542681	34.90873581	3754.91019	2527.393221	238.71531	53.38760588	25.46824756	1069.992425	25.87		250	12.31	1.7																$150/D first 5 Days; 2K OP	$150/D first 5 Days; 2K OP	$0/D (0-5 Days); $50 (6-20 Days)	No Cost Sharing	$100 CP/Trip ($0 Admit)	"20% Coins., 1K OP Max"	"20% Coins., 1K OP Max"	$50 CP / Visit ($0 admit)	$150 CP / Surg	No Cost Sharing	"$75 CP / (MRI, CT, Test)"	$150 /Admit; 2K OP	$30 CP / Visit	$150 CP / Surg	$15 CP / Visit	$30 CP / Visit	$30 CP / Visit	$15 CP / Visit	$30 CP / Visit	No Cost Sharing	"20% Coins., 1K OP max"		$3.50 / Trip	Various cost sharing	$30 CP/Exam																150	150	50	0	100	0.2	0.2	50	150	0	75	150	30	150	15	30	30	15	30	0	0.2		3.5	0.242	0.4235																123	150	50	0	100	0.2	0.13	50	150	0	75	150	30	150	15	30	30	15	30	0	0.04		3.5	0.242	0.4235																12.3682	0.6939625	0.613208333	0	1.633333333	1.33228902	0.266375694	1.27725	3.3875	0	1.588750952	0.213026609	0.023638857	0.436359198	4.693637738	6.318483054	0.596788275	0.066734507	0.063670619	0	1.0348	0	0.072916667	2.97902	0.71995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3799		6.99	12.3682	0.6939625	0.613208333	0	1.633333333	1.33228902	0.266375694	1.27725	3.3875	0	1.588750952	0.213026609	0.023638857	0.436359198	4.693637738	6.318483054	0.596788275	0.066734507	0.063670619	0	1.0348	0	0.072916667	2.97902	0.71995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3799																																																																																		0			12.3682	0.6939625	0.613208333	0	1.633333333	1.33228902	0.266375694	1.27725	3.3875	0	1.588750952	0.213026609	0.023638857	0.436359198	4.693637738	6.318483054	0.596788275	0.066734507	0.063670619	0	1.0348	0	0.072916667	2.97902	0.71995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3799
H4407_002_0	2009	5																					2250											D		D		T	COIN		P	P		P				V	V	V	V	V		COIN					V																																																							0		1585.786687		220.7931859		178.1433568	7.823525589		411.9082664	449.2234803		651.9621386				5334.837672	8430.881615	223.8607875	117.3666146	1680.303346		8.433816143					202.5															$100/day for 1st 10 days		$0 for days 1-5; $95 for days 6-100		$150 per trip	20% coinsurance		$50 per visit	$75 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															100		95		150	0.2		50	75		25				5	25	25	25	25		0.2					100															97.52948191		92.65300782		146.2942229	0.195058964		48.76474096	73.14711144		24.38237048				5	25	25	25	25		0.195058964					100															12.8884	0	1.704762731	0	2.171778661	1.526048795	0	1.673883326	2.738283331	0	1.324698533	0	0	0	2.22284903	17.5643367	0.466376641	0.24451378	3.500631971	0	1.645091438	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.3592		0.5742	12.8884	0	1.704762731	0	2.171778661	1.526048795	0	1.673883326	2.738283331	0	1.324698533	0	0	0	2.22284903	17.5643367	0.466376641	0.24451378	3.500631971	0	1.645091438	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.3592																																																																																		0			12.8884	0	1.704762731	0	2.171778661	1.526048795	0	1.673883326	2.738283331	0	1.324698533	0	0	0	2.22284903	17.5643367	0.466376641	0.24451378	3.500631971	0	1.645091438	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.3592
H4407_003_0	2009	6																																																							COIN	COIN																																																								0																									12.31	1.7																																							Various cost sharing	$30 CP/Exam																																							0.242	0.4235																																							0.242	0.4235																0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.97902	0.71995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.699			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.97902	0.71995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.699																																																																																		0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.97902	0.71995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.699
H4407_004_0	2009	5																																D	D	D		T	Coin		P	P	P	P	P	P	P	V	V	V	V	V	V	Coin		T			V																																																							0																																										$0 Copay	$0 Copay	$0 Copay		$0 per Trip	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 per Trip			$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
H4407_005_0	2009	5																					2000											D	D	D	P	T	COIN	COIN	V	V	P	P	V	P	P	V	V	P	P	P	P	COIN		V																																																										0		739	57.9425	220.21	842.1450406	187.7755834	5.316120341	2.233879659	297.37	240.04	274.0676361	224.8956357	15.96313813	0	47.4662456	2816.792755	3424.936859	246.5276918	157.7980597	46.93481051	1105.009824	34.61		245																		$150/D first 5 Days; 2K OP	$150/D first 5 Days; 2K OP	$0/D (0-5 Days); $50 (6-20 Days)	No Cost Sharing	$100 CP/Trip ($0 Admit)	"20% Coins., 1K OP Max"	"20% Coins., 1K OP Max"	$50 CP / Visit	$200 CP / Surg	No Cost Sharing	"$75 CP / (MRI, CT, Test)"	$150 /Admit; 2K OP	$30 CP / Visit	$200 CP / Surg	$15 CP / Visit	$30 CP / Visit	$30 CP / Visit	$15 CP / Visit	$30 CP / Visit	No Cost Sharing	"20% Coins., 1K OP max"		$3.50 / Trip																		150	150	50	0	100	0.2	0.2	50	200	0	75	150	30	200	15	30	30	15	30	0	0.2		3.5																		133	150	50	0	100	0.2	0.09	50	200	0	75	150	30	200	15	30	30	15	30	0	0.08		3.5																		8.1906	0.72428125	0.917541667	0	1.564796528	1.063224068	0.201049169	1.239041667	4.000666667	0	1.405597723	0.199539227	0	0.791104093	3.520990944	8.562342147	0.616319229	0.197247575	0.117337026	0	2.7688	0	0.071458333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.1519		5.45	8.1906	0.72428125	0.917541667	0	1.564796528	1.063224068	0.201049169	1.239041667	4.000666667	0	1.405597723	0.199539227	0	0.791104093	3.520990944	8.562342147	0.616319229	0.197247575	0.117337026	0	2.7688	0	0.071458333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.1519																																																																																		0			8.1906	0.72428125	0.917541667	0	1.564796528	1.063224068	0.201049169	1.239041667	4.000666667	0	1.405597723	0.199539227	0	0.791104093	3.520990944	8.562342147	0.616319229	0.197247575	0.117337026	0	2.7688	0	0.071458333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.1519
H4407_007_0	2009	4																					2000											D	D	D	P	T	COIN	COIN	V	V	V	V	V	V	V	V	V	V	V	P		COIN		T	COIN	COIN																																																								0		1206.65	55.517	147.17	868	196	6.661445102	2.049043798	306.54	271	178.8831776	254.2001524	17.04212873	9.455542681	34.90873581	3754.91019	2527.393221	238.71531	53.38760588	25.46824756	1069.992425	25.87		250	12.31	1.7																$150/D first 5 Days; 2K OP	$150/D first 5 Days; 2K OP	$0/D (0-5 Days); $50 (6-20 Days)		$100 CP/Trip ($0 Admit)	"20% Coins., 1K OP Max"	"20% Coins., 1K OP Max"	$50 CP / Visit ($0 admit)	$200 CP / Surg		"$75 CP / (MRI, CT, Test)"	$100 /Admit; 2K OP	$30 CP / Visit	$200 CP / Surg	$15 CP / Visit	$30 CP / Visit	$30 CP / Visit	$15 CP / Visit	$30 CP / Visit		"20% Coins., 1K OP max"		$3.50 / Trip	Various cost sharing	$30 CP/Exam																150	150	50		100	0.2	0.2	50	200		75	100	30	200	15	30	30	15	30		0.2		3.5	0.242	0.4235																123	150	50		100	0.2	0.13	50	200		75	100	30	200	15	30	30	15	30		0.04		3.5	0.242	0.4235																12.3682	0.6939625	0.613208333	0	1.633333333	1.33228902	0.266375694	1.27725	4.516666667	0	1.588750952	0.142017739	0.023638857	0.581812263	4.693637738	6.318483054	0.596788275	0.066734507	0.063670619	0	1.0348	0	0.072916667	2.97902	0.71995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.5835		7.9	12.3682	0.6939625	0.613208333	0	1.633333333	1.33228902	0.266375694	1.27725	4.516666667	0	1.588750952	0.142017739	0.023638857	0.581812263	4.693637738	6.318483054	0.596788275	0.066734507	0.063670619	0	1.0348	0	0.072916667	2.97902	0.71995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.5835																																																																																		0			12.3682	0.6939625	0.613208333	0	1.633333333	1.33228902	0.266375694	1.27725	4.516666667	0	1.588750952	0.142017739	0.023638857	0.581812263	4.693637738	6.318483054	0.596788275	0.066734507	0.063670619	0	1.0348	0	0.072916667	2.97902	0.71995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.5835
H4407_009_0	2009	5																					2000											D	D	D	P	T	COIN	COIN	V	V	V	V	V	V	V	V	V	V	V	P		COIN		T	COIN	COIN																																																								0		1206.65	55.517	147.17	868	196	6.661445102	2.049043798	306.54	271	178.8831776	254.2001524	17.04212873	9.455542681	34.90873581	3754.91019	2527.393221	238.71531	53.38760588	25.46824756	1069.992425	25.87		250	12.31	1.7																$165/D first 5 Days; 2K OP	$165/D first 5 Days; 2K OP	$0/D (0-5 Days); $50 (6-20 Days)		$100 CP/Trip ($0 Admit)	"20% Coins., 1K OP Max"	"20% Coins., 1K OP Max"	$50 CP / Visit ($0 admit)	$200 CP / Surg		"$75 CP / (MRI, CT, Test)"	$100 /Admit; 2K OP	$30 CP / Visit	$200 CP / Surg	$15 CP / Visit	$30 CP / Visit	$30 CP / Visit	$15 CP / Visit	$30 CP / Visit		"20% Coins., 1K OP max"		$3.50 / Trip	Various cost sharing	$30 CP/Exam																165	165	50		100	0.2	0.2	50	165		75	100	30	165	15	30	30	15	30		0.2		3.5	0.242	0.4235																135.3	165	50		100	0.2	0.13	50	165		75	100	30	165	15	30	30	15	30		0.04		3.5	0.242	0.4235																13.605	0.76335875	0.613208333	0	1.633333333	1.33228902	0.266375694	1.27725	3.72625	0	1.588750952	0.142017739	0.023638857	0.479995117	4.693637738	6.318483054	0.596788275	0.066734507	0.063670619	0	1.0348	0	0.072916667	2.97902	0.71995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.9974		7.9	13.605	0.76335875	0.613208333	0	1.633333333	1.33228902	0.266375694	1.27725	3.72625	0	1.588750952	0.142017739	0.023638857	0.479995117	4.693637738	6.318483054	0.596788275	0.066734507	0.063670619	0	1.0348	0	0.072916667	2.97902	0.71995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.9974																																																																																		0			13.605	0.76335875	0.613208333	0	1.633333333	1.33228902	0.266375694	1.27725	3.72625	0	1.588750952	0.142017739	0.023638857	0.479995117	4.693637738	6.318483054	0.596788275	0.066734507	0.063670619	0	1.0348	0	0.072916667	2.97902	0.71995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.9974
H4407_011_0	2009	6																					2250											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		1585.786687		220.7931859		178.1433568	7.823525589		411.9082664	449.2234803		651.9621386				5334.837672	8430.881615	223.8607875	117.3666146	1680.303346		8.433816143					202.5															$100/day for 1st 10 days		"$0/day, days 1-5; $95/day, days 6-100"		$150 per trip	20% coinsurance		$50 per visit	$75 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															100		95		150	0.2		50	75		25				5	25	25	25	25		0.2					100															96.35923651		91.54127468		144.5388548	0.192718473		48.17961825	72.26942738		24.08980913				5	25	25	25	25		0.192718473					100															12.7338	0	1.684307473	0	2.145719731	1.507737905	0	1.653798586	2.705426974	0	1.308803623	0	0	0	2.22284903	17.5643367	0.466376641	0.24451378	3.500631971	0	1.625352169	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.0511		0.8402	12.7338	0	1.684307473	0	2.145719731	1.507737905	0	1.653798586	2.705426974	0	1.308803623	0	0	0	2.22284903	17.5643367	0.466376641	0.24451378	3.500631971	0	1.625352169	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.0511																																																																																		0			12.7338	0	1.684307473	0	2.145719731	1.507737905	0	1.653798586	2.705426974	0	1.308803623	0	0	0	2.22284903	17.5643367	0.466376641	0.24451378	3.500631971	0	1.625352169	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.0511
H4407_012_0	2009	5																					2250											A	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		1535.04472	40.6	220.7931859		178.1433568	7.823525589		411.9082664	449.2234803		651.9621386				5334.837672	8430.881615	223.8607875	117.3666146	1680.303346		8.433816143					202.6															$175/day for 1st 10 days	$175/day for 1st 8 days	$0/day days 1-5; $95/day days 6-100		$150 per trip	20% coinsurance		$50 per visit	$125 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															175	175	95		150	0.2		50	125		25				5	25	25	25	25		0.2					100															170.9833614	170.9833614	92.81953902		146.5571669	0.195409556		48.85238896	122.1309724		24.42619448				5	25	25	25	25		0.195409556					100															21.8723	0.578493706	1.707826811	0	2.175682139	1.52879166	0	1.676891904	4.572008373	0	1.327079499	0	0	0	2.22284903	17.5643367	0.466376641	0.24451378	3.500631971	0	1.648048267	0	0	0	0	1.688333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7741		0.87	21.8723	0.578493706	1.707826811	0	2.175682139	1.52879166	0	1.676891904	4.572008373	0	1.327079499	0	0	0	2.22284903	17.5643367	0.466376641	0.24451378	3.500631971	0	1.648048267	0	0	0	0	1.688333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7741																																																																																		0			21.8723	0.578493706	1.707826811	0	2.175682139	1.52879166	0	1.676891904	4.572008373	0	1.327079499	0	0	0	2.22284903	17.5643367	0.466376641	0.24451378	3.500631971	0	1.648048267	0	0	0	0	1.688333333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7741
H4407_013_0	2009	4																					2250											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		1535.04	40.6	220.7931859		178.1433568	7.823525589		411.9082664	449.2234803		651.9621386				5334.837672	8430.881615	223.8607875	117.3666146	1680.303346		8.433816143					202.5															$175/day for days 1-10	$175/day for days 1-8	$0 day/1-5; $95/day; days 6-100		$150 per trip	20% coinsurance		$50 per visit	$125 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															175	175	95		150	0.2		50	125		25				5	25	25	25	25		0.2					100															171.0335693	171.0335693	92.84679479		146.6002023	0.195466936		48.8667341	122.1668352		24.43336705				5	25	25	25	25		0.195466936					100															21.8786	0.578663576	1.708328302	0	2.176321012	1.529240579	0	1.677384311	4.573350909	0	1.327469186	0	0	0	2.22284903	17.5643367	0.466376641	0.24451378	3.500631971	0	1.648532204	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7841		0.86	21.8786	0.578663576	1.708328302	0	2.176321012	1.529240579	0	1.677384311	4.573350909	0	1.327469186	0	0	0	2.22284903	17.5643367	0.466376641	0.24451378	3.500631971	0	1.648532204	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7841																																																																																		0			21.8786	0.578663576	1.708328302	0	2.176321012	1.529240579	0	1.677384311	4.573350909	0	1.327469186	0	0	0	2.22284903	17.5643367	0.466376641	0.24451378	3.500631971	0	1.648532204	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7841
H4407_015_0	2009	5																																D	D	D		T	Coin		P	P	P	P	P	P	P	V	V	V	V	V	V	Coin		T			V																																																							0																																										$0 Copay	$0 Copay	$0 Copay		$0 per Trip	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 per Trip			$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
H4407_018_0	2009	5																					2250											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		1535.04472	40.596224	220.7931859		178.1433568	7.823525589		411.9082664	449.2234803		651.9621386				5334.837672	8430.881615	223.8607875	117.3666146	1680.303346		8.433816143					202.5															$175/day for days 1-10	$175/day for days 1-8	$0 day/1-5; $95/day; days 6-100		$150 per trip	20% coinsurance		$50 per visit	$125 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															175	175	95		150	0.2		50	125		25				5	25	25	25	25		0.2					100															170.1298256	170.1298256	92.35619107		145.8255648	0.194434086		48.60852161	121.521304		24.30426081				5	25	25	25	25		0.194455271					100															21.7631	0.575552376	1.699301472	0	2.164821302	1.521160051	0	1.668520989	4.549185261	0	1.320454821	0	0	0	2.22284903	17.5643367	0.466376641	0.24451378	3.500631971	0	1.64	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.5883		1.01	21.7631	0.575552376	1.699301472	0	2.164821302	1.521160051	0	1.668520989	4.549185261	0	1.320454821	0	0	0	2.22284903	17.5643367	0.466376641	0.24451378	3.500631971	0	1.64	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.5883																																																																																		0			21.7631	0.575552376	1.699301472	0	2.164821302	1.521160051	0	1.668520989	4.549185261	0	1.320454821	0	0	0	2.22284903	17.5643367	0.466376641	0.24451378	3.500631971	0	1.64	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.5883
H4407_019_0	2009	6																					2000											D	D	D	P	T	COIN	COIN	V	V	V	V	V	V	V	V	V	V	V	P		COIN			COIN																																																									0		1206.65	55.517	147.17	868	196	6.661445102	2.049043798	306.54	271	178.8831776	254.2001524	17.04212873	9.455542681	34.90873581	3754.91019	2527.393221	238.71531	53.38760588	25.46824756	1069.992425	25.87			12.31																	$200/D first 5 Days; 2K OP	$200/D first 5 Days; 2K OP	0/day for 1-5 $50/day 6-20		$100 CP/Trip ($0 Admit)	"20% Coins., 1K OP Max"	"20% Coins., 1K OP Max"	$50 CP / Visit	$150 CP / Surg		"$100 CP / (MRI, CT, Test)"	$150 /Admit; 2K OP	$30 CP / Visit	$150 CP / Surg	$15 CP / Visit	$30 CP / Visit	$30 CP / Visit	$15 CP / Visit	$30 CP / Visit		"20% Coins., 1K OP max"			Various Cost Sharing																	200	200	50		100	0.2	0.2	50	150		100	150	30	150	15	30	30	15	30		0.2			0.242																	175	200	50		100	0.19	0.11	50	150		100	150	30	150	15	30	30	15	30		0.04			0.242																	17.597	0.925283333	0.613208333	0	1.633333333	1.265674569	0.225394818	1.27725	3.3875	0	2.118334603	0.213026609	0.023638857	0.436359198	4.693637738	6.318483054	0.596788275	0.066734507	0.063670619	0	1.0348	0	0	2.97902	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4691		6.99	17.597	0.925283333	0.613208333	0	1.633333333	1.265674569	0.225394818	1.27725	3.3875	0	2.118334603	0.213026609	0.023638857	0.436359198	4.693637738	6.318483054	0.596788275	0.066734507	0.063670619	0	1.0348	0	0	2.97902	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4691																																																																																		0			17.597	0.925283333	0.613208333	0	1.633333333	1.265674569	0.225394818	1.27725	3.3875	0	2.118334603	0.213026609	0.023638857	0.436359198	4.693637738	6.318483054	0.596788275	0.066734507	0.063670619	0	1.0348	0	0	2.97902	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4691
H4407_020_0	2009	5																					2250											A		D		T	COIN		P	P		P				V	V	V	V	V		COIN			COIN		V																																																							0		285.4657155		333.4330723		208.9752307	7.823525589		393.7182708	443.3651845		651.9621386				5270.694538	8329.513362	221.1692094	115.9554634	1660.100309		8.433816143			3.79		202.5															$150 per admit		$0 days 1-100		$50 per trip	20% Coinsurance		$50 per visit	$50 per visit		$25 per visit				$0 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit		20% per script			Various Coin		$100 limit on eyewear															150		0		50	0.2		50	50		25				0	25	25	25	25		0.2			0.2		100															133.8456501		0		44.61521669	0.178460867		44.61521669	44.61521669		22.30760835				0	25	25	25	25		0.178460867			0.2		100															3.184	0	0	0	0.776956267	1.396193158	0	1.463818831	1.648402815	0	1.211976337	0	0	0	0	17.35315284	0.460769186	0.241573882	3.45854231	0	1.505106139	0	0	0.758	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.146		1.3501	3.184	0	0	0	0.776956267	1.396193158	0	1.463818831	1.648402815	0	1.211976337	0	0	0	0	17.35315284	0.460769186	0.241573882	3.45854231	0	1.505106139	0	0	0.758	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.146																																																																																		0			3.184	0	0	0	0.776956267	1.396193158	0	1.463818831	1.648402815	0	1.211976337	0	0	0	0	17.35315284	0.460769186	0.241573882	3.45854231	0	1.505106139	0	0	0.758	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.146
H4407_802_0	2009	2																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																			21.98	0.45	4.88		0.25	0.9	-0.55	0.73	1.32	0.51	0.25	0.07	0.0176	0.53	2.5435	4.6403	0.1646	0.0392	1.0439		1.05																				40.819		2228.985452	45.48949901	912.2535721		7.987245294	8.310368441	2.761519948	23.64360988	42.7462031	16.68898728	7.972446151	2.118392835	0.584646051	17.1065916	82.04834107	149.6864857	5.310621483	1.262984479	33.67451387		33.98128179																				Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits																			8.91	8.91	4.831090432		0.2	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																			8.91	8.91	4.831090432		0.2	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																			1.655	0.033775953	0.367264959	0	1.597449059	1.662073688	0.55230399	4.728721976	8.549240619	3.337797455	1.59448923	0.423678567	0.11692921	3.42131832	16.40966821	29.93729715	1.062124297	0.252596896	6.734902774	0	6.796256358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.2329	40.81904016		23.635	0.483775953	5.247264959	0	1.847449059	2.562073688	0.00230399	5.458721976	9.869240619	3.847797455	1.84448923	0.493678567	0.134498026	3.95131832	18.95316679	34.57757821	1.226753562	0.291749415	7.778812704	0	7.846256358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.052																																																																																		0			23.635	0.483775953	5.247264959	0	1.847449059	2.562073688	0.00230399	5.458721976	9.869240619	3.847797455	1.84448923	0.493678567	0.134498026	3.95131832	18.95316679	34.57757821	1.226753562	0.291749415	7.778812704	0	7.846256358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.052
H4407_807_0	2009	2																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																			21.98	0.45	4.88		0.25	0.9	-0.55	0.73	1.32	0.51	0.25	0.07	0.0176	0.53	2.5435	4.6403	0.1646	0.0392	1.0439		1.05																				40.819		2228.985452	45.48949901	912.2535721		7.987245294	8.310368441	2.761519948	23.64360988	42.7462031	16.68898728	7.972446151	2.118392835	0.584646051	17.1065916	82.04834107	149.6864857	5.310621483	1.262984479	33.67451387		33.98128179																				Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits																			8.91	8.91	4.831090432		0.2	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																			8.91	8.91	4.831090432		0.2	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																			1.655	0.033775953	0.367264959	0	1.597449059	1.662073688	0.55230399	4.728721976	8.549240619	3.337797455	1.59448923	0.423678567	0.11692921	3.42131832	16.40966821	29.93729715	1.062124297	0.252596896	6.734902774	0	6.796256358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.2329	40.81904016		23.635	0.483775953	5.247264959	0	1.847449059	2.562073688	0.00230399	5.458721976	9.869240619	3.847797455	1.84448923	0.493678567	0.134498026	3.95131832	18.95316679	34.57757821	1.226753562	0.291749415	7.778812704	0	7.846256358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.052																																																																																		0			23.635	0.483775953	5.247264959	0	1.847449059	2.562073688	0.00230399	5.458721976	9.869240619	3.847797455	1.84448923	0.493678567	0.134498026	3.95131832	18.95316679	34.57757821	1.226753562	0.291749415	7.778812704	0	7.846256358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.052
H4407_808_0	2009	2																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																			21.98	0.45	4.88		0.25	0.9	-0.55	0.73	1.32	0.51	0.25	0.07	0.0176	0.53	2.5435	4.6403	0.1646	0.0392	1.0439		1.05																				40.819		2228.985452	45.48949901	912.2535721		7.987245294	8.310368441	2.761519948	23.64360988	42.7462031	16.68898728	7.972446151	2.118392835	0.584646051	17.1065916	82.04834107	149.6864857	5.310621483	1.262984479	33.67451387		33.98128179																				Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits																			8.91	8.91	4.831090432		0.2	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																			8.91	8.91	4.831090432		0.2	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																			1.655	0.033775953	0.367264959	0	1.597449059	1.662073688	0.55230399	4.728721976	8.549240619	3.337797455	1.59448923	0.423678567	0.11692921	3.42131832	16.40966821	29.93729715	1.062124297	0.252596896	6.734902774	0	6.796256358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.2329	40.81904016		23.635	0.483775953	5.247264959	0	1.847449059	2.562073688	0.00230399	5.458721976	9.869240619	3.847797455	1.84448923	0.493678567	0.134498026	3.95131832	18.95316679	34.57757821	1.226753562	0.291749415	7.778812704	0	7.846256358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.052																																																																																		0			23.635	0.483775953	5.247264959	0	1.847449059	2.562073688	0.00230399	5.458721976	9.869240619	3.847797455	1.84448923	0.493678567	0.134498026	3.95131832	18.95316679	34.57757821	1.226753562	0.291749415	7.778812704	0	7.846256358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.052
H4407_809_0	2009	2																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																			21.98	0.45	4.88		0.25	0.9	-0.55	0.73	1.32	0.51	0.25	0.07	0.0176	0.53	2.5435	4.6403	0.1646	0.0392	1.0439		1.05																				40.819		2228.985452	45.48949901	912.2535721		7.987245294	8.310368441	2.761519948	23.64360988	42.7462031	16.68898728	7.972446151	2.118392835	0.584646051	17.1065916	82.04834107	149.6864857	5.310621483	1.262984479	33.67451387		33.98128179																				Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits																			8.91	8.91	4.831090432		0.2	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																			8.91	8.91	4.831090432		0.2	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																			1.655	0.033775953	0.367264959	0	1.597449059	1.662073688	0.55230399	4.728721976	8.549240619	3.337797455	1.59448923	0.423678567	0.11692921	3.42131832	16.40966821	29.93729715	1.062124297	0.252596896	6.734902774	0	6.796256358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.2329	40.81904016		23.635	0.483775953	5.247264959	0	1.847449059	2.562073688	0.00230399	5.458721976	9.869240619	3.847797455	1.84448923	0.493678567	0.134498026	3.95131832	18.95316679	34.57757821	1.226753562	0.291749415	7.778812704	0	7.846256358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.052																																																																																		0			23.635	0.483775953	5.247264959	0	1.847449059	2.562073688	0.00230399	5.458721976	9.869240619	3.847797455	1.84448923	0.493678567	0.134498026	3.95131832	18.95316679	34.57757821	1.226753562	0.291749415	7.778812704	0	7.846256358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.052
H4408_001_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered							4000											D	D	D	V	T	Coin	Coin	V	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							0		1439.533179	64.095677	502.417722	718.068753	142.824545	9.612854	3.471518	323.058405	350.184883	619.118462	918.905005	0	19.136762	702.954655	3440.465462	4147.177054	28.290362	893.878413			21.726681								1.63	0.09	0.06	0.05	1.23	2.7							$195/Day(Days 1-5):1a	$195/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$200/Visit:9b. $0 Surgery ASC -- Physician,9b. $200 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $200 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$100/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	"$0-$90/Proc:12. $0 Dialysis -- Dialysis Center,12. $90 Dialysis -- OP Hosp"	"$35-$100/Visit:9d. $50 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $90 OP Other,5. $35 Partial Hospitalization,8b. $50 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$90/Visit:7h. $90 Psych -- OP,7e. $35 Psych -- Other Provider"	"$35-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								Silver Sneakers	Meals on Wheels	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit							119.55489	99.659513	43.132793	0	100.000038	0.2	0.2	50.000011	200.000009	43.978698	61.511085	0	1.408388	62.383762	15	34.999999	81.415713	38.23622			0.199999								0	0	0	0	0	0							101.367842	84.499009	36.571303	0	84.787732	0.169575	0.169575	42.393859	169.575408	37.288526	52.153834	0	1.19414	52.893757	12.718155	29.675694	69.03051	32.419611			0.169575								0	0	0	0	0	0							12.1602	0.451335099	1.531172562	0	1.009147437	1.630099717	0.588682665	1.141307706	4.948562034	1.923834572	3.993701591	0	0.001904331	3.098492725	3.646364418	10.2558631	0.16274151	2.414932536	0	0	3.684301931	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.6426	0	9.445	12.1602	0.451335099	1.531172562	0	1.009147437	1.630099717	0.588682665	1.141307706	4.948562034	1.923834572	3.993701591	0	0.001904331	3.098492725	3.646364418	10.2558631	0.16274151	2.414932536	0	0	3.684301931	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.6426		30% Coins:1a	30% Coins:1b	"30% Coins(Days 1-10) 30%(Days 11-100):2. 30% SNF 1,2. 30% SNF 2"	30% Coins:6	$100/Trip:10a	40% Coins:11a	40% Coins:11b	$50/Visit:4a	"30% Coins:9b. 30% Surgery ASC -- Physician,9b. 30% Surgery ASC -- Facility,9a. 30% Surgery OP -- Physician,9a. 30% Surgery OP -- Facility"	"30% Coins:8a. 30% Lab -- FSL,8. 30% Lab -- OP"	"30% Coins:14h. 30% DMAM -- OP,8b. 30% Radiology -- FSR,14h. 30% SMAM -- FSR,14h. 30% SMAM -- OP,8b. 30% Advanced Imaging -- FSR,8b. 30% Advanced Imaging -- Office,9a. 30% Advanced Imaging -- OP,8a. 30% Radiology OP -- Physician,8a. 30% Radiology OP -- Facility"		"$0-$90/Proc:12. $0 Dialysis -- Dialysis Center,12. $90 Dialysis -- OP Hosp"	"30% Coins:9d. 30% Cardiac Rehab,8b. 30% Nuclear Medicine,9a. 30% OP Other,5. 30% Partial Hospitalization,8b. 30% Rad therapy,3. 30% Therapy (AT,PT,ST,OT) -- CORF"	30% Coins:7a	"30% Coins:7b, 7d, 7f"	"30% Coins:7h. 30% Psych -- OP,7e. 30% Psych -- Other Provider"	"30% Coins:9a. 30% Therapy (AT,PT,ST,OT) -- OP,7d. 30% Therapy (AT,PT,ST,OT) - Specialist"			30% Coins:15								Silver Sneakers	Meals on Wheels	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit							7.8095	0.1118	0.4895	0.7427	0.8879	2.7279	0.9851	0.2658	3.5356	0.4555	1.8945		0.0004	1.0701	2.1456	4.8986	0.031	0.4136			1.4622								0	0	0	0	0	0							29.9273	1000	0	19.9697	0.563095099	2.020712562	0.742685	1.897040437	4.357964717	1.573804665	1.407118706	8.484158034	2.379301572	5.888230591	0	0.002347331	4.168591725	5.791937418	15.1544571	0.19369851	2.828558536	0	0	5.146489931	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.5699
H4408_002_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered							4000											D	D	D	V	T	Coin	Coin	V	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							0		1457.823082	64.910041	508.80116	727.192133	144.639195	9.858671	3.560291	327.163003	354.634137	626.984631	930.580094	0	19.379904	711.886002	3484.178088	4199.868762	28.6498	905.235528			22.282268								1.63	0.09	0.06	0.05	1.23	2.7							$195/Day(Days 1-5):1a	$195/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$200/Visit:9b. $0 Surgery ASC -- Physician,9b. $200 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $200 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$100/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	"$0-$90/Proc:12. $0 Dialysis -- Dialysis Center,12. $90 Dialysis -- OP Hosp"	"$35-$100/Visit:9d. $50 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $90 OP Other,5. $35 Partial Hospitalization,8b. $50 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$90/Visit:7h. $90 Psych -- OP,7e. $35 Psych -- Other Provider"	"$35-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								Silver Sneakers	Meals on Wheels	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit							119.554893	99.659465	43.132802	0	100.000031	0.199999	0.199999	49.999993	200.000001	43.978704	61.51109	0	1.408056	62.383763	15.000001	34.999999	81.415437	38.23621			0.2								0	0	0	0	0	0							100.988138	84.18245	36.434321	0	84.470126	0.16894	0.16894	42.235044	168.940201	37.148855	51.958479	0	1.189386	52.695627	12.670516	29.564534	68.771701	32.298165			0.16894								0	0	0	0	0	0							12.2686	0.45535719	1.544818732	0	1.018140919	1.665523879	0.601475562	1.151478652	4.992663532	1.940980095	4.029293856	0	0.001920849	3.126106602	3.678861184	10.34726357	0.16419129	2.436453871	0	0	3.764366356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1875	0	9.7786	12.2686	0.45535719	1.544818732	0	1.018140919	1.665523879	0.601475562	1.151478652	4.992663532	1.940980095	4.029293856	0	0.001920849	3.126106602	3.678861184	10.34726357	0.16419129	2.436453871	0	0	3.764366356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1875		30% Coins:1a	30% Coins:1b	"30% Coins(Days 1-10) 30%(Days 11-100):2. 30% SNF 1,2. 30% SNF 2"	30% Coins:6	$100/Trip:10a	40% Coins:11a	40% Coins:11b	$50/Visit:4a	"30% Coins:9b. 30% Surgery ASC -- Physician,9b. 30% Surgery ASC -- Facility,9a. 30% Surgery OP -- Physician,9a. 30% Surgery OP -- Facility"	"30% Coins:8a. 30% Lab -- FSL,8. 30% Lab -- OP"	"30% Coins:14h. 30% DMAM -- OP,8b. 30% Radiology -- FSR,14h. 30% SMAM -- FSR,14h. 30% SMAM -- OP,8b. 30% Advanced Imaging -- FSR,8b. 30% Advanced Imaging -- Office,9a. 30% Advanced Imaging -- OP,8a. 30% Radiology OP -- Physician,8a. 30% Radiology OP -- Facility"		"$0-$90/Proc:12. $0 Dialysis -- Dialysis Center,12. $90 Dialysis -- OP Hosp"	"30% Coins:9d. 30% Cardiac Rehab,8b. 30% Nuclear Medicine,9a. 30% OP Other,5. 30% Partial Hospitalization,8b. 30% Rad therapy,3. 30% Therapy (AT,PT,ST,OT) -- CORF"	30% Coins:7a	"30% Coins:7b, 7d, 7f"	"30% Coins:7h. 30% Psych -- OP,7e. 30% Psych -- Other Provider"	"30% Coins:9a. 30% Therapy (AT,PT,ST,OT) -- OP,7d. 30% Therapy (AT,PT,ST,OT) - Specialist"			30% Coins:15								Silver Sneakers	Meals on Wheels	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit							7.9492	0.1138	0.4983	0.756	0.8924	2.7766	1.0027	0.2672	3.5988	0.4636	1.9284		0.0004	1.0892	2.1839	4.9862	0.0315	0.421			1.4883								0	0	0	0	0	0							30.4476	1000	0	20.2177	0.56911519	2.043110732	0.755964	1.910569919	4.442157879	1.604209562	1.418646652	8.591470532	2.404590095	5.957694856	0	0.002365849	4.215336602	5.862793184	15.33343657	0.19570229	2.857474871	0	0	5.252696356	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.6351
H4408_006_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered							5000											D	D	D	V	T	Coin	Coin	V	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							0		1467.210691	65.328027	512.077571	731.874866	145.570594	9.986048	3.606291	329.26976	356.917793	631.02208	936.572536	0	0	716.47017	3506.614353	4226.913697	28.834292	911.064769			22.570163								1.63	0.09	0.06	0.05	1.23	2.7							$195/Day(Days 1-5):1a	$195/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$200/Visit:9b. $0 Surgery ASC -- Physician,9b. $200 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $200 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$100/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$35-$100/Visit:9d. $50 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $90 OP Other,5. $35 Partial Hospitalization,8b. $50 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$90/Visit:7h. $90 Psych -- OP,7e. $35 Psych -- Other Provider"	"$35-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								Silver Sneakers	Meals on Wheels	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit							119.554886	99.6594	43.132808	0	99.999976	0.2	0.199999	49.999987	200.000003	43.978708	61.511066	0	0	62.383755	15	35.000002	81.415142	38.23621			0.2								0	0	0	0	0	0							105.025022	87.547494	37.890749	0	87.846679	0.175693	0.175693	43.923339	175.693403	38.633843	54.035442	0	0	54.80207	13.177005	30.746346	71.520516	33.589248			0.175693								0	0	0	0	0	0							12.8412	0.476608754	1.616916893	0	1.06565777	1.754478731	0.633600085	1.205218941	5.225675137	2.031567331	4.217342579	0	0	3.272004034	3.850556239	10.83017925	0.17185362	2.550165039	0	0	3.965419648	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.7084	0	7.7074	12.8412	0.476608754	1.616916893	0	1.06565777	1.754478731	0.633600085	1.205218941	5.225675137	2.031567331	4.217342579	0	0	3.272004034	3.850556239	10.83017925	0.17185362	2.550165039	0	0	3.965419648	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.7084	6000	30% Coins:1a	30% Coins:1b	"30% Coins(Days 1-10) 30%(Days 11-100):2. 30% SNF 1,2. 30% SNF 2"	30% Coins:6	$100/Trip:10a	40% Coins:11a	40% Coins:11b	$50/Visit:4a	"30% Coins:9b. 30% Surgery ASC -- Physician,9b. 30% Surgery ASC -- Facility,9a. 30% Surgery OP -- Physician,9a. 30% Surgery OP -- Facility"	"30% Coins:8a. 30% Lab -- FSL,8. 30% Lab -- OP"	"30% Coins:14h. 30% DMAM -- OP,8b. 30% Radiology -- FSR,14h. 30% SMAM -- FSR,14h. 30% SMAM -- OP,8b. 30% Advanced Imaging -- FSR,8b. 30% Advanced Imaging -- Office,9a. 30% Advanced Imaging -- OP,8a. 30% Radiology OP -- Physician,8a. 30% Radiology OP -- Facility"		20% Coins:12	"30% Coins:9d. 30% Cardiac Rehab,8b. 30% Nuclear Medicine,9a. 30% OP Other,5. 30% Partial Hospitalization,8b. 30% Rad therapy,3. 30% Therapy (AT,PT,ST,OT) -- CORF"	30% Coins:7a	"30% Coins:7b, 7d, 7f"	"30% Coins:7h. 30% Psych -- OP,7e. 30% Psych -- Other Provider"	"30% Coins:9a. 30% Therapy (AT,PT,ST,OT) -- OP,7d. 30% Therapy (AT,PT,ST,OT) - Specialist"			30% Coins:15								Silver Sneakers	Meals on Wheels	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit							6.3689	0.0911	0.3992	0.6057	0.7104	2.2246	0.8034	0.2127	2.8834	0.3714	1.545		0.0004	0.8727	1.7498	3.9949	0.0252	0.3373			1.1924								0	0	0	0	0	0							24.3887	0	3.374090903	19.21	0.567752754	2.016148893	0.605678	1.77609677	3.979117731	1.436991085	1.417904941	8.109038137	2.403011331	5.762375579	0	0.000355	4.144694034	5.600322239	14.82509925	0.19709962	2.887488039	0	0	5.157868648	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.0971
H4408_007_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered							4000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			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		1434.406621	63.867415	500.62848	715.511521	142.31591	9.544514	3.446838	321.907908	348.937784	616.913616	915.632541	0	19.068613	700.451247	3428.213059	4132.407865	28.189612	890.695075			21.57222				2.47				1.63	0.09	0.06	0.05	1.23	2.7							$175/Day(Days 1-5):1a	$175/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$175/Visit:9b. $0 Surgery ASC -- Physician,9b. $175 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $175 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$100/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	"$0-$90/Proc:12. $0 Dialysis -- Dialysis Center,12. $90 Dialysis -- OP Hosp"	"$35-$100/Visit:9d. $50 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $90 OP Other,5. $35 Partial Hospitalization,8b. $50 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$90/Visit:7h. $90 Psych -- OP,7e. $35 Psych -- Other Provider"	"$35-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15				VIS743				Silver Sneakers	Meals on Wheels	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit							107.292848	89.437908	43.132799	0	100.000007	0.2	0.2	50.000001	174.999999	43.978708	61.511064	0	1.408387	62.383767	14.999998	34.999999	81.415522	38.23621			0.2				0				0	0	0	0	0	0							88.140001	73.472347	35.433163	0	82.149005	0.164298	0.164298	41.074501	143.760749	36.128069	50.530724	0	1.156976	51.247641	12.322349	28.752149	66.882037	31.410664			0.164298				0				0	0	0	0	0	0							10.5357	0.39104074	1.478237545	0	0.9742592	1.568144561	0.56630859	1.101850557	4.180296432	1.857324807	3.855631268	0	0.001838494	2.991372837	3.520303147	9.901300555	0.157114889	2.331443644	0	0	3.544272602	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9565	0	10.6383	10.5357	0.39104074	1.478237545	0	0.9742592	1.568144561	0.56630859	1.101850557	4.180296432	1.857324807	3.855631268	0	0.001838494	2.991372837	3.520303147	9.901300555	0.157114889	2.331443644	0	0	3.544272602	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9565	6000	30% Coins:1a	30% Coins:1b	"30% Coins(Days 1-10) 30%(Days 11-100):2. 30% SNF 1,2. 30% SNF 2"	30% Coins:6	$100/Trip:10a	40% Coins:11a	40% Coins:11b	$50/Visit:4a	"30% Coins:9b. 30% Surgery ASC -- Physician,9b. 30% Surgery ASC -- Facility,9a. 30% Surgery OP -- Physician,9a. 30% Surgery OP -- Facility"	"30% Coins:8a. 30% Lab -- FSL,8. 30% Lab -- OP"	"30% Coins:14h. 30% DMAM -- OP,8b. 30% Radiology -- FSR,14h. 30% SMAM -- FSR,14h. 30% SMAM -- OP,8b. 30% Advanced Imaging -- FSR,8b. 30% Advanced Imaging -- Office,9a. 30% Advanced Imaging -- OP,8a. 30% Radiology OP -- Physician,8a. 30% Radiology OP -- Facility"		"$0-$90/Proc:12. $0 Dialysis -- Dialysis Center,12. $90 Dialysis -- OP Hosp"	"30% Coins:9d. 30% Cardiac Rehab,8b. 30% Nuclear Medicine,9a. 30% OP Other,5. 30% Partial Hospitalization,8b. 30% Rad therapy,3. 30% Therapy (AT,PT,ST,OT) -- CORF"	30% Coins:7a	"30% Coins:7b, 7d, 7f"	"30% Coins:7h. 30% Psych -- OP,7e. 30% Psych -- Other Provider"	"30% Coins:9a. 30% Therapy (AT,PT,ST,OT) -- OP,7d. 30% Therapy (AT,PT,ST,OT) - Specialist"			30% Coins:15				VIS743				Silver Sneakers	Meals on Wheels	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit							5.6925	0.0815	0.3568	0.5413	0.6495	1.9884	0.7181	0.1944	2.5771	0.332	1.3809		0.0003	0.78	1.5639	3.5706	0.0226	0.3015			1.0658				0				0	0	0	0	0	0							21.8173	0	4.740904639	16.2282	0.47250374	1.835068545	0.54135	1.6237652	3.556510561	1.28437359	1.296294557	6.757426432	2.189319807	5.236572268	0	0.002162494	3.771378837	5.084232147	13.47193256	0.179680889	2.632939644	0	0	4.610075602	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.7738
H4408_801_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		260.636151	8.397651	506.349891	723.688715	4.947255	9.763915	3.526071	21.708067	55.800831	623.963987	30.172489	0	0.380736	17.189168	32.382102	73.932133	0.467229	6.242659			22.068105																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.00002	1024.00064	43.132798	0	0.2	0.2	0.2	0.199999	0.2	0	0.2	0	0.199999	0.2	0.199999	0.2	0.500001	0.2			0.199999																				1024.00002	1024.00064	43.132798	0	0.2	0.2	0.2	0.199999	0.2	0	0.2	0	0.199999	0.2	0.199999	0.2	0.500001	0.2			0.199999																				22.241	0.7166	1.820023964	0	0.989451	1.952783	0.7052142	4.341591692	11.1601662	0	6.0344978	0	0.076146819	3.4378336	6.476388018	14.7864266	0.233614967	1.2485318	0	0	4.413598932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6338	0	0	22.241	0.7166	1.820023964	0	0.989451	1.952783	0.7052142	4.341591692	11.1601662	0	6.0344978	0	0.076146819	3.4378336	6.476388018	14.7864266	0.233614967	1.2485318	0	0	4.413598932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6338		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4712	0.0796	0.2022		0.6273	1.238	0.4471	0.8178	2.1395		1.1464		0.0143	0.6476	1.2984	2.9643	0.0468	0.2503			0.8848																				15.2757	0	0	24.7122	0.796222	2.022248964	0	1.61675	3.190822	1.1523102	5.159378692	13.2996692	0	7.1809378	0	0.090489819	4.0853846	7.774743018	17.7507236	0.280449967	1.4988308	0	0	5.298415932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.9095
H4408_803_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		260.636151	8.397651	506.349891	723.688715	4.947255	9.763915	3.526071	21.708067	55.800831	623.963987	30.172489	0	0.380736	17.189168	32.382102	73.932133	0.467229	6.242659			22.068105																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.00002	1024.00064	43.132798	0	0.2	0.2	0.2	0.199999	0.2	0	0.2	0	0.199999	0.2	0.199999	0.2	0.500001	0.2			0.199999																				1024.00002	1024.00064	43.132798	0	0.2	0.2	0.2	0.199999	0.2	0	0.2	0	0.199999	0.2	0.199999	0.2	0.500001	0.2			0.199999																				22.241	0.7166	1.820023964	0	0.989451	1.952783	0.7052142	4.341591692	11.1601662	0	6.0344978	0	0.076146819	3.4378336	6.476388018	14.7864266	0.233614967	1.2485318	0	0	4.413598932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6338	0	0	22.241	0.7166	1.820023964	0	0.989451	1.952783	0.7052142	4.341591692	11.1601662	0	6.0344978	0	0.076146819	3.4378336	6.476388018	14.7864266	0.233614967	1.2485318	0	0	4.413598932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6338		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4712	0.0796	0.2022		0.6273	1.238	0.4471	0.8178	2.1395		1.1464		0.0143	0.6476	1.2984	2.9643	0.0468	0.2503			0.8848																				15.2757	0	0	24.7122	0.796222	2.022248964	0	1.61675	3.190822	1.1523102	5.159378692	13.2996692	0	7.1809378	0	0.090489819	4.0853846	7.774743018	17.7507236	0.280449967	1.4988308	0	0	5.298415932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.9095
H4408_804_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		260.636151	8.397651	506.349891	723.688715	4.947255	9.763915	3.526071	21.708067	55.800831	623.963987	30.172489	0	0.380736	17.189168	32.382102	73.932133	0.467229	6.242659			22.068105																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.00002	1024.00064	43.132798	0	0.2	0.2	0.2	0.199999	0.2	0	0.2	0	0.199999	0.2	0.199999	0.2	0.500001	0.2			0.199999																				1024.00002	1024.00064	43.132798	0	0.2	0.2	0.2	0.199999	0.2	0	0.2	0	0.199999	0.2	0.199999	0.2	0.500001	0.2			0.199999																				22.241	0.7166	1.820023964	0	0.989451	1.952783	0.7052142	4.341591692	11.1601662	0	6.0344978	0	0.076146819	3.4378336	6.476388018	14.7864266	0.233614967	1.2485318	0	0	4.413598932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6338	0	0	22.241	0.7166	1.820023964	0	0.989451	1.952783	0.7052142	4.341591692	11.1601662	0	6.0344978	0	0.076146819	3.4378336	6.476388018	14.7864266	0.233614967	1.2485318	0	0	4.413598932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6338		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4712	0.0796	0.2022		0.6273	1.238	0.4471	0.8178	2.1395		1.1464		0.0143	0.6476	1.2984	2.9643	0.0468	0.2503			0.8848																				15.2757	0	0	24.7122	0.796222	2.022248964	0	1.61675	3.190822	1.1523102	5.159378692	13.2996692	0	7.1809378	0	0.090489819	4.0853846	7.774743018	17.7507236	0.280449967	1.4988308	0	0	5.298415932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.9095
H4408_805_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		260.636151	8.397651	506.349891	723.688715	4.947255	9.763915	3.526071	21.708067	55.800831	623.963987	30.172489	0	0.380736	17.189168	32.382102	73.932133	0.467229	6.242659			22.068105																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.00002	1024.00064	43.132798	0	0.2	0.2	0.2	0.199999	0.2	0	0.2	0	0.199999	0.2	0.199999	0.2	0.500001	0.2			0.199999																				1024.00002	1024.00064	43.132798	0	0.2	0.2	0.2	0.199999	0.2	0	0.2	0	0.199999	0.2	0.199999	0.2	0.500001	0.2			0.199999																				22.241	0.7166	1.820023964	0	0.989451	1.952783	0.7052142	4.341591692	11.1601662	0	6.0344978	0	0.076146819	3.4378336	6.476388018	14.7864266	0.233614967	1.2485318	0	0	4.413598932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6338	0	0	22.241	0.7166	1.820023964	0	0.989451	1.952783	0.7052142	4.341591692	11.1601662	0	6.0344978	0	0.076146819	3.4378336	6.476388018	14.7864266	0.233614967	1.2485318	0	0	4.413598932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6338		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4712	0.0796	0.2022		0.6273	1.238	0.4471	0.8178	2.1395		1.1464		0.0143	0.6476	1.2984	2.9643	0.0468	0.2503			0.8848																				15.2757	0	0	24.7122	0.796222	2.022248964	0	1.61675	3.190822	1.1523102	5.159378692	13.2996692	0	7.1809378	0	0.090489819	4.0853846	7.774743018	17.7507236	0.280449967	1.4988308	0	0	5.298415932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.9095
H4449_008_0	2009	3	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	869.8834664	11.74088979	125.2657133		158.2524806	14.34381069	0.956254046	322.1454872	424.1583554	3132.709546	1728.394561	471.834901	7.357889056	1223.321034	12378.75483	3873.772605	148.4433125	1231.588261	1728.394561	5956.943809	16.87589213										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							150	150	125		100	0.2	0.2	50	100	30	30	30	30	30	10	30	30	30	30	30	0.2										50	200	25	25							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							10.1124	0.136487844	1.213511597	0	1.226456724	2.667948789	0.177863253	1.248313763	3.287227254	7.283549695	4.018517354	1.097016145	1.368567364	2.844221403	9.593534992	9.006521306	0.345130702	2.863442707	4.018517354	13.84989436	3.138915937	0	0	0	0	0	0	0	0	0	0.175491996	0.058939122	1.303309295	0.284453625	0	0	0	0	0	0	81.3202	0	6.0388	10.1124	0.136487844	1.213511597	0	1.226456724	2.667948789	0.177863253	1.248313763	3.287227254	7.283549695	4.018517354	1.097016145	1.368567364	2.844221403	9.593534992	9.006521306	0.345130702	2.863442707	4.018517354	13.84989436	3.138915937	0	0	0	0	0	0	0	0	0	0.175491996	0.058939122	1.303309295	0.284453625	0	0	0	0	0	0	81.3202	3000																																																																																	0	0	0	10.1124	0.136487844	1.213511597	0	1.226456724	2.667948789	0.177863253	1.248313763	3.287227254	7.283549695	4.018517354	1.097016145	1.368567364	2.844221403	9.593534992	9.006521306	0.345130702	2.863442707	4.018517354	13.84989436	3.138915937	0	0	0	0	0	0	0	0	0	0.175491996	0.058939122	1.303309295	0.284453625	0	0	0	0	0	0	81.3202
H4449_011_0	2009	5	h.1.	h.2.	f.	g.							OP Facility - Other	OP Facility - Other	OP Facility - Emergency	OP Facility - Surgery							3350	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										P	V	V	V																																															0		258.302143	4.81929089	45.08839036		334.6199059	16.29365329	2.93320176	71.93689843	255.6572334	5.129183674	20.3402723	0	1.402516059	20.18117984	1091.033104	3989.108403	101.4455782	707.6451844	2040.183295	7361.56746	0										45.288257	3.802524	672.675765	146.814774							$250/Stay	$250/Stay	$50 per day for days 21 -100	None	$100 per one way trip	25% coinsurance	25% coinsurance	$50 per visit	$100 per Surgery	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$10 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	20% coinsurance										$50/procedure	$200/visit	$25/visit	$25/visit							250	250	50		100	0.25	0.25	50	100	0.2	0.2	0.2	0.2	0.2	10	35	35	35	35	35	0.2										50	200	25	25							226.325	226.325	45.265	0	90.53	0.226325	0.226325	45.265	90.53	0.18106	0.18106	0.18106	0.18106	0.18106	9.053	31.6855	31.6855	31.6855	31.6855	31.6855	0.18106										45.6	182.4	22.8	22.8							4.8717	0.090893834	0.170077166	0	2.52442834	3.687661081	0.663856888	0.271351976	1.928720778	0.928689996	3.682809703	0	0.253939558	3.654004421	0.823093558	10.53307453	0.267862822	1.868507624	5.387018984	19.43791215	0	0	0	0	0	0	0	0	0	0	0.172095377	0.057798365	1.278083954	0.278948071	0	0	0	0	0	0	62.8325	0	7.67	4.8717	0.090893834	0.170077166	0	2.52442834	3.687661081	0.663856888	0.271351976	1.928720778	0.928689996	3.682809703	0	0.253939558	3.654004421	0.823093558	10.53307453	0.267862822	1.868507624	5.387018984	19.43791215	0	0	0	0	0	0	0	0	0	0	0.172095377	0.057798365	1.278083954	0.278948071	0	0	0	0	0	0	62.8325																																																																																		0			4.8717	0.090893834	0.170077166	0	2.52442834	3.687661081	0.663856888	0.271351976	1.928720778	0.928689996	3.682809703	0	0.253939558	3.654004421	0.823093558	10.53307453	0.267862822	1.868507624	5.387018984	19.43791215	0	0	0	0	0	0	0	0	0	0	0.172095377	0.057798365	1.278083954	0.278948071	0	0	0	0	0	0	62.8325
H4449_012_0	2009	2	h.1.	h.2.	f.	g.							OP Facility - Other	OP Facility - Other	OP Facility - Emergency	OP Facility - Surgery							2000	Complex diag	PET scans	Urgent Care	ASC							A	A	D		T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin										P	V	V	V																																															0		265.7808636	1.55671904	124.632314		166.6238498	20.68229169	1.378819446	257.8666768	246.5014824		767.0925825	471.834901	7.357889056	1223.321034	12484.07728	3948.783359	152.4200091	1266.584946	1755.136752	6185.182742	24.30691409										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	20% coins	$25/visit	$5/visit	$15/visit	$15/visit	$15/visit	$15/visit	$15/visit	20% Coins										$50/procedure	$200/visit	$25/visit	$25/visit							250	250	125		100	0.2	0.2	50	50		25	25	0.2	25	5	15	15	15	15	15	0.2										50	200	25	25							236.4490315	236.4490315	118.2245157		94.5796126	0.189159225	0.189159225	47.2898063	47.2898063		23.64490315	23.64490315	0.189159225	23.64490315	4.72898063	14.18694189	14.18694189	14.18694189	14.18694189	14.18694189	0.189159225										47.2898063	189.1592252	23.64490315	23.64490315							5.237	0.030673726	1.227882914	0	1.313268264	3.91224627	0.260816418	1.016205433	0.97141728	0	1.511485818	0.929707545	1.391812593	2.41044228	4.919746636	4.668430003	0.180197818	1.497413919	2.075001925	7.312402345	4.597877037	0	0	0	0	0	0	0	0	0	0.178472742	0.059940208	1.016205433	0.289285093	0	0	0	0	0	0	47.0079		2.694	5.237	0.030673726	1.227882914	0	1.313268264	3.91224627	0.260816418	1.016205433	0.97141728	0	1.511485818	0.929707545	1.391812593	2.41044228	4.919746636	4.668430003	0.180197818	1.497413919	2.075001925	7.312402345	4.597877037	0	0	0	0	0	0	0	0	0	0.178472742	0.059940208	1.016205433	0.289285093	0	0	0	0	0	0	47.0079																																																																																		0			5.237	0.030673726	1.227882914	0	1.313268264	3.91224627	0.260816418	1.016205433	0.97141728	0	1.511485818	0.929707545	1.391812593	2.41044228	4.919746636	4.668430003	0.180197818	1.497413919	2.075001925	7.312402345	4.597877037	0	0	0	0	0	0	0	0	0	0.178472742	0.059940208	1.016205433	0.289285093	0	0	0	0	0	0	47.0079
H4449_013_0	2009	8	h.1.	h.2.	f.	g.							OP Facility - Other	OP Facility - Other	OP Facility - Emergency	OP Facility - Surgery							3350	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										P	V	V	V																																															0		268.5861725	5.011165913	125.0227665		347.9424473	16.94236804	3.049984119	74.80099076	265.8359586	5.333396755	21.15009896	0	1.458355768	20.98467239	1134.471445	4147.930579	105.4845278	735.8193369	2121.411058	7654.660564	0										40.10931283	3.367685903	595.7518456	130.0257526							$450/Stay	$450/Stay	$100 per day for days 21 -100	None	$100 per one way trip	25% coinsurance	25% coinsurance	$50 per visit	$100 per Surgery	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$10  per visit	$45 per visit	$45 per visit	$45 per visit	$45 per visit	$45 per visit	0.2										$50/procedure	$200/visit	$25/visit	$25/visit							450	450	100		100	0.25	0.25	50	100	0.2	0.2	0.2	0.2	0.2	10	45	45	45	45	45	0.2										50	200	25	25							415.53	415.53	92.34	0	92.34	0.23085	0.23085	46.17	92.34	0.18468	0.18468	0.18468	0.18468	0.18468	9.234	41.553	41.553	41.553	41.553	41.553	0.18468										46.17	184.68	23.085	23.085							9.3005	0.173524148	0.962050188	0	2.677417132	3.911145663	0.704088834	0.287796812	2.045607701	0.984971713	3.906000275	0	0.269329143	3.875449297	0.872975777	14.36324661	0.365266548	2.547958409	7.345916142	26.50617587	0	0	0	0	0	0	0	0	0	0	0.154320581	0.051828686	1.146077613	0.250137042	0	0	0	0	0	0	82.7018	0	6.2	9.3005	0.173524148	0.962050188	0	2.677417132	3.911145663	0.704088834	0.287796812	2.045607701	0.984971713	3.906000275	0	0.269329143	3.875449297	0.872975777	14.36324661	0.365266548	2.547958409	7.345916142	26.50617587	0	0	0	0	0	0	0	0	0	0	0.154320581	0.051828686	1.146077613	0.250137042	0	0	0	0	0	0	82.7018																																																																																		0			9.3005	0.173524148	0.962050188	0	2.677417132	3.911145663	0.704088834	0.287796812	2.045607701	0.984971713	3.906000275	0	0.269329143	3.875449297	0.872975777	14.36324661	0.365266548	2.547958409	7.345916142	26.50617587	0	0	0	0	0	0	0	0	0	0	0.154320581	0.051828686	1.146077613	0.250137042	0	0	0	0	0	0	82.7018
H4454_002_0	2009	3																					2000											D	D	D	P	T	COIN	COIN	V	V	V	V	V	V	V	V	V	V	V	P		COIN		T																																																										0		946.37	53.9	355.68	1201	235	8.514602105	3.035397895	361.13	272.04	352.77	285.01	19.25	8.29	62.05	3766	4493.62	234.64	202.75	54.72	1050.03	48.83		245																		$175/D first 5 Days; 2K OP	$175/D first 5 Days; 2K OP	$0 (0-5 Days); $50/D ( 6-20 Days)	No Cost Sharing	$100 CP/Trip ($0 Admit)	"20% Coins., 1K OP Max"	"20% Coins., 1K OP Max"	$50 CP / Visit	$100 CP / Surg	No Cost Sharing	"$75 CP / (MRI, CT, Test)"	$100 /Admit; 2K OP	$30 CP / Visit	$100 CP / Surg	$15 CP / Visit	$30 CP / Visit	$30 CP / Visit	$15 CP / Visit	$30 CP / Visit	No Cost Sharing	"20% Coins., 1K OP max"		$3.50 / Trip																		175	175	50	0	100	0.2	0.2	50	100	0	75	100	30	100	15	30	30	15	30	0	0.2		3.5																		152	175	50	0	100	0.19	0.1	50	100	0	75	100	30	100	15	30	30	15	30	0	0.04		3.5																		11.9874	0.786041667	1.482	0	1.958333333	1.6177744	0.30353979	1.504708333	2.267	0	1.7813125	0.160416667	0.020725	0.517083333	4.7075	11.23405	0.5866	0.2534375	0.1368	0	1.9532	0	0.071458333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.3293		10.02	11.9874	0.786041667	1.482	0	1.958333333	1.6177744	0.30353979	1.504708333	2.267	0	1.7813125	0.160416667	0.020725	0.517083333	4.7075	11.23405	0.5866	0.2534375	0.1368	0	1.9532	0	0.071458333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.3293																																																																																		0			11.9874	0.786041667	1.482	0	1.958333333	1.6177744	0.30353979	1.504708333	2.267	0	1.7813125	0.160416667	0.020725	0.517083333	4.7075	11.23405	0.5866	0.2534375	0.1368	0	1.9532	0	0.071458333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.3293
H4454_007_0	2009	3																					2000											D	D	D	P	T	COIN	COIN	V	V	V	V	V	V	V	V	V	V	V	P		COIN																																																												0		946.37	53.9	355.68	1201	235	8.514602105	3.035397895	361.13	272.04	352.77	285.01	19.25	8.29	62.05	3766	4493.62	234.64	202.75	54.72	1050.03	48.83																				$225/D first 5 Days; 2K OP	$225/D first 5 Days; 2K OP	$0 (0-5 Days); $50/D ( 6-20 Days)	No Cost Sharing	$100 CP/Trip ($0 Admit)	"20% Coins., 1K OP Max"	"20% Coins., 1K OP Max"	$50 CP / Visit	$135 CP / Surg	No Cost Sharing	"$75 CP / (MRI, CT, Test)"	$100 /Admit; 2K OP	$30 CP / Visit	$135 CP / Surg	$15 CP / Visit	$30 CP / Visit	$30 CP / Visit	$15 CP / Visit	$30 CP / Visit	No Cost Sharing	"20% Coins., 1K OP max"																				225	225	50		100	0.2	0.2	50	135		75	100	30	135	15	30	30	15	30		0.2																				195.75	225	50		100	0.19	0.1	50	135		75	100	30	135	15	30	30	15	30		0.04																				15.4377	1.010625	1.482	0	1.958333333	1.6177744	0.30353979	1.504708333	3.06045	0	1.7813125	0.160416667	0.020725	0.6980625	4.7075	11.23405	0.5866	0.2534375	0.1368	0	1.9532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.9072		10.02	15.4377	1.010625	1.482	0	1.958333333	1.6177744	0.30353979	1.504708333	3.06045	0	1.7813125	0.160416667	0.020725	0.6980625	4.7075	11.23405	0.5866	0.2534375	0.1368	0	1.9532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.9072																																																																																		0			15.4377	1.010625	1.482	0	1.958333333	1.6177744	0.30353979	1.504708333	3.06045	0	1.7813125	0.160416667	0.020725	0.6980625	4.7075	11.23405	0.5866	0.2534375	0.1368	0	1.9532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.9072
H4454_008_0	2009	3																																																							COIN	COIN																																																								0																									12.31	1.7																																							Various cost sharing	$30 CP/Exam																																							0.242	0.4235																																							0.242	0.4235																0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.97902	0.71995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.699			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.97902	0.71995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.699																																																																																		0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.97902	0.71995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.699
H4454_012_0	2009	3																					2000											D	D	D	P	T	COIN	COIN	V	V	P	P	V	P	P	V	V	P	P	P	P	COIN		V																																																										0		739	57.9425	220.21	842.1450406	187.7755834	5.316120341	2.233879659	297.37	240.04	274.0676361	224.8956357	15.96313813	0	47.4662456	2816.792755	3424.936859	246.5276918	157.7980597	46.93481051	1105.009824	34.61		245																		$150/D first 5 Days; 2K OP	$150/D first 5 Days; 2K OP	$0/D (0-5 Days); $50 (6-20 Days)	No Cost Sharing	$100 CP/Trip ($0 Admit)	"20% Coins., 1K OP Max"	"20% Coins., 1K OP Max"	$50 CP / Visit	$200 CP / Surg	No Cost Sharing	"$75 CP / (MRI, CT, Test)"	$150 /Admit; 2K OP	$30 CP / Visit	$200 CP / Surg	$15 CP / Visit	$30 CP / Visit	$30 CP / Visit	$15 CP / Visit	$30 CP / Visit	No Cost Sharing	"20% Coins., 1K OP max"		$3.50 / Trip																		150	150	50	0	100	0.2	0.2	50	200	0	75	150	30	200	15	30	30	15	30	0	0.2		3.5																		133	150	50	0	100	0.2	0.09	50	200	0	75	150	30	200	15	30	30	15	30	0	0.08		3.5																		8.1906	0.72428125	0.917541667	0	1.564796528	1.063224068	0.201049169	1.239041667	4.000666667	0	1.405597723	0.199539227	0	0.791104093	3.520990944	8.562342147	0.616319229	0.197247575	0.117337026	0	2.7688	0	0.071458333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.1519		5.45	8.1906	0.72428125	0.917541667	0	1.564796528	1.063224068	0.201049169	1.239041667	4.000666667	0	1.405597723	0.199539227	0	0.791104093	3.520990944	8.562342147	0.616319229	0.197247575	0.117337026	0	2.7688	0	0.071458333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.1519																																																																																		0			8.1906	0.72428125	0.917541667	0	1.564796528	1.063224068	0.201049169	1.239041667	4.000666667	0	1.405597723	0.199539227	0	0.791104093	3.520990944	8.562342147	0.616319229	0.197247575	0.117337026	0	2.7688	0	0.071458333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.1519
H4454_013_0	2009	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
H4454_018_0	2009	2																					2000											D	D	D	P	T	COIN	COIN	V	V	V	V	V	V	V	V	V	V	V	P		COIN																																																												0		946.37	53.9	355.68	1201	235	8.514602105	3.035397895	361.13	272.04	352.77	285.01	19.25	8.29	62.05	3766	4493.62	234.64	202.75	54.72	1050.03	48.83																				$225/D first 5 Days; 2K OP	$225/D first 5 Days; 2K OP	$0 (0-5 Days); $50/D ( 6-20 Days)	No Cost Sharing	$100 CP/Trip ($0 Admit)	"20% Coins., 1K OP Max"	"20% Coins., 1K OP Max"	$50 CP / Visit	$135 CP / Surg	No Cost Sharing	"$75 CP / (MRI, CT, Test)"	$100 /Admit; 2K OP	$30 CP / Visit	$135 CP / Surg	$15 CP / Visit	$30 CP / Visit	$30 CP / Visit	$15 CP / Visit	$30 CP / Visit	No Cost Sharing	"20% Coins., 1K OP max"																				225	225	50		100	0.2	0.2	50	135		75	100	30	135	15	30	30	15	30		0.2																				191.25	225	50		100	0.19	0.1	50	135		75	100	30	135	15	30	30	15	30		0.04																				15.0828	1.010625	1.482	0	1.958333333	1.6177744	0.30353979	1.504708333	3.06045	0	1.7813125	0.160416667	0.020725	0.6980625	4.7075	11.23405	0.5866	0.2534375	0.1368	0	1.9532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.5523		10.87	15.0828	1.010625	1.482	0	1.958333333	1.6177744	0.30353979	1.504708333	3.06045	0	1.7813125	0.160416667	0.020725	0.6980625	4.7075	11.23405	0.5866	0.2534375	0.1368	0	1.9532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.5523																																																																																		0			15.0828	1.010625	1.482	0	1.958333333	1.6177744	0.30353979	1.504708333	3.06045	0	1.7813125	0.160416667	0.020725	0.6980625	4.7075	11.23405	0.5866	0.2534375	0.1368	0	1.9532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.5523
H4454_019_0	2009	3																					2000											D	D	D	P	T	COIN	COIN	V	V	V	V	V	V	V	V	V	V	V	P		COIN		T	COIN	COIN																																																								0		1206.65	55.517	147.17	868	196	6.661445102	2.049043798	306.54	271	178.8831776	254.2001524	17.04212873	9.455542681	34.90873581	3754.91019	2527.393221	238.71531	53.38760588	25.46824756	1069.992425	25.87		250	12.31	1.7																$150/D first 5 Days; 2K OP	$150/D first 5 Days; 2K OP	$0/D (0-5 Days); $50 (6-20 Days)	No Cost Sharing	$100 CP/Trip ($0 Admit)	"20% Coins., 1K OP Max"	"20% Coins., 1K OP Max"	$50 CP / Visit ($0 admit)	$150 CP / Surg	No Cost Sharing	"$75 CP / (MRI, CT, Test)"	$150 /Admit; 2K OP	$30 CP / Visit	$150 CP / Surg	$15 CP / Visit	$30 CP / Visit	$30 CP / Visit	$15 CP / Visit	$30 CP / Visit	No Cost Sharing	"20% Coins., 1K OP max"		$3.50 / Trip	Various cost sharing	$30 CP/Exam																150	150	50	0	100	0.2	0.2	50	150	0	75	150	30	150	15	30	30	15	30	0	0.2		3.5	0.242	0.4235																123	150	50	0	100	0.2	0.13	50	150	0	75	150	30	150	15	30	30	15	30	0	0.04		3.5	0.242	0.4235																12.3682	0.6939625	0.613208333	0	1.633333333	1.33228902	0.266375694	1.27725	3.3875	0	1.588750952	0.213026609	0.023638857	0.436359198	4.693637738	6.318483054	0.596788275	0.066734507	0.063670619	0	1.0348	0	0.072916667	2.97902	0.71995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3799		6.99	12.3682	0.6939625	0.613208333	0	1.633333333	1.33228902	0.266375694	1.27725	3.3875	0	1.588750952	0.213026609	0.023638857	0.436359198	4.693637738	6.318483054	0.596788275	0.066734507	0.063670619	0	1.0348	0	0.072916667	2.97902	0.71995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3799																																																																																		0			12.3682	0.6939625	0.613208333	0	1.633333333	1.33228902	0.266375694	1.27725	3.3875	0	1.588750952	0.213026609	0.023638857	0.436359198	4.693637738	6.318483054	0.596788275	0.066734507	0.063670619	0	1.0348	0	0.072916667	2.97902	0.71995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3799
H4454_020_0	2009	3																																D	D			COIN	COIN	COIN	V	V	COIN	COIN	COIN	COIN								COIN																				24.8218	1.6831			0.6144	0.7811	0.2072			0.0665	0.9687	0.294	0.0154								2.2596																				31.7117		2429.252289	164.7232717			19.81776023	25.19522504	6.68408897	1100	554	2.14473843	31.24826265	9.48323165	0.497296076	25.08							72.89																				Standard Medicare Benefits	Standard Medicare Benefits	No Cost Sharing	No Cost Sharing	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	After Pt B Ded/$50 per visit	After Pt B Ded/$50 per visit	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	Standard Medicare Benefits																				8.25	8	0	0	0.2	0.2	0.2	50	50	0.2	0.2	0.2	0.2	0	0	0	0	0	0	0	0.2																				8.25	8	0	0	0.2	0.2	0.2	50	50	0.2	0.2	0.2	0.2	0	0	0	0	0	0	0	0.2																				1.6701	0.109815514	0	0	3.963552045	5.039045007	1.336817794	4.583333333	2.308333333	0.428947686	6.249652531	1.89664633	0.099459215	0	0	0	0	0	0	0	14.578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.2637	31.71		26.4919	1.792935571	0	0	4.577902612	5.820096983	1.544024552	4.583333333	2.308333333	0.495434577	7.218348673	2.190626511	0.114875393	0	0	0	0	0	0	0	16.83761674	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.9754																																																																																		0			26.4919	1.792935571	0	0	4.577902612	5.820096983	1.544024552	4.583333333	2.308333333	0.495434577	7.218348673	2.190626511	0.114875393	0	0	0	0	0	0	0	16.83761674	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.9754
H4454_021_0	2009	3																					2000											D	D	D	P	T	COIN	COIN	V	V	V	V	V	V	V	V	V	V	V	P		COIN		T																																																										0		1102.376	57.9425	437.59	1484.684439	288	10.62519311	3.474806887	485.45	370.23	224.49	412.8424245	30.00532892	13.02104212	65.45	4699.43	4631.27	252.38	290.91	80.65	1129	55.36		245																		$200/D first 5 Days; 2K OP	$200/D first 5 Days; 2K OP	$0 (0-5 Days); $50 (6-20 Days)	No Cost Sharing	$100 CP/Trip ($0 Admit)	"20% Coins., 1K OP Max"	"20% Coins., 1K OP Max"	$50 CP / Visit	$150 CP / Surg	No Cost Sharing	"$100 CP / (MRI, CT, Test)"	$150 /Admit; 2K OP	$30 CP / Visit	$150 CP / Surg	$15 CP / Visit	$40 CP / Visit	$30 CP / Visit	$15 CP / Visit	$40 CP / Visit	No Cost Sharing	"20% Coins., 1K OP max"		$3.50 / Trip																		200	200	50	0	100	0.2	0.2	50	150	0	100	150	30	150	15	40	30	15	40	0	0.2		3.5																		175	200	50	0	100	0.19	0.11	50	150	0	100	150	30	150	15	40	30	15	40	0	0.04		3.5																		16.0763	0.965708333	1.823291667	0	2.4	2.018786692	0.382228758	2.022708333	4.627875	0	3.440353538	0.375066611	0.032552605	0.818125	5.8742875	15.43756667	0.63095	0.3636375	0.268833333	0	2.2144	0	0.071458333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8441		11.57	16.0763	0.965708333	1.823291667	0	2.4	2.018786692	0.382228758	2.022708333	4.627875	0	3.440353538	0.375066611	0.032552605	0.818125	5.8742875	15.43756667	0.63095	0.3636375	0.268833333	0	2.2144	0	0.071458333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8441																																																																																		0			16.0763	0.965708333	1.823291667	0	2.4	2.018786692	0.382228758	2.022708333	4.627875	0	3.440353538	0.375066611	0.032552605	0.818125	5.8742875	15.43756667	0.63095	0.3636375	0.268833333	0	2.2144	0	0.071458333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8441
H4454_022_0	2009	2																					2000											D	D	D	P	T	COIN	COIN	V	V	V	V	V	V	V	V	V	V	V	P		COIN																																																												0		1102.376	57.9425	437.59	1484.684439	288	10.62519311	3.474806887	485.45	370.23	224.49	412.8424245	30.00532892	13.02104212	65.45	4699.43	4631.27	252.38	290.91	80.65	1129	55.36																				$245/D first 5 Days; 2K OP	$245/D first 5 Days; 2K OP	$0 (0-5 Days); $50 (6-20 Days)	No Cost Sharing	$100 CP/Trip ($0 Admit)	"20% Coins., 1K OP Max"	"20% Coins., 1K OP Max"	$50 CP / Visit	$175 CP / Surg	No Cost Sharing	"$100 CP / (MRI, CT, Test)"	$150 /Admit; 2K OP	$30 CP / Visit	$175 CP / Surg	$15 CP / Visit	$40 CP / Visit	$30 CP / Visit	$15 CP / Visit	$40 CP / Visit	No Cost Sharing	"20% Coins., 1K OP max"																				245	245	50		100	0.2	0.2	50	175		100	150	30	175	15	40	30	15	40		0.2																				208.25	245	50		100	0.19	0.11	50	175		100	150	30	175	15	40	30	15	40		0.04																				19.1308	1.182992708	1.823291667	0	2.4	2.018786692	0.382228758	2.022708333	5.3991875	0	3.440353538	0.375066611	0.032552605	0.954479167	5.8742875	15.43756667	0.63095	0.3636375	0.268833333	0	2.2144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.9521		12.66	19.1308	1.182992708	1.823291667	0	2.4	2.018786692	0.382228758	2.022708333	5.3991875	0	3.440353538	0.375066611	0.032552605	0.954479167	5.8742875	15.43756667	0.63095	0.3636375	0.268833333	0	2.2144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.9521																																																																																		0			19.1308	1.182992708	1.823291667	0	2.4	2.018786692	0.382228758	2.022708333	5.3991875	0	3.440353538	0.375066611	0.032552605	0.954479167	5.8742875	15.43756667	0.63095	0.3636375	0.268833333	0	2.2144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.9521
H4454_023_0	2009	2																					2000											D	D	D	P	T	COIN	COIN	V	V	V	V	V	V	V	V	V	V	V	P		COIN																																																												0		1102.376	57.9425	437.59	1484.684439	288	10.62519311	3.474806887	485.45	370.23	224.49	412.8424245	30.00532892	13.02104212	65.45	4699.43	4631.27	252.38	290.91	80.65	1129	55.36																				$245/D first 5 Days; 2K OP	$245/D first 5 Days; 2K OP	$0 (0-5 Days); $50 (6-20 Days)		$100 CP/Trip ($0 Admit)	"20% Coins., 1K OP Max"	"20% Coins., 1K OP Max"	$50 CP / Visit	$175 CP / Surg		"$100 CP / (MRI, CT, Test)"	$150 /Admit; 2K OP	$30 CP / Visit	$175 CP / Surg	$15 CP / Visit	$40 CP / Visit	$30 CP / Visit	$15 CP / Visit	$40 CP / Visit		"20% Coins., 1K OP max"																				245	245	50		100	0.2	0.2	50	175		100	150	30	175	15	40	30	15	40		0.2																				208.25	245	50		100	0.19	0.11	50	175		100	150	30	175	15	40	30	15	40		0.04																				19.1308	1.182992708	1.823291667	0	2.4	2.018786692	0.382228758	2.022708333	5.3991875	0	3.440353538	0.375066611	0.032552605	0.954479167	5.8742875	15.43756667	0.63095	0.3636375	0.268833333	0	2.2144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.9521		12.66	19.1308	1.182992708	1.823291667	0	2.4	2.018786692	0.382228758	2.022708333	5.3991875	0	3.440353538	0.375066611	0.032552605	0.954479167	5.8742875	15.43756667	0.63095	0.3636375	0.268833333	0	2.2144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.9521																																																																																		0			19.1308	1.182992708	1.823291667	0	2.4	2.018786692	0.382228758	2.022708333	5.3991875	0	3.440353538	0.375066611	0.032552605	0.954479167	5.8742875	15.43756667	0.63095	0.3636375	0.268833333	0	2.2144	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.9521
H4454_024_0	2009	2																					2000											D	D	D	P	T	COIN	COIN	V	V	V	V	V	V	V	V	V	V	V	P		COIN		T	COIN	COIN																																																								0		1206.65	55.517	147.17	868	196	6.661445102	2.049043798	306.54	271	178.8831776	254.2001524	17.04212873	9.455542681	34.90873581	3754.91019	2527.393221	238.71531	53.38760588	25.46824756	1069.992425	25.87		250	12.31	1.7																$200/D first 5 Days; 2K OP	$200/D first 5 Days; 2K OP	$0/D (0-5 Days); $50 (6-20 Days)		$100 CP/Trip ($0 Admit)	"20% Coins., 1K OP Max"	"20% Coins., 1K OP Max"	$50 CP / Visit ($0 admit)	$200 CP / Surg		"$75 CP / (MRI, CT, Test)"	$150 /Admit; 2K OP	$30 CP / Visit	$200 CP / Surg	$15 CP / Visit	$30 CP / Visit	$30 CP / Visit	$15 CP / Visit	$30 CP / Visit		"20% Coins., 1K OP max"		$3.50 / Trip	Various cost sharing	$30 CP/Exam																200	200	50		100	0.2	0.2	50	200		75	150	30	200	15	30	30	15	30		0.2		3.5	0.242	0.4235																164	200	50		100	0.2	0.13	50	200		75	150	30	200	15	30	30	15	30		0.04		3.5	0.242	0.4235																16.4909	0.925283333	0.613208333	0	1.633333333	1.33228902	0.266375694	1.27725	4.516666667	0	1.588750952	0.213026609	0.023638857	0.581812263	4.693637738	6.318483054	0.596788275	0.066734507	0.063670619	0	1.0348	0	0.072916667	2.97902	0.71995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.0085		7.9	16.4909	0.925283333	0.613208333	0	1.633333333	1.33228902	0.266375694	1.27725	4.516666667	0	1.588750952	0.213026609	0.023638857	0.581812263	4.693637738	6.318483054	0.596788275	0.066734507	0.063670619	0	1.0348	0	0.072916667	2.97902	0.71995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.0085																																																																																		0			16.4909	0.925283333	0.613208333	0	1.633333333	1.33228902	0.266375694	1.27725	4.516666667	0	1.588750952	0.213026609	0.023638857	0.581812263	4.693637738	6.318483054	0.596788275	0.066734507	0.063670619	0	1.0348	0	0.072916667	2.97902	0.71995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.0085
H4454_025_0	2009	2																					2000											D	D	D	P	T	COIN	COIN	V	V	V	V	V	V	V	V	V	V	V	P		COIN		T	COIN	COIN																																																								0		1206.65	55.517	147.17	868	196	6.661445102	2.049043798	306.54	271	178.8831776	254.2001524	17.04212873	9.455542681	34.90873581	3754.91019	2527.393221	238.71531	53.38760588	25.46824756	1069.992425	25.87		250	12.31	1.7																$200/D first 5 Days; 2K OP	$200/D first 5 Days; 2K OP	$0/D (0-5 Days); $50 (6-20 Days)		$100 CP/Trip ($0 Admit)	"20% Coins., 1K OP Max"	"20% Coins., 1K OP Max"	$50 CP / Visit ($0 admit)	$200 CP / Surg		"$75 CP / (MRI, CT, Test)"	$150 /Admit; 2K OP	$30 CP / Visit	$200 CP / Surg	$15 CP / Visit	$30 CP / Visit	$30 CP / Visit	$15 CP / Visit	$30 CP / Visit		"20% Coins., 1K OP max"		$3.50 / Trip	Various cost sharing	$30 CP/Exam																200	200	50		100	0.2	0.2	50	200		75	150	30	200	15	30	30	15	30		0.2		3.5	0.242	0.4235																164	200	50		100	0.2	0.13	50	200		75	150	30	200	15	30	30	15	30		0.04		3.5	0.242	0.4235																16.4909	0.925283333	0.613208333	0	1.633333333	1.33228902	0.266375694	1.27725	4.516666667	0	1.588750952	0.213026609	0.023638857	0.581812263	4.693637738	6.318483054	0.596788275	0.066734507	0.063670619	0	1.0348	0	0.072916667	2.97902	0.71995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.0085		7.9	16.4909	0.925283333	0.613208333	0	1.633333333	1.33228902	0.266375694	1.27725	4.516666667	0	1.588750952	0.213026609	0.023638857	0.581812263	4.693637738	6.318483054	0.596788275	0.066734507	0.063670619	0	1.0348	0	0.072916667	2.97902	0.71995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.0085																																																																																		0			16.4909	0.925283333	0.613208333	0	1.633333333	1.33228902	0.266375694	1.27725	4.516666667	0	1.588750952	0.213026609	0.023638857	0.581812263	4.693637738	6.318483054	0.596788275	0.066734507	0.063670619	0	1.0348	0	0.072916667	2.97902	0.71995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.0085
H4454_027_0	2009	6																					2000											D	D	D	P	T	COIN	COIN	V	V	V	V	V	V	V	V	V	V	V	P		COIN			COIN																																																									0		1026	56.595	368.45		251.4519336	9.09906777	3.14093223	403.44	321.48	324.6881913	327.9072995	22.65969767	9.950745485	63.59383813	4136.136299	4457.159718	234.609978	216.7315829	59.87811143		50.99			12.31																	$200/D first 5 Days; 2K OP	$200/D first 5 Days; 2K OP	0/day for 1-5 $50/day 6-20		$100 CP/Trip ($0 Admit)	"20% Coins., 1K OP Max"	"20% Coins., 1K OP Max"	$50 CP / Visit	$150 CP / Surg		"$100 CP / (MRI, CT, Test)"	$150 /Admit; 2K OP	$30 CP / Visit	$150 CP / Surg	$15 CP / Visit	$30 CP / Visit	$30 CP / Visit	$15 CP / Visit	$30 CP / Visit		"20% Coins., 1K OP max"			Various Cost Sharing																	200	200	50		100	0.2	0.2	50	150		100	150	30	150	15	30	30	15	30		0.2			0.242																	175	200	50		100	0.19	0.11	50	150		100	150	30	150	15	30	30	15	30		0.04			0.242																	14.9625	0.94325	1.535208333	0	2.09543278	1.728822876	0.345502545	1.681	4.0185	0	2.732560829	0.283246221	0.024876864	0.794922977	5.170170373	11.1428993	0.586524945	0.270914479	0.149695279	0	2.0396	0	0	2.97902	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4846		10.67	14.9625	0.94325	1.535208333	0	2.09543278	1.728822876	0.345502545	1.681	4.0185	0	2.732560829	0.283246221	0.024876864	0.794922977	5.170170373	11.1428993	0.586524945	0.270914479	0.149695279	0	2.0396	0	0	2.97902	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4846																																																																																		0			14.9625	0.94325	1.535208333	0	2.09543278	1.728822876	0.345502545	1.681	4.0185	0	2.732560829	0.283246221	0.024876864	0.794922977	5.170170373	11.1428993	0.586524945	0.270914479	0.149695279	0	2.0396	0	0	2.97902	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4846
H4454_028_0	2009	3																																D	D		V	COIN	COIN	COIN	V	V	COIN	COIN	COIN	COIN	V							COIN																				23.6986	1.596			0.6887	0.7934	0.2346			0.1135	0.7985	0.3661	0.0113								1.67																				29.9707		2519	169.65	550	1842	22.21668264	25.59253836	7.566163649	1182.013	558.125	3.661255671	25.75953911	11.80995294	0.362981574	1000	52.74155226	164.3289005	3.770667928	4.745958392	15.81527351	3.683988079	53.85																				Standard Medicare Benefits	Standard Medicare Benefits	No Cost Sharing	No Cost Sharing	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	After Pt B Ded/$50 per visit	$50 CP/Visit	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	$50 CP/Visit	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	Standard Medicare Benefits																				9.95	5			0.2	0.2	0.2	50	50	0.2	0.2	0.2	0.2	50							0.2																				9.95	5			0.2	0.2	0.2	50	50	0.2	0.2	0.2	0.2	50							0.2																				2.0887	0.0706875	0	0	4.443336528	5.118507673	1.51323273	4.925054167	2.325520833	0.732251134	5.151907823	2.361990587	0.072596315	4.166666667	0	0	0	0	0	0	10.77	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7404	29.97		25.7873	1.666715357	0	0	5.13205369	5.911876362	1.747783803	4.925054167	2.325520833	0.84575006	5.950453535	2.728099128	0.083848744	4.166666667	0	0	0	0	0	0	12.44	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.7111																																																																																		0			25.7873	1.666715357	0	0	5.13205369	5.911876362	1.747783803	4.925054167	2.325520833	0.84575006	5.950453535	2.728099128	0.083848744	4.166666667	0	0	0	0	0	0	12.44	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.7111
H4454_803_0	2009	2																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																				15.2926	0.6584	0	0	0.2052	0.3343	0.0381	0.5076	1.4449	0.1174	0.758	0.1846	0	0.478	1.6405	4.1314	0.0333	0.0789	0.2898	0.1645	2.2194																				28.5769		1309.400983	56.37117651	429.5686526	1217.459899	6.62	10.78458631	1.228498439	16.37281564	46.60902388	3.788706046	24.45320715	5.954002509	0	15.41820963	52.91927055	133.2699422	1.075708821	2.544905163	9.349263358	5.306113143	71.59498911																				Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits																				9.4	9	153.4	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																				9.4	9	153.4	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																				1.0257	0.042278382	5.491319275	0	1.324	2.156917261	0.245699688	3.274563127	9.321804776	0.757741209	4.890641431	1.190800502	0	3.083641927	10.58385411	26.65398844	0.215141764	0.508981033	1.869852672	1.061222629	14.31899782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.0171	28.58		16.3183	0.700642934	5.491319275	0	1.529151404	2.491239437	0.283783139	3.782120412	10.76668452	0.875191097	5.648690852	1.37537458	0	3.561606426	12.2243515	30.78535665	0.248488738	0.587873093	2.159679836	1.225712136	16.53844248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.594																																																																																		0			16.3183	0.700642934	5.491319275	0	1.529151404	2.491239437	0.283783139	3.782120412	10.76668452	0.875191097	5.648690852	1.37537458	0	3.561606426	12.2243515	30.78535665	0.248488738	0.587873093	2.159679836	1.225712136	16.53844248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.594
H4454_805_0	2009	4																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																				12.7949	0.676	0	0	0.2004	0.2172	0.0629	0.5549	1.4538	0.0232	0.5885	0.1122	0	0.4802	1.3933	4.6116	0.0006	0.0457	0.1781	0.2259	1.7031																				25.3228		1050.15192	55.47993167	389.9302083	1078.257849	6.46	7.005148803	2.029514383	17.90138546	46.89809812	0.749903572	18.98396519	3.620792791	0	15.49167517	44.94565023	148.7625931	0.020363781	1.474374758	5.746728047	7.285690493	54.93910515																				Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits																				9.85	9	162.72	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																				9.85	9	162.72	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																				0.862	0.041609949	5.287453625	0	1.292	1.401029761	0.405902877	3.580277092	9.379619624	0.149980714	3.796793038	0.724158558	0	3.098335033	8.989130047	29.75251863	0.004072756	0.294874952	1.149345609	1.457138099	10.98782103	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.6541	25.29		13.6569	0.717570818	5.287453625	0	1.492383158	1.618189374	0.468817823	4.135220041	10.83346067	0.173227725	4.385295959	0.836403135	0	3.578576963	10.3824452	34.36415901	0.004704033	0.340580569	1.327494179	1.682994504	12.69093329	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.9768																																																																																		0			13.6569	0.717570818	5.287453625	0	1.492383158	1.618189374	0.468817823	4.135220041	10.83346067	0.173227725	4.385295959	0.836403135	0	3.578576963	10.3824452	34.36415901	0.004704033	0.340580569	1.327494179	1.682994504	12.69093329	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.9768
H4454_806_0	2009	2																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																				15.2926	0.6584	0	0	0.2052	0.3343	0.0381	0.5076	1.4449	0.1174	0.758	0.1846	0	0.478	1.6405	4.1314	0.0333	0.0789	0.2898	0.1645	2.2194																				28.5769		1309.400983	56.37117651	429.5686526	1217.459899	6.62	10.78458631	1.228498439	16.37281564	46.60902388	3.788706046	24.45320715	5.954002509	0	15.41820963	52.91927055	133.2699422	1.075708821	2.544905163	9.349263358	5.306113143	71.59498911																				Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits																				9.4	9	153.4	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																				9.4	9	153.4	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																				1.0257	0.042278382	5.491319275	0	1.324	2.156917261	0.245699688	3.274563127	9.321804776	0.757741209	4.890641431	1.190800502	0	3.083641927	10.58385411	26.65398844	0.215141764	0.508981033	1.869852672	1.061222629	14.31899782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.0171	28.58		16.3183	0.700642934	5.491319275	0	1.529151404	2.491239437	0.283783139	3.782120412	10.76668452	0.875191097	5.648690852	1.37537458	0	3.561606426	12.2243515	30.78535665	0.248488738	0.587873093	2.159679836	1.225712136	16.53844248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.594																																																																																		0			16.3183	0.700642934	5.491319275	0	1.529151404	2.491239437	0.283783139	3.782120412	10.76668452	0.875191097	5.648690852	1.37537458	0	3.561606426	12.2243515	30.78535665	0.248488738	0.587873093	2.159679836	1.225712136	16.53844248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.594
H4454_807_0	2009	2																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																				12.7949	0.676	0	0	0.2004	0.2172	0.0629	0.5549	1.4538	0.0232	0.5885	0.1122	0	0.4802	1.3933	4.6116	0.0006	0.0457	0.1781	0.2259	1.7031																				25.3228		1050.15192	55.47993167	389.9302083	1078.257849	6.46	7.005148803	2.029514383	17.90138546	46.89809812	0.749903572	18.98396519	3.620792791	0	15.49167517	44.94565023	148.7625931	0.020363781	1.474374758	5.746728047	7.285690493	54.93910515																				Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits																				9.88	9	162.72	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																				9.88	9	162.72	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																				0.8646	0.041609949	5.287453625	0	1.292	1.401029761	0.405902877	3.580277092	9.379619624	0.149980714	3.796793038	0.724158558	0	3.098335033	8.989130047	29.75251863	0.004072756	0.294874952	1.149345609	1.457138099	10.98782103	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.6567	23.32		13.6596	0.717570818	5.287453625	0	1.492383158	1.618189374	0.468817823	4.135220041	10.83346067	0.173227725	4.385295959	0.836403135	0	3.578576963	10.3824452	34.36415901	0.004704033	0.340580569	1.327494179	1.682994504	12.69093329	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.9795																																																																																		0			13.6596	0.717570818	5.287453625	0	1.492383158	1.618189374	0.468817823	4.135220041	10.83346067	0.173227725	4.385295959	0.836403135	0	3.578576963	10.3824452	34.36415901	0.004704033	0.340580569	1.327494179	1.682994504	12.69093329	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.9795
H4456_010_0	2009	5																					2650											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1326.357989	57.61802664	430.7083395	147.4053286	166.660688	16.90963436	2.610231174	697.533662	47.22249786	15390.52539	67.2048217	0	0.070125915	40.94946727	6158.161658	5258.467456	283.7522908	141.0383911	0	0	30.48156126	1179.615915	0	0	147.9890135	0	18.41008798	0	98.4	0											"$195 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$195 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$95 Days 1-28 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	15% (9b)	$0/$15 (8a1); $15 (8a2)	"$25 (8b1); 15% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); 15% (9a); $40/$30 (9c)"	"$5 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											192.7232568	195	95	0	150	0.2	0.144438576	49.91208767	0.15	6	0.163265742	0	0.2	0.151593444	3.379973168	20	37.5	20	0	0	0.2	18.56607596	0	0	20	0	20	0	0	0											125.6093198	127.067627	61.90474137	0	97.74432848	0.130325771	0.094120344	32.52415661	0.097744328	3.909773139	0.106388669	0	0.130325771	0.098873197	3.379973168	20	37.5	13.03257713	0	0	0.130325771	18.56607596	0	0	20	0	20	0	0	0											13.8836	0.610115493	2.221907363	0	1.35751142	2.20376114	0.245675856	1.890557839	4.615731343	5.014455232	7.149831512	0	0.009139214	4.048804735	1.734535098	8.764112426	0.886725909	0.153174476	0	0	3.972532982	1.82506989	0	0	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	60.8646	0	25.3184	13.8836	0.610115493	2.221907363	0	1.35751142	2.20376114	0.245675856	1.890557839	4.615731343	5.014455232	7.149831512	0	0.009139214	4.048804735	1.734535098	8.764112426	0.886725909	0.153174476	0	0	3.972532982	1.82506989	0	0	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	60.8646																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	13.8836	0.610115493	2.221907363	0	1.35751142	2.20376114	0.245675856	1.890557839	4.615731343	5.014455232	7.149831512	0	0.009139214	4.048804735	1.734535098	8.764112426	0.886725909	0.153174476	0	0	3.972532982	1.82506989	0	0	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	60.8646
H4456_013_0	2009	5																					3200											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1202.943577	68.75725154	532.1038238	109.0036555	207.0056082	15.49829993	2.532705555	719.6260854	45.43813725	14766.26978	56.33528761	0	0.164714514	33.61769024	5734.902952	5152.870327	332.4673772	145.2319504	0	0	27.56120475	1023.885837	0	0	158.1686387	0	18.58731116	0	453.6	0											"$195 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$195 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	"$95 Days 1-28 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	15% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 15% (8b2, 8b3)"	Included in h.5.	20% (12)	"$18 (3, 9d); $60 (5); 15% (9a); $40/$30 (9c)"	"$5 (7a); $18 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$18 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$18 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $18 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$18 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$18 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											192.7303081	195	75.92328607	0	150	0.2	0.129319346	49.91744996	0.15	2.8	0.143220757	0	0.2	0.151039489	3.443440789	18	37.5	18	0	0	0.2	15.94143589	0	0	18	0	18	0	0	0											142.5386693	144.1959993	56.142739	0	110.9199995	0.147893333	0.095627345	36.91229015	0.110919999	2.070506657	0.105906975	0	0.147893333	0.111795442	3.443440789	18	37.5	13.31039993	0	0	0.147893333	15.94143589	0	0	18	0	18	0	0	0											14.2888	0.82621005	2.489480508	0	1.913421829	2.292095226	0.242195908	2.213587238	5.039998159	2.54780499	5.966299917	0	0.024360178	3.758304547	1.645649895	7.729305491	1.038960554	0.161091279	0	0	4.076118421	1.360184202	0	0	0.237252958	0	0.027880967	0	0	0	0	0	0	0	0	0	0	0	0	0	57.879	0	16.1428	14.2888	0.82621005	2.489480508	0	1.913421829	2.292095226	0.242195908	2.213587238	5.039998159	2.54780499	5.966299917	0	0.024360178	3.758304547	1.645649895	7.729305491	1.038960554	0.161091279	0	0	4.076118421	1.360184202	0	0	0.237252958	0	0.027880967	0	0	0	0	0	0	0	0	0	0	0	0	0	57.879																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.2888	0.82621005	2.489480508	0	1.913421829	2.292095226	0.242195908	2.213587238	5.039998159	2.54780499	5.966299917	0	0.024360178	3.758304547	1.645649895	7.729305491	1.038960554	0.161091279	0	0	4.076118421	1.360184202	0	0	0.237252958	0	0.027880967	0	0	0	0	0	0	0	0	0	0	0	0	0	57.879
H4456_015_0	2009	5																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	262.3245207	6.401677792	474.1299426	109.0347276	133.2385612	15.00416353	2.489465859	676.4325007	720.0497697	16012.2205	63.03336778	0	0.046717971	3415.835576	6181.969976	5339.796697	304.4927925	199.8258978	0	0	33.64196193	1165.973297	0	0	107.8112182	242.0632717	18.5849048	0	98.4	0											"$50 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$50 (1b); $0 n/c (1b1, 1b2)"	"$15 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$25 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$15 (3, 9d); $60 (5); $25 (9a); $40/$30 (9c)"	"$15 (7a, 7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$15 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$15 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$15 (17a1)	"$15 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$15 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											49.9513511	50	14.98248497	0	150	0.2	0.141415193	49.90984897	25	2.8	0.180979695	0	0.2	1.804151081	10.15993676	15	37.5	15	0	0	0.2	13.61334788	0	0	15	15	15	0	0	0											49.9513511	50	14.98248497	0	150	0.2	0.141415193	49.90984897	25	2.8	0.180979695	0	0.2	1.804151081	10.15993676	15	37.5	15	0	0	0.2	13.61334788	0	0	15	15	15	0	0	0											1.092	0.026673657	0.591970395	0	1.665482015	3.000832705	0.352048295	2.813386996	1.500103687	3.736184784	11.4077597	0	0.009343594	0.513556954	5.234035333	6.674745871	0.951539977	0.249782372	0	0	6.728392386	1.322733343	0	0	0.134764023	0.30257909	0.023231131	0	0	0	0	0	0	0	0	0	0	0	0	0	48.3311	0	0	1.092	0.026673657	0.591970395	0	1.665482015	3.000832705	0.352048295	2.813386996	1.500103687	3.736184784	11.4077597	0	0.009343594	0.513556954	5.234035333	6.674745871	0.951539977	0.249782372	0	0	6.728392386	1.322733343	0	0	0.134764023	0.30257909	0.023231131	0	0	0	0	0	0	0	0	0	0	0	0	0	48.3311																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	1.092	0.026673657	0.591970395	0	1.665482015	3.000832705	0.352048295	2.813386996	1.500103687	3.736184784	11.4077597	0	0.009343594	0.513556954	5.234035333	6.674745871	0.951539977	0.249782372	0	0	6.728392386	1.322733343	0	0	0.134764023	0.30257909	0.023231131	0	0	0	0	0	0	0	0	0	0	0	0	0	48.3311
H4456_016_0	2009	4																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	297.9269868	5.947632749	462.3782725	158.2440248	178.9152286	17.71616866	2.734730671	748.7844064	650.27473	16522.1889	70.4102721	0	0.073470692	3822.417467	6633.535672	5644.393238	304.616563	151.4089272	0	0	31.93543213	1266.352933	0	0	147.9890135	292.8	18.41008798	0	98.4	0											"$50 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$50 (1b); $0 n/c (1b1, 1b2)"	"$15 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$25 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$15 (3, 9d); $60 (5); $25 (9a); $40/$30 (9c)"	"$15 (7a, 7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$15 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$15 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$15 (17a1)	"$15 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$15 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											49.73545261	50	14.98248497	0	150	0.2	0.144438576	49.91208311	25	2.8	0.177045807	0	0.2	1.71670948	10.1797712	15	37.5	15	0	0	0.2	13.92637326	0	0	15	15	15	0	0	0											49.73545261	50	14.98248497	0	150	0.2	0.144438576	49.91208311	25	2.8	0.177045807	0	0.2	1.71670948	10.1797712	15	37.5	15	0	0	0.2	13.92637326	0	0	15	15	15	0	0	0											1.2348	0.024781803	0.57729796	0	2.236440358	3.543233733	0.395000603	3.114449127	1.354739021	3.855177409	12.46584344	0	0.014694138	0.546831692	5.62732295	7.055491548	0.951926759	0.189261159	0	0	6.387086427	1.469641969	0	0	0.184986267	0.366	0.02301261	0	0	0	0	0	0	0	0	0	0	0	0	0	51.618	0	0	1.2348	0.024781803	0.57729796	0	2.236440358	3.543233733	0.395000603	3.114449127	1.354739021	3.855177409	12.46584344	0	0.014694138	0.546831692	5.62732295	7.055491548	0.951926759	0.189261159	0	0	6.387086427	1.469641969	0	0	0.184986267	0.366	0.02301261	0	0	0	0	0	0	0	0	0	0	0	0	0	51.618																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	1.2348	0.024781803	0.57729796	0	2.236440358	3.543233733	0.395000603	3.114449127	1.354739021	3.855177409	12.46584344	0	0.014694138	0.546831692	5.62732295	7.055491548	0.951926759	0.189261159	0	0	6.387086427	1.469641969	0	0	0.184986267	0.366	0.02301261	0	0	0	0	0	0	0	0	0	0	0	0	0	51.618
H4456_017_0	2009	6																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	301.4397151	6.009329769	618.3557477	122.6152861	164.4347036	18.30224462	3.205637746	704.2147992	726.2747542	17969.52521	59.54283876	0	0.039543229	4113.72698	6681.789758	5987.318856	280.3530773	228.3401502	0	0	25.95411472	1252.2248	0	0	96.2251992	225.8472862	18.63698239	0	98.4	0											"$0 (1a, 1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$15 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$0 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$0 (3, 9a, 9d); $60 (5); $40/$30 (9c)"	"$0 (7a, 7a1, 14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$0 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1); $0 (15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$15 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											0.344874041	0	14.98248497	0	150	0.2	0.149532767	49.90430575	0	2.8	0.182702365	0	0.2	0.032986372	0	0	37.5	0	0	0	0.2	0	0	0	0	15	0	0	0	0											0.344874041	0	14.98248497	0	150	0.2	0.149532767	49.90430575	0	2.8	0.182702365	0	0.2	0.032986372	0	0	37.5	0	0	0	0.2	0	0	0	0	15	0	0	0	0											0.0087	0	0.772042142	0	2.055433795	3.660448924	0.479347881	2.928612554	0	4.192889216	10.87861745	0	0.007908646	0.011308077	0	0	0.876103366	0	0	0	5.190822945	0	0	0	0	0.282309108	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.3445	0	0	0.0087	0	0.772042142	0	2.055433795	3.660448924	0.479347881	2.928612554	0	4.192889216	10.87861745	0	0.007908646	0.011308077	0	0	0.876103366	0	0	0	5.190822945	0	0	0	0	0.282309108	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.3445																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.0087	0	0.772042142	0	2.055433795	3.660448924	0.479347881	2.928612554	0	4.192889216	10.87861745	0	0.007908646	0.011308077	0	0	0.876103366	0	0	0	5.190822945	0	0	0	0	0.282309108	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.3445
H4456_019_0	2009	5																					2400											A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	292.4958668	5.910114149	459.4615179	157.2457967	177.7866033	17.4933609	2.700337274	744.1095739	646.172695	16417.96434	69.52475585	0	0.072546686	3798.305058	6650.562471	5608.850037	302.694994	150.453816	0	0	31.53379551	1258.36458	0	0	40.47541953	156.8201037	18.89826275	0	98.4	0											"$100 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$100 (1b); $0 n/c (1b1, 1b2)"	"$15 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$50 (9b)	$0/$0 (8a1); $0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$15 (3, 9d); $60 (5); $50 (9a); $40/$30 (9c)"	"$15 (7a, 7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$15 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$15 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$15 (17a1)	"$15 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$15 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											100.3276826	100	14.98248497	0	150	0.2	0.144438576	49.91208885	50	0	0.14227195	0	0.2	2.925828465	10.08965772	15	37.5	15	0	0	0.2	13.92637326	0	0	15	15	15	0	0	0											82.11725399	81.78530808	12.25347149	0	122.6779621	0.163570616	0.118129534	40.82075564	40.89265404	0	0.116357553	0	0.163570616	2.399430579	10.08965772	15	37.5	12.26779621	0	0	0.163570616	13.92637326	0	0	15	15	15	0	0	0											2.0016	0.040280042	0.469166551	0	1.817541516	2.861399821	0.318989584	2.53125959	2.201976372	0	8.089730451	0	0.011866506	0.759480776	5.591824915	7.011062546	0.945921856	0.153811396	0	0	5.158002362	1.460371237	0	0	0.050594274	0.19602513	0.023622828	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6945	0	5.8786	2.0016	0.040280042	0.469166551	0	1.817541516	2.861399821	0.318989584	2.53125959	2.201976372	0	8.089730451	0	0.011866506	0.759480776	5.591824915	7.011062546	0.945921856	0.153811396	0	0	5.158002362	1.460371237	0	0	0.050594274	0.19602513	0.023622828	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6945																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	2.0016	0.040280042	0.469166551	0	1.817541516	2.861399821	0.318989584	2.53125959	2.201976372	0	8.089730451	0	0.011866506	0.759480776	5.591824915	7.011062546	0.945921856	0.153811396	0	0	5.158002362	1.460371237	0	0	0.050594274	0.19602513	0.023622828	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6945
H4456_020_0	2009	3																					2400											A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	284.7251385	5.681991674	626.0267785	141.9367636	170.8909367	16.98753675	2.805386472	744.5480104	621.2530112	14916.30286	70.53837946	0	0.07442008	3515.000385	6174.758012	5336.230348	302.4768878	188.2236688	0	0	24.82887535	1136.753342	0	0	40.56710883	155.6887151	18.95981044	0	98.71963851	0											"$100 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$100 (1b); $0 n/c (1b1, 1b2)"	"$15 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$50 (9b)	$0/$0 (8a1); $0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$15 (3, 9d); $60 (5); $50 (9a); $40/$30 (9c)"	"$15 (7a, 7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$15 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$15 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$15 (17a1)	"$15 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$15 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											99.47751698	100	14.98248497	0	150	0.2	0.157686478	49.91473785	50	0	0.146493833	0	0.2	2.958440843	10.20771242	15	37.5	15	0	0	0.2	14.05822089	0	0	15	15	15	0	0	0											82.12760582	82.49528977	12.35984439	0	123.7429347	0.16499058	0.130083917	41.17730763	41.24764489	0	0.120850512	0	0.16499058	2.447380567	10.20771242	15	37.5	12.37429347	0	0	0.16499058	14.05822089	0	0	15	15	15	0	0	0											1.9486	0.039061462	0.644799464	0	1.762212168	2.802783533	0.36493566	2.554873539	2.135435299	0	8.52459926	0	0.012278612	0.716878636	5.252512838	6.670287935	0.945240274	0.194094576	0	0	4.096530533	1.331727465	0	0	0.050708886	0.194610894	0.023699763	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2659	0	5.4697	1.9486	0.039061462	0.644799464	0	1.762212168	2.802783533	0.36493566	2.554873539	2.135435299	0	8.52459926	0	0.012278612	0.716878636	5.252512838	6.670287935	0.945240274	0.194094576	0	0	4.096530533	1.331727465	0	0	0.050708886	0.194610894	0.023699763	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2659																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	1.9486	0.039061462	0.644799464	0	1.762212168	2.802783533	0.36493566	2.554873539	2.135435299	0	8.52459926	0	0.012278612	0.716878636	5.252512838	6.670287935	0.945240274	0.194094576	0	0	4.096530533	1.331727465	0	0	0.050708886	0.194610894	0.023699763	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2659
H4456_021_0	2009	5																					1950											D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1987.299056	58.52118408	681.0715451	198.6130934	295.3338646	37.23668779	6.31488741	1017.330686	843.1521653	22279.35776	85.9461076	0	0.340061399	5724.123399	8360.570644	7328.46714	254.3883311	323.0988375	0	0	51.58606355	1484.699048	0	0	47.17030665	165.207466	18.86594617	0	98.4	0											"$150 Days 1-13 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$150 Days 1-13 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-20 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$100 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$15 (3, 9d); $60 (5); $100 (9a); $40/$30 (9c)"	"$10 (7a); $15 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$15 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$15 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$15 (17a1)	"$15 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$15 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											148.2465189	150	100	0	150	0.2	0.160813149	49.91237165	100	2.8	0.178540116	0	0.2	5.346830573	7.408225648	15	37.5	15	0	0	0.2	13.90246003	0	0	15	15	15	0	0	0											77.29157202	78.18074941	52.12049961	0	78.18074941	0.104240999	0.083816617	26.01457747	52.12049961	1.459373989	0.093056001	0	0.104240999	2.795834157	7.408225648	15	37.5	7.818074941	0	0	0.104240999	13.90246003	0	0	15	15	15	0	0	0											12.8001	0.381269169	2.9581491	0	1.924118572	3.881589543	0.529292499	2.205452328	3.662126008	2.709492934	7.997801046	0	0.03544834	1.333641643	5.161416156	9.160583925	0.794963535	0.21050091	0	0	5.37738281	1.720080765	0	0	0.058962883	0.206509332	0.023582433	0	0	0	0	0	0	0	0	0	0	0	0	0	63.1325	0	42.2468	12.8001	0.381269169	2.9581491	0	1.924118572	3.881589543	0.529292499	2.205452328	3.662126008	2.709492934	7.997801046	0	0.03544834	1.333641643	5.161416156	9.160583925	0.794963535	0.21050091	0	0	5.37738281	1.720080765	0	0	0.058962883	0.206509332	0.023582433	0	0	0	0	0	0	0	0	0	0	0	0	0	63.1325																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.8001	0.381269169	2.9581491	0	1.924118572	3.881589543	0.529292499	2.205452328	3.662126008	2.709492934	7.997801046	0	0.03544834	1.333641643	5.161416156	9.160583925	0.794963535	0.21050091	0	0	5.37738281	1.720080765	0	0	0.058962883	0.206509332	0.023582433	0	0	0	0	0	0	0	0	0	0	0	0	0	63.1325
H4456_024_0	2009	5																																Coin	Coin	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		350.5126092	42.46125	7171.495277	95.59696622	21.01560096	11.56219345	13.20939894	9.178238981	6.420402678	26.38620125	21.82968639	0	0.082476392	4.296087084	1.062035049	119.8120299	43.2725	37.96764842	0	0	7.892139955	5.913850476	1498.037626	0	182.0000636	141.3063859	0	0	0	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.078064783	0.079143731	0	0	0.2	0.2	0.2	0.070523026	0.2	0.08	0.15003742	0	0.2	0.2	0	0.198497436	0.2	0	0	0	0.2	0.022666282	0	0	0	0	0	0	0	0											0.078064783	0.079143731	0	0	0.2	0.2	0.2	0.070523026	0.2	0.08	0.15003742	0	0.2	0.2	0	0.198497436	0.2	0	0	0	0.2	0.022666282	0	0	0	0	0	0	0	0											27.3627	3.360541759	0	0	4.203120192	2.312438689	2.641879788	0.647277189	1.284080536	2.1108961	3.275269815	0	0.016495278	0.859217417	0	23.78238075	8.6545	0	0	0	1.578427991	0.134045001	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.2233	0	0	27.3627	3.360541759	0	0	4.203120192	2.312438689	2.641879788	0.647277189	1.284080536	2.1108961	3.275269815	0	0.016495278	0.859217417	0	23.78238075	8.6545	0	0	0	1.578427991	0.134045001	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.2233		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.6963	0.3266	0.688	0.0435	0.3318	0.1826	0.2086	0.0341	0.1014	0.4166	0.3447	0	0.0009	0.0678	0.0168	1.8918	0.6833	0.004	0	0	0.1246	0.0933	0.1107	0	0.0089	0	0	0	0	0											8.3761	0	0	30.0589	3.687166759	0.688023659	0.04348558	4.53494547	2.494999638	2.850449245	0.681344409	1.385455315	2.527520331	3.619949074	0	0.017363451	0.927050371	0.016768974	25.67414964	9.33775	0.004025488	0	0	1.703040727	0.22730945	0.110719388	0	0.008933819	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.5994
H4456_025_0	2009	4																					1950											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1137.302338	60.82406346	387.3285675	108.9222471	140.894379	13.40545687	2.067403736	705.2921597	41.12929568	13617.04556	55.54768926	0	0.048427808	31.51180588	5649.812733	4844.878446	310.2113046	169.4426558	0	0	22.42747037	1011.028132	0	0	151.3147879	0	18.52180247	0	98.4	0											"$195 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$195 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$95 Days 1-21 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	15% (9b)	$0/$15 (8a1); $15 (8a2)	"$25 (8b1); 15% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); 15% (9a); $40/$30 (9c)"	"$5 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											192.7317516	195	95	0	150	0.2	0.140244131	49.91819747	0.15	6	0.166510699	0	0.2	0.151853951	3.391842774	20	37.5	20	0	0	0.2	18.54787822	0	0	20	0	20	0	0	0											118.366145	119.7270218	58.3285491	0	92.0977091	0.122796945	0.086107754	30.64901086	0.092097709	3.683908364	0.102235026	0	0.122796945	0.09338626	3.391842774	20	37.5	12.27969455	0	0	0.122796945	18.54787822	0	0	20	0	20	0	0	0											11.2182	0.606856998	1.88269278	0	1.081337461	1.646149156	0.178019493	1.801375589	3.787913909	4.180329004	5.678919479	0	0.005946787	2.942769712	1.596939708	8.07479741	0.969410327	0.173392005	0	0	2.754024856	1.562702222	0	0	0.252191313	0	0.030869671	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4248	0	23.8391	11.2182	0.606856998	1.88269278	0	1.081337461	1.646149156	0.178019493	1.801375589	3.787913909	4.180329004	5.678919479	0	0.005946787	2.942769712	1.596939708	8.07479741	0.969410327	0.173392005	0	0	2.754024856	1.562702222	0	0	0.252191313	0	0.030869671	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4248																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.2182	0.606856998	1.88269278	0	1.081337461	1.646149156	0.178019493	1.801375589	3.787913909	4.180329004	5.678919479	0	0.005946787	2.942769712	1.596939708	8.07479741	0.969410327	0.173392005	0	0	2.754024856	1.562702222	0	0	0.252191313	0	0.030869671	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4248
H4456_026_0	2009	6																					3200											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	4000	1428.158357	62.68299052	369.075487	119.1744644	182.9939046	13.69501119	2.189136902	688.5105889	39.65504401	13425.65498	58.06269505	0	0.045096417	34.75561485	5440.110207	5101.560446	305.0689217	124.951123	0	0	21.51047452	952.1331192	0	0	148.2019255	0	17.62185661	0	453.6	0											"$195 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$195 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	"$95 Days 1-28 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	15% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 15% (8b2, 8b3)"	Included in h.5.	20% (12)	"$18 (3, 9d); $60 (5); 15% (9a); $40/$30 (9c)"	"$5 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$18 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$18 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $18 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$18 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$18 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											192.71577	195	75.92328607	0	150	0.2	0.142053018	49.50192758	0.15	2.8	0.144729333	0	0.2	0.151808812	3.4370353	18	37.5	18	0	0	0.2	16.92688672	0	0	18	0	18	0	0	0											140.2410828	141.885693	55.24322083	0	109.1428408	0.145523788	0.103360466	36.01854	0.109142841	2.037333028	0.105307804	0	0.145523788	0.110556021	3.4370353	18	37.5	13.09714089	0	0	0.145523788	16.92688672	0	0	18	0	18	0	0	0											16.6905	0.741151629	1.699076552	0	1.664372883	1.992949902	0.226270211	2.066595516	4.328064155	2.279377526	6.114454907	0	0.006562601	3.842442474	1.558154235	7.652340668	0.95334038	0.136375205	0	0	3.130285728	1.343054121	0	0	0.222302888	0	0.026432785	0	0	0	0	0	0	0	0	0	0	0	0	0	56.6741	0	16.8076	16.6905	0.741151629	1.699076552	0	1.664372883	1.992949902	0.226270211	2.066595516	4.328064155	2.279377526	6.114454907	0	0.006562601	3.842442474	1.558154235	7.652340668	0.95334038	0.136375205	0	0	3.130285728	1.343054121	0	0	0.222302888	0	0.026432785	0	0	0	0	0	0	0	0	0	0	0	0	0	56.6741		"$250 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$250 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$125 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$15 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $25 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.0834	0.047	0.1383	0.0101	0.0823	0.1478	0.0236	0.1021	0.4278	0.1127	0.5538	0	0.0003	0.3755	0.289	0.5594	0.0569	0.0094	0	0	0.2321	0.1	0	0	0.0163	0	0.0019	0	0	0											4.3695	0	1.559071269	17.774	0.788115863	1.837338522	0.010088781	1.746636047	2.14070498	0.249888745	2.168738903	4.755901273	2.39203786	6.668231326	0	0.006886964	4.217921673	1.847160436	8.211722296	1.010206298	0.145736969	0	0	3.362361613	1.443054585	0	0	0.238553099	0	0.028365006	0	0	0	0	0	0	0	0	0	0	0	0	0	61.0436
H4456_027_0	2009	3																					2400											A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	3400	256.544374	5.078802204	542.1078493	113.7524539	240.4934285	14.02014788	2.887760728	584.3265009	732.8981616	15694.36923	57.11587613	0	0.240306676	4020.487833	6001.043734	5398.03654	289.3623178	280.3319518	0	0	23.13286694	1017.504396	0	0	71.77131254	191.2386939	17.81774587	0	98.4	0											"$100 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$100 (1b); $0 n/c (1b1, 1b2)"	"$15 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$50 (9b)	$0/$0 (8a1); $0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$15 (3, 9d); $60 (5); $50 (9a); $40/$30 (9c)"	"$15 (7a, 7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$15 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$15 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$15 (17a1)	"$15 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$15 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											99.97099872	100	14.98248497	0	150	0.2	0.155119813	49.90040604	50	0	0.139636278	0	0.2	2.914161467	10.58080164	15	37.5	15	0	0	0.2	13.81244423	0	0	15	15	15	0	0	0											83.39737358	83.35833082	12.48914939	0	125.0374962	0.166716662	0.129305287	41.59614554	41.67916541	0	0.11639847	0	0.166716662	2.434547552	10.58080164	15	37.5	12.50374962	0	0	0.166716662	13.81244423	0	0	15	15	15	0	0	0											1.7829	0.03528004	0.564205493	0	2.505891347	2.33739225	0.373402728	2.025477515	2.545548642	0	6.648200606	0	0.040063127	0.815672401	5.291321118	6.747545675	0.904257243	0.292100045	0	0	3.85663435	1.171185227	0	0	0.089714141	0.239048367	0.022272182	0	0	0	0	0	0	0	0	0	0	0	0	0	38.2881	0	4.7522	1.7829	0.03528004	0.564205493	0	2.505891347	2.33739225	0.373402728	2.025477515	2.545548642	0	6.648200606	0	0.040063127	0.815672401	5.291321118	6.747545675	0.904257243	0.292100045	0	0	3.85663435	1.171185227	0	0	0.089714141	0.239048367	0.022272182	0	0	0	0	0	0	0	0	0	0	0	0	0	38.2881		"$250 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$250 (1b); $0 n/c (1b1, 1b2)"	"$30 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	$225 (9b)	30%/$0 (8a1); $0 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $75 (5); $225 (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $25 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.2393	0.0042	0.0537	0.0162	0.1194	0.167	0.0344	0.0965	0.5456	0	0.5977	0	0.0019	0.1557	0.4212	0.5919	0.0539	0.0232	0	0	0.2756	0.1056	0	0	0.0079	0	0.002	0	0	0											3.5128	0	0.767406369	2.0222	0.039481237	0.61795461	0.016152796	2.625253395	2.504396255	0.407800911	2.121956217	3.091178265	0	7.245907052	0	0.041971437	0.971412358	5.712514437	7.339435647	0.958195395	0.315289172	0	0	4.132186466	1.276823915	0	0	0.097583802	0.239048367	0.024225883	0	0	0	0	0	0	0	0	0	0	0	0	0	41.801
H4456_028_0	2009	3																					2400											A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	3400	282.4655553	5.638970156	438.3823597	150.03168	169.6301162	16.76322232	2.587630492	709.925958	616.5276086	15664.74159	66.62292889	0	0.069518729	3624.046563	6291.183592	5351.486576	288.8079645	143.5513015	0	0	30.21763673	1200.633377	0	0	140.5895628	292.8	17.48958358	0	98.4	0											"$100 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$100 (1b); $0 n/c (1b1, 1b2)"	"$15 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$50 (9b)	$0/$0 (8a1); $0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$15 (3, 9d); $60 (5); $50 (9a); $40/$30 (9c)"	"$15 (7a, 7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$15 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$15 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$15 (17a1)	"$15 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$15 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											99.12402882	100	14.98248497	0	150	0.2	0.144438576	49.91208323	50	0	0.14227195	0	0.2	2.925842533	10.18059777	15	37.5	15	0	0	0.2	13.92637326	0	0	15	15	15	0	0	0											80.96603949	81.61721726	12.22828731	0	122.4258259	0.163234435	0.117886746	40.73685341	40.80860863	0	0.116118407	0	0.163234435	2.394584298	10.18059777	15	37.5	12.24258259	0	0	0.163234435	13.92637326	0	0	15	15	15	0	0	0											1.9058	0.038353088	0.446722121	0	1.730592256	2.736335117	0.305047339	2.410012474	2.096636157	0	7.736148353	0	0.01134785	0.72317375	5.337334139	6.68935822	0.902524889	0.146453222	0	0	4.932558844	1.393372381	0	0	0.175736954	0.366	0.021861979	0	0	0	0	0	0	0	0	0	0	0	0	0	40.1054	0	5.6759	1.9058	0.038353088	0.446722121	0	1.730592256	2.736335117	0.305047339	2.410012474	2.096636157	0	7.736148353	0	0.01134785	0.72317375	5.337334139	6.68935822	0.902524889	0.146453222	0	0	4.932558844	1.393372381	0	0	0.175736954	0.366	0.021861979	0	0	0	0	0	0	0	0	0	0	0	0	0	40.1054		"$250 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$250 (1b); $0 n/c (1b1, 1b2)"	"$30 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	$225 (9b)	30%/$0 (8a1); $0 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $75 (5); $225 (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $25 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.2565	0.0046	0.043	0.0134	0.0833	0.1975	0.0305	0.116	0.454	0	0.6799	0	0.0005	0.139	0.4294	0.5868	0.0538	0.0117	0	0	0.356	0.1252	0	0	0.0154	0	0.0019	0	0	0											3.5984	0	0.822564425	2.1624	0.042966566	0.489710943	0.013415547	1.813861162	2.933826723	0.335532844	2.525972256	2.55060253	0	8.416044797	0	0.011893862	0.862180819	5.766720181	7.276144029	0.956359707	0.158197756	0	0	5.288560184	1.518575053	0	0	0.191152476	0.366	0.023779697	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7039
H4456_801_0	2009	2																					5950											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1187.505543	84.90439	249.3874424	264.1215329	130.7146458	18.56453155	4.113017813	627.2457425	47.60107518	17022.71746	70.96241715	0	0.083089539	31.82494896	6998.190705	6766.711156	400.5574098	245.1377574	0	0	46.29745226	1507.531362	0	0	0	0	0	0	0	0											"$425 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$425 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-40 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$15 (8a1); $15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											419.9623027	425	150	0	150	0.2	0.160879406	49.90008514	0.3	6	0.239246057	0	0.2	0.301361681	19.41360827	29.9999551	37.5	30	0	0	0.2	27.72374329	0	0	0	0	0	0	0	0											310.3253078	314.0248851	110.8323124	0	110.8323124	0.147776417	0.118870911	36.87027884	0.221664625	4.433292496	0.176774625	0	0.147776417	0.222818558	19.41360827	29.9999551	37.5	22.16646248	0	0	0.147776417	27.72374329	0	0	0	0	0	0	0	0											30.7094	2.221840943	2.303348911	0	1.207283872	2.743399947	0.488918173	1.927227119	10.55147447	6.288890465	12.54435469	0	0.012278674	7.091189249	11.32167775	16.91675257	1.251741906	0.452819742	0	0	6.84167159	3.482867707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.3572	0	30.165	30.7094	2.221840943	2.303348911	0	1.207283872	2.743399947	0.488918173	1.927227119	10.55147447	6.288890465	12.54435469	0	0.012278674	7.091189249	11.32167775	16.91675257	1.251741906	0.452819742	0	0	6.84167159	3.482867707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.3572																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	30.7094	2.221840943	2.303348911	0	1.207283872	2.743399947	0.488918173	1.927227119	10.55147447	6.288890465	12.54435469	0	0.012278674	7.091189249	11.32167775	16.91675257	1.251741906	0.452819742	0	0	6.84167159	3.482867707	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.3572
H4456_805_0	2009	2																					5950											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1753.210995	90.24908124	789.6483426	158.523954	327.7303551	20.54031069	2.159594202	812.1620428	41.19238713	19624.53026	81.69537767	0	0.062635228	41.58708486	7186.69912	7209.63066	412.4644215	113.4245995	0	0	44.36785254	2111.939928	0	0	0	0	0	0	0	0											"$425 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$425 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-40 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$15 (8a1); $15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											419.9422446	425	150	0	150	0.2	0.185931986	49.90749235	0.3	6	0.250533696	0	0.2	0.301362391	20.18646378	29.99994231	37.5	30	0	0	0.2	27.88177629	0	0	0	0	0	0	0	0											282.1922226	285.5713698	100.7898952	0	100.7898952	0.134386527	0.124933769	33.53447284	0.20157979	4.031595809	0.168341767	0	0.134386527	0.202641391	20.18646378	29.99994231	37.5	20.15797905	0	0	0.134386527	27.88177629	0	0	0	0	0	0	0	0											41.2285	2.147712813	6.632381143	0	2.752659013	2.760341017	0.269806243	2.26961883	8.303552766	6.593181162	13.7527442	0	0.008417331	8.427264726	12.08950346	18.02404199	1.288951317	0.190534225	0	0	5.962441612	4.907053051	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.6087	0	49.4455	41.2285	2.147712813	6.632381143	0	2.752659013	2.760341017	0.269806243	2.26961883	8.303552766	6.593181162	13.7527442	0	0.008417331	8.427264726	12.08950346	18.02404199	1.288951317	0.190534225	0	0	5.962441612	4.907053051	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.6087																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	41.2285	2.147712813	6.632381143	0	2.752659013	2.760341017	0.269806243	2.26961883	8.303552766	6.593181162	13.7527442	0	0.008417331	8.427264726	12.08950346	18.02404199	1.288951317	0.190534225	0	0	5.962441612	4.907053051	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.6087
H4456_810_0	2009	2																					5950											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1187.505542	84.90438996	249.3874423	264.1215327	130.7146457	18.56453153	4.113017809	627.2457422	47.60107513	17022.71745	70.96241708	0	0.083089539	31.82494892	6998.190702	6766.711153	400.5574096	245.1377573	0	0	46.29745221	1507.531361	0	0	0	0	0	0	0	0											"$425 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$425 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-40 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$15 (8a1); $15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											419.9623027	425	150	0	150	0.2	0.160879406	49.90008514	0.3	6	0.239246057	0	0.2	0.301361681	19.41360827	29.9999551	37.5	30	0	0	0.2	27.72374329	0	0	0	0	0	0	0	0											310.3253078	314.0248852	110.8323124	0	110.8323124	0.147776417	0.118870911	36.87027884	0.221664625	4.433292497	0.176774625	0	0.147776417	0.222818558	19.41360827	29.9999551	37.5	22.16646249	0	0	0.147776417	27.72374329	0	0	0	0	0	0	0	0											30.7094	2.221840943	2.30334891	0	1.207283871	2.743399945	0.488918173	1.927227118	10.55147446	6.288890463	12.54435468	0	0.012278674	7.091189243	11.32167774	16.91675256	1.251741905	0.452819742	0	0	6.841671584	3.482867706	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.3572	0	30.165	30.7094	2.221840943	2.30334891	0	1.207283871	2.743399945	0.488918173	1.927227118	10.55147446	6.288890463	12.54435468	0	0.012278674	7.091189243	11.32167774	16.91675256	1.251741905	0.452819742	0	0	6.841671584	3.482867706	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.3572																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	30.7094	2.221840943	2.30334891	0	1.207283871	2.743399945	0.488918173	1.927227118	10.55147446	6.288890463	12.54435468	0	0.012278674	7.091189243	11.32167774	16.91675256	1.251741905	0.452819742	0	0	6.841671584	3.482867706	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.3572
H4456_811_0	2009	2																					5810											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1747.458295	89.95295265	787.0573195	158.0037994	326.6549943	20.4057366	2.145445174	809.4606986	40.92250669	19560.13753	81.16013352	0	0.06222486	41.31461848	7018.567789	7185.974156	411.1110282	113.0524266	0	0	44.07716738	2105.010154	0	0	0	0	0	0	0	0											"$415 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$415 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-39 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$15 (8a1); $15 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											410.0626365	415	150	0	150	0.2	0.185931986	49.90748819	0.3	6	0.250650362	0	0.2	0.301386693	20.60221168	29.99993927	37.5	30	0	0	0.2	27.88176711	0	0	0	0	0	0	0	0											274.5584018	277.844524	100.4257316	0	100.4257316	0.133900975	0.124482371	33.41330675	0.200851463	4.017029263	0.16781164	0	0.133900975	0.201927593	20.60221168	29.99993927	37.5	20.08514632	0	0	0.133900975	27.88176711	0	0	0	0	0	0	0	0											39.9816	2.08274461	6.586733926	0	2.733713898	2.732348036	0.267070103	2.253896552	8.219345345	6.547803738	13.61961508	0	0.00833197	8.342561456	12.04983494	17.96489902	1.284721963	0.189222877	0	0	5.901975707	4.890950239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.6574	0	49.0876	39.9816	2.08274461	6.586733926	0	2.733713898	2.732348036	0.267070103	2.253896552	8.219345345	6.547803738	13.61961508	0	0.00833197	8.342561456	12.04983494	17.96489902	1.284721963	0.189222877	0	0	5.901975707	4.890950239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.6574																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	39.9816	2.08274461	6.586733926	0	2.733713898	2.732348036	0.267070103	2.253896552	8.219345345	6.547803738	13.61961508	0	0.00833197	8.342561456	12.04983494	17.96489902	1.284721963	0.189222877	0	0	5.901975707	4.890950239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.6574
H4461_001_0	2009	7																					2800												A	D			COIN	COIN	V					V	V			V			V	COIN	V			V		V																																																						0	0	1672.45752	70.98739174	1348.608256	204.1348729	234.4104643	10.46363799	1.586745746	304.6002275	1110.517584	0	0	0	6.151919067	3074.283023	0	0	210.9903363	0	3761.830561	33694.62635	8.937236416	118.3872617	75.4453791	0	440.6425913	412.4851368	49.57098054	0														$100 per admission copayment	$100 copay for days 21-100			20% cost sharing	20% cost sharing	"$50 ER, $10 Urgent Care"					$20 Copay	$10 CORF (3a) and Outpaitient Mental Health (9c) copay			$15 copay			"$10/Visit PCP, $15/Visit Specialist, $20 Chiropractic, $20 Podiatry, 20% Immunizations"	20% cost sharing	"$10 Vision, $10 Hearing"			$10 per exam		$10 per exam														0	11.33598304	21.08509123	0	0	0.2	0.2	28.29245152	0	0	0	0	20	0.231606376	0	0	15	0	0	8.181905033	0.2	10	0	0	10	0	10	0	0	0	0										0	10.55206178	19.62699289	0	0	0.186169329	0.186169329	26.33593358	0	0	0	0	18.6169329	0.215590018	0	0	13.96269968	0	0	7.617120434	0.186169329	9.308466451	0	0	9.308466451	0	9.308466451	0	0	0	0										0	0.062421945	2.205760388	0	0	1.948008463	0.295403391	0.66849428	0	0	0	0	0.009544155	0.055232061	0	0	0.245499558	0	0	21.38800224	1.663839307	0.091833654	0	0	0.341808898	0	0.038452484	0	0	0	0	0	0	0	0	0	0	0	0	0	29.0143		2.16	0	0.062421945	2.205760388	0	0	1.948008463	0.295403391	0.66849428	0	0	0	0	0.009544155	0.055232061	0	0	0.245499558	0	0	21.38800224	1.663839307	0.091833654	0	0	0.341808898	0	0.038452484	0	0	0	0	0	0	0	0	0	0	0	0	0	29.0143	2800																																																																																	0			0	0.062421945	2.205760388	0	0	1.948008463	0.295403391	0.66849428	0	0	0	0	0.009544155	0.055232061	0	0	0.245499558	0	0	21.38800224	1.663839307	0.091833654	0	0	0.341808898	0	0.038452484	0	0	0	0	0	0	0	0	0	0	0	0	0	29.0143
H4461_004_0	2009	6																					2800												A	A			COIN	COIN	V					COIN	V			V			V	COIN	V			V		V																																																						0		1410.098626	53.88210701	808.9666974	160.8177589	203.008899	7.213825776	1.068278931	251.3705459	970.8383119	0	0	0	0.095860025	2451.315973	0	0	139.9470307	0	3132.150725	28060.3335	2.687783671	90.81835111	65.33873559	0	337.9024639	316.3101952	39.36999152	0	0	0												$100 per admission copayment	$100 copay for days 21-100			20% cost sharing	20% cost sharing	"$50 ER, $10 Urgent Care"					20% cost sharing	$10 CORF (3a) and Outpaitient Mental Health (9c) copay			$15 copay			"$10/Visit PCP, $15/Visit Specialist, $20 Chiropractic, $20 Podiatry, 20% Immunizations"	20% cost sharing	"$10 Vision, $10 Hearing"			$10 per exam		$10 per exam															10.82762172	21.08512384			0.2	0.2	28.29245152					0.2	1.027817041			15			7.206922664	0.2	10			10		10															9.751162321	18.98888513	0	0	0.18011642	0.18011642	25.47967544	0	0	0	0	0.18011642	0.925633631	0	0	13.50873152	0	0	6.490425555	0.18011642	9.005821012	0	0	9.005821012	0	9.005821012														0	0.043784431	1.280114641	0	0	1.299328475	0.192414577	0.53373666	0	0	0	0	0.017265965	0.189085042	0	0	0.157542239	0	0	15.1769588	0.484113973	0.068157818	0	0	0.253590759	0	0.029546591	0	0	0	0	0	0	0	0	0	0	0	0	0	19.7256		2.16	0	0.043784431	1.280114641	0	0	1.299328475	0.192414577	0.53373666	0	0	0	0	0.017265965	0.189085042	0	0	0.157542239	0	0	15.1769588	0.484113973	0.068157818	0	0	0.253590759	0	0.029546591	0	0	0	0	0	0	0	0	0	0	0	0	0	19.7256																																																																																		0			0	0.043784431	1.280114641	0	0	1.299328475	0.192414577	0.53373666	0	0	0	0	0.017265965	0.189085042	0	0	0.157542239	0	0	15.1769588	0.484113973	0.068157818	0	0	0.253590759	0	0.029546591	0	0	0	0	0	0	0	0	0	0	0	0	0	19.7256
H4461_007_0	2009	4																					2800												A	A			COIN	COIN	V					COIN	V			V			V	COIN	V			V		V																																																						0		1627.694688	68.10028879	1120.572722	180.6993488	200.8885909	10.62219923	1.294773831	295.3549487	909.5099539	0	0	0	0.038043426	2677.506756	0	0	173.5420251	0	3534.95046	31662.24879	6.447877009	113.9335331	64.65631108	0	424.0406935	396.944115	34.23692668	0	0	0												$100 per admission copayment	$100 copay for days 21-100			20% cost sharing	20% cost sharing	"$50 ER, $10 Urgent Care"					20% cost sharing	$10 CORF (3a) and Outpaitient Mental Health (9c) copay			$15 copay			"$10/Visit PCP, $15/Visit Specialist, $20 Chiropractic, $20 Podiatry, 20% Immunizations"	20% cost sharing	"$10 Vision, $10 Hearing"			$10 per exam		$10 per exam														0	8.605971459	21.08821691	0	0	0.2	0.2	28.29245152	0	0	0	0	0.2	0.238614154	0	0	15	0	0	7.734919713	0.2	10	0	0	10	0	10	0	0	0	0										0	7.931257276	19.43488595	0	0	0.18431986	0.18431986	26.07430353	0	0	0	0	0.18431986	0.219906638	0	0	13.82398951	0	0	7.128496596	0.18431986	9.215993005	0	0	9.215993005	0	9.215993005	0	0	0	0										0	0.045010076	1.814850255	0	0	1.957882275	0.238652531	0.641764548	0	0	0	0	0.007012159	0.049066792	0	0	0.199920261	0	0	18.80868606	1.188471788	0.087500887	0	0	0.325663005	0	0.02629394	0	0	0	0	0	0	0	0	0	0	0	0	0	25.3908		2.16	0	0.045010076	1.814850255	0	0	1.957882275	0.238652531	0.641764548	0	0	0	0	0.007012159	0.049066792	0	0	0.199920261	0	0	18.80868606	1.188471788	0.087500887	0	0	0.325663005	0	0.02629394	0	0	0	0	0	0	0	0	0	0	0	0	0	25.3908																																																																																		0			0	0.045010076	1.814850255	0	0	1.957882275	0.238652531	0.641764548	0	0	0	0	0.007012159	0.049066792	0	0	0.199920261	0	0	18.80868606	1.188471788	0.087500887	0	0	0.325663005	0	0.02629394	0	0	0	0	0	0	0	0	0	0	0	0	0	25.3908
H4461_011_0	2009	9																					3350											A	A	A	V	T	O	O	V	V					V			V		V	V	O	V			V		V																																																						0		2459.643449	35.29916452	391.401879	319.8732191	628.6893245	1919.488249	98.56863886	870.6081895	1226.422894					3840.232915			1108.19884		4218.260029	31979.67275	290.5101186	2.922511283			10.36334347		38.35698446														10% Cost Sharing Equivalent	10% Cost Sharing Equivalent	$100 Copay days 21-100	10% Cost Sharing Equivalent	$100 Copay	20% cost sharing	20% cost sharing	"$50 ER, $15 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, $15/Visit PCP, $25/Visit Specialist"	20% cost sharing	"$25 Vision, $25 Hearing"			$25 per exam		$25 per exam														161.4221788	398.8806465	10.89741882	2.752910711	1.574438681	1.85364903	3.64665901	1.593737999	1.407921706					1.423177962			1.392912321		0.305863888	0.640873329	8.703411202	1.392912321			1.392912321		1.392912321														154.195637	381.0235733	10.40956361	2.629668513	1.503954272	1.770664943	3.483405523	1.522389599	1.344891923					1.359465187			1.330554477		0.292170986	0.612182737	8.313777231	1.330554477			1.330554477		1.330554477														31.6055	1.120817817	0.339526896	0.070096711	0.078793333	0.283230879	0.028612878	0.110450404	0.13745052	0	0	0	0	0.435055246	0	0	0.122876577	0	0.102704433	1.631450298	0.201269701	0.000324047	0	0	0.001149083	0	0.004253005	0	0	0	0	0	0	0	0	0	0	0	0	0	36.2736		1.7	31.6055	1.120817817	0.339526896	0.070096711	0.078793333	0.283230879	0.028612878	0.110450404	0.13745052	0	0	0	0	0.435055246	0	0	0.122876577	0	0.102704433	1.631450298	0.201269701	0.000324047	0	0	0.001149083	0	0.004253005	0	0	0	0	0	0	0	0	0	0	0	0	0	36.2736																																																																																		0			31.6055	1.120817817	0.339526896	0.070096711	0.078793333	0.283230879	0.028612878	0.110450404	0.13745052	0	0	0	0	0.435055246	0	0	0.122876577	0	0.102704433	1.631450298	0.201269701	0.000324047	0	0	0.001149083	0	0.004253005	0	0	0	0	0	0	0	0	0	0	0	0	0	36.2736
H4461_012_0	2009	7																					2800												A	A			COIN	COIN	V					COIN	V			V			V	COIN	V			V		V																																																						0		1758.943097	123.9124354	956.9185515	220.1378447	272.5138015	13.49976877	1.745707633	348.8311012	973.5479906	0	0	0	0.037754502	3120.34542	0	0	225.4161647	0	4266.495136	37977.50978	10.7975206	139.3357682	87.70899854	0	518.6593587	485.5165631	53.30520306	0	0	0												$100 per admission copayment	$100 copay for days 21-100			20% cost sharing	20% cost sharing	"$50 ER, $10 Urgent Care"					20% cost sharing	$10 CORF (3a) and Outpaitient Mental Health (9c) copay			$15 copay			"$10/Visit PCP, $15/Visit Specialist, $20 Chiropractic, $20 Podiatry, 20% Immunizations"	20% cost sharing	"$10 Vision, $10 Hearing"			$10 per exam		$10 per exam														0	9.410765101	21.08468094	0	0	0.2	0.2	28.29245152	0	0	0	0	0.2	0.231859729	0	0	15	0	0	7.417541274	0.2	10	0	0	10	0	10	0	0	0											0	8.780011221	19.67148614	0	0	0.186595056	0.186595056	26.39615793	0	0	0	0	0.186595056	0.216319396	0	0	13.99462923	0	0	6.92038266	0.186595056	9.329752817	0	0	9.329752817	0	9.329752817	0	0	0											0	0.090662714	1.568667502	0	0	2.518990114	0.325740414	0.767316736	0	0	0	0	0.007044803	0.05624927	0	0	0.262884637	0	0	21.90157501	2.014763965	0.10833069	0	0	0.403246968	0	0.041443697	0	0	0	0	0	0	0	0	0	0	0	0	0	30.0669		2.16	0	0.090662714	1.568667502	0	0	2.518990114	0.325740414	0.767316736	0	0	0	0	0.007044803	0.05624927	0	0	0.262884637	0	0	21.90157501	2.014763965	0.10833069	0	0	0.403246968	0	0.041443697	0	0	0	0	0	0	0	0	0	0	0	0	0	30.0669																																																																																		0			0	0.090662714	1.568667502	0	0	2.518990114	0.325740414	0.767316736	0	0	0	0	0.007044803	0.05624927	0	0	0.262884637	0	0	21.90157501	2.014763965	0.10833069	0	0	0.403246968	0	0.041443697	0	0	0	0	0	0	0	0	0	0	0	0	0	30.0669
H4461_014_0	2009	9																					3350																Coin	Coin		Coin				Coin						Coin		Coin																																																												0		1282.077261	110.9500429	959.8348887	153.4534084	190.3949335	7.747297313	1.16601053	258.7324192	23.55659153	0	0	0	0.048112392	2502.041169	0	0	160.4143293	0	20.43582385	27595.70855	6.118340275	98.31461975	61.27891083	0	365.8861743	342.5057215	37.1941717	0	0	0											$500 per admission copayment	$500 per admission copayment	$100 Copay days 21-100		$100 Copay	20% cost sharing	20% cost sharing	"$50 ER, $15 Urgent Care"	10% cost sharing				20% Coinsurance	"$25 PT/OT/ST, $10 CORF, $25 Mental Health, 10% coin all other"			$25 MH/SA		10% cost sharing	"10% lab, $15/Visit PCP, $25/Visit Specialist"	20% cost sharing	"$25 Vision, $25 Hearing"			$15 per exam		$25 per exam														75.80116772	53.10665141	29.73483475	0	75	0.2	0.2	29.24641794	0.1	0	0	0	0.2	26.9173146	0	0	25	0	0.1	10.24342829	0.2	15.01293028	0	0	15	0	25	0	0	0											68.54936661	48.34686366	26.89014473	0	67.82484558	0.180866255	0.180866255	26.4484504	0.090433127	0	0	0	0.180866255	24.96073214	0	0	22.60828186	0	0.090433127	9.130889965	0.180866255	13.57689442	0	0	13.56496912	0	22.60828186	0	0	0											7.3238	0.447007216	2.150841589	0	1.076125581	1.40122465	0.210891958	0.570255963	2.130296244	0	0	0	0.008701908	5.204398285	0	0	0.302224364	0	1.848075463	20.99778152	1.106601292	0.111233934	0	0	0.413602888	0	0.070074693	0	0	0	0	0	0	0	0	0	0	0	0	0	45.3731		4.8	7.3238	0.447007216	2.150841589	0	1.076125581	1.40122465	0.210891958	0.570255963	2.130296244	0	0	0	0.008701908	5.204398285	0	0	0.302224364	0	1.848075463	20.99778152	1.106601292	0.111233934	0	0	0.413602888	0	0.070074693	0	0	0	0	0	0	0	0	0	0	0	0	0	45.3731																																																																																		0			7.3238	0.447007216	2.150841589	0	1.076125581	1.40122465	0.210891958	0.570255963	2.130296244	0	0	0	0.008701908	5.204398285	0	0	0.302224364	0	1.848075463	20.99778152	1.106601292	0.111233934	0	0	0.413602888	0	0.070074693	0	0	0	0	0	0	0	0	0	0	0	0	0	45.3731
H4461_015_0	2009	11																					3350											A	A	A		T	coin	coin	V	V				coin	V			V		coin	V	coin	V	coin		V		V																																																						0		1412.113979	51.87882852	969.3199195	7.533284689	207.5301399	7.994909783	1.176127325	304.8678986	1000.608067	0	0	0	0.048534314	2691.013523	0	0	158.8673612	0	20.65752031	28861.15301	6.479514357	110.2452304	0.659253048	0	410.327856	384.1075401	43.93377694	0	0	0											$500 per admission copayment	$500 per admission copayment	$100 Copay days 21-100		$100 Copay	20% cost sharing	20% cost sharing	"$50 ER, $15 Urgent Care"	10% cost sharing - represented by equivalent copay				20% Coinsurance	"$25 PT/OT/ST, $10 CORF, $25 Mental Health, 10% coin all other"			$25 MH/SA		10% cost sharing	"10% lab, $15/Visit PCP, $25/Visit Specialist"	20% cost sharing	"$25 Vision, $25 Hearing"			$15 per exam		$25 per exam														75.80116772	52.70355557	29.73480694	0	75	0.2	0.2	29.24641794	32.42748572	0	0	0	0.2	26.03370808	0	0	25	0	0.1	10.18036786	0.2	15.01253904	0	0	15	0	25	0	0	0	0										68.85159794	47.88736889	27.00868319	0	68.12388253	0.181663687	0.181663687	26.56506053	30.3350959	0	0	0	0.181663687	23.08840853	0	0	22.70796084	0	0.090831843	9.064453455	0.181663687	13.63585	0	0	13.62477651	0	22.70796084	0	0	0	0										8.1022	0.207028383	2.181671218	0	1.178146572	1.452384786	0.213659626	0.674902848	2.529461806	0	0	0	0.008816922	5.177601632	0	0	0.300629485	0	1.876360649	21.80088151	1.177092466	0.125273952	0	0	0.465885444	0	0.083137207	0	0	0	0	0	0	0	0	0	0	0	0	0	47.5551		4.8	8.1022	0.207028383	2.181671218	0	1.178146572	1.452384786	0.213659626	0.674902848	2.529461806	0	0	0	0.008816922	5.177601632	0	0	0.300629485	0	1.876360649	21.80088151	1.177092466	0.125273952	0	0	0.465885444	0	0.083137207	0	0	0	0	0	0	0	0	0	0	0	0	0	47.5551																																																																																		0			8.1022	0.207028383	2.181671218	0	1.178146572	1.452384786	0.213659626	0.674902848	2.529461806	0	0	0	0.008816922	5.177601632	0	0	0.300629485	0	1.876360649	21.80088151	1.177092466	0.125273952	0	0	0.465885444	0	0.083137207	0	0	0	0	0	0	0	0	0	0	0	0	0	47.5551
H4461_016_0	2009	10																																	A	A			COIN	COIN	V					COIN	V			V			V	COIN	V			V		V																																																						0			82.21979627	1033.181854			17.21570413	2.436545369	401.8349337					0.149713952	4208.033406			402.6286162			44471.23453	18.58496638	144.8248011			539.122961		61.93113397															$100 per admission copayment	$100 copay for days 21-100			20% cost sharing	20% cost sharing	"$50 ER, $10 Urgent Care"					20% cost sharing	$10 CORF (3a) and Outpaitient Mental Health (9c) copay			$15 copay			"$10/Visit PCP, $15/Visit Specialist, $20 Chiropractic, $20 Podiatry, 20% Immunizations"	20% cost sharing	"$10 Vision, $10 Hearing"			$10 per exam		$10 per exam														0	10.75834994	21.08476012	0	0	0.2	0.2	28.29245152	0	0	0	0	0.2	0.248218444	0	0	15	0	0	8.739231557	0.2	10	0	0	10	0	10	0	0	0											0	10.23156326	20.05233687	0	0	0.190206924	0.190206924	26.90710093	0	0	0	0	0.190206924	0.236064334	0	0	14.26551932	0	0	8.311311777	0.190206924	9.510346216	0	0	9.510346216	0	9.510346216	0	0	0											0	0.070103087	1.726475881	0	0	3.274546133	0.463447801	0.90101776	0	0	0	0	0.02847663	0.08278055	0	0	0.478642192	0	0	30.80119127	3.534989295	0.114777833	0	0	0.427270501	0	0.04908221	0	0	0	0	0	0	0	0	0	0	0	0	0	41.9528		2.16	0	0.070103087	1.726475881	0	0	3.274546133	0.463447801	0.90101776	0	0	0	0	0.02847663	0.08278055	0	0	0.478642192	0	0	30.80119127	3.534989295	0.114777833	0	0	0.427270501	0	0.04908221	0	0	0	0	0	0	0	0	0	0	0	0	0	41.9528	2800																																																																																	0			0	0.070103087	1.726475881	0	0	3.274546133	0.463447801	0.90101776	0	0	0	0	0.02847663	0.08278055	0	0	0.478642192	0	0	30.80119127	3.534989295	0.114777833	0	0	0.427270501	0	0.04908221	0	0	0	0	0	0	0	0	0	0	0	0	0	41.9528
H4461_017_0	2009	10																					3350											A	A	A		T	coin	coin	V	coin				coin	V			V		coin	V	coin	V	coin		V		V																																																						0		1665.095362	65.10967038	1208.816356	8.962070607	234.8256825	10.31993642	1.566809694	302.1120933	29.13579824	0	0	0	7.876736508	3054.581506	0	0	212.3313631	0	24.17597505	33612.30478	9.323806517	114.110013	0.749749341	0	424.6873376	397.549438	48.93562624	0	0	0											$500 per admission copayment	$500 per admission copayment	$100 Copay days 21-100		$100 Copay	20% cost sharing	20% cost sharing	"$50 ER, $15 Urgent Care"	10% cost sharing				20% Coinsurance	"$25 PT/OT/ST, $10 CORF, $25 Mental Health, 10% coin all other"			$25 MH/SA		10% cost sharing	"10% lab, $15/Visit PCP, $25/Visit Specialist"	20% cost sharing	"$25 Vision, $25 Hearing"			$15 per exam		$25 per exam														75.80116772	52.71946269	29.73481014	0.1	75	0.2	0.2	29.24641794	0.1	0	0	0	0	26.30141231	0	0	25	0	0.1	10.34846697	0.2	15.01277555	0	0	15	0	25	0	0	0											69.98390208	48.70793796	27.45286158	0	69.24421897	0.184651251	0.184651251	27.00193823	0.092325625	0	0	0	0	24.13461498	0	0	23.08140632	0	0.092325625	9.590753174	0.184651251	13.86064367	0	0	13.84884379	0	23.08140632	0	0	0											9.7108	0.264279815	2.765455674	0	1.355026748	1.905589166	0.289313369	0.679801007	2.689980791	0	0	0	0	6.14342905	0	0	0.408408872	0	2.232062014	26.86394323	1.721652534	0.131803186	0	0	0.49011905	0	0.094125256	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7458		4.8	9.7108	0.264279815	2.765455674	0	1.355026748	1.905589166	0.289313369	0.679801007	2.689980791	0	0	0	0	6.14342905	0	0	0.408408872	0	2.232062014	26.86394323	1.721652534	0.131803186	0	0	0.49011905	0	0.094125256	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7458																																																																																		0			9.7108	0.264279815	2.765455674	0	1.355026748	1.905589166	0.289313369	0.679801007	2.689980791	0	0	0	0	6.14342905	0	0	0.408408872	0	2.232062014	26.86394323	1.721652534	0.131803186	0	0	0.49011905	0	0.094125256	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7458
H4506_003_0	2009	5																					3000											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																																																			0		246.6268264	6.923571231	384.4875667		243.2593437	10.90992653	0.242093498	315.5041928	273.502579		226.2082133	50.20558117	4.082140175			3095.138329	1.654158428	474.3851064			13.81671046	624.4101496		992	148																1a: $300	1b : $300	2a: $100 days 21 - 100 / 2a2: $100 days 21-100	6a: $0	10a: $150	11a: 10%	11b: 20% 11c: 0%/20%	4a: $50 4b: $25	9b: $150 OP Surg/$100 ASC	8a: $0	8b1: $0 8b2: $0/$25/$125/$300 8b3: $50/$200	9a: $150	12: $50	9a: $0 9c: $35/$20 9d: $25 3: $25 5: $25	"7a: $0, 14b, 14c, 14d, 14d1, 14e, 14f, 14g, 14h: $0, 14i: $10"	7b: $30 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: $15	17a: $25	17b1: $0	18a: $25 18a1: (n/c)	18b: (n/c)													300	300	64.98915146		150	0.14	0.14	47.5	147.5		48.29254671	150	50			25.00937227	31.25	25			0.1	25		15	25																279.9989344	279.9989344	60.65631052		139.9994672	0.130666169	0.130666169	44.33316461	137.6661427		45.07287206	139.9994672	46.66648907			23.34199195	29.16655567	23.33324453			0.093332978	23.33324453		13.99994672	23.33324453																5.7546	0.161549381	1.943466436	0	2.838014876	1.425558308	0.03163343	1.165608276	3.137670424	0	0.849654488	0.585729551	0.015874929	0	0	6.02055783	0.004020509	0.922411974	0	0	1.289554736	1.214126226	0	1.157328929	0.287776683	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8051	0	2.0576	5.7546	0.161549381	1.943466436	0	2.838014876	1.425558308	0.03163343	1.165608276	3.137670424	0	0.849654488	0.585729551	0.015874929	0	0	6.02055783	0.004020509	0.922411974	0	0	1.289554736	1.214126226	0	1.157328929	0.287776683	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8051																																																																																		0	0	0	5.7546	0.161549381	1.943466436	0	2.838014876	1.425558308	0.03163343	1.165608276	3.137670424	0	0.849654488	0.585729551	0.015874929	0	0	6.02055783	0.004020509	0.922411974	0	0	1.289554736	1.214126226	0	1.157328929	0.287776683	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8051
H4506_010_0	2009	3																					3000											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																																																			0		204.6105664	6.594250057	241.1772959		216.3508157	3.851336346	0.141483064	213.8213792	149.8140231		99.75347813	19.28218115	1.987058267			2201.593691	1.562353472	433.5571288			6.527584934	442.4596606		992	148																1a: $300	1b : $300	2a: $100 days 21 - 100 / 2a2: $100 days 21-100	6a: $0	10a: $100	11a: 10%	11b: 20% 11c: 0%/20%	4a: $50 4b: $25	9b: $150 OP Surg/$100 ASC	8a: $0	8b1: $0 8b2: $0/$25/$125/$300 8b3: $50/$200	9a: $150	12: $50	9a: $0 9c: $35/$20 9d: $25 3: $25 5: $25	"7a: $0, 14b, 14c, 14d, 14d1, 14e, 14f, 14g, 14h: $0, 14i: $10"	7b: $30 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: $15	17a: $25	17b1: $0	18a: $25 18a1: (n/c)	18b: (n/c)													300	300	64.98915146		100	0.14	0.14	47.5	147.5		48.24528046	150	50			25.01122078	31.25	25			0.1	25		15	25																290.459499	290.459499	62.92238792		96.81983301	0.135547766	0.135547766	45.98942068	142.8092537		46.71099998	145.2297495	48.40991651			24.21582219	30.25619782	24.20495825			0.096819833	24.20495825		14.52297495	24.20495825																4.9526	0.159613547	1.264620947	0	1.745587487	0.522040039	0.019177713	0.819460113	1.782902403	0	0.388298726	0.233362195	0.00801611	0	0	4.442783448	0.00393924	0.87451935	0	0	0.631999683	0.892476468	0	1.200565929	0.298527818	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.2405	0	0.6648	4.9526	0.159613547	1.264620947	0	1.745587487	0.522040039	0.019177713	0.819460113	1.782902403	0	0.388298726	0.233362195	0.00801611	0	0	4.442783448	0.00393924	0.87451935	0	0	0.631999683	0.892476468	0	1.200565929	0.298527818	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.2405																																																																																		0	0	0	4.9526	0.159613547	1.264620947	0	1.745587487	0.522040039	0.019177713	0.819460113	1.782902403	0	0.388298726	0.233362195	0.00801611	0	0	4.442783448	0.00393924	0.87451935	0	0	0.631999683	0.892476468	0	1.200565929	0.298527818	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.2405
H4506_023_0	2009	6																					3000											A	A	D	Coin	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																																																			0		244.1164179	6.853096367	380.5738771		240.7832128	10.68895317	0.237190054	312.2926833	270.7186029		223.9056454	49.69453977	4.040588169			3063.632991	1.637320789	469.5563518			13.53686211	618.0542938		992	148																1a: $300	1b : $300	2a: $100 days 21 - 100 / 2a2: $100 days 21-100	6a: 0%	10a: $150	11a: 10%	11b: 20% 11c: 0%/20%	4a: $50 4b: $25	9b: $150 OP Surg/$100 ASC	8a: $0	8b1: $0 8b2: $0/$25/$125/$300 8b3 : $50/$200	9a: $150	12: $50	9a: $0 9c: $35/$20 9d: $25 3: $25 5: $25	"7a: $0, 14b, 14c, 14d, 14d1, 14e, 14f, 14g, 14h: $0, 14i: $10"	7b: $30 7d: $25 7f: $25	"7e, 7h: $35/$25"	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: $15	17a: $25	17b1: $0	18a: $25 18a1: (n/c)	18b: (n/c)		13c: $0											300	300	64.98915146		150	0.14	0.14	47.5	147.5		48.29254671	150	50			25.00937227	31.25	25			0.1	25		15	25																280.4275159	280.4275159	60.74915435		140.213758	0.130866174	0.130866174	44.40102335	137.876862		45.14186304	140.213758	46.73791932			23.37772047	29.21119957	23.36895966			0.093475839	23.36895966		14.0213758	23.36895966																5.7047	0.160149733	1.926628433	0	2.813426593	1.398822406	0.031040155	1.15550956	3.110485954	0	0.842293165	0.580654848	0.01573739	0	0	5.968396306	0.003985675	0.914420287	0	0	1.265369538	1.203607155	0	1.159100399	0.288217169	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.5426	0	1.9921	5.7047	0.160149733	1.926628433	0	2.813426593	1.398822406	0.031040155	1.15550956	3.110485954	0	0.842293165	0.580654848	0.01573739	0	0	5.968396306	0.003985675	0.914420287	0	0	1.265369538	1.203607155	0	1.159100399	0.288217169	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.5426																																																																																		0	0	0	5.7047	0.160149733	1.926628433	0	2.813426593	1.398822406	0.031040155	1.15550956	3.110485954	0	0.842293165	0.580654848	0.01573739	0	0	5.968396306	0.003985675	0.914420287	0	0	1.265369538	1.203607155	0	1.159100399	0.288217169	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.5426
H4506_025_0	2009	6																					2500											A	A	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	Coin	V	Coin	V	T	V	V	V	V	V	V	V																																																			0		246.6351761	6.923805634			243.2675795	10.91066527	0.242109891	315.5148745	273.5118387			50.20728091	4.082278379			3095.243117	1.654214431	474.401167			13.81764603	624.4312895		992	148																1a: $175	1b : $175	2a: $0 days 1 - 100 / 2a2: $0 days 1-100	6a: $0	10a: $100	11a: 0%	11b: 0% 11c: 0%/20%	4a: $40 4b: $20	9b: $125 OP Surg/$75 ASC	8a: 0%	8b1: 0% 8b2: 0% 8b3: 0%	9a: $125	12: $50	9a: $0 9c: $20 9d: $25 3: $25 5: $25	"7a: $0, 14b, 14c, 14d, 14d1, 14e, 14f, 14g, 14h: $0, 14i: $10"	7b: $25 7d: $20 7f: $20	"7e, 7h: $20"	7c: $25 7i: $25	8b1: 0% 8b2: 0% 8b3: 0%	7g: $25	15: 10%	13a: $0 14a: $0 14j: $10 16b: $0 17a: $10 17b: $0	10b: $0	16a: $5	17a: $10	17b1: $0	18a: $25 18a1: (n/c)	18b: (n/c)													175	175			100	0.06	0.06	38	122.5			125	50			20.00937227	20	25			0.1	10		5	10																168.2038199	168.2038199			96.1164685	0.057669881	0.057669881	36.52425803	117.7426739			120.1455856	48.05823425			19.23230199	19.2232937	24.02911712			0.096116468	9.61164685		4.805823425	9.61164685																3.4571	0.09705088	0	0	1.94850172	0.629216769	0.013962449	0.960328891	2.683667936	0	0	0.502681931	0.016348924	0	0	4.960720864	0.002649954	0.949953434	0	0	1.328103339	0.500151086	0	0.397281403	0.118543644	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.5662	0	0.7502	3.4571	0.09705088	0	0	1.94850172	0.629216769	0.013962449	0.960328891	2.683667936	0	0	0.502681931	0.016348924	0	0	4.960720864	0.002649954	0.949953434	0	0	1.328103339	0.500151086	0	0.397281403	0.118543644	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.5662																																																																																		0	0	0	3.4571	0.09705088	0	0	1.94850172	0.629216769	0.013962449	0.960328891	2.683667936	0	0	0.502681931	0.016348924	0	0	4.960720864	0.002649954	0.949953434	0	0	1.328103339	0.500151086	0	0.397281403	0.118543644	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.5662
H4506_801_0	2009	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																																																			0		276.0762494	4.664339677	17.31597187		9.711368227	12.65610094	0.280403906	20.37113121	40.14408909	28.34565616	58.40162806	7.67345321	0.274483258	7.95272067	59.73911842	154.9168249	3.640145638	2.192071466			16.04627252	9.747705766																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS											0.0661	0.0661	0.193		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.0661	0.0661	0.193		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			18.2486	0.308312853	3.341982573	0	2.24332606	2.923559316	0.064773302	4.705731308	9.273284579	6.547846572	13.49077608	1.772567692	0.063405633	1.837078475	13.79973636	35.78578656	0.840873642	0.506368509	0	0	3.706688953	2.251720032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.7125	0	0	18.2486	0.308312853	3.341982573	0	2.24332606	2.923559316	0.064773302	4.705731308	9.273284579	6.547846572	13.49077608	1.772567692	0.063405633	1.837078475	13.79973636	35.78578656	0.840873642	0.506368509	0	0	3.706688953	2.251720032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.7125																																																																																		0	0	0	18.2486	0.308312853	3.341982573	0	2.24332606	2.923559316	0.064773302	4.705731308	9.273284579	6.547846572	13.49077608	1.772567692	0.063405633	1.837078475	13.79973636	35.78578656	0.840873642	0.506368509	0	0	3.706688953	2.251720032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.7125
H4506_806_0	2009	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																																																			0		276.0762494	4.664339677	17.31597187		9.711368227	12.65610094	0.280403906	20.37113121	40.14408909	28.34565616	58.40162806	7.67345321	0.274483258	7.95272067	59.73911842	154.9168249	3.640145638	2.192071466			16.04627252	9.747705766																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS											0.0661	0.0661	0.193		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.0661	0.0661	0.193		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			18.2486	0.308312853	3.341982573	0	2.24332606	2.923559316	0.064773302	4.705731308	9.273284579	6.547846572	13.49077608	1.772567692	0.063405633	1.837078475	13.79973636	35.78578656	0.840873642	0.506368509	0	0	3.706688953	2.251720032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.7125	0	0	18.2486	0.308312853	3.341982573	0	2.24332606	2.923559316	0.064773302	4.705731308	9.273284579	6.547846572	13.49077608	1.772567692	0.063405633	1.837078475	13.79973636	35.78578656	0.840873642	0.506368509	0	0	3.706688953	2.251720032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.7125																																																																																		0	0	0	18.2486	0.308312853	3.341982573	0	2.24332606	2.923559316	0.064773302	4.705731308	9.273284579	6.547846572	13.49077608	1.772567692	0.063405633	1.837078475	13.79973636	35.78578656	0.840873642	0.506368509	0	0	3.706688953	2.251720032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.7125
H4506_808_0	2009	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																																																			0		276.0762494	4.664339677	17.31597187		9.711368227	12.65610094	0.280403906	20.37113121	40.14408909	28.34565616	58.40162806	7.67345321	0.274483258	7.95272067	59.73911842	154.9168249	3.640145638	2.192071466			16.04627252	9.747705766																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS											0.0661	0.0661	0.193		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.0661	0.0661	0.193		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			18.2486	0.308312853	3.341982573	0	2.24332606	2.923559316	0.064773302	4.705731308	9.273284579	6.547846572	13.49077608	1.772567692	0.063405633	1.837078475	13.79973636	35.78578656	0.840873642	0.506368509	0	0	3.706688953	2.251720032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.7125	0	0	18.2486	0.308312853	3.341982573	0	2.24332606	2.923559316	0.064773302	4.705731308	9.273284579	6.547846572	13.49077608	1.772567692	0.063405633	1.837078475	13.79973636	35.78578656	0.840873642	0.506368509	0	0	3.706688953	2.251720032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.7125																																																																																		0	0	0	18.2486	0.308312853	3.341982573	0	2.24332606	2.923559316	0.064773302	4.705731308	9.273284579	6.547846572	13.49077608	1.772567692	0.063405633	1.837078475	13.79973636	35.78578656	0.840873642	0.506368509	0	0	3.706688953	2.251720032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.7125
H4510_012_0	2009	7	r.	s.	t.	u.	v.	w.					OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered					1700	Renal Dialysis										A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin				V				O	O	P	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		309.333637	10.513001	960.077919	1932.559547	285.357802	10.884435	4.493479	361.586618	257.939332	104.260187	1343.173672	0	0	243.395148	4691.72337	4561.122371	11.057125	930.524595			49.270027				2.47				1.81	0.25	2.371015	0.06	1.32	0.05	1.23	2.7					$65/Admit:1a	$65/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	"0%-20% Coins:11b. 0% Supplies,11b. 20% Prosthetics"	$50/Visit:4a	"$0-$50/Visit:9b. $0 Surgery ASC -- Physician,9b. $30 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $50 Surgery OP -- Facility"	"$0-$30/Visit:8a. $0 Lab -- FSL,8. $30 Lab -- OP"	"$0-$100/Visit:14h. $50 DMAM -- OP,8b. $25 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $30 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$30-$100/Visit:9d. $30 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $50 OP Other,5. $35 Partial Hospitalization,8b. $50 Rad therapy,3. $40 Therapy (AT,PT,ST,OT) -- CORF"	$5/Visit:7a	"$10/Visit:7b, 7d, 7f"	"$10-$50/Visit:7h. $50 Psych -- OP,7e. $10 Psych -- Other Provider"	"$10-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $10 Therapy (AT,PT,ST,OT) - Specialist"			0% Coins:15				Vision Benefit				$0: Membership in health club/fitness class 14a	OTC Drugs OTC001 & NSP001	$0/Proc:12	$0: Nurse hotline 14a	$0: Nutritional benefit 14a	$0 Additional Smoking Cessation 14a	$0: Health Education Materials 14a	$0 Corp Health 14a					64.999992	64.999518	43.132799	0	100.000013	0.2	0.094199	50.000003	41.929813	25.696366	43.123763	0	0.2	42.923879	5	10.000001	37.838045	12.094661			0				0				0	0	0	0	0	0	0	0					45.905074	45.904739	30.461762	0	70.623209	0.141246	0.066526	35.311602	29.612175	18.147596	30.455381	0	0.15	30.314217	3.53116	7.062321	26.722438	8.541636			0				0				0	0	0	0	0	0	0	0					1.1833	0.040216381	2.437138756	0	1.679406974	1.537382906	0.298933184	1.064016895	0.636512053	0.157672646	3.408905494	0	0	0.614861111	1.380602158	2.684342525	0.024622778	0.662350198	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.8103	0	7.4085	1.1833	0.040216381	2.437138756	0	1.679406974	1.537382906	0.298933184	1.064016895	0.636512053	0.157672646	3.408905494	0	0	0.614861111	1.380602158	2.684342525	0.024622778	0.662350198	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.8103	1700																																																																																	0	0	0	1.1833	0.040216381	2.437138756	0	1.679406974	1.537382906	0.298933184	1.064016895	0.636512053	0.157672646	3.408905494	0	0	0.614861111	1.380602158	2.684342525	0.024622778	0.662350198	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.8103
H4510_015_0	2009	7	r.	s.	t.	u.	v.	w.					DME/Prosthetics/Supplies	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered					1800	Prosthetics/Supplies										A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin				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		329.571813	11.024355	859.237293	1480.239582	313.901608	12.0553	1.362303	360.078539	254.323572	145.034812	1227.301112	0	21.21271	249.138808	5783.356693	5599.809567	3.967789	668.132602			39.520625				2.47				1.81	0.35	7932.540879	0.06	0.27	0.05	1.23	2.7					$65/Admit:1a	$65/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$50/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$40/Visit:9b. $0 Surgery ASC -- Physician,9b. $30 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $40 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$100/Visit:14h. $50 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	"$0-$40/Proc:12. $0 Dialysis -- Dialysis Center,12. $40 Dialysis -- OP Hosp"	"$15-$100/Visit:9d. $15 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $50 OP Other,5. $20 Partial Hospitalization,8b. $50 Rad therapy,3. $40 Therapy (AT,PT,ST,OT) -- CORF"	$5/Visit:7a	"$15/Visit:7b, 7d, 7f"	"$15-$50/Visit:7h. $50 Psych -- OP,7e. $15 Psych -- Other Provider"	"$15-$40/Visit:9a. $40 Therapy (AT,PT,ST,OT) -- OP,7d. $15 Therapy (AT,PT,ST,OT) - Specialist"			"0%-20% Coins:15. 20% Part B Rx,15. 0% Part B Rx at Pharmacy,15. 20% Part B Rx - Chemo"				Vision Benefit				$0: Membership in health club/fitness class 14a	OTC004 &NSP001	:11b	$0: Nurse hotline 14a	$0: Nutritional benefit 14a	$0 Additional Smoking Cessation 14a	$0: Health Education Materials 14a	$0 Corp Health 14a					65.000012	64.999721	43.132806	0	49.999985	0.2	0.2	49.999991	34.075661	28.503749	34.217265	0	0	31.187192	5	15	48.10538	17.734671			0.163378				0				0	0	0	0	0	0	0	0					42.334638	42.334448	28.092483	0	32.56509	0.13026	0.13026	32.565094	22.193546	18.564549	22.285773	0	0	20.31228	3.25651	9.76953	31.33113	11.550626			0.106408				0				0	0	0	0	0	0	0	0					1.1627	0.038892499	2.011509087	0	0.851852843	1.570323378	0.177453589	0.977165956	0.470361825	0.22437549	2.279279499	0	0	0.421714769	1.569463242	4.558958963	0.010359609	0.643112484	0	0	4.205310665	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.1728	0	11.3357	1.1627	0.038892499	2.011509087	0	0.851852843	1.570323378	0.177453589	0.977165956	0.470361825	0.22437549	2.279279499	0	0	0.421714769	1.569463242	4.558958963	0.010359609	0.643112484	0	0	4.205310665	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.1728	1800																																																																																	0	0	0	1.1627	0.038892499	2.011509087	0	0.851852843	1.570323378	0.177453589	0.977165956	0.470361825	0.22437549	2.279279499	0	0	0.421714769	1.569463242	4.558958963	0.010359609	0.643112484	0	0	4.205310665	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.1728
H4510_017_0	2009	4	r.	s.	t.	u.	v.	w.					Part B Rx	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered																D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin		T	Coin	V				O	O	S	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		2118.801796	74.646761	923.554245	1591.040749	337.398253	13.944024	3.689226	387.03169	273.360591	155.891181	1319.168943	0	22.800556	267.787729	6216.261394	6018.975114	4.264792	718.14469			39.798249		7.5	2.74	2.47				1.81	1.32	1503.338807	0.06	0.43	0.05	1.23	2.7					$0/Day(Days 1-1):1a	$0/Day(Days 1-1):1b	$0/Day(Days 1-20) $0(Days 21-100):2	$0/Visit:6	$0/Trip:10a	0% Coins:11a	0% Coins:11b	$0/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"$0/Visit:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			0% Coins:15		$0 Other - Transportation 10b	"Dental 772 16a, 16b"	Vision Benefit				$0: Membership in health club/fitness class 14a	Other	$0/Script:15	$0: Nurse hotline 14a	OTC004 & NSP002	$0 Additional Smoking Cessation 14a	$0 Health Education Materials 14a	$0 Corp Health 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	0	0	0	0	0	0			0		0	0	0				0	0	0	0	0	0	0	0					0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	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	2009	5	r.	s.	t.	u.	v.	w.					DME/Prosthetics/Supplies	OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered						Prosthetics/Supplies	Renal Dialysis									D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin				V				O	O	O	P	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		2171.551902	76.505182	946.547232	1630.651613	345.798187	14.629746	1.653227	396.667308	280.166229	159.77228	1352.011231	0	0	274.454624	6371.022662	6168.824703	4.37097	736.023762			47.960378				2.47				1.81	0.27	8738.592548	23.368203	0.06	0.05	1.23	2.7					$175/Day(Days 1-5):1a	$175/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$50/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$100/Visit:14h. $50 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$15-$100/Visit:9d. $15 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $50 OP Other,5. $20 Partial Hospitalization,8b. $50 Rad therapy,3. $40 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$50/Visit:7h. $50 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			"0%-20% Coins:15. 20% Part B Rx,15. 0% Part B Rx at Pharmacy,15. 20% Part B Rx - Chemo"				Vision Benefit				$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	:11b	$0/Proc:12	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0 Health Education Materials 14a	$0 Corp Health 14a					107.292847	89.43802	43.132795	0	50.000007	0.199999	0.199999	49.999986	100.000018	28.503742	34.217271	0	0	31.187144	10	30	48.917288	32.187721			0.163378				0				0	0	0	0	0	0	0	0					107.292847	89.43802	43.132795	0	50.000007	0.199999	0.199999	49.999986	100.000018	28.503742	34.217271	0	0	31.187144	10	30	48.917288	32.187721			0.163378				0				0	0	0	0	0	0	0	0					19.416	0.570206	3.402268976	0	1.440825981	2.92593457	0.330643747	1.652779987	2.334718995	0.379508987	3.855177891	0	0	0.71328799	5.309185552	15.42206176	0.017818	1.974243958	0	0	7.835670637	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.5803	0	0	19.416	0.570206	3.402268976	0	1.440825981	2.92593457	0.330643747	1.652779987	2.334718995	0.379508987	3.855177891	0	0	0.71328799	5.309185552	15.42206176	0.017818	1.974243958	0	0	7.835670637	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.5803																																																																																		0	0	0	19.416	0.570206	3.402268976	0	1.440825981	2.92593457	0.330643747	1.652779987	2.334718995	0.379508987	3.855177891	0	0	0.71328799	5.309185552	15.42206176	0.017818	1.974243958	0	0	7.835670637	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.5803
H4510_019_0	2009	4	r.	s.	t.	u.	v.	w.					Part B Rx	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered																A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin		T	Coin	V				O	O	S	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		363.068716	12.144844	946.568148	1630.687645	345.805828	14.630379	3.870817	396.676072	280.172422	159.775811	1352.041107	0	23.36872	274.460691	6371.163441	6168.961015	4.371066	736.040026			41.757204		7.9	4.12	1.5				1.81	0.42	1540.800272	0.06	0.27	0.05	1.23	2.7					$0/Admit:1a	$0/Admit:1b	$0/Day(Days 1-20) $0(Days 21-100):2	$0/Visit:6	$0/Trip:10a	0% Coins:11a	0% Coins:11b	$0/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0/Visit:14h, 8a, 8b, 9a"	$0/Visit:9a	$0/Proc:12	"$0/Visit:3, 5, 8b, 9a, 9d"	$0/Visit:7a	"$0/Visit:7b, 7d, 7f"	"$0/Visit:7e, 7h"	"$0/Visit:7d, 9a"			0% Coins:15		$0 Other - Transportation 10b 26 Rides	"Dental 16a, 16b"	Vision Benefit				$0: Membership in health club/fitness class 14a	OTC004 & NSP002	$0/Script:15	$0: Nurse hotline 14a	$0: Nutritional benefit 14a	$0 Additional Smoking Cessation 14a	$0 Health Education Materials 14a	$0 Corp Health 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	0	0	0	0	0	0			0		0	0	0				0	0	0	0	0	0	0	0					0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	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_801_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		329.571456	11.024343	859.236361	1480.237974	8.292741	12.055289	3.189516	27.773224	45.12115	145.034658	32.828814	0	0.411724	5.684722	45.799032	100.724464	0.116127	5.754064			39.520589																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000003	1024.000069	43.132797	0	0.199999	0.2	0.199999	0.2	0.2	0	0.2	0	0.2	0.2	0.199999	0.2	0.500004	0.2			0.199999																				1024.000003	1024.000069	43.132797	0	0.199999	0.2	0.199999	0.2	0.2	0	0.2	0	0.2	0.2	0.199999	0.2	0.500004	0.2			0.199999																				28.1234	0.940743999	3.088438961	0	1.658539907	2.4110578	0.63790001	5.5546448	9.02423	0	6.5657628	0	0.0823448	1.1369444	9.159760601	20.1448928	0.058063965	1.1508128	0	0	7.904078279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.6416	0	0	28.1234	0.940743999	3.088438961	0	1.658539907	2.4110578	0.63790001	5.5546448	9.02423	0	6.5657628	0	0.0823448	1.1369444	9.159760601	20.1448928	0.058063965	1.1508128	0	0	7.904078279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.6416																																																																																		0	0	0	28.1234	0.940743999	3.088438961	0	1.658539907	2.4110578	0.63790001	5.5546448	9.02423	0	6.5657628	0	0.0823448	1.1369444	9.159760601	20.1448928	0.058063965	1.1508128	0	0	7.904078279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.6416
H4510_802_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		329.571456	11.024343	859.236361	1480.237974	8.292741	12.055289	3.189516	27.773224	45.12115	145.034658	32.828814	0	0.411724	5.684722	45.799032	100.724464	0.116127	5.754064			39.520589																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000003	1024.000069	43.132797	0	0.199999	0.2	0.199999	0.2	0.2	0	0.2	0	0.2	0.2	0.199999	0.2	0.500004	0.2			0.199999																				1024.000003	1024.000069	43.132797	0	0.199999	0.2	0.199999	0.2	0.2	0	0.2	0	0.2	0.2	0.199999	0.2	0.500004	0.2			0.199999																				28.1234	0.940743999	3.088438961	0	1.658539907	2.4110578	0.63790001	5.5546448	9.02423	0	6.5657628	0	0.0823448	1.1369444	9.159760601	20.1448928	0.058063965	1.1508128	0	0	7.904078279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.6416	0	0	28.1234	0.940743999	3.088438961	0	1.658539907	2.4110578	0.63790001	5.5546448	9.02423	0	6.5657628	0	0.0823448	1.1369444	9.159760601	20.1448928	0.058063965	1.1508128	0	0	7.904078279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.6416																																																																																		0	0	0	28.1234	0.940743999	3.088438961	0	1.658539907	2.4110578	0.63790001	5.5546448	9.02423	0	6.5657628	0	0.0823448	1.1369444	9.159760601	20.1448928	0.058063965	1.1508128	0	0	7.904078279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.6416
H4510_803_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		329.571456	11.024343	859.236361	1480.237974	8.292741	12.055289	3.189516	27.773224	45.12115	145.034658	32.828814	0	0.411724	5.684722	45.799032	100.724464	0.116127	5.754064			39.520589																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000003	1024.000069	43.132797	0	0.199999	0.2	0.199999	0.2	0.2	0	0.2	0	0.2	0.2	0.199999	0.2	0.500004	0.2			0.199999																				1024.000003	1024.000069	43.132797	0	0.199999	0.2	0.199999	0.2	0.2	0	0.2	0	0.2	0.2	0.199999	0.2	0.500004	0.2			0.199999																				28.1234	0.940743999	3.088438961	0	1.658539907	2.4110578	0.63790001	5.5546448	9.02423	0	6.5657628	0	0.0823448	1.1369444	9.159760601	20.1448928	0.058063965	1.1508128	0	0	7.904078279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.6416	0	0	28.1234	0.940743999	3.088438961	0	1.658539907	2.4110578	0.63790001	5.5546448	9.02423	0	6.5657628	0	0.0823448	1.1369444	9.159760601	20.1448928	0.058063965	1.1508128	0	0	7.904078279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.6416																																																																																		0	0	0	28.1234	0.940743999	3.088438961	0	1.658539907	2.4110578	0.63790001	5.5546448	9.02423	0	6.5657628	0	0.0823448	1.1369444	9.159760601	20.1448928	0.058063965	1.1508128	0	0	7.904078279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.6416
H4510_804_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		329.571456	11.024343	859.236361	1480.237974	8.292741	12.055289	3.189516	27.773224	45.12115	145.034658	32.828814	0	0.411724	5.684722	45.799032	100.724464	0.116127	5.754064			39.520589																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000003	1024.000069	43.132797	0	0.199999	0.2	0.199999	0.2	0.2	0	0.2	0	0.2	0.2	0.199999	0.2	0.500004	0.2			0.199999																				1024.000003	1024.000069	43.132797	0	0.199999	0.2	0.199999	0.2	0.2	0	0.2	0	0.2	0.2	0.199999	0.2	0.500004	0.2			0.199999																				28.1234	0.940743999	3.088438961	0	1.658539907	2.4110578	0.63790001	5.5546448	9.02423	0	6.5657628	0	0.0823448	1.1369444	9.159760601	20.1448928	0.058063965	1.1508128	0	0	7.904078279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.6416	0	0	28.1234	0.940743999	3.088438961	0	1.658539907	2.4110578	0.63790001	5.5546448	9.02423	0	6.5657628	0	0.0823448	1.1369444	9.159760601	20.1448928	0.058063965	1.1508128	0	0	7.904078279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.6416																																																																																		0	0	0	28.1234	0.940743999	3.088438961	0	1.658539907	2.4110578	0.63790001	5.5546448	9.02423	0	6.5657628	0	0.0823448	1.1369444	9.159760601	20.1448928	0.058063965	1.1508128	0	0	7.904078279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.6416
H4513_001_0	2009	3																					3000											A	A	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	V	V	Coin	O	T	V	V	V	V	V	O	O																																																			0	0	240.1882246	27.40916651	1043.29624	1321.348344	219.9276257	11.21459677	1.237644952	274.4567653	322.8598988	212.9421661	2308.784788	202.3382589	34.44306154	596.2145008	4985.935247	8232.616179	94.99761151	222.9729132	0	262.5461415	9.069758996	0	952.0313582	0	66.77114983	0	0	0	3622.481442	321.1714934											$300 per admit	$300 per admit	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	No Cost Sharing	"$0 copay for all x-rays; $100 copay for CAT scans, MRI's, and Cardiac Nuclear Medecine; $150 copay for PET scans"	No Cost Sharing	$25 copay	$25 copay	$5 copay	$25 copay	$25 copay	$25 copay	No Cost Sharing	$25 copay	15% Coinsurance	No Cost Sharing	No Cost Sharing	0	$25 copay	1 pair of eyeglasses after cataract surgery	0	0	No Cost Sharing	0											300	300	25	0	50	0.1	0.1	50	150	0	25.13031856	0	25	25	5	25	25	25	0	25	0.15	0	0	0	25	0	0	0	0	0											293.61955	300	24.25969104	0	48.94946233	0.098985704	0.1	49.91098633	148.9430663	0	25.13031856	0	17.49294624	24.68811389	5	25	25	25	0	25	0.134187333	0	0	0	25	0	0	0	0	0											5.877	0.685229163	2.109170371	0	0.897111586	1.110084759	0.123764495	1.141533989	4.007311943	0	4.835041433	0	0.050209219	1.226617625	2.077473019	17.15128371	0.197911691	0.464526903	0	0.546971128	1.21704677	0	0	0	0.139106562	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.8574		0.435	5.877	0.685229163	2.109170371	0	0.897111586	1.110084759	0.123764495	1.141533989	4.007311943	0	4.835041433	0	0.050209219	1.226617625	2.077473019	17.15128371	0.197911691	0.464526903	0	0.546971128	1.21704677	0	0	0	0.139106562	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.8574	3000																																																																																	0			5.877	0.685229163	2.109170371	0	0.897111586	1.110084759	0.123764495	1.141533989	4.007311943	0	4.835041433	0	0.050209219	1.226617625	2.077473019	17.15128371	0.197911691	0.464526903	0	0.546971128	1.21704677	0	0	0	0.139106562	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.8574
H4513_009_0	2009	3																					3000											D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	V	V	Coin	O	T	V	V	V	V	V	O	O																																																			0	0	1181.127812	105.2521978	819.5967264	1213.333977	166.9142702	6.710862747	0.587419714	221.9210017	258.1449948	128.05607	1853.979268	167.3875184	13.67032556	534.3281424	3578.790734	5942.49759	58.40939473	129.079756	0	157.5879304	0	0	655.1861598	0	0	0	0	0	3797.863863	0											"$150 per day, Days 1-10"	"$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	No Cost Sharing	"$0 copay for all x-rays; $100 copay for CAT scans, MRI's, and Cardiac Nuclear Medecine; $150 copay for PET scans"	No Cost Sharing	$30 copay	$30 copay	$10 copay	$30 copay	$30 copay	$30 copay	No Cost Sharing	$30 copay	10% Coinsurance	No Cost Sharing	No Cost Sharing	0	$30 copay	1 pair of eyeglasses after cataract surgery	0	0	No Cost Sharing	0											150	150	25	0	50	0.1	0.1	50	150	30	30	0	30	30	10	30	30	30	30	30	0.1	0	0	0	30	0	0	0	0	0											146.15991	150	21.61636259	0	48.44723123	0.099731424	0.098058647	49.70802756	148.4939902	30	30	0	30	27.67172946	10	30	30	30	0	30	0.1	0	0	0	0	0	0	0	0	0											14.3861	1.315652472	1.476391668	0	0.673877854	0.669283899	0.057601583	0.919271273	3.194415027	0.320140175	4.63494817	0	0.034175814	1.23214865	2.982325612	14.85624398	0.146023487	0.32269939	0	0.393969826	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.6153		0.7751	14.3861	1.315652472	1.476391668	0	0.673877854	0.669283899	0.057601583	0.919271273	3.194415027	0.320140175	4.63494817	0	0.034175814	1.23214865	2.982325612	14.85624398	0.146023487	0.32269939	0	0.393969826	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.6153	3000																																																																																	0			14.3861	1.315652472	1.476391668	0	0.673877854	0.669283899	0.057601583	0.919271273	3.194415027	0.320140175	4.63494817	0	0.034175814	1.23214865	2.982325612	14.85624398	0.146023487	0.32269939	0	0.393969826	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.6153
H4513_010_0	2009	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
H4513_014_0	2009	3																					3000											D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	V	V	Coin	O	T	V	V	V	V	V	O	O																																																			0	0	1179.918587	169.2725275	415.4444777	1416.342412	61.05956301	5.464043951	0.447071639	188.5662975	330.2963185	1674.660281	1980.329243	60.84405867	28.97336127	533.1098474	7202.070877	8593.144089	69.94939129	136.7868303	0	836.5980245	6.076186622	0	595.8846585	0	33.67239565	0	0	0	0	1739.599006											"$150 per day, Days 1-10"	"$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	No Cost Sharing	"$0 copay for all x-rays; $100 copay for CAT scans, MRI's, and Cardiac Nuclear Medecine; $150 copay for PET scans"	No Cost Sharing	$30 copay	$30 copay	$15 copay	$30 copay	$30 copay	$30 copay	No Cost Sharing	$30 copay	15% Coinsurance	No Cost Sharing	No Cost Sharing	0	$30 copay	1 pair of eyeglasses after cataract surgery	0	0	No Cost Sharing	0											150	150	25	0	50	0.1	0.1	50	150	0	25.13	0	30	30	15	30	30	30	0	30	0.15	0	0	0	30	0	0	0	0	0											149.5808496	150	23.07502701	0	50	0.099571703	0.1	50	149.4265536	0	25.13	0	30	29.94126704	15	30	30	30	0	30	0.117612408	0	0	0	30	0	0	0	0	0											14.7078	2.115906593	0.798866045	0	0.254414846	0.544064164	0.044707164	0.785692906	4.112920045	0	4.147139489	0	0.072433403	1.330165358	9.002588596	21.48286022	0.174873478	0.341967076	0	2.091495061	0.714634938	0	0	0	0.084180989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8067		0.3323	14.7078	2.115906593	0.798866045	0	0.254414846	0.544064164	0.044707164	0.785692906	4.112920045	0	4.147139489	0	0.072433403	1.330165358	9.002588596	21.48286022	0.174873478	0.341967076	0	2.091495061	0.714634938	0	0	0	0.084180989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8067	3000																																																																																	0			14.7078	2.115906593	0.798866045	0	0.254414846	0.544064164	0.044707164	0.785692906	4.112920045	0	4.147139489	0	0.072433403	1.330165358	9.002588596	21.48286022	0.174873478	0.341967076	0	2.091495061	0.714634938	0	0	0	0.084180989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8067
H4513_015_0	2009	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
H4513_019_0	2009	3																					3000											A	A	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	V	V	Coin	O	T	V	V	V	V	V	O	O																																																			0	0	257.3578249	29.36848169	1122.839325	1449.659278	237.2606937	12.14418239	1.340234191	297.9568585	382.7654705	245.8659378	2665.754497	233.6225215	39.76843	688.3974182	4565.458562	7538.338579	86.98621972	204.1690366	0	240.4049532	9.738925441	0	950.6549023	0	66.62814279	0	0	0	3622.76216	321.1714934											$300 per admit	$300 per admit	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	No Cost Sharing	"$0 copay for all x-rays; $100 copay for CAT scans, MRI's, and Cardiac Nuclear Medecine; $150 copay for PET scans"	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	No Cost Sharing	0											300	300	25	0	50	0.1	0.1	50	150	25	25.13	0	25	25	10	25	25	25	25	25	0.15	0	0	0	25	0	0	0	0	0											294.045221	300	24.31213528	0	49.0262093	0.099063344	0.1	49.91800691	149.1084841	25	25.13	0	18.49821166	24.72987838	10	25	25	25	0	25	0.135273829	0	0	0	25	0	0	0	0	0											6.3062	0.734212042	2.27488513	0	0.969332702	1.203043321	0.134023419	1.239451044	4.756131588	0.512220704	5.58253421	0	0.061303736	1.418665369	3.804548802	15.70487204	0.181221291	0.42535216	0	0.500843653	1.317421736	0	0	0	0.138808631	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.2651		0.435	6.3062	0.734212042	2.27488513	0	0.969332702	1.203043321	0.134023419	1.239451044	4.756131588	0.512220704	5.58253421	0	0.061303736	1.418665369	3.804548802	15.70487204	0.181221291	0.42535216	0	0.500843653	1.317421736	0	0	0	0.138808631	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.2651	3000																																																																																	0			6.3062	0.734212042	2.27488513	0	0.969332702	1.203043321	0.134023419	1.239451044	4.756131588	0.512220704	5.58253421	0	0.061303736	1.418665369	3.804548802	15.70487204	0.181221291	0.42535216	0	0.500843653	1.317421736	0	0	0	0.138808631	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.2651
H4513_020_0	2009	3																					3000											D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	V	V	Coin	O	T	V	V	V	V	V	O	O																																																			0	0	1859.244385	170.5375721	1250.078365	933.0728469	241.4195109	12.28299443	0.904495785	222.8722536	824.7087156	107.4927154	4088.82596	256.8337398	0.820555079	810.7084184	6817.419504	12160.78638	69.94939129	39.61553398	0	506.1327923	7.288202132	0	950.6549023	0	66.62814279	0	0	0	3622.76216	0											"$100 per day, Days 1-10"	"$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	No Cost Sharing	"$0 copay for all x-rays; $100 copay for CAT scans, MRI's, and Cardiac Nuclear Medecine; $150 copay for PET scans"	No Cost Sharing	$30 copay	$30 copay	$10 copay	$30 copay	$30 copay	$30 copay	No Cost Sharing	$30 copay	15% Coinsurance	No Cost Sharing	No Cost Sharing	0	$30 copay	1 pair of eyeglasses after cataract surgery	0	0	No Cost Sharing	0											100	100	25	0	50	0.1	0.1	50	150	0	28.92749245	0	30	30	10	30	30	30	0	30	0.15	0	0	0	30	0	0	0	0	0											99.17573559	100	24.38214949	0	49.04298432	0.09907393	0.1	49.89038383	149.5862278	0	28.92749245	0	30	29.77063144	10	30	30	30	0	30	0.130322022	0	0	0	30	0	0	0	0	0											15.366	1.421146434	2.539966465	0	0.986661108	1.216924525	0.090449579	0.926598523	10.28042215	0	9.856623507	0	0.002051388	2.011275127	5.68118292	30.40196595	0.174873478	0.099038835	0	1.265331981	0.94981324	0	0	0	0.166570357	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.4369		0.4135	15.366	1.421146434	2.539966465	0	0.986661108	1.216924525	0.090449579	0.926598523	10.28042215	0	9.856623507	0	0.002051388	2.011275127	5.68118292	30.40196595	0.174873478	0.099038835	0	1.265331981	0.94981324	0	0	0	0.166570357	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.4369	3000																																																																																	0			15.366	1.421146434	2.539966465	0	0.986661108	1.216924525	0.090449579	0.926598523	10.28042215	0	9.856623507	0	0.002051388	2.011275127	5.68118292	30.40196595	0.174873478	0.099038835	0	1.265331981	0.94981324	0	0	0	0.166570357	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.4369
H4513_021_0	2009	4																					3000											A	A	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	V	V	Coin	O	T	V	V	V	V	V	O	O																																																			0	0	283.9454561	19.11040029	1250.078365	933.0728469	241.4195109	12.28299443	0.904495785	222.8722536	824.7087156	107.4927154	4088.82596	256.8337398	0.820555079	810.7084184	7087.416316	12642.40168	72.71966421	41.18446602	0	526.1776554	7.288202132	0	950.6549023	0	66.62814279	0	0	0	3622.76216	0											$300 per admit	$300 per admit	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	No Cost Sharing	"$0 copay for all x-rays; $100 copay for CAT scans, MRI's, and Cardiac Nuclear Medecine; $150 copay for PET scans"	No Cost Sharing	$25 copay	$25 copay	$5 copay	$25 copay	$25 copay	$25 copay	No Cost Sharing	$25 copay	15% Coinsurance	No Cost Sharing	No Cost Sharing	0	$25 copay	1 pair of eyeglasses after cataract surgery	0	0	No Cost Sharing	0											300	300	25	0	50	0.1	0.1	50	150	0	25.13031856	0	25	25	5	25	25	25	0	25	0.15	0	0	0	25	0	0	0	0	0											294.6028051	300	24.38214949	0	49.04298432	0.09907393	0.1	49.89038383	149.5862278	0	25.13031856	0	25	24.77063144	5	25	25	25	0	25	0.130322022	0	0	0	25	0	0	0	0	0											6.9709	0.477760007	2.539966465	0	0.986661108	1.216924525	0.090449579	0.926598523	10.28042215	0	8.562791575	0	0.00170949	1.673479953	2.953090132	26.33833684	0.1514993	0.085800971	0	1.096203449	0.94981324	0	0	0	0.138808631	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.4412		0.4135	6.9709	0.477760007	2.539966465	0	0.986661108	1.216924525	0.090449579	0.926598523	10.28042215	0	8.562791575	0	0.00170949	1.673479953	2.953090132	26.33833684	0.1514993	0.085800971	0	1.096203449	0.94981324	0	0	0	0.138808631	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.4412	3000																																																																																	0			6.9709	0.477760007	2.539966465	0	0.986661108	1.216924525	0.090449579	0.926598523	10.28042215	0	8.562791575	0	0.00170949	1.673479953	2.953090132	26.33833684	0.1514993	0.085800971	0	1.096203449	0.94981324	0	0	0	0.138808631	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.4412
H4513_802_0	2009	2																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																			13.0627	0.9373	3.8489	0	0.1902	0.3437	0.04	0.266	0.9476	0.0501	0.0941	0.8527	0.0285	1.0798	10.342	1.0034	0	0.0047	0	0.0701	0.2747	0																			33.4365		1380.318536	99.04216728	696.8053252	11.2500816	6.13527826	11.08640128	1.288834775	8.581467579	30.56683079	1.00483837	1.886979649	17.10607693	0.571274837	21.66129597	270.6686871	26.26134499	0	0.123074807	0	1.835489065	8.862774282	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																			8.547697049	8.547697049	4.989077257	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																			8.547697049	8.547697049	4.989077257	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	0.2	0	0.2	0.2	0																			0.9832	0.070548537	0.2897013	0	1.227055652	2.217280257	0.257766955	1.716293516	6.113366158	0.200967674	0.37739593	3.421215386	0.114254967	4.332259194	54.13373741	5.252268997	0	0.024614961	0	0.367097813	1.772554856	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.8716			14.0459	1.007836239	4.138590001	0	1.417249278	2.560958696	0.297720833	1.982319011	7.060937913	0.251058465	0.47146111	4.273946478	0.142732789	5.412066134	64.47574467	6.255691385	0	0.029317539	0	0.4372302	2.047300859	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.308																																																																																		0			14.0459	1.007836239	4.138590001	0	1.417249278	2.560958696	0.297720833	1.982319011	7.060937913	0.251058465	0.47146111	4.273946478	0.142732789	5.412066134	64.47574467	6.255691385	0	0.029317539	0	0.4372302	2.047300859	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.308
H4513_804_0	2009	2																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																			13.0627	0.9373	3.8489	0	0.1902	0.3437	0.04	0.266	0.9476	0.0501	0.0941	0.8527	0.0285	1.0798	10.342	1.0034	0	0.0047	0	0.0701	0.2747	0																			33.4365		1380.318536	99.04216728	696.8053252	11.2500816	6.13527826	11.08640128	1.288834775	8.581467579	30.56683079	1.00483837	1.886979649	17.10607693	0.571274837	21.66129597	270.6686871	26.26134499	0	0.123074807	0	1.835489065	8.862774282	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																			8.547697049	8.547697049	4.989077257	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																			8.547697049	8.547697049	4.989077257	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	0.2	0	0.2	0.2	0																			0.9832	0.070548537	0.2897013	0	1.227055652	2.217280257	0.257766955	1.716293516	6.113366158	0.200967674	0.37739593	3.421215386	0.114254967	4.332259194	54.13373741	5.252268997	0	0.024614961	0	0.367097813	1.772554856	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.8716			14.0459	1.007836239	4.138590001	0	1.417249278	2.560958696	0.297720833	1.982319011	7.060937913	0.251058465	0.47146111	4.273946478	0.142732789	5.412066134	64.47574467	6.255691385	0	0.029317539	0	0.4372302	2.047300859	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.308																																																																																		0			14.0459	1.007836239	4.138590001	0	1.417249278	2.560958696	0.297720833	1.982319011	7.060937913	0.251058465	0.47146111	4.273946478	0.142732789	5.412066134	64.47574467	6.255691385	0	0.029317539	0	0.4372302	2.047300859	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.308
H4513_805_0	2009	2																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																			13.0627	0.9373	3.8489	0	0.1902	0.3437	0.04	0.266	0.9476	0.0501	0.0941	0.8527	0.0285	1.0798	10.342	1.0034	0	0.0047	0	0.0701	0.2747	0																			33.4365		1380.318536	99.04216728	696.8053252	11.2500816	6.13527826	11.08640128	1.288834775	8.581467579	30.56683079	1.00483837	1.886979649	17.10607693	0.571274837	21.66129597	270.6686871	26.26134499	0	0.123074807	0	1.835489065	8.862774282	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																			8.547697049	8.547697049	4.989077257	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																			8.547697049	8.547697049	4.989077257	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	0.2	0	0.2	0.2	0																			0.9832	0.070548537	0.2897013	0	1.227055652	2.217280257	0.257766955	1.716293516	6.113366158	0.200967674	0.37739593	3.421215386	0.114254967	4.332259194	54.13373741	5.252268997	0	0.024614961	0	0.367097813	1.772554856	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.8716			14.0459	1.007836239	4.138590001	0	1.417249278	2.560958696	0.297720833	1.982319011	7.060937913	0.251058465	0.47146111	4.273946478	0.142732789	5.412066134	64.47574467	6.255691385	0	0.029317539	0	0.4372302	2.047300859	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.308																																																																																		0			14.0459	1.007836239	4.138590001	0	1.417249278	2.560958696	0.297720833	1.982319011	7.060937913	0.251058465	0.47146111	4.273946478	0.142732789	5.412066134	64.47574467	6.255691385	0	0.029317539	0	0.4372302	2.047300859	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.308
H4513_806_0	2009	2																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																			13.0627	0.9373	3.8489	0	0.1902	0.3437	0.04	0.266	0.9476	0.0501	0.0941	0.8527	0.0285	1.0798	10.342	1.0034	0	0.0047	0	0.0701	0.2747	0																			33.4365		1380.318536	99.04216728	696.8053252	11.2500816	6.13527826	11.08640128	1.288834775	8.581467579	30.56683079	1.00483837	1.886979649	17.10607693	0.571274837	21.66129597	270.6686871	26.26134499	0	0.123074807	0	1.835489065	8.862774282	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																			8.547697049	8.547697049	4.989077257	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																			8.547697049	8.547697049	4.989077257	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	0.2	0	0.2	0.2	0																			0.9832	0.070548537	0.2897013	0	1.227055652	2.217280257	0.257766955	1.716293516	6.113366158	0.200967674	0.37739593	3.421215386	0.114254967	4.332259194	54.13373741	5.252268997	0	0.024614961	0	0.367097813	1.772554856	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.8716			14.0459	1.007836239	4.138590001	0	1.417249278	2.560958696	0.297720833	1.982319011	7.060937913	0.251058465	0.47146111	4.273946478	0.142732789	5.412066134	64.47574467	6.255691385	0	0.029317539	0	0.4372302	2.047300859	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.308																																																																																		0			14.0459	1.007836239	4.138590001	0	1.417249278	2.560958696	0.297720833	1.982319011	7.060937913	0.251058465	0.47146111	4.273946478	0.142732789	5.412066134	64.47574467	6.255691385	0	0.029317539	0	0.4372302	2.047300859	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.308
H4514_001_0	2009	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	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2792.052629	182.8672049	573.4629689	767.9513927	303.7396658	18.25479561	10.62538999	483.1784716	180.7625189	3137.344521	1262.513941	0	0.30551841	1639.562756	5460.390034	2988.251143	882.5932777	256.6229445	0	0	11.34442505	531.5447198	391.4973988	232.9004145	101.1587104	116.2062833	17.98400436	0.236119869	20.2	0											"$125 Days 1-20 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$125 Days 1-20 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$50 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); $30 (4b)	$30 (9b)	$0/$30 (8a1); $30/$0 (8a2)	"$30 (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 5, 9a); $35/$25 (9c); $100 (9d)"	"$10 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$30 (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"$35/$25 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											123.9427149	125	0	0	50	0.2	0.2	49.94337753	30	12	30	0	0.2	30.02027576	8.565220211	29.99644428	32.5	30	0	0	0.2	29.7334713	0	0	0	0	0	0	0	0											82.40472208	83.10767008	0	0	33.24306803	0.132972272	0.132972272	33.20542194	19.94584082	7.978336328	19.94584082	0	0.132972272	19.95932139	5.694683964	19.94347676	21.60799422	19.94584082	0	0	0.132972272	19.76863619	0	0	0	0	0	0	0	0											19.1732	1.266472278	0	0	0.841436531	2.42738165	1.41288225	1.337012085	0.300455036	2.085899147	2.098491842	0	0.040625477	2.727046666	2.591266297	4.9663431	1.58925587	0.4265467	0	0	1.508493974	0.875659515	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.6685	0	23.0202	19.1732	1.266472278	0	0	0.841436531	2.42738165	1.41288225	1.337012085	0.300455036	2.085899147	2.098491842	0	0.040625477	2.727046666	2.591266297	4.9663431	1.58925587	0.4265467	0	0	1.508493974	0.875659515	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.6685																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.1732	1.266472278	0	0	0.841436531	2.42738165	1.41288225	1.337012085	0.300455036	2.085899147	2.098491842	0	0.040625477	2.727046666	2.591266297	4.9663431	1.58925587	0.4265467	0	0	1.508493974	0.875659515	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.6685
H4514_004_0	2009	4																					2100											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2452.140691	176.4899031	17.44059245	9232.268815	205.142146	18.8440959	10.87155528	488.4207427	246.7118726	4589.71713	1536.653585	0	0.235244183	3602.638105	6357.768715	3755.774915	903.880677	401.9906164	0	0	32.78336415	761.8256273	1273.149456	0	3.752080964	13.34073232	0	0	20.2	0											"$150 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$150 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$75 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5, 9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											148.542875	150	0.194773676	0	75	0.14	0.09768918	49.97952585	75	4.4	37.14534858	0	0.2	74.52402408	3.980032706	25	20	20	0	0	0.2	22.24635944	0	0	0	0	0	0	0	0											85.69495812	86.53557918	0.194773676	0	43.26778959	0.080766541	0.056357265	28.83338144	43.26778959	2.538376989	21.42929502	0	0.115380772	42.99319724	3.980032706	25	20	20	0	0	0.115380772	22.24635944	0	0	0	0	0	0	0	0											17.5113	1.272721332	3.396968311	0	0.739670601	1.521972436	0.612691122	1.173568465	0.889556449	0.970869363	2.744116918	0	0.027142656	12.90741089	2.108677285	7.824531073	1.506467795	0.669984361	0	0	3.782569873	1.412320562	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.0726	0	32.3819	17.5113	1.272721332	3.396968311	0	0.739670601	1.521972436	0.612691122	1.173568465	0.889556449	0.970869363	2.744116918	0	0.027142656	12.90741089	2.108677285	7.824531073	1.506467795	0.669984361	0	0	3.782569873	1.412320562	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.0726																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.5113	1.272721332	3.396968311	0	0.739670601	1.521972436	0.612691122	1.173568465	0.889556449	0.970869363	2.744116918	0	0.027142656	12.90741089	2.108677285	7.824531073	1.506467795	0.669984361	0	0	3.782569873	1.412320562	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.0726
H4514_005_0	2009	5																					2400											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1642.125993	755.3313149	7937.196152	110.2587579	637.8628772	14.6117357	16.6933936	180.4401459	118.1070943	13322.74097	1751.435025	0	6.562574647	298.2953627	178.8288702	8483.670876	5957.422103	43.79078043	0	0	1568.226696	1003.181455	1576.881712	0	191.5790143	148.7435641	0	0	0	0											"$175 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $35 (4b)	$35 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$35 (3, 5, 9a, 9d); $35/$25 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $35 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$15 (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"$35/$25 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											173.6011825	175	0	0	75	0.2	0.2	49.81663475	35	0	0	0	0	34.82135723	0	14.54442594	32.5	0	0	0	0	14.67406104	0	0	0	0	0	0	0	0											137.0676649	138.1721082	0	0	59.21661778	0.157910981	0.157910981	39.33296826	27.63442163	0	0	0	0	27.49337336	0	11.48362282	25.66053437	0	0	0	0	11.58597685	0	0	0	0	0	0	0	0											18.7569	8.697143345	0	0	3.147673516	2.307353515	2.636070155	0.591437211	0.271985104	0	0	0	0	0.683428815	0	8.118606376	12.73921955	0	0	0	0	0.968569759	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.9184	0	15.7039	18.7569	8.697143345	0	0	3.147673516	2.307353515	2.636070155	0.591437211	0.271985104	0	0	0	0	0.683428815	0	8.118606376	12.73921955	0	0	0	0	0.968569759	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.9184																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.7569	8.697143345	0	0	3.147673516	2.307353515	2.636070155	0.591437211	0.271985104	0	0	0	0	0.683428815	0	8.118606376	12.73921955	0	0	0	0	0.968569759	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.9184
H4514_007_0	2009	5																					2500											D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1892.248264	130.8969262	909.5642794	761.4244695	173.301774	13.9511793	5.752309291	544.9133231	251.5327925	11965.29741	53.64773479	0	0.48438309	1523.610457	6106.181943	4635.985809	571.1680298	273.9752628	0	0	20.073352	936.164114	0	0	127.3088558	0	18.48897947	0	453.6	0											"$185 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$185 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-25 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$100 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); $100 (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											182.8342595	185	100	0	150	0.2	0.066275231	48.42576017	100	2.8	0.172851065	0	0.2	35.72007692	7.40622356	20	37.5	20	0	0	0.2	19.20206141	0	0	20	0	20	0	0	0											118.7528872	120.1376026	64.93924466	0	97.40886699	0.129878489	0.043038634	31.44732288	64.93924466	1.818298851	0.112248176	0	0.129878489	23.27077192	7.40622356	20	37.5	12.98784893	0	0	0.129878489	19.20206141	0	0	20	0	20	0	0	0											18.7258	1.310470242	4.92220144	0	1.406760788	1.811958091	0.247571537	1.428005434	1.361195796	1.813040545	6.02186038	0	0.062910944	2.95463262	3.768645714	7.726643015	1.784900093	0.29652911	0	0	2.607096633	1.498023401	0	0	0.212181426	0	0.030814966	0	0	0	0	0	0	0	0	0	0	0	0	0	59.9913	0	24.2596	18.7258	1.310470242	4.92220144	0	1.406760788	1.811958091	0.247571537	1.428005434	1.361195796	1.813040545	6.02186038	0	0.062910944	2.95463262	3.768645714	7.726643015	1.784900093	0.29652911	0	0	2.607096633	1.498023401	0	0	0.212181426	0	0.030814966	0	0	0	0	0	0	0	0	0	0	0	0	0	59.9913																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.7258	1.310470242	4.92220144	0	1.406760788	1.811958091	0.247571537	1.428005434	1.361195796	1.813040545	6.02186038	0	0.062910944	2.95463262	3.768645714	7.726643015	1.784900093	0.29652911	0	0	2.607096633	1.498023401	0	0	0.212181426	0	0.030814966	0	0	0	0	0	0	0	0	0	0	0	0	0	59.9913
H4514_010_0	2009	5																					3650											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1864.736349	191.9308278	1165.201056	988.5354315	149.1936621	16.07078189	5.936129583	424.2615245	48.82088241	13212.67063	56.81569404	0	0.295719552	36.94122204	6641.002331	5231.849982	823.8073129	296.3187188	0	0	24.48864109	1135.782759	0	0	147.9890135	0	18.41008798	0	453.6	0											"$240 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$240 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$115 Days 1-25 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$5 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											237.1736087	240	87.8078022	0	150	0.2	0.076056143	49.51688051	0.2	2.8	0.171294964	0	0.2	0.196954599	3.588458119	25	37.5	25	0	0	0.2	23.79925092	0	0	25	0	25	0	0	0											159.7753739	161.658332	59.14526184	0	101.0364575	0.134715277	0.051229622	33.35340129	0.134715277	1.886013874	0.115380243	0	0.134715277	0.132946972	3.588458119	25	37.5	16.83940959	0	0	0.134715277	23.79925092	0	0	25	0	25	0	0	0											24.8282	2.585601457	5.74301013	0	1.256166592	2.164979828	0.304105673	1.17921374	6.576918681	2.076606677	6.555408559	0	0.039837941	4.911223596	1.985913227	10.89968746	2.574397853	0.415819356	0	0	3.29899406	2.252564906	0	0	0.308310445	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	79.9954	0	29.9947	24.8282	2.585601457	5.74301013	0	1.256166592	2.164979828	0.304105673	1.17921374	6.576918681	2.076606677	6.555408559	0	0.039837941	4.911223596	1.985913227	10.89968746	2.574397853	0.415819356	0	0	3.29899406	2.252564906	0	0	0.308310445	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	79.9954																																										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	24.8282	2.585601457	5.74301013	0	1.256166592	2.164979828	0.304105673	1.17921374	6.576918681	2.076606677	6.555408559	0	0.039837941	4.911223596	1.985913227	10.89968746	2.574397853	0.415819356	0	0	3.29899406	2.252564906	0	0	0.308310445	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	79.9954
H4514_801_0	2009	2																					5000											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2048.026969	210.7962939	1279.732219	1085.701592	163.8583619	18.46223085	6.819468739	465.9115854	56.08578397	14511.3843	65.27028158	0	0.339724767	42.43834393	7279.981013	5735.220029	904.7818446	325.4447889	0	0	28.13272858	1247.422308	0	0	0	0	0	0	0	0											"$470 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$470 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-34 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											464.403823	470	150	0	150	0.2	0.076056143	49.51682669	0.3	2.8	0.24162434	0	0.2	0.294978221	25.16677362	39.69195835	37.5	40	0	0	0.2	38.06807164	0	0	0	0	0	0	0	0											278.7375233	282.0705512	90.02251633	0	90.02251633	0.120030022	0.045645103	29.71752893	0.180045033	1.680420305	0.145010874	0	0.120030022	0.177362633	25.16677362	39.69195835	37.5	24.00600435	0	0	0.120030022	38.06807164	0	0	0	0	0	0	0	0											47.5718	4.954952233	9.600392884	0	1.229245171	2.21602197	0.31127535	1.153811752	10.09796681	2.032102069	9.464900581	0	0.040777171	7.52697642	15.26780284	18.97017621	2.827443264	0.651052418	0	0	3.376772024	3.957246816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.2507	0	66.7462	47.5718	4.954952233	9.600392884	0	1.229245171	2.21602197	0.31127535	1.153811752	10.09796681	2.032102069	9.464900581	0	0.040777171	7.52697642	15.26780284	18.97017621	2.827443264	0.651052418	0	0	3.376772024	3.957246816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.2507																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	47.5718	4.954952233	9.600392884	0	1.229245171	2.21602197	0.31127535	1.153811752	10.09796681	2.032102069	9.464900581	0	0.040777171	7.52697642	15.26780284	18.97017621	2.827443264	0.651052418	0	0	3.376772024	3.957246816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.2507
H4514_803_0	2009	2																					5000											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2048.026969	210.7962939	1279.732219	1085.701592	163.8583619	18.46223085	6.819468739	466.0800859	56.08578397	14511.3843	65.27028158	0	0.339724767	42.43834393	7398.733769	5735.220029	904.7818446	325.4447889	0	0	28.13272858	1247.422308	0	0	0	0	0	0	0	0											"$470 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$470 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-34 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											464.403823	470	150	0	150	0.2	0.076056143	49.51700137	0.3	2.8	0.24162434	0	0.2	0.294978221	24.76283643	39.69195835	37.5	40	0	0	0.2	38.06807164	0	0	0	0	0	0	0	0											278.7369825	282.0700038	90.02234165	0	90.02234165	0.120029789	0.045645014	29.7175761	0.180044683	1.680417044	0.145010593	0	0.120029789	0.17736229	24.76283643	39.69195835	37.5	24.00595777	0	0	0.120029789	38.06807164	0	0	0	0	0	0	0	0											47.5717	4.954942618	9.600374256	0	1.229242786	2.21601767	0.311274746	1.154230868	10.09794721	2.032098126	9.464882215	0	0.040777092	7.526961883	15.26780284	18.97017621	2.827443264	0.651051155	0	0	3.376765472	3.957246816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.251	0	66.7467	47.5717	4.954942618	9.600374256	0	1.229242786	2.21601767	0.311274746	1.154230868	10.09794721	2.032098126	9.464882215	0	0.040777092	7.526961883	15.26780284	18.97017621	2.827443264	0.651051155	0	0	3.376765472	3.957246816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.251																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	47.5717	4.954942618	9.600374256	0	1.229242786	2.21601767	0.311274746	1.154230868	10.09794721	2.032098126	9.464882215	0	0.040777092	7.526961883	15.26780284	18.97017621	2.827443264	0.651051155	0	0	3.376765472	3.957246816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.251
H4514_806_0	2009	2																					5000											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2048.026969	210.7962939	1279.732219	1085.701592	163.8583619	18.46223085	6.819468739	465.9115854	56.08578397	14511.3843	65.27028158	0	0.339724767	42.43834393	7279.981013	5735.220029	904.7818446	325.4447889	0	0	28.13272858	1247.422308	0	0	0	0	0	0	0	0											"$470 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$470 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-34 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											464.403823	470	150	0	150	0.2	0.076056143	49.51682669	0.3	2.8	0.24162434	0	0.2	0.294978221	25.16677362	39.69195835	37.5	40	0	0	0.2	38.06807164	0	0	0	0	0	0	0	0											278.7375233	282.0705512	90.02251633	0	90.02251633	0.120030022	0.045645103	29.71752893	0.180045033	1.680420305	0.145010874	0	0.120030022	0.177362633	25.16677362	39.69195835	37.5	24.00600435	0	0	0.120030022	38.06807164	0	0	0	0	0	0	0	0											47.5718	4.954952233	9.600392884	0	1.229245171	2.21602197	0.31127535	1.153811752	10.09796681	2.032102069	9.464900581	0	0.040777171	7.52697642	15.26780284	18.97017621	2.827443264	0.651052418	0	0	3.376772024	3.957246816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.2507	0	66.7462	47.5718	4.954952233	9.600392884	0	1.229245171	2.21602197	0.31127535	1.153811752	10.09796681	2.032102069	9.464900581	0	0.040777171	7.52697642	15.26780284	18.97017621	2.827443264	0.651052418	0	0	3.376772024	3.957246816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.2507																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	47.5718	4.954952233	9.600392884	0	1.229245171	2.21602197	0.31127535	1.153811752	10.09796681	2.032102069	9.464900581	0	0.040777171	7.52697642	15.26780284	18.97017621	2.827443264	0.651052418	0	0	3.376772024	3.957246816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.2507
H4514_807_0	2009	2																					5000											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2048.026969	210.7962939	1279.732219	1085.701592	163.8583619	18.46223085	6.819468739	466.0800859	56.08578397	14511.3843	65.27028158	0	0.339724767	42.43834393	7398.733769	5735.220029	904.7818446	325.4447889	0	0	28.13272858	1247.422308	0	0	0	0	0	0	0	0											"$470 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$470 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-34 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											464.403823	470	150	0	150	0.2	0.076056143	49.51700137	0.3	2.8	0.24162434	0	0.2	0.294978221	24.76283643	39.69195835	37.5	40	0	0	0.2	38.06807164	0	0	0	0	0	0	0	0											278.7369825	282.0700038	90.02234165	0	90.02234165	0.120029789	0.045645014	29.7175761	0.180044683	1.680417044	0.145010593	0	0.120029789	0.17736229	24.76283643	39.69195835	37.5	24.00595777	0	0	0.120029789	38.06807164	0	0	0	0	0	0	0	0											47.5717	4.954942618	9.600374256	0	1.229242786	2.21601767	0.311274746	1.154230868	10.09794721	2.032098126	9.464882215	0	0.040777092	7.526961883	15.26780284	18.97017621	2.827443264	0.651051155	0	0	3.376765472	3.957246816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.251	0	66.7467	47.5717	4.954942618	9.600374256	0	1.229242786	2.21601767	0.311274746	1.154230868	10.09794721	2.032098126	9.464882215	0	0.040777092	7.526961883	15.26780284	18.97017621	2.827443264	0.651051155	0	0	3.376765472	3.957246816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.251																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	47.5717	4.954942618	9.600374256	0	1.229242786	2.21601767	0.311274746	1.154230868	10.09794721	2.032098126	9.464882215	0	0.040777092	7.526961883	15.26780284	18.97017621	2.827443264	0.651051155	0	0	3.376765472	3.957246816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.251
H4520_001_0	2009	6	r.	s.	t.	u.	v.						OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered						5000	Renal Dialysis										A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin				V				O	O	P	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		268.394695	8.64763	521.422773	745.231277	148.227197	10.35387	3.739124	335.278797	363.431395	642.537973	953.664601	0	0	729.545454	3570.60861	4304.053119	29.360504	927.69132			23.401504				2.47				1.81	0.27	19.54988	0.06	0.05	1.23	2.7						$750/Admit:1a	$750/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$125/Visit:9b. $0 Surgery ASC -- Physician,9b. $125 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $125 Surgery OP -- Facility"	"$0-$125/Visit:8a. $0 Lab -- FSL,8. $125 Lab -- OP"	"$0-$125/Visit:14h. $125 DMAM -- OP,8b. $25 Radiology -- FSR,14h. $25 SMAM -- FSR,14h. $125 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $125 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $125 Radiology OP -- Facility"	$125/Visit:9a	20% Coins:12	"$35-$125/Visit:9d. $125 Cardiac Rehab,8b. $125 Nuclear Medicine,9a. $125 OP Other,5. $35 Partial Hospitalization,8b. $100 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$125/Visit:7h. $125 Psych -- OP,7e. $35 Psych -- Other Provider"	"$35-$125/Visit:9a. $125 Therapy (AT,PT,ST,OT) -- OP,7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			"0%-20% Coins:15. 20% Part B Rx,15. 0% Part B Rx at Pharmacy,15. 20% Part B Rx - Chemo"				Vision Standard 8				$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	$0/Proc:12	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0 Health Education Materials 14a	$0 Corp Health 14a						749.999981	750.000177	43.132799	0	100.000028	0.2	0.199999	50	125.000009	109.946746	97.853672	0	0.2	88.96545	15	34.999999	110.952725	54.417294			0.155209				0				0	0	0	0	0	0	0						657.175483	657.175655	37.794425	0	87.623425	0.175246	0.175246	43.8117	109.529258	96.339077	85.742715	0	0.18	77.954552	13.14351	30.668189	97.22055	47.682283			0.135999				0				0	0	0	0	0	0	0						14.6985	0.473584326	1.642239491	0	1.08234789	1.814474302	0.655266525	1.224094506	3.317197586	5.158459605	6.814149341	0	0	4.739282419	3.910860831	10.99979288	0.237870362	3.686203338	0	0	3.182581142	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6369	0	8.9886	14.6985	0.473584326	1.642239491	0	1.08234789	1.814474302	0.655266525	1.224094506	3.317197586	5.158459605	6.814149341	0	0	4.739282419	3.910860831	10.99979288	0.237870362	3.686203338	0	0	3.182581142	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6369		$950/Admit	$950/Admit	$0/Day(Days 1-20) $125(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins			30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			0%-30% Coins				Vision Standard 8				0	0		0	0	0	0						2.5134	0.081	0.2165	0.7611	0.8767	2.0965	0.7571	0.2625	3.6231	0.4667	1.9414			1.0966	2.1987	5.0198	0.0317	0.4239			1.1628				0				0	0		0	0	0	0						23.5293	500	0	17.212	0.554566326	1.858744491	0.761059	1.95904189	3.910985302	1.412386525	1.486553506	6.940259586	5.625194605	8.755547341	0	0	5.835852419	6.109512831	16.01957188	0.269593362	4.110061338	0	0	4.345378142	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.1663
H4520_002_0	2009	10	r.	s.	t.	u.	v.						OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered							Renal Dialysis										D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin								O	O	P	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		1517.578093	67.570652	529.656517	756.999162	150.56784	10.684601	3.858561	340.573155	369.17031	652.684236	968.723835	0	0	741.065646	3626.991787	4372.018055	29.824135	942.340417			24.149013								1.81	1.32	19.85859	0.06	0.05	1.23	2.7						$100/Day(Days 1-5):1a	$100/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $30 Radiology -- FSR,14h. $30 SMAM -- FSR,14h. $30 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$15-$100/Visit:9d. $15 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $30 Partial Hospitalization,8b. $100 Rad therapy,3. $40 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			"0%-20% Coins:15. 20% Part B Rx,15. 0% Part B Rx at Pharmacy,15. 20% Part B Rx - Chemo"								$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	$0/Proc:12	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0: Health Education Materials 14a	$0 Corp Health 14a						61.310202	51.107394	43.132791	0	99.999999	0.199999	0.199999	50.000006	99.999991	0	76.886197	0	0.2	69.617897	15	29.999999	89.074168	45.102338			0.155209								0	0	0	0	0	0	0						61.310202	51.107394	43.132791	0	99.999999	0.199999	0.199999	50.000006	99.999991	0	76.886197	0	0.2	69.617897	15	29.999999	89.074168	45.102338			0.155209								0	0	0	0	0	0	0						7.7536	0.287779995	1.903796987	0	1.254731987	2.136909515	0.771708341	1.419054983	3.076418973	0	6.206790968	0	0	4.299285984	4.533739734	10.93004477	0.221380001	3.541813	0	0	3.748144159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.0852	0	0	7.7536	0.287779995	1.903796987	0	1.254731987	2.136909515	0.771708341	1.419054983	3.076418973	0	6.206790968	0	0	4.299285984	4.533739734	10.93004477	0.221380001	3.541813	0	0	3.748144159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.0852		$950/Admit	$950/Admit	20% Coins(Days 1-20) 20%(Days 21-100)	20% Coins	$100/Trip	20% Coins	20% Coins	$50/Visit	20% Coins	20% Coins	20% Coins			20% Coins	20% Coins	20% Coins	20% Coins	20% Coins			20% Coins								0	0		0	0	0	0						2.3982	0.0773	0.3242	0.4918	0.8365	1.3548	0.4893	0.2504	2.3412	0.3016	1.2545			0.7086	1.4208	3.2438	0.0205	0.2739			0.9683								0	0		0	0	0	0						16.7556	0	0	10.1517	0.365047995	2.227966987	0.491801	2.091219987	3.491688515	1.260963341	1.669475983	5.417664973	0.301607	7.461333968	0	0	5.007896984	5.954522734	14.17385977	0.241880001	3.815713	0	0	4.716395159	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.8408
H4520_003_0	2009	9	r.	s.	t.	u.							OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered							5000	Renal Dialysis										D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin								O	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		1445.13878	64.345269	504.374157	720.864943	143.380711	9.687862	3.498606	324.316407	351.548519	621.529332	922.483257	0	0	705.69199	3453.862776	4163.326333	28.400523	897.359211			21.896213								1.81	0.05	18.91067	0.06	1.23	2.7							$200/Day(Days 1-5):1a	$200/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$10/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$125/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $125 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$100/Visit:14h. $50 DMAM -- OP,8b. $30 Radiology -- FSR,14h. $30 SMAM -- FSR,14h. $30 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$15-$100/Visit:9d. $15 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $50 OP Other,5. $35 Partial Hospitalization,8b. $50 Rad therapy,3. $40 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$50/Visit:7h. $50 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			"0%-20% Coins:15. 20% Part B Rx,15. 0% Part B Rx at Pharmacy,15. 20% Part B Rx - Chemo"								$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	$0/Proc:12	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a							122.6204	102.21488	43.132788	10.000003	99.999978	0.199999	0.199999	49.999986	113.656607	0	63.268543	0	0.2	44.953765	10	30	46.878573	34.314953			0.155209								0	0	0	0	0	0							110.750132	92.319969	38.957319	9.031953	90.31948	0.180638	0.180638	45.159737	102.654079	0	57.143832	0	0.18	40.602015	9.03195	27.09585	42.340493	30.993094			0.140184								0	0	0	0	0	0							13.3374	0.495029437	1.637422077	0.54256819	1.079172605	1.749996016	0.631981191	1.220503637	3.00732412	0	4.392852355	0	0	2.38770973	2.599592992	9.400738818	0.100207679	2.317661532	0	0	3.069498723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.9697	0	5.1414	13.3374	0.495029437	1.637422077	0.54256819	1.079172605	1.749996016	0.631981191	1.220503637	3.00732412	0	4.392852355	0	0	2.38770973	2.599592992	9.400738818	0.100207679	2.317661532	0	0	3.069498723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.9697		$950/Admit	$950/Admit	15% Coins(Days 1-20) 15%(Days 21-100)	30% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	30% Coins	30% Coins	30% Coins			30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			0%-30% Coins								0	0		0	0	0							2.4971	0.0805	0.241	0.7314	0.871	2.6863	0.9701	0.2607	3.4818	0.4485	1.8657			1.0538	2.1129	4.824	0.0305	0.4073			1.1174								0	0		0	0	0							23.6801	500	0	15.8345	0.575484437	1.878465077	1.27394519	1.950155605	4.436325016	1.602103191	1.481251637	6.48908512	0.448532	6.258534355	0	0	3.44151573	4.712496992	14.22474682	0.130693679	2.724990532	0	0	4.186945723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.6498
H4520_005_0	2009	5	r.	s.	t.	u.							OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered							5000	Renal Dialysis										D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin								O	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		1697.435628	75.578867	592.429375	846.715799	168.412564	13.365828	4.826841	380.93658	412.922959	730.037867	1083.533265	0	0	828.893903	4056.848942	4890.172868	33.358776	1054.022991			30.209039								1.81	0.05	22.212155	0.06	1.23	2.7							$195/Day(Days 1-7):1a	$195/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$10/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$150/Visit:14h. $50 DMAM -- OP,8b. $30 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $150 Advanced Imaging -- FSR,8b. $150 Advanced Imaging -- Office,9a. $150 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$15-$100/Visit:9d. $15 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $50 OP Other,5. $35 Partial Hospitalization,8b. $50 Rad therapy,3. $40 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$50/Visit:7h. $50 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	$0/Proc:12	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a							138.925023	99.659445	43.132797	9.999992	99.999997	0.2	0.199999	50.000007	127.313182	0	78.124191	0	0.2	44.953772	9.999998	29.999999	46.878338	34.314947			0.199999								0	0	0	0	0	0							120.871994	86.7089	37.527776	8.700513	87.005197	0.17401	0.17401	43.502606	110.769088	0	67.972108	0	0.17	39.112119	8.700518	26.101559	40.786592	29.855789			0.17401								0	0	0	0	0	0							17.0977	0.546113368	1.852713073	0.613905151	1.221064026	2.32578773	0.839918602	1.380977829	3.811591632	0	6.137503343	0	0	2.701649748	2.941390604	10.6367613	0.113382566	2.622390668	0	0	5.256674876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.0995	0	8.9763	17.0977	0.546113368	1.852713073	0.613905151	1.221064026	2.32578773	0.839918602	1.380977829	3.811591632	0	6.137503343	0	0	2.701649748	2.941390604	10.6367613	0.113382566	2.622390668	0	0	5.256674876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.0995		$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	30% Coins	30% Coins	30% Coins			30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins								0	0		0	0	0							2.7223	0.0877	0.6173	0.9366	0.9496	3.44	1.2423	0.2843	4.4586	0.5744	2.3891			1.3495	2.7057	6.1774	0.039	0.5216			1.8439								0	0		0	0	0							30.3393	500	0	19.82	0.633827368	2.470053073	1.550476151	2.170628026	5.76578873	2.082216602	1.665250829	8.270189632	0.574371	8.526617343	0	0	4.051107748	5.647087604	16.8141843	0.152422566	3.143998668	0	0	7.100581876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.4388
H4520_006_0	2009	7	r.	s.	t.	u.	v.						OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered							Renal Dialysis										D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin	V				O	O	P	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		1510.582086	67.259154	527.214809	753.509409	149.873726	10.585168	3.822653	339.003119	367.468439	649.675372	964.258034	0	0	737.649348	3610.271421	4351.863129	29.686645	937.996244			23.924274			4.18	2.47				1.81	0.27	19.767043	0.06	0.05	1.23	2.7						$175/Day(Days 1-5):1a	$175/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$10/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$125/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $125 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$100/Visit:14h. $50 DMAM -- OP,8b. $30 Radiology -- FSR,14h. $30 SMAM -- FSR,14h. $30 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$15-$100/Visit:9d. $15 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $50 OP Other,5. $35 Partial Hospitalization,8b. $50 Rad therapy,3. $40 Therapy (AT,PT,ST,OT) -- CORF"	$5/Visit:7a	"$25/Visit:7b, 7d, 7f"	"$25-$50/Visit:7h. $50 Psych -- OP,7e. $25 Psych -- Other Provider"	"$25-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $25 Therapy (AT,PT,ST,OT) - Specialist"			"0%-15% Coins:15. 15% Part B Rx,15. 0% Part B Rx at Pharmacy,15. 15% Part B Rx - Chemo"			"Dental 16a, 16b"	Vision Standard 08 PPO				$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	$0/Proc:12	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0 Health Education Materials 14a	$0 Corp Health 14a						107.292846	89.437877	43.132802	10.000007	100.000022	0.2	0.2	50	113.656585	0	63.26855	0	0.2	44.953749	5	24.999998	46.0979	30.393691			0.116406			0	0				0	0	0	0	0	0	0						107.292846	89.437877	43.132802	10.000007	100.000022	0.2	0.2	50	113.656585	0	63.26855	0	0.2	44.953749	5	24.999998	46.0979	30.393691			0.116406			0	0				0	0	0	0	0	0	0						13.5062	0.501292995	1.895020997	0.627924947	1.248947991	2.1170336	0.7645306	1.412512996	3.480433989	0	5.08393397	0	0	2.76334197	1.504279759	9.066380793	0.114040999	2.375764	0	0	2.784929039	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.2466	0	0	13.5062	0.501292995	1.895020997	0.627924947	1.248947991	2.1170336	0.7645306	1.412512996	3.480433989	0	5.08393397	0	0	2.76334197	1.504279759	9.066380793	0.114040999	2.375764	0	0	2.784929039	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.2466		$950/Admit	$950/Admit	20% Coins(Days 1-20) 20%(Days 21-100)	20% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	20% Coins	20% Coins	15%-20% Coins			20% Coins	15% Coins	15% Coins	15%-20% Coins	15%-20% Coins			0%-15% Coins			"Dental 16a, 16b"	Vision Standard 08 PPO				0	0		0	0	0	0						2.3871	0.0769	0.3212	0.4872	0.8326	2.6843	0.9694	0.2493	2.3195	0.2988	1.189			0.702	1.0557	2.4102	0.0201	0.2203			0.5583			0	0				0	0		0	0	0	0						16.7819	0	0	15.8933	0.578204995	2.216174997	1.115148947	2.081579991	4.8013766	1.7339356	1.661779996	5.799891989	0.2988	6.27293197	0	0	3.46535897	2.559950759	11.47660079	0.134122999	2.596097	0	0	3.343239039	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.0285
H4520_016_0	2009	5	r.	s.	t.	u.							OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered								Renal Dialysis										D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin								O	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		1514.103361	67.415939	528.443785	755.265894	150.223093	10.634571	3.840494	339.79336	368.325036	651.189813	966.505787	0	0	739.368861	3618.687221	4362.007636	29.755847	940.182781			24.035934								1.81	0.05	19.813122	0.06	1.23	2.7							$175/Day(Days 1-7):1a	$175/Day(Days 1-7):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$75/Visit:9b. $0 Surgery ASC -- Physician,9b. $50 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $75 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$150/Visit:14h. $75 DMAM -- OP,8b. $30 Radiology -- FSR,14h. $25 SMAM -- FSR,14h. $25 SMAM -- OP,8b. $150 Advanced Imaging -- FSR,8b. $150 Advanced Imaging -- Office,9a. $150 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $75 Radiology OP -- Facility"	$75/Visit:9a	20% Coins:12	"$15-$150/Visit:9d. $15 Cardiac Rehab,8b. $150 Nuclear Medicine,9a. $75 OP Other,5. $30 Partial Hospitalization,8b. $75 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$75/Visit:7h. $75 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			"0%-15% Coins:15. 15% Part B Rx,15. 0% Part B Rx at Pharmacy,15. 15% Part B Rx - Chemo"								$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	$0/Proc:12	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a							124.676299	110.261758	43.132792	0	99.999991	0.199999	0.2	50.000011	63.656601	0	89.113726	0	0.2	58.881581	14.999999	30.000002	67.976421	39.70864			0.116406								0	0	0	0	0	0							124.676299	110.261758	43.132792	0	99.999991	0.199999	0.2	50.000011	63.656601	0	89.113726	0	0.2	58.881581	14.999999	30.000002	67.976421	39.70864			0.116406								0	0	0	0	0	0							15.7311	0.619449996	1.899437989	0	1.251858996	2.126903565	0.7680988	1.415805978	1.953859988	0	7.17741099	0	0	3.627933956	4.523358725	10.90501982	0.168557999	3.111114965	0	0	2.797926933	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.0778	0	0	15.7311	0.619449996	1.899437989	0	1.251858996	2.126903565	0.7680988	1.415805978	1.953859988	0	7.17741099	0	0	3.627933956	4.523358725	10.90501982	0.168557999	3.111114965	0	0	2.797926933	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.0778		$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		20% Coins	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			15% Coins								0	0		0	0	0							2.7296	0.0879	0.5521	0.8376	0.9521	2.3075	0.8333	0.285	3.9876	0.5137	2.1367		0	1.2069	2.4199	5.5249	0.0349	0.4665			0.8246								0	0		0	0	0							25.7009	500	0	18.4607	0.707395996	2.451567989	0.837639	2.203950996	4.434373565	1.6014018	1.700835978	5.941486988	0.513699	9.31415599	0	0	4.834847956	6.943246725	16.42990882	0.203473999	3.577623965	0	0	3.622491933	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.7788
H4520_018_0	2009	7	r.	s.	t.	u.							OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered								Renal Dialysis										D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin				V				O	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							0		1612.258187	71.786314	562.701226	804.227539	159.961609	12.058071	4.354567	361.821155	392.202454	693.404514	1029.16149	0	0	787.299947	3853.275971	4644.78364	31.684831	1001.132039			27.253286				2.47				1.81	0.05	21.097547	0.06	1.23	2.7							$175/Day(Days 1-5):1a	$175/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$75/Visit:9b. $0 Surgery ASC -- Physician,9b. $50 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $75 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$100/Visit:14h. $75 DMAM -- OP,8b. $30 Radiology -- FSR,14h. $25 SMAM -- FSR,14h. $25 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $75 Radiology OP -- Facility"	$75/Visit:9a	20% Coins:12	"$15-$100/Visit:9d. $15 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $75 OP Other,5. $30 Partial Hospitalization,8b. $75 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$5/Visit:7a	"$20/Visit:7b, 7d, 7f"	"$20-$75/Visit:7h. $75 Psych -- OP,7e. $20 Psych -- Other Provider"	"$20-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $20 Therapy (AT,PT,ST,OT) - Specialist"			"0%-15% Coins:15. 15% Part B Rx,15. 0% Part B Rx at Pharmacy,15. 15% Part B Rx - Chemo"				Vision Standard 8 PPO				$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	$0/Proc:12	$0: Nurse hotline 14a	$0 Health Education Materials 14a	$0 Corp Health 14a							107.292852	89.437939	43.132793	0	99.999969	0.199999	0.2	49.999995	63.656572	43.978692	69.241249	0	0.2	56.387093	5.000001	19.999999	66.41525	31.866118			0.116406				0				0	0	0	0	0	0							107.292852	89.437939	43.132793	0	99.999969	0.199999	0.2	49.999995	63.656572	43.978692	69.241249	0	0.2	56.387093	5.000001	19.999999	66.41525	31.866118			0.116406				0				0	0	0	0	0	0							14.4153	0.535034998	2.022572958	0	1.333012995	2.411602142	0.8709134	1.507587995	2.080521979	2.541251963	5.938368916	0	0	3.699462944	1.605531976	7.74130568	0.175362998	2.658515974	0	0	3.17244601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.7088	0	0	14.4153	0.535034998	2.022572958	0	1.333012995	2.411602142	0.8709134	1.507587995	2.080521979	2.541251963	5.938368916	0	0	3.699462944	1.605531976	7.74130568	0.175362998	2.658515974	0	0	3.17244601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.7088		$950/Admit	$950/Admit	20% Coins(Days 1-20) 20%(Days 21-100)	20% Coins	$100/Trip	20% Coins	20% Coins	$50/Visit	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins	20% Coins			15% Coins				Vision Standard 8 PPO				0	0		0	0	0							2.5478	0.0821	0.3658	0.555	0.8887	1.5289	0.5521	0.266	2.6422	0.3404	1.4158		0	0.7997	1.6034	3.6608	0.0231	0.3091			0.8195				0				0	0		0	0	0							18.4006	0	0	16.9631	0.617123998	2.388413958	0.555021	2.221688995	3.940534142	1.4230614	1.773632995	4.722727979	2.881628963	7.354179916	0	0	4.499163944	3.208951976	11.40210268	0.198498998	2.967624974	0	0	3.99198301	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.1094
H4520_801_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		271.575456	8.750114	527.602185	754.063057	5.371258	10.600728	3.828272	23.568549	60.58322	650.152728	32.758413	0	0.413366	18.662361	35.157398	80.268458	0.507273	6.777683			23.959443																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000003	1023.999458	43.132793	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.5	0.199999			0.199999																				1024.000003	1023.999458	43.132793	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.5	0.199999			0.199999																				23.1744	0.746675999	1.896412986	0	1.0742516	2.1201456	0.7656544	4.7137098	12.116644	0	6.5516826	0	0.082672787	3.732453538	7.0314796	16.05361133	0.2536365	1.355529822	0	0	4.791864641	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4609	0	0	23.1744	0.746675999	1.896412986	0	1.0742516	2.1201456	0.7656544	4.7137098	12.116644	0	6.5516826	0	0.082672787	3.732453538	7.0314796	16.05361133	0.2536365	1.355529822	0	0	4.791864641	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4609		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.5749	0.083	0.2107		0.6811	1.3441	0.4854	0.8879	2.3229		1.2447		0.0156	0.703	1.4096	3.2184	0.0508	0.2717			0.9607																				16.4645	0	0	25.7494	0.829639999	2.107125986	0	1.7553126	3.4642906	1.2510694	5.6015848	14.439512	0	7.7963776	0	0.098244787	4.435503538	8.4411096	19.27196233	0.3044845	1.627279822	0	0	5.752515641	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.9254
H4520_804_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		271.575456	8.750114	527.602185	754.063057	5.371258	10.600728	3.828272	23.568549	60.58322	650.152728	32.758413	0	0.413366	18.662361	35.157398	80.268458	0.507273	6.777683			23.959443																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000003	1023.999458	43.132793	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.5	0.199999			0.199999																				1024.000003	1023.999458	43.132793	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.5	0.199999			0.199999																				23.1744	0.746675999	1.896412986	0	1.0742516	2.1201456	0.7656544	4.7137098	12.116644	0	6.5516826	0	0.082672787	3.732453538	7.0314796	16.05361133	0.2536365	1.355529822	0	0	4.791864641	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4609	0	0	23.1744	0.746675999	1.896412986	0	1.0742516	2.1201456	0.7656544	4.7137098	12.116644	0	6.5516826	0	0.082672787	3.732453538	7.0314796	16.05361133	0.2536365	1.355529822	0	0	4.791864641	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4609		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.5749	0.083	0.2107		0.6811	1.3441	0.4854	0.8879	2.3229		1.2447		0.0156	0.703	1.4096	3.2184	0.0508	0.2717			0.9607																				16.4645	0	0	25.7494	0.829639999	2.107125986	0	1.7553126	3.4642906	1.2510694	5.6015848	14.439512	0	7.7963776	0	0.098244787	4.435503538	8.4411096	19.27196233	0.3044845	1.627279822	0	0	5.752515641	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.9254
H4520_805_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		271.575456	8.750114	527.602185	754.063057	5.371258	10.600728	3.828272	23.568549	60.58322	650.152728	32.758413	0	0.413366	18.662361	35.157398	80.268458	0.507273	6.777683			23.959443																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000003	1023.999458	43.132793	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.5	0.199999			0.199999																				1024.000003	1023.999458	43.132793	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.5	0.199999			0.199999																				23.1744	0.746675999	1.896412986	0	1.0742516	2.1201456	0.7656544	4.7137098	12.116644	0	6.5516826	0	0.082672787	3.732453538	7.0314796	16.05361133	0.2536365	1.355529822	0	0	4.791864641	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4609	0	0	23.1744	0.746675999	1.896412986	0	1.0742516	2.1201456	0.7656544	4.7137098	12.116644	0	6.5516826	0	0.082672787	3.732453538	7.0314796	16.05361133	0.2536365	1.355529822	0	0	4.791864641	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4609		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.5749	0.083	0.2107		0.6811	1.3441	0.4854	0.8879	2.3229		1.2447		0.0156	0.703	1.4096	3.2184	0.0508	0.2717			0.9607																				16.4645	0	0	25.7494	0.829639999	2.107125986	0	1.7553126	3.4642906	1.2510694	5.6015848	14.439512	0	7.7963776	0	0.098244787	4.435503538	8.4411096	19.27196233	0.3044845	1.627279822	0	0	5.752515641	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.9254
H4520_806_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		271.575456	8.750114	527.602185	754.063057	5.371258	10.600728	3.828272	23.568549	60.58322	650.152728	32.758413	0	0.413366	18.662361	35.157398	80.268458	0.507273	6.777683			23.959443																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000003	1023.999458	43.132793	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.5	0.199999			0.199999																				1024.000003	1023.999458	43.132793	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.5	0.199999			0.199999																				23.1744	0.746675999	1.896412986	0	1.0742516	2.1201456	0.7656544	4.7137098	12.116644	0	6.5516826	0	0.082672787	3.732453538	7.0314796	16.05361133	0.2536365	1.355529822	0	0	4.791864641	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4609	0	0	23.1744	0.746675999	1.896412986	0	1.0742516	2.1201456	0.7656544	4.7137098	12.116644	0	6.5516826	0	0.082672787	3.732453538	7.0314796	16.05361133	0.2536365	1.355529822	0	0	4.791864641	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.4609		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.5749	0.083	0.2107		0.6811	1.3441	0.4854	0.8879	2.3229		1.2447		0.0156	0.703	1.4096	3.2184	0.0508	0.2717			0.9607																				16.4645	0	0	25.7494	0.829639999	2.107125986	0	1.7553126	3.4642906	1.2510694	5.6015848	14.439512	0	7.7963776	0	0.098244787	4.435503538	8.4411096	19.27196233	0.3044845	1.627279822	0	0	5.752515641	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.9254
H4521_001_0	2009	6																					3350											A	A	A	V	T	Coin	Coin	V	P	P	P	V	P	O	V	V	V	V	P	V	S	O	T	V	V	V	V	V	V	V																																																			0		372.652419	5.624337432	315.7787375	2.418855064	301.9546342	1031.754264	723.7063037	292.426608	498.2634893	0	0	0	12.76657444	4389.970734	0	0	11.37868662	0	5286.095709	42302.35975	1999.433375	747.8592883	0	0	60.61871332	185.6609357	0	170.8543224	0	0											$100 per admit	$100 per admit	Days 1-24 $0 copay; Days 25-100 $25 copay	0	$50 per trip	%0 Coinsurance	%0 Coinsurance	ER $50 Copay; UC $25 Copay	$75 per visit	$0 Copay	$0 Copay	$0 Copay	$0 Copay	CORF $10 Copay; Part Hosp $25 Copay			Mental Health Sesion $25 copay			PCP $10; SPC $25	20% Coinsurance	Medicare covered vision $25 copay; Medicare covered hearing $25 copay						$1000 Hearing Exam Credit													98.81422925	100	9.749324674	0	50	0	0	48.87834115	75	0	0	0	0	1.043673955	0	0	25	0	0	7.266339495	35.29065643	25	0	0	0	0	0	25	0	0											90.41501976	91.5	8.920632077	0	45.75	0	0	44.72368215	68.625	0	0	0	0	0.954961669	0	0	22.875	0	0	6.648700638	32.29095064	22.875	0	0	0	0	0	22.875	0	0											2.8078	0.042885573	0.234745495	0	1.151202043	0	0	1.089866222	2.849444329	0	0	0	0	0.349354481	0	0	0.021690621	0	0	23.43797719	5.380300369	1.425606768	0	0	0	0	0	0.325691052	0	0	0	0	0	0	0	0	0	0	0	0	39.1165		3.6338	2.8078	0.042885573	0.234745495	0	1.151202043	0	0	1.089866222	2.849444329	0	0	0	0	0.349354481	0	0	0.021690621	0	0	23.43797719	5.380300369	1.425606768	0	0	0	0	0	0.325691052	0	0	0	0	0	0	0	0	0	0	0	0	39.1165																																										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			2.8078	0.042885573	0.234745495	0	1.151202043	0	0	1.089866222	2.849444329	0	0	0	0	0.349354481	0	0	0.021690621	0	0	23.43797719	5.380300369	1.425606768	0	0	0	0	0	0.325691052	0	0	0	0	0	0	0	0	0	0	0	0	39.1165
H4521_002_0	2009	4																																D	D	A	V	T	O	O	V	P	P	P	V	P	O	V	V	V	V	P	V	S	O	T	V	V	V	V	V	V	V																																																			0		454.531977	11.17797039	493.7363162	4.092510851	489.2460329	1075.040016	986.143373	418.8548728	584.1213191	0	0	0	7.776264838	4877.592931	0	0	15.52866251	0	5871.915337	48782.41246	2727.338328	836.8541502	0	99.06098922	213.7666719	450.5923869	81	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																																																																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	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	2009	4																					3350											A	A	A	V	T	O	O	V	P	P	P	V	P	O	V	V	V	V	P	V	O	O	T	V	V	V	V	V	V	V																																																			0		340.3654654	10.75375844	301.5275567	2.463519627	281.6405409	685.6043465	649.0428628	256.5942112	449.611374	0	0	0	5.400585636	3394.471068	0	0	9.180995582	0	4845.839482	34306.67096	1913.002437	580.4356806	0	0	115.9032523	273.0398566	170.8543224	0	0	0											"Days 1-6 $250 per day, $1500 per stay Benefit Max, Days 1-60 of lifetime reserve: $250 per day"	"Days 1-6 $250 per day, $1500 per stay Benefit Max, Days 1-60 of lifetime reserve: $250 per day"	"Days 1-24 $0, Days 25-100 $25 per day, No prior Auth"	0	$100 / trip	20% coinsurance	20% coinsurance	$50 copay; waived if admitted	$150 copay per visit	0	0	0	$35 per session	CORF $35 per visit			$35 copay per visit			"$15 copay primary, $35 specialist,"	20% coinsurance Diabetes monitoring supplies and all Part B drugs	"$35 copay vision and hearing services, $30 copay for medicare covered vision hardware"			vision exam: $35 copay		hearing exam: $35 copay														380.0151991	54.49189083	9.749324674	0	100	27.26882471	32.69315153	48.04471659	150	0	0	0	0	1.243472043	0	0	35	0	0	9.603270907	29.70736495	35	0	0	35	0	35	0	0	0											347.7139071	49.86008011	8.920632077	0	91.5	24.95097461	29.91423365	43.96091568	137.25	0	0	0	0	1.13777692	0	0	32.025	0	0	8.78699288	27.18223893	32.025	0	0	32.025	0	32.025	0	0	0											9.8625	0.044681938	0.224151366	0	2.147509125	1.425541387	1.617968321	0.940009707	5.14243009	0	0	0	0	0.321845903	0	0	0.024501782	0	0	25.12103945	4.333307443	1.549037723	0	0	0.309316804	0	0.455967473	0	0	0	0	0	0	0	0	0	0	0	0	0	53.5198		4.9718	9.8625	0.044681938	0.224151366	0	2.147509125	1.425541387	1.617968321	0.940009707	5.14243009	0	0	0	0	0.321845903	0	0	0.024501782	0	0	25.12103945	4.333307443	1.549037723	0	0	0.309316804	0	0.455967473	0	0	0	0	0	0	0	0	0	0	0	0	0	53.5198																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	9.8625	0.044681938	0.224151366	0	2.147509125	1.425541387	1.617968321	0.940009707	5.14243009	0	0	0	0	0.321845903	0	0	0.024501782	0	0	25.12103945	4.333307443	1.549037723	0	0	0.309316804	0	0.455967473	0	0	0	0	0	0	0	0	0	0	0	0	0	53.5198
H4521_005_0	2009	2																					3350											A	A	A	V	T	O	O	V	P	P	P	V	P	O	V	V	V	V	P	V	O	O	T	V	V	V	V	V	V	V																																																			0		358.4456315	11.86348594	332.6435076	2.717741021	310.7042635	756.3548658	665.4969556	276.9395335	417.2092636	0	0	0	5.957895753	3259.841547	0	0	10.12842278	0	4028.665678	33474.18036	1784.985567	591.8413963	0	0	127.8638172	289.09304	170.8543224	0	0	0											"Days 1-6 $250 per day, $1500 per stay Benefit Max, Days 1-60 of lifetime reserve: $250 per day"	"Days 1-6 $250 per day, $1500 per stay Benefit Max, Days 1-60 of lifetime reserve: $250 per day"	"Days 1-24 $0, Days 25-100 $25 per day, No prior Auth"	0	$100 / trip	20% coinsurance	20% coinsurance	$50 copay; waived if admitted	$150 copay per visit	0	0	0	$35 per session	CORF $35 per visit			$35 copay per visit			"$15 copay primary, $35 specialist,"	20% coinsurance Diabetes monitoring supplies and all Part B drugs	"$35 copay vision and hearing services, $30 copay for medicare covered vision hardware"			vision exam: $35 copay		hearing exam: $35 copay														380.3815104	54.49189083	9.749324674	0	100	27.26882471	32.86075224	47.96615421	150	0	0	0	0	1.428445546	0	0	35	0	0	9.812886552	33.12702435	35	0	0	35	0	35	0	0	0											348.0490821	49.86008011	8.920632077	0	91.5	24.95097461	30.0675883	43.8890311	137.25	0	0	0	0	1.307027675	0	0	32.025	0	0	8.978791195	30.31122728	32.025	0	0	32.025	0	32.025	0	0	0											10.3964	0.049292863	0.247282529	0	2.369120009	1.572649254	1.667490706	1.012883983	4.771830952	0	0	0	0	0.355058593	0	0	0.027030228	0	0	25.04647299	4.508758602	1.579476726	0	0	0.341236562	0	0.455967473	0	0	0	0	0	0	0	0	0	0	0	0	0	54.4009		4.9718	10.3964	0.049292863	0.247282529	0	2.369120009	1.572649254	1.667490706	1.012883983	4.771830952	0	0	0	0	0.355058593	0	0	0.027030228	0	0	25.04647299	4.508758602	1.579476726	0	0	0.341236562	0	0.455967473	0	0	0	0	0	0	0	0	0	0	0	0	0	54.4009																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		0	10.3964	0.049292863	0.247282529	0	2.369120009	1.572649254	1.667490706	1.012883983	4.771830952	0	0	0	0	0.355058593	0	0	0.027030228	0	0	25.04647299	4.508758602	1.579476726	0	0	0.341236562	0	0.455967473	0	0	0	0	0	0	0	0	0	0	0	0	0	54.4009
H4521_801_0	2009	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																																																			0		342.7863006	1.608307794	6.672105265	0.349475124	6.15125934	9.510460402	10.08400589	11.96823828	34.92021487	0	0	0	0.071356231	33.65386574	0	0	0.177141143	0	36.81483002	214.5427947	27.26632784	3.858632715	0	0	0	0	0	0	0	0											Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing																																																											0.072097426	0.072097426	0.211391086	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231											24.714	0.115954853	1.410423579	0	1.420940908	2.196916353	2.32940536	2.764663043	8.066569635	0	0	0	0.016483289	7.774042986	0	0	0.040919604	0	8.504225736	49.55938558	6.298521732	0.891344157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1038			24.714	0.115954853	1.410423579	0	1.420940908	2.196916353	2.32940536	2.764663043	8.066569635	0	0	0	0.016483289	7.774042986	0	0	0.040919604	0	8.504225736	49.55938558	6.298521732	0.891344157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1038																																																																																		0			24.714	0.115954853	1.410423579	0	1.420940908	2.196916353	2.32940536	2.764663043	8.066569635	0	0	0	0.016483289	7.774042986	0	0	0.040919604	0	8.504225736	49.55938558	6.298521732	0.891344157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1038
H4521_802_0	2009	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																																																			0		342.7863006	1.608307794	6.672105265	0.349475124	6.15125934	9.510460402	10.08400589	11.96823828	34.92021487	0	0	0	0.071356231	33.65386574	0	0	0.177141143	0	36.81483002	214.5427947	27.26632784	3.858632715	0	0	0	0	0	0	0	0											Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing	Medicare Fee-For-Service Cost Sharing																																																											0.072097426	0.072097426	0.211391086	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231											24.714	0.115954853	1.410423579	0	1.420940908	2.196916353	2.32940536	2.764663043	8.066569635	0	0	0	0.016483289	7.774042986	0	0	0.040919604	0	8.504225736	49.55938558	6.298521732	0.891344157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1038			24.714	0.115954853	1.410423579	0	1.420940908	2.196916353	2.32940536	2.764663043	8.066569635	0	0	0	0.016483289	7.774042986	0	0	0.040919604	0	8.504225736	49.55938558	6.298521732	0.891344157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1038																																																																																		0			24.714	0.115954853	1.410423579	0	1.420940908	2.196916353	2.32940536	2.764663043	8.066569635	0	0	0	0.016483289	7.774042986	0	0	0.040919604	0	8.504225736	49.55938558	6.298521732	0.891344157	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1038
H4522_001_0	2009	6																					2000											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	3000	1347.679009	125.9159003	614.2177506	527.3862367	77.65524683	12.41823882	6.412497785	240.3965443	29.2009348	7266.723611	35.23600595	0	0.010159781	15.1091847	4302.083778	3796.688318	525.9312819	374.9483534	0	0	12.53973986	785.5895007	532.44	0	109.0505731	312.6857143	15.11914794	8.976	396.586155	0											"$120 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$120 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-20 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											118.6258993	120	100	0	150	0.2	0.067788006	49.83291562	0.2	2.8	0.171362333	0	0.2	0.198675504	7.76988764	25	37.5	25	0	0	0.2	24.47083436	0	0	25	0	25	0	0	0											80.31699594	81.22393212	67.6866101	0	101.5299151	0.13537322	0.045883403	33.7302113	0.13537322	1.895225083	0.115989354	0	0.13537322	0.134934635	7.76988764	25	37.5	16.92165252	0	0	0.13537322	24.47083436	0	0	25	0	25	0	0	0											9.0201	0.852282045	3.46452645	0	0.657027552	1.681096978	0.294227221	0.675718853	3.953024577	1.147673071	4.08700157	0	0.001375362	2.038752323	2.785558965	7.909767328	1.643535256	0.528728813	0	0	1.697544965	1.602002545	0	0	0.227188694	0	0.031498225	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2987	0	14.3552	9.0201	0.852282045	3.46452645	0	0.657027552	1.681096978	0.294227221	0.675718853	3.953024577	1.147673071	4.08700157	0	0.001375362	2.038752323	2.785558965	7.909767328	1.643535256	0.528728813	0	0	1.697544965	1.602002545	0	0	0.227188694	0	0.031498225	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2987		"$275 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 40% (13c)"	"$275 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-18 (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 40% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	50% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"50% (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a7, 14a8, 14a9, 14a10); $0 (14a6)"	"$0 n/c (13b, 13d, 13e)"											1.082	0.0982	1.7794	0.089	0.0913	0.3506	0.181	0.0939	1.0992	0.1596	1.0708	0	0.0002	0.5641	1.5009	2.7482	0.4657	0.1458	0	0	0.5015	0.5629	0.1957	0	0.0743	0.285	0.011	0	0	0											13.1504	0	6.449788357	10.1021	0.950502372	5.243895184	0.088989967	0.748375565	2.031687	0.475263982	0.76966556	5.052220314	1.307236631	5.157779268	0	0.001566582	2.60289391	4.286442893	10.65795727	2.109203579	0.674524344	0	0	2.199073614	2.164866747	0.19575	0	0.301525034	0.285	0.042522604	0	0	0	0	0	0	0	0	0	0	0	0	0	57.4491
H4522_007_0	2009	4																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		292.6333038	22.2432	19.14102051	1691.721751	8.402785236	25.80189522	11.41499218	15.72828623	34.46994948	13.08496421	47.87514011	0	0.595188248	22.35723615	32.62596672	104.0750722	13.9175	5.514931073	0	0	13.71221538	6.339670043	150.812202	3510.266383	141.3464506	145.1002486	22.71078833	16.66089616	20.2	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.068164938	0.069047802	0.224187869	0	0.2	0.2	0.2	0.122560667	0.2	0.08	0.2	0	0.2	0.2	0	0.199829418	0.2	0.2	0	0	0.2	0.003582988	0	0	0	0	0	0	0	0											0.068164938	0.069047802	0.224187869	0	0.2	0.2	0.2	0.122560667	0.2	0.08	0.2	0	0.2	0.2	0	0.199829418	0.2	0.2	0	0	0.2	0.003582988	0	0	0	0	0	0	0	0											19.9473	1.535844068	4.291184606	0	1.680557047	5.160379043	2.282998435	1.927669252	6.893989897	1.046797137	9.575028023	0	0.11903765	4.47144723	0	20.79726113	2.7835	1.102986215	0	0	2.742443075	0.022714961	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.3812	0	0	19.9473	1.535844068	4.291184606	0	1.680557047	5.160379043	2.282998435	1.927669252	6.893989897	1.046797137	9.575028023	0	0.11903765	4.47144723	0	20.79726113	2.7835	1.102986215	0	0	2.742443075	0.022714961	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.3812		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.6579	0.278	0.3022	0.2696	0.1327	0.4074	0.1802	0.1016	0.5443	0.2066	0.7559	0	0.0063	0.353	0.5151	1.6433	0.2198	0.0871	0	0	0.2165	0.0929	0.0261	0	0.013	0	0.0014	0	0.003	0											10.014	0	0	23.6052	1.813884068	4.593411245	0.26962826	1.813232604	5.567777389	2.463235154	2.029235228	7.438252257	1.253401835	10.33095129	0	0.125302789	4.824456222	0.515146843	22.44055175	3.00325	1.190064074	0	0	2.958951739	0.115643156	0.0261	0	0.012979636	0	0.001440134	0	0.003	0	0	0	0	0	0	0	0	0	0	0	96.3951
H4522_008_0	2009	3																					2500											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1783.287233	255.1505488	39.29751119	48078.46817	83.2915836	19.6311996	8.679492369	340.3825496	356.857923	5651.454568	432.202487	0	0.76244841	1379.14124	5574.24071	4136.745241	1242.868229	246.6506994	0	0	25.26317342	1044.606118	769.983193	0	314.3760437	332.2285714	0	0	20.2	0											"$175 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$75 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5, 9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											172.9	175	0.225140967	0	75	0.14	0.2	49.97209023	75	4.4	64.79010385	0	0.2	70.29851368	3.250380945	25	20	20	0	0	0.2	13.6791576	0	0	0	0	0	0	0	0											121.8014686	123.2808386	0.225140967	0	52.83464513	0.098624671	0.140892387	35.20343538	52.83464513	3.099632515	45.64216193	0	0.140892387	49.52262698	3.250380945	25	20	20	0	0	0.140892387	13.6791576	0	0	0	0	0	0	0	0											18.1006	2.62126447	8.847479655	0	0.366723439	1.936120601	1.222874398	0.998552924	1.571205144	1.459786028	1.643887992	0	0.107423177	5.6915581	1.509867149	8.618219251	2.071447048	0.411084499	0	0	3.559388808	1.190777644	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9282	0	16.4786	18.1006	2.62126447	8.847479655	0	0.366723439	1.936120601	1.222874398	0.998552924	1.571205144	1.459786028	1.643887992	0	0.107423177	5.6915581	1.509867149	8.618219251	2.071447048	0.411084499	0	0	3.559388808	1.190777644	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9282		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.5131	0.2072	0.6205	0.525	0.1351	0.31	0.137	0.0747	0.6134	0.0965	0.2601	0	0.008	0.4889	0.6667	2.1014	0.1512	0.0722	0	0	0.3989	0.0829	0.0569	0	0.0155	0	0	0	0.003	0											10.5382	0	0	21.6137	2.82850447	9.467966674	0.524986136	0.501851078	2.24608691	1.359919014	1.073266253	2.184584327	1.556257212	1.904037864	0	0.115448949	6.180440073	2.176599802	10.71962881	2.222647048	0.483247091	0	0	3.95828102	1.273629355	0.056935837	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	72.4665
H4522_801_0	2009	2																					3800											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	4000	1415.063442	132.2117404	644.9288579	553.7557372	81.53803696	13.03915964	6.733127263	252.3535817	30.66100244	7630.062391	36.99783146	0	0.010667777	15.86465475	4597.516042	3986.08114	552.2280342	393.6959052	0	0	13.16673582	824.8692568	0	0	0	0	0	0	0	0											"$265 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$265 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											261.8789751	265	150	0	150	0.2	0.067788006	49.83287399	0.3	2.8	0.24218966	0	0.2	0.297158733	19.08533575	34.74422968	37.5	35	0	0	0.2	34.2591681	0	0	0	0	0	0	0	0											184.7453527	186.9257583	105.807033	0	105.807033	0.141076044	0.047816318	35.15112363	0.211614066	1.975064616	0.170835796	0	0.141076044	0.210027406	19.08533575	34.74422968	37.5	24.68830771	0	0	0.141076044	34.2591681	0	0	0	0	0	0	0	0											21.7855	2.059481652	5.686500747	0	0.718941481	1.83951306	0.321953357	0.739209329	6.488299395	1.255822188	6.320553988	0	0.001504968	3.332012277	7.312094774	11.54110989	1.725712607	0.809973804	0	0	1.857511003	2.354944544	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1507	0	22.2144	21.7855	2.059481652	5.686500747	0	0.718941481	1.83951306	0.321953357	0.739209329	6.488299395	1.255822188	6.320553988	0	0.001504968	3.332012277	7.312094774	11.54110989	1.725712607	0.809973804	0	0	1.857511003	2.354944544	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1507		"$380 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 40% (13c)"	"$380 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-23 (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 40% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.6823	0.1548	2.0294	0.1015	0.1042	0.3998	0.2065	0.1071	1.2536	0.182	1.2212	0	0.0002	0.6434	3.0946	3.2823	0.489	0.19	0	0	0.572	0.6753	0	0	0	0	0	0	0	0											16.3893	0	6.516254055	23.4679	2.214273166	7.715869519	0.101492994	0.823123789	2.23936073	0.528425654	0.846328666	7.74193135	1.437804252	7.541775137	0	0.001723054	3.975413564	10.40669139	14.82345926	2.214664512	1.000007682	0	0	2.429504069	3.030253097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.54
H4522_803_0	2009	2																					3800											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	4000	1415.064105	132.2118024	644.9291604	553.7559969	81.5380752	13.03917187	6.733133578	252.4165759	30.6610312	7630.06597	36.99786617	0	0.010667787	15.86466963	4517.191625	3986.083009	552.2282932	393.6960898	0	0	13.16674817	824.8696436	0	0	0	0	0	0	0	0											"$265 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$265 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											261.8789751	265	150	0	150	0.2	0.067788006	49.83291562	0.3	2.8	0.242189646	0	0.2	0.297158732	19.4247191	34.74423028	37.5	35	0	0	0.2	34.2591681	0	0	0	0	0	0	0	0											184.7737392	186.9544911	105.8232968	0	105.8232968	0.141097729	0.047823668	35.15655614	0.211646594	1.975368207	0.170862046	0	0.141097729	0.21005947	19.4247191	34.74423028	37.5	24.69210259	0	0	0.141097729	34.2591681	0	0	0	0	0	0	0	0											21.7889	2.059799185	5.687377497	0	0.719052328	1.839797541	0.322003147	0.739508127	6.489302811	1.256015811	6.321531098	0	0.001505201	3.332524098	7.312098203	11.5411155	1.725713416	0.810098687	0	0	1.857798267	2.354945649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1591	0	22.2063	21.7889	2.059799185	5.687377497	0	0.719052328	1.839797541	0.322003147	0.739508127	6.489302811	1.256015811	6.321531098	0	0.001505201	3.332524098	7.312098203	11.5411155	1.725713416	0.810098687	0	0	1.857798267	2.354945649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1591		"$380 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 40% (13c)"	"$380 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-23 (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 40% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.6829	0.1548	2.0301	0.1015	0.1042	0.4	0.2065	0.1072	1.2541	0.182	1.2217	0	0.0002	0.6436	3.0559	3.2824	0.489	0.1901	0	0	0.5722	0.6753	0	0	0	0	0	0	0	0											16.3539	0	6.484830055	23.4718	2.214647667	7.717494089	0.101530394	0.823272979	2.239792554	0.528551529	0.846693675	7.743396726	1.43806485	7.543202195	0	0.001723367	3.976160821	10.36797147	14.82346646	2.214665551	1.000202503	0	0	2.430002112	3.030255426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.5129
H4522_804_0	2009	2																					3800											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	4000	1415.063608	132.2117559	644.9289335	553.7558021	81.53804652	13.0391627	6.733128841	252.3536113	30.66100963	7630.063286	36.99784014	0	0.01066778	15.86465847	4597.516568	3986.081607	552.2280989	393.6959513	0	0	13.16673891	824.8693535	0	0	0	0	0	0	0	0											"$265 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$265 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											261.8789751	265	150	0	150	0.2	0.067788006	49.83287399	0.3	2.8	0.242189657	0	0.2	0.297158733	19.08533581	34.74422983	37.5	35	0	0	0.2	34.2591681	0	0	0	0	0	0	0	0											184.7453417	186.9257473	105.8070268	0	105.8070268	0.141076036	0.047816316	35.15112155	0.211614054	1.9750645	0.170835783	0	0.141076036	0.210027393	19.08533581	34.74422983	37.5	24.68830624	0	0	0.141076036	34.2591681	0	0	0	0	0	0	0	0											21.7855	2.059481772	5.686501077	0	0.718941523	1.839513383	0.321953413	0.739209372	6.488300533	1.25582226	6.320555005	0	0.001504968	3.332012858	7.312095631	11.54111129	1.725712809	0.809973851	0	0	1.857511328	2.35494482	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1507	0	22.2144	21.7855	2.059481772	5.686501077	0	0.718941523	1.839513383	0.321953413	0.739209372	6.488300533	1.25582226	6.320555005	0	0.001504968	3.332012858	7.312095631	11.54111129	1.725712809	0.809973851	0	0	1.857511328	2.35494482	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1507		"$380 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 40% (13c)"	"$380 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-23 (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 40% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.6823	0.1548	2.0294	0.1015	0.1042	0.3998	0.2065	0.1071	1.2536	0.182	1.2212	0	0.0002	0.6434	3.0946	3.2823	0.489	0.19	0	0	0.572	0.6753	0	0	0	0	0	0	0	0											16.3893	0	6.516256156	23.4679	2.21427329	7.715870145	0.101493009	0.823123834	2.239361111	0.528425741	0.846328712	7.74193267	1.43780433	7.541776315	0	0.001723054	3.975414238	10.4066926	14.82346106	2.214664772	1.000007734	0	0	2.429504478	3.030253453	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.54
H4522_805_0	2009	2																					3800											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	4000	1415.065598	132.2119419	644.9298409	553.7565812	81.53816123	13.03919939	6.733147787	252.4168422	30.6610959	7630.074021	36.99794424	0	0.01066781	15.86470311	4517.196391	3986.087215	552.2288759	393.6965052	0	0	13.16677596	824.870514	0	0	0	0	0	0	0	0											"$265 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$265 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											261.8789751	265	150	0	150	0.2	0.067788006	49.83291562	0.3	2.8	0.242189615	0	0.2	0.297158728	19.4247191	34.74423163	37.5	35	0	0	0.2	34.2591681	0	0	0	0	0	0	0	0											184.7736407	186.9543914	105.8232404	0	105.8232404	0.141097654	0.047823643	35.1565374	0.211646481	1.975367154	0.170861932	0	0.141097654	0.210059356	19.4247191	34.74423163	37.5	24.69208943	0	0	0.141097654	34.2591681	0	0	0	0	0	0	0	0											21.7889	2.05980026	5.687380466	0	0.719052703	1.839800442	0.322003655	0.739508513	6.489313046	1.256016467	6.32154025	0	0.001505203	3.332529322	7.312105918	11.54112812	1.725715237	0.81009911	0	0	1.857801197	2.354948134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1591	0	22.2064	21.7889	2.05980026	5.687380466	0	0.719052703	1.839800442	0.322003655	0.739508513	6.489313046	1.256016467	6.32154025	0	0.001505203	3.332529322	7.312105918	11.54112812	1.725715237	0.81009911	0	0	1.857801197	2.354948134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1591		"$380 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 40% (13c)"	"$380 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-23 (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 40% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.6829	0.1548	2.0301	0.1015	0.1042	0.4	0.2065	0.1072	1.2541	0.182	1.2217	0	0.0002	0.6436	3.0559	3.2824	0.489	0.1901	0	0	0.5722	0.6753	0	0	0	0	0	0	0	0											16.3539	0	6.484848941	23.4719	2.214648782	7.717499718	0.101530527	0.823273381	2.23979598	0.528552307	0.846694089	7.743408605	1.438065552	7.54321279	0	0.00172337	3.976166884	10.36798243	14.82348265	2.214667888	1.000202974	0	0	2.430005792	3.030258624	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.513
H4523_001_0	2009	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		2256.355102	0	918.455853	740.4698053	234.4712308	14.30739577	0	476.9994349	700.6427788	1635.259795	5455.966051	0	207.0748199	322.1346109	8235.632041	6161.403471	0	684.2283699	0	0	283.3098577	0	0	0	390.8192551	0	55.34083653	0	0	0											$0 	$0 	$0/day 1-20;  $120/day 21-100	$0 per visit	$150 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$50 per procedure	$0 per visit	$20 X-ray; $160 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$5 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	$150 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											0	0	48.39760649	0	150	0.2	0.2	47.5	50	0	76	20	20	20	5	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											0	0	48.39760649	0	150	0.2	0.2	47.5	50	0	76	20	20	20	5	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											0	0	3.704255413	0	2.930890385	2.861479154	0	1.888122763	2.919344912	0	34.55445165	0	0.3451247	0.536891018	3.431513351	10.26900579	0	1.140380616	0	0	1.062411966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.6439	0	0	0	0	3.704255413	0	2.930890385	2.861479154	0	1.888122763	2.919344912	0	34.55445165	0	0.3451247	0.536891018	3.431513351	10.26900579	0	1.140380616	0	0	1.062411966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.6439																																																																					0	0	0											0			0	0	3.704255413	0	2.930890385	2.861479154	0	1.888122763	2.919344912	0	34.55445165	0	0.3451247	0.536891018	3.431513351	10.26900579	0	1.140380616	0	0	1.062411966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.6439
H4523_005_0	2009	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1942.4498	0	1334.318816	1036.652771	270.5726515	8.049812533	0	252.5950127	389.2086552	1040.523826	4667.565342	0	67.51623878	793.60074	7264.865411	9291.354518	0	678.8069015	0	0	276.9433569	0	0	0	876.3166563	0	74.54373432	0	0	0											$100/day 1-5	$100/day 1-5	"$0 1-10, $75 11-100"	$0 per visit	$200 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$100 per procedure	$0 per visit	$25 X-ray; $175 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$150 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											61.28387407	61.28387407	47.56208437	0	200	0.2	0.2	47.5	100	0	85	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											61.28387407	61.28387407	47.56208437	0	200	0.2	0.2	47.5	100	0	85	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											9.9201	0	5.288582008	0	4.509544192	1.609962507	0	0.999855259	3.24340546	0	33.06192117	0	0.140658831	1.653334875	6.054054509	19.35698858	0	1.414181045	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.2911	0	0	9.9201	0	5.288582008	0	4.509544192	1.609962507	0	0.999855259	3.24340546	0	33.06192117	0	0.140658831	1.653334875	6.054054509	19.35698858	0	1.414181045	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.2911																																																																					0	0	0											0			9.9201	0	5.288582008	0	4.509544192	1.609962507	0	0.999855259	3.24340546	0	33.06192117	0	0.140658831	1.653334875	6.054054509	19.35698858	0	1.414181045	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.2911
H4523_009_0	2009	4																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1942.4498	0	1334.318816	1036.652771	270.5726515	8.049812533	0	252.5950127	389.2086552	1040.523826	4667.565342	0	67.51623878	793.60074	7264.865411	9291.354518	0	678.8069015	0	0	276.9433569	0	0	0	876.3166563	0	74.54373432	0	0	0											$0 	$0 	"$0/d 1-20, $100/d 21-100"	$0 per visit	$75 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$50 per procedure	$0 per visit	$25 X-ray; $165 Complex Radiology	$15 per visit	$15 per visit	$15 per visit	$5 PCP visit; $15 if no PCP selected	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$45 per script	0	Not Covered	0	$0 per visit	$150 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											0	0	40.33133874	0	75	0.2	0.2	47.5	50	0	81	15	15	15	5	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											0	0	40.33133874	0	75	0.2	0.2	47.5	50	0	81	15	15	15	5	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											0	0	4.484572013	0	1.691079072	1.609962507	0	0.999855259	1.62170273	0	31.50606606	0	0.084395298	0.992000925	3.027027254	11.61419315	0	0.848508627	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.5179	0	0	0	0	4.484572013	0	1.691079072	1.609962507	0	0.999855259	1.62170273	0	31.50606606	0	0.084395298	0.992000925	3.027027254	11.61419315	0	0.848508627	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.5179																																																																					0	0	0											0			0	0	4.484572013	0	1.691079072	1.609962507	0	0.999855259	1.62170273	0	31.50606606	0	0.084395298	0.992000925	3.027027254	11.61419315	0	0.848508627	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.5179
H4523_010_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$115/day 1-5	$115/day 1-5	"$0 1-10, $75 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$30 X-ray; $165 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$10 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$150 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											70.47645518	70.47645518	47.56208437	0	100	0.2	0.2	47.5	150	0	84	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											70.47645518	70.47645518	47.56208437	0	100	0.2	0.2	47.5	150	0	84	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											11.4757	0	5.345573617	0	2.276793099	1.576138182	0	1.007075897	4.806119247	0	33.00044462	0	0.139220051	1.967526475	6.088949555	23.17962445	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5822	0	0	11.4757	0	5.345573617	0	2.276793099	1.576138182	0	1.007075897	4.806119247	0	33.00044462	0	0.139220051	1.967526475	6.088949555	23.17962445	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5822																																																																					0	0	0											0			11.4757	0	5.345573617	0	2.276793099	1.576138182	0	1.007075897	4.806119247	0	33.00044462	0	0.139220051	1.967526475	6.088949555	23.17962445	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5822
H4523_012_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$150/day 1-5	$150/day 1-5	"$0 1-10, $75 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$150 per procedure	$0 per visit	$30 X-ray; $100 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$10 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$150 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											91.92581111	91.92581111	47.56208437	0	100	0.2	0.2	48.5	150	0	58	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											91.92581111	91.92581111	47.56208437	0	100	0.2	0.2	48.5	150	0	58	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											14.9684	0	5.345573617	0	2.276793099	1.576138182	0	1.028277495	4.806119247	0	22.78602128	0	0.139220051	1.967526475	6.088949555	23.17962445	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.8816	0	0	14.9684	0	5.345573617	0	2.276793099	1.576138182	0	1.028277495	4.806119247	0	22.78602128	0	0.139220051	1.967526475	6.088949555	23.17962445	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.8816																																																																					0	0	0											0			14.9684	0	5.345573617	0	2.276793099	1.576138182	0	1.028277495	4.806119247	0	22.78602128	0	0.139220051	1.967526475	6.088949555	23.17962445	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.8816
H4523_014_0	2009	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1942.4498	0	1334.318816	1036.652771	270.5726515	8.049812533	0	252.5950127	389.2086552	1040.523826	4667.565342	0	67.51623878	793.60074	7264.865411	9291.354518	0	678.8069015	0	0	276.9433569	0	0	3445.51	876.3166563	0	74.54373432	0	0	0											$0 	$0 	$0 	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $0 Urgent Care Ctr	$0 per procedure	$0 per visit	$0 X-ray; $0 Complex Radiology	$0 per visit	$0 per visit	$0 per visit	$0 PCP visit; $0 if no PCP selected	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$45 per script	0	$0 per Trip/50 One Way Trips	$5 copay	$0 per visit	$150 Every 2 Years	$0 per visit	$1000 Every 3 Yrs	Fitness/Coaching	0											0	0	0	0	100	0.2	0.2	45	0	0	0	0	0	0	0	0	0	0	0	0	45	0	0	5	0	0	0	0	0	0											0	0	0	0	100	0.2	0.2	45	0	0	0	0	0	0	0	0	0	0	0	0	45	0	0	5	0	0	0	0	0	0											0	0	0	0	2.254772096	1.609962507	0	0.947231298	0	0	0	0	0	0	0	0	0	0	0	0	1.038537588	0	0	1.435629167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.2861	0	0	0	0	0	0	2.254772096	1.609962507	0	0.947231298	0	0	0	0	0	0	0	0	0	0	0	0	1.038537588	0	0	1.435629167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.2861																																																																					0	0	0											0			0	0	0	0	2.254772096	1.609962507	0	0.947231298	0	0	0	0	0	0	0	0	0	0	0	0	1.038537588	0	0	1.435629167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.2861
H4523_015_0	2009	4																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1942.4498	0	1334.318816	1036.652771	270.5726515	8.049812533	0	252.5950127	389.2086552	1040.523826	4667.565342	0	67.51623878	793.60074	7264.865411	9291.354518	0	678.8069015	0	0	276.9433569	0	0	0	876.3166563	0	74.54373432	0	0	0											$100/day 1-5	$100/day 1-5	"$0/d 1-20, $100/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$100 per procedure	$0 per visit	$25 X-ray; $115 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$150 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											61.28387407	61.28387407	40.33133874	0	100	0.2	0.2	47.5	100	0	61	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											61.28387407	61.28387407	40.33133874	0	100	0.2	0.2	47.5	100	0	61	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											9.9201	0	4.484572013	0	2.254772096	1.609962507	0	0.999855259	3.24340546	0	23.72679049	0	0.140658831	1.653334875	6.054054509	19.35698858	0	1.414181045	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.8972	0	0	9.9201	0	4.484572013	0	2.254772096	1.609962507	0	0.999855259	3.24340546	0	23.72679049	0	0.140658831	1.653334875	6.054054509	19.35698858	0	1.414181045	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.8972																																																																					0	0	0											0			9.9201	0	4.484572013	0	2.254772096	1.609962507	0	0.999855259	3.24340546	0	23.72679049	0	0.140658831	1.653334875	6.054054509	19.35698858	0	1.414181045	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.8972
H4523_801_0	2009	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																																																			0		268.2464781	0	31.31390627	4.431036844	4.919406597	14.20163285	0	15.3794997	30.67881758	18.61851464	52.91201427	0	0	20.45254505	41.31727584	157.9998251	0	8.918335346	0	0	10.26321755	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.070162222	0.070162222	0.199545392	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											18.8208	0	6.248545696	0	1.136382924	3.280577189	0	3.55266443	7.086806861	4.300876881	12.2226753	0	0	4.724537908	9.544290719	36.49795959	0	2.060135465	0	0	2.370803255	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.847			18.8208	0	6.248545696	0	1.136382924	3.280577189	0	3.55266443	7.086806861	4.300876881	12.2226753	0	0	4.724537908	9.544290719	36.49795959	0	2.060135465	0	0	2.370803255	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.847																																																																																		0			18.8208	0	6.248545696	0	1.136382924	3.280577189	0	3.55266443	7.086806861	4.300876881	12.2226753	0	0	4.724537908	9.544290719	36.49795959	0	2.060135465	0	0	2.370803255	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.847
H4523_802_0	2009	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																																																			0		265.3726234	0	30.97842519	4.383564996	4.866702606	14.04948387	0	15.21473165	30.35014051	18.41904545	52.34514218	0	0	20.23342701	40.8746238	156.3070962	0	8.82278889	0	0	10.15326272	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.070110645	0.070110645	0.199311701	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											18.6054	0	6.174362607	0	1.124208302	3.245430773	0	3.514603011	7.010882459	4.254799499	12.09172784	0	0	4.673921639	9.442038099	36.10693923	0	2.038064234	0	0	2.345403688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.6278			18.6054	0	6.174362607	0	1.124208302	3.245430773	0	3.514603011	7.010882459	4.254799499	12.09172784	0	0	4.673921639	9.442038099	36.10693923	0	2.038064234	0	0	2.345403688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.6278																																																																																		0			18.6054	0	6.174362607	0	1.124208302	3.245430773	0	3.514603011	7.010882459	4.254799499	12.09172784	0	0	4.673921639	9.442038099	36.10693923	0	2.038064234	0	0	2.345403688	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.6278
H4524_001_0	2009	7																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3000	1709.355824	0	1174.200558	912.2544388	238.1039333	7.083835029	0	222.2836112	342.5036166	915.6609666	4107.457501	0	59.41429013	698.3686512	6393.081561	8176.391976	0	597.3500734	0	0	243.7101541	0	0	0	771.1586576	0	65.5984862	0	0	0											$100/day 1-5	$100/day 1-5	$0/day 1-20;  $120/day 21-100	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$210 per procedure	$0 per visit	$30 X-ray; $115 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$15 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$150 Every 2 Years	$0 per visit	$300 Every 3 Yrs	Fitness/Coaching	0											61.28387407	61.28387407	48.39760649	0	100	0.2	0.2	47.5	210	0	64	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											61.28387407	61.28387407	48.39760649	0	100	0.2	0.2	47.5	210	0	64	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											8.7297	0	4.735708046	0	1.984199444	1.416767006	0	0.879872628	5.993813291	0	21.90644	0	0.123779771	1.745921628	7.991351952	20.44097994	0	1.493375183	0	0	0.913913078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.3558	0	0	8.7297	0	4.735708046	0	1.984199444	1.416767006	0	0.879872628	5.993813291	0	21.90644	0	0.123779771	1.745921628	7.991351952	20.44097994	0	1.493375183	0	0	0.913913078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.3558		$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$100 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$50 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$25 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP		0	0	$150 ded; 20% coinsurance; $3000 max OOP	0	$150 ded; 20% coinsurance; $3000 max OOP	0	Not Covered												3.6027	0	0.4384	0.068	0.1415	0.1065	0	0.0722	0.4802	0.1634	0.6671	0	0.0126	0.1456	0.4879	2.1159	0	0.0628	0	0	0.0954	0	0	0	0.0433	0	0.0028	0	0	0											8.7064	150	0.947945096	12.3324	0	5.174122692	0.067988594	2.12569814	1.523255969	0	0.952055225	6.474037862	0.163412217	22.57357879	0	0.136387425	1.891561016	8.4792358	22.55687812	0	1.556221875	0	0	1.009297189	0	0	0	0.04329021	0	0.002773711	0	0	0	0	0	0	0	0	0	0	0	0	0	87.0622
H4524_002_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3000	1709.355824	0	1174.200558	912.2544388	238.1039333	7.083835029	0	222.2836112	342.5036166	915.6609666	4107.457501	0	59.41429013	698.3686512	6393.081561	8176.391976	0	597.3500734	0	0	243.7101541	0	0	0	771.1586576	0	65.5984862	0	0	0											$150/day 1-5	$150/day 1-5	$0/d 1-20; $120/d 21-100	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$210 per procedure	$0 per visit	$30 X-ray; $100 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$15 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$150 Every 2 Years	$0 per visit	$300 Every 3 Yrs	Fitness/Coaching	0											91.92581111	91.92581111	48.3976065	0	100	0.2	0.2	47.5	210	0	58	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											91.92581111	91.92581111	48.3976065	0	100	0.2	0.2	47.5	210	0	58	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											13.0945	0	4.735708046	0	1.984199444	1.416767006	0	0.879872628	5.993813291	0	19.85271125	0	0.123779771	1.745921628	7.991351952	20.44097994	0	1.493375183	0	0	0.913913078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6669	0	0	13.0945	0	4.735708046	0	1.984199444	1.416767006	0	0.879872628	5.993813291	0	19.85271125	0	0.123779771	1.745921628	7.991351952	20.44097994	0	1.493375183	0	0	0.913913078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6669		$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$100 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$50 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$25 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP		0	0	$150 ded; 20% coinsurance; $3000 max OOP	0	$150 ded; 20% coinsurance; $3000 max OOP	0	Not Covered												3.6027	0	0.4384	0.068	0.1415	0.1065	0	0.0722	0.4802	0.1634	0.6671	0	0.0126	0.1456	0.4879	2.1159	0	0.0628	0	0	0.0954	0	0	0	0.0433	0	0.0028	0	0	0											8.7064	150	0.947945096	16.6972	0	5.174122693	0.067988594	2.12569814	1.523255969	0	0.952055225	6.474037862	0.163412217	20.51985004	0	0.136387425	1.891561016	8.4792358	22.55687812	0	1.556221875	0	0	1.009297189	0	0	0	0.04329021	0	0.002773711	0	0	0	0	0	0	0	0	0	0	0	0	0	89.3733
H4524_003_0	2009	7																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3000	1709.355824	0	1174.200558	912.2544388	238.1039333	7.083835029	0	222.2836112	342.5036166	915.6609666	4107.457501	0	59.41429013	698.3686512	6393.081561	8176.391976	0	597.3500734	0	0	243.7101541	0	0	0	771.1586576	0	65.5984862	0	0	0											$100/day 1-5	$100/day 1-5	$0/day 1-20;  $120/day 21-100	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$75 per procedure	$0 per visit	$20 X-ray; $100 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$10 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$150 Every 2 Years	$0 per visit	$300 Every 3 Yrs	Fitness/Coaching	0											61.28387407	61.28387407	48.39760649	0	100	0.2	0.2	47.5	75	0	52	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											61.28387407	61.28387407	48.39760649	0	100	0.2	0.2	47.5	75	0	52	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											8.7297	0	4.735708046	0	1.984199444	1.416767006	0	0.879872628	2.140647604	0	17.7989825	0	0.123779771	1.745921628	5.327567968	20.44097994	0	1.493375183	0	0	0.913913078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.7314	0	0	8.7297	0	4.735708046	0	1.984199444	1.416767006	0	0.879872628	2.140647604	0	17.7989825	0	0.123779771	1.745921628	5.327567968	20.44097994	0	1.493375183	0	0	0.913913078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.7314		$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$100 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$50 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$25 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP		0	0	$150 ded; 20% coinsurance; $3000 max OOP	0	$150 ded; 20% coinsurance; $3000 max OOP	0	Not Covered												3.6027	0	0.4384	0.068	0.1415	0.1065	0	0.0722	0.4802	0.1634	0.6671	0	0.0126	0.1456	0.4879	2.1159	0	0.0628	0	0	0.0954	0	0	0	0.0433	0	0.0028	0	0	0											8.7064	150	0.947945096	12.3324	0	5.174122692	0.067988594	2.12569814	1.523255969	0	0.952055225	2.620872175	0.163412217	18.46612129	0	0.136387425	1.891561016	5.815451816	22.55687812	0	1.556221875	0	0	1.009297189	0	0	0	0.04329021	0	0.002773711	0	0	0	0	0	0	0	0	0	0	0	0	0	76.4378
H4524_005_0	2009	7																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3000	1709.355824	0	1174.200558	912.2544388	238.1039333	7.083835029	0	222.2836112	342.5036166	915.6609666	4107.457501	0	59.41429013	698.3686512	6393.081561	8176.391976	0	597.3500734	0	0	243.7101541	0	0	0	771.1586576	0	65.5984862	0	0	0											$100/day 1-5	$100/day 1-5	$0/day 1-20;  $120/day 21-100	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$100 per procedure	$0 per visit	$30 X-ray; $100 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$15 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$150 Every 2 Years	$0 per visit	$300 Every 3 Yrs	Fitness/Coaching	0											61.28387407	61.28387407	48.39760649	0	100	0.2	0.2	47.5	100	0	58	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											61.28387407	61.28387407	48.39760649	0	100	0.2	0.2	47.5	100	0	58	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											8.7297	0	4.735708046	0	1.984199444	1.416767006	0	0.879872628	2.854196805	0	19.85271125	0	0.123779771	1.745921628	7.991351952	20.44097994	0	1.493375183	0	0	0.913913078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.1624	0	0	8.7297	0	4.735708046	0	1.984199444	1.416767006	0	0.879872628	2.854196805	0	19.85271125	0	0.123779771	1.745921628	7.991351952	20.44097994	0	1.493375183	0	0	0.913913078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.1624		$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$100 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$50 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$25 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP		0	0	$150 ded; 20% coinsurance; $3000 max OOP	0	$150 ded; 20% coinsurance; $3000 max OOP	0	Not Covered												3.6027	0	0.4384	0.068	0.1415	0.1065	0	0.0722	0.4802	0.1634	0.6671	0	0.0126	0.1456	0.4879	2.1159	0	0.0628	0	0	0.0954	0	0	0	0.0433	0	0.0028	0	0	0											8.7064	150	0.947945096	12.3324	0	5.174122692	0.067988594	2.12569814	1.523255969	0	0.952055225	3.334421376	0.163412217	20.51985004	0	0.136387425	1.891561016	8.4792358	22.55687812	0	1.556221875	0	0	1.009297189	0	0	0	0.04329021	0	0.002773711	0	0	0	0	0	0	0	0	0	0	0	0	0	81.8688
H4524_007_0	2009	7																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3000	1709.355824	0	1174.200558	912.2544388	238.1039333	7.083835029	0	222.2836112	342.5036166	915.6609666	4107.457501	0	59.41429013	698.3686512	6393.081561	8176.391976	0	597.3500734	0	0	243.7101541	0	0	0	771.1586576	0	65.5984862	0	0	0											$100/day 1-5	$100/day 1-5	$0/day 1-20;  $120/day 21-100	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$100 per procedure	$0 per visit	$25 X-ray; $75 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$150 Every 2 Years	$0 per visit	$300 Every 3 Yrs	Fitness/Coaching	0											61.28387407	61.28387407	48.39760649	0	100	0.2	0.2	47.5	100	0	45	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											61.28387407	61.28387407	48.39760649	0	100	0.2	0.2	47.5	100	0	45	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											8.7297	0	4.735708046	0	1.984199444	1.416767006	0	0.879872628	2.854196805	0	15.40296563	0	0.123779771	1.45493469	5.327567968	17.03414995	0	1.24447932	0	0	0.913913078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.1022	0	0	8.7297	0	4.735708046	0	1.984199444	1.416767006	0	0.879872628	2.854196805	0	15.40296563	0	0.123779771	1.45493469	5.327567968	17.03414995	0	1.24447932	0	0	0.913913078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.1022		$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$100 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$50 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$25 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP		0	0	$150 ded; 20% coinsurance; $3000 max OOP	0	$150 ded; 20% coinsurance; $3000 max OOP	0	Not Covered												3.6027	0	0.4384	0.068	0.1415	0.1065	0	0.0722	0.4802	0.1634	0.6671	0	0.0126	0.1456	0.4879	2.1159	0	0.0628	0	0	0.0954	0	0	0	0.0433	0	0.0028	0	0	0											8.7064	150	0.947945096	12.3324	0	5.174122692	0.067988594	2.12569814	1.523255969	0	0.952055225	3.334421376	0.163412217	16.07010441	0	0.136387425	1.600574078	5.815451816	19.15004813	0	1.307326012	0	0	1.009297189	0	0	0	0.04329021	0	0.002773711	0	0	0	0	0	0	0	0	0	0	0	0	0	70.8086
H4524_008_0	2009	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3000	1709.355824	0	1174.200558	912.2544388	238.1039333	7.083835029	0	222.2836112	342.5036166	915.6609666	4107.457501	0	59.41429013	698.3686512	6393.081561	8176.391976	0	597.3500734	0	0	243.7101541	0	0	0	771.1586576	0	65.5984862	0	0	0											$100/day 1-5	$100/day 1-5	$0/day 1-20;  $120/day 21-100	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$100 per procedure	$0 per visit	$25 X-ray; $100 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$150 Every 2 Years	$0 per visit	$300 Every 3 Yrs	Fitness/Coaching	0											61.28387407	61.28387407	48.39760649	0	100	0.2	0.2	47.5	100	0	55	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											61.28387407	61.28387407	48.39760649	0	100	0.2	0.2	47.5	100	0	55	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											8.7297	0	4.735708046	0	1.984199444	1.416767006	0	0.879872628	2.854196805	0	18.82584688	0	0.123779771	1.45493469	5.327567968	17.03414995	0	1.24447932	0	0	0.913913078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.5251	0	0	8.7297	0	4.735708046	0	1.984199444	1.416767006	0	0.879872628	2.854196805	0	18.82584688	0	0.123779771	1.45493469	5.327567968	17.03414995	0	1.24447932	0	0	0.913913078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.5251		$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$100 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$50 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$25 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP		0	0	$150 ded; 20% coinsurance; $3000 max OOP	0	$150 ded; 20% coinsurance; $3000 max OOP	0	Not Covered												3.6027	0	0.4384	0.068	0.1415	0.1065	0	0.0722	0.4802	0.1634	0.6671	0	0.0126	0.1456	0.4879	2.1159	0	0.0628	0	0	0.0954	0	0	0	0.0433	0	0.0028	0	0	0											8.7064	150	0.947945096	12.3324	0	5.174122692	0.067988594	2.12569814	1.523255969	0	0.952055225	3.334421376	0.163412217	19.49298566	0	0.136387425	1.600574078	5.815451816	19.15004813	0	1.307326012	0	0	1.009297189	0	0	0	0.04329021	0	0.002773711	0	0	0	0	0	0	0	0	0	0	0	0	0	74.2315
H4524_009_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3000	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$100/day 1-5	$100/day 1-5	"$0 1-10, $75 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$150 per procedure	$0 per visit	$30 X-ray; $150 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$10 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$150 Every 2 Years	$0 per visit	$300 Every 3 Yrs	Fitness/Coaching	0											61.28387407	61.28387407	47.56208437	0	100	0.2	0.2	48.5	150	0	78	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											61.28387407	61.28387407	47.56208437	0	100	0.2	0.2	48.5	150	0	78	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											8.7814	0	4.704104783	0	2.003577927	1.3870016	0	0.904884196	4.229384937	0	26.9660776	0	0.122513645	1.731423298	5.358275608	20.39806951	0	1.478528581	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.9795	0	0	8.7814	0	4.704104783	0	2.003577927	1.3870016	0	0.904884196	4.229384937	0	26.9660776	0	0.122513645	1.731423298	5.358275608	20.39806951	0	1.478528581	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.9795		$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$100 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$50 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$25 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP		0	0	$150 ded; 20% coinsurance; $3000 max OOP	0	$150 ded; 20% coinsurance; $3000 max OOP	0	Not Covered												3.5511	0	0.4385	0.0665	0.1428	0.1044	0	0.0726	0.4768	0.1625	0.6625	0	0.0122	0.1374	0.4854	2.1084	0	0.0625	0	0	0.0943	0	0	0	0.044	0	0.0028	0	0	0											8.6248	150	0.947945096	12.3326	0	5.142598172	0.066480857	2.146388295	1.491383891	0	0.977520102	4.706221986	0.162537449	27.62859195	0	0.134701011	1.868844453	5.843669165	22.50649556	0	1.541017449	0	0	1.008469773	0	0	0	0.043978989	0	0.002807292	0	0	0	0	0	0	0	0	0	0	0	0	0	87.6043
H4524_011_0	2009	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3000	1709.355824	0	1174.200558	912.2544388	238.1039333	7.083835029	0	222.2836112	342.5036166	915.6609666	4107.457501	0	59.41429013	698.3686512	6393.081561	8176.391976	0	597.3500734	0	0	243.7101541	0	0	0	771.1586576	0	65.5984862	0	0	0											$75/day 1-5	$75/day 1-5	"$0/d 1-20, $100/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$75 per procedure	$0 per visit	$20 X-ray; $115 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$10 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	$150 Every 2 Years	$0 per visit	$300 Every 3 Yrs	Fitness/Coaching	0											45.96290555	45.96290555	40.33133874	0	100	0.2	0.2	47.5	75	0	58	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											45.96290555	45.96290555	40.33133874	0	100	0.2	0.2	47.5	75	0	58	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											6.5472	0	3.946423371	0	1.984199444	1.416767006	0	0.879872628	2.140647604	0	19.85271125	0	0.099023817	1.163947752	5.327567968	13.62731996	0	0.995583456	0	0	0.913913078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.8952	0	0	6.5472	0	3.946423371	0	1.984199444	1.416767006	0	0.879872628	2.140647604	0	19.85271125	0	0.099023817	1.163947752	5.327567968	13.62731996	0	0.995583456	0	0	0.913913078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.8952		$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$100 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$50 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$20 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP		0	0	$150 ded; 20% coinsurance; $3000 max OOP	0	$150 ded; 20% coinsurance; $3000 max OOP	0	Not Covered												3.6027	0	0.4384	0.068	0.1415	0.1065	0	0.0722	0.4802	0.1634	0.6671	0	0.0109	0.1456	0.4879	2.1159	0	0.0628	0	0	0.0954	0	0	0	0.0433	0	0.0028	0	0	0											8.7047	150	0.947945096	10.15	0	4.384838018	0.067988594	2.12569814	1.523255969	0	0.952055225	2.620872175	0.163412217	20.51985004	0	0.109973663	1.30958714	5.815451816	15.74321814	0	1.058430148	0	0	1.009297189	0	0	0	0.04329021	0	0.002773711	0	0	0	0	0	0	0	0	0	0	0	0	0	67.6
H4524_012_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3000	1709.355824	0	1174.200558	912.2544388	238.1039333	7.083835029	0	222.2836112	342.5036166	915.6609666	4107.457501	0	59.41429013	698.3686512	6393.081561	8176.391976	0	597.3500734	0	0	243.7101541	0	0	0	771.1586576	0	65.5984862	0	0	0											$75/day 1-5	$75/day 1-5	$0/day 1-20;  $120/day 21-100	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$75 per procedure	$0 per visit	$20 X-ray; $100 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$10 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	$150 Every 2 Years	$0 per visit	$300 Every 3 Yrs	Fitness/Coaching	0											45.96290555	45.96290555	48.39760649	0	100	0.2	0.2	47.5	75	0	52	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											45.96290555	45.96290555	48.39760649	0	100	0.2	0.2	47.5	75	0	52	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											6.5472	0	4.735708046	0	1.984199444	1.416767006	0	0.879872628	2.140647604	0	17.7989825	0	0.099023817	1.163947752	5.327567968	13.62731996	0	0.995583456	0	0	0.913913078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.6308	0	0	6.5472	0	4.735708046	0	1.984199444	1.416767006	0	0.879872628	2.140647604	0	17.7989825	0	0.099023817	1.163947752	5.327567968	13.62731996	0	0.995583456	0	0	0.913913078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.6308		$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$100 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$50 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$20 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP		0	0	$150 ded; 20% coinsurance; $3000 max OOP	0	$150 ded; 20% coinsurance; $3000 max OOP	0	Not Covered												3.6027	0	0.4384	0.068	0.1415	0.1065	0	0.0722	0.4802	0.1634	0.6671	0	0.0109	0.1456	0.4879	2.1159	0	0.0628	0	0	0.0954	0	0	0	0.0433	0	0.0028	0	0	0											8.7047	150	0.947945096	10.15	0	5.174122692	0.067988594	2.12569814	1.523255969	0	0.952055225	2.620872175	0.163412217	18.46612129	0	0.109973663	1.30958714	5.815451816	15.74321814	0	1.058430148	0	0	1.009297189	0	0	0	0.04329021	0	0.002773711	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3355
H4524_013_0	2009	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3000	1709.355824	0	1174.200558	912.2544388	238.1039333	7.083835029	0	222.2836112	342.5036166	915.6609666	4107.457501	0	59.41429013	698.3686512	6393.081561	8176.391976	0	597.3500734	0	0	243.7101541	0	0	0	771.1586576	0	65.5984862	0	0	0											$100/day 1-5	$100/day 1-5	"$0/d 1-20, $100/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$100 per procedure	$0 per visit	$25 X-ray; $100 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$150 Every 2 Years	$0 per visit	$300 Every 3 Yrs	Fitness/Coaching	0											61.28387407	61.28387407	40.33133874	0	100	0.2	0.2	47.5	100	0	55	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											61.28387407	61.28387407	40.33133874	0	100	0.2	0.2	47.5	100	0	55	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											8.7297	0	3.946423371	0	1.984199444	1.416767006	0	0.879872628	2.854196805	0	18.82584688	0	0.123779771	1.45493469	5.327567968	17.03414995	0	1.24447932	0	0	0.913913078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.7358	0	0	8.7297	0	3.946423371	0	1.984199444	1.416767006	0	0.879872628	2.854196805	0	18.82584688	0	0.123779771	1.45493469	5.327567968	17.03414995	0	1.24447932	0	0	0.913913078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.7358		$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$100 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$50 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$25 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP		0	0	$150 ded; 20% coinsurance; $3000 max OOP	0	$150 ded; 20% coinsurance; $3000 max OOP	0	Not Covered												3.6027	0	0.4384	0.068	0.1415	0.1065	0	0.0722	0.4802	0.1634	0.6671	0	0.0126	0.1456	0.4879	2.1159	0	0.0628	0	0	0.0954	0	0	0	0.0433	0	0.0028	0	0	0											8.7064	150	0.947945096	12.3324	0	4.384838018	0.067988594	2.12569814	1.523255969	0	0.952055225	3.334421376	0.163412217	19.49298566	0	0.136387425	1.600574078	5.815451816	19.15004813	0	1.307326012	0	0	1.009297189	0	0	0	0.04329021	0	0.002773711	0	0	0	0	0	0	0	0	0	0	0	0	0	73.4422
H4524_014_0	2009	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3000	1709.355824	0	1174.200558	912.2544388	238.1039333	7.083835029	0	222.2836112	342.5036166	915.6609666	4107.457501	0	59.41429013	698.3686512	6393.081561	8176.391976	0	597.3500734	0	0	243.7101541	0	0	0	771.1586576	0	65.5984862	0	0	0											$100/day 1-5	$100/day 1-5	"$0/d 1-20, $100/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$100 per procedure	$0 per visit	$25 X-ray; $100 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$150 Every 2 Years	$0 per visit	$300 Every 3 Yrs	Fitness/Coaching	0											61.28387407	61.28387407	40.33133874	0	100	0.2	0.2	47.5	100	0	55	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											61.28387407	61.28387407	40.33133874	0	100	0.2	0.2	47.5	100	0	55	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											8.7297	0	3.946423371	0	1.984199444	1.416767006	0	0.879872628	2.854196805	0	18.82584688	0	0.123779771	1.45493469	5.327567968	17.03414995	0	1.24447932	0	0	0.913913078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.7358	0	0	8.7297	0	3.946423371	0	1.984199444	1.416767006	0	0.879872628	2.854196805	0	18.82584688	0	0.123779771	1.45493469	5.327567968	17.03414995	0	1.24447932	0	0	0.913913078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.7358		$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$100 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$50 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$25 copay	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP	$150 ded; 20% coinsurance; $3000 max OOP		0	0	$150 ded; 20% coinsurance; $3000 max OOP	0	$150 ded; 20% coinsurance; $3000 max OOP	0	Not Covered												3.6027	0	0.4384	0.068	0.1415	0.1065	0	0.0722	0.4802	0.1634	0.6671	0	0.0126	0.1456	0.4879	2.1159	0	0.0628	0	0	0.0954	0	0	0	0.0433	0	0.0028	0	0	0											8.7064	150	0.947945096	12.3324	0	4.384838018	0.067988594	2.12569814	1.523255969	0	0.952055225	3.334421376	0.163412217	19.49298566	0	0.136387425	1.600574078	5.815451816	19.15004813	0	1.307326012	0	0	1.009297189	0	0	0	0.04329021	0	0.002773711	0	0	0	0	0	0	0	0	0	0	0	0	0	73.4422
H4524_801_0	2009	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																																																			0		297.0116071	0	36.67506861	5.560380288	6.558045988	8.730411441	0	7.716939251	39.88208699	13.5944401	55.41191707	0	3.023766117	11.49374292	40.59774324	176.3462618	0	5.226495001	0	0	7.88684614	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.070619547	0.070619547	0.201581272	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.9748	0	7.393006978	0	1.514908623	2.016725043	0	1.782612967	9.212762094	3.140315663	12.80015284	0	0.698489973	2.655054615	9.378078688	40.73598647	0	1.207320345	0	0	1.821861458	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.3321			20.9748	0	7.393006978	0	1.514908623	2.016725043	0	1.782612967	9.212762094	3.140315663	12.80015284	0	0.698489973	2.655054615	9.378078688	40.73598647	0	1.207320345	0	0	1.821861458	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.3321		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											2.8602	0	1.0081	0	0.2066	0.275	0	0.2431	1.2563	0.4282	1.7455	0	0.0952	0.3621	1.2788	5.5549	0	0.1646	0	0	0.2484	0	0	0	0	0	0	0	0	0											15.7271			23.835	0	8.401144294	0	1.721487072	2.291733003	0	2.025696553	10.46904783	3.568540526	14.54562823	0	0.793738606	3.017107516	10.6569076	46.29089372	0	1.371954938	0	0	2.070297112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.0592
H4524_802_0	2009	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																																																			0		290.1677508	0	35.8299875	5.432255855	6.406932957	8.529241924	0	7.539122553	38.96310851	13.28119175	54.13509425	0	2.954091329	11.22889965	39.66227434	172.282823	0	5.106064082	0	0	7.705114381	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.070569123	0.070569123	0.200715148	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.4769	0	7.191621259	0	1.480001513	1.970254884	0	1.74153731	9.000478067	3.067955295	12.50520677	0	0.682395097	2.593875819	9.161985372	39.79733212	0	1.179500803	0	0	1.779881422	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.6289			20.4769	0	7.191621259	0	1.480001513	1.970254884	0	1.74153731	9.000478067	3.067955295	12.50520677	0	0.682395097	2.593875819	9.161985372	39.79733212	0	1.179500803	0	0	1.779881422	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.6289		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											2.7923	0	0.9807	0	0.2018	0.2687	0	0.2375	1.2273	0.4184	1.7053	0	0.0931	0.3537	1.2494	5.4269	0	0.1608	0	0	0.2427	0	0	0	0	0	0	0	0	0											15.3585			23.2692	0	8.172296885	0	1.681819901	2.238926005	0	1.97901967	10.22781598	3.486312835	14.21046224	0	0.775448974	2.947586158	10.41134701	45.22424104	0	1.340341821	0	0	2.022592525	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.9874
H4524_804_0	2009	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																																																			0		290.16736	0	35.82993925	5.43224854	6.406924329	8.529230439	0	7.539112401	38.96305605	13.28117387	54.13502135	0	2.954087351	11.22888453	39.66222093	172.282591	0	5.106057206	0	0	7.705104005	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.070569123	0.070569123	0.200715148	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.4769	0	7.191611575	0	1.47999952	1.970252231	0	1.741534965	9.000465947	3.067951163	12.50518993	0	0.682394178	2.593872326	9.161973035	39.79727853	0	1.179499215	0	0	1.779879025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.6288			20.4769	0	7.191611575	0	1.47999952	1.970252231	0	1.741534965	9.000465947	3.067951163	12.50518993	0	0.682394178	2.593872326	9.161973035	39.79727853	0	1.179499215	0	0	1.779879025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.6288		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											2.7923	0	0.9807	0	0.2018	0.2687	0	0.2375	1.2273	0.4184	1.7053	0	0.0931	0.3537	1.2494	5.4269	0	0.1608	0	0	0.2427	0	0	0	0	0	0	0	0	0											15.3585			23.2692	0	8.17228588	0	1.681817636	2.23892299	0	1.979017005	10.22780221	3.48630814	14.2104431	0	0.77544793	2.947582189	10.41133299	45.22418015	0	1.340340017	0	0	2.022589801	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.9872
H4525_001_0	2009	5																					3350											A	A	A	V	T	O	O	V	P	P	P	V	P	O	V	V	V	V	P	V	S	O	T	V	V	V	V	V	V	V																																																			0		649.3143698	15.74294548	1044.721814	219.7585135	397.3639055	1431.816941	1763.724187	720.5319802	377.1637149	0	4435.532158	0	4.923092634	6453.241605	0	0	26.02206107	0	3574.106833	31534.00342	1371.738025	575.0152616	0	0	0	0	0	0	0	0											$75 Copay per Day 1-30	$75 Copay per Day 1-30	$25 Copay per Day 1-20 and $150 Copay per Day day 21-100	$0 Copay	$100 Copay per Trip	20% Coinsurance	20% Coinsurance	$50 Copay	$100 per Surgery	$0 Copay	"$10 Copay for X-rays, 20% Coinsurance for Chemo"	None	$0 Copay	"CORF $20 Copay, PT/OT/ST $20 Copay, OP MH/SA Ind days 1-20 $25, Grp days 1-20 $15, Days 21 and up $50"	$15 Copay	$30 Copay	None	None	None	None	20% Coinsurance	None	None	None	None	None	None	None	None	None											698.0747163	45.65588847	79.62091462	0	100	37.96308515	23.10008124	47.57687419	100	0	18.74189242	0	0	1.46745807	0	0	24.16	0	0	6.594544941	30.94022895	27.37447093	0	0	0	0	0	0	0	0											638.7383654	41.77513795	72.85313688	0	91.5	34.73622291	21.13657434	43.53283988	91.5	0	17.14883156	0	0	1.342724134	0	0	22.1064	0	0	6.034008621	28.31030949	25.0476409	0	0	0	0	0	0	0	0											34.5618	0.05480531	6.34260511	0	3.029899779	4.14465937	3.106590615	2.613900277	2.875873326	0	6.338682822	0	0	0.722076937	0	0	0.047937841	0	0	15.85637071	3.236194001	1.200231315	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.1317		7.8155	34.5618	0.05480531	6.34260511	0	3.029899779	4.14465937	3.106590615	2.613900277	2.875873326	0	6.338682822	0	0	0.722076937	0	0	0.047937841	0	0	15.85637071	3.236194001	1.200231315	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.1317																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			34.5618	0.05480531	6.34260511	0	3.029899779	4.14465937	3.106590615	2.613900277	2.875873326	0	6.338682822	0	0	0.722076937	0	0	0.047937841	0	0	15.85637071	3.236194001	1.200231315	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.1317
H4525_002_0	2009	6																					3350											A	A	A	V	T	O	O	V	P	P	P	V	P	O	V	V	V	V	P	V	S	O	T	V	V	V	V	V	V	V																																																			0		632.188523	12.23583176	1046.242623	298.2352145	420.0898336	1493.471146	1728.002109	672.3088673	362.2804686	0	4342.154396	0	3.826357224	7241.595938	0	0	25.16790012	0	4126.825626	33015.29357	1778.772253	667.1541248	0	0	0	0	0	0	0	0											$75 Copay per Day 1-30	$75 Copay per Day 1-30	$25 Copay per Day 1-20 and $150 Copay per Day day 21-100	$0 Copay	$100 Copay per Trip	20% Coinsurance	20% Coinsurance	$50 Copay	$100 per Surgery	$0 Copay	"$10 Copay for X-rays, 20% Coinsurance for Chemo"	None	None	None	None	None	"Ind visit days 1-20 $25, Grp visit days 1-20 $15, All else $50; CORF $20 Copay, PT/OT/ST $20 Copay, OP MH/SA Ind days 1-20 $25, Grp days 1-20 $15, Days 21 and up $50"	$0 Copay	$0 Copay	"PCP $10, SCP $35"	20% Coinsurance	"Medicare covered hearing $10, Medicare covered vision $30"	None	None	None	None	None	None	None	None											698.0747163	54.93864862	79.62091462	0	100	40.48148609	25.11103264	47.98159696	100	0	18.69943355	0	0	0	0	0	24.16	0	0	7.353578251	39.60658328	27.64388117	0	0	0	0	0	0	0	0											638.7383654	50.26886349	72.85313688	0	91.5	37.04055977	22.97659486	43.90316122	91.5	0	17.1099817	0	0	0	0	0	22.1064	0	0	6.728524099	36.2400237	25.29415127	0	0	0	0	0	0	0	0											33.6503	0.05125678	6.351838087	0	3.203184981	4.60991727	3.308633699	2.459707049	2.762388573	0	6.191181853	0	0	0	0	0	0.046364306	0	0	18.51201654	5.371895716	1.406258113	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.9249		8.1679	33.6503	0.05125678	6.351838087	0	3.203184981	4.60991727	3.308633699	2.459707049	2.762388573	0	6.191181853	0	0	0	0	0	0.046364306	0	0	18.51201654	5.371895716	1.406258113	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.9249																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			33.6503	0.05125678	6.351838087	0	3.203184981	4.60991727	3.308633699	2.459707049	2.762388573	0	6.191181853	0	0	0	0	0	0.046364306	0	0	18.51201654	5.371895716	1.406258113	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.9249
H4525_003_0	2009	6																																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																																																			0		740.323697	2.746058506	25.66518859	3.118468328	14.82955321	36.94873079	31.65148578	46.31475772	64.68399531	0	44.63289322	0	0.069014194	42.32556285	0	0	0.380564962	0	30.580085	274.8334814	26.01602659	3.634247579	0	0.155129137	0.603851349	1.522432195	0	0	0	0											$20 Copay per day for the first 30 days	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits											187.38	0.0749	0.2112	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0	0.231	0.231	0	0	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0											187.38	0.0749	0.2112	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0	0.231	0.231	0	0	0.231	0	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0	0	0											11.5602	0.205679782	5.420487831	0	3.425626791	8.535156813	7.311493214	10.69870903	14.94200292	0	10.31019833	0	0.015942279	9.777205018	0	0	0.087910506	0	7.063999636	63.48653419	6.009702141	0.839511191	0	0.035834831	0.139489662	0.351681837	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.2173			11.5602	0.205679782	5.420487831	0	3.425626791	8.535156813	7.311493214	10.69870903	14.94200292	0	10.31019833	0	0.015942279	9.777205018	0	0	0.087910506	0	7.063999636	63.48653419	6.009702141	0.839511191	0	0.035834831	0.139489662	0.351681837	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.2173																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			11.5602	0.205679782	5.420487831	0	3.425626791	8.535156813	7.311493214	10.69870903	14.94200292	0	10.31019833	0	0.015942279	9.777205018	0	0	0.087910506	0	7.063999636	63.48653419	6.009702141	0.839511191	0	0.035834831	0.139489662	0.351681837	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.2173
H4525_004_0	2009	4																					3350											A	A	A	V	T	O	O	V	P	P	P	V	P	O	V	V	V	V	P	V	S	O	T	V	V	V	V	V	V	V																																																			0		661.2480715	16.51037025	1095.649094	230.4711292	423.7433224	1484.016621	1836.287232	732.4197338	395.3166625	0	4606.138235	0	5.163079694	6314.777591	0	0	27.2905641	0	3693.550202	31707.94563	1477.246173	630.8490527	0	0	0	0	0	0	0	0											Days 1-30: $75 per day	Days 1-30: $75 per day	Days 1-20: $25/day	Days 21-100: $150/day	$100/ trip	20% Coinsurance	20% Coinsurance	ER $50/admit; UC $25/Admit	$100 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	CORF $20 copay			Days 1-20: Ind $25 copay Group $15 copay; 21+ $50			PCP $10 SPC $35	20% Coinsurance	Medicare covered Hearing exam $10; Medicare covered vision exam$30																			698.0747163	45.65588847	79.62091462	0	100	38.1958687	23.10953134	47.5	100	0	19.46418308	0	0	1.377154059	0	0	24.16	0	0	6.990896155	30.08013905	26.8235573	0	0	0	0	0	0	0	0											638.7383654	41.77513795	72.85313688	0	91.5	34.94921986	21.14522117	43.4625	91.5	0	17.80972752	0	0	1.260095964	0	0	22.1064	0	0	6.396669982	27.52332723	24.54355493	0	0	0	0	0	0	0	0											35.197	0.057476916	6.651789451	0	3.231042834	4.322101929	3.235724971	2.652732723	3.014289552	0	6.836172241	0	0	0.663102146	0	0	0.050274677	0	0	16.90210534	3.388227486	1.290273198	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.4924		8.1277	35.197	0.057476916	6.651789451	0	3.231042834	4.322101929	3.235724971	2.652732723	3.014289552	0	6.836172241	0	0	0.663102146	0	0	0.050274677	0	0	16.90210534	3.388227486	1.290273198	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.4924																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			35.197	0.057476916	6.651789451	0	3.231042834	4.322101929	3.235724971	2.652732723	3.014289552	0	6.836172241	0	0	0.663102146	0	0	0.050274677	0	0	16.90210534	3.388227486	1.290273198	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.4924
H4525_005_0	2009	3																					3350											A	A	A	V	T	O	O	V	P	P	P	V	P	O	V	V	V	V	P	V	S	O	T	V	V	V	V	V	V	V																																																			0		646.6099764	15.84331777	1087.144701	221.1596277	417.6411241	1424.059336	1876.995035	763.5846247	379.2011687	0	4454.508654	0	4.954480792	6153.209214	0	0	26.1879699	0	3999.547246	32571.45705	1414.427359	667.0328866	0	0	0	0	0	0	0	0											Days 1-30: $75 per day	Days 1-30: $75 per day	Days 1-20: $25/day	Days 21-100: $150/day	$100/ trip	20% Coinsurance	20% Coinsurance	ER $50/admit; UC $25/Admit	$100 Copay	$0 Copay	$0 Copay	$0 Copay	$0 Copay	CORF $20 copay			Days 1-20: Ind $25 copay Group $15 copay; 21+ $50			PCP $10 SPC $35	20% Coinsurance	Medicare covered Hearing exam $10; Medicare covered vision exam$30																			698.0747163	54.93864862	79.62091462	0	100	45.96185684	27.46763963	47.69891749	100	0	18.84452465	0	0	1.356214004	0	0	24.16	0	0	7.893377402	36.48072666	27.05720889	0	0	0	0	0	0	0	0											638.7383654	50.26886349	72.85313688	0	91.5	42.055099	25.13289026	43.6445095	91.5	0	17.24274006	0	0	1.240935813	0	0	22.1064	0	0	7.222440322	33.3798649	24.75734614	0	0	0	0	0	0	0	0											34.4179	0.066368798	6.600158478	0	3.184513571	4.990746365	3.93119252	2.777189701	2.891408912	0	6.400661233	0	0	0.636311473	0	0	0.048243478	0	0	19.60378373	3.934449513	1.376163671	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.8591		6.2387	34.4179	0.066368798	6.600158478	0	3.184513571	4.990746365	3.93119252	2.777189701	2.891408912	0	6.400661233	0	0	0.636311473	0	0	0.048243478	0	0	19.60378373	3.934449513	1.376163671	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.8591																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			34.4179	0.066368798	6.600158478	0	3.184513571	4.990746365	3.93119252	2.777189701	2.891408912	0	6.400661233	0	0	0.636311473	0	0	0.048243478	0	0	19.60378373	3.934449513	1.376163671	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.8591
H4525_006_0	2009	6																					3350											A	A	A	V	T	O	O	V	P	P	P	V	P	O	V	V	V	V	P	V	S	O	T	V	V	V	V	V	V	V																																																			0		607.3357129	14.61340443	999.6983306	203.9910535	408.4593932	1446.475544	1788.046187	731.9470821	391.9473349	0	4683.929762	0	4.569865517	6128.013294	0	0	24.15500345	0	3341.563029	30110.78733	1350.388173	545.8987535	0	31.95686013	118.957556	182.8866046	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	27.67049678	0	50	19.95570763	11.14514772	46.46608802	50	0	13.23108567	0	0	0	0	0	25	0	0	5.374832465	0	22.66654105	0	0	0	0	0	0	0	0											0	0	25.31850456	0	45.75	18.25947248	10.19781016	42.51647054	45.75	0	12.10644339	0	0	0	0	0	22.875	0	0	4.917971705	0	20.73988506	0	0	0	0	0	0	0	0											0	0	2.109238895	0	1.557251437	2.200990033	1.519512965	2.593317212	1.494299214	0	4.725477541	0	0	0	0	0	0.046045475	0	0	12.34033334	0	0.943489784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.53		2.7432	0	0	2.109238895	0	1.557251437	2.200990033	1.519512965	2.593317212	1.494299214	0	4.725477541	0	0	0	0	0	0.046045475	0	0	12.34033334	0	0.943489784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.53																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	2.109238895	0	1.557251437	2.200990033	1.519512965	2.593317212	1.494299214	0	4.725477541	0	0	0	0	0	0.046045475	0	0	12.34033334	0	0.943489784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.53
H4525_007_0	2009	5																					3350											A	A	A	V	T	O	O	V	P	P	P	V	P	O	V	V	V	V	P	V	S	O	T	V	V	V	V	V	V	V																																																			0		615.2046529	15.21483438	1000.779771	211.2715744	365.6518324	1365.111979	1803.830833	739.9982595	445.0216226	0	4417.59573	0	4.127391447	7180.849919	0	0	23.83257466	0	4064.087883	34263.30249	1508.513333	805.9694375	0	42.67948012	107.4395729	213.1326147	0	0	0	0											No Cost Sharing	No Cost Sharing	"Day 5-30 $50 per day; All other days up to 100, $0 copay"	No Cost Sharing	$50 per trip	20% Coinsurance	20% Coinsurance	ER: $50 copay UC:$25 copay; worldwide	$50 Copay	No Cost Sharing	Chemo $25 per visit; MRI/CT/PET/Nuc/Stress/Ultrsnd $50 per visit	No Cost Sharing	No Cost Sharing	No Cost Sharing			All visits $25			PCP: $5 SPC $30		20% Coinsurance Part B Rx; $25 Copay Medicare Covered Vision; $10 Copay Medicare covered hearing		$50 limit																	0	0	27.67049678	0	50	21.70820538	12.83236258	46.71659188	50	0	11.60488814	0	0	0	0	0	25	0	0	5.709684236	0	23.48182218	0	0	0	0	0	0	0	0											0	0	25.31850456	0	45.75	19.86300792	11.74161176	42.74568157	45.75	0	10.61847265	0	0	0	0	0	22.875	0	0	5.224361076	0	21.48586729	0	0	0	0	0	0	0	0											0	0	2.111520599	0	1.394047611	2.259602505	1.764990111	2.635977497	1.696644936	0	3.909009953	0	0	0	0	0	0.045430845	0	0	14.91698866	0	1.443079365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.1773		2.9686	0	0	2.111520599	0	1.394047611	2.259602505	1.764990111	2.635977497	1.696644936	0	3.909009953	0	0	0	0	0	0.045430845	0	0	14.91698866	0	1.443079365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.1773																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	2.111520599	0	1.394047611	2.259602505	1.764990111	2.635977497	1.696644936	0	3.909009953	0	0	0	0	0	0.045430845	0	0	14.91698866	0	1.443079365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.1773
H4525_008_0	2009	5																					3350											A	A	A	V	T	O	O	V	P	P	P	V	P	O	V	V	V	V	P	V	S	O	T	V	V	V	V	V	V	V																																																			0		706.9564475	17.91222347	1188.677851	250.0398422	452.1181302	1610.020669	1978.116846	813.9269444	413.6736835	0	4655.046795	0	5.601463559	6425.11667	0	0	29.60773596	0	3969.432354	33102.35215	1504.39307	638.7879179	0	33.10245513	145.8109463	212.034645	47.72328243	0	0	0											No Cost Sharing	No Cost Sharing	Days 1-100 No cost sharing	No Cost Sharing	No Cost Sharing	10% coinsurance	10% 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	All visits $25 copay	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$50 credit for cleaning	No Cost Sharing	$100 credit for hardware	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											0	0	0	0	0	19.09793435	11.51784767	0	0	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	17.47460993	10.53883062	0	0	0	0	0	0	0	0	0	22.875	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	2.344540264	1.737253199	0	0	0	0	0	0	0	0	0	0.056439747	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1382		0.3844	0	0	0	0	0	2.344540264	1.737253199	0	0	0	0	0	0	0	0	0	0.056439747	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1382																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	2.344540264	1.737253199	0	0	0	0	0	0	0	0	0	0.056439747	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1382
H4525_009_0	2009	6																					3350											A	A	A	V	T	O	O	V	P	P	P	V	P	O	V	V	V	V	P	V	S	O	T	V	V	V	V	V	V	V																																																			0		670.5712182	16.99032742	1127.49966	237.1709349	428.8487733	1527.157048	1876.308261	773.030535	392.3829634	0	4415.463514	0	5.313170643	6094.432447	0	0	28.08390197	0	3765.135885	31398.65926	1426.96583	605.9111474	0	31.39875694	138.306432	201.1217674	47.72328243	0	0	0											No Cost Sharing	No Cost Sharing	Days 1-100 No cost sharing	No Cost Sharing	No Cost Sharing	10% coinsurance	10% 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	All visits $25 copay	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$50 credit for cleaning	No Cost Sharing	$100 credit for hardware	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											0	0	0	0	0	22.98092842	13.8596577	0	0	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	21.0275495	12.6815868	0	0	0	0	0	0	0	0	0	22.875	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	2.676030868	1.982880506	0	0	0	0	0	0	0	0	0	0.053534938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.7124		0.4378	0	0	0	0	0	2.676030868	1.982880506	0	0	0	0	0	0	0	0	0	0.053534938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.7124																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	2.676030868	1.982880506	0	0	0	0	0	0	0	0	0	0.053534938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.7124
H4525_802_0	2009	1																																coin	coin	coin	coin	coin	coin	coin	coin	coin		coin		coin	coin			coin		coin	coin	coin	coin		coin	coin	coin																																																							0		408.307648	2.718150858	19.43713413	0	8.738417366	32.66824654	23.35135461	27.55285199	54.79385398		36.96520964		0.0403219	32.39153571			0.430962235		24.71410392	235.5176319	26.13681295	3.486502357		0	0	0															7.5% Medicare Cost Sharing	7.5% Medicare Cost Sharing	21.1% Medicare Cost Sharing	23.1% Medicare Cost Sharing	23.1% Medicare Cost Sharing	23.1% Medicare Cost Sharing	23.1% Medicare Cost Sharing	23.1% Medicare Cost Sharing	23.1% Medicare Cost Sharing		23.1% Medicare Cost Sharing		23.1% Medicare Cost Sharing	23.1% Medicare Cost Sharing			23.1% Medicare Cost Sharing		23.1% Medicare Cost Sharing	23.1% Medicare Cost Sharing	23.1% Medicare Cost Sharing	23.1% Medicare Cost Sharing		23.1% Medicare Cost Sharing	23.1% Medicare Cost Sharing	23.1% Medicare Cost Sharing															0.0749	0.0749	0.2112	0	0.231	0.231	0.231	0.231	0.231		0.231		0.231	0.231			0.231		0.231	0.231	0.231	0.231		0.231	0.231	0.231															0.0749	0.0749	0.2112	0	0.231	0.231	0.231	0.231	0.231		0.231		0.231	0.231			0.231		0.231	0.231	0.231	0.231		0.231	0.231	0.231															30.5822	0.203589499	4.105122729	0	2.018574412	7.54636495	5.394162914	6.36470881	12.65738027	0	8.538963427	0	0.009314359	7.48244475	0	0	0.099552276	0	5.708958005	54.40457296	6.037603791	0.805382045	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.9589		0	30.5822	0.203589499	4.105122729	0	2.018574412	7.54636495	5.394162914	6.36470881	12.65738027	0	8.538963427	0	0.009314359	7.48244475	0	0	0.099552276	0	5.708958005	54.40457296	6.037603791	0.805382045	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.9589																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			30.5822	0.203589499	4.105122729	0	2.018574412	7.54636495	5.394162914	6.36470881	12.65738027	0	8.538963427	0	0.009314359	7.48244475	0	0	0.099552276	0	5.708958005	54.40457296	6.037603791	0.805382045	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.9589
H4527_001_0	2009	4																					3450												A	D		T	Coin	Coin	V			Coin			V		V	V	V	Coin	P	Coin					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	4.276888747	153.9888474	0	262.2361789	5.669454061	3.561897395	432.5719865	0	0	12.95445062	0	0	559.8610422	0	2429.775435	132.1523651	459.8158797	31.23750511	998.6537869	14.79037048	0	0	0	0	371.5497949	0	0	0	0											No Cost Sharing	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	$100/Days 21-100 for SNF	No Cost Sharing	$75/Run for Ambulance	10% Coinsurance for DME	10% Coinsurance for Prosthetics/Supplies; 10% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $20/Visit for Urgent Care; $20/Visit for Urgent Care - Worldwide;	No Cost Sharing	No Cost Sharing	10% Coinsurance for OP Fac - Radiology;	No Cost Sharing	No Cost Sharing	$20/Case for OP Fac - Cardiovascular; $10/Case for OP Fac - Occ Therapy; $10/Case for OP Fac - Physical/Speech Therapy;	No Cost Sharing	$10/Visit for Speclst - Office Visits; $10/Consult for Speclst - Consults;	$10/Visit for OP Psych - Non-Physician; $10/Visit for OP Psych - Psychiatrist; $10/Visit for OP Substance Abuse;	$10/Visit for PT/ST (PCP); $10/Visit for Occ Therapy (PCP); $10/Visit for PT/ST (Specialist); $10/Visit for Occ Therapy (Specialist);	10% Coinsurance for Prof Radiology (Office); 7% Coinsurance for Prof Radiology (OP); 10% Coinsurance for Prof Radiology (IP);	$10/Visit for Chiropractor; $10/Service for Podiatrist;	10% Coinsurance for Part B Rx	No Cost Sharing	No Cost Sharing	No Cost Sharing for Preventive Services	No Cost Sharing	Max Plan Benefit of $300 every two years	No Cost Sharing	Max Plan Benefit of $400 every three years	Not Covered	Not Covered											0	900.0000002	100	0	75	0.1	0.091432458	40.16875179	0	0	0.058035026	0	0	12.79544882	0	10	9.999999999	10	0.096472263	10	0.1	0	0	0	0	9.999999999	0	0	0	0											0	900.0000002	100	0	75	0.1	0.091432458	40.16875179	0	0	0.058035026	0	0	12.79544882	0	10	9.999999999	10	0.096472263	10	0.1	0	0	0	0	9.999999999	0	0	0	0											0	0.320766656	1.283240395	0	1.638976118	0.566945406	0.325673035	1.44798973	0	0	0.751811883	0	0	0.596972776	0	2.024812862	0.110126971	0.3831799	3.013552799	0.832211489	1.479037048	0	0	0	0	0.309624829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.0849	0	0	0	0.320766656	1.283240395	0	1.638976118	0.566945406	0.325673035	1.44798973	0	0	0.751811883	0	0	0.596972776	0	2.024812862	0.110126971	0.3831799	3.013552799	0.832211489	1.479037048	0	0	0	0	0.309624829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.0849	0																																																																																	0	0	0	0	0.320766656	1.283240395	0	1.638976118	0.566945406	0.325673035	1.44798973	0	0	0.751811883	0	0	0.596972776	0	2.024812862	0.110126971	0.3831799	3.013552799	0.832211489	1.479037048	0	0	0	0	0.309624829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.0849
H4527_002_0	2009	4																					3450											D	A	D		T	Coin	Coin	V	V		Coin			V		V	V	V	Coin	P	Coin					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	846.5982406	3.802543342	398.7288451	0	266.7261284	5.758000886	3.804910723	370.6053321	511.5594644	0	14.47819827	0	0	914.6693438	0	2250.608612	103.5405316	314.6971851	30.85513872	573.7220386	9.104400055	0	0	0	0	461.0569935	0	0	0	0											$250/Days Custom for IP Medical; $250/Days Custom for IP Surgical;	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	$100/Days Custom for SNF	No Cost Sharing	$100/Run 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;	$125/Case for OP Fac - Surgery; $125/Case for OP Fac - ASC	No Cost Sharing	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	No Cost Sharing	No Cost Sharing	$20/Case for OP Fac - Cardiovascular; $25/Case for OP Fac - Occ Therapy; $25/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $20/Visit for Prof - CORF; $20/Visit for Prof - CORF;	No Cost Sharing	$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/Visit for PT/ST (PCP); $25/Visit for Occ Therapy (PCP); $25/Visit for PT/ST (Specialist); $25/Visit 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/Service for Podiatrist;	20% Coinsurance for Part B Rx	No Cost Sharing	No Cost Sharing	No Cost Sharing for Preventive Services	No Cost Sharing	Max Plan Benefit of $150 every two years	No Cost Sharing	Not Covered	Not Covered	Not Covered											250	900.0000002	100	0	100	0.2	0.183708779	43.1395382	125	0	0.2	0	0	22.53800192	0	25	25	25	0.2	25	0.2	0	0	0	0	5.000000002	0	0	0	0											250	900.0000002	100	0	100	0.2	0.183708779	43.1395382	125	0	0.2	0	0	22.53800192	0	25	25	25	0.2	25	0.2	0	0	0	0	5.000000002	0	0	0	0											17.6375	0.285190751	3.322740376	0	2.222717737	1.151600177	0.698995502	1.332311907	5.328744421	0	2.895639654	0	0	1.717901619	0	4.688767942	0.215709441	0.655619136	6.171027745	1.195254247	1.820880011	0	0	0	0	0.192107081	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.5327	0	0	17.6375	0.285190751	3.322740376	0	2.222717737	1.151600177	0.698995502	1.332311907	5.328744421	0	2.895639654	0	0	1.717901619	0	4.688767942	0.215709441	0.655619136	6.171027745	1.195254247	1.820880011	0	0	0	0	0.192107081	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.5327	0																																																																																	0	0	0	17.6375	0.285190751	3.322740376	0	2.222717737	1.151600177	0.698995502	1.332311907	5.328744421	0	2.895639654	0	0	1.717901619	0	4.688767942	0.215709441	0.655619136	6.171027745	1.195254247	1.820880011	0	0	0	0	0.192107081	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.5327
H4527_003_0	2009	2																					3450											D	A			T	Coin	Coin	V			Coin								Coin		Coin					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	1001.829968	38.03440877	0	0	1156.442005	14.0619538	10.52785331	792.4142824	0	0	11.76662984	0	0	0	0	0	0	0	32.52699662	0	9.482758502	0	0	0	0	411.0908014	0	0	0	0											$75/Days 1-5 for IP Medical; $75/Days 1-5 for IP Surgical;	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	No Cost Sharing	No Cost Sharing	$100/Run for Ambulance	10% Coinsurance for DME	10% Coinsurance for Prosthetics/Supplies;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $30/Visit for Urgent Care; $30/Visit for Urgent Care - Worldwide;	No Cost Sharing	No Cost Sharing	10% Coinsurance for OP Fac - Radiology;	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	10% Coinsurance for Prof Radiology (Office); 7% Coinsurance for Prof Radiology (OP); 10% Coinsurance for Prof Radiology (IP);	No Cost Sharing	10% Coinsurance for Part B Rx	No Cost Sharing	No Cost Sharing	No Cost Sharing for Preventive Services	No Cost Sharing	Max Plan Benefit of $150 every two years	No Cost Sharing	Not Covered	Not Covered	Not Covered											75	900	0	0	100	0.1	0.069177193	44.97972291	0	0	0.054402268	0	0	0	0	0	0	0	0.095549191	0	0.1	0	0	0	0	15	0	0	0	0											75	900	0	0	100	0.1	0.069177193	44.97972291	0	0	0.054402268	0	0	0	0	0	0	0	0.095549191	0	0.1	0	0	0	0	15	0	0	0	0											6.2614	2.852580658	0	0	9.63701671	1.40619538	0.728287342	2.970214571	0	0	0.640131345	0	0	0	0	0	0	0	3.107928202	0	0.94827585	0	0	0	0	0.513863502	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.0659	0	0	6.2614	2.852580658	0	0	9.63701671	1.40619538	0.728287342	2.970214571	0	0	0.640131345	0	0	0	0	0	0	0	3.107928202	0	0.94827585	0	0	0	0	0.513863502	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.0659	0																																																																																	0	0	0	6.2614	2.852580658	0	0	9.63701671	1.40619538	0.728287342	2.970214571	0	0	0.640131345	0	0	0	0	0	0	0	3.107928202	0	0.94827585	0	0	0	0	0.513863502	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.0659
H4527_004_0	2009	2																					3450												A			T	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	0	46.33842663	0	0	898.6424761	10.79808532	0	835.3972019	0	0	0	0	0	0	0	0	0	0	0	0	13.79209821	0	0	0	0	0	0	0	0	0											No Cost Sharing	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	No Cost Sharing	No Cost Sharing	$50/Run for Ambulance	5% Coinsurance for DME	No Cost Sharing	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $20/Visit for Urgent Care; $20/Visit for Urgent Care - Worldwide;	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	5% Coinsurance for Part B Rx	No Cost Sharing	No Cost Sharing	FALSE/Max plan benefit of $800 for Restorative Services every three years	No Cost Sharing	Max Plan Benefit of $353.6015772521 every two years	No Cost Sharing	Max Plan Benefit of $2000 every three years	Not Covered	No copay up to $125 every quarter											0	900	0	0	50	0.05	0	42.02297261	0	0	0	0	0	0	0	0	0	0	0	0	0.05	0	0	0	0	0	0	0	0	0											0	900	0	0	50	0.05	0	42.02297261	0	0	0	0	0	0	0	0	0	0	0	0	0.05	0	0	0	0	0	0	0	0	0											0	3.475381997	0	0	3.744343651	0.539904266	0	2.925489478	0	0	0	0	0	0	0	0	0	0	0	0	0.68960491	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.3747	0	0	0	3.475381997	0	0	3.744343651	0.539904266	0	2.925489478	0	0	0	0	0	0	0	0	0	0	0	0	0.68960491	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.3747	0																																																																																	0	0	0	0	3.475381997	0	0	3.744343651	0.539904266	0	2.925489478	0	0	0	0	0	0	0	0	0	0	0	0	0.68960491	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.3747
H4527_005_0	2009	4																					3450											D	A	D		T	Coin	Coin	V	Coin		Coin			V		V	V	V	Coin	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	548.4521643	2.616761825	348.4313426	0	186.7424322	11.04499581	7.253736753	233.6734926	28.28626883	0	13.63225661	0	0	436.4991838	0	2556.220542	108.3661982	325.1325793	21.75045367	581.488812	6.811682883	0	0	0	0	0	0	0	0	0											$150/Days 1-5 for IP Medical; $150/Days 1-5 for IP Surgical;	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	$75/Days Custom for SNF	No Cost Sharing	$100/Run 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;	20% Coinsurance for OP Fac - Surgery; 20% Coinsurance for OP Fac - ASC	No Cost Sharing	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	No Cost Sharing	No Cost Sharing	$20/Case for OP Fac - Cardiovascular; $25/Case for OP Fac - Occ Therapy; $25/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $20/Visit for Prof - CORF; $20/Visit for Prof - CORF;	No Cost Sharing	$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/Visit for PT/ST (PCP); $25/Visit for Occ Therapy (PCP); $25/Visit for PT/ST (Specialist); $25/Visit 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/Service for Podiatrist;	20% Coinsurance for Part B Rx	No Cost Sharing	Not Covered	No Cost Sharing for Preventive Services	No Cost Sharing	Not Covered	No Cost Sharing	Not Covered	Not Covered	Not Covered											150	899.9999999	75	0	100	0.2	0.183608068	43.05963748	0.2	0	0.2	0	0	22.39409243	0	25	25.00000001	25	0.2	25	0.2	0	0	0	0	0	0	0	0	0											150	899.9999999	75	0	100	0.2	0.183608068	43.05963748	0.2	0	0.2	0	0	22.39409243	0	25	25.00000001	25	0.2	25	0.2	0	0	0	0	0	0	0	0	0											6.8557	0.196257137	2.177695891	0	1.556186935	2.208999163	1.331844589	0.838491323	5.657253766	0	2.726451321	0	0	0.814583589	0	5.325459463	0.225762913	0.67735954	4.350090735	1.211435025	1.362336577	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5159	0	0	6.8557	0.196257137	2.177695891	0	1.556186935	2.208999163	1.331844589	0.838491323	5.657253766	0	2.726451321	0	0	0.814583589	0	5.325459463	0.225762913	0.67735954	4.350090735	1.211435025	1.362336577	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5159	0																																																																																	0	0	0	6.8557	0.196257137	2.177695891	0	1.556186935	2.208999163	1.331844589	0.838491323	5.657253766	0	2.726451321	0	0	0.814583589	0	5.325459463	0.225762913	0.67735954	4.350090735	1.211435025	1.362336577	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5159
H4527_006_0	2009	2																					3450												A			T	Coin	Coin	V													Coin					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	31.60082145	0	0	745.8179814	23.43683151	17.84877179	483.7944809	0	0	0	0	0	0	0	0	0	0	0	0	5.324468795	0	0	0	0	502.4298935	0	0	0	0											No Cost Sharing	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	No Cost Sharing	No Cost Sharing	$100/Run for Ambulance	5% Coinsurance for DME	10% Coinsurance for Prosthetics/Supplies; 10% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $30/Visit for Urgent Care; $30/Visit for Urgent Care - Worldwide;	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	10% Coinsurance for Part B Rx	No Cost Sharing	No Cost Sharing	No Cost Sharing for Preventive Services	No Cost Sharing	Max Plan Benefit of $300 every two years	No Cost Sharing	Max Plan Benefit of $400 every three years	Not Covered	Not Covered											0	900	0	0	100	0.05	0.09244377	44.41646201	0	0	0	0	0	0	0	0	0	0	0	0	0.1	0	0	0	0	9.999999999	0	0	0	0											0	900	0	0	100	0.05	0.09244377	44.41646201	0	0	0	0	0	0	0	0	0	0	0	0	0.1	0	0	0	0	9.999999999	0	0	0	0											0	2.370061608	0	0	6.215149845	1.171841575	1.650007761	1.790703265	0	0	0	0	0	0	0	0	0	0	0	0	0.532446879	0	0	0	0	0.418691578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.1489	0	0	0	2.370061608	0	0	6.215149845	1.171841575	1.650007761	1.790703265	0	0	0	0	0	0	0	0	0	0	0	0	0.532446879	0	0	0	0	0.418691578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.1489	0																																																																																	0	0	0	0	2.370061608	0	0	6.215149845	1.171841575	1.650007761	1.790703265	0	0	0	0	0	0	0	0	0	0	0	0	0.532446879	0	0	0	0	0.418691578	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.1489
H4527_008_0	2009	4																					3450											A	A	D		T	Coin	Coin	V	V		Coin			V		V	V	V	Coin	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	345.380342	39.64411842	943.4392616	0	523.2824075	23.10999811	17.2756523	519.22927	263.2167892	0	13.24727536	0	0	544.71152	0	5047.332988	1447.48076	794.1597838	28.95804856	1130.542723	5.749154124	0	0	0	0	0	0	0	0	0											$75/Admit for IP Medical; $75/Admit for IP Surgical;	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	$50/Days Custom for SNF	No Cost Sharing	$100/Run 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; $20/Visit for Urgent Care; $20/Visit for Urgent Care - Worldwide;	$50/Case for OP Fac - Surgery; $50/Case for OP Fac - ASC	No Cost Sharing	20% Coinsurance for OP Fac - Radiology;	No Cost Sharing	No Cost Sharing	$50/Case for OP Fac - Cardiovascular; $25/Case for OP Fac - Occ Therapy; $25/Case for OP Fac - Physical/Speech Therapy;	No Cost Sharing	$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/Visit for PT/ST (PCP); $25/Visit for Occ Therapy (PCP); $25/Visit for PT/ST (Specialist); $25/Visit for Occ Therapy (Specialist);	20% Coinsurance for Prof Radiology (Office); 13% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	$25/Visit for Chiropractor; $25/Service for Podiatrist;	20% Coinsurance for Part B Rx	No Cost Sharing	No Cost Sharing	No Cost Sharing for Preventive Services	No Cost Sharing	Max Plan Benefit of $300 every two years	No Cost Sharing	Max Plan Benefit of $400 every three years	Not Covered	No copay up to $100 every quarter											75	900	50	0	100	0.2	0.184603924	41.33594724	50	0	0.109985363	0	0	32.50427683	0	25	25	25	0.191115256	25	0.2	0	0	0	0	0	0	0	0	0											75	900	50	0	100	0.2	0.184603924	41.33594724	50	0	0.109985363	0	0	32.50427683	0	25	25	25	0.191115256	25	0.2	0	0	0	0	0	0	0	0	0											2.1586	2.973308881	3.930996923	0	4.360686729	4.621999621	3.18915321	1.788569476	1.096736622	0	1.457006393	0	0	1.475454503	0	10.51527706	3.015584917	1.654499549	5.534324859	2.355297339	1.149830825	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.2774	0	0	2.1586	2.973308881	3.930996923	0	4.360686729	4.621999621	3.18915321	1.788569476	1.096736622	0	1.457006393	0	0	1.475454503	0	10.51527706	3.015584917	1.654499549	5.534324859	2.355297339	1.149830825	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.2774	0																																																																																	0	0	0	2.1586	2.973308881	3.930996923	0	4.360686729	4.621999621	3.18915321	1.788569476	1.096736622	0	1.457006393	0	0	1.475454503	0	10.51527706	3.015584917	1.654499549	5.534324859	2.355297339	1.149830825	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.2774
H4527_011_0	2009	4																					3450											D	A	D		T	Coin	Coin	V	V		Coin			V		V	V	V	Coin	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	1030.507737	35.52532638	936.6881904	0	470.016965	25.82490521	19.91043776	541.5473437	224.9527683	0	14.82223423	0	0	455.2391042	0	5203.798652	1177.852425	591.0299693	24.47582224	854.5361186	7.661049923	0	0	0	0	0	0	0	0	0											$175/Days 1-5 for IP Medical; $175/Days 1-5 for IP Surgical;	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	$100/Days Custom for SNF	No Cost Sharing	$100/Run 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;	$150/Case for OP Fac - Surgery; $150/Case for OP Fac - ASC	No Cost Sharing	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	No Cost Sharing	No Cost Sharing	$50/Case for OP Fac - Cardiovascular; $40/Case for OP Fac - Occ Therapy; $40/Case for OP Fac - Physical/Speech Therapy;	No Cost Sharing	$40/Visit for Speclst - Office Visits; $40/Consult for Speclst - Consults;	$40/Visit for OP Psych - Non-Physician; $40/Visit for OP Psych - Psychiatrist; $40/Visit for OP Substance Abuse;	$40/Visit for PT/ST (PCP); $40/Visit for Occ Therapy (PCP); $40/Visit for PT/ST (Specialist); $40/Visit for Occ Therapy (Specialist);	20% Coinsurance for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	$40/Visit for Chiropractor; $10/Service for Podiatrist;	20% Coinsurance for Part B Rx	No Cost Sharing	Not Covered	No Cost Sharing for Preventive Services	No Cost Sharing	Max Plan Benefit of $300 every two years	No Cost Sharing	Max Plan Benefit of $800 every three years	Not Covered	No copay up to $50 every quarter											175	900	100	0	100	0.2	0.18507197	44.27988289	150	0	0.2	0	0	44.23780118	0	40	40	40	0.2	14.18086435	0.2	0	0	0	0	0	0	0	0	0											175	900	100	0	100	0.2	0.18507197	44.27988289	150	0	0.2	0	0	44.23780118	0	40	40	40	0.2	14.18086435	0.2	0	0	0	0	0	0	0	0	0											15.0282	2.664399479	7.80573492	0	3.916808042	5.164981042	3.684863934	1.998304413	2.811909604	0	2.964446846	0	0	1.678231415	0	17.34599551	3.926174751	1.970099898	4.895164449	1.009838398	1.532209985	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.3974	0	0	15.0282	2.664399479	7.80573492	0	3.916808042	5.164981042	3.684863934	1.998304413	2.811909604	0	2.964446846	0	0	1.678231415	0	17.34599551	3.926174751	1.970099898	4.895164449	1.009838398	1.532209985	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.3974	0																																																																																	0	0	0	15.0282	2.664399479	7.80573492	0	3.916808042	5.164981042	3.684863934	1.998304413	2.811909604	0	2.964446846	0	0	1.678231415	0	17.34599551	3.926174751	1.970099898	4.895164449	1.009838398	1.532209985	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.3974
H4527_012_0	2009	3																					3450											D	A	D		T	Coin	Coin	V	Coin		Coin			V	V	V	V	V	Coin	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	718.4280141	3.490105887	576.467871	0	233.7986387	11.16614994	7.119636967	293.7139044	35.3586716	0	18.14238107	0	0	272.3241189	4390.760536	3693.782334	206.4703496	691.3389678	31.78868384	823.5431696	8.626239002	0	0	0	0	0	0	0	0	0											$150/Days 1-5 for IP Medical; $150/Days 1-5 for IP Surgical;	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	$75/Days Custom for SNF	No Cost Sharing	$100/Run 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;	20% Coinsurance for OP Fac - Surgery; 20% Coinsurance for OP Fac - ASC	No Cost Sharing	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	No Cost Sharing	No Cost Sharing	$25/Case for OP Fac - Occ Therapy; $25/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $20/Visit for Prof - CORF; $20/Visit for Prof - CORF;	$5/Visit for PCP - Office Visits; $5/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/Visit for PT/ST (PCP); $25/Visit for Occ Therapy (PCP); $25/Visit for PT/ST (Specialist); $25/Visit for Occ Therapy (Specialist);	20% Coinsurance for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	$25/Service for Podiatrist;	20% Coinsurance for Part B Rx	No Cost Sharing	No Cost Sharing	No Cost Sharing for Preventive Services	No Cost Sharing	Max Plan Benefit of $150 every two years	No Cost Sharing	Not Covered	No Cost Sharing	Not Covered											150	900	75	0	100	0.2	0.18311613	43.0098833	0.2	0	0.2	0	0	23.20122035	5	25	25	25	0.2	25	0.2	0	0	0	0	0	0	0	0	0											150	900	75	0	100	0.2	0.18311613	43.0098833	0.2	0	0.2	0	0	23.20122035	5	25	25	25	0.2	25	0.2	0	0	0	0	0	0	0	0	0											8.9804	0.261757942	3.602924194	0	1.94832199	2.233229988	1.303720371	1.052716729	7.071734319	0	3.628476214	0	0	0.526520991	1.829483557	7.695379863	0.430146562	1.440289516	6.357736769	1.715714937	1.7252478	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.8038	0	0	8.9804	0.261757942	3.602924194	0	1.94832199	2.233229988	1.303720371	1.052716729	7.071734319	0	3.628476214	0	0	0.526520991	1.829483557	7.695379863	0.430146562	1.440289516	6.357736769	1.715714937	1.7252478	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.8038	0																																																																																	0	0	0	8.9804	0.261757942	3.602924194	0	1.94832199	2.233229988	1.303720371	1.052716729	7.071734319	0	3.628476214	0	0	0.526520991	1.829483557	7.695379863	0.430146562	1.440289516	6.357736769	1.715714937	1.7252478	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.8038
H4527_013_0	2009	5																					3450											D	A	D		T	Coin	Coin	V	Coin		Coin			V	V	V	V	V	Coin	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	686.4142852	3.320793495	558.2795472	0	222.0025893	10.53543621	6.760273965	289.7625945	34.93064978	0	17.82323743	0	0	426.6613221	4234.90083	3544.252327	190.2303631	619.0013601	29.77408609	1259.003042	8.58187945	0	0	0	0	0	0	0	0	0											$250/Days 1-5 for IP Medical; $250/Days 1-5 for IP Surgical;	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	$75/Days Custom for SNF	No Cost Sharing	$100/Run 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;	20% Coinsurance for OP Fac - Surgery; 20% Coinsurance for OP Fac - ASC	No Cost Sharing	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	No Cost Sharing	No Cost Sharing	$20/Case for OP Fac - Cardiovascular; $40/Case for OP Fac - Occ Therapy; $40/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $20/Visit for Prof - CORF; $20/Visit for Prof - CORF;	$10/Visit for PCP - Office Visits; $10/Consult for PCP - Consults;	$40/Visit for Speclst - Office Visits; $40/Consult for Speclst - Consults;	$40/Visit for OP Psych - Non-Physician; $40/Visit for OP Psych - Psychiatrist; $40/Visit for OP Substance Abuse;	$40/Visit for PT/ST (PCP); $40/Visit for Occ Therapy (PCP); $40/Visit for PT/ST (Specialist); $40/Visit for Occ Therapy (Specialist);	20% Coinsurance for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	$40/Visit for Chiropractor; $40/Service for Podiatrist;	20% Coinsurance for Part B Rx	No Cost Sharing	No Cost Sharing	No Cost Sharing for Preventive Services	No Cost Sharing	Not Covered	No Cost Sharing	Not Covered	Not Covered	Not Covered											250	900.0000002	75	0	100	0.2	0.183222988	42.95660959	0.2	0	0.2	0	0	28.42743352	10	40	40	40	0.2	37.25204199	0.2	0	0	0	0	0	0	0	0	0											250	900.0000002	75	0	100	0.2	0.183222988	42.95660959	0.2	0	0.2	0	0	28.42743352	10	40	40	40	0.2	37.25204199	0.2	0	0	0	0	0	0	0	0	0											14.3003	0.249059512	3.48924717	0	1.850021577	2.107087243	1.238637597	1.03726822	6.986129957	0	3.564647486	0	0	1.010740531	3.529084025	11.81417442	0.63410121	2.063337867	5.954817219	3.908369515	1.71637589	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.4534	0	0	14.3003	0.249059512	3.48924717	0	1.850021577	2.107087243	1.238637597	1.03726822	6.986129957	0	3.564647486	0	0	1.010740531	3.529084025	11.81417442	0.63410121	2.063337867	5.954817219	3.908369515	1.71637589	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.4534	0																																																																																	0	0	0	14.3003	0.249059512	3.48924717	0	1.850021577	2.107087243	1.238637597	1.03726822	6.986129957	0	3.564647486	0	0	1.010740531	3.529084025	11.81417442	0.63410121	2.063337867	5.954817219	3.908369515	1.71637589	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.4534
H4527_014_0	2009	5																					3450											D	A	D		T	Coin		V	V		Coin			V	V	V	V	V	Coin	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	704.0959374	3.404724075	567.29576	0	227.8500601	10.84809005	0	291.7213154	249.4149784	0	17.98187664	0	0	425.5400457	4359.747553	3671.670903	201.88844	670.1938804	31.09424081	1372.359317	8.603947249	0	0	0	0	0	0	0	0	0											$150/Days 1-5 for IP Medical; $150/Days 1-5 for IP Surgical;	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	$75/Days Custom for SNF	No Cost Sharing	$100/Run for Ambulance	10% Coinsurance for DME	No Cost Sharing	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $30/Visit for Urgent Care; $30/Visit for Urgent Care - Worldwide;	$100/Case for OP Fac - Surgery; $100/Case for OP Fac - ASC	No Cost Sharing	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	No Cost Sharing	No Cost Sharing	$20/Case for OP Fac - Cardiovascular; $25/Case for OP Fac - Occ Therapy; $25/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $20/Visit for Prof - CORF; $20/Visit for Prof - CORF;	$5/Visit for PCP - Office Visits; $5/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/Visit for PT/ST (PCP); $25/Visit for Occ Therapy (PCP); $25/Visit for PT/ST (Specialist); $25/Visit 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/Service for Podiatrist;	20% Coinsurance for Part B Rx	No Cost Sharing	No Cost Sharing	No Cost Sharing for Preventive Services	No Cost Sharing	Max Plan Benefit of $300 every two years	No Cost Sharing	Max Plan Benefit of $400 every three years	Not Covered	No copay up to $50 every quarter											150	900	75	0	100	0.1	0	42.98319851	100	0	0.2	0	0	22.08078791	5	25	25	25	0.2	25	0.2	0	0	0	0	0	0	0	0	0											150	900	75	0	100	0.1	0	42.98319851	100	0	0.2	0	0	22.08078791	5	25	25	25	0.2	25	0.2	0	0	0	0	0	0	0	0	0											8.8012	0.255354306	3.5455985	0	1.898750501	1.084809005	0	1.044926268	2.078458154	0	3.596375329	0	0	0.783021625	1.81656148	7.649314382	0.420600917	1.396237251	6.218848162	2.859081911	1.72078945	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.1699	0	0	8.8012	0.255354306	3.5455985	0	1.898750501	1.084809005	0	1.044926268	2.078458154	0	3.596375329	0	0	0.783021625	1.81656148	7.649314382	0.420600917	1.396237251	6.218848162	2.859081911	1.72078945	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.1699	0																																																																																	0	0	0	8.8012	0.255354306	3.5455985	0	1.898750501	1.084809005	0	1.044926268	2.078458154	0	3.596375329	0	0	0.783021625	1.81656148	7.649314382	0.420600917	1.396237251	6.218848162	2.859081911	1.72078945	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.1699
H4527_015_0	2009	3																					3450											D	A	D		T	Coin	Coin	V			Coin			V		V	V	V	Coin	P	Coin					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	1212.977809	41.41912313	1262.38274	0	641.3359319	29.89270612	22.56489831	607.0199289	0	0	19.96030785	0	0	213.8396528	0	6281.437267	1799.730141	963.4687793	30.98326053	1042.832321	10.95143052	0	0	0	0	585.7998236	0	0	0	0											$150/Days 1-5 for IP Medical; $150/Days 1-5 for IP Surgical;	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	$75/Days Custom for SNF	No Cost Sharing	$100/Run 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;	No Cost Sharing	No Cost Sharing	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	No Cost Sharing	No Cost Sharing	$10/Case for OP Fac - Occ Therapy; $10/Case for OP Fac - Physical/Speech Therapy;	No Cost Sharing	$10/Visit for Speclst - Office Visits; $10/Consult for Speclst - Consults;	$10/Visit for OP Psych - Non-Physician; $10/Visit for OP Psych - Psychiatrist; $10/Visit for OP Substance Abuse;	$10/Visit for PT/ST (PCP); $10/Visit for Occ Therapy (PCP); $10/Visit for PT/ST (Specialist); $10/Visit for Occ Therapy (Specialist);	20% Coinsurance for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	$10/Service for Podiatrist;	20% Coinsurance for Part B Rx	No Cost Sharing	No Cost Sharing	No Cost Sharing for Preventive Services	No Cost Sharing	Max Plan Benefit of $150 every two years	No Cost Sharing	Not Covered	Not Covered	Not Covered											150	900	75	0	100	0.2	0.18475328	44.31449341	0	0	0.2	0	0	9.999999998	0	10	9.999999999	10	0.2	10	0.2	0	0	0	0	10	0	0	0	0											150	900	75	0	100	0.2	0.18475328	44.31449341	0	0	0.2	0	0	9.999999998	0	10	9.999999999	10	0.2	10	0.2	0	0	0	0	10	0	0	0	0											15.1622	3.106434235	7.889892127	0	5.344466099	5.978541225	4.168938969	2.241648387	0	0	3.992061569	0	0	0.178199711	0	5.234531056	1.499775117	0.802890649	6.196652107	0.869026934	2.190286103	0	0	0	0	0.48816652	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.3437	0	0	15.1622	3.106434235	7.889892127	0	5.344466099	5.978541225	4.168938969	2.241648387	0	0	3.992061569	0	0	0.178199711	0	5.234531056	1.499775117	0.802890649	6.196652107	0.869026934	2.190286103	0	0	0	0	0.48816652	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.3437	0																																																																																	0	0	0	15.1622	3.106434235	7.889892127	0	5.344466099	5.978541225	4.168938969	2.241648387	0	0	3.992061569	0	0	0.178199711	0	5.234531056	1.499775117	0.802890649	6.196652107	0.869026934	2.190286103	0	0	0	0	0.48816652	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.3437
H4527_016_0	2009	1																					3450												A	D		T	Coin	Coin	V			Coin			0		V	V	V	Coin	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	3.453168461	543.2239846	0	238.9847982	9.951178492	6.339146981	288.3913907	0	0	15.19610853	0	0	299.8765124	0	3495.814562	189.2597134	626.1680313	31.17945078	745.9096467	7.473359297	0	0	0	0	0	0	0	0	0											No Cost Sharing	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	$75/Days Custom for SNF	No Cost Sharing	$100/Run 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;	No Cost Sharing	No Cost Sharing	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	No Cost Sharing	No Cost Sharing	$10/Case for OP Fac - Occ Therapy; $10/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $20/Visit for Prof - CORF; $20/Visit for Prof - CORF;	No Cost Sharing	$10/Visit for Speclst - Office Visits; $10/Consult for Speclst - Consults;	$10/Visit for OP Psych - Non-Physician; $10/Visit for OP Psych - Psychiatrist; $10/Visit for OP Substance Abuse;	$10/Visit for PT/ST (PCP); $10/Visit for Occ Therapy (PCP); $10/Visit for PT/ST (Specialist); $10/Visit for Occ Therapy (Specialist);	20% Coinsurance for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	$10/Service for Podiatrist;	20% Coinsurance for Part B Rx	No Cost Sharing	Not Covered	No Cost Sharing for Preventive Services	No Cost Sharing	Max Plan Benefit of $150 every two years	No Cost Sharing	Not Covered	No Cost Sharing	Not Covered											0	900.0000001	75	0	100	0.2	0.183100647	43.52026006	0	0	0.2	0	0	13.00934453	0	10	9.999999997	10	0.2	10	0.2	0	0	0	0	0	0	0	0	0											0	900.0000001	75	0	100	0.2	0.183100647	43.52026006	0	0	0.2	0	0	13.00934453	0	10	9.999999997	10	0.2	10	0.2	0	0	0	0	0	0	0	0	0											0	0.258987635	3.395149904	0	1.991539985	1.990235698	1.160701913	1.045905694	0	0	3.039221707	0	0	0.325099739	0	2.913178802	0.157716428	0.521806693	6.235890157	0.621591372	1.494671859	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.1517	0	0	0	0.258987635	3.395149904	0	1.991539985	1.990235698	1.160701913	1.045905694	0	0	3.039221707	0	0	0.325099739	0	2.913178802	0.157716428	0.521806693	6.235890157	0.621591372	1.494671859	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.1517	0																																																																																	0	0	0	0	0.258987635	3.395149904	0	1.991539985	1.990235698	1.160701913	1.045905694	0	0	3.039221707	0	0	0.325099739	0	2.913178802	0.157716428	0.521806693	6.235890157	0.621591372	1.494671859	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.1517
H4527_017_0	2009	4																					3450											D	A	D		T	Coin	Coin	V	Coin		Coin			V	V	V	V	V	Coin	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	668.0504164	3.356459916	533.7535223	0	231.2160604	9.596511057	6.133009462	285.3420801	36.87975215	0	15.0129919	0	0	464.8123224	3869.230326	3298.093771	173.0943158	564.3443107	29.0983565	1130.305265	7.419158021	0	0	0	0	0	0	0	0	0											$200/Days 1-5 for IP Medical; $200/Days 1-5 for IP Surgical;	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	$75/Days Custom for SNF	No Cost Sharing	$100/Run 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;	20% Coinsurance for OP Fac - Surgery; 20% Coinsurance for OP Fac - ASC	No Cost Sharing	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	No Cost Sharing	No Cost Sharing	$20/Case for OP Fac - Cardiovascular; $30/Case for OP Fac - Occ Therapy; $30/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $20/Visit for Prof - CORF; $20/Visit for Prof - CORF;	$10/Visit for PCP - Office Visits; $10/Consult for PCP - Consults;	$30/Visit for Speclst - Office Visits; $30/Consult for Speclst - Consults;	$30/Visit for OP Psych - Non-Physician; $30/Visit for OP Psych - Psychiatrist; $30/Visit for OP Substance Abuse;	$30/Visit for PT/ST (PCP); $30/Visit for Occ Therapy (PCP); $30/Visit for PT/ST (Specialist); $30/Visit for Occ Therapy (Specialist);	20% Coinsurance for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	$30/Visit for Chiropractor; $30/Service for Podiatrist;	20% Coinsurance for Part B Rx	No Cost Sharing	Not Covered	No Cost Sharing for Preventive Services	No Cost Sharing	Not Covered	No Cost Sharing	Not Covered	Not Covered	Not Covered											200	899.9999997	75	0	100	0.2	0.18315519	43.45277007	0.2	0	0.2	0	0	24.48706537	10	30	30	30	0.2	30	0.2	0	0	0	0	0	0	0	0	0											200	899.9999997	75	0	100	0.2	0.18315519	43.45277007	0.2	0	0.2	0	0	24.48706537	10	30	30	30	0.2	30	0.2	0	0	0	0	0	0	0	0	0											11.1342	0.251734494	3.335959514	0	1.926800503	1.919302211	1.123292513	1.033241983	7.375950431	0	3.00259838	0	0	0.94849081	3.224358605	8.245234428	0.43273579	1.410860777	5.8196713	2.825763164	1.483831604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.494	0	0	11.1342	0.251734494	3.335959514	0	1.926800503	1.919302211	1.123292513	1.033241983	7.375950431	0	3.00259838	0	0	0.94849081	3.224358605	8.245234428	0.43273579	1.410860777	5.8196713	2.825763164	1.483831604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.494	0																																																																																	0	0	0	11.1342	0.251734494	3.335959514	0	1.926800503	1.919302211	1.123292513	1.033241983	7.375950431	0	3.00259838	0	0	0.94849081	3.224358605	8.245234428	0.43273579	1.410860777	5.8196713	2.825763164	1.483831604	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.494
H4527_018_0	2009	5																					3450												A	D		T	Coin	Coin	V			Coin			V	V	V	V	V	Coin	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	3.409913586	538.9881266	0	235.5100713	9.792546226	6.246947758	287.0275241	0	0	15.11433736	0	0	467.4737921	3962.562874	3340.984653	177.4123499	582.1010476	29.83211778	1175.30654	7.449162353	0	0	0	0	0	0	0	0	0											No Cost Sharing	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	$75/Days Custom for SNF	No Cost Sharing	$100/Run 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;	No Cost Sharing	No Cost Sharing	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	No Cost Sharing	No Cost Sharing	$20/Case for OP Fac - Cardiovascular; $25/Case for OP Fac - Occ Therapy; $25/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $20/Visit for Prof - CORF; $20/Visit for Prof - CORF;	$5/Visit for PCP - Office Visits; $5/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/Visit for PT/ST (PCP); $25/Visit for Occ Therapy (PCP); $25/Visit for PT/ST (Specialist); $25/Visit 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/Service for Podiatrist;	20% Coinsurance for Part B Rx	No Cost Sharing	Not Covered	No Cost Sharing for Preventive Services	No Cost Sharing	Max Plan Benefit of $300 every two years	No Cost Sharing	Max Plan Benefit of $400 every three years	Not Covered	No copay up to $100 every quarter											0	899.9999999	75	0	100	0.2	0.183124597	43.49025103	0	0	0.2	0	0	22.23707944	5	25	25	25	0.2	25	0.2	0	0	0	0	0	0	0	0	0											0	899.9999999	75	0	100	0.2	0.183124597	43.49025103	0	0	0.2	0	0	22.23707944	5	25	25	25	0.2	25	0.2	0	0	0	0	0	0	0	0	0											0	0.255743519	3.368675791	0	1.962583928	1.958509245	1.143969794	1.04024159	0	0	3.022867472	0	0	0.866270988	1.651067864	6.960384694	0.369609062	1.212710516	5.966423557	2.448555292	1.489832471	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.7174	0	0	0	0.255743519	3.368675791	0	1.962583928	1.958509245	1.143969794	1.04024159	0	0	3.022867472	0	0	0.866270988	1.651067864	6.960384694	0.369609062	1.212710516	5.966423557	2.448555292	1.489832471	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.7174	0																																																																																	0	0	0	0	0.255743519	3.368675791	0	1.962583928	1.958509245	1.143969794	1.04024159	0	0	3.022867472	0	0	0.866270988	1.651067864	6.960384694	0.369609062	1.212710516	5.966423557	2.448555292	1.489832471	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.7174
H4527_019_0	2009	2																					3450												A	D		T	Coin	Coin	V			Coin								Coin		Coin					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	41.82279086	1115.706879	0	658.260724	26.70666719	20.03501301	573.7962697	0	0	17.39381421	0	0	0	0	0	0	0	32.35383788	0	9.237061839	0	0	0	0	585.8460045	0	0	0	0											No Cost Sharing	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	$75/Days Custom for SNF	No Cost Sharing	$100/Run for Ambulance	10% Coinsurance for DME	10% Coinsurance for Prosthetics/Supplies; 10% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $30/Visit for Urgent Care; $30/Visit for Urgent Care - Worldwide;	No Cost Sharing	No Cost Sharing	20% Coinsurance for OP Fac - Radiology;	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	20% Coinsurance for Prof Radiology (Office); 13% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	No Cost Sharing	10% Coinsurance for Part B Rx	No Cost Sharing	Not Covered	No Cost Sharing for Preventive Services	No Cost Sharing	Max Plan Benefit of $300 every two years	No Cost Sharing	Max Plan Benefit of $400 every three years	Not Covered	No copay up to $50 every quarter											0	900	75	0	100	0.1	0.092329129	44.45385955	0	0	0.1102969	0	0	0	0	0	0	0	0.19112821	0	0.1	0	0	0	0	10	0	0	0	0											0	900	75	0	100	0.1	0.092329129	44.45385955	0	0	0.1102969	0	0	0	0	0	0	0	0.19112821	0	0.1	0	0	0	0	10	0	0	0	0											0	3.136709314	6.973167995	0	5.485506034	2.670666719	1.849815311	2.125621565	0	0	1.91848378	0	0	0	0	0	0	0	6.183731117	0	0.923706184	0	0	0	0	0.488205004	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.7556	0	0	0	3.136709314	6.973167995	0	5.485506034	2.670666719	1.849815311	2.125621565	0	0	1.91848378	0	0	0	0	0	0	0	6.183731117	0	0.923706184	0	0	0	0	0.488205004	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.7556	0																																																																																	0	0	0	0	3.136709314	6.973167995	0	5.485506034	2.670666719	1.849815311	2.125621565	0	0	1.91848378	0	0	0	0	0	0	0	6.183731117	0	0.923706184	0	0	0	0	0.488205004	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.7556
H4527_020_0	2009	1																					3450												A	D		T	Coin		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	0	3.779388593	307.5753464	0	239.5201679	11.43406663	0	304.772832	0	0	0	0	0	0	0	0	0	0	0	799.4585147	5.620358274	0	0	0	0	0	0	0	0	0											No Cost Sharing	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	$100/Days 21-100 for SNF	No Cost Sharing	$75/Run for Ambulance	10% Coinsurance for DME	No Cost Sharing	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $20/Visit for Urgent Care; $20/Visit for Urgent Care - Worldwide;	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$10/Service for Podiatrist;	20% Coinsurance for Part B Rx	No Cost Sharing	No Cost Sharing	No Cost Sharing for Preventive Services	No Cost Sharing	Max Plan Benefit of $300 every two years	No Cost Sharing	Max Plan Benefit of $400 every three years	No Cost Sharing	No copay up to $100 every quarter											0	900.0000001	100	0	75	0.1	0	39.94559978	0	0	0	0	0	0	0	0	0	0	0	9.999999999	0.2	0	0	0	0	0	0	0	0	0											0	900.0000001	100	0	75	0.1	0	39.94559978	0	0	0	0	0	0	0	0	0	0	0	9.999999999	0.2	0	0	0	0	0	0	0	0	0											0	0.283454145	2.563127887	0	1.497001049	1.143406663	0	1.014527798	0	0	0	0	0	0	0	0	0	0	0	0.666215429	1.124071655	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.2918	0	0	0	0.283454145	2.563127887	0	1.497001049	1.143406663	0	1.014527798	0	0	0	0	0	0	0	0	0	0	0	0.666215429	1.124071655	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.2918	0																																																																																	0	0	0	0	0.283454145	2.563127887	0	1.497001049	1.143406663	0	1.014527798	0	0	0	0	0	0	0	0	0	0	0	0.666215429	1.124071655	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.2918
H4527_022_0	2009	1																					3450												A	D		T	Coin	Coin	V			Coin			V		V	V	V	Coin	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	2.716587504	458.3308636	0	162.2510575	8.634725173	5.68729927	268.0240215	0	0	13.07849366	0	0	228.6912796	0	3305.754327	154.237383	474.0481636	35.24552369	564.7000174	6.573744959	0	0	0	0	0	0	0	0	0											No Cost Sharing	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	$100/Days Custom for SNF	No Cost Sharing	$100/Run for Ambulance	10% Coinsurance for DME	10% Coinsurance for Prosthetics/Supplies; 10% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $30/Visit for Urgent Care; $30/Visit for Urgent Care - Worldwide;	No Cost Sharing	No Cost Sharing	10% Coinsurance for OP Fac - Radiology; 10% Coinsurance for OP Fac - CT/MRI/PET	No Cost Sharing	No Cost Sharing	$10/Case for OP Fac - Occ Therapy; $10/Case for OP Fac - Physical/Speech Therapy;	No Cost Sharing	$10/Visit for Speclst - Office Visits; $10/Consult for Speclst - Consults;	$10/Visit for OP Psych - Non-Physician; $10/Visit for OP Psych - Psychiatrist; $10/Visit for OP Substance Abuse;	$10/Visit for PT/ST (PCP); $10/Visit for Occ Therapy (PCP); $10/Visit for PT/ST (Specialist); $10/Visit for Occ Therapy (Specialist);	10% Coinsurance for Prof Radiology (Office); 10% Coinsurance for Prof Radiology (OP); 10% Coinsurance for Prof Radiology (IP);	$10/Service for Podiatrist;	20% Coinsurance for Part B Rx	No Cost Sharing	No Cost Sharing	No Cost Sharing for Preventive Services	No Cost Sharing	Max Plan Benefit of $300 every two years	No Cost Sharing	Max Plan Benefit of $400 every three years	No Cost Sharing	Not Covered											0	900.0000003	100	0	100	0.1	0.091827803	43.20195448	0	0	0.1	0	0	10	0	10	10	9.999999998	0.1	9.999999999	0.2	0	0	0	0	0	0	0	0	0											0	900.0000003	100	0	100	0.1	0.091827803	43.20195448	0	0	0.1	0	0	10	0	10	10	9.999999998	0.1	9.999999999	0.2	0	0	0	0	0	0	0	0	0											0	0.203744063	3.819423863	0	1.352092146	0.863472517	0.522252197	0.964930131	0	0	1.307849366	0	0	0.190576066	0	2.754795273	0.128531153	0.395040136	3.524552369	0.470583348	1.314748992	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.8126	0	0	0	0.203744063	3.819423863	0	1.352092146	0.863472517	0.522252197	0.964930131	0	0	1.307849366	0	0	0.190576066	0	2.754795273	0.128531153	0.395040136	3.524552369	0.470583348	1.314748992	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.8126	0																																																																																	0	0	0	0	0.203744063	3.819423863	0	1.352092146	0.863472517	0.522252197	0.964930131	0	0	1.307849366	0	0	0.190576066	0	2.754795273	0.128531153	0.395040136	3.524552369	0.470583348	1.314748992	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.8126
H4527_023_0	2009	3																					3450												A			T	Coin		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	0	2.825145676	0	0	166.8529335	8.929265144	0	274.0166466	0	0	0	0	0	379.2805577	0	3394.882065	146.211596	505.3114312	0	952.4653179	6.541136606	0	0	0	0	0	0	0	0	0											No Cost Sharing	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	No Cost Sharing	No Cost Sharing	$75/Run for Ambulance	10% Coinsurance for DME	No Cost Sharing	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $30/Visit for Urgent Care; $30/Visit for Urgent Care - Worldwide;	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$20/Case for OP Fac - Cardiovascular; $5/Case for OP Fac - Occ Therapy; $5/Case for OP Fac - Physical/Speech Therapy;	No Cost Sharing	$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 PT/ST (PCP); $5/Visit for Occ Therapy (PCP); $5/Visit for PT/ST (Specialist); $5/Visit for Occ Therapy (Specialist);	No Cost Sharing	$10/Visit for Chiropractor; $5/Service for Podiatrist;	20% Coinsurance for Part B Rx	No Cost Sharing	No Cost Sharing	No Cost Sharing for Preventive Services	No Cost Sharing	Max Plan Benefit of $300 every two years	No Cost Sharing	Max Plan Benefit of $400 every three years	Not Covered	Not Covered											0	900.0000003	0	0	75	0.1	0	43.32699623	0	0	0	0	0	10.57462394	0	5	5.000000007	4.999999998	0	6.840085809	0.2	0	0	0	0	0	0	0	0	0											0	900.0000003	0	0	75	0.1	0	43.32699623	0	0	0	0	0	10.57462394	0	5	5.000000007	4.999999998	0	6.840085809	0.2	0	0	0	0	0	0	0	0	0											0	0.211885926	0	0	1.042830835	0.892926514	0	0.989359851	0	0	0	0	0	0.334229106	0	1.414534194	0.060921498	0.21054643	0	0.542912042	1.308227321	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.0084	0	0	0	0.211885926	0	0	1.042830835	0.892926514	0	0.989359851	0	0	0	0	0	0.334229106	0	1.414534194	0.060921498	0.21054643	0	0.542912042	1.308227321	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.0084	0																																																																																	0	0	0	0	0.211885926	0	0	1.042830835	0.892926514	0	0.989359851	0	0	0	0	0	0.334229106	0	1.414534194	0.060921498	0.21054643	0	0.542912042	1.308227321	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.0084
H4527_024_0	2009	1																					3450											D	A	D		T	Coin	Coin	V	V		Coin			V		V	V	V	Coin	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	650.5147534	3.076668351	472.3251961	0	179.3175819	10.17286024	6.558475808	278.785301	254.0991941	0	13.27008029	0	0	268.1278525	0	3407.000093	141.2039522	448.2226659	27.4574882	533.9359303	6.276510203	0	0	0	0	0	0	0	0	0											$50/Days 1-5 for IP Medical; $50/Days 1-5 for IP Surgical;	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	$75/Days Custom for SNF	No Cost Sharing	$100/Run 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;	$50/Case for OP Fac - Surgery; $50/Case for OP Fac - ASC	No Cost Sharing	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	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; $10/Visit for Prof - CORF; $10/Visit for Prof - CORF;	No Cost Sharing	$10/Visit for Speclst - Office Visits; $10/Consult for Speclst - Consults;	$10/Visit for OP Psych - Non-Physician; $10/Visit for OP Psych - Psychiatrist; $10/Visit for OP Substance Abuse;	$10/Visit for PT/ST (PCP); $10/Visit for Occ Therapy (PCP); $10/Visit for PT/ST (Specialist); $10/Visit for Occ Therapy (Specialist);	20% Coinsurance for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	$10/Service for Podiatrist;	20% Coinsurance for Part B Rx	No Cost Sharing	No Cost Sharing	No Cost Sharing for Preventive Services	No Cost Sharing	Max Plan Benefit of $300 every two years	No Cost Sharing	Max Plan Benefit of $400 every three years	No Cost Sharing	Not Covered											50	899.9999998	75	0	100	0.2	0.18330192	43.4541524	50	0	0.2	0	0	9.999999996	0	10	10	10.00000001	0.2	10	0.2	0	0	0	0	0	0	0	0	0											50	899.9999998	75	0	100	0.2	0.18330192	43.4541524	50	0	0.2	0	0	9.999999996	0	10	10	10.00000001	0.2	10	0.2	0	0	0	0	0	0	0	0	0											2.7105	0.230750126	2.952032476	0	1.494313182	2.034572048	1.202181207	1.00953158	1.058746642	0	2.654016059	0	0	0.223439877	0	2.839166745	0.11766996	0.373518888	5.49149764	0.444946609	1.255302041	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.0922	0	0	2.7105	0.230750126	2.952032476	0	1.494313182	2.034572048	1.202181207	1.00953158	1.058746642	0	2.654016059	0	0	0.223439877	0	2.839166745	0.11766996	0.373518888	5.49149764	0.444946609	1.255302041	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.0922	0																																																																																	0	0	0	2.7105	0.230750126	2.952032476	0	1.494313182	2.034572048	1.202181207	1.00953158	1.058746642	0	2.654016059	0	0	0.223439877	0	2.839166745	0.11766996	0.373518888	5.49149764	0.444946609	1.255302041	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.0922
H4528_001_0	2009	2																																A	coin	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		277.7449725	4.541651197	295.4511858	12.5559425	237.1356175	9.637076368	3.066687148	354.8294793	244.5723234	2.778611403	448.007334	0	0.100712527	381.5423212	2356.299111	3628.462416	286.435972	272.3643152	30.91321429	30.68404622	11.95132472	0	0	194.126465	316.9367773	0	0	0	1029.266039	1997.065281											1a:  Acute - $400/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - MC Cost Shares for 1-/1-190	2:  Skilled Nursing Services - $0/$85/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$85/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $35/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $150/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $100/visit/8b:  Outpatient Therapeutic Radiological Services - $100/visit/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $35/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $0/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $35/visit/7b:  Chiropractic Services - $35/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $35/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $35/visit/7h:  Psychiatric Services - Individual - $35/visit/7h:  Psychiatric Services - Group - $35/visit	7c:  Occupational Therapy Services - $35/visit/7i:  Physical/Speech Therapy - $35/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $35/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service	17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service			14a:  Written health education materials - $0/service/14a:  Membership in Health Club/Fitness Classes - $0/service/14c:  Routine Exams - $0/visit/	13d:  Other: Over the Counter Benefit - $0/visit/7b:  Chiropractic Services - 20 Additional Visits											393.0875529	0.06751835	85	0	50	0.2	0.2	44.66936768	110.1315579	0	40.66395809	0	0.2	35	0.0257752	34.7830904	35	35	0	19.97256345	0.2	0	0	0	0	0	0	0	0	7.58141343											372.7710136	0.06751835	80.5921037	-7.77E-19	47.40711982	0.189628479	0.189628479	42.35292133	104.4203992	0	38.55522268	0	0.189628479	33.18498388	0.02443856	32.97932269	34.98977118	33.18498388	0	19.96980816	0.189628479	0	0	0	0	0	0	0	0	7.58141343											8.6279	0.306644794	1.984252717	-9.76E-18	0.936826386	1.827464137	0.58153122	1.252338752	2.128194971	0	1.439418544	0	0.019097963	1.055122981	0.004798713	9.972019406	0.835194093	0.753200451	0	0.051062876	2.266311531	0	0	0	0	0	0	0	0	1.261714795	0	0	0	0	0	0	0	0	0	0	35.3031	0	1.8532	8.6279	0.306644794	1.984252717	-9.76E-18	0.936826386	1.827464137	0.58153122	1.252338752	2.128194971	0	1.439418544	0	0.019097963	1.055122981	0.004798713	9.972019406	0.835194093	0.753200451	0	0.051062876	2.266311531	0	0	0	0	0	0	0	0	1.261714795	0	0	0	0	0	0	0	0	0	0	35.3031	4000	1a:  Acute - 20.0% for 1-90/1a:  Additional Days - 20.0% for 91-999		2:  Skilled Nursing Services - 20.0% for 1-100/2:  Non-Medicare Covered Stay - 20.0% for 1-100	6:  Home Health Services - 20.0%	10a:  Ambulance - 20.0%			4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $35/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - 20.0%	8a:  Outpatient Diagnostic Procedures/Tests - 20.0%/8a:  Outpatient Lab Services - 20.0%	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - 20.0%/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - 20.0%	7a:  Primary Care - 20.0%/14c:  Physical Exams (Initial Exam) - 20.0%/14d:  Pap Smears and Pelvic Exams Screening - 20.0%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%	7d:  Physician Specialist Services - 20.0%/7b:  Chiropractic Services - 20.0%/17a:  Vision Exams - 20.0%/18a:  Hearing Exams - 20.0%/14d:  Pap Smears and Pelvic Exams Screening - 20.0%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%		7c:  Occupational Therapy Services - 20.0%/7i:  Physical/Speech Therapy - 20.0%	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%	7a:  Primary Care - 20.0%/14c:  Physical Exams (Initial Exam) - 20.0%/14d:  Pap Smears and Pelvic Exams Screening - 20.0%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%/7d:  Physician Specialist Services - 20.0%/7b:  Chiropractic Services - 20.0%/17a:  Vision Exams - 20.0%/18a:  Hearing Exams - 20.0%/14d:  Pap Smears and Pelvic Exams Screening - 20.0%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%																			4.9197	0	0.3626	0.2184	0.0983	0	0	0.1485	0.4274	0.081	0.3184	0	0.0025	0.2993	0.5696	1.4146	0.0002	0.0484	0.6083	0.4229	0.25	0.0096	0	0	0	0	0	0	0	0											10.1999	0	0.058	13.5477	0.306644794	2.346822766	0.218435972	1.03515398	1.827464137	0.58153122	1.400823702	2.555631764	0.08102469	1.757856478	0	0.021557476	1.354398764	0.574416977	11.38661373	0.83540988	0.801632603	0.608299499	0.473978793	2.51633494	0.009579347	0	0	0	0	0	0	0	1.261714795	0	0	0	0	0	0	0	0	0	0	45.503
H4528_002_0	2009	2																																A	coin	coin	coin	coin	coin	coin	V	coin	coin	coin	O	coin	P	V	V	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		312.3812187	4.667867427	24.33002461	48.95165986	7.42897338	14.35012547	4.193316136	204.4317004	33.62008995	4.204181354	18.45573109	0	0.186335709	607.6454884	0	0	1.940855883	4.282678499	37.37201628	29.03471896	12.324233	0.669331857	1632.389242	432.657224	317.5230952	0	0	0	1029.266039	3864.060215											1a:  Acute - $500/$0/admit for 1-90	1b:  Psych - MC Cost Shares for 1-/1-190	2:  Skilled Nursing Services - MC Cost Shares for 1-100/2:  Non-Medicare Covered Stay - MC Cost Shares for 1-100	6:  Home Health Services - $0/visit	10a:  Ambulance - 20.0%	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $0/visit/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - 20.0%	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - $0/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $0/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $0/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - $0/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $0/visit/7b:  Chiropractic Services - $0/visit/7f:  Podiatry Services - $0/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $0/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $0/visit/7h:  Psychiatric Services - Individual - $0/visit/7h:  Psychiatric Services - Group - $0/visit	7c:  Occupational Therapy Services - $0/visit/7i:  Physical/Speech Therapy - $0/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%	10b:  Transportation - $0/trip	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Emergency Svcs - $0/visit/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $0/visit/18a:  Fitting for Hearing Aid - $0/visit	18b:  Hearing Aids - $0/service	14a:  Written health education materials - $0/service/14a:  Membership in Health Club/Fitness Classes - $0/service/14c:  Routine Exams - $0/visit/	13d:  Other: Over the Counter Benefit - $0/visit											492.3358101	0.0674275	0.213059991	0	0.2	0.2	0.2	50	0.2	0	0.140998533	0	0.2	36.82959349	0	0	-1.59E-19	0	0	21.05096176	0.2	0.2	0	0	0	0	0	0	0	0											492.3358101	0.0674275	0.213059991	0	0.2	0.2	0.2	50	0.2	0	0.140998533	0	0.2	36.82959349	0	0	-1.59E-19	0	0	21.05096176	0.2	0.2	0	0	0	0	0	0	0	0											12.8164	0.314742631	5.183754823	0	1.485794676	2.870025094	0.838663227	0.851798752	6.72401799	0	2.602231008	0	0.037267142	1.864944693	0	0	-3.09E-19	0	0	0.050934063	2.4648466	0.133866371	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.2393	0	0	12.8164	0.314742631	5.183754823	0	1.485794676	2.870025094	0.838663227	0.851798752	6.72401799	0	2.602231008	0	0.037267142	1.864944693	0	0	-3.09E-19	0	0	0.050934063	2.4648466	0.133866371	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.2393																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.8164	0.314742631	5.183754823	0	1.485794676	2.870025094	0.838663227	0.851798752	6.72401799	0	2.602231008	0	0.037267142	1.864944693	0	0	-3.09E-19	0	0	0.050934063	2.4648466	0.133866371	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.2393
H4528_005_0	2009	2																																A	coin	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		182.0392929	4.554260031	496.5581208	31.90996513	143.8683067	10.44409562	2.971777551	152.3504957	229.3468671	1.796714567	250.4548875	0	0.203291966	340.6112533	673.9580506	4243.178275	282.3771869	689.0597055	28.63747485	29.64180415	3.513194351	0	0	194.126465	322.0682612	0	0	0	1029.266039	1501.063107											1a:  Acute - $100/$0/admit for 1-90	1b:  Psych - MC Cost Shares for 1-/1-190	2:  Skilled Nursing Services - $0/$85/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$85/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $20/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $60/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $50/visit/8b:  Outpatient Therapeutic Radiological Services - $50/visit/8b:  Outpatient X-Ray Services - $10/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $0/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $20/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $20/visit/7h:  Psychiatric Services - Individual - $20/visit/7h:  Psychiatric Services - Group - $20/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service	17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service			14a:  Written health education materials - $0/service/14a:  Membership in Health Club/Fitness Classes - $0/service/14c:  Routine Exams - $0/visit/	/7b:  Chiropractic Services - 20 Additional Visits											99.07228608	0.0701	85	0	50	0.2	0.2	38.78703078	68.05282938	0	20.64223985	0	0.2	20	0.054963589	20	20	20	0	20.61982312	0.2	0	0	0	0	0	0	0	0	10											99.07228608	0.0701	85	0	50	0.2	0.2	38.78703078	68.05282938	0	20.64223985	0	0.2	20	0.054963589	20	20	20	0	20.61982312	0.2	0	0	0	0	0	0	0	0	10											1.5029	0.319253628	3.517286689	0	0.599451278	2.088819124	0.59435551	0.49243528	1.300641934	0	0.430829155	0	0.040658393	0.567685422	0.003086929	7.071963792	0.470628645	1.148432842	0	0.050934063	0.70263887	0	0	0	0	0	0	0	0	1.250885922	0	0	0	0	0	0	0	0	0	0	22.1529	0	0	1.5029	0.319253628	3.517286689	0	0.599451278	2.088819124	0.59435551	0.49243528	1.300641934	0	0.430829155	0	0.040658393	0.567685422	0.003086929	7.071963792	0.470628645	1.148432842	0	0.050934063	0.70263887	0	0	0	0	0	0	0	0	1.250885922	0	0	0	0	0	0	0	0	0	0	22.1529		1a:  Acute - 20.0% for 1-90		2:  Skilled Nursing Services - 20.0% for 1-100/2:  Non-Medicare Covered Stay - 20.0% for 1-100	6:  Home Health Services - 20.0%	10a:  Ambulance - 20.0%			4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $20/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - 20.0%	8a:  Outpatient Diagnostic Procedures/Tests - 20.0%/8a:  Outpatient Lab Services - 20.0%	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - 20.0%/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - 20.0%	7a:  Primary Care - 20.0%/14c:  Physical Exams (Initial Exam) - 20.0%/14d:  Pap Smears and Pelvic Exams Screening - 20.0%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%	7d:  Physician Specialist Services - 20.0%/7b:  Chiropractic Services - 20.0%/17a:  Vision Exams - 20.0%/18a:  Hearing Exams - 20.0%/14d:  Pap Smears and Pelvic Exams Screening - 20.0%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%		7c:  Occupational Therapy Services - 20.0%/7i:  Physical/Speech Therapy - 20.0%	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%	7a:  Primary Care - 20.0%/14c:  Physical Exams (Initial Exam) - 20.0%/14d:  Pap Smears and Pelvic Exams Screening - 20.0%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%/7d:  Physician Specialist Services - 20.0%/7b:  Chiropractic Services - 20.0%/17a:  Vision Exams - 20.0%/18a:  Hearing Exams - 20.0%/14d:  Pap Smears and Pelvic Exams Screening - 20.0%/14e:  Prostate Cancer Screening - 20.0%/14f:  Colorectal Screening - 20.0%/14g:  Bone Mass Measurement - 20.0%/14b:  Immunizations (Hepatitis B) - 20.0%	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%																			5.4917	0	0.9401	0.6171	0.1373	0	0	0.0863	0.746	0.1355	0.4291	0	0.0048	0.4292	0.6015	1.6256	0	0.1156	0.5636	0.7044	0.1682	0.018	0	0	0	0	0	0	0	0											12.8141	0	0	6.9947	0.319253628	4.45739636	0.617109151	0.736725426	2.088819124	0.59435551	0.578722546	2.046669322	0.135479945	0.859888374	0	0.045419675	0.996934025	0.604602734	8.69760939	0.470628645	1.264037159	0.563605623	0.755379849	0.870887669	0.017989452	0	0	0	0	0	0	0	1.250885922	0	0	0	0	0	0	0	0	0	0	34.9671
H4528_006_0	2009	2																																A	coin	coin	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		342.5626473	4.554260031	67.65178066	62.33911292	594.2488856	38.82545845	11.04745016	169.114045	51.76891999	3.207055047	12.89094226	0	0.250862736	0	0	0	1.940855883	6.611733227	38.6188844	29.64180415	6.270894601	0.673140483	1632.389242	432.657224	322.0682612	0	0	0	1029.266039	4899.076344											1a:  Acute - $500/$0/admit for 1-90	1b:  Psych - MC Cost Shares for 1-/1-190	2:  Skilled Nursing Services - MC Cost Shares for 1-100/2:  Non-Medicare Covered Stay - MC Cost Shares for 1-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $0/visit/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - $0/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $0/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $0/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - $0/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $0/visit/7b:  Chiropractic Services - $0/visit/7f:  Podiatry Services - $0/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $0/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $0/visit/7h:  Psychiatric Services - Individual - $0/visit/7h:  Psychiatric Services - Group - $0/visit	7c:  Occupational Therapy Services - $0/visit/7i:  Physical/Speech Therapy - $0/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%	10b:  Transportation - $0/trip	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Emergency Svcs - $0/visit/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $0/visit/18a:  Fitting for Hearing Aid - $0/visit	18b:  Hearing Aids - $0/service	14a:  Written health education materials - $0/service/14a:  Membership in Health Club/Fitness Classes - $0/service/14c:  Routine Exams - $0/visit/	13d:  Other: Over the Counter Benefit - $0/visit											493.1049498	0.0701	0.1985	0	50	0.2	0.2	50	0	0	0.141519144	0	0.2	0	0	0	0	0	0	20.61982312	0.2	0.2	0	0	0	0	0	0	0	0											493.1049498	0.0701	0.1985	0	50	0.2	0.2	50	0	0	0.141519144	0	0.2	0	0	0	0	0	0	20.61982312	0.2	0.2	0	0	0	0	0	0	0	0											14.0766	0.319253628	13.42887846	0	2.476037023	7.76509169	2.209490032	0.704641854	0	0	1.824315115	0	0.050172547	0	0	0	0	0	0	0.050934063	1.25417892	0.134628097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2942	0	0	14.0766	0.319253628	13.42887846	0	2.476037023	7.76509169	2.209490032	0.704641854	0	0	1.824315115	0	0.050172547	0	0	0	0	0	0	0.050934063	1.25417892	0.134628097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2942																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.0766	0.319253628	13.42887846	0	2.476037023	7.76509169	2.209490032	0.704641854	0	0	1.824315115	0	0.050172547	0	0	0	0	0	0	0.050934063	1.25417892	0.134628097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.2942
H4528_009_0	2009	2																																A	coin	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		334.5330929	4.535310019	578.1475017	53.48979116	257.0407247	13.34976809	3.798561652	195.2314419	259.4367889	3.312607842	647.3060271	0	0.201654806	409.8707577	2.239730799	4933.699488	268.4273839	635.3054607	29.98926585	28.17746019	8.54003725	0	0	194.1564274	315.9666361	0	0	0	1029.266039	2783.043369											1a:  Acute - $400/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - MC Cost Shares for 1-/1-190	2:  Skilled Nursing Services - $0/$85/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$85/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $35/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $150/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $100/visit/8b:  Outpatient Therapeutic Radiological Services - $100/visit/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $35/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $0/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $35/visit/7b:  Chiropractic Services - $35/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $35/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $35/visit/7h:  Psychiatric Services - Individual - $35/visit/7h:  Psychiatric Services - Group - $35/visit	7c:  Occupational Therapy Services - $35/visit/7i:  Physical/Speech Therapy - $35/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $35/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service	17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service			14a:  Written health education materials - $0/service/14a:  Membership in Health Club/Fitness Classes - $0/service/14a:  Nutritional Training - $0/service/14c:  Routine Exams - $0/visit/	13d:  Other: Over the Counter Benefit - $0/visit											394.2983994	0.066214573	85	0	50	0.2	0.2	44.67038783	110.1315579	0	37.61475967	0	0.2	35	27.01970889	34.82536268	35	35	0	21.69140705	0.2	0	0	0	0	0	0	0	0	0											368.6304554	0.066214573	79.45167892	0	46.73628171	0.186945127	0.186945127	41.75455659	102.9427903	0	35.1594801	0	0.186945127	32.7153972	25.25601453	32.55215922	35	32.7153972	0	21.69140705	0.186945127	0	0	0	0	0	0	0	0	0											10.2766	0.300303616	3.827899139	0	1.001093977	2.495674088	0.71012259	0.679316857	2.22559558	0	1.896578615	0	0.037698383	1.11742372	0.004713889	13.38354761	0.782913203	1.732022541	0	0.050934063	1.596518347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1189	0	2.86	10.2766	0.300303616	3.827899139	0	1.001093977	2.495674088	0.71012259	0.679316857	2.22559558	0	1.896578615	0	0.037698383	1.11742372	0.004713889	13.38354761	0.782913203	1.732022541	0	0.050934063	1.596518347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1189	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	10.2766	0.300303616	3.827899139	0	1.001093977	2.495674088	0.71012259	0.679316857	2.22559558	0	1.896578615	0	0.037698383	1.11742372	0.004713889	13.38354761	0.782913203	1.732022541	0	0.050934063	1.596518347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1189
H4528_010_0	2009	2																																A	coin	D	coin	T	coin	coin	V	V	coin	P	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		253.5812141	4.554260031	634.4909321	40.77384433	183.8317253	12.01070996	3.417544184	194.5853641	293.5281286	2.295801946	320.0256896	0	0.259761957	423.530958	2.129981316	5254.356718	282.3771869	880.4651792	36.59232897	29.64180415	4.489081671	0	0	194.126465	322.0682612	0	0	0	1029.266039	1748.02724											1a:  Acute - $100/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - MC Cost Shares for 1-/1-190	2:  Skilled Nursing Services - $0/$85/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$85/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $20/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $50/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $50/visit/8b:  Outpatient Therapeutic Radiological Services - $50/visit/8b:  Outpatient X-Ray Services - $10/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $0/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $20/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $20/visit/7h:  Psychiatric Services - Individual - $20/visit/7h:  Psychiatric Services - Group - $20/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service	17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service			14a:  Written health education materials - $0/service/14a:  Membership in Health Club/Fitness Classes - $0/service/14a:  Nutritional Training - $0/service/14c:  Routine Exams - $0/visit/	13d:  Other: Over the Counter Benefit - $0/visit											99.33401855	0.0701	85	0	50	0.2	0.2	38.78214916	60.04978863	0	20.64223985	0	0.2	20	20	20	20	20	0	20.61982312	0.2	0	0	0	0	0	0	0	0	0											97.29454924	0.0701	83.22814112	0	48.95773007	0.19583092	0.19583092	37.97371981	58.79802685	0	20.21194413	0	0.19583092	19.58309203	19.58309203	19.58309203	20	19.58309203	0	20.61982312	0.19583092	0	0	0	0	0	0	0	0	0											2.056	0.319253628	4.40062507	0	0.749998665	2.352068386	0.669260823	0.615760841	1.438239565	0	0.539028447	0	0.050869423	0.691170477	0.003475968	8.574712596	0.470628645	1.436852553	0	0.050934063	0.879100995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.298	0	0.52	2.056	0.319253628	4.40062507	0	0.749998665	2.352068386	0.669260823	0.615760841	1.438239565	0	0.539028447	0	0.050869423	0.691170477	0.003475968	8.574712596	0.470628645	1.436852553	0	0.050934063	0.879100995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.298	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	2.056	0.319253628	4.40062507	0	0.749998665	2.352068386	0.669260823	0.615760841	1.438239565	0	0.539028447	0	0.050869423	0.691170477	0.003475968	8.574712596	0.470628645	1.436852553	0	0.050934063	0.879100995	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.298
H4528_011_0	2009	2																																A	coin	coin	coin	coin	coin	coin	V	coin	coin	coin	O	coin	P	V	V	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		342.8232741	4.551857237	40.01594008	62.35750924	7.444554579	15.2303943	4.333677661	154.9235302	36.10859337	2.737212983	18.09502171	0	0.245992693	782.3153486	0	0	1.940855883	6.48337847	40.22288142	29.02957003	8.801875899	0.943046046	1632.389242	432.657224	316.9843473	0	0	0	1029.266039	483.0075269											1a:  Acute - $500/$0/admit for 1-90	1b:  Psych - MC Cost Shares for 1-/1-190	2:  Skilled Nursing Services - MC Cost Shares for 1-100/2:  Non-Medicare Covered Stay - MC Cost Shares for 1-100	6:  Home Health Services - $0/visit	10a:  Ambulance - 20.0%	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $0/visit/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - 20.0%/9b:  Ambulatory Surgical Center Services - 20.0%	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - $0/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $0/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $0/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - $0/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $0/visit/7b:  Chiropractic Services - $0/visit/7f:  Podiatry Services - $0/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $0/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $0/visit/7h:  Psychiatric Services - Individual - $0/visit/7h:  Psychiatric Services - Group - $0/visit	7c:  Occupational Therapy Services - $0/visit/7i:  Physical/Speech Therapy - $0/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%	10b:  Transportation - $0/trip	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Emergency Svcs - $0/visit/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $0/visit	17b:  Wear - $0/service			14a:  Written health education materials - $0/service/14a:  Membership in Health Club/Fitness Classes - $0/service/14c:  Routine Exams - $0/visit/	13d:  Other: Over the Counter Benefit - $0/visit											493.1651579	0.069609133	0.19883552	0	0.2	0.2	0.2	50	0.2	0	0.141519144	0	0.2	35.06931124	0	0	0	0	0	21.05469554	0.2	0.2	0	0	0	0	0	0	0	0											493.1651579	0.069609133	0.19883552	0	0.2	0.2	0.2	50	0.2	0	0.141519144	0	0.2	35.06931124	0	0	0	0	0	21.05469554	0.2	0.2	0	0	0	0	0	0	0	0											14.089	0.316850834	7.956590249	0	1.488910916	3.04607886	0.866735532	0.645514709	7.221718675	0	2.560791985	0	0.049198539	2.286271704	0	0	0	0	0	0.050934063	1.76037518	0.188609209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.5276	0	0	14.089	0.316850834	7.956590249	0	1.488910916	3.04607886	0.866735532	0.645514709	7.221718675	0	2.560791985	0	0.049198539	2.286271704	0	0	0	0	0	0.050934063	1.76037518	0.188609209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.5276																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.089	0.316850834	7.956590249	0	1.488910916	3.04607886	0.866735532	0.645514709	7.221718675	0	2.560791985	0	0.049198539	2.286271704	0	0	0	0	0	0.050934063	1.76037518	0.188609209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.5276
H4529_002_0	2009	9																					3200											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1657.124255	2.819023404	365.3836544	27.70170519	163.9379889	12.69107453	6.865327729	36.58934426	548.7930101	8.221818481	19.54239896	0.533283683	0.17406964	17.94087999	9861.619617	1778.833056	88.17082242	46.47228766	4137.941163	1096.098831	10.53572674	0	0	936	446.3141349	1.442168097	0.502256867	0	0	0											1a (IP Acute): 125 days 1-5	1b (IP Psych): 200 days 1-5	2a (SNF): 30 days 11-100	6a (Home Health): 10 copay	10a (Ambulance): 125 copay	11a (DME): 20% coin	11b (Medical Supplies): 10% coin	4a (ER): 50 copay	9b (OP Surg): 400 copay; 9b (OP ASC): 200 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 20% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 15% coin; 9c (OP SA): 30 copay; 3 (CORF): 35 copay; 5 (Partial Hosp): 45 copay; 9d (OP Cardiac Rehab): 10 copay		7b (Chiro): 10 copay; 7d (SPC w/Copay): 30 copay	7h (Psych): 45 copay; 7e (MH Non-Phys): 45 copay	7i (PT/ST): 10 copay; 7c (OT): 15 copay	7g (Prof. Other): 30 copay	7g (Prof. Other): 30 copay	15 (Part B Rx): 20% coin			16b (Comp. Dental): 30 copay	17a1 (Routine Eye Exam): 5 copay	17b1 (Non MCR Covered): 150 allowance	18a (Hearing Exam): 30 copay														66.17352474	142.8901802	18.34799697	10	125	0.2	0.1	50	399.1402001	0	0.2	0.15	0.2	0.148188355	0	29.52436313	45	10.03166709	30	28.2078876	0.2	0	0	30	5	0	30	0	0	0											57.05265019	123.1952431	15.8190433	8.621673156	107.7709145	0.172433463	0.086216732	43.10836578	344.1256349	0	0.172433463	0.129325097	0.172433463	0.127763156	0	25.4549409	38.7975292	8.648975483	25.86501947	24.31991873	0.172433463	0	0	25.86501947	5	0	30	0	0	0											7.8786	0.028940856	0.481668321	0.019902921	1.472312248	2.188365931	0.591906118	0.131442236	15.73781192	0	3.36976353	0.068966964	0.030015431	2.292183457	0	3.77334086	0.285067505	0.033494806	8.918994061	2.221419542	1.816711849	0	0	2.017471519	0.185964223	0	0.001255642	0	0	0	0	0	0	0	0	0	0	0	0	0	53.5456		8.5303	7.8786	0.028940856	0.481668321	0.019902921	1.472312248	2.188365931	0.591906118	0.131442236	15.73781192	0	3.36976353	0.068966964	0.030015431	2.292183457	0	3.77334086	0.285067505	0.033494806	8.918994061	2.221419542	1.816711849	0	0	2.017471519	0.185964223	0	0.001255642	0	0	0	0	0	0	0	0	0	0	0	0	0	53.5456																																																																																		0			7.8786	0.028940856	0.481668321	0.019902921	1.472312248	2.188365931	0.591906118	0.131442236	15.73781192	0	3.36976353	0.068966964	0.030015431	2.292183457	0	3.77334086	0.285067505	0.033494806	8.918994061	2.221419542	1.816711849	0	0	2.017471519	0.185964223	0	0.001255642	0	0	0	0	0	0	0	0	0	0	0	0	0	53.5456
H4529_004_0	2009	11																					4475											D	D	D	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		2424.419986	31.01139548	238.6387827	48.39737753	237.6508655	12.26496162	5.189939743	99.29305342	32.55540118	5.310861761	15.48605808	0.771548875	0.002346709	19.71563358	11547.20175	2090.529189	262.7913095	67.05168923	5567.972897	1673.743045	23.56717282	0	0	936	308.7007262	0.974756694	0.067595626	0	0	0											1a (IP Acute): 175 days 1-5	1b (IP Psych): 260 days 1-5	2a (SNF): 50 days 11-100	6a (Home Health): 15 copay	10a (Ambulance): 150 copay	11a (DME): 20% coin	11b (Medical Supplies): 15% coin	4a (ER): 50 copay	9b (OP Surg): 15% not to exceed 500 copay; 9b (OP ASC): 15% not to exceed $275 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 20% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 20% coin; 9c (OP SA): 50 copay; 3 (CORF): 50 copay; 5 (Partial Hosp): 55 copay; 9d (OP Cardiac Rehab): 25 copay	7a (PCP w/Copay): 10 copay	7b (Chiro): 20 copay; 7d (SPC w/Copay): 32 copay	7h (Psych): 55 copay; 7e (MH Non-Phys): 55 copay	7i (PT/ST): 30 copay; 7c (OT): 30 copay	7g (Prof. Other): 32 copay	7g (Prof. Other): 32 copay	15 (Part B Rx): 20% coin			16b (Comp. Dental): 32 copay	17a1 (Routine Eye Exam): 25 copay	17b1 (Non MCR Covered): 100 allowance	18a (Hearing Exam): 32 copay														84.06660921	186.7934126	27.77365412	15	150	0.2	0.15	50	0.15	0	0.150417239	0.2	0.2	0.198103727	9.586505186	31.54014908	55	30	32	18.40129993	0.2	0	0	32	25	0	32	0	0	0											75.10621947	166.883703	24.81334957	13.4011982	134.011982	0.178682643	0.134011982	44.67066066	0.134011982	0	0.134384749	0.178682643	0.178682643	0.176988487	8.564710402	28.17838594	49.13772673	26.8023964	28.58922283	16.4399645	0.178682643	0	0	28.58922283	25	0	32	0	0	0											15.1741	0.431274709	0.493452295	0.054048571	2.654005293	2.191535755	0.695514111	0.369623858	4.362813837	0	2.081090027	0.137862392	0.000419316	3.489440163	8.241536576	4.908978192	1.076080629	0.149762163	13.26533482	2.29302302	4.211044719	0	0	2.22995938	0.643126513	0	0.000180255	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1542		8.1735	15.1741	0.431274709	0.493452295	0.054048571	2.654005293	2.191535755	0.695514111	0.369623858	4.362813837	0	2.081090027	0.137862392	0.000419316	3.489440163	8.241536576	4.908978192	1.076080629	0.149762163	13.26533482	2.29302302	4.211044719	0	0	2.22995938	0.643126513	0	0.000180255	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1542																																																																																		0			15.1741	0.431274709	0.493452295	0.054048571	2.654005293	2.191535755	0.695514111	0.369623858	4.362813837	0	2.081090027	0.137862392	0.000419316	3.489440163	8.241536576	4.908978192	1.076080629	0.149762163	13.26533482	2.29302302	4.211044719	0	0	2.22995938	0.643126513	0	0.000180255	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1542
H4529_007_0	2009	8																					0											Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	Coin	V	V	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin	Coin																																																			0		322.2603924	0.36016067	6.085369898	64.75072119	11.56304335	14.79329759	8.57530251	9.90700743	29.15887164	11.23044125	22.07892001	0.181455065	0	24.94073392	11929.81573	2303.447929	160.359273	7.062487126	4949.981332	1118.372931	9.603879555	0	0	10.53	437.4845669	1.952829643	3.601402792	0	0	0											1a (IP Acute): MC CS;1a1 (Add'l Days): 0% coin	1b (IP Psych): MC CS;1a1 (Add'l Days): 0% coin	2a (SNF): MC CS;2a2 (Waiver 3 Day): 0% coin		10a (Ambulance): MC CS	11a (DME): MC CS	11b (Medical Supplies): MC CS	4a (ER): MC CS	9b (OP Surg): MC CS; 9b (OP ASC): MC CS	8a (OP Diag Proc/Test/Lab): MC CS	8b (OP Therap Rad): MC CS; 8b (OP Diag): MC CS	9a (OP Observation): MC CS	12 (Renal Dialysis): MC CS	9a (OP Other): MC CS; 9c (OP SA): MC CS; 3 (CORF): MC CS; 5 (Partial Hosp): MC CS; 9d (OP Cardiac Rehab): MC CS	7a (PCP w/Copay): 5 copay	7b (Chiro): 10 copay; 7d (SPC w/Copay): 10 copay	7h (Psych): 10 copay; 7e (MH Non-Phys): 10 copay	7i (PT/ST): MC CS; 7c (OT): MC CS	7g (Prof. Other): 10 copay	7g (Prof. Other): 10 copay	15 (Part B Rx): MC CS		10b (Transportation): 20 trips/year	16b (Comp. Dental): MC CS	17a1 (Routine Eye Exam): 5 copay	17b1 (Non MCR Covered): 100 allowance	18a (Hearing Exam): 10 copay														0.0682	0.0682	0.2294	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	4.745279084	10	10	0.231	10	10	0.231	0	0	0.231	5	0	10	0	0	0											0.0682	0.0682	0.2294	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	4.745279084	10	10	0.231	10	10	0.231	0	0	0.231	5	0	10	0	0	0											21.9782	0.024562958	1.395983855	0	2.671063014	3.417251744	1.98089488	2.288518716	6.735699348	2.594231928	5.100230523	0.04191612	0	5.761309535	4.71752542	1.919539941	0.133632727	1.631434526	4.124984443	0.931977442	2.218496177	0	0	2.43243	0.182285236	0	0.003001169	0	0	0	0	0	0	0	0	0	0	0	0	0	72.2851		0	21.9782	0.024562958	1.395983855	0	2.671063014	3.417251744	1.98089488	2.288518716	6.735699348	2.594231928	5.100230523	0.04191612	0	5.761309535	4.71752542	1.919539941	0.133632727	1.631434526	4.124984443	0.931977442	2.218496177	0	0	2.43243	0.182285236	0	0.003001169	0	0	0	0	0	0	0	0	0	0	0	0	0	72.2851																																																																																		0			21.9782	0.024562958	1.395983855	0	2.671063014	3.417251744	1.98089488	2.288518716	6.735699348	2.594231928	5.100230523	0.04191612	0	5.761309535	4.71752542	1.919539941	0.133632727	1.631434526	4.124984443	0.931977442	2.218496177	0	0	2.43243	0.182285236	0	0.003001169	0	0	0	0	0	0	0	0	0	0	0	0	0	72.2851
H4529_014_0	2009	10																					3000											D	D	D	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1733.865404	33.10200356	1202.658595	42.75727872	240.812383	17.81950179	5.498913725	58.94383076	31.01652141	6.017211538	23.50584818	0.909771638	0	30.13288085	10465.9581	3114.419353	89.98620995	69.81195797	6130.501984	1586.833874	18.69135881	0	0	936	482.5488404	3.955395444	4.835928399	0	0	0											1a (IP Acute): 125 days 1-5	1b (IP Psych): 200 days 1-5	2a (SNF): 20 days 11-100	6a (Home Health): 5 copay	10a (Ambulance): 100 copay	11a (DME): 15% coin	11b (Medical Supplies): 10% coin	4a (ER): 50 copay	9b (OP Surg): 15% NTE 350 copay; 9b (OP ASC): 15% NTE 125 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 15% coin; 9c (OP SA): 35 copay; 3 (CORF): 30 copay; 5 (Partial Hosp): 50 copay; 9d (OP Cardiac Rehab): 20 copay		7b (Chiro): 8 copay; 7d (SPC w/Copay): 21 copay	7h (Psych): 35 copay; 7e (MH Non-Phys): 35 copay	7i (PT/ST): 15 copay; 7c (OT): 15 copay	7g (Prof. Other): 21 copay	7g (Prof. Other): 21 copay	15 (Part B Rx): 20% coin		10b (Transportation): 20 trips/year	16b (Comp. Dental): 21 copay	17a1 (Routine Eye Exam): 5 copay	17b1 (Non MCR Covered): 150 allowance	18a (Hearing Exam): 22 copay														74.54955721	107.1422808	7.903282	5	100	0.15	0.1	50	0.15	0	0.150954356	0.15	0	0.148892935	0	19.98539118	35	15	21	16.27631791	0.2	0	0	21	5	0	22	0	0	0											65.63501658	94.33034401	6.958217654	4.4021064	88.04212799	0.132063192	0.088042128	44.021064	0.132063192	0	0.132903427	0.132063192	0	0.131088509	0	17.59556369	30.8147448	13.2063192	18.48884688	14.33001665	0.176084256	0	0	18.48884688	5	0	22	0	0	0											9.4835	0.260210282	0.697363356	0.015685174	1.766802888	2.353300286	0.484136066	0.216230846	4.096140822	0	3.124007777	0.120147347	0	3.95007441	0	4.566663672	0.231075175	0.076829917	9.445492706	1.89494632	3.29125401	0	0	1.442130057	0.201062017	0	0.008865869	0	0	0	0	0	0	0	0	0	0	0	0	0	47.7259		6.4536	9.4835	0.260210282	0.697363356	0.015685174	1.766802888	2.353300286	0.484136066	0.216230846	4.096140822	0	3.124007777	0.120147347	0	3.95007441	0	4.566663672	0.231075175	0.076829917	9.445492706	1.89494632	3.29125401	0	0	1.442130057	0.201062017	0	0.008865869	0	0	0	0	0	0	0	0	0	0	0	0	0	47.7259																																																																																		0			9.4835	0.260210282	0.697363356	0.015685174	1.766802888	2.353300286	0.484136066	0.216230846	4.096140822	0	3.124007777	0.120147347	0	3.95007441	0	4.566663672	0.231075175	0.076829917	9.445492706	1.89494632	3.29125401	0	0	1.442130057	0.201062017	0	0.008865869	0	0	0	0	0	0	0	0	0	0	0	0	0	47.7259
H4529_801_0	2009	9																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		232.9671936	1.275593196	13.4176138	3.889444794	9.36994426	15.49652584	6.506536052	7.830816586	30.76058994	7.304664843	19.96554786	0.793271306	0.071423971	19.58104891	87.02472877	66.50391845	1.052547893	4.702437869	50.35304286	6.63943659	16.50930912	0																			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																			0.079105229	0.079105229	0.181771175	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.079105229	0.079105229	0.181771175	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			18.4289	0.100906092	2.438935427	0	2.164457124	3.579697469	1.503009828	1.808918631	7.105696277	1.687377579	4.612041557	0.183245672	0.016498937	4.523222297	20.10271235	15.36240516	0.243138563	1.086263148	11.6315529	1.533709852	3.813650406	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.9264		0	18.4289	0.100906092	2.438935427	0	2.164457124	3.579697469	1.503009828	1.808918631	7.105696277	1.687377579	4.612041557	0.183245672	0.016498937	4.523222297	20.10271235	15.36240516	0.243138563	1.086263148	11.6315529	1.533709852	3.813650406	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.9264																																																																																		0			18.4289	0.100906092	2.438935427	0	2.164457124	3.579697469	1.503009828	1.808918631	7.105696277	1.687377579	4.612041557	0.183245672	0.016498937	4.523222297	20.10271235	15.36240516	0.243138563	1.086263148	11.6315529	1.533709852	3.813650406	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.9264
H4531_001_0	2009	9																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V	0	V	V	V	V	V	Coin	Coin	Coin	Coin	0	0	V	0	V	0	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	5000	240.9678787	97.78282995	1120.778115	2705.179816	199.6984156	6.416085727	1.045008015	192.4819189	259.0034479	536.9981673	444.1249471	11.56141396	0	652.636038	1579.1693	1943.953207	214.6168447	1579.228406	29.74330174	2.983193018	10.63254824	1.109767517	0	0	560.7847254	0	80.64201567	0	0	587.7496598											$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/$30 Urgent	$50 per visit.	$0-50 per visit.	$50 per visit.	$50 per visit.	0	$50 per visit.	"$5 per visit.  $0 additional copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	$30 per visit	$30 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.	0	0	$30 per exam	0	$30 per exam	0	0	$10 PCP copay/$30 Specialist copay for routine physicals											100	56.66763606	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	5	30	30	30	0.05	0.05	0.1	0.095	0	0	30	0	30	0	0	0											100	56.66763606	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	5	30	30	30	0.05	0.05	0.1	0.095	0	0	30	0	30	0	0	0											2.0081	0.461760152	1.810370318	2.254316513	1.664153464	0.641608573	0.104500802	0.785967836	1.079181033	1.118746182	1.850520613	0.048172558	0	2.719316825	0.657987208	4.859883017	0.536542112	3.948071015	1.487165087	0.149159651	1.063254824	0.105427914	0	0	1.401961813	0	0.201605039	0	0	0	0	0	0	0	0	0	0	0	0	0	30.9577	0	0	2.0081	0.461760152	1.810370318	2.254316513	1.664153464	0.641608573	0.104500802	0.785967836	1.079181033	1.118746182	1.850520613	0.048172558	0	2.719316825	0.657987208	4.859883017	0.536542112	3.948071015	1.487165087	0.149159651	1.063254824	0.105427914	0	0	1.401961813	0	0.201605039	0	0	0	0	0	0	0	0	0	0	0	0	0	30.9577	7700	$250 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	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	0	$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	0	0	$50 per exam	0	$50 per exam	0	0	$20 PCP copay/$60 Specialist copay for routine physicals											6.6095	0.2663	1.9219	1.047	0.3085	0.2687	0.0438	0.2969	0.6584	0.4091	0.6121	0.0411	0.0137	0.7536	1.5948	3.4347	0.1565	0.7164	0.9893	0.0992	0.4453	0.0455	0	0	0.3424	0	0.0671	0	0	0.2445											21.3864	500	0.047151194	8.6176	0.728011349	3.732225562	3.301297181	1.972617722	0.910345049	0.148270755	1.082903785	1.737557151	1.527802596	2.462618663	0.089244718	0.013683849	3.472963442	2.252772215	8.294600574	0.693013242	4.664492698	2.47648811	0.24838675	1.508596995	0.150953381	0	0	1.744410305	0	0.268728819	0	0	0.244516151	0	0	0	0	0	0	0	0	0	0	52.3441
H4531_003_0	2009	7																					2700											D	D	D	V	T	Coin	Coin	V	V	V	V	V	0	V	V	V	V	V	Coin	Coin	Coin	Coin	0	0	V	0	V	0	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	5000	1359.890944	97.78282995	1120.778115	2705.179816	199.6984156	6.416085727	1.045008015	192.4819189	259.0034479	536.9981673	444.1249471	11.56141396	49.47569092	652.636038	1579.1693	1943.953207	214.6168447	1579.228406	29.74330174	2.983193018	10.63254824	1.109767517	0	0	560.7847254	0	80.64201567	0	0	679.3393967											$275/day-First four 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.	0	$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.	0	0	$40 per exam	0	$40 per exam	0	0	$0 PCP copay/$40 Specialist copay for routine physicals											148.8459637	124.3483216	48.4583958	40	150	0.2	0.2	49	100	0	100	100	0	100	10	40	40	40	0.1	0.1	0.2	0.19	0	0	40	0	40	0	0	0											109.6619236	91.61334183	35.70161238	29.4699086	110.5121572	0.147349543	0.147349543	36.10063803	73.67477149	0	73.67477149	73.67477149	0	73.67477149	7.367477149	29.4699086	29.4699086	29.4699086	0.073674771	0.073674771	0.147349543	0.139982066	0	0	29.4699086	0	29.4699086	0	0	0											12.4274	0.746517652	3.334465487	6.643450159	1.839091892	0.9454073	0.153981453	0.579060007	1.59016832	0	2.726733666	0.070982044	0	4.006900914	0.969541144	4.774010277	0.527061566	3.878309732	2.191330959	0.219786064	1.566701124	0.15534755	0	0	1.37718955	0	0.198042736	0	0	0	0	0	0	0	0	0	0	0	0	0	50.9214	0	18.2071	12.4274	0.746517652	3.334465487	6.643450159	1.839091892	0.9454073	0.153981453	0.579060007	1.59016832	0	2.726733666	0.070982044	0	4.006900914	0.969541144	4.774010277	0.527061566	3.878309732	2.191330959	0.219786064	1.566701124	0.15534755	0	0	1.37718955	0	0.198042736	0	0	0	0	0	0	0	0	0	0	0	0	0	50.9214	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	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	0	0	$50 per exam	0	$50 per exam	0	0	30% coinsurance											12.3154	0.2677	2.2542	1.3124	0.3698	0.3152	0.0513	0.2888	1.1272	0.4637	0.9023	0.0736	0.0133	0.5676	1.861	3.8356	0.1071	0.8403	1.087	0.109	0.5223	0.0531	0	0	0.3331	0	0.0653	0	0	0.1776											29.314	500	0.890429789	24.7428	1.014208402	5.588638937	7.95583408	2.208913953	1.260612428	0.205319902	0.867881475	2.71733998	0.463653909	3.629020078	0.144592133	0.013309905	4.574526261	2.830548042	8.609636617	0.634114249	4.718611696	3.278348754	0.328811751	2.089049777	0.208471296	0	0	1.710279871	0	0.263332204	0	0	0.177607151	0	0	0	0	0	0	0	0	0	0	80.2354
H4531_004_0	2009	8																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V	0	V	V	V	V	V	Coin	Coin	Coin	Coin	0	0	V	0	V	0	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	5000	240.9678787	97.78282995	1120.778115	2705.179816	199.6984156	6.416085727	1.045008015	192.4819189	259.0034479	536.9981673	444.1249471	11.56141396	0	652.636038	1579.1693	1943.953207	312.3996747	1579.228406	29.74330174	2.983193018	10.63254824	1.109767517	0	0	560.7847254	0	80.64201567	0	0	91.58973693											$50 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.	0	$50 per visit.	"$0 per visit.  $0 additional copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	$15 per visit	$15 per visit	$15 per visit	10% coinsurance	"10% coinsurance except sustitute $0 copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	10% coinsurance.	10% coinsurance.	0	0	$15 per exam	0	$15 per exam	0	0	$0 PCP copay/$20 Specialist copay for routine physicals											50	56.66763606	0.193833583	10	100	0.1	0.1	49	50	0	50	50	0	50	10	15	15	15	0.05	0.05	0.1	0.095	0	0	20	0	30	0	0	4											50	56.66763606	0.193833583	10	100	0.1	0.1	49	50	0	50	50	0	50	10	15	15	15	0.05	0.05	0.1	0.095	0	0	20	0	30	0	0	4											1.004	0.461760152	0.018103703	2.254316513	1.664153464	0.641608573	0.104500802	0.785967836	1.079181033	0	1.850520613	0.048172558	0	2.719316825	1.315974417	2.429941508	0.390499593	1.974035508	1.487165087	0.149159651	1.063254824	0.105427914	0	0	0.934641209	0	0.201605039	0	0	0.030529912	0	0	0	0	0	0	0	0	0	0	22.7139	0	0	1.004	0.461760152	0.018103703	2.254316513	1.664153464	0.641608573	0.104500802	0.785967836	1.079181033	0	1.850520613	0.048172558	0	2.719316825	1.315974417	2.429941508	0.390499593	1.974035508	1.487165087	0.149159651	1.063254824	0.105427914	0	0	0.934641209	0	0.201605039	0	0	0.030529912	0	0	0	0	0	0	0	0	0	0	22.7139	7700	$100 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	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	0	$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	0	0	$50 per exam	0	$50 per exam	0	0	$20 PCP copay/$40 Specialist copay for routine physicals											6.3596	0.2667	1.9248	1.0486	0.3089	0.2692	0.0438	0.3099	0.6594	0.5063	0.613	0.0411	0.0137	0.7548	1.5972	3.1602	0.154	0.7175	0.9908	0.0994	0.446	0.0456	0	0	0.343	0	0.0672	0	0	0.1987											20.9396	500	0.013803834	7.3636	0.728422146	1.942924244	3.302912587	1.973093668	0.910759691	0.148338289	1.095829058	1.738572916	0.506303161	2.463563056	0.089308085	0.013704961	3.474126329	2.913219912	5.590156682	0.544470038	2.691562582	2.478014514	0.248539845	1.509284128	0.151023623	0	0	1.277618099	0	0.268832387	0	0	0.229215378	0	0	0	0	0	0	0	0	0	0	43.6534
H4531_802_0	2009	5																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V	0	V	V	V	V	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	5000	243.1530645	98.66956081	1130.941746	2729.711386	201.5093547	6.474269164	1.054484535	194.2274161	261.3521869	541.8678653	448.1524363	11.66625714	0	658.554383	1593.489791	1961.581693	216.5630696	1593.549433	30.01302499	3.010245715	10.72896812	1.119831299																			$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/$30 Urgent	$50 per visit.	$0-50 per visit.	$50 per visit.	$50 per visit.	0	$50 per visit.	"$5 per visit.  $0 additional copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	$30 per visit	$30 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.																			100	56.66763606	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	5	30	30	30	0.05	0.05	0.1	0.095																			100	56.66763606	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	5	30	30	30	0.05	0.05	0.1	0.095																			2.0263	0.465947564	1.826787425	2.274759489	1.679244623	0.647426916	0.105448453	0.793095282	1.088967445	1.128891386	1.867301818	0.048609405	0	2.743976596	0.66395408	4.903954233	0.541407674	3.983873583	1.50065125	0.150512286	1.072896812	0.106383973	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.6204	0	0	2.0263	0.465947564	1.826787425	2.274759489	1.679244623	0.647426916	0.105448453	0.793095282	1.088967445	1.128891386	1.867301818	0.048609405	0	2.743976596	0.66395408	4.903954233	0.541407674	3.983873583	1.50065125	0.150512286	1.072896812	0.106383973	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.6204	7700	$250 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	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	0	$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																			6.636	0.2678	1.9351	1.0539	0.3107	0.2706	0.0441	0.2984	0.6614	0.4113	0.6156	0.0412	0.0137	0.7602	1.6022	3.4536	0.1578	0.7214	0.9949	0.0998	0.4484	0.0458																			20.8441	500	0.026938169	8.6623	0.733787829	3.761930104	3.328623669	1.989979973	0.918021398	0.149521026	1.091522356	1.750401176	1.540171958	2.482855748	0.08985845	0.013731165	3.504165566	2.266158462	8.357583306	0.699196531	4.705248504	2.49554791	0.250298409	1.521318015	0.152219471	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4644
H4531_803_0	2009	5																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V	0	V	V	V	V	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	5000	243.1530645	98.66956081	1130.941746	2729.711386	201.5093547	6.474269164	1.054484535	194.2274161	261.3521869	541.8678653	448.1524363	11.66625714	0	658.554383	1593.489791	1961.581693	216.5630696	1593.549433	30.01302499	3.010245715	10.72896812	1.119831299																			$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/$30 Urgent	$50 per visit.	$0-50 per visit.	$50 per visit.	$50 per visit.	0	$50 per visit.	"$5 per visit.  $0 additional copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	$30 per visit	$30 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.																			100	56.66763606	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	5	30	30	30	0.05	0.05	0.1	0.095																			100	56.66763606	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	5	30	30	30	0.05	0.05	0.1	0.095																			2.0263	0.465947564	1.826787425	2.274759489	1.679244623	0.647426916	0.105448453	0.793095282	1.088967445	1.128891386	1.867301818	0.048609405	0	2.743976596	0.66395408	4.903954233	0.541407674	3.983873583	1.50065125	0.150512286	1.072896812	0.106383973	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.6204	0	0	2.0263	0.465947564	1.826787425	2.274759489	1.679244623	0.647426916	0.105448453	0.793095282	1.088967445	1.128891386	1.867301818	0.048609405	0	2.743976596	0.66395408	4.903954233	0.541407674	3.983873583	1.50065125	0.150512286	1.072896812	0.106383973	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.6204	7700	$250 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	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	0	$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																			6.636	0.2678	1.9351	1.0539	0.3107	0.2706	0.0441	0.2984	0.6614	0.4113	0.6156	0.0412	0.0137	0.7602	1.6022	3.4536	0.1578	0.7214	0.9949	0.0998	0.4484	0.0458																			20.8441	500	0.026938169	8.6623	0.733787829	3.761930104	3.328623669	1.989979973	0.918021398	0.149521026	1.091522356	1.750401176	1.540171958	2.482855748	0.08985845	0.013731165	3.504165566	2.266158462	8.357583306	0.699196531	4.705248504	2.49554791	0.250298409	1.521318015	0.152219471	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4644
H4531_804_0	2009	5																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V	0	V	V	V	V	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	5000	243.1530645	98.66956081	1130.941746	2729.711386	201.5093547	6.474269164	1.054484535	194.2274161	261.3521869	541.8678653	448.1524363	11.66625714	0	658.554383	1593.489791	1961.581693	216.5630696	1593.549433	30.01302499	3.010245715	10.72896812	1.119831299																			$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/$30 Urgent	$50 per visit.	$0-50 per visit.	$50 per visit.	$50 per visit.	0	$50 per visit.	"$5 per visit.  $0 additional copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	$30 per visit	$30 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.																			100	56.66763606	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	5	30	30	30	0.05	0.05	0.1	0.095																			100	56.66763606	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	5	30	30	30	0.05	0.05	0.1	0.095																			2.0263	0.465947564	1.826787425	2.274759489	1.679244623	0.647426916	0.105448453	0.793095282	1.088967445	1.128891386	1.867301818	0.048609405	0	2.743976596	0.66395408	4.903954233	0.541407674	3.983873583	1.50065125	0.150512286	1.072896812	0.106383973	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.6204	0	0	2.0263	0.465947564	1.826787425	2.274759489	1.679244623	0.647426916	0.105448453	0.793095282	1.088967445	1.128891386	1.867301818	0.048609405	0	2.743976596	0.66395408	4.903954233	0.541407674	3.983873583	1.50065125	0.150512286	1.072896812	0.106383973	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.6204	7700	$250 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	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	0	$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																			6.636	0.2678	1.9351	1.0539	0.3107	0.2706	0.0441	0.2984	0.6614	0.4113	0.6156	0.0412	0.0137	0.7602	1.6022	3.4536	0.1578	0.7214	0.9949	0.0998	0.4484	0.0458																			20.8441	500	0.026938169	8.6623	0.733787829	3.761930104	3.328623669	1.989979973	0.918021398	0.149521026	1.091522356	1.750401176	1.540171958	2.482855748	0.08985845	0.013731165	3.504165566	2.266158462	8.357583306	0.699196531	4.705248504	2.49554791	0.250298409	1.521318015	0.152219471	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4644
H4531_805_0	2009	5																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V	0	V	V	V	V	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	5000	243.1530645	98.66956081	1130.941746	2729.711386	201.5093547	6.474269164	1.054484535	194.2274161	261.3521869	541.8678653	448.1524363	11.66625714	0	658.554383	1593.489791	1961.581693	216.5630696	1593.549433	30.01302499	3.010245715	10.72896812	1.119831299																			$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/$30 Urgent	$50 per visit.	$0-50 per visit.	$50 per visit.	$50 per visit.	0	$50 per visit.	"$5 per visit.  $0 additional copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	$30 per visit	$30 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.																			100	56.66763606	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	5	30	30	30	0.05	0.05	0.1	0.095																			100	56.66763606	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	5	30	30	30	0.05	0.05	0.1	0.095																			2.0263	0.465947564	1.826787425	2.274759489	1.679244623	0.647426916	0.105448453	0.793095282	1.088967445	1.128891386	1.867301818	0.048609405	0	2.743976596	0.66395408	4.903954233	0.541407674	3.983873583	1.50065125	0.150512286	1.072896812	0.106383973	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.6204	0	0	2.0263	0.465947564	1.826787425	2.274759489	1.679244623	0.647426916	0.105448453	0.793095282	1.088967445	1.128891386	1.867301818	0.048609405	0	2.743976596	0.66395408	4.903954233	0.541407674	3.983873583	1.50065125	0.150512286	1.072896812	0.106383973	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.6204	7700	$250 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	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	0	$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																			6.636	0.2678	1.9351	1.0539	0.3107	0.2706	0.0441	0.2984	0.6614	0.4113	0.6156	0.0412	0.0137	0.7602	1.6022	3.4536	0.1578	0.7214	0.9949	0.0998	0.4484	0.0458																			20.8441	500	0.026938169	8.6623	0.733787829	3.761930104	3.328623669	1.989979973	0.918021398	0.149521026	1.091522356	1.750401176	1.540171958	2.482855748	0.08985845	0.013731165	3.504165566	2.266158462	8.357583306	0.699196531	4.705248504	2.49554791	0.250298409	1.521318015	0.152219471	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4644
H4531_806_0	2009	5																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V	0	V	V	V	V	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	5000	243.1530645	98.66956081	1130.941746	2729.711386	201.5093547	6.474269164	1.054484535	194.2274161	261.3521869	541.8678653	448.1524363	11.66625714	0	658.554383	1593.489791	1961.581693	216.5630696	1593.549433	30.01302499	3.010245715	10.72896812	1.119831299																			$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/$30 Urgent	$50 per visit.	$0-50 per visit.	$50 per visit.	$50 per visit.	0	$50 per visit.	"$5 per visit.  $0 additional copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	$30 per visit	$30 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.																			100	56.66763606	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	5	30	30	30	0.05	0.05	0.1	0.095																			100	56.66763606	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	5	30	30	30	0.05	0.05	0.1	0.095																			2.0263	0.465947564	1.826787425	2.274759489	1.679244623	0.647426916	0.105448453	0.793095282	1.088967445	1.128891386	1.867301818	0.048609405	0	2.743976596	0.66395408	4.903954233	0.541407674	3.983873583	1.50065125	0.150512286	1.072896812	0.106383973	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.6204	0	0	2.0263	0.465947564	1.826787425	2.274759489	1.679244623	0.647426916	0.105448453	0.793095282	1.088967445	1.128891386	1.867301818	0.048609405	0	2.743976596	0.66395408	4.903954233	0.541407674	3.983873583	1.50065125	0.150512286	1.072896812	0.106383973	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.6204	7700	$250 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	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	0	$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																			6.636	0.2678	1.9351	1.0539	0.3107	0.2706	0.0441	0.2984	0.6614	0.4113	0.6156	0.0412	0.0137	0.7602	1.6022	3.4536	0.1578	0.7214	0.9949	0.0998	0.4484	0.0458																			20.8441	500	0.026938169	8.6623	0.733787829	3.761930104	3.328623669	1.989979973	0.918021398	0.149521026	1.091522356	1.750401176	1.540171958	2.482855748	0.08985845	0.013731165	3.504165566	2.266158462	8.357583306	0.699196531	4.705248504	2.49554791	0.250298409	1.521318015	0.152219471	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4644
H4531_807_0	2009	5																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V	0	V	V	V	V	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	5000	243.1530645	98.66956081	1130.941746	2729.711386	201.5093547	6.474269164	1.054484535	194.2274161	261.3521869	541.8678653	448.1524363	11.66625714	0	658.554383	1593.489791	1961.581693	216.5630696	1593.549433	30.01302499	3.010245715	10.72896812	1.119831299																			$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/$30 Urgent	$50 per visit.	$0-50 per visit.	$50 per visit.	$50 per visit.	0	$50 per visit.	"$5 per visit.  $0 additional copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	$30 per visit	$30 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.																			100	56.66763606	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	5	30	30	30	0.05	0.05	0.1	0.095																			100	56.66763606	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	5	30	30	30	0.05	0.05	0.1	0.095																			2.0263	0.465947564	1.826787425	2.274759489	1.679244623	0.647426916	0.105448453	0.793095282	1.088967445	1.128891386	1.867301818	0.048609405	0	2.743976596	0.66395408	4.903954233	0.541407674	3.983873583	1.50065125	0.150512286	1.072896812	0.106383973	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.6204	0	0	2.0263	0.465947564	1.826787425	2.274759489	1.679244623	0.647426916	0.105448453	0.793095282	1.088967445	1.128891386	1.867301818	0.048609405	0	2.743976596	0.66395408	4.903954233	0.541407674	3.983873583	1.50065125	0.150512286	1.072896812	0.106383973	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.6204	7700	$250 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	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	0	$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																			6.636	0.2678	1.9351	1.0539	0.3107	0.2706	0.0441	0.2984	0.6614	0.4113	0.6156	0.0412	0.0137	0.7602	1.6022	3.4536	0.1578	0.7214	0.9949	0.0998	0.4484	0.0458																			20.8441	500	0.026938169	8.6623	0.733787829	3.761930104	3.328623669	1.989979973	0.918021398	0.149521026	1.091522356	1.750401176	1.540171958	2.482855748	0.08985845	0.013731165	3.504165566	2.266158462	8.357583306	0.699196531	4.705248504	2.49554791	0.250298409	1.521318015	0.152219471	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4644
H4531_808_0	2009	5																					2700											A	D	D	V	T	Coin	Coin	V	V	V	V	V	0	V	V	V	V	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	5000	243.1530645	98.66956081	1130.941746	2729.711386	201.5093547	6.474269164	1.054484535	194.2274161	261.3521869	541.8678653	448.1524363	11.66625714	0	658.554383	1593.489791	1961.581693	216.5630696	1593.549433	30.01302499	3.010245715	10.72896812	1.119831299																			$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/$30 Urgent	$50 per visit.	$0-50 per visit.	$50 per visit.	$50 per visit.	0	$50 per visit.	"$5 per visit.  $0 additional copay for colorectal screening, mamograms, bone mass measurements, and PSA's."	$30 per visit	$30 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.																			100	56.66763606	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	5	30	30	30	0.05	0.05	0.1	0.095																			100	56.66763606	19.38335832	10	100	0.1	0.1	49	50	25	50	50	0	50	5	30	30	30	0.05	0.05	0.1	0.095																			2.0263	0.465947564	1.826787425	2.274759489	1.679244623	0.647426916	0.105448453	0.793095282	1.088967445	1.128891386	1.867301818	0.048609405	0	2.743976596	0.66395408	4.903954233	0.541407674	3.983873583	1.50065125	0.150512286	1.072896812	0.106383973	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.6204	0	0	2.0263	0.465947564	1.826787425	2.274759489	1.679244623	0.647426916	0.105448453	0.793095282	1.088967445	1.128891386	1.867301818	0.048609405	0	2.743976596	0.66395408	4.903954233	0.541407674	3.983873583	1.50065125	0.150512286	1.072896812	0.106383973	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.6204	7700	$250 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	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	0	$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																			6.636	0.2678	1.9351	1.0539	0.3107	0.2706	0.0441	0.2984	0.6614	0.4113	0.6156	0.0412	0.0137	0.7602	1.6022	3.4536	0.1578	0.7214	0.9949	0.0998	0.4484	0.0458																			20.8441	500	0.026938169	8.6623	0.733787829	3.761930104	3.328623669	1.989979973	0.918021398	0.149521026	1.091522356	1.750401176	1.540171958	2.482855748	0.08985845	0.013731165	3.504165566	2.266158462	8.357583306	0.699196531	4.705248504	2.49554791	0.250298409	1.521318015	0.152219471	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4644
H4577_003_0	2009	5																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.6689	1.6025	0.5787	1.3952	1.2426	0	1.4171	0.1199	0.0018	0.9302	1.6284	3.947	0.2896	0.3033	1.4003	0.1271	0	0.0005	0	0	0	0	0	0	0	0											15.6533		580.7230227	43.95348073	2315.356369	4354.643294	14.44469818	34.60597148	12.49687769	30.12959163	26.8335693	11689.14059	30.60140958	2.588874082	0.038634955	20.08744634	37.2989036	92.12827725	6.25490606	6.550345234	30.24011074	5.441684035	28.74962192	0.011560007	0	684	2.76	158.976	116.4	31.04	0.07	6.8											Medicare FFS cost sharing	Medicare FFS cost sharing	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $0.00	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											724.1782215	740.5914717	66.88421864	6.506822407	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.188539027	0.182809397	0.5	0.2	0.2	0.021467244	0.2	0.2	0	0	0.2	10	0	0	0	0											724.1782215	740.5914717	66.88421864	6.506822407	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.188539027	0.182809397	0.5	0.2	0.2	0.021467244	0.2	0.2	0	0	0.2	10	0	0	0	0											35.0456	2.712631082	12.9050668	2.36124088	2.888939636	6.921194297	2.499375537	6.025918326	5.366713861	0	6.120281915	0.517774816	0.007726991	4.017489268	7.032298987	16.84191479	3.12745303	1.310069047	6.048022149	0.116817957	5.749924385	0.002312001	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.3032	135	0	35.0456	2.712631082	12.9050668	2.36124088	3.557835401	8.523705299	3.078072887	7.421140017	6.609305477	0	7.537352247	0.637658727	0.009516074	4.947685774	8.660706717	20.78894777	3.417101185	1.613398208	7.448361688	0.243921689	5.749924385	0.002847315	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.9565		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			35.0456	2.712631082	12.9050668	2.36124088	3.557835401	8.523705299	3.078072887	7.421140017	6.609305477	0	7.537352247	0.637658727	0.009516074	4.947685774	8.660706717	20.78894777	3.417101185	1.613398208	7.448361688	0.243921689	5.749924385	0.002847315	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.9565
H4577_012_0	2009	6																					3750											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		1551.020664	101.8815367	1180.03859	1051.370301	371.6999187	15.54726511	6.646370891	1468.770867	314.1944153	6084.05665	18.68931288	67.34217801	0.035750003	973.8509621	9074.594767	18129.15264	285.0717068	2601.253705	32.49598988	843.2550471	25.18377241	0.001138776	0	275	1.785	285.6	116.4	31.04	1848	4558.153846											"$175 days 1 - 6, $0 days 7 - 90"	"$175 days 1 - 6, $0 days 7 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $50.00 and $100.00	$20.00 copayment	20% coinsurance	$175.00 copayment	20% coinsurance	"Copay between $20.00 and $100.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$20.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											120.2389556	61.72541438	67.18307296	15.34825637	51.13717435	0.2	0.2	24.0135873	58.83843522	4.920492921	0.2	67.73509139	0.2	33.10367459	7.324361457	15.09648274	26.52460456	12.1175444	0.174425532	0.348505013	0.2	0.2	0	20	0.2	10	0	0	0	0											107.9624715	55.42320503	60.32363273	13.78118831	45.91603195	0.179579856	0.179579856	21.56178271	52.83098853	4.418107043	0.179579856	60.81928967	0.179579856	29.72376552	6.576538866	13.55512096	23.81642329	10.88033437	0.156616559	0.3129224	0.179579856	0.179579856	0	20	0.2	10	0	0	0	0											13.9543	0.470550108	5.932017875	1.207427675	1.422248778	2.791975625	1.193554325	2.639109857	1.383266796	2.240001128	3.356224109	0.341308619	0.00641998	2.412209804	4.973285432	20.47857141	0.56578237	2.358542508	5.089410125	0.021989449	4.522498215	0.000204501	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.4143	0	8.7968	13.9543	0.470550108	5.932017875	1.207427675	1.422248778	2.791975625	1.193554325	2.639109857	1.383266796	2.240001128	3.356224109	0.341308619	0.00641998	2.412209804	4.973285432	20.47857141	0.56578237	2.358542508	5.089410125	0.021989449	4.522498215	0.000204501	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.4143		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			13.9543	0.470550108	5.932017875	1.207427675	1.422248778	2.791975625	1.193554325	2.639109857	1.383266796	2.240001128	3.356224109	0.341308619	0.00641998	2.412209804	4.973285432	20.47857141	0.56578237	2.358542508	5.089410125	0.021989449	4.522498215	0.000204501	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.4143
H4577_016_0	2009	5																					3750											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		1478.382363	107.4597548	1126.691133	1545.943453	532.9664233	18.8817991	6.763279995	1906.983641	226.2460404	6684.555662	20.19960948	58.43594962	0.100577298	951.3639105	8861.093065	20687.2566	455.9799959	3643.622046	37.07904692	868.9907855	31.26627875	0.001356727	0	275	1.785	285.6	116.4	31.04	168	4080											"$250 days 1 - 5, $0 days 6 - 90"	"$250 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	20% coinsurance	$250.00 copayment	20% coinsurance	"Copay between $20.00 and $150.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$20.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											163.2202055	104.4759602	66.7	15.60306007	48.93121899	0.2	0.2	24.95054419	104.4428596	5.261989376	0.2	120.0865302	0.2	47.98733952	9.994644215	14.58489843	24.60980318	10.60526973	0.176134753	0.461792436	0.2	0.2	0	20	0.2	10	0	0	0	0											141.244574	90.40953263	57.71964969	13.50229627	42.34322068	0.173072413	0.173072413	21.59125443	90.38088855	4.553525989	0.173072413	103.9183277	0.173072413	41.52642319	8.64898595	12.62121781	21.29639008	9.177398111	0.152420334	0.399617656	0.173072413	0.173072413	0	20	0.2	10	0	0	0	0											17.4011	0.809615517	5.419351459	1.73948221	1.88062624	3.26791853	1.170537188	3.431180748	1.704026514	2.536524828	3.495995151	0.50604718	0.017407156	3.292228363	6.386622452	21.75819762	0.809227322	2.78658084	5.651600703	0.028938672	5.411330304	0.000234812	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.5581	0	13.9257	17.4011	0.809615517	5.419351459	1.73948221	1.88062624	3.26791853	1.170537188	3.431180748	1.704026514	2.536524828	3.495995151	0.50604718	0.017407156	3.292228363	6.386622452	21.75819762	0.809227322	2.78658084	5.651600703	0.028938672	5.411330304	0.000234812	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.5581		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			17.4011	0.809615517	5.419351459	1.73948221	1.88062624	3.26791853	1.170537188	3.431180748	1.704026514	2.536524828	3.495995151	0.50604718	0.017407156	3.292228363	6.386622452	21.75819762	0.809227322	2.78658084	5.651600703	0.028938672	5.411330304	0.000234812	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.5581
H4577_020_0	2009	6																					3500											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		1617.757091	126.4580523	1157.180419	1716.089154	556.103668	20.32616693	7.151105831	1981.709381	230.8119816	6824.528385	20.47546664	59.02539422	0.087298604	1008.032768	9559.391933	21557.36121	485.6074483	3603.450234	36.47311423	875.9261566	31.46846464	0.00170366	0	474.9090909	2.76	158.976	116.4	31.04	1848	4080											"$125 days 1 - 6, $0 days 7 - 90"	"$125 days 1 - 6, $0 days 7 - 90"	"$0 days 1 - 20, $128 days 21 - 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	$10.00 copayment	20% coinsurance	$125.00 copayment	20% coinsurance	"Copay between $10.00 and $75.00, 20% coinsurance"	"Copay between $0.00 and $10.00, 20% coinsurance"	"Copay between $0.00 and $15.00, 20% coinsurance"	Copay between $10.00 and $20.00	$15.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $15.00	20% coinsurance	20% coinsurance		$15.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											88.16838071	59.0008223	66.7	7.85022337	57.26960653	0.2	0.2	21.95900994	55.99238376	3.837373366	0.2	68.93897118	0.2	35.61250881	5.33985045	7.237835181	15.70054165	6.250162054	0.17552803	0.255139661	0.2	0.2	0	15	0.2	10	0	0	0	0											80.15532819	53.63862007	60.63806942	7.136767461	52.06474327	0.181823297	0.181823297	19.96329789	50.903599	3.488619378	0.181823297	62.67355503	0.181823297	32.37591876	4.854546061	6.580035265	14.2736212	5.682125345	0.159575425	0.231951671	0.181823297	0.181823297	0	15	0.2	10	0	0	0	0											10.806	0.565252952	5.847432216	1.020610769	2.412782892	3.69577068	1.300237637	3.296787891	0.979096713	1.984015164	3.722916844	0.308277608	0.01587292	2.719665583	3.867209038	11.82068308	0.577614731	1.706271325	5.820212705	0.016931045	5.72169998	0.000309765	0	0.593636364	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4838	0	6.8185	10.806	0.565252952	5.847432216	1.020610769	2.412782892	3.69577068	1.300237637	3.296787891	0.979096713	1.984015164	3.722916844	0.308277608	0.01587292	2.719665583	3.867209038	11.82068308	0.577614731	1.706271325	5.820212705	0.016931045	5.72169998	0.000309765	0	0.593636364	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4838		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			10.806	0.565252952	5.847432216	1.020610769	2.412782892	3.69577068	1.300237637	3.296787891	0.979096713	1.984015164	3.722916844	0.308277608	0.01587292	2.719665583	3.867209038	11.82068308	0.577614731	1.706271325	5.820212705	0.016931045	5.72169998	0.000309765	0	0.593636364	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4838
H4577_021_0	2009	5																					4000											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		1951.689526	249.9798737	1642.827702	2629.362274	725.2549494	25.44782122	9.005093404	2306.770916	238.097118	9002.96323	24.41316131	105.5993167	0.29435981	1194.408785	9660.797194	23727.35241	852.4216528	4582.993942	41.31662873	887.3032027	40.40679448	0.006631741	0	275	0.75	0	58.2	31.04	168	4080											"$200 days 1 - 6, $0 days 7 - 90"	"$200 days 1 - 6, $0 days 7 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	20% coinsurance	$200.00 copayment	20% coinsurance	"Copay between $20.00 and $150.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$20.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											140.3713468	90.41945794	66.7	13.23279682	50.89185874	0.2	0.2	24.32126559	110.3150507	5.157148834	0.2	88.64027115	0.2	43.21788328	10.40827219	14.82154445	23.29169907	9.769829825	0.176478229	0.394878716	0.2	0.2	0	20	0.2	0	0	0	0	0											117.7242537	75.8314531	55.93882154	11.09785697	42.6811185	0.167732598	0.167732598	20.39734536	92.51715047	4.325109869	0.167732598	74.33931499	0.167732598	36.24523929	8.729032694	12.43028081	19.53388602	8.193594709	0.14800576	0.331170165	0.167732598	0.167732598	0	20	0.2	0	0	0	0	0											19.1468	1.579694756	7.658153805	2.431690537	2.579557703	4.268429176	1.510447715	3.921000254	1.835672241	3.244900426	4.09488298	0.654181739	0.049373736	3.607636018	7.027451213	24.57813778	1.387592284	3.129266243	6.115099026	0.024487362	6.777536629	0.001112359	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.2314	0	20.3191	19.1468	1.579694756	7.658153805	2.431690537	2.579557703	4.268429176	1.510447715	3.921000254	1.835672241	3.244900426	4.09488298	0.654181739	0.049373736	3.607636018	7.027451213	24.57813778	1.387592284	3.129266243	6.115099026	0.024487362	6.777536629	0.001112359	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.2314		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			19.1468	1.579694756	7.658153805	2.431690537	2.579557703	4.268429176	1.510447715	3.921000254	1.835672241	3.244900426	4.09488298	0.654181739	0.049373736	3.607636018	7.027451213	24.57813778	1.387592284	3.129266243	6.115099026	0.024487362	6.777536629	0.001112359	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.2314
H4577_022_0	2009	6																					4000											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	V	V	V	V	V											0	0	0	0	0.6188	1.1896	0.4522	1.3156	1.1434	0	1.2213	0.0682	0.0085	0.8132	1.6319	5.6538	0.3199	0.8389	1.9269	0.2665	0	0.0002	0	0	0	0	0	0	0	0											17.469		1996.71092	279.2303013	1705.709303	2366.813263	750.6293896	23.94415494	9.101305336	2749.824763	258.8576208	9152.448242	24.58287843	98.82183397	0.170669674	1285.181159	9272.080639	22967.05861	796.1382536	4728.802158	38.78406198	939.6857426	37.26456992	0.004347359	0	275	0.75	0	58.2	31.04	1848	0											"$200 days 1 - 6, $0 days 7 - 90"	"$200 days 1 - 6, $0 days 7 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	20% coinsurance	$200.00 copayment	20% coinsurance	"Copay between $20.00 and $150.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$20.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											139.3960556	86.88797179	66.7	14.44695077	51.71934975	0.2	0.2	25.56496214	106.3716836	5.329257644	0.2	89.30592675	0.2	44.2328983	10.03206806	15.21288683	25.69943748	9.523357503	0.175345528	0.624657745	0.2	0.2	0	20	0.2	0	0	0	0	0											116.7285112	72.75889943	55.85374468	12.09769565	43.30913577	0.167477495	0.167477495	21.40777913	89.07431571	4.462653609	0.167477495	74.78366463	0.167477495	37.04007508	8.400728157	12.73908091	21.5203871	7.974740306	0.146832149	0.523080572	0.167477495	0.167477495	0	20	0.2	0	0	0	0	0											19.4228	1.693040784	7.939187659	2.38608221	2.709092512	4.010107096	1.524263821	4.905636764	1.921463786	3.403683848	4.117078907	0.615854907	0.028583329	3.966933887	6.491019075	24.38160149	1.42776695	3.142580764	5.694747178	0.040960946	6.240976832	0.000728085	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.6725	135	20.5966	19.4228	1.693040784	7.939187659	2.38608221	3.327927027	5.199711964	1.976439192	6.221246886	3.064882677	3.403683848	5.338417139	0.684047922	0.037062621	4.780120444	8.122962838	30.03542127	1.747706907	3.98143644	7.62163535	0.307464788	6.240976832	0.000944072	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.1415		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			19.4228	1.693040784	7.939187659	2.38608221	3.327927027	5.199711964	1.976439192	6.221246886	3.064882677	3.403683848	5.338417139	0.684047922	0.037062621	4.780120444	8.122962838	30.03542127	1.747706907	3.98143644	7.62163535	0.307464788	6.240976832	0.000944072	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.1415
H4577_023_0	2009	6																					4000											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	V	V	V	V	V											0	0	0	0	0.4764	1.1136	0.5843	1.1574	1.1508	0	1.2531	0.0657	0.0036	0.8937	1.7237	6.6462	0.4354	0.8917	2.3392	0.2981	0	0	0	0	0	0	0	0	0	0											19.0329		1902.146819	212.911293	1523.872472	1800.864299	572.8042266	21.88907838	11.48542956	2109.212973	279.2068161	8279.548785	24.63122454	67.04948493	0.070494691	1127.482778	8095.547267	25446.25757	955.4396735	4875.54311	45.97918439	906.6278918	44.85117383	0.000265656	0	275	0.75	0	58.2	31.04	1848	0											"$200 days 1 - 6, $0 days 7 - 90"	"$200 days 1 - 6, $0 days 7 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	20% coinsurance	$200.00 copayment	20% coinsurance	"Copay between $20.00 and $150.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$20.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											139.3550447	101.5049032	66.7	17.77055654	55.54079901	0.2	0.2	24.18211979	109.03298	6.318610016	0.2	84.48704799	0.2	51.17469774	11.33515164	15.43822869	23.78852392	11.73492755	0.177157091	0.300044012	0.2	0.2	0	20	0.2	0	0	0	0	0											115.915992	84.43211782	55.48128296	14.78160833	46.19902227	0.166360669	0.166360669	20.11476808	90.69399724	5.255840933	0.166360669	70.27660893	0.166360669	42.56728464	9.428617021	12.84157023	19.78737371	9.761151961	0.147359861	0.249577612	0.166360669	0.166360669	0	20	0.2	0	0	0	0	0											18.3741	1.498045948	7.045533316	2.218305894	2.205249602	3.641481713	1.91072374	3.535527482	2.110198518	3.626332617	4.097666982	0.392667536	0.011727544	3.999490027	6.360817896	27.23082532	1.575470156	3.965909766	6.775486214	0.018856169	7.461471263	4.42E-05	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.6643	135	21.8497	18.3741	1.498045948	7.045533316	2.218305894	2.68162937	4.755095337	2.495048517	4.69294013	3.260957131	3.626332617	5.350788138	0.458348387	0.015313983	4.893216585	8.084554369	33.87699321	2.010912652	4.857576368	9.114691421	0.316933912	7.461471263	5.77E-05	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.6972		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			18.3741	1.498045948	7.045533316	2.218305894	2.68162937	4.755095337	2.495048517	4.69294013	3.260957131	3.626332617	5.350788138	0.458348387	0.015313983	4.893216585	8.084554369	33.87699321	2.010912652	4.857576368	9.114691421	0.316933912	7.461471263	5.77E-05	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.6972
H4577_026_0	2009	5																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.526	1.0911	0.412	1.1737	1.082	0	1.0294	0.069	0.0003	0.7508	1.5138	4.0342	0.3438	0.5498	1.2019	0.1533	0	0	0	0	0	0	0	0	0	0											13.9311		621.729243	40.71322078	2685.075756	2807.271838	14.2623044	29.58371476	11.16996155	31.82334757	29.33775369	11191.82758	27.91125934	1.86962399	0.006880599	20.35635383	42.92776257	117.4518538	9.320500384	14.90598175	32.58869696	6.474128776	30.94156976	7.97E-06	0	684	2.76	158.976	116.4	31.04	0.07	6.8											Medicare FFS cost sharing	Medicare FFS cost sharing	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $0.00	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											705.5479595	704.0962122	66.50513073	6.131681957	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.191220084	0.184100651	0.5	0.2	0.2	0.04357001	0.2	0.2	0	0	0.2	10	0	0	0	0											705.5479595	704.0962122	66.50513073	6.131681957	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.191220084	0.184100651	0.5	0.2	0.2	0.04357001	0.2	0.2	0	0	0.2	10	0	0	0	0											36.555	2.388835378	14.88094285	1.434441506	2.852460881	5.916742951	2.23399231	6.364669514	5.867550737	0	5.582251867	0.373924798	0.00137612	4.071270766	8.208650357	21.62296274	4.660250192	2.981196351	6.517739392	0.282077854	6.188313951	1.59E-06	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.6691	135	0	36.555	2.388835378	14.88094285	1.434441506	3.378486485	7.007856349	2.64596541	7.538385567	6.949592543	0	6.611681378	0.442880702	0.001629892	4.822058508	9.722472125	25.65715172	5.004011039	3.530962211	7.719683238	0.435405432	6.188313951	1.89E-06	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	153.6002		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			36.555	2.388835378	14.88094285	1.434441506	3.378486485	7.007856349	2.64596541	7.538385567	6.949592543	0	6.611681378	0.442880702	0.001629892	4.822058508	9.722472125	25.65715172	5.004011039	3.530962211	7.719683238	0.435405432	6.188313951	1.89E-06	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	153.6002
H4577_027_0	2009	5																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.3406	0.8072	0.3326	0.8108	0.6499	0	0.9122	0.0505	0.0159	0.7759	0.8885	2.9432	0.1734	0.3896	1.045	0.0976	0	0	0	0	0	0	0	0	0	0											10.2329		415.749284	45.17823412	1788.971312	2528.314821	12.61791885	29.89993446	12.31979219	30.03416977	24.07391982	10477.32634	33.78793047	1.869436548	0.58785215	28.73904071	35.1414022	118.6321473	6.422168135	14.43297337	38.70593654	6.803375024	76.84435586	0.000114954	0	684	2.76	158.976	116.4	31.04	0.07	6.8											Medicare FFS cost sharing	Medicare FFS cost sharing	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $0.00	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											718.0484624	720.9499706	66.77089748	2.716669331	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.187275108	0.182908264	0.5	0.2	0.2	0.006680663	0.2	0.2	0	0	0.2	10	0	0	0	0											718.0484624	720.9499706	66.77089748	2.716669331	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.187275108	0.182908264	0.5	0.2	0.2	0.006680663	0.2	0.2	0	0	0.2	10	0	0	0	0											24.8773	2.714270547	9.954268341	0.572382945	2.52358377	5.979986892	2.463958437	6.006833954	4.814783964	0	6.757586093	0.37388731	0.11757043	5.747808142	6.581109905	21.69880013	3.211084068	2.886594675	7.741187308	0.045451053	15.36887117	2.30E-05	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.1219	135	0	24.8773	2.714270547	9.954268341	0.572382945	2.864232311	6.78720155	2.796558392	6.81767259	5.464712511	0	7.669765777	0.424356871	0.133440795	6.523681914	7.469626914	24.64199992	3.384464657	3.276244615	8.786139409	0.143026717	15.36887117	2.61E-05	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.3548		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			24.8773	2.714270547	9.954268341	0.572382945	2.864232311	6.78720155	2.796558392	6.81767259	5.464712511	0	7.669765777	0.424356871	0.133440795	6.523681914	7.469626914	24.64199992	3.384464657	3.276244615	8.786139409	0.143026717	15.36887117	2.61E-05	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.3548
H4577_029_0	2009	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	V	V	V	V	V											0	0	0	0	0.6063	1.1527	0.5195	1.0745	1.2435	0	1.2176	0.1222	0.0069	0.8342	1.7223	5.6642	0.2873	0.6097	1.9028	0.2504	0	0.0002	0	0	0	0	0	0	0	0											17.2144		1854.921962	119.8033394	1256.430798	1924.376543	617.853065	21.33347453	9.615268293	1944.289906	267.1191931	7809.440425	22.53473748	206.8137758	0.127356198	1251.58547	8468.020378	20012.79073	640.4496381	3230.678897	35.21608533	887.422866	33.26337025	0.003168298	0	275	0.75	0	58.2	31.04	168	10472											"$250 days 1 - 5, $0 days 6 - 90"	"$250 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	20% coinsurance	$250.00 copayment	20% coinsurance	"Copay between $20.00 and $150.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$20.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											158.6223537	113.2484972	66.66748661	13.73820282	48.96891473	0.2	0.2	24.13676096	108.697779	4.886740268	0.2	119.846808	0.2	41.71663242	10.58948999	14.97288029	23.85162979	10.7144113	0.175949736	0.538961016	0.2	0.2	0	20	0.2	0	0	0	0	0											134.382775	95.94263957	56.47981915	11.63882501	41.48582148	0.169437374	0.169437374	20.44834691	92.08733089	4.139982181	0.169437374	101.5326419	0.169437374	35.34178314	8.971276853	12.68482755	20.20678753	9.077108545	0.149062306	0.456600695	0.169437374	0.169437374	0	20	0.2	0	0	0	0	0											20.7725	0.957854051	5.913582021	1.86645682	2.13601183	3.614687892	1.629185805	3.313126207	2.049857794	2.69424535	3.818226731	1.74986242	0.0215789	3.686105189	6.330746267	21.15489994	1.07845248	2.443768585	5.249390889	0.033766491	5.63605809	0.000536828	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.7592	135	17.3434	20.7725	0.957854051	5.913582021	1.86645682	2.742330208	4.767410527	2.148732557	4.387582517	3.293358489	2.69424535	5.035857826	1.872093899	0.028460403	4.520310662	8.053038445	26.81911448	1.365791113	3.053447729	7.152239795	0.284139091	5.63605809	0.000708022	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.9736		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			20.7725	0.957854051	5.913582021	1.86645682	2.742330208	4.767410527	2.148732557	4.387582517	3.293358489	2.69424535	5.035857826	1.872093899	0.028460403	4.520310662	8.053038445	26.81911448	1.365791113	3.053447729	7.152239795	0.284139091	5.63605809	0.000708022	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.9736
H4577_030_0	2009	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	V	V	V	V	V											0	0	0	0	0.5533	1.1772	0.4476	1.0291	1.132	0	1.2631	0.0557	0.0043	1.0221	1.7902	6.0564	0.2335	0.6605	1.9728	0.2825	0	0.0002	0	0	0	0	0	0	0	0											17.6804		1825.355907	169.7839973	1149.539995	1961.390491	551.0964635	21.59271918	8.209713121	1910.051174	287.7850208	8110.065037	23.16829987	74.69933336	0.078789772	1181.549757	8795.999795	20884.72788	588.5922505	3383.604653	36.18631336	890.3124952	29.71100832	0.003583881	0	275	1.785	285.6	116.4	31.04	168	10472											"$250 days 1 - 5, $0 days 6 - 90"	"$250 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	20% coinsurance	$250.00 copayment	20% coinsurance	"Copay between $20.00 and $150.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$20.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											166.8488798	98.0027451	66.70060184	15.9444214	49.42482646	0.2	0.2	24.76894816	89.43682765	5.030753244	0.2	119.6760363	0.2	51.98228572	10.27354582	15.30739422	23.57170368	10.26613331	0.177400739	0.548295478	0.2	0.2	0	20	0.2	10	0	0	0	0											141.0201652	82.83162173	56.37514556	13.47617642	41.77371282	0.169039391	0.169039391	20.93463956	75.59173438	4.251977322	0.169039391	101.1498214	0.169039391	43.9352696	8.683169643	12.93776298	19.92273217	8.676904611	0.149938564	0.463417668	0.169039391	0.169039391	0	20	0.2	10	0	0	0	0											21.451	1.171956986	5.400457043	2.202670357	1.91844545	3.650020099	1.387764906	3.332186073	1.812847404	2.873651052	3.9163553	0.629652019	0.013318575	4.325975593	6.3647632	22.51680494	0.977197147	2.446601234	5.425723875	0.034382212	5.022330751	0.000605817	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.928	135	17.7432	21.451	1.171956986	5.400457043	2.202670357	2.471787656	4.827208466	1.835340716	4.361324513	2.944880482	2.873651052	5.17944092	0.685304171	0.017614023	5.348063271	8.154921215	28.57317699	1.210689948	3.107133568	7.398523445	0.316838219	5.022330751	0.000801203	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.6084		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			21.451	1.171956986	5.400457043	2.202670357	2.471787656	4.827208466	1.835340716	4.361324513	2.944880482	2.873651052	5.17944092	0.685304171	0.017614023	5.348063271	8.154921215	28.57317699	1.210689948	3.107133568	7.398523445	0.316838219	5.022330751	0.000801203	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.6084
H4577_031_0	2009	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	V	V	V	V	V											0	0	0	0	0.404	0.9532	0.5124	1.0024	1.1167	0	1.2056	0.0624	0.0039	0.8333	1.6065	6.3328	0.3346	0.832	2.2377	0.295	0	0	0	0	0	0	0	0	0	0											17.7326		1799.656542	156.5071917	1388.712683	1822.030326	495.7654748	19.82047724	10.65443133	1960.384692	277.3748236	7862.426011	25.0677741	63.34695884	0.081481376	1128.590044	8013.933462	25504.3115	760.0026992	4834.493872	46.529501	953.4501118	45.01839406	0.000362973	0	275	1.785	285.6	116.4	31.04	168	10472											"$250 days 1 - 5, $0 days 6 - 90"	"$250 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	20% coinsurance	$250.00 copayment	20% coinsurance	"Copay between $20.00 and $150.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$20.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											160.9881732	107.4363768	66.7	16.3826767	50.79953442	0.2	0.2	24.08482155	107.0354419	5.166691979	0.2	92.2006344	0.2	47.58642005	11.13248489	14.95425603	22.62080131	10.15346151	0.177405245	0.322493461	0.2	0.2	0	20	0.2	10	0	0	0	0											132.7432738	88.58698189	54.99768204	13.50838447	41.88690617	0.164910591	0.164910591	19.85921076	88.25638981	4.260211134	0.164910591	76.02430546	0.164910591	39.23752323	9.1793233	12.33057599	18.65204854	8.372066684	0.146280019	0.265912936	0.164910591	0.164910591	0	20	0.2	10	0	0	0	0											19.9077	1.15537498	6.364664883	2.05105718	1.730506827	3.268606612	1.757028566	3.24430773	2.04000838	2.79129957	4.133941437	0.401325712	0.013437142	3.690256505	6.13020718	26.20690424	1.181300603	3.37289209	6.806336288	0.021127893	7.424009963	5.99E-05	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.7457	135	22.0635	19.9077	1.15537498	6.364664883	2.05105718	2.134527933	4.221811852	2.269420859	4.246668493	3.156742999	2.79129957	5.339499374	0.463772376	0.017355739	4.52357271	7.736688254	32.53969993	1.515919964	4.204874242	9.044030349	0.316146801	7.424009963	7.73E-05	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.4782		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			19.9077	1.15537498	6.364664883	2.05105718	2.134527933	4.221811852	2.269420859	4.246668493	3.156742999	2.79129957	5.339499374	0.463772376	0.017355739	4.52357271	7.736688254	32.53969993	1.515919964	4.204874242	9.044030349	0.316146801	7.424009963	7.73E-05	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.4782
H4577_032_0	2009	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	V	V	V	V	V											0	0	0	0	0.3155	0.7375	0.2526	0.5762	0.7734	0	1.0436	0.0531	0.0076	0.5512	1.1635	4.497	0.179	0.6382	1.4248	0.2152	0	0	0	0	0	0	0	0	0	0											12.4283		1792.157662	142.6850559	1415.011172	1864.913414	590.8437031	21.42207736	7.336187463	1602.092009	223.5412683	7523.751455	30.31236277	69.669694	0.219905826	1137.539905	8641.235047	26003.57074	648.653187	5414.67501	41.38440263	1045.563875	43.46128679	0.000536817	0	275	1.785	285.6	116.4	31.04	168	10472											"$250 days 1 - 5, $0 days 6 - 90"	"$250 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	20% coinsurance	$250.00 copayment	20% coinsurance	"Copay between $20.00 and $150.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$20.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											154.1989353	102.7469445	66.7	17.14315087	49.539159	0.2	0.2	23.14408491	104.9585515	5.273815251	0.2	95.93379532	0.2	48.53741439	11.03240732	15.42060556	24.48571933	10.51602201	0.177188123	0.287862237	0.2	0.2	0	20	0.2	10	0	0	0	0											127.0578082	84.66207336	54.95988536	14.12572123	40.8195877	0.164797257	0.164797257	19.0704086	86.48440716	4.345551448	0.164797257	79.04813183	0.164797257	39.99416388	9.090552349	12.70636752	20.17589696	8.665057932	0.146000584	0.237194536	0.164797257	0.164797257	0	20	0.2	10	0	0	0	0											18.9756	1.006667722	6.48073765	2.195270585	2.00983303	3.530299597	1.208983574	2.546045768	1.611069505	2.724570753	4.995394251	0.458938263	0.036239877	3.791246448	6.546133296	27.53424389	1.090596656	3.90987272	6.042146952	0.020666836	7.162300868	8.85E-05	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.9303	135	22.1894	18.9756	1.006667722	6.48073765	2.195270585	2.325376548	4.267813662	1.46155205	3.122214458	2.384502779	2.724570753	6.038980899	0.512011505	0.043810741	4.34241321	7.709678273	32.03122144	1.269605633	4.548078324	7.466919093	0.235846939	7.162300868	0.000106947	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.3586		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			18.9756	1.006667722	6.48073765	2.195270585	2.325376548	4.267813662	1.46155205	3.122214458	2.384502779	2.724570753	6.038980899	0.512011505	0.043810741	4.34241321	7.709678273	32.03122144	1.269605633	4.548078324	7.466919093	0.235846939	7.162300868	0.000106947	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.3586
H4577_033_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		1630.040815	115.7685957	1277.950495	1768.361878	568.4705276	20.21333126	7.467757504	1979.222273	251.9469428	7528.151529	22.28859982	61.1227414	0.131080306	1037.604376	10104.26781	23342.91384	520.3009736	4309.529124	39.51627298	939.2841297	32.66876073	0.001905992	0	964.3636364	2.76	158.976	116.4	31.04	1848	4080											"$100 days 1 - 5, $0 days 6 - 90"	"$100 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 20, $128 days 21 - 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	$10.00 copayment	20% coinsurance	$100.00 copayment	20% coinsurance	"Copay between $10.00 and $75.00, 20% coinsurance"	"Copay between $0.00 and $10.00, 20% coinsurance"	"Copay between $0.00 and $10.00, 20% coinsurance"	Copay between $10.00 and $20.00	$10.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $10.00	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											65.44405539	41.50368378	66.7	4.517981263	49.25874853	0.2	0.2	21.19858412	53.64501819	2.698790306	0.2	48.96460238	0.2	31.44638302	2.90939312	4.987035251	14.30893286	3.038905577	0.17615817	0.120668918	0.2	0.2	0	0	0.2	10	0	0	0	0											60.74111237	38.52114459	61.90680225	4.193309934	45.7189146	0.185627593	0.185627593	19.67521072	49.789978	2.504849742	0.185627593	45.4459064	0.185627593	29.18658194	2.700318209	4.628656748	13.28066382	2.820523637	0.163499085	0.111997404	0.185627593	0.185627593	0	0	0.2	10	0	0	0	0											8.2509	0.371628235	6.592819046	0.617940786	2.165821292	3.752152026	1.38622185	3.245134606	1.045369395	1.571407368	4.137379134	0.231481532	0.024332122	2.523677094	2.273728196	9.003861307	0.575828527	1.012927397	6.460874491	0.008766449	6.064223419	0.000353805	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.0013	0	4.7475	8.2509	0.371628235	6.592819046	0.617940786	2.165821292	3.752152026	1.38622185	3.245134606	1.045369395	1.571407368	4.137379134	0.231481532	0.024332122	2.523677094	2.273728196	9.003861307	0.575828527	1.012927397	6.460874491	0.008766449	6.064223419	0.000353805	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.0013		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			8.2509	0.371628235	6.592819046	0.617940786	2.165821292	3.752152026	1.38622185	3.245134606	1.045369395	1.571407368	4.137379134	0.231481532	0.024332122	2.523677094	2.273728196	9.003861307	0.575828527	1.012927397	6.460874491	0.008766449	6.064223419	0.000353805	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.0013
H4577_034_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		1830.430287	157.9284901	1415.368539	2457.207117	592.7179162	20.90329848	7.933636172	1811.476728	235.4517783	8203.000974	24.00483461	80.00362812	0.192323398	1100.262819	9971.232227	25582.12672	661.1003865	4640.258738	44.89254181	928.6207498	40.11043745	0.005052658	0	964.3636364	2.76	158.976	116.4	31.04	1848	4080											"$100 days 1 - 5, $0 days 6 - 90"	"$100 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 20, $128 days 21 - 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 $90.00	$20.00 copayment	20% coinsurance	$100.00 copayment	20% coinsurance	"Copay between $20.00 and $90.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $25.00, 20% coinsurance"	Copay between $15.00 and $25.00	$25.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $25.00	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											63.79178329	38.76567929	66.7	10.04172852	50.66874019	0.2	0.2	20.30374235	66.18498556	5.288698668	0.2	45.76203847	0.2	34.09883767	5.437945929	10.90341801	16.33814156	7.476945249	0.177883624	0.216658762	0.2	0.2	0	0	0.2	10	0	0	0	0											55.75059916	33.87912574	58.29222468	8.775932463	44.28176293	0.174789279	0.174789279	17.74438247	57.84212966	4.622039146	0.174789279	39.99356864	0.174789279	29.80055632	4.752473252	9.529002881	14.27865995	6.534449361	0.155460752	0.189348144	0.174789279	0.174789279	0	0	0.2	10	0	0	0	0											8.504	0.445873264	6.875415075	1.797023643	2.187216187	3.653672478	1.38671455	2.678627991	1.134919357	3.159549301	4.195787743	0.266635883	0.033616068	2.732370342	3.949001204	20.3143466	0.786635634	2.526794645	6.979028327	0.014652718	7.010874459	0.00088315	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.3181	0	11.6302	8.504	0.445873264	6.875415075	1.797023643	2.187216187	3.653672478	1.38671455	2.678627991	1.134919357	3.159549301	4.195787743	0.266635883	0.033616068	2.732370342	3.949001204	20.3143466	0.786635634	2.526794645	6.979028327	0.014652718	7.010874459	0.00088315	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.3181		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			8.504	0.445873264	6.875415075	1.797023643	2.187216187	3.653672478	1.38671455	2.678627991	1.134919357	3.159549301	4.195787743	0.266635883	0.033616068	2.732370342	3.949001204	20.3143466	0.786635634	2.526794645	6.979028327	0.014652718	7.010874459	0.00088315	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.3181
H4577_035_0	2009	6																					3500											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		1975.342384	181.6756835	1535.499053	2228.418137	630.2549476	20.794796	8.389418126	2011.640581	264.8478392	8725.412569	25.63752482	85.88827051	0.110353664	1257.326463	9863.389517	24399.78763	591.1066556	4523.282714	42.85495498	987.6966191	40.1098675	0.006905451	0	964.3636364	2.76	158.976	116.4	31.04	1848	4080											"$125 days 1 - 5, $0 days 6 - 90"	"$125 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $55.00 and $105.00	$20.00 copayment	20% coinsurance	$125.00 copayment	20% coinsurance	"Copay between $20.00 and $105.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											79.37676807	47.73479678	66.7	15.84082657	52.32273425	0.2	0.2	24.30670533	75.12479647	5.779983217	0.2	60.35049393	0.2	38.12056549	7.711040206	15.34733897	25.57214737	10.77131253	0.176613293	0.495252328	0.2	0.2	0	0	0.2	10	0	0	0	0											66.30445052	39.87349885	55.71538067	13.23204922	43.70586291	0.167062611	0.167062611	20.30370825	62.75272314	4.82809543	0.167062611	50.41155537	0.167062611	31.84260596	6.44113254	12.81983257	21.36074851	8.997417957	0.147527389	0.413690735	0.167062611	0.167062611	0	0	0.2	10	0	0	0	0											10.9145	0.60367043	7.129242856	2.457211539	2.295486362	3.474032909	1.401558094	3.403646955	1.384993594	3.510593712	4.283071828	0.360813442	0.018435971	3.336379261	5.294283264	26.06676603	1.052206718	3.391488759	6.322279615	0.034050078	6.70085918	0.001153643	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.1212	0	18.4216	10.9145	0.60367043	7.129242856	2.457211539	2.295486362	3.474032909	1.401558094	3.403646955	1.384993594	3.510593712	4.283071828	0.360813442	0.018435971	3.336379261	5.294283264	26.06676603	1.052206718	3.391488759	6.322279615	0.034050078	6.70085918	0.001153643	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.1212		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			10.9145	0.60367043	7.129242856	2.457211539	2.295486362	3.474032909	1.401558094	3.403646955	1.384993594	3.510593712	4.283071828	0.360813442	0.018435971	3.336379261	5.294283264	26.06676603	1.052206718	3.391488759	6.322279615	0.034050078	6.70085918	0.001153643	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.1212
H4577_036_0	2009	6																					3500											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		1905.331897	175.6674508	1481.078576	1988.932438	498.7152221	20.31948726	10.86268915	1906.617173	265.1296139	7403.383328	25.66142469	58.81879024	0.096103782	1121.220356	8296.688611	27611.97411	867.5706499	5232.532654	50.0965424	967.2622649	44.5777028	0.000409065	0	964.3636364	2.76	158.976	116.4	31.04	1848	4080											"$125 days 1 - 5, $0 days 6 - 90"	"$125 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $55.00 and $105.00	$20.00 copayment	20% coinsurance	$125.00 copayment	20% coinsurance	"Copay between $20.00 and $105.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											80.19412654	50.2494036	66.7	17.76633322	52.69700716	0.2	0.2	23.82511084	76.95121394	5.911032187	0.2	51.42744738	0.2	41.55681457	8.740733624	14.81097714	22.78166856	11.74402402	0.177748674	0.296959932	0.2	0.2	0	0	0.2	10	0	0	0	0											66.302074	41.54468437	55.14553904	14.688666	43.56828884	0.16535394	0.16535394	19.69787976	63.62093212	4.887062313	0.16535394	42.51865528	0.16535394	34.35791515	7.226573723	12.24526714	18.83519329	9.709603227	0.146957218	0.245517474	0.16535394	0.16535394	0	0	0.2	10	0	0	0	0											10.5273	0.608170733	6.806239705	2.43456369	1.810680737	3.359907281	1.796188451	3.129692985	1.405649431	3.015066304	4.243217682	0.208407989	0.015891139	3.21023282	4.996385992	28.17633327	1.361738407	4.233817995	7.362048503	0.019789982	7.3710988	6.76E-05	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.777	0	20.1339	10.5273	0.608170733	6.806239705	2.43456369	1.810680737	3.359907281	1.796188451	3.129692985	1.405649431	3.015066304	4.243217682	0.208407989	0.015891139	3.21023282	4.996385992	28.17633327	1.361738407	4.233817995	7.362048503	0.019789982	7.3710988	6.76E-05	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.777		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			10.5273	0.608170733	6.806239705	2.43456369	1.810680737	3.359907281	1.796188451	3.129692985	1.405649431	3.015066304	4.243217682	0.208407989	0.015891139	3.21023282	4.996385992	28.17633327	1.361738407	4.233817995	7.362048503	0.019789982	7.3710988	6.76E-05	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.777
H4577_037_0	2009	5																					2500											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	V	T	V	Coin	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		1624.425894	91.62859806	1309.175615	1782.331523	528.5238523	19.65323289	7.454485441	1861.03128	257.6788333	7518.515222	22.51147316	72.09965963	0.124445609	1133.758306	10746.8171	23490.57117	456.9134584	4279.508089	40.54983465	970.6045711	33.38828748	0.662280236	0	964.3636364	2.76	158.976	116.4	31.04	1848	3960											"$0 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 7, $0 days 8 - 100"	Copay between $0.00 and $15.00	$150.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	20% coinsurance	$0.00 copayment	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	"Copay between $0.00 and $15.00, 20% coinsurance"	$15.00 copayment	$15.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $15.00	20% coinsurance	$0.00 copayment		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											0	105.6595337	0	5.926950869	65.40079079	0.2	0.2	20.58582295	0	0	0.2	0	0.2	14.58958732	0.069733382	6.48366451	10.38051761	3.472881263	0.176359018	0.119096728	0.2	0	0	0	0.2	10	0	0	0	0											0	97.99968198	0	5.497272983	60.65952093	0.185500879	0.185500879	19.09344127	0	0	0.185500879	0	0.185500879	13.53190637	0.064678018	6.013627332	9.627975712	3.221112637	0.163573765	0.110462739	0.185500879	0	0	0	0.2	10	0	0	0	0											0	0.748297789	0	0.816496911	2.671666974	3.645691978	1.382813603	2.961124288	0	0	4.175898061	0	0.02308477	1.278492604	0.057923569	11.77196174	0.366595973	1.148731465	6.632889107	0.008934637	6.19355668	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.5686	0	3.4301	0	0.748297789	0	0.816496911	2.671666974	3.645691978	1.382813603	2.961124288	0	0	4.175898061	0	0.02308477	1.278492604	0.057923569	11.77196174	0.366595973	1.148731465	6.632889107	0.008934637	6.19355668	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.5686		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	0.748297789	0	0.816496911	2.671666974	3.645691978	1.382813603	2.961124288	0	0	4.175898061	0	0.02308477	1.278492604	0.057923569	11.77196174	0.366595973	1.148731465	6.632889107	0.008934637	6.19355668	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.5686
H4577_038_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		1570.302499	129.7468699	1127.89195	1332.326333	595.235107	22.38098509	6.294974274	2002.060907	163.8458828	6171.389911	16.91616198	27.35267394	0.109086564	775.9729416	10055.73251	22890.76374	378.4753676	3824.228256	41.84815599	832.1023386	34.76449035	0	0	474.9090909	2.76	158.976	116.4	31.04	1848	4080											"$125 days 1 - 6, $0 days 7 - 90"	"$125 days 1 - 6, $0 days 7 - 90"	"$0 days 1 - 20, $128 days 21 - 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	$10.00 copayment	20% coinsurance	$125.00 copayment	20% coinsurance	"Copay between $10.00 and $75.00, 20% coinsurance"	"Copay between $0.00 and $15.00, 20% coinsurance"	"Copay between $0.00 and $15.00, 20% coinsurance"	Copay between $10.00 and $20.00	$15.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $15.00	20% coinsurance	20% coinsurance		$15.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											88.39229591	57.21977423	65.6995	7.380502844	46.55374805	0.2	0.2	20.59996763	57.00542713	2.402460822	0.2	51.7557035	0.2	41.09563472	7.070210444	6.726032443	15.39749185	4.828389195	0.177729387	0.062783053	0.2	0	0	15	0.2	10	0	0	0	0											80.5361505	52.13418546	59.86024873	6.724537265	42.41613616	0.182224366	0.182224366	18.76908023	51.93888914	2.188934503	0.182224366	47.15575134	0.182224366	37.44312996	6.441823085	6.128234994	14.02899096	4.399250804	0.161933125	0.05720301	0.182224366	0	0	15	0.2	10	0	0	0	0											10.5388	0.563687282	5.626324391	0.746606506	2.103964445	4.078360823	1.147097697	3.131403482	0.709164429	1.125730692	3.082536895	0.107486324	0.01987823	2.421237974	5.398104151	11.68999828	0.442468959	1.401978269	6.776602661	0.003966563	6.33493722	0	0	0.593636364	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7285	0	6.5797	10.5388	0.563687282	5.626324391	0.746606506	2.103964445	4.078360823	1.147097697	3.131403482	0.709164429	1.125730692	3.082536895	0.107486324	0.01987823	2.421237974	5.398104151	11.68999828	0.442468959	1.401978269	6.776602661	0.003966563	6.33493722	0	0	0.593636364	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7285		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			10.5388	0.563687282	5.626324391	0.746606506	2.103964445	4.078360823	1.147097697	3.131403482	0.709164429	1.125730692	3.082536895	0.107486324	0.01987823	2.421237974	5.398104151	11.68999828	0.442468959	1.401978269	6.776602661	0.003966563	6.33493722	0	0	0.593636364	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7285
H4577_039_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		1336.234186	110.4068823	959.7690785	1133.730599	506.5097326	19.04488939	5.356649328	1703.634955	139.4231176	5251.486373	14.3946494	23.27550139	0.092826188	660.3068981	8556.831283	19478.68075	322.060065	3254.191173	35.61029591	708.0696821	29.58251707	0	0	474.9090909	2.76	158.976	116.4	31.04	1848	4080											"$125 days 1 - 6, $0 days 7 - 90"	"$125 days 1 - 6, $0 days 7 - 90"	"$0 days 1 - 20, $128 days 21 - 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	$10.00 copayment	20% coinsurance	$125.00 copayment	20% coinsurance	"Copay between $10.00 and $75.00, 20% coinsurance"	"Copay between $0.00 and $15.00, 20% coinsurance"	"Copay between $0.00 and $15.00, 20% coinsurance"	Copay between $10.00 and $20.00	$15.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $15.00	20% coinsurance	20% coinsurance		$15.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											88.39229591	57.21977423	65.6995	7.380502844	46.55374805	0.2	0.2	20.59996763	57.00542713	2.402460822	0.2	51.7557035	0.2	41.09563472	7.070210444	6.726032443	15.39749185	4.828389195	0.177729387	0.062783053	0.2	0	0	15	0.2	10	0	0	0	0											82.61284623	53.47851146	61.40379809	6.897935395	43.50987367	0.186923182	0.186923182	19.25305753	53.27817924	2.245378112	0.186923182	48.37170402	0.186923182	38.40863411	6.60793118	6.286256943	14.39074088	4.512689369	0.166108713	0.05867804	0.186923182	0	0	15	0.2	10	0	0	0	0											9.1992	0.492032977	4.911122226	0.651700036	1.83651454	3.559931332	1.001281939	2.733348483	0.619017487	0.982631046	2.690693675	0.093822972	0.017351367	2.113457171	4.711912686	10.20399934	0.386223579	1.223762826	5.915180432	0.003462345	5.529658232	0	0	0.593636364	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1544	0	4.1189	9.1992	0.492032977	4.911122226	0.651700036	1.83651454	3.559931332	1.001281939	2.733348483	0.619017487	0.982631046	2.690693675	0.093822972	0.017351367	2.113457171	4.711912686	10.20399934	0.386223579	1.223762826	5.915180432	0.003462345	5.529658232	0	0	0.593636364	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1544		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			9.1992	0.492032977	4.911122226	0.651700036	1.83651454	3.559931332	1.001281939	2.733348483	0.619017487	0.982631046	2.690693675	0.093822972	0.017351367	2.113457171	4.711912686	10.20399934	0.386223579	1.223762826	5.915180432	0.003462345	5.529658232	0	0	0.593636364	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1544
H4577_040_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		1520.967823	125.6705726	1092.456622	1290.468227	576.5344227	21.67783481	6.097203132	1939.161544	158.6982864	5977.501457	16.38470172	26.49332657	0.105659358	751.5939612	9739.808471	22171.59758	366.5846907	3704.081302	40.53339961	805.9599237	33.67228367	0	0	474.9090909	2.76	158.976	116.4	31.04	1848	4080											"$125 days 1 - 6, $0 days 7 - 90"	"$125 days 1 - 6, $0 days 7 - 90"	"$0 days 1 - 20, $128 days 21 - 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	$10.00 copayment	20% coinsurance	$125.00 copayment	20% coinsurance	"Copay between $10.00 and $75.00, 20% coinsurance"	"Copay between $0.00 and $15.00, 20% coinsurance"	"Copay between $0.00 and $15.00, 20% coinsurance"	Copay between $10.00 and $20.00	$15.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $15.00	20% coinsurance	20% coinsurance		$15.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											88.39229591	57.21977423	65.6995	7.380502844	46.55374805	0.2	0.2	20.59996763	57.00542713	2.402460822	0.2	51.7557035	0.2	41.09563472	7.070210444	6.726032443	15.39749185	4.828389195	0.177729387	0.062783053	0.2	0	0	15	0.2	10	0	0	0	0											80.96895419	52.41435614	60.18193951	6.76067513	42.64408175	0.183203645	0.183203645	18.86994583	52.21801029	2.200697903	0.183203645	47.40916776	0.183203645	37.64435046	6.476441635	6.161168313	14.10438318	4.42289251	0.162803358	0.057510421	0.183203645	0	0	15	0.2	10	0	0	0	0											10.2626	0.548911846	5.47884653	0.727036371	2.048815088	3.971458361	1.117029841	3.049322774	0.690575729	1.09622291	3.001737083	0.10466888	0.019357179	2.357772207	5.256608425	11.3835787	0.430870912	1.365229454	6.598973573	0.003862591	6.168885118	0	0	0.593636364	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.9605	0	6.0218	10.2626	0.548911846	5.47884653	0.727036371	2.048815088	3.971458361	1.117029841	3.049322774	0.690575729	1.09622291	3.001737083	0.10466888	0.019357179	2.357772207	5.256608425	11.3835787	0.430870912	1.365229454	6.598973573	0.003862591	6.168885118	0	0	0.593636364	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.9605		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			10.2626	0.548911846	5.47884653	0.727036371	2.048815088	3.971458361	1.117029841	3.049322774	0.690575729	1.09622291	3.001737083	0.10466888	0.019357179	2.357772207	5.256608425	11.3835787	0.430870912	1.365229454	6.598973573	0.003862591	6.168885118	0	0	0.593636364	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.9605
H4577_041_0	2009	5																					4000											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		1477.902068	56.73019531	1010.937922	855.4066116	689.7267232	20.79165125	8.339927792	1740.703057	170.6005144	5487.490501	19.15717424	18.65794837	0	678.6096545	9014.092008	23518.15733	327.9248723	4480.310123	43.46435778	849.8552128	41.23513404	0.05513655	0	275	0.75	0	58.2	31.04	168	4080											"$200 days 1 - 6, $0 days 7 - 90"	"$200 days 1 - 6, $0 days 7 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	20% coinsurance	$200.00 copayment	20% coinsurance	"Copay between $20.00 and $150.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$20.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											141.2654785	138.6222786	65.6995	13.67553988	49.21071326	0.2	0.2	24.53961846	113.3964179	5.272123405	0.2	91.46864818	0	47.56849557	10.73151083	12.92834636	23.9328184	10.28301444	0.173567068	0.073521726	0.2	0.2	0	20	0.2	0	0	0	0	0											124.5403246	122.2100669	57.9209949	12.05642168	43.38440128	0.176320961	0.176320961	21.63424556	99.97082693	4.647929328	0.176320961	80.63919977	0	41.93661427	9.460951512	11.39769227	21.0992877	9.065554945	0.153017561	0.064817107	0.176320961	0.176320961	0	20	0.2	0	0	0	0	0											15.3382	0.577750081	4.879544185	0.859428568	2.493615078	3.66600393	1.470504083	3.138233115	1.421256208	2.12545567	3.377811373	0.125380169	0	2.371549277	7.106823951	22.33772668	0.576581769	3.384708132	6.650810014	0.00459043	7.270618464	0.009721729	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.7946	0	11.9773	15.3382	0.577750081	4.879544185	0.859428568	2.493615078	3.66600393	1.470504083	3.138233115	1.421256208	2.12545567	3.377811373	0.125380169	0	2.371549277	7.106823951	22.33772668	0.576581769	3.384708132	6.650810014	0.00459043	7.270618464	0.009721729	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.7946		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			15.3382	0.577750081	4.879544185	0.859428568	2.493615078	3.66600393	1.470504083	3.138233115	1.421256208	2.12545567	3.377811373	0.125380169	0	2.371549277	7.106823951	22.33772668	0.576581769	3.384708132	6.650810014	0.00459043	7.270618464	0.009721729	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.7946
H4577_042_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		1592.482801	131.5795263	1143.823266	1351.145255	603.6427193	22.69711337	6.383889902	2030.339736	166.1601829	6258.559927	17.15510039	27.73902662	0.110627396	786.9334505	10197.76832	23214.09256	383.8212791	3878.244943	42.43925532	843.8556673	35.2555339	0	0	474.9090909	2.76	158.976	116.4	31.04	1848	4080											"$125 days 1 - 6, $0 days 7 - 90"	"$125 days 1 - 6, $0 days 7 - 90"	"$0 days 1 - 20, $128 days 21 - 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	$10.00 copayment	20% coinsurance	$125.00 copayment	20% coinsurance	"Copay between $10.00 and $75.00, 20% coinsurance"	"Copay between $0.00 and $15.00, 20% coinsurance"	"Copay between $0.00 and $15.00, 20% coinsurance"	Copay between $10.00 and $20.00	$15.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $15.00	20% coinsurance	20% coinsurance		$15.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											88.39229591	57.21977423	65.6995	7.380502844	46.55374805	0.2	0.2	20.59996763	57.00542713	2.402460822	0.2	51.7557035	0.2	41.09563472	7.070210444	6.726032443	15.39749185	4.828389195	0.177729387	0.062783053	0.2	0	0	15	0.2	10	0	0	0	0											80.34885464	52.01294156	59.72103701	6.708898599	42.31749267	0.181800583	0.181800583	18.72543063	51.81809942	2.18384389	0.181800583	47.04608535	0.181800583	37.35605175	6.426841902	6.113983096	13.99636497	4.389019852	0.161556531	0.057069978	0.181800583	0	0	15	0.2	10	0	0	0	0											10.6628	0.570319851	5.692525966	0.755391376	2.128720529	4.126348442	1.160594906	3.168248823	0.71750874	1.138976488	3.118807252	0.108751051	0.020112125	2.449727225	5.461620396	11.82754746	0.447675225	1.418474504	6.856338868	0.004013235	6.409476616	0	0	0.593636364	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.5221	0	6.8317	10.6628	0.570319851	5.692525966	0.755391376	2.128720529	4.126348442	1.160594906	3.168248823	0.71750874	1.138976488	3.118807252	0.108751051	0.020112125	2.449727225	5.461620396	11.82754746	0.447675225	1.418474504	6.856338868	0.004013235	6.409476616	0	0	0.593636364	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.5221		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			10.6628	0.570319851	5.692525966	0.755391376	2.128720529	4.126348442	1.160594906	3.168248823	0.71750874	1.138976488	3.118807252	0.108751051	0.020112125	2.449727225	5.461620396	11.82754746	0.447675225	1.418474504	6.856338868	0.004013235	6.409476616	0	0	0.593636364	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.5221
H4577_043_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		1585.250377	130.9819443	1138.628475	1345.00889	600.9012137	22.59403209	6.354896808	2021.118739	165.4055494	6230.136032	17.07718873	27.61304697	0.11012497	783.3595112	10151.4541	23108.66337	382.0781152	3860.631495	42.24651307	840.0232099	35.09541726	0	0	474.9090909	2.76	158.976	116.4	31.04	1848	4080											"$125 days 1 - 6, $0 days 7 - 90"	"$125 days 1 - 6, $0 days 7 - 90"	"$0 days 1 - 20, $128 days 21 - 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	$10.00 copayment	20% coinsurance	$125.00 copayment	20% coinsurance	"Copay between $10.00 and $75.00, 20% coinsurance"	"Copay between $0.00 and $15.00, 20% coinsurance"	"Copay between $0.00 and $15.00, 20% coinsurance"	Copay between $10.00 and $20.00	$15.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $15.00	20% coinsurance	20% coinsurance		$15.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											88.39229591	57.21977423	65.6995	7.380502844	46.55374805	0.2	0.2	20.59996763	57.00542713	2.402460822	0.2	51.7557035	0.2	41.09563472	7.070210444	6.726032443	15.39749185	4.828389195	0.177729387	0.062783053	0.2	0	0	15	0.2	10	0	0	0	0											80.4103332	52.05273902	59.76673228	6.714031882	42.34987171	0.181939687	0.181939687	18.7397583	51.8577478	2.185514848	0.181939687	47.08208244	0.181939687	37.38463456	6.431759371	6.118661182	14.00707422	4.392378091	0.161680145	0.057113645	0.181939687	0	0	15	0.2	10	0	0	0	0											10.6225	0.56816408	5.671008601	0.752536047	2.120674109	4.110751123	1.156207935	3.156273056	0.714796605	1.134671234	3.107018371	0.108339979	0.020036103	2.440467421	5.440975839	11.78284013	0.445983043	1.413112766	6.830422369	0.003998066	6.385249226	0	0	0.593636364	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.2642	0	6.7487	10.6225	0.56816408	5.671008601	0.752536047	2.120674109	4.110751123	1.156207935	3.156273056	0.714796605	1.134671234	3.107018371	0.108339979	0.020036103	2.440467421	5.440975839	11.78284013	0.445983043	1.413112766	6.830422369	0.003998066	6.385249226	0	0	0.593636364	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.2642		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			10.6225	0.56816408	5.671008601	0.752536047	2.120674109	4.110751123	1.156207935	3.156273056	0.714796605	1.134671234	3.107018371	0.108339979	0.020036103	2.440467421	5.440975839	11.78284013	0.445983043	1.413112766	6.830422369	0.003998066	6.385249226	0	0	0.593636364	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.2642
H4577_044_0	2009	5																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.8599	1.8036	0.3841	1.9475	0.6998	0	0.8793	0.0265	0.0305	0.7041	1.4335	4.7016	0.2529	0.6232	1.5663	0.1428	0	0	0	0	0	0	0	0	0	0											16.0556		416.6118571	41.26403724	2198.660222	1854.507345	21.55448904	45.20980847	9.62859677	48.81670047	17.54276507	9643.75509	22.04043019	0.665115356	0.764956568	17.64894962	38.89009307	131.9388327	6.33994266	15.6221884	39.26109653	6.353623931	43.5668823	0	0	684	2.76	158.976	116.4	31.04	0.07	6.8											Medicare FFS cost sharing	Medicare FFS cost sharing	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $0.00	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											716.8	716.8	66.7	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.184757511	0.17705337	0.5	0.2	0.2	0.001819434	0.2	0	0	0	0.2	10	0	0	0	0											716.8	716.8	66.7	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.184757511	0.17705337	0.5	0.2	0.2	0.001819434	0.2	0	0	0	0.2	10	0	0	0	0											24.8856	2.464838491	12.2208864	0	4.310897807	9.041961695	1.925719354	9.763340095	3.508553014	0	4.408086038	0.133023071	0.152991314	3.529789925	7.18523678	23.36021496	3.16997133	3.12443768	7.852219307	0.01156	8.713376461	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.4472	135	0	24.8856	2.464838491	12.2208864	0	5.170777831	10.84553083	2.309835999	11.71080011	4.208392069	0	5.287351866	0.159556728	0.183507967	4.233865034	8.618756462	28.0617887	3.422892661	3.747658565	9.418474604	0.154398748	8.713376461	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	146.5028		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			24.8856	2.464838491	12.2208864	0	5.170777831	10.84553083	2.309835999	11.71080011	4.208392069	0	5.287351866	0.159556728	0.183507967	4.233865034	8.618756462	28.0617887	3.422892661	3.747658565	9.418474604	0.154398748	8.713376461	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	146.5028
H4577_045_0	2009	6																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.8599	1.8036	0.3841	1.9475	0.6998	0	0.8793	0.0265	0.0305	0.7041	1.4335	4.7016	0.2529	0.6232	1.5663	0.1428	0	0	0	0	0	0	0	0	0	0											16.0556		385.4923168	38.1817489	2034.42751	1715.981724	19.94443935	41.83278396	8.909372149	45.17025294	16.23237801	8923.398192	20.39408229	0.615433419	0.707816819	16.33063093	35.98513058	122.0834344	5.866369722	14.45526213	36.3284213	5.879029047	40.31257899	0	0	684	2.76	158.976	116.4	31.04	0.07	6.8											Medicare FFS cost sharing	Medicare FFS cost sharing	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $0.00	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											716.8	716.8	66.7	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.184757511	0.17705337	0.5	0.2	0.2	0.001819434	0.2	0	0	0	0.2	10	0	0	0	0											716.8	716.8	66.7	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.184757511	0.17705337	0.5	0.2	0.2	0.001819434	0.2	0	0	0	0.2	10	0	0	0	0											23.0267	2.280723134	11.30802624	0	3.98888787	8.366556791	1.78187443	9.034050589	3.246475603	0	4.078816458	0.123086684	0.141563364	3.266126186	6.648523142	21.61528347	2.933184861	2.891052425	7.26568426	0.010696505	8.062515797	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.7543	135	0	23.0267	2.280723134	11.30802624	0	4.848767894	10.17012593	2.165991075	10.98151061	3.946314659	0	4.958082286	0.14962034	0.172080017	3.970201296	8.082042824	26.31685721	3.186106192	3.514273311	8.831939558	0.153535254	8.062515797	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.8099		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			23.0267	2.280723134	11.30802624	0	4.848767894	10.17012593	2.165991075	10.98151061	3.946314659	0	4.958082286	0.14962034	0.172080017	3.970201296	8.082042824	26.31685721	3.186106192	3.514273311	8.831939558	0.153535254	8.062515797	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.8099
H4577_046_0	2009	5																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.8599	1.8036	0.3841	1.9475	0.6998	0	0.8793	0.0265	0.0305	0.7041	1.4335	4.7016	0.2529	0.6232	1.5663	0.1428	0	0	0	0	0	0	0	0	0	0											16.0556		409.2115581	40.53106191	2159.605302	1821.56563	21.17161548	44.4067442	9.457563484	47.94956678	17.23115198	9472.452546	21.64892484	0.653300876	0.751368603	17.33545038	38.19928624	129.5951961	6.227325916	15.34469062	38.56369955	6.240764165	42.79300142	0	0	684	2.76	158.976	116.4	31.04	0.07	6.8											Medicare FFS cost sharing	Medicare FFS cost sharing	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $0.00	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											716.8	716.8	66.7	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.184757511	0.17705337	0.5	0.2	0.2	0.001819434	0.2	0	0	0	0.2	10	0	0	0	0											716.8	716.8	66.7	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.184757511	0.17705337	0.5	0.2	0.2	0.001819434	0.2	0	0	0	0.2	10	0	0	0	0											24.4436	2.421055431	12.00380614	0	4.234323096	8.88134884	1.891512697	9.589913356	3.446230397	0	4.329784967	0.130660175	0.150273721	3.467090075	7.05760503	22.9452662	3.113662958	3.068938124	7.71273991	0.011354659	8.558600283	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.1422	135	0	24.4436	2.421055431	12.00380614	0	5.09420312	10.68491798	2.275629342	11.53737337	4.146069452	0	5.209050795	0.157193832	0.180790374	4.171165185	8.491124712	27.64683994	3.366584288	3.692159009	9.278995208	0.154193407	8.558600283	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	144.1978		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			24.4436	2.421055431	12.00380614	0	5.09420312	10.68491798	2.275629342	11.53737337	4.146069452	0	5.209050795	0.157193832	0.180790374	4.171165185	8.491124712	27.64683994	3.366584288	3.692159009	9.278995208	0.154193407	8.558600283	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	144.1978
H4577_047_0	2009	5																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	1.226	1.9209	0.4958	1.7958	0.634	0	0.811	0.0043	0	0.4577	1.7223	4.4517	0.1646	0.6209	1.5375	0.2111	0	0.0019	0	0	0	0	0	0	0	0											16.0556		366.5745346	35.44818695	1683.463235	1486.050897	26.92593252	42.18591737	10.88955156	39.43876689	13.92362879	6967.315359	17.81124903	0.094612222	0	10.05108639	40.51012545	109.6495896	3.615731059	13.63638187	33.76577123	7.034849928	27.50692578	0.041531378	0	684	2.76	158.976	116.4	31.04	0.07	6.8											Medicare FFS cost sharing	Medicare FFS cost sharing	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $0.00	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											716.8	716.8	66.7	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.186721727	0.177104451	0.5	0.2	0.2	0.000664198	0.2	0.2	0	0	0.2	10	0	0	0	0											716.8	716.8	66.7	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0	0.2	0.186721727	0.177104451	0.5	0.2	0.2	0.000664198	0.2	0.2	0	0	0.2	10	0	0	0	0											21.8967	2.117438367	9.357249815	0	5.385186504	8.437183474	2.177910312	7.887753377	2.784725759	0	3.562249805	0.018922444	0	2.010217279	7.564120593	19.41943037	1.80786553	2.727276374	6.753154245	0.004672536	5.501385155	0.008306276	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.1062	135	0	21.8967	2.117438367	9.357249815	0	6.61122722	10.35806968	2.673753254	9.683551311	3.418721844	0	4.373264112	0.023230501	0	2.467881694	9.28639859	23.87115944	1.972503597	3.348193008	8.290638984	0.215770087	5.501385155	0.010197358	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.1618		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			21.8967	2.117438367	9.357249815	0	6.61122722	10.35806968	2.673753254	9.683551311	3.418721844	0	4.373264112	0.023230501	0	2.467881694	9.28639859	23.87115944	1.972503597	3.348193008	8.290638984	0.215770087	5.501385155	0.010197358	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.1618
H4577_048_0	2009	5																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.8599	1.8036	0.3841	1.9475	0.6998	0	0.8793	0.0265	0.0305	0.7041	1.4335	4.7016	0.2529	0.6232	1.5663	0.1428	0	0	0	0	0	0	0	0	0	0											16.0556		393.5105009	38.97592372	2076.743306	1751.673894	20.35928078	42.70289977	9.094685792	46.10978763	16.57000911	9109.003575	20.81827623	0.628234345	0.722539306	16.67030568	36.73361606	124.622752	5.988389359	14.75592947	37.08404717	6.001311995	41.15107476	0	0	684	2.76	158.976	116.4	31.04	0.07	6.8											Medicare FFS cost sharing	Medicare FFS cost sharing	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $0.00	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											716.8	716.8	66.7	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.184757511	0.17705337	0.5	0.2	0.2	0.001819434	0.2	0	0	0	0.2	10	0	0	0	0											716.8	716.8	66.7	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.184757511	0.17705337	0.5	0.2	0.2	0.001819434	0.2	0	0	0	0.2	10	0	0	0	0											23.5057	2.328161843	11.54323154	0	4.071856157	8.540579954	1.818937158	9.221957526	3.314001823	0	4.163655247	0.125646869	0.144507861	3.334061135	6.786811455	22.06487822	2.994194679	2.951185895	7.416809435	0.010918991	8.230214952	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.2518	135	0	23.5057	2.328161843	11.54323154	0	4.931736181	10.34414909	2.203053804	11.16941754	4.013840878	0	5.042921074	0.152180525	0.175024515	4.038136245	8.220331138	26.76645196	3.24711601	3.57440678	8.983064732	0.15375774	8.230214952	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.3074		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			23.5057	2.328161843	11.54323154	0	4.931736181	10.34414909	2.203053804	11.16941754	4.013840878	0	5.042921074	0.152180525	0.175024515	4.038136245	8.220331138	26.76645196	3.24711601	3.57440678	8.983064732	0.15375774	8.230214952	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.3074
H4577_049_0	2009	5																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.8599	1.8036	0.3841	1.9475	0.6998	0	0.8793	0.0265	0.0305	0.7041	1.4335	4.7016	0.2529	0.6232	1.5663	0.1428	0	0	0	0	0	0	0	0	0	0											16.0556		402.0127297	39.81804158	2121.613638	1789.520742	20.79916552	43.62554306	9.291186519	47.1060405	16.92802245	9305.813653	21.26807807	0.641808041	0.738150565	17.03048603	37.52728638	127.3153642	6.117775122	15.07474762	37.88528895	6.130976966	42.04018916	0	0	684	2.76	158.976	116.4	31.04	0.07	6.8											Medicare FFS cost sharing	Medicare FFS cost sharing	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $0.00	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											716.8	716.8	66.7	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.184757511	0.17705337	0.5	0.2	0.2	0.001819434	0.2	0	0	0	0.2	10	0	0	0	0											716.8	716.8	66.7	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.184757511	0.17705337	0.5	0.2	0.2	0.001819434	0.2	0	0	0	0.2	10	0	0	0	0											24.0136	2.37846435	11.7926358	0	4.159833104	8.725108613	1.858237304	9.421208099	3.385604491	0	4.253615615	0.128361608	0.147630113	3.406097207	6.933448009	22.54161427	3.058887561	3.014949524	7.577057791	0.011154908	8.408037832	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.9	135	0	24.0136	2.37846435	11.7926358	0	5.019713128	10.52867775	2.242353949	11.36866812	4.085443546	0	5.132881443	0.154895265	0.178146766	4.110172316	8.366967691	27.24318801	3.311808891	3.638170409	9.143313088	0.153993657	8.408037832	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.9556		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			24.0136	2.37846435	11.7926358	0	5.019713128	10.52867775	2.242353949	11.36866812	4.085443546	0	5.132881443	0.154895265	0.178146766	4.110172316	8.366967691	27.24318801	3.311808891	3.638170409	9.143313088	0.153993657	8.408037832	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.9556
H4577_801_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.3436	0.7469	0.3288	0.6945	0.9788	0	0.9956	0.054	0.0043	0.6676	1.3813	4.895	0.1462	0.5606	1.7388	0.3052	0	0.0003	0	0	0	0	0	0	0	0											13.8414		327.6041783	8.944189615	1201.16344	2540.773897	8.5859254	18.66371944	8.216061195	17.35388953	24.45830428	7813.312892	24.87751845	1.349482697	0.107609766	16.6831031	36.25450555	135.8676867	3.653017311	14.00755082	43.45001293	7.625248938	40.01868761	0.007142617	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											819.2	819.2	76.71	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199937572	0.197199066	0.5	0.2	0.2	0.195807763	0.2	0.2	0	0	0	0	0	0	0	0											819.2	819.2	76.71	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199937572	0.197199066	0.5	0.2	0.2	0.195807763	0.2	0.2	0	0	0	0	0	0	0	0											22.3644	0.610590011	7.678437292	0	1.71718508	3.732743888	1.643212239	3.470777907	4.891660855	0	4.975503691	0.269896539	0.021521953	3.336620619	7.248637807	26.79298088	1.826508656	2.801510164	8.690002586	1.493082937	8.003737523	0.001428523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.5705	135	0	22.3644	0.610590011	7.678437292	0	2.060786386	4.479649792	1.9720119	4.165265551	5.870461031	0	5.971080455	0.323901669	0.025828403	4.004263971	8.629913647	31.68798691	1.972699248	3.362080228	10.42883451	1.798238802	8.003737523	0.001714365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4119		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			22.3644	0.610590011	7.678437292	0	2.060786386	4.479649792	1.9720119	4.165265551	5.870461031	0	5.971080455	0.323901669	0.025828403	4.004263971	8.629913647	31.68798691	1.972699248	3.362080228	10.42883451	1.798238802	8.003737523	0.001714365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4119
H4577_802_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.3436	0.7469	0.3288	0.6945	0.9788	0	0.9956	0.054	0.0043	0.6676	1.3813	4.895	0.1462	0.5606	1.7388	0.3052	0	0.0003	0	0	0	0	0	0	0	0											13.8414		327.6041783	8.944189615	1201.16344	2540.773897	8.5859254	18.66371944	8.216061195	17.35388953	24.45830428	7813.312892	24.87751845	1.349482697	0.107609766	16.6831031	36.25450555	135.8676867	3.653017311	14.00755082	43.45001293	7.625248938	40.01868761	0.007142617	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											819.2	819.2	76.71	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199937572	0.197199066	0.5	0.2	0.2	0.195807763	0.2	0.2	0	0	0	0	0	0	0	0											819.2	819.2	76.71	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199937572	0.197199066	0.5	0.2	0.2	0.195807763	0.2	0.2	0	0	0	0	0	0	0	0											22.3644	0.610590011	7.678437292	0	1.71718508	3.732743888	1.643212239	3.470777907	4.891660855	0	4.975503691	0.269896539	0.021521953	3.336620619	7.248637807	26.79298088	1.826508656	2.801510164	8.690002586	1.493082937	8.003737523	0.001428523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.5705	135	0	22.3644	0.610590011	7.678437292	0	2.060786386	4.479649792	1.9720119	4.165265551	5.870461031	0	5.971080455	0.323901669	0.025828403	4.004263971	8.629913647	31.68798691	1.972699248	3.362080228	10.42883451	1.798238802	8.003737523	0.001714365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4119		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			22.3644	0.610590011	7.678437292	0	2.060786386	4.479649792	1.9720119	4.165265551	5.870461031	0	5.971080455	0.323901669	0.025828403	4.004263971	8.629913647	31.68798691	1.972699248	3.362080228	10.42883451	1.798238802	8.003737523	0.001714365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4119
H4577_803_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.3436	0.7469	0.3288	0.6945	0.9788	0	0.9956	0.054	0.0043	0.6676	1.3813	4.895	0.1462	0.5606	1.7388	0.3052	0	0.0003	0	0	0	0	0	0	0	0											13.8414		327.6041783	8.944189615	1201.16344	2540.773897	8.5859254	18.66371944	8.216061195	17.35388953	24.45830428	7813.312892	24.87751845	1.349482697	0.107609766	16.6831031	36.25450555	135.8676867	3.653017311	14.00755082	43.45001293	7.625248938	40.01868761	0.007142617	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											819.2	819.2	76.71	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199937572	0.197199066	0.5	0.2	0.2	0.195807763	0.2	0.2	0	0	0	0	0	0	0	0											819.2	819.2	76.71	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199937572	0.197199066	0.5	0.2	0.2	0.195807763	0.2	0.2	0	0	0	0	0	0	0	0											22.3644	0.610590011	7.678437292	0	1.71718508	3.732743888	1.643212239	3.470777907	4.891660855	0	4.975503691	0.269896539	0.021521953	3.336620619	7.248637807	26.79298088	1.826508656	2.801510164	8.690002586	1.493082937	8.003737523	0.001428523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.5705	135	0	22.3644	0.610590011	7.678437292	0	2.060786386	4.479649792	1.9720119	4.165265551	5.870461031	0	5.971080455	0.323901669	0.025828403	4.004263971	8.629913647	31.68798691	1.972699248	3.362080228	10.42883451	1.798238802	8.003737523	0.001714365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4119		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			22.3644	0.610590011	7.678437292	0	2.060786386	4.479649792	1.9720119	4.165265551	5.870461031	0	5.971080455	0.323901669	0.025828403	4.004263971	8.629913647	31.68798691	1.972699248	3.362080228	10.42883451	1.798238802	8.003737523	0.001714365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4119
H4577_804_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.3436	0.7469	0.3288	0.6945	0.9788	0	0.9956	0.054	0.0043	0.6676	1.3813	4.895	0.1462	0.5606	1.7388	0.3052	0	0.0003	0	0	0	0	0	0	0	0											13.8414		327.6041783	8.944189615	1201.16344	2540.773897	8.5859254	18.66371944	8.216061195	17.35388953	24.45830428	7813.312892	24.87751845	1.349482697	0.107609766	16.6831031	36.25450555	135.8676867	3.653017311	14.00755082	43.45001293	7.625248938	40.01868761	0.007142617	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											819.2	819.2	76.71	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199937572	0.197199066	0.5	0.2	0.2	0.195807763	0.2	0.2	0	0	0	0	0	0	0	0											819.2	819.2	76.71	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199937572	0.197199066	0.5	0.2	0.2	0.195807763	0.2	0.2	0	0	0	0	0	0	0	0											22.3644	0.610590011	7.678437292	0	1.71718508	3.732743888	1.643212239	3.470777907	4.891660855	0	4.975503691	0.269896539	0.021521953	3.336620619	7.248637807	26.79298088	1.826508656	2.801510164	8.690002586	1.493082937	8.003737523	0.001428523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.5705	135	0	22.3644	0.610590011	7.678437292	0	2.060786386	4.479649792	1.9720119	4.165265551	5.870461031	0	5.971080455	0.323901669	0.025828403	4.004263971	8.629913647	31.68798691	1.972699248	3.362080228	10.42883451	1.798238802	8.003737523	0.001714365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4119		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			22.3644	0.610590011	7.678437292	0	2.060786386	4.479649792	1.9720119	4.165265551	5.870461031	0	5.971080455	0.323901669	0.025828403	4.004263971	8.629913647	31.68798691	1.972699248	3.362080228	10.42883451	1.798238802	8.003737523	0.001714365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4119
H4590_010_0	2009	9																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	258.4928861	12.9065913	988.2116536	405.6871215	316.4771423	15.60867525	9.506278956	327.3650215	277.7849924	12571.34479	61.73681135	0	5.181081985	1637.918429	6340.616562	5279.598751	633.7681766	190.0903208	0	0	42.49122871	1051.567131	0	0	103.9150116	146.4	0	0	510.642247	0											"$100 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$100 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-17/$100 Days 18-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$100 (9b)	$0/$0 (8a1); $0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $60 (5); $100 (9a); $40/$30 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14e1, 14h1)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 n/c (17b1, 17b3, 17b4, 17b5); $20 (17b2)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$0 n/c (13b, 13d, 13e)"											99.97351507	100	36.7115356	0	150	0.2	0.073327353	50	100	0	0.169017451	0	0	34.84636028	0	20	37.5	8.334199101	0	0	0.2	19.40440124	0	0	20	20	0	0	0	0											99.97351507	100	36.7115356	0	150	0.2	0.073327353	50	100	0	0.169017451	0	0	34.84636028	0	20	37.5	8.334199101	0	0	0.2	19.40440124	0	0	20	20	0	0	0	0											2.1535	0.107554928	3.023230608	0	3.955964279	3.12173505	0.697070275	1.364020923	2.314874936	0	10.43459847	0	0	4.756291308	0	8.799331251	1.980525552	0.132020882	0	0	8.498245743	1.700419212	0	0	0.173191686	0.244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4566	0	0	2.1535	0.107554928	3.023230608	0	3.955964279	3.12173505	0.697070275	1.364020923	2.314874936	0	10.43459847	0	0	4.756291308	0	8.799331251	1.980525552	0.132020882	0	0	8.498245743	1.700419212	0	0	0.173191686	0.244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4566																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	2.1535	0.107554928	3.023230608	0	3.955964279	3.12173505	0.697070275	1.364020923	2.314874936	0	10.43459847	0	0	4.756291308	0	8.799331251	1.980525552	0.132020882	0	0	8.498245743	1.700419212	0	0	0.173191686	0.244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4566
H4590_012_0	2009	7																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1793.912487	129.5479321	836.8544054	785.8332389	194.4059051	16.68221209	9.923318461	327.0072947	324.7125995	14411.30251	61.81807023	0	0.230925706	1657.235107	6211.117426	5893.915203	635.7631453	481.6585721	0	0	31.23353887	1182.730741	0	0	160.5362186	292.8	0	0	510.6433116	0											"$100 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$100 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-14/$95 Days 15-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$100 (9b)	$0/$0 (8a1); $0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $60 (5); $100 (9a); $30/$30 (9c)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$0 n/c (13b, 13d, 13e)"											61.15027733	45.31962557	41.37652798	0	149.8609691	0.2	0.095734877	49.9964413	100	0	0.190003984	0	0.2	34.78765823	3.413804235	25	30	8.334199101	0	0	0.2	24.4767465	0	0	25	30	0	0	0	0											61.15027733	45.31962557	41.37652798	0	149.8609691	0.2	0.095734877	49.9964413	100	0	0.190003984	0	0.2	34.78765823	3.413804235	25	30	8.334199101	0	0	0.2	24.4767465	0	0	25	30	0	0	0	0											9.1415	0.489255315	2.88551081	0	2.427821444	3.336442417	0.950007671	1.362433418	2.705938329	0	11.74567962	0	0.046185141	4.804277375	1.766961581	12.27899001	1.589407863	0.33451987	0	0	6.246707774	2.412450044	0	0	0.334450456	0.732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.5906	0	0	9.1415	0.489255315	2.88551081	0	2.427821444	3.336442417	0.950007671	1.362433418	2.705938329	0	11.74567962	0	0.046185141	4.804277375	1.766961581	12.27899001	1.589407863	0.33451987	0	0	6.246707774	2.412450044	0	0	0.334450456	0.732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.5906																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	9.1415	0.489255315	2.88551081	0	2.427821444	3.336442417	0.950007671	1.362433418	2.705938329	0	11.74567962	0	0.046185141	4.804277375	1.766961581	12.27899001	1.589407863	0.33451987	0	0	6.246707774	2.412450044	0	0	0.334450456	0.732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.5906
H4590_020_0	2009	7																																D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2725.465029	216.8078334	1142.887988	1091.481142	345.8495624	32.14603504	14.90369894	633.470864	368.0214139	16513.13638	70.55204333	0	0.269407332	2267.533639	6492.381838	6480.520596	879.61319	756.6233892	0	4704.553869	33.86348797	1180.075435	722.7893323	1764.485563	250.1315303	181.2965623	18.26195146	7.766431644	39.23406048	0											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$50 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4b); $0 (4a1)"	$0 (9b)	$0 (8a1); $0/$0 (8a2)	$0 (8b1); 20% (8b2); $20 (8b3)	Included in h.5.	20% (12)	"$0 (3, 9a, 9d); $10 (5, 9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $50 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$10 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0	0	0	0	50	0.2	0.088263388	49.95615717	0	0	0.137838584	0	0.2	0.04657805	0.012161852	0	10	0	0	0	0.2	0	0	0	0	0	0	0	0	0											0	0	0	0	50	0.2	0.088263388	49.95615717	0	0	0.137838584	0	0.2	0.04657805	0.012161852	0	10	0	0	0	0.2	0	0	0	0	0	0	0	0	0											0	0	0	0	1.441039843	6.429207007	1.315450954	2.637147504	0	0	9.724793729	0	0.053881466	0.008801441	0.006579949	0	0.733010992	0	0	0	6.772697593	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.1226	0	0	0	0	0	0	1.441039843	6.429207007	1.315450954	2.637147504	0	0	9.724793729	0	0.053881466	0.008801441	0.006579949	0	0.733010992	0	0	0	6.772697593	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.1226																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.441039843	6.429207007	1.315450954	2.637147504	0	0	9.724793729	0	0.053881466	0.008801441	0.006579949	0	0.733010992	0	0	0	6.772697593	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.1226
H4590_022_0	2009	7																																D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1083.312582	210.4850905	279.3737428	301.8515835	310.4622784	19.43309423	21.99468499	398.3414683	205.2685584	7521.78795	85.3030066	0	0.161270213	343.1501907	5218.289146	5037.08461	872.134157	177.5112784	0	0	68.0260246	1057.319551	725.3409752	1752.837198	426.3463802	349.7142857	18.16891711	7.149500578	40.58500899	0											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$50 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4b); $0 (4a1)"	$0 (9b)	$0 (8a1); $0/$0 (8a2)	$0 (8b1); 20% (8b2); $20 (8b3)	Included in h.5.	20% (12)	"$0 (3, 9a, 9d); $10 (5, 9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $50 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$10 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0	0	0	0	50	0.2	0.093297047	49.93063321	0	0	0.143651488	0	0.2	0.3076501	0	0	10	0	0	0	0.2	0	0	0	0	0	0	0	0	0											0	0	0	0	50	0.2	0.093297047	49.93063321	0	0	0.143651488	0	0.2	0.3076501	0	0	10	0	0	0	0.2	0	0	0	0	0	0	0	0	0											0	0	0	0	1.293592827	3.886618845	2.052039166	1.657453479	0	0	12.25390381	0	0.032254043	0.008797516	0	0	0.726778464	0	0	0	13.60520492	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.5166	0	0	0	0	0	0	1.293592827	3.886618845	2.052039166	1.657453479	0	0	12.25390381	0	0.032254043	0.008797516	0	0	0.726778464	0	0	0	13.60520492	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.5166																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.293592827	3.886618845	2.052039166	1.657453479	0	0	12.25390381	0	0.032254043	0.008797516	0	0	0.726778464	0	0	0	13.60520492	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.5166
H4590_025_0	2009	7																																A	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	308.373219	136.1673504	759.54625	524.1513627	217.8253542	13.6047816	10.27718051	407.3503412	347.6397185	13648.46988	50.24237535	0	0.131992418	1402.144135	5907.049822	5690.647445	622.1172305	417.7632095	0	0	24.00962196	1226.863873	0	0	131.537322	292.8	0	0	623.2254931	0											"$50 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$50 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$95 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$25 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$10 (3, 9d); $60 (5); $25 (9a); $40/$30 (9c)"	"$5 (7a); $15 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$15 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$10 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$15 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$0 n/c (13b, 13d, 13e)"											48.57334931	50	52.35147866	0	150	0.2	0.091754747	49.99884123	25	2.8	0.195124865	0	0.2	9.204725525	3.64762085	15	37.5	10	0	0	0.2	14.63600023	0	0	15	30	0	0	0	0											48.57334931	50	52.35147866	0	150	0.2	0.091754747	49.99884123	25	2.8	0.195124865	0	0.2	9.204725525	3.64762085	15	37.5	10	0	0	0.2	14.63600023	0	0	15	30	0	0	0	0											1.2482	0.56736396	3.313614108	0	2.722816927	2.720956319	0.942980099	1.697253753	0.724249414	3.184642971	9.803536687	0	0.026398484	1.075529325	1.795556508	7.113309306	1.944116345	0.348136008	0	0	4.801924392	1.496364994	0	0	0.164421652	0.732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.4234	0	0	1.2482	0.56736396	3.313614108	0	2.722816927	2.720956319	0.942980099	1.697253753	0.724249414	3.184642971	9.803536687	0	0.026398484	1.075529325	1.795556508	7.113309306	1.944116345	0.348136008	0	0	4.801924392	1.496364994	0	0	0.164421652	0.732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.4234																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	1.2482	0.56736396	3.313614108	0	2.722816927	2.720956319	0.942980099	1.697253753	0.724249414	3.184642971	9.803536687	0	0.026398484	1.075529325	1.795556508	7.113309306	1.944116345	0.348136008	0	0	4.801924392	1.496364994	0	0	0.164421652	0.732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.4234
H4590_027_0	2009	5																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1752.473088	129.4989121	771.9102747	643.2116509	180.5596172	13.53934398	7.533003872	313.1227573	314.6220613	13634.53841	61.17175037	0	0.176492204	1577.955859	5732.648709	5486.581282	635.0491182	461.3774642	0	0	32.18456968	1097.213833	0	0	148.8243812	292.5994363	0	0	510.2911829	0											"$100 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$100 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$95 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$100 (9b)	$0/$0 (8a1); $0 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $60 (5); $100 (9a); $30/$30 (9c)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$30/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$0 n/c (13b, 13d, 13e)"											61.15022314	45.31962557	52.35147866	0	150	0.2	0.115934256	49.99809085	100	0	0.18904382	0	0.2	34.24114251	3.341607704	25	30	8.334199101	0	0	0.2	24.23136982	0	0	25	30	0	0	0	0											61.15022314	45.31962557	52.35147866	0	150	0.2	0.115934256	49.99809085	100	0	0.18904382	0	0.2	34.24114251	3.341607704	25	30	8.334199101	0	0	0.2	24.23136982	0	0	25	30	0	0	0	0											8.9303	0.489070184	3.36755369	0	2.256995214	2.707868795	0.873333196	1.304628339	2.621850511	0	11.5641414	0	0.035298441	4.502584288	1.596355258	11.43037767	1.587622796	0.320434304	0	0	6.436913936	2.215582845	0	0	0.310050794	0.731498591	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.2825	0	0	8.9303	0.489070184	3.36755369	0	2.256995214	2.707868795	0.873333196	1.304628339	2.621850511	0	11.5641414	0	0.035298441	4.502584288	1.596355258	11.43037767	1.587622796	0.320434304	0	0	6.436913936	2.215582845	0	0	0.310050794	0.731498591	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.2825																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.9303	0.489070184	3.36755369	0	2.256995214	2.707868795	0.873333196	1.304628339	2.621850511	0	11.5641414	0	0.035298441	4.502584288	1.596355258	11.43037767	1.587622796	0.320434304	0	0	6.436913936	2.215582845	0	0	0.310050794	0.731498591	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.2825
H4590_029_0	2009	3																																A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	O	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	252.9064532	12.90498283	1015.052671	397.7901323	321.5276601	15.19952481	7.368417132	322.5904161	267.1333156	12492.89676	60.0721581	0	4.783070155	1641.200421	6232.565159	5094.991826	632.9728047	189.3296578	0	0	41.44622453	1002.11506	0	574.0770332	170.084797	146.4164288	8.791757611	1.718873466	510.6986441	465.842253											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-20/$100 Days 21-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$0 (9b)	$0/$0 (8a1); $0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $60 (5); $0 (9a); $40/$30 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14e1, 14h1)"	"$20 (7b, 7f, 7f1); $10 (7b1); $0 (7d)"	"$40/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$20 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 n/c (17b1, 17b3, 17b4, 17b5); $0 (17b2)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$10 (13b); $0 n/c (13d, 13e)"											0	0	31.01658425	0	150	0.2	0.091168339	50	0	0	0.169149114	0	0	0.536570961	0	0.121338556	37.5	8.334199101	0	0	0.2	19.36315676	0	20	20	0	0	0	0	10											0	0	31.01658425	0	150	0.2	0.091168339	50	0	0	0.169149114	0	0	0.536570961	0	0.121338556	37.5	8.334199101	0	0	0.2	19.36315676	0	20	20	0	0	0	0	10											0	0	2.623622222	0	4.019095752	3.039904962	0.671766352	1.344126734	0	0	10.16115232	0	0	0.073385041	0	0.051518246	1.978040015	0.131492589	0	0	8.289244905	1.61700925	0	0.956795055	0.283474662	0	0	0	0	0.388201877	0	0	0	0	0	0	0	0	0	0	35.6288	0	0	0	0	2.623622222	0	4.019095752	3.039904962	0.671766352	1.344126734	0	0	10.16115232	0	0	0.073385041	0	0.051518246	1.978040015	0.131492589	0	0	8.289244905	1.61700925	0	0.956795055	0.283474662	0	0	0	0	0.388201877	0	0	0	0	0	0	0	0	0	0	35.6288																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	2.623622222	0	4.019095752	3.039904962	0.671766352	1.344126734	0	0	10.16115232	0	0	0.073385041	0	0.051518246	1.978040015	0.131492589	0	0	8.289244905	1.61700925	0	0.956795055	0.283474662	0	0	0	0	0.388201877	0	0	0	0	0	0	0	0	0	0	35.6288
H4590_031_0	2009	5																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1612.866362	134.3495965	7795.770082	108.294152	626.4973473	14.09566683	16.10380308	177.2250381	116.0026456	13085.35451	1720.227711	0	6.445641775	285.3016441	176.2477961	8337.098713	252.808708	43.01051018	0	0	1540.283813	985.3066275	1576.881712	0	191.5790143	148.7435641	0	0	0	0											"$150 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$150 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $35 (4b)	$25 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$25 (3, 5, 9a, 9d); $0 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $35 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$10 (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"$0 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $10 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											121.118511	100.9460757	0	0	75	0.2	0.2	49.81663475	25	0	0	0	0	24.59826565	0	9.690944415	0	0	0	0	0	9.782707358	0	0	0	0	0	0	0	0											121.118511	100.9460757	0	0	75	0.2	0.2	49.81663475	25	0	0	0	0	24.59826565	0	9.690944415	0	0	0	0	0	9.782707358	0	0	0	0	0	0	0	0											16.279	1.130172045	0	0	3.915608421	2.819133366	3.220760616	0.735729583	0.241672178	0	0	0	0	0.584827136	0	6.732863351	0	0	0	0	0	0.8032472	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.463	0	0	16.279	1.130172045	0	0	3.915608421	2.819133366	3.220760616	0.735729583	0.241672178	0	0	0	0	0.584827136	0	6.732863351	0	0	0	0	0	0.8032472	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.463																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.279	1.130172045	0	0	3.915608421	2.819133366	3.220760616	0.735729583	0.241672178	0	0	0	0	0.584827136	0	6.732863351	0	0	0	0	0	0.8032472	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.463
H4590_033_0	2009	7																																D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2564.315607	365.0170032	1303.863021	2872.736199	379.9549207	30.27976071	11.779085	635.5888416	294.4623336	10939.52396	30.0304969	0	1.444676996	1566.86398	5694.640991	4833.12178	1610.923144	548.7378787	0	3395.652358	21.36363211	1160.369781	984.7262485	3001.016938	446.093249	303.2519576	27.585242	9.818384405	18.51192158	0											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$50 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4b); $0 (4a1)"	$0 (9b)	$0 (8a1); $0/$0 (8a2)	$0 (8b1); 20% (8b2); $20 (8b3)	Included in h.5.	20% (12)	"$0 (3, 9a, 9d); $10 (5, 9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $50 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$10 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0	0	0	0	50	0.2	0.14678739	49.96856654	0	0	0.151094837	0	0.2	0.122918396	0	0	10	0	0	0	0.2	0	0	0	0	0	0	0	0	0											0	0	0	0	50	0.2	0.14678739	49.96856654	0	0	0.151094837	0	0.2	0.122918396	0	0	10	0	0	0	0.2	0	0	0	0	0	0	0	0	0											0	0	0	0	1.583145503	6.055952142	1.729021145	2.646621944	0	0	4.537453043	0	0.288935399	0.016049701	0	0	1.342435953	0	0	0	4.272726423	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.4723	0	0	0	0	0	0	1.583145503	6.055952142	1.729021145	2.646621944	0	0	4.537453043	0	0.288935399	0.016049701	0	0	1.342435953	0	0	0	4.272726423	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.4723																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	1.583145503	6.055952142	1.729021145	2.646621944	0	0	4.537453043	0	0.288935399	0.016049701	0	0	1.342435953	0	0	0	4.272726423	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.4723
H4590_034_0	2009	6																																Coin	Coin	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		391.0117004	42.96	8183.594565	113.6815766	28.23302252	15.53301609	17.74592401	13.2057902	9.237773275	37.96486872	31.40888565	0	0.11866829	6.159263137	1.338895475	159.8971786	45.27	45.15019987	0	151498.2451	10.54943248	7.905050679	1576.881712	0	191.5790143	148.7435641	0	0	0	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.071127146	0.0721	0	0	0.2	0.2	0.2	0.058351067	0.2	0.08	0.15003742	0	0.2	0.2	0	0.198814862	0.2	0	0	0	0.2	0.022666282	0	0	0	0	0	0	0	0											0.071127146	0.0721	0	0	0.2	0.2	0.2	0.058351067	0.2	0.08	0.15003742	0	0.2	0.2	0	0.198814862	0.2	0	0	0	0.2	0.022666282	0	0	0	0	0	0	0	0											27.8115	3.097416	0	0	5.646604504	3.106603219	3.549184803	0.770571952	1.847554655	3.037189497	4.712508153	0	0.023733658	1.231852627	0	31.78993549	9.054	0	0	0	2.109886497	0.179178105	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.9678	0	0	27.8115	3.097416	0	0	5.646604504	3.106603219	3.549184803	0.770571952	1.847554655	3.037189497	4.712508153	0	0.023733658	1.231852627	0	31.78993549	9.054	0	0	0	2.109886497	0.179178105	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.9678																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	27.8115	3.097416	0	0	5.646604504	3.106603219	3.549184803	0.770571952	1.847554655	3.037189497	4.712508153	0	0.023733658	1.231852627	0	31.78993549	9.054	0	0	0	2.109886497	0.179178105	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.9678
H4590_035_0	2009	6																																D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	O	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	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 Only	2251.67269	235.9256124	944.2093894	901.7390622	285.7273919	26.63040784	12.3465174	523.3488705	304.0449092	13642.50791	58.44670067	0	13.92470481	1884.067835	5363.752139	5288.254353	1516.577323	625.0926738	0	0	28.05317963	974.9322047	365.1399043	0	327.7093149	349.7142857	0	0	98.17983361	0											"$100 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$100 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	$0 Days 1-20/$120 Days 21-100 (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $30 (4b)	$100 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); $0/20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-99 (3, 9d); $150 (5); $100 (9a); $30 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $30 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7f); $0 n/c (7b1, 7f1); $10 (7d)"	"$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-99 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											61.13313209	45.31962557	37.21990109	0	75	0.14	0.088263388	49.9461472	100	0	0.166222719	0	0	35.23515951	0.007297111	9.573653224	30	8.303264072	0	0	0.2	0	0	0	0	0	0	0	0	0											61.13313209	45.31962557	37.21990109	0	75	0.14	0.088263388	49.9461472	100	0	0.166222719	0	0	35.23515951	0.007297111	9.573653224	30	8.303264072	0	0	0.2	0	0	0	0	0	0	0	0	0											11.471	0.891005035	2.928615007	0	1.7857962	3.728257097	1.08974545	2.178271644	2.533707576	0	9.715169527	0	0	5.532119225	0.003261658	4.218992778	3.791443308	0.432525795	0	0	5.610635927	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.9105	0	0	11.471	0.891005035	2.928615007	0	1.7857962	3.728257097	1.08974545	2.178271644	2.533707576	0	9.715169527	0	0	5.532119225	0.003261658	4.218992778	3.791443308	0.432525795	0	0	5.610635927	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.9105																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.471	0.891005035	2.928615007	0	1.7857962	3.728257097	1.08974545	2.178271644	2.533707576	0	9.715169527	0	0	5.532119225	0.003261658	4.218992778	3.791443308	0.432525795	0	0	5.610635927	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.9105
H4590_036_0	2009	7																																D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	O	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	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 Only	1959.288537	235.9256124	1282.415444	53219.14419	92.66064157	23.0812227	10.20484231	378.6591256	396.9991044	6287.158719	20.74710027	0	16.43570723	1540.005175	6194.810236	4591.176965	1512.926942	273.7729023	0	0	28.49046654	1159.227789	365.1399043	0	327.7093149	349.7142857	0	0	98.17983361	0											"$100 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$100 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	$0 Days 1-20/$120 Days 21-100 (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $30 (4b)	$100 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); $0/20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-99 (3, 9d); $150 (5); $100 (9a); $30 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $30 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7f); $0 n/c (7b1, 7f1); $10 (7d)"	"$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-99 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											61.15263947	45.31962557	37.21990109	0	75	0.14	0.2	49.97359102	100	0	0.095212815	0	0	91.24066026	0	8.884666847	30	8.303264072	0	0	0.2	0	0	0	0	0	0	0	0	0											61.15263947	45.31962557	37.21990109	0	75	0.14	0.2	49.97359102	100	0	0.095212815	0	0	91.24066026	0	8.884666847	30	8.303264072	0	0	0.2	0	0	0	0	0	0	0	0	0											9.9846	0.891005035	3.977614666	0	0.57912901	3.231371178	2.040968461	1.576913023	3.30832587	0	1.975389821	0	0	11.70925741	0	3.399256481	3.782317355	0.189434059	0	0	5.698093307	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.3437	0	0	9.9846	0.891005035	3.977614666	0	0.57912901	3.231371178	2.040968461	1.576913023	3.30832587	0	1.975389821	0	0	11.70925741	0	3.399256481	3.782317355	0.189434059	0	0	5.698093307	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.3437																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	9.9846	0.891005035	3.977614666	0	0.57912901	3.231371178	2.040968461	1.576913023	3.30832587	0	1.975389821	0	0	11.70925741	0	3.399256481	3.782317355	0.189434059	0	0	5.698093307	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.3437
H4590_037_0	2009	5																																A	A	D	V	T	Coin	Coin	V	V	V	Coin	V	O	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	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 Only	268.2525956	12.03370809	220.352909	276.1524961	274.9829301	15.67052383	23.87582482	348.4934257	187.1780356	6683.023659	74.32669667	0	4.411561897	302.9421183	4635.91455	4456.43142	604.8761842	163.9828008	0	0	60.23737881	961.6655291	1415.584719	0	363.5245948	349.7142857	0	0	33.20326726	0											"$100 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$100 (1b); $0 n/c (1b1, 1b2)"	$0 Days 1-20/$120 Days 21-100 (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $30 (4b)	$100 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1); $0/20% (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 Visits 1-12/$30 Visits 13-99 (3, 9d); $150 (5); $100 (9a); $30 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $30 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7f); $0 n/c (7b1, 7f1); $10 (7d)"	"$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-99 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											97.10270634	100	37.21990109	0	75	0.14	0.076625625	49.9270068	100	0	0.162440068	0	0	34.96618017	0	9.921690698	30	8.303264072	0	0	0.2	0	0	0	0	0	0	0	0	0											97.10270634	100	37.21990109	0	75	0.14	0.076625625	49.9270068	100	0	0.162440068	0	0	34.96618017	0	9.921690698	30	8.303264072	0	0	0.2	0	0	0	0	0	0	0	0	0											2.1707	0.100280901	0.683459457	0	1.718643313	2.193873336	1.82949999	1.449936136	1.559816963	0	12.07363364	0	0	0.882727391	0	3.68461118	1.51219046	0.113466042	0	0	12.04747576	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.0203	0	0	2.1707	0.100280901	0.683459457	0	1.718643313	2.193873336	1.82949999	1.449936136	1.559816963	0	12.07363364	0	0	0.882727391	0	3.68461118	1.51219046	0.113466042	0	0	12.04747576	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.0203																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	2.1707	0.100280901	0.683459457	0	1.718643313	2.193873336	1.82949999	1.449936136	1.559816963	0	12.07363364	0	0	0.882727391	0	3.68461118	1.51219046	0.113466042	0	0	12.04747576	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.0203
H4590_801_0	2009	2																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1408.798915	126.5585956	856.6938209	801.1564776	147.4032856	19.21892643	10.12581593	229.1724796	375.6234734	16570.56463	67.23649046	0	0.066962399	2129.820213	6576.910808	5814.230074	636.5057578	538.7131611	0	0	44.95568723	1282.458829	0	0	0	0	0	0	0	0											"$250 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$250 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$300 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); $300 (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											201.9608399	168.2434595	159.8131731	0	150	0.2	0.095048917	49.99840025	300	2.8	0.271224749	0	0.2	101.7466463	12.87822462	39.99975248	37.5	35	0	0	0.2	36.99406954	0	0	0	0	0	0	0	0											201.9608399	168.2434595	159.8131731	0	150	0.2	0.095048917	49.99840025	300	2.8	0.271224749	0	0.2	101.7466463	12.87822462	39.99975248	37.5	35	0	0	0.2	36.99406954	0	0	0	0	0	0	0	0											23.7102	1.774387996	11.40924649	0	1.842541069	3.843785287	0.962447838	0.95485478	9.390586836	3.866465081	18.23620026	0	0.01339248	18.05850533	7.058244559	19.38064699	1.989080493	1.57124672	0	0	8.991137446	3.95361426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.0066	0	0	23.7102	1.774387996	11.40924649	0	1.842541069	3.843785287	0.962447838	0.95485478	9.390586836	3.866465081	18.23620026	0	0.01339248	18.05850533	7.058244559	19.38064699	1.989080493	1.57124672	0	0	8.991137446	3.95361426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.0066																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.7102	1.774387996	11.40924649	0	1.842541069	3.843785287	0.962447838	0.95485478	9.390586836	3.866465081	18.23620026	0	0.01339248	18.05850533	7.058244559	19.38064699	1.989080493	1.57124672	0	0	8.991137446	3.95361426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.0066
H4590_802_0	2009	2																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1399.942779	125.76301	851.3083843	796.1201655	146.4766639	18.97805395	9.998908196	227.731832	373.2621906	16466.39705	66.39380964	0	0.066123153	2116.431519	6535.566357	5777.680064	632.50449	535.3266472	0	0	44.39225366	1274.396905	0	0	0	0	0	0	0	0											"$250 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$250 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$300 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); $300 (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											201.9608399	168.2434595	159.8131731	0	150	0.2	0.095048917	49.99840025	300	2.8	0.271348671	0	0.2	101.1168265	12.87822462	39.99974294	37.5	35	0	0	0.2	36.99368048	0	0	0	0	0	0	0	0											201.9608399	168.2434595	159.8131731	0	150	0.2	0.095048917	49.99840025	300	2.8	0.271348671	0	0.2	101.1168265	12.87822462	39.99974294	37.5	35	0	0	0.2	36.99368048	0	0	0	0	0	0	0	0											23.5611	1.763233656	11.33752451	0	1.830958299	3.795610789	0.950385395	0.948852274	9.331554765	3.842159311	18.01587199	0	0.013224631	17.83390322	7.013874298	19.25880978	1.976576531	1.561369388	0	0	8.878450733	3.928719326	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.8422	0	0	23.5611	1.763233656	11.33752451	0	1.830958299	3.795610789	0.950385395	0.948852274	9.331554765	3.842159311	18.01587199	0	0.013224631	17.83390322	7.013874298	19.25880978	1.976576531	1.561369388	0	0	8.878450733	3.928719326	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.8422																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.5611	1.763233656	11.33752451	0	1.830958299	3.795610789	0.950385395	0.948852274	9.331554765	3.842159311	18.01587199	0	0.013224631	17.83390322	7.013874298	19.25880978	1.976576531	1.561369388	0	0	8.878450733	3.928719326	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.8422
H4590_803_0	2009	2																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1475.94891	126.7104252	932.0514443	850.8357143	139.3953659	20.20594863	10.58379505	235.8417894	385.8544832	15824.37752	72.36633812	0	0.041401367	2025.302411	6555.067101	5745.752389	633.2890335	544.7986939	0	0	40.93871875	1245.040467	0	0	0	0	0	0	0	0											"$260 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$260 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$300 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); $300 (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											210.0397934	174.9731979	159.8131731	0	150	0.2	0.088963049	49.99795722	300	2.8	0.270554582	0	0.2	103.9139648	12.9804501	39.99972017	37.5	35	0	0	0.2	38.29551218	0	0	0	0	0	0	0	0											210.0397934	174.9731979	159.8131731	0	150	0.2	0.088963049	49.99795722	300	2.8	0.270554582	0	0.2	103.9139648	12.9804501	39.99972017	37.5	35	0	0	0.2	38.29551218	0	0	0	0	0	0	0	0											25.834	1.847577358	12.41284156	0	1.742442073	4.041189726	0.941566678	0.982633975	9.646362081	3.692354756	19.57904436	0	0.008280273	17.53810029	7.090643452	19.15237398	1.97902823	1.588996191	0	0	8.18774375	3.973288529	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.2385	0	0	25.834	1.847577358	12.41284156	0	1.742442073	4.041189726	0.941566678	0.982633975	9.646362081	3.692354756	19.57904436	0	0.008280273	17.53810029	7.090643452	19.15237398	1.97902823	1.588996191	0	0	8.18774375	3.973288529	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.2385																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	25.834	1.847577358	12.41284156	0	1.742442073	4.041189726	0.941566678	0.982633975	9.646362081	3.692354756	19.57904436	0	0.008280273	17.53810029	7.090643452	19.15237398	1.97902823	1.588996191	0	0	8.18774375	3.973288529	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.2385
H4590_804_0	2009	2																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1475.948905	126.7104247	932.051441	850.8357113	139.3953654	20.20594849	10.58379498	235.7964978	385.8544819	15824.37747	72.36633761	0	0.041401367	2025.302404	6407.134453	5745.752369	633.2890313	544.798692	0	0	40.93871847	1245.040462	0	0	0	0	0	0	0	0											"$260 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$260 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$300 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); $300 (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											210.0397934	174.9731979	159.8131731	0	150	0.2	0.088963049	49.99795683	300	2.8	0.270554582	0	0.2	103.9139648	13.28015227	39.99972017	37.5	35	0	0	0.2	38.29551218	0	0	0	0	0	0	0	0											210.0397934	174.9731979	159.8131731	0	150	0.2	0.088963049	49.99795683	300	2.8	0.270554582	0	0.2	103.9139648	13.28015227	39.99972017	37.5	35	0	0	0.2	38.29551218	0	0	0	0	0	0	0	0											25.834	1.847577351	12.41284152	0	1.742442067	4.041189697	0.941566672	0.98244526	9.646362047	3.692354743	19.57904422	0	0.008280273	17.53810023	7.090643427	19.15237391	1.979028223	1.588996185	0	0	8.187743693	3.973288515	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.2383	0	0	25.834	1.847577351	12.41284152	0	1.742442067	4.041189697	0.941566672	0.98244526	9.646362047	3.692354743	19.57904422	0	0.008280273	17.53810023	7.090643427	19.15237391	1.979028223	1.588996185	0	0	8.187743693	3.973288515	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.2383																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	25.834	1.847577351	12.41284152	0	1.742442067	4.041189697	0.941566672	0.98244526	9.646362047	3.692354743	19.57904422	0	0.008280273	17.53810023	7.090643427	19.15237391	1.979028223	1.588996185	0	0	8.187743693	3.973288515	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.2383
H4604_003_0	2009	3																					2700											D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	3300	949.9829141	126.4056528	931.9683875	240.8819659	88.52260666	16.92349726	4.811077127	287.5595367	202.4240037	6357.776762	26.07012446	0	0.105017634	860.9959215	4314.66479	3614.380702	524.34627	281.1937361	0	0	14.59269293	629.8444494	0	596.4349318	118.3912108	292.8	14.72807038	5.04	453.6	0											"$75 Days 1-5 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$75 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$50 Days 11-64 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$50 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); $50 (9a); $40/$30 (9c)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$25 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											45.96288917	33.98971918	26.04131072	0	150	0.2	0.067620294	49.33329237	50	2.8	0.181275592	0	0.2	18.25860058	3.9907114	25	37.5	25	0	0	0.2	24.8113314	0	25	25	0	25	0	0	0											40.02484844	29.58879345	22.66953017	0	130.5782785	0.174104371	0.058864944	42.94570928	43.52609284	2.437461199	0.157804365	0	0.174104371	15.93322689	3.9907114	25	37.5	21.76304642	0	0	0.174104371	24.8113314	0	25	25	0	25	0	0	0											3.1686	0.311682563	1.760607123	0	0.963260799	2.946454852	0.283203785	1.029120689	0.734227165	1.291402848	4.113979429	0	0.018284029	1.143203614	1.43488183	7.529959797	1.638582094	0.509969361	0	0	2.540651629	1.30227328	0	1.242572774	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	34.2402	0	3.0915	3.1686	0.311682563	1.760607123	0	0.963260799	2.946454852	0.283203785	1.029120689	0.734227165	1.291402848	4.113979429	0	0.018284029	1.143203614	1.43488183	7.529959797	1.638582094	0.509969361	0	0	2.540651629	1.30227328	0	1.242572774	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	34.2402		"$300 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$300 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-19 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.9162	0.119	3.4367	0.2615	0.1152	0.5286	0.1503	0.1231	0.7593	0.1545	0.7223	0	0.0022	0.6646	1.3337	2.6033	0.4643	0.121	0	0	0.6457	0.4561	0	0	0.0863	0	0.0107	0	0	0											13.6746	0	6.126822123	4.0847	0.430694532	5.19730963	0.261463237	1.078472684	3.475075892	0.433482215	1.152209819	1.493525001	1.445862529	4.836235801	0	0.020470911	1.807833187	2.768604985	10.13330217	2.10284702	0.630943681	0	0	3.18639127	1.758371534	0	1.242572774	0.33297528	0	0.041422698	0	0	0	0	0	0	0	0	0	0	0	0	0	47.9148
H4604_005_0	2009	3																					2200											D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2600	950.6193019	126.4903311	932.5927074	241.0433312	88.58190741	16.94617875	4.817525108	287.7518705	202.5596063	6362.035798	26.1050646	0	0.105158382	861.5726974	4317.479995	3616.796643	524.6975264	281.3821061	0	0	14.61225059	630.2663783	0	596.4349318	118.3912108	292.8	14.72807038	5.04	453.6	0											"$60 Days 1-5 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$60 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$30 Days 11-84 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$30 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); $30 (9a); $40/$30 (9c)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$25 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											36.79062181	27.19177534	16.30884724	0	150	0.2	0.067620294	49.33329167	30	2.8	0.181252168	0	0.2	11.23459257	3.990780874	25	37.5	25	0	0	0.2	24.8113314	0	25	25	0	25	0	0	0											31.39793354	23.19503271	13.9117156	0	127.9524732	0.170603298	0.057681226	42.08211121	25.59049465	2.388446167	0.154611088	0	0.170603298	9.627243085	3.990780874	25	37.5	21.32541221	0	0	0.170603298	24.8113314	0	25	25	0	25	0	0	0											2.4873	0.244495614	1.08116371	0	0.944522845	2.891073978	0.277880753	1.009100518	0.43196671	1.266281668	4.036132441	0	0.017940367	0.691214149	1.435843049	7.534993006	1.63967977	0.500049117	0	0	2.492898136	1.303145665	0	1.242572774	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	31.8056	0	3.1606	2.4873	0.244495614	1.08116371	0	0.944522845	2.891073978	0.277880753	1.009100518	0.43196671	1.266281668	4.036132441	0	0.017940367	0.691214149	1.435843049	7.534993006	1.63967977	0.500049117	0	0	2.492898136	1.303145665	0	1.242572774	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	31.8056		"$265 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$265 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-15 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.736	0.0947	3.0971	0.2358	0.1038	0.4767	0.1355	0.1109	0.6847	0.1392	0.6512	0	0.002	0.5998	1.3214	2.6053	0.4646	0.109	0	0	0.5823	0.4564	0	0	0.0863	0	0.0107	0	0	0											12.7035	0	6.917066246	3.2233	0.339234826	4.178272396	0.235784892	1.048350199	3.367779063	0.413400315	1.12002662	1.116693788	1.405478593	4.687379454	0	0.019912475	1.290992178	2.757223777	10.14029076	2.104255705	0.609069498	0	0	3.075219587	1.759519534	0	1.242572774	0.33297528	0	0.041422698	0	0	0	0	0	0	0	0	0	0	0	0	0	44.5091
H4604_006_0	2009	3																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		299.7784912	22.4544	49.37685526	2912.582266	12.3975462	32.36672392	10.95672767	34.08664329	38.7998395	9.910094132	23.71811855	0	1.516953633	31.91443134	44.92551319	125.1820773	13.9175	4.224865514	0	0	20.62002669	5.628676921	315.7583775	0	140.0975409	193.8828815	0	0	11.66763854	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.07707091	0.078059479	0.180313613	0	0.2	0.2	0.2	0.124282512	0.2	0.08	0.2	0	0.2	0.2	0	0.19974333	0.2	0.2	0	0	0.2	0.016550563	0	0	0	0	0	0	0	0											0.07707091	0.078059479	0.180313613	0	0.2	0.2	0.2	0.124282512	0.2	0.08	0.2	0	0.2	0.2	0	0.19974333	0.2	0.2	0	0	0.2	0.016550563	0	0	0	0	0	0	0	0											23.1042	1.752778755	8.90331916	0	2.479509241	6.473344783	2.191345535	4.236373653	7.7599679	0.792807531	4.74362371	0	0.303390727	6.382886267	0	25.00428496	2.7835	0.844973103	0	0	4.124005338	0.093157772	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.9735	0	0	23.1042	1.752778755	8.90331916	0	2.479509241	6.473344783	2.191345535	4.236373653	7.7599679	0.792807531	4.74362371	0	0.303390727	6.382886267	0	25.00428496	2.7835	0.844973103	0	0	4.124005338	0.093157772	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.9735		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.7472	0.2807	0.7796	0.5789	0.1958	0.5111	0.173	0.2231	0.6126	0.1565	0.3745	0	0.016	0.5039	0.7094	1.9766	0.2198	0.0667	0	0	0.3256	0.0701	0.0261	0	0.0155	0	0	0	0.003	0											11.5654	0	0	26.8514	2.033458755	9.682953716	0.578930069	2.67525997	6.984398319	2.364346498	4.459450388	8.372596945	0.949282701	5.118120319	0	0.31935866	6.886798341	0.709350208	26.98084408	3.00325	0.911681506	0	0	4.449584707	0.163221169	0.0261	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	113.5389
H4604_007_0	2009	3																					2400											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1474.9346	742.7501546	7238.756709	96.49356988	558.2292714	11.78009408	13.45834274	157.9132048	103.3620855	11659.47142	1532.778177	0	5.743273977	261.9446464	159.0457263	7443.816716	5719.660608	38.32374688	0	0	1372.442381	877.9398718	1498.037626	0	182.0000636	141.3063859	0	0	0	0											"$175 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $35 (4b)	$35 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$35 (3, 5, 9a, 9d); $35/$25 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $35 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$15 (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"$35/$25 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											173.6011825	175	0	0	75	0.2	0.2	49.81663475	35	0	0	0	0	34.80994912	0	14.50674587	32.5	0	0	0	0	14.67406104	0	0	0	0	0	0	0	0											140.3236568	141.4543356	0	0	60.62328669	0.161662098	0.161662098	40.26730841	28.29086712	0	0	0	0	28.137247	0	11.72595485	26.2700909	0	0	0	0	11.86119746	0	0	0	0	0	0	0	0											17.2474	8.755435803	0	0	2.820141097	1.904394721	2.17570392	0.529894977	0.243683585	0	0	0	0	0.614200101	0	7.27382156	12.52133367	0	0	0	0	0.867784848	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.9537	0	13.0322	17.2474	8.755435803	0	0	2.820141097	1.904394721	2.17570392	0.529894977	0.243683585	0	0	0	0	0.614200101	0	7.27382156	12.52133367	0	0	0	0	0.867784848	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.9537		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $35 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $35 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.3085	0.3713	0.9113	0.0443	0.3381	0.186	0.2125	0.0345	0.1023	0.4202	0.3477	0	0	0.0686	0.017	1.9271	0.7422	0.0041	0	0	0.127	0.095	0.1107	0	0.0089	0	0	0	0	0											8.3771	0	0	19.5558	9.126685803	0.911287163	0.044305107	3.158219941	2.090396206	2.388204069	0.564398066	0.345936017	0.420231155	0.347663319	0	0	0.682762527	0.017000188	9.200936529	13.26353367	0.00410127	0	0	0.126958642	0.962805054	0.110719388	0	0.008933819	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.3309
H4604_008_0	2009	3																					2100											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1766.227481	247.6157034	38.54923119	47618.52727	82.49477772	19.2573939	8.514222602	337.12811	353.4440548	5597.390135	428.0678378	0	0.740451015	1364.50408	5521.590018	4097.171219	1242.868229	244.2911245	0	0	24.77308233	1034.612932	769.983193	0	314.3760437	332.2285714	0	0	20.2	0											"$150 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$150 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$75 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5, 9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											148.2	150	0.179824081	0	75	0.14	0.2	49.9718208	75	4.4	64.79010385	0	0.2	70.35701995	3.249983549	25	20	20	0	0	0.2	13.6791576	0	0	0	0	0	0	0	0											101.319835	102.5504403	0.179824081	0	51.27522014	0.095713744	0.13673392	34.16421483	51.27522014	3.008146248	44.2950245	0	0.13673392	48.10095582	3.249983549	25	20	20	0	0	0.13673392	13.6791576	0	0	0	0	0	0	0	0											14.9128	2.116091617	6.932080071	0	0.352494824	1.843197274	1.164183035	0.959809765	1.510243476	1.403147345	1.58010628	0	0.10124477	5.469495872	1.49542306	8.535773373	2.071447048	0.407151874	0	0	3.387320667	1.179386113	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.4214	0	16.1019	14.9128	2.116091617	6.932080071	0	0.352494824	1.843197274	1.164183035	0.959809765	1.510243476	1.403147345	1.58010628	0	0.10124477	5.469495872	1.49542306	8.535773373	2.071447048	0.407151874	0	0	3.387320667	1.179386113	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.4214		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.4118	0.2011	0.6087	0.515	0.1326	0.3041	0.1344	0.074	0.5957	0.0937	0.2526	0	0.0078	0.4747	0.6542	2.0614	0.1512	0.0708	0	0	0.3912	0.0813	0.0569	0	0.0155	0	0	0	0.003	0											10.2915	0	0	18.3246	2.317211617	7.540752142	0.51498966	0.485049443	2.147261389	1.298618129	1.033809401	2.105926059	1.49683524	1.832750569	0	0.109038991	5.944170718	2.149647224	10.59716913	2.222647048	0.477940389	0	0	3.778474598	1.260660211	0.056935837	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	65.7129
H4604_009_0	2009	3																					2700											D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	3300	976.6277227	129.951037	958.1079306	247.6381441	91.00545964	17.88613988	5.084740886	295.6123247	208.1015256	6536.097596	27.55304567	0	0.110991248	885.1448522	4432.534124	3715.533295	539.0529619	289.0805657	0	0	15.4227547	647.5101195	0	596.4349318	118.3912108	292.8	14.72807038	5.04	453.6	0											"$75 Days 1-5 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$75 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$50 Days 11-64 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$50 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); $50 (9a); $40/$30 (9c)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$25 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											45.96288917	33.98971918	26.04131072	0	150	0.2	0.067620294	49.33326398	50	2.8	0.180320995	0	0.2	18.25891953	3.993544686	25	37.5	25	0	0	0.2	24.8113314	0	25	25	0	25	0	0	0											39.69565499	29.34481468	22.4826052	0	129.501576	0.172668768	0.058379564	42.59156956	43.167192	2.417362752	0.15567902	0	0.172668768	15.80458805	3.993544686	25	37.5	21.583596	0	0	0.172668768	24.8113314	0	25	25	0	25	0	0	0											3.2307	0.317782425	1.795063529	0	0.982112537	3.088377738	0.296844957	1.049216074	0.748596543	1.316676573	4.289431147	0	0.019164722	1.165779146	1.475126924	7.740694366	1.684540506	0.519949845	0	0	2.663028053	1.338799013	0	1.242572774	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2417	0	3.3956	3.2307	0.317782425	1.795063529	0	0.982112537	3.088377738	0.296844957	1.049216074	0.748596543	1.316676573	4.289431147	0	0.019164722	1.165779146	1.475126924	7.740694366	1.684540506	0.519949845	0	0	2.663028053	1.338799013	0	1.242572774	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2417		"$300 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$300 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-19 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.9269	0.1202	3.4711	0.2715	0.1164	0.5489	0.156	0.1243	0.7884	0.156	0.7464	0	0.0023	0.69	1.371	2.6855	0.4773	0.1222	0	0	0.6705	0.4689	0	0	0.0863	0	0.0107	0	0	0											14.0107	0	6.533166715	4.1575	0.437987137	5.266208812	0.271490564	1.09847908	3.637271822	0.452886686	1.173533444	1.537014064	1.472684255	5.03579924	0	0.021435473	1.855738581	2.846092117	10.42615234	2.161826982	0.642136575	0	0	3.333532332	1.807692878	0	1.242572774	0.33297528	0	0.041422698	0	0	0	0	0	0	0	0	0	0	0	0	0	49.2524
H4604_801_0	2009	2																					4000											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1061.889601	141.2960656	1398.925441	297.7671527	109.4275549	20.93405946	5.951215229	355.4410233	30.06915132	7859.18978	32.24827157	0	0.12990491	26.39098476	5511.872254	4736.762941	688.6834129	369.3236187	0	0	19.17907777	827.2461345	0	0	0	0	0	0	0	0											"$265 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$265 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-27 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											261.9036115	265	150	0	150	0.2	0.067620294	49.33324212	0.3	2.8	0.254395262	0	0.2	0.298267087	24.02347879	34.58576844	37.5	35	0	0	0.2	34.73586396	0	0	0	0	0	0	0	0											189.1964594	191.4047221	108.3422955	0	108.3422955	0.144456394	0.048840919	35.63251132	0.216684591	2.022389517	0.183745111	0	0.144456394	0.215712023	24.02347879	34.58576844	37.5	25.27986896	0	0	0.144456394	34.73586396	0	0	0	0	0	0	0	0											16.7421	2.253727848	12.6302328	0	0.987969374	3.024058742	0.290662822	1.055438024	6.515521758	1.324528585	5.92546225	0	0.018765595	5.692852717	11.03452885	13.65204885	2.152135665	0.778037724	0	0	2.770540417	2.394592432	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.2433	0	23.0602	16.7421	2.253727848	12.6302328	0	0.987969374	3.024058742	0.290662822	1.055438024	6.515521758	1.324528585	5.92546225	0	0.018765595	5.692852717	11.03452885	13.65204885	2.152135665	0.778037724	0	0	2.770540417	2.394592432	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.2433																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.7421	2.253727848	12.6302328	0	0.987969374	3.024058742	0.290662822	1.055438024	6.515521758	1.324528585	5.92546225	0	0.018765595	5.692852717	11.03452885	13.65204885	2.152135665	0.778037724	0	0	2.770540417	2.394592432	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.2433
H4604_803_0	2009	2																					4000											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1061.889601	141.2960656	1398.925441	297.7671527	109.4275549	20.93405946	5.951215229	355.4410233	30.06915132	7859.18978	32.24827157	0	0.12990491	26.39098476	5511.872254	4736.762941	688.6834129	369.3236187	0	0	19.17907777	827.2461345	0	0	0	0	0	0	0	0											"$265 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$265 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-27 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											261.9036115	265	150	0	150	0.2	0.067620294	49.33324212	0.3	2.8	0.254395262	0	0.2	0.298267087	24.02347879	34.58576844	37.5	35	0	0	0.2	34.73586396	0	0	0	0	0	0	0	0											189.1964594	191.4047221	108.3422955	0	108.3422955	0.144456394	0.048840919	35.63251132	0.216684591	2.022389517	0.183745111	0	0.144456394	0.215712023	24.02347879	34.58576844	37.5	25.27986896	0	0	0.144456394	34.73586396	0	0	0	0	0	0	0	0											16.7421	2.253727848	12.6302328	0	0.987969374	3.024058742	0.290662822	1.055438024	6.515521758	1.324528585	5.92546225	0	0.018765595	5.692852717	11.03452885	13.65204885	2.152135665	0.778037724	0	0	2.770540417	2.394592432	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.2433	0	23.0602	16.7421	2.253727848	12.6302328	0	0.987969374	3.024058742	0.290662822	1.055438024	6.515521758	1.324528585	5.92546225	0	0.018765595	5.692852717	11.03452885	13.65204885	2.152135665	0.778037724	0	0	2.770540417	2.394592432	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.2433																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.7421	2.253727848	12.6302328	0	0.987969374	3.024058742	0.290662822	1.055438024	6.515521758	1.324528585	5.92546225	0	0.018765595	5.692852717	11.03452885	13.65204885	2.152135665	0.778037724	0	0	2.770540417	2.394592432	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.2433
H4604_804_0	2009	2																					4100											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1090.995985	145.1689894	1437.269974	305.9289475	112.4269631	22.09739211	6.281931926	365.1691862	31.7401328	8074.610096	34.04034957	0	0.137123893	27.85756578	5659.108347	4866.597568	707.5602186	379.4467756	0	0	20.24488384	849.9209431	0	0	0	0	0	0	0	0											"$270 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$270 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-28 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											266.843273	270	150	0	150	0.2	0.067620294	49.3332157	0.3	2.8	0.253462415	0	0.2	0.298191552	24.03979811	34.70271921	37.5	35	0	0	0.2	34.73586396	0	0	0	0	0	0	0	0											191.5520979	193.789135	107.6606306	0	107.6606306	0.143547507	0.048533623	35.40830073	0.215321261	2.009665104	0.181919489	0	0.143547507	0.214299353	24.03979811	34.70271921	37.5	25.1208138	0	0	0.143547507	34.73586396	0	0	0	0	0	0	0	0											17.4152	2.344347741	12.89478264	0	1.008663145	3.172025558	0.304884917	1.077501697	6.834325422	1.352271845	6.192603004	0	0.019683793	5.969858324	11.33698518	14.07368074	2.211125683	0.794334316	0	0	2.906102612	2.460228188	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.3686	0	24.4809	17.4152	2.344347741	12.89478264	0	1.008663145	3.172025558	0.304884917	1.077501697	6.834325422	1.352271845	6.192603004	0	0.019683793	5.969858324	11.33698518	14.07368074	2.211125683	0.794334316	0	0	2.906102612	2.460228188	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.3686																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	17.4152	2.344347741	12.89478264	0	1.008663145	3.172025558	0.304884917	1.077501697	6.834325422	1.352271845	6.192603004	0	0.019683793	5.969858324	11.33698518	14.07368074	2.211125683	0.794334316	0	0	2.906102612	2.460228188	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.3686
H4605_001_0	2009	4	h.6.										OP Facility - Other										1500	Urgent Care										D	D	D		T	Coin	Coin	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	3000	565.9719049	6.930949675			1.326798486	16.7857672	0.561733811	270.6809266							6916.033434	32.60164954	376.9570306	1428.307791		697.1729595	3.673051006				28.15442157						144.5593568										$100/day (days 1-5)	$100/day (days 1-5)			$100 	10%	10%	$50 							$10 	$10 	$10 	$10 		$10 chiro	10%				$10 						$10 										100	100			100	0.1	0.1	50	0	0	0	0	0	0	10	10	10	10	0	10	0.1	0	0	0	10	0					10										99.20135606	99.20135606	0	0	99.20135606	0.099201356	0.099201356	49.60067803	0	0	0	0	0	0	9.920135606	9.920135606	9.920135606	9.920135606	0	9.920135606	0.099201356	0	0	0	9.920135606	0					9.920135606										4.6788	0.057296634	0	0	0.010968351	1.665170869	0.055724756	1.118829791	0	0	0	0	0	0	5.71733246	0.026951065	0.311622072	1.180750581	0	0.576337525	0.364371641	0	0	0	0.02327464	0	0	0	0	0	0.119504035	0	0	0	0	0	0	0	0	0	15.9069	0	0.1281	4.6788	0.057296634	0	0	0.010968351	1.665170869	0.055724756	1.118829791	0	0	0	0	0	0	5.71733246	0.026951065	0.311622072	1.180750581	0	0.576337525	0.364371641	0	0	0	0.02327464	0	0	0	0	0	0.119504035	0	0	0	0	0	0	0	0	0	15.9069	N/A	$250/day (days 1-5)	$250/day (days 1-5)	$25/day (days 1-100)	20%	$100 	20%	20%	$50 	$100 	No cost sharing	20%	No cost sharing	No cost sharing	No cost sharing	$25 	$25 	$25 	$25 	No cost sharing	$25 	10%	No cost sharing	No cost sharing	No cost sharing	$25 	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$25 										0.4513	0.2281	0.2582	0.2292	0.5472	1.2619	0.0131	0.0212	0.1148	0	0	0	0	0	0.8651	0.0801	0.2081	0.5958	0	0.6392	0.0486	0	0	0	0.0138	0	0	0	0	0	0.0083										5.5839	0	0.087649343	5.1301	0.285385448	0.258216194	0.229205526	0.558128461	2.927097197	0.068808845	1.13999733	0.114761269	0	0	0	0	0	6.582445128	0.107055676	0.519769545	1.776554565	0	1.215514213	0.412950081	0	0	0	0.037048414	0	0	0	0	0	0.127805031	0	0	0	0	0	0	0	0	0	21.4908
H4605_002_0	2009	6	h.6.										OP Facility - Other										1500	Urgent Care										D	D	D		T	Coin	Coin	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	3000	565.9719049	6.930949675			1.326798486	16.7857672	0.561733811	270.6809266							6916.033434	32.60164954	376.9570306	1428.307791		697.1729595	3.673051006				28.15442157						144.5593568										$100/day (days 1-5)	$100/day (days 1-5)			$100 	10%	10%	$50 							$10 	$10 	$10 	$10 		$10 chiro	10%				$10 						$10 										100	100			100	0.1	0.1	50	0	0	0	0	0	0	10	10	10	10	0	10	0.1	0	0	0	10	0					10										99.20135606	99.20135606	0	0	99.20135606	0.099201356	0.099201356	49.60067803	0	0	0	0	0	0	9.920135606	9.920135606	9.920135606	9.920135606	0	9.920135606	0.099201356	0	0	0	9.920135606	0					9.920135606										4.6788	0.057296634	0	0	0.010968351	1.665170869	0.055724756	1.118829791	0	0	0	0	0	0	5.71733246	0.026951065	0.311622072	1.180750581	0	0.576337525	0.364371641	0	0	0	0.02327464	0	0	0	0	0	0.119504035	0	0	0	0	0	0	0	0	0	15.9069	0	0.1281	4.6788	0.057296634	0	0	0.010968351	1.665170869	0.055724756	1.118829791	0	0	0	0	0	0	5.71733246	0.026951065	0.311622072	1.180750581	0	0.576337525	0.364371641	0	0	0	0.02327464	0	0	0	0	0	0.119504035	0	0	0	0	0	0	0	0	0	15.9069	N/A	$250/day (days 1-5)	$250/day (days 1-5)	$25/day (days 1-100)	20%	$100 	20%	20%	$50 	$100 	No cost sharing	20%	No cost sharing	No cost sharing	No cost sharing	$25 	$25 	$25 	$25 	No cost sharing	$25 	10%	No cost sharing	No cost sharing	No cost sharing	$25 	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$25 										0.4513	0.2281	0.2582	0.2292	0.5472	1.2619	0.0131	0.0212	0.1148	0	0	0	0	0	0.8651	0.0801	0.2081	0.5958	0	0.6392	0.0486	0	0	0	0.0138	0	0	0	0	0	0.0083										5.5839	0	0.087649343	5.1301	0.285385448	0.258216194	0.229205526	0.558128461	2.927097197	0.068808845	1.13999733	0.114761269	0	0	0	0	0	6.582445128	0.107055676	0.519769545	1.776554565	0	1.215514213	0.412950081	0	0	0	0.037048414	0	0	0	0	0	0.127805031	0	0	0	0	0	0	0	0	0	21.4908
H4605_004_0	2009	7	h.6.										OP Facility - Other										1500	Urgent Care										D	D	D		T	Coin	Coin	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	3000	565.9719049	6.930949675			1.326798486	16.7857672	0.561733811	270.6809266							6916.033434	32.60164954	376.9570306	1428.307791		697.1729595	3.673051006				28.15442157						144.5593568										$100/day (days 1-5)	$100/day (days 1-5)			$100 	10%	10%	$50 							$10 	$10 	$10 	$10 		$10 chiro	10%				$10 						$10 										100	100			100	0.1	0.1	50	0	0	0	0	0	0	10	10	10	10	0	10	0.1	0	0	0	10	0					10										99.20135606	99.20135606	0	0	99.20135606	0.099201356	0.099201356	49.60067803	0	0	0	0	0	0	9.920135606	9.920135606	9.920135606	9.920135606	0	9.920135606	0.099201356	0	0	0	9.920135606	0					9.920135606										4.6788	0.057296634	0	0	0.010968351	1.665170869	0.055724756	1.118829791	0	0	0	0	0	0	5.71733246	0.026951065	0.311622072	1.180750581	0	0.576337525	0.364371641	0	0	0	0.02327464	0	0	0	0	0	0.119504035	0	0	0	0	0	0	0	0	0	15.9069	0	0.1281	4.6788	0.057296634	0	0	0.010968351	1.665170869	0.055724756	1.118829791	0	0	0	0	0	0	5.71733246	0.026951065	0.311622072	1.180750581	0	0.576337525	0.364371641	0	0	0	0.02327464	0	0	0	0	0	0.119504035	0	0	0	0	0	0	0	0	0	15.9069	N/A	$250/day (days 1-5)	$250/day (days 1-5)	$25/day (days 1-100)	20%	$100 	20%	20%	$50 	$100 	No cost sharing	20%	No cost sharing	No cost sharing	No cost sharing	$25 	$25 	$25 	$25 	No cost sharing	$25 	10%	No cost sharing	No cost sharing	No cost sharing	$25 	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$25 										0.4513	0.2281	0.2582	0.2292	0.5472	1.2619	0.0131	0.0212	0.1148	0	0	0	0	0	0.8651	0.0801	0.2081	0.5958	0	0.6392	0.0486	0	0	0	0.0138	0	0	0	0	0	0.0083										5.5839	0	0.087649343	5.1301	0.285385448	0.258216194	0.229205526	0.558128461	2.927097197	0.068808845	1.13999733	0.114761269	0	0	0	0	0	6.582445128	0.107055676	0.519769545	1.776554565	0	1.215514213	0.412950081	0	0	0	0.037048414	0	0	0	0	0	0.127805031	0	0	0	0	0	0	0	0	0	21.4908
H4605_006_0	2009	5	h.6.										OP Facility - Other										2500	Urgent Care										D	D	D	Coin	T	Coin	Coin	V	V		Coin				V	V	V	V	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	5000	565.9719049	6.930949675	925.7018535	6.646287508	1.115716909	16.44743212	0.540042647	270.6809266	1016.129909	0	20.69916316	0	0	0	6086.109422	31.29758356	331.7221869	1256.910856	12.32022728	592.5970156	3.672466058										127.212234										$250/day (days 1-5)	$250/day (days 1-5)	$25/day	10%	$100 	20%	20%	$50 	$250 		20%				$25 	$25 	$25 	$25 	20%	$25 chiro	20%										$25 										250	250	25	0.1	100	0.2	0.2	50	250	0	0.2	0	0	0	25	25	25	25	0.2	25	0.2	0	0	0	0	0	0	0	0	0	25										241.1849058	241.1849058	24.11849058	0.096473962	96.47396233	0.192947925	0.192947925	48.23698116	241.1849058	0	0.192947925	0	0	0	24.11849058	24.11849058	24.11849058	24.11849058	0.192947925	24.11849058	0.192947925	0	0	0	0	0	0	0	0	0	24.11849058										11.3753	0.13930337	1.860544286	0.641193691	0.008969803	3.173497894	0.104200108	1.08806923	20.42293302	0	3.993860575	0	0	0	12.2323144	0.062904206	0.66671987	2.52623272	2.377162284	1.191045462	0.708594704	0	0	0	0	0	0	0	0	0	0.255680589	0	0	0	0	0	0	0	0	0	62.8285	0	2.2962	11.3753	0.13930337	1.860544286	0.641193691	0.008969803	3.173497894	0.104200108	1.08806923	20.42293302	0	3.993860575	0	0	0	12.2323144	0.062904206	0.66671987	2.52623272	2.377162284	1.191045462	0.708594704	0	0	0	0	0	0	0	0	0	0.255680589	0	0	0	0	0	0	0	0	0	62.8285	N/A	$500/day (days 1-5)	$500/day (days 1-5)	$35/day (days 1-100)	40%	$100 	40%	40%	$50 	$500 	No cost sharing	40%	No cost sharing	No cost sharing	No cost sharing	$35 	$35 	$35 	$35 	40%	$35 	20%	No cost sharing	Not covered	Not covered	Not covered	Not covered	Not covered	Not covered	Not covered	Not covered	$35 										1.1253	0.5687	0.3605	0.4572	0.5457	2.5167	0	0.0211	0.5723	0	0.0367	0	0	0	1.2079	0.1118	0.2906	0.8319	0.2013	0.8925	0.0969	0	0	0	0	0	0	0	0	0	0.0116										9.8488	0	2.296234168	12.5006	0.70800224	2.22108132	1.098380244	0.55466835	5.690208027	0.104200108	1.109180227	20.99520663	0	4.030512856	0	0	0	13.44023691	0.174751098	0.957347934	3.358130198	2.578509184	2.083502526	0.805476631	0	0	0	0	0	0	0	0	0	0.26727094	0	0	0	0	0	0	0	0	0	72.6773
H4606_001_0	2009	7	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			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		1257.219268	55.978093	438.787553	627.126824	124.736112	7.332141	2.647877	282.143723	305.834689	540.708383	802.527577	0	16.713132	613.926897	3004.7376	3621.945626	24.707445	780.670555			16.571882			5.6	2.69				0.05	2.7	0.09	1.23	2.4	0.06							$135/Day(Days 1-7):1a	$135/Day(Days 1-7):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$10/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$125/Visit:9b. $0 Surgery ASC -- Physician,9b. $125 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $125 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$125/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $125 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $125 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$125/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$15-$125/Visit:9d. $15 Cardiac Rehab,8b. $125 Nuclear Medicine,9a. $50 OP Other,5. $50 Partial Hospitalization,8b. $50 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$5/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$50/Visit:7h. $50 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			"DEN 750 16a, 16b"	VIS 752				$0 Additional Smoking Cessation 14a	$0 Corp Health 14a	$0: Nutritional benefit 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0: Nurse hotline 14a							96.17886	85.05906	43.1328	10.000005	100.000038	0.199999	0.199999	50.000006	124.999999	43.978707	60.281532	0	0.782618	51.593497	5	29.999999	46.878177	34.314961			0.199999			0	0				0	0	0	0	0	0							80.762542	71.425113	36.21913	8.397125	83.971232	0.167942	0.167942	41.985605	104.963999	36.929448	50.619125	0	0.657173	43.323679	4.19856	25.191359	39.364168	28.814684			0.167942			0	0				0	0	0	0	0	0							8.4614	0.333186802	1.324375285	0.438838528	0.87285375	1.231374424	0.444689759	0.987164576	2.675135999	1.664005176	3.385270311	0	0.000915285	2.216464318	1.051297591	7.603477712	0.081049001	1.874564613	0	0	2.783115007	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.4291	0	7.1446	8.4614	0.333186802	1.324375285	0.438838528	0.87285375	1.231374424	0.444689759	0.987164576	2.675135999	1.664005176	3.385270311	0	0.000915285	2.216464318	1.051297591	7.603477712	0.081049001	1.874564613	0	0	2.783115007	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.4291	5000	$1000/Admit	$1000/Admit	40% Coins(Days 1-20) 40%(Days 21-100)	25% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$50/Proc	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins			"DEN 750 16a, 16b"	VIS 751				0	0	0	0	0	0							1.7561	0.0566	0.3736	0.3542	0.5819	1.5614	0.5639	0.1742	2.0237	0.2607	1.0844		0.0002	0.6125	1.2281	2.8038	0.0177	0.2367			0.8369			0	0				0	0	0	0	0	0							14.5265	0	2.772883502	10.2174	0.389767802	1.697975285	0.793082528	1.45475575	2.792728424	1.008546759	1.161370576	4.698812999	1.924702176	4.469646311	0	0.001076285	2.828958318	2.279364591	10.40729771	0.098768001	2.111312613	0	0	3.620031007	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.9556
H4606_004_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			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		1417.427857	63.111431	494.702648	707.042165	140.631346	9.371625	3.384403	318.097553	344.807481	609.611342	904.794393	0	18.842901	692.160155	3387.634033	4083.493437	27.855937	880.152109			21.181462			5.6	1.72				0.05	2.7	0.09	1.23	2.4	0.06							$75/Day(Days 1-5):1a	$75/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$10/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$50/Visit:9b. $0 Surgery ASC -- Physician,9b. $50 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $50 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $25 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $15 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$15-$50/Visit:9d. $15 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $25 Partial Hospitalization,8b. $50 Rad therapy,3. $25 Therapy (AT,PT,ST,OT) -- CORF"	$5/Visit:7a	"$15/Visit:7b, 7d, 7f"	"$15-$50/Visit:7h. $50 Psych -- OP,7e. $15 Psych -- Other Provider"	"$15-$25/Visit:9a. $25 Therapy (AT,PT,ST,OT) -- OP,7d. $15 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			"DEN 750 16a, 16b"	VIS 751				$0 Additional Smoking Cessation 14a	$0 Corp Health 14a	$0: Nutritional benefit 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0: Nurse hotline 14a							45.982649	38.330489	43.132795	10.000003	100.000009	0.2	0.2	49.999982	50.000005	43.978709	33.450658	0	0.782682	38.864259	4.999999	15	44.537435	17.157484			0.2			0	0				0	0	0	0	0	0							35.211903	29.352146	33.029584	7.657652	76.576507	0.153153	0.153153	38.288236	38.288254	33.677356	25.615343	0	0.59935	29.760889	3.828824	11.486475	34.105209	13.1386			0.153153			0	0				0	0	0	0	0	0							4.1592	0.154371328	1.361651889	0.451190237	0.897421438	1.435292484	0.518331473	1.014949515	1.100173034	1.710841516	1.931384893	0	0.000941124	1.716608462	1.080887874	3.90874544	0.079169379	0.963663875	0	0	3.24400445	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.7288	0	7.87	4.1592	0.154371328	1.361651889	0.451190237	0.897421438	1.435292484	0.518331473	1.014949515	1.100173034	1.710841516	1.931384893	0	0.000941124	1.716608462	1.080887874	3.90874544	0.079169379	0.963663875	0	0	3.24400445	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.7288	5000	$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	20% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	20% Coins	20% Coins	20%-25% Coins		$0-$50/Proc	20% Coins	25% Coins	25% Coins	20%-25% Coins	20%-25% Coins			25% Coins			"DEN 750 16a, 16b"	VIS 751				0	0	0	0	0	0							1.7152	0.0553	0.3266	0.3303	0.5983	1.8199	0.6572	0.1791	1.5725	0.2026	0.8792		0.0002	0.4759	1.1929	2.7234	0.0139	0.2186			0.8129			0	0				0	0	0	0	0	0							13.774	0	4.213254747	5.8744	0.209635328	1.688251889	0.781515237	1.495702438	3.255205484	1.175562473	1.194058515	2.672705034	1.913420516	2.810536893	0	0.001107124	2.192557462	2.273748874	6.63218744	0.093092379	1.182221875	0	0	4.05692845	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5029
H4606_801_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		225.859432	7.277152	438.787553	627.126824	3.715105	7.332141	2.647877	16.301515	41.903227	540.708383	22.657811	0	0.285911	12.908081	24.317103	55.518795	0.350862	4.687879			16.571882																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999989	1024.000598	43.1328	0	0.2	0.199999	0.199999	0.2	0.199999	0	0.2	0	0.199999	0.2	0.2	0.2	0.5	0.2			0.199999																				1023.999989	1024.000598	43.1328	0	0.2	0.199999	0.199999	0.2	0.199999	0	0.2	0	0.199999	0.2	0.2	0.2	0.5	0.2			0.199999																				19.2733	0.620984	1.577177981	0	0.743021	1.466420868	0.529572752	3.260303	8.380603497	0	4.5315622	0	0.057181914	2.5816162	4.8634206	11.103759	0.175431	0.9375758	0	0	3.314359828	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4163	0	0	19.2733	0.620984	1.577177981	0	0.743021	1.466420868	0.529572752	3.260303	8.380603497	0	4.5315622	0	0.057181914	2.5816162	4.8634206	11.103759	0.175431	0.9375758	0	0	3.314359828	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4163		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.1415	0.069	0.1752		0.4711	0.9297	0.3357	0.6141	1.6066		0.8609		0.0108	0.4863	0.975	2.226	0.0352	0.188			0.6644																				11.7895	0	0	21.4148	0.689982	1.752419981	0	1.214087	2.396116868	0.865315752	3.874414	9.987248497	0	5.3924732	0	0.067952914	3.0678892	5.8384106	13.329777	0.210601	1.1255358	0	0	3.978806828	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.2059
H4606_802_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		225.859432	7.277152	438.787553	627.126824	3.715105	7.332141	2.647877	16.301515	41.903227	540.708383	22.657811	0	0.285911	12.908081	24.317103	55.518795	0.350862	4.687879			16.571882																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999989	1024.000598	43.1328	0	0.2	0.199999	0.199999	0.2	0.199999	0	0.2	0	0.199999	0.2	0.2	0.2	0.5	0.2			0.199999																				1023.999989	1024.000598	43.1328	0	0.2	0.199999	0.199999	0.2	0.199999	0	0.2	0	0.199999	0.2	0.2	0.2	0.5	0.2			0.199999																				19.2733	0.620984	1.577177981	0	0.743021	1.466420868	0.529572752	3.260303	8.380603497	0	4.5315622	0	0.057181914	2.5816162	4.8634206	11.103759	0.175431	0.9375758	0	0	3.314359828	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4163	0	0	19.2733	0.620984	1.577177981	0	0.743021	1.466420868	0.529572752	3.260303	8.380603497	0	4.5315622	0	0.057181914	2.5816162	4.8634206	11.103759	0.175431	0.9375758	0	0	3.314359828	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4163		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.1415	0.069	0.1752		0.4711	0.9297	0.3357	0.6141	1.6066		0.8609		0.0108	0.4863	0.975	2.226	0.0352	0.188			0.6644																				11.7895	0	0	21.4148	0.689982	1.752419981	0	1.214087	2.396116868	0.865315752	3.874414	9.987248497	0	5.3924732	0	0.067952914	3.0678892	5.8384106	13.329777	0.210601	1.1255358	0	0	3.978806828	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.2059
H4606_803_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		225.859432	7.277152	438.787553	627.126824	3.715105	7.332141	2.647877	16.301515	41.903227	540.708383	22.657811	0	0.285911	12.908081	24.317103	55.518795	0.350862	4.687879			16.571882																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999989	1024.000598	43.1328	0	0.2	0.199999	0.199999	0.2	0.199999	0	0.2	0	0.199999	0.2	0.2	0.2	0.5	0.2			0.199999																				1023.999989	1024.000598	43.1328	0	0.2	0.199999	0.199999	0.2	0.199999	0	0.2	0	0.199999	0.2	0.2	0.2	0.5	0.2			0.199999																				19.2733	0.620984	1.577177981	0	0.743021	1.466420868	0.529572752	3.260303	8.380603497	0	4.5315622	0	0.057181914	2.5816162	4.8634206	11.103759	0.175431	0.9375758	0	0	3.314359828	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4163	0	0	19.2733	0.620984	1.577177981	0	0.743021	1.466420868	0.529572752	3.260303	8.380603497	0	4.5315622	0	0.057181914	2.5816162	4.8634206	11.103759	0.175431	0.9375758	0	0	3.314359828	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4163		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.1415	0.069	0.1752		0.4711	0.9297	0.3357	0.6141	1.6066		0.8609		0.0108	0.4863	0.975	2.226	0.0352	0.188			0.6644																				11.7895	0	0	21.4148	0.689982	1.752419981	0	1.214087	2.396116868	0.865315752	3.874414	9.987248497	0	5.3924732	0	0.067952914	3.0678892	5.8384106	13.329777	0.210601	1.1255358	0	0	3.978806828	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.2059
H4606_804_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		225.859432	7.277152	438.787553	627.126824	3.715105	7.332141	2.647877	16.301515	41.903227	540.708383	22.657811	0	0.285911	12.908081	24.317103	55.518795	0.350862	4.687879			16.571882																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999989	1024.000598	43.1328	0	0.2	0.199999	0.199999	0.2	0.199999	0	0.2	0	0.199999	0.2	0.2	0.2	0.5	0.2			0.199999																				1023.999989	1024.000598	43.1328	0	0.2	0.199999	0.199999	0.2	0.199999	0	0.2	0	0.199999	0.2	0.2	0.2	0.5	0.2			0.199999																				19.2733	0.620984	1.577177981	0	0.743021	1.466420868	0.529572752	3.260303	8.380603497	0	4.5315622	0	0.057181914	2.5816162	4.8634206	11.103759	0.175431	0.9375758	0	0	3.314359828	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4163	0	0	19.2733	0.620984	1.577177981	0	0.743021	1.466420868	0.529572752	3.260303	8.380603497	0	4.5315622	0	0.057181914	2.5816162	4.8634206	11.103759	0.175431	0.9375758	0	0	3.314359828	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4163		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.1415	0.069	0.1752		0.4711	0.9297	0.3357	0.6141	1.6066		0.8609		0.0108	0.4863	0.975	2.226	0.0352	0.188			0.6644																				11.7895	0	0	21.4148	0.689982	1.752419981	0	1.214087	2.396116868	0.865315752	3.874414	9.987248497	0	5.3924732	0	0.067952914	3.0678892	5.8384106	13.329777	0.210601	1.1255358	0	0	3.978806828	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.2059
H4720_001_0	2009	7																					3500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1360.509107	29.78796614	1060.469343	804.954056	102.9524609	14.11962064	5.232052492	398.9714452	42.67680573	10072.23621	42.10499612	0	0.110517214	27.7805025	5370.805481	4932.909759	190.7759709	347.284071	0	0	17.63707844	933.0814356	0	0	147.9890135	0	18.41008798	0	98.4	0											"$220 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$220 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-28 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $0 n/c (4b)"	20% (9b)	$0/$10 (8a1); $10 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											217.2573158	220	79.9192485	0	150	0.2	0.091742587	50	0.2	4	0.182256277	0	0.2	0.197523478	6.747131428	25	37.5	25	0	0	0.2	22.34642431	0	0	25	0	25	0	0	0											160.6646554	162.6728251	59.09404515	0	110.9132898	0.147884386	0.067836481	36.97109662	0.147884386	2.957687729	0.134764289	0	0.147884386	0.146319256	6.747131428	25	37.5	18.48554831	0	0	0.147884386	22.34642431	0	0	25	0	25	0	0	0											18.2155	0.403807717	5.222285271	0	0.951566344	2.088071436	0.354924028	1.229200987	6.311233232	2.482544121	5.674249852	0	0.01634377	4.064822457	3.019794204	10.27689533	0.596174909	0.534978039	0	0	2.608248524	1.737586139	0	0	0.308310445	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	66.1349	0	17.6629	18.2155	0.403807717	5.222285271	0	0.951566344	2.088071436	0.354924028	1.229200987	6.311233232	2.482544121	5.674249852	0	0.01634377	4.064822457	3.019794204	10.27689533	0.596174909	0.534978039	0	0	2.608248524	1.737586139	0	0	0.308310445	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	66.1349		"$0 n/c (1a, 1a1, 1a2, 1a3, 13c)"	"$0 n/c (1b, 1b1, 1b2)"	"$0 n/c (2a, 2a1, 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)"	$0 n/c (9b)	"$0 n/c (8a1, 8a2)"	"$0 n/c (8b1, 8b2, 8b3)"	Included in h.5.	$0 n/c (12)	"$0 n/c (3, 5, 9a, 9c, 9d)"	"$0 n/c (7a, 7a1, 14b, 14b1, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1)"	"$0 n/c (7e, 7h)"	"$0 n/c (7c, 7i)"	Included in h.2.	$0 n/c (7g)	"$0 n/c (15, 15a1, 15a2)"	"$0 n/c (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 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	18.2155	0.403807717	5.222285271	0	0.951566344	2.088071436	0.354924028	1.229200987	6.311233232	2.482544121	5.674249852	0	0.01634377	4.064822457	3.019794204	10.27689533	0.596174909	0.534978039	0	0	2.608248524	1.737586139	0	0	0.308310445	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	66.1349
H4720_002_0	2009	6																					3350											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1851.601975	47.61867813	1231.545377	2439.592977	156.929322	20.46549264	8.129391202	492.18702	33.42759594	9156.99448	37.27334434	0	0.363689897	25.08945205	5202.494516	4559.542137	240.6948703	404.2176092	0	0	20.58618224	1010.602615	0	0	147.9890135	0	18.41008798	0	98.4	0											"$195 Days 1-18 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$195 Days 1-18 (1b); $0 n/c (1b1, 1b2)"	"$95 Days 1-28 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $0 n/c (4b)"	20% (9b)	$0/$10 (8a1); $10 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											192.3593418	195	75.92328607	0	150	0.2	0.08733224	50	0.2	4	0.182395265	0	0.2	0.198532503	7.432766935	20	37.5	20	0	0	0.2	18.84177222	0	0	20	0	20	0	0	0											136.4178158	138.2748245	53.83732851	0	106.3652496	0.141820333	0.061927437	35.45508321	0.141820333	2.836406657	0.129336786	0	0.141820333	0.141100545	7.432766935	20	37.5	14.18203329	0	0	0.141820333	18.84177222	0	0	20	0	20	0	0	0											21.0493	0.548705364	5.525259419	0	1.390985542	2.902422979	0.50343236	1.454210979	4.740712784	2.164413342	4.820814554	0	0.051578622	3.540135358	3.222410768	7.599236895	0.75217147	0.477718966	0	0	2.919539217	1.586795356	0	0	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	65.5272	0	21.3541	21.0493	0.548705364	5.525259419	0	1.390985542	2.902422979	0.50343236	1.454210979	4.740712784	2.164413342	4.820814554	0	0.051578622	3.540135358	3.222410768	7.599236895	0.75217147	0.477718966	0	0	2.919539217	1.586795356	0	0	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	65.5272		"$0 n/c (1a, 1a1, 1a2, 1a3, 13c)"	"$0 n/c (1b, 1b1, 1b2)"	"$0 n/c (2a, 2a1, 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)"	$0 n/c (9b)	"$0 n/c (8a1, 8a2)"	"$0 n/c (8b1, 8b2, 8b3)"	Included in h.5.	$0 n/c (12)	"$0 n/c (3, 5, 9a, 9c, 9d)"	"$0 n/c (7a, 7a1, 14b, 14b1, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1)"	"$0 n/c (7e, 7h)"	"$0 n/c (7c, 7i)"	Included in h.2.	$0 n/c (7g)	"$0 n/c (15, 15a1, 15a2)"	"$0 n/c (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 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	21.0493	0.548705364	5.525259419	0	1.390985542	2.902422979	0.50343236	1.454210979	4.740712784	2.164413342	4.820814554	0	0.051578622	3.540135358	3.222410768	7.599236895	0.75217147	0.477718966	0	0	2.919539217	1.586795356	0	0	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	65.5272
H4720_801_0	2009	5																					7470											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2010.74795	18.36828683	936.0023219	1128.543614	150.1158284	24.89033554	6.370411561	323.0324256	50.92358295	12316.49091	59.44662294	0	0.551576401	35.38103352	6229.843202	6537.004879	156.6569643	1158.260076	0	0	43.10666327	1502.651027	0	0	0	0	0	0	0	0											"$415 Days 1-18 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$415 Days 1-18 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-47 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $0 n/c (4b)"	30% (9b)	$0/$10 (8a1); $10 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											409.6770935	415	160	0	150	0.2	0.121959279	50	0.3	4	0.245751093	0	0.2	0.296106383	13.99844133	38.93949052	37.5	40	0	0	0.2	37.31510959	0	0	0	0	0	0	0	0											300.821394	304.7162538	117.4809653	0	110.138405	0.146851207	0.089549336	36.71280166	0.22027681	2.937024133	0.180444223	0	0.146851207	0.217417898	13.99844133	38.93949052	37.5	29.37024133	0	0	0.146851207	37.31510959	0	0	0	0	0	0	0	0											50.4063	0.466426296	9.163538026	0	1.377793159	3.655175807	0.570466128	0.988285447	11.2172844	3.014485918	10.72679966	0	0.08099966	7.692469935	7.267341212	21.21230329	0.489553013	2.834864828	0	0	6.330265515	4.672632314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.167	0	39.2747	50.4063	0.466426296	9.163538026	0	1.377793159	3.655175807	0.570466128	0.988285447	11.2172844	3.014485918	10.72679966	0	0.08099966	7.692469935	7.267341212	21.21230329	0.489553013	2.834864828	0	0	6.330265515	4.672632314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.167		"$0 n/c (1a, 1a1, 1a2, 1a3, 13c)"	"$0 n/c (1b, 1b1, 1b2)"	"$0 n/c (2a, 2a1, 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)"	$0 n/c (9b)	"$0 n/c (8a1, 8a2)"	"$0 n/c (8b1, 8b2, 8b3)"	Included in h.5.	$0 n/c (12)	"$0 n/c (3, 5, 9a, 9c, 9d)"	"$0 n/c (7a, 7a1, 14b, 14b1, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1)"	"$0 n/c (7e, 7h)"	"$0 n/c (7c, 7i)"	Included in h.2.	$0 n/c (7g)	"$0 n/c (15, 15a1, 15a2)"	"$0 n/c (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 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	50.4063	0.466426296	9.163538026	0	1.377793159	3.655175807	0.570466128	0.988285447	11.2172844	3.014485918	10.72679966	0	0.08099966	7.692469935	7.267341212	21.21230329	0.489553013	2.834864828	0	0	6.330265515	4.672632314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.167
H4720_803_0	2009	5																					7470											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2010.74795	18.36828683	936.0023219	1128.543614	150.1158284	24.89033554	6.370411561	323.0324256	50.92358295	12316.49091	59.44662294	0	0.551576401	35.38103352	6229.843202	6537.004879	156.6569643	1158.260076	0	0	43.10666327	1502.651027	0	0	0	0	0	0	0	0											"$415 Days 1-18 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$415 Days 1-18 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-47 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $0 n/c (4b)"	30% (9b)	$0/$10 (8a1); $10 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											409.6770935	415	160	0	150	0.2	0.121959279	50	0.3	4	0.245751093	0	0.2	0.296106383	13.99844133	38.93949052	37.5	40	0	0	0.2	37.31510959	0	0	0	0	0	0	0	0											300.821394	304.7162538	117.4809653	0	110.138405	0.146851207	0.089549336	36.71280166	0.22027681	2.937024133	0.180444223	0	0.146851207	0.217417898	13.99844133	38.93949052	37.5	29.37024133	0	0	0.146851207	37.31510959	0	0	0	0	0	0	0	0											50.4063	0.466426296	9.163538026	0	1.377793159	3.655175807	0.570466128	0.988285447	11.2172844	3.014485918	10.72679966	0	0.08099966	7.692469935	7.267341212	21.21230329	0.489553013	2.834864828	0	0	6.330265515	4.672632314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.167	0	39.2747	50.4063	0.466426296	9.163538026	0	1.377793159	3.655175807	0.570466128	0.988285447	11.2172844	3.014485918	10.72679966	0	0.08099966	7.692469935	7.267341212	21.21230329	0.489553013	2.834864828	0	0	6.330265515	4.672632314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.167		"$0 n/c (1a, 1a1, 1a2, 1a3, 13c)"	"$0 n/c (1b, 1b1, 1b2)"	"$0 n/c (2a, 2a1, 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)"	$0 n/c (9b)	"$0 n/c (8a1, 8a2)"	"$0 n/c (8b1, 8b2, 8b3)"	Included in h.5.	$0 n/c (12)	"$0 n/c (3, 5, 9a, 9c, 9d)"	"$0 n/c (7a, 7a1, 14b, 14b1, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1)"	"$0 n/c (7e, 7h)"	"$0 n/c (7c, 7i)"	Included in h.2.	$0 n/c (7g)	"$0 n/c (15, 15a1, 15a2)"	"$0 n/c (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 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	50.4063	0.466426296	9.163538026	0	1.377793159	3.655175807	0.570466128	0.988285447	11.2172844	3.014485918	10.72679966	0	0.08099966	7.692469935	7.267341212	21.21230329	0.489553013	2.834864828	0	0	6.330265515	4.672632314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.167
H4779_001_0	2009	4																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1693.205366	43.17266743	2822.50303	5327.224227	279.4172809	18.50501093	10.20808217	397.9624353	404.9032309	6891.162835	506.6161907	0	8.067261945	1533.464974	7201.286264	5886.249049	247.8624147	721.6145752	0	0	1491.242427	1756.949789	2759.542995	510.601296	205.2567597	154.1150788	49.27524142	14.09480567	932.1	115.5175384											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b, 7d); $0 n/c (7b1); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0.2	0.2	49.974872	50	8	16.62123034	0	0	46.77659972	1.306489056	17.61245564	20	0	0	0	0	0.001757725	0	20	20	0	20	0	0	20											0	0	0	0	0	0.162137467	0.162137467	40.51399572	40.53436667	6.485498667	13.4746209	0	0	37.92119689	1.059154129	14.27819469	16.21374667	0	0	0	0	0.001424966	0	20	20	0	20	0	0	20											0	0	0	0	0	3.000355594	1.655112583	1.343587367	1.367708002	3.724385615	0.568871759	0	0	4.845902266	0.635606007	7.003750829	0.3348982	0	0	0	0	0.000208633	0	0.85100216	0.342094599	0	0.082125402	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	25.9481	0	5.7167	0	0	0	0	0	3.000355594	1.655112583	1.343587367	1.367708002	3.724385615	0.568871759	0	0	4.845902266	0.635606007	7.003750829	0.3348982	0	0	0	0	0.000208633	0	0.85100216	0.342094599	0	0.082125402	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	25.9481		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.651	0.0207	0.6794	0.4448	0.0893	0.1133	0.0625	0.0338	0.3036	0.0531	0.1287	0	0	0.2422	0.3656	1.1266	0.0144	0.0367	0	0	0.1901	0.0831	0	0	0.0039	0.0039	0.0016	0.0006	0	0											5.6489	0	0	1.651	0.020726553	0.679445196	0.444835386	0.089265417	3.113651579	1.717611046	1.377410703	1.671278136	3.777441849	0.697602858	0	0	5.088127188	1.001162446	8.130325567	0.349266771	0.036724371	0	0	0.190061441	0.083311697	0	0.85100216	0.346006016	0.003931507	0.083745916	0.000575298	0	0.192529231	0	0	0	0	0	0	0	0	0	0	31.5971
H4779_002_0	2009	2																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1711.947177	43.65053856	2853.74485	5384.657959	282.5101047	18.91693597	10.43531601	402.365202	409.3850379	6967.439978	512.2238417	0	8.156557135	1550.438644	7280.173907	5948.553743	250.6059628	729.6020078	0	0	1507.748743	1776.397176	2759.542995	510.601296	205.2567597	154.1150788	49.27524142	14.09480567	932.1	115.5175384											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b, 7d); $0 n/c (7b1); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0.2	0.2	49.97514696	50	8	16.62123034	0	0	46.77659972	1.306636608	17.62089161	20	0	0	0	0	0.001757725	0	20	20	0	20	0	0	20											0	0	0	0	0	0.161752312	0.161752312	40.41797778	40.43807797	6.470092475	13.44261217	0	0	37.83111573	1.056757461	14.25109978	16.17523119	0	0	0	0	0.001421581	0	20	20	0	20	0	0	20											0	0	0	0	0	3.059858127	1.68793649	1.355232316	1.379562007	3.756665081	0.573802204	0	0	4.887901982	0.641114841	7.064452743	0.337800782	0	0	0	0	0.000210441	0	0.85100216	0.342094599	0	0.082125402	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	26.2123	0	5.8511	0	0	0	0	0	3.059858127	1.68793649	1.355232316	1.379562007	3.756665081	0.573802204	0	0	4.887901982	0.641114841	7.064452743	0.337800782	0	0	0	0	0.000210441	0	0.85100216	0.342094599	0	0.082125402	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	26.2123		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.6878	0.0212	0.6946	0.4547	0.0913	0.1158	0.0639	0.0342	0.3103	0.0542	0.1316	0	0	0.2476	0.3737	1.1515	0.0147	0.0375	0	0	0.1974	0.085	0	0	0.0039	0.0039	0.0016	0.0006	0	0											5.777	0	0	1.6878	0.02118793	0.694569774	0.454737506	0.091252482	3.175676102	1.75182618	1.389430038	1.689889669	3.810902357	0.705398881	0	0	5.135518876	1.014808635	8.21597609	0.3524892	0.037541863	0	0	0.197359025	0.085163395	0	0.85100216	0.346006016	0.003931507	0.083745916	0.000575298	0	0.192529231	0	0	0	0	0	0	0	0	0	0	31.9893
H4779_003_0	2009	5																					1500											D	D	D	V	T	P	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2995.385501	64.79089115	2751.248256	91766.94445	166.0971765	3365.766811	18.85310941	474.5308455	456.0864748	8813.830776	574.2288264	0	12.88171056	1756.917305	8038.418196	6548.728583	261.5269418	300.3837022	0	0	1961.287774	1757.212011	1418.390092	510.601296	205.2567597	154.1150788	37.56409609	10.74492219	932.1	115.5175384											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	$0 (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b, 7d); $0 n/c (7b1); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0	0.2	49.97892655	50	3.2	16.87836848	0	0	45.70445279	1.386474261	17.96974409	20	0	0	0	0	0.001602202	0	20	0	0	20	0	0	20											0	0	0	0	0	0	0.156370263	39.07608956	39.09256586	2.501924215	13.19637463	0	0	35.73408661	1.084016727	14.04966809	15.63702634	0	0	0	0	0.001252684	0	20	0	0	20	0	0	20											0	0	0	0	0	0	2.948065686	1.545234151	1.485799213	1.837628054	0.631478226	0	0	5.231819595	0.726148315	7.667288582	0.340791973	0	0	0	0	0.000183436	0	0.85100216	0	0	0.062606827	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	23.5206	0	6.254	0	0	0	0	0	0	2.948065686	1.545234151	1.485799213	1.837628054	0.631478226	0	0	5.231819595	0.726148315	7.667288582	0.340791973	0	0	0	0	0.000183436	0	0.85100216	0	0	0.062606827	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	23.5206		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a3); $0 (6a2)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.8194	0.0311	0.6459	0.4351	0.1086	0.1789	0.1154	0.0403	0.357	0.0657	0.1483	0	0	0.288	0.4364	1.3014	0.0156	0.0383	0	0	0.2393	0.0866	0	0	0.0039	0.0039	0.0009	0.0004	0	0											7.3607	0	0	2.8194	0.031093988	0.645935906	0.435087164	0.108592531	0.178922743	3.063492886	1.585568407	1.842798724	1.903352038	0.779785605	0	0	5.519840604	1.162563925	8.968665337	0.356394501	0.038271821	0	0	0.239253113	0.086827545	0	0.85100216	0.003911416	0.003931507	0.063548589	0.000438568	0	0.192529231	0	0	0	0	0	0	0	0	0	0	30.8812
H4781_001_0	2009	7																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3000	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$500 per stay	$500 per stay	"$0 1-10, $75 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $30 Urgent Care Ctr	$100 per procedure	$0 per visit	$10 X-ray; $150 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$10 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	Not Covered	$0 per visit	$300 Every 3 Yrs	Fitness/Coaching	0											84.53846451	84.53846451	47.56208437	0	100	0.2	0.2	48	100	0	66	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											84.53846451	84.53846451	47.56208437	0	100	0.2	0.2	48	100	0	66	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											12.1136	0	4.704104783	0	2.003577927	1.3870016	0	0.895555493	2.819589958	0	22.81745028	0	0.122513645	1.731423298	5.358275608	20.39806951	0	1.478528581	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.7439	0	0	12.1136	0	4.704104783	0	2.003577927	1.3870016	0	0.895555493	2.819589958	0	22.81745028	0	0.122513645	1.731423298	5.358275608	20.39806951	0	1.478528581	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.7439		$150 ded; 25% coinsurance; $3000 max OOP	$150 ded; 25% coinsurance; $3000 max OOP	$150 ded; 25% coinsurance; $3000 max OOP	$150 ded; 25% coinsurance; $3000 max OOP	$100 copay	$150 ded; 25% coinsurance; $3000 max OOP	$150 ded; 25% coinsurance; $3000 max OOP	$50 copay	$150 ded; 25% coinsurance; $3000 max OOP	$150 ded; 25% coinsurance; $3000 max OOP	$150 ded; 25% coinsurance; $3000 max OOP	$150 ded; 25% coinsurance; $3000 max OOP	$25 copay	$150 ded; 25% coinsurance; $3000 max OOP	$150 ded; 25% coinsurance; $3000 max OOP	$150 ded; 25% coinsurance; $3000 max OOP	$150 ded; 25% coinsurance; $3000 max OOP	$150 ded; 25% coinsurance; $3000 max OOP	$150 ded; 25% coinsurance; $3000 max OOP	$150 ded; 25% coinsurance; $3000 max OOP	$150 ded; 25% coinsurance; $3000 max OOP		0	0	$150 ded; 25% coinsurance; $3000 max OOP	0	$150 ded; 25% coinsurance; $3000 max OOP	0	Not Covered												3.8844	0	0.4796	0.0727	0.1277	0.1142	0	0.065	0.5216	0.1778	0.7247	0	0.0109	0.1503	0.5309	2.3063	0	0.0684	0	0	0.1031	0	0	0	0.0481	0	0.0031	0	0	0											9.389	150	0.861463783	15.998	0	5.183749812	0.072719939	2.131298932	1.50117994	0	0.960605323	3.341177115	0.177791232	23.54214014	0	0.133463146	1.881741126	5.889222284	22.70436671	0	1.546881892	0	0	1.017319291	0	0	0	0.04810632	0	0.00307075	0	0	0	0	0	0	0	0	0	0	0	0	0	86.1328
H4781_002_0	2009	7																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3000	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$100/day 1-5	$100/day 1-5	"$0/d 1-20, $100/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $30 Urgent Care Ctr	$150 per procedure	$0 per visit	$15 X-ray; $150 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$15 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	Not Covered	$0 per visit	$300 Every 3 Yrs	Fitness/Coaching	0											61.28387407	61.28387407	40.33133874	0	100	0.2	0.2	48	150	0	69	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											61.28387407	61.28387407	40.33133874	0	100	0.2	0.2	48	150	0	69	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											8.7814	0	3.988951409	0	2.003577927	1.3870016	0	0.895555493	4.229384937	0	23.85460711	0	0.122513645	1.731423298	8.037413413	20.39806951	0	1.478528581	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.8226	0	0	8.7814	0	3.988951409	0	2.003577927	1.3870016	0	0.895555493	4.229384937	0	23.85460711	0	0.122513645	1.731423298	8.037413413	20.39806951	0	1.478528581	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.8226		$150 ded; 30% coinsurance; $3000 max OOP	$150 ded; 30% coinsurance; $3000 max OOP	$150 ded; 30% coinsurance; $3000 max OOP	$150 ded; 30% coinsurance; $3000 max OOP	$100 copay	$150 ded; 30% coinsurance; $3000 max OOP	$150 ded; 30% coinsurance; $3000 max OOP	$50 copay	$150 ded; 30% coinsurance; $3000 max OOP	$150 ded; 30% coinsurance; $3000 max OOP	$150 ded; 30% coinsurance; $3000 max OOP	$150 ded; 30% coinsurance; $3000 max OOP	$25 copay	$150 ded; 30% coinsurance; $3000 max OOP	$150 ded; 30% coinsurance; $3000 max OOP	$150 ded; 30% coinsurance; $3000 max OOP	$150 ded; 30% coinsurance; $3000 max OOP	$150 ded; 30% coinsurance; $3000 max OOP	$150 ded; 30% coinsurance; $3000 max OOP	$150 ded; 30% coinsurance; $3000 max OOP	$150 ded; 30% coinsurance; $3000 max OOP		0	0	$150 ded; 30% coinsurance; $3000 max OOP	0	$150 ded; 30% coinsurance; $3000 max OOP	0	Not Covered												4.1495	0	0.5124	0.0777	0.1155	0.122	0	0.0588	0.5572	0.1899	0.7742	0	0.0099	0.1606	0.5672	2.4637	0	0.073	0	0	0.1102	0	0	0	0.0514	0	0.0033	0	0	0											9.9963	150	0.770578802	12.9309	0	4.501333896	0.077683331	2.119059052	1.508973013	0	0.954317435	4.786572249	0.189926107	24.6287596	0	0.132383469	1.892000845	8.604599062	22.86177959	0	1.551547245	0	0	1.024359367	0	0	0	0.051389745	0	0.00328034	0	0	0	0	0	0	0	0	0	0	0	0	0	87.8189
H4781_801_0	2009	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																																																			0		316.9361745	0	39.13535926	5.933389858	6.99798243	9.316077682	0	8.234618267	42.55751553	14.50640223	59.12914041	0	3.226610823	12.26478301	43.32118048	188.1761799	0	5.57710639	0	0	8.415923098	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.078478416	0.078478416	0.203762408	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											24.8726	0	7.974315034	0	1.616533941	2.152013945	0	1.90219682	9.830786087	3.350978915	13.65883143	0	0.7453471	2.833164875	10.00719269	43.46869755	0	1.288311576	0	0	1.944078236	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.6451			24.8726	0	7.974315034	0	1.616533941	2.152013945	0	1.90219682	9.830786087	3.350978915	13.65883143	0	0.7453471	2.833164875	10.00719269	43.46869755	0	1.288311576	0	0	1.944078236	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.6451		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.3917	0	1.0874	0	0.2204	0.2935	0	0.2594	1.3406	0.457	1.8626	0	0.1016	0.3863	1.3646	5.9275	0	0.1757	0	0	0.2651	0	0	0	0	0	0	0	0	0											17.1334			28.2644	0	9.06172163	0	1.836970388	2.445470392	0	2.161587295	11.17134783	3.807930585	15.52139936	0	0.846985341	3.21950554	11.37180988	49.39624722	0	1.463990427	0	0	2.209179813	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.7785
H4781_802_0	2009	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																																																			0		316.9361799	0	39.13535992	5.933389959	6.997982548	9.316077839	0	8.234618406	42.55751625	14.50640248	59.12914141	0	3.226610877	12.26478322	43.32118121	188.1761831	0	5.577106484	0	0	8.41592324	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.078478416	0.078478416	0.203762408	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											24.8726	0	7.974315169	0	1.616533969	2.152013981	0	1.902196852	9.830786253	3.350978972	13.65883167	0	0.745347113	2.833164923	10.00719286	43.46869829	0	1.288311598	0	0	1.944078268	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.6451			24.8726	0	7.974315169	0	1.616533969	2.152013981	0	1.902196852	9.830786253	3.350978972	13.65883167	0	0.745347113	2.833164923	10.00719286	43.46869829	0	1.288311598	0	0	1.944078268	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.6451		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.3917	0	1.0874	0	0.2204	0.2935	0	0.2594	1.3406	0.457	1.8626	0	0.1016	0.3863	1.3646	5.9275	0	0.1757	0	0	0.2651	0	0	0	0	0	0	0	0	0											17.1334			28.2644	0	9.061721783	0	1.836970419	2.445470433	0	2.161587332	11.17134802	3.80793065	15.52139962	0	0.846985355	3.219505594	11.37181007	49.39624805	0	1.463990452	0	0	2.209179851	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.7785
H4836_001_0	2009	2																					2000											D	D	D	V	T	Coin	Coin	V	V	Coin	V	V	Coin	V	V	V	V	V	V	V	Coin	P	T	P	P	P	P	P	O	O																																																			0		1808.130998	72.46360052	1467.780196		154.5429282	11.50906328	11.38352029	352.0412097	332.1907811			77.48153382		166.7872697	4474.627534	6606.910884	252.0253152	465.4748397							147.9890135		255.8976692														1a: $200 days 1-8	1b: $200 days 1-8	2: $100 per Admit	6: $0	10a: $100	11a: 20%	"11b, 11c: 20%"	4a: $50	"9a: $150, 9b: $150"	8a: 0%	8b: 0	9a: $150	12: 0%	"3, 9c, 9d: $20; 5, 13a: $0"	"7a: $15, 14: $0"	"7b, 7d, 7f, 7g, 17a, 18a: $20; 14: $0"	"7e,7h: $20"	"7c, 7i: $20"					10b: n/c	16: n/c	17a: $20	17b: n/c	18a: $20	18b: n/c	14a: n/c												152.4478534	146.0436835	5.617977528		100	0.2	0.2	50	150			150		20	15	20	20	20							20		20														112.5063252	107.7800558	4.14606039		73.79987494	0.14759975	0.14759975	36.89993747	110.6998124			110.6998124		14.75997499	11.06998124	14.75997499	14.75997499	14.75997499							14.75997499		14.75997499														16.9522	0.650844242	0.507125444	0	0.950437398	1.698734862	1.680204747	1.082524885	3.064454763	0	0	0.714765938	0	0.205147994	4.127836905	8.126486616	0.309990612	0.572533083	0	0	0	0	0	0	0.182026178	0	0.3147536	0	0	0	0	0	0	0	0	0	0	0	0	0	41.14	0	14.6054	16.9522	0.650844242	0.507125444	0	0.950437398	1.698734862	1.680204747	1.082524885	3.064454763	0	0	0.714765938	0	0.205147994	4.127836905	8.126486616	0.309990612	0.572533083	0	0	0	0	0	0	0.182026178	0	0.3147536	0	0	0	0	0	0	0	0	0	0	0	0	0	41.14																																																																																		0	0	0	16.9522	0.650844242	0.507125444	0	0.950437398	1.698734862	1.680204747	1.082524885	3.064454763	0	0	0.714765938	0	0.205147994	4.127836905	8.126486616	0.309990612	0.572533083	0	0	0	0	0	0	0.182026178	0	0.3147536	0	0	0	0	0	0	0	0	0	0	0	0	0	41.14
H4836_002_0	2009	10																					2000											D	D	D	V	T	Coin	Coin	V	V	Coin	V	V	Coin	V	V	V	V	V	V	V	Coin	P	T	P	P	P	P	P	O	O																																																			0		1808.130998	72.46360052	1467.780196		154.5429282	11.50906328	11.38352029	352.0412097	332.1907811			77.48153382		166.7872697	4474.627534	6606.910884	252.0253152	465.4748397							147.9890135		255.8976692														1a: $200 days 1-8	1b: $200 days 1-8	2: $100 per Admit	6: $0	10a: $100	11a: 20%	"11b, 11c: 20%"	4a: $50	"9a: $150, 9b: $150"	8a: 0%	8b: 0	9a: $150	12: 0%	"3, 9c, 9d: $20; 5, 13a: $0"	"7a: $15, 14: $0"	"7b, 7d, 7f, 7g, 17a, 18a: $20; 14: $0"	"7e,7h: $20"	"7c, 7i: $20"					10b: n/c	16: n/c	17a: $20	17b: n/c	18a: $20	18b: n/c	14a: n/c												152.4478534	146.0436835	5.617977528		100	0.2	0.2	50	150			150		20	15	20	20	20							20		20														112.5063252	107.7800558	4.14606039		73.79987494	0.14759975	0.14759975	36.89993747	110.6998124			110.6998124		14.75997499	11.06998124	14.75997499	14.75997499	14.75997499							14.75997499		14.75997499														16.9522	0.650844242	0.507125444	0	0.950437398	1.698734862	1.680204747	1.082524885	3.064454763	0	0	0.714765938	0	0.205147994	4.127836905	8.126486616	0.309990612	0.572533083	0	0	0	0	0	0	0.182026178	0	0.3147536	0	0	0	0	0	0	0	0	0	0	0	0	0	41.14	0	14.6054	16.9522	0.650844242	0.507125444	0	0.950437398	1.698734862	1.680204747	1.082524885	3.064454763	0	0	0.714765938	0	0.205147994	4.127836905	8.126486616	0.309990612	0.572533083	0	0	0	0	0	0	0.182026178	0	0.3147536	0	0	0	0	0	0	0	0	0	0	0	0	0	41.14																																																																																		0	0	0	16.9522	0.650844242	0.507125444	0	0.950437398	1.698734862	1.680204747	1.082524885	3.064454763	0	0	0.714765938	0	0.205147994	4.127836905	8.126486616	0.309990612	0.572533083	0	0	0	0	0	0	0.182026178	0	0.3147536	0	0	0	0	0	0	0	0	0	0	0	0	0	41.14
H4836_801_0	2009	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																																																			0		293.8425658	4.812269731	50.2689533		8.045038846	11.5309418	11.40516014	16.05554539	45.08498945	8.528522388	22.64245411	5.346649767	0.202228911	23.1169553	41.80724348	126.7793081	1.715823054	11.42926131	27.22322815	2.460000342	25.75321832																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing											0.076992918	0.076992918	0.182323323		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.076992918	0.076992918	0.182323323		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				22.6238	0.37051069	9.165202631	0	1.858403974	2.663647555	2.634591993	3.708830984	10.41463256	1.970088672	5.2304069	1.235076096	0.046714879	5.340016673	9.657473245	29.28602018	0.396355126	2.640159361	6.288565703	0.568260079	5.948993431	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.0477	0	0	22.6238	0.37051069	9.165202631	0	1.858403974	2.663647555	2.634591993	3.708830984	10.41463256	1.970088672	5.2304069	1.235076096	0.046714879	5.340016673	9.657473245	29.28602018	0.396355126	2.640159361	6.288565703	0.568260079	5.948993431	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.0477																																																																																		0	0	0	22.6238	0.37051069	9.165202631	0	1.858403974	2.663647555	2.634591993	3.708830984	10.41463256	1.970088672	5.2304069	1.235076096	0.046714879	5.340016673	9.657473245	29.28602018	0.396355126	2.640159361	6.288565703	0.568260079	5.948993431	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.0477
H4836_802_0	2009	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																																																			0		293.8425658	4.812269731	50.2689533		8.045038846	11.5309418	11.40516014	16.05554539	45.08498945	8.528522388	22.64245411	5.346649767	0.202228911	23.1169553	41.80724348	126.7793081	1.715823054	11.42926131	27.22322815	2.460000342	25.75321832																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing											0.076992918	0.076992918	0.182323323		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.076992918	0.076992918	0.182323323		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				22.6238	0.37051069	9.165202631	0	1.858403974	2.663647555	2.634591993	3.708830984	10.41463256	1.970088672	5.2304069	1.235076096	0.046714879	5.340016673	9.657473245	29.28602018	0.396355126	2.640159361	6.288565703	0.568260079	5.948993431	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.0477	0	0	22.6238	0.37051069	9.165202631	0	1.858403974	2.663647555	2.634591993	3.708830984	10.41463256	1.970088672	5.2304069	1.235076096	0.046714879	5.340016673	9.657473245	29.28602018	0.396355126	2.640159361	6.288565703	0.568260079	5.948993431	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.0477																																																																																		0	0	0	22.6238	0.37051069	9.165202631	0	1.858403974	2.663647555	2.634591993	3.708830984	10.41463256	1.970088672	5.2304069	1.235076096	0.046714879	5.340016673	9.657473245	29.28602018	0.396355126	2.640159361	6.288565703	0.568260079	5.948993431	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.0477
H4836_803_0	2009	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																																																			0		293.8425658	4.812269731	50.2689533		8.045038846	11.5309418	11.40516014	16.05554539	45.08498945	8.528522388	22.64245411	5.346649767	0.202228911	23.1169553	41.80724348	126.7793081	1.715823054	11.42926131	27.22322815	2.460000342	25.75321832																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing											0.076992918	0.076992918	0.182323323		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.076992918	0.076992918	0.182323323		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				22.6238	0.37051069	9.165202631	0	1.858403974	2.663647555	2.634591993	3.708830984	10.41463256	1.970088672	5.2304069	1.235076096	0.046714879	5.340016673	9.657473245	29.28602018	0.396355126	2.640159361	6.288565703	0.568260079	5.948993431	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.0477	0	0	22.6238	0.37051069	9.165202631	0	1.858403974	2.663647555	2.634591993	3.708830984	10.41463256	1.970088672	5.2304069	1.235076096	0.046714879	5.340016673	9.657473245	29.28602018	0.396355126	2.640159361	6.288565703	0.568260079	5.948993431	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.0477																																																																																		0	0	0	22.6238	0.37051069	9.165202631	0	1.858403974	2.663647555	2.634591993	3.708830984	10.41463256	1.970088672	5.2304069	1.235076096	0.046714879	5.340016673	9.657473245	29.28602018	0.396355126	2.640159361	6.288565703	0.568260079	5.948993431	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.0477
H4836_804_0	2009	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																																																			0		293.8425658	4.812269731	50.2689533		8.045038846	11.5309418	11.40516014	16.05554539	45.08498945	8.528522388	22.64245411	5.346649767	0.202228911	23.1169553	41.80724348	126.7793081	1.715823054	11.42926131	27.22322815	2.460000342	25.75321832																				Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing											0.076992918	0.076992918	0.182323323		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.076992918	0.076992918	0.182323323		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				22.6238	0.37051069	9.165202631	0	1.858403974	2.663647555	2.634591993	3.708830984	10.41463256	1.970088672	5.2304069	1.235076096	0.046714879	5.340016673	9.657473245	29.28602018	0.396355126	2.640159361	6.288565703	0.568260079	5.948993431	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.0477	0	0	22.6238	0.37051069	9.165202631	0	1.858403974	2.663647555	2.634591993	3.708830984	10.41463256	1.970088672	5.2304069	1.235076096	0.046714879	5.340016673	9.657473245	29.28602018	0.396355126	2.640159361	6.288565703	0.568260079	5.948993431	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.0477																																																																																		0	0	0	22.6238	0.37051069	9.165202631	0	1.858403974	2.663647555	2.634591993	3.708830984	10.41463256	1.970088672	5.2304069	1.235076096	0.046714879	5.340016673	9.657473245	29.28602018	0.396355126	2.640159361	6.288565703	0.568260079	5.948993431	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.0477
H4837_001_0	2009	5																																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																																																			0		2744.644584	360.5626752	1747.651188		17.58048774	29.56357826	22.32125714	665.692525	34.68810366	19.67591082	45.42753809	3.270874416	3.925121502	36.57302445	59.39053429	110.4858387	11.15915849	8.374961414			24.1802545	6.289602143																			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 (14a)	$0 (13c)											123.8551626	54.24195071	66.76943168		0.22869	0.22869	0.22869	59.56818468	0.22869	0.22869	0.22869	0.22869	0.22869	0.22869	0.225611518	0.22869	0.22869	0.22869			0.22869	0.22869																			123.8551626	54.24195071	66.76943168		0.22869	0.22869	0.22869	59.56818468	0.22869	0.22869	0.22869	0.22869	0.22869	0.22869	0.225611518	0.22869	0.22869	0.22869			0.22869	0.22869																			28.3282	1.629801905	9.724139714	0	4.020481741	6.760894711	5.104648295	3.304507939	7.932822425	4.499684045	10.38882369	0.74801627	0.897636036	8.363884962	13.3991886	25.26700646	2.551987956	1.915269926	0	0	5.529782402	1.438369114	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.8051	135	0	28.3282	1.629801905	9.724139714	0	4.020481741	6.760894711	5.104648295	3.304507939	7.932822425	4.499684045	10.38882369	0.74801627	0.897636036	8.363884962	13.3991886	25.26700646	2.551987956	1.915269926	0	0	5.529782402	1.438369114	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.8051																																																																																		0	0	0	28.3282	1.629801905	9.724139714	0	4.020481741	6.760894711	5.104648295	3.304507939	7.932822425	4.499684045	10.38882369	0.74801627	0.897636036	8.363884962	13.3991886	25.26700646	2.551987956	1.915269926	0	0	5.529782402	1.438369114	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.8051
H4908_001_0	2009	3	X1	X2									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	V	P	V	V	V	V	V	P	Coin	O	V	P	V	P	V	P	O	O	Coin	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		292.0010744	53.24117104	55.12842393	405.0869039	29.54573186	10.91612387	0.613475447	300.1411081	238.1118719	7302.032277	1515.422622	35.46303299	0	6712.744938	10656.51213	9531.069357	575.2894518	3289.504349	1634.029998	1715.800321	0.703545819	0	0	0	62.69167355	0	0	0	0	0	1.845188659	393.1172779									$0 	$0 	$0 	$0 	$50 per trip	0	0	"$50 per visit, $10 UC"	$0 	$0 	0	0	$10 per visit	$0 	$10 per office visit	$10 per office visit	$10 per visit	$10  per visit	0	0	10%	0	0	0	$10 per visit	0	0	0	0	0	0.1	$50 per procedure									0	0	0	0	50	0	0	30.7	0	0	0	0	0	0	9.9	9.825	10	10	0	0	0.1	0	0	0	10	0	0	0	0	0	0.1	50									0	0	0	0	48.34445983	0	0	29.68349833	0	0	0	0	0	0	9.572203045	9.499686356	9.668891965	9.668891965	0	0	0.09668892	0	0	0	9.668891965	0	0	0	0	0	0.09668892	48.34445983									0	0	0	0	0.119031037	0	0	0.742436507	0	0	0	0	0	0	8.500524824	7.545180794	0.463534297	2.650488514	0	0	0.068025085	0	0	0	0.050513252	0	0	0	0	0	0.178409298	1.583753537	0	0	0	0	0	0	0	0	21.9019		0.75	0	0	0	0	0.119031037	0	0	0.742436507	0	0	0	0	0	0	8.500524824	7.545180794	0.463534297	2.650488514	0	0	0.068025085	0	0	0	0.050513252	0	0	0	0	0	0.178409298	1.583753537	0	0	0	0	0	0	0	0	21.9019	3000	$500 per admit	$500 per admit	$150 per admit	$15 per visit	$50 per trip	0.2	0.2	"$50 per visit, $10 UC"	$250 per admit	$15 per visit	$15 per visit	$0 	$10 per visit	$0 	$15 per office visit	$15 per office visit	$15 per office visit	$15  per visit	$15 per visit	0	0.2	0	0	0	0.2	0	0	0	0	0	0.15	$100 per procedure	0	0	0	0	0	0			0.4758	0.0506	0.0121	0.1039	0.0252	0.4478	0.0252	0.1575	1.0174	1.872	0.3885	0	0	0	2.7047	2.4007	0.1475	0.8433	0.4189	0	0.0289	0	0	0	0.0104	0	0	0	0	0	0	0.6719	0	0	0	0	0	0			11.8022		0.40416326	0.4758	0.05056168	0.012091986	0.103852995	0.144280045	0.447774398	0.025164482	0.899923039	1.017420818	1.872037608	0.388512134	0	0	0	11.20523727	9.945920137	0.611022482	3.493825768	0.41891976	0	0.096884212	0	0	0	0.060873404	0	0	0	0	0	0.178409298	2.255648978	0	0	0	0	0	0	0	0	33.7041
H4908_002_0	2009	4	X1	X2									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	V	P	V	V	V	V	V	P	Coin	O	V	P	V	P	V	P	O	O	Coin	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		290.6710507	36.23031659	28.8213663	571.9953468	43.25118175	15.81276257	0.928271643	390.4293034	291.7707885	9789.051845	1892.412262	41.04901601	0	10068.62168	14150.97553	13219.29877	805.3087563	3935.346771	2092.357258	2502.871706	3.314720647	0	0	0	73.14381606	0	0	0	0	0	0.612285683	497.937597									$0 	$0 	$0 	$0 	$50 per trip	0	0	"$50 per visit, $10 UC"	$0 	$0 	$0 	0	$10 per visit	$0 	$10 per office visit	$10 per office visit	$10 per visit	$0  per visit	0	0	10%	0	0	0	$10 per visit	0	0	0	0	0	0.1	$50 per procedure									0	0	0	0	50	0	0	30.7	0	0	13.63636364	0	0	0	9.9	9.825	9.825	10	0	0	0.1	0	0	0	10	0	0	0	0	0	0.1	50									0	0	0	0	46.82805707	0	0	28.75242704	0	0	12.77128829	0	0	0	9.271955299	9.201713213	2.935637414	9.365611413	0	0	0.093656114	0	0	0	9.365611413	0	0	0	0	0	0.093656114	46.82805707									0	0	0	0	0.168780734	0	0	0.935482505	0	0	2.014045214	0	0	0	10.93393438	10.13668301	0.197007876	3.071410719	0	0	0.310443855	0	0	0	0.05708638	0	0	0	0	0	0.057344298	1.943120851	0	0	0	0	0	0	0	0	29.8253		2.0202	0	0	0	0	0.168780734	0	0	0.935482505	0	0	2.014045214	0	0	0	10.93393438	10.13668301	0.197007876	3.071410719	0	0	0.310443855	0	0	0	0.05708638	0	0	0	0	0	0.057344298	1.943120851	0	0	0	0	0	0	0	0	29.8253	3000	$500 per admit	$500 per admit	$150 per admit	$15 per visit	$50 per trip	0.2	0.2	"$50 per visit, $10 UC"	$250 per admit	$15 per visit	$15 per visit	$0 	$10 per visit	$0 	$15 per office visit	$15 per office visit	$15 per office visit	$15  per visit	$15 per visit	0	0.2	0	0	0	$10 per visit	0	0	0	0	0	0.15	$100 per procedure	0	0	0	0	0	0			0.4849	0.0695	0.0151	0.142	0.0358	0.0001	0	0.1984	1.2076	2.4309	0.3418	0	0	0	3.479	3.2253	0.2	0.9773	0.5196	0	0	0	0	0	0	0	0	0	0	0	0.0002	0.8244	0	0	0	0	0	0			14.1518		0.958586406	0.4849	0.069478829	0.015134548	0.142043951	0.204582708	5.24E-05	3.07E-06	1.133918188	1.20759361	2.430921173	2.355822584	0	0	0	14.41291351	13.36199124	0.396990687	4.048677767	0.519596345	0	0.310454831	0	0	0	0.05708638	0	0	0	0	0	0.057496347	2.767475151	0	0	0	0	0	0	0	0	43.9772
H4908_005_0	2009	3	X1										DME/Prosthetics/Supplies											Diabetic Visit/Supplies										D	D	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	V	V	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		1287.251448	234.7072683	294.1683273	372.6838248	1.279400341	10.04293833	0.564403277	276.1326893	15.32649578	11.23996987	15.13723407	0.032113885	0	31.88658402	9804.093054	8768.67494	529.2717963	6.666797251	7.121922141		0.647268881										1.697591209										$125 for days 1-5	$125 for days 1-5	$90 for days 4-100	$0 	0.2	"20%, $25 Med cvrd Eyewear"	0.2	"$50 per visit, $10 UC"	0.2	0.2	0.2	0.2	0.2	0.2	"$10 per office visit, $30 Eye exams"	$10 per office visit	$10 per visit	0.2	0.2		0.2										0.2										81.05518352	53.7555795	68.17889663	0	0.2	0.2	0.2	30.7	0.2	0.2	0.2	0	0	0.2	9.9	9.825	10	0.2	0.2		0.2										0.2										72.4588172	48.0544925	60.94813426	0	0.178788855	0.178788855	0.178788855	27.44408922	0.178788855	0.178788855	0.178788855	0	0	0.178788855	8.850048315	8.783002494	8.939442742	0.178788855	0.178788855		0.178788855										0.178788855										7.7727	0.939894889	1.494084226	0	0.228742522	1.795565444	0.100909016	0.631517513	2.740206629	2.009581341	2.706368746	0	0	5.700965841	7.230558101	6.417941155	0.39428291	1.191949046	1.273320304	0	0.115724462	0	0	0	0	0	0	0	0	0	0.303510388	0	0	0	0	0	0	0	0	0	43.0478		5.1071	7.7727	0.939894889	1.494084226	0	0.228742522	1.795565444	0.100909016	0.631517513	2.740206629	2.009581341	2.706368746	0	0	5.700965841	7.230558101	6.417941155	0.39428291	1.191949046	1.273320304	0	0.115724462	0	0	0	0	0	0	0	0	0	0.303510388	0	0	0	0	0	0	0	0	0	43.0478	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, $10 UC"	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2	0.2		0.2										0.2										1.6488	0.1994	0.3169	0.0883	0	0	0	0.134	0	0	0	0	0	0	1.5338	1.3614	0.0836	0	0		0										0										5.3663		0.636651209	9.4215	1.139266532	1.811011183	0.0883375	0.228746565	1.795597184	0.100910799	0.765475774	2.740255067	2.009616864	2.706411512	0	0	5.700965841	8.764312849	7.779322613	0.477918679	1.191970116	1.273342812	0	0.115726508	0	0	0	0	0	0	0	0	0	0.303510388	0	0	0	0	0	0	0	0	0	48.4142
H4908_006_0	2009	5	X1										DME/Prosthetics/Supplies											Diabetic Visit/Supplies										D	D	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	Coin	V	V	V	Coin	Coin	P	Coin	O	V	P	V	P	V	P	O	O	Coin																																																		0		1280.351627	314.7332464	297.0671364	417.1492255	1.372291352	11.53205476	0.67697718	284.735326	15.51631509	11.61558075	14.73370173	0.024089994	0	33.62788148	10320.13375	9640.673256	587.3018475	6.3694116	6.627217542	1825.313789	2.417385313	0	0	0	53.34289236	0	0	0	0	0	0.446532476										$185 for days 1-5	$185 for days 1-5	$110 for days 4-100	$0 	0.2	"20%, $25 Med cvrd Eyewear"	0.2	"$50 per visit, $10 UC"	0.2	0.2	0.2	0.2	0.2	0.2	"$10 per office visit, $30 Eye exams"	$10 per office visit	$10 per visit	0.2	0.2	0	0.2	0	0	0	0	0	0	0	0	0	0.2										119.9616716	79.55825766	83.32976254	0	0.2	0.2	0.2	30.7	0.2	0.2	0.2	0	0	0	9.9	9.825	10	0.2	0.2	0	0.2	0	0	0	0	0	0	0	0	0	0.2										107.0242003	70.97816154	74.34292205	0	0.178430659	0.178430659	0.178430659	27.38910609	0.178430659	0.178430659	0.178430659	0	0	0	8.8323176	8.765406103	8.921532929	0.178430659	0.178430659	0	0.178430659	0	0	0	0	0	0	0	0	0	0.178430659										11.4191	1.861598934	1.840403247	0	0.24485885	2.057672125	0.120793484	0.649887171	2.76858632	2.072575722	2.628944104	0	0	0	7.59589158	7.042034683	0.436636064	1.136498306	1.182498791	0	0.431335653	0	0	0	0	0	0	0	0	0	0.079675084	0	0	0	0	0	0	0	0	0	43.5689		5.2668	11.4191	1.861598934	1.840403247	0	0.24485885	2.057672125	0.120793484	0.649887171	2.76858632	2.072575722	2.628944104	0	0	0	7.59589158	7.042034683	0.436636064	1.136498306	1.182498791	0	0.431335653	0	0	0	0	0	0	0	0	0	0.079675084	0	0	0	0	0	0	0	0	0	43.5689	3250	$185 for days 1-5	$185 for days 1-5	$110 for days 4-100	$15 per visit	0.3	0.3	0.3	"$50 per visit, $10 UC"	0.3	0.3	0.3	0.3	0.2	0.3	0.3	0.3	0.3	0.3	0.3	0	0.3	0	0	0	0	0	0	0	0	0	0.2										2.4222	0.2668	0.3194	0	0	0	0	0.1379	0	0	0	0	0	0	1.6112	1.4938	0.0926	0	0	0	0	0	0	0	0	0	0	0	0	0	0										6.3442		0.766904143	13.8413	2.128412868	2.159812075	0	0.244863178	2.057708498	0.120795619	0.787742025	2.768635259	2.072612359	2.628985563	0	0	0	9.207141309	8.535799616	0.529255836	1.136518396	1.182519693	0	0.431343278	0	0	0	0	0	0	0	0	0	0.079675084	0	0	0	0	0	0	0	0	0	49.9131
H4909_001_0	2009	12	H.6	H.7	I.7	I.8	I.9	I.10	I.11	I.12	I.13	I.14	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional	Professional		CORF	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies\Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Partial Hosp	Chemo/Radiation	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	0	Coin	0	0	0	V	V	V	0	V	0	V	V	V	V	V	Coin	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	0	0	0	0	0	0	0	0	0		1019.609714	46.4541142	410.2424175	454.6128335	58.51648515	7.923368983	1.112201815	261.0587107	257.5643516	4126.512319	633.232165	83.11277806	0.014794926	60.23117882	2897.444806	2740.816096	15.82485792	840.5192235	2004.985181	0	38.79685618	0	0	0	209.9427153	192.8614264	104.4934819	0	0	0	0	0.003452078	185.3052841	253.3881146	86.23784229	0.360273134	548.1765424	20.98371109	0.83654415	15.04546793	$220/day (days 1-10) w/$2200 yrly max	$220/day (days 1-10) w/$2200 yrly max	$75/day (for days 21-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$175 copay	$0 copay	$50/$100 copay for Lower/Higher Tier	$175 copay	20% coinsurance	$0 copay	$15 coapy	$30 copay	$30 copay	$30 copay	$50/$100 copay for Lower/Higher Tier	0	20% coinsurance	0	0	0	$30 copay/ $50 limit	$30 copay / Covd up to $75	$30 copay/ $50 limit	0	Silver Sneakers	0	$30 copay	$0 copay	$30 copay	$30 copay	$0 copay	20% coinsurance	$30 copay	$30 copay	$30 copay	20% coinsurance	220	220	75	0	100	0.2	0.2	50	175	0	68.60697963	175	0.2	0	15	30	30	30	56.71210249	0	0.2	0	0	0	30	30	30	0	0	0	30	0	30	30	0	0.2	30	30	30	0.2	133.5537716	136.3699736	71.25127202	0	95.00169603	0.190003392	0.190003392	47.50084801	166.252968	0	65.17779424	166.252968	0.190003392	0	14.2502544	28.50050881	28.50050881	28.50050881	53.87745922	0	0.190003392	0	0	0	28.50050881	28.50050881	28.50050881	0	0	0	0	0	28.50050881	28.50050881	0	0.190003392	28.50050881	28.50050881	28.50050881	0.190003392	11.3477	0.527912194	2.43585784	0	0.463263778	1.505466983	0.211322118	1.033375845	3.56840316	0	3.439389646	1.151478836	0.002811086	0	3.440777134	6.50955444	0.037584709	1.996268794	9.001958945	0	7.371534275	0	0	0	0.498622851	0.458054065	0.24817645	0	0	0	0	0	0.440107907	0.601807516	0	0.068453117	1.301942531	0.049837204	0.001986828	2.858689942	60.5724		3.1869	11.3477	0.527912194	2.43585784	0	0.463263778	1.505466983	0.211322118	1.033375845	3.56840316	0	3.439389646	1.151478836	0.002811086	0	3.440777134	6.50955444	0.037584709	1.996268794	9.001958945	0	7.371534275	0	0	0	0.498622851	0.458054065	0.24817645	0	0	0	0	0	0.440107907	0.601807516	0	0.068453117	1.301942531	0.049837204	0.001986828	2.858689942	60.5724	4500	$275/day (Days 1-10)	$275/day (Days 1-10)	20% Coinsurance	$0 copay	$100 copay	30% Coinsurance	30% Coinsurance	$50 copay	$250 copay	0% Coinsurance	20% Coinsurance	$250 copay	20% Coinsurance	$0 copay	$25 copay	$40 copay	$40 copay	$40 copay	20% Coinsurance		20% Coinsurance				$40 copay / $50 limit	$40 copay / Covd up to $75	$40 copay / $50 limit		Silver Sneakers		$40 copay	$40 copay	$40 copay	$40 copay	$0 copay	30% Coinsurance	$40 copay	$40 copay	$40 copay	20% coinsurance	9.7076	0.8877	1.299		0.5853	0.2355	0.0076	0.4625	1.9477		1.7973	0.3917			1.0924	0.9012	0.0135	0.2871	3.6794		0.7111				0.4956	0.476	0.3309					0	0.5632	0.1951		0.3444	0.1443	0.0251		0.3488	26.9299		1.416857125	21.0553	1.41565667	3.734820672	0	1.048564427	1.740924247	0.218890368	1.495885431	5.516063638	0	5.23665996	1.54313039	0.002811086	0	4.533130095	7.410750057	0.051093344	2.283382822	12.68133112	0	8.082675694	0	0	0	0.994225816	0.934056353	0.579078383	0	0	0	0	3.75E-06	1.003300721	0.796943155	0	0.412891913	1.44627832	0.074907599	0.001986828	3.207504035	87.5023
H4909_004_0	2009	13	H.6	H.7	I.7	I.8	I.9	I.10	I.11	I.12	I.13		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional	0		CORF	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies/Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemotherapy/Radiation	0	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	0	Coin	0	0	V	V	V	V	0	V	0	V	V	V	V	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1126.106069	83.86366695	261.7735521	278.5925637	49.81982632	13.68334358	0.951568527	266.0455991	292.0960819	4714.40963	817.3845813	142.1334985	0	101.343482	3204.573385	3354.286667	48.69893387	1104.320969	2194.28088	0	63.81932855	0	0	317.1784093	210.9646506	192.8614264	104.4934819	0	0	0	0	0.004696317	193.8449045	349.4584978	92.77439724	0.777584328	528.582323	24.94694443	12.13697239	0	$175/day (days 1-10) w/$1750 yrly max	$175/day (days 1-10) w/$1750 yrly max	$75/day (for days 21-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$125 copay	$0 copay	$50/$100 copay for Lower/Higher Tier	$125 copay	20% coinsurance	$0 copay	$10 copay	$25 copay	$25 copay	$25 copay	$50/$100 copay for Lower/Higher Tier	0	20% coinsurance	0	0	$10/$20 copay; Exam/Cleaning 1/yr	$25 copay	$25 copay / Covd up to $75	$25 copay	0	Silver Sneakers	0	$25 copay	$0 copay	$25 copay	$25 copay	$0 copay	20% coinsurance	$25 copay	$25 copay	20% coinsurance	0	175	175	75	0	100	0.2	0.2	50	125	0	67.67368843	125	0.2	0	10	25	25	25	55.81674214	0	0.2	0	0	19.47935514	25	25	25	0	0	0	25	0	25	25	0	0.2	25	25	0.2	0	111.0680519	114.5996074	69.21618732	0	92.28824976	0.1845765	0.1845765	46.14412488	115.3603122	0	62.4548626	115.3603122	0	0	9.228824976	23.07206244	23.07206244	23.07206244	51.51229439	0	0.1845765	0	0	17.97715592	23.07206244	23.07206244	23.07206244	0	0	0	0	0	23.07206244	23.07206244	0	0.1845765	23.07206244	23.07206244	0.1845765	0	10.4229	0.800895276	1.509913935	0	0.383148715	2.52562366	0.175637188	1.023036779	2.8080246	0	4.25413681	1.366380397	0	0	2.464537241	6.449192618	0.09363207	2.123246862	9.419370223	0	11.77954827	0	0	0.47516381	0.405615799	0.370809239	0.200906678	0	0	0	0	0	0.372700145	0.671894023	0	0.143523793	1.016290363	0.047964788	2.240199879	0	63.5443		5.3099	10.4229	0.800895276	1.509913935	0	0.383148715	2.52562366	0.175637188	1.023036779	2.8080246	0	4.25413681	1.366380397	0	0	2.464537241	6.449192618	0.09363207	2.123246862	9.419370223	0	11.77954827	0	0	0.47516381	0.405615799	0.370809239	0.200906678	0	0	0	0	0	0.372700145	0.671894023	0	0.143523793	1.016290363	0.047964788	2.240199879	0	63.5443	3500	$225/day (days 1-10)	$225/day (days 1-10)	20% Coinsurance	$0 copay	$100 copay	30% Coinsurance	30% Coinsurance	$50 copay	$250 copay	$0 copay	20% Coinsurance	$250 copay	20% Coinsurance	$0 copay	$20 copay	$35 copay	$35 copay	$35 copay	20% Coinsurance		20% Coinsurance			50% Coinsurance	$35 copay	$35 copay / Covd up to $75	Covd up to $50		Silver Sneakers		$35 copay	$40 copay	$35 copay	$35 copay	$0 copay	30% coinsurance	$35 copay	$35 copay	20% coinsurance		6.4863	1.0927	0.4956		0.6771	0.6754	0.0199	0.2525	2.0552		1.4015	0.235			0.9109	0.9121	0.0932	0.8048	4.4646		1.7406			0.4338	0.4163	0.4046	0.2813					0	0.509	0.1252		0.2638	0.1258	0.0254	0.5352		25.4377		2.125617361	16.9091	1.893635192	2.005506429	0	1.060209395	3.200993208	0.195536346	1.275536531	4.863253283	0	5.655653744	1.601420127	0	0	3.375407284	7.361262623	0.186793945	2.928085349	13.883969	0	13.52019586	0	0	0.908918584	0.821922342	0.775415077	0.482176028	0	0	0	0	8.61E-06	0.881680841	0.797091574	0	0.407341663	1.142130034	0.073349646	2.775375381	0	88.982
H4909_804_0	2009	3																					none											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	V											0	0	0	0	0	0	0	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	212.9589424	2.316458907	34.95129841	25.84788024	5.450901891	11.07658008	3.140533217	8.20929967	27.30883556	4.889455936	21.79083835	0	0.181345104	20.59762134	31.06819208	88.67577603	0.951617781	4.506880747	17.72041253	26.63551027	7.301734023	0.787108932	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.082068681	0.082068681	0.191179994	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.082068681	0.082068681	0.191179994	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											17.4773	0.190108728	6.681989024	0	1.259158337	2.558689999	0.725463173	1.896348224	6.308341014	1.129464321	5.03368366	0	0.041890719	4.75805053	7.17675237	20.48410426	0.219823707	1.041089453	4.093415294	6.152802872	1.686700559	0.181822163	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.097	0	0	17.4773	0.190108728	6.681989024	0	1.259158337	2.558689999	0.725463173	1.896348224	6.308341014	1.129464321	5.03368366	0	0.041890719	4.75805053	7.17675237	20.48410426	0.219823707	1.041089453	4.093415294	6.152802872	1.686700559	0.181822163	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.097	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											5.0198	0.0546	2.057	0	0.3644	0.7401	0.2098	0.4931	1.9468	0.3558	1.1199	0	0.0123	1.4934	2.0631	5.9264	0.0637	0.3034	1.5904	1.8538	0.4343	0.0467	0	0	0	0	0	0	0	0											26.1487	0	0	22.497	0.244711386	8.738951628	0	1.623557323	3.298740907	0.93528917	2.38946318	8.255143707	1.485230288	6.153570867	0	0.054160043	6.251467849	9.239829262	26.41047748	0.283477197	1.344507381	5.68384694	8.006642503	2.121031743	0.228559108	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.2457
H4909_805_0	2009	3																					none											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	V											0	0	0	0	0	0	0	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	212.9589424	2.316458907	34.95129841	25.84788024	5.450901891	11.07658008	3.140533217	8.20929967	27.30883556	4.889455936	21.79083835	0	0.181345104	20.59762134	31.06819208	88.67577603	0.951617781	4.506880747	17.72041253	26.63551027	7.301734023	0.787108932	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.082068681	0.082068681	0.191179994	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.082068681	0.082068681	0.191179994	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											17.4773	0.190108728	6.681989024	0	1.259158337	2.558689999	0.725463173	1.896348224	6.308341014	1.129464321	5.03368366	0	0.041890719	4.75805053	7.17675237	20.48410426	0.219823707	1.041089453	4.093415294	6.152802872	1.686700559	0.181822163	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.097	0	0	17.4773	0.190108728	6.681989024	0	1.259158337	2.558689999	0.725463173	1.896348224	6.308341014	1.129464321	5.03368366	0	0.041890719	4.75805053	7.17675237	20.48410426	0.219823707	1.041089453	4.093415294	6.152802872	1.686700559	0.181822163	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.097	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											5.0198	0.0546	2.057	0	0.3644	0.7401	0.2098	0.4931	1.9468	0.3558	1.1199	0	0.0123	1.4934	2.0631	5.9264	0.0637	0.3034	1.5904	1.8538	0.4343	0.0467	0	0	0	0	0	0	0	0											26.1487	0	0	22.497	0.244711386	8.738951628	0	1.623557323	3.298740907	0.93528917	2.38946318	8.255143707	1.485230288	6.153570867	0	0.054160043	6.251467849	9.239829262	26.41047748	0.283477197	1.344507381	5.68384694	8.006642503	2.121031743	0.228559108	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.2457
H4909_806_0	2009	3																					none											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	V											0	0	0	0	0	0	0	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	212.9589424	2.316458907	34.95129841	25.84788024	5.450901891	11.07658008	3.140533217	8.20929967	27.30883556	4.889455936	21.79083835	0	0.181345104	20.59762134	31.06819208	88.67577603	0.951617781	4.506880747	17.72041253	26.63551027	7.301734023	0.787108932	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.082068681	0.082068681	0.191179994	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.082068681	0.082068681	0.191179994	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											17.4773	0.190108728	6.681989024	0	1.259158337	2.558689999	0.725463173	1.896348224	6.308341014	1.129464321	5.03368366	0	0.041890719	4.75805053	7.17675237	20.48410426	0.219823707	1.041089453	4.093415294	6.152802872	1.686700559	0.181822163	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.097	0	0	17.4773	0.190108728	6.681989024	0	1.259158337	2.558689999	0.725463173	1.896348224	6.308341014	1.129464321	5.03368366	0	0.041890719	4.75805053	7.17675237	20.48410426	0.219823707	1.041089453	4.093415294	6.152802872	1.686700559	0.181822163	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.097	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											5.0198	0.0546	2.057	0	0.3644	0.7401	0.2098	0.4931	1.9468	0.3558	1.1199	0	0.0123	1.4934	2.0631	5.9264	0.0637	0.3034	1.5904	1.8538	0.4343	0.0467	0	0	0	0	0	0	0	0											26.1487	0	0	22.497	0.244711386	8.738951628	0	1.623557323	3.298740907	0.93528917	2.38946318	8.255143707	1.485230288	6.153570867	0	0.054160043	6.251467849	9.239829262	26.41047748	0.283477197	1.344507381	5.68384694	8.006642503	2.121031743	0.228559108	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.2457
H4910_002_0	2009	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$100/day 1-7	$100/day 1-7	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$200 per procedure	$25 per visit	$25 X-ray; $125 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											72.2855078	72.2855078	47.89	20	100	0.2	0.2	48.5	200	25	65	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											72.2855078	72.2855078	47.89	20	100	0.2	0.2	48.5	200	25	65	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											11.7703	0	5.382428544	1.711889696	2.276793099	1.576138182	0	1.028277495	6.408158995	2.185826699	25.53605833	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.499	0	0	11.7703	0	5.382428544	1.711889696	2.276793099	1.576138182	0	1.028277495	6.408158995	2.185826699	25.53605833	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.499																																																																																		0			11.7703	0	5.382428544	1.711889696	2.276793099	1.576138182	0	1.028277495	6.408158995	2.185826699	25.53605833	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.499
H4910_004_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$175/day 1-10	$175/day 1-10	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$200 per procedure	$35 per visit	$35 X-ray; $150 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$20 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											143.4382958	143.4382958	47.89	20	100	0.2	0.2	48.5	200	35	81	35	25	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											143.4382958	143.4382958	47.89	20	100	0.2	0.2	48.5	200	35	81	35	25	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											23.3562	0	5.382428544	1.711889696	2.276793099	1.576138182	0	1.028277495	6.408158995	3.060157379	31.82185731	0	0.139220051	2.295447554	12.17789911	27.04289519	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.2764	0	0	23.3562	0	5.382428544	1.711889696	2.276793099	1.576138182	0	1.028277495	6.408158995	3.060157379	31.82185731	0	0.139220051	2.295447554	12.17789911	27.04289519	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.2764																																																																																		0			23.3562	0	5.382428544	1.711889696	2.276793099	1.576138182	0	1.028277495	6.408158995	3.060157379	31.82185731	0	0.139220051	2.295447554	12.17789911	27.04289519	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.2764
H4910_005_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$100/day 1-7	$100/day 1-7	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$200 per procedure	$25 per visit	$25 X-ray; $125 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											72.2855078	72.2855078	47.89	20	100	0.2	0.2	48.5	200	25	65	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											72.2855078	72.2855078	47.89	20	100	0.2	0.2	48.5	200	25	65	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											11.7703	0	5.382428544	1.711889696	2.276793099	1.576138182	0	1.028277495	6.408158995	2.185826699	25.53605833	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.499	0	0	11.7703	0	5.382428544	1.711889696	2.276793099	1.576138182	0	1.028277495	6.408158995	2.185826699	25.53605833	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.499																																																																																		0			11.7703	0	5.382428544	1.711889696	2.276793099	1.576138182	0	1.028277495	6.408158995	2.185826699	25.53605833	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.499
H4910_801_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		306.597466	0	37.85873291	5.739837992	6.769702712	9.012179865	0	7.965998511	41.16925574	14.03319192	57.20030112	0	3.121356228	11.86469609	41.90800934	182.0377242	0	5.395176771	0	0	8.141389035	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.0667	0.0667	0.1553	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0667	0.0667	0.1553	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.4501	0	5.87946122	0	1.563801327	2.081813549	0	1.840145656	9.510098075	3.241667334	13.21326956	0	0.721033289	2.740744798	9.680750156	42.05071428	0	1.246285834	0	0	1.880660867	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1005	0	0	20.4501	0	5.87946122	0	1.563801327	2.081813549	0	1.840145656	9.510098075	3.241667334	13.21326956	0	0.721033289	2.740744798	9.680750156	42.05071428	0	1.246285834	0	0	1.880660867	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1005																																																																																		0			20.4501	0	5.87946122	0	1.563801327	2.081813549	0	1.840145656	9.510098075	3.241667334	13.21326956	0	0.721033289	2.740744798	9.680750156	42.05071428	0	1.246285834	0	0	1.880660867	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1005
H4910_802_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		306.597466	0	37.85873291	5.739837992	6.769702712	9.012179865	0	7.965998511	41.16925574	14.03319192	57.20030112	0	3.121356228	11.86469609	41.90800934	182.0377242	0	5.395176771	0	0	8.141389035	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.0667	0.0667	0.1553	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0667	0.0667	0.1553	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.4501	0	5.87946122	0	1.563801327	2.081813549	0	1.840145656	9.510098075	3.241667334	13.21326956	0	0.721033289	2.740744798	9.680750156	42.05071428	0	1.246285834	0	0	1.880660867	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1005	0	0	20.4501	0	5.87946122	0	1.563801327	2.081813549	0	1.840145656	9.510098075	3.241667334	13.21326956	0	0.721033289	2.740744798	9.680750156	42.05071428	0	1.246285834	0	0	1.880660867	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1005																																																																																		0			20.4501	0	5.87946122	0	1.563801327	2.081813549	0	1.840145656	9.510098075	3.241667334	13.21326956	0	0.721033289	2.740744798	9.680750156	42.05071428	0	1.246285834	0	0	1.880660867	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.1005
H4911_002_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	5000	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$500 per stay	$500 per stay	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$200 per procedure	$30 per visit	$30 X-ray; $150 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$15 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											84.53846451	84.53846451	47.8866492	20	100	0.2	0.2	48.5	200	30	78	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											84.53846451	84.53846451	47.8866492	20	100	0.2	0.2	48.5	200	30	78	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											12.1136	0	4.73620571	1.506462933	2.003577927	1.3870016	0	0.904884196	5.639179916	2.308232994	26.9660776	0	0.122513645	1.731423298	8.037413413	20.39806951	0	1.478528581	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.2474	0	0	12.1136	0	4.73620571	1.506462933	2.003577927	1.3870016	0	0.904884196	5.639179916	2.308232994	26.9660776	0	0.122513645	1.731423298	8.037413413	20.39806951	0	1.478528581	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.2474		$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$100 copay	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$50 copay	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$30 copay	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP		0	0	$150 ded; 20% coinsurance; $5000 max OOP	0	$150 ded; 20% coinsurance; $5000 max OOP	0	Not covered												4.3442	0	0.5364	0.0813	0.176	0.1277	0	0.0885	0.5833	0.1988	0.8105	0	6.005	0.1681	0.5938	2.5793	0	0.0764	0	0	0.1154	0	0	0	0.0538	0	0.0034	0	0	0											16.542	150	1.00463067	16.4578	0	5.272626309	1.587790729	2.179585602	1.514695227	0	0.993344188	6.222507332	2.50706937	27.77654899	0	6.127517304	1.899534244	8.631208232	22.97736305	0	1.554972871	0	0	1.02952868	0	0	0	0.053800664	0	0.003434235	0	0	0	0	0	0	0	0	0	0	0	0	0	106.7893
H4911_003_0	2009	7																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	7500	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$800 per stay	$800 per stay	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$200 per procedure	$35 per visit	$35 X-ray; $150 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$20 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											135.2615432	135.2615432	47.8866492	20	100	0.2	0.2	48.5	200	35	81	35	25	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											135.2615432	135.2615432	47.8866492	20	100	0.2	0.2	48.5	200	35	81	35	25	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											19.3818	0	4.73620571	1.506462933	2.003577927	1.3870016	0	0.904884196	5.639179916	2.692938494	28.00323443	0	0.122513645	2.019993848	10.71655122	23.79774777	0	1.724950012	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.5512	0	0	19.3818	0	4.73620571	1.506462933	2.003577927	1.3870016	0	0.904884196	5.639179916	2.692938494	28.00323443	0	0.122513645	2.019993848	10.71655122	23.79774777	0	1.724950012	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.5512		$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$100 copay	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$50 copay	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$30 copay	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP		0	0	$500 ded; 30% coinsurance; $7500 max OOP	0	$500 ded; 30% coinsurance; $7500 max OOP	0	Not Covered												7.0949	0	0.8761	0.1328	0.1938	0.2085	0	0.108	0.9527	0.3247	1.3236	0	6.0813	0.2746	0.9698	4.2125	0	0.1248	0	0	0.1884	0	0	0	0.0879	0	0.0056	0	0	0											23.16	500	2.744631237	26.4766	0	5.612279598	1.639286242	2.19736021	1.595548872	0	1.012896022	6.591861296	3.017675009	29.32688386	0	6.203802141	2.294550063	11.6863278	28.01021037	0	1.849797652	0	0	1.10256994	0	0	0	0.087866418	0	0.005608739	0	0	0	0	0	0	0	0	0	0	0	0	0	128.7112
H4911_801_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		289.4897982	0	35.74627374	5.419563845	6.391963695	8.509314066	0	7.521508025	38.87207448	13.25016136	54.00861214	0	2.947189343	11.20266427	39.56960676	171.8802987	0	5.094134191	0	0	7.687112028	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.0667	0.0667	0.1553	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0667	0.0667	0.1553	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											19.309	0	5.551396312	0	1.476543614	1.965651549	0	1.737468354	8.979449205	3.060787275	12.4759894	0	0.680800738	2.587815446	9.140579162	39.70434899	0	1.176744998	0	0	1.775722878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.6223			19.309	0	5.551396312	0	1.476543614	1.965651549	0	1.737468354	8.979449205	3.060787275	12.4759894	0	0.680800738	2.587815446	9.140579162	39.70434899	0	1.176744998	0	0	1.775722878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.6223		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered												2.633	0	0.757	0	0.2013	0.268	0	0.2369	1.2245	0.4174	1.7013	0	0.0928	0.3529	1.2464	5.4142	0	0.1605	0	0	0.2421	0	0	0	0	0	0	0	0	0											14.9485	135	0	21.942	0	6.3084049	0	1.67789047	2.233694942	0	1.974395857	10.20391955	3.478167358	14.17726069	0	0.773637202	2.940699371	10.38702178	45.1185784	0	1.337210225	0	0	2.017866907	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.5708
H4911_802_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		289.4897982	0	35.74627374	5.419563845	6.391963695	8.509314066	0	7.521508025	38.87207448	13.25016136	54.00861214	0	2.947189343	11.20266427	39.56960676	171.8802987	0	5.094134191	0	0	7.687112028	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.0667	0.0667	0.1553	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0667	0.0667	0.1553	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											19.309	0	5.551396312	0	1.476543614	1.965651549	0	1.737468354	8.979449205	3.060787275	12.4759894	0	0.680800738	2.587815446	9.140579162	39.70434899	0	1.176744998	0	0	1.775722878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.6223			19.309	0	5.551396312	0	1.476543614	1.965651549	0	1.737468354	8.979449205	3.060787275	12.4759894	0	0.680800738	2.587815446	9.140579162	39.70434899	0	1.176744998	0	0	1.775722878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.6223		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered												2.633	0	0.757	0	0.2013	0.268	0	0.2369	1.2245	0.4174	1.7013	0	0.0928	0.3529	1.2464	5.4142	0	0.1605	0	0	0.2421	0	0	0	0	0	0	0	0	0											14.9485	0	0	21.942	0	6.3084049	0	1.67789047	2.233694942	0	1.974395857	10.20391955	3.478167358	14.17726069	0	0.773637202	2.940699371	10.38702178	45.1185784	0	1.337210225	0	0	2.017866907	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.5708
H4911_804_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		289.4897982	0	35.74627374	5.419563845	6.391963695	8.509314066	0	7.521508025	38.87207448	13.25016136	54.00861214	0	2.947189343	11.20266427	39.56960676	171.8802987	0	5.094134191	0	0	7.687112028	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.0667	0.0667	0.1553	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0667	0.0667	0.1553	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											19.309	0	5.551396312	0	1.476543614	1.965651549	0	1.737468354	8.979449205	3.060787275	12.4759894	0	0.680800738	2.587815446	9.140579162	39.70434899	0	1.176744998	0	0	1.775722878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.6223			19.309	0	5.551396312	0	1.476543614	1.965651549	0	1.737468354	8.979449205	3.060787275	12.4759894	0	0.680800738	2.587815446	9.140579162	39.70434899	0	1.176744998	0	0	1.775722878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.6223		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered												2.633	0	0.757	0	0.2013	0.268	0	0.2369	1.2245	0.4174	1.7013	0	0.0928	0.3529	1.2464	5.4142	0	0.1605	0	0	0.2421	0	0	0	0	0	0	0	0	0											14.9485	0	0	21.942	0	6.3084049	0	1.67789047	2.233694942	0	1.974395857	10.20391955	3.478167358	14.17726069	0	0.773637202	2.940699371	10.38702178	45.1185784	0	1.337210225	0	0	2.017866907	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.5708
H4917_001_0	2009	11																					5000											D	D	D		T	Coin	Coin	V	V	V	Coin		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		2014.76724	211.0737975	2078.129989		714.708643	26.59907177	2.060287854	887.0946356	300.6928605	8389.818622	13.07641334		0	5106.636228	5470.951012	5178.270956	970.7393557	1655.251409			19.05239599				270																$200 Days 1-5	$300 Days 1-5	"$50 days 11-20, $124 days 21-100"		$100 waived if admitted	25%	25%	"$50 ER, $35 UC / waived if admitted"	"$200 Surgery, $150 ASC"	$15 to $35 varies by service	"0% to 20%, copays / varies by service"		20%	$0 to $50 varies by service	$10 / $0 for preventive	$35 / $0 for preventive	$50 	$40 			20%				$10 Copay																129.6882936	129.0133908	35.27899214		80	0.25	0.25	37.45	190	20	0.190909091		0	14.75	9.5	28.19444444	50	40			0.2				10																112.0506857	111.4675696	30.48104921		69.12	0.216	0.216	32.3568	164.16	17.28	0.164945455		0	12.744	8.208	24.36	43.2	34.56			0.1728				8.64																18.813	1.960656935	5.278631871	0	4.116721783	5.745399503	0.445022177	2.391961976	4.113478332	12.08133882	2.156894941	0	0	5.423247675	3.742130492	10.51189004	3.49466168	4.767124058	0	0	3.292254028	0	0	0	0.1944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.5288		13.9351	18.813	1.960656935	5.278631871	0	4.116721783	5.745399503	0.445022177	2.391961976	4.113478332	12.08133882	2.156894941	0	0	5.423247675	3.742130492	10.51189004	3.49466168	4.767124058	0	0	3.292254028	0	0	0	0.1944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.5288	5000																																																																																	0			18.813	1.960656935	5.278631871	0	4.116721783	5.745399503	0.445022177	2.391961976	4.113478332	12.08133882	2.156894941	0	0	5.423247675	3.742130492	10.51189004	3.49466168	4.767124058	0	0	3.292254028	0	0	0	0.1944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.5288
H4917_002_0	2009	10																					4000											D	D	D		T	Coin	Coin	V	V		Coin		Coin	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		2005.414562	210.0939795	2068.483177		711.39092	26.47559719	2.050723867	882.9766859	299.2970251		13.01571179		0	5082.930898	5445.554509	5154.233093	966.2331218	1647.567627			18.96395356				282																$100 Days 1-7	$300 Days 1-5	"$50 days 11-20, $124 days 21-100"		$50 waived if admitted	25%	25%	"$50 ER, $30 UC / waived if admitted"	"$100 Surgery, $75 ASC"		"$10 to $100, 20% varies by service"		20%	$0 to $50 varies by service	$10 / $0 for preventive	$30 / $0 for preventive	$50 	$30 			20%				10																75.12131465	129.0133908	35.27899214		40	0.25	0.25	36.1	87.5		0.190909091		0.2	13	9.5	24.16666667	50	30			0.2				10																66.85797004	114.8219178	31.398303		35.6	0.2225	0.2225	32.129	77.875		0.169909091		0.178	11.57	8.455	21.50833333	44.5	26.7			0.178				8.9																11.1732	2.010282803	5.412238463	0	2.110459729	5.890820375	0.45628606	2.364096495	1.942312986	0	2.211487758	0	0	4.900792541	3.836846948	9.238246954	3.583114494	3.66583797	0	0	3.375583734	0	0	0	0.20915	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3807		7.71	11.1732	2.010282803	5.412238463	0	2.110459729	5.890820375	0.45628606	2.364096495	1.942312986	0	2.211487758	0	0	4.900792541	3.836846948	9.238246954	3.583114494	3.66583797	0	0	3.375583734	0	0	0	0.20915	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3807	4000																																																																																	0			11.1732	2.010282803	5.412238463	0	2.110459729	5.890820375	0.45628606	2.364096495	1.942312986	0	2.211487758	0	0	4.900792541	3.836846948	9.238246954	3.583114494	3.66583797	0	0	3.375583734	0	0	0	0.20915	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3807
H4956_001_0	2009	5	r.	s.	t.	u.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered							4000											D	D	D	V	T	Coin	Coin	V	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							0		1492.505827	66.454302	520.905936	744.492599	148.080273	10.333338	3.731709	334.946465	363.071161	641.901086	952.71932	0	19.840968	728.822323	3567.069398	4299.786912	29.331403	926.771789			23.355098								1.17	0.09	0.06	0.05	1.23	2.7							$195/Day(Days 1-5):1a	$195/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$175/Visit:9b. $0 Surgery ASC -- Physician,9b. $175 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $175 Surgery OP -- Facility"	"$0-$75/Visit:8a. $0 Lab -- FSL,8. $75 Lab -- OP"	"$0-$100/Visit:14h. $75 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $75 Radiology OP -- Facility"	$50/Visit:9a	"$0-$75/Proc:12. $0 Dialysis -- Dialysis Center,12. $75 Dialysis -- OP Hosp"	"$30-$100/Visit:9d. $75 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $75 OP Other,5. $30 Partial Hospitalization,8b. $75 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$75/Visit:7h. $75 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								Silver Sneakers	Meals on Wheels	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit							119.554885	99.659462	43.132793	0	99.999977	0.2	0.2	49.99999	175.000007	65.968051	68.319878	0	1.173329	60.069834	10	29.999999	67.976155	39.708636			0.2								0	0	0	0	0	0							102.344481	85.313084	36.923655	0	85.60458	0.171209	0.171209	42.802291	149.808056	56.471686	58.484958	0	1.004424	51.422541	8.56046	25.681379	58.190715	33.992419			0.171209								0	0	0	0	0	0							12.7291	0.472451787	1.602812589	0	1.056362465	1.769160466	0.638902166	1.194706339	4.532582068	3.020769714	4.643312451	0	0.001660729	3.123157982	2.544646242	9.202038109	0.142234609	2.625267914	0	0	3.998602973	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.2978	0	8.9626	12.7291	0.472451787	1.602812589	0	1.056362465	1.769160466	0.638902166	1.194706339	4.532582068	3.020769714	4.643312451	0	0.001660729	3.123157982	2.544646242	9.202038109	0.142234609	2.625267914	0	0	3.998602973	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.2978		$950/Admit:1a	$950/Admit:1b	"30% Coins(Days 1-20) 30%(Days 21-100):2. 30% SNF 1,2. 30% SNF 2"	30% Coins:6	$100/Trip:10a	40% Coins:11a	40% Coins:11b	$50/Visit:4a	"30% Coins:9b. 30% Surgery ASC -- Physician,9b. 30% Surgery ASC -- Facility,9a. 30% Surgery OP -- Physician,9a. 30% Surgery OP -- Facility"	"30% Coins:8a. 30% Lab -- FSL,8. 30% Lab -- OP"	"30% Coins:14h. 30% DMAM -- OP,8b. 30% Radiology -- FSR,14h. 30% SMAM -- FSR,14h. 30% SMAM -- OP,8b. 30% Advanced Imaging -- FSR,8b. 30% Advanced Imaging -- Office,9a. 30% Advanced Imaging -- OP,8a. 30% Radiology OP -- Physician,8a. 30% Radiology OP -- Facility"		"$0-$75/Proc:12. $0 Dialysis -- Dialysis Center,12. $75 Dialysis -- OP Hosp"	"30% Coins:9d. 30% Cardiac Rehab,8b. 30% Nuclear Medicine,9a. 30% OP Other,5. 30% Partial Hospitalization,8b. 30% Rad therapy,3. 30% Therapy (AT,PT,ST,OT) -- CORF"	30% Coins:7a	"30% Coins:7b, 7d, 7f"	"30% Coins:7h. 30% Psych -- OP,7e. 30% Psych -- Other Provider"	"30% Coins:9a. 30% Therapy (AT,PT,ST,OT) -- OP,7d. 30% Therapy (AT,PT,ST,OT) - Specialist"			30% Coins:15								Silver Sneakers	Meals on Wheels	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit							2.019	0.0651	0.4026	0.6107	0.7042	2.2433	0.8101	0.2108	2.9075	0.3746	1.558		0.0003	0.88	1.7644	4.0283	0.0255	0.3401			1.2024								0	0	0	0	0	0							20.1469	0	0	14.7482	0.537504787	2.005385589	0.610745	1.760604465	4.012411466	1.449014166	1.405536339	7.440070068	3.395321714	6.201272451	0	0.001953729	4.003148982	4.309052242	13.23038311	0.167692609	2.965412914	0	0	5.201028973	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.4447
H4956_002_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered							4000											D	D	D	V	T	Coin	Coin	V	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							0		1386.016056	61.712809	483.739479	691.373313	137.514798	8.911395	3.218198	311.048153	337.166159	596.101666	884.743126	0	18.425322	676.821105	3312.560239	3992.998612	27.238618	860.646943			20.141266								1.17	0.09	0.06	0.05	1.23	2.7							$195/Day(Days 1-5):1a	$195/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $150 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$75/Visit:8a. $0 Lab -- FSL,8. $75 Lab -- OP"	"$0-$100/Visit:14h. $75 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $75 Radiology OP -- Facility"	$50/Visit:9a	"$0-$75/Proc:12. $0 Dialysis -- Dialysis Center,12. $75 Dialysis -- OP Hosp"	"$30-$100/Visit:9d. $75 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $75 OP Other,5. $30 Partial Hospitalization,8b. $75 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$75/Visit:7h. $75 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								Silver Sneakers	Meals on Wheels	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit							119.554892	99.65944	43.132795	0	100.00003	0.2	0.2	50.000001	150	65.968049	68.319897	0	1.173602	60.069846	10	30.000001	67.976576	39.708645			0.2								0	0	0	0	0	0							102.166469	85.164672	36.859432	0	85.455726	0.170911	0.170911	42.72785	128.18355	56.373458	58.383246	0	1.00291	51.333107	8.54557	25.636711	58.089859	33.9333			0.170911								0	0	0	0	0	0							11.8004	0.437979261	1.485863536	0	0.979285575	1.523055431	0.550025438	1.107534902	3.601596267	2.800359353	4.304514631	0	0.001539912	2.895277517	2.358976283	8.53061262	0.13185729	2.433715909	0	0	3.442363913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.3849	0	8.235	11.8004	0.437979261	1.485863536	0	0.979285575	1.523055431	0.550025438	1.107534902	3.601596267	2.800359353	4.304514631	0	0.001539912	2.895277517	2.358976283	8.53061262	0.13185729	2.433715909	0	0	3.442363913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.3849	7000	$950/Admit:1a	$950/Admit:1b	"30% Coins(Days 1-20) 30%(Days 21-100):2. 30% SNF 1,2. 30% SNF 2"	30% Coins:6	$100/Trip:10a	40% Coins:11a	40% Coins:11b	$50/Visit:4a	"30% Coins:9b. 30% Surgery ASC -- Physician,9b. 30% Surgery ASC -- Facility,9a. 30% Surgery OP -- Physician,9a. 30% Surgery OP -- Facility"	"30% Coins:8a. 30% Lab -- FSL,8. 30% Lab -- OP"	"30% Coins:14h. 30% DMAM -- OP,8b. 30% Radiology -- FSR,14h. 30% SMAM -- FSR,14h. 30% SMAM -- OP,8b. 30% Advanced Imaging -- FSR,8b. 30% Advanced Imaging -- Office,9a. 30% Advanced Imaging -- OP,8a. 30% Radiology OP -- Physician,8a. 30% Radiology OP -- Facility"		"$0-$75/Proc:12. $0 Dialysis -- Dialysis Center,12. $75 Dialysis -- OP Hosp"	"30% Coins:9d. 30% Cardiac Rehab,8b. 30% Nuclear Medicine,9a. 30% OP Other,5. 30% Partial Hospitalization,8b. 30% Rad therapy,3. 30% Therapy (AT,PT,ST,OT) -- CORF"	30% Coins:7a	"30% Coins:7b, 7d, 7f"	"30% Coins:7h. 30% Psych -- OP,7e. 30% Psych -- Other Provider"	"30% Coins:9a. 30% Therapy (AT,PT,ST,OT) -- OP,7d. 30% Therapy (AT,PT,ST,OT) - Specialist"			30% Coins:15								Silver Sneakers	Meals on Wheels	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit							1.8717	0.0603	0.3466	0.5258	0.6529	1.9312	0.6974	0.1954	2.503	0.3224	1.3412		0.0003	0.7576	1.519	3.468	0.0219	0.2928			1.0352								0	0	0	0	0	0							17.5427	0	2.985713681	13.6721	0.498285261	1.832435536	0.525786	1.632142575	3.454254431	1.247444438	1.302981902	6.104631267	3.122807353	5.645749631	0	0.001811912	3.652856517	3.877940283	11.99858562	0.15377429	2.726543909	0	0	4.477523913	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.9276
H4956_801_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		248.997774	8.022665	483.739479	691.373313	4.515294	8.911395	3.218198	19.812665	50.928677	596.101666	27.538031	0	0.347492	15.688326	29.554715	67.476876	0.426433	5.697591			20.141266																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999997	1024.000378	43.132795	0	0.2	0.2	0.2	0.2	0.199999	0	0.199999	0	0.199998	0.199999	0.2	0.199999	0.500001	0.199999			0.2																				1023.999997	1024.000378	43.132795	0	0.2	0.2	0.2	0.2	0.199999	0	0.199999	0	0.199998	0.199999	0.2	0.199999	0.500001	0.199999			0.2																				21.2478	0.684600999	1.738752982	0	0.9030588	1.782279	0.6436396	3.962533	10.18568447	0	5.507578662	0	0.069497705	3.137649512	5.910943	13.49530772	0.213216926	1.139512502	0	0	4.0282532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6503	0	0	21.2478	0.684600999	1.738752982	0	0.9030588	1.782279	0.6436396	3.962533	10.18568447	0	5.507578662	0	0.069497705	3.137649512	5.910943	13.49530772	0.213216926	1.139512502	0	0	4.0282532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6503		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3609	0.0761	0.1932		0.5725	1.1299	0.4081	0.7464	1.9527		1.0463		0.0131	0.591	1.185	2.7055	0.0427	0.2284			0.8076																				14.0594	0	0	23.6087	0.760667999	1.931947982	0	1.4755858	2.912221	1.0516986	4.708916	12.13838047	0	6.553918662	0	0.082588705	3.728659512	7.095935	16.20078272	0.255961926	1.367956502	0	0	4.8358142	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.7097
H4956_802_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		248.997774	8.022665	483.739479	691.373313	4.515294	8.911395	3.218198	19.812665	50.928677	596.101666	27.538031	0	0.347492	15.688326	29.554715	67.476876	0.426433	5.697591			20.141266																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999997	1024.000378	43.132795	0	0.2	0.2	0.2	0.2	0.199999	0	0.199999	0	0.199998	0.199999	0.2	0.199999	0.500001	0.199999			0.2																				1023.999997	1024.000378	43.132795	0	0.2	0.2	0.2	0.2	0.199999	0	0.199999	0	0.199998	0.199999	0.2	0.199999	0.500001	0.199999			0.2																				21.2478	0.684600999	1.738752982	0	0.9030588	1.782279	0.6436396	3.962533	10.18568447	0	5.507578662	0	0.069497705	3.137649512	5.910943	13.49530772	0.213216926	1.139512502	0	0	4.0282532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6503	0	0	21.2478	0.684600999	1.738752982	0	0.9030588	1.782279	0.6436396	3.962533	10.18568447	0	5.507578662	0	0.069497705	3.137649512	5.910943	13.49530772	0.213216926	1.139512502	0	0	4.0282532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6503		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3609	0.0761	0.1932		0.5725	1.1299	0.4081	0.7464	1.9527		1.0463		0.0131	0.591	1.185	2.7055	0.0427	0.2284			0.8076																				14.0594	0	0	23.6087	0.760667999	1.931947982	0	1.4755858	2.912221	1.0516986	4.708916	12.13838047	0	6.553918662	0	0.082588705	3.728659512	7.095935	16.20078272	0.255961926	1.367956502	0	0	4.8358142	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.7097
H4956_803_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		248.997774	8.022665	483.739479	691.373313	4.515294	8.911395	3.218198	19.812665	50.928677	596.101666	27.538031	0	0.347492	15.688326	29.554715	67.476876	0.426433	5.697591			20.141266																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999997	1024.000378	43.132795	0	0.2	0.2	0.2	0.2	0.199999	0	0.199999	0	0.199998	0.199999	0.2	0.199999	0.500001	0.199999			0.2																				1023.999997	1024.000378	43.132795	0	0.2	0.2	0.2	0.2	0.199999	0	0.199999	0	0.199998	0.199999	0.2	0.199999	0.500001	0.199999			0.2																				21.2478	0.684600999	1.738752982	0	0.9030588	1.782279	0.6436396	3.962533	10.18568447	0	5.507578662	0	0.069497705	3.137649512	5.910943	13.49530772	0.213216926	1.139512502	0	0	4.0282532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6503	0	0	21.2478	0.684600999	1.738752982	0	0.9030588	1.782279	0.6436396	3.962533	10.18568447	0	5.507578662	0	0.069497705	3.137649512	5.910943	13.49530772	0.213216926	1.139512502	0	0	4.0282532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6503		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3609	0.0761	0.1932		0.5725	1.1299	0.4081	0.7464	1.9527		1.0463		0.0131	0.591	1.185	2.7055	0.0427	0.2284			0.8076																				14.0594	0	0	23.6087	0.760667999	1.931947982	0	1.4755858	2.912221	1.0516986	4.708916	12.13838047	0	6.553918662	0	0.082588705	3.728659512	7.095935	16.20078272	0.255961926	1.367956502	0	0	4.8358142	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.7097
H4956_804_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		248.997774	8.022665	483.739479	691.373313	4.515294	8.911395	3.218198	19.812665	50.928677	596.101666	27.538031	0	0.347492	15.688326	29.554715	67.476876	0.426433	5.697591			20.141266																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999997	1024.000378	43.132795	0	0.2	0.2	0.2	0.2	0.199999	0	0.199999	0	0.199998	0.199999	0.2	0.199999	0.500001	0.199999			0.2																				1023.999997	1024.000378	43.132795	0	0.2	0.2	0.2	0.2	0.199999	0	0.199999	0	0.199998	0.199999	0.2	0.199999	0.500001	0.199999			0.2																				21.2478	0.684600999	1.738752982	0	0.9030588	1.782279	0.6436396	3.962533	10.18568447	0	5.507578662	0	0.069497705	3.137649512	5.910943	13.49530772	0.213216926	1.139512502	0	0	4.0282532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6503	0	0	21.2478	0.684600999	1.738752982	0	0.9030588	1.782279	0.6436396	3.962533	10.18568447	0	5.507578662	0	0.069497705	3.137649512	5.910943	13.49530772	0.213216926	1.139512502	0	0	4.0282532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6503		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3609	0.0761	0.1932		0.5725	1.1299	0.4081	0.7464	1.9527		1.0463		0.0131	0.591	1.185	2.7055	0.0427	0.2284			0.8076																				14.0594	0	0	23.6087	0.760667999	1.931947982	0	1.4755858	2.912221	1.0516986	4.708916	12.13838047	0	6.553918662	0	0.082588705	3.728659512	7.095935	16.20078272	0.255961926	1.367956502	0	0	4.8358142	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.7097
H4971_001_0	2009	5																					3700											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1546.533066	159.1792704	658.8874283	698.735172	105.4558651	10.7057346	3.954420407	299.9072842	32.52258749	9339.227905	37.84842241	0	0.196996951	24.60881627	4386.826583	3451.935355	543.4790206	195.4862558	0	0	15.22582832	749.2942728	0	0	103.5923094	0	12.88706159	0	453.6	0											"$125 Days 1-30 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$125 Days 1-30 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-28 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$5 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											123.5585015	125	79.9192485	0	150	0.2	0.076056143	49.51691722	0.2	2.8	0.1740709	0	0.2	0.196833706	3.583836509	20	37.5	20	0	0	0.2	19.0421597	0	0	20	0	20	0	0	0											94.9326333	96.02520142	61.39409548	0	115.2302417	0.153640322	0.058426452	38.03897559	0.153640322	2.150964512	0.133721546	0	0.153640322	0.151421208	3.583836509	20	37.5	15.36403223	0	0	0.153640322	19.0421597	0	0	20	0	20	0	0	0											12.2347	1.273768459	3.37098314	0	1.012642069	1.644832514	0.231042753	0.950680489	4.996780822	1.674028983	5.061149565	0	0.030266675	3.726296676	1.310139105	5.753225591	1.698371939	0.250288095	0	0	2.33930117	1.1890151	0	0	0.172653849	0	0.021478436	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9417	0	11.6973	12.2347	1.273768459	3.37098314	0	1.012642069	1.644832514	0.231042753	0.950680489	4.996780822	1.674028983	5.061149565	0	0.030266675	3.726296676	1.310139105	5.753225591	1.698371939	0.250288095	0	0	2.33930117	1.1890151	0	0	0.172653849	0	0.021478436	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9417		"$225 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$225 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											3.9755	0.4054	5.4843	0.608	0.4394	1.0706	0.3954	0.4125	3.2523	0.7264	3.2328	0	0.0131	2.419	2.59	3.6985	0.8249	0.2094	0	0	1.9576	0.7821	0	0	0.111	0	0.0138	0	0	0											32.622	0	0	16.2102	1.679149092	8.855300359	0.60798424	1.452041507	2.715405974	0.626484793	1.363193938	8.249039571	2.400413375	8.293939775	0	0.043399805	6.145319483	3.90010014	9.451727757	2.523295453	0.459737654	0	0	4.296907669	1.971159755	0	0	0.283645609	0	0.035286002	0	0	0	0	0	0	0	0	0	0	0	0	0	81.5637
H4971_801_0	2009	2																					4750											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	4750	1623.859719	167.1382339	691.8317997	733.6719306	110.7286584	11.24102133	4.152141428	314.8828489	34.14871686	9806.1893	39.74084353	0	0.206846799	25.83925709	4601.259134	3617.248038	570.6529716	205.2605686	0	0	15.98711974	786.7589865	0	0	0	0	0	0	0	0											"$400 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$400 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											395.2468012	400	150	0	150	0.2	0.076056143	49.51688684	0.3	2.8	0.246514502	0	0.2	0.294774438	17.93829933	30	37.5	30	0	0	0.2	28.55411299	0	0	0	0	0	0	0	0											255.0907766	258.1355664	96.80083738	0	96.80083738	0.129067783	0.049081989	31.95517407	0.193601675	1.806948964	0.159085401	0	0.129067783	0.190555679	17.93829933	30	37.5	19.36016748	0	0	0.129067783	28.55411299	0	0	0	0	0	0	0	0											34.5193	3.595360223	5.580824795	0	0.893218905	1.450853703	0.203795359	0.838511354	6.611248775	1.476606967	6.322188037	0	0.026697258	4.923817167	6.878230303	9.043120096	1.783290536	0.331156582	0	0	2.063422104	1.872100416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.4137	0	37.8132	34.5193	3.595360223	5.580824795	0	0.893218905	1.450853703	0.203795359	0.838511354	6.611248775	1.476606967	6.322188037	0	0.026697258	4.923817167	6.878230303	9.043120096	1.783290536	0.331156582	0	0	2.063422104	1.872100416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.4137		"$425 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$425 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											4.8373	0.4964	3.5456	0.3926	0.2837	0.6913	0.2554	0.2664	2.1001	0.4691	2.0875	0	0.0085	1.5655	3.1786	3.8756	0.8662	0.1353	0	0	1.2641	0.814	0	0	0	0	0	0	0	0											27.1331	0	11.61921475	39.3566	4.091781896	9.126410119	0.392599993	1.176956878	2.14216625	0.459148265	1.104871046	8.711363677	1.945662723	8.409731317	0	0.035177851	6.489335282	10.05680864	12.91874299	2.649460225	0.466406627	0	0	3.327527729	2.686066723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.5468
H4971_802_0	2009	2																					4750											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	4750	1623.859719	167.1382339	691.8317997	733.6719306	110.7286584	11.24102133	4.152141428	314.9575159	34.14871686	9806.1893	39.74084353	0	0.206846799	25.83925709	4666.439139	3617.248038	570.6529716	205.2605686	0	0	15.98711974	786.7589865	0	0	0	0	0	0	0	0											"$400 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$400 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											395.2468012	400	150	0	150	0.2	0.076056143	49.51700137	0.3	2.8	0.246514502	0	0.2	0.294774438	17.68774031	30	37.5	30	0	0	0.2	28.55411299	0	0	0	0	0	0	0	0											255.0360785	258.0802015	96.78007557	0	96.78007557	0.129040101	0.049071462	31.94839423	0.193560151	1.806561411	0.159051281	0	0.129040101	0.190515006	17.68774031	30	37.5	19.35601511	0	0	0.129040101	28.55411299	0	0	0	0	0	0	0	0											34.5119	3.594589091	5.579627821	0	0.893027327	1.450542525	0.203751649	0.83853224	6.609830796	1.476290265	6.320832056	0	0.026691532	4.922766207	6.878230303	9.043120096	1.783290536	0.331085556	0	0	2.062979542	1.872100416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.3992	0	37.828	34.5119	3.594589091	5.579627821	0	0.893027327	1.450542525	0.203751649	0.83853224	6.609830796	1.476290265	6.320832056	0	0.026691532	4.922766207	6.878230303	9.043120096	1.783290536	0.331085556	0	0	2.062979542	1.872100416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.3992		"$425 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$425 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											4.8373	0.4964	3.5456	0.3926	0.2837	0.6913	0.2554	0.2664	2.1001	0.4691	2.0876	0	0.0085	1.5655	3.2144	3.8756	0.8662	0.1353	0	0	1.2641	0.814	0	0	0	0	0	0	0	0											27.1691	0	11.64147045	39.3493	4.091015846	9.125249445	0.392604012	1.176768206	2.141862149	0.45910717	1.104958437	8.709967199	1.945350823	8.408396708	0	0.035172211	6.488300257	10.09260164	12.91874299	2.649460225	0.466336985	0	0	3.327098109	2.686066842	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.5683
H4971_803_0	2009	2																					4750											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	4750	1623.859719	167.1382339	691.8317997	733.6719306	110.7286584	11.24102133	4.152141428	314.8828489	34.14871686	9806.1893	39.74084353	0	0.206846799	25.83925709	4601.259134	3617.248038	570.6529716	205.2605686	0	0	15.98711974	786.7589865	0	0	0	0	0	0	0	0											"$400 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$400 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											395.2468012	400	150	0	150	0.2	0.076056143	49.51688684	0.3	2.8	0.246514502	0	0.2	0.294774438	17.93829933	30	37.5	30	0	0	0.2	28.55411299	0	0	0	0	0	0	0	0											255.0907766	258.1355664	96.80083738	0	96.80083738	0.129067783	0.049081989	31.95517407	0.193601675	1.806948964	0.159085401	0	0.129067783	0.190555679	17.93829933	30	37.5	19.36016748	0	0	0.129067783	28.55411299	0	0	0	0	0	0	0	0											34.5193	3.595360223	5.580824795	0	0.893218905	1.450853703	0.203795359	0.838511354	6.611248775	1.476606967	6.322188037	0	0.026697258	4.923817167	6.878230303	9.043120096	1.783290536	0.331156582	0	0	2.063422104	1.872100416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.4137	0	37.8132	34.5193	3.595360223	5.580824795	0	0.893218905	1.450853703	0.203795359	0.838511354	6.611248775	1.476606967	6.322188037	0	0.026697258	4.923817167	6.878230303	9.043120096	1.783290536	0.331156582	0	0	2.063422104	1.872100416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.4137		"$425 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$425 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											4.8373	0.4964	3.5456	0.3926	0.2837	0.6913	0.2554	0.2664	2.1001	0.4691	2.0875	0	0.0085	1.5655	3.1786	3.8756	0.8662	0.1353	0	0	1.2641	0.814	0	0	0	0	0	0	0	0											27.1331	0	11.61921475	39.3566	4.091781896	9.126410119	0.392599993	1.176956878	2.14216625	0.459148265	1.104871046	8.711363677	1.945662723	8.409731317	0	0.035177851	6.489335282	10.05680864	12.91874299	2.649460225	0.466406627	0	0	3.327527729	2.686066723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.5468
H4971_804_0	2009	2																					4750											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	4750	1623.859719	167.1382339	691.8317997	733.6719306	110.7286584	11.24102133	4.152141428	314.9575159	34.14871686	9806.1893	39.74084353	0	0.206846799	25.83925709	4666.439139	3617.248038	570.6529716	205.2605686	0	0	15.98711974	786.7589865	0	0	0	0	0	0	0	0											"$400 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$400 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											395.2468012	400	150	0	150	0.2	0.076056143	49.51700137	0.3	2.8	0.246514502	0	0.2	0.294774438	17.68774031	30	37.5	30	0	0	0.2	28.55411299	0	0	0	0	0	0	0	0											255.0360785	258.0802015	96.78007557	0	96.78007557	0.129040101	0.049071462	31.94839423	0.193560151	1.806561411	0.159051281	0	0.129040101	0.190515006	17.68774031	30	37.5	19.35601511	0	0	0.129040101	28.55411299	0	0	0	0	0	0	0	0											34.5119	3.594589091	5.579627821	0	0.893027327	1.450542525	0.203751649	0.83853224	6.609830796	1.476290265	6.320832056	0	0.026691532	4.922766207	6.878230303	9.043120096	1.783290536	0.331085556	0	0	2.062979542	1.872100416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.3992	0	37.828	34.5119	3.594589091	5.579627821	0	0.893027327	1.450542525	0.203751649	0.83853224	6.609830796	1.476290265	6.320832056	0	0.026691532	4.922766207	6.878230303	9.043120096	1.783290536	0.331085556	0	0	2.062979542	1.872100416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.3992		"$425 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$425 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											4.8373	0.4964	3.5456	0.3926	0.2837	0.6913	0.2554	0.2664	2.1001	0.4691	2.0876	0	0.0085	1.5655	3.2144	3.8756	0.8662	0.1353	0	0	1.2641	0.814	0	0	0	0	0	0	0	0											27.1691	0	11.64147045	39.3493	4.091015846	9.125249445	0.392604012	1.176768206	2.141862149	0.45910717	1.104958437	8.709967199	1.945350823	8.408396708	0	0.035172211	6.488300257	10.09260164	12.91874299	2.649460225	0.466336985	0	0	3.327098109	2.686066842	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.5683
H4979_001_1	2009	4																					5000											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	V	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	780.2489618	30.00526438	225.4555625	11.52423342	138.5708733	18.72355441	4.275074573	241.6164049	479.8172556	9.173243917	19.86005602	0	8.897675973	1054.192051	3549.164289	5245.040138	246.3772718	194.3632946	25.4101464	25.86280753	5.455677419	0	0	0	0	0	0	0	0	0											1a:  Acute - $215/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $215/$0/day for 1-5/6-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - $0/$150/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$150/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $200/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $250/visit/9b:  Ambulatory Surgical Center Services - $250/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 20.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 20.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $20/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $30/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $30/day	7a:  Primary Care - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $30/visit/7f:  Podiatry Services - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $30/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $30/visit/7h:  Psychiatric Services - Individual - $30/visit/7h:  Psychiatric Services - Group - $30/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $30/visit/9c:  Outpatient Substance Abuse Svcs - Group - $30/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service/15:  Medicare Chemo - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	$0 	$0 	$0 	$0 	/14c:  Routine Exams - $0/visit	$0 											215	215	150	0	200	0.2	0.052447212	51.17527204	250	0	0.148747907	0	20	30	29.99628048	29.95518721	30	30	0	30	0.04	0	0	0	0	0	0	0	0	0											198.4678561	198.4678561	138.4659461	0	184.6212615	0.184621262	0.048414352	47.24021642	230.7765769	0	0.137310131	0	18.46212615	27.69318923	27.68975572	27.65182226	27.69318923	27.69318923	0	27.69318923	0.036924252	0	0	0	0	0	0	0	0	0											12.9045	0.496256708	2.601493148	0	2.131927454	3.456766236	0.206974965	0.951167605	9.22754865	0	2.726986904	0	0.013689168	2.43282833	8.189624347	12.08624314	0.568581034	0.448544958	0	0.059685302	0.20144681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.7043	0	4.89	12.9045	0.496256708	2.601493148	0	2.131927454	3.456766236	0.206974965	0.951167605	9.22754865	0	2.726986904	0	0.013689168	2.43282833	8.189624347	12.08624314	0.568581034	0.448544958	0	0.059685302	0.20144681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.7043	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	12.9045	0.496256708	2.601493148	0	2.131927454	3.456766236	0.206974965	0.951167605	9.22754865	0	2.726986904	0	0.013689168	2.43282833	8.189624347	12.08624314	0.568581034	0.448544958	0	0.059685302	0.20144681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.7043
H4979_001_2	2009	3																					5000											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	V	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	834.2045366	32.08018068	258.1437052	12.34035856	178.1593429	23.12548707	5.280150317	308.3034092	504.8601573	10.79364558	22.7931723	0	9.30098293	1102.227319	3810.572529	5588.134164	257.5448697	203.1732433	24.37812243	27.03509682	6.43245594	0	0	0	0	0	0	0	0	0											1a:  Acute - $215/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $215/$0/day for 1-5/6-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - $0/$150/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$150/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $200/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $250/visit/9b:  Ambulatory Surgical Center Services - $250/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 20.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 20.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $20/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $30/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $30/day	7a:  Primary Care - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $30/visit/7f:  Podiatry Services - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $30/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $30/visit/7h:  Psychiatric Services - Individual - $30/visit/7h:  Psychiatric Services - Group - $30/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $30/visit/9c:  Outpatient Substance Abuse Svcs - Group - $30/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service/15:  Medicare Chemo - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	$0 	$0 	$0 	$0 	/14c:  Routine Exams - $0/visit	$0 											215	215	150	0	200	0.2	0.052447212	51.02364894	250	0	0.148747907	0	20	30	29.99617906	29.95170093	30	30	0	30	0.04	0	0	0	0	0	0	0	0	0											195.8673615	195.8673615	136.6516476	0	182.2021967	0.182202197	0.047779986	46.48310461	227.7527459	0	0.135510977	0	18.22021967	27.33032951	27.3268486	27.28632853	27.33032951	27.33032951	0	27.33032951	0.036440439	0	0	0	0	0	0	0	0	0											13.6161	0.523621696	2.939646885	0	2.705085304	4.213514546	0.252285508	1.194241635	9.581940595	0	3.088725055	0	0.014122163	2.510352985	8.677578215	12.70663872	0.586565513	0.462732641	0	0.061573175	0.234401521	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.3691	0	6.19	13.6161	0.523621696	2.939646885	0	2.705085304	4.213514546	0.252285508	1.194241635	9.581940595	0	3.088725055	0	0.014122163	2.510352985	8.677578215	12.70663872	0.586565513	0.462732641	0	0.061573175	0.234401521	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.3691	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	13.6161	0.523621696	2.939646885	0	2.705085304	4.213514546	0.252285508	1.194241635	9.581940595	0	3.088725055	0	0.014122163	2.510352985	8.677578215	12.70663872	0.586565513	0.462732641	0	0.061573175	0.234401521	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.3691
H4979_002_1	2009	3																					4000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	V	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	285.4919876	7.683194102	250.1122481	12.49750118	167.6601229	21.81824557	4.981673074	274.8363616	538.2040424	9.769692838	22.23827974	0	9.92490388	1122.675689	4047.979541	5977.464305	281.0672228	221.7296711	27.61953179	29.50429411	5.772651424	0	0	742.1107422	293.6889256	0	59.86061807	0	0	0											1a:  Acute - $250/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $250/$0/admit for 1-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - $0/$75/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 20.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 20.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $10/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $20/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $20/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $20/visit/7h:  Psychiatric Services - Individual - $20/visit/7h:  Psychiatric Services - Group - $20/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $20/visit/9c:  Outpatient Substance Abuse Svcs - Group - $20/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service/15:  Medicare Chemo - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $20/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $20/visit/18a:  Fitting for Hearing Aid - $20/visit	18b:  Hearing Aids - $0/service	/14c:  Routine Exams - $0/visit	$0 											250	250	75	0	100	0.2	0.052447212	51.16145553	100	0	0.08686768	0	10	20	19.99888056	20	20	20	0	20	0.04	0	0	0	20	0	20	0	0	0											235.2082034	235.2082034	70.56246103	0	94.08328137	0.188166563	0.049344058	48.13437615	94.08328137	0	0.081727964	0	9.408328137	18.81665627	18.81560307	18.81665627	18.81665627	18.81665627	0	18.81665627	0.037633313	0	0	0	18.81665627	0	18.81665627	0	0	0											5.5958	0.150595857	1.470711313	0	1.31450121	4.105464274	0.245815964	1.102423068	4.219666863	0	1.817489324	0	0.007781396	1.760416879	6.347098023	9.372990934	0.440728777	0.347684251	0	0.046264347	0.217243995	0	0	0	0.460520297	0	0.093864723	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1171	0	2.46	5.5958	0.150595857	1.470711313	0	1.31450121	4.105464274	0.245815964	1.102423068	4.219666863	0	1.817489324	0	0.007781396	1.760416879	6.347098023	9.372990934	0.440728777	0.347684251	0	0.046264347	0.217243995	0	0	0	0.460520297	0	0.093864723	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1171	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	5.5958	0.150595857	1.470711313	0	1.31450121	4.105464274	0.245815964	1.102423068	4.219666863	0	1.817489324	0	0.007781396	1.760416879	6.347098023	9.372990934	0.440728777	0.347684251	0	0.046264347	0.217243995	0	0	0	0.460520297	0	0.093864723	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1171
H4979_002_2	2009	3																					4000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	V	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	284.7024954	7.661947192	260.4408859	12.14933815	180.8099891	23.89255235	5.455291276	322.8572451	561.4339816	10.98131488	23.40848766	0	10.3282703	1222.637581	4156.964806	6162.281568	292.4903138	230.7411744	26.49767265	30.70340311	6.770556179	0	0	754.7762993	301.5927545	0	61.4716018	0	0	0											1a:  Acute - $250/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $250/$0/admit for 1-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - $0/$75/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 20.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 20.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $10/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $20/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $20/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $20/visit/7h:  Psychiatric Services - Individual - $20/visit/7h:  Psychiatric Services - Group - $20/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $20/visit/9c:  Outpatient Substance Abuse Svcs - Group - $20/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service/15:  Medicare Chemo - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $20/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $20/visit/18a:  Fitting for Hearing Aid - $20/visit	18b:  Hearing Aids - $0/service	/14c:  Routine Exams - $0/visit	$0 											250	250	75	0	100	0.2	0.052447212	51.02346667	100	0	0.08686768	0	10	20	19.99879141	20	20	20	0	20	0.04	0	0	0	20	0	20	0	0	0											233.9930738	233.9930738	70.19792214	0	93.59722952	0.187194459	0.049089137	47.75655121	93.59722952	0	0.081305742	0	9.359722952	18.7194459	18.7183147	18.7194459	18.7194459	18.7194459	0	18.7194459	0.037438892	0	0	0	18.7194459	0	18.7194459	0	0	0											5.5515	0.149403548	1.523534086	0	1.410276171	4.472553413	0.267795542	1.284879047	4.379055437	0	1.903244457	0	0.008055812	1.907258172	6.484281285	9.612874705	0.456271384	0.359945578	0	0.047895891	0.25348212	0	0	0	0.470470771	0	0.09589286	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6387	0	2.78	5.5515	0.149403548	1.523534086	0	1.410276171	4.472553413	0.267795542	1.284879047	4.379055437	0	1.903244457	0	0.008055812	1.907258172	6.484281285	9.612874705	0.456271384	0.359945578	0	0.047895891	0.25348212	0	0	0	0.470470771	0	0.09589286	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6387	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	5.5515	0.149403548	1.523534086	0	1.410276171	4.472553413	0.267795542	1.284879047	4.379055437	0	1.903244457	0	0.008055812	1.907258172	6.484281285	9.612874705	0.456271384	0.359945578	0	0.047895891	0.25348212	0	0	0	0.470470771	0	0.09589286	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6387
H4979_003_1	2009	3																					2500											coin	coin	coin	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	275.831907	5.067962883	28.20952186	16.34742726	220.8631309	30.32063713	6.594830925	362.9504869	69.05538627	12.91387255	29.54203476	0	0.274071645	1506.272685	5678.997442	8389.187744	397.0282339	313.2095548	36.94824497	41.67699693	7.613098612	0	0	871.5458629	412.3889882	0	84.05444523	0	0	0											1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - 0/admit for 1-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - 0/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 10.0%	11b:  Prosthetics Devices - 10.0%/11b:  Medical Supplies - 10.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 20.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 20.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $10/visit/3:  Rehab Services (CORF) - $10/day/5:  Partial Hospitalization - $10/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $10/visit/7b:  Chiropractic Services - $10/visit/7f:  Podiatry Services - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $10/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $10/visit/7h:  Psychiatric Services - Individual - $10/visit/7h:  Psychiatric Services - Group - $10/visit	7c:  Occupational Therapy Services - $10/visit/7i:  Physical/Speech Therapy - $10/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $10/visit/9c:  Outpatient Substance Abuse Svcs - Group - $10/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service/15:  Medicare Chemo - 10.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $10/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $10/visit/18a:  Fitting for Hearing Aid - $10/visit	18b:  Hearing Aids - $0/service	/14c:  Routine Exams - $0/visit	$0 											0	0	0	0	100	0.1	0.026628671	51.15959886	0	0	0.012493726	0	0	10	10	10	10	10	0	10	0.02	0	0	0	10	0	10	0	0	0											0	0	0	0	95.64722328	0.095647223	0.025469585	48.93273575	0	0	0.011949902	0	0	9.564722328	9.564722328	9.564722328	9.564722328	9.564722328	0	9.564722328	0.019129445	0	0	0	9.564722328	0	9.564722328	0	0	0											0	0	0	0	1.7604121	2.900084749	0.167967605	1.480013355	0	0	0.353024433	0	0	1.200589998	4.526502803	6.686687611	0.316455401	0.249646869	0	0.033219075	0.145634349	0	0	0	0.328698847	0	0.066996452	0	0	0	0	0	0	0	0	0	0	0	0	0	20.2159	0	0.92	0	0	0	0	1.7604121	2.900084749	0.167967605	1.480013355	0	0	0.353024433	0	0	1.200589998	4.526502803	6.686687611	0.316455401	0.249646869	0	0.033219075	0.145634349	0	0	0	0.328698847	0	0.066996452	0	0	0	0	0	0	0	0	0	0	0	0	0	20.2159	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	1.7604121	2.900084749	0.167967605	1.480013355	0	0	0.353024433	0	0	1.200589998	4.526502803	6.686687611	0.316455401	0.249646869	0	0.033219075	0.145634349	0	0	0	0.328698847	0	0.066996452	0	0	0	0	0	0	0	0	0	0	0	0	0	20.2159
H4979_003_2	2009	3																					2500											coin	coin	coin	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	258.1906129	4.743832784	26.22811687	14.91545857	225.4444766	30.89418295	6.719578888	399.5614498	67.74137283	13.83432097	28.6507777	0	0.26285034	1592.19855	5515.644861	8179.764946	390.727591	308.2390732	34.03822944	41.01560348	8.651190475	0	0	850.970116	400.5226924	0	81.6358188	0	0	0											1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - 0/admit for 1-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - 0/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 10.0%	11b:  Prosthetics Devices - 10.0%/11b:  Medical Supplies - 10.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 20.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 20.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $10/visit/3:  Rehab Services (CORF) - $10/day/5:  Partial Hospitalization - $10/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $10/visit/7b:  Chiropractic Services - $10/visit/7f:  Podiatry Services - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $10/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $10/visit/7h:  Psychiatric Services - Individual - $10/visit/7h:  Psychiatric Services - Group - $10/visit	7c:  Occupational Therapy Services - $10/visit/7i:  Physical/Speech Therapy - $10/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $10/visit/9c:  Outpatient Substance Abuse Svcs - Group - $10/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service/15:  Medicare Chemo - 10.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $10/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $10/visit/18a:  Fitting for Hearing Aid - $10/visit	18b:  Hearing Aids - $0/service	/14c:  Routine Exams - $0/visit	$0 											0	0	0	0	100	0.1	0.026628671	51.01959277	0	0	0.012493726	0	0	10	10	10	10	10	0	10	0.02	0	0	0	10	0	10	0	0	0											0	0	0	0	95.69433514	0.095694335	0.02548213	48.8228601	0	0	0.011955788	0	0	9.569433514	9.569433514	9.569433514	9.569433514	9.569433514	0	9.569433514	0.019138867	0	0	0	9.569433514	0	9.569433514	0	0	0											0	0	0	0	1.797813275	2.956398297	0.171229183	1.625644397	0	0	0.342542638	0	0	1.269703181	4.398466399	6.522976401	0.311586809	0.24580611	0	0.032708008	0.165573984	0	0	0	0.31939794	0	0.065100712	0	0	0	0	0	0	0	0	0	0	0	0	0	20.2249	0	0.91	0	0	0	0	1.797813275	2.956398297	0.171229183	1.625644397	0	0	0.342542638	0	0	1.269703181	4.398466399	6.522976401	0.311586809	0.24580611	0	0.032708008	0.165573984	0	0	0	0.31939794	0	0.065100712	0	0	0	0	0	0	0	0	0	0	0	0	0	20.2249	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	1.797813275	2.956398297	0.171229183	1.625644397	0	0	0.342542638	0	0	1.269703181	4.398466399	6.522976401	0.311586809	0.24580611	0	0.032708008	0.165573984	0	0	0	0.31939794	0	0.065100712	0	0	0	0	0	0	0	0	0	0	0	0	0	20.2249
H4979_801_0	2009	6																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	274.9550509	2.990820999	50.26837482	45.3052884	8.028064731	16.14809418	4.578456775	9.684264038	37.05684497	5.180478666	20.61749963	0	0.210193664	24.69738377	37.00285593	107.0343264	1.080424199	5.118115481	25.45266524	16791.12295	6.800375965	0.729945318	0.000001	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0.077608694	0.077608694	0.207741903	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.41680668	0.231	0.231	0	0	0	0	0	0	0	0											0.077608694	0.077608694	0.207741903	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.41680668	0.231	0.231	0	0	0	0	0	0	0	0											21.3389	0.232113713	10.44284783	0	1.854482953	3.730209755	1.057623515	2.237064993	8.560131189	1.196690572	4.762642414	0	0.048554736	5.70509565	8.54765972	24.72492941	0.24957799	1.182284676	5.87956567	7.579522248	1.570886848	0.168617368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.0694	0	0	21.3389	0.232113713	10.44284783	0	1.854482953	3.730209755	1.057623515	2.237064993	8.560131189	1.196690572	4.762642414	0	0.048554736	5.70509565	8.54765972	24.72492941	0.24957799	1.182284676	5.87956567	7.579522248	1.570886848	0.168617368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.0694	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	21.3389	0.232113713	10.44284783	0	1.854482953	3.730209755	1.057623515	2.237064993	8.560131189	1.196690572	4.762642414	0	0.048554736	5.70509565	8.54765972	24.72492941	0.24957799	1.182284676	5.87956567	7.579522248	1.570886848	0.168617368	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.0694
H5005_001_0	2009	5																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1332.943928	78.70248554	1171.554123	366.9384971	282.885963	14.06560318	8.366900748	335.6320567	210.379622	13906.49087	55.31795576	0	0.074527407	1976.703929	6222.061764	5102.073628	364.8212781	284.9175279	0	0	28.93025923	1066.238833	0	0	204.7656164	74.41463249	0	0	569.3756335	0											"$175 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$175 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-14/$95 Days 15-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$125 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $60 (5); $125 (9a); $40/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											107.0115557	79.30934475	41.37652798	0	148.7434279	0.2	0.077642585	49.99875705	125	2.8	0.190878507	0	0.2	43.71363226	9.410316659	30	37.5	8.334199101	0	0	0.2	29.27784113	0	0	30	30	0	0	0	0											107.0115557	79.30934475	41.37652798	0	148.7434279	0.2	0.077642585	49.99875705	125	2.8	0.190878507	0	0.2	43.71363226	9.410316659	30	37.5	8.334199101	0	0	0.2	29.27784113	0	0	30	30	0	0	0	0											11.8867	0.520153547	4.039570163	0	3.50645232	2.813120637	0.649627801	1.398432138	2.191454396	3.244847871	10.55900878	0	0.014905481	7.200742386	4.879297622	12.75518407	1.140066494	0.19787995	0	0	5.786051845	2.60143093	0	0	0.511914041	0.186036581	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.0829	0	0	11.8867	0.520153547	4.039570163	0	3.50645232	2.813120637	0.649627801	1.398432138	2.191454396	3.244847871	10.55900878	0	0.014905481	7.200742386	4.879297622	12.75518407	1.140066494	0.19787995	0	0	5.786051845	2.60143093	0	0	0.511914041	0.186036581	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.0829																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.8867	0.520153547	4.039570163	0	3.50645232	2.813120637	0.649627801	1.398432138	2.191454396	3.244847871	10.55900878	0	0.014905481	7.200742386	4.879297622	12.75518407	1.140066494	0.19787995	0	0	5.786051845	2.60143093	0	0	0.511914041	0.186036581	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.0829
H5005_010_0	2009	5																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1626.003536	86.52231488	1109.746879	472.8084489	277.9109959	15.73958773	9.380262488	373.4417759	169.9955861	13595.56316	55.35431846	0	0.007044345	1411.854522	5890.015201	6027.50379	361.6060397	398.2912995	0	0	21.02721031	1065.255341	0	0	344.5137252	108.9151915	18.85282829	5.04	1338.855431	78.90953532											"$200 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$200 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-14/$95 Days 15-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$150 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $60 (5); $150 (9a); $40/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $10 (7b1)"	"$40/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$10 (13b); $0 n/c (13d, 13e)"											122.3000843	90.63925114	41.37652798	0	150	0.2	0.08718949	49.99989958	150	2.8	0.192051998	0	0.2	52.53663671	9.699970521	28.18827531	37.5	8.334199101	0	0	0.2	28.75577133	0	0	30	30	0	0	0	10											122.3000843	90.63925114	41.37652798	0	150	0.2	0.08718949	49.99989958	150	2.8	0.192051998	0	0.2	52.53663671	9.699970521	28.18827531	37.5	8.334199101	0	0	0.2	28.75577133	0	0	30	30	0	0	0	10											16.5717	0.653526486	3.826456067	0	3.473887449	3.147917545	0.817860305	1.556004275	2.124944826	3.172298071	10.63090748	0	0.001408869	6.181174008	4.761081152	14.15874469	1.130018874	0.276619916	0	0	4.205442063	2.552686583	0	0	0.861284313	0.272287979	0	0	0	0.065757946	0	0	0	0	0	0	0	0	0	0	80.442	0	0	16.5717	0.653526486	3.826456067	0	3.473887449	3.147917545	0.817860305	1.556004275	2.124944826	3.172298071	10.63090748	0	0.001408869	6.181174008	4.761081152	14.15874469	1.130018874	0.276619916	0	0	4.205442063	2.552686583	0	0	0.861284313	0.272287979	0	0	0	0.065757946	0	0	0	0	0	0	0	0	0	0	80.442																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.5717	0.653526486	3.826456067	0	3.473887449	3.147917545	0.817860305	1.556004275	2.124944826	3.172298071	10.63090748	0	0.001408869	6.181174008	4.761081152	14.15874469	1.130018874	0.276619916	0	0	4.205442063	2.552686583	0	0	0.861284313	0.272287979	0	0	0	0.065757946	0	0	0	0	0	0	0	0	0	0	80.442
H5005_011_0	2009	5																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1099.308398	78.87668194	1300.679104	400.0449624	262.1560868	15.50369461	9.221502093	316.9561316	153.9259799	14143.19672	51.99882105	0	0.024109117	1325.040586	6129.128683	5761.26321	363.9794434	409.8944544	0	0	24.98614772	1354.363699	0	0	388.110797	74.58874019	18.89838539	5.04	1396.826782	41.6245876											"$200 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$200 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-14/$95 Days 15-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$150 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $60 (5); $150 (9a); $40/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $10 (7b1)"	"$40/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$10 (13b); $0 n/c (13d, 13e)"											122.2975696	90.63925114	41.37652798	0	149.5254464	0.2	0.082730692	49.99563098	150	2.8	0.191412299	0	0.2	52.85832746	9.720941287	27.8308817	37.5	8.334199101	0	0	0.2	28.99109363	0	0	30	30	0	0	0	10											122.2975696	90.63925114	41.37652798	0	149.5254464	0.2	0.082730692	49.99563098	150	2.8	0.191412299	0	0.2	52.85832746	9.720941287	27.8308817	37.5	8.334199101	0	0	0.2	28.99109363	0	0	30	30	0	0	0	10											11.2036	0.595776949	4.484798778	0	3.266583825	3.100738922	0.762901254	1.320535149	1.924074749	3.300079234	9.953213891	0	0.004821823	5.836619101	4.965075006	13.3617529	1.137435761	0.284678499	0	0	4.997229544	3.2720404	0	0	0.970276993	0.18647185	0	0	0	0.034687156	0	0	0	0	0	0	0	0	0	0	74.9634	0	0	11.2036	0.595776949	4.484798778	0	3.266583825	3.100738922	0.762901254	1.320535149	1.924074749	3.300079234	9.953213891	0	0.004821823	5.836619101	4.965075006	13.3617529	1.137435761	0.284678499	0	0	4.997229544	3.2720404	0	0	0.970276993	0.18647185	0	0	0	0.034687156	0	0	0	0	0	0	0	0	0	0	74.9634																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.2036	0.595776949	4.484798778	0	3.266583825	3.100738922	0.762901254	1.320535149	1.924074749	3.300079234	9.953213891	0	0.004821823	5.836619101	4.965075006	13.3617529	1.137435761	0.284678499	0	0	4.997229544	3.2720404	0	0	0.970276993	0.18647185	0	0	0	0.034687156	0	0	0	0	0	0	0	0	0	0	74.9634
H5005_015_0	2009	4																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1332.943928	78.70248554	1171.554123	366.9384971	282.885963	14.06560318	8.366900748	335.6320567	210.379622	13906.49087	55.31795576	0	0.074527407	1976.703929	6237.423077	5102.073628	364.8212781	284.9175279	0	0	28.93025923	1066.238833	0	0	204.7656164	74.41463249	0	0	569.3756335	0											"$200 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$200 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$95 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$150 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $60 (5); $150 (9a); $40/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											122.2989208	90.63925114	52.35147866	0	150	0.2	0.077642585	49.99875705	150	2.8	0.190878507	0	0.2	52.38089174	9.387141251	30	37.5	8.334199101	0	0	0.2	29.27784113	0	0	30	30	0	0	0	0											122.2989208	90.63925114	52.35147866	0	150	0.2	0.077642585	49.99875705	150	2.8	0.190878507	0	0.2	52.38089174	9.387141251	30	37.5	8.334199101	0	0	0.2	29.27784113	0	0	30	30	0	0	0	0											13.5848	0.594461196	5.111049224	0	3.536074538	2.813120637	0.649627801	1.398432138	2.629745275	3.244847871	10.55900878	0	0.014905481	8.628459542	4.879297622	12.75518407	1.140066494	0.19787995	0	0	5.786051845	2.60143093	0	0	0.511914041	0.186036581	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.8224	0	0	13.5848	0.594461196	5.111049224	0	3.536074538	2.813120637	0.649627801	1.398432138	2.629745275	3.244847871	10.55900878	0	0.014905481	8.628459542	4.879297622	12.75518407	1.140066494	0.19787995	0	0	5.786051845	2.60143093	0	0	0.511914041	0.186036581	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.8224																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	13.5848	0.594461196	5.111049224	0	3.536074538	2.813120637	0.649627801	1.398432138	2.629745275	3.244847871	10.55900878	0	0.014905481	8.628459542	4.879297622	12.75518407	1.140066494	0.19787995	0	0	5.786051845	2.60143093	0	0	0.511914041	0.186036581	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.8224
H5005_018_0	2009	8																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1142.848317	79.28218325	1049.624797	353.6239872	242.6196227	13.85815306	8.542303953	318.0105188	157.8531946	13231.56768	50.75738229	0	0.025081527	1262.778907	5687.746976	5011.917212	362.827109	344.0253055	0	0	23.97870888	1161.64025	0	0	171.4561634	247.3620172	0	0	453.6	0											"$200 Days 1-5 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$200 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$95 Days 11-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$150 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$0 Visits 1-12/$30 Visits 13-999 (3, 9d); $60 (5); $150 (9a); $40/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$0 Visits 1-12/$30 Visits 13-999 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											122.2978739	90.63925114	52.35147866	0	150	0.2	0.091755313	49.99772376	150	2.8	0.191614056	0	0.2	52.85496113	9.869415956	30	37.5	8.334199101	0	0	0.2	28.29133306	0	0	30	30	0	0	0	0											122.2978739	90.63925114	52.35147866	0	150	0.2	0.091755313	49.99772376	150	2.8	0.191614056	0	0.2	52.85496113	9.869415956	30	37.5	8.334199101	0	0	0.2	28.29133306	0	0	30	30	0	0	0	0											11.6473	0.59883981	4.579117512	0	3.032745283	2.771630612	0.783801769	1.324983506	1.973164932	3.087365792	9.725827911	0	0.005016305	5.562010838	4.677895063	12.52979303	1.133834716	0.238931283	0	0	4.795741776	2.738695933	0	0	0.428640409	0.618405043	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.2538	0	0	11.6473	0.59883981	4.579117512	0	3.032745283	2.771630612	0.783801769	1.324983506	1.973164932	3.087365792	9.725827911	0	0.005016305	5.562010838	4.677895063	12.52979303	1.133834716	0.238931283	0	0	4.795741776	2.738695933	0	0	0.428640409	0.618405043	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.2538																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	11.6473	0.59883981	4.579117512	0	3.032745283	2.771630612	0.783801769	1.324983506	1.973164932	3.087365792	9.725827911	0	0.005016305	5.562010838	4.677895063	12.52979303	1.133834716	0.238931283	0	0	4.795741776	2.738695933	0	0	0.428640409	0.618405043	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.2538
H5005_019_0	2009	5																					3350											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	Coin	V	V	Coin	O	T	V	P	P	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	1120.378265	90.68493269	724.1653513	238.4029771	181.4828305	12.34616696	9.591225922	292.9188473	35.28973579	12924.17361	47.28420836	0	0.022164894	17.21117474	5975.967343	4651.832107	386.0783679	3.431457259	0	0	17.74199053	915.0442413	0	0	247.0458262	76.99883116	0	0	453.6	0											"$295 Days 1-12 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$295 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 9a, 9d); $60 (5); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											291.4419738	295	85.36789939	0	149.448311	0.2	0.077945044	49.95482617	0.3	2.8	0.27816408	0	0.2	0.11177903	6.118575653	29.98093259	37.5	0.3	0	0	0.2	29.40698073	0	0	30	30	0	0	0	0											202.0363141	204.5028445	59.17958732	0	103.6020499	0.138645996	0.054033842	34.63018322	0.207968994	1.941043948	0.19283168	0	0.138645996	0.077488575	4.241580086	20.80328774	25.99612431	0.207968994	0	0	0.138645996	20.38580071	0	0	20.79689944	30	0	0	0	0											18.8631	1.545443891	3.57131722	0	1.566832771	1.711746619	0.518250783	0.845319446	7.339170868	2.090532414	9.117893341	0	0.003073074	1.333669404	2.11229534	8.064450153	0.836378437	0.713636716	0	0	2.459855954	1.554492462	0	0	0.428148934	0.192497078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.8681	0	28.6095	18.8631	1.545443891	3.57131722	0	1.566832771	1.711746619	0.518250783	0.845319446	7.339170868	2.090532414	9.117893341	0	0.003073074	1.333669404	2.11229534	8.064450153	0.836378437	0.713636716	0	0	2.459855954	1.554492462	0	0	0.428148934	0.192497078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.8681																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.8631	1.545443891	3.57131722	0	1.566832771	1.711746619	0.518250783	0.845319446	7.339170868	2.090532414	9.117893341	0	0.003073074	1.333669404	2.11229534	8.064450153	0.836378437	0.713636716	0	0	2.459855954	1.554492462	0	0	0.428148934	0.192497078	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.8681
H5005_024_0	2009	5																					1000											D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1342.656645	79.2759643	1180.090847	369.6122555	284.9472587	14.28311259	8.493059005	338.0282194	211.9125881	14007.82283	56.1737757	0	0.07564636	1991.107511	6119.211214	5129.268205	367.479609	286.9936269	0	0	29.38467092	1074.00816	0	0	147.9890135	292.8	0	0	453.6	0											"$100 Days 1-3 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$100 Days 1-3 (1b); $0 n/c (1b1, 1b2)"	"$0 Days 1-10/$60 Days 11-27 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$50 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$0 (9b)	$0/$0 (8a1); $0 (8a2)	"$0 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$5 (3, 9d); $60 (5); $0 (9a); $40/$30 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $30 (7a1); $0 n/c (14b1, 14e1, 14h1)"	"$0 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$5 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											44.29523246	30.61844948	20.41138823	0	50	0.2	0.077666364	49.99875687	0	0	0.170543629	0	0.2	0.26343229	0.001028892	0	37.5	5	0	0	0.2	0	0	0	30	0	0	0	0	0											29.69936026	20.5292604	13.6855625	0	33.52433051	0.134097322	0.052074257	33.523497	0	0	0.11434722	0	0.134097322	0.176627823	0.000689858	0	25.14324788	3.352433051	0	0	0.134097322	0	0	0	20.1145983	0	0	0	0	0											3.323	0.135623076	1.345850587	0	0.796055506	1.915327149	0.44226974	0.944324	0	0	6.423315066	0	0.010143974	0.029307082	0.000351782	0	0.769969242	0.080177243	0	0	3.940405679	0	0	0	0.24806163	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.4042	0	10.0277	3.323	0.135623076	1.345850587	0	0.796055506	1.915327149	0.44226974	0.944324	0	0	6.423315066	0	0.010143974	0.029307082	0.000351782	0	0.769969242	0.080177243	0	0	3.940405679	0	0	0	0.24806163	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.4042																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.323	0.135623076	1.345850587	0	0.796055506	1.915327149	0.44226974	0.944324	0	0	6.423315066	0	0.010143974	0.029307082	0.000351782	0	0.769969242	0.080177243	0	0	3.940405679	0	0	0	0.24806163	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.4042
H5005_801_0	2009	2																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1195.878889	74.39378675	812.7581416	413.3618623	220.3970385	15.51469654	13.58849245	303.7219348	204.1440548	15358.0639	60.15556496	0	0.091591811	2282.73793	7004.135294	5577.093317	364.3672733	621.2260908	0	0	39.92574268	1288.886836	0	0	0	0	0	0	0	0											"$350 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$350 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$300 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); $300 (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											282.7427664	235.5408433	159.8131731	0	148.9892821	0.2	0.071505995	49.99318001	300	2.8	0.27463409	0	0.2	104.450361	12.43159492	39.9598421	37.5	35	0	0	0.2	38.74756167	0	0	0	0	0	0	0	0											282.7427664	235.5408433	159.8131731	0	148.9892821	0.2	0.071505995	49.99318001	300	2.8	0.27463409	0	0.2	104.450361	12.43159492	39.9598421	37.5	35	0	0	0.2	38.74756167	0	0	0	0	0	0	0	0											28.1772	1.460231272	10.82412146	0	2.736399713	3.102939308	0.971658678	1.265335447	5.103601369	3.583548243	16.52076883	0	0.018318362	19.86940008	7.256047728	18.57164736	1.138647729	1.811909431	0	0	7.985148535	4.161768515	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.5587	0	0	28.1772	1.460231272	10.82412146	0	2.736399713	3.102939308	0.971658678	1.265335447	5.103601369	3.583548243	16.52076883	0	0.018318362	19.86940008	7.256047728	18.57164736	1.138647729	1.811909431	0	0	7.985148535	4.161768515	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.5587																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	28.1772	1.460231272	10.82412146	0	2.736399713	3.102939308	0.971658678	1.265335447	5.103601369	3.583548243	16.52076883	0	0.018318362	19.86940008	7.256047728	18.57164736	1.138647729	1.811909431	0	0	7.985148535	4.161768515	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.5587
H5005_802_0	2009	2																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1204.324556	74.91917875	818.4980917	416.281152	221.9535508	15.8292603	13.86702119	305.81756	205.5857834	15466.52731	61.38436429	0	0.093252131	2298.859334	6820.999939	5616.480479	366.940548	625.6133821	0	0	40.70822662	1297.989355	0	0	0	0	0	0	0	0											"$375 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$375 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$300 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); $300 (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											302.9386782	252.3651892	159.8131731	0	150	0.2	0.07135756	49.99317891	300	2.8	0.274373046	0	0.2	104.4504176	12.85552075	39.99905755	37.5	35	0	0	0.2	38.748651	0	0	0	0	0	0	0	0											302.9386782	252.3651892	159.8131731	0	150	0.2	0.07135756	49.99317891	300	2.8	0.274373046	0	0.2	104.4504176	12.85552075	39.99905755	37.5	35	0	0	0.2	38.748651	0	0	0	0	0	0	0	0											30.403	1.575582727	10.90056476	0	2.774419385	3.165852061	0.989516801	1.274066	5.139644585	3.608856373	16.84221501	0	0.018650426	20.00973478	7.307292188	18.7211605	1.146689212	1.824705698	0	0	8.141645324	4.191278043	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.0349	0	0	30.403	1.575582727	10.90056476	0	2.774419385	3.165852061	0.989516801	1.274066	5.139644585	3.608856373	16.84221501	0	0.018650426	20.00973478	7.307292188	18.7211605	1.146689212	1.824705698	0	0	8.141645324	4.191278043	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.0349																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	30.403	1.575582727	10.90056476	0	2.774419385	3.165852061	0.989516801	1.274066	5.139644585	3.608856373	16.84221501	0	0.018650426	20.00973478	7.307292188	18.7211605	1.146689212	1.824705698	0	0	8.141645324	4.191278043	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	138.0349
H5005_803_0	2009	2																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1228.87898	74.60875055	872.2323329	397.8199318	230.8933296	16.49274415	14.79704729	299.8695206	235.6717372	15465.68477	64.00009185	0	0.054332584	2051.98669	6838.174164	5633.413819	366.3553465	545.5160451	0	0	44.35975435	1178.188148	0	0	0	0	0	0	0	0											"$375 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$375 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$300 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); $300 (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											302.9390893	252.3651892	159.8131731	0	150	0.2	0.072907203	49.98824671	300	2.8	0.274652664	0	0.2	103.8754601	12.71981998	39.99875804	37.5	35	0	0	0.2	38.94167565	0	0	0	0	0	0	0	0											302.9390893	252.3651892	159.8131731	0	150	0.2	0.072907203	49.98824671	300	2.8	0.274652664	0	0.2	103.8754601	12.71981998	39.99875804	37.5	35	0	0	0.2	38.94167565	0	0	0	0	0	0	0	0											31.023	1.569054288	11.61618473	0	2.88616662	3.298548829	1.078811333	1.249162631	5.891793429	3.608659781	17.57779574	0	0.010866517	17.76258846	7.24836203	18.77746302	1.144860458	1.591088465	0	0	8.871950869	3.823385059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.0297	0	0	31.023	1.569054288	11.61618473	0	2.88616662	3.298548829	1.078811333	1.249162631	5.891793429	3.608659781	17.57779574	0	0.010866517	17.76258846	7.24836203	18.77746302	1.144860458	1.591088465	0	0	8.871950869	3.823385059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.0297																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	31.023	1.569054288	11.61618473	0	2.88616662	3.298548829	1.078811333	1.249162631	5.891793429	3.608659781	17.57779574	0	0.010866517	17.76258846	7.24836203	18.77746302	1.144860458	1.591088465	0	0	8.871950869	3.823385059	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.0297
H5005_804_0	2009	2																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1228.867778	74.60807044	872.2243818	397.8163054	230.8912249	16.49244346	14.79677752	299.8442548	235.6695889	15465.54379	63.99892504	0	0.054331593	2051.967985	6738.368233	5633.362466	366.3520069	545.5110723	0	0	44.35894561	1178.177408	0	0	0	0	0	0	0	0											"$375 Days 1-10 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$375 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$300 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); $300 (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											302.9390893	252.3651892	159.8131731	0	150	0.2	0.072907203	49.98824548	300	2.8	0.274652827	0	0.2	103.87546	12.90810297	39.99875799	37.5	35	0	0	0.2	38.94167454	0	0	0	0	0	0	0	0											302.9390893	252.3651892	159.8131731	0	150	0.2	0.072907203	49.98824548	300	2.8	0.274652827	0	0.2	103.87546	12.90810297	39.99875799	37.5	35	0	0	0.2	38.94167454	0	0	0	0	0	0	0	0											31.0227	1.569039984	11.61607884	0	2.886140311	3.298488692	1.078791665	1.249057351	5.891739721	3.608626885	17.57748569	0	0.010866319	17.76242653	7.248295916	18.77729183	1.144850021	1.591073961	0	0	8.871789122	3.823350097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.0281	0	0	31.0227	1.569039984	11.61607884	0	2.886140311	3.298488692	1.078791665	1.249057351	5.891739721	3.608626885	17.57748569	0	0.010866319	17.76242653	7.248295916	18.77729183	1.144850021	1.591073961	0	0	8.871789122	3.823350097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.0281																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	31.0227	1.569039984	11.61607884	0	2.886140311	3.298488692	1.078791665	1.249057351	5.891739721	3.608626885	17.57748569	0	0.010866319	17.76242653	7.248295916	18.77729183	1.144850021	1.591073961	0	0	8.871789122	3.823350097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.0281
H5006_014_1	2009	2																																D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	V	V	Coin	Coin																																																											0		895.2732072	26.29624851	45.17391959	26.39291807	197.7228574	14.66754911	9.445149186	452.256603	95.48396549	33.01420833	4.578962604	0.563606205	0.002027522	0.020286305	3616.483971	2645.306157	1.492319332	7.684721727	0	0	25.4537695	0.002865606																			$125 - days 1-5	$125 - days 1-5	$30 - days 11-100	10% Coinsurance	$100 Copay	20% Coinsurance	20% Coinsurance	$50 Copay	10% Coinsurance	10% Coinsurance	10% Coinsurance	50% Coinsurance	10% Coinsurance	10% Coinsurance	$10 Copay	$40 Copay	50% Coinsurance	10% Coinsurance	$40 Copay	$40 Copay	20% Coinsurance	10% Coinsurance																			125	125	30	0.1	100	0.2	0.2	50	0.1	0.1	0.1	0.5	0.1	0.1	10	40	0.5	0.1	40	40	0.2	0.1																			125	125	30	0.1	100	0.2	0.2	50	0.1	0.1	0.1	0.5	0.1	0.1	10	40	0.5	0.1	40	40	0.2	0.1																			9.3258	0.273919255	0.112934799	2.639291807	1.647690479	2.933509822	1.889029837	1.884402513	9.548396549	3.301420833	0.45789626	0.281803103	0.000202752	0.002028631	3.013736642	8.81768719	0.746159666	0.768472173	0	0	5.0907539	0.000286561	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.7354		0	9.3258	0.273919255	0.112934799	2.639291807	1.647690479	2.933509822	1.889029837	1.884402513	9.548396549	3.301420833	0.45789626	0.281803103	0.000202752	0.002028631	3.013736642	8.81768719	0.746159666	0.768472173	0	0	5.0907539	0.000286561	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.7354																																																																																		0			9.3258	0.273919255	0.112934799	2.639291807	1.647690479	2.933509822	1.889029837	1.884402513	9.548396549	3.301420833	0.45789626	0.281803103	0.000202752	0.002028631	3.013736642	8.81768719	0.746159666	0.768472173	0	0	5.0907539	0.000286561	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.7354
H5006_014_2	2009	2																																D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	V	V	Coin	Coin																																																											0		923.7744735	22.60855592	31.35777011	22.11078473	155.5895086	17.35036286	9.191651835	447.1674901	99.28027958	31.13613851	3.941761791	0.312927306	0	0.012429112	3517.774952	2477.521434	1.494317654	6.526689431	0	0	27.90093113	0.000306582																			$125 - days 1-5	$125 - days 1-5	$30 - days 11-100	10% Coinsurance	$100 Copay	20% Coinsurance	20% Coinsurance	$50 Copay	10% Coinsurance	10% Coinsurance	10% Coinsurance	50% Coinsurance	10% Coinsurance	10% Coinsurance	$10 Copay	$40 Copay	50% Coinsurance	10% Coinsurance	$40 Copay	$40 Copay	20% Coinsurance	10% Coinsurance																			125	125	30	0.1	100	0.2	0.2	50	0.1	0.1	0.1	0.5	0.1	0.1	10	40	0.5	0.1	40	40	0.2	0.1																			125	125	30	0.1	100	0.2	0.2	50	0.1	0.1	0.1	0.5	0.1	0.1	10	40	0.5	0.1	40	40	0.2	0.1																			9.6227	0.235505791	0.078394425	2.211078473	1.296579239	3.470072572	1.838330367	1.863197875	9.928027958	3.113613851	0.394176179	0.156463653	0	0.001242911	2.931479127	8.25840478	0.747158827	0.652668943	0	0	5.580186226	3.07E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.3793		0	9.6227	0.235505791	0.078394425	2.211078473	1.296579239	3.470072572	1.838330367	1.863197875	9.928027958	3.113613851	0.394176179	0.156463653	0	0.001242911	2.931479127	8.25840478	0.747158827	0.652668943	0	0	5.580186226	3.07E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.3793																																																																																		0			9.6227	0.235505791	0.078394425	2.211078473	1.296579239	3.470072572	1.838330367	1.863197875	9.928027958	3.113613851	0.394176179	0.156463653	0	0.001242911	2.931479127	8.25840478	0.747158827	0.652668943	0	0	5.580186226	3.07E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.3793
H5006_014_3	2009	2																																D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	V	V	Coin	Coin																																																											0		743.5959612	13.62493368	40.56747567	10.51811661	158.8290167	14.79152916	9.278098669	499.0368058	104.8955722	34.46948995	4.119537406	0.193641914	0.327945313	0.01303988	2895.912279	3068.803507	0.910789233	7.861743443	0	0	30.49010831	0																			$150 - days 1-5	$150 - days 1-5	$30 - days 11-100	10% Coinsurance	$100 Copay	20% Coinsurance	20% Coinsurance	$50 Copay	15% Coinsurance	15% Coinsurance	15% Coinsurance	50% Coinsurance	10% Coinsurance	50% Coinsurance	$20 Copay	$40 Copay	50% Coinsurance	15% Coinsurance	$40 Copay	$40 Copay	20% Coinsurance	15% Coinsurance																			150	150	30	0.1	100	0.2	0.2	50	0.15	0.15	0.15	0.5	0.1	0.15	20	40	0.5	0.15	40	40	0.2	0.15																			150	150	30	0.1	100	0.2	0.2	50	0.15	0.15	0.15	0.5	0.1	0.15	20	40	0.5	0.15	40	40	0.2	0.15																			9.2949	0.170311671	0.101418689	1.051811661	1.323575139	2.958305832	1.855619734	2.079320024	15.73433583	5.170423492	0.617930611	0.096820957	0.032794531	0.001955982	4.826520466	10.22934502	0.455394617	1.179261516	0	0	6.098021662	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.2781		0	9.2949	0.170311671	0.101418689	1.051811661	1.323575139	2.958305832	1.855619734	2.079320024	15.73433583	5.170423492	0.617930611	0.096820957	0.032794531	0.001955982	4.826520466	10.22934502	0.455394617	1.179261516	0	0	6.098021662	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.2781																																																																																		0			9.2949	0.170311671	0.101418689	1.051811661	1.323575139	2.958305832	1.855619734	2.079320024	15.73433583	5.170423492	0.617930611	0.096820957	0.032794531	0.001955982	4.826520466	10.22934502	0.455394617	1.179261516	0	0	6.098021662	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.2781
H5006_015_1	2009	2																					3000											D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	V	V	Coin	Coin																																																											0		895.2732072	26.29624851	45.17391959	26.39291807	197.7228574	14.66754911	9.445149186	452.256603	95.48396549	33.01420833	4.578962604	0.563606205	0.002027522	0.020286305	3616.483971	2645.306157	1.492319332	7.684721727	0	0	25.4537695	0.002865606																			$125 - days 1-5	$125 - days 1-5	$30 - days 11-100	10% Coinsurance	$100 Copay	20% Coinsurance	20% Coinsurance	$50 Copay	10% Coinsurance	10% Coinsurance	10% Coinsurance	50% Coinsurance	10% Coinsurance	50% Coinsurance	$10 Copay	$40 Copay	50% Coinsurance	10% Coinsurance	$40 Copay	$40 Copay	20% Coinsurance	10% Coinsurance																			125	125	30	0.1	100	0.2	0.2	50	0.1	0.1	0.1	0.5	0.1	0.5	10	40	0.5	0.1	40	40	0.2	0.1																			107.464113	107.464113	25.79138712	0.08597129	85.9712904	0.171942581	0.171942581	42.9856452	0.08597129	0.08597129	0.08597129	0.429856452	0.08597129	0.429856452	8.59712904	34.38851616	0.429856452	0.08597129	34.38851616	34.38851616	0.171942581	0.08597129																			8.0175	0.235491918	0.097091504	2.269033224	1.416540766	2.521976248	1.624023327	1.620045156	8.208879725	2.838274092	0.393659324	0.242269764	0.000174309	0.008720199	2.590948281	7.580679461	0.641483093	0.660665443	0	0	4.376586819	0.00024636	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.3443		7.3992	8.0175	0.235491918	0.097091504	2.269033224	1.416540766	2.521976248	1.624023327	1.620045156	8.208879725	2.838274092	0.393659324	0.242269764	0.000174309	0.008720199	2.590948281	7.580679461	0.641483093	0.660665443	0	0	4.376586819	0.00024636	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.3443																																																																																		0			8.0175	0.235491918	0.097091504	2.269033224	1.416540766	2.521976248	1.624023327	1.620045156	8.208879725	2.838274092	0.393659324	0.242269764	0.000174309	0.008720199	2.590948281	7.580679461	0.641483093	0.660665443	0	0	4.376586819	0.00024636	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.3443
H5006_015_2	2009	2																					3000											D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	V	V	Coin	Coin																																																											0		923.7744735	22.60855592	31.35777011	22.11078473	155.5895086	17.35036286	9.191651835	447.1674901	99.28027958	31.13613851	3.941761791	0.312927306	0	0.012429112	3517.774952	2477.521434	1.494317654	6.526689431	0	0	27.90093113	0.000306582																			$125 - days 1-5	$125 - days 1-5	$30 - days 11-100	10% Coinsurance	$100 Copay	20% Coinsurance	20% Coinsurance	$50 Copay	10% Coinsurance	10% Coinsurance	10% Coinsurance	50% Coinsurance	10% Coinsurance	50% Coinsurance	$10 Copay	$40 Copay	50% Coinsurance	10% Coinsurance	$40 Copay	$40 Copay	20% Coinsurance	10% Coinsurance																			125	125	30	0.1	100	0.2	0.2	50	0.1	0.1	0.1	0.5	0.1	0.5	10	40	0.5	0.1	40	40	0.2	0.1																			107.5948811	107.5948811	25.82277147	0.086075905	86.07590489	0.17215181	0.17215181	43.03795244	0.086075905	0.086075905	0.086075905	0.430379524	0.086075905	0.430379524	8.607590489	34.43036196	0.430379524	0.086075905	34.43036196	34.43036196	0.17215181	0.086075905																			8.2828	0.202713741	0.067478711	1.903205803	1.116042312	2.986896367	1.582359498	1.603764431	8.545639902	2.680071297	0.339290713	0.134677505	0	0.005349235	2.523297185	7.108496644	0.643123721	0.561790699	0	0	4.803195789	2.64E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0902		7.294	8.2828	0.202713741	0.067478711	1.903205803	1.116042312	2.986896367	1.582359498	1.603764431	8.545639902	2.680071297	0.339290713	0.134677505	0	0.005349235	2.523297185	7.108496644	0.643123721	0.561790699	0	0	4.803195789	2.64E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0902																																																																																		0			8.2828	0.202713741	0.067478711	1.903205803	1.116042312	2.986896367	1.582359498	1.603764431	8.545639902	2.680071297	0.339290713	0.134677505	0	0.005349235	2.523297185	7.108496644	0.643123721	0.561790699	0	0	4.803195789	2.64E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0902
H5006_015_3	2009	2																					3000											D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	V	V	Coin	Coin																																																											0		743.5959612	13.62493368	40.56747567	10.51811661	158.8290167	14.79152916	9.278098669	498.7349906	104.8955722	34.46948995	4.119537406	0.193641914	0.327945313	0.01303988	2895.912279	2603.878229	0.910789233	7.861743443	0	0	30.49010831	0																			$125 - days 1-5	$125 - days 1-5	$30 - days 11-100	10% Coinsurance	$100 Copay	20% Coinsurance	20% Coinsurance	$50 Copay	10% Coinsurance	10% Coinsurance	10% Coinsurance	50% Coinsurance	10% Coinsurance	50% Coinsurance	$10 Copay	$40 Copay	50% Coinsurance	10% Coinsurance	$40 Copay	$40 Copay	20% Coinsurance	10% Coinsurance																			125	125	30	0.1	100	0.2	0.2	50	0.1	0.1	0.1	0.5	0.1	0.5	10	40	0.5	0.1	40	40	0.2	0.1																			108.4209492	108.4209492	26.02102781	0.086736759	86.73675935	0.173473519	0.173473519	43.36837968	0.086736759	0.086736759	0.086736759	0.433683797	0.086736759	0.433683797	8.673675935	34.69470374	0.433683797	0.086736759	34.69470374	34.69470374	0.173473519	0.086736759																			6.7184	0.123102353	0.087967284	0.912307349	1.148026183	2.565938611	1.609504423	1.802444036	9.098302004	2.989771855	0.357315325	0.083979361	0.028444914	0.005655185	2.093183721	7.528398644	0.394994533	0.681902149	0	0	5.289226374	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5189		6.6546	6.7184	0.123102353	0.087967284	0.912307349	1.148026183	2.565938611	1.609504423	1.802444036	9.098302004	2.989771855	0.357315325	0.083979361	0.028444914	0.005655185	2.093183721	7.528398644	0.394994533	0.681902149	0	0	5.289226374	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5189																																																																																		0			6.7184	0.123102353	0.087967284	0.912307349	1.148026183	2.565938611	1.609504423	1.802444036	9.098302004	2.989771855	0.357315325	0.083979361	0.028444914	0.005655185	2.093183721	7.528398644	0.394994533	0.681902149	0	0	5.289226374	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.5189
H5006_016_1	2009	3																					4000											D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	V	V	Coin	Coin																																																											0		895.2732072	26.29624851	45.17391959	26.39291807	197.7228574	14.66754911	9.445149186	452.3316508	95.48396549	33.01420833	4.578962604	0.563606205	0.002027522	0.037759992	3616.483971	2682.94685	1.492319332	7.684721727	0	0	25.4537695	0.002865606																			$150 - days 1-5	$150 - days 1-5	$35 - days 11-100	15% Coinsurance	$150 Copay	20% Coinsurance	20% Coinsurance	$50 Copay	15% Coinsurance	15% Coinsurance	15% Coinsurance	50% Coinsurance	15% Coinsurance	50% Coinsurance	$20 Copay	$40 Copay	50% Coinsurance	15% Coinsurance	$40 Copay	$40 Copay	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	20	40	0.5	0.15	40	40	0.2	0.15																			131.5576117	131.5576117	30.69677607	0.131557612	131.5576117	0.175410149	0.175410149	43.85253725	0.131557612	0.131557612	0.131557612	0.438525372	0.131557612	0.438525372	8.77050745	30.69677607	0.438525372	0.131557612	30.69677607	30.69677607	0.175410149	0.131557612																			9.815	0.288289304	0.115557808	3.472189268	2.167662243	2.572836975	1.656775026	1.652990881	12.56164246	4.343270402	0.602397384	0.247155621	0.000266736	0.016558714	2.643199967	6.863151555	0.654419891	1.010983637	0	0	4.4648495	0.000376992	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1496		7.7311	9.815	0.288289304	0.115557808	3.472189268	2.167662243	2.572836975	1.656775026	1.652990881	12.56164246	4.343270402	0.602397384	0.247155621	0.000266736	0.016558714	2.643199967	6.863151555	0.654419891	1.010983637	0	0	4.4648495	0.000376992	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1496	.																																																																																	0			9.815	0.288289304	0.115557808	3.472189268	2.167662243	2.572836975	1.656775026	1.652990881	12.56164246	4.343270402	0.602397384	0.247155621	0.000266736	0.016558714	2.643199967	6.863151555	0.654419891	1.010983637	0	0	4.4648495	0.000376992	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1496
H5006_016_2	2009	3																					4000											D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	V	V	Coin	Coin																																																											0		923.7744735	22.60855592	31.35777011	22.11078473	155.5895086	17.35036286	9.191651835	447.810766	99.28027958	31.13613851	3.941761791	0.312927306	0	0.037098213	3517.774952	2733.680131	1.494317654	6.526689431	0	0	27.90093113	0.000306582																			$150 - days 1-5	$150 - days 1-5	$35 - days 11-100	15% Coinsurance	$150 Copay	20% Coinsurance	20% Coinsurance	$50 Copay	15% Coinsurance	15% Coinsurance	15% Coinsurance	50% Coinsurance	15% Coinsurance	50% Coinsurance	$20 Copay	$40 Copay	50% Coinsurance	15% Coinsurance	$40 Copay	$40 Copay	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	20	40	0.5	0.15	40	40	0.2	0.15																			130.0816104	130.0816104	30.35237576	0.13008161	130.0816104	0.173442147	0.173442147	43.3605368	0.13008161	0.13008161	0.13008161	0.433605368	0.13008161	0.433605368	17.34421472	34.68842944	0.433605368	0.13008161	0	0	0.173442147	0.13008161																			10.0138	0.24507978	0.079315235	2.876206485	1.686611154	3.00928419	1.594219831	1.6181096	12.91453865	4.050239039	0.512750722	0.13568696	0	0.016085984	5.084420343	7.902255861	0.647944156	0.849002272	0	0	4.839197405	3.99E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.0748		8.8925	10.0138	0.24507978	0.079315235	2.876206485	1.686611154	3.00928419	1.594219831	1.6181096	12.91453865	4.050239039	0.512750722	0.13568696	0	0.016085984	5.084420343	7.902255861	0.647944156	0.849002272	0	0	4.839197405	3.99E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.0748																																																																																		0			10.0138	0.24507978	0.079315235	2.876206485	1.686611154	3.00928419	1.594219831	1.6181096	12.91453865	4.050239039	0.512750722	0.13568696	0	0.016085984	5.084420343	7.902255861	0.647944156	0.849002272	0	0	4.839197405	3.99E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.0748
H5006_016_3	2009	3																					4000											D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	V	V	Coin	Coin																																																											0		743.5959612	13.62493368	40.56747567	10.51811661	158.8290167	14.79152916	9.278098669	501.4322543	104.8955722	34.46948995	4.119537406	0.193641914	0.327945313	0.023687979	2895.912279	3068.803507	0.910789233	7.861743443	0	0	30.49010831	0																			$150 - days 1-5	$150 - days 1-5	$35 - days 11-100	15% Coinsurance	$150 Copay	20% Coinsurance	20% Coinsurance	$50 Copay	15% Coinsurance	15% Coinsurance	15% Coinsurance	50% Coinsurance	15% Coinsurance	50% Coinsurance	$20 Copay	$40 Copay	50% Coinsurance	15% Coinsurance	$40 Copay	$40 Copay	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	20	40	0.5	0.15	40	40	0.2	0.15																			130.9434558	130.9434558	30.55347302	0.130943456	130.9434558	0.174591274	0.174591274	43.6478186	0.130943456	0.130943456	0.130943456	0.436478186	0.130943456	0.436478186	17.45912744	34.91825488	0.436478186	0.130943456	0	0	0.174591274	0.130943456																			8.1141	0.148674658	0.103289773	1.377278537	1.733135027	2.582471927	1.619875071	1.823868673	13.73538872	4.513554134	0.539426464	0.084520471	0.042942293	0.010339286	4.213341795	8.929771919	0.397539632	1.029443855	0	0	5.323306866	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3223		8.1967	8.1141	0.148674658	0.103289773	1.377278537	1.733135027	2.582471927	1.619875071	1.823868673	13.73538872	4.513554134	0.539426464	0.084520471	0.042942293	0.010339286	4.213341795	8.929771919	0.397539632	1.029443855	0	0	5.323306866	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3223																																																																																		0			8.1141	0.148674658	0.103289773	1.377278537	1.733135027	2.582471927	1.619875071	1.823868673	13.73538872	4.513554134	0.539426464	0.084520471	0.042942293	0.010339286	4.213341795	8.929771919	0.397539632	1.029443855	0	0	5.323306866	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3223
H5006_017_1	2009	3																																D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	V	V	Coin	Coin																																																											0		834.6254231	27.03793227	38.33455613	22.0329673	183.7982506	13.40535672	8.935310167	551.6115982	104.9591581	36.91093146	0	0.012291254	0.005483063	1.225866068	3841.560032	2988.132191	1.223681532	4.480745962	0	0	28.28461823	0.833846366																			$150 - days 1-5	$150 - days 1-5	$35 - days 11-100	15% Coinsurance	$150 Copay	20% Coinsurance	20% Coinsurance	$50 Copay	15% Coinsurance	15% Coinsurance	15% Coinsurance	50% Coinsurance	15% Coinsurance	50% Coinsurance	$20 Copay	$40 Copay	50% Coinsurance	15% Coinsurance	$40 Copay	$40 Copay	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	20	40	0.5	0.15	40	40	0.2	0.15																			150	150	35	0.15	150	0.2	0.2	50	0.15	0.15	0.15	0.5	0.15	0.5	20	40	0.5	0.15	40	40	0.2	0.15																			10.4328	0.337974153	0.111809122	3.304945095	2.297478133	2.681071343	1.787062033	2.298381659	15.74387372	5.536639719	0	0.006145627	0.00082246	0.612933034	6.402600053	9.960440636	0.611840766	0.672111894	0	0	5.656923646	0.125076955	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5809		0	10.4328	0.337974153	0.111809122	3.304945095	2.297478133	2.681071343	1.787062033	2.298381659	15.74387372	5.536639719	0	0.006145627	0.00082246	0.612933034	6.402600053	9.960440636	0.611840766	0.672111894	0	0	5.656923646	0.125076955	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5809																																																																																		0			10.4328	0.337974153	0.111809122	3.304945095	2.297478133	2.681071343	1.787062033	2.298381659	15.74387372	5.536639719	0	0.006145627	0.00082246	0.612933034	6.402600053	9.960440636	0.611840766	0.672111894	0	0	5.656923646	0.125076955	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5809
H5006_017_2	2009	3																																D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	V	V	Coin	Coin																																																											0		850.5473482	67.84010329	47.99247177	16.03755221	170.9994022	15.16308358	11.61402775	557.1889507	112.0917381	40.8232893	0	0	0.337031864	1.938311162	4188.661021	3085.555828	1.27517532	6.221344239	0	0	30.57300817	0.252379979																			$150 - days 1-5	$150 - days 1-5	$35 - days 11-100	15% Coinsurance	$150 Copay	20% Coinsurance	20% Coinsurance	$50 Copay	15% Coinsurance	15% Coinsurance	15% Coinsurance	50% Coinsurance	15% Coinsurance	50% Coinsurance	$20 Copay	$40 Copay	50% Coinsurance	15% Coinsurance	$40 Copay	$40 Copay	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	20	40	0.5	0.15	40	40	0.2	0.15																			150	150	35	0.15	150	0.2	0.2	50	0.15	0.15	0.15	0.5	0.15	0.5	20	40	0.5	0.15	40	40	0.2	0.15																			10.6318	0.848001291	0.139978043	2.405632831	2.137492528	3.032616715	2.322805549	2.321620628	16.81376071	6.123493395	0	0	0.05055478	0.969155581	6.981101702	10.28518609	0.63758766	0.933201636	0	0	6.114601634	0.037856997	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.7865			10.6318	0.848001291	0.139978043	2.405632831	2.137492528	3.032616715	2.322805549	2.321620628	16.81376071	6.123493395	0	0	0.05055478	0.969155581	6.981101702	10.28518609	0.63758766	0.933201636	0	0	6.114601634	0.037856997	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.7865																																																																																		0			10.6318	0.848001291	0.139978043	2.405632831	2.137492528	3.032616715	2.322805549	2.321620628	16.81376071	6.123493395	0	0	0.05055478	0.969155581	6.981101702	10.28518609	0.63758766	0.933201636	0	0	6.114601634	0.037856997	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.7865
H5006_017_3	2009	4																																D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	V	V	Coin	Coin																																																											0		697.1506575	41.66499035	31.61014159	10.77685816	134.2359139	10.98709689	9.919032273	433.7936681	101.9167664	41.00966212	0	0.005909132	0	0.304224043	3532.842126	3081.352555	1.404496994	5.980471247	0	0	32.52201521	0.54817698																			$150 - days 1-5	$150 - days 1-5	$35 - days 11-100	15% Coinsurance	$150 Copay	20% Coinsurance	20% Coinsurance	$50 Copay	15% Coinsurance	15% Coinsurance	15% Coinsurance	50% Coinsurance	15% Coinsurance	50% Coinsurance	$20 Copay	$40 Copay	50% Coinsurance	15% Coinsurance	$40 Copay	$40 Copay	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	20	40	0.5	0.15	40	40	0.2	0.15																			150	150	35	0.15	150	0.2	0.2	50	0.15	0.15	0.15	0.5	0.15	0.5	20	40	0.5	0.15	40	40	0.2	0.15																			8.7144	0.520812379	0.092196246	1.616528724	1.677948924	2.197419378	1.983806455	1.807473617	15.28751496	6.151449317	0	0.002954566	0	0.152112022	5.88807021	10.27117518	0.702248497	0.897070687	0	0	6.504403043	0.082226547	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5498			8.7144	0.520812379	0.092196246	1.616528724	1.677948924	2.197419378	1.983806455	1.807473617	15.28751496	6.151449317	0	0.002954566	0	0.152112022	5.88807021	10.27117518	0.702248497	0.897070687	0	0	6.504403043	0.082226547	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5498																																																																																		0			8.7144	0.520812379	0.092196246	1.616528724	1.677948924	2.197419378	1.983806455	1.807473617	15.28751496	6.151449317	0	0.002954566	0	0.152112022	5.88807021	10.27117518	0.702248497	0.897070687	0	0	6.504403043	0.082226547	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5498
H5006_018_1	2009	2																					5000											D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	V	V	Coin	Coin																																																											0		895.2732072	26.29624851	45.17391959	26.39291807	197.7228574	14.66754911	9.445149186	452.2607724	95.48396549	33.01420833	4.578962604	0.563606205	0.002027522	0.037759992	3616.483971	2908.791005	1.492319332	7.684721727	0	0	25.4537695	0.002865606																			$200 - days 1-5	$200 - days 1-5	$30 - days 11-100	15% Coinsurance	$100 Copay	20% Coinsurance	20% Coinsurance	$50 Copay	15% Coinsurance	15% Coinsurance	15% Coinsurance	50% Coinsurance	20% Coinsurance	50% Coinsurance	$20 Copay	$40 Copay	50% Coinsurance	15% Coinsurance	$40 Copay	$40 Copay	20% Coinsurance	15% Coinsurance																			200	200	30	0.15	100	0.2	0.2	50	0.15	0.15	0.15	0.5	0.2	0.5	20	40	0.5	0.15	40	40	0.2	0.15																			178.5377818	178.5377818	26.78066727	0.133903336	89.26889091	0.178537782	0.178537782	44.63444546	0.133903336	0.133903336	0.133903336	0.446344455	0.178537782	0.446344455	17.85377818	35.70755637	0.446344455	0.133903336	35.70755637	35.70755637	0.178537782	0.133903336																			13.32	0.39123949	0.100815643	3.534099786	1.470875016	2.618711683	1.686315985	1.682200731	12.78562155	4.420712644	0.61313837	0.251562504	0.000361989	0.016853963	5.380658551	8.655484897	0.666088458	1.029009878	0	0	4.544459545	0.000383714	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.1686		-7.5936	13.32	0.39123949	0.100815643	3.534099786	1.470875016	2.618711683	1.686315985	1.682200731	12.78562155	4.420712644	0.61313837	0.251562504	0.000361989	0.016853963	5.380658551	8.655484897	0.666088458	1.029009878	0	0	4.544459545	0.000383714	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.1686																																																																																		0			13.32	0.39123949	0.100815643	3.534099786	1.470875016	2.618711683	1.686315985	1.682200731	12.78562155	4.420712644	0.61313837	0.251562504	0.000361989	0.016853963	5.380658551	8.655484897	0.666088458	1.029009878	0	0	4.544459545	0.000383714	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.1686
H5006_018_2	2009	3																					5000											D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	V	V	Coin	Coin																																																											0		923.7744735	22.60855592	31.35777011	22.11078473	155.5895086	17.35036286	9.191651835	447.2237179	99.28027958	31.13613851	3.941761791	0.312927306	0	0.037098213	3517.774952	2733.680131	1.494317654	6.526689431	0	0	27.90093113	0.000306582																			$200 - days 1-5	$200 - days 1-5	$30 - days 11-100	15% Coinsurance	$100 Copay	20% Coinsurance	20% Coinsurance	$50 Copay	15% Coinsurance	15% Coinsurance	15% Coinsurance	50% Coinsurance	20% Coinsurance	50% Coinsurance	$20 Copay	$40 Copay	50% Coinsurance	15% Coinsurance	$40 Copay	$40 Copay	20% Coinsurance	15% Coinsurance																			200	200	30	0.15	100	0.2	0.2	50	0.15	0.15	0.15	0.5	0.2	0.5	20	40	0.5	0.15	40	40	0.2	0.15																			178.6978382	178.6978382	26.80467573	0.134023379	89.34891909	0.178697838	0.178697838	44.67445954	0.134023379	0.134023379	0.134023379	0.446744595	0.178697838	0.446744595	17.86978382	35.73956763	0.446744595	0.134023379	35.73956763	35.73956763	0.178697838	0.134023379																			13.7564	0.336675006	0.070044572	2.963362074	1.158479535	3.100472335	1.642528312	1.664956491	13.3058785	4.17297048	0.528288233	0.139798583	0	0.016573426	5.238489826	8.14171216	0.667578336	0.874728969	0	0	4.985836076	4.11E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7648		-7.482	13.7564	0.336675006	0.070044572	2.963362074	1.158479535	3.100472335	1.642528312	1.664956491	13.3058785	4.17297048	0.528288233	0.139798583	0	0.016573426	5.238489826	8.14171216	0.667578336	0.874728969	0	0	4.985836076	4.11E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7648																																																																																		0			13.7564	0.336675006	0.070044572	2.963362074	1.158479535	3.100472335	1.642528312	1.664956491	13.3058785	4.17297048	0.528288233	0.139798583	0	0.016573426	5.238489826	8.14171216	0.667578336	0.874728969	0	0	4.985836076	4.11E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7648
H5006_801_0	2009	2																																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																																																							0		903.9975872	25.35000031	213.4049302	23.09049549	190.2304296	15.44766207	9.401516792	455.822361	97.75421679	33.01314004	4.467080807	0.433067836	0.067599471	0.045484526	3527.173977	2904.739922	1.503947717	7.582918573	0	0	27.12836497	9.298569401				18.93981164															$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	$40 Per Visit	$40 Per Visit	25% Coinsurance	20% Coinsurance				$40 Per Visit															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	40	40	0.25	0.2				40															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	40	40	0.25	0.2				40															18.8333	0.528125006	1.333780814	4.618099097	2.37788037	3.089532415	1.880303358	1.899259837	19.55084336	6.602628007	0.893416161	0.216533918	0.013519894	0.009096905	5.878623296	9.682466408	0.751973859	1.516583715	0	0	6.782091243	1.85971388	0	0	0	0.063132705	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.3809		0	18.8333	0.528125006	1.333780814	4.618099097	2.37788037	3.089532415	1.880303358	1.899259837	19.55084336	6.602628007	0.893416161	0.216533918	0.013519894	0.009096905	5.878623296	9.682466408	0.751973859	1.516583715	0	0	6.782091243	1.85971388	0	0	0	0.063132705	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.3809																																																																																		0			18.8333	0.528125006	1.333780814	4.618099097	2.37788037	3.089532415	1.880303358	1.899259837	19.55084336	6.602628007	0.893416161	0.216533918	0.013519894	0.009096905	5.878623296	9.682466408	0.751973859	1.516583715	0	0	6.782091243	1.85971388	0	0	0	0.063132705	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.3809
H5008_001_0	2009	8																					2800											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1510.010186	383.5137809	7745.031087	62.12908532	482.1060833	11.79821697	11.3137304	163.7456047	101.603023	10283.04201	1313.177498	0	3.697908155	258.2200154	174.9612044	7033.640909	1402.677798	24.67541975	0	0	1640.781239	784.0747175	975.9038432	0	162.5096321	101.5436361	0	0	0	0											"$200 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$200 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $35 (4b)	$35 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$35 (3, 5, 9a, 9d); $35/$25 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $35 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$15 (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"$35/$25 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											198.3098957	200	0	0	75	0.2	0.2	49.28409616	35	0	0	0	0	34.78557944	0	14.45050644	32.5	0	0	0	0	14.70362623	0	0	0	0	0	0	0	0											173.3041234	174.781115	0	0	65.54291812	0.174781115	0.174781115	43.06964639	30.58669512	0	0	0	0	30.3993118	0	12.62837814	28.40193118	0	0	0	0	12.84958093	0	0	0	0	0	0	0	0											21.8076	5.585913853	0	0	2.633219962	2.062105517	1.977426415	0.587705441	0.258975057	0	0	0	0	0.654142564	0	7.401956424	3.319896524	0	0	0	0	0.839585962	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1285	0	6.8001	21.8076	5.585913853	0	0	2.633219962	2.062105517	1.977426415	0.587705441	0.258975057	0	0	0	0	0.654142564	0	7.401956424	3.319896524	0	0	0	0	0.839585962	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1285																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.8076	5.585913853	0	0	2.633219962	2.062105517	1.977426415	0.587705441	0.258975057	0	0	0	0	0.654142564	0	7.401956424	3.319896524	0	0	0	0	0.839585962	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1285
H5008_002_0	2009	5																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		342.0507875	22.93	79.81192504	2525.474174	19.51449301	25.7157648	10.43519668	36.72783638	45.5354602	12.60429213	32.71796483	0	1.270904797	40.04964108	47.10409861	141.089082	14.56	5.639972829	0	0	19.89798687	5.001642432	543.3336527	3695.017245	0	0	0	0	20.2	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.067640663	0.06848584	0.154845527	0	0.2	0.2	0.2	0.094094101	0.2	0.08	0.2	0	0.2	0.2	0	0.19958498	0.2	0.2	0	0	0.2	0.010805092	0	0	0	0	0	0	0	0											0.067640663	0.06848584	0.154845527	0	0.2	0.2	0.2	0.094094101	0.2	0.08	0.2	0	0.2	0.2	0	0.19958498	0.2	0.2	0	0	0.2	0.010805092	0	0	0	0	0	0	0	0											23.1365	1.57038032	12.35851956	0	3.902898601	5.143152959	2.087039337	3.455872737	9.107092039	1.00834337	6.543592966	0	0.254180959	8.009928215	0	28.15926162	2.912	1.127994566	0	0	3.979597375	0.054043204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8104	0	0	23.1365	1.57038032	12.35851956	0	3.902898601	5.143152959	2.087039337	3.455872737	9.107092039	1.00834337	6.543592966	0	0.254180959	8.009928215	0	28.15926162	2.912	1.127994566	0	0	3.979597375	0.054043204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8104																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.1365	1.57038032	12.35851956	0	3.902898601	5.143152959	2.087039337	3.455872737	9.107092039	1.00834337	6.543592966	0	0.254180959	8.009928215	0	28.15926162	2.912	1.127994566	0	0	3.979597375	0.054043204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.8104
H5008_003_0	2009	5																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		337.0298771	23.43	44.18892628	5157.781934	14.60735873	32.08609918	10.91106662	24.13547714	37.57034575	6.977119878	16.87966699	0	2.813712471	40.00084091	51.51824488	138.0269347	13.99	5.637352864	0	0	23.74732553	6.881187416	365.1399043	3695.017245	0	0	0	0	20.2	0											"6.9% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"6.9% (1b); $0 n/c (1b1, 1b2)"	16.5% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.067678	0.0685	0.1649	0	0.2	0.2	0.2	0.115487009	0.2	0.08	0.2	0	0.2	0.2	0	0.199575773	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											0.067678	0.0685	0.1649	0	0.2	0.2	0.2	0.115487009	0.2	0.08	0.2	0	0.2	0.2	0	0.199575773	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											22.8095	1.604955	7.286753943	0	2.921471745	6.417219836	2.182213324	2.787334061	7.51406915	0.55816959	3.375933399	0	0.562742494	8.000168183	0	27.54683215	2.798	1.127470573	0	0	4.749465106	0.102318295	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.3446	0	0	22.8095	1.604955	7.286753943	0	2.921471745	6.417219836	2.182213324	2.787334061	7.51406915	0.55816959	3.375933399	0	0.562742494	8.000168183	0	27.54683215	2.798	1.127470573	0	0	4.749465106	0.102318295	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.3446																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.8095	1.604955	7.286753943	0	2.921471745	6.417219836	2.182213324	2.787334061	7.51406915	0.55816959	3.375933399	0	0.562742494	8.000168183	0	27.54683215	2.798	1.127470573	0	0	4.749465106	0.102318295	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.3446
H5008_004_0	2009	4																					3350											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1829.639923	279.3248445	40.19059022	49697.56575	86.52916909	20.12765929	8.898990827	353.616004	370.7291688	5871.129432	449.0024137	0	0.822886347	1431.295021	5789.807046	4287.372948	1301.980366	255.6570012	0	0	25.88907432	1082.520213	810.5086242	0	327.7093149	349.7142857	0	0	20.2	0											"$225 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$225 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$125 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$125 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5); $125 (9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											222.3	225	0.154821907	0	125	0.14	0.2	49.97172074	125	4.4	64.79010385	0	0.2	115.5945484	3.251002517	25	20	20	0	0	0.2	13.67894853	0	0	0	0	0	0	0	0											157.4220535	159.3340623	0.154821907	0	88.51892347	0.099141194	0.141630278	35.38754339	88.51892347	3.115866106	45.88120195	0	0.141630278	81.85843987	3.251002517	25	20	20	0	0	0.141630278	13.67894853	0	0	0	0	0	0	0	0											24.0021	3.70883018	6.22238381	0	0.638289075	1.99548018	1.260366541	1.042800141	2.734712244	1.5244711	1.716730869	0	0.116545622	9.76363145	1.56855644	8.932026974	2.169967277	0.426095002	0	0	3.666676782	1.23397819	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.7237	0	21.501	24.0021	3.70883018	6.22238381	0	0.638289075	1.99548018	1.260366541	1.042800141	2.734712244	1.5244711	1.716730869	0	0.116545622	9.76363145	1.56855644	8.932026974	2.169967277	0.426095002	0	0	3.666676782	1.23397819	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.7237																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.0021	3.70883018	6.22238381	0	0.638289075	1.99548018	1.260366541	1.042800141	2.734712244	1.5244711	1.716730869	0	0.116545622	9.76363145	1.56855644	8.932026974	2.169967277	0.426095002	0	0	3.666676782	1.23397819	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.7237
H5008_005_0	2009	5																					2800											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1644.416579	785.8031161	7225.697887	100.3750517	580.6842058	12.10952702	13.83470827	164.2653093	107.5198553	12128.47704	1594.434624	0	5.97429884	272.6215635	165.8437838	7746.28321	6018.26179	39.86533072	0	0	1427.649274	913.2552578	1576.881712	0	191.5790143	148.7435641	0	0	0	0											"$200 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$200 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $35 (4b)	$35 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$35 (3, 5, 9a, 9d); $35/$25 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $35 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$15 (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"$35/$25 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											198.2881413	200	0	0	75	0.2	0.2	49.81663475	35	0	0	0	0	34.80979393	0	14.50105873	32.5	0	0	0	0	14.67406104	0	0	0	0	0	0	0	0											161.1083301	162.4992085	0	0	60.93720318	0.162499208	0.162499208	40.47581858	28.43736148	0	0	0	0	28.28281981	0	11.78205283	26.40612138	0	0	0	0	11.92261652	0	0	0	0	0	0	0	0											22.0774	10.64103203	0	0	2.948772619	1.967788555	2.248129144	0.554064405	0.254798416	0	0	0	0	0.642542213	0	7.605593167	13.24324594	0	0	0	0	0.907366018	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.0908	0	14.5598	22.0774	10.64103203	0	0	2.948772619	1.967788555	2.248129144	0.554064405	0.254798416	0	0	0	0	0.642542213	0	7.605593167	13.24324594	0	0	0	0	0.907366018	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.0908																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.0774	10.64103203	0	0	2.948772619	1.967788555	2.248129144	0.554064405	0.254798416	0	0	0	0	0.642542213	0	7.605593167	13.24324594	0	0	0	0	0.907366018	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.0908
H5008_006_0	2009	4																					2500											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1825.143395	263.4733519	39.99328798	49575.42889	86.3165148	20.02884929	8.855304213	352.747448	369.8180639	5856.70053	447.8989443	0	0.818846663	1427.819206	5775.760556	4276.836289	1301.980366	255.0286979	0	0	25.759526	1079.859808	810.5086242	0	327.7093149	349.7142857	0	0	20.2	0											"$175 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	16.5% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$75 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5, 9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											172.9	175	0.1649	0	75	0.14	0.2	49.97165111	75	4.4	64.79010385	0	0.2	70.35307622	3.250899763	25	20	20	0	0	0.2	13.67894853	0	0	0	0	0	0	0	0											120.6001497	122.0649289	0.1649	0	52.31354095	0.097651943	0.139502776	34.85592022	52.31354095	3.069061069	45.19199667	0	0.139502776	49.07224712	3.250899763	25	20	20	0	0	0.139502776	13.67894853	0	0	0	0	0	0	0	0											18.3427	2.68007133	6.594893188	0	0.376293544	1.955856051	1.235339519	1.024611409	1.612207703	1.497880966	1.6867873	0	0.114231382	5.838858075	1.564701552	8.910075603	2.169967277	0.42504783	0	0	3.593525382	1.230945562	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.854	0	17.3285	18.3427	2.68007133	6.594893188	0	0.376293544	1.955856051	1.235339519	1.024611409	1.612207703	1.497880966	1.6867873	0	0.114231382	5.838858075	1.564701552	8.910075603	2.169967277	0.42504783	0	0	3.593525382	1.230945562	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.854																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.3427	2.68007133	6.594893188	0	0.376293544	1.955856051	1.235339519	1.024611409	1.612207703	1.497880966	1.6867873	0	0.114231382	5.838858075	1.564701552	8.910075603	2.169967277	0.42504783	0	0	3.593525382	1.230945562	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.854
H5009_001_0	2009	4	h.6.										OP Facility - Other										1500	Urgent Care										D	D	D		T	Coin	Coin	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	3000	522.3539428	13.42440587			1.174278043	9.935247558	0.569951484	232.0585444							7617.446557	926.5225478	633.5568002	1774.552274		1277.786543	5.67592323				129.8927054						0.13405812										$100/day (days 1-5)	$100/day (days 1-5)			$100 	10%	10%	$50 							$10 	$10 	$10 	$10 		$10 chiro	10%				$10 						$10 										100	100			100	0.1	0.1	50	0	0	0	0	0	0	10	10	10	10	0	10	0.1	0	0	0	10	0					10										99.20135606	99.20135606	0	0	99.20135606	0.099201356	0.099201356	49.60067803	0	0	0	0	0	0	9.920135606	9.920135606	9.920135606	9.920135606	0	9.920135606	0.099201356	0	0	0	9.920135606	0					9.920135606										4.3182	0.110976606	0	0	0.009707498	0.985590031	0.05653996	0.959188429	0	0	0	0	0	0	6.297175235	0.765935776	0.523747448	1.466983267	0	1.056317982	0.563059281	0	0	0	0.107379438	0	0	0	0	0	0.000110823	0	0	0	0	0	0	0	0	0	17.2209	0	0.1386	4.3182	0.110976606	0	0	0.009707498	0.985590031	0.05653996	0.959188429	0	0	0	0	0	0	6.297175235	0.765935776	0.523747448	1.466983267	0	1.056317982	0.563059281	0	0	0	0.107379438	0	0	0	0	0	0.000110823	0	0	0	0	0	0	0	0	0	17.2209	N/A	$250/day (days 1-5)	$250/day (days 1-5)	$25/day (days 1-100)	20%	$100 	20%	20%	$50 	$100 	No cost sharing	20%	No cost sharing	No cost sharing	No cost sharing	$25 	$25 	$25 	$25 	No cost sharing	$25 	10%	No cost sharing	No cost sharing	No cost sharing	$25 	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$25 										1.42	0.0099	0.3074	0.1029	0.7308	0.5892	0.0225	0.0723	0.1675	0	0	0	0	0	1.772	0.1173	0.6741	0.4305	0	1.0285	0.0418	0	0	0	0.013	0	0	0	0	0	0.0006										7.5004	0	0.117740105	5.7382	0.120850782	0.307414628	0.102874781	0.740550105	1.574764048	0.079044482	1.031480601	0.167506252	0	0	0	0	0	8.069209844	0.883190153	1.197886645	1.897503722	0	2.084865144	0.604895965	0	0	0	0.12038256	0	0	0	0	0	0.000698564	0	0	0	0	0	0	0	0	0	24.7213
H5009_002_0	2009	7	h.6.										OP Facility - Other										1500	Urgent Care										D	D	D		T	Coin	Coin	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	3000	522.3539428	13.42440587			1.174278043	9.935247558	0.569951484	232.0585444							7617.446557	926.5225478	633.5568002	1774.552274		1277.786543	5.67592323				129.8927054						0.13405812										$100/day (days 1-5)	$100/day (days 1-5)			$100 	10%	10%	$50 							$10 	$10 	$10 	$10 		$10 chiro	10%				$10 						$10 										100	100			100	0.1	0.1	50	0	0	0	0	0	0	10	10	10	10	0	10	0.1	0	0	0	10	0					10										99.20135606	99.20135606	0	0	99.20135606	0.099201356	0.099201356	49.60067803	0	0	0	0	0	0	9.920135606	9.920135606	9.920135606	9.920135606	0	9.920135606	0.099201356	0	0	0	9.920135606	0					9.920135606										4.3182	0.110976606	0	0	0.009707498	0.985590031	0.05653996	0.959188429	0	0	0	0	0	0	6.297175235	0.765935776	0.523747448	1.466983267	0	1.056317982	0.563059281	0	0	0	0.107379438	0	0	0	0	0	0.000110823	0	0	0	0	0	0	0	0	0	17.2209	0	0.14	4.3182	0.110976606	0	0	0.009707498	0.985590031	0.05653996	0.959188429	0	0	0	0	0	0	6.297175235	0.765935776	0.523747448	1.466983267	0	1.056317982	0.563059281	0	0	0	0.107379438	0	0	0	0	0	0.000110823	0	0	0	0	0	0	0	0	0	17.2209	N/A	$250/day (days 1-5)	$250/day (days 1-5)	$25/day (days 1-100)	20%	$100 	20%	20%	$50 	$100 	No cost sharing	20%	No cost sharing	No cost sharing	No cost sharing	$25 	$25 	$25 	$25 	No cost sharing	$25 	10%	No cost sharing	No cost sharing	No cost sharing	$25 	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$25 										1.42	0.0099	0.3074	0.1029	0.7308	0.5892	0.0225	0.0723	0.1675	0	0	0	0	0	1.772	0.1173	0.6741	0.4305	0	1.0285	0.0418	0	0	0	0.013	0	0	0	0	0	0.0006										7.5004	0	0.12	5.7382	0.120850782	0.307414628	0.102874781	0.740550105	1.574764048	0.079044482	1.031480601	0.167506252	0	0	0	0	0	8.069209844	0.883190153	1.197886645	1.897503722	0	2.084865144	0.604895965	0	0	0	0.12038256	0	0	0	0	0	0.000698564	0	0	0	0	0	0	0	0	0	24.7213
H5009_004_0	2009	6	h.6.										OP Facility - Other										1500	Urgent Care										D	D	D		T	Coin	Coin	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	3000	522.3539428	13.42440587			1.174278043	9.935247558	0.569951484	232.0585444							7617.446557	926.5225478	633.5568002	1774.552274		1277.786543	5.67592323				129.8927054						0.13405812										$100/day (days 1-5)	$100/day (days 1-5)			$100 	10%	10%	$50 							$10 	$10 	$10 	$10 		$10 chiro	10%				$10 						$10 										100	100			100	0.1	0.1	50	0	0	0	0	0	0	10	10	10	10	0	10	0.1	0	0	0	10	0					10										99.20135606	99.20135606	0	0	99.20135606	0.099201356	0.099201356	49.60067803	0	0	0	0	0	0	9.920135606	9.920135606	9.920135606	9.920135606	0	9.920135606	0.099201356	0	0	0	9.920135606	0					9.920135606										4.3182	0.110976606	0	0	0.009707498	0.985590031	0.05653996	0.959188429	0	0	0	0	0	0	6.297175235	0.765935776	0.523747448	1.466983267	0	1.056317982	0.563059281	0	0	0	0.107379438	0	0	0	0	0	0.000110823	0	0	0	0	0	0	0	0	0	17.2209	0	0.14	4.3182	0.110976606	0	0	0.009707498	0.985590031	0.05653996	0.959188429	0	0	0	0	0	0	6.297175235	0.765935776	0.523747448	1.466983267	0	1.056317982	0.563059281	0	0	0	0.107379438	0	0	0	0	0	0.000110823	0	0	0	0	0	0	0	0	0	17.2209	N/A	$250/day (days 1-5)	$250/day (days 1-5)	$25/day (days 1-100)	20%	$100 	20%	20%	$50 	$100 	No cost sharing	20%	No cost sharing	No cost sharing	No cost sharing	$25 	$25 	$25 	$25 	No cost sharing	$25 	10%	No cost sharing	No cost sharing	No cost sharing	$25 	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$25 										1.42	0.0099	0.3074	0.1029	0.7308	0.5892	0.0225	0.0723	0.1675	0	0	0	0	0	1.772	0.1173	0.6741	0.4305	0	1.0285	0.0418	0	0	0	0.013	0	0	0	0	0	0.0006										7.5004	0	0.12	5.7382	0.120850782	0.307414628	0.102874781	0.740550105	1.574764048	0.079044482	1.031480601	0.167506252	0	0	0	0	0	8.069209844	0.883190153	1.197886645	1.897503722	0	2.084865144	0.604895965	0	0	0	0.12038256	0	0	0	0	0	0.000698564	0	0	0	0	0	0	0	0	0	24.7213
H5009_006_0	2009	5	h.6.										OP Facility - Other										2500	Urgent Care										D	D	D	Coin	T	Coin	Coin	V	V		Coin				V	V	V	V	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	5000	522.3539428	13.42440587	571.2788318	3.716187609	0.987461082	9.677045984	0.54468145	232.0585444	1078.803956	0	11.77453999	0	0	0	6703.35297	889.4616459	557.5299841	1561.606002	21.21909237	1086.118561	5.64123964										0.117971146										$250/day (days 1-5)	$250/day (days 1-5)	$25/day	10%	$100 	20%	20%	$50 	$250 		20%				$25 	$25 	$25 	$25 	20%	$25 chiro	20%										$25 										250	250	25	0.1	100	0.2	0.2	50	250	0	0.2	0	0	0	25	25	25	25	0.2	25	0.2	0	0	0	0	0	0	0	0	0	25										241.1849058	241.1849058	24.11849058	0.096473962	96.47396233	0.192947925	0.192947925	48.23698116	241.1849058	0	0.192947925	0	0	0	24.11849058	24.11849058	24.11849058	24.11849058	0.192947925	24.11849058	0.192947925	0	0	0	0	0	0	0	0	0	24.11849058										10.4987	0.269813672	1.148198594	0.358515343	0.00793869	1.86716594	0.105095155	0.932816969	21.68260254	0	2.271873054	0	0	0	13.47289629	1.787706027	1.120565139	3.138631637	4.094179836	2.182961691	1.088465481	0	0	0	0	0	0	0	0	0	0.000237107	0	0	0	0	0	0	0	0	0	66.0283	0	2.4133	10.4987	0.269813672	1.148198594	0.358515343	0.00793869	1.86716594	0.105095155	0.932816969	21.68260254	0	2.271873054	0	0	0	13.47289629	1.787706027	1.120565139	3.138631637	4.094179836	2.182961691	1.088465481	0	0	0	0	0	0	0	0	0	0.000237107	0	0	0	0	0	0	0	0	0	66.0283	N/A	$500/day (days 1-5)	$500/day (days 1-5)	$35/day (days 1-100)	40%	$100 	40%	40%	$50 	$500 	No cost sharing	40%	No cost sharing	No cost sharing	No cost sharing	$35 	$35 	$35 	$35 	40%	$35 	20%	No cost sharing	Not covered	Not covered	Not covered	Not covered	Not covered	Not covered	Not covered	Not covered	$35 										3.5406	0.0246	0.4292	0.2052	0.7289	1.168	0	0.0721	0.8353	0	0.2494	0	0	0	2.4742	0.1637	0.9413	0.6011	0.8432	1.4361	0.0829	0	0	0	0	0	0	0	0	0	0.0008										13.7968	0	2.413274619	14.0392	0.294433174	1.577429449	0.56371531	0.736829085	3.035185153	0.105095155	1.004916036	22.51789661	0	2.521308116	0	0	0	15.94711795	1.951423664	2.06183897	3.739750278	4.937425275	3.61908131	1.171405408	0	0	0	0	0	0	0	0	0	0.001057747	0	0	0	0	0	0	0	0	0	79.8251
H5010_001_0	2009	4	h.6.										OP Facility - Other										1500	Urgent Care										D	D	D		T	Coin	Coin	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	3000	583.8563465	15.0324231	0	0	1.115981382	7.457516132	0.370673692	250.7311142	0	0	0	0	0	0	8413.13551	1053.890961	680.9100398	1935.874203	0	1399.720087	7.188976457	0	0	0	150.2776996	0	0	0	0	0	0.136173114										$100/day (days 1-5)	$100/day (days 1-5)			$100 	10%	10%	$50 							$10 	$10 	$10 	$10 		$10 chiro	10%				$10 						$10 										100	100			100	0.1	0.1	50	0	0	0	0	0	0	10	10	10	10	0	10	0.1	0	0	0	10	0					10										99.20135606	99.20135606	0	0	99.20135606	0.099201356	0.099201356	49.60067803	0	0	0	0	0	0	9.920135606	9.920135606	9.920135606	9.920135606	0	9.920135606	0.099201356	0	0	0	9.920135606	0	0	0	0	0	9.920135606										4.8266	0.12426973	0	0	0.009225572	0.739795713	0.036771333	1.036369439	0	0	0	0	0	0	6.954953761	0.871228437	0.562893328	1.600344551	0	1.157117756	0.713156213	0	0	0	0.124231263	0	0	0	0	0	0.000112571	0	0	0	0	0	0	0	0	0	18.7571	0	0.15	4.8266	0.12426973	0	0	0.009225572	0.739795713	0.036771333	1.036369439	0	0	0	0	0	0	6.954953761	0.871228437	0.562893328	1.600344551	0	1.157117756	0.713156213	0	0	0	0.124231263	0	0	0	0	0	0.000112571	0	0	0	0	0	0	0	0	0	18.7571	N/A	$250/day (days 1-5)	$250/day (days 1-5)	$25/day (days 1-100)	20%	$100 	20%	20%	$50 	$100 	No cost sharing	20%	No cost sharing	No cost sharing	No cost sharing	$25 	$25 	$25 	$25 	No cost sharing	$25 	10%	No cost sharing	No cost sharing	No cost sharing	$25 	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$25 										1.5335	0.0096	0.0173	0.0829	0.5704	0.524	0.0159	0.0551	0.1985	0	0	0	0	0	1.7299	0.1199	0.6677	0.49	0.3633	1.0156	0.0696	0	0	0	0.0138	0	0	0	0	0	0.0029										7.4799	0	0.12	6.3601	0.133826877	0.017303995	0.082855807	0.579579157	1.263825567	0.052651998	1.091476397	0.198508945	0	0	0	0	0	8.684899425	0.991168076	1.230609031	2.090389334	0.363338194	2.172687961	0.782713363	0	0	0	0.138059975	0	0	0	0	0	0.00296313	0	0	0	0	0	0	0	0	0	26.237
H5010_002_0	2009	7	h.6.										OP Facility - Other										1500	Urgent Care										D	D	D		T	Coin	Coin	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	3000	583.8563465	15.0324231	0	0	1.115981382	7.457516132	0.370673692	250.7311142	0	0	0	0	0	0	8413.13551	1053.890961	680.9100398	1935.874203	0	1399.720087	7.188976457	0	0	0	150.2776996	0	0	0	0	0	0.136173114										$100/day (days 1-5)	$100/day (days 1-5)			$100 	10%	10%	$50 							$10 	$10 	$10 	$10 		$10 chiro	10%				$10 						$10 										100	100			100	0.1	0.1	50	0	0	0	0	0	0	10	10	10	10	0	10	0.1	0	0	0	10	0					10										99.20135606	99.20135606	0	0	99.20135606	0.099201356	0.099201356	49.60067803	0	0	0	0	0	0	9.920135606	9.920135606	9.920135606	9.920135606	0	9.920135606	0.099201356	0	0	0	9.920135606	0	0	0	0	0	9.920135606										4.8266	0.12426973	0	0	0.009225572	0.739795713	0.036771333	1.036369439	0	0	0	0	0	0	6.954953761	0.871228437	0.562893328	1.600344551	0	1.157117756	0.713156213	0	0	0	0.124231263	0	0	0	0	0	0.000112571	0	0	0	0	0	0	0	0	0	18.7571	0	0.15	4.8266	0.12426973	0	0	0.009225572	0.739795713	0.036771333	1.036369439	0	0	0	0	0	0	6.954953761	0.871228437	0.562893328	1.600344551	0	1.157117756	0.713156213	0	0	0	0.124231263	0	0	0	0	0	0.000112571	0	0	0	0	0	0	0	0	0	18.7571	N/A	$250/day (days 1-5)	$250/day (days 1-5)	$25/day (days 1-100)	20%	$100 	20%	20%	$50 	$100 	No cost sharing	20%	No cost sharing	No cost sharing	No cost sharing	$25 	$25 	$25 	$25 	No cost sharing	$25 	10%	No cost sharing	No cost sharing	No cost sharing	$25 	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$25 										1.5335	0.0096	0.0173	0.0829	0.5704	0.524	0.0159	0.0551	0.1985	0	0	0	0	0	1.7299	0.1199	0.6677	0.49	0.3633	1.0156	0.0696	0	0	0	0.0138	0	0	0	0	0	0.0029										7.4799	0	0.12	6.3601	0.133826877	0.017303995	0.082855807	0.579579157	1.263825567	0.052651998	1.091476397	0.198508945	0	0	0	0	0	8.684899425	0.991168076	1.230609031	2.090389334	0.363338194	2.172687961	0.782713363	0	0	0	0.138059975	0	0	0	0	0	0.00296313	0	0	0	0	0	0	0	0	0	26.237
H5010_004_0	2009	8	h.6.										OP Facility - Other										1500	Urgent Care										D	D	D		T	Coin	Coin	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	3000	583.8563465	15.0324231	0	0	1.115981382	7.457516132	0.370673692	250.7311142	0	0	0	0	0	0	8413.13551	1053.890961	680.9100398	1935.874203	0	1399.720087	7.188976457	0	0	0	150.2776996	0	0	0	0	0	0.136173114										$100/day (days 1-5)	$100/day (days 1-5)			$100 	10%	10%	$50 							$10 	$10 	$10 	$10 		$10 chiro	10%				$10 						$10 										100	100			100	0.1	0.1	50	0	0	0	0	0	0	10	10	10	10	0	10	0.1	0	0	0	10	0					10										99.20135606	99.20135606	0	0	99.20135606	0.099201356	0.099201356	49.60067803	0	0	0	0	0	0	9.920135606	9.920135606	9.920135606	9.920135606	0	9.920135606	0.099201356	0	0	0	9.920135606	0	0	0	0	0	9.920135606										4.8266	0.12426973	0	0	0.009225572	0.739795713	0.036771333	1.036369439	0	0	0	0	0	0	6.954953761	0.871228437	0.562893328	1.600344551	0	1.157117756	0.713156213	0	0	0	0.124231263	0	0	0	0	0	0.000112571	0	0	0	0	0	0	0	0	0	18.7571	0	0.15	4.8266	0.12426973	0	0	0.009225572	0.739795713	0.036771333	1.036369439	0	0	0	0	0	0	6.954953761	0.871228437	0.562893328	1.600344551	0	1.157117756	0.713156213	0	0	0	0.124231263	0	0	0	0	0	0.000112571	0	0	0	0	0	0	0	0	0	18.7571	N/A	$250/day (days 1-5)	$250/day (days 1-5)	$25/day (days 1-100)	20%	$100 	20%	20%	$50 	$100 	No cost sharing	20%	No cost sharing	No cost sharing	No cost sharing	$25 	$25 	$25 	$25 	No cost sharing	$25 	10%	No cost sharing	No cost sharing	No cost sharing	$25 	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$25 										1.5335	0.0096	0.0173	0.0829	0.5704	0.524	0.0159	0.0551	0.1985	0	0	0	0	0	1.7299	0.1199	0.6677	0.49	0.3633	1.0156	0.0696	0	0	0	0.0138	0	0	0	0	0	0.0029										7.4799	0	0.12	6.3601	0.133826877	0.017303995	0.082855807	0.579579157	1.263825567	0.052651998	1.091476397	0.198508945	0	0	0	0	0	8.684899425	0.991168076	1.230609031	2.090389334	0.363338194	2.172687961	0.782713363	0	0	0	0.138059975	0	0	0	0	0	0.00296313	0	0	0	0	0	0	0	0	0	26.237
H5010_006_0	2009	5	h.6.										OP Facility - Other										2500	Urgent Care										D	D	D	Coin	T	Coin	Coin	V	V		Coin				V	V	V	V	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	5000	583.8563465	15.0324231	520.7920338	4.343871626	1.115981382	7.459829659	0.378355801	250.7311142	1277.348217	0	7.184823138	0	0	0	7712.040884	1021.954871	624.1675365	1774.551353	24.44483363	1265.704334	7.336833321										0.124825355										$250/day (days 1-5)	$250/day (days 1-5)	$25/day	0.1	100	0.2	0.2	50	250		0.2				25	25	25	25	0.2	$25 chiro	0.2										25										250	250	25	0.1	100	0.2	0.2	50	250	0	0.2	0	0	0	25	25	25	25	0.2	25	0.2	0	0	0	0	0	0	0	0	0	25										241.1849058	241.1849058	24.11849058	0.096473962	96.47396233	0.192947925	0.192947925	48.23698116	241.1849058	0	0.192947925	0	0	0	24.11849058	24.11849058	24.11849058	24.11849058	0.192947925	24.11849058	0.192947925	0	0	0	0	0	0	0	0	0	24.11849058										11.7348	0.302132796	1.04672648	0.419070508	0.008971929	1.439358651	0.073002967	1.007876003	25.67309246	0	1.386296713	0	0	0	15.50023212	2.054000745	1.254498238	3.566625008	4.716579917	2.543906504	1.415626763	0	0	0	0	0	0	0	0	0	0.000250883	0	0	0	0	0	0	0	0	0	74.143	0	1.66	11.7348	0.302132796	1.04672648	0.419070508	0.008971929	1.439358651	0.073002967	1.007876003	25.67309246	0	1.386296713	0	0	0	15.50023212	2.054000745	1.254498238	3.566625008	4.716579917	2.543906504	1.415626763	0	0	0	0	0	0	0	0	0	0.000250883	0	0	0	0	0	0	0	0	0	74.143	N/A	$500/day (days 1-5)	$500/day (days 1-5)	$35/day (days 1-100)	0.4	100	0.4	0.4	50	500	No cost sharing	0.4	No cost sharing	No cost sharing	No cost sharing	35	35	35	35	0.4	35	0.2	No cost sharing	Not covered	Not covered	Not covered	Not covered	Not covered	Not covered	Not covered	Not covered	35										3.8039	0.0238	0.0242	0.1644	0.5688	1.0399	0.0315	0.055	0.9899	0	0.2945	0	0	0	2.3991	0.1675	0.9323	0.6842	0.4339	1.418	0.138	0	0	0	0	0	0	0	0	0	0.004										13.173	0	0.24	15.5387	0.325961843	1.070887363	0.583492811	0.577801997	2.479263986	0.104517179	1.06283576	26.66298592	0	1.680839349	0	0	0	17.89930154	2.221467707	2.186803198	4.250855107	5.15051406	3.961906913	1.553658692	0	0	0	0	0	0	0	0	0	0.004231005	0	0	0	0	0	0	0	0	0	87.316
H5041_001_0	2009	6	r.	s.	t.	u.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered							3700											A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			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		248.499904	8.006624	482.772243	689.990915	137.239837	8.875798	3.205343	310.426212	336.491996	594.909763	882.974088	0	18.388479	675.467806	3305.936792	3985.014635	27.184153	858.926086			20.06081				2.69				0.96	0.09	0.06	0.05	1.23	2.7							$650/Admit:1a	$650/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $50 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$50/Visit:9a	"$0-$100/Proc:12. $0 Dialysis -- Dialysis Center,12. $100 Dialysis -- OP Hosp"	"$30-$100/Visit:9d. $50 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $30 Partial Hospitalization,8b. $100 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15				VIS752				$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0 Health Education Materials 14a	$0 Corp Health 14a							649.999977	649.9998	43.132811	0	99.999973	0.2	0.199999	50.000017	127.313185	87.957406	83.490146	0	1.564892	71.766191	9.999998	29.999998	89.074248	39.708636			0.2				0				0	0	0	0	0	0							556.25763	556.257478	36.91224	0	85.578076	0.171156	0.171156	42.789064	108.952205	75.272277	71.449281	0	1.339205	61.416143	8.557808	25.673428	76.228049	33.981896			0.171156				0				0	0	0	0	0	0							11.5192	0.371145373	1.485017075	0	0.978726767	1.519146082	0.548613687	1.106903921	3.055128744	3.731684373	5.257321977	0	0.002052162	3.45705228	2.357631027	8.525748859	0.172682912	2.432328077	0	0	3.433527996	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.9539	0	8.4184	11.5192	0.371145373	1.485017075	0	0.978726767	1.519146082	0.548613687	1.106903921	3.055128744	3.731684373	5.257321977	0	0.002052162	3.45705228	2.357631027	8.525748859	0.172682912	2.432328077	0	0	3.433527996	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.9539		$975/Admit	$975/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$100/Proc	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins				VIS752				0	0	0	0	0	0							1.9199	0.0619	0.3457	0.5244	0.6525	1.9262	0.6956	0.1953	2.4966	0.3216	1.3378		0.0004	0.7556	1.5151	3.4591	0.0219	0.2921			1.0325				0				0	0	0	0	0	0							17.5541	0	0	13.439	0.433003373	1.830699075	0.524436	1.631211767	3.445386082	1.244241687	1.302239921	5.551735744	4.053305373	6.595113977	0	0.002414162	4.21268628	3.872695027	11.98481686	0.194542912	2.724403077	0	0	4.466028996	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.508
H5041_801_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		248.499904	8.006624	482.772243	689.990915	4.497257	8.875798	3.205343	19.733521	50.725237	594.909763	27.428029	0	0.346104	15.625658	29.436656	67.207334	0.42473	5.674832			20.06081																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999993	1024.000127	43.132811	0	0.199999	0.2	0.199999	0.199999	0.2	0	0.199999	0	0.2	0.199999	0.199999	0.2	0.5	0.2			0.2																				1023.999993	1024.000127	43.132811	0	0.199999	0.2	0.199999	0.199999	0.2	0	0.199999	0	0.2	0.199999	0.199999	0.2	0.5	0.2			0.2																				21.2053	0.683231999	1.735276993	0	0.899446903	1.7751596	0.641065395	3.946684466	10.1450474	0	5.485578372	0	0.0692208	3.125115974	5.887301763	13.4414668	0.212365	1.1349664	0	0	4.012162	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.3994	0	0	21.2053	0.683231999	1.735276993	0	0.899446903	1.7751596	0.641065395	3.946684466	10.1450474	0	5.485578372	0	0.0692208	3.125115974	5.887301763	13.4414668	0.212365	1.1349664	0	0	4.012162	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.3994		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3561	0.0759	0.1928		0.5702	1.1254	0.4064	0.7434	1.9449		1.0422		0.013	0.5887	1.1803	2.6947	0.0426	0.2275			0.8043																				14.0085	0	0	23.5615	0.759146999	1.928085993	0	1.469686903	2.9005876	1.047494395	4.690086466	12.0899434	0	6.527739372	0	0.0822588	3.713765974	7.067559763	16.1361348	0.25494	1.3624984	0	0	4.816497	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.4079
H5041_802_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		248.499904	8.006624	482.772243	689.990915	4.497257	8.875798	3.205343	19.733521	50.725237	594.909763	27.428029	0	0.346104	15.625658	29.436656	67.207334	0.42473	5.674832			20.06081																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999993	1024.000127	43.132811	0	0.199999	0.2	0.199999	0.199999	0.2	0	0.199999	0	0.2	0.199999	0.199999	0.2	0.5	0.2			0.2																				1023.999993	1024.000127	43.132811	0	0.199999	0.2	0.199999	0.199999	0.2	0	0.199999	0	0.2	0.199999	0.199999	0.2	0.5	0.2			0.2																				21.2053	0.683231999	1.735276993	0	0.899446903	1.7751596	0.641065395	3.946684466	10.1450474	0	5.485578372	0	0.0692208	3.125115974	5.887301763	13.4414668	0.212365	1.1349664	0	0	4.012162	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.3994	0	0	21.2053	0.683231999	1.735276993	0	0.899446903	1.7751596	0.641065395	3.946684466	10.1450474	0	5.485578372	0	0.0692208	3.125115974	5.887301763	13.4414668	0.212365	1.1349664	0	0	4.012162	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.3994		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3561	0.0759	0.1928		0.5702	1.1254	0.4064	0.7434	1.9449		1.0422		0.013	0.5887	1.1803	2.6947	0.0426	0.2275			0.8043																				14.0085	0	0	23.5615	0.759146999	1.928085993	0	1.469686903	2.9005876	1.047494395	4.690086466	12.0899434	0	6.527739372	0	0.0822588	3.713765974	7.067559763	16.1361348	0.25494	1.3624984	0	0	4.816497	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.4079
H5041_803_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		248.499904	8.006624	482.772243	689.990915	4.497257	8.875798	3.205343	19.733521	50.725237	594.909763	27.428029	0	0.346104	15.625658	29.436656	67.207334	0.42473	5.674832			20.06081																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999993	1024.000127	43.132811	0	0.199999	0.2	0.199999	0.199999	0.2	0	0.199999	0	0.2	0.199999	0.199999	0.2	0.5	0.2			0.2																				1023.999993	1024.000127	43.132811	0	0.199999	0.2	0.199999	0.199999	0.2	0	0.199999	0	0.2	0.199999	0.199999	0.2	0.5	0.2			0.2																				21.2053	0.683231999	1.735276993	0	0.899446903	1.7751596	0.641065395	3.946684466	10.1450474	0	5.485578372	0	0.0692208	3.125115974	5.887301763	13.4414668	0.212365	1.1349664	0	0	4.012162	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.3994	0	0	21.2053	0.683231999	1.735276993	0	0.899446903	1.7751596	0.641065395	3.946684466	10.1450474	0	5.485578372	0	0.0692208	3.125115974	5.887301763	13.4414668	0.212365	1.1349664	0	0	4.012162	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.3994		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3561	0.0759	0.1928		0.5702	1.1254	0.4064	0.7434	1.9449		1.0422		0.013	0.5887	1.1803	2.6947	0.0426	0.2275			0.8043																				14.0085	0	0	23.5615	0.759146999	1.928085993	0	1.469686903	2.9005876	1.047494395	4.690086466	12.0899434	0	6.527739372	0	0.0822588	3.713765974	7.067559763	16.1361348	0.25494	1.3624984	0	0	4.816497	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.4079
H5041_804_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		248.499904	8.006624	482.772243	689.990915	4.497257	8.875798	3.205343	19.733521	50.725237	594.909763	27.428029	0	0.346104	15.625658	29.436656	67.207334	0.42473	5.674832			20.06081																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999993	1024.000127	43.132811	0	0.199999	0.2	0.199999	0.199999	0.2	0	0.199999	0	0.2	0.199999	0.199999	0.2	0.5	0.2			0.2																				1023.999993	1024.000127	43.132811	0	0.199999	0.2	0.199999	0.199999	0.2	0	0.199999	0	0.2	0.199999	0.199999	0.2	0.5	0.2			0.2																				21.2053	0.683231999	1.735276993	0	0.899446903	1.7751596	0.641065395	3.946684466	10.1450474	0	5.485578372	0	0.0692208	3.125115974	5.887301763	13.4414668	0.212365	1.1349664	0	0	4.012162	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.3994	0	0	21.2053	0.683231999	1.735276993	0	0.899446903	1.7751596	0.641065395	3.946684466	10.1450474	0	5.485578372	0	0.0692208	3.125115974	5.887301763	13.4414668	0.212365	1.1349664	0	0	4.012162	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.3994		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3561	0.0759	0.1928		0.5702	1.1254	0.4064	0.7434	1.9449		1.0422		0.013	0.5887	1.1803	2.6947	0.0426	0.2275			0.8043																				14.0085	0	0	23.5615	0.759146999	1.928085993	0	1.469686903	2.9005876	1.047494395	4.690086466	12.0899434	0	6.527739372	0	0.0822588	3.713765974	7.067559763	16.1361348	0.25494	1.3624984	0	0	4.816497	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.4079
H5042_001_0	2009	8																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	S	P	P	P	P	P	P	P	P	P																																																			0		267.2577622	152.4581091	815.5431643	957.6917931	460.2100138	9.807995495	2.736794603	841.7031121	350.1324267		747.358928			1502.368273	5036.257621	9252.562554	4.33473278	1104.803002		660.5350366					553.3245399		64.83891084														1A: $250/admit - $750 annual max	1B: $250/admit - $750 annual max	"2: $0/day days 1-20, $65/day days 21-100"	"6: $0/day days 1-20, $25/day days 21+"	10A: $50	11A: 20%	11B: 20%	4A: $50; 4B: $35	9A: $100	"8A: $0-$10 for lab, x-rays"	"8A: $0-$10 for lab, x-rays; 8B: $10"		12: $0	"7I: $10; 9C: Ind - $10/visits 1-10, $25/visits 11+, Group - $5/visits 1-10, $10/visits 11+"	7A: $5; 9A: $100; 14B: $0	7D: $10; 15: $0	"7E: Ind - $10/visits 1-10, $25/visits 11+, Group - $5/visits 1-10, $10/visits 11+; 9C: Ind - $10/visits 1-10, $25/visits 11+, Group - $5/visits 1-10, $10/visits 11+"	7C: $10; 7I: $10	"8A: $0-$10 for lab, x-rays"	"6: $0/day days 1-20, $25/day days 21+; 7B: $10; 7D: $10; 14C: $0"	15: $0			16A: $0	17A: $10	17B: $0	18A: $10	18B: $0	14A: $0												250	247.1794872	33.28916668	2.5	50	0.2	0.2	42.27809755	100		10			11.22224979	43.65018079	10	13	10		9.676568654					10		10														195.5208209	193.314945	26.03490078	1.955208209	39.10416418	0.156416657	0.156416657	33.06499335	78.20832836		7.820832836			8.776733962	34.13807672	7.820832836	10.16708269	7.820832836		7.567882587					7.820832836		7.820832836														4.3545	2.456035915	1.769382114	0.156040571	1.499677328	1.534133864	0.428080262	2.319242317	2.281939316	0	0.48708077	0	0	1.098823887	14.32734575	6.030228753	0.003672632	0.720039966	0	0.416570967	0	0	0	0	0.360621561	0	0.042257857	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2857	0	11.2251	4.3545	2.456035915	1.769382114	0.156040571	1.499677328	1.534133864	0.428080262	2.319242317	2.281939316	0	0.48708077	0	0	1.098823887	14.32734575	6.030228753	0.003672632	0.720039966	0	0.416570967	0	0	0	0	0.360621561	0	0.042257857	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2857	2500	1A: $500/admit	1B: $500/admit	"2: $0/day days 1-20, $65/day days 21-100"	"6: $0/day days 1-20, $25/day days 21+"	10A: $50	11A: 20%	11B: 20%	4A: $50; 4B: $35	9A: $100	"8A: $0-$10 for lab, x-rays"	"8A: $0-$10 for lab, x-rays; 8B: $10"		12: $0	"7I: $10; 9C: Ind - $10/visits 1-10, $25/visits 11+, Group - $5/visits 1-10, $10/visits 11+"	7A: $5; 9A: $100; 14B: $0	7D: $10; 15: $0	"7E: Ind - $10/visits 1-10, $25/visits 11+, Group - $5/visits 1-10, $10/visits 11+; 9C: Ind - $10/visits 1-10, $25/visits 11+, Group - $5/visits 1-10, $10/visits 11+"	7C: $10; 7I: $10	"8A: $0-$10 for lab, x-rays"	"6: $0/day days 1-20, $25/day days 21+; 7B: $10; 7D: $10; 14C: $0"	15: $0			16A: $0	17A: $10	17B: $0	18A: $10	18B: $0	14A: $0												1.0502	0.5901	0.2134	0.0188	0.1808	0.185	0.0516	0.2797	0.2752		0.0587			0.1325	1.7276	0.7271	0.0004	0.0868		0.0502					0.0435		0.0051														5.6768	0	2.604013897	5.4047	3.046099374	1.982740971	0.17485654	1.680514151	1.719125588	0.479699816	2.598905418	2.557104279	0	0.545814831	0	0	1.231324271	16.05499185	6.757376779	0.004115492	0.806865137	0	0.466802686	0	0	0	0	0.404106687	0	0.047353471	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9625
H5042_002_0	2009	6																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	S	P	P	P	P	P	P	P	P	P																																																			0		294.3565948	29.02397193	944.3112783	1069.730413	491.7201857	10.68579961	2.982295354	868.8336224	340.0539123		775.1832667			1222.35233	5449.235156	10303.02204		871.1872501		608.9096666					646.7063836		58.1438904														1A: $350/admit - $1050 annual max	1B: $350/admit - $1050 annual max	"2: $0/day days 1-20, $65/day days 21-100"	"6: $0/day days 1-20, $25/day days 21+"	10A: $100	11A: 20%	11B: 20%	4A: $50; 4B: $35	9A: $125	"8A: $0-$25 for lab, x-rays"	"8A: $0-$25 for lab, x-rays; 8B: $25"		12: $0	"7I: $25; 9C: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+"	7A: $10; 9A: $125; 14B: $0	7D: $25; 15: $0	"7E: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+; 9C: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+"	7C: $25; 7I: $25	"8A: $0-$25 for lab, x-rays"	"6: $0/day days 1-20, $25/day days 21+; 7B: $25; 7D: $25; 14C: $0"	15: $0			16A: $0	17A: $25	17B: $0	18A: $25	18B: $0	14A: $0												350	321.2765957	33.28916668	2.5	100	0.2	0.2	43.97774687	125		25			12.54913135	57.6026545	25		25		23.52708721					25		25														259.6164506	238.3105412	24.69261513	1.854403218	74.17612873	0.148352257	0.148352257	32.62099013	92.72016092		18.54403218			9.308459827	42.72741916	18.54403218		18.54403218		17.4514825					18.54403218		18.54403218														6.3683	0.576393205	1.943126247	0.165309293	3.03949165	1.585262495	0.442430248	2.361851085	2.627487789	0	1.197918621	0	0	0.948184796	19.40264621	15.92163103	0	1.346277034	0	0.885531366	0	0	0	0	0.999378666	0	0.089851848	0	0	0	0	0	0	0	0	0	0	0	0	0	59.9011	0	20.8541	6.3683	0.576393205	1.943126247	0.165309293	3.03949165	1.585262495	0.442430248	2.361851085	2.627487789	0	1.197918621	0	0	0.948184796	19.40264621	15.92163103	0	1.346277034	0	0.885531366	0	0	0	0	0.999378666	0	0.089851848	0	0	0	0	0	0	0	0	0	0	0	0	0	59.9011	3350	1A: $700/admit	1B: $700/admit	"2: $0/day days 1-20, $65/day days 21-100"	"6: $0/day days 1-20, $25/day days 21+"	10A: $100	11A: 20%	11B: 20%	4A: $50; 4B: $35	9A: $125	"8A: $0-$25 for lab, x-rays"	"8A: $0-$25 for lab, x-rays; 8B: $25"		12: $0	"7I: $25; 9C: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+"	7A: $10; 9A: $125; 14B: $0	7D: $25; 15: $0	"7E: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+; 9C: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+"	7C: $25; 7I: $25	"8A: $0-$25 for lab, x-rays"	"6: $0/day days 1-20, $25/day days 21+; 7B: $25; 7D: $25; 14C: $0"	15: $0			16A: $0	17A: $25	17B: $0	18A: $25	18B: $0	14A: $0												1.5483	0.1367	0.2362	0.0201	0.3695	0.1927	0.0538	0.2871	0.3194		0.1456			0.1153	2.3587	1.9355		0.1637		0.1076					0.1215		0.0109														8.1226	0	4.269250537	7.9166	0.713050594	2.179340952	0.185404995	3.408985205	1.777973758	0.496213954	2.648967767	2.946896399	0	1.343542712	0	0	1.06345018	21.76131456	17.85713234	0	1.509936206	0	0.993180331	0	0	0	0	1.120867395	0	0.100774621	0	0	0	0	0	0	0	0	0	0	0	0	0	68.0237
H5042_004_0	2009	6																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	S	P	P	P	P	P	P	P	P	P																																																			0		309.8490471	30.5515494	994.0118719	1126.032014	517.6001955	11.24821012	3.139258268	914.5617078	357.9514866		815.982386			1286.686663	5736.037006	10845.28636		917.0392106		640.9575438					680.7435617		61.20409516														1A: $250/admit - $750 annual max	1B: $250/admit - $750 annual max	"2: $0/day days 1-20, $65/day days 21-100"	"6: $0/day days 1-20, $25/day days 21+"	10A: $50	11A: 20%	11B: 20%	4A: $50; 4B: $35	9A: $100	"8A: $0-$10 for lab, x-rays"	"8A: $0-$10 for lab, x-rays; 8B: $10"		12: $0	"7I: $10; 9C: Ind - $10/visits 1-10, $25/visits 11+, Group - $5/visits 1-10, $10/visits 11+"	7A: $5; 9A: $100; 14B: $0	7D: $10; 15: $0	"7E: Ind - $10/visits 1-10, $25/visits 11+, Group - $5/visits 1-10, $10/visits 11+; 9C: Ind - $10/visits 1-10, $25/visits 11+, Group - $5/visits 1-10, $10/visits 11+"	7C: $10; 7I: $10	"8A: $0-$10 for lab, x-rays"	"6: $0/day days 1-20, $25/day days 21+; 7B: $10; 7D: $10; 14C: $0"	15: $0			16A: $0	17A: $10	17B: $0	18A: $10	18B: $0	14A: $0												250	230.8510638	33.28916668	2.5	50	0.2	0.2	42.23574409	100		10			10.683108	44.32393198	10		10		9.50902907					10		10														191.0469222	176.4135409	25.43917135	1.910469222	38.20938444	0.152837538	0.152837538	32.27603566	76.41876888		7.641876888			8.163899611	33.87180314	7.641876888		7.641876888		7.266682947					7.641876888		7.641876888														4.933	0.449142251	2.107236527	0.179270792	1.648098738	1.719148738	0.479796504	2.459868858	2.27951766	0	0.519636411	0	0	0.875365062	16.19082635	6.9065286	0	0.583991729	0	0.388136271	0	0	0	0	0.433513208	0	0.03897618	0	0	0	0	0	0	0	0	0	0	0	0	0	42.192	0	13.0196	4.933	0.449142251	2.107236527	0.179270792	1.648098738	1.719148738	0.479796504	2.459868858	2.27951766	0	0.519636411	0	0	0.875365062	16.19082635	6.9065286	0	0.583991729	0	0.388136271	0	0	0	0	0.433513208	0	0.03897618	0	0	0	0	0	0	0	0	0	0	0	0	0	42.192	2500	1A: $500/admit	1B: $500/admit	"2: $0/day days 1-20, $65/day days 21-100"	"6: $0/day days 1-20, $25/day days 21+"	10A: $50	11A: 20%	11B: 20%	4A: $50; 4B: $35	9A: $100	"8A: $0-$10 for lab, x-rays"	"8A: $0-$10 for lab, x-rays; 8B: $10"		12: $0	"7I: $10; 9C: Ind - $10/visits 1-10, $25/visits 11+, Group - $5/visits 1-10, $10/visits 11+"	7A: $5; 9A: $100; 14B: $0	7D: $10; 15: $0	"7E: Ind - $10/visits 1-10, $25/visits 11+, Group - $5/visits 1-10, $10/visits 11+; 9C: Ind - $10/visits 1-10, $25/visits 11+, Group - $5/visits 1-10, $10/visits 11+"	7C: $10; 7I: $10	"8A: $0-$10 for lab, x-rays"	"6: $0/day days 1-20, $25/day days 21+; 7B: $10; 7D: $10; 14C: $0"	15: $0			16A: $0	17A: $10	17B: $0	18A: $10	18B: $0	14A: $0												1.202	0.1064	0.2567	0.0218	0.2008	0.2094	0.0585	0.2997	0.2777		0.0633			0.1066	1.9726	0.8414		0.0711		0.0473					0.0528		0.0047														5.7931	0	2.766556596	6.135	0.555557171	2.363968042	0.201111939	1.848891994	1.928598249	0.53825168	2.759562721	2.557238748	0	0.582945414	0	0	0.982013649	18.16340765	7.747973555	0	0.65514135	0	0.435424182	0	0	0	0	0.486329539	0	0.043724775	0	0	0	0	0	0	0	0	0	0	0	0	0	47.9851
H5042_005_0	2009	8																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	S	P	P	P	P	P	P	P	P	P																																																			0		253.8948741	144.8352037	774.7660061	909.8072035	437.1995131	9.31759572	2.599954873	799.6179565	332.6258054		709.9909816			1427.24986	4784.44474	8789.934427	4.117996141	1049.562852		627.5082848					525.6583129		61.5969653														1A: $350/admit - $1050 annual max	1B: $350/admit - $1050 annual max	"2: $0/day days 1-20, $65/day days 21-100"	"6: $0/day days 1-20, $25/day days 21+"	10A: $100	11A: 20%	11B: 20%	4A: $50; 4B: $35	9A: $125	"8A: $0-$25 for lab, x-rays"	"8A: $0-$25 for lab, x-rays; 8B: $25"		12: $0	"7I: $25; 9C: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+"	7A: $10; 9A: $125; 14B: $0	7D: $25; 15: $0	"7E: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+; 9C: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+"	7C: $25; 7I: $25	"8A: $0-$25 for lab, x-rays"	"6: $0/day days 1-20, $25/day days 21+; 7B: $25; 7D: $25; 14C: $0"	15: $0			16A: $0	17A: $25	17B: $0	18A: $25	18B: $0	14A: $0												350	345.7692308	33.28916668	2.5	100	0.2	0.2	43.97758255	125		25			14.56102878	56.78706095	25	21.195	25		24.02970596					25		25														265.9784918	262.7633672	25.29772099	1.89984637	75.9938548	0.15198771	0.15198771	33.42026023	94.99231849		18.9984637			11.06548707	43.15467664	18.9984637	16.10689752	18.9984637		18.26109986					18.9984637		18.9984637														5.6275	3.171448817	1.633317854	0.144041159	2.768706359	1.416160032	0.395161186	2.226953349	2.633074703	0	1.124061491	0	0	1.316101239	17.20593047	13.91627084	0.005527345	1.661673478	0	0.954915954	0	0	0	0	0.832225031	0	0.097520642	0	0	0	0	0	0	0	0	0	0	0	0	0	57.1306	0	18.0473	5.6275	3.171448817	1.633317854	0.144041159	2.768706359	1.416160032	0.395161186	2.226953349	2.633074703	0	1.124061491	0	0	1.316101239	17.20593047	13.91627084	0.005527345	1.661673478	0	0.954915954	0	0	0	0	0.832225031	0	0.097520642	0	0	0	0	0	0	0	0	0	0	0	0	0	57.1306	3350	1A: $700/admit	1B: $700/admit	"2: $0/day days 1-20, $65/day days 21-100"	"6: $0/day days 1-20, $25/day days 21+"	10A: $100	11A: 20%	11B: 20%	4A: $50; 4B: $35	9A: $125	"8A: $0-$25 for lab, x-rays"	"8A: $0-$25 for lab, x-rays; 8B: $25"		12: $0	"7I: $25; 9C: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+"	7A: $10; 9A: $125; 14B: $0	7D: $25; 15: $0	"7E: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+; 9C: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+"	7C: $25; 7I: $25	"8A: $0-$25 for lab, x-rays"	"6: $0/day days 1-20, $25/day days 21+; 7B: $25; 7D: $25; 14C: $0"	15: $0			16A: $0	17A: $25	17B: $0	18A: $25	18B: $0	14A: $0												1.357	0.7622	0.1969	0.0174	0.3338	0.1707	0.0476	0.2685	0.3175		0.1355			0.1587	2.0745	1.6779	0.0007	0.2003		0.1151					0.1003		0.0118														7.9466	0	3.984299228	6.9846	3.933614863	1.830247553	0.161408252	3.102530242	1.586906937	0.442805907	2.495457884	2.950545431	0	1.259589973	0	0	1.474784021	19.28045545	15.59416043	0.006193779	1.862022024	0	1.070050501	0	0	0	0	0.932566691	0	0.10927874	0	0	0	0	0	0	0	0	0	0	0	0	0	65.0772
H5042_006_0	2009	6																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	S	P	P	P	P	P	P	P	P	P																																																			0		356.3264042	35.13428181	1143.113653	1294.936816	595.2402248	12.93544163	3.610147008	1051.745964	411.6442096		1146.82731			1479.689662	2730.505878	12472.07932		1054.595092		737.1011753					782.8550959		70.38470943														1A: $100/admit - $300 annual max	1B: $100/admit - $300 annual max	"2: $0/day days 1-20, $30/day days 21-100"	"6: $0/day days 1-20, $10/day days 21+"	10A: $50	11A: 20%	11B: 20%	4A: $50; 4B: $35	9A: $50	"8A: $0 lab, $0 x-rays"	"8A: $0 lab, $0 x-rays; 8B: $0"		12: $0	"7I: $10; 9C: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+"	7A: $0; 9A: $50; 14B: $0	7D: $10; 15: $0	"7E: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+; 9C: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+"	7C: $10; 7I: $10	"8A: $0 lab, $0 x-rays"	"6: $0/day days 1-20, $10/day days 21+; 7B: $10; 7D: $10; 14C: $0"	15: $0			16A: $0	17A: $10	17B: $20	18A: $10	18B: $0	14A: $0												100	93.61702128	15.36423077	1	50	0.2	0.2	42.23574409	50		25			12.54913135	50	10		10		9.410834884					10		10														81.75604338	76.53757253	12.56118718	0.817560434	40.87802169	0.163512087	0.163512087	34.53027326	40.87802169		20.43901085			10.25967327	40.87802169	8.175604338		8.175604338		7.69392625					8.175604338		8.175604338														2.4277	0.224091054	1.196572046	0.088224092	2.027686902	2.115101055	0.590302671	3.026422961	1.402266744	0	1.953334652	0	0	1.265094374	9.301473209	8.497232148	0	0.718496018	0	0.472600174	0	0	0	0	0.53335946	0	0.047953128	0	0	0	0	0	0	0	0	0	0	0	0	0	35.8879	0	8.0084	2.4277	0.224091054	1.196572046	0.088224092	2.027686902	2.115101055	0.590302671	3.026422961	1.402266744	0	1.953334652	0	0	1.265094374	9.301473209	8.497232148	0	0.718496018	0	0.472600174	0	0	0	0	0.53335946	0	0.047953128	0	0	0	0	0	0	0	0	0	0	0	0	0	35.8879	2500	1A: $200/admit	1B: $200/admit	"2: $0/day days 1-20, $30/day days 21-100"	"6: $0/day days 1-20, $10/day days 21+"	10A: $50	11A: 20%	11B: 20%	4A: $50; 4B: $35	9A: $50	"8A: $0 lab, $0 x-rays"	"8A: $0 lab, $0 x-rays; 8B: $0"		12: $0	"7I: $10; 9C: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+"	7A: $0; 9A: $50; 14B: $0	7D: $10; 15: $0	"7E: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+; 9C: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+"	7C: $10; 7I: $10	"8A: $0 lab, $0 x-rays"	"6: $0/day days 1-20, $10/day days 21+; 7B: $10; 7D: $10; 14C: $0"	15: $0			16A: $0	17A: $10	17B: $20	18A: $10	18B: $0	14A: $0												0.6126	0.0546	0.151	0.0111	0.2558	0.2669	0.0745	0.3818	0.1769		0.2465			0.1596	1.1736	1.0721		0.0907		0.0596					0.0673		0.0061														4.8607	0	1.621573008	3.0403	0.278711313	1.347545936	0.099355502	2.283524216	2.381967588	0.66478234	3.408272804	1.579193546	0	2.199790794	0	0	1.424713863	10.4750587	9.569344935	0	0.809150098	0	0.532229083	0	0	0	0	0.60065449	0	0.05400347	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7486
H5042_007_0	2009	8																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	S	P	P	P	P	P	P	P	P	P																																																			0		307.3464266	175.3268255	937.8746389	1101.345562	529.2415158	11.27919482	3.147313794	967.9585789	402.6522907		1076.014543			1727.723514	2356.316923	10640.44694	4.984942696	1270.523452		759.6152921					636.3232208		74.56474746														1A: $100/admit - $300 annual max	1B: $100/admit - $300 annual max	"2: $0/day days 1-20, $30/day days 21-100"	"6: $0/day days 1-20, $10/day days 21+"	10A: $50	11A: 20%	11B: 20%	4A: $50; 4B: $35	9A: $50	"8A: $0 lab, $0 x-rays"	"8A: $0 lab, $0 x-rays; 8B: $0"		12: $0	"7I: $10; 9C: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+"	7A: $0; 9A: $50; 14B: $0	7D: $10; 15: $0	"7E: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+; 9C: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+"	7C: $10; 7I: $10	"8A: $0 lab, $0 x-rays"	"6: $0/day days 1-20, $10/day days 21+; 7B: $10; 7D: $10; 14C: $0"	15: $0			16A: $0	17A: $10	17B: $20	18A: $10	18B: $0	14A: $0												100	99.05982906	15.36423077	1	50	0.2	0.2	42.27809755	50		25			14.56102878	50	10	21.195	10		9.611882385					10		10														83.59559722	82.80965571	12.84382047	0.835955972	41.79779861	0.167191194	0.167191194	35.34262814	41.79779861		20.89889931			12.17237897	41.79779861	8.359559722	17.71808683	8.359559722		8.035110484					8.359559722		8.359559722														2.1411	1.209896171	1.003824458	0.076723033	1.843427525	1.885782054	0.526203152	2.850850009	1.40249828	0	1.873959965	0	0	1.752542115	8.207405016	7.412454304	0.007360304	0.885084723	0	0.508632733	0	0	0	0	0.443281831	0	0.051944038	0	0	0	0	0	0	0	0	0	0	0	0	0	34.0829	0	6.6883	2.1411	1.209896171	1.003824458	0.076723033	1.843427525	1.885782054	0.526203152	2.850850009	1.40249828	0	1.873959965	0	0	1.752542115	8.207405016	7.412454304	0.007360304	0.885084723	0	0.508632733	0	0	0	0	0.443281831	0	0.051944038	0	0	0	0	0	0	0	0	0	0	0	0	0	34.0829	2500	1A: $200/admit	1B: $200/admit	"2: $0/day days 1-20, $30/day days 21-100"	"6: $0/day days 1-20, $10/day days 21+"	10A: $50	11A: 20%	11B: 20%	4A: $50; 4B: $35	9A: $50	"8A: $0 lab, $0 x-rays"	"8A: $0 lab, $0 x-rays; 8B: $0"		12: $0	"7I: $10; 9C: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+"	7A: $0; 9A: $50; 14B: $0	7D: $10; 15: $0	"7E: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+; 9C: Ind - $20/visits 1-10, $25/visits 11+, Group - $20/visits 1-10, $25/visits 11+"	7C: $10; 7I: $10	"8A: $0 lab, $0 x-rays"	"6: $0/day days 1-20, $10/day days 21+; 7B: $10; 7D: $10; 14C: $0"	15: $0			16A: $0	17A: $10	17B: $20	18A: $10	18B: $0	14A: $0												0.5378	0.3025	0.1261	0.0096	0.2315	0.2368	0.0661	0.358	0.1761		0.2353			0.2201	1.0307	0.9309	0.0009	0.1112		0.0639					0.0557		0.0065														4.6998	0	1.458529137	2.6788	1.512347833	1.129891477	0.086358427	2.074937539	2.122611235	0.59228728	3.208878907	1.578633437	0	2.109304448	0	0	1.972638129	9.238146083	8.343360118	0.00828466	0.996239609	0	0.572510249	0	0	0	0	0.498952141	0	0.05846752	0	0	0	0	0	0	0	0	0	0	0	0	0	38.7827
H5042_801_0	2009	6																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	S	P	P	P	P	P	P	P	P	P																																																			0		332.4398343	189.6414462	1014.447746		572.4516267	13.19616923	3.68222077	1046.9879	435.5269795	8990.811038	5056.212542	13.95560969	29.02132469	2505.191631	14150.75748	14044.46056	5.391940107	1374.255789	2284.655757	1661.81687	256.0130724																				1A: Medicare defined cost share	1B: Medicare defined cost share	2: Medicare defined cost share	6: Medicare defined cost share	10A: Medicare defined cost share	11A: Medicare defined cost share	11B: Medicare defined cost share	4A: Medicare defined cost share; 4B: Medicare defined cost share	9A: Medicare defined cost share	8A: Medicare defined cost share	8A: Medicare defined cost share; 8B: Medicare defined cost share	Medicare defined cost share	12: Medicare defined cost share	7I: Medicare defined cost share; 9C: Medicare defined cost share	7A: Medicare defined cost share; 9A: Medicare defined cost share; 14B: Medicare defined cost share	7D: Medicare defined cost share; 15: Medicare defined cost share	7E: Medicare defined cost share; 9C: Medicare defined cost share	7C: Medicare defined cost share; 7I: Medicare defined cost share	8A: Medicare defined cost share	6: Medicare defined cost share; 7B: Medicare defined cost share; 7D: Medicare defined cost share; 14C: Medicare defined cost share	15: Medicare defined cost share																				929.5945072	58.87474987	76.79730352		63.08302755	0.231	0.231	37.47910328	363.3178912	4.77124479	23.31672845	35.06100595	67.81238518	34.9740393	22.07575541	23.57593454	19.8810203	10.20110629	33.85209092	14.87216385	60.15471021																				929.5945072	58.87474987	76.79730352		63.08302755	0.231	0.231	37.47910328	363.3178912	4.77124479	23.31672845	35.06100595	67.81238518	34.9740393	22.07575541	23.57593454	19.8810203	10.20110629	33.85209092	14.87216385	60.15471021																				25.7529	0.930424393	6.492237619	0	3.009331812	3.048315092	0.850592998	3.270013969	13.18622865	3.574780027	9.824527904	0.04077481	0.164000437	7.301389214	26.03238842	27.5926069	0.008933106	1.168244114	6.445031199	2.059567732	1.283366015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.0356	0	0	25.7529	0.930424393	6.492237619	0	3.009331812	3.048315092	0.850592998	3.270013969	13.18622865	3.574780027	9.824527904	0.04077481	0.164000437	7.301389214	26.03238842	27.5926069	0.008933106	1.168244114	6.445031199	2.059567732	1.283366015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.0356		1A: Medicare defined cost share	1B: Medicare defined cost share	2: Medicare defined cost share	6: Medicare defined cost share	10A: Medicare defined cost share	11A: Medicare defined cost share	11B: Medicare defined cost share	4A: Medicare defined cost share; 4B: Medicare defined cost share	9A: Medicare defined cost share	8A: Medicare defined cost share	8A: Medicare defined cost share; 8B: Medicare defined cost share	Medicare defined cost share	12: Medicare defined cost share	7I: Medicare defined cost share; 9C: Medicare defined cost share	7A: Medicare defined cost share; 9A: Medicare defined cost share; 14B: Medicare defined cost share	7D: Medicare defined cost share; 15: Medicare defined cost share	7E: Medicare defined cost share; 9C: Medicare defined cost share	7C: Medicare defined cost share; 7I: Medicare defined cost share	8A: Medicare defined cost share	6: Medicare defined cost share; 7B: Medicare defined cost share; 7D: Medicare defined cost share; 14C: Medicare defined cost share	15: Medicare defined cost share																				3.1585	0.1459	0.8931		0.414	0.4193	0.117	0.4498	1.814	0.5456	1.3515	0.0056	0.0226	1.0912	3.5812	3.7958	0.0012	0.1607	0.8866	0.2833	0.1765																				19.3135	0	0	28.9113	1.076358814	7.385349673	0	3.423313966	3.467660025	0.967605791	3.71985716	15.00020719	4.120338708	11.17605026	0.046384043	0.186561344	8.392558169	29.61356355	31.38841526	0.010161999	1.328954945	7.331649247	2.34289451	1.459913721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	161.3491
H5042_802_0	2009	6																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	S	P	P	P	P	P	P	P	P	P																																																			0		332.4398343	189.6414462	1014.447746		572.4516267	13.19616923	3.68222077	1046.9879	435.5269795	8990.811038	5056.212542	13.95560969	29.02132469	2505.191631	14150.75748	14044.46056	5.391940107	1374.255789	2284.655757	1661.81687	256.0130724																				1A: Medicare defined cost share	1B: Medicare defined cost share	2: Medicare defined cost share	6: Medicare defined cost share	10A: Medicare defined cost share	11A: Medicare defined cost share	11B: Medicare defined cost share	4A: Medicare defined cost share; 4B: Medicare defined cost share	9A: Medicare defined cost share	8A: Medicare defined cost share	8A: Medicare defined cost share; 8B: Medicare defined cost share	Medicare defined cost share	12: Medicare defined cost share	7I: Medicare defined cost share; 9C: Medicare defined cost share	7A: Medicare defined cost share; 9A: Medicare defined cost share; 14B: Medicare defined cost share	7D: Medicare defined cost share; 15: Medicare defined cost share	7E: Medicare defined cost share; 9C: Medicare defined cost share	7C: Medicare defined cost share; 7I: Medicare defined cost share	8A: Medicare defined cost share	6: Medicare defined cost share; 7B: Medicare defined cost share; 7D: Medicare defined cost share; 14C: Medicare defined cost share	15: Medicare defined cost share																				931.5919211	59.00125368	76.90207538		63.08302755	0.231	0.231	37.47910328	363.3178912	4.77124479	23.31672845	35.06100595	67.81238518	34.9740393	22.07575541	23.57593454	19.8810203	10.20110629	33.85209092	14.87216385	60.15471021																				931.5919211	59.00125368	76.90207538		63.08302755	0.231	0.231	37.47910328	363.3178912	4.77124479	23.31672845	35.06100595	67.81238518	34.9740393	22.07575541	23.57593454	19.8810203	10.20110629	33.85209092	14.87216385	60.15471021																				25.8082	0.93242359	6.501094751	0	3.009331812	3.048315092	0.850592998	3.270013969	13.18622865	3.574780027	9.824527904	0.04077481	0.164000437	7.301389214	26.03238842	27.5926069	0.008933106	1.168244114	6.445031199	2.059567732	1.283366015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.1018	0	0	25.8082	0.93242359	6.501094751	0	3.009331812	3.048315092	0.850592998	3.270013969	13.18622865	3.574780027	9.824527904	0.04077481	0.164000437	7.301389214	26.03238842	27.5926069	0.008933106	1.168244114	6.445031199	2.059567732	1.283366015	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.1018		1A: Medicare defined cost share	1B: Medicare defined cost share	2: Medicare defined cost share	6: Medicare defined cost share	10A: Medicare defined cost share	11A: Medicare defined cost share	11B: Medicare defined cost share	4A: Medicare defined cost share; 4B: Medicare defined cost share	9A: Medicare defined cost share	8A: Medicare defined cost share	8A: Medicare defined cost share; 8B: Medicare defined cost share	Medicare defined cost share	12: Medicare defined cost share	7I: Medicare defined cost share; 9C: Medicare defined cost share	7A: Medicare defined cost share; 9A: Medicare defined cost share; 14B: Medicare defined cost share	7D: Medicare defined cost share; 15: Medicare defined cost share	7E: Medicare defined cost share; 9C: Medicare defined cost share	7C: Medicare defined cost share; 7I: Medicare defined cost share	8A: Medicare defined cost share	6: Medicare defined cost share; 7B: Medicare defined cost share; 7D: Medicare defined cost share; 14C: Medicare defined cost share	15: Medicare defined cost share																				3.1653	0.1462	0.8943		0.414	0.4193	0.117	0.4498	1.814	0.5456	1.3515	0.0056	0.0226	1.0912	3.5812	3.7958	0.0012	0.1607	0.8866	0.2833	0.1765																				19.3218	0	0	28.9735	1.07867158	7.395425246	0	3.423313966	3.467660025	0.967605791	3.71985716	15.00020719	4.120338708	11.17605026	0.046384043	0.186561344	8.392558169	29.61356355	31.38841526	0.010161999	1.328954945	7.331649247	2.34289451	1.459913721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	161.4236
H5042_803_0	2009	6																																A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	P	P	P	S	P	P	P	P	P	P	P	P	P																																																			0		356.3317587	35.13480977	1143.13083		595.2491694	12.93563601	3.610201257	1051.761768	411.6503953	8761.553609	5153.973988	16.33473308	68.75216011	2163.332667	12825.95937	14921.50115		1054.61094	2275.621577	1574.08532	164.5442105																				1A: Medicare defined cost share	1B: Medicare defined cost share	2: Medicare defined cost share	6: Medicare defined cost share	10A: Medicare defined cost share	11A: Medicare defined cost share	11B: Medicare defined cost share	4A: Medicare defined cost share; 4B: Medicare defined cost share	9A: Medicare defined cost share	8A: Medicare defined cost share	8A: Medicare defined cost share; 8B: Medicare defined cost share	Medicare defined cost share	12: Medicare defined cost share	7I: Medicare defined cost share; 9C: Medicare defined cost share	7A: Medicare defined cost share; 9A: Medicare defined cost share; 14B: Medicare defined cost share	7D: Medicare defined cost share; 15: Medicare defined cost share	7E: Medicare defined cost share; 9C: Medicare defined cost share	7C: Medicare defined cost share; 7I: Medicare defined cost share	8A: Medicare defined cost share	6: Medicare defined cost share; 7B: Medicare defined cost share; 7D: Medicare defined cost share; 14C: Medicare defined cost share	15: Medicare defined cost share																				847.4721718	202.0285533	72.93309336		59.70141323	0.231	0.231	35.13829858	356.9937475	4.164447976	21.24878655	33.5470502	81.0083676	33.35828661	20.96836181	21.07909182		9.567093603	29.80617382	13.76141865	72.04677475																				847.4721718	202.0285533	72.93309336		59.70141323	0.231	0.231	35.13829858	356.9937475	4.164447976	21.24878655	33.5470502	81.0083676	33.35828661	20.96836181	21.07909182		9.567093603	29.80617382	13.76141865	72.04677475																				25.1651	0.591519566	6.947672297	0	2.96143472	2.988131919	0.83395649	3.079759922	12.24638477	3.040586183	9.126307765	0.045665176	0.464125022	6.013755928	22.41161304	26.2109744	0	0.840796798	5.65229769	1.805137257	0.987906639	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.4131	0	0	25.1651	0.591519566	6.947672297	0	2.96143472	2.988131919	0.83395649	3.079759922	12.24638477	3.040586183	9.126307765	0.045665176	0.464125022	6.013755928	22.41161304	26.2109744	0	0.840796798	5.65229769	1.805137257	0.987906639	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.4131		1A: Medicare defined cost share	1B: Medicare defined cost share	2: Medicare defined cost share	6: Medicare defined cost share	10A: Medicare defined cost share	11A: Medicare defined cost share	11B: Medicare defined cost share	4A: Medicare defined cost share; 4B: Medicare defined cost share	9A: Medicare defined cost share	8A: Medicare defined cost share	8A: Medicare defined cost share; 8B: Medicare defined cost share	Medicare defined cost share	12: Medicare defined cost share	7I: Medicare defined cost share; 9C: Medicare defined cost share	7A: Medicare defined cost share; 9A: Medicare defined cost share; 14B: Medicare defined cost share	7D: Medicare defined cost share; 15: Medicare defined cost share	7E: Medicare defined cost share; 9C: Medicare defined cost share	7C: Medicare defined cost share; 7I: Medicare defined cost share	8A: Medicare defined cost share	6: Medicare defined cost share; 7B: Medicare defined cost share; 7D: Medicare defined cost share; 14C: Medicare defined cost share	15: Medicare defined cost share																				3.0864	0.1044	0.9558		0.4074	0.4111	0.1147	0.4237	1.6847	0.4721	1.2555	0.0063	0.0638	0.914	3.0831	3.6057		0.1157	0.7776	0.2483	0.1359																				17.8661	0	0	28.2515	0.69589677	7.90343674	0	3.368827856	3.399197686	0.948680664	3.503430599	13.93107262	3.51265788	10.38177867	0.051947158	0.527972908	6.927790145	25.49469208	29.81671691	0	0.956461966	6.429862451	2.053463018	1.12380914	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	149.2792
H5050_001_0	2009	3																					2500											D	D			T	Coin	Coin	V	V						V	V	V	V	V	V		V	T																																																										0		545.8725937	8.312780614	0	0	234.5504926	3.589288401	1.7946442	150.7856969	149.3673718	0	0	0	0	0	3678.951105	2401.291922	121.4784273	178.7150984	0	359.5658934	0	532.2531218	2.370083571	0	138.1468167	0	91.93123167	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	$20 Copay	$0 Copay	$20 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	20	0	20	0	0	0											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	20	0	20	0	0	0											9.0979	0.138546344	0	0	2.931881158	0.71785768	0.35892884	0.628273737	2.489456196	0	0	0	0	0	6.131585174	4.002153203	0.202464045	0.297858497	0	0.599276489	0	0.887088536	0.029626045	0	0.230244695	0	0.153218719	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8963		0	9.0979	0.138546344	0	0	2.931881158	0.71785768	0.35892884	0.628273737	2.489456196	0	0	0	0	0	6.131585174	4.002153203	0.202464045	0.297858497	0	0.599276489	0	0.887088536	0.029626045	0	0.230244695	0	0.153218719	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8963																																																																																		0			9.0979	0.138546344	0	0	2.931881158	0.71785768	0.35892884	0.628273737	2.489456196	0	0	0	0	0	6.131585174	4.002153203	0.202464045	0.297858497	0	0.599276489	0	0.887088536	0.029626045	0	0.230244695	0	0.153218719	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8963
H5050_004_0	2009	6																					1000											D	D			T	Coin	Coin	V	V						V	V	V	V	V	V		V	T																																																										0		865.9099139	13.18644539	0	0	598.3426864	10.11042578	5.055212892	304.2614269	101.5348167	0	0	0	0	0	5140.916954	3199.228234	145.8609517	207.7155375	0	273.830081	0	732.1826559	3.566618341	0	231.3206752	0	103.467315	0	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	$0 Copay	$15 Copay											100	100	0	0	75	0.2	0.2	50	100	0	0	0	0	0	15	15	15	15	0	15	0	15	75	0	15	0	15	0	0	15											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	14.25											6.8551	0.104392693	0	0	3.5526597	1.920980899	0.960490449	1.204368148	0.803817299	0	0	0	0	0	6.104838883	3.799083527	0.17320988	0.246662201	0	0.325173221	0	0.869466904	0.021176796	0	0.274693302	0	0.122867437	0	0	0.197125	0	0	0	0	0	0	0	0	0	0	27.5361		1.4493	6.8551	0.104392693	0	0	3.5526597	1.920980899	0.960490449	1.204368148	0.803817299	0	0	0	0	0	6.104838883	3.799083527	0.17320988	0.246662201	0	0.325173221	0	0.869466904	0.021176796	0	0.274693302	0	0.122867437	0	0	0.197125	0	0	0	0	0	0	0	0	0	0	27.5361																																																																																		0			6.8551	0.104392693	0	0	3.5526597	1.920980899	0.960490449	1.204368148	0.803817299	0	0	0	0	0	6.104838883	3.799083527	0.17320988	0.246662201	0	0.325173221	0	0.869466904	0.021176796	0	0.274693302	0	0.122867437	0	0	0.197125	0	0	0	0	0	0	0	0	0	0	27.5361
H5050_009_0	2009	6																					2500											D	D			T	Coin	Coin	V	V						V	V	V	V	V	V		V	T																																																										0		735.7485353	11.20429242	0	0	364.3442613	7.377922165	3.688961082	207.9730133	169.5100256	0	0	0	0	0	4582.567124	3025.244367	299.6390713	231.732931	0	460.9484291	0	626.9077181	3.023870789	0	137.1811796	0	97.88007998	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	$15 Copay	$0 Copay	$15 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	15	0	15	0	0	0											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	15	0	15	0	0	0											12.2625	0.186738207	0	0	4.554303266	1.475584433	0.737792216	0.866554222	2.825167093	0	0	0	0	0	5.728208904	3.781555459	0.374548839	0.289666164	0	0.576185536	0	0.783634648	0.037798385	0	0.171476474	0	0.1223501	0	0	0	0	0	0	0	0	0	0	0	0	0	34.774		0	12.2625	0.186738207	0	0	4.554303266	1.475584433	0.737792216	0.866554222	2.825167093	0	0	0	0	0	5.728208904	3.781555459	0.374548839	0.289666164	0	0.576185536	0	0.783634648	0.037798385	0	0.171476474	0	0.1223501	0	0	0	0	0	0	0	0	0	0	0	0	0	34.774																																																																																		0			12.2625	0.186738207	0	0	4.554303266	1.475584433	0.737792216	0.866554222	2.825167093	0	0	0	0	0	5.728208904	3.781555459	0.374548839	0.289666164	0	0.576185536	0	0.783634648	0.037798385	0	0.171476474	0	0.1223501	0	0	0	0	0	0	0	0	0	0	0	0	0	34.774
H5050_012_0	2009	6																					2500											D	D			T			V	V					V	V	V	V	V		P			T		V		V														0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	812.1789175	15.36026982	0	0	271.7241496	0	0	471.0246908	492.0693416	0	0	0	0	92.22441143	5220.154281	7166.379852	247.8012971	824.6990638	0	2895.16356	0	0	291.3592316	0	374.7999554	0	160.6285523	0	0	0											$100 per day for 1st 5 days	$100 per day for 1st 5 days	$0 Copay	$0 Copay	$150 per trip	$0 Copay	$0 Copay	$50 per visit	$200 per visit	$0 Copay	$0 Copay	$0 Copay	$0 Copay	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$0 Copay	$15 per visit	$0 Copay	$0 Copay	$150 per trip	$0 Copay	$15 per exam	$0 Copay	$15 per exam	$0 Copay	$0 Copay	$0 Copay											100	99.99999997	0	0	150	0	0	39.50396702	200	0	0	0	0	15	15	15	15	15	0	15	0	0	150	0	15	0	15	0	0	0											100	99.99999997	0	0	150	0	0	39.50396702	200	0	0	0	0	15	15	15	15	15	0	15	0	0	150	0	15	0	15	0	0	0											6.7682	0.128002249	0	0	3.39655187	0	0	1.550611987	8.201155693	0	0	0	0	0.115280514	6.525192851	8.957974815	0.309751621	1.03087383	0	3.61895445	0	0	3.641990395	0	0.468499944	0	0.20078569	0	0	0	0	0	0	0	0	0	0	0	0	0	44.9138	0	0	6.7682	0.128002249	0	0	3.39655187	0	0	1.550611987	8.201155693	0	0	0	0	0.115280514	6.525192851	8.957974815	0.309751621	1.03087383	0	3.61895445	0	0	3.641990395	0	0.468499944	0	0.20078569	0	0	0	0	0	0	0	0	0	0	0	0	0	44.9138	0																																																																																	0	0		6.7682	0.128002249	0	0	3.39655187	0	0	1.550611987	8.201155693	0	0	0	0	0.115280514	6.525192851	8.957974815	0.309751621	1.03087383	0	3.61895445	0	0	3.641990395	0	0.468499944	0	0.20078569	0	0	0	0	0	0	0	0	0	0	0	0	0	44.9138
H5050_801_0	2009	3																					2500											D	D			T	Coin	Coin	V	V						V	V	V	V	V	V		V	T																																																										0		479.0830825	7.29568146	0	0	268.4945272	5.923833811	2.961916906	172.4954453	179.4974546	0	0	0	0	0	4536.195664	2978.865784	205.5946184	256.4057255	0	837.466693	0	647.0235078	2.764120939	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											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											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											7.9847	0.121594691	0	0	3.35618159	1.184766762	0.592383381	0.718731022	2.991624243	0	0	0	0	0	7.560326107	4.964776306	0.342657697	0.427342876	0	1.395777822	0	1.078372513	0.034551512	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7538		0	7.9847	0.121594691	0	0	3.35618159	1.184766762	0.592383381	0.718731022	2.991624243	0	0	0	0	0	7.560326107	4.964776306	0.342657697	0.427342876	0	1.395777822	0	1.078372513	0.034551512	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7538																																																																																		0			7.9847	0.121594691	0	0	3.35618159	1.184766762	0.592383381	0.718731022	2.991624243	0	0	0	0	0	7.560326107	4.964776306	0.342657697	0.427342876	0	1.395777822	0	1.078372513	0.034551512	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7538
H5050_802_0	2009	2																					2500											D	D			T	Coin	Coin	V	V						V	V	V	V	V	V		V	T																																																										0		463.3385681	7.055917281	0	0	259.6707634	5.729153827	2.864576914	166.8265809	173.5984772	0	0	0	0	0	4387.118811	2880.968786	198.8379877	247.9792462	0	809.9443135	0	625.7598245	2.673281284	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											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											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											7.7223	0.117598621	0	0	3.245884542	1.145830765	0.572915383	0.695110754	2.893307953	0	0	0	0	0	7.311864685	4.801614644	0.331396646	0.413298744	0	1.349907189	0	1.042933041	0.033416016	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6774		0	7.7223	0.117598621	0	0	3.245884542	1.145830765	0.572915383	0.695110754	2.893307953	0	0	0	0	0	7.311864685	4.801614644	0.331396646	0.413298744	0	1.349907189	0	1.042933041	0.033416016	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6774																																																																																		0			7.7223	0.117598621	0	0	3.245884542	1.145830765	0.572915383	0.695110754	2.893307953	0	0	0	0	0	7.311864685	4.801614644	0.331396646	0.413298744	0	1.349907189	0	1.042933041	0.033416016	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6774
H5087_001_0	2009	12																					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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	909.8921367	221.1984489	210.0564738	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	$0 copay	$0 copay	16A - copays $10-$55	17A - $10 copay	"17B - $25 copay, $150 max"	$0 copay	18B - $1000 max	$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	25	10	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	25	10	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	1.895608618	0.184332041	0.437617654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.5176			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.895608618	0.184332041	0.437617654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.5176	0	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.895608618	0.184332041	0.437617654	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.5176
H5087_002_0	2009	11																					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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	947.426704	230.4543346	217.658426	238.4579212	15.29864558	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	$0 copay	$0 copay	16A - copays $15-$30	17A - $10 copay	"17B - $25 copay, $150 max"	18A - $10 copay	"18B - $50 copay, $1000 max"	$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	15	10	25	10	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	15	10	25	10	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	1.18428338	0.192045279	0.453455054	0.198714934	0.063744357	0	0	0	0	0	0	0	0	0	0	0	0	2.0922			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.18428338	0.192045279	0.453455054	0.198714934	0.063744357	0	0	0	0	0	0	0	0	0	0	0	0	2.0922	0	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.18428338	0.192045279	0.453455054	0.198714934	0.063744357	0	0	0	0	0	0	0	0	0	0	0	0	2.0922
H5087_005_0	2009	14																					Unlimited											Coin	D	D	V	T	P	P	V	V	V	V	V	Coin	V	P	P	P	P	P	P	S	P	T	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	121.2648935	956.2067794	49.22619507	135.3724287	194.6453885	0	32.24105877	0	0.08	14.6975566	0	405.7175801	145.6368491	0	2418.141069	6283.94979	176.1223536	560.9652664	1000	992.517347	302.917669	225.1579453	129.8218582	16.1052736	0	572.6061617											$0 copay	$0 copay	$0 copay	$0 copay	10A - $50 copay	"11A - $20 copay, 11C - $3 copay"	11B - $20 copay	4A - $50 copay	"9A - $50 copay, 9B -$0 outpatient"	$0 copay	8B - $25 copay	$0 copay	12 - 20% coinsurance	9D - $10 copay	$0 copay	"17A - $10 copay, 18A - copay"	7E & 7H - 1-4 ($5); 5-9 ($10); 10+ ($20)	7C & 7I - $10 copay	"8b - $5 copay, $50 for MRI"	8B - $5 copay	"15 - $25 copay, $100 copay chemo"	$0 copay	10B - $5 copay	16A - copays $15-$30	17A - $10 copay	"17B - $25 copay, $150 max"	18A - $10 copay	"18B - $50 copay, $500 max"	$0 copay	13B-$10 copay											0	0	0	0	50	11.11	20	50	25	0	25	0	0.21	10	0	10	18	0	10.98	5	28	10	5	15	10	25	10	50	0	10											0	0	0	0	50	11.11	20	50	25	0	25	0	0.21	10	0	10	18	0	10.98	5	28	10	5	15	10	25	10	50	0	10											0	0	0	0	0.50527039	0.88528811	0.082043658	0.564051786	0.405511226	0	0.067168872	0	0.0168	0.012247964	0	0.338097983	0.218455274	0	2.212599078	2.618312412	0.410952158	0.467471055	0.416666667	1.240646684	0.252431391	0.469079053	0.108184882	0.067105307	0	0.477171801	0	0	0	0	0	0	0	0	0	0	11.8356			0	0	0	0	0.50527039	0.88528811	0.082043658	0.564051786	0.405511226	0	0.067168872	0	0.0168	0.012247964	0	0.338097983	0.218455274	0	2.212599078	2.618312412	0.410952158	0.467471055	0.416666667	1.240646684	0.252431391	0.469079053	0.108184882	0.067105307	0	0.477171801	0	0	0	0	0	0	0	0	0	0	11.8356	0	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			0	0	0	0	0.50527039	0.88528811	0.082043658	0.564051786	0.405511226	0	0.067168872	0	0.0168	0.012247964	0	0.338097983	0.218455274	0	2.212599078	2.618312412	0.410952158	0.467471055	0.416666667	1.240646684	0.252431391	0.469079053	0.108184882	0.067105307	0	0.477171801	0	0	0	0	0	0	0	0	0	0	11.8356
H5106_013_0	2009	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		291.6646428	0	139.9966177	0	179.8352695	19.91907701	0	339.1176433	43.47872544	0	0	0	0	5049.50399	2811.39991	7601.19235	0	0	0	0	1060.157	0	0	0	365.0275772	0	10.99680781	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											232.0375541	0	35	0	50	0.096979208	0	50	75	0	0	0	0	18	15	30	0	0	0	0	2.1	0	0	0	30	0	30	0	0	0											220.2017874	0	33.21472072	0	50	0.060773637	0	47.44960103	71.17440155	0	0	0	0	17.08185637	14.23488031	28.46976062	0	0	0	0	1.992883243	0	0	0	30	0	30	0	0	0											5.3521	0	0.387495713	0	0.749313623	1.21055475	0	1.340916406	0.257881022	0	0	0	0	7.187908492	3.334995102	18.03367722	0	0	0	0	0.176064093	0	0	0	0.912568943	0	0.02749202	0	0	0	0	0	0	0	0	0	0	0	0	0	38.971	0	2.66	5.3521	0	0.387495713	0	0.749313623	1.21055475	0	1.340916406	0.257881022	0	0	0	0	7.187908492	3.334995102	18.03367722	0	0	0	0	0.176064093	0	0	0	0.912568943	0	0.02749202	0	0	0	0	0	0	0	0	0	0	0	0	0	38.971	3350	"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											4.1759	0	0.262	0.518	0.3178	1.0976	0	0.0821	0.7324	0	0	0	0	1.2356	0.6195	2.4778	0	0	0	0	0.2999	0	0	0	0.1357	0	0.0113	0	0	0											11.9656	250	8.112248586	9.528	0	0.649498211	0.518036912	1.067153136	2.308136789	0	1.422966816	0.990261927	0	0	0	0	8.423524318	3.954446995	20.51148479	0	0	0	0	0.475971723	0	0	0	1.048248287	0	0.038833567	0	0	0	0	0	0	0	0	0	0	0	0	0	50.9365
H5106_014_0	2009	7																																A				T	Coin		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		294.8718662	0	0	0	181.8127868	20.13811257	0	342.8466727	43.95682927	0	0	0	0	555.5464845	2842.314825	7684.777118	0	0	0	0	1060.157	0	0	9.038571429	369.0415193	0	11.11773168	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											126.2190176	0	0	0	50	0.096979208	0	50	50	0	0	0	0	15	15	15	0	0	0	0	2.1	0	0	0.3	15	0	15	0	0	0											124.6804909	0	0	0	50	0.060773637	0	49.39053292	49.39053292	0	0	0	0	14.81715988	14.81715988	14.81715988	0	0	0	0	2.074402383	0	0	0.3	15	0	15	0	0	0											3.0637	0	0	0	0.757553278	1.223866338	0	1.41111499	0.180920935	0	0	0	0	0.685968423	3.509586098	9.488880931	0	0	0	0	0.183266017	0	0	2.711571429	0.461301899	0	0.013897165	0	0	0	0	0	0	0	0	0	0	0	0	0	23.6917	0	0.9577	3.0637	0	0	0	0.757553278	1.223866338	0	1.41111499	0.180920935	0	0	0	0	0.685968423	3.509586098	9.488880931	0	0	0	0	0.183266017	0	0	2.711571429	0.461301899	0	0.013897165	0	0	0	0	0	0	0	0	0	0	0	0	0	23.6917	3350	"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											3.5458	0	0.2225	0.4399	0.2249	1.1097	0	0.1003	0.6219	0	0	0	0	1.0492	0.526	2.104	0	0	0	0	0.2547	0	0	0.5122	0.0802	0	0.0076	0	0	0											10.7988	250	4.286771914	6.6095	0	0.222471089	0.43987457	0.982471098	2.333517686	0	1.511436058	0.802798891	0	0	0	0	1.735152308	4.035573974	11.59283243	0	0	0	0	0.437923043	0	0	3.223757143	0.541526075	0	0.02154134	0	0	0	0	0	0	0	0	0	0	0	0	0	34.4904
H5106_015_0	2009	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		310.1510357	0	148.8699335	0	191.233653	21.18159508	0	360.6117192	46.23450958	0	0	0	0	5084.332849	2989.593066	8082.973846	0	0	0	0	1060.157	0	0	0	388.1638859	0	11.69381142	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											232.0375541	0	35	0	50	0.096979208	0	50	75	0	0	0	0	18	15	30	0	0	0	0	2.1	0	0	0	30	0	30	0	0	0											219.3172692	0	33.08130208	0	50	0.060773637	0	47.25900297	70.88850446	0	0	0	0	17.01324107	14.17770089	28.35540178	0	0	0	0	1.984878125	0	0	0	30	0	30	0	0	0											5.6685	0	0.410400937	0	0.796806887	1.287282565	0	1.420179193	0.273124603	0	0	0	0	7.208415036	3.53212969	19.09966425	0	0	0	0	0.17535687	0	0	0	0.970409715	0	0.029234529	0	0	0	0	0	0	0	0	0	0	0	0	0	40.8715	0	2.9586	5.6685	0	0.410400937	0	0.796806887	1.287282565	0	1.420179193	0.273124603	0	0	0	0	7.208415036	3.53212969	19.09966425	0	0	0	0	0.17535687	0	0	0	0.970409715	0	0.029234529	0	0	0	0	0	0	0	0	0	0	0	0	0	40.8715	3350	"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											4.2881	0	0.269	0.532	0.3366	1.1671	0	0.0845	0.7521	0	0	0	0	1.2688	0.6361	2.5444	0	0	0	0	0.308	0	0	0	0.1376	0	0.0121	0	0	0											12.3363	250	8.926898279	9.9565	0	0.679441796	0.531953312	1.133421024	2.454431941	0	1.50470225	1.025179985	0	0	0	0	8.477224101	4.168222366	21.64403495	0	0	0	0	0.483321134	0	0	0	1.108055645	0	0.041294931	0	0	0	0	0	0	0	0	0	0	0	0	0	53.2078
H5106_016_0	2009	7																																A				T	Coin		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		313.4669071	0	0	0	193.2781608	21.40805071	0	364.4670735	46.7288097	0	0	0	0	590.5800392	3021.555256	8169.390138	0	0	0	0	1060.157	0	0	9.038571429	392.3138045	0	11.81883172	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											126.2190176	0	0	0	50	0.096979208	0	50	50	0	0	0	0	15	15	15	0	0	0	0	2.1	0	0	0.3	15	0	15	0	0	0											124.4254417	0	0	0	50	0.060773637	0	49.28949854	49.28949854	0	0	0	0	14.78684956	14.78684956	14.78684956	0	0	0	0	2.070158939	0	0	0.3	15	0	15	0	0	0											3.2503	0	0	0	0.80532567	1.301045097	0	1.497033274	0.191936633	0	0	0	0	0.727734849	3.723273585	10.06662858	0	0	0	0	0.182891124	0	0	2.711571429	0.490392256	0	0.01477354	0	0	0	0	0	0	0	0	0	0	0	0	0	24.9629	0	1.0582	3.2503	0	0	0	0.80532567	1.301045097	0	1.497033274	0.191936633	0	0	0	0	0.727734849	3.723273585	10.06662858	0	0	0	0	0.182891124	0	0	2.711571429	0.490392256	0	0.01477354	0	0	0	0	0	0	0	0	0	0	0	0	0	24.9629	3350	"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											3.6455	0	0.2287	0.4522	0.2375	1.1796	0	0.1036	0.6394	0	0	0	0	1.0787	0.5408	2.1631	0	0	0	0	0.2618	0	0	0.5122	0.0809	0	0.0081	0	0	0											11.1322	250	4.776402177	6.8958	0	0.228725127	0.452240188	1.042868439	2.480672643	0	1.600659148	0.831296629	0	0	0	0	1.806413067	4.264047869	12.22972572	0	0	0	0	0.44470699	0	0	3.223757143	0.571275813	0	0.022899767	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0951
H5106_017_0	2009	6																					3350											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	3350	291.5628286	0	139.9477477	0	179.7724927	19.91212366	0	338.9992642	43.4635479	0	0	0	0	5049.312169	2810.418508	7598.538928	0	0	0	0	1060.157	0	0	0	364.9001535	0	10.99296905	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											232.0375541	0	35	0	50	0.096979208	0	50	250	0	0	0	0	18	15	30	0	0	0	0	2.1	0	0	0	30	0	30	0	0	0											219.9122518	0	33.17104786	0	50	0.060773637	0	47.38721123	236.9360561	0	0	0	0	17.05939604	14.21616337	28.43232674	0	0	0	0	1.990262872	0	0	0	30	0	30	0	0	0											5.3432	0	0.38685112	0	0.749052053	1.21013217	0	1.338685812	0.858173469	0	0	0	0	7.178184669	3.329447386	18.00367846	0	0	0	0	0.175832593	0	0	0	0.912250384	0	0.027482423	0	0	0	0	0	0	0	0	0	0	0	0	0	39.513	0	2.7397	5.3432	0	0.38685112	0	0.749052053	1.21013217	0	1.338685812	0.858173469	0	0	0	0	7.178184669	3.329447386	18.00367846	0	0	0	0	0.175832593	0	0	0	0.912250384	0	0.027482423	0	0	0	0	0	0	0	0	0	0	0	0	0	39.513	3350	"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											4.1752	0	0.262	0.518	0.3177	1.0972	0	0.082	0.7323	0	0	0	0	1.2354	0.6193	2.4774	0	0	0	0	0.2999	0	0	0	0.1357	0	0.0113	0	0	0											11.9633	250	8.107948633	9.5184	0	0.648810157	0.517950983	1.066788164	2.307331065	0	1.420720834	1.59043289	0	0	0	0	8.413595538	3.948796528	20.48107503	0	0	0	0	0.475690475	0	0	0	1.047918897	0	0.038820011	0	0	0	0	0	0	0	0	0	0	0	0	0	51.4763
H5106_018_0	2009	6																					3350											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	3350	310.0448434	0	148.8189621	0	191.1681767	21.17434274	0	360.4882498	46.2186794	0	0	0	0	5084.13278	2988.569463	8080.206325	0	0	0	0	1060.157	0	0	0	388.0309829	0	11.68980759	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											232.0375541	0	35	0	50	0.096979208	0	50	250	0	0	0	0	18	15	30	0	0	0	0	2.1	0	0	0	30	0	30	0	0	0											218.9786893	0	33.03023148	0	50	0.060773637	0	47.18604498	235.9302249	0	0	0	0	16.98697619	14.15581349	28.31162699	0	0	0	0	1.981813889	0	0	0	30	0	30	0	0	0											5.6578	0	0.409627064	0	0.79653407	1.286841813	0	1.417501231	0.908698619	0	0	0	0	7.19700354	3.525469327	19.06364895	0	0	0	0	0.175086156	0	0	0	0.970077457	0	0.029224519	0	0	0	0	0	0	0	0	0	0	0	0	0	41.4375	0	3.0539	5.6578	0	0.409627064	0	0.79653407	1.286841813	0	1.417501231	0.908698619	0	0	0	0	7.19700354	3.525469327	19.06364895	0	0	0	0	0.175086156	0	0	0	0.970077457	0	0.029224519	0	0	0	0	0	0	0	0	0	0	0	0	0	41.4375	3350	"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											4.2874	0	0.269	0.5319	0.3365	1.1667	0	0.0845	0.7519	0	0	0	0	1.2686	0.636	2.544	0	0	0	0	0.3079	0	0	0	0.1376	0	0.0121	0	0	0											12.3342	250	8.922191383	9.9452	0	0.678628179	0.531874728	1.133040358	2.453591571	0	1.502010319	1.660642902	0	0	0	0	8.465625167	4.161468035	21.60764379	0	0	0	0	0.483004925	0	0	0	1.107712091	0	0.041280792	0	0	0	0	0	0	0	0	0	0	0	0	0	53.7717
H5106_806_0	2009	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		208.6877976	0	13.15927073	0	8.97634086	20.60330232	0	10.28904971	36.78437692	0	0	0	0	62.05972595	30.95687093	123.8274837	0	0	0	0	15.06308426	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											0.077695141	0	0.203053609	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0.231	0	0	0	0	0.231	0	0	0	0	0	0	0	0	0											0.077695141	0	0.203053609	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0.231	0	0	0	0	0.231	0	0	0	0	0	0	0	0	0											16.214	0	2.67203741	0	2.073534739	4.759362836	0	2.376770484	8.497191069	0	0	0	0	14.33579669	7.151037186	28.60414874	0	0	0	0	3.479572463	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.1635	0	0	16.214	0	2.67203741	0	2.073534739	4.759362836	0	2.376770484	8.497191069	0	0	0	0	14.33579669	7.151037186	28.60414874	0	0	0	0	3.479572463	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.1635		"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											1.8376	0	0.3028	0	0.235	0.5394	0	0.2694	0.963	0	0	0	0	1.6247	0.8105	3.2418	0	0	0	0	0.3944	0	0	0	0	0	0	0	0	0											10.2185	0	0	18.0516	0	2.974868316	0	2.308535342	5.298757291	0	2.646137806	9.460206057	0	0	0	0	15.96052032	7.961488067	31.84595227	0	0	0	0	3.873924009	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.382
H5106_807_0	2009	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		208.6877976	0	13.15927073	0	8.97634086	20.60330232	0	10.28904971	36.78437692	0	0	0	0	62.05972595	30.95687093	123.8274837	0	0	0	0	15.06308426	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											0.077695141	0	0.203053609	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0.231	0	0	0	0	0.231	0	0	0	0	0	0	0	0	0											0.077695141	0	0.203053609	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0.231	0	0	0	0	0.231	0	0	0	0	0	0	0	0	0											16.214	0	2.67203741	0	2.073534739	4.759362836	0	2.376770484	8.497191069	0	0	0	0	14.33579669	7.151037186	28.60414874	0	0	0	0	3.479572463	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.1635	0	0	16.214	0	2.67203741	0	2.073534739	4.759362836	0	2.376770484	8.497191069	0	0	0	0	14.33579669	7.151037186	28.60414874	0	0	0	0	3.479572463	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.1635		"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											1.8376	0	0.3028	0	0.235	0.5394	0	0.2694	0.963	0	0	0	0	1.6247	0.8105	3.2418	0	0	0	0	0.3944	0	0	0	0	0	0	0	0	0											10.2185	0	0	18.0516	0	2.974868316	0	2.308535342	5.298757291	0	2.646137806	9.460206057	0	0	0	0	15.96052032	7.961488067	31.84595227	0	0	0	0	3.873924009	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.382
H5106_808_0	2009	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		208.6877976	0	13.15927073	0	8.97634086	20.60330232	0	10.28904971	36.78437692	0	0	0	0	62.05972595	30.95687093	123.8274837	0	0	0	0	15.06308426	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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											0.077695141	0	0.203053609	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0.231	0	0	0	0	0.231	0	0	0	0	0	0	0	0	0											0.077695141	0	0.203053609	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0.231	0	0	0	0	0.231	0	0	0	0	0	0	0	0	0											16.214	0	2.67203741	0	2.073534739	4.759362836	0	2.376770484	8.497191069	0	0	0	0	14.33579669	7.151037186	28.60414874	0	0	0	0	3.479572463	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.1635	0	0	16.214	0	2.67203741	0	2.073534739	4.759362836	0	2.376770484	8.497191069	0	0	0	0	14.33579669	7.151037186	28.60414874	0	0	0	0	3.479572463	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.1635		"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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b-i, 14d-j, 17a, 18a"					PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	"PBP 17a, 17b"		"PBP 18a, 18b"		PBP 14a	PBP 13b-e											1.8376	0	0.3028	0	0.235	0.5394	0	0.2694	0.963	0	0	0	0	1.6247	0.8105	3.2418	0	0	0	0	0.3944	0	0	0	0	0	0	0	0	0											10.2185	0	0	18.0516	0	2.974868316	0	2.308535342	5.298757291	0	2.646137806	9.460206057	0	0	0	0	15.96052032	7.961488067	31.84595227	0	0	0	0	3.873924009	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.382
H5144_001_0	2009	6																					5000											D	D	D	V	T	Coin	Coin	V	V	P	P	V	P	V	V	V	V	V	V	P	S	P	T	P	P	O	P	O	O	O																																																			0	5000	960.9229988	36.75800254	707.2029506		115.3938427	8.526722225	21.89369601	244.673867	378.6115332		909.2301538		3.992094271	291.4833383	3088.524335	4075.647546	188.7368383	625.1867486			1081.222388	942.7996358																			$100/day 1-7	$100/day 1-7	"$0/day 1-8, $75/day 9-14, $100/day 15-100"	No Cost Sharing	$100/trip	20% Coinsurance	20% Coinsurance	"$50/visit ER, $25/visit Urgent Care"	$150/visit	No Cost Sharing	"$25/proc X-Rays and therapeutic radiology, $125/proc diag radiology"	No Cost Sharing	$25/proc	No Cost Sharing	$10/visit	$25/visit	$25/visit	$25/visit	No Cost Sharing	No Cost Sharing	$45/script	$25/visit	No Cost Sharing	No Cost Sharing	No Cost Sharing	$125 every 2 years	No Cost Sharing	$500 every 3 years	No Cost Sharing	No Cost Sharing											72.48205663	56.98855908	57.53177546		100	0.2	0.2	45	150		43.23789816		24.1616366	25	9.9982081	25	25	25			45	24.9883335																			43.12736706	33.90861987	34.23183769		84.35470432	0.119001499	0.119001499	26.77533734	89.25112447		35.66531176		24.1616366	14.87518741	9.9982081	25	24.68049491	25			45	24.9883335																			3.4535	0.103867761	2.017404718	0	0.81116779	1.014692729	2.60538265	0.545935444	2.815958756	0	2.702331408	0	0.008037961	0.36132244	2.573309086	8.490932387	0.388176548	1.302472393	0	0	4.054583955	1.96324931	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2123	0	9.5219	3.4535	0.103867761	2.017404718	0	0.81116779	1.014692729	2.60538265	0.545935444	2.815958756	0	2.702331408	0	0.008037961	0.36132244	2.573309086	8.490932387	0.388176548	1.302472393	0	0	4.054583955	1.96324931	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.2123		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											7.3747	0.1038	1.1114	0.7488	0.2025	0.2749	0.7058	0.4268	1.236	0.194	0.566	0.1696	0.0009	0.8315	0.9554	1.5827	0.0489	0.1749	0.7645	1.7755	0.9139	0.215			0.0285	0.1054	0.0378	0.0202	0.0614												20.6311	500	10.15487538	10.8282	0.207686448	3.12877898	0.748813739	1.013644577	1.289580531	3.311200174	0.972782792	4.051965167	0.193982929	3.268368855	0.169608111	0.008973345	1.192774575	3.528738322	10.07367386	0.437110689	1.477389137	0.764520242	1.775482002	4.968457373	2.17829039	0	0	0.028513408	0.105379562	0.037843266	0.020213471	0.061448952	0	0	0	0	0	0	0	0	0	0	0	55.8434
H5144_801_0	2009	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																																																			0		217.5420602	3.092783147	32.73578714		6.182594261	8.548927223	21.95071082	12.42802128	36.01167118	5.651790629	16.49178697	4.941617984	0.02929811	24.22477798	32.78911531	49.55732079	1.525558446	5.50532914	23.98767245	55.59356783	28.42118599	6.703692414																			Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing											0.072985663	0.072985663	0.158629117		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.072985663	0.072985663	0.158629117		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			15.8775	0.225728829	5.192849015	0	1.428179274	1.974802189	5.0706142	2.870872915	8.318696043	1.305563635	3.809602789	1.141513754	0.006767863	5.595923714	7.574285638	11.4477411	0.352404001	1.271731031	5.541152337	12.84211417	6.565293965	1.548552948	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.9618	0	0	15.8775	0.225728829	5.192849015	0	1.428179274	1.974802189	5.0706142	2.870872915	8.318696043	1.305563635	3.809602789	1.141513754	0.006767863	5.595923714	7.574285638	11.4477411	0.352404001	1.271731031	5.541152337	12.84211417	6.565293965	1.548552948	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.9618		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing											2.3792	0.0338	0.7868		0.2088	0.2835	0.7278	0.4399	1.2746	0.2	0.5837	0.1749	0.001	0.8574	0.9852	1.6321	0.0505	0.1804	0.7884	1.8246	0.9424	0.2218																			14.5767	0	0	18.2567	0.259554328	5.979644321	0	1.636973431	2.258266618	5.798453559	3.310741084	9.593266427	1.505598922	4.393300867	1.316413717	0.007732431	6.453317542	8.55952471	13.07986484	0.402864909	1.452105259	6.329525966	14.66675542	7.507680658	1.77030341	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.5386
H5144_802_0	2009	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																																																			0		217.5420602	3.092783147	32.73578714		6.182594261	8.548927223	21.95071082	12.42802128	36.01167118	5.651790629	16.49178697	4.941617984	0.02929811	24.22477798	32.78911531	49.55732079	1.525558446	5.50532914	23.98767245	55.59356783	28.42118599	6.703692414																			Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing											0.072985663	0.072985663	0.158629117		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.072985663	0.072985663	0.158629117		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			15.8775	0.225728829	5.192849015	0	1.428179274	1.974802189	5.0706142	2.870872915	8.318696043	1.305563635	3.809602789	1.141513754	0.006767863	5.595923714	7.574285638	11.4477411	0.352404001	1.271731031	5.541152337	12.84211417	6.565293965	1.548552948	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.9618	0	0	15.8775	0.225728829	5.192849015	0	1.428179274	1.974802189	5.0706142	2.870872915	8.318696043	1.305563635	3.809602789	1.141513754	0.006767863	5.595923714	7.574285638	11.4477411	0.352404001	1.271731031	5.541152337	12.84211417	6.565293965	1.548552948	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.9618		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing											2.3792	0.0338	0.7868		0.2088	0.2835	0.7278	0.4399	1.2746	0.2	0.5837	0.1749	0.001	0.8574	0.9852	1.6321	0.0505	0.1804	0.7884	1.8246	0.9424	0.2218																			14.5767	0	0	18.2567	0.259554328	5.979644321	0	1.636973431	2.258266618	5.798453559	3.310741084	9.593266427	1.505598922	4.393300867	1.316413717	0.007732431	6.453317542	8.55952471	13.07986484	0.402864909	1.452105259	6.329525966	14.66675542	7.507680658	1.77030341	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.5386
H5151_002_0	2009	6																					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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1916	55.4	2180.4	2434.6	356.7	18.47992316	0	350.4	359.1	14796.4	615.1	110.8	5.3	5658.1	3889.2	3264	179.5	40.1	41.6	0	27.65477933	0	0	0	495.9	2132.3	2.1	0	0	0											$50 / days 1-10	$50 / days 1-10	$25 / days 21-100	$0.00 	$50.00 	20%	20%	$50.00 	$100.00 	$0.00 	$50 Scans	$0.00 	$0.00 	"$25 Rad Ther, CORF"	"$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 	$25.00 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											41.18613684	41.18613684	7.675146675	$0.00 	$50.00 	20%	20%	$50.00 	$100.00 	$0.00 	5	$0.00 	$0.00 	2.5	15	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	0.18	$0.00 	$0.00 	$0.00 	$25.00 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											37.52582732	37.52582732	6.993038212	0	45.55638158	0.182225526	0.182225526	45.55638158	91.11276317	0	4.555638158	0	0	2.277819079	13.66691448	22.77819079	22.77819079	22.77819079	0	0	0.164002974	0	0	0	22.77819079	13.66691448	22.77819079	0	0	0											5.9916	0.173244236	1.270635043	0	1.354163443	3.367513725	0	1.330246342	2.726549438	0	0.233514419	0	0	1.074010678	4.429446981	6.195667895	0.340723771	0.076117121	0	0	4.535466046	0	0	0	0.941308734	2.428496811	0.003986183	0	0	0	0	0	0	0	0	0	0	0	0	0	36.4727		3.5576	5.9916	0.173244236	1.270635043	0	1.354163443	3.367513725	0	1.330246342	2.726549438	0	0.233514419	0	0	1.074010678	4.429446981	6.195667895	0.340723771	0.076117121	0	0	4.535466046	0	0	0	0.941308734	2.428496811	0.003986183	0	0	0	0	0	0	0	0	0	0	0	0	0	36.4727	0																																																																																	0		0	5.9916	0.173244236	1.270635043	0	1.354163443	3.367513725	0	1.330246342	2.726549438	0	0.233514419	0	0	1.074010678	4.429446981	6.195667895	0.340723771	0.076117121	0	0	4.535466046	0	0	0	0.941308734	2.428496811	0.003986183	0	0	0	0	0	0	0	0	0	0	0	0	0	36.4727
H5151_004_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1721.9	36.7	1864.2	2106.8	312.3	18.15566201	0	346.5	340.7	12637.9	614.4	75.7	2.8	5219.4	3592.1	3117.6	106.1	77	33.5	0	16.26354503	0	0	0	514.7	2226.3	4.6	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	$0.00 	$0.00 	"$25 Rad Ther, CORF"	"$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 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											41.18613684	41.18613684	7.675146675	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	5	$0.00 	$0.00 	2.5	15	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	0.18	$0.00 	$0.00 	$0.00 	$15.00 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											37.52582732	37.52582732	6.993038212	0	22.77819079	0.182225526	0.182225526	45.55638158	91.11276317	0	4.555638158	0	0	2.277819079	13.66691448	22.77819079	22.77819079	22.77819079	0	0	0.164002974	0	0	0	13.66691448	13.66691448	22.77819079	0	0	0											5.3846	0.114766489	1.086368486	0	0.592802415	3.308425065	0	1.315440518	2.586843201	0	0.233248674	0	0	0.990737408	4.091076957	5.917773968	0.20139717	0.146160058	0	0	2.667269748	0	0	0	0.58619674	2.535554308	0.00873164	0	0	0	0	0	0	0	0	0	0	0	0	0	31.7674		3.0986	5.3846	0.114766489	1.086368486	0	0.592802415	3.308425065	0	1.315440518	2.586843201	0	0.233248674	0	0	0.990737408	4.091076957	5.917773968	0.20139717	0.146160058	0	0	2.667269748	0	0	0	0.58619674	2.535554308	0.00873164	0	0	0	0	0	0	0	0	0	0	0	0	0	31.7674	0																																																																																	0		0	5.3846	0.114766489	1.086368486	0	0.592802415	3.308425065	0	1.315440518	2.586843201	0	0.233248674	0	0	0.990737408	4.091076957	5.917773968	0.20139717	0.146160058	0	0	2.667269748	0	0	0	0.58619674	2.535554308	0.00873164	0	0	0	0	0	0	0	0	0	0	0	0	0	31.7674
H5151_802_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1916	55.4	2180.4	2434.6	356.7	18.47992316	0	350.4	359.1	14796.4	615.1	110.8	5.3	5658.1	3889.2	3264	179.5	40.1	41.6	0	27.65477933	0	0	0	495.9	2132.3	2.1	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	$0.00 	$0.00 	"$25 Rad Ther, CORF"	"$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 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											41.18613684	41.18613684	7.675146675	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	5	$0.00 	$0.00 	2.5	15	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	0.18	$0.00 	$0.00 	$0.00 	$15.00 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											37.52582732	37.52582732	6.993038212	0	22.77819079	0.182225526	0.182225526	45.55638158	91.11276317	0	4.555638158	0	0	2.277819079	13.66691448	22.77819079	22.77819079	22.77819079	0	0	0.164002974	0	0	0	13.66691448	13.66691448	22.77819079	0	0	0											5.9916	0.173244236	1.270635043	0	0.677081721	3.367513725	0	1.330246342	2.726549438	0	0.233514419	0	0	1.074010678	4.429446981	6.195667895	0.340723771	0.076117121	0	0	4.535466046	0	0	0	0.564785241	2.428496811	0.003986183	0	0	0	0	0	0	0	0	0	0	0	0	0	35.4191		3.4548	5.9916	0.173244236	1.270635043	0	0.677081721	3.367513725	0	1.330246342	2.726549438	0	0.233514419	0	0	1.074010678	4.429446981	6.195667895	0.340723771	0.076117121	0	0	4.535466046	0	0	0	0.564785241	2.428496811	0.003986183	0	0	0	0	0	0	0	0	0	0	0	0	0	35.4191	0																																																																																	0		0	5.9916	0.173244236	1.270635043	0	0.677081721	3.367513725	0	1.330246342	2.726549438	0	0.233514419	0	0	1.074010678	4.429446981	6.195667895	0.340723771	0.076117121	0	0	4.535466046	0	0	0	0.564785241	2.428496811	0.003986183	0	0	0	0	0	0	0	0	0	0	0	0	0	35.4191
H5151_803_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1274.9	37.7	868	1322.6	174.7	11.70779045	0	301.6	404.8	13831.4	643.5	96.6	1	5070	3686.8	3369.3	126.1	50.2	54.7	0	17.81899124	0	0	0	591.4	2511.8	3.9	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	$0.00 	$0.00 	"$25 Rad Ther, CORF"	"$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 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											41.18613684	41.18613684	7.675146675	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	5	$0.00 	$0.00 	2.5	15	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	0.18	$0.00 	$0.00 	$0.00 	$15.00 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											37.52582732	37.52582732	6.993038212	0	22.77819079	0.182225526	0.182225526	45.55638158	91.11276317	0	4.555638158	0	0	2.277819079	13.66691448	22.77819079	22.77819079	22.77819079	0	0	0.164002974	0	0	0	13.66691448	13.66691448	22.77819079	0	0	0											3.9868	0.117893641	0.505829764	0	0.331612494	2.133458277	0	1.144983724	3.073537211	0	0.244296096	0	0	0.962378561	4.198931691	6.39554652	0.239360822	0.095288765	0	0	2.922367552	0	0	0	0.673551102	2.860712982	0.007402912	0	0	0	0	0	0	0	0	0	0	0	0	0	29.894		2.9159	3.9868	0.117893641	0.505829764	0	0.331612494	2.133458277	0	1.144983724	3.073537211	0	0.244296096	0	0	0.962378561	4.198931691	6.39554652	0.239360822	0.095288765	0	0	2.922367552	0	0	0	0.673551102	2.860712982	0.007402912	0	0	0	0	0	0	0	0	0	0	0	0	0	29.894	0																																																																																	0		0	3.9868	0.117893641	0.505829764	0	0.331612494	2.133458277	0	1.144983724	3.073537211	0	0.244296096	0	0	0.962378561	4.198931691	6.39554652	0.239360822	0.095288765	0	0	2.922367552	0	0	0	0.673551102	2.860712982	0.007402912	0	0	0	0	0	0	0	0	0	0	0	0	0	29.894
H5179_001_0	2009	4																					3800											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1538.204935	39.7254849	1023.341482	1429.528411	209.2840408	13.16687426	8.108090021	247.494019	314.6341149	5.856507822	17.14493404	0.876295891	35.05183565	105.1372861	6245.038993	10337.22097	245.6703129	1215.341045	70.29806948	0	7.694643827	0	0	0	0	0	0	0	0	47.1415549											"$230 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$230 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$45 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$250/Visit	15% Coinsurance	15% Coinsurance	$45 Copay	$45 Copay	$45 Copay	$15 Copay	$45 Copay	$15 Copay Group Session; $45 for Indiv.	$45 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood								$15/Routine Physical											147.8970954	131.2929032	28.10077519	0	150	0.15	0.15	49.78045234	250	0.15	0.15	45	45	45	15	45	30	45	0.15	0	0.2	0	0	0	0	0	0	0	0	15											105.9435073	94.04938361	20.12950069	0	107.4498864	0.107449886	0.107449886	35.65935967	179.0831441	0.107449886	0.107449886	32.23496593	32.23496593	32.23496593	10.74498864	32.23496593	21.48997729	32.23496593	0.107449886	0	0.143266515	0	0	0	0	0	0	0	0	10.74498864											13.5802	0.311346447	1.716612755	0	1.873962202	1.414779144	0.871213352	0.73545652	4.695472211	0.6292811	1.842221216	0.002353947	0.094157894	0.282424736	5.591906088	27.76833047	0.43995412	3.264706432	7.553519582	0	1.102384807	0	0	0	0	0	0	0	0	0.042211289	0	0	0	0	0	0	0	0	0	0	73.8125	0	29.225	13.5802	0.311346447	1.716612755	0	1.873962202	1.414779144	0.871213352	0.73545652	4.695472211	0.6292811	1.842221216	0.002353947	0.094157894	0.282424736	5.591906088	27.76833047	0.43995412	3.264706432	7.553519582	0	1.102384807	0	0	0	0	0	0	0	0	0.042211289	0	0	0	0	0	0	0	0	0	0	73.8125	3800																																																																																	0	0	0	13.5802	0.311346447	1.716612755	0	1.873962202	1.414779144	0.871213352	0.73545652	4.695472211	0.6292811	1.842221216	0.002353947	0.094157894	0.282424736	5.591906088	27.76833047	0.43995412	3.264706432	7.553519582	0	1.102384807	0	0	0	0	0	0	0	0	0.042211289	0	0	0	0	0	0	0	0	0	0	73.8125
H5179_002_0	2009	4																					3800											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1480.083737	38.22445424	1060.900263	1357.539326	219.4746788	13.58015198	8.36258421	267.213201	339.8052366	6.530178641	19.11710621	0.946400656	37.85602622	113.5484001	5409.96371	8497.477864	185.2527679	916.452989	48.35279735	0	8.579754402	0	0	0	0	0	0	0	0	43.39788986											"$230 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$230 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$45 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$250/Visit	15% Coinsurance	15% Coinsurance	$45 Copay	$45 Copay	$45 Copay	$15 Copay	$45 Copay	$15 Copay Group Session; $45 for Indiv.	$45 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood								$15/Routine Physical											147.2098297	131.2929032	28.10077519	0	150	0.15	0.15	49.78045234	250	0.15	0.15	45	45	45	15	45	30	45	0.15	0	0.2	0	0	0	0	0	0	0	0	15											110.2167075	98.2996281	21.03918554	0	112.3057214	0.112305721	0.112305721	37.27086409	187.1762024	0.112305721	0.112305721	33.69171643	33.69171643	33.69171643	11.23057214	33.69171643	22.46114429	33.69171643	0.112305721	0	0.149740962	0	0	0	0	0	0	0	0	11.23057214											13.5942	0.313120803	1.860039789	0	2.054021845	1.525128765	0.939166053	0.829938908	5.300287811	0.733376423	2.146960405	0.002657155	0.106286208	0.318803375	5.063082311	23.85788454	0.346749096	2.573072852	5.43029579	0	1.284740677	0	0	0	0	0	0	0	0	0.040615261	0	0	0	0	0	0	0	0	0	0	68.3204	0	22.9291	13.5942	0.313120803	1.860039789	0	2.054021845	1.525128765	0.939166053	0.829938908	5.300287811	0.733376423	2.146960405	0.002657155	0.106286208	0.318803375	5.063082311	23.85788454	0.346749096	2.573072852	5.43029579	0	1.284740677	0	0	0	0	0	0	0	0	0.040615261	0	0	0	0	0	0	0	0	0	0	68.3204	3800																																																																																	0	0	0	13.5942	0.313120803	1.860039789	0	2.054021845	1.525128765	0.939166053	0.829938908	5.300287811	0.733376423	2.146960405	0.002657155	0.106286208	0.318803375	5.063082311	23.85788454	0.346749096	2.573072852	5.43029579	0	1.284740677	0	0	0	0	0	0	0	0	0.040615261	0	0	0	0	0	0	0	0	0	0	68.3204
H5179_004_0	2009	3																					3600											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1526.780841	39.43044772	1018.627354	1397.973619	215.029656	13.76858725	8.478621631	250.918762	319.007392	5.933093495	17.36913869	0.893218698	35.72874792	106.5986485	6167.028418	10202.43321	239.9692606	1185.92135	68.17480321	0	7.836877896	0	0	0	0	0	0	0	0	46.57257757											"$230 Copay/Day, up to 6 days; Unlimited"	"$230 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$40 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$250/Visit	15% Coinsurance	15% Coinsurance	$40 Copay	$40 Copay	$40 Copay	$15 Copay	$40 Copay	$15 Copay Group Session; $40 for Indiv.	$40 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood								$15/Routine Physical											140.5927273	131.2929032	28.10077519	0	150	0.15	0.15	49.56090468	250	0.15	0.15	40	40	40	15	40	27.5	40	0.15	0	0.2	0	0	0	0	0	0	0.757591441	0	15											100.7953141	94.12798003	20.14632277	0	107.5396816	0.107539682	0.107539682	35.53175938	179.2328026	0.107539682	0.107539682	28.67724842	28.67724842	28.67724842	10.75396816	28.67724842	19.71560829	28.67724842	0.107539682	0	0.143386242	0	0	0	0	0	0	0	0	10.75396816											12.8244	0.309292366	1.710132955	0	1.927018394	1.480669488	0.91178827	0.742965423	4.764715743	0.638042985	1.867871644	0.002134588	0.085383515	0.254746327	5.526668935	24.38147597	0.394261662	2.834080096	7.331496628	0	1.123700471	0	0	0	0	0	0	0	0	0.041736668	0	0	0	0	0	0	0	0	0	0	69.1525	0	27.3047	12.8244	0.309292366	1.710132955	0	1.927018394	1.480669488	0.91178827	0.742965423	4.764715743	0.638042985	1.867871644	0.002134588	0.085383515	0.254746327	5.526668935	24.38147597	0.394261662	2.834080096	7.331496628	0	1.123700471	0	0	0	0	0	0	0	0	0.041736668	0	0	0	0	0	0	0	0	0	0	69.1525	3600																																																																																	0	0	0	12.8244	0.309292366	1.710132955	0	1.927018394	1.480669488	0.91178827	0.742965423	4.764715743	0.638042985	1.867871644	0.002134588	0.085383515	0.254746327	5.526668935	24.38147597	0.394261662	2.834080096	7.331496628	0	1.123700471	0	0	0	0	0	0	0	0	0.041736668	0	0	0	0	0	0	0	0	0	0	69.1525
H5179_005_0	2009	5																					3600											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1281.202886	33.08818271	1083.939672	1133.674227	239.9943851	15.67873433	9.654879883	268.3401825	341.2461135	6.374134548	18.66028693	0.955486979	38.21947916	114.0298797	5089.769656	8127.727548	180.4228943	891.6448791	44.30994408	0	8.419438222	0	0	0	0	0	0	0	0	39.87348772											"$230 Copay/Day, up to 6 days; Unlimited"	"$230 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $125 Copay Days 21-100; 100 day limit	$0/Visit; 365 Day Limit	$150/Trip	15% Coinsurance	15% Coinsurance	$40 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$250/Visit	15% Coinsurance	15% Coinsurance	$40 Copay	$40 Copay	$40 Copay	$15 Copay	$40 Copay	$15 Copay Group Session; $40 for Indiv.	$40 Copay	15% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood								$15/Routine Physical											140.5927273	131.2929032	28.10077519	0	150	0.15	0.15	49.56090468	250	0.15	0.15	40	40	40	15	40	27.5	40	0.15	0	0.2	0	0	0	0	0	0	0	0	15											106.7610472	99.69909619	21.33871535	0	113.9045909	0.113904591	0.113904591	37.63476381	189.8409848	0.113904591	0.113904591	30.37455757	30.37455757	30.37455757	11.39045909	30.37455757	20.88250833	30.37455757	0.113904591	0	0.151872788	0	0	0	0	0	0	0	0	11.39045909											11.3985	0.274905159	1.92749001	0	2.278038521	1.78587982	1.099735143	0.841576616	5.398541521	0.726043188	2.125492349	0.002418541	0.096741647	0.288633929	4.831234419	20.57301069	0.313973549	2.256943226	5.047106053	0	1.278683555	0	0	0	0	0	0	0	0	0.037848111	0	0	0	0	0	0	0	0	0	0	62.5828	0	19.8336	11.3985	0.274905159	1.92749001	0	2.278038521	1.78587982	1.099735143	0.841576616	5.398541521	0.726043188	2.125492349	0.002418541	0.096741647	0.288633929	4.831234419	20.57301069	0.313973549	2.256943226	5.047106053	0	1.278683555	0	0	0	0	0	0	0	0	0.037848111	0	0	0	0	0	0	0	0	0	0	62.5828	3600																																																																																	0	0	0	11.3985	0.274905159	1.92749001	0	2.278038521	1.78587982	1.099735143	0.841576616	5.398541521	0.726043188	2.125492349	0.002418541	0.096741647	0.288633929	4.831234419	20.57301069	0.313973549	2.256943226	5.047106053	0	1.278683555	0	0	0	0	0	0	0	0	0.037848111	0	0	0	0	0	0	0	0	0	0	62.5828
H5179_006_0	2009	6																					3000											D	D	D	V	T	Coin	Coin	V	P	Coin	Coin	P	P	P	V	V	V	V	Coin	V	Coin	O	T	Coin	V	Coin	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	1537.120281	39.69747278	1122.143536	1180.582442	293.7927115	20.25017488	12.46994827	302.6374287	405.3292291	7.086994399	20.47973158	1.11243436	44.4973744	130.345683	5700.643972	8881.450261	180.8815508	887.9398932	46.43083341	0	9.534449288	0	0	0	381.6357415	2.5186875	163.5581749	0	0	40.4806483											"$50 Copay/Day, up to 6 days; Unlimited, 25% Add'l Days"	"$50 Copay/Day, up to 6 days; 190 day limit"	$0 Copay Days 1-20; $50 Copay Days 21-100; 100 day limit	$0/Visit; Unlimited Days	$100/Trip	10% Coinsurance	10% Coinsurance	$20 Copay for UC; $50 Copay for ER; $50 Copay for Worldwide Covg	$50/Visit	10% Coinsurance	10% Coinsurance	$20 Copay	$20 Copay	$20 Copay	$10 Copay	$20 Copay	$10 Copay Group Session; $20 for Indiv.	$20 Copay	10% Coinsurance	No charge for IP physician services	20% Coinsurance	No charge for blood			$20/Exam	$100 Allowance	$20/Exam			$10/Routine Physical											37.61056342	28.54193548	11.24031008	0	100	0.1	0.1	48.68271405	50	0.1	0.1	20	20	20	10	20	15	20	0.1	0	0.2	0	0	0	20	0	20	0	0	10											32.42316053	24.60531489	9.690000492	0	86.20759059	0.086207591	0.086207591	41.96819481	43.10379529	0.086207591	0.086207591	17.24151812	17.24151812	17.24151812	8.620759059	17.24151812	12.93113859	17.24151812	0.086207591	0	0.172415181	0	0	0	17.24151812	0	17.24151812	0	0	8.620759059											4.1532	0.081397402	0.906130951	0	2.110596816	1.745718785	1.075004195	1.05842888	1.455935676	0.610952712	1.765508315	0.001598338	0.063933524	0.187279788	4.09532318	12.76080713	0.194917033	1.27578598	4.002690277	0	1.643883801	0	0	0	0.548331629	0	0.23499927	0	0	0.02908116	0	0	0	0	0	0	0	0	0	0	40.0015	0	6.3999	4.1532	0.081397402	0.906130951	0	2.110596816	1.745718785	1.075004195	1.05842888	1.455935676	0.610952712	1.765508315	0.001598338	0.063933524	0.187279788	4.09532318	12.76080713	0.194917033	1.27578598	4.002690277	0	1.643883801	0	0	0	0.548331629	0	0.23499927	0	0	0.02908116	0	0	0	0	0	0	0	0	0	0	40.0015	3000																																																																																	0	0	0	4.1532	0.081397402	0.906130951	0	2.110596816	1.745718785	1.075004195	1.05842888	1.455935676	0.610952712	1.765508315	0.001598338	0.063933524	0.187279788	4.09532318	12.76080713	0.194917033	1.27578598	4.002690277	0	1.643883801	0	0	0	0.548331629	0	0.23499927	0	0	0.02908116	0	0	0	0	0	0	0	0	0	0	40.0015
H5189_001_0	2009	7																																D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	Coin	T	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		1374.36703	357.5176094	866.1280959	269.4338639	158.5279127	16.16316231	5.050652247	700.9103496	2472.170359	2398.763412	639.0287928	0	0.885507755	117.8495071	3313.655584	5342.776336	712.2370975	148.6407856	1625.681815	0	15.87674998	0.39888946	8227.886166	1689.981239	494.7281237	466.7689813	16.11496142	1.488189049	3.043965941	12000											$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	$100/visit	$0 Lab / $30 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$30/visit	$10/visit	$30/visit	$30/visit	$30/visit	$30/visit	$30/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											77.33153234	77.33153234	40.66337511	0	124.2484388	0.2	0.122529278	46.84373331	33	0	0	0	0	0	8.014175484	15	29.44109091	30	0.033635429	0	0.2	0	0	9.332565056	0	0	0	0	0	0											56.77555321	56.77555321	40.66337511	0	124.2484388	0.2	0.122529278	46.84373331	33	0	0	0	0	0	8.014175484	15	29.44109091	30	0.033635429	0	0.2	0	0	9.332565056	0	0	0	0	0	0											6.5025	1.691521671	2.934974305	0	1.641403806	3.232632461	0.618852773	2.736104791	6.798468486	0	0	0	0	0	2.213018112	6.678470419	1.747419761	0.371601964	0.004556709	0	3.175349996	0	0	1.314321655	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6612	0	0	6.5025	1.691521671	2.934974305	0	1.641403806	3.232632461	0.618852773	2.736104791	6.798468486	0	0	0	0	0	2.213018112	6.678470419	1.747419761	0.371601964	0.004556709	0	3.175349996	0	0	1.314321655	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6612		$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	$100/visit	$0 Lab / $30 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$30/visit	$10/visit	$30/visit	$30/visit	$30/visit	$30/visit	$30/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											1.2163	0.3164	0.2102	0	2.8868	0.028	0.0774	0.4822	0.5235	0	0	0	0	0	0.7541	2.2757	0.5954	0.1266	0.0016	0	0.8199	0	0	0.1099	0	0	0	0	0	0											10.4239	0	0	7.7188	2.0079175	3.145153643	0	4.528205739	3.260677577	0.696263998	3.218286749	7.321960596	0	0	0	0	0	2.967101774	8.954152397	2.342851261	0.498224954	0.006109403	0	3.995237012	0	0	1.424194008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.0852
H5189_002_0	2009	7																																D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	Coin	T	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		2087.133803	542.9314525	1187.405222	354.5890451	559.4943711	23.26441827	7.269647125	1054.711663	3406.229915	3882.665272	1034.339147	0	1.43329275	190.7525295	5683.738739	9164.182596	1221.662747	254.9557036	2788.446317	0	25.55593753	0.650778009	12000	2125.927667	632.9156938	597.1469974	33.27417758	0	3.072813233	12004.74091											$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	$100/visit	$0 Lab / $20 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$30/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	$20/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											73.46495573	73.46495573	60.99506267	0	125.3164557	0.2	0.122529278	46.72576966	33	0	0	0	0	0	4.270845528	10	20	20	0	0	0.2	0	0	9.02200489	0	0	0	0	0	0											53.93677555	53.93677555	60.99506267	0	125.3164557	0.2	0.122529278	46.72576966	33	0	0	0	0	0	4.270845528	10	20	20	0	0	0.2	0	0	9.02200489	0	0	0	0	0	0											9.3811	2.440330991	6.035487991	0	5.842820964	4.652883653	0.890744614	4.106851186	9.367132266	0	0	0	0	0	2.022864182	7.63681883	2.036104578	0.424926173	0	0	5.111187507	0	0	1.598344151	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.5476	0	0	9.3811	2.440330991	6.035487991	0	5.842820964	4.652883653	0.890744614	4.106851186	9.367132266	0	0	0	0	0	2.022864182	7.63681883	2.036104578	0.424926173	0	0	5.111187507	0	0	1.598344151	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.5476		$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	$100/visit	$0 Lab / $20 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$30/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	$20/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											1.4782	0.3845	0.4033	0	3.7249	0.0359	0.099	0.6153	0.6697	0	0	0	0	0	0.5141	1.9409	0.5175	0.108	0	0	1.0489	0	0	0.1233	0	0	0	0	0	0											11.6636	0	0	10.8593	2.824863994	6.438818008	0	9.56771065	4.688762337	0.989778359	4.722162904	10.03684631	0	0	0	0	0	2.536971532	9.577702813	2.553576951	0.532920407	0	0	6.160085547	0	0	1.721651672	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.2112
H5189_003_0	2009	9																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0.1963	0.6055	0.1892	0.8411	1.3517	0.4068	0.405	0	0.0332	0.0407	0.8192	2.2374	0.1972	0.0515	0.2665	0	0.5947	0.0149	0	0	0	0	0	0	0	0											8.2509		285.9916726	47.96547996	1102.255429	18.01916259	6.331628099	19.53150192	6.103188359	27.13227152	43.60204667	13.12228512	13.06514206	0	1.070044097	1.312181153	26.42702301	72.17447236	6.361292897	1.660614089	8.597454067	0	19.18540239	0.482016458	1.912983534	28.0703454	2.737244523	2.201394382	0.061548117	0.107154007	0.003694635	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	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											671.8322409	454.845604	73.9183099	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											671.8322409	454.845604	73.9183099	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											16.0115	1.818073975	6.789738198	0	1.26632562	3.906300383	1.220637672	5.426454303	8.720409333	2.624457024	2.613028412	0	0.214008819	0.262436231	5.285404603	14.43489447	1.272258579	0.332122818	1.719490813	0	3.837080477	0.096403292	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.8511	135	0	16.0115	1.818073975	6.789738198	0	1.462606091	4.511776942	1.409836511	6.26755472	10.07207278	3.031247863	3.018047816	0	0.247180186	0.303113846	6.104642316	16.67230312	1.469458659	0.383601855	1.986011889	0	4.431827951	0.111345802	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.102		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											2.9949	0.3401	0.4862	0	2.5723	0.5644	0.1764	1.1045	0.7756	0.8039	0.8004	0	0.0656	0.0804	2.0802	5.6811	0.5007	0.1307	0.6767	0	1.1443	0.0306	0	0	0	0	0	0	0	0											21.009	135	0	19.0065	2.158141165	7.275964832	0	4.034949396	5.07614733	1.586190526	7.37208179	10.84763725	3.835170885	3.818470029	0	0.312735315	0.383503247	8.184792953	22.35337338	1.970175197	0.514313795	2.662743413	0	5.576142184	0.141995601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.111
H5189_004_0	2009	5																																D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	Coin	T	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		1374.385549	357.5224269	866.1397669	269.4374945	158.5300489	16.1633801	5.050720304	700.9197943	2472.203671	2398.795735	639.0374036	0	0.885519687	117.8510951	3313.700235	5342.848329	712.2466948	148.6427885	1625.703721	0	15.87696392	0.398894834	8227.886166	1689.981239	494.7347901	466.7752709	16.11517857	1.488209102	3.044006958	12000											$50/day - 1st 5 days	$50/day - 1st 5 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	$100/visit	$0 Lab / $20 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$30/visit	$5/visit	$15/visit	$15/visit	$15/visit	$15/visit	$15/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											28.63574966	28.63574966	40.66337511	0	124.2484388	0.2	0.122529278	46.84373331	33	0	0	0	0	0	4.007087742	7.5	14.72054545	15	0.016817715	0	0.2	0	0	9.332565056	0	0	0	0	0	0											18.46304381	18.46304381	40.66337511	0	124.2484388	0.2	0.122529278	46.84373331	33	0	0	0	0	0	4.007087742	7.5	14.72054545	15	0.016817715	0	0.2	0	0	9.332565056	0	0	0	0	0	0											2.1146	0.550079352	2.935013853	0	1.641425923	3.23267602	0.618861112	2.73614166	6.798560095	0	0	0	0	0	1.106523966	3.339280206	0.873721654	0.185803486	0.002278385	0	3.175392784	0	0	1.314321655	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.6247	0	0	2.1146	0.550079352	2.935013853	0	1.641425923	3.23267602	0.618861112	2.73614166	6.798560095	0	0	0	0	0	1.106523966	3.339280206	0.873721654	0.185803486	0.002278385	0	3.175392784	0	0	1.314321655	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.6247		$50/day - 1st 5 days	$50/day - 1st 5 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	$100/visit	$0 Lab / $20 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$30/visit	$5/visit	$15/visit	$15/visit	$15/visit	$15/visit	$15/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											0.3955	0.1029	0.2102	0	2.8868	0.028	0.0774	0.4822	0.5235	0	0	0	0	0	0.377	1.1379	0.2977	0.0633	0.0008	0	0.8199	0	0	0.1099	0	0	0	0	0	0											7.5131	0	0	2.5101	0.652970622	3.145196023	0	4.528266756	3.260721514	0.69627338	3.218330115	7.322059259	0	0	0	0	0	1.483570878	4.477136526	1.171441415	0.249115834	0.003054743	0	3.995290848	0	0	1.424194008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.1378
H5189_801_0	2009	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																							0.1949	0.6011	0.1878	0.835	1.3418	0.4038	0.4021	0	0.0329	0.0404	0.8133	2.2211	0.1958	0.0511	0.2646	0	0.5904	0.0148																			8.1908		206.8002317	23.48170285	30.90796207	17.88785933	6.285490362	19.38917844	6.058715232	26.93456224	43.28432432	13.02666476	12.9699381	0	1.062246827	1.302619463	26.23445279	71.64854652	6.314938996	1.648513413	8.534805555	0	19.0456009	0.478504068																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			0.076061629	0.076061629	0.220432076	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																			0.076061629	0.076061629	0.220432076	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																			15.7296	1.786056572	6.813106232	0	1.257098072	3.877835688	1.211743046	5.386912448	8.656864863	2.605332952	2.59398762	0	0.212449365	0.260523893	5.246890558	14.3297093	1.262987799	0.329702683	1.706961111	0	3.809120179	0.095700814	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.1725	135	0	15.7296	1.786056572	6.813106232	0	1.451948274	4.47890022	1.399563219	6.221883877	9.998678917	3.00915956	2.996055701	0	0.245379017	0.300905096	6.060158594	16.55081425	1.458750908	0.380806599	1.971540083	0	4.399533807	0.11053444	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.3633		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			2.9422	0.3341	0.4879	0	2.2109	0.4851	0.1516	0.9493	0.6666	0.691	0.688	0	0.0563	0.0691	1.7879	4.8828	0.4304	0.1123	0.5816	0	0.9835	0.0263																			18.5369	135	0	18.6717	2.120134969	7.301006298	0	3.662856481	4.96397199	1.551138064	7.171215935	10.66527029	3.700124877	3.684012101	0	0.301723118	0.369999134	7.848031195	21.43364806	1.889112711	0.493152451	2.553185339	0	5.383062608	0.136877693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.9003
H5189_802_0	2009	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																							0.1949	0.6011	0.1878	0.835	1.3418	0.4038	0.4021	0	0.0329	0.0404	0.8133	2.2211	0.1958	0.0511	0.2646	0	0.5904	0.0148																			8.1908		206.8002317	23.48170285	30.90796207	17.88785933	6.285490362	19.38917844	6.058715232	26.93456224	43.28432432	13.02666476	12.9699381	0	1.062246827	1.302619463	26.23445279	71.64854652	6.314938996	1.648513413	8.534805555	0	19.0456009	0.478504068																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			0.076061629	0.076061629	0.220432076	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																			0.076061629	0.076061629	0.220432076	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																			15.7296	1.786056572	6.813106232	0	1.257098072	3.877835688	1.211743046	5.386912448	8.656864863	2.605332952	2.59398762	0	0.212449365	0.260523893	5.246890558	14.3297093	1.262987799	0.329702683	1.706961111	0	3.809120179	0.095700814	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.1725	135	0	15.7296	1.786056572	6.813106232	0	1.451948274	4.47890022	1.399563219	6.221883877	9.998678917	3.00915956	2.996055701	0	0.245379017	0.300905096	6.060158594	16.55081425	1.458750908	0.380806599	1.971540083	0	4.399533807	0.11053444	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.3633		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			2.9422	0.3341	0.4879	0	2.2109	0.4851	0.1516	0.9493	0.6666	0.691	0.688	0	0.0563	0.0691	1.7879	4.8828	0.4304	0.1123	0.5816	0	0.9835	0.0263																			18.5369	135	0	18.6717	2.120134969	7.301006298	0	3.662856481	4.96397199	1.551138064	7.171215935	10.66527029	3.700124877	3.684012101	0	0.301723118	0.369999134	7.848031195	21.43364806	1.889112711	0.493152451	2.553185339	0	5.383062608	0.136877693	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.9003
H5206_002_0	2009	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		652.6354076		272.8510048		41.47698412	62.89568392		48.73017799	24.77517723	150.6223447					368.8185375						45.12325929	2.302470346																			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																			0.0827		0.1627		0.231	0.231		0.231	0.231	0.231					0.231						0.231	0.231																			0.0827		0.1627		0.231	0.231		0.231	0.231	0.231					0.231						0.231	0.231																			53.9729	0	44.39285848	0	9.581183332	14.52890298	0	11.25667112	5.72306594	34.79376162	0	0	0	0	85.19708216	0	0	0	0	0	10.42347289	0.53187065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	270.4018	0	0	53.9729	0	44.39285848	0	9.581183332	14.52890298	0	11.25667112	5.72306594	34.79376162	0	0	0	0	85.19708216	0	0	0	0	0	10.42347289	0.53187065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	270.4018																																																																																		0	0	0	53.9729	0	44.39285848	0	9.581183332	14.52890298	0	11.25667112	5.72306594	34.79376162	0	0	0	0	85.19708216	0	0	0	0	0	10.42347289	0.53187065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	270.4018
H5206_003_0	2009	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		709.6200739		372.7543021		71.59506257	33.45593201		30.59817969	20.80177028	203.2477573					343.5806988						43.12388616	7.241354617																			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																			0.0769		0.1344		0.231	0.231		0.231	0.231	0.231					0.231						0.231	0.231																			0.0769		0.1344		0.231	0.231		0.231	0.231	0.231					0.231						0.231	0.231																			54.5698	0	50.0981782	0	16.53845945	7.728320294	0	7.068179508	4.805208934	46.95023194	0	0	0	0	79.36714142	0	0	0	0	0	9.961617702	1.672752917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	278.7599	0	0	54.5698	0	50.0981782	0	16.53845945	7.728320294	0	7.068179508	4.805208934	46.95023194	0	0	0	0	79.36714142	0	0	0	0	0	9.961617702	1.672752917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	278.7599																																																																																		0	0	0	54.5698	0	50.0981782	0	16.53845945	7.728320294	0	7.068179508	4.805208934	46.95023194	0	0	0	0	79.36714142	0	0	0	0	0	9.961617702	1.672752917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	278.7599
H5207_001_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	779.9265941	27.71560978	336.228514	72.48506381	35.18371321	41.58791436	37.96374429	30.94284348	54.16160874	22.85815317	53.99875167	6.316527823	13.7614225	188.693182	100.3624986	185.6543024	5.875207388	10.79372392	40.54118201	64.19958418	28.3254977	9.061832734	0	0	0	0	0	0	0	0											Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	Standard Medicare Fee for Service Cost Sharing Levels	0	0	0	0	0	0	0	0											0.075967399	0.075950242	0.164016384	0	0.230993705	0.230999833	0.231005645	0.230977788	0.23099999	0.230981456	0.230967906	0.231000102	0.230999982	0.230987868	0.230993336	0.231004945	0.231014072	0.231008946	0.230991375	0.231003636	0.230997702	0.231002147	0	0	0	0	0	0	0	0											0.075967399	0.075950242	0.164016384	0	0.230993705	0.230999833	0.231005645	0.230977788	0.23099999	0.230981456	0.230967906	0.231000102	0.230999982	0.230987868	0.230993336	0.231004945	0.231014072	0.231008946	0.230991375	0.231003636	0.230997702	0.231002147	0	0	0	0	0	0	0	0											59.249	2.105007283	55.14698519	0	8.127216267	9.606801287	8.769839244	7.147109554	12.51133106	5.279809503	12.47197859	1.459118573	3.178888352	43.58583583	23.18306835	42.88706197	1.357255581	2.493446791	9.364663397	14.8303374	6.543124886	2.093302822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	331.3912	0	0	59.249	2.105007283	55.14698519	0	8.127216267	9.606801287	8.769839244	7.147109554	12.51133106	5.279809503	12.47197859	1.459118573	3.178888352	43.58583583	23.18306835	42.88706197	1.357255581	2.493446791	9.364663397	14.8303374	6.543124886	2.093302822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	331.3912	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	59.249	2.105007283	55.14698519	0	8.127216267	9.606801287	8.769839244	7.147109554	12.51133106	5.279809503	12.47197859	1.459118573	3.178888352	43.58583583	23.18306835	42.88706197	1.357255581	2.493446791	9.364663397	14.8303374	6.543124886	2.093302822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	331.3912
H5209_002_0	2009	4																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		456.3664965		518.5745336		32.47335147	17.56806679		24.30770443	18.00874058	188.1043414					463.7576225						28.28718791	12.5770238																			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																			0.0766		0.1524		0.231	0.231		0.231	0.231	0.231					0.231						0.231	0.231																			0.0766		0.1524		0.231	0.231		0.231	0.231	0.231					0.231						0.231	0.231																			34.9577	0	79.03075893	0	7.50134419	4.058223428	0	5.615079723	4.160019073	43.45210285	0	0	0	0	107.1280108	0	0	0	0	0	6.534340406	2.905292497	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	295.3428	0	0	34.9577	0	79.03075893	0	7.50134419	4.058223428	0	5.615079723	4.160019073	43.45210285	0	0	0	0	107.1280108	0	0	0	0	0	6.534340406	2.905292497	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	295.3428																																																																																		0	0	0	34.9577	0	79.03075893	0	7.50134419	4.058223428	0	5.615079723	4.160019073	43.45210285	0	0	0	0	107.1280108	0	0	0	0	0	6.534340406	2.905292497	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	295.3428
H5211_001_0	2009	7																					$300 on all but ER; no limit on ER																		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	POS available as on optional rider (see Wkst 7)	0	0	0	0	0	0	0	313.4193941	0	0	0	0	0	0	3124.114446	6028.658108	83.78851004	0	0	0	0	0	0	0	2.151381309	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	$50 per visit if not admitted (PBP 4A)	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	$15 per visit (PBP 4B & 7A)	"$15 per visit (PBP 7B, 7D, 7F, & 7G)"	"$15 per visit (PBP 5, 7E, 7H, & 9C)"	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	$15 per visit (PBP 17A)	no cost sharing	$15 per visit (PBP 18A)	no cost sharing	no cost sharing	no cost sharing											0	0	0	0	0	0	0	49.95959629	0	0	0	0	0	0	14.99613895	14.99682106	15	0	0	0	0	0	0	0	15	0	15	0	0	0											0	0	0	0	0	0	0	49.95959629	0	0	0	0	0	0	14.34958057	13.74782946	12.53734686	0	0	0	0	0	0	0	15	0	15	0	0	0											0	0	0	0	0	0	0	1.304858866	0	0	0	0	0	0	3.735810996	6.906746962	0.087540468	0	0	0	0	0	0	0	0.002689227	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.0376	0	0.813	0	0	0	0	0	0	0	1.304858866	0	0	0	0	0	0	3.735810996	6.906746962	0.087540468	0	0	0	0	0	0	0	0.002689227	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.0376	In Network coverage only without the optional POS rider																																																																																	0		0	0	0	0	0	0	0	0	1.304858866	0	0	0	0	0	0	3.735810996	6.906746962	0.087540468	0	0	0	0	0	0	0	0.002689227	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.0376
H5211_002_0	2009	9																					$2500 on all but ER; no limit on ER											D	D	D		T	Coin	Coin	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	POS available as on optional rider (see Wkst 7)	902.5736075	18.68692959	1218.263457	0	113.7336435	2.835018519	5.245226784	193.4653493	307.7460972	0	0	0	0	0	1933.828685	3730.408503	52.68875161	0	0	125.2409942	0	0	0	0	2.147168681	0	0	0	0	0											$150 each of days 1-5/admit (PBP 1A)	$150 each of days 1-5/admit (PBP 1B)	$50 for each of days 1-20/admit (PBP 2)	no cost sharing	$50 per trip (PBP 10A)	20% coinsurance (PBP 11A)	20% coinsurance (PBP 11B)	$50 per visit if not admitted (PBP 4A)	$50 Hosp OP surgery copay (PBP 9A)	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	$20 per visit (PBP 4B & 7A)	"$20 per visit (PBP 7B, 7D, 7F, & 7G)"	"$20 per visit (PBP 5, 7E, 7H, & 9C)"	no cost sharing	no cost sharing	ASC $50/visit (PBP 9B)	no cost sharing	no cost sharing	no cost sharing	no cost sharing	$20 per visit (PBP 17A)	no cost sharing	$20 per visit (PBP 18A)	no cost sharing	no cost sharing	no cost sharing											108.730114	76.83923706	41.96792134	0	49.8743436	0.2	0.2	49.96073541	37.86002405	0	0	0	0	0	19.97300575	19.96671896	20	0	0	49.9327957	0	0	0	0	20	0	20	0	0	0											95.45409184	67.45711307	30.26572395	0	44.05191644	0.183629226	0.183629226	49.96073541	36.15343768	0	0	0	0	0	19.59400251	19.5495112	19.44125887	0	0	49.2716844	0	0	0	0	20	0	20	0	0	0											7.1795	0.105047194	3.072635458	0	0.417515413	0.520592256	0.963176933	0.805472594	0.927173279	0	0	0	0	0	3.157620343	6.077305234	0.085361305	0	0	0.514236229	0	0	0	0	0.003578614	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.8292		2.6325	7.1795	0.105047194	3.072635458	0	0.417515413	0.520592256	0.963176933	0.805472594	0.927173279	0	0	0	0	0	3.157620343	6.077305234	0.085361305	0	0	0.514236229	0	0	0	0	0.003578614	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.8292	In Network coverage only without the optional POS rider																																																																																	0		0	7.1795	0.105047194	3.072635458	0	0.417515413	0.520592256	0.963176933	0.805472594	0.927173279	0	0	0	0	0	3.157620343	6.077305234	0.085361305	0	0	0.514236229	0	0	0	0	0.003578614	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.8292
H5211_003_0	2009	8																					$2500 on all but ER; no limit on ER											D	D	D		T	Coin	Coin	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	POS available as on optional rider (see Wkst 7)	902.5736075	18.68692959	1218.263457	0	113.7336435	2.835018519	5.245226784	193.4653493	307.7460972	0	0	0	0	0	1933.828685	3730.408503	52.68875161	0	0	125.2409942	0	0	0	0	2.147168681	0	0	0	0	0											$150 each of days 1-5/admit (PBP 1A)	$150 each of days 1-5/admit (PBP 1B)	$50 for each of days 1-20/admit (PBP 2)	no cost sharing	$50 per trip (PBP 10A)	20% coinsurance (PBP 11A)	20% coinsurance (PBP 11B)	$50 per visit if not admitted (PBP 4A)	$50 Hosp OP surgery copay (PBP 9A)	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	$20 per visit (PBP 4B & 7A)	"$20 per visit (PBP 7B, 7D, 7F, & 7G)"	"$20 per visit (PBP 5, 7E, 7H, & 9C)"	no cost sharing	no cost sharing	ASC $50/visit (PBP 9B)	no cost sharing	no cost sharing	no cost sharing	no cost sharing	$20 per visit (PBP 17A)	no cost sharing	$20 per visit (PBP 18A)	no cost sharing	no cost sharing	no cost sharing											108.730114	76.83923706	41.96792134	0	49.8743436	0.2	0.2	49.96073541	37.86002405	0	0	0	0	0	19.97300575	19.96671896	20	0	0	49.9327957	0	0	0	0	20	0	20	0	0	0											95.45409184	67.45711307	30.26572395	0	44.05191644	0.183629226	0.183629226	49.96073541	36.15343768	0	0	0	0	0	19.59400251	19.5495112	19.44125887	0	0	49.2716844	0	0	0	0	20	0	20	0	0	0											7.1795	0.105047194	3.072635458	0	0.417515413	0.520592256	0.963176933	0.805472594	0.927173279	0	0	0	0	0	3.157620343	6.077305234	0.085361305	0	0	0.514236229	0	0	0	0	0.003578614	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.8292		2.6325	7.1795	0.105047194	3.072635458	0	0.417515413	0.520592256	0.963176933	0.805472594	0.927173279	0	0	0	0	0	3.157620343	6.077305234	0.085361305	0	0	0.514236229	0	0	0	0	0.003578614	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.8292	In Network coverage only without the optional POS rider																																																																																	0		0	7.1795	0.105047194	3.072635458	0	0.417515413	0.520592256	0.963176933	0.805472594	0.927173279	0	0	0	0	0	3.157620343	6.077305234	0.085361305	0	0	0.514236229	0	0	0	0	0.003578614	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.8292
H5211_004_0	2009	9																					$300 on all but ER; no limit on ER																		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	POS available as on optional rider (see Wkst 7)	0	0	0	0	0	0	0	313.4193941	0	0	0	0	0	0	3124.114446	6028.658108	83.78851004	0	0	0	0	0	0	0	2.151381309	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	$50 per visit if not admitted (PBP 4A)	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	$15 per visit (PBP 4B & 7A)	"$15 per visit (PBP 7B, 7D, 7F, & 7G)"	"$15 per visit (PBP 5, 7E, 7H, & 9C)"	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	$15 per visit (PBP 17A)	no cost sharing	$15 per visit (PBP 18A)	no cost sharing	no cost sharing	no cost sharing											0	0	0	0	0	0	0	49.95959629	0	0	0	0	0	0	14.99613895	14.99682106	15	0	0	0	0	0	0	0	15	0	15	0	0	0											0	0	0	0	0	0	0	49.95959629	0	0	0	0	0	0	14.34958057	13.74782946	12.53734686	0	0	0	0	0	0	0	15	0	15	0	0	0											0	0	0	0	0	0	0	1.304858866	0	0	0	0	0	0	3.735810996	6.906746962	0.087540468	0	0	0	0	0	0	0	0.002689227	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.0376	0	0.813	0	0	0	0	0	0	0	1.304858866	0	0	0	0	0	0	3.735810996	6.906746962	0.087540468	0	0	0	0	0	0	0	0.002689227	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.0376	In Network coverage only without the optional POS rider																																																																																	0		0	0	0	0	0	0	0	0	1.304858866	0	0	0	0	0	0	3.735810996	6.906746962	0.087540468	0	0	0	0	0	0	0	0.002689227	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.0376
H5211_005_0	2009	8																					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	POS available as on optional rider (see Wkst 7)																																									no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	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	In Network coverage only without the optional POS rider																																																																																	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5211_006_0	2009	6																					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	POS available as on optional rider (see Wkst 7)																																									no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	no cost sharing	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	In Network coverage only without the optional POS rider																																																																																	0		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5214_003_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered							4000											D	D	D	V	T	Coin	Coin	V	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							0		1395.256078	62.124224	486.964378	695.982424	138.431555	9.030604	3.261249	313.121787	339.413911	600.075641	890.641362	0	18.548155	681.333207	3334.64377	4019.618358	27.420207	866.384538			20.410699								1.81	0.09	0.06	0.05	1.23	2.7							$175/Day(Days 1-5):1a	$175/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$125/Visit:9b. $0 Surgery ASC -- Physician,9b. $125 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $125 Surgery OP -- Facility"	"$0-$75/Visit:8a. $0 Lab -- FSL,8. $75 Lab -- OP"	"$0-$100/Visit:14h. $75 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $75 Radiology OP -- Facility"	$50/Visit:9a	"$0-$75/Proc:12. $0 Dialysis -- Dialysis Center,12. $75 Dialysis -- OP Hosp"	"$35-$100/Visit:9d. $75 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $75 OP Other,5. $35 Partial Hospitalization,8b. $75 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$75/Visit:7h. $75 Psych -- OP,7e. $35 Psych -- Other Provider"	"$35-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								Silver Sneakers	Meals On Wheels	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit							107.292846	89.437962	43.132805	0	99.999974	0.2	0.2	49.999995	125.000015	65.968043	68.319903	0	1.173593	61.867314	10	35	68.75703	43.629906			0.2								0	0	0	0	0	0							89.163037	74.325182	35.84444	0	83.102478	0.166205	0.166205	41.551246	103.878137	54.821093	56.775547	0	0.975285	51.413285	8.31025	29.085875	57.13881	36.257542			0.166205								0	0	0	0	0	0							10.3671	0.384782855	1.454580452	0	0.958667104	1.500931538	0.54203589	1.0842167	2.938140396	2.74140021	4.213887542	0	0.001507478	2.919131529	2.309310282	9.742843092	0.130563166	2.617747815	0	0	3.392360227	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.2992	0	9.6175	10.3671	0.384782855	1.454580452	0	0.958667104	1.500931538	0.54203589	1.0842167	2.938140396	2.74140021	4.213887542	0	0.001507478	2.919131529	2.309310282	9.742843092	0.130563166	2.617747815	0	0	3.392360227	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.2992	6000	30% Coins:1a	30% Coins:1b	"30% Coins(Days 1-20) 30%(Days 21-100):2. 30% SNF 1,2. 30% SNF 2"	30% Coins:6	$100/Trip:10a	40% Coins:11a	40% Coins:11b	$50/Visit:4a	"30% Coins:9b. 30% Surgery ASC -- Physician,9b. 30% Surgery ASC -- Facility,9a. 30% Surgery OP -- Physician,9a. 30% Surgery OP -- Facility"	"30% Coins:8a. 30% Lab -- FSL,8. 30% Lab -- OP"	"30% Coins:14h. 30% DMAM -- OP,8b. 30% Radiology -- FSR,14h. 30% SMAM -- FSR,14h. 30% SMAM -- OP,8b. 30% Advanced Imaging -- FSR,8b. 30% Advanced Imaging -- Office,9a. 30% Advanced Imaging -- OP,8a. 30% Radiology OP -- Physician,8a. 30% Radiology OP -- Facility"		"$0-$75/Proc:12. $0 Dialysis -- Dialysis Center,12. $75 Dialysis -- OP Hosp"	"30% Coins:9d. 30% Cardiac Rehab,8b. 30% Nuclear Medicine,9a. 30% OP Other,5. 30% Partial Hospitalization,8b. 30% Rad therapy,3. 30% Therapy (AT,PT,ST,OT) -- CORF"	30% Coins:7a	"30% Coins:7b, 7d, 7f"	"30% Coins:7h. 30% Psych -- OP,7e. 30% Psych -- Other Provider"	"30% Coins:9a. 30% Therapy (AT,PT,ST,OT) -- OP,7d. 30% Therapy (AT,PT,ST,OT) - Specialist"			30% Coins:15								Silver Sneakers	Meals On Wheels	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit							6.5101	0.0932	0.4081	0.6191	0.7636	2.274	0.8212	0.2286	2.9473	0.3797	1.5793		0.0003	0.892	1.7886	4.0835	0.0258	0.3448			1.2189								0	0	0	0	0	0							24.9779	500	4.250639629	16.8772	0.477946855	1.862662452	0.619105	1.722304104	3.774886538	1.36323489	1.3128287	5.885422396	3.12107821	5.793171542	0	0.001825478	3.811168529	4.097865282	13.82632409	0.156370166	2.962547815	0	0	4.611243227	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.2771
H5214_004_0	2009	4	r.	s.	t.								Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered								4000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin				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		1371.149327	61.050865	478.550777	683.957482	136.039782	8.721245	3.149529	307.711778	333.549637	589.707741	875.253165	0	18.227687	669.561365	3277.028953	3950.168786	26.94645	851.415445			19.711493				2.47				1.81	0.05	0.06	1.23	2.7								$175/Day(Days 1-5):1a	$175/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$175/Visit:9b. $0 Surgery ASC -- Physician,9b. $175 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $175 Surgery OP -- Facility"	"$0-$75/Visit:8a. $0 Lab -- FSL,8. $75 Lab -- OP"	"$0-$100/Visit:14h. $75 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $75 Radiology OP -- Facility"	$50/Visit:9a	"$0-$75/Proc:12. $0 Dialysis -- Dialysis Center,12. $75 Dialysis -- OP Hosp"	"$30-$100/Visit:9d. $75 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $75 OP Other,5. $30 Partial Hospitalization,8b. $75 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$5/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$75/Visit:7h. $75 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15				VIS743				Silver Sneakers	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit								107.292847	89.437946	43.132802	0	100.000013	0.2	0.2	49.999984	174.99998	65.96806	68.319903	0	1.173818	60.06981	5	30	67.976598	39.708638			0.2				0				0	0	0	0	0								94.140997	78.474732	37.845626	0	87.742111	0.175484	0.175484	43.871036	153.548657	57.881761	59.945318	0	1.029933	52.706512	4.387105	26.32263	59.644094	34.841193			0.175484				0				0	0	0	0	0								10.7568	0.399245856	1.509254477	0	0.994701471	1.530438958	0.552691947	1.124969541	4.268008234	2.844443544	4.372277442	0	0.001564441	2.940853677	1.198055842	8.664902616	0.13393305	2.472027487	0	0	3.459051638	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.2232	0	6.5973	10.7568	0.399245856	1.509254477	0	0.994701471	1.530438958	0.552691947	1.124969541	4.268008234	2.844443544	4.372277442	0	0.001564441	2.940853677	1.198055842	8.664902616	0.13393305	2.472027487	0	0	3.459051638	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.2232		$850/Admit:1a	$850/Admit:1b	"30% Coins(Days 1-20) 30%(Days 21-100):2. 30% SNF 1,2. 30% SNF 2"	30% Coins:6	$100/Trip:10a	40% Coins:11a	40% Coins:11b	$50/Visit:4a	"30% Coins:9b. 30% Surgery ASC -- Physician,9b. 30% Surgery ASC -- Facility,9a. 30% Surgery OP -- Physician,9a. 30% Surgery OP -- Facility"	"30% Coins:8a. 30% Lab -- FSL,8. 30% Lab -- OP"	"30% Coins:14h. 30% DMAM -- OP,8b. 30% Radiology -- FSR,14h. 30% SMAM -- FSR,14h. 30% SMAM -- OP,8b. 30% Advanced Imaging -- FSR,8b. 30% Advanced Imaging -- Office,9a. 30% Advanced Imaging -- OP,8a. 30% Radiology OP -- Physician,8a. 30% Radiology OP -- Facility"		"$0-$75/Proc:12. $0 Dialysis -- Dialysis Center,12. $75 Dialysis -- OP Hosp"	"30% Coins:9d. 30% Cardiac Rehab,8b. 30% Nuclear Medicine,9a. 30% OP Other,5. 30% Partial Hospitalization,8b. 30% Rad therapy,3. 30% Therapy (AT,PT,ST,OT) -- CORF"	30% Coins:7a	"30% Coins:7b, 7d, 7f"	"30% Coins:7h. 30% Psych -- OP,7e. 30% Psych -- Other Provider"	"30% Coins:9a. 30% Therapy (AT,PT,ST,OT) -- OP,7d. 30% Therapy (AT,PT,ST,OT) - Specialist"			30% Coins:15				VIS743				Silver Sneakers	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit								1.701	0.0548	0.3483	0.5283	0.6631	1.9406	0.7008	0.1985	2.5152	0.324	1.3477		0.0003	0.7613	1.5263	3.4848	0.022	0.2942			1.0402				0				0	0	0	0	0								17.4515	0	0	12.4578	0.454052856	1.857505477	0.528335	1.657836471	3.470997958	1.253491947	1.323493541	6.783174234	3.168455544	5.720014442	0	0.001840441	3.702104677	2.724381842	12.14968362	0.15595605	2.766275487	0	0	4.499228638	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6747
H5214_801_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		250.657954	8.076156	486.964788	695.983009	4.575698	9.030608	3.26125	20.07771	51.609978	600.076143	27.906422	0	0.352141	15.898198	29.950085	68.379552	0.432139	5.773811			20.410707																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000012	1023.999536	43.132794	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.2	0.2	0.199999	0.500001	0.199999			0.199999																				1024.000012	1023.999536	43.132794	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.2	0.2	0.199999	0.500001	0.199999			0.199999																				21.3895	0.689165	1.750345991	0	0.9151396	1.8061216	0.65225	4.015542	10.3219956	0	5.5812844	0	0.070427848	3.1796396	5.990017	13.67584202	0.216069932	1.154756426	0	0	4.082120989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.4902	0	0	21.3895	0.689165	1.750345991	0	0.9151396	1.8061216	0.65225	4.015542	10.3219956	0	5.5812844	0	0.070427848	3.1796396	5.990017	13.67584202	0.216069932	1.154756426	0	0	4.082120989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.4902		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3766	0.0766	0.1945		0.5802	1.1451	0.4135	0.7564	1.9788		1.0603		0.0133	0.5989	1.2008	2.7417	0.0433	0.2315			0.8184																				14.2298	0	0	23.7661	0.765739	1.944828991	0	1.4953266	2.9511796	1.065768	4.77191	12.3008126	0	6.6416214	0	0.083693848	3.7785566	7.190861	16.41750902	0.259386932	1.386257426	0	0	4.900484989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.72
H5214_803_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		250.657954	8.076156	486.964788	695.983009	4.575698	9.030608	3.26125	20.07771	51.609978	600.076143	27.906422	0	0.352141	15.898198	29.950085	68.379552	0.432139	5.773811			20.410707																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000012	1023.999536	43.132794	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.2	0.2	0.199999	0.500001	0.199999			0.199999																				1024.000012	1023.999536	43.132794	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.2	0.2	0.199999	0.500001	0.199999			0.199999																				21.3895	0.689165	1.750345991	0	0.9151396	1.8061216	0.65225	4.015542	10.3219956	0	5.5812844	0	0.070427848	3.1796396	5.990017	13.67584202	0.216069932	1.154756426	0	0	4.082120989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.4902	0	0	21.3895	0.689165	1.750345991	0	0.9151396	1.8061216	0.65225	4.015542	10.3219956	0	5.5812844	0	0.070427848	3.1796396	5.990017	13.67584202	0.216069932	1.154756426	0	0	4.082120989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.4902		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3766	0.0766	0.1945		0.5802	1.1451	0.4135	0.7564	1.9788		1.0603		0.0133	0.5989	1.2008	2.7417	0.0433	0.2315			0.8184																				14.2298	0	0	23.7661	0.765739	1.944828991	0	1.4953266	2.9511796	1.065768	4.77191	12.3008126	0	6.6416214	0	0.083693848	3.7785566	7.190861	16.41750902	0.259386932	1.386257426	0	0	4.900484989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.72
H5214_804_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		250.657954	8.076156	486.964788	695.983009	4.575698	9.030608	3.26125	20.07771	51.609978	600.076143	27.906422	0	0.352141	15.898198	29.950085	68.379552	0.432139	5.773811			20.410707																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000012	1023.999536	43.132794	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.2	0.2	0.199999	0.500001	0.199999			0.199999																				1024.000012	1023.999536	43.132794	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.2	0.2	0.199999	0.500001	0.199999			0.199999																				21.3895	0.689165	1.750345991	0	0.9151396	1.8061216	0.65225	4.015542	10.3219956	0	5.5812844	0	0.070427848	3.1796396	5.990017	13.67584202	0.216069932	1.154756426	0	0	4.082120989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.4902	0	0	21.3895	0.689165	1.750345991	0	0.9151396	1.8061216	0.65225	4.015542	10.3219956	0	5.5812844	0	0.070427848	3.1796396	5.990017	13.67584202	0.216069932	1.154756426	0	0	4.082120989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.4902		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3766	0.0766	0.1945		0.5802	1.1451	0.4135	0.7564	1.9788		1.0603		0.0133	0.5989	1.2008	2.7417	0.0433	0.2315			0.8184																				14.2298	0	0	23.7661	0.765739	1.944828991	0	1.4953266	2.9511796	1.065768	4.77191	12.3008126	0	6.6416214	0	0.083693848	3.7785566	7.190861	16.41750902	0.259386932	1.386257426	0	0	4.900484989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.72
H5214_805_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		250.657954	8.076156	486.964788	695.983009	4.575698	9.030608	3.26125	20.07771	51.609978	600.076143	27.906422	0	0.352141	15.898198	29.950085	68.379552	0.432139	5.773811			20.410707																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000012	1023.999536	43.132794	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.2	0.2	0.199999	0.500001	0.199999			0.199999																				1024.000012	1023.999536	43.132794	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.2	0.2	0.199999	0.500001	0.199999			0.199999																				21.3895	0.689165	1.750345991	0	0.9151396	1.8061216	0.65225	4.015542	10.3219956	0	5.5812844	0	0.070427848	3.1796396	5.990017	13.67584202	0.216069932	1.154756426	0	0	4.082120989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.4902	0	0	21.3895	0.689165	1.750345991	0	0.9151396	1.8061216	0.65225	4.015542	10.3219956	0	5.5812844	0	0.070427848	3.1796396	5.990017	13.67584202	0.216069932	1.154756426	0	0	4.082120989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.4902		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3766	0.0766	0.1945		0.5802	1.1451	0.4135	0.7564	1.9788		1.0603		0.0133	0.5989	1.2008	2.7417	0.0433	0.2315			0.8184																				14.2298	0	0	23.7661	0.765739	1.944828991	0	1.4953266	2.9511796	1.065768	4.77191	12.3008126	0	6.6416214	0	0.083693848	3.7785566	7.190861	16.41750902	0.259386932	1.386257426	0	0	4.900484989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.72
H5215_001_0	2009	6																					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	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	3.70074628	8.649566872	0.970951147	296.2951681	192.1962343	3082.072928	2102.988771	0	0	1168.558573	6762.583491	4033.974591	102.9140117	162.7762856	680.5098586	798.8487056	9.673695634	0	0	0.623721283	0	17.67210302	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: $25	11A DME: 10%	"11B Prosthetic Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: 10%"	"4A ER: $50, 4B Urgent Care: $10"	"9B ASC Services: $0,  9A OP Hospital: $10"	8A OP C/D/T: $5	8B OP Diagnostic Radiological Services: $5; MRI/PET/NUC/CAT: $50	"5 Partial Hosp: $10,"	12 Renal Dialysis: $10	"3 CORF: $10, 9C OP Substance Abuse: $10, 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 14J Nutrition Therapy: $0"	"7B Chiropractic: $15, 7D Physician Specialist (excl. Radiology): $15, 7F Podiatry: $15"	"7E Mental Health: $15, 7H Psychiatric: $15"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	7D Physician Specialist (Radiology): $5	7G Other Health Care: $15	15 Part B Drugs: 10%	"13A Blood: $0, 13C Anti Coagulation Benefit: $0"	10B Transportation: Not Covered	16B Medicare Covered Comprehensive Dental: $15	17A Routine Eye Exams: Not Covered	17B Eye Wear: $100 allowance per year with any new prescription	18A Routine Hearing Exams: $15	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0	0	0	0	25	0.1	0.1	43.7852609	10	5	9	10	10	10	0	15	15	15	5	15	0.1	0	0	15	0	0	0	0	0	0											0	0	0	0	25	0.1	0.1	43.7852609	10	5	9	10	10	10	0	15	15	15	5	15	0.1	0	0	15	0	0	0	0	0	0											0	0	0	0	0.007709888	0.864956687	0.097095115	1.081113437	0.160163529	1.284197053	1.577241579	0	0	0.973798811	0	5.042468239	0.128642515	0.203470357	0.283545774	0.998560882	0.967369563	0	0	0.000779652	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.6711	0	0	0	0	0	0	0.007709888	0.864956687	0.097095115	1.081113437	0.160163529	1.284197053	1.577241579	0	0	0.973798811	0	5.042468239	0.128642515	0.203470357	0.283545774	0.998560882	0.967369563	0	0	0.000779652	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.6711	2000	PBP: 1A IP Acute: $75 (days 1-7)	1B IP Psych: $125 (days 1-7)-reduced to $75 with prior notification	2 SNF: $50 (days 21-100)-waived for 1-20 with prior notification	6 Home Health: $15	10A Ambulance: $25	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $15"	"9B ASC Services: $75,  9A OP Hospital: $75"	8A OP C/D/T: $10	8B OP Diagnostic Radiological Services: $10; MRI/PET/NUC/CAT: $100; Therapeutic Radiological Services: 10%	5 Partial Hosp: $15	12 Renal Dialysis: $15	"3 CORF: $15, 9C OP Substance Abuse: $15, 9D Cardiac Rehab: $15"	"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: $0, 14J Nutrition Therapy: $15"	"7B Chiropractic: $20, 7D Physician Specialist (excl. Radiology): $20, 7F Podiatry: $20"	"7E Mental Health: $20, 7H Psychiatric: $20"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	7D Physician Specialist (Radiology): $10	7G Other Health Care: $20	15 Part B Drugs: 20%	"13A Blood: $10, 13C Anti Coagulation Benefit: $10"	10B Transportation: Not Covered	16B Medicare Covered Comprehensive Dental: $20	17A Routine Eye Exams: Not Covered	17B Eye Wear: $100 allowance per year with any new prescription	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: 35%	13B Acupuncture: Not Covered											0.5239	0.0091	0.0358	0.002	0.2523	0.3481	0.0391	0.1582	0.2754	0.1124	0.2692	0	0	0.1503	0.8238	1.7895	0.0736	0.21	0.1387	0.1022	0.3894	0	0	0	0	0	0	0	0	0											5.7028	0	0	0.5239	0.009050067	0.03578173	0.001991421	0.259999256	1.213105178	0.136176283	1.23928225	0.435535542	1.396574132	1.846443238	0	0	1.124082143	0.823765678	6.831982814	0.202218525	0.413456522	0.422278887	1.10076593	1.356739642	0	0	0.000779652	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.3739
H5215_002_0	2009	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	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	3.374622631	7.866517092	0.883050436	270.184526	175.2591809	2810.469096	1917.665509	0	0	1065.580807	6166.639257	3678.485612	93.84484283	148.4318285	620.5407762	728.4511599	8.797930945	0	0	0.568756623	0	16.11477099	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: $25	11A DME: 10%	"11B Prosthetic Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: 10%"	"4A ER: $50, 4B Urgent Care: $10"	"9B ASC Services: $0,  9A OP Hospital: $10"	8A OP C/D/T: $5	8B OP Diagnostic Radiological Services: $5; MRI/PET/NUC/CAT: $50	"5 Partial Hosp: $10,"	12 Renal Dialysis: $10	"3 CORF: $10, 9C OP Substance Abuse: $10, 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 14J Nutrition Therapy: $0"	"7B Chiropractic: $15, 7D Physician Specialist (excl. Radiology): $15, 7F Podiatry: $15"	"7E Mental Health: $15, 7H Psychiatric: $15"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	7D Physician Specialist (Radiology): $5	7G Other Health Care: $15	15 Part B Drugs: 10%	"13A Blood: $0, 13C Anti Coagulation Benefit: $0"	10B Transportation: Not Covered	16B Medicare Covered Comprehensive Dental: $15	17A Routine Eye Exams: Not Covered	17B Eye Wear: $100 allowance per year with any new prescription	18A Routine Hearing Exams: $15	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0	0	0	0	25	0.1	0.1	43.7852609	10	5	9	10	10	10	0	15	15	15	5	15	0.1	0	0	15	0	0	0	0	0	0											0	0	0	0	25	0.1	0.1	43.7852609	10	5	9	10	10	10	0	15	15	15	5	15	0.1	0	0	15	0	0	0	0	0	0											0	0	0	0	0.007030464	0.786651709	0.088305044	0.985841664	0.146049317	1.17102879	1.438249132	0	0	0.887984006	0	4.598107016	0.117306054	0.185539786	0.258558657	0.91056395	0.879793094	0	0	0.000710946	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.4617	0	0	0	0	0	0	0.007030464	0.786651709	0.088305044	0.985841664	0.146049317	1.17102879	1.438249132	0	0	0.887984006	0	4.598107016	0.117306054	0.185539786	0.258558657	0.91056395	0.879793094	0	0	0.000710946	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.4617	2000	PBP: 1A IP Acute: $75 (days 1-7)	1B IP Psych: $125 (days 1-7)-reduced to $75 with prior notification	2 SNF: $50 (days 21-100)-waived for 1-20 with prior notification	6 Home Health: $15	10A Ambulance: $25	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $15"	"9B ASC Services: $75,  9A OP Hospital: $75"	8A OP C/D/T: $10	8B OP Diagnostic Radiological Services: $10; MRI/PET/NUC/CAT: $100; Therapeutic Radiological Services: 10%	5 Partial Hosp: $15	12 Renal Dialysis: $15	"3 CORF: $15, 9C OP Substance Abuse: $15, 9D Cardiac Rehab: $15"	"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: $0, 14J Nutrition Therapy: $15"	"7B Chiropractic: $20, 7D Physician Specialist (excl. Radiology): $20, 7F Podiatry: $20"	"7E Mental Health: $20, 7H Psychiatric: $20"	"7C Occupational Therapy: $20, 7I Physical and Speech Therapy: $20"	7D Physician Specialist (Radiology): $10	7G Other Health Care: $20	15 Part B Drugs: 20%	"13A Blood: $10, 13C Anti Coagulation Benefit: $10"	10B Transportation: Not Covered	16B Medicare Covered Comprehensive Dental: $20	17A Routine Eye Exams: Not Covered	17B Eye Wear: $100 allowance per year with any new prescription	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: 35%	13B Acupuncture: Not Covered											0.4778	0.0083	0.0326	0.0018	0.2301	0.3166	0.0355	0.1442	0.2511	0.1025	0.2455	0	0	0.137	0.7512	1.6318	0.0671	0.1915	0.1265	0.0932	0.3541	0	0	0	0	0	0	0	0	0											5.1984	0	0	0.4778	0.008252541	0.03262851	0.00181593	0.237087146	1.103282136	0.123848173	1.130072048	0.397154516	1.273502779	1.683727731	0	0	1.025023806	0.751172355	6.229922851	0.18439827	0.377021182	0.385066087	1.003762306	1.233913298	0	0	0.000710946	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.6601
H5215_005_0	2009	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	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											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,  9A OP Hospital: $0"	8A OP C/D/T: $0	8B OP Diag/X-Ray/Labs: $0; MRI/PET/NUC/CAT: $0	5 Partial Hosp: $0	12 Renal Dialysis: $0	"3 CORF: $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"	"7B Chiropractic: $0, 7D Physician Specialist (excl. Radiology): $0, 7F Podiatry: $0"	"7E Mental Health: $0, 7H Psychiatric: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	7D Physician Specialist (Radiology): $0	7G Other Health Care: $0	15 Part B Drugs: $0	"13A Blood: $0, 13C Anti Coagulation Benefit:  $0"	10B Transportation: Not Covered	16B Medicare Covered Comprehensive Dental: $0	17A Routine Eye Exams: $0	17B Eye Wear: $50 allowance per year with any new prescription	18A Routine Hearing Exams: $0	18B Hearing Aids: Limited to $100 per year	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	1000	PBP: 1A IP Acute: $75 (days 1-7)-reduced to $35 with prior notification	1B IP Psych: $125 (days 1-7)-reduced to $75 with prior notification	2 SNF: $25 (days 21-100)-waived for 1-20 with prior notification	6 Home Health: $15	10A Ambulance: $25	11A DME: 10%-reduced to 5% with prior notification	"11B Prosthetic Medical Supplies: 10%-reduced to 5% with prior notification, 11C Diabetes Monitoring Supplies: 10%-reduced to 5% with prior notification"	"4A ER: $0, 4B Urgent Care: $15"	"9B ASC Services: $75,  9A OP Hospital: $75"	8A OP C/D/T: $5	8B Radiation Therapy/X-Ray: $5; MRI/PET/CAT: $25	5 Partial Hosp: $10	12 Renal Dialysis: $10	"3 CORF: $10, 9C OP Substance Abuse: $10, 9D Cardiac Rehab: $10"	"7A PCP: $5, 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, 14J Nutrition Therapy: $10"	"7B Chiropractic: $10, 7D Physician Specialist (excl. Radiology): $10, 7F Podiatry: $10"	"7E Mental Health: $10, 7H Psychiatric: $10"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	7D Physician Specialist (Radiology): $10	7G Other Health Care: $10	15 Part B Drugs: 10%-reduced to 5% with prior notification	"13A Blood: $10, 13C Anti Coagulation Benefit:  $10"	10B Transportation: Not Covered	16B Medicare Covered Comprehensive Dental: $5	17A Routine Eye Exams: $10	17B Eye Wear: $100 allowance per year with any new prescription	18A Routine Hearing Exams: $10	18B Hearing Aids: Limited to $100 per year	14A Health Education/Wellness Programs: 35%	13B Acupuncture: Not Covered											0.5922	0.0026	0.0461	0.003	0.006	0.1049	0.0115	0.015	0.2107	0.0594	0.0869	0	0	0.069	0.2404	0.7246	0.0376	0.0885	0.0597	0.0433	0.111	0	0	0	0.086	0	0.0033	0	0	0											2.6015	0	0	0.5922	0.002570186	0.046089537	0.002960276	0.005972743	0.104870025	0.011491718	0.015019145	0.210680164	0.059449119	0.086853417	0	0	0.069031865	0.240441499	0.724560459	0.037552537	0.088496451	0.059659409	0.043345311	0.110982297	0	0	0	0.08596933	0	0.003306513	0	0	0	0	0	0	0	0	0	0	0	0	0	2.6015
H5215_006_0	2009	6																					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	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											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,  9A OP Hospital: $0"	8A OP C/D/T: $0	8B OP Diag/X-Ray/Labs: $0; MRI/PET/NUC/CAT: $0	5 Partial Hosp: $0	12 Renal Dialysis: $0	"3 CORF: $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"	"7B Chiropractic: $0, 7D Physician Specialist (excl. Radiology): $0, 7F Podiatry: $0"	"7E Mental Health: $0, 7H Psychiatric: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	7D Physician Specialist (Radiology): $0	7G Other Health Care: $0	15 Part B Drugs: $0	"13A Blood: $0, 13C Anti Coagulation Benefit:  $0"	10B Transportation: Not Covered	16B Medicare Covered Comprehensive Dental: $0	17A Routine Eye Exams: $0	17B Eye Wear: $100 allowance per year with any new prescription	18A Routine Hearing Exams: $0	18B Hearing Aids: Limited to $100 per year	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	1000	PBP: 1A IP Acute: $75 (days 1-7)-reduced to $35 with prior notification	1B IP Psych: $125 (days 1-7)-reduced to $75 with prior notification	2 SNF: $25 (days 21-100)-waived for 1-20 with prior notification	6 Home Health: $15	10A Ambulance: $25	11A DME: 10%-reduced to 5% with prior notification	"11B Prosthetic Medical Supplies: 10%-reduced to 5% with prior notification, 11C Diabetes Monitoring Supplies: 10%-reduced to 5% with prior notification"	"4A ER: $0, 4B Urgent Care: $15"	"9B ASC Services: $75,  9A OP Hospital: $75"	8A OP C/D/T: $5	8B Radiation Therapy/X-Ray: $5; MRI/PET/CAT: $25	5 Partial Hosp: $10	12 Renal Dialysis: $10	"3 CORF: $10, 9C OP Substance Abuse: $10, 9D Cardiac Rehab: $10"	"7A PCP: $5, 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, 14J Nutrition Therapy: $10"	"7B Chiropractic: $10, 7D Physician Specialist (excl. Radiology): $10, 7F Podiatry: $10"	"7E Mental Health: $10, 7H Psychiatric: $10"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	7D Physician Specialist (Radiology): $10	7G Other Health Care: $10	15 Part B Drugs: 10%-reduced to 5% with prior notification	"13A Blood: $10, 13C Anti Coagulation Benefit:  $10"	10B Transportation: Not Covered	16B Medicare Covered Comprehensive Dental: $5	17A Routine Eye Exams: $10	17B Eye Wear: $100 allowance per year with any new prescription	18A Routine Hearing Exams: $10	18B Hearing Aids: Limited to $100 per year	14A Health Education/Wellness Programs: 35%	13B Acupuncture: Not Covered											0.6714	0.0029	0.0523	0.0034	0.0068	0.1191	0.013	0.017	0.2389	0.0674	0.0985	0	0	0.0783	0.2726	0.8215	0.0426	0.1003	0.0676	0.0491	0.126	0	0	0	0.0975	0	0.0037	0	0	0											2.9499	0	0	0.6714	0.002914061	0.052256016	0.003356341	0.006771857	0.119077709	0.013048605	0.017028608	0.238867791	0.067403022	0.098473835	0	0	0.078267877	0.272610998	0.821501905	0.042576821	0.100336697	0.067641447	0.04914463	0.126018065	0	0	0	0.097471464	0	0.003748902	0	0	0	0	0	0	0	0	0	0	0	0	0	2.9499
H5215_007_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	298.55	23.44	145.64	23.73	14.55	18.23	16.97	22.55	31.21	12.84	26.48	1.21	2.14	57.5	45.15	90.32	8	6.36	17.12	36.79	7.53	3	0	31.73	0	0	0	0	0	10.5											Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.0827001	0.082698888	0.162699784	0	0.231011249	0.231000178	0.230946855	0.229875229	0.231	0.230985826	0.231017164	0.230999827	0.231000002	0.231009295	0.212077039	0.231005894	0.230988343	0.23095805	0.230992275	0.231004405	0.23099985	0.230991235	0	0	0	0	0	0	0	0											0.0827001	0.082698888	0.162699784	0	0.231011249	0.231000178	0.230946855	0.229875229	0.231	0.230985826	0.231017164	0.230999827	0.231000002	0.231009295	0.212077039	0.231005894	0.230988343	0.23095805	0.230992275	0.231004405	0.23099985	0.230991235	0	0	0	0	0	0	0	0											24.6901	1.938461925	23.69559658	0	3.36121368	4.211133251	3.919168129	5.183686404	7.209510013	2.965858011	6.117334493	0.279509791	0.494340004	13.28303447	9.575278308	20.86445231	1.847906748	1.468893195	3.954587741	8.498652066	1.739428869	0.692973705	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.9911	0	0	24.6901	1.938461925	23.69559658	0	3.36121368	4.211133251	3.919168129	5.183686404	7.209510013	2.965858011	6.117334493	0.279509791	0.494340004	13.28303447	9.575278308	20.86445231	1.847906748	1.468893195	3.954587741	8.498652066	1.739428869	0.692973705	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.9911	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	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	24.6901	1.938461925	23.69559658	0	3.36121368	4.211133251	3.919168129	5.183686404	7.209510013	2.965858011	6.117334493	0.279509791	0.494340004	13.28303447	9.575278308	20.86445231	1.847906748	1.468893195	3.954587741	8.498652066	1.739428869	0.692973705	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.9911
H5215_008_0	2009	7																					0											D	D	D	V	T	coin	O	V	V	V	V	V	V	V	V	V	V	V	V	V	coin	V	T	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	466.2781636	10.27115649	928.7117264	273.6083699	61.34161688	7.487775284	29.61764546	255.9381251	329.1802884	2558.894564	1668.646833	0	0	979.7480004	6304.995181	3641.76649	102.6452094	210.6132745	559.256419	814.0298908	9.019403577	709.5094729	0	0.251207055	0	0	0	0	0	0											PBP: 1A IP Acute: $150 per day for days 1-4	1B IP Psych: $175 per day for days 1-5	2 SNF: $10 for days 1-100	6 Home Health: $10	10A Ambulance: $75	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: $15"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $100	"8A OP C/D/T: Lab $0, X-ray 5%"	8B OP Diag: 5%; MRI/PET/NUC/CAT: $60	5 Partial Hosp: $25	12 Renal Dialysis: $20	"3 CORF: $25, 9A OP Hospital: $100,  9C OP Substance Abuse: $25, 9D Cardiac Rehab: $25"	"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"	"7B Chiropractic: $25, 7D Physician Specialist (excl. Radiology): $25, 7F Podiatry: $25"	"7E Mental Health: $25, 7H Psychiatric: $25"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	7D Physician Specialist (Radiology): $25	7G Other Health Care: $25	15 Part B Drugs: 20% coinsurance	"13A Blood: $0, 13C Anti Coagulation Benefit:  $0"	10B Transportation: Not Covered	16B Medicare Covered Comprehensive Dental: $25	17A Routine Eye Exams: Not covered	17B Eye Wear: Not Covered	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											150	175	10	10	75	0.2	15	46.125	100	3.088513912	12.31937806	25	20	71.8581636	3.479499856	25	25	25	25	25	0.2	0	0	25	0	0	0	0	0	0											144.3539326	168.4129213	9.623595506	9.623595506	72.17696629	0.19247191	14.43539326	44.38883427	96.23595506	2.97226086	11.85567114	24.05898876	19.24719101	69.15339002	3.348529917	24.05898876	24.05898876	24.05898876	24.05898876	24.05898876	0.19247191	0	0	24.05898876	0	0	0	0	0	0											5.6091	0.144149623	0.7447955	0.21942469	0.368954318	1.441186411	0.03562853	0.946732918	2.639914953	0.633808513	1.648577341	0	0	5.646074633	1.759372083	7.301434923	0.205794995	0.422261867	1.121261992	1.632061333	1.735981835	0	0	0.000503649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.257	0	1.2851	5.6091	0.144149623	0.7447955	0.21942469	0.368954318	1.441186411	0.03562853	0.946732918	2.639914953	0.633808513	1.648577341	0	0	5.646074633	1.759372083	7.301434923	0.205794995	0.422261867	1.121261992	1.632061333	1.735981835	0	0	0.000503649	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.257	2700	PBP: 1A IP Acute: $200 per day for days 1-7	1B IP Psych: $300 per day for days 1-7	"2 SNF: $35 for days 1-100, reduced to $15 (days 1-100) with prenotification"	6 Home Health: $25	10A Ambulance: $75	11A DME: 30%	"11B Prosthetic Medical Supplies: 30%, 11C Diabetes Monitoring Supplies: $35"	"4A ER: $50, 4B Urgent Care: $35"	9B ASC Services: $200	"8A OP C/D/T: Lab $10, X-ray 10%"	8B OP Diag: 10%; MRI/PET/NUC/CAT: $110	5 Partial Hosp: $35	12 Renal Dialysis: $35	"3 CORF: $35, 9A OP Hospital: $200, 9C OP Substance Abuse: $35, 9D Cardiac Rehab: $35"	"7A PCP: $15, 14B Immunizations: $5, 14C Routine Physical Exams: $15, 14D Pap Smears: $5, 14D Pelvic Exams: $5, 14E Prostate Screening: $5, 14F Colorectal Screening: $5, 14G Bone Mass Measurement: $5, 14H Mammography: $5, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $5"	"7B Chiropractic: $35, 7D Physician Specialist (excl. Radiology): $35, 7F Podiatry: $35"	"7E Mental Health: $35, 7H Psychiatric: $35"	"7C Occupational Therapy: $35, 7I Physical and Speech Therapy: $35"	7D Physician Specialist (Radiology): $35	7G Other Health Care: $35	15 Part B Drugs: 30% coinsurance	"13A Blood: $35,  13C Anti Coagulation Benefit:  $35"	10B Transportation: Not Covered	16B Medicare Covered Comprehensive Dental: $35	17A Routine Eye Exams: Not covered	17B Eye Wear: $100 allowance per year with any new prescription	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $5	13B Acupuncture: Not Covered											1.2755	0.0319	0.2413	0.0092	0.1405	0.4378	0.0107	0.1982	0.806	0.9637	0.6424	0	0	1.9553	0.8786	2.7563	0.0524	0.0992	0.6238	0.2384	0.5274	0.4033	0	0.0001	0	0	0	0	0	0											12.292	0	0.39033845	6.8846	0.176028093	0.986140852	0.228591843	0.509480141	1.879004127	0.046283384	1.144914693	3.445897599	1.59748832	2.29097759	0	0	7.601421003	2.637990925	10.05773629	0.258223714	0.521486539	1.745037706	1.870438622	2.26335539	0.403333477	0	0.000646452	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.549
H5215_801_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	226.1821257	1.643512042	58.93464288	11.37510132	6.148369331	11.99029072	1.331662965	23.7186549	52.19104073	14.95359169	32.75497925	0	0	23.44148483	51.30361731	111.485714	1.105409647	1.982701313	13.77855532	29.52108529	13.11648414	5.03589773	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.082698581	0.082669204	0.162706335	0	0.230942241	0.230999792	0.231024784	0.231023859	0.230999976	0.230909497	0.23098196	0.230999894	0.230999983	0.231026008	0.231014204	0.231008513	0.231017708	0.231044454	0.230999058	0.230999961	0.230997162	0.231007335	0	0	0	0	0	0	0	0											0.082698581	0.082669204	0.162706335	0	0.230942241	0.230999792	0.231024784	0.231023859	0.230999976	0.230909497	0.23098196	0.230999894	0.230999983	0.231026008	0.231014204	0.231008513	0.231017708	0.231044454	0.230999058	0.230999961	0.230997162	0.231007335	0	0	0	0	0	0	0	0											18.7049	0.135867832	9.589039757	0	1.419918192	2.769754665	0.307647149	5.479575177	12.05612915	3.452926341	7.565809304	0	0	5.415592662	11.8518643	25.754149	0.255369203	0.458092142	3.182833307	6.819369537	3.029870615	1.163329314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.4121	0	0	18.7049	0.135867832	9.589039757	0	1.419918192	2.769754665	0.307647149	5.479575177	12.05612915	3.452926341	7.565809304	0	0	5.415592662	11.8518643	25.754149	0.255369203	0.458092142	3.182833307	6.819369537	3.029870615	1.163329314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.4121	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.7049	0.135867832	9.589039757	0	1.419918192	2.769754665	0.307647149	5.479575177	12.05612915	3.452926341	7.565809304	0	0	5.415592662	11.8518643	25.754149	0.255369203	0.458092142	3.182833307	6.819369537	3.029870615	1.163329314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.4121
H5215_804_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	226.1821257	1.643512042	58.93464288	11.37510132	6.148369331	11.99029072	1.331662965	23.7186549	52.19104073	14.95359169	32.75497925	0	0	23.44148483	51.30361731	111.485714	1.105409647	1.982701313	13.77855532	29.52108529	13.11648414	5.03589773	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.082698581	0.082669204	0.162706335	0	0.230942241	0.230999792	0.231024784	0.231023859	0.230999976	0.230909497	0.23098196	0.230999894	0.230999983	0.231026008	0.231014204	0.231008513	0.231017708	0.231044454	0.230999058	0.230999961	0.230997162	0.231007335	0	0	0	0	0	0	0	0											0.082698581	0.082669204	0.162706335	0	0.230942241	0.230999792	0.231024784	0.231023859	0.230999976	0.230909497	0.23098196	0.230999894	0.230999983	0.231026008	0.231014204	0.231008513	0.231017708	0.231044454	0.230999058	0.230999961	0.230997162	0.231007335	0	0	0	0	0	0	0	0											18.7049	0.135867832	9.589039757	0	1.419918192	2.769754665	0.307647149	5.479575177	12.05612915	3.452926341	7.565809304	0	0	5.415592662	11.8518643	25.754149	0.255369203	0.458092142	3.182833307	6.819369537	3.029870615	1.163329314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.4121	0	0	18.7049	0.135867832	9.589039757	0	1.419918192	2.769754665	0.307647149	5.479575177	12.05612915	3.452926341	7.565809304	0	0	5.415592662	11.8518643	25.754149	0.255369203	0.458092142	3.182833307	6.819369537	3.029870615	1.163329314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.4121	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.7049	0.135867832	9.589039757	0	1.419918192	2.769754665	0.307647149	5.479575177	12.05612915	3.452926341	7.565809304	0	0	5.415592662	11.8518643	25.754149	0.255369203	0.458092142	3.182833307	6.819369537	3.029870615	1.163329314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.4121
H5215_805_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	226.1821257	1.643512042	58.93464288	11.37510132	6.148369331	11.99029072	1.331662965	23.7186549	52.19104073	14.95359169	32.75497925	0	0	23.44148483	51.30361731	111.485714	1.105409647	1.982701313	13.77855532	29.52108529	13.11648414	5.03589773	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											0.082698581	0.082669204	0.162706335	0	0.230942241	0.230999792	0.231024784	0.231023859	0.230999976	0.230909497	0.23098196	0.230999894	0.230999983	0.231026008	0.231014204	0.231008513	0.231017708	0.231044454	0.230999058	0.230999961	0.230997162	0.231007335	0	0	0	0	0	0	0	0											0.082698581	0.082669204	0.162706335	0	0.230942241	0.230999792	0.231024784	0.231023859	0.230999976	0.230909497	0.23098196	0.230999894	0.230999983	0.231026008	0.231014204	0.231008513	0.231017708	0.231044454	0.230999058	0.230999961	0.230997162	0.231007335	0	0	0	0	0	0	0	0											18.7049	0.135867832	9.589039757	0	1.419918192	2.769754665	0.307647149	5.479575177	12.05612915	3.452926341	7.565809304	0	0	5.415592662	11.8518643	25.754149	0.255369203	0.458092142	3.182833307	6.819369537	3.029870615	1.163329314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.4121	0	0	18.7049	0.135867832	9.589039757	0	1.419918192	2.769754665	0.307647149	5.479575177	12.05612915	3.452926341	7.565809304	0	0	5.415592662	11.8518643	25.754149	0.255369203	0.458092142	3.182833307	6.819369537	3.029870615	1.163329314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.4121	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.7049	0.135867832	9.589039757	0	1.419918192	2.769754665	0.307647149	5.479575177	12.05612915	3.452926341	7.565809304	0	0	5.415592662	11.8518643	25.754149	0.255369203	0.458092142	3.182833307	6.819369537	3.029870615	1.163329314	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.4121
H5216_001_0	2009	4	r.	s.	t.	u.	v.	w.					Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered						Mental Health (MH)	Therapy (PT/OT/ST)									A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin	V				O	O	P	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	0	0	0				0		258.369019	8.324605	501.945431	717.393742	142.690286	9.595607	3.46529	322.754718	349.855698	618.536465	918.041197	0	0	702.29385	3437.231299	4143.278558	4.411454	192.670867			21.687699			5.28	2.69				0.05	0.27	18.819609	23.852312	700.367267	1.23	3.01	0.06	2.7				$650/Admit:1a	$650/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $50 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$30-$50/Visit:9d. $50 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $30 Partial Hospitalization,8b. $50 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35/Visit:7e, 7h"	"$50/Visit:7d, 9a"			20% Coins:15			"DEN 749 16a, 16b"	VIS 752				$0 Additional Smoking Cessation 14a	$0: Nutritional benefit 14a	$0/Proc:12	"$50/Visit:7e, 7h"	"$35/Visit:7d, 9a"	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0: Nurse hotline 14a	$0 Corp Health 14a				650.00002	649.999859	43.132808	0	100.000023	0.199999	0.2	49.999987	127.313175	43.978697	48.236959	0	0	42.810028	9.999998	35.000001	35.000701	49.999982			0.2			0	0				0	0	0	50.000183	35.000002	0	0	0	0				650.00002	649.999859	43.132808	0	100.000023	0.199999	0.2	49.999987	127.313175	43.978697	48.236959	0	0	42.810028	9.999998	35.000001	35.000701	49.999982			0.2			0	0				0	0	0	50.000183	35.000002	0	0	0	0				13.995	0.450916006	1.804192992	0	1.18908599	1.919111804	0.693058	1.344810975	3.711769975	2.266868981	3.690292965	0	0	2.505434949	2.864358843	12.08456281	0.012866999	0.80279499	0	0	4.3375398	0	0	0	0	0	0	0	0	0	0	0.099384997	2.042737979	0	0	0	0	0	0	0	55.8148	0	0	13.995	0.450916006	1.804192992	0	1.18908599	1.919111804	0.693058	1.344810975	3.711769975	2.266868981	3.690292965	0	0	2.505434949	2.864358843	12.08456281	0.012866999	0.80279499	0	0	4.3375398	0	0	0	0	0	0	0	0	0	0	0.099384997	2.042737979	0	0	0	0	0	0	0	55.8148		30% Coins	30% Coins	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins			30% Coins	$40/Visit	$40/Visit	$40/Visit	30% Coins			30% Coins			"DEN 749 16a, 16b"	VIS 752				0	0		30% Coins	$40/Visit	0	0	0	0				7.813	0.1118	0.4898	0.743	0.889	2.0468	0.7392	0.2662	3.5371	0.4557	1.8954			1.0706	2.2676	2.7334	0.0029	0.1026			1.4628			0	0				0	0		0.0296	0.462	0	0	0	0				27.1183	500	0	21.808	0.562725006	2.293946992	0.743011	2.07812799	3.965905804	1.432222	1.610965975	7.248912975	2.722534981	5.585647965	0	0	3.576001949	5.131924843	14.81791281	0.015776999	0.90539699	0	0	5.8003678	0	0	0	0	0	0	0	0	0	0	0.128969997	2.504775979	0	0	0	0	0	0	0	82.9331
H5216_003_0	2009	5	r.	s.	t.	u.	v.	w.	x.				OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered				5000	Renal Dialysis	Mental Health (MH)	Therapy (PT/OT/ST)								A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin	V				O	O	P	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	0	0	0				0		235.012527	7.572063	456.569693	652.541533	129.791122	7.938456	2.866838	293.577774	318.228834	562.62093	835.050514	0	0	638.806668	3126.506476	3768.727244	4.012659	175.253469			17.942257			5.28	2.69				0.05	1.23	17.118322	21.696069	637.054247	3.01	0.06	0.27	2.7				$650/Admit:1a	$650/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$95/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $95 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $50 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$30-$50/Visit:9d. $50 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $30 Partial Hospitalization,8b. $50 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30/Visit:7e, 7h"	"$50/Visit:7d, 9a"			20% Coins:15			"DEN 749 16a, 16b"	VIS 752				$0 Additional Smoking Cessation 14a	$0: Health Education Materials 14a	$0/Proc:12	"$50/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Membership in health club/fitness class 14a	$0: Nurse hotline 14a	$0: Nutritional benefit 14a	$0 Corp Health 14a				649.999989	649.999346	43.132797	0	100.000029	0.199999	0.199999	50.000011	85.925262	43.978705	47.649289	0	0	42.810041	9.999999	29.999996	30.001054	50.000014			0.199999			0	0				0	0	0	49.99984	30.000007	0	0	0	0				588.20644	588.205858	39.032291	0	90.493326	0.180986	0.180986	45.24666	77.756605	39.797781	43.119414	0	0	38.740219	9.049329	27.147986	27.148943	45.246663			0.180986			0	0				0	0	0	45.246506	27.147996	0	0	0	0				11.5197	0.371160984	1.485080093	0	0.978769193	1.436749398	0.518857542	1.106951144	2.062032812	1.865922047	3.000574069	0	0	2.062292518	2.357732143	8.526112871	0.009078288	0.660802888	0	0	3.247297325	0	0	0	0	0	0	0	0	0	0	0.081805943	1.441228846	0	0	0	0	0	0	0	42.7321	0	4.49	11.5197	0.371160984	1.485080093	0	0.978769193	1.436749398	0.518857542	1.106951144	2.062032812	1.865922047	3.000574069	0	0	2.062292518	2.357732143	8.526112871	0.009078288	0.660802888	0	0	3.247297325	0	0	0	0	0	0	0	0	0	0	0.081805943	1.441228846	0	0	0	0	0	0	0	42.7321	10000	30% Coins	30% Coins	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		12. 20% Coins	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			"DEN 749 16a, 16b"	VIS 752				0	0	0	30% Coins	$35/Visit	0	0	0	0				6.4447	0.0922	0.404	0.6129	0.8063	1.6883	0.6097	0.2414	2.9177	0.3759	1.5634		0.0002	0.8831	1.7994	2.1691	0.0023	0.0846			1.2066			0	0				0	0	0	0.0244	0.3667	0	0	0	0				22.2929	500	1.629478203	17.9643	0.463388984	1.889063093	0.612885	1.785063193	3.125082398	1.128571542	1.348333144	4.979707812	2.241786047	4.563992069	0	0.000224	2.945368518	4.157179143	10.69518787	0.011387288	0.745434888	0	0	4.453936325	0	0	0	0	0	0	0	0	0	0	0.106209943	1.807882846	0	0	0	0	0	0	0	65.025
H5216_801_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		256.005036	8.248438	497.352813	710.82985	4.773008	9.420021	3.40188	20.94349	53.835475	612.877081	29.109788	0	0.367326	16.583751	31.241576	71.328178	0.450773	6.022786			21.290845																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999996	1024.000422	43.132801	0	0.2	0.199999	0.2	0.2	0.199999	0	0.2	0	0.199999	0.199999	0.199999	0.199999	0.500001	0.2			0.2																				1023.999996	1024.000422	43.132801	0	0.2	0.199999	0.2	0.2	0.199999	0	0.2	0	0.199999	0.199999	0.199999	0.199999	0.500001	0.2			0.2																				21.8458	0.703866999	1.787684992	0	0.9546016	1.88399478	0.680376	4.188698	10.76704116	0	5.8219576	0	0.073464833	3.316733616	6.248283958	14.26556427	0.225386951	1.2045572	0	0	4.258169	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2261	0	0	21.8458	0.703866999	1.787684992	0	0.9546016	1.88399478	0.680376	4.188698	10.76704116	0	5.8219576	0	0.073464833	3.316733616	6.248283958	14.26556427	0.225386951	1.2045572	0	0	4.258169	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2261		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4273	0.0782	0.1986		0.6052	1.1944	0.4313	0.789	2.0641		1.1061		0.0138	0.6247	1.2526	2.8599	0.0452	0.2415			0.8537																				14.7857	0	0	24.2731	0.782073999	1.986316992	0	1.5598066	3.07842878	1.111725	4.977682	12.83118916	0	6.9280186	0	0.087302833	3.941476616	7.500909958	17.12545627	0.270571951	1.4460402	0	0	5.111822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0119
H5216_802_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		256.005036	8.248438	497.352813	710.82985	4.773008	9.420021	3.40188	20.94349	53.835475	612.877081	29.109788	0	0.367326	16.583751	31.241576	71.328178	0.450773	6.022786			21.290845																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999996	1024.000422	43.132801	0	0.2	0.199999	0.2	0.2	0.199999	0	0.2	0	0.199999	0.199999	0.199999	0.199999	0.500001	0.2			0.2																				1023.999996	1024.000422	43.132801	0	0.2	0.199999	0.2	0.2	0.199999	0	0.2	0	0.199999	0.199999	0.199999	0.199999	0.500001	0.2			0.2																				21.8458	0.703866999	1.787684992	0	0.9546016	1.88399478	0.680376	4.188698	10.76704116	0	5.8219576	0	0.073464833	3.316733616	6.248283958	14.26556427	0.225386951	1.2045572	0	0	4.258169	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2261	0	0	21.8458	0.703866999	1.787684992	0	0.9546016	1.88399478	0.680376	4.188698	10.76704116	0	5.8219576	0	0.073464833	3.316733616	6.248283958	14.26556427	0.225386951	1.2045572	0	0	4.258169	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2261		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4273	0.0782	0.1986		0.6052	1.1944	0.4313	0.789	2.0641		1.1061		0.0138	0.6247	1.2526	2.8599	0.0452	0.2415			0.8537																				14.7857	0	0	24.2731	0.782073999	1.986316992	0	1.5598066	3.07842878	1.111725	4.977682	12.83118916	0	6.9280186	0	0.087302833	3.941476616	7.500909958	17.12545627	0.270571951	1.4460402	0	0	5.111822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0119
H5216_803_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		256.005036	8.248438	497.352813	710.82985	4.773008	9.420021	3.40188	20.94349	53.835475	612.877081	29.109788	0	0.367326	16.583751	31.241576	71.328178	0.450773	6.022786			21.290845																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999996	1024.000422	43.132801	0	0.2	0.199999	0.2	0.2	0.199999	0	0.2	0	0.199999	0.199999	0.199999	0.199999	0.500001	0.2			0.2																				1023.999996	1024.000422	43.132801	0	0.2	0.199999	0.2	0.2	0.199999	0	0.2	0	0.199999	0.199999	0.199999	0.199999	0.500001	0.2			0.2																				21.8458	0.703866999	1.787684992	0	0.9546016	1.88399478	0.680376	4.188698	10.76704116	0	5.8219576	0	0.073464833	3.316733616	6.248283958	14.26556427	0.225386951	1.2045572	0	0	4.258169	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2261	0	0	21.8458	0.703866999	1.787684992	0	0.9546016	1.88399478	0.680376	4.188698	10.76704116	0	5.8219576	0	0.073464833	3.316733616	6.248283958	14.26556427	0.225386951	1.2045572	0	0	4.258169	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2261		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4273	0.0782	0.1986		0.6052	1.1944	0.4313	0.789	2.0641		1.1061		0.0138	0.6247	1.2526	2.8599	0.0452	0.2415			0.8537																				14.7857	0	0	24.2731	0.782073999	1.986316992	0	1.5598066	3.07842878	1.111725	4.977682	12.83118916	0	6.9280186	0	0.087302833	3.941476616	7.500909958	17.12545627	0.270571951	1.4460402	0	0	5.111822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0119
H5216_804_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		256.005036	8.248438	497.352813	710.82985	4.773008	9.420021	3.40188	20.94349	53.835475	612.877081	29.109788	0	0.367326	16.583751	31.241576	71.328178	0.450773	6.022786			21.290845																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999996	1024.000422	43.132801	0	0.2	0.199999	0.2	0.2	0.199999	0	0.2	0	0.199999	0.199999	0.199999	0.199999	0.500001	0.2			0.2																				1023.999996	1024.000422	43.132801	0	0.2	0.199999	0.2	0.2	0.199999	0	0.2	0	0.199999	0.199999	0.199999	0.199999	0.500001	0.2			0.2																				21.8458	0.703866999	1.787684992	0	0.9546016	1.88399478	0.680376	4.188698	10.76704116	0	5.8219576	0	0.073464833	3.316733616	6.248283958	14.26556427	0.225386951	1.2045572	0	0	4.258169	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2261	0	0	21.8458	0.703866999	1.787684992	0	0.9546016	1.88399478	0.680376	4.188698	10.76704116	0	5.8219576	0	0.073464833	3.316733616	6.248283958	14.26556427	0.225386951	1.2045572	0	0	4.258169	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2261		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4273	0.0782	0.1986		0.6052	1.1944	0.4313	0.789	2.0641		1.1061		0.0138	0.6247	1.2526	2.8599	0.0452	0.2415			0.8537																				14.7857	0	0	24.2731	0.782073999	1.986316992	0	1.5598066	3.07842878	1.111725	4.977682	12.83118916	0	6.9280186	0	0.087302833	3.941476616	7.500909958	17.12545627	0.270571951	1.4460402	0	0	5.111822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0119
H5227_001_0	2009	9																					3350											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	COIN	COIN	P	COIN	P	P	COIN	P	COIN	V	T	COIN	V	V	V	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	1866.43583	60.16183201	765.954186	0	203.6431595	15.23230014	11.79177016	433.0333753	303.1159277	1319.877592	23.81621124	58.79951169	0.133065366	14.65040768	3319.089206	89.29046883	257.3467903	661.0528673	14.68567277	2139.476877	19.71142532	0	0	0.957264605	20.04232729	0	2.608916083	0	0	0											1a:$180 Days1-6	1b:$180 Days1-6	2a:$80 4-40		10a:$150 (WIA)	11a:20%	11b:20%; 11c:20%	4a:$50	9a:$90; 9b:$90	8a:$5	8b:$15-110;20%	9a:$90	12:20%	3:20%; 7a:$15-$50; 7d:$30; 9a:$90; 9d:$30; 13a 20%	7a:$15-$50	7b:$35; 7d:$30; 7f:$30; 17a:$30; 17b 20%	5:$35; 7e:$35; 7h:$35 ;9c:$35;	7c:$30; 7i:$30	8b:$15-110;20%	7g:$30	15:20%			16a:50%	17a:$30		18a:$30														124.8406378	124.8406378	63.96816424	0	90	0.199999486	0.19189598	50	90	5	0.216321273	90	0.198107581	0.129290147	14.75528012	0.096710928	35	30	0.450493832	0.019702996	0.190146021	0	0	0.5	30	0	30	0	0	0											96.3038965	96.3038965	49.34597883	0	69.42731822	0.154282533	0.14803137	38.57073235	69.42731822	3.857073235	0.166873398	69.42731822	0.15282309	0.099736313	11.3824392	0.074604226	26.99951264	23.14243941	0.34751754	0.015199179	0.146681425	0	0	0.385707323	23.14243941	0	23.14243941	0	0	0											14.9788	0.482818237	3.149729921	0	1.17819987	2.350077844	1.745551887	1.391867868	1.753710497	0.424238711	3.974292099	0.340191034	0.02033546	1.461177643	3.148277591	6.661446323	0.579019826	1.274864661	5.103528878	0.002709858	2.891299962	0	0	0.369223969	0.038652362	0	0.00503139	0	0	0	0	0	0	0	0	0	0	0	0	0	53.325	0	15.8012	14.9788	0.482818237	3.149729921	0	1.17819987	2.350077844	1.745551887	1.391867868	1.753710497	0.424238711	3.974292099	0.340191034	0.02033546	1.461177643	3.148277591	6.661446323	0.579019826	1.274864661	5.103528878	0.002709858	2.891299962	0	0	0.369223969	0.038652362	0	0.00503139	0	0	0	0	0	0	0	0	0	0	0	0	0	53.325	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.9788	0.482818237	3.149729921	0	1.17819987	2.350077844	1.745551887	1.391867868	1.753710497	0.424238711	3.974292099	0.340191034	0.02033546	1.461177643	3.148277591	6.661446323	0.579019826	1.274864661	5.103528878	0.002709858	2.891299962	0	0	0.369223969	0.038652362	0	0.00503139	0	0	0	0	0	0	0	0	0	0	0	0	0	53.325
H5227_002_0	2009	5																					3350											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	COIN	COIN	P	COIN	P	P	COIN	P	COIN	V	T	COIN	V	V	V	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	1923.722654	62.00838908	789.4637446	0	209.8936127	16.18170506	12.52673235	446.3245404	312.419515	1360.388813	25.28498821	60.60425483	0.141280641	15.55391752	3420.96256	94.80734903	265.2455779	681.3426723	15.59294634	2205.144195	20.94000695	0	0	1.016929378	20.65748976	0	2.688991976	0	0	0											1a:$180 Days1-6	1b:$180 Days1-6	2a:$80 4-40		10a:$150 (WIA)	11a:20%	11b:20%; 11c:20%	4a:$50	9a:$90; 9b:$90	8a:$5	8b:$15-110;20%	9a:$90	12:20%	3:20%; 7a:$15-$50; 7d:$30; 9a:$90; 9d:$30; 13a 20%	7a:$15-$50	7b:$35; 7d:$30; 7f:$30; 17a:$30; 17b 20%	5:$35; 7e:$35; 7h:$35 ;9c:$35;	7c:$30; 7i:$30	8b:$15-110;20%	7g:$30	15:20%			16a:50%	17a:$30		18a:$30														124.8406378	124.8406378	63.96816424	0	90	0.199999486	0.19189598	50	90	5	0.212923487	90	0.2	0.125826001	14.75528012	0.093883791	35	30	0.438811473	0.019702996	0.190146021	0	0	0.5	30	0	30	0	0	0											95.1644003	95.1644003	48.76210261	0	68.60583365	0.152457016	0.146279819	38.11435203	68.60583365	3.811435203	0.162308814	68.60583365	0.152457408	0.09591553	11.24775881	0.071566397	26.68004642	22.86861122	0.334500299	0.015019338	0.144945847	0	0	0.38114352	22.86861122	0	22.86861122	0	0	0											15.2558	0.491749263	3.207992677	0	1.199993856	2.467014469	1.832408136	1.417614221	1.786150106	0.432086151	4.103976458	0.346483785	0.02153928	1.491862237	3.206513482	6.785020369	0.589730361	1.298446723	5.215845217	0.002759984	3.035167051	0	0	0.387596043	0.039367342	0	0.005124459	0	0	0	0	0	0	0	0	0	0	0	0	0	54.6203	0	17.0329	15.2558	0.491749263	3.207992677	0	1.199993856	2.467014469	1.832408136	1.417614221	1.786150106	0.432086151	4.103976458	0.346483785	0.02153928	1.491862237	3.206513482	6.785020369	0.589730361	1.298446723	5.215845217	0.002759984	3.035167051	0	0	0.387596043	0.039367342	0	0.005124459	0	0	0	0	0	0	0	0	0	0	0	0	0	54.6203	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	15.2558	0.491749263	3.207992677	0	1.199993856	2.467014469	1.832408136	1.417614221	1.786150106	0.432086151	4.103976458	0.346483785	0.02153928	1.491862237	3.206513482	6.785020369	0.589730361	1.298446723	5.215845217	0.002759984	3.035167051	0	0	0.387596043	0.039367342	0	0.005124459	0	0	0	0	0	0	0	0	0	0	0	0	0	54.6203
H5227_004_0	2009	5																					3350											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	COIN	COIN	P	COIN	P	P	COIN	P	COIN	V	T	COIN	V	V	V	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	1866.43583	60.16183201	765.954186	0	203.6431595	15.23230014	11.79177016	433.0333753	303.1159277	1319.877592	23.81621124	58.79951169	0.133065366	14.65040768	3319.089206	89.29046883	257.3467903	661.0528673	14.68567277	2139.476877	19.71142532	0	0	0.957264605	20.04232729	0	2.608916083	0	0	0											1a:$180 Days1-6	1b:$180 Days1-6	2a:$80 4-40		10a:$150 (WIA)	11a:20%	11b:20%; 11c:20%	4a:$50	9a:$90; 9b:$90	8a:$5	8b:$15-110;20%	9a:$90	12:20%	3:20%; 7a:$15-$50; 7d:$30; 9a:$90; 9d:$30; 13a 20%	7a:$15-$50	7b:$35; 7d:$30; 7f:$30; 17a:$30; 17b 20%	5:$35; 7e:$35; 7h:$35 ;9c:$35;	7c:$30; 7i:$30	8b:$15-110;20%	7g:$30	15:20%			16a:50%	17a:$30		18a:$30														124.8406378	124.8406378	63.96816424	0	90	0.199999486	0.19189598	50	90	5	0.216321273	90	0.198107581	0.129290147	14.75528012	0.096710928	35	30	0.450493832	0.019702996	0.190146021	0	0	0.5	30	0	30	0	0	0											96.3038965	96.3038965	49.34597883	0	69.42731822	0.154282533	0.14803137	38.57073235	69.42731822	3.857073235	0.166873398	69.42731822	0.15282309	0.099736313	11.3824392	0.074604226	26.99951264	23.14243941	0.34751754	0.015199179	0.146681425	0	0	0.385707323	23.14243941	0	23.14243941	0	0	0											14.9788	0.482818237	3.149729921	0	1.17819987	2.350077844	1.745551887	1.391867868	1.753710497	0.424238711	3.974292099	0.340191034	0.02033546	1.461177643	3.148277591	6.661446323	0.579019826	1.274864661	5.103528878	0.002709858	2.891299962	0	0	0.369223969	0.038652362	0	0.00503139	0	0	0	0	0	0	0	0	0	0	0	0	0	53.325	0	15.8012	14.9788	0.482818237	3.149729921	0	1.17819987	2.350077844	1.745551887	1.391867868	1.753710497	0.424238711	3.974292099	0.340191034	0.02033546	1.461177643	3.148277591	6.661446323	0.579019826	1.274864661	5.103528878	0.002709858	2.891299962	0	0	0.369223969	0.038652362	0	0.00503139	0	0	0	0	0	0	0	0	0	0	0	0	0	53.325	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	14.9788	0.482818237	3.149729921	0	1.17819987	2.350077844	1.745551887	1.391867868	1.753710497	0.424238711	3.974292099	0.340191034	0.02033546	1.461177643	3.148277591	6.661446323	0.579019826	1.274864661	5.103528878	0.002709858	2.891299962	0	0	0.369223969	0.038652362	0	0.00503139	0	0	0	0	0	0	0	0	0	0	0	0	0	53.325
H5227_005_0	2009	6																					3350											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	COIN	COIN	P	COIN	P	P	COIN	P	COIN	V	T	COIN	V	V	V	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	1923.722654	62.00838908	789.4637446	0	209.8936127	16.18170506	12.52673235	446.3245404	312.419515	1360.388813	25.28498821	60.60425483	0.141280641	15.55391752	3420.96256	94.80734903	265.2455779	681.3426723	15.59294634	2205.144195	20.94000695	0	0	1.016929378	20.65748976	0	2.688991976	0	0	0											1a:$180 Days1-6	1b:$180 Days1-6	2a:$80 4-40		10a:$150 (WIA)	11a:20%	11b:20%; 11c:20%	4a:$50	9a:$90; 9b:$90	8a:$5	8b:$15-110;20%	9a:$90	12:20%	3:20%; 7a:$15-$50; 7d:$30; 9a:$90; 9d:$30; 13a 20%	7a:$15-$50	7b:$35; 7d:$30; 7f:$30; 17a:$30; 17b 20%	5:$35; 7e:$35; 7h:$35 ;9c:$35;	7c:$30; 7i:$30	8b:$15-110;20%	7g:$30	15:20%			16a:50%	17a:$30		18a:$30														124.8406378	124.8406378	63.96816424	0	90	0.199999486	0.19189598	50	90	5	0.212923487	90	0.2	0.125826001	14.75528012	0.093883791	35	30	0.438811473	0.019702996	0.190146021	0	0	0.5	30	0	30	0	0	0											95.1644003	95.1644003	48.76210261	0	68.60583365	0.152457016	0.146279819	38.11435203	68.60583365	3.811435203	0.162308814	68.60583365	0.152457408	0.09591553	11.24775881	0.071566397	26.68004642	22.86861122	0.334500299	0.015019338	0.144945847	0	0	0.38114352	22.86861122	0	22.86861122	0	0	0											15.2558	0.491749263	3.207992677	0	1.199993856	2.467014469	1.832408136	1.417614221	1.786150106	0.432086151	4.103976458	0.346483785	0.02153928	1.491862237	3.206513482	6.785020369	0.589730361	1.298446723	5.215845217	0.002759984	3.035167051	0	0	0.387596043	0.039367342	0	0.005124459	0	0	0	0	0	0	0	0	0	0	0	0	0	54.6203	0	17.0329	15.2558	0.491749263	3.207992677	0	1.199993856	2.467014469	1.832408136	1.417614221	1.786150106	0.432086151	4.103976458	0.346483785	0.02153928	1.491862237	3.206513482	6.785020369	0.589730361	1.298446723	5.215845217	0.002759984	3.035167051	0	0	0.387596043	0.039367342	0	0.005124459	0	0	0	0	0	0	0	0	0	0	0	0	0	54.6203	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	15.2558	0.491749263	3.207992677	0	1.199993856	2.467014469	1.832408136	1.417614221	1.786150106	0.432086151	4.103976458	0.346483785	0.02153928	1.491862237	3.206513482	6.785020369	0.589730361	1.298446723	5.215845217	0.002759984	3.035167051	0	0	0.387596043	0.039367342	0	0.005124459	0	0	0	0	0	0	0	0	0	0	0	0	0	54.6203
H5227_801_0	2009	7																					0											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	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	365.5038423	2.357469324	96.70557084	0	13.54779974	14.56339934	8.124608744	13.94858825	44.69990063	11.82137571	28.6354379	0.414161513	0.293482566	15.38585197	32.52604028	150.3086282	1.561917216	12.15216908	20.3286048	4.927991575	37.74494485	0	0	0	0	0	0	0	0	0											Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.075674826	0.075674826	0.178141414	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.075674826	0.075674826	0.178141414	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											27.6594	0.178401082	17.22726709	0	3.12954174	3.364145249	1.87678462	3.222123886	10.32567704	2.73073779	6.614786155	0.095671309	0.067794473	3.554131805	7.513515305	34.72129312	0.360802877	2.807151057	4.695907708	1.138366054	8.719082261	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.0026	0	0	27.6594	0.178401082	17.22726709	0	3.12954174	3.364145249	1.87678462	3.222123886	10.32567704	2.73073779	6.614786155	0.095671309	0.067794473	3.554131805	7.513515305	34.72129312	0.360802877	2.807151057	4.695907708	1.138366054	8.719082261	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.0026	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	27.6594	0.178401082	17.22726709	0	3.12954174	3.364145249	1.87678462	3.222123886	10.32567704	2.73073779	6.614786155	0.095671309	0.067794473	3.554131805	7.513515305	34.72129312	0.360802877	2.807151057	4.695907708	1.138366054	8.719082261	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.0026
H5227_802_0	2009	6																					0											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	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	351.3769078	3.723277688	55.87545359	0	16.14118166	18.30899567	9.391871209	17.31852855	47.93478977	15.39288444	40.9884394	0.89270615	0.442308941	18.88231527	33.0953885	139.0833176	2.128621845	11.97760378	23.9732253	3.793181813	41.78299956	0	0	0	0	0	0	0	0	0											Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			0.077042832	0.077042832	0.189629024	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.077042832	0.077042832	0.189629024	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											27.0711	0.286851857	10.59560772	0	3.728612964	4.229378	2.169522249	4.000580095	11.07293644	3.555756306	9.468329502	0.206215121	0.102173365	4.361814827	7.645034743	32.12824637	0.491711646	2.766826473	5.537815044	0.876224999	9.651872898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.9466	0	0	27.0711	0.286851857	10.59560772	0	3.728612964	4.229378	2.169522249	4.000580095	11.07293644	3.555756306	9.468329502	0.206215121	0.102173365	4.361814827	7.645034743	32.12824637	0.491711646	2.766826473	5.537815044	0.876224999	9.651872898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.9466	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	27.0711	0.286851857	10.59560772	0	3.728612964	4.229378	2.169522249	4.000580095	11.07293644	3.555756306	9.468329502	0.206215121	0.102173365	4.361814827	7.645034743	32.12824637	0.491711646	2.766826473	5.537815044	0.876224999	9.651872898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.9466
H5227_803_0	2009	4																					0											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	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	382.6441912	2.468023146	101.2399671	0	14.18741181	15.25125698	8.508349794	14.60260612	46.79577824	12.37565338	29.97808905	0.433580613	0.307254116	16.1072599	34.05378415	157.3692046	1.635252073	12.72222196	21.28343671	5.159458696	39.5277119	0	0	0	0	0	0	0	0	0											Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.073310123	0.073310123	0.176985905	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.073310123	0.073310123	0.176985905	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											28.0517	0.18093108	17.91804721	0	3.277292129	3.523040362	1.965428802	3.373202014	10.80982477	2.858775931	6.924938571	0.100157122	0.070975701	3.720777036	7.866424138	36.35228627	0.377743229	2.938833272	4.91647388	1.191834959	9.13090145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.5496	0	0	28.0517	0.18093108	17.91804721	0	3.277292129	3.523040362	1.965428802	3.373202014	10.80982477	2.858775931	6.924938571	0.100157122	0.070975701	3.720777036	7.866424138	36.35228627	0.377743229	2.938833272	4.91647388	1.191834959	9.13090145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.5496	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	28.0517	0.18093108	17.91804721	0	3.277292129	3.523040362	1.965428802	3.373202014	10.80982477	2.858775931	6.924938571	0.100157122	0.070975701	3.720777036	7.866424138	36.35228627	0.377743229	2.938833272	4.91647388	1.191834959	9.13090145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.5496
H5253_004_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1545.638546	163.9107021	1100.63788	623.3910987	189.0829881	6.961577743	4.63813581	290.9927269	34.667043	9706.925808	40.82745767	0	0.366770381	31.35920115	4784.074093	4259.142727	731.9497036	295.3638436	0	0	20.69928597	717.4488181	0	0	172.7073527	307.2358058	17.67028734	5.12	459.9257363	0											"$210 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$210 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-28 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 25% (9a); $40/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$15 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											207.5354254	210	79.9192485	0	150	0.2	0.055726123	49.64947663	0.25	2.8	0.184130086	0	0.2	0.247532301	10.4825033	30	37.5	30	0	0	0.2	29.68673628	0	0	29.39917872	15	30	0	0	0											147.8186389	149.5552799	56.91593132	0	106.8251999	0.1424336	0.039686362	35.35876844	0.178042	1.994070399	0.131131555	0	0.1424336	0.176571541	10.4825033	30	37.5	21.36503998	0	0	0.1424336	29.68673628	0	0	29.39917872	15	30	0	0	0											19.0395	2.042809244	5.220319167	0	1.683235667	0.991562579	0.184070736	0.857428704	6.172189665	1.613024451	5.353768024	0	0.052240426	5.537142479	4.179089373	10.64785682	2.287342824	0.525871694	0	0	2.948273816	1.774892822	0	0	0.423121194	0.384044757	0.044175718	0	0	0	0	0	0	0	0	0	0	0	0	0	71.962	0	21.09	19.0395	2.042809244	5.220319167	0	1.683235667	0.991562579	0.184070736	0.857428704	6.172189665	1.613024451	5.353768024	0	0.052240426	5.537142479	4.179089373	10.64785682	2.287342824	0.525871694	0	0	2.948273816	1.774892822	0	0	0.423121194	0.384044757	0.044175718	0	0	0	0	0	0	0	0	0	0	0	0	0	71.962		"$325 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$325 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.2954	0.1368	1.5269	0.0299	0.036	0.0318	0.0212	0.0183	0.1584	0.0345	0.1683	0	0.0011	0.1418	0.4342	0.8597	0.1802	0.0599	0	0	0.4317	0.144	0	0	0.0294	0	0.0036	0	0	0											5.7431	0	0	20.3349	2.179561842	6.747197917	0.02992674	1.719228622	1.023366741	0.205260189	0.875763268	6.330567019	1.647516066	5.522059815	0	0.053357493	5.67891778	4.613332701	11.50756599	2.467557713	0.58576053	0	0	3.379970154	1.918940193	0	0	0.452536036	0.384044757	0.047758597	0	0	0	0	0	0	0	0	0	0	0	0	0	77.7051
H5253_007_0	2009	9																					2800											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1579.241311	103.6605606	7913.049404	82.31477424	891.193541	7.498677749	7.208151011	208.6861226	172.5283979	12898.33177	1468.558339	0	48.72771391	496.6169368	272.8214129	5945.180749	1582.280114	26.14112857	0	0	1690.717375	834.0140543	1621.073576	0	156.7879193	259.2939443	0	0	0	0											"$200 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$200 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $35 (4b)	$35 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$35 (3, 5, 9a, 9d); $35/$25 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $35 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$15 (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"$35/$25 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											198.2661633	200	0	0	75	0.2	0.2	49.07777735	35	0	0	0	0	34.92950226	0	14.43164485	32.5	0	0	0	0	14.71855654	0	0	0	0	0	0	0	0											174.6144848	176.1414877	0	0	66.05305788	0.176141488	0.176141488	43.22316358	30.82476035	0	0	0	0	30.76267246	0	12.71005697	28.62299175	0	0	0	0	12.96274223	0	0	0	0	0	0	0	0											22.9799	1.521577113	0	0	4.905504879	1.320828254	1.269654443	0.751672868	0.443178876	0	0	0	0	1.273105347	0	6.2969655	3.774132553	0	0	0	0	0.900925767	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4374	0	6.1545	22.9799	1.521577113	0	0	4.905504879	1.320828254	1.269654443	0.751672868	0.443178876	0	0	0	0	1.273105347	0	6.2969655	3.774132553	0	0	0	0	0.900925767	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4374		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $35 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $35 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.7533	0.1576	0.974	0.0254	0.4751	0.1184	0.1138	0.0449	0.1644	0.4026	0.3433	0	0	0.0872	0.0264	1.7562	0.9218	0.0028	0	0	0.1822	0.0929	0.0831	0	0.0121	0	0	0	0	0											8.7374	0	0	25.7332	1.679152113	0.973986458	0.025411397	5.380613106	1.439228429	1.383467353	0.796593267	0.607534362	0.402580201	0.343324091	0	0	1.36031814	0.026352644	8.053140929	4.695882553	0.002838813	0	0	0.18215927	0.993860154	0.083079753	0	0.01213029	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.1749
H5253_011_0	2009	5																					2500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1065.02572	153.394078	800.2838676	424.9270284	92.57351191	8.851175292	5.089316931	283.1198417	29.58776078	9640.346839	34.46888648	0	0.094675253	21.46263503	5135.760717	4052.187278	682.8835493	178.903237	0	0	21.36718101	798.5923074	0	0	254.904777	305.0786419	16.98852634	0	456.9511934	0											"$150 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$150 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-25 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); 25% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$15 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											148.2806909	150	100	0	150	0.2	0.089885103	49.59464398	0.25	2.8	0.182259294	0	0.2	0.245682992	6.355929301	20	37.5	20	0	0	0.2	19.47215413	0	0	20	15	20	0	0	0											103.1485151	104.3168964	69.5445976	0	104.3168964	0.139089195	0.062510233	34.49039559	0.173861494	1.947248733	0.126751493	0	0.139089195	0.171250229	6.355929301	20	37.5	13.90891952	0	0	0.139089195	19.47215413	0	0	20	15	20	0	0	0											9.1547	1.333466179	4.637951628	0	0.804748454	1.231102848	0.318134388	0.813742945	5.144172294	1.564346097	4.368982821	0	0.013168305	3.675481168	2.720211002	6.753645463	2.134011091	0.20736256	0	0	2.971944011	1.295859375	0	0	0.424841295	0.381348302	0.028314211	0	0	0	0	0	0	0	0	0	0	0	0	0	49.9775	0	15.8546	9.1547	1.333466179	4.637951628	0	0.804748454	1.231102848	0.318134388	0.813742945	5.144172294	1.564346097	4.368982821	0	0.013168305	3.675481168	2.720211002	6.753645463	2.134011091	0.20736256	0	0	2.971944011	1.295859375	0	0	0.424841295	0.381348302	0.028314211	0	0	0	0	0	0	0	0	0	0	0	0	0	49.9775		"$250 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$250 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$125 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$15 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$15 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.8162	0.2581	2.1471	0.1232	0.1358	0.3115	0.1791	0.1373	1.0414	0.2639	1.0834	0	0.0022	0.7436	0.4955	1.0011	0.2392	0.0442	0	0	0.634	0.1942	0	0	0.063	0	0.0042	0	0	0											10.9183	0	0	10.9709	1.591551633	6.785051042	0.123169511	0.940505699	1.54262466	0.497255598	0.951017518	6.185529238	1.82824386	5.452405818	0	0.015389735	4.419121226	3.215744914	7.754748326	2.373207939	0.251596877	0	0	3.605915315	1.490061978	0	0	0.487867201	0.381348302	0.03251467	0	0	0	0	0	0	0	0	0	0	0	0	0	60.8958
H5253_021_0	2009	5																					3200											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1728.434851	164.4426815	1517.0924	578.9187332	184.5865368	6.615090625	3.90456414	304.747135	35.64627726	10031.55291	40.80227692	0	0.288125932	33.53303022	4806.667347	4522.18733	729.3491331	357.8067	0	0	21.36809071	743.3515231	0	0	188.1963003	304.9997917	17.6677531	5.04	459.9107167	0											"$210 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$210 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 25% (9a); $40/$30 (9c)"	"$15 (7a); $30 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$15 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											207.5295566	210	85.36789939	0	150	0.2	0.055442919	49.65708804	0.25	2.8	0.18554611	0	0.2	0.247819454	10.67442854	30	37.5	30	0	0	0.2	29.62566469	0	0	29.43248593	15	30	0	0	0											137.6335728	139.2523263	56.60799325	0	99.46594737	0.132621263	0.03676455	32.92792871	0.165776579	1.856697684	0.123036797	0	0.132621263	0.164639132	10.67442854	30	37.5	19.89318947	0	0	0.132621263	29.62566469	0	0	29.43248593	15	30	0	0	0											19.8242	1.908252162	7.156629697	0	1.53000623	0.877301675	0.143549543	0.836224328	5.909317896	1.552130088	5.02018147	0	0.038211625	5.520848995	4.275702258	11.30546832	2.279216041	0.593159707	0	0	2.833863181	1.835190248	0	0	0.461590414	0.38124974	0.044169383	0	0	0	0	0	0	0	0	0	0	0	0	0	74.3265	0	27.285	19.8242	1.908252162	7.156629697	0	1.53000623	0.877301675	0.143549543	0.836224328	5.909317896	1.552130088	5.02018147	0	0.038211625	5.520848995	4.275702258	11.30546832	2.279216041	0.593159707	0	0	2.833863181	1.835190248	0	0	0.461590414	0.38124974	0.044169383	0	0	0	0	0	0	0	0	0	0	0	0	0	74.3265		"$325 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$325 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.4466	0.1372	2.1046	0.0249	0.0351	0.0302	0.0178	0.0192	0.1629	0.0356	0.1692	0	0.0009	0.1518	0.4415	0.9133	0.1796	0.0725	0	0	0.4456	0.1489	0	0	0.0321	0	0.0036	0	0	0											6.5733	0	0	21.2709	2.045448597	9.261242113	0.024918845	1.565143261	0.907522901	0.161387653	0.855428459	6.072168909	1.5877752	5.189416996	0	0.039089166	5.672633087	4.717211877	12.21879405	2.458790638	0.665709639	0	0	3.279507854	1.984094067	0	0	0.493679587	0.38124974	0.047751748	0	0	0	0	0	0	0	0	0	0	0	0	0	80.8998
H5253_024_0	2009	5																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		390.9664579	22.5719	43.62688668	2371.565982	15.74905589	21.95819504	10.66328596	25.07160278	50.23214116	11.42677649	32.54152691	0	1.173002202	42.20286392	39.01942362	131.3844996	14.1814	3.905258582	0	0	28.740771	5.025575199	112.8598201	3584.166727	0	0	0	0	20.2	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.074581316	0.075527151	0.162593815	0	0.2	0.2	0.2	0.11472056	0.2	0.08	0.2	0	0.2	0.2	0	0.199320674	0.2	0.2	0	0	0.2	0.016351272	0	0	0	0	0	0	0	0											0.074581316	0.075527151	0.162593815	0	0.2	0.2	0.2	0.11472056	0.2	0.08	0.2	0	0.2	0.2	0	0.199320674	0.2	0.2	0	0	0.2	0.016351272	0	0	0	0	0	0	0	0											29.1588	1.704791291	7.093461956	0	3.149811177	4.391639009	2.132657192	2.876228321	10.04642823	0.914142119	6.508305383	0	0.23460044	8.440572785	0	26.18764706	2.83628	0.781051716	0	0	5.7481542	0.08217455	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.2867	0	0	29.1588	1.704791291	7.093461956	0	3.149811177	4.391639009	2.132657192	2.876228321	10.04642823	0.914142119	6.508305383	0	0.23460044	8.440572785	0	26.18764706	2.83628	0.781051716	0	0	5.7481542	0.08217455	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.2867		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.6275	0.2094	0.4048	0.2781	0.1461	0.2037	0.0989	0.089	0.4661	0.106	0.3019	0	0.0073	0.3916	0.362	1.219	0.1316	0.0362	0	0	0.2667	0.038	0.0156	0	0	0	0	0	0.0018	0											8.4014	0	0	32.7863	1.914221291	7.498247502	0.278083125	3.295936438	4.595374839	2.231594897	2.965249656	10.51249964	1.020163756	6.810237076	0	0.241856124	8.832145749	0.362035889	27.4066785	2.96786	0.817286074	0	0	6.014821148	0.120192728	0.01557	0	0	0	0	0	0.0018	0	0	0	0	0	0	0	0	0	0	0	120.6882
H5253_027_0	2009	4																					3350											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1773.587453	270.2202396	38.87117429	47816.9564	82.8385382	19.41822162	8.585328954	338.5321505	354.9168764	5620.714781	429.851621	0	0.767751822	1371.736254	5544.304744	4114.244367	1242.868229	245.3090997	0	0	24.98394116	1038.924224	769.983193	0	119.3840337	149.3972702	0	0	20.2	0											"$225 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$225 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$125 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$125 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5); $125 (9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											222.3	225	0.162166462	0	125	0.14	0.2	49.97193767	125	4.4	64.79010385	0	0.2	115.4853807	3.25015592	25	20	20	0	0	0.2	13.6791576	0	0	0	0	0	0	0	0											159.4071089	161.3432276	0.162166462	0	89.63512645	0.100391342	0.143416202	35.83392762	89.63512645	3.155156451	46.45975321	0	0.143416202	82.81237358	3.25015592	25	20	20	0	0	0.143416202	13.6791576	0	0	0	0	0	0	0	0											23.5602	3.633183802	6.303600802	0	0.618770237	1.94942132	1.231275274	1.010911381	2.651084925	1.477852875	1.664233352	0	0.110108051	9.466394595	1.501654574	8.571342431	2.071447048	0.408848499	0	0	3.58310196	1.184300683	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.9977	0	20.1045	23.5602	3.633183802	6.303600802	0	0.618770237	1.94942132	1.231275274	1.010911381	2.651084925	1.477852875	1.664233352	0	0.110108051	9.466394595	1.501654574	8.571342431	2.071447048	0.408848499	0	0	3.58310196	1.184300683	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.9977		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.5376	0.2195	0.6138	0.5193	0.1337	0.3066	0.1356	0.0743	0.6176	0.0971	0.262	0	0.0081	0.4923	0.6596	2.0786	0.1512	0.0714	0	0	0.3945	0.082	0.0569	0	0.0059	0	0	0	0.003	0											10.5204	0	0	27.0978	3.852663802	6.917356186	0.519290586	0.752431883	2.25602482	1.3668331	1.085218921	3.268730629	1.574995091	1.926192766	0	0.118189649	9.958665639	2.161260442	10.6499539	2.222647048	0.480228203	0	0	3.977585242	1.266253539	0.056935837	0	0.005867124	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	81.5181
H5253_801_0	2009	2																					5040											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1421.218017	177.5565211	887.1538042	559.7882892	131.9549903	6.170988052	4.784963497	226.4029387	41.28537314	11207.06385	45.86597522	0	0.107431394	39.36554975	5458.292142	5222.239771	787.0082462	521.8463097	0	0	26.02684972	1089.341965	0	0	0	0	0	0	0	0											"$360 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$360 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											355.7354643	360	160	0	150	0.2	0.0509148	49.61344168	0.2	2.8	0.181940031	0	0.2	0.199195502	19.63552285	34.7665225	37.5	35	0	0	0.2	29.20993973	0	0	0	0	0	0	0	0											263.4436942	266.5826769	118.4811897	0	111.0761154	0.148101487	0.037702788	36.73912249	0.148101487	2.073420821	0.134727946	0	0.148101487	0.147708962	19.63552285	34.7665225	37.5	25.91776026	0	0	0.148101487	29.20993973	0	0	0	0	0	0	0	0											31.2009	3.944457725	8.759253184	0	1.221420644	0.913932508	0.180406463	0.693153775	6.114425161	1.936413293	6.179428616	0	0.015910749	5.81464448	8.931368337	15.12992638	2.45940077	1.127090629	0	0	3.85461515	2.651634428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1284	0	25.2014	31.2009	3.944457725	8.759253184	0	1.221420644	0.913932508	0.180406463	0.693153775	6.114425161	1.936413293	6.179428616	0	0.015910749	5.81464448	8.931368337	15.12992638	2.45940077	1.127090629	0	0	3.85461515	2.651634428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1284																																										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	31.2009	3.944457725	8.759253184	0	1.221420644	0.913932508	0.180406463	0.693153775	6.114425161	1.936413293	6.179428616	0	0.015910749	5.81464448	8.931368337	15.12992638	2.45940077	1.127090629	0	0	3.85461515	2.651634428	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1284
H5253_802_0	2009	2																					5040											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1421.232789	177.5583666	887.163025	559.7941075	131.9563618	6.171116332	4.785062965	226.4052918	41.28623136	11207.18033	45.86692866	0	0.107433628	39.36636806	5458.348874	5222.29405	787.0164262	521.8517336	0	0	26.02739076	1089.353287	0	0	0	0	0	0	0	0											"$360 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$360 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											355.7354643	360	160	0	150	0.2	0.0509148	49.61344168	0.2	2.8	0.181939708	0	0.2	0.199195465	19.63552285	34.76656421	37.5	35	0	0	0.2	29.20993973	0	0	0	0	0	0	0	0											263.4426525	266.5816226	118.4807212	0	111.0756761	0.148100901	0.037702639	36.73897719	0.148100901	2.07341262	0.134727174	0	0.148100901	0.147708351	19.63552285	34.76656421	37.5	25.91765775	0	0	0.148100901	29.20993973	0	0	0	0	0	0	0	0											31.2011	3.944483123	8.759309582	0	1.221428509	0.913947892	0.1804095	0.693158238	6.114528082	1.936425761	6.179521669	0	0.015911017	5.814741296	8.931461167	15.13010178	2.459426332	1.127097886	0	0	3.854680033	2.651661988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1294	0	25.202	31.2011	3.944483123	8.759309582	0	1.221428509	0.913947892	0.1804095	0.693158238	6.114528082	1.936425761	6.179521669	0	0.015911017	5.814741296	8.931461167	15.13010178	2.459426332	1.127097886	0	0	3.854680033	2.651661988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1294																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	31.2011	3.944483123	8.759309582	0	1.221428509	0.913947892	0.1804095	0.693158238	6.114528082	1.936425761	6.179521669	0	0.015911017	5.814741296	8.931461167	15.13010178	2.459426332	1.127097886	0	0	3.854680033	2.651661988	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1294
H5253_805_0	2009	2																					5040											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1421.218016	177.556521	887.1538036	559.7882888	131.9549902	6.170988044	4.78496349	226.4029385	41.28537308	11207.06384	45.86597516	0	0.107431394	39.36554969	5458.292138	5222.239768	787.0082457	521.8463093	0	0	26.02684968	1089.341964	0	0	0	0	0	0	0	0											"$360 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$360 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											355.7354643	360	160	0	150	0.2	0.0509148	49.61344168	0.2	2.8	0.181940031	0	0.2	0.199195502	19.63552285	34.7665225	37.5	35	0	0	0.2	29.20993973	0	0	0	0	0	0	0	0											263.4436942	266.582677	118.4811898	0	111.0761154	0.148101487	0.037702788	36.7391225	0.148101487	2.073420821	0.134727946	0	0.148101487	0.147708962	19.63552285	34.7665225	37.5	25.91776026	0	0	0.148101487	29.20993973	0	0	0	0	0	0	0	0											31.2009	3.944457724	8.75925318	0	1.221420644	0.913932507	0.180406463	0.693153774	6.114425154	1.936413292	6.17942861	0	0.015910749	5.814644473	8.931368331	15.12992636	2.459400768	1.127090628	0	0	3.854615146	2.651634426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1284	0	25.2014	31.2009	3.944457724	8.75925318	0	1.221420644	0.913932507	0.180406463	0.693153774	6.114425154	1.936413292	6.17942861	0	0.015910749	5.814644473	8.931368331	15.12992636	2.459400768	1.127090628	0	0	3.854615146	2.651634426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1284																																										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	31.2009	3.944457724	8.75925318	0	1.221420644	0.913932507	0.180406463	0.693153774	6.114425154	1.936413292	6.17942861	0	0.015910749	5.814644473	8.931368331	15.12992636	2.459400768	1.127090628	0	0	3.854615146	2.651634426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1284
H5253_806_0	2009	2																					5040											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1421.245619	177.5599695	887.171034	559.7991611	131.9575531	6.171227753	4.78514936	226.4073357	41.2869768	11207.2815	45.8677568	0	0.107435567	39.36707883	5458.398149	5222.341194	787.023531	521.8564447	0	0	26.02786069	1089.363121	0	0	0	0	0	0	0	0											"$360 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$360 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											355.7354643	360	160	0	150	0.2	0.0509148	49.61344168	0.2	2.8	0.181939428	0	0.2	0.199195432	19.63552285	34.76660043	37.5	35	0	0	0.2	29.20993973	0	0	0	0	0	0	0	0											263.4417478	266.5807069	118.4803142	0	111.0752945	0.148100393	0.037702509	36.73885098	0.148100393	2.073405498	0.134726503	0	0.148100393	0.14770782	19.63552285	34.76660043	37.5	25.91756872	0	0	0.148100393	29.20993973	0	0	0	0	0	0	0	0											31.2013	3.944505182	8.759358568	0	1.221435339	0.913961254	0.180412138	0.693162114	6.114617477	1.93643659	6.179602491	0	0.01591125	5.814825388	8.931541797	15.13025414	2.459448534	1.127104189	0	0	3.854736389	2.651685926	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1303	0	25.2026	31.2013	3.944505182	8.759358568	0	1.221435339	0.913961254	0.180412138	0.693162114	6.114617477	1.93643659	6.179602491	0	0.01591125	5.814825388	8.931541797	15.13025414	2.459448534	1.127104189	0	0	3.854736389	2.651685926	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1303																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	31.2013	3.944505182	8.759358568	0	1.221435339	0.913961254	0.180412138	0.693162114	6.114617477	1.93643659	6.179602491	0	0.01591125	5.814825388	8.931541797	15.13025414	2.459448534	1.127104189	0	0	3.854736389	2.651685926	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1303
H5262_001_0	2009	4	f.										OP Facility - Emergency										2500	Urgent Care										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										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0										0	0	0	0	25.33317401	0	0	10.77995031	5.714151916	280.5336517	0	0	0	0	0	1.79768793	5600.002602	1906.069361	123.8490669	241.9917957	0	179.4355532	0	715.1042414	0	0	3.426161438	0	0	0	0	0	2.594549076										1A IP Acute: $0 per admit	1B IP Psych: $0 per admit	2 SNF: 10% for days 1 - 20 only	6 Home Health: $0	10A Ambulance: $0	11A DME: 10%	"11B Prosthetic Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: 10%"	4A ER: $50	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: $15, 9D Cardiac Rehab: $10"	"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 Meaurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $15, 14J Nutrition Therapy: $15"	"7B Chiropractic: $15, 7D Physician Specialist (excl. Radiology) $15, 7F Podiatry: $15"	"7E Mental Health: $15, 7H Psychiatric: $15"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	7D physician Specialist (Radiology): $0	"7G Other Health Care: $15, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comp Dental Services: $15, 17A medicare Covered Eye Exams: $15"	10B Transportation: Not Covered	"16A Preventative Dental Services: Not Covered, 16B Non Medicare Covered Comp Dental: Not Covered"	17A Routine Eye Exams: $15	"17B Eye Wear: Medicare Covered: $0, Routine: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered	4B Urgent Care: $15												0.1			0.1	0.1	50						10	15	15	15	15		15		15			15						15												0.09996			0.09996	0.09996	49.98						10	14.994	14.994	14.994	14.994		14.994		14.994			14.994						14.994										0	0	2.532304074	0	0	1.077563833	0.571186626	1.168422659	0	0	0	0	0	0.001498073	6.997203251	2.381633666	0.154749409	0.302368749	0	0.224204724	0	0.89352275	0	0	0.004280989	0	0	0	0	0	0.003241889	0	0	0	0	0	0	0	0	0	16.3122	0	0.003	0	0	2.532304074	0	0	1.077563833	0.571186626	1.168422659	0	0	0	0	0	0.001498073	6.997203251	2.381633666	0.154749409	0.302368749	0	0.224204724	0	0.89352275	0	0	0.004280989	0	0	0	0	0	0.003241889	0	0	0	0	0	0	0	0	0	16.3122	0																																																																																	0	0	0	0	0	2.532304074	0	0	1.077563833	0.571186626	1.168422659	0	0	0	0	0	0.001498073	6.997203251	2.381633666	0.154749409	0.302368749	0	0.224204724	0	0.89352275	0	0	0.004280989	0	0	0	0	0	0.003241889	0	0	0	0	0	0	0	0	0	16.3122
H5262_003_0	2009	4	I.4										Professional										2500	Urgent care										A	A	Coin	V	P	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V																																																		0	0	132.3099217	0	16.6812412	0	0	7.098319036	3.762621547	269.1607828	159.9680452	12.03930746	4.74353645	0	0	0.070442497	3395.161861	1359.975622	132.401667	176.9510409	19.12941149	122.2894689	1.281268201	486.1947896	0	0	2.377421299	0	0	0	0	0	2.420295097										1A IP Acute: $200 per admit	1B IP Psych: $200 per admit	2 SNF: 10% for days 1 - 20 only	6 Home Health: $0	10A Ambulance: $0	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	4A ER: $50	9B ASC Services: $75	8A OP C/D/T: 10%	8B OP X-Ray: 10%	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9C OP substance Abuse: $30, 9D Cardiac Rehab: $15"	"7A PCP: $30, 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 Meaurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $30, 14J Nutrition Therapy: $30"	"7B Chiropractic: $30, 7D Physician Specialist (excl. Radiology) $30, 7F Podiatry: $30"	"7E Mental Health: $30, 7H Psychiatric: $30"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	7D physician Specialist (Radiology): $0	"7G Other Health Care: $30, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comp Dental Services: $30, 17A medicare Covered Eye Exams: $30"	10B Transportation: Not Covered	"16A Preventative Dental Services: Not Covered, 16B Non Medicare Covered Comp Dental: Not Covered"	17A Routine Eye Exams: $30	"17B Eye Wear: Medicare Covered: $0, Routine: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered	4B Urgent Care: $30										200	200	0.1			0.2	0.2	50	75	0.1	0.1			15	30	30	30	30		30		30			30						30										197.58	197.58	0.09879			0.19758	0.19758	49.395	74.0925	0.09879	0.09879			14.8185	29.637	29.637	29.637	29.637		29.637		29.637			29.637						29.637										2.1785	0	1.647939818	0	0	1.402485875	0.743418765	1.107933072	0.987702699	1.189363184	0.468613966	0	0	8.70E-05	8.385201007	3.358799793	0.326999017	0.437024833	0	0.302024416	0	1.200779582	0	0	0.005871636	0	0	0	0	0	0.005977524	0	0	0	0	0	0	0	0	0	23.7487	0	0.3239	2.1785	0	1.647939818	0	0	1.402485875	0.743418765	1.107933072	0.987702699	1.189363184	0.468613966	0	0	8.70E-05	8.385201007	3.358799793	0.326999017	0.437024833	0	0.302024416	0	1.200779582	0	0	0.005871636	0	0	0	0	0	0.005977524	0	0	0	0	0	0	0	0	0	23.7487	0																																																																																	0	0	0	2.1785	0	1.647939818	0	0	1.402485875	0.743418765	1.107933072	0.987702699	1.189363184	0.468613966	0	0	8.70E-05	8.385201007	3.358799793	0.326999017	0.437024833	0	0.302024416	0	1.200779582	0	0	0.005871636	0	0	0	0	0	0.005977524	0	0	0	0	0	0	0	0	0	23.7487
H5262_004_0	2009	2	I.4										Professional										2500	Urgent care										A	A	Coin	V	P	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	V	V	Coin	V	V	V	V	V	V	V	V	V	V																																																		0	0	130.4397442	0	16.44545479	0	0	6.997985542	3.709437552	265.3562424	157.706925	11.86913396	4.676487395	0	0	0.069446805	3347.171844	1340.752606	130.5301927	174.449869	18.85902061	120.5609287	1.2631577	479.3225116	0	0	2.343816866	0	0	0	0	0	2.386084651										1A IP Acute: $200 per admit	1B IP Psych: $200 per admit	2 SNF: 10% for days 1 - 20 only	6 Home Health: $0	10A Ambulance: $0	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	4A ER: $50	9B ASC Services: $75	8A OP C/D/T: 10%	8B OP X-Ray: 10%	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9C OP substance Abuse: $30, 9D Cardiac Rehab: $15"	"7A PCP: $30, 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 Meaurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $30, 14J Nutrition Therapy: $30"	"7B Chiropractic: $30, 7D Physician Specialist (excl. Radiology) $30, 7F Podiatry: $30"	"7E Mental Health: $30, 7H Psychiatric: $30"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	7D physician Specialist (Radiology): $0	"7G Other Health Care: $30, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comp Dental Services: $30, 17A medicare Covered Eye Exams: $30"	10B Transportation: Not Covered	"16A Preventative Dental Services: Not Covered, 16B Non Medicare Covered Comp Dental: Not Covered"	17A Routine Eye Exams: $30	"17B Eye Wear: Medicare Covered: $0, Routine: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered	4B Urgent Care: $30										200	200	0.1			0.2	0.2	50	75	0.1	0.1			15	30	30	30	30		30		30			30						30										197.58	197.58	0.09879			0.19758	0.19758	49.395	74.0925	0.09879	0.09879			14.8185	29.637	29.637	29.637	29.637		29.637		29.637			29.637						29.637										2.1477	0	1.624646478	0	0	1.382661983	0.732910672	1.092272633	0.973741695	1.172551744	0.46199019	0	0	8.58E-05	8.266677663	3.311323748	0.322376943	0.430847564	0	0.297755354	0	1.183806773	0	0	0.005788642	0	0	0	0	0	0.005893033	0	0	0	0	0	0	0	0	0	23.413	0	0.3239	2.1477	0	1.624646478	0	0	1.382661983	0.732910672	1.092272633	0.973741695	1.172551744	0.46199019	0	0	8.58E-05	8.266677663	3.311323748	0.322376943	0.430847564	0	0.297755354	0	1.183806773	0	0	0.005788642	0	0	0	0	0	0.005893033	0	0	0	0	0	0	0	0	0	23.413	0																																																																																	0	0	0	2.1477	0	1.624646478	0	0	1.382661983	0.732910672	1.092272633	0.973741695	1.172551744	0.46199019	0	0	8.58E-05	8.266677663	3.311323748	0.322376943	0.430847564	0	0.297755354	0	1.183806773	0	0	0.005788642	0	0	0	0	0	0.005893033	0	0	0	0	0	0	0	0	0	23.413
H5262_005_0	2009	2	f.										OP Facility - Emergency										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										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0										0	0	0	0	26.89159775	0	0	11.44310174	6.065670049	297.7912722	0	0	0	0	0	1.908276503	5944.498599	2023.325246	131.467904	256.8784326	0	190.4739106	0	759.0953904	0	0	3.636929001	0	0	0	0	0	2.754158247										1A IP Acute: $0 per admit	1B IP Psych: $0 per admit	2 SNF: 10% for days 1 - 20 only	6 Home Health: $0	10A Ambulance: $0	11A DME: 10%	"11B Prosthetic Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: 10%"	4A ER: $50	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: $15, 9D Cardiac Rehab: $10"	"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 Meaurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $15, 14J Nutrition Therapy: $15"	"7B Chiropractic: $15, 7D Physician Specialist (excl. Radiology) $15, 7F Podiatry: $15"	"7E Mental Health: $15, 7H Psychiatric: $15"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	7D physician Specialist (Radiology): $0	"7G Other Health Care: $15, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: $0	"13A Blood: $0, 16B Medicare Covered Comp Dental Services: $15, 17A medicare Covered Eye Exams: $15"	10B Transportation: Not Covered	"16A Preventative Dental Services: Not Covered, 16B Non Medicare Covered Comp Dental: Not Covered"	17A Routine Eye Exams: $15	"17B Eye Wear: Medicare Covered: $0, Routine: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered	4B Urgent Care: $15												0.1			0.1	0.1	50						10	15	15	15	15		15		15			15						15												0.09996			0.09996	0.09996	49.98						9.996	14.994	14.994	14.994	14.994		14.994		14.994			14.994						14.994										0	0	2.688084112	0	0	1.14385245	0.606324378	1.240300649	0	0	0	0	0	0.001589594	7.427651	2.528144895	0.164269146	0.320969601	0	0.237997151	0	0.94848969	0	0	0.004544343	0	0	0	0	0	0.003441321	0	0	0	0	0	0	0	0	0	17.3157	0	0.003	0	0	2.688084112	0	0	1.14385245	0.606324378	1.240300649	0	0	0	0	0	0.001589594	7.427651	2.528144895	0.164269146	0.320969601	0	0.237997151	0	0.94848969	0	0	0.004544343	0	0	0	0	0	0.003441321	0	0	0	0	0	0	0	0	0	17.3157	0																																																																																	0	0	0	0	0	2.688084112	0	0	1.14385245	0.606324378	1.240300649	0	0	0	0	0	0.001589594	7.427651	2.528144895	0.164269146	0.320969601	0	0.237997151	0	0.94848969	0	0	0.004544343	0	0	0	0	0	0.003441321	0	0	0	0	0	0	0	0	0	17.3157
H5270_001_0	2009	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	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1048.49937	19.48967309	226.1359187	2139.534004	220.1336593	16727.97756	16811.65209	179.3225352	203.4052768	1757.61223	535.6722997	0	82.48093125	473.6160476	10727.9188	18574.63835	167.0048922	557.7973016	3857.405803	9060.431093	148.8557268	794.0461645	0	4679.461472	0	334.1480387	178.2710204	0	0	423.5063666											"$0 copay, days 1-1"	"$0 copay, days 1-1"	"$0 copay, days 1-1"	$0 copay	$0 copay	$0 copay	$0 copay	$25 copay	$0 copay	$0 copay	0% coinsurance		$0 copay	Varies	$0 copay	$0 copay	"$0 copay Group, $0 copay Individual"	$0 copay	0% coinsurance	Varies		Varies	Not Covered	$0 copay	$10 copay	$0 copay	$0 copay	Not Covered	Varies	Varies											0	0	0	0	0	0	0	22.5	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	22.5	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	0.336229753	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.3362		0	0	0	0	0	0	0	0	0.336229753	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.3362																																																																																		0			0	0	0	0	0	0	0	0.336229753	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.3362
H5291_001_0	2009	7	r.	s.	t.	u.	v.	w.					DME/Prosthetics/Supplies	OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered						Prosthetics/Supplies	Renal Dialysis									D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin								O	O	O	P	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		2014.598071	70.975596	878.133387	1512.792573	320.804839	12.591366	1.422881	367.997278	259.916582	148.224375	1254.29156	0	0	254.617796	5910.542567	5722.958925	4.055047	682.825978			41.278001								3.36	0.27	8106.990976	21.679214	0.06	0.05	1.23	2.7					$175/Day(Days 1-7):1a	$175/Day(Days 1-7):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$10/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$100/Visit:14h. $50 DMAM -- OP,8b. $30 Radiology -- FSR,14h. $30 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$15-$100/Visit:9d. $15 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $50 OP Other,5. $35 Partial Hospitalization,8b. $50 Rad therapy,3. $40 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$50/Visit:7h. $50 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			"0%-20% Coins:15. 20% Part B Rx,15. 0% Part B Rx at Pharmacy,15. 20% Part B Rx - Chemo"								$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	:11b	$0/Proc:12	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0: Health Education Materials 14a	$0 Corp Health 14a					124.676301	110.261786	43.132804	9.999996	100.000012	0.199999	0.199999	50	120.378498	28.503813	53.55462	0	0	40.566685	9.999999	29.999999	48.913859	32.187738			0.163378								0	0	0	0	0	0	0	0					124.676301	110.261786	43.132804	9.999996	100.000012	0.199999	0.199999	50	120.378498	28.503813	53.55462	0	0	40.566685	9.999999	29.999999	48.913859	32.187738			0.163378								0	0	0	0	0	0	0	0					20.9311	0.652157998	3.156362939	1.260659973	2.673373979	2.518260609	0.284574777	1.533321992	2.607363979	0.352079989	5.597758989	0	0	0.860749994	4.925451647	14.30739684	0.016529	1.831551973	0	0	6.743917247	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.2526	0	0	20.9311	0.652157998	3.156362939	1.260659973	2.673373979	2.518260609	0.284574777	1.533321992	2.607363979	0.352079989	5.597758989	0	0	0.860749994	4.925451647	14.30739684	0.016529	1.831551973	0	0	6.743917247	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.2526																																																																																		0	0	0	20.9311	0.652157998	3.156362939	1.260659973	2.673373979	2.518260609	0.284574777	1.533321992	2.607363979	0.352079989	5.597758989	0	0	0.860749994	4.925451647	14.30739684	0.016529	1.831551973	0	0	6.743917247	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.2526
H5291_801_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		334.19696	11.179069	871.295664	1501.012975	8.52715	12.396053	3.279674	28.558284	46.396581	147.070204	33.756778	0	0.423362	5.845411	47.093624	103.571622	0.11941	5.916712			40.637709																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000014	1023.999762	43.132798	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.2	0.5	0.2			0.2																				1024.000014	1023.999762	43.132798	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.2	0.5	0.2			0.2																				28.5181	0.953947	3.131784989	0	1.70543	2.4792106	0.6559348	5.7116568	9.2793162	0	6.7513556	0	0.084671977	1.169076355	9.4187248	20.7143244	0.059705	1.1833424	0	0	8.1275418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.9442	0	0	28.5181	0.953947	3.131784989	0	1.70543	2.4792106	0.6559348	5.7116568	9.2793162	0	6.7513556	0	0.084671977	1.169076355	9.4187248	20.7143244	0.059705	1.1833424	0	0	8.1275418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.9442																																																																																		0	0	0	28.5181	0.953947	3.131784989	0	1.70543	2.4792106	0.6559348	5.7116568	9.2793162	0	6.7513556	0	0.084671977	1.169076355	9.4187248	20.7143244	0.059705	1.1833424	0	0	8.1275418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.9442
H5291_802_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		334.19696	11.179069	871.295664	1501.012975	8.52715	12.396053	3.279674	28.558284	46.396581	147.070204	33.756778	0	0.423362	5.845411	47.093624	103.571622	0.11941	5.916712			40.637709																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000014	1023.999762	43.132798	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.2	0.5	0.2			0.2																				1024.000014	1023.999762	43.132798	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.2	0.5	0.2			0.2																				28.5181	0.953947	3.131784989	0	1.70543	2.4792106	0.6559348	5.7116568	9.2793162	0	6.7513556	0	0.084671977	1.169076355	9.4187248	20.7143244	0.059705	1.1833424	0	0	8.1275418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.9442	0	0	28.5181	0.953947	3.131784989	0	1.70543	2.4792106	0.6559348	5.7116568	9.2793162	0	6.7513556	0	0.084671977	1.169076355	9.4187248	20.7143244	0.059705	1.1833424	0	0	8.1275418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.9442																																																																																		0	0	0	28.5181	0.953947	3.131784989	0	1.70543	2.4792106	0.6559348	5.7116568	9.2793162	0	6.7513556	0	0.084671977	1.169076355	9.4187248	20.7143244	0.059705	1.1833424	0	0	8.1275418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.9442
H5291_803_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		334.19696	11.179069	871.295664	1501.012975	8.52715	12.396053	3.279674	28.558284	46.396581	147.070204	33.756778	0	0.423362	5.845411	47.093624	103.571622	0.11941	5.916712			40.637709																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000014	1023.999762	43.132798	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.2	0.5	0.2			0.2																				1024.000014	1023.999762	43.132798	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.2	0.5	0.2			0.2																				28.5181	0.953947	3.131784989	0	1.70543	2.4792106	0.6559348	5.7116568	9.2793162	0	6.7513556	0	0.084671977	1.169076355	9.4187248	20.7143244	0.059705	1.1833424	0	0	8.1275418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.9442	0	0	28.5181	0.953947	3.131784989	0	1.70543	2.4792106	0.6559348	5.7116568	9.2793162	0	6.7513556	0	0.084671977	1.169076355	9.4187248	20.7143244	0.059705	1.1833424	0	0	8.1275418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.9442																																																																																		0	0	0	28.5181	0.953947	3.131784989	0	1.70543	2.4792106	0.6559348	5.7116568	9.2793162	0	6.7513556	0	0.084671977	1.169076355	9.4187248	20.7143244	0.059705	1.1833424	0	0	8.1275418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.9442
H5291_804_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		334.19696	11.179069	871.295664	1501.012975	8.52715	12.396053	3.279674	28.558284	46.396581	147.070204	33.756778	0	0.423362	5.845411	47.093624	103.571622	0.11941	5.916712			40.637709																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000014	1023.999762	43.132798	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.2	0.5	0.2			0.2																				1024.000014	1023.999762	43.132798	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.2	0.5	0.2			0.2																				28.5181	0.953947	3.131784989	0	1.70543	2.4792106	0.6559348	5.7116568	9.2793162	0	6.7513556	0	0.084671977	1.169076355	9.4187248	20.7143244	0.059705	1.1833424	0	0	8.1275418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.9442	0	0	28.5181	0.953947	3.131784989	0	1.70543	2.4792106	0.6559348	5.7116568	9.2793162	0	6.7513556	0	0.084671977	1.169076355	9.4187248	20.7143244	0.059705	1.1833424	0	0	8.1275418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.9442																																																																																		0	0	0	28.5181	0.953947	3.131784989	0	1.70543	2.4792106	0.6559348	5.7116568	9.2793162	0	6.7513556	0	0.084671977	1.169076355	9.4187248	20.7143244	0.059705	1.1833424	0	0	8.1275418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.9442
H5294_001_0	2009	7																																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		394.0961618	32.60848799	73.52886325	0	19.61674472	33.51538252	24.31483142	23.32335687	36.19108616	4.496928012	12.48845911	0	4.447323046	40.78058693	65.16342192	130.8753967	13.45703274	8.915317614	40.65819006	55.21457336	6.867186238	0.522485935	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											0.0701	0.0701	0.1985	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0701	0.0701	0.1985	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											27.6261	2.285855008	14.59547936	0	4.53146803	7.742053361	5.616726059	5.387695437	8.360140903	1.038790371	2.884834056	0	1.027331624	9.42031558	15.05275046	30.23221663	3.108574563	2.059438369	9.392041904	12.75456645	1.586320021	0.120694251	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	164.8234	0		27.6261	2.285855008	14.59547936	0	4.53146803	7.742053361	5.616726059	5.387695437	8.360140903	1.038790371	2.884834056	0	1.027331624	9.42031558	15.05275046	30.23221663	3.108574563	2.059438369	9.392041904	12.75456645	1.586320021	0.120694251	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	164.8234																																																																																		0	0		27.6261	2.285855008	14.59547936	0	4.53146803	7.742053361	5.616726059	5.387695437	8.360140903	1.038790371	2.884834056	0	1.027331624	9.42031558	15.05275046	30.23221663	3.108574563	2.059438369	9.392041904	12.75456645	1.586320021	0.120694251	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	164.8234
H5302_003_0	2009	6																					3000											D	D	D	V	T	COIN	COIN	V	V	O	O	O	COIN	O	COIN	COIN	P	P	P	P	COIN	V	T	V	V	V	V	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	4500	1243.779095	68.29242174	397.764279	0	149.0921752	8.354184193	5.607485462	353.3824036	325.777046	994.7658822	556.0776325	25.39020374	0.564112105	477.2087624	12.25183553	92.75392666	224.6657029	604.4293179	3885.780269	6204.569519	19.38545589	0	0	0	0	0	0	0	0	197.8961238											$175/day days 1 - 7; $0 after day 7	$175/day days 1 - 7; $0 after day 7	$0 days 1 - 7; $90/day days 8 - 100	$0 copay	$100 copay	20% coinsurance	20% coinsurance	(4a) $50/visit; waive if admitted; (4b) $30/visit	(9a) $150/visit (9b) $100/visit	$30 copay	"$30 copay except: MRI, CT, PET @ $100 copay"	$75/visit	20% coinsurance	$30/visit	"(7a) $10/visit, 14(b) $0 copay, 14(c) $10/visit, 14(d) - 14(h) $0 copay, 14(i) 20%, 14(j) $0 copay"	"(7b, 7d, 7f, 7g) $30/visit, (14d, 14e, 14f, 14g, 14h, 14j) $0 copay, (14i) 20% coinsurance"	$30/visit	$30/visit	$30/visit	"(7b, 7d, 7f, 7g) $30/visit, (14d, 14e, 14f, 14g, 14h, 14j) $0 copay, (14i) 20% coinsurance"	20% coinsurance	$0 copay	not covered	"(16a) $0 copay, (16b) not covered"	$30 copay	$30 copay	$30 copay	not covered	$0 copay	"Immunizations $0 copay, Physicals $10 copay"											135.0184913	129.1735353	60.97806544	0	60	0.2	0.2	48	116.6772713	30	36.23107372	75	0.202393035	144.5623935	0.059981954	0.130177473	29.80965553	29.38468406	9.383157812	0.545179082	0.20169243	0	0	0	0	0	0	0	0	4.058544965											122.0420582	116.7588525	55.11755123	0	54.23348625	0.180778288	0.180778288	43.386789	105.4635865	27.11674313	32.74895731	67.79185782	0.186110561	130.6719608	0.059981954	0.130177473	29.69301064	28.54785781	9.383157812	0.545179082	0.18230806	0	0	0	0	0	0	0	0	4.058544965											12.6494	0.664478733	1.826982752	0	0.673815703	1.510255112	1.013711619	1.277677315	2.863134639	2.247900908	1.517580221	0.143437424	0.10498722	5.196483724	0.734889033	12.07447174	0.555916759	1.437930186	3.038407457	0.28188346	3.534124862	0	0	0	0	0	0	0	0	0.06693086	0	0	0	0	0	0	0	0	0	0	53.4144	0	3.7876	12.6494	0.664478733	1.826982752	0	0.673815703	1.510255112	1.013711619	1.277677315	2.863134639	2.247900908	1.517580221	0.143437424	0.10498722	5.196483724	0.734889033	12.07447174	0.555916759	1.437930186	3.038407457	0.28188346	3.534124862	0	0	0	0	0	0	0	0	0.06693086	0	0	0	0	0	0	0	0	0	0	53.4144	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	$100 copay	30% coinsurance	30% coinsurance	(4a) $50/visit; waive if admitted; (4b) $30/visit	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	not covered	"(16a) $0 copay, (16b) not covered"	30% coinsurance	100% coinsurance	30% coinsurance	100% coinsurance	not covered	not covered											2.602	0.0675	2.9104	0.3234	0.0453	0.1767	0.1843	0.0451	0.4693	0.1371	0.2103	0.0218	0.008	0.1933	0.0984	1.4831	0.01	0.1063	0.1862	0.5044	0.2969	0	0	0	0	0	0	0	0	0											10.0798	0	0	15.2515	0.731952615	4.737422079	0.323440123	0.71907463	1.686957886	1.198037469	1.322785483	3.332433856	2.385020091	1.727834434	0.165226133	0.112955461	5.389763205	0.833255409	13.55758499	0.565956323	1.544262121	3.224560511	0.786290331	3.831058153	0	0	0	0	0	0	0	0	0.06693086	0	0	0	0	0	0	0	0	0	0	63.4943
H5302_004_0	2009	7																					2500											D	D	D	V	T	COIN	COIN	V	V	O	O	O	COIN	O	COIN	COIN	P	P	P	P	COIN	V	T	V	V	V	V	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	4000	1433.374393	60.50838845	457.6370251	0	167.535568	8.844562456	5.567689147	339.1812835	381.6730443	1306.807956	670.973324	33.06579999	0.499814086	546.7773099	15.62176822	110.955948	211.6265392	616.7473249	4100.62978	5789.719012	20.55613067	0	0	0	0	316.5797782	146.6705436	0	0	0											$600/admit	$600/admit	$0 days 1 - 7; $90/day days 8 - 100	$0 copay	$100 copay	20% coinsurance	20% coinsurance	(4a) $50/visit; waive if admitted; (4b) $25/visit	(9a) $150/visit (9b) $100/visit	$30 copay	"$30 copay except: MRI, CT, PET @ $100 copay"	$75/visit	20% coinsurance	$25/visit	"(7a, 14c) $5/visit, (14b, 14d - h, 14j) $0 copay, (14i) 20%"	"(7b, 7d, 7f, 7g) $25/visit, (14d, 14e, 14f, 14g, 14h, 14j) $0 copay, (14i) 20% coinsurance"	$25/visit	$25/visit	$25/visit	"(7b, 7d, 7f, 7g) $25/visit, (14d, 14e, 14f, 14g, 14h, 14j) $0 copay, (14i) 20% coinsurance"	20% coinsurance	$0 copay	not covered	"(16a) $0 copay, (16b) $50 ded, 50% coinsurance"	$30 copay	$30 copay	$30 copay	$0 copay	$0 copay	"Immunizations $0 copay, Physicals $5 copay"											105.4131022	68.00159625	55.78020581	0	84.064587	0.2	0.2	47.5	121.6661031	25	26.14947684	100	0.196063578	54.93985439	0.04612664	0.148690413	0.95133201	24.465707	7.892504832	13.62666507	0.202569295	0	0	0	0	30	30	0	0	0											92.9256407	59.94598174	49.17236335	0	74.10611626	0.176307572	0.176307572	41.87304843	107.2532763	22.03844654	23.0517539	88.15378616	0.175994016	48.43414408	0.04612664	0.148690413	0.838635186	23.91919995	7.892504832	13.62666507	0.178572503	0	0	0	0	30	30	0	0	0											11.0998	0.302269562	1.87525784	0	1.034617523	1.559363335	0.981625757	1.183546192	3.411307041	2.40000144	1.288925995	0.242906288	0.087964288	2.206890917	0.720579682	16.49808572	0.014789788	1.229341882	2.69702003	6.574546817	3.6707597	0	0	0	0	0.791449446	0.366676359	0	0	0	0	0	0	0	0	0	0	0	0	0	60.2377	0	4.2405	11.0998	0.302269562	1.87525784	0	1.034617523	1.559363335	0.981625757	1.183546192	3.411307041	2.40000144	1.288925995	0.242906288	0.087964288	2.206890917	0.720579682	16.49808572	0.014789788	1.229341882	2.69702003	6.574546817	3.6707597	0	0	0	0	0.791449446	0.366676359	0	0	0	0	0	0	0	0	0	0	0	0	0	60.2377	0	30% coinsurance	30% coinsurance	30% coinsurance	30% coinsurance	$100 copay	30% coinsurance	30% coinsurance	(4a) $50/visit; waive if admitted; (4b) $25/visit	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	not covered	"(16a) $0 copay, (16b) $50 ded, 50% coinsurance"	30% coinsurance	100% coinsurance	30% coinsurance	100% coinsurance	not covered	not covered											2.3816	0.6721	0.1984	0.4099	0.0176	1.6588	0.3505	0.04	0.6205	0.3395	0.2138	0.0193	0.0071	0.2905	0.0669	2.1935	0.0089	0.1214	0.2608	0.6666	0.3841	0	0	0	0	0	0	0	0	0											10.9217	0	0	13.4813	0.97434002	2.073660154	0.409929842	1.052181658	3.218123204	1.332159497	1.22351289	4.031803264	2.739461432	1.502763709	0.262211501	0.095024302	2.497379523	0.787464042	18.69161438	0.023685034	1.350783262	2.957780111	7.24115734	4.054862473	0	0	0	0	0.791449446	0.366676359	0	0	0	0	0	0	0	0	0	0	0	0	0	71.1594
H5302_809_0	2009	4																					0											COIN	COIN	COIN	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	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	230.8849467	4.993294284	16.11199386	0	7.240748664	8.844562456	5.567689147	17.36124789	48.43310227	5.17382552	21.22417149	1.832497822	0.499814086	14.26219445	15.62176822	110.955948	2.082144958	8.358371052	39.40343245	29.82557794	20.55613067	0	0	0	0	0	0	0	0	0											Medicare FFS 7.7%	Medicare FFS 7.7%	Medicare FFS 19.5%		Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%																			0.077041062	0.077041062	0.194561696	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.077041062	0.077041062	0.194561696	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											17.7876	0.384688695	3.134776854	0	1.672612941	2.043093927	1.286136193	4.010448263	11.18804662	1.195153695	4.902783614	0.423306997	0.115457054	3.294566918	3.608628459	25.63082398	0.480975485	1.930783713	9.102192895	6.889708504	4.748466186	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.8303	0	0	17.7876	0.384688695	3.134776854	0	1.672612941	2.043093927	1.286136193	4.010448263	11.18804662	1.195153695	4.902783614	0.423306997	0.115457054	3.294566918	3.608628459	25.63082398	0.480975485	1.930783713	9.102192895	6.889708504	4.748466186	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.8303	0	Medicare FFS 7.7%	Medicare FFS 7.7%	Medicare FFS 19.5%		Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%																			0.6116	0.1726	0.1287	0	0.0417	1.2772	0.2699	0.0905	0.528	0.2614	0.1647	0.0149	0.0054	0.2237	0.1026	2.6201	0.023	0.0935	0.5817	0.5292	0.2958	0	0	0	0	0	0	0	0	0											8.0362	0	0	18.3992	0.557278768	3.26344849	0	1.714335009	3.320339027	1.556047173	4.100982858	11.71606773	1.456537889	5.067438654	0.43817201	0.120893265	3.518243144	3.71120678	28.25095357	0.503948984	2.024293576	9.683912813	7.41888169	5.04422532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.8664
H5302_810_0	2009	4																					0											COIN	COIN	COIN	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	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	230.8849467	4.993294284	16.11199386	0	7.240748664	8.844562456	5.567689147	17.36124789	48.43310227	5.17382552	21.22417149	1.832497822	0.499814086	14.26219445	15.62176822	110.955948	2.082144958	8.358371052	39.40343245	29.82557794	20.55613067	0	0	0	0	0	0	0	0	0											Medicare FFS 7.7%	Medicare FFS 7.7%	Medicare FFS 19.5%		Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%																			0.077041062	0.077041062	0.194561696	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.077041062	0.077041062	0.194561696	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											17.7876	0.384688695	3.134776854	0	1.672612941	2.043093927	1.286136193	4.010448263	11.18804662	1.195153695	4.902783614	0.423306997	0.115457054	3.294566918	3.608628459	25.63082398	0.480975485	1.930783713	9.102192895	6.889708504	4.748466186	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.8303	0	0	17.7876	0.384688695	3.134776854	0	1.672612941	2.043093927	1.286136193	4.010448263	11.18804662	1.195153695	4.902783614	0.423306997	0.115457054	3.294566918	3.608628459	25.63082398	0.480975485	1.930783713	9.102192895	6.889708504	4.748466186	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.8303	0	Medicare FFS 7.7%	Medicare FFS 7.7%	Medicare FFS 19.5%		Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%																			0.6116	0.1726	0.1287	0	0.0417	1.2772	0.2699	0.0905	0.528	0.2614	0.1647	0.0149	0.0054	0.2237	0.1026	2.6201	0.023	0.0935	0.5817	0.5292	0.2958	0	0	0	0	0	0	0	0	0											8.0362	0	0	18.3992	0.557278768	3.26344849	0	1.714335009	3.320339027	1.556047173	4.100982858	11.71606773	1.456537889	5.067438654	0.43817201	0.120893265	3.518243144	3.71120678	28.25095357	0.503948984	2.024293576	9.683912813	7.41888169	5.04422532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.8664
H5302_811_0	2009	4																					0											COIN	COIN	COIN	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	COIN	COIN	COIN	V	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	230.8849467	4.993294284	16.11199386	0	7.240748664	8.844562456	5.567689147	17.36124789	48.43310227	5.17382552	21.22417149	1.832497822	0.499814086	14.26219445	15.62176822	110.955948	2.082144958	8.358371052	39.40343245	29.82557794	20.55613067	0	0	0	0	0	0	0	0	0											Medicare FFS 7.7%	Medicare FFS 7.7%	Medicare FFS 19.5%		Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%																			0.077041062	0.077041062	0.194561696	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.077041062	0.077041062	0.194561696	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											17.7876	0.384688695	3.134776854	0	1.672612941	2.043093927	1.286136193	4.010448263	11.18804662	1.195153695	4.902783614	0.423306997	0.115457054	3.294566918	3.608628459	25.63082398	0.480975485	1.930783713	9.102192895	6.889708504	4.748466186	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.8303	0	0	17.7876	0.384688695	3.134776854	0	1.672612941	2.043093927	1.286136193	4.010448263	11.18804662	1.195153695	4.902783614	0.423306997	0.115457054	3.294566918	3.608628459	25.63082398	0.480975485	1.930783713	9.102192895	6.889708504	4.748466186	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.8303	0	Medicare FFS 7.7%	Medicare FFS 7.7%	Medicare FFS 19.5%		Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%																			0.6116	0.1726	0.1287	0	0.0417	1.2772	0.2699	0.0905	0.528	0.2614	0.1647	0.0149	0.0054	0.2237	0.1026	2.6201	0.023	0.0935	0.5817	0.5292	0.2958	0	0	0	0	0	0	0	0	0											8.0362	0	0	18.3992	0.557278768	3.26344849	0	1.714335009	3.320339027	1.556047173	4.100982858	11.71606773	1.456537889	5.067438654	0.43817201	0.120893265	3.518243144	3.71120678	28.25095357	0.503948984	2.024293576	9.683912813	7.41888169	5.04422532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.8664
H5304_002_0	2009	6	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Ambulatory Surgical Center	Urgent Care	Radiology	Chiropractic	Podiatric	Vision Exam Diagnostic	Hearing Exam Diagnostic	Radiation-Chemotherapy	Radiology	Diabetes Supplies	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	Coin	V	V	0	Coin	0	0	0	V	V	V	0	0	0	V	V	V	V	V	V	V	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	0	0	0	0	0	0	0	0	0		1431.687762	41.72930722	555.4540048	60.63330427	121.5116906	11.88443332	0.484274427	516.9434421	479.9850659	5137.377686	542.4156386	165.7571737	0.362144318	1288.804915	2987.632135	2447.193491	0.385459907	1478.400405	223.3024439	0	49.64698754	0	0	0	465.3336841	351.2071332	190.2861391	0	0	0	102.3135951	22.43317886	1001.96086	1870.972866	280.4229052	746.4873094	0.588196969	20.45393602	2060.274257	2.046308153	$200/day (days 1-5); $1000 yrly max	$200/day (days 1-5); $1000 yrly max	$125/day (for days 21-100)	$0 copay	$100 copay	30% coinsurance	30% coinsurance	$50 copay	$175 copay	$15 copay	$100 copay/Higher Tier	$175 copay	20% coinsurance	$25 copay	$15 copay	$25 copay	50% coinsurance	$25 copay	$100 copay/Higher Tier	0	20% coinsurance	0	0	0	$25 copay	Covd up to $50/ Every 2 yrs.	$25 copay	0	0	0	$100 copay	$25 copay	$15 copay/Lower Tier	$25 copay	$25 copay	$25 copay	$25 copay	20% coinsurance	$15 copay/Lower Tier	20% coinsurance	200	200	125	0	100	0.3	0.3	50	175	15	100	175	0.2	25	15	25	0.5	25	100	0	0.2	0	0	0	25	0	25	0	0	0	100	25	15	25	25	25	25	0.2	15	0.2	93.05439977	47.34829788	117.1778612	0	93.74228897	0.281226867	0.281226867	46.87114449	164.0490057	14.06134335	93.74228897	164.0490057	0.187484578	23.43557224	14.06134335	23.43557224	0.468711445	23.43557224	93.74228897	0	0.187484578	0	0	0	23.43557224	0	23.43557224	0	0	0	93.74228897	23.43557224	14.06134335	23.43557224	23.43557224	23.43557224	23.43557224	0.187484578	14.06134335	0.187484578	11.1021	0.164650972	5.423909357	0	0.949232001	3.342221948	0.13619098	2.019144231	6.561756067	6.019869295	4.237273629	2.266024962	0.067896475	2.516990058	3.500843436	4.779281655	0.18066947	2.887263291	1.744406852	0	9.308044505	0	0	0	0.908780098	0	0.371622047	0	0	0	0.799259216	0.043811199	1.174076306	3.653943313	0.547655938	1.457863106	0.001148728	3.834797563	2.41418531	0.38365122	82.7985		5.5272	11.1021	0.164650972	5.423909357	0	0.949232001	3.342221948	0.13619098	2.019144231	6.561756067	6.019869295	4.237273629	2.266024962	0.067896475	2.516990058	3.500843436	4.779281655	0.18066947	2.887263291	1.744406852	0	9.308044505	0	0	0	0.908780098	0	0.371622047	0	0	0	0.799259216	0.043811199	1.174076306	3.653943313	0.547655938	1.457863106	0.001148728	3.834797563	2.41418531	0.38365122	82.7985	4000																																																																																	0		0	11.1021	0.164650972	5.423909357	0	0.949232001	3.342221948	0.13619098	2.019144231	6.561756067	6.019869295	4.237273629	2.266024962	0.067896475	2.516990058	3.500843436	4.779281655	0.18066947	2.887263291	1.744406852	0	9.308044505	0	0	0	0.908780098	0	0.371622047	0	0	0	0.799259216	0.043811199	1.174076306	3.653943313	0.547655938	1.457863106	0.001148728	3.834797563	2.41418531	0.38365122	82.7985
H5304_005_0	2009	6	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Ambulatory Surgical Center	Urgent Care	Radiology	Chiropractic	Podiatric	Vision Exam Diagnostic	Hearing Exam Diagnostic	Radiation-Chemotherapy	Radiology	Diabetes Supplies	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	Coin	V	V	0	Coin	0	0	0	V	V	V	0	0	0	V	V	V	V	V	V	V	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	0	0	0	0	0	0	0	0	0		1431.687762	41.72930722	555.4540048	60.63330427	121.5116906	11.88443332	0.484274427	516.9434421	479.9850659	5137.377686	542.4156386	165.7571737	0.362144318	1288.804915	2987.632135	2447.193491	0.385459907	1478.400405	223.3024439	0	49.64698754	0	0	0	465.3336841	351.2071332	190.2861391	0	0	0	102.3135951	22.43317886	1001.96086	1870.972866	280.4229052	746.4873094	0.588196969	20.45393602	2060.274257	2.046308153	$250/day (days 1-5)	$250/day (days 1-5)	$125/day (for days 21-100)	$0 copay	$150 copay	30% coinsurance	30% coinsurance	$50 copay	$200 copay	$30 copay	$100 copay/Higher Tier	$200 copay	20% coinsurance	$20-$30 copay	$20 copay	$30 copay	50% coinsurance	$30 copay	$100 copay/Higher Tier	0	20% coinsurance	0	0	0	$25 copay	Covd up to $75/ Every 2 yrs.	$25 copay	0	0	0	$100 copay	$30 copay	$30 copay/Lower Tier	$30 copay	$30 copay	$25 copay	$25 copay	20% coinsurance	$30 copay/Lower Tier	20% coinsurance	250	250	125	0	150	0.3	0.3	50	200	30	100	200	0.2	22.1875	20	30	0.5	30	100	0	0.2	0	0	0	25	0	25	0	0	0	100	30	30	30	30	25	25	0.2	30	0.2	116.4540211	59.25458329	117.3148882	0	140.7778658	0.281555732	0.281555732	46.92595526	187.703821	28.15557316	93.85191052	187.703821	0.187703821	20.82339265	18.7703821	28.15557316	0.469259553	28.15557316	93.85191052	0	0.187703821	0	0	0	23.46297763	0	23.46297763	0	0	0	93.85191052	28.15557316	28.15557316	28.15557316	28.15557316	23.46297763	23.46297763	0.187703821	28.15557316	0.187703821	13.8938	0.206054393	5.430252037	0	1.425513039	3.346130318	0.13635024	2.021505403	7.507919242	12.05381777	4.242228665	2.59277124	0.067975872	2.2364409	4.67324973	5.741844615	0.180880744	3.468767563	1.746446749	0	9.318929264	0	0	0	0.909842818	0	0.372056619	0	0	0	0.800193864	0.052634917	2.350898524	4.38985945	0.657955635	1.45956792	0.001150071	3.839281947	4.834016881	0.384099859	100.3425		6.5733	13.8938	0.206054393	5.430252037	0	1.425513039	3.346130318	0.13635024	2.021505403	7.507919242	12.05381777	4.242228665	2.59277124	0.067975872	2.2364409	4.67324973	5.741844615	0.180880744	3.468767563	1.746446749	0	9.318929264	0	0	0	0.909842818	0	0.372056619	0	0	0	0.800193864	0.052634917	2.350898524	4.38985945	0.657955635	1.45956792	0.001150071	3.839281947	4.834016881	0.384099859	100.3425	4500																																																																																	0		0	13.8938	0.206054393	5.430252037	0	1.425513039	3.346130318	0.13635024	2.021505403	7.507919242	12.05381777	4.242228665	2.59277124	0.067975872	2.2364409	4.67324973	5.741844615	0.180880744	3.468767563	1.746446749	0	9.318929264	0	0	0	0.909842818	0	0.372056619	0	0	0	0.800193864	0.052634917	2.350898524	4.38985945	0.657955635	1.45956792	0.001150071	3.839281947	4.834016881	0.384099859	100.3425
H5304_006_0	2009	8	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Ambulatory Surgical Center	Urgent Care	Radiology	Chiropractic	Podiatric	Vision Exam Diagnostic	Hearing Exam Diagnostic	Radiation-Chemotherapy	Radiology	Diabetes Supplies	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	Coin	V	V	0	Coin	0	0	0	V	V	V	0	0	0	V	V	V	V	V	V	V	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	0	0	0	0	0	0	0	0	0		1431.687762	41.72930722	555.4540048	60.63330427	121.5116906	11.88443332	0.484274427	516.9434421	479.9850659	5137.377686	542.4156386	165.7571737	0.362144318	1288.804915	2987.632135	2447.193491	0.385459907	1478.400405	223.3024439	0	49.64698754	0	0	0	465.3336841	351.2071332	190.2861391	0	0	0	102.3135951	22.43317886	1001.96086	1870.972866	280.4229052	746.4873094	0.588196969	20.45393602	2060.274257	2.046308153	$250/day (days 1-5)	$250/day (days 1-5)	$125/day (for days 21-100)	$0 copay	$150 copay	30% coinsurance	30% coinsurance	$50 copay	$200 copay	$30 copay	$100 copay/Higher Tier	$200 copay	20% coinsurance	$20-$30 copay	$20 copay	$30 copay	50% coinsurance	$30 copay	$100 copay/Higher Tier	0	20% coinsurance	0	0	0	$25 copay	Covd up to $75/ Every 2 yrs.	$25 copay	0	0	0	$100 copay	$30 copay	$30 copay/Lower Tier	$30 copay	$30 copay	$25 copay	$25 copay	20% coinsurance	$30 copay/Lower Tier	20% coinsurance	250	250	125	0	150	0.3	0.3	50	200	30	100	200	0.2	22.1875	20	30	0.5	30	100	0	0.2	0	0	0	25	0	25	0	0	0	100	30	30	30	30	25	25	0.2	30	0.2	116.4540211	59.25458329	117.3148882	0	140.7778658	0.281555732	0.281555732	46.92595526	187.703821	28.15557316	93.85191052	187.703821	0.187703821	20.82339265	18.7703821	28.15557316	0.469259553	28.15557316	93.85191052	0	0.187703821	0	0	0	23.46297763	0	23.46297763	0	0	0	93.85191052	28.15557316	28.15557316	28.15557316	28.15557316	23.46297763	23.46297763	0.187703821	28.15557316	0.187703821	13.8938	0.206054393	5.430252037	0	1.425513039	3.346130318	0.13635024	2.021505403	7.507919242	12.05381777	4.242228665	2.59277124	0.067975872	2.2364409	4.67324973	5.741844615	0.180880744	3.468767563	1.746446749	0	9.318929264	0	0	0	0.909842818	0	0.372056619	0	0	0	0.800193864	0.052634917	2.350898524	4.38985945	0.657955635	1.45956792	0.001150071	3.839281947	4.834016881	0.384099859	100.3425		6.5733	13.8938	0.206054393	5.430252037	0	1.425513039	3.346130318	0.13635024	2.021505403	7.507919242	12.05381777	4.242228665	2.59277124	0.067975872	2.2364409	4.67324973	5.741844615	0.180880744	3.468767563	1.746446749	0	9.318929264	0	0	0	0.909842818	0	0.372056619	0	0	0	0.800193864	0.052634917	2.350898524	4.38985945	0.657955635	1.45956792	0.001150071	3.839281947	4.834016881	0.384099859	100.3425	4500																																																																																	0		0	13.8938	0.206054393	5.430252037	0	1.425513039	3.346130318	0.13635024	2.021505403	7.507919242	12.05381777	4.242228665	2.59277124	0.067975872	2.2364409	4.67324973	5.741844615	0.180880744	3.468767563	1.746446749	0	9.318929264	0	0	0	0.909842818	0	0.372056619	0	0	0	0.800193864	0.052634917	2.350898524	4.38985945	0.657955635	1.45956792	0.001150071	3.839281947	4.834016881	0.384099859	100.3425
H5304_007_0	2009	10	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Ambulatory Surgical Center	Urgent Care	Radiology	Chiropractic	Podiatric	Vision Exam Diagnostic	Hearing Exam Diagnostic	Radiation-Chemotherapy	Radiology	Diabetes Supplies	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	Coin	V	V	0	Coin	0	0	0	V	V	V	0	0	0	V	V	V	V	V	V	V	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	0	0	0	0	0	0	0	0	0		1286.660946	64.62302239	373.502993	33.14001148	100.3991711	12.31961076	0.434917	303.2311051	277.9995054	4162.91267	305.4906513	86.6159391	0.252443547	646.1549057	3083.376796	2360.020727	0.361830723	875.8001216	223.6197593	0	34.89647041	0	0	0	457.8133097	364.7200047	197.6074942	0	0	0	65.90343192	11.97559506	582.4357018	901.7849034	200.5723877	667.6959132	0.602545663	12.32775592	1937.410262	1.749417115	$275/day (days 1-5); $1375 yrly max	$275/day (days 1-5); $1375 yrly max	$125/day (for days 21-100)	$0 copay	$150 copay	30% coinsurance	30% coinsurance	$50 copay	$200 copay	$20 copay	$100 copay/Higher Tier	$200 copay	20% coinsurance	$30 copay	$20 copay	$30 copay	50% coinsurance	$30 copay	$100 copay/Higher Tier	0	20% coinsurance	0	0	0	$30 copay	Covd up to $50/ Every 2 yrs.	$30 copay	0	0	0	$100 copay	$30 copay	$30 copay/Lower Tier	$30 copay	$30 copay	$30 copay	$30 copay	20% coinsurance	$30 copay/Lower Tier	20% coinsurance	275	275	125	0	150	0.3	0.3	50	200	20	100	200	0.2	30	20	30	0.5	30	100	0	0.2	0	0	0	30	0	30	0	0	0	100	30	30	30	30	30	30	0.2	30	0.2	125.8265237	70.6306473	119.7650106	0	143.7180128	0.287436026	0.287436026	47.90600426	191.624017	19.1624017	95.81200851	191.624017	0.191624017	28.74360255	19.1624017	28.74360255	0.479060043	28.74360255	95.81200851	0	0.191624017	0	0	0	28.74360255	0	28.74360255	0	0	0	95.81200851	28.74360255	28.74360255	28.74360255	28.74360255	28.74360255	28.74360255	0.191624017	28.74360255	0.191624017	13.4913	0.380363825	3.727715828	0	1.20243078	3.541099952	0.125010814	1.210549217	4.43928183	6.647617069	2.439139407	1.383141182	0.048374247	1.547734983	4.923742063	5.652958149	0.173338642	2.097804218	1.785454857	0	6.687001841	0	0	0	1.096600318	0	0.473329273	0	0	0	0.526195015	0.028685145	1.39510836	2.160045571	0.480431083	1.599332163	0.001443278	2.36229411	4.640679213	0.335230335	76.6035		3.3484	13.4913	0.380363825	3.727715828	0	1.20243078	3.541099952	0.125010814	1.210549217	4.43928183	6.647617069	2.439139407	1.383141182	0.048374247	1.547734983	4.923742063	5.652958149	0.173338642	2.097804218	1.785454857	0	6.687001841	0	0	0	1.096600318	0	0.473329273	0	0	0	0.526195015	0.028685145	1.39510836	2.160045571	0.480431083	1.599332163	0.001443278	2.36229411	4.640679213	0.335230335	76.6035	4000																																																																																	0		0	13.4913	0.380363825	3.727715828	0	1.20243078	3.541099952	0.125010814	1.210549217	4.43928183	6.647617069	2.439139407	1.383141182	0.048374247	1.547734983	4.923742063	5.652958149	0.173338642	2.097804218	1.785454857	0	6.687001841	0	0	0	1.096600318	0	0.473329273	0	0	0	0.526195015	0.028685145	1.39510836	2.160045571	0.480431083	1.599332163	0.001443278	2.36229411	4.640679213	0.335230335	76.6035
H5304_801_0	2009	4																																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	V																																																			0		247.5375914	2.963843184	7.68630221	3.177434419	4.84379798	9.794487796	0	9.842371081	34.07696192	16.65823291	44.99744282	0	0.377462639	44.27925303	30.48692104	82.63182828	0.940089748	3.163692065	20.54537936	27.20596427	52.96602134	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.072782762	0.072782762	0.174509851	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.072782762	0.072782762	0.174509851	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			18.0165	0.215716694	1.341335452	0	1.118917333	2.262526681	0	2.27358772	7.871778203	3.848051802	10.39440929	0	0.08719387	10.22850745	7.042478761	19.08795233	0.217160732	0.730812867	4.745982632	6.284577747	12.23515093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.0026			18.0165	0.215716694	1.341335452	0	1.118917333	2.262526681	0	2.27358772	7.871778203	3.848051802	10.39440929	0	0.08719387	10.22850745	7.042478761	19.08795233	0.217160732	0.730812867	4.745982632	6.284577747	12.23515093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.0026																																																																																		0			18.0165	0.215716694	1.341335452	0	1.118917333	2.262526681	0	2.27358772	7.871778203	3.848051802	10.39440929	0	0.08719387	10.22850745	7.042478761	19.08795233	0.217160732	0.730812867	4.745982632	6.284577747	12.23515093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	108.0026
H5304_802_0	2009	4																																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	V																																																			0		234.5045507	2.807794607	11.68541654	4.364894315	4.94897249	11.84145273	0	12.35888197	37.39736568	21.70078349	58.61844827	0	0.491722924	57.68285796	19.36353106	52.48296379	0.5970907	2.009394438	13.04923809	17.27965685	34.21826236	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.072782762	0.072782762	0.174509851	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.072782762	0.072782762	0.174509851	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			17.0679	0.204359047	2.039220297	0	1.143212645	2.735375581	0	2.854901735	8.638791472	5.012880985	13.54086155	0	0.113587995	13.32474019	4.472975674	12.12356464	0.137927952	0.464170115	3.014373998	3.991600733	7.904418605	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7849			17.0679	0.204359047	2.039220297	0	1.143212645	2.735375581	0	2.854901735	8.638791472	5.012880985	13.54086155	0	0.113587995	13.32474019	4.472975674	12.12356464	0.137927952	0.464170115	3.014373998	3.991600733	7.904418605	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7849																																																																																		0			17.0679	0.204359047	2.039220297	0	1.143212645	2.735375581	0	2.854901735	8.638791472	5.012880985	13.54086155	0	0.113587995	13.32474019	4.472975674	12.12356464	0.137927952	0.464170115	3.014373998	3.991600733	7.904418605	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7849
H5304_804_0	2009	4																																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	V																																																			0		234.5045507	2.807794607	11.68541654	4.364894315	4.94897249	11.84145273	0	12.35888197	37.39736568	21.70078349	58.61844827	0	0.491722924	57.68285796	19.36353106	52.48296379	0.5970907	2.009394438	13.04923809	17.27965685	34.21826236	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.072782762	0.072782762	0.174509851	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.072782762	0.072782762	0.174509851	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			17.0679	0.204359047	2.039220297	0	1.143212645	2.735375581	0	2.854901735	8.638791472	5.012880985	13.54086155	0	0.113587995	13.32474019	4.472975674	12.12356464	0.137927952	0.464170115	3.014373998	3.991600733	7.904418605	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7849			17.0679	0.204359047	2.039220297	0	1.143212645	2.735375581	0	2.854901735	8.638791472	5.012880985	13.54086155	0	0.113587995	13.32474019	4.472975674	12.12356464	0.137927952	0.464170115	3.014373998	3.991600733	7.904418605	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7849																																																																																		0			17.0679	0.204359047	2.039220297	0	1.143212645	2.735375581	0	2.854901735	8.638791472	5.012880985	13.54086155	0	0.113587995	13.32474019	4.472975674	12.12356464	0.137927952	0.464170115	3.014373998	3.991600733	7.904418605	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.7849
H5378_001_0	2009	2																					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																																																			0		316.473544	8.897823935	814.7460048	4952.805605	217.1204632	12.21687968	8.43208733	243.9323511	336.9046731		5330.28383	42.32831697	20.40091835	55.22955909	3070.96834	4212.728646	378.3815099	317.419374			22.4652056	1120.55121					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	27.17592185	100	0.2	0.2	48.55335081	47.5		11.06536625	50	50	15.31242781	10	24.51849726	50.94739451	15			0.2	15					15														140.2100331	120.4826089	49.32354706	20.62517867	75.89504702	0.151790094	0.151790094	36.84958843	36.05014734		8.398064922	37.94752351	37.94752351	11.62137429	7.589504702	18.60832502	38.66654902	11.38425705			0.151790094	11.38425705					11.38425705														3.6977	0.089336087	3.348846909	8.512708376	1.373197314	1.854401316	1.279907329	0.749067229	1.012121925	0	3.730339138	0.133854567	0.064513694	0.053486948	1.942260722	6.532651989	1.2192256	0.301131979	0	0	3.40999567	1.063053585	0	0	0	0	0.20635201	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5742	0	12.8867	3.6977	0.089336087	3.348846909	8.512708376	1.373197314	1.854401316	1.279907329	0.749067229	1.012121925	0	3.730339138	0.133854567	0.064513694	0.053486948	1.942260722	6.532651989	1.2192256	0.301131979	0	0	3.40999567	1.063053585	0	0	0	0	0.20635201	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5742		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										5.9768	0.1461	1.6621	4.4677	0.3757	0.811	0.5598	0.2612	2.2715	1.0222	2.9165	0.2526	0.0219	1.3989	1.8388	2.9538	0.5013	0.1846			1.0557	0.6311					0.1159														29.4255	500	0	9.6745	0.235470173	5.0109705	12.98044775	1.748882438	2.665441841	1.839687298	1.010295927	3.283604278	1.022244713	6.646884975	0.386484674	0.086460756	1.45241333	3.781013805	9.486493784	1.720505225	0.485735919	0	0	4.465707336	1.694107339	0	0	0	0	0.322284246	0	0	0	0	0	0	0	0	0	0	0	0	0	69.9997
H5378_002_0	2009	2																					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																																																			0		287.4828784	8.143867014	937.6844093	5239.847783	133.9788412	14.56830268	9.753930482	269.3197701	390.546138		5157.157733	21.57439727	18.642493	117.853139	3359.867639	4155.282385	323.8937094	303.6958207			31.42793745	1260.850087					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	28.81610513	100	0.2	0.2	48.54574384	47.5		11.33427751	50	50	15.1231747	10	24.46297351	30.9884728	15			0.2	15					15														137.4953843	118.1499087	48.36857897	21.44656493	74.4256201	0.14885124	0.14885124	36.13047088	35.35216955		8.435606319	37.21281005	37.21281005	11.25551655	7.44256201	18.20671973	23.06336304	11.16384302			0.14885124	11.16384302					11.16384302														3.294	0.080183095	3.779538534	9.364727977	0.830954861	2.168509922	1.451884649	0.810887509	1.150554441	0	3.625312697	0.066903662	0.057811629	0.110541496	2.083835271	6.304505149	0.622506517	0.282534372	0	0	4.678087467	1.172994369	0	0	0	0	0.202356766	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1386	0	14.4798	3.294	0.080183095	3.779538534	9.364727977	0.830954861	2.168509922	1.451884649	0.810887509	1.150554441	0	3.625312697	0.066903662	0.057811629	0.110541496	2.083835271	6.304505149	0.622506517	0.282534372	0	0	4.678087467	1.172994369	0	0	0	0	0.202356766	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1386		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										5.4625	0.1329	1.9309	5.0219	0.2388	0.8722	0.5839	0.2826	2.5478	1.0507	2.8533	0.0762	0.0208	1.275	2.0048	2.8975	0.2587	0.1778			1.3335	0.7098					0.116														29.8475	500	0	8.7564	0.213047074	5.710431034	14.38667415	1.069754809	3.040676748	2.035827389	1.093488924	3.69834995	1.050681408	6.478615098	0.143136605	0.078616623	1.38557363	4.088589734	9.202011751	0.881157422	0.46032973	0	0	6.011579299	1.882776116	0	0	0	0	0.318380731	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9861
H5378_003_0	2009	2																					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																																																			0		299.3784278	7.333469629	908.6377573	4928.824302	190.8413893	14.25803476	10.46959643	281.1203634	349.6638254		5039.988611	42.07649225	11.47109354	90.13129621	3136.116409	3919.196817	281.4687854	350.1445263			26.70987185	1238.309836					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	25.1417903	100	0.2	0.2	48.54184243	47.5		10.57582457	50	50	15.15446519	10	24.40824694	39.2324577	15			0.2	15					15														140.7317305	120.9309039	49.50707149	19.15237207	76.17743943	0.152354879	0.152354879	36.97793261	36.18428373		8.056392354	38.08871971	38.08871971	11.54428354	7.617743943	18.59357753	29.8862817	11.42661591			0.152354879	11.42661591					11.42661591														3.511	0.073903593	3.748666201	7.86655641	1.211484031	2.172281159	1.595094096	0.866270821	1.054361256	0	3.383677142	0.13355331	0.036409939	0.086708437	1.990844315	6.072657489	0.701004618	0.333413918	0	0	4.06937929	1.179140906	0	0	0	0	0.20711981	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2935	0	12.6008	3.511	0.073903593	3.748666201	7.86655641	1.211484031	2.172281159	1.595094096	0.866270821	1.054361256	0	3.383677142	0.13355331	0.036409939	0.086708437	1.990844315	6.072657489	0.701004618	0.333413918	0	0	4.06937929	1.179140906	0	0	0	0	0.20711981	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2935		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										5.6736	0.1207	1.7818	4.1388	0.3481	0.8572	0.6294	0.2959	2.3267	1.0245	2.6704	0.1727	0.0124	1.3322	1.8762	2.7645	0.2912	0.2039			1.141	0.6944					0.1162														28.4718	500	0	9.1846	0.194628285	5.530496708	12.00540066	1.559555185	3.02946055	2.224516205	1.162160733	3.381053491	1.024483472	6.054066563	0.306281897	0.048773469	1.418947881	3.867045263	8.837121972	0.992169429	0.53733096	0	0	5.210363563	1.873543574	0	0	0	0	0.32333734	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7653
H5378_004_0	2009	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																																																			0		316.473544	8.897823935	814.7460048	4952.805605	217.1204632	12.21687968	8.43208733	243.9323511	336.9046731		5330.28383	42.32831697	20.40091835	55.22955909	3070.96834	4212.728646	378.3815099	317.419374			22.4652056	1120.55121					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	27.17592185	100	0.2	0.2	48.55335081	47.5		11.06536625	50	50	15.31242781	10	24.51849726	50.94739451	15			0.2	15					15														140.2100331	120.4826089	49.32354706	20.62517867	75.89504702	0.151790094	0.151790094	36.84958843	36.05014734		8.398064922	37.94752351	37.94752351	11.62137429	7.589504702	18.60832502	38.66654902	11.38425705			0.151790094	11.38425705					11.38425705														3.6977	0.089336087	3.348846909	8.512708376	1.373197314	1.854401316	1.279907329	0.749067229	1.012121925	0	3.730339138	0.133854567	0.064513694	0.053486948	1.942260722	6.532651989	1.2192256	0.301131979	0	0	3.40999567	1.063053585	0	0	0	0	0.20635201	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5742	0	12.8867	3.6977	0.089336087	3.348846909	8.512708376	1.373197314	1.854401316	1.279907329	0.749067229	1.012121925	0	3.730339138	0.133854567	0.064513694	0.053486948	1.942260722	6.532651989	1.2192256	0.301131979	0	0	3.40999567	1.063053585	0	0	0	0	0.20635201	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5742		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										5.9768	0.1461	1.6621	4.4677	0.3757	0.811	0.5598	0.2612	2.2715	1.0222	2.9165	0.2526	0.0219	1.3989	1.8388	2.9538	0.5013	0.1846			1.0557	0.6311					0.1159														29.4255	500	0	9.6745	0.235470173	5.0109705	12.98044775	1.748882438	2.665441841	1.839687298	1.010295927	3.283604278	1.022244713	6.646884975	0.386484674	0.086460756	1.45241333	3.781013805	9.486493784	1.720505225	0.485735919	0	0	4.465707336	1.694107339	0	0	0	0	0.322284246	0	0	0	0	0	0	0	0	0	0	0	0	0	69.9997
H5378_005_0	2009	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																																																			0		287.4828784	8.143867014	937.6844093	5239.847783	133.9788412	14.56830268	9.753930482	269.3197701	390.546138		5157.157733	21.57439727	18.642493	117.853139	3359.867639	4155.282385	323.8937094	303.6958207			31.42793745	1260.850087					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	28.81610513	100	0.2	0.2	48.54574384	47.5		11.33427751	50	50	15.1231747	10	24.46297351	30.9884728	15			0.2	15					15														137.4953843	118.1499087	48.36857897	21.44656493	74.4256201	0.14885124	0.14885124	36.13047088	35.35216955		8.435606319	37.21281005	37.21281005	11.25551655	7.44256201	18.20671973	23.06336304	11.16384302			0.14885124	11.16384302					11.16384302														3.294	0.080183095	3.779538534	9.364727977	0.830954861	2.168509922	1.451884649	0.810887509	1.150554441	0	3.625312697	0.066903662	0.057811629	0.110541496	2.083835271	6.304505149	0.622506517	0.282534372	0	0	4.678087467	1.172994369	0	0	0	0	0.202356766	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1386	0	14.4798	3.294	0.080183095	3.779538534	9.364727977	0.830954861	2.168509922	1.451884649	0.810887509	1.150554441	0	3.625312697	0.066903662	0.057811629	0.110541496	2.083835271	6.304505149	0.622506517	0.282534372	0	0	4.678087467	1.172994369	0	0	0	0	0.202356766	0	0	0	0	0	0	0	0	0	0	0	0	0	42.1386		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										5.4625	0.1329	1.9309	5.0219	0.2388	0.8722	0.5839	0.2826	2.5478	1.0507	2.8533	0.0762	0.0208	1.275	2.0048	2.8975	0.2587	0.1778			1.3335	0.7098					0.116														29.8475	500	0	8.7564	0.213047074	5.710431034	14.38667415	1.069754809	3.040676748	2.035827389	1.093488924	3.69834995	1.050681408	6.478615098	0.143136605	0.078616623	1.38557363	4.088589734	9.202011751	0.881157422	0.46032973	0	0	6.011579299	1.882776116	0	0	0	0	0.318380731	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9861
H5378_006_0	2009	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																																																			0		299.3784278	7.333469629	908.6377573	4928.824302	190.8413893	14.25803476	10.46959643	281.1203634	349.6638254		5039.988611	42.07649225	11.47109354	90.13129621	3136.116409	3919.196817	281.4687854	350.1445263			26.70987185	1238.309836					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	25.1417903	100	0.2	0.2	48.54184243	47.5		10.57582457	50	50	15.15446519	10	24.40824694	39.2324577	15			0.2	15					15														140.7317305	120.9309039	49.50707149	19.15237207	76.17743943	0.152354879	0.152354879	36.97793261	36.18428373		8.056392354	38.08871971	38.08871971	11.54428354	7.617743943	18.59357753	29.8862817	11.42661591			0.152354879	11.42661591					11.42661591														3.511	0.073903593	3.748666201	7.86655641	1.211484031	2.172281159	1.595094096	0.866270821	1.054361256	0	3.383677142	0.13355331	0.036409939	0.086708437	1.990844315	6.072657489	0.701004618	0.333413918	0	0	4.06937929	1.179140906	0	0	0	0	0.20711981	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2935	0	12.6008	3.511	0.073903593	3.748666201	7.86655641	1.211484031	2.172281159	1.595094096	0.866270821	1.054361256	0	3.383677142	0.13355331	0.036409939	0.086708437	1.990844315	6.072657489	0.701004618	0.333413918	0	0	4.06937929	1.179140906	0	0	0	0	0.20711981	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2935		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										5.6736	0.1207	1.7818	4.1388	0.3481	0.8572	0.6294	0.2959	2.3267	1.0245	2.6704	0.1727	0.0124	1.3322	1.8762	2.7645	0.2912	0.2039			1.141	0.6944					0.1162														28.4718	500	0	9.1846	0.194628285	5.530496708	12.00540066	1.559555185	3.02946055	2.224516205	1.162160733	3.381053491	1.024483472	6.054066563	0.306281897	0.048773469	1.418947881	3.867045263	8.837121972	0.992169429	0.53733096	0	0	5.210363563	1.873543574	0	0	0	0	0.32333734	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7653
H5378_801_0	2009	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																																																			0		300.4025807	4.923627104	32.38950659		9.036757921	13.75247167	10.09836424	13.52739944	42.30635807	18.39981208	47.90717647	3.140732291	0.557126797	23.82193914	38.66118464	104.8031765	3.314859899	3.570517753			25.76279004	8.939101955																			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																			0.068864903	0.068864903	0.198264156		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.068864903	0.068864903	0.198264156		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			20.6872	0.339065103	6.421678182	0	2.08749108	3.176820956	2.332722139	3.12482927	9.772768714	4.250356591	11.06655776	0.725509159	0.12869629	5.502867942	8.930733652	24.20953377	0.765732637	0.824789601	0	0	5.951204498	2.064932552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.3635	0	0	20.6872	0.339065103	6.421678182	0	2.08749108	3.176820956	2.332722139	3.12482927	9.772768714	4.250356591	11.06655776	0.725509159	0.12869629	5.502867942	8.930733652	24.20953377	0.765732637	0.824789601	0	0	5.951204498	2.064932552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.3635		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																			3.6898	0.0605	1.1454		0.4059	0.6422	0.4715	0.5573	1.7431	0.7675	2.0006	0.1294	0.023	0.9815	1.5817	4.4118	0.1382	0.1491			1.203	0.3751																			20.4765	0	0	24.377	0.399541167	7.567056518	0	2.493382993	3.818992162	2.80426492	3.682177622	11.51585164	5.017866629	13.06712755	0.854911856	0.15172144	6.484371627	10.51239801	28.62137317	0.903886939	0.973905292	0	0	7.15419712	2.439994931	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.84
H5378_802_0	2009	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																																																			0		300.4025807	4.923627104	32.38950659		9.036757921	13.75247167	10.09836424	13.52739944	42.30635807	18.39981208	47.90717647	3.140732291	0.557126797	23.82193914	38.66118464	104.8031765	3.314859899	3.570517753			25.76279004	8.939101955																			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																			0.068864903	0.068864903	0.198264156		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.068864903	0.068864903	0.198264156		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			20.6872	0.339065103	6.421678182	0	2.08749108	3.176820956	2.332722139	3.12482927	9.772768714	4.250356591	11.06655776	0.725509159	0.12869629	5.502867942	8.930733652	24.20953377	0.765732637	0.824789601	0	0	5.951204498	2.064932552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.3635	0	0	20.6872	0.339065103	6.421678182	0	2.08749108	3.176820956	2.332722139	3.12482927	9.772768714	4.250356591	11.06655776	0.725509159	0.12869629	5.502867942	8.930733652	24.20953377	0.765732637	0.824789601	0	0	5.951204498	2.064932552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.3635		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																			3.6898	0.0605	1.1454		0.4059	0.6422	0.4715	0.5573	1.7431	0.7675	2.0006	0.1294	0.023	0.9815	1.5817	4.4118	0.1382	0.1491			1.203	0.3751																			20.4765	0	0	24.377	0.399541167	7.567056518	0	2.493382993	3.818992162	2.80426492	3.682177622	11.51585164	5.017866629	13.06712755	0.854911856	0.15172144	6.484371627	10.51239801	28.62137317	0.903886939	0.973905292	0	0	7.15419712	2.439994931	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.84
H5378_803_0	2009	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																																																			0		300.4025807	4.923627104	32.38950659		9.036757921	13.75247167	10.09836424	13.52739944	42.30635807	18.39981208	47.90717647	3.140732291	0.557126797	23.82193914	38.66118464	104.8031765	3.314859899	3.570517753			25.76279004	8.939101955																			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																			0.068864903	0.068864903	0.198264156		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.068864903	0.068864903	0.198264156		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			20.6872	0.339065103	6.421678182	0	2.08749108	3.176820956	2.332722139	3.12482927	9.772768714	4.250356591	11.06655776	0.725509159	0.12869629	5.502867942	8.930733652	24.20953377	0.765732637	0.824789601	0	0	5.951204498	2.064932552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.3635	0	0	20.6872	0.339065103	6.421678182	0	2.08749108	3.176820956	2.332722139	3.12482927	9.772768714	4.250356591	11.06655776	0.725509159	0.12869629	5.502867942	8.930733652	24.20953377	0.765732637	0.824789601	0	0	5.951204498	2.064932552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.3635		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																			3.6898	0.0605	1.1454		0.4059	0.6422	0.4715	0.5573	1.7431	0.7675	2.0006	0.1294	0.023	0.9815	1.5817	4.4118	0.1382	0.1491			1.203	0.3751																			20.4765	0	0	24.377	0.399541167	7.567056518	0	2.493382993	3.818992162	2.80426492	3.682177622	11.51585164	5.017866629	13.06712755	0.854911856	0.15172144	6.484371627	10.51239801	28.62137317	0.903886939	0.973905292	0	0	7.15419712	2.439994931	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.84
H5402_007_0	2009	6																					3000											D	D	D	V	T	Coin	Coin	V	V	V	P	V	Coin	V	P	V	V	V	P	P	Coin	V	T	V	V	P	V	P	O	V																																																			0		1364.47574	41.28714789	579.299508		97.6472104		0.810762063	230.1798157	563.9250283		218.0010704		0.367604802	185.8833485	1.396718903	3810.893192	192.4060432	983.6441614	4625.230266		29.62251785	976.2503175								280.1612306											"$75/day for days 1-7, $0/day for days 8-90"	"$125/day for days 1-5, $0/day for days 6-90"	"$0/day for days 1-10, $100/day for days 11-100"	No cost sharing	$100/trip	0%-20% coinsurance	0%-20% coinsurance	$50/visit ER; $20/visit Urgently Needed Care	"$50 ambulatory center, $150/visit outpatient hospital"	No cost sharing	$5 x-rays; $100 CT Scan; $150 Nuclear Medicine; $150 MRI; 20% Therapeutic Radiology	No cost sharing	Dialysis: 20% coinsurance	"CORF, PT/OT/ST - $15; OP Substance Abuse - $25; OP Chemo - 20%; OP Cardiac Rehab - $25"	Hep B - 20% Coinsurance	$5/visit Spc; $5/visit Podiatry	$25/visit	$15/visit	$5/procedure	No cost sharing	20% coinsurance	"Blood - 20% Coinsurance; $15 Eye exams, Hearing Screening, Medicare Covered Eyewear"	No cost sharing	No cost sharing	No cost sharing	Not covered	Not covered	No cost sharing	Not covered	Routine Foot Care - $5/visit; Routine Chiro - $5/visit											39.32018277	56.64953196	64.3093881		100		0.2	50	92.01182688		33.49964639		0.2	3.785077529	6.629262245	4.999702517	25	15	5		0.2	13.982789								5											39.32018277	56.64953196	64.3093881		100		0.2	48.91519506	90.01552919		32.77283476		0.19566078	3.72089848	6.485433117	4.891228478	24.45759753	15	4.891519506		0.19566078	13.77407816								4.891519506											4.471	0.194908134	3.104533074	0	0.813726753	0	0.162152413	0.938274215	4.230167487	0	0.595376088	0	0.071925842	0.057637756	0.000754861	1.553329109	0.392149131	1.229555202	1.885367006	0	5.795964956	1.120579015	0	0	0	0	0	0	0	0.114201177	0	0	0	0	0	0	0	0	0	0	26.7316	0	0.3634	4.471	0.194908134	3.104533074	0	0.813726753	0	0.162152413	0.938274215	4.230167487	0	0.595376088	0	0.071925842	0.057637756	0.000754861	1.553329109	0.392149131	1.229555202	1.885367006	0	5.795964956	1.120579015	0	0	0	0	0	0	0	0.114201177	0	0	0	0	0	0	0	0	0	0	26.7316																																																																																		0	0	0	4.471	0.194908134	3.104533074	0	0.813726753	0	0.162152413	0.938274215	4.230167487	0	0.595376088	0	0.071925842	0.057637756	0.000754861	1.553329109	0.392149131	1.229555202	1.885367006	0	5.795964956	1.120579015	0	0	0	0	0	0	0	0.114201177	0	0	0	0	0	0	0	0	0	0	26.7316
H5402_010_0	2009	6																					2500											D	D	D	V	T	Coin	Coin	V	V	V	P	V	Coin	V	P	V	V	V	P	P	Coin	V	T	V	V	P	V	P	O	V																																																			0		1700.292128	32.15809461	960.9587059		338.5459931		0.661129255	273.7214885	167.3638883		329.1370874		0.765445441	181.8840442	4.801491417	5192.353671	180.9789815	1084.489669	5760.737922		35.85023274	1092.742376								246.0879259											"$50/day for days 1-3, $0/day for days 4-90"	"$75/day for days 1-3, $0/day for days 4-90"	"$0/day for days 1-14, $75/day for days 15-100"	No cost sharing	$100/trip	0%-20% coinsurance	0%-20% coinsurance	$50/visit ER; $20/visit Urgently Needed Care	"$0 ambulatory center, $150/visit outpatient hospital"	No cost sharing	"$5 x-rays; $100 CT Scan, Nuclear Medicine, MRI; 20% Therapeutic Radiology"	No cost sharing	Dialysis: 20% coinsurance	"CORF, PT/OT/ST - $15; OP Substance Abuse - $25; OP Chemo - 20%; OP Cardiac Rehab - $25"	Hep B - 20% Coinsurance	$5/visit Spc; $5/visit Podiatry	$25/visit	$15/visit	$5/procedure	No cost sharing	20% coinsurance	"Blood - 20% Coinsurance; $10 Eye exams, Hearing Screening, Medicare Covered Eyewear"	No cost sharing	No cost sharing	No cost sharing	Not covered	Not covered	No cost sharing	Not covered	Routine Foot Care - $5/visit; Routine Chiro - $5/visit											14.86513693	22.96383711	40.60215631		100		0.2	47.58208813	150		51.07360837		0.2	18.26223733	6.662837647	4.999151653	25	15	5		0.2	10.33138209								5											14.86513693	22.96383711	40.60215631		100		0.2	47.06117043	148.3578347		50.62446158		0.2	18.26223733	6.58989444	4.944422096	24.72630578	15	4.945261155		0.2	10.22401427								4.945261155											2.1063	0.061539437	3.251416298	0	2.821216609	0	0.132225851	1.073471135	2.069145339	0	1.38853232	0	0.153089088	0.276800798	0.002636777	2.139432352	0.372911803	1.355612086	2.374029456	0	7.170046548	0.931017804	0	0	0	0	0	0	0	0.101414088	0	0	0	0	0	0	0	0	0	0	27.7808	0	0.1121	2.1063	0.061539437	3.251416298	0	2.821216609	0	0.132225851	1.073471135	2.069145339	0	1.38853232	0	0.153089088	0.276800798	0.002636777	2.139432352	0.372911803	1.355612086	2.374029456	0	7.170046548	0.931017804	0	0	0	0	0	0	0	0.101414088	0	0	0	0	0	0	0	0	0	0	27.7808																																																																																		0	0	0	2.1063	0.061539437	3.251416298	0	2.821216609	0	0.132225851	1.073471135	2.069145339	0	1.38853232	0	0.153089088	0.276800798	0.002636777	2.139432352	0.372911803	1.355612086	2.374029456	0	7.170046548	0.931017804	0	0	0	0	0	0	0	0.101414088	0	0	0	0	0	0	0	0	0	0	27.7808
H5402_032_0	2009	6																																D	D	D	V	T	Coin	Coin	V	V	V	P	V	Coin	V	P	V	V	V	P	P	Coin	V	T	V	V	P	V	P	O	V																																																			0		1625.929455				140.8227854			167.7096622	412.0341035		281.7628323		0.669540002	43.20304635							44.24545719																				"$25/day for days 1-5, $0/day for days 6-90"	No cost sharing	No cost sharing	No cost sharing	$100/trip	0%-20% coinsurance	0%-20% coinsurance	$50/visit ER	"$25 ambulatory center, $150/visit outpatient hospital"	No cost sharing	20% Therapeutic Radiology	No cost sharing	Dialysis: 20% coinsurance	OP Chemo - 20%	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	20% coinsurance	Blood - 20% Coinsurance	No cost sharing	No cost sharing	No cost sharing	Not covered	Not covered	No cost sharing	Not covered	No cost sharing											10.7080499				100			50	75.74827028		47.11576892		0.2	21.47625942							0.2																				10.7080499				100			50	75.74827028		47.11576892		0.2	21.47625942							0.2																				1.4509	0	0	0	1.173523212	0	0	0.698790259	2.600905886	0	1.106289375	0	0.133908	0.077319986	0	0	0	0	0	0	8.849091438	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.0907	0	0	1.4509	0	0	0	1.173523212	0	0	0.698790259	2.600905886	0	1.106289375	0	0.133908	0.077319986	0	0	0	0	0	0	8.849091438	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.0907																																																																																		0	0	0	1.4509	0	0	0	1.173523212	0	0	0.698790259	2.600905886	0	1.106289375	0	0.133908	0.077319986	0	0	0	0	0	0	8.849091438	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.0907
H5402_034_0	2009	6																					3000											D	D	D	V	T	Coin	Coin	V	V	V	P	V	Coin	V	P	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	O	V																																																			0		1596.292087	144.0267858	496.5721305		138.2558741	31.06248855	4.881203114	205.8158226	396.0547425	3011.583183	886.9815071		0.581886846	42.41554319	0.879472475	0.274835149			54.37847057		46.04242356																				"$50/day for days 1-7, $0/day for days 8-90; 60 lifetime reserve days at $476/day"	"$25/day for days 1-7, $0/day for days 8-90; 60 lifetime reserve days at $476/day"	"$0/day for days 1-10, $25/day for days 11-100"	No cost sharing	$100/trip	0%-20% coinsurance	0%-20% coinsurance	$50/visit ER; $25/visit Urgently Needed Care	"$50 ambulatory center, 20% coinsurance outpatient hospital"	No cost sharing	"0% - 10% Lab, Diagnostic tests; 0% - 20% x-rays, Radiology services"	No cost sharing	Dialysis: 20% coinsurance	PT/OT/ST - $15; OP Chemo - 20%; OP Cardiac Rehab - $25	Hep B - 20% Coinsurance	No cost sharing	No cost sharing	$15/visit	0% - 20%	No cost sharing	20% coinsurance	Blood - 20% Coinsurance	Not covered	No cost sharing	No cost sharing	Not covered	Not covered	No cost sharing	Not covered	No cost sharing											30.97539939	15.92212257	16.07734702		100	0.2	0.2	45	176.3355169	1.305793466	47.08077354		0.2	22.76341772	11.14446734	9.481013495			0.2		0.2																				30.97539939	15.92212257	16.07734702		100	0.2	0.2	43.4851284	170.399391	1.261835478	45.49585517		0.193267237	21.99711427	10.76930207	9.161846427			0.193267237		0.2																				4.1205	0.191101011	0.665296872	0	1.152132284	6.21249771	0.976240623	0.745827289	5.623957244	0.316676876	3.362831849	0	0.112459663	0.077751629	0.000789275	0.000209833	0	0	10.50957678	0	9.208484711	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.2763	0	0.7229	4.1205	0.191101011	0.665296872	0	1.152132284	6.21249771	0.976240623	0.745827289	5.623957244	0.316676876	3.362831849	0	0.112459663	0.077751629	0.000789275	0.000209833	0	0	10.50957678	0	9.208484711	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.2763																																																																																		0	0	0	4.1205	0.191101011	0.665296872	0	1.152132284	6.21249771	0.976240623	0.745827289	5.623957244	0.316676876	3.362831849	0	0.112459663	0.077751629	0.000789275	0.000209833	0	0	10.50957678	0	9.208484711	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.2763
H5402_035_0	2009	9																					3000											D	D	D	V	T	Coin	Coin	V	V	V	P	V	Coin	V	P	V	V	V	P	P	Coin	V	T	V	V	P	V	P	O	V																																																			0		2243.910299	93.16221554	707.0804185		181.9535725	30.22973987	5.851192615	310.5256482	538.5685804		781.0429308		0.769207634	497.4554652	0.820841759	7781.480771	499.4433765	956.2611512	6062.528449		43.63200469	1162.517008								142.51											"$75/day for days 1-5, $0/day for days 6-90"	"$125/day for days 1-5, $0/day for days 6-90"	"$0/day for days 1-10, $100/day for days 11-100"	No cost sharing	$100/trip	0%-20% coinsurance	0%-20% coinsurance	$50/visit ER; $20/visit Urgently Needed Care	"$75 ambulatory center, $150/visit outpatient hospital"	No cost sharing	$9 x-rays; $100 CT Scan; $150 Nuclear Medicine; $150 MRI; 20% Therapeutic Radiology	No cost sharing	Dialysis: 20% coinsurance	"CORF, PT/OT/ST - $15; OP Substance Abuse - $25; OP Chemo - 20%; OP Cardiac Rehab - $25"	Hep B - 20% Coinsurance	$5/visit Spc; $5/visit Podiatry	$25/visit	$15/visit	$9/procedure	No cost sharing	20% coinsurance	"Blood - 20% Coinsurance; $15 Eye exams, Hearing Screening, Medicare Covered Eyewear"	No cost sharing	No cost sharing	No cost sharing	Not covered	Not covered	No cost sharing	Not covered	Routine Foot Care - $5/visit; Routine Chiro - $5/visit											32.12414969	56.64953196	64.3093881		100	0.2	0.2	44	100.4985459		68.32562563		0.2	18.24945291	7.865725131	5.000206823	25	15	9		0.2	15.72009347								5											32.12414969	56.64953196	64.3093881		100	0.2	0.2	41.41658552	94.59787772		64.31395721		0.188257207	18.1989528	7.403897217	4.706624853	23.53215086	15	8.471574311		0.188257207	14.88969031								4.706430173											6.007	0.439799659	3.789325754	0	1.516279771	6.045947974	1.170238523	1.071742672	4.245620393	0	4.185996802	0	0.144808881	0.754430711	0.000506452	3.052042566	0.97941474	1.195326439	4.279930022	0	8.214039336	1.442459852	0	0	0	0	0	0	0	0.05589278	0	0	0	0	0	0	0	0	0	0	48.5908	0	1.7187	6.007	0.439799659	3.789325754	0	1.516279771	6.045947974	1.170238523	1.071742672	4.245620393	0	4.185996802	0	0.144808881	0.754430711	0.000506452	3.052042566	0.97941474	1.195326439	4.279930022	0	8.214039336	1.442459852	0	0	0	0	0	0	0	0.05589278	0	0	0	0	0	0	0	0	0	0	48.5908																																																																																		0	0	0	6.007	0.439799659	3.789325754	0	1.516279771	6.045947974	1.170238523	1.071742672	4.245620393	0	4.185996802	0	0.144808881	0.754430711	0.000506452	3.052042566	0.97941474	1.195326439	4.279930022	0	8.214039336	1.442459852	0	0	0	0	0	0	0	0.05589278	0	0	0	0	0	0	0	0	0	0	48.5908
H5402_036_0	2009	7																					3350											D	D	D	V	T	Coin	Coin	V	V	V	P	V	Coin	V	P	V	V	V	P	P	Coin	V	T	V	V	P	V	P	O	V																																																			0		1612.4045	112.913993	603.5145547		137.2038656		3.696687026	275.125575	515.8346002		720.0089066		0.399596679	401.2520123	0.957844265	6294.033938	522.8787117	884.1255066	5204.081965		37.5080688	1124.063318								543.3008204											"$75/day for days 1-7, $0/day for days 8-90"	"$125/day for days 1-5, $0/day for days 6-90"	"$0/day for days 1-10, $100/day for days 11-100"	No cost sharing	$100/trip	0%-20% coinsurance	0%-20% coinsurance	$50/visit ER; $20/visit Urgently Needed Care	"$50 ambulatory center, $150/visit outpatient hospital"	No cost sharing	$5 x-rays; $100 CT Scan; $150 Nuclear Medicine; $150 MRI; 20% Therapeutic Radiology	No cost sharing	Dialysis: 20% coinsurance	"CORF, PT/OT/ST - $15; OP Substance Abuse - $25; OP Chemo - 20%; OP Cardiac Rehab - $25"	Hep B - 20% Coinsurance	$5/visit Spc; $5/visit Podiatry	$25/visit	$15/visit	$5/procedure	No cost sharing	20% coinsurance	"Blood - 20% Coinsurance; $15 Eye exams, Hearing Screening, Medicare Covered Eyewear"	No cost sharing	No cost sharing	No cost sharing	Not covered	Not covered	No cost sharing	Not covered	Routine Foot Care - $5/visit; Routine Chiro - $5/visit											39.32018277	56.64953196	64.3093881		100		0.2	44	80.547756		64.9066365		0.2	17.40222015	8.588262547	5.000174175	25	15	5		0.2	15.59626957								5											39.32018277	56.64953196	64.3093881		100		0.2	42.6307305	78.04112906		62.88675746		0.193776048	17.37171657	8.320997867	4.844569949	24.22200597	15	4.844401194		0.193776048	15.15128625								4.844401194											5.2833	0.533043738	3.23430431	0	1.143365547	0	0.739337405	0.977400353	3.354692884	0	3.773252123	0	0.077432265	0.580869686	0.000664185	2.540990639	1.05543094	1.105156883	2.100888407	0	7.26816533	1.419250425	0	0	0	0	0	0	0	0.219330595	0	0	0	0	0	0	0	0	0	0	35.4069	0	0.729	5.2833	0.533043738	3.23430431	0	1.143365547	0	0.739337405	0.977400353	3.354692884	0	3.773252123	0	0.077432265	0.580869686	0.000664185	2.540990639	1.05543094	1.105156883	2.100888407	0	7.26816533	1.419250425	0	0	0	0	0	0	0	0.219330595	0	0	0	0	0	0	0	0	0	0	35.4069																																																																																		0	0	0	5.2833	0.533043738	3.23430431	0	1.143365547	0	0.739337405	0.977400353	3.354692884	0	3.773252123	0	0.077432265	0.580869686	0.000664185	2.540990639	1.05543094	1.105156883	2.100888407	0	7.26816533	1.419250425	0	0	0	0	0	0	0	0.219330595	0	0	0	0	0	0	0	0	0	0	35.4069
H5402_038_0	2009	6																					3350											D	D	D	V	T	Coin	Coin	V	V	V	P	V	Coin	V	P	V	V	V	P	P	Coin	V	T	V	V	P	V	P	O	V																																																			0		1116.257116	33.90030843	642.7588159		88.67511596		0.566925961	241.1599565	507.7000593		439.7480603		0.233697231	628.1968242	0.839526877	3221.110274	205.6768884	658.0341117	3963.319052		16.05263808	829.9417399			151.902748					454.5202953											"$100/day for days 1-5, $0/day for days 6-90"	"$125/day for days 1-5, $0/day for days 6-90"	"$0/day for days 1-10, $100/day for days 11-100"	No cost sharing	$100/trip	0%-20% coinsurance	0%-20% coinsurance	$50/visit ER; $20/visit Urgently Needed Care	"$75 ambulatory center, $150/visit outpatient hospital"	No cost sharing	$5 x-rays; $100 CT Scan; $150 Nuclear Medicine; $150 MRI; 20% Therapeutic Radiology	No cost sharing	Dialysis: 20% coinsurance	"CORF, PT/OT/ST - $15; OP Substance Abuse - $25; OP Chemo - 20%; OP Cardiac Rehab - $25"	Hep B - 20% Coinsurance	$5/visit Spc; $5/visit Podiatry	$25/visit	$15/visit	$5/procedure	No cost sharing	20% coinsurance	"Blood - 20% Coinsurance; $20 Eye exams, Medicare Covered Eyewear; $15 Hearing Screening"	Not covered	No cost sharing	No cost sharing	Not covered	Not covered	No cost sharing	Not covered	Routine Foot Care - $5/visit; Routine Chiro - $5/visit											42.83219959	56.64953196	64.3093881		100		0.2	47.98225472	108.0851017		50.56846707		0.2	27.28519821	7.488310396	4.998529823	25	15	5		0.2	18.2577671								5											42.83219959	56.64953196	64.3093881		100		0.2	47.18843033	106.2969283		49.73185605		0.196691175	26.91891866	7.364422857	4.915833524	24.58639689	15	4.917279378		0.196691175	18.04682475								4.917279378											3.9843	0.160036384	3.444618845	0	0.7389593	0	0.113385192	0.948329984	4.497246402	0	1.82245727	0	0.045966183	1.409198268	0.000515219	1.319536823	0.421404467	0.82254264	1.624062254	0	3.157412247	1.248151095	0	0	0	0	0	0	0	0.186250273	0	0	0	0	0	0	0	0	0	0	25.9444	0	0.2697	3.9843	0.160036384	3.444618845	0	0.7389593	0	0.113385192	0.948329984	4.497246402	0	1.82245727	0	0.045966183	1.409198268	0.000515219	1.319536823	0.421404467	0.82254264	1.624062254	0	3.157412247	1.248151095	0	0	0	0	0	0	0	0.186250273	0	0	0	0	0	0	0	0	0	0	25.9444																																																																																		0	0	0	3.9843	0.160036384	3.444618845	0	0.7389593	0	0.113385192	0.948329984	4.497246402	0	1.82245727	0	0.045966183	1.409198268	0.000515219	1.319536823	0.421404467	0.82254264	1.624062254	0	3.157412247	1.248151095	0	0	0	0	0	0	0	0.186250273	0	0	0	0	0	0	0	0	0	0	25.9444
H5402_039_0	2009	7																					3500											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	P	V	V	V	Coin	P	Coin	V	T	V	V	P	V	P	O	V																																																			0		1143.793508	39.0527803	467.2192407		84.74455303		0.65389946	228.0207844	382.1681666		2.086056654		0.296482275	149.919473	6044.90142	3262.501676	191.7562497	807.7826548	29.74889032		15.21106987	829.798195			77.09399066					271.8253835											"$275/day for days 1-7, $0/day for days 8-90; 60 lifetime reserve days at $476/day"	"$150/day for days 1-5, $0/day for days 6-90; 60 lifetime reserve days at $476/day"	"$0/day for days 1-10, $100/day for days 11-100"	No cost sharing	$100/trip	0%-20% coinsurance	0%-20% coinsurance	$50/visit ER; $25/visit Urgently Needed Care	"$100 ambulatory center, $200/visit outpatient hospital"	No cost sharing	"0% - 20% x-rays, CT Scan, Nuclear Medicine, MRI; 20% Therapeutic Radiology"	No cost sharing	Dialysis: 20% coinsurance	"CORF, PT/OT/ST - $25; OP Substance Abuse - $25; OP Chemo - 20%; OP Cardiac Rehab - $25"	$15/visit PCP; Hep B - 20% Coinsurance	$25/visit Spc; $25/visit Podiatry	$25/visit	$25/visit	0% - 20% Coinsurance	No cost sharing	20% coinsurance	"Blood - 20% Coinsurance; $15 Eye exams, Medicare Covered Eyewear; $20 Hearing Screening"	Not covered	No cost sharing	No cost sharing	Not covered	Not covered	No cost sharing	Not covered	Routine Foot Care - $25/visit; Routine Chiro - $25/visit											148.9359477	102.835	64.3093881		100		0.2	50	130.9881217		0.2		0.2	3.937417028	14.99833642	24.99650272	25	18.53025355	0.2		0.2	14.23693215								25											132.832258	91.71597229	57.35593967		100		0.2	44.59375324	116.8250396		0.178375013		0.178375013	3.617573558	13.37664227	22.29375748	22.29687662	18.53025355	0.178375013		0.178375013	13.14519786								22.29687662											12.6611	0.29848031	2.233149882	0	0.706204609	0	0.130779892	0.847358549	3.720567599	0	0.372100383	0	0.05288503	0.045195393	6.738373654	6.06111843	0.35629712	1.247368117	5.306458697	0	2.713274786	0.908988455	0	0	0	0	0	0	0	0.50507142	0	0	0	0	0	0	0	0	0	0	44.9047	0	5.1551	12.6611	0.29848031	2.233149882	0	0.706204609	0	0.130779892	0.847358549	3.720567599	0	0.372100383	0	0.05288503	0.045195393	6.738373654	6.06111843	0.35629712	1.247368117	5.306458697	0	2.713274786	0.908988455	0	0	0	0	0	0	0	0.50507142	0	0	0	0	0	0	0	0	0	0	44.9047																																																																																		0	0	0	12.6611	0.29848031	2.233149882	0	0.706204609	0	0.130779892	0.847358549	3.720567599	0	0.372100383	0	0.05288503	0.045195393	6.738373654	6.06111843	0.35629712	1.247368117	5.306458697	0	2.713274786	0.908988455	0	0	0	0	0	0	0	0.50507142	0	0	0	0	0	0	0	0	0	0	44.9047
H5402_040_0	2009	7																					3000											D	D	D	V	T	Coin	Coin	V	V	V	P	V	Coin	V	P	V	V	V	P	P	Coin	V	T	V	V	P	V	P	O	V																																																			0		1143.057925	36.73500829	817.3453545		82.8199322		0.540963457	199.8387931	380.7110536		474.3974614		0.38595336	204.4732408	1.038063994	2773.968004	200.2445002	795.530038	3549.001913		20.31636405	722.559274								262.4627143											"$150/day for days 1-5, $0/day for days 6-90"	"$150/day for days 1-5, $0/day for days 6-90"	"$0/day for days 1-10, $75/day for days 11-100"	No cost sharing	$100/trip	0%-20% coinsurance	0%-20% coinsurance	$50/visit ER; $20/visit Urgently Needed Care	"$50 ambulatory center, $150/visit outpatient hospital"	No cost sharing	$5 x-rays; $100 CT Scan; $150 Nuclear Medicine; $150 MRI; 20% Therapeutic Radiology	No cost sharing	Dialysis: 20% coinsurance	"CORF, PT/OT/ST - $15; OP Substance Abuse - $25; OP Chemo - 20%; OP Cardiac Rehab - $25"	Hep B - 20% Coinsurance	$5/visit Spc; $5/visit Podiatry	$25/visit	$15/visit	$5/procedure	No cost sharing	20% coinsurance	"Blood - 20% Coinsurance; $15 Eye exams, Hearing Screening, Medicare Covered Eyewear"	Not covered	No cost sharing	No cost sharing	Not covered	Not covered	No cost sharing	Not covered	Routine Foot Care - $5/visit; Routine Chiro - $5/visit											64.24829939	67.97943836	48.23204107		100		0.2	45.7905857	92.20792442		59.30363885		0.2	17.39933781	7.073757672	4.999759197	25	15	5		0.2	14.61230792								5											64.24829939	67.97943836	48.23204107		100		0.2	45.11903889	90.85563908		58.43391489		0.197066878	17.38500485	6.97001671	4.926434685	24.63335978	15	4.926671957		0.197066878	14.47170534								4.926671957											6.12	0.208102103	3.285186226	0	0.690166102	0	0.108192691	0.751377857	2.88247884	0	2.310075074	0	0.076058624	0.29623069	0.000602944	1.138814349	0.411057902	0.994412548	1.457064017	0	4.003682442	0.871388742	0	0	0	0	0	0	0	0.107755641	0	0	0	0	0	0	0	0	0	0	25.7126	0	0.2043	6.12	0.208102103	3.285186226	0	0.690166102	0	0.108192691	0.751377857	2.88247884	0	2.310075074	0	0.076058624	0.29623069	0.000602944	1.138814349	0.411057902	0.994412548	1.457064017	0	4.003682442	0.871388742	0	0	0	0	0	0	0	0.107755641	0	0	0	0	0	0	0	0	0	0	25.7126																																																																																		0	0	0	6.12	0.208102103	3.285186226	0	0.690166102	0	0.108192691	0.751377857	2.88247884	0	2.310075074	0	0.076058624	0.29623069	0.000602944	1.138814349	0.411057902	0.994412548	1.457064017	0	4.003682442	0.871388742	0	0	0	0	0	0	0	0.107755641	0	0	0	0	0	0	0	0	0	0	25.7126
H5402_041_0	2009	8																					2500											D	D	D	V	T	Coin	Coin	V	V	V	P	V	P	V	P	V	V	V	P	P	Coin	V	T	V	V	P	V	P	O	V																																																			0		1650.682154		617.8416799		140.4610148		0.960186626	225.3255317	528.0802484		179.908337		34.74386635	18.35764633	1.554331674	0.770583808					38.37901208	53.77371859																			"$75/day for days 1-5, $0/day for days 6-90"	No cost sharing	"$0/day for days 1-25, $40/day for days 26-100"	No cost sharing	$100/trip	0%-20% coinsurance	0%-20% coinsurance	$50/visit ER	"$25 ambulatory center, $150/visit outpatient hospital"	No cost sharing	$15/procedure Therapeutic Radiology	No cost sharing	Dialysis: $15/procedure	OP Chemo - $15/procedure	Hep B - 20% Coinsurance	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	20% coinsurance	Blood - 20% Coinsurance	Not covered	No cost sharing	No cost sharing	Not covered	Not covered	No cost sharing	Not covered	No cost sharing											32.12414969		13.81789824		100		0.2	50	63.184695		15		15	15	6.491519533	3.2576673					0.2	27.74598045																			32.12414969		13.81789824		100		0.2	49.91867103	63.08192008		15		15	15	6.480960562	3.252368446					0.2	27.74598045																			4.4189	0	0.711439455	0	1.170508457	0	0.192037325	0.937329258	2.776026335	0	0.224885421	0	0.043429833	0.022947058	0.000839464	0.000208852	0	0	0	0	7.675802416	0.124333712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.2987	0	0.0061	4.4189	0	0.711439455	0	1.170508457	0	0.192037325	0.937329258	2.776026335	0	0.224885421	0	0.043429833	0.022947058	0.000839464	0.000208852	0	0	0	0	7.675802416	0.124333712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.2987																																																																																		0	0	0	4.4189	0	0.711439455	0	1.170508457	0	0.192037325	0.937329258	2.776026335	0	0.224885421	0	0.043429833	0.022947058	0.000839464	0.000208852	0	0	0	0	7.675802416	0.124333712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.2987
H5404_001_0	2009	7																					3350											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1948.458654	49.72537666	1207.415207	1324.532507	373.5932284	2.600240867	2.92026423	300.0604365	90.89639131	1029.656214	313.2628555	0	0.488308657	280.5689427	5971.597917	9011.153021	141.4656535	553.2134417	3346.804379	8424.558942	12.19408047	1429.022457	0	3111.044959	655.8605037	439.0995914	19.07368925	2.206753032	0	0											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$125 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$5 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	Varies	$10 copay	10 copay; and $100 credit covered every 1 year(s)	$10 copay	$250 credit	Varies	Varies											128.5090909	121.8024691	66.2299152	20	100	0.2	0.2	45	149.3294792	36.12576912	71.88242607	0	0.2	33.66964654	3.970984102	15.13763143	25	25	22.58412707	14.41014808	0.2	4.494319372	0	4	10	10	10	0	0	0											62.62857264	121.8024691	54.40407875	0.703483307	100	0.012380687	0.032941348	45	86.49444449	36.12576912	71.88242607	0	0.2	33.66964654	0.158948562	11.32559589	25	25	14.05139366	12.71525878	0.2	4.494319372	0	4	10	10	10	0	0	0											10.1691	0.504722805	5.474026001	0.077648876	3.113276903	0.032192769	0.096197441	1.125226637	0.655169406	3.099760222	1.876507838	0	0.097661731	0.787221428	0.079098075	8.504723133	0.294720112	1.152528004	3.918938821	8.926703922	2.438816094	0.535206943	0	1.037014986	0.54655042	0.365916326	0.015894741	0	0	0	0	0	0	0	0	0	0	0	0	0	54.9248		23.7978	10.1691	0.504722805	5.474026001	0.077648876	3.113276903	0.032192769	0.096197441	1.125226637	0.655169406	3.099760222	1.876507838	0	0.097661731	0.787221428	0.079098075	8.504723133	0.294720112	1.152528004	3.918938821	8.926703922	2.438816094	0.535206943	0	1.037014986	0.54655042	0.365916326	0.015894741	0	0	0	0	0	0	0	0	0	0	0	0	0	54.9248																																																																																		0			10.1691	0.504722805	5.474026001	0.077648876	3.113276903	0.032192769	0.096197441	1.125226637	0.655169406	3.099760222	1.876507838	0	0.097661731	0.787221428	0.079098075	8.504723133	0.294720112	1.152528004	3.918938821	8.926703922	2.438816094	0.535206943	0	1.037014986	0.54655042	0.365916326	0.015894741	0	0	0	0	0	0	0	0	0	0	0	0	0	54.9248
H5404_002_0	2009	7																					3350											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1236.311121	30.41247388	840.5113828	938.3975784	255.5763286	1.872285139	2.110515914	303.5923899	91.96631517	1042.063928	317.1574481	0	0.431177662	283.5397352	4931.284428	8109.490268	139.8414161	549.6702482	2838.88163	7532.266377	10.78977077	1166.314893	0	3111.044959	532.0338791	387.3648558	15.244452	1.918051304	0	0											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$125 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$5 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$50 copay	Varies	20% coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1 year(s)	$10 copay	$250 credit	Varies	Varies											128.5090909	121.8024691	66.2299152	20	100	0.2	0.2	45	149.3154047	34.23136639	71.95706081	0	0.2	33.68769719	4.285672773	15.30552299	25	25	22.62420035	14.92945271	0.2	4.414862825	0	4	10	10	10	0	0	0											40.72257548	121.8024691	51.73771639	1.17829309	100	0.026509929	0.046093138	45	16.86627874	34.23136639	71.95706081	0	0.2	33.68769719	0.549435213	11.56928542	25	25	14.04275198	13.31229561	0.2	4.414862825	0	4	10	10	10	0	0	0											4.1955	0.308692868	3.623844962	0.092142282	2.129802738	0.049634146	0.097280301	1.138471462	0.129260792	2.972606009	1.901809815	0	0.086235532	0.795983395	0.225785109	7.818417297	0.291336284	1.14514635	3.322142553	8.35597972	2.157954154	0.429093355	0	1.037014986	0.443361566	0.322804046	0.01270371	0	0	0	0	0	0	0	0	0	0	0	0	0	43.083		20.3014	4.1955	0.308692868	3.623844962	0.092142282	2.129802738	0.049634146	0.097280301	1.138471462	0.129260792	2.972606009	1.901809815	0	0.086235532	0.795983395	0.225785109	7.818417297	0.291336284	1.14514635	3.322142553	8.35597972	2.157954154	0.429093355	0	1.037014986	0.443361566	0.322804046	0.01270371	0	0	0	0	0	0	0	0	0	0	0	0	0	43.083																																																																																		0			4.1955	0.308692868	3.623844962	0.092142282	2.129802738	0.049634146	0.097280301	1.138471462	0.129260792	2.972606009	1.901809815	0	0.086235532	0.795983395	0.225785109	7.818417297	0.291336284	1.14514635	3.322142553	8.35597972	2.157954154	0.429093355	0	1.037014986	0.443361566	0.322804046	0.01270371	0	0	0	0	0	0	0	0	0	0	0	0	0	43.083
H5404_003_0	2009	8																					3350											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1249.278126	30.73145403	849.3270563	948.2399278	258.2569317	1.891922535	2.132651985	306.7766079	92.93090057	1053.031022	320.4655997	0	0.435677568	286.4972329	4982.375581	8193.509597	141.2902596	555.3651715	2868.294197	7615.253377	10.90293889	1178.547745	0	3111.044959	537.6140974	391.4277182	15.40434289	1.938168716	0	0											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$125 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$5 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$50 copay	Varies	20% coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1 year(s)	$10 copay	$250 credit	Varies	Varies											128.5090909	121.8024691	66.2299152	20	100	0.2	0.2	45	149.3154047	33.93411054	71.95706081	0	0.2	33.68769719	4.283515954	15.30057982	25	25	22.62420035	14.63242051	0.2	4.414862825	0	4	10	10	10	0	0	0											48.35962111	121.8024691	52.66350158	1.165526995	100	0.007141398	0.028910888	45	25.32734395	33.93411054	71.95706081	0	0.2	33.68769719	0.78551275	11.80257662	25	25	14.58993235	13.11936224	0.2	4.414862825	0	4	10	10	10	0	0	0											5.0346	0.311930582	3.727378064	0.092099936	2.152141098	0.013510972	0.061656862	1.150412279	0.196141074	2.977805924	1.921646887	0	0.087135514	0.804286002	0.326143295	8.058710398	0.294354707	1.157010774	3.487351524	8.325605632	2.180587778	0.433593885	0	1.037014986	0.448011748	0.326189765	0.012836952	0	0	0	0	0	0	0	0	0	0	0	0	0	44.6181		19.2039	5.0346	0.311930582	3.727378064	0.092099936	2.152141098	0.013510972	0.061656862	1.150412279	0.196141074	2.977805924	1.921646887	0	0.087135514	0.804286002	0.326143295	8.058710398	0.294354707	1.157010774	3.487351524	8.325605632	2.180587778	0.433593885	0	1.037014986	0.448011748	0.326189765	0.012836952	0	0	0	0	0	0	0	0	0	0	0	0	0	44.6181																																																																																		0			5.0346	0.311930582	3.727378064	0.092099936	2.152141098	0.013510972	0.061656862	1.150412279	0.196141074	2.977805924	1.921646887	0	0.087135514	0.804286002	0.326143295	8.058710398	0.294354707	1.157010774	3.487351524	8.325605632	2.180587778	0.433593885	0	1.037014986	0.448011748	0.326189765	0.012836952	0	0	0	0	0	0	0	0	0	0	0	0	0	44.6181
H5404_004_0	2009	7																					3350											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1606.172889	40.97391254	907.4732019	1124.1524	266.7780758	2.51994788	2.835413747	263.7223134	79.8885947	905.1271854	275.4124657	0	0.410909934	246.4200819	4282.62617	6175.799704	84.77949888	325.0117313	2422.385684	6181.493234	10.27372833	1120.274727	0	3111.044959	512.4336248	358.3435133	14.79446694	1.787840306	0	0											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$125 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$5 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$50 copay	Varies	20% coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1 year(s)	$10 copay	$250 credit	Varies	Varies											128.5090909	121.8024691	66.2299152	20	100	0.2	0.2	45	149.3216827	34.81774424	71.92375274	0	0.2	33.6796334	3.84836764	14.9812613	25	25	22.63139669	13.59391455	0.2	4.453461413	0	4	10	10	10	0	0	0											36.26753271	121.8024691	50.98603096	0.926255655	100	0.007865242	0.029242002	45	80.05814644	34.81774424	71.92375274	0	0.2	33.6796334	0.541604127	11.67449779	25	25	11.21008048	11.35603838	0.2	4.453461413	0	4	10	10	10	0	0	0											4.8543	0.415893643	3.855704731	0.086771043	2.223150632	0.019820001	0.082913174	0.988958675	0.532977734	2.626207237	1.65072484	0	0.082181987	0.691611502	0.193290667	6.008280001	0.176623956	0.677107773	2.262928206	5.849772868	2.054745667	0.415758356	0	1.037014986	0.427028021	0.298619594	0.012328722	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5247		23.0557	4.8543	0.415893643	3.855704731	0.086771043	2.223150632	0.019820001	0.082913174	0.988958675	0.532977734	2.626207237	1.65072484	0	0.082181987	0.691611502	0.193290667	6.008280001	0.176623956	0.677107773	2.262928206	5.849772868	2.054745667	0.415758356	0	1.037014986	0.427028021	0.298619594	0.012328722	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5247																																																																																		0			4.8543	0.415893643	3.855704731	0.086771043	2.223150632	0.019820001	0.082913174	0.988958675	0.532977734	2.626207237	1.65072484	0	0.082181987	0.691611502	0.193290667	6.008280001	0.176623956	0.677107773	2.262928206	5.849772868	2.054745667	0.415758356	0	1.037014986	0.427028021	0.298619594	0.012328722	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5247
H5404_013_0	2009	7																					3350											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1624.952146	40.94998933	1135.152022	1018.967257	441.1140172	2.844953595	3.187109059	219.4406402	66.4744827	752.8672693	228.5178533	0	0.394378003	205.6310547	5210.023429	8184.789059	134.8033276	527.2216415	3341.181765	8792.980834	9.797010935	1208.469035	0	3111.044959	570.7804456	408.4178025	16.40978504	2.029111651	0	0											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$125 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$5 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$50 copay	Varies	20% coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1 year(s)	$10 copay	$250 credit	Varies	Varies											128.5090909	121.8024691	66.2299152	20	100	0.2	0.2	45	149.3659474	36.69392501	71.68968039	0	0.2	33.62333313	4.144499943	15.32439574	25	25	22.55757799	12.81566425	0.2	4.538358932	0	4	10	10	10	0	0	0											52.90847417	121.8024691	54.39270131	0.615231092	100	0.005652905	0.026517243	45	68.51063737	36.69392501	71.68968039	0	0.2	33.62333313	0.131890647	11.31178645	25	25	14.51429377	11.28750929	0.2	4.538358932	0	4	10	10	10	0	0	0											7.1645	0.415650818	5.145332072	0.052241695	3.675950144	0.016082253	0.084513346	0.822902401	0.379517432	2.302137926	1.365197656	0	0.078875601	0.576166788	0.05726278	7.715382163	0.280840266	1.09837842	4.04124114	8.270904407	1.959402187	0.457038853	0	1.037014986	0.475650371	0.340348169	0.013674821	0	0	0	0	0	0	0	0	0	0	0	0	0	47.8262		22.3951	7.1645	0.415650818	5.145332072	0.052241695	3.675950144	0.016082253	0.084513346	0.822902401	0.379517432	2.302137926	1.365197656	0	0.078875601	0.576166788	0.05726278	7.715382163	0.280840266	1.09837842	4.04124114	8.270904407	1.959402187	0.457038853	0	1.037014986	0.475650371	0.340348169	0.013674821	0	0	0	0	0	0	0	0	0	0	0	0	0	47.8262																																																																																		0			7.1645	0.415650818	5.145332072	0.052241695	3.675950144	0.016082253	0.084513346	0.822902401	0.379517432	2.302137926	1.365197656	0	0.078875601	0.576166788	0.05726278	7.715382163	0.280840266	1.09837842	4.04124114	8.270904407	1.959402187	0.457038853	0	1.037014986	0.475650371	0.340348169	0.013674821	0	0	0	0	0	0	0	0	0	0	0	0	0	47.8262
H5404_016_0	2009	7																					3350											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1649.702154	42.06764015	1031.245588	1113.862767	321.3245094	2.226056861	2.499808962	254.966032	77.23608112	874.9813403	266.1381929	0	0.412309767	238.3827664	5064.967718	7640.340857	119.8014932	468.2851151	2870.785889	7200.856743	10.29651497	1213.311178	0	3111.044959	557.2408961	374.50528	16.19583518	1.880986965	0	0											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$125 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$5 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$50 copay	Varies	20% coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1 year(s)	$10 copay	$250 credit	Varies	Varies											128.5090909	121.8024691	66.2299152	20	100	0.2	0.2	45	149.3301376	35.45751041	71.87893852	0	0.2	33.66880468	3.969841125	15.13780229	25	25	22.58086581	13.90063529	0.2	4.494030032	0	4	10	10	10	0	0	0											40.42446788	121.8024691	53.44311311	1.058588357	100	0.007482083	0.028564568	45	81.03908472	35.45751041	71.87893852	0	0.2	33.66880468	1.686548833	12.85451	25	25	13.39429896	12.06941802	0.2	4.494030032	0	4	10	10	10	0	0	0											5.5574	0.426995203	4.592747886	0.09826018	2.677704245	0.016655542	0.071405962	0.95612262	0.52159511	2.585388332	1.594144234	0	0.082461953	0.668838567	0.711859616	8.184403163	0.249586444	0.97559399	3.204347037	7.242512509	2.059302994	0.454388073	0	1.037014986	0.464367413	0.312087733	0.013496529	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7586		21.9772	5.5574	0.426995203	4.592747886	0.09826018	2.677704245	0.016655542	0.071405962	0.95612262	0.52159511	2.585388332	1.594144234	0	0.082461953	0.668838567	0.711859616	8.184403163	0.249586444	0.97559399	3.204347037	7.242512509	2.059302994	0.454388073	0	1.037014986	0.464367413	0.312087733	0.013496529	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7586																																																																																		0			5.5574	0.426995203	4.592747886	0.09826018	2.677704245	0.016655542	0.071405962	0.95612262	0.52159511	2.585388332	1.594144234	0	0.082461953	0.668838567	0.711859616	8.184403163	0.249586444	0.97559399	3.204347037	7.242512509	2.059302994	0.454388073	0	1.037014986	0.464367413	0.312087733	0.013496529	0	0	0	0	0	0	0	0	0	0	0	0	0	44.7586
H5404_022_0	2009	7																					3350											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1722.739676	43.96494587	1067.542325	1171.092184	330.3143619	2.299016249	2.581966541	265.2999682	80.36650885	910.441682	276.9407173	0	0.431695348	248.0375917	5278.615726	7965.441529	125.0490796	489.0150365	2958.419919	7455.427756	10.78145856	1263.477507	0	3111.044959	579.8824157	388.2321475	16.86409982	1.951111969	0	0											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$125 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$5 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$50 copay	Varies	20% coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1 year(s)	$10 copay	$250 credit	Varies	Varies											128.5090909	121.8024691	66.2299152	20	100	0.2	0.2	45	149.3294792	35.50801252	71.88242607	0	0.2	33.66964654	3.967659354	15.1293273	25	25	22.58412707	13.89318001	0.2	4.494319372	0	4	10	10	10	0	0	0											58.6688887	121.8024691	53.97946035	1.015675206	100	0.010384419	0.031163846	45	84.23829018	35.50801252	71.88242607	0	0.2	33.66964654	0.11659413	11.27826208	25	25	13.74300281	12.13903799	0.2	4.494319372	0	4	10	10	10	0	0	0											8.4226	0.446253247	4.802113218	0.099120775	2.752619683	0.023873948	0.080464006	0.994874881	0.564161441	2.693997887	1.658930886	0	0.08633907	0.695944837	0.051287968	7.486361429	0.260518916	1.018781326	3.388131106	7.541810065	2.156291712	0.473205953	0	1.037014986	0.483235346	0.32352679	0.014053417	0	0	0	0	0	0	0	0	0	0	0	0	0	47.5555		21.7965	8.4226	0.446253247	4.802113218	0.099120775	2.752619683	0.023873948	0.080464006	0.994874881	0.564161441	2.693997887	1.658930886	0	0.08633907	0.695944837	0.051287968	7.486361429	0.260518916	1.018781326	3.388131106	7.541810065	2.156291712	0.473205953	0	1.037014986	0.483235346	0.32352679	0.014053417	0	0	0	0	0	0	0	0	0	0	0	0	0	47.5555																																																																																		0			8.4226	0.446253247	4.802113218	0.099120775	2.752619683	0.023873948	0.080464006	0.994874881	0.564161441	2.693997887	1.658930886	0	0.08633907	0.695944837	0.051287968	7.486361429	0.260518916	1.018781326	3.388131106	7.541810065	2.156291712	0.473205953	0	1.037014986	0.483235346	0.32352679	0.014053417	0	0	0	0	0	0	0	0	0	0	0	0	0	47.5555
H5404_025_0	2009	7																					3350											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1278.375015	31.67387869	755.0220205	876.8696876	259.612154	1.951948304	2.198897966	297.3395415	90.07215889	1020.722093	310.5968949	0	0.41717694	277.6288227	4796.690444	7841.739609	131.4848534	515.9743588	2953.33767	6973.808702	10.44269735	1170.265889	0	3111.044959	532.3770035	378.5719558	15.32359155	1.8830298	0	0											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$125 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$5 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$50 copay	Varies	20% coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1 year(s)	$10 copay	$250 credit	Varies	Varies											128.5090909	121.8024691	66.2299152	20	100	0.2	0.2	45	149.3141348	33.28543799	71.96380158	0	0.2	33.68933071	4.270478997	15.24769526	25	25	22.5816518	15.07422611	0.2	4.423968972	0	4	10	10	10	0	0	0											18.89529394	121.8024691	47.76285284	0.759881301	100	0.021421516	0.04147697	45	87.39471857	33.28543799	71.96380158	0	0.2	33.68933071	0.144415502	11.12163177	25	25	13.13942724	13.07488266	0.2	4.423968972	0	4	10	10	10	0	0	0											2.0129	0.321496386	3.005167138	0.055526407	2.163434617	0.041813692	0.091203625	1.115023281	0.655985915	2.83126516	1.862644443	0	0.083435388	0.779427435	0.057726371	7.267745029	0.273926778	1.074946581	3.233763785	7.598477542	2.088539469	0.431434998	0	1.037014986	0.443647503	0.31547663	0.01276966	0	0	0	0	0	0	0	0	0	0	0	0	0	38.8548		23.2384	2.0129	0.321496386	3.005167138	0.055526407	2.163434617	0.041813692	0.091203625	1.115023281	0.655985915	2.83126516	1.862644443	0	0.083435388	0.779427435	0.057726371	7.267745029	0.273926778	1.074946581	3.233763785	7.598477542	2.088539469	0.431434998	0	1.037014986	0.443647503	0.31547663	0.01276966	0	0	0	0	0	0	0	0	0	0	0	0	0	38.8548																																																																																		0			2.0129	0.321496386	3.005167138	0.055526407	2.163434617	0.041813692	0.091203625	1.115023281	0.655985915	2.83126516	1.862644443	0	0.083435388	0.779427435	0.057726371	7.267745029	0.273926778	1.074946581	3.233763785	7.598477542	2.088539469	0.431434998	0	1.037014986	0.443647503	0.31547663	0.01276966	0	0	0	0	0	0	0	0	0	0	0	0	0	38.8548
H5404_028_0	2009	7																					3350											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1578.83859	40.17443978	968.4010828	888.7330631	304.8652027	2.397229426	2.693079036	255.9267711	77.52711487	878.3535195	267.1720061	0	0.411517238	239.2080626	4706.12538	6820.181212	105.8625588	411.5271773	2693.079054	6599.196082	10.28214672	1148.058658	0	3111.044959	526.8588523	363.5665493	15.24621748	1.81810609	0	0											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$125 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$5 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$50 copay	Varies	20% coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1 year(s)	$10 copay	$250 credit	Varies	Varies											128.5090909	121.8024691	66.2299152	20	100	0.2	0.2	45	149.3268828	34.82985526	71.89618438	0	0.2	33.67296909	3.913409678	15.43949381	25	25	22.59352952	12.92600151	0.2	4.473373591	0	4	10	10	10	0	0	0											37.23743559	121.8024691	52.19167955	1.644014611	100	0.058225474	0.073800189	45	79.18552577	34.82985526	71.89618438	0	0.2	33.67296909	0.139186255	11.66527039	25	25	12.49754471	10.86595625	0.2	4.473373591	0	4	10	10	10	0	0	0											4.8993	0.40777883	4.211873249	0.121757512	2.540543356	0.13957982	0.198749742	0.959725391	0.511585446	2.549410496	1.600720651	0	0.082303448	0.671237141	0.054585664	6.62993816	0.220546997	0.857348286	2.804739658	5.975547991	2.056429344	0.427974607	0	1.037014986	0.439049044	0.302972124	0.012705181	0	0	0	0	0	0	0	0	0	0	0	0	0	39.7134		22.6577	4.8993	0.40777883	4.211873249	0.121757512	2.540543356	0.13957982	0.198749742	0.959725391	0.511585446	2.549410496	1.600720651	0	0.082303448	0.671237141	0.054585664	6.62993816	0.220546997	0.857348286	2.804739658	5.975547991	2.056429344	0.427974607	0	1.037014986	0.439049044	0.302972124	0.012705181	0	0	0	0	0	0	0	0	0	0	0	0	0	39.7134																																																																																		0			4.8993	0.40777883	4.211873249	0.121757512	2.540543356	0.13957982	0.198749742	0.959725391	0.511585446	2.549410496	1.600720651	0	0.082303448	0.671237141	0.054585664	6.62993816	0.220546997	0.857348286	2.804739658	5.975547991	2.056429344	0.427974607	0	1.037014986	0.439049044	0.302972124	0.012705181	0	0	0	0	0	0	0	0	0	0	0	0	0	39.7134
H5404_034_0	2009	8																					3350											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1896.530074	48.05402534	1125.286794	1098.037329	525.8700897	3.357839255	3.75866545	391.1157089	118.4794868	1345.552803	419.4382787	0	0.524259966	354.0090203	5113.791061	7589.056079	123.3836202	479.00416	3200.905202	7145.748309	13.60235245	1314.886923	0	3111.044959	522.2985951	359.6208592	17.05222438	2.028964879	0	0											"$25 copay, days 1-7"	"$25 copay, days 1-7"	"$25 copay, days 11-100"	$20 copay	"$50 copay, waived if admitted"	20% coinsurance	20% coinsurance	$25 copay	$0 copay to $25 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$0 copay	$0 copay	"$0 copay Group, $0 copay Individual"	$0 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	Varies	$0 copay	$10 copay; and $100 credit covered every 2 year(s)	$0 copay	$250 credit	Varies	Varies											16.06363636	15.22530864	13.20544116	20	40	0.2	0.2	22.5	16.64388497	34.84787727	72.06488911	0	0.2	1.285795177	0.000979833	0.00181319	0	0	22.31029267	12.88141444	0.2	0	0	4	0	10	0	0	0	0											1.595256942	15.22530864	0.5780359	12.65799814	40	0.149981524	0.155315522	22.5	0.738107646	34.84787727	72.06488911	0	0.2	1.285795177	0	0	0	0	19.79169508	10.51220653	0.2	0	0	4	0	10	0	0	0	0											0.2521	0.060969781	0.05420468	1.158246206	1.752900299	0.503613849	0.583779088	0.733341954	0.007287551	3.907471578	2.518897753	0	0.104851993	0.037931924	0	0	0	0	5.279278314	6.2597985	2.720470491	0	0	1.037014986	0	0.299684049	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.2719		6.7182	0.2521	0.060969781	0.05420468	1.158246206	1.752900299	0.503613849	0.583779088	0.733341954	0.007287551	3.907471578	2.518897753	0	0.104851993	0.037931924	0	0	0	0	5.279278314	6.2597985	2.720470491	0	0	1.037014986	0	0.299684049	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.2719																																																																																		0			0.2521	0.060969781	0.05420468	1.158246206	1.752900299	0.503613849	0.583779088	0.733341954	0.007287551	3.907471578	2.518897753	0	0.104851993	0.037931924	0	0	0	0	5.279278314	6.2597985	2.720470491	0	0	1.037014986	0	0.299684049	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.2719
H5404_037_0	2009	7																					3350											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1889.645498	48.22444343	1170.970041	1284.552219	362.3165216	2.521754021	2.832117655	291.0032767	88.15273356	998.6299928	303.7810636	0	0.473532662	272.0767251	5790.373517	8737.685045	137.172493	536.4246734	3245.236487	8175.787866	11.82600884	1385.888197	0	3111.044959	636.0637139	425.8456109	18.4979604	2.140143401	0	0											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$125 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$5 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$50 copay	Varies	20% coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1 year(s)	$10 copay	$250 credit	Varies	Varies											128.5090909	121.8024691	66.2299152	20	100	0.2	0.2	45	149.3294792	35.66942059	71.88242607	0	0.2	33.66964654	3.968527867	15.13149656	25	25	22.58412707	14.02826423	0.2	4.494319372	0	4	10	10	10	0	0	0											65.76307993	121.8024691	54.97925093	1.5394477	100	0.069394569	0.006178739	45	89.55054665	35.66942059	71.88242607	0	0.2	33.66964654	0.341287314	11.50425601	25	25	14.46503261	12.41689772	0.2	4.494319372	0	4	10	10	10	0	0	0											10.3557	0.489488024	5.36492131	0.164791747	3.019304347	0.174996034	0.017498915	1.091262288	0.65784379	2.968379436	1.819709987	0	0.094706532	0.763393931	0.164681752	8.376713807	0.285776027	1.117551403	3.911870967	8.459826808	2.365201768	0.519052014	0	1.037014986	0.530053095	0.354871342	0.015414967	0	0	0	0	0	0	0	0	0	0	0	0	0	54.1201		21.957	10.3557	0.489488024	5.36492131	0.164791747	3.019304347	0.174996034	0.017498915	1.091262288	0.65784379	2.968379436	1.819709987	0	0.094706532	0.763393931	0.164681752	8.376713807	0.285776027	1.117551403	3.911870967	8.459826808	2.365201768	0.519052014	0	1.037014986	0.530053095	0.354871342	0.015414967	0	0	0	0	0	0	0	0	0	0	0	0	0	54.1201																																																																																		0			10.3557	0.489488024	5.36492131	0.164791747	3.019304347	0.174996034	0.017498915	1.091262288	0.65784379	2.968379436	1.819709987	0	0.094706532	0.763393931	0.164681752	8.376713807	0.285776027	1.117551403	3.911870967	8.459826808	2.365201768	0.519052014	0	1.037014986	0.530053095	0.354871342	0.015414967	0	0	0	0	0	0	0	0	0	0	0	0	0	54.1201
H5404_043_0	2009	7																					3350											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1573.536989	39.6913225	840.2042889	1040.352026	273.7323613	2.129654547	2.398546628	275.3945497	83.42442956	945.2483613	287.4158131	0	0.406754109	257.3924553	5339.681595	8534.50496	143.9220379	566.1492876	3037.642508	7391.427822	10.16214883	1258.05308	0	3111.044959	577.9560931	397.1354468	16.73696243	1.987412061	0	0											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$125 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$5 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$50 copay	Varies	20% coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1 year(s)	$10 copay	$250 credit	Varies	Varies											128.5090909	121.8024691	66.2299152	20	100	0.2	0.2	45	149.3286682	34.04551122	71.88672291	0	0.2	33.67068396	4.188389702	15.29218022	25	25	22.59349956	14.99276486	0.2	4.479819352	0	4	10	10	10	0	0	0											43.19101656	121.8024691	49.58575551	1.181089092	100	0.035836117	0.054239916	45	82.27639385	34.04551122	71.88672291	0	0.2	33.67068396	0.156587391	11.26037791	25	25	13.38603402	13.10077664	0.2	4.479819352	0	4	10	10	10	0	0	0											5.6636	0.40287509	3.471847038	0.102395703	2.281103011	0.076318551	0.130096967	1.032729561	0.571988435	2.681788641	1.721781743	0	0.081350822	0.722215001	0.069677234	8.008479258	0.299837579	1.179477683	3.388498829	8.069453745	2.032429766	0.469654211	0	1.037014986	0.481630078	0.330946206	0.013947469	0	0	0	0	0	0	0	0	0	0	0	0	0	44.3211		23.3075	5.6636	0.40287509	3.471847038	0.102395703	2.281103011	0.076318551	0.130096967	1.032729561	0.571988435	2.681788641	1.721781743	0	0.081350822	0.722215001	0.069677234	8.008479258	0.299837579	1.179477683	3.388498829	8.069453745	2.032429766	0.469654211	0	1.037014986	0.481630078	0.330946206	0.013947469	0	0	0	0	0	0	0	0	0	0	0	0	0	44.3211																																																																																		0			5.6636	0.40287509	3.471847038	0.102395703	2.281103011	0.076318551	0.130096967	1.032729561	0.571988435	2.681788641	1.721781743	0	0.081350822	0.722215001	0.069677234	8.008479258	0.299837579	1.179477683	3.388498829	8.069453745	2.032429766	0.469654211	0	1.037014986	0.481630078	0.330946206	0.013947469	0	0	0	0	0	0	0	0	0	0	0	0	0	44.3211
H5404_053_0	2009	8																					3350											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		2429.674255	63.78040236	665.1759828	1673.533415	491.5332721	3.786819813	4.234343212	269.356772	81.59542403	925.7613073	288.4782688	0	0.585809193	244.7534263	6448.523868	9164.390731	174.6634815	694.7353246	3268.911436	9774.80505	15.11752382	1482.420234	0	3111.044959	594.4783036	322.8610588	20.15057941	1.891187855	0	0											"$25 copay, days 1-7"	"$25 copay, days 1-7"	"$25 copay, days 11-100"	$0 copay	"$50 copay, waived if admitted"	20% coinsurance	20% coinsurance	$25 copay	$0 copay to $25 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$0 copay	$0 copay	"$0 copay Group, $0 copay Individual"	$0 copay	$50 copay	Varies	20% coinsurance	Varies	Not Covered	Varies	$0 copay	$0 copay; and $100 credit covered every 2 year(s)	$0 copay	$250 credit	Varies	Varies											16.06363636	15.22530864	13.20544116	0	40	0.2	0.2	22.5	16.64469121	41.50801465	71.93596827	0	0.2	1.279543768	0.001060428	0.002049151	0	0	22.25425561	12.00888737	0.2	0	0	4	0	0	0	0	0	0											0.940049926	15.22530864	1.233255457	0	40	0.151319883	0.156464834	22.5	0.675999833	41.50801465	71.93596827	0	0.2	1.279543768	0	0	0	0	19.54740467	9.926856204	0.2	0	0	4	0	0	0	0	0	0											0.1903	0.080923026	0.068360993	0	1.63844424	0.57302113	0.662525809	0.505043948	0.004596541	3.202209492	1.729330299	0	0.117161839	0.026097727	0	0	0	0	5.324894557	8.086090346	3.023504763	0	0	1.037014986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2696		7.3737	0.1903	0.080923026	0.068360993	0	1.63844424	0.57302113	0.662525809	0.505043948	0.004596541	3.202209492	1.729330299	0	0.117161839	0.026097727	0	0	0	0	5.324894557	8.086090346	3.023504763	0	0	1.037014986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2696																																																																																		0			0.1903	0.080923026	0.068360993	0	1.63844424	0.57302113	0.662525809	0.505043948	0.004596541	3.202209492	1.729330299	0	0.117161839	0.026097727	0	0	0	0	5.324894557	8.086090346	3.023504763	0	0	1.037014986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.2696
H5404_086_0	2009	10																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		2259.618028	57.43128038	2213.261107	384.8912674	2.128662122	7.222929468	8.111765713	371.5112214	147.3585914	2645.501882	803.5190026	0	1.115798444	719.7144799	6180.073595	9566.403847	159.2904853	626.0272093	3523.956318	9681.955861	4.968317007	1005.393162	0	0	74.65901368	0	12.39626076	1.429482516	0	2.623904114											"$300 copay, days 1-7"	"$300 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$150 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$10 copay	$35 copay	"$35 copay Group, $35 copay Individual"	$35 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	Varies	$10 copay	Not Covered	$10 copay	$250 credit	Varies	Varies											192.7636364	182.7037037	66.2299152	20	120	0.2	0.2	45	149.3250298	35.52564096	71.90302113	0	0.2	43.21119328	7.462283669	21.20872935	35	35	22.6229717	14.33700301	0.2	4.48526968	0	0	10	0	10	0	0	0.007238059											108.0391472	182.7037037	57.25698471	1.424889807	120	0.085437538	0.097990571	45	14.55556792	35.52564096	71.90302113	0	0.2	43.21119328	2.417488567	16.16393425	35	35	11.35186827	12.28582262	0.2	4.48526968	0	0	10	0	10	0	0	0.007238059											20.3439	0.874408969	10.56038811	0.045702304	0.021286621	0.617109307	0.794876556	1.39316708	0.178740666	7.831929168	4.814620318	0	0.223159689	2.591643458	1.245021438	12.88589357	0.464597249	1.825912694	3.333623993	9.912566025	0.993663401	0.375788289	0	0	0.062215845	0	0.010330217	0	0	1.58E-06	0	0	0	0	0	0	0	0	0	0	81.4006		33.0991	20.3439	0.874408969	10.56038811	0.045702304	0.021286621	0.617109307	0.794876556	1.39316708	0.178740666	7.831929168	4.814620318	0	0.223159689	2.591643458	1.245021438	12.88589357	0.464597249	1.825912694	3.333623993	9.912566025	0.993663401	0.375788289	0	0	0.062215845	0	0.010330217	0	0	1.58E-06	0	0	0	0	0	0	0	0	0	0	81.4006	3350																																																																																	0			20.3439	0.874408969	10.56038811	0.045702304	0.021286621	0.617109307	0.794876556	1.39316708	0.178740666	7.831929168	4.814620318	0	0.223159689	2.591643458	1.245021438	12.88589357	0.464597249	1.825912694	3.333623993	9.912566025	0.993663401	0.375788289	0	0	0.062215845	0	0.010330217	0	0	1.58E-06	0	0	0	0	0	0	0	0	0	0	81.4006
H5404_094_0	2009	7																					3350											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1265.740604	31.44425977	640.7796933	628.2005114	202.2253925	1.541262765	1.74161173	279.1631336	84.56603517	958.2791595	291.5500703	0	0.397915546	260.7262567	4611.20074	7331.541696	108.7483177	422.6312668	2751.67004	7624.906124	9.955766228	1188.922453	0	3111.044959	541.4032465	370.494971	15.6892543	1.855373026	0	0											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$125 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$5 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1 year(s)	$10 copay	$250 credit	Varies	Varies											128.5090909	121.8024691	66.2299152	20	100	0.2	0.2	45	149.3177585	33.5650995	71.94456915	0	0.2	33.68467145	4.141748114	14.86393049	25	25	22.59881852	14.57036696	0.2	4.454130542	0	4	10	10	10	0	0	0											37.14683127	121.8024691	47.43941955	0.833240631	100	0.007479189	0.027163428	45	6.937096942	33.5650995	71.94456915	0	0.2	33.68467145	0.310621488	11.03280387	25	25	13.84735642	12.99125663	0.2	4.454130542	0	4	10	10	10	0	0	0											3.9182	0.319165707	2.533184726	0.043620183	1.685211604	0.011527395	0.047308145	1.046861751	0.048886899	2.680394612	1.747953683	0	0.079583109	0.731873191	0.119361503	6.740621798	0.226558995	0.880481806	3.175279649	8.25475935	1.991153246	0.441301317	0	1.037014986	0.451169372	0.308745809	0.013074379	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5333		20.0676	3.9182	0.319165707	2.533184726	0.043620183	1.685211604	0.011527395	0.047308145	1.046861751	0.048886899	2.680394612	1.747953683	0	0.079583109	0.731873191	0.119361503	6.740621798	0.226558995	0.880481806	3.175279649	8.25475935	1.991153246	0.441301317	0	1.037014986	0.451169372	0.308745809	0.013074379	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5333																																																																																		0			3.9182	0.319165707	2.533184726	0.043620183	1.685211604	0.011527395	0.047308145	1.046861751	0.048886899	2.680394612	1.747953683	0	0.079583109	0.731873191	0.119361503	6.740621798	0.226558995	0.880481806	3.175279649	8.25475935	1.991153246	0.441301317	0	1.037014986	0.451169372	0.308745809	0.013074379	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5333
H5404_110_0	2009	7																					3250											Coin	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	V	V	Coin	V	V	V	S	O	T	V	V	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	0	0	0	0	0											0		309.9542958	2.876496171	50.09516012	3385.529706	9.316311281	23740.7958	23843.42062	317.4687817	315.529246	2717.807244	860.9047474	0	116.5995127	697.7107544	16608.59884	30169.79828	2.637647986	1201.19932	6621.633863	17668.47156	216.3042039	1126.02041	0	3111.044959	601.7562829	2.081454757	257.8955498	26.99639005	0	17520.00474											"$0 copay, days 1-1"	"$0 copay, days 1-1"	"$0 copay, days 1-1"	$0 copay	"$0 copay, waived if admitted"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay to 0% coinsurance		$0 copay	Varies	$0 copay	$0 copay	"$0 copay Group, $0 copay Individual"	$0 copay	$0 copay	Varies		Varies	Not Covered	Varies	$0 copay	$0 copay; and $85 credit covered every 2years	$0 copay	$250 credit	Varies	Varies											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	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	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	1.037014986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.037		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.037014986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.037																																																																																		0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.037014986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.037
H5404_111_0	2009	7																					3250											D	D	D	V	Coin	P	P	V	V	V	V	V	V	V	V	V	Coin	V	V	V	S	O	T	V	V	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	0	0	0	0	0											0		1257.273853	27.31649458	1288.431664	2427.258117	5.772313445	18060.61579	18143.72375	226.0824421	261.3373725	2283.738973	718.2322774	0	99.7144309	590.8610406	13053.30372	24057.9292	1.774196201	893.9291836	5404.139786	12933.154	183.9604387	907.221522	0	3111.044959	487.8957709	1.799704663	209.0981875	24.40924755	0	17437.10961											"$100 copay, days 1-5"	"$100 copay, days 1-5"	"$25 copay, days 11-100"	$0 copay	"$0 copay, waived if admitted"	$0 copay	$0 copay	$50 copay	$125 copay	$0 copay	$0 copay to 0% coinsurance		$0 copay	Varies	$0 copay	$0 copay	"$0 copay Group, $0 copay Individual"	$0 copay	$0 copay	Varies		Varies	Not Covered	Varies	$0 copay	$0 copay; and $80 credit covered every 2years	$0 copay	$250 credit	Varies	Varies											56.63636364	48.61728395	36.79455884	0	0	0	0	45	125	0	0	0	0	6.034448209	0.070365198	0.0539483	0	0	0	0	0	0	0	4	0	0	0	0	0	0.002964629											55.94965439	48.61728395	36.710796	0	0	0	0	45	124.5870369	0	0	0	0	6.034448209	0.058732849	0.042315952	0	0	0	0	0	0	0	4	0	0	0	0	0	0.002964629											5.862	0.110671148	3.941612666	0	0	0	0	0.847809158	2.713270738	0	0	0	0	0.297126696	0.063888143	0.084836181	0	0	0	0	0	0	0	1.037014986	0	0	0	0	0	0.00430788	0	0	0	0	0	0	0	0	0	0	14.9625		0.1799	5.862	0.110671148	3.941612666	0	0	0	0	0.847809158	2.713270738	0	0	0	0	0.297126696	0.063888143	0.084836181	0	0	0	0	0	0	0	1.037014986	0	0	0	0	0	0.00430788	0	0	0	0	0	0	0	0	0	0	14.9625																																																																																		0			5.862	0.110671148	3.941612666	0	0	0	0	0.847809158	2.713270738	0	0	0	0	0.297126696	0.063888143	0.084836181	0	0	0	0	0	0	0	1.037014986	0	0	0	0	0	0.00430788	0	0	0	0	0	0	0	0	0	0	14.9625
H5404_112_0	2009	7																					3250											Coin	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	V	V	Coin	V	V	V	S	O	T	V	V	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	0	0	0	0	0											0		416.5339741	4.501486556	75.02808942	9942.20326	12.83514655	31857.70884	62801.23926	577.3758684	460.1155689	4452.251418	954.7044261	0	233.5741879	1515.037371	27462.70092	51700.27851	3.694054224	2157.14896	7220.244631	25761.5561	123.7397032	1934.438824	0	3111.044959	1043.938075	3.509265705	405.421505	39.08006448	0	5812.660232											"$0 copay, days 1-1"	"$0 copay, days 1-1"	"$0 copay, days 1-1"	$0 copay	"$0 copay, waived if admitted"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay to 0% coinsurance		$0 copay	Varies	$0 copay	$0 copay	"$0 copay Group, $0 copay Individual"	$0 copay	$0 copay	Varies		Varies	Not Covered	Varies	$0 copay	$0 copay; and $100 credit covered every 2years	$0 copay	$250 credit	Varies	Varies											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	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	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	1.037014986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.037		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.037014986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.037																																																																																		0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.037014986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.037
H5404_113_0	2009	8																					3250											Coin	Coin	Coin	V	Coin	P	P	V	V	V	V	V	V	V	V	V	Coin	V	V	V	S	O	T	V	V	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	0	0	0	0	0											0		318.4632801	15.94868975	372.8881089	138.4497554	32.93595398	9910.153478	36525.49373	346.3534518	89.03076436	3873.903486	442.5302607	0	465.1543426	1919.327101	11210.90447	9537.740299	8.440196468	120.7123097	6738.885947	15539.27512	164.6583115	517.4718005	0	3111.044959	251.6983503	3.672977851	160.3078779	39.69305	0	5116.538049											"$0 copay, days 1-1"	"$0 copay, days 1-1"	"$0 copay, days 1-1"	$0 copay	"$0 copay, waived if admitted"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay to 0% coinsurance		$0 copay	Varies	$0 copay	$0 copay	"$0 copay Group, $0 copay Individual"	$0 copay	$0 copay	Varies		Varies	Not Covered	Varies	$0 copay	$0 copay; and $100 credit covered every 2years	$0 copay	$250 credit	Varies	Varies											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	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	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	1.037014986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.037		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.037014986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.037																																																																																		0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.037014986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.037
H5404_114_0	2009	7																					3350											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1502.922297	37.95296882	1025.051423	937.0909802	291.7231315	2.498701095	2.809687571	238.8694774	72.360001	819.6105327	249.2081607	0	0.414543828	223.5043692	4718.047574	6834.296903	107.0699312	415.6890686	2805.290598	6896.612034	10.33669807	1131.565497	0	3111.044959	525.2687849	371.4510791	15.13447492	1.849502249	0	0											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$125 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$5 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1 year(s)	$10 copay	$250 credit	Varies	Varies											128.5090909	121.8024691	66.2299152	20	100	0.2	0.2	45	149.3400567	36.53822419	71.82642629	0	0.2	33.65614594	3.936937208	15.54951644	25	25	22.58705689	14.46121552	0.2	4.492220838	0	4	10	10	10	0	0	0											20.85575886	121.8024691	45.1845199	1.912204786	100	0.04582981	0.06289393	45	64.16035162	36.53822419	71.82642629	0	0.2	33.65614594	0.202178008	11.81475724	25	25	11.60137942	11.78007143	0.2	4.492220838	0	4	10	10	10	0	0	0											2.612	0.385230443	3.859704703	0.149325821	2.431026096	0.114514997	0.176712293	0.89576054	0.386886926	2.495592783	1.491644299	0	0.082908766	0.626857972	0.079490455	6.728796568	0.223062357	0.866018893	2.712103385	6.770215198	2.067339613	0.423603509	0	1.037014986	0.437723987	0.309542566	0.012612062	0	0	0	0	0	0	0	0	0	0	0	0	0	37.3757		25.6817	2.612	0.385230443	3.859704703	0.149325821	2.431026096	0.114514997	0.176712293	0.89576054	0.386886926	2.495592783	1.491644299	0	0.082908766	0.626857972	0.079490455	6.728796568	0.223062357	0.866018893	2.712103385	6.770215198	2.067339613	0.423603509	0	1.037014986	0.437723987	0.309542566	0.012612062	0	0	0	0	0	0	0	0	0	0	0	0	0	37.3757																																																																																		0			2.612	0.385230443	3.859704703	0.149325821	2.431026096	0.114514997	0.176712293	0.89576054	0.386886926	2.495592783	1.491644299	0	0.082908766	0.626857972	0.079490455	6.728796568	0.223062357	0.866018893	2.712103385	6.770215198	2.067339613	0.423603509	0	1.037014986	0.437723987	0.309542566	0.012612062	0	0	0	0	0	0	0	0	0	0	0	0	0	37.3757
H5404_116_0	2009	7																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1971.584621	50.3155598	1221.745839	1340.253187	378.0273511	2.63110274	2.954924414	303.6218094	91.97522712	1041.853262	316.9925669	0	0.494120659	283.9094	6042.908438	9118.760738	143.1549818	559.8197035	3386.770628	8522.088939	12.33881021	1445.983313	0	3111.044959	663.6448149	444.3111994	19.30007205	2.232944657	0	0											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$125 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$5 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1 year(s)	$10 copay	$250 credit	Varies	Varies											128.5090909	121.8024691	66.2299152	20	100	0.2	0.2	45	149.3294792	36.32057624	71.88242607	0	0.2	33.66964654	3.972032937	15.14025107	25	25	22.58412707	14.57314972	0.2	4.494319372	0	4	10	10	10	0	0	0											42.56025857	121.8024691	52.49730286	2.474306344	100	0.040582413	0.058052528	45	76.36304029	36.32057624	71.88242607	0	0.2	33.66964654	0.098965514	11.26718365	25	25	12.67630405	12.60441153	0.2	4.494319372	0	4	10	10	10	0	0	0											6.9926	0.510713285	5.344863446	0.276349747	3.150227926	0.106776498	0.171540833	1.138581785	0.585292331	3.153392571	1.898849563	0	0.098824132	0.796594096	0.049836628	8.56189599	0.298239545	1.166291049	3.57764452	8.951326339	2.467762042	0.541559235	0	1.037014986	0.553037346	0.370259333	0.016083393	0	0	0	0	0	0	0	0	0	0	0	0	0	51.8156		27.9629	6.9926	0.510713285	5.344863446	0.276349747	3.150227926	0.106776498	0.171540833	1.138581785	0.585292331	3.153392571	1.898849563	0	0.098824132	0.796594096	0.049836628	8.56189599	0.298239545	1.166291049	3.57764452	8.951326339	2.467762042	0.541559235	0	1.037014986	0.553037346	0.370259333	0.016083393	0	0	0	0	0	0	0	0	0	0	0	0	0	51.8156																																																																																		0			6.9926	0.510713285	5.344863446	0.276349747	3.150227926	0.106776498	0.171540833	1.138581785	0.585292331	3.153392571	1.898849563	0	0.098824132	0.796594096	0.049836628	8.56189599	0.298239545	1.166291049	3.57764452	8.951326339	2.467762042	0.541559235	0	1.037014986	0.553037346	0.370259333	0.016083393	0	0	0	0	0	0	0	0	0	0	0	0	0	51.8156
H5404_117_0	2009	5																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1207.543678	29.70481292	820.9537137	916.5622176	249.6293809	1.82871936	2.061406797	296.5281674	89.82637181	1017.76269	309.8038836	0	0.421176926	276.965626	4817.443624	7922.279226	136.6131174	536.9808761	2773.344836	7351.284682	10.53870603	1139.176176	0	3111.044959	519.6541032	378.3513507	14.8897323	1.873420602	0	0											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$125 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$5 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1 year(s)	$10 copay	$250 credit	Varies	Varies											128.5090909	121.8024691	66.2299152	20	100	0.2	0.2	45	149.3154047	34.67207541	71.95706081	0	0.2	33.68769719	4.288871556	15.3128542	25	25	22.62420035	15.36971176	0.2	4.414862825	0	4	10	10	10	0	0	0											0.823175161	121.8024691	44.13419069	0.209126297	100	0.062232316	0.077783254	45	82.00196162	34.67207541	71.95706081	0	0.2	33.68769719	0.017295015	11.04127766	25	25	11.72306342	13.31343091	0.2	4.414862825	0	4	10	10	10	0	0	0											0.0828	0.301509963	3.019343979	0.015973105	2.08024484	0.11380544	0.160342928	1.111980628	0.613828224	2.940662063	1.857714741	0	0.084235385	0.777527845	0.006943146	7.289340388	0.284610661	1.118710158	2.709341449	8.155901729	2.107741207	0.419108879	0	1.037014986	0.433045086	0.315292792	0.01240811	0	0	0	0	0	0	0	0	0	0	0	0	0	37.0495		25.1938	0.0828	0.301509963	3.019343979	0.015973105	2.08024484	0.11380544	0.160342928	1.111980628	0.613828224	2.940662063	1.857714741	0	0.084235385	0.777527845	0.006943146	7.289340388	0.284610661	1.118710158	2.709341449	8.155901729	2.107741207	0.419108879	0	1.037014986	0.433045086	0.315292792	0.01240811	0	0	0	0	0	0	0	0	0	0	0	0	0	37.0495																																																																																		0			0.0828	0.301509963	3.019343979	0.015973105	2.08024484	0.11380544	0.160342928	1.111980628	0.613828224	2.940662063	1.857714741	0	0.084235385	0.777527845	0.006943146	7.289340388	0.284610661	1.118710158	2.709341449	8.155901729	2.107741207	0.419108879	0	1.037014986	0.433045086	0.315292792	0.01240811	0	0	0	0	0	0	0	0	0	0	0	0	0	37.0495
H5404_118_0	2009	5																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1226.619637	30.17406949	833.9225862	931.0414486	253.5728572	1.857608234	2.09397151	301.2125191	91.24538817	1033.840618	314.6979562	0	0.427830395	281.3409419	4893.546345	8047.430044	138.7712391	545.4637373	2817.156265	7467.415313	10.7051894	1157.172112	0	3111.044959	527.8632478	384.3282898	15.12495024	1.903015636	0	0											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$125 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$5 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1 year(s)	$10 copay	$250 credit	Varies	Varies											128.5090909	121.8024691	66.2299152	20	100	0.2	0.2	45	149.3154047	34.67207541	71.95706081	0	0.2	33.68769719	4.288871556	15.3128542	25	25	22.62420035	15.36971176	0.2	4.414862825	0	4	10	10	10	0	0	0											2.193549019	121.8024691	48.025715	0.433661171	100	0	0.018754773	45	82.76565784	34.67207541	71.95706081	0	0.2	33.68769719	0.06575765	11.0897403	25	25	11.8467409	13.33676019	0.2	4.414862825	0	4	10	10	10	0	0	0											0.2242	0.306273014	3.337477371	0.033646377	2.113107144	0	0.039271959	1.129546947	0.629332048	2.987116656	1.887061664	0	0.085566079	0.789810705	0.026815676	7.436992438	0.289106748	1.136382786	2.781176695	8.299260607	2.141037879	0.425729678	0	1.037014986	0.43988604	0.320273575	0.012604125	0	0	0	0	0	0	0	0	0	0	0	0	0	37.9087		25.3015	0.2242	0.306273014	3.337477371	0.033646377	2.113107144	0	0.039271959	1.129546947	0.629332048	2.987116656	1.887061664	0	0.085566079	0.789810705	0.026815676	7.436992438	0.289106748	1.136382786	2.781176695	8.299260607	2.141037879	0.425729678	0	1.037014986	0.43988604	0.320273575	0.012604125	0	0	0	0	0	0	0	0	0	0	0	0	0	37.9087																																																																																		0			0.2242	0.306273014	3.337477371	0.033646377	2.113107144	0	0.039271959	1.129546947	0.629332048	2.987116656	1.887061664	0	0.085566079	0.789810705	0.026815676	7.436992438	0.289106748	1.136382786	2.781176695	8.299260607	2.141037879	0.425729678	0	1.037014986	0.43988604	0.320273575	0.012604125	0	0	0	0	0	0	0	0	0	0	0	0	0	37.9087
H5404_119_0	2009	6																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1425.723957	36.3861523	713.7570344	1322.208306	221.279614	1.934983089	2.179057663	248.7808267	75.36241577	853.6691737	260.0638287	0	0.432745684	232.4368985	4987.532849	7615.628733	130.5707027	516.107879	2744.729429	7981.87042	10.82672347	1172.801192	0	3111.044959	530.4890467	329.0921401	15.59454255	1.671787997	0	0											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$125 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$5 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1 year(s)	$10 copay	$250 credit	Varies	Varies											128.5090909	121.8024691	66.2299152	20	100	0.2	0.2	45	149.3133841	36.80014283	71.96778695	0	0.2	33.69029675	4.10754778	15.64601018	25	25	22.54756154	14.20192264	0.2	4.491126243	0	4	10	10	10	0	0	0											1.3099332	121.8024691	2.34712021	0.406060551	100	0.02148151	0.041477229	45	11.80574597	36.80014283	71.96778695	0	0.2	33.69029675	0.160763706	11.6992261	25	25	7.445296542	7.710394179	0.2	4.491126243	0	4	10	10	10	0	0	0											0.1556	0.369326933	0.13960613	0.044741386	1.843996783	0.041566358	0.090381273	0.9329281	0.074142461	2.61792896	1.559684851	0	0.086549137	0.652572341	0.066817855	7.424746871	0.272022297	1.075224748	1.70294371	5.128613935	2.165344695	0.438933184	0	1.037014986	0.442074206	0.27424345	0.012995452	0	0	0	0	0	0	0	0	0	0	0	0	0	28.65		34.543	0.1556	0.369326933	0.13960613	0.044741386	1.843996783	0.041566358	0.090381273	0.9329281	0.074142461	2.61792896	1.559684851	0	0.086549137	0.652572341	0.066817855	7.424746871	0.272022297	1.075224748	1.70294371	5.128613935	2.165344695	0.438933184	0	1.037014986	0.442074206	0.27424345	0.012995452	0	0	0	0	0	0	0	0	0	0	0	0	0	28.65																																																																																		0			0.1556	0.369326933	0.13960613	0.044741386	1.843996783	0.041566358	0.090381273	0.9329281	0.074142461	2.61792896	1.559684851	0	0.086549137	0.652572341	0.066817855	7.424746871	0.272022297	1.075224748	1.70294371	5.128613935	2.165344695	0.438933184	0	1.037014986	0.442074206	0.27424345	0.012995452	0	0	0	0	0	0	0	0	0	0	0	0	0	28.65
H5404_120_0	2009	6																					2500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1601.519307	40.35946455	1118.782411	1004.273104	434.7528738	2.803927563	3.141148928	216.2761672	65.51587857	741.9463146	225.2537748	0	0.388739311	202.6938842	5136.328079	8069.015896	132.8965457	519.7641351	3293.921026	8657.508809	9.655731833	1191.042146	0	3111.044959	562.5494302	402.5281591	16.17314555	1.999850576	0	0											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$125 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$5 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1 year(s)	$10 copay	$250 credit	Varies	Varies											128.5090909	121.8024691	66.2299152	20	100	0.2	0.2	45	149.3659474	37.47828257	71.68968039	0	0.2	33.62333313	4.148275029	15.33345273	25	25	22.55757799	13.40603112	0.2	4.538358932	0	4	10	10	10	0	0	0											3.25640218	121.8024691	29.03131752	0.108771624	100	0.014469455	0.034387283	45	22.32151884	37.47828257	71.68968039	0	0.2	33.62333313	0.051276274	11.23645398	25	25	9.923050184	9.079679984	0.2	4.538358932	0	4	10	10	10	0	0	0											0.4346	0.40965687	2.706643951	0.009103035	3.622940615	0.040571303	0.108015576	0.811035627	0.121867826	2.317239469	1.345697594	0	0.077747862	0.567936999	0.021947647	7.555593814	0.276867804	1.082841948	2.72381197	6.550617454	1.931146367	0.450448064	0	1.037014986	0.468791192	0.335440133	0.013477621	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0211		34.6809	0.4346	0.40965687	2.706643951	0.009103035	3.622940615	0.040571303	0.108015576	0.811035627	0.121867826	2.317239469	1.345697594	0	0.077747862	0.567936999	0.021947647	7.555593814	0.276867804	1.082841948	2.72381197	6.550617454	1.931146367	0.450448064	0	1.037014986	0.468791192	0.335440133	0.013477621	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0211																																																																																		0			0.4346	0.40965687	2.706643951	0.009103035	3.622940615	0.040571303	0.108015576	0.811035627	0.121867826	2.317239469	1.345697594	0	0.077747862	0.567936999	0.021947647	7.555593814	0.276867804	1.082841948	2.72381197	6.550617454	1.931146367	0.450448064	0	1.037014986	0.468791192	0.335440133	0.013477621	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0211
H5404_121_0	2009	5																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1593.104381	40.28253083	1089.850354	996.1785969	362.8778298	2.398214877	2.690947158	255.8009962	77.48901428	877.9207279	266.8334144	0	0.388224967	239.2137523	4997.680691	7510.899756	116.2857014	452.3827599	3164.228792	7598.995838	9.687889416	1207.34359	0	3111.044959	558.6254194	390.1878468	16.13141982	1.947121771	0	0											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$125 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$5 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1 year(s)	$10 copay	$250 credit	Varies	Varies											128.5090909	121.8024691	66.2299152	20	100	0.2	0.2	45	149.336882	34.51662489	71.8432256	0	0.2	33.6601921	3.989933609	15.2199891	25	25	22.55064964	13.58650331	0.2	4.491051752	0	4	10	10	10	0	0	0											41.86794135	121.8024691	53.56502094	0.601896744	100	0.056113399	0.071765974	45	78.08632031	34.51662489	71.8432256	0	0.2	33.6601921	0.017442696	11.24749819	25	25	13.82635036	11.77010022	0.2	4.491051752	0	4	10	10	10	0	0	0											5.5583	0.408875977	4.864821419	0.049966388	3.023981915	0.134571988	0.193118444	0.959253736	0.504235999	2.52523837	1.597514432	0	0.077644993	0.670998404	0.007264419	7.039902616	0.242261878	0.942464083	3.645811325	7.453411883	1.937577883	0.451853545	0	1.037014986	0.465521183	0.325156539	0.01344285	0	0	0	0	0	0	0	0	0	0	0	0	0	44.1302		23.0047	5.5583	0.408875977	4.864821419	0.049966388	3.023981915	0.134571988	0.193118444	0.959253736	0.504235999	2.52523837	1.597514432	0	0.077644993	0.670998404	0.007264419	7.039902616	0.242261878	0.942464083	3.645811325	7.453411883	1.937577883	0.451853545	0	1.037014986	0.465521183	0.325156539	0.01344285	0	0	0	0	0	0	0	0	0	0	0	0	0	44.1302																																																																																		0			5.5583	0.408875977	4.864821419	0.049966388	3.023981915	0.134571988	0.193118444	0.959253736	0.504235999	2.52523837	1.597514432	0	0.077644993	0.670998404	0.007264419	7.039902616	0.242261878	0.942464083	3.645811325	7.453411883	1.937577883	0.451853545	0	1.037014986	0.465521183	0.325156539	0.01344285	0	0	0	0	0	0	0	0	0	0	0	0	0	44.1302
H5404_122_0	2009	6																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1730.477551	44.16241927	1072.337309	1176.352274	331.7980053	2.309342534	2.593563728	266.4915923	80.72748388	914.4439768	278.2272263	0	0.433694145	249.1898332	5303.915074	8003.618295	125.6484148	491.3587876	2972.599033	7479.914091	10.82988467	1269.152556	0	3111.044959	582.4870215	389.9759349	16.93984678	1.959875604	0	0											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$125 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$5 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1 year(s)	$10 copay	$250 credit	Varies	Varies											128.5090909	121.8024691	66.2299152	20	100	0.2	0.2	45	149.3294792	36.32057624	71.88242607	0	0.2	33.66964654	3.972032937	15.14025107	25	25	22.58412707	14.57314972	0.2	4.494319372	0	4	10	10	10	0	0	0											25.2018157	121.8024691	50.41288844	0.390894746	100	0.0163851	0.036506929	45	65.28777699	36.32057624	71.88242607	0	0.2	33.66964654	0.020911338	11.18912947	25	25	11.17243803	12.30558519	0.2	4.494319372	0	4	10	10	10	0	0	0											3.6343	0.448257642	4.504968428	0.03831916	2.764983377	0.037838809	0.094683048	0.999343471	0.43920983	2.767761014	1.666637336	0	0.086738829	0.699177801	0.009242663	7.462793446	0.261767531	1.023664141	2.767598207	7.670393339	2.165976934	0.47533141	0	1.037014986	0.485405851	0.324979946	0.014116539	0	0	0	0	0	0	0	0	0	0	0	0	0	41.8805		28.2686	3.6343	0.448257642	4.504968428	0.03831916	2.764983377	0.037838809	0.094683048	0.999343471	0.43920983	2.767761014	1.666637336	0	0.086738829	0.699177801	0.009242663	7.462793446	0.261767531	1.023664141	2.767598207	7.670393339	2.165976934	0.47533141	0	1.037014986	0.485405851	0.324979946	0.014116539	0	0	0	0	0	0	0	0	0	0	0	0	0	41.8805																																																																																		0			3.6343	0.448257642	4.504968428	0.03831916	2.764983377	0.037838809	0.094683048	0.999343471	0.43920983	2.767761014	1.666637336	0	0.086738829	0.699177801	0.009242663	7.462793446	0.261767531	1.023664141	2.767598207	7.670393339	2.165976934	0.47533141	0	1.037014986	0.485405851	0.324979946	0.014116539	0	0	0	0	0	0	0	0	0	0	0	0	0	41.8805
H5404_123_0	2009	5																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1271.088949	31.49335424	750.7187921	871.8719915	258.1325012	1.940823225	2.186365404	295.6448625	89.55879495	1014.904513	308.8266559	0	0.414799251	276.0464844	4769.351831	7797.045817	130.7354588	513.0335763	2936.505198	6934.06166	10.38317946	1163.595989	0	3111.044959	529.3427346	376.4142947	15.23625514	1.87229752	0	0											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$125 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$5 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1 year(s)	$10 copay	$250 credit	Varies	Varies											128.5090909	121.8024691	66.2299152	20	100	0.2	0.2	45	149.3141348	33.28543798	71.96380158	0	0.2	33.68933071	4.270478997	15.24769526	25	25	22.5816518	15.0742261	0.2	4.423968972	0	4	10	10	10	0	0	0											11.28585178	121.8024691	46.77128782	0.564543228	100	0.011832976	0.032965281	45	84.07003563	33.28543798	71.96380158	0	0.2	33.68933071	0.039118041	11.01633431	25	25	12.63243921	12.9675305	0.2	4.423968972	0	4	10	10	10	0	0	0											1.1954	0.319664026	2.926007058	0.041017452	2.151104177	0.022965714	0.07207415	1.108668234	0.627434257	2.815128436	1.852028349	0	0.08295985	0.774985109	0.015547308	7.157905277	0.272365539	1.068819951	3.091268617	7.493138003	2.076635893	0.428976046	0	1.037014986	0.441118945	0.313678579	0.012696879	0	0	0	0	0	0	0	0	0	0	0	0	0	37.3986		24.3466	1.1954	0.319664026	2.926007058	0.041017452	2.151104177	0.022965714	0.07207415	1.108668234	0.627434257	2.815128436	1.852028349	0	0.08295985	0.774985109	0.015547308	7.157905277	0.272365539	1.068819951	3.091268617	7.493138003	2.076635893	0.428976046	0	1.037014986	0.441118945	0.313678579	0.012696879	0	0	0	0	0	0	0	0	0	0	0	0	0	37.3986																																																																																		0			1.1954	0.319664026	2.926007058	0.041017452	2.151104177	0.022965714	0.07207415	1.108668234	0.627434257	2.815128436	1.852028349	0	0.08295985	0.774985109	0.015547308	7.157905277	0.272365539	1.068819951	3.091268617	7.493138003	2.076635893	0.428976046	0	1.037014986	0.441118945	0.313678579	0.012696879	0	0	0	0	0	0	0	0	0	0	0	0	0	37.3986
H5404_124_0	2009	5																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1574.957928	40.07569415	966.0208288	886.5486268	304.1158679	2.391337224	2.686459659	255.2977231	77.33655929	876.1945953	266.5153182	0	0.41050576	238.6201079	4694.558092	6803.41774	105.6023569	410.5156757	2686.459676	6582.975775	10.25687401	1145.23682	0	3111.044959	525.5638745	362.6729312	15.20874347	1.813637328	0	0											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$125 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$5 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1 year(s)	$10 copay	$250 credit	Varies	Varies											128.5090909	121.8024691	66.2299152	20	100	0.2	0.2	45	149.3268828	34.82985526	71.89618438	0	0.2	33.67296909	3.913409678	15.43949381	25	25	22.59352952	12.92600151	0.2	4.473373591	0	4	10	10	10	0	0	0											32.7789127	121.8024691	51.47809311	0.389465725	100	0.051018844	0.023180329	45	75.62012603	34.82985526	71.89618438	0	0.2	33.67296909	0.071276107	11.59736024	25	25	11.98434932	10.76124078	0.2	4.473373591	0	4	10	10	10	0	0	0											4.3021	0.406776542	4.144075847	0.028773359	2.534298899	0.12200326	0.062273018	0.957366462	0.48735003	2.543144245	1.596786205	0	0.082101152	0.669587293	0.027884152	6.575140532	0.22000491	0.855240991	2.682955932	5.903415614	2.051374802	0.426922679	0	1.037014986	0.437969895	0.302227443	0.012673953	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4695		23.7509	4.3021	0.406776542	4.144075847	0.028773359	2.534298899	0.12200326	0.062273018	0.957366462	0.48735003	2.543144245	1.596786205	0	0.082101152	0.669587293	0.027884152	6.575140532	0.22000491	0.855240991	2.682955932	5.903415614	2.051374802	0.426922679	0	1.037014986	0.437969895	0.302227443	0.012673953	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4695																																																																																		0			4.3021	0.406776542	4.144075847	0.028773359	2.534298899	0.12200326	0.062273018	0.957366462	0.48735003	2.543144245	1.596786205	0	0.082101152	0.669587293	0.027884152	6.575140532	0.22000491	0.855240991	2.682955932	5.903415614	2.051374802	0.426922679	0	1.037014986	0.437969895	0.302227443	0.012673953	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4695
H5404_125_0	2009	5																					2500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1704.757682	43.04987377	1162.711001	1062.937885	330.900174	2.834264882	3.187015378	270.9485231	82.07760831	929.7340384	284.1107808	0	0.467110664	252.3662031	5331.429004	7713.673267	124.5020459	484.3755591	3171.889913	7794.607796	11.72486793	1283.529413	0	3111.044959	595.8099086	421.3352094	17.16696362	2.09788169	0	0											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$125 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$5 copay	$15 copay	"$15 copay Group, $15 copay Individual"	$15 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1 year(s)	$10 copay	$250 credit	Varies	Varies											128.5090909	121.8024691	66.2299152	20	100	0.2	0.2	45	149.3400567	35.86580336	71.83565091	0	0.2	24.11918799	3.638126892	9.517493397	15	15	22.54381827	13.54518301	0.2	4.492220838	0	4	10	10	10	0	0	0											34.33751923	121.8024691	53.02268482	0.4966409	100	0.064548722	0.001	45	74.50263212	35.86580336	71.83565091	0	0.2	24.11918799	0.106642416	5.986008921	15	15	12.86114172	11.57507849	0.2	4.492220838	0	4	10	10	10	0	0	0											4.8781	0.436965077	5.137504914	0.043991536	2.75750145	0.182948175	0.003187015	1.016056961	0.509583155	2.77880485	1.700773572	0	0.093422133	0.507238991	0.047379706	3.847843083	0.155627557	0.605469449	3.399510474	7.518599753	2.344973586	0.480491465	0	1.037014986	0.496508257	0.351112675	0.014305803	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3449		25.5937	4.8781	0.436965077	5.137504914	0.043991536	2.75750145	0.182948175	0.003187015	1.016056961	0.509583155	2.77880485	1.700773572	0	0.093422133	0.507238991	0.047379706	3.847843083	0.155627557	0.605469449	3.399510474	7.518599753	2.344973586	0.480491465	0	1.037014986	0.496508257	0.351112675	0.014305803	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3449																																																																																		0			4.8781	0.436965077	5.137504914	0.043991536	2.75750145	0.182948175	0.003187015	1.016056961	0.509583155	2.77880485	1.700773572	0	0.093422133	0.507238991	0.047379706	3.847843083	0.155627557	0.605469449	3.399510474	7.518599753	2.344973586	0.480491465	0	1.037014986	0.496508257	0.351112675	0.014305803	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3449
H5404_127_0	2009	6																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1882.887454	48.05197569	1166.782236	1279.958204	361.020749	2.512735333	2.821988996	289.9625457	87.83746808	995.0585372	302.6946346	0	0.471839141	271.1036821	5769.665085	8706.43598	136.6819155	534.5062283	3233.630369	8146.548345	11.78371483	1380.931769	0	3111.044959	633.7889242	424.3226358	18.43180512	2.132489488	0	0											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$125 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$5 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1 year(s)	$10 copay	$250 credit	Varies	Varies											128.5090909	121.8024691	66.2299152	20	100	0.2	0.2	45	149.3294792	35.6694206	71.88242607	0	0.2	33.66964654	3.968527867	15.13149656	25	25	22.58412707	14.02826423	0.2	4.494319372	0	4	10	10	10	0	0	0											53.75675242	121.8024691	53.53190325	0.322103468	100	0.052592764	0.0687467	45	81.86025411	35.6694206	71.88242607	0	0.2	33.66964654	0.079352468	11.24232116	25	25	13.42054739	12.20960262	0.2	4.494319372	0	4	10	10	10	0	0	0											8.4348	0.48773744	5.205006149	0.034356581	3.008506242	0.132151697	0.19400243	1.087359546	0.599199788	2.957763457	1.813202058	0	0.094367828	0.760663763	0.038153097	8.156712456	0.284753991	1.113554642	3.616424133	8.288843166	2.356742966	0.5171957	0	1.037014986	0.528157437	0.353602196	0.015359838	0	0	0	0	0	0	0	0	0	0	0	0	0	51.1157		24.693	8.4348	0.48773744	5.205006149	0.034356581	3.008506242	0.132151697	0.19400243	1.087359546	0.599199788	2.957763457	1.813202058	0	0.094367828	0.760663763	0.038153097	8.156712456	0.284753991	1.113554642	3.616424133	8.288843166	2.356742966	0.5171957	0	1.037014986	0.528157437	0.353602196	0.015359838	0	0	0	0	0	0	0	0	0	0	0	0	0	51.1157																																																																																		0			8.4348	0.48773744	5.205006149	0.034356581	3.008506242	0.132151697	0.19400243	1.087359546	0.599199788	2.957763457	1.813202058	0	0.094367828	0.760663763	0.038153097	8.156712456	0.284753991	1.113554642	3.616424133	8.288843166	2.356742966	0.5171957	0	1.037014986	0.528157437	0.353602196	0.015359838	0	0	0	0	0	0	0	0	0	0	0	0	0	51.1157
H5404_128_0	2009	5																					1500											D	D	D	V	T	Coin	Coin	V	V	Coin	V	V	Coin	V	V	V	Coin	V	V	V	Coin	O	T	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		2420.480442	63.54657588	662.6609824	1667.205861	489.674807	3.772502018	4.218333351	268.3383462	81.28691541	7.847748915	283.5452516	0	0.574969943	235.3681703	8606.080168	15365.67531	2.037363684	686.1603778	3271.685316	10005.89997	15.06036514	1476.81527	0	3111.044959	696.7418917	378.4003949	20.07439098	1.884037359	0	0											"$25 copay, days 1-5"	"$25 copay, days 1-5"	"$10 copay, days 11-100"	$0 copay	"$25 copay, waived if admitted"	20% coinsurance	20% coinsurance	$25 copay	$0 copay to $25 copay	$0 copay to 20% coinsurance	$25 copay to $50 copay		20% coinsurance	Varies	$0 copay	$0 copay	"$0 copay Group, $0 copay Individual"	$0 copay	$25 copay	Varies	20% Coinsurance	Varies	Not Covered	Varies	$0 copay	$10 copay; and $100 credit covered every 1 year(s)	$0 copay	$250 credit	Varies	Varies											14.15909091	12.15432099	5.282176464	0	20	0.2	0.19375943	22.5	16.64469121	0.173287724	30.36282986	0	0.2	0	0	0	0	0	11.30997411	0.364987936	0.2	0	0	4	0	10	0	0	0	0											8.174283426	12.15432099	2.626368124	0	20	0.180562187	0.176375979	22.5	0	0.173287724	30.36282986	0	0.2	0	0	0	0	0	10.2341368	0.189101652	0.2	0	0	4	0	10	0	0	0	0											1.6488	0.06436379	0.14503264	0	0.816124678	0.681171213	0.744012676	0.503134399	0	1.359918545	0.717436353	0	0.114993989	0	0	0	0	0	2.790239591	0.157677684	3.012073028	0	0	1.037014986	0	0.315333662	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.1073		2.9332	1.6488	0.06436379	0.14503264	0	0.816124678	0.681171213	0.744012676	0.503134399	0	1.359918545	0.717436353	0	0.114993989	0	0	0	0	0	2.790239591	0.157677684	3.012073028	0	0	1.037014986	0	0.315333662	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.1073																																																																																		0			1.6488	0.06436379	0.14503264	0	0.816124678	0.681171213	0.744012676	0.503134399	0	1.359918545	0.717436353	0	0.114993989	0	0	0	0	0	2.790239591	0.157677684	3.012073028	0	0	1.037014986	0	0.315333662	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.1073
H5404_131_0	2009	6																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1219.243315	30.28914726	617.2404957	605.1234131	194.7965936	1.484644103	1.6776332	268.9080081	81.45948135	923.076542	280.8399077	0	0.383298022	251.1484144	4441.807162	7062.215732	104.7534219	407.1058047	2650.586773	7344.803347	9.590038739	1145.247098	0	3111.044959	521.5146668	356.8847483	15.11290574	1.787215448	0	0											"$200 copay, days 1-7"	"$200 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$125 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$5 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1 year(s)	$10 copay	$250 credit	Varies	Varies											128.5090909	121.8024691	66.2299152	20	100	0.2	0.2	45	149.3177585	33.5650995	71.94456915	0	0.2	33.68467145	4.141748114	14.86393049	25	25	22.59881852	14.57036695	0.2	4.454130542	0	4	10	10	10	0	0	0											23.30465987	121.8024691	46.01476888	0.204860035	100	0.017903732	0.01405937	45	88.04750869	33.5650995	71.94456915	0	0.2	33.68467145	0.020154582	10.74233696	25	25	13.18384138	12.87153223	0.2	4.454130542	0	4	10	10	10	0	0	0											2.3678	0.307441077	2.366848229	0.010330467	1.623304947	0.02658067	0.023586467	1.00840503	0.597692033	2.581929665	1.68374218	0	0.076659604	0.704987652	0.00746023	6.322058424	0.218236296	0.848137093	2.912076299	7.878239419	1.918007748	0.425090006	0	1.037014986	0.434595556	0.297403957	0.012594088	0	0	0	0	0	0	0	0	0	0	0	0	0	35.6903		20.796	2.3678	0.307441077	2.366848229	0.010330467	1.623304947	0.02658067	0.023586467	1.00840503	0.597692033	2.581929665	1.68374218	0	0.076659604	0.704987652	0.00746023	6.322058424	0.218236296	0.848137093	2.912076299	7.878239419	1.918007748	0.425090006	0	1.037014986	0.434595556	0.297403957	0.012594088	0	0	0	0	0	0	0	0	0	0	0	0	0	35.6903																																																																																		0			2.3678	0.307441077	2.366848229	0.010330467	1.623304947	0.02658067	0.023586467	1.00840503	0.597692033	2.581929665	1.68374218	0	0.076659604	0.704987652	0.00746023	6.322058424	0.218236296	0.848137093	2.912076299	7.878239419	1.918007748	0.425090006	0	1.037014986	0.434595556	0.297403957	0.012594088	0	0	0	0	0	0	0	0	0	0	0	0	0	35.6903
H5404_133_0	2009	5																					1500											Coin	Coin	Coin	V	T	P	P	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	O	T	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		215.8776531	2.241306435	24.00995712	1096.786737	525.2711584	282.9264762	283.9950117	390.6702539	118.3445465	1347.447328	436.6624625	0	54.50516383	335.4553212	6689.530696	12116.62624	121.8691038	473.1244522	3297.210228	7315.348948	13.58686027	1313.389354	0	3111.044959	613.7690959	422.6014998	17.03280302	2.026654022	0	0											"$0 copay, days 1-1"	"$0 copay, days 1-1"	"$0 copay, days 1-1"	$0 copay	"$0 copay, waived if admitted"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay to 0% coinsurance		$0 copay	Varies	$0 copay	$0 copay	"$0 copay Group, $0 copay Individual"	$0 copay	$0 copay	Varies	20% Coinsurance	Varies	Not Covered	Varies	$0 copay	$0 copay; and $100 credit covered every 1 year(s)	$0 copay	$250 credit	Varies	Varies											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.325710578	0.2	0	0	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	0.32560352	0.2	0	0	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	0.198491948	2.717372054	0	0	1.037014986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.9529		0.0013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.198491948	2.717372054	0	0	1.037014986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.9529																																																																																		0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.198491948	2.717372054	0	0	1.037014986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.9529
H5404_134_0	2009	5																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1640.781971	41.37642493	876.1045719	1084.80423	285.4284088	2.220650513	2.501031825	287.1616192	86.98899197	985.6369717	299.6965276	0	0.424133915	268.3903306	5567.835727	8899.167634	150.0715446	590.3397373	3167.43502	7707.249051	10.59635754	1311.807223	0	3111.044959	602.6510245	414.1042663	17.45210004	2.072330284	0	0											"$300 copay, days 1-7"	"$300 copay, days 1-7"	"$150 copay, days 6-20"	$20 copay	"$125 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$5 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 0 year(s)	$10 copay	$250 credit	Varies	Varies											192.7636364	182.7037037	66.2299152	20	100	0.2	0.2	45	149.3286682	34.04551121	71.88672291	0	0.2	33.67068396	4.188389702	15.29218022	25	25	22.59349956	14.99276485	0.2	4.479819352	0	4	10	10	10	0	0	0											84.93615179	182.7037037	46.71871195	0.303065412	100	0.00755803	0.029131979	45	70.72628889	34.04551121	71.88672291	0	0.2	33.67068396	0.171033557	11.27482407	25	25	11.79999992	12.77487177	0.2	4.479819352	0	4	10	10	10	0	0	0											11.6135	0.62996884	3.410873095	0.02739722	2.378570073	0.016783743	0.072860006	1.076856072	0.512700715	2.796376214	1.795350103	0	0.084826783	0.753073833	0.079357229	8.361379123	0.312649051	1.229874453	3.114644416	8.204926525	2.119271507	0.489721615	0	1.037014986	0.502209187	0.345086889	0.014543417	0	0	0	0	0	0	0	0	0	0	0	0	0	50.9798		28.4898	11.6135	0.62996884	3.410873095	0.02739722	2.378570073	0.016783743	0.072860006	1.076856072	0.512700715	2.796376214	1.795350103	0	0.084826783	0.753073833	0.079357229	8.361379123	0.312649051	1.229874453	3.114644416	8.204926525	2.119271507	0.489721615	0	1.037014986	0.502209187	0.345086889	0.014543417	0	0	0	0	0	0	0	0	0	0	0	0	0	50.9798																																																																																		0			11.6135	0.62996884	3.410873095	0.02739722	2.378570073	0.016783743	0.072860006	1.076856072	0.512700715	2.796376214	1.795350103	0	0.084826783	0.753073833	0.079357229	8.361379123	0.312649051	1.229874453	3.114644416	8.204926525	2.119271507	0.489721615	0	1.037014986	0.502209187	0.345086889	0.014543417	0	0	0	0	0	0	0	0	0	0	0	0	0	50.9798
H5407_001_0	2009	5																					3350											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																																																			0		1090.81137	83.94538685	482.5028339	1820.893317	80.74736452	3.628470911	2.539151552	207.7420354	409.5552273	3022.313371	643.1430359			493.3090157		5528.5221	419.6181252	629.9141182	3846.173443		28.14171644																				"$0/Day days 1-5, $150/Day days 6-10, $0/Day days 11-90"	"$0/Day days 1-5, $150/Day days 6-10, $0/Day days 11-90"	"$50/Day days 1-14, $75/Day days 15-100"	"No Copay for visits 1-25, $25 per Visit for Visits 26+"	$150 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $25 per Urgent Care Visit"	$250 Hospital/$75 ASC	$0 Freestanding/$75 Hospital	"$10 Basic/$100 Major Freestanding, $50 Basic/$250 Major Hospital"	No Cost Sharing	No Cost Sharing	$25 copay for Partial Hospitalization	No Cost Sharing	$10 per Specialist Visit	$25 per Visit	$35 per Visit	$25 per Visit	"$10 Chiro and Podiatry, $25 Radiation Therapy"	20% Coinsurance	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	"$80 Max Benefit, Every Year"	No Cost Sharing	"$500 Max Benefit, Every 2 Years"	No Cost Sharing	No Cost Sharing											29.98517785	32.96663733	63.18700094	5.412	150	0.2	0.2	45	128.7807792	3.818292414	96.18223201			28.72636745		10	24.97867387	35	25		0.2																				28.59544354	31.4387202	60.25844926	5.161168002	143.0478936	0.190730525	0.190730525	42.91436809	122.812128	3.818292414	92.23795306			27.39497571		9.977565669	24.94259275	35	25		0.190730525																				2.5994	0.219927961	2.422906044	0.78316136	0.962561701	0.692060161	0.484293708	0.742926515	4.191529085	0.961673018	4.943516429	0	0	1.126182375	0	4.596766026	0.872197	1.837249511	8.012861339	0	5.367484347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.8166	0	1.1752	2.5994	0.219927961	2.422906044	0.78316136	0.962561701	0.692060161	0.484293708	0.742926515	4.191529085	0.961673018	4.943516429	0	0	1.126182375	0	4.596766026	0.872197	1.837249511	8.012861339	0	5.367484347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.8166		30% Coinsurance	30% Coinsurance	30% Coinsurance	20% Coinsurance	20% Coinsurance	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	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.9165	0.1032	0.3722	0.5084	0.0879	0.2335	0.1634	0.182	0.718	0.0673	0.2231	0.0802	0.0074	0.3519	0.5894	1.2876	0.0805	0.1034	0.8492	1.4368		0.009																			11.3711	0	0	6.5159	0.323114276	2.795109825	1.291579352	1.050473549	0.925583713	0.647710118	0.924955499	4.909553066	1.028952725	5.16666079	0.080174984	0.007357435	1.478092619	0.58943022	5.88441307	0.952702374	1.940620682	8.862103108	1.436825263	5.367484347	0.008970628	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.1878
H5407_004_0	2009	4																					3350											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																																																			0		1141.188081	87.82221896	504.7861605	1904.987249	84.47650303	3.872327065	2.709798568	217.3361421	428.46963	3161.892232	672.8451751			516.091402		5777.263162	438.9972606	659.0053092	4023.80046		28.86139636																				"$75/Day days 1-7, $0/Day days 8-90"	"$75/Day days 1-7, $0/Day days 8-90"	"$0/Day days 1-14, $75/Day days 15-45, $0/Day days 46-100"	"No Copay for visits 1-25, $25 per Visit for Visits 26+"	$100 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $20 per Urgent Care Visit"	$125 Hospital/$50 ASC	$0 Freestanding/$25 Hospital	"$25 Basic/$75 Major Freestanding, $100 Basic/$250 Major Hospital"	No Cost Sharing	No Cost Sharing	$25 copay for Partial Hospitalization	No Cost Sharing	$25 per Specialist Visit	$25 per Visit	$25 per Visit	$50 per Visit	"$25 Chiro and Podiatry, 20% Coinsurance Radiation Therapy"	20% Coinsurance	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	"$80 Max Benefit, Every Year"	No Cost Sharing	"$500 Max Benefit, Every 2 Years"	No Cost Sharing	No Cost Sharing											39.32018277	42.09636771	28.89130202	5.412	100	0.2	0.2	44	73.04890538	3.895022757	107.6872268			21.86282492		24.33447538	24.97867387	25	50		0.2																				37.65787131	40.31668945	27.66988495	5.183200717	95.77237097	0.191544742	0.191544742	42.13984323	69.96066865	3.895022757	104.3613781			20.93854578		24.33447538	24.94576206	25	50		0.191544742																				3.5812	0.295058427	1.163947916	0.822827606	0.674209582	0.741723888	0.519047667	0.763209246	2.498001818	1.026303516	5.851587475	0	0	0.900516954	0	11.71555568	0.912593434	1.372927727	16.76583525	0	5.528248719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1328	0	0.9597	3.5812	0.295058427	1.163947916	0.822827606	0.674209582	0.741723888	0.519047667	0.763209246	2.498001818	1.026303516	5.851587475	0	0	0.900516954	0	11.71555568	0.912593434	1.372927727	16.76583525	0	5.528248719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1328		30% Coinsurance	30% Coinsurance	30% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $20 per Urgent Care 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	Not Covered	20% Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.7638	0.0992	0.3577	0.4886	0.0845	0.2244	0.157	0.1749	0.69	0.0647	0.2144	0.077	0.0071	0.3382	0.5664	1.2374	0.0774	0.0993	0.8161	1.3808		0.0086																			10.9275	0	0	7.345	0.394219331	1.521631617	1.311411652	0.758691892	0.966137429	0.676089023	0.938137079	3.188014892	1.090958568	6.066026728	0.077047269	0.007070413	1.238698792	0.566435898	12.9529702	0.989958204	1.472266274	17.58194716	1.380773127	5.528248719	0.008620673	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.0603
H5407_005_0	2009	5																					3350											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																																																			0		991.134139	76.27454299	438.4122169	1654.501942	73.36875268	3.36315776	2.35348924	188.7587801	372.1304882	2746.137456	584.373281			448.2309408		5036.353806	381.2738487	572.3532084	3494.714035		25.06643357																				"$200/Day days 1-15, $0/Day days 16-90"	"$150/Day days 1-15, $0/Day days 16-90"	"$50/Day days 1-14, $75/Day days 15-100"	$25/Visit	$150 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $20 per Urgent Care Visit"	$150 Hospital/$100 ASC	$0 Freestanding/$50 Hospital	"$50 Basic/$100 Major Freestanding, $150 Basic/$250 Major Hospital"	No Cost Sharing	No Cost Sharing	$35 copay for Partial Hospitalization	No Cost Sharing	$35 per Specialist Visit	$35 per Visit	$35 per Visit	$50 per Visit	"$35 Chiro and Podiatry, $50 Copay Radiation Therapy"	20% Coinsurance	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	"$80 Max Benefit, Every Year"	No Cost Sharing	"$500 Max Benefit, Every 2 Years"	No Cost Sharing	No Cost Sharing											148.235	118.6474918	63.187	25	150	0.2	0.2	44	115.3659369	3.895022757	107.6872268			25.59038841		33.85415568	34.93491749	35	50		0.2																				135.7800735	108.678552	57.87793372	22.89946259	137.3967756	0.183195701	0.183195701	40.30305416	105.6727183	3.895022757	101.0773094			23.44024568		33.85415568	34.84334324	35	50		0.183195701																				11.2147	0.690783907	2.114532769	3.157267111	0.840052504	0.616116043	0.431149111	0.633962945	3.277003354	0.891355657	4.922239912	0	0	0.875553615	0	14.20845882	1.107071298	1.669363524	14.56130848	0	4.592062864	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.803	0	2.9339	11.2147	0.690783907	2.114532769	3.157267111	0.840052504	0.616116043	0.431149111	0.633962945	3.277003354	0.891355657	4.922239912	0	0	0.875553615	0	14.20845882	1.107071298	1.669363524	14.56130848	0	4.592062864	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.803		30% Coinsurance	30% Coinsurance	30% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $20 per Urgent Care 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	Not Covered	20% Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.7638	0.0992	0.3577	0.4886	0.0845	0.2244	0.157	0.1749	0.69	0.0647	0.2144	0.077	0.0071	0.3382	0.5664	1.2374	0.0774	0.0993	0.8161	1.3808		0.0086																			10.9275	0	0	14.9784	0.78994481	2.47221647	3.645851157	0.924534814	0.840529583	0.588190466	0.808890778	3.967016428	0.956010708	5.136679166	0.077047269	0.007070413	1.213735452	0.566435898	15.44587333	1.184436068	1.768702071	15.37742039	1.380773127	4.592062864	0.008620673	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.7305
H5407_006_0	2009	4																					3350											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																																																			0				529.7361776	1999.144871	88.65191503	4.071434995	2.849131423	182.4627157	138.18512	3318.174776	706.101829			201.9108251			460.695536	691.5779013	4222.684459		36.69190043																				No Cost Sharing	No Cost Sharing	"$0/Day days 1-14, $75/Day days 15-30, $100/Day days 31-100"	"No Copay for visits 1-25, $25 per Visit for Visits 26+"	$150 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, No Copay for Urgent Care Visit"	"$50 Hospital, No Copay for ASC"	$0 Freestanding/$25 Hospital	"$25 Basic/$75 Major Freestanding, $50 Basic/$100 Major Hospital"	No Cost Sharing	No Cost Sharing	$15 copay for Partial Hospitalization	No Cost Sharing	No Cost Sharing	$15 per Visit	$15 per Visit	$25 per Visit	"No Copay for Chiro and Podiatry, $25 Radiation Therapy"	20% Coinsurance	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	"$80 Max Benefit, Every Year"	No Cost Sharing	"$500 Max Benefit, Every 2 Years"	No Cost Sharing	No Cost Sharing													47.676	5.412	150	0.2	0.2	50	50	3.902413444	60.64083736			14.99807507			14.98720432	15	25		0.2																						46.51058209	5.279706148	146.3333189	0.195111092	0.195111092	48.77777298	48.77777298	3.902413444	59.48013978			14.63145402			14.97578638	15	25		0.195111092																				0	0	2.053194831	0.879574789	1.081060746	0.794382128	0.555897143	0.741677077	0.561696868	1.079074154	3.499919624	0	0	0.246187413	0	0	0.574939828	0.864472377	8.797259289	0	7.158996758	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8883	0	0.4214	0	0	2.053194831	0.879574789	1.081060746	0.794382128	0.555897143	0.741677077	0.561696868	1.079074154	3.499919624	0	0	0.246187413	0	0	0.574939828	0.864472377	8.797259289	0	7.158996758	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8883		30% Coinsurance	30% Coinsurance	30% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, No Copay for Urgent Care 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	Not Covered	20% Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											5.5236	0.1455	0.5249	0.717	0.124	0.3293	0.2305	0.2567	1.0126	0.0949	0.3147	0.1131	0.0104	0.4963	0.8313	1.816	0.1135	0.1458	1.1977	2.0264		0.0127																			16.037	0	0	5.5236	0.145526411	2.578123748	1.596610239	1.20504517	1.123726619	0.786367663	0.998397407	1.574345234	1.173960519	3.814626065	0.113072918	0.010376387	0.742495813	0.831289156	1.816002961	0.688478702	1.010259494	9.9949676	2.026392981	7.158996758	0.012651515	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.9253
H5407_007_0	2009	4																					3350											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																																																			0		1128.998686	86.88416174	499.3943781	1884.639471	83.57418248	3.635736057	2.546184845	215.0147052	130.2702647	3128.119049	665.6583005			510.5788646			434.3081904	651.9662626	3980.82096		30.47784442																				"$0/Day days 1-10, $50/Day days 11-30, $0/Day days 31-90"	"$0/Day days 1-10, $50/Day days 11-30, $0/Day days 31-90"	"$0/Day days 1-15, $50/Day days 16-100"	"No Copay for visits 1-25, $25 per Visit for Visits 26+"	$100 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $20 per Urgent Care Visit"	"$50 Hospital, No Copay for ASC"	$0 Freestanding/$50 Hospital	"$25 Basic/$75 Major Freestanding, $50 Basic/$100 Major Hospital"	No Cost Sharing	No Cost Sharing	$15 copay for Partial Hospitalization	No Cost Sharing	No Cost Sharing	$15 per Visit	$25 per Visit	$25 per Visit	No Copay for Chiro/Podiatry; $25 Radiation Therapy	20% Coinsurance	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	"$80 Max Benefit, Every Year"	No Cost Sharing	"$500 Max Benefit, Every 2 Years"	No Cost Sharing	No Cost Sharing											13.17181315	12.9850388	25.94938566	5.412	100	0.2	0.2	44	50	3.698343372	59.04393206			21.86282492			15	25	25		0.2																				12.8999298	12.71701072	25.4137566	5.300289283	97.93586998	0.19587174	0.19587174	43.09178279	48.96793499	3.698343372	58.06382333			21.41154778			14.99035853	25	25		0.19587174																				1.2137	0.092075568	1.057623931	0.832427866	0.682075856	0.712137947	0.498725656	0.772113914	0.531588821	0.964071529	3.22088883	0	0	0.911023646	0	0	0.542536291	1.358263047	8.293377	0	5.969748417	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.6523	0	0.3345	1.2137	0.092075568	1.057623931	0.832427866	0.682075856	0.712137947	0.498725656	0.772113914	0.531588821	0.964071529	3.22088883	0	0	0.911023646	0	0	0.542536291	1.358263047	8.293377	0	5.969748417	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.6523		30% Coinsurance	30% Coinsurance	30% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $20 per Urgent Care 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	Not Covered	20% Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											4.2872	0.1131	0.4074	0.5566	0.0963	0.2556	0.179	0.1992	0.7859	0.0737	0.2443	0.0877	0.0081	0.3852	0.6447	1.4093	0.0881	0.1131	0.9295	1.5729		0.0097																			12.4466	0	0	5.5008	0.205150795	1.464976234	1.389015592	0.778329904	0.967712384	0.677709979	0.971320527	1.317477904	1.03772497	3.465167953	0.087746284	0.008130329	1.296259397	0.644686214	1.409339572	0.630662298	1.471405398	9.222885358	1.572888891	5.969748417	0.009734097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0989
H5407_009_0	2009	5																					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																																																			0						83.73389953	3.762082345	2.632650905	215.4256158		3134.097139	666.9304276			511.5301487				653.2122231	3988.428632		29.1871609																				No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$150 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $25 per Urgent Care Visit"	No Cost Sharing	$0 Freestanding/$50 Hospital	"$10 Basic/$25 Major Freestanding, $50 Basic/$100 Major Hospital"	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$25 per Visit	$25 per Visit	No Cost Sharing	20% Coinsurance	No Cost Sharing	"No Copay, Up to 12 One-Way Trips Every Year"	No Cost Sharing	No Cost Sharing	"$80 Max Benefit, Every Year"	No Cost Sharing	"$500 Max Benefit, Every 2 Years"	No Cost Sharing	No Cost Sharing															150	0.2	0.2	45		3.817691893	58.56434112			25				25	25		0.2																								146.3100765	0.195080102	0.195080102	43.89302295		3.817691893	57.39628608			24.38501275				25	25		0.195080102																				0	0	0	0	1.020926104	0.733907408	0.513577807	0.787973458	0	0.99708477	3.189944135	0	0	1.039472433	0	0	0	1.360858798	8.309226317	0	5.693834326	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.6468	0	0.3118	0	0	0	0	1.020926104	0.733907408	0.513577807	0.787973458	0	0.99708477	3.189944135	0	0	1.039472433	0	0	0	1.360858798	8.309226317	0	5.693834326	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.6468		30% Coinsurance	30% Coinsurance	30% Coinsurance	20% Coinsurance	20% Coinsurance	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	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.9178	0.1032	0.3723	0.5086	0.0879	0.2336	0.1635	0.1821	0.7182	0.0673	0.2232	0.0802	0.0074	0.352	0.5896	1.2881	0.0805	0.1034	0.8495	1.4373		0.009																			11.3747	0	0	3.9178	0.10321878	0.372320885	0.508577952	1.108865611	0.967504431	0.677045631	0.970059713	0.718249889	1.064385644	3.413158702	0.080200209	0.00735975	1.391493396	0.589615669	1.288052169	0.080530702	1.464262491	9.158735278	1.437277323	5.693834326	0.00897345	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0215
H5407_011_0	2009	6																																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																																																			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 Copay, Up to 12 One-Way Trips Every Year"	No Cost Sharing	No Cost Sharing	"$80 Max Benefit, Every Year"	No Cost Sharing	"$500 Max Benefit, Every 2 Years"	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
H5407_014_0	2009	5																					3350											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																																																			0		960.7136961	73.93348209	424.9562241	1603.721044	71.11687792	3.194888808	2.235737057	182.9652901	360.7088513	2661.851471	566.4373697			434.4735863		4886.149217	369.5715787	554.7862238	3387.452319		24.78673382																				"$200/Day days 1-10, $0/Day days 11-90"	"$200/Day days 1-10, $0/Day days 11-90"	"$50/Day days 1-14, $75/Day days 15-100"	$25 per Visit	$150 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $35 per Urgent Care Visit"	$250 Hospital/$150 ASC	$0 Freestanding/$100 Hospital	"$25 Basic/$150 Major Freestanding, $100 Basic/$250 Major Hospital"	No Cost Sharing	No Cost Sharing	$35 copay for Partial Hospitalization	No Cost Sharing	$35 per Specialist Visit	$35 per Visit	$35 per Visit	$25 per Visit	"$35 Chiro and Podiatry, $25 Radiation Therapy"	20% Coinsurance	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	"$80 Max Benefit, Every Year"	No Cost Sharing	"$500 Max Benefit, Every 2 Years"	No Cost Sharing	No Cost Sharing											125.64	134.595	63.18700094	25	150	0.2	0.2	47	180.7318738	3.817305877	100.2870317			34.99832555		33.85034104	34.93257771	35	25		0.2																				115.4816739	123.7126385	58.07816488	22.97868391	137.8721035	0.183829471	0.183829471	43.19992576	166.1192241	3.817305877	94.57201317			32.16861841		33.85034104	34.84445716	35	25		0.183829471																				9.2454	0.762208845	2.056723137	3.070949912	0.817086129	0.58731472	0.410994361	0.658673912	4.993389541	0.846758439	4.464093532	0	0	1.16470125	0	13.78315145	1.073126754	1.618126486	7.057192331	0	4.556532174	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.1664	0	2.764	9.2454	0.762208845	2.056723137	3.070949912	0.817086129	0.58731472	0.410994361	0.658673912	4.993389541	0.846758439	4.464093532	0	0	1.16470125	0	13.78315145	1.073126754	1.618126486	7.057192331	0	4.556532174	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.1664		30% Coinsurance	30% Coinsurance	30% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $35 per Urgent Care 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	Not Covered	20% Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.917	0.1032	0.3722	0.5085	0.0879	0.2335	0.1634	0.182	0.7181	0.0673	0.2232	0.0802	0.0074	0.3519	0.5895	1.2878	0.0805	0.1034	0.8493	1.437		0.009																			11.3724	0	0	13.1624	0.865406752	2.428968733	3.579425023	0.905007854	0.820864508	0.57442913	0.840723347	5.711494189	0.914045704	4.687262962	0.080183991	0.007358262	1.51665103	0.58949644	15.07094315	1.153641171	1.72150927	7.906529508	1.436986684	4.556532174	0.008971635	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5388
H5407_015_0	2009	5																					3350											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																																																			0				475.0670744	1792.831876	79.50298223	3.650982623	2.554904923	204.5405624	403.2436495	2975.737074	633.2316808			485.7067242		5445.519291	413.15147	620.2066315	3786.900795		32.87392438																				No Cost Sharing	No Cost Sharing	"$0/Day days 1-14, $75/Day days 15-30, $100/Day days 31-100"	"No Copay for visits 1-25, $25 per Visit for Visits 26+"	$150 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $25 per Urgent Care Visit"	"$100 for Hospital, $50 ASC"	$0 Freestanding/$50 Hospital	"$50 Basic/$75 Major Freestanding, $100 Basic/$150 Major Hospital"	No Cost Sharing	No Cost Sharing	$25 copay for Partial Hospitalization	No Cost Sharing	$20 per Specialist Visit	$25 per Visit	$25 per Visit	$25 per Visit	"$20 Chiro and Podiatry, $25 Radiation Therapy"	20% Coinsurance	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	"$80 Max Benefit, Every Year"	No Cost Sharing	"$500 Max Benefit, Every 2 Years"	No Cost Sharing	No Cost Sharing													47.67645524	5.412	150	0.2	0.2	45	65.36593692	3.902116592	80.72443271			24.99880396		19.5862975	24.97867387	25	25		0.2																						46.28330567	5.253856418	145.616863	0.194155817	0.194155817	43.6850589	63.45588455	3.902116592	79.3918241			24.26831608		19.5830878	24.95592558	25	25		0.194155817																				0	0	1.832306218	0.784940105	0.964747906	0.708859515	0.496049654	0.744613876	2.132348539	0.967639417	4.189451518	0	0	0.982273692	0	8.886673532	0.859214778	1.292097149	7.889376655	0	6.382663657	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1133	0	0.5249	0	0	1.832306218	0.784940105	0.964747906	0.708859515	0.496049654	0.744613876	2.132348539	0.967639417	4.189451518	0	0	0.982273692	0	8.886673532	0.859214778	1.292097149	7.889376655	0	6.382663657	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1133		30% Coinsurance	30% Coinsurance	30% Coinsurance	20% Coinsurance	20% Coinsurance	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	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											5.5131	0.1452	0.5239	0.7157	0.1237	0.3287	0.23	0.2562	1.0107	0.0947	0.3141	0.1129	0.0104	0.4954	0.8297	1.8125	0.1133	0.1455	1.1954	2.0225		0.0126																			16.0064	0	0	5.5131	0.145249255	2.356235404	1.500609956	1.088496201	1.037576768	0.726081241	1.000845281	3.143068309	1.06234507	4.503558599	0.112857569	0.010356625	1.47763687	0.82970596	10.6992179	0.972537417	1.437606614	9.084803923	2.022533701	6.382663657	0.01262742	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1197
H5407_016_0	2009	5																					3350											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																																																			0		1032.954722	79.49292255	456.9108779	1724.313114	76.46452335	3.327838204	2.328773125	196.7233954	387.8324132	2862.009834	609.0307217			467.1438997		5242.847955	397.3615749	596.503466	3642.172358		27.88108097																				"$75/Day days 1-5, $100/Day days 6-25, $0/Day days 26-90"	"$50/Day days 1-5, $75/Day days 6-25, $0/Day days 26-90"	"$0/Day days 1-7, $75/Day days 8-30, $0/Day days 31-100"	"No Copay for visits 1-25, $25 per Visit for Visits 26+"	$150 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $25 per Urgent Care Visit"	$150 Hospital/$75 ASC	$0 Freestanding/$50 Hospital	"$50 Basic/$75 Major Freestanding, $100 Basic/$100 Major Hospital"	No Cost Sharing	No Cost Sharing	$35 copay for Partial Hospitalization	No Cost Sharing	$35 per Specialist Visit	$35 per Visit	$25 per Visit	$50 per Visit	"$35 Chiro and Podiatry, $25 Radiation Therapy"	20% Coinsurance	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	"$80 Max Benefit, Every Year"	No Cost Sharing	"$500 Max Benefit, Every 2 Years"	No Cost Sharing	No Cost Sharing											75.18440909	56.49351948	33.73120358	5.412	150	0.2	0.2	45	98.04890538	3.698078391	76.57408331			24.99880396		33.8375356	34.9289882	25	50		0.2																				71.79679928	53.94807152	32.21136512	5.168149652	143.2413984	0.190988531	0.190988531	42.97241951	93.63108209	3.698078391	74.5192603			23.87242424		33.8375356	34.87988062	25	50		0.190988531																				6.1802	0.357374156	1.226476926	0.742625685	0.912740437	0.635578931	0.444768959	0.704473356	3.026097376	0.881994727	3.78204324	0	0	0.929321446	0	14.78375453	1.154993691	1.242715554	15.17571816	0	5.324966701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.5059	0	1.0724	6.1802	0.357374156	1.226476926	0.742625685	0.912740437	0.635578931	0.444768959	0.704473356	3.026097376	0.881994727	3.78204324	0	0	0.929321446	0	14.78375453	1.154993691	1.242715554	15.17571816	0	5.324966701	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.5059		30% Coinsurance	30% Coinsurance	30% Coinsurance	20% Coinsurance	20% Coinsurance	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	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	Not Covered	20% Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											4.287	0.1129	0.4074	0.5565	0.0962	0.2556	0.1789	0.1992	0.7859	0.0736	0.2443	0.0878	0.0081	0.3852	0.6452	1.4095	0.0881	0.1131	0.9296	1.5727		0.0098																			12.4468	0	0	10.4673	0.470321727	1.633890572	1.299139183	1.008968602	0.891193426	0.623644292	0.903721983	3.812045246	0.955638983	4.02629669	0.087759406	0.008053436	1.314521821	0.645189349	16.19321087	1.24311474	1.355865467	16.1052968	1.572746571	5.324966701	0.009819234	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.9527
H5407_021_0	2009	5																					3350											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																																																			0					2045.882936	90.72451069	3.949053536	2.763490645	233.410646		3395.750478	722.6098038			554.2622887				707.7463208	4321.406719		33.08224307																				No Cost Sharing	No Cost Sharing	No Cost Sharing	"No Copay for visits 1-25, $25 per Visit for Visits 26+"	$50 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $20 per Urgent Care Visit"	No Cost Sharing	$0 Freestanding/$50 Hospital	"$50 Basic/$75 Major Freestanding, $100 Basic/$100 Major Hospital"	No Cost Sharing	No Cost Sharing	$5 copay for Partial Hospitalization	No Cost Sharing	No Cost Sharing	No Cost Sharing	$25 per Visit	$50 per Visit	"No Copay for Chiro and Podiatry, $25 Radiation Therapy"	20% Coinsurance	No Cost Sharing	"No Copay, Up to 12 One-Way Trips Every Year"	No Cost Sharing	No Cost Sharing	"$80 Max Benefit, Every Year"	No Cost Sharing	"$500 Max Benefit, Every 2 Years"	No Cost Sharing	No Cost Sharing														5.411554757	50	0.2	0.2	44		3.698641875	51.82095193			21.86282492				25	50		0.2																							5.328681495	49.23429342	0.196937174	0.196937174	43.32617821		3.698641875	51.02735906			21.52801474				25	50		0.196937174																				0	0	0	0.908488212	0.372229765	0.777715442	0.544234037	0.842732604	0	1.046638743	3.07273916	0	0	0.994347227	0	0	0	1.474471502	18.00586133	0	6.515123449	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.5546	0	0.2182	0	0	0	0.908488212	0.372229765	0.777715442	0.544234037	0.842732604	0	1.046638743	3.07273916	0	0	0.994347227	0	0	0	1.474471502	18.00586133	0	6.515123449	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.5546		30% Coinsurance	30% Coinsurance	30% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $20 per Urgent Care 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	Not Covered	20% Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											4.2875	0.113	0.4075	0.5566	0.0962	0.2556	0.1789	0.1993	0.786	0.0737	0.2443	0.0878	0.0081	0.3852	0.6453	1.4096	0.0881	0.1132	0.9297	1.5729		0.0098																			12.448	0	0	4.2875	0.112958334	0.40745247	1.465054741	0.468467099	1.033354296	0.723126416	1.042000218	0.786022765	1.120290017	3.317015886	0.087767768	0.008054204	1.379584308	0.645250832	1.409590649	0.088129447	1.587632197	18.93552856	1.572896443	6.515123449	0.00982017	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.0026
H5407_022_0	2009	5																					3350											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																																																			0					1956.19321	86.74722719	3.976415022	2.782637817	223.1781266		3246.883736	690.9312196			529.9639129				676.7193388	4131.960014		29.63718925																				No Cost Sharing	No Cost Sharing	No Cost Sharing	"No Copay for visits 1-25, $25 per Visit for Visits 26+"	$100 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $10 per Urgent Care Visit"	No Cost Sharing	$0 Freestanding/$25 Hospital	"$25 Basic/$75 Major Freestanding, $100 Basic/$150 Major Hospital"	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$25 per Visit	$50 per Visit	No Cost Sharing	20% Coinsurance	No Cost Sharing	"No Copay, Up to 12 One-Way Trips Every Year"	No Cost Sharing	No Cost Sharing	"$80 Max Benefit, Every Year"	No Cost Sharing	"$500 Max Benefit, Every 2 Years"	No Cost Sharing	No Cost Sharing														5.412	100	0.2	0.2	42		3.895022757	74.62248579			15.59086682				25	50		0.2																							5.32381852	98.37063045	0.196741261	0.196741261	41.31566479		3.895022757	73.87941802			15.33683399				25	50		0.196741261																				0	0	0	0.867868137	0.711114952	0.782324905	0.547459673	0.768396056	0	1.053890503	4.2537997	0	0	0.677330713	0	0	0	1.409831956	17.21650006	0	5.830857982	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.1194	0	0.2115	0	0	0	0.867868137	0.711114952	0.782324905	0.547459673	0.768396056	0	1.053890503	4.2537997	0	0	0.677330713	0	0	0	1.409831956	17.21650006	0	5.830857982	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.1194		30% Coinsurance	30% Coinsurance	30% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $10 per Urgent Care 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	Not Covered	20% Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.7638	0.0992	0.3577	0.4886	0.0845	0.2244	0.157	0.1749	0.69	0.0647	0.2144	0.077	0.0071	0.3382	0.5664	1.2374	0.0774	0.0993	0.8161	1.3808		0.0086																			10.9275	0	0	3.7638	0.099160903	0.357683701	1.356452182	0.795597263	1.006738446	0.704501028	0.943323889	0.690013075	1.118545555	4.468238953	0.077047269	0.007070413	1.01551255	0.566435898	1.237414514	0.07736477	1.509170503	18.03261197	1.380773127	5.830857982	0.008620673	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0469
H5407_024_0	2009	4																					3350											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																																																			0		1280.358638	98.53234402	566.3460138	2137.304901	94.77861021	4.212819395	2.948070184	243.840793	480.7225038		754.9002184			579.0299559		6464.434492	492.5340035	739.3725484	4514.51234		33.38681853																				"$100/Day days 1-5, $0/Day days 6-90"	"$100/Day days 1-5, $0/Day days 6-90"	"$0/Day days 1-14, $75/Day days 15-60, $0/Day days 61-100"	$25/Visit	$100 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER Visit, $20 per Urgent Care Visit"	$150 Hospital/$75 ASC	No Cost Sharing	"$50 Basic/$100 Major Freestanding, $150 Basic/$150 Major Hospital"	No Cost Sharing	No Cost Sharing	$20 copay for Partial Hospitalization	No Cost Sharing	$20 per Visit	$20 per Visit	$25 per Visit	$50 per Visit	"$20 Chiro and Podiatry, 20% Coinsurance Radiation Therapy"	20% Coinsurance	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	"$100 Max Benefit, Every Year"	No Cost Sharing	"$800 Max Benefit, Every 2 Years"	No Cost Sharing	No Cost Sharing											42.83219959	45.31962557	34.44988564	25	100	0.2	0.2	44	98.04890538		44.4962488			21.86282492		19.57656129	19.9829391	25	50		0.2																				40.55513239	42.91032057	32.61844329	23.67093727	94.6837491	0.189367498	0.189367498	41.6608496	92.83637956		43.12593689			20.70054229		19.57640362	19.94982977	25	50		0.189367498																				4.3271	0.352337872	1.539443778	4.216000853	0.747832846	0.797771069	0.558268675	0.846551217	3.719044736	0	2.712981598	0	0	0.998852841	0	10.5458649	0.818830794	1.540359476	18.81046808	0	6.322378297	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.8541	0	1.4591	4.3271	0.352337872	1.539443778	4.216000853	0.747832846	0.797771069	0.558268675	0.846551217	3.719044736	0	2.712981598	0	0	0.998852841	0	10.5458649	0.818830794	1.540359476	18.81046808	0	6.322378297	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.8541																																																																																		0	0	0	4.3271	0.352337872	1.539443778	4.216000853	0.747832846	0.797771069	0.558268675	0.846551217	3.719044736	0	2.712981598	0	0	0.998852841	0	10.5458649	0.818830794	1.540359476	18.81046808	0	6.322378297	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.8541
H5410_001_0	2009	6																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	Coin	T	V	V	V	V	V	V	O																																																			0																																										"$0 copay, unlimited days, 30% coinsurance for gastric restrictive surgery"	$0 copay	$0 copay up to 100 days with 3-day hospital stay	$0 copay for Medicare covered visits	$0 copay for Medicare covered benefits	$0 copay for Medicare covered items	$0 copay for Medicare covered items	"$0 copay, worldwide coverage"	$0 copay for Medicare covered OP facility and ASC visits	$0 copay for Medicare covered services	$0 copay for Medicare covered services	$0 copay for Medicare covered services	$0 copay for dialysis	$0 copay for Medicare covered services	$0 copay	"$0 copay, 30% coninsurance for gastric restrictive surgery"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay for each round trip to plan-approved location	"Comprehensive dental with $0 copay and $2,000 max annual allowable benefit, 90 days waiting period for Denture"	$0 copay for exams	"$0 copay for 1 pair of contacts with a $150 deductible, up to 2 pairs of basic glasses every year"	$0 copay for exams	$600 limit for hearing aids every 3 years	No cost sharing	$20 limit for vitamins every 3 months																																																																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5410_003_0	2009	8																					2250											A		D		T	COIN		P	P		P				V	V	V	V	V		COIN			DED		V																																						0.75																	0.75		285.4657155		333.4330723		208.9752307	7.823525589		393.7182708	443.3651845		651.9621386				5270.694538	8329.513362	221.1692094	115.9554634	1660.100309		8.433816143					202.5															$150 per admit		$0 days 1-100		$50 per trip	20% Coinsurance		$50 per visit	$50 per visit		$25 per visit				$0 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit		20% per script			No Copay or Coinsurance		$100 limit on eyewear															150		0		50	0.2		50	50		25				0	25	25	25	25		0.2					100															133.8456501		0		44.61521669	0.178460867		44.61521669	44.61521669		22.30760835				0	25	25	25	25		0.178460867					100															3.184	0	0	0	0.776956267	1.396193158	0	1.463818831	1.648402815	0	1.211976337	0	0	0	0	17.35315284	0.460769186	0.241573882	3.45854231	0	1.505106139	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.388		1.3501	3.184	0	0	0	0.776956267	1.396193158	0	1.463818831	1.648402815	0	1.211976337	0	0	0	0	17.35315284	0.460769186	0.241573882	3.45854231	0	1.505106139	0	0	0.75	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.138																																																																																		0			3.184	0	0	0	0.776956267	1.396193158	0	1.463818831	1.648402815	0	1.211976337	0	0	0	0	17.35315284	0.460769186	0.241573882	3.45854231	0	1.505106139	0	0	0.75	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.138
H5410_004_0	2009	3																					2250											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		1810.333365		333.4330723		208.9752307	7.823525589		393.7182708	443.3651845		651.9621386				5270.694538	8329.513362	221.1692094	115.9554634	1660.100309		8.433816143					202.5															$100 per day 1-5		$0 for days 1-5; $95 for days 6 to 100		$150 per trip	20% coinsurance		$50 per visit	$100 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															100		95		150	0.2		50	100		25				5	25	25	25	25		0.2					100															96.41043155		91.58990997		144.6156473	0.192820863		48.20521578	96.41043155		24.10260789				5	25	25	25	25		0.192820863					100															14.5446	0	2.544925423	0	2.518424022	1.508538957	0	1.581606183	3.562085731	0	1.309498982	0	0	0	2.196122724	17.35315284	0.460769186	0.241573882	3.45854231	0	1.626215708	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5935		0.9709	14.5446	0	2.544925423	0	2.518424022	1.508538957	0	1.581606183	3.562085731	0	1.309498982	0	0	0	2.196122724	17.35315284	0.460769186	0.241573882	3.45854231	0	1.626215708	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5935																																																																																		0			14.5446	0	2.544925423	0	2.518424022	1.508538957	0	1.581606183	3.562085731	0	1.309498982	0	0	0	2.196122724	17.35315284	0.460769186	0.241573882	3.45854231	0	1.626215708	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.5935
H5410_005_0	2009	6																					2250											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		1810.333365		333.4330723		208.9752307	7.823525589		393.7182708	443.3651845		651.9621386				5270.694538	8329.513362	221.1692094	115.9554634	1660.100309		8.433816143					202.5															$150 days 1-5		"$0/day; days 1-5, $95/day ;days 6-100"		$150 per trip	20% Coinsurance		$50 per visit	$100 per visit		$25 per visit				$5 per visit	$27 per visit	$27 per visit	$27 per visit	$27 per visit		20% Script					$100 limit on eyewear															150		95		150	0.2		50	100		25				5	27	27	27	27		0.2					100															145.800214		92.34013552		145.800214	0.194400285		48.60007133	97.20014265		24.30003566				5	27	27	27	27		0.194400285					100															21.9956	0	2.565771257	0	2.539052779	1.520895607	0	1.594561337	3.591263265	0	1.320225268	0	0	0	2.196122724	18.74140507	0.497630721	0.260899793	3.735225695	0	1.639536264	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.8857		0.97	21.9956	0	2.565771257	0	2.539052779	1.520895607	0	1.594561337	3.591263265	0	1.320225268	0	0	0	2.196122724	18.74140507	0.497630721	0.260899793	3.735225695	0	1.639536264	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.8857																																																																																		0			21.9956	0	2.565771257	0	2.539052779	1.520895607	0	1.594561337	3.591263265	0	1.320225268	0	0	0	2.196122724	18.74140507	0.497630721	0.260899793	3.735225695	0	1.639536264	0	0	0	0	1.6875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.8857
H5414_002_0	2009	4																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	10570.53335	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$150/day 1-7	$150/day 1-7	"$0/d 1-10, $75/d 11-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$200 per procedure	$30 per visit	$30 X-ray; $175 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$20 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											108.4282617	108.4282617	47.56208437	20	100	0.2	0.2	47.5	200	30	56.1	30	25	30	20	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											96.94874691	96.94874691	42.52659231	20	100	0.178825604	0.178825604	42.47108094	178.8256039	26.82384059	50.16058191	26.82384059	22.35320049	26.82384059	20	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											15.7863	0	4.779627152	1.711889696	2.276793099	1.409269311	0	0.900454778	5.729714513	2.345290678	19.70620839	0	0.124480548	1.759220551	12.17789911	26.42633338	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.8524	0	6.2212	15.7863	0	4.779627152	1.711889696	2.276793099	1.409269311	0	0.900454778	5.729714513	2.345290678	19.70620839	0	0.124480548	1.759220551	12.17789911	26.42633338	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.8524																																																																					0	0	0											0			15.7863	0	4.779627152	1.711889696	2.276793099	1.409269311	0	0.900454778	5.729714513	2.345290678	19.70620839	0	0.124480548	1.759220551	12.17789911	26.42633338	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.8524
H5414_004_0	2009	4																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	10570.53335	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$100/day 1-7	$100/day 1-7	"$0/d 1-10, $75/d 11-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$200 per procedure	$20 per visit	$20 X-ray; $175 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$10 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											72.2855078	72.2855078	47.56208437	20	100	0.2	0.2	47.5	200	20	47.9	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											67.88932593	67.88932593	44.66950494	20	100	0.187836616	0.187836616	44.61119635	187.8366162	18.78366162	44.98686959	18.78366162	18.78366162	18.78366162	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											11.0545	0	5.0204723	1.711889696	2.276793099	1.480282314	0	0.945828644	6.01843451	1.642313163	17.67365117	0	0.104602493	1.231911718	6.088949555	17.61755559	0	1.12009741	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.0261	0	2.9251	11.0545	0	5.0204723	1.711889696	2.276793099	1.480282314	0	0.945828644	6.01843451	1.642313163	17.67365117	0	0.104602493	1.231911718	6.088949555	17.61755559	0	1.12009741	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.0261																																																																					0	0	0											0			11.0545	0	5.0204723	1.711889696	2.276793099	1.480282314	0	0.945828644	6.01843451	1.642313163	17.67365117	0	0.104602493	1.231911718	6.088949555	17.61755559	0	1.12009741	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.0261
H5414_009_0	2009	6																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	10570.53335	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$200/day 1-10	$200/day 1-10	"$0/d 1-10, $75/d 11-100"	$20 per visit	$150 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$225 per procedure	$35 per visit	$40 X-ray; $175 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$25 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											163.9294809	163.9294809	47.56208437	20	150	0.2	0.2	47.5	225	35	64.3	35	25	35	25	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											142.4064065	142.4064065	41.3174341	20	150	0.173741057	0.173741057	41.26350108	195.4586893	30.404685	55.85774988	30.404685	21.71763215	30.404685	25	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											23.1882	0	4.643728057	1.711889696	3.415189648	1.36919957	0	0.874852155	6.262651791	2.658374891	21.94441168	0	0.120941194	1.994067424	15.22237389	30.83072228	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.2356	0	9.5302	23.1882	0	4.643728057	1.711889696	3.415189648	1.36919957	0	0.874852155	6.262651791	2.658374891	21.94441168	0	0.120941194	1.994067424	15.22237389	30.83072228	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.2356																																																																					0	0	0											0			23.1882	0	4.643728057	1.711889696	3.415189648	1.36919957	0	0.874852155	6.262651791	2.658374891	21.94441168	0	0.120941194	1.994067424	15.22237389	30.83072228	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.2356
H5414_010_0	2009	5																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	10570.53335	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$200/day 1-10	$200/day 1-10	"$0/d 1-10, $75/d 11-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$200 per procedure	$40 per visit	$40 X-ray; $175 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$25 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											163.9294809	163.9294809	47.56208437	20	100	0.2	0.2	47.5	200	40	64.3	35	25	35	25	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											138.2257977	138.2257977	40.10448284	20	100	0.168640561	0.168640561	40.05213313	168.6405605	33.72811211	54.21794021	29.51209809	21.08007007	29.51209809	25	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											22.5074	0	4.507402656	1.711889696	2.276793099	1.329004132	0	0.849169219	5.403377625	2.948952319	21.30019206	0	0.117390737	1.935527811	15.22237389	30.83072228	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.9392	0	11.3243	22.5074	0	4.507402656	1.711889696	2.276793099	1.329004132	0	0.849169219	5.403377625	2.948952319	21.30019206	0	0.117390737	1.935527811	15.22237389	30.83072228	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.9392																																																																					0	0	0											0			22.5074	0	4.507402656	1.711889696	2.276793099	1.329004132	0	0.849169219	5.403377625	2.948952319	21.30019206	0	0.117390737	1.935527811	15.22237389	30.83072228	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.9392
H5414_011_0	2009	4																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	10570.53335	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$100/day 1-7	$100/day 1-7	"$0/d 1-10, $75/d 11-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$20 per visit	$20 X-ray; $125 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$10 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											72.2855078	72.2855078	47.56208437	20	100	0.2	0.2	47.5	150	20	38.9	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											66.54897728	66.54897728	43.78758853	20	100	0.184128131	0.184128131	43.73043113	138.0960983	18.41281311	35.8129215	18.41281311	18.41281311	18.41281311	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											10.8362	0	4.921352398	1.711889696	2.276793099	1.451056889	0	0.927155014	4.424708773	1.60988874	14.06955158	0	0.102537311	1.207589909	6.088949555	17.61755559	0	1.12009741	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4042	0	3.4092	10.8362	0	4.921352398	1.711889696	2.276793099	1.451056889	0	0.927155014	4.424708773	1.60988874	14.06955158	0	0.102537311	1.207589909	6.088949555	17.61755559	0	1.12009741	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4042																																																																					0	0	0											0			10.8362	0	4.921352398	1.711889696	2.276793099	1.451056889	0	0.927155014	4.424708773	1.60988874	14.06955158	0	0.102537311	1.207589909	6.088949555	17.61755559	0	1.12009741	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4042
H5414_012_0	2009	4																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	10347.32211	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$150/day 1-7	$150/day 1-7	"$0/d 1-10, $75/d 11-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$30 per visit	$30 X-ray; $125 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$15 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											108.4282617	108.4282617	47.56208437	20	100	0.2	0.2	47.5	150	30	47.1	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											93.76591878	93.76591878	41.13044394	20	100	0.172954758	0.172954758	41.07675501	129.7160685	25.94321369	40.7308455	25.94321369	21.61934474	25.94321369	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											15.268	0	4.622711955	1.711889696	2.276793099	1.363002989	0	0.87089284	4.156205955	2.268294766	16.00161918	0	0.120393851	1.701465326	9.133424332	25.86830528	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.082	0	7.2514	15.268	0	4.622711955	1.711889696	2.276793099	1.363002989	0	0.87089284	4.156205955	2.268294766	16.00161918	0	0.120393851	1.701465326	9.133424332	25.86830528	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.082																																																																					0	0	0											0			15.268	0	4.622711955	1.711889696	2.276793099	1.363002989	0	0.87089284	4.156205955	2.268294766	16.00161918	0	0.120393851	1.701465326	9.133424332	25.86830528	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.082
H5414_013_0	2009	6																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	10570.53335	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$200/day 1-10	$200/day 1-10	"$0/d 1-10, $75/d 11-100"	$20 per visit	$150 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$225 per procedure	$35 per visit	$35 X-ray; $175 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$25 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											163.9294809	163.9294809	47.56208437	20	150	0.2	0.2	47.5	225	35	60.2	35	25	35	25	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											142.4062618	142.4062618	41.31739211	20	150	0.173740881	0.173740881	41.26345915	195.4584907	30.40465411	52.29600507	30.40465411	21.71761008	30.40465411	25	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											23.1881	0	4.643723338	1.711889696	3.415189648	1.369198179	0	0.874851266	6.262645427	2.658372189	20.54513594	0	0.120941071	1.994065397	15.22237389	30.83072228	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.8363	0	9.3188	23.1881	0	4.643723338	1.711889696	3.415189648	1.369198179	0	0.874851266	6.262645427	2.658372189	20.54513594	0	0.120941071	1.994065397	15.22237389	30.83072228	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.8363																																																																					0	0	0											0			23.1881	0	4.643723338	1.711889696	3.415189648	1.369198179	0	0.874851266	6.262645427	2.658372189	20.54513594	0	0.120941071	1.994065397	15.22237389	30.83072228	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.8363
H5414_014_0	2009	5																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	10347.32211	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$150/day 1-7	$150/day 1-7	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$200 per procedure	$35 per visit	$35 X-ray; $125 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$15 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											108.4282617	108.4282617	47.56208437	0	100	0.2	0.2	47.5	200	35	51.2	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											89.15552282	89.15552282	39.1080926	0	100	0.164450709	0.164450709	39.0570435	164.4507095	28.77887416	42.09938163	24.66760642	20.55633869	24.66760642	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											14.5173	0	4.39541687	0	2.276793099	1.295985211	0	0.828071729	5.269131467	2.516225261	16.53926562	0	0.114474181	1.617805624	9.133424332	25.86830528	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.0912	0	10.1802	14.5173	0	4.39541687	0	2.276793099	1.295985211	0	0.828071729	5.269131467	2.516225261	16.53926562	0	0.114474181	1.617805624	9.133424332	25.86830528	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.0912																																																																					0	0	0											0			14.5173	0	4.39541687	0	2.276793099	1.295985211	0	0.828071729	5.269131467	2.516225261	16.53926562	0	0.114474181	1.617805624	9.133424332	25.86830528	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.0912
H5414_015_0	2009	4																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	10022.65122	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$150/day 1-7	$150/day 1-7	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$30 X-ray; $125 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$0 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											108.4282617	108.4282617	47.56208437	0	100	0.2	0.2	47.5	150	0	47.1	30	25	30	0	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											93.94163037	93.94163037	41.20751988	0	100	0.173278865	0.173278865	41.15373034	129.9591484	0	40.80717261	0	21.65985807	25.99182969	0	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											15.2966	0	4.631374634	0	2.276793099	1.365557173	0	0.87252484	4.16399443	0	16.03160523	0	0.120619462	1.704653768	0	25.05662805	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.2393	0	6.814	15.2966	0	4.631374634	0	2.276793099	1.365557173	0	0.87252484	4.16399443	0	16.03160523	0	0.120619462	1.704653768	0	25.05662805	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.2393																																																																					0	0	0											0			15.2966	0	4.631374634	0	2.276793099	1.365557173	0	0.87252484	4.16399443	0	16.03160523	0	0.120619462	1.704653768	0	25.05662805	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.2393
H5414_016_0	2009	4																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	10184.98667	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$100/day 1-7	$100/day 1-7	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$20 X-ray; $125 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$0 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											72.2855078	72.2855078	47.56208437	0	100	0.2	0.2	47.5	150	0	38.9	20	20	20	0	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											66.23937164	66.23937164	43.58387564	0	100	0.183271512	0.183271512	43.52698416	137.4536342	0	35.64630913	0	18.32715123	18.32715123	0	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											10.7858	0	4.898456803	0	2.276793099	1.444306141	0	0.922841613	4.404123712	0	14.00409584	0	0.102060277	1.201971841	0	16.97497778	0	1.12009741	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.1744	0	3.447	10.7858	0	4.898456803	0	2.276793099	1.444306141	0	0.922841613	4.404123712	0	14.00409584	0	0.102060277	1.201971841	0	16.97497778	0	1.12009741	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.1744																																																																					0	0	0											0			10.7858	0	4.898456803	0	2.276793099	1.444306141	0	0.922841613	4.404123712	0	14.00409584	0	0.102060277	1.201971841	0	16.97497778	0	1.12009741	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.1744
H5414_017_0	2009	4																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	10022.65122	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$150/day 1-7	$150/day 1-7	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$200 per procedure	$0 per visit	$30 X-ray; $175 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$0 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											108.4282617	108.4282617	47.56208437	0	100	0.2	0.2	47.5	200	0	56.1	30	25	30	0	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											94.86241585	94.86241585	41.61142266	0	100	0.174977288	0.174977288	41.55710589	174.977288	0	49.08112927	0	21.872161	26.2465932	0	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											15.4465	0	4.676769871	0	2.276793099	1.378941923	0	0.881077046	5.606411409	0	19.282132	0	0.121801735	1.721362233	0	25.05662805	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.1674	0	7.0237	15.4465	0	4.676769871	0	2.276793099	1.378941923	0	0.881077046	5.606411409	0	19.282132	0	0.121801735	1.721362233	0	25.05662805	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.1674																																																																					0	0	0											0			15.4465	0	4.676769871	0	2.276793099	1.378941923	0	0.881077046	5.606411409	0	19.282132	0	0.121801735	1.721362233	0	25.05662805	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.1674
H5414_018_0	2009	5																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	10570.53335	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$200/day 1-7	$200/day 1-7	"$0/d 1-10, $75/d 11-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$200 per procedure	$30 per visit	$30 X-ray; $175 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$20 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											144.5710156	144.5710156	47.56208437	20	100	0.2	0.2	47.5	200	30	56.1	30	25	30	20	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											125.421208	125.421208	41.26203341	20	100	0.173508096	0.173508096	41.20817271	173.5080956	26.02621434	48.66902082	26.02621434	21.68851195	26.02621434	20	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											20.4224	0	4.637501491	1.711889696	2.276793099	1.367363672	0	0.873679105	5.559337319	2.275551768	19.12023007	0	0.120779029	1.706908859	12.17789911	26.42633338	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.3957	0	8.5631	20.4224	0	4.637501491	1.711889696	2.276793099	1.367363672	0	0.873679105	5.559337319	2.275551768	19.12023007	0	0.120779029	1.706908859	12.17789911	26.42633338	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.3957																																																																					0	0	0											0			20.4224	0	4.637501491	1.711889696	2.276793099	1.367363672	0	0.873679105	5.559337319	2.275551768	19.12023007	0	0.120779029	1.706908859	12.17789911	26.42633338	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.3957
H5414_801_0	2009	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																																																			0		197.6308719	0	14.19765343	3.585139471	3.592799439	8.007995855	0	10.3291309	33.34191737	14.30543719	67.34337589	0	0	22.22794492	37.58401444	147.460046	0	7.95063792	0	0	10.41154372	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.080217417	0.080217417	0.171979111	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											15.8534	0	2.441699817	0	0.829936671	1.849847043	0	2.386029238	7.701982913	3.304555991	15.55631983	0	0	5.134655275	8.681907336	34.06327062	0	1.83659736	0	0	2.4050666	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.0453			15.8534	0	2.441699817	0	0.829936671	1.849847043	0	2.386029238	7.701982913	3.304555991	15.55631983	0	0	5.134655275	8.681907336	34.06327062	0	1.83659736	0	0	2.4050666	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.0453																																																																																		0			15.8534	0	2.441699817	0	0.829936671	1.849847043	0	2.386029238	7.701982913	3.304555991	15.55631983	0	0	5.134655275	8.681907336	34.06327062	0	1.83659736	0	0	2.4050666	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.0453
H5414_803_0	2009	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																																																			0		195.0437283	0	14.01179498	3.538207175	3.545766868	7.903164889	0	10.19391445	32.90544544	14.11816776	66.46179812	0	0	21.93696363	37.09201013	145.529678	0	7.846557814	0	0	10.27524842	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.080179967	0.080179967	0.172016895	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											15.6386	0	2.410265472	0	0.819072147	1.825631089	0	2.354794238	7.601157897	3.261296753	15.35267537	0	0	5.067438598	8.568254339	33.61735561	0	1.812554855	0	0	2.373582386	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.7027			15.6386	0	2.410265472	0	0.819072147	1.825631089	0	2.354794238	7.601157897	3.261296753	15.35267537	0	0	5.067438598	8.568254339	33.61735561	0	1.812554855	0	0	2.373582386	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.7027																																																																																		0			15.6386	0	2.410265472	0	0.819072147	1.825631089	0	2.354794238	7.601157897	3.261296753	15.35267537	0	0	5.067438598	8.568254339	33.61735561	0	1.812554855	0	0	2.373582386	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.7027
H5415_039_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.			OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered			5000	Radiology	Renal Dialysis	Mental Health (MH)	Therapy (PT/OT/ST)							A	A	D	Coin	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin					O	O	V	P	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	0	0	0			0		278.189409	8.963214	540.451419	12.784697	153.636556	11.136472	4.021747	347.514359	376.694349	665.986559	116.179183	0	0	756.169267	3700.913319	4461.12393	4.749872	207.451321			25.170315			2.02					0.05	0.27	872.288163	20.263328	25.682106	754.094887	1.23	4.65	0.06	2.7			$800/Admit:1a	$800/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	0% Coins:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$75/Visit:14h, 8a, 8b, 9a"	$100/Visit:9a	20% Coins:12	"$35-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $35 Partial Hospitalization,8b. $100 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35/Visit:7e, 7h"	"$100/Visit:7d, 9a"			20% Coins:15			DEN 768					SMC 001	MOW 001	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $75 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $100 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $75 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $100 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$0/Proc:12	"$100/Visit:7e, 7h"	"$35/Visit:7d, 9a"	HAM 001	FTP 002	Other Added Benefit	Other Added Benefit			800.000015	800.000521	43.132809	0	100.000028	0.199999	0.199999	49.999982	127.313181	87.957396	75.00001	0	0	76.632619	15.000001	34.999998	35.000525	99.999999			0.199999			0					0	0	86.418382	0	100.000208	34.999993	0	0	0	0			674.829613	674.830039	36.38412	0	84.353724	0.168707	0.168707	42.176835	107.393379	74.195318	63.265284	0	0	64.64245	12.653055	29.523793	29.524238	84.353699			0.168707			0					0	0	72.897103	0	84.353876	29.523789	0	0	0	0			15.6442	0.504053838	1.638654107	0	1.079984637	1.878800782	0.678496871	1.221421315	3.371206582	4.117757044	0.612509084	0	0	4.073386169	3.902321648	10.97577495	0.011686363	1.458273857	0	0	4.246408333	0	0	0	0	0	0	0	0	0	5.298940005	0	0.180532099	1.855311527	0	0	0	0	0	0	62.7497	0	11.6395	15.6442	0.504053838	1.638654107	0	1.079984637	1.878800782	0.678496871	1.221421315	3.371206582	4.117757044	0.612509084	0	0	4.073386169	3.902321648	10.97577495	0.011686363	1.458273857	0	0	4.246408333	0	0	0	0	0	0	0	0	0	5.298940005	0	0.180532099	1.855311527	0	0	0	0	0	0	62.7497	7500	$950/Admit	$950/Admit	20% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$40/Visit			30% Coins	$40/Visit	$40/Visit	$40/Visit	30% Coins			30% Coins			DEN 768					SMC 001	MOW 001	30% Coins		30% Coins	$40/Visit	HAM 001	FTP 002	Other Added Benefit	Other Added Benefit			2.5408	0.0819	0.5262	0.7984	0.8863	2.1993	0.7942	0.2653	3.8007	0.4896	0.071			1.1503	2.2605	2.7248	0.0029	0.1102			1.5718			0					0	0	1.6835		0.0318	0.4606	0	0	0	0			22.4501	500	0	18.185	0.585918838	2.164901107	0.798373	1.966237637	4.078102782	1.472737871	1.486741315	7.171906582	4.607376044	0.683470084	0	0	5.223722169	6.162776648	13.70055295	0.014587363	1.568520857	0	0	5.818233333	0	0	0	0	0	0	0	0	0	6.982431005	0	0.212322099	2.315899527	0	0	0	0	0	0	85.1998
H5415_801_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		263.767783	8.498552	544.485299	590.786777	4.367745	8.620193	3.113036	22.138839	55.435077	622.400276	30.620373	0	0.354371	17.522695	33.832881	76.490929	0.433874	5.723434			22.50602																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999993	1024.000323	43.1328	0	0.2	0.2	0.199999	0.2	0.199999	0	0.2	0	0.199999	0.2	0.199999	0.2	0.500002	0.2			0.2																				1023.999993	1024.000323	43.1328	0	0.2	0.2	0.199999	0.2	0.199999	0	0.2	0	0.199999	0.2	0.199999	0.2	0.500002	0.2			0.2																				22.5082	0.725209999	1.957097959	0	0.873549	1.7240386	0.622604087	4.4277678	11.08695996	0	6.1240746	0	0.070873846	3.504539	6.766542367	15.2981858	0.216937868	1.1446868	0	0	4.501204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.5525	0	0	22.5082	0.725209999	1.957097959	0	0.873549	1.7240386	0.622604087	4.4277678	11.08695996	0	6.1240746	0	0.070873846	3.504539	6.766542367	15.2981858	0.216937868	1.1446868	0	0	4.501204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.5525		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.5009	0.0806	0.2175		0.5538	1.093	0.3947	0.834	2.125		1.1635		0.0134	0.6601	1.3565	3.0669	0.0435	0.2295			0.9024																				15.2353	0	0	25.0091	0.805788999	2.174552959	0	1.427368	2.8170566	1.017329087	5.2617828	13.21199196	0	7.2875816	0	0.084223846	4.164655	8.123066367	18.3650778	0.260428868	1.3741668	0	0	5.40358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.7877
H5415_803_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		263.767783	8.498552	544.485299	590.786777	4.367745	8.620193	3.113036	22.138839	55.435077	622.400276	30.620373	0	0.354371	17.522695	33.832881	76.490929	0.433874	5.723434			22.50602																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999993	1024.000323	43.1328	0	0.2	0.2	0.199999	0.2	0.199999	0	0.2	0	0.199999	0.2	0.199999	0.2	0.500002	0.2			0.2																				1023.999993	1024.000323	43.1328	0	0.2	0.2	0.199999	0.2	0.199999	0	0.2	0	0.199999	0.2	0.199999	0.2	0.500002	0.2			0.2																				22.5082	0.725209999	1.957097959	0	0.873549	1.7240386	0.622604087	4.4277678	11.08695996	0	6.1240746	0	0.070873846	3.504539	6.766542367	15.2981858	0.216937868	1.1446868	0	0	4.501204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.5525	0	0	22.5082	0.725209999	1.957097959	0	0.873549	1.7240386	0.622604087	4.4277678	11.08695996	0	6.1240746	0	0.070873846	3.504539	6.766542367	15.2981858	0.216937868	1.1446868	0	0	4.501204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.5525		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.5009	0.0806	0.2175		0.5538	1.093	0.3947	0.834	2.125		1.1635		0.0134	0.6601	1.3565	3.0669	0.0435	0.2295			0.9024																				15.2353	0	0	25.0091	0.805788999	2.174552959	0	1.427368	2.8170566	1.017329087	5.2617828	13.21199196	0	7.2875816	0	0.084223846	4.164655	8.123066367	18.3650778	0.260428868	1.3741668	0	0	5.40358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.7877
H5415_804_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		263.767783	8.498552	544.485299	590.786777	4.367745	8.620193	3.113036	22.138839	55.435077	622.400276	30.620373	0	0.354371	17.522695	33.832881	76.490929	0.433874	5.723434			22.50602																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999993	1024.000323	43.1328	0	0.2	0.2	0.199999	0.2	0.199999	0	0.2	0	0.199999	0.2	0.199999	0.2	0.500002	0.2			0.2																				1023.999993	1024.000323	43.1328	0	0.2	0.2	0.199999	0.2	0.199999	0	0.2	0	0.199999	0.2	0.199999	0.2	0.500002	0.2			0.2																				22.5082	0.725209999	1.957097959	0	0.873549	1.7240386	0.622604087	4.4277678	11.08695996	0	6.1240746	0	0.070873846	3.504539	6.766542367	15.2981858	0.216937868	1.1446868	0	0	4.501204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.5525	0	0	22.5082	0.725209999	1.957097959	0	0.873549	1.7240386	0.622604087	4.4277678	11.08695996	0	6.1240746	0	0.070873846	3.504539	6.766542367	15.2981858	0.216937868	1.1446868	0	0	4.501204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.5525		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.5009	0.0806	0.2175		0.5538	1.093	0.3947	0.834	2.125		1.1635		0.0134	0.6601	1.3565	3.0669	0.0435	0.2295			0.9024																				15.2353	0	0	25.0091	0.805788999	2.174552959	0	1.427368	2.8170566	1.017329087	5.2617828	13.21199196	0	7.2875816	0	0.084223846	4.164655	8.123066367	18.3650778	0.260428868	1.3741668	0	0	5.40358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.7877
H5415_805_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		263.767783	8.498552	544.485299	590.786777	4.367745	8.620193	3.113036	22.138839	55.435077	622.400276	30.620373	0	0.354371	17.522695	33.832881	76.490929	0.433874	5.723434			22.50602																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999993	1024.000323	43.1328	0	0.2	0.2	0.199999	0.2	0.199999	0	0.2	0	0.199999	0.2	0.199999	0.2	0.500002	0.2			0.2																				1023.999993	1024.000323	43.1328	0	0.2	0.2	0.199999	0.2	0.199999	0	0.2	0	0.199999	0.2	0.199999	0.2	0.500002	0.2			0.2																				22.5082	0.725209999	1.957097959	0	0.873549	1.7240386	0.622604087	4.4277678	11.08695996	0	6.1240746	0	0.070873846	3.504539	6.766542367	15.2981858	0.216937868	1.1446868	0	0	4.501204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.5525	0	0	22.5082	0.725209999	1.957097959	0	0.873549	1.7240386	0.622604087	4.4277678	11.08695996	0	6.1240746	0	0.070873846	3.504539	6.766542367	15.2981858	0.216937868	1.1446868	0	0	4.501204	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.5525		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.5009	0.0806	0.2175		0.5538	1.093	0.3947	0.834	2.125		1.1635		0.0134	0.6601	1.3565	3.0669	0.0435	0.2295			0.9024																				15.2353	0	0	25.0091	0.805788999	2.174552959	0	1.427368	2.8170566	1.017329087	5.2617828	13.21199196	0	7.2875816	0	0.084223846	4.164655	8.123066367	18.3650778	0.260428868	1.3741668	0	0	5.40358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.7877
H5416_001_0	2009	8																					3850											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1360.821893	22.41031207	1484.984763	13.46743921	182.4409074	14.92055622	8.11104244	40.57563732	661.864911	6.984828034	13.89963946	1.35129138	0.02159173	10.44032015	13202.27365	3483.15588	276.2754227	76.28833504	6738.926472	3056.264205	21.75246505	0	0	936	418.029601	6.602499933	7.606777258	0	0	0											1a (IP Acute): 100 days 1-5	1b (IP Psych): 200 days 1-5	2a (SNF): 25 days 11-100	6a (Home Health): 10 copay	10a (Ambulance): 100 copay	11a (DME): 20% coin	11b (Medical Supplies): 10% coin	4a (ER): 50 copay	9b (OP Surg): 370 copay; 9b (OP ASC): 170 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 15% coin; 9c (OP SA): 40 copay; 3 (CORF): 25 copay; 5 (Partial Hosp): 40 copay; 9d (OP Cardiac Rehab): 15 copay	7a (PCP w/Copay): 5 copay	7b (Chiro): 8 copay; 7d (SPC w/Copay): 23 copay	7h (Psych): 50 copay; 7e (MH Non-Phys): 40 copay	7i (PT/ST): 15 copay; 7c (OT): 15 copay	7g (Prof. Other): 23 copay	7g (Prof. Other): 23 copay	15 (Part B Rx): 20% coin			16b (Comp. Dental): 20 copay	17a1 (Routine Eye Exam): 5 copay	17b1 (Non MCR Covered): 150 allowance	18a (Hearing Exam): 20 copay														55.71586244	88.18679693	13.35746174	10	100	0.2	0.1	50	369.4932141	0	0.15017917	0.15	0.2	0.12134982	4.665642246	21.50790954	40	15	23	13.89874394	0.2	0	0	20	5	0	20	0	0	0											48.88038013	77.36762868	11.71870593	8.77315328	87.7315328	0.175463066	0.087731533	43.8657664	324.1620604	0	0.131754488	0.131597299	0.175463066	0.106462057	4.093239457	18.86921871	35.09261312	13.15972992	20.17825254	12.1935811	0.175463066	0	0	17.54630656	5	0	20	0	0	0											5.5431	0.144486059	1.450174979	0.009845992	1.333818371	2.618006535	0.711594186	0.148323452	17.8792911	0	1.831339879	0.177826296	0.003788551	1.111497957	4.503338951	5.477035842	0.807935544	0.083661157	11.33164669	3.10556712	3.816754201	0	0	1.368611912	0.174179	0	0.012677962	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6445		8.874	5.5431	0.144486059	1.450174979	0.009845992	1.333818371	2.618006535	0.711594186	0.148323452	17.8792911	0	1.831339879	0.177826296	0.003788551	1.111497957	4.503338951	5.477035842	0.807935544	0.083661157	11.33164669	3.10556712	3.816754201	0	0	1.368611912	0.174179	0	0.012677962	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6445																																																																																		0			5.5431	0.144486059	1.450174979	0.009845992	1.333818371	2.618006535	0.711594186	0.148323452	17.8792911	0	1.831339879	0.177826296	0.003788551	1.111497957	4.503338951	5.477035842	0.807935544	0.083661157	11.33164669	3.10556712	3.816754201	0	0	1.368611912	0.174179	0	0.012677962	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6445
H5416_002_0	2009	9																					5000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1287.444246	65.05701705	956.772504	9.692159157	252.7426178	15.34402139	6.056393261	53.18914769	620.7929404	6.325722917	8.921561293	1.619232067	0.009431288	36.10608753	10979.1418	3015.180453	169.1357147	43.48091612	5855.111211	2780.134422	25.72395205	0	0	936	268.4881553	5.385019081	3.839207204	0	0	0											1a (IP Acute): 175 days 1-5	1b (IP Psych): 250 days 1-5	2a (SNF): 35 days 11-100	6a (Home Health): 15 copay	10a (Ambulance): 125 copay	11a (DME): 20% coin	11b (Medical Supplies): 15% coin	4a (ER): 50 copay	9b (OP Surg): 475 copay; 9b (OP ASC): 300 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 20% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 20% coin; 9c (OP SA): $50 copay; 3 (CORF): 50 copay; 5 (Partial Hosp): 50 copay; 9d (OP Cardiac Rehab): 30 copay	7a (PCP w/Copay): 6 copay	7b (Chiro): 12 copay; 7d (SPC w/Copay): 30 copay	7h (Psych): 55 copay; 7e (MH Non-Phys): 55 copay	7i (PT/ST): 25 copay; 7c (OT): 25 copay	7g (Prof. Other): 30 copay	7g (Prof. Other): 30 copay	15 (Part B Rx): 20% coin			16b (Comp. Dental): 30 copay	17a1 (Routine Eye Exam): 25 copay	17b1 (Non MCR Covered): 100 allowance	18a (Hearing Exam): 30 copay														103.9862584	68.06221202	23.61601418	15	125	0.2	0.15	50	408.4953673	0	0.150130461	0.2	0.2	0.199455801	5.652215666	27.52305368	55	25	30	15.52011771	0.2	0	0	30	25	0	30	0	0	0											91.46925984	59.86945058	20.77331535	13.1944251	109.9535425	0.175925668	0.131944251	43.981417	359.3241018	0	0.132059008	0.175925668	0.175925668	0.175446975	4.971849084	24.21005802	48.3795587	21.9907085	26.3888502	13.65193538	0.175925668	0	0	26.3888502	25	0	30	0	0	0											9.8135	0.324577322	1.656278079	0.010656872	2.315828847	2.699407213	0.799106273	0.194944507	18.58882215	0	1.178172537	0.284864483	0.001659206	6.334703837	4.54888634	6.083141143	0.681892603	0.079681346	12.87580439	3.162851288	4.525503449	0	0	2.058330316	0.559350324	0	0.009598018	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7875		10.7037	9.8135	0.324577322	1.656278079	0.010656872	2.315828847	2.699407213	0.799106273	0.194944507	18.58882215	0	1.178172537	0.284864483	0.001659206	6.334703837	4.54888634	6.083141143	0.681892603	0.079681346	12.87580439	3.162851288	4.525503449	0	0	2.058330316	0.559350324	0	0.009598018	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7875																																																																																		0			9.8135	0.324577322	1.656278079	0.010656872	2.315828847	2.699407213	0.799106273	0.194944507	18.58882215	0	1.178172537	0.284864483	0.001659206	6.334703837	4.54888634	6.083141143	0.681892603	0.079681346	12.87580439	3.162851288	4.525503449	0	0	2.058330316	0.559350324	0	0.009598018	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7875
H5416_003_0	2009	5																					5000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1778.74105	26.67564241	565.2656792	17.66294502	250.2672286	15.55093001	4.104189407	43.9564446	630.8010031	5.48895522	13.1565262	0.902074481	0.041859245	12.04001237	9979.285322	2672.958688	127.3354412	46.97897409	5030.50483	1833.411719	11.62592916	0	0	936	280.5321695	3.721679984	3.654741809	0	0	0											1a (IP Acute): 150 days 1-5	1b (IP Psych): 200 days 1-5	2a (SNF): 25 days 11-100	6a (Home Health): $5 copay	10a (Ambulance): 100 copay	11a (DME): 20% coin	11b (Medical Supplies): 20% coin	4a (ER): 50 copay	9b (OP Surg): 400 copay; 9b (OP ASC): 200 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 15% coin; 9c (OP SA): 40 copay; 3 (CORF): 20 copay; 5 (Partial Hosp): 50 copay; 9d (OP Cardiac Rehab): 20 copay	7a (PCP w/Copay): 8 copay	7b (Chiro): 12 copay; 7d (SPC w/Copay): 30 copay	7h (Psych): 50 copay; 7e (MH Non-Phys): 50 copay	7i (PT/ST): 20 copay; 7c (OT): 20 copay	7g (Prof. Other): 30 copay	7g (Prof. Other): 30 copay	15 (Part B Rx): 20% coin			16b (Comp. Dental): 30 copay	17a1 (Routine Eye Exam): 25 copay	17b1 (Non MCR Covered): 70 allowance	18a (Hearing Exam): 30 copay														74.01695849	105.4647512	12.25198659	5	100	0.2	0.2	50	399.5635251	0	0.150366971	0.15	0.2	0.148049118	7.561248597	27.85128452	50	20	30	18.679399	0.2	0	0	30	25	0	30	0	0	0											65.61078185	93.48701871	10.86051678	4.432145226	88.64290453	0.177285809	0.177285809	44.32145226	354.1847141	0	0.133289651	0.132964357	0.177285809	0.131235038	6.702510375	24.68818755	44.32145226	17.72858091	26.59287136	16.55796183	0.177285809	0	0	26.59287136	25	0	30	0	0	0											9.7254	0.207818857	0.511589783	0.006523728	1.848701171	2.756959208	0.72761454	0.162351122	18.61833941	0	1.75362878	0.119943753	0.00742105	1.580071483	5.573855284	5.499208783	0.47030764	0.069405879	11.14796399	2.529796771	2.061112256	0	0	2.074243966	0.58444202	0	0.009136855	0	0	0	0	0	0	0	0	0	0	0	0	0	68.0458		8.6421	9.7254	0.207818857	0.511589783	0.006523728	1.848701171	2.756959208	0.72761454	0.162351122	18.61833941	0	1.75362878	0.119943753	0.00742105	1.580071483	5.573855284	5.499208783	0.47030764	0.069405879	11.14796399	2.529796771	2.061112256	0	0	2.074243966	0.58444202	0	0.009136855	0	0	0	0	0	0	0	0	0	0	0	0	0	68.0458																																																																																		0			9.7254	0.207818857	0.511589783	0.006523728	1.848701171	2.756959208	0.72761454	0.162351122	18.61833941	0	1.75362878	0.119943753	0.00742105	1.580071483	5.573855284	5.499208783	0.47030764	0.069405879	11.14796399	2.529796771	2.061112256	0	0	2.074243966	0.58444202	0	0.009136855	0	0	0	0	0	0	0	0	0	0	0	0	0	68.0458
H5416_004_0	2009	9																					4950											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin	Coin																																																			0		1527.842641	30.29111504	479.9800081	16.72946735	243.5452853	16.11914607	7.320318701	50.37136175	814.1738139	7.847871161	23.1949028	1.330497511	0.216593812	23.71433248	11156.38412	3153.305679	140.1110781	69.1173866	5347.347687	2451.599614	19.03322373	0	0	0	277.1085045	3.444253754	2.392793322	0	0	0											1a (IP Acute): 190 days 1-5	1b (IP Psych): 260 days 1-5	2a (SNF): 50 days 11-100	6a (Home Health): 15 copay	10a (Ambulance): 175 copay	11a (DME): 25% coin	11b (Medical Supplies): 20% coin	4a (ER): 50 copay	9b (OP Surg): 450 copay; 9b (OP ASC): 300 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 20% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 20% coin; 9c (OP SA): 50 copay; 3 (CORF): 50 copay; 5 (Partial Hosp): 55 copay; 9d (OP Cardiac Rehab): 45 copay	7a (PCP w/Copay): 7 copay	7b (Chiro): 18 copay; 7d (SPC w/Copay): 34 copay	7h (Psych): 55 copay; 7e (MH Non-Phys): 55 copay	7i (PT/ST): 30 copay; 7c (OT): 30 copay	7g (Prof. Other): 30 copay	7g (Prof. Other): 30 copay	15 (Part B Rx): 20% coin			16b (Comp. Dental): 34 copay	17a1 (Routine Eye Exam): 25 copay	17b1 (Non MCR Covered): 100 allowance	18a (Hearing Exam): 34 copay														107.1002418	109.0455463	26.54778382	15	175	0.25	0.2	50	449.8246108	0	0.150640549	0.2	0.2	0.198573573	6.673059057	31.89375288	55	30	30	14.91932217	0.2	0	0	0	25	0	34	0	0	0											92.80156409	94.48715598	23.0034575	12.99738859	151.6362002	0.216623143	0.173298515	43.32462864	389.7696843	0	0.130528917	0.173298515	0.173298515	0.172062526	5.78215611	27.63569999	47.6570915	25.99477718	25.99477718	12.92748185	0.173298515	0	0	0	25	0	34	0	0	0											11.8155	0.238510109	0.920099977	0.018119949	3.07752347	3.491780088	1.268600357	0.181860045	26.44502253	0	3.027605547	0.230573242	0.037535386	4.080347946	5.375662886	7.261984144	0.556440539	0.149724255	11.58359264	2.641084126	3.298429399	0	0	0	0.577309384	0	0.006779581	0	0	0	0	0	0	0	0	0	0	0	0	0	86.2841		13.2045	11.8155	0.238510109	0.920099977	0.018119949	3.07752347	3.491780088	1.268600357	0.181860045	26.44502253	0	3.027605547	0.230573242	0.037535386	4.080347946	5.375662886	7.261984144	0.556440539	0.149724255	11.58359264	2.641084126	3.298429399	0	0	0	0.577309384	0	0.006779581	0	0	0	0	0	0	0	0	0	0	0	0	0	86.2841																																																																																		0			11.8155	0.238510109	0.920099977	0.018119949	3.07752347	3.491780088	1.268600357	0.181860045	26.44502253	0	3.027605547	0.230573242	0.037535386	4.080347946	5.375662886	7.261984144	0.556440539	0.149724255	11.58359264	2.641084126	3.298429399	0	0	0	0.577309384	0	0.006779581	0	0	0	0	0	0	0	0	0	0	0	0	0	86.2841
H5416_009_0	2009	9																					4950											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin	Coin																																																			0		1529.955793	15.98049038	400.9547915	19.64850833	225.7216949	17.24529338	6.551347685	60.58325363	1115.068378	10.72672274	25.52363601	1.00478615	0.038153506	15.71256368	11239.47221	2837.186512	103.8189149	53.01050982	5087.217921	2138.675814	16.63051249	0	0	0	316.8139067	3.865854555	2.76167755	0	0	0											1a (IP Acute): 190 days 1-5	1b (IP Psych): 260 days 1-5	2a (SNF): 50 days 11-100	6a (Home Health): 15 copay	10a (Ambulance): 175 copay	11a (DME): 25% coin	11b (Medical Supplies): 20% coin	4a (ER): 50 copay	9b (OP Surg): 450 copay; 9b (OP ASC): 300 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 20% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 20% coin; 9c (OP SA): 50 copay; 3 (CORF): 50 copay; 5 (Partial Hosp): 55 copay; 9d (OP Cardiac Rehab): 45 copay	7a (PCP w/Copay): 7 copay	7b (Chiro): 18 copay; 7d (SPC w/Copay): 34 copay	7h (Psych): 55 copay; 7e (MH Non-Phys): 55 copay	7i (PT/ST): 30 copay; 7c (OT): 30 copay	7g (Prof. Other): 30 copay	7g (Prof. Other): 30 copay	15 (Part B Rx): 20% coin			16b (Comp. Dental): 34 copay	17a1 (Routine Eye Exam): 25 copay	17b1 (Non MCR Covered): 100 allowance	18a (Hearing Exam): 34 copay														114.1300533	153.4968849	25.4285182	15	175	0.25	0.2	50	370.8355027	0	0.15024264	0.2	0.2	0.198665227	6.606378657	31.98944383	55	30	30	12.93749983	0.2	0	0	0	25	0	34	0	0	0											98.54178331	132.5317595	21.95540488	12.95124909	151.0979061	0.215854152	0.172683321	43.17083031	320.1855312	0	0.12972199	0.172683321	0.172683321	0.171530856	5.704057039	27.62021703	47.48791334	25.90249819	25.90249819	11.1704522	0.172683321	0	0	0	25	0	34	0	0	0											12.5637	0.176493542	0.733593732	0.02120606	2.842172954	3.72246817	1.131308477	0.217952447	29.75239673	0	3.310976868	0.17350981	0.006588474	2.695189494	5.342549214	6.530308935	0.410845303	0.114425386	10.98097108	1.990831329	2.871812131	0	0	0	0.660028972	0	0.007824753	0	0	0	0	0	0	0	0	0	0	0	0	0	86.2572		13.5393	12.5637	0.176493542	0.733593732	0.02120606	2.842172954	3.72246817	1.131308477	0.217952447	29.75239673	0	3.310976868	0.17350981	0.006588474	2.695189494	5.342549214	6.530308935	0.410845303	0.114425386	10.98097108	1.990831329	2.871812131	0	0	0	0.660028972	0	0.007824753	0	0	0	0	0	0	0	0	0	0	0	0	0	86.2572																																																																																		0			12.5637	0.176493542	0.733593732	0.02120606	2.842172954	3.72246817	1.131308477	0.217952447	29.75239673	0	3.310976868	0.17350981	0.006588474	2.695189494	5.342549214	6.530308935	0.410845303	0.114425386	10.98097108	1.990831329	2.871812131	0	0	0	0.660028972	0	0.007824753	0	0	0	0	0	0	0	0	0	0	0	0	0	86.2572
H5416_010_0	2009	10																					4950											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin	Coin																																																			0		1220.414472	12.74731062	319.833444	15.67321359	180.0535835	13.76667599	5.230267122	60.58325363	889.4672592	8.561417103	20.37315667	0.80203272	0.030482472	12.39436511	9099.10369	2263.165705	82.81422698	42.28540045	4057.969782	1705.977995	13.27696131	0	0	0	316.6743533	3.864237578	0	0	0	0											1a (IP Acute): 190 days 1-5	1b (IP Psych): 260 days 1-5	2a (SNF): 50 days 11-100	6a (Home Health): 15 copay	10a (Ambulance): 175 copay	11a (DME): 25% coin	11b (Medical Supplies): 20% coin	4a (ER): 50 copay	9b (OP Surg): 450 copay; 9b (OP ASC): 300 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 20% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 20% coin; 9c (OP SA): 50 copay; 3 (CORF): 50 copay; 5 (Partial Hosp): 55 copay; 9d (OP Cardiac Rehab): 45 copay	7a (PCP w/Copay): 7 copay	7b (Chiro): 18 copay; 7d (SPC w/Copay): 34 copay	7h (Psych): 55 copay; 7e (MH Non-Phys): 55 copay	7i (PT/ST): 30 copay; 7c (OT): 30 copay	7g (Prof. Other): 30 copay	7g (Prof. Other): 30 copay	15 (Part B Rx): 20% coin			16b (Comp. Dental): 34 copay	17a1 (Routine Eye Exam): 25 copay	17b1 (Non MCR Covered): 100 allowance															114.1805153	153.5721259	25.44562387	15	175	0.25	0.2	50	371.1146471	0	0.150242753	0.2	0.2	0.198662039	6.606378657	31.98944383	55	30	30	12.94715334	0.2	0	0	0	25	0	0	0	0	0											101.5000418	136.516963	22.61972525	13.33415445	155.5651352	0.222235907	0.177788726	50	329.9000015	0	0.133557338	0.177788726	0.177788726	0.176599354	5.929068551	28.43681232	48.89189965	26.6683089	26.6683089	11.50928949	0.177788726	0	0	0	25	0	0	0	0	0											10.3227	0.145018678	0.602878719	0.017415754	2.334171673	3.059449731	0.929882528	0.252430223	24.45293751	0	2.720984569	0.142592376	0.00541944	2.188836874	4.495767461	5.363101533	0.337412073	0.093973343	9.01826597	1.636216216	2.360494037	0	0	0	0.659738236	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.1397		7.3004	10.3227	0.145018678	0.602878719	0.017415754	2.334171673	3.059449731	0.929882528	0.252430223	24.45293751	0	2.720984569	0.142592376	0.00541944	2.188836874	4.495767461	5.363101533	0.337412073	0.093973343	9.01826597	1.636216216	2.360494037	0	0	0	0.659738236	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.1397		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.	20% coins.	20% coins.	20% coins.	20% coins.																				5.1614	0.0431	0.4147	0.1387	0.4019	0.6983	0.2653	0.495	1.3964	0.4343	1.0335	0.0407	0.0015	0.6287	3.6002	2.7194	0.0295	0.1266	1.662	0.2178	0.6735																				20.1828			15.4841	0.188086768	1.017608997	0.15614476	2.736082274	3.757795278	1.19519957	0.747436794	25.84938626	0.434297104	3.754458681	0.183277286	0.006965732	2.817568871	8.095979735	8.082512938	0.366924976	0.220547292	10.6802578	1.854057053	3.033997708	0	0	0	0.659738236	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.3224
H5417_001_0	2009	3																					2400											D	D	D	V	T	P	P	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1721.783658	46.71995407	8433.49204	54.02863463	328.2113319	343.3595472	1003.952576	146.1802778	110.0770313	12005.12895	1793.346717	0	5.049405106	137.5738098	191.931215	25236.76509	3525.210612	2.218857977	0	0	2132.83133	1645.837905	1099.507962	0	153.2976742	287.4465178	0	0	0	0											"$175 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0 (11a)	"$0 (11b, 11c)"	$50 (4a); $0 n/c (4a1); $35 (4b)	$35 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$35 (3, 5, 9a, 9d); $35/$25 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $35 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$15 (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"$35/$25 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											173.5454192	175	0	0	75	0	0	49.81865285	35	0	0	0	0	34.82157182	0	14.97692057	32.5	0	0	0	0	14.89888777	0	0	0	0	0	0	0	0											138.369887	139.529642	0	0	59.79841801	0	0	39.7210217	27.9059284	0	0	0	0	27.76366544	0	11.94128209	25.9126478	0	0	0	0	11.87906558	0	0	0	0	0	0	0	0											19.8536	0.543234872	0	0	1.635543202	0	0	0.483869166	0.25598348	0	0	0	0	0.318296102	0	25.11327758	7.612295085	0	0	0	0	1.629251367	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.4453	0	14.6034	19.8536	0.543234872	0	0	1.635543202	0	0	0.483869166	0.25598348	0	0	0	0	0.318296102	0	25.11327758	7.612295085	0	0	0	0	1.629251367	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.4453		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $35 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $35 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											3.008	0.3053	1.1239	0.0062	0.2195	0.1352	0.2521	0.0319	0.2074	0.7808	0.5471	0	0	0.0877	0.0176	2.7613	0.6675	0.0004	0	0	0.2419	0.1394	0.0994	0	0.0124	0	0	0	0	0											10.645	0	0	22.8616	0.848559872	1.123912036	0.006242085	1.855056246	0.13517313	0.252104548	0.515809975	0.463409785	0.78076516	0.54705241	0	0	0.405957176	0.017578522	27.87459049	8.279795085	0.000367599	0	0	0.241851325	1.768694707	0.099409385	0	0.012429412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.0904
H5417_005_0	2009	3																					3350											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1921.941178	8.153005896	38.37803004	1763.890952	141.065101	20.51045825	10.42996763	281.3242347	458.7298199	4458.3686	1294.976038	0	0.112534225	367.2283614	6237.751791	9032.091498	13.04868632	562.6606333	0	0	50.50672271	1712.352241	16.62305609	0	241.624264	247.1982329	0	0	20.2	0											"$225 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$225 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$125 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$125 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5); $125 (9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											222.80966	225	0.174015476	0	125	0.14	0.060960224	47.88117098	125	4.4	35.30964968	0	0.2	121.534681	3.509451956	25	20	20	0	0	0.2	24.87672998	0	0	0	0	0	0	0	0											163.8355455	165.4461379	0.174015476	0	91.91452106	0.102944264	0.044825038	35.20779919	91.91452106	3.235391141	25.96375631	0	0.147063234	89.36641599	3.509451956	25	20	20	0	0	0.147063234	24.87672998	0	0	0	0	0	0	0	0											26.2402	0.112406945	6.678371168	0	1.080494266	2.11143402	0.467523696	0.825400597	3.513660974	1.20204719	2.80187019	0	0.016549647	2.734823542	1.824257519	18.81685729	0.021747811	0.937767722	0	0	7.427681964	3.54981036	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.3629	0	17.4703	26.2402	0.112406945	6.678371168	0	1.080494266	2.11143402	0.467523696	0.825400597	3.513660974	1.20204719	2.80187019	0	0.016549647	2.734823542	1.824257519	18.81685729	0.021747811	0.937767722	0	0	7.427681964	3.54981036	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.3629		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.7781	0.1768	0.606	0.1696	0.1201	0.3238	0.1647	0.0592	0.7345	0.3048	1.0992	0	0.0012	0.1957	0.4652	2.5454	0.1203	0.0797	0	0	0.7975	0.1388	0.0014	0	0.0155	0	0	0	0.003	0											11.9004	0	0	30.0183	0.289166945	7.284340063	0.16960786	1.200550392	2.435283361	0.632207396	0.884589831	4.248187111	1.506890719	3.901117097	0	0.017734218	2.930537938	2.289443478	21.36226763	0.142047811	1.017468203	0	0	8.225156533	3.68859902	0.001435262	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	92.2633
H5417_006_0	2009	5																					2800											D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	7200	1773.162867	119.5444878	698.302305	1508.114895	127.6935253	11.17850276	4.617596504	290.7973184	308.7226759	11423.06267	67.80874705	0	0.232270445	369.2812957	5188.910678	5892.137781	442.3856602	493.6002491	0	0	30.19668603	1659.396837	0	689.5	88.13719193	0	12.96934645	0	350.9872136	0											"$175 Days 1-16/$325 Days 1-9 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-16/$325 Days 1-9 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-28 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$175 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 10%/20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); $175 (9a); $40/$30 (9c)"	"$5 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											298.9154279	302.5	100	0	150	0.2	0.086361462	47.54734146	175	2.8	0.099238954	0	0.2	61.09475657	3.657267708	20	37.5	20	0	0	0.2	19.66375538	0	0	20	0	20	0	0	0											171.9098956	173.9469545	57.50312544	0	86.25468816	0.115006251	0.04966054	27.3412074	100.6304695	1.610087512	0.0570655	0	0.115006251	35.38282	3.657267708	20	37.5	11.50062509	0	0	0.115006251	19.66375538	0	0	20	0	20	0	0	0											25.402	1.732866631	3.346213753	0	0.9178471	1.285597693	0.229312334	0.662562483	2.588908986	1.532677546	3.869540078	0	0.026712553	1.088851134	1.581436289	9.820229634	1.382455188	0.473059284	0	0	3.472807649	2.719164457	0	0	0.14689532	0	0.021615577	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3008	0	34.4408	25.402	1.732866631	3.346213753	0	0.9178471	1.285597693	0.229312334	0.662562483	2.588908986	1.532677546	3.869540078	0	0.026712553	1.088851134	1.581436289	9.820229634	1.382455188	0.473059284	0	0	3.472807649	2.719164457	0	0	0.14689532	0	0.021615577	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3008		"$375 Days 1-20 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$375 Days 1-20 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-48 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$40 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$40 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$40 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a7, 14a8, 14a9, 14a10); $0 (14a6)"	"$0 n/c (13b, 13d, 13e)"											5.2101	0.3501	3.999	0.9878	0.3656	0.7682	0.3173	0.2639	3.5238	0.6106	3.7647	0	0.0106	1.4579	5.7357	8.4149	0.6715	0.4846	0	0	2.668	2.3403	0	0.684	0.1259	0	0.0185	0	0	0											42.773	0	11.38766986	30.6121	2.082946389	7.345210753	0.987771123	1.283481025	2.053794482	0.546637729	0.926501129	6.112757604	2.143235563	7.634196916	0	0.037353776	2.546768398	7.317094732	18.23512169	2.053933423	0.957640058	0	0	6.140849278	5.059417194	0	0.684	0.272805594	0	0.040143215	0	0	0	0	0	0	0	0	0	0	0	0	0	105.0738
H5419_001_0	2009	6	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Ambulatory Surgical Center	Urgent Care	Radiology	Chiropractic	Podiatric	Vision Exam Diagnostic	Hearing Exam Diagnostic	Radiation-Chemotherapy	Radiology	Diabetes Supplies	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	Coin	V	V	0	Coin	0	0	0	V	V	V	0	0	0	V	V	V	V	V	V	V	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	0	0	0	0	0	0	0	0	0		1792.794331	6.672103948	432.3523358	50.70799	202.1647496	14.10850212	1.566731343	305.5823608	211.5056951	4747.201959	233.5236382	42.70146527	0	304.9151504	4450.293333	3026.466351	0.090670582	1454.518661	382.9787666	0	51.87562337	0	0	0	441.9477469	351.2071332	190.2861391	0	0	0	142.7830245	6.672103948	530.4322638	765.2903228	487.7307986	748.6100629	2.668841579	22.26120424	2651.494109	1.702368547	$200/day (days 1-5); $1000 yrly max	$200/day (days 1-5); $1000 yrly max	$125/day (for days 21-100)	$0 copay	$100 copay	30% coinsurance	30% coinsurance	$50 copay	$175 copay	$15 copay	$100 copay/Higher Tier	$175 copay	20% coinsurance	$25 copay	$15 copay	$25 copay	50% coinsurance	$25 copay	$100 copay/Higher Tier	0	20% coinsurance	0	0	0	$25 copay	Covd up to $50/ Every 2 yrs.	$25 copay	0	0	0	$100 copay	$25 copay	$15 copay/Lower Tier	$25 copay	$25 copay	$25 copay	$25 copay	20% coinsurance	$15 copay/Lower Tier	20% coinsurance	200	200	125	0	100	0.3	0.3	50	175	15	100	175	0.2	25	15	25	0.5	25	100	0	0.2	0	0	0	25	0	25	0	0	0	100	25	15	25	25	25	25	0.2	15	0.2	75.29126982	192.6739448	120.4212155	0	96.33697239	0.289010917	0.289010917	48.1684862	168.5897017	14.45054586	96.33697239	168.5897017	0	24.0842431	14.45054586	24.0842431	0.481684862	24.0842431	96.33697239	0	0.192673945	0	0	0	24.0842431	0	24.0842431	0	0	0	96.33697239	24.0842431	14.45054586	24.0842431	24.0842431	24.0842431	24.0842431	0.192673945	14.45054586	0.192673945	11.2485	0.107128382	4.338699483	0	1.622994992	4.077511138	0.452802462	1.226619977	2.971473504	5.7166383	1.87474669	0.599918941	0	0.611970884	5.359097325	6.074179276	0.043674647	2.919248418	3.074584572	0	9.995080992	0	0	0	0.886998081	0	0.381908136	0	0	0	1.146273691	0.013391048	0.638752979	1.535953181	0.978885593	1.502475562	0.005356419	4.289154036	3.192961434	0.328002063	77.215		2.936	11.2485	0.107128382	4.338699483	0	1.622994992	4.077511138	0.452802462	1.226619977	2.971473504	5.7166383	1.87474669	0.599918941	0	0.611970884	5.359097325	6.074179276	0.043674647	2.919248418	3.074584572	0	9.995080992	0	0	0	0.886998081	0	0.381908136	0	0	0	1.146273691	0.013391048	0.638752979	1.535953181	0.978885593	1.502475562	0.005356419	4.289154036	3.192961434	0.328002063	77.215	4000																																																																																	0		0	11.2485	0.107128382	4.338699483	0	1.622994992	4.077511138	0.452802462	1.226619977	2.971473504	5.7166383	1.87474669	0.599918941	0	0.611970884	5.359097325	6.074179276	0.043674647	2.919248418	3.074584572	0	9.995080992	0	0	0	0.886998081	0	0.381908136	0	0	0	1.146273691	0.013391048	0.638752979	1.535953181	0.978885593	1.502475562	0.005356419	4.289154036	3.192961434	0.328002063	77.215
H5419_004_0	2009	9	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Ambulatory Surgical Center	Urgent Care	Radiology	Chiropractic	Podiatric	Vision Exam Diagnostic	Hearing Exam Diagnostic	Radiation-Chemotherapy	Radiology	Diabetes Supplies	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	Coin	V	V	0	Coin	0	0	0	V	V	V	0	0	0	V	V	V	V	V	V	V	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	0	0	0	0	0	0	0	0	0		1483.157731	23.56938678	292.2859332	42.83913952	161.0861539	10.00354563	0.638984915	254.2056812	260.8099465	4351.698448	230.4908513	73.60077864	0.080616503	402.8148183	3803.643531	2570.751058	0.756253186	955.1043133	277.6550294	0	61.41404738	0	0	0	458.9609627	364.7200047	197.6074942	0	0	0	110.9718768	12.62144797	566.2281873	570.4650397	350.4463789	709.7728649	1.169875909	18.77393229	2213.910107	1.279071828	$275/day (days 1-5); $1375 yrly max	$275/day (days 1-5); $1375 yrly max	$125/day (for days 21-100)	$0 copay	$150 copay	30% coinsurance	30% coinsurance	$50 copay	$200 copay	$20 copay	$100 copay/Higher Tier	$200 copay	20% coinsurance	$30 copay	$20 copay	$30 copay	50% coinsurance	$30 copay	$100 copay/Higher Tier	0	20% coinsurance	0	0	0	$30 copay	Covd up to $50/ Every 2 yrs.	$30 copay	0	0	0	$100 copay	$30 copay	$30 copay/Lower Tier	$30 copay	$30 copay	$30 copay	$30 copay	20% coinsurance	$30 copay/Lower Tier	20% coinsurance	275	275	125	0	150	0.3	0.3	50	200	20	100	200	0.2	30	20	30	0.5	30	100	0	0.2	0	0	0	30	0	30	0	0	0	100	30	30	30	30	30	30	0.2	30	0.2	111.9507926	203.3809461	120.6454985	0	144.7745981	0.289549196	0.289549196	48.25819938	193.0327975	19.30327975	96.51639876	193.0327975	0.193032798	28.95491963	19.30327975	28.95491963	0.482581994	28.95491963	96.51639876	0	0.193032798	0	0	0	28.95491963	0	28.95491963	0	0	0	96.51639876	28.95491963	28.95491963	28.95491963	28.95491963	28.95491963	28.95491963	0.193032798	28.95491963	0.193032798	13.8367	0.399463682	2.938581842	0	1.943431933	2.896518598	0.185017569	1.02229237	4.195406132	7.000171045	1.853845576	1.183947017	0.015561629	0.971955891	6.118566263	6.202990855	0.36495417	2.304580719	2.233188628	0	11.85492537	0	0	0	1.107431482	0	0.476809093	0	0	0	0.892550493	0.030454418	1.366257638	1.376480781	0.845595561	1.712618022	0.002822805	3.623984671	5.341965768	0.246902813	84.546		3.0515	13.8367	0.399463682	2.938581842	0	1.943431933	2.896518598	0.185017569	1.02229237	4.195406132	7.000171045	1.853845576	1.183947017	0.015561629	0.971955891	6.118566263	6.202990855	0.36495417	2.304580719	2.233188628	0	11.85492537	0	0	0	1.107431482	0	0.476809093	0	0	0	0.892550493	0.030454418	1.366257638	1.376480781	0.845595561	1.712618022	0.002822805	3.623984671	5.341965768	0.246902813	84.546	4000																																																																																	0		0	13.8367	0.399463682	2.938581842	0	1.943431933	2.896518598	0.185017569	1.02229237	4.195406132	7.000171045	1.853845576	1.183947017	0.015561629	0.971955891	6.118566263	6.202990855	0.36495417	2.304580719	2.233188628	0	11.85492537	0	0	0	1.107431482	0	0.476809093	0	0	0	0.892550493	0.030454418	1.366257638	1.376480781	0.845595561	1.712618022	0.002822805	3.623984671	5.341965768	0.246902813	84.546
H5419_805_0	2009	4																																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	V																																																			0		365.3593499	4.374559083	12.26254411	7.51591603	9.063740348	18.32327681	0.772050688	17.30993187	60.772274	19.07280383	51.51971427	0	0.432174943	50.69742458	52.19049506	141.4572505	1.609337633	5.415917694	35.17159107	46.57383216	68.71254642	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.06440299	0.06440299	0.158372334	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.06440299	0.06440299	0.158372334	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			23.5302	0.281734687	1.942047727	0	2.09372402	4.232676943	0.178343709	3.998594261	14.03839529	4.405817685	11.901054	0	0.099832412	11.71110508	12.05600436	32.67662486	0.371756993	1.251076987	8.124637537	10.75855523	15.87259822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	159.5248			23.5302	0.281734687	1.942047727	0	2.09372402	4.232676943	0.178343709	3.998594261	14.03839529	4.405817685	11.901054	0	0.099832412	11.71110508	12.05600436	32.67662486	0.371756993	1.251076987	8.124637537	10.75855523	15.87259822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	159.5248																																																																																		0			23.5302	0.281734687	1.942047727	0	2.09372402	4.232676943	0.178343709	3.998594261	14.03839529	4.405817685	11.901054	0	0.099832412	11.71110508	12.05600436	32.67662486	0.371756993	1.251076987	8.124637537	10.75855523	15.87259822	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	159.5248
H5419_806_0	2009	4																																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	V																																																			0		359.5747749	4.305298601	17.91769503	6.692858994	7.588448345	17.42284045	0.73411083	18.95034527	57.34280767	33.2746393	89.88190328	0	0.753977521	88.44732697	29.69084097	80.47413084	0.915541952	3.081081158	20.00889465	26.49555715	52.46816726	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.06440299	0.06440299	0.158372334	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.06440299	0.06440299	0.158372334	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			23.1577	0.277274104	2.837667174	0	1.752931568	4.024676143	0.169579602	4.377529758	13.24618857	7.686441679	20.76271966	0	0.174168807	20.43133253	6.858584265	18.58952422	0.211490191	0.711729748	4.622054664	6.120473701	12.12014664	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.1322			23.1577	0.277274104	2.837667174	0	1.752931568	4.024676143	0.169579602	4.377529758	13.24618857	7.686441679	20.76271966	0	0.174168807	20.43133253	6.858584265	18.58952422	0.211490191	0.711729748	4.622054664	6.120473701	12.12014664	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.1322																																																																																		0			23.1577	0.277274104	2.837667174	0	1.752931568	4.024676143	0.169579602	4.377529758	13.24618857	7.686441679	20.76271966	0	0.174168807	20.43133253	6.858584265	18.58952422	0.211490191	0.711729748	4.622054664	6.120473701	12.12014664	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.1322
H5419_808_0	2009	4																																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	V																																																			0		359.5747749	4.305298601	17.91769503	6.692858994	7.588448345	17.42284045	0.73411083	18.95034527	57.34280767	33.2746393	89.88190328	0	0.753977521	88.44732697	29.69084097	80.47413084	0.915541952	3.081081158	20.00889465	26.49555715	52.46816726	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.06440299	0.06440299	0.158372334	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.06440299	0.06440299	0.158372334	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			23.1577	0.277274104	2.837667174	0	1.752931568	4.024676143	0.169579602	4.377529758	13.24618857	7.686441679	20.76271966	0	0.174168807	20.43133253	6.858584265	18.58952422	0.211490191	0.711729748	4.622054664	6.120473701	12.12014664	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.1322			23.1577	0.277274104	2.837667174	0	1.752931568	4.024676143	0.169579602	4.377529758	13.24618857	7.686441679	20.76271966	0	0.174168807	20.43133253	6.858584265	18.58952422	0.211490191	0.711729748	4.622054664	6.120473701	12.12014664	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.1322																																																																																		0			23.1577	0.277274104	2.837667174	0	1.752931568	4.024676143	0.169579602	4.377529758	13.24618857	7.686441679	20.76271966	0	0.174168807	20.43133253	6.858584265	18.58952422	0.211490191	0.711729748	4.622054664	6.120473701	12.12014664	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.1322
H5420_001_0	2009	6																					1500																	P	V																																							0	0																																	0								555.0924048	501.2442838																																							$0 to $25 varies by service	"$50 ER waived if admitted, $0 UC"																																							0.125	28																																							0.125	28																																	0	0	0	0	0	0	0.005782213	1.169569996	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.1754		0	0	0	0	0	0	0	0.005782213	1.169569996	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.1754									"$50 ER waived if admitted, $0 UC"																																								0.0487																																	0.0487			0	0	0	0	0	0	0.005782213	1.218302079	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.2241
H5420_003_0	2009	6																					2500													D		T	Coin	Coin	V			V		Coin				V	V			Coin																																																												0				430.9097183		493.6891204	7.213826374	0.978287796	497.3530986			3356.066903		0.298046862				965.6022834	942.1136672			8.287161184																						$25/Day days 7-21		"$40 Copay, waived if admitted"	0-20%	20%	"$50 ER, $10 UC waived if admitted"			$0 to $25 varies by service		20%				$10 	$10 			20%																						13.59281081		32	0.1	0.2	36.9			12.5		0.2				10	5			0.2																						13.44736773		31.6576	0.09893	0.19786	36.50517			12.37		0.19786				9.893	4.9465			0.19786																				0	0	0.482883453	0	1.302417725	0.713663843	0.193564023	1.512996618	0	0	3.459545632	0	0.058971552	0	0	0	0.796058616	0.388347105	0	0	1.639697712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.5481		0.1141	0	0	0.482883453	0	1.302417725	0.713663843	0.193564023	1.512996618	0	0	3.459545632	0	0.058971552	0	0	0	0.796058616	0.388347105	0	0	1.639697712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.5481				$25/Day days 7-21		"$40 Copay, waived if admitted"		20%	"$50 ER, $10 UC waived if admitted"			$0 to $25 varies by service							$10 			20%																						0.0149		0.0403		0.006	0.0468			0.107							0.012			0.0507																				0.2777			0	0	0.497817993	0	1.342698685	0.713663843	0.199550539	1.559790328	0	0	3.566509453	0	0.058971552	0	0	0	0.796058616	0.40035784	0	0	1.690410012	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.8258
H5420_004_0	2009	5																					2500																	P	V																																																																									0								372.9446295	409.9021359																																							$0 to $25 varies by service	"$50 ER waived if admitted, $0 UC"																																							0.125	36																																							0.125	36																																	0	0	0	0	0	0	0.00388484	1.229706408	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.2336		0	0	0	0	0	0	0	0.00388484	1.229706408	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.2336									"$50 ER waived if admitted, $0 UC"																																								0.0384																																	0.0384			0	0	0	0	0	0	0.00388484	1.268134733	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.272
H5420_005_0	2009	5																					2500												D	D		T	Coin	Coin	V	V				Coin				V	V			Coin																																																												0			503.4420177	617.2283552		834.8606323	8.022852219	2.008096693	444.6430717	253.8061164				0.461068571				1783.376392	1026.323227			7.38047178																					$175 / days 1-5	$25 / days 7-100		"$25, waived if admitted"	0% to 20% varies by type	20%	"$50 ER, $25 UC Waived if Admitted"	$100 				20%				$25 	$25 			20%																					75.2578113	12.62720943		20	0.1	0.198	38.25	100				0.2				25	25			0.2																					65.47429583	10.9856722		17.4	0.087	0.17226	33.2775	87				0.174				21.75	21.75			0.174																				0	2.746875967	0.565055699	0	1.210547917	0.697988143	0.345914736	1.233050818	1.840094344	0	0	0	0.080225931	0	0	0	3.232369711	1.86021085	0	0	1.28420209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.0965		2.2558	0	2.746875967	0.565055699	0	1.210547917	0.697988143	0.345914736	1.233050818	1.840094344	0	0	0	0.080225931	0	0	0	3.232369711	1.86021085	0	0	1.28420209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.0965			$175 / days 1-5	$25 / days 7-100		"$25, waived if admitted"		20%	"$50 ER, $25 UC Waived if Admitted"	$100 									$25 			20%																					0.0858	0.0177		0.0378		0.0108	0.0385	0.0575									0.0581			0.0401																				0.3464			0	2.832715841	0.582713689	0	1.248377539	0.697988143	0.356724572	1.271583656	1.897597292	0	0	0	0.080225931	0	0	0	3.232369711	1.918342439	0	0	1.324333405	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.443
H5420_006_0	2009	5																					1000															T			V																																																																									0						497.4923027			419.7681821																																					$25 / Waived if admitted			$25 / Waived if admitted																																					20			18																																					20			18																																	0	0	0	0	0.829153838	0	0	0.629652273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.4588		0	0	0	0	0	0.829153838	0	0	0.629652273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.4588						$25 / Waived if admitted			$25 / Waived if admitted																																					0.0259			0.0197																																	0.0456			0	0	0	0	0.855064895	0	0	0.649328907	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.5044
H5420_007_0	2009	2																					1500															T		P	V																P																																																									0						576.8928043		532.8887086	501.2442838																500																					$25 / waived if admitted		$0 to $25 for diabetic supplies	"$25 ER, $10 UC waived if admitted"																$0-$175																					20		0.125	16.7																15																					20		0.125	16.7																15																	0	0	0	0	0.961488007	0	0.005550924	0.697564962	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.2896		0	0	0	0	0	0.961488007	0	0.005550924	0.697564962	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.2896						$25 / waived if admitted			"$25 ER, $10 UC waived if admitted"																																					0.03			0.0218																																	0.0518			0	0	0	0	0.991534507	0	0.005550924	0.719363867	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.3414
H5420_008_0	2009	4																					2500												D	D		T	Coin	Coin	V	V				Coin				V	V			Coin																																																												0			584.1843744	557.5026888		534.579291	7.457198503	2.330156541	464.4793831	250.4100707				0.535015046				1983.0557	1034.675039			8.564156621																					$175 / days 1-5	$25 / days 7-100		$100 / Waived if admitted	0% to 20% varies by type	"20% Prosthetics, $0-$25 Diabetes Monitoring Supplies"	"$50 ER, $15 UC waived if admitted"	$100 				20%				$10 	$25 			20%																					75.2578113	14.01148604		80	0.1	0.2	37.35	100				0.2				10	25			0.2																					72.6237879	13.52108403		77.2	0.0965	0.193	36.04275	96.5				0.193				9.65	24.125			0.193																				0	3.535473508	0.628170059	0	3.439126772	0.719619656	0.449720212	1.395092857	2.013714319	0	0	0	0.103257904	0	0	0	1.594707292	2.080127943	0	0	1.652882228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.6119		0.6388	0	3.535473508	0.628170059	0	3.439126772	0.719619656	0.449720212	1.395092857	2.013714319	0	0	0	0.103257904	0	0	0	1.594707292	2.080127943	0	0	1.652882228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.6119			$175 / days 1-5	$25 / days 7-100		$100 / Waived if admitted			"$50 ER, $15 UC waived if admitted"	$100 				20%					$25 			20%																					0.1105	0.0196		0.1075			0.0436	0.0629				0.0032					0.065			0.0517																				0.464			0	3.645957055	0.647800373	0	3.546599484	0.719619656	0.449720212	1.438689509	2.076642891	0	0	0	0.106484713	0	0	0	1.594707292	2.145131941	0	0	1.704534797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	18.0759
H5420_009_0	2009	5																					3350											D	D	D		T		Coin	V	V		V		Coin			V	V	V			Coin				V																																																								0		3357.817706	590.2696283	563.3100085		540.1478252		2.354429005	469.31771	253.018509		2731.125421		0.54058812			15634.40961	2003.71253	1045.452904			8.653366586				375.1702058																$75 / days 1-5	$175 / days 1-5	$75 / days 8-30		$100 		"20% Prosthetics, $0-$25 Diabetes Monitoring Supplies"	"$50 ER waived if admitted, $0 UC"	$50 		$0-$100 varies by service		20%			$10 	$25 	$20 			20%				$10 																48.63311011	75.2578113	37.07552223		100		0.2	36	50		40		0.2			10	25	20			0.2				10																46.93095126	72.6237879	35.77787895		96.5		0.193	34.74	48.25		38.6		0.193			9.65	24.125	19.3			0.193				9.65																13.1321	3.572301357	1.679503108	0	4.343688761	0	0.454404798	1.35867477	1.017345255	0	8.785120104	0	0.104333507	0	0	12.57267106	4.028297066	1.681436754	0	0	1.670099751	0	0	0	0.301699374	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.7017		1.984	13.1321	3.572301357	1.679503108	0	4.343688761	0	0.454404798	1.35867477	1.017345255	0	8.785120104	0	0.104333507	0	0	12.57267106	4.028297066	1.681436754	0	0	1.670099751	0	0	0	0.301699374	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.7017		$75 / days 1-5	$175 / days 1-5	$75 / days 8-30		$100 		20%	"$50 ER waived if admitted, $0 UC"	$50 		$0-$100 varies by service		20%			$10 		$20 																							0.4061	0.1105	0.0519		0.1343		0.0141	0.042	0.0315		0.2717		0.0032			0.3888		0.052																							1.5062			13.5383	3.682784904	1.731446503	0	4.478029651	0	0.468458555	1.40069564	1.048809541	0	9.05682485	0	0.107560317	0	0	12.96151656	4.028297066	1.733439952	0	0	1.670099751	0	0	0	0.301699374	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.2079
H5421_046_0	2009	2																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		310.097846	38.8339373	412.8707588	20.78123278	178.4242967	22.35849299	1.271130047	757.5141131	1401.747006		15.54979747		4.232685203	2.402369459	3910.176937	3607.924114	1.05918068	588.2623445		44.13446316	1.281811413	617.9212396			94.77503051		20.84518003														1a: $350 per admit $875 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.63135167		0.1		50	0.259087199	10	25	0.5	15		30.55670103	0.2	15			15		15														284.684682	90.40772114	24.94651199	0.122007721	81.33848056	0.162676961	0.162676961	40.66924028	77.78508838		0.081338481		40.66924028	0.210737591	8.133848056	20.33462014	0.406692403	12.20077208		24.85435633	0.162676961	12.20077208			12.20077208		12.20077208														7.3567	0.292573981	0.858307111	2.535470847	1.209396766	3.637211696	0.206783573	2.567293623	9.08625123	0	1.264796899	0	0.014345008	0.506269552	2.650398757	6.113813862	0.430760736	0.598104566	0	0.091411139	0.208521185	0.628259684	0	0	0.096360712	0	0.021193941	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3742	0	9.2631	7.3567	0.292573981	0.858307111	2.535470847	1.209396766	3.637211696	0.206783573	2.567293623	9.08625123	0	1.264796899	0	0.014345008	0.506269552	2.650398757	6.113813862	0.430760736	0.598104566	0	0.091411139	0.208521185	0.628259684	0	0	0.096360712	0	0.021193941	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3742																																																																																		0	0	0	7.3567	0.292573981	0.858307111	2.535470847	1.209396766	3.637211696	0.206783573	2.567293623	9.08625123	0	1.264796899	0	0.014345008	0.506269552	2.650398757	6.113813862	0.430760736	0.598104566	0	0.091411139	0.208521185	0.628259684	0	0	0.096360712	0	0.021193941	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3742
H5421_047_0	2009	2																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		295.0678001	17.63664421	159.9885393	13.20765358	147.5819257	22.91787082	1.235329858	698.1519739	1397.58872		16.65680768		4.548786859	3.158871615	3962.397873	3419.861855	1.030660357	612.5182702		50.61216424	1.311613554	657.4210508			98.01911915		20.91712333														1a: $350 per admit $875 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.58622574		0.1		50	0.278802468	10	25	0.5	15		30.93964335	0.2	15			15		15														289.5059635	91.93882239	25.368994	0.124073984	82.71598956	0.165431979	0.165431979	41.35799478	79.06509251		0.08271599		41.35799478	0.23061422	8.271598956	20.67899739	0.413579948	12.40739843		25.59203216	0.165431979	12.40739843			12.40739843		12.40739843														7.1187	0.135124358	0.338229024	1.638726203	1.017282085	3.791348727	0.204363063	2.406180474	9.208373451	0	1.37778433	0	0.015677392	0.728480714	2.731280509	5.893276197	0.426260456	0.633313186	0	0.107939011	0.216982826	0.67974041	0	0	0.101346855	0	0.021627257	0	0	0	0	0	0	0	0	0	0	0	0	0	38.792	0	8.1058	7.1187	0.135124358	0.338229024	1.638726203	1.017282085	3.791348727	0.204363063	2.406180474	9.208373451	0	1.37778433	0	0.015677392	0.728480714	2.731280509	5.893276197	0.426260456	0.633313186	0	0.107939011	0.216982826	0.67974041	0	0	0.101346855	0	0.021627257	0	0	0	0	0	0	0	0	0	0	0	0	0	38.792																																																																																		0	0	0	7.1187	0.135124358	0.338229024	1.638726203	1.017282085	3.791348727	0.204363063	2.406180474	9.208373451	0	1.37778433	0	0.015677392	0.728480714	2.731280509	5.893276197	0.426260456	0.633313186	0	0.107939011	0.216982826	0.67974041	0	0	0.101346855	0	0.021627257	0	0	0	0	0	0	0	0	0	0	0	0	0	38.792
H5421_048_0	2009	2																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		316.6413747	56.93778892	480.4005306	18.73237234	148.803136	20.81240754	1.149920255	682.9094393	1524.498352		15.57878456		17.39597195	2.701764859	3688.043597	3968.177923	1.684543961	638.5276527		47.47242762	1.945804247	695.6250589			99.41526125		21.5787025														1a: $350 per admit $875 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.82883577		0.1		50	0.23961455	10	25	0.5	15		30.89108911	0.2	15			15		15														282.0977681	89.58619122	24.71982442	0.120899043	80.59936232	0.161198725	0.161198725	40.29968116	77.23743056		0.080599362		40.29968116	0.193127799	8.059936232	20.14984058	0.402996812	12.08990435		24.89802084	0.161198725	12.08990435			12.08990435		12.08990435														7.4437	0.42506997	0.989618064	2.264725898	0.999453156	3.354933553	0.185365678	2.293419389	9.812361303	0	1.255640101	0	0.05842101	0.521785901	2.477116351	6.663179378	0.678865845	0.64331152	0	0.098497458	0.313661163	0.700836702	0	0	0.100160083	0	0.021740371	0	0	0	0	0	0	0	0	0	0	0	0	0	41.3018	0	9.9415	7.4437	0.42506997	0.989618064	2.264725898	0.999453156	3.354933553	0.185365678	2.293419389	9.812361303	0	1.255640101	0	0.05842101	0.521785901	2.477116351	6.663179378	0.678865845	0.64331152	0	0.098497458	0.313661163	0.700836702	0	0	0.100160083	0	0.021740371	0	0	0	0	0	0	0	0	0	0	0	0	0	41.3018																																																																																		0	0	0	7.4437	0.42506997	0.989618064	2.264725898	0.999453156	3.354933553	0.185365678	2.293419389	9.812361303	0	1.255640101	0	0.05842101	0.521785901	2.477116351	6.663179378	0.678865845	0.64331152	0	0.098497458	0.313661163	0.700836702	0	0	0.100160083	0	0.021740371	0	0	0	0	0	0	0	0	0	0	0	0	0	41.3018
H5421_049_0	2009	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		341.9764774	28.21871092	207.5003049	18.59544189	178.5061334	24.03469446	1.490823879	722.8385298	1621.152186		16.08733933		5.644494402	2.856021494	3755.580397	4232.553329	1.153352698	703.5255427		47.39227453	1.485193668	695.1062516			101.6619832		19.65573155														1a: $350 per admit $875 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.87832592		0.1		50	0.267081258	10	25	0.5	15		30.8004827	0.2	15			15		15														278.9401426	88.58341957	24.44312621	0.119545775	79.6971836	0.159394367	0.159394367	39.8485918	76.41232544		0.079697184		39.8485918	0.21285624	7.96971836	19.9242959	0.398485918	11.95457754		24.54711725	0.159394367	11.95457754			11.95457754		11.95457754														7.9492	0.208309159	0.422663012	2.22300652	1.185536341	3.830994914	0.237628929	2.400341459	10.3230007	0	1.282115636	0	0.018743763	0.607921997	2.49424317	7.027553744	0.459594809	0.700862554	0	0.09694531	0.236731505	0.692475132	0	0	0.101277172	0	0.019581331	0	0	0	0	0	0	0	0	0	0	0	0	0	42.5188	0	10.8316	7.9492	0.208309159	0.422663012	2.22300652	1.185536341	3.830994914	0.237628929	2.400341459	10.3230007	0	1.282115636	0	0.018743763	0.607921997	2.49424317	7.027553744	0.459594809	0.700862554	0	0.09694531	0.236731505	0.692475132	0	0	0.101277172	0	0.019581331	0	0	0	0	0	0	0	0	0	0	0	0	0	42.5188																																																																																		0	0	0	7.9492	0.208309159	0.422663012	2.22300652	1.185536341	3.830994914	0.237628929	2.400341459	10.3230007	0	1.282115636	0	0.018743763	0.607921997	2.49424317	7.027553744	0.459594809	0.700862554	0	0.09694531	0.236731505	0.692475132	0	0	0.101277172	0	0.019581331	0	0	0	0	0	0	0	0	0	0	0	0	0	42.5188
H5421_050_0	2009	2																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		367.1546524	46.67220158	328.6576127	21.36721975	168.6404255	24.65765648	2.180281502	713.9611861	1663.009805		14.56290383		12.83085896	2.331365764	3652.68267	4506.881242	1.342159293	620.4842771		33.04611427	1.599140049	720.6435507			109.0423899		21.6258992														1a: $350 per admit $875 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.80881391		0.1		50	0.256209975	10	25	0.5	15		30.52631579	0.2	15			15		15														275.7451471	87.56878029	24.16315332	0.118176492	78.78432775	0.157568656	0.157568656	39.39216388	75.48232997		0.078784328		39.39216388	0.201853306	7.878432775	19.69608194	0.393921639	11.81764916		24.04995268	0.157568656	11.81764916			11.81764916		11.81764916														8.4368	0.340585647	0.66178369	2.525103066	1.107185213	3.88527378	0.343544025	2.343706337	10.46065457	0	1.147328588	0	0.042119608	0.470593888	2.398117905	7.397325185	0.528705588	0.611055458	0	0.06622979	0.251974348	0.709692721	0	0	0.107385392	0	0.021297274	0	0	0	0	0	0	0	0	0	0	0	0	0	43.8564	0	11.81	8.4368	0.340585647	0.66178369	2.525103066	1.107185213	3.88527378	0.343544025	2.343706337	10.46065457	0	1.147328588	0	0.042119608	0.470593888	2.398117905	7.397325185	0.528705588	0.611055458	0	0.06622979	0.251974348	0.709692721	0	0	0.107385392	0	0.021297274	0	0	0	0	0	0	0	0	0	0	0	0	0	43.8564																																																																																		0	0	0	8.4368	0.340585647	0.66178369	2.525103066	1.107185213	3.88527378	0.343544025	2.343706337	10.46065457	0	1.147328588	0	0.042119608	0.470593888	2.398117905	7.397325185	0.528705588	0.611055458	0	0.06622979	0.251974348	0.709692721	0	0	0.107385392	0	0.021297274	0	0	0	0	0	0	0	0	0	0	0	0	0	43.8564
H5421_051_0	2009	2																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		380.7466031	26.34266798	212.5384885	25.59586884	178.6262131	23.14494801	2.911006303	726.5261673	1792.664786		15.66967818		0.531474885	2.212981857	3790.965363	4822.788031	1.236348632	853.5649412		32.41049574	1.269881084	785.7313947			117.0551417		24.39276879														1a: $350 per admit $875 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	96.09398162		0.1		50	0.223606243	10	25	0.5	15		29.50819672	0.2	15			15		15														272.420241	86.5128851	23.87179654	0.116751532	77.83435456	0.155668709	0.155668709	38.91717728	74.79413037		0.077834355		38.91717728	0.174042476	7.783435456	19.45858864	0.389171773	11.67515318		22.96751446	0.155668709	11.67515318			11.67515318		11.67515318														8.6436	0.189915017	0.422806296	2.988356896	1.158604667	3.602944179	0.453152593	2.356195638	11.17340031	0	1.219639287	0	0.001723625	0.385152843	2.458894518	7.820387366	0.481151989	0.830458453	0	0.062032377	0.197680749	0.7644612	0	0	0.113886392	0	0.023732443	0	0	0	0	0	0	0	0	0	0	0	0	0	45.3482	0	12.9142	8.6436	0.189915017	0.422806296	2.988356896	1.158604667	3.602944179	0.453152593	2.356195638	11.17340031	0	1.219639287	0	0.001723625	0.385152843	2.458894518	7.820387366	0.481151989	0.830458453	0	0.062032377	0.197680749	0.7644612	0	0	0.113886392	0	0.023732443	0	0	0	0	0	0	0	0	0	0	0	0	0	45.3482																																																																																		0	0	0	8.6436	0.189915017	0.422806296	2.988356896	1.158604667	3.602944179	0.453152593	2.356195638	11.17340031	0	1.219639287	0	0.001723625	0.385152843	2.458894518	7.820387366	0.481151989	0.830458453	0	0.062032377	0.197680749	0.7644612	0	0	0.113886392	0	0.023732443	0	0	0	0	0	0	0	0	0	0	0	0	0	45.3482
H5421_052_0	2009	2																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		324.2932495	88.56081707	306.2680382	27.38207202	196.9426136	24.33158891	2.88059933	772.4456832	1056.047757		13.35449592		0.97040915	2.682592658	2826.946065	2490.555006	1.089786115	420.3069262		29.5888315	1.19039867	465.7137833			71.06502468		15.5419966														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	182.6786125		0.2		50	0.401998629	20	35	0.5	35		35	0.2	35			35		35														110.583369	137.9983932	25.17044734	0.16413725	123.1029378	0.16413725	0.16413725	41.03431259	149.9218257		0.16413725		41.03431259	0.329914748	16.41372504	28.72401881	0.410343126	28.72401881		28.72401881	0.16413725	28.72401881			28.72401881		28.72401881														2.9885	1.018437538	0.642408627	4.49441801	2.020351192	3.993720101	0.472813653	2.641398135	13.19371732	0	2.19197024	0	0.003318339	0.885026882	3.866726284	5.961562403	0.447186241	1.006075338	0	0.070825846	0.195388764	1.114764289	0	0	0.170106092	0	0.037202384	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4159	0	10.36	2.9885	1.018437538	0.642408627	4.49441801	2.020351192	3.993720101	0.472813653	2.641398135	13.19371732	0	2.19197024	0	0.003318339	0.885026882	3.866726284	5.961562403	0.447186241	1.006075338	0	0.070825846	0.195388764	1.114764289	0	0	0.170106092	0	0.037202384	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4159																																																																																		0	0	0	2.9885	1.018437538	0.642408627	4.49441801	2.020351192	3.993720101	0.472813653	2.641398135	13.19371732	0	2.19197024	0	0.003318339	0.885026882	3.866726284	5.961562403	0.447186241	1.006075338	0	0.070825846	0.195388764	1.114764289	0	0	0.170106092	0	0.037202384	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4159
H5421_053_0	2009	2																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		324.2932495	88.56081707	306.2680382	25.07629946	196.9426136	22.28268955	2.638031607	772.4456832	1056.047757		12.2299488		0.97040915	2.456698558	2826.946065	2490.555006	0.998018081	420.3069262		29.5888315	1.090158316	465.7137833			71.06502468		15.5419966														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	182.6786125		0.2		50	0.438962513	20	35	0.5	35		35	0.2	34.94786782			35		35														111.2854974	138.8745881	25.33026238	0.165179409	123.8845568	0.165179409	0.165179409	41.29485226	150.8737262		0.165179409		41.29485226	0.362537842	16.5179409	28.90639658	0.412948523	28.90639658		28.90639658	0.165179409	28.90639658			28.90639658		28.90639658														3.0074	1.024903916	0.64648748	4.142088326	2.033179033	3.680641492	0.435748502	2.658169197	13.27748835	0	2.020135715	0	0.003339409	0.890646194	3.891277337	5.999414225	0.412130092	1.012463224	0	0.071275541	0.180071706	1.121842276	0	0	0.171186149	0	0.037438593	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7174	0	9.8462	3.0074	1.024903916	0.64648748	4.142088326	2.033179033	3.680641492	0.435748502	2.658169197	13.27748835	0	2.020135715	0	0.003339409	0.890646194	3.891277337	5.999414225	0.412130092	1.012463224	0	0.071275541	0.180071706	1.121842276	0	0	0.171186149	0	0.037438593	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7174																																																																																		0	0	0	3.0074	1.024903916	0.64648748	4.142088326	2.033179033	3.680641492	0.435748502	2.658169197	13.27748835	0	2.020135715	0	0.003339409	0.890646194	3.891277337	5.999414225	0.412130092	1.012463224	0	0.071275541	0.180071706	1.121842276	0	0	0.171186149	0	0.037438593	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7174
H5421_054_0	2009	2																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		324.2932495	88.56081707	306.2680382	27.31932378	196.9426136	24.27583111	2.873998204	772.4456832	1056.047757		13.32389301		0.97040915	2.67644528	2826.946065	2490.555006	1.087288782	420.3069262		29.5888315	1.187670775	465.7137833			71.06502468		15.5419966														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	182.6786125		0.2		50	0.402921958	20	35	0.5	35		35	0.2	35			35		35														110.6020549	138.0217116	25.17470054	0.164164986	123.1237392	0.164164986	0.164164986	41.04124639	149.9471589		0.164164986		41.04124639	0.330728387	16.41649856	28.72887247	0.410412464	28.72887247		28.72887247	0.164164986	28.72887247			28.72887247		28.72887247														2.989	1.018609629	0.642517179	4.484876395	2.020692583	3.985241464	0.471809874	2.641844467	13.19594674	0	2.187316704	0	0.0033189	0.88517643	3.867379667	5.962569762	0.446236868	1.00624534	0	0.070837814	0.194973956	1.114952657	0	0	0.170134836	0	0.03720867	0	0	0	0	0	0	0	0	0	0	0	0	0	47.3968	0	10.3461	2.989	1.018609629	0.642517179	4.484876395	2.020692583	3.985241464	0.471809874	2.641844467	13.19594674	0	2.187316704	0	0.0033189	0.88517643	3.867379667	5.962569762	0.446236868	1.00624534	0	0.070837814	0.194973956	1.114952657	0	0	0.170134836	0	0.03720867	0	0	0	0	0	0	0	0	0	0	0	0	0	47.3968																																																																																		0	0	0	2.989	1.018609629	0.642517179	4.484876395	2.020692583	3.985241464	0.471809874	2.641844467	13.19594674	0	2.187316704	0	0.0033189	0.88517643	3.867379667	5.962569762	0.446236868	1.00624534	0	0.070837814	0.194973956	1.114952657	0	0	0.170134836	0	0.03720867	0	0	0	0	0	0	0	0	0	0	0	0	0	47.3968
H5421_055_0	2009	4																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		328.3207965	22.77369686	146.3323652	28.27820866	175.7880411	20.90562462	3.944271085	795.7338676	1037.14671		13.26237789		2.785532792	2.712338552	2838.866249	2515.529439	0.765626135	311.2696944		31.25073473	0.522967709	395.3852012			63.91284547		12.42945745														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	183.3780961		0.2		50	0.392476374	20	35	0.5	35		35	0.2	34.98080852			35		35														112.2204268	140.0412985	25.54306645	0.166567111	124.9253332	0.166567111	0.166567111	41.64177772	152.7237983		0.166567111		41.64177772	0.326868278	16.65671109	29.1492444	0.416417777	29.1492444		29.1492444	0.166567111	29.1492444			29.1492444		29.1492444														3.0704	0.265771507	0.311481444	4.710219518	1.830031633	3.482189494	0.656985839	2.761314403	13.19974874	0	2.209075969	0	0.009666211	0.886577433	3.940514577	6.110481869	0.318820333	0.756106367	0	0.075911275	0.08710922	0.960431655	0	0	0.155250929	0	0.030192441	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8282	0	9.1979	3.0704	0.265771507	0.311481444	4.710219518	1.830031633	3.482189494	0.656985839	2.761314403	13.19974874	0	2.209075969	0	0.009666211	0.886577433	3.940514577	6.110481869	0.318820333	0.756106367	0	0.075911275	0.08710922	0.960431655	0	0	0.155250929	0	0.030192441	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8282																																																																																		0	0	0	3.0704	0.265771507	0.311481444	4.710219518	1.830031633	3.482189494	0.656985839	2.761314403	13.19974874	0	2.209075969	0	0.009666211	0.886577433	3.940514577	6.110481869	0.318820333	0.756106367	0	0.075911275	0.08710922	0.960431655	0	0	0.155250929	0	0.030192441	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8282
H5421_056_0	2009	2																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		324.2932495	88.56081707	306.2680382	30.39942866	196.9426136	27.01279878	3.198025839	772.4456832	1056.047757		14.82608934		0.97040915	2.9781999	2826.946065	2490.555006	1.209874667	420.3069262		29.5888315	1.321574183	465.7137833			71.06502468		15.5419966														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	182.6786125		0.2		50	0.362097444	20	35	0.5	35		35	0.2	35			35		35														109.7092983	136.9076293	24.97149563	0.16283988	122.1299102	0.16283988	0.16283988	40.70997005	148.7368169		0.16283988		40.70997005	0.294819522	16.28398802	28.49697904	0.407099701	28.49697904		28.49697904	0.16283988	28.49697904			28.49697904		28.49697904														2.9648	1.010387626	0.637330915	4.950239322	2.004381976	4.398760917	0.520766145	2.620520053	13.08943182	0	2.414278612	0	0.003292111	0.878031471	3.836162989	5.914441149	0.492539614	0.998123139	0	0.070266026	0.215204982	1.105952993	0	0	0.168761543	0	0.036908329	0	0	0	0	0	0	0	0	0	0	0	0	0	48.3306	0	11.0291	2.9648	1.010387626	0.637330915	4.950239322	2.004381976	4.398760917	0.520766145	2.620520053	13.08943182	0	2.414278612	0	0.003292111	0.878031471	3.836162989	5.914441149	0.492539614	0.998123139	0	0.070266026	0.215204982	1.105952993	0	0	0.168761543	0	0.036908329	0	0	0	0	0	0	0	0	0	0	0	0	0	48.3306																																																																																		0	0	0	2.9648	1.010387626	0.637330915	4.950239322	2.004381976	4.398760917	0.520766145	2.620520053	13.08943182	0	2.414278612	0	0.003292111	0.878031471	3.836162989	5.914441149	0.492539614	0.998123139	0	0.070266026	0.215204982	1.105952993	0	0	0.168761543	0	0.036908329	0	0	0	0	0	0	0	0	0	0	0	0	0	48.3306
H5421_057_0	2009	2																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		324.2932495	88.56081707	306.2680382	31.51290472	196.9426136	28.00222871	3.315163738	772.4456832	1056.047757		15.36914216		0.97040915	3.087285973	2826.946065	2490.555006	1.254190186	420.3069262		29.5888315	1.369981053	465.7137833			71.06502468		15.5419966														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	182.6786125		0.2		50	0.349303104	20	35	0.5	35		35	0.2	35			35		35														109.3984127	136.5196711	24.90073336	0.162378437	121.783828	0.162378437	0.162378437	40.59460932	148.3153381		0.162378437		40.59460932	0.283596461	16.23784373	28.41622652	0.405946093	28.41622652		28.41622652	0.162378437	28.41622652			28.41622652		28.41622652														2.9564	1.007524469	0.635524896	5.117016222	1.998702115	4.546958138	0.538311107	2.613094227	13.05234001	0	2.495617286	0	0.003282782	0.875543374	3.82529237	5.897681268	0.509133606	0.995294735	0	0.070066912	0.222455382	1.10281903	0	0	0.16828332	0	0.036803741	0	0	0	0	0	0	0	0	0	0	0	0	0	48.6682	0	11.276	2.9564	1.007524469	0.635524896	5.117016222	1.998702115	4.546958138	0.538311107	2.613094227	13.05234001	0	2.495617286	0	0.003282782	0.875543374	3.82529237	5.897681268	0.509133606	0.995294735	0	0.070066912	0.222455382	1.10281903	0	0	0.16828332	0	0.036803741	0	0	0	0	0	0	0	0	0	0	0	0	0	48.6682																																																																																		0	0	0	2.9564	1.007524469	0.635524896	5.117016222	1.998702115	4.546958138	0.538311107	2.613094227	13.05234001	0	2.495617286	0	0.003282782	0.875543374	3.82529237	5.897681268	0.509133606	0.995294735	0	0.070066912	0.222455382	1.10281903	0	0	0.16828332	0	0.036803741	0	0	0	0	0	0	0	0	0	0	0	0	0	48.6682
H5421_064_0	2009	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		345.2310167	37.76748976	436.4036434	20.41156168	171.5121876	22.82584086	1.09477053	714.741291	1678.148075		15.45544923		5.504058347	2.58189236	4033.001232	4557.993937	1.564020341	766.8057404		47.06560093	1.036894871	721.8277109			105.8478159		23.02492382														1a: $350 per admit $875 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.81381047		0.1		50	0.256738556	10	25	0.5	15		31.11691023	0.2	15			15		15														276.0882609	87.67774342	24.19321989	0.11832354	78.88236025	0.157764721	0.157764721	39.44118013	75.58019515		0.07888236		39.44118013	0.202521433	7.888236025	19.72059006	0.394411801	11.83235404		24.54575323	0.157764721	11.83235404			11.83235404		11.83235404														7.9429	0.275947356	0.879834109	2.415168242	1.127440514	3.601112403	0.172716167	2.349186667	10.56956325	0	1.219162314	0	0.018090546	0.522888539	2.651105467	7.490527496	0.61686808	0.756093083	0	0.096271719	0.16358543	0.711743419	0	0	0.104369069	0	0.022703254	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7072	0	11.7009	7.9429	0.275947356	0.879834109	2.415168242	1.127440514	3.601112403	0.172716167	2.349186667	10.56956325	0	1.219162314	0	0.018090546	0.522888539	2.651105467	7.490527496	0.61686808	0.756093083	0	0.096271719	0.16358543	0.711743419	0	0	0.104369069	0	0.022703254	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7072																																																																																		0	0	0	7.9429	0.275947356	0.879834109	2.415168242	1.127440514	3.601112403	0.172716167	2.349186667	10.56956325	0	1.219162314	0	0.018090546	0.522888539	2.651105467	7.490527496	0.61686808	0.756093083	0	0.096271719	0.16358543	0.711743419	0	0	0.104369069	0	0.022703254	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7072
H5421_065_0	2009	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		345.2310167	37.76748976	436.4036434	20.44783204	171.5121876	22.86640128	1.096715884	714.741291	1678.148075		15.48291282		5.504058347	2.586480259	4033.001232	4557.993937	1.56679953	766.8057404		47.06560093	1.038737384	721.8277109			105.8478159		23.02492382														1a: $350 per admit $875 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.81381047		0.1		50	0.256287921	10	25	0.5	15		31.11691023	0.2	15			15		15														276.0636366	87.66992344	24.19106209	0.118312987	78.87532473	0.157750649	0.157750649	39.43766237	75.57345415		0.078875325		39.43766237	0.20214793	7.887532473	19.71883118	0.394376624	11.83129871		24.54356399	0.157750649	11.83129871			11.83129871		11.83129871														7.9421	0.275922745	0.879755636	2.419244088	1.127339958	3.607189653	0.173007643	2.348977143	10.56862055	0	1.221219776	0	0.018088933	0.522851631	2.650869015	7.489859415	0.617909109	0.756025647	0	0.096263132	0.163861497	0.711679939	0	0	0.104359761	0	0.022701229	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7179	0	11.7087	7.9421	0.275922745	0.879755636	2.419244088	1.127339958	3.607189653	0.173007643	2.348977143	10.56862055	0	1.221219776	0	0.018088933	0.522851631	2.650869015	7.489859415	0.617909109	0.756025647	0	0.096263132	0.163861497	0.711679939	0	0	0.104359761	0	0.022701229	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7179																																																																																		0	0	0	7.9421	0.275922745	0.879755636	2.419244088	1.127339958	3.607189653	0.173007643	2.348977143	10.56862055	0	1.221219776	0	0.018088933	0.522851631	2.650869015	7.489859415	0.617909109	0.756025647	0	0.096263132	0.163861497	0.711679939	0	0	0.104359761	0	0.022701229	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7179
H5421_066_0	2009	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		345.2310167	37.76748976	436.4036434	21.74111775	171.5121876	24.3126568	1.166081036	714.741291	1678.148075		16.46217702		5.504058347	2.750070117	4033.001232	4557.993937	1.665896561	766.8057404		47.06560093	1.104435508	721.8277109			105.8478159		23.02492382														1a: $350 per admit $875 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.81381047		0.1		50	0.241202358	10	25	0.5	15		31.11691023	0.2	15			15		15														275.1962044	87.39445176	24.11505025	0.11794123	78.62748697	0.157254974	0.157254974	39.31374348	75.33599134		0.078627487		39.31374348	0.189651352	7.862748697	19.65687174	0.393137435	11.79412304		24.46644454	0.157254974	11.79412304			11.79412304		11.79412304														7.9172	0.275055755	0.876991316	2.564174179	1.123797691	3.823286212	0.183372043	2.341596314	10.53541241	0	1.294379609	0	0.018032095	0.521554517	2.642539598	7.466325185	0.654926301	0.753650105	0	0.09596066	0.173677977	0.709443737	0	0	0.104031847	0	0.022629899	0	0	0	0	0	0	0	0	0	0	0	0	0	44.098	0	11.9867	7.9172	0.275055755	0.876991316	2.564174179	1.123797691	3.823286212	0.183372043	2.341596314	10.53541241	0	1.294379609	0	0.018032095	0.521554517	2.642539598	7.466325185	0.654926301	0.753650105	0	0.09596066	0.173677977	0.709443737	0	0	0.104031847	0	0.022629899	0	0	0	0	0	0	0	0	0	0	0	0	0	44.098																																																																																		0	0	0	7.9172	0.275055755	0.876991316	2.564174179	1.123797691	3.823286212	0.183372043	2.341596314	10.53541241	0	1.294379609	0	0.018032095	0.521554517	2.642539598	7.466325185	0.654926301	0.753650105	0	0.09596066	0.173677977	0.709443737	0	0	0.104031847	0	0.022629899	0	0	0	0	0	0	0	0	0	0	0	0	0	44.098
H5421_067_0	2009	6																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		345.2310167	37.76748976	436.4036434	22.60919492	171.5121876	25.28341013	1.212640203	714.741291	1678.148075		17.11947717		5.504058347	2.859874641	4033.001232	4557.993937	1.732412312	766.8057404		47.06560093	1.148533298	721.8277109			105.8478159		23.02492382														1a: $350 per admit $875 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.81381047		0.1		50	0.232044634	10	25	0.5	15		31.11691023	0.2	15			15		15														274.6252977	87.2131481	24.06502251	0.117696556	78.46437076	0.156928742	0.156928742	39.23218538	75.17970349		0.078464371		39.23218538	0.182072362	7.846437076	19.61609269	0.392321854	11.76965561		24.41568781	0.156928742	11.76965561			11.76965561		11.76965561														7.9008	0.27448514	0.875171959	2.661024379	1.121466323	3.967693733	0.190298101	2.336738569	10.51355623	0	1.343269004	0	0.017994686	0.52070413	2.637057533	7.450835963	0.67966321	0.752086624	0	0.095761585	0.180237885	0.707971964	0	0	0.103816028	0	0.022582952	0	0	0	0	0	0	0	0	0	0	0	0	0	44.3532	0	12.1733	7.9008	0.27448514	0.875171959	2.661024379	1.121466323	3.967693733	0.190298101	2.336738569	10.51355623	0	1.343269004	0	0.017994686	0.52070413	2.637057533	7.450835963	0.67966321	0.752086624	0	0.095761585	0.180237885	0.707971964	0	0	0.103816028	0	0.022582952	0	0	0	0	0	0	0	0	0	0	0	0	0	44.3532																																																																																		0	0	0	7.9008	0.27448514	0.875171959	2.661024379	1.121466323	3.967693733	0.190298101	2.336738569	10.51355623	0	1.343269004	0	0.017994686	0.52070413	2.637057533	7.450835963	0.67966321	0.752086624	0	0.095761585	0.180237885	0.707971964	0	0	0.103816028	0	0.022582952	0	0	0	0	0	0	0	0	0	0	0	0	0	44.3532
H5421_068_0	2009	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		345.2310167	37.76748976	436.4036434	23.17606936	171.5121876	25.91733446	1.243044414	714.741291	1678.148075		17.54870935		5.504058347	2.931579531	4033.001232	4557.993937	1.775848633	766.8057404		47.06560093	1.177330174	721.8277109			105.8478159		23.02492382														1a: $350 per admit $875 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.81381047		0.1		50	0.226434694	10	25	0.5	15		31.11691023	0.2	15			15		15														274.2572743	87.09627441	24.03277315	0.117538832	78.35922124	0.156718442	0.156718442	39.17961062	75.07895573		0.078359221		39.17961062	0.177432463	7.835922124	19.58980531	0.391796106	11.75388319		24.38296853	0.156718442	11.75388319			11.75388319		11.75388319														7.8902	0.274117304	0.873999147	2.724088119	1.119963455	4.06172429	0.194807984	2.333607123	10.49946709	0	1.375103198	0	0.017970572	0.520157376	2.633523632	7.440851153	0.69577058	0.751078758	0	0.095633256	0.184509351	0.707023216	0	0	0.103676905	0	0.022552689	0	0	0	0	0	0	0	0	0	0	0	0	0	44.5198	0	12.2952	7.8902	0.274117304	0.873999147	2.724088119	1.119963455	4.06172429	0.194807984	2.333607123	10.49946709	0	1.375103198	0	0.017970572	0.520157376	2.633523632	7.440851153	0.69577058	0.751078758	0	0.095633256	0.184509351	0.707023216	0	0	0.103676905	0	0.022552689	0	0	0	0	0	0	0	0	0	0	0	0	0	44.5198																																																																																		0	0	0	7.8902	0.274117304	0.873999147	2.724088119	1.119963455	4.06172429	0.194807984	2.333607123	10.49946709	0	1.375103198	0	0.017970572	0.520157376	2.633523632	7.440851153	0.69577058	0.751078758	0	0.095633256	0.184509351	0.707023216	0	0	0.103676905	0	0.022552689	0	0	0	0	0	0	0	0	0	0	0	0	0	44.5198
H5421_069_0	2009	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		345.2310167	37.76748976	436.4036434	23.87762441	171.5121876	26.70186943	1.280672196	714.741291	1678.148075		18.07992046		5.504058347	3.020320395	4033.001232	4557.993937	1.829604754	766.8057404		47.06560093	1.212968742	721.8277109			105.8478159		23.02492382														1a: $350 per admit $875 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.81381047		0.1		50	0.219860734	10	25	0.5	15		31.11691023	0.2	15			15		15														273.8069569	86.95326646	23.99331248	0.117345839	78.23055912	0.156461118	0.156461118	39.11527956	74.95567964		0.078230559		39.11527956	0.171998282	7.823055912	19.55763978	0.391152796	11.73458387		24.34293285	0.156461118	11.73458387			11.73458387		11.73458387														7.8772	0.273667217	0.872564082	2.801939861	1.118124528	4.17780435	0.200375404	2.329775451	10.48222746	0	1.414402287	0	0.017941065	0.519489918	2.629199511	7.428633628	0.715655014	0.749845523	0	0.09547623	0.189782446	0.705862318	0	0	0.103506673	0	0.022515658	0	0	0	0	0	0	0	0	0	0	0	0	0	44.726	0	12.446	7.8772	0.273667217	0.872564082	2.801939861	1.118124528	4.17780435	0.200375404	2.329775451	10.48222746	0	1.414402287	0	0.017941065	0.519489918	2.629199511	7.428633628	0.715655014	0.749845523	0	0.09547623	0.189782446	0.705862318	0	0	0.103506673	0	0.022515658	0	0	0	0	0	0	0	0	0	0	0	0	0	44.726																																																																																		0	0	0	7.8772	0.273667217	0.872564082	2.801939861	1.118124528	4.17780435	0.200375404	2.329775451	10.48222746	0	1.414402287	0	0.017941065	0.519489918	2.629199511	7.428633628	0.715655014	0.749845523	0	0.09547623	0.189782446	0.705862318	0	0	0.103506673	0	0.022515658	0	0	0	0	0	0	0	0	0	0	0	0	0	44.726
H5421_070_0	2009	4																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		287.0739877	38.51853295	308.5650658	12.30232625	150.004864	18.70779072	2.395371783	693.5290308	1183.409759		11.9566712		6.216009239	1.736818396	3197.350303	2751.703884	1.173282797	430.2588932		37.58107252	1.979466799	533.6537539			82.21527278		20.66104731														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	182.2911456		0.2		50	0.399067622	20	35	0.5	35		35	0.2	35			35		35														112.4612809	140.3418634	25.59788849	0.166924607	125.1934553	0.166924607	0.166924607	41.73115176	152.1443892		0.166924607		41.73115176	0.33307103	16.6924607	29.21180623	0.417311518	29.21180623		29.21180623	0.166924607	29.21180623			29.21180623		29.21180623														2.6904	0.450480224	0.658217846	2.053560975	1.564968936	3.122790615	0.399846494	2.411813769	15.00409625	0	1.995862641	0	0.021616769	0.578483893	4.447637025	6.698520056	0.489624424	1.047386618	0	0.091484251	0.330421718	1.299082505	0	0	0.200138051	0	0.050295543	0	0	0	0	0	0	0	0	0	0	0	0	0	45.6067	0	9.0368	2.6904	0.450480224	0.658217846	2.053560975	1.564968936	3.122790615	0.399846494	2.411813769	15.00409625	0	1.995862641	0	0.021616769	0.578483893	4.447637025	6.698520056	0.489624424	1.047386618	0	0.091484251	0.330421718	1.299082505	0	0	0.200138051	0	0.050295543	0	0	0	0	0	0	0	0	0	0	0	0	0	45.6067																																																																																		0	0	0	2.6904	0.450480224	0.658217846	2.053560975	1.564968936	3.122790615	0.399846494	2.411813769	15.00409625	0	1.995862641	0	0.021616769	0.578483893	4.447637025	6.698520056	0.489624424	1.047386618	0	0.091484251	0.330421718	1.299082505	0	0	0.200138051	0	0.050295543	0	0	0	0	0	0	0	0	0	0	0	0	0	45.6067
H5421_071_0	2009	4																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		287.0739877	38.51853295	308.5650658	11.97981628	150.004864	18.21735916	2.332576238	693.5290308	1183.409759		11.6432227		6.216009239	1.691287069	3197.350303	2751.703884	1.14252476	430.2588932		37.58107252	1.927574355	533.6537539			82.21527278		20.66104731														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	182.2911456		0.2		50	0.409810966	20	35	0.5	35		35	0.2	35			35		35														112.6291786	140.5513851	25.63610456	0.167173815	125.3803614	0.167173815	0.167173815	41.79345379	152.3715314		0.167173815		41.79345379	0.342548314	16.71738152	29.25541765	0.417934538	29.25541765		29.25541765	0.167173815	29.25541765			29.25541765		29.25541765														2.6944	0.451152763	0.659200524	2.002711593	1.567305339	3.045465434	0.389945669	2.415414459	15.02649644	0	1.946441959	0	0.021649041	0.579347534	4.454277072	6.708520534	0.477500558	1.048950302	0	0.091620831	0.322239959	1.301021955	0	0	0.200436845	0	0.050370631	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4545	0	8.9254	2.6944	0.451152763	0.659200524	2.002711593	1.567305339	3.045465434	0.389945669	2.415414459	15.02649644	0	1.946441959	0	0.021649041	0.579347534	4.454277072	6.708520534	0.477500558	1.048950302	0	0.091620831	0.322239959	1.301021955	0	0	0.200436845	0	0.050370631	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4545																																																																																		0	0	0	2.6944	0.451152763	0.659200524	2.002711593	1.567305339	3.045465434	0.389945669	2.415414459	15.02649644	0	1.946441959	0	0.021649041	0.579347534	4.454277072	6.708520534	0.477500558	1.048950302	0	0.091620831	0.322239959	1.301021955	0	0	0.200436845	0	0.050370631	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4545
H5421_072_0	2009	4																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		287.0739877	38.51853295	308.5650658	12.81263971	150.004864	19.4838096	2.49473433	693.5290308	1183.409759		12.45264652		6.216009239	1.808863455	3197.350303	2751.703884	1.221951804	430.2588932		37.58107252	2.061577169	533.6537539			82.21527278		20.66104731														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	182.2911456		0.2		50	0.383173194	20	35	0.5	35		35	0.2	35			35		35														112.1988975	140.0144318	25.53816606	0.166535155	124.9013664	0.166535155	0.166535155	41.63378881	151.7894212		0.166535155		41.63378881	0.319059037	16.65351553	29.14365217	0.416337888	29.14365217		29.14365217	0.166535155	29.14365217			29.14365217		29.14365217														2.6841	0.449429209	0.656682158	2.133754944	1.561317708	3.244739258	0.415460969	2.406186767	14.96909019	0	2.073803422	0	0.021566335	0.577134232	4.437260243	6.68289174	0.508744834	1.044942961	0	0.091270809	0.343325074	1.296051615	0	0	0.199671109	0	0.050178198	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8476	0	9.213	2.6841	0.449429209	0.656682158	2.133754944	1.561317708	3.244739258	0.415460969	2.406186767	14.96909019	0	2.073803422	0	0.021566335	0.577134232	4.437260243	6.68289174	0.508744834	1.044942961	0	0.091270809	0.343325074	1.296051615	0	0	0.199671109	0	0.050178198	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8476																																																																																		0	0	0	2.6841	0.449429209	0.656682158	2.133754944	1.561317708	3.244739258	0.415460969	2.406186767	14.96909019	0	2.073803422	0	0.021566335	0.577134232	4.437260243	6.68289174	0.508744834	1.044942961	0	0.091270809	0.343325074	1.296051615	0	0	0.199671109	0	0.050178198	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8476
H5421_073_0	2009	6																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		287.0739877	38.51853295	308.5650658	13.7992525	150.004864	20.98412306	2.686836571	693.5290308	1183.409759		13.41153873		6.216009239	1.948151522	3197.350303	2751.703884	1.316045863	430.2588932		37.58107252	2.220324971	533.6537539			82.21527278		20.66104731														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	182.2911456		0.2		50	0.355777249	20	35	0.5	35		35	0.2	35			35		35														111.7027287	139.3952564	25.42523054	0.165798699	124.3490245	0.165798699	0.165798699	41.44967483	151.1181742		0.165798699		41.44967483	0.294937025	16.57986993	29.01477238	0.414496748	29.01477238		29.01477238	0.165798699	29.01477238			29.01477238		29.01477238														2.6722	0.447441732	0.653778161	2.287898116	1.554413209	3.479140309	0.445474009	2.395546067	14.9028935	0	2.223615676	0	0.021470963	0.574582015	4.417637679	6.653338488	0.545496731	1.040321988	0	0.090867189	0.368126992	1.290320183	0	0	0.198788119	0	0.049956299	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3134	0	9.5536	2.6722	0.447441732	0.653778161	2.287898116	1.554413209	3.479140309	0.445474009	2.395546067	14.9028935	0	2.223615676	0	0.021470963	0.574582015	4.417637679	6.653338488	0.545496731	1.040321988	0	0.090867189	0.368126992	1.290320183	0	0	0.198788119	0	0.049956299	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3134																																																																																		0	0	0	2.6722	0.447441732	0.653778161	2.287898116	1.554413209	3.479140309	0.445474009	2.395546067	14.9028935	0	2.223615676	0	0.021470963	0.574582015	4.417637679	6.653338488	0.545496731	1.040321988	0	0.090867189	0.368126992	1.290320183	0	0	0.198788119	0	0.049956299	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3134
H5421_074_0	2009	4																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		287.0739877	38.51853295	308.5650658	14.07941052	150.004864	21.41015122	2.741385815	693.5290308	1183.409759		13.68382522		6.216009239	1.987703683	3197.350303	2751.703884	1.342764759	430.2588932		37.58107252	2.265402908	533.6537539			82.21527278		20.66104731														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	182.2911456		0.2		50	0.348697844	20	35	0.5	35		35	0.2	35			35		35														111.5644373	139.2226809	25.39375333	0.165593435	124.1950766	0.165593435	0.165593435	41.39835887	150.9310853		0.165593435		41.39835887	0.288710369	16.55934355	28.97885121	0.413983589	28.97885121		28.97885121	0.165593435	28.97885121			28.97885121		28.97885121														2.6689	0.446887785	0.652968764	2.331457957	1.552488798	3.545380495	0.453955495	2.392580309	14.88444327	0	2.265951628	0	0.021444382	0.573870665	4.412168509	6.645101453	0.555882574	1.039034037	0	0.090754692	0.37513585	1.288722728	0	0	0.198542013	0	0.049894451	0	0	0	0	0	0	0	0	0	0	0	0	0	46.4456	0	9.6503	2.6689	0.446887785	0.652968764	2.331457957	1.552488798	3.545380495	0.453955495	2.392580309	14.88444327	0	2.265951628	0	0.021444382	0.573870665	4.412168509	6.645101453	0.555882574	1.039034037	0	0.090754692	0.37513585	1.288722728	0	0	0.198542013	0	0.049894451	0	0	0	0	0	0	0	0	0	0	0	0	0	46.4456																																																																																		0	0	0	2.6689	0.446887785	0.652968764	2.331457957	1.552488798	3.545380495	0.453955495	2.392580309	14.88444327	0	2.265951628	0	0.021444382	0.573870665	4.412168509	6.645101453	0.555882574	1.039034037	0	0.090754692	0.37513585	1.288722728	0	0	0.198542013	0	0.049894451	0	0	0	0	0	0	0	0	0	0	0	0	0	46.4456
H5421_075_0	2009	4																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		287.0739877	38.51853295	308.5650658	14.22426571	150.004864	21.63042832	2.769590404	693.5290308	1183.409759		13.82461046		6.216009239	2.008154057	3197.350303	2751.703884	1.356579717	430.2588932		37.58107252	2.288710375	533.6537539			82.21527278		20.66104731														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	182.2911456		0.2		50	0.345146821	20	35	0.5	35		35	0.2	35			35		35														111.4933759	139.1340024	25.37757867	0.16548796	124.11597	0.16548796	0.16548796	41.37199	150.834949		0.16548796		41.37199	0.285588216	16.548796	28.960393	0.4137199	28.960393		28.960393	0.16548796	28.960393			28.960393		28.960393														2.6672	0.446603138	0.652552853	2.353944716	1.551499934	3.579575457	0.458333866	2.391056344	14.87496256	0	2.287806583	0	0.021430723	0.573505135	4.409358159	6.640868826	0.561244025	1.03837222	0	0.090696886	0.378754011	1.28790187	0	0	0.198415551	0	0.049862671	0	0	0	0	0	0	0	0	0	0	0	0	0	46.514	0	9.7004	2.6672	0.446603138	0.652552853	2.353944716	1.551499934	3.579575457	0.458333866	2.391056344	14.87496256	0	2.287806583	0	0.021430723	0.573505135	4.409358159	6.640868826	0.561244025	1.03837222	0	0.090696886	0.378754011	1.28790187	0	0	0.198415551	0	0.049862671	0	0	0	0	0	0	0	0	0	0	0	0	0	46.514																																																																																		0	0	0	2.6672	0.446603138	0.652552853	2.353944716	1.551499934	3.579575457	0.458333866	2.391056344	14.87496256	0	2.287806583	0	0.021430723	0.573505135	4.409358159	6.640868826	0.561244025	1.03837222	0	0.090696886	0.378754011	1.28790187	0	0	0.198415551	0	0.049862671	0	0	0	0	0	0	0	0	0	0	0	0	0	46.514
H5421_100_0	2009	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																																																			0		397.4796088	20.37705804	1615.562137	6317.734168	332.8295572	17.41249308	12.22552736	336.8993389	371.0092843		6360.25984	49.44314813	31.8154883	58.74533508	3560.263523	4729.009754	909.0368403	368.7104168			28.8241123	1193.216603			147.9890135		255.8976692														"1a: $350 per admit, $875 Max OOP"	1b : $195 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4b: (n/c)	9a: $100 9b: $75	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $100	12: $50	9a: $100 9c: 50% 9d: $15 3: $15 5: $175	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $25 7d: $25 7f: $25	"7e, 7h: 50%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $15	10b: (n/c)	16a: (n/c)	17a1: $15	17b1: (n/c)	18a: $15 18a1: $15	18b: (n/c)		14a: (n/c)											331.5882178	325.8531583	64.98915146	26.99238987	100	0.2	0.2	50	97.5		10.36136437	100	50	16.36450349	10	25	81.09561752	15			0.2	15			15		15														229.9701239	225.9926233	45.07266064	18.72033718	69.35413008	0.13870826	0.13870826	34.67706504	67.62027683		7.186034122	69.35413008	34.67706504	11.34945904	6.935413008	17.33853252	56.24316006	10.40311951			0.13870826	10.40311951			10.40311951		10.40311951														7.6174	0.3837554	6.068140328	9.855842821	1.923592033	2.41525662	1.695781629	0.97355669	2.090645876	0	3.808753686	0.285757211	0.09193898	0.055560648	2.057658162	6.832840783	4.260592043	0.319644878	0	0	3.998142468	1.034431244	0	0	0.128295616	0	0.221844503	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1194	0	24.7978	7.6174	0.3837554	6.068140328	9.855842821	1.923592033	2.41525662	1.695781629	0.97355669	2.090645876	0	3.808753686	0.285757211	0.09193898	0.055560648	2.057658162	6.832840783	4.260592043	0.319644878	0	0	3.998142468	1.034431244	0	0	0.128295616	0	0.221844503	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1194																																																																																		0	0	0	7.6174	0.3837554	6.068140328	9.855842821	1.923592033	2.41525662	1.695781629	0.97355669	2.090645876	0	3.808753686	0.285757211	0.09193898	0.055560648	2.057658162	6.832840783	4.260592043	0.319644878	0	0	3.998142468	1.034431244	0	0	0.128295616	0	0.221844503	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1194
H5421_101_0	2009	3																					3000											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																																																			0		397.4796088	20.37705804	1615.562137	6317.734168	332.8295572	17.41249308	12.22552736	336.8993389	371.0092843		6360.25984	49.44314813	31.8154883	58.74533508	3560.263523	4729.009754	909.0368403	368.7104168			28.8241123	1193.216603			147.9890135		255.8976692														1a: $195 days 1-5	1b : $295 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20%/$250 Ded.	9a: $200 9b: $100	8a: 0%	8b1: 20% 8b2: 20% 8b3: 20%	9a: $0	12: $50	9a: $100 9c: 50% 9d: $35 3: $35 5: $195	"7a: $20, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 20% 8b2: 20% 8b3: 20%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $0 17a: $35 17b: $35	10b: (n/c)	16a: (n/c)	17a1: $35	17b1: (n/c)	18a: $35 18a1: $35	18b: (n/c)		14a: $0											360.9139764	492.9573421	64.98915146	35.98985316	150	0.2	0.2	50	190		20.72272874	200	50	35.30150113	20	35	81.09561752	35			0.2	35			35		35														241.0506918	329.2410827	43.40557846	24.03724868	100.1834402	0.13357792	0.13357792	33.39448006	126.8990242		13.84049503	133.5779203	33.39448006	23.57750552	13.35779203	23.37613604	54.16291965	23.37613604			0.13357792	23.37613604			23.37613604		23.37613604														7.9844	0.559080388	5.843700757	12.65507894	2.778667503	2.325924612	1.633060518	0.937548188	3.923393013	0	7.335762061	0.550376075	0.088538474	0.115422372	3.963104975	9.212164614	4.103007445	0.718252072	0	0	3.850264974	2.324399471	0	0	0.288284276	0	0.498491561	0	0	0	0	0	0	0	0	0	0	0	0	0	71.6889	0	35.6476	7.9844	0.559080388	5.843700757	12.65507894	2.778667503	2.325924612	1.633060518	0.937548188	3.923393013	0	7.335762061	0.550376075	0.088538474	0.115422372	3.963104975	9.212164614	4.103007445	0.718252072	0	0	3.850264974	2.324399471	0	0	0.288284276	0	0.498491561	0	0	0	0	0	0	0	0	0	0	0	0	0	71.6889																																																																																		0	0	0	7.9844	0.559080388	5.843700757	12.65507894	2.778667503	2.325924612	1.633060518	0.937548188	3.923393013	0	7.335762061	0.550376075	0.088538474	0.115422372	3.963104975	9.212164614	4.103007445	0.718252072	0	0	3.850264974	2.324399471	0	0	0.288284276	0	0.498491561	0	0	0	0	0	0	0	0	0	0	0	0	0	71.6889
H5421_103_0	2009	4																					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																																																			0		397.4796088	20.37705804	1615.562137	6317.734168	332.8295572	17.41249308	12.22552736	336.8993389	371.0092843		6360.25984	49.44314813	31.8154883	58.74533508	3560.263523	4729.009754	909.0368403	368.7104168			28.8241123	1193.216603			147.9890135		255.8976692														"1a: $350 per admit, $875 Max OOP"	1b : $195 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4b: (n/c)	9a: $100 9b: $75	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $100	12: $50	9a: $100 9c: 50% 9d: $15 3: $15 5: $175	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $25 7d: $25 7f: $25	"7e, 7h: 50%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $15	10b: (n/c)	16a: (n/c)	17a1: $15	17b1: (n/c)	18a: $15 18a1: $15	18b: (n/c)		14a: (n/c)											331.5882178	325.8531583	64.98915146	26.99238987	100	0.2	0.2	50	97.5		10.36136437	100	50	16.36450349	10	25	81.09561752	15			0.2	15			15		15														229.9701239	225.9926233	45.07266064	18.72033718	69.35413008	0.13870826	0.13870826	34.67706504	67.62027683		7.186034122	69.35413008	34.67706504	11.34945904	6.935413008	17.33853252	56.24316006	10.40311951			0.13870826	10.40311951			10.40311951		10.40311951														7.6174	0.3837554	6.068140328	9.855842821	1.923592033	2.41525662	1.695781629	0.97355669	2.090645876	0	3.808753686	0.285757211	0.09193898	0.055560648	2.057658162	6.832840783	4.260592043	0.319644878	0	0	3.998142468	1.034431244	0	0	0.128295616	0	0.221844503	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1194	0	24.7978	7.6174	0.3837554	6.068140328	9.855842821	1.923592033	2.41525662	1.695781629	0.97355669	2.090645876	0	3.808753686	0.285757211	0.09193898	0.055560648	2.057658162	6.832840783	4.260592043	0.319644878	0	0	3.998142468	1.034431244	0	0	0.128295616	0	0.221844503	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1194																																																																																		0	0	0	7.6174	0.3837554	6.068140328	9.855842821	1.923592033	2.41525662	1.695781629	0.97355669	2.090645876	0	3.808753686	0.285757211	0.09193898	0.055560648	2.057658162	6.832840783	4.260592043	0.319644878	0	0	3.998142468	1.034431244	0	0	0.128295616	0	0.221844503	0	0	0	0	0	0	0	0	0	0	0	0	0	56.1194
H5421_104_0	2009	4																					3000											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																																																			0		397.4796088	20.37705804	1615.562137	6317.734168	332.8295572	17.41249308	12.22552736	336.8993389	371.0092843		6360.25984	49.44314813	31.8154883	58.74533508	3560.263523	4729.009754	909.0368403	368.7104168			28.8241123	1193.216603			147.9890135		255.8976692														1a: $195 days 1-5	1b : $295 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20%/$250 Ded.	9a: $200 9b: $100	8a: 0%	8b1: 20% 8b2: 20% 8b3: 20%	9a: $0	12: $50	9a: $100 9c: 50% 9d: $35 3: $35 5: $195	"7a: $20, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 20% 8b2: 20% 8b3: 20%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $0 17a: $35 17b: $35	10b: (n/c)	16a: (n/c)	17a1: $35	17b1: (n/c)	18a: $35 18a1: $35	18b: (n/c)		14a: $0											360.9139764	325.8531583	64.98915146	35.98985316	150	0.2	0.2	50	190		20.72272874	200	50	35.30150113	20	35	81.09561752	35			0.2	35			35		35														241.3273843	217.8837494	43.455402	24.06484008	100.2984368	0.133731249	0.133731249	33.43281227	127.0446866		13.85638199	133.7312491	33.43281227	23.6045692	13.37312491	23.40296859	54.22509112	23.40296859			0.133731249	23.40296859			23.40296859		23.40296859														7.9936	0.369985817	5.850408509	12.6696052	2.781857025	2.328594448	1.634935044	0.938624362	3.927896521	0	7.344182492	0.55100783	0.088640104	0.115554861	3.967654066	9.222738892	4.107717125	0.719076525	0	0	3.854684541	2.327067557	0	0	0.288615186	0	0.499063759	0	0	0	0	0	0	0	0	0	0	0	0	0	71.5815	0	35.4712	7.9936	0.369985817	5.850408509	12.6696052	2.781857025	2.328594448	1.634935044	0.938624362	3.927896521	0	7.344182492	0.55100783	0.088640104	0.115554861	3.967654066	9.222738892	4.107717125	0.719076525	0	0	3.854684541	2.327067557	0	0	0.288615186	0	0.499063759	0	0	0	0	0	0	0	0	0	0	0	0	0	71.5815																																																																																		0	0	0	7.9936	0.369985817	5.850408509	12.6696052	2.781857025	2.328594448	1.634935044	0.938624362	3.927896521	0	7.344182492	0.55100783	0.088640104	0.115554861	3.967654066	9.222738892	4.107717125	0.719076525	0	0	3.854684541	2.327067557	0	0	0.288615186	0	0.499063759	0	0	0	0	0	0	0	0	0	0	0	0	0	71.5815
H5421_106_0	2009	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																																																			0		364.9669103	18.33926931	2211.405606	7119.457189	221.4937468	19.69236954	12.43644171	381.263847	421.8369504		6262.292066	26.06682093	33.0643216	118.4941073	3821.41343	4593.230736	870.4846021	345.4187662			35.3516971	1365.804102			147.9890135		255.8976692														"1a: $350 per admit, $875 Max OOP"	1b : $195 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20%/$250 Ded.	9a: $100 9b: $75	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $100	12: $50	9a: $100 9c: 50% 9d: $15 3: $15 5: $175	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $25 7d: $25 7f: $25	"7e, 7h: 50%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $15	10b: (n/c)	16a: (n/c)	17a1: $15	17b1: (n/c)	18a: $15 18a1: $15	18b: (n/c)		14a: (n/c)											331.5882178	325.8531583	64.98915146	29.26144591	100	0.2	0.2	50.03511327	97.5		10.31175248	100	50	15.65823162	10	25	47.31116087	15			0.2	15			15		15														225.5430547	221.6421235	44.20498363	19.90334861	68.01901954	0.136038039	0.136038039	34.03339347	66.31854406		7.013952932	68.01901954	34.00950977	10.65057563	6.801901954	17.00475489	32.18058776	10.20285293			0.136038039	10.20285293			10.20285293		10.20285293														6.8596	0.338729549	8.146262384	11.80841986	1.255482291	2.678911337	1.691829144	1.081308544	2.331301031	0	3.66028515	0.1477533	0.093708447	0.105169204	2.16607329	6.508896899	2.334392177	0.293688073	0	0	4.809175551	1.161258199	0	0	0.125825845	0	0.217573857	0	0	0	0	0	0	0	0	0	0	0	0	0	57.8157	0	27.1836	6.8596	0.338729549	8.146262384	11.80841986	1.255482291	2.678911337	1.691829144	1.081308544	2.331301031	0	3.66028515	0.1477533	0.093708447	0.105169204	2.16607329	6.508896899	2.334392177	0.293688073	0	0	4.809175551	1.161258199	0	0	0.125825845	0	0.217573857	0	0	0	0	0	0	0	0	0	0	0	0	0	57.8157																																																																																		0	0	0	6.8596	0.338729549	8.146262384	11.80841986	1.255482291	2.678911337	1.691829144	1.081308544	2.331301031	0	3.66028515	0.1477533	0.093708447	0.105169204	2.16607329	6.508896899	2.334392177	0.293688073	0	0	4.809175551	1.161258199	0	0	0.125825845	0	0.217573857	0	0	0	0	0	0	0	0	0	0	0	0	0	57.8157
H5421_107_0	2009	5																					3000											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																																																			0		364.9669103	18.33926931	2211.405606	7119.457189	221.4937468	19.69236954	12.43644171	381.263847	421.8369504		6262.292066	26.06682093	33.0643216	118.4941073	3821.41343	4593.230736	870.4846021	345.4187662			35.3516971	1365.804102			147.9890135		255.8976692														1a: $195 days 1-5	1b : $295 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20%/$250 Ded.	9a: $200 9b: $100	8a: 0%	8b1: 20% 8b2: 20% 8b3: 20%	9a: $0	12: $50	9a: $100 9c: 50% 9d: $35 3: $35 5: $195	"7a: $20, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 20% 8b2: 20% 8b3: 20%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $0 17a: $35 17b: $35	10b: (n/c)	16a: (n/c)	17a1: $35	17b1: (n/c)	18a: $35 18a1: $35	18b: (n/c)		14a: $0											360.9139764	325.8531583	64.98915146	39.01526121	150	0.2	0.2	50.03511327	190		20.62350495	200	50	35.22614932	20	35	47.31116087	35			0.2	35			35		35														236.5463018	213.5671229	42.5944808	25.57095696	98.31136392	0.131081819	0.131081819	32.79346819	124.5277276		13.51683267	131.0818186	32.77045464	23.08753857	13.10818186	22.93931825	31.00816502	22.93931825			0.131081819	22.93931825			22.93931825		22.93931825														7.1943	0.326388749	7.849472801	15.17094444	1.814612695	2.581311611	1.630191396	1.041913653	4.377533071	0	7.053862833	0.284740524	0.090294404	0.227978106	4.174315182	8.780465135	2.249344182	0.660305917	0	0	4.633964744	2.61088458	0	0	0.282897256	0	0.489176506	0	0	0	0	0	0	0	0	0	0	0	0	0	73.5249	0	38.6568	7.1943	0.326388749	7.849472801	15.17094444	1.814612695	2.581311611	1.630191396	1.041913653	4.377533071	0	7.053862833	0.284740524	0.090294404	0.227978106	4.174315182	8.780465135	2.249344182	0.660305917	0	0	4.633964744	2.61088458	0	0	0.282897256	0	0.489176506	0	0	0	0	0	0	0	0	0	0	0	0	0	73.5249																																																																																		0	0	0	7.1943	0.326388749	7.849472801	15.17094444	1.814612695	2.581311611	1.630191396	1.041913653	4.377533071	0	7.053862833	0.284740524	0.090294404	0.227978106	4.174315182	8.780465135	2.249344182	0.660305917	0	0	4.633964744	2.61088458	0	0	0.282897256	0	0.489176506	0	0	0	0	0	0	0	0	0	0	0	0	0	73.5249
H5421_109_0	2009	6																					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																																																			0		364.9669103	18.33926931	2211.405606	7119.457189	221.4937468	19.69236954	12.43644171	381.263847	421.8369504		6262.292066	26.06682093	33.0643216	118.4941073	3821.41343	4593.230736	870.4846021	345.4187662			35.3516971	1365.804102			147.9890135		255.8976692														"1a: $350 per admit, $875 Max OOP"	1b : $195 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20%/$250 Ded.	9a: $100 9b: $75	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $100	12: $50	9a: $100 9c: 50% 9d: $15 3: $15 5: $175	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $25 7d: $25 7f: $25	"7e, 7h: 50%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $15	10b: (n/c)	16a: (n/c)	17a1: $15	17b1: (n/c)	18a: $15 18a1: $15	18b: (n/c)		14a: (n/c)											331.5882178	325.8531583	64.98915146	29.26144591	100	0.2	0.2	50.03511327	97.5		10.31175248	100	50	15.65823162	10	25	47.31116087	15			0.2	15			15		15														225.5430547	221.6421235	44.20498363	19.90334861	68.01901954	0.136038039	0.136038039	34.03339347	66.31854406		7.013952932	68.01901954	34.00950977	10.65057563	6.801901954	17.00475489	32.18058776	10.20285293			0.136038039	10.20285293			10.20285293		10.20285293														6.8596	0.338729549	8.146262384	11.80841986	1.255482291	2.678911337	1.691829144	1.081308544	2.331301031	0	3.66028515	0.1477533	0.093708447	0.105169204	2.16607329	6.508896899	2.334392177	0.293688073	0	0	4.809175551	1.161258199	0	0	0.125825845	0	0.217573857	0	0	0	0	0	0	0	0	0	0	0	0	0	57.8157	0	27.1836	6.8596	0.338729549	8.146262384	11.80841986	1.255482291	2.678911337	1.691829144	1.081308544	2.331301031	0	3.66028515	0.1477533	0.093708447	0.105169204	2.16607329	6.508896899	2.334392177	0.293688073	0	0	4.809175551	1.161258199	0	0	0.125825845	0	0.217573857	0	0	0	0	0	0	0	0	0	0	0	0	0	57.8157																																																																																		0	0	0	6.8596	0.338729549	8.146262384	11.80841986	1.255482291	2.678911337	1.691829144	1.081308544	2.331301031	0	3.66028515	0.1477533	0.093708447	0.105169204	2.16607329	6.508896899	2.334392177	0.293688073	0	0	4.809175551	1.161258199	0	0	0.125825845	0	0.217573857	0	0	0	0	0	0	0	0	0	0	0	0	0	57.8157
H5421_110_0	2009	6																					3000											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																																																			0		364.9669103	18.33926931	2211.405606	7119.457189	221.4937468	19.69236954	12.43644171	343.1618223	421.8369504		6262.292066	26.06682093	33.0643216	118.4941073	3821.41343	4593.230736	870.4846021	345.4187662			35.3516971	1365.804102			147.9890135		255.8976692														1a: $195 days 1-5	1b : $295 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20%/$250 Ded.	9a: $200 9b: $100	8a: 0%	8b1: 20% 8b2: 20% 8b3: 20%	9a: $0	12: $50	9a: $100 9c: 50% 9d: $35 3: $35 5: $195	"7a: $20, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 20% 8b2: 20% 8b3: 20%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $0 17a: $35 17b: $35	10b: (n/c)	16a: (n/c)	17a1: $35	17b1: (n/c)	18a: $35 18a1: $35	18b: (n/c)		14a: $0											360.9139764	325.8531583	64.98915146	39.01526121	150	0.2	0.2	50.03901197	190		20.62350495	200	50	35.22614932	20	35	47.31116087	35			0.2	35			35		35														236.6877171	213.6948004	42.6199452	25.58624413	98.37013773	0.131160184	0.131160184	32.81563	124.6021745		13.52491348	131.1601836	32.79004591	23.10134107	13.11601836	22.95303214	31.02670274	22.95303214			0.131160184	22.95303214			22.95303214		22.95303214														7.1986	0.326583875	7.854165478	15.18001414	1.815697531	2.582854805	1.631165979	0.938422616	4.380150107	0	7.058079868	0.284910752	0.090348385	0.228114399	4.176810727	8.785714391	2.250688915	0.66070067	0	0	4.636735083	2.612445454	0	0	0.283066382	0	0.489468952	0	0	0	0	0	0	0	0	0	0	0	0	0	73.4647	0	38.5582	7.1986	0.326583875	7.854165478	15.18001414	1.815697531	2.582854805	1.631165979	0.938422616	4.380150107	0	7.058079868	0.284910752	0.090348385	0.228114399	4.176810727	8.785714391	2.250688915	0.66070067	0	0	4.636735083	2.612445454	0	0	0.283066382	0	0.489468952	0	0	0	0	0	0	0	0	0	0	0	0	0	73.4647																																																																																		0	0	0	7.1986	0.326583875	7.854165478	15.18001414	1.815697531	2.582854805	1.631165979	0.938422616	4.380150107	0	7.058079868	0.284910752	0.090348385	0.228114399	4.176810727	8.785714391	2.250688915	0.66070067	0	0	4.636735083	2.612445454	0	0	0.283066382	0	0.489468952	0	0	0	0	0	0	0	0	0	0	0	0	0	73.4647
H5421_112_0	2009	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																																																			0		368.6483978	21.20912996	2107.894539	1938.239529	253.6111929	11.96473221	9.827632011	382.6244642	423.8517355		5819.651362	158.5325594	10.72348592	138.5941895	3595.055328	4288.333145	713.1635448	535.3441083			27.38564596	1206.780883			147.9890135		255.8976692														"1a: $350 per admit, $875 Max OOP"	1b : $195 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20%/$250 Ded.	9a: $100 9b: $75	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $100	12: $50	9a: $100 9c: 50% 9d: $15 3: $15 5: $175	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $25 7d: $25 7f: $25	"7e, 7h: 50%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $15	10b: (n/c)	16a: (n/c)	17a1: $15	17b1: (n/c)	18a: $15 18a1: $15	18b: (n/c)		14a: (n/c)											331.5882178	325.8531583	64.98915146	20.91651969	100	0.2	0.2	50.02778127	97.5		9.352186172	100	50	16.47916766	10	25	40.71407917	15			0.2	15			15		15														248.2053148	243.9124234	48.64664043	15.65674254	74.85347836	0.149706957	0.149706957	37.44753443	72.9821414		7.000436653	74.85347836	37.42673918	12.3352302	7.485347836	18.71336959	30.47590444	11.22802175			0.149706957	11.22802175			11.22802175		11.22802175														7.625	0.431097524	8.54516564	2.528876441	1.581973328	1.791203648	1.47126488	1.194028566	2.577800608	0	3.395008392	0.988892792	0.033445426	0.142465936	2.242519968	6.687430256	1.811192004	0.500904608	0	0	4.099821715	1.129146834	0	0	0.138468655	0	0.239435383	0	0	0	0	0	0	0	0	0	0	0	0	0	49.1552	0	16.5134	7.625	0.431097524	8.54516564	2.528876441	1.581973328	1.791203648	1.47126488	1.194028566	2.577800608	0	3.395008392	0.988892792	0.033445426	0.142465936	2.242519968	6.687430256	1.811192004	0.500904608	0	0	4.099821715	1.129146834	0	0	0.138468655	0	0.239435383	0	0	0	0	0	0	0	0	0	0	0	0	0	49.1552																																																																																		0	0	0	7.625	0.431097524	8.54516564	2.528876441	1.581973328	1.791203648	1.47126488	1.194028566	2.577800608	0	3.395008392	0.988892792	0.033445426	0.142465936	2.242519968	6.687430256	1.811192004	0.500904608	0	0	4.099821715	1.129146834	0	0	0.138468655	0	0.239435383	0	0	0	0	0	0	0	0	0	0	0	0	0	49.1552
H5421_113_0	2009	3																					3000											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																																																			0		368.6483978	21.20912996	2107.894539	1938.239529	253.6111929	11.96473221	9.827632011	382.6244642	423.8517355		5819.651362	158.5325594	10.72348592	138.5941895	3595.055328	4288.333145	713.1635448	535.3441083			27.38564596	1206.780883			147.9890135		255.8976692														1a: $195 days 1-5	1b : $295 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20%/$250 Ded.	9a: $200 9b: $100	8a: 0%	8b1: 20% 8b2: 20% 8b3: 20%	9a: $0	12: $50	9a: $100 9c: 50% 9d: $35 3: $35 5: $195	"7a: $20, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 20% 8b2: 20% 8b3: 20%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $0 17a: $35 17b: $35	10b: (n/c)	16a: (n/c)	17a1: $35	17b1: (n/c)	18a: $35 18a1: $35	18b: (n/c)		14a: $0											360.9139764	325.8531583	64.98915146	27.88869293	150	0.2	0.2	50.02778127	190		18.70437234	200	50	34.91429663	20	35	40.71407917	35			0.2	35			35		35														260.2819797	234.9970096	46.868523	20.11261598	108.1761847	0.144234913	0.144234913	36.07876337	137.0231673		13.48911758	144.2349129	36.05872823	25.17930267	14.42349129	25.24110976	29.36195832	25.24110976			0.144234913	25.24110976			25.24110976		25.24110976														7.996	0.415340176	8.232825306	3.248588943	2.28622427	1.725732109	1.417487647	1.150384792	4.839792271	0	6.541830125	1.905494158	0.032222939	0.290808754	4.321104101	9.020190633	1.744989856	1.126056616	0	0	3.94996626	2.538374061	0	0	0.311283911	0	0.538261763	0	0	0	0	0	0	0	0	0	0	0	0	0	63.633	0	24.6022	7.996	0.415340176	8.232825306	3.248588943	2.28622427	1.725732109	1.417487647	1.150384792	4.839792271	0	6.541830125	1.905494158	0.032222939	0.290808754	4.321104101	9.020190633	1.744989856	1.126056616	0	0	3.94996626	2.538374061	0	0	0.311283911	0	0.538261763	0	0	0	0	0	0	0	0	0	0	0	0	0	63.633																																																																																		0	0	0	7.996	0.415340176	8.232825306	3.248588943	2.28622427	1.725732109	1.417487647	1.150384792	4.839792271	0	6.541830125	1.905494158	0.032222939	0.290808754	4.321104101	9.020190633	1.744989856	1.126056616	0	0	3.94996626	2.538374061	0	0	0.311283911	0	0.538261763	0	0	0	0	0	0	0	0	0	0	0	0	0	63.633
H5421_115_0	2009	4																					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																																																			0		368.6483978	21.20912996	2107.894539	1938.239529	253.6111929	11.96473221	9.827632011	382.6244642	423.8517355		5819.651362	158.5325594	10.72348592	138.5941895	3595.055328	4288.333145	713.1635448	535.3441083			27.38564596	1206.780883			147.9890135		255.8976692														"1a: $350 per admit, $875 Max OOP"	1b : $195 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20%/$250 Ded.	9a: $100 9b: $75	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $100	12: $50	9a: $100 9c: 50% 9d: $15 3: $15 5: $175	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $25 7d: $25 7f: $25	"7e, 7h: 50%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $15	10b: (n/c)	16a: (n/c)	17a1: $15	17b1: (n/c)	18a: $15 18a1: $15	18b: (n/c)		14a: (n/c)											331.5882178	325.8531583	64.98915146	20.91651969	100	0.2	0.2	50.02778127	97.5		9.352186172	100	50	16.47916766	10	25	40.71407917	15			0.2	15			15		15														248.2053148	243.9124234	48.64664043	15.65674254	74.85347836	0.149706957	0.149706957	37.44753443	72.9821414		7.000436653	74.85347836	37.42673918	12.3352302	7.485347836	18.71336959	30.47590444	11.22802175			0.149706957	11.22802175			11.22802175		11.22802175														7.625	0.431097524	8.54516564	2.528876441	1.581973328	1.791203648	1.47126488	1.194028566	2.577800608	0	3.395008392	0.988892792	0.033445426	0.142465936	2.242519968	6.687430256	1.811192004	0.500904608	0	0	4.099821715	1.129146834	0	0	0.138468655	0	0.239435383	0	0	0	0	0	0	0	0	0	0	0	0	0	49.1552	0	16.5134	7.625	0.431097524	8.54516564	2.528876441	1.581973328	1.791203648	1.47126488	1.194028566	2.577800608	0	3.395008392	0.988892792	0.033445426	0.142465936	2.242519968	6.687430256	1.811192004	0.500904608	0	0	4.099821715	1.129146834	0	0	0.138468655	0	0.239435383	0	0	0	0	0	0	0	0	0	0	0	0	0	49.1552																																																																																		0	0	0	7.625	0.431097524	8.54516564	2.528876441	1.581973328	1.791203648	1.47126488	1.194028566	2.577800608	0	3.395008392	0.988892792	0.033445426	0.142465936	2.242519968	6.687430256	1.811192004	0.500904608	0	0	4.099821715	1.129146834	0	0	0.138468655	0	0.239435383	0	0	0	0	0	0	0	0	0	0	0	0	0	49.1552
H5421_116_0	2009	4																					3000											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																																																			0		368.6483978	21.20912996	2107.894539	1938.239529	253.6111929	11.96473221	9.827632011	382.6244642	423.8517355		5819.651362	158.5325594	10.72348592	138.5941895	3595.055328	4288.333145	713.1635448	535.3441083			27.38564596	1206.780883			147.9890135		255.8976692														1a: $195 days 1-5	1b : $295 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20%/$250 Ded.	9a: $200 9b: $100	8a: 0%	8b1: 20% 8b2: 20% 8b3: 20%	9a: $0	12: $50	9a: $100 9c: 50% 9d: $35 3: $35 5: $195	"7a: $20, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 20% 8b2: 20% 8b3: 20%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $0 17a: $35 17b: $35	10b: (n/c)	16a: (n/c)	17a1: $35	17b1: (n/c)	18a: $35 18a1: $35	18b: (n/c)		14a: $0											360.9139764	325.8531583	64.98915146	27.88869293	150	0.2	0.2	50.02778127	190		18.70437234	200	50	34.91429663	20	35	40.71407917	35			0.2	35			35		35														260.2819797	234.9970096	46.868523	20.11261598	108.1761847	0.144234913	0.144234913	36.07876337	137.0231673		13.48911758	144.2349129	36.05872823	25.17930267	14.42349129	25.24110976	29.36195832	25.24110976			0.144234913	25.24110976			25.24110976		25.24110976														7.996	0.415340176	8.232825306	3.248588943	2.28622427	1.725732109	1.417487647	1.150384792	4.839792271	0	6.541830125	1.905494158	0.032222939	0.290808754	4.321104101	9.020190633	1.744989856	1.126056616	0	0	3.94996626	2.538374061	0	0	0.311283911	0	0.538261763	0	0	0	0	0	0	0	0	0	0	0	0	0	63.633	0	24.6022	7.996	0.415340176	8.232825306	3.248588943	2.28622427	1.725732109	1.417487647	1.150384792	4.839792271	0	6.541830125	1.905494158	0.032222939	0.290808754	4.321104101	9.020190633	1.744989856	1.126056616	0	0	3.94996626	2.538374061	0	0	0.311283911	0	0.538261763	0	0	0	0	0	0	0	0	0	0	0	0	0	63.633																																																																																		0	0	0	7.996	0.415340176	8.232825306	3.248588943	2.28622427	1.725732109	1.417487647	1.150384792	4.839792271	0	6.541830125	1.905494158	0.032222939	0.290808754	4.321104101	9.020190633	1.744989856	1.126056616	0	0	3.94996626	2.538374061	0	0	0.311283911	0	0.538261763	0	0	0	0	0	0	0	0	0	0	0	0	0	63.633
H5421_124_0	2009	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																																																			0		373.6865646	25.00296775	1393.32513	4741.958187	187.3442172	16.16304672	12.10241935	382.2252542	422.4424079		5539.840808	70.31616241	7.634170225	49.98962182	3607.812621	3700.133952	739.0138969	468.273319			23.06431568	1185.580334			147.9890135		255.8976692														"1a: $350 per admit, $875 Max OOP"	1b : $195 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20%/$250 Ded.	9a: $100 9b: $75	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $100	12: $50	9a: $100 9c: 50% 9d: $15 3: $15 5: $175	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $25 7d: $25 7f: $25	"7e, 7h: 50%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $15	10b: (n/c)	16a: (n/c)	17a1: $15	17b1: (n/c)	18a: $15 18a1: $15	18b: (n/c)		14a: (n/c)											331.5882178	325.8531583	64.98915146	22.93534076	100	0.2	0.2	50.02802802	97.5		9.688820898	100	50	16.71397747	10	25	49.85960233	15			0.2	15			15		15														247.8019299	243.5160153	48.56757958	17.13999894	74.73182599	0.149463652	0.149463652	37.38685884	72.86353034		7.240632774	74.73182599	37.36591299	12.49066056	7.473182599	18.6829565	37.26099125	11.2097739			0.149463652	11.2097739			11.2097739		11.2097739														7.7167	0.507385256	5.639202427	6.773096526	1.16671462	2.41578799	1.808871794	1.190850136	2.565053767	0	3.342662743	0.437904601	0.023771478	0.052033616	2.246820208	5.760786805	2.294699196	0.437436502	0	0	3.447276851	1.10750729	0	0	0.138243615	0	0.239046251	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3118	0	16.6732	7.7167	0.507385256	5.639202427	6.773096526	1.16671462	2.41578799	1.808871794	1.190850136	2.565053767	0	3.342662743	0.437904601	0.023771478	0.052033616	2.246820208	5.760786805	2.294699196	0.437436502	0	0	3.447276851	1.10750729	0	0	0.138243615	0	0.239046251	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3118																																																																																		0	0	0	7.7167	0.507385256	5.639202427	6.773096526	1.16671462	2.41578799	1.808871794	1.190850136	2.565053767	0	3.342662743	0.437904601	0.023771478	0.052033616	2.246820208	5.760786805	2.294699196	0.437436502	0	0	3.447276851	1.10750729	0	0	0.138243615	0	0.239046251	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3118
H5421_125_0	2009	3																					3000											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																																																			0		373.6865646	25.00296775	1393.32513	4741.958187	187.3442172	16.16304672	12.10241935	382.2252542	422.4424079		5539.840808	70.31616241	7.634170225	49.98962182	3607.812621	3700.133952	739.0138969	468.273319			23.06431568	1185.580334			147.9890135		255.8976692														1a: $195 days 1-5	1b : $295 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20%/$250 Ded.	9a: $200 9b: $100	8a: 0%	8b1: 20% 8b2: 20% 8b3: 20%	9a: $0	12: $50	9a: $100 9c: 50% 9d: $35 3: $35 5: $195	"7a: $20, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 20% 8b2: 20% 8b3: 20%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $0 17a: $35 17b: $35	10b: (n/c)	16a: (n/c)	17a1: $35	17b1: (n/c)	18a: $35 18a1: $35	18b: (n/c)		14a: $0											360.9139764	325.8531583	64.98915146	30.58045434	150	0.2	0.2	50.02802802	190		19.3776418	200	50	35.73045049	20	35	49.85960233	35			0.2	35			35		35														259.8599073	234.6159392	46.79252116	22.0180834	108.0007665	0.144001022	0.144001022	36.02043582	136.8009709		13.95200112	144.001022	36.00025551	25.72610694	14.4001022	25.20017886	35.89916847	25.20017886			0.144001022	25.20017886			25.20017886		25.20017886														8.0922	0.48884123	5.433099635	8.700735902	1.686109922	2.327495247	1.742760756	1.147326687	4.81587763	0	6.440988762	0.843799938	0.022902673	0.107169863	4.329405872	7.770336449	2.210832032	0.983380949	0	0	3.32128503	2.489736372	0	0	0.310779134	0	0.537388919	0	0	0	0	0	0	0	0	0	0	0	0	0	63.8024	0	24.8114	8.0922	0.48884123	5.433099635	8.700735902	1.686109922	2.327495247	1.742760756	1.147326687	4.81587763	0	6.440988762	0.843799938	0.022902673	0.107169863	4.329405872	7.770336449	2.210832032	0.983380949	0	0	3.32128503	2.489736372	0	0	0.310779134	0	0.537388919	0	0	0	0	0	0	0	0	0	0	0	0	0	63.8024																																																																																		0	0	0	8.0922	0.48884123	5.433099635	8.700735902	1.686109922	2.327495247	1.742760756	1.147326687	4.81587763	0	6.440988762	0.843799938	0.022902673	0.107169863	4.329405872	7.770336449	2.210832032	0.983380949	0	0	3.32128503	2.489736372	0	0	0.310779134	0	0.537388919	0	0	0	0	0	0	0	0	0	0	0	0	0	63.8024
H5421_127_0	2009	4																					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																																																			0		373.6865646	25.00296775	1393.32513	4741.958187	187.3442172	16.16304672	12.10241935	382.2252542	422.4424079		5539.840808	70.31616241	7.634170225	49.98962182	3607.812621	3700.133952	739.0138969	468.273319			23.06431568	1185.580334			147.9890135		255.8976692														"1a: $350 per admit, $875 Max OOP"	1b : $195 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20%/$250 Ded.	9a: $100 9b: $75	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $100	12: $50	9a: $100 9c: 50% 9d: $15 3: $15 5: $175	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $25 7d: $25 7f: $25	"7e, 7h: 50%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $15	10b: (n/c)	16a: (n/c)	17a1: $15	17b1: (n/c)	18a: $15 18a1: $15	18b: (n/c)		14a: (n/c)											331.5882178	325.8531583	64.98915146	22.93534076	100	0.2	0.2	50.02802802	97.5		9.688820898	100	50	16.71397747	10	25	49.85960233	15			0.2	15			15		15														247.8019299	243.5160153	48.56757958	17.13999894	74.73182599	0.149463652	0.149463652	37.38685884	72.86353034		7.240632774	74.73182599	37.36591299	12.49066056	7.473182599	18.6829565	37.26099125	11.2097739			0.149463652	11.2097739			11.2097739		11.2097739														7.7167	0.507385256	5.639202427	6.773096526	1.16671462	2.41578799	1.808871794	1.190850136	2.565053767	0	3.342662743	0.437904601	0.023771478	0.052033616	2.246820208	5.760786805	2.294699196	0.437436502	0	0	3.447276851	1.10750729	0	0	0.138243615	0	0.239046251	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3118	0	16.6732	7.7167	0.507385256	5.639202427	6.773096526	1.16671462	2.41578799	1.808871794	1.190850136	2.565053767	0	3.342662743	0.437904601	0.023771478	0.052033616	2.246820208	5.760786805	2.294699196	0.437436502	0	0	3.447276851	1.10750729	0	0	0.138243615	0	0.239046251	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3118																																																																																		0	0	0	7.7167	0.507385256	5.639202427	6.773096526	1.16671462	2.41578799	1.808871794	1.190850136	2.565053767	0	3.342662743	0.437904601	0.023771478	0.052033616	2.246820208	5.760786805	2.294699196	0.437436502	0	0	3.447276851	1.10750729	0	0	0.138243615	0	0.239046251	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3118
H5421_128_0	2009	4																					3000											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																																																			0		373.6865646	25.00296775	1393.32513	4741.958187	187.3442172	16.16304672	12.10241935	382.2252542	422.4424079		5539.840808	70.31616241	7.634170225	49.98962182	3607.812621	3700.133952	739.0138969	468.273319			23.06431568	1185.580334			147.9890135		255.8976692														1a: $195 days 1-5	1b : $295 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20%/$250 Ded.	9a: $200 9b: $100	8a: 0%	8b1: 20% 8b2: 20% 8b3: 20%	9a: $0	12: $50	9a: $100 9c: 50% 9d: $35 3: $35 5: $195	"7a: $20, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 20% 8b2: 20% 8b3: 20%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $0 17a: $35 17b: $35	10b: (n/c)	16a: (n/c)	17a1: $35	17b1: (n/c)	18a: $35 18a1: $35	18b: (n/c)		14a: $0											360.9139764	325.8531583	64.98915146	30.58045434	150	0.2	0.2	50.02802802	190		19.3776418	200	50	35.73045049	20	35	49.85960233	35			0.2	35			35		35														259.8599073	234.6159392	46.79252116	22.0180834	108.0007665	0.144001022	0.144001022	36.02043582	136.8009709		13.95200112	144.001022	36.00025551	25.72610694	14.4001022	25.20017886	35.89916847	25.20017886			0.144001022	25.20017886			25.20017886		25.20017886														8.0922	0.48884123	5.433099635	8.700735902	1.686109922	2.327495247	1.742760756	1.147326687	4.81587763	0	6.440988762	0.843799938	0.022902673	0.107169863	4.329405872	7.770336449	2.210832032	0.983380949	0	0	3.32128503	2.489736372	0	0	0.310779134	0	0.537388919	0	0	0	0	0	0	0	0	0	0	0	0	0	63.8024	0	24.8114	8.0922	0.48884123	5.433099635	8.700735902	1.686109922	2.327495247	1.742760756	1.147326687	4.81587763	0	6.440988762	0.843799938	0.022902673	0.107169863	4.329405872	7.770336449	2.210832032	0.983380949	0	0	3.32128503	2.489736372	0	0	0.310779134	0	0.537388919	0	0	0	0	0	0	0	0	0	0	0	0	0	63.8024																																																																																		0	0	0	8.0922	0.48884123	5.433099635	8.700735902	1.686109922	2.327495247	1.742760756	1.147326687	4.81587763	0	6.440988762	0.843799938	0.022902673	0.107169863	4.329405872	7.770336449	2.210832032	0.983380949	0	0	3.32128503	2.489736372	0	0	0.310779134	0	0.537388919	0	0	0	0	0	0	0	0	0	0	0	0	0	63.8024
H5421_130_0	2009	3																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		295.0678001	35.68137979	347.7564309	10.78317853	147.5819257	18.71093084	1.008565399	698.1519739	1397.58872		13.5991855		4.548786859	2.579010449	3962.397873	3419.861855	0.841466243	612.5182702		50.61216424	1.070846009	657.4210508			98.01911915		20.91712333														"1a: $200 per admit IN, $500 per admit OON"	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $75; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												245	111.15	30.67	0.15	100	0.2	0.2	50	75		0.1		50	0.341470472	10	25	0.5	15		30.93964335	0.2	15			15		15														210.10589	95.31946805	26.30182713	0.128636259	85.75750612	0.171515012	0.171515012	42.87875306	64.31812959		0.085757506		42.87875306	0.292836561	8.575750612	21.43937653	0.428787531	12.86362592		26.53306654	0.171515012	12.86362592			12.86362592		12.86362592														5.1663	0.283427512	0.762219127	1.387107749	1.054688158	3.209205532	0.172984107	2.494657174	7.490857699	0	1.166232234	0	0.016253859	0.755228551	2.831711332	6.109975499	0.360810232	0.656600491	0	0.111907993	0.183666166	0.704734872	0	0	0.10507344	0	0.022422504	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0461	0	5.8204	5.1663	0.283427512	0.762219127	1.387107749	1.054688158	3.209205532	0.172984107	2.494657174	7.490857699	0	1.166232234	0	0.016253859	0.755228551	2.831711332	6.109975499	0.360810232	0.656600491	0	0.111907993	0.183666166	0.704734872	0	0	0.10507344	0	0.022422504	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0461																																																																																		0	0	0	5.1663	0.283427512	0.762219127	1.387107749	1.054688158	3.209205532	0.172984107	2.494657174	7.490857699	0	1.166232234	0	0.016253859	0.755228551	2.831711332	6.109975499	0.360810232	0.656600491	0	0.111907993	0.183666166	0.704734872	0	0	0.10507344	0	0.022422504	0	0	0	0	0	0	0	0	0	0	0	0	0	35.0461
H5421_131_0	2009	3																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		311.8204322	85.1546318	294.4884983	15.20715987	189.3678977	13.51301546	1.599796192	742.7362338	1015.430536		7.41667593		0.933085721	1.489829382	2718.217371	2394.764429	0.60523366	404.1412752		28.45079952	0.661110776	447.8017147			68.3317545		14.9442275														"1a: $195 Per Day (Days 1-5) IN, $295 Per Day (Days 1-5) OON"	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												145.11	168.15	30.67	0.2	150	0.2	0.2	50	100		0.2		50	0.696000305	20	34.98150927	0.5	35		35	0.2	34.54219544			35		29.21446604														128.2394035	148.6007559	27.10428299	0.176747851	132.5608884	0.176747851	0.176747851	44.18696281	88.37392561		0.176747851		44.18696281	0.615082792	17.67478512	30.93087396	0.441869628	30.93087396		30.93087396	0.176747851	30.60683918			30.93087396		29.21446604														3.3323	1.054503555	0.665158299	2.687832831	2.091898063	2.388396447	0.282760539	2.734938195	7.478131886	0	1.310881534	0	0.003435852	0.916368415	4.003658995	6.172679726	0.267434372	1.041703571	0	0.073334008	0.116849909	1.142149589	0	0	0.176130074	0	0.036382302	0	0	0	0	0	0	0	0	0	0	0	0	0	37.9769	0	4.9842	3.3323	1.054503555	0.665158299	2.687832831	2.091898063	2.388396447	0.282760539	2.734938195	7.478131886	0	1.310881534	0	0.003435852	0.916368415	4.003658995	6.172679726	0.267434372	1.041703571	0	0.073334008	0.116849909	1.142149589	0	0	0.176130074	0	0.036382302	0	0	0	0	0	0	0	0	0	0	0	0	0	37.9769																																																																																		0	0	0	3.3323	1.054503555	0.665158299	2.687832831	2.091898063	2.388396447	0.282760539	2.734938195	7.478131886	0	1.310881534	0	0.003435852	0.916368415	4.003658995	6.172679726	0.267434372	1.041703571	0	0.073334008	0.116849909	1.142149589	0	0	0.176130074	0	0.036382302	0	0	0	0	0	0	0	0	0	0	0	0	0	37.9769
H5421_133_0	2009	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		295.0678001	35.68137979	347.7564309	13.62505981	147.5819257	23.64215255	1.274370432	698.1519739	1397.58872		17.18321877		4.548786859	3.258702572	3962.397873	3419.861855	1.063232687	612.5182702		50.61216424	1.35306495	657.4210508			98.01911915		20.91712333														"1a: $200 per admit IN, $500 per admit OON"	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $75; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												245	111.15	30.67	0.15	100	0.2	0.2	50	75		0.1		50	0.270263695	10	25	0.5	15		30.93964335	0.2	15			15		15														208.0007205	94.36440849	26.03829427	0.12734738	84.89825325	0.169796507	0.169796507	42.44912663	63.67368994		0.084898253		42.44912663	0.229449156	8.489825325	21.22456331	0.424491266	12.73473799		26.26721676	0.169796507	12.73473799			12.73473799		12.73473799														5.1145	0.280587692	0.754582024	1.735115668	1.044120642	4.014354909	0.216383647	2.469661795	7.415802567	0	1.458825259	0	0.016091002	0.747706556	2.803338818	6.048756205	0.45133299	0.65002164	0	0.110786724	0.229745702	0.697673736	0	0	0.10402065	0	0.02219784	0	0	0	0	0	0	0	0	0	0	0	0	0	36.3856	0	6.4723	5.1145	0.280587692	0.754582024	1.735115668	1.044120642	4.014354909	0.216383647	2.469661795	7.415802567	0	1.458825259	0	0.016091002	0.747706556	2.803338818	6.048756205	0.45133299	0.65002164	0	0.110786724	0.229745702	0.697673736	0	0	0.10402065	0	0.02219784	0	0	0	0	0	0	0	0	0	0	0	0	0	36.3856																																																																																		0	0	0	5.1145	0.280587692	0.754582024	1.735115668	1.044120642	4.014354909	0.216383647	2.469661795	7.415802567	0	1.458825259	0	0.016091002	0.747706556	2.803338818	6.048756205	0.45133299	0.65002164	0	0.110786724	0.229745702	0.697673736	0	0	0.10402065	0	0.02219784	0	0	0	0	0	0	0	0	0	0	0	0	0	36.3856
H5421_134_0	2009	5																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		311.8204322	85.1546318	294.4884983	23.45178944	189.3678977	20.83915708	2.467132835	742.7362338	1015.430536		11.43765987		0.933085721	2.297547028	2718.217371	2394.764429	0.933363789	404.1412752		28.45079952	1.019534933	447.8017147			68.3317545		14.9442275														"1a: $195 Per Day (Days 1-5) IN, $295 Per Day (Days 1-5) OON"	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												145.11	168.15	30.67	0.2	150	0.2	0.2	50	100		0.2		50	0.451316857	20	35	0.5	35		35	0.2	34.91779834			35		35														125.4216776	145.3356426	26.50873719	0.172864279	129.6482093	0.172864279	0.172864279	43.21606975	86.43213951		0.172864279		43.21606975	0.390082816	17.2864279	30.25124883	0.432160698	30.25124883		30.25124883	0.172864279	30.25124883			30.25124883		30.25124883														3.2591	1.031333594	0.650543184	4.053976673	2.045934069	3.602345864	0.426479139	2.674845074	7.313819477	0	1.977162828	0	0.003360358	0.896233614	3.91568905	6.037051218	0.403363146	1.018814856	0	0.071722685	0.176241171	1.128880091	0	0	0.172260076	0	0.037673462	0	0	0	0	0	0	0	0	0	0	0	0	0	40.8968	0	6.4168	3.2591	1.031333594	0.650543184	4.053976673	2.045934069	3.602345864	0.426479139	2.674845074	7.313819477	0	1.977162828	0	0.003360358	0.896233614	3.91568905	6.037051218	0.403363146	1.018814856	0	0.071722685	0.176241171	1.128880091	0	0	0.172260076	0	0.037673462	0	0	0	0	0	0	0	0	0	0	0	0	0	40.8968																																																																																		0	0	0	3.2591	1.031333594	0.650543184	4.053976673	2.045934069	3.602345864	0.426479139	2.674845074	7.313819477	0	1.977162828	0	0.003360358	0.896233614	3.91568905	6.037051218	0.403363146	1.018814856	0	0.071722685	0.176241171	1.128880091	0	0	0.172260076	0	0.037673462	0	0	0	0	0	0	0	0	0	0	0	0	0	40.8968
H5421_136_0	2009	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																																																			0		295.2306576	2.965057787	34.62671741		6.921439351	25.84404543	0.608623708	13.55609737	54.7473061	7.185644003	17.65753747	2.334003726	0.054761475	20.0779012	32.48403715	22.33451842	0.941798926	5.547658451	43.73344927	74.94483646	1.079343487	14.30616062		1000	500		40														Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	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: $0	17a: $0	17b: $200 Allowance	18a: $0	18b: $500 Allowance		14a10: $20 OTC Benefit											0.080340084	0.080340084	0.20451317		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.080340084	0.080340084	0.20451317		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			23.7189	0.238212993	7.081619758	0	1.59885249	5.969974494	0.140592077	3.131458494	12.64662771	1.659883765	4.078891155	0.539154861	0.012649901	4.637995177	7.503812582	5.159273755	0.217555552	1.281509102	10.10242678	17.31225722	0.249328345	3.304723103	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.5857	0	0	23.7189	0.238212993	7.081619758	0	1.59885249	5.969974494	0.140592077	3.131458494	12.64662771	1.659883765	4.078891155	0.539154861	0.012649901	4.637995177	7.503812582	5.159273755	0.217555552	1.281509102	10.10242678	17.31225722	0.249328345	3.304723103	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.5857																																																																																		0	0	0	23.7189	0.238212993	7.081619758	0	1.59885249	5.969974494	0.140592077	3.131458494	12.64662771	1.659883765	4.078891155	0.539154861	0.012649901	4.637995177	7.503812582	5.159273755	0.217555552	1.281509102	10.10242678	17.31225722	0.249328345	3.304723103	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.5857
H5421_801_0	2009	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		305.1908663	2.995005405	36.60838905		7.773514726	25.3207705	1.364852087	13.07246609	61.13294558	9.805167214	18.40324556	1.903788799	0.09684589	18.56846366	30.97971254	22.86215103	1.138723338	7.937775198	44.72075808	71.72911375	1.449133999	15.87785745																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																			0.077439714	0.077439714	0.185144142		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.077439714	0.077439714	0.185144142		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			23.6339	0.231932363	6.777828796	0	1.795681902	5.849097985	0.315280832	3.019739667	14.12171043	2.264993626	4.251149725	0.439775213	0.022371401	4.289315105	7.156313596	5.281156888	0.263045091	1.833626071	10.33049512	16.56942528	0.334749954	3.667785072	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.4494	0	0	23.6339	0.231932363	6.777828796	0	1.795681902	5.849097985	0.315280832	3.019739667	14.12171043	2.264993626	4.251149725	0.439775213	0.022371401	4.289315105	7.156313596	5.281156888	0.263045091	1.833626071	10.33049512	16.56942528	0.334749954	3.667785072	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.4494																																																																																		0	0	0	23.6339	0.231932363	6.777828796	0	1.795681902	5.849097985	0.315280832	3.019739667	14.12171043	2.264993626	4.251149725	0.439775213	0.022371401	4.289315105	7.156313596	5.281156888	0.263045091	1.833626071	10.33049512	16.56942528	0.334749954	3.667785072	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.4494
H5421_804_0	2009	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		305.1908663	2.995005405	36.60838905		7.773514726	25.3207705	1.364852087	13.07246609	61.13294558	9.805167214	18.40324556	1.903788799	0.09684589	18.56846366	30.97971254	22.86215103	1.138723338	7.937775198	44.72075808	71.72911375	1.449133999	15.87785745																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																			0.077439714	0.077439714	0.185144142		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.077439714	0.077439714	0.185144142		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			23.6339	0.231932363	6.777828796	0	1.795681902	5.849097985	0.315280832	3.019739667	14.12171043	2.264993626	4.251149725	0.439775213	0.022371401	4.289315105	7.156313596	5.281156888	0.263045091	1.833626071	10.33049512	16.56942528	0.334749954	3.667785072	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.4494	0	0	23.6339	0.231932363	6.777828796	0	1.795681902	5.849097985	0.315280832	3.019739667	14.12171043	2.264993626	4.251149725	0.439775213	0.022371401	4.289315105	7.156313596	5.281156888	0.263045091	1.833626071	10.33049512	16.56942528	0.334749954	3.667785072	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.4494																																																																																		0	0	0	23.6339	0.231932363	6.777828796	0	1.795681902	5.849097985	0.315280832	3.019739667	14.12171043	2.264993626	4.251149725	0.439775213	0.022371401	4.289315105	7.156313596	5.281156888	0.263045091	1.833626071	10.33049512	16.56942528	0.334749954	3.667785072	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.4494
H5421_805_0	2009	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		305.1908663	2.995005405	36.60838905		7.773514726	25.3207705	1.364852087	13.07246609	61.13294558	9.805167214	18.40324556	1.903788799	0.09684589	18.56846366	30.97971254	22.86215103	1.138723338	7.937775198	44.72075808	71.72911375	1.449133999	15.87785745																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																			0.077439714	0.077439714	0.185144142		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.077439714	0.077439714	0.185144142		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			23.6339	0.231932363	6.777828796	0	1.795681902	5.849097985	0.315280832	3.019739667	14.12171043	2.264993626	4.251149725	0.439775213	0.022371401	4.289315105	7.156313596	5.281156888	0.263045091	1.833626071	10.33049512	16.56942528	0.334749954	3.667785072	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.4494	0	0	23.6339	0.231932363	6.777828796	0	1.795681902	5.849097985	0.315280832	3.019739667	14.12171043	2.264993626	4.251149725	0.439775213	0.022371401	4.289315105	7.156313596	5.281156888	0.263045091	1.833626071	10.33049512	16.56942528	0.334749954	3.667785072	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.4494																																																																																		0	0	0	23.6339	0.231932363	6.777828796	0	1.795681902	5.849097985	0.315280832	3.019739667	14.12171043	2.264993626	4.251149725	0.439775213	0.022371401	4.289315105	7.156313596	5.281156888	0.263045091	1.833626071	10.33049512	16.56942528	0.334749954	3.667785072	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.4494
H5421_806_0	2009	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		305.1908663	2.995005405	36.60838905		7.773514726	25.3207705	1.364852087	13.07246609	61.13294558	9.805167214	18.40324556	1.903788799	0.09684589	18.56846366	30.97971254	22.86215103	1.138723338	7.937775198	44.72075808	71.72911375	1.449133999	15.87785745																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																			0.077439714	0.077439714	0.185144142		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.077439714	0.077439714	0.185144142		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			23.6339	0.231932363	6.777828796	0	1.795681902	5.849097985	0.315280832	3.019739667	14.12171043	2.264993626	4.251149725	0.439775213	0.022371401	4.289315105	7.156313596	5.281156888	0.263045091	1.833626071	10.33049512	16.56942528	0.334749954	3.667785072	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.4494	0	0	23.6339	0.231932363	6.777828796	0	1.795681902	5.849097985	0.315280832	3.019739667	14.12171043	2.264993626	4.251149725	0.439775213	0.022371401	4.289315105	7.156313596	5.281156888	0.263045091	1.833626071	10.33049512	16.56942528	0.334749954	3.667785072	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.4494																																																																																		0	0	0	23.6339	0.231932363	6.777828796	0	1.795681902	5.849097985	0.315280832	3.019739667	14.12171043	2.264993626	4.251149725	0.439775213	0.022371401	4.289315105	7.156313596	5.281156888	0.263045091	1.833626071	10.33049512	16.56942528	0.334749954	3.667785072	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.4494
H5421_807_0	2009	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		305.1908663	2.995005405	36.60838905		7.773514726	25.3207705	1.364852087	13.07246609	61.13294558	9.805167214	18.40324556	1.903788799	0.09684589	18.56846366	30.97971254	22.86215103	1.138723338	7.937775198	44.72075808	71.72911375	1.449133999	15.87785745																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																			0.077439714	0.077439714	0.185144142		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.077439714	0.077439714	0.185144142		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			23.6339	0.231932363	6.777828796	0	1.795681902	5.849097985	0.315280832	3.019739667	14.12171043	2.264993626	4.251149725	0.439775213	0.022371401	4.289315105	7.156313596	5.281156888	0.263045091	1.833626071	10.33049512	16.56942528	0.334749954	3.667785072	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.4494	0	0	23.6339	0.231932363	6.777828796	0	1.795681902	5.849097985	0.315280832	3.019739667	14.12171043	2.264993626	4.251149725	0.439775213	0.022371401	4.289315105	7.156313596	5.281156888	0.263045091	1.833626071	10.33049512	16.56942528	0.334749954	3.667785072	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.4494																																																																																		0	0	0	23.6339	0.231932363	6.777828796	0	1.795681902	5.849097985	0.315280832	3.019739667	14.12171043	2.264993626	4.251149725	0.439775213	0.022371401	4.289315105	7.156313596	5.281156888	0.263045091	1.833626071	10.33049512	16.56942528	0.334749954	3.667785072	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.4494
H5421_808_0	2009	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		305.1908663	2.995005405	36.60838905		7.773514726	25.3207705	1.364852087	13.07246609	61.13294558	9.805167214	18.40324556	1.903788799	0.09684589	18.56846366	30.97971254	22.86215103	1.138723338	7.937775198	44.72075808	71.72911375	1.449133999	15.87785745																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																			0.077439714	0.077439714	0.185144142		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.077439714	0.077439714	0.185144142		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			23.6339	0.231932363	6.777828796	0	1.795681902	5.849097985	0.315280832	3.019739667	14.12171043	2.264993626	4.251149725	0.439775213	0.022371401	4.289315105	7.156313596	5.281156888	0.263045091	1.833626071	10.33049512	16.56942528	0.334749954	3.667785072	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.4494	0	0	23.6339	0.231932363	6.777828796	0	1.795681902	5.849097985	0.315280832	3.019739667	14.12171043	2.264993626	4.251149725	0.439775213	0.022371401	4.289315105	7.156313596	5.281156888	0.263045091	1.833626071	10.33049512	16.56942528	0.334749954	3.667785072	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.4494																																																																																		0	0	0	23.6339	0.231932363	6.777828796	0	1.795681902	5.849097985	0.315280832	3.019739667	14.12171043	2.264993626	4.251149725	0.439775213	0.022371401	4.289315105	7.156313596	5.281156888	0.263045091	1.833626071	10.33049512	16.56942528	0.334749954	3.667785072	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.4494
H5422_002_0	2009	10	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Urgent Care	Therapy (PT/OT/ST)	ASC	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemo-Radiation	D	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	0	Coin	0	0	V	V	V	V	0	V	0	V	V	V	V	V	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1541.442357	6.520370859	139.7655145	222.8830838	147.0504059	3.344854366	0.353529249	255.2571198	195.6473504	8572.084817	626.7464185	68.69138411	0	76.90635818	4227.233075	2589.436704	8.803116912	313.6075452	3262.11977	0	37.91132772	0	0	427.2423858	282.8064976	263.226233	183.0156642	0	0	0	1.258063579	398.3169191	93.61949284	132.9252027	270.7773401	129.3557068	0.644743385	598.0673736	5.067755144	24.14719273	"$150/day (days 1-5), $750 yrly Max"	$1024/admit	$175/day (for days 21-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$125 copay	$0 copay	$30/$100 copay for Lower/Higher Tier	$125 copay	20% coinsurance	$30 copay	$20 coapy	$30 copay	$30 copay	$30 copay	$30/$100 copay for Lower/Higher Tier	0	20% coinsurance	0	0	$15/$40 copay; Exam 1/yr Cleaning 2/yr	$20 copay	$100/$80 lenses/frames	$30 copay	0	SilverSneakers	0	$40 copay	$30 copay	$100 copay	$30 copay	$30 copay	$0 copay	20% coinsurance	$30 copay	$30 copay	20% coinsurance	150	1024	175	0	100	0.2	0.2	50	125	0	55.70339703	125	0.2	30	20	30	30	30	38.83358312	0	0.2	0	0	38.81108894	20	0	30	0	0	0	40	30	100	30	30	0	0.2	30	30	0.2	62.30199131	972.994801	166.2832912	0	95.01902353	0.190038047	0.190038047	47.50951177	118.7737794	0	52.92882393	118.7737794	0	28.50570706	19.00380471	28.50570706	28.50570706	28.50570706	36.89929148	0	0.190038047	0	0	38.81108894	19.00380471	0	28.50570706	0	0	0	38.00760941	28.50570706	95.01902353	28.50570706	28.50570706	0	0.190038047	28.50570706	28.50570706	0.190038047	8.0029	0.528690579	1.936722478	0	1.164382165	0.635649591	0.067184008	1.010595095	1.93648127	0	2.76441257	0.679894609	0	0.182689176	6.694459317	6.151143678	0.020911589	0.744967068	10.03082569	0	7.204594682	0	0	1.381811853	0.447866621	0	0.434749242	0	0	0	0.003984666	0.946192118	0.741302733	0.315760574	0.643224961	0	0.122525774	1.420694446	0.012038329	4.588885348	60.8156		3.1156	8.0029	0.528690579	1.936722478	0	1.164382165	0.635649591	0.067184008	1.010595095	1.93648127	0	2.76441257	0.679894609	0	0.182689176	6.694459317	6.151143678	0.020911589	0.744967068	10.03082569	0	7.204594682	0	0	1.381811853	0.447866621	0	0.434749242	0	0	0	0.003984666	0.946192118	0.741302733	0.315760574	0.643224961	0	0.122525774	1.420694446	0.012038329	4.588885348	60.8156	4000																																																																																	0		0	8.0029	0.528690579	1.936722478	0	1.164382165	0.635649591	0.067184008	1.010595095	1.93648127	0	2.76441257	0.679894609	0	0.182689176	6.694459317	6.151143678	0.020911589	0.744967068	10.03082569	0	7.204594682	0	0	1.381811853	0.447866621	0	0.434749242	0	0	0	0.003984666	0.946192118	0.741302733	0.315760574	0.643224961	0	0.122525774	1.420694446	0.012038329	4.588885348	60.8156
H5422_006_0	2009	10	H.6	H.7	H.8	H.9	I.7	I.8	I.9	I.10	I.11		OP Facility - Other	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	0		Urgent Care	Therapy (PT/OT/ST)	Radiology	ASC	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemo-Radiation	Radiology	0	D	A	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	0	Coin	0	0	0	V	V	V	0	V	0	V	V	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	0	0	0	0	0	0	0	0	0	0		1516.678379	6.982597564	460.99691	429.7206917	229.6712649	9.539099319	1.29819546	346.2204625	270.284714	4846.626635	21.37136541	137.178948	0	189.6939005	4062.953433	4043.005338	23.37033625	411.3038939	21.48447554	0	30.08981795	0	0	0	387.2560739	358.1232441	183.0156642	0	0	0	2.763944869	1014.94965	684.2945612	179.0745334	0.536895099	834.6627519	27.41069216	9.334955503	2473.994357	0	"$245/day (days 1-5) w/$1,225 yrly max"	$1024/admit	$175/day (for days 21-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$200 copay	$0 copay	30% coinsurance/Tier 2	$200 copay	20% coinsurance	$35 copay	$25 coapy	$35 copay	$35 copay	$35 copay	30% coinsurance/Tier 2	0	20% coinsurance	0	0	0	$20 copay	$100/$80 lenses/frames	$35 copay	0	SilverSneakers	0	$40 copay	$35 copay	$35 copay/Tier 1	$175 copay	20% coinsurance	$35 copay	$35 copay	20% coinsurance	$35 copay/Tier 1	0	245	1024	175	0	100	0.2	0.2	50	200	0	0.3	200	0.2	35	25	35	35	35	0.3	0	0.2	0	0	0	20	0	35	0	0	0	40	35	35	175	0.2	35	35	0.2	35	0	110.3033497	968.68714	165.5471186	0	94.59835351	0.189196707	0.189196707	47.29917676	189.196707	0	0.283795061	189.196707	0	33.10942373	23.64958838	33.10942373	33.10942373	33.10942373	0.283795061	0	0.189196707	0	0	0	18.9196707	0	33.10942373	0	0	0	37.8393414	33.10942373	33.10942373	165.5471186	0.189196707	33.10942373	33.10942373	0.189196707	33.10942373	0	13.9412	0.563662705	6.359725846	0	1.810543626	1.804766179	0.245614306	1.364661905	4.261414821	0	6.06508794	2.162817102	0	0.523387977	8.007264691	11.15513141	0.06448153	1.134836242	6.097188036	0	5.692894471	0	0	0	0.610563116	0	0.504961931	0	0	0	0.008715488	2.800366502	1.888049882	2.470439418	0.101578785	2.30293356	0.075629352	1.766142841	6.826043955	0	90.6101		5.1739	13.9412	0.563662705	6.359725846	0	1.810543626	1.804766179	0.245614306	1.364661905	4.261414821	0	6.06508794	2.162817102	0	0.523387977	8.007264691	11.15513141	0.06448153	1.134836242	6.097188036	0	5.692894471	0	0	0	0.610563116	0	0.504961931	0	0	0	0.008715488	2.800366502	1.888049882	2.470439418	0.101578785	2.30293356	0.075629352	1.766142841	6.826043955	0	90.6101	4500																																																																																	0		0	13.9412	0.563662705	6.359725846	0	1.810543626	1.804766179	0.245614306	1.364661905	4.261414821	0	6.06508794	2.162817102	0	0.523387977	8.007264691	11.15513141	0.06448153	1.134836242	6.097188036	0	5.692894471	0	0	0	0.610563116	0	0.504961931	0	0	0	0.008715488	2.800366502	1.888049882	2.470439418	0.101578785	2.30293356	0.075629352	1.766142841	6.826043955	0	90.6101
H5422_803_0	2009	4																					none											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	V											0	0	0	0	0	0	0	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	282.2092126	3.069728075	37.99497194	38.84019464	7.886828033	16.20479153	4.60333242	10.67697669	43.47255599	4.037352982	22.84017649	0	0.266468611	20.12200388	46.62882296	131.6530271	1.39642997	6.648515636	37.36046383	41.88899221	6.671069886	0.716740712	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.076575541	0.076575541	0.191150886	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.076575541	0.076575541	0.191150886	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											21.6103	0.235066089	7.262772564	0	1.821857276	3.743306843	1.063369789	2.466381616	10.04216043	0.932628539	5.276080769	0	0.061554249	4.648182896	10.7712581	30.41184927	0.322575323	1.535807112	8.630267145	9.6763572	1.541017144	0.165567105	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.2184	0	0	21.6103	0.235066089	7.262772564	0	1.821857276	3.743306843	1.063369789	2.466381616	10.04216043	0.932628539	5.276080769	0	0.061554249	4.648182896	10.7712581	30.41184927	0.322575323	1.535807112	8.630267145	9.6763572	1.541017144	0.165567105	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.2184	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.6103	0.235066089	7.262772564	0	1.821857276	3.743306843	1.063369789	2.466381616	10.04216043	0.932628539	5.276080769	0	0.061554249	4.648182896	10.7712581	30.41184927	0.322575323	1.535807112	8.630267145	9.6763572	1.541017144	0.165567105	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.2184
H5422_804_0	2009	4																					none											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	V											0	0	0	0	0	0	0	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	282.2092126	3.069728075	37.99497194	38.84019464	7.886828033	16.20479153	4.60333242	10.67697669	43.47255599	4.037352982	22.84017649	0	0.266468611	20.12200388	46.62882296	131.6530271	1.39642997	6.648515636	37.36046383	41.88899221	6.671069886	0.716740712	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.076575541	0.076575541	0.191150886	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.076575541	0.076575541	0.191150886	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											21.6103	0.235066089	7.262772564	0	1.821857276	3.743306843	1.063369789	2.466381616	10.04216043	0.932628539	5.276080769	0	0.061554249	4.648182896	10.7712581	30.41184927	0.322575323	1.535807112	8.630267145	9.6763572	1.541017144	0.165567105	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.2184	0	0	21.6103	0.235066089	7.262772564	0	1.821857276	3.743306843	1.063369789	2.466381616	10.04216043	0.932628539	5.276080769	0	0.061554249	4.648182896	10.7712581	30.41184927	0.322575323	1.535807112	8.630267145	9.6763572	1.541017144	0.165567105	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.2184	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.6103	0.235066089	7.262772564	0	1.821857276	3.743306843	1.063369789	2.466381616	10.04216043	0.932628539	5.276080769	0	0.061554249	4.648182896	10.7712581	30.41184927	0.322575323	1.535807112	8.630267145	9.6763572	1.541017144	0.165567105	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.2184
H5422_805_0	2009	4																					none											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	V											0	0	0	0	0	0	0	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	282.2092126	3.069728075	37.99497194	38.84019464	7.886828033	16.20479153	4.60333242	10.67697669	43.47255599	4.037352982	22.84017649	0	0.266468611	20.12200388	46.62882296	131.6530271	1.39642997	6.648515636	37.36046383	41.88899221	6.671069886	0.716740712	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.076575541	0.076575541	0.191150886	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.076575541	0.076575541	0.191150886	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											21.6103	0.235066089	7.262772564	0	1.821857276	3.743306843	1.063369789	2.466381616	10.04216043	0.932628539	5.276080769	0	0.061554249	4.648182896	10.7712581	30.41184927	0.322575323	1.535807112	8.630267145	9.6763572	1.541017144	0.165567105	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.2184	0	0	21.6103	0.235066089	7.262772564	0	1.821857276	3.743306843	1.063369789	2.466381616	10.04216043	0.932628539	5.276080769	0	0.061554249	4.648182896	10.7712581	30.41184927	0.322575323	1.535807112	8.630267145	9.6763572	1.541017144	0.165567105	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.2184	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.6103	0.235066089	7.262772564	0	1.821857276	3.743306843	1.063369789	2.466381616	10.04216043	0.932628539	5.276080769	0	0.061554249	4.648182896	10.7712581	30.41184927	0.322575323	1.535807112	8.630267145	9.6763572	1.541017144	0.165567105	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.2184
H5424_001_0	2009	4																					2500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	3750	1259.204834	126.5702716	167.0443994	46.69478642	64.12744609	4.211165138	3.209114181	229.6469577	26.26107724	11625.74248	34.23454788	0	0.090876814	19.13391811	6293.41088	5197.767631	533.6569567	421.0719931	0	0	12.48824006	1150.429259	618.12	648.5075791	118.3912108	234.24	14.72807038	8.976	704.16	557.3333333											"$175 Days 1-5 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-23 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$5 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$20 (7b, 7d, 7f, 7f1); $10 (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 (10b)	"$0 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$10 (13b); $0 n/c (13d, 13e)"											107.0884146	79.30934475	110	0	150	0.2	0.064573342	49.97728053	0.2	2.8	0.185351062	0	0.2	0.199852092	3.679852179	18.65753219	37.5	20	0	0	0.2	19.85333809	0	0	20	0	20	0	0	10											82.42207313	61.02841143	84.64482059	0	115.4247553	0.153899674	0.049689082	38.45743585	0.153899674	2.154595433	0.14262734	0	0.153899674	0.154045457	3.679852179	18.65753219	37.5	15.38996738	0	0	0.153899674	19.85333809	0	0	20	0	20	0	0	10											8.6489	0.643698551	1.178286935	0	0.616824565	0.648096941	0.159457936	0.735969429	4.04157122	2.087397638	4.882782486	0	0.013985912	2.947493155	1.929901812	8.081459741	1.66767799	0.540023687	0	0	1.921936072	1.903321752	0	0	0.197318685	0	0.024546784	0	0	0.464444444	0	0	0	0	0	0	0	0	0	0	43.3351	0	8.6979	8.6489	0.643698551	1.178286935	0	0.616824565	0.648096941	0.159457936	0.735969429	4.04157122	2.087397638	4.882782486	0	0.013985912	2.947493155	1.929901812	8.081459741	1.66767799	0.540023687	0	0	1.921936072	1.903321752	0	0	0.197318685	0	0.024546784	0	0	0.464444444	0	0	0	0	0	0	0	0	0	0	43.3351		"$375 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$375 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$125 Days 1-30 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a3); 50% (6a2)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); 50% (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	50% (10b)	"50% (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"30% (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a7, 14a8, 14a9, 14a10); $0 (14a6)"	"50% (13b); $0 n/c (13d, 13e)"											1.7234	0.172	0.5081	0.0283	0.0964	0.1519	0.1158	0.115	0.9473	0.3262	1.122	0	0.0022	0.6908	2.107	3.4987	0.4725	0.2092	0	0	0.6382	0.8329	0.2273	0.439	0.0863	0.1281	0.0107	0	0	0.209											14.8581	0	3.261403485	10.3723	0.815714187	1.686384011	0.02826569	0.713205045	0.799997249	0.275213414	0.850966611	4.988830612	2.413559075	6.004799548	0	0.016171248	3.638243369	4.036914668	11.58018259	2.140186754	0.749216113	0	0	2.560089779	2.736175971	0.22725	0.439	0.283645609	0.1281	0.035286002	0	0	0.673444444	0	0	0	0	0	0	0	0	0	0	58.1931
H5424_003_0	2009	4																					2500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	3750	1259.204834	126.5702716	167.0443994	46.69478642	64.12744609	4.211165138	3.209114181	229.6469577	26.26107724	11625.74248	34.23454788	0	0.090876814	19.13391811	6293.41088	5197.767631	533.6569567	421.0719931	0	0	12.48824006	1150.429259	618.12	648.5075791	118.3912108	234.24	14.72807038	8.976	704.16	557.3333333											"$175 Days 1-5 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-5 (1b); $0 n/c (1b1, 1b2)"	"$25 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$10 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$5 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$10 (7b, 7b1, 7d, 7f, 7f1)"	"$40/$30 (7e, 7h)"	"$10 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $10 (16b, 17a, 18a)"	$0 (10b)	"$0 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$10 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$10 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$10 (13b); $0 n/c (13d, 13e)"											107.0884146	79.30934475	25	0	150	0.2	0.064573342	49.97728053	0.2	2.8	0.185351062	0	0.2	0.19923495	3.679852179	10	37.5	10	0	0	0.2	9.926669045	0	0	10	0	10	0	0	10											83.54198089	61.8584072	19.49909162	0	116.9945497	0.155992733	0.050364861	38.98046289	0.155992733	2.183898262	0.144567093	0	0.155992733	0.155643833	3.679852179	10	37.5	7.79963665	0	0	0.155992733	9.926669045	0	0	10	0	10	0	0	10											8.7664	0.65245295	0.271434504	0	0.625213474	0.656911159	0.161626589	0.745978726	4.09653721	2.115786566	4.949189078	0	0.014176123	2.978076358	1.929901812	4.331473026	1.66767799	0.273684046	0	0	1.948074698	0.951660876	0	0	0.098659342	0	0.012273392	0	0	0.464444444	0	0	0	0	0	0	0	0	0	0	37.7116	0	7.9628	8.7664	0.65245295	0.271434504	0	0.625213474	0.656911159	0.161626589	0.745978726	4.09653721	2.115786566	4.949189078	0	0.014176123	2.978076358	1.929901812	4.331473026	1.66767799	0.273684046	0	0	1.948074698	0.951660876	0	0	0.098659342	0	0.012273392	0	0	0.464444444	0	0	0	0	0	0	0	0	0	0	37.7116		"$375 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$375 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$125 Days 1-30 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a3); 50% (6a2)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); 50% (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	50% (10b)	"50% (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"30% (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a7, 14a8, 14a9, 14a10); $0 (14a6)"	"50% (13b); $0 n/c (13d, 13e)"											1.7234	0.172	0.5081	0.0283	0.0964	0.1519	0.1158	0.115	0.9473	0.3262	1.122	0	0.0022	0.6908	2.107	3.4987	0.4725	0.2092	0	0	0.6382	0.8329	0.2273	0.439	0.0863	0.1281	0.0107	0	0	0.209											14.8581	0	3.261403485	10.4898	0.824468586	0.77953158	0.02826569	0.721593954	0.808811467	0.277382067	0.860975908	5.043796601	2.441948004	6.07120614	0	0.016361459	3.668826572	4.036914668	7.830195872	2.140186754	0.482876472	0	0	2.586228405	1.784515095	0.22725	0.439	0.184986267	0.1281	0.02301261	0	0	0.673444444	0	0	0	0	0	0	0	0	0	0	52.5697
H5424_005_0	2009	3																					2400											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2305.263742	137.6568388	24.38131723	2077.436958	232.8008083	22.28042022	9.642671192	554.0545005	245.5886825	4835.230856	1005.043349	0	1.004764759	1700.916254	6849.910357	5012.679638	697.8072056	489.7585531	0	0	18.21018543	1164.969333	348.1804451	3510.266383	176.27235	171.0040126	27.23272692	9.867532219	20.2	0											"$200 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$200 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	16.4% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$100 (10a)	20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $35 (4b)	$35 (9b)	"$0 (8a1, 8a2)"	"$0 (8b1); $25 (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 5, 9a); $35/$25 (9c); $35 (9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $35 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$15 (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"$35/$25 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											197.8364328	200	0.1636	0	100	0.2	0.147357216	49.96679294	35	0	11.38821469	0	0.2	25.1474749	0	14.89091909	32.5	0	0	0	0.2	20.98522592	0	0	0	0	0	0	0	0											128.8534443	130.2626037	0.1636	0	65.13130186	0.130262604	0.095975673	32.54402274	22.79595565	0	7.417292489	0	0.130262604	16.37887779	0	9.698649459	21.1676731	0	0	0	0.130262604	13.66795084	0	0	0	0	0	0	0	0											24.7534	1.494294853	3.988783499	0	1.263551643	2.90230555	0.925461857	1.502596855	0.466535726	0	0.62122504	0	0.130883274	2.321591621	0	4.051351889	1.230912902	0	0	0	2.372106169	1.326895298	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3519	0	24.2856	24.7534	1.494294853	3.988783499	0	1.263551643	2.90230555	0.925461857	1.502596855	0.466535726	0	0.62122504	0	0.130883274	2.321591621	0	4.051351889	1.230912902	0	0	0	2.372106169	1.326895298	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3519		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $35 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $35 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.8298	0.2774	0.385	0.3858	0.182	0.3518	0.1523	0.1215	0.4064	0.2108	0.381	0	0.0106	0.3858	0.6772	1.6478	0.1962	0.0632	0	0	0.2875	0.1031	0.0261	0	0.0148	0	0.0017	0	0.003	0											10.1009	0	0	28.5833	1.771734853	4.373751666	0.385768585	1.445554776	3.254101659	1.07771456	1.62412904	0.872933501	0.210750532	1.002241377	0	0.141459745	2.707399484	0.677190978	5.699200378	1.427112902	0.063242369	0	0	2.659635412	1.430038722	0.0261	0	0.014776137	0	0.001736366	0	0.003	0	0	0	0	0	0	0	0	0	0	0	59.4528
H5424_801_0	2009	2																					4250											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1322.165075	132.8987852	175.3966194	31.53263877	67.3338184	4.421723394	3.36956989	241.1068662	27.5741311	12207.0296	35.94627528	0	0.095420655	20.09061401	6602.471392	4716.658594	560.3398046	442.1255928	0	0	13.11265207	1207.950722	0	0	0	0	0	0	0	0											"$425 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$425 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$130 Days 1-33 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$20 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											419.9550719	425	130	0	150	0.2	0.064573342	49.97727842	0.3	2.8	0.261697641	0	0.2	0.298576443	7.365957801	20	37.5	20	0	0	0.2	19.85333809	0	0	0	0	0	0	0	0											293.9744947	297.4826823	90.99470282	0	104.9938879	0.13999185	0.045198708	34.98205844	0.209987776	1.959885907	0.183177685	0	0.13999185	0.209329259	7.365957801	20	37.5	13.99918505	0	0	0.13999185	19.85333809	0	0	0	0	0	0	0	0											32.3902	3.294590592	1.330013605	0	0.589136615	0.61900524	0.152300207	0.702867874	5.790230457	1.993698774	6.584555486	0	0.013358114	4.205553339	4.052793805	7.861097657	1.751061889	0.515783166	0	0	1.835664427	1.99848784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.6804	0	25.7132	32.3902	3.294590592	1.330013605	0	0.589136615	0.61900524	0.152300207	0.702867874	5.790230457	1.993698774	6.584555486	0	0.013358114	4.205553339	4.052793805	7.861097657	1.751061889	0.515783166	0	0	1.835664427	1.99848784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.6804		"$350 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 40% (13c)"	"$350 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$130 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 40% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.4776	0.2464	0.8134	0.0303	0.1485	0.2341	0.1784	0.1772	1.9464	0.5026	2.2134	0	0.0034	1.4124	2.3716	3.4343	0.4961	0.3224	0	0	0.9834	0.8746	0	0	0	0	0	0	0	0											18.8667	0	0	34.8678	3.54102869	2.143404171	0.030340239	0.737667097	0.853096479	0.330689201	0.88007177	7.736639711	2.496341169	8.797980292	0	0.016725902	5.617958973	6.424414758	11.29538277	2.247196091	0.83816641	0	0	2.819113332	2.8730589	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.5471
H5424_803_0	2009	2																					4250											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1322.165075	132.8987852	175.3966194	31.53263877	67.3338184	4.421723394	3.36956989	241.1068662	27.5741311	12207.0296	35.94627528	0	0.095420655	20.09061401	6602.471392	4716.658594	560.3398046	442.1255928	0	0	13.11265207	1207.950722	0	0	0	0	0	0	0	0											"$425 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$425 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$130 Days 1-33 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$20 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											419.9550719	425	130	0	150	0.2	0.064573342	49.97727842	0.3	2.8	0.261697641	0	0.2	0.298576443	7.365957801	20	37.5	20	0	0	0.2	19.85333809	0	0	0	0	0	0	0	0											293.9744947	297.4826823	90.99470282	0	104.9938879	0.13999185	0.045198708	34.98205844	0.209987776	1.959885907	0.183177685	0	0.13999185	0.209329259	7.365957801	20	37.5	13.99918505	0	0	0.13999185	19.85333809	0	0	0	0	0	0	0	0											32.3902	3.294590592	1.330013605	0	0.589136615	0.61900524	0.152300207	0.702867874	5.790230457	1.993698774	6.584555486	0	0.013358114	4.205553339	4.052793805	7.861097657	1.751061889	0.515783166	0	0	1.835664427	1.99848784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.6804	0	25.7132	32.3902	3.294590592	1.330013605	0	0.589136615	0.61900524	0.152300207	0.702867874	5.790230457	1.993698774	6.584555486	0	0.013358114	4.205553339	4.052793805	7.861097657	1.751061889	0.515783166	0	0	1.835664427	1.99848784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.6804		"$350 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 40% (13c)"	"$350 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$130 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 40% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.4776	0.2464	0.8134	0.0303	0.1485	0.2341	0.1784	0.1772	1.9464	0.5026	2.2134	0	0.0034	1.4124	2.3716	3.4343	0.4961	0.3224	0	0	0.9834	0.8746	0	0	0	0	0	0	0	0											18.8667	0	0	34.8678	3.54102869	2.143404171	0.030340239	0.737667097	0.853096479	0.330689201	0.88007177	7.736639711	2.496341169	8.797980292	0	0.016725902	5.617958973	6.424414758	11.29538277	2.247196091	0.83816641	0	0	2.819113332	2.8730589	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.5471
H5425_001_0	2009	8																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	V	Coin	O	T	P	V	P	V	P	V	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	209.6											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% coinsurance	$10/visit	0	0	$10/visit	$25/service	$0-$10/visit	0	0	IHRB											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	15											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	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	0.262	0	0	0	0	0	0	0	0	0	0	29.2601			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	0.262	0	0	0	0	0	0	0	0	0	0	29.2601																																																																																		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	0.262	0	0	0	0	0	0	0	0	0	0	29.2601
H5425_003_0	2009	10																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	V	Coin	O	T	P	V	P	V	P	V	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	209.6											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	$5/visit	$10/visit	$10/visit	"$10 PT & OT, $20 CORF"	"20% rad therapy, 20% specialized"	"$10 hearing, podiatry, & chiro"	20% coinsurance	$10/visit	0	0	$10/visit	$25/service	$0-$10/visit	0	0	IHRB											100	100	20	0	100	0.05	0.045684211	41.741239	100	0	0.088	0	0	10	5	10	10	11	0.088	4.335471306	0.2	10	0	0	10	25	5	0	0	15											100	100	20	0	100	0.05	0.045684211	41.741239	100	0	0.088	0	0	10	5	10	10	11	0.088	4.335471306	0.2	10	0	0	10	25	5	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	1.634497126	2.957054489	0.149246438	1.407279754	3.327364948	3.773042407	1.192404442	0.556780108	0	0	0.24567149	0.4553394	0.072648668	0	0	0.262	0	0	0	0	0	0	0	0	0	0	28.6218			4.4763	0.079689829	0.72183849	0	1.609465699	0.687760611	0.392231413	1.051954929	1.589255842	0	1.835690394	0	0	0.144319566	1.634497126	2.957054489	0.149246438	1.407279754	3.327364948	3.773042407	1.192404442	0.556780108	0	0	0.24567149	0.4553394	0.072648668	0	0	0.262	0	0	0	0	0	0	0	0	0	0	28.6218																																																																																		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	1.634497126	2.957054489	0.149246438	1.407279754	3.327364948	3.773042407	1.192404442	0.556780108	0	0	0.24567149	0.4553394	0.072648668	0	0	0.262	0	0	0	0	0	0	0	0	0	0	28.6218
H5425_004_0	2009	11																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	V	Coin	O	T	P	V	P	V	P	V	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	209.6											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	IHRB											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	15											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	15											0	0	0	0	1.221093122	2.148150209	1.231543446	1.069242953	3.306585277	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	0.262	0	0	0	0	0	0	0	0	0	0	29.8788			0	0	0	0	1.221093122	2.148150209	1.231543446	1.069242953	3.306585277	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	0.262	0	0	0	0	0	0	0	0	0	0	29.8788																																																																																		0			0	0	0	0	1.221093122	2.148150209	1.231543446	1.069242953	3.306585277	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	0.262	0	0	0	0	0	0	0	0	0	0	29.8788
H5425_005_0	2009	11																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	V	Coin	O	T	P	V	P	V	P	V	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	209.6											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	IHRB											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	15											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	15											0	0	0	0	1.354099157	2.382134775	1.36568777	1.185708899	1.833375464	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	0.262	0	0	0	0	0	0	0	0	0	0	33.061			0	0	0	0	1.354099157	2.382134775	1.36568777	1.185708899	1.833375464	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	0.262	0	0	0	0	0	0	0	0	0	0	33.061																																																																																		0			0	0	0	0	1.354099157	2.382134775	1.36568777	1.185708899	1.833375464	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	0.262	0	0	0	0	0	0	0	0	0	0	33.061
H5425_006_0	2009	8																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	V	Coin	O	T	P	V	P	V	P	V	V																																																			0		699.3939676	12.5482961	354.208241	0	247.2857329	2.485971734	1.559902835	796.9276111	164.9969226	0	11.33319986	0	0	104.9765415	5816.608889	5271.473881	263.8490148	2265.430584	41.55048398	2315.561897	0.000155569	0	0	0	106.2791459	133.4903312	25.86218138	0	0	206											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, 0% specialized"	"$10 hearing, podiatry, & chiro"	20% coinsurance	0	0	0	$10/visit	$25/service	$0-$10/visit	0	0	IHRB											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	15											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	15											2.9141	0.052284567	0.590347068	0	1.030357221	0.124298587	0.071291509	2.822533277	0.687487178	0	0.509993994	0	0	0.087480451	2.423587037	4.392894901	0.219874179	2.076644702	3.65644259	1.929634914	3.11E-05	0	0	0	0.088565955	0.278104857	0.010775909	0	0	0.2575	0	0	0	0	0	0	0	0	0	0	24.2243			2.9141	0.052284567	0.590347068	0	1.030357221	0.124298587	0.071291509	2.822533277	0.687487178	0	0.509993994	0	0	0.087480451	2.423587037	4.392894901	0.219874179	2.076644702	3.65644259	1.929634914	3.11E-05	0	0	0	0.088565955	0.278104857	0.010775909	0	0	0.2575	0	0	0	0	0	0	0	0	0	0	24.2243																																																																																		0			2.9141	0.052284567	0.590347068	0	1.030357221	0.124298587	0.071291509	2.822533277	0.687487178	0	0.509993994	0	0	0.087480451	2.423587037	4.392894901	0.219874179	2.076644702	3.65644259	1.929634914	3.11E-05	0	0	0	0.088565955	0.278104857	0.010775909	0	0	0.2575	0	0	0	0	0	0	0	0	0	0	24.2243
H5425_007_0	2009	9																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	V	Coin	O	T	P	V	P	V	P	V	V																																																			0		566.0751182	9.969163643	243.7512327	0	196.5233032	1.803505358	1.130886557	554.9872335	144.2473894	0	0	0	0	0	3295.247329	2986.111829	156.3631516	1344.200806	25.39677077	2899.81307	9.16E-05	0	0	0	143.8020544	98.81986479	11.28941814	0	0	218.7585564											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, 10% specialized"	"$10 hearing, podiatry, & chiro"	20% coinsurance	0	0	0	$10/visit	$25/service	$0-$10/visit	0	0	IHRB											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	15											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	15											2.3586	0.041538182	0.406252054	0	0.818847097	0.090175268	0.051684379	1.965636418	0.601030789	0	0	0	0	0	1.37301972	2.488426524	0.130302626	1.232184072	2.234915828	2.416510892	1.83E-05	0	0	0	0.119835045	0.205874718	0.004703924	0	0	0.273448196	0	0	0	0	0	0	0	0	0	0	16.8131			2.3586	0.041538182	0.406252054	0	0.818847097	0.090175268	0.051684379	1.965636418	0.601030789	0	0	0	0	0	1.37301972	2.488426524	0.130302626	1.232184072	2.234915828	2.416510892	1.83E-05	0	0	0	0.119835045	0.205874718	0.004703924	0	0	0.273448196	0	0	0	0	0	0	0	0	0	0	16.8131																																																																																		0			2.3586	0.041538182	0.406252054	0	0.818847097	0.090175268	0.051684379	1.965636418	0.601030789	0	0	0	0	0	1.37301972	2.488426524	0.130302626	1.232184072	2.234915828	2.416510892	1.83E-05	0	0	0	0.119835045	0.205874718	0.004703924	0	0	0.273448196	0	0	0	0	0	0	0	0	0	0	16.8131
H5425_008_0	2009	8																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	V	Coin	O	T	P	V	P	V	P	V	V																																																			0		568.1800548	11.41223152	270.3699994	0	176.5595466	2.858366744	1.787941544	841.0339964	163.5442583	0	0	0	0	0	3980.141966	3603.199012	191.4529985	1555.265405	27.91651377	8651.509991	0.049360211	0	0	0	158.1706392	113.4060274	3.660881475	0	0	353.4218197											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, 10% specialized"	"$10 hearing, podiatry, & chiro, 10% lab"	20% coinsurance	0	0	0	$10/visit	$25/service	$0-$10/visit	0	0	IHRB											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	15											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	15											2.3674	0.047550965	0.450616666	0	1.103497166	0.142918337	0.081695475	3.030655282	0.68143441	0	0	0	0	0	3.316784972	3.002665844	0.159544165	1.425659955	2.456653212	2.26175501	0.009872042	0	0	0	0.131808866	0.236262557	0.001525367	0	0	0.441777275	0	0	0	0	0	0	0	0	0	0	21.3501			2.3674	0.047550965	0.450616666	0	1.103497166	0.142918337	0.081695475	3.030655282	0.68143441	0	0	0	0	0	3.316784972	3.002665844	0.159544165	1.425659955	2.456653212	2.26175501	0.009872042	0	0	0	0.131808866	0.236262557	0.001525367	0	0	0.441777275	0	0	0	0	0	0	0	0	0	0	21.3501																																																																																		0			2.3674	0.047550965	0.450616666	0	1.103497166	0.142918337	0.081695475	3.030655282	0.68143441	0	0	0	0	0	3.316784972	3.002665844	0.159544165	1.425659955	2.456653212	2.26175501	0.009872042	0	0	0	0.131808866	0.236262557	0.001525367	0	0	0.441777275	0	0	0	0	0	0	0	0	0	0	21.3501
H5425_009_0	2009	9																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	V	Coin	O	T	P	V	P	V	P	V	V																																																			0		709.5141267	12.465744	294.7643074	0	222.6724815	3.749115215	2.345115042	1567.991367	130.4025188	0	0	0	0	0	3587.654931	3247.882818	180.7146458	1468.032567	25.16362962	8166.257912	0.011832773	0	0	0	148.6325552	106.5673611	10.02918641	0	0	454.1658911											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, 10% specialized"	"$10 hearing, podiatry, & chiro, 10% lab"	20% coinsurance	0	0	0	$10/visit	$25/service	$0-$10/visit	0	0	IHRB											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	15											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	15											2.9563	0.0519406	0.491273846	0	1.39170301	0.187455761	0.107154112	5.650236899	0.543343828	0	0	0	0	0	2.989712443	2.706569015	0.150595538	1.34569652	2.214399407	2.134896077	0.002366555	0	0	0	0.123860463	0.222015336	0.004178828	0	0	0.567707364	0	0	0	0	0	0	0	0	0	0	23.8414			2.9563	0.0519406	0.491273846	0	1.39170301	0.187455761	0.107154112	5.650236899	0.543343828	0	0	0	0	0	2.989712443	2.706569015	0.150595538	1.34569652	2.214399407	2.134896077	0.002366555	0	0	0	0.123860463	0.222015336	0.004178828	0	0	0.567707364	0	0	0	0	0	0	0	0	0	0	23.8414																																																																																		0			2.9563	0.0519406	0.491273846	0	1.39170301	0.187455761	0.107154112	5.650236899	0.543343828	0	0	0	0	0	2.989712443	2.706569015	0.150595538	1.34569652	2.214399407	2.134896077	0.002366555	0	0	0	0.123860463	0.222015336	0.004178828	0	0	0.567707364	0	0	0	0	0	0	0	0	0	0	23.8414
H5425_010_0	2009	9																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	V	Coin	O	T	P	V	P	V	P	V	V																																																			0		816.0147219	14.64066725	483.8978293	0	328.5249198	3.344246959	2.098455201	1272.036133	208.8038575	0	15.35250243	0	0	142.2063166	8947.099795	8108.573875	405.8521917	3484.682209	63.91289732	3561.794126	0.000299218	0	0	0	164.0389662	206.0386895	555.5728101	0	0	218.7585564											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, 0% specialized"	"$10 hearing, podiatry, & chiro"	20% coinsurance	0	0	0	$10/visit	$25/service	$0-$10/visit	0	0	IHRB											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	15											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	15											3.4001	0.06100278	0.806496382	0	1.368853833	0.167212348	0.095904715	4.505257774	0.870016073	0	0.690862609	0	0	0.118505264	3.727958248	6.757144896	0.33821016	3.194292025	5.624334964	2.968161772	5.98E-05	0	0	0	0.136699138	0.42924727	0.231488671	0	0	0.273448196	0	0	0	0	0	0	0	0	0	0	35.7652			3.4001	0.06100278	0.806496382	0	1.368853833	0.167212348	0.095904715	4.505257774	0.870016073	0	0.690862609	0	0	0.118505264	3.727958248	6.757144896	0.33821016	3.194292025	5.624334964	2.968161772	5.98E-05	0	0	0	0.136699138	0.42924727	0.231488671	0	0	0.273448196	0	0	0	0	0	0	0	0	0	0	35.7652																																																																																		0			3.4001	0.06100278	0.806496382	0	1.368853833	0.167212348	0.095904715	4.505257774	0.870016073	0	0.690862609	0	0	0.118505264	3.727958248	6.757144896	0.33821016	3.194292025	5.624334964	2.968161772	5.98E-05	0	0	0	0.136699138	0.42924727	0.231488671	0	0	0.273448196	0	0	0	0	0	0	0	0	0	0	35.7652
H5425_011_0	2009	9																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	V	Coin	O	T	P	V	P	V	P	V	V																																																			0		790.8220372	15.88412705	512.9967529	0	267.6473941	5.582720915	3.492056671	1653.87292	301.5908923	0	0	0	0	0	6296.944757	5700.586894	302.8959684	2460.570608	44.16645097	13687.47169	0	0	0	0	251.452998	180.2881099	236.066074	0	0	353.4218197											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, 10% specialized"	"$10 hearing, podiatry, & chiro, 10% lab"	20% coinsurance	0	0	0	$10/visit	$25/service	$0-$10/visit	0	0	IHRB											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	15											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	15											3.2951	0.066183863	0.854994588	0	1.672796213	0.279136046	0.159560714	5.95970998	1.256628718	0	0	0	0	0	5.247453964	4.750489079	0.252413307	2.255523058	3.886647686	3.578301094	0	0	0	0	0.209544165	0.375600229	0.098360864	0	0	0.441777275	0	0	0	0	0	0	0	0	0	0	34.6402			3.2951	0.066183863	0.854994588	0	1.672796213	0.279136046	0.159560714	5.95970998	1.256628718	0	0	0	0	0	5.247453964	4.750489079	0.252413307	2.255523058	3.886647686	3.578301094	0	0	0	0	0.209544165	0.375600229	0.098360864	0	0	0.441777275	0	0	0	0	0	0	0	0	0	0	34.6402																																																																																		0			3.2951	0.066183863	0.854994588	0	1.672796213	0.279136046	0.159560714	5.95970998	1.256628718	0	0	0	0	0	5.247453964	4.750489079	0.252413307	2.255523058	3.886647686	3.578301094	0	0	0	0	0.209544165	0.375600229	0.098360864	0	0	0.441777275	0	0	0	0	0	0	0	0	0	0	34.6402
H5425_012_0	2009	9																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	V	Coin	O	T	P	V	P	V	P	V	V																																																			0		955.55933	16.78861285	278.3868078	0	393.5614983	4.979535808	3.114757392	3394.027836	158.1520163	0	0	0	0	0	5495.177	4974.75128	276.7989075	2248.571547	38.54289261	12508.17972	0	0	0	0	228.4207463	163.7743234	125.1010787	0	0	454.1658911											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, 10% specialized"	"$10 hearing, podiatry, & chiro, 10% lab"	20% coinsurance	0	0	0	$10/visit	$25/service	$0-$10/visit	0	0	IHRB											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	15											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	15											3.9815	0.069952554	0.463978013	0	2.459759364	0.24897679	0.142320976	12.23033603	0.658966734	0	0	0	0	0	4.579314167	4.145626066	0.230665756	2.061190584	3.39177455	3.270000055	0	0	0	0	0.190350622	0.341196507	0.052125449	0	0	0.567707364	0	0	0	0	0	0	0	0	0	0	39.0857			3.9815	0.069952554	0.463978013	0	2.459759364	0.24897679	0.142320976	12.23033603	0.658966734	0	0	0	0	0	4.579314167	4.145626066	0.230665756	2.061190584	3.39177455	3.270000055	0	0	0	0	0.190350622	0.341196507	0.052125449	0	0	0.567707364	0	0	0	0	0	0	0	0	0	0	39.0857																																																																																		0			3.9815	0.069952554	0.463978013	0	2.459759364	0.24897679	0.142320976	12.23033603	0.658966734	0	0	0	0	0	4.579314167	4.145626066	0.230665756	2.061190584	3.39177455	3.270000055	0	0	0	0	0.190350622	0.341196507	0.052125449	0	0	0.567707364	0	0	0	0	0	0	0	0	0	0	39.0857
H5425_013_0	2009	10																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	V	Coin	O	T	P	V	P	V	P	V	V																																																			0		699.3939676	12.5482961	354.208241	0	247.2857329	2.485971734	1.559902835	796.9276111	164.9969226	0	11.33319986	0	0	104.9765415	5816.608889	5271.473881	263.8490148	2265.430584	41.55048398	2315.561897	0.000155569	0	0	0	106.2791459	133.4903312	25.86218138	0	0	1674.8											0	copay/days 1-8	copay/days 21-100	0	$100/run	20% DME	20% DME	"$50 ER, $25 urgent care"	$50/OP hospital and ASC visits	0	20% Radiation Therapy	0	0	$10/visit cardiac rehab	0	0	$20/visit	"$10 PT & OT, $20 CORF"	20% Radiation Therapy	$10/visit	20% coinsurance	0	0	0	$10/visit	$25/service	0	0	0	$15/visit IHRB; $10/visit Chiro&Acupuncture											0	50	50	0	100	0.2	0.2	42.50122452	50	0	0.1	0	0	10	0	0	20	11	0.088	10	0.2	0	0	0	10	25	0	0	0	10.61499881											0	50	50	0	100	0.2	0.2	42.50122452	50	0	0.1	0	0	10	0	0	20	11	0.088	10	0.2	0	0	0	10	25	0	0	0	10.61499881											0	0.052284567	1.475867671	0	2.060714441	0.497194347	0.311980567	2.822533277	0.687487178	0	1.133319986	0	0	0.087480451	0	0	0.439748358	2.076644702	3.65644259	1.929634914	3.11E-05	0	0	0	0.088565955	0.278104857	0	0	0	1.4815	0	0	0	0	0	0	0	0	0	0	19.0795			0	0.052284567	1.475867671	0	2.060714441	0.497194347	0.311980567	2.822533277	0.687487178	0	1.133319986	0	0	0.087480451	0	0	0.439748358	2.076644702	3.65644259	1.929634914	3.11E-05	0	0	0	0.088565955	0.278104857	0	0	0	1.4815	0	0	0	0	0	0	0	0	0	0	19.0795																																																																																		0			0	0.052284567	1.475867671	0	2.060714441	0.497194347	0.311980567	2.822533277	0.687487178	0	1.133319986	0	0	0.087480451	0	0	0.439748358	2.076644702	3.65644259	1.929634914	3.11E-05	0	0	0	0.088565955	0.278104857	0	0	0	1.4815	0	0	0	0	0	0	0	0	0	0	19.0795
H5425_014_0	2009	10																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	V	Coin	O	T	P	V	P	V	P	V	V																																																			0		566.0751182	9.969163643	243.7512327	0	196.5233032	1.803505358	1.130886557	554.9872335	144.2473894	0	0	0	0	0	3295.247329	2986.111829	156.3631516	1344.200806	25.39677077	2899.81307	9.16E-05	0	0	0	143.8020544	98.81986479	11.28941814	0	0	1687.558556											0	copay/days 1-10	copay/days 21-100	0	$100/run	20% DME	20% DME	"$50 ER, $25 urgent care"	$50/OP hospital and ASC visits	0	"20% Radiation Therapy, 10% Spec Rad"	0	0	$10/visit cardiac rehab	0	0	$20/visit	"$10 PT & OT, $20 CORF"	"20% Radiation Therapy, 10% Spec Rad"	$10/visit	20% coinsurance	0	0	0	$10/visit	$25/service	0	0	0	$15/visit IHRB; $10/visit Chiro&Acupuncture											0	50	50	0	100	0.2	0.2	42.50122452	50	0	0.1	0	0	10	0	0	20	11	0.088	10	0.2	0	0	0	10	25	0	0	0	10.64815101											0	50	50	0	100	0.2	0.2	42.50122452	50	0	0.1	0	0	10	0	0	20	11	0.088	10	0.2	0	0	0	10	25	0	0	0	10.64815101											0	0.041538182	1.015630136	0	1.637694193	0.360701072	0.226177311	1.965636418	0.601030789	0	0	0	0	0	0	0	0.260605253	1.232184072	2.234915828	2.416510892	1.83E-05	0	0	0	0.119835045	0.205874718	0	0	0	1.497448196	0	0	0	0	0	0	0	0	0	0	13.8158			0	0.041538182	1.015630136	0	1.637694193	0.360701072	0.226177311	1.965636418	0.601030789	0	0	0	0	0	0	0	0.260605253	1.232184072	2.234915828	2.416510892	1.83E-05	0	0	0	0.119835045	0.205874718	0	0	0	1.497448196	0	0	0	0	0	0	0	0	0	0	13.8158																																																																																		0			0	0.041538182	1.015630136	0	1.637694193	0.360701072	0.226177311	1.965636418	0.601030789	0	0	0	0	0	0	0	0.260605253	1.232184072	2.234915828	2.416510892	1.83E-05	0	0	0	0.119835045	0.205874718	0	0	0	1.497448196	0	0	0	0	0	0	0	0	0	0	13.8158
H5425_015_0	2009	11																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	V	Coin	O	T	P	V	P	V	P	V	V																																																			0		568.1800548	11.41223152	270.3699994	0	176.5595466	2.858366744	1.787941544	841.0339964	163.5442583	0	0	0	0	0	3980.141966	3603.199012	191.4529985	1555.265405	27.91651377	8651.509991	0.049360211	0	0	0	158.1706392	113.4060274	3.660881475	0	0	1822.22182											0	copay/days 1-10	copay/days 21-100	0	$100/run	20% DME	20% DME	"$50 ER, $25 urgent care"	$50/OP hospital and ASC visits	0	"20% Radiation Therapy, 10% Spec Rad"	0	0	$10/visit cardiac rehab	0	0	$20/visit	"$10 PT & OT, $20 CORF"	"20% Radiation Therapy, 10% Spec Rad"	$10/visit	20% coinsurance	0	0	0	$10/visit	$25/service	0	0	0	$15/visit IHRB; $10/visit Chiro&Acupuncture											0	50	50	0	100	0.2	0.2	42.50122452	50	0	0.075	0	0	10	0	0	20	11	0.088	10	0.2	0	0	0	10	25	0	0	0	10.96975521											0	50	50	0	100	0.2	0.2	42.50122452	50	0	0.075	0	0	10	0	0	20	11	0.088	10	0.2	0	0	0	10	25	0	0	0	10.96975521											0	0.047550965	1.126541664	0	1.471329555	0.571673349	0.357588309	2.978747893	0.68143441	0	0	0	0	0	0	0	0.319088331	1.425659955	2.456653212	7.209591659	0.009872042	0	0	0	0.131808866	0.236262557	0	0	0	1.665777275	0	0	0	0	0	0	0	0	0	0	20.6896			0	0.047550965	1.126541664	0	1.471329555	0.571673349	0.357588309	2.978747893	0.68143441	0	0	0	0	0	0	0	0.319088331	1.425659955	2.456653212	7.209591659	0.009872042	0	0	0	0.131808866	0.236262557	0	0	0	1.665777275	0	0	0	0	0	0	0	0	0	0	20.6896																																																																																		0			0	0.047550965	1.126541664	0	1.471329555	0.571673349	0.357588309	2.978747893	0.68143441	0	0	0	0	0	0	0	0.319088331	1.425659955	2.456653212	7.209591659	0.009872042	0	0	0	0.131808866	0.236262557	0	0	0	1.665777275	0	0	0	0	0	0	0	0	0	0	20.6896
H5425_016_0	2009	11																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	V	Coin	O	T	P	V	P	V	P	V	V																																																			0		709.5141267	12.465744	294.7643074	0	222.6724815	3.749115215	2.345115042	1567.991367	130.4025188	0	0	0	0	0	3587.654931	3247.882818	180.7146458	1468.032567	25.16362962	8166.257912	0.011832773	0	0	0	148.6325552	106.5673611	10.02918641	0	0	1922.965891											0	copay/days 1-10	copay/days 21-100	0	$100/run	20% DME	20% DME	"$50 ER, $25 urgent care"	$50/OP hospital and ASC visits	0	"20% Radiation Therapy, 10% Spec Rad"	0	0	$10/visit cardiac rehab	0	0	$20/visit	"$10 PT & OT, $20 CORF"	"20% Radiation Therapy, 10% Spec Rad"	$10/visit	20% coinsurance	0	0	0	$10/visit	$25/service	0	0	0	$15/visit IHRB; $10/visit Chiro&Acupuncture											0	50	50	0	100	0.2	0.2	42.50122452	50	0	0.045	0	0	10	0	0	20	11	0.088	10	0.2	0	0	0	10	25	0	0	0	11.1808995											0	50	50	0	100	0.2	0.2	42.50122452	50	0	0.045	0	0	10	0	0	20	11	0.088	10	0.2	0	0	0	10	25	0	0	0	11.1808995											0	0.0519406	1.228184614	0	1.855604013	0.749823043	0.469023008	5.553462763	0.543343828	0	0	0	0	0	0	0	0.301191076	1.34569652	2.214399407	6.805214926	0.002366555	0	0	0	0.123860463	0.222015336	0	0	0	1.791707364	0	0	0	0	0	0	0	0	0	0	23.2578			0	0.0519406	1.228184614	0	1.855604013	0.749823043	0.469023008	5.553462763	0.543343828	0	0	0	0	0	0	0	0.301191076	1.34569652	2.214399407	6.805214926	0.002366555	0	0	0	0.123860463	0.222015336	0	0	0	1.791707364	0	0	0	0	0	0	0	0	0	0	23.2578																																																																																		0			0	0.0519406	1.228184614	0	1.855604013	0.749823043	0.469023008	5.553462763	0.543343828	0	0	0	0	0	0	0	0.301191076	1.34569652	2.214399407	6.805214926	0.002366555	0	0	0	0.123860463	0.222015336	0	0	0	1.791707364	0	0	0	0	0	0	0	0	0	0	23.2578
H5425_801_0	2009	4																																D	D	D	V	T	P	P	V	V	P	P	V	V	V	V	V	V	V	P	V	Coin	O	T	P	V	P	V	P	V	V																																																			0		251.6797233	3.265448277	447.4920287	0	0	0	0	1148.153817	205.560824	1068.484077	538.011619	0	0	279.6	12132.2841	10992.77853	553.1346954	4749.153016	11263.64357	19587.53835	0.124476517	800.6220047	0	90	177.5802267	122.6904854	564.9743662	0	0	206											copay/admit	copay/admit	copay/days 21-100	0	0	0	0	"$50 ER, $25 urgent care"	$15/OP hospital and ASC visits	$0 copay	$0 copay	0	0	0	$15/visit	$30/visit	$15/visit	$15/visit	0	"$15 hearing, pod, chiro"	20% coinsurance	0	0	$8/visit	$15/visit	$20/service	$0-$15/visit	0	0	IHRB											100	100	50	0	0	0	0	39.27857074	15	0	0	0	0	15	15	30	15	15	0	14.3838103	0.2	0	0	8	15	20	7.5	0	0	15											100	100	50	0	0	0	0	39.27857074	15	0	0	0	0	15	15	30	15	15	0	14.3838103	0.2	0	0	8	15	20	7.5	0	0	15											2.0973	0.027212069	1.864550119	0	0	0	0	3.758153411	0.25695103	0	0	0	0	0.3495	15.16535512	27.48194634	0.691418369	5.93644127	0	23.47861965	0.024895303	0	0	0.06	0.221975283	0.204484142	0.353108979	0	0	0.2575	0	0	0	0	0	0	0	0	0	0	82.2294			2.0973	0.027212069	1.864550119	0	0	0	0	3.758153411	0.25695103	0	0	0	0	0.3495	15.16535512	27.48194634	0.691418369	5.93644127	0	23.47861965	0.024895303	0	0	0.06	0.221975283	0.204484142	0.353108979	0	0	0.2575	0	0	0	0	0	0	0	0	0	0	82.2294																																																																																		0			2.0973	0.027212069	1.864550119	0	0	0	0	3.758153411	0.25695103	0	0	0	0	0.3495	15.16535512	27.48194634	0.691418369	5.93644127	0	23.47861965	0.024895303	0	0	0.06	0.221975283	0.204484142	0.353108979	0	0	0.2575	0	0	0	0	0	0	0	0	0	0	82.2294
H5425_802_0	2009	4																																D	D	D	V	T	P	P	V	V	P	P	V	V	V	V	V	V	V	P	V	Coin	O	T	P	V	P	V	P	V	V																																																			0		251.6797233	3.265448277	447.4920287	0	0	0	0	1148.153817	205.560824	1068.484077	538.011619	0	0	279.6	12132.2841	10992.77853	553.1346954	4749.153016	11263.64357	19587.53835	0.124476517	800.6220047	0	90	177.5802267	122.6904854	564.9743662	0	0	206											copay/admit	copay/admit	copay/days 21-100	0	0	0	0	"$50 ER, $25 urgent care"	$15/OP hospital and ASC visits	$0 copay	$0 copay	0	0	0	$15/visit	$30/visit	$15/visit	$15/visit	0	"$15 hearing, pod, chiro"	20% coinsurance	0	0	$8/visit	$15/visit	$20/service	$0-$15/visit	0	0	IHRB											100	100	50	0	0	0	0	39.27857074	15	0	0	0	0	15	15	30	15	15	0	14.3838103	0.2	0	0	8	15	20	7.5	0	0	15											100	100	50	0	0	0	0	39.27857074	15	0	0	0	0	15	15	30	15	15	0	14.3838103	0.2	0	0	8	15	20	7.5	0	0	15											2.0973	0.027212069	1.864550119	0	0	0	0	3.758153411	0.25695103	0	0	0	0	0.3495	15.16535512	27.48194634	0.691418369	5.93644127	0	23.47861965	0.024895303	0	0	0.06	0.221975283	0.204484142	0.353108979	0	0	0.2575	0	0	0	0	0	0	0	0	0	0	82.2294			2.0973	0.027212069	1.864550119	0	0	0	0	3.758153411	0.25695103	0	0	0	0	0.3495	15.16535512	27.48194634	0.691418369	5.93644127	0	23.47861965	0.024895303	0	0	0.06	0.221975283	0.204484142	0.353108979	0	0	0.2575	0	0	0	0	0	0	0	0	0	0	82.2294																																																																																		0			2.0973	0.027212069	1.864550119	0	0	0	0	3.758153411	0.25695103	0	0	0	0	0.3495	15.16535512	27.48194634	0.691418369	5.93644127	0	23.47861965	0.024895303	0	0	0.06	0.221975283	0.204484142	0.353108979	0	0	0.2575	0	0	0	0	0	0	0	0	0	0	82.2294
H5425_803_0	2009	4																																D	D	D	V	T	P	P	V	V	P	P	V	V	V	V	V	V	V	P	V	Coin	O	T	P	V	P	V	P	V	V																																																			0		251.6797233	3.265448277	447.4920287	0	0	0	0	1148.153817	205.560824	1068.484077	538.011619	0	0	279.6	12132.2841	10992.77853	553.1346954	4749.153016	11263.64357	19587.53835	0.124476517	800.6220047	0	90	177.5802267	122.6904854	564.9743662	0	0	206											copay/admit	copay/admit	copay/days 21-100	0	0	0	0	"$50 ER, $25 urgent care"	$15/OP hospital and ASC visits	$0 copay	$0 copay	0	0	0	$15/visit	$30/visit	$15/visit	$15/visit	0	"$15 hearing, pod, chiro"	20% coinsurance	0	0	$8/visit	$15/visit	$20/service	$0-$15/visit	0	0	IHRB											100	100	50	0	0	0	0	39.27857074	15	0	0	0	0	15	15	30	15	15	0	14.3838103	0.2	0	0	8	15	20	7.5	0	0	15											100	100	50	0	0	0	0	39.27857074	15	0	0	0	0	15	15	30	15	15	0	14.3838103	0.2	0	0	8	15	20	7.5	0	0	15											2.0973	0.027212069	1.864550119	0	0	0	0	3.758153411	0.25695103	0	0	0	0	0.3495	15.16535512	27.48194634	0.691418369	5.93644127	0	23.47861965	0.024895303	0	0	0.06	0.221975283	0.204484142	0.353108979	0	0	0.2575	0	0	0	0	0	0	0	0	0	0	82.2294			2.0973	0.027212069	1.864550119	0	0	0	0	3.758153411	0.25695103	0	0	0	0	0.3495	15.16535512	27.48194634	0.691418369	5.93644127	0	23.47861965	0.024895303	0	0	0.06	0.221975283	0.204484142	0.353108979	0	0	0.2575	0	0	0	0	0	0	0	0	0	0	82.2294																																																																																		0			2.0973	0.027212069	1.864550119	0	0	0	0	3.758153411	0.25695103	0	0	0	0	0.3495	15.16535512	27.48194634	0.691418369	5.93644127	0	23.47861965	0.024895303	0	0	0.06	0.221975283	0.204484142	0.353108979	0	0	0.2575	0	0	0	0	0	0	0	0	0	0	82.2294
H5425_804_0	2009	4																																D	D	D	V	T	P	P	V	V	P	P	V	V	V	V	V	V	V	P	V	Coin	O	T	P	V	P	V	P	V	V																																																			0		251.6797233	3.265448277	447.4920287	0	0	0	0	1148.153817	205.560824	1068.484077	538.011619	0	0	279.6	12132.2841	10992.77853	553.1346954	4749.153016	11263.64357	19587.53835	0.124476517	800.6220047	0	90	177.5802267	122.6904854	564.9743662	0	0	206											copay/admit	copay/admit	copay/days 21-100	0	0	0	0	"$50 ER, $25 urgent care"	$15/OP hospital and ASC visits	$0 copay	$0 copay	0	0	0	$15/visit	$30/visit	$15/visit	$15/visit	0	"$15 hearing, pod, chiro"	20% coinsurance	0	0	$8/visit	$15/visit	$20/service	$0-$15/visit	0	0	IHRB											100	100	50	0	0	0	0	39.27857074	15	0	0	0	0	15	15	30	15	15	0	14.3838103	0.2	0	0	8	15	20	7.5	0	0	15											100	100	50	0	0	0	0	39.27857074	15	0	0	0	0	15	15	30	15	15	0	14.3838103	0.2	0	0	8	15	20	7.5	0	0	15											2.0973	0.027212069	1.864550119	0	0	0	0	3.758153411	0.25695103	0	0	0	0	0.3495	15.16535512	27.48194634	0.691418369	5.93644127	0	23.47861965	0.024895303	0	0	0.06	0.221975283	0.204484142	0.353108979	0	0	0.2575	0	0	0	0	0	0	0	0	0	0	82.2294			2.0973	0.027212069	1.864550119	0	0	0	0	3.758153411	0.25695103	0	0	0	0	0.3495	15.16535512	27.48194634	0.691418369	5.93644127	0	23.47861965	0.024895303	0	0	0.06	0.221975283	0.204484142	0.353108979	0	0	0.2575	0	0	0	0	0	0	0	0	0	0	82.2294																																																																																		0			2.0973	0.027212069	1.864550119	0	0	0	0	3.758153411	0.25695103	0	0	0	0	0.3495	15.16535512	27.48194634	0.691418369	5.93644127	0	23.47861965	0.024895303	0	0	0.06	0.221975283	0.204484142	0.353108979	0	0	0.2575	0	0	0	0	0	0	0	0	0	0	82.2294
H5426_001_0	2009	8																					3000											D	A	D	V	T	Coin	Coin	V	V	P	P	V	P	V	V	V	V	V	V	V	S	P	T	V	P	O	P	O	O	O																																																			0		889.5352984	0.906455807	648.4107064		336.2564169	4.146577586	3.709814043	274.8623241	304.0835679	126.0166137	267.2526252	21.00276895		218.8549403	15.45296034	12039.02621	61.52114566	2822.946794	3297.982593		1840.714856	0.883150641			724.292722																"$75/day 1-4, $100/day 5-7, $0 additional days"	$400/admit	"$0/day 1-5, $50/day 6-20, $75/day 21-100"	$0/visit	$100/trip	20% Coinsurance	20% Coinsurance	$50/visit	$150/visit	$25/proc	"MRI, MRA, CT, PET $150/proc, Diag Radiology $100/proc"	$25/visit	No Cost Sharing	$25/visit	$0/visit	$15/visit	$20/visit	$10/visit	$15/visit	Chiro & Podiatry $10/visit	20% Coinsurance	$10 Copay routine hearing exam	No Cost Sharing	No Cost Sharing	$10/proc	"$0 Copay, $85 limit every year"	$10/proc	"$0 Copay, $700 limit every 3 years"	No Cost Sharing												43.21487376	266.6666667	50.5845155		100	0.2	0.2	50	116.8168168	25	117.4829157	25		25	12.6	9.279874422	15.12559064	10.01313773	18.14883477		27.61959697	6.553385778			15																38.7666461	239.2179218	45.37771003		89.70672068	0.179413441	0.179413441	44.85336034	104.7925356	22.42668017	105.3900711	22.42668017		22.42668017	11.30304681	8.336960644	13.56867135	8.982457493	16.28072452		24.77663471	5.878827475			13.4560081																2.8737	0.01807004	2.451949418	0	2.513705039	0.743951755	0.665590504	1.027374906	2.655474009	0.235511191	2.347147764	0.039251865	0	0.409015812	0.014555461	8.364073978	0.069563351	2.113083299	4.474462172	0	3.800559967	0.000432658	0	0	0.812174061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.6296	0	4.0745	2.8737	0.01807004	2.451949418	0	2.513705039	0.743951755	0.665590504	1.027374906	2.655474009	0.235511191	2.347147764	0.039251865	0	0.409015812	0.014555461	8.364073978	0.069563351	2.113083299	4.474462172	0	3.800559967	0.000432658	0	0	0.812174061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.6296		20% Coinsurance	Not Covered	20% Coinsurance	Not Covered	$100/trip	Not Covered	Not Covered	$50/visit	20% Coinsurance	Not Covered	Not Covered	20% Coinsurance	No Cost Sharing	Not Covered	20% Coinsurance	20% Coinsurance	Not Covered	Not Covered	Not Covered	20% Coinsurance	20% Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered												0.4794							0.101	0.127			0.0204			0.0564	0.255				0.4891	0.0209																				1.5492	0	0	3.3531	0.01807004	2.451949418	0	2.513705039	0.743951755	0.665590504	1.128330244	2.782470147	0.235511191	2.347147764	0.059661342	0	0.409015812	0.070973423	8.619045856	0.069563351	2.113083299	4.474462172	0.489075709	3.821471937	0.000432658	0	0	0.812174061	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.1788
H5426_002_0	2009	8																					3000											D	A	D	V	T	Coin	Coin	V	V	P	P	V	P	V	V	V	V	V	V	V	S	P	T	V	P	O	P	O	O	O																																																			0		867.4703759	9.461694537	677.3869105		215.4597277	5.214030981	2.571340715	149.8998256	273.1167629	440.3932886	142.5352891	22.95779667		236.669547	29.60555552	4249.897819	286.2417437	1264.590621	3198.7764		1627.345848	5.529562365			2119.412205		31.14190481														"$175/day 1-7, $0/day 8-90, $0 additional days"	$400/admit	"$0/day 1-5, $50/day 6-20, $75/day 21-100"	$0/visit	$100/trip	20% Coinsurance	20% Coinsurance	$50/visit	$150/visit	$25/proc	"MRI, MRA, CT, PET $150/proc, Diag Radiology $100/proc"	$25/visit	No Cost Sharing	$25/visit	$0/visit	$20/visit	$20/visit	$10/visit	$15/visit	Chiro & Podiatry $10/visit	20% Coinsurance	$10 Copay routine hearing exam	No Cost Sharing	No Cost Sharing	$10/proc	"$0 Copay, $85 limit every year"	$10/proc	"$0 Copay, $700 limit every 3 years"	No Cost Sharing												91.74709313	400	50.5845155		100	0.2	0.2	48.73573637	116.6476023	25	118.3716572	25		24.77478263	10.05321615	19.40366162	19.27452576	12.01623321	26.83308903		48.80242111	22.62777703			19.8782469		10														80.13063492	349.3544359	44.1798122		87.33860898	0.174677218	0.174677218	42.56511422	101.8783933	21.83465225	103.3841588	21.83465225		21.63795052	8.783037957	16.94718201	16.83410268	11.08112732	23.43564671		42.62335575	19.7627857			17.36138433		8.733860898														5.7926	0.27545708	2.493902208	0	1.568162742	0.910772426	0.449154642	0.5317086	2.318724748	0.801319526	1.227990913	0.041772959	0	0.426753662	0.021668893	6.001982657	0.401551909	1.167757473	6.247116134	0	5.780245083	0.00910663	0	0	3.066327488	0	0.022665755	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5567	0	5.6636	5.7926	0.27545708	2.493902208	0	1.568162742	0.910772426	0.449154642	0.5317086	2.318724748	0.801319526	1.227990913	0.041772959	0	0.426753662	0.021668893	6.001982657	0.401551909	1.167757473	6.247116134	0	5.780245083	0.00910663	0	0	3.066327488	0	0.022665755	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5567		20% Coinsurance	Not Covered	20% Coinsurance	Not Covered	$100/trip	Not Covered	Not Covered	$50/visit	20% Coinsurance	Not Covered	Not Covered	20% Coinsurance	No Cost Sharing	Not Covered	20% Coinsurance	20% Coinsurance	Not Covered	Not Covered	Not Covered	20% Coinsurance	20% Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered												1.6561		0.0368					0.4914	0.3057			0.0038			0.1284	0.3974				0.5053	0.0216																				3.5464	0	0	7.4487	0.27545708	2.530722211	0	1.568162742	0.910772426	0.449154642	1.023073504	2.624392746	0.801319526	1.227990913	0.045540531	0	0.426753662	0.150069054	6.399428283	0.401551909	1.167757473	6.247116134	0.505250187	5.80182387	0.00910663	0	0	3.066327488	0	0.022665755	0	0	0	0	0	0	0	0	0	0	0	0	0	43.1032
H5426_007_0	2009	9																					3250											D	A	D	V	T	Coin	Coin	V	V	P	P	V	P	V	V	V	V	V	V	V	S	P	T	V	P	O	P	O	O	O																																																			0		1115.68313	51.45762344	784.7766708		112.1562325	11.51040992	7.943214879	200.2251732	383.3190219	2622.970708	586.695517	73.33481658		1120.42174	32.57090908	6961.547529	1095.169319	853.9715401	7220.929054		1407.748093	23.83464544			10083.1209		221.6051536														"$300/day 1-7, $0/day 8-90, $0 additional days"	$400/admit	"$0/day 1-5, $50/day 6-25, $100/day 26-100"	$0/visit	$100/trip	20% Coinsurance	20% Coinsurance	$50/visit	20% Coinsurance	$25/proc	"MRI, MRA, CT, PET $150/proc, Diag Radiology $25/proc"	20% Coinsurance	No Cost Sharing	$25/visit	$0/visit	$30/visit	$20/visit	$10/visit	$10/visit	Chiro & Podiatry $10/visit	20% Coinsurance	$10 Copay routine hearing exam	No Cost Sharing	No Cost Sharing	$10/proc	"$0 Copay, $85 limit every year"	$10/proc	"$0 Copay, $700 limit every 3 years"	No Cost Sharing												157.2807311	400	57.30054778		100	0.2	0.2	43.99253325	214.5979738	12.82104566	113.1194651	99.29195739		24.6980507	10.64216595	27.94635848	8.228825959	10	7.39124377		47.45882975	24.93509339			3.939286796		10														122.8722239	312.4914871	44.76483346		78.12287177	0.156245744	0.156245744	34.36823034	167.6500999	12.82104566	88.37217463	77.56972854		19.29482648	8.341833583	21.85373236	7.360709972	7.812287177	6.294646448		37.07620071	19.48001103			3.911464203		7.812287177														11.4239	1.340005772	2.927533081	0	0.730163914	1.798452556	1.241093515	0.573448739	5.355289358	2.802435601	4.32062989	0.474046818	0	1.801528588	0.022641759	12.67798304	0.671768644	0.555955909	3.787766285	0	4.349495904	0.038691596	0	0	3.286647203	0	0.144270258	0	0	0	0	0	0	0	0	0	0	0	0	0	60.3237	0	14.6854	11.4239	1.340005772	2.927533081	0	0.730163914	1.798452556	1.241093515	0.573448739	5.355289358	2.802435601	4.32062989	0.474046818	0	1.801528588	0.022641759	12.67798304	0.671768644	0.555955909	3.787766285	0	4.349495904	0.038691596	0	0	3.286647203	0	0.144270258	0	0	0	0	0	0	0	0	0	0	0	0	0	60.3237		30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	$100/trip	Not Covered	Not Covered	$50/visit	30% Coinsurance	Not Covered	Not Covered	30% Coinsurance	No Cost Sharing	Not Covered	30% Coinsurance	30% Coinsurance	Not Covered	Not Covered	Not Covered	30% Coinsurance	20% Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered												0.6986							0.0261							0.0796	0.1392				0.2582	0.0002																				1.2019	0	0	12.1225	1.340005772	2.927533081	0	0.730163914	1.798452556	1.241093515	0.599527785	5.355289358	2.802435601	4.32062989	0.474046818	0	1.801528588	0.102207341	12.81715504	0.671768644	0.555955909	3.787766285	0.258248878	4.349685372	0.038691596	0	0	3.286647203	0	0.144270258	0	0	0	0	0	0	0	0	0	0	0	0	0	61.5256
H5426_008_0	2009	9																					3250											D	A	D	V	T	Coin	Coin	V	V	P	P	V	P	V	V	V	V	V	V	V	S	P	T	V	P	O	P	O	O	O																																																			0		1052.004563	50.74179596	742.2095218		91.15058159	11.08195069	7.482101471	186.2844606	345.5375787	2574.138734	553.21055	38.36919196		1079.830018	34.92833007	7198.958667	1971.180684	637.1356487	3333.917124		3188.980535	23.50308146			15877.71679		220.2399412														"$345/day 1-7, $0/day 8-90, $0 additional days"	$400/admit	"$0/day 1-5, $50/day 6-25, $100/day 26-100"	$0/visit	$100/trip	20% Coinsurance	20% Coinsurance	$50/visit	20% Coinsurance	$25/proc	"MRI, MRA, CT, PET $150/proc, Diag Radiology $25/proc"	20% Coinsurance	No Cost Sharing	$25/visit	$0/visit	$40/visit	$20/visit	$10/visit	$10/visit	Chiro & Podiatry $10/visit	20% Coinsurance	$10 Copay routine hearing exam	No Cost Sharing	No Cost Sharing	$10/proc	"$0 Copay, $85 limit every year"	$10/proc	"$0 Copay, $700 limit every 3 years"	No Cost Sharing												180.8728408	400	57.30054778		100	0.2	0.2	43.6327847	193.5806642	12.3253804	102.1868834	172.261958		24.69105849	10.89045855	33.84414723	4.840548106	10	10		18.10183943	24.93509339			2.841107171		10														141.2156211	312.2981218	44.73713362		78.07453044	0.156149061	0.156149061	34.06609178	151.1371946	12.3253804	82.05797767	134.4927148		19.27742798	8.527443923	26.46529405	4.363889665	7.807453044	7.807453044		14.13292614	19.46795708			2.823508604		7.807453044														12.38	1.320547298	2.767027212	0	0.593044905	1.730436193	1.168323118	0.528831961	4.351965023	2.64393659	3.782944913	0.430031399	0	1.73469545	0.024820781	15.87687983	0.716834585	0.414533888	2.169116783	0	3.755802196	0.038129748	0	0	3.735905831	0	0.14329275	0	0	0	0	0	0	0	0	0	0	0	0	0	60.3071	0	14.878	12.38	1.320547298	2.767027212	0	0.593044905	1.730436193	1.168323118	0.528831961	4.351965023	2.64393659	3.782944913	0.430031399	0	1.73469545	0.024820781	15.87687983	0.716834585	0.414533888	2.169116783	0	3.755802196	0.038129748	0	0	3.735905831	0	0.14329275	0	0	0	0	0	0	0	0	0	0	0	0	0	60.3071		30% Coinsurance	Not Covered	30% Coinsurance	Not Covered	$100/trip	Not Covered	Not Covered	$50/visit	30% Coinsurance	Not Covered	Not Covered	30% Coinsurance	No Cost Sharing	Not Covered	30% Coinsurance	30% Coinsurance	Not Covered	Not Covered	Not Covered	30% Coinsurance	20% Coinsurance	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered												0.6798							0.1038	0.0291						0.0773	0.2485				0.2435	0.0004																				1.3823	0	0	13.0597	1.320547298	2.767027212	0	0.593044905	1.730436193	1.168323118	0.632633307	4.381022399	2.64393659	3.782944913	0.430031399	0	1.73469545	0.102071103	16.12535101	0.716834585	0.414533888	2.169116783	0.243467669	3.756222325	0.038129748	0	0	3.735905831	0	0.14329275	0	0	0	0	0	0	0	0	0	0	0	0	0	61.6893
H5426_013_0	2009	6																																D	A	D	V	T	Coin	Coin	V	V	P	P	V	P	V	V	V	V	V	V	V	S	P	T	V	P	O	P	O	O	O																																																			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																																																																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	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	2009	6																																D	A	D	V	T	Coin	Coin	V	V	P	P	V	P	V	V	V	V	V	V	V	S	P	T	V	P	O	P	O	O	O																																																			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																																																																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	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	2009	6																																D	A	D	V	T	Coin	Coin	V	V	P	P	V	P	V	V	V	V	V	V	V	S	P	T	V	P	O	P	O	O	O																																																			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																																																																																											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																		0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	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_052_0	2009	7																					3350											D	D	D	V	T	Coin	Coin	V	P	P	Coin	V	Coin	Coin	P	V	V	V	Coin	P	Coin	O	T	P	P	P	P	P	O	V																																																			0		795.7425322	93.75309157	589.9247796	89.78326114	288.6903554	3.523476115	4.691032727	177.1908632	54.31057226		10.59026512		1.750657266	2.343729507	0.467186177	2919.178027	119.0142328		3.755391455		26.92908092	285.4351172				55															$200 per day for days 1-10	$175 per day for days1-10	"$0 per day for days 1-10, $100 per day for days 11-100"	$30 per visit	"$100 per trip, no copay if admitted to the hospital within 24 hours"	20% coins	20% coins	$50 per visit	$200 per visit		$25-$200 copay		20% coins	20% coins		$20 copay for individual or group therapy	$20 copay for individual or group therapy	$25-$50 per visit	20% coins		20% coins	$20 copay for Med- covered eyewear	2 approved trips per year	"$0 copay for preventative services, e.g. cleaning, exams. Up to $75 copay for one X-ray"	$0 copay for one routine eye exam	$10 copay for contacts/eyeglasses $150 max	$0 copay for routine hearing test		fitness benefit	"$50 copay for ER worldwide coverage, $15/month OTC"											125.6446363	117.7704216	64.3093881	30	100	0.2	0.2	50	200		0.108201887		0.2	0.160018741	4.829774219	20.02897576	20		0.2		0.2	19.63981332				10															119.8261673	112.3165991	61.33128894	28.61073201	99.9932726	0.190738213	0.198638145	47.68455335	190.7382134		0.103191173		0.190738213	0.159535361	4.606112528	19.10531309	19.07382134		0.190738213		0.190738213	18.74699438				10															7.9459	0.877502366	3.015070593	0.214063735	2.405591117	0.672061539	0.93181804	0.704105597	0.86325846	0	1.092821882	0	0.333917239	0.373907734	0.000179326	4.647650847	0.189171351	0	0.716296657	0	5.136404782	0.445920878	0	0	0	0.045833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.6115	0	1.3103	7.9459	0.877502366	3.015070593	0.214063735	2.405591117	0.672061539	0.93181804	0.704105597	0.86325846	0	1.092821882	0	0.333917239	0.373907734	0.000179326	4.647650847	0.189171351	0	0.716296657	0	5.136404782	0.445920878	0	0	0	0.045833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.6115																																										0.25	0.0276	0.1583	0.0286	0.0486	0.0346	0.0461	0.0507	0.1577	0.0501	0.1067	0.0184	0.0115	0.0891	0.5324	0.5708	0.0101	0.0182	0.4051	0.7008	0.2648	0.0288																			3.6091	0	0	8.1959	0.905105719	3.173395137	0.242617453	2.454240176	0.706706118	0.977942619	0.754781821	1.020930489	0.050084417	1.199559147	0.018426301	0.345392797	0.463035095	0.53256264	5.218449865	0.199284265	0.018195184	1.12135472	0.700823225	5.40118497	0.474769575	0	0	0	0.045833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.2205
H5427_053_0	2009	11																					3350											D	D	D	V	T	P	P	V	P	P	P	V	P	P	P	V	V	V	P	P	Coin	O	T	P	P	P	P	P	O	V																																																			0		768.3499228	90.52573885	569.6172323	86.69256571	278.7524901	423.9447153	189.3931166	221.5959531	52.44098727		186.8842905		32.25203636	21.86728426	5998.431147	2818.688358	114.9172916		359.6839455		25.10698089	275.60931				55															$225 per day for days 1-10	$200 per day for days1-10	"$0 per day for days 1-10, $100 per day for days 11-100"	$30 per visit	"$100 per trip, no copay if admitted to the hospital within 24 hours"	20% coins	20% coins	$50 per visit	$200 per Procedure	$0 per procedure	$25-$200 per visit		20% coins	20% coins	$0 per visit	$30 copay	$30 copay for individual or group therapy	$25-$50 per visit	20% coins		20% coins	$10 copay for Med- covered eyewear	2 plan approved trips to PCP	"$0 copay for preventative services, e.g. cleaning, exams. Up to $75 copay for one X-ray"	$0 copay for one routine eye exam	$10 copay on contacts/eyeglasses	$0 copay for routine hearing test	$500 per ear per 2 years	"written manuals, smoking cessation, and nursing hotline, fitness benefit"	"$50 copay for ER worldwide coverage, $10/month OTC"											141.3502159	134.5947676	64.3093881	30	100	18.59714633	55.42280148	50	200		86.21343445		121.458578	53.23936858	9.999231029	29.6638127	30		23.3624488		0.2	29.27962665				10															131.1114044	124.8452923	59.65108819	27.82692697	99.9894771	17.25004776	54.83249498	47.20366595	185.5128464		79.96849814		112.6606327	53.00462304	9.274929053	27.52091828	27.82692697		21.67017189		0.185512846	27.18482481				10															8.395	0.94180936	2.83152398	0.201032308	2.322692977	0.609422215	0.865408093	0.871678446	0.810706401	0	1.24540467	0	0.302794568	0.09658893	4.636251943	6.464407663	0.266482923	0	0.64953441	0	4.657667491	0.624365901	0	0	0	0.045833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.8386	0	2.6082	8.395	0.94180936	2.83152398	0.201032308	2.322692977	0.609422215	0.865408093	0.871678446	0.810706401	0	1.24540467	0	0.302794568	0.09658893	4.636251943	6.464407663	0.266482923	0	0.64953441	0	4.657667491	0.624365901	0	0	0	0.045833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.8386		$225 per day for days 1-10	$225 per day for days1-10	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins																			0.2715	0.0305	0.1476	0.0266	0.0454	0.0323	0.043	0.0374	0.147	0.0467	0.0995	0.0172	0.0107	0.0831	0.4964	0.5322	0.0094	0.017	0.3777	0.6534	0.2469	0.0269																			3.3982	0	0	8.6665	0.972270087	2.979135824	0.227653998	2.368050299	0.641722641	0.908411749	0.909034137	0.957709882	0.046695559	1.34491978	0.017179523	0.313493657	0.179685674	5.132612652	6.996584757	0.275911568	0.016964045	1.027185066	0.653403485	4.90453188	0.651262611	0	0	0	0.045833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2367
H5427_054_0	2009	11																					3350											D	D	D	V	T	Coin	Coin	V	V	P	P	V	Coin	Coin	P	V	V	V	Coin	P	Coin	O	T	P	P	P	P	P	O	V																																																			0		748.1320707	88.14370438	554.9306215	84.41139483	271.4175812	3.205825864	4.268124305	166.5892698	51.06108978		181.9667408		1.592831101	0.469700168	0.439233732	2744.519255	111.8934339	429.7510842	3.416833452		24.50135641	268.3571088				55															$175/day days 1-10	$175/day days1-10	"$0/day days 1-10, $100/day days 11-100"	$30/visit	"$100/trip, no copay if admitted to the hospital within 24 hours"	20% coins	20% coins	$50/visit	$200/Procedure	$0/procedure	$25-$200/visit		20% coins	20% coins	$0/visit	$20 copay	$20 copay individual or group therapy	$25-$50/visit	20% coins		20% coins	$10 copay Med- covered eyewear	2 plan approved trips to PCP	"$0 copay preventative services, e.g. cleaning, exams. Up to $75 copay one X-ray"	$0 copay one routine eye exam	$10 copay on contacts/eyeglasses	$0 copay routine hearing test	$500/ear/2 years	fitness benefit	"$50 copay ER worldwide coverage, $25/month OTC"											109.9390568	98.22485799	64.3093881	30	100	0.2	0.2	50	200		86.21343445		0.2	0.201253013	4.674010942	20.00606515	20	25	0.2		0.2	19.63981332				10															105.4977049	94.25673992	61.71281111	28.78805076	99.99413125	0.191920338	0.198811965	47.9800846	191.9203384		82.73055757		0.191920338	0.200758452	4.485188808	19.20111086	19.19203384	23.9900423	0.191920338		0.191920338	18.86094903				10															6.5772	0.692344852	2.853860719	0.202503293	2.261680437	0.615263185	0.84855418	0.666080605	0.816638469	0	1.254517494	0	0.305696684	0.094296279	0.000164171	4.391484873	0.178955214	0.859145557	0.655759832	0	4.702308613	0.421789146	0	0	0	0.045833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.4441	0	1.0649	6.5772	0.692344852	2.853860719	0.202503293	2.261680437	0.615263185	0.84855418	0.666080605	0.816638469	0	1.254517494	0	0.305696684	0.094296279	0.000164171	4.391484873	0.178955214	0.859145557	0.655759832	0	4.702308613	0.421789146	0	0	0	0.045833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.4441		$175/day days 1-10	$175/day days1-10	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins																			0.2056	0.0216	0.1441	0.026	0.0443	0.0315	0.042	0.0471	0.1435	0.0456	0.0971	0.0168	0.011	0.0811	0.4844	0.5193	0.0092	0.0166	0.3685	0.6376	0.2409	0.0262																			3.2601	0	0	6.7828	0.713989609	2.998007809	0.228482821	2.305943661	0.646784467	0.890520513	0.713188301	0.960095968	0.04556918	1.351632125	0.016765123	0.316718396	0.175388584	0.484551787	4.91082492	0.188156424	0.8757004	1.024300891	0.637642245	4.9432182	0.44803706	0	0	0	0.045833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.7042
H5427_056_0	2009	11																					3350											D	D	D	V	T	P	P	V	V	P	P	V	P	P	P	V	V	V	P	P	Coin	O	T	P	P	P	P	P	O	O																																																			0		901.3207893	106.1921502	668.4202308	101.695607	326.993479		222.1695458	264.7028966	61.51644014		219.2265415		37.83358338	25.65164299	0.529171933	94.29364203			421.9309562		34.93143496	11.64506355				55															$75 per day for days 1-5	$75 per day for days 1-5	"$0 per day for days 1-7, $50 per day for days 8-20"	$10 per visit	"$50 per trip, no copay if admitted to the hospital within 24 hours"	20% coins	20% coins	$25 per visit	20% coins	$0 per procedure	$25-$200 per visit		20% coins	20% coins	$0 per visit	$0 per visit	$0 per visit	$10 per visit	20% coins		20% coins	$10 copay for Med- covered eyewear	2 plan approved trips to PCP	"$0 copay for preventative services, e.g. cleaning, exams. Up to $75 copay for one X-ray"	$0 copay for one routine eye exam	$10 copay for contacts/eyeglasses	$0 copay for routine hearing test	$500/ear every 2 years	"written manuals, smoking cessation, and nursing hotline, fitness benefit"	$30/month OTC											32.12414969	33.98971918	21.11268105	10	50.07263607		65.73400183	25	200		86.21343445		142.4782357	26.41371927	5.47058343	24.90687976			27.40556115		0.333333333	10				10															31.31112554	33.12947968	20.57852388	9.746911854	50.0689594		65.48937849	24.52026516	194.9382371		84.03147462		138.8722805	26.39731541	5.332129448	24.27651616			26.71195889		0.324897062	10				10															2.3518	0.293174223	1.146258473	0.08260151	1.364351936	0	1.212478789	0.540882101	0.999325533	0	1.535160797	0	0.437836333	0.056427876	0.000235134	0.190760094	0	0	0.939216863	0	11.34912058	0.00970422	0	0	0	0.045833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.5551	0	0.517	2.3518	0.293174223	1.146258473	0.08260151	1.364351936	0	1.212478789	0.540882101	0.999325533	0	1.535160797	0	0.437836333	0.056427876	0.000235134	0.190760094	0	0	0.939216863	0	11.34912058	0.00970422	0	0	0	0.045833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.5551		$75 per day for days 1-5	$75 per day for days 1-5	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins																			0.0724	0.009	0.2031	0.0366	0.0631	0.0449	0.0598	0.0514	0.2023	0.0643	0.1369	0.0236	0.0155	0.1143	0.683	0.7324	0.013	0.0233	0.5197	0.8991	0.3435	0.037																			4.3484	0	0	2.4242	0.302197827	1.349382772	0.119234831	1.427456032	0.044939701	1.272309934	0.592286165	1.20161268	0.06425638	1.6721006	0.023640235	0.453377876	0.170774852	0.683262444	0.923111568	0.01297448	0.023343721	1.458890775	0.899129235	11.69258392	0.046724652	0	0	0	0.045833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.9036
H5427_058_0	2009	5																					2500											D	D	D	V	T	P	P	V	V	P	P	V	P	P	P	V	V	V	P	P	Coin	O	T	P	P	P	P	P	O	V																																																			0		1048.130185	160.4536151	727.4912261		405.3697824		212.5027506	168.4155457	49.43983285		104.3927406		21.95862204	61.71087049	176.86	4755.563743	124.0518246		389.4464584	0.227451427	37.57618893	937.718172				55															$175 per day for days 1-7	$150 per day for days1-7	"$0 per day for days 1-10, $100 per day for days 11-100"	$0 per visit	$100 per trip	20% coins	20% coins	$50 per visit	$200 copay		$25-150  copay		20% coins	20% coins		$20 copay for individual or group therapy	$20 copay for individual or group therapy	$20-$40 per visit	$25-150  copay		20% coins	$10 copay for Med- covered eyewear	4 one way trips	"$0 copay for preventative services, e.g. cleaning, exams. Up to $75 copay for one X-ray"	$0 copay for one routine eye exam	$10 for contacts/eyeglasses	$0 copay for routine hearing test		"written manuals, smoking cessation, and nursing hotline"	"$50 copay for ER worldwide coverage, International Routine Care: $500/year, $15/month OTC, fitness benefit"											78.64036554	84.19273542	73.27213381		100		75.23795847	50	200		57.879046		187.8804168	40.57605226	10	19.93774274	20		21.35680558	5.496442311	0.2	19.36916436				10															70.60580954	75.59090297	65.78885222		99.99551774		73.35049595	44.89158274	179.566331		51.96563965		168.6849856	40.50538828	10	17.90456416	17.9566331		19.1748161	4.934879896	0.179566331	17.45470033				10															6.167	1.010736138	3.988401064	0	3.377930105	0	1.298931846	0.6300367	0.739810782	0	0.452069628	0	0.308674153	0.208301898	0.147383333	7.095524679	0.185629425	0	0.622297018	9.35E-05	6.747418379	1.363965807	0	0	0	0.045833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.39	0	3.362	6.167	1.010736138	3.988401064	0	3.377930105	0	1.298931846	0.6300367	0.739810782	0	0.452069628	0	0.308674153	0.208301898	0.147383333	7.095524679	0.185629425	0	0.622297018	9.35E-05	6.747418379	1.363965807	0	0	0	0.045833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.39																																										0.2061	0.0338	0.1911	0.1042	0.0693	0.0831	0.0655	0.0577	0.15	0.0285	0.0477	0.0203	0.0113	0.0614	0.7347	0.8775	0.0105	0.0342	0.6352	1.089	0.3695	0.0716																			4.9521	0	0	6.3731	1.04450871	4.17953751	0.104161381	3.447238263	0.083058829	1.364433802	0.687749636	0.889858836	0.028462976	0.499745642	0.020335876	0.319942185	0.269690823	0.882066856	7.973063913	0.196172071	0.034208113	1.257496081	1.089054361	7.116886256	1.435572044	0	0	0	0.045833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.3421
H5427_059_0	2009	9																					2500											D	D	D	V	T	P	P	V	V	P	P	V	P	P	P	V	V	V	P	P	Coin	O	T	P	P	P	P	P	O	V																																																			0		998.5020582	152.8562646	693.0698259	339.0688528	386.175847		202.4409151	221.7334797	47.09889625		99.44982769		20.91889883	58.78891007		4530.391598	118.1780698		371.0064797	0.216681784	34.10202769	893.3179655				55															$150 per day for days 1-7	$150 per day for days 1-7	"$0 per day for days 1-7, $100 per day for days 8-100"	$15 per visit	"$100 per trip, no copay if admitted to the hospital within 24 hours"	20% coins	20% coins	$50 per visit	$200 per service	$0 copay	$25-150 copay		20% coins	20% coins	$0 copay	$20 copay	$20 copay for individual or group therapy	$20-$40 per visit	$25-150 copay		20% coins	$10 copay for Med- covered eyewear	4 one way trips	"$0 copay for preventative services, e.g. cleaning, exams. Up to $75 copay for one X-ray"	$0 copay for one routine eye exam	$10 for contacts/eyeglasses	$0 copay for routine hearing test		"written manuals, smoking cessation, and nursing hotline"	"$50 copay for ER worldwide coverage, $15/month OTC, fitness benefit, International Routine Care $500/year, fitness benefit"											78.64036554	84.19273542	73.27213381	15	100		71.67550123	50	200		57.879046		178.7290762	40.50511168		19.90308275	20		20.14660034	5.184980782	0.2	19.36916436				10															71.20025701	76.22732115	66.33990983	13.58086077	99.99584936		70.01044287	46.57714586	181.0781436		52.403151		161.8196466	40.43967587		18.02344296	18.10781436		18.24054494	4.694433472	0.181078144	17.59634453				10															5.9245	0.970985298	3.831515813	0.38373724	3.217998485	0	1.18108151	0.860642719	0.710715058	0	0.434290361	0	0.282090735	0.198117039	0	6.80443788	0.178328879	0	0.563946697	8.48E-05	6.175131865	1.309927558	0	0	0	0.045833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.0733	0	2.9664	5.9245	0.970985298	3.831515813	0.38373724	3.217998485	0	1.18108151	0.860642719	0.710715058	0	0.434290361	0	0.282090735	0.198117039	0	6.80443788	0.178328879	0	0.563946697	8.48E-05	6.175131865	1.309927558	0	0	0	0.045833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.0733		$150 per day for days 1-7	$150 per day for days 1-7	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins																			0.1963	0.0322	0.1736	0.0945	0.0629	0.0754	0.0594	0.0427	0.1362	0.0258	0.0433	0.0185	0.0102	0.0557	0.6602	0.7886	0.0095	0.0307	0.5708	0.9786	0.3353	0.0644																			4.4649	0	0	6.1208	1.003158765	4.005076364	0.478268229	3.280898656	0.075379504	1.240527388	0.903391185	0.846890201	0.02583139	0.47755842	0.018455693	0.292302374	0.253830162	0.660237852	7.593078511	0.187803217	0.030741732	1.134779684	0.978698867	6.510440052	1.374307396	0	0	0	0.045833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5383
H5427_060_0	2009	9																					2500											D	D	D	V	T	P	P	V	V	P	P	V	P	P	P	V	V	V	P	P	Coin	O	T	P	P	P	P	P	O	V																																																			0		1008.621579	154.4054173	700.0866118		390.0896241		204.4925935	162.0672279	54.42173018		104.5650225		21.13090563	59.38471816	176.86	4434.166932	119.3757693		5482.555077		34.79675816	1158.440045				55															$75 per day for days 1-7	$75 per day for days1-7	"$0 per day for days 1-7, $75 per day for days 8-100"	$0 per visit	$100 per trip	20% coins	20% coins	$50 per visit	$200 per service	$0 copay	$25-150 copay		20% coins	20% coins	$0 copay	$10 copay	$10 copay for individual or group therapy	$20-$40 per visit	$25-150 copay		20% coins	$10 copay for Med- covered eyewear	4 one way trips	"$0 copay for preventative services, e.g. cleaning, exams. Up to $75 copay for one X-ray"	$0 copay for one routine eye exam	$10 copay for contacts/eyeglasses	$0 copay for routine hearing test		"Gym benefit, smoking cessation, nutritional benefits"	"$50 copay for ER worldwide coverage, International Routine Care $500/year, $20/month OTC"											39.32018277	42.09636771	54.95410036		100		72.40191108	50	200		72.8314239		180.5404421	40.17375563	10	9.998016041	10		25.93175604		0.2	10				10															35.25290983	37.74192667	49.27193593		99.99546196		70.56299126	44.8280086	179.3120344		65.29775393		161.8653699	40.13798394	10	8.963822982	8.96560172		23.24937966		0.179312034	9.245080845				10															2.9631	0.485629828	2.87455189	0	3.250599347	0	1.202467424	0.605429257	0.81320593	0	0.568988426	0	0.285030155	0.198631905	0.147383333	3.312257288	0.089189634	0	10.62216704	0	6.239477496	0.892489323	0	0	0	0.045833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.5964	0	3.434	2.9631	0.485629828	2.87455189	0	3.250599347	0	1.202467424	0.605429257	0.81320593	0	0.568988426	0	0.285030155	0.198631905	0.147383333	3.312257288	0.089189634	0	10.62216704	0	6.239477496	0.892489323	0	0	0	0.045833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.5964		$75 per day for days 1-7	$75 per day for days1-7	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins	30% coins																			0.0991	0.0162	0.177	0.0965	0.0642	0.0769	0.0607	0.0309	0.1389	0.0264	0.0441	0.0188	0.0104	0.0568	0.6737	0.8047	0.0097	0.0314	0.5825	0.9986	0.3421	0.0657																			4.4253	0	0	3.0622	0.501879596	3.05155038	0.096456785	3.314780928	0.076915144	1.26312434	0.636340751	0.952155248	0.026357631	0.613137946	0.018831675	0.295449827	0.255480022	0.821071628	4.116964197	0.098856983	0.031368006	11.2046291	0.99855054	6.581616621	0.958180715	0	0	0	0.045833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.0217
H5427_062_0	2009	8																					2500											D	D	D	V	T	P	P	V	V	P	P	V	P	P	P	V	V	V	P	P	Coin	O	T	P	P	P	P	P	O	V																																																			0		1208.774064	185.0458761	838.9015273	410.4724989			231.6648249	271.9007748	65.22126565		67.06715052		25.32415645	71.16911692		173.0522887			449.1357893	0.262312249	49.9772712	1081.439521				55															"$0 per day for days 1-30, $25 per day 31-90"	"$0 per day for days 1-30, $25 per day 31-90"	"$0 per day for days 1-30, $25 per day for days 31-100"	$0 per visit	$0 per trip	20% coins	20% coins	$25 per visit	$50 per service	$0 copay	$0-50 copay		20% coins	20% coins	$0 copay	$0 copay	$0 copay for individual or group therapy	$0-$25 per visit	$0-50 copay		20% coins	$10 copay for Med- covered eyewear	4 one way trips	"$0 copay for preventative services, e.g. cleaning, exams. Up to $75 copay for one X-ray"	$0 copay for one routine eye exam	$10 for contacts/eyeglasses	$0 copay for routine hearing test			"$50 copay for ER worldwide coverage, International Routine Care $500/month, $20/month OTC, fitness benefit"											2.39682637	1.58412673	7.074298927	10			90.35677393	25	50		50		216.3671772	26.15150487		21.00419494			25	25	0.2	10				10															2.337942417	1.545208749	6.900501321	9.754325328			89.8030585	24.56126525	48.77162664		48.77162664		211.0515837	26.14088493		20.48817507			24.38581332	24.38581332	0.195086507	9.769823362				10															0.2355	0.023827876	0.482403425	0.333656858	0	0	1.733684152	0.556518921	0.265078935	0	0.272581169	0	0.445391944	0.155035308	0	0.295460466	0	0	0.912711793	0.000533058	9.749891246	0.880456091	0	0	0	0.045833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.3886	0	0.3693	0.2355	0.023827876	0.482403425	0.333656858	0	0	1.733684152	0.556518921	0.265078935	0	0.272581169	0	0.445391944	0.155035308	0	0.295460466	0	0	0.912711793	0.000533058	9.749891246	0.880456091	0	0	0	0.045833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.3886																																										0.0072	0.0007	0.2543	0.1385	0.0922	0.1105	0.0871	0.0126	0.1996	0.0379	0.0634	0.027	0.015	0.0816	0.9676	1.1558	0.0139	0.0451	0.8366	1.4342	0.4914	0.0944																			6.1665	0	0	0.2427	0.024560716	0.736715583	0.4721941	0.092181583	0.11047032	1.820803392	0.569094851	0.4646466	0.037856471	0.33599146	0.027047224	0.460357326	0.236684114	0.967593086	1.451230646	0.01388485	0.045052684	1.749280083	1.434713534	10.24129277	0.974806159	0	0	0	0.045833333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.555
H5427_068_0	2009	7																					2500											D	D	D	V	T	P	P	V	V	P	P	V	P	P	P	V	V	V	P	P	Coin	O	T	P	P	P	P	P	O	V																																																			0		1581.631959	444.3188172	3154.827833						65.13390833	3466.441051	438.0554092		32.54704401	20.07516015		108.3663711				10.42149396	91.23194047	653.3637879		1348.819783		324															$25/days 16-90	$25/days 16-90	$25/days 31-100	$0 copay	$0 copay				$25 copay		$0-$25 copay		$0 copay		$0 copay	$0 copay	$0 copay	$0 copay	$0 copay		20% coins			"$0 copay for preventative services, e.g. cleaning, exams. Up to $75 copay for one X-ray"	$0 copay for one routine eye exam	$0 copay for one pair of frames or contacts per year	$0 copay for routine hearing test	$10 copay for hearing aids	"written manuals, smoking cessation, and nursing hotline"	N/A											6.158945302	5.126410113	7.074298927						25	10.93872409	25		124.0387338	19.39786526		16.26179944				14.84664375	0.2	10		1		10															5.818150448	4.842748853	6.682854525						23.61666715	10.93872409	23.61666715		117.1752597	19.39786526		15.36198019				14.02512976	0.188933337	9.446666862		1		10															0.7668	0.17931037	1.756937955	0	0	0	0	0	0.128187153	3.159870187	0.862117399	0	0.317809028	0.032451271	0	0.138726837	0	0	0	0.012180234	17.23675498	0.514342504	0	0.112401649	0	0.27	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.4879	0	1.2836	0.7668	0.17931037	1.756937955	0	0	0	0	0	0.128187153	3.159870187	0.862117399	0	0.317809028	0.032451271	0	0.138726837	0	0	0	0.012180234	17.23675498	0.514342504	0	0.112401649	0	0.27	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.4879																																																																																		0	0	0	0.7668	0.17931037	1.756937955	0	0	0	0	0	0.128187153	3.159870187	0.862117399	0	0.317809028	0.032451271	0	0.138726837	0	0	0	0.012180234	17.23675498	0.514342504	0	0.112401649	0	0.27	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.4879
H5427_070_0	2009	8																					2500											D	D	D	V	T	P	P	V	V	P	P	V	P	P	P	V	V	V	P	P	Coin	O	T	P	P	P	P	P	O	V																																																			0		1916.661333	144.5210941	2712.55563		243.700176	3391.4988	1704.344112	338.3625085	348.9372919		845.0042832		20.48766392	559.72187		6818.337609	781.1691167			13.01295704	55.31141225	1415.601345																			$75/days 1-7	$75/days 1-7	$75/days 8-100	$0 per visit	$100 per trip	20% coins	20% coins	$50 per visit	20% coins	$0 copay	"$25-$150 copay (Diag.), 20% coins (Therap.)"		20% coins	20% coins	$0 copay	$10 per visit	$10 per visit	$20-$40 copay			20% coins			"$0 copay for preventative services, e.g. cleaning, exams. Up to $75 copay for one X-ray"	$0 copay for one routine eye exam	$10 copay for one pair of frames or contacts per year	$0 copay for routine hearing test	$0 copay for hearing aids	"written manuals, smoking cessation, and nursing hotline"	"$50 copay for ER worldwide coverage, $0 copay for up to 2 routine physical exam, $30 OTC"											39.32018277	42.09636771	54.95410036		100	24.95761092	33.82018002	50	102.6655234		83.20102348		112.9934839	39.12884576		10.35995146	10			17.25150432	0.2	10																			30.76885062	32.94127235	43.00271224		98.00372498	19.52984315	32.05651202	41.30763353	80.33788075		69.91573398		88.41972195	36.88499276		8.106874805	7.825205391			13.49965646	0.156504108	7.825205391																			4.9145	0.396725727	9.720604099	0	1.990293752	5.519619968	4.55294396	1.164746208	2.336073545	0	4.92325789	0	0.150959462	1.72044476	0	4.606284115	0.509400732	0	0	0.014639204	8.656463227	0.923114273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.1	0	12.0674	4.9145	0.396725727	9.720604099	0	1.990293752	5.519619968	4.55294396	1.164746208	2.336073545	0	4.92325789	0	0.150959462	1.72044476	0	4.606284115	0.509400732	0	0	0.014639204	8.656463227	0.923114273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.1																																																																																		0	0	0	4.9145	0.396725727	9.720604099	0	1.990293752	5.519619968	4.55294396	1.164746208	2.336073545	0	4.92325789	0	0.150959462	1.72044476	0	4.606284115	0.509400732	0	0	0.014639204	8.656463227	0.923114273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.1
H5427_072_0	2009	11																					3350											D	D	D	V	T	P	P	V	V	P	P	V	P	P	P	V	V	V	P	P	Coin	O	T	P	P	P	P	P	O	V																																																			0		1961.381057	123.9707664	2688.705166	5359.810089	23.82292749	3499.606569	1527.49835	352.6097459	370.7726245		858.4255677		25.75147577	584.559413		7435.721955	760.2181473			6.247017937	49.65672865	1597.60804																			$200/days 1-10	$175days 1-7	$100/days 11-100	$30 per visit	$100 per trip	20% coins	20% coins	$50 per visit	$200 per service	$0 copay	$25-$150 copay		20% coins	20% coins	$0 per visit	$10 per visit	$10 per visit	$20-$40 copay			20% coins			"$0 copay for preventative services, e.g. cleaning, exams. Up to $75 copay for one X-ray"	$0 copay for one routine eye exam	$10 copay for one pair of frames or contacts per year	$0 copay for routine hearing test	$0 copay for hearing aids	"written manuals, smoking cessation, and nursing hotline"	"$50 copay for ER worldwide coverage, $0 copay for up to 2 routine physical exam"											125.6446363	117.7704216	64.3093881	30	100	24.44878622	34.38153778	50	103.098417		92.89747317		120.6492873	92.53029304		19.72019739	20			15.09856386	0.2	10																			91.42363281	85.69406621	46.79386288	21.82909724	72.76365748	17.78983107	31.49404194	39.11350328	75.01817904		72.31786399		87.78883414	90.80346256		14.37599167	14.5527315			10.9862673	0.145527315	7.276365748																			14.943	0.885296588	10.48457507	9.749984637	0.144453611	5.188117472	4.008924757	1.149316871	2.317890594	0	5.173291954	0	0.188391003	4.423334898	0	8.907989739	0.921937548	0	0	0.005719284	7.226410391	0.968731702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.6874	0	25.403	14.943	0.885296588	10.48457507	9.749984637	0.144453611	5.188117472	4.008924757	1.149316871	2.317890594	0	5.173291954	0	0.188391003	4.423334898	0	8.907989739	0.921937548	0	0	0.005719284	7.226410391	0.968731702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.6874																																																																																		0	0	0	14.943	0.885296588	10.48457507	9.749984637	0.144453611	5.188117472	4.008924757	1.149316871	2.317890594	0	5.173291954	0	0.188391003	4.423334898	0	8.907989739	0.921937548	0	0	0.005719284	7.226410391	0.968731702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.6874
H5427_075_0	2009	11																					3350											D	D	D	V	T	P	P	V	V	P	P	V	P	P	P	V	V	V	P	P	Coin	O	T	P	P	P	P	P	O	V																																																			0		1069.528234	72.76262378	744.6853947	2624.765387	110.185587	1592.92591	806.5388639	252.2769067	375.1560467		518.9560859		9.418246273	368.5598601	3476.459564	6067.316438	430.2607653		292.3844189	4.690516043	36.719906	1429.376571			150.0832565																$350 per day for days 1-7	$300 per day for days 1-7	"$0 per day for days 1-10, $100 per day for days 11-100"	$30 per visit	"$100 per trip, no copay if admitted to the hospital within 24 hours"	20% coins	20% coins	$100 per visit	$300 per service	$0 copay	"25% coins (Therap), $0-$300 (Diag.)"		20% coins	20% coins	$10 copay	$35 copay	$35 copay for individual or group therapy	$50 per visit			20% coins	$20 copay for Med- covered eyewear		"$0 copay for preventative services, e.g. cleaning, exams. Up to $75 copay for one X-ray"	$0 copay for one routine eye exam	$10 copay for eyewear	$0 copay for routine hearing test		"written manuals, smoking cessation, and nursing hotline"												183.4941863	168.3854708	64.3093881	30	100	26.09154433	31.78617987	60	161.0555717		189.6134594		105.3900607	46.14342085	10.00213614	34.22498964	34.98266253		20.17657721	16.46613823	0.2	9.99438691			10																145.9657518	133.9470876	51.15676071	23.86436672	97.84466086	20.75527274	29.58995688	51.81915563	128.1163075		161.6951716		102.2100746	45.45550841	7.956488162	27.25268248	27.82796958		16.05004126	13.09846538	0.2	7.951713187			7.954788908																13.0095	0.812195128	3.174641045	5.219863647	0.898422616	2.75513431	1.988787517	1.089398024	4.005300622	0	6.992724444	0	0.080219971	1.396089652	2.305034114	13.7792207	0.997773624	0	0.391065166	0.00511988	7.343981201	0.947166044	0	0	0.099490052	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.2912	0	13.7656	13.0095	0.812195128	3.174641045	5.219863647	0.898422616	2.75513431	1.988787517	1.089398024	4.005300622	0	6.992724444	0	0.080219971	1.396089652	2.305034114	13.7792207	0.997773624	0	0.391065166	0.00511988	7.343981201	0.947166044	0	0	0.099490052	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.2912		$350 per day for days 1-7	$350 per day for days 1-7	"$0 per day for days 1-10, $100 per day for days 11-100"	$35 per visit	"$100 per trip, no copay if admitted to the hospital within 24 hours"	20% coins	20% coins	$100 per visit	$300 per service	$0 copay	"25% coins (Therap), $0-$300 (Diag.)"		20% coins	20% coins	$10 copay	$35 copay	$35 copay for individual or group therapy	$50 per visit			20% coins	$20 copay for Med- covered eyewear								$500 deductible for ER worldwide coverage											0.7397	0.0462	0.1354	0.2597	0.0311	0.1175	0.0725	0.0285	0.2277		0.2782		0.0029	0.0481	0.1092	0.6488	0.047		0.0185	0.0002	0.2491	0.0449																			3.1051	0	0	13.7492	0.858372922	3.310012997	5.47954455	0.929568902	2.8726178	2.061255323	1.117922585	4.233024157	0	7.270875843	0	0.083071729	1.444162438	2.41424575	14.42806153	1.044751348	0	0.409593684	0.005362458	7.593092989	0.992039662	0	0	0.099490052	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.3963
H5428_001_0	2009	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	V	V	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	374.3936773	24.05004005	59.07152788	28.66908785	14.97860152	20.55774868	3.833808723	10.65914922	31.92340887	22.27748677	30.0185419	0.081058169	0.797071995	46.00051088	66.07686926	122.3424539	29.3627577	1.54989859	20.74589031	8.247166812	3.470269281	0.802425081	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	5% Member Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	Medicare Cost-Sharing	10B Transportation:  $0 copay	"16A Preventive Dental: $0 copay, 16B Comp Dental: $0"	not covered	not covered	not covered	not covered	not covered	14C Routine Physical: $0 copay											0.0539	0.0539	0.1261	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.05	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0539	0.0539	0.1261	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.05	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.1798	1.296297159	7.448919666	0	3.460056951	4.748839945	0.885609815	2.462263469	7.37430745	5.146099443	6.93428318	0.018724437	0.184123631	10.62611801	15.2637568	28.26110684	1.468137885	0.358026574	4.792300661	1.905095533	0.801632204	0.185360194	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.8009	0	0	20.1798	1.296297159	7.448919666	0	3.460056951	4.748839945	0.885609815	2.462263469	7.37430745	5.146099443	6.93428318	0.018724437	0.184123631	10.62611801	15.2637568	28.26110684	1.468137885	0.358026574	4.792300661	1.905095533	0.801632204	0.185360194	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.8009	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.1798	1.296297159	7.448919666	0	3.460056951	4.748839945	0.885609815	2.462263469	7.37430745	5.146099443	6.93428318	0.018724437	0.184123631	10.62611801	15.2637568	28.26110684	1.468137885	0.358026574	4.792300661	1.905095533	0.801632204	0.185360194	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.8009
H5429_001_0	2009	11																					3350											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1328.796577	33.98107415	986.7217086	1999.718637	291.9284925	8.412215582	9.436506864	257.1678072	75.93787492	913.2624154	277.5202732	0	0.263725342	248.213474	8116.284786	12720.66966	207.9365243	818.9628616	4721.897149	12233.31194	10.60663103	1455.50547	0	3111.044959	412.1202741	282.9386839	37.93562337	0	0	0											"$300 copay, days 1-7"	"$300 copay, days 1-7"	"$150 copay, days 6-20"	$30 copay	"$150 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$10 copay	$35 copay	"$35 copay Group, $35 copay Individual"	$35 copay	$50 copay	Varies	20% coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1years	$10 copay	Not Covered	Varies	Varies											192.7636364	182.7037037	66.2299152	30	120	0.2	0.2	45	149.3137157	34.68759436	71.96315539	0	0.2	43.2255163	7.468067136	20.91609888	35	35	22.58963637	14.33697609	0.2	13.36130439	0	4	10	20	10	0	0	0											68.86211237	182.7037037	46.82811559	10.85312952	120	0.105176701	0.115469352	45	48.47245891	34.68759436	71.96315539	0	0.2	43.2255163	3.793023949	17.24105569	35	35	14.48095622	12.77205426	0.2	13.36130439	0	4	10	20	10	0	0	0											7.6253	0.517372342	3.850526519	1.808600448	2.919284925	0.884769081	1.089627337	0.964379277	0.306741293	2.639906351	1.664269545	0	0.052745068	0.894096297	2.565438548	18.27648116	0.606481529	2.38864168	5.698132156	13.02037699	2.121326205	1.620620969	0	1.037014986	0.343433562	0.471564473	0.031613019	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3988		31.907	7.6253	0.517372342	3.850526519	1.808600448	2.919284925	0.884769081	1.089627337	0.964379277	0.306741293	2.639906351	1.664269545	0	0.052745068	0.894096297	2.565438548	18.27648116	0.606481529	2.38864168	5.698132156	13.02037699	2.121326205	1.620620969	0	1.037014986	0.343433562	0.471564473	0.031613019	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3988																																																																																		0			7.6253	0.517372342	3.850526519	1.808600448	2.919284925	0.884769081	1.089627337	0.964379277	0.306741293	2.639906351	1.664269545	0	0.052745068	0.894096297	2.565438548	18.27648116	0.606481529	2.38864168	5.698132156	13.02037699	2.121326205	1.620620969	0	1.037014986	0.343433562	0.471564473	0.031613019	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3988
H5429_005_0	2009	10																					3350											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1606.942359	41.86729377	747.6193198	3036.669584	351.7960165	11.79661805	13.2018156	278.1180429	82.12417171	987.3377353	300.5926188	0	0.339236224	268.3937452	9595.008927	14506.83428	250.795476	996.5546638	5149.612076	15271.68441	13.65799043	1676.91385	0	3111.044959	468.5730874	284.460964	43.28427723	0	0	0											"$300 copay, days 1-7"	"$300 copay, days 1-7"	"$150 copay, days 6-20"	$30 copay	"$150 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$10 copay	$35 copay	"$35 copay Group, $35 copay Individual"	$35 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1years	$10 copay	Not Covered	Varies	Varies											192.7636364	182.7037037	66.2299152	30	120	0.2	0.2	45	149.3006038	37.83174657	72.03296787	0	0.2	43.24219706	7.380149035	21.56425773	35	35	22.55430062	14.4572233	0.2	13.43185561	0	4	10	20	10	0	0	0											41.54712407	182.7037037	28.43611619	11.39055072	120	0.100199595	0.110822322	45	11.67791014	37.83174657	72.03296787	0	0.2	43.24219706	2.690819002	16.8749277	35	35	11.58051312	12.60704269	0.2	13.43185561	0	4	10	20	10	0	0	0											5.5637	0.63744247	1.77161582	2.882444909	3.517960165	1.182016347	1.463055856	1.042942661	0.079919891	3.112725915	1.804381538	0	0.067847245	0.967161268	2.151536028	20.40014831	0.731486805	2.906617769	4.96959585	16.04423144	2.731598087	1.877005392	0	1.037014986	0.390477573	0.474101607	0.036070231	0	0	0	0	0	0	0	0	0	0	0	0	0	77.8431		47.0923	5.5637	0.63744247	1.77161582	2.882444909	3.517960165	1.182016347	1.463055856	1.042942661	0.079919891	3.112725915	1.804381538	0	0.067847245	0.967161268	2.151536028	20.40014831	0.731486805	2.906617769	4.96959585	16.04423144	2.731598087	1.877005392	0	1.037014986	0.390477573	0.474101607	0.036070231	0	0	0	0	0	0	0	0	0	0	0	0	0	77.8431																																																																																		0			5.5637	0.63744247	1.77161582	2.882444909	3.517960165	1.182016347	1.463055856	1.042942661	0.079919891	3.112725915	1.804381538	0	0.067847245	0.967161268	2.151536028	20.40014831	0.731486805	2.906617769	4.96959585	16.04423144	2.731598087	1.877005392	0	1.037014986	0.390477573	0.474101607	0.036070231	0	0	0	0	0	0	0	0	0	0	0	0	0	77.8431
H5429_015_0	2009	10																					3350											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1315.465316	33.89465697	939.4720877	1611.331359	176.4427167	7.098997938	8.005476331	258.6279778	76.36904184	918.5052417	279.3336519	0	0.256858431	249.4390794	7835.826723	11885.15509	198.6453244	784.0860224	4523.734214	11510.48508	10.34628093	1409.545671	0	3111.044959	394.54271	260.281854	36.37548988	0	0	0											"$300 copay, days 1-7"	"$300 copay, days 1-7"	"$150 copay, days 6-20"	$30 copay	"$150 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$10 copay	$35 copay	"$35 copay Group, $35 copay Individual"	$35 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1years	$10 copay	Not Covered	Varies	Varies											192.7636364	182.7037037	66.2299152	30	120	0.2	0.2	45	149.3014418	34.62470596	72.02850175	0	0.2	43.24112824	7.390540062	21.37903718	35	35	22.56837653	14.26014471	0.2	13.31545182	0	4	10	20	10	0	0	0											50.45630442	182.7037037	43.06000528	2.981989675	120	0.07223852	0.086705244	45	35.28935988	34.62470596	72.02850175	0	0.2	43.24112824	2.975448796	16.96394591	35	35	12.94469724	12.36904425	0.2	13.31545182	0	4	10	20	10	0	0	0											5.5311	0.516056614	3.371139421	0.400414456	1.764427167	0.512821102	0.694116781	0.969854917	0.22458455	2.650247827	1.676665369	0	0.051371686	0.898835602	1.942925099	16.80159402	0.579382196	2.286917565	4.879864148	11.86447495	2.069256186	1.564061456	0	1.037014986	0.328785592	0.43380309	0.030312908	0	0	0	0	0	0	0	0	0	0	0	0	0	63.0801		36.2791	5.5311	0.516056614	3.371139421	0.400414456	1.764427167	0.512821102	0.694116781	0.969854917	0.22458455	2.650247827	1.676665369	0	0.051371686	0.898835602	1.942925099	16.80159402	0.579382196	2.286917565	4.879864148	11.86447495	2.069256186	1.564061456	0	1.037014986	0.328785592	0.43380309	0.030312908	0	0	0	0	0	0	0	0	0	0	0	0	0	63.0801																																																																																		0			5.5311	0.516056614	3.371139421	0.400414456	1.764427167	0.512821102	0.694116781	0.969854917	0.22458455	2.650247827	1.676665369	0	0.051371686	0.898835602	1.942925099	16.80159402	0.579382196	2.286917565	4.879864148	11.86447495	2.069256186	1.564061456	0	1.037014986	0.328785592	0.43380309	0.030312908	0	0	0	0	0	0	0	0	0	0	0	0	0	63.0801
H5429_020_0	2009	11																					3350											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1096.872182	27.55523267	716.2915642	1510.703553	222.2941983	6.927491815	7.796684772	286.3210073	84.54638655	1017.024582	309.2023357	0	0.259100323	276.0496552	7591.961649	12438.18498	203.9055268	802.7220382	4695.934078	11725.17348	10.44108948	1425.821168	0	3111.044959	399.1849661	279.2278117	36.71136604	0	0	0											"$300 copay, days 1-7"	"$300 copay, days 1-7"	"$150 copay, days 6-20"	$30 copay	"$150 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$10 copay	$35 copay	"$35 copay Group, $35 copay Individual"	$35 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1years	$10 copay	Not Covered	Varies	Varies											192.7636364	182.7037037	66.2299152	30	120	0.2	0.2	45	149.2997219	33.3341587	72.03766813	0	0.2	43.24332216	7.779517586	20.8803931	35	35	22.58659794	15.44431426	0.2	13.20651299	0	4	10	20	10	0	0	0											9.074688183	182.7037037	33.89810947	0.873107872	120	0.06070596	0.076234791	45	39.7314688	33.3341587	72.03766813	0	0.2	43.24332216	3.154688797	16.25556431	35	35	12.7231717	13.46916227	0.2	13.20651299	0	4	10	20	10	0	0	0											0.8295	0.419536922	2.023410821	0.109917264	2.222941983	0.420540042	0.594378634	1.073703777	0.279929343	2.825138236	1.856184604	0	0.051820065	0.994775348	1.995856363	16.84914299	0.594724453	2.341272611	4.978931297	13.16068869	2.088217895	1.569177148	0	1.037014986	0.332654138	0.465379686	0.030592805	0	0	0	0	0	0	0	0	0	0	0	0	0	59.1454		38.5983	0.8295	0.419536922	2.023410821	0.109917264	2.222941983	0.420540042	0.594378634	1.073703777	0.279929343	2.825138236	1.856184604	0	0.051820065	0.994775348	1.995856363	16.84914299	0.594724453	2.341272611	4.978931297	13.16068869	2.088217895	1.569177148	0	1.037014986	0.332654138	0.465379686	0.030592805	0	0	0	0	0	0	0	0	0	0	0	0	0	59.1454																																																																																		0			0.8295	0.419536922	2.023410821	0.109917264	2.222941983	0.420540042	0.594378634	1.073703777	0.279929343	2.825138236	1.856184604	0	0.051820065	0.994775348	1.995856363	16.84914299	0.594724453	2.341272611	4.978931297	13.16068869	2.088217895	1.569177148	0	1.037014986	0.332654138	0.465379686	0.030592805	0	0	0	0	0	0	0	0	0	0	0	0	0	59.1454
H5429_053_0	2009	8																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1334.634695	34.20974099	916.5796453	2179.546095	277.9010629	8.457611055	9.490538405	264.2935696	78.04200787	938.5132417	285.3693914	0	0.271481082	255.0357245	8187.289553	12827.25384	210.9184948	832.0251417	4646.18628	12429.8718	10.92551914	1466.427134	0	3111.044959	412.8997177	278.4273292	38.03686562	0	0	0											"$300 copay, days 1-7"	"$300 copay, days 1-7"	"$150 copay, days 6-20"	$30 copay	"$150 copay, waived if admitted"	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	$37.5 copay to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$10 copay	$35 copay	"$35 copay Group, $35 copay Individual"	$35 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	Varies	$10 copay	$10 copay; and $100 credit covered every 1years	$10 copay	Not Covered	Varies	Varies											192.7636364	182.7037037	66.2299152	30	120	0.2	0.2	45	149.3077106	35.38662619	71.99511234	0	0.2	43.23314497	7.458231532	20.9261963	35	35	22.59050656	14.55856088	0.2	13.33769906	0	4	10	20	10	0	0	0											57.68893171	182.7037037	43.35983027	10.76456893	120	0.096728845	0.107968629	45	41.86683401	35.38662619	71.99511234	0	0.2	43.23314497	3.468184461	16.93614923	35	35	13.56708259	12.87211917	0.2	13.33769906	0	4	10	20	10	0	0	0											6.4161	0.520853865	3.311894821	1.955156182	2.779010629	0.818094947	1.024680417	0.991100886	0.272280982	2.767568105	1.712100116	0	0.054296216	0.918833037	2.366252533	18.10369044	0.615178943	2.426739996	5.25293275	13.33323259	2.185103827	1.629896983	0	1.037014986	0.344083098	0.464045549	0.031697388	0	0	0	0	0	0	0	0	0	0	0	0	0	71.3319		34.9371	6.4161	0.520853865	3.311894821	1.955156182	2.779010629	0.818094947	1.024680417	0.991100886	0.272280982	2.767568105	1.712100116	0	0.054296216	0.918833037	2.366252533	18.10369044	0.615178943	2.426739996	5.25293275	13.33323259	2.185103827	1.629896983	0	1.037014986	0.344083098	0.464045549	0.031697388	0	0	0	0	0	0	0	0	0	0	0	0	0	71.3319																																																																																		0			6.4161	0.520853865	3.311894821	1.955156182	2.779010629	0.818094947	1.024680417	0.991100886	0.272280982	2.767568105	1.712100116	0	0.054296216	0.918833037	2.366252533	18.10369044	0.615178943	2.426739996	5.25293275	13.33323259	2.185103827	1.629896983	0	1.037014986	0.344083098	0.464045549	0.031697388	0	0	0	0	0	0	0	0	0	0	0	0	0	71.3319
H5430_001_0	2009	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																																																			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% 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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	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	2009	7																																	D						V													Coin																																																												0			334.2450021						440.8535049													12.20086332																					$200 days 1-5						$50 waived if admitted													20%																					86.0089272						41.5													0.2																					85.89711559						41.44605													0.19974																				0	2.392556799	0	0	0	0	0	1.522636367	0	0	0	0	0	0	0	0	0	0	0	0	2.43700044	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.3522		0.0083	0	2.392556799	0	0	0	0	0	1.522636367	0	0	0	0	0	0	0	0	0	0	0	0	2.43700044	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.3522	3350																																																																																	0			0	2.392556799	0	0	0	0	0	1.522636367	0	0	0	0	0	0	0	0	0	0	0	0	2.43700044	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.3522
H5431_002_0	2009	6																																	D	D		T			V	V												Coin				V																																																								0			194.7539032	366.0773083		657.3673066			376.3939617	22.8841761												7.147039479				587.6986199																	$75 per day days 1-5	$25 per day for days 7-25		$25 waived if admitted			$25 waived if admitted	50												20%				10																	32.2533477	13.65946557		20			20.25	50												0.2				10																	32.21141835	13.64170827		19.974			20.223675	49.935												0.19974				9.987																0	0.522774954	0.416159987	0	1.094187882	0	0	0.634339096	0.095226778	0	0	0	0	0	0	0	0	0	0	0	1.427549666	0	0	0	0.489112176	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.6794			0	0.522774954	0.416159987	0	1.094187882	0	0	0.634339096	0.095226778	0	0	0	0	0	0	0	0	0	0	0	1.427549666	0	0	0	0.489112176	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.6794	3350																																																																																	0			0	0.522774954	0.416159987	0	1.094187882	0	0	0.634339096	0.095226778	0	0	0	0	0	0	0	0	0	0	0	1.427549666	0	0	0	0.489112176	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.6794
H5431_005_0	2009	8																																D	D						V	V												Coin																				0	0						0	0												0																				0		1711.252552	300.8205019						396.7681544	35.34732412												10.98077699																				$50 days 1-5	$200 days 1-5						$50 waived if admitted	"$100 OP Surgery, $0 ASC"												20%																				32.42207341	86.0089272						40.5	90												0.2																				32.2859007	85.6476897						40.3299	89.622												0.19916																				4.6041	2.147048417	0	0	0	0	0	1.333468333	0.26399149	0	0	0	0	0	0	0	0	0	0	0	2.186931545	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.5356			4.6041	2.147048417	0	0	0	0	0	1.333468333	0.26399149	0	0	0	0	0	0	0	0	0	0	0	2.186931545	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.5356	3350																																																																																	0			4.6041	2.147048417	0	0	0	0	0	1.333468333	0.26399149	0	0	0	0	0	0	0	0	0	0	0	2.186931545	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.5356
H5433_001_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	253.1899508	0	31.97601818	5.84964334	14.32443261	7.471489273	0	16.66298304	10.96248219	0	0	0	0	21.67350802	321.3805681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: Cost Sharing is 44% of Standard Medicare	1B IP Psych: Cost Sharing is 44% of Standard Medicare	2 SNF: Cost Sharing is 44% of Standard Medicare	6 Home Health: Cost Sharing is 44% of Standard Medicare	10A Ambulance: Cost Sharing is 44% of Standard Medicare	11A DME: Cost Sharing is 44% of Standard Medicare	"11B Prosthetic Medical Supplies: Cost Sharing is 44% of Standard Medicare, 11C Diabetes Monitoring Supplies: Cost Sharing is 44% of Standard Medicare"	"4A ER: Cost Sharing is 44% of Standard Medicare, 4B Urgent Care: Cost Sharing is 44% of Standard Medicare"	9B ASC Services: Cost Sharing is 44% of Standard Medicare	8A OP C/D/T: Cost Sharing is 44% of Standard Medicare	8B OP X-Ray: Cost Sharing is 44% of Standard Medicare	9A OP Hospital: Cost Sharing is 44% of Standard Medicare	12 Renal Dialysis: Cost Sharing is 44% of Standard Medicare	"3 CORF: Cost Sharing is 44% of Standard Medicare, 5 Partial Hosp: Cost Sharing is 44% of Standard Medicare, 9C OP Substance Abuse: Cost Sharing is 44% of Standard Medicare, 9D Cardiac Rehab: Cost Sharing is 44% of Standard Medicare"	"7A PCP: Cost Sharing is 44% of Standard Medicare, 14B Immunizations: Cost Sharing is 44% of Standard Medicare, 14C Routine Physical Exams: Cost Sharing is 44% of Standard Medicare, 14D Pap Smears: Cost Sharing is 44% of Standard Medicare, 14D Pelvic Exams: Cost Sharing is 44% of Standard Medicare, 14E Prostate Screening: Cost Sharing is 44% of Standard Medicare, 14F Colorectal Screening: Cost Sharing is 44% of Standard Medicare, 14G Bone Mass Measurement: Cost Sharing is 44% of Standard Medicare, 14H Mammography: Cost Sharing is 44% of Standard Medicare, 14I Diabetes Monitoring: Cost Sharing is 44% of Standard Medicare"	"7B Chiropractic: Cost Sharing is 44% of Standard Medicare, 7D Physician Specialist (excl. Radiology): Cost Sharing is 44% of Standard Medicare, 7F Podiatry: Cost Sharing is 44% of Standard Medicare"	"7E Mental Health: Cost Sharing is 44% of Standard Medicare, 7H Psychiatric: Cost Sharing is 44% of Standard Medicare"	"7C Occupational Therapy: Cost Sharing is 44% of Standard Medicare, 7I Physical and Speech Therapy: Cost Sharing is 44% of Standard Medicare"	7D Physician Specialist (Radiology): Cost Sharing is 44% of Standard Medicare	"7G Other Health Care: Cost Sharing is 44% of Standard Medicare, 18A Medicare Covered Hearing Exams: Cost Sharing is 44% of Standard Medicare"	15 Part B Drugs: Cost Sharing is 44% of Standard Medicare	"13A Blood: Cost Sharing is 44% of Standard Medicare, 16B Medicare Covered Comprehensive Dental Services: Cost Sharing is 44% of Standard Medicare, 17A Medicare Covered Eye Exams: Cost Sharing is 44% of Standard Medicare"	10B Transportation: $0 Cost Sharing	"16A Preventive Dental Services: 0% Cost Sharing, 16B Non Medicare Covered Comprehensive Dental: 0% minimum Cost Sharing, 50% maximum 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	14A Health Education/Wellness Programs: Cost Sharing is 44% of Standard Medicare	13B Acupuncture: Not Covered											0.033946475	0.033946475	0.0955199	0	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0	0	0	0	0	0	0	0											0.033946475	0.033946475	0.0955199	0	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0.12918675	0	0	0	0	0	0	0	0											8.5949	0	3.054346059	0	1.850526894	0.965217417	0	2.152636624	1.416207446	0	0	0	0	2.799930063	41.51811111	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3519	0	0	8.5949	0	3.054346059	0	1.850526894	0.965217417	0	2.152636624	1.416207446	0	0	0	0	2.799930063	41.51811111	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.5949	0	3.054346059	0	1.850526894	0.965217417	0	2.152636624	1.416207446	0	0	0	0	2.799930063	41.51811111	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3519
H5434_001_0	2009	7	e.3.	i.9.	f.1.	i.10.	g.1.	h.6.	h.7.	h.8.	i.7.	i.8.	DME/Prosthetics/Supplies	Professional	OP Facility - Emergency	Professional	OP Facility - Surgery	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	3300	Electric Wheelchairs	Urgent Care	Worldwide ER	Worldwide Urgent Care	Ambulatory Surgical Center	Cardiac Rehab	Chemotherapy	Radiation Therapy	Allergy Shots	Advanced Imaging	A	A	D		T	O		V	V	V			V	V	V	V	V	V	V	V	Coin			V							O	V	V	V	V	V	V	V	V	V																																									0	6000	267.2352897	2.832210253	877.0298948	0	233.9157095	0	0	260.3699551	126.9359279	1602.342118	0	0	47.78648031	275.3131428	4485.238825	7680.351503	317.6298066	0	0	0	49.44710788	0	0	369.6130905	0	0	0	0	0	0	0.011819314	294.1068484	0.569281179	0.768828053	112.6907981	350.1131486	8.501361256	318.5321871	555.4594601	324.3708692	$200 for days 1-7	$200 for days 1-7	$125 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	$175 copay	$15 copay	$0 copay	$0 copay	$35 copay	"$175 copay on OP Facility, $75 copay on IDTF"	$15 copay	$30 copay	$30 copay	with Cardiac Rehab	$0 copay	$0 copay	20% coinsurance	$0 copay	$0 copay	"$0 copay for select services, $15 copay for Medicare-covered services"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$500 copay	$30 copay	$50 copay	$30 copay	$125 copay	$30 copay for Cardiac Rehab and PT/OT/ST	$175 copay	$50 copay	$5 copay	$100 copay	994.7044511	994.7044511	146.1547142	0	100	0	0	50	175	15	0	0	35	175	15	30	30	0	0	0	0.2	0	0	3.25	0	0	0	0	0	0	500	30	50	30	125	30	175	50	5	100	738.8932996	738.8932996	108.5676644	0	74.28269761	0	0	37.14134881	129.9947208	11.14240464	0	0	25.99894417	129.9947208	11.14240464	22.28480928	22.28480928	0	0	0	0.148565395	0	0	3.25	0	0	0	0	0	0	400	22.28480928	37.14134881	22.28480928	92.85337202	22.28480928	129.9947208	37.14134881	3.714134881	74.28269761	16.4549	0.174391765	7.934757275	0	1.447990826	0	0	0.805874277	1.375083376	1.487828688	0	0	0.103533169	2.982437928	4.164695492	14.26293071	0.589859972	0	0	0	7.346129126	0	0	0.100103545	0	0	0	0	0	0	0.000393977	0.546176252	0.001761989	0.001427766	0.871976717	0.650183729	0.09209434	0.985892922	0.171920946	2.0079286	64.5602	0	22.3166	16.4549	0.174391765	7.934757275	0	1.447990826	0	0	0.805874277	1.375083376	1.487828688	0	0	0.103533169	2.982437928	4.164695492	14.26293071	0.589859972	0	0	0	7.346129126	0	0	0.100103545	0	0	0	0	0	0	0.000393977	0.546176252	0.001761989	0.001427766	0.871976717	0.650183729	0.09209434	0.985892922	0.171920946	2.0079286	64.5602		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	$35 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	$30 copay	$50 copay	$30 copay	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	8.6344	0.0911	0.6715	0.9957	0.1685	1.689	0.0359	0.1632	1.3916	0.5175	0.8121	0	0.0421	0.4368	1.9195	2.8867	0.2426	0.1511	1.4282	9.2195	1.6073	1.2922	0	0	0	0	0	0	0	0	0.0001	0.1009	0.0003	0.0004	2.1266	0.6608	0.0374	0	0.0437	0.6934	38.0604	500	8.547576394	25.0893	0.265479995	8.606209887	0.995746347	1.616536234	1.688996446	0.035887156	0.969037471	2.766690387	2.005290887	0.812121732	0	0.145651361	3.41924212	6.084239953	17.14964943	0.832500529	0.151102455	1.428197888	9.219523518	8.953448908	1.292189119	0	0.100103545	0	0	0	0	0	0	0.00052641	0.647124767	0.002029129	0.001805906	2.998607323	1.311012256	0.129466631	0.985892922	0.215664402	2.701356352	102.6206
H5434_002_0	2009	5	e.3.	i.9.	f.1.	i.10.	g.1.	h.6.	h.7.	h.8.	i.7.	i.8.	DME/Prosthetics/Supplies	Professional	OP Facility - Emergency	Professional	OP Facility - Surgery	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	3300	Electric Wheelchairs	Urgent Care	Worldwide ER	Worldwide Urgent Care	Ambulatory Surgical Center	Cardiac Rehab	Chemotherapy	Radiation Therapy	Allergy Shots	Advanced Imaging	A	A	D		T	O		V	V	V			V	V	V	V	V	V	V	V	Coin			V							O	V			V	V	V	V	V	V																																									0	6000	279.6850882	2.964155577	1441.410272	0	232.6764229	0	0	246.9203171	105.6821884	1784.998411	0	0	46.89643125	301.7072111	3776.452387	5933.508559	229.8281405	0	0	0	54.8112802	0	0	369.6130905	0	0	0	0	0	0	0.013636993	370.30569	0.727668823	1.141242623	111.2217423	386.880144	8.626494073	318.1056793	420.5155461	289.1345586	$175 for days 1-7	$175 for days 1-7	$125 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	$150 copay	$15 copay	$0 copay	$0 copay	$30 copay	"$150 copay on OP Facility, $75 copay on IDTF"	$10 copay	$25 copay	$25 copay	with Cardiac Rehab	$0 copay	$0 copay	20% coinsurance	$0 copay	$0 copay	"$0 copay for select services, $15 copay for Medicare-covered services"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$500 copay	$25 copay	$50 copay	$25 copay	$100 copay	$25 copay for Cardiac Rehab and PT/OT/ST	$150 copay	$50 copay	$5 copay	$100 copay	870.3663947	870.3663947	148.4125617	0	100	0	0	50	150	15	0	0	30	150	10	25	25	0	0	0	0.2	0	0	3.25	0	0	0	0	0	0	500	25	50	25	100	25	150	50	5	100	657.3994873	657.3994873	112.0980113	0	75.53134993	0	0	37.76567497	113.2970249	11.32970249	0	0	22.65940498	113.2970249	7.553134993	18.88283748	18.88283748	0	0	0	0.1510627	0	0	3.25	0	0	0	0	0	0	400	18.88283748	37.76567497	18.88283748	75.53134993	18.88283748	113.2970249	37.76567497	3.776567497	75.53134993	15.3221	0.162386196	13.46493542	0	1.46453036	0	0	0.777092703	0.997789794	1.685291745	0	0	0.088553769	2.848544117	2.377004556	9.336789819	0.361650619	0	0	0	8.279939969	0	0	0.100103545	0	0	0	0	0	0	0.000454566	0.582701847	0.002290075	0.001795825	0.700060695	0.608782907	0.081446343	1.001122974	0.132342112	1.819893627	62.1976	0	20.1167	15.3221	0.162386196	13.46493542	0	1.46453036	0	0	0.777092703	0.997789794	1.685291745	0	0	0.088553769	2.848544117	2.377004556	9.336789819	0.361650619	0	0	0	8.279939969	0	0	0.100103545	0	0	0	0	0	0	0.000454566	0.582701847	0.002290075	0.001795825	0.700060695	0.608782907	0.081446343	1.001122974	0.132342112	1.819893627	62.1976		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	$30 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	$25 copay	$50 copay	$25 copay	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	7.1999	0.076	1.3148	0.8324	0.1646	0.8227	0.0452	0.136	0.7375	0.4721	0.5263	0	0.0378	0.2839	1.0372	1.6504	0.1382	0.0861	0.884	5.6591	1.7783	1.0858	0	0	0	0	0	0	0	0	0.0002	0.1324	0.0004	0.0004	0.8119	0.4931	0.0347	0	0.0146	0.4292	26.885	500	6.049300765	22.522	0.238384824	14.77974761	0.832352992	1.629157492	0.822713822	0.045214276	0.913095631	1.735300682	2.157346766	0.526295481	0	0.12635635	3.132398836	3.414181687	10.98714088	0.49982887	0.086107895	0.88402362	5.659094039	10.05822046	1.08582063	0	0.100103545	0	0	0	0	0	0	0.000607074	0.715066073	0.002700271	0.002199524	1.511939649	1.101895739	0.116139424	1.001122974	0.146902641	2.249110416	89.0826
H5434_014_0	2009	6	e.3.	i.9.	f.1.	i.10.	g.1.	h.6.	h.7.	h.8.	i.7.	i.8.	DME/Prosthetics/Supplies	Professional	OP Facility - Emergency	Professional	OP Facility - Surgery	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	3300	Electric Wheelchairs	Urgent Care	Worldwide ER	Worldwide Urgent Care	Ambulatory Surgical Center	Cardiac Rehab	Chemotherapy	Radiation Therapy	Allergy Shots	Advanced Imaging	A	A	D		T	O		V	V	V			V	V	V	V	V	V	V	V	Coin			V							O	V			V	V	V	V	V	V																																									0	6000	168.0882609	1.781431249	777.6992292	0	189.1758847	0	0	263.2735366	113.2311564	2030.502428	0	0	53.37422265	341.97217	3738.484227	6101.503929	246.3729406	0	0	0	45.48179856	0	0	369.6130905	0	0	0	0	0	0	0.011401568	382.8422508	0.818810738	1.190479505	124.1176621	439.2624613	9.818069374	362.045531	467.8093488	311.2834962	$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	$0 copay	$50 copay	$150 copay	$15 copay	$0 copay	$0 copay	$30 copay	"$150 copay on OP Facility, $75 copay on IDTF"	$5 copay	$20 copay	$20 copay	with Cardiac Rehab	$0 copay	$0 copay	20% coinsurance	$0 copay	$0 copay	"$0 copay for select services, $15 copay for Medicare-covered services"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$500 copay	$20 copay	$50 copay	$20 copay	$100 copay	$20 copay for Cardiac Rehab and PT/OT/ST	$150 copay	$50 copay	$5 copay	$100 copay	746.0283383	746.0283383	78.50053342	0	100	0	0	50	150	15	0	0	30	150	5	20	20	0	0	0	0.2	0	0	3.25	0	0	0	0	0	0	500	20	50	20	100	20	150	50	5	100	606.6881062	606.6881062	63.83851325	0	81.32239421	0	0	40.66119711	121.9835913	12.19835913	0	0	24.39671826	121.9835913	4.066119711	16.26447884	16.26447884	0	0	0	0.162644788	0	0	3.25	0	0	0	0	0	0	400	16.26447884	40.66119711	16.26447884	81.32239421	16.26447884	121.9835913	40.66119711	4.066119711	81.32239421	8.4981	0.090064429	4.137263546	0	1.282019656	0	0	0.892084764	1.151028592	2.064066486	0	0	0.108512989	3.476249452	1.266760367	8.26981513	0.33392729	0	0	0	7.397377504	0	0	0.100103545	0	0	0	0	0	0	0.000380052	0.518894141	0.002774485	0.001613544	0.841128787	0.595364584	0.099803614	1.226767058	0.158514068	2.109526599	44.6221	0	10.2255	8.4981	0.090064429	4.137263546	0	1.282019656	0	0	0.892084764	1.151028592	2.064066486	0	0	0.108512989	3.476249452	1.266760367	8.26981513	0.33392729	0	0	0	7.397377504	0	0	0.100103545	0	0	0	0	0	0	0.000380052	0.518894141	0.002774485	0.001613544	0.841128787	0.595364584	0.099803614	1.226767058	0.158514068	2.109526599	44.6221		$200 for days 1-7	$200 for days 1-7	$100 for days 7-25	"$0 copay for Home Health Care, $50 copay for Respite Care"	$100 per trip	$0 copay for DME except electric wheelchairs and scooters	$0 copay	$50 copay	$150 copay	$15 copay	$150 copay	$150 copay	$30 copay	"$150 copay on OP Facility, $75 copay on IDTF"	$15 copay	$50 copay	$50 copay	with Cardiac Rehab	$0 copay	$0 copay	CYD + 30% coins	$0 copay	$0 copay	"$0 copay for select services, $15 copay for Medicare-covered services"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$500 copay	$20 copay	$50 copay	$20 copay	$100 copay	$50 copay for Cardiac Rehab and PT/OT/ST	$150 copay	$50 copay	$5 copay	$100 copay	7.0803	0.075	2.3159	2.4934	0.1424	0	0	0.1325	0.1709	0.3065	0.5465	0	0.0161	0.5162	0.5577	3.07	0.124	0	0	0	1.4828	0	0	0	0	0	0	0	0	0	0.0005	0.0771	0.0004	0.0002	0.1016	0.6858	0.0148	0.2134	0.0191	0.3133	20.4564	0	0.072925282	15.5784	0.165102381	6.453138029	2.493357169	1.424466285	0	0	1.024554096	1.321949557	2.370568199	0.546503043	0	0.124626529	3.992452017	1.824481052	11.3398622	0.457892878	0	0	0	8.88021721	0	0	0.100103545	0	0	0	0	0	0	0.000854651	0.595946864	0.00318648	0.001853146	0.942702629	1.281130403	0.114623862	1.440215681	0.177656063	2.422778872	65.0786
H5434_015_0	2009	5	e.3.	i.9.	f.1.	i.10.	g.1.	h.6.	h.7.	h.8.	i.7.	i.8.	DME/Prosthetics/Supplies	Professional	OP Facility - Emergency	Professional	OP Facility - Surgery	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	3300	Electric Wheelchairs	Urgent Care	Worldwide ER	Worldwide Urgent Care	Ambulatory Surgical Center	Cardiac Rehab	Chemotherapy	Radiation Therapy	Allergy Shots	Advanced Imaging	A	A	D		T	O		V	V	V			V	V	V	V	V	V	V	V	Coin			V							O	V	V	V	V	V	V	V	V	V																																									0	6000	160.0834482	1.696594726	790.2608001	0	232.3391118	0	0	302.9614068	130.3267643	2337.067109	0	0	61.43264767	393.6030314	3374.338604	5111.383328	187.5483579	0	0	0	55.85913181	0	0	369.6130905	0	0	0	0	0	0	0.014003001	430.8452214	1.003528424	1.4479015	142.8569116	505.5821833	11.30039871	416.7070627	356.1140884	283.159608	$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	$0 copay	$50 copay	$125 copay	$15 copay	$0 copay	$0 copay	$25 copay	"$125 copay on OP Facility, $75 copay on IDTF"	$5 copay	$20 copay	$20 copay	with Cardiac Rehab	$0 copay	$0 copay	20% coinsurance	$0 copay	$0 copay	"$0 copay for select services, $15 copay for Medicare-covered services"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$500 copay	$20 copay	$50 copay	$20 copay	$75 copay	$20 copay for Cardiac Rehab and PT/OT/ST	$125 copay	$50 copay	$5 copay	$100 copay	746.0283383	746.0283383	64.57256584	0	100	0	0	50	125	15	0	0	25	125	5	20	20	0	0	0	0.2	0	0	3.25	0	0	0	0	0	0	500	20	50	20	75	20	125	50	5	100	616.0408457	616.0408457	53.32148395	0	82.57606501	0	0	41.2880325	103.2200813	12.38640975	0	0	20.64401625	103.2200813	4.12880325	16.515213	16.515213	0	0	0	0.16515213	0	0	3.25	0	0	0	0	0	0	400	16.515213	41.2880325	16.515213	61.93204876	16.515213	103.2200813	41.2880325	4.12880325	82.57606501	8.2182	0.087097637	3.51148988	0	1.598804133	0	0	1.042390034	1.121028267	2.412322569	0	0	0.105684715	3.38564474	1.16099835	7.034632033	0.258116757	0	0	0	9.225254599	0	0	0.100103545	0	0	0	0	0	0	0.000466767	0.592958384	0.00345281	0.0019927	0.737285101	0.695816454	0.097202339	1.433751229	0.122527084	1.948517183	44.8957	0	9.4521	8.2182	0.087097637	3.51148988	0	1.598804133	0	0	1.042390034	1.121028267	2.412322569	0	0	0.105684715	3.38564474	1.16099835	7.034632033	0.258116757	0	0	0	9.225254599	0	0	0.100103545	0	0	0	0	0	0	0.000466767	0.592958384	0.00345281	0.0019927	0.737285101	0.695816454	0.097202339	1.433751229	0.122527084	1.948517183	44.8957		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	$25 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	$20 copay	$50 copay	$20 copay	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	33.0289	0.349	4.9696	3.5202	0.1776	0.7319	0.051	0.1425	0.4753	0.4854	0.3345	0	0.042	0.1804	0.5118	1.1826	0.0989	0.0617	0.6502	4.2943	1.8111	0.9473	0	0	0	0	0	0	0	0	0.0002	0.1587	0.0005	0.0005	0.2084	0.443	0.443	0.392	0.0134	0.3157	56.0214	500	24.18740233	41.247	0.436085322	8.481111971	3.520178604	1.776449037	0.731903265	0.050976275	1.184865522	1.59637171	2.897757014	0.334526584	0	0.147661577	3.566068655	1.672789281	8.217259114	0.357015576	0.06167014	0.650184448	4.294270956	11.03632188	0.947253352	0	0.100103545	0	0	0	0	0	0	0.000623263	0.751639811	0.003929188	0.002525167	0.945703062	1.138816765	0.540202651	1.82572108	0.135918314	2.264198881	100.9171
H5434_016_0	2009	5	e.3.	i.9.	f.1.	i.10.	g.1.	h.6.	h.7.	h.8.	i.7.	i.8.	DME/Prosthetics/Supplies	Professional	OP Facility - Emergency	Professional	OP Facility - Surgery	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	3300	Electric Wheelchairs	Urgent Care	Worldwide ER	Worldwide Urgent Care	Ambulatory Surgical Center	Cardiac Rehab	Chemotherapy	Radiation Therapy	Allergy Shots	Advanced Imaging	A	A	D		T	O		V	V	V			V	V	V	V	V	V	V	V	Coin			V							O	V	V	V	V	V	V	V	V	V																																									0	6000	251.9812153	2.670544681	1624.73515	0	228.1309352	0	0	213.0227144	91.64416537	1643.396625	0	0	43.19867643	276.7767733	3396.026873	5522.962581	222.0777	0	0	0	54.84739905	0	0	369.6130905	0	0	0	0	0	0	0.013749376	343.6406928	0.72166055	1.164157222	100.4552096	355.519125	7.946300311	293.0232417	421.6779	358.8062092	$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	$0 copay	$50 copay	$125 copay	$15 copay	$0 copay	$0 copay	$25 copay	"$125 copay on OP Facility, $75 copay on IDTF"	$5 copay	$20 copay	$20 copay	with Cardiac Rehab	$0 copay	$0 copay	20% coinsurance	$0 copay	$0 copay	"$0 copay for select services, $15 copay for Medicare-covered services"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$500 copay	$20 copay	$50 copay	$20 copay	$75 copay	$20 copay for Cardiac Rehab and PT/OT/ST	$125 copay	$50 copay	$5 copay	$100 copay	746.0283383	746.0283383	118.7300493	0	100	0	0	50	125	15	0	0	25	125	5	20	20	0	0	0	0.2	0	0	3.25	0	0	0	0	0	0	500	20	50	20	75	20	125	50	5	100	582.1575543	582.1575543	92.65009329	0	78.03424138	0	0	39.01712069	97.54280172	11.70513621	0	0	19.50856034	97.54280172	3.901712069	15.60684828	15.60684828	0	0	0	0.156068483	0	0	3.25	0	0	0	0	0	0	400	15.60684828	39.01712069	15.60684828	58.52568103	15.60684828	97.54280172	39.01712069	3.901712069	78.03424138	12.2244	0.12955648	12.54432193	0	1.483502039	0	0	0.692627747	0.744935721	1.603015111	0	0	0.070228665	2.249798493	1.104193253	7.183003253	0.288827747	0	0	0	8.559950353	0	0	0.100103545	0	0	0	0	0	0	0.000458313	0.446929013	0.002346426	0.001514069	0.48993413	0.462377754	0.064592033	0.952743599	0.137105479	2.333264195	53.8697	0	15.1355	12.2244	0.12955648	12.54432193	0	1.483502039	0	0	0.692627747	0.744935721	1.603015111	0	0	0.070228665	2.249798493	1.104193253	7.183003253	0.288827747	0	0	0	8.559950353	0	0	0.100103545	0	0	0	0	0	0	0.000458313	0.446929013	0.002346426	0.001514069	0.48993413	0.462377754	0.064592033	0.952743599	0.137105479	2.333264195	53.8697		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	$25 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	$20 copay	$50 copay	$20 copay	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	5.7806	0.061	1.2608	0.5487	0.1648	0.6931	0.0483	0.1239	0.4132	0.422	0.2908	0	0.0365	0.1569	0.5449	1.2577	0.1051	0.0656	1.0992	4.7022	1.784	1.0074	0	0	0	0	0	0	0	0	0.0002	0.123	0.0004	0.0004	0.1812	0.3851	0.3851	0.3408	0.0142	0.5337	22.5309	500	5.360529534	18.005	0.190576836	13.80512037	0.548667477	1.648335598	0.693069901	0.048271573	0.816484562	1.158179499	2.025031627	0.290823498	0	0.106721603	2.406651539	1.649113992	8.440712233	0.393950931	0.065585416	1.099232554	4.702233328	10.34392946	1.007391982	0	0.100103545	0	0	0	0	0	0	0.000612468	0.569968338	0.002766018	0.001930891	0.671124019	0.847503799	0.449718078	1.293505884	0.151346884	2.866970598	76.4006
H5434_018_0	2009	5	e.3.	i.9.	f.1.	i.10.	g.1.	h.6.	h.7.	h.8.	i.7.	i.8.	DME/Prosthetics/Supplies	Professional	OP Facility - Emergency	Professional	OP Facility - Surgery	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	3300	Electric Wheelchairs	Urgent Care	Worldwide ER	Worldwide Urgent Care	Ambulatory Surgical Center	Cardiac Rehab	Chemotherapy	Radiation Therapy	Allergy Shots	Advanced Imaging	A	A	D		T	O		V	V	V			V	V	V	V	V	V	V	V	Coin			V							O	V	V	V	V	V	V	V	V	V																																									0	6000	256.4827681	2.718252991	1457.280739	0	222.7278341	0	0	282.5083698	121.4872654	2178.553988	0	0	57.26593773	366.9066456	3794.365874	6206.585739	251.276805	0	0	0	53.5483817	0	0	369.6130905	0	0	0	0	0	0	0.013423733	404.5961728	0.839942723	1.212612227	133.1675471	471.2907375	10.53394169	388.4436307	477.120735	330.601542	$200 for days 1-7	$200 for days 1-7	$125 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	$175 copay	$15 copay	$0 copay	$0 copay	$35 copay	"$175 copay on OP Facility, $75 copay on IDTF"	$15 copay	$30 copay	$30 copay	with Cardiac Rehab	$0 copay	$0 copay	20% coinsurance	$0 copay	$0 copay	"$0 copay for select services, $15 copay for Medicare-covered services"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$500 copay	$30 copay	$50 copay	$30 copay	$125 copay	$30 copay for Cardiac Rehab and PT/OT/ST	$175 copay	$50 copay	$5 copay	$100 copay	994.7044511	994.7044511	127.3442127	0	100	0	0	50	175	15	0	0	35	175	15	30	30	0	0	0	0.2	0	0	3.25	0	0	0	0	0	0	500	30	50	30	125	30	175	50	5	100	754.4580699	754.4580699	96.587352	0	75.84746093	0	0	37.92373046	132.7330566	11.37711914	0	0	26.54661132	132.7330566	11.37711914	22.75423828	22.75423828	0	0	0	0.151694922	0	0	3.25	0	0	0	0	0	0	400	22.75423828	37.92373046	22.75423828	94.80932616	22.75423828	132.7330566	37.92373046	3.792373046	75.84746093	16.1255	0.170900659	11.72957397	0	1.407778391	0	0	0.892814272	1.343781339	2.065472356	0	0	0.126684716	4.058386713	3.597412717	11.76884423	0.476467691	0	0	0	8.123017578	0	0	0.100103545	0	0	0	0	0	0	0.000447458	0.76718981	0.00265448	0.002299339	1.052127117	0.893655145	0.116516857	1.227602629	0.150784985	2.089607295	68.2896	0	21.7139	16.1255	0.170900659	11.72957397	0	1.407778391	0	0	0.892814272	1.343781339	2.065472356	0	0	0.126684716	4.058386713	3.597412717	11.76884423	0.476467691	0	0	0	8.123017578	0	0	0.100103545	0	0	0	0	0	0	0.000447458	0.76718981	0.00265448	0.002299339	1.052127117	0.893655145	0.116516857	1.227602629	0.150784985	2.089607295	68.2896		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	$35 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	$30 copay	$50 copay	$30 copay	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	CYD + 30% coins	13.8061	0.1457	2.4774	1.5043	0.1564	0.6737	0.0469	0.1483	0.4946	0.5051	0.3481	0	0.0437	0.1877	0.6145	1.4198	0.1189	0.074	0.9319	4.9965	1.7357	1.1373	0	0	0	0	0	0	0	0	0.0001	0.1453	0.0004	0.0004	0.2169	0.461	0.461	0.4079	0.0161	0.4525	33.7283	500	13.09462112	29.9316	0.31658076	14.20695561	1.504344778	1.564198212	0.673680537	0.046921125	1.041125671	1.838401584	2.570592881	0.348092818	0	0.170363888	4.246127454	4.211958244	13.18868926	0.5953196	0.074040281	0.931927831	4.996455551	9.858726304	1.137258716	0	0.100103545	0	0	0	0	0	0	0.000597442	0.91250045	0.003092152	0.002734958	1.268997139	1.354620684	0.577482395	1.635468242	0.166862303	2.542082841	102.0179
H5434_801_0	2009	5																																Coin		Coin		Coin	Coin		Coin	Coin					Coin						Coin	Coin	Coin																																																											0		275.9077344		40.03966194		8.62547636	24.83769031		5.234498617	25.1038623					41.04422173						241.1969822	58.59044003	38.90745721																			7.9% coinsurance		17.3% coinsurance		23.1% coinsurance	23.1% coinsurance		23.1% coinsurance	23.1% coinsurance					23.1% coinsurance						23.1% coinsurance	23.1% coinsurance	23.1% coinsurance																																																											0.078935812		0.172888957		0.231	0.231		0.231	0.231					0.231						0.231	0.231	0.231																			21.779	0	6.922415374	0	1.992485039	5.737506462	0	1.209169181	5.798992191	0	0	0	0	9.481215219	0	0	0	0	0	55.71650288	13.53439165	8.987622616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.1593	0	0	21.779	0	6.922415374	0	1.992485039	5.737506462	0	1.209169181	5.798992191	0	0	0	0	9.481215219	0	0	0	0	0	55.71650288	13.53439165	8.987622616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.1593		7.9% coinsurance		17.3% coinsurance		23.1% coinsurance	23.1% coinsurance		23.1% coinsurance	23.1% coinsurance					23.1% coinsurance						23.1% coinsurance	23.1% coinsurance	23.1% coinsurance																			2.4199		0.7692		0.2214	0.6375		0.1344	0.6443					1.0535						6.1907	1.5038	0.9986																			14.5733	0	0	24.1989	0	7.691572637	0	2.213872266	6.37500718	0	1.343521312	6.443324657	0	0	0	0	10.53468358	0	0	0	0	0	61.90722542	15.03821294	9.986247351	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.7326
H5434_802_0	2009	5																																Coin		Coin		Coin	Coin		Coin	Coin					Coin						Coin	Coin	Coin																																																											0		275.9077344		40.03966194		8.62547636	24.83769031		5.234498617	25.1038623					41.04422173						241.1969822	58.59044003	38.90745721																			7.9% coinsurance		17.3% coinsurance		23.1% coinsurance	23.1% coinsurance		23.1% coinsurance	23.1% coinsurance					23.1% coinsurance						23.1% coinsurance	23.1% coinsurance	23.1% coinsurance																																																											0.078935812		0.172888957		0.231	0.231		0.231	0.231					0.231						0.231	0.231	0.231																			21.779	0	6.922415374	0	1.992485039	5.737506462	0	1.209169181	5.798992191	0	0	0	0	9.481215219	0	0	0	0	0	55.71650288	13.53439165	8.987622616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.1593	0	0	21.779	0	6.922415374	0	1.992485039	5.737506462	0	1.209169181	5.798992191	0	0	0	0	9.481215219	0	0	0	0	0	55.71650288	13.53439165	8.987622616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.1593		7.9% coinsurance		17.3% coinsurance		23.1% coinsurance	23.1% coinsurance		23.1% coinsurance	23.1% coinsurance					23.1% coinsurance						23.1% coinsurance	23.1% coinsurance	23.1% coinsurance																			2.4199		0.7692		0.2214	0.6375		0.1344	0.6443					1.0535						6.1907	1.5038	0.9986																			14.5733	0	0	24.1989	0	7.691572637	0	2.213872266	6.37500718	0	1.343521312	6.443324657	0	0	0	0	10.53468358	0	0	0	0	0	61.90722542	15.03821294	9.986247351	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.7326
H5434_803_0	2009	5																																Coin		Coin		Coin	Coin		Coin	Coin					Coin						Coin	Coin	Coin																																																											0		275.9077344		40.03966194		8.62547636	24.83769031		5.234498617	25.1038623					41.04422173						241.1969822	58.59044003	38.90745721																			7.9% coinsurance		17.3% coinsurance		23.1% coinsurance	23.1% coinsurance		23.1% coinsurance	23.1% coinsurance					23.1% coinsurance						23.1% coinsurance	23.1% coinsurance	23.1% coinsurance																																																											0.078935812		0.172888957		0.231	0.231		0.231	0.231					0.231						0.231	0.231	0.231																			21.779	0	6.922415374	0	1.992485039	5.737506462	0	1.209169181	5.798992191	0	0	0	0	9.481215219	0	0	0	0	0	55.71650288	13.53439165	8.987622616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.1593	0	0	21.779	0	6.922415374	0	1.992485039	5.737506462	0	1.209169181	5.798992191	0	0	0	0	9.481215219	0	0	0	0	0	55.71650288	13.53439165	8.987622616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.1593		7.9% coinsurance		17.3% coinsurance		23.1% coinsurance	23.1% coinsurance		23.1% coinsurance	23.1% coinsurance					23.1% coinsurance						23.1% coinsurance	23.1% coinsurance	23.1% coinsurance																			2.4199		0.7692		0.2214	0.6375		0.1344	0.6443					1.0535						6.1907	1.5038	0.9986																			14.5733	0	0	24.1989	0	7.691572637	0	2.213872266	6.37500718	0	1.343521312	6.443324657	0	0	0	0	10.53468358	0	0	0	0	0	61.90722542	15.03821294	9.986247351	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.7326
H5434_804_0	2009	6																																Coin		Coin		Coin	Coin		Coin	Coin					Coin						Coin	Coin	Coin																																																											0		275.9077344		40.03966194		8.62547636	24.83769031		5.234498617	25.1038623					41.04422173						241.1969822	58.59044003	38.90745721																			7.9% coinsurance		17.3% coinsurance		23.1% coinsurance	23.1% coinsurance		23.1% coinsurance	23.1% coinsurance					23.1% coinsurance						23.1% coinsurance	23.1% coinsurance	23.1% coinsurance																																																											0.078935812		0.172888957		0.231	0.231		0.231	0.231					0.231						0.231	0.231	0.231																			21.779	0	6.922415374	0	1.992485039	5.737506462	0	1.209169181	5.798992191	0	0	0	0	9.481215219	0	0	0	0	0	55.71650288	13.53439165	8.987622616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.1593	0	0	21.779	0	6.922415374	0	1.992485039	5.737506462	0	1.209169181	5.798992191	0	0	0	0	9.481215219	0	0	0	0	0	55.71650288	13.53439165	8.987622616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.1593		7.9% coinsurance		17.3% coinsurance		23.1% coinsurance	23.1% coinsurance		23.1% coinsurance	23.1% coinsurance					23.1% coinsurance						23.1% coinsurance	23.1% coinsurance	23.1% coinsurance																			2.4199		0.7692		0.2214	0.6375		0.1344	0.6443					1.0535						6.1907	1.5038	0.9986																			14.5733	0	0	24.1989	0	7.691572637	0	2.213872266	6.37500718	0	1.343521312	6.443324657	0	0	0	0	10.53468358	0	0	0	0	0	61.90722542	15.03821294	9.986247351	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.7326
H5434_805_0	2009	6																																Coin		Coin		Coin	Coin		Coin	Coin					Coin						Coin	Coin	Coin																																																											0		275.9077344		40.03966194		8.62547636	24.83769031		5.234498617	25.1038623					41.04422173						241.1969822	58.59044003	38.90745721																			7.9% coinsurance		17.3% coinsurance		23.1% coinsurance	23.1% coinsurance		23.1% coinsurance	23.1% coinsurance					23.1% coinsurance						23.1% coinsurance	23.1% coinsurance	23.1% coinsurance																																																											0.078935812		0.172888957		0.231	0.231		0.231	0.231					0.231						0.231	0.231	0.231																			21.779	0	6.922415374	0	1.992485039	5.737506462	0	1.209169181	5.798992191	0	0	0	0	9.481215219	0	0	0	0	0	55.71650288	13.53439165	8.987622616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.1593	0	0	21.779	0	6.922415374	0	1.992485039	5.737506462	0	1.209169181	5.798992191	0	0	0	0	9.481215219	0	0	0	0	0	55.71650288	13.53439165	8.987622616	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	131.1593		7.9% coinsurance		17.3% coinsurance		23.1% coinsurance	23.1% coinsurance		23.1% coinsurance	23.1% coinsurance					23.1% coinsurance						23.1% coinsurance	23.1% coinsurance	23.1% coinsurance																			2.4199		0.7692		0.2214	0.6375		0.1344	0.6443					1.0535						6.1907	1.5038	0.9986																			14.5733	0	0	24.1989	0	7.691572637	0	2.213872266	6.37500718	0	1.343521312	6.443324657	0	0	0	0	10.53468358	0	0	0	0	0	61.90722542	15.03821294	9.986247351	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.7326
H5435_001_0	2009	4																					2900											D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1861.021973	39.34054571	1140.631605	2666.500357	135.8808706	21.95692211	8.367869867	479.7201739	301.9932851	9592.623156	39.28958821	0	0.396181093	1153.393589	5139.605514	4631.430864	233.2092685	418.4862795	0	0	23.1199714	1048.391533	0	0	147.9890135	0	18.41008798	0	98.4	0											"$100 Days 1-29 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$100 Days 1-29 (1b); $0 n/c (1b1, 1b2)"	"$50 Days 1-58 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $0 n/c (4b)"	$75 (9b)	$0/$10 (8a1); $10 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$15 (3, 9d); $60 (5); $75 (9a); $40/$30 (9c)"	"$5 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$15 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$15 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$15 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$15 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											98.67557038	100	50	0	150	0.2	0.082907194	50	75	4	0.181986311	0	0.2	26.83068877	3.717211497	15	37.5	15	0	0	0.2	14.15875954	0	0	15	0	15	0	0	0											75.98577917	76.99263557	38.49631778	0	115.4889534	0.153985271	0.063832433	38.49631778	57.74447668	3.079705423	0.140116057	0	0.153985271	20.6941821	3.717211497	15	37.5	11.54889534	0	0	0.153985271	14.15875954	0	0	15	0	15	0	0	0											11.7843	0.252411025	3.659176394	0	1.307728294	3.381042604	0.534141496	1.538955022	1.453203684	2.461871129	5.505102195	0	0.061006053	1.989044748	1.592083392	5.78928858	0.728778964	0.40275452	0	0	3.560135064	1.236993635	0	0	0.184986267	0	0.02301261	0	0	0	0	0	0	0	0	0	0	0	0	0	47.446	0	11.3156	11.7843	0.252411025	3.659176394	0	1.307728294	3.381042604	0.534141496	1.538955022	1.453203684	2.461871129	5.505102195	0	0.061006053	1.989044748	1.592083392	5.78928858	0.728778964	0.40275452	0	0	3.560135064	1.236993635	0	0	0.184986267	0	0.02301261	0	0	0	0	0	0	0	0	0	0	0	0	0	47.446		"$0 n/c (1a, 1a1, 1a2, 1a3, 13c)"	"$0 n/c (1b, 1b1, 1b2)"	"$0 n/c (2a, 2a1, 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)"	$0 n/c (9b)	"$0 n/c (8a1, 8a2)"	"$0 n/c (8b1, 8b2, 8b3)"	Included in h.5.	$0 n/c (12)	"$0 n/c (3, 5, 9a, 9c, 9d)"	"$0 n/c (7a, 7a1, 14b, 14b1, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1)"	"$0 n/c (7e, 7h)"	"$0 n/c (7c, 7i)"	Included in h.2.	$0 n/c (7g)	"$0 n/c (15, 15a1, 15a2)"	"$0 n/c (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 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	11.7843	0.252411025	3.659176394	0	1.307728294	3.381042604	0.534141496	1.538955022	1.453203684	2.461871129	5.505102195	0	0.061006053	1.989044748	1.592083392	5.78928858	0.728778964	0.40275452	0	0	3.560135064	1.236993635	0	0	0.184986267	0	0.02301261	0	0	0	0	0	0	0	0	0	0	0	0	0	47.446
H5435_002_0	2009	4																					3200											D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1765.152279	44.16279783	1288.775523	1725.997023	147.1801874	20.50686516	7.880405658	537.0540803	349.7592309	9694.77443	42.8970848	0	0.332069239	1257.289988	5238.260034	4826.538195	270.2029658	453.6106306	0	0	20.20702124	1053.560785	0	0	147.9890135	0	18.41008798	0	98.4	0											"$150 Days 1-22 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$150 Days 1-22 (1b); $0 n/c (1b1, 1b2)"	"$75 Days 1-43 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $0 n/c (4b)"	$125 (9b)	$0/$10 (8a1); $10 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$15 (3, 9d); $60 (5); $125 (9a); $40/$30 (9c)"	"$5 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$15 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$15 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$15 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$15 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											148.0098742	150	75	0	150	0.2	0.086856709	50	125	4	0.1781724	0	0.2	44.32678563	3.692512494	15	37.5	15	0	0	0.2	14.05489017	0	0	15	0	15	0	0	0											108.8599017	110.3081042	55.15405209	0	110.3081042	0.147077472	0.063873326	36.76936806	91.92342016	2.941549445	0.131025731	0	0.147077472	32.69594444	3.692512494	15	37.5	11.03081042	0	0	0.147077472	14.05489017	0	0	15	0	15	0	0	0											16.0129	0.405959542	5.923432694	0	1.35293062	3.016097892	0.503347718	1.645594929	2.679255395	2.376471529	5.620621912	0	0.048839904	3.425690299	1.611861718	6.033172744	0.844384268	0.416974406	0	0	2.971997606	1.233973427	0	0	0.184986267	0	0.02301261	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3315	0	16.6789	16.0129	0.405959542	5.923432694	0	1.35293062	3.016097892	0.503347718	1.645594929	2.679255395	2.376471529	5.620621912	0	0.048839904	3.425690299	1.611861718	6.033172744	0.844384268	0.416974406	0	0	2.971997606	1.233973427	0	0	0.184986267	0	0.02301261	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3315		"$0 n/c (1a, 1a1, 1a2, 1a3, 13c)"	"$0 n/c (1b, 1b1, 1b2)"	"$0 n/c (2a, 2a1, 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)"	$0 n/c (9b)	"$0 n/c (8a1, 8a2)"	"$0 n/c (8b1, 8b2, 8b3)"	Included in h.5.	$0 n/c (12)	"$0 n/c (3, 5, 9a, 9c, 9d)"	"$0 n/c (7a, 7a1, 14b, 14b1, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1)"	"$0 n/c (7e, 7h)"	"$0 n/c (7c, 7i)"	Included in h.2.	$0 n/c (7g)	"$0 n/c (15, 15a1, 15a2)"	"$0 n/c (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 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	16.0129	0.405959542	5.923432694	0	1.35293062	3.016097892	0.503347718	1.645594929	2.679255395	2.376471529	5.620621912	0	0.048839904	3.425690299	1.611861718	6.033172744	0.844384268	0.416974406	0	0	2.971997606	1.233973427	0	0	0.184986267	0	0.02301261	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3315
H5435_003_0	2009	5																					3350											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2017.409847	57.43760569	1350.99079	2888.238493	193.5176003	22.76005883	9.812833248	523.4930939	37.87674412	9236.738209	40.83554915	0	0.371431298	26.44006258	5387.266013	4494.853163	241.5778003	386.9703456	0	0	22.19153626	999.773662	0	0	147.9890135	0	18.41008798	0	98.4	0											"$195 Days 1-18 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$195 Days 1-18 (1b); $0 n/c (1b1, 1b2)"	"$95 Days 1-28 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $0 n/c (4b)"	20% (9b)	$0/$10 (8a1); $10 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											192.3992981	195	75.92328607	0	150	0.2	0.089097715	50	0.2	4	0.18170695	0	0.2	0.198949422	7.701358062	20	37.5	20	0	0	0.2	18.83440703	0	0	20	0	20	0	0	0											132.074931	133.8440161	52.11219244	0	102.9569355	0.137275914	0.061154851	34.3189785	0.137275914	2.74551828	0.124719938	0	0.137275914	0.13707991	7.701358062	20	37.5	13.7275914	0	0	0.137275914	18.83440703	0	0	20	0	20	0	0	0											22.2041	0.640639985	5.866924338	0	1.660331591	3.124407879	0.600102359	1.497145686	5.199564668	2.1133028	5.093007161	0	0.050988571	3.624401405	3.457438712	7.491421938	0.754930626	0.442680899	0	0	3.046363423	1.569178674	0	0	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7143	0	25.1814	22.2041	0.640639985	5.866924338	0	1.660331591	3.124407879	0.600102359	1.497145686	5.199564668	2.1133028	5.093007161	0	0.050988571	3.624401405	3.457438712	7.491421938	0.754930626	0.442680899	0	0	3.046363423	1.569178674	0	0	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7143		"$0 n/c (1a, 1a1, 1a2, 1a3, 13c)"	"$0 n/c (1b, 1b1, 1b2)"	"$0 n/c (2a, 2a1, 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)"	$0 n/c (9b)	"$0 n/c (8a1, 8a2)"	"$0 n/c (8b1, 8b2, 8b3)"	Included in h.5.	$0 n/c (12)	"$0 n/c (3, 5, 9a, 9c, 9d)"	"$0 n/c (7a, 7a1, 14b, 14b1, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1)"	"$0 n/c (7e, 7h)"	"$0 n/c (7c, 7i)"	Included in h.2.	$0 n/c (7g)	"$0 n/c (15, 15a1, 15a2)"	"$0 n/c (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 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	22.2041	0.640639985	5.866924338	0	1.660331591	3.124407879	0.600102359	1.497145686	5.199564668	2.1133028	5.093007161	0	0.050988571	3.624401405	3.457438712	7.491421938	0.754930626	0.442680899	0	0	3.046363423	1.569178674	0	0	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7143
H5435_013_0	2009	6																					3450											D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1266.66198	38.8816132	785.8716314	640.7185791	104.6072587	14.0383877	5.669654737	391.6107775	347.8357188	10099.49197	47.11836764	0	0.059102574	1023.029258	5891.967621	4510.670699	194.5554771	486.2419507	0	0	15.88823945	1033.90709	0	0	147.9890135	0	18.41008798	0	98.4	0											"$110 Days 1-32 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$110 Days 1-32 (1b); $0 n/c (1b1, 1b2)"	"$75 Days 1-46 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $0 n/c (4b)"	$100 (9b)	$0/$10 (8a1); $10 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); $100 (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											108.6859884	110	75	0	150	0.2	0.088997942	50	100	4	0.173510588	0	0.2	35.6886381	6.934157688	20	37.5	20	0	0	0.2	18.4330507	0	0	20	0	20	0	0	0											89.92818573	91.00044941	62.04576096	0	124.0915219	0.165455363	0.073625933	41.36384064	82.72768128	3.309107251	0.143541286	0	0.165455363	29.54823047	6.934157688	20	37.5	16.54553626	0	0	0.165455363	18.4330507	0	0	20	0	20	0	0	0											9.4924	0.29485369	4.063333616	0	1.081739495	2.322726527	0.417433622	1.349877149	2.397970207	2.785025175	6.763431077	0	0.009778838	2.519058692	3.404652715	7.517784498	0.607985866	0.670427819	0	0	2.628794418	1.588171817	0	0	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	50.1928	0	7.6783	9.4924	0.29485369	4.063333616	0	1.081739495	2.322726527	0.417433622	1.349877149	2.397970207	2.785025175	6.763431077	0	0.009778838	2.519058692	3.404652715	7.517784498	0.607985866	0.670427819	0	0	2.628794418	1.588171817	0	0	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	50.1928		"$0 n/c (1a, 1a1, 1a2, 1a3, 13c)"	"$0 n/c (1b, 1b1, 1b2)"	"$0 n/c (2a, 2a1, 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)"	$0 n/c (9b)	"$0 n/c (8a1, 8a2)"	"$0 n/c (8b1, 8b2, 8b3)"	Included in h.5.	$0 n/c (12)	"$0 n/c (3, 5, 9a, 9c, 9d)"	"$0 n/c (7a, 7a1, 14b, 14b1, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1)"	"$0 n/c (7e, 7h)"	"$0 n/c (7c, 7i)"	Included in h.2.	$0 n/c (7g)	"$0 n/c (15, 15a1, 15a2)"	"$0 n/c (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 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	9.4924	0.29485369	4.063333616	0	1.081739495	2.322726527	0.417433622	1.349877149	2.397970207	2.785025175	6.763431077	0	0.009778838	2.519058692	3.404652715	7.517784498	0.607985866	0.670427819	0	0	2.628794418	1.588171817	0	0	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	50.1928
H5435_014_0	2009	6																					3200											D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1766.020321	48.58180472	982.5936527	1446.583677	134.9858285	18.43562239	7.516586333	509.3681208	335.2314267	9873.301091	44.304988	0	0.092987846	1159.246139	5533.025305	5068.901864	210.6158494	475.2029432	0	0	21.23664944	987.0803678	0	0	147.9890135	0	18.41008798	0	98.4	0											"$150 Days 1-22 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$150 Days 1-22 (1b); $0 n/c (1b1, 1b2)"	"$75 Days 1-43 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $0 n/c (4b)"	$125 (9b)	$0/$8 (8a1); $8 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$15 (3, 9d); $60 (5); $125 (9a); $40/$30 (9c)"	"$5 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$15 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$15 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$15 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$15 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											148.0694695	150	75	0	150	0.2	0.083798418	50	125	3.2	0.181813101	0	0.2	44.23837382	3.484306415	15	37.5	15	0	0	0.2	13.76965166	0	0	15	0	15	0	0	0											110.5725548	111.9981989	55.99909945	0	111.9981989	0.149330932	0.062568479	37.33273297	93.33183241	2.38929491	0.135751599	0	0.149330932	33.06994566	3.484306415	15	37.5	11.19981989	0	0	0.149330932	13.76965166	0	0	15	0	15	0	0	0											16.2728	0.453422886	4.585363306	0	1.259847473	2.75300867	0.470301377	1.584675336	2.607313612	1.965852337	6.01447295	0	0.013885962	3.194683903	1.606562964	6.33612733	0.658174529	0.443515615	0	0	3.17128865	1.132646069	0	0	0.184986267	0	0.02301261	0	0	0	0	0	0	0	0	0	0	0	0	0	54.7319	0	15.1895	16.2728	0.453422886	4.585363306	0	1.259847473	2.75300867	0.470301377	1.584675336	2.607313612	1.965852337	6.01447295	0	0.013885962	3.194683903	1.606562964	6.33612733	0.658174529	0.443515615	0	0	3.17128865	1.132646069	0	0	0.184986267	0	0.02301261	0	0	0	0	0	0	0	0	0	0	0	0	0	54.7319		"$0 n/c (1a, 1a1, 1a2, 1a3, 13c)"	"$0 n/c (1b, 1b1, 1b2)"	"$0 n/c (2a, 2a1, 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)"	$0 n/c (9b)	"$0 n/c (8a1, 8a2)"	"$0 n/c (8b1, 8b2, 8b3)"	Included in h.5.	$0 n/c (12)	"$0 n/c (3, 5, 9a, 9c, 9d)"	"$0 n/c (7a, 7a1, 14b, 14b1, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1)"	"$0 n/c (7e, 7h)"	"$0 n/c (7c, 7i)"	Included in h.2.	$0 n/c (7g)	"$0 n/c (15, 15a1, 15a2)"	"$0 n/c (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 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	16.2728	0.453422886	4.585363306	0	1.259847473	2.75300867	0.470301377	1.584675336	2.607313612	1.965852337	6.01447295	0	0.013885962	3.194683903	1.606562964	6.33612733	0.658174529	0.443515615	0	0	3.17128865	1.132646069	0	0	0.184986267	0	0.02301261	0	0	0	0	0	0	0	0	0	0	0	0	0	54.7319
H5435_017_0	2009	4																					3600											A	A	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	414.2101599	6.476100461	1316.105459	2607.099742	167.7043666	23.37236973	9.284073451	525.9451981	38.17558391	9785.729905	42.56757461	0	0.415347673	28.65310697	5550.077117	4871.927899	257.2214055	431.9719046	0	0	23.51020183	1079.992377	0	0	147.9890135	0	18.41008798	0	98.4	0											"$500 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$500 (1b); $0 n/c (1b1, 1b2)"	"$50 Days 1-72 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $0 n/c (4b)"	20% (9b)	$0/$10 (8a1); $10 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											467.2566549	500	50	0	150	0.2	0.08733224	50	0.2	4	0.179986261	0	0.2	0.198687613	7.445663433	25	37.5	25	0	0	0.2	23.55221527	0	0	25	0	25	0	0	0											358.882007	383.9677669	38.39677669	0	115.1903301	0.153587107	0.06706553	38.39677669	0.153587107	3.071742135	0.138217846	0	0.153587107	0.152818766	7.445663433	25	37.5	19.19838835	0	0	0.153587107	23.55221527	0	0	25	0	25	0	0	0											12.3877	0.207217819	4.211183951	0	1.609826778	3.589694646	0.622641311	1.682883361	5.863277483	2.504936573	5.883598457	0	0.063792047	4.378732454	3.443667187	10.14984979	0.803816892	0.691097032	0	0	3.610863879	2.119684412	0	0	0.308310445	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1711	0	14.2844	12.3877	0.207217819	4.211183951	0	1.609826778	3.589694646	0.622641311	1.682883361	5.863277483	2.504936573	5.883598457	0	0.063792047	4.378732454	3.443667187	10.14984979	0.803816892	0.691097032	0	0	3.610863879	2.119684412	0	0	0.308310445	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1711		"$0 n/c (1a, 1a1, 1a2, 1a3, 13c)"	"$0 n/c (1b, 1b1, 1b2)"	"$0 n/c (2a, 2a1, 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)"	$0 n/c (9b)	"$0 n/c (8a1, 8a2)"	"$0 n/c (8b1, 8b2, 8b3)"	Included in h.5.	$0 n/c (12)	"$0 n/c (3, 5, 9a, 9c, 9d)"	"$0 n/c (7a, 7a1, 14b, 14b1, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1)"	"$0 n/c (7e, 7h)"	"$0 n/c (7c, 7i)"	Included in h.2.	$0 n/c (7g)	"$0 n/c (15, 15a1, 15a2)"	"$0 n/c (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 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	12.3877	0.207217819	4.211183951	0	1.609826778	3.589694646	0.622641311	1.682883361	5.863277483	2.504936573	5.883598457	0	0.063792047	4.378732454	3.443667187	10.14984979	0.803816892	0.691097032	0	0	3.610863879	2.119684412	0	0	0.308310445	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1711
H5435_018_0	2009	5																					3600											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2183.793197	64.50237987	1478.028834	2760.460854	185.7960644	25.39823633	9.478396762	541.0459217	32.41736157	10170.72948	40.76533945	0	0.565612888	29.08320936	5181.049676	4822.918056	246.8133137	397.2894326	0	0	22.57826666	1035.744078	0	0	147.9890135	0	18.41008798	0	98.4	0											"$220 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$220 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $0 n/c (4b)"	20% (9b)	$0/$10 (8a1); $10 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											216.855762	220	85.36789939	0	150	0.2	0.092510065	50	0.2	4	0.179965214	0	0.2	0.198436809	7.503111316	25	37.5	25	0	0	0.2	23.66556739	0	0	25	0	25	0	0	0											146.4159702	148.5233058	57.63237558	0	101.2658903	0.135021187	0.062454094	33.75529678	0.135021187	2.700423742	0.121495584	0	0.135021187	0.134063669	7.503111316	25	37.5	16.87764839	0	0	0.135021187	23.66556739	0	0	25	0	25	0	0	0											26.6452	0.798342224	7.098526073	0	1.567900324	3.429300019	0.591964684	1.521930471	4.377030642	2.288773281	4.952808732	0	0.076369724	3.899001753	3.239499371	10.04774595	0.771291605	0.558775946	0	0	3.048544368	2.042622606	0	0	0.308310445	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	77.3023	0	29.2778	26.6452	0.798342224	7.098526073	0	1.567900324	3.429300019	0.591964684	1.521930471	4.377030642	2.288773281	4.952808732	0	0.076369724	3.899001753	3.239499371	10.04774595	0.771291605	0.558775946	0	0	3.048544368	2.042622606	0	0	0.308310445	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	77.3023		"$0 n/c (1a, 1a1, 1a2, 1a3, 13c)"	"$0 n/c (1b, 1b1, 1b2)"	"$0 n/c (2a, 2a1, 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)"	$0 n/c (9b)	"$0 n/c (8a1, 8a2)"	"$0 n/c (8b1, 8b2, 8b3)"	Included in h.5.	$0 n/c (12)	"$0 n/c (3, 5, 9a, 9c, 9d)"	"$0 n/c (7a, 7a1, 14b, 14b1, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1)"	"$0 n/c (7e, 7h)"	"$0 n/c (7c, 7i)"	Included in h.2.	$0 n/c (7g)	"$0 n/c (15, 15a1, 15a2)"	"$0 n/c (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 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	26.6452	0.798342224	7.098526073	0	1.567900324	3.429300019	0.591964684	1.521930471	4.377030642	2.288773281	4.952808732	0	0.076369724	3.899001753	3.239499371	10.04774595	0.771291605	0.558775946	0	0	3.048544368	2.042622606	0	0	0.308310445	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	77.3023
H5435_019_0	2009	5																					3900											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2238.06399	44.19612095	1326.776732	2518.552385	200.5120746	21.5466942	9.437461437	525.3858708	38.32014697	10008.73923	46.51994888	0	0.333507377	32.15326026	5247.826613	4910.64879	282.8129165	495.8565737	0	0	20.10419758	1025.640971	0	0	147.9890135	0	18.41008798	0	98.4	0											"$240 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$240 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $0 n/c (4b)"	20% (9b)	$0/$10 (8a1); $10 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$15 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											236.703322	240	85.36789939	0	150	0.2	0.07697729	50	0.2	4	0.177050445	0	0.2	0.198022028	11.22840206	30	37.5	30	0	0	0.2	28.27796347	0	0	30	0	30	0	0	0											161.5036279	163.7380571	58.24155829	0	102.3362857	0.136448381	0.052517133	34.11209524	0.136448381	2.728967619	0.120791233	0	0.136448381	0.135331363	11.22840206	30	37.5	20.46725714	0	0	0.136448381	28.27796347	0	0	30	0	30	0	0	0											30.1213	0.603048915	6.439462032	0	1.709971746	2.940011539	0.495628414	1.493501072	5.228722012	2.276127105	5.619201969	0	0.045506542	4.351344535	4.910392264	12.27662198	0.883790364	0.845735333	0	0	2.74318521	2.416919825	0	0	0.369972534	0	0.04602522	0	0	0	0	0	0	0	0	0	0	0	0	0	85.8165	0	30.2185	30.1213	0.603048915	6.439462032	0	1.709971746	2.940011539	0.495628414	1.493501072	5.228722012	2.276127105	5.619201969	0	0.045506542	4.351344535	4.910392264	12.27662198	0.883790364	0.845735333	0	0	2.74318521	2.416919825	0	0	0.369972534	0	0.04602522	0	0	0	0	0	0	0	0	0	0	0	0	0	85.8165		"$0 n/c (1a, 1a1, 1a2, 1a3, 13c)"	"$0 n/c (1b, 1b1, 1b2)"	"$0 n/c (2a, 2a1, 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)"	$0 n/c (9b)	"$0 n/c (8a1, 8a2)"	"$0 n/c (8b1, 8b2, 8b3)"	Included in h.5.	$0 n/c (12)	"$0 n/c (3, 5, 9a, 9c, 9d)"	"$0 n/c (7a, 7a1, 14b, 14b1, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1)"	"$0 n/c (7e, 7h)"	"$0 n/c (7c, 7i)"	Included in h.2.	$0 n/c (7g)	"$0 n/c (15, 15a1, 15a2)"	"$0 n/c (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 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	30.1213	0.603048915	6.439462032	0	1.709971746	2.940011539	0.495628414	1.493501072	5.228722012	2.276127105	5.619201969	0	0.045506542	4.351344535	4.910392264	12.27662198	0.883790364	0.845735333	0	0	2.74318521	2.416919825	0	0	0.369972534	0	0.04602522	0	0	0	0	0	0	0	0	0	0	0	0	0	85.8165
H5435_020_0	2009	4																					2400											A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	397.6010241	7.029964364	1608.536102	2186.770891	184.4465839	25.62633898	9.747545235	554.3274035	391.0679741	13006.87606	58.09705925	0	0.287754566	1660.511347	6481.675407	6825.551094	305.6564609	565.9118602	0	0	60.81698531	1312.86091	0	0	147.9890135	0	18.41008798	0	98.4	0											"$150 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$150 (1b); $0 n/c (1b1, 1b2)"	"$50 Days 1-48 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $0 n/c (4b)"	$100 (9b)	$0/$10 (8a1); $10 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$15 (3, 9d); $60 (5); $100 (9a); $40/$30 (9c)"	"$5 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$15 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$15 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$15 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$15 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											143.1288745	150	50	0	150	0.2	0.09161166	50	100	4	0.179018267	0	0.2	35.27145287	3.613223398	15	37.5	15	0	0	0.2	14.01621093	0	0	15	0	15	0	0	0											98.14953001	102.7666895	34.25556315	0	102.7666895	0.137022253	0.06276418	34.25556315	68.5111263	2.740445052	0.122647431	0	0.137022253	24.47159367	3.613223398	15	37.5	10.27666895	0	0	0.137022253	14.01621093	0	0	15	0	15	0	0	0											3.252	0.060203847	4.591775834	0	1.5795804	3.511378694	0.611796683	1.582399781	2.232708947	2.970385762	7.12545507	0	0.039428779	3.386279914	1.951645103	8.531938867	0.95517644	0.484640737	0	0	8.333280324	1.53344462	0	0	0.184986267	0	0.02301261	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9415	0	18.2087	3.252	0.060203847	4.591775834	0	1.5795804	3.511378694	0.611796683	1.582399781	2.232708947	2.970385762	7.12545507	0	0.039428779	3.386279914	1.951645103	8.531938867	0.95517644	0.484640737	0	0	8.333280324	1.53344462	0	0	0.184986267	0	0.02301261	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9415		"$0 n/c (1a, 1a1, 1a2, 1a3, 13c)"	"$0 n/c (1b, 1b1, 1b2)"	"$0 n/c (2a, 2a1, 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)"	$0 n/c (9b)	"$0 n/c (8a1, 8a2)"	"$0 n/c (8b1, 8b2, 8b3)"	Included in h.5.	$0 n/c (12)	"$0 n/c (3, 5, 9a, 9c, 9d)"	"$0 n/c (7a, 7a1, 14b, 14b1, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1)"	"$0 n/c (7e, 7h)"	"$0 n/c (7c, 7i)"	Included in h.2.	$0 n/c (7g)	"$0 n/c (15, 15a1, 15a2)"	"$0 n/c (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 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	3.252	0.060203847	4.591775834	0	1.5795804	3.511378694	0.611796683	1.582399781	2.232708947	2.970385762	7.12545507	0	0.039428779	3.386279914	1.951645103	8.531938867	0.95517644	0.484640737	0	0	8.333280324	1.53344462	0	0	0.184986267	0	0.02301261	0	0	0	0	0	0	0	0	0	0	0	0	0	52.9415
H5435_022_0	2009	6																					3900											A	A	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	324.2578692	3.676040637	1141.721275	866.6287023	110.840559	16.36616704	6.064514565	429.4997209	49.46703237	10843.95927	48.8042432	0	0.128101401	32.20060623	5771.564515	5310.104267	205.3930045	373.8925738	0	0	20.44328096	1004.573053	0	0	147.9890135	0	18.41008798	0	98.4	0											"$750 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$750 (1b); $0 n/c (1b1, 1b2)"	"$75 Days 1-52 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $0 n/c (4b)"	20% (9b)	$0/$10 (8a1); $10 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											706.9353604	750	75	0	150	0.2	0.091742587	50	0.2	4	0.179935928	0	0.2	0.197238222	6.759693652	25	37.5	25	0	0	0.2	22.34642431	0	0	25	0	25	0	0	0											542.231178	575.1774568	57.51774568	0	115.0354914	0.153380655	0.07035769	38.34516379	0.153380655	3.067613103	0.137993452	0	0.153380655	0.151483705	6.759693652	25	37.5	19.17258189	0	0	0.153380655	22.34642431	0	0	25	0	25	0	0	0											14.6519	0.176197975	5.472436159	0	1.062549848	2.510253423	0.426685237	1.372436429	7.587285834	2.772089295	6.734666009	0	0.019648277	4.877867122	3.251167334	11.06271722	0.641853139	0.597373833	0	0	3.135603828	1.870717974	0	0	0.308310445	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5701	0	15.6098	14.6519	0.176197975	5.472436159	0	1.062549848	2.510253423	0.426685237	1.372436429	7.587285834	2.772089295	6.734666009	0	0.019648277	4.877867122	3.251167334	11.06271722	0.641853139	0.597373833	0	0	3.135603828	1.870717974	0	0	0.308310445	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5701		"$0 n/c (1a, 1a1, 1a2, 1a3, 13c)"	"$0 n/c (1b, 1b1, 1b2)"	"$0 n/c (2a, 2a1, 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)"	$0 n/c (9b)	"$0 n/c (8a1, 8a2)"	"$0 n/c (8b1, 8b2, 8b3)"	Included in h.5.	$0 n/c (12)	"$0 n/c (3, 5, 9a, 9c, 9d)"	"$0 n/c (7a, 7a1, 14b, 14b1, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1)"	"$0 n/c (7e, 7h)"	"$0 n/c (7c, 7i)"	Included in h.2.	$0 n/c (7g)	"$0 n/c (15, 15a1, 15a2)"	"$0 n/c (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 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	14.6519	0.176197975	5.472436159	0	1.062549848	2.510253423	0.426685237	1.372436429	7.587285834	2.772089295	6.734666009	0	0.019648277	4.877867122	3.251167334	11.06271722	0.641853139	0.597373833	0	0	3.135603828	1.870717974	0	0	0.308310445	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5701
H5435_023_0	2009	7																					3350											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1366.34196	29.91567483	1065.015849	808.4051016	103.3938446	14.23952498	5.276483275	400.7321775	43.03921874	10115.41848	42.4625533	0	0.11145573	28.01641556	5402.549462	4954.015927	191.5938766	348.7729674	0	0	17.78685316	937.0817963	0	0	147.9890135	0	18.41008798	0	98.4	0											"$195 Days 1-18 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$195 Days 1-18 (1b); $0 n/c (1b1, 1b2)"	"$95 Days 1-28 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $0 n/c (4b)"	20% (9b)	$0/$10 (8a1); $10 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											192.5776327	195	75.92328607	0	150	0.2	0.091742587	50	0.2	4	0.182120336	0	0.2	0.196911804	6.736243758	20	37.5	20	0	0	0.2	17.87713945	0	0	20	0	20	0	0	0											142.4666466	144.2386249	56.15933529	0	110.9527884	0.147937051	0.067860639	36.9842628	0.147937051	2.958741024	0.134711728	0	0.147937051	0.145917445	6.736243758	20	37.5	14.79370512	0	0	0.147937051	17.87713945	0	0	20	0	20	0	0	0											16.2215	0.359582983	4.984215179	0	0.95598628	2.106553337	0.358065525	1.235065347	6.367095107	2.494075304	5.72020391	0	0.016488432	4.088083789	3.032740841	8.256693211	0.598730864	0.429970369	0	0	2.631334607	1.396028495	0	0	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	61.5298	0	16.8682	16.2215	0.359582983	4.984215179	0	0.95598628	2.106553337	0.358065525	1.235065347	6.367095107	2.494075304	5.72020391	0	0.016488432	4.088083789	3.032740841	8.256693211	0.598730864	0.429970369	0	0	2.631334607	1.396028495	0	0	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	61.5298		"$0 n/c (1a, 1a1, 1a2, 1a3, 13c)"	"$0 n/c (1b, 1b1, 1b2)"	"$0 n/c (2a, 2a1, 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)"	$0 n/c (9b)	"$0 n/c (8a1, 8a2)"	"$0 n/c (8b1, 8b2, 8b3)"	Included in h.5.	$0 n/c (12)	"$0 n/c (3, 5, 9a, 9c, 9d)"	"$0 n/c (7a, 7a1, 14b, 14b1, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1)"	"$0 n/c (7e, 7h)"	"$0 n/c (7c, 7i)"	Included in h.2.	$0 n/c (7g)	"$0 n/c (15, 15a1, 15a2)"	"$0 n/c (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 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	16.2215	0.359582983	4.984215179	0	0.95598628	2.106553337	0.358065525	1.235065347	6.367095107	2.494075304	5.72020391	0	0.016488432	4.088083789	3.032740841	8.256693211	0.598730864	0.429970369	0	0	2.631334607	1.396028495	0	0	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	61.5298
H5435_024_0	2009	7																					3600											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1723.914961	44.47315026	1211.122122	1702.060963	159.5371375	20.96684514	7.085288603	459.2691012	37.54704118	9588.560126	41.8485952	0	0.089510039	26.55359684	5964.14007	4766.140761	228.4716231	425.0567144	0	0	18.95995716	928.9679157	0	0	147.9890135	0	18.41008798	0	98.4	0											"$220 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$220 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $0 n/c (4b)"	20% (9b)	$0/$10 (8a1); $10 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											217.0039834	220	85.36789939	0	150	0.2	0.075191106	50	0.2	4	0.182148337	0	0.2	0.197715627	7.191465637	25	37.5	25	0	0	0.2	22.98187076	0	0	25	0	25	0	0	0											154.8825914	157.0031581	60.92286276	0	107.0476078	0.142730144	0.053660187	35.68253594	0.142730144	2.854602875	0.129990291	0	0.142730144	0.141359607	7.191465637	25	37.5	17.84126797	0	0	0.142730144	22.98187076	0	0	25	0	25	0	0	0											22.2504	0.581868754	6.148752237	0	1.42317241	2.99260082	0.380197912	1.365657184	5.359094585	2.280960942	5.439911082	0	0.012775781	3.753606023	3.574242364	9.929459919	0.713973822	0.631962562	0	0	2.706157411	1.779118381	0	0	0.308310445	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	71.6705	0	22.1866	22.2504	0.581868754	6.148752237	0	1.42317241	2.99260082	0.380197912	1.365657184	5.359094585	2.280960942	5.439911082	0	0.012775781	3.753606023	3.574242364	9.929459919	0.713973822	0.631962562	0	0	2.706157411	1.779118381	0	0	0.308310445	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	71.6705		"$0 n/c (1a, 1a1, 1a2, 1a3, 13c)"	"$0 n/c (1b, 1b1, 1b2)"	"$0 n/c (2a, 2a1, 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)"	$0 n/c (9b)	"$0 n/c (8a1, 8a2)"	"$0 n/c (8b1, 8b2, 8b3)"	Included in h.5.	$0 n/c (12)	"$0 n/c (3, 5, 9a, 9c, 9d)"	"$0 n/c (7a, 7a1, 14b, 14b1, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1)"	"$0 n/c (7e, 7h)"	"$0 n/c (7c, 7i)"	Included in h.2.	$0 n/c (7g)	"$0 n/c (15, 15a1, 15a2)"	"$0 n/c (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 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	22.2504	0.581868754	6.148752237	0	1.42317241	2.99260082	0.380197912	1.365657184	5.359094585	2.280960942	5.439911082	0	0.012775781	3.753606023	3.574242364	9.929459919	0.713973822	0.631962562	0	0	2.706157411	1.779118381	0	0	0.308310445	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	71.6705
H5435_025_0	2009	6																					3900											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1463.761607	32.04865073	1140.951062	866.0440688	110.7657852	16.34409304	6.056335001	429.2103337	49.4003133	10836.64386	48.73841807	0	0.127928623	32.1571754	5767.765593	5306.528721	205.254445	373.6403434	0	0	20.41570792	1003.895361	0	0	147.9890135	0	18.41008798	0	98.4	0											"$240 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$240 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $0 n/c (4b)"	20% (9b)	$0/$10 (8a1); $10 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$15 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											237.0010623	240	85.36789939	0	150	0.2	0.091742587	50	0.2	4	0.179956371	0	0.2	0.197796044	10.13937415	30	37.5	30	0	0	0.2	26.81570917	0	0	30	0	30	0	0	0											173.1662158	175.3366429	62.36717037	0	109.5854018	0.146113869	0.067024321	36.52846727	0.146113869	2.922277381	0.131470609	0	0.146113869	0.144759424	10.13937415	30	37.5	21.91708036	0	0	0.146113869	26.81570917	0	0	30	0	30	0	0	0											21.1228	0.468275236	5.929824105	0	1.01152609	2.388098671	0.405921744	1.306532969	7.21807091	2.638973271	6.407669481	0	0.018692146	4.655054178	4.873461113	13.2663218	0.641420141	0.682425453	0	0	2.983018074	2.243347171	0	0	0.369972534	0	0.04602522	0	0	0	0	0	0	0	0	0	0	0	0	0	78.6775	0	21.094	21.1228	0.468275236	5.929824105	0	1.01152609	2.388098671	0.405921744	1.306532969	7.21807091	2.638973271	6.407669481	0	0.018692146	4.655054178	4.873461113	13.2663218	0.641420141	0.682425453	0	0	2.983018074	2.243347171	0	0	0.369972534	0	0.04602522	0	0	0	0	0	0	0	0	0	0	0	0	0	78.6775		"$0 n/c (1a, 1a1, 1a2, 1a3, 13c)"	"$0 n/c (1b, 1b1, 1b2)"	"$0 n/c (2a, 2a1, 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)"	$0 n/c (9b)	"$0 n/c (8a1, 8a2)"	"$0 n/c (8b1, 8b2, 8b3)"	Included in h.5.	$0 n/c (12)	"$0 n/c (3, 5, 9a, 9c, 9d)"	"$0 n/c (7a, 7a1, 14b, 14b1, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1)"	"$0 n/c (7e, 7h)"	"$0 n/c (7c, 7i)"	Included in h.2.	$0 n/c (7g)	"$0 n/c (15, 15a1, 15a2)"	"$0 n/c (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 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	21.1228	0.468275236	5.929824105	0	1.01152609	2.388098671	0.405921744	1.306532969	7.21807091	2.638973271	6.407669481	0	0.018692146	4.655054178	4.873461113	13.2663218	0.641420141	0.682425453	0	0	2.983018074	2.243347171	0	0	0.369972534	0	0.04602522	0	0	0	0	0	0	0	0	0	0	0	0	0	78.6775
H5435_027_0	2009	6																					2850											A	A	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	333.3815598	3.779473925	1173.846051	891.0131596	113.9592959	15.72723751	5.827758002	441.5697608	386.2201999	11149.07732	46.89894232	0	0.123100366	1452.579129	5930.013605	5459.236592	211.1721772	384.4128433	0	0	19.6451823	1032.838871	0	0	147.9890135	0	18.41008798	0	98.4	0											"$200 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$200 (1b); $0 n/c (1b1, 1b2)"	"$75 Days 1-38 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $0 n/c (4b)"	$180 (9b)	$0/$10 (8a1); $10 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$15 (3, 9d); $60 (5); $180 (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$15 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$15 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$15 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$15 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											188.7682026	200	75	0	150	0.2	0.091742587	50	180	4	0.182052981	0	0.2	63.06097157	6.764192038	15	37.5	15	0	0	0.2	13.40785458	0	0	15	0	15	0	0	0											144.1800371	152.6726258	57.25223466	0	114.5044693	0.152672626	0.070032908	38.16815644	137.4053632	3.053452515	0.138972533	0	0.152672626	48.19980036	6.764192038	15	37.5	11.45044693	0	0	0.152672626	13.40785458	0	0	15	0	15	0	0	0											4.0056	0.048085184	5.600442466	0	1.087404058	2.401118646	0.40813484	1.404491976	4.422393903	2.836931516	6.5176648	0	0.018794056	5.834502001	3.342645901	6.82404574	0.659913054	0.366808239	0	0	2.999281566	1.154012782	0	0	0.184986267	0	0.02301261	0	0	0	0	0	0	0	0	0	0	0	0	0	50.1403	0	11.752	4.0056	0.048085184	5.600442466	0	1.087404058	2.401118646	0.40813484	1.404491976	4.422393903	2.836931516	6.5176648	0	0.018794056	5.834502001	3.342645901	6.82404574	0.659913054	0.366808239	0	0	2.999281566	1.154012782	0	0	0.184986267	0	0.02301261	0	0	0	0	0	0	0	0	0	0	0	0	0	50.1403		"$0 n/c (1a, 1a1, 1a2, 1a3, 13c)"	"$0 n/c (1b, 1b1, 1b2)"	"$0 n/c (2a, 2a1, 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)"	$0 n/c (9b)	"$0 n/c (8a1, 8a2)"	"$0 n/c (8b1, 8b2, 8b3)"	Included in h.5.	$0 n/c (12)	"$0 n/c (3, 5, 9a, 9c, 9d)"	"$0 n/c (7a, 7a1, 14b, 14b1, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1)"	"$0 n/c (7e, 7h)"	"$0 n/c (7c, 7i)"	Included in h.2.	$0 n/c (7g)	"$0 n/c (15, 15a1, 15a2)"	"$0 n/c (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 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	4.0056	0.048085184	5.600442466	0	1.087404058	2.401118646	0.40813484	1.404491976	4.422393903	2.836931516	6.5176648	0	0.018794056	5.834502001	3.342645901	6.82404574	0.659913054	0.366808239	0	0	2.999281566	1.154012782	0	0	0.184986267	0	0.02301261	0	0	0	0	0	0	0	0	0	0	0	0	0	50.1403
H5435_030_0	2009	6																					3600											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1637.169143	35.84536021	1276.116181	968.6417647	123.8878823	18.58705525	6.887468946	479.9950717	56.17970666	12120.42922	55.42697702	0	0.145484756	36.57022719	6434.440734	5934.003539	229.570336	417.9044169	0	0	23.21743336	1122.823895	0	0	147.9890135	0	18.41008798	0	98.4	0											"$220 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$220 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $0 n/c (4b)"	20% (9b)	$0/$10 (8a1); $10 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											217.2573158	220	85.36789939	0	150	0.2	0.091742587	50	0.2	4	0.179456279	0	0.2	0.197179255	6.777037452	25	37.5	25	0	0	0.2	22.34642431	0	0	25	0	25	0	0	0											149.8106251	151.6779207	58.85647944	0	103.4167641	0.137889019	0.063251476	34.47225471	0.137889019	2.757780377	0.123725251	0	0.137889019	0.136234132	6.777037452	25	37.5	17.23612736	0	0	0.137889019	22.34642431	0	0	25	0	25	0	0	0											20.4388	0.453079142	6.258975483	0	1.067673659	2.562950811	0.435642578	1.378876031	7.74656463	2.785456821	6.857716657	0	0.02006075	4.982113165	3.633870487	12.36250737	0.7174073	0.600254479	0	0	3.201429106	2.090924932	0	0	0.308310445	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	77.9409	0	26.4612	20.4388	0.453079142	6.258975483	0	1.067673659	2.562950811	0.435642578	1.378876031	7.74656463	2.785456821	6.857716657	0	0.02006075	4.982113165	3.633870487	12.36250737	0.7174073	0.600254479	0	0	3.201429106	2.090924932	0	0	0.308310445	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	77.9409		"$0 n/c (1a, 1a1, 1a2, 1a3, 13c)"	"$0 n/c (1b, 1b1, 1b2)"	"$0 n/c (2a, 2a1, 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)"	$0 n/c (9b)	"$0 n/c (8a1, 8a2)"	"$0 n/c (8b1, 8b2, 8b3)"	Included in h.5.	$0 n/c (12)	"$0 n/c (3, 5, 9a, 9c, 9d)"	"$0 n/c (7a, 7a1, 14b, 14b1, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1)"	"$0 n/c (7e, 7h)"	"$0 n/c (7c, 7i)"	Included in h.2.	$0 n/c (7g)	"$0 n/c (15, 15a1, 15a2)"	"$0 n/c (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 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	20.4388	0.453079142	6.258975483	0	1.067673659	2.562950811	0.435642578	1.378876031	7.74656463	2.785456821	6.857716657	0	0.02006075	4.982113165	3.633870487	12.36250737	0.7174073	0.600254479	0	0	3.201429106	2.090924932	0	0	0.308310445	0	0.03835435	0	0	0	0	0	0	0	0	0	0	0	0	0	77.9409
H5435_849_0	2009	5																					7200											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1804.423573	14.86185922	765.0654559	1107.261346	117.4674457	22.45060946	7.353129135	305.3216007	49.81848615	12293.03188	55.02211791	0	0.415272722	29.40796268	6133.812209	6347.07	130.3738947	998.6283492	0	0	35.12599563	1528.000849	0	0	0	0	0	0	0	0											"$400 Days 1-18 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$400 Days 1-18 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-45 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $0 n/c (4b)"	30% (9b)	$0/$10 (8a1); $10 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											394.8781577	400	160	0	150	0.2	0.113136325	50	0.3	4	0.240822857	0	0.2	0.296413921	13.37772635	38.67841508	37.5	40	0	0	0.2	37.61160451	0	0	0	0	0	0	0	0											298.4827203	302.3399889	120.9359956	0	113.3774959	0.151169994	0.085514088	37.79249862	0.226754992	3.023399889	0.18202595	0	0.151169994	0.22434937	13.37772635	38.67841508	37.5	30.23399889	0	0	0.151169994	37.61160451	0	0	0	0	0	0	0	0											44.8824	0.374444529	7.710329383	0	1.10984707	3.393858507	0.628796135	0.961572181	11.29659041	3.097229269	10.01545326	0	0.062776775	6.597657906	6.838038434	20.457884	0.407418421	2.516044034	0	0	5.309996565	4.789213635	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.4496	0	31.6268	44.8824	0.374444529	7.710329383	0	1.10984707	3.393858507	0.628796135	0.961572181	11.29659041	3.097229269	10.01545326	0	0.062776775	6.597657906	6.838038434	20.457884	0.407418421	2.516044034	0	0	5.309996565	4.789213635	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.4496		"$0 n/c (1a, 1a1, 1a2, 1a3, 13c)"	"$0 n/c (1b, 1b1, 1b2)"	"$0 n/c (2a, 2a1, 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)"	$0 n/c (9b)	"$0 n/c (8a1, 8a2)"	"$0 n/c (8b1, 8b2, 8b3)"	Included in h.5.	$0 n/c (12)	"$0 n/c (3, 5, 9a, 9c, 9d)"	"$0 n/c (7a, 7a1, 14b, 14b1, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1)"	"$0 n/c (7e, 7h)"	"$0 n/c (7c, 7i)"	Included in h.2.	$0 n/c (7g)	"$0 n/c (15, 15a1, 15a2)"	"$0 n/c (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 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	44.8824	0.374444529	7.710329383	0	1.10984707	3.393858507	0.628796135	0.961572181	11.29659041	3.097229269	10.01545326	0	0.062776775	6.597657906	6.838038434	20.457884	0.407418421	2.516044034	0	0	5.309996565	4.789213635	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.4496
H5435_850_0	2009	5																					7830											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2080.382548	19.00440249	968.4171975	1167.626424	155.3145184	26.64415095	6.819281604	334.2011385	54.51174529	12743.02566	63.63533319	0	0.590441413	37.87404137	6440.733042	6763.389146	162.0821816	1198.372002	0	0	46.14403214	1554.689623	0	0	0	0	0	0	0	0											"$435 Days 1-18 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$435 Days 1-18 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-49 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $0 n/c (4b)"	30% (9b)	$0/$10 (8a1); $10 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											429.4181166	435	160	0	150	0.2	0.121959279	50	0.3	4	0.244794233	0	0.2	0.296021765	14.00899776	39.09793932	37.5	40	0	0	0.2	37.31510959	0	0	0	0	0	0	0	0											312.9963951	317.0509751	116.6164506	0	109.3279225	0.145770563	0.088890364	36.44264082	0.218655845	2.915411266	0.178418966	0	0.145770563	0.215756297	14.00899776	39.09793932	37.5	29.15411266	0	0	0.145770563	37.31510959	0	0	0	0	0	0	0	0											54.2627	0.502113695	9.411114692	0	1.415017802	3.883932892	0.606168424	1.014931004	11.91931173	3.095930047	11.35375037	0	0.086068977	8.171562915	7.519017897	22.03621487	0.506506817	2.911456029	0	0	6.726441557	4.834451139	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.2567	0	42.913	54.2627	0.502113695	9.411114692	0	1.415017802	3.883932892	0.606168424	1.014931004	11.91931173	3.095930047	11.35375037	0	0.086068977	8.171562915	7.519017897	22.03621487	0.506506817	2.911456029	0	0	6.726441557	4.834451139	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.2567		"$0 n/c (1a, 1a1, 1a2, 1a3, 13c)"	"$0 n/c (1b, 1b1, 1b2)"	"$0 n/c (2a, 2a1, 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)"	$0 n/c (9b)	"$0 n/c (8a1, 8a2)"	"$0 n/c (8b1, 8b2, 8b3)"	Included in h.5.	$0 n/c (12)	"$0 n/c (3, 5, 9a, 9c, 9d)"	"$0 n/c (7a, 7a1, 14b, 14b1, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1)"	"$0 n/c (7e, 7h)"	"$0 n/c (7c, 7i)"	Included in h.2.	$0 n/c (7g)	"$0 n/c (15, 15a1, 15a2)"	"$0 n/c (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 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	54.2627	0.502113695	9.411114692	0	1.415017802	3.883932892	0.606168424	1.014931004	11.91931173	3.095930047	11.35375037	0	0.086068977	8.171562915	7.519017897	22.03621487	0.506506817	2.911456029	0	0	6.726441557	4.834451139	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.2567
H5435_869_0	2009	5																					7200											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2016.88235	18.42432489	938.8578823	1131.98658	150.5738025	25.04243831	6.409340618	324.0610098	51.23477274	12354.06612	59.80989632	0	0.554947038	35.59724408	6253.346942	6556.948005	157.1348941	1161.793701	0	0	43.37008451	1507.235322	0	0	0	0	0	0	0	0											"$400 Days 1-18 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$400 Days 1-18 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-45 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $0 n/c (4b)"	30% (9b)	$0/$10 (8a1); $10 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											394.8713261	400	160	0	150	0.2	0.121959279	50	0.3	4	0.245664145	0	0.2	0.296098694	13.98837298	38.94938419	37.5	40	0	0	0.2	36.71860132	0	0	0	0	0	0	0	0											287.5718158	291.2928581	116.5171432	0	109.2348218	0.145646429	0.088814667	36.41160726	0.218469644	2.912928581	0.178900527	0	0.145646429	0.215628587	13.98837298	38.94938419	37.5	29.12928581	0	0	0.145646429	36.71860132	0	0	0	0	0	0	0	0											48.3332	0.447239521	9.11608653	0	1.370658541	3.647341715	0.569243455	0.983298518	11.19324254	2.998876023	10.700022	0	0.080826054	7.675783439	7.289512452	21.28242391	0.491046544	2.820185064	0	0	6.316697937	4.611964409	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.9277	0	39.6491	48.3332	0.447239521	9.11608653	0	1.370658541	3.647341715	0.569243455	0.983298518	11.19324254	2.998876023	10.700022	0	0.080826054	7.675783439	7.289512452	21.28242391	0.491046544	2.820185064	0	0	6.316697937	4.611964409	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.9277		"$0 n/c (1a, 1a1, 1a2, 1a3, 13c)"	"$0 n/c (1b, 1b1, 1b2)"	"$0 n/c (2a, 2a1, 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)"	$0 n/c (9b)	"$0 n/c (8a1, 8a2)"	"$0 n/c (8b1, 8b2, 8b3)"	Included in h.5.	$0 n/c (12)	"$0 n/c (3, 5, 9a, 9c, 9d)"	"$0 n/c (7a, 7a1, 14b, 14b1, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1)"	"$0 n/c (7e, 7h)"	"$0 n/c (7c, 7i)"	Included in h.2.	$0 n/c (7g)	"$0 n/c (15, 15a1, 15a2)"	"$0 n/c (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 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	48.3332	0.447239521	9.11608653	0	1.370658541	3.647341715	0.569243455	0.983298518	11.19324254	2.998876023	10.700022	0	0.080826054	7.675783439	7.289512452	21.28242391	0.491046544	2.820185064	0	0	6.316697937	4.611964409	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.9277
H5435_870_0	2009	5																					8100											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2096.019351	19.1472455	975.696123	1176.402668	156.4819107	27.04618769	6.92217855	336.7091299	55.33427946	12838.80621	64.59553425	0	0.599350653	38.44552725	6488.08943	6814.224887	163.3004418	1207.379339	0	0	46.8403049	1566.375155	0	0	0	0	0	0	0	0											"$450 Days 1-18 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$450 Days 1-18 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-51 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $0 n/c (4b)"	30% (9b)	$0/$10 (8a1); $10 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											444.223884	450	160	0	150	0.2	0.121959279	50	0.3	4	0.244588107	0	0.2	0.296003536	14.01127391	39.1335198	37.5	40	0	0	0.2	37.31510959	0	0	0	0	0	0	0	0											324.6258889	328.833033	116.9184117	0	109.611011	0.146148015	0.089120533	36.53700367	0.219222022	2.922960294	0.178730331	0	0.146148015	0.216301646	14.01127391	39.1335198	37.5	29.22960294	0	0	0.146148015	37.31510959	0	0	0	0	0	0	0	0											56.7018	0.524687234	9.50640342	0	1.429345037	3.952746636	0.616908239	1.025195226	12.13049263	3.127276731	11.54518123	0	0.087593908	8.315830821	7.575533178	22.22205038	0.510313881	2.94093489	0	0	6.845617567	4.87078838	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	153.9287	0	43.7532	56.7018	0.524687234	9.50640342	0	1.429345037	3.952746636	0.616908239	1.025195226	12.13049263	3.127276731	11.54518123	0	0.087593908	8.315830821	7.575533178	22.22205038	0.510313881	2.94093489	0	0	6.845617567	4.87078838	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	153.9287		"$0 n/c (1a, 1a1, 1a2, 1a3, 13c)"	"$0 n/c (1b, 1b1, 1b2)"	"$0 n/c (2a, 2a1, 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)"	$0 n/c (9b)	"$0 n/c (8a1, 8a2)"	"$0 n/c (8b1, 8b2, 8b3)"	Included in h.5.	$0 n/c (12)	"$0 n/c (3, 5, 9a, 9c, 9d)"	"$0 n/c (7a, 7a1, 14b, 14b1, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14e1, 14f, 14f1, 14g, 14h, 14h1, 14i, 14j)"	"$0 n/c (7b, 7b1, 7d, 7f, 7f1)"	"$0 n/c (7e, 7h)"	"$0 n/c (7c, 7i)"	Included in h.2.	$0 n/c (7g)	"$0 n/c (15, 15a1, 15a2)"	"$0 n/c (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 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	56.7018	0.524687234	9.50640342	0	1.429345037	3.952746636	0.616908239	1.025195226	12.13049263	3.127276731	11.54518123	0	0.087593908	8.315830821	7.575533178	22.22205038	0.510313881	2.94093489	0	0	6.845617567	4.87078838	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	153.9287
H5436_001_0	2009	8																					3350											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																																																			0		1557.929933	2.060433239	668.2531418		209.9561484	0.012290381		157.6208472	361.3355413		983.5732979			783.7165901	3999.904615	9257.002757					2281.489171				0.392158181																"$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											63.56	100	33.11		100	0.1		49.53724139	100		25			19.88545246	10	20					25				20																57.46060248	90.40371693	29.93267067		90.40371693	0.090403717		44.78350748	90.40371693		22.60092923			17.97718815	9.040371693	18.08074339					22.60092923				18.08074339																7.46	0.015522569	1.666883435	0	1.581734684	0.001111096	0	0.588234532	2.722172999	0	1.852472542	0	0	1.17408505	3.013385372	13.94779095	0	0	0	0	4.296981275	0	0	0	0.000590876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.3209	0	4.0677	7.46	0.015522569	1.666883435	0	1.581734684	0.001111096	0	0.588234532	2.722172999	0	1.852472542	0	0	1.17408505	3.013385372	13.94779095	0	0	0	0	4.296981275	0	0	0	0.000590876	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.3209		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										31.098	0.0045	1.6651	0.0037	0.8335	0.0012		0.31	5.396		1.4649			0.9372	2.2508	6.6541					4.1434				0.0002																54.7625	0	0	38.558	0.02000286	3.331957605	0.003679158	2.415214403	0.002304762	0	0.898199003	8.11816369	0	3.317410039	0	0	2.111332941	5.264163549	20.60186039	0	0	0	0	8.44035728	0	0	0	0.000744494	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.0834
H5436_002_0	2009	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																																																			0		1380.827694	0.540018652	704.8845471		226.7361916	0.00059886		145.3445453	307.0228577		803.1687746			374.3941711	3921.42649	8131.323984					2938.523647				0.090655678																"$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											69.04	100	25.27		100	0.1		48.53198709	150		25			19.92737543	10	19.99905046					25				20																69.04	100	25.27		100	0.1		48.53198709	150		25			19.92737543	10	19.99905046					25				20																7.9444	0.004500155	1.484369375	0	1.889468263	5.99E-05	0	0.587821633	3.837785721	0	1.67326828	0	0	0.621724434	3.267855409	13.55156322	0	0	0	0	6.121924265	0	0	0	0.000151093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.9849	0	0	7.9444	0.004500155	1.484369375	0	1.889468263	5.99E-05	0	0.587821633	3.837785721	0	1.67326828	0	0	0.621724434	3.267855409	13.55156322	0	0	0	0	6.121924265	0	0	0	0.000151093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.9849		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										28.783	0.0036	1.5948	0.0197	0.9143	0.0001		0.2844	4.7024		1.2092			0.5347	2.2283	5.7777					5.3621																				51.4142	0	0	36.7274	0.008081854	3.079208784	0.01966736	2.803763752	0.00011807	0	0.872262858	8.540141312	0	2.882456043	0	0	1.156396012	5.496112812	19.32922676	0	0	0	0	11.48402811	0	0	0	0.000151093	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.399
H5437_001_0	2009	7																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	5000	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$150/day 1-7	$150/day 1-7	"$0/d 1-10, $75/d 11-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$200 per procedure	$30 per visit	$30 X-ray; $125 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$20 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											108.4282617	108.4282617	47.56208437	20	100	0.2	0.2	47.5	200	30	47.1	30	25	30	20	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											84.60209175	84.60209175	37.11072891	20	100	0.156051735	0.156051735	37.06228704	156.0517349	23.40776024	36.75018357	23.40776024	19.50646686	23.40776024	20	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											12.1227	0	3.670418563	1.506462933	2.003577927	1.08222003	0	0.69148614	4.400019047	1.801018817	12.70523464	0	0.095592334	1.350958047	10.71655122	20.39806951	0	1.478528581	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.937	0	10.6792	12.1227	0	3.670418563	1.506462933	2.003577927	1.08222003	0	0.69148614	4.400019047	1.801018817	12.70523464	0	0.095592334	1.350958047	10.71655122	20.39806951	0	1.478528581	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.937		$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$100 copay	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$50 copay	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$25 copay	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP		Not Covered		$500 ded; 30% coinsurance; $5000 max OOP	0	$500 ded; 30% coinsurance; $5000 max OOP	0	Not Covered												6.1213	0	0.7559	0.1146	0.1666	0.1799	0	0.0943	0.822	0.2802	1.142	0	0.0196	0.2369	0.8367	3.6344	0	0.1077	0	0	0.1625	0	0	0	0.0758	0	0.0048	0	0	0											14.7552	500	8.275408174	18.244	0	4.426274349	1.621059736	2.170225623	1.262149673	0	0.785792615	5.221969962	2.081193786	13.847248	0	0.115182919	1.587838643	11.55325147	24.03248241	0	1.586244167	0	0	1.076717455	0	0	0	0.075809063	0	0.004839087	0	0	0	0	0	0	0	0	0	0	0	0	0	89.6923
H5437_003_0	2009	6																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	5000	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$200/day 1-7	$200/day 1-7	"$0/d 1-10, $75/d 11-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$30 per visit	$30 X-ray; $125 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$20 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											144.5710156	144.5710156	47.56208437	20	100	0.2	0.2	47.5	150	30	47.1	30	25	30	20	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											113.2610634	113.2610634	37.26149554	20	100	0.156685713	0.156685713	37.21285687	117.5142849	23.50285697	36.89948544	23.50285697	19.58571414	23.50285697	20	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											16.2293	0	3.685330063	1.506462933	2.003577927	1.086616674	0	0.694295383	3.313420975	1.808335664	12.75685113	0	0.095980689	1.356446471	10.71655122	20.39806951	0	1.478528581	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.044	0	11.3414	16.2293	0	3.685330063	1.506462933	2.003577927	1.086616674	0	0.694295383	3.313420975	1.808335664	12.75685113	0	0.095980689	1.356446471	10.71655122	20.39806951	0	1.478528581	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.044		$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$100 copay	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$50 copay	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$25 copay	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP		Not Covered		$500 ded; 30% coinsurance; $5000 max OOP	0	$500 ded; 30% coinsurance; $5000 max OOP	0	Not Covered												6.1213	0	0.7559	0.1146	0.1666	0.1799	0	0.0943	0.822	0.2802	1.142	0	0.0196	0.2369	0.8367	3.6344	0	0.1077	0	0	0.1625	0	0	0	0.0758	0	0.0048	0	0	0											14.7552	500	8.275408174	22.3506	0	4.441185849	1.621059736	2.170225623	1.266546317	0	0.788601858	4.13537189	2.088510633	13.89886448	0	0.115571274	1.593327066	11.55325147	24.03248241	0	1.586244167	0	0	1.076717455	0	0	0	0.075809063	0	0.004839087	0	0	0	0	0	0	0	0	0	0	0	0	0	92.7992
H5437_004_0	2009	7																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3500	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$100/day 1-7	$100/day 1-7	"$0/d 1-10, $75/d 11-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$20 per visit	$20 X-ray; $125 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$10 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											72.2855078	72.2855078	47.56208437	20	100	0.2	0.2	47.5	150	20	38.9	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											54.39813717	54.39813717	35.79263491	20	100	0.15050911	0.15050911	35.74591359	112.8818324	15.05091099	29.27402187	15.05091099	15.05091099	15.05091099	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											7.7948	0	3.540053118	1.506462933	2.003577927	1.043781881	0	0.666926026	3.182804811	1.158033645	10.12058392	0	0.073757678	0.868649931	5.358275608	13.59871301	0	0.985685721	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.8163	0	9.3548	7.7948	0	3.540053118	1.506462933	2.003577927	1.043781881	0	0.666926026	3.182804811	1.158033645	10.12058392	0	0.073757678	0.868649931	5.358275608	13.59871301	0	0.985685721	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.8163		$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$100 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$50 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$20 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP		Not Covered		$500 ded; 30% coinsurance; $3500 max OOP	0	$500 ded; 30% coinsurance; $3500 max OOP	0	Not Covered												5.2917	0	0.6534	0.0991	0.1436	0.1555	0	0.0824	0.7106	0.2422	0.9872	0	0.016	0.2048	0.7233	3.1419	0	0.0931	0	0	0.1405	0	0	0	0.0655	0	0.0042	0	0	0											12.755	500	10.08660758	13.0864	0	4.193469708	1.605528725	2.147220091	1.199326121	0	0.749315226	3.893358826	1.400237218	11.10782313	0	0.089773414	1.073426707	6.081580021	16.74056325	0	1.078802889	0	0	1.054688261	0	0	0	0.065534855	0	0.004183258	0	0	0	0	0	0	0	0	0	0	0	0	0	65.5713
H5437_005_0	2009	6																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3500	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$100/day 1-7	$100/day 1-7	"$0/d 1-10, $75/d 11-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$200 per procedure	$20 per visit	$20 X-ray; $125 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$10 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											72.2855078	72.2855078	47.56208437	20	100	0.2	0.2	47.5	200	20	38.9	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											56.11657156	56.11657156	36.92332243	20	100	0.155263685	0.155263685	36.87512519	155.263685	15.5263685	30.19878673	15.5263685	15.5263685	15.5263685	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											8.041	0	3.651883216	1.506462933	2.003577927	1.076754898	0	0.687994186	4.377799271	1.194615869	10.44029265	0	0.07608768	0.896090538	5.358275608	13.59871301	0	0.985685721	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.8094	0	8.7714	8.041	0	3.651883216	1.506462933	2.003577927	1.076754898	0	0.687994186	4.377799271	1.194615869	10.44029265	0	0.07608768	0.896090538	5.358275608	13.59871301	0	0.985685721	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.8094		$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$100 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$50 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$20 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP		Not Covered		$500 ded; 30% coinsurance; $3500 max OOP	0	$500 ded; 30% coinsurance; $3500 max OOP	0	Not Covered												5.2917	0	0.6534	0.0991	0.1436	0.1555	0	0.0824	0.7106	0.2422	0.9872	0	0.016	0.2048	0.7233	3.1419	0	0.0931	0	0	0.1405	0	0	0	0.0655	0	0.0042	0	0	0											12.755	500	10.08660758	13.3327	0	4.305299806	1.605528725	2.147220091	1.232299138	0	0.770383385	5.088353287	1.436819442	11.42753186	0	0.092103416	1.100867314	6.081580021	16.74056325	0	1.078802889	0	0	1.054688261	0	0	0	0.065534855	0	0.004183258	0	0	0	0	0	0	0	0	0	0	0	0	0	67.5644
H5437_006_0	2009	7																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	5000	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$150/day 1-7	$150/day 1-7	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$30 X-ray; $125 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$15 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											108.4282617	108.4282617	47.56208437	0	100	0.2	0.2	47.5	150	0	47.1	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											80.52933605	80.52933605	35.32421359	0	100	0.148539384	0.148539384	35.27810372	111.4045381	0	34.98102495	0	18.56742301	22.28090761	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											11.5391	0	3.493724136	0	2.003577927	1.030121817	0	0.658197907	3.141151168	0	12.09360299	0	0.090990507	1.285922751	8.037413413	20.39806951	0	1.478528581	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.1646	0	11.548	11.5391	0	3.493724136	0	2.003577927	1.030121817	0	0.658197907	3.141151168	0	12.09360299	0	0.090990507	1.285922751	8.037413413	20.39806951	0	1.478528581	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.1646		$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$100 copay	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$50 copay	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$25 copay	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP	$500 ded; 30% coinsurance; $5000 max OOP		Not Covered		$500 ded; 30% coinsurance; $5000 max OOP	0	$500 ded; 30% coinsurance; $5000 max OOP	0	Not Covered												6.1213	0	0.7559	0.1146	0.1666	0.1799	0	0.0943	0.822	0.2802	1.142	0	0.0196	0.2369	0.8367	3.6344	0	0.1077	0	0	0.1625	0	0	0	0.0758	0	0.0048	0	0	0											14.7552	500	8.275408174	17.6604	0	4.249579922	0.114596803	2.170225623	1.21005146	0	0.752504383	3.963102083	0.280174969	13.23561635	0	0.110581092	1.522803347	8.874113664	24.03248241	0	1.586244167	0	0	1.076717455	0	0	0	0.075809063	0	0.004839087	0	0	0	0	0	0	0	0	0	0	0	0	0	80.9199
H5437_007_0	2009	6																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3500	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$100/day 1-7	$100/day 1-7	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$20 X-ray; $125 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$0 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											72.2855078	72.2855078	47.56208437	0	100	0.2	0.2	47.5	150	0	38.9	20	20	20	0	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											54.53763256	54.53763256	35.88441944	0	100	0.150895067	0.150895067	35.83757831	113.1712999	0	29.34909045	0	15.08950666	15.08950666	0	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											7.8148	0	3.549131022	0	2.003577927	1.046458494	0	0.668636252	3.190966608	0	10.14653655	0	0.073946818	0.870877446	0	13.59871301	0	0.985685721	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.8635	0	8.904	7.8148	0	3.549131022	0	2.003577927	1.046458494	0	0.668636252	3.190966608	0	10.14653655	0	0.073946818	0.870877446	0	13.59871301	0	0.985685721	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.8635		$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$100 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$50 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$20 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP		Not Covered		$500 ded; 30% coinsurance; $3500 max OOP	0	$500 ded; 30% coinsurance; $3500 max OOP	0	Not Covered												5.2917	0	0.6534	0.0991	0.1436	0.1555	0	0.0824	0.7106	0.2422	0.9872	0	0.016	0.2048	0.7233	3.1419	0	0.0931	0	0	0.1405	0	0	0	0.0655	0	0.0042	0	0	0											12.755	500	10.08660758	13.1064	0	4.202547612	0.099065792	2.147220091	1.202002734	0	0.751025452	3.901520624	0.242203574	11.13377576	0	0.089962554	1.075654222	0.723304412	16.74056325	0	1.078802889	0	0	1.054688261	0	0	0	0.065534855	0	0.004183258	0	0	0	0	0	0	0	0	0	0	0	0	0	57.6185
H5437_801_0	2009	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																																																			0	Unlimited	324.4168686	0	40.05907725	6.073436586	7.163156903	9.535966519	0	8.428981249	43.56200722	14.84879911	60.52477475	0	3.302769022	12.5542706	44.34369707	192.6177317	0	5.708743703	0	0	8.614565446	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.080178445	0.080178445	0.172349404	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											26.0112	0	6.904158102	0	1.654689245	2.202808266	0	1.947094668	10.06282367	3.430072594	13.98122297	0	0.762939644	2.900036508	10.24339402	44.49469601	0	1.318719795	0	0	1.989964618	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.9039			26.0112	0	6.904158102	0	1.654689245	2.202808266	0	1.947094668	10.06282367	3.430072594	13.98122297	0	0.762939644	2.900036508	10.24339402	44.49469601	0	1.318719795	0	0	1.989964618	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.9039		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.547	0	0.9415	0	0.2256	0.3004	0	0.2655	1.3722	0.4677	1.9065	0	0.104	0.3955	1.3968	6.0675	0	0.1798	0	0	0.2714	0	0	0	0	0	0	0	0	0											17.4414		0	29.5582	0	7.845634207	0	1.880328687	2.503191211	0	2.212607578	11.43502689	3.897809766	15.88775337	0	0.866976868	3.295496032	11.64022048	50.56215456	0	1.498545222	0	0	2.26132343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.3453
H5437_802_0	2009	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																																																			0	Unlimited	337.1402691	0	41.63016598	6.311632481	7.444090859	9.909960393	0	8.759559942	45.27047838	15.43115853	62.89851368	0	3.432301291	13.04664023	46.08282556	200.1720631	0	5.9326366	0	0	8.95242262	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.080409172	0.080409172	0.173717027	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											27.1092	0	7.231868687	0	1.719584988	2.289200851	0	2.023458347	10.45748051	3.564597619	14.52955666	0	0.792861598	3.013773892	10.64513271	46.23974657	0	1.370439055	0	0	2.068009625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.0549			27.1092	0	7.231868687	0	1.719584988	2.289200851	0	2.023458347	10.45748051	3.564597619	14.52955666	0	0.792861598	3.013773892	10.64513271	46.23974657	0	1.370439055	0	0	2.068009625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.0549		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.6967	0	0.9862	0	0.2345	0.3122	0	0.2759	1.426	0.4861	1.9813	0	0.1081	0.411	1.4516	6.3054	0	0.1869	0	0	0.282	0	0	0	0	0	0	0	0	0											18.1438		0	30.8059	0	8.218032598	0	1.95407385	2.601364603	0	2.299384485	11.88350058	4.050679113	16.51085984	0	0.900979089	3.42474306	12.09674171	52.54516656	0	1.557317108	0	0	2.350010938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.1987
H5437_804_0	2009	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																																																			0	Unlimited	324.4168686	0	40.05907725	6.073436586	7.163156903	9.535966519	0	8.428981249	43.56200722	14.84879911	60.52477475	0	3.302769022	12.5542706	44.34369707	192.6177317	0	5.708743703	0	0	8.614565446	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.080178445	0.080178445	0.172349404	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											26.0112	0	6.904158102	0	1.654689245	2.202808266	0	1.947094668	10.06282367	3.430072594	13.98122297	0	0.762939644	2.900036508	10.24339402	44.49469601	0	1.318719795	0	0	1.989964618	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.9039			26.0112	0	6.904158102	0	1.654689245	2.202808266	0	1.947094668	10.06282367	3.430072594	13.98122297	0	0.762939644	2.900036508	10.24339402	44.49469601	0	1.318719795	0	0	1.989964618	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.9039		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.547	0	0.9415	0	0.2256	0.3004	0	0.2655	1.3722	0.4677	1.9065	0	0.104	0.3955	1.3968	6.0675	0	0.1798	0	0	0.2714	0	0	0	0	0	0	0	0	0											17.4414		0	29.5582	0	7.845634207	0	1.880328687	2.503191211	0	2.212607578	11.43502689	3.897809766	15.88775337	0	0.866976868	3.295496032	11.64022048	50.56215456	0	1.498545222	0	0	2.26132343	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.3453
H5439_001_0	2009	5																					1500											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	V	P	V	V	V	V	coin	V	S	O	T	P	V	P	V	P	O	V											13.3871	0	1.9634	0.9894	0.4692	0.6904	0.2129	0.5508	2.7024	0.2401	1.3415	0	0	0.8791	0.5169	2.8762	0	0	0.468	1.359	1.2756	0.049	0	0	0	0	0	0	0	0											29.971	2750	172.2175257	2.225519101	40.527717	13.56148681	139.6345996	9.463130882	2.918889714	160.0035093	305.6003378	3.29088412	18.38790745	0	18.9003277	260.1780718	4241.373491	6107.36741	147.8881283	572.3786249	25.87243967	15.52416816	688.8790495	0	0	0	204.5854218	0	79.79720865	0	850	0											1a:  Acute - $50/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $50/admit for 1-190	2:  Skilled Nursing Services - $50/admit for /2:  Non-Medicare Covered Stay - $50/admit for 0	6:  Home Health Services - $0/visit	10a:  Ambulance - $25/trip	11a:  Durable Medical Equipment - $10/service	11b:  Prosthetics Devices - $10/service/11b:  Medical Supplies - $10/service/11c:  Diabetes Monitoring Supplies - $10/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $25 to $50/visit/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $50/visit/9b:  Ambulatory Surgical Center Services - $50/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $10/visit/8b:  Outpatient Therapeutic Radiological Services - $10/visit/8b:  Outpatient X-Ray Services - $0/visit		12:  Renal Dialysis - $10/service/14i:  Diabetes Monitoring - $10/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $10/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - $25/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $10/visit/7b:  Chiropractic Services - $10/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $10 to $25/visit	15:  Medicare Part B Rx Drugs - $10/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $10/visit		18a:  Routine Hearing Test - $10/visit		14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit	0											50	50	50	0	25	0.1	0.069275651	40.7989228	50	0	0.008185534	0	10	25	10	13.22469552	25	25	0	25	10	0	0	0	10	0	10	0	0	0											44.87464835	50	44.86370141	0	22.4318507	0.089727403	0.062159242	36.60781381	44.86370141	2.64E-19	0.007344667	0	8.972740282	22.4318507	8.972740282	11.86617582	22.4318507	22.4318507	0	22.4318507	8.972740282	0	0	0	8.972740282	0	8.972740282	0	1.19E-17	0											0.644	0.009272996	0.151518616	0	0.261021874	0.849102157	0.181435972	0.48811489	1.142530192	8.67E-19	0.135053066	0	0.014132311	0.486356305	3.171395231	6.039257957	0.276450368	1.069959322	0	0.029019652	0.5150944	0	0	0	0.152974321	0	0.059666636	0	8.40E-19	0	0	0	0	0	0	0	0	0	0	0	15.6764	500	1.9045	14.0311	0.009272996	2.114891031	0.989360962	0.730176814	1.539472793	0.394379846	1.038904599	3.844920149	0.240082251	1.476519386	0	0.014132311	1.365504928	3.688320689	8.915443075	0.276450368	1.069959322	0.468018216	1.388026016	1.790742488	0.049047099	0	0	0.152974321	0	0.059666636	0	8.40E-19	0	0	0	0	0	0	0	0	0	0	0	45.6474		1a:  Acute - 10.0% for 1-90/1a:  Additional Days - 10.0% for 91-999	1b:  Psych - 10.0% for 1-190/ $250 deductible	2:  Skilled Nursing Services - 10.0% for /2:  Non-Medicare Covered Stay - 10.0% for 0	6:  Home Health Services - $0/visit	10a:  Ambulance - $25/trip	11a:  Durable Medical Equipment - 10%	11b:  Prosthetics Devices - 10.0%/11b:  Medical Supplies - 10.0%/11c:  Diabetes Monitoring Supplies - 10.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $25 to $50/visit/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - 10.0%/9b:  Ambulatory Surgical Center Services - 10.0%	8a:  Outpatient Diagnostic Procedures/Tests - 1000.0%/8a:  Outpatient Lab Services - 10.0%	8b:  Outpatient Diagnostic Radiological Services - 10.0%/8b:  Outpatient Therapeutic Radiological Services - 10.0%/8b:  Outpatient X-Ray Services - 10.0%		12:  Renal Dialysis - $10/service/14i:  Diabetes Monitoring - 10.0%/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - 10.0%	9d:  Cardiac Rehabilitation Services - $35/visit/3:  Rehab Services (CORF) - $35/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - 10.0%/17a:  Vision Exams - 10.0%/18a:  Hearing Exams - 10.0%/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - 10.0%/14e:  Prostate Cancer Screening - 10.0%/14f:  Colorectal Screening - 10.0%/14g:  Bone Mass Measurement - 10.0%/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - 10.0%/7b:  Chiropractic Services - $50/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - 10.0%/18a:  Hearing Exams - 10.0%/14d:  Pap Smears and Pelvic Exams Screening - 10.0%/14e:  Prostate Cancer Screening - 10.0%/14f:  Colorectal Screening - 10.0%/14g:  Bone Mass Measurement - 10.0%/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $35/visit/7i:  Physical/Speech Therapy - $35/visit	8b:  Outpatient Diagnostic Radiological Services - 10.0%/8b:  Outpatient Therapeutic Radiological Services - 10.0%/8b:  Outpatient X-Ray Services - 10.0%	9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - 10.0%	15:  Medicare Part B Rx Drugs - 10.0%	13a:  Blood - 10.0%/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - 10.0%		18a:  Routine Hearing Test - 10.0%		14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												5.9641	0.0476	0.9009	0.2179	0.1515	0.2879	0.0848	0.2238	1.104	0.1234	0.5652	0	0.0116	0.4735	1.1129	3.4263	0.0991	0.3099	0.6308	1.3401	0.5496	0.0221	0	0	0.059	0	0.0137	0	0.0276	0											17.7473	750	0.111	19.9952	0.056851426	3.015760208	1.20722959	0.881690361	1.827417532	0.47918163	1.262699544	4.948954682	0.363480156	2.041708441	0	0.025747182	1.839031027	4.801267342	12.34174024	0.375526152	1.379869501	1.098808668	2.72809443	2.340293844	0.071149112	0	0	0.212012311	0	0.073401163	0	0.02755836	0	0	0	0	0	0	0	0	0	0	0	63.3947
H5440_001_0	2009	5																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		536.1246694	23.25	107.1869305	4438.699485	24.58793254	38.76390717	15.06958073	42.68204734	47.4215574	21.41745466	52.18230936	0	1.046196656	28.87600295	41.23335531	206.7521813	14.57	7.660058325	0	0	28.06723833	7.277128943	450.3865197	292.8401477	161.2327045	151.369021	0	0	20.2	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.080188913	0.081218864	0.173064224	0	0.2	0.2	0.2	0.073398875	0.2	0.08	0.2	0	0.2	0.2	0	0.199918127	0.2	0.2	0	0	0.2	0.007097613	0	0	0	0	0	0	0	0											0.080188913	0.081218864	0.173064224	0	0.2	0.2	0.2	0.073398875	0.2	0.08	0.2	0	0.2	0.2	0	0.199918127	0.2	0.2	0	0	0.2	0.007097613	0	0	0	0	0	0	0	0											42.9913	1.888338596	18.5502229	0	4.917586508	7.752781435	3.013916147	3.132814248	9.48431148	1.713396373	10.43646187	0	0.209239331	5.775200591	0	41.33350893	2.914	1.532011665	0	0	5.613447665	0.051650248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	161.3101	0	0	42.9913	1.888338596	18.5502229	0	4.917586508	7.752781435	3.013916147	3.132814248	9.48431148	1.713396373	10.43646187	0	0.209239331	5.775200591	0	41.33350893	2.914	1.532011665	0	0	5.613447665	0.051650248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	161.3101																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	42.9913	1.888338596	18.5502229	0	4.917586508	7.752781435	3.013916147	3.132814248	9.48431148	1.713396373	10.43646187	0	0.209239331	5.775200591	0	41.33350893	2.914	1.532011665	0	0	5.613447665	0.051650248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	161.3101
H5470_002_0	2009	4	r.	s.	t.	u.	v.	w.					Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered						Mental Health (MH)	Therapy (PT/OT/ST)									A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin								O	O	P	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	0				0		261.885933	8.43792	508.777901	727.15889	144.632583	9.857775	3.559968	327.148048	354.617926	626.95597	930.537551	0	0	711.85346	3484.018815	4199.676773	4.471503	195.293498			22.280243								0.05	0.27	19.075781	24.17699	709.900652	1.41	1.23	0.06	2.7				$750/Admit:1a	$750/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$95/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $95 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $50 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$30-$50/Visit:9d. $50 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $30 Partial Hospitalization,8b. $50 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30/Visit:7e, 7h"	"$50/Visit:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a	$0: Nutritional benefit 14a	$0/Proc:12	"$50/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Membership in health club/fitness class 14a	$0: Health Education Materials 14a	$0: Nurse hotline 14a	$0 Corp Health 14a				750.000008	750	43.132793	0	100.000039	0.2	0.199999	50.000004	85.925267	43.978705	47.649309	0	0	42.810046	9.999999	30	30.00065	50.000005			0.199999								0	0	0	49.999772	30.000006	0	0	0	0				750.000008	750	43.132793	0	100.000039	0.2	0.199999	50.000004	85.925267	43.978705	47.649309	0	0	42.810046	9.999999	30	30.00065	50.000005			0.199999								0	0	0	49.999772	30.000006	0	0	0	0				16.3679	0.52737	1.828750991	0	1.205271995	1.971555	0.71199004	1.363116976	2.539219998	2.297725971	3.694955942	0	0	2.539539947	2.903348722	10.49919193	0.011179	0.81372299	0	0	4.45602632	0	0	0	0	0	0	0	0	0	0	0.100736999	1.774751985	0	0	0	0	0	0	0	55.6063	0	0	16.3679	0.52737	1.828750991	0	1.205271995	1.971555	0.71199004	1.363116976	2.539219998	2.297725971	3.694955942	0	0	2.539539947	2.903348722	10.49919193	0.011179	0.81372299	0	0	4.45602632	0	0	0	0	0	0	0	0	0	0	0.100736999	1.774751985	0	0	0	0	0	0	0	55.6063		30% Coins	30% Coins	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins			30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins								0	0		30% Coins	$35/Visit	0	0	0	0				8.0409	0.1151	0.504	0.7647	0.9028	2.1065	0.7607	0.2703	3.6404	0.469	1.9507			1.1018	2.0148	2.4286	0.0026	0.1056			1.5055								0	0		0.0304	0.4105	0	0	0	0				27.1249	500	0	24.4088	0.642442	2.332796991	0.764692	2.108044995	4.078075	1.47272404	1.633381976	6.179576998	2.766687971	5.645619942	0	0	3.641344947	4.918114722	12.92781393	0.013765	0.91931899	0	0	5.96154032	0	0	0	0	0	0	0	0	0	0	0.131185999	2.185278985	0	0	0	0	0	0	0	82.7312
H5470_801_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		261.885933	8.43792	508.777901	727.15889	4.994813	9.857775	3.559968	21.916746	56.337241	626.95597	30.462537	0	0.384396	17.354408	32.693389	74.642838	0.47172	6.302669			22.280243																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000017	1024.000227	43.132793	0	0.2	0.2	0.199999	0.199999	0.199999	0	0.199999	0	0.199999	0.2	0.2	0.2	0.500002	0.2			0.199999																				1024.000017	1024.000227	43.132793	0	0.2	0.2	0.199999	0.199999	0.199999	0	0.199999	0	0.199999	0.2	0.2	0.2	0.500002	0.2			0.199999																				22.3476	0.720036	1.828750991	0	0.9989626	1.971555	0.71199004	4.383327283	11.26739186	0	6.092476937	0	0.076878816	3.4708816	6.5386778	14.9285676	0.235860943	1.2605338	0	0	4.45602632	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.2895	0	0	22.3476	0.720036	1.828750991	0	0.9989626	1.971555	0.71199004	4.383327283	11.26739186	0	6.092476937	0	0.076878816	3.4708816	6.5386778	14.9285676	0.235860943	1.2605338	0	0	4.45602632	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.2895		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4831	0.08	0.2032		0.6333	1.2499	0.4514	0.8256	2.1601		1.1575		0.0145	0.6538	1.3108	2.9928	0.0473	0.2527			0.8933																				15.4093	0	0	24.8307	0.80004	2.031945991	0	1.6322916	3.221495	1.16338504	5.208975283	13.42746186	0	7.249937937	0	0.091359816	4.1246586	7.8495138	17.9213606	0.283145943	1.5132378	0	0	5.34934932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.6988
H5470_802_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		261.885933	8.43792	508.777901	727.15889	4.994813	9.857775	3.559968	21.916746	56.337241	626.95597	30.462537	0	0.384396	17.354408	32.693389	74.642838	0.47172	6.302669			22.280243																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000017	1024.000227	43.132793	0	0.2	0.2	0.199999	0.199999	0.199999	0	0.199999	0	0.199999	0.2	0.2	0.2	0.500002	0.2			0.199999																				1024.000017	1024.000227	43.132793	0	0.2	0.2	0.199999	0.199999	0.199999	0	0.199999	0	0.199999	0.2	0.2	0.2	0.500002	0.2			0.199999																				22.3476	0.720036	1.828750991	0	0.9989626	1.971555	0.71199004	4.383327283	11.26739186	0	6.092476937	0	0.076878816	3.4708816	6.5386778	14.9285676	0.235860943	1.2605338	0	0	4.45602632	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.2895	0	0	22.3476	0.720036	1.828750991	0	0.9989626	1.971555	0.71199004	4.383327283	11.26739186	0	6.092476937	0	0.076878816	3.4708816	6.5386778	14.9285676	0.235860943	1.2605338	0	0	4.45602632	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.2895		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4831	0.08	0.2032		0.6333	1.2499	0.4514	0.8256	2.1601		1.1575		0.0145	0.6538	1.3108	2.9928	0.0473	0.2527			0.8933																				15.4093	0	0	24.8307	0.80004	2.031945991	0	1.6322916	3.221495	1.16338504	5.208975283	13.42746186	0	7.249937937	0	0.091359816	4.1246586	7.8495138	17.9213606	0.283145943	1.5132378	0	0	5.34934932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.6988
H5470_803_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		261.885933	8.43792	508.777901	727.15889	4.994813	9.857775	3.559968	21.916746	56.337241	626.95597	30.462537	0	0.384396	17.354408	32.693389	74.642838	0.47172	6.302669			22.280243																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000017	1024.000227	43.132793	0	0.2	0.2	0.199999	0.199999	0.199999	0	0.199999	0	0.199999	0.2	0.2	0.2	0.500002	0.2			0.199999																				1024.000017	1024.000227	43.132793	0	0.2	0.2	0.199999	0.199999	0.199999	0	0.199999	0	0.199999	0.2	0.2	0.2	0.500002	0.2			0.199999																				22.3476	0.720036	1.828750991	0	0.9989626	1.971555	0.71199004	4.383327283	11.26739186	0	6.092476937	0	0.076878816	3.4708816	6.5386778	14.9285676	0.235860943	1.2605338	0	0	4.45602632	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.2895	0	0	22.3476	0.720036	1.828750991	0	0.9989626	1.971555	0.71199004	4.383327283	11.26739186	0	6.092476937	0	0.076878816	3.4708816	6.5386778	14.9285676	0.235860943	1.2605338	0	0	4.45602632	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.2895		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4831	0.08	0.2032		0.6333	1.2499	0.4514	0.8256	2.1601		1.1575		0.0145	0.6538	1.3108	2.9928	0.0473	0.2527			0.8933																				15.4093	0	0	24.8307	0.80004	2.031945991	0	1.6322916	3.221495	1.16338504	5.208975283	13.42746186	0	7.249937937	0	0.091359816	4.1246586	7.8495138	17.9213606	0.283145943	1.5132378	0	0	5.34934932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.6988
H5470_804_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		261.885933	8.43792	508.777901	727.15889	4.994813	9.857775	3.559968	21.916746	56.337241	626.95597	30.462537	0	0.384396	17.354408	32.693389	74.642838	0.47172	6.302669			22.280243																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000017	1024.000227	43.132793	0	0.2	0.2	0.199999	0.199999	0.199999	0	0.199999	0	0.199999	0.2	0.2	0.2	0.500002	0.2			0.199999																				1024.000017	1024.000227	43.132793	0	0.2	0.2	0.199999	0.199999	0.199999	0	0.199999	0	0.199999	0.2	0.2	0.2	0.500002	0.2			0.199999																				22.3476	0.720036	1.828750991	0	0.9989626	1.971555	0.71199004	4.383327283	11.26739186	0	6.092476937	0	0.076878816	3.4708816	6.5386778	14.9285676	0.235860943	1.2605338	0	0	4.45602632	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.2895	0	0	22.3476	0.720036	1.828750991	0	0.9989626	1.971555	0.71199004	4.383327283	11.26739186	0	6.092476937	0	0.076878816	3.4708816	6.5386778	14.9285676	0.235860943	1.2605338	0	0	4.45602632	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.2895		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4831	0.08	0.2032		0.6333	1.2499	0.4514	0.8256	2.1601		1.1575		0.0145	0.6538	1.3108	2.9928	0.0473	0.2527			0.8933																				15.4093	0	0	24.8307	0.80004	2.031945991	0	1.6322916	3.221495	1.16338504	5.208975283	13.42746186	0	7.249937937	0	0.091359816	4.1246586	7.8495138	17.9213606	0.283145943	1.5132378	0	0	5.34934932	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.6988
H5485_001_0	2009	11																					0											D	D	D		T	Coin	Coin	V	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	1058.782194	28.27535867	835.5341104	0	230.3394427	10.9484473	6.799363469	389.5088962	311.1679887	2139.289098	1342.941055	0	0	445.2195678	3758.248059	3447.634709	149.0161126	1207.135829	1392.225769	3859.47287	0	0	0	0	335.1830801	0	141.3839114	0	0	0											$175/Days 1-10 for IP Medical; $175/Days 1-10 for IP Surgical;	$175/Days 1-10 for IP Psych; $175/Days 1-10 for IP Substance Abuse;	$50/Days 11-30; $75/Days 31-100		$125/Run 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; $40/Visit for Urgent Care; $40/Visit for Urgent Care - Worldwide;	$175/Case for OP Fac - Surgery; $175/Case for OP Fac - ASC	$25/Case for OP Fac - Pathology	$28/Case for OP Fac - Radiology; $25/Case for OP Fac - CT/MRI/PET;15% Coinsurance for Chemo/Radiation Therapy			$5/Case for OP Fac - Occ Therapy; $5/Case for OP Fac - Physical/Speech Therapy; $5/Case for OP Fac - CORF; $5/Service for Prof - CORF; $5/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 OP Psych - Non-Physician; $25/Visit for OP Psych - Psychiatrist; $25/Visit for OP Substance Abuse;	$5/Service for PT/ST (PCP); $5/Service for Occ Therapy (PCP); $5/Service for PT/ST (Specialist); $5/Service for Occ Therapy (Specialist);	$25/Procedure for Prof Radiology (Office);	$25/Visit for Chiropractor; $25/Exam for Vision Exams; $25/Service for Podiatrist; $25/Exam for Hearing/Speech Exams; $25/Procedure for Prof Path (Labs)					$25/Exam for Vision (Refractions)		$25/Exam for Routine Hearing Exams														175	175	57.90719697	0	125	0.2	0.2	47.60897663	175	25	35.49246403	0	0	4.999999999	25	25	24.99999999	5	25	25	0	0	0	0	25	0	25	0	0	0											175	175	57.90719697	0	125	0.2	0.2	47.60897663	175	25	35.49246403	0	0	4.999999999	25	25	24.99999999	5	25	25	0	0	0	0	25	0	25	0	0	0											15.4406	0.412348981	4.031953192	0	2.399369194	2.189689461	1.359872694	1.545343328	4.537866502	4.456852287	3.972023925	0	0	0.185508153	7.829683455	7.182572311	0.310450235	0.502973262	2.900470351	8.04056848	0	0	0	0	0.698298084	0	0.294549815	0	0	0	0	0	0	0	0	0	0	0	0	0	68.291	0	0	15.4406	0.412348981	4.031953192	0	2.399369194	2.189689461	1.359872694	1.545343328	4.537866502	4.456852287	3.972023925	0	0	0.185508153	7.829683455	7.182572311	0.310450235	0.502973262	2.900470351	8.04056848	0	0	0	0	0.698298084	0	0.294549815	0	0	0	0	0	0	0	0	0	0	0	0	0	68.291	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	15.4406	0.412348981	4.031953192	0	2.399369194	2.189689461	1.359872694	1.545343328	4.537866502	4.456852287	3.972023925	0	0	0.185508153	7.829683455	7.182572311	0.310450235	0.502973262	2.900470351	8.04056848	0	0	0	0	0.698298084	0	0.294549815	0	0	0	0	0	0	0	0	0	0	0	0	0	68.291
H5485_801_0	2009	6																					0											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	294.0693862	0	61.016587	0	8.857524502	26.00690123	0	17.88512726	46.73208614	15.25295922	34.84448709	0	0	33.69859241	54.78261549	155.5020624	1.01472991	7.033567823	24.93034815	14.63265669	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;	18% 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 Speclst - Office Visits; 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 - 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 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 Chiropractor; 23% Coinsurance for Vistion Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical (PCP); 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 Part B Rx	23% Coinsurance for Blood Products																			0.078131334	0.078131334	0.183744852	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0											0.078131334	0.078131334	0.183744852	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0											22.976	0	11.21148376	0	2.04608816	6.007594185	0	4.131464397	10.7951119	3.52343358	8.049076517	0	0	7.784374846	12.65478418	35.92097641	0.234402609	1.624754167	5.758910422	3.380143694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.0986	0	0	22.976	0	11.21148376	0	2.04608816	6.007594185	0	4.131464397	10.7951119	3.52343358	8.049076517	0	0	7.784374846	12.65478418	35.92097641	0.234402609	1.624754167	5.758910422	3.380143694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.0986	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.976	0	11.21148376	0	2.04608816	6.007594185	0	4.131464397	10.7951119	3.52343358	8.049076517	0	0	7.784374846	12.65478418	35.92097641	0.234402609	1.624754167	5.758910422	3.380143694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.0986
H5485_802_0	2009	6																					0											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	294.0693862	0	61.016587	0	8.857524502	26.00690123	0	17.88512726	46.73208614	15.25295922	34.84448709	0	0	33.69859241	54.78261549	155.5020624	1.01472991	7.033567823	24.93034815	14.63265669	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;	18% 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 Speclst - Office Visits; 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 - 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 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 Chiropractor; 23% Coinsurance for Vistion Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical (PCP); 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 Part B Rx	23% Coinsurance for Blood Products																			0.078131334	0.078131334	0.183744852	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0											0.078131334	0.078131334	0.183744852	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0											22.976	0	11.21148376	0	2.04608816	6.007594185	0	4.131464397	10.7951119	3.52343358	8.049076517	0	0	7.784374846	12.65478418	35.92097641	0.234402609	1.624754167	5.758910422	3.380143694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.0986	0	0	22.976	0	11.21148376	0	2.04608816	6.007594185	0	4.131464397	10.7951119	3.52343358	8.049076517	0	0	7.784374846	12.65478418	35.92097641	0.234402609	1.624754167	5.758910422	3.380143694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.0986	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.976	0	11.21148376	0	2.04608816	6.007594185	0	4.131464397	10.7951119	3.52343358	8.049076517	0	0	7.784374846	12.65478418	35.92097641	0.234402609	1.624754167	5.758910422	3.380143694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.0986
H5485_803_0	2009	6																					0											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	294.0693862	0	61.016587	0	8.857524502	26.00690123	0	17.88512726	46.73208614	15.25295922	34.84448709	0	0	33.69859241	54.78261549	155.5020624	1.01472991	7.033567823	24.93034815	14.63265669	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;	18% 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 Speclst - Office Visits; 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 - 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 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 Chiropractor; 23% Coinsurance for Vistion Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical (PCP); 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 Part B Rx	23% Coinsurance for Blood Products																			0.078131334	0.078131334	0.183744852	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0											0.078131334	0.078131334	0.183744852	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0											22.976	0	11.21148376	0	2.04608816	6.007594185	0	4.131464397	10.7951119	3.52343358	8.049076517	0	0	7.784374846	12.65478418	35.92097641	0.234402609	1.624754167	5.758910422	3.380143694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.0986	0	0	22.976	0	11.21148376	0	2.04608816	6.007594185	0	4.131464397	10.7951119	3.52343358	8.049076517	0	0	7.784374846	12.65478418	35.92097641	0.234402609	1.624754167	5.758910422	3.380143694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.0986	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.976	0	11.21148376	0	2.04608816	6.007594185	0	4.131464397	10.7951119	3.52343358	8.049076517	0	0	7.784374846	12.65478418	35.92097641	0.234402609	1.624754167	5.758910422	3.380143694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.0986
H5485_804_0	2009	5																					0											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	294.0693862	0	61.016587	0	8.857524502	26.00690123	0	17.88512726	46.73208614	15.25295922	34.84448709	0	0	33.69859241	54.78261549	155.5020624	1.01472991	7.033567823	24.93034815	14.63265669	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;	18% 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 Speclst - Office Visits; 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 - 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 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 Chiropractor; 23% Coinsurance for Vistion Exams; 23% Coinsurance for Podiatrist; 23% Coinsurance for Hearing/Speech Exams; 23% Coinsurance for Misc. Medical (PCP); 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 Part B Rx	23% Coinsurance for Blood Products																			0.078131334	0.078131334	0.183744852	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0											0.078131334	0.078131334	0.183744852	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0	0											22.976	0	11.21148376	0	2.04608816	6.007594185	0	4.131464397	10.7951119	3.52343358	8.049076517	0	0	7.784374846	12.65478418	35.92097641	0.234402609	1.624754167	5.758910422	3.380143694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.0986	0	0	22.976	0	11.21148376	0	2.04608816	6.007594185	0	4.131464397	10.7951119	3.52343358	8.049076517	0	0	7.784374846	12.65478418	35.92097641	0.234402609	1.624754167	5.758910422	3.380143694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.0986	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.976	0	11.21148376	0	2.04608816	6.007594185	0	4.131464397	10.7951119	3.52343358	8.049076517	0	0	7.784374846	12.65478418	35.92097641	0.234402609	1.624754167	5.758910422	3.380143694	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.0986
H5501_001_0	2009	9																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	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	0	0	0											0		0	0	0	0	330.847166	0	0	316.1865377	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											- zero -	- zero -	- zero -	- zero -	"$50 Copay, per Trip"	- zero -	- zero -	"ER: $50 Copay, MC & WW, Choice 1: Urgent Care: $35 Copay, Worldwide: $35 Copay"	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	Varies by Service	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -											0	0	0	0	50	0	0	45.07682801	0	0	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	0	0	45.07682801	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	1.378529858	0	0	1.187723848	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.5663	0		0	0	0	0	1.378529858	0	0	1.187723848	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.5663		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	- zero -	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	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -											2.4295	0.0357	0.3964	1.1243	0.1525	0.2679	0.2193	0.1157	0.8086	0.1186	0.8188	0	0.0047	0.4639	0.4612	3.0336	0.0397	0.109	0.7658	1.0651	0.454	0.0506	0	0	0	0	0	0	0	0											12.9351	0		2.4295	0.035740005	0.396359129	1.124288662	1.531041345	0.267925662	0.219327877	1.303466451	0.808605202	0.118601757	0.818777683	0	0.004725129	0.46389054	0.461166803	3.033648174	0.039730059	0.108965242	0.765838642	1.065112512	0.454000247	0.050624198	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.5013
H5507_001_0	2009	4																					3900											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1903.321035	130.6194087	703.0098103	968.2164934	135.4240663	10.99304958	6.204307487	299.2937446	41.78663527	9638.143915	63.4978284	0	0.677879575	42.72498747	5230.308192	5742.632066	555.0727806	386.8576974	0	0	22.3670313	2180.350213	0	0	279.9345388	0	17.19768195	0	112.7129472	0											"$260 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$260 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$115 Days 1-25 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$10 (8a1); $10 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 25% (9a); $40/$30 (9c)"	"$15 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											256.9239337	260	87.8078022	0	150	0.2	0.063893255	48.38948233	0.25	4	0.184547772	0	0.2	0.243582785	9.881871235	30	37.5	30	0	0	0.2	29.29002588	0	0	30	0	30	0	0	0											172.0002191	174.0417408	58.7777798	0	100.4086966	0.133878262	0.04276959	32.391499	0.167347828	2.677565243	0.123534675	0	0.133878262	0.163222503	9.881871235	30	37.5	20.08173932	0	0	0.133878262	29.29002588	0	0	30	0	30	0	0	0											27.281	1.894435773	3.443446319	0	1.133146165	1.471730373	0.265355685	0.807881086	6.992902639	2.150563262	7.844183577	0	0.090753339	6.973679405	4.307102673	14.35658016	1.734602439	0.647397953	0	0	2.99445928	5.32187618	0	0	0.699836347	0	0.042994205	0	0	0	0	0	0	0	0	0	0	0	0	0	90.4539	0	31.5897	27.281	1.894435773	3.443446319	0	1.133146165	1.471730373	0.265355685	0.807881086	6.992902639	2.150563262	7.844183577	0	0.090753339	6.973679405	4.307102673	14.35658016	1.734602439	0.647397953	0	0	2.99445928	5.32187618	0	0	0.699836347	0	0.042994205	0	0	0	0	0	0	0	0	0	0	0	0	0	90.4539		"30% Days 1-999 (1a); 30% (1a1, 13c); $0 n/c (1a2, 1a3)"	"30% Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"30% Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$10 (8a1); $10 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 9a, 9d); $75 (5); $45/$35 (9c)"	"30% (7a, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	30% (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); 30% (16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.4508	0.0424	0.4767	0.148	0.1274	0.2482	0.1401	0.0908	0.9436	0.2418	1.1329	0	0.0102	0.9657	0.7442	3.6414	0.1944	0.0999	0	0	0.6636	0.4147	0	0	0.0576	0	0.002	0	0	0											11.8366	0	0	28.7318	1.936865201	3.920121202	0.148011487	1.260561282	1.719960525	0.405452951	0.898722202	7.936471822	2.392380493	8.977061994	0	0.100957978	7.939393011	5.051335675	17.99799369	1.929030405	0.747270471	0	0	3.658096473	5.73659875	0	0	0.757408181	0	0.045007357	0	0	0	0	0	0	0	0	0	0	0	0	0	102.2905
H5508_001_0	2009	4																					4000											D	D	D	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																																																			0	0	1721.984727	17.22588184	886.945122	344.7930319	168.8172004	9.99181341	1.004529832	261.49744	368.1998321	7035.195112	2582.820392	0	0	21317.56031	6953.739654	0	212.0724573	0	5001.064038	44627.83832	36.19221832	656.3809649	0	0	385.11639	36.110664	0	0	0	70.66806009											$100 Copay for 1st 5 Days	$100 Copay for 1st 5 Days			$50 Copay	20% Coinsurance	20% Coinsurance	$40 Emergency Room Copy; $50 Urgent Care Copay	$100 Copay for 1st 5 Days						"$10 PCP copay, $25 Specialist Copay"		$25 MHSA Copay			"$25 Chiropractic, $25 Podiatry, $25 Physical Medicine"	20% Coinsurance	$25 Medicare Covered Vision Copay			$20 Non-Medicare Covered Vision Copay																59.05526624	59.67482669	0	0	50	0.2	0.2	42.3	100	0	0	0	0	0	17.2	0	25	0	0	1.135084625	0.2	18.89780761	0	0	20	0	0	0	0	0											59.05526624	59.67482669	0	0	50	0.2	0.2	42.3	100	0	0	0	0	0	17.2	0	25	0	0	1.135084625	0.2	18.89780761	0	0	20	0	0	0	0	0											8.4744	0.085662626	0	0	0.703405002	1.998362682	0.200905966	0.921778476	3.068331934	0	0	0	0	0	9.967026837	0	0.441817619	0	0	4.221364425	7.238443664	1.0336801	0	0	0.64186065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.997		0	8.4744	0.085662626	0	0	0.703405002	1.998362682	0.200905966	0.921778476	3.068331934	0	0	0	0	0	9.967026837	0	0.441817619	0	0	4.221364425	7.238443664	1.0336801	0	0	0.64186065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.997		Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing											2.3229	0.0224	0.8976	0	1.4465	0.728	0.5811	0.1219	0.9537	0.1899	0.2813	0	0	0.6055	0	0	0.2295	0	0.8059	7.0744	0.2752	0.2683	0	0	0.1248	0	0	0	0	0											16.9289			10.7973	0.108053705	0.897588648	0	2.149896829	2.72637721	0.782038704	1.043642633	4.022061434	0.189874535	0.281325301	0	0	0.605509268	9.967026837	0	0.671267969	0	0.805865543	11.29578731	7.513685381	1.301948179	0	0	0.766666888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.9259
H5508_002_0	2009	2																					4000											D	D	D	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																																																			0	0	1512.179231	15.12724017	366.3420482	302.7615974	148.2371019	8.246217746	0.882117554	229.6234064	323.3197989	6177.672205	2267.999322	0	0	18710.93323	6106.56051	0	186.2355161	0	4391.780781	39190.79642	31.78289412	527.1825902	0	0	385.11639	36.110664	0	0	0	62.05308698											$100 Copay for 1st 5 Days	$100 Copay for 1st 5 Days			$50 Ambulance Copay	20% Coinsurance	20% Coinsurance	$40 Emergency Room Copy; $50 Urgent Care Copay	$100 Outpatient Surgery Copay						"$10 PCP Copay, $25 Specialist Copay"		$25 MHSA Copay			"$25 Chiropractic Copay, $25 Podiatry Copay"	20% Coinsurance	$25 Medicare Covered Vision Copay			$20 Non-Medicare Covered Vision Copay																58.96930606	59.67482669	0	0	50	0.2	0.2	42.3	100	0	0	0	0	0	17.2	0	25	0	0	1.135084625	0.2	18.3285377	0	0	20	0	0	0	0	0											58.96930606	59.67482669	0	0	50	0.2	0.2	42.3	100	0	0	0	0	0	17.2	0	25	0	0	1.135084625	0.2	18.3285377	0	0	20	0	0	0	0	0											7.431	0.075226286	0	0	0.617654591	1.649243549	0.176423511	0.809422508	2.694331657	0	0	0	0	0	8.752736731	0	0.387990658	0	0	3.707072537	6.356578825	0.805207165	0	0	0.64186065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.1048		0	7.431	0.075226286	0	0	0.617654591	1.649243549	0.176423511	0.809422508	2.694331657	0	0	0	0	0	8.752736731	0	0.387990658	0	0	3.707072537	6.356578825	0.805207165	0	0	0.64186065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.1048		Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing											2.0476	0.0197	0.7909	0	1.2745	0.6414	0.512	0.1074	0.8403	0.1673	0.2479	0	0	0.5297	1.0528	0	0.2022	0	0.71	5.1802	0.2425	0.2933	0	0	0.1248	0	0	0	0	0											14.9845			9.4786	0.094963366	0.79085498	0	1.892107613	2.290671519	0.688439106	0.916792726	3.534629142	0.167291768	0.247865818	0	0	0.529689356	9.805568858	0	0.590151283	0	0.710019758	8.887265347	6.599084611	1.098555996	0	0	0.766666888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0892
H5508_003_0	2009	4																					4000											D	D	D	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																																																			0	0	1715.723132	17.16324837	883.7241216	343.5393612	168.2033795	9.953156038	1.000877352	260.5466328	366.8610541	7009.615077	2573.429233	0	0	21240.04946	6928.455792	0	211.3013599	0	4982.880123	44465.57108	36.06062308	652.4547259	0	0	385.11639	36.110664	0	0	0	70.41111037											$100 Copay for 1st 5 Days	$100 Copay for 1st 5 Days			$50 Copay	20% Coinsurance	20% Coinsurance	$40 Emergency Room Copy; $50 Urgent Care Copay	$100 Copay for 1st 5 Days						"$10 PCP copay, $25 Specialist Copay"		$25 MHSA Copay			"$25 Chiropractic, $25 Podiatry, $25 Physical Medicine"	20% Coinsurance	$25 Medicare Covered Vision Copay			$20 Non-Medicare Covered Vision Copay																59.05300513	59.67482669	0	0	50	0.2	0.2	42.3	100	0	0	0	0	0	17.2	0	25	0	0	1.135084625	0.2	18.88340795	0	0	20	0	0	0	0	0											59.05300513	59.67482669	0	0	50	0.2	0.2	42.3	100	0	0	0	0	0	17.2	0	25	0	0	1.135084625	0.2	18.88340795	0	0	20	0	0	0	0	0											8.4432	0.085351156	0	0	0.700847415	1.990631208	0.20017547	0.918426881	3.057175451	0	0	0	0	0	9.930786635	0	0.440211166	0	0	4.206015505	7.212124616	1.026714063	0	0	0.64186065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.8535		0	8.4432	0.085351156	0	0	0.700847415	1.990631208	0.20017547	0.918426881	3.057175451	0	0	0	0	0	9.930786635	0	0.440211166	0	0	4.206015505	7.212124616	1.026714063	0	0	0.64186065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.8535		Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing											2.3145	0.0223	0.8943	0	1.4412	0.7254	0.579	0.1214	0.9503	0.1892	0.2803	0	0	0.6033	0	0	0.2286	0	0.8029	7.0487	0.2742	0.2671	0	0	0.1248	0	0	0	0	0											16.8676			10.7577	0.10766082	0.894325008	0	2.142079784	2.715998668	0.779195204	1.039847938	4.007437181	0.18918415	0.2803024	0	0	0.603307631	9.930786635	0	0.668827232	0	0.802935408	11.25471572	7.486365551	1.29377154	0	0	0.766666888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.7211
H5508_801_0	2009	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																																																			0		249.1999642	0.757724568	35.16220761	3.618991741	1.305051077	9.995327717	1.004861875	4.198663591	29.91535622	7.287445855	32.67217857	0	0	41.82890943	42.32950141	0	1.544577621	0	31.00484393	116.7467446	36.20418152	7.454839948	0	0	0	0	0	0	0	0											Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing											0.075862102	0.075862102	0.197753227	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231											0.075862102	0.075862102	0.197753227	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231											18.9048	0.057482578	6.95344001	0	0.301466799	2.308920703	0.232123093	0.96989129	6.910447288	1.683399992	7.54727325	0	0	9.662478079	9.778114825	0	0.35679743	0	7.162118949	26.968498	8.363165932	1.722068028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.8825			18.9048	0.057482578	6.95344001	0	0.301466799	2.308920703	0.232123093	0.96989129	6.910447288	1.683399992	7.54727325	0	0	9.662478079	9.778114825	0	0.35679743	0	7.162118949	26.968498	8.363165932	1.722068028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.8825		Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing	Fee For Service Cost Sharing											2.3821	0.023	0.8863	0	1.447	0.7283	0.5813	0.1219	0.954	0.1899	0.2814	0	0	0.6057	0	0	0.2295	0	0.8061	7.0768	0.2753	0.3329	0	0	0	0	0	0	0	0											16.9216			21.287	0.080444429	7.839736821	0	1.748436758	3.037175873	0.813447922	1.091795728	7.864492039	1.87333729	7.828691542	0	0	10.2681875	9.778114825	0	0.586323624	0	7.968250867	34.04525931	8.638498629	2.05498491	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.8041
H5509_001_0	2009	7																					2450											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	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	1356.510405	41.17418582	623.5800606	0	0	6.635586726	2.855699098	357.1144917	551.471832	0	22.47827796	0	0	745.1754182	5256.537408	9530.803524	267.7489361	713.7478368	2938.916066	814.8686025	16.86022081	0	0	0	426.5060779	0	0.14788699	0	0	360.4005935											1a $175 days 1-7	1b $200 days 1-10	2 $170 days 5-18	6 $0	10a $150	11a 20%	"11b 20%, 11c $0"	"4a $50, 4b $30"	"9a $200, 9b $200"	8a $0	"8b 20% Ther., $150 Diag."	5 $0	12 $0	"3 $0, 4b $30, 9d $30, 13a $0, 14b $0"	"7a $5, 14c $5, 14d - 14g $0, 14i - 14j $0"	"17a $30, 18a $30, 7b $30, 7d $30, 7f $30, 14d - 14g $0, 14i - 14j $0"	"7e $30, 7h $30, 9c $30"	"7c $30, 7i $30"	"8b $150, 14h $0"	7g $30	15 20%			"16a $0, 16b $30"	17a $5	17b $0	18a $5	18b $0	14a $0	"14c $5, 7f $30"											136.4648997	171.08	77.99216301	0	0	0.2	0.2	49.98733623	200	0	0.171464223	0	0	2.064561295	3.168601226	12.76821838	30	30	23.27695226	0.197643482	0.22436582	0	0	0	14.34466019	0	5	0	0	8.153467378											102.004379	127.8783716	58.29735095	0	0	0.149495407	0.149495407	37.364386	149.4954075	0	0.128165569	0	0	1.54321216	2.368456657	9.543950046	22.42431112	22.42431112	17.39898732	0.147733964	0.167708298	0	0	0	10.72230411	0	3.737385187	0	0	6.094529641											11.5308	0.438773986	3.029422137	0	0	0.991989742	0.4269139	1.111946976	6.870208854	0	2.880941293	0	0	0.095830314	1.037490085	7.580126061	0.500340454	1.333775296	4.26118028	0.010031981	2.827598941	0	0	0	0.381093989	0	4.61E-05	0	0	0.183039342	0	0	0	0	0	0	0	0	0	0	45.4916	0	15.3686	11.5308	0.438773986	3.029422137	0	0	0.991989742	0.4269139	1.111946976	6.870208854	0	2.880941293	0	0	0.095830314	1.037490085	7.580126061	0.500340454	1.333775296	4.26118028	0.010031981	2.827598941	0	0	0	0.381093989	0	4.61E-05	0	0	0.183039342	0	0	0	0	0	0	0	0	0	0	45.4916	0	20%	20%	20%	20%	10a $150	20%	20%	"4a $50, 4b $30"	20%	20%	20%	20%	20%	4b $30; 20%	20%	20%	20%	20%	20%	20%	20%			"16a $0, 16b 20%"	20%	17b $0	20%	18b $0	20%	20%											1.5762	0	0.432	0.2149	1.718	0.5166	0.0168	0.2536	0.276	0.4046	0.0454	0.007	0.0009	0.0551	0.8552	3.9166	0.0115	0.157	0.7809	0.0511	0.1288	0	0	0	0.0267	0	0	0	0	0.0359											11.4808	0	0	13.1071	0.438773986	3.461435085	0.214881923	1.718004609	1.508624379	0.443729692	1.365567208	7.146256535	0.404582194	2.926303815	0.006983194	0.000898312	0.150915305	1.892643786	11.49667875	0.51185899	1.490824073	5.042101195	0.061146182	2.956431135	0	0	0	0.407745517	0	7.17E-05	0	0	0.218895972	0	0	0	0	0	0	0	0	0	0	56.9724
H5509_003_0	2009	6																					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	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	1043.927035	65.2314999	541.3167807	0	54.26532394	6.510077587	2.114627464	275.3616113	336.4992418	0	13.68893395	0	0	295.7659685	5269.66375	9113.408398	266.888137	793.549049	2758.741955	953.9464276	36.65775405	0	0	0	348.1397444	0	0.078821807	0	0	199.5214707											1a $150 days 1-5	1b $200 days 1-10	2 $140 days 4-20	6 $0	10a $150	11a 20%	"11b 20%, 11c $0"	"4a $50, 4b $15"	"9a $150, 9b $150"	8a $0	"8b 20% Ther., $100 Diag."	5 $0	12 $0	"3 $0, 4b $15, 9d $30, 13a $0, 14b $0"	"7a $5, 14c $5, 14d - 14d $0, 14i - 14j $0"	"17a $30, 18a $30, 7b $30, 7d $30, 7f $30, 14d - 14g $0, 14i - 14j $0"	"7e $30, 7h $30, 9c $30"	"7c $30, 7i $30"	"8b $100, 14h $0"	7g $30	15 20%			"16a $0, 16b $30"	17a $5	17b $0	18a $5	18b $0	14a $0	"14c $5, 7f $5"											101.3968481	171.08	76.81347962	0	141.7203335	0.2	0.2	49.9714228	150	0	0.151638064	0	0	0.981237201	2.897584912	10.61829712	30	30	20.2013359	0.078302883	0.210740383	0	0	0	15.08167627	0	5	0	0	3.714297361											84.0882916	141.8764507	63.70133187	0	117.5285124	0.165859774	0.165859774	41.44124447	124.3948305	0	0.125753275	0	0	0.813738902	2.402963893	8.805741806	24.87896611	24.87896611	16.75294504	0.064936492	0.174766761	0	0	0	12.50721709	0	4.146494351	0	0	3.080262605											7.3152	0.771234473	2.873549991	0	0.5314769	1.079759998	0.350731633	0.950943987	3.488230513	0	1.721428279	0	0	0.020056356	1.05523431	6.687526777	0.553325076	1.645223324	3.851421029	0.005162161	6.406556945	0	0	0	0.362854947	0	2.72E-05	0	0	0.051214877	0	0	0	0	0	0	0	0	0	0	39.7211	0	8.1761	7.3152	0.771234473	2.873549991	0	0.5314769	1.079759998	0.350731633	0.950943987	3.488230513	0	1.721428279	0	0	0.020056356	1.05523431	6.687526777	0.553325076	1.645223324	3.851421029	0.005162161	6.406556945	0	0	0	0.362854947	0	2.72E-05	0	0	0.051214877	0	0	0	0	0	0	0	0	0	0	39.7211	0	20%	20%	20%	20%	10a $150	20%	20%	"4a $50, 4b $15"	20%	20%	20%	20%	20%	4b $15; 20%	20%	20%	20%	20%	20%	20%	20%			"16a $0, 16b 20%"	20%	17b $0	20%	18b $0	20%	20%											15.5515	0.0965	0.3107	0.4711	1.353	0.7326	0.0589	0.8446	1.8544	0.6049	0.4301	0.0441	0.001	0.2343	1.9681	5.3385	0.0144	0.3073	0.8929	0.09	0.7882	0	0	0	0.1065	0	0	0	0	0.0591											32.1531	0	0	22.8667	0.867748803	3.184231019	0.471147333	1.884505612	1.812384404	0.409647738	1.795549991	5.342671827	0.60488611	2.151517769	0.044145477	0.001048939	0.254371946	3.02334358	12.02604184	0.567774961	1.952528935	4.744331553	0.095175367	7.194763901	0	0	0	0.469349444	0	4.62E-05	0	0	0.110266246	0	0	0	0	0	0	0	0	0	0	71.8742
H5509_004_0	2009	7																					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	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	2157.526568	34.90843387	1335.788213	0	291.2192564	15.40842234	3.764448483	515.2955825	599.6666787	0	22.98977556	0	0	817.8670674	7257.323272	15960.82103	206.8379882	811.4601874	4083.547106	985.7722477	35.42504991	0	0	0	455.0768689	0	0.306242846	0	0	418.9402131											1a $165 days 1-5	1b $200 days 1-10	2 $150 days 8-23	6 $0	10a $100	11a 20%	"11b 20%, 11c $0"	"4a $50, 4b $10"	"9a $100, 9b $100"	8a $0	"8b 20% Ther., $100 Diag."	5 $0	12 $0	"3 $0, 4b  $10, 9d $30, 13a $0, 14b $0"	"7a $5, 14c $5, 14d - 14g $0, 14i - 14j $0"	"17a $30, 18a $30, 7b $30, 7d $30, 7f $0, 14d - 14g $0, 14i - 14j $0"	"7e $30, 7h $30, 9c $30"	"7c $30, 7i $30"	"8b $100, 14h $0"	7g $30	15 20%			"16a $0, 16b $30"	17a $5	17b $0	18a $5	18b $0	14a $0	"14c $5, 7f $0"											111.536533	171.08	63.00940439	0	95.46241855	0.2	0.2	49.98255301	100	0	0.124625843	0	0	1.772336737	3.017984181	9.664025297	30	30	17.36375059	0.270006506	0.206239206	0	0	0	5	0	5	0	0	1.995614035											71.71706033	110.003013	40.51452144	0	61.38153885	0.128598332	0.128598332	32.13836467	64.29916587	0	0.080133377	0	0	1.139597738	1.940538654	6.213887656	19.28974976	19.28974976	11.16474679	0.173611931	0.132610089	0	0	0	3.214958293	0	3.214958293	0	0	1.283163179											12.8943	0.320002742	4.509901683	0	1.489623842	1.981497408	0.484101795	1.380063112	3.21317227	0	1.842248363	0	0	0.077669955	1.173593028	8.264895733	0.332487753	1.30440533	3.799314121	0.014261819	4.697719024	0	0	0	0.121921096	0	8.20E-05	0	0	0.044797388	0	0	0	0	0	0	0	0	0	0	47.946	0	26.6211	12.8943	0.320002742	4.509901683	0	1.489623842	1.981497408	0.484101795	1.380063112	3.21317227	0	1.842248363	0	0	0.077669955	1.173593028	8.264895733	0.332487753	1.30440533	3.799314121	0.014261819	4.697719024	0	0	0	0.121921096	0	8.20E-05	0	0	0.044797388	0	0	0	0	0	0	0	0	0	0	47.946	0	20%	20%	20%	20%	10a $100	20%	20%	"4a $50, 4b $10"	20%	20%	20%	20%	20%	4b $10; 20%	20%	20%	20%	20%	20%	20%	20%			"16a $0, 16b 20%"	20%	17b $0	20%	18b $0	20%	20%											6.5323	0.0759	0.8675	0.3818	0.2536	0.331	0.0809	0.2302	1.2796	0.2192	0.4939	0.0105	0.0083	0.2351	0.8541	3.2768	0.0435	0.1562	0.8512	0.0861	0.8051	0	0	0	0.0867	0	0	0	0	0.0499											17.2094	0	0	19.4266	0.395874843	5.377434254	0.381755091	1.743204537	2.312531066	0.564976989	1.610241225	4.492786494	0.219207759	2.336159377	0.010451509	0.008264308	0.312817225	2.027654485	11.54166861	0.376025717	1.460594056	4.650513176	0.100398732	5.502858489	0	0	0	0.208668009	0	8.71E-05	0	0	0.094718079	0	0	0	0	0	0	0	0	0	0	65.1554
H5509_005_0	2009	6																					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	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	1825.917172	29.54304703	1130.479074	0	246.4591857	13.23576772	3.23364486	436.0952336	507.4985877	0	19.74811713	0	0	692.1618232	6141.880884	11849.26257	175.0472231	686.7396733	3455.910529	834.260167	30.42996366	0	0	0	385.1320683	0	0.259173666	0	0	354.5495756											1a $180 days 1-7	1b $200 days 1-10	2 $140 days 4-20	6 $0	10a $150	11a 20%	"11b 20%, 11c $0"	"4a $50, 4b $15"	"9a $150, 9b $150"	8a $0	"8b 20% Ther., $100 Diag."	5 $0	12 $0	"3 $0, 4b $15, 9d $30, 13a $0, 14b $0"	"7a $10, 14c $10, $14d - 14g $0, 14i - 14j $0"	"17a $30, 18a $30, 7b $30, 7d $30, 7f $0, 14d - 14g $0, 14i - 14j $0"	"7e $30, 7h $30, 9c $30"	"7c $30, 7i $30"	"8b $100, 14h $0"	7g $30	15 20%			"16a $0, 16b $30"	17a $10	17b $0	18a $10	18b $0	14a $0	"14c $10,7f $0"											140.3638968	171.08	76.81347962	0	143.1936278	0.2	0.2	49.98473389	150	0	0.123586016	0	0	1.814718703	6.035968362	11.01669682	30	29.82611658	17.36375059	0.325309044	0.206239206	0	0	0	10	0	10	0	0	3.99122807											102.2166208	124.5848817	55.93756298	0	104.2773041	0.145645174	0.145645174	36.40017629	109.2338804	0	0.089998534	0	0	1.321525105	4.395548308	8.022643622	21.84677608	21.72014967	12.64473237	0.236898461	0.150188725	0	0	0	7.282258694	0	7.282258694	0	0	2.906515531											15.5533	0.306718085	5.269687032	0	2.141674955	1.92772569	0.470964768	1.322828615	4.619670003	0	1.777301589	0	0	0.076225769	2.249744511	7.921867567	0.318684791	1.243007374	3.641588644	0.016469579	4.570237444	0	0	0	0.233719279	0	0.000157281	0	0	0.085875321	0	0	0	0	0	0	0	0	0	0	53.7474	0	20.0585	15.5533	0.306718085	5.269687032	0	2.141674955	1.92772569	0.470964768	1.322828615	4.619670003	0	1.777301589	0	0	0.076225769	2.249744511	7.921867567	0.318684791	1.243007374	3.641588644	0.016469579	4.570237444	0	0	0	0.233719279	0	0.000157281	0	0	0.085875321	0	0	0	0	0	0	0	0	0	0	53.7474	0	20%	20%	20%	20%	10a $150	20%	20%	"4a $50, 4b $15"	20%	20%	20%	20%	20%	4b $15; 20%	20%	20%	20%	20%	20%	20%	20%			"16a $0, 16b 20%"	20%	17b $0	20%	18b $0	20%	20%											5.6112	0.0652	0.7452	0.3279	0.32	0.2844	0.0695	0.1948	1.0992	0.196	0.4243	0.009	0.0071	0.2022	0.7336	2.4058	0.0374	0.1342	0.7312	0.074	0.6916	0	0	0	0.0745	0	0	0	0	0.0429											14.4811	0	0	21.1644	0.371891889	6.014893734	0.327925961	2.461645799	2.212082162	0.540436208	1.517628612	5.718853051	0.196034431	2.201569	0.008977801	0.007099005	0.278452095	2.983379584	10.32770106	0.356083712	1.37717281	4.372764927	0.090460812	5.261848739	0	0	0	0.3082345	0	0.000161581	0	0	0.128756977	0	0	0	0	0	0	0	0	0	0	68.2285
H5509_006_0	2009	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	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	2096.510545	33.92120441	1298.011397	0	282.9834177	12.95135418	3.164159478	500.7808509	582.7077794	0	19.32376458	0	0	794.745263	7052.082229	15509.44035	200.9884976	788.5116526	3968.062176	957.8940733	29.77607688	0	0	0	442.2070479	0	0.297582132	0	0	407.0923564											1a $165 days 1-5	1b $200 days 1-10	2 $150 days 8-23	6 $0	10a $100	11a 20%	"11b 20%, 11c $0"	"4a $50, 4b $10"	"9a $100, 9b $100"	8a $0	"8b 20% Ther., $100 Diag."	5 $0	12 $0	"3 $0, 4b $10, 9d $30, 13a $0, 14b $0"	"7a $5, 14c $5, 14d - 14g $0, 14i - 14j $0"	"17a $30, 18a $30, 7b $30, 7d $30, 7f $0, 14d - 14g $0, 14i - 14j $0"	"7e $30, 7h $30, 9c $30"	"7c $30, 7i $30"	"8b $100, 14h $0"	7g $30	15 20%			"16a $0, 16b $30"	17a $5	17b $0	18a $5	18b $0	14a $0	"14c $5, 7f $0"											111.536533	171.08	63.00940439	0	95.46241855	0.2	0.2	49.98153777	100	0	0.135607137	0	0	1.772319074	3.017984181	9.664025297	30	29.78264572	17.36375059	0.270006506	0.206239206	0	0	0	5	0	5	0	0	1.995614035											73.23665754	112.3338429	41.37297484	0	62.68213894	0.131323174	0.131323174	32.81867087	65.66158693	0	0.089041798	0	0	1.16373283	1.981656307	6.345552372	19.69847608	19.55575781	11.40131419	0.177290557	0.135419935	0	0	0	3.283079347	0	3.283079347	0	0	1.310351844											12.7951	0.317541604	4.475216072	0	1.478167159	1.700812937	0.415527465	1.36958016	3.188459793	0	1.720622746	0	0	0.077072596	1.164566935	8.201330499	0.329930593	1.284995242	3.770093632	0.014152131	4.032274409	0	0	0	0.120983402	0	8.14E-05	0	0	0.044452852	0	0	0	0	0	0	0	0	0	0	46.501	0	24.3182	12.7951	0.317541604	4.475216072	0	1.478167159	1.700812937	0.415527465	1.36958016	3.188459793	0	1.720622746	0	0	0.077072596	1.164566935	8.201330499	0.329930593	1.284995242	3.770093632	0.014152131	4.032274409	0	0	0	0.120983402	0	8.14E-05	0	0	0.044452852	0	0	0	0	0	0	0	0	0	0	46.501	0	20%	20%	20%	20%	10a $100	20%	20%	"4a $50, 4b $10"	20%	20%	20%	20%	20%	4b $10; 20%	20%	20%	20%	20%	20%	20%	20%			"16a $0, 16b 20%"	20%	17b $0	20%	18b $0	20%	20%											5.4906	0.0638	0.7292	0.3209	0.2458	0.2782	0.068	0.2237	1.0756	0.1843	0.4152	0.0088	0.0069	0.1977	0.7179	2.7542	0.0366	0.1313	0.7155	0.0724	0.6767	0	0	0	0.0729	0	0	0	0	0.042											14.528	0	0	18.2857	0.381314937	5.204409583	0.320879405	1.723957196	1.979059084	0.483506085	1.593248712	4.264023317	0.184252305	2.135773391	0.008784883	0.00694646	0.274785594	1.882437472	10.95558043	0.366525876	1.416277698	4.485558213	0.086553422	4.709024185	0	0	0	0.193897421	0	8.56E-05	0	0	0.086413056	0	0	0	0	0	0	0	0	0	0	61.029
H5509_007_0	2009	7																					2400											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	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	1271.455252	34.94380354	796.2195235	0	170.3460961	8.245179636	2.085505367	370.0124048	456.8828007	0	17.58842172	0	0	573.4399521	4887.482533	9817.982274	191.4065578	622.2141869	3063.56686	716.7927705	15.66353271	0	0	0	368.673938	0	0.247432173	0	0	329.7033708											1a $180 days 1-7	1b $200 days 1-10	2 $150 days 8-23	6 $0	10a $150	11a 20%	"11b 20%, 11c $0"	"4a $50, 4b $35"	"9a $150, 9b $150"	8a $0	"8b 20% Ther., $150 Diag."	5 $0	12 $0	"3 $0, 4b $35, 9d $35, 13a $0, 14b $0"	"7a $10, 14c $10, 14d - 14g $0, 14i - 14j $0"	"17a $35, 18a $35, 7b $35, 7d $35, 7f $35, 14d - 14g $0, 14i - 14j $0"	"7e $35, 7h $35, 9c $35"	"7c $35, 7i $35"	"8b $150, 14h $0"	7g $35	15 20%			"16a $0, 16b $35"	17a $10	17b $0	18a $10	18b $0	14a $0	"14c $10, 7f $10"											140.3638968	171.08	63.00940439	0	141.7203335	0.2	0.2	49.99084067	150	0	0.163312794	0	0	2.024040395	6.23982824	13.52227673	35	35	26.58861214	0.435116573	0.221370653	0	0	0	9.989932886	0	10	0	0	8.195121951											104.3261817	127.156082	46.83206096	0	105.3343602	0.148651019	0.148651019	37.15594712	111.4882645	0	0.121383067	0	0	1.50437834	4.637784143	10.0505011	26.01392839	26.01392839	19.76212149	0.323402611	0.164534866	0	0	0	7.425068535	0	7.432550968	0	0	6.091066159											11.0538	0.370276429	3.107383438	0	1.495274753	1.225654358	0.310012499	1.145680112	4.244755879	0	2.13493657	0	0	0.07188922	1.888924082	8.222970135	0.414936374	1.348852942	5.045215041	0.019317721	2.577197253	0	0	0	0.228119105	0	0.000153254	0	0	0.167353754	0	0	0	0	0	0	0	0	0	0	45.0727	0	15.5696	11.0538	0.370276429	3.107383438	0	1.495274753	1.225654358	0.310012499	1.145680112	4.244755879	0	2.13493657	0	0	0.07188922	1.888924082	8.222970135	0.414936374	1.348852942	5.045215041	0.019317721	2.577197253	0	0	0	0.228119105	0	0.000153254	0	0	0.167353754	0	0	0	0	0	0	0	0	0	0	45.0727	0	20%	20%	20%	20%	10a $150	20%	20%	"4a $50, 4b $35"	20%	20%	20%	20%	20%	4b $35; 20%	20%	20%	20%	20%	20%	20%	20%			"16a $0, 16b 20%"	20%	17b $0	20%	18b $0	20%	20%											3.9535	0.0721	0.5121	0.2117	0.2195	0.1771	0.0448	0.1651	0.9213	0.2943	0.3779	0.0069	0.0032	0.1485	0.5723	1.9632	0.0417	0.1036	0.6834	0.0519	0.3773	0	0	0	0.0793	0	0.0001	0	0	0.0475											11.0284	0	0	15.0073	0.442356925	3.619506666	0.211700497	1.714756655	1.402793322	0.354817376	1.310829664	5.166084219	0.294258159	2.512805209	0.006900387	0.003244098	0.220396733	2.461184646	10.18613102	0.456641825	1.452491723	5.728625511	0.071208923	2.954526077	0	0	0	0.307440046	0	0.000211803	0	0	0.214885966	0	0	0	0	0	0	0	0	0	0	56.1011
H5509_008_0	2009	7																					3250											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	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	1100.836086	30.25462349	689.3732066	0	147.487007	7.245823348	1.832731868	320.4644735	395.5727686	0	15.45661858	0	0	496.5031618	4231.621313	8500.487268	165.7213226	538.7179999	2652.460594	620.6048911	13.76503558	0	0	0	319.2008326	0	0.214228747	0	0	285.459805											1a $180 days 1-10	1b $200 days 1-10	2 $140 days 4-20	6 $0	10a $150	11a 20%	"11b 20%, 11c $0"	"4a $50, 4b $35"	"9a $150, 9b $150"	8a $0	"8b 20% Ther., $150 Diag."	5 $0	12 $0	"3 $0, 4b $35, 9d $35, 13a $0, 14b $0"	"7a $15, 14c $15, 14d - 14g $0, 14i - 14j $0"	"17a $35, 18a $35, 7b $35, 7d $35, 7f $35, 14d - 14g $0, 14i - 14j $0"	"7e $35, 7h $35, 9c $35"	"7c $35, 7i $35"	"8b $150, 14h $0"	7g $35	15 20%			"16a $0, 16b $35"	17a $15	17b $0	18a $15	18b $0	14a $0	"14c $15, 7f $15"											155.1318052	171.08	76.81347962	0	141.7203335	0.2	0.2	49.98976867	150	0	0.161505136	0	0	2.023982169	9.35974236	13.52227673	35	35	26.58861214	0.499277065	0.221370653	0	0	0	14.98489933	0	15	0	0	12.29268293											128.9624272	142.2203012	63.85571783	0	117.8133535	0.16626175	0.16626175	41.55693217	124.6963127	0	0.134260633	0	0	1.68255409	7.780835734	11.24118698	29.0958063	29.0958063	22.10334596	0.415053393	0.184027361	0	0	0	12.45707795	0	12.46963127	0	0	10.21901489											11.8305	0.358568472	3.668368413	0	1.447994908	1.204703272	0.304713208	1.109793366	4.110538804	0	2.075215392	0	0	0.069616119	2.74379586	7.962963901	0.401816292	1.306202881	4.885687846	0.021465347	2.533143168	0	0	0	0.331359138	0	0.000222613	0	0	0.243093167	0	0	0	0	0	0	0	0	0	0	46.6098	0	9.4582	11.8305	0.358568472	3.668368413	0	1.447994908	1.204703272	0.304713208	1.109793366	4.110538804	0	2.075215392	0	0	0.069616119	2.74379586	7.962963901	0.401816292	1.306202881	4.885687846	0.021465347	2.533143168	0	0	0	0.331359138	0	0.000222613	0	0	0.243093167	0	0	0	0	0	0	0	0	0	0	46.6098	0	20%	20%	20%	20%	10a $150	20%	20%	"4a $50, 4b $35"	20%	20%	20%	20%	20%	4b $35; 20%	20%	20%	20%	20%	20%	20%	20%			"16a $0, 16b 20%"	20%	17b $0	20%	18b $0	20%	20%											3.4743	0.0633	0.4501	0.186	0.1901	0.1557	0.0394	0.143	0.8097	0.2586	0.3321	0.0061	0.0029	0.1305	0.5029	1.7252	0.0367	0.0911	0.6006	0.0456	0.3316	0	0	0	0.0697	0	0.0001	0	0	0.0418											9.6867	0	0	15.3049	0.421912458	4.118419789	0.186041357	1.638067928	1.360372123	0.344087514	1.252781163	4.920197623	0.258592624	2.407284496	0.006064026	0.002850898	0.200089863	3.246695631	9.688180036	0.438466837	1.397280133	5.486265609	0.06706708	2.864737884	0	0	0	0.401065991	0	0.000274065	0	0	0.284864241	0	0	0	0	0	0	0	0	0	0	56.2965
H5509_009_0	2009	9																					2400											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	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	1140.774956	31.35227598	714.3840028	0	152.8379076	6.399044464	1.618550736	331.9097039	409.9243417	0	13.65028994	0	0	514.4918159	4385.146599	8808.889093	171.733773	558.2629517	2748.693158	643.1207393	12.15639279	0	0	0	330.7815945	0	0.22200107	0	0	295.816426											1a $180 days 1-7	1b $200 days 1-10	2 $150 days 8-23	6 $0	10a $150	11a 20%	"11b 20%, 11c $0"	"4a $50, 4b $35"	"9a $150, 9b $150"	8a $0	"8b 20% Ther., $150 Diag."	5 $ 0	12 $0	"3 $0, 4b $35, 9d $35, 13a $0, 14b $0"	"7a $10, 14c $10, 14d - 14g $0, 14i - 14j $0"	"17a $35, 18a $35, 7b $35, 7d $35, 7f $35, 14d - 14g $0, 14i - 14j $0"	"7e $35, 7h $35, 9c $35"	"7c $35, 7i $35"	"8b $150, 14h $0"	7g $35	15 20%			"16a $0, 16b $35"	17a $10	17b $0	18a $10	18b $0	14a $0	"14c $10, 7f $10"											140.3638968	171.08	63.00940439	0	141.7203335	0.2	0.2	49.99155966	150	0	0.182402923	0	0	2.024079427	6.23982824	13.52227673	35	35	26.58861214	0.435116573	0.221370653	0	0	0	9.989932886	0	10	0	0	8.195121951											108.4641965	132.1996265	48.68961728	0	109.5123635	0.154547143	0.154547143	38.6302637	115.9103576	0	0.140949253	0	0	1.564078468	4.821738149	10.4491462	27.0457501	27.0457501	20.54597027	0.336230117	0.17106101	0	0	0	7.719577952	0	7.727357171	0	0	6.332663438											10.3111	0.345396598	2.898590307	0	1.394803375	0.988954042	0.250142393	1.068479949	3.959539751	0	1.923998174	0	0	0.067058798	1.762002387	7.670447501	0.387055726	1.258220023	4.706213992	0.018019713	2.079484828	0	0	0	0.212791192	0	0.000142957	0	0	0.156108822	0	0	0	0	0	0	0	0	0	0	41.4586	0	12.1931	10.3111	0.345396598	2.898590307	0	1.394803375	0.988954042	0.250142393	1.068479949	3.959539751	0	1.923998174	0	0	0.067058798	1.762002387	7.670447501	0.387055726	1.258220023	4.706213992	0.018019713	2.079484828	0	0	0	0.212791192	0	0.000142957	0	0	0.156108822	0	0	0	0	0	0	0	0	0	0	41.4586	0	20%	20%	20%	20%	10a $150	20%	20%	"4a $50, 4b $35"	20%	20%	20%	20%	20%	4b $35; 20%	20%	20%	20%	20%	20%	20%	20%			"16a $0, 16b 20%"	20%	17b $0	20%	18b $0	20%	20%											3.0683	0.0559	0.3975	0.1643	0.1965	0.1375	0.0348	0.1482	0.715	0.2284	0.2933	0.0054	0.0025	0.1156	0.4441	1.5236	0.0324	0.0804	0.5304	0.0403	0.2928	0	0	0	0.0616	0	0	0	0	0.0369											8.6056	0	0	13.3794	0.401337926	3.296046694	0.164299743	1.591318016	1.126430745	0.284915244	1.216655413	4.674578268	0.228372349	2.217260217	0.005355357	0.002517729	0.182631196	2.206131072	9.194047268	0.419423127	1.338653586	5.236605588	0.058292227	2.372327923	0	0	0	0.274351795	0	0.000188396	0	0	0.192998345	0	0	0	0	0	0	0	0	0	0	50.0641
H5509_010_0	2009	7																					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	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	1324.581458	36.40388773	829.4885848	0	177.4637999	7.430085662	1.879338499	385.4535768	475.9730911	0	15.84968258	0	0	597.3978041	5091.700027	10228.21468	199.4042473	641.730521	3191.574263	746.7430819	14.11508238	0	0	0	384.0785287	0	0.257770825	0	0	343.4796238											1a $165 days 1-5	1b $200 days 1-10	2 $150 days 8-23	6 $0	10a $100	11a 20%	"11b 20%, 11c $0"	"4a $50, 4b $10"	"9a $100, 9b $100"	8a $0	"8b 20% Ther., $100 Diag."	5 $0	12 $0	"3 $0, 4b $10, 9d $30, 13a $0, 14b $0"	"7a $5, 14c $5, 14d - 14g $0, 14i - 14j $0"	"17a $30, 18a $30, 7b $30, 7d $30, 7f $30, 14d - 14g $0, 14i - 14j $0"	"7e $30, 7h $30, 9c $30"	"7c $30, 7i $30"	"8b $100, 14h $0"	7g $30	15 20%			"16a $0, 16b $30"	17a $5	17b $0	18a $5	18b $0	14a $0	"14c $5, 7f $5"											111.536533	171.08	63.00940439	0	94.48022233	0.2	0.2	49.97601389	100	0	0.135266804	0	0	1.44408455	3.11991412	11.59052291	30	30	17.88375338	0.32712814	0.221370653	0	0	0	14.22734899	0	5	0	0	4.097560976											83.19552883	127.6092299	46.99895703	0	70.47316114	0.149180769	0.149180769	37.27730094	74.59038454	0	0.100896029	0	0	1.077148219	2.327155939	8.645415607	22.37711536	22.37711536	13.33956042	0.244006138	0.165121221	0	0	0	10.61223432	0	3.729519227	0	0	3.056386488											9.1833	0.387122673	3.248758196	0	1.042202914	1.108425893	0.280361163	1.197389082	2.958584658	0	1.599170032	0	0	0.053623832	0.987431663	7.368930572	0.371840987	1.196673158	3.54784981	0.015184158	2.330699638	0	0	0	0.339660945	0	8.01E-05	0	0	0.087483873	0	0	0	0	0	0	0	0	0	0	37.3047	0	12.7081	9.1833	0.387122673	3.248758196	0	1.042202914	1.108425893	0.280361163	1.197389082	2.958584658	0	1.599170032	0	0	0.053623832	0.987431663	7.368930572	0.371840987	1.196673158	3.54784981	0.015184158	2.330699638	0	0	0	0.339660945	0	8.01E-05	0	0	0.087483873	0	0	0	0	0	0	0	0	0	0	37.3047	0	20%	20%	20%	20%	10a $100	20%	20%	"4a $50, 4b $10"	20%	20%	20%	20%	20%	4b $10; 20%	20%	20%	20%	20%	20%	20%	20%			"16a $0, 16b 20%"	20%	17b $0	20%	18b $0	20%	20%											3.5627	0.0461	0.4615	0.1908	0.1531	0.1596	0.0404	0.1721	0.8302	0.2652	0.3405	0.0062	0.0029	0.1322	0.5157	1.7691	0.0376	0.0925	0.6159	0.0468	0.34	0	0	0	0.0715	0	0.0001	0	0	0.0428											9.8954	0	0	12.7459	0.433214534	3.710254442	0.190772415	1.19533554	1.268053426	0.320736763	1.369439206	3.788833215	0.265168671	1.9396837	0.006218235	0.002923396	0.18587376	1.503120247	9.138019198	0.409423561	1.289132584	4.16370035	0.061945549	2.670726854	0	0	0	0.411140454	0	0.000132874	0	0	0.130317192	0	0	0	0	0	0	0	0	0	0	47.2001
H5509_011_0	2009	7																					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	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	1427.246827	39.22547229	893.7804042	0	191.2186252	8.64460203	2.186533796	415.2495993	512.8647091	0	18.44046011	0	0	643.6899282	0	11020.98091	214.859628	698.4541713	3438.946102	804.621481	16.42232343	0	0	0	413.8476032	0	0.277750069	0	0	370.1019673											1a $165 days 1-5	1b $200 days 1-10	2 $150 days 8-23	6 $0	10a $100	11a 20%	"11b 20%, 11c $0"	"4a $50, 4b $10"	"9a $100, 9b $100"	8a $0	"8b 20% Ther., $100 Diag."	5 $0	12 $0	"3 $0, 4b $10, 9d $30, 13a $0, 14b $0"	"7a $0, 14c $5, 14d - 14g $0, 14i - 14j $0"	"17a $30, 18a $30, 7b $30, 7d $30, 7f $30, 14d - 14g $0, 14i - 14j $0"	"7e $30, 7h $30, 9c $30"	"7c $30, 7i $30"	"8b $100, 14h $0"	7g $30	15 20%			"16a $0, 16b $30"	17a $5	17b $0	18a $5	18b $0	14a $0	"14c $5, 7f $5"											111.536533	171.08	63.00940439	0	94.48022233	0.2	0.2	49.97769047	100	0	0.128302366	0	0	1.4441089	0	11.59052291	30	30	17.88375338	0.262967649	0.221370653	0	0	0	14.22734899	0	5	0	0	4.097560976											81.60508611	125.1697337	46.10048148	0	69.12593098	0.146328891	0.146328891	36.56590022	73.16444572	0	0.093871715	0	0	1.056574272	0	8.480141842	21.94933372	21.94933372	13.08454904	0.192398823	0.161964611	0	0	0	10.40936103	0	3.658222286	0	0	2.997957776											9.7059	0.409153494	3.433642247	0	1.10151379	1.264955032	0.319953066	1.265331285	3.126955181	0	1.731037617	0	0	0.056675518	0	7.788290111	0.39300214	1.277550308	3.749754909	0.012900685	2.659835225	0	0	0	0.358990759	0	8.47E-05	0	0	0.092462506	0	0	0	0	0	0	0	0	0	0	38.748	0	14.2121	9.7059	0.409153494	3.433642247	0	1.10151379	1.264955032	0.319953066	1.265331285	3.126955181	0	1.731037617	0	0	0.056675518	0	7.788290111	0.39300214	1.277550308	3.749754909	0.012900685	2.659835225	0	0	0	0.358990759	0	8.47E-05	0	0	0.092462506	0	0	0	0	0	0	0	0	0	0	38.748	0	20%	20%	20%	20%	10a $100	20%	20%	"4a $50, 4b $10"	20%	20%	20%	20%	20%	4b $10; 20%	20%	20%	20%	20%	20%	20%	20%			"16a $0, 16b 20%"	20%	17b $0	20%	18b $0	20%	20%											4.145	0.0536	0.5369	0.222	0.1653	0.1857	0.047	0.1854	0.966	0.3085	0.3962	0.0072	0.0034	0.1538	0.6	2.0583	0.0437	0.1087	0.7165	0.0544	0.3956	0	0	0	0.0832	0	0.0001	0	0	0.0498											11.4862	0	0	13.8509	0.462779496	3.970574332	0.221955934	1.266776856	1.450675164	0.366928433	1.450716632	4.09291556	0.308512948	2.1272114	0.007234663	0.003401252	0.210476088	0.599982662	9.84655267	0.436727934	1.386209677	4.466271929	0.06730566	3.055443041	0	0	0	0.442154256	0	0.000146057	0	0	0.142297328	0	0	0	0	0	0	0	0	0	0	50.2342
H5509_012_0	2009	7																					2800											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	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	1374.5441	37.7770267	860.776537	0	184.157658	8.133745758	2.057319692	399.9250885	493.9265911	0	17.35071362	0	0	619.9221734	5283.756759	11289.55348	206.9256896	672.6629494	3311.95907	774.9099094	15.45183955	0	0	0	398.5658054	0	0.267493829	0	0	356.4355273											1a $165 days 1-10	1b $200 days 1-10	2 $150 days 8-23	6 $0	10a $150	11a 20%	"11b 20%, 11c $0"	"4a $50, 4b $35"	"9a $150, 9b $150"	8a $0	"8b 20% Ther., $150 Diag."	5 $0	12 $0	"3 $0, 4b $35, 9d $35, 13a $0, 14b $0"	"7a $5, 14c $5, 14d - 14g $0, 14i - 14j $0"	"17a $35, 18a $35, 7b $35, 7d $35, 7f $35, 14d - 14g $0, 14i - 14j $0"	"7e $35, 7h $35, 9c $35"	"7c $35, 7i $35"	"8b $150, 14h $0"	7g $35	15 20%			"16a $0, 16b $35"	17a $5	17b $0	18a $5	18b $0	14a $0	"14c $5, 7f $5"											142.2041547	171.08	63.00940439	0	141.7203335	0.2	0.2	49.99155966	150	0	0.17504194	0	0	2.024079427	3.11991412	12.71314194	35	35	26.58861214	0.370956082	0.221370653	0	0	0	16.0738255	0	5	0	0	4.097560976											109.1991521	131.3730318	48.38517939	0	108.8276238	0.153580818	0.153580818	38.38872317	115.1856136	0	0.134415422	0	0	1.554298872	2.395794815	9.762473701	26.87664318	26.87664318	20.41750403	0.284858693	0.16999143	0	0	0	12.34315636	0	3.839520454	0	0	3.146533835											12.5083	0.413573544	3.470735596	0	1.670120027	1.249187328	0.315964842	1.279384459	4.741103123	0	2.332203485	0	0	0.080295361	1.054899754	9.184497414	0.46345566	1.506576839	5.635161473	0.018394985	2.626680296	0	0	0	0.409963338	0	8.56E-05	0	0	0.093461371	0	0	0	0	0	0	0	0	0	0	49.054	0	14.8264	12.5083	0.413573544	3.470735596	0	1.670120027	1.249187328	0.315964842	1.279384459	4.741103123	0	2.332203485	0	0	0.080295361	1.054899754	9.184497414	0.46345566	1.506576839	5.635161473	0.018394985	2.626680296	0	0	0	0.409963338	0	8.56E-05	0	0	0.093461371	0	0	0	0	0	0	0	0	0	0	49.054	0	20%	20%	20%	20%	10a $150	20%	20%	"4a $50, 4b $35"	20%	20%	20%	20%	20%	4b $35; 20%	20%	20%	20%	20%	20%	20%	20%			"16a $0, 16b 20%"	20%	17b $0	20%	18b $0	20%	20%											3.9001	0.0505	0.5052	0.2088	0.237	0.1747	0.0442	0.1785	0.9089	0.2903	0.3728	0.0068	0.0032	0.1467	0.5645	1.9366	0.0411	0.1022	0.6742	0.0512	0.3722	0	0	0	0.0782	0	0.0001	0	0	0.0469											10.895	0	0	16.4083	0.464030497	3.975937461	0.208839358	1.907078064	1.423932254	0.360164179	1.45792424	5.649979681	0.29028125	2.704965217	0.006807128	0.003200254	0.22704291	1.619426197	11.12112611	0.504597461	1.608814939	6.309335628	0.069584875	2.998909508	0	0	0	0.488212254	0	0.000143344	0	0	0.140351183	0	0	0	0	0	0	0	0	0	0	59.949
H5509_013_0	2009	6																					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	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	1308.423509	38.54877117	653.6530764	0	138.181397	8.630938519	2.752327201	391.4349779	532.9768823	0	21.25733208	0	0	723.4613937	5571.908093	11257.19361	252.706084	767.5411809	3463.540174	812.4944174	16.18069073	0	0	0	430.3249201	0	0.276914363	0	0	374.6651331											1a $165 days 1-5	1b $100 days 1-21	2 $100 days 8-32	6 $0	10a $100	11a 20%	"11b 20%, 11c $0"	"4a $50, 4b $10"	"9a $100, 9b $100"	8a $0	"8b 20% Ther., $100 Diag."	5 $0	12 $0	"3 $0, 4b $10, 9d $30, 13a $0, 14b $0"	"7a $5, 14c $5, 14d - 14g $0, 14i - 14j $0"	"17a $30, 18a $30, 7b $30, 7d $30, 7f $30, 14d - 14g $0, 14i - 14j $0"	"7e $30, 7h $30, 9c $30"	"7c $30,7i $30"	"8b $100, 14h $0"	7g $30	15 20%			"16a $0, 16b $30"	17a $5	17b $0	18a $5	18b $0	14a $0	"14c $5, 7f $5"											111.536533	95.33	53.06426332	0	93.12156176	0.2	0.2	49.97604266	100	0	0.13001342	0	0	1.58132395	3.092165179	12.45028662	30	30	17.38498891	0.251605996	0.220335	0	0	0	14.18597169	0	5	0	0	3.967110126											81.82269117	69.93365261	38.92770122	0	68.31355241	0.146719087	0.146719087	36.66219664	73.35954328	0	0.095377251	0	0	1.160052027	2.268398253	9.133473404	22.00786299	22.00786299	12.75354846	0.184577009	0.16163675	0	0	0	10.40676404	0	3.667977164	0	0	2.91025387											8.9216	0.224654698	2.120434305	0	0.786638509	1.266323416	0.403818933	1.195905511	3.258245056	0	2.027465907	0	0	0.069937738	1.053275549	8.568106536	0.463460073	1.407661762	3.681035622	0.012497316	2.615394254	0	0	0	0.373190825	0	8.46E-05	0	0	0.090864221	0	0	0	0	0	0	0	0	0	0	38.5406	0	13.996	8.9216	0.224654698	2.120434305	0	0.786638509	1.266323416	0.403818933	1.195905511	3.258245056	0	2.027465907	0	0	0.069937738	1.053275549	8.568106536	0.463460073	1.407661762	3.681035622	0.012497316	2.615394254	0	0	0	0.373190825	0	8.46E-05	0	0	0.090864221	0	0	0	0	0	0	0	0	0	0	38.5406	0	20%	20%	20%	20%	10a $100	20%	20%	"4a $50, 4b $10"	20%	20%	20%	20%	20%	4b $10; 20%	20%	20%	20%	20%	20%	20%	20%			"16a $0, 16b 20%"	20%	17b $0	20%	18b $0	0.2	20%											4.2707	0.0796	0.4139	0.1917	0.1187	0.1854	0.0591	0.1747	1.055	0.3279	0.4567	0.0107	0.0023	0.171	0.643	2.2433	0.0577	0.1219	0.8393	0.0594	0.3936	0	0	0	0.0756	0	0	0	0	0.0555											12.0068	0	0	13.1923	0.304266262	2.534292586	0.191700632	0.905329315	1.451750002	0.462949772	1.370626053	4.31323392	0.327895506	2.484157205	0.010679161	0.002332022	0.240893189	1.696309449	10.81141003	0.521165432	1.529521054	4.520379407	0.071941751	3.008987946	0	0	0	0.448801265	0	8.95E-05	0	0	0.146409334	0	0	0	0	0	0	0	0	0	0	50.5474
H5509_801_0	2009	6																					0											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	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	141.5391256	2.00541144	13.83347365	0	3.849450992	6.467016259	1.728836509	9.678308283	39.25230296	8.019319073	14.94449845	0.447488199	0.066514484	5.505014326	24.16152601	81.96465719	1.424548498	3.755489193	28.87648814	2.535810549	15.38302384	0	0	0	0	0	0	0	0	0											FFS Medicare 8.4%	FFS Medicare 8.4%	FFS Medicare 17.6%		FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%																			0.083528664	0.083528664	0.175698655	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.083528664	0.083528664	0.175698655	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											11.8226	0.167509338	2.43052272	0	0.889223179	1.493880756	0.399361234	2.235689213	9.067281985	1.852462706	3.452179141	0.103369774	0.015364846	1.271658309	5.581312509	18.93383581	0.329070703	0.867518003	6.670468761	0.585772237	3.553478507	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7225	0	0	11.8226	0.167509338	2.43052272	0	0.889223179	1.493880756	0.399361234	2.235689213	9.067281985	1.852462706	3.452179141	0.103369774	0.015364846	1.271658309	5.581312509	18.93383581	0.329070703	0.867518003	6.670468761	0.585772237	3.553478507	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7225	0	FFS Medicare 8.4%	FFS Medicare 8.4%	FFS Medicare 17.6%		FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%																			1.27	0.018	0.2611	0	0.0955	0.1605	0.0429	0.2402	0.974	0.1988	0.3708	0.0111	0.0017	0.1366	0.5995	2.0241	0.0353	0.0932	0.7165	0.0629	0.428	0	0	0	0	0	0	0	0	0											7.7408	0	0	13.0926	0.185503143	2.691608771	0	0.984743277	1.654352996	0.442260502	2.475846305	10.0412868	2.05125547	3.823011231	0.114473725	0.017015333	1.408259479	6.180855492	20.95792107	0.364419383	0.960706538	7.387008594	0.648695722	3.981521553	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.4633
H5509_802_0	2009	6																					0											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	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	145.1775326	3.26008658	17.1694723	0	4.227628122	6.5217295	1.473791917	9.077674106	37.8471154	7.256458329	16.22899793	0.212269765	0.099794976	4.930981752	23.26259414	78.2210188	1.758456749	3.834381063	26.52143271	2.382246127	14.34077239	0	0	0	0	0	0	0	0	0											FFS Medicare 8.4%	FFS Medicare 8.4%	FFS Medicare 18.5%		FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%																			0.0839	0.0839	0.1847	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.0839	0.0839	0.1847	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											12.1804	0.273521264	3.171201534	0	0.976582096	1.506519514	0.340445933	2.096942718	8.742683657	1.676241874	3.748898522	0.049034316	0.02305264	1.139056785	5.373659247	18.06905534	0.406203509	0.885742025	6.126450956	0.550298855	3.312718423	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.6487	0	0	12.1804	0.273521264	3.171201534	0	0.976582096	1.506519514	0.340445933	2.096942718	8.742683657	1.676241874	3.748898522	0.049034316	0.02305264	1.139056785	5.373659247	18.06905534	0.406203509	0.885742025	6.126450956	0.550298855	3.312718423	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.6487	0	FFS Medicare 8.4%	FFS Medicare 8.4%	FFS Medicare 18.5%		FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%																			1.3084	0.0294	0.3406	0	0.1049	0.1618	0.0366	0.2253	0.9391	0.1798	0.4027	0.0053	0.0025	0.1224	0.5772	1.9262	0.0436	0.0951	0.6581	0.0591	0.3978	0	0	0	0	0	0	0	0	0											7.6159	0	0	13.4888	0.30290284	3.511851089	0	1.081486264	1.668349407	0.377016537	2.322195701	9.681820218	1.856005854	4.151604121	0.054301568	0.025528947	1.261413937	5.950896176	19.99525801	0.449837773	0.980888179	6.784552554	0.6094118	3.710478752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2646
H5509_803_0	2009	6																					0											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	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	217.2080433	6.281948025	28.66342449	0	7.082606449	10.27475746	2.525645071	14.831822	53.70583098	9.036795857	21.17989861	0.364463481	0.171346232	7.613024606	33.81085472	114.3451278	2.927222802	6.499542365	38.51645446	2.80734643	19.0514822	0	0	0	0	0	0	0	0	0											FFS Medicare 8.4%	FFS Medicare 8.4%	FFS Medicare 18.5%		FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%																			0.0839	0.0839	0.1847	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.0839	0.0839	0.1847	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											18.2238	0.527055439	5.294134504	0	1.63608209	2.373468974	0.583424011	3.426150881	12.40604696	2.087499843	4.892556578	0.084191064	0.03958098	1.758608684	7.810307441	26.41372451	0.676188467	1.501394286	8.89730098	0.648497025	4.400892388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.6809	0	0	18.2238	0.527055439	5.294134504	0	1.63608209	2.373468974	0.583424011	3.426150881	12.40604696	2.087499843	4.892556578	0.084191064	0.03958098	1.758608684	7.810307441	26.41372451	0.676188467	1.501394286	8.89730098	0.648497025	4.400892388	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.6809	0	FFS Medicare 8.4%	FFS Medicare 8.4%	FFS Medicare 18.5%		FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%	FFS Medicare 23.1%																			1.9576	0.0566	0.5687	0	0.1757	0.255	0.0627	0.368	1.3327	0.2237	0.5256	0.009	0.0043	0.1889	0.839	2.8121	0.0726	0.1613	0.9557	0.0697	0.5324	0	0	0	0	0	0	0	0	0											11.1712	0	0	20.1813	0.583671583	5.862828908	0	1.811829557	2.628426327	0.646095251	3.794187022	13.73870095	2.311227777	5.418113597	0.093234844	0.043832757	1.947517923	8.649288418	29.22578827	0.748824438	1.662673628	9.85304649	0.718158389	4.933246372	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.852
H5510_002_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	5000	1729.066335	0	1089.400869	819.9739571	215.4956946	6.563667016	0	275.8134083	286.4101822	857.4565536	3886.185681	0	5.950733461	667.2142311	4343.680592	5974.30817	0	687.2517371	0	0	239.703291	0	0	0	768.5156727	0	62.56678646	0	0	0											$350 per stay	$350 per stay	"$0 1-15, $75 16-20, $100 21+"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$30 per visit	$40 X-ray; $150 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$15 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											59.17692516	59.17692516	47.8866492	20	100	0.2	0.2	48.5	250	30	84	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											59.17692516	59.17692516	47.8866492	20	100	0.2	0.2	48.5	250	30	84	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											8.5267	0	4.347313103	1.366623262	1.795797455	1.312733403	0	1.114745859	5.966878796	2.143641384	27.20329977	0	0.012397361	1.668035578	5.42960074	14.93577043	0	1.718129343	0	0	0.898887341	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.4406	0	0	8.5267	0	4.347313103	1.366623262	1.795797455	1.312733403	0	1.114745859	5.966878796	2.143641384	27.20329977	0	0.012397361	1.668035578	5.42960074	14.93577043	0	1.718129343	0	0	0.898887341	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.4406		$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$100 copay	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$50 copay	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$25 copay	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP		0	0	$150 ded; 20% coinsurance; $5000 max OOP	0	$150 ded; 20% coinsurance; $5000 max OOP	0	Not Covered												4.7707	0	0.4711	0.0759	0.1588	0.1215	0	0.1054	0.4327	0.1664	0.7163	0	0.0013	0.2753	0.569	1.9942	0	0.0826	0	0	0.1057	0	0	0	0.0489	0	0.0032	0	0	0											10.0989	150	4.010296076	13.2975	0	4.818389385	1.442503429	1.954555597	1.434229647	0	1.220168164	6.399606607	2.309991602	27.91958876	0	0.013701662	1.943293328	5.99856156	16.9300075	0	1.800723899	0	0	1.004629648	0	0	0	0.048902334	0	0.003153931	0	0	0	0	0	0	0	0	0	0	0	0	0	88.5395
H5510_003_0	2009	8																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	7500	1729.066335	0	1089.400869	819.9739571	215.4956946	6.563667016	0	275.8134083	286.4101822	857.4565536	3886.185681	0	5.950733461	667.2142311	4343.680592	5974.30817	0	687.2517371	0	0	239.703291	0	0	0	768.5156727	0	62.56678646	0	0	0											$850 per stay	$850 per stay	"$0 1-15, $75 16-20, $100 21+"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$35 per visit	$35 X-ray; $150 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$20 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											143.7153897	143.7153897	47.8866492	20	100	0.2	0.2	48.5	250	35	81	35	25	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											143.7153897	143.7153897	47.8866492	20	100	0.2	0.2	48.5	250	35	81	35	25	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											20.7078	0	4.347313103	1.366623262	1.795797455	1.312733403	0	1.114745859	5.966878796	2.500914948	26.23175335	0	0.012397361	1.946041507	7.239467653	17.4250655	0	2.004484233	0	0	0.898887341	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.8709	0	0	20.7078	0	4.347313103	1.366623262	1.795797455	1.312733403	0	1.114745859	5.966878796	2.500914948	26.23175335	0	0.012397361	1.946041507	7.239467653	17.4250655	0	2.004484233	0	0	0.898887341	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.8709		$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$100 copay	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$50 copay	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$25 copay	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP		0	0	$500 ded; 30% coinsurance; $7500 max OOP	0	$500 ded; 30% coinsurance; $7500 max OOP	0	Not Covered												7.8191	0	0.7721	0.1244	0.1764	0.1991	0	0.1234	0.7092	0.2726	1.174	0	0.002	0.4511	0.9325	3.2685	0	0.1354	0	0	0.1733	0	0	0	0.0801	0	0.0052	0	0	0											16.4185	500	5.805850465	28.5269	0	5.119394629	1.490988843	1.972224576	1.511862524	0	1.23810003	6.676108197	2.773558541	27.405732	0	0.014393282	2.397181656	8.171979341	20.69356715	0	2.13985452	0	0	1.072196177	0	0	0	0.080149628	0	0.005169209	0	0	0	0	0	0	0	0	0	0	0	0	0	111.2893
H5510_005_0	2009	8																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	7500	1729.066335	0	1089.400869	819.9739571	215.4956946	6.563667016	0	275.8134083	286.4101822	857.4565536	3886.185681	0	5.950733461	667.2142311	4343.680592	5974.30817	0	687.2517371	0	0	239.703291	0	0	0	768.5156727	0	62.56678646	0	0	0											$150/day 1-8	$150/day 1-8	"$0 1-15, $75 16-20, $100 21+"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$200 per procedure	$30 per visit	$30 X-ray; $125 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$10 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											114.2747829	114.2747829	47.8866492	20	100	0.2	0.2	48.5	200	30	68	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											114.2747829	114.2747829	47.8866492	20	100	0.2	0.2	48.5	200	30	68	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											16.4657	0	4.347313103	1.366623262	1.795797455	1.312733403	0	1.114745859	4.773503037	2.143641384	22.02171886	0	0.012397361	1.668035578	3.619733827	14.93577043	0	1.718129343	0	0	0.898887341	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.1948	0	0	16.4657	0	4.347313103	1.366623262	1.795797455	1.312733403	0	1.114745859	4.773503037	2.143641384	22.02171886	0	0.012397361	1.668035578	3.619733827	14.93577043	0	1.718129343	0	0	0.898887341	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.1948		$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$100 copay	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$50 copay	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$25 copay	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP		0	0	$500 ded; 30% coinsurance; $7500 max OOP	0	$500 ded; 30% coinsurance; $7500 max OOP	0	Not covered												7.8191	0	0.7721	0.1244	0.1764	0.1991	0	0.1234	0.7092	0.2726	1.174	0	0.0018	0.4511	0.9325	3.2685	0	0.1354	0	0	0.1733	0	0	0	0.0801	0	0.0052	0	0	0											16.4182	500	5.805761785	24.2848	0	5.119394629	1.490988843	1.972224576	1.511862524	0	1.23810003	5.482732437	2.416284977	23.19569752	0	0.014184425	2.119175727	4.552245515	18.20427208	0	1.853499629	0	0	1.072196177	0	0	0	0.080149628	0	0.005169209	0	0	0	0	0	0	0	0	0	0	0	0	0	94.613
H5510_006_0	2009	7																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	5000	1729.066335	0	1089.400869	819.9739571	215.4956946	6.563667016	0	275.8134083	286.4101822	857.4565536	3886.185681	0	5.950733461	667.2142311	4343.680592	5974.30817	0	687.2517371	0	0	239.703291	0	0	0	768.5156727	0	62.56678646	0	0	0											$150/day 1-8	$150/day 1-8	"$0 1-15, $75 16-20, $100 21+"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$200 per procedure	$20 per visit	$20 X-ray; $125 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$10 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											114.2747829	114.2747829	47.8866492	20	100	0.2	0.2	48.5	200	20	62	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											114.2747829	114.2747829	47.8866492	20	100	0.2	0.2	48.5	200	20	62	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											16.4657	0	4.347313103	1.366623262	1.795797455	1.312733403	0	1.114745859	4.773503037	1.429094256	20.07862602	0	0.009917889	1.112023718	3.619733827	9.957180284	0	1.145419562	0	0	0.898887341	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4273	0	0	16.4657	0	4.347313103	1.366623262	1.795797455	1.312733403	0	1.114745859	4.773503037	1.429094256	20.07862602	0	0.009917889	1.112023718	3.619733827	9.957180284	0	1.145419562	0	0	0.898887341	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4273		$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$100 copay	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$50 copay	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$20 copay	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP	$150 ded; 20% coinsurance; $5000 max OOP		0	0	$150 ded; 20% coinsurance; $5000 max OOP	0	$150 ded; 20% coinsurance; $5000 max OOP	0	Not Covered												4.7707	0	0.4711	0.0759	0.1588	0.1215	0	0.1054	0.4327	0.1664	0.7163	0	0.0011	0.2753	0.569	1.9942	0	0.0826	0	0	0.1057	0	0	0	0.0489	0	0.0032	0	0	0											10.0987	150	4.010205023	21.2365	0	4.818389385	1.442503429	1.954555597	1.434229647	0	1.220168164	5.206230848	1.595444474	20.79491501	0	0.011015706	1.387281469	4.188694647	11.95141736	0	1.228014118	0	0	1.004629648	0	0	0	0.048902334	0	0.003153931	0	0	0	0	0	0	0	0	0	0	0	0	0	79.526
H5510_801_0	2009	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																																																			0		382.581441	0	47.24125342	7.162340637	8.447436479	11.2456662	0	9.940209973	51.37222231	17.51103445	71.37623775	0	3.894921178	14.80512082	52.29406104	227.1520888	0	6.732262111	0	0	10.15906749	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.061326545	0.061326545	0.160865165	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.4624	0	7.599472013	0	1.951357827	2.597748891	0	2.296188504	11.86698335	4.045048957	16.48791092	0	0.899726792	3.41998291	12.0799281	52.47213252	0	1.555152548	0	0	2.34674459	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.0808			23.4624	0	7.599472013	0	1.951357827	2.597748891	0	2.296188504	11.86698335	4.045048957	16.48791092	0	0.899726792	3.41998291	12.0799281	52.47213252	0	1.555152548	0	0	2.34674459	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	143.0808		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.1994	0	1.0363	0	0.2661	0.3542	0	0.3131	1.6182	0.5516	2.2484	0	0.1227	0.4664	1.6473	7.1553	0	0.2121	0	0	0.32	0	0	0	0	0	0	0	0	0											19.511			26.6618	0	8.635763651	0	2.217452076	2.951987376	0	2.609305118	13.48520836	4.596646542	18.73626241	0	1.022416809	3.886344216	13.72719102	59.62742331	0	1.767218804	0	0	2.666755216	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	162.5918
H5510_802_0	2009	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																																																			0		381.4631703	0	47.10316907	7.141405394	8.422744951	11.21279555	0	9.911155126	51.22206331	17.45985037	71.16760778	0	3.883536475	14.76184603	52.14120753	226.4881321	0	6.71258397	0	0	10.12937293	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.061337049	0.061337049	0.160997346	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.3978	0	7.583485218	0	1.945654084	2.590155772	0	2.289476834	11.83229662	4.033225436	16.4397174	0	0.897096926	3.409986433	12.04461894	52.31875851	0	1.550606897	0	0	2.339885146	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.6728			23.3978	0	7.583485218	0	1.945654084	2.590155772	0	2.289476834	11.83229662	4.033225436	16.4397174	0	0.897096926	3.409986433	12.04461894	52.31875851	0	1.550606897	0	0	2.339885146	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.6728		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.1906	0	1.0341	0	0.2653	0.3532	0	0.3122	1.6135	0.55	2.2418	0	0.1223	0.465	1.6424	7.1344	0	0.2114	0	0	0.3191	0	0	0	0	0	0	0	0	0											19.4554			26.5884	0	8.617596839	0	2.21097055	2.943358832	0	2.60167822	13.44579162	4.583210723	18.68149704	0	1.019428325	3.874984583	13.68706698	59.45313467	0	1.762053292	0	0	2.658960394	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	162.1282
H5510_804_0	2009	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																																																			0		381.4631703	0	47.10316907	7.141405394	8.422744951	11.21279555	0	9.911155126	51.22206331	17.45985037	71.16760778	0	3.883536475	14.76184603	52.14120753	226.4881321	0	6.71258397	0	0	10.12937293	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.061337049	0.061337049	0.160997346	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.3978	0	7.583485218	0	1.945654084	2.590155772	0	2.289476834	11.83229662	4.033225436	16.4397174	0	0.897096926	3.409986433	12.04461894	52.31875851	0	1.550606897	0	0	2.339885146	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.6728			23.3978	0	7.583485218	0	1.945654084	2.590155772	0	2.289476834	11.83229662	4.033225436	16.4397174	0	0.897096926	3.409986433	12.04461894	52.31875851	0	1.550606897	0	0	2.339885146	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.6728		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.1906	0	1.0341	0	0.2653	0.3532	0	0.3122	1.6135	0.55	2.2418	0	0.1223	0.465	1.6424	7.1344	0	0.2114	0	0	0.3191	0	0	0	0	0	0	0	0	0											19.4554			26.5884	0	8.617596839	0	2.21097055	2.943358832	0	2.60167822	13.44579162	4.583210723	18.68149704	0	1.019428325	3.874984583	13.68706698	59.45313467	0	1.762053292	0	0	2.658960394	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	162.1282
H5512_001_0	2009	7																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	5000	1473.451376	0	1108.695168	972.8173033	228.5240822	12.02412482	0	210.2764211	330.6759515	1767.288615	4671.447538	0	84.05117042	676.2739043	5852.14391	6870.381264	0	979.9096356	0	0	220.9124198	0	0	0	830.4682882	0	45.17218171	0	0	0											$200/day 1-10	$200/day 1-10	"$0 1-10, $75 11-100"	$35 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$100 per procedure	$35 per visit	$35 X-ray; $175 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$25 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$1000 Every 3 Yrs	Fitness/Coaching	0											163.9294809	163.9294809	47.56208437	35	100	0.2	0.2	47.5	100	35	60.2	35	25	35	25	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											126.9563558	126.9563558	36.83479549	35	100	0.154891427	0.154891427	36.78671381	77.44571329	27.10599965	46.6223194	27.10599965	19.36142832	27.10599965	25	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											15.5887	0	3.403213314	2.837383801	1.904367352	1.862433847	0	0.644614877	2.134119578	3.992010381	18.1494766	0	0.135612559	1.527590018	12.19196648	20.03861202	0	2.858069771	0	0	0.828421574	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.0966	0	13.8152	15.5887	0	3.403213314	2.837383801	1.904367352	1.862433847	0	0.644614877	2.134119578	3.992010381	18.1494766	0	0.135612559	1.527590018	12.19196648	20.03861202	0	2.858069771	0	0	0.828421574	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.0966		$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$100 copay	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$50 copay	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$25 copay	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP				$1000 ded; 30% coinsurance; $5000 max OOP	0	$1000 ded; 30% coinsurance; $5000 max OOP	0	Not Covered												10.6923	0	1.07	0.172	0.1758	0.3315	0	0.1089	0.9275	0.6348	1.7541	0	0.0498	0.5983	1.0014	4.6715	0	0.1846	0	0	0.243	0	0	0	0.1215	0	0.0048	0	0	0											22.7418	1000	11.5335522	26.281	0	4.473202229	3.009339492	2.080142316	2.193913294	0	0.753509371	3.061634513	4.626843243	19.90358213	0	0.185453371	2.125883017	13.19335247	24.71007939	0	3.042718821	0	0	1.071372525	0	0	0	0.121491701	0	0.004847875	0	0	0	0	0	0	0	0	0	0	0	0	0	110.8383
H5512_002_0	2009	6																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3500	1499.123029	0	1128.011746	989.7665079	232.5056123	12.23361878	0	213.9400259	336.4372536	1798.079737	4752.83725	0	85.51557744	688.0564916	5954.104662	6990.082565	0	996.9824085	0	0	224.7613335	0	0	0	844.9373739	0	45.95920775	0	0	0											$200/day 1-10	$200/day 1-10	"$0 1-10, $75 11-100"	$35 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$100 per procedure	$25 per visit	$25 X-ray; $175 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$1000 Every 3 Yrs	Fitness/Coaching	0											163.9294809	163.9294809	47.56208437	35	100	0.2	0.2	47.5	100	25	52	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											120.1145764	120.1145764	34.84973897	35	100	0.146544204	0.146544204	34.80424845	73.27210199	18.3180255	38.10149303	18.3180255	18.3180255	18.3180255	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											15.0055	0	3.275909574	2.886818981	1.93754677	1.792765926	0	0.620501818	2.05428873	2.744772539	15.09084961	0	0.130539711	1.050319696	4.961753885	14.56267201	0	2.077046684	0	0	0.842855001	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.0342	0	15.235	15.0055	0	3.275909574	2.886818981	1.93754677	1.792765926	0	0.620501818	2.05428873	2.744772539	15.09084961	0	0.130539711	1.050319696	4.961753885	14.56267201	0	2.077046684	0	0	0.842855001	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.0342		$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$100 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$50 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$25 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP				$500 ded; 30% coinsurance; $3500 max OOP	0	$500 ded; 30% coinsurance; $3500 max OOP	0	Not Covered												8.3117	0	0.8318	0.1337	0.1364	0.2577	0	0.0772	0.721	0.4935	1.3636	0	0.0298	0.4651	0.7784	3.6314	0	0.1435	0	0	0.1889	0	0	0	0.0944	0	0.0038	0	0	0											17.6618	500	14.86305203	23.3172	0	4.107667674	3.020489094	2.073980824	2.050442162	0	0.697665228	2.775294387	3.23826118	16.45440718	0	0.160381954	1.515403999	5.740183358	18.19404686	0	2.220584006	0	0	1.031713426	0	0	0	0.094441825	0	0.003768506	0	0	0	0	0	0	0	0	0	0	0	0	0	86.696
H5512_008_0	2009	7																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	V	V	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	7500	1099.099212	0	618.3907755	989.1954635	219.4271937	12.73261227	0	187.848307	266.9440145	1783.279566	3588.407254	0	144.0883606	983.0379993	4904.734716	9953.832025	0	1600.291	0	0	214.3443451	0	0	0	531.7688406	0	57.60720481	0	0	0											$900 per stay	$900 per stay	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$35 per visit	$35 X-ray; $150 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$25 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											152.1692361	152.1692361	47.8866492	20	100	0.2	0.2	48.5	250	35	81	35	25	35	25	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											152.1692361	152.1692361	47.8866492	20	100	0.2	0.2	48.5	250	35	81	35	25	35	25	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											13.9374	0	2.467721845	1.648659106	1.828559947	2.546522454	0	0.759220241	5.561333635	5.201232067	24.22174896	0	0.300184085	2.867194165	10.21819732	29.03201007	0	4.667515418	0	0	0.803791294	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.0613	0	0	13.9374	0	2.467721845	1.648659106	1.828559947	2.546522454	0	0.759220241	5.561333635	5.201232067	24.22174896	0	0.300184085	2.867194165	10.21819732	29.03201007	0	4.667515418	0	0	0.803791294	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.0613		$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$100 copay	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$50 copay	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$25 per visit	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP		0	0	$500 ded; 30% coinsurance; $7500 max OOP	0	$500 ded; 30% coinsurance; $7500 max OOP	0	Not Covered												7.1834	0	0.8852	0.134	0.1937	0.2116	0	0.1079	0.9499	0.3301	1.3437	0	6.5085	0.2944	0.9849	4.2788	0	0.1262	0	0	0.1914	0	0	0	0.0892	0	0.0057	0	0	0											23.8184	500	8.947850619	21.1208	0	3.352937631	1.782685819	2.022291746	2.758095926	0	0.867157635	6.511223867	5.531294525	25.56540494	0	6.808678503	3.161565891	11.20312558	33.31079643	0	4.793715051	0	0	0.995170919	0	0	0	0.089154894	0	0.005667276	0	0	0	0	0	0	0	0	0	0	0	0	0	129.8797
H5512_009_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	5000	1136.050646	0	639.180915	1022.451962	226.8042797	13.16067944	0	194.163719	275.9186039	1843.232968	3709.048587	0	148.9325744	1016.087485	5069.630641	10288.47731	0	1654.092374	0	0	221.5505471	0	0	0	549.6467729	0	59.54394429	0	0	0											$500/stay	$500/stay	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$35 per visit	$35 X-ray; $150 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$15 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											84.53846451	84.53846451	47.8866492	20	100	0.2	0.2	48.5	250	35	81	35	25	35	15	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											84.53846451	84.53846451	47.8866492	20	100	0.2	0.2	48.5	250	35	81	35	25	35	15	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											8.0033	0	2.550686021	1.704086603	1.890035664	2.632135887	0	0.784745031	5.748304248	5.376096157	25.03607796	0	0.310276197	2.963588498	6.337038302	30.00805882	0	4.824436091	0	0	0.830814552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.9997	0	0	8.0033	0	2.550686021	1.704086603	1.890035664	2.632135887	0	0.784745031	5.748304248	5.376096157	25.03607796	0	0.310276197	2.963588498	6.337038302	30.00805882	0	4.824436091	0	0	0.830814552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.9997		$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$100 copay	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$50 copay	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$25 per visit	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP		0	0	$250 ded; 20% coinsurance; $5000 max OOP	0	$250 ded; 20% coinsurance; $5000 max OOP	0	Not Covered												4.7047	0	0.5798	0.0878	0.1834	0.1386	0	0.096	0.6221	0.2162	0.88	0	6.4905	0.1928	0.6451	2.8024	0	0.0827	0	0	0.1253	0	0	0	0.0584	0	0.0037	0	0	0											17.9094	250	6.952542552	12.708	0	3.130449775	1.791866138	2.073429418	2.770703942	0	0.880765167	6.370425922	5.59226746	25.9160928	0	6.800809072	3.156384492	6.982107801	32.8104097	0	4.907089354	0	0	0.956156837	0	0	0	0.058391159	0	0.003711729	0	0	0	0	0	0	0	0	0	0	0	0	0	116.9091
H5512_801_0	2009	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																																																			0	Unlimited	333.6210869	0	36.25777728	4.377502319	8.952612773	7.91790947	0	7.649429043	37.69839853	25.5536088	70.5564854	0	13.26934836	17.42967391	31.19740039	136.018593	0	8.339177325	0	0	7.891608663	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.063629027	0.063629027	0.158560919	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											21.228	0	5.749066502	0	2.068053551	1.829037087	0	1.767018109	8.708330061	5.902883633	16.29854813	0	3.065219471	4.026254673	7.206599491	31.42029498	0	1.926349962	0	0	1.822961601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.0186			21.228	0	5.749066502	0	2.068053551	1.829037087	0	1.767018109	8.708330061	5.902883633	16.29854813	0	3.065219471	4.026254673	7.206599491	31.42029498	0	1.926349962	0	0	1.822961601	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.0186		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											2.8947	0	0.784	0	0.282	0.2494	0	0.241	1.1875	0.8049	2.2225	0	0.418	0.549	0.9827	4.2846	0	0.2627	0	0	0.2486	0	0	0	0	0	0	0	0	0											15.4116	135	0	24.1227	0	6.533030116	0	2.350060853	2.078451236	0	2.007975124	9.895829615	6.70782231	18.52107742	0	3.483203944	4.575289401	8.189317604	35.70488065	0	2.189034048	0	0	2.071547274	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4302
H5512_802_0	2009	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																																																			0	Unlimited	325.7682436	0	35.4043341	4.274463749	8.741884292	7.731536052	0	7.469375174	36.81104571	24.95212258	68.89571202	0	12.95701165	17.01941058	30.46306943	132.8169587	0	8.142888017	0	0	7.70585432	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.063668971	0.063668971	0.158461293	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.7413	0	5.610216545	0	2.019375271	1.785984828	0	1.725425665	8.503351558	5.763940317	15.91490948	0	2.993069691	3.931483845	7.036969038	30.68071747	0	1.881007132	0	0	1.780052348	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.3678			20.7413	0	5.610216545	0	2.019375271	1.785984828	0	1.725425665	8.503351558	5.763940317	15.91490948	0	2.993069691	3.931483845	7.036969038	30.68071747	0	1.881007132	0	0	1.780052348	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.3678		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											2.8284	0	0.765	0	0.2754	0.2435	0	0.2353	1.1595	0.786	2.1702	0	0.4081	0.5361	0.9596	4.1837	0	0.2565	0	0	0.2427	0	0	0	0	0	0	0	0	0											15.0502	135	0	23.5697	0	6.375246073	0	2.294744627	2.029528214	0	1.960710983	9.662899498	6.549932179	18.08512441	0	3.401215558	4.467595278	7.996555725	34.86445167	0	2.137508104	0	0	2.022786759	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.418
H5516_001_0	2009	5																					3750											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	6500	1556.66514	177.6358797	847.1387471	647.075962	111.29157	12.82853023	5.624263357	288.1245771	45.37845034	12069.67889	51.22422067	0	0.066327593	33.96626874	5979.060274	5408.351003	692.4875125	436.2059106	0	0	26.32456859	1093.336432	0	0	217.3191066	0	17.09154623	0	109.6126117	0											"$270 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$270 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$115 Days 1-25 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$15 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											266.8145086	270	87.8078022	0	150	0.2	0.075999193	49.24003655	0.2	2.8	0.172400676	0	0.2	0.194832651	10.55007405	25	37.5	25	0	0	0.2	23.72698762	0	0	25	0	25	0	0	0											184.5635617	186.7463196	60.73253293	0	103.7479553	0.138330607	0.052565072	34.05702074	0.138330607	1.936628499	0.119241451	0	0.138330607	0.135006187	10.55007405	25	37.5	17.29132589	0	0	0.138330607	23.72698762	0	0	25	0	25	0	0	0											23.942	2.764403896	4.287406821	0	0.962189403	1.774578374	0.29563981	0.817722058	6.277228584	1.947873676	6.108050386	0	0.009175136	4.585656432	5.256627387	11.26739792	2.164023477	0.628548213	0	0	3.641493554	2.161798332	0	0	0.452748139	0	0.035607388	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3801	0	25.8597	23.942	2.764403896	4.287406821	0	0.962189403	1.774578374	0.29563981	0.817722058	6.277228584	1.947873676	6.108050386	0	0.009175136	4.585656432	5.256627387	11.26739792	2.164023477	0.628548213	0	0	3.641493554	2.161798332	0	0	0.452748139	0	0.035607388	0	0	0	0	0	0	0	0	0	0	0	0	0	79.3801		"$350 Days 1-19 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$350 Days 1-19 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-38 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.5049	0.0574	0.4729	0.0916	0.0762	0.2107	0.0924	0.0647	0.7453	0.1542	0.7124	0	0.0007	0.5431	0.9273	1.5458	0.2426	0.0915	0	0	0.5681	0.3032	0	0	0.0627	0	0.0049	0	0	0											7.4726	0	1.680051583	24.4469	2.821787601	4.760311716	0.091617922	1.038345282	1.985261285	0.388007069	0.882443559	7.022478728	2.102045018	6.820418012	0	0.009901335	5.128791554	6.183933498	12.81323858	2.40658435	0.720063895	0	0	4.209560731	2.46504076	0	0	0.515436343	0	0.040537642	0	0	0	0	0	0	0	0	0	0	0	0	0	86.8527
H5517_002_0	2009	6																					2500											D	D	D	V	T	Coin	P	V	V	P	P	V	Coin	V	V	V	V	V	P	V	Coin	Coin	T	V	V	P	V	P	O	P																																																			0	3500	1767.922802	65.4305597	748.3337391		148.6279941	12.03469736	854.8870285	354.2160996	329.8097702		284.8021538	35.32961853	0.018282539	807.6193998	3165.673381	4342.597574	171.6479182	558.0441489	175.3991775	8.549101236	15.49685987				105.4421721		250.2787971														1a: $75/d (1-7) then $0;1a1: $75/d (1-7) then $0	1b: $75/d (1-7) then $0	2: $25/d (1-20) then $50/d (21-100)	6: $0	10a: $50/trip	11a: 20%	11b: $50/visit;11c: $0/visit	4a: $50/visit;4a1: $50/visit;4b: $30/visit	9a: $75/visit;9b: $75/visit	8a: $0/visit	8b: $0/visit;8b: $150/visit;8b: $30/visit	9a: $30/visit	12a: 20%	3: 20%;5: 20%;9a: $30/visit;9c: $30/visit;9d: $30/visit; 7i: $30/visit; 7c: $30/visit; 7e: $30/visit	7a: $15/visit;14c: $0/visit;14d: $0/visit;14d1: $0/visit;14e: $0/visit;14e1: $0/visit;14f: $0/visit;14f1: $0/visit;14g: $0/visit	7b: $0/visit;7d: $30/visit;7f: $30/visit;7f1: $30/visit;16b: $30/visit;17a: $30/visit;18a: $30/visit	7e: $30/visit;7h: $30/visit	7c: $30/visit;7i: $30/visit	8b: $0/visit; 8b: $150/visit; 8b: $30/visit; 14h: $0/visit	7g: $30/visit;14b: $0/visit;14i: $0/visit;17b: $0/visit; 7a: $15/visit; 7d: $30/visit; 8a: $0/visit; 12: 20%	15: 20%	13a: $0		16a: $200 max combined with 16b1;16b1: $200 max combined with 16a	17a1: $30/visit	17b1: $200/2 years	18a1: $30/visit ($300/3 years combined with 18b)	18b: $300/3 years combined with 18a	14a: $0/visit	14c1: $0/visit;13a1: $0											58.90310245	49.04845132	30.1431129		30	0.2	50	45	72.93647465		121.8153586	30	0.2	30.05919621	15	30	29.53430905	29.65158787	27.8104384	29.06416583	0.2				30		30														54.24074051	49.04845132	27.75719269		27.62540762	0.184169384	46.04234603	41.43811143	67.16332808		112.1732979	27.62540762	0.184169384	27.97616209	15	30	29.53430905	29.65158787	27.8104384	29.06416583	0.184169384				30		30														7.9911	0.267438969	1.730970316	0	0.342159077	2.216422802	3.280083699	1.223170517	1.845926817	0	2.662266403	0.081332926	0.003367084	1.882840936	3.957091727	10.85649394	0.422458555	1.378907926	0.406494002	0.020706041	2.854047139	0	0	0	0.26360543	0	0.625696993	0	0	0	0	0	0	0	0	0	0	0	0	0	44.3126	0	2.223	7.9911	0.267438969	1.730970316	0	0.342159077	2.216422802	3.280083699	1.223170517	1.845926817	0	2.662266403	0.081332926	0.003367084	1.882840936	3.957091727	10.85649394	0.422458555	1.378907926	0.406494002	0.020706041	2.854047139	0	0	0	0.26360543	0	0.625696993	0	0	0	0	0	0	0	0	0	0	0	0	0	44.3126		OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: $50/visit	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%			OON: $200 max combined 16a and 16b1	OON: $35/visit	OON: 30%	OON: $35/visit	OON: 30%		OON: 30%											2.761	0.0589	0.2584	0.1767	0.0862	0.1262	0.1086	0.0521	0.3413	0.0714	0.1779	0.0187	0.0002	0.2437	0.3268	0.9028	0.0143	0.0413	0.2383	0.096	0.1625			0.1272	0.0172		0.0409	0.0099		0.0184											6.4771	250	4.5025	10.7522	0.326363479	1.989398071	0.176662173	0.428393374	2.342637871	3.3887254	1.27528948	2.187276449	0.071361356	2.840136398	0.099984381	0.003523962	2.126546665	4.283891314	11.75926458	0.436776483	1.420215332	0.644816611	0.116667147	3.016571977	0	0	0.127196595	0.280848663	0	0.666625736	0.009914205	0	0.018417049	0	0	0	0	0	0	0	0	0	0	50.7897
H5517_003_0	2009	4																					3500											D	D	D	V	T	Coin	Coin	V	V	P	P	Coin	Coin	Coin	V	V	V	V	P	V	Coin	Coin	T	Coin	V	Coin	V	P	O	P											4.2683	0.1313	0.6259		0.1529	0.2939	0.253	0.328	0.66		0.9939	0.0531	0.0009	0.6356	1.3029	2.6835	0.1047	0.3419	0.103	0.9281	0.3785				0.0559		0.1327														14.4282	4000	1714.908161	63.46935427	725.9152193		144.2680339	11.55324251	9.944643938	343.8252704	320.1348937		276.4475631	2.086678689	0.017551136	26.59523051	3072.809247	4219.180167	166.612675	541.6740814	170.2538922	5779.981149	14.87689926				105.4421721		250.2787971														1a: $150/d (1-7) then $0;1a1: $150/d (1-7) then $0	1b: $150/d (1-7) then $0	2: $25/d (1-20) then $100/d (21-100)	6: $0	10a: $50/trip	11a: 10%	11b: 10%;11c: $0/visit	4a: $50/visit;4a1: $50/visit;4b: $25/visit	9a: $100/visit;9b: $100/visit	8a: $0/visit	8b: 10%;8b: $200/visit	9a: 10%	12a: 20%	3: 10%;5: 10%;9a: 10%;9c: $30/visit;9d: 10%; 7i: $30/visit; 7c: $30/visit; 7e: $30/visit	7a: $20/visit;14c: $0/visit;14d: $0/visit;14d1: $0/visit;14e: $0/visit;14e1: $0/visit;14f: $0/visit;14f1: $0/visit;14g: $0/visit	7b: $30/visit;7d: $30/visit;7f: $30/visit;7f1: $30/visit;16b: $30/visit;17a: $30/visit;18a: $30/visit	7e: $30/visit;7h: $30/visit	7c: $30/visit;7i: $30/visit	8b: 10%; 8b: $200/visit; 8b: 10%; 14h: $0/visit	7g: $30/visit;14b: $0/visit;14i: $20/visit;17b: $0/visit; 7a: $20/visit; 7d: $30/visit; 8a: $0/visit; 12: 20%	15: 10%	13a: $0		16a: $100 max combined with 16b1;16b1: $100 max combined with 16a	17a1: $30/visit	17b1: $100/2 years	18a1: $30/visit ($200/3 years combined with 18b)	18b: $200/3 years combined with 18a	14a: $0/visit	14c1: $0/visit;13a1: $0											117.3975135	97.57691176	40.66761737		50	0.1	0.1	45	97.24863286		169.5767991	0.1	0.2	0.093940982	20	30	29.65233129	29.76772525	28.54029227	7.57376142	0.1				25		25														138.6601214	122.4018044	48.03318737		59.05581698	0.118111634	0.118111634	53.15023528	114.8619493		200.2899282	0.118111634	0.236223268	0.111007956	25.08827185	37.63240777	37.19628742	37.34103916	35.80133055	9.50062927	0.118111634				31.36033981		31.36033981														19.8158	0.647396957	2.905668478	0	0.709988884	1.36457235	1.174578145	1.522866168	3.064276494	0	4.614138547	0.246461029	0.004145987	2.95228217	6.424289477	13.23149238	0.516447746	1.685556091	0.507942989	4.576121507	1.757134879	0	0	0	0.275558529	0	0.65406901	0	0	0	0	0	0	0	0	0	0	0	0	0	68.6508	200	2.489	24.0841	0.778698616	3.531552255	0	0.86292117	1.658502543	1.427583404	1.850893001	3.72432459	0	5.608028415	0.299548972	0.005039036	3.587904531	7.727230208	15.91503433	0.621190971	2.027411746	0.610961325	5.504226494	2.135623418	0	0	0	0.331445866	0	0.78672386	0	0	0	0	0	0	0	0	0	0	0	0	0	83.079		OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: $50/visit	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%				OON: $35/visit	OON: 30%	OON: $35/visit	OON: 30%		OON: 30%											2.8836	0.0591	0.2698	0.1845	0.09	0.1318	0.1134	0.0551	0.3564	0.0745	0.1857	0.0195	0.0002	0.2543	0.3516	0.9428	0.0144	0.0431	0.2488	0.1002	0.1697				0.0175	0.0185	0.0416	0.0063		0.0101											6.6425	300	3.76	26.9677	0.83777092	3.801392255	0.184459242	0.952961459	1.790288175	1.541020058	1.905952568	4.080739849	0.074510924	5.793748787	0.319023618	0.005202838	3.842183126	8.078783564	16.85787122	0.635544811	2.070542273	0.859802416	5.60442289	2.305321367	0	0	0	0.348975187	0.01854528	0.828331665	0.006279691	0	0.010139161	0	0	0	0	0	0	0	0	0	0	89.7215
H5517_004_0	2009	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																																																			0	0	325.8612102	2.654962867	34.97408704		20.71585101	27.8912735	23.5423386	46.2986358	37.77521103	9.440626665	21.32402398	1.907714085	3.540047728	36.93216999	39.75887463	87.46771618	0.902804829	9.433276842	22.7083207	11.75963219	6.509936576																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS			16a: $750 max combined with 16b1;16b1: $750 max combined with 16a	17a1: $0/visit	17b1: $300/year	18a1: $0/visit	"18b: $1,500/3 years"	14a: $0/visit	13c: $35/month OTC Card											0.081549262	0.081549262	0.208536463		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.081549262	0.081549262	0.208536463		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				26.5737	0.216510261	7.293372397	0	4.785361584	6.442884179	5.438280217	10.69498487	8.726073749	2.18078476	4.92584954	0.440681954	0.817751025	8.531331268	9.184300039	20.20504244	0.208547915	2.179086951	5.245622082	2.716475037	1.503795349	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.3105	0	0	26.5737	0.216510261	7.293372397	0	4.785361584	6.442884179	5.438280217	10.69498487	8.726073749	2.18078476	4.92584954	0.440681954	0.817751025	8.531331268	9.184300039	20.20504244	0.208547915	2.179086951	5.245622082	2.716475037	1.503795349	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.3105		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS			OON: $750 max combined 16a and 16b1	OON: $0/visit	OON: $300/year	OON: $0/visit	"OON: $1,500/3 years"													1.434	0.0114	0.3936		0.2503	0.3391	0.2862	0.4605	0.3758	0.0939	0.2121	0.019	0.036	0.3674	0.4739	1.0426	0.011	0.1008	0.2707	0.1402	0.0791																				6.3976	0	0	28.0078	0.227905538	7.687006405	0	5.035694167	6.781983346	5.724505492	11.15553446	9.10183769	2.274694151	5.137967463	0.459658689	0.853788309	8.898709169	9.65820613	21.24761429	0.219524122	2.279850994	5.516294016	2.856644027	1.582942473	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.7081
H5517_005_0	2009	4																					1500											D	D	D	V	T	Coin	P	V	V	P	V	V	V	V	V	V	V	V	P	V	Coin	Coin	T	P	V	P	V	P	O	V																																																			0	2500	2009.107998	58.81981829	777.1395784		191.2903746	16.51218659	1109.983328	355.9250432	448.891518		328.0003608	7.425582478	0.515903145	1031.863175	4124.089174	4767.394986	251.0682601	562.4350495	155.2210386	5.723976817	12.81133292				105.4421721		250.2787971														1a: $50/d (1-5) then $0;1a1: $50/d (1-5) then $0	1b: $50/d (1-5) then $0	2: $0/d (1-20) then $25/d (21-100)	6: $0	10a: $50/trip	11a: 10%	11b: $50/visit;11c: $0/visit	4a: $50/visit;4a1: $50/visit;4b: $25/visit	9a: $75/visit;9b: $75/visit	8a: $0/visit	8b: $0/visit;8b: $50/visit;8b: $25/visit	9a: $25/visit	12a: 20%	3: 10%;5: 10%;9a: $25/visit;9c: $30/visit;9d: $25/visit; 7i: $25/visit; 7c: $25/visit; 7e: $25/visit	7a: $15/visit;14c: $0/visit;14d: $0/visit;14d1: $0/visit;14e: $0/visit;14e1: $0/visit;14f: $0/visit;14f1: $0/visit;14g: $0/visit	7b: $25/visit;7d: $25/visit;7f: $25/visit;7f1: $25/visit;16b: $25/visit;17a: $25/visit;18a: $25/visit	7e: $25/visit;7h: $25/visit	7c: $25/visit;7i: $25/visit	7a: $15; 7d: $25/visit; 8b: $0/visit; 8b: $50/visit; 8b: 2500%; 14h: $0/visit	7g: $25/visit;14b: $0/visit;14i: $25/visit;17b: $0/visit; 7a: $15/visit; 7d: $25/visit; 8a: $0/visit; 12: 20%	15: 10%	13a: $0		16a: $200 max combined with 16b1;16b1: $200 max combined with 16a	17a1: $25/visit	17b1: $200/2 years	18a1: $25/visit ($300/3 years combined with 18b)	18b: $300/3 years combined with 18a		14c1: $0/visit;13a1: $0											33.99089777	30.09331989	6.342794384		30	0.09	50	45	73.32628527		46.20752801	25	162.2896245	25	15	25	24.88994143	24.58334468	25	25	0.1				25		25														30.97841503	30.09331989	5.780656875		27.3412152	0.082023646	45.56869201	41.01182281	66.82765819		42.11233225	22.784346	147.9065183	22.79110154	13.6706076	22.784346	24.88994143	22.40461724	22.784346	22.784346	0.091137384				25		25														5.1866	0.147506967	0.374364771	0	0.435842608	1.354389741	4.2150407	1.2164279	2.499864077	0	1.151071681	0.01409892	0.006358786	1.959774865	4.698233734	9.051831408	0.520756191	1.050095167	0.294717487	0.010868089	1.167591368	0	0	0	0.219671192	0	0.521414161	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0965	0	3.3725	5.1866	0.147506967	0.374364771	0	0.435842608	1.354389741	4.2150407	1.2164279	2.499864077	0	1.151071681	0.01409892	0.006358786	1.959774865	4.698233734	9.051831408	0.520756191	1.050095167	0.294717487	0.010868089	1.167591368	0	0	0	0.219671192	0	0.521414161	0	0	0	0	0	0	0	0	0	0	0	0	0	36.0965		OON: $125/d (1-5) then $0	OON: $125/d (1-5) then $0	OON: $0/d (1-20) then $25/d (21-100)	OON: 30%	OON: $50/trip	OON: 30%	OON: 30%	OON: $50/visit	OON: $100/visit	OON: $25/visit;OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%;OON: $35/visit	OON: $25/visit;OON: 30%	OON: $35/visit;OON: 30%		OON: $35/visit	OON: 2500%	OON: $35/visit;OON: 30%	OON: 30%	OON: 30%		OON: $200 max combined 16a and 16b1	OON: $35/visit		OON: $35/visit			OON: 30%											0.7382	0.0225	0.0223	0.2906	0.0252	0.2606	0.2035	0.0788	0.1924	0.2038	0.2423	0.007	0.0005	0.3087	0.452	0.7276	0.0462	0.0853	0.1705	0.4231	0.2022				0.0185		0.0439														4.7654	250	0.947	5.9248	0.169973092	0.39666367	0.29055888	0.460998674	1.614966359	4.418520129	1.29524124	2.692247733	0.203829914	1.393338157	0.021076893	0.006809218	2.268459784	5.150189998	9.77941189	0.567003055	1.135359564	0.465182597	0.433935688	1.369765307	0	0	0	0.238180758	0	0.565348687	0	0	0	0	0	0	0	0	0	0	0	0	0	40.8619
H5517_802_0	2009	5																					0											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	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	265.6930214	1.782405929	71.87912929	0	7.293914218	12.42539717	40.14907573	0.456248834	18.73753912	2.790868445	3.409886584	3.871893331	2.147253361	9.053805368	47.72245821	207.4579678	1.829511027	13.65169154	81.62815742	9.429395936	73.97704203	0	0	0	0	0	0	0	0	0											Medicare FFS 8.1%	Medicare FFS 8.1%	Medicare FFS 20.3%		Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%																			0.0808	0.0808	0.203	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.0808	0.0808	0.203	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											21.468	0.144018399	14.59146325	0	1.684894184	2.870266747	9.274436493	0.105393481	4.328371536	0.644690611	0.787683801	0.894407359	0.496015526	2.09142904	11.02388785	47.92279055	0.422617047	3.153540745	18.85610436	2.178190461	17.08869671	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.0269	0	0	21.468	0.144018399	14.59146325	0	1.684894184	2.870266747	9.274436493	0.105393481	4.328371536	0.644690611	0.787683801	0.894407359	0.496015526	2.09142904	11.02388785	47.92279055	0.422617047	3.153540745	18.85610436	2.178190461	17.08869671	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.0269	0	Medicare FFS 8.1%	Medicare FFS 8.1%	Medicare FFS 20.3%		Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%																			0.4852	0	0.827	0	1.5577	0.0449	0.4434	0.0047	0.0252	0.0557	0.0668	0.0019	0.0484	0.082	0.2157	1.9888	0	0.1934	0.1961	0.0801	0.437	0	0	0	0	0	0	0	0	0											6.7541	0	0	21.9532	0.144018399	15.4184879	0	3.242605356	2.915185382	9.717829936	0.110088275	4.353593202	0.700439133	0.854507621	0.89634704	0.544378283	2.173471014	11.23958484	49.91159183	0.422617047	3.346922321	19.05215568	2.258244707	17.52573882	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	166.781
H5517_804_0	2009	5																					0											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	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	266.008564	1.780763534	72.00163313	0	7.306345261	12.44657382	40.2174091	0.45702642	18.76113865	2.795624931	3.415698065	3.878492212	2.150912932	9.069235799	47.74364157	207.5829028	1.828476422	13.67360751	81.7468079	9.423401369	73.98242966	0	0	0	0	0	0	0	0	0											Medicare FFS 8%	Medicare FFS 8%	Medicare FFS 19.5%		Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%																			0.079600808	0.079600808	0.195076737	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.079600808	0.079600808	0.195076737	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											21.1745	0.141750216	14.04584365	0	1.687765755	2.875158552	9.290221503	0.105573103	4.333823028	0.645789359	0.789026253	0.895931701	0.496860887	2.09499347	11.0287812	47.95165055	0.422378054	3.158603334	18.88351263	2.176805716	17.08994125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	159.2889	0	0	21.1745	0.141750216	14.04584365	0	1.687765755	2.875158552	9.290221503	0.105573103	4.333823028	0.645789359	0.789026253	0.895931701	0.496860887	2.09499347	11.0287812	47.95165055	0.422378054	3.158603334	18.88351263	2.176805716	17.08994125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	159.2889	0	Medicare FFS 8%	Medicare FFS 8%	Medicare FFS 19.5%		Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%																			0.4788	0	0.7961	0	1.5604	0.045	0.4441	0.0047	0.0253	0.0558	0.0669	0.0019	0.0484	0.0822	0.2161	1.9916	0	0.1937	0.1964	0.0801	0.4378	0	0	0	0	0	0	0	0	0											6.7253	0	0	21.6533	0.141750216	14.84194332	0	3.24813174	2.920153742	9.734370623	0.110275899	4.359087679	0.701632894	0.855963962	0.897874687	0.545306068	2.177175268	11.24484581	49.94322454	0.422378054	3.352314491	19.07989807	2.256867739	17.52772821	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	166.0142
H5517_805_0	2009	5																					0											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	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	265.6930214	1.782405929	71.87912929	0	7.293914218	12.42539717	40.14907573	0.456248834	18.73753912	2.790868445	3.409886584	3.871893331	2.147253361	9.053805368	47.72245821	207.4579678	1.829511027	13.65169154	81.62815742	9.429395936	73.97704203	0	0	0	0	0	0	0	0	0											Medicare FFS 7.8%	Medicare FFS 7.8%	Medicare FFS 18.3%		Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%																			0.0779	0.0779	0.1833	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.0779	0.0779	0.1833	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											20.6975	0.138849422	13.1754444	0	1.684894184	2.870266747	9.274436493	0.105393481	4.328371536	0.644690611	0.787683801	0.894407359	0.496015526	2.09142904	11.02388785	47.92279055	0.422617047	3.153540745	18.85610436	2.178190461	17.08869671	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	157.8352	0	0	20.6975	0.138849422	13.1754444	0	1.684894184	2.870266747	9.274436493	0.105393481	4.328371536	0.644690611	0.787683801	0.894407359	0.496015526	2.09142904	11.02388785	47.92279055	0.422617047	3.153540745	18.85610436	2.178190461	17.08869671	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	157.8352	0	Medicare FFS 7.8%	Medicare FFS 7.8%	Medicare FFS 18.3%		Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%	Medicare FFS 23.1%																			0.4678	0	0.7468	0	1.5577	0.0449	0.4434	0.0047	0.0252	0.0557	0.0668	0.0019	0.0484	0.082	0.2157	1.9888	0	0.1934	0.1961	0.0801	0.437	0	0	0	0	0	0	0	0	0											6.6564	0	0	21.1652	0.138849422	13.92221099	0	3.242605356	2.915185382	9.717829936	0.110088275	4.353593202	0.700439133	0.854507621	0.89634704	0.544378283	2.173471014	11.23958484	49.91159183	0.422617047	3.346922321	19.05215568	2.258244707	17.52573882	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	164.4916
H5520_001_0	2009	3																					1500											D	D	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	V											0	0	0	0	0	0	0	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	427.0704269	10.19336802	130.3459588	9.450363589	138.5344306	8.427239379	3.333378852	349.7848377	330.1596645	5.850209636	18.37351253	0	1.193872455	245.0940026	4185.84294	5187.129311	202.6542174	455.9718841	13.40557241	21.27309465	9.821724276	0	0	557.6	249.6737561	0	0	0	8840	568.5274295											1a:  Acute - $100/$0/day for 1-4/5-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $100/$0/day for 1-4/5-190	2:  Skilled Nursing Services - $100/$0/day for 1-4/5-100/2:  Non-Medicare Covered Stay - $100/$0/day for 1-4/5-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $25/trip	11a:  Durable Medical Equipment - min $20 / max $600/service	11b:  Prosthetics Devices - min $20 / max $600/service/11b:  Medical Supplies - min $20 / max $600/service/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $25 to $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - min $20 / max $600/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - min $20 / max $600/visit/8b:  Outpatient Therapeutic Radiological Services - min $20 / max $600/visit/8b:  Outpatient X-Ray Services - $10/visit		12:  Renal Dialysis - min $20 / max $600/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - $25/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $10/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:   - $0	7d:  Physician Specialist Services - $10/visit/7b:  Chiropractic Services - $15/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14d:  Pap Smears and Pelvic Exams Screening - $10/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:   - $0	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $10 to $25/visit	15:  Medicare Part B Rx Drugs - min $20 / max $600/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $35/service/16a:  Preventive Dental - Prophylaxis - $35/service/16a:  Preventive Dental - X-Rays - $35/service	17a:  Routine Eye Exams - $10/visit	17b:  Wear - $100/service			14b:  Other Immunizations - n/a/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit	13b:  Acupuncture - $15/visit											100	100	100	0	25	0.15	0.060031366	40.82971422	100	0	0.122266752	0	0.15	25	10	13.68142681	25	25	0	25	0.15	0	0	35	10	0	0	0	0	15											82.57875539	82.57875539	82.57875539	0	25	0.15	0.060031366	33.74581994	82.57875539	4.15E-18	0.100966362	0	0.123868133	20.64468885	8.257875539	11.29795198	20.64468885	20.64468885	0	20.64468885	0.123868133	0	0	35	8.257875539	0	0	0	0	15											2.9389	0.070146304	0.896983921	0	0.288613397	1.264085907	0.200107285	0.983648013	2.272014514	2.43E-17	1.855106716	0	0.147882752	0.421657452	2.880514169	4.88366149	0.348644439	0.784449806	0	0.036598035	1.21659865	0	0	1.626333333	0.171814567	0	0	0	0	0.710659287	0	0	0	0	0	0	0	0	0	0	23.9984	0	4.4945	2.9389	0.070146304	0.896983921	0	0.288613397	1.264085907	0.200107285	0.983648013	2.272014514	2.43E-17	1.855106716	0	0.147882752	0.421657452	2.880514169	4.88366149	0.348644439	0.784449806	0	0.036598035	1.21659865	0	0	1.626333333	0.171814567	0	0	0	0	0.710659287	0	0	0	0	0	0	0	0	0	0	23.9984		1a:  Acute - $200/$0/day for 1-4/5-90	1b:  Psych - $200/$0/day for 1-4/5-90	2:  Skilled Nursing Services - $200/$0/day for 1-4/5-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $25/trip	11a:  Durable Medical Equipment - min $30 / max $900/service	11b:  Prosthetics Devices - min $30 / max $900/service/11b:  Medical Supplies - min $30 / max $900/service/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $200/visit/9b:  Ambulatory Surgical Center Services - $200/visit	8a:  Outpatient Diagnostic Procedures/Tests - min $20 / max $900/visit/8a:  Outpatient Lab Services - $20 / max $900/visit	8b:  Outpatient Diagnostic Radiological Services - min $30 / max $900/visit/8b:  Outpatient Therapeutic Radiological Services - min $30 / max $900/visit/8b:  Outpatient X-Ray Services - $20/visit		12:  Renal Dialysis - min $30 / max $900/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $35/visit/3:  Rehab Services (CORF) - $35/day/5:  Partial Hospitalization - $0/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $15-50/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $35/visit/7i:  Physical/Speech Therapy - $35/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $20 to $50/visit	15:  Medicare Part B Rx Drugs - min $30 / max $900/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $35/service/16a:  Preventive Dental - Prophylaxis - $35/service/16a:  Preventive Dental - X-Rays - $35/service; OON covered at 80% of UCR after $35 ded	17a:  Routine Eye Exams - $10/visit	17b:  Wear - $0/service			14b:  Other Immunizations - n/a/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit	13b:  Acupuncture - $15/visit/13b:  Chiropractic Services (Routine) - $15/visit											1.236	0.0295	0.3747	0	0.0529	0.3345	0.054	0.2417	0.934	0.2765	0.6226	0	0.0467	0.1233	1.1416	1.9466	0.1432	0.2333	0	0.015	0.3831	0	0	0.287	0.0362	0	0	0	0	0.1254											8.6378	0	0.2955	4.1749	0.099649454	1.271685856	0	0.341504075	1.598616871	0.254113035	1.22538317	3.206026154	0.276454898	2.477692141	0	0.194536396	0.544928088	4.022157964	6.830309261	0.491819779	1.017768183	0	0.051627491	1.599706829	0	0	1.913333333	0.207972046	0	0	0	0	0.836069749	0	0	0	0	0	0	0	0	0	0	32.6362
H5520_002_0	2009	6																					1950											D	D	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	V											0	0	0	0	0	0	0	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	437.4719872	10.83670491	132.3800686	8.218241239	143.8891215	10.77919538	3.378151324	373.4648528	385.8353555	7.091088813	19.96455056	0	2.251875087	312.7937643	5045.16299	5827.571432	214.4697617	512.9984801	12.80827673	22.51340039	11.81172291	0	0	557.6	262.1507512	0	0	0	8840	568.5274295											1a:  Acute - $100/$0/day for 1-4/5-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $100/$0/day for 1-4/5-190	2:  Skilled Nursing Services - $100/$0/day for 1-4/5-100/2:  Non-Medicare Covered Stay - $100/$0/day for 1-4/5-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - min $20 / max $600/service	11b:  Prosthetics Devices - min $20 / max $600/service/11b:  Medical Supplies - min $20 / max $600/service/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $25 to $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - min $20 / max $600/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - min $20 / max $600/visit/8b:  Outpatient Therapeutic Radiological Services - min $20 / max $600/visit/8b:  Outpatient X-Ray Services - $10/visit		12:  Renal Dialysis - min $20 / max $600/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - $25/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $10/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:   - $0	7d:  Physician Specialist Services - $10/visit/7b:  Chiropractic Services - $15/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14d:  Pap Smears and Pelvic Exams Screening - $10/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:   - $0	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $10 to $25/visit	15:  Medicare Part B Rx Drugs - min $20 / max $600/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $35/service/16a:  Preventive Dental - Prophylaxis - $35/service/16a:  Preventive Dental - X-Rays - $35/service	17a:  Routine Eye Exams - $10/visit	17b:  Wear - $100/service			14b:  Other Immunizations - n/a/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit	13b:  Acupuncture - $15/visit											100	100	100	0	50	0.15	0.036447234	40.82939427	100	0	0.124328829	0	0.15	25	10	13.00969824	25	25	0	25	0.15	0	0	35	10	0	0	0	0	15											85.79452797	85.79452797	85.79452797	0	50	0.15	0.036447234	35.05290842	85.79452797	1.71E-18	0.106667332	0	0.128691792	21.44863199	8.579452797	11.16160919	21.44863199	21.44863199	0	21.44863199	0.128691792	0	0	35	8.579452797	0	0	0	0	15											3.1277	0.077477499	0.946457125	0	0.599538006	1.616879307	0.123124272	1.090919107	2.75854685	1.21E-17	2.129565342	0	0.28979784	0.559083195	3.607061477	5.420422906	0.383340249	0.916926301	0	0.040240137	1.520071787	0	0	1.626333333	0.187425833	0	0	0	0	0.710659287	0	0	0	0	0	0	0	0	0	0	27.7316	0	4.19	3.1277	0.077477499	0.946457125	0	0.599538006	1.616879307	0.123124272	1.090919107	2.75854685	1.21E-17	2.129565342	0	0.28979784	0.559083195	3.607061477	5.420422906	0.383340249	0.916926301	0	0.040240137	1.520071787	0	0	1.626333333	0.187425833	0	0	0	0	0.710659287	0	0	0	0	0	0	0	0	0	0	27.7316		1a:  Acute - $200/$0/day for 1-4/5-90	1b:  Psych - $200/$0/day for 1-4/5-90	2:  Skilled Nursing Services - $200/$0/day for 1-4/5-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - min $30 / max $900/service	11b:  Prosthetics Devices - min $30 / max $900/service/11b:  Medical Supplies - min $30 / max $900/service/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $200/visit/9b:  Ambulatory Surgical Center Services - $200/visit	8a:  Outpatient Diagnostic Procedures/Tests - min $20 / max $900/visit/8a:  Outpatient Lab Services - $20 / max $900/visit	8b:  Outpatient Diagnostic Radiological Services - min $30 / max $900/visit/8b:  Outpatient Therapeutic Radiological Services - min $30 / max $900/visit/8b:  Outpatient X-Ray Services - $20/visit		12:  Renal Dialysis - min $30 / max $900/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $35/visit/3:  Rehab Services (CORF) - $35/day/5:  Partial Hospitalization - $0/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $15-50/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $35/visit/7i:  Physical/Speech Therapy - $35/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $20 to $50/visit	15:  Medicare Part B Rx Drugs - min $30 / max $900/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $35/service/16a:  Preventive Dental - Prophylaxis - $35/service/16a:  Preventive Dental - X-Rays - $35/service; OON covered at 80% of UCR after $35 ded	17a:  Routine Eye Exams - $10/visit	17b:  Wear - $0/service			14b:  Other Immunizations - n/a/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit	13b:  Acupuncture - $15/visit/13b:  Chiropractic Services (Routine) - $15/visit											1.2504	0.031	0.3768	0	0.1073	0.4216	0.0327	0.2541	1.0748	0.3385	0.6972	0	0.0863	0.1553	1.3555	2.1043	0.1478	0.2564	0	0.0155	0.4566	0	0	0.287	0.0374	0	0	0	0	0.1254											9.6117	0	0.3735	4.3782	0.108444991	1.323255223	0	0.706797591	2.038438368	0.155818478	1.345013029	3.833363861	0.338458131	2.826779262	0	0.376053768	0.71435833	4.962576777	7.524733304	0.531113496	1.17331744	0	0.055752245	1.976630966	0	0	1.913333333	0.224850314	0	0	0	0	0.836069749	0	0	0	0	0	0	0	0	0	0	37.3433
H5520_003_0	2009	3																					1750											D	D	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	V											0	0	0	0	0	0	0	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	611.8710233	17.14901515	200.6743952	10.60571308	151.588037	10.09652454	3.229200381	390.0976463	387.4022155	7.538427848	21.93494409	0	2.403451657	322.3207079	4950.932756	6326.462443	227.4470682	563.9998443	11.77092079	23.87565909	12.53900961	0	0	557.6	279.0700955	0	0	0	8840	568.5274295											1a:  Acute - $100/$0/day for 1-7/8-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $100/$0/day for 1-7/8-190	2:  Skilled Nursing Services - $100/$0/day for 1-7/8-100/2:  Non-Medicare Covered Stay - $100/$0/day for 1-7/8-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $25/trip	11a:  Durable Medical Equipment - min $20 / max $600/service	11b:  Prosthetics Devices - min $20 / max $600/service/11b:  Medical Supplies - min $20 / max $600/service/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $25 to $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - min $20 / max $600/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - min $20 / max $600/visit/8b:  Outpatient Therapeutic Radiological Services - min $20 / max $600/visit/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - min $20 / max $600/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - $25/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $15/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $15/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:   - $0	7d:  Physician Specialist Services - $15/visit/7b:  Chiropractic Services - $15/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14d:  Pap Smears and Pelvic Exams Screening - $15/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:   - $0	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $15 to $25/visit	15:  Medicare Part B Rx Drugs - min $20 / max $600/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $35/service/16a:  Preventive Dental - Prophylaxis - $35/service/16a:  Preventive Dental - X-Rays - $35/service	17a:  Routine Eye Exams - $10/visit	17b:  Wear - $100/service			14b:  Other Immunizations - n/a/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit	13b:  Acupuncture - $15/visit											100	100	100	0	25	0.15	0.038732742	40.82788162	100	0	0.136735644	0	0.15	25	15	17.02134988	25	25	0	25	0.15	0	0	35	10	0	0	0	0	15											78.32482593	78.32482593	78.32482593	0	25	0.15	0.038732742	32.01247667	78.32482593	-1.38E-18	0.107097955	0	0.117487239	19.58120648	11.74872389	13.33194266	19.58120648	19.58120648	0	19.58120648	0.117487239	0	0	35	7.832482593	0	0	0	0	15											3.9937	0.111932802	1.309815589	0	0.31580841	1.514478681	0.125075787	1.040665983	2.528600924	-1.04E-17	2.349187652	0	0.282374899	0.525952361	4.847261829	7.028669547	0.371140667	0.920316451	0	0.038959518	1.473173618	0	0	1.626333333	0.182150972	0	0	0	0	0.710659287	0	0	0	0	0	0	0	0	0	0	31.2963	0	8.049	3.9937	0.111932802	1.309815589	0	0.31580841	1.514478681	0.125075787	1.040665983	2.528600924	-1.04E-17	2.349187652	0	0.282374899	0.525952361	4.847261829	7.028669547	0.371140667	0.920316451	0	0.038959518	1.473173618	0	0	1.626333333	0.182150972	0	0	0	0	0.710659287	0	0	0	0	0	0	0	0	0	0	31.2963		1a:  Acute - $200/$0/day for 1-7/8-90	1b:  Psych - $200/$0/day for 1-7/8-90	2:  Skilled Nursing Services - $200/$0/day for 1-7/8-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $25/trip	11a:  Durable Medical Equipment - min $30 / max $900/service	11b:  Prosthetics Devices - min $30 / max $900/service/11b:  Medical Supplies - min $30 / max $900/service/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $200/visit/9b:  Ambulatory Surgical Center Services - $200/visit	8a:  Outpatient Diagnostic Procedures/Tests - min $25 / max $900/visit/8a:  Outpatient Lab Services - min $25 / max $900/visit	8b:  Outpatient Diagnostic Radiological Services - min $30 / max $900/visit/8b:  Outpatient Therapeutic Radiological Services - min $30 / max $900/visit/8b:  Outpatient X-Ray Services - $25/visit		12:  Renal Dialysis - min $30 / max $900/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $35/visit/3:  Rehab Services (CORF) - $35/day/5:  Partial Hospitalization - $0/day	7a:  Primary Care - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit	7d:  Physician Specialist Services - $25/visit/7b:  Chiropractic Services - $15-50/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $35/visit/7i:  Physical/Speech Therapy - $35/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $25 to $50/visit	15:  Medicare Part B Rx Drugs - min $30 / max $900/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $35/service/16a:  Preventive Dental - Prophylaxis - $35/service/16a:  Preventive Dental - X-Rays - $35/service; OON covered at 80% of UCR after $35 ded	17a:  Routine Eye Exams - $10/visit	17b:  Wear - $0/service			14b:  Other Immunizations - n/a/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit	13b:  Acupuncture - $15/visit/13b:  Chiropractic Services (Routine) - $15/visit											1.6197	0.0453	0.5326	0	0.0532	0.3747	0.0314	0.2483	1.0294	0.4619	0.6203	0	0.0879	0.1486	1.5527	2.4408	0.1458	0.2615	0	0.0153	0.4227	0	0	0.287	0.037	0	0	0	0	0.1254											10.5416	0	0.5775	5.6134	0.157246655	1.842410941	0	0.369042977	1.889176032	0.156488073	1.288954951	3.557984406	0.461901252	2.969504732	0	0.370231668	0.674526907	6.399987145	9.469506161	0.516904187	1.181864417	0	0.054260661	1.895919339	0	0	1.913333333	0.21911711	0	0	0	0	0.836069749	0	0	0	0	0	0	0	0	0	0	41.8379
H5520_004_0	2009	5																					2100											D	D	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	V											0	0	0	0	0	0	0	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	619.2087376	17.29232583	230.5691004	10.773385	151.9560581	11.99471612	3.93541674	371.3485365	423.7447966	8.546106895	21.13888056	0	1.578906868	313.7920065	5469.720306	6546.55913	229.6641511	725.4807294	11.79349023	24.10839155	12.88350546	0	0	557.6	282.4630093	0	0	0	8840	568.5274295											1a:  Acute - $100/$0/day for 1-7/8-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $100/$0/day for 1-7/8-190	2:  Skilled Nursing Services - $100/$0/day for 1-7/8-100/2:  Non-Medicare Covered Stay - $100/$0/day for 1-7/8-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - min $20 / max $600/service	11b:  Prosthetics Devices - min $20 / max $600/service/11b:  Medical Supplies - min $20 / max $600/service/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $25 to $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - min $20 / max $600/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - min $20 / max $600/visit/8b:  Outpatient Therapeutic Radiological Services - min $20 / max $600/visit/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - min $20 / max $600/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - $25/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $15/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $15/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:   - $0	7d:  Physician Specialist Services - $15/visit/7b:  Chiropractic Services - $15/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14d:  Pap Smears and Pelvic Exams Screening - $15/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:   - $0	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $15 to $25/visit	15:  Medicare Part B Rx Drugs - min $20 / max $600/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $35/service/16a:  Preventive Dental - Prophylaxis - $35/service/16a:  Preventive Dental - X-Rays - $35/service	17a:  Routine Eye Exams - $10/visit	17b:  Wear - $100/service			14b:  Other Immunizations - n/a/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit	13b:  Acupuncture - $15/visit											100	100	100	0	50	0.15	0.041534975	40.82811573	100	0	0.142521304	0	0.15	25	15	16.511812	25	25	0	25	0.15	0	0	35	10	0	0	0	0	15											81.66340558	81.66340558	81.66340558	0	50	0.15	0.041534975	33.37071867	81.66340558	2.44E-18	0.11638775	0	0.122495108	20.4158514	12.24951084	13.48410801	20.4158514	20.4158514	0	20.4158514	0.122495108	0	0	35	8.166340558	0	0	0	0	15											4.2139	0.117679185	1.569088163	0	0.633150242	1.799207418	0.163457437	1.032680628	2.883703599	2.08E-17	2.46030675	0	0.193408368	0.533860914	5.583449847	7.356209198	0.390732432	1.234275563	0	0.041016112	1.578166398	0	0	1.626333333	0.192224094	0	0	0	0	0.710659287	0	0	0	0	0	0	0	0	0	0	34.3135	0	7.1945	4.2139	0.117679185	1.569088163	0	0.633150242	1.799207418	0.163457437	1.032680628	2.883703599	2.08E-17	2.46030675	0	0.193408368	0.533860914	5.583449847	7.356209198	0.390732432	1.234275563	0	0.041016112	1.578166398	0	0	1.626333333	0.192224094	0	0	0	0	0.710659287	0	0	0	0	0	0	0	0	0	0	34.3135		1a:  Acute - $200/$0/day for 1-7/8-90	1b:  Psych - $200/$0/day for 1-7/8-90	2:  Skilled Nursing Services - $200/$0/day for 1-7/8-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - min $30 / max $900/service	11b:  Prosthetics Devices - min $30 / max $900/service/11b:  Medical Supplies - min $30 / max $900/service/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $200/visit/9b:  Ambulatory Surgical Center Services - $200/visit	8a:  Outpatient Diagnostic Procedures/Tests - min $25 / max $900/visit/8a:  Outpatient Lab Services - min $25 / max $900/visit	8b:  Outpatient Diagnostic Radiological Services - min $30 / max $900/visit/8b:  Outpatient Therapeutic Radiological Services - min $30 / max $900/visit/8b:  Outpatient X-Ray Services - $25/visit		12:  Renal Dialysis - min $30 / max $900/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $35/visit/3:  Rehab Services (CORF) - $35/day/5:  Partial Hospitalization - $0/day	7a:  Primary Care - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit	7d:  Physician Specialist Services - $25/visit/7b:  Chiropractic Services - $15-50/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $35/visit/7i:  Physical/Speech Therapy - $35/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $25 to $50/visit	15:  Medicare Part B Rx Drugs - min $30 / max $900/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $35/service/16a:  Preventive Dental - Prophylaxis - $35/service/16a:  Preventive Dental - X-Rays - $35/service; OON covered at 80% of UCR after $35 ded	17a:  Routine Eye Exams - $10/visit	17b:  Wear - $0/service			14b:  Other Immunizations - n/a/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit	13b:  Acupuncture - $15/visit/13b:  Chiropractic Services (Routine) - $15/visit											1.6625	0.0464	0.624	0	0.1079	0.4619	0.0427	0.2388	1.1385	0.5564	0.6623	0	0.0573	0.1464	1.7478	2.5395	0.1493	0.3443	0	0.0157	0.4461	0	0	0.287	0.038	0	0	0	0	0.1254											11.4381	0	0.5985	5.8764	0.164042002	2.193100063	0	0.741055045	2.261066592	0.206189324	1.271445952	4.02221116	0.556429407	3.122640225	0	0.250670309	0.680291873	7.331233415	9.895732181	0.539985371	1.578603111	0	0.056683547	2.024283984	0	0	1.913333333	0.230180203	0	0	0	0	0.836069749	0	0	0	0	0	0	0	0	0	0	45.7516
H5520_005_0	2009	5																					3350											D	D	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	coin	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	538.9858429	17.1966806	256.7772897	7.699081172	123.1525462	9.031955794	2.775111157	307.6545307	42.03490403	6.184898115	15.93649569	0	1.750432632	261.0584561	4369.253329	5087.237936	180.4314878	2.977151161	11.12000349	18.94032192	9.990646936	0	0	0	228.8003635	0	0	0	8840	568.5274295											1a:  Acute - $200/$0/day for 1-10/11-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $200/$0/day for 1-10/11-190	2:  Skilled Nursing Services - $100/$0/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $100/$0/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50 to $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - 30.0%/9b:  Ambulatory Surgical Center Services - 30.0%	8a:  Outpatient Diagnostic Procedures/Tests - min $20 / max $600/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - min $20 / max $600/visit/8b:  Outpatient Therapeutic Radiological Services - min $20 / max $600/visit/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - min $20 / max $600/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - 30.0%/5:  Partial Hospitalization - $40/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $10/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:   - $0	7d:  Physician Specialist Services - $10/visit/7b:  Chiropractic Services - $15/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14d:  Pap Smears and Pelvic Exams Screening - $10/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:   - $0	7e:  Mental Hlth Spec-Non-Physician - Individual - $40/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $40/visit/7h:  Psychiatric Services - Individual - $40/visit/7h:  Psychiatric Services - Group - $40/visit	7c:  Occupational Therapy Services - 30.0%/7i:  Physical/Speech Therapy - 30.0%		9c:  Outpatient Substance Abuse Svcs - Individual - $40/visit/9c:  Outpatient Substance Abuse Svcs - Group - $40/visit/7g:  Other Health Care Professional Services - $10 to $40/visit	15:  Medicare Part B Rx Drugs - min $20 / max $600/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $10/visit				14b:  Other Immunizations - n/a/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit	13b:  Acupuncture - $15/visit											200	200	100	0	150	0.3	0.3	50	0.3	0	0.135274096	0	0.15	49.21063704	10	12.99112501	40	0.3	0	40	0.15	0	0	0	10	0	0	0	0	15											179.4836407	179.4836407	89.74182033	9.01E-19	150	0.3	0.3	44.88885019	0.269225461	2.80E-19	0.121397436	0	0.13461273	44.16252147	8.974182033	11.65847207	35.89672813	0.269225461	0	35.89672813	0.13461273	0	0	0	8.974182033	0	0	0	0	15											8.0616	0.257210237	1.920305116	6.94E-18	1.539406827	2.709586738	0.832533347	1.150854845	11.31686641	1.73E-18	1.934649717	0	0.235630516	0.960749973	3.26753956	4.942451781	0.539741672	0.801524894	0	0.056657966	1.344868263	0	0	0	0.171108009	0	0	0	0	0.710659287	0	0	0	0	0	0	0	0	0	0	42.7539	0	4.586	8.0616	0.257210237	1.920305116	6.94E-18	1.539406827	2.709586738	0.832533347	1.150854845	11.31686641	1.73E-18	1.934649717	0	0.235630516	0.960749973	3.26753956	4.942451781	0.539741672	0.801524894	0	0.056657966	1.344868263	0	0	0	0.171108009	0	0	0	0	0.710659287	0	0	0	0	0	0	0	0	0	0	42.7539		1a:  Acute - $400/$0/day for 1-10/11-90	1b:  Psych - $400/$0/day for 1-10/11-90	2:  Skilled Nursing Services - $200/$0/day for 1-10/11-100	6:  Home Health Services - 40%/visit	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 30%/service	11b:  Prosthetics Devices - 30%/service/11b:  Medical Supplies - 30%/service/11c:  Diabetes Monitoring Supplies - 30%/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - 40%/visit/9b:  Ambulatory Surgical Center Services - 40%/visit	8a:  Outpatient Diagnostic Procedures/Tests - min $30 / max $900/visit/8a:  Outpatient Lab Services - min $30 / max $900/visit	8b:  Outpatient Diagnostic Radiological Services - min $30 / max $900/visit/8b:  Outpatient Therapeutic Radiological Services - min $30 / max $900/visit/8b:  Outpatient X-Ray Services - $30/visit		12:  Renal Dialysis - min $30 / max $900/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $35/visit/3:  Rehab Services (CORF) - $35/day/5:  Partial Hospitalization - $0/day	7a:  Primary Care - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - 0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $15-50/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $40/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $40/visit/7h:  Psychiatric Services - Individual - $40/visit/7h:  Psychiatric Services - Group - $40/visit	7c:  Occupational Therapy Services - 40%/visit/7i:  Physical/Speech Therapy - 40%/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $40/visit/9c:  Outpatient Substance Abuse Svcs - Group - $40/visit/7g:  Other Health Care Professional Services - $30/visit	15:  Medicare Part B Rx Drugs - min $30 / max $900/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $30/visit	17b:  Wear - 40%/service			14b:  Other Immunizations - n/a/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit	13b:  Acupuncture - $15/visit/13b:  Chiropractic Services (Routine) - $15/visit											3.1772	0.1014	0.7525	0.5	0.2789	0.4894	0.1504	0.225	2.9355	0.4807	0.6614	0	0.0692	0.2476	1.7789	2.3551	0.1064	0.2056	0	0.0112	0.4012	0	0	0	0.0927	0	0	0	0	0.1254											15.1455	0	0.3615	11.2388	0.358581927	2.672825723	0.499995494	1.818313551	3.198971342	0.982899083	1.375835613	14.25235715	0.480665444	2.596028599	0	0.304862233	1.208376972	5.046391411	7.297594851	0.646137443	1.007076192	0	0.067826582	1.746059203	0	0	0	0.263789187	0	0	0	0	0.836069749	0	0	0	0	0	0	0	0	0	0	57.8995
H5520_006_0	2009	4																					3350											D	D	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	coin	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	609.4213315	19.44396883	285.9316243	8.903459495	137.0008904	9.956482088	3.05917624	337.5703788	45.43830143	7.248415656	23.41278001	0	1.94844412	293.146458	4792.111698	5635.575966	204.0932201	3.316522142	11.51147196	21.42415018	12.02994562	0	0	0	250.6149417	0	0	0	8840	568.5274295											1a:  Acute - $200/$0/day for 1-10/11-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $200/$0/day for 1-10/11-190	2:  Skilled Nursing Services - $100/$0/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $100/$0/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50 to $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - 30.0%/9b:  Ambulatory Surgical Center Services - 30.0%	8a:  Outpatient Diagnostic Procedures/Tests - min $20 / max $600/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - min $20 / max $600/visit/8b:  Outpatient Therapeutic Radiological Services - min $20 / max $600/visit/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - min $20 / max $600/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - 30.0%/5:  Partial Hospitalization - $40/day	7a:  Primary Care - $15/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $15/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:   - $0	7d:  Physician Specialist Services - $15/visit/7b:  Chiropractic Services - $15/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14d:  Pap Smears and Pelvic Exams Screening - $15/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:   - $0	7e:  Mental Hlth Spec-Non-Physician - Individual - $40/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $40/visit/7h:  Psychiatric Services - Individual - $40/visit/7h:  Psychiatric Services - Group - $40/visit	7c:  Occupational Therapy Services - 30.0%/7i:  Physical/Speech Therapy - 30.0%		9c:  Outpatient Substance Abuse Svcs - Individual - $40/visit/9c:  Outpatient Substance Abuse Svcs - Group - $40/visit/7g:  Other Health Care Professional Services - $15 to $40/visit	15:  Medicare Part B Rx Drugs - min $20 / max $600/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $15/visit				14b:  Other Immunizations - n/a/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit	13b:  Acupuncture - $15/visit											200	200	100	0	150	0.3	0.3	50	0.3	0	0.135254558	0	0.15	45.62529024	15	16.52785724	40	0.3	0	40	0.15	0	0	0	15	0	0	0	0	15											172.9492902	172.9492902	86.47464508	2.53E-18	150	0.3	0.3	43.25935502	0.259423935	3.83E-18	0.116960899	0	0.129711968	39.4543078	12.97119676	14.29240589	34.58985803	0.259423935	0	34.58985803	0.129711968	0	0	0	12.97119676	0	0	0	0	15											8.7832	0.280235051	2.060486311	2.26E-17	1.71251113	2.986944626	0.917752872	1.216923072	11.78778297	2.78E-17	2.738379797	0	0.252736521	0.963824215	5.179951978	6.712161593	0.588296293	0.860385225	0	0.061754859	1.560427916	0	0	0	0.270897977	0	0	0	0	0.710659287	0	0	0	0	0	0	0	0	0	0	49.6454	0	7.136	8.7832	0.280235051	2.060486311	2.26E-17	1.71251113	2.986944626	0.917752872	1.216923072	11.78778297	2.78E-17	2.738379797	0	0.252736521	0.963824215	5.179951978	6.712161593	0.588296293	0.860385225	0	0.061754859	1.560427916	0	0	0	0.270897977	0	0	0	0	0.710659287	0	0	0	0	0	0	0	0	0	0	49.6454		1a:  Acute - $400/$0/day for 1-10/11-90	1b:  Psych - $400/$0/day for 1-10/11-90	2:  Skilled Nursing Services - $200/$0/day for 1-10/11-100	6:  Home Health Services - 40%/visit	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 30%/service	11b:  Prosthetics Devices - 30%/service/11b:  Medical Supplies - 30%/service/11c:  Diabetes Monitoring Supplies - 30%/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - 40%/visit/9b:  Ambulatory Surgical Center Services - 40%/visit	8a:  Outpatient Diagnostic Procedures/Tests - min $30 / max $900/visit/8a:  Outpatient Lab Services - min $30 / max $900/visit	8b:  Outpatient Diagnostic Radiological Services - min $30 / max $900/visit/8b:  Outpatient Therapeutic Radiological Services - min $30 / max $900/visit/8b:  Outpatient X-Ray Services - $30/visit		12:  Renal Dialysis - min $30 / max $900/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $35/visit/3:  Rehab Services (CORF) - $35/day/5:  Partial Hospitalization - $0/day	7a:  Primary Care - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - 0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $15-50/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $40/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $40/visit/7h:  Psychiatric Services - Individual - $40/visit/7h:  Psychiatric Services - Group - $40/visit	7c:  Occupational Therapy Services - 40%/visit/7i:  Physical/Speech Therapy - 40%/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $40/visit/9c:  Outpatient Substance Abuse Svcs - Group - $40/visit/7g:  Other Health Care Professional Services - $30/visit	15:  Medicare Part B Rx Drugs - min $30 / max $900/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $30/visit	17b:  Wear - 40%/service			14b:  Other Immunizations - n/a/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit	13b:  Acupuncture - $15/visit/13b:  Chiropractic Services (Routine) - $15/visit											3.2486	0.1036	0.7694	0.5112	0.2851	0.5002	0.1537	0.23	3.0014	0.4095	0.6762	0	0.0708	0.2532	1.8188	2.408	0.1088	0.2102	0	0.0114	0.4102	0	0	0	0.0948	0	0	0	0	0.1254											15.4004	0	0.3615	12.0318	0.383882436	2.829900267	0.511219907	1.997561575	3.487109327	1.071430843	1.446954105	14.78917259	0.409546596	3.414605988	0	0.323522422	1.217010198	6.99873731	9.120111808	0.697080544	1.070550952	0	0.073174201	1.970625199	0	0	0	0.365659756	0	0	0	0	0.836069749	0	0	0	0	0	0	0	0	0	0	65.0457
H5520_007_0	2009	5																					1950											D	D	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	V											0	0	0	0	0	0	0	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	424.3867551	10.32404375	125.5888518	8.431707301	137.2278856	10.16617657	3.289514692	352.4438938	369.6935124	6.773438179	17.45297442	0	1.916999614	289.498895	4785.020983	5571.327282	204.5750639	519.9689282	12.17815636	21.47473046	10.94160086	0	0	557.6	250.5724564	0	0	0	8840	568.5274295											1a:  Acute - $100/$0/day for 1-4/5-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $100/$0/day for 1-4/5-190	2:  Skilled Nursing Services - $100/$0/day for 1-4/5-100/2:  Non-Medicare Covered Stay - $100/$0/day for 1-4/5-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - min $20 / max $600/service	11b:  Prosthetics Devices - min $20 / max $600/service/11b:  Medical Supplies - min $20 / max $600/service/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $25 to $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - min $20 / max $600/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - min $20 / max $600/visit/8b:  Outpatient Therapeutic Radiological Services - min $20 / max $600/visit/8b:  Outpatient X-Ray Services - $10/visit		12:  Renal Dialysis - min $20 / max $600/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - $25/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $10/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:   - $0	7d:  Physician Specialist Services - $10/visit/7b:  Chiropractic Services - $15/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14d:  Pap Smears and Pelvic Exams Screening - $10/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:   - $0	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $10 to $25/visit	15:  Medicare Part B Rx Drugs - min $20 / max $600/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $35/service/16a:  Preventive Dental - Prophylaxis - $35/service/16a:  Preventive Dental - X-Rays - $35/service	17a:  Routine Eye Exams - $10/visit	17b:  Wear - $100/service			14b:  Other Immunizations - n/a/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit	13b:  Acupuncture - $15/visit											100	100	100	0	50	0.15	0.040019347	40.82968883	100	0	0.125562517	0	0.15	25	10	12.99112501	25	25	0	25	0.15	0	0	35	10	0	0	0	0	15											86.84064918	86.84064918	86.84064918	0	50	0.15	0.040019347	35.47876758	86.84064918	0	0.109039305	0	0.130260974	21.7101623	8.684064918	11.2815773	21.7101623	21.7101623	0	21.7101623	0.130260974	0	0	35	8.684064918	0	0	0	0	15											3.0712	0.074712222	0.908851451	0	0.571782856	1.524926486	0.131644231	1.042022916	2.675368718	0	1.903060193	0	0.249710236	0.523755666	3.462786071	5.237779948	0.370113153	0.940717485	0	0.038851657	1.425263583	0	0	1.626333333	0.18133229	0	0	0	0	0.710659287	0	0	0	0	0	0	0	0	0	0	26.6708	0	3.7165	3.0712	0.074712222	0.908851451	0	0.571782856	1.524926486	0.131644231	1.042022916	2.675368718	0	1.903060193	0	0.249710236	0.523755666	3.462786071	5.237779948	0.370113153	0.940717485	0	0.038851657	1.425263583	0	0	1.626333333	0.18133229	0	0	0	0	0.710659287	0	0	0	0	0	0	0	0	0	0	26.6708		1a:  Acute - $200/$0/day for 1-4/5-90	1b:  Psych - $200/$0/day for 1-4/5-90	2:  Skilled Nursing Services - $200/$0/day for 1-4/5-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - min $30 / max $900/service	11b:  Prosthetics Devices - min $30 / max $900/service/11b:  Medical Supplies - min $30 / max $900/service/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $200/visit/9b:  Ambulatory Surgical Center Services - $200/visit	8a:  Outpatient Diagnostic Procedures/Tests - min $0 / max $900/visit/8a:  Outpatient Lab Services - min $0 / max $900/visit	8b:  Outpatient Diagnostic Radiological Services - min $30 / max $900/visit/8b:  Outpatient Therapeutic Radiological Services - min $30 / max $900/visit/8b:  Outpatient X-Ray Services - $20/visit		12:  Renal Dialysis - min $30 / max $900/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $35/visit/3:  Rehab Services (CORF) - $35/day/5:  Partial Hospitalization - $0/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $15-50/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $35/visit/7i:  Physical/Speech Therapy - $35/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $20 to $50/visit	15:  Medicare Part B Rx Drugs - min $30 / max $900/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $35/service/16a:  Preventive Dental - Prophylaxis - $35/service/16a:  Preventive Dental - X-Rays - $35/service; OON covered at 80% of UCR after $35 ded	17a:  Routine Eye Exams - $10/visit	17b:  Wear - $0/service			14b:  Other Immunizations - n/a/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit	13b:  Acupuncture - $15/visit/13b:  Chiropractic Services (Routine) - $15/visit											1.2256	0.0298	0.3606	0	0.1036	0.402	0.0353	0.2414	1.0357	0	0.6464	0	0.0743	0.1451	1.2998	2.0325	0.1427	0.2629	0	0.015	0.4305	0	0	0.287	0.0362	0	0	0	0	0.1254											8.9318	0	0.3675	4.2968	0.104527552	1.269480402	0	0.675377358	1.926891438	0.166937567	1.283458444	3.711062188	0	2.549474306	0	0.324000079	0.668848499	4.762538829	7.270314346	0.512824568	1.203590009	0	0.053832413	1.85576586	0	0	1.913333333	0.217496849	0	0	0	0	0.836069749	0	0	0	0	0	0	0	0	0	0	35.6026
H5520_008_0	2009	5																					2100											D	D	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	V											0	0	0	0	0	0	0	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	715.9128368	20.72102649	272.0356615	11.1669185	185.6713235	13.44074896	4.349082554	471.1998356	475.2061785	9.565412747	31.3487914	0	2.468257865	388.9237518	6193.630744	7273.981237	271.8928495	691.070705	14.50756064	28.54123834	16.20485391	0	0	557.6	334.3596179	0	0	0	8840	568.5274295											1a:  Acute - $100/$0/day for 1-7/8-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $100/$0/day for 1-7/8-190	2:  Skilled Nursing Services - $100/$0/day for 1-7/8-100/2:  Non-Medicare Covered Stay - $100/$0/day for 1-7/8-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - min $20 / max $600/service	11b:  Prosthetics Devices - min $20 / max $600/service/11b:  Medical Supplies - min $20 / max $600/service/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $25 to $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - min $20 / max $600/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - min $20 / max $600/visit/8b:  Outpatient Therapeutic Radiological Services - min $20 / max $600/visit/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - min $20 / max $600/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - $25/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $15/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $15/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:   - $0	7d:  Physician Specialist Services - $15/visit/7b:  Chiropractic Services - $15/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14d:  Pap Smears and Pelvic Exams Screening - $15/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:   - $0	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $15 to $25/visit	15:  Medicare Part B Rx Drugs - min $20 / max $600/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $35/service/16a:  Preventive Dental - Prophylaxis - $35/service/16a:  Preventive Dental - X-Rays - $35/service	17a:  Routine Eye Exams - $10/visit	17b:  Wear - $100/service			14b:  Other Immunizations - n/a/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit	13b:  Acupuncture - $15/visit											100	100	100	0	50	0.15	0.040019347	40.8272147	100	0	0.134906777	0	0.15	25	15	16.52319102	25	25	0	25	0.15	0	0	35	10	0	0	0	0	15											78.13398862	78.13398862	78.13398862	0	50	0.15	0.040019347	31.9335486	78.13398862	0	0.105408046	0	0.117200983	19.53349715	11.72009829	12.91022819	19.53349715	19.53349715	0	19.53349715	0.117200983	0	0	35	7.813398862	0	0	0	0	15											4.6614	0.134918037	1.771269274	0	0.773630515	2.016112345	0.174047446	1.253923571	3.094146178	0	3.304414837	0	0.289282248	0.63308675	6.049163426	7.825729802	0.44258485	1.124918971	0	0.046459183	1.899224807	0	0	1.626333333	0.217707088	0	0	0	0	0.710659287	0	0	0	0	0	0	0	0	0	0	38.049	0	9.715	4.6614	0.134918037	1.771269274	0	0.773630515	2.016112345	0.174047446	1.253923571	3.094146178	0	3.304414837	0	0.289282248	0.63308675	6.049163426	7.825729802	0.44258485	1.124918971	0	0.046459183	1.899224807	0	0	1.626333333	0.217707088	0	0	0	0	0.710659287	0	0	0	0	0	0	0	0	0	0	38.049		1a:  Acute - $200/$0/day for 1-7/8-90	1b:  Psych - $200/$0/day for 1-7/8-90	2:  Skilled Nursing Services - $200/$0/day for 1-7/8-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - min $30 / max $900/service	11b:  Prosthetics Devices - min $30 / max $900/service/11b:  Medical Supplies - min $30 / max $900/service/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $200/visit/9b:  Ambulatory Surgical Center Services - $200/visit	8a:  Outpatient Diagnostic Procedures/Tests - min $0 / max $900/visit/8a:  Outpatient Lab Services - min $0 / max $900/visit	8b:  Outpatient Diagnostic Radiological Services - min $30 / max $900/visit/8b:  Outpatient Therapeutic Radiological Services - min $30 / max $900/visit/8b:  Outpatient X-Ray Services - $25/visit		12:  Renal Dialysis - min $30 / max $900/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $35/visit/3:  Rehab Services (CORF) - $35/day/5:  Partial Hospitalization - $0/day	7a:  Primary Care - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit	7d:  Physician Specialist Services - $25/visit/7b:  Chiropractic Services - $15-50/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $35/visit/7i:  Physical/Speech Therapy - $35/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $25 to $50/visit	15:  Medicare Part B Rx Drugs - min $30 / max $900/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		16a:  Preventive Dental - Oral Exams - $35/service/16a:  Preventive Dental - Prophylaxis - $35/service/16a:  Preventive Dental - X-Rays - $35/service; OON covered at 80% of UCR after $35 ded	17a:  Routine Eye Exams - $10/visit	17b:  Wear - $0/service			14b:  Other Immunizations - n/a/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit	13b:  Acupuncture - $15/visit/13b:  Chiropractic Services (Routine) - $15/visit											1.8841	0.0545	0.7328	0	0.1274	0.4942	0.0434	0.2959	1.2692	0	0.831	0	0.091	0.1778	1.9494	2.7832	0.1749	0.3222	0	0.0184	0.5276	0	0	0.287	0.0443	0	0	0	0	0.1254											12.2335	0	0.552	6.5455	0.189449901	2.504070806	0	0.900993286	2.510302377	0.21743833	1.549806582	4.363390081	0	4.13537463	0	0.380324562	0.810898234	7.998544362	10.60888724	0.617477903	1.447069643	0	0.064818122	2.426805993	0	0	1.913333333	0.26202681	0	0	0	0	0.836069749	0	0	0	0	0	0	0	0	0	0	50.2826
H5521_005_0	2009	8																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	7500	1240.605279	0	655.7558269	1050.845684	178.9633292	10.30049609	0	195.8783435	345.0743756	1624.183302	3478.831209	0	0	783.0014642	5086.206534	8419.631554	0	1094.485613	0	0	223.5752783	0	0	0	613.7856752	0	60.97786067	0	0	0											$900 per stay	$900 per stay	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$35 per visit	$35 X-ray; $150 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$20 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											152.1692361	152.1692361	47.8866492	20	100	0.2	0.2	48.5	250	35	81	35	25	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											152.1692361	152.1692361	47.8866492	20	100	0.2	0.2	48.5	250	35	81	35	25	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											15.7318	0	2.616829104	1.751409473	1.491361076	2.060099217	0	0.791674972	7.189049492	4.737201297	23.48211066	0	0	2.283754271	8.477010889	24.5572587	0	3.192249705	0	0	0.838407294	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.2002			15.7318	0	2.616829104	1.751409473	1.491361076	2.060099217	0	0.791674972	7.189049492	4.737201297	23.48211066	0	0	2.283754271	8.477010889	24.5572587	0	3.192249705	0	0	0.838407294	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.2002		$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$100 copay	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$50 copay	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$25 copay	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP		0	0	$500 ded; 30% coinsurance; $7500 max OOP	0	$500 ded; 30% coinsurance; $7500 max OOP	0	Not Covered												9.454	0	0.8772	0.262	0.1698	0.2951	0	0.126	1.5222	0.8119	1.9161	0	0.001	0.617	0.8816	5.4698	0	0.2979	0	0	0.2488	0	0	0	0.0877	0	0.0076	0	0	0											23.046	500	8.624513297	25.1859	0	3.494047413	2.013412421	1.661139433	2.355244122	0	0.917653495	8.711296072	5.549148883	25.39822979	0	0.001044284	2.900784506	9.358660805	30.02706624	0	3.490177729	0	0	1.087177778	0	0	0	0.087694687	0	0.007599089	0	0	0	0	0	0	0	0	0	0	0	0	0	122.2462
H5521_006_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	5000	1278.941736	0	676.019609	1083.318301	184.4935491	10.61879598	0	201.9312612	355.7376617	1674.372862	3586.332012	0	0	807.1973164	5243.377506	8679.810073	0	1128.306766	0	0	230.4840705	0	0	0	632.7525203	0	62.86216277	0	0	0											$500 per stay	$500 per stay	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$30 per visit	$30 X-ray; $150 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$15 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											84.53846451	84.53846451	47.8866492	20	100	0.2	0.2	48.5	250	30	78	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											84.53846451	84.53846451	47.8866492	20	100	0.2	0.2	48.5	250	30	78	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											9.01	0	2.697692822	1.805530502	1.537446242	2.123759195	0	0.816138848	7.411201285	4.185932155	23.31115808	0	0	2.017993291	6.554221883	21.69952518	0	2.820766915	0	0	0.864315264	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.8557	0	0	9.01	0	2.697692822	1.805530502	1.537446242	2.123759195	0	0.816138848	7.411201285	4.185932155	23.31115808	0	0	2.017993291	6.554221883	21.69952518	0	2.820766915	0	0	0.864315264	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.8557		$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$100 copay	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$50 copay	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$25 per visit	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP		0	0	$250 ded; 20% coinsurance; $5000 max OOP	0	$250 ded; 20% coinsurance; $5000 max OOP	0	Not Covered												6.3905	0	0.593	0.1771	0.1621	0.1995	0	0.1142	1.029	0.5488	1.2952	0	0.001	0.4171	0.596	3.6973	0	0.2014	0	0	0.1682	0	0	0	0.0593	0	0.0051	0	0	0											15.6547	250	5.988730087	15.4005	0	3.290650896	1.982632098	1.699548512	2.323263187	0	0.930304529	8.440167951	4.734770308	24.60636395	0	0.001042179	2.435076537	7.150175513	25.39685629	0	3.022152163	0	0	1.032472342	0	0	0	0.059277459	0	0.005136625	0	0	0	0	0	0	0	0	0	0	0	0	0	102.5103
H5521_008_0	2009	7																																D	D	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	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	7500	1723.739964	0	642.7242453	687.4021589	156.44325	10.07268549	0	217.2098202	353.1305108	1848.365934	3583.304183	0	0	812.1479051	5827.824325	10557.78124	0	1118.174178	0	0	227.5523432	0	0	0	443.2558749	0	42.6663409	0	0	0											$900/stay	$900/stay	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$30 per visit	$30 X-ray; $150 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$10 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											152.1692361	152.1692361	47.8866492	20	100	0.2	0.2	48.5	250	30	78	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											152.1692361	152.1692361	47.8866492	20	100	0.2	0.2	48.5	250	30	78	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											21.8583	0	2.564825872	1.145670265	1.30369375	2.014537099	0	0.87788969	7.356885642	4.620914835	23.29147719	0	0	2.030369763	4.856520271	26.3944531	0	2.795435446	0	0	0.853321287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.9643			21.8583	0	2.564825872	1.145670265	1.30369375	2.014537099	0	0.87788969	7.356885642	4.620914835	23.29147719	0	0	2.030369763	4.856520271	26.3944531	0	2.795435446	0	0	0.853321287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.9643		$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$100 copay	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$50 copay	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$25 per visit	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP		0	0	$500 ded; 30% coinsurance; $7500 max OOP	0	$500 ded; 30% coinsurance; $7500 max OOP	0	Not Covered												11.0517	0	0.9591	0.2087	0.1647	0.2841	0	0.1294	1.5376	0.9405	1.9387	0	0.001	0.8042	0.9261	6.5283	0	0.2906	0	0	0.2464	0	0	0	0.0629	0	0.0051	0	0	0											26.0793	500	9.913397911	32.91	0	3.523967552	1.3543785	1.468383707	2.298669096	0	1.007305451	8.894482466	5.561447076	25.2301731	0	0.001044284	2.834523375	5.782598425	32.92279409	0	3.086081466	0	0	1.099761997	0	0	0	0.06288647	0	0.00505477	0	0	0	0	0	0	0	0	0	0	0	0	0	128.0436
H5521_009_0	2009	8																																D	D	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	O	O											0	0	0	0	0	0	0	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	1739.90722	0	648.7524676	693.8494231	157.9105584	10.16715896	0	219.2470689	356.4425832	1865.702079	3616.912615	0	0	819.7651813	5882.484501	10656.8045	0	1128.661728	0	0	229.6865962	0	0	0	447.4132487	0	43.06651591	0	0	0											$500 per stay	$500 per stay	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$25 per visit	$25 X-ray; $150 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$15 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											84.53846451	84.53846451	47.8866492	20	100	0.2	0.2	48.5	250	25	75	25	25	25	15	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											84.53846451	84.53846451	47.8866492	20	100	0.2	0.2	48.5	250	25	75	25	25	25	15	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											12.2574	0	2.588881819	1.156415705	1.31592132	2.033431792	0	0.88612357	7.425887149	3.886879331	22.60570385	0	0	1.707844128	7.353105626	22.20167605	0	2.3513786	0	0	0.861324736	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.632			12.2574	0	2.588881819	1.156415705	1.31592132	2.033431792	0	0.88612357	7.425887149	3.886879331	22.60570385	0	0	1.707844128	7.353105626	22.20167605	0	2.3513786	0	0	0.861324736	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.632		$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$100 copay	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$50 copay	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$25 copay	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP		0	0	$250 ded; 20% coinsurance; $5000 max OOP	0	$250 ded; 20% coinsurance; $5000 max OOP	0	Not Covered												7.3422	0	0.6372	0.1387	0.159	0.1888	0	0.1163	1.0215	0.6248	1.288	0	0.001	0.5342	0.6152	4.3371	0	0.1931	0	0	0.1637	0	0	0	0.0418	0	0.0034	0	0	0											17.406	250	6.737355354	19.5996	0	3.226085762	1.295070623	1.474968227	2.222194341	0	1.002374173	8.447386663	4.511720129	23.89367277	0	0.001042179	2.242082044	7.968343879	26.53876691	0	2.544468729	0	0	1.025047151	0	0	0	0.041778506	0	0.003358127	0	0	0	0	0	0	0	0	0	0	0	0	0	106.038
H5521_011_0	2009	9																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	7500	1570.935447	0	1150.093298	1057.805202	229.5223926	13.33001115	0	243.4578457	345.5532472	1910.094496	3992.568541	0	0	732.7781246	5762.273019	8655.536268	0	706.4615445	0	0	222.9710049	0	0	0	528.1732752	0	44.85485072	0	0	0											$150/day 1-8	$150/day 1-8	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$200 per procedure	$30 per visit	$30 X-ray; $125 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$10 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											114.2747829	114.2747829	47.8866492	20	100	0.2	0.2	48.5	200	30	68	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											114.2747829	114.2747829	47.8866492	20	100	0.2	0.2	48.5	200	30	68	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											14.9599	0	4.589509527	1.763008669	1.912686605	2.666002229	0	0.98397546	5.759220787	4.775236241	22.62455507	0	0	1.831945311	4.801894183	21.63884067	0	1.766153861	0	0	0.836141268	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.909			14.9599	0	4.589509527	1.763008669	1.912686605	2.666002229	0	0.98397546	5.759220787	4.775236241	22.62455507	0	0	1.831945311	4.801894183	21.63884067	0	1.766153861	0	0	0.836141268	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.909		$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$100 copay	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$50 copay	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$25 per visit	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP		0	0	$500 ded; 30% coinsurance; $7500 max OOP	0	$500 ded; 30% coinsurance; $7500 max OOP	0	0												10.521	0	1.1461	0.188	0.1922	0.3814	0	0.1049	1.4346	0.5952	1.5197	0	0	0.1375	1.1183	5.4987	0	0.2259	0	0	0.2441	0	0	0	0.0778	0	0.0052	0	0	0											23.3907	500	8.766251891	25.4808	0	5.735646529	1.951022068	2.10492955	3.047356756	0	1.088888661	7.193843005	5.370432517	24.14425121	0	0	1.969493596	5.92022181	27.1374927	0	1.992089357	0	0	1.080256123	0	0	0	0.077767538	0	0.005223665	0	0	0	0	0	0	0	0	0	0	0	0	0	114.2998
H5521_012_0	2009	8																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	5000	1620.353248	0	1186.27243	1091.081175	236.7426077	13.74934081	0	251.1164362	356.4235102	1970.181414	4118.165017	0	0	755.8295384	5943.540084	8927.818343	0	728.6851029	0	0	229.9851293	0	0	0	544.7883192	0	46.26587501	0	0	0											$100/day 1-9	$100/day 1-9	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$200 per procedure	$25 per visit	$35 X-ray; $125 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$15 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											79.34537217	79.34537217	47.8866492	20	100	0.2	0.2	48.5	200	25	71	25	25	25	15	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											79.34537217	79.34537217	47.8866492	20	100	0.2	0.2	48.5	200	25	71	25	25	25	15	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											10.714	0	4.733884311	1.818468625	1.972855064	2.749868162	0	1.014928929	5.940391837	4.104544612	24.36580968	0	0	1.574644872	7.429425105	18.59962155	0	1.518093964	0	0	0.862444235	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.3989	0	0	10.714	0	4.733884311	1.818468625	1.972855064	2.749868162	0	1.014928929	5.940391837	4.104544612	24.36580968	0	0	1.574644872	7.429425105	18.59962155	0	1.518093964	0	0	0.862444235	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.3989		$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$100 copay	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$50 copay	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$25 copay	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP	$250 ded; 20% coinsurance; $5000 max OOP		0	0	$250 ded; 20% coinsurance; $5000 max OOP	0	$250 ded; 20% coinsurance; $5000 max OOP	0	0												7.1134	0	0.7749	0.1271	0.165	0.2578	0	0.1124	0.97	0.4024	1.0275	0	0.001	0.093	0.7561	3.7177	0	0.1528	0	0	0.165	0	0	0	0.0526	0	0.0035	0	0	0											15.8924	250	6.090349402	17.8274	0	5.5088058	1.94558748	2.137887349	3.007708034	0	1.127321829	6.910362777	4.506966298	25.39330046	0	0.001042179	1.667643459	8.185544233	22.3173478	0	1.670852553	0	0	1.027494178	0	0	0	0.052579872	0	0.003531803	0	0	0	0	0	0	0	0	0	0	0	0	0	103.2913
H5521_801_0	2009	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																																																			0		324.9960838	0	42.66338688	8.307578118	7.515300138	10.57061473	0	8.27971624	48.88492282	12.62642026	57.87169145	0	1.312413359	23.75461977	39.36690107	166.88676	0	6.425478701	0	0	7.661431096	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.071102811	0.071102811	0.164655798	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.1081	0	7.024774008	0	1.736034332	2.441812002	0	1.912614452	11.29241717	2.91670308	13.36836072	0	0.303167486	5.487317168	9.093754148	38.55084157	0	1.48428558	0	0	1.769790583	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.49			23.1081	0	7.024774008	0	1.736034332	2.441812002	0	1.912614452	11.29241717	2.91670308	13.36836072	0	0.303167486	5.487317168	9.093754148	38.55084157	0	1.48428558	0	0	1.769790583	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.49		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.1511	0	0.9579	0	0.2367	0.333	0	0.2608	1.5399	0.3977	1.823	0	0.0413	0.7483	1.2401	5.2569	0	0.2024	0	0	0.2413	0	0	0	0	0	0	0	0	0											16.4305			26.2592	0	7.982697737	0	1.972766286	2.774786365	0	2.173425513	12.83229224	3.314435318	15.19131901	0	0.344508507	6.235587691	10.33381153	43.80777451	0	1.686688159	0	0	2.011125663	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.9205
H5521_802_0	2009	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																																																			0		324.9960838	0	42.66338688	8.307578118	7.515300138	10.57061473	0	8.27971624	48.88492282	12.62642026	57.87169145	0	1.312413359	23.75461977	39.36690107	166.88676	0	6.425478701	0	0	7.661431096	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.071102811	0.071102811	0.164655798	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.1081	0	7.024774008	0	1.736034332	2.441812002	0	1.912614452	11.29241717	2.91670308	13.36836072	0	0.303167486	5.487317168	9.093754148	38.55084157	0	1.48428558	0	0	1.769790583	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.49			23.1081	0	7.024774008	0	1.736034332	2.441812002	0	1.912614452	11.29241717	2.91670308	13.36836072	0	0.303167486	5.487317168	9.093754148	38.55084157	0	1.48428558	0	0	1.769790583	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.49		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.1511	0	0.9579	0	0.2367	0.333	0	0.2608	1.5399	0.3977	1.823	0	0.0413	0.7483	1.2401	5.2569	0	0.2024	0	0	0.2413	0	0	0	0	0	0	0	0	0											16.4305			26.2592	0	7.982697737	0	1.972766286	2.774786365	0	2.173425513	12.83229224	3.314435318	15.19131901	0	0.344508507	6.235587691	10.33381153	43.80777451	0	1.686688159	0	0	2.011125663	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.9205
H5521_804_0	2009	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																																																			0		324.9960838	0	42.66338688	8.307578118	7.515300138	10.57061473	0	8.27971624	48.88492282	12.62642026	57.87169145	0	1.312413359	23.75461977	39.36690107	166.88676	0	6.425478701	0	0	7.661431096	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.071102811	0.071102811	0.164655798	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.1081	0	7.024774008	0	1.736034332	2.441812002	0	1.912614452	11.29241717	2.91670308	13.36836072	0	0.303167486	5.487317168	9.093754148	38.55084157	0	1.48428558	0	0	1.769790583	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.49			23.1081	0	7.024774008	0	1.736034332	2.441812002	0	1.912614452	11.29241717	2.91670308	13.36836072	0	0.303167486	5.487317168	9.093754148	38.55084157	0	1.48428558	0	0	1.769790583	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.49		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.1511	0	0.9579	0	0.2367	0.333	0	0.2608	1.5399	0.3977	1.823	0	0.0413	0.7483	1.2401	5.2569	0	0.2024	0	0	0.2413	0	0	0	0	0	0	0	0	0											16.4305			26.2592	0	7.982697737	0	1.972766286	2.774786365	0	2.173425513	12.83229224	3.314435318	15.19131901	0	0.344508507	6.235587691	10.33381153	43.80777451	0	1.686688159	0	0	2.011125663	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.9205
H5522_001_0	2009	8																					1000											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	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	4000	0	0	1182.444647	0	246.524064	11.10937019	8.384600212	124.7163194	0	0	0	0	0	367.6752019	6540.831306	19154.04458	338.0954438	1884.319276	5327.066822	1736.052217	1930.367722	0	0	0	251.2922785	0	268.8164997	0	0	460.2716031											1a $0	1b $0	2 $25 days 11-100	6 $0	10a $75	11a 30% with $300 OOP Max	11b 30% with $300 OOP Max	4a $50	"9a $0, 9b $0"	8a $0	8b $0	5 $0	12 $0	4b $50	7a $10	"16b $20, 17a $15, 18a $15, 7b $20, 7d $20, 7f $20"	"7e $25, 7h $25, 9c $25"	"7c $20, 7i $20"	8b $0	7g $20	"15 $50/$100, 11c DS $20/$40, Nebulizers $10/$30"		10b $0	16a $0	17a $15	17b $150 Allowance every two years	18a $15	"18b $750 Allowance every 3 yrs ($500 for 1st aid, $250 for 2nd aid)"		14a $0											0	0	14.25540322	0	75	0.298203923	0.3	45.88541521	0	0	0	0	0	0.00463348	5.535642719	3.74978908	21.22149787	3.055319467	0.013615731	0.61196421	8.202654913	0	0	0	6.030735259	0	14.91332157	0	0	2.808033716											0	0	12.39436199	0	65.20875874	0.110658771	0.203848071	39.89507961	0	0	0	0	0	0.004028579	4.812965207	3.260254553	21.22149787	2.656447867	0.011838199	0.532072354	8.202654913	0	0	0	5.243423474	0	12.96638918	0	0	2.441445242											0	0	1.221303916	0	1.339627351	1.229349249	1.709184582	0.414630624	0	0	0	0	0	0.000123434	2.623399458	5.203921754	0.597907645	0.417132993	0.00525524	0.076975449	1.31951169	0	0	0	0.109802653	0	0.290464946	0	0	0.093643993	0	0	0	0	0	0	0	0	0	0	16.6522	0	1.7712	0	0	1.221303916	0	1.339627351	1.229349249	1.709184582	0.414630624	0	0	0	0	0	0.000123434	2.623399458	5.203921754	0.597907645	0.417132993	0.00525524	0.076975449	1.31951169	0	0	0	0.109802653	0	0.290464946	0	0	0.093643993	0	0	0	0	0	0	0	0	0	0	16.6522	5000	0.2	0.2	0.2	0.2	0.2	0.2	0.2	50	0.2	0.2	0.2	0.5	0.2	50	0.2	0.2	0.5	0.2	0.2	0.2	0.2		0	0	0.2	$150 Allowance every two years	$25 maximum benefit per year	$375 maximum benefit every three years		0.5											5.6933	0.0041	0.2624	0.0823	0.3244	0.0824	0.0565	0.0154	0.4355	0.055	0.2997	0.0174	0.001	0.1117	3.0936	3.2864	0.0014	0.0854	0.9143	0.0657	0.4607	0	0	0	0.0021	0	0.0006	0	0	0.016											15.3675	500	3.506368819	5.6933	0.004067076	1.483749387	0.082305617	1.664058266	1.311758404	1.76566997	0.43003223	0.435522042	0.05504912	0.299723981	0.017379298	0.00100661	0.111810112	5.71701179	8.490354092	0.599291607	0.50256217	0.919579048	0.14264594	1.780190008	0	0	0	0.111898992	9.34E-06	0.291091169	0	0	0.109689737	0	0	0	0	0	0	0	0	0	0	32.0197
H5522_002_0	2009	7																					2900											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	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	3500	0	0	1035.965674	0	147.596982	6.559422692	6.69685231	79.47660243	720.0255008	0	953.5769475	0	0	325.4098937	6318.554417	16000.64649	178.4897039	2073.793113	4863.538522	1493.591039	1632.133841	0	0	0	214.4730792	0	280.9738362	0	0	836.2829443											1a $0	1b $0	2 $45 days 11-100	6 $0	10a $50	11a 20% with $200 OOP Max	11b 20% with $200 OOP Max	4a $50	"9a $100, 9b $100"	8a $0	8b $0	5 $0	12 $0	4b $50	7a $10	"16b $25, 17a $25, 18a $20, 7b $20, 7d $25, 7f $25"	"7e $25, 7h $25, 9c $25"	"7c $25, 7i $25"	8b $0	7g $25	"15 $50/$100, 11c DS Covered in Full, Nebulizers $10/$30"		10b $0	16a N/A	17a $25	17b $150 Allowance every two years	18a $20	"18b $750 Allowance every 3 yrs ($500 for 1st aid, $250 for 2nd aid)"		14a $0											0	0	25.6597258	0	50	0.199110467	0.2	45.88541521	100	0	1.389748984	0	0	18.0148157	5.54972064	5.167561149	22.22836725	5.768561379	0.001488344	0.711280502	1.947419986	0	0	0	8.627250941	0	19.93483575	0	0	2.186981953											0	0	24.39800505	0	47.54143758	0.076734133	0.137267899	43.62917207	95.08287516	0	1.321413292	0	0	17.12900472	5.276833948	4.913465717	22.22836725	5.484914014	0.00141516	0.676305952	1.947419986	0	0	0	8.203038242	0	18.95461499	0	0	2.07944532											0	0	2.106291312	0	0.584747725	0.503331614	0.919262847	0.288958197	5.705174567	0	0.105005771	0	0	0.464495634	2.778496871	6.55155233	0.330627891	0.947881409	0.000573557	0.084177042	0.264870839	0	0	0	0.146610906	0	0.443812574	0	0	0.144917055	0	0	0	0	0	0	0	0	0	0	22.3708	0	1.0525	0	0	2.106291312	0	0.584747725	0.503331614	0.919262847	0.288958197	5.705174567	0	0.105005771	0	0	0.464495634	2.778496871	6.55155233	0.330627891	0.947881409	0.000573557	0.084177042	0.264870839	0	0	0	0.146610906	0	0.443812574	0	0	0.144917055	0	0	0	0	0	0	0	0	0	0	22.3708	6400	0.2	0.2	0.2	0.2	0.2	0.2	0.2	50	0.2	0.2	0.2		0.2	50	0.2	0.2	0.5	0.2	0.2	0.2	0.2		0	0	0.2	$150 Allowance every two years	$25 maximum benefit every year	$375 maximum benefit every three years		0.5											1.8882	0.0022	0.5962	0.0824	0.4936	0.2144	0.0777	0.0166	1.3953	0.0447	0.1854	0.0114	0.0007	0.0324	0.3077	1.5463	0.0007	0.2057	0.5323	0.0645	0.1967	0	0	0	0.0014	0	0.0004	0	0	0.0237											7.9205	300	0	1.8882	0.002161818	2.702539072	0.082373977	1.078333822	0.71771112	0.996971953	0.305532777	7.100523873	0.0446828	0.290371601	0.011411615	0.000660961	0.496859972	3.086148111	8.097858024	0.331363523	1.153553063	0.532886104	0.148714602	0.461600203	0	0	0	0.14798732	4.96E-06	0.444223765	0	0	0.168605647	0	0	0	0	0	0	0	0	0	0	30.2913
H5522_003_0	2009	7																					1000											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	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	4000	0	0	1114.454306	0	257.2094963	11.50573837	7.921666954	122.0616183	0	0	0	0	0	509.3650877	6546.494202	19624.33887	169.6656862	1656.852677	5514.638762	1672.4542	1923.903199	0	0	0	250.6631553	0	263.7540815	0	0	458.5202432											1a $0	1b $0	2 $25 days 11-100	6 $0	10a $75	11a 20% with $200 OOP Max	11b 20% with $200 OOP Max	4a $50	"9a $0, 9b $0"	8a $0	8b $0	5 $0	12 $0	4b $50	7a $10	"16b $20, 17a $15, 18a $15, 7b $20, 7d $20, 7f $20"	"7e $25, 7h $25, 9c $25"	"7c $20, 7i $20"	8b $0	7g $20	"15 $50/$100, 11c DS $20/$40, Nebulizers $10/$30"		10b $0	16a $0	17a $15	17b $150 Allowance every two years	18a $15	"18b $750 Allowance every 3 yrs ($500 for 1st aid, $250 for 2nd aid)"		14a $0											0	0	14.25540322	0	75	0.198897319	0.2	45.88541521	0	0	0	0	0	0.003500553	5.495615814	3.725342833	22.74105166	3.027460629	0.002331113	0.590382537	9.176751186	0	0	0	6.196338748	0	14.90753826	0	0	2.508389269											0	0	12.23737118	0	64.38280448	0.07501735	0.155872366	39.38975621	0	0	0	0	0	0.003005006	4.717642113	3.19797359	22.74105166	2.59888541	0.002001115	0.506806446	9.176751186	0	0	0	5.319168881	0	12.79718828	0	0	2.153295145											0	0	1.13649925	0	1.379989059	0.863130008	1.234768967	0.400664782	0	0	0	0	0	0.000127554	2.573668062	5.229843119	0.321531344	0.358830854	0.000919619	0.070634214	1.47126508	0	0	0	0.111109971	0	0.281275887	0	0	0.082277451	0	0	0	0	0	0	0	0	0	0	15.5165	0	1.9172	0	0	1.13649925	0	1.379989059	0.863130008	1.234768967	0.400664782	0	0	0	0	0	0.000127554	2.573668062	5.229843119	0.321531344	0.358830854	0.000919619	0.070634214	1.47126508	0	0	0	0.111109971	0	0.281275887	0	0	0.082277451	0	0	0	0	0	0	0	0	0	0	15.5165	5000	0.2	0.2	0.2	0.2	0.2	0.2	0.2	50	0.2	0.2	0.2	0.5	0.2	50	0.2	0.2	0.5	0.2	0.2	0.2	0.2		0	0	0.2	$150 Allowance every two years	$25 maximum benefit per year	$375 maximum benefit every three years		0.5											2.4908	0.0041	0.3247	0.0988	0.0931	0.102	0.0699	0.0196	0.3892	0.0619	0.3246	0.0215	0.0012	0.0566	0.4052	1.1031	0.0014	0.1057	0.4837	0.0723	0.3769	0	0	0	0.0026	0	0.0008	0	0	0.0199											6.6295	500	0.104072436	2.4908	0.004141434	1.46121943	0.098754944	1.473131605	0.965093724	1.304657563	0.420251517	0.389187746	0.061850489	0.324575759	0.021503167	0.001245464	0.056774008	2.978831917	6.332913121	0.322940609	0.464531202	0.484610096	0.142935159	1.848143129	0	0	0	0.113703591	9.51E-06	0.282050704	0	0	0.10213063	0	0	0	0	0	0	0	0	0	0	22.146
H5522_004_0	2009	5																					2900											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	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	3500	1779.289633	47.73329353	1047.129867	0	241.980526	9.049203704	6.167227825	112.1468536	555.1623808	519.6764286	906.579502	0	0	329.6975362	5629.84506	15136.61427	156.2944621	1569.763898	4855.192225	1491.353253	1705.488347	0	0	0	213.0617798	0	233.6762584	0	0	382.1451271											"1a $150 per admit, with a max of 4/yr"	"1b $150 per admit, with a max of 4/yr"	2 20% days 11-100	6 $0	10a $75	11a 20% with $300 OOP Max	11b 20% with $300 OOP Max	4a $50	"9a $100, 9b $100"	8a $25	8b $25	5 $0	12 $0	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	"15 $50/$100, 11c DS $20/$40, Nebulizers $10/$30"		10b $0	16a N/A	17a $25	17b $150 Allowance every two years	18a $25	"18b $750 Allowance every 3 yrs ($500 for 1st aid, $250 for 2nd aid)"		14a $0											18.64690158	18.67550665	37.39840513	0	75	0.198860702	0.2	50	100	25	19.67508334	0	0	15.67814911	8.698809039	6.245663283	9.301871513	13.35684067	21.82069703	0.800741202	8.621272646	0	0	0	9.770606115	0	24.84300144	0	0	3.485281245											15.92482472	18.67550665	31.9389816	0	64.05149127	0.110931672	0.163153382	42.70099418	85.40198836	21.35049709	16.80291238	0	0	13.38945108	7.428955883	5.33392063	9.301871513	11.40700751	18.63530914	0.683848908	7.362738262	0	0	0	8.344291898	0	21.2164172	0	0	2.976499483											2.3612	0.074286953	2.787021796	0	1.291601129	1.003843296	1.006204079	0.399065179	3.950997599	0.924612506	1.269431329	0	0	0.367872419	3.485322548	6.728124926	0.121152584	1.492192381	7.539834002	0.084988358	1.046422026	0	0	0	0.14815414	0	0.413147749	0	0	0.094787898	0	0	0	0	0	0	0	0	0	0	36.5903	0	5.8775	2.3612	0.074286953	2.787021796	0	1.291601129	1.003843296	1.006204079	0.399065179	3.950997599	0.924612506	1.269431329	0	0	0.367872419	3.485322548	6.728124926	0.121152584	1.492192381	7.539834002	0.084988358	1.046422026	0	0	0	0.14815414	0	0.413147749	0	0	0.094787898	0	0	0	0	0	0	0	0	0	0	36.5903	6400	0.2	0.2	0.2	0.2	0.2	0.2	0.2	50	0.2	0.2	0.2		0.2	50	0.2	0.2	0.5	0.2	0.2	0.2	0.2		0	0	0.2	$150 Allowance every two years	$25 maximum benefit every year	$375 maximum benefit every three years		0.5											2.3361	0.0038	0.3046	0.0926	0.0874	0.0956	0.0655	0.0206	0.3326	0.058	0.2861	0.0202	0.0012	0.0449	0.3115	0.9028	0.0013	0.0991	0.446	0.057	0.3477	0	0	0	0.0024	0	0.0007	0	0	0.0186											5.9365	300	0.000186153	4.6974	0.078107697	3.0915786	0.092622793	1.378960024	1.099475614	1.071752969	0.419618042	4.283607202	0.982622413	1.555546009	0.020167936	0.001168128	0.412759419	3.796845362	7.630918983	0.122452723	1.591329306	7.985871147	0.142017273	1.394116685	0	0	0	0.1505867	8.77E-06	0.413874454	0	0	0.113408301	0	0	0	0	0	0	0	0	0	0	42.5268
H5522_005_0	2009	5																					3350											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	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	3500	1999.404929	53.40875374	1176.669935	0	271.9158519	10.9691106	7.475685856	126.0205014	623.841324	583.9652064	1018.732134	0	0	370.4843026	6326.311215	17009.11653	174.8025821	1763.958838	5455.82635	1675.844459	1916.46992	0	0	0	239.4195778	0	262.5842662	0	0	429.4201665											1a $150 per admit	1b $150 per admit	2 20% days 7-100	6 $0	10a $100	11a 20%	11b 20%	4a $50	"9a $100, 9b $100"	8a $25	8b $25	5 $0	12 $0	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	"15 $50/$100, 11c DS $20/$40, Nebulizers $10/$30"		10b $0	16a $0	17a $25	17b $150 Allowance every two years	18a $25	"18b $750 Allowance every 3 yrs ($500 for 1st aid, $250 for 2nd aid)"		14a $0											28.36338607	28.42036734	51.06532819	0	100	0.198860702	0.2	50	100	25	19.67508334	0	0	15.67814911	8.698809039	6.24565761	9.302785566	13.35684067	21.82069703	0.800742548	8.621286585	0	0	0	9.770606115	0	24.84300144	0	0	3.485281245											23.50823628	28.42036734	42.32413569	0	82.88233366	0.16482039	0.165764667	41.44116683	82.88233366	20.72058341	16.30716822	0	0	12.99441585	7.209775932	5.17654678	9.302785566	11.07046125	18.08550292	0.663674111	7.145523513	0	0	0	8.098106361	0	20.59045935	0	0	2.888682431											3.9169	0.126491367	4.150128167	0	1.87808503	1.80793309	1.239204579	0.435203052	4.308785397	1.008341647	1.384386357	0	0	0.401185591	3.800940528	7.337373951	0.135512578	1.62731983	8.222613613	0.092684548	1.14118174	0	0	0	0.161570434	0	0.450560888	0	0	0.103371541	0	0	0	0	0	0	0	0	0	0	43.7297	0	8.9774	3.9169	0.126491367	4.150128167	0	1.87808503	1.80793309	1.239204579	0.435203052	4.308785397	1.008341647	1.384386357	0	0	0.401185591	3.800940528	7.337373951	0.135512578	1.62731983	8.222613613	0.092684548	1.14118174	0	0	0	0.161570434	0	0.450560888	0	0	0.103371541	0	0	0	0	0	0	0	0	0	0	43.7297	6850	0.2	0.2	0.2	0.2	0.2	0.2	0.2	50	0.2	0.2	0.2	0.5	0.2	50	0.2	0.2	0.5	0.2	0.2	0.2	0.2		0	0	0.2	$150 Allowance every two years	$25 maximum benefit per year	$375 maximum benefit every three years		0.5											2.8301	0.0046	0.3689	0.1122	0.1058	0.1159	0.0794	0.0231	0.4029	0.0703	0.3466	0.0244	0.0014	0.0544	0.3774	1.0937	0.0016	0.1201	0.5403	0.0691	0.4212	0	0	0	0.0029	0	0.0009	0	0	0.0226											7.1898	300	0.004587087	6.7469	0.131122731	4.51907737	0.112206016	1.983914204	1.923784935	1.318612461	0.458284533	4.7117186	1.07861658	1.730994221	0.02443204	0.001415105	0.455562438	4.178328564	8.431046089	0.137088558	1.747417261	8.762956326	0.161771078	1.562375386	0	0	0	0.164517309	1.06E-05	0.451441241	0	0	0.125928854	0	0	0	0	0	0	0	0	0	0	50.9196
H5522_006_0	2009	7																					2500											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	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	3500	0	0	1394.580687	0	211.6030271	8.312340169	5.665039407	81.99406509	0	0	0	0	0	354.66449	5972.425283	16057.64784	165.0243445	1665.285188	0	1582.099818	1784.191793	0	0	0	197.1487407	0	276.6750948	0	0	516.5638755											1a $0	1b $0	2 $45 days 16-100	6 $0	10a $50	11a 15% with $200 OOP Max	11b 15% with $200 OOP Max	4a $50	"9a $0, 9b $0"	8a $0	8b $0	5 $0	12 $0	4b $50	7a $0	"16b $20, 17a $20, 18a $20, 7b $20, 7d $20, 7f $20"	"7e $25, 7h $25, 9c $25"	"7c $20, 7i $20"	8b $0	7g $20	"15 $50/$100, 11c DS Covered in Full, Nebulizers $10/$30"		10b $0	16a 0	17a $20	17b $150 Allowance every two years	18a $20	"18b $750 Allowance every 3 yrs ($500 for 1st aid, $250 for 2nd aid)"		14a $0											0	0	18.84857231	0	50	0.149145526	0.15	45.88541521	0	0	0	0	0	0.005382131	0.000318229	4.148935386	22.62208296	3.00364583	0	0.270534349	2.365597091	0	0	0	7.816484892	0	19.86151922	0	0	2.775244209											0	0	18.68145509	0	49.55668466	0.079645522	0.120876057	45.47858104	0	0	0	0	0	0.005334412	0.000315408	4.112149652	22.62208296	2.977014584	0	0.268135709	2.365597091	0	0	0	7.747181539	0	19.6854209	0	0	2.750638042											0	0	2.171066373	0	0.873862041	0.66204067	0.684767624	0.310747811	0	0	0	0	0	0.000157661	0.000156979	5.502620914	0.311099534	0.413131524	0	0.035351455	0.351723243	0	0	0	0.127278924	0	0.453872141	0	0	0.118406687	0	0	0	0	0	0	0	0	0	0	12.0163	0	0.0895	0	0	2.171066373	0	0.873862041	0.66204067	0.684767624	0.310747811	0	0	0	0	0	0.000157661	0.000156979	5.502620914	0.311099534	0.413131524	0	0.035351455	0.351723243	0	0	0	0.127278924	0	0.453872141	0	0	0.118406687	0	0	0	0	0	0	0	0	0	0	12.0163	6000	0.2	0.2	0.2	0.2	0.2	0.2	0.2	50	0.2	0.2	0.2		0.2	50	0.2	0.2	0.5	0.2	0.2	0.2	0.2		0	0	0.2	$150 Allowance every two years	$25 maximum benefit every year	$375 maximum benefit every three years		0.5											2.1059	0.0034	0.4056	0.0841	0.0764	0.0878	0.0602	0.0145	0.4685	0.0624	0.3078	0.0217	0.0013	0.0483	0.3305	0.9578	0.0014	0.1052	0.4732	0.0605	0.3637	0	0	0	0.0023	0	0.0009	0	0	0.0252											6.0685	300	0	2.1059	0.003444034	2.576692467	0.084126238	0.950256713	0.749888717	0.74498097	0.325236791	0.468477102	0.062404895	0.307791504	0.021695914	0.001256628	0.048445421	0.330647205	6.460382566	0.312478788	0.518304511	0.473194611	0.095852638	0.715463744	0	0	0	0.129529876	8.12E-06	0.454732596	0	0	0.143577618	0	0	0	0	0	0	0	0	0	0	18.0847
H5522_802_0	2009	4																					0											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	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	303.7853759	2.168067098	45.22277949	0	12.13112602	13.08020112	9.688701089	3.352248481	51.86651683	8.591168391	36.19539319	3.762951954	0.100012684	8.903069339	42.9118787	132.3610755	2.392694959	15.7050424	62.16217643	10.85077541	49.30741383	0	0	0	0	0	0	0	0	0											FFS 7.8%	FFS 7.8%	FFS 18.4%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%		FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%			FFS 23.1%											0.077891934	0.077891934	0.18408516	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.077891934	0.077891934	0.18408516	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											23.6624	0.168874938	8.324842619	0	2.80229011	3.021526459	2.238089951	0.774369399	11.98116539	1.984559898	8.361135827	0.869241901	0.02310293	2.056609017	9.912643979	30.57540844	0.552712536	3.627864793	14.35946276	2.506529121	11.39001259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1929	0	0	23.6624	0.168874938	8.324842619	0	2.80229011	3.021526459	2.238089951	0.774369399	11.98116539	1.984559898	8.361135827	0.869241901	0.02310293	2.056609017	9.912643979	30.57540844	0.552712536	3.627864793	14.35946276	2.506529121	11.39001259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1929	0	FFS 7.8%	FFS 7.8%	FFS 18.4%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%		FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%			FFS 23.1%											1.2676	0.0025	0.446	0	0.1489	0.1606	0.1189	0.0412	0.6367	0.1011	0.4443	0.0462	0.0012	0.1093	0.5268	1.6048	0.0003	0.1928	0.7631	0.133	0.6263	0	0	0	0	0	0	0	0	0											7.3717	0	0	24.9301	0.171337971	8.770823182	0	2.951216934	3.18210453	2.357028474	0.815523017	12.61790064	2.08568796	8.805467899	0.915433426	0.024330728	2.165906855	10.43942031	32.18017308	0.553044954	3.820669148	15.12260106	2.639538036	12.01630784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	146.5646
H5522_803_0	2009	4																					0											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	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	287.2275392	2.209635709	38.34043815	0	3.603589787	11.20797797	11.27156683	2.855928846	41.26494583	7.13744479	27.44907042	6.736060066	0.135050932	12.57083476	35.18037953	120.6847941	1.512198284	12.8494809	61.93276857	11.32958767	45.23074173	0	0	0	0	0	0	0	0	0											FFS 7.8%	FFS 7.8%	FFS 18.4%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%		FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%			FFS 23.1%											0.077867161	0.077867161	0.184432048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.077867161	0.077867161	0.184432048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											22.3656	0.172058058	7.071205517	0	0.832429241	2.589042911	2.603731938	0.659719563	9.532202487	1.648749746	6.340735267	1.556029875	0.031196765	2.90386283	8.126667671	27.87818743	0.349317804	2.968230088	14.30646954	2.617134753	10.44830134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0009	0	0	22.3656	0.172058058	7.071205517	0	0.832429241	2.589042911	2.603731938	0.659719563	9.532202487	1.648749746	6.340735267	1.556029875	0.031196765	2.90386283	8.126667671	27.87818743	0.349317804	2.968230088	14.30646954	2.617134753	10.44830134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0009	0	FFS 7.8%	FFS 7.8%	FFS 18.4%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%		FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%			FFS 23.1%											0.729	0	0.1559	0	2.3293	0.017	0.0061	0.0158	0.154	0.0564	0.0251	0	0	0.0046	0.1802	0.7826	0	0.0645	0.0625	0.0277	0.0136	0	0	0	0	0	0	0	0	0											4.6246	0	0	23.0946	0.172058058	7.227155049	0	3.161747146	2.606047326	2.609851238	0.675567228	9.686236143	1.705178272	6.365832682	1.556029875	0.031196765	2.908510163	8.306912175	28.66082957	0.349317804	3.032772789	14.36896184	2.644806521	10.46188182	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.6255
H5522_805_0	2009	3																					0											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	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	303.7853759	2.168067098	45.22277949	0	12.13112602	13.08020112	9.688701089	3.352248481	51.86651683	8.591168391	36.19539319	3.762951954	0.100012684	8.903069339	42.9118787	132.3610755	2.392694959	15.7050424	62.16217643	10.85077541	49.30741383	0	0	0	0	0	0	0	0	0											FFS 7.8%	FFS 7.8%	FFS 18.4%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%		FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%			FFS 23.1%											0.077891934	0.077891934	0.18408516	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.077891934	0.077891934	0.18408516	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											23.6624	0.168874938	8.324842619	0	2.80229011	3.021526459	2.238089951	0.774369399	11.98116539	1.984559898	8.361135827	0.869241901	0.02310293	2.056609017	9.912643979	30.57540844	0.552712536	3.627864793	14.35946276	2.506529121	11.39001259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1929	0	0	23.6624	0.168874938	8.324842619	0	2.80229011	3.021526459	2.238089951	0.774369399	11.98116539	1.984559898	8.361135827	0.869241901	0.02310293	2.056609017	9.912643979	30.57540844	0.552712536	3.627864793	14.35946276	2.506529121	11.39001259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1929	0	FFS 7.8%	FFS 7.8%	FFS 18.4%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%		FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%			FFS 23.1%											1.2676	0.0025	0.446	0	0.1489	0.1606	0.1189	0.0412	0.6367	0.1011	0.4443	0.0462	0.0012	0.1093	0.5268	1.6048	0.0003	0.1928	0.7631	0.133	0.6263	0	0	0	0	0	0	0	0	0											7.3717	0	0	24.9301	0.171337971	8.770823182	0	2.951216934	3.18210453	2.357028474	0.815523017	12.61790064	2.08568796	8.805467899	0.915433426	0.024330728	2.165906855	10.43942031	32.18017308	0.553044954	3.820669148	15.12260106	2.639538036	12.01630784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	146.5646
H5523_001_0	2009	17																																D	D	D			COIN	COIN	V	V					V			V			V		V			V																																																								0		1459.950518	98.66926419	914.6952704	165.519657	215.7247056	9.143278276	1.123656689	278.3659569	978.3879474	0	0	0	5.513057373	2735.181674	0	0	254.2234395	0	3297.344214	30757.16425	9206.5226	127.0750305	69.43133808	0	473.0632657																$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																36.84210526	36.84210526	100			0.2	0.2	35.23016792	100					0.573985689			20			4.156689424		14.99491423			15																36.84210526	36.84210526	100			0.2	0.2	35.23016792	100					0.573985689			20			4.156689424		14.99491423			15																4.4823	0.302931951	7.622460586	0	0	1.828655655	0.224731338	0.81723995	8.153232895	0	0	0	0	0.130829595	0	0	0.423705733	0	0	10.65399828	0	0.158789932	0	0	0.591329082	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.3902			4.4823	0.302931951	7.622460586	0	0	1.828655655	0.224731338	0.81723995	8.153232895	0	0	0	0	0.130829595	0	0	0.423705733	0	0	10.65399828	0	0.158789932	0	0	0.591329082	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.3902		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; 35% Cost Sharing Other			50% Cost Sharing		30% Cost Sharing	30% Cost Sharing		$10 Hearing Exam	30% Cost Sharing		$15 per exam																7.0833	0.1696	0.6914	0.2384	0.2206	0.3048	0.0375	0.0908	0.8284	0	0	0	0.0015	1.966	0	0	0.0972	0	0.7347	5.6745	0	0.0176	0.0241	0	0.0657	0	0	0	0	0											18.2462			11.5656	0.472543753	8.313891879	0.238422413	0.220569391	2.133431598	0.262186561	0.908044389	8.981625542	0	0	0	0.001497534	2.096835892	0	0	0.52089682	0	0.734729493	16.32854185	0	0.176433258	0.024136807	0	0.657032313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.6364
H5525_001_0	2009	4																					1000											D	D	D		T	Coin	Coin	V	V	V	V			V	V	V	V	V	P	P	Coin						V																																																						0		799.9080077	16.37551942	678.2231021	0	242.5744095	12.69963872	7.938263214	435.4722052	389.31581	3114.494272	1151.513532	0	0	2091.892087	7587.54965	12648.11621	161.0671487	513.7049017	1261.493805	4179.904066	17.65672807	0	0	0	0	0	131.5241229	0	0	0											1a. $150/day (Days 1 - 5)	1b. $150/day (Days 1 - 5)	2.  $75/day (Days 14 - 100)	6. No cost sharing	10a.  $100	11a.  20%	11b-c.  20%	4a. $50; 4b. $35	9a. $50-$95;  9b. $75	8a.  $0-$50	8b.  $10-$50	No cost sharing	12.  $0-$50	3/5. $30; 9c/9d. $20-$50;	7a/14c-j. $10; 14b. $0;	7d/14d-j. $20;	7e/7h. $20	7c/7i. $20-$50	7d. $20	7b/7f $20; 7g. $0	15. 20%	13a.  No cost sharing	10b.  No benefit	16a-b.  No cost sharing	17a.  No cost sharing	17b.  No cost sharing	18a.  $20	18b.  No benefit	14a.  No cost sharing	13b.  No benefit											150	150.0000001	75	0	100	0.2	0.2	45.60220588	85	50	50	0	0	49.60305264	5.767692173	7.325698841	20.00000001	19.32317549	20	16.57343694	0.2	0	0	0	0	0	20	0	0	0											120.2721086	120.2721087	60.0613611	0	80.0818148	0.16016363	0.16016363	36.6010158	68.06954258	40.0409074	40.0409074	0	0	39.72302475	4.631723924	5.866552579	16.01636297	15.4743496	16.01636296	13.4105958	0.16016363	0	0	0	0	0	20	0	0	0											8.0172	0.164126521	3.394583553	0	1.618816578	2.034020232	1.271421049	1.328227089	2.208379092	10.39226473	3.842303894	0	0	6.924690097	2.928619603	6.183403233	0.214975826	0.662437437	1.683711887	4.671250327	2.827965655	0	0	0	0	0	0.219206872	0	0	0	0	0	0	0	0	0	0	0	0	0	60.5876	0	14.9283	8.0172	0.164126521	3.394583553	0	1.618816578	2.034020232	1.271421049	1.328227089	2.208379092	10.39226473	3.842303894	0	0	6.924690097	2.928619603	6.183403233	0.214975826	0.662437437	1.683711887	4.671250327	2.827965655	0	0	0	0	0	0.219206872	0	0	0	0	0	0	0	0	0	0	0	0	0	60.5876	5000	$1000/admit	$1000/admit	0.3	0.3	100	0.3	0.3		0.3	0.3	0.3	0.3	0.3	0.3	35	35	35	35	35	35	0.3	0.3		0.5	No cost sharing	No cost sharing	0.3		0.5												1.2357	0.0199	0.7939	0.0551	0	0.2129	0.1331	0	0.7468	0.181	0.4175	0	0.0099	0.5596	0.7978	1.6381	0.0261	0.0829	0.2932	0.7714	0.0573	0.0109	0	0.1805	0	0	0.023	0	0	0											8.2465	110	5.198242152	9.253	0.184041606	4.188447512	0.055122699	1.618816578	2.246956078	1.404522536	1.328227089	2.955154045	10.57327463	4.259755792	0	0.009922515	7.484296132	3.726440177	7.821486921	0.241084176	0.745297754	1.976871003	5.442630907	2.885283766	0.010902925	0	0.180450467	0	0	0.242216312	0	0	0	0	0	0	0	0	0	0	0	0	0	68.8342
H5525_002_0	2009	3																					1000											D	D	D		T	Coin	Coin	V	V	V	V			V	V	V	V	V	P	P	Coin						V																																																						0		811.0136162	16.55367601	690.6422433	0	247.0162604	12.93218551	8.08362307	443.4462639	396.4446854	3171.524686	1172.599233	0	0	2130.197334	7725.59105	12879.71956	164.0164963	523.1115021	1284.593386	4253.786544	17.98004557	0	0	0	0	0	131.5241229	0	0	0											1a. $150/day (Days 1 - 5)	1b. $150/day (Days 1 - 5)	2.  $75/day (Days 14 - 100)	6. No cost sharing	10a.  $100	11a.  20%	11b-c.  20%	4a. $50; 4b. $35	9a. $50-$95;  9b. $75	8a.  $0-$50	8b.  $10-$50	No cost sharing	12.  $0-$50	3/5. $30; 9c/9d. $20-$50;	7a/14c-j. $10; 14b. $0;	7d/14d-j. $20;	7e/7h. $20	7c/7i. $20-$50	7d. $20	7b/7f $20; 7g. $0	15. 20%	13a.  No cost sharing	10b.  No benefit	16a-b.  No cost sharing	17a.  No cost sharing	17b.  No cost sharing	18a.  $20	18b.  No benefit	14a.  No cost sharing	13b.  No benefit											150	150	75	0	100	0.2	0.2	45.60220587	85	50	50	0	0	49.60305264	5.767201079	7.325698841	20	19.32317549	20	16.57129667	0.2	0	0	0	0	0	20	0	0	0											120.0692656	120.0692657	59.95942997	0	79.94590663	0.159891813	0.159891813	36.53959779	67.95402063	39.97295331	39.97295331	0	0	39.65561015	4.623349042	5.856596355	15.98918132	15.44808783	15.98918133	13.38488542	0.159891813	0	0	0	0	0	20	0	0	0											8.1148	0.16563231	3.450876268	0	1.645661574	2.067750591	1.29250515	1.35027901	2.245000861	10.56460068	3.9060212	0	0	7.039522919	2.976508665	6.285943221	0.218540792	0.673422703	1.711633048	4.744703791	2.874862089	0	0	0	0	0	0.219206872	0	0	0	0	0	0	0	0	0	0	0	0	0	61.5475	0	15.2963	8.1148	0.16563231	3.450876268	0	1.645661574	2.067750591	1.29250515	1.35027901	2.245000861	10.56460068	3.9060212	0	0	7.039522919	2.976508665	6.285943221	0.218540792	0.673422703	1.711633048	4.744703791	2.874862089	0	0	0	0	0	0.219206872	0	0	0	0	0	0	0	0	0	0	0	0	0	61.5475	5000	$1000/admit	$1000/admit	0.3	0.3	100	0.3	0.3		0.3	0.3	0.3	0.3	0.3	0.3	35	35	35	35	35	35	0.3	0.3		0.5	No cost sharing	No cost sharing	0.3		0.5												1.2378	0.0199	0.8021	0.0557	0	0.2151	0.1345	0	0.7545	0.1829	0.4218	0	0.01	0.5654	0.8061	1.6551	0.0264	0.0837	0.2962	0.779	0.0579	0.011	0	0.1804	0	0	0.023	0	0	0											8.3184	110	5.341031146	9.3526	0.185580918	4.252934044	0.055691645	1.645661574	2.282884241	1.426980436	1.35027901	2.999483605	10.74747887	4.327781802	0	0.010024929	7.604907661	3.782586691	7.941062544	0.244923785	0.757153943	2.007817987	5.523717593	2.932771806	0.011015459	0	0.180379611	0	0	0.242201481	0	0	0	0	0	0	0	0	0	0	0	0	0	69.8659
H5525_004_0	2009	5																					1000											D	D	D		T	Coin	Coin	V	V	V	V			V	V	V	V	V	P	P	Coin						V																																																						0		756.7369385	15.61547568	628.5465371	0	224.8070062	11.76945155	7.356823793	403.5759704	360.8003081	2886.372616	1067.170731	0	0	1938.6711	7035.384051	11721.70282	149.2697584	476.0784999	1169.095479	3884.374156	16.36345806	0	0	0	0	0	131.5241229	0	0	0											1a. $150/day (Days 1 - 5)	1b. $150/day (Days 1 - 5)	2.  $75/day (Days 14 - 100)	6. No cost sharing	10a.  $100	11a.  20%	11b-c.  20%	4a. $50; 4b. $35	9a. $50-$95;  9b. $75	8a.  $0-$50	8b.  $10-$50	No cost sharing	12.  $0-$50	3/5. $30; 9c/9d. $20-$50;	7a/14c-j. $10; 14b. $0;	7d/14d-j. $20;	7e/7h. $20	7c/7i. $20-$50	7d. $20	7b/7f $20; 7g. $0	15. 20%	13a.  No cost sharing	10b.  No benefit	16a-b.  No cost sharing	17a.  No cost sharing	17b.  No cost sharing	18a.  $20	18b.  No benefit	14a.  No cost sharing	13b.  No benefit											150	150	75	0	100	0.2	0.2	45.60220587	85	50	50	0	0	49.60305264	5.769849269	7.325698841	20.00000001	19.32317549	20	16.58281221	0.2	0	0	0	0	0	20	0	0	0											121.1580398	121.1580397	60.50655264	0	80.67540352	0.161350807	0.161350807	36.86926337	68.57409299	40.33770176	40.33770176	0	0	40.01746288	4.66829612	5.910037101	16.13508072	15.5890498	16.1350807	13.52262381	0.161350807	0	0	0	0	0	20	0	0	0											7.6404	0.157661702	3.169265345	0	1.511366328	1.899010506	1.187029456	1.239962395	2.061796157	9.702469813	3.587267888	0	0	6.465058232	2.736938006	5.772974879	0.200706633	0.61846762	1.571954159	4.377244203	2.640257164	0	0	0	0	0	0.219206872	0	0	0	0	0	0	0	0	0	0	0	0	0	56.759	0	13.4607	7.6404	0.157661702	3.169265345	0	1.511366328	1.899010506	1.187029456	1.239962395	2.061796157	9.702469813	3.587267888	0	0	6.465058232	2.736938006	5.772974879	0.200706633	0.61846762	1.571954159	4.377244203	2.640257164	0	0	0	0	0	0.219206872	0	0	0	0	0	0	0	0	0	0	0	0	0	56.759	5000	$1000/admit	$1000/admit	0.3	0.3	100	0.3	0.3		0.3	0.3	0.3	0.3	0.3	0.3	35	35	35	35	35	35	0.3	0.3		0.5	No cost sharing	No cost sharing	0.3		0.5												1.228	0.0198	0.761	0.0528	0	0.2041	0.1276	0	0.7158	0.1735	0.4002	0	0.0095	0.5364	0.7647	1.5697	0.025	0.0794	0.281	0.7408	0.0549	0.0105	0	0.1808	0	0	0.0231	0	0	0											7.9585	110	4.626086825	8.8684	0.177449306	3.930245201	0.05283936	1.511366328	2.103125944	1.314617501	1.239962395	2.777637568	9.875981775	3.987427742	0	0.009511496	7.001472695	3.501626398	7.342690328	0.22571278	0.697832746	1.85296979	5.117995414	2.695200996	0.010451295	0	0.18076165	0	0	0.24228145	0	0	0	0	0	0	0	0	0	0	0	0	0	64.7176
H5525_801_0	2009	3																																A	A	D		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		254.6084113	6.191823638	420.5892932		6.14054251	14.08326849	7.80156484	7.485377167	36.5108549	21.38609443	29.7431238	0.754246363	0.051977711	35.15755052	27.7458708	100.4707021	2.092585998	8.639045787	13.44154384	0.421023724	43.59882298	5.950265054																			$1024/admit	$1024/admit	$128/day (days 21 - 100)	no cost sharing	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered											1024	1024	128		0.2	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	0.2	0.2	0.2	0.2																			1024	1024	128		0.2	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	0.2	0.2	0.2	0.2																			21.7266	0.52836895	4.486285794	0	1.228108502	2.816653699	1.560312968	1.497075433	7.302170981	4.277218886	5.94862476	0.150849273	0.010395542	7.031510104	5.549174161	20.09414043	1.046292999	1.727809157	2.688308768	0.084204745	8.719764596	1.190053011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.6639	0		21.7266	0.52836895	4.486285794	0	1.228108502	2.816653699	1.560312968	1.497075433	7.302170981	4.277218886	5.94862476	0.150849273	0.010395542	7.031510104	5.549174161	20.09414043	1.046292999	1.727809157	2.688308768	0.084204745	8.719764596	1.190053011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.6639		$1024/admit	$1024/admit	$128/day (days 21 - 100)	no cost sharing	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered											1.6949	0.0412	0.4141	0	0	0.2512	0.1391	0	0.5422	0.258	0.3588	0.0091	0.0006	0.4241	0.5269	1.908	0.0993	0.1641	0.2553	0.008	0.1513	0.0379																			7.2841	0		23.4215	0.569588043	4.900343449	0	1.228108502	3.067812275	1.699444727	1.497075433	7.844407513	4.535194342	6.307409107	0.15994757	0.011022537	7.455607414	6.076074357	22.00210118	1.145639671	1.891866539	2.943566645	0.092200078	8.871053734	1.227984824	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.948
H5525_802_0	2009	3																																A	A	D		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		254.6084113	6.191823638	420.5892932		6.14054251	14.08326849	7.80156484	7.485377167	36.5108549	21.38609443	29.7431238	0.754246363	0.051977711	35.15755052	27.7458708	100.4707021	2.092585998	8.639045787	13.44154384	0.421023724	43.59882298	5.950265054																			$1024/admit	$1024/admit	$128/day (days 21 - 100)	no cost sharing	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered											1024	1024	128		0.2	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	0.2	0.2	0.2	0.2																			1024	1024	128		0.2	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	0.2	0.2	0.2	0.2																			21.7266	0.52836895	4.486285794	0	1.228108502	2.816653699	1.560312968	1.497075433	7.302170981	4.277218886	5.94862476	0.150849273	0.010395542	7.031510104	5.549174161	20.09414043	1.046292999	1.727809157	2.688308768	0.084204745	8.719764596	1.190053011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.6639	0		21.7266	0.52836895	4.486285794	0	1.228108502	2.816653699	1.560312968	1.497075433	7.302170981	4.277218886	5.94862476	0.150849273	0.010395542	7.031510104	5.549174161	20.09414043	1.046292999	1.727809157	2.688308768	0.084204745	8.719764596	1.190053011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.6639		$1024/admit	$1024/admit	$128/day (days 21 - 100)	no cost sharing	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered											1.6949	0.0412	0.4141		0	0.2512	0.1391	0	0.5422	0.258	0.3588	0.0091	0.0006	0.4241	0.5269	1.908	0.0993	0.1641	0.2553	0.008	0.1513	0.0379																			7.2841	0		23.4215	0.569588043	4.900343449	0	1.228108502	3.067812275	1.699444727	1.497075433	7.844407513	4.535194342	6.307409107	0.15994757	0.011022537	7.455607414	6.076074357	22.00210118	1.145639671	1.891866539	2.943566645	0.092200078	8.871053734	1.227984824	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.948
H5525_805_0	2009	4																																A	A	D		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		254.6084113	6.191823638	420.5892932		6.14054251	14.08326849	7.80156484	7.485377167	36.5108549	21.38609443	29.7431238	0.754246363	0.051977711	35.15755052	27.7458708	100.4707021	2.092585998	8.639045787	13.44154384	0.421023724	43.59882298	5.950265054																			$1024/admit	$1024/admit	$128/day (days 21 - 100)	no cost sharing	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered											1024	1024	128		0.2	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	0.2	0.2	0.2	0.2																			1024	1024	128		0.2	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	0.2	0.2	0.2	0.2																			21.7266	0.52836895	4.486285794	0	1.228108502	2.816653699	1.560312968	1.497075433	7.302170981	4.277218886	5.94862476	0.150849273	0.010395542	7.031510104	5.549174161	20.09414043	1.046292999	1.727809157	2.688308768	0.084204745	8.719764596	1.190053011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.6639	0		21.7266	0.52836895	4.486285794	0	1.228108502	2.816653699	1.560312968	1.497075433	7.302170981	4.277218886	5.94862476	0.150849273	0.010395542	7.031510104	5.549174161	20.09414043	1.046292999	1.727809157	2.688308768	0.084204745	8.719764596	1.190053011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.6639		$1024/admit	$1024/admit	$128/day (days 21 - 100)	no cost sharing	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered											1.6949	0.0412	0.4141		0	0.2512	0.1391	0	0.5422	0.258	0.3588	0.0091	0.0006	0.4241	0.5269	1.908	0.0993	0.1641	0.2553	0.008	0.1513	0.0379																			7.2841	0		23.4215	0.569588043	4.900343449	0	1.228108502	3.067812275	1.699444727	1.497075433	7.844407513	4.535194342	6.307409107	0.15994757	0.011022537	7.455607414	6.076074357	22.00210118	1.145639671	1.891866539	2.943566645	0.092200078	8.871053734	1.227984824	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.948
H5525_808_0	2009	3																																A	A	D		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		254.6084113	6.191823638	420.5892932		6.14054251	14.08326849	7.80156484	7.485377167	36.5108549	21.38609443	29.7431238	0.754246363	0.051977711	35.15755052	27.7458708	100.4707021	2.092585998	8.639045787	13.44154384	0.421023724	43.59882298	5.950265054																			$1024/admit	$1024/admit	$128/day (days 21 - 100)	no cost sharing	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered											1024	1024	128		0.2	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	0.2	0.2	0.2	0.2																			1024	1024	128		0.2	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	0.2	0.2	0.2	0.2																			21.7266	0.52836895	4.486285794	0	1.228108502	2.816653699	1.560312968	1.497075433	7.302170981	4.277218886	5.94862476	0.150849273	0.010395542	7.031510104	5.549174161	20.09414043	1.046292999	1.727809157	2.688308768	0.084204745	8.719764596	1.190053011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.6639	0		21.7266	0.52836895	4.486285794	0	1.228108502	2.816653699	1.560312968	1.497075433	7.302170981	4.277218886	5.94862476	0.150849273	0.010395542	7.031510104	5.549174161	20.09414043	1.046292999	1.727809157	2.688308768	0.084204745	8.719764596	1.190053011	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.6639		$1024/admit	$1024/admit	$128/day (days 21 - 100)	no cost sharing	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	50% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	not covered	not covered	not covered	not covered	not covered	not covered	not covered	not covered											1.6949	0.0412	0.4141		0	0.2512	0.1391	0	0.5422	0.258	0.3588	0.0091	0.0006	0.4241	0.5269	1.908	0.0993	0.1641	0.2553	0.008	0.1513	0.0379																			7.2841	0		23.4215	0.569588043	4.900343449	0	1.228108502	3.067812275	1.699444727	1.497075433	7.844407513	4.535194342	6.307409107	0.15994757	0.011022537	7.455607414	6.076074357	22.00210118	1.145639671	1.891866539	2.943566645	0.092200078	8.871053734	1.227984824	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.948
H5526_001_0	2009	8	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									V																																																		0		325.101187	1.485077456	4.620082063		199.7740411	11.67549272	1.585474183	266.909469	485.8167913		959.8439	0.109099302		2.666444822	4321.395536	7134.057113	2.916363769	1332.319476	991.487099	2438.825809	0.924621743	60.86799015									33.421009										$250 Copay	$250 Copay	$250 Copay		$50 Copay	25% Coinsurance	25% Coinsurance	$50 Copay	$100 Copay		$15 Copay	50% Coinsurance		50% Coinsurance	$15 Copay	$15 Copay	20% Coinsurance	$15 Copay	$15 Copay	$15 Copay	20% Coinsurance	$0 Copay for blood and $15 Copay for other									$15 Copay										250	250	250		50	0.25	0.25	50	100		15	0.5		0.5	15	15	0.2	15	15	15	0.2	15									15										210.2686597	210.2686597	210.2686597		42.05373194	0.21026866	0.21026866	42.05373194	84.10746389		12.61611958	0.420537319		0.420537319	12.61611958	12.61611958	0.168214928	12.61611958	12.61611958	12.61611958	0.168214928	12.61611958									12.61611958										5.6965	0.026022104	0.080954872	0	0.700103664	2.454990205	0.333375532	0.935378272	3.405068186	0	1.009125452	0.045880328	0	1.121339558	4.543270237	7.500343138	0.490575921	1.400725153	1.042393317	2.564043171	0.15553518	0.063993154	0	0	0	0	0	0	0	0	0.035136954	0	0	0	0	0	0	0	0	0	33.6048	0	4.1231	5.6965	0.026022104	0.080954872	0	0.700103664	2.454990205	0.333375532	0.935378272	3.405068186	0	1.009125452	0.045880328	0	1.121339558	4.543270237	7.500343138	0.490575921	1.400725153	1.042393317	2.564043171	0.15553518	0.063993154	0	0	0	0	0	0	0	0	0.035136954	0	0	0	0	0	0	0	0	0	33.6048	3350	20% Coinsurance	20% Coinsurance	20% Coinsurance	$25 Copay	$50 Copay	50% Coinsurance	50% Coinsurance	$50 Copay	20% Coinsurance	$25 Copay	$25 Copay	55% Coinsurance	$25 Copay	55% Coinsurance	$25 Copay	$25 Copay	50% Coinsurance	$25 Copay	$25 Copay	$25 Copay	20% Coinsurance	$25 Copay									$25 Copay										4.0433	0.0106	0.2078	0.0406	0.2039	0.6592	0.0643	0.0673	0.5708	0.9248	0.1796	0.1701	0.0059	1.0249	1.1701	3.4002	0.0909	0.3052	1.3879	3.715	0.2542	0.0058									0.0325										18.5347	0	2.276939075	9.7398	0.036609329	0.288732549	0.040627108	0.903982364	3.114212592	0.397634141	1.002658244	3.975859895	0.924752574	1.188708376	0.216014202	0.005922859	2.146193228	5.713340165	10.90053823	0.581456402	1.705878174	2.43030754	6.279081693	0.40974607	0.069777195	0	0	0	0	0	0	0	0	0.067666404	0	0	0	0	0	0	0	0	0	52.1395
H5526_002_0	2009	7	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									V																																																		0		224.5208947	0	12.37201422		230.8908716	13.34795332	1.378623565	297.8326385	434.7668887		661.9539167	0.078053965		2.118219131	5376.620004	5926.172971	1.680575198	874.4013785	1213.344036	2248.058125	1.28970379	37.33585476									22.12242281										$250 Copay	$250 Copay	$250 Copay		$50 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$50 Copay		$20 Copay	50% Coinsurance		50% Coinsurance	$10 Copay	$20 Copay	20% Coinsurance	$20 Copay	$20 Copay	$20 Copay	20% Coinsurance	"$0 Copay for Blood, $20 Copay for other"									$20 Copay										250	250	250		50	0.3	0.3	50	50		20	0.5		0.5	10	20	0.2	20	20	20	0.2	20									20										212.7264704	212.7264704	212.7264704		42.54529408	0.255271764	0.255271764	42.54529408	42.54529408		17.01811763	0.425452941		0.425452941	8.509058816	17.01811763	0.170181176	17.01811763	17.01811763	17.01811763	0.170181176	17.01811763									17.01811763										3.9801	0	0.219321243	0	0.818610003	3.407355595	0.35192367	1.055948099	1.541440428	0	0.938767468	0.033208289	0	0.901202559	3.812497987	8.40435906	0.286002264	1.24005546	1.720735961	3.188143135	0.219483308	0.052948831	0	0	0	0	0	0	0	0	0.031373499	0	0	0	0	0	0	0	0	0	32.2035	0	3.6896	3.9801	0	0.219321243	0	0.818610003	3.407355595	0.35192367	1.055948099	1.541440428	0	0.938767468	0.033208289	0	0.901202559	3.812497987	8.40435906	0.286002264	1.24005546	1.720735961	3.188143135	0.219483308	0.052948831	0	0	0	0	0	0	0	0	0.031373499	0	0	0	0	0	0	0	0	0	32.2035	3350	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										4.1837	0.0042	0.7352	0.0301	0.2634	0.4692	0.0647	0.0869	0.2308	0.4162	0.1813	0.0699	0.0067	0.9138	0.66	2.6627	0.0947	0.2495	1.0982	4.3036	0.2333	0.0101									0.0301										16.998	0	1.947506682	8.1638	0.004159503	0.954479632	0.030055513	1.081974555	3.87657755	0.416615434	1.14283282	1.772224491	0.416160383	1.120027611	0.103111162	0.006674883	1.814978512	4.472450989	11.06709125	0.38072065	1.489588405	2.818911893	7.491760566	0.452808857	0.063072402	0	0	0	0	0	0	0	0	0.061447553	0	0	0	0	0	0	0	0	0	49.2015
H5526_003_0	2009	10	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									V																																																		0		293.0596895	1.050474286	3.544735682		205.5964246	11.13680364	1.577789014	246.9585881	461.4911432		946.6770734	0.057496579		2.607393351	4272.622621	6815.933843	2.500293371	1154.992045	942.6564579	2453.583143	1.087191877	62.1317713									34.50120734										$250 Copay	$250 Copay	$250 Copay		$50 Copay	25% Coinsurance	25% Coinsurance	$50 Copay	$100 Copay		$15 Copay	50% Coinsurance		50% Coinsurance	$15 Copay	$15 Copay	20% Coinsurance	$15 Copay	$15 Copay	$15 Copay	20% Coinsurance	$0 Copay for blood and $15 Copay for other									$15 Copay										250	250	250		50	0.25	0.25	50	100		15	0.5		0.5	15	15	0.2	15	15	15	0.2	15									15										207.9898064	207.9898064	207.9898064		41.59796128	0.207989806	0.207989806	41.59796128	83.19592256		12.47938838	0.415979613		0.415979613	12.47938838	12.47938838	0.166391845	12.47938838	12.47938838	12.47938838	0.166391845	12.47938838									12.47938838										5.0795	0.018207329	0.061439074	0	0.712699343	2.316341632	0.328164032	0.856081149	3.199515118	0	0.984495906	0.023917404	0	1.084622477	4.443309759	7.088223802	0.416028427	1.201132859	0.980314671	2.551601414	0.180899862	0.064613875	0	0	0	0	0	0	0	0	0.035879497	0	0	0	0	0	0	0	0	0	31.6269	0	4.0352	5.0795	0.018207329	0.061439074	0	0.712699343	2.316341632	0.328164032	0.856081149	3.199515118	0	0.984495906	0.023917404	0	1.084622477	4.443309759	7.088223802	0.416028427	1.201132859	0.980314671	2.551601414	0.180899862	0.064613875	0	0	0	0	0	0	0	0	0.035879497	0	0	0	0	0	0	0	0	0	31.6269	3350	20% Coinsurance	20% Coinsurance	20% Coinsurance	$25 Copay	$50 Copay	50% Coinsurance	50% Coinsurance	$50 Copay	20% Coinsurance	$25 Copay	$25 Copay	55% Coinsurance	$25 Copay	55% Coinsurance	$25 Copay	$25 Copay	50% Coinsurance	$25 Copay	$25 Copay	$25 Copay	20% Coinsurance	$25 Copay									$25 Copay										4.0433	0.0106	0.2078	0.0406	0.2039	0.6592	0.0643	0.0673	0.5708	0.9248	0.1796	0.1701	0.0059	1.0249	1.1701	3.4002	0.0909	0.3052	1.3879	3.715	0.2542	0.0058									0.0325										18.5347	0	2.364800212	9.1228	0.028794553	0.269216751	0.040627108	0.916578042	2.975564019	0.392422641	0.923361121	3.770306827	0.924752574	1.16407883	0.194051279	0.005922859	2.109476147	5.613379686	10.48841889	0.506908908	1.50628588	2.368228894	6.266639936	0.435110752	0.070397917	0	0	0	0	0	0	0	0	0.068408947	0	0	0	0	0	0	0	0	0	50.1617
H5526_004_0	2009	9	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									V																																																		0		285.2572859	0.498478244	18.78417563		247.6879746	12.09778268	1.716606971	304.0107607	516.066217		762.2615892	0.029901319		2.804501473	4343.813933	6805.77878	2.451487528	1423.562745	1190.864602	2245.509067	1.403800567	2.807616598									24.51255789										$250 Copay	$250 Copay	$250 Copay		$50 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$50 Copay		$15 Copay	50% Coinsurance		50% Coinsurance	$10 Copay	$15 Copay	20% Coinsurance	$15 Copay	$15 Copay	$15 Copay	20% Coinsurance	"$0 Copay for Blood, $15 Copay for other"									$15 Copay										250	250	250		50	0.3	0.3	50	50		15	0.5		0.5	10	15	0.2	15	15	15	0.2	15									15										211.1601416	211.1601416	211.1601416		42.23202832	0.25339217	0.25339217	42.23202832	42.23202832		12.6696085	0.422320283		0.422320283	8.446405664	12.6696085	0.168928113	12.6696085	12.6696085	12.6696085	0.168928113	12.6696085									12.6696085										5.0196	0.008771561	0.330539099	0	0.87169713	3.065483404	0.434974765	1.069915921	1.816210258	0	0.804796326	0.012627934	0	1.184397856	3.057467884	7.185546054	0.414125163	1.502998554	1.25731569	2.370810063	0.237141381	0.002964284	0	0	0	0	0	0	0	0	0.025880376	0	0	0	0	0	0	0	0	0	30.6732	0	3.7693	5.0196	0.008771561	0.330539099	0	0.87169713	3.065483404	0.434974765	1.069915921	1.816210258	0	0.804796326	0.012627934	0	1.184397856	3.057467884	7.185546054	0.414125163	1.502998554	1.25731569	2.370810063	0.237141381	0.002964284	0	0	0	0	0	0	0	0	0.025880376	0	0	0	0	0	0	0	0	0	30.6732	3350	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										4.1837	0.0042	0.7352	0.024	0.2634	0.4692	0.0647	0.0869	0.2308	0.3329	0.145	0.0699	0.0053	0.9138	0.66	2.1302	0.0947	0.1996	0.8785	3.4429	0.2333	0.0081									0.0241										15.2004	0	1.867883713	9.2033	0.012931064	1.065697488	0.02404441	1.135061682	3.534705359	0.49966653	1.156800642	2.04699432	0.332928307	0.94980444	0.082530807	0.005339906	2.098173809	3.717420885	9.315731804	0.508843549	1.70262491	2.135856435	5.813704008	0.47046693	0.011063141	0	0	0	0	0	0	0	0	0.049939619	0	0	0	0	0	0	0	0	0	45.8736
H5526_007_0	2009	7	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									V																																																		0		322.0885163	1.471315435	4.57726836		197.9227609	11.56729744	1.570781799	264.4360535	524.7964867		940.780019	0.108088293		2.641735223	4397.309327	6962.364293	2.889338203	1281.628658	979.310803	2389.536761	0.916053393	58.80150104									32.9867154										$250 Copay	$250 Copay	$250 Copay		$50 Copay	25% Coinsurance	25% Coinsurance	$50 Copay	$75 Copay		$20 Copay	50% Coinsurance		50% Coinsurance	$10 Copay	$20 Copay	20% Coinsurance	$20 Copay	$20 Copay	$20 Copay	20% Coinsurance	$0 Copay for blood and $20 Copay for other									$20 Copay										250	250	250		50	0.25	0.25	50	75		20	0.5		0.5	10	20	0.2	20	20	20	0.2	20									20										212.2354179	212.2354179	212.2354179		42.44708358	0.212235418	0.212235418	42.44708358	63.67062536		16.97883343	0.424470836		0.424470836	8.489416715	16.97883343	0.169788334	16.97883343	16.97883343	16.97883343	0.169788334	16.97883343									16.97883343										5.6965	0.026022104	0.080954872	0	0.700103664	2.454990205	0.333375532	0.935378272	2.784510042	0	1.33111227	0.045880328	0	1.121339558	3.110882609	9.851068634	0.490575921	1.813379959	1.385629583	3.38096222	0.15553518	0.083198408	0	0	0	0	0	0	0	0	0.046672996	0	0	0	0	0	0	0	0	0	35.8281	0	4.0853	5.6965	0.026022104	0.080954872	0	0.700103664	2.454990205	0.333375532	0.935378272	2.784510042	0	1.33111227	0.045880328	0	1.121339558	3.110882609	9.851068634	0.490575921	1.813379959	1.385629583	3.38096222	0.15553518	0.083198408	0	0	0	0	0	0	0	0	0.046672996	0	0	0	0	0	0	0	0	0	35.8281	3350	20% Coinsurance	20% Coinsurance	20% Coinsurance	$30 Copay	$50 Copay	50% Coinsurance	50% Coinsurance	$50 Copay	20% Coinsurance	$30 Copay	$30 Copay	55% Coinsurance	$30 Copay	55% Coinsurance	$20 Copay	$30 Copay	50% Coinsurance	$30 Copay	$30 Copay	$30 Copay	20% Coinsurance	$30 Copay									$30 Copay										4.0433	0.0106	0.2078	0.0488	0.2039	0.6592	0.0643	0.0673	0.5708	1.1097	0.2155	0.1701	0.0071	1.0249	0.9361	4.0802	0.0909	0.3662	1.6655	4.458	0.2542	0.0069									0.039										20.3002	0	2.314720947	9.7398	0.036609329	0.288732549	0.04875253	0.903982364	3.114212592	0.397634141	1.002658244	3.355301751	1.109703089	1.546611779	0.216014202	0.00710743	2.146193228	4.046938551	13.93130274	0.581456402	2.179563585	3.051126651	7.839008447	0.40974607	0.090139258	0	0	0	0	0	0	0	0	0.085708336	0	0	0	0	0	0	0	0	0	56.1284
H5526_008_0	2009	9	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									V																																																		0		584.2001189	0.642967104	37.8604783		247.8707458	22.39012187	2.709941276	340.3972037	573.5799015		982.9230744	0.049537316		1.238588602	5219.159614	9856.178119	5.423573587	1833.1875	1703.978673	3904.529836	1.534697329	30.33837951									14.87464715										$100 Copay	$100 Copay	$100 Copay		$50 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$35 Copay		$5 Copay	50% Coinsurance		50% Coinsurance	$5 Copay	$5 Copay	20% Coinsurance	$5 Copay	$5 Copay	$5 Copay	20% Coinsurance	"$0 Copay for Blood, $5 Copay for other"									$5 Copay										100	100	100		50	0.3	0.3	50	35		5	0.5		0.5	5	5	0.2	5	5	5	0.2	5									5										80.33964429	80.33964429	80.33964429		40.16982214	0.241018933	0.241018933	40.16982214	28.1188755		4.016982214	0.401698221		0.401698221	4.016982214	4.016982214	0.160679289	4.016982214	4.016982214	4.016982214	0.160679289	4.016982214									4.016982214										3.9112	0.004304646	0.25347478	0	0.829743648	5.39644328	0.653147154	1.139474594	1.344035153	0	0.329032042	0.019899052	0	0.497538839	1.747105945	3.299341017	0.871455946	0.613656798	0.570404335	1.307035575	0.246594075	0.010155728	0	0	0	0	0	0	0	0	0.004979266	0	0	0	0	0	0	0	0	0	23.049	0	3.494	3.9112	0.004304646	0.25347478	0	0.829743648	5.39644328	0.653147154	1.139474594	1.344035153	0	0.329032042	0.019899052	0	0.497538839	1.747105945	3.299341017	0.871455946	0.613656798	0.570404335	1.307035575	0.246594075	0.010155728	0	0	0	0	0	0	0	0	0.004979266	0	0	0	0	0	0	0	0	0	23.049	3350	20% Coinsurance	20% Coinsurance	20% Coinsurance	$10 Copay	$50 Copay	35% Coinsurance	35% Coinsurance	$50 Copay	$50 Copay	$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										4.1837	0.0042	0.7352	0.012	0.2634	0.4692	0.0647	0.0869	0.1539	0.1665	0.0725	0.0699	0.0027	0.9138	0.44	1.0651	0.0947	0.0998	0.4393	1.7214	0.2333	0.004									0.012										11.3081	0	2.143111622	8.0949	0.008464149	0.988633169	0.012022205	1.0931082	5.865665234	0.717838919	1.226359315	1.497891195	0.166464153	0.401536099	0.089801925	0.002669953	1.411314791	2.187074613	4.364433892	0.966174331	0.713469976	1.009674708	3.028482548	0.479919624	0.014205156	0	0	0	0	0	0	0	0	0.017008888	0	0	0	0	0	0	0	0	0	34.3571
H5526_010_0	2009	7	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded		T	Coin	Coin	V	V		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									V																																																		0		373.8872745	0.521187967	21.30236784		272.5749262	17.30641702	1.971207133	381.0024372	567.5363008		874.4587272	0.068348906		2.240641277	5877.651016	8233.125029	3.734860749	1616.018933	1524.267901	3064.375269	1.624662975	38.11193354									22.03596961										$100 Copay	$100 Copay	$100 Copay		$50 Copay	30% Coinsurance	30% Coinsurance	$25 Copay	$35 Copay		$10 Copay	50% Coinsurance		50% Coinsurance	$5 Copay	$10 Copay	20% Coinsurance	$10 Copay	$10 Copay	$10 Copay	20% Coinsurance	"$0 Copay for Blood, $10 Copay for other"									$10 Copay										100	100	100		50	0.3	0.3	25	35		10	0.5		0.5	5	10	0.2	10	10	10	0.2	10									10										81.11210188	81.11210188	81.11210188		40.55605094	0.243336306	0.243336306	20.27802547	28.38923566		8.111210188	0.405560509		0.405560509	4.055605094	8.111210188	0.162224204	8.111210188	8.111210188	8.111210188	0.162224204	8.111210188									8.111210188										2.5272	0.003522888	0.143989986	0	0.921213549	4.211279581	0.479666261	0.643831427	1.342660149	0	0.591076545	0.027719617	0	0.908715618	1.986452617	5.565050635	0.605884811	1.092322436	1.030304777	2.071315992	0.263559658	0.025761159	0	0	0	0	0	0	0	0	0.014894865	0	0	0	0	0	0	0	0	0	24.4565	0	3.4211	2.5272	0.003522888	0.143989986	0	0.921213549	4.211279581	0.479666261	0.643831427	1.342660149	0	0.591076545	0.027719617	0	0.908715618	1.986452617	5.565050635	0.605884811	1.092322436	1.030304777	2.071315992	0.263559658	0.025761159	0	0	0	0	0	0	0	0	0.014894865	0	0	0	0	0	0	0	0	0	24.4565	3350	20% Coinsurance	20% Coinsurance	20% Coinsurance	$10 Copay	$50 Copay	35% Coinsurance	35% Coinsurance	$50 Copay	$50 Copay	$10 Copay	$25 Copay	55% Coinsurance	$10 Copay	55% Coinsurance	$15 Copay	$25 Copay	50% Coinsurance	$25 Copay	$25 Copay	$25 Copay	20% Coinsurance	$25 Copay									$25 Copay										4.1837	0.0042	0.7352	0.012	0.2634	0.4477	0.0617	0.0869	0.1539	0.1665	0.1813	0.0699	0.0027	0.9138	0.66	2.6627	0.0904	0.2495	1.0982	4.2769	0.2333	0.0101									0										16.5638	0	2.216075689	6.7109	0.007682391	0.879148375	0.012022205	1.184578102	4.659010454	0.541395044	0.730716148	1.496516191	0.166464153	0.772336688	0.09762249	0.002669953	1.82249157	2.646405618	8.227782822	0.69626495	1.341855381	2.128480709	6.348183362	0.496885207	0.03588473	0	0	0	0	0	0	0	0	0.014894865	0	0	0	0	0	0	0	0	0	41.0202
H5526_801_0	2009	8	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded	V	T	Coin	Coin	V	Coin		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									Coin																																																		0		542.5621127	3.958367526	33.46396097	1.082751868	138.7842702	10.87434311	1.415560706	258.5709869	15.17550426		887.7848489	0.069227716		8.150268053	4744.377961	4959.818383	0.605262858	2785.997327	1188.892491	1908.251475	0.13541524	9.607795042									2.708338462										$600 Copay	$600 Copay	$600 Copay	$20 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	20% Coinsurance		$35 Copay	50% Coinsurance		50% Coinsurance	$20 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	"$0 Copay for Blood, $35 Copay for other"									50% Coinsurance										600	600	600	20	100	0.3	0.3	50	0.2		35	0.5		0.5	20	35	0.5	35	35	35	0.2	35									0.5										559.9161886	559.9161886	559.9161886	18.66387295	93.31936477	0.279958094	0.279958094	46.65968238	0.18663873		32.66177767	0.466596824		0.466596824	18.66387295	32.66177767	0.466596824	32.66177767	32.66177767	32.66177767	0.18663873	32.66177767									0.466596824										25.3158	0.184696172	1.56141779	0.001684029	1.079271661	3.044360374	0.396297678	1.005403343	2.832336834	0	2.416385946	0.032301432	0	3.802889187	7.379038959	13.49970711	0.282413727	7.582968773	3.235945184	5.193907119	0.025273728	0.026150639	0	0	0	0	0	0	0	0	1.263702124	0	0	0	0	0	0	0	0	0	80.1619	0	4.4978	25.3158	0.184696172	1.56141779	0.001684029	1.079271661	3.044360374	0.396297678	1.005403343	2.832336834	0	2.416385946	0.032301432	0	3.802889187	7.379038959	13.49970711	0.282413727	7.582968773	3.235945184	5.193907119	0.025273728	0.026150639	0	0	0	0	0	0	0	0	1.263702124	0	0	0	0	0	0	0	0	0	80.1619	3350	20% Coinsurance	20% Coinsurance	20% Coinsurance	$30 Copay	$100 Copay	50% Coinsurance	50% Coinsurance	$50 Copay	25% Coinsurance	$45 Copay	$45 Copay	55% Coinsurance	$30 Copay	55% Coinsurance	$30 Copay	$45 Copay	55% Coinsurance	$45 Copay	$45 Copay	$45 Copay	30% Coinsurance	$45 Copay									55% Coinsurance										3.5506	0	0.2448	0.0229	0.4151	0.7489	0.089	0.0777	0.748	1.0716	0.4137	0.1085	0.0041	1.2912	1.2871	4.9688	0.0788	2.0251	2.0878	6.89	0.2558	0.0061									0.285										26.6705	0	1.496441605	28.8664	0.184696172	1.806168936	0.024545603	1.494393161	3.793267634	0.485302377	1.083096638	3.580369046	1.071628596	2.830127175	0.140755208	0.004124236	5.094087493	8.666115042	18.46848984	0.361261553	9.608044095	5.323744511	12.08390305	0.281033306	0.032230845	0	0	0	0	0	0	0	0	1.548660471	0	0	0	0	0	0	0	0	0	106.8324
H5526_802_0	2009	8	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded	V	T	Coin	Coin	V	Coin		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									Coin																																																		0		542.5621127	3.958367526	33.46396097	1.082751868	138.7842702	10.87434311	1.415560706	258.5709869	15.17550426		887.7848489	0.069227716		8.150268053	4744.377961	4959.818383	0.605262858	2785.997327	1188.892491	1908.251475	0.13541524	9.607795042									2.708338462										$600 Copay	$600 Copay	$600 Copay	$20 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	20% Coinsurance		$35 Copay	50% Coinsurance		50% Coinsurance	$20 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	"$0 Copay for Blood, $35 Copay for other"									50% Coinsurance										600	600	600	20	100	0.3	0.3	50	0.2		35	0.5		0.5	20	35	0.5	35	35	35	0.2	35									0.5										559.9161886	559.9161886	559.9161886	18.66387295	93.31936477	0.279958094	0.279958094	46.65968238	0.18663873		32.66177767	0.466596824		0.466596824	18.66387295	32.66177767	0.466596824	32.66177767	32.66177767	32.66177767	0.18663873	32.66177767									0.466596824										25.3158	0.184696172	1.56141779	0.001684029	1.079271661	3.044360374	0.396297678	1.005403343	2.832336834	0	2.416385946	0.032301432	0	3.802889187	7.379038959	13.49970711	0.282413727	7.582968773	3.235945184	5.193907119	0.025273728	0.026150639	0	0	0	0	0	0	0	0	1.263702124	0	0	0	0	0	0	0	0	0	80.1619	0	4.4978	25.3158	0.184696172	1.56141779	0.001684029	1.079271661	3.044360374	0.396297678	1.005403343	2.832336834	0	2.416385946	0.032301432	0	3.802889187	7.379038959	13.49970711	0.282413727	7.582968773	3.235945184	5.193907119	0.025273728	0.026150639	0	0	0	0	0	0	0	0	1.263702124	0	0	0	0	0	0	0	0	0	80.1619	3350	20% Coinsurance	20% Coinsurance	20% Coinsurance	$30 Copay	$100 Copay	50% Coinsurance	50% Coinsurance	$50 Copay	25% Coinsurance	$45 Copay	$45 Copay	55% Coinsurance	$30 Copay	55% Coinsurance	$30 Copay	$45 Copay	55% Coinsurance	$45 Copay	$45 Copay	$45 Copay	30% Coinsurance	$45 Copay									55% Coinsurance										3.5506	0	0.2448	0.0229	0.4151	0.7489	0.089	0.0777	0.748	1.0716	0.4137	0.1085	0.0041	1.2912	1.2871	4.9688	0.0788	2.0251	2.0878	6.89	0.2558	0.0061									0.285										26.6705	0	1.496441605	28.8664	0.184696172	1.806168936	0.024545603	1.494393161	3.793267634	0.485302377	1.083096638	3.580369046	1.071628596	2.830127175	0.140755208	0.004124236	5.094087493	8.666115042	18.46848984	0.361261553	9.608044095	5.323744511	12.08390305	0.281033306	0.032230845	0	0	0	0	0	0	0	0	1.548660471	0	0	0	0	0	0	0	0	0	106.8324
H5526_803_0	2009	8	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded	V	T	Coin	Coin	V	Coin		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									Coin																																																		0		550.9065846	4.019246245	33.97862846	1.107174298	142.5025026	11.32606678	1.474363547	264.4032849	16.08024418		907.8096238	0.073354964		8.63617434	4871.486745	5092.699129	0.630405669	2860.638246	1220.744649	1959.376307	0.135172439	9.824507383									2.703482386										$600 Copay	$600 Copay	$600 Copay	$20 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	20% Coinsurance		$35 Copay	50% Coinsurance		50% Coinsurance	$20 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	"$0 Copay for Blood, $35 Copay for other"									50% Coinsurance										600	600	600	20	100	0.3	0.3	50	0.2		35	0.5		0.5	20	35	0.5	35	35	35	0.2	35									0.5										560.921927	560.921927	560.921927	18.69739757	93.48698783	0.280460963	0.280460963	46.74349391	0.186973976		32.72044574	0.467434939		0.467434939	18.69739757	32.72044574	0.467434939	32.72044574	32.72044574	32.72044574	0.186973976	32.72044574									0.467434939										25.7513	0.187873612	1.588279813	0.001725107	1.110177477	3.176519601	0.413501421	1.029927778	3.006587184	0	2.475327962	0.034288673	0	4.036849627	7.590343701	13.88628213	0.294673636	7.80011321	3.328609088	5.342638845	0.025273728	0.026788522	0	0	0	0	0	0	0	0	1.263702124	0	0	0	0	0	0	0	0	0	82.3708	0	4.4913	25.7513	0.187873612	1.588279813	0.001725107	1.110177477	3.176519601	0.413501421	1.029927778	3.006587184	0	2.475327962	0.034288673	0	4.036849627	7.590343701	13.88628213	0.294673636	7.80011321	3.328609088	5.342638845	0.025273728	0.026788522	0	0	0	0	0	0	0	0	1.263702124	0	0	0	0	0	0	0	0	0	82.3708	3350	20% Coinsurance	20% Coinsurance	20% Coinsurance	$30 Copay	$100 Copay	50% Coinsurance	50% Coinsurance	$50 Copay	25% Coinsurance	$45 Copay	$45 Copay	55% Coinsurance	$30 Copay	55% Coinsurance	$30 Copay	$45 Copay	55% Coinsurance	$45 Copay	$45 Copay	$45 Copay	30% Coinsurance	$45 Copay									55% Coinsurance										3.6993	0	0.255	0.0234	0.427	0.7814	0.0929	0.0796	0.7941	1.0978	0.4238	0.1151	0.0042	1.3706	1.3239	5.1111	0.0823	2.0831	2.1476	7.0873	0.2558	0.0062									0.3025										27.5639	0	1.502928771	29.4506	0.187873612	1.843282203	0.025144335	1.537186317	3.957937796	0.506369918	1.109516217	3.800639655	1.097768439	2.899161429	0.149414716	0.004224837	5.407484726	8.914276247	18.99734997	0.376944337	9.8831782	5.476194236	12.42993537	0.281033306	0.03301704	0	0	0	0	0	0	0	0	1.566191611	0	0	0	0	0	0	0	0	0	109.9347
H5526_804_0	2009	8	h.6.										OP Facility - Other											Cardiac Rehab and CORF										Ded	Ded	Ded		T	Coin	Coin	V	Coin		V	Coin		Coin	V	V	Coin	V	V	V	Coin	V									Coin																																																		0		550.9065846	4.019246245	33.97862846	1.107174298	142.5025026	11.32606678	1.474363547	264.4032849	16.08024418		907.8096238	0.073354964		8.63617434	4871.486745	5092.699129	0.630405669	2860.638246	1220.744649	1959.376307	0.135172439	9.824507383									2.703482386										$600 Copay	$600 Copay	$600 Copay	$20 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	20% Coinsurance		$35 Copay	50% Coinsurance		50% Coinsurance	$20 Copay	$35 Copay	50% Coinsurance	$35 Copay	$35 Copay	$35 Copay	20% Coinsurance	"$0 Copay for Blood, $35 Copay for other"									50% Coinsurance										600	600	600	20	100	0.3	0.3	50	0.2		35	0.5		0.5	20	35	0.5	35	35	35	0.2	35									0.5										560.921927	560.921927	560.921927	18.69739757	93.48698783	0.280460963	0.280460963	46.74349391	0.186973976		32.72044574	0.467434939		0.467434939	18.69739757	32.72044574	0.467434939	32.72044574	32.72044574	32.72044574	0.186973976	32.72044574									0.467434939										25.7513	0.187873612	1.588279813	0.001725107	1.110177477	3.176519601	0.413501421	1.029927778	3.006587184	0	2.475327962	0.034288673	0	4.036849627	7.590343701	13.88628213	0.294673636	7.80011321	3.328609088	5.342638845	0.025273728	0.026788522	0	0	0	0	0	0	0	0	1.263702124	0	0	0	0	0	0	0	0	0	82.3708	0	4.4913	25.7513	0.187873612	1.588279813	0.001725107	1.110177477	3.176519601	0.413501421	1.029927778	3.006587184	0	2.475327962	0.034288673	0	4.036849627	7.590343701	13.88628213	0.294673636	7.80011321	3.328609088	5.342638845	0.025273728	0.026788522	0	0	0	0	0	0	0	0	1.263702124	0	0	0	0	0	0	0	0	0	82.3708	3350	20% Coinsurance	20% Coinsurance	20% Coinsurance	$30 Copay	$100 Copay	50% Coinsurance	50% Coinsurance	$50 Copay	25% Coinsurance	$45 Copay	$45 Copay	55% Coinsurance	$30 Copay	55% Coinsurance	$30 Copay	$45 Copay	55% Coinsurance	$45 Copay	$45 Copay	$45 Copay	30% Coinsurance	$45 Copay									55% Coinsurance										3.6993	0	0.255	0.0234	0.427	0.7814	0.0929	0.0796	0.7941	1.0978	0.4238	0.1151	0.0042	1.3706	1.3239	5.1111	0.0823	2.0831	2.1476	7.0873	0.2558	0.0062									0.3025										27.5639	0	1.502928771	29.4506	0.187873612	1.843282203	0.025144335	1.537186317	3.957937796	0.506369918	1.109516217	3.800639655	1.097768439	2.899161429	0.149414716	0.004224837	5.407484726	8.914276247	18.99734997	0.376944337	9.8831782	5.476194236	12.42993537	0.281033306	0.03301704	0	0	0	0	0	0	0	0	1.566191611	0	0	0	0	0	0	0	0	0	109.9347
H5528_001_0	2009	2	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	314.37	12.87	876.06	2689.92	469.35	5.2425		179.76	210.32	452.4	335.36			618.88	4216.334126	4110.372289	790.11	805.741409	23.98716421	686.2745731	21.492				245	245					282.874723	0	52.06242291	298.9588461	10.5714359	2.1					1A IP Acute: $0 per stay	1B IP Psych: $0 per stay (up to 190 days)	2 SNF: $0 days 1-100	6 Home Health - $0 per day	10A Ambulance - $50 per trip	11A DME - 20% coinsurance	11B Pros./Med Supp. - 20%; 11C Diabetes Mon Supplies - 0%	4A Emergency Care - $50; 4B Urgent Care - $0/$10	9B ASC Services - $0; 9A Outpatient Hospital - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0; Outpatient Radiology Therapy - $20; $0 High-tech Radiology			3 CORF - $10; 5 Partial Hosp - $10; 9D Cardiac Rehab Svcs - $10; 9C Outpatient Sub Abuse - $10; 12 Renal Dialysis - $0	7A Primary Care - $0; 14B Immunizations - $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 - $10; 7H Psychiatric Services - $10	7C Occupational Therapy - $10; 7I PT and ST Services - $10	7D Physician Specialist - $10	7G Other Health Care - $10	15 Medicare Part B Rx Drugs - 10%	13A Blood - $0	10B Transportation - NA	16A Preventative Dental - $0; 16B Comp Dental - NA	17A Eye Exams (Routine) - $0	17B Eye Wear - $0; Eyewear every year	18A Hearing Exams (Routine) - NA	18B Hearing Aids - NA		14C Routine Physical Exams - $0	7B Chiropractic Services - $10	7F Podiatry Services - $10	18A Hearing Exams (Medicare Covered) - $10	7D High Tech Radiology: $0 copayment	17A Eye Exams (Medicare Covered) - $10	14B Immunizations - $10					0	0	0	0	50	0.2	0.2	50	0	0	0.211780278			0.681624538	0	10	10	10	10	10	0.1				0	0					10	10	10	0	10	10					0	0	0	0	50	0.2	0.2	50	0	0	0.211780278			0.681624538	0	10	10	10	10	10	0.1				0	0					10	10	10	0	10	10					0	0	0	0	1.955625	1.0485	0	0.749	0	0	0.005918553	0	0	0.03515365	0	3.425310241	0.658425	0.671451174	0.019989304	0.571895478	2.1492	0	0	0	0	0	0	0	0	0	0.235728936	0	0.043385352	0	0.00880953	0.00175	0	0	0	0	11.5801	0	0	0	0	0	0	1.955625	1.0485	0	0.749	0	0	0.005918553	0	0	0.03515365	0	3.425310241	0.658425	0.671451174	0.019989304	0.571895478	2.1492	0	0	0	0	0	0	0	0	0	0.235728936	0	0.043385352	0	0.00880953	0.00175	0	0	0	0	11.5801	Unlimited	1A IP Acute: 25%; $1500 OOP Max	1A IP Psych: 25%; $7500 OOP Max	2 SNF: 25%	6 Home Health - $40 per day	10A Ambulance - 25%	11A DME - 50%	11B Pros./Med Supp. - 50%; 11C Diabetes Mon Supplies - 50%	4A Emergency Care - $50; 4B Urgent Care - $0/$10	9B ASC Services - 25%; 9A Outpatient Hospital - 25%	8A Outpatient C/D/T - 25%	8B Outpatient X-Rays - 25%			3 CORF - 50%; 5 Partial Hosp - 50%; 9D Cardiac Rehab Svcs - 50%; 9C Outpatient Sub Abuse - 50%; 12 Renal Dialysis - 25%	7A Primary Care - 25%; 14B Immunizations - 25%; 14D Pap/Pelvic - 25%; 14E Prostate Screening - 25%; 14F Colorectal Screening - 25%; 14G Bone Mass Meas. - 25%; 14H Mammography - 25%; 14I Diabetes Monitoring - 25%	7D Physician Specialist - 25%	7E Mental Health - 50%; 7H Psychiatric Services - 50%	7C Occupational Therapy - 50%; 7I PT and ST Services - 50%	7D Physician Specialist - 25%	7G Other Health Care - 25%	15 Medicare Part B Rx Drugs - 50%		10B Transportation - NA	16A Preventative Dental - 50%	17A Eye Exams (Routine) - 50%	17B Eye Wear - 50%				14C Routine Physical Exams - 25%	7B Chiropractic Services - $40	7F Podiatry Services - $40	18A Hearing Exams (Medicare Covered) - $40		17A Eye Exams (Medicare Covered) - 50%						2.438	0.495	0.988	1.146	0.313	0.546		0.216	1.664	0.412	0.86			0.83	1.319	3.823	0.429	0.353	1.849	2.668	1.374			0.001	0.0252	0.0286				0.03	0.0984	0	0.0044		0.0812						21.9918	0	9	2.438	0.495	0.988	1.146	2.268625	1.5945	0	0.965	1.664	0.412	0.865918553	0	0	0.86515365	1.319030396	7.248279845	1.087425	1.024451174	1.868989304	3.239895478	3.5232	0	0	0.001	0.0252	0.0286	0	0	0	0.03	0.334160423	0	0.047795044	0	0.09000953	0.00175	0	0	0	0	33.572
H5528_002_0	2009	4	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	292.908496	11.95374284	816.306823	2506.351444	437.3444187	4.7745		167.5238299	195.9332321	421.5588718	312.5034245			576.619222	3928.582745	3829.854267	736.2273677	750.7407268	22.34996988	639.3167397	20.025				245	245	427.5				263.5534808	0	48.50109608	278.5540278	9.850355143	2.1					1A IP Acute: $0 per stay	1B IP Psych: $0 per stay (up to 190 days)	2 SNF: $0 days 1-20; $50 per day for days 21-100	6 Home Health - $0 per day	10A Ambulance - $50 per trip	11A DME - 20% coinsurance	11B Pros./Med Supp. - 20%; 11C Diabetes Mon Supplies - 0%	4A Emergency Care - $50; 4B Urgent Care - $10	9B ASC Services - $0; 9A Outpatient Hospital - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0; Outpatient Radiology Therapy - $20; $75 High-tech Radiology			3 CORF - $20; 5 Partial Hosp - $20; 9D Cardiac Rehab Svcs - $20; 9C Outpatient Sub Abuse - $20; 12 Renal Dialysis - $0	7A Primary Care - $0; 14B Immunizations - $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	7C Occupational Therapy - $20; 7I PT and ST Services - $20	7D Physician Specialist - $10	7G Other Health Care - $10	15 Medicare Part B Rx Drugs - 10%	13A Blood - $0	10B Transportation - NA	16A Preventative Dental - $0; 16B Comp Dental - NA	17A Eye Exams (Routine) - $0	17B Eye Wear - $0; Eyewear every year	18A Hearing Exams (Routine) - $10	18B Hearing Aids - $0 $600 every 2 years		14C Routine Physical Exams - $0	7B Chiropractic Services - $10	7F Podiatry Services - $10	18A Hearing Exams (Medicare Covered) - $10	7D High Tech Radiology: $75 copayment	17A Eye Exams (Medicare Covered) - $10	14B Immunizations - $10					0	0	22.7	0	50	0.2	0.2	50	0	0	5.261283131			1.363249077	0	10	20	20	10	10	0.1				0	0	10				10	10	10	75	10	10					0	0	22.7	0	50	0.2	0.2	50	0	0	5.261283131			1.363249077	0	10	20	20	10	10	0.1				0	0	10				10	10	10	75	10	10					0	0	1.544180407	0	1.822268411	0.9549	0	0.698015958	0	0	0.137014083	0	0	0.065506302	0	3.191545222	1.227045613	1.251234545	0.018624975	0.53276395	2.0025	0	0	0	0	0	0.35625	0	0	0	0.219627901	0	0.04041758	1.740962674	0.008208629	0.00175	0	0	0	0	15.8128	0	0	0	0	1.544180407	0	1.822268411	0.9549	0	0.698015958	0	0	0.137014083	0	0	0.065506302	0	3.191545222	1.227045613	1.251234545	0.018624975	0.53276395	2.0025	0	0	0	0	0	0.35625	0	0	0	0.219627901	0	0.04041758	1.740962674	0.008208629	0.00175	0	0	0	0	15.8128	Unlimited	1A IP Acute: 25%; $1500 OOP Max	1A IP Psych: 25%; $1500 OOP Max	2 SNF: 25%	6 Home Health - $40 per day	10A Ambulance - 25%	11A DME - 50%	11B Pros./Med Supp. - 50%; 11C Diabetes Mon Supplies - 50%	4A Emergency Care - $50; 4B Urgent Care - $10	9B ASC Services - 25%; 9A Outpatient Hospital - 25%	8A Outpatient C/D/T - 25%	8B Outpatient X-Rays - 25%			3 CORF - 50%; 5 Partial Hosp - 50%; 9D Cardiac Rehab Svcs - 50%; 9C Outpatient Sub Abuse - 50%; 12 Renal Dialysis - 25%	7A Primary Care - 25%; 14B Immunizations - 25%; 14D Pap/Pelvic - 25%; 14E Prostate Screening - 25%; 14F Colorectal Screening - 25%; 14G Bone Mass Meas. - 25%; 14H Mammography - 25%; 14I Diabetes Monitoring - 25%	7D Physician Specialist - 25%	7E Mental Health - 50%; 7H Psychiatric Services - 50%	7C Occupational Therapy - 50%; 7I PT and ST Services - 50%	7D Physician Specialist - 25%	7G Other Health Care - 25%	15 Medicare Part B Rx Drugs - 50%		10B Transportation - NA	16A Preventative Dental - 50%	17A Eye Exams (Routine) - 50%	17B Eye Wear - 50%	18A Hearing Exams (Routine) - $40			14C Routine Physical Exams - 25%	7B Chiropractic Services - $40	7F Podiatry Services - $40	18A Hearing Exams (Medicare Covered) - $40		17A Eye Exams (Medicare Covered) - 50%						2.272	0.155	0.921	1.068	0.292	0.508		0.2	1.552	0.384	0.802			0.774	1.2289	3.5611	0.4	0.329	1.723	2.486	1.28			0.001	0.0252	0.0286	0.0865			0.03	0.096	0	0.021		0.0758						20.3001	0	8.7	2.272	0.155	2.465180407	1.068	2.114268411	1.4629	0	0.898015958	1.552	0.384	0.939014083	0	0	0.839506302	1.228929766	6.752615456	1.627045613	1.580234545	1.741624975	3.01876395	3.2825	0	0	0.001	0.0252	0.0286	0.44275	0	0	0.03	0.315627901	0	0.06141758	1.740962674	0.084008629	0.00175	0	0	0	0	36.1129
H5528_003_0	2009	4	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	288.54	11.79	804.06	2468.88	430.83	4.6755		165.04	193.04	415.28	307.84			568	3869.764103	3772.51356	725.22	739.4896713	22.01521687	629.6946294	19.728				245	245					259.5985714	0	47.76898678	274.3819058	9.70325641	2.1					1A IP Acute: $50 per day; days 1-5	1B IP Psych: $50 per day; days 1-5 (up to 190 days)	2 SNF: $0 days 1-20; $50 per day for days 21-100	6 Home Health - $0 per day	10A Ambulance - $50 per trip	11A DME - 20% coinsurance	11B Pros./Med Supp. - 20%; 11C Diabetes Mon Supplies - 0%	4A Emergency Care - $50; 4B Urgent Care - $10	9B ASC Services - $0; 9A Outpatient Hospital - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0; Outpatient Radiology Therapy - $20; $50 High-tech Radiology			3 CORF - $20; 5 Partial Hosp - $20; 9D Cardiac Rehab Svcs - $20; 9C Outpatient Sub Abuse - $20; 12 Renal Dialysis - $0	7A Primary Care - $0; 14B Immunizations - $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	7C Occupational Therapy - $20; 7I PT and ST Services - $20	7D Physician Specialist - $10	7G Other Health Care - $10	15 Medicare Part B Rx Drugs - 10%	13A Blood - $0	10B Transportation - NA	16A Preventative Dental - $0; 16B Comp Dental - NA	17A Eye Exams (Routine) - $0	17B Eye Wear - $0; Eyewear every year	18A Hearing Exams (Routine) - NA	18B Hearing Aids - NA		14C Routine Physical Exams - $0	7B Chiropractic Services - $10	7F Podiatry Services - $10	18A Hearing Exams (Medicare Covered) - $10	7D High Tech Radiology: $50 copayment	17A Eye Exams (Medicare Covered) - $10	14B Immunizations - $10					180	225	22.7	0	50	0.2	0.2	50	0	0	3.578115513			1.363249077	0	10	20	20	10	10	0.1				0	0					10	10	10	50	10	10					180	225	22.7	0	50	0.2	0.2	50	0	0	3.578115513			1.363249077	0	10	20	20	10	10	0.1				0	0					10	10	10	50	10	10					4.3281	0.2210625	1.5210135	0	1.795125	0.9351	0	0.687666667	0	0	0.09179059	0	0	0.064527123	0	3.1437613	1.2087	1.232482786	0.018346014	0.524745525	1.9728	0	0	0	0	0	0	0	0	0	0.216332143	0	0.039807489	1.143257941	0.008086047	0.00175	0	0	0	0	19.1545	0	0	4.3281	0.2210625	1.5210135	0	1.795125	0.9351	0	0.687666667	0	0	0.09179059	0	0	0.064527123	0	3.1437613	1.2087	1.232482786	0.018346014	0.524745525	1.9728	0	0	0	0	0	0	0	0	0	0.216332143	0	0.039807489	1.143257941	0.008086047	0.00175	0	0	0	0	19.1545	Unlimited	1A IP Acute: 25%; $1500 OOP Max	1A IP Psych: 25%; $1500 OOP Max	2 SNF: 25%	6 Home Health - $40 per day	10A Ambulance - 25%	11A DME - 50%	11B Pros./Med Supp. - 50%; 11C Diabetes Mon Supplies - 50%	4A Emergency Care - $50; 4B Urgent Care - $10	9B ASC Services - 25%; 9A Outpatient Hospital - 25%	8A Outpatient C/D/T - 25%	8B Outpatient X-Rays - 25%			3 CORF - 50%; 5 Partial Hosp - 50%; 9D Cardiac Rehab Svcs - 50%; 9C Outpatient Sub Abuse - 50%; 12 Renal Dialysis - 25%	7A Primary Care - 25%; 14B Immunizations - 25%; 14D Pap/Pelvic - 25%; 14E Prostate Screening - 25%; 14F Colorectal Screening - 25%; 14G Bone Mass Meas. - 25%; 14H Mammography - 25%; 14I Diabetes Monitoring - 25%	7D Physician Specialist - 25%	7E Mental Health - 50%; 7H Psychiatric Services - 50%	7C Occupational Therapy - 50%; 7I PT and ST Services - 50%	7D Physician Specialist - 25%	7G Other Health Care - 25%	15 Medicare Part B Rx Drugs - 50%		10B Transportation - NA	16A Preventative Dental - 50%	17A Eye Exams (Routine) - 50%	17B Eye Wear - 50%				14C Routine Physical Exams - 25%	7B Chiropractic Services - $40	7F Podiatry Services - $40	18A Hearing Exams (Medicare Covered) - $40		17A Eye Exams (Medicare Covered) - 50%						2.238	0.153	0.907	1.052	0.287	0.501		0.198	1.528	0.378	0.79			0.762	1.2103	3.5077	0.394	0.324	1.697	2.449	1.261			0.001	0.0252	0.0286				0.03	0.0917	0	0.004		0.0746						19.8921	0	8.57	6.5661	0.3740625	2.4280135	1.052	2.082125	1.4361	0	0.885666667	1.528	0.378	0.88179059	0	0	0.826527123	1.210287781	6.651473519	1.6027	1.556482786	1.715346014	2.973745525	3.2338	0	0	0.001	0.0252	0.0286	0	0	0	0.03	0.308008528	0	0.0438163	1.143257941	0.082686047	0.00175	0	0	0	0	39.0465
H5528_004_0	2009	2	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	255.92	7.12	707.44	4226.32	455.76	5.2695		206.22	238.7	260.82	321.58			327.25	4741.332735	4636.687334	918.27	1026.068475	26.1628211	810.1387961	29.646				245	245					483.1538484	0	51.95418502	326.0746764	10.0324359	2.1					1A IP Acute: $0 per stay	1B IP Psych: $0 per stay (up to 190 days)	2 SNF: $0 days 1-100	6 Home Health - $0 per day	10A Ambulance - $50 per trip	11A DME - 20% coinsurance	11B Pros./Med Supp. - 20%; 11C Diabetes Mon Supplies - 0%	4A Emergency Care - $50; 4B Urgent Care - $0/$10	9B ASC Services - $0; 9A Outpatient Hospital - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0; Outpatient Radiology Therapy - $20; $0 High-tech Radiology			3 CORF - $10; 5 Partial Hosp - $10; 9D Cardiac Rehab Svcs - $10; 9C Outpatient Sub Abuse - $10; 12 Renal Dialysis - $0	7A Primary Care - $0; 14B Immunizations - $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 - $10; 7H Psychiatric Services - $10	7C Occupational Therapy - $10; 7I PT and ST Services - $10	7D Physician Specialist - $10	7G Other Health Care - $10	15 Medicare Part B Rx Drugs - 10%	13A Blood - $0	10B Transportation - NA	16A Preventative Dental - $0; 16B Comp Dental - NA	17A Eye Exams (Routine) - $0	17B Eye Wear - $0; Eyewear every year	18A Hearing Exams (Routine) - NA	18B Hearing Aids - $0		14C Routine Physical Exams - $0	7B Chiropractic Services - $10	7F Podiatry Services - $10	18A Hearing Exams (Medicare Covered) - $10	7D High Tech Radiology: $0 copayment	17A Eye Exams (Medicare Covered) - $10	14B Immunizations - $10					0	0	0	0	50	0.2	0.2	50	0	0	0.211780278			0.681624538	0	10	10	10	10	10	0.1				0	0					10	10	10	0	10	10					0	0	0	0	50	0.2	0.2	50	0	0	0.211780278			0.681624538	0	10	10	10	10	10	0.1				0	0					10	10	10	0	10	10					0	0	0	0	1.899	1.0539	0	0.85925	0	0	0.005675358	0	0	0.018588469	0	3.863906112	0.765225	0.855057063	0.021802351	0.675115663	2.9646	0	0	0	0	0	0	0	0	0	0.402628207	0	0.043295154	0	0.008360363	0.00175	0	0	0	0	13.4382	0	0	0	0	0	0	1.899	1.0539	0	0.85925	0	0	0.005675358	0	0	0.018588469	0	3.863906112	0.765225	0.855057063	0.021802351	0.675115663	2.9646	0	0	0	0	0	0	0	0	0	0.402628207	0	0.043295154	0	0.008360363	0.00175	0	0	0	0	13.4382	Unlimited	1A IP Acute: 25%; $1500 OOP Max	1A IP Psych: 25%; $7500 OOP Max	2 SNF: 25%	6 Home Health - $40 per day	10A Ambulance - 25%	11A DME - 50%	11B Pros./Med Supp. - 50%; 11C Diabetes Mon Supplies - 50%	4A Emergency Care - $50; 4B Urgent Care - $0/$10	9B ASC Services - 25%; 9A Outpatient Hospital - 25%	8A Outpatient C/D/T - 25%	8B Outpatient X-Rays - 25%			3 CORF - 50%; 5 Partial Hosp - 50%; 9D Cardiac Rehab Svcs - 50%; 9C Outpatient Sub Abuse - 50%; 12 Renal Dialysis - 25%	7A Primary Care - 25%; 14B Immunizations - 25%; 14D Pap/Pelvic - 25%; 14E Prostate Screening - 25%; 14F Colorectal Screening - 25%; 14G Bone Mass Meas. - 25%; 14H Mammography - 25%; 14I Diabetes Monitoring - 25%	7D Physician Specialist - 25%	7E Mental Health - 50%; 7H Psychiatric Services - 50%	7C Occupational Therapy - 50%; 7I PT and ST Services - 50%	7D Physician Specialist - 25%	7G Other Health Care - 25%	15 Medicare Part B Rx Drugs - 50%		10B Transportation - NA	16A Preventative Dental - 50%	17A Eye Exams (Routine) - 50%	17B Eye Wear - 50%				14C Routine Physical Exams - 25%	7B Chiropractic Services - $40	7F Podiatry Services - $40	18A Hearing Exams (Medicare Covered) - $40		17A Eye Exams (Medicare Covered) - 50%						4.51	0.194	1.774	4.05	0.371	0.548		0.423	2.904	0.267	1.425			1.269	1.4318	4.4762	0.489	0.461	2.031	2.984	1.895			0.001	0.0252	0.0286				0.068	0.1988	0	0.0044		0.0712						31.9002	0	16.26	4.51	0.194	1.774	4.05	2.27	1.6019	0	1.28225	2.904	0.267	1.430675358	0	0	1.287588469	1.43183457	8.340071541	1.254225	1.316057063	2.052802351	3.659115663	4.8596	0	0	0.001	0.0252	0.0286	0	0	0	0.068	0.60142121	0	0.047704846	0	0.079560363	0.00175	0	0	0	0	45.3384
H5528_005_0	2009	3	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	212.56	5.92	587.44	3509.44	378.45	4.1085		171.29	198.24	216.58	267.05			271.74	3937.053649	3850.160593	762.48	852.0228399	21.72448104	672.3534507	24.624				245	245					401.1662099	0	43.13279736	270.7583826	8.33	2.1					1A IP Acute: $50 per day; days 1-5	1B IP Psych: $50 per day; days 1-5 (up to 190 days)	2 SNF: $0 days 1-20; $100 per day for days 21-100	6 Home Health - $0 per day	10A Ambulance - $50 per trip	11A DME - 20% coinsurance	11B Pros./Med Supp. - 20%; 11C Diabetes Mon Supplies - 0%	4A Emergency Care - $50; 4B Urgent Care - $0/$15	9B ASC Services - $0;  9A Outpatient Hospital - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0; Outpatient Radiology Therapy - $20; $50 High-tech Radiology			3 CORF - $20; 5 Partial Hosp - $20; 9D Cardiac Rehab Svcs - $20; 9C Outpatient Sub Abuse - $20; 12 Renal Dialysis - $0	7A Primary Care - $0; 14B Immunizations - $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 - $20; 7H Psychiatric Services - $20	7C Occupational Therapy - $20; 7I PT and ST Services - $20	7D Physician Specialist - $15	7G Other Health Care - $15	15 Medicare Part B Rx Drugs - 10%	13A Blood - $0	10B Transportation - NA	16A Preventative Dental - $0; 16B Comp Dental - NA	17A Eye Exams (Routine) - $0	17B Eye Wear - $0; Eyewear every year	18A Hearing Exams (Routine) - NA	18B Hearing Aids - NA		14C Routine Physical Exams - $0	7B Chiropractic Services - $15	7F Podiatry Services - $15	18A Hearing Exams (Medicare Covered) - $15	7D High Tech Radiology: $50 copayment	17A Eye Exams (Medicare Covered) - $20	14B Immunizations - $10					180	225	45.4	0	50	0.2	0.2	50	0	0	3.578115513			1.363249077	0	15	20	20	15	15	0.1				0	0					15	15	15	50	20	10					180	225	45.4	0	50	0.2	0.2	50	0	0	3.578115513			1.363249077	0	15	20	20	15	15	0.1				0	0					15	15	15	50	20	10					3.1884	0.111	2.222481333	0	1.576875	0.8217	0	0.713708333	0	0	0.079627979	0	0	0.030870775	0	4.812700741	1.2708	1.420038066	0.027155601	0.840441813	2.4624	0	0	0	0	0	0	0	0	0	0.501457762	0	0.053915997	1.128159927	0.013883333	0.00175	0	0	0	0	21.2774	0	0	3.1884	0.111	2.222481333	0	1.576875	0.8217	0	0.713708333	0	0	0.079627979	0	0	0.030870775	0	4.812700741	1.2708	1.420038066	0.027155601	0.840441813	2.4624	0	0	0	0	0	0	0	0	0	0.501457762	0	0.053915997	1.128159927	0.013883333	0.00175	0	0	0	0	21.2774	Unlimited	1A IP Acute: 25%; $1500 OOP Max	1A IP Psych: 25%; $1500 OOP Max	2 SNF: 25%	6 Home Health - $40 per day	10A Ambulance - 25%	11A DME - 50%	11B Pros./Med Supp. - 50%; 11C Diabetes Mon Supplies - 50%	4A Emergency Care - $50; 4B Urgent Care - $5/$15	9B ASC Services - 25%; 9A Outpatient Hospital - 25%	8A Outpatient C/D/T - 25%	8B Outpatient X-Rays - 25%			3 CORF - 50%; 5 Partial Hosp - 50%; 9D Cardiac Rehab Svcs - 50%; 9C Outpatient Sub Abuse - 50%; 12 Renal Dialysis - 25%	7A Primary Care - 25%; 14B Immunizations - 25%; 14D Pap/Pelvic - 25%; 14E Prostate Screening - 25%; 14F Colorectal Screening - 25%; 14G Bone Mass Meas. - 25%; 14H Mammography - 25%; 14I Diabetes Monitoring - 25%	7D Physician Specialist - 25%	7E Mental Health - 50%; 7H Psychiatric Services - 50%	7C Occupational Therapy - 50%; 7I PT and ST Services - 50%	7D Physician Specialist - 25%	7G Other Health Care - 25%	15 Medicare Part B Rx Drugs - 50%		10B Transportation - NA	16A Preventative Dental - 50%	17A Eye Exams (Routine) - 50%	17B Eye Wear - 50%				14C Routine Physical Exams - 25%	7B Chiropractic Services - $40	7F Podiatry Services - $40	18A Hearing Exams (Medicare Covered) - $40		17A Eye Exams (Medicare Covered) - 50%						3.746	0.054	1.472	3.364	0.308	0.455		0.351	2.412	0.222	1.182			1.053	1.1889	3.7171	0.406	0.383	1.687	2.477	1.573			0.001	0.0252	0.0286				0.068	0.165	0	0.0036		0.059						26.4014	0	13.62	6.9344	0.165	3.694481333	3.364	1.884875	1.2767	0	1.064708333	2.412	0.222	1.261627979	0	0	1.083870775	1.188907266	8.529793476	1.6768	1.803038066	1.714155601	3.317441813	4.0354	0	0	0.001	0.0252	0.0286	0	0	0	0.068	0.666475255	0	0.057523926	1.128159927	0.072883333	0.00175	0	0	0	0	47.6788
H5528_008_0	2009	4	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	264.4	7.36	730.8	4366.16	470.88	5.4945		213.08	246.61	269.5	332.22			338.03	4898.193236	4790.084693	948.6	1060.027802	27.02822206	837.0269182	30.627				245	245					499.1344898	0	53.66795154	336.8604145	10.36412821	2.1					1A IP Acute: $50 per day; days 1-5	1B IP Psych: $50 per day; days 1-5 (up to 190 days)	2 SNF: $0 days 1-20; $75 per day for days 21-100	6 Home Health - $0 per day	10A Ambulance - $50 per trip	11A DME - 20% coinsurance	11B Pros./Med Supp. - 20%; 11C Diabetes Mon Supplies - 0%	4A Emergency Care - $50; 4B Urgent Care - $5/$15	9B ASC Services - $50; 9A Outpatient Hospital - $50	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0; Outpatient Radiology Therapy - $20; $50 High-tech Radiology			3 CORF - $20; 5 Partial Hosp - $20; 9D Cardiac Rehab Svcs - $20; 9C Outpatient Sub Abuse - $20; 12 Renal Dialysis - $0	7A Primary Care - $5; 14B Immunizations - $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 - $20; 7H Psychiatric Services - $20	7C Occupational Therapy - $20; 7I PT and ST Services - $20	7D Physician Specialist - $15	7G Other Health Care - $15	15 Medicare Part B Rx Drugs - 10%	13A Blood - $0	10B Transportation - NA	16A Preventative Dental - $0; 16B Comp Dental - NA	17A Eye Exams (Routine) - $0	17B Eye Wear - $0; Eyewear every year	18A Hearing Exams (Routine) - NA	18B Hearing Aids - NA		14C Routine Physical Exams - $0	7B Chiropractic Services - $15	7F Podiatry Services - $15	18A Hearing Exams (Medicare Covered) - $15	7D High Tech Radiology: $50 copayment	17A Eye Exams (Medicare Covered) - $20	14B Immunizations - $10					180	225	34.05	0	50	0.2	0.2	50	50	0	3.578115513			1.363249077	5	15	20	20	15	15	0.1				0	0					15	15	15	50	20	10					180	225	34.05	0	50	0.2	0.2	50	50	0	3.578115513			1.363249077	5	15	20	20	15	15	0.1				0	0					15	15	15	50	20	10					3.966	0.138	2.073645	0	1.962	1.0989	0	0.887833333	1.027541667	0	0.099060128	0	0	0.03840159	2.040913848	5.987605866	1.581	1.766713003	0.033785278	1.046283648	3.0627	0	0	0	0	0	0	0	0	0	0.623918112	0	0.067084939	1.403585061	0.017273547	0.00175	0	0	0	0	28.924	0	0	3.966	0.138	2.073645	0	1.962	1.0989	0	0.887833333	1.027541667	0	0.099060128	0	0	0.03840159	2.040913848	5.987605866	1.581	1.766713003	0.033785278	1.046283648	3.0627	0	0	0	0	0	0	0	0	0	0.623918112	0	0.067084939	1.403585061	0.017273547	0.00175	0	0	0	0	28.924	Unlimited	1A IP Acute: 25%; $1500 OOP Max	1A IP Psych: 25%; $1500 OOP Max	2 SNF: 25%	6 Home Health - $40 per day	10A Ambulance - 25%	11A DME - 50%	11B Pros./Med Supp. - 50%; 11C Diabetes Mon Supplies - 50%	4A Emergency Care - $50; 4B Urgent Care - $5/$15	9B ASC Services - 25%; 9A Outpatient Hospital - 25%	8A Outpatient C/D/T - 25%	8B Outpatient X-Rays - 25%			3 CORF - 50%; 5 Partial Hosp - 50%; 9D Cardiac Rehab Svcs - 50%; 9C Outpatient Sub Abuse - 50%; 12 Renal Dialysis - 25%	7A Primary Care - 25%; 14B Immunizations - 25%; 14D Pap/Pelvic - 25%; 14E Prostate Screening - 25%; 14F Colorectal Screening - 25%; 14G Bone Mass Meas. - 25%; 14H Mammography - 25%; 14I Diabetes Monitoring - 25%	7D Physician Specialist - 25%	7E Mental Health - 50%; 7H Psychiatric Services - 50%	7C Occupational Therapy - 50%; 7I PT and ST Services - 50%	7D Physician Specialist - 25%	7G Other Health Care - 25%	15 Medicare Part B Rx Drugs - 50%		10B Transportation - NA	16A Preventative Dental - 50%	17A Eye Exams (Routine) - 50%	17B Eye Wear - 50%				14C Routine Physical Exams - 25%	7B Chiropractic Services - $40	7F Podiatry Services - $40	18A Hearing Exams (Medicare Covered) - $40		17A Eye Exams (Medicare Covered) - 50%						4.658	0.068	1.832	4.184	0.383	0.566		0.438	2.997	0.276	1.473			1.311	1.4792	4.6238	0.506	0.476	2.098	3.082	1.957			0.001	0.0252	0.0286				0.068	0.2055	0	0.0046		0.0734						32.8144	0	16.94	8.624	0.206	3.905645	4.184	2.345	1.6649	0	1.325833333	4.024541667	0.276	1.572060128	0	0	1.34940159	3.52007971	10.61144	2.087	2.242713003	2.131785278	4.128283648	5.0197	0	0	0.001	0.0252	0.0286	0	0	0	0.068	0.829466217	0	0.071695072	1.403585061	0.090673547	0.00175	0	0	0	0	61.7384
H5528_009_0	2009	2	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	87.77577197	7.809900567	366.2733068	936.3328712	138.8938547	5.211328036		75.22340633	86.96010614	105.5254072	108.779778			89.73917402	4773.665211	4663.023938	846.3557067	1017.448313	26.23216342	814.963448	36.22953194				245	245					809.4043885	0	40.70821209	326.9389095	11.99307467	2.1					1A IP Acute: $50 per day; days 1-5	1B IP Psych: $50 per day; days 1-5 (up to 190 days)	2 SNF: $0 days 1-20; $50 per day for days 21-100	6 Home Health - $0 per day	10A Ambulance - $50 per trip	11A DME - 20% coinsurance	11B Pros./Med Supp. - 20%; 11C Diabetes Mon Supplies - 0%	4A Emergency Care - $50; 4B Urgent Care - $5/$10	9B ASC Services - $0; 9A Outpatient Hospital - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0; Outpatient Radiology Therapy - $20; $0 High-tech Radiology			3 CORF - $10; 5 Partial Hosp - $10; 9D Cardiac Rehab Svcs - $10; 9C Outpatient Sub Abuse - $10; 12 Renal Dialysis - $0	7A Primary Care - $5; 14B Immunizations - $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 - $10; 7H Psychiatric Services - $10	7C Occupational Therapy - $10; 7I PT and ST Services - $10	7D Physician Specialist - $10	7G Other Health Care - $10	15 Medicare Part B Rx Drugs - 10%	13A Blood - $0	10B Transportation - NA	16A Preventative Dental - $0; 16B Comp Dental - NA	17A Eye Exams (Routine) - $0	17B Eye Wear - $0; Eyewear every year	18A Hearing Exams (Routine) - NA	18B Hearing Aids - NA		14C Routine Physical Exams - $0	7B Chiropractic Services - $10	7F Podiatry Services - $10	18A Hearing Exams (Medicare Covered) - $10	7D High Tech Radiology: $0 copayment	17A Eye Exams (Medicare Covered) - $10	14B Immunizations - $10					180	225	22.7	0	50	0.2	0.2	50	0	0	0.211780278			0.681624538	5	10	10	10	10	10	0.1				0	0					10	10	10	0	10	10					180	225	22.7	0	50	0.2	0.2	50	0	0	0.211780278			0.681624538	5	10	10	10	10	10	0.1				0	0					10	10	10	0	10	10					1.3166	0.146435636	0.692867005	0	0.578724394	1.042265607	0	0.31343086	0	0	0.001919784	0	0	0.005097369	1.989027171	3.885853282	0.705296422	0.847873594	0.021860136	0.679136207	3.622953194	0	0	0	0	0	0	0	0	0	0.674503657	0	0.03392351	0	0.009994229	0.00175	0	0	0	0	16.5695	0	0	1.3166	0.146435636	0.692867005	0	0.578724394	1.042265607	0	0.31343086	0	0	0.001919784	0	0	0.005097369	1.989027171	3.885853282	0.705296422	0.847873594	0.021860136	0.679136207	3.622953194	0	0	0	0	0	0	0	0	0	0.674503657	0	0.03392351	0	0.009994229	0.00175	0	0	0	0	16.5695	Unlimited	1A IP Acute: $50 per day; days 1-5	1A IP Psych: 25%; $7500 OOP Max	2 SNF: 25%	6 Home Health - $40 per day	10A Ambulance - 25%	11A DME - 50%	11B Pros./Med Supp. - 50%; 11C Diabetes Mon Supplies - 50%	4A Emergency Care - $50; 4B Urgent Care - $5/$10	9B ASC Services - $0;  9A Outpatient Hospital - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0; Outpatient Radiology Therapy - $20; $0 High-tech Radiology			3 CORF - $10; 5 Partial Hosp - $10; 9D Cardiac Rehab Svcs - $10; 9C Outpatient Sub Abuse - 50%; 12 Renal Dialysis - $0	7A Primary Care - 25%; 14B Immunizations - 25%; 14D Pap/Pelvic - 25%; 14E Prostate Screening - 25%; 14F Colorectal Screening - 25%; 14G Bone Mass Meas. - 25%; 14H Mammography - 25%; 14I Diabetes Monitoring - 25%	7D Physician Specialist - 25%	7E Mental Health - 50%; 7H Psychiatric Services - 50%	7C Occupational Therapy - $10; 7I PT and ST Services - $10	7D Physician Specialist - 25%	7G Other Health Care - 25%	15 Medicare Part B Rx Drugs - 50%		10B Transportation - NA	16A Preventative Dental - 50%	17A Eye Exams (Routine) - 50%	17B Eye Wear - 50%				14C Routine Physical Exams - 25%	7B Chiropractic Services - $40	7F Podiatry Services - $40	18A Hearing Exams (Medicare Covered) - $40		17A Eye Exams (Medicare Covered) - 50%						3.535	0.125	0.095	0.399	0.108	0.543		0.84	0	0	0.007			0.049	1.7938	5.1252	0.482	0.597	2.019	3.331	2.315			0.001	0.0252	0.0286				0.066	0.3329	0	0.0034		0.0866						21.9077	0	0.41	4.8516	0.271435636	0.787867005	0.399	0.686724394	1.585265607	0	1.15343086	0	0	0.008919784	0	0	0.054097369	3.782777547	9.011102906	1.187296422	1.444873594	2.040860136	4.010136207	5.937953194	0	0	0.001	0.0252	0.0286	0	0	0	0.066	1.007433686	0	0.037330999	0	0.096594229	0.00175	0	0	0	0	38.4773
H5528_010_0	2009	3	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	67.98873422	6.010337949	283.6520551	725.1437088	108.2934575	3.719075551		58.74299213	67.92058989	82.3837638	84.96990057			69.99329286	3728.775834	3642.35514	661.03346	794.8059195	20.4899392	636.1183934	28.05189374				245	245					632.5718838	0	31.77955089	255.3719367	9.367814314	2.1					1A IP Acute: $50 per day; days 1-5	1B IP Psych: $50 per day; days 1-5 (up to 190 days)	2 SNF: $0 days 1-20; $50 per day for days 21-100	6 Home Health - $0 per day	10A Ambulance - $50 per trip	11A DME - 20% coinsurance	11B Pros./Med Supp. - 20%; 11C Diabetes Mon Supplies - 0%	4A Emergency Care - $50; 4B Urgent Care - $0/$20	9B ASC Services - $0; 9A Outpatient Hospital - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0; Outpatient Radiology Therapy - $20; $50 High-tech Radiology			3 CORF - $20; 5 Partial Hosp - $20; 9D Cardiac Rehab Svcs - $20; 9C Outpatient Sub Abuse - $20; 12 Renal Dialysis - $0	7A Primary Care - $0; 14B Immunizations - $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 - $20	7E Mental Health - $20; 7H Psychiatric Services - $20	7C Occupational Therapy - $20; 7I PT and ST Services - $20	7D Physician Specialist - $20	7G Other Health Care - $20	15 Medicare Part B Rx Drugs - 10%	13A Blood - $0	10B Transportation - NA	16A Preventative Dental - $0; 16B Comp Dental - NA	17A Eye Exams (Routine) - $0	17B Eye Wear - $0; Eyewear every year	18A Hearing Exams (Routine) - NA	18B Hearing Aids - NA		14C Routine Physical Exams - $0	7B Chiropractic Services - $20	7F Podiatry Services - $20	18A Hearing Exams (Medicare Covered) - $20	7D High Tech Radiology: $50 copayment	17A Eye Exams (Medicare Covered) - $20	14B Immunizations - $10					180	225	22.7	0	50	0.2	0.2	50	0	0	3.578115513			1.363249077	0	20	20	20	20	20	0.1				0	0					20	20	20	50	20	10					180	225	22.7	0	50	0.2	0.2	50	0	0	3.578115513			1.363249077	0	20	20	20	20	20	0.1				0	0					20	20	20	50	20	10					1.0198	0.112693837	0.536575138	0	0.45122274	0.74381511	0	0.244762467	0	0	0.02533601	0	0	0.007951524	0	6.0705919	1.101722433	1.324676533	0.034149899	1.060197322	2.805189374	0	0	0	0	0	0	0	0	0	1.054286473	0	0.052965918	1.064049736	0.015613024	0.00175	0	0	0	0	17.7274	0	0	1.0198	0.112693837	0.536575138	0	0.45122274	0.74381511	0	0.244762467	0	0	0.02533601	0	0	0.007951524	0	6.0705919	1.101722433	1.324676533	0.034149899	1.060197322	2.805189374	0	0	0	0	0	0	0	0	0	1.054286473	0	0.052965918	1.064049736	0.015613024	0.00175	0	0	0	0	17.7274	Unlimited	1A IP Acute: $50 per day; days 1-5	1A IP Psych: 25%; $7500 OOP Max	2 SNF: 25%	6 Home Health - $40 per day	10A Ambulance - 25%	11A DME - 50%	11B Pros./Med Supp. - 50%; 11C Diabetes Mon Supplies - 50%	4A Emergency Care - $50; 4B Urgent Care - $0/$20	9B ASC Services - $0; 9A Outpatient Hospital - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0; Outpatient Radiology Therapy - $20; $50 High-tech Radiology			3 CORF - $20; 5 Partial Hosp - $20; 9D Cardiac Rehab Svcs - $20; 9C Outpatient Sub Abuse - 50%; 12 Renal Dialysis - $0	7A Primary Care - 25%; 14B Immunizations - 25%; 14D Pap/Pelvic - 25%; 14E Prostate Screening - 25%; 14F Colorectal Screening - 25%; 14G Bone Mass Meas. - 25%; 14H Mammography - 25%; 14I Diabetes Monitoring - 25%	7D Physician Specialist - 25%	7E Mental Health - 50%; 7H Psychiatric Services - 50%	7C Occupational Therapy - $20; 7I PT and ST Services - $20	7D Physician Specialist - 25%	7G Other Health Care - 25%	15 Medicare Part B Rx Drugs - 50%		10B Transportation - NA	16A Preventative Dental - 50%	17A Eye Exams (Routine) - 50%	17B Eye Wear - 50%				14C Routine Physical Exams - 25%	7B Chiropractic Services - $40	7F Podiatry Services - $40	18A Hearing Exams (Medicare Covered) - $40		17A Eye Exams (Medicare Covered) - 50%						2.737	0.032	0.074	0.309	0.084	0.424		0.658	0	0	0.07			0.056	1.4009	4.0031	0.377	0.466	1.577	2.602	1.793			0.001	0.0252	0.0286				0.066	0.269	0	0.014		0.0676						17.1344	0	0.38	3.7568	0.144693837	0.610575138	0.309	0.53522274	1.16781511	0	0.902762467	0	0	0.09533601	0	0	0.063951524	1.400935115	10.07365679	1.478722433	1.790676533	1.611149899	3.662197322	4.598189374	0	0	0.001	0.0252	0.0286	0	0	0	0.066	1.323286473	0	0.066965918	1.064049736	0.083213024	0.00175	0	0	0	0	34.8618
H5528_011_0	2009	4	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	77.53128225	6.865119258	323.4156432	826.8897015	122.6490935	4.418388672		66.40551699	76.7771439	93.18652717	96.07215702			79.25287194	4215.461217	4117.754258	747.3567901	898.4649884	23.16511232	719.4153428	31.99127347				245	245					714.7450625	0	35.94797867	288.7133798	10.59102434	2.1					1A IP Acute: $50 per day; days 1-5	1B IP Psych: $50 per day; days 1-5 (up to 190 days)	2 SNF: $0 days 1-20; $50 per day for days 21-100	6 Home Health - $0 per day	10A Ambulance - $50 per trip	11A DME - 20% coinsurance	11B Pros./Med Supp. - 20%; 11C Diabetes Mon Supplies - 0%	4A Emergency Care - $50; 4B Urgent Care - $5/$15	9B ASC Services - $0; 9A Outpatient Hospital - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0; Outpatient Radiology Therapy - $20; $0 High-tech Radiology			3 CORF - $20; 5 Partial Hosp - $20; 9D Cardiac Rehab Svcs - $20; 9C Outpatient Sub Abuse - $20; 12 Renal Dialysis - $0	7A Primary Care - $5; 14B Immunizations - $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 - $20; 7H Psychiatric Services - $20	7C Occupational Therapy - $20; 7I PT and ST Services - $20	7D Physician Specialist - $15	7G Other Health Care - $15	15 Medicare Part B Rx Drugs - 10%	13A Blood - $0	10B Transportation - NA	16A Preventative Dental - $0; 16B Comp Dental - NA	17A Eye Exams (Routine) - $0	17B Eye Wear - $0; Eyewear every year	18A Hearing Exams (Routine) - NA	18B Hearing Aids - NA		14C Routine Physical Exams - $0	7B Chiropractic Services - $15	7F Podiatry Services - $15	18A Hearing Exams (Medicare Covered) - $15	7D High Tech Radiology: $0 copayment	17A Eye Exams (Medicare Covered) - $15	14B Immunizations - $10					180	225	22.7	0	50	0.2	0.2	50	0	0	0.211780278			1.363249077	5	15	20	20	15	15	0.1				0	0					15	15	15	0	15	10					180	225	22.7	0	50	0.2	0.2	50	0	0	0.211780278			1.363249077	5	15	20	20	15	15	0.1				0	0					15	15	15	0	15	10					1.163	0.128720986	0.611794592	0	0.51103789	0.883677734	0	0.276689654	0	0	0.001695516	0	0	0.00900345	1.756442174	5.147192822	1.24559465	1.497441647	0.02895639	0.899269178	3.199127347	0	0	0	0	0	0	0	0	0	0.893431328	0	0.044934973	0	0.01323878	0.00175	0	0	0	0	18.313	0	0	1.163	0.128720986	0.611794592	0	0.51103789	0.883677734	0	0.276689654	0	0	0.001695516	0	0	0.00900345	1.756442174	5.147192822	1.24559465	1.497441647	0.02895639	0.899269178	3.199127347	0	0	0	0	0	0	0	0	0	0.893431328	0	0.044934973	0	0.01323878	0.00175	0	0	0	0	18.313	Unlimited	1A IP Acute: $50 per day; days 1-5	1A IP Psych: 25%; $1500 OOP Max	2 SNF: 25%	6 Home Health - $40 per day	10A Ambulance - 25%	11A DME - 50%	11B Pros./Med Supp. - 50%; 11C Diabetes Mon Supplies - 50%	4A Emergency Care - $50; 4B Urgent Care - $5/$15	9B ASC Services - $0; 9A Outpatient Hospital - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0; Outpatient Radiology Therapy - $20; $0 High-tech Radiology			3 CORF - $20; 5 Partial Hosp - $20; 9D Cardiac Rehab Svcs - $20; 9C Outpatient Sub Abuse - 50%; 12 Renal Dialysis - $0	7A Primary Care - 25%; 14B Immunizations - 25%; 14D Pap/Pelvic - 25%; 14E Prostate Screening - 25%; 14F Colorectal Screening - 25%; 14G Bone Mass Meas. - 25%; 14H Mammography - 25%; 14I Diabetes Monitoring - 25%	7D Physician Specialist - 25%	7E Mental Health - 50%; 7H Psychiatric Services - 50%	7C Occupational Therapy - $20; 7I PT and ST Services - $20	7D Physician Specialist - 25%	7G Other Health Care - 25%	15 Medicare Part B Rx Drugs - 50%		10B Transportation - NA	16A Preventative Dental - 50%	17A Eye Exams (Routine) - 50%	17B Eye Wear - 50%				14C Routine Physical Exams - 25%	7B Chiropractic Services - $40	7F Podiatry Services - $40	18A Hearing Exams (Medicare Covered) - $40		17A Eye Exams (Medicare Covered) - 50%						3.122	0.037	0.084	0.352	0.095	0.48		0.742	0	0	0.007			0.056	1.5842	4.5258	0.426	0.527	1.783	2.941	2.045			0.001	0.0252	0.0286				0.066	0.304	0	0.015		0.0764						19.3232	0	0.44	4.285	0.165720986	0.695794592	0.352	0.60603789	1.363677734	0	1.018689654	0	0	0.008695516	0	0	0.06500345	3.340596709	9.673038287	1.67159465	2.024441647	1.81195639	3.840269178	5.244127347	0	0	0.001	0.0252	0.0286	0	0	0	0.066	1.197431328	0	0.059934973	0	0.08963878	0.00175	0	0	0	0	37.6362
H5528_012_0	2009	4																					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	V																																																			0	Unlimited	363.1260916	29.92729726	1292.156236	4916.218762	936.8722182	17.53130937		342.61156	189.8111791	826.5198858	0			1815.85642	4347.438844	4709.308002	1381.762131	735.1025138	23.87683641	203.9032307	12.13049553				328.3	215.6															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;  9A Outpatient Hospital - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0			3 CORF - $10; 5 Partial Hosp - $20; 9D Cardiac Rehab Svcs - $10; 9C Outpatient Sub Abuse - $20; 12 Renal Dialysis - $0	7A Primary Care - $0; 14B Immunizations - $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	7C Occupational Therapy - $10; 7I PT and ST Services - $10	7D Physician Specialist - $10	7B Chiropractic Services - $10; 7F Podiatry Services - $10; 7G Other Health Care - $10; 18A Hearing Exams (Medicare Covered) - $0; 17A Eye Exams (Medicare Covered) - $0	15 Medicare Part B Rx Drugs - $0	13A Blood - $0	10B Transportation - NA	16A Preventative Dental - NA; 16B Comp Dental - NA	17A Eye Exams (Routine) - $0	17B Eye Wear - $0	18A Hearing Exams (Routine) - $0	18B Hearing Aids - $0	14A Health Ed/Wellness - $0	13B Acupuncture - not covered; Respite Care - not covered; 14C Routine Physical Exams - $0											0	0	0	0	0	0	0	50	0	0	0.211780278			0.681624538	0	10	20	10	10	10	0				0	0															0	0	0	0	0	0	0	50	0	0	0.211780278			0.681624538	0	10	20	10	10	10	0				0	0															0	0	0	0	0	0	0	1.427548167	0	0	0	0	0	0.103144358	0	3.924423335	2.302936885	0.612585428	0.019897364	0.169919359	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.5605	0	0	0	0	0	0	0	0	0	1.427548167	0	0	0	0	0	0.103144358	0	3.924423335	2.302936885	0.612585428	0.019897364	0.169919359	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.5605	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;  9A Outpatient Hospital - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0			3 CORF - $10; 5 Partial Hosp - $20; 9D Cardiac Rehab Svcs - $10; 9C Outpatient Sub Abuse - $20; 12 Renal Dialysis - $0	7A Primary Care - $0; 14B Immunizations - $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	7C Occupational Therapy - $10; 7I PT and ST Services - $10	7D Physician Specialist - $10	7B Chiropractic Services - $10; 7F Podiatry Services - $10; 7G Other Health Care - $10; 18A Hearing Exams (Medicare Covered) - $0; 17A Eye Exams (Medicare Covered) - $0	15 Medicare Part B Rx Drugs - $0	13A Blood - $0	10B Transportation - NA	16A Preventative Dental - NA; 16B Comp Dental - NA	17A Eye Exams (Routine) - $0	17B Eye Wear - $0	18A Hearing Exams (Routine) - $0	18B Hearing Aids - $0	14A Health Ed/Wellness - $0	13B Acupuncture - not covered; Respite Care - not covered; 14C Routine Physical Exams - $0											0	0	0	0	0	0		0.681	0	0	0.003			0.048	0	0.499	0.31	0.085	0	0.025	0			0	0	0				0											1.651	0	0	0	0	0	0	0	0	0	2.108548167	0	0	0.003	0	0	0.151144358	0	4.423423335	2.612936885	0.697585428	0.019897364	0.194919359	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.2115
H5528_013_0	2009	3																					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	V																																																			0	Unlimited	436.3869897	34.59923855	1413.865236	6305.414911	1035.754425	18.6913058		425.7879676	239.9385762	1007.137652	0			2302.377732	4416.919372	4788.131292	1325.330013	702.2065226	24.12320792	0	15.10354015				328.3	215.6															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; 9A Outpatient Hospital - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0			3 CORF - $10; 5 Partial Hosp - $20; 9D Cardiac Rehab Svcs - $10; 9C Outpatient Sub Abuse - $20; 12 Renal Dialysis - $0	7A Primary Care - $0; 14B Immunizations - $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	7C Occupational Therapy - $10; 7I PT and ST Services - $10	7D Physician Specialist - $10	7B Chiropractic Services - $0; 7F Podiatry Services - $10; 7G Other Health Care - $0; 18A Hearing Exams (Medicare Covered) - $0; 17A Eye Exams (Medicare Covered) - $0	15 Medicare Part B Rx Drugs - $0	13A Blood - $0	10B Transportation - NA	16A Preventative Dental - $0; 16B Comp Dental - NA	17A Eye Exams (Routine) - $0	17B Eye Wear - $0	18A Hearing Exams (Routine) - $0	18B Hearing Aids - $0	14A Health Ed/Wellness - $0	13B Acupuncture - not covered; Respite Care - $0; Message Therapy - $0;14C Routine Physical Exams - $0											0	0	0	0	0	0	0	50	0	0	0			0.681624538	0	10	20	10	0	10	0				0	0															0	0	0	0	0	0	0	50	0	0	0			0.681624538	0	10	20	10	0	10	0				0	0															0	0	0	0	0	0	0	1.774116531	0	0	0	0	0	0.130779763	0	3.99010941	2.208883354	0.585172102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.6891	0	0	0	0	0	0	0	0	0	1.774116531	0	0	0	0	0	0.130779763	0	3.99010941	2.208883354	0.585172102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.6891	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; 9A Outpatient Hospital - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0			3 CORF - $10; 5 Partial Hosp - $20; 9D Cardiac Rehab Svcs - $10; 9C Outpatient Sub Abuse - $20; 12 Renal Dialysis - $0	7A Primary Care - $0; 14B Immunizations - $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	7C Occupational Therapy - $10; 7I PT and ST Services - $10	7D Physician Specialist - $10	7B Chiropractic Services - $0; 7F Podiatry Services - $10; 7G Other Health Care - $0; 18A Hearing Exams (Medicare Covered) - $0; 17A Eye Exams (Medicare Covered) - $0	15 Medicare Part B Rx Drugs - $0	13A Blood - $0	10B Transportation - NA	16A Preventative Dental - $0; 16B Comp Dental - NA	17A Eye Exams (Routine) - $0	17B Eye Wear - $0	18A Hearing Exams (Routine) - $0	18B Hearing Aids - $0	14A Health Ed/Wellness - $0	13B Acupuncture - not covered; Respite Care - $0; Message Therapy - $0;14C Routine Physical Exams - $0											0	0	0	0	0	0		0.504	0	0	0			0.036	0	0.523	0.316	0.086	0	0	0			0	0	0				0											1.465	0	0	0	0	0	0	0	0	0	2.278116531	0	0	0	0	0	0.166779763	0	4.51310941	2.524883354	0.671172102	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.1541
H5528_014_0	2009	3																					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	V																																																			0	Unlimited	307.0467102	24.82798335	1012.216512	4387.553497	805.7601242	14.3660601		327.171398	184.6762165	774.1353222	0			1762.969063	3416.289044	3713.631433	1063.530292	565.6463852	18.90217133	142.7163358	10.6008947				328.3	215.6															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; 9A Outpatient Hospital - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0			3 CORF - $10; 5 Partial Hosp - $20; 9D Cardiac Rehab Svcs - $10; 9C Outpatient Sub Abuse - $20; 12 Renal Dialysis - $0	7A Primary Care - $0; 14B Immunizations - $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	7C Occupational Therapy - $10; 7I PT and ST Services - $10	7D Physician Specialist - $10	7B Chiropractic Services - $10; 7F Podiatry Services - $10; 7G Other Health Care - $10; 18A Hearing Exams (Medicare Covered) - $0; 17A Eye Exams (Medicare Covered) - $0	15 Medicare Part B Rx Drugs - $0	13A Blood - $0	10B Transportation - NA	16A Preventative Dental - NA; 16B Comp Dental - NA	17A Eye Exams (Routine) - $0	17B Eye Wear - $0	18A Hearing Exams (Routine) - $0	18B Hearing Aids - $0	14A Health Ed/Wellness - $0	13B Acupuncture - not covered; Respite Care - $0; 14C Routine Physical Exams - $0											0	0	0	0	0	0	0	50	0	0	0.105890139			0.681624538	0	10	20	10	10	10	0				0	0															0	0	0	0	0	0	0	50	0	0	0.105890139			0.681624538	0	10	20	10	10	10	0				0	0															0	0	0	0	0	0	0	1.363214158	0	0	0	0	0	0.100140248	0	3.09469286	1.772550487	0.471371988	0.015751809	0.11893028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.9367	0	0	0	0	0	0	0	0	0	1.363214158	0	0	0	0	0	0.100140248	0	3.09469286	1.772550487	0.471371988	0.015751809	0.11893028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.9367	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; 9A Outpatient Hospital - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0			3 CORF - $10; 5 Partial Hosp - $20; 9D Cardiac Rehab Svcs - $10; 9C Outpatient Sub Abuse - $20; 12 Renal Dialysis - $0	7A Primary Care - $0; 14B Immunizations - $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	7C Occupational Therapy - $10; 7I PT and ST Services - $10	7D Physician Specialist - $10	7B Chiropractic Services - $10; 7F Podiatry Services - $10; 7G Other Health Care - $10; 18A Hearing Exams (Medicare Covered) - $0; 17A Eye Exams (Medicare Covered) - $0	15 Medicare Part B Rx Drugs - $0	13A Blood - $0	10B Transportation - NA	16A Preventative Dental - NA; 16B Comp Dental - NA	17A Eye Exams (Routine) - $0	17B Eye Wear - $0	18A Hearing Exams (Routine) - $0	18B Hearing Aids - $0	14A Health Ed/Wellness - $0	13B Acupuncture - not covered; Respite Care - $0; 14C Routine Physical Exams - $0											0	0	0	0	0	0		0.378	0	0	0.002			0.028	0	0.385	0.233	0.064	0	0.017	0			0	0	0				0											1.107	0	0	0	0	0	0	0	0	0	1.741214158	0	0	0.002	0	0	0.128140248	0	3.47969286	2.005550487	0.535371988	0.015751809	0.13593028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.0437
H5528_015_0	2009	4	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	305.9182596	12.48467783	852.5637391	2617.673034	456.7694185	5.0535		174.9645339	204.6357623	440.282744	326.3835124			602.2302229	4103.073869	3999.960287	768.9274911	784.0854726	23.34266155	667.9657738	20.916				245	245					275.259418	0	50.6553108	290.9262262	10.28786649	1.94					1A IP Acute: $0 per stay	1B IP Psych: $0 per stay (up to 190 days)	2 SNF: $0 days 1-100	6 Home Health - $0 per day	10A Ambulance - $50 per trip	11A DME - 20% coinsurance	11B Pros./Med Supp. - 20%; 11C Diabetes Mon Supplies - 0%	4A Emergency Care - $50; 4B Urgent Care - $0/$10	9B ASC Services - $0;  9A Outpatient Hospital - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0; Outpatient Radiology Therapy - $20; $0 High-tech Radiology			3 CORF - $10; 5 Partial Hosp - $10; 9D Cardiac Rehab Svcs - $10; 9C Outpatient Sub Abuse - $10; 12 Renal Dialysis - $0	7A Primary Care - $0; 14B Immunizations - $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 - $10; 7H Psychiatric Services - $10	7C Occupational Therapy - $10; 7I PT and ST Services - $10	7D Physician Specialist - $10	7G Other Health Care - $10	15 Medicare Part B Rx Drugs - 10%	13A Blood - $0	10B Transportation - NA	16A Preventative Dental - $0; 16B Comp Dental - NA	17A Eye Exams (Routine) - $0	17B Eye Wear - $0; Eyewear every year	18A Hearing Exams (Routine) - NA	18B Hearing Aids - NA		14C Routine Physical Exams - $0	7B Chiropractic Services - $10	7F Podiatry Services - $10	18A Hearing Exams (Medicare Covered) - $10	7D High Tech Radiology: $0 copayment	17A Eye Exams (Medicare Covered) - $20	14B Immunizations - $10					0	0	0	0	50	0.2	0.2	50	0	0	0.211780278			0.681624538	0	10	10	10	10	10	0.1				0	0					10	10	10	0	20	10					0	0	0	0	50	0.2	0.2	50	0	0	0.211780278			0.681624538	0	10	10	10	10	10	0.1				0	0					10	10	10	0	20	10					0	0	0	0	1.90320591	1.0107	0	0.729018891	0	0	0.005760133	0	0	0.034207908	0	3.333300239	0.640772909	0.65340456	0.019452218	0.556638145	2.0916	0	0	0	0	0	0	0	0	0	0.229382848	0	0.042212759	0	0.017146444	0.001616667	0	0	0	0	11.2684	0	0	0	0	0	0	1.90320591	1.0107	0	0.729018891	0	0	0.005760133	0	0	0.034207908	0	3.333300239	0.640772909	0.65340456	0.019452218	0.556638145	2.0916	0	0	0	0	0	0	0	0	0	0.229382848	0	0.042212759	0	0.017146444	0.001616667	0	0	0	0	11.2684	Unlimited	1A IP Acute: $0 per stay	1A IP Psych: 20%; $1500 OOP Max	2 SNF: 20%	6 Home Health - 20%	10A Ambulance - 20%	11A DME - 20%	11B Pros./Med Supp. - 20%; 11C Diabetes Mon Supplies - 20%	4A Emergency Care - $50; 4B Urgent Care - $0/$10	9B ASC Services - $0; 9A Outpatient Hospital - $0	8A Outpatient C/D/T - $10	8B Outpatient X-Rays - $10; Outpatient Radiology Therapy - 20%; $10 High-tech Radiology			3 CORF - 20%; 5 Partial Hosp - 20%; 9D Cardiac Rehab Svcs - 20%; 9C Outpatient Sub Abuse - 20%; 12 Renal Dialysis - $0	7A Primary Care - $10; 14B Immunizations - 20%; 14D Pap/Pelvic - 20%; 14E Prostate Screening - 20%; 14F Colorectal Screening - 20%; 14G Bone Mass Meas. - 20%; 14H Mammography - 20%; 14I Diabetes Monitoring - 20%	7D Physician Specialist - $20	7E Mental Health - 20%; 7H Psychiatric Services - 20%	7C Occupational Therapy - 20%; 7I PT and ST Services - 20%	7D Physician Specialist - $20	7G Other Health Care - $20	15 Medicare Part B Rx Drugs - 20%		10B Transportation - NA	16A Preventative Dental - 50%	17A Eye Exams (Routine) - 50%	17B Eye Wear - 50%				14C Routine Physical Exams - $0	7B Chiropractic Services - 20%	7F Podiatry Services - 20%	18A Hearing Exams (Medicare Covered) - $20		17A Eye Exams (Medicare Covered) - 50%						0	0.158	0.619	0.222	0.196	0.171		0.21	0	0.106	0.114			0.508	0.8221	1.4309	0.134	0.111	0.463	1.394	0.43			0.001	0.0252	0.0286				0	0.017	0.175	0.005		0.0254						7.3662	0	2.38	0	0.158	0.619	0.222	2.09920591	1.1817	0	0.939018891	0	0.106	0.119760133	0	0	0.542207908	0.822054604	4.764245634	0.774772909	0.76440456	0.482452218	1.950638145	2.5216	0	0	0.001	0.0252	0.0286	0	0	0	0	0.246382848	0.175	0.047212759	0	0.042546444	0.001616667	0	0	0	0	18.6346
H5528_016_0	2009	4	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	245.36	6.8	678.16	4051.6	436.95	4.9905		197.68	228.83	250.04	308.28			313.67	4545.304236	4444.982841	880.29	983.6438302	25.08058373	776.7269488	28.422				245	245					463.1780466	0	49.78942731	312.5864444	9.616564103	1.94					1A IP Acute: $0 per stay	1B IP Psych: $0 per stay (up to 190 days)	2 SNF: $0 days 1-100	6 Home Health - $0 per day	10A Ambulance - $50 per trip	11A DME - 20% coinsurance	11B Pros./Med Supp. - 20%; 11C Diabetes Mon Supplies - 0%	4A Emergency Care - $50; 4B Urgent Care - $0/$10	9B ASC Services - $0; 9A Outpatient Hospital - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0; Outpatient Radiology Therapy - $20; $0 High-tech Radiology			3 CORF - $10; 5 Partial Hosp - $10; 9D Cardiac Rehab Svcs - $10; 9C Outpatient Sub Abuse - $10; 12 Renal Dialysis - $0	7A Primary Care - $0; 14B Immunizations - $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 - $10; 7H Psychiatric Services - $10	7C Occupational Therapy - $10; 7I PT and ST Services - $10	7D Physician Specialist - $10	7G Other Health Care - $10	15 Medicare Part B Rx Drugs - 10%	13A Blood - $0	10B Transportation - NA	16A Preventative Dental - $0; 16B Comp Dental - NA	17A Eye Exams (Routine) - $0	17B Eye Wear - $0; Eyewear every year	18A Hearing Exams (Routine) - NA	18B Hearing Aids - NA		14C Routine Physical Exams - $0	7B Chiropractic Services - $10	7F Podiatry Services - $10	18A Hearing Exams (Medicare Covered) - $10	7D High Tech Radiology: $0 copayment	17A Eye Exams (Medicare Covered) - $20	14B Immunizations - $10					0	0	0	0	50	0.2	0.2	50	0	0	0.211780278			0.681624538	0	10	10	10	10	10	0.1				0	0					10	10	10	0	20	10					0	0	0	0	50	0.2	0.2	50	0	0	0.211780278			0.681624538	0	10	10	10	10	10	0.1				0	0					10	10	10	0	20	10					0	0	0	0	1.820625	0.9981	0	0.823666667	0	0	0.005440635	0	0	0.017817097	0	3.704152368	0.733575	0.819703192	0.020900486	0.647272457	2.8422	0	0	0	0	0	0	0	0	0	0.385981706	0	0.041491189	0	0.016027607	0.001616667	0	0	0	0	12.8786	0	0	0	0	0	0	1.820625	0.9981	0	0.823666667	0	0	0.005440635	0	0	0.017817097	0	3.704152368	0.733575	0.819703192	0.020900486	0.647272457	2.8422	0	0	0	0	0	0	0	0	0	0.385981706	0	0.041491189	0	0.016027607	0.001616667	0	0	0	0	12.8786	Unlimited	1A IP Acute: $0 per stay	1A IP Psych: 20%; $1500 OOP Max	2 SNF: 20%	6 Home Health - 20%	10A Ambulance - 20%	11A DME - 20%	11B Pros./Med Supp. - 20%; 11C Diabetes Mon Supplies - 20%	4A Emergency Care - $50; 4B Urgent Care - $0/$10	9B ASC Services - $0; 9A Outpatient Hospital - $0	8A Outpatient C/D/T - $10	8B Outpatient X-Rays - $10; Outpatient Radiology Therapy - 20%; $10 High-tech Radiology			3 CORF - 20%; 5 Partial Hosp - 20%; 9D Cardiac Rehab Svcs - 20%; 9C Outpatient Sub Abuse - 20%; 12 Renal Dialysis - $0	7A Primary Care - $10; 14B Immunizations - 20%; 14D Pap/Pelvic - 20%; 14E Prostate Screening - 20%; 14F Colorectal Screening - 20%; 14G Bone Mass Meas. - 20%; 14H Mammography - 20%; 14I Diabetes Monitoring - 20%	7D Physician Specialist - $20	7E Mental Health - 20%; 7H Psychiatric Services - 20%	7C Occupational Therapy - 20%; 7I PT and ST Services - 20%	7D Physician Specialist - $20	7G Other Health Care - $20	15 Medicare Part B Rx Drugs - 20%		10B Transportation - NA	16A Preventative Dental - 50%	17A Eye Exams (Routine) - 50%	17B Eye Wear - 50%				14C Routine Physical Exams - $0	7B Chiropractic Services - 20%	7F Podiatry Services - 20%	18A Hearing Exams (Medicare Covered) - $20		17A Eye Exams (Medicare Covered) - 50%						0	0.06	1.094	1.198	0.229	0.169		0.405	0	0.102	0.186			0.765	0.8722	1.5808	0.151	0.142	0.497	1.512	0.585			0.001	0.0252	0.0286				0	0.034	0.232	0.005		0.022						9.8958	0	3.14	0	0.06	1.094	1.198	2.049625	1.1671	0	1.228666667	0	0.102	0.191440635	0	0	0.782817097	0.872162569	5.284989799	0.884575	0.961703192	0.517900486	2.159272457	3.4272	0	0	0.001	0.0252	0.0286	0	0	0	0	0.419981706	0.232	0.046491189	0	0.038027607	0.001616667	0	0	0	0	22.7744
H5528_017_0	2009	4	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	79.91234917	7.071988043	334.0587842	854.8377129	126.9164393	4.598344934		68.42418166	79.11073568	96.12150063	99.02009272			81.88937289	4342.869479	4242.200592	769.9782413	925.4566957	23.86654056	741.3462771	32.94173471				245	245					735.6380791	0	37.06052521	297.4554793	10.91072885	1.94					1A IP Acute: $0 per stay	1B IP Psych: $0 per stay (up to 190 days)	2 SNF: $0 days 1-100	6 Home Health - $0 per day	10A Ambulance - $50 per trip	11A DME - 20% coinsurance	11B Pros./Med Supp. - 20%; 11C Diabetes Mon Supplies - 0%	4A Emergency Care - $50; 4B Urgent Care - $5/$10	9B ASC Services - $0; 9A Outpatient Hospital - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0; Outpatient Radiology Therapy - $20; $0 High-tech Radiology			3 CORF - $10; 5 Partial Hosp - $10; 9D Cardiac Rehab Svcs - $10; 9C Outpatient Sub Abuse - $10; 12 Renal Dialysis - $0	7A Primary Care - $5; 14B Immunizations - $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 - $10; 7H Psychiatric Services - $10	7C Occupational Therapy - $10; 7I PT and ST Services - $10	7D Physician Specialist - $10	7G Other Health Care - $10	15 Medicare Part B Rx Drugs - 10%	13A Blood - $0	10B Transportation - NA	16A Preventative Dental - $0; 16B Comp Dental - NA	17A Eye Exams (Routine) - $0	17B Eye Wear - $0; Eyewear every year	18A Hearing Exams (Routine) - NA	18B Hearing Aids - NA		14C Routine Physical Exams - $0	7B Chiropractic Services - $10	7F Podiatry Services - $10	18A Hearing Exams (Medicare Covered) - $10	7D High Tech Radiology: $0 copayment	17A Eye Exams (Medicare Covered) - $20	14B Immunizations - $10					0	0	0	0	50	0.2	0.2	50	0	0	0.211780278			0.681624538	5	10	10	10	10	10	0.1				0	0					10	10	10	0	20	10					0	0	0	0	50	0.2	0.2	50	0	0	0.211780278			0.681624538	5	10	10	10	10	10	0.1				0	0					10	10	10	0	20	10					0	0	0	0	0.528818497	0.919668987	0	0.285100757	0	0	0.001747542	0	0	0.004651484	1.80952895	3.53516716	0.641648534	0.771213913	0.019888784	0.617788564	3.294173471	0	0	0	0	0	0	0	0	0	0.613031733	0	0.030883771	0	0.018184548	0.001616667	0	0	0	0	13.0931	0	0	0	0	0	0	0.528818497	0.919668987	0	0.285100757	0	0	0.001747542	0	0	0.004651484	1.80952895	3.53516716	0.641648534	0.771213913	0.019888784	0.617788564	3.294173471	0	0	0	0	0	0	0	0	0	0.613031733	0	0.030883771	0	0.018184548	0.001616667	0	0	0	0	13.0931	Unlimited	1A IP Acute: $0 per stay	1A IP Psych: 20%; $1500 OOP Max	2 SNF: 20%	6 Home Health - 20%	10A Ambulance - 20%	11A DME - 20%	11B Pros./Med Supp. - 20%; 11C Diabetes Mon Supplies - 20%	4A Emergency Care - $50; 4B Urgent Care - $5/$10	9B ASC Services - $0; 9A Outpatient Hospital - $0	8A Outpatient C/D/T - $0	8B Outpatient X-Rays - $0; Outpatient Radiology Therapy - $20; $0 High-tech Radiology			3 CORF - $10; 5 Partial Hosp - $10; 9D Cardiac Rehab Svcs - $10; 9C Outpatient Sub Abuse - 20%; 12 Renal Dialysis - $0	7A Primary Care - $10; 14B Immunizations - 20%; 14D Pap/Pelvic - 20%; 14E Prostate Screening - 20%; 14F Colorectal Screening - 20%; 14G Bone Mass Meas. - 20%; 14H Mammography - 20%; 14I Diabetes Monitoring - 20%	7D Physician Specialist - $20	7E Mental Health - 20%; 7H Psychiatric Services - 20%	7C Occupational Therapy - $10; 7I PT and ST Services - $10	7D Physician Specialist - $20	7G Other Health Care - $20	15 Medicare Part B Rx Drugs - 20%		10B Transportation - NA	16A Preventative Dental - 50%	17A Eye Exams (Routine) - 50%	17B Eye Wear - 50%				14C Routine Physical Exams - $0	7B Chiropractic Services - 20%	7F Podiatry Services - 20%	18A Hearing Exams (Medicare Covered) - $20		17A Eye Exams (Medicare Covered) - 50%						0	0.037	0.256	0.085	0.063	0.159		0.763	0	0	0.007			0.049	0.8222	1.2948	0.141	0.099	0.355	1.494	0.678			0.001	0.0252	0.0286				0	0.079	0.429	0.004		0.0254						6.8952	0	1.92	0	0.037	0.256	0.085	0.591818497	1.078668987	0	1.048100757	0	0	0.008747542	0	0	0.053651484	2.631695266	4.830000844	0.782648534	0.870213913	0.374888784	2.111788564	3.972173471	0	0	0.001	0.0252	0.0286	0	0	0	0	0.692031733	0.429	0.034883771	0	0.043584548	0.001616667	0	0	0	0	19.9883
H5528_802_0	2009	3																					Unlimited											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																												0	Unlimited	397.0761645	7.107465591	28.18009312	13.74777517	6.178120659	6.35921289		7.291180456	31.42608101	10.35360364	18.45767309			11.66974287	25.95564218	104.3615274	4.621501458	4.455598374	45.81536858	60.12504248	20.01667456																				1A IP Acute: Deductible for days 1-60: $1064; Days 61-90:$266 per day; Days 91-150:$532 per day	1B IP Psych:Deductible for days 1-60: $1064; Days 61-90:$266 per day; Days 91-150:$532 per day  (190 days lifetime max)	2 SNF: $133 for Days 21-100	6 Home Health - $0 per day	10A Ambulance - 20% after Deductible	11A DME - 20% after deductible	11B Pros./Med Supp. - 20% after deductible; 11C Diabetes Mon Supplies - 20% after deductible	4A Emergency Care - 20% after Deductible; 4B Urgent Care - 20% after Deductible	9B ASC Services - 20% after Ded; 9A Outpatient Hospital - 20% after Ded	8A Outpatient C/D/T - 20% after Ded	8B Outpatient X-Rays - 20% after Ded			3 CORF - 20% after Ded; 5 Partial Hosp - 20% after Ded; 9D Cardiac Rehab Svcs - 20% after Ded; 9C Outpatient Sub Abuse - 20% after Ded; 12 Renal Dialysis - 20% after Ded	7A Primary Care - 20% after Ded; 14B Immunizations - 20% after Ded; 14D Pap/Pelvic - 20% after Ded; 14E Prostate Screening - 20% after Ded; 14F Colorectal Screening - 20% after Ded; 14G Bone Mass Meas. - 20% after Ded; 14H Mammography - 20% after Ded; 14I Diabetes Monitoring - 20% after Ded	7D Physician Specialist - 20% after Ded	7E Mental Health - 50% after Ded; 7H Psychiatric Services - 50% after Ded	7C Occupational Therapy - 20% after Ded; 7I PT and ST Services - 20% after Ded	7D Physician Specialist - 20% after Ded	7G Other Health Care - 20% after Ded; 7B Chiropractic Services - 20% after Ded; 7F Podiatry Services - 20% after Ded; 17A Eye Exams (Medicare Covered) - 20% after Ded; 18A Hearing Exams (Medicare Covered) - 20% after Ded	15 Medicare Part B Rx Drugs - 20% after Ded	13A Blood - 20% after Ded	10B Transportation - NA	16A Preventative Dental - NA; 16B Comp Dental - NA	17A Eye Exams (Routine) - NA	17B Eye Wear - NA	18A Hearing Exams (Routine) - NA	18B Hearing Aids - NA		14C Routine Physical Exams - NA											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				23.9834	0.429290922	4.494724853	0	1.427145872	1.468978178	0	1.684262685	7.259424713	2.391682441	4.263722483	0	0	2.695710603	5.995753344	24.10751284	1.067566837	1.029243224	10.58335014	13.88888481	4.623851823	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.3945	0	0	23.9834	0.429290922	4.494724853	0	1.427145872	1.468978178	0	1.684262685	7.259424713	2.391682441	4.263722483	0	0	2.695710603	5.995753344	24.10751284	1.067566837	1.029243224	10.58335014	13.88888481	4.623851823	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.3945	Unlimited	1A IP Acute: Deductible for days 1-60: $1064; Days 61-90:$266 per day; Days 91-150:$532 per day	1B IP Psych:Deductible for days 1-60: $1064; Days 61-90:$266 per day; Days 91-150:$532 per day  (190 days lifetime max)	2 SNF: $133 for Days 21-100	6 Home Health - $0 per day	10A Ambulance - 20% after Deductible	11A DME - 20% after deductible	11B Pros./Med Supp. - 20% after deductible; 11C Diabetes Mon Supplies - 20% after deductible	4A Emergency Care - 20% after Deductible; 4B Urgent Care - 20% after Deductible	9B ASC Services - 20% after Ded; 9A Outpatient Hospital - 20% after Ded	8A Outpatient C/D/T - 20% after Ded	8B Outpatient X-Rays - 20% after Ded			3 CORF - 20% after Ded; 5 Partial Hosp - 20% after Ded; 9D Cardiac Rehab Svcs - 20% after Ded; 9C Outpatient Sub Abuse - 20% after Ded; 12 Renal Dialysis - 20% after Ded	7A Primary Care - 20% after Ded; 14B Immunizations - 20% after Ded; 14D Pap/Pelvic - 20% after Ded; 14E Prostate Screening - 20% after Ded; 14F Colorectal Screening - 20% after Ded; 14G Bone Mass Meas. - 20% after Ded; 14H Mammography - 20% after Ded; 14I Diabetes Monitoring - 20% after Ded	7D Physician Specialist - 20% after Ded	7E Mental Health - 50% after Ded; 7H Psychiatric Services - 50% after Ded	7C Occupational Therapy - 20% after Ded; 7I PT and ST Services - 20% after Ded	7D Physician Specialist - 20% after Ded	7G Other Health Care - 20% after Ded; 7B Chiropractic Services - 20% after Ded; 7F Podiatry Services - 20% after Ded; 17A Eye Exams (Medicare Covered) - 20% after Ded; 18A Hearing Exams (Medicare Covered) - 20% after Ded	15 Medicare Part B Rx Drugs - 20% after Ded	13A Blood - 20% after Ded	10B Transportation - NA	16A Preventative Dental - NA; 16B Comp Dental - NA	17A Eye Exams (Routine) - NA	17B Eye Wear - NA	18A Hearing Exams (Routine) - NA	18B Hearing Aids - NA		14C Routine Physical Exams - NA											2.5134	0.1721	0.587	0	0.2692	0.2346		0.4495	1.4324	0.3549	0.7404			0.5612	1.1345	3.2879	0.1844	0.1519	1.5911	2.7625	0.5908																				17.0178	0	0	26.4968	0.601350042	5.081740596	0	1.69632779	1.703580504	0	2.133743941	8.691795575	2.746584781	5.004155117	0	0	3.256905851	7.130298812	27.39544751	1.251993313	1.18112808	12.17441237	16.65134941	5.214684386	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4123
H5528_804_0	2009	3																					Unlimited											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																												0	Unlimited	230.752	3.744	20.032	11.28	10.656	6.291		5.852	25.361	2.856	6.818			6.622	27.2910472	112.5689528	5.463	5.121	49.572	65.727	27.198																				1A IP Acute: Deductible for days 1-60: $1064; Days 61-90:$266 per day; Days 91-150:$532 per day	1B IP Psych:Deductible for days 1-60: $1064; Days 61-90:$266 per day; Days 91-150:$532 per day  (190 days lifetime max)	2 SNF: $133 for Days 21-100	6 Home Health - $0 per day	10A Ambulance - 20% after Deductible	11A DME - 20% after deductible	11B Pros./Med Supp. - 20% after deductible; 11C Diabetes Mon Supplies - 20% after deductible	4A Emergency Care - 20% after Deductible; 4B Urgent Care - 20% after Deductible	9B ASC Services - 20% after Ded; 9A Outpatient Hospital - 20% after Ded	8A Outpatient C/D/T - 20% after Ded	8B Outpatient X-Rays - 20% after Ded			3 CORF - 20% after Ded; 5 Partial Hosp - 20% after Ded; 9D Cardiac Rehab Svcs - 20% after Ded; 9C Outpatient Sub Abuse - 20% after Ded; 12 Renal Dialysis - 20% after Ded	7A Primary Care - 20% after Ded; 14B Immunizations - 20% after Ded; 14D Pap/Pelvic - 20% after Ded; 14E Prostate Screening - 20% after Ded; 14F Colorectal Screening - 20% after Ded; 14G Bone Mass Meas. - 20% after Ded; 14H Mammography - 20% after Ded; 14I Diabetes Monitoring - 20% after Ded	7D Physician Specialist - 20% after Ded	7E Mental Health - 50% after Ded; 7H Psychiatric Services - 50% after Ded	7C Occupational Therapy - 20% after Ded; 7I PT and ST Services - 20% after Ded	7D Physician Specialist - 20% after Ded	7G Other Health Care - 20% after Ded; 7B Chiropractic Services - 20% after Ded; 7F Podiatry Services - 20% after Ded; 17A Eye Exams (Medicare Covered) - 20% after Ded; 18A Hearing Exams (Medicare Covered) - 20% after Ded	15 Medicare Part B Rx Drugs - 20% after Ded	13A Blood - 20% after Ded	10B Transportation - NA	16A Preventative Dental - NA; 16B Comp Dental - NA	17A Eye Exams (Routine) - NA	17B Eye Wear - NA	18A Hearing Exams (Routine) - NA	18B Hearing Aids - NA		14C Routine Physical Exams - NA											0.06266941	0.06266941	0.168370242	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.06266941	0.06266941	0.168370242	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				14.4611	0.234634272	3.372792697	0	2.461536	1.453221	0	1.351812	5.858391	0.659736	1.574958	0	0	1.529682	6.304231904	26.0034281	1.261953	1.182951	11.451132	15.182937	6.282738	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.6272	0	0	14.4611	0.234634272	3.372792697	0	2.461536	1.453221	0	1.351812	5.858391	0.659736	1.574958	0	0	1.529682	6.304231904	26.0034281	1.261953	1.182951	11.451132	15.182937	6.282738	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.6272	Unlimited	1A IP Acute: Deductible for days 1-60: $1064; Days 61-90:$266 per day; Days 91-150:$532 per day	1B IP Psych:Deductible for days 1-60: $1064; Days 61-90:$266 per day; Days 91-150:$532 per day  (190 days lifetime max)	2 SNF: $133 for Days 21-100	6 Home Health - $0 per day	10A Ambulance - 20% after Deductible	11A DME - 20% after deductible	11B Pros./Med Supp. - 20% after deductible; 11C Diabetes Mon Supplies - 20% after deductible	4A Emergency Care - 20% after Deductible; 4B Urgent Care - 20% after Deductible	9B ASC Services - 20% after Ded; 9A Outpatient Hospital - 20% after Ded	8A Outpatient C/D/T - 20% after Ded	8B Outpatient X-Rays - 20% after Ded			3 CORF - 20% after Ded; 5 Partial Hosp - 20% after Ded; 9D Cardiac Rehab Svcs - 20% after Ded; 9C Outpatient Sub Abuse - 20% after Ded; 12 Renal Dialysis - 20% after Ded	7A Primary Care - 20% after Ded; 14B Immunizations - 20% after Ded; 14D Pap/Pelvic - 20% after Ded; 14E Prostate Screening - 20% after Ded; 14F Colorectal Screening - 20% after Ded; 14G Bone Mass Meas. - 20% after Ded; 14H Mammography - 20% after Ded; 14I Diabetes Monitoring - 20% after Ded	7D Physician Specialist - 20% after Ded	7E Mental Health - 50% after Ded; 7H Psychiatric Services - 50% after Ded	7C Occupational Therapy - 20% after Ded; 7I PT and ST Services - 20% after Ded	7D Physician Specialist - 20% after Ded	7G Other Health Care - 20% after Ded; 7B Chiropractic Services - 20% after Ded; 7F Podiatry Services - 20% after Ded; 17A Eye Exams (Medicare Covered) - 20% after Ded; 18A Hearing Exams (Medicare Covered) - 20% after Ded	15 Medicare Part B Rx Drugs - 20% after Ded	13A Blood - 20% after Ded	10B Transportation - NA	16A Preventative Dental - NA; 16B Comp Dental - NA	17A Eye Exams (Routine) - NA	17B Eye Wear - NA	18A Hearing Exams (Routine) - NA	18B Hearing Aids - NA		14C Routine Physical Exams - NA											4.7515	0.0683	1.0954	0	0.3146	0.2322		0.7277	2.4595	0.2266	1.2079			0.8455	1.2133	3.7923	0.2074	0.1952	1.7216	3.0813	0.8027																				22.9429	0	0	19.2126	0.30294393	4.468209495	0	2.776158	1.685376	0	2.079462	8.317848	0.886347	2.782857	0	0	2.375142	7.517487243	29.79571176	1.469391	1.378146	13.172775	18.264246	7.085463	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.5701
H5528_806_0	2009	3																					Unlimited											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																												0	Unlimited	397.0761645	7.107465591	28.18009312	13.74777517	6.178120659	6.35921289		7.291180456	31.42608101	10.35360364	18.45767309			11.66974287	25.95564218	104.3615274	4.621501458	4.455598374	45.81536858	60.12504248	20.01667456																				1A IP Acute: Deductible for days 1-60: $1064; Days 61-90:$266 per day; Days 91-150:$532 per day	1B IP Psych:Deductible for days 1-60: $1064; Days 61-90:$266 per day; Days 91-150:$532 per day  (190 days lifetime max)	2 SNF: $133 for Days 21-100	6 Home Health - $0 per day	10A Ambulance - 20% after Deductible	11A DME - 20% after deductible	11B Pros./Med Supp. - 20% after deductible; 11C Diabetes Mon Supplies - 20% after deductible	4A Emergency Care - 20% after Deductible; 4B Urgent Care - 20% after Deductible	9B ASC Services - 20% after Ded; 9A Outpatient Hospital - 20% after Ded	8A Outpatient C/D/T - 20% after Ded	8B Outpatient X-Rays - 20% after Ded			3 CORF - 20% after Ded; 5 Partial Hosp - 20% after Ded; 9D Cardiac Rehab Svcs - 20% after Ded; 9C Outpatient Sub Abuse - 20% after Ded; 12 Renal Dialysis - 20% after Ded	7A Primary Care - 20% after Ded; 14B Immunizations - 20% after Ded; 14D Pap/Pelvic - 20% after Ded; 14E Prostate Screening - 20% after Ded; 14F Colorectal Screening - 20% after Ded; 14G Bone Mass Meas. - 20% after Ded; 14H Mammography - 20% after Ded; 14I Diabetes Monitoring - 20% after Ded	7D Physician Specialist - 20% after Ded	7E Mental Health - 50% after Ded; 7H Psychiatric Services - 50% after Ded	7C Occupational Therapy - 20% after Ded; 7I PT and ST Services - 20% after Ded	7D Physician Specialist - 20% after Ded	7G Other Health Care - 20% after Ded; 7B Chiropractic Services - 20% after Ded; 7F Podiatry Services - 20% after Ded; 17A Eye Exams (Medicare Covered) - 20% after Ded; 18A Hearing Exams (Medicare Covered) - 20% after Ded	15 Medicare Part B Rx Drugs - 20% after Ded	13A Blood - 20% after Ded	10B Transportation - NA	16A Preventative Dental - NA; 16B Comp Dental - NA	17A Eye Exams (Routine) - NA	17B Eye Wear - NA	18A Hearing Exams (Routine) - NA	18B Hearing Aids - NA		14C Routine Physical Exams - NA											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				23.9834	0.429290922	4.494724853	0	1.427145872	1.468978178	0	1.684262685	7.259424713	2.391682441	4.263722483	0	0	2.695710603	5.995753344	24.10751284	1.067566837	1.029243224	10.58335014	13.88888481	4.623851823	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.3945	0	0	23.9834	0.429290922	4.494724853	0	1.427145872	1.468978178	0	1.684262685	7.259424713	2.391682441	4.263722483	0	0	2.695710603	5.995753344	24.10751284	1.067566837	1.029243224	10.58335014	13.88888481	4.623851823	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.3945	Unlimited	1A IP Acute: Deductible for days 1-60: $1064; Days 61-90:$266 per day; Days 91-150:$532 per day	1B IP Psych:Deductible for days 1-60: $1064; Days 61-90:$266 per day; Days 91-150:$532 per day  (190 days lifetime max)	2 SNF: $133 for Days 21-100	6 Home Health - $0 per day	10A Ambulance - 20% after Deductible	11A DME - 20% after deductible	11B Pros./Med Supp. - 20% after deductible; 11C Diabetes Mon Supplies - 20% after deductible	4A Emergency Care - 20% after Deductible; 4B Urgent Care - 20% after Deductible	9B ASC Services - 20% after Ded; 9A Outpatient Hospital - 20% after Ded	8A Outpatient C/D/T - 20% after Ded	8B Outpatient X-Rays - 20% after Ded			3 CORF - 20% after Ded; 5 Partial Hosp - 20% after Ded; 9D Cardiac Rehab Svcs - 20% after Ded; 9C Outpatient Sub Abuse - 20% after Ded; 12 Renal Dialysis - 20% after Ded	7A Primary Care - 20% after Ded; 14B Immunizations - 20% after Ded; 14D Pap/Pelvic - 20% after Ded; 14E Prostate Screening - 20% after Ded; 14F Colorectal Screening - 20% after Ded; 14G Bone Mass Meas. - 20% after Ded; 14H Mammography - 20% after Ded; 14I Diabetes Monitoring - 20% after Ded	7D Physician Specialist - 20% after Ded	7E Mental Health - 50% after Ded; 7H Psychiatric Services - 50% after Ded	7C Occupational Therapy - 20% after Ded; 7I PT and ST Services - 20% after Ded	7D Physician Specialist - 20% after Ded	7G Other Health Care - 20% after Ded; 7B Chiropractic Services - 20% after Ded; 7F Podiatry Services - 20% after Ded; 17A Eye Exams (Medicare Covered) - 20% after Ded; 18A Hearing Exams (Medicare Covered) - 20% after Ded	15 Medicare Part B Rx Drugs - 20% after Ded	13A Blood - 20% after Ded	10B Transportation - NA	16A Preventative Dental - NA; 16B Comp Dental - NA	17A Eye Exams (Routine) - NA	17B Eye Wear - NA	18A Hearing Exams (Routine) - NA	18B Hearing Aids - NA		14C Routine Physical Exams - NA											2.5134	0.1721	0.587	0	0.2692	0.2346		0.4495	1.4324	0.3549	0.7404			0.5612	1.1345	3.2879	0.1844	0.1519	1.5911	2.7625	0.5908																				17.0178	0	0	26.4968	0.601350042	5.081740596	0	1.69632779	1.703580504	0	2.133743941	8.691795575	2.746584781	5.004155117	0	0	3.256905851	7.130298812	27.39544751	1.251993313	1.18112808	12.17441237	16.65134941	5.214684386	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4123
H5528_807_0	2009	3																					Unlimited											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																												0	Unlimited	230.752	3.744	20.032	11.28	10.656	6.291		5.852	25.361	2.856	6.818			6.622	27.2910472	112.5689528	5.463	5.121	49.572	65.727	27.198																				1A IP Acute: Deductible for days 1-60: $1064; Days 61-90:$266 per day; Days 91-150:$532 per day	1B IP Psych:Deductible for days 1-60: $1064; Days 61-90:$266 per day; Days 91-150:$532 per day  (190 days lifetime max)	2 SNF: $133 for Days 21-100	6 Home Health - $0 per day	10A Ambulance - 20% after Deductible	11A DME - 20% after deductible	11B Pros./Med Supp. - 20% after deductible; 11C Diabetes Mon Supplies - 20% after deductible	4A Emergency Care - 20% after Deductible; 4B Urgent Care - 20% after Deductible	9B ASC Services - 20% after Ded; 9A Outpatient Hospital - 20% after Ded	8A Outpatient C/D/T - 20% after Ded	8B Outpatient X-Rays - 20% after Ded			3 CORF - 20% after Ded; 5 Partial Hosp - 20% after Ded; 9D Cardiac Rehab Svcs - 20% after Ded; 9C Outpatient Sub Abuse - 20% after Ded; 12 Renal Dialysis - 20% after Ded	7A Primary Care - 20% after Ded; 14B Immunizations - 20% after Ded; 14D Pap/Pelvic - 20% after Ded; 14E Prostate Screening - 20% after Ded; 14F Colorectal Screening - 20% after Ded; 14G Bone Mass Meas. - 20% after Ded; 14H Mammography - 20% after Ded; 14I Diabetes Monitoring - 20% after Ded	7D Physician Specialist - 20% after Ded	7E Mental Health - 50% after Ded; 7H Psychiatric Services - 50% after Ded	7C Occupational Therapy - 20% after Ded; 7I PT and ST Services - 20% after Ded	7D Physician Specialist - 20% after Ded	7G Other Health Care - 20% after Ded; 7B Chiropractic Services - 20% after Ded; 7F Podiatry Services - 20% after Ded; 17A Eye Exams (Medicare Covered) - 20% after Ded; 18A Hearing Exams (Medicare Covered) - 20% after Ded	15 Medicare Part B Rx Drugs - 20% after Ded	13A Blood - 20% after Ded	10B Transportation - NA	16A Preventative Dental - NA; 16B Comp Dental - NA	17A Eye Exams (Routine) - NA	17B Eye Wear - NA	18A Hearing Exams (Routine) - NA	18B Hearing Aids - NA		14C Routine Physical Exams - NA											0.06266941	0.06266941	0.168370242	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.06266941	0.06266941	0.168370242	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				14.4611	0.234634272	3.372792697	0	2.461536	1.453221	0	1.351812	5.858391	0.659736	1.574958	0	0	1.529682	6.304231904	26.0034281	1.261953	1.182951	11.451132	15.182937	6.282738	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.6272	0	0	14.4611	0.234634272	3.372792697	0	2.461536	1.453221	0	1.351812	5.858391	0.659736	1.574958	0	0	1.529682	6.304231904	26.0034281	1.261953	1.182951	11.451132	15.182937	6.282738	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.6272	Unlimited	1A IP Acute: Deductible for days 1-60: $1064; Days 61-90:$266 per day; Days 91-150:$532 per day	1B IP Psych:Deductible for days 1-60: $1064; Days 61-90:$266 per day; Days 91-150:$532 per day  (190 days lifetime max)	2 SNF: $133 for Days 21-100	6 Home Health - $0 per day	10A Ambulance - 20% after Deductible	11A DME - 20% after deductible	11B Pros./Med Supp. - 20% after deductible; 11C Diabetes Mon Supplies - 20% after deductible	4A Emergency Care - 20% after Deductible; 4B Urgent Care - 20% after Deductible	9B ASC Services - 20% after Ded; 9A Outpatient Hospital - 20% after Ded	8A Outpatient C/D/T - 20% after Ded	8B Outpatient X-Rays - 20% after Ded			3 CORF - 20% after Ded; 5 Partial Hosp - 20% after Ded; 9D Cardiac Rehab Svcs - 20% after Ded; 9C Outpatient Sub Abuse - 20% after Ded; 12 Renal Dialysis - 20% after Ded	7A Primary Care - 20% after Ded; 14B Immunizations - 20% after Ded; 14D Pap/Pelvic - 20% after Ded; 14E Prostate Screening - 20% after Ded; 14F Colorectal Screening - 20% after Ded; 14G Bone Mass Meas. - 20% after Ded; 14H Mammography - 20% after Ded; 14I Diabetes Monitoring - 20% after Ded	7D Physician Specialist - 20% after Ded	7E Mental Health - 50% after Ded; 7H Psychiatric Services - 50% after Ded	7C Occupational Therapy - 20% after Ded; 7I PT and ST Services - 20% after Ded	7D Physician Specialist - 20% after Ded	7G Other Health Care - 20% after Ded; 7B Chiropractic Services - 20% after Ded; 7F Podiatry Services - 20% after Ded; 17A Eye Exams (Medicare Covered) - 20% after Ded; 18A Hearing Exams (Medicare Covered) - 20% after Ded	15 Medicare Part B Rx Drugs - 20% after Ded	13A Blood - 20% after Ded	10B Transportation - NA	16A Preventative Dental - NA; 16B Comp Dental - NA	17A Eye Exams (Routine) - NA	17B Eye Wear - NA	18A Hearing Exams (Routine) - NA	18B Hearing Aids - NA		14C Routine Physical Exams - NA											4.7515	0.0683	1.0954	0	0.3146	0.2322		0.7277	2.4595	0.2266	1.2079			0.8455	1.2133	3.7923	0.2074	0.1952	1.7216	3.0813	0.8027																				22.9429	0	0	19.2126	0.30294393	4.468209495	0	2.776158	1.685376	0	2.079462	8.317848	0.886347	2.782857	0	0	2.375142	7.517487243	29.79571176	1.469391	1.378146	13.172775	18.264246	7.085463	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	123.5701
H5528_809_0	2009	2																					Unlimited											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																												0	Unlimited	84.19088367	4.246841945	11.73446312	5.505396571	2.74539163	6.051888672		2.034903251	10.51767431	5.457315135	5.949896968			3.60637211	27.67752576	111.5441235	5.455682914	4.995612335	47.8150607	64.87797127	32.26494345																				1A IP Acute: Deductible for days 1-60: $1064; Days 61-90:$266 per day; Days 91-150:$532 per day	1B IP Psych:Deductible for days 1-60: $1064; Days 61-90:$266 per day; Days 91-150:$532 per day  (190 days lifetime max)	2 SNF: $133 for Days 21-100	6 Home Health - $0 per day	10A Ambulance - 20% after Deductible	11A DME - 20% after deductible	11B Pros./Med Supp. - 20% after deductible; 11C Diabetes Mon Supplies - 20% after deductible	4A Emergency Care - 20% after Deductible; 4B Urgent Care - 20% after Deductible	9B ASC Services - 20% after Ded; 9A Outpatient Hospital - 20% after Ded	8A Outpatient C/D/T - 20% after Ded	8B Outpatient X-Rays - 20% after Ded			3 CORF - 20% after Ded; 5 Partial Hosp - 20% after Ded; 9D Cardiac Rehab Svcs - 20% after Ded; 9C Outpatient Sub Abuse - 20% after Ded; 12 Renal Dialysis - 20% after Ded	7A Primary Care - 20% after Ded; 14B Immunizations - 20% after Ded; 14D Pap/Pelvic - 20% after Ded; 14E Prostate Screening - 20% after Ded; 14F Colorectal Screening - 20% after Ded; 14G Bone Mass Meas. - 20% after Ded; 14H Mammography - 20% after Ded; 14I Diabetes Monitoring - 20% after Ded	7D Physician Specialist - 20% after Ded	7E Mental Health - 50% after Ded; 7H Psychiatric Services - 50% after Ded	7C Occupational Therapy - 20% after Ded; 7I PT and ST Services - 20% after Ded	7D Physician Specialist - 20% after Ded	7G Other Health Care - 20% after Ded; 7B Chiropractic Services - 20% after Ded; 7F Podiatry Services - 20% after Ded; 17A Eye Exams (Medicare Covered) - 20% after Ded; 18A Hearing Exams (Medicare Covered) - 20% after Ded	15 Medicare Part B Rx Drugs - 20% after Ded	13A Blood - 20% after Ded	10B Transportation - NA	16A Preventative Dental - NA; 16B Comp Dental - NA	17A Eye Exams (Routine) - NA	17B Eye Wear - NA	18A Hearing Exams (Routine) - NA	18B Hearing Aids - NA		14C Routine Physical Exams - NA											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				5.0851	0.256509253	1.871646868	0	0.634185467	1.397986283	0	0.470062651	2.429582766	1.260639796	1.3744262	0	0	0.833071957	6.39350845	25.76669254	1.260262753	1.153986449	11.04527902	14.98681136	7.453201938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.673	0	0	5.0851	0.256509253	1.871646868	0	0.634185467	1.397986283	0	0.470062651	2.429582766	1.260639796	1.3744262	0	0	0.833071957	6.39350845	25.76669254	1.260262753	1.153986449	11.04527902	14.98681136	7.453201938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.673	Unlimited	1A IP Acute: Deductible for days 1-60: $1064; Days 61-90:$266 per day; Days 91-150:$532 per day	1B IP Psych:Deductible for days 1-60: $1064; Days 61-90:$266 per day; Days 91-150:$532 per day  (190 days lifetime max)	2 SNF: $133 for Days 21-100	6 Home Health - $0 per day	10A Ambulance - 20% after Deductible	11A DME - 20% after deductible	11B Pros./Med Supp. - 20% after deductible; 11C Diabetes Mon Supplies - 20% after deductible	4A Emergency Care - 20% after Deductible; 4B Urgent Care - 20% after Deductible	9B ASC Services - 20% after Ded; 9A Outpatient Hospital - 20% after Ded	8A Outpatient C/D/T - 20% after Ded	8B Outpatient X-Rays - 20% after Ded			3 CORF - 20% after Ded; 5 Partial Hosp - 20% after Ded; 9D Cardiac Rehab Svcs - 20% after Ded; 9C Outpatient Sub Abuse - 20% after Ded; 12 Renal Dialysis - 20% after Ded	7A Primary Care - 20% after Ded; 14B Immunizations - 20% after Ded; 14D Pap/Pelvic - 20% after Ded; 14E Prostate Screening - 20% after Ded; 14F Colorectal Screening - 20% after Ded; 14G Bone Mass Meas. - 20% after Ded; 14H Mammography - 20% after Ded; 14I Diabetes Monitoring - 20% after Ded	7D Physician Specialist - 20% after Ded	7E Mental Health - 50% after Ded; 7H Psychiatric Services - 50% after Ded	7C Occupational Therapy - 20% after Ded; 7I PT and ST Services - 20% after Ded	7D Physician Specialist - 20% after Ded	7G Other Health Care - 20% after Ded; 7B Chiropractic Services - 20% after Ded; 7F Podiatry Services - 20% after Ded; 17A Eye Exams (Medicare Covered) - 20% after Ded; 18A Hearing Exams (Medicare Covered) - 20% after Ded	15 Medicare Part B Rx Drugs - 20% after Ded	13A Blood - 20% after Ded	10B Transportation - NA	16A Preventative Dental - NA; 16B Comp Dental - NA	17A Eye Exams (Routine) - NA	17B Eye Wear - NA	18A Hearing Exams (Routine) - NA	18B Hearing Aids - NA		14C Routine Physical Exams - NA											11.855	0.0416	0.2479	0	0.0887	0.2236		1.5126	4.4978	1.3528	1.8951			1.5407	1.476	4.2169	0.1984	0.1854	1.661	3.6568	0.9526																				35.603	0	0	16.9402	0.298125987	2.119526743	0	0.722879847	1.621581399	0	1.98267989	6.92733506	2.613405672	3.269514654	0	0	2.373817744	7.869495313	29.98360478	1.45871196	1.339415563	12.70627011	18.64365986	8.405804711	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.276
H5528_810_0	2009	2																					Unlimited											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																												0	Unlimited	84.19088367	4.246841945	11.73446312	5.505396571	2.74539163	6.051888672		2.034903251	10.51767431	5.457315135	5.949896968			3.60637211	27.67752576	111.5441235	5.455682914	4.995612335	47.8150607	64.87797127	32.26494345																				1A IP Acute: Deductible for days 1-60: $1064; Days 61-90:$266 per day; Days 91-150:$532 per day	1B IP Psych:Deductible for days 1-60: $1064; Days 61-90:$266 per day; Days 91-150:$532 per day  (190 days lifetime max)	2 SNF: $133 for Days 21-100	6 Home Health - $0 per day	10A Ambulance - 20% after Deductible	11A DME - 20% after deductible	11B Pros./Med Supp. - 20% after deductible; 11C Diabetes Mon Supplies - 20% after deductible	4A Emergency Care - 20% after Deductible; 4B Urgent Care - 20% after Deductible	9B ASC Services - 20% after Ded; 9A Outpatient Hospital - 20% after Ded	8A Outpatient C/D/T - 20% after Ded	8B Outpatient X-Rays - 20% after Ded			3 CORF - 20% after Ded; 5 Partial Hosp - 20% after Ded; 9D Cardiac Rehab Svcs - 20% after Ded; 9C Outpatient Sub Abuse - 20% after Ded; 12 Renal Dialysis - 20% after Ded	7A Primary Care - 20% after Ded; 14B Immunizations - 20% after Ded; 14D Pap/Pelvic - 20% after Ded; 14E Prostate Screening - 20% after Ded; 14F Colorectal Screening - 20% after Ded; 14G Bone Mass Meas. - 20% after Ded; 14H Mammography - 20% after Ded; 14I Diabetes Monitoring - 20% after Ded	7D Physician Specialist - 20% after Ded	7E Mental Health - 50% after Ded; 7H Psychiatric Services - 50% after Ded	7C Occupational Therapy - 20% after Ded; 7I PT and ST Services - 20% after Ded	7D Physician Specialist - 20% after Ded	7G Other Health Care - 20% after Ded; 7B Chiropractic Services - 20% after Ded; 7F Podiatry Services - 20% after Ded; 17A Eye Exams (Medicare Covered) - 20% after Ded; 18A Hearing Exams (Medicare Covered) - 20% after Ded	15 Medicare Part B Rx Drugs - 20% after Ded	13A Blood - 20% after Ded	10B Transportation - NA	16A Preventative Dental - NA; 16B Comp Dental - NA	17A Eye Exams (Routine) - NA	17B Eye Wear - NA	18A Hearing Exams (Routine) - NA	18B Hearing Aids - NA		14C Routine Physical Exams - NA											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				5.0851	0.256509253	1.871646868	0	0.634185467	1.397986283	0	0.470062651	2.429582766	1.260639796	1.3744262	0	0	0.833071957	6.39350845	25.76669254	1.260262753	1.153986449	11.04527902	14.98681136	7.453201938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.673	0	0	5.0851	0.256509253	1.871646868	0	0.634185467	1.397986283	0	0.470062651	2.429582766	1.260639796	1.3744262	0	0	0.833071957	6.39350845	25.76669254	1.260262753	1.153986449	11.04527902	14.98681136	7.453201938	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.673	Unlimited	1A IP Acute: Deductible for days 1-60: $1064; Days 61-90:$266 per day; Days 91-150:$532 per day	1B IP Psych:Deductible for days 1-60: $1064; Days 61-90:$266 per day; Days 91-150:$532 per day  (190 days lifetime max)	2 SNF: $133 for Days 21-100	6 Home Health - $0 per day	10A Ambulance - 20% after Deductible	11A DME - 20% after deductible	11B Pros./Med Supp. - 20% after deductible; 11C Diabetes Mon Supplies - 20% after deductible	4A Emergency Care - 20% after Deductible; 4B Urgent Care - 20% after Deductible	9B ASC Services - 20% after Ded; 9A Outpatient Hospital - 20% after Ded	8A Outpatient C/D/T - 20% after Ded	8B Outpatient X-Rays - 20% after Ded			3 CORF - 20% after Ded; 5 Partial Hosp - 20% after Ded; 9D Cardiac Rehab Svcs - 20% after Ded; 9C Outpatient Sub Abuse - 20% after Ded; 12 Renal Dialysis - 20% after Ded	7A Primary Care - 20% after Ded; 14B Immunizations - 20% after Ded; 14D Pap/Pelvic - 20% after Ded; 14E Prostate Screening - 20% after Ded; 14F Colorectal Screening - 20% after Ded; 14G Bone Mass Meas. - 20% after Ded; 14H Mammography - 20% after Ded; 14I Diabetes Monitoring - 20% after Ded	7D Physician Specialist - 20% after Ded	7E Mental Health - 50% after Ded; 7H Psychiatric Services - 50% after Ded	7C Occupational Therapy - 20% after Ded; 7I PT and ST Services - 20% after Ded	7D Physician Specialist - 20% after Ded	7G Other Health Care - 20% after Ded; 7B Chiropractic Services - 20% after Ded; 7F Podiatry Services - 20% after Ded; 17A Eye Exams (Medicare Covered) - 20% after Ded; 18A Hearing Exams (Medicare Covered) - 20% after Ded	15 Medicare Part B Rx Drugs - 20% after Ded	13A Blood - 20% after Ded	10B Transportation - NA	16A Preventative Dental - NA; 16B Comp Dental - NA	17A Eye Exams (Routine) - NA	17B Eye Wear - NA	18A Hearing Exams (Routine) - NA	18B Hearing Aids - NA		14C Routine Physical Exams - NA											11.855	0.0416	0.2479	0	0.0887	0.2236		1.5126	4.4978	1.3528	1.8951			1.5407	1.476	4.2169	0.1984	0.1854	1.661	3.6568	0.9526																				35.603	0	0	16.9402	0.298125987	2.119526743	0	0.722879847	1.621581399	0	1.98267989	6.92733506	2.613405672	3.269514654	0	0	2.373817744	7.869495313	29.98360478	1.45871196	1.339415563	12.70627011	18.64365986	8.405804711	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.276
H5529_001_0	2009	7	H.6	H.7	I.7	I.8	I.9	I.10	I.11	I.12	I.13	I.14	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional	Professional		CORF	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies\Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Partial Hosp	Chemo/Radiation	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	0	Coin	0	0	V	V	V	V	0	V	0	V	V	V	V	V	Coin	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	0	0	0	0	0	0	0	0	0		1253.809506	72.22450709	501.4047511	373.8213499	93.39781731	10.64520221	1.897381819	297.2316253	431.1644338	4634.418527	885.1470498	114.8845868	0.021055152	155.1636388	3382.891459	3283.64797	35.16357556	1282.163064	2219.765603	0	46.97181337	0	0	317.1784093	319.8414928	290.871007	157.5956627	0	0	0	0	0.00587095	188.3081578	431.0338498	104.1371517	0.5383203	715.0620588	22.90234352	1.388932829	0	$200/day (days 1-10) w/$2000 yrly max	$200/day (days 1-10) w/$2000 yrly max	$100/day (for days 21-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$200 copay	$0 copay	$75/$125 copay for Lower/Higher Tier	$200 copay	20% coinsurance	$0 copay	$15 coapy	$30 copay	$35 copay	$30 copay	$75/$125 copay for Lower/Higher Tier	0	20% coinsurance	0	0	$10/$20 copay; Exam/Cleaning 1/yr	$30 copay/ $50 limit	$30 copay / Covd up to $75	$30 copay/ $50 limit	0	Silver Sneakers	0	$30 copay	$0 copay	$30 copay	$30 copay	$0 copay	20% coinsurance	$30 copay	$30 copay	$35 copay	20% coinsurance	200	200	100	0	100	0.2	0.2	50	200	0	91.74512441	200	0.2	0	15	30	35	30	80.68342152	0	0.2	0	0	19.47935514	30	30	30	0	0	0	30	0	30	30	0	0.2	30	30	35	0.2	127.8342253	80.8263366	91.93995788	0	91.93995788	0.183879916	0.183879916	45.96997894	183.8799158	0	84.35042874	183.8799158	0.183879916	0	13.79099368	27.58198736	32.17898526	27.58198736	74.18030376	0	0.183879916	0	0	19.47935514	27.58198736	27.58198736	27.58198736	0	0	0	0	0	27.58198736	27.58198736	0	0.183879916	27.58198736	27.58198736	32.17898526	0	13.3566	0.486470193	3.841594308	0	0.715582616	1.957438886	0.348890409	1.138644296	6.606873314	0	6.221877762	1.760414012	0.00387162	0	3.887786228	7.547461402	0.094294015	2.947050452	13.72190722	0	8.637173086	0	0	0.51486924	0.735155334	0.668566703	0.362233465	0	0	0	0	0	0.432826102	0.99073085	0	0.098986291	1.643569389	0.052641012	0.003724537	0	78.7773		6.861	13.3566	0.486470193	3.841594308	0	0.715582616	1.957438886	0.348890409	1.138644296	6.606873314	0	6.221877762	1.760414012	0.00387162	0	3.887786228	7.547461402	0.094294015	2.947050452	13.72190722	0	8.637173086	0	0	0.51486924	0.735155334	0.668566703	0.362233465	0	0	0	0	0	0.432826102	0.99073085	0	0.098986291	1.643569389	0.052641012	0.003724537	0	78.7773	4500	$250/day (Days 1-10)	$250/day (Days 1-10)	25% Coinsurance	$0 copay	$100 copay	30% Coinsurance	30% Coinsurance	$50 copay	$275 copay	$0 copay	25% Coinsurance	$275 copay	20% Coinsurance	$0 copay	$20 copay	$40 copay	$45 copay	$40 copay	25% Coinsurance		20% Coinsurance			50% Coinsurance	$40 copay / $50 limit	$40 copay / Covd up to $75	$40 copay / $50 limit		Silver Sneakers		$40 copay	$40 copay	$40 copay	$40 copay	$0 copay	30% Coinsurance	$40 copay	$40 copay	$45 copay	20% coinsurance	3.5687	0.0342	0.6283		0.987	0.6582	0.0219	0.1399	0.556		0.7574	0.3177			0.8459	1.195	0.0339	0.5743	2.1542		0.5881			0.488	0.1873	0.1603	0.0868					0	0.9154	0.3287		0.1677	0.1812	0.012		0.169	15.7572		1.338595929	16.9254	0.520675129	4.469872425	0	1.70259841	2.615662231	0.370779778	1.278504477	7.162893543	0	6.979263693	2.078139857	0.00387162	0	4.733641813	8.742457378	0.128148821	3.521382014	15.87610125	0	9.225313484	0	0	1.00286924	0.922445737	0.828861714	0.449082267	0	0	0	0	1.41E-06	1.348269806	1.319474723	0	0.266715286	1.824738458	0.064638964	0.003724537	0.168996968	94.5345
H5530_001_0	2009	9	H.6	H.7	I.7	I.8	I.9	I.10	I.11	I.12	I.13	I.14	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional	Professional		CORF	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies\Education	Vision Exam Diagnostic	Hearing Exam Diagnostic	Partial Hosp	Chemo/Radiation	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	0	Coin	0	0	0	V	V	V	0	V	0	V	V	V	V	V	Coin	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	0	0	0	0	0	0	0	0	0		1858.24365	149.3152586	430.2708722	694.6076047	148.0060877	15.5718396	1.157292124	332.4896658	399.0364534	4832.308908	787.7236931	166.5387968	0.004836882	93.66031903	3297.028499	3722.569115	71.85727091	1130.811821	2357.159359	0	35.21735432	0	0	0	310.6346955	293.179279	158.8462983	0	0	0	0	0.004160297	255.7706743	331.9294355	105.6073167	0.518913299	547.2481705	28.87433224	1.749409583	0	$215/day (days 1-10) w/$2150 yrly max	$215/day (days 1-10) w/$2150 yrly max	$100/day (for days 21-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$200 copay	$0 copay	$75/$125 copay for Lower/Higher Tier	$200 copay	20% coinsurance	$0 copay	$15 coapy	$30 copay	$35 copay	$30 copay	$75/$125 copay for Lower/Higher Tier	0	20% coinsurance	0	0	0	$30 copay/ $50 limit	$30 copay / Covd up to $75	$30 copay/ $50 limit	0	Silver Sneakers	0	$30 copay	$0 copay	$30 copay	$30 copay	$0 copay	20% coinsurance	$30 copay	$30 copay	$35 copay	20% coinsurance	215	215	100	0	100	0.2	0.2	50	200	0	94.35509511	200	0.2	0	15	30	35	30	81.04909677	0	0.2	0	0	0	30	30	30	0	0	0	30	0	30	30	0	0.2	30	30	35	0.2	111.7762541	98.99768878	92.49080006	0	92.49080006	0.1849816	0.1849816	46.24540003	184.9816001	0	87.26978236	184.9816001	0.1849816	0	13.87362001	27.74724002	32.37178002	27.74724002	74.96295804	0	0.1849816	0	0	0	27.74724002	27.74724002	27.74724002	0	0	0	0	0	27.74724002	27.74724002	0	0.1849816	27.74724002	27.74724002	32.37178002	0	17.309	1.231822125	3.316341435	0	1.140766789	2.880503806	0.214077749	1.281343133	6.151200137	0	5.728706271	2.567217759	0.000894734	0	3.811810046	8.607584894	0.193845647	2.614742251	14.72496985	0	6.514562554	0	0	0	0.718271288	0.677909652	0.36729553	0	0	0	0	0	0.591410857	0.767510476	0	0.095989412	1.265385528	0.066765252	0.004719292	0	82.8446		6.726	17.309	1.231822125	3.316341435	0	1.140766789	2.880503806	0.214077749	1.281343133	6.151200137	0	5.728706271	2.567217759	0.000894734	0	3.811810046	8.607584894	0.193845647	2.614742251	14.72496985	0	6.514562554	0	0	0	0.718271288	0.677909652	0.36729553	0	0	0	0	0	0.591410857	0.767510476	0	0.095989412	1.265385528	0.066765252	0.004719292	0	82.8446	4500	$300/day (Days 1-10)	$300/day (Days 1-10)	25% Coinsurance	$0 copay	$100 copay	30% Coinsurance	30% Coinsurance	$50 copay	$275 copay	$0 copay	25% Coinsurance	$275 copay	20% Coinsurance	$0 copay	$20 copay	$40 copay	$45 copay	$40 copay	25% Coinsurance		20% Coinsurance				$40 copay / $50 limit	$40 copay / Covd up to $75	$40 copay / $50 limit		Silver Sneakers		$40 copay	$40 copay	$40 copay	$40 copay	$0 copay	30% Coinsurance	$40 copay	$40 copay	$45 copay	20% coinsurance	4.7585	0.0234	0.5043		1.0215	0.993	0.008	0.2239	0.9823		1.1712	0.402			0.9748	2.4159	0.0231	0.6749	4.025		0.8039				0.1927	0.1541	0.0835					0	1.0226	0.2772		0.3094	0.2221	0.0188		0.4948	21.7811		1.768380067	22.0675	1.255271899	3.82059968	0	2.162253957	3.873514015	0.222102605	1.50521803	7.133542489	0	6.899909436	2.969204345	0.000894734	0	4.78662743	11.02351405	0.216918694	3.289652002	18.74993893	0	7.318511898	0	0	0	0.910975684	0.832048578	0.450808929	0	0	0	0	2.46E-06	1.614013773	1.044672699	0	0.405405991	1.48751787	0.085605759	0.004719292	0.49479835	104.6257
H5531_001_0	2009	6																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	5000	1268.368981	0	542.4374171	1563.788341	167.6788635	8.117701486	0	180.4435864	204.1548807	2314.439052	4402.17237	0	0	745.4528956	5576.481882	9760.97974	0	1313.235914	0	0	217.0090254	0	0	0	864.2780718	0	80.11861079	0	0	0											$225/day 1-10	$225/day 1-10	"$0 1-10, $75 11-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$200 per procedure	$35 per visit	$35 X-ray; $150 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$25 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$750 Every 3 Yrs	Fitness/Coaching	0											184.420666	184.420666	47.56208437	20	100	0.2	0.2	47.5	200	35	55.7	35	25	35	25	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											136.7178416	136.7178416	35.25952735	20	100	0.148267376	0.148267376	35.21350191	148.2673765	25.94679088	41.29246435	25.94679088	0	25.94679088	25	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											14.4507	0	1.593840578	2.606313901	1.397323863	1.203590302	0	0.529504215	2.522459047	5.004355507	15.14804547	0	0	1.611842533	11.61767059	28.46952424	0	3.830271417	0	0	0.813783845	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.7992	0	14.6769	14.4507	0	1.593840578	2.606313901	1.397323863	1.203590302	0	0.529504215	2.522459047	5.004355507	15.14804547	0	0	1.611842533	11.61767059	28.46952424	0	3.830271417	0	0	0.813783845	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.7992		$1000 ded; 35% coinsurance; $5000 max OOP	$1000 ded; 35% coinsurance; $5000 max OOP	$1000 ded; 35% coinsurance; $5000 max OOP	$1000 ded; 35% coinsurance; $5000 max OOP	$100 copay	$1000 ded; 35% coinsurance; $5000 max OOP	$1000 ded; 35% coinsurance; $5000 max OOP	$50 copay	$1000 ded; 35% coinsurance; $5000 max OOP	$1000 ded; 35% coinsurance; $5000 max OOP	$1000 ded; 35% coinsurance; $5000 max OOP	$1000 ded; 35% coinsurance; $5000 max OOP	$25 copay	$1000 ded; 35% coinsurance; $5000 max OOP	$1000 ded; 35% coinsurance; $5000 max OOP	$1000 ded; 35% coinsurance; $5000 max OOP	$1000 ded; 35% coinsurance; $5000 max OOP	$1000 ded; 35% coinsurance; $5000 max OOP	$1000 ded; 35% coinsurance; $5000 max OOP	$1000 ded; 35% coinsurance; $5000 max OOP	$1000 ded; 35% coinsurance; $5000 max OOP				$1000 ded; 35% coinsurance; $5000 max OOP	0	$1000 ded; 35% coinsurance; $5000 max OOP	0	Not Covered												9.2795	0	0.5835	0.2693	0.113	0.2311	0	0.0835	0.8772	0.7711	1.9682	0	0	0.4617	1.0131	8.6352	0	0.259	0	0	0.2459	0	0	0	0.1772	0	0.0098	0	0	0											24.9783	1000	16.03152605	23.7302	0	2.177380029	2.875644538	1.51029831	1.434651861	0	0.613038542	3.3996709	5.775496847	17.11625779	0	0	2.073524329	12.63072143	37.10470515	0	4.089251458	0	0	1.059732757	0	0	0	0.177193304	0	0.009782796	0	0	0	0	0	0	0	0	0	0	0	0	0	115.7776
H5531_002_0	2009	6																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3500	1304.775126	0	558.0070627	1608.673943	172.4917699	8.350704836	0	185.6228801	210.0147625	2380.870671	4528.528446	0	0	766.8497186	5736.544303	10041.1503	0	1350.929881	0	0	223.2378612	0	0	0	889.0855479	0	82.41826479	0	0	0											$150/day 1-10	$150/day 1-10	"$0 1-10, $75 11-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$200 per procedure	$30 per visit	$30 X-ray; $150 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$15 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$750 Every 3 Yrs	Fitness/Coaching	0											122.9471107	122.9471107	47.56208437	20	100	0.2	0.2	47.5	200	30	51.6	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											76.91489591	76.91489591	29.75452411	20	100	0.125118672	0.125118672	29.71568454	125.1186718	18.76780076	32.28061731	18.76780076	0	18.76780076	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											8.3631	0	1.383602883	2.681123238	1.437431416	1.044829097	0	0.459659246	2.189730678	3.723642199	12.18197448	0	0	1.199340228	7.170680379	25.10287575	0	3.377324702	0	0	0.83714198	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.1524	0	18.2811	8.3631	0	1.383602883	2.681123238	1.437431416	1.044829097	0	0.459659246	2.189730678	3.723642199	12.18197448	0	0	1.199340228	7.170680379	25.10287575	0	3.377324702	0	0	0.83714198	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.1524		$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$100 copay	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$50 copay	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$25 copay	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP				$1000 ded; 30% coinsurance; $3500 max OOP	0	$1000 ded; 30% coinsurance; $3500 max OOP	0	Not Covered												7.897	0	0.4966	0.2292	0.1089	0.1966	0	0.0819	0.7465	0.6563	1.675	0	0	0.3929	0.8621	7.3486	0	0.2204	0	0	0.2093	0	0	0	0.1508	0	0.0083	0	0	0											21.2804	1000	15.50497701	16.26	0	1.880201871	2.910326802	1.54634911	1.241465222	0	0.541512508	2.93624836	4.379892617	13.85694649	0	0	1.592236907	8.032798653	32.45151704	0	3.597719786	0	0	1.046447418	0	0	0	0.150793601	0	0.008325275	0	0	0	0	0	0	0	0	0	0	0	0	0	92.4328
H5531_003_0	2009	6																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	5000	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$0 	$0 	"$0/d 1-20, $100/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$100 per procedure	$0 per visit	$10 X-ray; $100 Complex Radiology	$10 per visit	$10 per visit	$10 per visit	$0 PCP visit; $10 if no PCP selected	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$45 per script	0	Not Covered	0	$0 per visit	0	$0 per visit	0	0	0											0	0	40.33133874	0	100	0.2	0.2	47.5	100	0	26.2	10	10	10	0	10	10	10	10	10	45	0	0	0	0	0	0	0	0	0											0	0	38.76023743	0	100	0.19220903	0.19220903	45.64964455	96.10451485	0	25.17938289	0	9.610451485	9.610451485	0	10	10	10	10	10	45	0	0	0	0	0	0	0	0	0											0	0	3.8335624	0	2.003577927	1.332971159	0	0.851703957	2.70975325	0	8.704989654	0	0.047096458	0.554658653	0	6.799356505	0	0.49284286	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.2447	0	0.731	0	0	3.8335624	0	2.003577927	1.332971159	0	0.851703957	2.70975325	0	8.704989654	0	0.047096458	0.554658653	0	6.799356505	0	0.49284286	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.2447	10000	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$100 copay	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$50 copay	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$10 copay	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP				$1000 ded; 30% coinsurance; $5000 max OOP	0	$1000 ded; 30% coinsurance; $5000 max OOP	0	0												7.109	0	0.8778	0.1331	0.1893	0.209	0	0.1183	0.9546	0.3254	1.3263	0	0.0232	0.2751	0.9717	4.2209	0	0.1251	0	0	0.1888				0.088	0	0.0056		0	0											17.1411	1000	7.961167568	7.109	0	4.711382853	0.133088109	2.19283852	1.541934196	0	0.970021013	3.664333923	0.325383919	10.03127795	0	0.070266316	0.829762232	0.971709958	11.0202172	0	0.617939401	0	0	1.102945533	0	0	0	0.088041591	0	0.005619921	0	0	0	0	0	0	0	0	0	0	0	0	0	45.3858
H5531_004_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3500	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$0 	$0 	"$0 1-20, $100 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$100 per procedure	$0 per visit	$10 X-ray; $100 Complex Radiology	$10 per visit	$10 per visit	$10 per visit	$0 PCP visit; $10 if no PCP selected	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$45 per script	0	Not Covered	0	$0 per visit	0	$0 per visit	0	0	0											0	0	40.33	0	100	0.2	0.2	47.5	100	0	26.2	10	10	10	0	10	10	10	10	10	45	0	0	0	0	0	0	0	0	0											0	0	36.51951767	0	100	0.181103485	0.181103485	43.01207759	90.5517423	0	23.72455648	0	9.05517423	9.05517423	0	10	10	10	10	10	45	0	0	0	0	0	0	0	0	0											0	0	3.611945103	0	2.003577927	1.255954115	0	0.802493799	2.553187833	0	8.202028604	0	0.044375296	0.522611321	0	6.799356505	0	0.49284286	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.2025	0	1.773	0	0	3.611945103	0	2.003577927	1.255954115	0	0.802493799	2.553187833	0	8.202028604	0	0.044375296	0.522611321	0	6.799356505	0	0.49284286	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.2025		$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$100 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$50 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$10 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP				$500 ded; 30% coinsurance; $3500 max OOP	0	$500 ded; 30% coinsurance; $3500 max OOP	0	0												5.2917	0	0.6534	0.0991	0.1436	0.1555	0	0.0824	0.7106	0.2422	0.9872	0	0.013	0.2048	0.7233	3.1419	0	0.0931	0	0	0.1405				0.0655	0	0.0042		0	0											12.752	500	10.08370683	5.2917	0	4.265361693	0.099065792	2.147220091	1.411498355	0	0.884882998	3.263741848	0.242203574	9.189267818	0	0.057411134	0.727388097	0.723304412	9.941206742	0	0.585960029	0	0	1.054688261	0	0	0	0.065534855	0	0.004183258	0	0	0	0	0	0	0	0	0	0	0	0	0	39.9546
H5531_005_0	2009	5																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	5000	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$100/day 1-5	$100/day 1-5	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$20 X-ray; $125 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$10 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	0	$0 per visit	0	0	0											61.28387407	61.28387407	47.8866492	20	100	0.2	0.2	47.5	150	0	38.9	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											50.17864523	50.17864523	39.20912667	20	100	0.163758072	0.163758072	38.89254203	122.8185538	0	31.85094495	0	16.37580717	16.37580717	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											7.1902	0	3.877959572	1.506462933	2.003577927	1.135663538	0	0.725633951	3.462979609	0	11.01147504	0	0.080250393	0.945115135	5.358275608	13.59871301	0	0.985685721	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.7961	0	6.2918	7.1902	0	3.877959572	1.506462933	2.003577927	1.135663538	0	0.725633951	3.462979609	0	11.01147504	0	0.080250393	0.945115135	5.358275608	13.59871301	0	0.985685721	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.7961		$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$100 copay	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$50 copay	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$20 copay	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP				$1000 ded; 30% coinsurance; $5000 max OOP	0	$1000 ded; 30% coinsurance; $5000 max OOP	0	0												7.109	0	0.8778	0.1331	0.1893	0.209	0	0.1183	0.9546	0.3254	1.3263	0	0.0268	0.2751	0.9717	4.2209	0	0.1251	0	0	0.1888				0.088	0	0.0056		0	0											17.1447	1000	7.963457739	14.2992	0	4.755780025	1.639551042	2.19283852	1.344626575	0	0.843951007	4.417560282	0.325383919	12.33776333	0	0.107010735	1.220218714	6.329985566	17.8195737	0	1.110782262	0	0	1.102945533	0	0	0	0.088041591	0	0.005619921	0	0	0	0	0	0	0	0	0	0	0	0	0	69.9408
H5531_006_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3500	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$0 	$0 	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$20 X-ray; $125 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$10 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	0	$0 per visit	0	0	0											0	0	47.8866492	20	100	0.2	0.2	47.5	150	0	38.9	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											0	0	36.10055039	20	100	0.150775011	0.150775011	35.8090652	113.0812585	0	29.32573971	0	15.07750114	15.07750114	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											0	0	3.570507349	1.506462933	2.003577927	1.04562591	0	0.668104271	3.18842781	0	10.13846375	0	0.073887985	0.870184558	5.358275608	13.59871301	0	0.985685721	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.9221	0	6.3844	0	0	3.570507349	1.506462933	2.003577927	1.04562591	0	0.668104271	3.18842781	0	10.13846375	0	0.073887985	0.870184558	5.358275608	13.59871301	0	0.985685721	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.9221		$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$100 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$50 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$20 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP				$500 ded; 30% coinsurance; $3500 max OOP	0	$500 ded; 30% coinsurance; $3500 max OOP	0	0												5.2917	0	0.6534	0.0991	0.1436	0.1555	0	0.0824	0.7106	0.2422	0.9872	0	0.016	0.2048	0.7233	3.1419	0	0.0931	0	0	0.1405				0.0655	0	0.0042		0	0											12.755	500	10.08660758	5.2917	0	4.223923939	1.605528725	2.147220091	1.20117015	0	0.750493471	3.898981826	0.242203574	11.12570297	0	0.089903721	1.074961334	6.081580021	16.74056325	0	1.078802889	0	0	1.054688261	0	0	0	0.065534855	0	0.004183258	0	0	0	0	0	0	0	0	0	0	0	0	0	56.6771
H5531_007_0	2009	6																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	5000	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$50/day 1-5	$50/day 1-5	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$150 per procedure	$20 per visit	$20 X-ray; $125 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$10 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	0	$0 per visit	0	0	0											30.64193704	30.64193704	47.8866492	20	100	0.2	0.2	48.5	150	20	38.9	20	20	20	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											24.27501533	24.27501533	37.93654239	20	100	0.158443086	0.158443086	38.42244836	118.8323145	15.8443086	30.81718023	15.8443086	15.8443086	15.8443086	10	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											3.4784	0	3.752095243	1.506462933	2.003577927	1.098804069	0	0.716863222	3.350584006	1.219078529	10.65408299	0	0.07764576	0.914440168	5.358275608	13.59871301	0	0.985685721	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.6289	0	6.6258	3.4784	0	3.752095243	1.506462933	2.003577927	1.098804069	0	0.716863222	3.350584006	1.219078529	10.65408299	0	0.07764576	0.914440168	5.358275608	13.59871301	0	0.985685721	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.6289		$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$100 copay	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$50 copay	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$20 copay	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP				$1000 ded; 30% coinsurance; $5000 max OOP	0	$1000 ded; 30% coinsurance; $5000 max OOP	0	0												7.109	0	0.8778	0.1331	0.1893	0.209	0	0.1183	0.9546	0.3254	1.3263	0	0.0268	0.2751	0.9717	4.2209	0	0.1251	0	0	0.1888				0.088	0	0.0056		0	0											17.1447	1000	7.963457739	10.5874	0	4.629915696	1.639551042	2.19283852	1.307767106	0	0.835180279	4.30516468	1.544462449	11.98037129	0	0.104406102	1.189543747	6.329985566	17.8195737	0	1.110782262	0	0	1.102945533	0	0	0	0.088041591	0	0.005619921	0	0	0	0	0	0	0	0	0	0	0	0	0	66.7735
H5531_008_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3500	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$0 	$0 	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$100 per procedure	$20 per visit	$20 X-ray; $125 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$0 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0	Not Covered	0	$0 per visit	0	$0 per visit	0	0	0											0	0	47.8866492	20	100	0.2	0.2	48.5	100	20	38.9	20	20	20	0	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											0	0	38.01666956	20	100	0.158777739	0.158777739	38.50360183	79.38886975	15.87777395	30.88227033	15.87777395	15.87777395	15.87777395	0	20	20	20	20	20	45	0	0	0	0	0	0	0	0	0											0	0	3.760020182	1.506462933	2.003577927	1.101124894	0	0.718377335	2.238440599	1.22165339	10.67658588	0	0.077809758	0.916371591	0	13.59871301	0	0.985685721	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.719	0	5.3769	0	0	3.760020182	1.506462933	2.003577927	1.101124894	0	0.718377335	2.238440599	1.22165339	10.67658588	0	0.077809758	0.916371591	0	13.59871301	0	0.985685721	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.719		$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$100 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$50 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$20 copay	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP	$500 ded; 30% coinsurance; $3500 max OOP				$500 ded; 30% coinsurance; $3500 max OOP	0	$500 ded; 30% coinsurance; $3500 max OOP	0	0												5.2917	0	0.6534	0.0991	0.1436	0.1555	0	0.0824	0.7106	0.2422	0.9872	0	0.016	0.2048	0.7233	3.1419	0	0.0931	0	0	0.1405				0.0655	0	0.0042		0	0											12.755	500	10.08660758	5.2917	0	4.413436772	1.605528725	2.147220091	1.256669134	0	0.800766535	2.948994615	1.463856964	11.66382509	0	0.093825494	1.121148367	0.723304412	16.74056325	0	1.078802889	0	0	1.054688261	0	0	0	0.065534855	0	0.004183258	0	0	0	0	0	0	0	0	0	0	0	0	0	52.474
H5531_009_0	2009	6																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	5000	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$150/day 1-5	$150/day 1-5	"$0 1-10, $75 11-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$30 X-ray; $125 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$15 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	0	$0 per visit	0	0	0											91.92581111	91.92581111	47.56208437	20	100	0.2	0.2	47.5	150	0	47.1	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											72.51876563	72.51876563	37.52094877	20	100	0.157776722	0.157776722	37.47197143	118.3325414	0	37.15641799	0	19.72209023	23.66650827	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											10.3913	0	3.710991159	1.506462933	2.003577927	1.094182828	0	0.699129788	3.336492453	0	12.84567757	0	0.096649006	1.36589146	8.037413413	20.39806951	0	1.478528581	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.8785	0	8.9759	10.3913	0	3.710991159	1.506462933	2.003577927	1.094182828	0	0.699129788	3.336492453	0	12.84567757	0	0.096649006	1.36589146	8.037413413	20.39806951	0	1.478528581	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.8785		$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$100 copay	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$50 copay	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$25 copay	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP	$1000 ded; 30% coinsurance; $5000 max OOP				$1000 ded; 30% coinsurance; $5000 max OOP	0	$1000 ded; 30% coinsurance; $5000 max OOP	0	0												7.109	0	0.8778	0.1331	0.1893	0.209	0	0.1183	0.9546	0.3254	1.3263	0	5.299	0.2751	0.9717	4.2209	0	0.1251	0	0	0.1888				0.088	0	0.0056		0	0											22.4169	1000	11.32635856	17.5003	0	4.588811612	1.639551042	2.19283852	1.303145865	0	0.817446845	4.291073126	0.325383919	14.17196587	0	5.395697308	1.640995039	9.00912337	24.61893021	0	1.603625122	0	0	1.102945533	0	0	0	0.088041591	0	0.005619921	0	0	0	0	0	0	0	0	0	0	0	0	0	90.2955
H5531_010_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3500	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$100/day 1-5	$100/day 1-5	"$0 1-10, $75 11-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$25 X-ray; $125 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	0	$0 per visit	0	0	0											61.28387407	61.28387407	47.56208437	20	100	0.2	0.2	47.5	150	0	43	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											45.25388771	45.25388771	35.12129835	20	100	0.147686119	0.147686119	35.07545335	110.7645895	0	31.75251566	0	18.46076492	18.46076492	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											6.4845	0	3.473654902	1.506462933	2.003577927	1.024204419	0	0.654416977	3.123107243	0	10.97744617	0	0.090467824	1.065446616	5.358275608	16.99839126	0	1.232107151	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.9062	0	9.5262	6.4845	0	3.473654902	1.506462933	2.003577927	1.024204419	0	0.654416977	3.123107243	0	10.97744617	0	0.090467824	1.065446616	5.358275608	16.99839126	0	1.232107151	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.9062		$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$100 copay	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$50 copay	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$25 copay	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP	$1000 ded; 30% coinsurance; $3500 max OOP				$1000 ded; 30% coinsurance; $3500 max OOP	0	$1000 ded; 30% coinsurance; $3500 max OOP	0	0												6.2079	0	0.7665	0.1162	0.1647	0.1825	0	0.1044	0.8336	0.2841	1.1582	0	0.0257	0.2402	0.8485	3.6858	0	0.1092	0	0	0.1648				0.0769	0	0.0049		0	0											14.9743	1000	9.75446055	12.6923	0	4.240203634	1.622680915	2.168312547	1.206679492	0	0.758837094	3.956686139	0.28413855	12.13561537	0	0.116130306	1.305678315	6.206812496	20.68421949	0	1.341346568	0	0	1.079016936	0	0	0	0.076881519	0	0.004907545	0	0	0	0	0	0	0	0	0	0	0	0	0	69.8805
H5531_801_0	2009	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																																																			0	Unlimited	309.0594031	0	38.16273352	5.785928131	6.824062529	9.084546476	0	8.029964425	41.49983941	14.1458766	57.65961196	0	3.146420305	11.95996803	42.2445251	183.499463	0	5.438499327	0	0	8.206763311	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.065202824	0.065202824	0.168015447	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.1515	0	6.411928721	0	1.576358444	2.098530236	0	1.854921782	9.586462904	3.267697494	13.31937036	0	0.72682309	2.762752616	9.758485299	42.38837595	0	1.256293344	0	0	1.895762325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.0553			20.1515	0	6.411928721	0	1.576358444	2.098530236	0	1.854921782	9.586462904	3.267697494	13.31937036	0	0.72682309	2.762752616	9.758485299	42.38837595	0	1.256293344	0	0	1.895762325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.0553		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											2.7479	0	0.8744	0	0.215	0.2862	0	0.2529	1.3072	0.4456	1.8163	0	0.0991	0.3767	1.3307	5.7802	0	0.1713	0	0	0.2585	0	0	0	0	0	0	0	0	0											15.9621	135	0	22.8995	0	7.286282638	0	1.791316414	2.38469345	0	2.107865661	10.89370785	3.713292607	15.13564814	0	0.82593533	3.139491609	11.08918784	48.16860904	0	1.427606073	0	0	2.154275369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.0174
H5531_802_0	2009	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																																																			0	Unlimited	320.7703501	0	39.60880423	6.005169795	7.08264141	9.428780114	0	8.334237606	43.07236047	14.68189527	59.84446269	0	3.265645157	12.41315778	43.84526396	190.4526651	0	5.644576142	0	0	8.517735796	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.062305655	0.062305655	0.164208419	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											19.9858	0	6.504099109	0	1.636090166	2.178048206	0	1.925208887	9.949715269	3.391517808	13.82407088	0	0.754364031	2.867439447	10.12825597	43.99456564	0	1.303897089	0	0	1.967596969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.4107			19.9858	0	6.504099109	0	1.636090166	2.178048206	0	1.925208887	9.949715269	3.391517808	13.82407088	0	0.754364031	2.867439447	10.12825597	43.99456564	0	1.303897089	0	0	1.967596969	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.4107		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											2.7253	0	0.8869	0	0.2231	0.297	0	0.2625	1.3568	0.4625	1.8851	0	0.1029	0.391	1.3811	5.9993	0	0.1778	0	0	0.2683	0	0	0	0	0	0	0	0	0											16.4196	135	0	22.7111	0	7.391021715	0	1.85919337	2.47505478	0	2.187737372	11.30649462	3.853997509	15.70917146	0	0.857231854	3.258453917	11.50938179	49.99382459	0	1.481701237	0	0	2.235905646	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.8303
H5532_001_0	2009	5																					3750											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		2046.965611	121.0850855	1198.148056	2252.46369	179.3155348	13.44818057	5.372605906	328.8493162	55.54006187	13612.00813	74.38086604	0	0.263964746	33.70004749	6548.390743	7842.059048	523.7949903	638.1819909	0	0	42.08097983	2096.722617	0	0	212.7577147	0	17.00791084	0	108.2604936	0											"$270 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$270 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$115 Days 1-25 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$15 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											266.8022405	270	87.8078022	0	150	0.2	0.086383584	47.75331724	0.2	2.8	0.162669945	0	0.2	0.197801307	10.9449052	24.99722673	37.5	25	0	0	0.2	24.43705914	0	0	25	0	25	0	0	0											168.0068318	170.0011712	55.28677486	0	94.44509509	0.125926793	0.054390039	30.06711058	0.125926793	1.762975108	0.102422523	0	0.125926793	0.124769074	10.9449052	24.99722673	37.5	15.74084918	0	0	0.125926793	24.43705914	0	0	25	0	25	0	0	0											28.6587	1.715383862	5.520145154	0	1.411289394	1.693486257	0.292216244	0.823962396	6.9939819	1.999802625	7.618275946	0	0.033240234	4.20472371	5.972626324	16.33581067	1.636859345	0.837127206	0	0	5.299122856	4.269811216	0	0	0.443245239	0	0.035433148	0	0	0	0	0	0	0	0	0	0	0	0	0	95.7952	0	39.4534	28.6587	1.715383862	5.520145154	0	1.411289394	1.693486257	0.292216244	0.823962396	6.9939819	1.999802625	7.618275946	0	0.033240234	4.20472371	5.972626324	16.33581067	1.636859345	0.837127206	0	0	5.299122856	4.269811216	0	0	0.443245239	0	0.035433148	0	0	0	0	0	0	0	0	0	0	0	0	0	95.7952		"$350 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$350 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											0.9066	0.0536	0.9186	0.4179	0.1687	0.3037	0.1213	0.0985	1.2541	0.2391	1.3441	0	0.004	0.7514	0.8873	1.9384	0.1835	0.1578	0	0	1.2486	0.5107	0	0	0.0526	0	0.0042	0	0	0											11.5646	0	0	29.5653	1.768952317	6.438702513	0.417857125	1.580000247	1.99715485	0.413533152	0.922461966	8.248112329	2.238866567	8.962394253	0	0.037213897	4.956132752	6.859960904	18.27424399	1.820331491	0.994919456	0	0	6.5476794	4.780534238	0	0	0.495850168	0	0.0396384	0	0	0	0	0	0	0	0	0	0	0	0	0	107.3598
H5533_002_0	2009	5																					3100											A	A	D		T	coin	coin	V	V		P	V		V	V	V	V	V			S	P	T	V			V														0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		286.5201698	9.367351234	1278.497912	929.4119769	182.7572287	17.79613143	3.062918586	262.3810202	288.4917552	20925.19981	3044.055673	214.6603282	12.49893817	7914.376203	16412.26037	7742.70244	66.65432925	1410.596362	0	0	231.0480786	82.09201312	42.30856095	0	0	211.0833109	1.692836951	30.42610375	69.71283368	124.1932543											"1a:  $100 per Admit, max 2"	"1b:  $100 per Admit, max 2"	"2:  $60 per day, day 16 - 50"		10a:  $100 per Trip	11a:  20% Coinsurance	"11b:  20% Coinsurance, Medical Supplies 100%"	"4a,b:  $50 Copay"	"9a,b:  $60 Copay, max 2x"		"8b:  $15/$50 Copay depending on type of Service, $200 Max"	"9a:  $100 Observation copay- no PBP code, 2x Max"		"7c,i:  $15 Copay"		"7a,b,d,f,g 16b, 17a, 18a:  $25 Copay"	"7e,h 9c:  $25 Copay"	"7c,i:  $15 Copay"			15:  $25/$75 Copay per 31/90 day supply	11c:  $15/$45 Copay per 31/90 day supply	10a:  $100 per Trip				18a:  $25 copay														68.36160952	98.33	36.96678388	0	98.33	0.040951592	0.19666	49.165	47.60439565	0	21.8910354	68.53863232	0	1.271182666	0	16.93103299	17.47815599	14.7495	0	0	0	125.2963963	70.70018865	0	0	0	24.5825	0	0	0											66.0440958	94.99653367	35.71358008	0	94.99653367	0.0395633	0.189993067	47.49826684	45.99056823	0	21.14891164	66.21511739	0	1.228088548	0	16.35705731	16.8856324	14.24948005	0	0	0	121.0487474	68.30339521	0	0	0	23.74913342	0	0	0											1.5769	0.074155491	3.804978131	0	1.446775269	0.704073685	0.581933297	1.038553642	1.105658313	0	5.364872037	1.184479903	0	0.809962899	0	10.55398563	0.093791708	1.67502206	0	0	0	0.828094613	0.240818197	0	0	0	0.003350284	0	0	0	0	0	0	0	0	0	0	0	0	0	31.0874	0	1.1175	1.5769	0.074155491	3.804978131	0	1.446775269	0.704073685	0.581933297	1.038553642	1.105658313	0	5.364872037	1.184479903	0	0.809962899	0	10.55398563	0.093791708	1.67502206	0	0	0	0.828094613	0.240818197	0	0	0	0.003350284	0	0	0	0	0	0	0	0	0	0	0	0	0	31.0874		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	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	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	50%Coinsurance	20%Coinsurance	50%Coinsurance	50%Coinsurance	50%Coinsurance											1.2582	0.002	0.0432	0	0.4086	0.1925	0.022	0.1184	0.0927	0.3084	0.4102	0.044	0	0.1238	0.0846	0.4281	0.038	0.495	0	0	0	0.9782	0.01	0	0	0	0.0154	0	0	0											5.0734	500	0	2.8351	0.076127943	3.848197859	0	1.855372091	0.896535492	0.60395879	1.156991986	1.198374651	0.30836453	5.775099523	1.228500617	0	0.933737756	0.08460456	10.98208694	0.131787801	2.169981987	0	0	0	1.806338911	0.250844423	0	0	0	0.018769923	0	0	0	0	0	0	0	0	0	0	0	0	0	36.1608
H5533_801_0	2009	3																					3100											A	A	D		T	coin	coin	V	V		P	V		V	V	V	V	V			S	P	T	V			V														0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		313.7623439	3.709734904	1240.469886	671.6080224	222.4674047	19.12033677	2.795574086	521.9486462	324.5400844	19609.53975	2698.372943	482.5281822	26.04894776	11080.73449	18960.63306	11579.11191	63.21361029	1520.258017	0	0	258.3602126	113.6996177	46.93301794	104.5912908	0	257.6339971	0.111865443	33.77568156	146.4982375	128.3359797											1a:  $100 per Admit	1b:  $100 per Admit	"2:  $30 per day, day 21 - 100"		10a:  $75 per Trip	11a:  15% Coinsurance	"11b:  15% Coinsurance, Medical Supplies 100%"	"4a,b:  $50 Copay"	"9a,b:  $100 Copay"		8b:  $0/$30 Copay depending on type of Service	9a:  $100 Observation copay- no PBP code		"7c,i:  $20 Copay"	"7a, 14c:  $10 copay"	"7a,b,d,f,g 16b, 17a, 18a:  $20 Copay"	"7e,h 9c:  $20 Copay"	"7c,i:  $20 Copay"			15:  $15/$45 Copay per 31/90 day supply	11c:  $15/$45 Copay per 31/90 day supply	10a:  $75 per Trip	"16a:  $20 Copay, 16b:  20% coinsurance"			18a:  $20 copay														94.58562873	80.57949232	24.1738477	0	71.81923057	0.026846847	0.143638461	47.87948704	95.75897409	0	10.72634333	80.57949232	0	0.610904105	2.895296778	13.83537572	1.631627376	19.15179482	0	0	0	119.7488661	4.196698479	0	0	0	16.11589846	0	0	0											91.37909961	77.84778252	23.35433476	0	69.38450071	0.025936717	0.138769001	46.25633381	92.51266761	0	10.36271164	77.84778252	0	0.590193963	2.797143882	13.36634532	1.576313891	18.50253352	0	0	0	115.689283	4.054427014	0	0	0	15.5695565	0	0	0											2.3893	0.02406622	2.414195748	0	1.286315816	0.495918768	0.387939024	2.011952567	2.502005746	0	2.330205059	3.130312416	0	0.544981883	4.419634897	12.89753403	0.008303708	2.344052076	0	0	0	1.09615227	0.015857208	0	0	0	0.000145141	0	0	0	0	0	0	0	0	0	0	0	0	0	38.2988	0	0.6281	2.3893	0.02406622	2.414195748	0	1.286315816	0.495918768	0.387939024	2.011952567	2.502005746	0	2.330205059	3.130312416	0	0.544981883	4.419634897	12.89753403	0.008303708	2.344052076	0	0	0	1.09615227	0.015857208	0	0	0	0.000145141	0	0	0	0	0	0	0	0	0	0	0	0	0	38.2988		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	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	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	50%Coinsurance	20%Coinsurance	50%Coinsurance	50%Coinsurance	50%Coinsurance											0.1231	0.0015	0.1551	0	0.0673	0.0271	0.0173	0.102	0.1232	0	0.1167	0.0806	0	0.0422	0.2139	0.572	0.0005	0.0994	0	0	0	0.1915	0.001	0	0	0	0	0	0	0	0										1.9345	500	0	2.5123	0.025611943	2.569254483	0	1.353578522	0.523066984	0.405253932	2.113916794	2.625186205	0	2.44692049	3.210920061	0	0.587228761	4.633537081	13.4695508	0.008837037	2.443497452	0	0	0	1.287612708	0.016875683	0	0	0	0.000154463	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2333
H5533_802_0	2009	3																					3100											A	A	D		T	coin	coin	V	V		P	V		V	V	V	V	V			S	P	T	V			V														0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		306.7971076	2.838958884	1512.533435	801.3511438	199.1067819	18.67721664	2.075384928	510.5388967	321.5912059	19903.60621	3215.616569	218.3894896	30.87649688	9399.482162	17869.15909	10415.93676	51.50192174	1346.824231	0	0	264.9604325	98.44778442	39.04282871	38.78221021	0	233.8163312	0.085607571	20.70815516	95.26117221	170.1162529											1a:  $100 per Admit	1b:  $100 per Admit	"2:  $30 per day, day 21 - 100"		10a:  $75 per Trip	11a:  15% Coinsurance	"11b:  15% Coinsurance, Medical Supplies 100%"	"4a,b:  $50 Copay"	"9a,b:  $100 Copay"		8b:  $0/$30 Copay depending on type of Service	9a:  $100 Observation copay- no PBP code		"7c,i:  $20 Copay"	"7a, 14c:  $10 copay"	"7a,b,d,f,g 16b, 17a, 18a:  $20 Copay"	"7e,h 9c:  $20 Copay"	"7c,i:  $20 Copay"			15:  $15/$45 Copay per 31/90 day supply	11c:  $15/$45 Copay per 31/90 day supply	10a:  $75 per Trip	"16a:  $20 Copay, 16b:  20% coinsurance"			18a:  $20 copay														95.85652943	61.66528649	53.58875807	0	72.56584395	0.029204439	0.145131688	48.3772293	96.75445861	0	10.43530214	96.75445861	0	0.938921431	3.066666839	15.03619627	8.266474328	19.35089172	0	0	0	120.0411579	17.3180077	0	0	0	12.3330573	0	0	0											92.60691574	59.57478353	51.77205593	0	70.1058033	0.028214385	0.140211607	46.7372022	93.4744044	0	10.08153698	93.4744044	0	0.907091237	2.962704359	14.52645709	7.986234179	18.69488088	0	0	0	115.9716658	16.73091326	0	0	0	11.91495671	0	0	0											2.3676	0.014094197	6.525580466	0	1.163211741	0.526966189	0.290993055	1.98842997	2.505045536	0	2.701529778	1.701152289	0	0.710515658	4.411752961	12.6088882	0.034275534	2.098226547	0	0	0	0.951429463	0.054435182	0	0	0	8.50E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6542	0	0.6287	2.3676	0.014094197	6.525580466	0	1.163211741	0.526966189	0.290993055	1.98842997	2.505045536	0	2.701529778	1.701152289	0	0.710515658	4.411752961	12.6088882	0.034275534	2.098226547	0	0	0	0.951429463	0.054435182	0	0	0	8.50E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6542		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	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	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	50%Coinsurance	20%Coinsurance	50%Coinsurance	50%Coinsurance	50%Coinsurance											0.3404	0.0012	5.9095	0	0.1805	0.044	0.0133	0.1432	0.1681	0.078	0.117	0.0617	0	0.1135	0.1902	0.5255	0.0004	0.1913	0	0	0	0.364	0.0008	0	0	0	0	0	0	0											8.4424	500	0	2.708	0.015277096	12.43503395	0	1.343663695	0.57100671	0.304243681	2.131591054	2.673097734	0.077991845	2.818522155	1.762891225	0	0.824010542	4.60191958	13.13440267	0.034683677	2.289568697	0	0	0	1.315439523	0.055214593	0	0	0	9.21E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0966
H5533_803_0	2009	3																					3100											A	A	D		T	coin	coin	V	V		P	V		V	V	V	V	V			S	P	T	V			V														0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		306.7971076	2.838958884	1512.533435	801.3511438	199.1067819	18.67721664	2.075384928	510.5388967	321.5912059	19903.60621	3215.616569	218.3894896	30.87649688	9399.482162	17869.15909	10415.93676	51.50192174	1346.824231	0	0	264.9604325	98.44778442	39.04282871	38.78221021	0	233.8163312	0.085607571	20.70815516	95.26117221	170.1162529											1a:  $100 per Admit	1b:  $100 per Admit	"2:  $30 per day, day 21 - 100"		10a:  $75 per Trip	11a:  15% Coinsurance	"11b:  15% Coinsurance, Medical Supplies 100%"	"4a,b:  $50 Copay"	"9a,b:  $100 Copay"		8b:  $0/$30 Copay depending on type of Service	9a:  $100 Observation copay- no PBP code		"7c,i:  $20 Copay"	"7a, 14c:  $10 copay"	"7a,b,d,f,g 16b, 17a, 18a:  $20 Copay"	"7e,h 9c:  $20 Copay"	"7c,i:  $20 Copay"			15:  $15/$45 Copay per 31/90 day supply	11c:  $15/$45 Copay per 31/90 day supply	10a:  $75 per Trip	"16a:  $20 Copay, 16b:  20% coinsurance"			18a:  $20 copay														95.85652943	61.66528649	53.58875807	0	72.56584395	0.029204439	0.145131688	48.3772293	96.75445861	0	10.43530214	96.75445861	0	0.938921431	3.066666839	15.03619627	8.266474328	19.35089172	0	0	0	120.0411579	17.3180077	0	0	0	12.3330573	0	0	0											92.60691574	59.57478353	51.77205593	0	70.1058033	0.028214385	0.140211607	46.7372022	93.4744044	0	10.08153698	93.4744044	0	0.907091237	2.962704359	14.52645709	7.986234179	18.69488088	0	0	0	115.9716658	16.73091326	0	0	0	11.91495671	0	0	0											2.3676	0.014094197	6.525580466	0	1.163211741	0.526966189	0.290993055	1.98842997	2.505045536	0	2.701529778	1.701152289	0	0.710515658	4.411752961	12.6088882	0.034275534	2.098226547	0	0	0	0.951429463	0.054435182	0	0	0	8.50E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6542	0	0.6287	2.3676	0.014094197	6.525580466	0	1.163211741	0.526966189	0.290993055	1.98842997	2.505045536	0	2.701529778	1.701152289	0	0.710515658	4.411752961	12.6088882	0.034275534	2.098226547	0	0	0	0.951429463	0.054435182	0	0	0	8.50E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6542		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	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	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	20%Coinsurance	50%Coinsurance	20%Coinsurance	50%Coinsurance	50%Coinsurance	50%Coinsurance											0.3404	0.0012	5.9095	0	0.1805	0.044	0.0133	0.1432	0.1681	0.078	0.117	0.0617	0	0.1135	0.1902	0.5255	0.0004	0.1913	0	0	0	0.364	0.0008	0	0	0	0	0	0	0	0										8.4424	500	0	2.708	0.015277096	12.43503395	0	1.343663695	0.57100671	0.304243681	2.131591054	2.673097734	0.077991845	2.818522155	1.762891225	0	0.824010542	4.60191958	13.13440267	0.034683677	2.289568697	0	0	0	1.315439523	0.055214593	0	0	0	9.21E-05	0	0	0	0	0	0	0	0	0	0	0	0	0	49.0966
H5549_001_0	2009	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		730.9238678	50.36590651	53.48183869		24.44041716	15.16080964	14.74915572	9.444769289	24.10215675	4.014588018	8.15432463	0.971863064	6.149754883	44.22592611	123.6991344	68.4479464	18.28645095	24.03035104	33.81851132	64.05810616	12.3984906	12.36394027																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																			0.0604	0.0604	0.1595		0.2	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																			0.0604	0.0604	0.1595		0.2	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																			44.1478	3.042100753	8.530353272	0	4.888083433	3.032161929	2.949831144	1.888953858	4.82043135	0.802917604	1.630864926	0.194372613	1.229950977	8.845185223	24.73982688	13.68958928	3.65729019	4.806070207	6.763702264	12.81162123	2.47969812	2.472788053	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	157.4236	0	0	44.1478	3.042100753	8.530353272	0	4.888083433	3.032161929	2.949831144	1.888953858	4.82043135	0.802917604	1.630864926	0.194372613	1.229950977	8.845185223	24.73982688	13.68958928	3.65729019	4.806070207	6.763702264	12.81162123	2.47969812	2.472788053	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	157.4236																																																																																		0	0	0	44.1478	3.042100753	8.530353272	0	4.888083433	3.032161929	2.949831144	1.888953858	4.82043135	0.802917604	1.630864926	0.194372613	1.229950977	8.845185223	24.73982688	13.68958928	3.65729019	4.806070207	6.763702264	12.81162123	2.47969812	2.472788053	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	157.4236
H5549_002_0	2009	5																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		730.9238678	50.36590651	53.48183869		24.44041716	15.16080964	14.74915572	9.444769289	24.10215675	4.014588018	8.15432463	0.971863064	6.149754883	44.22592611	123.7007689	68.4479464	18.28645095	24.03035104	33.81851132	64.05810616	12.3984906	12.36394027																			Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share																			0.0604	0.0604	0.1595		0.2	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																			0.0604	0.0604	0.1595		0.2	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																			44.1478	3.042100753	8.530353272	0	4.888083433	3.032161929	2.949831144	1.888953858	4.82043135	0.802917604	1.630864926	0.194372613	1.229950977	8.845185223	24.74015379	13.68958928	3.65729019	4.806070207	6.763702264	12.81162123	2.47969812	2.472788053	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	157.4239	0	0	44.1478	3.042100753	8.530353272	0	4.888083433	3.032161929	2.949831144	1.888953858	4.82043135	0.802917604	1.630864926	0.194372613	1.229950977	8.845185223	24.74015379	13.68958928	3.65729019	4.806070207	6.763702264	12.81162123	2.47969812	2.472788053	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	157.4239																																																																																		0	0	0	44.1478	3.042100753	8.530353272	0	4.888083433	3.032161929	2.949831144	1.888953858	4.82043135	0.802917604	1.630864926	0.194372613	1.229950977	8.845185223	24.74015379	13.68958928	3.65729019	4.806070207	6.763702264	12.81162123	2.47969812	2.472788053	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	157.4239
H5549_003_0	2009	6																					3250											Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	P	Coin	V	V	V	Coin	Coin	Coin	Coin																																																											0									368.8185578						521.9470468	18.67741701	3730.716444	2046.401618	3658.821639																							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; (UC) - $10	9a (OP Surgery) - $0; 9b (ASC) - $0	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $0	9a (OP Observation) - $0	12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT) - $10, 9c (OP SA) - $20, 9d (Cardiac Rehab) - $10; 3 (CORF)- $10; 5 (Partial Hospitalization) - $0, 9a (OP Other excluding Surgery) - $0"	"7a (PCP) - $0, 14c (Routine Physical) - $0"	"7b (Chiro), 7d (Spec), 7f (Pod) - $10; 17a (MCR Eye Exam) - $0; 18a (MCR Hearing Exam) - $0, 14j (Nutrition Therap) - $0; 14i (Diab Mon.) - $0"	"7e (MH), 7h (Psychiatric) - $20"	"7c (OT), 7i (PT/ST) - $10"	"8b (Professional Radiology) - $0, 14h (Mammography) - $0"	"7g (Prof. Other - allergy visits)  - $0; 14b (Immun), 14d (Pap/Pelvic), 14e (Prostate), 14f (Colorectal), 14g (Bone Mass) - $0"	15 (Part B Rx) - $0	13a (Blood) - $0																										43.78445195						10.16168719	0.049373972	10	20	10																														43.37949357						10.06770268	0.048917317	9.907510916	19.81502183	9.907510916																							0	0	0	0	0	0	0	1.333263521	0	0	0	0	0	0.43790064	0.913649121	3.080176158	3.379124394	3.020817944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.1649	0	0.1136	0	0	0	0	0	0	0	1.333263521	0	0	0	0	0	0.43790064	0.913649121	3.080176158	3.379124394	3.020817944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.1649																																																																																		0	0	0	0	0	0	0	0	0	0	1.333263521	0	0	0	0	0	0.43790064	0.913649121	3.080176158	3.379124394	3.020817944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.1649
H5554_001_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	255.29	13.29	108.02	55.5	10.29	16.76	12.96	14.26	24.68	5.88	16.56	2.21	4.38	47.05	52.24	100.76	5.85	8.31	24.31	42.81	5.23	4.03	0	0	0	0	0	0	0.5	10.22											Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits	Standard Medicare Benefits											0.052898934	0.052899189	0.119099477	0	0.230958041	0.230999822	0.231018431	0.231058637	0.231000018	0.23108184	0.230947511	0.230999904	0.230999994	0.230983959	0.228609428	0.230995966	0.230995288	0.231010753	0.231006711	0.223393328	0.230999306	0.23099961	0	0	0	0	0	0	0	0											0.052898934	0.052899189	0.119099477	0	0.230958041	0.230999822	0.231018431	0.231058637	0.231000018	0.23108184	0.230947511	0.230999904	0.230999994	0.230983959	0.228609428	0.230995966	0.230995288	0.231010753	0.231006711	0.223393328	0.230999306	0.23099961	0	0	0	0	0	0	0	0											13.5046	0.703030224	12.86512553	0	2.376558239	3.871557009	2.993998861	3.294896166	5.701080439	1.358761221	3.824490776	0.510509788	1.011779975	10.86779525	11.94255654	23.27515349	1.351322437	1.919699354	5.615773152	9.563468367	1.208126369	0.930928426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6912	0	0	13.5046	0.703030224	12.86512553	0	2.376558239	3.871557009	2.993998861	3.294896166	5.701080439	1.358761221	3.824490776	0.510509788	1.011779975	10.86779525	11.94255654	23.27515349	1.351322437	1.919699354	5.615773152	9.563468367	1.208126369	0.930928426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6912	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	13.5046	0.703030224	12.86512553	0	2.376558239	3.871557009	2.993998861	3.294896166	5.701080439	1.358761221	3.824490776	0.510509788	1.011779975	10.86779525	11.94255654	23.27515349	1.351322437	1.919699354	5.615773152	9.563468367	1.208126369	0.930928426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.6912
H5575_005_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	384.8015537	19.83549324	359.1018766	3.552562697	40.34923515	7.819081393	37.95353833	17.22757272	16.00658183	18.42863788	14.33467365	1.44970405	2.226745421	159.5370313	42.75277566	70.03402135	4.639270657	0.61273386	13.48014493	26.09225022	2.373202014	4.197710841	16.73379466	0	0	0	0	0	0	37.39932429											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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0.078491123	0.078491232	0	0	0.230983398	0.2309996	0.230970524	0.230964235	0.231000006	0.230983015	0.23088529	0.231000129	0.230999981	0.231000623	0	0.230998052	0.231002322	0.230972183	0.231007849	0.230159053	0.230996715	0.230991359	0	0	0	0	0	0	0	0											0.078491123	0.078491232	0	0	0.230983398	0.2309996	0.230970524	0.230964235	0.231000006	0.230983015	0.23088529	0.231000129	0.230999981	0.231000623	0	0.230998052	0.231002322	0.230972183	0.231007849	0.230159053	0.230996715	0.230991359	0	0	0	0	0	0	0	0											30.2035	1.556912303	0	0	9.320003449	1.806204676	8.766148641	3.978953152	3.697520493	4.256702339	3.309665283	0.334881822	0.51437815	36.85315365	0	16.17772247	1.071682292	0.141524477	3.114019284	6.005367596	0.548201868	0.96963493	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.6262	0	0	30.2035	1.556912303	0	0	9.320003449	1.806204676	8.766148641	3.978953152	3.697520493	4.256702339	3.309665283	0.334881822	0.51437815	36.85315365	0	16.17772247	1.071682292	0.141524477	3.114019284	6.005367596	0.548201868	0.96963493	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.6262	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	30.2035	1.556912303	0	0	9.320003449	1.806204676	8.766148641	3.978953152	3.697520493	4.256702339	3.309665283	0.334881822	0.51437815	36.85315365	0	16.17772247	1.071682292	0.141524477	3.114019284	6.005367596	0.548201868	0.96963493	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.6262
H5575_006_0	2009	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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1571.76	103.95	0	0	1734.05	0	0	265.36	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	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											25	25	0	0	50	0	0	49.65179379	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											19.45584194	19.45584194	0	0	38.91168389	0	0	38.64069809	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											2.5483	0.168536231	0	0	5.622900454	0	0	0.854474637	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.1942	0	2.62	2.5483	0.168536231	0	0	5.622900454	0	0	0.854474637	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.1942	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	2.5483	0.168536231	0	0	5.622900454	0	0	0.854474637	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.1942
H5575_007_0	2009	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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1479.07	91.68	0	0	1636.28	0	0	253.98	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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											25	25	0	0	50	0	0	49.64564139	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											19.72667536	19.72667536	0	0	39.45335071	0	0	39.17373802	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											2.4314	0.1507118	0	0	5.379727392	0	0	0.829112165	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.791	0	2.35	2.4314	0.1507118	0	0	5.379727392	0	0	0.829112165	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.791	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	2.4314	0.1507118	0	0	5.379727392	0	0	0.829112165	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.791
H5576_005_0	2009	5																					3600											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																																																			0		2121.359455	137.7650438	574.0905142		6.183663633	16.18341075	11.04317447	305.3354417	478.3354432		447.2777845		0.061223091	6.512820254	3245.926603	4161.059734	226.46314	3.876749232		217.2360064	1385.875695	1375.053498			259.8270369																1a (IP Acute) - $150 per day 1-4	1b (IP Psych) - $150 per day 1-4	2 (SNF) - $100 days 21-100	6 (Home Health)- $0	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	4a (ER) - $50	9a (OP Surgery) - $250; 9b (ASC) - $250	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $150 High Tech	9a (OP Observation) - $0	12 (Renal Dialysis) - 20%	"7i, 7c (OP PT/ST/OT), 20%; 9c (OP SA) - 50%, 9d (Cardiac Rehab) 20%; 3 (CORF)- 20%; 5 (Partial Hospitalization) - 50%, 9a (OP Other excluding Surgery) - $0"	"7a (PCP) - $10, 14c (Routine Physical) - $10"	"7b (Chiro), 7d (Spec), 7f (Pod) - $30; 17a (MCR Eye Exam) - $30; 18a (MCR Hearing Exam) - 20%, 14j (Nutrition Therap) - 20%; 14i (Diab Mon.) - 20%"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - 20%"	8b (Professional Radiology) - $0; 14h (Mammography) - $0	"7g (Prof. Other - allergy visits)  - 20%; 14b (Immun), 14d (Pap/Pelvic), 14e (Prostate), 14g (Bone Mass) - $0; 14f (Colorectal) - $350"	15 (Part B Rx) - 20%	13a (Blood) - $0			20%																81.6	81.6	67.99168329		0.282083752	0.2	0.2	50	250		150		0.2	0.200227001	10	30	189.3940831	0.2		57.03275468	49.45950639	30			30																65.98212686	65.98212686	54.97838079		0.22809419	0.161720899	0.161720899	40.43022479	202.151124		121.2906744		0.161720899	0.161904453	8.086044958	24.25813488	153.1449071	0.161720899		55.93990542	39.99317923	24.25813488			24.25813488																11.6643	0.757502549	2.630213908	0	1.410457749	2.617195739	1.785912105	1.028731712	8.058003956	0	4.520885343	0	0.009901053	1.054454601	2.187225704	8.41162902	2.890139711	0.626951372	0	1.012680138	4.618797921	2.779686102	0	0	0.525243275	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5899	0	13.6482	11.6643	0.757502549	2.630213908	0	1.410457749	2.617195739	1.785912105	1.028731712	8.058003956	0	4.520885343	0	0.009901053	1.054454601	2.187225704	8.41162902	2.890139711	0.626951372	0	1.012680138	4.618797921	2.779686102	0	0	0.525243275	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.5899		Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%																			4.804	0.1345	0.2905	1.2296	0.1018	0.2599	0.1774	0.1721	0.7084	0.2715	0.2414	0.0956	0.001	0.3705	0.4591	1.5382	0.1254	0.0623	0.4913	0.1023	0.4587	0.1507																			12.246	0	0	16.4684	0.891989957	2.920666541	1.229606715	1.512268351	2.877104644	1.963267758	1.200842646	8.766378433	0.271493018	4.762308119	0.095573392	0.010884309	1.424949827	2.646294526	9.949817563	3.015506802	0.689212762	0.491268302	1.115024645	5.077482264	2.930347936	0	0	0.525243275	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.8359
H5576_006_0	2009	5																					3600											A	A	D	V	Coin	Coin	Coin	V	V	P	P	V	Coin	Coin	P	Coin	V	Coin	Coin	P	S	V	P	P	Coin	P	P	P	Coin	P																																																			0		388.0604031	13.38959061	646.1176111		6.717702727	17.53202832	11.96343901	342.9666956	537.2881886		502.4028097		0.068768568	7.315496785	3696.072502	31.52511544	254.3737287	4.354541572		169.5914638	1501.365336	1544.522811																			1a (IP Acute) - $100 per admit	1b (IP Psych) - $100 per admit	2 (SNF) - $100 days 21-100	6 (Home Health)- $0	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	4a (ER) - $50	9a (OP Surgery) - $100; 9b (ASC) - $100	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $50 High Tech	9a (OP Observation) - $0	12 (Renal Dialysis) - 20%	"7i, 7c (OP PT/ST/OT), 20%; 9c (OP SA) - 50%, 9d (Cardiac Rehab) 20%; 3 (CORF)- 20%; 5 (Partial Hospitalization) - 50%, 9a (OP Other excluding Surgery) - $0"	"7a (PCP) - $5, 14c (Routine Physical) - $5"	"7b (Chiro), 7d (Spec), 7f (Pod) - $25; 17a (MCR Eye Exam) - $25; 18a (MCR Hearing Exam) - 20%, 14j (Nutrition Therap) - 20%; 14i (Diab Mon.) - 20%"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - 20%"	8b (Professional Radiology) - $0; 14h (Mammography) - $0	"7g (Prof. Other - allergy visits)  - 20%; 14b (Immun), 14d (Pap/Pelvic), 14e (Prostate), 14g (Bone Mass) - $0; 14f (Colorectal) - $100,"	15 (Part B Rx) - 20%	13a (Blood) - $0																			100	100	67.99168329		0.283122758	0.2	0.2	50	100		50		0.2	0.200227001	6.634264874	0.325785947	189.3940831	0.2		7.654321262	49.45950639	25																			88.42001812	88.42001812	60.11825868		0.250337194	0.176840036	0.176840036	44.21000906	88.42001812		44.21000906		0.176840036	0.17704075	5.866018204	0.288059993	167.4622826	0.176840036		6.767952247	43.73210452	22.10500453																			2.8594	0.098658987	3.236955474	0	1.681690849	3.100364523	2.115614989	1.263546727	3.958919281	0	1.850936064	0	0.012161036	1.29514104	1.806769049	9.081124541	3.549833771	0.770057289	0	0.095648911	5.471488816	2.845140311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0934	0	5.9057	2.8594	0.098658987	3.236955474	0	1.681690849	3.100364523	2.115614989	1.263546727	3.958919281	0	1.850936064	0	0.012161036	1.29514104	1.806769049	9.081124541	3.549833771	0.770057289	0	0.095648911	5.471488816	2.845140311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0934		Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%	Additional 20%																			5.4617	0.15	0.3326	1.3621	0.1123	0.2863	0.1954	0.197	0.7778	0.3118	0.2553	0.1098	0.0011	0.4249	0.6244	1.7525	0.1422	0.0711	0.5642	0.0088	0.5053	0.1684																			13.8149	0	0	8.321	0.248631701	3.569563907	1.362082589	1.793963975	3.386695771	2.31100062	1.460580855	4.736685162	0.311823258	2.106196125	0.109770803	0.013284157	1.720013312	2.431167425	10.83358544	3.692015259	0.841175206	0.564246122	0.104482476	5.976803016	3.013492436	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.9083
H5576_007_0	2009	7																					4800											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	P	Coin	P																																																			0		2121.359455	137.7650438	574.0905142		139.5448832	16.18341075	11.04317447	305.3354417	478.3354432	18.00917998	14.1880615	6.339752087	0.061223091	24.15037774	3302.53288	5545.759542	7.148463126	3.876749232	32.58772302	0.481531499	28.56030324																				1a (IP Acute) - $365 per day 1-4	1b (IP Psych) - $365 per day 1-4	2 (SNF) - $100 days 21-100	6 (Home Health)- $0	10a (Ambulance) - $200	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	4a (ER) - $50	9a (OP Surgery) - 365; 9b (ASC) - $365	8a (OP Diag Proc/Test/Lab) - 25%	8b (OP Diag & Therap Rad) - 25%	9a (OP Observation) - 25%	12 (Renal Dialysis) - 20%	"7i, 7c (OP PT/ST/OT) - 20%, 9d (Cardiac Rehab) - 20%; 3 (CORF)- 20%; 5 (Partial Hospitalization) - 50%, 9a (OP Other excluding Surgery) - 25%"	"7a (PCP) - $30, 14c (Routine Physical) - $30"	"7b (Chiro), 7d (Spec), 7f (Pod) - $60; 17a (MCR Eye Exam) - $60; 18a (MCR Hearing Exam) - 20%, 14j (Nutrition Therap) - $0; 14i (Diab Mon.) - $0"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - 20%"	"8b (Professional Radiology) - 25%, 14h (Mammography) - 25%"	"7g (Prof. Other - allergy visits)  - 20%; 14b (Immun), 14d (Pap/Pelvic), 14e (Prostate), 14g (Bone Mass) - $0; 14f (Colorectal) - $350"	15 (Part B Rx) - 20%	13a (Blood) - $0																			198.56	198.56	67.99168329		200	0.2	0.2	50	365	0.25	0.25	0.25	0.2	0.236600991	32.86173793	59.77309351	0.5	0.2	0.25	0.2	0.2																				144.0807269	144.0807269	49.33667985		145.1256314	0.145125631	0.145125631	36.28140786	264.8542774	0.181407039	0.181407039	0.181407039	0.145125631	0.171697326	24.7716668	43.47304498	0.362814079	0.145125631	0.181407039	0.145125631	0.145125631																				25.4706	1.654107304	2.360309992	0	1.687628274	2.348627705	1.602647668	0.923166641	10.55743235	3.266992021	2.57381423	1.150075656	0.00888504	4.146555288	6.817437007	20.09092117	2.593563062	0.56261568	5.911642351	0.069882563	4.144832042	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.9417	0	36.6179	25.4706	1.654107304	2.360309992	0	1.687628274	2.348627705	1.602647668	0.923166641	10.55743235	3.266992021	2.57381423	1.150075656	0.00888504	4.146555288	6.817437007	20.09092117	2.593563062	0.56261568	5.911642351	0.069882563	4.144832042	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.9417																																										4.9059	0.1411	0.2905	1.2296	0.1047	0.2599	0.1774	0.1721	0.7309	0.2937	0.2314	0.1034	0.001	0.3922	0.5789	1.7307	0.1254	0.0623	0.5314	0.0077	0.4587	0.011																			12.5396	0	0	30.3765	1.79520741	2.650762625	1.229606715	1.792302304	2.608536609	1.780003321	1.095277575	11.28838208	3.560657684	2.805171043	1.253454461	0.009868295	4.538746198	7.396294227	21.82158486	2.718930153	0.62487707	6.443032192	0.077616058	4.603516385	0.01100099	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.4813
H5576_008_0	2009	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																																																			0		393.9490701	39.37501566	28.21739147		12.99442473	30.67809385	17.47241028	21.19692174	37.15515259	18.04076578	12.70896366	2.692790295	0.49798125	35.5072282	25.49881	91.39703565	37.35422665	3.317352586	29.79758784	0.301976677	20.19555225	6.70102576		11.31001912	1.581632582	3.699725337	1.399501197	5.331201441													Medicare Cost Sharing	Medicare Cost Sharing	$100 days 21-100	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	50	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	"$0 - Office Visit, Medicare Cost Sharing - Other PCP"	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing		0.2	0.2	0.2	0.2	0.2													0.074993179	0.074993179	0.178682693		0.231	0.231	0.231	0.140682734	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.2	0.2	0.2	0.2	0.2													0.074993179	0.074993179	0.178682693		0.231	0.231	0.231	0.140682734	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.2	0.2	0.2	0.2	0.2													29.5435	2.952857599	5.041959499	0	3.001712113	7.08663968	4.036126774	2.982040904	8.582840248	4.167416895	2.935770605	0.622034558	0.115033669	8.202169713	5.890225109	21.11271523	8.628826356	0.766308447	6.883242792	0.069756612	4.66517257	1.547936951	0	2.262003824	0.316326516	0.739945067	0.279900239	1.066240288	0	0	0	0	0	0	0	0	0	0	0	0	133.4987	0	0	29.5435	2.952857599	5.041959499	0	3.001712113	7.08663968	4.036126774	2.982040904	8.582840248	4.167416895	2.935770605	0.622034558	0.115033669	8.202169713	5.890225109	21.11271523	8.628826356	0.766308447	6.883242792	0.069756612	4.66517257	1.547936951	0	2.262003824	0.316326516	0.739945067	0.279900239	1.066240288	0	0	0	0	0	0	0	0	0	0	0	0	133.4987		additional 20%	additional 20%	additional 20%	additional 20%	additional 20%	additional 20%	additional 20%	additional 20%	additional 20%	additional 20%	additional 20%	additional 20%	additional 20%	additional 20%	additional 20%	additional 20%	additional 20%	additional 20%	additional 20%	additional 20%	additional 20%	additional 20%																			7.1848	0.7181	0.5272	2.7629	0.222	0.5221	0.2974	0.3719	0.6656	0.3232	0.2277	0.0482	0.0089	0.6361	0.7591	1.6369	0.6692	0.0594	0.5338	0.0054	0.3437	0.12																			18.6437	0	0	36.7283	3.670972301	5.569186251	2.762947296	3.223736638	7.60874502	4.333486797	3.353962121	9.248458477	4.490609285	3.163446103	0.670274713	0.123954784	8.8382661	6.649308723	22.74957618	9.298010909	0.825737361	7.417053482	0.075166392	5.00887729	1.667982882	0	2.262003824	0.316326516	0.739945067	0.279900239	1.066240288	0	0	0	0	0	0	0	0	0	0	0	0	152.1424
H5576_009_0	2009	5																					3600											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	P	P	P	Coin	P																																																			0		2121.359455	137.7650438	574.0905142		139.5448832	16.18341075	11.04317447	305.3354417	478.3354432	18.00917998	14.1880615	6.339752087	0.061223091	24.15037774	3302.53288	32.69541486	7.148463126	3.876749232	32.58772302	0.481531499	28.56030324																				1a (IP Acute) - $350 per day 1-4	1b (IP Psych) - $350 per day 1-4	2 (SNF) - $100 days 21-100	6 (Home Health)- $0	10a (Ambulance) - $200	11a (Medical Equip) - 20%	"11b (Med Supp), 11c (Diab Supp) - 20%"	4a (ER) - $50	9a (OP Surgery) - $350; 9b (ASC) - $350	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), 9d (Cardiac Rehab) - 20%; 3 (CORF)- 20%; 5 (Partial Hospitalization) - 50%, 9a (OP Other excluding Surgery) - 20%"	"7a (PCP) - $15, 14c (Routine Physical) - $15"	"7b (Chiro), 7d (Spec), 7f (Pod) - $35; 17a (MCR Eye Exam) - $35; 18a (MCR Hearing Exam) - 20% 14j (Nutrition Therap) - 20%; 14i (Diab Mon.) - 20%"	"7e (MH), 7h (Psychiatric) - 50%"	"7c (OT), 7i (PT/ST) - 20%"	"8b (Professional Radiology) - 20%, 14h (Mammography) - 20%"	"7g (Prof. Other - allergy visits)  - 20%; 14b (Immun), 14d (Pap/Pelvic), 14e (Prostate), 14g (Bone Mass) - $0, 14f (Colorectal) - $350"	15 (Part B Rx) - 20%	13a (Blood) - $0																			190.4	190.4	67.99168329		200	0.2	0.2	50	350	0.2	0.2	0.2	0.2	0.200061217	18.11884185	0.494077137	0.5	0.2	0.2	0.2	0.2																				132.5904386	132.5904386	47.34793647		139.2756707	0.139275671	0.139275671	34.81891769	243.7324238	0.139275671	0.139275671	0.139275671	0.139275671	0.139318301	13.64257947	0.344064623	0.348189177	0.139275671	0.139275671	0.139275671	0.139275671																				23.4393	1.522193964	2.265166766	0	1.6196006	2.253955388	1.538045532	0.885954134	9.71548808	2.508240622	1.976051782	0.882973224	0.008526887	3.364589594	3.754588939	11.24933559	2.489017492	0.53993685	4.538676982	0.067065623	3.977755391	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.5965	0	33.8631	23.4393	1.522193964	2.265166766	0	1.6196006	2.253955388	1.538045532	0.885954134	9.71548808	2.508240622	1.976051782	0.882973224	0.008526887	3.364589594	3.754588939	11.24933559	2.489017492	0.53993685	4.538676982	0.067065623	3.977755391	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.5965																																										4.8988	0.1406	0.2905	1.2296	0.1047	0.2599	0.1774	0.1721	0.728	0.2892	0.2279	0.1018	0.001	0.3879	0.5411	1.6898	0.1254	0.0623	0.5234	0.0077	0.4587	0.011																			12.4286	0	0	28.3381	1.662832719	2.5556194	1.229606715	1.72427463	2.513864293	1.715401185	1.058065069	10.44349322	2.797471756	2.203914967	0.984790947	0.009510142	3.752456908	4.295668366	12.93911188	2.614384583	0.60219824	5.062042516	0.074799117	4.436439734	0.01100099	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.025
H5576_801_0	2009	5																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		360.5599951	9.893780659	20.90631842		6.854798701	17.88982481	12.20759083	12.60920437	50.12629151	20.6415637	16.26191617	7.266427271	0.070172008	27.68041415	40.72652444	113.0535509	8.193346789	4.443409767	37.35103771	0.551916474	31.57176379	10.16764737																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																			0.074993179	0.074993179	0.228713847		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.074993179	0.074993179	0.228713847		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			27.0395	0.741966064	4.781564515	0	1.5834585	4.132549532	2.819953481	2.912726209	11.57917334	4.768201216	3.756502636	1.6785447	0.016209734	6.394175669	9.407827146	26.11537025	1.892663108	1.026427656	8.628089712	0.127492706	7.293077435	2.348726543	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.0442	0	0	27.0395	0.741966064	4.781564515	0	1.5834585	4.132549532	2.819953481	2.912726209	11.57917334	4.768201216	3.756502636	1.6785447	0.016209734	6.394175669	9.407827146	26.11537025	1.892663108	1.026427656	8.628089712	0.127492706	7.293077435	2.348726543	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.0442																																																																																		0	0	0	27.0395	0.741966064	4.781564515	0	1.5834585	4.132549532	2.819953481	2.912726209	11.57917334	4.768201216	3.756502636	1.6785447	0.016209734	6.394175669	9.407827146	26.11537025	1.892663108	1.026427656	8.628089712	0.127492706	7.293077435	2.348726543	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.0442
H5576_802_0	2009	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		360.5599951	9.893780659	20.90631842		6.854798701	17.88982481	12.20759083	12.60920437	50.12629151	20.6415637	16.26191617	7.266427271	0.070172008	27.68041415	40.72652444	113.0535509	8.193346789	4.443409767	37.35103771	0.551916474	31.57176379	10.16764737																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																			0.074993179	0.074993179	0.228713847		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.074993179	0.074993179	0.228713847		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			27.0395	0.741966064	4.781564515	0	1.5834585	4.132549532	2.819953481	2.912726209	11.57917334	4.768201216	3.756502636	1.6785447	0.016209734	6.394175669	9.407827146	26.11537025	1.892663108	1.026427656	8.628089712	0.127492706	7.293077435	2.348726543	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.0442	0	0	27.0395	0.741966064	4.781564515	0	1.5834585	4.132549532	2.819953481	2.912726209	11.57917334	4.768201216	3.756502636	1.6785447	0.016209734	6.394175669	9.407827146	26.11537025	1.892663108	1.026427656	8.628089712	0.127492706	7.293077435	2.348726543	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.0442																																																																																		0	0	0	27.0395	0.741966064	4.781564515	0	1.5834585	4.132549532	2.819953481	2.912726209	11.57917334	4.768201216	3.756502636	1.6785447	0.016209734	6.394175669	9.407827146	26.11537025	1.892663108	1.026427656	8.628089712	0.127492706	7.293077435	2.348726543	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.0442
H5576_803_0	2009	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		360.5599951	9.893780659	20.90631842		6.854798701	17.88982481	12.20759083	12.60920437	50.12629151	20.6415637	16.26191617	7.266427271	0.070172008	27.68041415	40.72652444	113.0535509	8.193346789	4.443409767	37.35103771	0.551916474	31.57176379	10.16764737																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing																			0.074993179	0.074993179	0.228713847		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.074993179	0.074993179	0.228713847		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			27.0395	0.741966064	4.781564515	0	1.5834585	4.132549532	2.819953481	2.912726209	11.57917334	4.768201216	3.756502636	1.6785447	0.016209734	6.394175669	9.407827146	26.11537025	1.892663108	1.026427656	8.628089712	0.127492706	7.293077435	2.348726543	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.0442	0	0	27.0395	0.741966064	4.781564515	0	1.5834585	4.132549532	2.819953481	2.912726209	11.57917334	4.768201216	3.756502636	1.6785447	0.016209734	6.394175669	9.407827146	26.11537025	1.892663108	1.026427656	8.628089712	0.127492706	7.293077435	2.348726543	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.0442																																																																																		0	0	0	27.0395	0.741966064	4.781564515	0	1.5834585	4.132549532	2.819953481	2.912726209	11.57917334	4.768201216	3.756502636	1.6785447	0.016209734	6.394175669	9.407827146	26.11537025	1.892663108	1.026427656	8.628089712	0.127492706	7.293077435	2.348726543	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.0442
H5577_002_0	2009	7																																D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	P	P	P	P	P	P	Coin	O		P	P	P	P	P																																																					0							16.1507897	17.8478351																																		"1a (IP Acute) - $0, 1a (additional days)"	1b (IP Psych) - $0	2 (SNF) - $0; 2a2 (Waiver 3 Day) - $0	6a (Home Health) - $0	10a (Ambulance) - $0	11a (Medical Equip) - 10%	"11b (Med Supp), 11c (Diab Supp) - 10%"	"4a (ER) $25 (WW coverage), 4b (UC) - $0 (WW coverage)"	"9a (OP Surgery) - $0, 9b (ASC) - $0"	8a (OP Diag Proc/Test/Lab) - $0	"8b (OP Therap Rad, CT scans, PET, scans, & MRI) - $0, 8b (OP x-rays) - 0%"	9a (OP Observation) - $0	12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA) - $0, 9d (Cardiac Rehab) - $0, 3 (CORF)- $0; 5 (Partial Hospitalization) - $0, 9a (OP Other excluding Surgery) - $0"	"7a (PCP) - $0, 14c (Routine Physical) - $0"	"7b (Chiro) - $0, 7d (Spec) - $0, 7f (Pod) - $0; 17a (MCR Eye Exam) - $0; 18a (MCR Hearing Exam) - $0, 16b (Comp Dental) - $0, 14j (Nutrition Therap) - $0; 14i (Diab Mon.) - $0;"	"7e (MH), 7h (Psychiatric) - $0"	"7c (OT), 7i (PT/ST) - $0"	"8b (OP Therap Rad, CT scans, PET, scans, & MRI) - 0%, 8b (OP x-rays) - 0%"	"7g (Prof. Other - allergy visits)  - $0; 14b (Immun), 14d (Pap/Pelvic), 14e (Prostate), 14f (Colorectal), 14g (Bone Mass) - $0"	15 (Part B Rx) - 0%	13a (Blood) - $0	1 Round trip per year	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	14a (Health Ed & Wellness) - $0	13C OTC - $22/Qtr																0.1	0.1																																							0.1	0.1																																		0	0	0	0	0	1.61507897	1.78478351	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.3999	0	0	0	0	0	0	0	1.61507897	1.78478351	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.3999																																																																																		0	0	0	0	0	0	0	0	1.61507897	1.78478351	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.3999
H5578_002_0	2009	18																					3200											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1824.209585	21.85739458	573.8859235	17.87734122	288.2332575	13.55569076	5.525902909	44.72709799	823.9835952	6.915844226	21.65088513	1.041920939	0.04807304	20.02249196	10787.26777	2533.994516	142.563431	52.74420658	5000.062236	1497.383515	12.26737622	0	0	2670.222222	500.464807	3.470210383	1.372059329	0	0	0											1a (IP Acute): 150 days 1-5	1b (IP Psych): 200 days 1-5	2a (SNF): 25 days 11-100	6a (Home Health): 5 copay	10a (Ambulance): 100 copay	11a (DME): 10% coin	11b (Medical Supplies): 10% coin	4a (ER): 50 copay	9b (OP Surg): 350 copay; 9b (OP ASC): 100 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 15% coin	9a (OP Other): 15% coin; 9c (OP SA): 25 copay; 3 (CORF): 35 copay; 5 (Partial Hosp): 50 copay; 9d (OP Cardiac Rehab): 35 copay		7b (Chiro): 8 copay; 7d (SPC w/Copay): 25 copay	7h (Psych): 25 copay; 7e (MH Non-Phys): 25 copay	7i (PT/ST): 10 copay; 7c (OT): 10 copay	7g (Prof. Other): 25 copay	7g (Prof. Other): 25 copay	15 (Part B Rx): 20% coin		10b (Transportation): 20 trips/year	16b (Comp. Dental): 25 copay	17a1 (Routine Eye Exam): 5 copay	17b1 (Non MCR Covered): 150 allowance	18a (Hearing Exam): 25 copay														76.51829778	125.3443377	13.70098195	5	100	0.1	0.1	50	349.5757516	0	0.15048137	0.15	0.15	0.14881339	0	23.71607514	25	10	25	17.91939893	0.2	0	0	25	5	0	25	0	0	0											65.15881088	106.7364046	11.6670093	4.257727417	85.15454835	0.085154548	0.085154548	42.57727417	297.6796524	0	0.128141731	0.127731823	0.127731823	0.12672137	0	20.19531667	21.28863709	8.515454835	21.28863709	15.25918322	0.170309097	0	0	21.28863709	5	0	25	0	0	0											9.9053	0.194414976	0.557961034	0.00634307	2.045364405	1.154328724	0.470555766	0.158696493	20.44026252	0	2.774381906	0.13308646	0.006140457	2.537277611	0	4.264568474	0.252915095	0.037428409	8.870375863	1.904070784	2.089245762	0	0	4.737115986	0.208527003	0	0.002858457	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7512		10.9029	9.9053	0.194414976	0.557961034	0.00634307	2.045364405	1.154328724	0.470555766	0.158696493	20.44026252	0	2.774381906	0.13308646	0.006140457	2.537277611	0	4.264568474	0.252915095	0.037428409	8.870375863	1.904070784	2.089245762	0	0	4.737115986	0.208527003	0	0.002858457	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7512																																																																																		0			9.9053	0.194414976	0.557961034	0.00634307	2.045364405	1.154328724	0.470555766	0.158696493	20.44026252	0	2.774381906	0.13308646	0.006140457	2.537277611	0	4.264568474	0.252915095	0.037428409	8.870375863	1.904070784	2.089245762	0	0	4.737115986	0.208527003	0	0.002858457	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7512
H5578_006_0	2009	18																					4200											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1724.752028	22.04656946	582.9143881	25.44018126	208.7548779	15.49382661	6.505402723	53.87515284	732.1648796	7.303392494	19.9620702	0.793133132	0.071411531	19.57763822	10801.42486	2644.55606	129.2002997	56.41968121	5241.011707	1741.542864	16.50643347	0	0	936	359.5562649	4.166106725	1.952496044	0	0	0											1a (IP Acute): 160 days 1-5	1b (IP Psych): 250 days 1-5	2a (SNF): 25 days 11-100	6a (Home Health): 15 copay	10a (Ambulance): 125 copay	11a (DME): 20% coin	11b (Medical Supplies): 10% coin	4a (ER): 50 copay	9b (OP Surg): 450 copay; 9b (OP ASC): 175 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 15% coin; 9c (OP SA): 50 copay; 3 (CORF): 50 copay; 5 (Partial Hosp): 50 copay; 9d (OP Cardiac Rehab): 50 copay		7b (Chiro): 15 copay; 7d (SPC w/Copay): 30 copay	7h (Psych): 50 copay; 7e (MH Non-Phys): 50 copay	7i (PT/ST): 20 copay; 7c (OT): 20 copay	7g (Prof. Other): 30 copay	7g (Prof. Other): 30 copay	15 (Part B Rx): 20% coin			16b (Comp. Dental): 30 copay	17a1 (Routine Eye Exam): 10 copay	17b1 (Non MCR Covered): 100 allowance	18a (Hearing Exam): 30 copay														86.91137865	120.910349	13.5642	15	125	0.2	0.1	50	449.2526229	0	0.150412614	0.15	0.2	0.148941999	0	28.4737888	50	20	30	19.6925412	0.2	0	0	30	10	0	30	0	0	0											75.86026121	105.5361311	11.83945958	13.09269207	109.1057673	0.174569228	0.087284614	43.6423069	392.1284169	0	0.13128707	0.130926921	0.174569228	0.130003449	0	24.85323659	43.6423069	17.45692276	26.18538414	17.18855854	0.174569228	0	0	26.18538414	10	0	30	0	0	0											10.9033	0.19389247	0.575115945	0.027756705	1.898030093	2.704745344	0.567821564	0.19593633	23.92522126	0	2.620761699	0.103842479	0.012466256	2.545160492	0	5.477148119	0.469883261	0.082076168	11.43649207	2.494550956	2.881515342	0	0	2.042459963	0.299630221	0	0.00488124	0	0	0	0	0	0	0	0	0	0	0	0	0	71.4627		10.3661	10.9033	0.19389247	0.575115945	0.027756705	1.898030093	2.704745344	0.567821564	0.19593633	23.92522126	0	2.620761699	0.103842479	0.012466256	2.545160492	0	5.477148119	0.469883261	0.082076168	11.43649207	2.494550956	2.881515342	0	0	2.042459963	0.299630221	0	0.00488124	0	0	0	0	0	0	0	0	0	0	0	0	0	71.4627																																																																																		0			10.9033	0.19389247	0.575115945	0.027756705	1.898030093	2.704745344	0.567821564	0.19593633	23.92522126	0	2.620761699	0.103842479	0.012466256	2.545160492	0	5.477148119	0.469883261	0.082076168	11.43649207	2.494550956	2.881515342	0	0	2.042459963	0.299630221	0	0.00488124	0	0	0	0	0	0	0	0	0	0	0	0	0	71.4627
H5578_007_0	2009	15																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	V	V	Coin	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		313.6578982	1.344558366	10.72205647	10.29105917	13.65190882	19.27894484	9.663538626	13.16616222	31.09998153	1337.256425	22.533	0.204598976	0	25.36689966	122.9601241	2508.974047	246.4721054	6.998762442	5312.540975	1236.373598	12.53083547	0	0	936	468.219084	3.016687156	12.81101101	0	0	0											1a (IP Acute): MC CS;1a1 (Add'l Days): 0% coin	1b (IP Psych): MC CS;1a1 (Add'l Days): 0% coin	2a (SNF): MC CS;2a2 (Waiver 3 Day): 0% coin		10a (Ambulance): MC CS	11a (DME): MC CS	11b (Medical Supplies): MC CS	4a (ER): MC CS	9b (OP Surg): MC CS; 9b (OP ASC): MC CS		8b (OP Therap Rad): MC CS; 8b (OP Diag): MC CS	9a (OP Observation): MC CS	12 (Renal Dialysis): MC CS	9a (OP Other): MC CS; 9c (OP SA): 10 copay; 3 (CORF): MC CS; 5 (Partial Hosp): MC CS; 9d (OP Cardiac Rehab): MC CS		7b (Chiro): 10 copay; 7d (SPC w/Copay): 10 copay	7h (Psych): 10 copay; 7e (MH Non-Phys): 10 copay	7i (PT/ST): MC CS; 7c (OT): MC CS	7g (Prof. Other): 10 copay	7g (Prof. Other): 10 copay	15 (Part B Rx): MC CS		10b (Transportation): 20 trips/year	16b (Comp. Dental): 10 copay	17a1 (Routine Eye Exam): 5 copay	17b1 (Non MCR Covered): 150 allowance	18a (Hearing Exam): 10 copay														0.0782	0.0782	0.2045	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0	0.229846904	0	10	10	0.231	10	10	0.231	0	0	10	5	0	10	0	0	0											0.0782	0.0782	0.2045	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0	0.229846904	0	10	10	0.231	10	10	0.231	0	0	10	5	0	10	0	0	0											24.528	0.105144464	2.192660549	0	3.153590938	4.453436258	2.232277423	3.041383473	7.184095733	0	5.205123001	0.047262363	0	5.830503363	0	2.090811705	0.205393421	1.616714124	4.427117479	1.030311332	2.894622993	0	0	0.78	0.195091285	0	0.010675843	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2243		0	24.528	0.105144464	2.192660549	0	3.153590938	4.453436258	2.232277423	3.041383473	7.184095733	0	5.205123001	0.047262363	0	5.830503363	0	2.090811705	0.205393421	1.616714124	4.427117479	1.030311332	2.894622993	0	0	0.78	0.195091285	0	0.010675843	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2243																																																																																		0			24.528	0.105144464	2.192660549	0	3.153590938	4.453436258	2.232277423	3.041383473	7.184095733	0	5.205123001	0.047262363	0	5.830503363	0	2.090811705	0.205393421	1.616714124	4.427117479	1.030311332	2.894622993	0	0	0.78	0.195091285	0	0.010675843	0	0	0	0	0	0	0	0	0	0	0	0	0	71.2243
H5578_801_0	2009	7																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		223.0137011	1.221093646	12.84434803	3.72326878	8.969614631	14.83443883	6.22854516	7.496245983	29.44634781	6.992574005	19.11252247	0.759378895	0.068372392	18.74445118	83.30660875	63.66254734	1.007577924	4.501526834	48.20171577	6.355767541	15.80395107	0																			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																			0.079105229	0.079105229	0.181771175	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.079105229	0.079105229	0.181771175	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			17.6415	0.096594893	2.334732234	0	2.07198098	3.426755369	1.438793932	1.731632822	6.802106344	1.615284595	4.414992692	0.175416525	0.015794022	4.329968223	19.24382662	14.70604843	0.2327505	1.039852699	11.13459634	1.468182302	3.650712697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.5716		0	17.6415	0.096594893	2.334732234	0	2.07198098	3.426755369	1.438793932	1.731632822	6.802106344	1.615284595	4.414992692	0.175416525	0.015794022	4.329968223	19.24382662	14.70604843	0.2327505	1.039852699	11.13459634	1.468182302	3.650712697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.5716																																																																																		0			17.6415	0.096594893	2.334732234	0	2.07198098	3.426755369	1.438793932	1.731632822	6.802106344	1.615284595	4.414992692	0.175416525	0.015794022	4.329968223	19.24382662	14.70604843	0.2327505	1.039852699	11.13459634	1.468182302	3.650712697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.5716
H5580_001_0	2009	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																																																			0		600.1515128	2.654276421	0.018277311		18.90533982	23.44620766	16.85894548	36.91342833	24.56474689	11.44780481	1.478783138	3.238318119	0.789563589	17.68459637	69.42074947	158.5189402	7.985367755	8.293797376	64.8637682	0.169513735	36.67546391	0.132977814																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	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) - $0	17a1 (Routine Eye Exam) - $0	17a2 (Non MCR Covered) - $175 MAB per year		18b (Non MCR Covered) - $2000 MAB per year													0.070740832	0.070740832	0.148780713		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.070740832	0.070740832	0.148780713		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			42.4552	0.187765723	0.002719311	0	4.367133499	5.41607397	3.894416406	8.527001944	5.674456531	2.644442911	0.341598905	0.748051486	0.182389189	4.085141762	16.03619313	36.61787518	1.844619951	1.915867194	14.98353046	0.039157673	8.472032164	0.030717875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	158.4664	0	0	42.4552	0.187765723	0.002719311	0	4.367133499	5.41607397	3.894416406	8.527001944	5.674456531	2.644442911	0.341598905	0.748051486	0.182389189	4.085141762	16.03619313	36.61787518	1.844619951	1.915867194	14.98353046	0.039157673	8.472032164	0.030717875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	158.4664																																																																																		0	0	0	42.4552	0.187765723	0.002719311	0	4.367133499	5.41607397	3.894416406	8.527001944	5.674456531	2.644442911	0.341598905	0.748051486	0.182389189	4.085141762	16.03619313	36.61787518	1.844619951	1.915867194	14.98353046	0.039157673	8.472032164	0.030717875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	158.4664
H5587_001_0	2009	5																					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	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	2500.140085	483.320637	1178.116627	0	16.7623464	12.28751424	1.410940877	12.9922636	11.6473461	13.96402825	39.99937007	1.177689129	1.451081249	16.42455732	55.40029011	120.1823228	2.020375267	1.680312103	1.200222931	25.46609198	25.37109621	5.589674167		14.98056659	3.732857249	3.823261409		10.5042871	2.3347	7.5											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	Medicare FFS Cost Share		No Cost Sharing- Two Dental Exam/Cleaning per year and One X rays per year	"No Cost Sharing, One vision exam per year"	"No Cost Sharing, $100 toward hardware per year"		No Cost Sharing - $1000 toward hardware per year	No Cost Sharing - Silver Sneaker: Use of ftness facilities and health education seminars	No Cost Sharing - limited to $25 per quarter for OTC Drugs											133.1278968	36.24469704	47.29345265	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231		0	0	0		0	0	0											133.1278968	36.24469704	47.29345265	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231		0	0	0		0	0	0											27.7365	1.459817505	4.643100241	0	3.872102019	2.83841579	0.325927343	3.001212891	2.690536948	3.225690525	9.239854486	0.272046189	0.335199768	3.794072741	12.79746702	27.76211656	0.466706687	0.388152096	0.277251497	5.882667248	5.860723225	1.291214733	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.1608			27.7365	1.459817505	4.643100241	0	3.872102019	2.83841579	0.325927343	3.001212891	2.690536948	3.225690525	9.239854486	0.272046189	0.335199768	3.794072741	12.79746702	27.76211656	0.466706687	0.388152096	0.277251497	5.882667248	5.860723225	1.291214733	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.1608	0																																																																																	0			27.7365	1.459817505	4.643100241	0	3.872102019	2.83841579	0.325927343	3.001212891	2.690536948	3.225690525	9.239854486	0.272046189	0.335199768	3.794072741	12.79746702	27.76211656	0.466706687	0.388152096	0.277251497	5.882667248	5.860723225	1.291214733	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.1608
H5588_001_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		392.9291674	29.25011568	73.76629921	84.45549014	20.11833239	34.27622669	25.53900548	23.41382621	38.24292624	5.253397817	14.53667618	0	5.178485674	42.52204521	81.18267831	151.9730363	13.75413737	8.971305078	49.99988817	57.60021404	8.358575835	1.052271292	0	0	0	0	0	0	0	0											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	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing											0.068463491	0.068463491	0.158822548	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.068463491	0.068463491	0.158822548	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											26.9013	2.002565044	11.71575163	0	4.647334782	7.917808365	5.899510266	5.408593854	8.834115962	1.213534896	3.357972199	0	1.196230191	9.822592444	18.75319869	35.10577139	3.177205732	2.072371473	11.54997417	13.30564944	1.930831018	0.243074669	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	175.0554	0	0	26.9013	2.002565044	11.71575163	0	4.647334782	7.917808365	5.899510266	5.408593854	8.834115962	1.213534896	3.357972199	0	1.196230191	9.822592444	18.75319869	35.10577139	3.177205732	2.072371473	11.54997417	13.30564944	1.930831018	0.243074669	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	175.0554																																																																																		0	0	0	26.9013	2.002565044	11.71575163	0	4.647334782	7.917808365	5.899510266	5.408593854	8.834115962	1.213534896	3.357972199	0	1.196230191	9.822592444	18.75319869	35.10577139	3.177205732	2.072371473	11.54997417	13.30564944	1.930831018	0.243074669	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	175.0554
H5588_002_0	2009	7																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	V	Coin	Coin	Coin	V	V	V	V	V	P	Coin	Coin	T	P	V	Coin	V	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	722.5941848	14.06376845	430.1651696	0	203.7797424	10.61749048	7.044585879	264.1640251	281.727563	0	82.03748871	0	0.404752771	10.9841437	5163.176	6911.196713	179.0229058	607.1248581	109.3885288	1975.182079	5.716353541	0	737.51995	2778.277794	398.2113322	0	187.8284338	0	0	0											$200/Days 1-5 for IP Medical; $200/Days 1-5 for IP Surgical;	$500/Days 1-5 for IP Psych; $500/Days 1-5 for IP Substance Abuse;	$150/Days Custom for SNF	No Cost-Sharing	$100/Run 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;	$150/Case for OP Fac - Surgery; $65/Case for OP Fac - ASC	No Cost-Sharing	$100/Case for OP Fac - CT/MRI/PET	No Cost-Sharing	20% Coinsurance for Renal Dialysis - Fac; 20% Coinsurance for Renal Dialysis - Prof	20% Coinsurance for OP Fac - Cardiovascular; $30/Case for OP Fac - Occ Therapy; $30/Case for OP Fac - Physical/Speech Therapy; $15/Case for OP Fac - CORF; $15/Visit for Prof - CORF; $15/Visit for Prof - CORF;	$10/Visit for PCP - Office Visits; $10/Consult for PCP - Consults; $10/Procedure for PCP - Surgery (Office); $5/Visit for PCP - Tx Injections; $5/Visit for PCP - Allergy Testing; $5/Visit for PCP - Allergy Tx;	$30/Visit for Speclst - Office Visits; $30/Procedure for Speclst - Surgery (Office); $15/Visit for Speclst - Tx Injections; $15/Visit for Speclst - Allergy Testing; $15/Visit for Speclst - Allergy Tx; $30/Consult for Speclst - Consults;	$30/Visit for OP Psych - Non-Physician; $30/Visit for OP Psych - Psychiatrist; $30/Visit for OP Substance Abuse;	$30/Visit for PT/ST (PCP); $30/Visit for Occ Therapy (PCP); $30/Visit for PT/ST (Specialist); $30/Visit for Occ Therapy (Specialist);	$100/Visit for Prof Radiology (Office);	$30/Visit for Chiropractor; $15/Exam for Vistion Exams; $30/Service for Podiatrist; $15/Exam for Hearing/Speech Exams;	20% Coinsurance for Part B Rx	No Cost-Sharing	$5/Service for Non-Emergent Transportation (Routine);	$15/Service for Dental: Preventive Services; $15/Service for Dental: Comprehensive Services;	$15/Service for Vision Exams (Refractions);	No Cost-Sharing	$15/Service for Hearing Exam;	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing											200	500	150	0	100	0.2	0.2	43.08809896	107.2681641	0	100	0	0.2	0.126299701	8.806973763	23.17123292	29.99999999	30	100	24.67566016	0.2	0	5	15	15	0	15	0	0	0											192.1673275	480.4183189	144.1254957	0	96.08366377	0.192167328	0.192167328	41.40062413	103.0671821	0	96.08366379	0	0.192167327	0.12135338	8.462063059	22.26376954	28.82509912	28.82509913	96.08366377	23.70927834	0.192167328	0	4.804183189	14.41254957	14.41254957	0	14.41254957	0	0	0											11.5716	0.563041	5.166480691	0	1.631658688	2.040334771	1.353739242	0.911379626	2.419738837	0	0.656871874	0	0.077780258	1.332962969	3.640926741	12.8224409	0.430029417	1.458369518	0.875870885	3.902511807	1.098496383	0	0.295265079	3.336838868	0.478270047	0	0.225590551	0	0	0	0	0	0	0	0	0	0	0	0	0	56.2902	0	2.2944	11.5716	0.563041	5.166480691	0	1.631658688	2.040334771	1.353739242	0.911379626	2.419738837	0	0.656871874	0	0.077780258	1.332962969	3.640926741	12.8224409	0.430029417	1.458369518	0.875870885	3.902511807	1.098496383	0	0.295265079	3.336838868	0.478270047	0	0.225590551	0	0	0	0	0	0	0	0	0	0	0	0	0	56.2902	0																																																																																	0	0	0	11.5716	0.563041	5.166480691	0	1.631658688	2.040334771	1.353739242	0.911379626	2.419738837	0	0.656871874	0	0.077780258	1.332962969	3.640926741	12.8224409	0.430029417	1.458369518	0.875870885	3.902511807	1.098496383	0	0.295265079	3.336838868	0.478270047	0	0.225590551	0	0	0	0	0	0	0	0	0	0	0	0	0	56.2902
H5590_001_0	2009	7																																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		313.4669061	15.95884693	157.2718677	0	29.70415375	19.8458006	53.01627189	15.7875902	18.59103353	5.602114562	10.51785359	0	21.21104864	59.89677013	54.1327571	95.85062388	65.1445993	2.998820482	22.20533267	65.64855766	5.739226554	0.771738428	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											0.069236325	0.069236325	0.157194996	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.069236325	0.069236325	0.157194996	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											21.7033	1.10493192	24.72235054	0	6.861659517	4.584379939	12.24675881	3.646933336	4.294528746	1.294088464	2.42962418	0	4.899752236	13.8361539	12.50466689	22.14149412	15.04840244	0.692727531	5.129431846	15.16481682	1.325761334	0.178271577	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	173.81	0		21.7033	1.10493192	24.72235054	0	6.861659517	4.584379939	12.24675881	3.646933336	4.294528746	1.294088464	2.42962418	0	4.899752236	13.8361539	12.50466689	22.14149412	15.04840244	0.692727531	5.129431846	15.16481682	1.325761334	0.178271577	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	173.81																																																																																		0	0		21.7033	1.10493192	24.72235054	0	6.861659517	4.584379939	12.24675881	3.646933336	4.294528746	1.294088464	2.42962418	0	4.899752236	13.8361539	12.50466689	22.14149412	15.04840244	0.692727531	5.129431846	15.16481682	1.325761334	0.178271577	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	173.81
H5591_001_0	2009	11																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	P	P	Coin	P	T	V	V	O	V	O	O	O																																																			0		1705.79291	61.25493703	1123.138489		273.6413257	7.248740918	6.576301778	333.8538853	297.1504942		12.36132615	51.54498145	4.167140462	53.3342065	3784.292977	3608.708208	229.8728717	536.5959474		230.215634	22.31769294	417.8382382																			$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	No cost sharing	$20 per Visit	20% Coinsurance	"$20 Eye Exam, $20 Hearing Exam"	No cost sharing	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	No cost sharing	No cost sharing											52.42691036	56.12849028	52.78170262		100	0.2	0.2	47.00255366	75		0.2	50	23.15589857	19.68404908	15	19.99924145	19	19.19582568		20	0.2	19.99374269																			44.34995783	47.48126791	44.65009036		84.59388036	0.169187761	0.169187761	39.761284	63.44541027		0.169187761	42.29694018	19.58847313	16.65150093	12.68908205	16.91813438	16.07283727	16.23849381		16.91877607	0.169187761	16.91348277																			6.3043	0.24237184	4.179019584	0	1.929031797	1.226398244	1.112629772	1.106204929	1.571069585	0	2.091385092	0.181682916	0.006802327	0.074007882	4.001600341	5.087717533	0.307892438	0.726125831	0	0.324580563	3.775880493	0.588924987	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.8376	0	6.3446	6.3043	0.24237184	4.179019584	0	1.929031797	1.226398244	1.112629772	1.106204929	1.571069585	0	2.091385092	0.181682916	0.006802327	0.074007882	4.001600341	5.087717533	0.307892438	0.726125831	0	0.324580563	3.775880493	0.588924987	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.8376	2500					$100 per Trip	30% Coinsurance	"30% Coinsurance, 20% Diabetic Supplies"	ER - $50 per Visit	$125 per Visit		"PET, MRI, CAT, Thera Rad - 30% Coinsurance"	$50 per Visit;	$75 per Visit	"OP Rehab, PT/OT/ST - $30 per visit;"	$30 per Visit	$30 per Visit	Individual - $30 per Visit; Group - $20 per Visit	$30 per Visit		$30 per Visit		"$30 Eye Exam, $30 Hearing Exam"																							0.1245	0.3469	0.3147	0.2526	0.3572		0.7898	0.5423	0.0031	0.129	0.8348	0.8881	0.232	0.1164		0.0464		0.2043																			5.1821	0	0	6.3043	0.24237184	4.179019584	0	2.053563006	1.573328827	1.427376876	1.358766587	1.928263978	0	2.881168078	0.723941514	0.009897562	0.203032291	4.836356516	5.975823357	0.539852928	0.842536041	0	0.370939587	3.775880493	0.793268508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0197
H5591_002_0	2009	8																					3500											D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	P	P	Coin	P	T	V	V	O	V	O	O	O																																																			0		1698.499354	61.25554959	1123.14972		275.663035	8.054156576	7.307001975	370.9171857	330.1672158		13.73480684	57.27220161	4.630156069	59.26022945	4204.769974	4006.766471	162.6726415	596.2177193		255.7951489	22.31769294	464.1194566																			$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	No cost sharing	$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	No cost sharing	$25 per Visit	20% Coinsurance	"$25 Eye Exam, $25 Hearing Exam"			1 Routine Eye Exam - $0 Copay		1 Routine Hearing Exam - $0 Copay			Same cost sharing as in network benefits											78.64036554	84.19273542	63.33804314		150	0.2	0.2	47.00229849	125		0.2	50	29.30349805	24.68168948	20	24.99814019	24	24.19582568		25	0.2	25																			68.06315033	72.86872038	54.81900703		129.8248359	0.173099781	0.173099781	40.68043791	108.1873632		0.173099781	43.27494529	25.3621455	21.36197524	17.30997812	21.63586298	20.77197374	20.94146065		21.63747265	0.173099781	21.63747265																			9.6338	0.371967793	5.130829368	0	2.98232569	1.394172741	1.264840443	1.257422795	2.976660042	0	2.377492058	0.206537616	0.009785891	0.105492963	6.06537302	7.224154198	0.281585986	1.040472492	0	0.461230045	3.863187764	0.836864337	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4842	0	7.4031	9.6338	0.371967793	5.130829368	0	2.98232569	1.394172741	1.264840443	1.257422795	2.976660042	0	2.377492058	0.206537616	0.009785891	0.105492963	6.06537302	7.224154198	0.281585986	1.040472492	0	0.461230045	3.863187764	0.836864337	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4842																																																																																		0	0	0	9.6338	0.371967793	5.130829368	0	2.98232569	1.394172741	1.264840443	1.257422795	2.976660042	0	2.377492058	0.206537616	0.009785891	0.105492963	6.06537302	7.224154198	0.281585986	1.040472492	0	0.461230045	3.863187764	0.836864337	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4842
H5591_003_0	2009	6																					3500											D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	P	P	Coin	P	T	V	V	O	V	O	O	O																																																			0		1676.613436	61.25554959	1123.14972		275.663035	8.054156576	7.307001975	370.9171857	330.1672158		13.73480684	57.27220161	4.630156069	59.26022945	4204.769974	4006.766471	162.6726415	596.2177193		255.7951489	22.31769294	464.1194566																			$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	No cost sharing	$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	No cost sharing	$25 per Visit	20% Coinsurance	"$25 Eye Exam, $25 Hearing Exam"			1 Routine Eye Exam - $0 Copay		1 Routine Hearing Exam - $0 Copay			Same Cost Sharing as In-Network Benefits											78.64036554	84.19273542	63.33804314		150	0.2	0.2	47.00229849	125		0.2	50	29.30349805	24.68168948	20	24.99814019	24	24.19582568		25	0.2	25																			68.10290049	72.91127709	54.85102237		129.900656	0.173200875	0.173200875	40.70419605	108.2505467		0.173200875	43.30021867	25.37695747	21.37445103	17.32008747	21.64849873	20.78410496	20.95369086		21.65010934	0.173200875	21.65010934																			9.5152	0.372185029	5.133825869	0	2.984067424	1.394986964	1.265579134	1.258157154	2.978398467	0	2.378880558	0.206658238	0.009791606	0.105554573	6.068915311	7.22837324	0.281750438	1.041080148	0	0.461499412	3.865443938	0.837353082	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.3877	0	7.3561	9.5152	0.372185029	5.133825869	0	2.984067424	1.394986964	1.265579134	1.258157154	2.978398467	0	2.378880558	0.206658238	0.009791606	0.105554573	6.068915311	7.22837324	0.281750438	1.041080148	0	0.461499412	3.865443938	0.837353082	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.3877																																																																																		0	0	0	9.5152	0.372185029	5.133825869	0	2.984067424	1.394986964	1.265579134	1.258157154	2.978398467	0	2.378880558	0.206658238	0.009791606	0.105554573	6.068915311	7.22837324	0.281750438	1.041080148	0	0.461499412	3.865443938	0.837353082	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.3877
H5594_001_0	2009	8																					3350											D	D	D	V	T	Coin	Coin	V	V		V			0	V	V	V	V	V		Coin					V		V																																																					0		1283.249313	80.04584743	953.6065405	2296.765193	243.011721	10.86255059	0.274239313	144.4968619	185.4724421		525.091478			5682.070646	5276.568264	6762.145879	675.5861656	1984.538329	2051.1586		19.19587621					249.1947493		14.59050122													$100 days 1-7	$100 days 1-7	$50 8-100	25	100	20%	0.2/0	50 ER/20 UC	250 OP/ 50 ASC		0 Basic/ 150 Rad/250Otr			20 Rehab/20 Sub Abs	5	20	20	20	0 Basic/ 150 Rad/250Otr		20% coin					10		10													75.12131465	52.54732954	25.25441885	25	100	0.2	0.01891757	33.4	248.8012092		49.57278839			8	4.75	17.2	20	20	25		0.2					10		10													66.10675689	46.24164999	22.22388859	22	88	0.176	0.016647462	29.392	218.9450641		43.62405378			7.04	4.18	15.136	17.6	17.6	22		0.176					8.8		8.8													7.0693	0.308454338	1.76607046	4.210736187	1.782085954	1.911808904	0.004565388	0.35392098	3.384022977	0	1.908884906	0	0	3.333481446	1.838004612	8.529320002	0.99085971	2.910656215	3.760457434	0	3.378474213	0	0	0	0	0.182742816	0	0.010699701	0	0	0	0	0	0	0	0	0	0	0	0	47.6345		6.8042	7.0693	0.308454338	1.76607046	4.210736187	1.782085954	1.911808904	0.004565388	0.35392098	3.384022977	0	1.908884906	0	0	3.333481446	1.838004612	8.529320002	0.99085971	2.910656215	3.760457434	0	3.378474213	0	0	0	0	0.182742816	0	0.010699701	0	0	0	0	0	0	0	0	0	0	0	0	47.6345		$100 days 1-7	$100 days 1-7	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%																		0.2186	0.0095	0.1784	0.0861	0.0206	0.0672	0.0017	0.0226	0.0811	0.0139	0.0151	0.0042	0	0.0683	0.1413	0.1635	0.0155	0.0304	0.1034	0.6521	0.1187	0	0																		2.0122		0	7.2879	0.317994163	1.944468986	4.296804508	1.80271874	1.978999939	0.006261714	0.376526363	3.465085883	0.013858032	1.924000371	0.004233268	0	3.401750909	1.979265329	8.692802055	1.006349416	2.9410595	3.863886496	0.652123045	3.497211592	0	0	0	0	0.182742816	0	0.010699701	0	0	0	0	0	0	0	0	0	0	0	0	49.6468
H5594_002_0	2009	8																					2500											D		D			Coin	Coin	V	V		P								P		Coin				V		V																																																						0		1745.01669		1343.763904			16.075129	0.361247142	430.9555599	259.669308		281.9621577								2328.44393		27.89086174				0		26.5220105														$50 (6-10)		$100 (21-100)			0.2	0.2/0	50 ER/10 UC	200 OP/ 0 ASC		0 Basic/ 50 Rad/250Otr								0 Basic/ 50 Rad/250Otr		20% coin				10		0														9.534042337		10.39695293			0.2	0.14612971	36.9	198.8012092		29.38550665								29.38550665		0.2				10		10														9.146612195		9.974457115			0.191872699	0.140191509	35.40051303	190.7226232		28.19138242								28.19138242		0.191872699				9.593634968		9.593634968														1.3301	0	1.116942952	0	0	3.084378395	0.050643782	1.271337326	4.127067633	0	0.662408585	0	0	0	0	0	0	0	5.470171105	0	5.35149493	0	0	0	0	0	0.021203541	0	0	0	0	0	0	0	0	0	0	0	0	0	22.4857		0.9604	1.3301	0	1.116942952	0	0	3.084378395	0.050643782	1.271337326	4.127067633	0	0.662408585	0	0	0	0	0	0	0	5.470171105	0	5.35149493	0	0	0	0	0	0.021203541	0	0	0	0	0	0	0	0	0	0	0	0	0	22.4857		$50 (6-10)		0.2	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	0.2																		0.0411		0.2421	0.1162	0.0337	0.0994	0.0022	0.054	0.1264	0.0274	0.0199	0.0056	0	0.1007	0.1884	0.2154	0.0204	0.0485	0.139	0.8802	0.1725	0	0.0001																		2.5333		0	1.3712	0	1.358995703	0.116196627	0.033709524	3.183812182	0.052878301	1.325304716	4.253509399	0.027358499	0.682319728	0.005576356	0	0.100675506	0.188357022	0.215439973	0.020404121	0.0485346	5.6092063	0.880197837	5.524015724	0	0.000110954	0	0	0	0.021203541	0	0	0	0	0	0	0	0	0	0	0	0	0	25.019
H5594_004_0	2009	9																																D	D	D						V																		V																																																						0		1798.986279	110.7804019	1385.323612						267.7003175																		27.34227887														$25 Copay (16-90)	$25 Copay (16-90)	$25 Copay (31-100)						$25 Per Visit																		$25 Per Visit														2.258874919	6.568416192	0.268702017						24.85015115																		0														2.258874919	6.568416192	0.268702017						24.85015115																		0														0.3386	0.060637649	0.031019937	0	0	0	0	0	0.554366113	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.9847		0	0.3386	0.060637649	0.031019937	0	0	0	0	0	0.554366113	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.9847	4000																																																																																	0		0	0.3386	0.060637649	0.031019937	0	0	0	0	0	0.554366113	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.9847
H5594_005_0	2009	8																					3350											D	D	D	V	T	Coin	Coin	V	V		V			0	V	V	V	V	V		Coin					V		V																																																					0		1283.249313	80.04584743	953.6065405	2296.765193	243.011721	10.86255059	0.274239313	144.4968619	185.4724421		525.091478			5682.070646	5276.568264	6762.145879	675.5861656	1984.538329	2051.1586		19.19587621					249.1947493		14.59050122													$200 days 1-7	$200 days 1-7	$100 (10-100)	30	100	0.2	0.2/0	50 ER/20 UC	200 OP/ 50 ASC		0 Basic/ 50 Rad/200Otr			20 Rehab/20 Sub Abs	10	20	20	20	0 Basic/ 50 Rad/200Otr		20% coin					10		10													150.2426293	105.0946591	40.74391478	30	100	0.2	0.000130908	33.4	199.1009069		23.90087517			8	9.5	17.2	20	20	23.90087517		0.2					10		10													143.2793553	100.2238517	38.85556228	28.60959421	95.36531404	0.190730628	0.000124841	31.85201489	189.8732051		22.79314467			7.629225123	9.059704834	16.40283402	19.07306281	19.07306281	22.79314467		0.190730628					9.536531404		9.536531404													15.3219	0.668541928	3.087743194	5.475793347	1.931240758	2.071821097	3.42E-05	0.383543016	2.934687254	0	0.997373835	0	0	3.612483011	3.98367925	9.24319637	1.073791447	3.154268682	3.896029559	0	3.661241526	0	0	0	0	0.198037796	0	0.011595231	0	0	0	0	0	0	0	0	0	0	0	0	61.707		2.9989	15.3219	0.668541928	3.087743194	5.475793347	1.931240758	2.071821097	3.42E-05	0.383543016	2.934687254	0	0.997373835	0	0	3.612483011	3.98367925	9.24319637	1.073791447	3.154268682	3.896029559	0	3.661241526	0	0	0	0	0.198037796	0	0.011595231	0	0	0	0	0	0	0	0	0	0	0	0	61.707		$200 days 1-7	$200 days 1-7	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%	20%																		0.4739	0.0006	0.1784	0.0861	0.0206	0.0672	0.0017	0.0226	0.0811	0.0139	0.0151	0.0042	0	0.0683	0.1413	0.1635	0.0155	0.0304	0.1034	0.6521	0.1187	0	0																		2.2585		0	15.7958	0.66911864	3.26614172	5.561861669	1.951873544	2.139012131	0.001730562	0.406148399	3.015750159	0.013858032	1.0124893	0.004233268	0	3.680752474	4.124939967	9.406678423	1.089281154	3.184671967	3.999458621	0.652123045	3.779978905	0	0	0	0	0.198037796	0	0.011595231	0	0	0	0	0	0	0	0	0	0	0	0	63.9655
H5594_006_0	2009	8																					3000											D	D	D		T	Coin	Coin	V	V		V			V		V	V	V			Coin				V	V	V																																																						0		1745.01669	107.4569899	1343.763904		209.8321622	16.075129	0.361247142	430.9555599	259.669308		281.9621577			8058.567894		7439.931303	906.9359385	8393.901769			27.89086174				0	234.719793	26.5220105														$50 day 1-7	$50 day 1-7	$50 8-100		100	0.2	0.2/0	50 ER/20 UC	150 OP/ 50 ASC		0 Basic/ 25 Rad/150Otr			20 Rehab/10 Sub Abs		10	10	20			20% coin				10	10	10														37.56065733	26.27366477	25.23894543		100	0.2	0.18	33.4	149.4006046		17.43506907			7.5		8.6	10	15			0.2				10	10	10														33.25092404	23.25900806	22.34301306		88.52593753	0.177051875	0.159346688	29.56766313	132.2582859		15.43455835			6.639445315		7.613230627	8.852593753	13.27889063			0.177051875				8.852593753	8.852593753	8.852593753														4.8353	0.208278583	2.501977871	0	1.547965741	2.846131732	0.057563536	1.061862402	2.861951465	0	0.362663448	0	0	4.458701737	0	4.720159405	0.669061285	9.288475295	0	0	4.938129368	0	0	0	0	0.173156581	0.019565715	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5509		5.2559	4.8353	0.208278583	2.501977871	0	1.547965741	2.846131732	0.057563536	1.061862402	2.861951465	0	0.362663448	0	0	4.458701737	0	4.720159405	0.669061285	9.288475295	0	0	4.938129368	0	0	0	0	0.173156581	0.019565715	0	0	0	0	0	0	0	0	0	0	0	0	0	40.5509		$50 day 1-7	$50 day 1-7	0.2	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																			0.1495	0.0064	0.2421	0.1162	0.0337	0.0994	0.0022	0.054	0.1264	0.0274	0.0199	0.0056	0	0.1007	0.1884	0.2154	0.0204	0.0485	0.139	0.8802	0.1725	0																			2.648		0	4.9848	0.214720188	2.744030622	0.116196627	1.581675265	2.94556552	0.059798054	1.115829791	2.988393231	0.027358499	0.382574592	0.005576356	0	4.559377243	0.188357022	4.935599378	0.689465406	9.337009895	0.139035195	0.880197837	5.110650163	0	0	0	0	0.173156581	0.019565715	0	0	0	0	0	0	0	0	0	0	0	0	0	43.199
H5594_007_0	2009	9																					3350											D	D	D	V	T	Coin	Coin	V	V		V			V	V	V	V	V	V		Coin				V	V	V																																																						0		1283.249313	80.04584743	953.6065405	2296.765193	243.011721	10.86255059	0.274239313	144.4968619	185.4724421		525.091478			5682.070646	5276.568264	6762.145879	675.5861656	1984.538329	2051.1586		19.19587621				239.5578016	249.1947493	112.5909141														$200 days 1-7	$200 days 1-7	$100 (8-100)	25	100	20%	0.2/0	50 ER/0 UC	250 OP/ 100 ASC		0 Basic/ 50 Rad/250Otr			25 Rehab/25 Sub Abs	10	25	25	25	0 Basic/ 50 Rad/250Otr		20% coin				10	10	10														150.2426293	105.0946591	50.50883771	25	100	0.2	0.000130908	30.7	249.1009069		29.38550665			10	9.5	21.5	25	25	29.38550665		0.2				10	10	10														137.3319479	96.0636426	46.16850158	22.85169471	91.40677885	0.182813558	0.000119659	28.06188111	227.6951151		26.86034508			9.140677885	8.68364399	19.65245745	22.85169471	22.85169471	26.86034508		0.182813558				9.140677885	9.140677885	9.140677885														14.6859	0.640791307	3.668882089	4.373748084	1.851076554	1.985821519	3.28E-05	0.33790448	3.519264088	0	1.175344858	0	0	4.328164791	3.818320024	11.07439868	1.286524067	3.779172002	4.591235651	0	3.509266423	0	0	0	0.182476725	0.189817411	0.085763107	0	0	0	0	0	0	0	0	0	0	0	0	0	65.0839		6.1186	14.6859	0.640791307	3.668882089	4.373748084	1.851076554	1.985821519	3.28E-05	0.33790448	3.519264088	0	1.175344858	0	0	4.328164791	3.818320024	11.07439868	1.286524067	3.779172002	4.591235651	0	3.509266423	0	0	0	0.182476725	0.189817411	0.085763107	0	0	0	0	0	0	0	0	0	0	0	0	0	65.0839		$200 days 1-7	$200 days 1-7	0.2	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	0.2																		0.0132	0.0006	0.1784	0.0861	0.0206	0.0672	0.0017	0.0226	0.0811	0.0139	0.0151	0.0042	0	0.0683	0.1413	0.1635	0.0155	0.0304	0.1034	0.6521	0.1187	0	0																		1.7979		0	14.6991	0.641368019	3.847280616	4.459816406	1.87170934	2.053012554	0.001729141	0.360509862	3.600326993	0.013858032	1.190460322	0.004233268	0	4.396434255	3.959580741	11.23788073	1.302013773	3.809575287	4.694664713	0.652123045	3.628003802	0	0	0	0.182476725	0.189817411	0.085763107	0	0	0	0	0	0	0	0	0	0	0	0	0	66.8818
H5594_008_0	2009	9																					3000											Ded	Ded	Ded	V	T	Coin	Coin	V	V		V			O		V	V	V	0		Coin					V															0	0	0	0	0	0	0	0	0		0			0		0	0	0	0		0					0															0		1745.01669	107.4569899	1343.763904	4038.374975	209.8321622	16.075129	0.361247142	430.9555599	259.669308		281.9621577			8058.567894		7439.931303	906.9359385	8393.901769	2328.44393		27.89086174					234.719793															$150 day 1-7	$150 day 1-7	$100 8-100	0	100	20%	0%-20%	50 ER/0 UC	200 OP/ 50 ASC		0 Basic/ 25 Rad/200Otr			20 Rehab/20 Sub Abs		20	20	20	0 Basic/ 25 Rad/200Otr		20% coin					10															112.681972	78.82099431	50.50883771	0	100	0.2	0.14612971	30.7	199.1009069		22.91970055			8		17.2	20	20	22.91970055		0.2					10															94.42739986	66.05192842	42.32636447	0	83.79991777	0.167599836	0.122456577	25.72657476	166.8463963		19.20669021			6.703993422		14.41358586	16.75998355	16.75998355	19.20669021		0.167599836					8.379991777															13.7314	0.59147845	4.739720062	0	1.465326495	2.694188977	0.044237088	0.923917536	3.610407355	0	0.451296651	0	0	4.502048846	0	8.936340717	1.266685951	11.7234713	3.726808436	0	4.674503841	0	0	0	0	0.163912495	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.2458		12.2266	13.7314	0.59147845	4.739720062	0	1.465326495	2.694188977	0.044237088	0.923917536	3.610407355	0	0.451296651	0	0	4.502048846	0	8.936340717	1.266685951	11.7234713	3.726808436	0	4.674503841	0	0	0	0	0.163912495	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.2458		$150 day 1-7	$150 day 1-7	0.2	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																			0.4247	0.0183	0.2421	0.1162	0.0337	0.0994	0.0022	0.054	0.1264	0.0274	0.0199	0.0056	0	0.1007	0.1884	0.2154	0.0204	0.0485	0.139	0.8802	0.1725	0																			2.935		0	14.1561	0.609771598	4.981772813	0.116196627	1.499036019	2.793622765	0.046471607	0.977884925	3.736849121	0.027358499	0.471207795	0.005576356	0	4.602724352	0.188357022	9.15178069	1.287090072	11.7720059	3.865843631	0.880197837	4.847024635	0	0	0	0	0.163912495	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.1808
H5594_009_0	2009	10																					3350											D	D		V	T	Coin	Coin	V	V		V			V	V	V	V	V	V		Coin			P																	0	0		0	0	0	0	0	0		0			0	0	0	0	0	0		0			0																	0		1157.570257	72.20630567		2071.824272	219.211604	9.798692543	0.247380823	130.3451074	167.3076153		473.6649931			5125.579191	4759.790959	6099.87386	609.4205102	1790.176327	1850.271933		17.31586772			100																	$350 1st 7 days	$350 1st 7 days		$35 per visit	$100 per trip	20% coin	20% coin	$50 ER/ $25 UC	$300 hosp; $100 ASC		$25-$300			Sbst Abs/PT/OT/ST	$10 ($0 Preventive)	$35 ($0 Preventive)	$35 	$50 	$25-$300		20% coin			X-ray (only) $75																	262.9246013	183.9156534		35	90	0.2	0.2	36	298.8012092		44.30392767			19.25	9.5	30.1	35	50	44.30392767		0.2			8.333333333																	225.4571112	157.7071591		30.01240224	77.17474862	0.171499441	0.171499441	30.86989945	256.2212023		37.99049423			16.50682123	8.146223466	25.81066593	30.01240224	42.87486035	37.99049423		0.171499441			7.145810058																	21.7485	0.948954278	0	5.181701952	1.409800036	1.680470297	0.042425673	0.335311697	3.572313196	0	1.499563932	0	0	7.050584952	3.2311934	13.12015053	1.524181124	6.396130002	5.857728767	0	2.96966164	0	0	0.059548417	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.6283		12.7344	21.7485	0.948954278	0	5.181701952	1.409800036	1.680470297	0.042425673	0.335311697	3.572313196	0	1.499563932	0	0	7.050584952	3.2311934	13.12015053	1.524181124	6.396130002	5.857728767	0	2.96966164	0	0	0.059548417	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.6283		$350 1st 7 days	$350 1st 7 days		$35 per visit	$100 per trip	20% coin	20% coin	$50 ER/ $25 UC	$300 hosp; $100 ASC		$25-$300			Sbst Abs/PT/OT/ST	$10 ($0 Preventive)	$35 ($0 Preventive)	$35 	$50 	$25-$300		20% coin			X-ray (only) $75																	3.1069	0.1356		0.7402	0.2014	0.2401	0.0061	0.0479	0.5103		0.2142			1.0072	0.4616	1.8743	0.2177	0.9137	0.8368		0.4242			0.0018																	10.9402		0	24.8555	1.084519175	0	5.921945087	1.611200042	1.920537483	0.048486483	0.383213368	4.082643652	0	1.713787351	0	0	8.057811374	3.692792458	14.99445775	1.741921284	7.30986286	6.694547163	0	3.393899017	0	0	0.061390121	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.5685
H5608_001_0	2009	8																																Coin	Coin	Coin	Coin	Coin	Coin	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		463.1996958	13.69075625	37.9842514		17.37351193	25.2143447	12.80916152	25.16387798	20.46678972	14.75723095	21.17051595	4.690840543	0.81656111	55.70475749	86.11519736	24.11856744	16.12087642	6.816430718	6.382333703	19.04780172	5.981203292																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	10B: Additional Transportation	16A&16B: $2500 Allowance		17B: $200 Allowance/2 yrs		18B: $1500 Allowance/3 yrs		13C: OTC $30 per month											0.0721	0.0721	0.1587		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.0721	0.0721	0.1587		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				33.3967	0.987103525	6.028100698	0	4.013281257	5.824513626	2.958916311	5.812855813	4.727828426	3.408920349	4.890389183	1.083584165	0.188625616	12.86779898	19.89261059	5.57138908	3.723922452	1.574595496	1.474319085	4.400042197	1.38165796	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.2072	0	0	33.3967	0.987103525	6.028100698	0	4.013281257	5.824513626	2.958916311	5.812855813	4.727828426	3.408920349	4.890389183	1.083584165	0.188625616	12.86779898	19.89261059	5.57138908	3.723922452	1.574595496	1.474319085	4.400042197	1.38165796	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.2072																																																																																		0	0	0	33.3967	0.987103525	6.028100698	0	4.013281257	5.824513626	2.958916311	5.812855813	4.727828426	3.408920349	4.890389183	1.083584165	0.188625616	12.86779898	19.89261059	5.57138908	3.723922452	1.574595496	1.474319085	4.400042197	1.38165796	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.2072
H5608_002_0	2009	13																																Coin	Coin	Coin	Coin	Coin	Coin	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		326.6576289	15.75380539	37.13403716		12.45115476	17.90594304	18.27033305	22.23219451	25.95767089	12.23314277	22.86392805	3.739433434	0.80683641	48.81971601		50.54275286	5.71769161	9.179466899	13.13741088	6.97755878	11.41641142																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	23% Coinsurance	23% Coinsurance	23% Coinsurance	23% Coinsurance	23% Coinsurance	23% Coinsurance	23% Coinsurance	23% Coinsurance	23% Coinsurance	23% Coinsurance		23% Coinsurance	23% Coinsurance	23% Coinsurance	23% Coinsurance	23% Coinsurance	23% Coinsurance		10B: Additional Transportation Options	16A&16B: $2000 Allowance		17B: $200 Allowance/2 yrs		18B: $1500 Allowance/3 yrs		13C: $24.00 per month OTC Card											0.0721	0.0721	0.1587		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231																				0.0721	0.0721	0.1587		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231																				23.552	1.135849369	5.893171697	0	2.876216749	4.136272842	4.220446934	5.135636931	5.996221975	2.82585598	5.28156738	0.863809123	0.186379211	11.2773544	0	11.67537591	1.320786762	2.120456854	3.034741912	1.611816078	2.637191038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.7812	0	0	23.552	1.135849369	5.893171697	0	2.876216749	4.136272842	4.220446934	5.135636931	5.996221975	2.82585598	5.28156738	0.863809123	0.186379211	11.2773544	0	11.67537591	1.320786762	2.120456854	3.034741912	1.611816078	2.637191038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.7812																																																																																		0	0	0	23.552	1.135849369	5.893171697	0	2.876216749	4.136272842	4.220446934	5.135636931	5.996221975	2.82585598	5.28156738	0.863809123	0.186379211	11.2773544	0	11.67537591	1.320786762	2.120456854	3.034741912	1.611816078	2.637191038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.7812
H5608_003_0	2009	6																					3750											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	V	O	P																																																			0		1392.920413	125.3296978	1100.013961		163.2851768	8.987841771	18.64423223	306.6651073	271.5995628	568.4022721	432.179419	105.8271229	0.036906533	902.9160723	3368.71142	4352.327065	286.2365123	861.2450889	3789.715743	9012.599384	30.15309974				110.9917601		197.588524														1a: $175/d (1-5) then $0;1a1: $175/d (1-5) then $0	1b: $175/d (1-5) then $0	2a1: $0/d (1-7) then $100/d (21+);2a2: $0/d (1-7) then $100/d (21+)	6a: $0	10a: $150/trip	11a: 20%	11b: 20%;11c: 20%	4a: $50/visit;4a1: $50/visit;4b: $30/visit	9a: $175/visit;9b: $175/visit	8a: $10/visit	8b: $10/visit;8b: $50/visit;8b: $100/visit	9a: $175/visit	12a: 20%	3: $50/visit;5: $60/visit;9a: $175/visit;9c: $30/visit;9d: $30/visit	7a: $10/visit;14c: $10/visit;14c1: $10/visit;14i: $10 - $30	7b: $30/visit;7d: $30/visit;7f: $30/visit;16b: $30/visit;17a: $30/visit;18a: $30/visit	7e: $30/visit;7h: $30/visit	7c: $30/visit;7i: $30/visit	7a: $10; 7d: $30; 8b: $10/visit	7g: $10 PCP -$30 Spec/visit	15: 20%	13a: $0		16b: 1 cleaning exam and xray per year	17a: $30/visit	17b: $100 allowance	18a: $30/visit														124.3737569	76.27504139	53.49108736		150	0.2	0.2	46.00258743	160.4940628	10	55.02770997	175	0.386973192	37.70236282	10	29.99823828	29.87499116	28.97898035	8.249919367	8.788885462	0.2				30		30														110.2487767	67.61257528	47.41616793		132.9646777	0.177286237	0.177286237	40.77812806	142.2669422	8.864311845	48.77827813	155.1254573	0.343025105	33.42055013	8.864311845	26.59137389	26.4821238	25.68787188	7.312985797	7.79074215	0.177286237				26.59293553		26.59293553														12.7973	0.706155302	4.346537226	0	1.809263409	1.593420645	3.305365771	1.042102418	3.219969941	0.419874583	1.756747325	1.368040069	0.012659867	2.514662655	2.488442379	9.644529689	0.63167923	1.843629458	2.30951145	5.851236492	5.345729584	0	0	0	0.245966393	0	0.437871573	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6907	0	8.16	12.7973	0.706155302	4.346537226	0	1.809263409	1.593420645	3.305365771	1.042102418	3.219969941	0.419874583	1.756747325	1.368040069	0.012659867	2.514662655	2.488442379	9.644529689	0.63167923	1.843629458	2.30951145	5.851236492	5.345729584	0	0	0	0.245966393	0	0.437871573	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6907																																																																																		0	0	0	12.7973	0.706155302	4.346537226	0	1.809263409	1.593420645	3.305365771	1.042102418	3.219969941	0.419874583	1.756747325	1.368040069	0.012659867	2.514662655	2.488442379	9.644529689	0.63167923	1.843629458	2.30951145	5.851236492	5.345729584	0	0	0	0.245966393	0	0.437871573	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6907
H5608_801_0	2009	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																																																			0		316.2715674	7.90216377	43.9915601		7.79017586	10.24539403	14.59608772	14.6713341	30.48250442	4.996593662	23.07428262	5.715191129	0.231629535	30.15997921	53.87436857	75.10617097	6.240431435	12.11178542	23.92874169	24.26849043	29.13782316																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.0721	0.0721	0.1587		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.0721	0.0721	0.1587		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				22.8032	0.569746008	6.981460587	0	1.799530624	2.366686022	3.371696263	3.389078177	7.041458521	1.154213136	5.330159286	1.320209151	0.053506423	6.966955198	12.44497914	17.34952549	1.441539661	2.797822432	5.52753933	5.606021289	6.730837149	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.0461	0	0	22.8032	0.569746008	6.981460587	0	1.799530624	2.366686022	3.371696263	3.389078177	7.041458521	1.154213136	5.330159286	1.320209151	0.053506423	6.966955198	12.44497914	17.34952549	1.441539661	2.797822432	5.52753933	5.606021289	6.730837149	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.0461																																																																																		0	0	0	22.8032	0.569746008	6.981460587	0	1.799530624	2.366686022	3.371696263	3.389078177	7.041458521	1.154213136	5.330159286	1.320209151	0.053506423	6.966955198	12.44497914	17.34952549	1.441539661	2.797822432	5.52753933	5.606021289	6.730837149	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.0461
H5609_001_0	2009	11																																D	A	D		T	Coin	Coin	V	V					V	V	V	V	V	Coin		Coin			V	V		V																																																						0		1549.238482	168.4452612	1492.655912		147.563055	10.57536628	5.52674535	368.5324808	558.2085748					55.86501956	6378.63527	5573.602829	0	25.61400106	27.5625		24.80562317			638.6162862	476.6360568		318.0213878														$100 days 1-5	$948.48 per admit	$75 days 15-100		$175 waived if admitted	20% coinsurance	"Pros/Med Supplies 20%, Diabetic Supplies 0%"	"$50 ER, $10 UC waived if admitted"	$100 					$0 to $30 varies by service	$5 / $0 preventive	$10 / $0 preventive	$30 	$10 	"0% Diagnostic, 20% Therapeutic"		20%			"$2 to $425, varies by service"	"$10 covered, $20 non-covered"		$10 														64.84414681	105.4028875	17.33351187		140	0.2	0.18	36.9	100					1.5	4.75	8.833333333	30	10	0.02		0.2			20	15		10														61.09308703	99.30561347	16.33081475		131.9013759	0.188430537	0.169587483	34.76543408	94.21526851					1.413229028	4.475225254	8.322348719	28.26458055	9.421526851	0.018843054		0.188430537			18.8430537	14.13229028		9.421526851														7.8873	1.393963333	2.031357266	0	1.621980833	1.992721947	0.937266835	1.067682639	4.382647564	0	0	0	0	0.006579172	2.378819137	3.86545553	0	0.02011025	0.519361668	0	4.674136895	0	0	1.002790081	0.561329926	0	0.249687254	0	0	0	0	0	0	0	0	0	0	0	0	0	34.5932		2.124	7.8873	1.393963333	2.031357266	0	1.621980833	1.992721947	0.937266835	1.067682639	4.382647564	0	0	0	0	0.006579172	2.378819137	3.86545553	0	0.02011025	0.519361668	0	4.674136895	0	0	1.002790081	0.561329926	0	0.249687254	0	0	0	0	0	0	0	0	0	0	0	0	0	34.5932	3350																																																																																	0			7.8873	1.393963333	2.031357266	0	1.621980833	1.992721947	0.937266835	1.067682639	4.382647564	0	0	0	0	0.006579172	2.378819137	3.86545553	0	0.02011025	0.519361668	0	4.674136895	0	0	1.002790081	0.561329926	0	0.249687254	0	0	0	0	0	0	0	0	0	0	0	0	0	34.5932
H5609_801_0	2009	2																																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		217.9910792	8.509455075	25.17048305		9.862279062	10.96367082	4.518525142	4.736257677	28.00644024	0.136827158	12.13778894	1.210798374	0.198818302	3.39083222	308.1511525	8.657692549	0	0.125388838	0	0.000237445	11.18778214																				FFS Medicare Act. Equiv. Cost Sharing	FFS Medicare Act. Equiv. Cost Sharing	FFS Medicare Act. Equiv. Cost Sharing		FFS Medicare Act. Equiv. Cost Sharing	FFS Medicare Act. Equiv. Cost Sharing	FFS Medicare Act. Equiv. Cost Sharing	FFS Medicare Act. Equiv. Cost Sharing	FFS Medicare Act. Equiv. Cost Sharing	FFS Medicare Act. Equiv. Cost Sharing	FFS Medicare Act. Equiv. Cost Sharing	FFS Medicare Act. Equiv. Cost Sharing	FFS Medicare Act. Equiv. Cost Sharing	FFS Medicare Act. Equiv. Cost Sharing	FFS Medicare Act. Equiv. Cost Sharing	FFS Medicare Act. Equiv. Cost Sharing	FFS Medicare Act. Equiv. Cost Sharing	FFS Medicare Act. Equiv. Cost Sharing	FFS Medicare Act. Equiv. Cost Sharing	FFS Medicare Act. Equiv. Cost Sharing	FFS Medicare Act. Equiv. Cost Sharing																				0.0632	0.0632	0.1884		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.0632	0.0632	0.1884		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				13.777	0.537797561	4.742119007	0	2.278186463	2.532607959	1.043779308	1.094075523	6.469487696	0.031607074	2.803829246	0.279694424	0.045927028	0.783282243	71.18291623	1.999926979	0	0.028964822	0	5.48E-05	2.584377675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.2157			13.777	0.537797561	4.742119007	0	2.278186463	2.532607959	1.043779308	1.094075523	6.469487696	0.031607074	2.803829246	0.279694424	0.045927028	0.783282243	71.18291623	1.999926979	0	0.028964822	0	5.48E-05	2.584377675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.2157																																																																																		0			13.777	0.537797561	4.742119007	0	2.278186463	2.532607959	1.043779308	1.094075523	6.469487696	0.031607074	2.803829246	0.279694424	0.045927028	0.783282243	71.18291623	1.999926979	0	0.028964822	0	5.48E-05	2.584377675	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.2157
H5619_001_0	2009	8																					3300											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1396.312698	16.19972392	468.6080453	26.74894978	198.8409784	10.85377041	4.557179409	42.92026452	806.8165135	5.116189006	13.98387451	0.555607413	0.050025367	13.71457134	10755.63731	2667.272805	180.258572	60.57817579	5613.332631	1755.135523	11.56312406	0	0	923.5059296	424.3723106	8.124346752	1.434685651	0	0	0											1a (IP Acute): 150 days 1-5	1b (IP Psych): 260 days 1-5	2a (SNF): 25 days 11-100	6a (Home Health): 15 copay	10a (Ambulance): 125 copay	11a (DME): 15% coin	11b (Medical Supplies): 15% coin	4a (ER): 50 copay	9b (OP Surg): 425 copay; 9b (OP ASC): 125 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 15% coin; 9c (OP SA): 50 copay; 3 (CORF): 30 copay; 5 (Partial Hosp): 50 copay; 9d (OP Cardiac Rehab): 25 copay	7a (PCP w/Copay): 5 copay	7b (Chiro): 15 copay; 7d (SPC w/Copay): 25 copay	7h (Psych): 50 copay; 7e (MH Non-Phys): 50 copay	7i (PT/ST): 25 copay; 7c (OT): 25 copay	7g (Prof. Other): 25 copay	7g (Prof. Other): 25 copay	15 (Part B Rx): 20% coin			16b (Comp. Dental): 25 copay	17a1 (Routine Eye Exam): 10 copay	17b1 (Non MCR Covered): 150 allowance	18a (Hearing Exam): 25 copay														71.7787416	122.0489843	12.13900868	15	125	0.15	0.15	50	424.4563379	0	0.150412614	0.15	0.2	0.148088952	4.688405763	23.53026593	50	25	25	25	0.2	0	0	25	10	0	25	0	0	0											59.3610078	100.9344905	10.03895823	12.4049976	103.37498	0.124049976	0.124049976	41.34999199	351.0253234	0	0.124391208	0.124049976	0.165399968	0.12246954	3.877310815	19.45952615	41.34999199	20.67499599	20.67499599	20.67499599	0.165399968	0	0	20.67499599	10	0	25	0	0	0											6.9072	0.13625924	0.392028049	0.027651721	1.712931846	1.346409959	0.565317996	0.14789605	23.60108563	0	1.739471042	0.068923086	0.008274194	1.679617241	3.475245739	4.325322074	0.621140876	0.104371128	9.671302473	3.023951658	1.912540349	0	0	1.59112345	0.353643592	0	0.002988928	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4147		13.1911	6.9072	0.13625924	0.392028049	0.027651721	1.712931846	1.346409959	0.565317996	0.14789605	23.60108563	0	1.739471042	0.068923086	0.008274194	1.679617241	3.475245739	4.325322074	0.621140876	0.104371128	9.671302473	3.023951658	1.912540349	0	0	1.59112345	0.353643592	0	0.002988928	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4147																																																																																		0			6.9072	0.13625924	0.392028049	0.027651721	1.712931846	1.346409959	0.565317996	0.14789605	23.60108563	0	1.739471042	0.068923086	0.008274194	1.679617241	3.475245739	4.325322074	0.621140876	0.104371128	9.671302473	3.023951658	1.912540349	0	0	1.59112345	0.353643592	0	0.002988928	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4147
H5619_003_0	2009	8																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	V	V	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin	Coin																																																			0		267.4133707	0.905494703	8.634002311	10.64418321	15.32389975	19.72523553	11.69832621	14.13416405	34.19417133	11.37032097	22.15812558	0.143426402	0	25.71303938	112.6933908	2917.373285	379.1450497	6.143425949	5759.469164	1554.109345	15.58408784	0	0	10.53	512.1475262	2.105518193	36.90297855	0	0	0											1a (IP Acute): MC CS;1a1 (Add'l Days): 0% coin	1b (IP Psych): MC CS;1a1 (Add'l Days): 0% coin	2a (SNF): MC CS;2a2 (Waiver 3 Day): 0% coin		10a (Ambulance): MC CS	11a (DME): MC CS	11b (Medical Supplies): MC CS	4a (ER): MC CS	9b (OP Surg): MC CS; 9b (OP ASC): MC CS	8a (OP Diag Proc/Test/Lab): MC CS	8b (OP Therap Rad): MC CS; 8b (OP Diag): MC CS	9a (OP Observation): MC CS	12 (Renal Dialysis): MC CS	9a (OP Other): MC CS; 9c (OP SA): 8 copay; 3 (CORF): MC CS; 5 (Partial Hosp): MC CS; 9d (OP Cardiac Rehab): MC CS		7b (Chiro): 8 copay; 7d (SPC w/Copay): 8 copay	7h (Psych): 8 copay; 7e (MH Non-Phys): 8 copay	7i (PT/ST): MC CS; 7c (OT): MC CS	7g (Prof. Other): 8 copay	7g (Prof. Other): 8 copay	15 (Part B Rx): MC CS		10b (Transportation): 20 trips/year	16b (Comp. Dental): MC CS	17a1 (Routine Eye Exam): 5 copay	17b1 (Non MCR Covered): 150 allowance	18a (Hearing Exam): 8 copay														0.0768	0.0768	0.1473	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.227427268	0	8	8	0.231	8	8	0.231	0	0	0.231	5	0	8	0	0	0											0.0768	0.0768	0.1473	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.227427268	0	8	8	0.231	8	8	0.231	0	0	0.231	5	0	8	0	0	0											20.5373	0.069541993	1.27178854	0	3.539820841	4.556529408	2.702313354	3.264991896	7.898853578	2.626544145	5.118527008	0.033131499	0	5.847846307	0	1.944915524	0.252763366	1.419131394	3.839646109	1.036072897	3.59992429	0	0	2.43243	0.213394803	0	0.024601986	0	0	0	0	0	0	0	0	0	0	0	0	0	72.2301		0	20.5373	0.069541993	1.27178854	0	3.539820841	4.556529408	2.702313354	3.264991896	7.898853578	2.626544145	5.118527008	0.033131499	0	5.847846307	0	1.944915524	0.252763366	1.419131394	3.839646109	1.036072897	3.59992429	0	0	2.43243	0.213394803	0	0.024601986	0	0	0	0	0	0	0	0	0	0	0	0	0	72.2301																																																																																		0			20.5373	0.069541993	1.27178854	0	3.539820841	4.556529408	2.702313354	3.264991896	7.898853578	2.626544145	5.118527008	0.033131499	0	5.847846307	0	1.944915524	0.252763366	1.419131394	3.839646109	1.036072897	3.59992429	0	0	2.43243	0.213394803	0	0.024601986	0	0	0	0	0	0	0	0	0	0	0	0	0	72.2301
H5619_004_0	2009	8																					3900											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1724.752028	22.04656946	582.9143881	25.44018126	208.7548779	14.86891395	6.243020251	53.87515284	732.1648796	7.008824692	19.15693983	0.761143685	0.068531289	18.78801314	10801.42486	2644.55606	129.2002997	56.41968121	5241.011707	1741.542864	15.84067933	0	0	936	312.5439307	3.621384186	1.952496044	0	0	0											1a (IP Acute): 165 days 1-5	1b (IP Psych): 260 days 1-5	2a (SNF): 30 days 11-100	6a (Home Health): 15 copay	10a (Ambulance): 130 copay	11a (DME): 20% coin	11b (Medical Supplies): 20% coin	4a (ER): 50 copay	9b (OP Surg): 425 copay; 9b (OP ASC): 170 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 15% coin; 9c (OP SA): 50 copay; 3 (CORF): 35 copay; 5 (Partial Hosp): 50 copay; 9d (OP Cardiac Rehab): 40 copay	7a (PCP w/Copay): 5 copay	7b (Chiro): 15 copay; 7d (SPC w/Copay): 30 copay	7h (Psych): 50 copay; 7e (MH Non-Phys): 50 copay	7i (PT/ST): 30 copay; 7c (OT): 30 copay	7g (Prof. Other): 40 copay	7g (Prof. Other): 40 copay	15 (Part B Rx): 20% coin			16b (Comp. Dental): 30 copay	17a1 (Routine Eye Exam): 25 copay	17b1 (Non MCR Covered): 100 allowance	18a (Hearing Exam): 30 copay														86.99172773	122.0489843	16.01380351	15	130	0.2	0.2	50	424.3069776	0	0.150412614	0.15	0.2	0.148653007	4.722008299	28.4737888	50	30	40	21.02162836	0.2	0	0	30	25	0	30	0	0	0											74.09035578	103.9484202	13.63886464	12.775414	110.7202547	0.170338853	0.170338853	42.58471335	361.3798202	0	0.128105561	0.12775414	0.170338853	0.126606914	4.021707397	24.25096268	42.58471335	25.55082801	34.06777068	17.90400036	0.170338853	0	0	25.55082801	25	0	30	0	0	0											10.649	0.190975506	0.662524203	0.027084071	1.926116104	2.532753753	1.063428911	0.191188162	22.04913438	0	2.45411053	0.097239257	0.011673541	2.378692363	3.620014188	5.344419192	0.458496477	0.120130798	14.87913208	2.598382006	2.698283154	0	0	1.992964585	0.651133189	0	0.00488124	0	0	0	0	0	0	0	0	0	0	0	0	0	76.6017		13.2244	10.649	0.190975506	0.662524203	0.027084071	1.926116104	2.532753753	1.063428911	0.191188162	22.04913438	0	2.45411053	0.097239257	0.011673541	2.378692363	3.620014188	5.344419192	0.458496477	0.120130798	14.87913208	2.598382006	2.698283154	0	0	1.992964585	0.651133189	0	0.00488124	0	0	0	0	0	0	0	0	0	0	0	0	0	76.6017																																																																																		0			10.649	0.190975506	0.662524203	0.027084071	1.926116104	2.532753753	1.063428911	0.191188162	22.04913438	0	2.45411053	0.097239257	0.011673541	2.378692363	3.620014188	5.344419192	0.458496477	0.120130798	14.87913208	2.598382006	2.698283154	0	0	1.992964585	0.651133189	0	0.00488124	0	0	0	0	0	0	0	0	0	0	0	0	0	76.6017
H5619_007_0	2009	7																					0											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1724.752028	22.04656946	582.9143881	25.44018126	208.7548779	14.92025086	6.264575114	53.87515284	732.1648796	7.033023598	19.22308173	0.763771636	0.068767902	18.85288127	10801.42486	2644.55606	129.2002997	56.41968121	5241.011707	1741.542864	15.89537139	0	0	936	425.085299	4.925378573	1.952496044	0	0	0											1a (IP Acute): 180 days 1-5	1b (IP Psych): 260 days 1-5	2a (SNF): 30 days 11-100	6a (Home Health): 15 copay	10a (Ambulance): 130 copay	11a (DME): 20% coin	11b (Medical Supplies): 20% coin	4a (ER): 50 copay	9b (OP Surg): 440 copay; 9b (OP ASC): 225 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 15% coin; 9c (OP SA): 50 copay; 3 (CORF): 35 copay; 5 (Partial Hosp): 50 copay; 9d (OP Cardiac Rehab): 40 copay	7a (PCP w/Copay): 5 copay	7b (Chiro): 15 copay; 7d (SPC w/Copay): 30 copay	7h (Psych): 40 copay; 7e (MH Non-Phys): 40 copay	7i (PT/ST): 30 copay; 7c (OT): 30 copay	7g (Prof. Other): 40 copay	7g (Prof. Other): 40 copay	15 (Part B Rx): 20% coin			16b (Comp. Dental): 30 copay	17a1 (Routine Eye Exam): 5 copay	17b1 (Non MCR Covered): 150 allowance	18a (Hearing Exam): 30 copay														94.90006662	122.0489843	16.05410071	15	130	0.2	0.2	50	439.415687	0	0.150412614	0.15	0.2	0.148646387	4.722008299	28.4737888	40	30	40	21.06804905	0.2	0	0	30	5	0	30	0	0	0											94.90006662	122.0489843	16.05410071	15	130	0.2	0.2	50	439.415687	0	0.150412614	0.15	0.2	0.148646387	4.722008299	28.4737888	40	30	40	21.06804905	0.2	0	0	30	5	0	30	0	0	0											13.6399	0.224230118	0.779847191	0.031800227	2.261511177	2.984050173	1.252915023	0.224479803	26.81039446	0	2.891393978	0.114565745	0.01375358	2.802412691	4.250368153	6.275044226	0.430667666	0.141049203	17.47003902	3.057575873	3.179074279	0	0	2.34	0.177118875	0	0.00488124	0	0	0	0	0	0	0	0	0	0	0	0	0	91.3571		0	13.6399	0.224230118	0.779847191	0.031800227	2.261511177	2.984050173	1.252915023	0.224479803	26.81039446	0	2.891393978	0.114565745	0.01375358	2.802412691	4.250368153	6.275044226	0.430667666	0.141049203	17.47003902	3.057575873	3.179074279	0	0	2.34	0.177118875	0	0.00488124	0	0	0	0	0	0	0	0	0	0	0	0	0	91.3571																																																																																		0			13.6399	0.224230118	0.779847191	0.031800227	2.261511177	2.984050173	1.252915023	0.224479803	26.81039446	0	2.891393978	0.114565745	0.01375358	2.802412691	4.250368153	6.275044226	0.430667666	0.141049203	17.47003902	3.057575873	3.179074279	0	0	2.34	0.177118875	0	0.00488124	0	0	0	0	0	0	0	0	0	0	0	0	0	91.3571
H5619_008_0	2009	8																					0											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1724.752028	22.04656946	582.9143881	25.44018126	208.7548779	16.68849823	7.00701025	53.87515284	732.1648796	7.866530058	21.50127155	0.854288692	0.076917809	21.08719744	10801.42486	2644.55606	129.2002997	56.41968121	5241.011707	1741.542864	17.77918347	0	0	936	265.5872318	3.077306282	1.952496044	0	0	0											1a (IP Acute): 200 days 1-5	1b (IP Psych): 260 days 1-5	2a (SNF): 25 days 11-100	6a (Home Health): 15 copay	10a (Ambulance): 125 copay	11a (DME): 15% coin	11b (Medical Supplies): 15% coin	4a (ER): 50 copay	9b (OP Surg): 425 copay; 9b (OP ASC): 225 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 15% coin; 9c (OP SA): 50 copay; 3 (CORF): 35 copay; 5 (Partial Hosp): 50 copay; 9d (OP Cardiac Rehab): 34 copay	7a (PCP w/Copay): 15 copay	7b (Chiro): 20 copay; 7d (SPC w/Copay): 34 copay	7h (Psych): 50 copay; 7e (MH Non-Phys): 50 copay	7i (PT/ST): 30 copay; 7c (OT): 30 copay	7g (Prof. Other): 40 copay	7g (Prof. Other): 40 copay	15 (Part B Rx): 20% coin			16b (Comp. Dental): 34 copay	17a1 (Routine Eye Exam): 25 copay	17b1 (Non MCR Covered): 70 allowance	18a (Hearing Exam): 34 copay														105.4445185	122.0489843	14.50173423	15	125	0.15	0.15	50	424.456453	0	0.150412614	0.15	0.2	0.148239026	14.1660249	32.57553621	50	30	40	40	0.2	0	0	34	25	0	34	0	0	0											105.4445185	122.0489843	14.50173423	15	125	0.15	0.15	50	424.456453	0	0.150412614	0.15	0.2	0.148239026	14.1660249	32.57553621	50	30	40	40	0.2	0	0	34	25	0	34	0	0	0											15.1555	0.224230118	0.704439128	0.031800227	2.174529978	2.503274735	1.051051537	0.224479803	25.89767565	0	3.234062466	0.128143304	0.015383562	3.12594561	12.75110446	7.178985974	0.538334582	0.141049203	17.47003902	5.805142881	3.555836693	0	0	2.652	0.553306733	0	0.005532072	0	0	0	0	0	0	0	0	0	0	0	0	0	105.1218		0	15.1555	0.224230118	0.704439128	0.031800227	2.174529978	2.503274735	1.051051537	0.224479803	25.89767565	0	3.234062466	0.128143304	0.015383562	3.12594561	12.75110446	7.178985974	0.538334582	0.141049203	17.47003902	5.805142881	3.555836693	0	0	2.652	0.553306733	0	0.005532072	0	0	0	0	0	0	0	0	0	0	0	0	0	105.1218																																																																																		0			15.1555	0.224230118	0.704439128	0.031800227	2.174529978	2.503274735	1.051051537	0.224479803	25.89767565	0	3.234062466	0.128143304	0.015383562	3.12594561	12.75110446	7.178985974	0.538334582	0.141049203	17.47003902	5.805142881	3.555836693	0	0	2.652	0.553306733	0	0.005532072	0	0	0	0	0	0	0	0	0	0	0	0	0	105.1218
H5619_801_0	2009	7																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		210.7430244	1.153906539	12.13762534	3.518406804	8.476087818	14.01821721	5.885837678	7.083786971	27.82614864	6.60782807	18.06091182	0.717596292	0.064610401	17.71309258	78.72290624	60.15970185	0.952138895	4.253843485	45.54955732	6.006060019	14.93438488	0																			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																			0.078238976	0.078238976	0.146543024	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.078238976	0.078238976	0.146543024	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			16.4883	0.090280466	1.778684319	0	1.957976286	3.238208176	1.359628504	1.63635479	6.427840335	1.526408284	4.172070631	0.165764743	0.014925003	4.091724385	18.18499134	13.89689113	0.219944085	0.982637845	10.52194774	1.387399864	3.449842907	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.5918		0	16.4883	0.090280466	1.778684319	0	1.957976286	3.238208176	1.359628504	1.63635479	6.427840335	1.526408284	4.172070631	0.165764743	0.014925003	4.091724385	18.18499134	13.89689113	0.219944085	0.982637845	10.52194774	1.387399864	3.449842907	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.5918																																																																																		0			16.4883	0.090280466	1.778684319	0	1.957976286	3.238208176	1.359628504	1.63635479	6.427840335	1.526408284	4.172070631	0.165764743	0.014925003	4.091724385	18.18499134	13.89689113	0.219944085	0.982637845	10.52194774	1.387399864	3.449842907	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.5918
H5628_001_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		262.2599716	22.50453278	70.30289781	80.96300433	23.73531675	46.91671297	33.6458197	21.88420499	34.62919959	12.5167358	27.39881766	0	8.91099991	78.53098213	46.41008162	105.6849352	7.670055818	5.044034332	19.30624993	32.6798872	10.38093339	2.427123675	0	0	0	0	0	0	0	0											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	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing											0.078219115	0.078219115	0.179310129	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.078219115	0.078219115	0.179310129	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.5137	1.760284638	12.60602166	0	5.482858169	10.8377607	7.772184352	5.055251353	7.999345106	2.891365969	6.329126879	0	2.058440979	18.14065687	10.72072885	24.41322002	1.771782894	1.165171931	4.459743734	7.549053943	2.397995613	0.560665569	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	154.4854	0	0	20.5137	1.760284638	12.60602166	0	5.482858169	10.8377607	7.772184352	5.055251353	7.999345106	2.891365969	6.329126879	0	2.058440979	18.14065687	10.72072885	24.41322002	1.771782894	1.165171931	4.459743734	7.549053943	2.397995613	0.560665569	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	154.4854																																																																																		0	0	0	20.5137	1.760284638	12.60602166	0	5.482858169	10.8377607	7.772184352	5.055251353	7.999345106	2.891365969	6.329126879	0	2.058440979	18.14065687	10.72072885	24.41322002	1.771782894	1.165171931	4.459743734	7.549053943	2.397995613	0.560665569	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	154.4854
H5628_002_0	2009	8																					3350											D	D	D	Coin	T	Coin	Coin	V	V	Coin	V	Coin	Coin	Coin	V	V	V	V	V	P	Coin	Coin	T	Coin	V	Coin	V	Coin	Coin	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	527.7275166	8.422363595	454.5643323	0	147.452764	11.27289921	7.639727727	257.1315344	228.2589505	0	112.4194204	0	0.492700342	13.75361435	4397.906782	5908.892737	126.6623142	383.4482679	75.12515182	1285.791867	7.187065187	0	642.3233472	27.64273843	366.0287896	0	158.3652898	0.997974337	0	845.2694045											$150/Days 1-5 for IP Medical; $150/Days 1-5 for IP Surgical;	$300/Days 1-5 for IP Psych; $300/Days 1-5 for IP Substance Abuse;	$150/Days Custom for SNF	No Cost-Sharing	$100/Run 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; $35/Visit for Urgent Care;	$100/Case for OP Fac - Surgery; $75/Case for OP Fac - ASC	No Cost-Sharing	$100/Case for OP Fac - CT/MRI/PET	No Cost-Sharing	20% Coinsurance for Renal Dialysis - Fac; 20% Coinsurance for Renal Dialysis - Prof	20% 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; $30/Visit for Prof - CORF; $30/Visit for Prof - CORF;	$15/Visit for PCP - Office Visits; $15/Consult for PCP - Consults; $15/Procedure for PCP - Surgery (Office); $15/Visit for PCP - Tx Injections; $15/Visit for PCP - Allergy Testing; $15/Visit for PCP - Allergy Tx;	$25/Visit for Speclst - Office Visits; $25/Procedure for Speclst - Surgery (Office); $25/Visit for Speclst - Tx Injections; $25/Visit for Speclst - Allergy Testing; $25/Visit for Speclst - Allergy Tx; $25/Consult for Speclst - Consults;	$35/Visit for OP Psych - Non-Physician; $35/Visit for OP Psych - Psychiatrist; $40/Visit for OP Substance Abuse;	$30/Visit for PT/ST (PCP); $30/Visit for Occ Therapy (PCP); $30/Visit for PT/ST (Specialist); $30/Visit for Occ Therapy (Specialist);	$100/Visit for Prof Radiology (Office);	$30/Visit for Chiropractor; $25/Exam for Vistion Exams; $30/Service for Podiatrist; $25/Exam for Hearing/Speech Exams;	20% Coinsurance for Part B Rx	No Cost-Sharing	$2/Service for Non-Emergent Transportation (Routine);	40% Coinsurance for Dental: Comprehensive Services;	$15/Service for Vision Exams (Refractions);	No Cost-Sharing	$15/Service for Hearing Exam;	40% Coinsurance for Hearing Aids;	No Cost-Sharing	$10/Service for Physical Exams (Routine);											150	300	150	0	100	0.2	0.2	45.18230272	87.48468608	0	100	0	0.2	0.133483586	15	24.91929635	35.47694077	30	100	27.66806462	0.2	0	2	0.4	15	0	15	0.4	0	0.535561848											144.2938559	288.5877119	144.2938559	0	96.19590393	0.192391808	0.192391808	43.46352452	84.15668457	0	96.19590393	0	0.192391808	0.128405742	14.42938559	23.97134238	34.12736386	28.85877118	96.19590392	26.61554485	0.192391808	0	1.923918078	0.384783616	14.42938559	0	14.42938559	0.384783616	0	0.51518856											6.3457	0.20254922	5.465903355	0	1.182029326	2.168813459	1.469821029	0.931320229	1.600793041	0	0.901190647	0	0.09479151	1.766043052	5.288257728	11.80367424	0.360220907	0.922153818	0.602227657	2.851837592	1.382732464	0	0.102981458	10.63647284	0.440130879	0	0.190426153	0.384004174	0	0.036289427	0	0	0	0	0	0	0	0	0	0	57.1303	0	2.2592	6.3457	0.20254922	5.465903355	0	1.182029326	2.168813459	1.469821029	0.931320229	1.600793041	0	0.901190647	0	0.09479151	1.766043052	5.288257728	11.80367424	0.360220907	0.922153818	0.602227657	2.851837592	1.382732464	0	0.102981458	10.63647284	0.440130879	0	0.190426153	0.384004174	0	0.036289427	0	0	0	0	0	0	0	0	0	0	57.1303	0																																																																																	0	0	0	6.3457	0.20254922	5.465903355	0	1.182029326	2.168813459	1.469821029	0.931320229	1.600793041	0	0.901190647	0	0.09479151	1.766043052	5.288257728	11.80367424	0.360220907	0.922153818	0.602227657	2.851837592	1.382732464	0	0.102981458	10.63647284	0.440130879	0	0.190426153	0.384004174	0	0.036289427	0	0	0	0	0	0	0	0	0	0	57.1303
H5628_006_0	2009	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																																																			0		264.0306755	22.65647691	70.77756276	81.50964325	23.89557078	47.23348112	33.8729866	22.03196085	34.86300599	12.6012452	27.58380659	0	8.971164418	79.06120073	46.72342914	106.3984895	7.721841828	5.078090201	19.43660018	32.9005324	10.45102247	2.443510916	0	0	0	0	0	0	0	0											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	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing											0.078144848	0.078144848	0.17978155	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.078144848	0.078144848	0.17978155	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.6326	1.77048695	12.72449992	0	5.519876851	10.91093414	7.824659905	5.089382956	8.053354383	2.910887641	6.371859323	0	2.072338981	18.26313737	10.79311213	24.57805106	1.783745462	1.173038837	4.489854641	7.600022984	2.41418619	0.564451022	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	155.5405			20.6326	1.77048695	12.72449992	0	5.519876851	10.91093414	7.824659905	5.089382956	8.053354383	2.910887641	6.371859323	0	2.072338981	18.26313737	10.79311213	24.57805106	1.783745462	1.173038837	4.489854641	7.600022984	2.41418619	0.564451022	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	155.5405																																																																																		0			20.6326	1.77048695	12.72449992	0	5.519876851	10.91093414	7.824659905	5.089382956	8.053354383	2.910887641	6.371859323	0	2.072338981	18.26313737	10.79311213	24.57805106	1.783745462	1.173038837	4.489854641	7.600022984	2.41418619	0.564451022	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	155.5405
H5640_001_0	2009	7																					Unlimited											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	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	288.419553	18.78041779	55.68082609	0	10.11476019	31.98578313	1.883979373	16.21541696	27.16463097	4.543535627	22.81208927	0	0.035404174	24.33446874	41.2575225	100.5541757	4.44357054	5.100787375	31.84068427	7.837555986	6.905546422	3.175212356	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 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											0.0641	0.0641	0.1526	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0641	0.0641	0.1526	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											18.4877	1.203824781	8.496894062	0	2.336509603	7.388715902	0.435199235	3.745761318	6.275029753	1.04955673	5.269592621	0	0.008178364	5.621262278	9.530487697	23.22801459	1.026464795	1.178281884	7.355198066	1.810475433	1.595181223	0.733474054	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.7758			18.4877	1.203824781	8.496894062	0	2.336509603	7.388715902	0.435199235	3.745761318	6.275029753	1.04955673	5.269592621	0	0.008178364	5.621262278	9.530487697	23.22801459	1.026464795	1.178281884	7.355198066	1.810475433	1.595181223	0.733474054	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.7758	0	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			18.4877	1.203824781	8.496894062	0	2.336509603	7.388715902	0.435199235	3.745761318	6.275029753	1.04955673	5.269592621	0	0.008178364	5.621262278	9.530487697	23.22801459	1.026464795	1.178281884	7.355198066	1.810475433	1.595181223	0.733474054	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.7758
H5649_001_0	2009	7																					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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	87.38821347	7.317231127	1.05724252	48.54954051	0	0	4.755579981	0	0.077169655	15.3826206	38.23886782	0	132.3082137	0	0	0	5.274045505	0	0	237.9695344	0	147.3212392	0	0	0	403.3315472											$0 copay	$0 copay	$0 copay	$0 copay	10A - $50 copay	11A - 10% coinsurance	"11B - 10% coinsurance, prosthetics"	4A - $50 copay	$0 copay	$0 copay	8B - 20% coinsurance radiation therapy	$0 copay	12 - 20% coinsurance	5 - $10 copay	4B- $5 copay	$0 copay	7E & 7H & 9C- $10 copay	$0 copay	$0 copay	$0 copay	15 - 20% coinsurance	$0 copay	$0 copay	16A - $10 copay	$0 copay	"17B - $10 copay, $100 max"	$0 copay	$0 copay	$0 copay	"$10 copay - acupuncture, 4A - $50 worldwide emerg."											0	0	0	0	50	0.1	0.1	50	0	0	0.2	0	0.29	10	5	0	10	0	0	0	0.2	0	0	10	0	10	0	0	0	10.26											0	0	0	0	50	0.1	0.1	50	0	0	0.2	0	0.29	10	5	0	10	0	0	0	0.2	0	0	10	0	10	0	0	0	10.26											0	0	0	0	0.364117556	0.731723113	0.105724252	0.202289752	0	0	0.951115996	0	0.0223792	0.012818851	0.015932862	0	0.110256845	0	0	0	1.054809101	0	0	0.198307945	0	0.122767699	0	0	0	0.344848473	0	0	0	0	0	0	0	0	0	0	4.2371			0	0	0	0	0.364117556	0.731723113	0.105724252	0.202289752	0	0	0.951115996	0	0.0223792	0.012818851	0.015932862	0	0.110256845	0	0	0	1.054809101	0	0	0.198307945	0	0.122767699	0	0	0	0.344848473	0	0	0	0	0	0	0	0	0	0	4.2371	0	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			0	0	0	0	0.364117556	0.731723113	0.105724252	0.202289752	0	0	0.951115996	0	0.0223792	0.012818851	0.015932862	0	0.110256845	0	0	0	1.054809101	0	0	0.198307945	0	0.122767699	0	0	0	0.344848473	0	0	0	0	0	0	0	0	0	0	4.2371
H5649_002_0	2009	8																					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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	198.3866521	0	0	4.530478825	0	0	0	0	0	0	0	0	0	6.298300323	0	0	0	0	0	0	0	0	2.38118096											$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	4A - $50 copay	$0 copay	$0 copay	8B - 20% coinsurance radiation therapy	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	15 - 20% coinsurance	$0 copay	$0 copay	$0 copay	$0 copay	17B - $100 max	$0 copay	18B - $200 max	$0 copay	4A - $50 worldwide emerg.											0	0	0	0	0	0	0	50	0	0	0.2	0	0	0	0	0	0	0	0	0	0.2	0	0	0	0	0	0	0	0	50											0	0	0	0	0	0	0	50	0	0	0.2	0	0	0	0	0	0	0	0	0	0.2	0	0	0	0	0	0	0	0	50											0	0	0	0	0	0	0	0.82661105	0	0	0.906095765	0	0	0	0	0	0	0	0	0	1.259660065	0	0	0	0	0	0	0	0	0.009921587	0	0	0	0	0	0	0	0	0	0	3.0023			0	0	0	0	0	0	0	0.82661105	0	0	0.906095765	0	0	0	0	0	0	0	0	0	1.259660065	0	0	0	0	0	0	0	0	0.009921587	0	0	0	0	0	0	0	0	0	0	3.0023	0	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			0	0	0	0	0	0	0	0.82661105	0	0	0.906095765	0	0	0	0	0	0	0	0	0	1.259660065	0	0	0	0	0	0	0	0	0.009921587	0	0	0	0	0	0	0	0	0	0	3.0023
H5652_001_0	2009	4																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1685.30599	22.32259203	5694.988556	3223.79781	319.502745	14.52417471	7.651181861	310.2887851	409.414503	6158.952996	914.3301468	0	5.958818746	1095.490946	8609.137012	6992.58277	426.1128856	1146.482646	0	0	1350.825483	1914.157202	1620.696507	533.7295777	162.8577469	120.7842948	33.7352194	25.6437982	471.5924831	115.5175384											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b); $0 n/c (7b1); $0/$20 (7d); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0.2	0.2	49.69363533	50	8	8.78693277	0	0	47.28696736	1.448988285	9.738939643	20	0	0	0	0	15.71569051	0	20	20	0	20	0	0	20											0	0	0	0	0	0.168351477	0.168351477	41.82998461	42.08786933	6.734059093	7.396465565	0	0	39.80415407	1.219696592	8.197824383	16.83514773	0	0	0	0	15.7079106	0	20	20	0	20	0	0	20											0	0	0	0	0	2.445166269	1.28808777	1.081614592	1.435948675	3.456229452	0.56356762	0	0	3.633757532	0.875044589	4.776997128	0.597806115	0	0	0	0	2.505617518	0	0.889549296	0.271429578	0	0.056225366	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	24.0696	0	3.79	0	0	0	0	0	2.445166269	1.28808777	1.081614592	1.435948675	3.456229452	0.56356762	0	0	3.633757532	0.875044589	4.776997128	0.597806115	0	0	0	0	2.505617518	0	0.889549296	0.271429578	0	0.056225366	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	24.0696		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.8851	0.0105	0.7305	0.2478	0.0837	0.0889	0.0468	0.0262	0.3149	0.0816	0.2592	0	0	0.4018	0.3504	1.0801	0.0187	0.0642	0	0	0.1401	0.0899	0	0	0.0042	0.0039	0.001	0.0022	0	0											5.9318	0	0	1.8851	0.010540382	0.730543452	0.247848201	0.083696981	2.534089788	1.33493174	1.107838024	1.750881142	3.537781476	0.822806022	0	0	4.035568664	1.225474271	5.857056378	0.616458249	0.064192453	0	0	0.140054651	2.595510168	0	0.889549296	0.27560886	0.003943254	0.057256848	0.00216783	0	0.192529231	0	0	0	0	0	0	0	0	0	0	30.0014
H5652_002_0	2009	2																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1698.084923	22.49185441	5738.171146	3248.242449	321.9253936	14.74527062	7.767652851	312.6415683	412.5189128	6205.653623	921.2631095	0	6.004001844	1103.797571	8674.416306	7045.604445	429.3439119	1155.175919	0	0	1361.068198	1928.671413	1632.985535	533.7295777	164.0926255	121.7001489	33.99101871	25.83824383	475.1683611	116.393457											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b); $0 n/c (7b1); $0/$20 (7d); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0.2	0.2	49.69363533	50	8	8.78693277	0	0	47.28696736	1.448988285	9.738939643	20	0	0	0	0	15.71569051	0	20	20	0	20	0	0	20											0	0	0	0	0	0.168089444	0.168089444	41.76487775	42.02236109	6.723577774	7.384953234	0	0	39.74220035	1.217798178	8.185064766	16.80894444	0	0	0	0	15.70784619	0	20	20	0	20	0	0	20											0	0	0	0	0	2.478524345	1.305660452	1.08811974	1.444584892	3.477016231	0.566957082	0	0	3.655612017	0.880307365	4.805727391	0.601401497	0	0	0	0	2.524606159	0	0.889549296	0.273487709	0	0.056651698	0	0	0.193989095	0	0	0	0	0	0	0	0	0	0	24.2422	0	3.8558	0	0	0	0	0	2.478524345	1.305660452	1.08811974	1.444584892	3.477016231	0.566957082	0	0	3.655612017	0.880307365	4.805727391	0.601401497	0	0	0	0	2.524606159	0	0.889549296	0.273487709	0	0.056651698	0	0	0.193989095	0	0	0	0	0	0	0	0	0	0	24.2422		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.9137	0.0107	0.7417	0.2516	0.085	0.0903	0.0476	0.0264	0.3197	0.0828	0.2632	0	0	0.4079	0.3558	1.0965	0.0189	0.0652	0	0	0.1422	0.0913	0	0	0.0042	0.004	0.001	0.0022	0	0											6.0219	0	0	1.9137	0.010700835	0.741664234	0.251621098	0.084971068	2.568801512	1.35321751	1.114542012	1.764311454	3.55980969	0.83014177	0	0	4.063539765	1.236071502	5.902227967	0.620337565	0.065169629	0	0	0.142186649	2.61586721	0	0.889549296	0.27773061	0.00400328	0.057698882	0.00220083	0	0.193989095	0	0	0	0	0	0	0	0	0	0	30.2641
H5652_003_0	2009	4																					500											D	D	D	V	T	P	P	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1084.126881	20.07004931	3946.156807	48.28619248	296.9038783	250.717065	827.3099489	92.05561193	98.34510203	8147.105697	1138.778738	0	7.01251758	125.2655043	122.4268904	7006.626801	2081.209013	16.65481528	0	0	1263.633405	351.4631121	1576.881712	0	141.7308499	107.1725454	39.26078599	13.66333203	0	0											"$25 Days 1-20 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$25 Days 1-20 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$50 (10a)	$0 (11a)	"$0 (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	$0 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$0 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a9, 14a10); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											24.67742194	25	0	0	50	0	0	49.80411636	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											22.84573921	23.1443739	0	0	46.2887478	0	0	46.10740364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											2.064	0.03870906	0	0	1.145275729	0	0	0.353703771	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.6017	0	0.2888	2.064	0.03870906	0	0	1.145275729	0	0	0.353703771	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.6017		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.1347	0.1636	0.5319	0.0451	0.1396	0.1301	0.1349	0.0201	0.2219	0.4446	0.4204	0	0	0.0625	0.01	1.9729	0.3144	0.0029	0	0	0.1205	0.0687	0	0	0.0074	0.0072	0.0032	0.0054	0	0											6.962	0	0	4.1986	0.202296736	0.53191064	0.045089215	1.284844142	0.1300839	0.134938197	0.373812317	0.221889829	0.444572309	0.420412013	0	0	0.062512994	0.009992422	1.972900856	0.314388606	0.002919196	0	0	0.12050744	0.06874	0	0	0.007384653	0.007204611	0.003233379	0.005393421	0	0	0	0	0	0	0	0	0	0	0	0	10.5637
H5652_004_0	2009	3																					1500											D	D	D	V	T	P	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2934.645793	63.47707702	2695.459104	89909.84043	162.7290978	3297.5166	18.09626392	464.9124785	446.8380628	8635.106032	562.5847522	0	12.62049832	1721.290957	7876.923338	6418.969551	256.2237613	294.2925936	0	0	1921.517252	1721.579688	1418.390092	533.7295777	205.2567597	154.1150788	37.56409609	10.74492219	932.1	115.5175384											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	$0 (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b); $0 n/c (7b1); $0/$20 (7d); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0	0.2	49.97849058	50	3.2	16.87836848	0	0	45.70445279	1.386209134	9.281270305	20	0	0	0	0	0.001602202	0	20	0	0	20	0	0	20											0	0	0	0	0	0	0.164467055	41.09907571	41.11676366	2.631472875	13.87967776	0	0	37.58438367	1.139928667	7.632315953	16.44670547	0	0	0	0	0.001317547	0	20	0	0	20	0	0	20											0	0	0	0	0	0	2.976239228	1.592289429	1.531044585	1.893587274	0.650707923	0	0	5.391138313	0.748260893	4.082633642	0.351169728	0	0	0	0	0.000189022	0	0.889549296	0	0	0.062606827	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	20.3619	0	4.1519	0	0	0	0	0	0	2.976239228	1.592289429	1.531044585	1.893587274	0.650707923	0	0	5.391138313	0.748260893	4.082633642	0.351169728	0	0	0	0	0.000189022	0	0.889549296	0	0	0.062606827	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	20.3619		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a3); $0 (6a2)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.6955	0.0297	0.62	0.4176	0.1042	0.1717	0.1108	0.0395	0.32	0.0589	0.1329	0	0	0.2581	0.4373	1.3039	0.0156	0.0383	0	0	0.2397	0.0868	0	0	0.0039	0.0039	0.0009	0.0004	0	0											7.0899	0	0	2.6955	0.029726833	0.620005241	0.41762088	0.104233157	0.171740009	3.087032681	1.631805796	1.850996036	1.952490672	0.783624522	0	0	5.64926959	1.18552185	5.38652466	0.366802478	0.038345955	0	0	0.239722363	0.087000962	0	0.889549296	0.003911416	0.003931507	0.063548589	0.000438568	0	0.192529231	0	0	0	0	0	0	0	0	0	0	27.4518
H5656_001_0	2009	5																					3600											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	Coin	V	Coin	V	T	V	V	V	V	V	V	V																																																			0		1528.181854	79.04692149	536.4420403		114.1750005	8.736523154	4.293417942	352.214752	310.5194172		51.01580969	18.84491991	14.94573778	63.85721133	0.531132899	3690.667954	232.1534029	994.6032402			18.20195684	901.7056351		992	148																1a: $75 Days 1-7	1b : $75 Days 1-7	2a: $125 days 21 - 100 / 2a2: $125 days 21-100	6a: $0	10a: $100	11a: 15%	11b: 15% 11c: 0%/20%	4a / 4a1: $50 4b: $25	9b: $150 OP Surg/$75 ASC	8a: 0%	8b1: 20% 8b2: 20% 8b3: 20%	9a: $150	12: $50	9a: $0 9c: $35/$20 9d: $20 3: $20 5: $20	"7a: $0, 14b, 14c, 14d, 14d1, 14e, 14f, 14g, 14h: $0, 14i: $10"	7b: $25 7d: $20 7f: $20	"7e, 7h: $35/$20"	7c: $20 7i: $20	8b1: 20% 8b2: 20% 8b3: 20%	7g: $20	15: 20%	13a: $0 14a: $0 14j: $10 16b: $0 17a: $25 17b: $0	10b: (n/c)	16a: $15	17a: $25	17b1: $0	18a: $20 18a1: (n/c)	18b: (n/c)													34.7167245	29.51636131	81.23643933		100	0.15	0.15	47.50099973	146.25		0.2	150	50	20.26076809	10	20.2238076	31.25	20			0.2	24.98168664		15	25																31.89749238	27.11943375	74.63949269		91.87932572	0.137818989	0.137818989	43.64359826	134.3735139		0.183758651	137.8189886	45.93966286	18.61545711	9.187932572	18.58149806	28.71228929	18.37586514			0.183758651	22.95300524		13.78189886	22.96983143																4.0621	0.178642313	3.336646812	0	0.874193505	1.204058785	0.591714518	1.280993261	3.4771321	0	9.37459639	0.216432317	0.057216846	0.099060932	0.000406668	5.714844951	0.555471305	1.523057918	0	0	3.344767043	1.724737847	0	1.139303639	0.283294588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.0387	0	3.4504	4.0621	0.178642313	3.336646812	0	0.874193505	1.204058785	0.591714518	1.280993261	3.4771321	0	9.37459639	0.216432317	0.057216846	0.099060932	0.000406668	5.714844951	0.555471305	1.523057918	0	0	3.344767043	1.724737847	0	1.139303639	0.283294588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.0387																																																																																		0	0	0	4.0621	0.178642313	3.336646812	0	0.874193505	1.204058785	0.591714518	1.280993261	3.4771321	0	9.37459639	0.216432317	0.057216846	0.099060932	0.000406668	5.714844951	0.555471305	1.523057918	0	0	3.344767043	1.724737847	0	1.139303639	0.283294588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.0387
H5656_003_0	2009	3																					3000											A	A	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	Coin	V	Coin	V	T	V	V	V	V	V	V	V																																																			0		1072.327374	74.01160479	535.6852866		114.0138288	8.71187526	4.281305148	351.7179565	310.0810817		50.87188147	18.81831804	14.92464008	63.76706921	0.530383141	3685.458133	231.8256905	993.1992383			18.15060462	900.4327693		992	148																1a: $75 Days 1-7	1b : $75 Days 1-7	2a: $125 days 21 - 100 / 2a2: $125 days 21-100	6a: $0	10a: $100	11a: 15%	11b: 15% 11c: 0%20%	4a / 4a1: $50 4b: $25	9b: $150 OP Surg/$75 ASC	8a: 0%	8b1: 20% 8b2: 20% 8b3: 20%	9a: $150	12: $50	9a: $0 9c: $35/$20 9d: $20 3: $20 5: $20	"7a: $0, 14b, 14c, 14d, 14d1, 14e, 14f, 14g, 14h: $0, 14i: $10"	7b: $25 7d: $20 7f: $20	"7e, 7h: $35/$20"	7c: $20 7i: $20	8b1: 20% 8b2: 20% 8b3: 20%	7g: $20	15: 20%	13a: $0 14a: $0 14j: $10 16b: $0 17a: $25 17b: $0	10b: (n/c)	16a: $15	17a: $25	17b1: $0	18a: $20 18a1: (n/c)	18b: (n/c)													34.7167245	29.51636131	81.23643933		100	0.15	0.15	47.50100256	146.25		0.2	150	50	20.26076809	10	20.2238076	31.25	20			0.2	24.98168664		15	25																31.08138377	26.42557345	72.7298149		89.52856071	0.134292841	0.134292841	42.52696391	130.93552		0.179057121	134.2928411	44.76428036	18.13917406	8.952856071	18.10608386	27.97767522	17.90571214			0.179057121	22.36574449		13.42928411	22.38214018																2.7775	0.162983258	3.246690979	0	0.850624499	1.16994248	0.574948632	1.24645807	3.383385641	0	9.108972657	0.210597116	0.055674231	0.096390164	0.000395704	5.560767836	0.540495323	1.481994972	0	0	3.249995015	1.678237438	0	1.110154153	0.276046396	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.7822	0	4.3021	2.7775	0.162983258	3.246690979	0	0.850624499	1.16994248	0.574948632	1.24645807	3.383385641	0	9.108972657	0.210597116	0.055674231	0.096390164	0.000395704	5.560767836	0.540495323	1.481994972	0	0	3.249995015	1.678237438	0	1.110154153	0.276046396	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.7822																																																																																		0	0	0	2.7775	0.162983258	3.246690979	0	0.850624499	1.16994248	0.574948632	1.24645807	3.383385641	0	9.108972657	0.210597116	0.055674231	0.096390164	0.000395704	5.560767836	0.540495323	1.481994972	0	0	3.249995015	1.678237438	0	1.110154153	0.276046396	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.7822
H5656_004_0	2009	6																					3600											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	Coin	V	Coin	V	T	V	V	V	V	V	V	V																																																			0		1523.766379	78.81852608	534.8930849		113.8451072	8.68611008	4.268643282	351.1978901	309.6222132		50.72142899	18.79047005	14.90255409	63.67270453	0.529598262	3680.004267	231.482627	991.7294684			18.0969246	899.1002783		992	148																1a: $75 Days 1-7	1b : $75 Days 1-7	2a: $125 days 21 - 100 / 2a2: $125 days 21-100	6a: $0	10a: $100	11a: 15%	11b: 15% 11c: 0%/20%	4a / 4a1: $50 4b: $25	9b: $150 OP Surg/$75 ASC	8a: 0%	8b1: 20% 8b2: 20% 8b3: 20%	9a: $150	12: $50	9a: $0 9c: $35/$20 9d: $20 3: $20 5: $20	"7a: $0, 14b, 14c, 14d, 14d1, 14e, 14f, 14g, 14h: $0, 14i: $10"	7b: $25 7d: $20 7f: $20	"7e, 7h: $35/$20"	7c: $20 7i: $20	8b1: 20% 8b2: 20% 8b3: 20%	7g: $20	15: 20%	13a: $0 14a: $0 14j: $10 16b: $0 17a: $25 17b: $0	10b: (n/c)	16a: $15	17a: $25	17b1: $0	18a: $20 18a1: (n/c)	18b: (n/c)		13c : $0											34.7167245	29.51636131	81.23643933		100	0.15	0.15	47.50100553	146.25		0.2	150	50	20.26076809	10	20.2238076	31.25	20			0.2	24.98168664		15	25																31.9137546	27.13325998	74.67754594		91.92616831	0.137889252	0.137889252	43.66585429	134.4420212		0.183852337	137.8892525	45.96308415	18.62494778	9.192616831	18.59097141	28.7269276	18.38523366			0.183852337	22.96470731		13.78892525	22.98154208																4.0524	0.178216963	3.328708577	0	0.872112041	1.197721226	0.588600031	1.277946325	3.468853011	0	9.325253237	0.215916989	0.057080612	0.098825066	0.000405699	5.701237843	0.554148722	1.5194315	0	0	3.327161874	1.720631228	0	1.139884487	0.283439019	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.908	0	3.4173	4.0524	0.178216963	3.328708577	0	0.872112041	1.197721226	0.588600031	1.277946325	3.468853011	0	9.325253237	0.215916989	0.057080612	0.098825066	0.000405699	5.701237843	0.554148722	1.5194315	0	0	3.327161874	1.720631228	0	1.139884487	0.283439019	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.908																																																																																		0	0	0	4.0524	0.178216963	3.328708577	0	0.872112041	1.197721226	0.588600031	1.277946325	3.468853011	0	9.325253237	0.215916989	0.057080612	0.098825066	0.000405699	5.701237843	0.554148722	1.5194315	0	0	3.327161874	1.720631228	0	1.139884487	0.283439019	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.908
H5656_009_0	2009	6																					2500											A	A	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	Coin	V	Coin	V	T	V	V	V	V	V	V	V																																																			0		1073.776027	74.11159025			114.1678549	8.735429654	4.29288056	352.1927266	310.4999836			18.84374051	14.94480242	63.85321488	0.531099659	3690.436977	232.1388738	994.5409939			18.19967861	901.6492027		992	147.9897653																1a: $50 Days 1-7	1b : $50 Days 1-7	2a: $0 days 1 - 100 / 2a2: $0 days 1-100	6a: $0	10a: $75	11a: 10%	11b: 10% 11c: 0%/20%	4a / 4a1: $25 4b: $15	9b: $100 OP Surg/$50 ASC	8a: 0%	8b1: 0% 8b2: 0% 8b3: 0%	9a: $100	12: $50	9a: $0 9c: $15 9d: $20 3: $20 5: $20	"7a: $0, 14b, 14c, 14d, 14d1, 14e, 14f, 14g, 14h: $0, 14i: $10"	7b: $20 7d: $15 7f: $15	"7e, 7h: $15"	7c: $20 7i: $20	8b1: 0% 8b2: 0% 8b3: 0%	7g: $20	15: 20%	13a: $0 14a: $0 14j: $10 16b: $0 17a: $10 17b: $0	10b: (n/c)	16a: $15	17a: $10	17b1: $0	18a: $15 18a1: (n/c)	18b: (n/c)													23.144483	19.67757421			75	0.12	0.12	24.00039994	97.5			100	50	19.88410307	10	15.2238076	15	20			0.2	10.00005644		15	10																22.21735104	18.88932121			71.99561674	0.115192987	0.115192987	23.03898128	93.59430177			95.99415566	47.99707783	19.08757685	9.599415566	14.61396556	14.39912335	19.19883113			0.191988311	9.599469743		14.39912335	9.599415566																1.988	0.116659803	0	0	0.684965427	1.006260233	0.494509734	0.676180136	2.42175243	0	0	0.150740747	0.05977557	0.101566929	0.000424854	4.494326574	0.27854969	1.591168716	0	0	3.494125562	0.72127952	0	1.19032753	0.118384605	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.589	0	0.8175	1.988	0.116659803	0	0	0.684965427	1.006260233	0.494509734	0.676180136	2.42175243	0	0	0.150740747	0.05977557	0.101566929	0.000424854	4.494326574	0.27854969	1.591168716	0	0	3.494125562	0.72127952	0	1.19032753	0.118384605	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.589																																																																																		0	0	0	1.988	0.116659803	0	0	0.684965427	1.006260233	0.494509734	0.676180136	2.42175243	0	0	0.150740747	0.05977557	0.101566929	0.000424854	4.494326574	0.27854969	1.591168716	0	0	3.494125562	0.72127952	0	1.19032753	0.118384605	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.589
H5656_801_0	2009	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																																																			0		264.0399352	6.710793924	20.22128592		5.758668423	9.999214956	4.746998209	21.15192214	50.16556672	25.99128575	58.48303562	1.650699385	0.679744946	18.73017096	67.11034109	123.3493586	2.470076872	5.793603076			20.62197707	8.912605039																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS											0.0721	0.0721	0.2015		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.0721	0.0721	0.2015		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			19.0373	0.483848242	4.074589113	0	1.330252406	2.309818655	1.096556586	4.886094014	11.58824591	6.003987008	13.50958123	0.381311558	0.157021083	4.326669491	15.50248879	28.49370184	0.570587757	1.338322311	0	0	4.763676703	2.058811764	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.9128	0	0	19.0373	0.483848242	4.074589113	0	1.330252406	2.309818655	1.096556586	4.886094014	11.58824591	6.003987008	13.50958123	0.381311558	0.157021083	4.326669491	15.50248879	28.49370184	0.570587757	1.338322311	0	0	4.763676703	2.058811764	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.9128																																																																																		0	0	0	19.0373	0.483848242	4.074589113	0	1.330252406	2.309818655	1.096556586	4.886094014	11.58824591	6.003987008	13.50958123	0.381311558	0.157021083	4.326669491	15.50248879	28.49370184	0.570587757	1.338322311	0	0	4.763676703	2.058811764	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.9128
H5656_802_0	2009	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																																																			0		264.0399352	6.710793924	20.22128592		5.758668423	9.999214956	4.746998209	21.15192214	50.16556672	25.99128575	58.48303562	1.650699385	0.679744946	18.73017096	67.11034109	123.3493586	2.470076872	5.793603076			20.62197707	8.912605039																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS											0.0721	0.0721	0.2015		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.0721	0.0721	0.2015		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			19.0373	0.483848242	4.074589113	0	1.330252406	2.309818655	1.096556586	4.886094014	11.58824591	6.003987008	13.50958123	0.381311558	0.157021083	4.326669491	15.50248879	28.49370184	0.570587757	1.338322311	0	0	4.763676703	2.058811764	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.9128	0	0	19.0373	0.483848242	4.074589113	0	1.330252406	2.309818655	1.096556586	4.886094014	11.58824591	6.003987008	13.50958123	0.381311558	0.157021083	4.326669491	15.50248879	28.49370184	0.570587757	1.338322311	0	0	4.763676703	2.058811764	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.9128																																																																																		0	0	0	19.0373	0.483848242	4.074589113	0	1.330252406	2.309818655	1.096556586	4.886094014	11.58824591	6.003987008	13.50958123	0.381311558	0.157021083	4.326669491	15.50248879	28.49370184	0.570587757	1.338322311	0	0	4.763676703	2.058811764	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.9128
H5656_803_0	2009	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																																																			0		264.0399352	6.710793924	20.22128592		5.758668423	9.999214956	4.746998209	21.15192214	50.16556672	25.99128575	58.48303562	1.650699385	0.679744946	18.73017096	67.11034109	123.3493586	2.470076872	5.793603076			20.62197707	8.912605039																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS											0.0721	0.0721	0.2015		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.0721	0.0721	0.2015		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			19.0373	0.483848242	4.074589113	0	1.330252406	2.309818655	1.096556586	4.886094014	11.58824591	6.003987008	13.50958123	0.381311558	0.157021083	4.326669491	15.50248879	28.49370184	0.570587757	1.338322311	0	0	4.763676703	2.058811764	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.9128	0	0	19.0373	0.483848242	4.074589113	0	1.330252406	2.309818655	1.096556586	4.886094014	11.58824591	6.003987008	13.50958123	0.381311558	0.157021083	4.326669491	15.50248879	28.49370184	0.570587757	1.338322311	0	0	4.763676703	2.058811764	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.9128																																																																																		0	0	0	19.0373	0.483848242	4.074589113	0	1.330252406	2.309818655	1.096556586	4.886094014	11.58824591	6.003987008	13.50958123	0.381311558	0.157021083	4.326669491	15.50248879	28.49370184	0.570587757	1.338322311	0	0	4.763676703	2.058811764	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.9128
H5657_004_0	2009	3	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		263.016024	6.091898	640.637968	213.423989	8.596791	18.357143	9.263297	485.879407	38.032226	11.349757	15.133009	0	0.199702	20.789675	5139.241086	5305.913955	0.621297	2.485186			21.068611								0.05		0	394.590195	300.028188	3.883027	525.871104	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000005	949.999415	43.132797	0	0.199999	0.2	0.199999	50.000011	0.240475	0.249999	0.244134	0	0.199997	0.231352	14.999999	30	0.249999	0.25			0.2								0		0	0	14.225503	30.001338	30.000005	0	0	0	0		755.229104	755.228635	34.289625	0	0.158995	0.158995	0.158995	39.748909	0.191172	0.198744	0.194081	0	0.158993	0.18392	11.924669	23.84934	0.198744	0.198744			0.158995								0		0	0	11.308962	23.850403	23.849344	0	0	0	0		16.5531	0.383397984	1.830602974	0	1.366846785	2.918693951	1.472817907	1.609431361	7.270696709	2.255696105	2.93702952	0	0.03175122	3.823637026	5.106979072	10.54521216	0.123479051	0.493915806	0	0	3.349803806	0	0	0	0	0	0	0	0	0	0	0	0.282750615	0.007717647	1.045140072	0	0	0	0	0	63.4087	0	16.3529	16.5531	0.383397984	1.830602974	0	1.366846785	2.918693951	1.472817907	1.609431361	7.270696709	2.255696105	2.93702952	0	0.03175122	3.823637026	5.106979072	10.54521216	0.123479051	0.493915806	0	0	3.349803806	0	0	0	0	0	0	0	0	0	0	0	0.282750615	0.007717647	1.045140072	0	0	0	0	0	63.4087	5000																																																																																	0	0	0	16.5531	0.383397984	1.830602974	0	1.366846785	2.918693951	1.472817907	1.609431361	7.270696709	2.255696105	2.93702952	0	0.03175122	3.823637026	5.106979072	10.54521216	0.123479051	0.493915806	0	0	3.349803806	0	0	0	0	0	0	0	0	0	0	0	0.282750615	0.007717647	1.045140072	0	0	0	0	0	63.4087
H5657_005_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)							5000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	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							0		279.939669	6.483878	681.859521	227.156657	220.003112	20.749192	10.470362	517.143091	363.560719	1859.917703	993.600265	0	0.225725	1107.60873	5469.923173	5647.320529	53.654977	956.999519			23.81398								0.05		0.06	1.22	2.07	2.7							$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$50-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $50 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$100/Visit:9a. $100 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								$0 Additional Smoking Cessation 14a		$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a							949.99998	949.999958	43.132802	0	99.999985	0.199999	0.199999	50.000002	91.015146	77.419438	70.072348	0	0.2	92.025027	15	29.999999	94.608035	59.059992			0.199999								0		0	0	0	0							714.564335	714.564318	32.443329	0	75.217289	0.150434	0.150434	37.608652	68.459135	58.232811	52.706528	0	0.150434	69.218741	11.282595	22.565189	71.16161	44.423331			0.150434								0		0	0	0	0							16.6696	0.386095655	1.843482731	0	1.379003138	3.121383949	1.575098437	1.620754545	2.074087695	9.02568634	4.364101682	0	0.033956715	6.388940151	5.142910654	10.61940459	0.318181212	3.542758867	0	0	3.582432267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.6879	0	23.6198	16.6696	0.386095655	1.843482731	0	1.379003138	3.121383949	1.575098437	1.620754545	2.074087695	9.02568634	4.364101682	0	0.033956715	6.388940151	5.142910654	10.61940459	0.318181212	3.542758867	0	0	3.582432267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.6879	5000																																																																																	0	0	0	16.6696	0.386095655	1.843482731	0	1.379003138	3.121383949	1.575098437	1.620754545	2.074087695	9.02568634	4.364101682	0	0.033956715	6.388940151	5.142910654	10.61940459	0.318181212	3.542758867	0	0	3.582432267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.6879
H5657_006_0	2009	4	r.	s.	t.	u.	v.	w.	x.	y.	z.		OP Facility - Surgery	OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)		5000		Lab	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)						A	A	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin			Coin								O		V	V	V	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	0	0		0		275.469028	6.38033	670.970214	223.528961	9.409707	20.093	10.139237	508.884308	41.628564	12.422993	16.563991	0	0.218586	22.755553	5382.568411	5557.132727	0.680047	2.720186			23.060864								0.05		0	413.272832	314.233604	4.066877	550.769492	0.06	1.22	2.07	2.7		$950/Admit:1a	$950/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	"20% Coins, up to $50 maximum:4a"	"20%-25% Coins:9b. $0 Surgery ASC -- Physician,9b. 20% Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. 25% Surgery OP -- Facility"	"25% Coins:8, 8a"	"20%-25% Coins:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	25% Coins:9a	20% Coins:12	"20%-25% Coins:9d. 25% Cardiac Rehab,8b. 25% Nuclear Medicine,9a. 25% OP Other,5. 20% Partial Hospitalization,8b. 20% Rad therapy,3. 20% Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"25% Coins:7e, 7h"	"25% Coins:7d, 9a"			20% Coins:15								$0 Additional Smoking Cessation 14a		"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$30/Visit:14h. 25% DMAM -- OP,8b. 20% Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. 20% Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. 25% Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. 25% Radiology OP -- Facility"	"$30/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0 Corp Health 14a		950.000013	949.999082	43.132793	0	0.199999	0.199999	0.199999	49.999993	0.240475	0.249999	0.244134	0	0.199998	0.231352	15.000001	30	0.25	0.25			0.199999								0		0	0	14.225505	29.999432	30.000005	0	0	0	0		740.72261	740.721884	33.630984	0	0.155941	0.155941	0.155941	38.985394	0.1875	0.194926	0.190353	0	0.15594	0.180387	11.69562	23.39124	0.194927	0.194927			0.155941								0		0	0	11.09174	23.390797	23.391244	0	0	0	0		17.0038	0.393837505	1.880449044	0	1.467359119	3.133322513	1.581122757	1.653254604	7.80535575	2.421564334	3.153005379	0	0.034086301	4.104805939	5.246039563	10.83235211	0.132559522	0.530237696	0	0	3.596134193	0	0	0	0	0	0	0	0	0	0	0	0.290449786	0.007927291	1.073598631	0	0	0	0	0	66.3413	0	18.7435	17.0038	0.393837505	1.880449044	0	1.467359119	3.133322513	1.581122757	1.653254604	7.80535575	2.421564334	3.153005379	0	0.034086301	4.104805939	5.246039563	10.83235211	0.132559522	0.530237696	0	0	3.596134193	0	0	0	0	0	0	0	0	0	0	0	0.290449786	0.007927291	1.073598631	0	0	0	0	0	66.3413	5000																																																																																	0	0	0	17.0038	0.393837505	1.880449044	0	1.467359119	3.133322513	1.581122757	1.653254604	7.80535575	2.421564334	3.153005379	0	0.034086301	4.104805939	5.246039563	10.83235211	0.132559522	0.530237696	0	0	3.596134193	0	0	0	0	0	0	0	0	0	0	0	0.290449786	0.007927291	1.073598631	0	0	0	0	0	66.3413
H5657_805_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		312.656608	7.241657	761.549395	253.704772	12.120629	25.881764	13.060336	35.367165	75.3488	2077.28888	36.540335	0	0.281561	29.311393	55.158423	77.356267	0.891894	8.297967			29.704664																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000017	1024.000446	43.132797	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				1024.000017	1024.000446	43.132797	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167	0	0	26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167																																																																																		0	0	0	26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167
H5657_806_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		312.656608	7.241657	761.549395	253.704772	12.120629	25.881764	13.060336	35.367165	75.3488	2077.28888	36.540335	0	0.281561	29.311393	55.158423	77.356267	0.891894	8.297967			29.704664																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000017	1024.000446	43.132797	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				1024.000017	1024.000446	43.132797	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167	0	0	26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167																																																																																		0	0	0	26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167
H5657_807_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		312.656608	7.241657	761.549395	253.704772	12.120629	25.881764	13.060336	35.367165	75.3488	2077.28888	36.540335	0	0.281561	29.311393	55.158423	77.356267	0.891894	8.297967			29.704664																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000017	1024.000446	43.132797	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				1024.000017	1024.000446	43.132797	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167	0	0	26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167																																																																																		0	0	0	26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167
H5657_808_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		312.656608	7.241657	761.549395	253.704772	12.120629	25.881764	13.060336	35.367165	75.3488	2077.28888	36.540335	0	0.281561	29.311393	55.158423	77.356267	0.891894	8.297967			29.704664																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000017	1024.000446	43.132797	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				1024.000017	1024.000446	43.132797	0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167	0	0	26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167																																																																																		0	0	0	26.68	0.617955	2.737312955	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.167
H5657_809_0	2009	4																																			V	Coin	Coin	Coin	Coin	Coin	V	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					253.704772	12.120629	25.881764	13.060336	35.367165	75.3488	2077.28888	36.540335	0	0.281561	29.311393	55.158423	77.356267	0.891894	8.297967			29.704664																							$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																							0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																							0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317	0	0	0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317																																																																																		0	0	0	0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317
H5657_810_0	2009	4																																			V	Coin	Coin	Coin	Coin	Coin	V	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					253.704772	12.120629	25.881764	13.060336	35.367165	75.3488	2077.28888	36.540335	0	0.281561	29.311393	55.158423	77.356267	0.891894	8.297967			29.704664																							$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																							0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																							0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317	0	0	0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317																																																																																		0	0	0	0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317
H5657_811_0	2009	4																																			V	Coin	Coin	Coin	Coin	Coin	V	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					253.704772	12.120629	25.881764	13.060336	35.367165	75.3488	2077.28888	36.540335	0	0.281561	29.311393	55.158423	77.356267	0.891894	8.297967			29.704664																							$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																							0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																							0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317	0	0	0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317																																																																																		0	0	0	0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317
H5657_812_0	2009	4																																			V	Coin	Coin	Coin	Coin	Coin	V	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					253.704772	12.120629	25.881764	13.060336	35.367165	75.3488	2077.28888	36.540335	0	0.281561	29.311393	55.158423	77.356267	0.891894	8.297967			29.704664																							$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																							0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																							0	0.2	0.2	0.199999	0.2	0.2	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317	0	0	0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317																																																																																		0	0	0	0	0	0	0	2.4241258	5.1763528	2.61205414	7.073433	15.06976	0	7.308067	0	0.056311918	5.862249289	11.0316846	15.47117604	0.445947892	1.6595934	0	0	5.9409328	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.1317
H5665_002_0	2009	9																					3350											D	A	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	Coin	V	S	V	T	V	V	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	2132.066745	11.71290274	344.799042	352.2565885	545.7093446	20.35783618	14.99425047	565.5660501	275.8848943	10.81932634	28.13702403	20.28659274	0.266495246	993.5875885	9107.529361	10291.16536	180.5506754	891.2082768	32.86272285	11616.30587	669.9799271	510.2078073	210	300	138.5915645	0	0	0	0	0											"PBP: 1A IP Acute: $230 per day, days 1 - 10"	1B IP Psych: $1000 per admit	"2 SNF: $100, days 21 - 100"	6 Home Health: $0	10A Ambulance: $150	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $225	8A OP C/D/T: 20%	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $30	"3 CORF: $30, 5 Partial Hosp: $30, 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 Individual: $30, Group: $15, 7H Psychiatric Individual: $30, Group: $15,  9C Outpatient Sub Abuse Individual: $30, Group: $15"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $30, 7B Chiropractic: $30, 7F Podiatry: $30, 8A OP C/D/T: 20%"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $25"	"10B Transportation: $0, 12 one-way trips"	16A Preventive Dental Services: $10	17A Routine Eye Exams: $25	"17B Eye Wear: Medicare Covered: $25, Routine: $0 with a $150 allowance"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	OTC Drug Card: Not Covered											230.7799261	1049.986527	115.6339551	0	156.4922573	0.220821636	0.057251632	96.62833994	459.6100498	0.260144397	0.264809326	29.50841591	26.65674876	53.69910474	8.111630757	12.59877156	31.24479881	31.08994312	0.191585293	6.55285258	21.34479359	113.1533191	0	10	20	0	0	0	0	0											217.2636203	1009.134301	107.8192593	0	156.1744515	0.217339275	0.056715179	96.62408986	448.3797819	0.25683778	0.261523558	29.50841591	26.65674876	52.51578201	7.990743077	12.50201921	31.0336952	31.05081384	0.187972267	6.364285444	21.08783154	112.9443647	0	10	20	0	0	0	0	0											38.6017	0.984990993	3.097998111	0	7.1021548	4.424557359	0.850401598	4.553942071	10.30843406	2.778811763	7.358494625	0.049885435	0.000591991	4.348252434	6.064660599	10.72169559	0.466929552	2.306061858	6.177280524	6.160790528	1.177368653	4.80209139	0	0.25	0.230985941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.8181	0	3.7492	38.6017	0.984990993	3.097998111	0	7.1021548	4.424557359	0.850401598	4.553942071	10.30843406	2.778811763	7.358494625	0.049885435	0.000591991	4.348252434	6.064660599	10.72169559	0.466929552	2.306061858	6.177280524	6.160790528	1.177368653	4.80209139	0	0.25	0.230985941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.8181	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	38.6017	0.984990993	3.097998111	0	7.1021548	4.424557359	0.850401598	4.553942071	10.30843406	2.778811763	7.358494625	0.049885435	0.000591991	4.348252434	6.064660599	10.72169559	0.466929552	2.306061858	6.177280524	6.160790528	1.177368653	4.80209139	0	0.25	0.230985941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.8181
H5678_001_0	2009	4																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1748.206364	44.5750607	2530.345576	4790.13347	250.4947818	14.87237024	8.204176592	356.7900224	362.9916738	6177.858167	454.1763192	0	7.23221919	1374.735925	6463.569551	5303.607554	222.2061616	646.9202084	0	0	1336.883836	1575.087814	2759.542995	588.881634	205.2567597	154.1150788	49.27524142	14.09480567	932.1	115.5175384											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b); $0 n/c (7b1); $0/$20 (7d); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0.2	0.2	49.97197231	50	8	16.62123034	0	0	46.77659972	1.3049349	9.448022769	20	0	0	0	0	10.95381953	0	20	20	0	20	0	0	20											0	0	0	0	0	0.169270681	0.169270681	42.29394896	42.31767029	6.770827246	14.06743491	0	0	39.58953448	1.104436097	7.996366249	16.92706812	0	0	0	0	10.95354947	0	20	20	0	20	0	0	20											0	0	0	0	0	2.517456241	1.38872656	1.257504916	1.280080164	3.485767533	0.532424651	0	0	4.535429608	0.594883294	3.53413237	0.313441569	0	0	0	0	1.437733523	0	0.98146939	0.342094599	0	0.082125402	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	22.4758	0	3.5291	0	0	0	0	0	2.517456241	1.38872656	1.257504916	1.280080164	3.485767533	0.532424651	0	0	4.535429608	0.594883294	3.53413237	0.313441569	0	0	0	0	1.437733523	0	0.98146939	0.342094599	0	0.082125402	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	22.4758		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.5221	0.0191	0.5461	0.3575	0.0717	0.0911	0.0502	0.0303	0.2278	0.0398	0.0966	0	0	0.1818	0.3067	0.9461	0.0121	0.0308	0	0	0.159	0.0697	0	0	0.0039	0.0039	0.0016	0.0006	0	0											4.7685	0	0	1.5221	0.019108291	0.546066174	0.357511627	0.071742099	2.608511569	1.438956213	1.287827197	1.507883675	3.525581715	0.629026368	0	0	4.717198766	0.901559281	4.480183426	0.325495784	0.030809149	0	0	0.158964889	1.507451114	0	0.98146939	0.346006016	0.003931507	0.083745916	0.000575298	0	0.192529231	0	0	0	0	0	0	0	0	0	0	27.2443
H5678_002_0	2009	2																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1748.206364	44.5750607	2530.345576	4790.13347	250.4947818	14.87237024	8.204176592	356.7900224	362.9916738	6177.858167	454.1763192	0	7.23221919	1374.735925	6463.569551	5303.607554	222.2061616	646.9202084	0	0	1336.883836	1575.087814	2759.542995	588.881634	205.2567597	154.1150788	49.27524142	14.09480567	932.1	115.5175384											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b); $0 n/c (7b1); $0/$20 (7d); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0.2	0.2	49.97197231	50	8	16.62123034	0	0	46.77659972	1.3049349	9.448022769	20	0	0	0	0	10.95381953	0	20	20	0	20	0	0	20											0	0	0	0	0	0.169270681	0.169270681	42.29394896	42.31767029	6.770827246	14.06743491	0	0	39.58953448	1.104436097	7.996366249	16.92706812	0	0	0	0	10.95354947	0	20	20	0	20	0	0	20											0	0	0	0	0	2.517456241	1.38872656	1.257504916	1.280080164	3.485767533	0.532424651	0	0	4.535429608	0.594883294	3.53413237	0.313441569	0	0	0	0	1.437733523	0	0.98146939	0.342094599	0	0.082125402	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	22.4758	0	3.5291	0	0	0	0	0	2.517456241	1.38872656	1.257504916	1.280080164	3.485767533	0.532424651	0	0	4.535429608	0.594883294	3.53413237	0.313441569	0	0	0	0	1.437733523	0	0.98146939	0.342094599	0	0.082125402	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	22.4758		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.5221	0.0191	0.5461	0.3575	0.0717	0.0911	0.0502	0.0303	0.2278	0.0398	0.0966	0	0	0.1818	0.3067	0.9461	0.0121	0.0308	0	0	0.162	0.0697	0	0	0.0039	0.0039	0.0016	0.0006	0	0											4.7715	0	0	1.5221	0.019108291	0.546066174	0.357511627	0.071742099	2.608511569	1.438956213	1.287827197	1.507883675	3.525581715	0.629026368	0	0	4.717198766	0.901559281	4.480183426	0.325495784	0.030809149	0	0	0.161964889	1.507451114	0	0.98146939	0.346006016	0.003931507	0.083745916	0.000575298	0	0.192529231	0	0	0	0	0	0	0	0	0	0	27.2473
H5678_003_0	2009	4																					500											D	D	D	V	T	P	P	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1177.487286	24.72239473	4301.263365	59.47919173	327.0121537	226.5638922	847.2841889	81.93813965	94.52502255	8058.731208	1174.331494	0	8.638056891	122.8462638	100.3991387	5221.280122	2311.11074	20.51549108	0	0	1211.820107	323.7290267	1576.881712	0	182.0000636	141.3063859	46.85749586	13.66333203	0	0											"$25 Days 1-20 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$25 Days 1-20 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$50 (10a)	$0 (11a)	"$0 (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	$0 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$0 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a9, 14a10); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											24.68089501	25	0	0	50	0	0	49.72891566	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											22.67995981	22.97319425	0	0	45.9463885	0	0	45.69728158	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											2.2254	0.047329365	0	0	1.252085622	0	0	0.312029187	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.8369	0	0.3385	2.2254	0.047329365	0	0	1.252085622	0	0	0.312029187	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.8369		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.0981	0.1845	0.4198	0.0508	0.1395	0.1137	0.1284	0.0179	0.1812	0.448	0.4192	0	0	0.0569	0.0077	1.4808	0.3378	0.0033	0	0	0.1084	0.0562	0	0	0.0089	0.0093	0.004	0.0054	0	0											6.2796	0	0	4.3235	0.231797941	0.41980449	0.050844559	1.391598023	0.113663316	0.128367747	0.329900655	0.181173378	0.44801229	0.419168784	0	0	0.056871313	0.007678904	1.480775883	0.337815695	0.003290112	0	0	0.10841474	0.056189696	0	0	0.008933819	0.009296473	0.003969466	0.005393421	0	0	0	0	0	0	0	0	0	0	0	0	10.1165
H5678_004_0	2009	3																					1500											D	D	D	V	T	P	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2691.848235	58.22530887	2472.450627	82486.35528	149.265726	3024.69697	15.2257496	426.4645488	409.8689707	7920.681598	516.039372	0	11.57634295	1578.880162	7231.372699	5900.277956	235.0251199	269.9443321	0	0	1762.540758	1579.145004	1418.390092	588.881634	205.2567597	154.1150788	37.56409609	10.74492219	932.1	115.5175384											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	$0 (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b); $0 n/c (7b1); $0/$20 (7d); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0	0.2	49.97655139	50	3.2	16.87836848	0	0	45.70445279	1.385031052	9.261794619	20	0	0	0	0	0.001602202	0	20	0	0	20	0	0	20											0	0	0	0	0	0	0.168852478	42.19332272	42.2131195	2.701639648	14.24977171	0	0	38.58655054	1.169329626	7.819384861	16.8852478	0	0	0	0	0.001352679	0	20	0	0	20	0	0	20											0	0	0	0	0	0	2.570905549	1.499496361	1.441820653	1.78323562	0.612786937	0	0	5.076961598	0.704654861	3.84471201	0.330704782	0	0	0	0	0.000178006	0	0.98146939	0	0	0.062606827	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	19.1021	0	3.2956	0	0	0	0	0	0	2.570905549	1.499496361	1.441820653	1.78323562	0.612786937	0	0	5.076961598	0.704654861	3.84471201	0.330704782	0	0	0	0	0.000178006	0	0.98146939	0	0	0.062606827	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	19.1021		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a3); $0 (6a2)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.2679	0.025	0.5217	0.3514	0.0877	0.1445	0.0932	0.0362	0.2692	0.0496	0.1118	0	0	0.2172	0.3679	1.0976	0.0132	0.0323	0	0	0.2012	0.073	0	0	0.0039	0.0039	0.0009	0.0004	0	0											5.9698	0	0	2.2679	0.025011423	0.521657099	0.351375896	0.087699204	0.144497803	2.664124424	1.535743347	1.711019903	1.832795484	0.724619682	0	0	5.29414688	1.072555432	4.942308779	0.343857793	0.032263339	0	0	0.201220602	0.073219429	0	0.98146939	0.003911416	0.003931507	0.063548589	0.000438568	0	0.192529231	0	0	0	0	0	0	0	0	0	0	25.0718
H5679_001_0	2009	8	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Urgent Care	Therapy (PT/OT/ST)	ASC	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemo-Radiation	D	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	0	Coin	0	0	0	V	V	V	0	V	0	V	V	V	V	V	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1693.805363	5.719763698	475.9537689	512.9077597	210.4819673	10.09182362	1.063411029	359.5873797	266.0980667	6405.999929	1029.784684	121.3086337	0	195.612906	4396.373781	3247.745931	19.14370686	350.326417	2933.166249	0	31.15024618	0	0	0	359.4500992	337.7881703	183.0156642	0	0	0	2.26407313	916.3130249	186.9140987	241.759071	407.8164796	140.0317048	0.751804802	777.5709245	26.9229011	15.85623661	$170/day (days 1-5); $850 yrly max	$1024/admit	$125/day (for days 21-100)	$0 copay	$100 copay	30% coinsurance	30% coinsurance	$50 copay	$125 copay	$0 copay	$0/$100 copay for Lower/Higher Tier	$125 copay	20% coinsurance	$25 copay	$15 coapy	$25 copay	$25 copay	$25 copay	$0/$100 copay for Lower/Higher Tier	0	20% coinsurance	0	0	0	$20 copay	$100/$80 glasses/contacts	$20 copay	0	ForeverFit	0	$25 copay	$25 copay	$100 copay	$25 copay	$25 copay	$0 copay	20% coinsurance	$25 copay	$25 copay	20% coinsurance	170	1024	125	0	100	0.3	0.3	50	125	0	29.71135861	125	0.2	25	15	25	25	25	10.23776398	0	0.2	0	0	0	20	30	20	0	0	0	25	25	100	25	25	0	0.2	25	25	0.2	72.71824931	991.4883025	121.0312869	0	96.82502954	0.290475089	0.290475089	48.41251477	121.0312869	0	28.76803175	121.0312869	0	24.20625739	14.52375443	24.20625739	24.20625739	24.20625739	9.912718002	0	0.193650059	0	0	0	19.36500591	29.04750886	19.36500591	0	0	0	24.20625739	24.20625739	96.82502954	24.20625739	24.20625739	0	0.193650059	24.20625739	24.20625739	0.193650059	10.2642	0.4725899	4.800441431	0	1.698326891	2.931423361	0.308894413	1.450710778	2.683849288	0	2.468739874	1.223511671	0	0.394588029	5.320987766	6.551314494	0.038616458	0.706674285	2.422970823	0	6.032247013	0	0	0	0.580062775	0.817658739	0.295341618	0	0	0	0.004567061	1.848375744	1.508163594	0.487673525	0.822642556	0	0.145587044	1.568506828	0.054308556	3.070561157	60.9735		1.9994	10.2642	0.4725899	4.800441431	0	1.698326891	2.931423361	0.308894413	1.450710778	2.683849288	0	2.468739874	1.223511671	0	0.394588029	5.320987766	6.551314494	0.038616458	0.706674285	2.422970823	0	6.032247013	0	0	0	0.580062775	0.817658739	0.295341618	0	0	0	0.004567061	1.848375744	1.508163594	0.487673525	0.822642556	0	0.145587044	1.568506828	0.054308556	3.070561157	60.9735	4000																																																																																	0		0	10.2642	0.4725899	4.800441431	0	1.698326891	2.931423361	0.308894413	1.450710778	2.683849288	0	2.468739874	1.223511671	0	0.394588029	5.320987766	6.551314494	0.038616458	0.706674285	2.422970823	0	6.032247013	0	0	0	0.580062775	0.817658739	0.295341618	0	0	0	0.004567061	1.848375744	1.508163594	0.487673525	0.822642556	0	0.145587044	1.568506828	0.054308556	3.070561157	60.9735
H5679_002_0	2009	8	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Urgent Care	Therapy (PT/OT/ST)	ASC	Chiropractic	Podiatric	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemo-Radiation	Dental Diagnostic	D	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	0	Coin	0	0	V	V	V	V	0	V	0	V	V	V	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	0	0	0	0	0	0	0	0	0		1516.678379	6.982597564	460.99691	429.7206917	229.6712649	9.539099319	1.29819546	346.2204625	270.284714	4846.626635	989.7832047	137.178948	0	189.6939005	4062.953433	3419.160946	23.37033625	411.3038939	2762.308915	0	30.08981795	0	0	636.8700339	361.113762	337.7881703	183.0156642	0	0	0	2.763944869	1014.94965	179.0745334	153.2702577	470.574134	0.536895099	834.6627519	27.41069216	9.334955503	0	$100/day (days 1-5); $500 yrly max	$1024/admit	$125/day (for days 21-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$100 copay	$0 copay	$0/$100 copay for Lower/Higher Tier	$100 copay	20% coinsurance	$25 copay	$10 coapy	$25 copay	$25 copay	$25 copay	$0/$100 copay for Lower/Higher Tier	0	20% coinsurance	0	0	$0/$0 copay; Exam/ 2 Cleanings per yr	$20 copay	$100/$80 glasses/contacts	$20 copay	0	Silver Sneakers	0	$25 copay	$25 copay	$75 copay	$25 copay	$25 copay	20% coinsurance	$25 copay	$25 copay	20% coinsurance	$25 copay	100	1024	125	0	100	0.2	0.2	50	100	0	30.86419753	100	0.2	25	10	25	25	25	10.43744805	0	0.2	0	0	0	20	30	20	0	0	0	25	25	75	25	25	0.2	25	25	0.2	0	45.92156879	988.0470673	120.6112143	0	96.48897142	0.192977943	0.192977943	48.24448571	96.48897142	0	29.78054673	96.48897142	0	24.12224285	9.648897142	24.12224285	24.12224285	24.12224285	10.07098626	0	0.192977943	0	0	0	19.29779428	28.94669143	19.29779428	0	0	0	24.12224285	24.12224285	72.36672856	24.12224285	24.12224285	0.192977943	24.12224285	24.12224285	0.192977943	0	5.804	0.57492792	4.633449758	0	1.846728676	1.840835763	0.250523089	1.39193568	2.173291171	0	2.456357082	1.103021299	0	0.381320195	3.266918314	6.873152559	0.046978744	0.826797701	2.318264594	0	5.806671169	0	0	0	0.580724924	0.814820828	0.294316553	0	0	0	0.005556046	2.040238495	1.079919846	0.308101865	0.945941962	0.103608912	1.677828134	0.055100614	1.80144051	0	51.3028		1.8668	5.804	0.57492792	4.633449758	0	1.846728676	1.840835763	0.250523089	1.39193568	2.173291171	0	2.456357082	1.103021299	0	0.381320195	3.266918314	6.873152559	0.046978744	0.826797701	2.318264594	0	5.806671169	0	0	0	0.580724924	0.814820828	0.294316553	0	0	0	0.005556046	2.040238495	1.079919846	0.308101865	0.945941962	0.103608912	1.677828134	0.055100614	1.80144051	0	51.3028	3450																																																																																	0		0	5.804	0.57492792	4.633449758	0	1.846728676	1.840835763	0.250523089	1.39193568	2.173291171	0	2.456357082	1.103021299	0	0.381320195	3.266918314	6.873152559	0.046978744	0.826797701	2.318264594	0	5.806671169	0	0	0	0.580724924	0.814820828	0.294316553	0	0	0	0.005556046	2.040238495	1.079919846	0.308101865	0.945941962	0.103608912	1.677828134	0.055100614	1.80144051	0	51.3028
H5679_801_0	2009	4																					none											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	V											0	0	0	0	0	0	0	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	251.4891106	2.735570453	57.97292455	38.92827625	9.131451694	18.858208	5.366158379	8.784676522	33.2531955	2.922548205	21.36443677	0	0.286081544	31.86127714	42.79362523	122.4805453	1.439793277	6.882048465	32.04637024	40.76964625	9.706845438	1.036981821	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.0721	0.0721	0.1587	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0721	0.0721	0.1587	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											18.1324	0.19723463	9.200303126	0	2.109365341	4.356246048	1.239582585	2.029260277	7.681488161	0.675108635	4.935184893	0	0.066084837	7.359955019	9.885327427	28.29300597	0.332592247	1.589753195	7.402711526	9.417788284	2.242281296	0.239542801	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.3852	0	0	18.1324	0.19723463	9.200303126	0	2.109365341	4.356246048	1.239582585	2.029260277	7.681488161	0.675108635	4.935184893	0	0.066084837	7.359955019	9.885327427	28.29300597	0.332592247	1.589753195	7.402711526	9.417788284	2.242281296	0.239542801	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.3852	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.1324	0.19723463	9.200303126	0	2.109365341	4.356246048	1.239582585	2.029260277	7.681488161	0.675108635	4.935184893	0	0.066084837	7.359955019	9.885327427	28.29300597	0.332592247	1.589753195	7.402711526	9.417788284	2.242281296	0.239542801	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.3852
H5679_802_0	2009	4																					none											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	V											0	0	0	0	0	0	0	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	251.4891106	2.735570453	57.97292455	38.92827625	9.131451694	18.858208	5.366158379	8.784676522	33.2531955	2.922548205	21.36443677	0	0.286081544	31.86127714	42.79362523	122.4805453	1.439793277	6.882048465	32.04637024	40.76964625	9.706845438	1.036981821	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.0721	0.0721	0.1587	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0721	0.0721	0.1587	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											18.1324	0.19723463	9.200303126	0	2.109365341	4.356246048	1.239582585	2.029260277	7.681488161	0.675108635	4.935184893	0	0.066084837	7.359955019	9.885327427	28.29300597	0.332592247	1.589753195	7.402711526	9.417788284	2.242281296	0.239542801	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.3852	0	0	18.1324	0.19723463	9.200303126	0	2.109365341	4.356246048	1.239582585	2.029260277	7.681488161	0.675108635	4.935184893	0	0.066084837	7.359955019	9.885327427	28.29300597	0.332592247	1.589753195	7.402711526	9.417788284	2.242281296	0.239542801	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.3852	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.1324	0.19723463	9.200303126	0	2.109365341	4.356246048	1.239582585	2.029260277	7.681488161	0.675108635	4.935184893	0	0.066084837	7.359955019	9.885327427	28.29300597	0.332592247	1.589753195	7.402711526	9.417788284	2.242281296	0.239542801	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.3852
H5679_803_0	2009	4																					none											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	V											0	0	0	0	0	0	0	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	251.4891106	2.735570453	57.97292455	38.92827625	9.131451694	18.858208	5.366158379	8.784676522	33.2531955	2.922548205	21.36443677	0	0.286081544	31.86127714	42.79362523	122.4805453	1.439793277	6.882048465	32.04637024	40.76964625	9.706845438	1.036981821	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.0721	0.0721	0.1587	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0721	0.0721	0.1587	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											18.1324	0.19723463	9.200303126	0	2.109365341	4.356246048	1.239582585	2.029260277	7.681488161	0.675108635	4.935184893	0	0.066084837	7.359955019	9.885327427	28.29300597	0.332592247	1.589753195	7.402711526	9.417788284	2.242281296	0.239542801	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.3852	0	0	18.1324	0.19723463	9.200303126	0	2.109365341	4.356246048	1.239582585	2.029260277	7.681488161	0.675108635	4.935184893	0	0.066084837	7.359955019	9.885327427	28.29300597	0.332592247	1.589753195	7.402711526	9.417788284	2.242281296	0.239542801	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.3852	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.1324	0.19723463	9.200303126	0	2.109365341	4.356246048	1.239582585	2.029260277	7.681488161	0.675108635	4.935184893	0	0.066084837	7.359955019	9.885327427	28.29300597	0.332592247	1.589753195	7.402711526	9.417788284	2.242281296	0.239542801	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.3852
H5685_001_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	326.5418394	33.89251807	50.71386746	58.3339977	13.40247762	16.87163786	13.83233988	20.78791344	22.09658955	8.90993305	17.85781872	1.569125934	2.480915328	47.27177185	57.75079489	95.44888372	9.569092693	4.98688046	22.9836954	27.80639262	7.690130703	2.957207309	8.74	0	0	0	0	0	0.353406742	4.41											PBP: 1A IP Acute: Standard Medicare FFS Cost Sharing	1B IP Psych: Standard Medicare FFS Cost Sharing	2 SNF: Standard Medicare FFS Cost Sharing	6 Home Health: Standard Medicare FFS Cost Sharing	10A Ambulance: Standard Medicare FFS Cost Sharing	11A DME: Standard Medicare FFS Cost Sharing	"11B Prosthetic Medical Supplies, 11C Diabetes Monitoring Supplies: Standard Medicare FFS Cost Sharing"	"4A ER, 4B Urgent Care: Standard Medicare FFS Cost Sharing"	9B ASC Services: Standard Medicare FFS Cost Sharing	8A OP C/D/T: Standard Medicare FFS Cost Sharing	8B OP X-Ray: Standard Medicare FFS Cost Sharing	9A OP Hospital: Standard Medicare FFS Cost Sharing	12 Renal Dialysis: Standard Medicare FFS Cost Sharing	"3 CORF, 5 Partial Hosp, 9C OP Substance Abuse, 9D Cardiac Rehab: Standard Medicare FFS Cost Sharing"	"7A PCP, 14B Immunizations, 14C Routine Physical Exams, 14D Pap Smears, 14D Pelvic Exams, 14E Prostate Screening, 14F Colorectal Screening, 14G Bone Mass Measurement, 14H Mammography, 14I Diabetes Monitoring: Standard Medicare FFS Cost Sharing"	"7B Chiropractic, 7D Physician Specialist (excl. Radiology), 7F Podiatry: Standard Medicare FFS Cost Sharing"	"7E Mental Health, 7H Psychiatric: Standard Medicare FFS Cost Sharing"	"7C Occupational Therapy, 7I Physical and Speech Therapy: Standard Medicare FFS Cost Sharing"	7D Physician Specialist (Radiology): Standard Medicare FFS Cost Sharing	"7G Other Health Care, 18A Medicare Covered Hearing Exams: Standard Medicare FFS Cost Sharing"	15 Part B Drugs: Standard Medicare FFS Cost Sharing	"13A Blood, 16B Medicare Covered Comprehensive Dental Services, 17A Medicare Covered Eye Exams: Standard Medicare FFS Cost Sharing"	10B Transportation: $132 Max	"16A Preventive Dental Services, 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	14A Health Education/Wellness Programs: $0	"7F Podiatry: 6 routine visits, $0; 13B Acupuncture: Not Covered; 13C Other 1: CVS Pharmacy Card, $30/year, $0; 13D Other 2: Emergency Response Service, $0"											0.0682	0.0682	0.1789	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0682	0.0682	0.1789	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											22.2702	2.311469732	9.072710888	0	3.095972331	3.897348345	3.195270511	4.802008004	5.104312187	2.058194535	4.125156124	0.362468091	0.573091441	10.9197793	13.34043362	22.04869214	2.210460412	1.151969386	5.309233636	6.423276695	1.776420192	0.683114888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.7315	0	0	22.2702	2.311469732	9.072710888	0	3.095972331	3.897348345	3.195270511	4.802008004	5.104312187	2.058194535	4.125156124	0.362468091	0.573091441	10.9197793	13.34043362	22.04869214	2.210460412	1.151969386	5.309233636	6.423276695	1.776420192	0.683114888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.7315	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.2702	2.311469732	9.072710888	0	3.095972331	3.897348345	3.195270511	4.802008004	5.104312187	2.058194535	4.125156124	0.362468091	0.573091441	10.9197793	13.34043362	22.04869214	2.210460412	1.151969386	5.309233636	6.423276695	1.776420192	0.683114888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.7315
H5696_001_0	2009	8	q.										Other Non-Covered										3000	Acupuncture										D	D	D		T	COIN	COIN	V	V	V	V	V	COIN	V	V	V	V	V	V	V	COIN			V	V	P	V				V																																																		0		1182.104015	84.68291797	890.1158932		58.30103582	10.25612759	0.107958202	566.9489876	333.132732	3538.217978	1264.184187	146.4248935	0	1827.171335	3476.649806	6169.88917	109.2479029	487.1739862	1618.351152	2623.357441	0.273617162			208.9908487	350.2008816	262.6506612	50.83561185				14.98626411										$175Copay days 1-5	$175 Copay days 1-5	$75 Copay days 6-43		$100 Copay Per Trip	20% Coinsurance	20% Coinsurance	$50 Copay per ER Visit/$20 Copay per Urgent Care Visit	$175 Copay per OP Service/$75 Copay per ASC	$0-20 Lab Copay	$0-90 Radiologic Copay	$175 Copay	20% Coinsurance	$50 copays	$0 Copay; Physicals $10 Copay	$25 Copay per visit	$20 Copay per visit	$25 Copay per visit	$25 Copay per visit	$25 Copay per visit	20% Coinsurance			$10 Copay (Non-Medicare Covered)	$10 Copay (Non-Medicare Covered)	$10 Copay (per Glass/Contact)	$10 annual exam/routine (Non-Medicare covered)				$20 Copay per visit/ 6-visit max										113.4772569	75.2578113	46.29351901		100	0.2	0.2	41	87.5	12	65.419	175	0.2	50	2.25	21.17479184	20	25	25	25	0.2			3.5	10	10	10				20										91.13198646	60.43848809	37.17767298		100	0.2	0.2	32.92652243	70.27001737	9.637030954	52.53707733	175	0.160617183	50	1.806943304	17.00517703	16.06171826	25	25	25	0.160617183			3.5	10	10	10				20										8.9773	0.426508961	2.757703133	0	0.485841965	2.051225518	0.02159164	1.555638213	1.950770239	2.841493015	5.534711868	2.13536303	0	7.613213896	0.523509091	8.743338133	0.146225753	1.014945805	3.3715649	5.465328002	0.043947618	0	0	0.060955664	0.291834068	0.218875551	0.04236301	0	0	0	0.024977107	0	0	0	0	0	0	0	0	0	56.2992		8.2144	8.9773	0.426508961	2.757703133	0	0.485841965	2.051225518	0.02159164	1.555638213	1.950770239	2.841493015	5.534711868	2.13536303	0	7.613213896	0.523509091	8.743338133	0.146225753	1.014945805	3.3715649	5.465328002	0.043947618	0	0	0.060955664	0.291834068	0.218875551	0.04236301	0	0	0	0.024977107	0	0	0	0	0	0	0	0	0	56.2992																																																																																		0			8.9773	0.426508961	2.757703133	0	0.485841965	2.051225518	0.02159164	1.555638213	1.950770239	2.841493015	5.534711868	2.13536303	0	7.613213896	0.523509091	8.743338133	0.146225753	1.014945805	3.3715649	5.465328002	0.043947618	0	0	0.060955664	0.291834068	0.218875551	0.04236301	0	0	0	0.024977107	0	0	0	0	0	0	0	0	0	56.2992
H5696_002_0	2009	9	q.										Other Non-Covered										4200	Acupuncture										D	D	D		T	COIN	COIN	V	V	V	V	V	COIN	V	V	V	V	V	V	V	COIN			V	V	P	V				V																																																		0		1143.346514	81.90642938	376.7941708		35.66496461	2.664419906	0.056032036	289.2601291	163.0718101	3826.717392	872.784773	486.6673406	0	1106.535197	4997.283286	9617.684648	150.0653401	19.72135785	1053.989788	1953.619333	0.158925465			158.739962	265.9966931	199.4975198	38.6124232				20										$300 Copay days 1-5	$300 Copay days 1-5	"$75 Copay days 6-43, $30 days 44-100"		$125 Copay Per Trip	20% Coinsurance	20% Coinsurance	$50 Copay per ER Visit/$30 Copay per Urgent Care Visit	$200 Copay per OP Service/$100 Copay per ASC	$0-30 Lab Copay	$0-100 Radiologic Copay	$200 Copay	20% Coinsurance	"$80 Copay, $30 Subs Abuse, $60 Cardiac Rehab"	$10 Copay; Physicals $20 Copay	$30 Copay per visit	$30 Copay per visit	$30 Copay per visit	$30 Copay per visit	$30 Copay per visit	20% Coinsurance			"$10 Exam, cleaning, flouride, $10 x-ray"	$15 Copay (Non-Medicare Covered)	$15 Copay Glasses/Contacts Copay	$10 Copay (Non-Medicare Covered)				$20 Copay per visit/6 visit Max										194.5324404	129.0133908	46.41314051		125	0.2	0.2	44	112.5	15	76.15	200	0.2	66.5	12	5.25	30	30	30	30	0.2			2.222222222	15	15	10				25										175.3463949	116.289257	41.83557686		112.6716928	0.180274708	0.180274708	44	101.4045235	13.52060313	68.63959523	200	0.180274708	66.5	10.8164825	5.25	27.04120626	30	30	30	0.180274708			2.222222222	15	15	10				22.53433855										16.7068	0.793736485	1.313616791	0	0.334869328	0.480327522	0.010101159	1.060620474	1.378018267	4.311627263	4.992299462	8.111122343	0	6.132049216	4.504418936	4.207737033	0.338162318	0.049303395	2.634974469	4.884048333	0.028650242	0	0	0.029396289	0.332495866	0.2493719	0.032177019	0	0	0	0.037557231	0	0	0	0	0	0	0	0	0	62.9535		3.8548	16.7068	0.793736485	1.313616791	0	0.334869328	0.480327522	0.010101159	1.060620474	1.378018267	4.311627263	4.992299462	8.111122343	0	6.132049216	4.504418936	4.207737033	0.338162318	0.049303395	2.634974469	4.884048333	0.028650242	0	0	0.029396289	0.332495866	0.2493719	0.032177019	0	0	0	0.037557231	0	0	0	0	0	0	0	0	0	62.9535																																																																																		0			16.7068	0.793736485	1.313616791	0	0.334869328	0.480327522	0.010101159	1.060620474	1.378018267	4.311627263	4.992299462	8.111122343	0	6.132049216	4.504418936	4.207737033	0.338162318	0.049303395	2.634974469	4.884048333	0.028650242	0	0	0.029396289	0.332495866	0.2493719	0.032177019	0	0	0	0.037557231	0	0	0	0	0	0	0	0	0	62.9535
H5696_003_0	2009	7	q.										Other Non-Covered										3000	Acupuncture										D	D	D		T	COIN	COIN	V	V	V	V	V	COIN	V	V	V	V	V	V	V	COIN		V	V	V	V	V				V																																																		0		1144.343147	47.81614799	479.0152192		42.67979121	18.35942907	0.186105101	605.7239086	1038.545825	249.8484716	1290.219223	67.99930054	0.036635546	370.852554	3259.115272	3729.9773	178.1237265	624.07494	2433.41019	4932.90495	0.170554241			208.9908487	350.2008816	0	50.83561185				0										$100 Copay days 1-6	$150 Copay days 1-7	$75 Copay days 6-43		$100 Copay Per Trip	20% Coinsurance	20% Coinsurance	$50 Copay per ER Visit/$15 Copay per Urgent Care Visit	$145 Copay per OP Service/$50 Copay per ASC	$0-25 Lab Copay	$0-100 Radiologic Copay	$145 Copay	20% Coinsurance	$50 Copay	$20 Physical Exams; $25 Copay Shingles Vacine	"$15 Copay per visit, $20 Copay Chiro/Podiatry"	$20 Copay per visit	$25 Copay per visit	$15 Copay per visit	$20 Copay per visit	20% Coinsurance			$0 Copay	$10 Copay (Non-Medicare Covered)	$10 Copay glasses to $100	$10 annual exam/routine (Non-Medicare Covered)				$20 Copay per visit/ 6 Visit Max										70.60082986	78.82099431	46.29351901		100	0.2	0.2	32.05	61.875	25	72.85333333	145	0.2	50	2.5	5.5	20	25	15	15	0.2			0	10	10	10				20										64.69094018	72.22300697	42.4183579		100	0.2	0.2	32.05	56.69553646	22.90728746	66.75488996	145	0.1832583	50	2.290728746	5.5	18.32582997	25	15	15	0.2			0	10	10	10				18.32582997										6.1691	0.287785499	1.693253251	0	0.355664927	3.671885814	0.03722102	1.617787606	4.906742723	0.476945897	7.177370188	0.821658215	0.006713768	1.545218975	0.622145753	1.709572929	0.272022094	1.300156125	3.041762737	6.166131187	0.034110848	0	0	0	0.291834068	0	0.04236301	0	0	0	0	0	0	0	0	0	0	0	0	0	42.2474		1.9744	6.1691	0.287785499	1.693253251	0	0.355664927	3.671885814	0.03722102	1.617787606	4.906742723	0.476945897	7.177370188	0.821658215	0.006713768	1.545218975	0.622145753	1.709572929	0.272022094	1.300156125	3.041762737	6.166131187	0.034110848	0	0	0	0.291834068	0	0.04236301	0	0	0	0	0	0	0	0	0	0	0	0	0	42.2474																																																																																		0			6.1691	0.287785499	1.693253251	0	0.355664927	3.671885814	0.03722102	1.617787606	4.906742723	0.476945897	7.177370188	0.821658215	0.006713768	1.545218975	0.622145753	1.709572929	0.272022094	1.300156125	3.041762737	6.166131187	0.034110848	0	0	0	0.291834068	0	0.04236301	0	0	0	0	0	0	0	0	0	0	0	0	0	42.2474
H5696_004_0	2009	8	q.										Other Non-Covered										4200	Acupuncture										D	D	D		T	COIN	COIN	V	V	V	V	V	COIN	V	V	V	V	V	V	V	COIN			V	V	V	V				V																																																		0		781.4853899	37.30080421	357.8714184		5.048736598	5.163192674	2.317880572	130.8562168	592.8634619	669.508258	887.5007597	194.1147868	6.77499501	471.0148744	2051.347176	3038.769156	144.6203187	656.7561515	4457.946954	4803.698947	0.387228858			160.3318406	268.6641654	201.498124	38.99963691				19.93625499										$205 Copay days 1-7	$205 Copay days 1-7	"$50 Copay days 6-61, $30 62-100"		$100 Copay Per Trip	20% Coinsurance	20% Coinsurance	$50 Copay per ER Visit/$20 Copay per Urgent Care Visit	$200 Copay per OP Service/$75 Copay per ASC	$0-30 Lab Copay	$0-125 Radiologic Copay	$200 Copay	20% Coinsurance	"$80 Copay, $20 Sub Abuse, Cardiac Rehab"	"$10 Copay per visit; Physicals, $20"	$25 Copay per visit	$25 Copay per visit	$35 Copay per visit	$25 Copay per visit	$25 Copay per visit	20% Coinsurance			"$10 (exam , 2 cleanings, flouride), $10 x-ray"	$15 Copay (Non-Medicare Covered)	$15 Copay glasses to $100	$10 annual exam/routine (non-Medicare Covered)				"$25 Copay per visit, 6 Visits/year"										153.998695	107.7220256	31.04314706		100	0.2	0.2	33.4	122.5	15	79.925	200	0.2	40	12.25	21.17479184	25	35	25	25	0.2			2.222222222	15	15	10				25										136.8973099	95.75961351	27.59583984		88.89511037	0.177790221	0.177790221	29.69096686	108.8965102	13.33426656	71.04941697	200	0.177790221	35.55804415	12.25	18.82335457	25	31.11328863	22.22377759	25	0.177790221			2.222222222	15	13.33426656	10				25										8.9153	0.297659216	0.822980196	0	0.037400666	0.917965165	0.412096499	0.323770633	5.380063502	0.743950131	5.254700961	3.235246446	1.204527858	1.395697308	2.094083576	4.76665244	0.301292331	1.702820309	8.256035136	10.00770614	0.068845504	0	0	0.029691082	0.335830207	0.223902475	0.032499697	0	0	0	0.041533865	0	0	0	0	0	0	0	0	0	56.8022		5.0873	8.9153	0.297659216	0.822980196	0	0.037400666	0.917965165	0.412096499	0.323770633	5.380063502	0.743950131	5.254700961	3.235246446	1.204527858	1.395697308	2.094083576	4.76665244	0.301292331	1.702820309	8.256035136	10.00770614	0.068845504	0	0	0.029691082	0.335830207	0.223902475	0.032499697	0	0	0	0.041533865	0	0	0	0	0	0	0	0	0	56.8022																																																																																		0			8.9153	0.297659216	0.822980196	0	0.037400666	0.917965165	0.412096499	0.323770633	5.380063502	0.743950131	5.254700961	3.235246446	1.204527858	1.395697308	2.094083576	4.76665244	0.301292331	1.702820309	8.256035136	10.00770614	0.068845504	0	0	0.029691082	0.335830207	0.223902475	0.032499697	0	0	0	0.041533865	0	0	0	0	0	0	0	0	0	56.8022
H5696_018_0	2009	4	q.										Other Non-Covered										2800	Acupuncture										D	D	D		T	COIN	COIN	V	V	V	V	V	COIN	V		V	V	V	V	V	COIN				V	V	V				V																																																		0		1118.029313	67.86886711	485.5764794		14.92285122	21.05233405	0.151762009	964.3232632	64.90512233	928.5541321	390.6015015	302.201431	0.021622835	742.0921316		2614.961991	310.13066	863.125886	3094.307887	2674.041853	0.239060039				160.3318406	268.6641654	201.498124				45										$100 Copay days 1-6	$100 Copay days 1-6	$50 Copay days 6-61		$100 Copay Per Trip	20% Coinsurance	20% Coinsurance	$50 Copay per ER Visit/$15 Copay per Urgent Care Visit	$150 Copay per OP Service/$75 Copay per ASC	$0-25 Lab Copay	$0-90 Radiologic Copay	$150 Copay	20% Coinsurance	$50 Copay		$20 Copay per visit	$20 Copay per visit	$25 Copay per visit	$20 Copay per visit	$20 Copay per visit	20% Coinsurance				$10 Copay (Non-Medicare Covered)	$10 Copay glasses to $100	$10 annual exam/routine (Non-Medicare Covered)				"$20 Copay per visit, 6 visit limit"										70.60082986	52.54732954	31.01529489		100	0.2	0.2	32.05	84.375	20	66.15	150	0.2	50		16.93983347	20	25	20	20	0.2				10	10	10				20										63.57913796	47.3211706	27.93063079		100	0.2	0.2	32.05	75.98338116	18.01087553	59.57097083	150	0.180108755	50		16.93983347	18.01087553	25	20	20	0.2				10	10	10				20										5.9236	0.267636187	1.130204781	0	0.124357093	4.21046681	0.030352402	2.575546715	0.410975887	1.393672742	1.939042554	3.777517888	0.003894462	3.092050548	0	3.691418388	0.46547706	1.798178929	5.157179811	4.456736422	0.047812008	0	0	0	0.133609867	0.223886804	0.167915103	0	0	0	0.075	0	0	0	0	0	0	0	0	0	41.0965		1.2739	5.9236	0.267636187	1.130204781	0	0.124357093	4.21046681	0.030352402	2.575546715	0.410975887	1.393672742	1.939042554	3.777517888	0.003894462	3.092050548	0	3.691418388	0.46547706	1.798178929	5.157179811	4.456736422	0.047812008	0	0	0	0.133609867	0.223886804	0.167915103	0	0	0	0.075	0	0	0	0	0	0	0	0	0	41.0965																																																																																		0			5.9236	0.267636187	1.130204781	0	0.124357093	4.21046681	0.030352402	2.575546715	0.410975887	1.393672742	1.939042554	3.777517888	0.003894462	3.092050548	0	3.691418388	0.46547706	1.798178929	5.157179811	4.456736422	0.047812008	0	0	0	0.133609867	0.223886804	0.167915103	0	0	0	0.075	0	0	0	0	0	0	0	0	0	41.0965
H5696_019_0	2009	5	q.										Other Non-Covered										4200	Acupuncture										D	D	D		T	COIN	COIN	V	V	V	V	V	COIN	V	V	V	V	V	V	V	COIN			V	V	V	V				V																																																		0		749.6695891	50.2820211	127.7409298		58.0932644	14.1534343	0	122.3467364	125.6444921	2583.900669	758.6267418	634.263274	0.02528401	1092.689496	2064.181128	2400.314364	189.7526969	886.3098659	2564.469562	7100.001582	0.239397195			160.3318406	268.6641654	201.498124	38.99963691				45										$250 Copay days 1-5	$250 Copay days 1-5	"$50 Copay days 6-61, $30 days 62-100"		$125 Copay Per Trip	20% Coinsurance	20% Coinsurance	$50 Copay per ER Visit/$25 Copay per Urgent Care Visit	$200 Copay per OP Service/$125 Copay per ASC	$0-30 Lab Copay	$0-125 Radiologic Copay	$200 Copay	20% Coinsurance	"$70 Copay; $35 AS, Cardiac"	$15 Copay per visit	$35 Copay per visit	$35 Copay per visit	$35 Copay per visit	$35 Copay per visit	$35 Copay per visit	20% Coinsurance			"$10 (exam , 2 cleanings, flouride), $10 x-ray"	$10 Copay (Non-Medicare Covered)	$10 Copay glasses to $100	$10 annual exam/routine (Non-Medicare Covered)				$25 Copay per visit										162.110367	107.511159	31.04004553		125	0.2	0.2	31.25	134.375	15	80.20285714	200	0.2	48.64695	12.75	29.00535507	35	35	35	35	0.2			2.222222222	10	10	10				25										151.7061533	100.6111125	29.04790108		116.9775228	0.187164037	0.187164037	31.25	125.750837	14.03730274	75.05545242	200	0.187164037	48.64695	11.93170733	29.00535507	32.75370639	35	35	35	0.187164037			2.222222222	10	10	10				25										9.4775	0.421577507	0.309217158	0	0.566300514	2.649013895	0	0.318611293	1.316658338	3.022582995	4.744922777	10.57105457	0.004732257	4.429667606	2.052433758	5.801830866	0.517925344	2.585070442	7.47970289	20.70833795	0.044806545	0	0	0.029691082	0.223886804	0.167915103	0.032499697	0	0	0	0.09375	0	0	0	0	0	0	0	0	0	77.5696		1.7233	9.4775	0.421577507	0.309217158	0	0.566300514	2.649013895	0	0.318611293	1.316658338	3.022582995	4.744922777	10.57105457	0.004732257	4.429667606	2.052433758	5.801830866	0.517925344	2.585070442	7.47970289	20.70833795	0.044806545	0	0	0.029691082	0.223886804	0.167915103	0.032499697	0	0	0	0.09375	0	0	0	0	0	0	0	0	0	77.5696																																																																																		0			9.4775	0.421577507	0.309217158	0	0.566300514	2.649013895	0	0.318611293	1.316658338	3.022582995	4.744922777	10.57105457	0.004732257	4.429667606	2.052433758	5.801830866	0.517925344	2.585070442	7.47970289	20.70833795	0.044806545	0	0	0.029691082	0.223886804	0.167915103	0.032499697	0	0	0	0.09375	0	0	0	0	0	0	0	0	0	77.5696
H5696_021_0	2009	6																																					COIN	COIN	V			P		COIN		V						COIN			V	V	P	V																																																						0							2.977096175	0.023407391	65.06051066			855.1679586		0.330314338		1722.35568						0.330314338			213.1497686	357.1698826	267.8774119	51.84724102																			20% Coinsurance	20% Coinsurance	$25 Copay-ER; $0 Copay UC			$0-50 Therapy; $10 MRI/MRA		20% Coinsurance		"$0 Copay per visit, Preventive $10"						20% Coinsurance			"$10 (exam , 2 cleanings, flouride), $10 x-ray"	$10 Copay (Non-Medicare Covered)	$10 Copay glasses to $100	$10 annual exam/routine;$10 Fitting																			0.2	0.2	15			6.363636364		0.2		4						0.2			2.222222222	10	10	10																			0.2	0.2	15			6.363636364		0.2		4						0.2			2.222222222	10	10	10														0	0	0	0	0	0.595419235	0.004681478	0.081325638	0	0	0.45349816	0	0.066062868	0	0.57411856	0	0	0	0	0	0.066062868	0	0	0.039472179	0.297641569	0.223231177	0.043206034	0	0	0	0	0	0	0	0	0	0	0	0	0	2.4447			0	0	0	0	0	0.595419235	0.004681478	0.081325638	0	0	0.45349816	0	0.066062868	0	0.57411856	0	0	0	0	0	0.066062868	0	0	0.039472179	0.297641569	0.223231177	0.043206034	0	0	0	0	0	0	0	0	0	0	0	0	0	2.4447																																																																																		0			0	0	0	0	0	0.595419235	0.004681478	0.081325638	0	0	0.45349816	0	0.066062868	0	0.57411856	0	0	0	0	0	0.066062868	0	0	0.039472179	0.297641569	0.223231177	0.043206034	0	0	0	0	0	0	0	0	0	0	0	0	0	2.4447
H5696_022_0	2009	11	q.										Other Non-Covered										3200	Acupuncture										D	D	D		T	COIN	COIN	V	V	V	V	V	COIN	V	V	V	V	V	V	V	COIN			V	V	V	V				V																																																		0		1529.607454	100.9934905	781.9570359		155.1631801	2.913227152	0.03145431	117.1089192	334.0708162	3220.187994	747.1238211	584.7433427	0	755.6486214	3110.072033	3626.42191	344.9448494	875.4695192	5899.733331	3161.258851	0.324169089			160.3318406	268.6641654	201.498124	38.99963691				96.0134093										$150 Copay days 1-5	$150 Copay days 1-5	$75 Copay days 6-43		$100 Copay Per Trip	20% Coinsurance	20% Coinsurance	$50 Copay per ER Visit/$20 Copay per Urgent Care Visit	$160 Copay per OP Service/$50 Copay per ASC	$0-10 Lab Copay	$0-100 Radiologic Copay	$160 Copay	20% Coinsurance	$55 Copay	$0 Copay	"$25 Copay per visit, Chiro/Pod $25 Per visit, Preventive $0"	$25 Copay per visit	$30 Copay per visit	$25 Copay per visit	$25 Copay per visit	20% Coinsurance			$5 Copay (Non-Medicare Covered)	$15 Copay (Non-Medicare Covered)	"$15 Copay (Glasses/contacts, $100 benefit limit)"	$15 Copay Hearing Exam/Aid Fitting				"$30 Copay per visit, Max 6 visits"										97.26622022	64.5066954	41.74968756		100	0.2	0.2	33.4	63.75	10	53.63636364	160	0.2	35	0	7.5	25	30	25	25	0.2			1.111111111	15	15	15				18										66.16797739	43.88242448	28.40135431		100	0.2	0.2	33.4	43.36766196	6.802770504	36.48758725	160	0.13605541	35	0	7.5	17.00692626	30	25	25	0.13605541			1.111111111	15	15	15				18										8.4343	0.369319935	1.850719902	0	1.293026501	0.58264543	0.006290862	0.325953158	1.207322519	1.825516658	2.271728801	7.796577902	0	2.203975146	0	2.266513693	0.488870968	2.188673798	12.29111111	6.585955939	0.044104958	0	0	0.014845541	0.335830207	0.251872655	0.048749546	0	0	0	0.144020114	0	0	0	0	0	0	0	0	0	52.8279		7.0973	8.4343	0.369319935	1.850719902	0	1.293026501	0.58264543	0.006290862	0.325953158	1.207322519	1.825516658	2.271728801	7.796577902	0	2.203975146	0	2.266513693	0.488870968	2.188673798	12.29111111	6.585955939	0.044104958	0	0	0.014845541	0.335830207	0.251872655	0.048749546	0	0	0	0.144020114	0	0	0	0	0	0	0	0	0	52.8279																																																																																		0			8.4343	0.369319935	1.850719902	0	1.293026501	0.58264543	0.006290862	0.325953158	1.207322519	1.825516658	2.271728801	7.796577902	0	2.203975146	0	2.266513693	0.488870968	2.188673798	12.29111111	6.585955939	0.044104958	0	0	0.014845541	0.335830207	0.251872655	0.048749546	0	0	0	0.144020114	0	0	0	0	0	0	0	0	0	52.8279
H5697_001_0	2009	5																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1437.468605	25.70252422	1267.126112	2682.519985	191.1929183	14.45129706	6.435222613	288.3487372	476.5215629	6220.580434	1213.691005	0	5.208618387	1312.462946	8340.408575	6616.879656	174.4840119	509.1012453	0	0	1262.950953	1895.475133	1814.127009	533.7295777	208.4925153	227.5379985	38.49309125	21.53814506	612.1709614	143.8976931											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b, 7d); $0 n/c (7b1); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0.2	0.2	49.96531977	50	8	11.3906649	0	0	47.16696965	1.295404095	18.39282264	20	0	0	0	0	0.102548544	0	20	20	0	20	0	0	20											0	0	0	0	0	0.163018199	0.163018199	40.7262821	40.75454964	6.520727942	9.284428362	0	0	38.44537212	1.05587221	14.99182407	16.30181986	0	0	0	0	0.083586394	0	20	20	0	20	0	0	20											0	0	0	0	0	2.355824413	1.049058398	0.978614334	1.618368474	3.380226054	0.939035599	0	0	4.204843863	0.733867136	8.266591307	0.237033911	0	0	0	0	0.013202994	0	0.889549296	0.347487525	0	0.064155152	0	0	0.239829488	0	0	0	0	0	0	0	0	0	0	25.3177	0	5.3939	0	0	0	0	0	2.355824413	1.049058398	0.978614334	1.618368474	3.380226054	0.939035599	0	0	4.204843863	0.733867136	8.266591307	0.237033911	0	0	0	0	0.013202994	0	0.889549296	0.347487525	0	0.064155152	0	0	0.239829488	0	0	0	0	0	0	0	0	0	0	25.3177		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.3267	0.0113	0.3037	0.1982	0.0618	0.0885	0.0394	0.0245	0.2983	0.0781	0.4765	0	0	0.3636	0.3258	1.0709	0.0092	0.0243	0	0	0.1197	0.085	0	0	0.0055	0.008	0.0012	0.0013	0	0											4.9214	0	0	1.3267	0.011279611	0.303733375	0.198175497	0.061782544	2.444301742	1.08845772	1.003116778	1.916670448	3.458289056	1.415507374	0	0	4.56843657	1.059698615	9.337493167	0.246187474	0.024312299	0	0	0.119717155	0.098226298	0	0.889549296	0.352947917	0.008016906	0.065367121	0.001296323	0	0.239829488	0	0	0	0	0	0	0	0	0	0	30.239
H5697_002_0	2009	3																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1445.603602	25.84798128	1274.297098	2697.701041	192.2749272	14.61532695	6.508265805	289.9805753	479.2183185	6255.784265	1220.559588	0	5.23809527	1319.890504	8387.609047	6654.326245	175.4714608	511.9823774	0	0	1270.098311	1906.202104	1824.393611	533.7295777	209.6724269	228.8256933	38.71093335	21.66003484	615.635391	144.7120463											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b, 7d); $0 n/c (7b1); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0.2	0.2	49.96531977	50	8	11.3906649	0	0	47.16698626	1.295404095	18.39282264	20	0	0	0	0	0.102548544	0	20	20	0	20	0	0	20											0	0	0	0	0	0.162860662	0.162860662	40.68692518	40.7151654	6.514426465	9.275456109	0	0	38.40823294	1.05485184	14.97733632	16.28606616	0	0	0	0	0.083505618	0	20	20	0	20	0	0	20											0	0	0	0	0	2.380261817	1.059940475	0.983201498	1.625954425	3.396070548	0.94343724	0	0	4.224555163	0.73730707	8.30534018	0.238144985	0	0	0	0	0.013264882	0	0.889549296	0.349454045	0	0.064518222	0	0	0.241186744	0	0	0	0	0	0	0	0	0	0	25.4522	0	5.4519	0	0	0	0	0	2.380261817	1.059940475	0.983201498	1.625954425	3.396070548	0.94343724	0	0	4.224555163	0.73730707	8.30534018	0.238144985	0	0	0	0	0.013264882	0	0.889549296	0.349454045	0	0.064518222	0	0	0.241186744	0	0	0	0	0	0	0	0	0	0	25.4522		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.3417	0.0114	0.3072	0.2004	0.0625	0.0895	0.0398	0.0246	0.3017	0.0789	0.4819	0	0	0.3677	0.3295	1.0831	0.0093	0.0246	0	0	0.1211	0.086	0	0	0.0055	0.0081	0.0012	0.0013	0	0											4.9771	0	0	1.3417	0.011407641	0.30718091	0.200424894	0.062483808	2.46974341	1.099787	1.007842607	1.927642285	3.475019606	1.425317224	0	0	4.59227484	1.066836909	9.388397345	0.247402446	0.024588257	0	0	0.121076008	0.099253246	0	0.889549296	0.354976415	0.008107902	0.065743947	0.001311037	0	0.241186744	0	0	0	0	0	0	0	0	0	0	30.4293
H5697_003_0	2009	3																					1500											D	D	D	V	T	P	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2813.251621	60.8512926	2583.959097	86198.23872	155.9976674	3161.111962	16.63009373	445.6892432	428.3542183	8277.907371	539.3129453	0	12.09844045	1650.088262	7554.160268	6159.633595	245.6248428	282.1189249	0	0	1842.032022	1650.365049	1418.390092	533.7295777	205.2567597	154.1150788	37.56409609	10.74492219	932.1	115.5175384											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	$0 (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b, 7d); $0 n/c (7b1); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0	0.2	49.97756284	50	3.2	16.87836848	0	0	45.70445279	1.385645284	17.94319839	20	0	0	0	0	0.001602202	0	20	0	0	20	0	0	20											0	0	0	0	0	0	0.159210478	39.78475823	39.80261938	2.547367641	13.43606553	0	0	36.38313877	1.103046237	14.28372592	15.92104775	0	0	0	0	0.001275437	0	20	0	0	20	0	0	20											0	0	0	0	0	0	2.647685164	1.477636566	1.420801659	1.757239447	0.603853673	0	0	5.002949184	0.694382338	7.331876503	0.325883738	0	0	0	0	0.000175411	0	0.889549296	0	0	0.062606827	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	22.4072	0	5.4474	0	0	0	0	0	0	2.647685164	1.477636566	1.420801659	1.757239447	0.603853673	0	0	5.002949184	0.694382338	7.331876503	0.325883738	0	0	0	0	0.000175411	0	0.889549296	0	0	0.062606827	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	22.4072		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a3); $0 (6a2)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.4771	0.0273	0.5698	0.3838	0.0958	0.1578	0.1018	0.0379	0.3643	0.0671	0.1513	0	0	0.2939	0.3617	1.079	0.0129	0.0317	0	0	0.1978	0.0718	0	0	0.0039	0.0039	0.0009	0.0004	0	0											6.492	0	0	2.4771	0.027318347	0.569772043	0.383784985	0.095788124	0.15782553	2.749502064	1.515518304	1.785103332	1.824307767	0.75519457	0	0	5.296861451	1.056032767	8.410883868	0.338813296	0.031715228	0	0	0.197751166	0.071975958	0	0.889549296	0.003911416	0.003931507	0.063548589	0.000438568	0	0.192529231	0	0	0	0	0	0	0	0	0	0	28.8991
H5697_004_0	2009	3																					500											D	D	D	V	T	P	P	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1259.230042	45.3281224	5616.555744	74.8694197	433.130432	344.5180288	963.1790169	122.5249519	80.19870512	9046.590983	1189.283522	0	4.456209781	195.2225932	132.3348116	5843.400013	1756.00915	29.73541857	0	0	1064.87888	681.1940818	1576.881712	0	182.0000636	141.3063859	46.85749586	13.66333203	0	0											"$25 Days 1-20 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$25 Days 1-20 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$50 (10a)	$0 (11a)	"$0 (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	$0 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$0 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a9, 14a10); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											24.6793694	25	0	0	50	0	0	49.6332695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											22.13114689	22.41867138	0	0	44.83734275	0	0	44.50847833	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											2.3224	0.084683023	0	0	1.618368136	0	0	0.45444993	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.4799	0	0.5158	2.3224	0.084683023	0	0	1.618368136	0	0	0.45444993	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.4799		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.0527	0.2324	0.5678	0.0359	0.2738	0.1507	0.1721	0.0267	0.1037	0.426	0.3524	0	0	0.0689	0.0105	1.6038	0.3832	0.0034	0	0	0.1064	0.0798	0	0	0.0089	0.0093	0.004	0.0054	0	0											6.6778	0	0	4.375	0.317070709	0.56779703	0.035886823	1.892209603	0.150659884	0.172123613	0.48112236	0.103655171	0.425996053	0.352432703	0	0	0.068945413	0.010491156	1.60380724	0.383195305	0.003438569	0	0	0.106444105	0.07976221	0	0	0.008933819	0.009296473	0.003969466	0.005393421	0	0	0	0	0	0	0	0	0	0	0	0	11.1576
H5698_002_0	2009	4																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		1856.811977	338.2287938	727.826072		579.7046698	1036.75937	2818.226179	391.100932	375.0337653		617.4387097	68.54217999		124.9074673	4809.032244	5885.542775	377.5259956	341.596542			25.04808291		100		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	$50; waived if admitted within 24 hrs	20% or $250 per visit	No Cost Sharing	"$0 for diagnostic, $75 for all other services"	$50/Obs	No Cost Sharing	$20 Visit	$20/Visit	$20/Visit	$20 Visit	$20 Visit	No Cost Sharing	No Cost Sharing	20% Scripts	20% medicare covered eyewear	$3/Trip; 40 trip/yr limit	No Cost Sharing	$30 Visit	"$100 lens, frames & contacts"	$30 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	26.54055058	4.489237417	49.98999745	158.8935155		75	50		23.49752825	20	20	20	20			0.2		3		30		30														60.95983703	79.55	31.06		50	26.54055058	4.489237417	49.98999745	158.8935155		75	50		23.49752825	20	20	20	20			0.2		3		30		30														9.4326	2.242175045	1.883856483	0	2.415436124	2.293013708	1.054307201	1.629261216	4.965869452	0	3.858991935	0.285592417	0	0.244584728	8.01505374	9.809237959	0.629209993	0.56932757	0	0	5.009616582	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	55.3456	0	0.1455	9.4326	2.242175045	1.883856483	0	2.415436124	2.293013708	1.054307201	1.629261216	4.965869452	0	3.858991935	0.285592417	0	0.244584728	8.01505374	9.809237959	0.629209993	0.56932757	0	0	5.009616582	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	55.3456																																																																																		0	0	0	9.4326	2.242175045	1.883856483	0	2.415436124	2.293013708	1.054307201	1.629261216	4.965869452	0	3.858991935	0.285592417	0	0.244584728	8.01505374	9.809237959	0.629209993	0.56932757	0	0	5.009616582	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	55.3456
H5698_003_0	2009	8																																D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0									997.4432604													23.56978569				144		249														No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	"$50ER, waived if admitted within 24 hrs; $35 UC"	No Cost Sharing	No Cost Sharing	No Cost Sharing	$35/Obs	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	20% Scripts with $2000 OOP Max	No Cost Sharing	$0/Trip; 40 trip/yr limit	$250 Allowance	$10 Visit	"$150 lens, frames & contacts allowance"	$10 Visit	Not Covered	Not Covered	No Cost Sharing																		34.99695812													0.12				10		10																					34.99695812													0.12				10		10														0	0	0	0	0	0	0	2.908956668	0	0	0	0	0	0	0	0	0	0	0	0	2.828374282	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	6.0648	0	0	0	0	0	0	0	0	0	2.908956668	0	0	0	0	0	0	0	0	0	0	0	0	2.828374282	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	6.0648																																																																																		0	0	0	0	0	0	0	0	0	0	2.908956668	0	0	0	0	0	0	0	0	0	0	0	0	2.828374282	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	6.0648
H5698_005_0	2009	5																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		2067.813623	220.0345363	374.0386013		278.0476021	1008.494954	2314.542872	309.8111278	261.2281781		467.9661378	63.56061143		66.11060169	3798.144212	4893.10942	251.9386147	413.0235674			27.89985031		100		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	$50; waived if admitted within 24 hrs	Lesser of 20% or $250 per visit	No Cost Sharing	"$0 for diagnostic, $75 for all other services"	$50/Obs	No Cost Sharing	$20 Visit	$20/Visit	$20/Visit	$20 Visit	$20 Visit	No Cost Sharing	No Cost Sharing	20% Scripts	20% medicare covered eyewear	$3/Trip; 40 trip/yr limit	No Cost Sharing	$30 Visit	"$100 lens, frames & contacts"	$30 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	24.65430945	4.739446059	49.98736327	171.1184669		75	50		27.62728542	20	20	20	20			0.2		3		30		30														60.72326848	79.55	31.06		50	24.65430945	4.739446059	49.98736327	171.1184669		75	50		27.62728542	20	20	20	20			0.2		3		30		30														10.4637	1.458645613	0.96813658	0	1.158531675	2.07197889	0.914137591	1.290553449	3.725080447	0	2.924788361	0.264835881	0	0.152204705	6.330240353	8.155182366	0.419897691	0.688372612	0	0	5.579970062	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	47.5738	0	0.2028	10.4637	1.458645613	0.96813658	0	1.158531675	2.07197889	0.914137591	1.290553449	3.725080447	0	2.924788361	0.264835881	0	0.152204705	6.330240353	8.155182366	0.419897691	0.688372612	0	0	5.579970062	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	47.5738																																																																																		0	0	0	10.4637	1.458645613	0.96813658	0	1.158531675	2.07197889	0.914137591	1.290553449	3.725080447	0	2.924788361	0.264835881	0	0.152204705	6.330240353	8.155182366	0.419897691	0.688372612	0	0	5.579970062	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	47.5738
H5698_006_0	2009	3																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		1855.458778	256.8236531	727.328551		579.4695682	1035.853638	2817.728022	390.8583934	374.7817948		616.7879317	68.4556451		124.8614734	4804.643541	5879.984575	341.2908058	341.1830498			25.00565558		100		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	$50; waived if admitted within 24 hrs	Lesser of 20% or $250 per visit	No Cost Sharing	"$0 for diagnostic, $75 for all other services"	$50/Obs	No Cost Sharing	$20 Visit	$20/Visit	$20/Visit	$20 Visit	$20 Visit	No Cost Sharing	No Cost Sharing	20% Scripts with $2000 Annualized OOP Max	20% medicare covered eyewear	$3/Trip; 40 trip/yr limit	No Cost Sharing	$30 Visit	"$100 lens, frames & contacts"	$30 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	26.52640594	4.48062054	49.98997859	158.7832317		75	50		23.49621887	20	20	20	20			0.12		3		30		30														60.96152783	79.55	31.06		50	26.52640594	4.48062054	49.98997859	158.7832317		75	50		23.49621887	20	20	20	20			0.12		3		30		30														9.426	1.7025268	1.882568733	0	2.414456534	2.289789508	1.052097504	1.628250227	4.959088713	0	3.854924573	0.285231855	0	0.244481042	8.007739236	9.799974292	0.56881801	0.568638416	0	0	3.00067867	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	52.6927	0	0.1451	9.426	1.7025268	1.882568733	0	2.414456534	2.289789508	1.052097504	1.628250227	4.959088713	0	3.854924573	0.285231855	0	0.244481042	8.007739236	9.799974292	0.56881801	0.568638416	0	0	3.00067867	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	52.6927																																																																																		0	0	0	9.426	1.7025268	1.882568733	0	2.414456534	2.289789508	1.052097504	1.628250227	4.959088713	0	3.854924573	0.285231855	0	0.244481042	8.007739236	9.799974292	0.56881801	0.568638416	0	0	3.00067867	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	52.6927
H5698_007_0	2009	4																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		2068.149751	159.351591	374.1530537		278.1013253	1008.704115	2314.66222	309.865325	261.2868169		468.1350553	62.61484426		66.12540808	3799.142598	4894.508288	291.1773227	413.1177486			27.90950503		100		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	$50; waived if admitted within 24 hrs	Lesser of 20% or $250 per visit	No Cost Sharing	"$0 for diagnostic, $75 for all other services"	$50/Obs	No Cost Sharing	$20 Visit	$20/Visit	$20/Visit	$20 Visit	$20 Visit	No Cost Sharing	No Cost Sharing	20% Scripts with $2000 Annualized OOP Max	20% medicare covered eyewear	$3/Trip; 40 trip/yr limit	No Cost Sharing	$30 Visit	"$100 lens, frames & contacts"	$30 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	24.65803497	4.741834805	49.98737129	171.1523641		75	50		27.62672532	20	20	20	20			0.12		3		30		30														60.72293014	79.55	31.06		50	24.65803497	4.741834805	49.98737129	171.1523641		75	50		27.62672532	20	20	20	20			0.12		3		30		30														10.4653	1.056368256	0.968432821	0	1.158755522	2.072721779	0.91464549	1.290779421	3.726654701	0	2.925844096	0.260895184	0	0.152235707	6.331904329	8.157513813	0.485295538	0.688529581	0	0	3.349140604	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0126	0	0.2029	10.4653	1.056368256	0.968432821	0	1.158755522	2.072721779	0.91464549	1.290779421	3.726654701	0	2.925844096	0.260895184	0	0.152235707	6.331904329	8.157513813	0.485295538	0.688529581	0	0	3.349140604	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0126																																																																																		0	0	0	10.4653	1.056368256	0.968432821	0	1.158755522	2.072721779	0.91464549	1.290779421	3.726654701	0	2.925844096	0.260895184	0	0.152235707	6.331904329	8.157513813	0.485295538	0.688529581	0	0	3.349140604	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0126
H5698_009_0	2009	9																																D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0									727.119539				0.385621625									28.19994662				144		249														No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	"$35ER, waived if admitted within 24 hrs; $35 UC"	No Cost Sharing	No Cost Sharing	No Cost Sharing	$35/Obs	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	20% Scripts with $2000 Annualized OOP Max	No Cost Sharing	$0/Trip; 40 trip/yr limit	$250 Allowance	$10 Visit	"$150 lens, frames & contacts allowance"	$10 Visit	Not Covered	Not Covered	No Cost Sharing																		34.99581638				35									0.12				10		10																					34.99581638				35									0.12				10		10														0	0	0	0	0	0	0	2.120511823	0	0	0	0.00112473	0	0	0	0	0	0	0	0	3.383993594	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	5.8331	0	0	0	0	0	0	0	0	0	2.120511823	0	0	0	0.00112473	0	0	0	0	0	0	0	0	3.383993594	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	5.8331																																																																																		0	0	0	0	0	0	0	0	0	0	2.120511823	0	0	0	0.00112473	0	0	0	0	0	0	0	0	3.383993594	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	5.8331
H5698_017_0	2009	6																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		1842.631808	168.2730087	750.5464203		405.7343984	1556.285868	6859.021202	360.2916277	452.0476872		600.8288901	44.66375719		53.77851635			484.9322312				37.77654662		100		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$50 Visit	No Cost Sharing	$50/ Trip	10% Coinsurance	10% Coinsurance	$50; waived if admitted within 24 hrs	Lesser of 10% or $250	No Cost Sharing	No Cost Sharing	$50/Obs	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$15 Visit	No Cost Sharing	No Cost Sharing	No Cost Sharing	10% Scripts with $1000 Annualized OOP Max	No Cost Sharing	$3/Trip; 40 trip/yr limit	$250/yr Allowance	$10 Visit	"$150 lens, frames & contacts Allowance"	$10 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	13.14341184	1.488868459	49.9891412	95.09368663		50	50		15			15				0.06		3		10		10														60.97767828	79.55	31.06		50	13.14341184	1.488868459	49.9891412	95.09368663		50	50		15			15				0.06		3		10		10														9.3633	1.11550982	1.942664318	0	1.690559993	1.704575509	0.851015027	1.500889088	3.582240092	0	2.503453709	0.186098988	0	0.067223145	0	0	0.606165289	0	0	0	2.266592797	0	0.025	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	27.7328	0	0.1416	9.3633	1.11550982	1.942664318	0	1.690559993	1.704575509	0.851015027	1.500889088	3.582240092	0	2.503453709	0.186098988	0	0.067223145	0	0	0.606165289	0	0	0	2.266592797	0	0.025	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	27.7328																																																																																		0	0	0	9.3633	1.11550982	1.942664318	0	1.690559993	1.704575509	0.851015027	1.500889088	3.582240092	0	2.503453709	0.186098988	0	0.067223145	0	0	0.606165289	0	0	0	2.266592797	0	0.025	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	27.7328
H5698_018_0	2009	7																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		2228.126192	394.2481127	633.6738609		383.6523464	1326.681422	12707.04251	342.1506721	300.8876347		609.8494559	68.19004455		17.09070744			199.4152867				34.52923921		100		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$50 Visit	No Cost Sharing	$50/ Trip	10% Coinsurance	10% Coinsurance	$50; waived if admitted within 24 hrs	Lesser of 10% or $250	No Cost Sharing	No Cost Sharing	$50/Obs	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$15 Visit	No Cost Sharing	No Cost Sharing	No Cost Sharing	10% Scripts with $1000 Annualized OOP Max	No Cost Sharing	$3/Trip; 40 trip/yr limit	$250/yr Allowance	$10 Visit	"$150 lens, frames & contacts Allowance"	$10 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	14.59591122	0.752171736	49.98854806	94.48107812		50	50		15			15				0.06		3		10		10														60.53030218	79.55	31.06		50	14.59591122	0.752171736	49.98854806	94.48107812		50	50		15			15				0.06		3		10		10														11.2391	2.613536447	1.640159177	0	1.598551443	1.613677021	0.796489852	1.425301276	2.369015677	0	2.5410394	0.284125186	0	0.021363384	0	0	0.249269108	0	0	0	2.071754353	0	0.025	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8159	0	0.2543	11.2391	2.613536447	1.640159177	0	1.598551443	1.613677021	0.796489852	1.425301276	2.369015677	0	2.5410394	0.284125186	0	0.021363384	0	0	0.249269108	0	0	0	2.071754353	0	0.025	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8159																																																																																		0	0	0	11.2391	2.613536447	1.640159177	0	1.598551443	1.613677021	0.796489852	1.425301276	2.369015677	0	2.5410394	0.284125186	0	0.021363384	0	0	0.249269108	0	0	0	2.071754353	0	0.025	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	28.8159
H5698_019_0	2009	3																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		1687.436371	52.93066311	571.2596979		259.2188923	1039.972139	571.989853	266.1295605	285.6954075		660.9334732	60.7767164		52.00961371	4829.299356	5546.39676	269.2666482	455.086			22.84155533		100		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	$50; waived if admitted within 24 hrs	Lesser of 20% or $250 per visit	No Cost Sharing	"$0 for diagnostic, $75 for all other services"	$50/Obs	No Cost Sharing	$20 Visit	$20/Visit	$20/Visit	$20 Visit	$20 Visit	No Cost Sharing	No Cost Sharing	20% Scripts with $2000 Annualized OOP Max	20% medicare covered eyewear	$3/Trip; 40 trip/yr limit	No Cost Sharing	$30 Visit	"$100 lens, frames & contacts"	$30 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	20.89573093	26.03764269	49.98496523	157.9655966		75	50		27.07118008	20	20	20	20			0.12		3		30		30														61.12665204	79.55	31.06		50	20.89573093	26.03764269	49.98496523	157.9655966		75	50		27.07118008	20	20	20	20			0.12		3		30		30														8.5956	0.350886188	1.478610518	0	1.080078718	1.810914833	1.241105618	1.108539736	3.760837124	0	4.130834207	0.253236318	0	0.117330135	8.04883226	9.2439946	0.448777747	0.758476667	0	0	2.74098664	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	46.1766	0	0.1087	8.5956	0.350886188	1.478610518	0	1.080078718	1.810914833	1.241105618	1.108539736	3.760837124	0	4.130834207	0.253236318	0	0.117330135	8.04883226	9.2439946	0.448777747	0.758476667	0	0	2.74098664	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	46.1766																																																																																		0	0	0	8.5956	0.350886188	1.478610518	0	1.080078718	1.810914833	1.241105618	1.108539736	3.760837124	0	4.130834207	0.253236318	0	0.117330135	8.04883226	9.2439946	0.448777747	0.758476667	0	0	2.74098664	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	46.1766
H5698_020_0	2009	6																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		1672.185365	52.45227716	566.0966676		256.8760787	1030.572898	566.8202236	263.7339759	283.1132998		654.9599736	60.22741802		51.53955217	4785.652274	5496.26857	266.8330233	450.9729446			22.43053838		100		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	$50; waived if admitted within 24 hrs	Lesser of 20% or $250 per visit	No Cost Sharing	"$0 for diagnostic, $75 for all other services"	$50/Obs	No Cost Sharing	$20 Visit	$20/Visit	$20/Visit	$20 Visit	$20 Visit	No Cost Sharing	No Cost Sharing	20% Scripts	20% medicare covered eyewear	$3/Trip; 40 trip/yr limit	No Cost Sharing	$30 Visit	"$100 lens, frames & contacts"	$30 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	20.70687586	25.80231515	49.9846903	156.5379076		75	50		27.07118008	20	20	20	20			0.2		3		30		30														61.14063731	79.55	31.06		50	20.70687586	25.80231515	49.9846903	156.5379076		75	50		27.07118008	20	20	20	20			0.2		3		30		30														8.5199	0.347714887	1.465246875	0	1.070316994	1.778328755	1.218772837	1.098555092	3.693163631	0	4.093499835	0.250947575	0	0.116269708	7.976087123	9.160447617	0.444721705	0.751621574	0	0	4.486107676	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4792	0	0.1058	8.5199	0.347714887	1.465246875	0	1.070316994	1.778328755	1.218772837	1.098555092	3.693163631	0	4.093499835	0.250947575	0	0.116269708	7.976087123	9.160447617	0.444721705	0.751621574	0	0	4.486107676	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4792																																																																																		0	0	0	8.5199	0.347714887	1.465246875	0	1.070316994	1.778328755	1.218772837	1.098555092	3.693163631	0	4.093499835	0.250947575	0	0.116269708	7.976087123	9.160447617	0.444721705	0.751621574	0	0	4.486107676	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4792
H5698_021_0	2009	6																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		2002.162053	100.8076947	408.4694714		259.2161835	1234.26934	3044.743578	333.7484476	454.3309795		673.7171235	63.97208714		16.03354614			392.8152555				30.88074153		100		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$50 Visit	No Cost Sharing	$50/ Trip	10% Coinsurance	10% Coinsurance	$50; waived if admitted within 24 hrs	Lesser of 10% or $250	No Cost Sharing	No Cost Sharing	$50/Obs	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$15 Visit	No Cost Sharing	No Cost Sharing	No Cost Sharing	10% Scripts with $1000 Annualized OOP Max	No Cost Sharing	$3/Trip; 40 trip/yr limit	$250/yr Allowance	$10 Visit	"$150 lens, frames & contacts Allowance"	$10 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	12.41184332	2.453395927	49.98800327	74.01088671		50	50		15			15				0.06		3		10		10														60.79153142	79.55	31.06		50	12.41184332	2.453395927	49.98800327	74.01088671		50	50		15			15				0.06		3		10		10														10.1429	0.66827101	1.057255149	0	1.080067431	1.276629806	0.622496791	1.390284874	2.802119888	0	2.807154681	0.266550363	0	0.020041933	0	0	0.491019069	0	0	0	1.852844492	0	0.025	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	24.8301	0	0.1849	10.1429	0.66827101	1.057255149	0	1.080067431	1.276629806	0.622496791	1.390284874	2.802119888	0	2.807154681	0.266550363	0	0.020041933	0	0	0.491019069	0	0	0	1.852844492	0	0.025	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	24.8301																																																																																		0	0	0	10.1429	0.66827101	1.057255149	0	1.080067431	1.276629806	0.622496791	1.390284874	2.802119888	0	2.807154681	0.266550363	0	0.020041933	0	0	0.491019069	0	0	0	1.852844492	0	0.025	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	24.8301
H5698_022_0	2009	8																																D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0									673.9781422				34.30161022									35.14039299				144		249														No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	"$35ER, waived if admitted within 24 hrs; $35 UC"	No Cost Sharing	No Cost Sharing	No Cost Sharing	$35/Obs	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	20% Scripts with $2000 Annualized OOP Max	No Cost Sharing	$0/Trip; 40 trip/yr limit	$250 Allowance	$10 Visit	"$150 lens, frames & contacts allowance"	$10 Visit	Not Covered	Not Covered	No Cost Sharing																		34.99540858				35									0.12				10		10																					34.99540858				35									0.12				10		10														0	0	0	0	0	0	0	1.965511705	0	0	0	0.100046363	0	0	0	0	0	0	0	0	4.216847158	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	6.6099	0	0	0	0	0	0	0	0	0	1.965511705	0	0	0	0.100046363	0	0	0	0	0	0	0	0	4.216847158	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	6.6099																																																																																		0	0	0	0	0	0	0	0	0	0	1.965511705	0	0	0	0.100046363	0	0	0	0	0	0	0	0	4.216847158	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	6.6099
H5698_027_0	2009	4																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		1720.754895	80.27906371	580.2194492		219.2154714	941.0386439	1993.920386	337.6342444	246.4326519		446.1212223	51.48706198		12.90438097	3556.943036	4393.110439	242.2860588	345.6928352			21.59797109		100		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	$50; waived if admitted within 24 hrs	Lesser of 20% or $250 per visit	No Cost Sharing	"$0 for diagnostic, $75 for all other services"	$50/Obs	No Cost Sharing	$20 Visit	$20/Visit	$20/Visit	$20 Visit	$20 Visit	No Cost Sharing	No Cost Sharing	20% Scripts with $2000 Annualized OOP Max	20% medicare covered eyewear	$3/Trip; 40 trip/yr limit	No Cost Sharing	$30 Visit	"$100 lens, frames & contacts"	$30 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	25.18300352	5.666980374	49.98852665	154.3014488		75	50		20	20	20	20	20			0.12		3		30		30														61.09696111	79.55	31.06		50	25.18300352	5.666980374	49.98852665	154.3014488		75	50		20	20	20	20	20			0.12		3		30		30														8.7611	0.532183293	1.501801341	0	0.913397798	1.97484829	0.941625641	1.406486535	3.168742934	0	2.788257639	0.214529425	0	0.021507302	5.928238393	7.321850732	0.403810098	0.576154725	0	0	2.59175653	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0538	0	0.1152	8.7611	0.532183293	1.501801341	0	0.913397798	1.97484829	0.941625641	1.406486535	3.168742934	0	2.788257639	0.214529425	0	0.021507302	5.928238393	7.321850732	0.403810098	0.576154725	0	0	2.59175653	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0538																																																																																		0	0	0	8.7611	0.532183293	1.501801341	0	0.913397798	1.97484829	0.941625641	1.406486535	3.168742934	0	2.788257639	0.214529425	0	0.021507302	5.928238393	7.321850732	0.403810098	0.576154725	0	0	2.59175653	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	40.0538
H5698_028_0	2009	5																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		1722.080416	84.15377256	580.61528		219.4026737	941.7592497	1994.316723	337.8274096	246.6344741		446.6607677	30.83847045		54.02569681	3526.467228	4397.673463	246.5884834	346.0219588			21.63212211		100		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	$50; waived if admitted within 24 hrs	Lesser of 20% or $250 per visit	No Cost Sharing	"$0 for diagnostic, $75 for all other services"	$50/Obs	No Cost Sharing	$20 Visit	$20/Visit	$20/Visit	$20 Visit	$20 Visit	No Cost Sharing	No Cost Sharing	20% Scripts	20% medicare covered eyewear	$3/Trip; 40 trip/yr limit	No Cost Sharing	$30 Visit	"$100 lens, frames & contacts"	$30 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	25.19678854	5.67655171	49.98855059	154.4424162		75	50		27.60780924	20	20	20	20			0.2		3		30		30														61.09580367	79.55	31.06		50	25.19678854	5.67655171	49.98855059	154.4424162		75	50		27.60780924	20	20	20	20			0.2		3		30		30														8.7677	0.557869384	1.502825883	0	0.914177807	1.97744239	0.9434035	1.40729188	3.174235342	0	2.791629798	0.128493627	0	0.124294261	5.87744538	7.329455772	0.410980806	0.576703265	0	0	4.326424422	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	41.8178	0	0.1154	8.7677	0.557869384	1.502825883	0	0.914177807	1.97744239	0.9434035	1.40729188	3.174235342	0	2.791629798	0.128493627	0	0.124294261	5.87744538	7.329455772	0.410980806	0.576703265	0	0	4.326424422	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	41.8178																																																																																		0	0	0	8.7677	0.557869384	1.502825883	0	0.914177807	1.97744239	0.9434035	1.40729188	3.174235342	0	2.791629798	0.128493627	0	0.124294261	5.87744538	7.329455772	0.410980806	0.576703265	0	0	4.326424422	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	41.8178
H5698_029_0	2009	7																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		1825.635173	203.4058186	395.0272692		266.1883656	1109.990136	480.2397714	311.6863902	334.1671783		523.8736719	52.5922184		13.18137016			279.3092401				21.9511449		100		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$50 Visit	No Cost Sharing	$50/ Trip	10% Coinsurance	10% Coinsurance	$50; waived if admitted within 24 hrs	Lesser of 10% or $250	No Cost Sharing	No Cost Sharing	$50/Obs	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$15 Visit	No Cost Sharing	No Cost Sharing	No Cost Sharing	10% Scripts with $1000 Annualized OOP Max	No Cost Sharing	$3/Trip; 40 trip/yr limit	$250/yr Allowance	$10 Visit	"$150 lens, frames & contacts Allowance"	$10 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	10.71835558	11.90750944	49.98755041	82.59070973		50	50		15			15				0.06		3		10		10														60.99942836	79.55	31.06		50	10.71835558	11.90750944	49.98755041	82.59070973		50	50		15			15				0.06		3		10		10														9.2802	1.348411072	1.022462248	0	1.10911819	0.991439081	0.476538301	1.298369929	2.299925369	0	2.182806966	0.219134243	0	0.016476713	0	0	0.34913655	0	0	0	1.317068694	0	0.025	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2636	0	0.137	9.2802	1.348411072	1.022462248	0	1.10911819	0.991439081	0.476538301	1.298369929	2.299925369	0	2.182806966	0.219134243	0	0.016476713	0	0	0.34913655	0	0	0	1.317068694	0	0.025	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2636																																																																																		0	0	0	9.2802	1.348411072	1.022462248	0	1.10911819	0.991439081	0.476538301	1.298369929	2.299925369	0	2.182806966	0.219134243	0	0.016476713	0	0	0.34913655	0	0	0	1.317068694	0	0.025	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	22.2636
H5698_030_0	2009	8																																D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0									722.8091376				25.59337103									22.68137911				237.1651437		410.098061														No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	"$35ER, waived if admitted within 24 hrs; $35 UC"	No Cost Sharing	No Cost Sharing	No Cost Sharing	$35/Obs	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	20% Scripts with $2000 Annualized OOP Max	No Cost Sharing	$0/Trip; 40 trip/yr limit	$250 Allowance	$10 Visit	"$150 lens, frames & contacts allowance"	$10 Visit	Not Covered	Not Covered	No Cost Sharing																		34.99315999				35									0.12				10		10																					34.99315999				35									0.12				10		10														0	0	0	0	0	0	0	2.107781316	0	0	0	0.074647332	0	0	0	0	0	0	0	0	2.721765493	0	0	0	0.19763762	0	0.341748384	0	0	0	0	0	0	0	0	0	0	0	0	0	5.4436	0	0	0	0	0	0	0	0	0	2.107781316	0	0	0	0.074647332	0	0	0	0	0	0	0	0	2.721765493	0	0	0	0.19763762	0	0.341748384	0	0	0	0	0	0	0	0	0	0	0	0	0	5.4436																																																																																		0	0	0	0	0	0	0	0	0	0	2.107781316	0	0	0	0.074647332	0	0	0	0	0	0	0	0	2.721765493	0	0	0	0.19763762	0	0.341748384	0	0	0	0	0	0	0	0	0	0	0	0	0	5.4436
H5698_035_0	2009	3																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		1620.277454	51.39653324	570.0099191		267.2958272	1059.417481	582.6848881	281.2651215	295.7157276		682.1772525	59.90012059		52.8411024	4820.938217	5568.078315	275.1739703	474.9913242			22.87154794		100		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	$50; waived if admitted within 24 hrs	Lesser of 20% or $250 per visit	No Cost Sharing	"$0 for diagnostic, $75 for all other services"	$50/Obs	No Cost Sharing	$20 Visit	$20/Visit	$20/Visit	$20 Visit	$20 Visit	No Cost Sharing	No Cost Sharing	20% Scripts with $2000 Annualized OOP Max	20% medicare covered eyewear	$3/Trip; 40 trip/yr limit	No Cost Sharing	$30 Visit	"$100 lens, frames & contacts"	$30 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	20.37082345	25.38356872	49.98540773	153.99745		75	50		27.07118008	20	20	20	20			0.12		3		30		30														61.19021019	79.55	31.06		50	20.37082345	25.38356872	49.98540773	153.99745		75	50		27.07118008	20	20	20	20			0.12		3		30		30														8.2621	0.340716185	1.475375674	0	1.113732613	1.798433873	1.232551825	1.171595982	3.794955663	0	4.263607828	0.249583836	0	0.119205917	8.034897028	9.280130525	0.458623284	0.791652207	0	0	2.744585752	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	46.1392	0	0.0958	8.2621	0.340716185	1.475375674	0	1.113732613	1.798433873	1.232551825	1.171595982	3.794955663	0	4.263607828	0.249583836	0	0.119205917	8.034897028	9.280130525	0.458623284	0.791652207	0	0	2.744585752	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	46.1392																																																																																		0	0	0	8.2621	0.340716185	1.475375674	0	1.113732613	1.798433873	1.232551825	1.171595982	3.794955663	0	4.263607828	0.249583836	0	0.119205917	8.034897028	9.280130525	0.458623284	0.791652207	0	0	2.744585752	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	46.1392
H5698_036_0	2009	4																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		1619.136604	51.36034456	569.6085709		267.1076223	1058.671538	582.2746153	281.0678516	295.5075119		681.6969265	59.85794447		52.80389658	4817.543758	5564.15779	274.9802183	474.6568793			22.83935122		100		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	$50; waived if admitted within 24 hrs	Lesser of 20% or $250 per visit	No Cost Sharing	"$0 for diagnostic, $75 for all other services"	$50/Obs	No Cost Sharing	$20 Visit	$20/Visit	$20/Visit	$20 Visit	$20 Visit	No Cost Sharing	No Cost Sharing	20% Scripts	20% medicare covered eyewear	$3/Trip; 40 trip/yr limit	No Cost Sharing	$30 Visit	"$100 lens, frames & contacts"	$30 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	20.3564802	25.36569596	49.9853872	153.8890192		75	50		27.07118008	20	20	20	20			0.2		3		30		30														61.19133542	79.55	31.06		50	20.3564802	25.36569596	49.9853872	153.8890192		75	50		27.07118008	20	20	20	20			0.2		3		30		30														8.2564	0.340476284	1.474336851	0	1.112948426	1.795902183	1.230816738	1.170773782	3.789613432	0	4.26060579	0.249408102	0	0.119121983	8.029239597	9.273596317	0.458300364	0.791094799	0	0	4.567870245	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	47.928	0	0.0956	8.2564	0.340476284	1.474336851	0	1.112948426	1.795902183	1.230816738	1.170773782	3.789613432	0	4.26060579	0.249408102	0	0.119121983	8.029239597	9.273596317	0.458300364	0.791094799	0	0	4.567870245	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	47.928																																																																																		0	0	0	8.2564	0.340476284	1.474336851	0	1.112948426	1.795902183	1.230816738	1.170773782	3.789613432	0	4.26060579	0.249408102	0	0.119121983	8.029239597	9.273596317	0.458300364	0.791094799	0	0	4.567870245	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	47.928
H5698_037_0	2009	6																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		1695.669654	53.78803585	596.5327237		279.733216	1108.712629	609.7974644	294.3303233	309.4755065		713.919251	62.68729874		16.19632188			287.9779325				23.79320343		100		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$50 Visit	No Cost Sharing	$50/ Trip	10% Coinsurance	10% Coinsurance	$50; waived if admitted within 24 hrs	Lesser of 10% or $250	No Cost Sharing	No Cost Sharing	$50/Obs	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$15 Visit	No Cost Sharing	No Cost Sharing	No Cost Sharing	10% Scripts with $1000 Annualized OOP Max	No Cost Sharing	$3/Trip; 40 trip/yr limit	$250/yr Allowance	$10 Visit	"$150 lens, frames & contacts Allowance"	$10 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	10.12474489	14.22780866	49.98597192	91.74558668		50	50		15			15				0.06		3		10		10														61.11920662	79.55	31.06		50	10.12474489	14.22780866	49.98597192	91.74558668		50	50		15			15				0.06		3		10		10														8.6365	0.356569854	1.544025533	0	1.165555067	0.93545271	0.723006804	1.226032273	2.366084325	0	2.974663546	0.261197078	0	0.020245402	0	0	0.359972416	0	0	0	1.427592206	0	0.025	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	22.3494	0	0.1103	8.6365	0.356569854	1.544025533	0	1.165555067	0.93545271	0.723006804	1.226032273	2.366084325	0	2.974663546	0.261197078	0	0.020245402	0	0	0.359972416	0	0	0	1.427592206	0	0.025	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	22.3494																																																																																		0	0	0	8.6365	0.356569854	1.544025533	0	1.165555067	0.93545271	0.723006804	1.226032273	2.366084325	0	2.974663546	0.261197078	0	0.020245402	0	0	0.359972416	0	0	0	1.427592206	0	0.025	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	22.3494
H5698_038_0	2009	8																																D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0									371.067108				66.00002575									23.29163653				144		249														No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	"$35ER, waived if admitted within 24 hrs; $35 UC"	No Cost Sharing	No Cost Sharing	No Cost Sharing	$35/Obs	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	20% Scripts with $2000 Annualized OOP Max	No Cost Sharing	$0/Trip; 40 trip/yr limit	$250 Allowance	$10 Visit	"$150 lens, frames & contacts allowance"	$10 Visit	Not Covered	Not Covered	No Cost Sharing																		34.99136712				35									0.12				10		10																					34.99136712				35									0.12				10		10														0	0	0	0	0	0	0	1.082012117	0	0	0	0.192500075	0	0	0	0	0	0	0	0	2.794996383	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	4.397	0	0	0	0	0	0	0	0	0	1.082012117	0	0	0	0.192500075	0	0	0	0	0	0	0	0	2.794996383	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	4.397																																																																																		0	0	0	0	0	0	0	0	0	0	1.082012117	0	0	0	0.192500075	0	0	0	0	0	0	0	0	2.794996383	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	4.397
H5698_055_0	2009	3																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		1767.968879	57.12532977	569.4933741		257.6265204	1099.144833	604.5351294	280.6670788	296.2027563		679.9059967	54.72772332		51.18877602	4354.43209	5086.728917	260.2479931	467.020512			21.15357821		100		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	$50; waived if admitted within 24 hrs	Lesser of 20% or $250 per visit	No Cost Sharing	"$0 for diagnostic, $75 for all other services"	$50/Obs	No Cost Sharing	$20 Visit	$20/Visit	$20/Visit	$20 Visit	$20 Visit	No Cost Sharing	No Cost Sharing	20% Scripts with $2000 Annualized OOP Max	20% medicare covered eyewear	$3/Trip; 40 trip/yr limit	No Cost Sharing	$30 Visit	"$100 lens, frames & contacts"	$30 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	19.73269188	24.58840909	49.98490373	149.1733625		75	50		27.07118008	20	20	20	20			0.12		3		30		30														61.05680409	79.55	31.06		50	19.73269188	24.58840909	49.98490373	149.1733625		75	50		27.07118008	20	20	20	20			0.12		3		30		30														8.9955	0.378693332	1.474038683	0	1.073443835	1.807423861	1.238713089	1.169093076	3.682130095	0	4.249412479	0.228032181	0	0.115478381	7.257386816	8.477881529	0.433746655	0.77836752	0	0	2.538429385	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	44.9053	0	0.1242	8.9955	0.378693332	1.474038683	0	1.073443835	1.807423861	1.238713089	1.169093076	3.682130095	0	4.249412479	0.228032181	0	0.115478381	7.257386816	8.477881529	0.433746655	0.77836752	0	0	2.538429385	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	44.9053																																																																																		0	0	0	8.9955	0.378693332	1.474038683	0	1.073443835	1.807423861	1.238713089	1.169093076	3.682130095	0	4.249412479	0.228032181	0	0.115478381	7.257386816	8.477881529	0.433746655	0.77836752	0	0	2.538429385	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	44.9053
H5698_056_0	2009	4																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		1757.364173	56.7826782	566.0774148		256.0812141	1092.551896	600.9089812	278.9903673	294.4260604		675.8277558	54.39945318		50.88173334	4328.313151	5056.217485	258.6869626	464.2192098			20.90057072		100		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	$50; waived if admitted within 24 hrs	Lesser of 20% or $250 per visit	No Cost Sharing	"$0 for diagnostic, $75 for all other services"	$50/Obs	No Cost Sharing	$20 Visit	$20/Visit	$20/Visit	$20 Visit	$20 Visit	No Cost Sharing	No Cost Sharing	20% Scripts	20% medicare covered eyewear	$3/Trip; 40 trip/yr limit	No Cost Sharing	$30 Visit	"$100 lens, frames & contacts"	$30 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	19.61433041	24.44092185	49.98472136	148.2785845		75	50		27.07118008	20	20	20	20			0.2		3		30		30														61.06563584	79.55	31.06		50	19.61433041	24.44092185	49.98472136	148.2785845		75	50		27.07118008	20	20	20	20			0.2		3		30		30														8.9429	0.376421838	1.465197042	0	1.067005059	1.785806157	1.223897454	1.162104648	3.638089957	0	4.223923474	0.226664388	0	0.114785714	7.213855252	8.427029141	0.431144938	0.773698683	0	0	4.180114143	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	46.2601	0	0.1222	8.9429	0.376421838	1.465197042	0	1.067005059	1.785806157	1.223897454	1.162104648	3.638089957	0	4.223923474	0.226664388	0	0.114785714	7.213855252	8.427029141	0.431144938	0.773698683	0	0	4.180114143	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	46.2601																																																																																		0	0	0	8.9429	0.376421838	1.465197042	0	1.067005059	1.785806157	1.223897454	1.162104648	3.638089957	0	4.223923474	0.226664388	0	0.114785714	7.213855252	8.427029141	0.431144938	0.773698683	0	0	4.180114143	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	46.2601
H5698_057_0	2009	6																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		1865.337685	60.27144009	600.8575515		271.8149978	1159.678942	637.8291903	296.0921577	312.5157746		717.3510194	57.74178829		15.81795238			274.5808451				22.36676514		100		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$50 Visit	No Cost Sharing	$50/ Trip	10% Coinsurance	10% Coinsurance	$50; waived if admitted within 24 hrs	Lesser of 10% or $250	No Cost Sharing	No Cost Sharing	$50/Obs	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$15 Visit	No Cost Sharing	No Cost Sharing	No Cost Sharing	10% Scripts with $1000 Annualized OOP Max	No Cost Sharing	$3/Trip; 40 trip/yr limit	$250/yr Allowance	$10 Visit	"$150 lens, frames & contacts Allowance"	$10 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	9.887644142	13.89462258	49.985721	89.59709335		50	50		15			15				0.06		3		10		10														60.94924069	79.55	31.06		50	9.887644142	13.89462258	49.985721	89.59709335		50	50		15			15				0.06		3		10		10														9.4742	0.399549422	1.555219629	0	1.132562491	0.955541058	0.738532989	1.233364999	2.333375419	0	2.988962581	0.240590785	0	0.01977244	0	0	0.343226056	0	0	0	1.342005908	0	0.025	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	23.1094	0	0.1478	9.4742	0.399549422	1.555219629	0	1.132562491	0.955541058	0.738532989	1.233364999	2.333375419	0	2.988962581	0.240590785	0	0.01977244	0	0	0.343226056	0	0	0	1.342005908	0	0.025	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	23.1094																																																																																		0	0	0	9.4742	0.399549422	1.555219629	0	1.132562491	0.955541058	0.738532989	1.233364999	2.333375419	0	2.988962581	0.240590785	0	0.01977244	0	0	0.343226056	0	0	0	1.342005908	0	0.025	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	23.1094
H5698_058_0	2009	8																																D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0									354.4352601				61.91437155									21.21175303				144		249														No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	"$35ER, waived if admitted within 24 hrs; $35 UC"	No Cost Sharing	No Cost Sharing	No Cost Sharing	$35/Obs	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	20% Scripts with $2000 Annualized OOP Max	No Cost Sharing	$0/Trip; 40 trip/yr limit	$250 Allowance	$10 Visit	"$150 lens, frames & contacts allowance"	$10 Visit	Not Covered	Not Covered	No Cost Sharing																		34.99068116				35									0.12				10		10																					34.99068116				35									0.12				10		10														0	0	0	0	0	0	0	1.033494265	0	0	0	0.180583584	0	0	0	0	0	0	0	0	2.545410364	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	4.087	0	0	0	0	0	0	0	0	0	1.033494265	0	0	0	0.180583584	0	0	0	0	0	0	0	0	2.545410364	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	4.087																																																																																		0	0	0	0	0	0	0	0	0	0	1.033494265	0	0	0	0.180583584	0	0	0	0	0	0	0	0	2.545410364	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	4.087
H5698_059_0	2009	6																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		2066.193571		373.4821954		277.7879107	1007.482825	2313.990505	309.5495578	260.9441147		467.143735	62.44561121		57.13019461	3793.298339	4886.313522	262.1469097	412.5672315			27.85307589				144																"$175 for Days 1-5, $2000 OOP Max"	Medicare Cost Sharing	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	"$50 ER; waived if admitted within 24 hrs , $35 UC"	300	No Cost Sharing	"$0 for diagnostic, $75 for all other services"	$100/Obs	No Cost Sharing	$30 Visit	$15/Visit	$30/Visit	$30 Visit	$30 Visit	No Cost Sharing	No Cost Sharing	20% Scripts	20% medicare covered eyewear	Not Covered	Not Covered	$30 Visit	"$100 lens, frames & contacts Allowance"	Not Covered	Not Covered	Not Covered	No Cost Sharing											108.32		31.06		50	24.6361963	4.727775596	49.98732415	300		75	100		30	15.00314893	30	30	30			0.2				30																102.27067		31.06		50	24.6361963	4.727775596	49.98732415	300		75	100		30	15.00314893	30	30	30			0.2				30																17.6093	0	0.966696416	0	1.157449628	2.068378721	0.911668986	1.28946284	6.523602868	0	2.919648344	0.520380093	0	0.142825487	4.742618327	12.21578381	0.655367274	1.031418079	0	0	5.570615178	0	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.6852	0	1.0416	17.6093	0	0.966696416	0	1.157449628	2.068378721	0.911668986	1.28946284	6.523602868	0	2.919648344	0.520380093	0	0.142825487	4.742618327	12.21578381	0.655367274	1.031418079	0	0	5.570615178	0	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.6852																																																																																		0	0	0	17.6093	0	0.966696416	0	1.157449628	2.068378721	0.911668986	1.28946284	6.523602868	0	2.919648344	0.520380093	0	0.142825487	4.742618327	12.21578381	0.655367274	1.031418079	0	0	5.570615178	0	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.6852
H5698_060_0	2009	5																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		1855.854661		727.4741024		579.5383479	1036.118613	2817.873759	390.9293487	374.8555096		616.9783189	68.48096116		124.8749291	4805.92747	5881.610644	341.3652795	341.3040182			25.01806229				144																"$175 for Days 1-5, $2000 OOP Max"	Medicare Cost Sharing	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	"$50 ER; waived if admitted within 24 hrs , $35 UC"	300	No Cost Sharing	"$0 for diagnostic, $75 for all other services"	$100/Obs	No Cost Sharing	$30 Visit	$15/Visit	$30/Visit	$30 Visit	$30 Visit	No Cost Sharing	No Cost Sharing	20% Scripts	20% medicare covered eyewear	Not Covered	Not Covered	$30 Visit	"$100 lens, frames & contacts Allowance"	Not Covered	Not Covered	Not Covered	No Cost Sharing											108.32		31.06		50	26.53054168	4.483140519	49.98998411	300		75	100		30	15.00280119	30	30	30			0.2				30																103.3828783		31.06		50	26.53054168	4.483140519	49.98998411	300		75	100		30	15.00280119	30	30	30			0.2				30																15.9886	0	1.882945468	0	2.414743116	2.290732337	1.052743669	1.628545994	9.37138774	0	3.856114493	0.570674676	0	0.312187323	6.008531197	14.70402661	0.853413199	0.853260046	0	0	5.003612457	0	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.1516	0	0.7635	15.9886	0	1.882945468	0	2.414743116	2.290732337	1.052743669	1.628545994	9.37138774	0	3.856114493	0.570674676	0	0.312187323	6.008531197	14.70402661	0.853413199	0.853260046	0	0	5.003612457	0	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.1516																																																																																		0	0	0	15.9886	0	1.882945468	0	2.414743116	2.290732337	1.052743669	1.628545994	9.37138774	0	3.856114493	0.570674676	0	0.312187323	6.008531197	14.70402661	0.853413199	0.853260046	0	0	5.003612457	0	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.1516
H5698_061_0	2009	6																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		1721.3706		580.4033127		219.3024269	941.3733654	1994.104484	337.7239693	246.5263983		446.3718412	51.52337986		54.00129065	3524.596488	4395.229965	144.0282077	345.8457132			21.6138278				144																"$175 for Days 1-5, $2000 OOP Max"	Medicare Cost Sharing	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	"$50 ER; waived if admitted within 24 hrs , $35 UC"	300	No Cost Sharing	"$0 for diagnostic, $75 for all other services"	$100/Obs	No Cost Sharing	$30 Visit	$15/Visit	$30/Visit	$30 Visit	$30 Visit	No Cost Sharing	No Cost Sharing	20% Scripts	20% medicare covered eyewear	Not Covered	Not Covered	$30 Visit	"$100 lens, frames & contacts Allowance"	Not Covered	Not Covered	Not Covered	No Cost Sharing											108.32		31.06		50	25.18940305	5.671424715	49.98853778	300		75	100		30	15.00294847	30	30	30			0.2				30																104.0704907		31.06		50	25.18940305	5.671424715	49.98853778	300		75	100		30	15.00294847	30	30	30			0.2				30																14.9287	0	1.502277241	0	0.913760112	1.97605276	0.942451121	1.406860617	6.163159958	0	2.789824008	0.429361499	0	0.135003227	4.406611625	10.98807491	0.360070519	0.864614283	0	0	4.322765559	0	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.4895	0	0.6096	14.9287	0	1.502277241	0	0.913760112	1.97605276	0.942451121	1.406860617	6.163159958	0	2.789824008	0.429361499	0	0.135003227	4.406611625	10.98807491	0.360070519	0.864614283	0	0	4.322765559	0	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.4895																																																																																		0	0	0	14.9287	0	1.502277241	0	0.913760112	1.97605276	0.942451121	1.406860617	6.163159958	0	2.789824008	0.429361499	0	0.135003227	4.406611625	10.98807491	0.360070519	0.864614283	0	0	4.322765559	0	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.4895
H5698_062_0	2009	5																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		1624.009752		571.3229332		267.9115414	1061.857843	584.0270989	281.9104957	296.3969068		683.7486434	60.03810012		52.96282153	4832.043216	5580.904347	275.8078317	476.0854636			22.97703822				144																"$175 for Days 1-5, $2000 OOP Max"	Medicare Cost Sharing	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	"$50 ER; waived if admitted within 24 hrs , $35 UC"	300	No Cost Sharing	"$0 for diagnostic, $75 for all other services"	$100/Obs	No Cost Sharing	$30 Visit	$15/Visit	$30/Visit	$30 Visit	$30 Visit	No Cost Sharing	No Cost Sharing	20% Scripts	20% medicare covered eyewear	Not Covered	Not Covered	$30 Visit	"$100 lens, frames & contacts Allowance"	Not Covered	Not Covered	Not Covered	No Cost Sharing											108.32		31.06		50	20.41774751	25.44203961	49.98547459	300		75	100		30	15.00206111	30	30	30			0.2				30																104.4949553		31.06		50	20.41774751	25.44203961	49.98547459	300		75	100		30	15.00206111	30	30	30			0.2				30																14.1417	0	1.478774192	0	1.116298089	1.806728776	1.238236715	1.174285826	7.40992267	0	4.273429021	0.500317501	0	0.132407054	6.04088397	13.95226087	0.689519579	1.190213659	0	0	4.595407643	0	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1004	0	0.5177	14.1417	0	1.478774192	0	1.116298089	1.806728776	1.238236715	1.174285826	7.40992267	0	4.273429021	0.500317501	0	0.132407054	6.04088397	13.95226087	0.689519579	1.190213659	0	0	4.595407643	0	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1004																																																																																		0	0	0	14.1417	0	1.478774192	0	1.116298089	1.806728776	1.238236715	1.174285826	7.40992267	0	4.273429021	0.500317501	0	0.132407054	6.04088397	13.95226087	0.689519579	1.190213659	0	0	4.595407643	0	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1004
H5698_063_0	2009	5																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		1678.785193		568.3309539		257.8899244	1034.640392	569.0573655	264.7706472	284.2306993		657.544988	60.46512528		51.74296992	4804.54042	5517.961397	267.8861673	452.7528573			22.60794675				144																"$175 for Days 1-5, $2000 OOP Max"	Medicare Cost Sharing	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	"$50 ER; waived if admitted within 24 hrs , $35 UC"	300	No Cost Sharing	"$0 for diagnostic, $75 for all other services"	$100/Obs	No Cost Sharing	$30 Visit	$15/Visit	$30/Visit	$30 Visit	$30 Visit	No Cost Sharing	No Cost Sharing	20% Scripts	20% medicare covered eyewear	Not Covered	Not Covered	$30 Visit	"$100 lens, frames & contacts Allowance"	Not Covered	Not Covered	Not Covered	No Cost Sharing											108.32		31.06		50	20.78860234	25.90415245	49.98481019	300		75	100		30	15.00222187	30	30	30			0.2				30																104.2525513		31.06		50	20.78860234	25.90415245	49.98481019	300		75	100		30	15.00222187	30	30	30			0.2				30																14.5848	0	1.471029952	0	1.074541352	1.792393973	1.228412396	1.102875879	7.105767483	0	4.109656175	0.503876044	0	0.129357425	6.006565114	13.79490349	0.669715418	1.131882143	0	0	4.521589349	0	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.5874	0	0.569	14.5848	0	1.471029952	0	1.074541352	1.792393973	1.228412396	1.102875879	7.105767483	0	4.109656175	0.503876044	0	0.129357425	6.006565114	13.79490349	0.669715418	1.131882143	0	0	4.521589349	0	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.5874																																																																																		0	0	0	14.5848	0	1.471029952	0	1.074541352	1.792393973	1.228412396	1.102875879	7.105767483	0	4.109656175	0.503876044	0	0.129357425	6.006565114	13.79490349	0.669715418	1.131882143	0	0	4.521589349	0	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.5874
H5698_064_0	2009	5																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		1756.02059		565.6446233		255.8854285	1091.716592	600.4495594	278.7779361	294.2009585		675.3110552	54.35786237		50.84283198	4325.003962	5052.35178	258.4891848	463.8642935			20.86862409				144																"$175 for Days 1-5, $2000 OOP Max"	Medicare Cost Sharing	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	"$50 ER; waived if admitted within 24 hrs , $35 UC"	300	No Cost Sharing	"$0 for diagnostic, $75 for all other services"	$100/Obs	No Cost Sharing	$30 Visit	$15/Visit	$30/Visit	$30 Visit	$30 Visit	No Cost Sharing	No Cost Sharing	20% Scripts	20% medicare covered eyewear	Not Covered	Not Covered	$30 Visit	"$100 lens, frames & contacts Allowance"	Not Covered	Not Covered	Not Covered	No Cost Sharing											108.32		31.06		50	19.59933438	24.42223568	49.98469802	300		75	100		30	15.00171432	30	30	30			0.2				30																103.8832543		31.06		50	19.59933438	24.42223568	49.98469802	300		75	100		30	15.00171432	30	30	30			0.2				30																15.2018	0	1.464076833	0	1.066189286	1.783076544	1.222026721	1.161219246	7.355023963	0	4.220694095	0.452982186	0	0.12710708	5.406872823	12.63087945	0.646222962	1.159660734	0	0	4.173724819	0	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.4315	0	0.6493	15.2018	0	1.464076833	0	1.066189286	1.783076544	1.222026721	1.161219246	7.355023963	0	4.220694095	0.452982186	0	0.12710708	5.406872823	12.63087945	0.646222962	1.159660734	0	0	4.173724819	0	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.4315																																																																																		0	0	0	15.2018	0	1.464076833	0	1.066189286	1.783076544	1.222026721	1.161219246	7.355023963	0	4.220694095	0.452982186	0	0.12710708	5.406872823	12.63087945	0.646222962	1.159660734	0	0	4.173724819	0	0	0	0.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.4315
H5698_065_0	2009	5																																D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0						391.3115576			349.9042563				71.18058915				229.3518618		468.451855									249			150											No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$100/ Trip	No Cost Sharing	No Cost Sharing	"$50ER, waived if admitted within 24 hrs; $35 UC"	No Cost Sharing	No Cost Sharing	No Cost Sharing	$50/Obs	No Cost Sharing	No Cost Sharing	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/Trip; 10 trip/yr limit	$250 Allowance	No Cost Sharing	"$150 lens, frames & contacts allowance"	$10 Visit	$750 Allowance	Not Covered	No Cost Sharing															100			49.98500267				50				10		10									10			20															100			49.98500267				50				10		10									10			20											0	0	0	0	3.260929647	0	0	1.457497099	0	0	0	0.296585788	0	0	0	0.191126552	0	0.390376546	0	0	0	0	0	0	0	0	0.2075	0	0	0.25	0	0	0	0	0	0	0	0	0	0	6.054	0	0	0	0	0	0	3.260929647	0	0	1.457497099	0	0	0	0.296585788	0	0	0	0.191126552	0	0.390376546	0	0	0	0	0	0	0	0	0.2075	0	0	0.25	0	0	0	0	0	0	0	0	0	0	6.054																																																																																		0	0	0	0	0	0	0	3.260929647	0	0	1.457497099	0	0	0	0.296585788	0	0	0	0.191126552	0	0.390376546	0	0	0	0	0	0	0	0	0.2075	0	0	0.25	0	0	0	0	0	0	0	0	0	0	6.054
H5698_066_0	2009	4																																D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0						414.3210209			369.1743536				46.6214765				326.6457765		564.3193533									249			150											No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$100/ Trip	No Cost Sharing	No Cost Sharing	"$50ER, waived if admitted within 24 hrs; $35 UC"	No Cost Sharing	No Cost Sharing	No Cost Sharing	$50/Obs	No Cost Sharing	No Cost Sharing	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/Trip; 10 trip/yr limit	$250 Allowance	No Cost Sharing	"$150 lens, frames & contacts allowance"	$10 Visit	$750 Allowance	Not Covered	No Cost Sharing															100			49.98585908				50				10		10									10			20															100			49.98585908				50				10		10									10			20											0	0	0	0	3.452675174	0	0	1.537791435	0	0	0	0.194256152	0	0	0	0.272204814	0	0.470266128	0	0	0	0	0	0	0	0	0.2075	0	0	0.25	0	0	0	0	0	0	0	0	0	0	6.3847	0	0	0	0	0	0	3.452675174	0	0	1.537791435	0	0	0	0.194256152	0	0	0	0.272204814	0	0.470266128	0	0	0	0	0	0	0	0	0.2075	0	0	0.25	0	0	0	0	0	0	0	0	0	0	6.3847																																																																																		0	0	0	0	0	0	0	3.452675174	0	0	1.537791435	0	0	0	0.194256152	0	0	0	0.272204814	0	0.470266128	0	0	0	0	0	0	0	0	0.2075	0	0	0.25	0	0	0	0	0	0	0	0	0	0	6.3847
H5698_067_0	2009	5																																D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0						273.2252093			318.9752113				55.31480072				51.80991307		443.2149093									249			150											No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$100/ Trip	No Cost Sharing	No Cost Sharing	"$50ER, waived if admitted within 24 hrs; $35 UC"	No Cost Sharing	No Cost Sharing	No Cost Sharing	$50/Obs	No Cost Sharing	No Cost Sharing	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/Trip; 10 trip/yr limit	$250 Allowance	No Cost Sharing	"$150 lens, frames & contacts allowance"	$10 Visit	$750 Allowance	Not Covered	No Cost Sharing															100			49.98383026				50				10		10									10			20															100			49.98383026				50				10		10									10			20											0	0	0	0	2.276876744	0	0	1.328633568	0	0	0	0.230478336	0	0	0	0.043174928	0	0.369345758	0	0	0	0	0	0	0	0	0.2075	0	0	0.25	0	0	0	0	0	0	0	0	0	0	4.706	0	0	0	0	0	0	2.276876744	0	0	1.328633568	0	0	0	0.230478336	0	0	0	0.043174928	0	0.369345758	0	0	0	0	0	0	0	0	0.2075	0	0	0.25	0	0	0	0	0	0	0	0	0	0	4.706																																																																																		0	0	0	0	0	0	0	2.276876744	0	0	1.328633568	0	0	0	0.230478336	0	0	0	0.043174928	0	0.369345758	0	0	0	0	0	0	0	0	0.2075	0	0	0.25	0	0	0	0	0	0	0	0	0	0	4.706
H5698_068_0	2009	4																																D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0						293.45719			308.7431417				65.76279641				27.33217163		521.4807156									249			150											No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$100/ Trip	No Cost Sharing	No Cost Sharing	"$50ER, waived if admitted within 24 hrs; $35 UC"	No Cost Sharing	No Cost Sharing	No Cost Sharing	$50/Obs	No Cost Sharing	No Cost Sharing	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/Trip; 10 trip/yr limit	$250 Allowance	No Cost Sharing	"$150 lens, frames & contacts allowance"	$10 Visit	$750 Allowance	Not Covered	No Cost Sharing															100			49.98217857				50				10		10									10			20															100			49.98217857				50				10		10									10			20											0	0	0	0	2.445476583	0	0	1.285971237	0	0	0	0.274011652	0	0	0	0.02277681	0	0.434567263	0	0	0	0	0	0	0	0	0.2075	0	0	0.25	0	0	0	0	0	0	0	0	0	0	4.9203	0	0	0	0	0	0	2.445476583	0	0	1.285971237	0	0	0	0.274011652	0	0	0	0.02277681	0	0.434567263	0	0	0	0	0	0	0	0	0.2075	0	0	0.25	0	0	0	0	0	0	0	0	0	0	4.9203																																																																																		0	0	0	0	0	0	0	2.445476583	0	0	1.285971237	0	0	0	0.274011652	0	0	0	0.02277681	0	0.434567263	0	0	0	0	0	0	0	0	0.2075	0	0	0.25	0	0	0	0	0	0	0	0	0	0	4.9203
H5698_069_0	2009	4																																D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0						264.230597			341.7568716				66.81628393				115.2058361		829.1706179									249			150											No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$100/ Trip	No Cost Sharing	No Cost Sharing	"$50ER, waived if admitted within 24 hrs; $35 UC"	No Cost Sharing	No Cost Sharing	No Cost Sharing	$50/Obs	No Cost Sharing	No Cost Sharing	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/Trip; 10 trip/yr limit	$250 Allowance	No Cost Sharing	"$150 lens, frames & contacts allowance"	$10 Visit	$750 Allowance	Not Covered	No Cost Sharing															100			49.98431876				50				10		10									10			20															100			49.98431876				50				10		10									10			20											0	0	0	0	2.201921642	0	0	1.423540368	0	0	0	0.278401183	0	0	0	0.096004863	0	0.690975515	0	0	0	0	0	0	0	0	0.2075	0	0	0.25	0	0	0	0	0	0	0	0	0	0	5.1483	0	0	0	0	0	0	2.201921642	0	0	1.423540368	0	0	0	0.278401183	0	0	0	0.096004863	0	0.690975515	0	0	0	0	0	0	0	0	0.2075	0	0	0.25	0	0	0	0	0	0	0	0	0	0	5.1483																																																																																		0	0	0	0	0	0	0	2.201921642	0	0	1.423540368	0	0	0	0.278401183	0	0	0	0.096004863	0	0.690975515	0	0	0	0	0	0	0	0	0.2075	0	0	0.25	0	0	0	0	0	0	0	0	0	0	5.1483
H5698_070_0	2009	4																																D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0						283.9295495			309.2657176				60.31528821				26.95452758		514.7021486									249			150											No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$100/ Trip	No Cost Sharing	No Cost Sharing	"$50ER, waived if admitted within 24 hrs; $35 UC"	No Cost Sharing	No Cost Sharing	No Cost Sharing	$50/Obs	No Cost Sharing	No Cost Sharing	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/Trip; 10 trip/yr limit	$250 Allowance	No Cost Sharing	"$150 lens, frames & contacts allowance"	$10 Visit	$750 Allowance	Not Covered	No Cost Sharing															100			49.98170372				50				10		10									10			20															100			49.98170372				50				10		10									10			20											0	0	0	0	2.366079579	0	0	1.288135622	0	0	0	0.251313701	0	0	0	0.022462106	0	0.428918457	0	0	0	0	0	0	0	0	0.2075	0	0	0.25	0	0	0	0	0	0	0	0	0	0	4.8144	0	0	0	0	0	0	2.366079579	0	0	1.288135622	0	0	0	0.251313701	0	0	0	0.022462106	0	0.428918457	0	0	0	0	0	0	0	0	0.2075	0	0	0.25	0	0	0	0	0	0	0	0	0	0	4.8144																																																																																		0	0	0	0	0	0	0	2.366079579	0	0	1.288135622	0	0	0	0.251313701	0	0	0	0.022462106	0	0.428918457	0	0	0	0	0	0	0	0	0.2075	0	0	0.25	0	0	0	0	0	0	0	0	0	0	4.8144
H5698_071_0	2009	6																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		2299.887507	1879.101259	2628.953052		368.931427	1765.775145	1031.187171	642.5649889	435.0329777		529.8380555	21.78987674		276.0051054							12.23559376				144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	"$50ER, waived if admitted within 24 hrs; $35 UC"	lesser of 15% or $250 OP Surgery/ASC	No Cost Sharing	"$0 for diagnostic, $50 for all other services"	$20/Obs	No Cost Sharing	"$10 Visit for PT, OT, ST"	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	10% Scripts with $1000 OOP Max	20% medicare covered eyewear	$0/Trip; 40 trip/yr limit	$200 Allowance	$30 Visit	"$100 lens, frames & contacts allowance"	$30 Visit	Not Covered	Not Covered	No Cost Sharing											61.9	56.99	31.06		50	17.60233086	31.9943706	49.99249649	128.2289858		50	20		10							0.06				30		30														60.42372961	56.99	31.06		50	17.60233086	31.9943706	49.99249649	128.2289858		50	20		10							0.06				30		30														11.5806	8.924165063	6.804606817	0	1.537214279	2.590146527	2.749348708	2.676952329	4.648653127	0	2.207658564	0.036316461	0	0.230004254	0	0	0	0	0	0	0.734135626	0	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	45.7024	0	0.2829	11.5806	8.924165063	6.804606817	0	1.537214279	2.590146527	2.749348708	2.676952329	4.648653127	0	2.207658564	0.036316461	0	0.230004254	0	0	0	0	0	0	0.734135626	0	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	45.7024																																																																																		0	0	0	11.5806	8.924165063	6.804606817	0	1.537214279	2.590146527	2.749348708	2.676952329	4.648653127	0	2.207658564	0.036316461	0	0.230004254	0	0	0	0	0	0	0.734135626	0	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	45.7024
H5698_072_0	2009	6																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		2453.205513	2004.368281	2804.207642		393.5255998	1883.487478	1099.929472	685.3174351	464.0336956		565.1587892	23.24246103		294.4045063							13.92129784				144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	"$50ER, waived if admitted within 24 hrs; $35 UC"	lesser of 15% or $250 OP Surgery/ASC	No Cost Sharing	"$0 for diagnostic, $50 for all other services"	$20/Obs	No Cost Sharing	"$10 Visit for PT, OT, ST"	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	10% Scripts with $1000 OOP Max	20% medicare covered eyewear	$0/Trip; 40 trip/yr limit	$200 Allowance	$30 Visit	"$100 lens, frames & contacts allowance"	$30 Visit	Not Covered	Not Covered	No Cost Sharing											61.9	56.99	31.06		50	18.77575967	34.12721975	49.99340428	136.7771484		50	20		10							0.06				30		30														60.21692791	56.99	31.06		50	18.77575967	34.12721975	49.99340428	136.7771484		50	20		10							0.06				30		30														12.3104	9.519079027	7.258224112	0	1.639689999	2.946992352	3.1281279	2.855112633	5.289100471	0	2.354828288	0.038737435	0	0.245337089	0	0	0	0	0	0	0.83527787	0	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	49.4034	0	0.3441	12.3104	9.519079027	7.258224112	0	1.639689999	2.946992352	3.1281279	2.855112633	5.289100471	0	2.354828288	0.038737435	0	0.245337089	0	0	0	0	0	0	0.83527787	0	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	49.4034																																																																																		0	0	0	12.3104	9.519079027	7.258224112	0	1.639689999	2.946992352	3.1281279	2.855112633	5.289100471	0	2.354828288	0.038737435	0	0.245337089	0	0	0	0	0	0	0.83527787	0	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	49.4034
H5698_073_0	2009	6																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		2640.27913	1617.486392	4320.409851		563.0047042	2123.575328	1156.254815	681.3868998	529.9312937		598.9931466	35.15422838		401.0324563							19.78660014				144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	"$50ER, waived if admitted within 24 hrs; $35 UC"	lesser of 15% or $250 OP Surgery/ASC	No Cost Sharing	"$0 for diagnostic, $50 for all other services"	$20/Obs	No Cost Sharing	"$10 Visit for PT, OT, ST"	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	10% Scripts with $1000 OOP Max	20% medicare covered eyewear	$0/Trip; 40 trip/yr limit	$200 Allowance	$30 Visit	"$100 lens, frames & contacts allowance"	$30 Visit	Not Covered	Not Covered	No Cost Sharing											61.9	56.99	31.06		50	17.56045467	31.46744568	49.99293933	96.67694807		50	20		10							0.06				30		30														59.99712662	56.99	31.06		50	17.56045467	31.46744568	49.99293933	96.67694807		50	20		10							0.06				30		30														13.2008	7.681712457	11.18266083	0	2.345852934	3.107579024	3.032032131	2.838711162	4.269345014	0	2.495804778	0.058590381	0	0.334193714	0	0	0	0	0	0	1.187196008	0	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	52.7169	0	0.4187	13.2008	7.681712457	11.18266083	0	2.345852934	3.107579024	3.032032131	2.838711162	4.269345014	0	2.495804778	0.058590381	0	0.334193714	0	0	0	0	0	0	1.187196008	0	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	52.7169																																																																																		0	0	0	13.2008	7.681712457	11.18266083	0	2.345852934	3.107579024	3.032032131	2.838711162	4.269345014	0	2.495804778	0.058590381	0	0.334193714	0	0	0	0	0	0	1.187196008	0	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	52.7169
H5698_074_0	2009	6																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		1915.742007	2250.288271	2389.906566		361.5306379	1992.169597	603.4674326	664.3113285	540.7416739		555.5059517	35.9879271		281.4440453							24.05238506				144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	"$50ER, waived if admitted within 24 hrs; $35 UC"	lesser of 15% or $250 OP Surgery/ASC	No Cost Sharing	"$0 for diagnostic, $50 for all other services"	$20/Obs	No Cost Sharing	"$10 Visit for PT, OT, ST"	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	10% Scripts with $1000 OOP Max	20% medicare covered eyewear	$0/Trip; 40 trip/yr limit	$200 Allowance	$30 Visit	"$100 lens, frames & contacts allowance"	$30 Visit	Not Covered	Not Covered	No Cost Sharing											61.9	56.99	31.06		50	17.32274757	30.60537386	49.99258207	77.30130963		50	20		10							0.06				30		30														60.88852181	56.99	31.06		50	17.32274757	30.60537386	49.99258207	77.30130963		50	20		10							0.06				30		30														9.7206	10.68699404	6.185874829	0	1.506377658	2.875820919	1.539112199	2.767553217	3.48333663	0	2.314608132	0.059979879	0	0.234536704	0	0	0	0	0	0	1.443143104	0	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	43.8004	0	0.1615	9.7206	10.68699404	6.185874829	0	1.506377658	2.875820919	1.539112199	2.767553217	3.48333663	0	2.314608132	0.059979879	0	0.234536704	0	0	0	0	0	0	1.443143104	0	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	43.8004																																																																																		0	0	0	9.7206	10.68699404	6.185874829	0	1.506377658	2.875820919	1.539112199	2.767553217	3.48333663	0	2.314608132	0.059979879	0	0.234536704	0	0	0	0	0	0	1.443143104	0	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	43.8004
H5698_075_0	2009	6																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		2945.943619	1401.013286	5099.909268		645.7987321	2200.177829	1378.418867	696.5425325	532.6972105		623.0083323	35.29400161		451.0365793							18.645224				144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	"$50ER, waived if admitted within 24 hrs; $35 UC"	lesser of 15% or $250 OP Surgery/ASC	No Cost Sharing	"$0 for diagnostic, $50 for all other services"	$20/Obs	No Cost Sharing	"$10 Visit for PT, OT, ST"	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	10% Scripts with $1000 OOP Max	20% medicare covered eyewear	$0/Trip; 40 trip/yr limit	$200 Allowance	$30 Visit	"$100 lens, frames & contacts allowance"	$30 Visit	Not Covered	Not Covered	No Cost Sharing											61.9	56.99	31.06		50	17.87480429	32.09467969	49.99323948	105.4942984		50	20		10							0.06				30		30														59.56419736	56.99	31.06		50	17.87480429	32.09467969	49.99323948	105.4942984		50	20		10							0.06				30		30														14.6227	6.653645598	13.20026515	0	2.69082805	3.277312342	3.686659336	2.901868136	4.683043205	0	2.595868051	0.058823336	0	0.375863816	0	0	0	0	0	0	1.11871344	0	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	56.8481	0	0.5734	14.6227	6.653645598	13.20026515	0	2.69082805	3.277312342	3.686659336	2.901868136	4.683043205	0	2.595868051	0.058823336	0	0.375863816	0	0	0	0	0	0	1.11871344	0	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	56.8481																																																																																		0	0	0	14.6227	6.653645598	13.20026515	0	2.69082805	3.277312342	3.686659336	2.901868136	4.683043205	0	2.595868051	0.058823336	0	0.375863816	0	0	0	0	0	0	1.11871344	0	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	56.8481
H5698_076_0	2009	6																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		2549.495487	1620.961841	4865.706376		658.553377	2443.627846	1394.755435	1117.931969	507.7849079		626.6594095	31.92000505		403.9531673							12.72671751				144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	"$50ER, waived if admitted within 24 hrs; $35 UC"	lesser of 15% or $250 OP Surgery/ASC	No Cost Sharing	"$0 for diagnostic, $50 for all other services"	$20/Obs	No Cost Sharing	"$10 Visit for PT, OT, ST"	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	10% Scripts with $1000 OOP Max	20% medicare covered eyewear	$0/Trip; 40 trip/yr limit	$200 Allowance	$30 Visit	"$100 lens, frames & contacts allowance"	$30 Visit	Not Covered	Not Covered	No Cost Sharing											61.9	56.99	31.06		50	16.89409973	30.85133185	49.99509054	94.42868117		50	20		10							0.06				30		30														60.09976386	56.99	31.06		50	16.89409973	30.85133185	49.99509054	94.42868117		50	20		10							0.06				30		30														12.7687	7.698217942	12.59407	0	2.743972404	3.440241045	3.585838564	4.657592502	3.995788264	0	2.611080873	0.053200008	0	0.336627639	0	0	0	0	0	0	0.763603051	0	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	56.2314	0	0.3825	12.7687	7.698217942	12.59407	0	2.743972404	3.440241045	3.585838564	4.657592502	3.995788264	0	2.611080873	0.053200008	0	0.336627639	0	0	0	0	0	0	0.763603051	0	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	56.2314																																																																																		0	0	0	12.7687	7.698217942	12.59407	0	2.743972404	3.440241045	3.585838564	4.657592502	3.995788264	0	2.611080873	0.053200008	0	0.336627639	0	0	0	0	0	0	0.763603051	0	0	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	56.2314
H5698_077_0	2009	6																																D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		3398.122587		4031.822687			2206.139356	1308.756156	1059.814631	273.3856112		430.6759628			258.4055777	3641.083055	3347.392515		375.0814325			10.76918746				144		249														No Cost Sharing	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	No Cost Sharing	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	"$50ER, waived if admitted within 24 hrs; $35 UC"	Lesser of 10% or $250 per visit	No Cost Sharing	"$0 for diagnostic, $75 for all other services"	$50/Obs	No Cost Sharing	$20 Visit	$10/Visit	$10/Visit	No Cost Sharing	$10 Visit	No Cost Sharing	No Cost Sharing	20% Scripts with $2000 annualized Max OOP	20% medicare covered eyewear	$0/Trip; 40 trip/yr limit	$200 Allowance	$30 Visit	"$100 lens, frames & contacts allowance"	$30 Visit	Not Covered	Not Covered	No Cost Sharing											106.6482094		31.06			16.71057109	26.5816711	49.99486045	102.5343032		25			10	10	10		10			0.121				10		10														106.6482094		31.06			16.71057109	26.5816711	49.99486045	102.5343032		25			10	10	10		10			0.121				10		10														30.2003	0	10.43570105	0	0	3.072154045	2.89907714	4.415440382	2.335950263	0	0.897241589	0	0	0.215337981	3.034235879	2.789493763	0	0.31256786	0	0	1.303071683	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	62.2381	0	0	30.2003	0	10.43570105	0	0	3.072154045	2.89907714	4.415440382	2.335950263	0	0.897241589	0	0	0.215337981	3.034235879	2.789493763	0	0.31256786	0	0	1.303071683	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	62.2381																																																																																		0	0	0	30.2003	0	10.43570105	0	0	3.072154045	2.89907714	4.415440382	2.335950263	0	0.897241589	0	0	0.215337981	3.034235879	2.789493763	0	0.31256786	0	0	1.303071683	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	62.2381
H5698_078_0	2009	6																																D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		3624.652527		4300.597143			2353.207804	1396.002112	1130.371528	291.6103881		459.3862279			275.6317367	3883.809533	3570.540623		400.0855847			12.25286398				144		249														No Cost Sharing	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	No Cost Sharing	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	"$50ER, waived if admitted within 24 hrs; $35 UC"	Lesser of 10% or $250 per visit	No Cost Sharing	"$0 for diagnostic, $75 for all other services"	$50/Obs	No Cost Sharing	$20 Visit	$10/Visit	$10/Visit	No Cost Sharing	$10 Visit	No Cost Sharing	No Cost Sharing	20% Scripts with $2000 annualized Max OOP	20% medicare covered eyewear	$0/Trip; 40 trip/yr limit	$200 Allowance	$30 Visit	"$100 lens, frames & contacts allowance"	$30 Visit	Not Covered	Not Covered	No Cost Sharing											111.7216682		31.06			17.82455229	28.35369203	49.99548241	109.3695745		25			10	10	10		10			0.121				10		10														111.7216682		31.06			17.82455229	28.35369203	49.99548241	109.3695745		25			10	10	10		10			0.121				10		10														33.746	0	11.13137894	0	0	3.495406296	3.298484496	4.709455822	2.657775338	0	0.957054641	0	0	0.229693114	3.236507944	2.975450519	0	0.333404654	0	0	1.482596542	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5807	0	0	33.746	0	11.13137894	0	0	3.495406296	3.298484496	4.709455822	2.657775338	0	0.957054641	0	0	0.229693114	3.236507944	2.975450519	0	0.333404654	0	0	1.482596542	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5807																																																																																		0	0	0	33.746	0	11.13137894	0	0	3.495406296	3.298484496	4.709455822	2.657775338	0	0.957054641	0	0	0.229693114	3.236507944	2.975450519	0	0.333404654	0	0	1.482596542	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5807
H5698_079_0	2009	6																																D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		2396.934325		5208.279006			2644.108441	1260.131795	1137.238018	497.9715553		657.2144917			421.4989587	3854.960242	5095.701132		232.3616468			7.697303278				144		249														No Cost Sharing	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	No Cost Sharing	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	"$50ER, waived if admitted within 24 hrs; $35 UC"	Lesser of 10% or $250 per visit	No Cost Sharing	"$0 for diagnostic, $75 for all other services"	$50/Obs	No Cost Sharing	$20 Visit	$10/Visit	$10/Visit	No Cost Sharing	$10 Visit	No Cost Sharing	No Cost Sharing	20% Scripts with $2000 annualized Max OOP	20% medicare covered eyewear	$0/Trip; 40 trip/yr limit	$200 Allowance	$30 Visit	"$100 lens, frames & contacts allowance"	$30 Visit	Not Covered	Not Covered	No Cost Sharing											118.0093349		31.06			16.88894282	31.3989594	49.99495313	65.65007687		25			10	10	10		10			0.121				10		10														118.0093349		31.06			16.88894282	31.3989594	49.99495313	65.65007687		25			10	10	10		10			0.121				10		10														23.5717	0	13.48076216	0	0	3.72134969	3.297235588	4.738013451	2.724322574	0	1.369196858	0	0	0.351249132	3.212466868	4.24641761	0	0.193634706	0	0	0.931373697	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	62.1652	0	0	23.5717	0	13.48076216	0	0	3.72134969	3.297235588	4.738013451	2.724322574	0	1.369196858	0	0	0.351249132	3.212466868	4.24641761	0	0.193634706	0	0	0.931373697	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	62.1652																																																																																		0	0	0	23.5717	0	13.48076216	0	0	3.72134969	3.297235588	4.738013451	2.724322574	0	1.369196858	0	0	0.351249132	3.212466868	4.24641761	0	0.193634706	0	0	0.931373697	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	62.1652
H5698_080_0	2009	6																																D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		2650.799682		5672.170113			1884.705674	591.9727717	944.4919005	438.9505545		585.267406			515.157248	2742.822372	3811.402647		293.6070366			7.302632694				144		249														No Cost Sharing	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	No Cost Sharing	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	"$50ER, waived if admitted within 24 hrs; $35 UC"	Lesser of 10% or $250 per visit	No Cost Sharing	"$0 for diagnostic, $75 for all other services"	$50/Obs	No Cost Sharing	$20 Visit	$10/Visit	$10/Visit	No Cost Sharing	$10 Visit	No Cost Sharing	No Cost Sharing	20% Scripts with $2000 annualized Max OOP	20% medicare covered eyewear	$0/Trip; 40 trip/yr limit	$200 Allowance	$30 Visit	"$100 lens, frames & contacts allowance"	$30 Visit	Not Covered	Not Covered	No Cost Sharing											107.9106899		31.06			14.03135196	27.87260941	49.99405864	64.93846603		25			10	10	10		10			0.121				10		10														107.9106899		31.06			14.03135196	27.87260941	49.99405864	64.93846603		25			10	10	10		10			0.121				10		10														23.8375	0	14.68146697	0	0	2.203747388	1.374985487	3.934915289	2.375397972	0	1.219307096	0	0	0.429297707	2.28568531	3.176168872	0	0.244672531	0	0	0.883618556	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	56.9742	0	0	23.8375	0	14.68146697	0	0	2.203747388	1.374985487	3.934915289	2.375397972	0	1.219307096	0	0	0.429297707	2.28568531	3.176168872	0	0.244672531	0	0	0.883618556	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	56.9742																																																																																		0	0	0	23.8375	0	14.68146697	0	0	2.203747388	1.374985487	3.934915289	2.375397972	0	1.219307096	0	0	0.429297707	2.28568531	3.176168872	0	0.244672531	0	0	0.883618556	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	56.9742
H5698_081_0	2009	6																																D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		2323.466782		5085.904013			3004.550445	1561.982187	1235.380122	530.1774063		697.1929995			387.761009	4382.575881	5714.223203		209.6794252			8.085768798				144		249														No Cost Sharing	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	No Cost Sharing	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	"$50ER, waived if admitted within 24 hrs; $35 UC"	Lesser of 10% or $250 per visit	No Cost Sharing	"$0 for diagnostic, $75 for all other services"	$50/Obs	No Cost Sharing	$20 Visit	$10/Visit	$10/Visit	No Cost Sharing	$10 Visit	No Cost Sharing	No Cost Sharing	20% Scripts with $2000 annualized Max OOP	20% medicare covered eyewear	$0/Trip; 40 trip/yr limit	$200 Allowance	$30 Visit	"$100 lens, frames & contacts allowance"	$30 Visit	Not Covered	Not Covered	No Cost Sharing											130.7702005		31.06			17.94277493	32.5218143	49.99538951	66.89330808		25			10	10	10		10			0.121				10		10														130.7702005		31.06			17.94277493	32.5218143	49.99538951	66.89330808		25			10	10	10		10			0.121				10		10														25.32	0	13.16401489	0	0	4.492497701	4.233207884	5.146942533	2.955443381	0	1.452485416	0	0	0.323134174	3.652146567	4.761852669	0	0.174732854	0	0	0.978378025	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	66.9824	0	0	25.32	0	13.16401489	0	0	4.492497701	4.233207884	5.146942533	2.955443381	0	1.452485416	0	0	0.323134174	3.652146567	4.761852669	0	0.174732854	0	0	0.978378025	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	66.9824																																																																																		0	0	0	25.32	0	13.16401489	0	0	4.492497701	4.233207884	5.146942533	2.955443381	0	1.452485416	0	0	0.323134174	3.652146567	4.761852669	0	0.174732854	0	0	0.978378025	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	66.9824
H5698_082_0	2009	6																																D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		2216.372847		4851.482985			2866.063796	1489.986831	1472.938852	505.7403087		665.0577686			369.8882111	4180.572866	5450.841496		200.0148176			7.357563608				144		249														No Cost Sharing	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	No Cost Sharing	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	"$50ER, waived if admitted within 24 hrs; $35 UC"	Lesser of 10% or $250 per visit	No Cost Sharing	"$0 for diagnostic, $75 for all other services"	$50/Obs	No Cost Sharing	$20 Visit	$10/Visit	$10/Visit	No Cost Sharing	$10 Visit	No Cost Sharing	No Cost Sharing	20% Scripts with $2000 annualized Max OOP	20% medicare covered eyewear	$0/Trip; 40 trip/yr limit	$200 Allowance	$30 Visit	"$100 lens, frames & contacts allowance"	$30 Visit	Not Covered	Not Covered	No Cost Sharing											129.478682		31.06			17.11575112	31.02280898	49.99594626	63.81004146		25			10	10	10		10			0.121				10		10														129.478682		31.06			17.11575112	31.02280898	49.99594626	63.81004146		25			10	10	10		10			0.121				10		10														23.9144	0	12.55725513	0	0	4.087902885	3.851964736	6.136747641	2.689275839	0	1.385537018	0	0	0.308240176	3.483810722	4.542367914	0	0.166679015	0	0	0.890265197	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	64.342	0	0	23.9144	0	12.55725513	0	0	4.087902885	3.851964736	6.136747641	2.689275839	0	1.385537018	0	0	0.308240176	3.483810722	4.542367914	0	0.166679015	0	0	0.890265197	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	64.342																																																																																		0	0	0	23.9144	0	12.55725513	0	0	4.087902885	3.851964736	6.136747641	2.689275839	0	1.385537018	0	0	0.308240176	3.483810722	4.542367914	0	0.166679015	0	0	0.890265197	0	0	0	0.12	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	64.342
H5698_086_0	2009	6																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		4089.219566	272.5106756	2864.897446		386.639144	5840.595938	4379.370412	523.3023824	509.4490725		722.7518377	145.1697585		263.6282815			495.7860168				41.27161347		50		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	$50; waived if admitted within 24 hrs	lesser of 15% or $250 OP Surgery/ASC	No Cost Sharing	"$0 for diagnostic, $50 for all other services"	$50/Obs	No Cost Sharing	"$10 Visit for PT, OT, ST; $20 Visit for OP MH/SA"	No Cost Sharing	No Cost Sharing	$20 Visit	No Cost Sharing	No Cost Sharing	No Cost Sharing	10% Scripts with $1000 OOP Max	20% medicare covered eyewear	$3/Trip; 20 trip/yr limit	No Cost Sharing	$30 Visit	"$100 lens, frames & contacts"	$30 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	9.173991455	29.09792678	49.99231223	115.6884368		50	50		10.14684288			20				0.06		3		30		30														57.5708282	79.55	31.06		50	9.173991455	29.09792678	49.99231223	115.6884368		50	50		10.14684288			20				0.06		3		30		30														19.6183	1.806518687	7.415309555	0	1.610996433	4.465131436	10.61921663	2.180091341	4.911447236	0	3.011465991	0.604873994	0	0.222916229	0	0	0.826310028	0	0	0	2.476296808	0	0.0125	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	60.7639	0	1.4752	19.6183	1.806518687	7.415309555	0	1.610996433	4.465131436	10.61921663	2.180091341	4.911447236	0	3.011465991	0.604873994	0	0.222916229	0	0	0.826310028	0	0	0	2.476296808	0	0.0125	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	60.7639																																																																																		0	0	0	19.6183	1.806518687	7.415309555	0	1.610996433	4.465131436	10.61921663	2.180091341	4.911447236	0	3.011465991	0.604873994	0	0.222916229	0	0	0.826310028	0	0	0	2.476296808	0	0.0125	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	60.7639
H5698_087_0	2009	6																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		3018.188575	188.5023973	2214.976495		309.1292915	4645.357793	1747.616852	397.3701182	448.611028		591.900854	110.551422		195.2442496			373.8449427				36.06380804		50				249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	$50; waived if admitted within 24 hrs	lesser of 15% or $250 OP Surgery/ASC	No Cost Sharing	"$0 for diagnostic, $50 for all other services"	$50/Obs	No Cost Sharing	"$10 Visit for PT, OT, ST; $20 Visit for OP MH/SA"	No Cost Sharing	No Cost Sharing	$20 Visit	No Cost Sharing	No Cost Sharing	No Cost Sharing	10% Scripts with $1000 OOP Max	20% medicare covered eyewear	$3/Trip; 20 trip/yr limit	No Cost Sharing	No Cost Sharing	"$150 lens, frames & contacts"	$30 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	13.72296679	34.57654473	49.99011515	128.1323196		50	50		10.18226002			20				0.06		3				30														59.46094469	79.55	31.06		50	13.72296679	34.57654473	49.99011515	128.1323196		50	50		10.18226002			20				0.06		3				30														14.9554	1.249613809	5.733097494	0	1.288038715	5.312340892	5.035546022	1.655381497	4.790130969	0	2.466253558	0.460630925	0	0.165668977	0	0	0.623074905	0	0	0	2.163828482	0	0.0125	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	46.534	0	0.6135	14.9554	1.249613809	5.733097494	0	1.288038715	5.312340892	5.035546022	1.655381497	4.790130969	0	2.466253558	0.460630925	0	0.165668977	0	0	0.623074905	0	0	0	2.163828482	0	0.0125	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	46.534																																																																																		0	0	0	14.9554	1.249613809	5.733097494	0	1.288038715	5.312340892	5.035546022	1.655381497	4.790130969	0	2.466253558	0.460630925	0	0.165668977	0	0	0.623074905	0	0	0	2.163828482	0	0.0125	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	46.534
H5698_088_0	2009	6																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		5420.285517	231.5093829	4538.399496		537.6692269	4396.111653	3139.538079	595.7238869	481.4456717		724.4182537	165.2540793		283.0589676			316.8474047				47.18305335		50		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	$50; waived if admitted within 24 hrs	lesser of 15% or $250 OP Surgery/ASC	No Cost Sharing	"$0 for diagnostic, $50 for all other services"	$50/Obs	No Cost Sharing	"$10 Visit for PT, OT, ST; $20 Visit for OP MH/SA"	No Cost Sharing	No Cost Sharing	$20 Visit	No Cost Sharing	No Cost Sharing	No Cost Sharing	10% Scripts with $1000 OOP Max	20% medicare covered eyewear	$3/Trip; 20 trip/yr limit	No Cost Sharing	$30 Visit	"$100 lens, frames & contacts"	$30 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	10.81846528	30.62206437	49.99393219	139.6378644		50	50		10.27456647			20				0.06		3		30		30														55.02175475	79.55	31.06		50	10.81846528	30.62206437	49.99393219	139.6378644		50	50		10.27456647			20				0.06		3		30		30														24.8528	1.534714284	11.74689069	0	2.240288445	3.963265105	8.011594762	2.481881634	5.602337117	0	3.01840939	0.688558664	0	0.242359015	0	0	0.528079008	0	0	0	2.830983201	0	0.0125	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7372	0	3.1068	24.8528	1.534714284	11.74689069	0	2.240288445	3.963265105	8.011594762	2.481881634	5.602337117	0	3.01840939	0.688558664	0	0.242359015	0	0	0.528079008	0	0	0	2.830983201	0	0.0125	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7372																																																																																		0	0	0	24.8528	1.534714284	11.74689069	0	2.240288445	3.963265105	8.011594762	2.481881634	5.602337117	0	3.01840939	0.688558664	0	0.242359015	0	0	0.528079008	0	0	0	2.830983201	0	0.0125	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	68.7372
H5698_089_0	2009	6																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		3913.666692	388.8076381	3887.049711		530.5805163	5852.598398	4168.053036	592.8389496	509.0307555		1191.153826	47.95217262		377.3330506			796.0750546				38.22082798		50		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	$50; waived if admitted within 24 hrs	lesser of 15% or $250 OP Surgery/ASC	No Cost Sharing	"$0 for diagnostic, $50 for all other services"	$50/Obs	No Cost Sharing	"$10 Visit for PT, OT, ST; $20 Visit for OP MH/SA"	No Cost Sharing	No Cost Sharing	$20 Visit	No Cost Sharing	No Cost Sharing	No Cost Sharing	10% Scripts with $1000 OOP Max	20% medicare covered eyewear	$3/Trip; 20 trip/yr limit	No Cost Sharing	$30 Visit	"$100 lens, frames & contacts"	$30 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	10.05943568	28.72069581	49.99263962	108.4922715		50	50		11.2961622			20				0.06		3		30		30														57.93097948	79.55	31.06		50	10.05943568	28.72069581	49.99263962	108.4922715		50	50		11.2961622			20				0.06		3		30		30														18.8935	2.577470634	10.06098034	0	2.210752151	4.906153095	9.975781947	2.469798664	4.602158577	0	4.963140943	0.199800719	0	0.355201279	0	0	1.326791758	0	0	0	2.293249679	0	0.0125	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8298	0	1.2945	18.8935	2.577470634	10.06098034	0	2.210752151	4.906153095	9.975781947	2.469798664	4.602158577	0	4.963140943	0.199800719	0	0.355201279	0	0	1.326791758	0	0	0	2.293249679	0	0.0125	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8298																																																																																		0	0	0	18.8935	2.577470634	10.06098034	0	2.210752151	4.906153095	9.975781947	2.469798664	4.602158577	0	4.963140943	0.199800719	0	0.355201279	0	0	1.326791758	0	0	0	2.293249679	0	0.0125	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8298
H5698_090_0	2009	6																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		2770.518575	247.2933873	2951.572484		378.4332264	4421.859053	1574.352272	423.6076013	418.5205013		767.260026	34.97316713		354.7750831			607.0462286				25.63360789		50				249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	$50; waived if admitted within 24 hrs	lesser of 15% or $250 OP Surgery/ASC	No Cost Sharing	"$0 for diagnostic, $50 for all other services"	$50/Obs	No Cost Sharing	"$10 Visit for PT, OT, ST; $20 Visit for OP MH/SA"	No Cost Sharing	No Cost Sharing	$20 Visit	No Cost Sharing	No Cost Sharing	No Cost Sharing	10% Scripts with $1000 OOP Max	20% medicare covered eyewear	$3/Trip; 20 trip/yr limit	No Cost Sharing	No Cost Sharing	"$150 lens, frames & contacts"	$30 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	14.16420153	32.36535809	49.99015072	116.0032542		50	50		11.38429271			20				0.06		3				30														59.82352201	79.55	31.06		50	14.16420153	32.36535809	49.99015072	116.0032542		50	50		11.38429271			20				0.06		3				30														13.8118	1.63934908	7.639653445	0	1.57680511	5.219341896	4.246206252	1.764683986	4.045811676	0	3.196916775	0.14572153	0	0.336571949	0	0	1.011743714	0	0	0	1.538016473	0	0.0125	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	46.8077	0	0.4794	13.8118	1.63934908	7.639653445	0	1.57680511	5.219341896	4.246206252	1.764683986	4.045811676	0	3.196916775	0.14572153	0	0.336571949	0	0	1.011743714	0	0	0	1.538016473	0	0.0125	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	46.8077																																																																																		0	0	0	13.8118	1.63934908	7.639653445	0	1.57680511	5.219341896	4.246206252	1.764683986	4.045811676	0	3.196916775	0.14572153	0	0.336571949	0	0	1.011743714	0	0	0	1.538016473	0	0.0125	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	46.8077
H5698_091_0	2009	6																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		4937.185834	215.6191244	5745.34856		743.0310377	4550.335237	3030.201491	556.0845371	420.7886651		731.1768633	49.58971796		429.2949306			765.940854				37.43165754		50		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	$50; waived if admitted within 24 hrs	lesser of 15% or $250 OP Surgery/ASC	No Cost Sharing	"$0 for diagnostic, $50 for all other services"	$50/Obs	No Cost Sharing	"$10 Visit for PT, OT, ST; $20 Visit for OP MH/SA"	No Cost Sharing	No Cost Sharing	$20 Visit	No Cost Sharing	No Cost Sharing	No Cost Sharing	10% Scripts with $1000 OOP Max	20% medicare covered eyewear	$3/Trip; 20 trip/yr limit	No Cost Sharing	$30 Visit	"$100 lens, frames & contacts"	$30 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	10.93460866	29.60320825	49.9927856	125.0370127		50	50		10.95699831			20				0.06		3		30		30														55.89781971	79.55	31.06		50	10.93460866	29.60320825	49.9927856	125.0370127		50	50		10.95699831			20				0.06		3		30		30														22.9982	1.429375112	14.87087719	0	3.095962657	4.14634459	7.475307148	2.316684587	4.384513137	0	3.046570264	0.206623825	0	0.391981986	0	0	1.27656809	0	0	0	2.245899452	0	0.0125	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	68.8799	0	2.4695	22.9982	1.429375112	14.87087719	0	3.095962657	4.14634459	7.475307148	2.316684587	4.384513137	0	3.046570264	0.206623825	0	0.391981986	0	0	1.27656809	0	0	0	2.245899452	0	0.0125	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	68.8799																																																																																		0	0	0	22.9982	1.429375112	14.87087719	0	3.095962657	4.14634459	7.475307148	2.316684587	4.384513137	0	3.046570264	0.206623825	0	0.391981986	0	0	1.27656809	0	0	0	2.245899452	0	0.0125	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	68.8799
H5698_092_0	2009	6																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		4117.72466	637.2963181	3509.641077		492.2558748	7212.0382	3653.765885	609.6581353	562.1793108		1303.412242	69.65921652		360.0694713			360.6486005				54.0954267		50		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	$50; waived if admitted within 24 hrs	lesser of 15% or $250 OP Surgery/ASC	No Cost Sharing	"$0 for diagnostic, $50 for all other services"	$50/Obs	No Cost Sharing	"$10 Visit for PT, OT, ST; $20 Visit for OP MH/SA"	No Cost Sharing	No Cost Sharing	$20 Visit	No Cost Sharing	No Cost Sharing	No Cost Sharing	10% Scripts with $1000 OOP Max	20% medicare covered eyewear	$3/Trip; 20 trip/yr limit	No Cost Sharing	$30 Visit	"$100 lens, frames & contacts"	$30 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	9.067417959	28.26772082	49.99284649	103.2938223		50	50		11.55313351			20				0.06		3		30		30														57.51524724	79.55	31.06		50	9.067417959	28.26772082	49.99284649	103.2938223		50	50		11.55313351			20				0.06		3		30		30														19.736	4.224743509	9.084120987	0	2.051066145	5.449547058	8.606969497	2.539878797	4.839137487	0	5.43088434	0.290246736	0	0.34666089	0	0	0.601081001	0	0	0	3.245725602	0	0.0125	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	67.4411	0	1.5046	19.736	4.224743509	9.084120987	0	2.051066145	5.449547058	8.606969497	2.539878797	4.839137487	0	5.43088434	0.290246736	0	0.34666089	0	0	0.601081001	0	0	0	3.245725602	0	0.0125	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	67.4411																																																																																		0	0	0	19.736	4.224743509	9.084120987	0	2.051066145	5.449547058	8.606969497	2.539878797	4.839137487	0	5.43088434	0.290246736	0	0.34666089	0	0	0.601081001	0	0	0	3.245725602	0	0.0125	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	67.4411
H5698_093_0	2009	6																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		2952.528223	322.8514107	2918.322452		356.6887967	4532.878565	1386.339597	453.4021958	435.0776716		760.3394735	40.13449941		327.7240412			306.9453279				25.64034521		50				249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	$50; waived if admitted within 24 hrs	lesser of 15% or $250 OP Surgery/ASC	No Cost Sharing	"$0 for diagnostic, $50 for all other services"	$50/Obs	No Cost Sharing	"$10 Visit for PT, OT, ST; $20 Visit for OP MH/SA"	No Cost Sharing	No Cost Sharing	$20 Visit	No Cost Sharing	No Cost Sharing	No Cost Sharing	10% Scripts with $1000 OOP Max	20% medicare covered eyewear	$3/Trip; 20 trip/yr limit	No Cost Sharing	No Cost Sharing	"$150 lens, frames & contacts"	$30 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	14.18032348	33.41417104	49.99094914	107.2802953		50	50		11.92336589			20				0.06		3				30														59.55506361	79.55	31.06		50	14.18032348	33.41417104	49.99094914	107.2802953		50	50		11.92336589			20				0.06		3				30														14.6532	2.14023581	7.553591279	0	1.48620332	5.356473695	3.860282369	1.888833843	3.889605092	0	3.16808114	0.167227081	0	0.325631138	0	0	0.511575547	0	0	0	1.538420713	0	0.0125	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1743	0	0.577	14.6532	2.14023581	7.553591279	0	1.48620332	5.356473695	3.860282369	1.888833843	3.889605092	0	3.16808114	0.167227081	0	0.325631138	0	0	0.511575547	0	0	0	1.538420713	0	0.0125	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1743																																																																																		0	0	0	14.6532	2.14023581	7.553591279	0	1.48620332	5.356473695	3.860282369	1.888833843	3.889605092	0	3.16808114	0.167227081	0	0.325631138	0	0	0.511575547	0	0	0	1.538420713	0	0.0125	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	47.1743
H5698_094_0	2009	6																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		5164.272004	363.5741015	5243.724001		673.070467	4674.934046	2270.482412	611.619716	411.5165746		720.2991102	69.06977769		431.8312151			231.9088295				39.07352373		50		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	$50; waived if admitted within 24 hrs	lesser of 15% or $250 OP Surgery/ASC	No Cost Sharing	"$0 for diagnostic, $50 for all other services"	$50/Obs	No Cost Sharing	"$10 Visit for PT, OT, ST; $20 Visit for OP MH/SA"	No Cost Sharing	No Cost Sharing	$20 Visit	No Cost Sharing	No Cost Sharing	No Cost Sharing	10% Scripts with $1000 OOP Max	20% medicare covered eyewear	$3/Trip; 20 trip/yr limit	No Cost Sharing	$30 Visit	"$100 lens, frames & contacts"	$30 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	11.59477441	28.81276555	49.99319026	120.9163612		50	50		12.27150538			20				0.06		3		30		30														55.46868245	79.55	31.06		50	11.59477441	28.81276555	49.99319026	120.9163612		50	50		12.27150538			20				0.06		3		30		30														23.8713	2.410193314	13.57250562	0	2.804460279	4.517067139	5.451573117	2.548068402	4.146590565	0	3.001246292	0.28779074	0	0.44160159	0	0	0.386514716	0	0	0	2.344411424	0	0.0125	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	66.7783	0	2.7678	23.8713	2.410193314	13.57250562	0	2.804460279	4.517067139	5.451573117	2.548068402	4.146590565	0	3.001246292	0.28779074	0	0.44160159	0	0	0.386514716	0	0	0	2.344411424	0	0.0125	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	66.7783																																																																																		0	0	0	23.8713	2.410193314	13.57250562	0	2.804460279	4.517067139	5.451573117	2.548068402	4.146590565	0	3.001246292	0.28779074	0	0.44160159	0	0	0.386514716	0	0	0	2.344411424	0	0.0125	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	66.7783
H5698_095_0	2009	6																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		3887.46532	296.9094889	4087.996376		552.8481651	5400.901231	4426.408197	594.3678664	495.2119426		1163.556123	40.1160062		389.25962			977.3572832				32.87957226		50		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	$50; waived if admitted within 24 hrs	lesser of 15% or $250 OP Surgery/ASC	No Cost Sharing	"$0 for diagnostic, $50 for all other services"	$50/Obs	No Cost Sharing	"$10 Visit for PT, OT, ST; $20 Visit for OP MH/SA"	No Cost Sharing	No Cost Sharing	$20 Visit	No Cost Sharing	No Cost Sharing	No Cost Sharing	10% Scripts with $1000 OOP Max	20% medicare covered eyewear	$3/Trip; 20 trip/yr limit	No Cost Sharing	$30 Visit	"$100 lens, frames & contacts"	$30 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	10.71328916	29.28311958	49.99275452	112.2940423		50	50		11.20315582			20				0.06		3		30		30														57.98752197	79.55	31.06		50	10.71328916	29.28311958	49.99275452	112.2940423		50	50		11.20315582			20				0.06		3		30		30														18.7854	1.968262487	10.58109729	0	2.303534021	4.821784719	10.80158671	2.476173903	4.63411257	0	4.848150511	0.167150026	0	0.363411348	0	0	1.628928805	0	0	0	1.972774335	0	0.0125	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3473	0	1.2675	18.7854	1.968262487	10.58109729	0	2.303534021	4.821784719	10.80158671	2.476173903	4.63411257	0	4.848150511	0.167150026	0	0.363411348	0	0	1.628928805	0	0	0	1.972774335	0	0.0125	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3473																																																																																		0	0	0	18.7854	1.968262487	10.58109729	0	2.303534021	4.821784719	10.80158671	2.476173903	4.63411257	0	4.848150511	0.167150026	0	0.363411348	0	0	1.628928805	0	0	0	1.972774335	0	0.0125	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	66.3473
H5698_096_0	2009	6																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		2711.587003	211.6781542	3005.043953		394.2357086	4419.654768	1690.019166	413.5783438	415.2158798		780.2782177	32.76362025		373.0012152			768.131195				26.25380918		50				249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	$50; waived if admitted within 24 hrs	lesser of 15% or $250 OP Surgery/ASC	No Cost Sharing	"$0 for diagnostic, $50 for all other services"	$50/Obs	No Cost Sharing	"$10 Visit for PT, OT, ST; $20 Visit for OP MH/SA"	No Cost Sharing	No Cost Sharing	$20 Visit	No Cost Sharing	No Cost Sharing	No Cost Sharing	10% Scripts with $1000 OOP Max	20% medicare covered eyewear	$3/Trip; 20 trip/yr limit	No Cost Sharing	$30 Visit	"$100 lens, frames & contacts"	$30 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	14.3231508	32.3477712	49.98993347	122.2123687		50	50		11.14189189			20				0.06		3				30														59.91816776	79.55	31.06		50	14.3231508	32.3477712	49.98993347	122.2123687		50	50		11.14189189			20				0.06		3				30														13.5394	1.403249764	7.778055431	0	1.642648786	5.275281812	4.55569611	1.722896158	4.228709682	0	3.251159241	0.136515084	0	0.346328268	0	0	1.280218658	0	0	0	1.575228551	0	0.0125	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	47.3704	0	0.4478	13.5394	1.403249764	7.778055431	0	1.642648786	5.275281812	4.55569611	1.722896158	4.228709682	0	3.251159241	0.136515084	0	0.346328268	0	0	1.280218658	0	0	0	1.575228551	0	0.0125	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	47.3704																																																																																		0	0	0	13.5394	1.403249764	7.778055431	0	1.642648786	5.275281812	4.55569611	1.722896158	4.228709682	0	3.251159241	0.136515084	0	0.346328268	0	0	1.280218658	0	0	0	1.575228551	0	0.0125	0	0	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	47.3704
H5698_097_0	2009	6																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		4896.871921	150.5037609	6049.950757		784.7591111	4552.051959	3418.113444	537.7801506	430.4913106		745.6343925	41.29093635		433.6880282			1020.959208				37.61092506		50		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	$50; waived if admitted within 24 hrs	lesser of 15% or $250 OP Surgery/ASC	No Cost Sharing	"$0 for diagnostic, $50 for all other services"	$50/Obs	No Cost Sharing	"$10 Visit for PT, OT, ST; $20 Visit for OP MH/SA"	No Cost Sharing	No Cost Sharing	$20 Visit	No Cost Sharing	No Cost Sharing	No Cost Sharing	10% Scripts with $1000 OOP Max	20% medicare covered eyewear	$3/Trip; 20 trip/yr limit	No Cost Sharing	$30 Visit	"$100 lens, frames & contacts"	$30 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	10.75317718	30.284793	49.9927693	128.5072981		50	50		10.35626536			20				0.06		3		30		30														55.97816323	79.55	31.06		50	10.75317718	30.284793	49.9927693	128.5072981		50	50		10.35626536			20				0.06		3		30		30														22.8432	0.997714515	15.65928921	0	3.269829629	4.079085106	8.626404842	2.240426583	4.610106264	0	3.106809969	0.172045568	0	0.374282359	0	0	1.70159868	0	0	0	2.256655504	0	0.0125	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	70.9324	0	2.4165	22.8432	0.997714515	15.65928921	0	3.269829629	4.079085106	8.626404842	2.240426583	4.610106264	0	3.106809969	0.172045568	0	0.374282359	0	0	1.70159868	0	0	0	2.256655504	0	0.0125	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	70.9324																																																																																		0	0	0	22.8432	0.997714515	15.65928921	0	3.269829629	4.079085106	8.626404842	2.240426583	4.610106264	0	3.106809969	0.172045568	0	0.374282359	0	0	1.70159868	0	0	0	2.256655504	0	0.0125	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	70.9324
H5698_111_0	2009	6																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		1964.390952	124.6092237	346.3173471		273.5901466	995.6176714	2266.776214	293.6427372	245.4452185		428.9618809	56.32744491		54.08612299	3544.171512	4553.721628	171.4891864	387.822698			27.43689519		100		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	$50; waived if admitted within 24 hrs	Lesser of 20% or $250 per visit	No Cost Sharing	"$0 for diagnostic, $75 for all other services"	$50/Obs	No Cost Sharing	$20 Visit	$20/Visit	$20/Visit	$20 Visit	$20 Visit	No Cost Sharing	No Cost Sharing	20% Scripts	20% medicare covered eyewear	$3/Trip; 40 trip/yr limit	No Cost Sharing	$30 Visit	"$100 lens, frames & contacts"	$30 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	24.61973181	4.794832592	49.98666747	171.5025552		75	50		28.87555323	20	20	20	20			0.2		3		30		30														60.60145584	79.55	31.06		50	24.61973181	4.794832592	49.98666747	171.5025552		75	50		28.87555323	20	20	20	20			0.2		3		30		30														9.9204	0.826055312	0.896384733	0	1.139958944	2.042653338	0.905734372	1.223185155	3.507873511	0	2.681011756	0.234697687	0	0.130147227	5.906952519	7.589536047	0.285815311	0.646371163	0	0	5.487379039	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	44.4317	0	0.2126	9.9204	0.826055312	0.896384733	0	1.139958944	2.042653338	0.905734372	1.223185155	3.507873511	0	2.681011756	0.234697687	0	0.130147227	5.906952519	7.589536047	0.285815311	0.646371163	0	0	5.487379039	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	44.4317		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50; waived if admitted within 24 hrs	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	20% Coinsurance											5.31	0.0664	0.3842		0.0099			0.1063	0.6089	0.0773	0.3337	0.0707	0.0043	0.1812	0.865	1.6931	0.0348	0.081	0.5626	0.5235	0.0267																				10.9395	0	0	15.2304	0.892422591	1.280593497	0	1.149820937	2.042653338	0.905734372	1.329492336	4.116758781	0.07733413	3.014662803	0.305349478	0.004266091	0.311312064	6.771986912	9.282620047	0.320622537	0.727412538	0.562593897	0.523477177	5.514126944	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	55.3712
H5698_112_0	2009	6																																D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0						373.0811935			331.4496033				64.06253023				227.672732		436.429972									249														No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$100/ Trip	No Cost Sharing	No Cost Sharing	"$50ER, waived if admitted within 24 hrs; $35 UC"	No Cost Sharing	No Cost Sharing	No Cost Sharing	$50/Obs	No Cost Sharing	No Cost Sharing	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/Trip; 10 trip/yr limit	$250 Allowance	No Cost Sharing	"$150 lens, frames & contacts allowance"	$10 Visit	$750 Allowance	Not Covered	No Cost Sharing															100			49.9843244				50				10		10									10																		100			49.9843244				50				10		10									10														0	0	0	0	3.109009946	0	0	1.380607041	0	0	0	0.266927209	0	0	0	0.189727277	0	0.363691643	0	0	0	0	0	0	0	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	5.5175	0	0	0	0	0	0	3.109009946	0	0	1.380607041	0	0	0	0.266927209	0	0	0	0.189727277	0	0.363691643	0	0	0	0	0	0	0	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	5.5175		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	"$50ER, waived if admitted within 24 hrs; $35 UC"	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	20% Coinsurance											4.7557	0.0594	0.3441					0.0966	0.5453	0.0693	0.2988	0.0633	0.0038	0.1623	0.7747	1.5255	0.0312	0.0726	0.5039	0.4688	0.4211																				10.1965	0	0	4.7557	0.059438961	0.344099832	0	3.109009946	0	0	1.477254149	0.545321552	0.069260943	0.298820017	0.330203406	0.003820738	0.16225239	0.774730349	1.715249306	0.031173575	0.436272819	0.503862702	0.468829516	0.421128718	0	0	0	0	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	15.7139
H5698_113_0	2009	5																					2000											D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0		1734.680555	252.8173515	688.7062239		561.1211647	965.542107	2779.05633	373.0166793	354.4262932		564.2146629	61.46490153		121.1458464	4462.895185	5447.167349	321.4678598	308.9844004			23.37390423		100		144		249														"$100 for Days 1-5, $2000 OOP Max"	"$100 for Days 1-5, $2000 OOP Max"	$100 for Days 21-100	No Cost Sharing	$50/ Trip	20%/Item	"20%/Item, Diabetic Supplies 10%/Item"	$50; waived if admitted within 24 hrs	Lesser of 20% or $250 per visit	No Cost Sharing	"$0 for diagnostic, $75 for all other services"	$50/Obs	No Cost Sharing	$20 Visit	$20/Visit	$20/Visit	$20 Visit	$20 Visit	No Cost Sharing	No Cost Sharing	20% Scripts	20% medicare covered eyewear	$3/Trip; 40 trip/yr limit	No Cost Sharing	$30 Visit	"$100 lens, frames & contacts"	$30 Visit	No Cost Sharing	Not Covered	No Cost Sharing											61.9	79.55	31.06		50	26.92176709	4.17715297	49.98951252	158.7380676		75	50		23.38715578	20	20	20	20			0.2		3		30		30														60.98076136	79.55	31.06		50	26.92176709	4.17715297	49.98951252	158.7380676		75	50		23.38715578	20	20	20	20			0.2		3		30		30														8.8152	1.675968359	1.782601276	0	2.338004853	2.166174977	0.967378617	1.553910163	4.688412073	0	3.526341643	0.256103756	0	0.236104732	7.438158642	9.078612249	0.535779766	0.514974001	0	0	4.674780845	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	51.256	0	0.1329	8.8152	1.675968359	1.782601276	0	2.338004853	2.166174977	0.967378617	1.553910163	4.688412073	0	3.526341643	0.256103756	0	0.236104732	7.438158642	9.078612249	0.535779766	0.514974001	0	0	4.674780845	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	51.256		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50; waived if admitted within 24 hrs	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	20% Coinsurance											5.2857	0.0661	0.4168	0.2748	0.3058	0.1963	0.1517	0.1199	0.652	0.0828	0.3573	0.0757	0.0046	0.194	0.9501	1.8709	0.0382	0.089	0.6179	0.575	0.5165																				12.841	0	0	14.1009	1.742031181	2.199410727	0.274812826	2.643853313	2.362479441	1.119101373	1.673767139	5.340389635	0.082807254	3.883605986	0.331755746	0.004568012	0.430091045	8.388267021	10.94946738	0.574010197	0.603985594	0.617923612	0.574959859	5.191241733	0	0.025	0	0.36	0	0.6225	0	0	0	0	0	0	0	0	0	0	0	0	0	64.0969
H5698_114_0	2009	5																																D	D	D	V	T	O	O	V	V	P	P	V	P	O	V	V	V	V	P	V	Coin	V	T	V	V	V	V	V	O	O																																																			0						396.1401427			351.3505687				42.19119072				325.7946287		531.947957									249														No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$100/ Trip	No Cost Sharing	No Cost Sharing	"$50ER, waived if admitted within 24 hrs; $35 UC"	No Cost Sharing	No Cost Sharing	No Cost Sharing	$50/Obs	No Cost Sharing	No Cost Sharing	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/Trip; 10 trip/yr limit	$250 Allowance	No Cost Sharing	"$150 lens, frames & contacts allowance"	$10 Visit	$750 Allowance	Not Covered	No Cost Sharing															100			49.98514172				50				10		10									10																		100			49.98514172				50				10		10									10														0	0	0	0	3.301167856	0	0	1.463525664	0	0	0	0.175796628	0	0	0	0.271495524	0	0.443289964	0	0	0	0	0	0	0	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	5.8628	0	0	0	0	0	0	3.301167856	0	0	1.463525664	0	0	0	0.175796628	0	0	0	0.271495524	0	0.443289964	0	0	0	0	0	0	0	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	5.8628		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	"$50ER, waived if admitted within 24 hrs; $35 UC"	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	20% Coinsurance											4.4766	0.056	0.353	0.2327	0.259	0.1663	0.1285	0.1016	0.5522	0.0701	0.3026	0.0641	0.0039	0.1643	0.8047	1.5845	0.0324	0.0754	0.5233	0.4869	0.4374																				10.8754	0	0	4.4766	0.055950211	0.353006068	0.23274567	3.560198361	0.166255028	0.128497695	1.565122172	0.552175664	0.070131479	0.302575867	0.239868139	0.003868761	0.164291729	0.804669909	1.855968265	0.032378282	0.518676049	0.523334545	0.486947497	0.437403295	0	0	0	0	0	0.2075	0	0	0	0	0	0	0	0	0	0	0	0	0	16.7382
H5700_002_0	2009	18																					4950											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	S	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		2081.716724	99.27230328	484.6783644	28.59200691	250.6645526	25.72083525	5.151172097	42.67845134	789.1206791	7.42227166	19.5660154	0.356349904	0	12.10824191	11255.07941	2663.774709	230.8773672	85.3016168	5308.926354	1544.644543	715.7622746	0	0	936	417.8496013	6.629295735	2.736151475	0	0	0											1a (IP Acute): 200 days 1-5	1b (IP Psych): 250 days 1-5	2a (SNF): 25 days 11-100	6a (Home Health): 15 copay	10a (Ambulance): 125 copay	11a (DME): 15% coin	11b (Medical Supplies): 10% coin	4a (ER): 50 copay	9b (OP Surg): 450 copay; 9b (OP ASC): 175 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 15% coin; 9c (OP SA): 55 copay; 3 (CORF): 50 copay; 5 (Partial Hosp): 55 copay; 9d (OP Cardiac Rehab): 50 copay	7a (PCP w/Copay): 9 copay	7b (Chiro): 18 copay; 7d (SPC w/Copay): 30 copay	7h (Psych): 55 copay; 7e (MH Non-Phys): 55 copay	7i (PT/ST): 25 copay; 7c (OT): 25 copay	7g (Prof. Other): 30 copay	7g (Prof. Other): 30 copay	15 (Part B Rx): 0.2			16b (Comp. Dental): 30 copay	17a1 (Routine Eye Exam): 10 copay	17b1 (Non MCR Covered): 100 allowance	18a (Hearing Exam): 30 copay														111.0500299	86.60474673	8.894406791	15	125	0.15	0.1	50	317.5967311	0	0.151026219	0.15	0	0.148726696	8.520977731	28.12640817	55	25	30	18.19358355	0.2	0	0	30	10	0	30	0	0	0											97.41572167	75.97173912	7.802384717	13.15835598	109.6529665	0.13158356	0.087722373	43.86118659	278.6033896	0	0.132483783	0.13158356	0	0.130466587	7.474803884	24.67315273	48.24730525	21.93059329	26.31671195	15.95984325	0.175444746	0	0	26.31671195	10	0	30	0	0	0											16.8993	0.628490794	0.315137255	0.031351984	2.290509315	3.384439063	0.451873041	0.15599396	18.32097467	0	2.592179745	0.046889789	0	1.579721001	7.010792607	5.476976686	0.928267568	0.155892922	11.64279047	2.054357066	0.010464728	0	0	2.052703532	0.348208001	0	0.006840379	0	0	0	0	0	0	0	0	0	0	0	0	0	76.3842		10.641	16.8993	0.628490794	0.315137255	0.031351984	2.290509315	3.384439063	0.451873041	0.15599396	18.32097467	0	2.592179745	0.046889789	0	1.579721001	7.010792607	5.476976686	0.928267568	0.155892922	11.64279047	2.054357066	0.010464728	0	0	2.052703532	0.348208001	0	0.006840379	0	0	0	0	0	0	0	0	0	0	0	0	0	76.3842																																																																																		0			16.8993	0.628490794	0.315137255	0.031351984	2.290509315	3.384439063	0.451873041	0.15599396	18.32097467	0	2.592179745	0.046889789	0	1.579721001	7.010792607	5.476976686	0.928267568	0.155892922	11.64279047	2.054357066	0.010464728	0	0	2.052703532	0.348208001	0	0.006840379	0	0	0	0	0	0	0	0	0	0	0	0	0	76.3842
H5700_005_0	2009	9																					4000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	S	Coin	Coin	V	V	V	Coin	Coin	Coin	Coin																																																			0		2022.526844	230.5341367	359.2655425	19.04979049	178.8947817	19.43427602	5.122030551	50.77082183	1055.788315	7.87529817	22.43701042	0.476082446	0	16.30683128	11119.23731	2671.390263	185.1194017	58.49986519	5927.292578	926.8671699	706.997834	0	0	936	292.1918364	3.16353516	0	0	0	0											1a (IP Acute): 160 days 1-5	1b (IP Psych): 250 days 1-5	2a (SNF): 30 days 11-100	6a (Home Health): 15 copay	10a (Ambulance): 125 copay	11a (DME): 20% coin	11b (Medical Supplies): 10% coin	4a (ER): 50 copay	9b (OP Surg): 450 copay; 9b (OP ASC): 225 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 15% coin; 9c (OP SA): 50 copay; 3 (CORF): 30 copay; 5 (Partial Hosp): 50 copay; 9d (OP Cardiac Rehab): 30 copay		7b (Chiro): 25 copay; 7d (SPC w/Copay): 30 copay	7h (Psych): 50 copay; 7e (MH Non-Phys): 50 copay	7i (PT/ST): 25 copay; 7c (OT): 25 copay	7g (Prof. Other): 30 copay	7g (Prof. Other): 30 copay	15 (Part B Rx): 0.2			16b (Comp. Dental): 30 copay	17a1 (Routine Eye Exam): 25 copay	17b1 (Non MCR Covered): 100 allowance	18a (Hearing Exam): 30 copay														88.36508676	74.89042958	14.78700199	15	125	0.2	0.1	50	391.3011051	0	0.151029617	0.15	0	0.144968105	0	29.77205436	50	25	30	29.28613571	0.2	0	0	30	25	0	0	0	0	0											75.50335082	63.98996012	12.63472079	12.81671646	106.8059705	0.170889553	0.085444776	42.72238821	334.3463544	0	0.129046919	0.128167165	0	0.123867674	0	25.43866528	42.72238821	21.36119411	25.63343293	25.02347318	0.170889553	0	0	25.63343293	25	0	0	0	0	0											12.7256	1.229322518	0.378268318	0.020346314	1.592252565	3.321114739	0.437650755	0.18075423	29.41658117	0	2.895427064	0.061018137	0	2.019889254	0	5.663050229	0.659061912	0.104135581	12.66140473	1.932786314	0.010068212	0	0	1.999407768	0.608732993	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.9169		13.1692	12.7256	1.229322518	0.378268318	0.020346314	1.592252565	3.321114739	0.437650755	0.18075423	29.41658117	0	2.895427064	0.061018137	0	2.019889254	0	5.663050229	0.659061912	0.104135581	12.66140473	1.932786314	0.010068212	0	0	1.999407768	0.608732993	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.9169																																																																																		0			12.7256	1.229322518	0.378268318	0.020346314	1.592252565	3.321114739	0.437650755	0.18075423	29.41658117	0	2.895427064	0.061018137	0	2.019889254	0	5.663050229	0.659061912	0.104135581	12.66140473	1.932786314	0.010068212	0	0	1.999407768	0.608732993	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.9169
H5700_009_0	2009	19																					3450											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		2056.068874	80.37644592	1393.673946	40.27704821	218.9326035	17.54796432	3.875647426	42.89757516	905.3640208	7.933170166	17.58519271	0.444922702	0	14.92522323	10425.25603	2719.414762	143.1074062	44.15662747	5223.501715	1086.836497	12.72108078	0	0	936	389.227261	12.85559525	0.199945829	0	0	0											1a (IP Acute): 150 days 1-5	1b (IP Psych): 260 days 1-5	2a (SNF): 25 days 11-100	6a (Home Health): 10 copay	10a (Ambulance): 125 copay	11a (DME): 20% coin	11b (Medical Supplies): 10% coin	4a (ER): 50 copay	9b (OP Surg): 450 copay; 9b (OP ASC): 125 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 15% coin; 9c (OP SA): 50 copay; 3 (CORF): 35 copay; 5 (Partial Hosp): 50 copay; 9d (OP Cardiac Rehab): 35 copay		7b (Chiro): 10 copay; 7d (SPC w/Copay): 25 copay	7h (Psych): 50 copay; 7e (MH Non-Phys): 50 copay	7i (PT/ST): 25 copay; 7c (OT): 25 copay	7g (Prof. Other): 25 copay	7g (Prof. Other): 25 copay	15 (Part B Rx): 20% coin		10b (Transportation): 20 trips/year	16b (Comp. Dental): 25 copay	17a1 (Routine Eye Exam): 5 copay	17b1 (Non MCR Covered): 150 allowance	18a (Hearing Exam): 25 copay														78.93167997	97.48105766	5.943134316	10	125	0.2	0.1	50	321.9494003	0	0.150746573	0.15	0	0.147404961	0	23.62560315	50	25	25	22.72986744	0.2	0	0	25	5	0	25	0	0	0											66.80526854	82.50487303	5.030080243	8.463682588	105.7960323	0.169273652	0.084636826	42.31841294	272.4877533	0	0.127587115	0.126955239	0	0.12475888	0	19.9959606	42.31841294	21.15920647	21.15920647	19.23783833	0.169273652	0	0	21.15920647	5	0	25	0	0	0											11.4464	0.552620705	0.584190982	0.028407679	1.9301834	2.970408001	0.328022496	0.151279775	20.558384	0	2.243644003	0.056485268	0	1.862054133	0	4.531442536	0.504673192	0.077859933	9.210429273	1.742365402	2.153343797	0	0	1.650418105	0.162178025	0	0.000416554	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7452		11.3599	11.4464	0.552620705	0.584190982	0.028407679	1.9301834	2.970408001	0.328022496	0.151279775	20.558384	0	2.243644003	0.056485268	0	1.862054133	0	4.531442536	0.504673192	0.077859933	9.210429273	1.742365402	2.153343797	0	0	1.650418105	0.162178025	0	0.000416554	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7452																																																																																		0			11.4464	0.552620705	0.584190982	0.028407679	1.9301834	2.970408001	0.328022496	0.151279775	20.558384	0	2.243644003	0.056485268	0	1.862054133	0	4.531442536	0.504673192	0.077859933	9.210429273	1.742365402	2.153343797	0	0	1.650418105	0.162178025	0	0.000416554	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7452
H5700_018_0	2009	7																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	V	V	Coin	Coin	Coin	Coin	V	V	V	Coin	Coin	Coin																																																			0		312.0625728	1.672764145	19.57228155	8.826734898	14.91955542	19.37343163	8.066383814	12.66914008	28.23668574	12.15576149	21.98419585	0.492248593	0	20.29078551	111.606901	2606.449425	312.3467112	6.316110519	5883.583406	1212.345585	12.89939308	0	0	10.53	423.5337503	5.600977949	10.5029541	0	0	0											1a (IP Acute): MC CS;1a1 (Add'l Days): 0% coin	1b (IP Psych): MC CS;1a1 (Add'l Days): 0% coin	2a (SNF): MC CS;2a2 (Waiver 3 Day): 0% coin		10a (Ambulance): MC CS	11a (DME): MC CS	11b (Medical Supplies): MC CS	4a (ER): MC CS	9b (OP Surg): MC CS; 9b (OP ASC): MC CS	8a (OP Diag Proc/Test/Lab): MC CS	8b (OP Therap Rad): MC CS; 8b (OP Diag): MC CS	9a (OP Observation): MC CS	12 (Renal Dialysis): MC CS	9a (OP Other): MC CS; 9c (OP SA): 10 copay; 3 (CORF): MC CS; 5 (Partial Hosp): MC CS; 9d (OP Cardiac Rehab): MC CS		7b (Chiro): 10 copay; 7d (SPC w/Copay): 10 copay	7h (Psych): 10 copay; 7e (MH Non-Phys): 10 copay	7i (PT/ST): MC CS; 7c (OT): MC CS	7g (Prof. Other): 10 copay	7g (Prof. Other): 10 copay	15 (Part B Rx): MC CS		10b (Transportation): 20 trips/year	16b (Comp. Dental): MC CS	17a1 (Routine Eye Exam): 5 copay	17b1 (Non MCR Covered): 100 allowance	18a (Hearing Exam): 10 copay														0.0797	0.0797	0.2096	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.229948908	0	10	10	0.231	10	10	0.231	0	0	0.231	5	0	10	0	0	0											0.0797	0.0797	0.2096	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.229948908	0	10	10	0.231	10	10	0.231	0	0	0.231	5	0	10	0	0	0											24.8714	0.133319302	4.102350213	0	3.446417302	4.475262706	1.863334661	2.926571359	6.522674407	2.807980903	5.078349242	0.113709425	0	4.665843978	0	2.172041187	0.260288926	1.45902153	4.902986171	1.010287987	2.979759801	0	0	2.43243	0.176472396	0	0.008752462	0	0	0	0	0	0	0	0	0	0	0	0	0	76.4092		0	24.8714	0.133319302	4.102350213	0	3.446417302	4.475262706	1.863334661	2.926571359	6.522674407	2.807980903	5.078349242	0.113709425	0	4.665843978	0	2.172041187	0.260288926	1.45902153	4.902986171	1.010287987	2.979759801	0	0	2.43243	0.176472396	0	0.008752462	0	0	0	0	0	0	0	0	0	0	0	0	0	76.4092																																																																																		0			24.8714	0.133319302	4.102350213	0	3.446417302	4.475262706	1.863334661	2.926571359	6.522674407	2.807980903	5.078349242	0.113709425	0	4.665843978	0	2.172041187	0.260288926	1.45902153	4.902986171	1.010287987	2.979759801	0	0	2.43243	0.176472396	0	0.008752462	0	0	0	0	0	0	0	0	0	0	0	0	0	76.4092
H5700_020_0	2009	17																					3500											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		2318.950641	105.7671146	1695.357031	21.26592078	255.2429405	25.57745822	5.863691187	66.29777238	1077.968263	8.853959575	18.09744091	0.78568303	0	27.93713339	9958.02049	2608.934298	158.9468937	105.8929941	6335.683594	1062.531585	12.07598604	0	0	936	383.8421027	12.18402759	0.056435206	0	0	0											1a (IP Acute): 135 days 1-5	1b (IP Psych): 200 days 1-5	2a (SNF): 25 days 11-100	6a (Home Health): 5 copay	10a (Ambulance): 100 copay	11a (DME): 20% coin	11b (Medical Supplies): 10% coin	4a (ER): 50 copay	9b (OP Surg): 400 copay; 9b (OP ASC): 100 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 15% coin	9a (OP Other): 15% coin; 9c (OP SA): 30 copay; 3 (CORF): 20 copay; 5 (Partial Hosp): 50 copay; 9d (OP Cardiac Rehab): 20 copay		7b (Chiro): 8 copay; 7d (SPC w/Copay): 25 copay	7h (Psych): 30 copay; 7e (MH Non-Phys): 30 copay	7i (PT/ST): 10 copay; 7c (OT): 10 copay	7g (Prof. Other): 25 copay	7g (Prof. Other): 25 copay	15 (Part B Rx): 20% coin		10b (Transportation): 20 trips/year	16b (Comp. Dental): 25 copay	17a1 (Routine Eye Exam): 5 copay	17b1 (Non MCR Covered): 150 allowance	18a (Hearing Exam): 25 copay														74.51488587	58.73283259	5.36082603	5	100	0.2	0.1	50	337.1946669	0	0.151012807	0.15	0	0.14053737	0	23.89816014	30	10	25	25	0.2	0	0	25	5	0	25	0	0	0											63.15520573	49.77910228	4.543576318	4.237757664	84.75515327	0.169510307	0.084755153	42.37757664	285.7898567	0	0.127991136	0.12713273	0	0.119112664	0	20.25492225	25.42654598	8.475515327	21.18878832	21.18878832	0.169510307	0	0	21.18878832	5	0	25	0	0	0											12.2045	0.438749335	0.641915338	0.007509985	1.802762879	4.335642783	0.496978045	0.234128244	25.67269963	0	2.316312023	0.099886029	0	3.32766637	0	4.40364678	0.336789208	0.074791475	11.18712154	1.876146402	2.047004095	0	0	1.652725489	0.159934209	0	0.000117573	0	0	0	0	0	0	0	0	0	0	0	0	0	73.317		13.1587	12.2045	0.438749335	0.641915338	0.007509985	1.802762879	4.335642783	0.496978045	0.234128244	25.67269963	0	2.316312023	0.099886029	0	3.32766637	0	4.40364678	0.336789208	0.074791475	11.18712154	1.876146402	2.047004095	0	0	1.652725489	0.159934209	0	0.000117573	0	0	0	0	0	0	0	0	0	0	0	0	0	73.317																																																																																		0			12.2045	0.438749335	0.641915338	0.007509985	1.802762879	4.335642783	0.496978045	0.234128244	25.67269963	0	2.316312023	0.099886029	0	3.32766637	0	4.40364678	0.336789208	0.074791475	11.18712154	1.876146402	2.047004095	0	0	1.652725489	0.159934209	0	0.000117573	0	0	0	0	0	0	0	0	0	0	0	0	0	73.317
H5700_025_0	2009	20																					3600											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1640.084126	64.11464848	1111.705228	32.12817833	174.6380641	13.95572532	3.081651517	42.89757516	722.190379	6.312563591	13.98852763	0.353884147	0	11.80983861	8429.953093	2169.221586	114.1538536	35.22283943	4166.68058	866.9472651	10.11163341	0	0	936	389.7872463	12.86698809	0	0	0	0											1a (IP Acute): 150 days 1-5	1b (IP Psych): 160 days 1-5	2a (SNF): 20 days 11-100		10a (Ambulance): 100 copay	11a (DME): 20% coin	11b (Medical Supplies): 10% coin	4a (ER): 50 copay	9b (OP Surg): 400 copay; 9b (OP ASC): 100 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 15% coin	9a (OP Other): 15% coin; 9c (OP SA): 40 copay; 3 (CORF): 35 copay; 5 (Partial Hosp): 25 copay; 9d (OP Cardiac Rehab): 30 copay		7b (Chiro): 8 copay; 7d (SPC w/Copay): 25 copay	7h (Psych): 40 copay; 7e (MH Non-Phys): 40 copay	7i (PT/ST): 20 copay; 7c (OT): 20 copay	7g (Prof. Other): 25 copay	7g (Prof. Other): 25 copay	15 (Part B Rx): 20% coin			16b (Comp. Dental): 25 copay	17a1 (Routine Eye Exam): $5 copay	17b1 (Non MCR Covered): $150 allowance															78.82599075	59.87003448	4.75005678	0	100	0.2	0.1	50	320.9746795	0	0.150745912	0.15	0	0.14705318	0	23.44235023	40	20	25	22.68892522	0.2	0	0	25	5	0	0	0	0	0											69.51183374	52.795732	4.188785374	0	88.18390111	0.176367802	0.088183901	50	283.047994	0	0.132933626	0.132275852	0	0.129677231	0	20.67237895	35.27356044	17.63678022	22.04597528	20.00797938	0.176367802	0	0	25	5	0	0	0	0	0											9.5004	0.28208165	0.388057883	0	1.283355481	2.461340604	0.271752053	0.178739896	17.03454484	0	1.859545697	0.046810327	0	1.531467169	0	3.736914221	0.335551071	0.051768123	7.654878087	1.445488583	1.783366561	0	0	1.95	0.162411353	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.9585		5.5894	9.5004	0.28208165	0.388057883	0	1.283355481	2.461340604	0.271752053	0.178739896	17.03454484	0	1.859545697	0.046810327	0	1.531467169	0	3.736914221	0.335551071	0.051768123	7.654878087	1.445488583	1.783366561	0	0	1.95	0.162411353	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.9585		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.	20% coins.	20% coins.	20% coins.																				5.5629	0.1124	0.4382	0.1825	0.3103	0.7079	0.1563	0.3174	0.9851	0.3202	0.7096	0.018		0.5991	3.036	2.0292	0.0403	0.1618	1.1349	0.197	0.5129																				17.5321			15.0634	0.394438902	0.826302429	0.182501132	1.593607498	3.169276103	0.428075744	0.496171991	18.01965182	0.320218961	2.569145167	0.064761895	0	2.130547747	3.035984298	5.766150553	0.375860618	0.213570534	8.789803679	1.642510105	2.296301867	0	0	1.95	0.162411353	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4906
H5700_801_0	2009	8																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		201.2219146	4.624352262	7.772726824	3.721636253	6.179030731	18.41158027	4.335652826	5.964326605	25.1146701	6.83470939	17.047646	0.448617651	0	15.52672178	66.55872544	47.69411187	1.000051229	4.576636742	33.41030355	4.823914709	15.68261737	0																			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																			0.079105229	0.079105229	0.181771175	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.079105229	0.079105229	0.181771175	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			15.9177	0.365810446	1.412857688	0	1.427356099	4.253075043	1.001535803	1.377759446	5.801488793	1.578817869	3.938006225	0.103630677	0	3.586672731	15.37506558	11.01733984	0.231011834	1.057203087	7.717780119	1.114324298	3.622684613	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.9001		0	15.9177	0.365810446	1.412857688	0	1.427356099	4.253075043	1.001535803	1.377759446	5.801488793	1.578817869	3.938006225	0.103630677	0	3.586672731	15.37506558	11.01733984	0.231011834	1.057203087	7.717780119	1.114324298	3.622684613	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.9001																																																																																		0			15.9177	0.365810446	1.412857688	0	1.427356099	4.253075043	1.001535803	1.377759446	5.801488793	1.578817869	3.938006225	0.103630677	0	3.586672731	15.37506558	11.01733984	0.231011834	1.057203087	7.717780119	1.114324298	3.622684613	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.9001
H5703_001_0	2009	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		332.663694		33.33800502		19.3803221	35.04765835		33.23327092	32.99245327	94.886944					161.6228208						25.87732531	3.040992586																			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																			0.0793		0.1517		0.231	0.231		0.231	0.231	0.231					0.231						0.231	0.231																			0.0793		0.1517		0.231	0.231		0.231	0.231	0.231					0.231						0.231	0.231																			26.3802	0	5.057375362	0	4.476854405	8.096009079	0	7.676885583	7.621256705	21.91888406	0	0	0	0	37.33487161	0	0	0	0	0	5.977662147	0.702469287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.2425	0	0	26.3802	0	5.057375362	0	4.476854405	8.096009079	0	7.676885583	7.621256705	21.91888406	0	0	0	0	37.33487161	0	0	0	0	0	5.977662147	0.702469287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.2425																																																																																		0	0	0	26.3802	0	5.057375362	0	4.476854405	8.096009079	0	7.676885583	7.621256705	21.91888406	0	0	0	0	37.33487161	0	0	0	0	0	5.977662147	0.702469287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.2425
H5721_001_0	2009	2																					3250											D	D	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	V											0	0	0	0	0	0	0	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	1617.125452	54.96143847	770.1803993	17.60108969	311.8109205	15.55289982	4.164883677	458.8228611	594.1750069	8.41162727	31.5695558	0	0.16258074	529.2832219	3882.920593	6242.404986	193.8154256	519.7233187	29.30791756	20.34526567	24.21542042	0	0	0	0	0	0	0	12000	0											1a:  Acute - $250/$0/day for 1-7/8-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/$0/day for 1-7/8-190	2:  Skilled Nursing Services - $0/$100/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $25/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $30/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $30/visit/7f:  Podiatry Services - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $20 to $50/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												250	250	100	0	100	0.2	0.2	49.99999978	100	0	0.231867017	0	0	30	20.00347168	30	50	30	0	50	0.2	0	0	0	0	0	0	0	0	0											192.2713141	192.2713141	76.90852562	0	76.90852562	0.153817051	0.153817051	38.45426264	76.90852562	0	0.178325504	0	0	23.07255769	15.38437514	23.07255769	38.45426281	23.07255769	0	38.45426281	0.153817051	0	0	0	0	0	0	0	0	0											25.9106	0.880625666	4.936119914	0	1.998409847	2.392301189	0.640630126	1.470307901	3.808093645	0	5.62965696	0	0	1.017659806	4.978025587	12.0023541	0.621085776	0.999278854	0	0.065196849	3.724744563	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.0751	0	21.34	25.9106	0.880625666	4.936119914	0	1.998409847	2.392301189	0.640630126	1.470307901	3.808093645	0	5.62965696	0	0	1.017659806	4.978025587	12.0023541	0.621085776	0.999278854	0	0.065196849	3.724744563	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.0751																																																																																		0			25.9106	0.880625666	4.936119914	0	1.998409847	2.392301189	0.640630126	1.470307901	3.808093645	0	5.62965696	0	0	1.017659806	4.978025587	12.0023541	0.621085776	0.999278854	0	0.065196849	3.724744563	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.0751
H5721_002_0	2009	2																					3250											D	D	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	V											0	0	0	0	0	0	0	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	1705.011409	57.94842911	711.2896109	15.64649813	355.6828851	16.64793788	4.458121993	520.7636201	638.3560709	9.548369562	37.81670778	0	0.14613087	587.7026623	4027.643298	6147.857173	171.3585465	459.504357	27.73203977	17.98791372	21.74829962	0	0	0	0	0	0	0	12000	0											1a:  Acute - $250/$0/day for 1-7/8-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/$0/day for 1-7/8-190	2:  Skilled Nursing Services - $0/$100/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $25/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $30/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $30/visit/7f:  Podiatry Services - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $20 to $50/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												250	250	100	0	100	0.2	0.2	49.99999978	100	0	0.232437126	0	0	30	20.0034717	30	50	30	0	50	0.2	0	0	0	0	0	0	0	0	0											190.3401207	190.3401207	76.13604828	0	76.13604828	0.152272097	0.152272097	38.06802397	76.13604828	0	0.176968442	0	0	22.84081448	15.22985287	22.84081448	38.06802414	22.84081448	0	38.06802414	0.152272097	0	0	0	0	0	0	0	0	0											27.0443	0.919159249	4.512898346	0	2.256690776	2.535016404	0.678847582	1.652036831	4.050159053	0	6.692363866	0	0	1.118633957	5.111701236	11.70183876	0.543606774	0.874621148	0	0.057063694	3.31165918	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.0606	0	22.9	27.0443	0.919159249	4.512898346	0	2.256690776	2.535016404	0.678847582	1.652036831	4.050159053	0	6.692363866	0	0	1.118633957	5.111701236	11.70183876	0.543606774	0.874621148	0	0.057063694	3.31165918	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.0606																																																																																		0			27.0443	0.919159249	4.512898346	0	2.256690776	2.535016404	0.678847582	1.652036831	4.050159053	0	6.692363866	0	0	1.118633957	5.111701236	11.70183876	0.543606774	0.874621148	0	0.057063694	3.31165918	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.0606
H5721_003_0	2009	1																					2000											A	A	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	452.6206464	9.845976968	590.3010491	17.28273146	323.5160501	15.8105815	4.2338878	468.9750295	55.44178741	8.564518007	32.37737307	0	0.15804625	533.4554291	4138.085983	6308.954394	198.6808826	514.6076026	29.19623928	20.85600425	23.07417175	0	0	0	0	0	0	0	12000	0											1a:  Acute - $100/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $100/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$50/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$50/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $0/visit/8b:  Outpatient Therapeutic Radiological Services - $0/visit/8b:  Outpatient X-Ray Services - $0/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $20/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $20/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $20/visit/7h:  Psychiatric Services - Individual - $20/visit/7h:  Psychiatric Services - Group - $20/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $20/visit/9c:  Outpatient Substance Abuse Svcs - Group - $20/visit/7g:  Other Health Care Professional Services - $10 to $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												100	100	50	0	100	0.2	0.2	49.99999965	0	0	0	0	0	20	10.00333211	20	20	20	0	20	0.2	0	0	0	0	0	0	0	0	0											84.01766634	84.01766634	42.00883317	0	84.01766634	0.168035333	0.168035333	42.00883287	0	0	0	0	0	16.80353327	8.404566191	16.80353327	16.80353327	16.80353327	0	16.80353327	0.168035333	0	0	0	0	0	0	0	0	0											3.169	0.068936334	2.066488191	0	2.265088629	2.656736321	0.711442745	1.641757803	0	0	0	0	0	0.746994671	2.898234796	8.834393753	0.278211735	0.720602164	0	0.029204547	3.877276126	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9644	0	5.7	3.169	0.068936334	2.066488191	0	2.265088629	2.656736321	0.711442745	1.641757803	0	0	0	0	0	0.746994671	2.898234796	8.834393753	0.278211735	0.720602164	0	0.029204547	3.877276126	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9644	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	500	0	3.169	0.068936334	2.066488191	0	2.265088629	2.656736321	0.711442745	1.641757803	0	0	0	0	0	0.746994671	2.898234796	8.834393753	0.278211735	0.720602164	0	0.029204547	3.877276126	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.9644
H5721_004_0	2009	4																					3250											D	D	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	V											0	0	0	0	0	0	0	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	1663.683946	56.54382764	791.3435172	19.34854708	300.9434452	15.75158948	4.218090431	458.3591037	622.3343184	8.732063414	30.48135774	0	0.16707893	528.2075741	3984.983854	6321.054954	198.0485876	531.0747013	30.70904595	20.78963074	22.94458524	0	0	0	0	0	0	0	12000	0											1a:  Acute - $250/$0/day for 1-7/8-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/$0/day for 1-7/8-190	2:  Skilled Nursing Services - $0/$100/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $175/visit/9b:  Ambulatory Surgical Center Services - $150/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - $25/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $40/visit/7f:  Podiatry Services - $40/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $20 to $50/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												250	250	100	0	100	0.2	0.2	49.99999978	174.5476478	0	0.197533714	0	0	28.14964202	20.00520752	33.80264773	50	30	0	50	0.2	0	0	0	0	0	0	0	0	0											188.6473883	188.6473883	75.45895532	0	75.45895532	0.150917911	0.150917911	37.72947749	131.7118315	0	0.149056877	0	0	21.2414258	15.0957206	25.93762658	37.72947766	22.6376866	0	37.72947766	0.150917911	0	0	0	0	0	0	0	0	0											26.1541	0.888903784	4.976162925	0	1.892406499	2.377196973	0.636585395	1.441137457	6.830732742	0	4.543455999	0	0	0.934990166	5.013016905	13.66276359	0.622689147	1.001858554	0	0.065365159	3.462748865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5042	0	23.93	26.1541	0.888903784	4.976162925	0	1.892406499	2.377196973	0.636585395	1.441137457	6.830732742	0	4.543455999	0	0	0.934990166	5.013016905	13.66276359	0.622689147	1.001858554	0	0.065365159	3.462748865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5042																																																																																		0			26.1541	0.888903784	4.976162925	0	1.892406499	2.377196973	0.636585395	1.441137457	6.830732742	0	4.543455999	0	0	0.934990166	5.013016905	13.66276359	0.622689147	1.001858554	0	0.065365159	3.462748865	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.5042
H5721_006_0	2009	1																					2000											A	A	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	522.7405038	11.37131282	531.5661425	14.95564638	345.8525955	17.41828647	4.664412285	562.5185117	60.38128239	10.6093097	42.9784674	0	0.151038804	690.0909235	4654.429552	6700.231584	186.3061505	482.5555444	28.46666663	19.55699922	23.40704586	0	0	0	0	0	0	0	12000	0											1a:  Acute - $100/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $100/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$50/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$50/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $0/visit/8b:  Outpatient Therapeutic Radiological Services - $0/visit/8b:  Outpatient X-Ray Services - $0/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $20/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $20/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $20/visit/7h:  Psychiatric Services - Individual - $20/visit/7h:  Psychiatric Services - Group - $20/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $20/visit/9c:  Outpatient Substance Abuse Svcs - Group - $20/visit/7g:  Other Health Care Professional Services - $10 to $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												100	100	50	0	100	0.2	0.2	49.99999965	0	0	0	0	0	20	10.00333212	20	20	20	0	20	0.2	0	0	0	0	0	0	0	0	0											82.44388623	82.44388623	41.22194311	0	82.44388623	0.164887772	0.164887772	41.22194282	0	0	0	0	0	16.48877725	8.247135756	16.48877725	16.48877725	16.48877725	0	16.48877725	0.164887772	0	0	0	0	0	0	0	0	0											3.5914	0.078124602	1.826015774	0	2.376119336	2.872062456	0.769104552	1.932342161	0	0	0	0	0	0.948229626	3.198809365	9.206552174	0.255996718	0.663062573	0	0.026872584	3.859535651	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6042	0	6.73	3.5914	0.078124602	1.826015774	0	2.376119336	2.872062456	0.769104552	1.932342161	0	0	0	0	0	0.948229626	3.198809365	9.206552174	0.255996718	0.663062573	0	0.026872584	3.859535651	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6042	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	500	0	3.5914	0.078124602	1.826015774	0	2.376119336	2.872062456	0.769104552	1.932342161	0	0	0	0	0	0.948229626	3.198809365	9.206552174	0.255996718	0.663062573	0	0.026872584	3.859535651	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.6042
H5721_802_0	2009	3																					none											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	V											0	0	0	0	0	0	0	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	349.7426507	3.804322412	61.75717571	46.57272094	9.630862511	19.17496394	5.424331977	11.79370646	46.07116911	8.484342671	26.58260379	0	0.294205372	35.63305373	49.31707078	142.6785157	1.489125086	7.109107116	37.37891354	44.40331287	10.30727834	1.109758025	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											25.861	0.281302249	11.02606737	0	2.22472924	4.429416671	1.253020687	2.724346192	10.64244006	1.959883157	6.140581474	0	0.067961441	8.231235411	11.39224335	32.95873714	0.343987895	1.642203744	8.634529028	10.25716527	2.380981297	0.256354104	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.7081	0	0	25.861	0.281302249	11.02606737	0	2.22472924	4.429416671	1.253020687	2.724346192	10.64244006	1.959883157	6.140581474	0	0.067961441	8.231235411	11.39224335	32.95873714	0.343987895	1.642203744	8.634529028	10.25716527	2.380981297	0.256354104	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.7081	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	25.861	0.281302249	11.02606737	0	2.22472924	4.429416671	1.253020687	2.724346192	10.64244006	1.959883157	6.140581474	0	0.067961441	8.231235411	11.39224335	32.95873714	0.343987895	1.642203744	8.634529028	10.25716527	2.380981297	0.256354104	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.7081
H5721_804_0	2009	3																					none											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	V											0	0	0	0	0	0	0	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	349.7426502	3.804322412	61.75717542	46.57272094	9.630862482	19.17496397	5.424331984	11.79370645	46.07116926	8.484342673	26.58260375	0	0.294205372	35.63305375	49.31707075	142.6785158	1.489125086	7.109107124	37.37891353	44.40331286	10.30727824	1.109758014	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											25.861	0.281302249	11.02606732	0	2.224729233	4.429416678	1.253020688	2.72434619	10.6424401	1.959883157	6.140581467	0	0.067961441	8.231235417	11.39224334	32.95873715	0.343987895	1.642203746	8.634529024	10.25716527	2.380981273	0.256354101	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.7081	0	0	25.861	0.281302249	11.02606732	0	2.224729233	4.429416678	1.253020688	2.72434619	10.6424401	1.959883157	6.140581467	0	0.067961441	8.231235417	11.39224334	32.95873715	0.343987895	1.642203746	8.634529024	10.25716527	2.380981273	0.256354101	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.7081	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	25.861	0.281302249	11.02606732	0	2.224729233	4.429416678	1.253020688	2.72434619	10.6424401	1.959883157	6.140581467	0	0.067961441	8.231235417	11.39224334	32.95873715	0.343987895	1.642203746	8.634529024	10.25716527	2.380981273	0.256354101	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.7081
H5721_807_0	2009	3																					none											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	V											0	0	0	0	0	0	0	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	349.7426505	3.804322416	61.75717549	46.57272099	9.630862491	19.17496396	5.424331982	11.79370645	46.07116912	8.484342663	26.58260376	0	0.294205372	35.63305376	49.31707073	142.6785157	1.489125085	7.109107123	37.37891353	44.40331286	10.30727824	1.109758014	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											25.861	0.28130225	11.02606733	0	2.224729235	4.429416674	1.253020688	2.724346191	10.64244007	1.959883155	6.140581469	0	0.067961441	8.231235418	11.39224334	32.95873712	0.343987895	1.642203745	8.634529026	10.25716527	2.380981273	0.256354101	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.7081	0	0	25.861	0.28130225	11.02606733	0	2.224729235	4.429416674	1.253020688	2.724346191	10.64244007	1.959883155	6.140581469	0	0.067961441	8.231235418	11.39224334	32.95873712	0.343987895	1.642203745	8.634529026	10.25716527	2.380981273	0.256354101	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.7081	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	25.861	0.28130225	11.02606733	0	2.224729235	4.429416674	1.253020688	2.724346191	10.64244007	1.959883155	6.140581469	0	0.067961441	8.231235418	11.39224334	32.95873712	0.343987895	1.642203745	8.634529026	10.25716527	2.380981273	0.256354101	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.7081
H5721_808_0	2009	4																					none											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	V											0	0	0	0	0	0	0	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	349.7426505	3.804322416	61.75717549	46.57272099	9.630862491	19.17496396	5.424331982	11.79370645	46.07116912	8.484342663	26.58260376	0	0.294205372	35.63305376	49.31707073	142.6785157	1.489125085	7.109107123	37.37891353	44.40331286	10.30727824	1.109758014	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											25.861	0.28130225	11.02606733	0	2.224729235	4.429416674	1.253020688	2.724346191	10.64244007	1.959883155	6.140581469	0	0.067961441	8.231235418	11.39224334	32.95873712	0.343987895	1.642203745	8.634529026	10.25716527	2.380981273	0.256354101	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.7081	0	0	25.861	0.28130225	11.02606733	0	2.224729235	4.429416674	1.253020688	2.724346191	10.64244007	1.959883155	6.140581469	0	0.067961441	8.231235418	11.39224334	32.95873712	0.343987895	1.642203745	8.634529026	10.25716527	2.380981273	0.256354101	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.7081	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	25.861	0.28130225	11.02606733	0	2.224729235	4.429416674	1.253020688	2.724346191	10.64244007	1.959883155	6.140581469	0	0.067961441	8.231235418	11.39224334	32.95873712	0.343987895	1.642203745	8.634529026	10.25716527	2.380981273	0.256354101	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.7081
H5732_001_0	2009	4																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	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	0	0	0											0		0	0	0	0	0	0	0	494.0001661	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	$25/Case for ER - Facility;	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -											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	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	1.029167013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.0292	0		0	0	0	0	0	0	0	1.029167013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.0292																																																																																		0			0	0	0	0	0	0	0	1.029167013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.0292
H5732_002_0	2009	5																																D	D	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	O	V	T	V	V	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	0	0	0											0		0	0	0	0	0	0	0	488.8171148	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	$25/Case for ER - Facility;	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -	- zero -											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	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	1.018368989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.0184	0		0	0	0	0	0	0	0	1.018368989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.0184																																																																																		0			0	0	0	0	0	0	0	1.018368989	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.0184
H5736_002_0	2009	6																					3000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	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	3000	1964.848108	0	1237.955532	931.7885876	244.8814712	7.458712518	0	313.4243276	325.4661162	974.3824473	4416.120092	0	6.762197115	758.1979899	4936.000673	6788.986557	0	780.9678831	0	0	272.3901034	0			873.3132645		71.09862098														$150/day 1-7	$150/day 1-7	"Low Option Plan:  $0/d 1-15, $75/d 16-20, $100/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm	$150 per procedure	$15 per visit	$25 X-ray; $125 Complex Radiology	$15 per visit	$15 per visit	$15 per visit	$15 PCP visit; $15 if no PCP selected	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$45 per script	0			$0 per visit		$0 per visit														108.4282617	108.4282617	47.8866492	0	100	0.2	0.2	45	150	15	65	15	15	15	15	15	15	15	15	15	45	0			0		0														108.4282617	108.4282617	47.8866492	0	100	0.2	0.2	45	150	15	65	15	15	15	15	15	15	15	15	15	45	0			0		0														17.7538	0	4.940128526	0	2.040678926	1.491742504	0	1.175341229	4.068326452	1.217978059	23.9206505	0	0.008452746	0.947747487	6.170000841	8.486233197	0	0.976209854	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.2187	0	6.18	17.7538	0	4.940128526	0	2.040678926	1.491742504	0	1.175341229	4.068326452	1.217978059	23.9206505	0	0.008452746	0.947747487	6.170000841	8.486233197	0	0.976209854	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.2187	3000																																																																																	0	0	0	17.7538	0	4.940128526	0	2.040678926	1.491742504	0	1.175341229	4.068326452	1.217978059	23.9206505	0	0.008452746	0.947747487	6.170000841	8.486233197	0	0.976209854	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.2187
H5736_003_0	2009	5																					4000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	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	4000	1964.848108	0	1237.955532	931.7885876	244.8814712	7.458712518	0	313.4243276	325.4661162	974.3824473	4416.120092	0	6.762197115	758.1979899	4936.000673	6788.986557	0	780.9678831	0	0	272.3901034	0			873.3132645		71.09862098														$200/day 1-7	$200/day 1-7	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm	$200 per procedure	$20 per visit	$20 X-ray; $150 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$20 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0			$0 per visit		$0 per visit														144.5710156	144.5710156	47.56208437	0	100	0.2	0.2	45	200	20	72	20	20	20	20	20	20	20	20	20	45	0			0		0														144.5710156	144.5710156	47.56208437	0	100	0.2	0.2	45	200	20	72	20	20	20	20	20	20	20	20	20	45	0			0		0														23.6717	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	5.424435269	1.623970745	26.49672055	0	0.011270329	1.263663316	8.226667788	11.3149776	0	1.301613139	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.9709	0	9.45	23.6717	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	5.424435269	1.623970745	26.49672055	0	0.011270329	1.263663316	8.226667788	11.3149776	0	1.301613139	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.9709	4000																																																																																	0	0	0	23.6717	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	5.424435269	1.623970745	26.49672055	0	0.011270329	1.263663316	8.226667788	11.3149776	0	1.301613139	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.9709
H5736_007_0	2009	6																					4000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	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	4000	1964.848108	0	1237.955532	931.7885876	244.8814712	7.458712518	0	313.4243276	325.4661162	974.3824473	4416.120092	0	6.762197115	758.1979899	4936.000673	6788.986557	0	780.9678831	0	0	272.3901034	0			873.3132645		71.09862098														$200/day 1-7	$200/day 1-7	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm	$200 per procedure	$20 per visit	$20 X-ray; $150 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$20 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0			$0 per visit		$0 per visit														144.5710156	144.5710156	47.56208437	0	100	0.2	0.2	45	200	20	72	20	20	20	20	20	20	20	20	20	45	0			0		0														144.5710156	144.5710156	47.56208437	0	100	0.2	0.2	45	200	20	72	20	20	20	20	20	20	20	20	20	45	0			0		0														23.6717	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	5.424435269	1.623970745	26.49672055	0	0.011270329	1.263663316	8.226667788	11.3149776	0	1.301613139	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.9709	0	10.85	23.6717	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	5.424435269	1.623970745	26.49672055	0	0.011270329	1.263663316	8.226667788	11.3149776	0	1.301613139	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.9709	4000																																																																																	0	0	0	23.6717	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	5.424435269	1.623970745	26.49672055	0	0.011270329	1.263663316	8.226667788	11.3149776	0	1.301613139	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.9709
H5736_011_0	2009	4																					3000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	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	3000	1964.848108	0	1237.955532	931.7885876	244.8814712	7.458712518	0	313.4243276	325.4661162	974.3824473	4416.120092	0	6.762197115	758.1979899	4936.000673	6788.986557	0	780.9678831	0	0	272.3901034	0			873.3132645		71.09862098														$150/day 1-7	$150/day 1-7	"Low Option Plan:  $0/d 1-15, $75/d 16-20, $100/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm	$150 per procedure	$15 per visit	$15 X-ray; $125 Complex Radiology	$15 per visit	$15 per visit	$15 per visit	$15 PCP visit; $15 if no PCP selected	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$45 per script	0			$0 per visit		$0 per visit														108.4282617	108.4282617	47.8866492	0	100	0.2	0.2	45	150	15	59	15	15	15	15	15	15	15	15	15	45	0			0		0														108.4282617	108.4282617	47.8866492	0	100	0.2	0.2	45	150	15	59	15	15	15	15	15	15	15	15	15	45	0			0		0														17.7538	0	4.940128526	0	2.040678926	1.491742504	0	1.175341229	4.068326452	1.217978059	21.71259045	0	0.008452746	0.947747487	6.170000841	8.486233197	0	0.976209854	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.0106	0	6.09	17.7538	0	4.940128526	0	2.040678926	1.491742504	0	1.175341229	4.068326452	1.217978059	21.71259045	0	0.008452746	0.947747487	6.170000841	8.486233197	0	0.976209854	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.0106	3000																																																																																	0			17.7538	0	4.940128526	0	2.040678926	1.491742504	0	1.175341229	4.068326452	1.217978059	21.71259045	0	0.008452746	0.947747487	6.170000841	8.486233197	0	0.976209854	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.0106
H5736_012_0	2009	6																					3000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	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	3000	1964.848108	0	1237.955532	931.7885876	244.8814712	7.458712518	0	313.4243276	325.4661162	974.3824473	4416.120092	0	6.762197115	758.1979899	4936.000673	6788.986557	0	780.9678831	0	0	272.3901034	0			873.3132645		71.09862098														$150/day 1-7	$150/day 1-7	"Low Option Plan:  $0/d 1-15, $75/d 16-20, $100/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm	$150 per procedure	$15 per visit	$25 X-ray; $125 Complex Radiology	$15 per visit	$15 per visit	$15 per visit	$15 PCP visit; $15 if no PCP selected	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$45 per script	0			$0 per visit		$0 per visit														108.4282617	108.4282617	47.8866492	0	100	0.2	0.2	45	150	15	65	15	15	15	15	15	15	15	15	15	45	0			0		0														108.4282617	108.4282617	47.8866492	0	100	0.2	0.2	45	150	15	65	15	15	15	15	15	15	15	15	15	45	0			0		0														17.7538	0	4.940128526	0	2.040678926	1.491742504	0	1.175341229	4.068326452	1.217978059	23.9206505	0	0.008452746	0.947747487	6.170000841	8.486233197	0	0.976209854	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.2187	0	6.09	17.7538	0	4.940128526	0	2.040678926	1.491742504	0	1.175341229	4.068326452	1.217978059	23.9206505	0	0.008452746	0.947747487	6.170000841	8.486233197	0	0.976209854	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.2187	3000																																																																																	0	0	0	17.7538	0	4.940128526	0	2.040678926	1.491742504	0	1.175341229	4.068326452	1.217978059	23.9206505	0	0.008452746	0.947747487	6.170000841	8.486233197	0	0.976209854	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.2187
H5736_013_0	2009	4																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	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		1964.848108	0	1237.955532	931.7885876	244.8814712	7.458712518	0	313.4243276	325.4661162	974.3824473	4416.120092	0	6.762197115	758.1979899	4936.000673	6788.986557	0	780.9678831	0	0	272.3901034	0			873.3132645		71.09862098														$0 	$0 	"High Option Plan: $0/d 1-10, $0/d 11-20, $0/ 21-100"	$0 per visit	$50 per trip	0.2	0.2	$0 Emer Rm	$0 per procedure	$0 per visit	$0 X-ray; $0.2 Complex Radiology	$0 per visit	$0 per visit	$0 per visit	$0 PCP visit; $0 if no PCP selected	$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	0	50	0.2	0.2	0	0	0	0.08	0	0	0	0	0	0	0	0	0	45	0			0		0														0	0	0	0	50	0.2	0.2	0	0	0	0.08	0	0	0	0	0	0	0	0	0	45	0			0		0														0	0	0	0	1.020339463	1.491742504	0	0	0	0	0.029440801	0	0	0	0	0	0	0	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.563	0	0.77	0	0	0	0	1.020339463	1.491742504	0	0	0	0	0.029440801	0	0	0	0	0	0	0	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.563	1000																																																																																	0			0	0	0	0	1.020339463	1.491742504	0	0	0	0	0.029440801	0	0	0	0	0	0	0	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.563
H5736_014_0	2009	6																					1000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	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	1000	1964.848108	0	1237.955532	931.7885876	244.8814712	7.458712518	0	313.4243276	325.4661162	974.3824473	4416.120092	0	6.762197115	758.1979899	4936.000673	6788.986557	0	780.9678831	0	0	272.3901034	0			873.3132645		71.09862098														$0 	$0 	"High Option Plan: $0/d 1-10, $0/d 11-20, $0/ 21-100"	$0 per visit	$50 per trip	0.2	0.2	$0 Emer Rm	$0 per procedure	$0 per visit	$0 X-ray; $0.2 Complex Radiology	$0 per visit	$0 per visit	$0 per visit	$0 PCP visit; $0 if no PCP selected	$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	0	50	0.2	0.2	0	0	0	0.08	0	0	0	0	0	0	0	0	0	45	0			0		0														0	0	0	0	50	0.2	0.2	0	0	0	0.08	0	0	0	0	0	0	0	0	0	45	0			0		0														0	0	0	0	1.020339463	1.491742504	0	0	0	0	0.029440801	0	0	0	0	0	0	0	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.563	0	0.77	0	0	0	0	1.020339463	1.491742504	0	0	0	0	0.029440801	0	0	0	0	0	0	0	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.563	1000																																																																																	0	0	0	0	0	0	0	1.020339463	1.491742504	0	0	0	0	0.029440801	0	0	0	0	0	0	0	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.563
H5736_015_0	2009	4																					3000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	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	3000	1964.848108	0	1237.955532	931.7885876	244.8814712	7.458712518	0	313.4243276	325.4661162	974.3824473	4416.120092	0	6.762197115	758.1979899	4936.000673	6788.986557	0	780.9678831	0	0	272.3901034	0			873.3132645		71.09862098														$150/day 1-7	$150/day 1-7	"Low Option Plan:  $0/d 1-15, $75/d 16-20, $100/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm	$150 per procedure	$15 per visit	$15 X-ray; $125 Complex Radiology	$15 per visit	$15 per visit	$15 per visit	$15 PCP visit; $15 if no PCP selected	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$45 per script	0			$0 per visit		$0 per visit														108.4282617	108.4282617	47.8866492	0	100	0.2	0.2	45	150	15	59	15	15	15	15	15	15	15	15	15	45	0			0		0														108.4282617	108.4282617	47.8866492	0	100	0.2	0.2	45	150	15	59	15	15	15	15	15	15	15	15	15	45	0			0		0														17.7538	0	4.940128526	0	2.040678926	1.491742504	0	1.175341229	4.068326452	1.217978059	21.71259045	0	0.008452746	0.947747487	6.170000841	8.486233197	0	0.976209854	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.0106	0	6.18	17.7538	0	4.940128526	0	2.040678926	1.491742504	0	1.175341229	4.068326452	1.217978059	21.71259045	0	0.008452746	0.947747487	6.170000841	8.486233197	0	0.976209854	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.0106	3000																																																																																	0			17.7538	0	4.940128526	0	2.040678926	1.491742504	0	1.175341229	4.068326452	1.217978059	21.71259045	0	0.008452746	0.947747487	6.170000841	8.486233197	0	0.976209854	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.0106
H5736_016_0	2009	4																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	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		1964.848108	0	1237.955532	931.7885876	244.8814712	7.458712518	0	313.4243276	325.4661162	974.3824473	4416.120092	0	6.762197115	758.1979899	4936.000673	6788.986557	0	780.9678831	0	0	272.3901034	0			873.3132645		71.09862098														$0 	$0 	"High Option Plan: $0/d 1-10, $0/d 11-20, $0/ 21-100"	$0 per visit	$50 per trip	0.2	0.2	$0 Emer Rm	$0 per procedure	$0 per visit	$0 X-ray; $0.2 Complex Radiology	$0 per visit	$0 per visit	$0 per visit	$0 PCP visit; $0 if no PCP selected	$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	0	50	0.2	0.2	0	0	0	0.08	0	0	0	0	0	0	0	0	0	45	0			0		0														0	0	0	0	50	0.2	0.2	0	0	0	0.08	0	0	0	0	0	0	0	0	0	45	0			0		0														0	0	0	0	1.020339463	1.491742504	0	0	0	0	0.029440801	0	0	0	0	0	0	0	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.563	0	0.78	0	0	0	0	1.020339463	1.491742504	0	0	0	0	0.029440801	0	0	0	0	0	0	0	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.563	1000																																																																																	0			0	0	0	0	1.020339463	1.491742504	0	0	0	0	0.029440801	0	0	0	0	0	0	0	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.563
H5736_017_0	2009	6																					1000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	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	1000	1964.848108	0	1237.955532	931.7885876	244.8814712	7.458712518	0	313.4243276	325.4661162	974.3824473	4416.120092	0	6.762197115	758.1979899	4936.000673	6788.986557	0	780.9678831	0	0	272.3901034	0			873.3132645		71.09862098														$0 	$0 	"High Option Plan: $0/d 1-10, $0/d 11-20, $0/ 21-100"	$0 per visit	$50 per trip	0.2	0.2	$0 Emer Rm	$0 per procedure	$0 per visit	$0 X-ray; $0.2 Complex Radiology	$0 per visit	$0 per visit	$0 per visit	$0 PCP visit; $0 if no PCP selected	$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	0	50	0.2	0.2	0	0	0	0.08	0	0	0	0	0	0	0	0	0	45	0			0		0														0	0	0	0	50	0.2	0.2	0	0	0	0.08	0	0	0	0	0	0	0	0	0	45	0			0		0														0	0	0	0	1.020339463	1.491742504	0	0	0	0	0.029440801	0	0	0	0	0	0	0	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.563	0	0.78	0	0	0	0	1.020339463	1.491742504	0	0	0	0	0.029440801	0	0	0	0	0	0	0	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.563	1000																																																																																	0	0	0	0	0	0	0	1.020339463	1.491742504	0	0	0	0	0.029440801	0	0	0	0	0	0	0	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.563
H5736_018_0	2009	4																					4000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	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	4000	1964.848108	0	1237.955532	931.7885876	244.8814712	7.458712518	0	313.4243276	325.4661162	974.3824473	4416.120092	0	6.762197115	758.1979899	4936.000673	6788.986557	0	780.9678831	0	0	272.3901034	0			873.3132645		71.09862098														$200/day 1-7	$200/day 1-7	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm	$200 per procedure	$20 per visit	$20 X-ray; $150 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$20 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0			$0 per visit		$0 per visit														144.5710156	144.5710156	47.56208437	0	100	0.2	0.2	45	200	20	72	20	20	20	20	20	20	20	20	20	45	0			0		0														144.5710156	144.5710156	47.56208437	0	100	0.2	0.2	45	200	20	72	20	20	20	20	20	20	20	20	20	45	0			0		0														23.6717	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	5.424435269	1.623970745	26.49672055	0	0.011270329	1.263663316	8.226667788	11.3149776	0	1.301613139	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.9709	0	9.45	23.6717	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	5.424435269	1.623970745	26.49672055	0	0.011270329	1.263663316	8.226667788	11.3149776	0	1.301613139	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.9709	4000																																																																																	0			23.6717	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	5.424435269	1.623970745	26.49672055	0	0.011270329	1.263663316	8.226667788	11.3149776	0	1.301613139	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.9709
H5736_019_0	2009	4																					3000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	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	3000	1964.848108	0	1237.955532	931.7885876	244.8814712	7.458712518	0	313.4243276	325.4661162	974.3824473	4416.120092	0	6.762197115	758.1979899	4936.000673	6788.986557	0	780.9678831	0	0	272.3901034	0			873.3132645		71.09862098														$0 	$0 	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm	$150 per procedure	$10 per visit	$10 X-ray; $150 Complex Radiology	$10 per visit	$10 per visit	$10 per visit	$10 PCP visit; $10 if no PCP selected	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$45 per script	0			$0 per visit		$0 per visit														0	0	47.56208437	0	100	0.2	0.2	45	150	10	66	10	10	10	10	10	10	10	10	10	45	0			0		0														0	0	47.56208437	0	100	0.2	0.2	45	150	10	66	10	10	10	10	10	10	10	10	10	45	0			0		0														0	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	4.068326452	0.811985373	24.28866051	0	0.005635164	0.631831658	4.113333894	5.657488798	0	0.650806569	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8639	0	3.19	0	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	4.068326452	0.811985373	24.28866051	0	0.005635164	0.631831658	4.113333894	5.657488798	0	0.650806569	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8639	3000																																																																																	0			0	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	4.068326452	0.811985373	24.28866051	0	0.005635164	0.631831658	4.113333894	5.657488798	0	0.650806569	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8639
H5736_020_0	2009	4																					4000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	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	4000	1964.848108	0	1237.955532	931.7885876	244.8814712	7.458712518	0	313.4243276	325.4661162	974.3824473	4416.120092	0	6.762197115	758.1979899	4936.000673	6788.986557	0	780.9678831	0	0	272.3901034	0			873.3132645		71.09862098														$200/day 1-7	$200/day 1-7	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm	$200 per procedure	$20 per visit	$20 X-ray; $150 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$20 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0			$0 per visit		$0 per visit														144.5710156	144.5710156	47.56208437	0	100	0.2	0.2	45	200	20	72	20	20	20	20	20	20	20	20	20	45	0			0		0														144.5710156	144.5710156	47.56208437	0	100	0.2	0.2	45	200	20	72	20	20	20	20	20	20	20	20	20	45	0			0		0														23.6717	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	5.424435269	1.623970745	26.49672055	0	0.011270329	1.263663316	8.226667788	11.3149776	0	1.301613139	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.9709	0	9.45	23.6717	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	5.424435269	1.623970745	26.49672055	0	0.011270329	1.263663316	8.226667788	11.3149776	0	1.301613139	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.9709	4000																																																																																	0			23.6717	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	5.424435269	1.623970745	26.49672055	0	0.011270329	1.263663316	8.226667788	11.3149776	0	1.301613139	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.9709
H5736_021_0	2009	4																					3000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	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	3000	1964.848108	0	1237.955532	931.7885876	244.8814712	7.458712518	0	313.4243276	325.4661162	974.3824473	4416.120092	0	6.762197115	758.1979899	4936.000673	6788.986557	0	780.9678831	0	0	272.3901034	0			873.3132645		71.09862098														$0 	$0 	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm	$150 per procedure	$10 per visit	$10 X-ray; $150 Complex Radiology	$10 per visit	$10 per visit	$10 per visit	$10 PCP visit; $10 if no PCP selected	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$45 per script	0			$0 per visit		$0 per visit														0	0	47.56208437	0	100	0.2	0.2	45	150	10	66	10	10	10	10	10	10	10	10	10	45	0			0		0														0	0	47.56208437	0	100	0.2	0.2	45	150	10	66	10	10	10	10	10	10	10	10	10	45	0			0		0														0	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	4.068326452	0.811985373	24.28866051	0	0.005635164	0.631831658	4.113333894	5.657488798	0	0.650806569	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8639	0	3.19	0	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	4.068326452	0.811985373	24.28866051	0	0.005635164	0.631831658	4.113333894	5.657488798	0	0.650806569	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8639	3000																																																																																	0			0	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	4.068326452	0.811985373	24.28866051	0	0.005635164	0.631831658	4.113333894	5.657488798	0	0.650806569	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8639
H5736_022_0	2009	4																					4000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	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	4000	1964.848108	0	1237.955532	931.7885876	244.8814712	7.458712518	0	313.4243276	325.4661162	974.3824473	4416.120092	0	6.762197115	758.1979899	4936.000673	6788.986557	0	780.9678831	0	0	272.3901034	0			873.3132645		71.09862098														$200/day 1-7	$200/day 1-7	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm	$200 per procedure	$20 per visit	$20 X-ray; $150 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$20 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0			$0 per visit		$0 per visit														144.5710156	144.5710156	47.56208437	0	100	0.2	0.2	45	200	20	72	20	20	20	20	20	20	20	20	20	45	0			0		0														144.5710156	144.5710156	47.56208437	0	100	0.2	0.2	45	200	20	72	20	20	20	20	20	20	20	20	20	45	0			0		0														23.6717	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	5.424435269	1.623970745	26.49672055	0	0.011270329	1.263663316	8.226667788	11.3149776	0	1.301613139	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.9709	0	10.85	23.6717	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	5.424435269	1.623970745	26.49672055	0	0.011270329	1.263663316	8.226667788	11.3149776	0	1.301613139	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.9709	4000																																																																																	0			23.6717	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	5.424435269	1.623970745	26.49672055	0	0.011270329	1.263663316	8.226667788	11.3149776	0	1.301613139	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.9709
H5736_023_0	2009	4																					3000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	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	3000	1964.848108	0	1237.955532	931.7885876	244.8814712	7.458712518	0	313.4243276	325.4661162	974.3824473	4416.120092	0	6.762197115	758.1979899	4936.000673	6788.986557	0	780.9678831	0	0	272.3901034	0			873.3132645		71.09862098														$0 	$0 	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm	$150 per procedure	$10 per visit	$10 X-ray; $150 Complex Radiology	$10 per visit	$10 per visit	$10 per visit	$10 PCP visit; $10 if no PCP selected	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$45 per script	0			$0 per visit		$0 per visit														0	0	47.56208437	0	100	0.2	0.2	45	150	10	66	10	10	10	10	10	10	10	10	10	45	0			0		0														0	0	47.56208437	0	100	0.2	0.2	45	150	10	66	10	10	10	10	10	10	10	10	10	45	0			0		0														0	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	4.068326452	0.811985373	24.28866051	0	0.005635164	0.631831658	4.113333894	5.657488798	0	0.650806569	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8639	0	3.66	0	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	4.068326452	0.811985373	24.28866051	0	0.005635164	0.631831658	4.113333894	5.657488798	0	0.650806569	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8639	3000																																																																																	0			0	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	4.068326452	0.811985373	24.28866051	0	0.005635164	0.631831658	4.113333894	5.657488798	0	0.650806569	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8639
H5736_024_0	2009	5																					3000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	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	3000	1964.848108	0	1237.955532	931.7885876	244.8814712	7.458712518	0	313.4243276	325.4661162	974.3824473	4416.120092	0	6.762197115	758.1979899	4936.000673	6788.986557	0	780.9678831	0	0	272.3901034	0			873.3132645		71.09862098														$0 	$0 	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm	$150 per procedure	$10 per visit	$10 X-ray; $150 Complex Radiology	$10 per visit	$10 per visit	$10 per visit	$10 PCP visit; $10 if no PCP selected	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$45 per script	0			$0 per visit		$0 per visit														0	0	47.56208437	0	100	0.2	0.2	45	150	10	66	10	10	10	10	10	10	10	10	10	45	0			0		0														0	0	47.56208437	0	100	0.2	0.2	45	150	10	66	10	10	10	10	10	10	10	10	10	45	0			0		0														0	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	4.068326452	0.811985373	24.28866051	0	0.005635164	0.631831658	4.113333894	5.657488798	0	0.650806569	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8639	0	3.19	0	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	4.068326452	0.811985373	24.28866051	0	0.005635164	0.631831658	4.113333894	5.657488798	0	0.650806569	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8639	3000																																																																																	0	0	0	0	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	4.068326452	0.811985373	24.28866051	0	0.005635164	0.631831658	4.113333894	5.657488798	0	0.650806569	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8639
H5736_025_0	2009	5																					4000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	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	4000	1964.848108	0	1237.955532	931.7885876	244.8814712	7.458712518	0	313.4243276	325.4661162	974.3824473	4416.120092	0	6.762197115	758.1979899	4936.000673	6788.986557	0	780.9678831	0	0	272.3901034	0			873.3132645		71.09862098														$200/day 1-7	$200/day 1-7	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm	$200 per procedure	$20 per visit	$20 X-ray; $150 Complex Radiology	$20 per visit	$20 per visit	$20 per visit	$20 PCP visit; $20 if no PCP selected	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$20 per visit	$45 per script	0			$0 per visit		$0 per visit														144.5710156	144.5710156	47.56208437	0	100	0.2	0.2	45	200	20	72	20	20	20	20	20	20	20	20	20	45	0			0		0														144.5710156	144.5710156	47.56208437	0	100	0.2	0.2	45	200	20	72	20	20	20	20	20	20	20	20	20	45	0			0		0														23.6717	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	5.424435269	1.623970745	26.49672055	0	0.011270329	1.263663316	8.226667788	11.3149776	0	1.301613139	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.9709	0	9.45	23.6717	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	5.424435269	1.623970745	26.49672055	0	0.011270329	1.263663316	8.226667788	11.3149776	0	1.301613139	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.9709	4000																																																																																	0	0	0	23.6717	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	5.424435269	1.623970745	26.49672055	0	0.011270329	1.263663316	8.226667788	11.3149776	0	1.301613139	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.9709
H5736_026_0	2009	5																					3000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	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	3000	1964.848108	0	1237.955532	931.7885876	244.8814712	7.458712518	0	313.4243276	325.4661162	974.3824473	4416.120092	0	6.762197115	758.1979899	4936.000673	6788.986557	0	780.9678831	0	0	272.3901034	0			873.3132645		71.09862098														$0 	$0 	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm	$150 per procedure	$10 per visit	$10 X-ray; $150 Complex Radiology	$10 per visit	$10 per visit	$10 per visit	$10 PCP visit; $10 if no PCP selected	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$45 per script	0			$0 per visit		$0 per visit														0	0	47.56208437	0	100	0.2	0.2	45	150	10	66	10	10	10	10	10	10	10	10	10	45	0			0		0														0	0	47.56208437	0	100	0.2	0.2	45	150	10	66	10	10	10	10	10	10	10	10	10	45	0			0		0														0	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	4.068326452	0.811985373	24.28866051	0	0.005635164	0.631831658	4.113333894	5.657488798	0	0.650806569	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8639	0	3.19	0	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	4.068326452	0.811985373	24.28866051	0	0.005635164	0.631831658	4.113333894	5.657488798	0	0.650806569	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8639	3000																																																																																	0	0	0	0	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	4.068326452	0.811985373	24.28866051	0	0.005635164	0.631831658	4.113333894	5.657488798	0	0.650806569	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8639
H5736_027_0	2009	6																					3000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	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	3000	1964.848108	0	1237.955532	931.7885876	244.8814712	7.458712518	0	313.4243276	325.4661162	974.3824473	4416.120092	0	6.762197115	758.1979899	4936.000673	6788.986557	0	780.9678831	0	0	272.3901034	0			873.3132645		71.09862098														$0 	$0 	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm	$150 per procedure	$10 per visit	$10 X-ray; $150 Complex Radiology	$10 per visit	$10 per visit	$10 per visit	$10 PCP visit; $10 if no PCP selected	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$10 per visit	$45 per script	0			$0 per visit		$0 per visit														0	0	47.56208437	0	100	0.2	0.2	45	150	10	66	10	10	10	10	10	10	10	10	10	45	0			0		0														0	0	47.56208437	0	100	0.2	0.2	45	150	10	66	10	10	10	10	10	10	10	10	10	45	0			0		0														0	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	4.068326452	0.811985373	24.28866051	0	0.005635164	0.631831658	4.113333894	5.657488798	0	0.650806569	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8639	0	3.66	0	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	4.068326452	0.811985373	24.28866051	0	0.005635164	0.631831658	4.113333894	5.657488798	0	0.650806569	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8639	3000																																																																																	0	0	0	0	0	4.906645457	0	2.040678926	1.491742504	0	1.175341229	4.068326452	0.811985373	24.28866051	0	0.005635164	0.631831658	4.113333894	5.657488798	0	0.650806569	0	0	1.021462888	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8639
H5736_801_0	2009	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																																																			0		367.9297834	0	45.34055401	6.864818201	8.117812706	10.83674574	0	9.547720092	48.65316465	16.90572508	68.82175756	0	3.949286013	15.0776538	50.4478045	219.1584776	0	6.463916914	0	0	9.802421472	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.076338146	0.076338146	0.179898998	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											28.0871	0	8.156720249	0	1.875214735	2.503288265	0	2.205523341	11.23888103	3.905222492	15.897826	0	0.912285069	3.482938029	11.65344284	50.62560832	0	1.493164807	0	0	2.26435936	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	144.3016			28.0871	0	8.156720249	0	1.875214735	2.503288265	0	2.205523341	11.23888103	3.905222492	15.897826	0	0.912285069	3.482938029	11.65344284	50.62560832	0	1.493164807	0	0	2.26435936	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	144.3016																																																																																		0			28.0871	0	8.156720249	0	1.875214735	2.503288265	0	2.205523341	11.23888103	3.905222492	15.897826	0	0.912285069	3.482938029	11.65344284	50.62560832	0	1.493164807	0	0	2.26435936	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	144.3016
H5736_802_0	2009	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														0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0														0		348.8546902	0	42.98990088	6.508915925	7.696949701	10.27492132	0	9.052724418	46.13077126	16.02925816	65.25373588	0	3.74453771	14.29596212	47.83236911	207.7963412	0	6.128799118	0	0	9.294220962	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			Not Covered		Not Covered																																																						0.07406274	0.07406274	0.178105864	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											25.8371	0	7.656753421	0	1.777995381	2.373506825	0	2.091179341	10.65620816	3.702758635	15.07361299	0	0.864988211	3.30236725	11.04927726	48.00095481	0	1.415752596	0	0	2.146965042	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.9495			25.8371	0	7.656753421	0	1.777995381	2.373506825	0	2.091179341	10.65620816	3.702758635	15.07361299	0	0.864988211	3.30236725	11.04927726	48.00095481	0	1.415752596	0	0	2.146965042	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.9495																																																																																		0			25.8371	0	7.656753421	0	1.777995381	2.373506825	0	2.091179341	10.65620816	3.702758635	15.07361299	0	0.864988211	3.30236725	11.04927726	48.00095481	0	1.415752596	0	0	2.146965042	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.9495
H5736_808_0	2009	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														0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0														0		332.964847	0	41.1145838	6.233464039	7.351897121	9.787227301	0	8.651074354	44.70981158	15.24004638	62.11952681	0	3.389792852	12.88505992	45.51209799	197.6929678	0	5.859161954	0	0	8.841548463	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			Not Covered		Not Covered																																																						0	0	0	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0		0														0	0	0	0	1.698288235	2.260849507	0	1.998398176	10.32796648	3.520450714	14.34961069	0	0.783042149	2.97644884	10.51329464	45.66707556	0	1.353466411	0	0	2.042397695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.4913			0	0	0	0	1.698288235	2.260849507	0	1.998398176	10.32796648	3.520450714	14.34961069	0	0.783042149	2.97644884	10.51329464	45.66707556	0	1.353466411	0	0	2.042397695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.4913																																																																																		0			0	0	0	0	1.698288235	2.260849507	0	1.998398176	10.32796648	3.520450714	14.34961069	0	0.783042149	2.97644884	10.51329464	45.66707556	0	1.353466411	0	0	2.042397695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.4913
H5736_809_0	2009	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														0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0														0		335.6858511	0	41.45057407	6.284404194	7.411977163	9.867208973	0	8.721771332	45.07518222	15.36458874	62.62717044	0	3.417494395	12.99035722	45.88402495	199.3085238	0	5.907043296	0	0	8.913802004	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			Not Covered		Not Covered																																																						0	0	0	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0		0														0	0	0	0	1.712166725	2.279325273	0	2.014729178	10.41236709	3.549219999	14.46687637	0	0.789441205	3.000772517	10.59920976	46.040269	0	1.364527001	0	0	2.059088263	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.288	0	0	0	0	0	0	1.712166725	2.279325273	0	2.014729178	10.41236709	3.549219999	14.46687637	0	0.789441205	3.000772517	10.59920976	46.040269	0	1.364527001	0	0	2.059088263	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.288																																																																																		0			0	0	0	0	1.712166725	2.279325273	0	2.014729178	10.41236709	3.549219999	14.46687637	0	0.789441205	3.000772517	10.59920976	46.040269	0	1.364527001	0	0	2.059088263	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	98.288
H5736_810_0	2009	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														0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0														0		348.4312184	0	43.02437527	6.523011332	7.693396149	10.24184854	0	9.052920767	46.78660305	15.9479536	65.00500761	0	3.547250301	13.48357692	47.62615603	206.8758978	0	6.131322742	0	0	9.252242486	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			Not Covered		Not Covered																																						0		0														0.078437442	0.078437442	0.181783007	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0		0														27.3301	0	7.82110029	0	1.777174511	2.365867014	0	2.091224697	10.8077053	3.683977281	15.01615676	0	0.819414819	3.114706268	11.00164204	47.78833238	0	1.416335553	0	0	2.137268014	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.171	0	0	27.3301	0	7.82110029	0	1.777174511	2.365867014	0	2.091224697	10.8077053	3.683977281	15.01615676	0	0.819414819	3.114706268	11.00164204	47.78833238	0	1.416335553	0	0	2.137268014	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.171																																																																																		0			27.3301	0	7.82110029	0	1.777174511	2.365867014	0	2.091224697	10.8077053	3.683977281	15.01615676	0	0.819414819	3.114706268	11.00164204	47.78833238	0	1.416335553	0	0	2.137268014	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.171
H5736_811_0	2009	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														0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0		0														0		330.7113407	0	40.83632027	6.19127595	7.302139477	9.72098734	0	8.592523878	44.40721555	15.13690174	61.69910181	0	3.366850732	12.79785382	45.20407208	196.3549817	0	5.819507142	0	0	8.781708857	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			Not Covered		Not Covered																																																						0	0	0	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0		0														0	0	0	0	1.686794219	2.245548076	0	1.984873016	10.25806679	3.496624301	14.25249252	0	0.777742519	2.956304233	10.44214065	45.35800076	0	1.34430615	0	0	2.028574746	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.8315	0	0	0	0	0	0	1.686794219	2.245548076	0	1.984873016	10.25806679	3.496624301	14.25249252	0	0.777742519	2.956304233	10.44214065	45.35800076	0	1.34430615	0	0	2.028574746	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.8315																																																																																		0			0	0	0	0	1.686794219	2.245548076	0	1.984873016	10.25806679	3.496624301	14.25249252	0	0.777742519	2.956304233	10.44214065	45.35800076	0	1.34430615	0	0	2.028574746	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.8315
H5746_006_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	277.36	17.46	91.98	43.1	19.59	24.56	22.85	14.17	21.93	6.73	14.72	3.63	6.42	84.38	43.96	83.73	5.24	4.56	22.03	29.66	12.71	3.56	7.96	4.39	1.28	2.35	0.29	1.56	3.03	19.58											PBP: 1A IP Acute: Standard Medicare	1B IP Psych: Standard Medicare	2 SNF: Standard Medicare	6 Home Health: Standard Medicare	10A Ambulance: Standard Medicare	11A DME: Standard Medicare	"11B Prosthetic Medical Supplies: Standard Medicare, 11C Diabetes Monitoring Supplies: $0"	"4A ER, 4B Urgent Care: Standard Medicare, 4A Worldwide Coverage: $0"	9B ASC Services: Standard Medicare	8A OP C/D/T: Standard Medicare	8B OP X-Ray: Standard Medicare	"9A OP Hospital, 5 Partial Hosp: Standard Medicare"	12 Renal Dialysis: Standard Medicare	"3 CORF, 9A OP Hospital, 9D Cardiac Rehab: Standard Medicare"	"7A PCP, 14B Immunizations, 14C Routine Physical Exams: $0"	7D Physician Specialist (excl. Radiology): $0	"7E Mental Health, 7H Psychiatric, 9C OP Substance Abuse,: $0"	"7C Occupational Therapy, 7I Physical and Speech Therapy: $0"	"8B Physician Specialist (Radiology), 14G Bone Mass Measurement, 14H Mammography: $0"	"7B Chiropractic, 7F Podiatry - Medicare Covered, 7G Other Health Care, 14D Pap Smears/Pelvic Exams, 14E Prostate Screening, 14F Colorectal Screening, 14I Diabetes Monitoring, 14J Nutrition Therapy, 18A Medicare Covered Hearing Exams: $0, 7F Podiatry - Routine: $0"	15 Part B Drugs: Standard Medicare	"13A Blood, 16B Medicare Covered Comprehensive Dental Services, 17A Medicare Covered Eye Exams, 17B Medicare Covered Eyewear: $0"	10B Transportation: $0 for 24 one-way trips	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	17B Eye Wear - Non-Covered: $0	18A Hearing - Routine: $0	18B Hearing Aids: $0	"14A Medical Nutrition: $0, 14A Health Education/Wellness Programs: $0"	"6 Respite Care: $0, 13B Acupuncture: Not Covered, 13C Other: OTC Drugs: $0, 13D Other: Assistive Devices: $0 13E Other: PERS: $0"											0.071234995	0.071244103	0.183600584	0	0.231025257	0.230999846	0.182417563	0.229395457	0.230999997	0.231159499	0.231010066	0.231000228	0.231000009	0.230988516	0	0	0	0	0	0	0.230999129	0	0	0	0	0	0	0	0	0											0.071234995	0.071244103	0.183600584	0	0.231025257	0.230999846	0.182417563	0.229395457	0.230999997	0.231159499	0.231010066	0.231000228	0.231000009	0.230988516	0	0	0	0	0	0	0.230999129	0	0	0	0	0	0	0	0	0											19.7577	1.243922045	16.88758173	0	4.52578479	5.673356222	4.168241316	3.250533633	5.065829929	1.555703431	3.400468177	0.838530827	1.483020059	19.49081099	0	0	0	0	0	0	2.93599893	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.2775	0	0	19.7577	1.243922045	16.88758173	0	4.52578479	5.673356222	4.168241316	3.250533633	5.065829929	1.555703431	3.400468177	0.838530827	1.483020059	19.49081099	0	0	0	0	0	0	2.93599893	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.2775	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.7577	1.243922045	16.88758173	0	4.52578479	5.673356222	4.168241316	3.250533633	5.065829929	1.555703431	3.400468177	0.838530827	1.483020059	19.49081099	0	0	0	0	0	0	2.93599893	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.2775
H5746_007_0	2009	4																					0											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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	195.66	2.88	499.52	0	137.17	11.35	8.14	237.91	312.76	0	584.92	131.36	0.48	2399.03	4140.04	5083.08	137.74	509.7	1506.89	1087.78	11.76	508.87	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $200 per admit	1B IP Psych: $200 per admit	2 SNF: $125 per day for days 21-100	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50,4A Non Covered Foreign Travel: $50,  4B Urgent Care: $20"	9B ASC Services: $150	8A OP Lab Services: $0	8B OP X-Ray: $25	"9A OP Hospital: $150, 5 Partial Hosp: $150"	12 Renal Dialysis: 20%	"3 CORF: $150, 8A OP Diagnostic Procedures/Tests: $150, 9A OP Hospital: $150, 9D Cardiac Rehab: $150"	"7A PCP: $5, 14B Immunizations: $0, 14C Routine Physical Exams: $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"	"8B Physician Specialist Services - Radiology: $25, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7B Chiropractic: $20, 7F Podiatry: $20, 7F Non Medicare Covered Podiatry: $0,  7G Other Health Care: $20, 14D Pap Smears & Pelvic Exams: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $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, 17B Medicare Covered Eyewear: $20"	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: $0	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: Over-the-Counter Drugs: $0, 13D Other: PERS: $0, 13E Other: Assistive Devices: Not Covered"											200	200	125	0	75	0.19999986	0.199950899	48.55365474	150	0	25	150	0.199999983	122.6006344	5	20	20	20	25	20	0.200002098	20	0	0	0	0	0	0	0	0											200	200	125	0	75	0.19999986	0.199950899	48.55365474	150	0	25	150	0.199999983	122.6006344	5	20	20	20	25	20	0.200002098	20	0	0	0	0	0	0	0	0											3.261	0.048	5.203333333	0	0.8573125	2.269998416	1.627600318	0.962616667	3.9095	0	1.218583333	1.642	0.095999992	24.51021667	1.725016667	8.4718	0.229566667	0.8495	3.139354167	1.812966667	2.352024675	0.848116667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.0345	0	0	3.261	0.048	5.203333333	0	0.8573125	2.269998416	1.627600318	0.962616667	3.9095	0	1.218583333	1.642	0.095999992	24.51021667	1.725016667	8.4718	0.229566667	0.8495	3.139354167	1.812966667	2.352024675	0.848116667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.0345	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.261	0.048	5.203333333	0	0.8573125	2.269998416	1.627600318	0.962616667	3.9095	0	1.218583333	1.642	0.095999992	24.51021667	1.725016667	8.4718	0.229566667	0.8495	3.139354167	1.812966667	2.352024675	0.848116667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.0345
H5746_011_0	2009	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	O	V											32.8242	0.344	6.1916	4.1293	0	1.9465	1.3872	0	4.8012	0.6928	2.305	0.4645	0.0804	5.2031	0	0	0	0	0	0	1.8356	0.1447	0	0	0	0	0	0	0	0											62.35	0	0	0	0	0	138.99	0	0	261.63	0	0	0	0	0	510.41	0	5304.09	150.49	560.82	0	1218.75	0	557.68	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: $75	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4A Non Medicare Covered Foreign Travel: $50,  4B Urgent Care: $10"	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, 9A Outpatient Hospital Services $0,  9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $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"	"8B Physician Specialist Services - Radiology: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7G Other Health Care: $10, 18A Medicare Covered Hearing Exams: $10, 7B Chiropractic: $10, 7F Medicare Covered Podiatry: $10, 7F Non Medicare Covered Podiatry (Routine): $0, 14D Pap Smears & Pelvic Exams: $0, , 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $10"	15 Part B Drugs: 0%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $10, 17A Medicare Covered Eye Exams: $10, 17B Medicare Covered Eyewear: $10"	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: $0	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: Over-the-Counter Drugs: $0, 13D Other: PERS: $0, 13E Other: Assistive Devices: Not Covered"											0	0	0	0	75	0	0	48.16687689	0	0	0	0	0	10	0	10	10	10	0	10	0	10	0	0	0	0	0	0	0	0											0	0	0	0	75	0	0	48.16687689	0	0	0	0	0	10	0	10	10	10	0	10	0	10	0	0	0	0	0	0	0	0											0	0	0	0	0.8686875	0	0	1.050158333	0	0	0	0	0	0.425341667	0	4.420075	0.125408333	0.46735	0	1.015625	0	0.464733333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.8374	1300	0	32.8242	0.343977829	6.191600928	4.129341325	0.8686875	1.946528745	1.387162929	1.050158333	4.801223253	0.692777778	2.304972931	0.464530807	0.080368652	5.628408179	0	4.420075	0.125408333	0.46735	0	1.015625	1.835620005	0.609396906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.1874	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	32.8242	0.343977829	6.191600928	4.129341325	0.8686875	1.946528745	1.387162929	1.050158333	4.801223253	0.692777778	2.304972931	0.464530807	0.080368652	5.628408179	0	4.420075	0.125408333	0.46735	0	1.015625	1.835620005	0.609396906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.1874
H5746_012_0	2009	7																					0											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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	137.067	2.093	500.93	0	133.99	11.14	7.87	175.364	233.45	0	430.773	147.13	0.49	2652.37	3968.62	3410.82	95.97	365.967	1072.246	815.01	12.33	344.105	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $200 per admit	1B IP Psych: $200 per admit	2 SNF: $125 per day for days 21-100	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER/Worldwide Coverage: $50, 4B Urgent Care: $20"	9B ASC Services: $150	8A OP Lab Services: $0	8B OP X-Ray: $25	"9A OP Hospital: $150,  5 Partial Hosp: $150"	12 Renal Dialysis: 20%	"3 CORF: $150, 8A OP Diagnostic Procedures/Tests: $150, 9A OP Hospital: $150, 9D Cardiac Rehab: $150"	"7A PCP: $5, 14B Immunizations: $0, 14C Routine Physical Exams: $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"	"8B Physician Specialist Services - Radiology: $25, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7B Chiropractic: $20, 7F Podiatry - Medicare Covered: $20, 7F Podiatry - Routine: $0, 7G Other Health Care: $20, 14D Pap Smears/Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutritional Therapy: $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, 17B Medicare Covered Eyewear: $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	14A Health Education/Wellness Programs: $0	"13B Acupuncture: Not Covered, 13C Other: OTC drugs: $0, 13D Other: PERS: $0"											200	200	125	0	75	0.200000034	0.200091318	48.67914737	150	0	25	150	0.20000001	123.3184284	5	20	20	20	25	20	0.199999131	20	0	0	0	0	0	0	0	0											200	200	125	0	75	0.200000034	0.200091318	48.67914737	150	0	25	150	0.20000001	123.3184284	5	20	20	20	25	20	0.199999131	20	0	0	0	0	0	0	0	0											2.2845	0.034883333	5.218020833	0	0.8374375	2.228000377	1.574718676	0.711380833	2.918125	0	0.89744375	1.839125	0.098000005	27.257175	1.653591667	5.6847	0.15995	0.609945	2.233845833	1.35835	2.46598928	0.573508333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.6386	0	0	2.2845	0.034883333	5.218020833	0	0.8374375	2.228000377	1.574718676	0.711380833	2.918125	0	0.89744375	1.839125	0.098000005	27.257175	1.653591667	5.6847	0.15995	0.609945	2.233845833	1.35835	2.46598928	0.573508333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.6386	0	PBP: 1A IP Acute: $300 per admit	1B IP Psych: $300 per admit	2 SNF: Not Covered	6 Home Health: Not Covered	10A Ambulance: Not Covered	11A DME: Not Covered	"11B Prosthetic Medical Supplies, 11C Diabetes Monitoring Supplies: Not Covered"	"4A ER/Worldwide Coverage: $50, 4B Urgent Care: $30"	9B ASC Services: $175	8A OP Lab Services: Not Covered	8B OP X-Ray: $75	"9A OP Hospital, 5 Partial Hosp: Not Covered"	12 Renal Dialysis: Not Covered	"3 CORF, 8A OP Diagnostic Procedures/Tests, 9A OP Hospital, 9D Cardiac Rehab: Not Covered"	"7A PCP, 14B Immunizations, 14C Routine Physical Exams, 14I Diabetes Monitoring: Not Covered"	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: $75, 14H Mammography: $0, 14G Bone Mass Measurement:$0"	"7B Chiropractic: $30, 7F Podiatry: $30, 7G Other Health Care: $30, 14D Pap Smears:$0, 14D Pelvic Exams:$0, 14E Prostate Screening:$0, 14F Colorectal Screening:$0, 14I Diabetes Monitoring:$0, 14J Nutrition Therapy:$0, 18A Medicare Covered Hearing Exams: $30"	15 Part B Drugs: Not Covered	"13A Blood: Not Covered, 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: Not Covered	17B Eye Wear: Not Covered	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: OTC drugs: Not Covered, 13D Other: PERS: Not Covered"											1.4828	0.024	0	0	0	0	0	0.3365	1.6397	0	1.1769	0	0	0	0	3.9158	0.1149	0.4444	3.2551	1.006	0	0.4175	0	0	0	0	0	0	0	0											13.8135	0	0	3.7672	0.058883333	5.218020833	0	0.8374375	2.228000377	1.574718676	1.047855833	4.55783125	0	2.0743625	1.839125	0.098000005	27.257175	1.653591667	9.600465	0.2748875	1.054335	5.488902083	2.3643325	2.46598928	0.990988333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4521
H5749_001_0	2009	3																					2400											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1563.097431	160.8841829	665.9445368	706.2190755	106.5853653	10.93629336	4.039582827	303.1152429	33.22299411	9439.257048	38.66352624	0	0.201239479	25.13879188	4432.760796	3488.833502	549.3000308	197.5800395	0	0	15.55373184	757.3196969	0	0	103.5923094	0	12.88706159	0	453.6	0											"$165 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$165 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-24 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$5 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											163.0767997	165	100	0	150	0.2	0.076056143	49.51691046	0.2	2.8	0.230029839	0	0.2	0.197296558	3.584686653	30	37.5	30	0	0	0.2	28.55430849	0	0	30	0	30	0	0	0											100.3523829	101.5110142	61.52182677	0	92.28274015	0.123043654	0.046791129	30.46370787	0.123043654	1.722611149	0.141518559	0	0.123043654	0.121730667	3.584686653	30	37.5	18.45654803	0	0	0.123043654	28.55430849	0	0	30	0	30	0	0	0											13.0717	1.360959714	3.414177036	0	0.819665798	1.345641491	0.189016639	0.769501184	4.087878576	1.35501412	5.471606516	0	0.024761241	3.060161906	1.324171539	8.722083756	1.716562596	0.303887124	0	0	1.913787992	1.802061687	0	0	0.258980774	0	0.032217654	0	0	0	0	0	0	0	0	0	0	0	0	0	51.0438	0	23.2392	13.0717	1.360959714	3.414177036	0	0.819665798	1.345641491	0.189016639	0.769501184	4.087878576	1.35501412	5.471606516	0	0.024761241	3.060161906	1.324171539	8.722083756	1.716562596	0.303887124	0	0	1.913787992	1.802061687	0	0	0.258980774	0	0.032217654	0	0	0	0	0	0	0	0	0	0	0	0	0	51.0438		"$250 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$250 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$10 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$10 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											4.4575	0.4552	6.4669	0.6211	0.4441	1.0936	0.404	0.4169	3.3223	0.7342	4.3208	0	0.0134	2.4729	1.4498	4.3332	0.8338	0.247	0	0	1.9998	0.9194	0	0	0.1295	0	0.0161	0	0	0											35.1514	0	0	17.5292	1.81620696	9.881077788	0.621077792	1.263771487	2.439270826	0.592974922	1.186427027	7.410177987	2.089178557	9.792387704	0	0.038177206	5.533081635	2.774019642	13.05524632	2.550321572	0.550862173	0	0	3.913553515	2.721419526	0	0	0.38847116	0	0.048326481	0	0	0	0	0	0	0	0	0	0	0	0	0	86.1952
H5749_801_0	2009	2																					4800											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	4800	1641.252302	168.928392	699.2417637	741.5300293	111.9146336	11.48310802	4.241561968	318.2512056	34.88414381	9911.219901	40.59670255	0	0.211301452	26.39573147	4649.490058	3655.991093	576.7650323	207.4590414	0	0	16.33141844	795.1856817	0	0	0	0	0	0	0	0											"$455 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$455 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 25% (9a); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											449.5844612	455	150	0	150	0.2	0.076056143	49.5168804	0.25	2.8	0.27286054	0	0.2	0.246264338	17.94235623	34.78552689	37.5	35	0	0	0.2	33.31028513	0	0	0	0	0	0	0	0											282.8036899	286.1862817	94.34712582	0	94.34712582	0.125796168	0.047837857	31.14516897	0.15724521	1.761146349	0.171624051	0	0.125796168	0.155233244	17.94235623	34.78552689	37.5	22.01432936	0	0	0.125796168	33.31028513	0	0	0	0	0	0	0	0											38.6794	4.028749032	5.497620888	0	0.879902001	1.444530983	0.202907233	0.825998964	5.485364509	1.454592395	6.967370556	0	0.026580913	4.097495018	6.951900577	10.59796471	1.802390726	0.380589306	0	0	2.054429853	2.207321816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5851	0	42.4666	38.6794	4.028749032	5.497620888	0	0.879902001	1.444530983	0.202907233	0.825998964	5.485364509	1.454592395	6.967370556	0	0.026580913	4.097495018	6.951900577	10.59796471	1.802390726	0.380589306	0	0	2.054429853	2.207321816	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5851		"$455 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 25% (13c)"	"$455 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"25% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	25%/$7 (8a1); $7 (8a2)	"$20 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 25% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 25% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											5.2088	0.5362	3.5775	0.3336	0.2863	0.705	0.2604	0.2688	1.7848	0.4733	2.4295	0	0.0086	1.3345	3.1835	4.542	0.8754	0.1592	0	0	1.2891	0.9579	0	0	0	0	0	0	0	0											28.2145	0	11.82200892	43.8882	4.564996322	9.07512261	0.333647435	1.166194108	2.149537593	0.463318371	1.094752738	7.270127534	1.927870464	9.396913057	0	0.035229496	5.431948616	10.13540397	15.13994958	2.67783765	0.539801423	0	0	3.343575878	3.165184963	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.7996
H5749_802_0	2009	2																					4800											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	4800	1641.235963	168.9267102	699.2348024	741.5226469	111.9135194	11.48287938	4.241477514	318.2480412	34.88344924	9911.121229	40.59589424	0	0.211297245	26.39520591	4649.444747	3655.954696	576.7592903	207.4569761	0	0	16.33109326	795.1777652	0	0	0	0	0	0	0	0											"$455 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$455 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 25% (9a); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											449.5844612	455	150	0	150	0.2	0.076056143	49.51688041	0.25	2.8	0.272861124	0	0.2	0.246264364	17.94235246	34.78551289	37.5	35	0	0	0.2	33.31028495	0	0	0	0	0	0	0	0											282.8051678	286.1877775	94.34761897	0	94.34761897	0.125796825	0.047838107	31.14533177	0.157246032	1.761155554	0.171625316	0	0.125796825	0.15523407	17.94235246	34.78551289	37.5	22.01444443	0	0	0.125796825	33.31028495	0	0	0	0	0	0	0	0											38.6792	4.028729981	5.497594892	0	0.879897841	1.444509772	0.202904254	0.825995069	5.485283961	1.454585517	6.96728317	0	0.026580523	4.097435243	6.951831368	10.59785493	1.802372782	0.380587506	0	0	2.054399686	2.207299829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5843	0	42.4657	38.6792	4.028729981	5.497594892	0	0.879897841	1.444509772	0.202904254	0.825995069	5.485283961	1.454585517	6.96728317	0	0.026580523	4.097435243	6.951831368	10.59785493	1.802372782	0.380587506	0	0	2.054399686	2.207299829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5843		"$455 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 25% (13c)"	"$455 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"25% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	25%/$7 (8a1); $7 (8a2)	"$20 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 25% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 25% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											5.2088	0.5362	3.5775	0.3336	0.2863	0.705	0.2604	0.2688	1.7847	0.4733	2.4295	0	0.0086	1.3344	3.1835	4.5419	0.8754	0.1592	0	0	1.2891	0.9579	0	0	0	0	0	0	0	0											28.2143	0	11.82173749	43.888	4.564974963	9.075081216	0.333642678	1.166188715	2.149506328	0.463311678	1.094747689	7.270021537	1.927861549	9.396797502	0	0.035228982	5.431869943	10.13530326	15.13979276	2.677810991	0.539798938	0	0	3.343527328	3.165153383	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.7986
H5749_803_0	2009	2																					4800											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	4800	1641.235963	168.9267102	699.2348024	741.5226469	111.9135194	11.48287938	4.241477514	318.2480412	34.88344924	9911.121229	40.59589424	0	0.211297245	26.39520591	4649.444747	3655.954696	576.7592903	207.4569761	0	0	16.33109326	795.1777652	0	0	0	0	0	0	0	0											"$455 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$455 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 25% (9a); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											449.5844612	455	150	0	150	0.2	0.076056143	49.51688041	0.25	2.8	0.272861124	0	0.2	0.246264364	17.94235246	34.78551289	37.5	35	0	0	0.2	33.31028495	0	0	0	0	0	0	0	0											282.8051678	286.1877775	94.34761897	0	94.34761897	0.125796825	0.047838107	31.14533177	0.157246032	1.761155554	0.171625316	0	0.125796825	0.15523407	17.94235246	34.78551289	37.5	22.01444443	0	0	0.125796825	33.31028495	0	0	0	0	0	0	0	0											38.6792	4.028729981	5.497594892	0	0.879897841	1.444509772	0.202904254	0.825995069	5.485283961	1.454585517	6.96728317	0	0.026580523	4.097435243	6.951831368	10.59785493	1.802372782	0.380587506	0	0	2.054399686	2.207299829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5843	0	42.4657	38.6792	4.028729981	5.497594892	0	0.879897841	1.444509772	0.202904254	0.825995069	5.485283961	1.454585517	6.96728317	0	0.026580523	4.097435243	6.951831368	10.59785493	1.802372782	0.380587506	0	0	2.054399686	2.207299829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5843		"$455 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 25% (13c)"	"$455 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"25% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	25%/$7 (8a1); $7 (8a2)	"$20 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 25% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 25% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											5.2088	0.5362	3.5775	0.3336	0.2863	0.705	0.2604	0.2688	1.7847	0.4733	2.4295	0	0.0086	1.3344	3.1835	4.5419	0.8754	0.1592	0	0	1.2891	0.9579	0	0	0	0	0	0	0	0											28.2143	0	11.82173749	43.888	4.564974963	9.075081216	0.333642678	1.166188715	2.149506328	0.463311678	1.094747689	7.270021537	1.927861549	9.396797502	0	0.035228982	5.431869943	10.13530326	15.13979276	2.677810991	0.539798938	0	0	3.343527328	3.165153383	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.7986
H5749_804_0	2009	2																					4800											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	4800	1641.235963	168.9267102	699.2348024	741.5226469	111.9135194	11.48287938	4.241477514	318.2480412	34.88344924	9911.121229	40.59589424	0	0.211297245	26.39520591	4649.444747	3655.954696	576.7592903	207.4569761	0	0	16.33109326	795.1777652	0	0	0	0	0	0	0	0											"$455 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$455 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 25% (9a); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											449.5844612	455	150	0	150	0.2	0.076056143	49.51688041	0.25	2.8	0.272861124	0	0.2	0.246264364	17.94235246	34.78551289	37.5	35	0	0	0.2	33.31028495	0	0	0	0	0	0	0	0											282.8051678	286.1877775	94.34761897	0	94.34761897	0.125796825	0.047838107	31.14533177	0.157246032	1.761155554	0.171625316	0	0.125796825	0.15523407	17.94235246	34.78551289	37.5	22.01444443	0	0	0.125796825	33.31028495	0	0	0	0	0	0	0	0											38.6792	4.028729981	5.497594892	0	0.879897841	1.444509772	0.202904254	0.825995069	5.485283961	1.454585517	6.96728317	0	0.026580523	4.097435243	6.951831368	10.59785493	1.802372782	0.380587506	0	0	2.054399686	2.207299829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5843	0	42.4657	38.6792	4.028729981	5.497594892	0	0.879897841	1.444509772	0.202904254	0.825995069	5.485283961	1.454585517	6.96728317	0	0.026580523	4.097435243	6.951831368	10.59785493	1.802372782	0.380587506	0	0	2.054399686	2.207299829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.5843		"$455 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 25% (13c)"	"$455 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-32 (2a, 2a2); $0 n/c (2a1)"	"25% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	25%/$7 (8a1); $7 (8a2)	"$20 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 25% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 25% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											5.2088	0.5362	3.5775	0.3336	0.2863	0.705	0.2604	0.2688	1.7847	0.4733	2.4295	0	0.0086	1.3344	3.1835	4.5419	0.8754	0.1592	0	0	1.2891	0.9579	0	0	0	0	0	0	0	0											28.2143	0	11.82173749	43.888	4.564974963	9.075081216	0.333642678	1.166188715	2.149506328	0.463311678	1.094747689	7.270021537	1.927861549	9.396797502	0	0.035228982	5.431869943	10.13530326	15.13979276	2.677810991	0.539798938	0	0	3.343527328	3.165153383	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.7986
H5750_001_0	2009	6																					1750											A	A	A		T	Coin	Coin	V	V	V	V			V		V	V							V	V		V																																																						0	1750	214.5470808	11.35481999	38.84879939		131.6097112	21.54029729	1.237651531	245.378392	168.7602129	280.8638911	486.1849485			182.9435911		6243.755558	443.0664897							1000	508.5116581		253.7834892														$250 per admit	$250 per admit	$250 per admit		$50 per trip	20% coinsurance	20% coinsurance	$50 per ER visit	$50 per OP surgical visit	$10 per lab visit	$50 per radiology visit			$25 per visit		$10 per visit	$10 per visit							$10 per visit	$10 per visit		$10 per visit														250	250	250		50	0.2	0.2	50	50	10	50			25		10	10							10	10		10														238.6475872	238.6475872	238.6475872		47.72951744	0.19091807	0.19091807	47.72951744	47.72951744	9.545903489	47.72951744			23.86475872		9.545903489	9.545903489							9.545903489	9.545903489		9.545903489														4.2668	0.2258167	0.772597687	0	0.523472334	4.112431981	0.236290041	0.975982687	0.67123696	0.223424967	1.933781082	0	0	0.363825389	0	4.96685733	0.352455829	0	0	0	0	0	0	0.795491957	0.404516934	0	0.201882725	0	0	0	0	0	0	0	0	0	0	0	0	0	21.0268		1.0002	4.2668	0.2258167	0.772597687	0	0.523472334	4.112431981	0.236290041	0.975982687	0.67123696	0.223424967	1.933781082	0	0	0.363825389	0	4.96685733	0.352455829	0	0	0	0	0	0	0.795491957	0.404516934	0	0.201882725	0	0	0	0	0	0	0	0	0	0	0	0	0	21.0268	1750																																																																																	0		0.01	4.2668	0.2258167	0.772597687	0	0.523472334	4.112431981	0.236290041	0.975982687	0.67123696	0.223424967	1.933781082	0	0	0.363825389	0	4.96685733	0.352455829	0	0	0	0	0	0	0.795491957	0.404516934	0	0.201882725	0	0	0	0	0	0	0	0	0	0	0	0	0	21.0268
H5750_002_0	2009	3																					1900											A	A	A		T	Coin	Coin	V	V	V	V			V		V	V								V		V																																																						0	1900	215.5557273	11.50955847	38.84879939		132.445677	21.80566015	1.163611517	245.370864	169.144896	278.0544516	487.0974871			173.3111492		6125.600801	435.5885588								514.4838773		256.6129653														$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	$10 per lab visit	$15 per radiology visit			$15 per visit		$10 per visit	$10 per visit								$10 per visit		$10 per visit														100	100	100		50	0.2	0.2	50	50	10	15			15		10	10								10		10														99.40760529	99.40760529	99.40760529		49.70380265	0.198815211	0.198815211	49.70380265	49.70380265	9.940760529	14.91114079			14.91114079		9.940760529	9.940760529								9.940760529		9.940760529														1.7857	0.095344804	0.321822176	0	0.548587816	4.335296914	0.231343669	1.016322083	0.700595378	0.230339393	0.605264934	0	0	0.215355579	0	5.074427555	0.360840129	0	0	0	0	0	0	0	0.426196752	0	0.212577336	0	0	0	0	0	0	0	0	0	0	0	0	0	16.16		0.0963	1.7857	0.095344804	0.321822176	0	0.548587816	4.335296914	0.231343669	1.016322083	0.700595378	0.230339393	0.605264934	0	0	0.215355579	0	5.074427555	0.360840129	0	0	0	0	0	0	0	0.426196752	0	0.212577336	0	0	0	0	0	0	0	0	0	0	0	0	0	16.16	1900																																																																																	0		0.01	1.7857	0.095344804	0.321822176	0	0.548587816	4.335296914	0.231343669	1.016322083	0.700595378	0.230339393	0.605264934	0	0	0.215355579	0	5.074427555	0.360840129	0	0	0	0	0	0	0	0.426196752	0	0.212577336	0	0	0	0	0	0	0	0	0	0	0	0	0	16.16
H5750_003_0	2009	6																					1750											A	A	A		T	Coin	Coin	V	V	V	V			V		V	V							V	V		V																																																						0	1750	212.0840748	14.27641418	38.62130537		144.4646716	21.85043786	5.076819872	254.7434806	162.7015262	291.4172116	473.9934705			214.0271735		6651.464098	462.6887927							1000	440.0423348		218.0074433														$250 per admit	$250 per admit	$250 per admit		$50 per trip	20% coinsurance	20% coinsurance	$50 per ER visit	$100 per OP surgical visit	$25 per lab visit	$50 per radiology visit			$50 per visit		$25 per office visit	$25 per office visit							$25 per visit	$25 per visit		$25 per visit														250	250	250		50	0.2	0.2	50	100	25	50			50		25	25							25	25		25														228.3333953	228.3333953	228.3333953		45.66667905	0.182666716	0.182666716	45.66667905	91.3333581	22.83333953	45.66667905			45.66667905		22.83333953	22.83333953							22.83333953	22.83333953		22.83333953														4.0355	0.27164851	0.734877815	0	0.549768483	3.991347731	0.927366015	0.969440731	1.23833973	0.554502345	1.803808974	0	0	0.81449252	0	12.65626151	0.880394192	0	0	0	0	0	0	1.902778294	0.837303003	0	0.414819831	0	0	0	0	0	0	0	0	0	0	0	0	0	32.5826		3.0918	4.0355	0.27164851	0.734877815	0	0.549768483	3.991347731	0.927366015	0.969440731	1.23833973	0.554502345	1.803808974	0	0	0.81449252	0	12.65626151	0.880394192	0	0	0	0	0	0	1.902778294	0.837303003	0	0.414819831	0	0	0	0	0	0	0	0	0	0	0	0	0	32.5826	1750																																																																																	0		0.01	4.0355	0.27164851	0.734877815	0	0.549768483	3.991347731	0.927366015	0.969440731	1.23833973	0.554502345	1.803808974	0	0	0.81449252	0	12.65626151	0.880394192	0	0	0	0	0	0	1.902778294	0.837303003	0	0.414819831	0	0	0	0	0	0	0	0	0	0	0	0	0	32.5826
H5750_004_0	2009	5																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin		Coin	Coin		Coin	Coin	Coin	Coin																																																											0		725.5063504	34.78661932	114.0735157		31.52713187	46.82195113	4.927463197	26.06699458	60.72161152	42.15549337	47.05046211			131.5732432		290.8492916	6.533635333		33.30037215	15.23470957	15.75192829	0.774515448																			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																			0.0769	0.0769	0.1344		0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231		0.231	0.231		0.231	0.231	0.231	0.231																			0.0769	0.0769	0.1344		0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231		0.231	0.231		0.231	0.231	0.231	0.231																			55.7914	2.675091025	15.33148051	0	7.282767461	10.81587071	1.138243998	6.021475748	14.02669226	9.737918969	10.86865675	0	0	30.39341919	0	67.18618636	1.509269762	0	7.692385966	3.51921791	3.638695435	0.178913069	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	247.8077			55.7914	2.675091025	15.33148051	0	7.282767461	10.81587071	1.138243998	6.021475748	14.02669226	9.737918969	10.86865675	0	0	30.39341919	0	67.18618636	1.509269762	0	7.692385966	3.51921791	3.638695435	0.178913069	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	247.8077																																																																																		0			55.7914	2.675091025	15.33148051	0	7.282767461	10.81587071	1.138243998	6.021475748	14.02669226	9.737918969	10.86865675	0	0	30.39341919	0	67.18618636	1.509269762	0	7.692385966	3.51921791	3.638695435	0.178913069	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	247.8077
H5754_001_0	2009	4																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1433.223273	36.40172557	3023.38307	3433.888196	329.9136151	14.37979135	6.944262012	348.9814403	434.4424214	6503.448189	932.1916373	0	13.35177428	1502.782488	8726.840228	6128.468819	265.1197313	691.1315572	0	0	1273.805012	1664.828954	2157.653669	569.3115495	183.8736699	162.670831	40.22603176	20.20646452	664.2536102	136.2430098											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b); $0 n/c (7b1); $0/$20 (7d); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0.2	0.2	49.97134518	50	8	10.45041131	0	0	47.5701854	1.350412105	9.626994834	20	0	0	0	0	13.54834332	0	20	20	0	20	0	0	20											0	0	0	0	0	0.167124048	0.167124048	41.75706743	41.78101198	6.684961917	8.732575204	0	0	39.75060972	1.128431686	8.04451173	16.71240479	0	0	0	0	13.53800628	0	20	20	0	20	0	0	20											0	0	0	0	0	2.403208938	1.160553177	1.214370128	1.512620334	3.622941956	0.678369465	0	0	4.978043346	0.82063692	4.108378275	0.369232356	0	0	0	0	1.878205403	0	0.948852583	0.306456117	0	0.067043386	0	0	0.227071683	0	0	0	0	0	0	0	0	0	0	24.296	0	4.1066	0	0	0	0	0	2.403208938	1.160553177	1.214370128	1.512620334	3.622941956	0.678369465	0	0	4.978043346	0.82063692	4.108378275	0.369232356	0	0	0	0	1.878205403	0	0.948852583	0.306456117	0	0.067043386	0	0	0.227071683	0	0	0	0	0	0	0	0	0	0	24.296		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.2316	0.018	0.5748	0.2685	0.0898	0.088	0.0425	0.0297	0.3482	0.0836	0.2074	0	0	0.2857	0.3563	1.0032	0.0159	0.034	0	0	0.1476	0.0747	0	0	0.004	0.0047	0.0013	0.0012	0	0											4.9107	0	0	1.2316	0.017952023	0.574789732	0.26850396	0.089840224	2.491248477	1.203069067	1.244028414	1.860832779	3.706523464	0.885799192	0	0	5.2637698	1.176951067	5.111557384	0.38513456	0.033985542	0	0	0.147560933	1.95294998	0	0.948852583	0.310455154	0.004710473	0.06832079	0.001157895	0	0.227071683	0	0	0	0	0	0	0	0	0	0	29.2067
H5754_002_0	2009	3																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1437.959116	36.52200888	3033.373325	3445.234896	331.0037586	14.47497951	6.9902301	350.1345902	435.8779625	6524.937728	935.2719061	0	13.39589294	1507.748177	8755.676588	6148.719303	265.9957744	693.4152839	0	0	1278.014084	1670.330099	2164.783269	569.3115495	184.4812492	163.2083491	40.35895185	20.27323335	666.4485234	136.6932016											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b); $0 n/c (7b1); $0/$20 (7d); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0.2	0.2	49.97134518	50	8	10.45041131	0	0	47.57019265	1.350412105	9.626994834	20	0	0	0	0	13.54834332	0	20	20	0	20	0	0	20											0	0	0	0	0	0.167013799	0.167013799	41.72952098	41.75344973	6.680551957	8.726814467	0	0	39.72439295	1.127687278	8.039204897	16.70137989	0	0	0	0	13.53797161	0	20	20	0	20	0	0	20											0	0	0	0	0	2.417521317	1.167464884	1.21757906	1.516617383	3.632515459	0.680162033	0	0	4.99119842	0.822805425	4.119234527	0.37020804	0	0	0	0	1.884406788	0	0.948852583	0.307468749	0	0.06726492	0	0	0.227822003	0	0	0	0	0	0	0	0	0	0	24.3711	0	4.1363	0	0	0	0	0	2.417521317	1.167464884	1.21757906	1.516617383	3.632515459	0.680162033	0	0	4.99119842	0.822805425	4.119234527	0.37020804	0	0	0	0	1.884406788	0	0.948852583	0.307468749	0	0.06726492	0	0	0.227822003	0	0	0	0	0	0	0	0	0	0	24.3711		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.2398	0.0181	0.5786	0.2703	0.0904	0.0886	0.0428	0.0298	0.3505	0.0841	0.2088	0	0	0.2876	0.3587	1.0098	0.016	0.0342	0	0	0.1485	0.0752	0	0	0.004	0.0047	0.0013	0.0012	0	0											4.9431	0	0	1.2398	0.018070858	0.578594598	0.270281343	0.090434928	2.50614364	1.210262212	1.247335347	1.867134847	3.716650242	0.888964858	0	0	5.278816263	1.181478223	5.12905426	0.38621551	0.034210512	0	0	0.148537724	1.959646143	0	0.948852583	0.311494258	0.004741655	0.06855078	0.00116556	0	0.227822003	0	0	0	0	0	0	0	0	0	0	29.3142
H5754_003_0	2009	6																					500											D	D	D	V	T	P	P	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1250.184752	89.62522795	7758.921121	172.4652136	489.4160626	685.8946784	1705.87027	181.9805357	93.96380602	13473.12975	1412.005837	0	3.568245798	424.9926933	143.9184874	3486.777931	2299.909382	5.973305757	0	0	998.9412073	1151.541351	1576.881712	0	182.0000636	141.3063859	46.85749586	13.66333203	0	0											"$25 Days 1-20 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$25 Days 1-20 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$50 (10a)	$0 (11a)	"$0 (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	$0 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$0 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a9, 14a10); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											24.67787901	25	0	0	50	0	0	49.3557423	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											21.82523946	22.11012487	0	0	44.22024974	0	0	43.65046501	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											2.2738	0.165135415	0	0	1.803508376	0	0	0.661961251	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.9044	0	0.641	2.2738	0.165135415	0	0	1.803508376	0	0	0.661961251	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.9044		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.081	0.2872	0.8804	0.0816	0.427	0.2984	0.2239	0.0394	0.0948	0.6357	0.4143	0	0	0.1319	0.014	1.744	0.5942	0.0019	0	0	0.1368	0.1364	0	0	0.0089	0.0093	0.004	0.0054	0	0											8.2503	0	0	4.3548	0.452321167	0.88039082	0.081596273	2.230511168	0.29841954	0.223873003	0.701355042	0.094768754	0.635749463	0.414268596	0	0	0.131936967	0.013966637	1.743951771	0.594151621	0.001926457	0	0	0.136781752	0.136353279	0	0	0.008933819	0.009296473	0.003969466	0.005393421	0	0	0	0	0	0	0	0	0	0	0	0	13.1547
H5754_004_0	2009	3																					1500											D	D	D	V	T	P	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2894.364777	62.60578918	2658.461169	88678.25667	160.4954744	3252.25481	17.60289384	458.5338241	440.7047531	8516.580365	554.8627007	0	12.44726907	1697.664477	7769.824089	6332.916689	252.7068279	290.2531266	0	0	1895.142461	1697.949245	1418.390092	569.3115495	205.2567597	154.1150788	37.56409609	10.74492219	932.1	115.5175384											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	$0 (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b); $0 n/c (7b1); $0/$20 (7d); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0	0.2	49.97819136	50	3.2	16.87836848	0	0	45.70445279	1.38602723	9.278259951	20	0	0	0	0	0.001602202	0	20	0	0	20	0	0	20											0	0	0	0	0	0	0.165142723	41.26767311	41.2856808	2.642283571	13.93669867	0	0	37.73878898	1.144461556	7.661185575	16.51427232	0	0	0	0	0.00132296	0	20	0	0	20	0	0	20											0	0	0	0	0	0	2.906989826	1.57688533	1.51623298	1.875268365	0.644412855	0	0	5.338983456	0.741022081	4.043137498	0.347772448	0	0	0	0	0.000187193	0	0.948852583	0	0	0.062606827	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	20.1949	0	4.0085	0	0	0	0	0	0	2.906989826	1.57688533	1.51623298	1.875268365	0.644412855	0	0	5.338983456	0.741022081	4.043137498	0.347772448	0	0	0	0	0.000187193	0	0.948852583	0	0	0.062606827	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	20.1949		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a3); $0 (6a2)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.622	0.0289	0.6333	0.4062	0.1014	0.1671	0.1078	0.039	0.4914	0.0905	0.2042	0	0	0.3965	0.4041	1.2052	0.0144	0.0354	0	0	0.2213	0.0802	0	0	0.0039	0.0039	0.0009	0.0004	0	0											7.258	0	0	2.622	0.028916371	0.633256721	0.406235014	0.101391381	0.167057751	3.014762645	1.615859295	2.007662637	1.96574108	0.8485662	0	0	5.735460374	1.145094729	5.248318611	0.362218665	0.035435479	0	0	0.221299624	0.080410067	0	0.948852583	0.003911416	0.003931507	0.063548589	0.000438568	0	0.192529231	0	0	0	0	0	0	0	0	0	0	27.4529
H5760_001_0	2009	1																																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	P	P																																																			0									349.4662577																																								$25 ER IN/$0 ER Outside US/$25 Urgent Care IN/$0 Urgent Care Outside US																																								25																																								25																																	0	0	0	0	0	0	0	0.728054704	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7281	0	0	0	0	0	0	0	0	0	0.728054704	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7281		20% Coins	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$25 ER OON/$25 ER Outside US/$25 Urgent Care OON/$0 Urgent Care Outside US	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	20% Coins	20% Coins	20% Coins	20% Coins											2.9662	0.0502	0.0682	0.4533		0.7107	0.3264		0.4428	1.0989	0.1227	0.0219		0.1449	1.3216	2.1425	0.0876	0.173			0.4681	0.1427		0.247	0.0156	0.026	0.0376		0.0208	0.0196											11.1081	0	0	2.9662	0.050152731	0.068169738	0.453312418	0	0.710734308	0.326444578	0.728054704	0.44277659	1.098852048	0.122656244	0.021879111	0	0.144856115	1.321635412	2.142475113	0.087550987	0.172963325	0	0	0.468097264	0.14270881	0	0.247	0.0156	0.026	0.03761503	0	0.0208	0.01963849	0	0	0	0	0	0	0	0	0	0	11.8361
H5760_003_0	2009	10																																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	P	P																																																			0									468.7021565																																								$25 ER IN/$0 ER Outside US/$25 Urgent Care IN/$0 Urgent Care Outside US																																								25																																								25																																	0	0	0	0	0	0	0	0.976462826	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.9765	0	0	0	0	0	0	0	0	0	0.976462826	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.9765		20% Coins	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$25 ER OON/$0 ER Outside US/$25 Urgent Care OON/$0 Urgent Care Outside US	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	20% Coins	20% Coins	20% Coins	20% Coins											0.9823	0.0149	0.0202	0.9803		1.2081	0.7612	0.2717	0.147	0.6927	0.0363	0.1739		0.0453	1.9586	2.089	0.0658	0.108			1.0312	0.1309	0.0098	0.247	0.0156	0.052	0.0376		0.0078	0.0326											11.1199	0	0	0.9823	0.014862413	0.020201628	0.980330761	0	1.208146682	0.761169379	1.248144568	0.146976736	0.692741117	0.036348325	0.173947898	0	0.04529343	1.958639453	2.089009627	0.065780458	0.108003784	0	0	1.031209033	0.130854122	0.00975	0.247	0.0156	0.052	0.03761503	0	0.0078	0.03263849	0	0	0	0	0	0	0	0	0	0	12.0963
H5760_004_0	2009	8																																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	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		20% Coins	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$25 ER IN/$0 ER Outside US/$25 Urgent Care IN/$0 Urgent Care Outside US	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	20% Coins	20% Coins	20% Coins	20% Coins											1.3738	0.0135	0.0096	2.2172		1.9874	1.3184	0.9534	0.1673	0.699	0.0378	0.1293		0.0575	4.0085	2.0516	0.2192	0.3307			1.0791	0.2075	0.0025	0.19	0.012	0.04	0.0289	0.0056	0.016	0.0151											17.1707	0	0	1.3738	0.013462626	0.009595025	2.217159608	0	1.987421985	1.318393491	0.953385626	0.167261418	0.699009552	0.037755398	0.129274762	0	0.057516183	4.008474657	2.051579585	0.219222259	0.330674404	0	0	1.079063308	0.207472818	0.0025	0.19	0.012	0.04	0.028934638	0.00561	0.016	0.015106531	0	0	0	0	0	0	0	0	0	0	17.1707
H5760_007_0	2009	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	P	P																																																			0									349.4662577																																								$25 ER IN/$0 ER Outside US/$25 Urgent Care IN/$0 Urgent Care Outside US																																								25																																								25																																	0	0	0	0	0	0	0	0.728054704	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7281	0	0	0	0	0	0	0	0	0	0.728054704	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7281		20% Coins	20% Coins	20% Coins	20% Coins		20% Coins	20% Coins	$25 ER OON/$0 ER Outside US/$25 Urgent Care OON/$0 Urgent Care Outside US	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	20% Coins	20% Coins	20% Coins	20% Coins											2.9662	0.0502	0.0682	0.4533		0.7107	0.3264		0.4428	1.0989	0.1227	0.0219		0.1449	1.3216	2.1425	0.0876	0.173			0.4681	0.1427	0.0813	0.2964	0.0156	0.078	0.0376	0.0122	0.0208	0.0196											11.3029	0	0	2.9662	0.050152731	0.068169738	0.453312418	0	0.710734308	0.326444578	0.728054704	0.44277659	1.098852048	0.122656244	0.021879111	0	0.144856115	1.321635412	2.142475113	0.087550987	0.172963325	0	0	0.468097264	0.14270881	0.08125	0.2964	0.0156	0.078	0.03761503	0.012155	0.0208	0.01963849	0	0	0	0	0	0	0	0	0	0	12.0309
H5760_802_0	2009	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	P	P																																																			0		207.7590015	5.953514954	8.038747818		111.1160688	3684.824435	717.6086072	349.4662577	983.2444767	17416.13375	594.8096928	69.51958976	23.11794264	875.6684984	9356.240256	13872.17874	507.7312313	1818.140918			1376.563558	1090.603169																			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																			791.6366612	471.8668464	586.3162871		95.94385349	19.22386863	45.33902028	46.64359139	45.61068761	6.390628295	20.93096841	31.87615746	65.45210697	16.75485183	14.54048611	15.64143954	17.48895664	9.640033473			33.89144965	13.25553399																			791.6366612	471.8668464	586.3162871		95.94385349	19.22386863	45.33902028	46.64359139	45.61068761	6.390628295	20.93096841	31.87615746	65.45210697	16.75485183	14.54048611	15.64143954	17.48895664	9.640033473			33.89144965	13.25553399																			13.7058	0.234105527	0.392770731	0	0.888408652	5.903048404	2.711305933	1.358363444	3.737204722	9.275003092	1.037495241	0.184668116	0.126093171	1.222641328	11.33702345	18.08173708	0.739974124	1.460578276	0	0	3.88781121	1.204710615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.4887	0	0	13.7058	0.234105527	0.392770731	0	0.888408652	5.903048404	2.711305933	1.358363444	3.737204722	9.275003092	1.037495241	0.184668116	0.126093171	1.222641328	11.33702345	18.08173708	0.739974124	1.460578276	0	0	3.88781121	1.204710615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.4887																																																																																		0	0	0	13.7058	0.234105527	0.392770731	0	0.888408652	5.903048404	2.711305933	1.358363444	3.737204722	9.275003092	1.037495241	0.184668116	0.126093171	1.222641328	11.33702345	18.08173708	0.739974124	1.460578276	0	0	3.88781121	1.204710615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.4887
H5760_803_0	2009	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	P	P																																																			0		207.7590015	5.953514954	8.038747818		111.1160688	3684.824435	717.6086072	349.4662577	983.2444767	17416.13375	594.8096928	69.51958976	23.11794264	875.6684984	9356.240256	13872.17874	507.7312313	1818.140918			1376.563558	1090.603169																			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																			791.6366612	471.8668464	586.3162871		95.94385349	19.22386863	45.33902028	46.64359139	45.61068761	6.390628295	20.93096841	31.87615746	65.45210697	16.75485183	14.54048611	15.64143954	17.48895664	9.640033473			33.89144965	13.25553399																			791.6366612	471.8668464	586.3162871		95.94385349	19.22386863	45.33902028	46.64359139	45.61068761	6.390628295	20.93096841	31.87615746	65.45210697	16.75485183	14.54048611	15.64143954	17.48895664	9.640033473			33.89144965	13.25553399																			13.7058	0.234105527	0.392770731	0	0.888408652	5.903048404	2.711305933	1.358363444	3.737204722	9.275003092	1.037495241	0.184668116	0.126093171	1.222641328	11.33702345	18.08173708	0.739974124	1.460578276	0	0	3.88781121	1.204710615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.4887	0	0	13.7058	0.234105527	0.392770731	0	0.888408652	5.903048404	2.711305933	1.358363444	3.737204722	9.275003092	1.037495241	0.184668116	0.126093171	1.222641328	11.33702345	18.08173708	0.739974124	1.460578276	0	0	3.88781121	1.204710615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.4887																																																																																		0	0	0	13.7058	0.234105527	0.392770731	0	0.888408652	5.903048404	2.711305933	1.358363444	3.737204722	9.275003092	1.037495241	0.184668116	0.126093171	1.222641328	11.33702345	18.08173708	0.739974124	1.460578276	0	0	3.88781121	1.204710615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.4887
H5774_003_0	2009	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	V	V	P	V	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	N/A	0	0	0	0	0	0	0	497.8720113	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.84299871											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 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 14a	"PBP 13b, 13c, 13d"											0	0	0	0	0	0	0	22.47759375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5											0	0	0	0	0	0	0	22.47759375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5											0	0	0	0	0	0	0	0.932580401	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.032017916	0	0	0	0	0	0	0	0	0	0	0.9646	0	0	0	0	0	0	0	0	0	0.932580401	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.032017916	0	0	0	0	0	0	0	0	0	0	0.9646	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 14a	"PBP 13b, 13c, 13d"											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0.932580401	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.032017916	0	0	0	0	0	0	0	0	0	0	0.9646
H5774_005_0	2009	9																					None											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	V	V	P	V	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	N/A	0	0	0	0	0	0	105.3694962	497.8720113	0	0	0	0	0	0	0	7324.127847	44.69678587	0	0	0	0	0	0	416.9188861	280.5489302	0	56.3659951	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 14a	"PBP 13b, 13c, 13d"											0	0	0	0	0	0	73.98751901	22.47759375	0	0	0	0	0	0	0	5.079225103	10	0	0	0	0	0	0	10	5	0	5	0	0	0											0	0	0	0	0	0	73.98751901	22.47759375	0	0	0	0	0	0	0	5.079225103	10	0	0	0	0	0	0	10	5	0	5	0	0	0											0	0	0	0	0	0	0.649668967	0.932580401	0	0	0	0	0	0	0	3.100074502	0.037247322	0	0	0	0	0	0	0.347432405	0.116895388	0	0.023485831	0	0	0	0	0	0	0	0	0	0	0	0	0	5.2074	0	0	0	0	0	0	0	0	0.649668967	0.932580401	0	0	0	0	0	0	0	3.100074502	0.037247322	0	0	0	0	0	0	0.347432405	0.116895388	0	0.023485831	0	0	0	0	0	0	0	0	0	0	0	0	0	5.2074	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 14a	"PBP 13b, 13c, 13d"											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0.649668967	0.932580401	0	0	0	0	0	0	0	3.100074502	0.037247322	0	0	0	0	0	0	0.347432405	0.116895388	0	0.023485831	0	0	0	0	0	0	0	0	0	0	0	0	0	5.2074
H5774_006_0	2009	9																					None											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	V	V	P	V	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	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	82.76611961	0	0	0	0	0	76.84299871											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 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 14a	"PBP 13b, 13c, 13d"											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25	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	0	25	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	0	0.172429416	0	0	0	0	0	0.032017916	0	0	0	0	0	0	0	0	0	0	0.2044	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.172429416	0	0	0	0	0	0.032017916	0	0	0	0	0	0	0	0	0	0	0.2044	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 14a	"PBP 13b, 13c, 13d"											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.172429416	0	0	0	0	0	0.032017916	0	0	0	0	0	0	0	0	0	0	0.2044
H5774_008_0	2009	8																					None											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	V	V	P	V	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	N/A	0	0	0	0	0	0	0	498.3083865	0	0	0	0	0	0	0	6751.50217	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 14a	"PBP 13b, 13c, 13d"											0	0	0	0	0	0	0	22.47759375	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	22.47759375	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	0.93339779	0	0	0	0	0	0	0	5.626251808	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5596	0	0	0	0	0	0	0	0	0	0.93339779	0	0	0	0	0	0	0	5.626251808	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5596	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 14a	"PBP 13b, 13c, 13d"											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0.93339779	0	0	0	0	0	0	0	5.626251808	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.5596
H5774_009_0	2009	9																					None											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	V	V	P	V	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	N/A	0	0	0	0	3245.306671	0	0	543.2353328	0	0	0	0	0	0	0	0	53.01011713	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 14a	"PBP 13b, 13c, 13d"											0	0	0	0	21.01406718	0	0	22.47759375	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	21.01406718	0	0	22.47759375	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	5.683091033	0	0	1.017551927	0	0	0	0	0	0	0	0	0.044175098	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.7448	0	0	0	0	0	0	5.683091033	0	0	1.017551927	0	0	0	0	0	0	0	0	0.044175098	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.7448	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 14a	"PBP 13b, 13c, 13d"											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	5.683091033	0	0	1.017551927	0	0	0	0	0	0	0	0	0.044175098	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.7448
H5774_014_0	2009	9																					None											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	V	V	P	V	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	N/A	0	0	0	0	0	0	0	495.3801433	0	0	0	0	0	0	0	0	48.34030086	0	0	0	0	0	0	0	0	0	0	0	0	76.45839664											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 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 14a	"PBP 13b, 13c, 13d"											0	0	0	0	0	0	0	22.47759375	0	0	0	0	0	0	0	0	10	0	0	0	0	0	0	0	0	0	0	0	0	5											0	0	0	0	0	0	0	22.47759375	0	0	0	0	0	0	0	0	10	0	0	0	0	0	0	0	0	0	0	0	0	5											0	0	0	0	0	0	0	0.927912801	0	0	0	0	0	0	0	0	0.040283584	0	0	0	0	0	0	0	0	0	0	0	0	0.031857665	0	0	0	0	0	0	0	0	0	0	1.0001	0	0	0	0	0	0	0	0	0	0.927912801	0	0	0	0	0	0	0	0	0.040283584	0	0	0	0	0	0	0	0	0	0	0	0	0.031857665	0	0	0	0	0	0	0	0	0	0	1.0001	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 14a	"PBP 13b, 13c, 13d"											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0.927912801	0	0	0	0	0	0	0	0	0.040283584	0	0	0	0	0	0	0	0	0	0	0	0	0.031857665	0	0	0	0	0	0	0	0	0	0	1.0001
H5774_016_0	2009	10																					None											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	V	V	P	V	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	N/A	2958.51101	0.484938207	3.398196556	0	4904.637909	117444.5608	122.5991861	785.0173214	126.8535832	1218.938161	1467.028417	0	1475.868656	2296.569748	10206.36132	12320.86554	56.42248929	7631.29227	4677.444441	54567.77565	21760.92402	154214.093	0	1808.75114	334.6393537	0	61.92262353	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 14a	"PBP 13b, 13c, 13d"											111.7612937	80.90176544	87.51769661	0	3.41192021	0.971088218	82.8068125	39.5253455	254.2302284	4.821564732	23.29917376	0	20.87433635	24.20267801	21.17557521	13.78396312	419.5000324	4.77657836	15.92414859	3.964309187	1.598975226	0.46089666	0	7	1	0	1	0	0	0											111.7612937	80.90176544	87.51769661	0	3.41192021	0.971088218	82.8068125	39.5253455	254.2302284	4.821564732	23.29917376	0	20.87433635	24.20267801	21.17557521	13.78396312	419.5000324	4.77657836	15.92414859	3.964309187	1.598975226	0.46089666	0	7	1	0	1	0	0	0											27.5539	0.003269363	0.024783528	0	1.394519434	9.504085776	0.846003985	2.585673405	2.687501287	0.489765771	2.848379166	0	2.567314894	4.63192818	18.01046431	14.15252968	1.97243634	3.037622127	6.207026691	18.02696119	2.8995982	5.923063369	0	1.055104831	0.027886613	0	0.005160219	0	0	0	0	0	0	0	0	0	0	0	0	0	126.455	0	0	27.5539	0.003269363	0.024783528	0	1.394519434	9.504085776	0.846003985	2.585673405	2.687501287	0.489765771	2.848379166	0	2.567314894	4.63192818	18.01046431	14.15252968	1.97243634	3.037622127	6.207026691	18.02696119	2.8995982	5.923063369	0	1.055104831	0.027886613	0	0.005160219	0	0	0	0	0	0	0	0	0	0	0	0	0	126.455	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 14a	"PBP 13b, 13c, 13d"											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	27.5539	0.003269363	0.024783528	0	1.394519434	9.504085776	0.846003985	2.585673405	2.687501287	0.489765771	2.848379166	0	2.567314894	4.63192818	18.01046431	14.15252968	1.97243634	3.037622127	6.207026691	18.02696119	2.8995982	5.923063369	0	1.055104831	0.027886613	0	0.005160219	0	0	0	0	0	0	0	0	0	0	0	0	0	126.455
H5774_017_0	2009	6																					None											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	V	V	P	V	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	N/A	390.7267509	0	0	0	2989.355189	0	105.9026867	500.3913423	0	0	0	0	0	1317.808853	8214.067818	6973.593849	44.92296046	1879.432179	0	0	0	0	0	1079.973159	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 14a	"PBP 13c, 13d"											200	0	0	0	21.83719631	0	55.58439221	22.47759375	0	0	0	0	0	10	5	14.88925102	10	10	0	0	0	0	0	15	0	0	0	0	0	0											200	0	0	0	21.83719631	0	55.58439221	22.47759375	0	0	0	0	0	10	5	14.88925102	10	10	0	0	0	0	0	15	0	0	0	0	0	0											6.5121	0	0	0	5.439928008	0	0.490544706	0.937299442	0	0	0	0	0	1.098174044	3.422528257	8.652632444	0.0374358	1.566193483	0	0	0	0	0	1.349966449	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.5068	0	0	6.5121	0	0	0	5.439928008	0	0.490544706	0.937299442	0	0	0	0	0	1.098174044	3.422528257	8.652632444	0.0374358	1.566193483	0	0	0	0	0	1.349966449	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.5068	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 14a	"PBP 13c, 13d"											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.5121	0	0	0	5.439928008	0	0.490544706	0.937299442	0	0	0	0	0	1.098174044	3.422528257	8.652632444	0.0374358	1.566193483	0	0	0	0	0	1.349966449	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.5068
H5774_019_0	2009	10																					None											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	V	V	P	V	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	N/A	2914.133345	0.477664133	3.347223607	0	4831.06834	115682.8924	120.7601983	773.2420616	124.9507795	1200.654089	1445.022991	0	1453.730626	2262.121202	10053.2659	12136.05256	55.57615195	7516.822886	4607.282775	53749.25901	21434.51016	151900.8816	0	1781.619873	329.6197634	0	60.99378418	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 14a	"PBP 13b, 13c, 13d"											111.7612937	80.90176544	87.51769661	0	3.41192021	0.971088218	82.8068125	39.5253455	254.2302284	4.821564732	23.29917376	0	20.87433635	24.20267801	21.17557521	13.78396312	419.5000324	4.77657836	15.92414859	3.964309187	1.598975226	0.46089666	0	7	1	0	1	0	0	0											111.7612937	80.90176544	87.51769661	0	3.41192021	0.971088218	82.8068125	39.5253455	254.2302284	4.821564732	23.29917376	0	20.87433635	24.20267801	21.17557521	13.78396312	419.5000324	4.77657836	15.92414859	3.964309187	1.598975226	0.46089666	0	7	1	0	1	0	0	0											27.1406	0.003220323	0.024411775	0	1.373601642	9.361524489	0.833313925	2.546888304	2.647188768	0.482419284	2.805653479	0	2.528805171	4.562449257	17.74030734	13.94024173	1.942849795	2.992057795	6.113921291	17.75655678	2.856104227	5.834217418	0	1.039278259	0.027468314	0	0.005082815	0	0	0	0	0	0	0	0	0	0	0	0	0	124.5582	0	0	27.1406	0.003220323	0.024411775	0	1.373601642	9.361524489	0.833313925	2.546888304	2.647188768	0.482419284	2.805653479	0	2.528805171	4.562449257	17.74030734	13.94024173	1.942849795	2.992057795	6.113921291	17.75655678	2.856104227	5.834217418	0	1.039278259	0.027468314	0	0.005082815	0	0	0	0	0	0	0	0	0	0	0	0	0	124.5582	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 14a	"PBP 13b, 13c, 13d"											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	27.1406	0.003220323	0.024411775	0	1.373601642	9.361524489	0.833313925	2.546888304	2.647188768	0.482419284	2.805653479	0	2.528805171	4.562449257	17.74030734	13.94024173	1.942849795	2.992057795	6.113921291	17.75655678	2.856104227	5.834217418	0	1.039278259	0.027468314	0	0.005082815	0	0	0	0	0	0	0	0	0	0	0	0	0	124.5582
H5774_020_0	2009	10																					None											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	V	V	P	V	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	N/A	2914.133345	0.477664133	3.347223607	0	4831.06834	115682.8924	120.7601983	773.2420616	124.9507795	1200.654089	1445.022991	0	1453.730626	2262.121202	10053.2659	12136.05256	55.57615195	7516.822886	4607.282775	53749.25901	21434.51016	151900.8816	0	1781.619873	329.6197634	0	60.99378418	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 14a	"PBP 13b, 13c, 13d"											111.7612937	80.90176544	87.51769661	0	3.41192021	0.971088218	82.8068125	39.5253455	254.2302284	4.821564732	23.29917376	0	20.87433635	24.20267801	21.17557521	13.78396312	419.5000324	4.77657836	15.92414859	3.964309187	1.598975226	0.46089666	0	7	1	0	1	0	0	0											111.7612937	80.90176544	87.51769661	0	3.41192021	0.971088218	82.8068125	39.5253455	254.2302284	4.821564732	23.29917376	0	20.87433635	24.20267801	21.17557521	13.78396312	419.5000324	4.77657836	15.92414859	3.964309187	1.598975226	0.46089666	0	7	1	0	1	0	0	0											27.1406	0.003220323	0.024411775	0	1.373601642	9.361524489	0.833313925	2.546888304	2.647188768	0.482419284	2.805653479	0	2.528805171	4.562449257	17.74030734	13.94024173	1.942849795	2.992057795	6.113921291	17.75655678	2.856104227	5.834217418	0	1.039278259	0.027468314	0	0.005082815	0	0	0	0	0	0	0	0	0	0	0	0	0	124.5582	0	0	27.1406	0.003220323	0.024411775	0	1.373601642	9.361524489	0.833313925	2.546888304	2.647188768	0.482419284	2.805653479	0	2.528805171	4.562449257	17.74030734	13.94024173	1.942849795	2.992057795	6.113921291	17.75655678	2.856104227	5.834217418	0	1.039278259	0.027468314	0	0.005082815	0	0	0	0	0	0	0	0	0	0	0	0	0	124.5582	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 14a	"PBP 13b, 13c, 13d"											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	27.1406	0.003220323	0.024411775	0	1.373601642	9.361524489	0.833313925	2.546888304	2.647188768	0.482419284	2.805653479	0	2.528805171	4.562449257	17.74030734	13.94024173	1.942849795	2.992057795	6.113921291	17.75655678	2.856104227	5.834217418	0	1.039278259	0.027468314	0	0.005082815	0	0	0	0	0	0	0	0	0	0	0	0	0	124.5582
H5774_021_0	2009	10																					None											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	V	V	P	V	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	N/A	0	0	0	0	0	0	0	524.9524126	0	0	0	0	0	0	0	0	51.22602895	0	0	0	0	0	0	0	0	0	0	0	0	81.02266577											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 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 14a	"PBP 13b, 13c, 13d"											0	0	0	0	0	0	0	22.47759375	0	0	0	0	0	0	0	0	10	0	0	0	0	0	0	0	0	0	0	0	0	5											0	0	0	0	0	0	0	22.47759375	0	0	0	0	0	0	0	0	10	0	0	0	0	0	0	0	0	0	0	0	0	5											0	0	0	0	0	0	0	0.983305589	0	0	0	0	0	0	0	0	0.042688357	0	0	0	0	0	0	0	0	0	0	0	0	0.033759444	0	0	0	0	0	0	0	0	0	0	1.0598	0	0	0	0	0	0	0	0	0	0.983305589	0	0	0	0	0	0	0	0	0.042688357	0	0	0	0	0	0	0	0	0	0	0	0	0.033759444	0	0	0	0	0	0	0	0	0	0	1.0598	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 14a	"PBP 13b, 13c, 13d"											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0.983305589	0	0	0	0	0	0	0	0	0.042688357	0	0	0	0	0	0	0	0	0	0	0	0	0.033759444	0	0	0	0	0	0	0	0	0	0	1.0598
H5774_802_0	2009	5																					None											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	V	V	P	V	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	N/A	2285.448308	0	0	0	3077.07342	68015.56411	109.0102453	510.3068136	111.5603134	965.6194351	1011.483708	0	1050.150884	1665.720024	8498.251031	10033.1104	75.39319345	7738.325407	3759.802612	42750.07195	17032.7922	91789.77282	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 14a	"PBP 13c, 13d"											114.6104769	0	0	0	5.037933204	1.212877525	85.45558445	36.07470082	280.8556297	4.497862097	24.52774251	0	22.71677417	26.21553404	22.87661166	14.27635232	318.7514654	4.838981843	14.96991188	4.060889879	1.378875303	0.504833825	0	0	0	0	0	0	0	0											114.6104769	0	0	0	5.037933204	1.212877525	85.45558445	36.07470082	280.8556297	4.497862097	24.52774251	0	22.71677417	26.21553404	22.87661166	14.27635232	318.7514654	4.838981843	14.96991188	4.060889879	1.378875303	0.504833825	0	0	0	0	0	0	0	0											21.828	0	0	0	1.291840863	6.874545754	0.776294518	1.534097135	2.611028507	0.361935255	2.067450996	0	1.988003373	3.638978333	16.20093239	11.93635157	2.002640908	3.120468012	4.69032615	14.46694454	1.957174708	3.861548511	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.2086	0	0	21.828	0	0	0	1.291840863	6.874545754	0.776294518	1.534097135	2.611028507	0.361935255	2.067450996	0	1.988003373	3.638978333	16.20093239	11.93635157	2.002640908	3.120468012	4.69032615	14.46694454	1.957174708	3.861548511	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.2086	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 14a	"PBP 13c, 13d"											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.828	0	0	0	1.291840863	6.874545754	0.776294518	1.534097135	2.611028507	0.361935255	2.067450996	0	1.988003373	3.638978333	16.20093239	11.93635157	2.002640908	3.120468012	4.69032615	14.46694454	1.957174708	3.861548511	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.2086
H5774_806_0	2009	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	V	V	P	V	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	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	1225.041986	0	0	0	0	0	79.49809423											PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 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 14a	"PBP 13b, 13c, 13d"											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25	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	0	25	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	0	2.552170805	0	0	0	0	0	0.033124206	0	0	0	0	0	0	0	0	0	0	2.5853	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.552170805	0	0	0	0	0	0.033124206	0	0	0	0	0	0	0	0	0	0	2.5853	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 14a	"PBP 13b, 13c, 13d"											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.552170805	0	0	0	0	0	0.033124206	0	0	0	0	0	0	0	0	0	0	2.5853
H5774_808_0	2009	5																					None											D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	V	V	P	V	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	N/A	2285.448308	0	0	0	3077.07342	68015.56411	109.0102453	510.3068136	111.5603134	965.6194351	1011.483708	0	1050.150884	1665.720024	8498.251031	10033.1104	75.39319345	7738.325407	3759.802612	42750.07195	17032.7922	91789.77282	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 14a	"PBP 13c, 13d"											114.6104769	0	0	0	5.037933204	1.212877525	85.45558445	36.07470082	280.8556297	4.497862097	24.52774251	0	22.71677417	26.21553404	22.87661166	14.27635232	318.7514654	4.838981843	14.96991188	4.060889879	1.378875303	0.504833825	0	0	0	0	0	0	0	0											114.6104769	0	0	0	5.037933204	1.212877525	85.45558445	36.07470082	280.8556297	4.497862097	24.52774251	0	22.71677417	26.21553404	22.87661166	14.27635232	318.7514654	4.838981843	14.96991188	4.060889879	1.378875303	0.504833825	0	0	0	0	0	0	0	0											21.828	0	0	0	1.291840863	6.874545754	0.776294518	1.534097135	2.611028507	0.361935255	2.067450996	0	1.988003373	3.638978333	16.20093239	11.93635157	2.002640908	3.120468012	4.69032615	14.46694454	1.957174708	3.861548511	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.2086	0	0	21.828	0	0	0	1.291840863	6.874545754	0.776294518	1.534097135	2.611028507	0.361935255	2.067450996	0	1.988003373	3.638978333	16.20093239	11.93635157	2.002640908	3.120468012	4.69032615	14.46694454	1.957174708	3.861548511	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.2086	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 14a	"PBP 13c, 13d"											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.828	0	0	0	1.291840863	6.874545754	0.776294518	1.534097135	2.611028507	0.361935255	2.067450996	0	1.988003373	3.638978333	16.20093239	11.93635157	2.002640908	3.120468012	4.69032615	14.46694454	1.957174708	3.861548511	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.2086
H5782_001_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	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 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 (excl. Radiology): $0, 7F Podiatry: $0"	"7E Mental Health: $0, 7H Psychiatric: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	7D Physician Specialist (Radiology): $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: $0	"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	14A Health Education/Wellness Programs: Not Covered	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	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	2009	8																					3500											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		3017.71549	25.05995116	448.0279062	27.68682383	196.04	16.8560639	7.840089342	63.9816638	1034.021322	6.459671837	19.91809802	0.729536287	0.030893346	19.83350309	11494.29526	2968.373456	130.5611975	86.00328076	6380.435624	2234.644307	22.68881983	0	0	936	378.0726784	6.741152476	0.907484969	0	0	0											1a (IP Acute): 160 days 1-5	1b (IP Psych): 250 days 1-5	2a (SNF): 25 days 11-100	6a (Home Health): 15 copay	10a (Ambulance): 125 copay	11a (DME): 20% coin	11b (Medical Supplies): 10% coin	4a (ER): 50 copay	9b (OP Surg): 450 copay; 9b (OP ASC): 150 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 15% coin; 9c (OP SA): 50 copay; 3 (CORF): 35 copay; 5 (Partial Hosp): 50 copay; 9d (OP Cardiac Rehab): 25 copay	7a (PCP w/Copay): 14 copay	7b (Chiro): 8 copay; 7d (SPC w/Copay): 30 copay	7h (Psych): 50 copay; 7e (MH Non-Phys): 50 copay	7i (PT/ST): 15 copay; 7c (OT): 15 copay	7g (Prof. Other): 30 copay	7g (Prof. Other): 30 copay	15 (Part B Rx): 20% coin		10b (Transportation): 20 trips/year	16b (Comp. Dental): 30 copay	17a1 (Routine Eye Exam): 10 copay	17b1 (Non MCR Covered): 100 allowance	18a (Hearing Exam): 30 copay														54.43405224	94.21196028	14.65434489	15	125	0.2	0.1	50	387.22271	0	0.150344127	0.15	0.2	0.148793615	13.09034944	28.49593176	50	15	30	13.55846441	0.2	0	0	30	10	0	30	0	0	0											43.54285174	75.36197013	11.72229406	11.99879026	99.98991887	0.15998387	0.079991935	39.99596755	309.7469389	0	0.120263176	0.119987903	0.15998387	0.119022892	10.47122383	22.79444724	39.99596755	11.99879026	23.99758053	10.84567805	0.15998387	0	0	23.99758053	10	0	30	0	0	0											10.95	0.157380608	0.437659572	0.027684033	1.633501975	2.696698338	0.627143918	0.213250712	26.69041161	0	2.395413733	0.087535529	0.004942437	2.360640888	10.02994486	5.638536012	0.435160118	0.085994611	12.75958481	2.019686059	3.629845206	0	0	1.871811281	0.315060565	0	0.002268712	0	0	0	0	0	0	0	0	0	0	0	0	0	85.0702		21.1989	10.95	0.157380608	0.437659572	0.027684033	1.633501975	2.696698338	0.627143918	0.213250712	26.69041161	0	2.395413733	0.087535529	0.004942437	2.360640888	10.02994486	5.638536012	0.435160118	0.085994611	12.75958481	2.019686059	3.629845206	0	0	1.871811281	0.315060565	0	0.002268712	0	0	0	0	0	0	0	0	0	0	0	0	0	85.0702																																																																																		0			10.95	0.157380608	0.437659572	0.027684033	1.633501975	2.696698338	0.627143918	0.213250712	26.69041161	0	2.395413733	0.087535529	0.004942437	2.360640888	10.02994486	5.638536012	0.435160118	0.085994611	12.75958481	2.019686059	3.629845206	0	0	1.871811281	0.315060565	0	0.002268712	0	0	0	0	0	0	0	0	0	0	0	0	0	85.0702
H5783_006_0	2009	19																					3000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1554.836214	40.95112896	398.6576075	27.24938597	206.3856756	10.6088844	5.396485779	142.2039326	922.7247297	6.354097923	15.166692	0.475977841	0.039786449	12.82573719	10917.0947	2461.556615	201.5960342	40.87195443	5212.056578	1435.253789	10.34978695	0	0	936	389.3946949	6.832025485	1.190438731	0	0	0											1a (IP Acute): 125 days 1-5	1b (IP Psych): 200 days 1-5	2a (SNF): 25 days 11-100	6a (Home Health): 5 copay	10a (Ambulance): 100 copay	11a (DME): 15% coin	11b (Medical Supplies): 10% coin	4a (ER): 50 copay	9b (OP Surg): 330 copay; 9b (OP ASC): 125 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 15% coin; 9c (OP SA): 35 copay; 3 (CORF): 20 copay; 5 (Partial Hosp): 50 copay; 9d (OP Cardiac Rehab): 20 copay		7b (Chiro): 8 copay; 7d (SPC w/Copay): 25 copay	7h (Psych): 50 copay; 7e (MH Non-Phys): 35 copay	7i (PT/ST): 10 copay; 7c (OT): 10 copay	7g (Prof. Other): 25 copay	7g (Prof. Other): 25 copay	15 (Part B Rx): 20% coin			16b (Comp. Dental): 25 copay	17a1 (Routine Eye Exam): 5 copay	17b1 (Non MCR Covered): 150 allowance	18a (Hearing Exam): 25 copay														65.0467486	124.1994461	12.66530408	5	100	0.15	0.1	50	329.7304654	0	0.15030257	0.15	0.2	0.145841785	0	23.7788593	35	10	25	18.89644919	0.2	0	0	25	5	0	25	0	0	0											54.19858212	103.4860931	10.55304897	4.166125386	83.32250772	0.124983762	0.083322508	41.66125386	274.7396925	0	0.12523587	0.124983762	0.166645015	0.121519032	0	19.81314187	29.1628777	8.332250772	20.83062693	15.74499533	0.166645015	0	0	20.83062693	5	0	25	0	0	0											7.0225	0.353156029	0.350587771	0.009460363	1.433047671	1.325938278	0.449648728	0.493699511	21.12575904	0	1.899413875	0.059489501	0.006630213	1.558571171	0	4.064264204	0.489926707	0.028379614	9.047533843	1.883172018	1.724740406	0	0	1.624788901	0.16224779	0	0.002480081	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1154		10.9987	7.0225	0.353156029	0.350587771	0.009460363	1.433047671	1.325938278	0.449648728	0.493699511	21.12575904	0	1.899413875	0.059489501	0.006630213	1.558571171	0	4.064264204	0.489926707	0.028379614	9.047533843	1.883172018	1.724740406	0	0	1.624788901	0.16224779	0	0.002480081	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1154																																																																																		0			7.0225	0.353156029	0.350587771	0.009460363	1.433047671	1.325938278	0.449648728	0.493699511	21.12575904	0	1.899413875	0.059489501	0.006630213	1.558571171	0	4.064264204	0.489926707	0.028379614	9.047533843	1.883172018	1.724740406	0	0	1.624788901	0.16224779	0	0.002480081	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1154
H5783_008_0	2009	16																					0											D	D	Coin	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		2334.302402	92.99910176	13.5586769	48.62880504	11.85410865	20.71761878	8.661147517	15.79095557	25.30812015	1180.863021	18.36470293	0.120262962	0	18.5622911	12152.84459	2434.384161	287.055814	73.65415474	5382.079033	1119.67691	11.48371559	0	0	2670.222222	434.6712172	6.28256151	12.53221652	0	0	0											1a (IP Acute): $250 days 1-4;1a1 (Add'l Days): 0% coin	1b (IP Psych): $250 days 1-4;1a1 (Add'l Days): 0% coin	2a (SNF): MC CS;2a2 (Waiver 3 Day): 0% coin		10a (Ambulance): MC CS	11a (DME): MC CS	11b (Medical Supplies): MC CS	4a (ER): MC CS	9b (OP Surg): MC CS; 9b (OP ASC): 100		8b (OP Therap Rad): MC CS; 8b (OP Diag): MC CS	9a (OP Observation): MC CS	12 (Renal Dialysis): MC CS	9a (OP Other): MC CS; 9c (OP SA): 8 copay; 3 (CORF): MC CS; 5 (Partial Hosp): MC CS; 9d (OP Cardiac Rehab): 8 copay		; 7d (SPC w/Copay): 8 copay	7h (Psych): 8 copay; 7e (MH Non-Phys): 8 copay	7i (PT/ST): 5; 7c (OT): 5	7g (Prof. Other): 8 copay	7g (Prof. Other): 8 copay	15 (Part B Rx): MC CS			16b (Comp. Dental): 8 copay	17a1 (Routine Eye Exam): 5 copay	17b1 (Non MCR Covered): 150 allowance	18a (Hearing Exam): 8 copay														127.7509132	103.8371324	0.2028	0	0.231	0.231	0.231	0.231	0.230933939	0	0.231	0.231	0	0.229819343	0	7.593820615	8	5	8	8	0.231	0	0	8	5	0	8	0	0	0											127.7509132	103.8371324	0.2028	0	0.231	0.231	0.231	0.231	0.230933939	0	0.231	0.231	0	0.229819343	0	7.593820615	8	5	8	8	0.231	0	0	8	5	0	8	0	0	0											24.8508	0.804730004	2.749699676	0	2.738299097	4.785769938	2.000725076	3.647710736	5.844503876	0	4.242246376	0.027780744	0	4.265973555	0	1.540523053	0.191370543	0.030689231	3.588052688	0.746451273	2.6527383	0	0	1.780148148	0.181113007	0	0.008354811	0	0	0	0	0	0	0	0	0	0	0	0	0	66.6777		0	24.8508	0.804730004	2.749699676	0	2.738299097	4.785769938	2.000725076	3.647710736	5.844503876	0	4.242246376	0.027780744	0	4.265973555	0	1.540523053	0.191370543	0.030689231	3.588052688	0.746451273	2.6527383	0	0	1.780148148	0.181113007	0	0.008354811	0	0	0	0	0	0	0	0	0	0	0	0	0	66.6777																																																																																		0			24.8508	0.804730004	2.749699676	0	2.738299097	4.785769938	2.000725076	3.647710736	5.844503876	0	4.242246376	0.027780744	0	4.265973555	0	1.540523053	0.191370543	0.030689231	3.588052688	0.746451273	2.6527383	0	0	1.780148148	0.181113007	0	0.008354811	0	0	0	0	0	0	0	0	0	0	0	0	0	66.6777
H5783_009_0	2009	16																					3200											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1724.752028	22.04656946	582.9143881	25.44018126	208.7548779	15.05022343	6.319146779	53.87515284	732.1648796	7.094289334	19.39053691	0.770424967	0.06936695	19.01711158	10801.42486	2644.55606	129.2002997	56.41968121	5241.011707	1741.542864	16.03383839	0	0	2670.222222	423.245817	4.904064862	1.952496044	0	0	0											1a (IP Acute): 150 days 1-5	1b (IP Psych): 200 days 1-5	2a (SNF): 25 days 11-100	6a (Home Health): 5 copay	10a (Ambulance): 100 copay	11a (DME): 10% coin	11b (Medical Supplies): 10% coin	4a (ER): 50 copay	9b (OP Surg): 350 copay; 9b (OP ASC): 100 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 15% coin	9a (OP Other): 15% coin; 9c (OP SA): 25 copay; 3 (CORF): 35 copay; 5 (Partial Hosp): 50 copay; 9d (OP Cardiac Rehab): 35 copay		7b (Chiro): 8 copay; 7d (SPC w/Copay): 25 copay	7h (Psych): 25 copay; 7e (MH Non-Phys): 25 copay	7i (PT/ST): 10 copay; 7c (OT): 10 copay	7g (Prof. Other): 25 copay	7g (Prof. Other): 25 copay	15 (Part B Rx): 20% coin			16b (Comp. Dental): 25 copay	17a1 (Routine Eye Exam): 5 copay	17b1 (Non MCR Covered): 150 allowance	18a (Hearing Exam): 25 copay														80.30452978	95.3335114	13.36861181	5	100	0.1	0.1	50	349.3205662	0	0.150412614	0.15	0.15	0.148245539	0	23.27029398	25	10	25	25	0.2	0	0	25	5	0	25	0	0	0											68.83559161	81.71816303	11.45933243	4.285909636	85.71819273	0.085718193	0.085718193	42.85909636	299.4312762	0	0.128930975	0.128577289	0.128577289	0.127073396	0	19.94687544	21.42954818	8.571819273	21.42954818	21.42954818	0.171436385	0	0	21.42954818	5	0	25	0	0	0											9.8937	0.150133763	0.556650813	0.009086193	1.491174238	1.290077953	0.541665841	0.192420031	18.26942203	0	2.500040823	0.099059154	0.008919014	2.41656896	0	4.395885859	0.230725337	0.040301609	9.359376075	3.110039727	2.748783298	0	0	4.768471314	0.176352424	0	0.0040677	0	0	0	0	0	0	0	0	0	0	0	0	0	62.2529		10.3421	9.8937	0.150133763	0.556650813	0.009086193	1.491174238	1.290077953	0.541665841	0.192420031	18.26942203	0	2.500040823	0.099059154	0.008919014	2.41656896	0	4.395885859	0.230725337	0.040301609	9.359376075	3.110039727	2.748783298	0	0	4.768471314	0.176352424	0	0.0040677	0	0	0	0	0	0	0	0	0	0	0	0	0	62.2529																																																																																		0			9.8937	0.150133763	0.556650813	0.009086193	1.491174238	1.290077953	0.541665841	0.192420031	18.26942203	0	2.500040823	0.099059154	0.008919014	2.41656896	0	4.395885859	0.230725337	0.040301609	9.359376075	3.110039727	2.748783298	0	0	4.768471314	0.176352424	0	0.0040677	0	0	0	0	0	0	0	0	0	0	0	0	0	62.2529
H5783_801_0	2009	8																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		230.0092225	1.259397062	13.24725113	3.840060737	9.250974616	15.29976734	6.423922937	7.731389157	30.3700245	7.211917933	19.71204645	0.783199186	0.070517105	19.33242945	85.91978079	65.65952202	1.039183753	4.642731286	49.71371316	6.555136045	16.29969137	0																			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																			0.079105229	0.079105229	0.181771175	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.079105229	0.079105229	0.181771175	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			18.1949	0.099624893	2.407968404	0	2.136975136	3.534246256	1.483926198	1.785950895	7.015475659	1.665953043	4.55348273	0.180919012	0.016289451	4.465791203	19.84746936	15.16734959	0.240051447	1.072470927	11.48386774	1.514236426	3.765228705	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.6322		0	18.1949	0.099624893	2.407968404	0	2.136975136	3.534246256	1.483926198	1.785950895	7.015475659	1.665953043	4.55348273	0.180919012	0.016289451	4.465791203	19.84746936	15.16734959	0.240051447	1.072470927	11.48386774	1.514236426	3.765228705	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.6322																																																																																		0			18.1949	0.099624893	2.407968404	0	2.136975136	3.534246256	1.483926198	1.785950895	7.015475659	1.665953043	4.55348273	0.180919012	0.016289451	4.465791203	19.84746936	15.16734959	0.240051447	1.072470927	11.48386774	1.514236426	3.765228705	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.6322
H5793_001_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9842.726754	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$200/day 1-7	$200/day 1-7	"$0 1-10, $75 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$200 per procedure	$35 per visit	$45 X-ray; $150 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$20 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											144.5710156	144.5710156	47.56208437	0	100	0.2	0.2	47.5	200	35	63.9	35	25	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											112.028067	112.028067	36.8558549	0	100	0.154979982	0.154979982	36.80774573	154.979982	27.12149685	49.51610426	27.12149685	19.37249775	27.12149685	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											18.2416	0	4.142284515	0	2.276793099	1.221349336	0	0.780383022	4.96568183	2.371315678	19.45301734	0	0.107881605	1.778742103	12.17789911	28.70795303	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.2239	0	15.414	18.2416	0	4.142284515	0	2.276793099	1.221349336	0	0.780383022	4.96568183	2.371315678	19.45301734	0	0.107881605	1.778742103	12.17789911	28.70795303	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.2239																																																																																		0			18.2416	0	4.142284515	0	2.276793099	1.221349336	0	0.780383022	4.96568183	2.371315678	19.45301734	0	0.107881605	1.778742103	12.17789911	28.70795303	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.2239
H5793_003_0	2009	4																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9842.726754	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$0 	$0 	"$0 1-10, $75 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$75 per procedure	$0 per visit	$15 X-ray; $150 Complex Radiology	$15 per visit	$15 per visit	$15 per visit	$0 PCP visit; $15 if no PCP selected	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$15 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											0	0	47.56208437	0	100	0.2	0.2	47.5	75	0	39.3	15	15	15	0	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											0	0	38.99036532	0	100	0.163955663	0.163955663	38.9394699	61.48337353	0	32.21728773	0	12.29667471	12.29667471	0	15	15	15	15	15	45	0	0	0	0	0	0	0	0	0											0	0	4.382185325	0	2.276793099	1.292083901	0	0.825578981	1.969976166	0	12.65696214	0	0.068477747	0.806467768	0	12.30340844	0	0.840073058	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4608	0	4.8369	0	0	4.382185325	0	2.276793099	1.292083901	0	0.825578981	1.969976166	0	12.65696214	0	0.068477747	0.806467768	0	12.30340844	0	0.840073058	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4608																																																																																		0			0	0	4.382185325	0	2.276793099	1.292083901	0	0.825578981	1.969976166	0	12.65696214	0	0.068477747	0.806467768	0	12.30340844	0	0.840073058	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4608
H5793_007_0	2009	3																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9842.726754	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$200/day 1-7	$200/day 1-7	"$0 1-10, $75 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$200 per procedure	$35 per visit	$35 X-ray; $150 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$20 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											144.5710156	144.5710156	47.56208437	0	100	0.2	0.2	47.5	200	35	55.7	35	25	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											112.0283505	112.0283505	36.85594817	0	100	0.154980374	0.154980374	36.80783887	154.9803742	27.12156549	43.16203422	27.12156549	19.37254678	27.12156549	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											18.2417	0	4.142294997	0	2.276793099	1.221352426	0	0.780384997	4.965694395	2.371321679	16.9567419	0	0.107881878	1.778746604	12.17789911	28.70795303	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.7277	0	14.6887	18.2417	0	4.142294997	0	2.276793099	1.221352426	0	0.780384997	4.965694395	2.371321679	16.9567419	0	0.107881878	1.778746604	12.17789911	28.70795303	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.7277																																																																																		0			18.2417	0	4.142294997	0	2.276793099	1.221352426	0	0.780384997	4.965694395	2.371321679	16.9567419	0	0.107881878	1.778746604	12.17789911	28.70795303	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.7277
H5793_008_0	2009	4																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9842.726754	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$0 	$0 	"$0 1-10, $75 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$30 per visit	$30 X-ray; $150 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$15 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											0	0	47.56208437	0	100	0.2	0.2	47.5	150	30	51.6	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											0	0	37.47567159	0	100	0.15758633	0.15758633	37.42675336	118.1897474	23.63794949	40.65727312	23.63794949	19.69829124	23.63794949	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											0	0	4.211946638	0	2.276793099	1.241889158	0	0.793506973	3.786893466	2.066738444	15.97271535	0	0.109695884	1.550276381	9.133424332	24.60681688	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.4697	0	8.0027	0	0	4.211946638	0	2.276793099	1.241889158	0	0.793506973	3.786893466	2.066738444	15.97271535	0	0.109695884	1.550276381	9.133424332	24.60681688	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.4697																																																																																		0			0	0	4.211946638	0	2.276793099	1.241889158	0	0.793506973	3.786893466	2.066738444	15.97271535	0	0.109695884	1.550276381	9.133424332	24.60681688	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.4697
H5793_801_0	2009	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																																																			0		318.789408	0	39.36419699	5.968084404	7.03890201	9.370551952	0	8.282768876	42.80636377	14.59122609	59.47488857	0	3.245477912	12.33649936	43.57449413	189.2765099	0	5.609717624	0	0	8.465133858	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.066251026	0.066251026	0.17175677	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											21.1201	0	6.761067325	0	1.625986364	2.164597501	0	1.91331961	9.888270032	3.370573227	13.73869926	0	0.749705398	2.849731352	10.06570815	43.72287379	0	1.295844771	0	0	1.955445921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.2219			21.1201	0	6.761067325	0	1.625986364	2.164597501	0	1.91331961	9.888270032	3.370573227	13.73869926	0	0.749705398	2.849731352	10.06570815	43.72287379	0	1.295844771	0	0	1.955445921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.2219																																																																																		0			21.1201	0	6.761067325	0	1.625986364	2.164597501	0	1.91331961	9.888270032	3.370573227	13.73869926	0	0.749705398	2.849731352	10.06570815	43.72287379	0	1.295844771	0	0	1.955445921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.2219
H5793_802_0	2009	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																																																			0		318.789408	0	39.36419699	5.968084404	7.03890201	9.370551952	0	8.282768876	42.80636377	14.59122609	59.47488857	0	3.245477912	12.33649936	43.57449413	189.2765099	0	5.609717624	0	0	8.465133858	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.066251026	0.066251026	0.17175677	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											21.1201	0	6.761067325	0	1.625986364	2.164597501	0	1.91331961	9.888270032	3.370573227	13.73869926	0	0.749705398	2.849731352	10.06570815	43.72287379	0	1.295844771	0	0	1.955445921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.2219			21.1201	0	6.761067325	0	1.625986364	2.164597501	0	1.91331961	9.888270032	3.370573227	13.73869926	0	0.749705398	2.849731352	10.06570815	43.72287379	0	1.295844771	0	0	1.955445921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.2219																																																																																		0			21.1201	0	6.761067325	0	1.625986364	2.164597501	0	1.91331961	9.888270032	3.370573227	13.73869926	0	0.749705398	2.849731352	10.06570815	43.72287379	0	1.295844771	0	0	1.955445921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.2219
H5810_001_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		264.5358609	17.6191655	54.24325834	52.83617964	10.04656315	18.04670955	13.99400045	11.17437688	17.37071075	7.547000416	17.62573625	0	4.709984165	37.67533366	82.60632157	161.1853496	14.4235169	9.199785115	40.88531321	60.9246476	7.616295796	2.264520119	0	0	0	0	0	0	0	0											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	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing											0.062801552	0.062801552	0.160900963	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.062801552	0.062801552	0.160900963	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											16.6133	1.106510943	8.727792505	0	2.320756087	4.168789905	3.232614105	2.58128106	4.012634183	1.743357096	4.071545073	0	1.088006342	8.703002076	19.08206028	37.23381577	3.331832404	2.125150362	9.444507352	14.07359359	1.759364329	0.523104148	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.943	0	0	16.6133	1.106510943	8.727792505	0	2.320756087	4.168789905	3.232614105	2.58128106	4.012634183	1.743357096	4.071545073	0	1.088006342	8.703002076	19.08206028	37.23381577	3.331832404	2.125150362	9.444507352	14.07359359	1.759364329	0.523104148	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.943																																																																																		0	0	0	16.6133	1.106510943	8.727792505	0	2.320756087	4.168789905	3.232614105	2.58128106	4.012634183	1.743357096	4.071545073	0	1.088006342	8.703002076	19.08206028	37.23381577	3.331832404	2.125150362	9.444507352	14.07359359	1.759364329	0.523104148	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.943
H5810_002_0	2009	7																					3350											D	D	D	Coin	T	Coin	Coin	V	V	Coin	V	Coin	Coin	V	V	V	V	V	V	V	Coin	Coin	Coin	Coin	V	Coin	V	Coin	Coin	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	691.4458273	13.86799354	488.0356599	0	151.7517855	9.551828787	6.450249238	266.2240138	254.94247	0	116.6642206	0	0	408.8732294	3918.544951	6902.962103	163.0064262	528.594214	81.2970258	1724.121002	6.715208253	0	0	0	1014.889157	0	189.9944024	0	0	287.743837											$100/Days Custom for IP Medical; $100/Days Custom for IP Surgical;	$100/Days Custom for IP Psych; $100/Days Custom for IP Substance Abuse;	$50/Days Custom for SNF	No Cost-Sharing	$50/Run 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;	$50/Case for OP Fac - Surgery; $50/Case for OP Fac - ASC	No Cost-Sharing	$100/Case for OP Fac - CT/MRI/PET	No Cost-Sharing	No Cost-Sharing	$30/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/Visit for Prof - CORF; $10/Visit for Prof - CORF;	$5/Visit for PCP - Office Visits; $5/Consult for PCP - Consults; $5/Procedure for PCP - Surgery (Office);	$10/Visit for Speclst - Office Visits; $10/Procedure for Speclst - Surgery (Office); $10/Visit for Speclst - Tx Injections; $10/Visit for Speclst - Allergy Testing; $10/Visit for Speclst - Allergy Tx; $10/Consult for Speclst - Consults;	$15/Visit for OP Psych - Non-Physician; $15/Visit for OP Psych - Psychiatrist; $15/Visit for OP Substance Abuse;	$10/Visit for PT/ST (PCP); $10/Visit for Occ Therapy (PCP); $10/Visit for PT/ST (Specialist); $10/Visit for Occ Therapy (Specialist);	$100/Visit for Prof Radiology (Office);	$10/Visit for Chiropractor; $10/Exam for Vistion Exams; $10/Visit for Podiatrist; $10/Exam for Hearing/Speech Exams;	20% Coinsurance for Part B Rx	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$10/Service for Vision Exams (Refractions);	No Cost-Sharing	$10/Service for Hearing Exam;	No Cost-Sharing	No Cost-Sharing	$3/Service for Physical Exams (Routine); $15/Service for Podiatry;											100	99.99999998	50	0	50	0.2	0.2	41.34990844	50	0	100	0	0	17.27703287	5	10	15	10	99.99999999	10	0.2	0	0	0	10	0	10	0	0	9.915855015											98.17225324	98.17225316	49.08612662	0	49.08612662	0.196344506	0.196344507	40.59413683	49.08612662	0	98.17225324	0	0	16.96125246	4.908612662	9.817225324	14.72583799	9.817225324	98.17225323	9.817225324	0.196344506	0	0	0	9.817225325	0	9.817225328	0	0	9.734618297											5.6567	0.113454348	1.996315016	0	0.62074228	1.875449109	1.266471004	0.900594504	1.042844863	0	0.954432451	0	0	0.577916839	1.602884947	5.647327864	0.200033852	0.432444042	0.665092684	1.410507031	1.31849425	0	0	0	0.830282961	0	0.155434822	0	0	0.233423035	0	0	0	0	0	0	0	0	0	0	27.5009	0	0.5043	5.6567	0.113454348	1.996315016	0	0.62074228	1.875449109	1.266471004	0.900594504	1.042844863	0	0.954432451	0	0	0.577916839	1.602884947	5.647327864	0.200033852	0.432444042	0.665092684	1.410507031	1.31849425	0	0	0	0.830282961	0	0.155434822	0	0	0.233423035	0	0	0	0	0	0	0	0	0	0	27.5009	0																																																																																	0	0	0	5.6567	0.113454348	1.996315016	0	0.62074228	1.875449109	1.266471004	0.900594504	1.042844863	0	0.954432451	0	0	0.577916839	1.602884947	5.647327864	0.200033852	0.432444042	0.665092684	1.410507031	1.31849425	0	0	0	0.830282961	0	0.155434822	0	0	0.233423035	0	0	0	0	0	0	0	0	0	0	27.5009
H5811_001_0	2009	6																					3000											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	V	V	V	V	V	V	V	V	S	V	T	V	V	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	627.6292143	4.171009969	884.3077465	337.1425517	176.6737826	8.295164411	3.066669244	268.0590391	366.1203359	0	11.8368575	0	0	394.3566203	0	5481.68	155.42	593.4	0	1318.93	518.1417508	538.9074239	0	0	127.3050008	0	174.5585909	90.03085045	0	19.96308234											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: $150	"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: 20% for MRI/CAT/PET, all other $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: 20%	"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	14A Health Education/Wellness Programs: $0	13B Acupuncture: $20											200	200	57.5	0	150	0.199999864	0.199891213	48.74437032	100	0	0.087305099	0	0	20	0	20	19	20	0	20	82.376	20	0	0	20	0	0	0	0	20											200	200	55.7721198	0	145.4924864	0.19398985	0.193884464	47.27959759	96.99499096	0	0.084681573	0	0	19.39899819	0	19.39899819	18.42904828	19.39899819	0	19.39899819	79.90059375	19.39899819	0	0	19.39899819	0	0	0	0	20											10.4605	0.069516833	4.109976465	0	2.142058993	1.609177703	0.594579523	1.056143625	2.95931989	0	1.002363716	0	0	0.63751028	0	8.861591701	0.23868689	0.959280461	0	2.132160057	3.449986128	0.871188679	0	0	0.205799123	0	0	0	0	0.033271804	0	0	0	0	0	0	0	0	0	0	41.3931	0	1.0548	10.4605	0.069516833	4.109976465	0	2.142058993	1.609177703	0.594579523	1.056143625	2.95931989	0	1.002363716	0	0	0.63751028	0	8.861591701	0.23868689	0.959280461	0	2.132160057	3.449986128	0.871188679	0	0	0.205799123	0	0	0	0	0.033271804	0	0	0	0	0	0	0	0	0	0	41.3931	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.4605	0.069516833	4.109976465	0	2.142058993	1.609177703	0.594579523	1.056143625	2.95931989	0	1.002363716	0	0	0.63751028	0	8.861591701	0.23868689	0.959280461	0	2.132160057	3.449986128	0.871188679	0	0	0.205799123	0	0	0	0	0.033271804	0	0	0	0	0	0	0	0	0	0	41.3931
H5811_002_0	2009	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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	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 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	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	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	2009	3																					3000											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	V	V	V	V	V	V	V	V	S	V	T	V	V	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	627.6292143	4.171009969	884.3077465	337.1425517	177.1664884	8.295164411	3.066669244	268.0590391	366.1203359	0	11.8368575	0	0	394.3566203	0	5481.68	155.42	593.4	0	1318.93	518.1417508	538.9074239	0	0	127.3050008	0	174.5585909	90.03085045	0	19.96308234											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: 20% for MRI/CAT/PET, all other $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: 20%	"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	14A Health Education/Wellness Programs: $0	13B Acupuncture: $20											200	200	57.5	0	100	0.199999864	0.199891213	48.74437032	100	0	0.087305099	0	0	20	0	20	19	20	0	20	82.376	20	0	0	20	0	0	0	0	20											200	200	55.74528702	0	96.94832525	0.193896519	0.193791184	47.25685068	96.94832525	0	0.084640832	0	0	19.38966505	0	19.38966505	18.4201818	19.38966505	0	19.38966505	79.86215241	19.38966505	0	0	19.38966505	0	0	0	0	20											10.4605	0.069516833	4.107999095	0	1.431332862	1.608403504	0.594293463	1.055635499	2.957896118	0	1.001881464	0	0	0.637203565	0	8.857328259	0.238572055	0.958818937	0	2.131134244	3.448326289	0.870769537	0	0	0.20570011	0	0	0	0	0.033271804	0	0	0	0	0	0	0	0	0	0	40.6686	0	1.0018	10.4605	0.069516833	4.107999095	0	1.431332862	1.608403504	0.594293463	1.055635499	2.957896118	0	1.001881464	0	0	0.637203565	0	8.857328259	0.238572055	0.958818937	0	2.131134244	3.448326289	0.870769537	0	0	0.20570011	0	0	0	0	0.033271804	0	0	0	0	0	0	0	0	0	0	40.6686	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	10.4605	0.069516833	4.107999095	0	1.431332862	1.608403504	0.594293463	1.055635499	2.957896118	0	1.001881464	0	0	0.637203565	0	8.857328259	0.238572055	0.958818937	0	2.131134244	3.448326289	0.870769537	0	0	0.20570011	0	0	0	0	0.033271804	0	0	0	0	0	0	0	0	0	0	40.6686
H5812_012_0	2009	3																					3000											A	A	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	Coin	P	P	P	Coin	O	T	V	V	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	0	0											0	N/A	240.0144783	4.007638341	489.9731988	1185.658345	144.3859551	12.41718809	0.652490976	216.7704408	295.2556239	2171.697622	774.5099751	0	0	337.7476297	3725.174261	4312.382768	1.062882047	506.7728894	946.4214524	2357.34969	19.68654476	0	0	0	296.4390157	0	63.52264623	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 14a												175	175	50	10	100	0.2	0.2	50	78.5	20	32.13958678	0	0	15	15	24.61315583	0.5	15	26.85430407	20	0.07706111	0	0	0	25	0	25	0	0	0											154.2406911	154.2406911	44.06876887	8.813753775	88.13753775	0.176275075	0.176275075	44.06876887	69.18796713	17.62750755	28.32704043	0	0	13.22063066	13.22063066	21.69342951	0.440687689	13.22063066	23.66872239	17.62750755	0.067919765	0	0	0	22.03438444	0	22.03438444	0	0	0											3.085	0.051511742	1.799376304	0.870841726	1.060485214	2.188840769	0.115017896	0.796067204	1.7023447	3.190134685	1.828297948	0	0	0.372103056	4.104096088	7.795864299	0.468399033	0.558321433	1.866715552	3.462849955	1.337105487	0	0	0	0.544320936	0	0.116640201	0	0	0	0	0	0	0	0	0	0	0	0	0	37.3143	0	5.0221	3.085	0.051511742	1.799376304	0.870841726	1.060485214	2.188840769	0.115017896	0.796067204	1.7023447	3.190134685	1.828297948	0	0	0.372103056	4.104096088	7.795864299	0.468399033	0.558321433	1.866715552	3.462849955	1.337105487	0	0	0	0.544320936	0	0.116640201	0	0	0	0	0	0	0	0	0	0	0	0	0	37.3143	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	3.085	0.051511742	1.799376304	0.870841726	1.060485214	2.188840769	0.115017896	0.796067204	1.7023447	3.190134685	1.828297948	0	0	0.372103056	4.104096088	7.795864299	0.468399033	0.558321433	1.866715552	3.462849955	1.337105487	0	0	0	0.544320936	0	0.116640201	0	0	0	0	0	0	0	0	0	0	0	0	0	37.3143
H5812_030_0	2009	3																					3000											A	A	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	Coin	P	P	P	Coin	O	T	V	V	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	0	0											0	N/A	269.460598	4.499314507	581.8330438	2092.205812	176.9339511	14.95018178	0.785593214	255.0197443	305.0757092	2468.85995	842.6543993	0	0	321.6929872	3623.948658	4174.466035	0.977832593	480.9815133	881.4860723	1717.11012	19.47200444	0	0	0	288.3837635	0	61.79652076	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 14a												175	175	50	10	100	0.2	0.2	50	78.5	20	32.13958678	0	0	15	15	24.61123436	0.5	15	26.85430407	20	0.085652265	0	0	0	25	0	25	0	0	0											152.6997839	152.6997839	43.62850967	8.725701935	87.25701935	0.174514039	0.174514039	43.62850967	68.49676019	17.45140387	28.04404545	0	0	13.0885529	13.0885529	21.47502953	0.436285097	13.0885529	23.4322653	17.45140387	0.074737614	0	0	0	21.81425484	0	21.81425484	0	0	0											3.4289	0.057253696	2.115375715	1.521330358	1.286560766	2.609016602	0.137097045	0.927177615	1.741391474	3.590422673	1.969286523	0	0	0.35087464	3.952686977	7.470565114	0.426613787	0.524612665	1.721267959	2.497165182	1.455291148	0	0	0	0.524239742	0	0.112337088	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4194	0	5.6108	3.4289	0.057253696	2.115375715	1.521330358	1.286560766	2.609016602	0.137097045	0.927177615	1.741391474	3.590422673	1.969286523	0	0	0.35087464	3.952686977	7.470565114	0.426613787	0.524612665	1.721267959	2.497165182	1.455291148	0	0	0	0.524239742	0	0.112337088	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4194	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	3.4289	0.057253696	2.115375715	1.521330358	1.286560766	2.609016602	0.137097045	0.927177615	1.741391474	3.590422673	1.969286523	0	0	0.35087464	3.952686977	7.470565114	0.426613787	0.524612665	1.721267959	2.497165182	1.455291148	0	0	0	0.524239742	0	0.112337088	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4194
H5812_044_0	2009	5																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	Coin	P	P	Coin	P	P	Coin	Coin	Coin	T	V	V	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	0	0											0	N/A	847.2683664	24.18052308	986.6118915	1456.425612	147.7858977	12.60741083	0.662486687	222.4990914	285.7565807	9.160288339	790.8003049	0	646.4812806	14.32689664	3548.493516	5851.873676	0.995228288	453.1339837	1258.71858	62.79314127	19.05528768	17.57651818	0	0	275.9615427	0	59.1346163	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 14a												200	200	65	20	100	0.2	0.2	50	299.75	0.2	45.36357968	0	29.80838763	0.158044344	15	23.06415192	0.5	25	32.37957579	0.095384883	0.2	0.2	0	0	30	0	30	0	0	0											146.910984	146.910984	47.74606981	14.6910984	73.45549201	0.146910984	0.146910984	36.72774601	220.1828373	0.146910984	33.32204065	0	21.89589779	0.11609225	11.0183238	16.94188627	0.36727746	18.363873	23.78457671	0.070065435	0.146910984	0.146910984	0	0	22.0366476	0	22.0366476	0	0	0											10.3728	0.296032037	3.92557002	1.783040998	0.904640486	1.852167131	0.097326571	0.680990843	5.24322456	1.345746974	2.195923326	0	1.179607337	1.663241671	3.258204214	8.261814857	0.365524918	0.693441244	2.494840719	4.399628786	2.799431064	2.582183581	0	0	0.506772272	0	0.108594058	0	0	0	0	0	0	0	0	0	0	0	0	0	57.0107	0	20.6019	10.3728	0.296032037	3.92557002	1.783040998	0.904640486	1.852167131	0.097326571	0.680990843	5.24322456	1.345746974	2.195923326	0	1.179607337	1.663241671	3.258204214	8.261814857	0.365524918	0.693441244	2.494840719	4.399628786	2.799431064	2.582183581	0	0	0.506772272	0	0.108594058	0	0	0	0	0	0	0	0	0	0	0	0	0	57.0107	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	10.3728	0.296032037	3.92557002	1.783040998	0.904640486	1.852167131	0.097326571	0.680990843	5.24322456	1.345746974	2.195923326	0	1.179607337	1.663241671	3.258204214	8.261814857	0.365524918	0.693441244	2.494840719	4.399628786	2.799431064	2.582183581	0	0	0.506772272	0	0.108594058	0	0	0	0	0	0	0	0	0	0	0	0	0	57.0107
H5812_054_0	2009	5																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	Coin	P	P	Coin	P	P	Coin	Coin	Coin	T	V	V	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	0	0											0	N/A	863.6241537	24.64730729	1081.850512	1382.186083	164.2364096	14.3461354	0.753852146	225.137832	250.6445258	7.752440415	800.3352167	0	662.863655	14.67589877	3638.858064	5973.623758	1.061412337	459.9976122	1214.365317	68.18984909	19.83375895	18.7487995	0	0	282.9890714	0	60.64051531	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 14a												200	200	65	20	100	0.2	0.2	50	299.75	0.2	46.72369492	0	31.33525792	0.156082709	15	23.24344203	0.5	25	32.48371117	0.094305079	0.2	0.2	0	0	30	0	30	0	0	0											145.9477309	145.9477309	47.43301254	14.59477309	72.97386545	0.145947731	0.145947731	36.48693272	218.7391617	0.145947731	34.09608626	0	22.86654895	0.113899586	10.94607982	16.96163811	0.364869327	18.24346636	23.70461968	0.068818061	0.145947731	0.145947731	0	0	21.89215963	0	21.89215963	0	0	0											10.5037	0.299768214	4.276285743	1.681057688	0.998747138	2.093785909	0.11002301	0.684549078	4.568814455	1.131451087	2.274024882	0	1.263117018	1.671578796	3.319269234	8.443537033	0.387276805	0.699329247	2.398838999	4.692693203	2.894692114	2.736344745	0	0	0.516270161	0	0.11062932	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7557	0	21.3901	10.5037	0.299768214	4.276285743	1.681057688	0.998747138	2.093785909	0.11002301	0.684549078	4.568814455	1.131451087	2.274024882	0	1.263117018	1.671578796	3.319269234	8.443537033	0.387276805	0.699329247	2.398838999	4.692693203	2.894692114	2.736344745	0	0	0.516270161	0	0.11062932	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7557	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	10.5037	0.299768214	4.276285743	1.681057688	0.998747138	2.093785909	0.11002301	0.684549078	4.568814455	1.131451087	2.274024882	0	1.263117018	1.671578796	3.319269234	8.443537033	0.387276805	0.699329247	2.398838999	4.692693203	2.894692114	2.736344745	0	0	0.516270161	0	0.11062932	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7557
H5812_055_0	2009	5																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	Coin	P	P	Coin	P	P	Coin	Coin	Coin	T	V	V	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	0	0											0	N/A	1039.581962	29.66903594	1154.537736	2054.163208	140.9450044	14.07558862	0.739635616	215.1418037	241.2526231	6.627076687	857.5507413	0	505.8936684	14.71049806	3856.817712	6570.26705	1.326724842	528.4990792	1183.776837	79.43457889	21.80760887	23.40237815	0	0	299.9394986	0	64.27274969	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 14a												200	200	65	20	100	0.2	0.2	50	299.75	0.2	48.42738621	0	33.24782793	0.147260567	15	23.25159831	0.5	25	34.30418024	0.094544192	0.2	0.2	0	0	30	0	30	0	0	0											140.4178269	140.4178269	45.63579374	14.04178269	70.20891345	0.140417827	0.140417827	35.10445673	210.4512181	0.140417827	34.00034167	0	23.34293873	0.103390044	10.53133702	16.32469453	0.351044567	17.55222836	24.08459221	0.06637845	0.140417827	0.140417827	0	0	21.06267404	0	21.06267404	0	0	0											12.1647	0.347171796	4.390687165	2.403676115	0.824632968	1.976463566	0.103858026	0.629369678	4.230992366	0.930559707	2.429751517	0	0.984087076	1.520919046	3.384787261	8.938133548	0.465739548	0.773028044	2.375898534	5.2727442	3.062177048	3.286111084	0	0	0.526460657	0	0.112812998	0	0	0	0	0	0	0	0	0	0	0	0	0	61.1347	0	25.9407	12.1647	0.347171796	4.390687165	2.403676115	0.824632968	1.976463566	0.103858026	0.629369678	4.230992366	0.930559707	2.429751517	0	0.984087076	1.520919046	3.384787261	8.938133548	0.465739548	0.773028044	2.375898534	5.2727442	3.062177048	3.286111084	0	0	0.526460657	0	0.112812998	0	0	0	0	0	0	0	0	0	0	0	0	0	61.1347	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	12.1647	0.347171796	4.390687165	2.403676115	0.824632968	1.976463566	0.103858026	0.629369678	4.230992366	0.930559707	2.429751517	0	0.984087076	1.520919046	3.384787261	8.938133548	0.465739548	0.773028044	2.375898534	5.2727442	3.062177048	3.286111084	0	0	0.526460657	0	0.112812998	0	0	0	0	0	0	0	0	0	0	0	0	0	61.1347
H5812_056_0	2009	5																					3000											D	D	D	V	P	Coin	Coin	V	V	Coin	V	V	V	Coin	P	P	Coin	P	P	Coin	Coin	Coin	T	V	V	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	0	0											0	N/A	1079.464849	30.80726925	1154.546067	2601.234298	174.5178342	16.21717022	0.852170165	260.6678617	257.1420544	9.243240936	901.8123003	0	671.3734303	16.91078469	3587.140734	5951.770969	1.02889031	464.269407	1280.98082	69.11434357	20.52417131	18.16666201	0	0	278.9670847	0	59.778661	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 14a												200	200	65	20	100	0.2	0.2	50	299.75	0.2	45.0090637	0	29.4104067	0.159418069	15	23.0446232	0.5	25	30.47946173	0.086472976	0.2	0.2	0	0	30	0	30	0	0	0											140.9035628	140.9035628	45.79365793	14.09035628	70.45178142	0.140903563	0.140903563	35.22589071	211.1792148	0.140903563	31.70968718	0	20.72015544	0.11231287	10.56776721	16.23534757	0.352258907	17.61294536	21.47332376	0.060921752	0.140903563	0.140903563	0	0	21.13553443	0	21.13553443	0	0	0											12.675	0.361737833	4.405907306	3.054359837	1.024591026	2.285057063	0.120073812	0.765188134	4.525254762	1.30240558	2.383015495	0	1.15924682	1.899298757	3.159005687	8.052422528	0.362435776	0.681429308	2.292242989	4.210566917	2.891928863	2.559747402	0	0	0.491343202	0	0.105287829	0	0	0	0	0	0	0	0	0	0	0	0	0	60.7676	0	25.4866	12.675	0.361737833	4.405907306	3.054359837	1.024591026	2.285057063	0.120073812	0.765188134	4.525254762	1.30240558	2.383015495	0	1.15924682	1.899298757	3.159005687	8.052422528	0.362435776	0.681429308	2.292242989	4.210566917	2.891928863	2.559747402	0	0	0.491343202	0	0.105287829	0	0	0	0	0	0	0	0	0	0	0	0	0	60.7676	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	12.675	0.361737833	4.405907306	3.054359837	1.024591026	2.285057063	0.120073812	0.765188134	4.525254762	1.30240558	2.383015495	0	1.15924682	1.899298757	3.159005687	8.052422528	0.362435776	0.681429308	2.292242989	4.210566917	2.891928863	2.559747402	0	0	0.491343202	0	0.105287829	0	0	0	0	0	0	0	0	0	0	0	0	0	60.7676
H5812_057_0	2009	5																					3000											A	A	D	V	P	Coin	Coin	V	V	Coin	V	V	V	Coin	P	P	Coin	P	P	Coin	Coin	Coin	T	V	V	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	0	0											0	N/A	240.4845673	4.015487645	996.9972798	1471.756408	149.3415388	12.74012042	0.669460231	224.8411871	288.7645447	9.256712427	799.1245186	0	653.2863467	14.47770608	3585.846079	5913.472346	1.005704375	457.9038151	1271.96825	64.04425507	19.25586966	17.76153416	0	0	278.8664011	0	59.75708595	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 14a												300	300	65	20	100	0.2	0.2	50	299.75	0.2	45.36357968	0	29.80838763	0.158044344	15	23.06415192	0.5	25	32.37957579	0.094505963	0.2	0.2	0	0	30	0	30	0	0	0											228.7811295	228.7811295	49.56924472	15.2520753	76.26037649	0.152520753	0.152520753	38.13018825	228.5904785	0.152520753	34.59443666	0	22.73198863	0.120525212	11.43905647	17.58880909	0.381301882	19.06509412	24.69278641	0.072070603	0.152520753	0.152520753	0	0	22.87811295	0	22.87811295	0	0	0											4.5849	0.07655565	4.118366846	1.870611629	0.949070164	1.94313276	0.102106579	0.714436399	5.500735455	1.41184075	2.303771878	0	1.237541484	1.744928588	3.41822465	8.667578012	0.383476971	0.727498278	2.617370025	4.615708096	2.936919739	2.709002564	0	0	0.531661418	0	0.113927447	0	0	0	0	0	0	0	0	0	0	0	0	0	53.2793	0	16.5857	4.5849	0.07655565	4.118366846	1.870611629	0.949070164	1.94313276	0.102106579	0.714436399	5.500735455	1.41184075	2.303771878	0	1.237541484	1.744928588	3.41822465	8.667578012	0.383476971	0.727498278	2.617370025	4.615708096	2.936919739	2.709002564	0	0	0.531661418	0	0.113927447	0	0	0	0	0	0	0	0	0	0	0	0	0	53.2793	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	4.5849	0.07655565	4.118366846	1.870611629	0.949070164	1.94313276	0.102106579	0.714436399	5.500735455	1.41184075	2.303771878	0	1.237541484	1.744928588	3.41822465	8.667578012	0.383476971	0.727498278	2.617370025	4.615708096	2.936919739	2.709002564	0	0	0.531661418	0	0.113927447	0	0	0	0	0	0	0	0	0	0	0	0	0	53.2793
H5812_058_0	2009	5																					3000											A	A	D	V	P	Coin	Coin	V	V	Coin	V	V	V	Coin	P	P	Coin	P	P	Coin	Coin	Coin	T	V	V	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	0	0											0	N/A	259.0234309	4.325040057	1093.238412	1396.735411	165.9652139	14.49714735	0.761787432	227.507704	253.2828893	7.834045051	808.7597979	0	669.8411672	14.83038192	3677.161833	6036.504008	1.072585099	464.8396923	1227.14811	69.5490767	20.04253536	18.94615529	0	0	285.9679038	0	61.27883652	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 14a												300	300	65	20	100	0.2	0.2	50	299.75	0.2	46.72369492	0	31.33525792	0.156082709	15	23.24344203	0.5	25	32.48371117	0.093435318	0.2	0.2	0	0	30	0	30	0	0	0											226.7620687	226.7620687	49.13178155	15.11747125	75.58735623	0.151174712	0.151174712	37.79367811	226.5731003	0.151174712	35.31720572	0	23.68549303	0.117978793	11.33810343	17.56910332	0.377936781	18.89683906	24.55357848	0.070625287	0.151174712	0.151174712	0	0	22.67620687	0	22.67620687	0	0	0											4.8947	0.081729586	4.476062572	1.759592284	1.045405979	2.191602083	0.115162996	0.716529411	4.782257456	1.184309508	2.380261347	0	1.322126524	1.749670563	3.474336767	8.837996887	0.40536936	0.732000071	2.510906451	4.911923493	3.02992452	2.864179578	0	0	0.540388945	0	0.115797631	0	0	0	0	0	0	0	0	0	0	0	0	0	54.1223	0	17.48	4.8947	0.081729586	4.476062572	1.759592284	1.045405979	2.191602083	0.115162996	0.716529411	4.782257456	1.184309508	2.380261347	0	1.322126524	1.749670563	3.474336767	8.837996887	0.40536936	0.732000071	2.510906451	4.911923493	3.02992452	2.864179578	0	0	0.540388945	0	0.115797631	0	0	0	0	0	0	0	0	0	0	0	0	0	54.1223	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	4.8947	0.081729586	4.476062572	1.759592284	1.045405979	2.191602083	0.115162996	0.716529411	4.782257456	1.184309508	2.380261347	0	1.322126524	1.749670563	3.474336767	8.837996887	0.40536936	0.732000071	2.510906451	4.911923493	3.02992452	2.864179578	0	0	0.540388945	0	0.115797631	0	0	0	0	0	0	0	0	0	0	0	0	0	54.1223
H5812_059_0	2009	5																					3000											A	A	D	V	P	Coin	Coin	V	V	Coin	V	V	V	Coin	P	P	Coin	P	P	Coin	Coin	Coin	T	V	V	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	0	0											0	N/A	296.9911411	4.959005358	1166.690765	2075.785979	142.4286361	14.22375271	0.747421254	217.4064543	243.7921244	6.696835389	866.5775913	0	511.218865	14.8653454	3897.415793	6639.427756	1.340690366	534.0622274	1196.237646	81.02371093	22.03716265	23.64871897	0	0	303.0967564	0	64.94930495	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 14a												300	300	65	20	100	0.2	0.2	50	299.75	0.2	48.42738621	0	33.24782793	0.147260567	15	23.25159831	0.5	25	34.30418024	0.093665563	0.2	0.2	0	0	30	0	30	0	0	0											220.5292402	220.5292402	47.78133537	14.70194934	73.50974672	0.147019493	0.147019493	36.75487336	220.3454658	0.147019493	35.59884895	0	24.4403941	0.10825087	11.02646201	17.09219102	0.367548734	18.37743668	25.21691601	0.068853318	0.147019493	0.147019493	0	0	22.05292402	0	22.05292402	0	0	0											5.4579	0.091133807	4.645503558	2.543175026	0.87249108	2.091168918	0.109885494	0.665895558	4.476540767	0.984565347	2.570763731	0	1.041199211	1.609186575	3.581225597	9.456863957	0.492769046	0.817891231	2.513785354	5.578751348	3.239892489	3.476822683	0	0	0.557014145	0	0.119360174	0	0	0	0	0	0	0	0	0	0	0	0	0	56.9938	0	20.5385	5.4579	0.091133807	4.645503558	2.543175026	0.87249108	2.091168918	0.109885494	0.665895558	4.476540767	0.984565347	2.570763731	0	1.041199211	1.609186575	3.581225597	9.456863957	0.492769046	0.817891231	2.513785354	5.578751348	3.239892489	3.476822683	0	0	0.557014145	0	0.119360174	0	0	0	0	0	0	0	0	0	0	0	0	0	56.9938	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	5.4579	0.091133807	4.645503558	2.543175026	0.87249108	2.091168918	0.109885494	0.665895558	4.476540767	0.984565347	2.570763731	0	1.041199211	1.609186575	3.581225597	9.456863957	0.492769046	0.817891231	2.513785354	5.578751348	3.239892489	3.476822683	0	0	0.557014145	0	0.119360174	0	0	0	0	0	0	0	0	0	0	0	0	0	56.9938
H5812_060_0	2009	5																					3000											A	A	D	V	P	Coin	Coin	V	V	Coin	V	V	V	Coin	P	P	Coin	P	P	Coin	Coin	Coin	T	V	V	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	0	0											0	N/A	315.0497556	5.260538817	1166.699184	2628.615712	176.3548641	16.38787727	0.861140377	263.4117339	259.8488129	9.340538209	911.3050614	0	678.4405191	17.08879295	3624.90011	6014.42119	1.039720734	469.1564534	1294.464828	70.53986364	20.74021522	18.35789003	0	0	281.9035803	0	60.40791006	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 14a												300	300	65	20	100	0.2	0.2	50	299.75	0.2	45.0090637	0	29.4104067	0.159418069	15	23.0446232	0.5	25	30.47946173	0.085617316	0.2	0.2	0	0	30	0	30	0	0	0											221.515971	221.515971	47.99512706	14.7677314	73.83865701	0.147677314	0.147677314	36.91932851	221.3313744	0.147677314	33.23408817	0	21.71624933	0.117712161	11.07579855	17.01584029	0.369193285	18.45966425	22.5056252	0.063218676	0.147677314	0.147677314	0	0	22.1515971	0	22.1515971	0	0	0											5.8157	0.09710778	4.666322964	3.234890899	1.085150527	2.420117698	0.127170898	0.810415361	4.792724574	1.379385594	2.523866063	0	1.227765289	2.011558753	3.345721949	8.528369199	0.383857913	0.721705884	2.427728355	4.459436782	3.062859276	2.711043891	0	0	0.520384544	0	0.111510974	0	0	0	0	0	0	0	0	0	0	0	0	0	56.4648	0	20.0057	5.8157	0.09710778	4.666322964	3.234890899	1.085150527	2.420117698	0.127170898	0.810415361	4.792724574	1.379385594	2.523866063	0	1.227765289	2.011558753	3.345721949	8.528369199	0.383857913	0.721705884	2.427728355	4.459436782	3.062859276	2.711043891	0	0	0.520384544	0	0.111510974	0	0	0	0	0	0	0	0	0	0	0	0	0	56.4648	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	5.8157	0.09710778	4.666322964	3.234890899	1.085150527	2.420117698	0.127170898	0.810415361	4.792724574	1.379385594	2.523866063	0	1.227765289	2.011558753	3.345721949	8.528369199	0.383857913	0.721705884	2.427728355	4.459436782	3.062859276	2.711043891	0	0	0.520384544	0	0.111510974	0	0	0	0	0	0	0	0	0	0	0	0	0	56.4648
H5812_061_0	2009	3																					3000											A	A	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	Coin	P	P	P	Coin	O	T	V	V	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	0	0											0	N/A	256.3396426	4.28022754	562.2059819	1434.393865	162.0943043	14.22675496	0.747579014	226.1969827	269.7158122	1757.21207	797.3967086	0	0	327.067528	3715.641805	4287.084588	1.100181896	497.2072639	868.5259287	2478.411072	20.31229584	0	0	0	295.6804494	0	63.3600963	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 14a												175	175	50	10	100	0.2	0.2	50	78.5	20	32.13958678	0	0	15	15	24.6118688	0.5	15	26.85430407	20	0.076667028	0	0	0	25	0	25	0	0	0											153.7617798	153.7617798	43.9319371	8.786387419	87.86387419	0.175727748	0.175727748	43.9319371	68.97314124	17.57277484	28.23908609	0	0	13.17958113	13.17958113	21.62494144	0.439319371	13.17958113	23.59523195	17.57277484	0.067362621	0	0	0	21.96596855	0	21.96596855	0	0	0											3.2846	0.054844617	2.058233153	1.050261684	1.186852796	2.500035616	0.131370377	0.828105968	1.550262234	2.573257671	1.876479525	0	0	0.359217752	4.080883551	7.725662763	0.483331219	0.546081956	1.707755895	3.629379977	1.368289488	0	0	0	0.541242288	0	0.11598049	0	0	0	0	0	0	0	0	0	0	0	0	0	37.6521	0	5.2007	3.2846	0.054844617	2.058233153	1.050261684	1.186852796	2.500035616	0.131370377	0.828105968	1.550262234	2.573257671	1.876479525	0	0	0.359217752	4.080883551	7.725662763	0.483331219	0.546081956	1.707755895	3.629379977	1.368289488	0	0	0	0.541242288	0	0.11598049	0	0	0	0	0	0	0	0	0	0	0	0	0	37.6521	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	3.2846	0.054844617	2.058233153	1.050261684	1.186852796	2.500035616	0.131370377	0.828105968	1.550262234	2.573257671	1.876479525	0	0	0.359217752	4.080883551	7.725662763	0.483331219	0.546081956	1.707755895	3.629379977	1.368289488	0	0	0	0.541242288	0	0.11598049	0	0	0	0	0	0	0	0	0	0	0	0	0	37.6521
H5812_062_0	2009	3																					3000											A	A	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	Coin	P	P	P	Coin	O	T	V	V	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	0	0											0	N/A	300.8395393	5.023263932	602.3343809	2164.347327	143.9122677	14.3719168	0.755206892	219.6711049	255.2456696	1476.023716	856.7289211	0	0	343.9441875	3938.013874	4618.383259	1.354655891	570.2859083	852.4641932	2948.211779	22.13573437	0	0	0	313.3762007	0	67.15204301	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 14a												175	175	50	10	100	0.2	0.2	50	78.5	20	32.13958678	0	0	15	15	24.61814891	0.5	15	26.85430407	20	0.060649423	0	0	0	25	0	25	0	0	0											151.5175215	151.5175215	43.29072042	8.658144083	86.58144083	0.173162882	0.173162882	43.29072042	67.96643105	17.31628817	27.82691731	0	0	12.98721612	12.98721612	21.31474803	0.432907204	12.98721612	23.25084339	17.31628817	0.052511144	0	0	0	21.64536021	0	21.64536021	0	0	0											3.7985	0.063426042	2.17295744	1.561602583	1.038344291	2.488682528	0.130773802	0.792476699	1.445678101	2.129937667	1.98667707	0	0	0.372239791	4.26198644	8.20330629	0.586440294	0.617202195	1.651709288	4.254340396	1.162372743	0	0	0	0.565261729	0	0.121127513	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4051	0	6.1071	3.7985	0.063426042	2.17295744	1.561602583	1.038344291	2.488682528	0.130773802	0.792476699	1.445678101	2.129937667	1.98667707	0	0	0.372239791	4.26198644	8.20330629	0.586440294	0.617202195	1.651709288	4.254340396	1.162372743	0	0	0	0.565261729	0	0.121127513	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4051	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	3.7985	0.063426042	2.17295744	1.561602583	1.038344291	2.488682528	0.130773802	0.792476699	1.445678101	2.129937667	1.98667707	0	0	0.372239791	4.26198644	8.20330629	0.586440294	0.617202195	1.651709288	4.254340396	1.162372743	0	0	0	0.565261729	0	0.121127513	0	0	0	0	0	0	0	0	0	0	0	0	0	39.4051
H5812_063_0	2009	3																					3000											A	A	D	V	P	Coin	Coin	V	V	V	V	V	V	V	P	P	Coin	P	P	P	Coin	O	T	V	V	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	0	0											0	N/A	319.1321565	5.328704648	602.3387276	2740.762991	178.1918939	16.55858433	0.87011059	266.1556062	272.0567139	2327.329428	900.9480628	0	0	389.7040602	3662.659486	4244.687164	1.050551158	500.9777896	922.4629561	2138.587152	20.85468105	0	0	0	291.4642637	0	62.45662794	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 14a												175	175	50	10	100	0.2	0.2	50	78.5	20	32.13958678	0	0	15	15	24.61358176	0.5	15	26.85430407	20	0.085293674	0	0	0	25	0	25	0	0	0											150.5023597	150.5023597	43.0006742	8.600134839	86.00134839	0.172002697	0.172002697	43.0006742	67.51105849	17.20026968	27.64047799	0	0	12.90020226	12.90020226	21.1680122	0.430006742	12.90020226	23.0950636	17.20026968	0.07335371	0	0	0	21.5003371	0	21.5003371	0	0	0											4.0025	0.066831885	2.158414282	1.964244274	1.277061929	2.848121159	0.149661368	0.953739209	1.530569727	3.335891149	2.075219592	0	0	0.418938433	3.937420682	7.487632472	0.451744081	0.538559568	1.77536172	3.065356312	1.529768221	0	0	0	0.522214993	0	0.111903213	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2012	0	6.5436	4.0025	0.066831885	2.158414282	1.964244274	1.277061929	2.848121159	0.149661368	0.953739209	1.530569727	3.335891149	2.075219592	0	0	0.418938433	3.937420682	7.487632472	0.451744081	0.538559568	1.77536172	3.065356312	1.529768221	0	0	0	0.522214993	0	0.111903213	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2012	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	4.0025	0.066831885	2.158414282	1.964244274	1.277061929	2.848121159	0.149661368	0.953739209	1.530569727	3.335891149	2.075219592	0	0	0.418938433	3.937420682	7.487632472	0.451744081	0.538559568	1.77536172	3.065356312	1.529768221	0	0	0	0.522214993	0	0.111903213	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2012
H5812_801_0	2009	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	T	V	V	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	0	0											0	N/A	264.5162236	3.165625114	47.76604399	34.11323081	7.242967553	19.28453546	0.960017912	12.84020245	37.43984378	12.22711091	26.92261958	0	13.02759608	19.35806495	22.73343478	45.36648218	1.322989565	5.191447975	29.95563254	75.36351833	24.19456075	20.89245074	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 14a												0.0778765	0.0778765	0.19690307	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0778765	0.0778765	0.19690307	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.5996	0.246527803	9.405280702	0	1.673125505	4.454727691	0.221764138	2.966086765	8.648603912	2.824462621	6.219125123	0	3.009374694	4.471713004	5.251423435	10.47965738	0.305610589	1.199224482	6.919751116	17.40897274	5.588943532	4.826156122	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.7201	0	0	20.5996	0.246527803	9.405280702	0	1.673125505	4.454727691	0.221764138	2.966086765	8.648603912	2.824462621	6.219125123	0	3.009374694	4.471713004	5.251423435	10.47965738	0.305610589	1.199224482	6.919751116	17.40897274	5.588943532	4.826156122	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.7201	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	20.5996	0.246527803	9.405280702	0	1.673125505	4.454727691	0.221764138	2.966086765	8.648603912	2.824462621	6.219125123	0	3.009374694	4.471713004	5.251423435	10.47965738	0.305610589	1.199224482	6.919751116	17.40897274	5.588943532	4.826156122	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.7201
H5812_802_0	2009	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	T	V	V	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	0	0											0	N/A	264.5162236	3.165625114	47.76604399	34.11323081	7.242967553	19.28453546	0.960017912	12.84020245	37.43984378	12.22711091	26.92261958	0	13.02759608	19.35806495	22.73343478	45.36648218	1.322989565	5.191447975	29.95563254	75.36351833	24.19456075	20.89245074	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 14a												0.0778765	0.0778765	0.19690307	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0778765	0.0778765	0.19690307	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.5996	0.246527803	9.405280702	0	1.673125505	4.454727691	0.221764138	2.966086765	8.648603912	2.824462621	6.219125123	0	3.009374694	4.471713004	5.251423435	10.47965738	0.305610589	1.199224482	6.919751116	17.40897274	5.588943532	4.826156122	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.7201	0	0	20.5996	0.246527803	9.405280702	0	1.673125505	4.454727691	0.221764138	2.966086765	8.648603912	2.824462621	6.219125123	0	3.009374694	4.471713004	5.251423435	10.47965738	0.305610589	1.199224482	6.919751116	17.40897274	5.588943532	4.826156122	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.7201	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	20.5996	0.246527803	9.405280702	0	1.673125505	4.454727691	0.221764138	2.966086765	8.648603912	2.824462621	6.219125123	0	3.009374694	4.471713004	5.251423435	10.47965738	0.305610589	1.199224482	6.919751116	17.40897274	5.588943532	4.826156122	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.7201
H5813_003_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$850 per stay	$850 per stay	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$35 per visit	$35 X-ray; $150 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$20 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											143.7153897	143.7153897	47.8866492	20	100	0.2	0.2	48.5	250	35	81	35	25	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											143.7153897	143.7153897	47.8866492	20	100	0.2	0.2	48.5	250	35	81	35	25	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											23.4013	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	8.010198744	3.060157379	31.82185731	0	0.139220051	2.295447554	12.17789911	27.04289519	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.9231	0	0	23.4013	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	8.010198744	3.060157379	31.82185731	0	0.139220051	2.295447554	12.17789911	27.04289519	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.9231																																																																							0											0			23.4013	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	8.010198744	3.060157379	31.82185731	0	0.139220051	2.295447554	12.17789911	27.04289519	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.9231
H5813_004_0	2009	7																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$350 per stay	$350 per stay	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$25 per visit	$25 X-ray; $150 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											59.17692516	59.17692516	47.8866492	20	100	0.2	0.2	48.5	250	25	75	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											59.17692516	59.17692516	47.8866492	20	100	0.2	0.2	48.5	250	25	75	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											9.6358	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	8.010198744	2.185826699	29.46468269	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.8948	0	0	9.6358	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	8.010198744	2.185826699	29.46468269	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.8948																																																																							0											0			9.6358	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	8.010198744	2.185826699	29.46468269	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.8948
H5813_005_0	2009	7																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$950 per stay	$950 per stay	"$0/d 1-20, $100/d 21-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$200 per procedure	$0 per visit	$25 X-ray; $150 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$0 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	$0 per Trip/50 One Way Trips	0	$0 per visit	$150 Every 2 Years	$0 per visit	$1000 Every 3 Yrs	Not Covered	0											160.6230826	160.6230826	40.33133874	0	100	0.2	0.2	47.5	200	0	75	25	25	25	0	25	25	25	25	25	45	0	$0 per Trip/50 One Way Trips	0	0	0	0	0	0	0											160.6230826	160.6230826	40.33133874	0	100	0.2	0.2	47.5	200	0	75	25	25	25	0	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											26.1544	0	4.532899329	0	2.276793099	1.576138182	0	1.007075897	6.408158995	0	29.46468269	0	0.139220051	1.639605396	0	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.9543	0	0	26.1544	0	4.532899329	0	2.276793099	1.576138182	0	1.007075897	6.408158995	0	29.46468269	0	0.139220051	1.639605396	0	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.9543																																																																							0											0			26.1544	0	4.532899329	0	2.276793099	1.576138182	0	1.007075897	6.408158995	0	29.46468269	0	0.139220051	1.639605396	0	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.9543
H5813_006_0	2009	7																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$350 per stay	$350 per stay	"$0 1-15, $75 16-20, $100 21-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$25 per visit	$25 X-ray; $150 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											59.17692516	59.17692516	47.8866492	20	100	0.2	0.2	48.5	250	25	75	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											59.17692516	59.17692516	47.8866492	20	100	0.2	0.2	48.5	250	25	75	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											9.6358	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	8.010198744	2.185826699	29.46468269	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.8948	0	0	9.6358	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	8.010198744	2.185826699	29.46468269	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.8948																																																																																		0			9.6358	0	5.382051943	1.711889696	2.276793099	1.576138182	0	1.028277495	8.010198744	2.185826699	29.46468269	0	0.139220051	1.639605396	6.088949555	19.31635371	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.8948
H5813_801_0	2009	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																																																			0		320.0801652	0	39.52358002	5.992248783	7.067402058	9.408492696	0	8.316305259	42.97968391	14.650305	59.71569846	0	3.258618637	12.38644903	43.75092438	190.042878	0	5.632431	0	0	8.499408625	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.0702	0.0702	0.1592	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											22.4696	0	6.292153939	0	1.632569875	2.173361813	0	1.921066515	9.928306983	3.384220455	13.79432634	0	0.752740905	2.861269726	10.10646353	43.89990481	0	1.301091561	0	0	1.963363392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.4805			22.4696	0	6.292153939	0	1.632569875	2.173361813	0	1.921066515	9.928306983	3.384220455	13.79432634	0	0.752740905	2.861269726	10.10646353	43.89990481	0	1.301091561	0	0	1.963363392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.4805																																																																																		0			22.4696	0	6.292153939	0	1.632569875	2.173361813	0	1.921066515	9.928306983	3.384220455	13.79432634	0	0.752740905	2.861269726	10.10646353	43.89990481	0	1.301091561	0	0	1.963363392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.4805
H5813_802_0	2009	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																																																			0		320.0801652	0	39.52358002	5.992248783	7.067402058	9.408492696	0	8.316305259	42.97968391	14.650305	59.71569846	0	3.258618637	12.38644903	43.75092438	190.042878	0	5.632431	0	0	8.499408625	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.0702	0.0702	0.1592	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											22.4696	0	6.292153939	0	1.632569875	2.173361813	0	1.921066515	9.928306983	3.384220455	13.79432634	0	0.752740905	2.861269726	10.10646353	43.89990481	0	1.301091561	0	0	1.963363392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.4805			22.4696	0	6.292153939	0	1.632569875	2.173361813	0	1.921066515	9.928306983	3.384220455	13.79432634	0	0.752740905	2.861269726	10.10646353	43.89990481	0	1.301091561	0	0	1.963363392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.4805																																																																																		0			22.4696	0	6.292153939	0	1.632569875	2.173361813	0	1.921066515	9.928306983	3.384220455	13.79432634	0	0.752740905	2.861269726	10.10646353	43.89990481	0	1.301091561	0	0	1.963363392	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.4805
H5817_009_0	2009	3																					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	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	394.6786357	34.33295275	15.24487813	1.602818859	19.72628484	34.04192252	0	17.06000835	18.85907361	39.78062732	6.716717258	0	0.156293596	13.94529606	76.44333616	73.65576289	13.98345768	1.0779051	33.7895568	0.240981805	12.19559899	0	7.96	8.52893735	10.93766585	0	0.011698038	0	3.03	18.39											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 (excl. Radiology): $0, 7F Podiatry: $0"	"7E Mental Health: $0, 7H Psychiatric: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	7D Physician Specialist (Radiology): $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	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H5817_010_0	2009	4																					0											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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	230.29	3.16	478.34	0	317.78	13.2	9.39	202.72	245.66	0	667.26	45.29	0.22	1096.76	0	7222.55	170.2	729.23	1901.46	1574.52	11.73	705.34	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $300 per admit	1B IP Psych: $300 per admit	2 SNF: $100 per day for 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: $50,4A Non Covered Foreign Travel: $50,  4B Urgent Care: $30"	9B ASC Services: $150	8A OP Lab Services: $0	8B OP X-Ray: $50	"9A OP Hospital: $150, 5 Partial Hosp: $150"	12 Renal Dialysis: 20%	"3 CORF: $150, 8A OP Diagnostic Procedures/Tests: $150, 9A OP Hospital: $150, 9D Cardiac Rehab: $150"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $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"	"8B Physician Specialist Services - Radiology: $50, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7B Chiropractic: $30, 7F Podiatry: $30, 7F Non Medicare Covered Podiatry: $0,  7G Other Health Care: $30, 14D Pap Smears & Pelvic Exams: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $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, 17B Medicare Covered Eyewear: $30"	"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	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: Over-the-Counter Drugs: $0, 13D Other: PERS: Not Covered, 13E Other: Assistive Devices: Not Covered"											300	300	100	0	100	0.20000014	0.199949994	48.39976322	150	0	50	150	0.200000022	110.4230643	0	30	30	30	50	30	0.199998012	30	0	0	0	0	0	0	0	0											300	300	100	0	100	0.20000014	0.199949994	48.39976322	150	0	50	150	0.200000022	110.4230643	0	30	30	30	50	30	0.199998012	30	0	0	0	0	0	0	0	0											5.7572	0.079	3.986166667	0	2.648166667	2.640001845	1.877530443	0.817633333	3.07075	0	2.78025	0.566125	0.044000005	10.0923	0	18.056375	0.4255	1.823075	7.92275	3.9363	2.345976675	1.76335	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.6325	0	0	5.7572	0.079	3.986166667	0	2.648166667	2.640001845	1.877530443	0.817633333	3.07075	0	2.78025	0.566125	0.044000005	10.0923	0	18.056375	0.4255	1.823075	7.92275	3.9363	2.345976675	1.76335	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.6325	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	5.7572	0.079	3.986166667	0	2.648166667	2.640001845	1.877530443	0.817633333	3.07075	0	2.78025	0.566125	0.044000005	10.0923	0	18.056375	0.4255	1.823075	7.92275	3.9363	2.345976675	1.76335	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.6325
H5817_011_0	2009	7																					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	O	V											43.9888	0.4227	6.2433	8.8908	0	2.2966	1.6241	0	5.7814	0.6562	3.5795	0.2024	0.0343	2.9788	0	0	0	0	0	0	1.7073	0.1338	0	0	0	0	0	0	0	0											78.54	0	0	0	0	0	309.41	0	0	219.19	0	0	0	0	0	372.01	0	7691.1	193.78	865.51	0	1900.58	0	789.87	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, 4A Non Medicare Covered Foreign Travel: $50,  4B Urgent Care: $5"	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, 9A Outpatient Hospital Services $0,  9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $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"	"8B Physician Specialist Services - Radiology: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7G Other Health Care: $5, 18A Medicare Covered Hearing Exams: $5, 7B Chiropractic: $5, 7F Medicare Covered Podiatry: $5, 7F Non Medicare Covered Podiatry (Routine): $0, 14D Pap Smears & Pelvic Exams: $0, , 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $5"	15 Part B Drugs: 0%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $5, 17A Medicare Covered Eye Exams: $5, 17B Medicare Covered Eyewear: $5"	"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	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: Over-the-Counter Drugs: $0, 13D Other: PERS: $0, 13E Other: Assistive Devices: Not Covered"											0	0	0	0	100	0	0	46.52424837	0	0	0	0	0	5	0	5	5	5	0	5	0	5	0	0	0	0	0	0	0	0											0	0	0	0	100	0	0	46.52424837	0	0	0	0	0	5	0	5	5	5	0	5	0	5	0	0	0	0	0	0	0	0											0	0	0	0	2.578416667	0	0	0.849804167	0	0	0	0	0	0.155004167	0	3.204625	0.080741667	0.360629167	0	0.791908333	0	0.3291125	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.3502	1500	0	43.9888	0.422749491	6.243308118	8.890797207	2.578416667	2.296558045	1.624076229	0.849804167	5.781384929	0.656159441	3.579496654	0.20239744	0.034276986	3.133837452	0	3.204625	0.080741667	0.360629167	0	0.791908333	1.707320338	0.462955968	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.8902	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	43.9888	0.422749491	6.243308118	8.890797207	2.578416667	2.296558045	1.624076229	0.849804167	5.781384929	0.656159441	3.579496654	0.20239744	0.034276986	3.133837452	0	3.204625	0.080741667	0.360629167	0	0.791908333	1.707320338	0.462955968	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.8902
H5817_014_0	2009	4																					0											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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	234.09	3.37	517.63	0	226.46	11.87	8.46	212.4	282.93	0	352.49	31.04	0.14	915.96	0	7708.53	217.15	941.43	1933.48	2012.62	6.07	655.69	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $300 per admit	1B IP Psych: $300 per admit	2 SNF: $100 per day for 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: $50,4A Non Covered Foreign Travel: $50,  4B Urgent Care: $25"	9B ASC Services: $100	8A OP Lab Services: $0	8B OP X-Ray: $50	"9A OP Hospital: $100, 5 Partial Hosp: $100"	12 Renal Dialysis: 20%	"3 CORF: $100, 8A OP Diagnostic Procedures/Tests: $100, 9A OP Hospital: $100, 9D Cardiac Rehab: $100"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $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"	"8B Physician Specialist Services - Radiology: $50, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7B Chiropractic: $25, 7F Podiatry: $25, 7F Non Medicare Covered Podiatry: $0,  7G Other Health Care: $25, 14D Pap Smears & Pelvic Exams: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $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, 17B Medicare Covered Eyewear: $25"	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: $0	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: Over-the-Counter Drugs: $0, 13D Other: PERS: Not Covered, 13E Other: Assistive Devices: Not Covered"											300	300	100	0	100	0.199999748	0.20000738	48.22740113	100	0	50	100	0.2	67.34982969	0	25	25	25	50	25	0.199999325	25	0	0	0	0	0	0	0	0											300	300	100	0	100	0.199999748	0.20000738	48.22740113	100	0	50	100	0.2	67.34982969	0	25	25	25	50	25	0.199999325	25	0	0	0	0	0	0	0	0											5.8522	0.08425	4.313583333	0	1.887166667	2.37399701	1.692062438	0.853625	2.35775	0	1.468708333	0.258666667	0.028	5.1408125	0	16.0594375	0.452395833	1.9613125	8.056166667	4.192958333	1.2139959	1.366020833	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.6132	0	0	5.8522	0.08425	4.313583333	0	1.887166667	2.37399701	1.692062438	0.853625	2.35775	0	1.468708333	0.258666667	0.028	5.1408125	0	16.0594375	0.452395833	1.9613125	8.056166667	4.192958333	1.2139959	1.366020833	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.6132	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	5.8522	0.08425	4.313583333	0	1.887166667	2.37399701	1.692062438	0.853625	2.35775	0	1.468708333	0.258666667	0.028	5.1408125	0	16.0594375	0.452395833	1.9613125	8.056166667	4.192958333	1.2139959	1.366020833	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.6132
H5817_015_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	416.9	21.6	119.83	97.31	26.14	31.84	29.22	17.76	32.75	4.37	11.25	0.95	1.87	47.73	70.92	131.69	7.43	9.86	42.92	57.93	5.97	4.79	7.96	3.87	2.03	3.03	0.43	1.8	3.03	12.63											PBP: 1A IP Acute: Standard Medicare	1B IP Psych: Standard Medicare	2 SNF: Standard Medicare	6 Home Health: Standard Medicare	10A Ambulance: Standard Medicare	11A DME: Standard Medicare	"11B Prosthetic Medical Supplies: Standard Medicare, 11C Diabetes Monitoring Supplies: $0"	"4A ER, 4B Urgent Care: Standard Medicare, 4A Worldwide Coverage: $0"	9B ASC Services: Standard Medicare	8A OP C/D/T: Standard Medicare	8B OP X-Ray: Standard Medicare	"9A OP Hospital, 5 Partial Hosp: Standard Medicare"	12 Renal Dialysis: Standard Medicare	"3 CORF, 9A OP Hospital, 9D Cardiac Rehab: Standard Medicare"	"7A PCP, 14B Immunizations, 14C Routine Physical Exams: $0"	7D Physician Specialist (excl. Radiology): $0	"7E Mental Health, 7H Psychiatric, 9C OP Substance Abuse,: $0"	"7C Occupational Therapy, 7I Physical and Speech Therapy: $0"	"8B Physician Specialist (Radiology), 14G Bone Mass Measurement, 14H Mammography: $0"	"7B Chiropractic, 7F Podiatry - Medicare Covered, 7G Other Health Care, 14D Pap Smears/Pelvic Exams, 14E Prostate Screening, 14F Colorectal Screening, 14I Diabetes Monitoring, 14J Nutrition Therapy, 18A Medicare Covered Hearing Exams: $0, 7F Podiatry - Routine: $0"	15 Part B Drugs: Standard Medicare	"13A Blood, 16B Medicare Covered Comprehensive Dental Services, 17A Medicare Covered Eye Exams, 17B Medicare Covered Eyewear: $0"	10B Transportation: $0 for 24 one-way trips	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	17B Eye Wear - Non-Covered: $0	18A Hearing - Routine: $0	18B Hearing Aids: $0	"14A Medical Nutrition: $0, 14A Health Education/Wellness Programs: $0"	"6 Respite Care: $0, 13B Acupuncture: Not Covered, 13C Other: OTC Drugs: $0, 13D Other: Assistive Devices: $0 13E Other: PERS: $0"											0.069259551	0.069245081	0.198503972	0	0.231035908	0.230999953	0.182051721	0.229517926	0.230999999	0.231217346	0.230888425	0.230999791	0.230999992	0.231035892	0	0	0	0	0	0	0.23099836	0	0	0	0	0	0	0	0	0											0.069259551	0.069245081	0.198503972	0	0.231035908	0.230999953	0.182051721	0.229517926	0.230999999	0.231217346	0.230888425	0.230999791	0.230999992	0.231035892	0	0	0	0	0	0	0.23099836	0	0	0	0	0	0	0	0	0											28.8743	1.495693753	23.78673092	0	6.039278628	7.355038511	5.319551296	4.076238358	7.565249981	1.0104198	2.597494779	0.219449802	0.431969984	11.02734314	0	0	0	0	0	0	1.379060209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1778	0	0	28.8743	1.495693753	23.78673092	0	6.039278628	7.355038511	5.319551296	4.076238358	7.565249981	1.0104198	2.597494779	0.219449802	0.431969984	11.02734314	0	0	0	0	0	0	1.379060209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1778	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	28.8743	1.495693753	23.78673092	0	6.039278628	7.355038511	5.319551296	4.076238358	7.565249981	1.0104198	2.597494779	0.219449802	0.431969984	11.02734314	0	0	0	0	0	0	1.379060209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.1778
H5817_016_0	2009	3																					0											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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	166.11	2.317	482.33	0	317.78	13.2	9.39	144.55	175.616	0	467.082	45.29	0.22	1096.76	0	5055.785	120.393	510.461	1331.022	1102.164	11.73	493.898	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $300 per admit	1B IP Psych: $300 per admit	2 SNF: $100 per day for 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/Worldwide Coverage: $50, 4B Urgent Care: $30"	9B ASC Services: $150	8A OP Lab Services: $0	8B OP X-Ray: $50	"9A OP Hospital: $150,  5 Partial Hosp: $150"	12 Renal Dialysis: 20%	"3 CORF: $150, 8A OP Diagnostic Procedures/Tests: $150, 9A OP Hospital: $150, 9D Cardiac Rehab: $150"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $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"	"8B Physician Specialist Services - Radiology: $50, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7B Chiropractic: $30, 7F Podiatry - Medicare Covered: $30, 7F Podiatry - Routine: $0, 7G Other Health Care: $30, 14D Pap Smears/Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutritional Therapy: $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, 17B Medicare Covered Eyewear: $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	14A Health Education/Wellness Programs: $0	"13B Acupuncture: Not Covered, 13C Other: OTC drugs: $0, 13D Other: PERS: $0"											300	300	100	0	100	0.20000014	0.199949994	48.42905569	150	0	50	150	0.200000022	110.4230643	0	30	30	30	50	30	0.199998012	30	0	0	0	0	0	0	0	0											300	300	100	0	100	0.20000014	0.199949994	48.42905569	150	0	50	150	0.200000022	110.4230643	0	30	30	30	50	30	0.199998012	30	0	0	0	0	0	0	0	0											4.1527	0.057925	4.019416667	0	2.648166667	2.640001845	1.877530443	0.583368333	2.1952	0	1.946175	0.566125	0.044000005	10.0923	0	12.6394625	0.3009825	1.2761525	5.545925	2.75541	2.345976675	1.234745	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.9216	0	0	4.1527	0.057925	4.019416667	0	2.648166667	2.640001845	1.877530443	0.583368333	2.1952	0	1.946175	0.566125	0.044000005	10.0923	0	12.6394625	0.3009825	1.2761525	5.545925	2.75541	2.345976675	1.234745	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.9216	0	PBP: 1A IP Acute: $400 per admit	1B IP Psych: $400 per admit	2 SNF: Not Covered	6 Home Health: Not Covered	10A Ambulance: Not Covered	11A DME: Not Covered	"11B Prosthetic Medical Supplies, 11C Diabetes Monitoring Supplies: Not Covered"	"4A ER/Worldwide Coverage: $50, 4B Urgent Care: $40"	9B ASC Services: $175	8A OP Lab Services: Not Covered	8B OP X-Ray: $100	"9A OP Hospital, 5 Partial Hosp: Not Covered"	12 Renal Dialysis: Not Covered	"3 CORF, 8A OP Diagnostic Procedures/Tests, 9A OP Hospital, 9D Cardiac Rehab: Not Covered"	"7A PCP, 14B Immunizations, 14C Routine Physical Exams, 14I Diabetes Monitoring: Not Covered"	7D Physician Specialist: $40	"7E Mental Health: $40,  7H Psychiatric: $40, 9C OP Substance Abuse: $40"	"7C Occupational Therapy: $40,  7I Physical and Speech Therapy: $40"	"7D Physician Specialist Services - Radiology: $100, 14H Mammography: $0, 14G Bone Mass Measurement:$0"	"7B Chiropractic: $40, 7F Podiatry: $40, 7G Other Health Care: $40, 14D Pap Smears:$0, 14D Pelvic Exams:$0, 14E Prostate Screening:$0, 14F Colorectal Screening:$0, 14I Diabetes Monitoring:$0, 14J Nutrition Therapy:$0, 18A Medicare Covered Hearing Exams: $40"	15 Part B Drugs: Not Covered	"13A Blood: Not Covered, 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: Not Covered	17B Eye Wear: Not Covered	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: OTC drugs: Not Covered, 13D Other: PERS: Not Covered"											3.1894	0.051	0	0	0	0	0	0.3092	1.379	0	1.8147	0	0	0	0	7.9956	0.2163	0.9158	5.8106	2.0712	0	0.847	0	0	0	0	0	0	0	0											24.5998	0	0	7.3422	0.108925	4.019416667	0	2.648166667	2.640001845	1.877530443	0.892573333	3.57415625	0	3.7609	0.566125	0.044000005	10.0923	0	20.6350425	0.5173025	2.1919225	11.3565	4.82664	2.345976675	2.081735	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.5214
H5817_017_0	2009	3																					0											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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	162.981	2.338	516.31	0	226.46	11.87	8.46	148.015	196.609	0	246.743	31.04	0.14	915.96	0	5395.971	151.263	659.001	1353.436	1408.834	6.07	459.073	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $300 per admit	1B IP Psych: $300 per admit	2 SNF: $100 per day for 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/Worldwide Coverage: $50, 4B Urgent Care: $25"	9B ASC Services: $100	8A OP Lab Services: $0	8B OP X-Ray: $75	"9A OP Hospital: $100,  5 Partial Hosp: $100"	12 Renal Dialysis: 20%	"3 CORF: $100, 8A OP Diagnostic Procedures/Tests: $100, 9A OP Hospital: $100, 9D Cardiac Rehab: $100"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $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"	"8B Physician Specialist Services - Radiology: $75, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7B Chiropractic: $25, 7F Podiatry - Medicare Covered: $25, 7F Podiatry - Routine: $0, 7G Other Health Care: $25, 14D Pap Smears/Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutritional Therapy: $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, 17B Medicare Covered Eyewear: $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	14A Health Education/Wellness Programs: $0	"13B Acupuncture: Not Covered, 13C Other: OTC drugs: $0, 13D Other: PERS: $0"											300	300	100	0	100	0.199999748	0.20000738	48.21943722	100	0	75	100	0.2	67.34982969	0	25	25	25	75	25	0.199999325	25	0	0	0	0	0	0	0	0											300	300	100	0	100	0.199999748	0.20000738	48.21943722	100	0	75	100	0.2	67.34982969	0	25	25	25	75	25	0.199999325	25	0	0	0	0	0	0	0	0											4.0745	0.05845	4.302583333	0	1.887166667	2.37399701	1.692062438	0.594766667	1.638408333	0	1.54214375	0.258666667	0.028	5.1408125	0	11.24160625	0.31513125	1.37291875	8.458975	2.935070833	1.2139959	0.956402083	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.0857	0	0	4.0745	0.05845	4.302583333	0	1.887166667	2.37399701	1.692062438	0.594766667	1.638408333	0	1.54214375	0.258666667	0.028	5.1408125	0	11.24160625	0.31513125	1.37291875	8.458975	2.935070833	1.2139959	0.956402083	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.0857	0	PBP: 1A IP Acute: $400 per admit	1B IP Psych: $400 per admit	2 SNF: Not Covered	6 Home Health: Not Covered	10A Ambulance: Not Covered	11A DME: Not Covered	"11B Prosthetic Medical Supplies, 11C Diabetes Monitoring Supplies: Not Covered"	"4A ER/Worldwide Coverage: $50, 4B Urgent Care: $35"	9B ASC Services: $125	8A OP Lab Services: Not Covered	8B OP X-Ray: $125	"9A OP Hospital, 5 Partial Hosp: Not Covered"	12 Renal Dialysis: Not Covered	"3 CORF, 8A OP Diagnostic Procedures/Tests, 9A OP Hospital, 9D Cardiac Rehab: Not Covered"	"7A PCP, 14B Immunizations, 14C Routine Physical Exams, 14I Diabetes Monitoring: Not Covered"	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: $125, 14H Mammography: $0, 14G Bone Mass Measurement:$0"	"7B Chiropractic: $35, 7F Podiatry: $35, 7G Other Health Care: $35, 14D Pap Smears:$0, 14D Pelvic Exams:$0, 14E Prostate Screening:$0, 14F Colorectal Screening:$0, 14I Diabetes Monitoring:$0, 14J Nutrition Therapy:$0, 18A Medicare Covered Hearing Exams: $35"	15 Part B Drugs: Not Covered	"13A Blood: Not Covered, 16B Medicare Covered Comprehensive Dental Services: $35, 17A Medicare Covered Eye Exams: $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: Not Covered	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: OTC drugs: Not Covered, 13D Other: PERS: Not Covered"											2.7501	0.044	0	0	0	0	0	0.2977	1.0981	0	1.0869	0	0	0	0	7.494	0.2424	1.0448	7.34	2.3227	0	0.6725	0	0	0	0	0	0	0	0											24.3932	0	0	6.8246	0.10245	4.302583333	0	1.887166667	2.37399701	1.692062438	0.892431667	2.736533333	0	2.62905	0.258666667	0.028	5.1408125	0	18.7356225	0.557515	2.4177125	15.79894375	5.257793333	1.2139959	1.628909583	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.4789
H5820_002_0	2009	7																					3350											D	D	D	V	T	Coin	Coin	V	V	Coin	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1709.142701	44.88390259	754.3967534	2822.320015	537.8150011	12.24433353	13.69984603	342.8617108	214.6244309	8.426704763	890.7807975	0	0.636243298	795.0806521	4204.07334	5992.697732	92.06427902	359.5193398	2249.44793	5896.74568	14.99642798	1265.143919	0	3111.044959	924.7558884	0	43.32783943	5.674951437	0	5290.225766											"$300 copay, days 1-7"	"$300 copay, days 1-7"	"$150 copay, days 6-20"	$10 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	5% coinsurance to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$15 copay	$35 copay	"$35 copay Group, $35 copay Individual"	$35 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	$0 copay	$30 copay	Not Covered	$30 copay	$0 credit	Varies	Varies											192.7636364	182.7037037	66.2299152	10	125	0.2	0.2	45	149.2978729	0.180012641	72.04752464	0	0.2	43.24568234	12.11363137	20.05069605	35	35	22.73129813	3.147424648	0.2	26.48104764	0	4	30	0	30	0	0	0.007293364											124.4614254	182.7037037	47.35871928	0.92042577	125	0.151554567	0.156701554	45	82.96633334	0.180012641	72.04752464	0	0.2	43.24568234	6.528973701	14.46603839	35	35	10.07364223	0.733149096	0.2	26.48104764	0	4	30	0	30	0	0	0.007293364											17.7269	0.68337127	2.977272006	0.216478006	5.602239595	1.855684666	2.146787168	1.285731415	1.483883507	1.516913378	5.348212622	0	0.12724866	2.86531711	2.287357023	7.224216287	0.268520814	1.048598074	1.888344472	0.360266147	2.999285596	2.791861366	0	1.037014986	2.311889721	0	0.108319599	0	0	0.003215295	0	0	0	0	0	0	0	0	0	0	66.1649		23.7273	17.7269	0.68337127	2.977272006	0.216478006	5.602239595	1.855684666	2.146787168	1.285731415	1.483883507	1.516913378	5.348212622	0	0.12724866	2.86531711	2.287357023	7.224216287	0.268520814	1.048598074	1.888344472	0.360266147	2.999285596	2.791861366	0	1.037014986	2.311889721	0	0.108319599	0	0	0.003215295	0	0	0	0	0	0	0	0	0	0	66.1649																																																																																		0			17.7269	0.68337127	2.977272006	0.216478006	5.602239595	1.855684666	2.146787168	1.285731415	1.483883507	1.516913378	5.348212622	0	0.12724866	2.86531711	2.287357023	7.224216287	0.268520814	1.048598074	1.888344472	0.360266147	2.999285596	2.791861366	0	1.037014986	2.311889721	0	0.108319599	0	0	0.003215295	0	0	0	0	0	0	0	0	0	0	66.1649
H5820_003_0	2009	7																					3350											D	D	D	V	T	Coin	Coin	V	V	Coin	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1544.197035	40.24023911	708.4239619	2572.717421	458.5111614	12.24637121	13.72538447	357.1959314	223.5973603	9.170517927	928.4134849	0	0.692303226	828.1641933	4123.390673	5991.840019	90.38711936	352.5754254	2485.498446	5768.84282	16.32613167	1229.059552	0	3111.044959	905.1158981	0	41.78333621	0.119904406	0	5286.211594											"$300 copay, days 1-7"	"$300 copay, days 1-7"	"$150 copay, days 6-20"	$10 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	5% coinsurance to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$15 copay	$35 copay	"$35 copay Group, $35 copay Individual"	$35 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	$0 copay	$30 copay	Not Covered	$30 copay	$0 credit	Varies	Varies											192.7636364	182.7037037	66.2299152	10	125	0.2	0.2	45	149.2931647	0.180016805	72.07263514	0	0.2	43.25170028	12.24938038	19.94617428	35	35	22.68148804	3.312963254	0.2	26.30265501	0	4	30	0	30	0	0	0.007362783											117.5549253	182.7037037	46.35873467	0.424468867	125	0.15210411	0.157265252	45	86.33526389	0.180016805	72.07263514	0	0.2	43.25170028	6.68263816	14.37943206	35	35	11.35400524	0.872747621	0.2	26.30265501	0	4	30	0	30	0	0	0.007362783											15.1273	0.61267006	2.736803207	0.091003204	4.776157932	1.862723391	2.158526043	1.339484743	1.608694759	1.65084734	5.57610053	0	0.138460645	2.984959123	2.296260655	7.179938041	0.263629098	1.028344991	2.351696866	0.419561987	3.265226334	2.693960782	0	1.037014986	2.262789745	0	0.104458341	0	0	0.003243436	0	0	0	0	0	0	0	0	0	0	63.5699		23.462	15.1273	0.61267006	2.736803207	0.091003204	4.776157932	1.862723391	2.158526043	1.339484743	1.608694759	1.65084734	5.57610053	0	0.138460645	2.984959123	2.296260655	7.179938041	0.263629098	1.028344991	2.351696866	0.419561987	3.265226334	2.693960782	0	1.037014986	2.262789745	0	0.104458341	0	0	0.003243436	0	0	0	0	0	0	0	0	0	0	63.5699																																																																																		0			15.1273	0.61267006	2.736803207	0.091003204	4.776157932	1.862723391	2.158526043	1.339484743	1.608694759	1.65084734	5.57610053	0	0.138460645	2.984959123	2.296260655	7.179938041	0.263629098	1.028344991	2.351696866	0.419561987	3.265226334	2.693960782	0	1.037014986	2.262789745	0	0.104458341	0	0	0.003243436	0	0	0	0	0	0	0	0	0	0	63.5699
H5820_004_0	2009	7																					3350											D	D	D	V	T	Coin	Coin	V	V	Coin	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1458.760154	37.933899	654.8340005	2047.821034	456.8362065	10.96489872	12.28552097	340.8806612	213.3843344	8.487053131	885.7930883	0	0.640654716	790.3391242	4092.948168	6107.530748	95.10047731	372.515004	2489.877736	6254.323732	15.10577195	1218.947743	0	3111.044959	891.7324043	0	41.60393238	0.120079457	0	5289.599571											"$300 copay, days 1-7"	"$300 copay, days 1-7"	"$150 copay, days 6-20"	$10 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	5% coinsurance to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$15 copay	$35 copay	"$35 copay Group, $35 copay Individual"	$35 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	$0 copay	$30 copay	Not Covered	$30 copay	$0 credit	Varies	Varies											192.7636364	182.7037037	66.2299152	10	125	0.2	0.2	45	149.2950482	0.18001511	72.06258777	0	0.2	43.24929146	12.60634415	20.0411481	35	35	22.67397733	3.248652004	0.2	26.40131059	0	4	30	0	30	0	0	0.007326253											110.3139399	182.7037037	44.87276603	0.438841053	125	0.146855462	0.152568192	45	83.75421329	0.18001511	72.06258777	0	0.2	43.24929146	7.122135989	14.55693994	35	35	11.44018281	1.012536953	0.2	26.40131059	0	4	30	0	30	0	0	0.007326253											13.4101	0.57755532	2.448684408	0.074888995	4.758710484	1.610255267	1.874379718	1.27830248	1.489319754	1.527797805	5.319378514	0	0.128130943	2.848467261	2.429211121	7.408913189	0.277376392	1.086502095	2.373721372	0.527727825	3.021154391	2.681818163	0	1.037014986	2.229331011	0	0.104009831	0	0	0.003229412	0	0	0	0	0	0	0	0	0	0	60.526		23.309	13.4101	0.57755532	2.448684408	0.074888995	4.758710484	1.610255267	1.874379718	1.27830248	1.489319754	1.527797805	5.319378514	0	0.128130943	2.848467261	2.429211121	7.408913189	0.277376392	1.086502095	2.373721372	0.527727825	3.021154391	2.681818163	0	1.037014986	2.229331011	0	0.104009831	0	0	0.003229412	0	0	0	0	0	0	0	0	0	0	60.526																																																																																		0			13.4101	0.57755532	2.448684408	0.074888995	4.758710484	1.610255267	1.874379718	1.27830248	1.489319754	1.527797805	5.319378514	0	0.128130943	2.848467261	2.429211121	7.408913189	0.277376392	1.086502095	2.373721372	0.527727825	3.021154391	2.681818163	0	1.037014986	2.229331011	0	0.104009831	0	0	0.003229412	0	0	0	0	0	0	0	0	0	0	60.526
H5820_008_0	2009	7																					3350											D	D	D	V	T	Coin	Coin	V	V	Coin	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1868.996666	49.1501648	809.0740373	3235.47276	585.1591652	13.34144904	14.92637932	371.5171669	232.5621614	9.144991172	971.0187972	0	0.685333609	854.8600739	4635.13089	6542.710079	99.34958213	388.1862177	2494.020919	6406.419115	16.30824536	1377.436205	0	3111.044959	583.7448273	420.3590335	53.33794332	0	0	5296.881788											"$150 copay, days 1-5"	"$150 copay, days 1-5"	"$150 copay, days 6-20"	$5 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay	$25 copay to $100 copay	$0 copay to 20% coinsurance	$25 copay to $150 copay		20% coinsurance	Varies	$10 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$25 copay	Varies	20% coinsurance	Varies	Not Covered	$0 copay	$15 copay	$15 copay; and $100 credit covered every 1 year(s)	$20 copay	Not Covered	Varies	Varies											84.95454545	72.92592593	66.2299152	5	125	0.2	0.2	45	74.79144068	0.173350529	52.17118673	0	0.2	27.03055916	8.458680709	14.69592273	25	25	11.39443384	2.280351246	0.2	13.31195406	0	4	15	15	20	0	0	0.007329976											58.57662613	72.92592593	58.61314575	1.190646088	125	0.180753807	0.182797429	45	48.29301819	0.173350529	52.17118673	0	0.2	27.03055916	6.253413905	12.49065593	25	25	6.452590439	1.318420674	0.2	13.31195406	0	4	15	15	20	0	0	0.007329976											9.1233	0.29869344	3.951864539	0.321025249	6.09540797	2.411517707	2.728503765	1.393189376	0.935927391	1.585289057	4.221600249	0	0.137066722	1.92561215	2.41544933	6.810228368	0.206978296	0.808721287	1.341074628	0.70386295	3.261649072	1.528030623	0	1.037014986	0.729681034	0.525448792	0.088896572	0	0	0.003235501	0	0	0	0	0	0	0	0	0	0	54.5893		10.2709	9.1233	0.29869344	3.951864539	0.321025249	6.09540797	2.411517707	2.728503765	1.393189376	0.935927391	1.585289057	4.221600249	0	0.137066722	1.92561215	2.41544933	6.810228368	0.206978296	0.808721287	1.341074628	0.70386295	3.261649072	1.528030623	0	1.037014986	0.729681034	0.525448792	0.088896572	0	0	0.003235501	0	0	0	0	0	0	0	0	0	0	54.5893																																																																																		0			9.1233	0.29869344	3.951864539	0.321025249	6.09540797	2.411517707	2.728503765	1.393189376	0.935927391	1.585289057	4.221600249	0	0.137066722	1.92561215	2.41544933	6.810228368	0.206978296	0.808721287	1.341074628	0.70386295	3.261649072	1.528030623	0	1.037014986	0.729681034	0.525448792	0.088896572	0	0	0.003235501	0	0	0	0	0	0	0	0	0	0	54.5893
H5820_009_0	2009	7																					3350											D	D	D	V	T	Coin	Coin	V	V	Coin	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1675.531871	43.69096035	774.7703462	2862.450065	510.577673	13.41097463	15.02626885	390.9728044	244.7409933	9.966329099	1022.24611	0	0.74654857	899.2283259	4477.538633	6455.440009	96.282135	375.4790486	2690.399468	6194.798976	17.77806447	1323.941159	0	3111.044959	475.1386094	355.0711826	51.00156512	0	0	5291.10018											"$150 copay, days 1-5"	"$150 copay, days 1-5"	"$150 copay, days 6-20"	$5 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay	$25 copay to $100 copay	$0 copay to 20% coinsurance	$25 copay to $150 copay		20% coinsurance	Varies	$10 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$25 copay	Varies	20% Coinsurance	Varies	Not Covered	$0 copay	$15 copay	$15 copay; and $100 credit covered every 2 years	$20 copay	Not Covered	Varies	Varies											84.95454545	72.92592593	66.2299152	5	125	0.2	0.2	45	74.78983161	0.173357017	52.20390693	0	0.2	27.03324044	8.451420543	14.37945779	25	25	11.37622556	2.309261491	0.2	13.19904312	0	4	15	15	20	0	0	0.007436035											56.18559304	72.92592593	58.45288538	0.790031654	125	0.181279598	0.183292004	45	50.17028585	0.173357017	52.20390693	0	0.2	27.03324044	6.246929972	12.17496722	25	25	6.897030442	1.336604895	0.2	13.19904312	0	4	15	15	20	0	0	0.007436035											7.8451	0.265516978	3.77396352	0.18845218	5.318517427	2.43113609	2.754194932	1.466148016	1.023227133	1.727733086	4.447103397	0	0.149309714	2.025754628	2.330905857	6.549564207	0.200587781	0.782248018	1.546313919	0.689999886	3.555612893	1.456229705	0	1.037014986	0.593923262	0.443838978	0.085002609	0	0	0.003278734	0	0	0	0	0	0	0	0	0	0	52.6906		10.0424	7.8451	0.265516978	3.77396352	0.18845218	5.318517427	2.43113609	2.754194932	1.466148016	1.023227133	1.727733086	4.447103397	0	0.149309714	2.025754628	2.330905857	6.549564207	0.200587781	0.782248018	1.546313919	0.689999886	3.555612893	1.456229705	0	1.037014986	0.593923262	0.443838978	0.085002609	0	0	0.003278734	0	0	0	0	0	0	0	0	0	0	52.6906																																																																																		0			7.8451	0.265516978	3.77396352	0.18845218	5.318517427	2.43113609	2.754194932	1.466148016	1.023227133	1.727733086	4.447103397	0	0.149309714	2.025754628	2.330905857	6.549564207	0.200587781	0.782248018	1.546313919	0.689999886	3.555612893	1.456229705	0	1.037014986	0.593923262	0.443838978	0.085002609	0	0	0.003278734	0	0	0	0	0	0	0	0	0	0	52.6906
H5820_010_0	2009	8																					3350											D	D	D	V	T	Coin	Coin	V	V	Coin	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1567.513397	40.80521369	706.0364441	2293.063408	499.125917	11.90186704	13.33214277	366.9523391	229.7046724	9.112356461	959.2678709	0	0.682622889	844.0927372	4386.731231	6476.263494	99.32117119	388.8493252	2661.378915	6592.67888	16.25177686	1295.680724	0	3111.044959	465.5988759	341.2240363	50.01828548	0	0	5293.6462											"$150 copay, days 1-5"	"$150 copay, days 1-5"	"$150 copay, days 6-20"	$5 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay	$25 copay to $100 copay	$0 copay to 20% coinsurance	$25 copay to $150 copay		20% coinsurance	Varies	$10 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$25 copay	Varies	20% Coinsurance	Varies	Not Covered	$0 copay	$15 copay	$15 copay; and $100 credit covered every 2 years	$20 copay	Not Covered	Varies	Varies											84.95454545	72.92592593	66.2299152	5	125	0.2	0.2	45	74.79045033	0.17335447	52.19132282	0	0.2	27.03220871	8.675079731	14.43897657	25	25	11.37204194	2.26166762	0.2	13.25187646	0	4	15	15	20	0	0	0.007368804											54.14112906	72.92592593	57.83596503	0.218665037	125	0.179252433	0.181478238	45	48.99021447	0.17335447	52.19132282	0	0.2	27.03220871	6.492832616	12.25672946	25	25	6.918384712	1.362725804	0.2	13.25187646	0	4	15	15	20	0	0	0.007368804											7.0722	0.247979833	3.402858258	0.041784399	5.199228302	2.133438628	2.419493774	1.376071272	0.937773431	1.579667727	4.172121593	0	0.136524578	1.901474253	2.373525968	6.61481746	0.206919107	0.810102761	1.534370267	0.748667802	3.250355372	1.430850074	0	1.037014986	0.581998595	0.426530045	0.083363809	0	0	0.003250654	0	0	0	0	0	0	0	0	0	0	49.7224		9.8774	7.0722	0.247979833	3.402858258	0.041784399	5.199228302	2.133438628	2.419493774	1.376071272	0.937773431	1.579667727	4.172121593	0	0.136524578	1.901474253	2.373525968	6.61481746	0.206919107	0.810102761	1.534370267	0.748667802	3.250355372	1.430850074	0	1.037014986	0.581998595	0.426530045	0.083363809	0	0	0.003250654	0	0	0	0	0	0	0	0	0	0	49.7224																																																																																		0			7.0722	0.247979833	3.402858258	0.041784399	5.199228302	2.133438628	2.419493774	1.376071272	0.937773431	1.579667727	4.172121593	0	0.136524578	1.901474253	2.373525968	6.61481746	0.206919107	0.810102761	1.534370267	0.748667802	3.250355372	1.430850074	0	1.037014986	0.581998595	0.426530045	0.083363809	0	0	0.003250654	0	0	0	0	0	0	0	0	0	0	49.7224
H5820_011_0	2009	7																					3350											D	D	D	V	T	Coin	Coin	V	V	Coin	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1483.049845	38.48312889	758.5266129	2459.337552	503.2325026	11.56131297	12.94626506	386.6489424	242.0343439	9.201683537	1005.012342	0	0.693672686	895.6179488	4290.17372	6541.718647	103.546241	406.594816	2540.265769	6245.286803	16.37743401	1267.741072	0	3111.044959	923.0472579	0	42.81791446	0.119419719	0	5293.225565											"$300 copay, days 1-7"	"$300 copay, days 1-7"	"$150 copay, days 6-20"	$10 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	5% coinsurance to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$15 copay	$35 copay	"$35 copay Group, $35 copay Individual"	$35 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	$0 copay	$30 copay	Not Covered	$30 copay	$0 credit	Varies	Varies											192.7636364	182.7037037	66.2299152	10	125	0.2	0.2	45	149.2856603	0.180023974	72.11269395	0	0.2	43.26131594	12.69973793	19.80848445	35	35	22.68539624	3.545925823	0.2	26.1667539	0	4	30	0	30	0	0	0.007478327											106.477753	182.7037037	46.38241802	0.817737808	125	0.145742701	0.151546982	45	87.08434391	0.180023974	72.11269395	0	0.2	43.26131594	7.140282835	14.24902935	35	35	10.83242007	1.135331196	0.2	26.1667539	0	4	30	0	30	0	0	0.007478327											13.1593	0.585917515	2.931858203	0.167591108	5.242005235	1.684976977	1.961967395	1.449933534	1.75645017	1.656523638	6.039512286	0	0.138734537	3.22880092	2.552754481	7.767761752	0.30200987	1.185901547	2.293102158	0.590872411	3.275486801	2.764389053	0	1.037014986	2.307618145	0	0.107044786	0	0	0.003298706	0	0	0	0	0	0	0	0	0	0	64.1908		25.0914	13.1593	0.585917515	2.931858203	0.167591108	5.242005235	1.684976977	1.961967395	1.449933534	1.75645017	1.656523638	6.039512286	0	0.138734537	3.22880092	2.552754481	7.767761752	0.30200987	1.185901547	2.293102158	0.590872411	3.275486801	2.764389053	0	1.037014986	2.307618145	0	0.107044786	0	0	0.003298706	0	0	0	0	0	0	0	0	0	0	64.1908																																																																																		0			13.1593	0.585917515	2.931858203	0.167591108	5.242005235	1.684976977	1.961967395	1.449933534	1.75645017	1.656523638	6.039512286	0	0.138734537	3.22880092	2.552754481	7.767761752	0.30200987	1.185901547	2.293102158	0.590872411	3.275486801	2.764389053	0	1.037014986	2.307618145	0	0.107044786	0	0	0.003298706	0	0	0	0	0	0	0	0	0	0	64.1908
H5820_013_0	2009	7																					3350											D	D	D	V	T	Coin	Coin	V	V	Coin	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1559.355018	40.48944048	797.5670716	2585.916718	529.1332784	12.14129629	13.59572571	406.5493016	254.4915625	9.64331732	1063.16955	0	0.72146245	934.3264974	4554.706101	6885.237754	107.5760342	422.4185969	2693.160307	6590.167916	17.19902223	1332.99019	0	3111.044959	558.8535202	411.7018775	51.02045317	0	0	5298.003088											"$150 copay, days 1-5"	"$150 copay, days 1-5"	"$150 copay, days 6-20"	$5 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay	$25 copay to $100 copay	$0 copay to 20% coinsurance	$25 copay to $150 copay		20% coinsurance	Varies	$10 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	$25 copay	Varies	20% Coinsurance	Varies	Not Covered	$0 copay	$15 copay	$15 copay; and $100 credit covered every 1 years	$20 copay	Not Covered	Varies	Varies											84.95454545	72.92592593	66.2299152	5	125	0.2	0.2	45	74.78792695	0.173365299	52.24266527	0	0.2	27.03642216	8.760789037	14.27007186	25	25	11.3763224	2.466277565	0.2	13.15391552	0	4	15	15	20	0	0	0.007506571											51.3322051	72.92592593	58.11431381	0.244162681	125	0.177786775	0.180163078	45	49.35393466	0.173365299	52.24266527	0	0.2	27.03642216	6.497583371	12.00686619	25	25	6.569526141	1.484096758	0.2	13.15391552	0	4	15	15	20	0	0	0.007506571											6.6704	0.246060828	3.862505257	0.052615363	5.511804983	2.158561907	2.449447791	1.524559881	1.046679996	1.671816588	4.628567578	0	0.14429249	2.105070468	2.466215218	6.889177368	0.224116738	0.880038744	1.47439892	0.815037237	3.439804447	1.461170029	0	1.037014986	0.6985669	0.514627347	0.085034089	0	0	0.003314153	0	0	0	0	0	0	0	0	0	0	52.0609		10.7879	6.6704	0.246060828	3.862505257	0.052615363	5.511804983	2.158561907	2.449447791	1.524559881	1.046679996	1.671816588	4.628567578	0	0.14429249	2.105070468	2.466215218	6.889177368	0.224116738	0.880038744	1.47439892	0.815037237	3.439804447	1.461170029	0	1.037014986	0.6985669	0.514627347	0.085034089	0	0	0.003314153	0	0	0	0	0	0	0	0	0	0	52.0609																																																																																		0			6.6704	0.246060828	3.862505257	0.052615363	5.511804983	2.158561907	2.449447791	1.524559881	1.046679996	1.671816588	4.628567578	0	0.14429249	2.105070468	2.466215218	6.889177368	0.224116738	0.880038744	1.47439892	0.815037237	3.439804447	1.461170029	0	1.037014986	0.6985669	0.514627347	0.085034089	0	0	0.003314153	0	0	0	0	0	0	0	0	0	0	52.0609
H5820_026_0	2009	5																					3250											D	D	D	V	T	Coin	Coin	V	V	Coin	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1702.022776	44.7350049	736.7821626	2946.378832	532.8743914	12.11922495	13.55895811	338.3215986	211.7824134	8.324040633	879.0158587	0	0.628495833	784.5494226	4181.243462	5949.202062	91.59605916	357.8910651	2254.012142	5815.073715	14.81422996	1254.360391	0	3111.044959	914.385804	0	42.9734852	0.121193013	0	5296.802292											"$300 copay, days 1-7"	"$300 copay, days 1-7"	"$150 copay, days 6-20"	$10 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	5% coinsurance to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$15 copay	$35 copay	"$35 copay Group, $35 copay Individual"	$35 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	$0 copay	$30 copay	Not Covered	$30 copay	$0 credit	Varies	Varies											192.7636364	182.7037037	66.2299152	10	125	0.2	0.2	45	149.2975756	0.180012897	72.04910955	0	0.2	43.24606196	12.09362985	20.05899147	35	35	22.72320511	3.176009819	0.2	26.49240911	0	4	30	0	30	0	0	0.007413931											118.6276018	182.7037037	45.21643389	0.278791594	125	0.146770667	0.152422727	45	76.19255265	0.180012897	72.04910955	0	0.2	43.24606196	5.980430523	13.94579214	35	35	8.98560547	0.513557207	0.2	26.49240911	0	4	30	0	30	0	0	0.007413931											16.8256	0.681104257	2.776221829	0.068452138	5.55077491	1.778746731	2.066693364	1.268705995	1.34468689	1.498434667	5.277692492	0	0.125699167	2.827389412	2.083803002	6.913861277	0.267155173	1.04384894	1.687805319	0.248864418	2.962845991	2.769252387	0	1.037014986	2.28596451	0	0.107433713	0	0	0.003272511	0	0	0	0	0	0	0	0	0	0	63.5013		25.8039	16.8256	0.681104257	2.776221829	0.068452138	5.55077491	1.778746731	2.066693364	1.268705995	1.34468689	1.498434667	5.277692492	0	0.125699167	2.827389412	2.083803002	6.913861277	0.267155173	1.04384894	1.687805319	0.248864418	2.962845991	2.769252387	0	1.037014986	2.28596451	0	0.107433713	0	0	0.003272511	0	0	0	0	0	0	0	0	0	0	63.5013																																																																																		0			16.8256	0.681104257	2.776221829	0.068452138	5.55077491	1.778746731	2.066693364	1.268705995	1.34468689	1.498434667	5.277692492	0	0.125699167	2.827389412	2.083803002	6.913861277	0.267155173	1.04384894	1.687805319	0.248864418	2.962845991	2.769252387	0	1.037014986	2.28596451	0	0.107433713	0	0	0.003272511	0	0	0	0	0	0	0	0	0	0	63.5013
H5820_027_0	2009	5																					3250											D	D	D	V	T	Coin	Coin	V	V	Coin	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1539.698721	40.14369215	723.101763	2651.438779	472.4249513	12.34171183	13.82625126	360.297946	225.5391582	9.192415875	936.5991902	0	0.693841851	835.2416032	4140.669403	6035.184755	91.44820149	357.1124091	2471.339596	5855.895279	16.36653542	1229.70138	0	3111.044959	901.2212564	0	41.75201101	5.575186441	0	5296.138085											"$300 copay, days 1-7"	"$300 copay, days 1-7"	"$150 copay, days 6-20"	$10 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	5% coinsurance to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$15 copay	$35 copay	"$35 copay Group, $35 copay Individual"	$35 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	$0 copay	$30 copay	Not Covered	$30 copay	$0 credit	Varies	Varies											192.7636364	182.7037037	66.2299152	10	125	0.2	0.2	45	149.2910964	0.180018713	72.08367173	0	0.2	43.25434761	12.25739753	19.91179101	35	35	22.68168306	3.353515398	0.2	26.27922109	0	4	30	0	30	0	0	0.00756311											107.2353331	182.7037037	44.41971212	0.185651616	125	0.146755778	0.152472667	45	79.36533967	0.180018713	72.08367173	0	0.2	43.25434761	6.058017678	13.71241116	35	35	9.918567601	0.660332622	0.2	26.27922109	0	4	30	0	30	0	0	0.00756311											13.7592	0.611200103	2.676664345	0.041020324	4.921093242	1.811217521	2.108125407	1.351117298	1.491665992	1.654806876	5.626125714	0	0.13876837	3.010652554	2.090354037	6.896411234	0.266723921	1.04157786	2.042679071	0.322236557	3.273307085	2.692966203	0	1.037014986	2.253053141	0	0.104380028	0	0	0.00333794	0	0	0	0	0	0	0	0	0	0	61.2257		26.285	13.7592	0.611200103	2.676664345	0.041020324	4.921093242	1.811217521	2.108125407	1.351117298	1.491665992	1.654806876	5.626125714	0	0.13876837	3.010652554	2.090354037	6.896411234	0.266723921	1.04157786	2.042679071	0.322236557	3.273307085	2.692966203	0	1.037014986	2.253053141	0	0.104380028	0	0	0.00333794	0	0	0	0	0	0	0	0	0	0	61.2257																																																																																		0			13.7592	0.611200103	2.676664345	0.041020324	4.921093242	1.811217521	2.108125407	1.351117298	1.491665992	1.654806876	5.626125714	0	0.13876837	3.010652554	2.090354037	6.896411234	0.266723921	1.04157786	2.042679071	0.322236557	3.273307085	2.692966203	0	1.037014986	2.253053141	0	0.104380028	0	0	0.00333794	0	0	0	0	0	0	0	0	0	0	61.2257
H5820_028_0	2009	5																					3250											D	D	D	V	T	Coin	Coin	V	V	Coin	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1508.035921	39.25063409	693.3417584	2388.644144	481.20551	11.36751605	12.73247718	351.6280966	220.1120095	8.914757107	913.8756241	0	0.673015103	815.2841718	4364.430917	6587.718929	104.9464456	412.6439765	2626.841172	6847.268456	15.8698397	1277.094435	0	3111.044959	925.7268071	0	43.63923276	0.123871134	0	5301.938419											"$300 copay, days 1-7"	"$300 copay, days 1-7"	"$150 copay, days 6-20"	$10 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	5% coinsurance to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$15 copay	$35 copay	"$35 copay Group, $35 copay Individual"	$35 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	$0 copay	$30 copay	Not Covered	$30 copay	$0 credit	Varies	Varies											192.7636364	182.7037037	66.2299152	10	125	0.2	0.2	45	149.2939966	0.180016052	72.06819694	0	0.2	43.25063609	12.68721228	19.98902502	35	35	22.66558334	3.308025277	0.2	26.43883189	0	4	30	0	30	0	0	0.007499057											101.4268109	182.7037037	43.12992527	0.612807376	125	0.141294022	0.147587485	45	76.53019028	0.180016052	72.06819694	0	0.2	43.25063609	6.837698587	14.13951132	35	35	10.47132675	0.968962958	0.2	26.43883189	0	4	30	0	30	0	0	0.007499057											12.7463	0.597603018	2.491981519	0.121981563	5.012557395	1.606162059	1.879154284	1.318605362	1.403767831	1.604799376	5.488447372	0	0.134603021	2.938463252	2.486888593	7.762260531	0.3060938	1.203544931	2.292209352	0.552895792	3.17396794	2.813740422	0	1.037014986	2.314317018	0	0.109098082	0	0	0.003313295	0	0	0	0	0	0	0	0	0	0	61.3997		26.6936	12.7463	0.597603018	2.491981519	0.121981563	5.012557395	1.606162059	1.879154284	1.318605362	1.403767831	1.604799376	5.488447372	0	0.134603021	2.938463252	2.486888593	7.762260531	0.3060938	1.203544931	2.292209352	0.552895792	3.17396794	2.813740422	0	1.037014986	2.314317018	0	0.109098082	0	0	0.003313295	0	0	0	0	0	0	0	0	0	0	61.3997																																																																																		0			12.7463	0.597603018	2.491981519	0.121981563	5.012557395	1.606162059	1.879154284	1.318605362	1.403767831	1.604799376	5.488447372	0	0.134603021	2.938463252	2.486888593	7.762260531	0.3060938	1.203544931	2.292209352	0.552895792	3.17396794	2.813740422	0	1.037014986	2.314317018	0	0.109098082	0	0	0.003313295	0	0	0	0	0	0	0	0	0	0	61.3997
H5820_029_0	2009	5																					3250											D	D	D	V	T	Coin	Coin	V	V	Coin	V	V	Coin	V	V	V	V	V	V	V	Coin	O	T	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		1607.022708	41.99142414	683.0700187	1948.318695	562.6741074	12.05650805	13.48431675	367.2204724	229.8725184	9.506052166	954.7602443	0	0.717676051	851.378706	4153.644872	5943.101379	86.52586851	336.5201386	2471.464264	5687.189883	16.92834288	1269.491077	0	3111.044959	924.4123035	0	43.14965095	0.119658685	0	5299.520526											"$300 copay, days 1-7"	"$300 copay, days 1-7"	"$150 copay, days 6-20"	$10 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay	$50 copay to $200 copay	5% coinsurance to 20% coinsurance	$50 copay to $150 copay		20% coinsurance	Varies	$15 copay	$35 copay	"$35 copay Group, $35 copay Individual"	$35 copay	$50 copay	Varies	20% Coinsurance	Varies	Not Covered	$0 copay	$30 copay	Not Covered	$30 copay	$0 credit	Varies	Varies											192.7636364	182.7037037	66.2299152	10	125	0.2	0.2	45	149.2905668	0.18001921	72.08649816	0	0.2	43.25502581	11.97634413	19.70801721	35	35	22.68403948	3.154970603	0.2	26.31119594	0	4	30	0	30	0	0	0.00755738											108.8418065	182.7037037	43.66552082	0.111306402	125	0.146733259	0.152373494	45	82.2400929	0.18001921	72.08649816	0	0.2	43.25502581	5.870194324	13.6018674	35	35	10.21122204	0.444834032	0.2	26.31119594	0	4	30	0	30	0	0	0.00755738											14.5759	0.639332393	2.485550677	0.018071695	5.861188619	1.769090723	2.054652462	1.377076772	1.575394772	1.711271998	5.735443549	0	0.14353521	3.068867325	2.03189188	6.736439743	0.252367116	0.981517071	2.103055864	0.210821301	3.385668575	2.783485705	0	1.037014986	2.311030759	0	0.107874127	0	0	0.003337541	0	0	0	0	0	0	0	0	0	0	62.9599		25.6884	14.5759	0.639332393	2.485550677	0.018071695	5.861188619	1.769090723	2.054652462	1.377076772	1.575394772	1.711271998	5.735443549	0	0.14353521	3.068867325	2.03189188	6.736439743	0.252367116	0.981517071	2.103055864	0.210821301	3.385668575	2.783485705	0	1.037014986	2.311030759	0	0.107874127	0	0	0.003337541	0	0	0	0	0	0	0	0	0	0	62.9599																																																																																		0			14.5759	0.639332393	2.485550677	0.018071695	5.861188619	1.769090723	2.054652462	1.377076772	1.575394772	1.711271998	5.735443549	0	0.14353521	3.068867325	2.03189188	6.736439743	0.252367116	0.981517071	2.103055864	0.210821301	3.385668575	2.783485705	0	1.037014986	2.311030759	0	0.107874127	0	0	0.003337541	0	0	0	0	0	0	0	0	0	0	62.9599
H5820_801_0	2009	5																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																			15.3764	0.1669	0	0	0.198	0.2397	0.2683	0.2361	0.7937	0.4477	0.4332	0	0.0339	0.4494	1.2842	2.7801	0.0378	0.1592	0.929	1.056	0.1507	0.2107																			25.251		1299.320856	34.27261404	981.1490536	2499.960594	6.387136127	7.731333674	8.655189002	7.616139992	25.60333477	14.44116836	13.97322435	0	1.093550873	14.49567212	41.4248838	89.67945007	1.21860474	5.136243755	29.9680512	34.0654964	4.862774437	6.797424559	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										9.859651344	4.057456185	72.91273818	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										9.859651344	4.057456185	72.91273818	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										1.0676	0.011588302	5.961522005	0	1.277427225	1.546266735	1.7310378	1.523227998	5.120666955	2.888233671	2.794644871	0	0.218710175	2.899134424	8.28497676	17.93589001	0.243720948	1.027248751	5.99361024	6.813099281	0.972554887	1.359484912	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.6706	Medicare Standard		16.444	0.178496592	5.961522005	0	1.475428445	1.785938079	1.999348659	1.759328338	5.914370333	3.33590989	3.227814825	0	0.252610252	3.34850026	9.569148157	20.71595297	0.281497695	1.186472307	6.922619827	7.869129669	1.123300895	1.570205073	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.9216																																																																																		0			16.444	0.178496592	5.961522005	0	1.475428445	1.785938079	1.999348659	1.759328338	5.914370333	3.33590989	3.227814825	0	0.252610252	3.34850026	9.569148157	20.71595297	0.281497695	1.186472307	6.922619827	7.869129669	1.123300895	1.570205073	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.9216
H5821_001_0	2009	5																																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																																																			0		1091.283272	28.74792649	1.657684008		2.173230203	4.810495298	4.306451202	3.883536815	9.259409692	10.66283354	18.50105816	0.47534813	0.337397743	3.616019211	34.0522695	52.82466367	3.349661557	3.846618255			12.02608375	0.396007164																			"1a (IP Acute) - Medicare copay, no deductible"	"1b (IP Psych) - Medicare copay, no deductible"	2 (SNF) - Medicare copay	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) -20%	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%"	Radiology (PCP) - 0%	7g (Prof Others) - 20%	15 (Part B Rx) - 20%	"13a (Blood),  14j (Nutrient Therapy), 16b(Comp Den),  17a (Eye Exam) - 20%, 14a (Education/Wellness), 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 (Health & Education)	13c (other)											3.09	3.09	0.182542068		0.2	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			0.2	0.2																			3.09	3.09	0.182542068		0.2	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			0.2	0.2																			0.281	0.007402591	0.302597068	0	0.434646041	0.96209906	0.86129024	0.776707363	1.851881938	2.132566707	3.700211633	0.095069626	0.067479549	0.723203842	6.8104539	10.56493273	1.674830778	0.769323651	0	0	2.405216751	0.079201433	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.5001	0	0	0.281	0.007402591	0.302597068	0	0.434646041	0.96209906	0.86129024	0.776707363	1.851881938	2.132566707	3.700211633	0.095069626	0.067479549	0.723203842	6.8104539	10.56493273	1.674830778	0.769323651	0	0	2.405216751	0.079201433	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.5001		1a (IP Acute) - 20%	1b (IP Psych) - 20%	2 (SNF) - 20%	6 (Home Health)- 0%	10a (Ambulance) - 0%	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) -20%	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.) - 20%; 14j (Nutrition Therap) - 0%"	"7b (Chiro), 7d (Spec), 7f (Pod) - 20%"	"7e (MH), 7h (Psychiatric) - 20%"	"7c (OT), 7i (PT/ST) - 20%"	Radiology (PCP) - 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) - 20%	16a(Preventative Den) - 20%	17a1(Routine Eye Exam) - 20%	17b1(Non MCR Covered) - 20%	"18a(Hearing Exam), 18a1(Routine Hearing Exam) - 20%"	18b(Hearing Aids) - 20%	19a (Health & Education) - 20%	13c (other) - 20%	N/A (Exclude)										1.5433		0.039						0.1929	0.2909	0.4041	0.0113		0.0858	0.7505	1.1957		0.1534				0.1002		0.0059							0.0001										4.7731	0	0	1.8244	0.007402591	0.341564506	0	0.434646041	0.96209906	0.86129024	0.776707363	2.044782169	2.423461816	4.104336459	0.106355194	0.067479549	0.809003852	7.560937286	11.76058383	1.674830778	0.922714519	0	0	2.405216751	0.179440762	0	0.005878294	0	0	0	0	0	0	0.000132262	0	0	0	0	0	0	0	0	0	39.2732
H5821_004_0	2009	5																																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	P	P																																																			0							15.38147321	13.22898307	5.235918554																																	"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) - 20%	"11b (Med Supp) - 20%, 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%"	Professional Radiology - 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 (Health & Education)	13c (Other)																0.2	0.2	0.139111813																																						0.2	0.2	0.139111813																																	0	0	0	0	0	3.076294642	2.645796615	0.728378123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.4505	0	0	0	0	0	0	0	3.076294642	2.645796615	0.728378123	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.4505		"1a (IP Acute) , 1a1 (Add'l Days) - 20%"	1b (IP Psych) - 20%	"2 (SNF), 2a2 (Waiver 3 Day) - 20%"	6 (Home Health)- 20%	10a (Ambulance) - 0%	11a (Medical Equip) - 0%	"11b (Med Supp), 11c (Diab Supp) - 0%"	"4a (ER), 4(b) - 20%"	9b (OP Surg/ASC) - 20%	8a (OP Diag Proc/Test/Lab) - 20%	8b (OP Diag & Therap Rad) - 20%	9a (OP Observation) -20%	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.) - 20% 14j (Nutrition Therap) - 0%"	"7b (Chiro), 7d (Spec), 7f (Pod) - 20%"	"7e (MH), 7h (Psychiatric) -20%"	"7c (OT), 7i (PT/ST) - 20%"	Professional Radiology - 20%	7g (Prof Others) - 20%	15 (Part B Rx) - 0%	"13a (Blood), 14a (Education/Wellness), 16b(Comp Den),  17a (Eye Exam), 17b (MCR Eyewear), 18a (MCR Hearing Exam) - 20% 14j (Nutrient Therapy) - 0%"	10b(Transportation) - 20%	16a(Preventative Den) - 20%	17a1(Routine Eye Exam) - 20%	17b1(Non MCR Covered) - 20%	"18a(Hearing Exam), 18a1(Routine Hearing Exam) - 20%"	18b(Hearing Aids) - 20%	19a (Health & Education) - 20%	13c (Other) - 20%											2.4475		0.0262						0.1436	0.5794	0.9638	0.0084		0.063	1.8485	3.0573		0.1539				0.2527		0.4166	0.0125			0.0079													9.9814	0	0	2.4475	0	0.026169535	0	0	3.076294642	2.645796615	0.728378123	0.143591973	0.579447194	0.963814554	0.008410904	0	0.062967361	1.848518778	3.057277689	0	0.153906701	0	0	0	0.252671975	0	0.41663607	0.012534065	0	0	0.007948936	0	0	0	0	0	0	0	0	0	0	0	0	16.4319
H5821_013_0	2009	5																																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	P	P																																																			0							19.49909267	17.31297562	5.305606023													12.89143848																				"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) - 20%	"11b (Med Supp) - 20%, 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%"	Professional Radiology - 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 (Health & Education)	13b (Other)																0.2	0.2	0.063647008													0.080568664																									0.2	0.2	0.063647008													0.080568664																				0	0	0	0	0	3.899818533	3.462595123	0.337685947	0	0	0	0	0	0	0	0	0	0	0	0	1.038645975	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.7387	0	0	0	0	0	0	0	3.899818533	3.462595123	0.337685947	0	0	0	0	0	0	0	0	0	0	0	0	1.038645975	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.7387		"1a (IP Acute) , 1a1 (Add'l Days) - 20%"	1b (IP Psych) - 20%	"2 (SNF), 2a2 (Waiver 3 Day) - 20%"	6 (Home Health)- 20%	10a (Ambulance) - 0%	11a (Medical Equip) - 20%	"11b (Med Supp) - 20%, 11c (Diab Supp) - 0%"	"4a (ER), 4(b) 20%"	9b (OP Surg/ASC) - 20%	8a (OP Diag Proc/Test/Lab) - 20%	8b (OP Diag & Therap Rad) - 20%	9a (OP Observation) - 20%	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.) -20%; (Nutrition Therap) - 0%"	"7b (Chiro), 7d (Spec), 7f (Pod) - 20%"	"7e (MH), 7h (Psychiatric) -20%"	"7c (OT), 7i (PT/ST) - 20%"	Professional Radiology - 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) - 20%	16a(Preventative Den) - 20%	17a1(Routine Eye Exam) - 20%	17b1(Non MCR Covered) - 20%	"18a(Hearing Exam), 18a1(Routine Hearing Exam) - 20%"	18b(Hearing Aids) - 20%	19a (Health & Education)  - 20%	13b (Other) - 20%											1.1921								0.0225	0.5443	0.6508			0.0044	2.1669	2.7269		0.2512				0.3037		0.299	0.0165			0.0015													8.1798	0	0	1.1921	0	0	0	0	3.899818533	3.462595123	0.337685947	0.02249912	0.544332601	0.650777134	0	0	0.004434002	2.166946033	2.726901645	0	0.25124319	0	0	1.038645975	0.303702746	0	0.298954995	0.016468418	0	0	0.00145158	0	0	0	0	0	0	0	0	0	0	0	0	16.9185
H5821_015_0	2009	6																																A	A	A	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																																																			0		310.0693152	36.86426407				17.24732776	6.764978361	6.790525931													23.96657151																				"1a (IP Acute) , 1a1 (Add'l Days) - $85"	1b (IP Psych) - $85	"2 (SNF), 2a2 (Waiver 3 Day) - $85"	6 (Home Health)- $0	10a (Ambulance) - 0%	11a (Medical Equip) - 20%	"11b (Med Supp) - 20%, 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%"	Professional Radiology - 0%	7g (Prof Others) - 0%	15 (Part B Rx) - 10%	"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 (Health & Education)	13b (Other)											85	85				0.2	0.2	0.118186397													0.15																				85	85				0.2	0.2	0.118186397													0.15																				2.1963	0.261121871	0	0	0	3.449465552	1.352995672	0.802547792	0	0	0	0	0	0	0	0	0	0	0	0	3.594985726	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.6574	0	0	2.1963	0.261121871	0	0	0	3.449465552	1.352995672	0.802547792	0	0	0	0	0	0	0	0	0	0	0	0	3.594985726	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.6574		"1a (IP Acute) , 1a1 (Add'l Days) - 20%"	1b (IP Psych) - 20%	"2 (SNF), 2a2 (Waiver 3 Day) - 20%"	6 (Home Health)- 20%	10a (Ambulance) - 0%	11a (Medical Equip) - 20%	"11b (Med Supp) - 20%, 11c (Diab Supp) - 0%"	"4a (ER), 4(b) -20%"	9b (OP Surg/ASC) - 20%	8a (OP Diag Proc/Test/Lab) - 20%	8b (OP Diag & Therap Rad) - 20%	9a (OP Observation) -20%	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.) - 20%;14j (Nutrition Therap) - 0%"	"7b (Chiro), 7d (Spec), 7f (Pod) - 20%"	"7e (MH), 7h (Psychiatric) -20%"	"7c (OT), 7i (PT/ST) - 20%"	Professional Radiology - 20%	7g (Prof Others) - 20%	15 (Part B Rx) - 20%	"13a (Blood), 14a (Education/Wellness), 16b(Comp Den),  17a (Eye Exam), 17b (MCR Eyewear), 18a (MCR Hearing Exam) - 20%, 14j (Nutrient Therapy) - 0%"	10b(Transportation) - 20%	16a(Preventative Den) - 20%	17a1(Routine Eye Exam) - 20%	17b1(Non MCR Covered) - 20%	"18a(Hearing Exam), 18a1(Routine Hearing Exam) - 20%"	18b(Hearing Aids) - 20%	19a (Health & Education)  - 20%	13b (Other)											4.4807		0.1012						0.3947	0.5231	0.8758	0.0329		0.2105	1.6736	2.6653		0.1543				0.1561																			11.2681	0	0	6.677	0.261121871	0.101176676	0	0	3.449465552	1.352995672	0.802547792	0.394689763	0.523125878	0.875829588	0.03287842	0	0.210519198	1.673574876	2.665302962	0	0.154286475	0	0	3.594985726	0.156082447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.9256
H5821_017_0	2009	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																																																			0							23.7126171	21.05410589								60.61594431	0.5228032						4.128017794		2489.955411																	"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) - 20%	"11b (Med Supp) - 20%, 11c (Diab Supp) - 0%"	"4a (ER), 4(b) -0%"	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%"	Professional Radiology - 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 (Health & Education)	13b (Other)																0.2	0.2								0.015461824	0.034459322						0.01691524		1																						0.2	0.2								0.015461824	0.034459322						0.01691524		1																	0	0	0	0	0	4.742523421	4.210821178	0	0	0	0	0	0	0	0.937233056	0.018015444	0	0	0	0	0	0.069826414	0	0.207496284	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.1859	0	0	0	0	0	0	0	4.742523421	4.210821178	0	0	0	0	0	0	0	0.937233056	0.018015444	0	0	0	0	0	0.069826414	0	0.207496284	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.1859		"1a (IP Acute) , 1a1 (Add'l Days) - 20%"	1b (IP Psych) - 0%	"2 (SNF), 2a2 (Waiver 3 Day) - 20%"	6 (Home Health)- 0%	10a (Ambulance) - 0%	11a (Medical Equip) - 0%	"11b (Med Supp), 11c (Diab Supp) - 0%"	"4a (ER), 4(b) - 20%"	9b (OP Surg/ASC) - 20%	8a (OP Diag Proc/Test/Lab) - 20%	8b (OP Diag & Therap Rad) - 20%	9a (OP Observation) -20%	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.) - 20%; 14j (Nutrition Therap) - 0%"	"7b (Chiro), 7d (Spec), 7f (Pod) - 20%"	"7e (MH), 7h (Psychiatric) -20%"	"7c (OT), 7i (PT/ST) - 20%"	Professional Radiology - 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) - 20%	17a1(Routine Eye Exam) - 20%	17b1(Non MCR Covered) - 20%	"18a(Hearing Exam), 18a1(Routine Hearing Exam) - 20%"	18b(Hearing Aids) - 20%	19a (Health & Education) - 20%	13b (Other) - 20%											1.4497								0.0274	0.662	0.7914			0.0054	2.6354	3.3147		0.3055				0.3693		0.3247	0.02			0.0018													9.9072	0	0	1.4497	0	0	0	0	4.742523421	4.210821178	0	0.027360915	0.661956469	0.791402413	0	0	0.005392138	3.572647293	3.332709658	0	0.305533886	0	0	0	0.439155748	0	0.532156054	0.02002705	0	0	0.001765249	0	0	0	0	0	0	0	0	0	0	0	0	20.0931
H5821_804_0	2009	3																																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																																																			0		1671.124334	39.22308957	2.111511695		3.361770156	25.31549363	16.21980406	6.078966643	13.07066913	20.29689136	33.73806066	0.675178641	0.482759263	5.362591073	56.59476584	89.10377686	3.405183963	7.123199671			20.03796728	7.934525518																			1a (IP Acute) - medicare cost share	1b (IP Psych) - medicare cost share	2 (SNF) - medicare cost share	6 (Home Health) 0%	10a (Ambulance) - medicare cost share	11a (Medical Equip) - medicare cost share	"11b (Med Supp), 11c (Diab Supp) - medicare cost share"	"4a (ER) -23%, 4(b) -medicare cost share"	9b (OP Surg/ASC) - medicare cost share	8a (OP Diag Proc/Test/Lab) - medicare cost share	8b (OP Diag & Therap Rad) - medicare cost share	9a (OP Observation) -medicare cost share	12 (Renal Dialysis) - medicare cost share	"3 (CORF), 5 (Partial Hospital),9a (OP Other), 9c (OP SA), 9d (Cardiac Rehab) - medicare cost share"	"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) - medicare cost share"	"7b (Chiro), 7d (Spec), 7f (Pod) - medicare cost share"	"7e (MH), 7h (Psychiatric) -medicare cost share"	"7c (OT), 7i (PT/ST) - medicare cost share"	Professional Radiology - medicare cost share	7g (Prof Others) - medicare cost share	15 (Part B Rx) - medicare cost share	"13a (Blood), 14a (Education/Wellness), 14j (Nutrient Therapy), 16b(Comp Den),  17a (Eye Exam), 17b (MCR Eyewear), 18a (MCR Hearing Exam) - medicare cost share"	10b(Transportation) - medicare cost share	16a(Preventative Den) - medicare cost share	17a1(Routine Eye Exam) - medicare cost share	17b1(Non MCR Covered) - medicare cost share	"18a(Hearing Exam), 18a1(Routine Hearing Exam) - medicare cost share"	18b(Hearing Aids) - medicare cost share	19a (Health & Education) - medicare cost share	13b (Other) - medicare cost share											125.2238892	67.55119798	0.184993115		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			125.2238892	67.55119798	0.184993115		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			17.4387	0.220797224	0.390615126	0	0.776568906	5.847879029	3.746774738	1.404241294	3.019324569	4.688581904	7.793492012	0.155966266	0.11151739	1.238758538	13.07339091	20.58297246	0.786597495	1.645459124	0	0	4.628770441	1.832875395	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.3833	0	0	17.4387	0.220797224	0.390615126	0	0.776568906	5.847879029	3.746774738	1.404241294	3.019324569	4.688581904	7.793492012	0.155966266	0.11151739	1.238758538	13.07339091	20.58297246	0.786597495	1.645459124	0	0	4.628770441	1.832875395	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.3833		1a (IP Acute) - medicare cost share	1b (IP Psych) - medicare cost share	2 (SNF) - medicare cost share	6 (Home Health)- $0	10a (Ambulance) - medicare cost share	11a (Medical Equip) - medicare cost share	"11b (Med Supp), 11c (Diab Supp) - medicare cost share"	"4a (ER) -23%, 4(b) -medicare cost share"	9b (OP Surg/ASC) - medicare cost share	8a (OP Diag Proc/Test/Lab) - medicare cost share	8b (OP Diag & Therap Rad) - medicare cost share	9a (OP Observation) -medicare cost share	12 (Renal Dialysis) - medicare cost share	"3 (CORF), 5 (Partial Hospital),9a (OP Other), 9c (OP SA), 9d (Cardiac Rehab) - medicare cost share"	"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) - medicare cost share"	"7b (Chiro), 7d (Spec), 7f (Pod) - medicare cost share"	"7e (MH), 7h (Psychiatric) -medicare cost share"	"7c (OT), 7i (PT/ST) - medicare cost share"	Professional Radiology - medicare cost share	7g (Prof Others) - medicare cost share	15 (Part B Rx) - medicare cost share	"13a (Blood), 14a (Education/Wellness), 14j (Nutrient Therapy), 16b(Comp Den),  17a (Eye Exam), 17b (MCR Eyewear), 18a (MCR Hearing Exam) - medicare cost share"	10b(Transportation) - medicare cost share	16a(Preventative Den) - medicare cost share	17a1(Routine Eye Exam) - medicare cost share	17b1(Non MCR Covered) - medicare cost share	"18a(Hearing Exam), 18a1(Routine Hearing Exam) - medicare cost share"	18b(Hearing Aids) - medicare cost share	19a (Health & Education) - medicare cost share	13b (Other) - medicare cost share											2.5317		0.0622		0.265				0.4833	0.8268	1.3538	0.025		0.1869	2.3981	3.7932	0.0866	0.3475				0.2582																			12.6184	0	0	19.9704	0.220797224	0.452822324	0	1.041604354	5.847879029	3.746774738	1.404241294	3.502631303	5.515412734	9.147314873	0.180931965	0.11151739	1.425661656	15.47149856	24.37621471	0.873177169	1.993008624	0	0	4.628770441	2.091072849	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.0017
H5823_001_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		291.5723114	23.12334303	72.93319353	47.66313689	12.80563481	23.86929752	17.46085528	19.88101565	32.49997859	12.02043067	18.94608708	0	7.691755572	57.05579768	51.84930103	114.9545857	10.36718913	6.662672358	29.40017062	41.69580948	9.808488809	1.945138627	0	0	0	0	0	0	0	0											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	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing											0.068320477	0.068320477	0.155924755	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.068320477	0.068320477	0.155924755	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											19.9204	1.579797816	11.37209034	0	2.958101641	5.513807727	4.033457569	4.592514614	7.507495055	2.776719484	4.376546115	0	1.776795537	13.17988926	11.97718854	26.5545093	2.39482069	1.539077315	6.791439414	9.631731989	2.265760915	0.449327023	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.1914	0	0	19.9204	1.579797816	11.37209034	0	2.958101641	5.513807727	4.033457569	4.592514614	7.507495055	2.776719484	4.376546115	0	1.776795537	13.17988926	11.97718854	26.5545093	2.39482069	1.539077315	6.791439414	9.631731989	2.265760915	0.449327023	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.1914																																																																																		0	0	0	19.9204	1.579797816	11.37209034	0	2.958101641	5.513807727	4.033457569	4.592514614	7.507495055	2.776719484	4.376546115	0	1.776795537	13.17988926	11.97718854	26.5545093	2.39482069	1.539077315	6.791439414	9.631731989	2.265760915	0.449327023	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.1914
H5823_002_0	2009	7																					3350											D	D	D	Coin	T	Coin	Coin	V	V	Coin	V	Coin	Coin	V	V	V	V	V	V	V	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	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	512.873496	8.410986016	440.1595066	0	147.2481301	6.857831373	4.636634561	249.0276293	229.6012424	0	99.35848844	0	0.568032235	386.3074052	4412.753622	5841.251785	132.7629724	412.1656532	70.29302443	1366.386524	7.842469269	0	0	0	370.244022	0	0	0	0	139.9130044											$250/Days 1-5 for IP Medical; $250/Days 1-5 for IP Surgical;	$250/Days 1-5 for IP Psych; $250/Days 1-5 for IP Substance Abuse;	$150/Days Custom for SNF	No Cost-Sharing	$100/Run 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;	$300/Case for OP Fac - Surgery; $300/Case for OP Fac - ASC	No Cost-Sharing	$100/Case for OP Fac - CT/MRI/PET	No Cost-Sharing	20% Coinsurance for Renal Dialysis - Fac; 20% Coinsurance for Renal Dialysis - Prof	$30/Case for OP Fac - Cardiovascular; $20/Case for OP Fac - Occ Therapy; $30/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $20/Visit for Prof - CORF; $20/Visit for Prof - CORF;	$10/Visit for PCP - Office Visits; $10/Consult for PCP - Consults; $10/Procedure for PCP - Surgery (Office); $10/Visit for PCP - Tx Injections; $10/Visit for PCP - Allergy Testing; $10/Visit for PCP - Allergy Tx;	$30/Visit for Speclst - Office Visits; $30/Procedure for Speclst - Surgery (Office); $30/Visit for Speclst - Tx Injections; $30/Visit for Speclst - Allergy Testing; $30/Visit for Speclst - Allergy Tx; $30/Consult for Speclst - Consults;	$30/Visit for OP Psych - Non-Physician; $30/Visit for OP Psych - Psychiatrist; $30/Visit for OP Substance Abuse;	$30/Visit for PT/ST (PCP); $20/Visit for Occ Therapy (PCP); $30/Visit for PT/ST (Specialist); $20/Visit for Occ Therapy (Specialist);	$100/Visit for Prof Radiology (Office);	$15/Visit for Chiropractor; $30/Exam for Vistion Exams; $20/Service for Podiatrist; $30/Exam for Hearing/Speech Exams;	20% Coinsurance for Part B Rx	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$25/Service for Vision Exams (Refractions);	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$25/Service for Podiatry;											250	250.0000001	150	0	100	0.2	0.2	41.71066563	300	0	100	0	0.2	25.91708225	10	29.9121872	30	24.94486911	100	23.2402266	0.2	0	0	0	25	0	0	0	0	16.55660608											231.5011766	231.5011767	138.9007059	0	92.60047063	0.185200941	0.185200941	38.62427268	277.8014119	0	92.60047062	0	0.185200941	23.99934014	9.260047063	27.69882612	27.78014119	23.09906619	92.60047062	21.52055921	0.185200941	0	0	0	23.15011766	0	0	0	0	15.33149515											9.8942	0.162262763	5.094872183	0	1.136270512	1.270076825	0.858709085	0.801542588	5.315295775	0	0.766720233	0	0.105200105	0.772593568	3.405192184	13.48298479	0.307347843	0.793386809	0.542430595	2.450450174	1.45243269	0	0	0	0.714266056	0	0	0	0	0.178756296	0	0	0	0	0	0	0	0	0	0	49.505	0	3.9559	9.8942	0.162262763	5.094872183	0	1.136270512	1.270076825	0.858709085	0.801542588	5.315295775	0	0.766720233	0	0.105200105	0.772593568	3.405192184	13.48298479	0.307347843	0.793386809	0.542430595	2.450450174	1.45243269	0	0	0	0.714266056	0	0	0	0	0.178756296	0	0	0	0	0	0	0	0	0	0	49.505	0																																																																																	0	0	0	9.8942	0.162262763	5.094872183	0	1.136270512	1.270076825	0.858709085	0.801542588	5.315295775	0	0.766720233	0	0.105200105	0.772593568	3.405192184	13.48298479	0.307347843	0.793386809	0.542430595	2.450450174	1.45243269	0	0	0	0.714266056	0	0	0	0	0.178756296	0	0	0	0	0	0	0	0	0	0	49.505
H5826_005_0	2009	11																																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		254.0257845	25.15728795	47.10957296		14.76475944	19.82196796	11.82441137	41.14344581	31.09410498	20.45425867	10.62962622	6.455950174	1.350294583	23.05692267	56.405094	60.50213978	7.556095269	10.26642332	22.9547773	32.62341713	14.39499025																				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		$2400 per year		$400 per year		$3000 per year													0.069345997	0.069345997	0.156187337		0.231	0.231	0.231	0.230991618	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.069345997	0.069345997	0.156187337		0.231	0.231	0.231	0.230991618	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				17.6157	1.744557223	7.35791875	0	3.41065943	4.578874598	2.731439026	9.503791099	7.182738251	4.724933754	2.455443656	1.49132449	0.311918049	5.326149136	13.02957671	13.97599429	1.745458007	2.371543788	5.302553556	7.536009358	3.325242747	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.7218	Part B FFS	0	17.6157	1.744557223	7.35791875	0	3.41065943	4.578874598	2.731439026	9.503791099	7.182738251	4.724933754	2.455443656	1.49132449	0.311918049	5.326149136	13.02957671	13.97599429	1.745458007	2.371543788	5.302553556	7.536009358	3.325242747	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.7218																																																																																		0	0	0	17.6157	1.744557223	7.35791875	0	3.41065943	4.578874598	2.731439026	9.503791099	7.182738251	4.724933754	2.455443656	1.49132449	0.311918049	5.326149136	13.02957671	13.97599429	1.745458007	2.371543788	5.302553556	7.536009358	3.325242747	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.7218
H5826_006_0	2009	9																					3350											D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin	V			V	P	V	P																																																					0		654.5524366	60.92390003	472.7904236		74.52888512	5.259942435	4.30951258	243.1551331	24.47993993		10.08138452	6.163554644	0.06075131	8.645329767	3222.153251	2838.640932	179.6340513	469.6808522	19.46173527	26.45287316	19.08404669																				$160/d 1-10	$160/d 1-10	$100 for days 21-55		100 per trip	0.2	0.2	50ER/40UC/0.2WWER	0.2		0.15	0.2	0.2	0.2	$0 PCP/ $5 Specialist	$5 per visit	$5 per visit	$5 per visit	0.15	"20% mcr dental, vision, podiatry, op surgeon's fees"	0.2					$100 every three years				$250 for alternative med											100.8	100.8	31.1		100	0.2	0.2	50.04652129	0.2		0.15	0.2	0.2	0.2	2.687433326	2.687433326	5	5	0.15	0.084027437	0.2																				94.8712492	94.8712492	29.27079216		94.11830278	0.188236606	0.188236606	47.10777845	0.188236606		0.141177454	0.188236606	0.188236606	0.188236606	2.529366635	2.529366635	4.705915139	4.705915139	0.141177454	0.079085197	0.188236606																				5.1749	0.481660542	1.153245852	0	0.584544348	0.990113709	0.81120802	0.954541512	4.608020796	0	1.423264202	1.160206604	0.01143562	1.627367529	0.679167244	0.598330305	0.070445217	0.184189853	2.74755824	2.092030697	3.592316169	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.9445	0	1.8087	5.1749	0.481660542	1.153245852	0	0.584544348	0.990113709	0.81120802	0.954541512	4.608020796	0	1.423264202	1.160206604	0.01143562	1.627367529	0.679167244	0.598330305	0.070445217	0.184189853	2.74755824	2.092030697	3.592316169	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.9445																																																																																		0	0	0	5.1749	0.481660542	1.153245852	0	0.584544348	0.990113709	0.81120802	0.954541512	4.608020796	0	1.423264202	1.160206604	0.01143562	1.627367529	0.679167244	0.598330305	0.070445217	0.184189853	2.74755824	2.092030697	3.592316169	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.9445
H5826_007_0	2009	15																					5000											D	D	D	V	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	Coin	Coin	V			V	P	V	P																																																					0		834.5007486	21.2379378	501.2099726		106.9782477	7.788830023	6.505797477	320.1832312	28.13704786		10.88231195	4.474520227	0.297382902	15.35032986	3895.448057	2995.323779	120.2795537	502.1238998	2331.996301	31.14246263	12.7698597																				"$300 per day, days 1-10"	"$275 per day, days 1-10"	$100 for days 11-100		165 per trip	0.25	0.25	50ER/40UC/0.2WW ER	0.25		0.25	0.25	0.25	0.25	$10PCP/$25SCP	25% Chiro & Podiatry; $10 PCP $25 copay specialist	0.25	0.25	0.25	25%OPSurgeon'sFees	0.2																				198	198	55.22358648		165	0.25	0.25	50.04054101	0.25		0.25	0.25	0.25	0.25	17.12890993	16.76005108	21.26174326	38.56802711	25.45675645	0.096220154	0.2																				170.9967227	170.9967227	55.22358648		165	0.215904953	0.215904953	50.04054101	0.215904953		0.215904953	0.215904953	0.215904953	0.215904953	17.12890993	16.76005108	18.36206271	33.30811232	21.98495921	0.083097631	0.172723962																				11.8914	0.302634813	2.306551022	0	1.470950905	1.68164698	1.404633898	1.335178509	6.074927995	0	2.349545049	0.966071079	0.064206441	3.314212247	5.560398243	4.183481628	0.184048392	1.393733271	4.272403629	2.587864867	2.205660766	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.5496	0	6.1103	11.8914	0.302634813	2.306551022	0	1.470950905	1.68164698	1.404633898	1.335178509	6.074927995	0	2.349545049	0.966071079	0.064206441	3.314212247	5.560398243	4.183481628	0.184048392	1.393733271	4.272403629	2.587864867	2.205660766	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.5496																																																																																		0	0	0	11.8914	0.302634813	2.306551022	0	1.470950905	1.68164698	1.404633898	1.335178509	6.074927995	0	2.349545049	0.966071079	0.064206441	3.314212247	5.560398243	4.183481628	0.184048392	1.393733271	4.272403629	2.587864867	2.205660766	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.5496
H5826_008_0	2009	11																					3350											D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin	V			V	P	V	P																																																					0		1026.403083	182.4819339	739.9367675		147.8053566	9.173931813	7.775731075	368.2095151	30.22010479		8.97066361	6.499693826	0.311260993	12.23395231	4530.607131	3629.845562	392.7356791	645.961614	25.41171568	34.92215919	21.30732383																				$160/day days 1-10	$160/day days 1-10	$100 for days 21+		100 per trip	0.2	0.2	50ER/40UC/0.2WWER	0.2		0.15	0.2	0.2	0.2	$0 PCP/ $5 Specialist	$0 PCP/ $5 Specialist	5 per visit	5 per visit	0.15	"20% mcr dental, vision, podiatry, op surgeon's fees"	0.2					$100 every two years				$250 for alternative med											100.8	100.8	31.1		100	0.2	0.2	50.02902025	0.2		0.15	0.2	0.2	0.2	2.610789066	2.610789066	5	5	0.15	0.093611624	0.2																				94.8712492	94.8712492	29.27079216		94.11830278	0.188236606	0.188236606	47.08971541	0.188236606		0.141177454	0.188236606	0.188236606	0.188236606	2.457230358	2.457230358	4.705915139	4.705915139	0.141177454	0.088105672	0.188236606																				8.1147	1.442690752	1.804877945	0	1.159265776	1.726869784	1.463677223	1.444906773	5.688529945	0	1.266455451	1.223480303	0.058590713	2.302877655	0.927728782	0.743280559	0.154015065	0.253320045	3.587561325	3.076840286	4.010818311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.4505	0	2.5277	8.1147	1.442690752	1.804877945	0	1.159265776	1.726869784	1.463677223	1.444906773	5.688529945	0	1.266455451	1.223480303	0.058590713	2.302877655	0.927728782	0.743280559	0.154015065	0.253320045	3.587561325	3.076840286	4.010818311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.4505																																																																																		0	0	0	8.1147	1.442690752	1.804877945	0	1.159265776	1.726869784	1.463677223	1.444906773	5.688529945	0	1.266455451	1.223480303	0.058590713	2.302877655	0.927728782	0.743280559	0.154015065	0.253320045	3.587561325	3.076840286	4.010818311	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.4505
H5826_009_0	2009	14																					5000											D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	Coin			V	P	V	P																																																					0		1081.988748	55.65097989	607.3914185		184.3205805	10.85216315	7.819725703	457.0730517	34.34251357		13.41299801	7.317677581	0.384346495	20.19096392	6068.316437	3124.885838	1.766575856	7.506821803	26.38097881	38.43500523	13.80396729																				"$300 per day, days 1-10"	"$275 per day, days 1-10"	$100 for days 11-100		$165 per trip	0.25	0.25	50ER/40UC/0.2WWER	0.25		0.25	0.25	0.25	0.25	$10 PCP/ $25 specialist	$10 PCP/ $25 specialist/25% chiro and podiatry	0.25	0.25	0.25	25%OPSurgeon'sFees	0.2																				198	198	55.22358648		165	0.25	0.25	50.02276207	0.25		0.25	0.25	0.25	0.25	16.95252785	16.95252785	0.25	0.25	0.25	0.094149949	0.2																				170.9967227	170.9967227	55.22358648		165	0.215904953	0.215904953	50.02276207	0.215904953		0.215904953	0.215904953	0.215904953	0.215904953	16.95252785	16.95252785	0.215904953	0.215904953	0.215904953	0.081309761	0.172723962																				15.418	0.793011265	2.795194377	0	2.534407982	2.343035773	1.68831751	1.905338043	7.414718776	0	2.895932705	1.579922834	0.082982312	4.359329115	8.572775284	4.414559518	0.381412477	1.620760008	5.695783988	3.125141095	2.384275927	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.0049	0	7.8615	15.418	0.793011265	2.795194377	0	2.534407982	2.343035773	1.68831751	1.905338043	7.414718776	0	2.895932705	1.579922834	0.082982312	4.359329115	8.572775284	4.414559518	0.381412477	1.620760008	5.695783988	3.125141095	2.384275927	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.0049																																																																																		0	0	0	15.418	0.793011265	2.795194377	0	2.534407982	2.343035773	1.68831751	1.905338043	7.414718776	0	2.895932705	1.579922834	0.082982312	4.359329115	8.572775284	4.414559518	0.381412477	1.620760008	5.695783988	3.125141095	2.384275927	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.0049
H5826_010_0	2009	9																					3350											D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V		P	Coin	V			V	P	V	P																																																					0		1052.011313	83.53172601	1194.135089		104.751967	8.525674505	6.733896366	257.2641957	34.17728338		9.637112681	8.735176936	0.01360632	13.66802125	4156.422381	4938.616579	261.1073238	826.0087347	3188.655751	3550.134245	31.31739447																				$225/day days 1-10	$225/day days 1-10	$100 for days 21+		175 per trip	0.2	0.2	50ER/40UC/0.2WWER	0.2		0.2	0.2	0.2	0.2	$0 PCP/ $15 Specialist	$0 PCP/ $15 Specialist	0.2	0.2	0.2	20%MCR Dental/vision/podiatry	0.2					$75 every 2 yrs															141.75	141.75	47.93352047		175	0.2	0.2	50.05736299	0.2		0.2	0.2	0.2	0.2	8.145017191	8.145017191	21.54525177	31.85194707	23.42632836	12.69501511	0.2																				128.8018393	128.8018393	47.93352047		175	0.18173099	0.18173099	50.05736299	0.18173099		0.18173099	0.18173099	0.18173099	0.18173099	8.145017191	8.145017191	19.57719969	28.94242939	21.28644924	11.53538832	0.18173099																				11.2917	0.896586662	4.769924892	0	1.527632852	1.549379269	1.223757654	1.073163936	6.211071549	0	1.75136203	1.587452353	0.00247269	2.483903035	2.821177646	3.352093078	0.425979185	1.992224957	5.656263232	3.412681427	5.691341105	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7202	0	4.4409	11.2917	0.896586662	4.769924892	0	1.527632852	1.549379269	1.223757654	1.073163936	6.211071549	0	1.75136203	1.587452353	0.00247269	2.483903035	2.821177646	3.352093078	0.425979185	1.992224957	5.656263232	3.412681427	5.691341105	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7202																																																																																		0	0	0	11.2917	0.896586662	4.769924892	0	1.527632852	1.549379269	1.223757654	1.073163936	6.211071549	0	1.75136203	1.587452353	0.00247269	2.483903035	2.821177646	3.352093078	0.425979185	1.992224957	5.656263232	3.412681427	5.691341105	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.7202
H5832_001_0	2009	6																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$250/stay	$250/stay	$0/day 1-10;  $75/day 11-100	$0 per visit	$180 per trip	0.2	0.2	$50 Emer Rm; $30 Urgent Care Ctr	$200 per procedure	$0 per visit	$20 X-ray; $175 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$10 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	Not Covered	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											42.26923225	42.26923225	47.56208437	0	180	0.2	0.2	48	200	0	82	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											42.26923225	42.26923225	47.56208437	0	180	0.2	0.2	48	200	0	82	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											6.8827	0	5.345573617	0	4.098227577	1.576138182	0	1.017676696	6.408158995	0	32.21471974	0	0.139220051	1.967526475	6.088949555	23.17962445	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.6375	0	0	6.8827	0	5.345573617	0	4.098227577	1.576138182	0	1.017676696	6.408158995	0	32.21471974	0	0.139220051	1.967526475	6.088949555	23.17962445	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.6375																																																																																		0			6.8827	0	5.345573617	0	4.098227577	1.576138182	0	1.017676696	6.408158995	0	32.21471974	0	0.139220051	1.967526475	6.088949555	23.17962445	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.6375
H5832_002_0	2009	8																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1942.4498	0	1334.318816	1036.652771	270.5726515	8.049812533	0	252.5950127	389.2086552	1040.523826	4667.565342	0	67.51623878	793.60074	7264.865411	9291.354518	0	678.8069015	0	0	276.9433569	0	0	0	876.3166563	0	74.54373432	0	0	0											$200/day 1-5	$200/day 1-5	"$0/d 1-20, $100/d 21-100"	$0 per visit	$180 per trip	0.2	0.2	$50 Emer Rm; $30 Urgent Care Ctr	$200 per procedure	$0 per visit	$15 X-ray; $165 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$15 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	Not Covered	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											122.5677481	122.5677481	40.33133874	0	180	0.2	0.2	48	200	0	75	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											122.5677481	122.5677481	40.33133874	0	180	0.2	0.2	48	200	0	75	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											19.8401	0	4.484572013	0	4.058589773	1.609962507	0	1.010380051	6.48681092	0	29.17228339	0	0.140658831	1.98400185	9.081081763	23.22838629	0	1.697017254	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.8324	0	0	19.8401	0	4.484572013	0	4.058589773	1.609962507	0	1.010380051	6.48681092	0	29.17228339	0	0.140658831	1.98400185	9.081081763	23.22838629	0	1.697017254	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.8324																																																																																		0			19.8401	0	4.484572013	0	4.058589773	1.609962507	0	1.010380051	6.48681092	0	29.17228339	0	0.140658831	1.98400185	9.081081763	23.22838629	0	1.697017254	0	0	1.038537588	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.8324
H5832_801_0	2009	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																																																			0		333.2898946	0	41.15472076	6.239549282	7.359074204	9.796781806	0	8.659519722	44.75345828	15.25492405	62.18016925	0	3.393102042	12.89763859	45.55652789	197.88596	0	5.864881796	0	0	8.850179776	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.078599637	0.078599637	0.204227821	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											26.1965	0	8.404938963	0	1.699946141	2.263056597	0	2.000349056	10.33804886	3.523887455	14.3636191	0	0.783806572	2.979354515	10.52355794	45.71165676	0	1.354787695	0	0	2.044391528	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.1879			26.1965	0	8.404938963	0	1.699946141	2.263056597	0	2.000349056	10.33804886	3.523887455	14.3636191	0	0.783806572	2.979354515	10.52355794	45.71165676	0	1.354787695	0	0	2.044391528	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.1879																																																																																		0			26.1965	0	8.404938963	0	1.699946141	2.263056597	0	2.000349056	10.33804886	3.523887455	14.3636191	0	0.783806572	2.979354515	10.52355794	45.71165676	0	1.354787695	0	0	2.044391528	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.1879
H5832_802_0	2009	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																																																			0		333.2898946	0	41.15472076	6.239549282	7.359074204	9.796781806	0	8.659519722	44.75345828	15.25492405	62.18016925	0	3.393102042	12.89763859	45.55652789	197.88596	0	5.864881796	0	0	8.850179776	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.078599637	0.078599637	0.204227821	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											26.1965	0	8.404938963	0	1.699946141	2.263056597	0	2.000349056	10.33804886	3.523887455	14.3636191	0	0.783806572	2.979354515	10.52355794	45.71165676	0	1.354787695	0	0	2.044391528	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.1879			26.1965	0	8.404938963	0	1.699946141	2.263056597	0	2.000349056	10.33804886	3.523887455	14.3636191	0	0.783806572	2.979354515	10.52355794	45.71165676	0	1.354787695	0	0	2.044391528	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.1879																																																																																		0			26.1965	0	8.404938963	0	1.699946141	2.263056597	0	2.000349056	10.33804886	3.523887455	14.3636191	0	0.783806572	2.979354515	10.52355794	45.71165676	0	1.354787695	0	0	2.044391528	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.1879
H5839_001_0	2009	4																																D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	V	V	Coin	Coin																																																											0		885.9176355	25.35000031	42.94925286	23.09049549	190.2304296	15.44766207	9.401516792	455.8159864	95.79913245	33.01314004	4.467080807	0.433067836	0.067599471	0.039283092	3527.173977	2661.337843	1.503947717	7.582918573	0	0	27.12836497	0.001761248																			$150 - days 1-5	$150 - days 1-5	$35 - days 11-100	15% Coinsurance	$150 Copay	20% Coinsurance	20% Coinsurance	$50 Copay	15% Coinsurance	15% Coinsurance	15% Coinsurance	50% Coinsurance	15% Coinsurance	50% Coinsurance	$20 Copay	$40 Copay	50% Coinsurance	15% Coinsurance	$40 Copay	$40 Copay	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	20	40	0.5	0.15	40	40	0.2	0.15																			150	150	35	0.15	150	0.2	0.2	50	0.15	0.15	0.15	0.5	0.15	0.5	20	40	0.5	0.15	40	40	0.2	0.15																			11.074	0.316875004	0.125268654	3.463574323	2.37788037	3.089532415	1.880303358	1.899233277	14.36986987	4.951971006	0.670062121	0.216533918	0.010139921	0.019641546	5.878623296	8.871126142	0.751973859	1.137437786	0	0	5.425672994	0.000264187	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.53			11.074	0.316875004	0.125268654	3.463574323	2.37788037	3.089532415	1.880303358	1.899233277	14.36986987	4.951971006	0.670062121	0.216533918	0.010139921	0.019641546	5.878623296	8.871126142	0.751973859	1.137437786	0	0	5.425672994	0.000264187	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.53		$500 per day								20% Coinsurance																																0.7533								0.391																																1.1443			11.8273	0.316875004	0.125268654	3.463574323	2.37788037	3.089532415	1.880303358	1.899233277	14.76088674	4.951971006	0.670062121	0.216533918	0.010139921	0.019641546	5.878623296	8.871126142	0.751973859	1.137437786	0	0	5.425672994	0.000264187	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.6743
H5849_003_1	2009	5	i.5.	h.2.									Professional	OP Facility - Other									3000	Radiology	Radiology									D	D	D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	Coin	P									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	NA	920.8659867	26.28814716	357.3657754	0	315.4276178	20.48232989	1.018572953	263.3977724	318.7204033	0	186.5643926	0	0	1652.486815	3631.527625	4229.770349	104.1210541	486.5125359	136.5835747	0	11.81404107	0	0	0	0	0	0	0	0	0	5.416406345	4.541216656									$100 for days 1-5	$100 for days 1-5	$130 for days 21-100	No cost sharing	"$150 copay ground, $300 copay air"	10% coinsurance	10% coinsurance	$50 copay	$100 copay	No cost sharing	$100 copay for advanced imaging			"$100 copay, $25 copay for PT/OT/ST"	$10 copay	$25 copay; $20 copay for chiropractor/podiatrist	$25 copay	$25 copay	$100 copay for advanced imaging		10% coinsurance										10% coinsurance for Therapeutic radiology	10% coinsurance for Therapeutic radiology									100	100	130	0	150	0.1	0.1	50	100	0	100	0	0	86.42895233	10	22.96496615	25	25	100	0	0.1	0	0	0	0	0	0	0	0	0	0.1	0.1									83.8301398	83.8301398	108.9791817	0	125.7452097	0.08383014	0.08383014	41.9150699	83.8301398	0	83.8301398	0	0	72.45351157	8.38301398	19.25156323	20.95753495	20.95753495	83.8301398	0	0.08383014	0	0	0	0	0	0	0	0	0	0.08383014	0.08383014									6.433	0.183644921	3.245452482	0	3.305292662	1.717036578	0.085387113	0.920028003	2.226531331	0	1.303309926	0	0	9.977372713	2.536928904	6.78580761	0.181843386	0.84967529	0.95415168	0	0.990372714	0	0	0	0	0	0	0	0	0	0.454058101	0.380690827	0	0	0	0	0	0	0	0	42.5306	0	8.2037	6.433	0.183644921	3.245452482	0	3.305292662	1.717036578	0.085387113	0.920028003	2.226531331	0	1.303309926	0	0	9.977372713	2.536928904	6.78580761	0.181843386	0.84967529	0.95415168	0	0.990372714	0	0	0	0	0	0	0	0	0	0.454058101	0.380690827	0	0	0	0	0	0	0	0	42.5306	3000																																																																																	0	NA	0	6.433	0.183644921	3.245452482	0	3.305292662	1.717036578	0.085387113	0.920028003	2.226531331	0	1.303309926	0	0	9.977372713	2.536928904	6.78580761	0.181843386	0.84967529	0.95415168	0	0.990372714	0	0	0	0	0	0	0	0	0	0.454058101	0.380690827	0	0	0	0	0	0	0	0	42.5306
H5849_003_2	2009	5	i.5.	h.2.									Professional	OP Facility - Other									4000	Radiology	Radiology									D	D	D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	Coin	P									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	NA	1157.044179	33.03037368	334.5987008	0	317.6292205	20.18677151	1.003875027	251.5130406	422.759122	0	182.2269235	0	0	1846.982593	4140.86467	4775.213685	114.5906935	535.4326209	156.674449	0	13.03825781	0	0	0	0	0	0	0	0	0	6.115393068	4.661670173									$200 for days 1-5	$200 for days 1-5	$130 for days 21-100	No cost sharing	"$150 copay ground, $300 copay air"	20% coinsurance	20% coinsurance	$50 copay	$250 copay	No cost sharing	$250 copay for advanced imaging			"$250 copay, $35 copay for PT/OT/ST"	$15 copay	$35 copay; $25 copay for chiropractor/podiatrist	$35 copay	$35 copay	$250 copay for advanced imaging		20% coinsurance										20% coinsurance for Therapeutic radiology	20% coinsurance for Therapeutic radiology									200	200	130	0	150	0.2	0.2	50	250	0	250	0	0	206.2711605	15	31.47401235	35	35	250	0	0.2	0	0	0	0	0	0	0	0	0	0.2	0.2									145.7386325	145.7386325	94.73011111	0	109.3039744	0.145738632	0.145738632	36.43465812	182.1732906	0	182.1732906	0	0	150.3083843	10.93039744	22.93489759	25.50426068	25.50426068	182.1732906	0	0.145738632	0	0	0	0	0	0	0	0	0	0.145738632	0.145738632									14.0522	0.401150124	2.641381008	0	2.893178014	2.941992474	0.146303374	0.763649304	6.417951698	0	2.766406524	0	0	23.13474745	3.771774714	9.126586404	0.24354591	1.137984429	2.378491661	0	1.900177864	0	0	0	0	0	0	0	0	0	0.891249023	0.679385436	0	0	0	0	0	0	0	0	76.2881	0	28.4036	14.0522	0.401150124	2.641381008	0	2.893178014	2.941992474	0.146303374	0.763649304	6.417951698	0	2.766406524	0	0	23.13474745	3.771774714	9.126586404	0.24354591	1.137984429	2.378491661	0	1.900177864	0	0	0	0	0	0	0	0	0	0.891249023	0.679385436	0	0	0	0	0	0	0	0	76.2881	4000																																																																																	0	NA	0	14.0522	0.401150124	2.641381008	0	2.893178014	2.941992474	0.146303374	0.763649304	6.417951698	0	2.766406524	0	0	23.13474745	3.771774714	9.126586404	0.24354591	1.137984429	2.378491661	0	1.900177864	0	0	0	0	0	0	0	0	0	0.891249023	0.679385436	0	0	0	0	0	0	0	0	76.2881
H5849_003_3	2009	5	i.5.	h.2.									Professional	OP Facility - Other									4000	Radiology	Radiology									D	D	D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	Coin	P									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	NA	1054.94759	30.11580174	429.4323214	0	379.3714845	21.87368938	1.087764356	287.0828309	364.5141958	0	209.4758093	0	0	2083.431994	4038.862881	4682.39544	114.5479871	535.2330724	145.7925764	0	13.65403666	0	0	0	0	0	0	0	0	0	5.378557405	5.963730621									$200 for days 1-5	$200 for days 1-5	$130 for days 21-100	No cost sharing	"$150 copay ground, $300 copay air"	20% coinsurance	20% coinsurance	$50 copay	$250 copay	No cost sharing	$250 copay for advanced imaging			"$250 copay, $35 copay for PT/OT/ST"	$15 copay	$35 copay; $25 copay for chiropractor/podiatrist	$35 copay	$35 copay	$250 copay for advanced imaging		20% coinsurance										20% coinsurance for Therapeutic radiology	20% coinsurance for Therapeutic radiology									200	200	130	0	150	0.2	0.2	50	250	0	250	0	0	212.7488955	15	31.43971011	35	35	250	0	0.2	0	0	0	0	0	0	0	0	0	0.2	0.2									143.1389586	143.1389586	93.04032308	0	107.3542189	0.143138959	0.143138959	35.78473965	178.9236982	0	178.9236982	0	0	152.2632767	10.73542189	22.50123682	25.04931775	25.04931775	178.9236982	0	0.143138959	0	0	0	0	0	0	0	0	0	0.143138959	0.143138959									12.5837	0.359228708	3.329543494	0	3.39392745	3.130977118	0.155701457	0.856098697	5.435018998	0	3.123348874	0	0	26.43584852	3.613241417	8.779974057	0.239112411	1.117268609	2.173812245	0	1.954424588	0	0	0	0	0	0	0	0	0	0.769881106	0.85364219	0	0	0	0	0	0	0	0	78.3047	0	31.1061	12.5837	0.359228708	3.329543494	0	3.39392745	3.130977118	0.155701457	0.856098697	5.435018998	0	3.123348874	0	0	26.43584852	3.613241417	8.779974057	0.239112411	1.117268609	2.173812245	0	1.954424588	0	0	0	0	0	0	0	0	0	0.769881106	0.85364219	0	0	0	0	0	0	0	0	78.3047	4000																																																																																	0	NA	0	12.5837	0.359228708	3.329543494	0	3.39392745	3.130977118	0.155701457	0.856098697	5.435018998	0	3.123348874	0	0	26.43584852	3.613241417	8.779974057	0.239112411	1.117268609	2.173812245	0	1.954424588	0	0	0	0	0	0	0	0	0	0.769881106	0.85364219	0	0	0	0	0	0	0	0	78.3047
H5849_005_0	2009	5	i.5.	h.2.									Professional	OP Facility - Other									4000	Radiology	Radiology									D	D	D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	Coin	P									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	NA	913.8897293	26.08899453	357.3657754	0	315.4276178	20.07268329	0.998201494	263.3977724	309.8670588	0	182.0140416	0	0	1644.327206	3544.522275	4075.123017	99.3882789	464.3983297	133.252268	0	11.57776025	0	0	0	0	0	0	0	0	0	5.253798419	4.452173192									$150 for days 1-5	$150 for days 1-5	$130 for days 21-100	No cost sharing	"$150 copay ground, $300 copay air"	20% coinsurance	20% coinsurance	$50 copay	$250 copay	No cost sharing	$250 copay for advanced imaging			"$250 copay, $35 copay for PT/OT/ST"	$14 copay	$35 copay; $25 copay for chiropractor/podiatrist	$35 copay	$35 copay	$250 copay for advanced imaging		20% coinsurance										20% coinsurance for Therapeutic radiology	20% coinsurance for Therapeutic radiology									150	150	130	0	150	0.2	0.2	50	250	0	250	0	0	211.2942464	14	31.44518876	35	35	250	0	0.2	0	0	0	0	0	0	0	0	0	0.2	0.2									116.4835238	116.4835238	100.9523873	0	116.4835238	0.155311365	0.155311365	38.82784127	194.1392063	0	194.1392063	0	0	164.0819892	10.87179555	24.41897596	27.17948889	27.17948889	194.1392063	0	0.155311365	0	0	0	0	0	0	0	0	0	0.155311365	0.155311365									8.8711	0.253244835	3.00641068	0	3.061843369	3.117515842	0.155032037	0.852263908	5.013112072	0	2.944671798	0	0	22.48370656	3.211276793	8.292527581	0.225110218	1.051842437	2.155790796	0	1.798157748	0	0	0	0	0	0	0	0	0	0.815974604	0.691473096	0	0	0	0	0	0	0	0	68.001	0	19.5663	8.8711	0.253244835	3.00641068	0	3.061843369	3.117515842	0.155032037	0.852263908	5.013112072	0	2.944671798	0	0	22.48370656	3.211276793	8.292527581	0.225110218	1.051842437	2.155790796	0	1.798157748	0	0	0	0	0	0	0	0	0	0.815974604	0.691473096	0	0	0	0	0	0	0	0	68.001	4000																																																																																	0		0	8.8711	0.253244835	3.00641068	0	3.061843369	3.117515842	0.155032037	0.852263908	5.013112072	0	2.944671798	0	0	22.48370656	3.211276793	8.292527581	0.225110218	1.051842437	2.155790796	0	1.798157748	0	0	0	0	0	0	0	0	0	0.815974604	0.691473096	0	0	0	0	0	0	0	0	68.001
H5849_006_0	2009	5	i.5.	h.2.									Professional	OP Facility - Other									4000	Radiology	Radiology									D	D	D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	Coin	P									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	NA	1165.944519	33.28445348	334.5987008	0	317.6292205	20.18677151	1.003875027	251.5130406	422.759122	0	182.2269235	0	0	1846.982593	4167.579926	4775.213685	114.5906935	535.4326209	156.674449	0	13.03825781	0	0	0	0	0	0	0	0	0	6.143836757	4.661670173									$150 for days 1-5	$150 for days 1-5	$130 for days 21-100	No cost sharing	"$150 copay ground, $300 copay air"	20% coinsurance	20% coinsurance	$50 copay	$250 copay	No cost sharing	$250 copay for advanced imaging			"$250 copay, $35 copay for PT/OT/ST"	$14 copay	$35 copay; $25 copay for chiropractor/podiatrist	$35 copay	$35 copay	$250 copay for advanced imaging		20% coinsurance										20% coinsurance for Therapeutic radiology	20% coinsurance for Therapeutic radiology									150	150	130	0	150	0.2	0.2	50	250	0	250	0	0	206.2711605	14	31.47401235	35	35	250	0	0.2	0	0	0	0	0	0	0	0	0	0.2	0.2									111.2258662	111.2258662	96.39575075	0	111.2258662	0.148301155	0.148301155	37.07528875	185.3764437	0	185.3764437	0	0	152.9512567	10.38108085	23.33816192	25.95270212	25.95270212	185.3764437	0	0.148301155	0	0	0	0	0	0	0	0	0	0.148301155	0.148301155									10.8069	0.308507681	2.687824413	0	2.944048766	2.993721531	0.148875826	0.77707655	6.53079855	0	2.815048253	0	0	23.54152573	3.605332013	9.287059182	0.247828178	1.15799361	2.420312682	0	1.933588693	0	0	0	0	0	0	0	0	0	0.911138087	0.691331071	0	0	0	0	0	0	0	0	73.8089	0	25.7303	10.8069	0.308507681	2.687824413	0	2.944048766	2.993721531	0.148875826	0.77707655	6.53079855	0	2.815048253	0	0	23.54152573	3.605332013	9.287059182	0.247828178	1.15799361	2.420312682	0	1.933588693	0	0	0	0	0	0	0	0	0	0.911138087	0.691331071	0	0	0	0	0	0	0	0	73.8089	4000																																																																																	0	NA	0	10.8069	0.308507681	2.687824413	0	2.944048766	2.993721531	0.148875826	0.77707655	6.53079855	0	2.815048253	0	0	23.54152573	3.605332013	9.287059182	0.247828178	1.15799361	2.420312682	0	1.933588693	0	0	0	0	0	0	0	0	0	0.911138087	0.691331071	0	0	0	0	0	0	0	0	73.8089
H5849_007_0	2009	5	i.5.	h.2.									Professional	OP Facility - Other									4000	Radiology	Radiology									D	D	D	V	T	Coin	Coin	V	V	V	V			V	V	V	V	V	V	V	Coin	P									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	NA	1063.062571	30.34746175	429.4323214	0	379.3714845	21.87368938	1.087764356	287.0828309	364.5141958	0	209.4758093	0	0	2083.431994	4077.948651	4682.39544	114.5479871	535.2330724	145.7925764	0	13.65403666	0	0	0	0	0	0	0	0	0	5.416082224	5.963730621									$150 for days 1-5	$150 for days 1-5	$130 for days 21-100	No cost sharing	"$150 copay ground, $300 copay air"	20% coinsurance	20% coinsurance	$50 copay	$250 copay	No cost sharing	$250 copay for advanced imaging			"$250 copay, $35 copay for PT/OT/ST"	$14 copay	$35 copay; $25 copay for chiropractor/podiatrist	$35 copay	$35 copay	$250 copay for advanced imaging		20% coinsurance										20% coinsurance for Therapeutic radiology	20% coinsurance for Therapeutic radiology									150	150	130	0	150	0.2	0.2	50	250	0	250	0	0	212.7488955	14	31.43971011	35	35	250	0	0.2	0	0	0	0	0	0	0	0	0	0.2	0.2									109.2958371	109.2958371	94.7230588	0	109.2958371	0.145727783	0.145727783	36.43194569	182.1597285	0	182.1597285	0	0	155.0171242	10.20094479	22.90819623	25.50236199	25.50236199	182.1597285	0	0.145727783	0	0	0	0	0	0	0	0	0	0.145727783	0.145727783									9.6824	0.27640427	3.389761919	0	3.45531033	3.187604254	0.158517488	0.871582175	5.533317244	0	3.179838045	0	0	26.91396968	3.466577422	8.938769464	0.243437019	1.13747563	2.21312801	0	1.989772489	0	0	0	0	0	0	0	0	0	0.789273654	0.86908124	0	0	0	0	0	0	0	0	76.2962	0	28.4144	9.6824	0.27640427	3.389761919	0	3.45531033	3.187604254	0.158517488	0.871582175	5.533317244	0	3.179838045	0	0	26.91396968	3.466577422	8.938769464	0.243437019	1.13747563	2.21312801	0	1.989772489	0	0	0	0	0	0	0	0	0	0.789273654	0.86908124	0	0	0	0	0	0	0	0	76.2962	4000																																																																																	0	0	0	9.6824	0.27640427	3.389761919	0	3.45531033	3.187604254	0.158517488	0.871582175	5.533317244	0	3.179838045	0	0	26.91396968	3.466577422	8.938769464	0.243437019	1.13747563	2.21312801	0	1.989772489	0	0	0	0	0	0	0	0	0	0.789273654	0.86908124	0	0	0	0	0	0	0	0	76.2962
H5850_001_0	2009	5																																							V													S			P																																																									0									222.9079902													577.6356851			701.3173445																	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$50 copay PBP L.4a	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	18% chemo; $50 copay Part B Rx PBP L.15	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay																		50													85.38793134			79.65242276																								50													85.38793134			79.65242276																	0	0	0	0	0	0	0	0.928783293	0	0	0	0	0	0	0	0	0	0	0	0	4.110259685	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.6942			0	0	0	0	0	0	0	0.928783293	0	0	0	0	0	0	0	0	0	0	0	0	4.110259685	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.6942																																																																																		0			0	0	0	0	0	0	0	0.928783293	0	0	0	0	0	0	0	0	0	0	0	0	4.110259685	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.6942
H5850_002_0	2009	5																																																							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																																		23.60651183																																								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	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	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	4.1323
H5850_003_0	2009	5																																		D					V	V		V	V	V	V							S			P																																																									0				847.2222222					341.7385443	79.19750309		51.91731377	69.19707089	0	45.28279165							573.0108427			701.3173445																	$0 copay	$0 copay	$30 per day (days 11 through 100)  PBP L.2	$0 copay	$0 copay	$0 copay	$0 copay	$50 copay PBP L.4a	$100 copay @ Hospital PBP L.9a	$0 copay	$50 diag copay (hosp); $25 therap. copay PBP L.8a/8b	$50 copay PBP L.9a	$25 copay @ Hospital PBP L.12	"$25 copay @ Hospital PBP L.9a, 7c, 7i"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	18% chemo; $50 copay Part B Rx PBP L.15	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay													13.82142857					50	100		47.35521266	50	25	25							117.6647293			79.65242276																			13.82142857					50	100		47.35521266	50	25	25							117.6647293			79.65242276																	0	0	0.975818452	0	0	0	0	1.423910601	0.659979192	0	0.20487962	0.288321129	0	0.094339149	0	0	0	0	0	0	5.618597142	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.921			0	0	0.975818452	0	0	0	0	1.423910601	0.659979192	0	0.20487962	0.288321129	0	0.094339149	0	0	0	0	0	0	5.618597142	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.921																																																																																		0			0	0	0.975818452	0	0	0	0	1.423910601	0.659979192	0	0.20487962	0.288321129	0	0.094339149	0	0	0	0	0	0	5.618597142	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.921
H5850_004_0	2009	6																																		D		T			V	V		V		V	V		V					S			P																																																									0				926.897952		265.0801138			243.2532561	387.6228112		1808.624917	23.85150493	4.969947298	72.88173383		6675.855084					734.3659006			701.3173445																	$0 copay	$0 copay	$50 per day (days 8 through 100)  PBP L.2	$0 copay	$100 copay PBP L.10a	$0 copay	$0 copay	$50 copay PBP L.4a	$150 copay (hosp.); $50 copay (ASC) PBP L.9a	$0 copay	$50 copay (diagnostic); $100 copay (therapy) PBP L.8a/8b	$50 copay PBP L.9a	$30 copay @ Hospital PBP L.12	"$100 copay @ Hospital PBP L.9a, 7c, 7i"	$0 copay	$10 copay PBP L.7a thru 7f	Included in i.2.	Included in i.2.	Included in i.2.	Included in i.2.	18% chemo; $50 copay Part B Rx PBP L.15	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay													29.52247191		100			50	67.40442739		52.62168728	50	30	100		10					95.16914124			79.65242276																			29.52247191		100			50	67.40442739		52.62168728	50	30	100		10					95.16914124			79.65242276																	0	0	2.280359896	0	2.209000948	0	0	1.013555234	2.177291136	0	7.931074565	0.099381271	0.012424868	0.607347782	0	5.56321257	0	0	0	0	5.82408101	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.3729			0	0	2.280359896	0	2.209000948	0	0	1.013555234	2.177291136	0	7.931074565	0.099381271	0.012424868	0.607347782	0	5.56321257	0	0	0	0	5.82408101	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.3729																																																																																		0			0	0	2.280359896	0	2.209000948	0	0	1.013555234	2.177291136	0	7.931074565	0.099381271	0.012424868	0.607347782	0	5.56321257	0	0	0	0	5.82408101	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.3729
H5850_005_0	2009	5																																D		D		T			V	V		V		V	V		V					S			P																																																									0		1595.462963		973.1842782		304.1434473			224.0669425	120.1688254		1919.060923	12.28120304	0	83.84516774		6836.562228					606.8335314			701.3173445																	$50 per day (days 1-5) PBP L.1a	$0 copay	$40 per day (days 8 through 34)  PBP L.2	$0 copay	$100 copay PBP L.10a	$0 copay	$0 copay	$50 copay PBP L.4a	$250 copay @ Hospital PBP L.9a	$0 copay	$175 diag copay (hosp); $50 therap. Copay PBP L.8a/8b	$50 copay PBP L.9a	$30 copay @ Hospital PBP L.12	"$50 copay @ Hospital PBP L.9a, 7c, 7i"	$0 copay	$15 copay PBP L.7a thru 7f	Included in i.2.	Included in i.2.	Included in i.2.	Included in i.2.	18% chemo; $40 copay Part B Rx PBP L.15	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											34.74183657		20.65168539		100			50	150		4.907152861	50	30	50		15					80.98827761			79.65242276																	34.74183657		20.65168539		100			50	150		4.907152861	50	30	50		15					80.98827761			79.65242276																	4.6191	0	1.674824629	0	2.534528728	0	0	0.933612261	1.502110317	0	0.784760441	0.051171679	0	0.349354866	0	8.545702785	0	0	0	0	4.095533542	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7458			4.6191	0	1.674824629	0	2.534528728	0	0	0.933612261	1.502110317	0	0.784760441	0.051171679	0	0.349354866	0	8.545702785	0	0	0	0	4.095533542	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7458																																																																																		0			4.6191	0	1.674824629	0	2.534528728	0	0	0.933612261	1.502110317	0	0.784760441	0.051171679	0	0.349354866	0	8.545702785	0	0	0	0	4.095533542	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.7458
H5850_006_0	2009	5																																							V				V									S			P																																																									0									193.4286094													460.3725267			701.3173445																	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$50 copay PBP L.4a	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$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																		50													86.55324695			79.65242276																								50													86.55324695			79.65242276																	0	0	0	0	0	0	0	0.805952539	0	0	0	0	0	0	0	0	0	0	0	0	3.320561416	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.7816			0	0	0	0	0	0	0	0.805952539	0	0	0	0	0	0	0	0	0	0	0	0	3.320561416	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.7816																																																																																		0			0	0	0	0	0	0	0	0.805952539	0	0	0	0	0	0	0	0	0	0	0	0	3.320561416	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	8.7816
H5850_007_0	2009	5																																D		D		T			V	V		V		V	V		V					S			P																																																									0				1008.853864					212.0321207	99.36953573		67.57986079	12.65860258	20.62149722	73.97108925		6685.187248					614.8684465			701.3173445																	$0 copay	$0 copay	$30 per day (days 8 through 100)  PBP L.2	$0 copay	$100 copay PBP L.10a	$0 copay	$0 copay	$50 copay PBP L.4a	$100 copay @ Hospital PBP L.9a	$0 copay	$100 diag copay (hosp); $50 therap. Copay PBP L.8a/8b	$50 copay PBP L.9a	$30 copay @ Hospital; $0 copay @ Freestanding facility PBP L.12	"$50 copay @ Hospital PBP L.9a, 7c, 7i"	$0 copay	$15 copay PBP L.7a thru 7f	Included in i.2.	Included in i.2.	Included in i.2.	Included in i.2.	18% chemo; $40 copay Part B Rx PBP L.15	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay													17.71348315					50	100		89.66802841	50	0	50		15					81.21535385			79.65242276																			17.71348315					50	100		89.66802841	50	0	50		15					81.21535385			79.65242276																	0	0	1.489192993	0	0	0	0	0.88346717	0.828079464	0	0.504979406	0.052744177	0	0.308212872	0	8.356484059	0	0	0	0	4.161396538	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.2397			0	0	1.489192993	0	0	0	0	0.88346717	0.828079464	0	0.504979406	0.052744177	0	0.308212872	0	8.356484059	0	0	0	0	4.161396538	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.2397																																																																																		0			0	0	1.489192993	0	0	0	0	0.88346717	0.828079464	0	0.504979406	0.052744177	0	0.308212872	0	8.356484059	0	0	0	0	4.161396538	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.2397
H5850_010_0	2009	7																																D		D					V	V		V		V	V		V					S			P																																																									0		1010.301602		587.1784257					277.3462552	72.75290561		61.59591173	57.00806445	0.1	37.61307549		5832.620436					609.5729853			701.3173445																	$200 copay (days 1-6) PBP L.1a	$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	$0 copay	$150 diag copay (hosp); $50 therapy vopay PBP L.8a/8b	$50 copay PBP L.9a	$30 copay @ Hospital; $15 copay @ Freestanding facility PBP L.12	"$50 copay @ Hospital PBP L.9a, 7c, 7i"	$0 copay	$25 copay PBP L.7a thru 7f	Included in i.2.	Included in i.2.	Included in i.2.	Included in i.2.	18% chemo; $50 copay Part B Rx PBP L.15	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											150.3234037		29.52247191					50	150		127.5622564	50	0	50		25					69.04655049			79.65242276																	150.3234037		29.52247191					50	150		127.5622564	50	0	50		25					69.04655049			79.65242276																	12.656	0	1.444579882	0	0	0	0	1.155609397	0.90941132	0	0.654776124	0.237533602	0	0.156721148	0	12.15129257	0	0	0	0	3.507409326	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5285			12.656	0	1.444579882	0	0	0	0	1.155609397	0.90941132	0	0.654776124	0.237533602	0	0.156721148	0	12.15129257	0	0	0	0	3.507409326	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5285																																																																																		0			12.656	0	1.444579882	0	0	0	0	1.155609397	0.90941132	0	0.654776124	0.237533602	0	0.156721148	0	12.15129257	0	0	0	0	3.507409326	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5285
H5850_012_0	2009	5																																							V													S			P																																																									0									222.9079902													577.6356851			701.3173445																	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$50 copay PBP L.4a	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	18% chemo; $50 copay Part B Rx PBP L.15	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay																		50													85.38793134			79.65242276																								50													85.38793134			79.65242276																	0	0	0	0	0	0	0	0.928783293	0	0	0	0	0	0	0	0	0	0	0	0	4.110259685	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.6942			0	0	0	0	0	0	0	0.928783293	0	0	0	0	0	0	0	0	0	0	0	0	4.110259685	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.6942																																																																																		0			0	0	0	0	0	0	0	0.928783293	0	0	0	0	0	0	0	0	0	0	0	0	4.110259685	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.6942
H5850_013_0	2009	5																																		D					V	V		V	V	V	V							S			P																																																									0				794.927525					320.6447708	74.30904605		48.71272336	64.9258894	0	42.48771638							723.7815514			701.3173445																	$0 copay	$0 copay	$30 per day (days 11 through 100)  PBP L.2	$0 copay	$0 copay	$0 copay	$0 copay	$50 copay PBP L.4a	$100 copay @ Hospital PBP L.9a	$0 copay	$50 diag copay (hosp); $25 therap. copay PBP L.8a/8b	$50 copay PBP L.9a	$25 copay @ Hospital PBP L.12	"$25 copay @ Hospital PBP L.9a, 7c, 7i"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	18% chemo; $40 copay Part B Rx PBP L.15	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay													13.82142857					50	100		47.35521266	50	25	25							85.95696661			79.65242276																			13.82142857					50	100		47.35521266	50	25	25							85.95696661			79.65242276																	0	0	0.915586167	0	0	0	0	1.336019878	0.61924205	0	0.192233448	0.270524539	0	0.088516076	0	0	0	0	0	0	5.184505554	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.2618			0	0	0.915586167	0	0	0	0	1.336019878	0.61924205	0	0.192233448	0.270524539	0	0.088516076	0	0	0	0	0	0	5.184505554	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.2618																																																																																		0			0	0	0.915586167	0	0	0	0	1.336019878	0.61924205	0	0.192233448	0.270524539	0	0.088516076	0	0	0	0	0	0	5.184505554	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.2618
H5850_014_0	2009	3																																																				S			P																																																									0																						415.6678136			701.3173445																	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	18% chemo; $40 copay Part B Rx PBP L.15	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay																															81.19067612			79.65242276																																					81.19067612			79.65242276																	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.812362569	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.4675			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.812362569	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.4675																																																																																		0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.812362569	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.4675
H5850_015_0	2009	5																																		D					V	V		V	V	V	V							S			P																																																									0				841.3643149					243.9793282	96.50197445		97.86552027	44.09991958	0.81721046	65.41465987							770.9699253			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	$50 copay (Hospital) PBP L.9a	$0 copay	$50 diag copay (hosp); $25 therap. copay PBP L.8a/8b	$50 copay PBP L.9a	$50 copay @ Hospital PBP L.12	"$25 copay @ Hospital PBP L.9a, 7c, 7i"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	18% chemo; $50 copay Part B Rx PBP L.15	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay													29.52247191					50	50		40.27199735	50	50	25							68.98082908			79.65242276																			29.52247191					50	50		40.27199735	50	50	25							68.98082908			79.65242276																	0	0	2.069929529	0	0	0	0	1.016580534	0.40209156	0	0.328436664	0.183749665	0.003405044	0.136280541	0	0	0	0	0	0	4.431845387	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.2275			0	0	2.069929529	0	0	0	0	1.016580534	0.40209156	0	0.328436664	0.183749665	0.003405044	0.136280541	0	0	0	0	0	0	4.431845387	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.2275																																																																																		0			0	0	2.069929529	0	0	0	0	1.016580534	0.40209156	0	0.328436664	0.183749665	0.003405044	0.136280541	0	0	0	0	0	0	4.431845387	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.2275
H5850_016_0	2009	5																																D		D		T			V	V		V		V	V		V					S			P																																																									0				841.3643149		353.8981374			243.9793282	297.2140148		97.86552027	44.09991958	5.302255836	65.41465987		6807.464583					770.9699253			701.3173445																	$0 copay	$0 copay	$50 per day (days 8 through 100)  PBP L.2	$0 copay	$100 copay PBP L.10a	$0 copay	$0 copay	$50 copay PBP L.4a	$100 copay (Hospital); $25 copay (ASC) PBP L.9a/9b	$0 copay	$100 diag copay (hosp); $25 therap. copay PBP L.8a/8b	$50 copay PBP L.9a	$100 copay @ Hospital; $25 copay freestanding PBP L.12	"$25 copay @ Hospital PBP L.9a, 7c, 7i"	$0 copay	$15 copay PBP L.7a thru 7f	Included in i.2.	Included in i.2.	Included in i.2.	Included in i.2.	18% chemo; $50 copay Part B Rx PBP L.15	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay													29.52247191		100			50	49.35163796		70.81599204	50	36.55937895	25		15					68.98082908			79.65242276																			29.52247191		100			50	49.35163796		70.81599204	50	36.55937895	25		15					68.98082908			79.65242276																	0	0	2.069929529	0	2.949151145	0	0	1.016580534	1.222333204	0	0.577536992	0.183749665	0.016153932	0.136280541	0	8.509330729	0	0	0	0	4.431845387	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.768			0	0	2.069929529	0	2.949151145	0	0	1.016580534	1.222333204	0	0.577536992	0.183749665	0.016153932	0.136280541	0	8.509330729	0	0	0	0	4.431845387	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.768																																																																																		0			0	0	2.069929529	0	2.949151145	0	0	1.016580534	1.222333204	0	0.577536992	0.183749665	0.016153932	0.136280541	0	8.509330729	0	0	0	0	4.431845387	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	25.768
H5850_017_0	2009	5																																D		D		T			V	V		V	V	V	V		V					S			P																																																									0		1514.428107		896.7138791		377.1795			260.029628	316.7663845		1796.761239	47.00105442	5.651067337	69.71799536		7255.29698					821.6885601			701.3173445																	$75 copay (days 1-7) PBP L.1a	$0 copay	$50 per day (days 8 through 100)  PBP L.2	$0 copay	$100 copay PBP L.10a	$0 copay	$0 copay	$50 copay PBP L.4a	$150 copay (Hospital); $50 copay (ASC) PBP L.9a/9b	$0 copay	$150 diag copay (hosp); $25 diag copay (freest); $50 therap. copay PBP L.8a/8b	$50 copay PBP L.9a	$30 copay @ Hospital; $15 copay @ Freestanding facility PBP L.12	"$50 copay @ Hospital PBP L.9a, 7c, 7i"	$0 copay	$20 copay PBP L.7a thru 7f	Included in i.2.	Included in i.2.	Included in i.2.	Included in i.2.	18% chemo; $50 copay Part B Rx PBP L.15	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											59.63105123		29.52247191		100			50	82.46885061		29.9974874	50	17.31187579	50		20					68.98082908			79.65242276																	59.63105123		29.52247191		100			50	82.46885061		29.9974874	50	17.31187579	50		20					68.98082908			79.65242276																	7.5256	0	2.206100859	0	3.1431625	0	0	1.083456783	2.176946637	0	4.491526886	0.195837727	0.008152548	0.290491647	0	12.09216163	0	0	0	0	4.72339651	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.5919			7.5256	0	2.206100859	0	3.1431625	0	0	1.083456783	2.176946637	0	4.491526886	0.195837727	0.008152548	0.290491647	0	12.09216163	0	0	0	0	4.72339651	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.5919																																																																																		0			7.5256	0	2.206100859	0	3.1431625	0	0	1.083456783	2.176946637	0	4.491526886	0.195837727	0.008152548	0.290491647	0	12.09216163	0	0	0	0	4.72339651	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.5919
H5850_018_0	2009	6																																D		D		T			V	V		V	V	V	V		V					S			P																																																									0	3000	1458.394267		863.5354656		363.2238585			250.4085318	305.0460283		1730.281074	45.26201541	5.441977846	67.13842953	9754.296319	6986.850992					791.2860833			701.3173445																	$75 copay (days 1-7) PBP L.1a	$0 copay	$50 per day (days 8 through 100)  PBP L.2	$0 copay	$100 copay PBP L.10a	$0 copay	$0 copay	$50 copay PBP L.4a	$150 copay (Hospital); $50 copay (ASC) PBP L.9a/9b	$0 copay	$150 diag copay (hosp); $25 diag copay (freest); $50 therap. copay PBP L.8a/8b	$50 copay PBP L.9a	$30 copay @ Hospital; $15 copay @ Freestanding facility PBP L.12	"$50 copay @ Hospital PBP L.9a, 7c, 7i"	$5 copay PBP L.7a	$20 copay PBP L.7b thru 7f	Included in i.2.	Included in i.2.	Included in i.2.	Included in i.2.	18% chemo; $50 copay Part B Rx PBP L.15	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											59.63105123		29.52247191		100			50	82.46885061		53.54621428	50	17.31187579	50	0	20					68.98082908			79.65242276																	59.63105123		29.52247191		100			50	82.46885061		53.54621428	50	17.31187579	50	0	20					68.98082908			79.65242276																	7.2471	0	2.124475127	0	3.026865488	0	0	1.043368882	2.096399611	0	7.720833427	0.188591731	0.007850904	0.279743456	0	11.64475165	0	0	0	0	4.548630839	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.5838			7.2471	0	2.124475127	0	3.026865488	0	0	1.043368882	2.096399611	0	7.720833427	0.188591731	0.007850904	0.279743456	0	11.64475165	0	0	0	0	4.548630839	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.5838		20% coinsurance	Included in a.1.	20% coinsurance	20% coinsurance	$100 copay	20% coinsurance	Included in e.1.	$50 copay	20% coinsurance	Included in h.5.	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	Included in i.2.	Included in i.2.	Included in i.2.	Included in i.2.	20% coinsurance	0	0	0	0	0	0	0	0	0											1.8642		0.1272	0.0716	0.109	0.1289		0.0983	0.5956		0.6543	0.138	0.011	0.127	2.0965	1.1413					0.1869																				7.3497		2.490143327	9.1113	0	2.25166986	0.071574829	3.135912877	0.128904527	0	1.141663177	2.691986341	0	8.375155714	0.326574824	0.018870582	0.40673899	2.096491406	12.78602268	0	0	0	0	4.735495577	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.9335
H5850_019_0	2009	5																																D		D		T			V	V		V		V	V		V					S			P																																																									0		1100.88484		651.849177		274.1834964			189.023615	230.2673259		1306.121565	34.16652665	4.10793641	50.68017676		5274.100776					597.3109418			701.3173445																	$100 copay (days 1-7) PBP L.1a	$0 copay	$50 per day (days 8 through 100)  PBP L.2	$0 copay	$100 copay PBP L.10a	$0 copay	$0 copay	$50 copay PBP L.4a	$150 copay (Hospital); $50 copay (ASC) PBP L.9a/9b	$0 copay	$150 diag copay (hosp); $25 diag copay (freest); $50 therap. copay PBP L.8a/8b	$50 copay PBP L.9a	$30 copay @ Hospital; $0 copay @ Freestanding facility PBP L.12	"$50 copay @ Hospital PBP L.9a, 7c, 7i"	$0 copay	$30 copay PBP L.7a thru 7f	Included in i.2.	Included in i.2.	Included in i.2.	Included in i.2.	18% chemo; $50 copay Part B Rx PBP L.15	$0 copay	$0 copay	"Various copays PBP L.16a,b"	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay											79.50806831		29.52247191		100			50	82.46885061		29.9974874	50	17.31187579	50		30					68.98082908			79.65242276																	79.50806831		29.52247191		100			50	82.46885061		29.9974874	50	17.31187579	50		30					68.98082908			79.65242276																	7.2941	0	1.603683252	0	2.28486247	0	0	0.787598396	1.582490142	0	3.265030432	0.142360528	0.00592634	0.211167403	0	13.18525194	0	0	0	0	3.433583665	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4512			7.2941	0	1.603683252	0	2.28486247	0	0	0.787598396	1.582490142	0	3.265030432	0.142360528	0.00592634	0.211167403	0	13.18525194	0	0	0	0	3.433583665	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4512																																																																																		0			7.2941	0	1.603683252	0	2.28486247	0	0	0.787598396	1.582490142	0	3.265030432	0.142360528	0.00592634	0.211167403	0	13.18525194	0	0	0	0	3.433583665	0	0	4.655135468	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4512
H5850_802_0	2009	4																																																																																																																0		1559.428883		819.097021		379.2832528	947.1342372		275.2908979	323.7791828					2119.038216						21803.67883	2291.92383																				Medicare FFS cost sharing	included in a.1	Medicare FFS cost sharing		Medicare FFS cost sharing	Medicare FFS cost sharing	included in e.1.	Medicare FFS cost sharing	Medicare FFS cost sharing	included in h.5	included in h.5	included in h.5	included in h.5	Medicare FFS cost sharing	included in i.6.	included in i.6.	included in i.6.	included in i.6.	included in i.6.	Medicare FFS cost sharing	Medicare FFS cost sharing																				146.2974919		45.69592451		74.27925318	21.05808027		151.0760911	311.8192123					67.4398775						42.29121662	71.92920005																				146.2974919		45.69592451		74.27925318	21.05808027		151.0760911	311.8192123					67.4398775						42.29121662	71.92920005																				19.0117	0	3.119116303	0	2.34773973	1.662069066	0	3.465822731	8.41338081	0	0	0	0	11.90897314	0	0	0	0	0	76.84200872	13.73802064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.5088			19.0117	0	3.119116303	0	2.34773973	1.662069066	0	3.465822731	8.41338081	0	0	0	0	11.90897314	0	0	0	0	0	76.84200872	13.73802064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.5088																																																																																		0			19.0117	0	3.119116303	0	2.34773973	1.662069066	0	3.465822731	8.41338081	0	0	0	0	11.90897314	0	0	0	0	0	76.84200872	13.73802064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.5088
H5850_803_0	2009	4																																																																																																																0		1559.428883		819.097021		379.2832528	947.1342372		275.2908979	323.7791828					2119.038216						21803.67883	2291.92383																				Medicare FFS cost sharing	included in a.1	Medicare FFS cost sharing		Medicare FFS cost sharing	Medicare FFS cost sharing	included in e.1.	Medicare FFS cost sharing	Medicare FFS cost sharing	included in h.5	included in h.5	included in h.5	included in h.5	Medicare FFS cost sharing	included in i.6.	included in i.6.	included in i.6.	included in i.6.	included in i.6.	Medicare FFS cost sharing	Medicare FFS cost sharing																				146.2974919		45.69592451		74.27925318	21.05808027		151.0760911	311.8192123					67.4398775						42.29121662	71.92920005																				146.2974919		45.69592451		74.27925318	21.05808027		151.0760911	311.8192123					67.4398775						42.29121662	71.92920005																				19.0117	0	3.119116303	0	2.34773973	1.662069066	0	3.465822731	8.41338081	0	0	0	0	11.90897314	0	0	0	0	0	76.84200872	13.73802064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.5088			19.0117	0	3.119116303	0	2.34773973	1.662069066	0	3.465822731	8.41338081	0	0	0	0	11.90897314	0	0	0	0	0	76.84200872	13.73802064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.5088																																																																																		0			19.0117	0	3.119116303	0	2.34773973	1.662069066	0	3.465822731	8.41338081	0	0	0	0	11.90897314	0	0	0	0	0	76.84200872	13.73802064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.5088
H5850_804_0	2009	4																																																																																																																0		1559.428883		819.097021		379.2832528	947.1342372		275.2908979	323.7791828					2119.038216						21803.67883	2291.92383																				Medicare FFS cost sharing	included in a.1	Medicare FFS cost sharing		Medicare FFS cost sharing	Medicare FFS cost sharing	included in e.1.	Medicare FFS cost sharing	Medicare FFS cost sharing	included in h.5	included in h.5	included in h.5	included in h.5	Medicare FFS cost sharing	included in i.6.	included in i.6.	included in i.6.	included in i.6.	included in i.6.	Medicare FFS cost sharing	Medicare FFS cost sharing																				146.2974919		45.69592451		74.27925318	21.05808027		151.0760911	311.8192123					67.4398775						42.29121662	71.92920005																				146.2974919		45.69592451		74.27925318	21.05808027		151.0760911	311.8192123					67.4398775						42.29121662	71.92920005																				19.0117	0	3.119116303	0	2.34773973	1.662069066	0	3.465822731	8.41338081	0	0	0	0	11.90897314	0	0	0	0	0	76.84200872	13.73802064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.5088			19.0117	0	3.119116303	0	2.34773973	1.662069066	0	3.465822731	8.41338081	0	0	0	0	11.90897314	0	0	0	0	0	76.84200872	13.73802064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.5088																																																																																		0			19.0117	0	3.119116303	0	2.34773973	1.662069066	0	3.465822731	8.41338081	0	0	0	0	11.90897314	0	0	0	0	0	76.84200872	13.73802064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.5088
H5850_805_0	2009	4																																																																																																																0		1559.428883		819.097021		379.2832528	947.1342372		275.2908979	323.7791828					2119.038216						21803.67883	2291.92383																				Medicare FFS cost sharing	included in a.1	Medicare FFS cost sharing		Medicare FFS cost sharing	Medicare FFS cost sharing	included in e.1.	Medicare FFS cost sharing	Medicare FFS cost sharing	included in h.5	included in h.5	included in h.5	included in h.5	Medicare FFS cost sharing	included in i.6.	included in i.6.	included in i.6.	included in i.6.	included in i.6.	Medicare FFS cost sharing	Medicare FFS cost sharing																				146.2974919		45.69592451		74.27925318	21.05808027		151.0760911	311.8192123					67.4398775						42.29121662	71.92920005																				146.2974919		45.69592451		74.27925318	21.05808027		151.0760911	311.8192123					67.4398775						42.29121662	71.92920005																				19.0117	0	3.119116303	0	2.34773973	1.662069066	0	3.465822731	8.41338081	0	0	0	0	11.90897314	0	0	0	0	0	76.84200872	13.73802064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.5088			19.0117	0	3.119116303	0	2.34773973	1.662069066	0	3.465822731	8.41338081	0	0	0	0	11.90897314	0	0	0	0	0	76.84200872	13.73802064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.5088																																																																																		0			19.0117	0	3.119116303	0	2.34773973	1.662069066	0	3.465822731	8.41338081	0	0	0	0	11.90897314	0	0	0	0	0	76.84200872	13.73802064	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.5088
H5852_001_0	2009	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
H5854_002_0	2009	7	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Urgent Care	Therapy (PT/OT/ST)	Ambulatory Surgery	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemo/Radiation	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V			V	V	V	V	V		V	V	V	V	V	V	Coin	V	V	Coin																																									0		1609.870129	17.49378223	1026.047733	1372.355601	185.9307203	7.86831719	0.850563356	268.0290515	236.2413001	1366.331267	392.3483197	15.19246741	0.16108197	56.52045978	5205.480529	4102.299586	350.099559	770.5409982	1947.72496	0	43.87728257	0	0	0	439.0217218	306.3838279	186.5182769	24.17829515	0	0	16.29661143	216.1623298	44.91682688	545.7247482	778.2129488	331.2615392	3.068766461	1274.761002	26.25592421	17.85771183	$200/day (days 1-7)	$200/day (days 1-7)	$35/day (for days 1-100)	$0 copay	$125 copay	20% coinsurance	20% coinsurance	$50 copay	$125 copay	$0 copay	$90 copay	$125 copay	10% coinsurance	$30 copay	$20 coapy	$30 copay	$25 copay	$30 copay	$30 copay	$0 copay	20% coinsurance	$0 copay	n/c	n/c	$20 copay	$80 contacts/$100 frames yrly	$0 copay	$1000/3yrs Hearing Aids	Silver Sneakers		$30 copay	$50 copay	$125 copay	$30 copay	$30 copay	$0 copay	20% coinsurance	$30 copay	$0 copay (1/yr)	20% coinsurance	200	200	35	0	125	0.2	0.2	50	125	0	90	125	0.1	30	20	30	25	30	30	0	0.2	0	0	0	20	0	0	0	0	0	30	50	125	30	30	0	0.2	30	0	0.2	129.6386149	45.54318458	33.17277861	0	118.4742093	0.189558735	0.189558735	47.38968374	118.4742093	0	85.30143072	118.4742093	0.094779367	28.43381024	18.95587349	28.43381024	23.69484187	28.43381024	28.43381024	0	0.189558735	0	0	0	18.95587349	0	0	0	0	0	28.43381024	47.38968374	118.4742093	28.43381024	28.43381024	0	0.189558735	28.43381024	0	0.189558735	17.3918	0.066393546	2.836404525	0	1.835666257	1.491508253	0.161231714	1.058484332	2.332375103	0	2.788989418	0.149992964	0.015267247	0.133924336	8.222869198	9.720333997	0.691296141	1.82578471	4.615103493	0	8.317322176	0	0	0	0.693503352	0	0	0	0	0	0.038614563	0.853655371	0.443457129	1.293086161	1.843963276	0	0.581711488	3.020526037	0	3.385085264	75.8083		4.1757	17.3918	0.066393546	2.836404525	0	1.835666257	1.491508253	0.161231714	1.058484332	2.332375103	0	2.788989418	0.149992964	0.015267247	0.133924336	8.222869198	9.720333997	0.691296141	1.82578471	4.615103493	0	8.317322176	0	0	0	0.693503352	0	0	0	0	0	0.038614563	0.853655371	0.443457129	1.293086161	1.843963276	0	0.581711488	3.020526037	0	3.385085264	75.8083	4000																																																																																	0			17.3918	0.066393546	2.836404525	0	1.835666257	1.491508253	0.161231714	1.058484332	2.332375103	0	2.788989418	0.149992964	0.015267247	0.133924336	8.222869198	9.720333997	0.691296141	1.82578471	4.615103493	0	8.317322176	0	0	0	0.693503352	0	0	0	0	0	0.038614563	0.853655371	0.443457129	1.293086161	1.843963276	0	0.581711488	3.020526037	0	3.385085264	75.8083
H5854_003_0	2009	7	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Urgent Care	Therapy (PT/OT/ST)	Ambulatory Surgery	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemotherapy	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V			V	V	V	V	V		V	V	V	V	V	V	Coin	V	V	Coin																																									0		2130.760518	28.60648249	1247.892506	1817.97784	238.3010646	11.75503085	1.165194677	278.2868479	283.4702067	1663.144369	489.158021	13.74348414	0.173994805	38.4054662	5964.890102	5012.860746	301.9672944	831.5596601	2270.578797	0	54.16078573	0	0	0	436.8399323	306.3838279	186.5182769	24.17829515	0	0	11.3545791	236.7904761	50.64599502	467.8406224	1004.052665	308.8185795	4.503802684	1357.666058	29.35514066	26.92422673	$100/day (days 1-7)	$200/day (days 1-7)	$25/day (for days 1-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$100 copay	$0 copay	$60 copay	$100 copay	10% coinsurance	$20 copay	$10 coapy	$20 copay	$25 copay	$20 copay	$20 copay	$0 copay	20% coinsurance	$0 copay	n/c	n/c	$20 copay	$80 contacts/$100 frames yrly	$0 copay	$1000/3yrs Hearing Aids	Silver Sneakers		$20 copay	$50 copay	$100 copay	$20 copay	$20 copay	$0 copay	20% coinsurance	$20 copay	$0 copay (1/yr)	20% coinsurance	100	200	25	0	100	0.2	0.2	50	100	0	60	100	0.1	20	10	20	25	20	20	0	0.2	0	0	0	20	0	0	0	0	0	20	50	100	20	20	0	0.2	20	0	0.2	66.28866322	140.4801805	23.93054386	0	95.72217545	0.191444351	0.191444351	47.86108772	95.72217545	0	57.43330527	95.72217545	0.095722175	19.14443509	9.572217545	19.14443509	23.93054386	19.14443509	19.14443509	0	0.191444351	0	0	0	19.14443509	0	0	0	0	0	19.14443509	47.86108772	95.72217545	19.14443509	19.14443509	0	0.191444351	19.14443509	0	0.191444351	11.7704	0.334886985	2.488562197	0	1.900891359	2.250434251	0.223069939	1.109925937	2.261198738	0	2.341163495	0.109629683	0.016655161	0.061270913	4.758102141	7.997365597	0.602186799	1.326644995	3.622412366	0	10.36877647	0	0	0	0.696921144	0	0	0	0	0	0.01811475	0.944420812	0.403995402	0.746378702	1.601835089	0	0.862227581	2.165979143	0	5.15449111	66.138		2.9557	11.7704	0.334886985	2.488562197	0	1.900891359	2.250434251	0.223069939	1.109925937	2.261198738	0	2.341163495	0.109629683	0.016655161	0.061270913	4.758102141	7.997365597	0.602186799	1.326644995	3.622412366	0	10.36877647	0	0	0	0.696921144	0	0	0	0	0	0.01811475	0.944420812	0.403995402	0.746378702	1.601835089	0	0.862227581	2.165979143	0	5.15449111	66.138	4000																																																																																	0			11.7704	0.334886985	2.488562197	0	1.900891359	2.250434251	0.223069939	1.109925937	2.261198738	0	2.341163495	0.109629683	0.016655161	0.061270913	4.758102141	7.997365597	0.602186799	1.326644995	3.622412366	0	10.36877647	0	0	0	0.696921144	0	0	0	0	0	0.01811475	0.944420812	0.403995402	0.746378702	1.601835089	0	0.862227581	2.165979143	0	5.15449111	66.138
H5854_004_0	2009	5	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Urgent Care	Therapy (PT/OT/ST)	Ambulatory Surgery	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemotherapy	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V		Coin				V	V	V	V	V		V	V	V	V	V	V	Coin	V	V	Coin																																									0		2080.882114	54.68699513	1127.320446	1754.546758	219.1284032	9.369078818	1.396250357	265.356387	255.2813982	995.9451399	379.2969096	8.932491389	0.264425638	30.76890142	5595.039265	4821.24602	279.4853485	692.9112142	2227.221695	0	51.1813241	0	0	0	438.006937	306.3838279	186.5182769	24.17829515	0	0	12.04152241	247.5525764	60.75860158	530.883341	981.2714791	274.1224885	3.73242847	1428.845237	26.80459857	24.02070681	$200/day (days 1-7)	$200/day (days 1-7)	$35/day (for days 1-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$100 copay	$0 copay	$90 copay	$100 copay	10% coinsurance	$30 copay	$20 coapy	$30 copay	$25 copay	$30 copay	$30 copay		20% coinsurance		n/c	n/c	$20 copay	$80 contacts/$100 frames yrly	$0 copay	$1000/3yrs Hearing Aids	Silver Sneakers		$30 copay	$50 copay	$100 copay	$30 copay	$30 copay	$0 copay	20% coinsurance	$30 copay	$0 copay (1/yr)	20% coinsurance	200	200	35	0	100	0.2	0.2	50	100	0	90	100	0.1	30	20	30	25	30	30	0	0.2	0	0	0	20	0	0	0	0	0	30	50	100	30	30	0	0.2	30	0	0.2	134.4851035	108.6356273	33.25192544	0	95.00550125	0.190011002	0.190011002	47.50275062	95.00550125	0	85.50495112	95.00550125	0.095005501	28.50165037	19.00110025	28.50165037	23.75137531	28.50165037	28.50165037	0	0.190011002	0	0	0	19.00110025	0	0	0	0	0	28.50165037	47.50275062	95.00550125	28.50165037	28.50165037	0	0.190011002	28.50165037	0	0.190011002	23.3206	0.495079668	3.123797952	0	1.734866982	1.780228059	0.26530293	1.050429857	2.021094766	0	2.702646976	0.070719652	0.02512189	0.073080373	8.859325164	11.45112237	0.553180117	1.645759431	5.289957838	0	9.725014702	0	0	0	0.693551143	0	0	0	0	0	0.028600272	0.979952359	0.48103345	1.260920948	2.330654718	0	0.709202475	3.393703948	0	4.564198581	88.6292		4.6593	23.3206	0.495079668	3.123797952	0	1.734866982	1.780228059	0.26530293	1.050429857	2.021094766	0	2.702646976	0.070719652	0.02512189	0.073080373	8.859325164	11.45112237	0.553180117	1.645759431	5.289957838	0	9.725014702	0	0	0	0.693551143	0	0	0	0	0	0.028600272	0.979952359	0.48103345	1.260920948	2.330654718	0	0.709202475	3.393703948	0	4.564198581	88.6292	4000																																																																																	0			23.3206	0.495079668	3.123797952	0	1.734866982	1.780228059	0.26530293	1.050429857	2.021094766	0	2.702646976	0.070719652	0.02512189	0.073080373	8.859325164	11.45112237	0.553180117	1.645759431	5.289957838	0	9.725014702	0	0	0	0.693551143	0	0	0	0	0	0.028600272	0.979952359	0.48103345	1.260920948	2.330654718	0	0.709202475	3.393703948	0	4.564198581	88.6292
H5854_005_0	2009	7	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Urgent Care	Therapy (PT/OT/ST)	Ambulatory Surgery	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemotherapy	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V			V	V	V	V	V		V	V	V	V	V	V	Coin	V	V	Coin																																									0		2619.755803	41.26024374	1601.059262	2334.338741	252.6515742	13.0368628	2.006109995	263.1014726	279.7201818	743.1273282	408.1528033	3.505772344	0.379922493	25.55168689	6515.241936	5944.50894	370.4657506	896.0619274	2683.870986	0	67.51061032	0	0	0	436.1194651	306.3838279	186.5182769	24.17829515	0	0	14.19163612	299.7098261	65.53097536	433.1651406	1288.607302	229.0550296	5.038974511	1549.214283	32.29355679	33.22249029	$210/day (days 1-7)	$210/day (days 1-7)	$50/day (for days 1-100)	$0 copay	$150 copay	20% coinsurance	20% coinsurance	$50 copay	$150 copay	$0 copay	$75 copay	$150 copay	10% coinsurance	$25 copay	$15 coapy	$25 copay	$25 copay	$25 copay	$25 copay	$0 copay	20% coinsurance	$0 copay	n/c	n/c	$20 copay	$80 contacts/$100 frames yrly	$0 copay	$1000/3yrs Hearing Aids	Silver Sneakers		$25 copay	$50 copay	$150 copay	$25 copay	$25 copay	$0 copay	20% coinsurance	$25 copay	$0 copay (1/yr)	20% coinsurance	210	210	50	0	150	0.2	0.2	50	150	0	75	150	0.1	25	15	25	25	25	25	0	0.2	0	0	0	20	0	0	0	0	0	25	50	150	25	25	0	0.2	25	0	0.2	131.363611	108.4206325	45.55488759	0	136.6646628	0.18221955	0.18221955	45.55488759	136.6646628	0	68.33233139	136.6646628	0.091109775	22.7774438	13.66646628	22.7774438	22.7774438	22.7774438	22.7774438	0	0.18221955	0	0	0	18.22195504	0	0	0	0	0	22.7774438	45.55488759	136.6646628	22.7774438	22.7774438	0	0.18221955	22.7774438	0	0.18221955	28.6784	0.372788477	6.078006226	0	2.877378516	2.375571277	0.365552461	0.998796501	3.18565536	0	2.324169384	0.039926266	0.034614653	0.048500176	7.420027851	11.28339319	0.703188568	1.700833349	5.094310044	0	12.30175306	0	0	0	0.662245774	0	0	0	0	0	0.026937433	1.13777062	0.746314054	0.822199554	2.4459317	0	0.91819967	2.940595104	0	6.053787244	101.6368		9.9174	28.6784	0.372788477	6.078006226	0	2.877378516	2.375571277	0.365552461	0.998796501	3.18565536	0	2.324169384	0.039926266	0.034614653	0.048500176	7.420027851	11.28339319	0.703188568	1.700833349	5.094310044	0	12.30175306	0	0	0	0.662245774	0	0	0	0	0	0.026937433	1.13777062	0.746314054	0.822199554	2.4459317	0	0.91819967	2.940595104	0	6.053787244	101.6368	3700																																																																																	0			28.6784	0.372788477	6.078006226	0	2.877378516	2.375571277	0.365552461	0.998796501	3.18565536	0	2.324169384	0.039926266	0.034614653	0.048500176	7.420027851	11.28339319	0.703188568	1.700833349	5.094310044	0	12.30175306	0	0	0	0.662245774	0	0	0	0	0	0.026937433	1.13777062	0.746314054	0.822199554	2.4459317	0	0.91819967	2.940595104	0	6.053787244	101.6368
H5854_801_0	2009	3																					none											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	V											0	0	0	0	0	0	0	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	307.6466012	3.346423033	97.11919432	48.08607378	7.039857951	13.46730262	3.780592717	11.78362408	37.77736219	8.881560484	20.89052711	0	0.286253744	27.09737033	41.37343785	123.1937114	1.419125626	6.789879717	31.35138833	38.26348307	10.62155893	1.129363308	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.067416239	0.067416239	0.176076442	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.067416239	0.067416239	0.176076442	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.7404	0.225603254	17.10040223	0	1.626207187	3.110946905	0.873316918	2.722017162	8.726570666	2.051640472	4.825711761	0	0.066124615	6.259492546	9.557264144	28.45774732	0.32781802	1.568462215	7.242170704	8.838864589	2.453580112	0.260882924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0352	0	0	20.7404	0.225603254	17.10040223	0	1.626207187	3.110946905	0.873316918	2.722017162	8.726570666	2.051640472	4.825711761	0	0.066124615	6.259492546	9.557264144	28.45774732	0.32781802	1.568462215	7.242170704	8.838864589	2.453580112	0.260882924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0352	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.7404	0.225603254	17.10040223	0	1.626207187	3.110946905	0.873316918	2.722017162	8.726570666	2.051640472	4.825711761	0	0.066124615	6.259492546	9.557264144	28.45774732	0.32781802	1.568462215	7.242170704	8.838864589	2.453580112	0.260882924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0352
H5854_803_0	2009	3																					none											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	V											0	0	0	0	0	0	0	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	307.6466012	3.346423033	97.11919432	48.08607378	7.039857951	13.46730262	3.780592717	11.78362408	37.77736219	8.881560484	20.89052711	0	0.286253744	27.09737033	41.37343785	123.1937114	1.419125626	6.789879717	31.35138833	38.26348307	10.62155893	1.129363308	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.067416239	0.067416239	0.176076442	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.067416239	0.067416239	0.176076442	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.7404	0.225603254	17.10040223	0	1.626207187	3.110946905	0.873316918	2.722017162	8.726570666	2.051640472	4.825711761	0	0.066124615	6.259492546	9.557264144	28.45774732	0.32781802	1.568462215	7.242170704	8.838864589	2.453580112	0.260882924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0352	0	0	20.7404	0.225603254	17.10040223	0	1.626207187	3.110946905	0.873316918	2.722017162	8.726570666	2.051640472	4.825711761	0	0.066124615	6.259492546	9.557264144	28.45774732	0.32781802	1.568462215	7.242170704	8.838864589	2.453580112	0.260882924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0352	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.7404	0.225603254	17.10040223	0	1.626207187	3.110946905	0.873316918	2.722017162	8.726570666	2.051640472	4.825711761	0	0.066124615	6.259492546	9.557264144	28.45774732	0.32781802	1.568462215	7.242170704	8.838864589	2.453580112	0.260882924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0352
H5854_805_0	2009	3																					none											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	V											0	0	0	0	0	0	0	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	307.6466012	3.346423033	97.11919432	48.08607378	7.039857951	13.46730262	3.780592717	11.78362408	37.77736219	8.881560484	20.89052711	0	0.286253744	27.09737033	41.37343785	123.1937114	1.419125626	6.789879717	31.35138833	38.26348307	10.62155893	1.129363308	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.067416239	0.067416239	0.176076442	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.067416239	0.067416239	0.176076442	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.7404	0.225603254	17.10040223	0	1.626207187	3.110946905	0.873316918	2.722017162	8.726570666	2.051640472	4.825711761	0	0.066124615	6.259492546	9.557264144	28.45774732	0.32781802	1.568462215	7.242170704	8.838864589	2.453580112	0.260882924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0352	0	0	20.7404	0.225603254	17.10040223	0	1.626207187	3.110946905	0.873316918	2.722017162	8.726570666	2.051640472	4.825711761	0	0.066124615	6.259492546	9.557264144	28.45774732	0.32781802	1.568462215	7.242170704	8.838864589	2.453580112	0.260882924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0352	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.7404	0.225603254	17.10040223	0	1.626207187	3.110946905	0.873316918	2.722017162	8.726570666	2.051640472	4.825711761	0	0.066124615	6.259492546	9.557264144	28.45774732	0.32781802	1.568462215	7.242170704	8.838864589	2.453580112	0.260882924	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0352
H5859_001_0	2009	6																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T																																																										0		316.6150824	47.96194228	62.84885246		23.13608975	39.48310239	10.82124689	64.73829991	38.57319603	15.55036139	23.08414632	2.052186513	0.893916803	19.59894859	24.21276581	71.58913095	4.918273576	0.802571181	16.61175835	43.12767768	22.16897825	2.409218785																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	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 Copay, 5 trip limit per year"					Two hearing aids every three years													0.073939685	0.073939685	0.141276795		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.073939685	0.073939685	0.141276795		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			23.4104	3.546290921	8.879084442	0	5.344436733	9.120596651	2.499708031	14.95454728	8.910408284	3.592133482	5.3324378	0.474055084	0.206494781	4.527357124	5.593148901	16.53708925	1.136121196	0.185393943	3.83731618	9.962493543	5.121033975	0.556529539	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.7271	0	0	23.4104	3.546290921	8.879084442	0	5.344436733	9.120596651	2.499708031	14.95454728	8.910408284	3.592133482	5.3324378	0.474055084	0.206494781	4.527357124	5.593148901	16.53708925	1.136121196	0.185393943	3.83731618	9.962493543	5.121033975	0.556529539	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.7271																																																																																		0	0	0	23.4104	3.546290921	8.879084442	0	5.344436733	9.120596651	2.499708031	14.95454728	8.910408284	3.592133482	5.3324378	0.474055084	0.206494781	4.527357124	5.593148901	16.53708925	1.136121196	0.185393943	3.83731618	9.962493543	5.121033975	0.556529539	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	133.7271
H5859_003_0	2009	4																																D	D	D	A	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	P	V	V	V	V	V	V	Coin	P	O	V	V	V	V	V	V	V																																																			0		1010.546767	76.04137444	925.3005973		126.8374092	9.494064396	9.498416303	345.8461751	51.05686719	18.11479501	39.06508761	0.989703355	0.260410473	1948.116232	3612.13661	3131.28993	390.2566731	457.4380037			24.83460156	838.1438823			147.9890135		255.8976692														"Days 1-5 $200, $0 Days 6-90"	"Days 1-5 $200, $0 Days 6-90"	"Days 1-20 $0, $100 Days 21-100"		$150/trip	20% coinsurance	20% coinsurance	$50 copay	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$75 for partial hospitalization, 20% coinsurance all other."	"$30 copay for urgent care, $15 copay all other."	$30 copay	$30 copay	$30 copay			20% coinsurance	"$20 copay for Medicare covered eye exam, 20% coinsurance for other categories with cost sharing"	"$0 Copay, 5 trip limit"		$20 copay. One eye exam every two years.	One pair of eye glasses (lenses & frames) every two years.	$20 Copay	Two hearing aids every three years.													151.3324704	112.4452585	18.59738347		150	0.2	0.2	46	0.2	0.2	0.2	0.2	0.2	37.5296118	15	30	30	30			0.2	20			20		20														151.3324704	112.4452585	18.59738347		150	0.2	0.2	46	0.2	0.2	0.2	0.2	0.2	37.5296118	15	30	30	30			0.2	20			20		20														12.744	0.712541001	1.434014169	0	1.585467615	1.898812879	1.899683261	1.325743671	10.21137344	3.622959001	7.813017521	0.197940671	0.052082095	6.092670492	4.515170762	7.828224825	0.975641683	1.143595009	0	0	4.966920313	1.39690647	0	0	0.246648356	0	0.426496115	0	0	0	0	0	0	0	0	0	0	0	0	0	71.09	0	0	12.744	0.712541001	1.434014169	0	1.585467615	1.898812879	1.899683261	1.325743671	10.21137344	3.622959001	7.813017521	0.197940671	0.052082095	6.092670492	4.515170762	7.828224825	0.975641683	1.143595009	0	0	4.966920313	1.39690647	0	0	0.246648356	0	0.426496115	0	0	0	0	0	0	0	0	0	0	0	0	0	71.09																																																																																		0	0	0	12.744	0.712541001	1.434014169	0	1.585467615	1.898812879	1.899683261	1.325743671	10.21137344	3.622959001	7.813017521	0.197940671	0.052082095	6.092670492	4.515170762	7.828224825	0.975641683	1.143595009	0	0	4.966920313	1.39690647	0	0	0.246648356	0	0.426496115	0	0	0	0	0	0	0	0	0	0	0	0	0	71.09
H5862_001_0	2009	15																					3000											D	D	D		Coin	Coin	Coin	V	Coin	Coin	Coin		Coin	Coin	V	V	V	V	P	P	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	670.9646477	17.00283921	310.9183729	0	5.58651636	9.545545799	5.944926302	301.5963545	35.12615344	5.759617782	16.46543953	0	0.679140916	31.4702144	4940.020987	11839.49387	107.3660779	367.9775701	2480.382538	6468.20758	8.211637434	0.915654916	0	0	0	0	126.4877245	0	0	0											$150/Days 1-10 for IP Medical; $150/Days 1-10 for IP Surgical;	$150/Days 1-10 for IP Psych; $150/Days 1-10 for IP Substance Abuse;	$128/Days Custom for SNF		20% Coinsurance for Ambulance	20% Coinsurance for DME	20% Coinsurance for Prosthetics/Supplies; 20% Coinsurance for Diabetes Monitoring Supplies; 20% Coinsurance for Prosthetics;	$42/Case for ER - Facility; $42/Case for ER - Worldwide; $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% Coinsurance for Renal Dialysis - Fac; 20% Coinsurance for Renal Dialysis - Prof	20% Coinsurance for OP Fac - Cardiovascular; $30/Case for OP Fac - Occ Therapy; $30/Case 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;	$30/Visit for Speclst - Office Visits; 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 - 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; $30/Visit for Chiropractor; $30/Service for Podiatrist; $30/Exam for Vision Exams; $30/Exam for Hearing/Speech Exams;	$23/Visit for OP Psych - Non-Physician; $23/Visit for OP Psych - Psychiatrist; $23/Visit for OP Substance Abuse;	$30/Visit for PT/ST (PCP); $30/Visit for Occ Therapy (PCP); $30/Visit for PT/ST (Specialist); $30/Visit 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 (PCP); 20% Coinsurance for Misc. Medical; 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														150	150	128	0	0.2	0.2	0.2	39.86811171	0.2	0.2	0.2	0	0.2	0.185054117	18.21314088	22.01817043	23.14400001	30	15.16290034	12.1474996	0.2	0.2	0	0	0	0	30	0	0	0	0	0	0	0	0	0	0	0	0	0	130.1168331	130.0915331	111.0114416	0	0.173455377	0.173455377	0.173455377	34.57669182	0.173455377	0.173455377	0.173455377	0	0.173455377	0.160493159	15.79583613	19.09585031	20.07225629	26.01830662	13.15043301	10.53524564	0.173455377	0.173455378	0	0	0	0	26.01830661	0	0	0	0	0	0	0	0	0	0	0	0	0	7.2753	0.184327118	2.876291399	0	0.969011304	1.65572625	1.031179436	0.869017017	6.092820203	0.999036676	2.856019029	0	0.117800644	5.050754109	6.502646832	18.84043356	0.179589953	0.797846104	2.718175368	5.678679644	1.424352671	0.158825269	0	0	0	0	0.2742497	0	0	0	0	0	0	0	0	0	0	0	0	0	66.5521	0	10.1845	7.2753	0.184327118	2.876291399	0	0.969011304	1.65572625	1.031179436	0.869017017	6.092820203	0.999036676	2.856019029	0	0.117800644	5.050754109	6.502646832	18.84043356	0.179589953	0.797846104	2.718175368	5.678679644	1.424352671	0.158825269	0	0	0	0	0.2742497	0	0	0	0	0	0	0	0	0	0	0	0	0	66.5521	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.2753	0.184327118	2.876291399	0	0.969011304	1.65572625	1.031179436	0.869017017	6.092820203	0.999036676	2.856019029	0	0.117800644	5.050754109	6.502646832	18.84043356	0.179589953	0.797846104	2.718175368	5.678679644	1.424352671	0.158825269	0	0	0	0	0.2742497	0	0	0	0	0	0	0	0	0	0	0	0	0	66.5521
H5862_801_0	2009	12																					3000													D			Coin	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	0	0	459.0150147	0	0	11.4328862	6.516896731	388.7218023	0	0	0	0	0	693.9299402	3413.470411	4717.005295	127.6204484	446.7684759	0	0	0	0	0	0	311.4418761	0	133.4750898	0	0	0													$25/Days Custom for SNF			10% Coinsurance for DME	10% Coinsurance for Prosthetics/Supplies; 10% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $20/Visit for Urgent Care;						$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/Visit for Prof - CORF; $20/Visit 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 Chiropractor; $20/Service for Podiatrist; $20/Exam for Vision Exams; $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;	$20/Visit for PT/ST (PCP); $20/Visit for Occ Therapy (PCP); $20/Visit for PT/ST (Specialist); $20/Visit for Occ Therapy (Specialist);							$20/Exam for Vision (Refractions)		$20/Exam for Routine Hearing Exams														0	0	25	0	0	0.1	0.1	43.43322362	0	0	0	0	0	20	20	20	20.00000001	20	0	0	0	0	0	0	20	0	20	0	0	0											0	0	24.69248756	0	0	0.09876995	0.09876995	42.89897337	0	0	0	0	0	19.75399005	19.75399005	19.75399005	19.75399005	19.75399005	0	0	0	0	0	0	19.75399005	0	19.75399005	0	0	0											0	0	0.944518545	0	0	1.129225601	0.643673566	1.389647187	0	0	0	0	0	1.142323761	5.619138378	7.764972974	0.210084422	0.735455002	0	0	0	0	0	0	0.512684977	0	0.219722133	0	0	0	0	0	0	0	0	0	0	0	0	0	20.3114	0	0.253	0	0	0.944518545	0	0	1.129225601	0.643673566	1.389647187	0	0	0	0	0	1.142323761	5.619138378	7.764972974	0.210084422	0.735455002	0	0	0	0	0	0	0.512684977	0	0.219722133	0	0	0	0	0	0	0	0	0	0	0	0	0	20.3114	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0.944518545	0	0	1.129225601	0.643673566	1.389647187	0	0	0	0	0	1.142323761	5.619138378	7.764972974	0.210084422	0.735455002	0	0	0	0	0	0	0.512684977	0	0.219722133	0	0	0	0	0	0	0	0	0	0	0	0	0	20.3114
H5868_001_0	2009	4	r.	s.	t.	u.	v.	w.					Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered					6000	Mental Health (MH)	Therapy (PT/OT/ST)									A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin	V				O	O	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	0	0					0		238.213195	7.675189	462.787779	661.428586	131.558763	8.156164	2.94546	297.57605	322.562834	570.283342	846.423179	0	17.627284	647.506663	3169.086798	3820.054059	4.06731	177.640271			18.434313			3.25	2.69				0.05	0.27	21.99155	645.730376	1.23	2.65	0.06	2.7					$650/Admit:1a	$650/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$95/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $95 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $50 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$30-$50/Visit:9d. $50 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $30 Partial Hospitalization,8b. $50 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30/Visit:7e, 7h"	"$50/Visit:7d, 9a"			20% Coins:15			"DEN 767 16a, 16b"	VIS 752				$0 Additional Smoking Cessation 14a	$0: Nutritional benefit 14a	"$50/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0: Nurse hotline 14a	$0 Corp Health 14a					650.000013	649.999368	43.132789	0	99.999997	0.2	0.2	49.999991	85.925286	43.978706	47.649314	0	0.782196	42.810055	10.000001	29.999999	29.999188	50.000013			0.2			0	0				0	0	49.999749	30.000001	0	0	0	0					595.860862	595.86027	39.540216	0	91.670897	0.183341	0.183341	45.835442	78.768483	40.315676	43.680555	0	0.717046	39.244362	9.167091	27.501269	27.500526	45.835462			0.183341			0	0				0	0	45.83522	27.501271	0	0	0	0					11.8285	0.381111682	1.524894062	0	1.005009151	1.495359264	0.540023582	1.136627482	2.117315426	1.915946537	3.081019519	0	0.001053298	2.117582157	2.420942255	8.754694523	0.009321097	0.678518658	0	0	3.37976538	0	0	0	0	0	0	0	0	0	0.083998961	1.479867172	0	0	0	0	0	0	0	0	43.9515	0	3.9934	11.8285	0.381111682	1.524894062	0	1.005009151	1.495359264	0.540023582	1.136627482	2.117315426	1.915946537	3.081019519	0	0.001053298	2.117582157	2.420942255	8.754694523	0.009321097	0.678518658	0	0	3.37976538	0	0	0	0	0	0	0	0	0	0.083998961	1.479867172	0	0	0	0	0	0	0	0	43.9515	10000	30% Coins	30% Coins	30% Coins(Days 1-20) 30%(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			"DEN 767 16a, 16b"	VIS 752				0	0	30% Coins	$35/Visit	0	0	0	0					6.5896	0.0943	0.4131	0.6267	0.8133	1.7263	0.6234	0.2435	2.9833	0.3843	1.5986		0.0002	0.9029	1.8152	2.1881	0.0023	0.0865			1.2338			0	0				0	0	0.025	0.3699	0	0	0	0					22.7202	500	1.70052028	18.4181	0.475413682	1.937961062	0.626669	1.818357151	3.221660264	1.163448582	1.380121482	5.100603426	2.300263537	4.679597519	0	0.001279298	3.020517157	4.236134255	10.94274752	0.011650097	0.765054658	0	0	4.61354138	0	0	0	0	0	0	0	0	0	0.108951961	1.849729172	0	0	0	0	0	0	0	0	66.6718
H5868_003_0	2009	3	r.	s.	t.	u.	v.	w.	x.				OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered				5000	Renal Dialysis	Mental Health (MH)	Therapy (PT/OT/ST)								A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin	V				O	O	P	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	0	0	0				0		230.605358	7.430065	448.007684	640.304481	127.35716	7.643518	2.760326	288.072337	312.261118	552.070149	819.390885	0	0	626.827184	3067.875382	3698.052642	3.93741	171.966957			17.275647			3.25	0.35				0.05	0.09	17.06432	21.289205	625.107626	1.23	2.65	0.06	2.7				$650/Admit:1a	$650/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$95/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $95 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $50 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$50/Visit:9a	12. 20% Coins	"$30-$50/Visit:9d. $50 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $30 Partial Hospitalization,8b. $50 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30/Visit:7e, 7h"	"$50/Visit:7d, 9a"			20% Coins:15			"DEN 767 16a, 16b"	VIS 738				$0 Additional Smoking Cessation 14a	$0: Nutritional benefit 14a	12. $0/proc	"$50/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0: Nurse hotline 14a	$0 Corp Health 14a				650.000022	650.000235	43.132804	0	100.000031	0.2	0.199999	49.999983	85.925241	43.978693	47.649287	0	0.2	42.810038	10	29.999998	30.001447	50			0.199999			0	0				0	0	0	49.999988	29.999998	0	0	0	0				597.669821	597.670016	39.660268	0	91.949228	0.183898	0.183898	45.974584	79.007572	40.438057	43.813138	0	0.183898	39.363488	9.19492	27.584758	27.586091	45.9746			0.183898			0	0				0	0	0	45.974589	27.584758	0	0	0	0				11.4855	0.370060589	1.480675401	0	0.975866045	1.405627673	0.507618431	1.103667155	2.055916064	1.860387013	2.991673827	0	0	2.056175361	2.350739059	8.500823933	0.009051479	0.658842672	0	0	3.176956932	0	0	0	0	0	0	0	0	0	0	0.081563538	1.436953549	0	0	0	0	0	0	0	42.5081	0	3.722	11.4855	0.370060589	1.480675401	0	0.975866045	1.405627673	0.507618431	1.103667155	2.055916064	1.860387013	2.991673827	0	0	2.056175361	2.350739059	8.500823933	0.009051479	0.658842672	0	0	3.176956932	0	0	0	0	0	0	0	0	0	0	0.081563538	1.436953549	0	0	0	0	0	0	0	42.5081	10000	30% Coins	30% Coins	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		20% Coins	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			"DEN 767 16a, 16b"	VIS 738				0	0	0	$35/Visit	0	0	0	0					6.2421	0.0893	0.3913	0.5936	0.7959	1.6353	0.5906	0.2383	2.826	0.3641	1.5143		0.0002	0.8553	1.7762	2.1411	0.0023	0.082			1.1687			0	0				0	0	0	0.3619	0	0	0	0					21.6684	500	1.552538814	17.7276	0.459391589	1.871963401	0.593626	1.771747045	3.040907673	1.098171431	1.341932155	4.881907064	2.224440013	4.505963827	0	0.00022	2.911503361	4.126949059	10.64188693	0.011331479	0.740816672	0	0	4.345679932	0	0	0	0	0	0	0	0	0	0	0.443482538	1.436953549	0	0	0	0	0	0	0	64.1765
H5868_801_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		238.213195	7.675189	462.787779	661.428586	4.132627	8.156164	2.94546	18.133562	46.612523	570.283342	25.204212	0	0.318043	14.358757	27.049983	61.758279	0.390294	5.214727			18.434313																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000001	1023.999278	43.132789	0	0.199999	0.2	0.2	0.199999	0.199999	0	0.2	0	0.200001	0.2	0.2	0.2	0.500002	0.2			0.2																				1024.000001	1023.999278	43.132789	0	0.199999	0.2	0.2	0.199999	0.199999	0	0.2	0	0.200001	0.2	0.2	0.2	0.500002	0.2			0.2																				20.3275	0.654949	1.663443969	0	0.826521267	1.6312328	0.589092	3.626694266	9.322457987	0	5.0408424	0	0.063608918	2.8717514	5.4099966	12.3516558	0.195147781	1.0429454	0	0	3.6868626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.3047	0	0	20.3275	0.654949	1.663443969	0	0.826521267	1.6312328	0.589092	3.626694266	9.322457987	0	5.0408424	0	0.063608918	2.8717514	5.4099966	12.3516558	0.195147781	1.0429454	0	0	3.6868626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.3047		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.2586	0.0728	0.1848		0.524	1.0342	0.3735	0.6831	1.7872		0.9577		0.012	0.5409	1.0846	2.4762	0.0391	0.2091			0.7391																				12.9769	0	0	22.5861	0.727721	1.848270969	0	1.350527267	2.6654128	0.962569	4.309822266	11.10966599	0	5.9985064	0	0.075589918	3.4126754	6.4945616	14.8278438	0.234269781	1.2520284	0	0	4.4259836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.2816
H5868_802_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		238.213195	7.675189	462.787779	661.428586	4.132627	8.156164	2.94546	18.133562	46.612523	570.283342	25.204212	0	0.318043	14.358757	27.049983	61.758279	0.390294	5.214727			18.434313																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000001	1023.999278	43.132789	0	0.199999	0.2	0.2	0.199999	0.199999	0	0.2	0	0.200001	0.2	0.2	0.2	0.500002	0.2			0.2																				1024.000001	1023.999278	43.132789	0	0.199999	0.2	0.2	0.199999	0.199999	0	0.2	0	0.200001	0.2	0.2	0.2	0.500002	0.2			0.2																				20.3275	0.654949	1.663443969	0	0.826521267	1.6312328	0.589092	3.626694266	9.322457987	0	5.0408424	0	0.063608918	2.8717514	5.4099966	12.3516558	0.195147781	1.0429454	0	0	3.6868626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.3047	0	0	20.3275	0.654949	1.663443969	0	0.826521267	1.6312328	0.589092	3.626694266	9.322457987	0	5.0408424	0	0.063608918	2.8717514	5.4099966	12.3516558	0.195147781	1.0429454	0	0	3.6868626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.3047		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.2586	0.0728	0.1848		0.524	1.0342	0.3735	0.6831	1.7872		0.9577		0.012	0.5409	1.0846	2.4762	0.0391	0.2091			0.7391																				12.9769	0	0	22.5861	0.727721	1.848270969	0	1.350527267	2.6654128	0.962569	4.309822266	11.10966599	0	5.9985064	0	0.075589918	3.4126754	6.4945616	14.8278438	0.234269781	1.2520284	0	0	4.4259836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.2816
H5868_803_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		238.213195	7.675189	462.787779	661.428586	4.132627	8.156164	2.94546	18.133562	46.612523	570.283342	25.204212	0	0.318043	14.358757	27.049983	61.758279	0.390294	5.214727			18.434313																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000001	1023.999278	43.132789	0	0.199999	0.2	0.2	0.199999	0.199999	0	0.2	0	0.200001	0.2	0.2	0.2	0.500002	0.2			0.2																				1024.000001	1023.999278	43.132789	0	0.199999	0.2	0.2	0.199999	0.199999	0	0.2	0	0.200001	0.2	0.2	0.2	0.500002	0.2			0.2																				20.3275	0.654949	1.663443969	0	0.826521267	1.6312328	0.589092	3.626694266	9.322457987	0	5.0408424	0	0.063608918	2.8717514	5.4099966	12.3516558	0.195147781	1.0429454	0	0	3.6868626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.3047	0	0	20.3275	0.654949	1.663443969	0	0.826521267	1.6312328	0.589092	3.626694266	9.322457987	0	5.0408424	0	0.063608918	2.8717514	5.4099966	12.3516558	0.195147781	1.0429454	0	0	3.6868626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.3047		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.2586	0.0728	0.1848		0.524	1.0342	0.3735	0.6831	1.7872		0.9577		0.012	0.5409	1.0846	2.4762	0.0391	0.2091			0.7391																				12.9769	0	0	22.5861	0.727721	1.848270969	0	1.350527267	2.6654128	0.962569	4.309822266	11.10966599	0	5.9985064	0	0.075589918	3.4126754	6.4945616	14.8278438	0.234269781	1.2520284	0	0	4.4259836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.2816
H5868_804_0	2009	4																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		238.213195	7.675189	462.787779	661.428586	4.132627	8.156164	2.94546	18.133562	46.612523	570.283342	25.204212	0	0.318043	14.358757	27.049983	61.758279	0.390294	5.214727			18.434313																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000001	1023.999278	43.132789	0	0.199999	0.2	0.2	0.199999	0.199999	0	0.2	0	0.200001	0.2	0.2	0.2	0.500002	0.2			0.2																				1024.000001	1023.999278	43.132789	0	0.199999	0.2	0.2	0.199999	0.199999	0	0.2	0	0.200001	0.2	0.2	0.2	0.500002	0.2			0.2																				20.3275	0.654949	1.663443969	0	0.826521267	1.6312328	0.589092	3.626694266	9.322457987	0	5.0408424	0	0.063608918	2.8717514	5.4099966	12.3516558	0.195147781	1.0429454	0	0	3.6868626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.3047	0	0	20.3275	0.654949	1.663443969	0	0.826521267	1.6312328	0.589092	3.626694266	9.322457987	0	5.0408424	0	0.063608918	2.8717514	5.4099966	12.3516558	0.195147781	1.0429454	0	0	3.6868626	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.3047		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.2586	0.0728	0.1848		0.524	1.0342	0.3735	0.6831	1.7872		0.9577		0.012	0.5409	1.0846	2.4762	0.0391	0.2091			0.7391																				12.9769	0	0	22.5861	0.727721	1.848270969	0	1.350527267	2.6654128	0.962569	4.309822266	11.10966599	0	5.9985064	0	0.075589918	3.4126754	6.4945616	14.8278438	0.234269781	1.2520284	0	0	4.4259836	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.2816
H5883_001_1	2009	6																					3350											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	V											0	0	0	0	0	0	0	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	204.6870998	3.002534994	475.2043586	0	177.9705432	9.09026648	0.861371012	99.23342893	167.9465261	0	508.1996216	0	0	0	1333.108706	2029.454335	142.0244368	52.37708009	748.97168	2370.98491	0	0	0	0	0	0	64.56237764	0	0	0											$500 copay per admit	$500 copay per admit	"$0 copay days 1-20, $130 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$100 OP surgery		"$20 copay for low-tech radiology, $40 copay for high-tech radiology"				$20 copay	$35 copay	$30 copay	$30 copay	$20 copay	"$50 office surgery, $30 allergy, $30 cardiovascular"				No copay			"$25 copay on exam, $0 on hearing aid/fitting"														400	400	52	0	50	0.15	0.15	46.3717435	100	0	24.61781382	0	0	0	20	35	35	35	21.82417349	37.41283201	0	0	0	0	0	0	4.22	0	0	0											354.8	354.8	46.124	0	44.35	0.13305	0.13305	41.13173649	88.7	0	21.83600086	0	0	0	17.74	31.045	31.045	31.045	19.35804188	33.18518199	0	0	0	0	0	0	3.74314	0	0	0											6.0519	0.088774951	1.826527153	0	0.657749466	1.209459955	0.114605413	0.340136937	1.241404739	0	0.924753948	0	0	0	1.970779037	5.250367485	0.367429053	0.135503871	1.208218763	6.556797143	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	27.9646	0	3.5626	6.0519	0.088774951	1.826527153	0	0.657749466	1.209459955	0.114605413	0.340136937	1.241404739	0	0.924753948	0	0	0	1.970779037	5.250367485	0.367429053	0.135503871	1.208218763	6.556797143	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	27.9646	N/A																																																																																	0	0	0	6.0519	0.088774951	1.826527153	0	0.657749466	1.209459955	0.114605413	0.340136937	1.241404739	0	0.924753948	0	0	0	1.970779037	5.250367485	0.367429053	0.135503871	1.208218763	6.556797143	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	27.9646
H5883_001_2	2009	6																					3350											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	V											0	0	0	0	0	0	0	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	205.4336491	3.013486052	476.9375576	0	178.61965	9.123421144	0.864512665	99.5900096	168.5590726	0	510.0531633	0	0	0	1336.807419	2036.856304	142.5424384	52.56811349	751.7033825	2379.632534	0	0	0	0	0	0	64.56237764	0	0	0											$500 copay per admit	$500 copay per admit	"$0 copay days 1-20, $130 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$100 OP surgery		"$20 copay for low-tech radiology, $40 copay for high-tech radiology"				$20 copay	$35 copay	$30 copay	$30 copay	$20 copay	"$50 office surgery, $30 allergy, $30 cardiovascular"				No copay			"$25 copay on exam, $0 on hearing aid/fitting"														400	400	52	0	50	0.15	0.15	46.37165123	100	0	24.61781382	0	0	0	20	35	35	35	21.82417349	37.41283201	0	0	0	0	0	0	4.22	0	0	0											354.8	354.8	46.124	0	44.35	0.13305	0.13305	41.13165464	88.7	0	21.83600086	0	0	0	17.74	31.045	31.045	31.045	19.35804188	33.18518199	0	0	0	0	0	0	3.74314	0	0	0											6.074	0.089098738	1.833188992	0	0.660148457	1.213871183	0.11502341	0.34135849	1.245932478	0	0.928126776	0	0	0	1.976246968	5.269516997	0.368769167	0.13599809	1.212625464	6.580711559	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	28.0647	0	3.5753	6.074	0.089098738	1.833188992	0	0.660148457	1.213871183	0.11502341	0.34135849	1.245932478	0	0.928126776	0	0	0	1.976246968	5.269516997	0.368769167	0.13599809	1.212625464	6.580711559	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	28.0647	N/A																																																																																	0	0	0	6.074	0.089098738	1.833188992	0	0.660148457	1.213871183	0.11502341	0.34135849	1.245932478	0	0.928126776	0	0	0	1.976246968	5.269516997	0.368769167	0.13599809	1.212625464	6.580711559	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	28.0647
H5883_001_3	2009	6																					3350											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	V											0	0	0	0	0	0	0	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	204.1524275	2.994691937	473.9630559	0	177.5056584	9.066521387	0.859120986	98.97804883	167.5078255	0	506.8721306	0	0	0	1330.459719	2024.153106	141.6534484	52.24026357	747.0152574	2364.791553	0	0	0	0	0	0	64.56237764	0	0	0											$500 copay per admit	$500 copay per admit	"$0 copay days 1-20, $130 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$100 OP surgery		"$20 copay for low-tech radiology, $40 copay for high-tech radiology"				$20 copay	$35 copay	$30 copay	$30 copay	$20 copay	"$50 office surgery, $30 allergy, $30 cardiovascular"				No copay			"$25 copay on exam, $0 on hearing aid/fitting"														400	400	52	0	50	0.15	0.15	46.37181	100	0	24.61781382	0	0	0	20	35	35	35	21.82417349	37.41283201	0	0	0	0	0	0	4.22	0	0	0											354.8	354.8	46.124	0	44.35	0.13305	0.13305	41.13179547	88.7	0	21.83600086	0	0	0	17.74	31.045	31.045	31.045	19.35804188	33.18518199	0	0	0	0	0	0	3.74314	0	0	0											6.0361	0.088543058	1.821755999	0	0.656031329	1.206300671	0.114306047	0.339262072	1.23816201	0	0.922338357	0	0	0	1.966862951	5.236652764	0.366469276	0.135149915	1.20506272	6.539669839	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	27.8928	0	3.5534	6.0361	0.088543058	1.821755999	0	0.656031329	1.206300671	0.114306047	0.339262072	1.23816201	0	0.922338357	0	0	0	1.966862951	5.236652764	0.366469276	0.135149915	1.20506272	6.539669839	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	27.8928	N/A																																																																																	0	0	0	6.0361	0.088543058	1.821755999	0	0.656031329	1.206300671	0.114306047	0.339262072	1.23816201	0	0.922338357	0	0	0	1.966862951	5.236652764	0.366469276	0.135149915	1.20506272	6.539669839	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	27.8928
H5883_001_4	2009	6																					3350											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	V											0	0	0	0	0	0	0	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	220.2968528	3.231512929	511.4441736	0	191.5428505	9.783504179	0.92706049	106.6892476	180.7543864	0	546.9557062	0	0	0	1410.445863	2184.223643	152.8554388	56.37143676	806.0894119	2551.799864	0	0	0	0	0	0	64.56237764	0	0	0											$500 copay per admit	$500 copay per admit	"$0 copay days 1-20, $130 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$100 OP surgery		"$20 copay for low-tech radiology, $40 copay for high-tech radiology"				$20 copay	$35 copay	$30 copay	$30 copay	$20 copay	"$50 office surgery, $30 allergy, $30 cardiovascular"				No copay			"$25 copay on exam, $0 on hearing aid/fitting"														400	400	52	0	50	0.15	0.15	46.36994249	100	0	24.61781382	0	0	0	20	35	35	35	21.82417349	37.41283201	0	0	0	0	0	0	4.22	0	0	0											354.8	354.8	46.124	0	44.35	0.13305	0.13305	41.13013899	88.7	0	21.83600086	0	0	0	17.74	31.045	31.045	31.045	19.35804188	33.18518199	0	0	0	0	0	0	3.74314	0	0	0											6.5134	0.095545066	1.965820922	0	0.707910452	1.301695231	0.123345398	0.365678632	1.336076173	0	0.995277106	0	0	0	2.085109134	5.650768582	0.395449758	0.145837605	1.300359383	7.056828575	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	30.0593	0	3.8294	6.5134	0.095545066	1.965820922	0	0.707910452	1.301695231	0.123345398	0.365678632	1.336076173	0	0.995277106	0	0	0	2.085109134	5.650768582	0.395449758	0.145837605	1.300359383	7.056828575	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	30.0593	N/A																																																																																	0	0	0	6.5134	0.095545066	1.965820922	0	0.707910452	1.301695231	0.123345398	0.365678632	1.336076173	0	0.995277106	0	0	0	2.085109134	5.650768582	0.395449758	0.145837605	1.300359383	7.056828575	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	30.0593
H5883_001_5	2009	6																					3350											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	V											0	0	0	0	0	0	0	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	224.4844691	3.292940662	521.1662007	0	195.1838829	9.969478519	0.944682955	108.6894143	184.1903412	0	557.352771	0	0	0	1431.193042	2225.743485	155.7610633	57.44299972	821.4123416	2600.306952	0	0	0	0	0	0	64.56237764	0	0	0											$500 copay per admit	$500 copay per admit	"$0 copay days 1-20, $130 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$100 OP surgery		"$20 copay for low-tech radiology, $40 copay for high-tech radiology"				$20 copay	$35 copay	$30 copay	$30 copay	$20 copay	"$50 office surgery, $30 allergy, $30 cardiovascular"				No copay			"$25 copay on exam, $0 on hearing aid/fitting"														400	400	52	0	50	0.15	0.15	46.36950137	100	0	24.61781382	0	0	0	20	35	35	35	21.82417349	37.41283201	0	0	0	0	0	0	4.22	0	0	0											354.8	354.8	46.124	0	44.35	0.13305	0.13305	41.12974772	88.7	0	21.83600086	0	0	0	17.74	31.045	31.045	31.045	19.35804188	33.18518199	0	0	0	0	0	0	3.74314	0	0	0											6.6373	0.097361279	2.003189153	0	0.7213671	1.326439117	0.125690067	0.372530683	1.361473605	0	1.014196299	0	0	0	2.11578038	5.758183874	0.402966851	0.148609827	1.325077876	7.19097162	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	30.6212	0	3.901	6.6373	0.097361279	2.003189153	0	0.7213671	1.326439117	0.125690067	0.372530683	1.361473605	0	1.014196299	0	0	0	2.11578038	5.758183874	0.402966851	0.148609827	1.325077876	7.19097162	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	30.6212	N/A																																																																																	0	0	0	6.6373	0.097361279	2.003189153	0	0.7213671	1.326439117	0.125690067	0.372530683	1.361473605	0	1.014196299	0	0	0	2.11578038	5.758183874	0.402966851	0.148609827	1.325077876	7.19097162	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	30.6212
H5883_002_1	2009	9																					3350											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	V											0	0	0	0	0	0	0	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	218.7641272	3.209029528	507.8857771	0	190.2101823	9.715434995	0.920610423	105.9571589	179.4967794	0	543.1502365	0	0	0	1449.613845	2183.026112	152.6796121	56.30659379	800.4810075	2557.516425	0	0	0	0	0	0	64.56237764	0	0	0											$500 copay per admit	$500 copay per admit	"$0 copay days 1-20, $130 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$100 OP surgery		"$20 copay for low-tech radiology, $40 copay for high-tech radiology"				$15 copay	$30 copay	$30 copay	$30 copay	$20 copay	"$50 office surgery, $30 allergy, $30 cardiovascular"				No copay			"$25 copay on exam, $0 on hearing aid/fitting"														400	400	52	0	50	0.15	0.15	46.37010811	100	0	24.61781382	0	0	0	15	30	30	30	21.82417349	33.1691793	0	0	0	0	0	0	4.22	0	0	0											354.8	354.8	46.124	0	44.35	0.13305	0.13305	41.1302859	88.7	0	21.83600086	0	0	0	13.305	26.61	26.61	26.61	19.35804188	29.42106204	0	0	0	0	0	0	3.74314	0	0	0											6.4681	0.094880306	1.952143632	0	0.702985132	1.292638626	0.122487217	0.363170687	1.326780361	0	0.988352419	0	0	0	1.607259351	4.840860404	0.33856704	0.124859872	1.291312072	6.270404118	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	27.805	0	3.5422	6.4681	0.094880306	1.952143632	0	0.702985132	1.292638626	0.122487217	0.363170687	1.326780361	0	0.988352419	0	0	0	1.607259351	4.840860404	0.33856704	0.124859872	1.291312072	6.270404118	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	27.805	N/A																																																																																	0	0	0	6.4681	0.094880306	1.952143632	0	0.702985132	1.292638626	0.122487217	0.363170687	1.326780361	0	0.988352419	0	0	0	1.607259351	4.840860404	0.33856704	0.124859872	1.291312072	6.270404118	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	27.805
H5883_002_2	2009	9																					3350											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	V											0	0	0	0	0	0	0	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	220.2102375	3.230242377	511.2430863	0	191.4675405	9.779657544	0.926695992	106.6478768	180.6833182	0	546.7406566	0	0	0	1457.017293	2197.456706	153.6888798	56.67880079	805.7724772	2574.422536	0	0	0	0	0	0	64.56237764	0	0	0											$500 copay per admit	$500 copay per admit	"$0 copay days 1-20, $130 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$100 OP surgery		"$20 copay for low-tech radiology, $40 copay for high-tech radiology"				$15 copay	$30 copay	$30 copay	$30 copay	$20 copay	"$50 office surgery, $30 allergy, $30 cardiovascular"				No copay			"$25 copay on exam, $0 on hearing aid/fitting"														400	400	52	0	50	0.15	0.15	46.36995179	100	0	24.61781382	0	0	0	15	30	30	30	21.82417349	33.1691793	0	0	0	0	0	0	4.22	0	0	0											354.8	354.8	46.124	0	44.35	0.13305	0.13305	41.13014724	88.7	0	21.83600086	0	0	0	13.305	26.61	26.61	26.61	19.35804188	29.42106204	0	0	0	0	0	0	3.74314	0	0	0											6.5109	0.0955075	1.965048009	0	0.707632119	1.301183436	0.123296902	0.365536906	1.335550861	0	0.994885787	0	0	0	1.615467923	4.872860246	0.340805091	0.125685241	1.299848114	6.311853763	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	27.9862	0	3.5653	6.5109	0.0955075	1.965048009	0	0.707632119	1.301183436	0.123296902	0.365536906	1.335550861	0	0.994885787	0	0	0	1.615467923	4.872860246	0.340805091	0.125685241	1.299848114	6.311853763	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	27.9862	N/A																																																																																	0	0	0	6.5109	0.0955075	1.965048009	0	0.707632119	1.301183436	0.123296902	0.365536906	1.335550861	0	0.994885787	0	0	0	1.615467923	4.872860246	0.340805091	0.125685241	1.299848114	6.311853763	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	27.9862
H5883_002_3	2009	9																					3350											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	V											0	0	0	0	0	0	0	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	218.3160163	3.202456232	506.8454366	0	189.8205605	9.695534142	0.918724668	105.7431239	179.1291027	0	542.0376612	0	0	0	1447.319714	2178.554456	152.3668671	56.19125678	798.8413223	2552.277673	0	0	0	0	0	0	64.56237764	0	0	0											$500 copay per admit	$500 copay per admit	"$0 copay days 1-20, $130 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$100 OP surgery		"$20 copay for low-tech radiology, $40 copay for high-tech radiology"				$15 copay	$30 copay	$30 copay	$30 copay	$20 copay	"$50 office surgery, $30 allergy, $30 cardiovascular"				No copay			"$25 copay on exam, $0 on hearing aid/fitting"														400	400	52	0	50	0.15	0.15	46.37015697	100	0	24.61781382	0	0	0	15	30	30	30	21.82417349	33.1691793	0	0	0	0	0	0	4.22	0	0	0											354.8	354.8	46.124	0	44.35	0.13305	0.13305	41.13032923	88.7	0	21.83600086	0	0	0	13.305	26.61	26.61	26.61	19.35804188	29.42106204	0	0	0	0	0	0	3.74314	0	0	0											6.4549	0.094685956	1.94814491	0	0.701545155	1.289990818	0.122236317	0.362437458	1.324062618	0	0.986327903	0	0	0	1.604715733	4.830944507	0.337873528	0.124604112	1.288666981	6.257559979	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	27.7488	0	3.5351	6.4549	0.094685956	1.94814491	0	0.701545155	1.289990818	0.122236317	0.362437458	1.324062618	0	0.986327903	0	0	0	1.604715733	4.830944507	0.337873528	0.124604112	1.288666981	6.257559979	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	27.7488	N/A																																																																																	0	0	0	6.4549	0.094685956	1.94814491	0	0.701545155	1.289990818	0.122236317	0.362437458	1.324062618	0	0.986327903	0	0	0	1.604715733	4.830944507	0.337873528	0.124604112	1.288666981	6.257559979	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	27.7488
H5883_002_4	2009	9																					3350											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	V											0	0	0	0	0	0	0	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	233.8305249	3.430037038	542.8641311	0	203.3100551	10.38454199	0.984013336	113.1534502	191.8588147	0	580.557272	0	0	0	1526.747167	2333.37224	163.1947354	60.18445779	855.6105451	2733.653894	0	0	0	0	0	0	64.56237764	0	0	0											$500 copay per admit	$500 copay per admit	"$0 copay days 1-20, $130 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$100 OP surgery		"$20 copay for low-tech radiology, $40 copay for high-tech radiology"				$15 copay	$30 copay	$30 copay	$30 copay	$20 copay	"$50 office surgery, $30 allergy, $30 cardiovascular"				No copay			"$25 copay on exam, $0 on hearing aid/fitting"														400	400	52	0	50	0.15	0.15	46.3685731	100	0	24.61781382	0	0	0	15	30	30	30	21.82417349	33.1691793	0	0	0	0	0	0	4.22	0	0	0											354.8	354.8	46.124	0	44.35	0.13305	0.13305	41.12892434	88.7	0	21.83600086	0	0	0	13.305	26.61	26.61	26.61	19.35804188	29.42106204	0	0	0	0	0	0	3.74314	0	0	0											6.9136	0.101414762	2.086588765	0	0.751400079	1.381663311	0.130922974	0.387823308	1.418156405	0	1.056420758	0	0	0	1.692780922	5.174252943	0.361884326	0.133459035	1.380245397	6.702250066	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	29.693	0	3.7828	6.9136	0.101414762	2.086588765	0	0.751400079	1.381663311	0.130922974	0.387823308	1.418156405	0	1.056420758	0	0	0	1.692780922	5.174252943	0.361884326	0.133459035	1.380245397	6.702250066	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	29.693	N/A																																																																																	0	0	0	6.9136	0.101414762	2.086588765	0	0.751400079	1.381663311	0.130922974	0.387823308	1.418156405	0	1.056420758	0	0	0	1.692780922	5.174252943	0.361884326	0.133459035	1.380245397	6.702250066	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	29.693
H5883_002_7	2009	8																					3350											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	V											0	0	0	0	0	0	0	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	239.5577923	3.514049762	556.1606331	0	208.2897773	10.63889308	1.008115011	115.8890135	196.5580589	0	594.7770012	0	0	0	1556.068255	2390.524089	167.1919033	61.65857022	876.5672204	2800.609937	0	0	0	0	0	0	64.56237764	0	0	0											$500 copay per admit	$500 copay per admit	"$0 copay days 1-20, $130 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$100 OP surgery		"$20 copay for low-tech radiology, $40 copay for high-tech radiology"				$15 copay	$30 copay	$30 copay	$30 copay	$20 copay	"$50 office surgery, $30 allergy, $30 cardiovascular"				No copay			"$25 copay on exam, $0 on hearing aid/fitting"														400	400	52	0	50	0.15	0.15	46.3680396	100	0	24.61781382	0	0	0	15	30	30	30	21.82417349	33.1691793	0	0	0	0	0	0	4.22	0	0	0											354.8	354.8	46.124	0	44.35	0.13305	0.13305	41.12845113	88.7	0	21.83600086	0	0	0	13.305	26.61	26.61	26.61	19.35804188	29.42106204	0	0	0	0	0	0	3.74314	0	0	0											7.0829	0.103898738	2.137696087	0	0.769804302	1.415504724	0.134129702	0.397194636	1.452891652	0	1.082295926	0	0	0	1.725290677	5.300987167	0.370748046	0.136727879	1.414052081	6.866409893	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	30.4107	0	3.8742	7.0829	0.103898738	2.137696087	0	0.769804302	1.415504724	0.134129702	0.397194636	1.452891652	0	1.082295926	0	0	0	1.725290677	5.300987167	0.370748046	0.136727879	1.414052081	6.866409893	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	30.4107	N/A																																																																																	0	0	0	7.0829	0.103898738	2.137696087	0	0.769804302	1.415504724	0.134129702	0.397194636	1.452891652	0	1.082295926	0	0	0	1.725290677	5.300987167	0.370748046	0.136727879	1.414052081	6.866409893	0	0	0	0	0	0	0.020138835	0	0	0	0	0	0	0	0	0	0	0	0	0	30.4107
H5883_003_1	2009	9																					3000											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	V											0	0	0	0	0	0	0	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	270.9376293	3.974357512	623.9356667	0	185.6917083	8.256463884	0.782361955	146.5167191	217.3618112	0	761.2689948	0	0	0	1677.181925	2694.243828	188.4338902	70.65855032	1001.904022	3156.431711	0	0	0	0	0	0	64.7979422	0	0	0											$150 copay per admit	$150 copay per admit	"$0 copay days 1-20, $130 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$50 OP surgery		"$10 copay for low-tech radiology, $20 copay for high-tech radiology"				$10 copay	$20 copay	$20 copay	$20 copay	$15 copay	"$30 office surgery, $20 allergy, $20 cardiovascular"				No copay			"$25 copay on exam, $0 on hearing aid/fitting"														120	120	52	0	50	0.15	0.15	46.36600464	50	0	12.30890691	0	0	0	10	20	20	20	10.91208674	21.57906785	0	0	0	0	0	0	4.22	0	0	0											105.36	105.36	45.656	0	43.9	0.1317	0.1317	40.70935208	43.9	0	10.80722027	0	0	0	8.78	17.56	17.56	17.56	9.580812161	18.94642157	0	0	0	0	0	0	3.70516	0	0	0											2.3788	0.034894859	2.373867233	0	0.679322166	1.087376294	0.103037069	0.497050059	0.795181959	0	0.685600143	0	0	0	1.227138109	3.942576802	0.275741593	0.103397012	0.799921186	4.983590487	0	0	0	0	0	0	0.020007229	0	0	0	0	0	0	0	0	0	0	0	0	0	19.9875	0	2.7773	2.3788	0.034894859	2.373867233	0	0.679322166	1.087376294	0.103037069	0.497050059	0.795181959	0	0.685600143	0	0	0	1.227138109	3.942576802	0.275741593	0.103397012	0.799921186	4.983590487	0	0	0	0	0	0	0.020007229	0	0	0	0	0	0	0	0	0	0	0	0	0	19.9875	N/A																																																																																	0	0	0	2.3788	0.034894859	2.373867233	0	0.679322166	1.087376294	0.103037069	0.497050059	0.795181959	0	0.685600143	0	0	0	1.227138109	3.942576802	0.275741593	0.103397012	0.799921186	4.983590487	0	0	0	0	0	0	0.020007229	0	0	0	0	0	0	0	0	0	0	0	0	0	19.9875
H5883_003_2	2009	9																					3000											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	V											0	0	0	0	0	0	0	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	267.0044351	3.916661873	610.7508062	0	231.9956863	11.84972845	1.122850756	128.9116305	218.9287557	0	672.405312	0	0	0	1654.293606	2662.594794	186.2203746	69.82853082	990.1347472	3119.353397	0	0	0	0	0	0	64.56237764	0	0	0											$150 copay per admit	$150 copay per admit	"$0 copay days 1-20, $130 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$50 OP surgery		"$10 copay for low-tech radiology, $20 copay for high-tech radiology"				$10 copay	$20 copay	$20 copay	$20 copay	$15 copay	"$30 office surgery, $20 allergy, $20 cardiovascular"				No copay			"$25 copay on exam, $0 on hearing aid/fitting"														120	120	52	0	50	0.15	0.15	46.36581033	50	0	12.30890691	0	0	0	10	20	20	20	10.91208674	21.57906785	0	0	0	0	0	0	4.22	0	0	0											105.36	105.36	45.656	0	43.9	0.1317	0.1317	40.70918147	43.9	0	10.80722027	0	0	0	8.78	17.56	17.56	17.56	9.580812161	18.94642157	0	0	0	0	0	0	3.70516	0	0	0											2.3443	0.034388291	2.323703234	0	0.848717552	1.560609237	0.147879445	0.437323913	0.800914365	0	0.60556936	0	0	0	1.210391489	3.896263715	0.272502482	0.102182417	0.790524586	4.925048708	0	0	0	0	0	0	0.019934495	0	0	0	0	0	0	0	0	0	0	0	0	0	20.3203	0	2.8235	2.3443	0.034388291	2.323703234	0	0.848717552	1.560609237	0.147879445	0.437323913	0.800914365	0	0.60556936	0	0	0	1.210391489	3.896263715	0.272502482	0.102182417	0.790524586	4.925048708	0	0	0	0	0	0	0.019934495	0	0	0	0	0	0	0	0	0	0	0	0	0	20.3203	N/A																																																																																	0	0	0	2.3443	0.034388291	2.323703234	0	0.848717552	1.560609237	0.147879445	0.437323913	0.800914365	0	0.60556936	0	0	0	1.210391489	3.896263715	0.272502482	0.102182417	0.790524586	4.925048708	0	0	0	0	0	0	0.019934495	0	0	0	0	0	0	0	0	0	0	0	0	0	20.3203
H5883_003_3	2009	9																					3000											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	V											0	0	0	0	0	0	0	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	261.178905	3.831207743	597.4253825	0	226.9339806	11.59118987	1.098352283	126.1310303	214.1521457	0	657.734704	0	0	0	1625.216715	2604.502028	182.1573994	68.30500478	968.5318859	3051.295025	0	0	0	0	0	0	64.56237764	0	0	0											$150 copay per admit	$150 copay per admit	"$0 copay days 1-20, $130 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$50 OP surgery		"$10 copay for low-tech radiology, $20 copay for high-tech radiology"				$10 copay	$20 copay	$20 copay	$20 copay	$15 copay	"$30 office surgery, $20 allergy, $20 cardiovascular"				No copay			"$25 copay on exam, $0 on hearing aid/fitting"														120	120	52	0	50	0.15	0.15	46.36624767	50	0	12.30890691	0	0	0	10	20	20	20	10.91208674	21.57906785	0	0	0	0	0	0	4.22	0	0	0											105.36	105.36	45.656	0	43.9	0.1317	0.1317	40.70956546	43.9	0	10.80722027	0	0	0	8.78	17.56	17.56	17.56	9.580812161	18.94642157	0	0	0	0	0	0	3.70516	0	0	0											2.2932	0.033638004	2.273004439	0	0.830200146	1.526559705	0.144652996	0.427894953	0.783439933	0	0.592356985	0	0	0	1.189116896	3.811254634	0.266556994	0.09995299	0.773276839	4.81759349	0	0	0	0	0	0	0.019934495	0	0	0	0	0	0	0	0	0	0	0	0	0	19.8826	0	2.7627	2.2932	0.033638004	2.273004439	0	0.830200146	1.526559705	0.144652996	0.427894953	0.783439933	0	0.592356985	0	0	0	1.189116896	3.811254634	0.266556994	0.09995299	0.773276839	4.81759349	0	0	0	0	0	0	0.019934495	0	0	0	0	0	0	0	0	0	0	0	0	0	19.8826	N/A																																																																																	0	0	0	2.2932	0.033638004	2.273004439	0	0.830200146	1.526559705	0.144652996	0.427894953	0.783439933	0	0.592356985	0	0	0	1.189116896	3.811254634	0.266556994	0.09995299	0.773276839	4.81759349	0	0	0	0	0	0	0.019934495	0	0	0	0	0	0	0	0	0	0	0	0	0	19.8826
H5883_003_4	2009	9																					3000											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	V											0	0	0	0	0	0	0	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	275.1008636	4.035427589	533.0328322	0	172.5648526	6.659714632	0.631057972	133.1591677	235.5417889	0	741.9428587	0	0	0	1746.869671	2843.082393	198.8435752	74.56195248	1057.252374	3330.802997	0	0	0	0	0	0	64.56131095	0	0	0											$150 copay per admit	$150 copay per admit	"$0 copay days 1-20, $130 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$50 OP surgery		"$10 copay for low-tech radiology, $20 copay for high-tech radiology"				$10 copay	$20 copay	$20 copay	$20 copay	$15 copay	"$30 office surgery, $20 allergy, $20 cardiovascular"				No copay			"$25 copay on exam, $0 on hearing aid/fitting"														120	120	52	0	50	0.15	0.15	46.36469232	50	0	12.30890691	0	0	0	10	20	20	20	10.91208674	21.57906785	0	0	0	0	0	0	4.22	0	0	0											105.36	105.36	45.656	0	43.9	0.1317	0.1317	40.70819986	43.9	0	10.80722027	0	0	0	8.78	17.56	17.56	17.56	9.580812161	18.94642157	0	0	0	0	0	0	3.70516	0	0	0											2.4154	0.035431054	2.028012249	0	0.631299752	0.877084417	0.083110335	0.451722501	0.861690378	0	0.668194992	0	0	0	1.278126309	4.160377234	0.290974432	0.10910899	0.844111367	5.258899813	0	0	0	0	0	0	0.019934166	0	0	0	0	0	0	0	0	0	0	0	0	0	20.0135	0	2.7809	2.4154	0.035431054	2.028012249	0	0.631299752	0.877084417	0.083110335	0.451722501	0.861690378	0	0.668194992	0	0	0	1.278126309	4.160377234	0.290974432	0.10910899	0.844111367	5.258899813	0	0	0	0	0	0	0.019934166	0	0	0	0	0	0	0	0	0	0	0	0	0	20.0135	N/A																																																																																	0	0	0	2.4154	0.035431054	2.028012249	0	0.631299752	0.877084417	0.083110335	0.451722501	0.861690378	0	0.668194992	0	0	0	1.278126309	4.160377234	0.290974432	0.10910899	0.844111367	5.258899813	0	0	0	0	0	0	0.019934166	0	0	0	0	0	0	0	0	0	0	0	0	0	20.0135
H5883_003_5	2009	9																					3000											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	V											0	0	0	0	0	0	0	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	276.409924	4.054630066	671.6157273	0	193.3279335	8.293860742	0.785905588	135.5468699	239.0597136	0	740.3300491	0	0	0	1853.313942	3027.137286	211.7162704	79.38892909	1125.696564	3546.431849	0	0	0	0	0	0	65.3057167	0	0	0											$150 copay per admit	$150 copay per admit	"$0 copay days 1-20, $130 copay days 21 - 100"		$50 copay	15% coinsurance	15% coinsurance	"$50 ER copay, $35 urgent care copay"	$50 OP surgery		"$10 copay for low-tech radiology, $20 copay for high-tech radiology"				$10 copay	$20 copay	$20 copay	$20 copay	$15 copay	"$30 office surgery, $20 allergy, $20 cardiovascular"				No copay			"$25 copay on exam, $0 on hearing aid/fitting"														120	120	52	0	50	0.15	0.15	46.36433538	50	0	12.30890691	0	0	0	10	20	20	20	10.91208674	21.57906785	0	0	0	0	0	0	4.22	0	0	0											105.36	105.36	45.656	0	43.9	0.1317	0.1317	40.70788646	43.9	0	10.80722027	0	0	0	8.78	17.56	17.56	17.56	9.580812161	18.94642157	0	0	0	0	0	0	3.70516	0	0	0											2.4269	0.035599652	2.555273971	0	0.707258023	1.09230146	0.103503766	0.459818882	0.874560119	0	0.666742493	0	0	0	1.356008034	4.429710895	0.309811476	0.116172466	0.898757278	5.599349407	0	0	0	0	0	0	0.020164011	0	0	0	0	0	0	0	0	0	0	0	0	0	21.6519	0	3.0086	2.4269	0.035599652	2.555273971	0	0.707258023	1.09230146	0.103503766	0.459818882	0.874560119	0	0.666742493	0	0	0	1.356008034	4.429710895	0.309811476	0.116172466	0.898757278	5.599349407	0	0	0	0	0	0	0.020164011	0	0	0	0	0	0	0	0	0	0	0	0	0	21.6519	N/A																																																																																	0	0	0	2.4269	0.035599652	2.555273971	0	0.707258023	1.09230146	0.103503766	0.459818882	0.874560119	0	0.666742493	0	0	0	1.356008034	4.429710895	0.309811476	0.116172466	0.898757278	5.599349407	0	0	0	0	0	0	0.020164011	0	0	0	0	0	0	0	0	0	0	0	0	0	21.6519
H5883_801_0	2009	6																					0											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	V											0	0	0	0	0	0	0	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	296.9633315	4.356125986	773.3791581	0	643.5180163	13.14768196	1.245841598	324.8052618	728.7998706	18.18018614	1150.261704	0	575.130852	456.4951848	4115.751602	5732.035948	295.1684589	227.2890668	5927.821794	15782.76039	610.8423735	339.3568742	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																			780.5677981	406.3677102	94.96686044	0	45.09570294	0.231	0.231	116.0985631	242.227201	35.63110263	69.26021944	0	111.329205	83.17046503	13.03378914	22.12341933	17.49788406	12.23228744	18.2202656	24.05473592	150.7166218	30.14332436	0	0	0	0	0	0	0	0											780.5677981	406.3677102	94.96686044	0	45.09570294	0.231	0.231	116.0985631	242.227201	35.63110263	69.26021944	0	111.329205	83.17046503	13.03378914	22.12341933	17.49788406	12.23228744	18.2202656	24.05473592	150.7166218	30.14332436	0	0	0	0	0	0	0	0											19.3167	0.147515745	6.120449214	0	2.418324775	3.037114533	0.287789409	3.142452016	14.71126273	0.053981673	6.63894817	0	5.335738376	3.163909734	4.470319876	10.56768624	0.430401956	0.231688766	9.000540628	31.6375111	7.672008249	0.852445361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2368	0	0	19.3167	0.147515745	6.120449214	0	2.418324775	3.037114533	0.287789409	3.142452016	14.71126273	0.053981673	6.63894817	0	5.335738376	3.163909734	4.470319876	10.56768624	0.430401956	0.231688766	9.000540628	31.6375111	7.672008249	0.852445361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2368	0																																																																																	0	0	0	19.3167	0.147515745	6.120449214	0	2.418324775	3.037114533	0.287789409	3.142452016	14.71126273	0.053981673	6.63894817	0	5.335738376	3.163909734	4.470319876	10.56768624	0.430401956	0.231688766	9.000540628	31.6375111	7.672008249	0.852445361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2368
H5883_805_0	2009	6																					0											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	V											0	0	0	0	0	0	0	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	296.9633315	4.356125986	773.3791581	0	643.5180163	13.14768196	1.245841598	324.8052618	728.7998706	18.18018614	1150.261704	0	575.130852	456.4951848	4115.751602	5732.035948	295.1684589	227.2890668	5927.821794	15782.76039	610.8423735	339.3568742	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																			780.5677981	406.3677102	94.96686044	0	45.09570294	0.231	0.231	116.0985631	242.227201	35.63110263	69.26021944	0	111.329205	83.17046503	13.03378914	22.12341933	17.49788406	12.23228744	18.2202656	24.05473592	150.7166218	30.14332436	0	0	0	0	0	0	0	0											780.5677981	406.3677102	94.96686044	0	45.09570294	0.231	0.231	116.0985631	242.227201	35.63110263	69.26021944	0	111.329205	83.17046503	13.03378914	22.12341933	17.49788406	12.23228744	18.2202656	24.05473592	150.7166218	30.14332436	0	0	0	0	0	0	0	0											19.3167	0.147515745	6.120449214	0	2.418324775	3.037114533	0.287789409	3.142452016	14.71126273	0.053981673	6.63894817	0	5.335738376	3.163909734	4.470319876	10.56768624	0.430401956	0.231688766	9.000540628	31.6375111	7.672008249	0.852445361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2368	0	0	19.3167	0.147515745	6.120449214	0	2.418324775	3.037114533	0.287789409	3.142452016	14.71126273	0.053981673	6.63894817	0	5.335738376	3.163909734	4.470319876	10.56768624	0.430401956	0.231688766	9.000540628	31.6375111	7.672008249	0.852445361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2368	0																																																																																	0	0	0	19.3167	0.147515745	6.120449214	0	2.418324775	3.037114533	0.287789409	3.142452016	14.71126273	0.053981673	6.63894817	0	5.335738376	3.163909734	4.470319876	10.56768624	0.430401956	0.231688766	9.000540628	31.6375111	7.672008249	0.852445361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2368
H5883_807_0	2009	6																					0											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	V											0	0	0	0	0	0	0	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	296.9633315	4.356125986	773.3791581	0	643.5180163	13.14768196	1.245841598	324.8052618	728.7998706	18.18018614	1150.261704	0	575.130852	456.4951848	4115.751602	5732.035948	295.1684589	227.2890668	5927.821794	15782.76039	610.8423735	339.3568742	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																			780.5677981	406.3677102	94.96686044	0	45.09570294	0.231	0.231	116.0985631	242.227201	35.63110263	69.26021944	0	111.329205	83.17046503	13.03378914	22.12341933	17.49788406	12.23228744	18.2202656	24.05473592	150.7166218	30.14332436	0	0	0	0	0	0	0	0											780.5677981	406.3677102	94.96686044	0	45.09570294	0.231	0.231	116.0985631	242.227201	35.63110263	69.26021944	0	111.329205	83.17046503	13.03378914	22.12341933	17.49788406	12.23228744	18.2202656	24.05473592	150.7166218	30.14332436	0	0	0	0	0	0	0	0											19.3167	0.147515745	6.120449214	0	2.418324775	3.037114533	0.287789409	3.142452016	14.71126273	0.053981673	6.63894817	0	5.335738376	3.163909734	4.470319876	10.56768624	0.430401956	0.231688766	9.000540628	31.6375111	7.672008249	0.852445361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2368	0	0	19.3167	0.147515745	6.120449214	0	2.418324775	3.037114533	0.287789409	3.142452016	14.71126273	0.053981673	6.63894817	0	5.335738376	3.163909734	4.470319876	10.56768624	0.430401956	0.231688766	9.000540628	31.6375111	7.672008249	0.852445361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2368	0																																																																																	0	0	0	19.3167	0.147515745	6.120449214	0	2.418324775	3.037114533	0.287789409	3.142452016	14.71126273	0.053981673	6.63894817	0	5.335738376	3.163909734	4.470319876	10.56768624	0.430401956	0.231688766	9.000540628	31.6375111	7.672008249	0.852445361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.2368
H5884_001_1	2009	4																					4000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	V	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	281.3519173	7.571777075	246.4852546	12.31626897	165.2288076	21.50184891	4.909431799	270.8508533	530.3993005	9.628019406	21.91579451	0	9.780977816	1106.395239	3989.27788	5890.782213	276.9913638	218.5142652	27.21900808	29.07644151	5.689088301	0	0	742.1107422	289.4299992	0	58.99255204	0	0	0											1a:  Acute - $250/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $250/$0/admit for 1-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - $0/$75/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 20.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 20.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $10/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $20/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $20/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $20/visit/7h:  Psychiatric Services - Individual - $20/visit/7h:  Psychiatric Services - Group - $20/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $20/visit/9c:  Outpatient Substance Abuse Svcs - Group - $20/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service/15:  Medicare Chemo - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $20/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $20/visit/18a:  Fitting for Hearing Aid - $20/visit	18b:  Hearing Aids - $0/service	/14c:  Routine Exams - $0/visit	$0 											250	250	75	0	100	0.2	0.052447209	51.16145548	100	0	0.08686768	0	10	20	19.99888056	20	20	20	0	20	0.04	0	0	0	20	0	20	0	0	0											235.3566307	235.3566307	70.6069892	0	94.14265226	0.188285305	0.049375194	48.16475112	94.14265226	0	0.081779538	0	9.414265226	18.82853045	18.82747658	18.82853045	18.82853045	18.82853045	0	18.82853045	0.037657061	0	0	0	18.82853045	0	18.82853045	0	0	0											5.5182	0.148505662	1.450298476	0	1.296256515	4.048482169	0.242404148	1.087121995	4.161099742	0	1.792263553	0	0.007673393	1.735983038	6.259002989	9.242897691	0.434611694	0.342858541	0	0.045622222	0.214234345	0	0	0	0.454128463	0	0.092561922	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5742	0	2.4	5.5182	0.148505662	1.450298476	0	1.296256515	4.048482169	0.242404148	1.087121995	4.161099742	0	1.792263553	0	0.007673393	1.735983038	6.259002989	9.242897691	0.434611694	0.342858541	0	0.045622222	0.214234345	0	0	0	0.454128463	0	0.092561922	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5742	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	5.5182	0.148505662	1.450298476	0	1.296256515	4.048482169	0.242404148	1.087121995	4.161099742	0	1.792263553	0	0.007673393	1.735983038	6.259002989	9.242897691	0.434611694	0.342858541	0	0.045622222	0.214234345	0	0	0	0.454128463	0	0.092561922	0	0	0	0	0	0	0	0	0	0	0	0	0	38.5742
H5884_001_2	2009	4																					4000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	V	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	276.8669566	7.451075583	253.2730623	11.81496586	175.8337663	23.23498558	5.305151585	313.9716318	545.9822883	10.67908867	22.76424251	0	10.04401712	1188.988335	4042.557457	5992.68423	284.4404543	224.3907417	25.76840733	29.85839023	6.584127894	0	0	754.7762993	293.2923628	0	59.77978823	0	0	0											1a:  Acute - $250/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $250/$0/admit for 1-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - $0/$75/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 20.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 20.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $10/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $20/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $20/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $20/visit/7h:  Psychiatric Services - Individual - $20/visit/7h:  Psychiatric Services - Group - $20/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $20/visit/9c:  Outpatient Substance Abuse Svcs - Group - $20/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service/15:  Medicare Chemo - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $20/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $20/visit/18a:  Fitting for Hearing Aid - $20/visit	18b:  Hearing Aids - $0/service	/14c:  Routine Exams - $0/visit	$0 											250	250	75	0	100	0.2	0.052447215	51.02346663	100	0	0.08686768	0	10	20	19.99879141	20	20	20	0	20	0.04	0	0	0	20	0	20	0	0	0											234.9610663	234.9610663	70.48831989	0	93.98442652	0.187968853	0.049292214	47.9541125	93.98442652	0	0.081642091	0	9.398442652	18.7968853	18.79574942	18.7968853	18.7968853	18.7968853	0	18.7968853	0.037593771	0	0	0	18.7968853	0	18.7968853	0	0	0											5.4211	0.145892722	1.48773272	0	1.377136308	4.36745359	0.261502666	1.254685913	4.276152688	0	1.858520361	0	0.00786651	1.862439779	6.33190808	9.386983179	0.44554955	0.351487253	0	0.046770395	0.247522194	0	0	0	0.459415242	0	0.093639485	0	0	0	0	0	0	0	0	0	0	0	0	0	39.6837	0	2.54	5.4211	0.145892722	1.48773272	0	1.377136308	4.36745359	0.261502666	1.254685913	4.276152688	0	1.858520361	0	0.00786651	1.862439779	6.33190808	9.386983179	0.44554955	0.351487253	0	0.046770395	0.247522194	0	0	0	0.459415242	0	0.093639485	0	0	0	0	0	0	0	0	0	0	0	0	0	39.6837	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	5.4211	0.145892722	1.48773272	0	1.377136308	4.36745359	0.261502666	1.254685913	4.276152688	0	1.858520361	0	0.00786651	1.862439779	6.33190808	9.386983179	0.44554955	0.351487253	0	0.046770395	0.247522194	0	0	0	0.459415242	0	0.093639485	0	0	0	0	0	0	0	0	0	0	0	0	0	39.6837
H5884_002_1	2009	6																					5000											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	V	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	706.4667749	27.16789486	197.2568588	9.87895527	128.0311378	16.8962605	3.857855901	213.0605448	426.8908298	7.601235626	17.73422703	0	7.906597011	910.2830511	3129.110566	4634.904587	218.934234	172.7139175	21.7137812	22.98204666	4.550427134	0	0	0	0	0	0	0	0	0											1a:  Acute - $250/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/$0/day for 1-5/6-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - $0/$150/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$150/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $200/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $250/visit/9b:  Ambulatory Surgical Center Services - $250/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 20.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 20.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $20/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $30/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $30/day	7a:  Primary Care - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $30/visit/7f:  Podiatry Services - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $30/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $30/visit/7h:  Psychiatric Services - Individual - $30/visit/7h:  Psychiatric Services - Group - $30/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $30/visit/9c:  Outpatient Substance Abuse Svcs - Group - $30/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service/15:  Medicare Chemo - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	$0 	$0 	$0 	$0 	/14c:  Routine Exams - $0/visit	$0 											250	250	150	0	200	0.2	0.052447213	51.17821113	250	0	0.148747906	0	20	30	29.9961993	29.9528	30	30	0	30	0.04	0	0	0	0	0	0	0	0	0											233.5044276	233.5044276	140.1026566	0	186.8035421	0.186803542	0.048986626	47.80135559	233.5044276	0	0.138933178	0	18.68035421	28.02053131	28.01698139	27.97644568	28.02053131	28.02053131	0	28.02053131	0.037360708	0	0	0	0	0	0	0	0	0											13.7469	0.528651978	2.303017495	0	1.993055837	3.156281309	0.188983342	0.848715239	8.306741571	0	2.463872526	0	0.012308169	2.125551228	7.30568604	10.8056797	0.51122113	0.403294645	0	0.053664097	0.170007181	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.9237	0	3.88	13.7469	0.528651978	2.303017495	0	1.993055837	3.156281309	0.188983342	0.848715239	8.306741571	0	2.463872526	0	0.012308169	2.125551228	7.30568604	10.8056797	0.51122113	0.403294645	0	0.053664097	0.170007181	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.9237	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	13.7469	0.528651978	2.303017495	0	1.993055837	3.156281309	0.188983342	0.848715239	8.306741571	0	2.463872526	0	0.012308169	2.125551228	7.30568604	10.8056797	0.51122113	0.403294645	0	0.053664097	0.170007181	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.9237
H5884_002_2	2009	6																					5000											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	V	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	775.2123627	29.81157649	237.4960228	10.9876579	160.7947592	21.61798928	4.935949037	290.2454416	488.941755	9.71265298	20.84344493	0	9.21111735	1052.663265	3601.532021	5353.668072	255.0564924	201.2102007	23.26037984	26.77388594	6.132376545	0	0	0	0	0	0	0	0	0											1a:  Acute - $250/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/$0/day for 1-5/6-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - $0/$150/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$150/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $200/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $250/visit/9b:  Ambulatory Surgical Center Services - $250/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 20.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 20.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $20/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $30/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $30/day	7a:  Primary Care - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $30/visit/7f:  Podiatry Services - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $30/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $30/visit/7h:  Psychiatric Services - Individual - $30/visit/7h:  Psychiatric Services - Group - $30/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $30/visit/9c:  Outpatient Substance Abuse Svcs - Group - $30/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service/15:  Medicare Chemo - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	$0 	$0 	$0 	$0 	/14c:  Routine Exams - $0/visit	$0 											250	250	150	0	200	0.2	0.052447209	51.01766458	250	0	0.148747907	0	20	30	29.99613233	29.95092067	30	30	0	30	0.04	0	0	0	0	0	0	0	0	0											229.1139444	229.1139444	137.4683667	0	183.2911555	0.183291156	0.048065548	46.75543347	229.1139444	0	0.136320879	0	18.32911555	27.49367333	27.49012878	27.44869429	27.49367333	27.49367333	0	27.49367333	0.036658231	0	0	0	0	0	0	0	0	0											14.801	0.569187323	2.720682528	0	2.456021436	3.962386236	0.237249096	1.130879286	9.335281175	0	2.841396732	0	0.014069303	2.411798327	8.250548255	12.24593319	0.58436999	0.461000627	0	0.061342706	0.224802077	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3079	0	5.68	14.801	0.569187323	2.720682528	0	2.456021436	3.962386236	0.237249096	1.130879286	9.335281175	0	2.841396732	0	0.014069303	2.411798327	8.250548255	12.24593319	0.58436999	0.461000627	0	0.061342706	0.224802077	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3079	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	14.801	0.569187323	2.720682528	0	2.456021436	3.962386236	0.237249096	1.130879286	9.335281175	0	2.841396732	0	0.014069303	2.411798327	8.250548255	12.24593319	0.58436999	0.461000627	0	0.061342706	0.224802077	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.3079
H5884_003_1	2009	6																					4000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	V	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	309.9320879	8.34092917	263.7302746	13.23583963	170.7700474	22.36973866	5.107593426	281.9454834	594.8665927	10.16134588	23.94191066	0	10.90945308	1265.727026	4354.695965	6471.169059	308.949067	243.7252238	30.15253321	32.43111753	6.138541316	0	0	742.1107422	315.9362271	0	64.39513493	0	0	0											1a:  Acute - $250/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $250/$0/admit for 1-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - $0/$75/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 20.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 20.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $10/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $20/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $20/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $20/visit/7h:  Psychiatric Services - Individual - $20/visit/7h:  Psychiatric Services - Group - $20/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $20/visit/9c:  Outpatient Substance Abuse Svcs - Group - $20/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service/15:  Medicare Chemo - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $20/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $20/visit/18a:  Fitting for Hearing Aid - $20/visit	18b:  Hearing Aids - $0/service	/14c:  Routine Exams - $0/visit	$0 											250	250	75	0	100	0.2	0.052447217	51.20281375	100	0	0.08686768	0	10	20	19.99887177	20	20	20	0	20	0.04	0	0	0	20	0	20	0	0	0											232.718076	232.718076	69.8154228	0	93.0872304	0.186174461	0.048821662	47.66328121	93.0872304	0	0.080862717	0	9.30872304	18.61744608	18.61639584	18.61744608	18.61744608	18.61744608	0	18.61744608	0.037234892	0	0	0	18.61744608	0	18.61744608	0	0	0											6.0106	0.161757082	1.534370052	0	1.324709229	4.164674034	0.2493612	1.119870572	4.614540298	0	1.936007958	0	0.008462756	1.963717055	6.755728654	10.03972009	0.479320216	0.378128434	0	0.050315382	0.228567924	0	0	0	0.490160473	0	0.099906079	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6099	0	3.09	6.0106	0.161757082	1.534370052	0	1.324709229	4.164674034	0.2493612	1.119870572	4.614540298	0	1.936007958	0	0.008462756	1.963717055	6.755728654	10.03972009	0.479320216	0.378128434	0	0.050315382	0.228567924	0	0	0	0.490160473	0	0.099906079	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6099	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	6.0106	0.161757082	1.534370052	0	1.324709229	4.164674034	0.2493612	1.119870572	4.614540298	0	1.936007958	0	0.008462756	1.963717055	6.755728654	10.03972009	0.479320216	0.378128434	0	0.050315382	0.228567924	0	0	0	0.490160473	0	0.099906079	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6099
H5884_003_2	2009	6																					4000											A	A	D	coin	T	coin	coin	V	V	coin	coin	O	V	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	280.4314033	7.547003769	264.0417163	12.059425	178.5428204	24.05231842	5.49177024	321.0357818	555.06644	10.74525825	23.30667314	0	10.4072542	1180.227999	4129.936817	6147.850107	294.7271024	232.5057274	26.37375923	30.93820412	6.816857536	0	0	754.7762993	299.6283319	0	61.07120626	0	0	0											1a:  Acute - $250/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $250/$0/admit for 1-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - $0/$75/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 20.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 20.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $10/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $20/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $20/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $20/visit/7h:  Psychiatric Services - Individual - $20/visit/7h:  Psychiatric Services - Group - $20/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $20/visit/9c:  Outpatient Substance Abuse Svcs - Group - $20/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service/15:  Medicare Chemo - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $20/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $20/visit/18a:  Fitting for Hearing Aid - $20/visit	18b:  Hearing Aids - $0/service	/14c:  Routine Exams - $0/visit	$0 											250	250	75	0	100	0.2	0.052447211	51.02810331	100	0	0.08686768	0	10	20	19.99880575	20	20	20	0	20	0.04	0	0	0	20	0	20	0	0	0											234.3607154	234.3607154	70.30821463	0	93.74428618	0.187488572	0.049166263	47.83593119	93.74428618	0	0.081433487	0	9.374428618	18.74885724	18.74773769	18.74885724	18.74885724	18.74885724	0	18.74885724	0.037497714	0	0	0	18.74885724	0	18.74885724	0	0	0											5.4768	0.147393434	1.547025138	0	1.394780771	4.509534843	0.270009822	1.279753797	4.336192266	0	1.897943656	0	0.008130172	1.843993854	6.452247678	9.60543033	0.460483031	0.363268057	0	0.048337998	0.255616577	0	0	0	0.468140735	0	0.095417944	0	0	0	0	0	0	0	0	0	0	0	0	0	40.4605	0	2.7	5.4768	0.147393434	1.547025138	0	1.394780771	4.509534843	0.270009822	1.279753797	4.336192266	0	1.897943656	0	0.008130172	1.843993854	6.452247678	9.60543033	0.460483031	0.363268057	0	0.048337998	0.255616577	0	0	0	0.468140735	0	0.095417944	0	0	0	0	0	0	0	0	0	0	0	0	0	40.4605	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	5.4768	0.147393434	1.547025138	0	1.394780771	4.509534843	0.270009822	1.279753797	4.336192266	0	1.897943656	0	0.008130172	1.843993854	6.452247678	9.60543033	0.460483031	0.363268057	0	0.048337998	0.255616577	0	0	0	0.468140735	0	0.095417944	0	0	0	0	0	0	0	0	0	0	0	0	0	40.4605
H5884_004_1	2009	6																					2500											coin	coin	coin	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	227.155755	4.173617712	23.85538748	13.74356683	176.2180984	24.43841761	5.315430093	299.2064904	57.62349325	11.1305953	24.75401959	0	0.227822072	1311.402294	4672.112175	6905.547078	327.2390405	258.1539158	30.64910743	34.3510595	6.530893132	0	0	871.5458629	339.2719954	0	69.15150637	0	0	0											1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - 0/admit for 1-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - 0/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 10.0%	11b:  Prosthetics Devices - 10.0%/11b:  Medical Supplies - 10.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 20.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 20.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $10/visit/3:  Rehab Services (CORF) - $10/day/5:  Partial Hospitalization - $10/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $10/visit/7b:  Chiropractic Services - $10/visit/7f:  Podiatry Services - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $10/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $10/visit/7h:  Psychiatric Services - Individual - $10/visit/7h:  Psychiatric Services - Group - $10/visit	7c:  Occupational Therapy Services - $10/visit/7i:  Physical/Speech Therapy - $10/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $10/visit/9c:  Outpatient Substance Abuse Svcs - Group - $10/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service/15:  Medicare Chemo - 10.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $10/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $10/visit/18a:  Fitting for Hearing Aid - $10/visit	18b:  Hearing Aids - $0/service	/14c:  Routine Exams - $0/visit	$0 											0	0	0	0	100	0.1	0.026628671	51.15703923	0	0	0.012493726	0	0	10	10	10	10	10	0	10	0.02	0	0	0	10	0	10	0	0	0											0	0	0	0	97.06339451	0.097063395	0.025846692	49.65475881	0	0	0.012126835	0	0	9.706339451	9.706339451	9.706339451	9.706339451	9.706339451	0	9.706339451	0.019412679	0	0	0	9.706339451	0	9.706339451	0	0	0											0	0	0	0	1.425360567	2.37207577	0.137386285	1.238085509	0	0	0.30018791	0	0	1.060742985	3.779092227	5.585632003	0.264691101	0.208810795	0	0.027785254	0.126782131	0	0	0	0.274424096	0	0.055934	0	0	0	0	0	0	0	0	0	0	0	0	0	16.857	0	0.51	0	0	0	0	1.425360567	2.37207577	0.137386285	1.238085509	0	0	0.30018791	0	0	1.060742985	3.779092227	5.585632003	0.264691101	0.208810795	0	0.027785254	0.126782131	0	0	0	0.274424096	0	0.055934	0	0	0	0	0	0	0	0	0	0	0	0	0	16.857	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	1.425360567	2.37207577	0.137386285	1.238085509	0	0	0.30018791	0	0	1.060742985	3.779092227	5.585632003	0.264691101	0.208810795	0	0.027785254	0.126782131	0	0	0	0.274424096	0	0.055934	0	0	0	0	0	0	0	0	0	0	0	0	0	16.857
H5884_004_2	2009	6																					2500											coin	coin	coin	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	221.9736548	4.078404991	22.69874556	12.95118603	193.7640834	27.14885403	5.904958433	349.2423913	58.24940995	11.85576198	25.13699031	0	0.228537188	1339.786374	4765.389731	7077.086363	339.1784907	267.5727788	29.24861427	35.60437195	7.314987859	0	0	850.970116	346.0410416	0	70.53119401	0	0	0											1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - 0/admit for 1-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - 0/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 10.0%	11b:  Prosthetics Devices - 10.0%/11b:  Medical Supplies - 10.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 20.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 20.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $10/visit/3:  Rehab Services (CORF) - $10/day/5:  Partial Hospitalization - $10/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $10/visit/7b:  Chiropractic Services - $10/visit/7f:  Podiatry Services - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $10/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $10/visit/7h:  Psychiatric Services - Individual - $10/visit/7h:  Psychiatric Services - Group - $10/visit	7c:  Occupational Therapy Services - $10/visit/7i:  Physical/Speech Therapy - $10/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $10/visit/9c:  Outpatient Substance Abuse Svcs - Group - $10/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service/15:  Medicare Chemo - 10.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $10/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $10/visit/18a:  Fitting for Hearing Aid - $10/visit	18b:  Hearing Aids - $0/service	/14c:  Routine Exams - $0/visit	$0 											0	0	0	0	100	0.1	0.026628671	51.01313846	0	0	0.012493727	0	0	10	10	10	10	10	0	10	0.02	0	0	0	10	0	10	0	0	0											0	0	0	0	96.88516129	0.096885161	0.025799231	49.42416147	0	0	0.012104567	0	0	9.688516129	9.688516129	9.688516129	9.688516129	9.688516129	0	9.688516129	0.019377032	0	0	0	9.688516129	0	9.688516129	0	0	0											0	0	0	0	1.564405372	2.630321101	0.152343387	1.438417695	0	0	0.304272386	0	0	1.081711824	3.847462939	5.713872115	0.27384469	0.216031932	0	0.028746128	0.141742756	0	0	0	0.279385351	0	0.056945218	0	0	0	0	0	0	0	0	0	0	0	0	0	17.7295	0	0.57	0	0	0	0	1.564405372	2.630321101	0.152343387	1.438417695	0	0	0.304272386	0	0	1.081711824	3.847462939	5.713872115	0.27384469	0.216031932	0	0.028746128	0.141742756	0	0	0	0.279385351	0	0.056945218	0	0	0	0	0	0	0	0	0	0	0	0	0	17.7295	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	1.564405372	2.630321101	0.152343387	1.438417695	0	0	0.304272386	0	0	1.081711824	3.847462939	5.713872115	0.27384469	0.216031932	0	0.028746128	0.141742756	0	0	0	0.279385351	0	0.056945218	0	0	0	0	0	0	0	0	0	0	0	0	0	17.7295
H5884_006_1	2009	4																					2500											coin	coin	coin	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	262.6970503	4.826631245	26.86621205	15.56897903	210.3458508	28.87679845	6.280791615	345.6671484	65.76703325	12.29892686	28.13527187	0	0.261020606	1434.545398	5408.568967	7989.702498	378.1221134	298.2948029	35.18880379	39.69237654	7.250570376	0	0	871.5458629	392.7514154	0	80.05185222	0	0	0											1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - 0/admit for 1-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - 0/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 10.0%	11b:  Prosthetics Devices - 10.0%/11b:  Medical Supplies - 10.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 20.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 20.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $10/visit/3:  Rehab Services (CORF) - $10/day/5:  Partial Hospitalization - $10/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $10/visit/7b:  Chiropractic Services - $10/visit/7f:  Podiatry Services - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $10/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $10/visit/7h:  Psychiatric Services - Individual - $10/visit/7h:  Psychiatric Services - Group - $10/visit	7c:  Occupational Therapy Services - $10/visit/7i:  Physical/Speech Therapy - $10/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $10/visit/9c:  Outpatient Substance Abuse Svcs - Group - $10/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service/15:  Medicare Chemo - 10.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $10/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $10/visit/18a:  Fitting for Hearing Aid - $10/visit	18b:  Hearing Aids - $0/service	/14c:  Routine Exams - $0/visit	$0 											0	0	0	0	100	0.1	0.026628671	51.15959881	0	0	0.012493726	0	0	10	10	10	10	10	0	10	0.02	0	0	0	10	0	10	0	0	0											0	0	0	0	96.07540406	0.096075404	0.025583604	49.15179127	0	0	0.012003398	0	0	9.607540406	9.607540406	9.607540406	9.607540406	9.607540406	0	9.607540406	0.019215081	0	0	0	9.607540406	0	9.607540406	0	0	0											0	0	0	0	1.684088551	2.774350079	0.160685283	1.415846627	0	0	0.337718871	0	0	1.14853774	4.330253741	6.396782465	0.30273529	0.238823281	0	0.031778843	0.139320296	0	0	0	0.314447924	0	0.064091784	0	0	0	0	0	0	0	0	0	0	0	0	0	19.3395	0	0.79	0	0	0	0	1.684088551	2.774350079	0.160685283	1.415846627	0	0	0.337718871	0	0	1.14853774	4.330253741	6.396782465	0.30273529	0.238823281	0	0.031778843	0.139320296	0	0	0	0.314447924	0	0.064091784	0	0	0	0	0	0	0	0	0	0	0	0	0	19.3395	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	1.684088551	2.774350079	0.160685283	1.415846627	0	0	0.337718871	0	0	1.14853774	4.330253741	6.396782465	0.30273529	0.238823281	0	0.031778843	0.139320296	0	0	0	0.314447924	0	0.064091784	0	0	0	0	0	0	0	0	0	0	0	0	0	19.3395
H5884_006_2	2009	4																					2500											coin	coin	coin	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	245.8958218	4.517935983	24.97915901	14.20519868	214.7090255	29.42303145	6.399598956	380.5347145	64.51559312	13.17554379	27.28645503	0	0.250333658	1516.379566	5252.995108	7790.252331	372.1215151	293.5610219	32.41736136	39.06247949	8.239229019	0	0	850.970116	381.4501834	0	77.74839889	0	0	0											1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - 0/admit for 1-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - 0/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 10.0%	11b:  Prosthetics Devices - 10.0%/11b:  Medical Supplies - 10.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 20.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 20.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $10/visit/3:  Rehab Services (CORF) - $10/day/5:  Partial Hospitalization - $10/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $10/visit/7b:  Chiropractic Services - $10/visit/7f:  Podiatry Services - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $10/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $10/visit/7h:  Psychiatric Services - Individual - $10/visit/7h:  Psychiatric Services - Group - $10/visit	7c:  Occupational Therapy Services - $10/visit/7i:  Physical/Speech Therapy - $10/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $10/visit/9c:  Outpatient Substance Abuse Svcs - Group - $10/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service/15:  Medicare Chemo - 10.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $10/visit	17b:  Wear - $0/service	18a:  Routine Hearing Test - $10/visit/18a:  Fitting for Hearing Aid - $10/visit	18b:  Hearing Aids - $0/service	/14c:  Routine Exams - $0/visit	$0 											0	0	0	0	100	0.1	0.026628671	51.01959277	0	0	0.012493726	0	0	10	10	10	10	10	0	10	0.02	0	0	0	10	0	10	0	0	0											0	0	0	0	96.07522088	0.096075221	0.025583555	49.01718645	0	0	0.012003375	0	0	9.607522088	9.607522088	9.607522088	9.607522088	9.607522088	0	9.607522088	0.019215044	0	0	0	9.607522088	0	9.607522088	0	0	0											0	0	0	0	1.719018088	2.826824246	0.163724491	1.554395087	0	0	0.32752956	0	0	1.214054181	4.205688877	6.237085112	0.297930473	0.235032834	0	0.03127447	0.15831715	0	0	0	0.305399255	0	0.062247455	0	0	0	0	0	0	0	0	0	0	0	0	0	19.3385	0	0.79	0	0	0	0	1.719018088	2.826824246	0.163724491	1.554395087	0	0	0.32752956	0	0	1.214054181	4.205688877	6.237085112	0.297930473	0.235032834	0	0.03127447	0.15831715	0	0	0	0.305399255	0	0.062247455	0	0	0	0	0	0	0	0	0	0	0	0	0	19.3385	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	1.719018088	2.826824246	0.163724491	1.554395087	0	0	0.32752956	0	0	1.214054181	4.205688877	6.237085112	0.297930473	0.235032834	0	0.03127447	0.15831715	0	0	0	0.305399255	0	0.062247455	0	0	0	0	0	0	0	0	0	0	0	0	0	19.3385
H5884_802_0	2009	5																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	268.4821685	2.920412281	51.83004888	46.54188384	7.693851966	15.49210681	4.39246518	10.00519717	38.55361708	5.403457027	22.02729612	0	0.215469676	25.88897442	36.49128127	107.2699367	1.106010541	5.243797424	25.00979953	16600.71061	6.497438759	0.696814875	0.000001	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0.075995413	0.075995413	0.202607601	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.607181677	0.231	0.231	0	0	0	0	0	0	0	0											0.075995413	0.075995413	0.202607601	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.607181677	0.231	0.231	0	0	0	0	0	0	0	0											20.4034	0.221937937	10.50116188	0	1.777279804	3.578676673	1.014659457	2.311200545	8.905885544	1.248198573	5.088305403	0	0.049773495	5.98035309	8.429485973	24.77935537	0.255488435	1.211317205	5.777263692	7.756933362	1.500908353	0.160964236	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.9526	0	0	20.4034	0.221937937	10.50116188	0	1.777279804	3.578676673	1.014659457	2.311200545	8.905885544	1.248198573	5.088305403	0	0.049773495	5.98035309	8.429485973	24.77935537	0.255488435	1.211317205	5.777263692	7.756933362	1.500908353	0.160964236	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.9526	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	20.4034	0.221937937	10.50116188	0	1.777279804	3.578676673	1.014659457	2.311200545	8.905885544	1.248198573	5.088305403	0	0.049773495	5.98035309	8.429485973	24.77935537	0.255488435	1.211317205	5.777263692	7.756933362	1.500908353	0.160964236	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.9526
H5884_803_0	2009	4																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	279.1542084	3.036497296	53.58401186	48.13099549	7.076826304	14.23346221	4.035602642	9.140058633	38.50140941	5.718825544	21.31209021	0	0.213436983	28.48161919	36.82709748	109.0509048	1.095238378	5.193713728	26.13251612	16587.09682	7.273728026	0.780380527	0.000001	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0.074488134	0.074488134	0.197296741	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.627397315	0.231	0.231	0	0	0	0	0	0	0	0											0.074488134	0.074488134	0.197296741	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.627397315	0.231	0.231	0	0	0	0	0	0	0	0											20.7937	0.226183019	10.57195088	0	1.634746876	3.28792977	0.93222421	2.111353544	8.893825574	1.321048701	4.923092838	0	0.049303943	6.579254033	8.507059517	25.19075901	0.253000065	1.199747871	6.036611223	7.77851534	1.680231174	0.180267902	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1508	0	0	20.7937	0.226183019	10.57195088	0	1.634746876	3.28792977	0.93222421	2.111353544	8.893825574	1.321048701	4.923092838	0	0.049303943	6.579254033	8.507059517	25.19075901	0.253000065	1.199747871	6.036611223	7.77851534	1.680231174	0.180267902	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1508	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	20.7937	0.226183019	10.57195088	0	1.634746876	3.28792977	0.93222421	2.111353544	8.893825574	1.321048701	4.923092838	0	0.049303943	6.579254033	8.507059517	25.19075901	0.253000065	1.199747871	6.036611223	7.77851534	1.680231174	0.180267902	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.1508
H5884_804_0	2009	4																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	348.4138293	3.789868176	55.74537074	49.64312839	9.025919239	18.13390991	5.141493598	12.40154177	49.24261851	6.923763084	24.15122145	0	0.255026195	34.61417693	44.74055133	132.2555774	1.319332504	6.225147994	30.98550144	21130.96703	9.413251746	1.011031072	0.000001	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0.075104749	0.075104749	0.196149359	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.167282106	0.231	0.231	0	0	0	0	0	0	0	0											0.075104749	0.075104749	0.196149359	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.167282106	0.231	0.231	0	0	0	0	0	0	0	0											26.1675	0.2846371	10.93441876	0	2.084987344	4.188933189	1.187685021	2.86475615	11.37504488	1.599389273	5.578932155	0	0.058911051	7.99587487	10.33506736	30.55103838	0.304765808	1.438009187	7.157650832	9.099138987	2.174461153	0.233548178	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.6148	0	0	26.1675	0.2846371	10.93441876	0	2.084987344	4.188933189	1.187685021	2.86475615	11.37504488	1.599389273	5.578932155	0	0.058911051	7.99587487	10.33506736	30.55103838	0.304765808	1.438009187	7.157650832	9.099138987	2.174461153	0.233548178	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.6148	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	26.1675	0.2846371	10.93441876	0	2.084987344	4.188933189	1.187685021	2.86475615	11.37504488	1.599389273	5.578932155	0	0.058911051	7.99587487	10.33506736	30.55103838	0.304765808	1.438009187	7.157650832	9.099138987	2.174461153	0.233548178	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.6148
H5887_001_0	2009	10																																A							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		137.5	0	0	0	0	0	0	388.8472718	0	0	0	0	0	0	0	0	143.9792857	0	0	0	0	0	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											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											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											1.1458	0	0	0	0	0	0	0.810098483	0	0	0	0	0	0	0	0	0.059991369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.0159	0	0	1.1458	0	0	0	0	0	0	0.810098483	0	0	0	0	0	0	0	0	0.059991369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.0159																																																																																		0	0	0	1.1458	0	0	0	0	0	0	0.810098483	0	0	0	0	0	0	0	0	0.059991369	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.0159
H5887_006_0	2009	10																																							V																																	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	483.7190203	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											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	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	1.007747959	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.0077	0	0	0	0	0	0	0	0	0	1.007747959	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.0077																																																																																		0	0	0	0	0	0	0	0	0	0	1.007747959	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.0077
H5887_007_0	2009	10																																							V																																	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		0	0	0	0	0	0	0	560.7018719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 10a	PBP 11a	"PBP 11b, 11c"	"PBP 4a, 4b"	"PBP 9a, 9b"	PBP 8a	"PBP 7d, 8b"		0	0	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	0	"PBP 3, 5, 7d, 7g, 9a, 9c, 9d, 12, 13a, 13b"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											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	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	1.1681289	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.1681	0	0	0	0	0	0	0	0	0	1.1681289	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.1681																																																																																		0	0	0	0	0	0	0	0	0	0	1.1681289	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.1681
H5895_001_0	2009	6																																																																																																																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
H5896_007_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	524.0452423	33.29609918	127.8926455	61.8	16.76864613	24.30150384	19.09403873	33.78648283	57.5997842	47.16908438	15.13507412	0	0	37.95148285	115.0165168	124.4759025	5.31145884	1.093535644	57.05912769	7.576639817	7.3875109	5.62	9.55	20.84	5.077656533	0	2.029143005	0	3.03	14.39											PBP: 1A IP Acute: Standard Medicare	1B IP Psych: Standard Medicare	2 SNF: Standard Medicare	6 Home Health: Standard Medicare	10A Ambulance: Standard Medicare	11A DME: Standard Medicare	"11B Prosthetic Medical Supplies: Standard Medicare, 11C Diabetes Monitoring Supplies: $0"	"4A ER, 4B Urgent Care: Standard Medicare, 4A Worldwide Coverage: $0"	9B ASC Services: Standard Medicare	8A OP C/D/T: Standard Medicare	8B OP X-Ray: Standard Medicare	"9A OP Hospital, 5 Partial Hosp: Standard Medicare"	12 Renal Dialysis: Standard Medicare	"3 CORF, 9A OP Hospital, 9D Cardiac Rehab: Standard Medicare"	"7A PCP, 14B Immunizations, 14C Routine Physical Exams: Standard Medicare"	7D Physician Specialist (excl. Radiology): Standard Medicare	"7E Mental Health, 7H Psychiatric, 9C OP Substance Abuse,: Standard Medicare"	"7C Occupational Therapy, 7I Physical and Speech Therapy: Standard Medicare"	"8B Physician Specialist (Radiology), 14G Bone Mass Measurement, 14H Mammography: Standard Medicare"	"7B Chiropractic, 7F Podiatry - Medicare Covered, 7G Other Health Care, 14D Pap Smears/Pelvic Exams, 14E Prostate Screening, 14F Colorectal Screening, 14I Diabetes Monitoring, 14J Nutrition Therapy, 18A Medicare Covered Hearing Exams: Standard Medicare, 7F Podiatry - Routine: $0"	15 Part B Drugs: Standard Medicare	"13A Blood, 16B Medicare Covered Comprehensive Dental Services, 17A Medicare Covered Eye Exams, 17B Medicare Covered Eyewear: Standard Medicare"	10B Transportation: $0 for 30 one-way trips	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental: $0"	17A Routine Eye Exams: $0	17B Eye Wear - Non-Covered: $0	18A Hearing - Routine: $0	18B Hearing Aids: $0	"14A Medical Nutrition: $0, 14A Health Education/Wellness Programs: $0"	"6 Respite Care: Not Covered, 13B Acupuncture: Not Covered, 13C Other: OTC Drugs: $0, 13D Other: Assistive Devices: $0 13E Other: PERS: $0"											0.058377814	0.058382456	0.161279545	0	0.23098449	0.231000203	0.182405643	0.230218285	0.230999979	0.231071584	0.230994971	0.23100007	0.230999992	0.231010494	0.22869965	0.230995573	0.231005205	0.230994287	0.231008304	0.222741999	0.231001496	0.230995158	0	0	0	0	0	0	0	0											0.058377814	0.058382456	0.161279545	0	0.23098449	0.231000203	0.182405643	0.230218285	0.230999979	0.231071584	0.230994971	0.23100007	0.230999992	0.231010494	0.22869965	0.230995573	0.231005205	0.230994287	0.231008304	0.222741999	0.231001496	0.230995158	0	0	0	0	0	0	0	0											30.5926	1.943908045	20.62646772	0	3.873297171	5.61365233	3.482860413	7.778266123	13.30554893	10.89943503	3.496126013	0	0	8.767190818	26.30423716	28.75338248	1.226974638	0.252600487	13.18113231	1.687635899	1.706526069	1.29819279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	184.7901	0	0	30.5926	1.943908045	20.62646772	0	3.873297171	5.61365233	3.482860413	7.778266123	13.30554893	10.89943503	3.496126013	0	0	8.767190818	26.30423716	28.75338248	1.226974638	0.252600487	13.18113231	1.687635899	1.706526069	1.29819279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	184.7901	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	30.5926	1.943908045	20.62646772	0	3.873297171	5.61365233	3.482860413	7.778266123	13.30554893	10.89943503	3.496126013	0	0	8.767190818	26.30423716	28.75338248	1.226974638	0.252600487	13.18113231	1.687635899	1.706526069	1.29819279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	184.7901
H5896_008_0	2009	4																					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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	711.94	13.43	552.48	0	200.8	9.94	7.09	229.21	322.15	0	409.17	31.51	0.2	1045.03	5806.35	7290.83	172.63	778.14	1872.99	1676.12	8.89	706.57	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $100 per day for the first 5 days	1B IP Psych: $100 per day for the first 5 days	2 SNF: $125 per day for 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: $50,4A Non Covered Foreign Travel: $50,  4B Urgent Care: $30"	9B ASC Services: $50	8A OP Lab Services: $0	8B OP X-Ray: $50	"9A OP Hospital: $200, 5 Partial Hosp: $200"	12 Renal Dialysis: 20%	"3 CORF: $200, 8A OP Diagnostic Procedures/Tests: $200, 9A OP Hospital: $200, 9D Cardiac Rehab: $200"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $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"	"8B Physician Specialist Services - Radiology: $50, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7B Chiropractic: $30, 7F Podiatry: $30, 7F Non Medicare Covered Podiatry: $0,  7G Other Health Care: $30, 14D Pap Smears & Pelvic Exams: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $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, 17B Medicare Covered Eyewear: $30"	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: $0	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: Over-the-Counter Drugs: $0, 13D Other: PERS: $0, 13E Other: Assistive Devices: Not Covered"											100	100	125	0	100	0.200000181	0.200086776	48.62309672	50	0	50	200	0.200000003	116.8764533	10	30	30	30	50	30	0.200000078	30	0	0	0	0	0	0	0	0											100	100	125	0	100	0.200000181	0.200086776	48.62309672	50	0	50	200	0.200000003	116.8764533	10	30	30	30	50	30	0.200000078	30	0	0	0	0	0	0	0	0											5.9328	0.111916667	5.755	0	1.673333333	1.988001795	1.418615242	0.928741667	1.342291667	0	1.704875	0.525166667	0.040000001	10.17828333	4.838625	18.227075	0.431575	1.94535	7.804125	4.1903	1.778000695	1.766425	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.5805	0	0	5.9328	0.111916667	5.755	0	1.673333333	1.988001795	1.418615242	0.928741667	1.342291667	0	1.704875	0.525166667	0.040000001	10.17828333	4.838625	18.227075	0.431575	1.94535	7.804125	4.1903	1.778000695	1.766425	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.5805	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	5.9328	0.111916667	5.755	0	1.673333333	1.988001795	1.418615242	0.928741667	1.342291667	0	1.704875	0.525166667	0.040000001	10.17828333	4.838625	18.227075	0.431575	1.94535	7.804125	4.1903	1.778000695	1.766425	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.5805
H5896_009_0	2009	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	O	V											47.7343	0.4776	8.0509	5.9801	0	1.7355	1.2317	0	9.9401	1.2448	3.0244	0.1914	0.0327	3.0522	0	0	0	0	0	0	1.4132	0.1112	0	0	0	0	0	0	0	0											84.22	0	0	0	0	0	204.54	0	0	247.91	0	0	0	0	0	518.27	0	7836.56	199.65	886.83	0	1946.51	0	801.52	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, 4A Non Medicare Covered Foreign Travel: $50,  4B Urgent Care: $20"	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, 9A Outpatient Hospital Services $0,  9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $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"	"8B Physician Specialist Services - Radiology: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7G Other Health Care: $20, 18A Medicare Covered Hearing Exams: $20, 7B Chiropractic: $20, 7F Medicare Covered Podiatry: $20, 7F Non Medicare Covered Podiatry (Routine): $0, 14D Pap Smears & Pelvic Exams: $0, , 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $20"	15 Part B Drugs: 0%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $20, 17A Medicare Covered Eye Exams: $20, 17B Medicare Covered Eyewear: $20"	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: $0	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: Over-the-Counter Drugs: $0, 13D Other: PERS: $0, 13E Other: Assistive Devices: Not Covered"											0	0	0	0	100	0	0	47.92101972	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	0	100	0	0	47.92101972	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	0	1.7045	0	0	0.990008333	0	0	0	0	0	0.863783333	0	13.06093333	0.33275	1.47805	0	3.244183333	0	1.335866667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.0101	1500	0	47.7343	0.477621239	8.050862126	5.980079629	1.7045	1.735466216	1.23167395	0.990008333	9.940083125	1.244759463	3.024389287	0.191375634	0.032713784	3.915979336	0	13.06093333	0.33275	1.47805	0	3.244183333	1.413235448	1.447093531	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.2301	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	47.7343	0.477621239	8.050862126	5.980079629	1.7045	1.735466216	1.23167395	0.990008333	9.940083125	1.244759463	3.024389287	0.191375634	0.032713784	3.915979336	0	13.06093333	0.33275	1.47805	0	3.244183333	1.413235448	1.447093531	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.2301
H5896_012_0	2009	3																					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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	495.229	9.317	550.87	0	200.8	9.94	7.09	159.852	222.551	0	286.419	31.51	0.2	1044.06	5705.4	5030.025	119.847	538.839	1309.322	1160.194	8.89	489.565	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $150 per day for the first 5 days	1B IP Psych: $150 per day for the first 5 days	2 SNF: $125 per day for 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/Worldwide Coverage: $50, 4B Urgent Care: $35"	9B ASC Services: $125	8A OP Lab Services: $0	8B OP X-Ray: $100	"9A OP Hospital: $200,  5 Partial Hosp: $200"	12 Renal Dialysis: 20%	"3 CORF: $200, 8A OP Diagnostic Procedures/Tests: $200, 9A OP Hospital: $200, 9D Cardiac Rehab: $200"	"7A PCP: $15, 14B Immunizations: $0, 14C Routine Physical Exams: $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"	"8B Physician Specialist Services - Radiology: $100, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7B Chiropractic: $35, 7F Podiatry - Medicare Covered: $35, 7F Podiatry - Routine: $0, 7G Other Health Care: $35, 14D Pap Smears/Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutritional Therapy: $35, 18A Medicare Covered Hearing Exams: $35"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $35, 17A Medicare Covered Eye Exams: $35, 17B Medicare Covered Eyewear: $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	14A Health Education/Wellness Programs: $0	"13B Acupuncture: Not Covered, 13C Other: OTC drugs: $0, 13D Other: PERS: $0"											150	150	125	0	100	0.200000181	0.200086776	48.9838413	125	0	100	200	0.200000003	119.3996035	15	35	35	35	100	35	0.200000078	35	0	0	0	0	0	0	0	0											150	150	125	0	100	0.200000181	0.200086776	48.9838413	125	0	100	200	0.200000003	119.3996035	15	35	35	35	100	35	0.200000078	35	0	0	0	0	0	0	0	0											6.1904	0.1164625	5.738229167	0	1.673333333	1.988001795	1.418615242	0.65251375	2.318239583	0	2.386825	0.525166667	0.040000001	10.3883625	7.13175	14.67090625	0.34955375	1.57161375	10.91101667	3.383899167	1.778000695	1.427897917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6608	0	0	6.1904	0.1164625	5.738229167	0	1.673333333	1.988001795	1.418615242	0.65251375	2.318239583	0	2.386825	0.525166667	0.040000001	10.3883625	7.13175	14.67090625	0.34955375	1.57161375	10.91101667	3.383899167	1.778000695	1.427897917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.6608	0	PBP: 1A IP Acute: $200 per day for the first 5 days	1B IP Psych: $200 per day for the first 5 days	2 SNF: Not Covered	6 Home Health: Not Covered	10A Ambulance: Not Covered	11A DME: Not Covered	"11B Prosthetic Medical Supplies, 11C Diabetes Monitoring Supplies: Not Covered"	"4A ER/Worldwide Coverage: $50, 4B Urgent Care: $45"	9B ASC Services: $150	8A OP Lab Services: Not Covered	8B OP X-Ray: $150	"9A OP Hospital, 5 Partial Hosp: Not Covered"	12 Renal Dialysis: Not Covered	"3 CORF, 8A OP Diagnostic Procedures/Tests, 9A OP Hospital, 9D Cardiac Rehab: Not Covered"	"7A PCP, 14B Immunizations, 14C Routine Physical Exams, 14I Diabetes Monitoring: Not Covered"	7D Physician Specialist: $45	"7E Mental Health: $45,  7H Psychiatric: $45, 9C OP Substance Abuse: $45"	"7C Occupational Therapy: $45,  7I Physical and Speech Therapy: $45"	"7D Physician Specialist Services - Radiology: $150, 14H Mammography: $0, 14G Bone Mass Measurement:$0"	"7B Chiropractic: $45, 7F Podiatry: $45, 7G Other Health Care: $45, 14D Pap Smears:$0, 14D Pelvic Exams:$0, 14E Prostate Screening:$0, 14F Colorectal Screening:$0, 14I Diabetes Monitoring:$0, 14J Nutrition Therapy:$0, 18A Medicare Covered Hearing Exams: $45"	15 Part B Drugs: Not Covered	"13A Blood: Not Covered, 16B Medicare Covered Comprehensive Dental Services: $45, 17A Medicare Covered Eye Exams: $45"	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: Not Covered	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: OTC drugs: Not Covered, 13D Other: PERS: Not Covered"											4.8489	0.1111	0	0	0	0	0	0.3543	1.6785	0	1.5547	0	0	0	0	9.254	0.2615	1.104	8.644	2.4874	0	0.9516	0	0	0	0	0	0	0	0											31.2498	0	0	11.0392	0.2275625	5.738229167	0	1.673333333	1.988001795	1.418615242	1.00676375	3.996739583	0	3.9415	0.525166667	0.040000001	10.3883625	7.13175	23.92486375	0.61106	2.6755875	19.55499167	5.871251667	1.778000695	2.379512917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.9105
H5908_003_0	2009	6																																D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	V	V	Coin	Coin	T	Coin	V	Coin	V	V	V	V																																																			0		1368.217172	43.1843657	528.8563561	1604.286694	155.3688195	8.709483494	16.3849811	304.1008478	509.9226405	3.905392082	11.02763243	82.67548241	0.166851659	1838.004237	4632.863043	8451.372015	222.172337	1163.622018			29.26909047																				1a: $150 days 1-4/$750 per admit	"1b: $175/$250 days 1-8, $250/$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: $0/20%	"4a: $50, 4b: $25/$40; 7a: $10/$25"	"9b: $25-$150,20%/$30-$250, 20%"	8a: $0-$125/20%	8b: $0-$350; 20%	4a: $150/$175	12: 20%	"3: $10/$20, 9d: $10/$30;  5: $20; 7g:  $10-$75; 9a: $150/$250, $25/$35, 20%; 9c:$20/$40;"	"7a: $10/$20; 14b: $0/$25; 14c: $20/$30; 14g: $10/$20; 14i,14h:  $0/$20"	7b: $30/$40; 7d:$20-$30/$40; 7f: $30/$40; 14b:$0/$25 16b: 20%; 17a: $20/$40; 17b: $20/$30; 18a: $0/$20	"7e, 7h: $20/$40"	"7c, 7i: $10/$30"			15: 20%																				135.0087697	152.9999418	38.24537711	11	150	0.00255	0.065968325	46.65	205	0.11	0.239873964	163.75	0.2	22.24703082	15.72452106	30.95246739	31	21			0.2																				135.0087697	152.9999418	38.24537711	11	150	0.00255	0.065968325	46.65	205	0.11	0.239873964	163.75	0.2	22.24703082	15.72452106	30.95246739	31	21			0.2																				15.3934	0.550600453	1.685525898	1.470596136	1.942110244	0.022209183	1.080889755	1.182192046	8.711178442	0.429593129	2.645241904	1.128175854	0.033370332	3.407511409	6.07079604	21.79923472	0.573945204	2.036338532	0	0	5.853818095	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.0168	0	0	15.3934	0.550600453	1.685525898	1.470596136	1.942110244	0.022209183	1.080889755	1.182192046	8.711178442	0.429593129	2.645241904	1.128175854	0.033370332	3.407511409	6.07079604	21.79923472	0.573945204	2.036338532	0	0	5.853818095	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.0168																																																																																		0	0	0	15.3934	0.550600453	1.685525898	1.470596136	1.942110244	0.022209183	1.080889755	1.182192046	8.711178442	0.429593129	2.645241904	1.128175854	0.033370332	3.407511409	6.07079604	21.79923472	0.573945204	2.036338532	0	0	5.853818095	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.0168
H5908_004_0	2009	2																																D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	V	V	Coin	Coin	T	Coin	V	Coin	V	V	V	V																																																			0		1368.217172	43.1843657	528.8563561	1604.286694	155.3688195	8.709483494	16.3849811	304.1008478	509.9226405	3.905392082	11.02763243	82.67548241	0.166851659	1838.004237	4632.863043	8451.372015	222.172337	1163.622018			29.26909047																				1a: $150 days 1-4/$750 per admit	"1b: $175/$250 days 1-8, $250/$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: $0/20%	"4a: $50, 4b: $25/$40; 7a: $10/$25"	"9b: $25-$150,20%/$30-$250, 20%"	8a: $0-$125/20%	8b: $0-$350; 20%	4a: $150/$175	12: 20%	"3: $10/$20, 9d: $10/$30;  5: $20; 7g:  $10-$75; 9a: $150/$250, $25/$35, 20%; 9c:$20/$40;"	"7a: $10/$20; 14b: $0/$25; 14c: $20/$30; 14g: $10/$20; 14i,14h:  $0/$20"	7b: $30/$40; 7d:$20-$30/$40; 7f: $30/$40; 14b:$0/$25 16b: 20%; 17a: $20/$40; 17b: $20/$30; 18a: $0/$20	"7e, 7h: $20/$40"	"7c, 7i: $10/$30"			15: 20%																				135.0087697	152.9999418	38.24537711	11	150	0.00255	0.065968325	46.65	205	0.11	0.239873964	163.75	0.2	22.24703082	15.72452106	30.95246739	31	21			0.2																				135.0087697	152.9999418	38.24537711	11	150	0.00255	0.065968325	46.65	205	0.11	0.239873964	163.75	0.2	22.24703082	15.72452106	30.95246739	31	21			0.2																				15.3934	0.550600453	1.685525898	1.470596136	1.942110244	0.022209183	1.080889755	1.182192046	8.711178442	0.429593129	2.645241904	1.128175854	0.033370332	3.407511409	6.07079604	21.79923472	0.573945204	2.036338532	0	0	5.853818095	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.0168	0	0	15.3934	0.550600453	1.685525898	1.470596136	1.942110244	0.022209183	1.080889755	1.182192046	8.711178442	0.429593129	2.645241904	1.128175854	0.033370332	3.407511409	6.07079604	21.79923472	0.573945204	2.036338532	0	0	5.853818095	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.0168																																																																																		0	0	0	15.3934	0.550600453	1.685525898	1.470596136	1.942110244	0.022209183	1.080889755	1.182192046	8.711178442	0.429593129	2.645241904	1.128175854	0.033370332	3.407511409	6.07079604	21.79923472	0.573945204	2.036338532	0	0	5.853818095	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.0168
H5918_001_0	2009	5																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2191.704351	34.12069392	3593.976914	4409.723687	376.3811813	19.82451206	7.866559865	379.9171373	335.4268849	6556.358805	894.5321627	0	6.914133041	1211.648467	8013.001143	7061.047322	309.8279887	1404.759736	0	0	1320.030965	2036.190608	1935.406138	587.1025354	207.3709072	168.733727	39.27796716	17.09670221	636.0416563	115.5175384											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b, 7d); $0 n/c (7b1); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0.2	0.2	49.97367847	50	8	10.00812735	0	0	47.61053649	1.432003159	18.38087945	20	0	0	0	0	0.057052518	0	20	20	0	20	0	0	20											0	0	0	0	0	0.161615042	0.161615042	40.38249082	40.40376059	6.464601695	8.087319628	0	0	38.47289437	1.157166256	14.85313305	16.16150424	0	0	0	0	0.046102725	0	20	20	0	20	0	0	20											0	0	0	0	0	3.203939356	1.271354406	1.278500026	1.12937563	3.532020687	0.60286396	0	0	3.884635289	0.772697878	8.739889614	0.417273863	0	0	0	0	0.007822828	0	0.978504226	0.345618179	0	0.065463279	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	26.4225	0	5.8998	0	0	0	0	0	3.203939356	1.271354406	1.278500026	1.12937563	3.532020687	0.60286396	0	0	3.884635289	0.772697878	8.739889614	0.417273863	0	0	0	0	0.007822828	0	0.978504226	0.345618179	0	0.065463279	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	26.4225		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.0029	0.0156	0.7691	0.3301	0.1101	0.1214	0.0482	0.0323	0.2167	0.0812	0.181	0	0	0.1696	0.3291	1.1342	0.0152	0.0909	0	0	0.1779	0.0878	0	0	0.0049	0.0061	0.0013	0.0011	0	0											5.9267	0	0	2.0029	0.015597649	0.769115192	0.330053435	0.110139355	3.32531392	1.319517017	1.310788898	1.346056819	3.61324719	0.78387612	0	0	4.054282462	1.10177705	9.874102357	0.432475958	0.090896552	0	0	0.177931936	0.095672651	0	0.978504226	0.350491809	0.006144745	0.066714774	0.001054356	0	0.192529231	0	0	0	0	0	0	0	0	0	0	32.3492
H5918_002_0	2009	3																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2181.820106	33.96681491	3577.768638	4389.83652	374.6837608	19.64610434	7.795765942	378.2037702	333.9141619	6526.790649	890.497962	0	6.882951378	1206.184121	7976.863756	7029.203099	308.4307127	1398.424488	0	0	1314.077831	2027.007705	1926.677758	587.1025354	206.4356967	167.9727641	39.10082965	17.01959874	633.1732075	114.9965723											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b, 7d); $0 n/c (7b1); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0.2	0.2	49.97367847	50	8	10.00812735	0	0	47.6105225	1.432003159	18.38087945	20	0	0	0	0	0.057052518	0	20	20	0	20	0	0	20											0	0	0	0	0	0.161770364	0.161770364	40.42130087	40.44259109	6.470814574	8.095092038	0	0	38.50985786	1.158278364	14.86740782	16.17703643	0	0	0	0	0.046147033	0	20	20	0	20	0	0	20											0	0	0	0	0	3.178157457	1.261123897	1.273957365	1.125362826	3.519471004	0.600721914	0	0	3.870831587	0.769952392	8.708835763	0.41579124	0	0	0	0	0.007795033	0	0.978504226	0.344059495	0	0.065168049	0	0	0.191660954	0	0	0	0	0	0	0	0	0	0	26.3114	0	5.8447	0	0	0	0	0	3.178157457	1.261123897	1.273957365	1.125362826	3.519471004	0.600721914	0	0	3.870831587	0.769952392	8.708835763	0.41579124	0	0	0	0	0.007795033	0	0.978504226	0.344059495	0	0.065168049	0	0	0.191660954	0	0	0	0	0	0	0	0	0	0	26.3114		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.9849	0.0155	0.7622	0.3271	0.1091	0.1203	0.0477	0.0321	0.2147	0.0805	0.1794	0	0	0.1681	0.3261	1.124	0.0151	0.0901	0	0	0.1763	0.0871	0	0	0.0048	0.0061	0.0012	0.001	0	0											5.8735	0	0	1.9849	0.01545728	0.762193655	0.327083169	0.109148172	3.298439728	1.308853076	1.30610062	1.340094025	3.599966521	0.780105082	0	0	4.038952045	1.096070066	9.832841328	0.430856526	0.090078543	0	0	0.176330664	0.094854265	0	0.978504226	0.348889265	0.006089447	0.066408282	0.001044868	0	0.191660954	0	0	0	0	0	0	0	0	0	0	32.1849
H5918_003_0	2009	4																					500											D	D	D	V	T	P	P	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1183.511359	42.6024999	5806.709679	77.40419643	447.7944823	356.1820203	995.7883755	126.6731528	82.91390997	9352.872083	1229.547868	0	4.607079079	201.8320432	135.6649687	6032.51056	1815.460541	30.74213997	0	0	1100.931386	704.2565672	1576.881712	0	182.0000636	141.3063859	46.85749586	13.66333203	0	0											"$25 Days 1-20 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$25 Days 1-20 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$50 (10a)	$0 (11a)	"$0 (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	$0 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$0 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a9, 14a10); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											24.6793694	25	0	0	50	0	0	49.6332695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											22.18314765	22.47134772	0	0	44.94269543	0	0	44.61305829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											2.1878	0.079777966	0	0	1.67709092	0	0	0.470939729	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.4156	0	0.4969	2.1878	0.079777966	0	0	1.67709092	0	0	0.470939729	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.4156		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.9946	0.2258	0.6069	0.0384	0.2927	0.161	0.184	0.0276	0.0894	0.3675	0.304	0	0	0.0595	0.0101	1.5514	0.3707	0.0033	0	0	0.103	0.0772	0	0	0.0089	0.0093	0.004	0.0054	0	0											6.4946	0	0	4.1824	0.305586579	0.606894491	0.038357923	1.969788606	0.161034047	0.183975729	0.49851518	0.089421046	0.367497464	0.304035974	0	0	0.059477698	0.010148602	1.551440173	0.370683318	0.003326294	0	0	0.102968522	0.077157836	0	0	0.008933819	0.009296473	0.003969466	0.005393421	0	0	0	0	0	0	0	0	0	0	0	0	10.9103
H5918_004_0	2009	3																					1500											D	D	D	V	T	P	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2850.447905	61.65585694	2618.123718	87335.5074	158.0602392	3202.90759	17.07276088	451.5794182	434.0178371	8387.356305	546.4436396	0	12.25840375	1671.905418	7653.057822	6239.096502	248.8724483	285.8490482	0	0	1866.387023	1672.185865	1418.390092	587.1025354	205.2567597	154.1150788	37.56409609	10.74492219	932.1	115.5175384											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	$0 (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b, 7d); $0 n/c (7b1); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0	0.2	49.9778555	50	3.2	16.87836848	0	0	45.70445279	1.385823106	17.94888873	20	0	0	0	0	0.001602202	0	20	0	0	20	0	0	20											0	0	0	0	0	0	0.158670999	39.65018123	39.66774967	2.538735979	13.39053792	0	0	36.25985584	1.099449681	14.2398405	15.86709987	0	0	0	0	0.001271115	0	20	0	0	20	0	0	20											0	0	0	0	0	0	2.708952019	1.492100481	1.434709243	1.774440268	0.609764523	0	0	5.051920788	0.701179332	7.403644922	0.329073666	0	0	0	0	0.000177128	0	0.978504226	0	0	0.062606827	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	22.7396	0	5.6017	0	0	0	0	0	0	2.708952019	1.492100481	1.434709243	1.774440268	0.609764523	0	0	5.051920788	0.701179332	7.403644922	0.329073666	0	0	0	0	0.000177128	0	0.978504226	0	0	0.062606827	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	22.7396		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a3); $0 (6a2)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.543	0.028	0.5849	0.394	0.0983	0.162	0.1045	0.0384	0.3019	0.0556	0.1254	0	0	0.2435	0.3271	0.9764	0.0117	0.0287	0	0	0.1786	0.0649	0	0	0.0039	0.0039	0.0009	0.0004	0	0											6.2763	0	0	2.543	0.028045519	0.584938486	0.394000743	0.098337854	0.1620266	2.813479127	1.530483084	1.736564622	1.83001216	0.735163519	0	0	5.295452469	1.028315622	8.379999043	0.340769291	0.028688483	0	0	0.178592461	0.065125383	0	0.978504226	0.003911416	0.003931507	0.063548589	0.000438568	0	0.192529231	0	0	0	0	0	0	0	0	0	0	29.0159
H5926_001_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		270.4807764	17.80409278	52.7866632	61.84167722	13.7688529	25.81064626	20.00312279	15.13104576	23.03035642	9.750397373	18.03736594	0	6.389052934	53.00064025	51.37104856	98.62266431	8.246551067	5.155095142	19.68192708	33.44300107	8.490402055	2.119553376	0	0	0	0	0	0	0	0											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	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing											0.068379376	0.068379376	0.179363067	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.068379376	0.068379376	0.179363067	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											18.4953	1.217432754	9.467977803	0	3.18060502	5.962259286	4.620721363	3.49527157	5.320012334	2.252341793	4.166631532	0	1.475871228	12.2431479	11.86671222	22.78183546	1.904953296	1.190826978	4.546525156	7.725333248	1.961282875	0.48961683	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.3647	0	0	18.4953	1.217432754	9.467977803	0	3.18060502	5.962259286	4.620721363	3.49527157	5.320012334	2.252341793	4.166631532	0	1.475871228	12.2431479	11.86671222	22.78183546	1.904953296	1.190826978	4.546525156	7.725333248	1.961282875	0.48961683	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.3647																																																																																		0	0	0	18.4953	1.217432754	9.467977803	0	3.18060502	5.962259286	4.620721363	3.49527157	5.320012334	2.252341793	4.166631532	0	1.475871228	12.2431479	11.86671222	22.78183546	1.904953296	1.190826978	4.546525156	7.725333248	1.961282875	0.48961683	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.3647
H5926_002_0	2009	6																					3000											A	A	D	Coin	T	Coin	Coin	V	V	Coin	V	Coin	Coin	Coin	V	V	V	V	V	P	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	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	283.1906576	4.259685138	674.3037996	0	197.6252468	10.72109115	7.143984197	349.3683575	298.1041268	0	177.8982445	0	0.677569827	17.86972304	6001.534663	8051.166993	192.9745282	658.0140369	126.1133536	2176.583845	9.600665885	0	0	0	460.425859	0	0	0	0	857.6953523											$500/Admit for IP Medical; $500/Admit for IP Surgical;	$500/Admit for IP Psych; $500/Admit for IP Substance Abuse;	$75/Days Custom for SNF	No Cost-Sharing	$125/Run 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;	$300/Case for OP Fac - Surgery; $300/Case for OP Fac - ASC	No Cost-Sharing	$100/Case for OP Fac - CT/MRI/PET	No Cost-Sharing	20% Coinsurance for Renal Dialysis - Fac; 20% Coinsurance for Renal Dialysis - Prof	20% Coinsurance for OP Fac - Cardiovascular; $20/Case for OP Fac - Occ Therapy; $30/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $20/Visit for Prof - CORF; $20/Visit for Prof - CORF;	$10/Visit for PCP - Office Visits; $10/Consult for PCP - Consults; $10/Procedure for PCP - Surgery (Office); $10/Visit for PCP - Tx Injections; $10/Visit for PCP - Allergy Testing; $10/Visit for PCP - Allergy Tx;	$20/Visit for Speclst - Office Visits; $20/Procedure for Speclst - Surgery (Office); $20/Visit for Speclst - Tx Injections; $20/Visit for Speclst - Allergy Testing; $20/Visit 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;	$30/Visit for PT/ST (PCP); $20/Visit for Occ Therapy (PCP); $30/Visit for PT/ST (Specialist); $20/Visit for Occ Therapy (Specialist);	$100/Visit for Prof Radiology (Office);	$20/Visit for Chiropractor; $20/Exam for Vistion Exams; $30/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/Service for Vision Exams (Refractions);	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	$10/Service for Physical Exams (Routine);											500	499.9999999	75	0	125	0.2	0.2	43.8005287	300	0	100	0	0.2	0.131474178	10	20	30	24.9159809	100	23.54075006	0.2	0	0	0	20	0	0	0	0	0.67267885											489.3465361	489.3465359	73.40198041	0	122.336634	0.195738614	0.195738614	42.86727399	293.6079217	0	97.86930722	0	0.195738614	0.128672867	9.786930722	19.57386144	29.36079217	24.38509789	97.86930722	23.039169	0.195738614	0	0	0	19.57386145	0	0	0	0	0.658346131											11.5482	0.173705181	4.124602858	0	2.014733958	2.098531526	1.398353568	1.248039092	7.293811092	0	1.450898162	0	0.132626579	2.299348492	4.894716998	13.13270227	0.472157085	1.337144725	1.028552212	4.178890254	1.879221038	0	0	0	0.751025998	0	0	0	0	0.047055035	0	0	0	0	0	0	0	0	0	0	61.5043	0	1.339	11.5482	0.173705181	4.124602858	0	2.014733958	2.098531526	1.398353568	1.248039092	7.293811092	0	1.450898162	0	0.132626579	2.299348492	4.894716998	13.13270227	0.472157085	1.337144725	1.028552212	4.178890254	1.879221038	0	0	0	0.751025998	0	0	0	0	0.047055035	0	0	0	0	0	0	0	0	0	0	61.5043	0																																																																																	0	0	0	11.5482	0.173705181	4.124602858	0	2.014733958	2.098531526	1.398353568	1.248039092	7.293811092	0	1.450898162	0	0.132626579	2.299348492	4.894716998	13.13270227	0.472157085	1.337144725	1.028552212	4.178890254	1.879221038	0	0	0	0.751025998	0	0	0	0	0.047055035	0	0	0	0	0	0	0	0	0	0	61.5043
H5928_001_0	2009	5																																																				coin																																																												0																						35.72783203																				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	15% Coinsurance	0% Coinsurance			0% Coinsurance	0% Coinsurance	0% Coinsurance	0% Coinsurance																																	0.15																																								0.15																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.359174805	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.3592			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.359174805	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.3592																																																																																		0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.359174805	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.3592
H5928_002_0	2009	4																																					coin	coin																																																																										0		1180.643141	24.92151678	799.1045737	1930.196494	588.9184304	21.18749724	1.478078966	211.6853238	127.3933369	2621.01936	1328.049403	0	0	2788.144932	0	0	259.687507	0	3629.273069	42095.87254	0	1661.88885	0	0	399.6870178	301.5182766	176.0229922	7.869078847	0	0													$50/day after day 20		$50 copay	20% coinsurance	20% coinsurance	$50 ER; $15/$25 urgent care	$20/$50 copay	$20 copay	$20 copay			$20 copay on other OP services			$10 copay			"$0 PCP, $5 Specialist, $5 Chiropractic, $3 Physical Exam"	20% coinsurance	$10 copay			$5 copay		$10 copay														0	0	11.1	0	50	0.2	0.2	38.58021231	27.5	20	20	0	0	20	0	0	10	0	0	0.836171975	0.2	42.80105848	0	0	5	0	10	0	0	0											0	0	11.1	0	50	0.2	0.2	38.58021231	27.5	20	20	0	0	20	0	0	10	0	0	0.836171975	0.2	42.80105848	0	0	5	0	10	0	0	0											0	0	0.739171731	0	2.453826794	4.237499448	0.295615793	0.680572061	0.291943064	4.368365601	2.213415671	0	0	4.646908221	0	0	0.216406256	0	0	2.933282408	0	5.927550156	0	0	0.166536257	0	0.146685827	0	0	0	0	0	0	0	0	0	0	0	0	0	29.3178			0	0	0.739171731	0	2.453826794	4.237499448	0.295615793	0.680572061	0.291943064	4.368365601	2.213415671	0	0	4.646908221	0	0	0.216406256	0	0	2.933282408	0	5.927550156	0	0	0.166536257	0	0.146685827	0	0	0	0	0	0	0	0	0	0	0	0	0	29.3178																																																																																		0			0	0	0.739171731	0	2.453826794	4.237499448	0.295615793	0.680572061	0.291943064	4.368365601	2.213415671	0	0	4.646908221	0	0	0.216406256	0	0	2.933282408	0	5.927550156	0	0	0.166536257	0	0.146685827	0	0	0	0	0	0	0	0	0	0	0	0	0	29.3178
H5928_004_0	2009	6																																					coin	coin																																																																										0		1134.916919	23.95630827	752.3587632	1802.189204	558.4893262	21.32359823	1.487573623	221.9017596	120.8109904	2485.592675	1259.429791	0	0	2644.082957	0	0	248.7728539	0	3476.734901	40324.85392	0	1542.688164	0	0	379.0354007	285.9389865	166.9279772	18.78618226	0	0											$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	$20 copay	$20 copay			$20 copay on other OP services			$10 copay			"$0 PCP, $5 Specialist, $5 Chiropractic, $3 Physical Exam"	20% coinsurance	$10 copay			$5 copay		$10 copay														25.7	42.93896657	11.1	0	50	0.2	0.2	36.79741902	27.5	20	20	0	0	20	0	0	10	0	0	1.269191985	0.2	42.85273874	0	0	5	0	10	0	0	0											25.7	42.93896657	11.1	0	50	0.2	0.2	36.79741902	27.5	20	20	0	0	20	0	0	10	0	0	1.269191985	0.2	42.85273874	0	0	5	0	10	0	0	0											2.4306	0.085721593	0.695931856	0	2.327038859	4.264719645	0.297514725	0.680451002	0.27685852	4.142654458	2.099049652	0	0	4.406804928	0	0	0.207310712	0	0	4.26499845	0	5.509034403	0	0	0.157931417	0	0.139106648	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9857			2.4306	0.085721593	0.695931856	0	2.327038859	4.264719645	0.297514725	0.680451002	0.27685852	4.142654458	2.099049652	0	0	4.406804928	0	0	0.207310712	0	0	4.26499845	0	5.509034403	0	0	0.157931417	0	0.139106648	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9857																																																																																		0			2.4306	0.085721593	0.695931856	0	2.327038859	4.264719645	0.297514725	0.680451002	0.27685852	4.142654458	2.099049652	0	0	4.406804928	0	0	0.207310712	0	0	4.26499845	0	5.509034403	0	0	0.157931417	0	0.139106648	0	0	0	0	0	0	0	0	0	0	0	0	0	31.9857
H5928_005_0	2009	5																																																				coin																																																												0																						40.9750663																				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	15% Coinsurance	0% Coinsurance			0% Coinsurance	0% Coinsurance	0% Coinsurance	0% Coinsurance																																	0.15																																								0.15																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.146259944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.1463			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.146259944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.1463																																																																																		0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.146259944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	6.1463
H5928_006_0	2009	5																																					coin	coin																																																																										0		1198.254387	25.29326242	814.2723861	1955.185534	601.7773049	19.89318342	1.387785242	227.9377746	130.1749359	2678.248608	1357.047002	0	0	2849.023322	0	0	264.624815	0	3698.274613	42891.84068	0	1660.969048	0	0	408.4140756	308.1018465	179.8664065	18.84680734	0	0													$50/day after day 20		$50 copay	20% coinsurance	20% coinsurance	$50 ER; $15/$25 urgent care	$20/$50 copay	$20 copay	$20 copay			$20 copay on other OP services			$10 copay			"$0 PCP, $5 Specialist, $5 Chiropractic, $3 Physical Exam"	20% coinsurance	$10 copay			$5 copay		$10 copay														0	0	11.1	0	50	0.2	0.2	37.62600243	27.5	20	20	0	0	20	0	0	10	0	0	0.835951035	0.2	40.39909567	0	0	5	0	10	0	0	0											0	0	11.1	0	50	0.2	0.2	37.62600243	27.5	20	20	0	0	20	0	0	10	0	0	0.835951035	0.2	40.39909567	0	0	5	0	10	0	0	0											0	0	0.753201957	0	2.507405437	3.978636684	0.277557048	0.714698938	0.298317561	4.46374768	2.261745003	0	0	4.748372203	0	0	0.220520679	0	0	2.987956552	0	5.591803957	0	0	0.170172531	0	0.149888672	0	0	0	0	0	0	0	0	0	0	0	0	0	29.124			0	0	0.753201957	0	2.507405437	3.978636684	0.277557048	0.714698938	0.298317561	4.46374768	2.261745003	0	0	4.748372203	0	0	0.220520679	0	0	2.987956552	0	5.591803957	0	0	0.170172531	0	0.149888672	0	0	0	0	0	0	0	0	0	0	0	0	0	29.124																																																																																		0			0	0	0.753201957	0	2.507405437	3.978636684	0.277557048	0.714698938	0.298317561	4.46374768	2.261745003	0	0	4.748372203	0	0	0.220520679	0	0	2.987956552	0	5.591803957	0	0	0.170172531	0	0.149888672	0	0	0	0	0	0	0	0	0	0	0	0	0	29.124
H5928_007_0	2009	5																																																				coin																																																												0																						34.72345098																				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	15% Coinsurance	0% Coinsurance			0% Coinsurance	0% Coinsurance	0% Coinsurance	0% Coinsurance																																	0.15																																								0.15																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.208517646	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.2085			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.208517646	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.2085																																																																																		0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.208517646	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.2085
H5928_008_0	2009	6																																					coin	coin																																																																										0		1184.119755	25.95267368	910.1579879	2187.639836	672.3201171	22.03131837	1.536945488	253.7497965	145.4345776	2992.203932	1516.125636	0	0	3182.99756	0	0	295.7844633	0	4133.747516	47944.59765	0	1855.236256	0	0	456.2900543	344.2188129	200.9510869	22.16630024	0	0													$50/day after day 20		$50 copay	20% coinsurance	20% coinsurance	$50 ER; $15/$25 urgent care	$20/$50 copay	$20 copay	$20 copay			$20 copay on other OP services			$10 copay			"$0 PCP, $5 Specialist, $5 Chiropractic, $3 Physical Exam"	20% coinsurance	$10 copay			$5 copay		$10 copay														0	0	11.1	0	50	0.2	0.2	37.68949138	27.5	20	20	0	0	20	0	0	10	0	0	1.269170089	0.2	40.03558273	0	0	5	0	10	0	0	0											0	0	11.1	0	50	0.2	0.2	37.68949138	27.5	20	20	0	0	20	0	0	10	0	0	1.269170089	0.2	40.03558273	0	0	5	0	10	0	0	0											0	0	0.841896139	0	2.801333821	4.406263673	0.307389098	0.796975064	0.333287574	4.987006554	2.52687606	0	0	5.304995934	0	0	0.246487053	0	0	5.070820774	0	6.189622052	0	0	0.190120856	0	0.167459239	0	0	0	0	0	0	0	0	0	0	0	0	0	34.1705			0	0	0.841896139	0	2.801333821	4.406263673	0.307389098	0.796975064	0.333287574	4.987006554	2.52687606	0	0	5.304995934	0	0	0.246487053	0	0	5.070820774	0	6.189622052	0	0	0.190120856	0	0.167459239	0	0	0	0	0	0	0	0	0	0	0	0	0	34.1705																																																																																		0			0	0	0.841896139	0	2.801333821	4.406263673	0.307389098	0.796975064	0.333287574	4.987006554	2.52687606	0	0	5.304995934	0	0	0.246487053	0	0	5.070820774	0	6.189622052	0	0	0.190120856	0	0.167459239	0	0	0	0	0	0	0	0	0	0	0	0	0	34.1705
H5928_009_0	2009	6																																																				coin																																																												0																						36.07678061																				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	15% Coinsurance	0% Coinsurance			0% Coinsurance	0% Coinsurance	0% Coinsurance	0% Coinsurance																																	0.15																																								0.15																				0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.411517091	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.4115			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.411517091	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.4115																																																																																		0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.411517091	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	5.4115
H5928_010_0	2009	5																																					coin	coin																																																																										0		1110.025412	23.43088777	756.0181778	1809.230193	559.6023299	17.0605521	1.190175646	224.9488081	121.0517526	2490.546169	1261.939687	0	0	2649.352304	0	0	245.6974452	0	3433.754405	39829.13867	0	1545.76256	0	0	379.7907738	286.5088294	167.260645	20.01609104	0	0											$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														0	0	11.1	0	50	0.2	0.2	36.60151129	27.5	20	20	0	0	20	0	0	10	0	0	0.836230844	0.2	37.34793096	0	0	5	0	10	0	0	0											0	0	11.1	0	50	0.2	0.2	36.60151129	27.5	20	20	0	0	20	0	0	10	0	0	0.836230844	0.2	37.34793096	0	0	5	0	10	0	0	0											0	0	0.699316815	0	2.331676375	3.41211042	0.238035129	0.686122195	0.277410266	4.150910282	2.103232812	0	0	4.415587173	0	0	0.204747871	0	0	2.77552952	0	4.810919448	0	0	0.158246156	0	0.139383871	0	0	0	0	0	0	0	0	0	0	0	0	0	26.4032			0	0	0.699316815	0	2.331676375	3.41211042	0.238035129	0.686122195	0.277410266	4.150910282	2.103232812	0	0	4.415587173	0	0	0.204747871	0	0	2.77552952	0	4.810919448	0	0	0.158246156	0	0.139383871	0	0	0	0	0	0	0	0	0	0	0	0	0	26.4032																																																																																		0			0	0	0.699316815	0	2.331676375	3.41211042	0.238035129	0.686122195	0.277410266	4.150910282	2.103232812	0	0	4.415587173	0	0	0.204747871	0	0	2.77552952	0	4.810919448	0	0	0.158246156	0	0.139383871	0	0	0	0	0	0	0	0	0	0	0	0	0	26.4032
H5928_011_0	2009	5																																					coin	coin														coin																																																												0		1060.943035	22.3948361	724.7882469	1684.722512	522.086992	16.61143841	1.158844645	207.4382029	112.9365301	2323.581744	1177.340158	0	0	2471.741629	0	0	232.5578393	0	3250.12132	37696.47994	0	1442.135749	0	0	354.3298733	267.3014834	156.0476116	17.5616989	0	0											$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	$20 copay	$20 copay			$20 copay on other OP services			$10 copay			"$0 PCP, $5 Specialist, $5 Chiropractic, $3 Physical Exam"	20% coinsurance	$10 copay			$5 copay		$10 copay														25.7	42.93896657	11.1	0	50	0.2	0.2	36.79741902	27.5	20	20	0	0	20	0	0	10	0	0	0.836079081	0.2	35.79833706	0	0	5	0	10	0	0	0											25.7	42.93896657	11.1	0	50	0.2	0.2	36.79741902	27.5	20	20	0	0	20	0	0	10	0	0	0.836079081	0.2	35.79833706	0	0	5	0	10	0	0	0											2.2722	0.08013426	0.670429128	0	2.175362466	3.322287682	0.231768929	0.636099206	0.258812881	3.87263624	1.962233596	0	0	4.119569382	0	0	0.193798199	0	0	2.626436524	0	4.302171803	0	0	0.147637447	0	0.130039676	0	0	0	0	0	0	0	0	0	0	0	0	0	27.0016			2.2722	0.08013426	0.670429128	0	2.175362466	3.322287682	0.231768929	0.636099206	0.258812881	3.87263624	1.962233596	0	0	4.119569382	0	0	0.193798199	0	0	2.626436524	0	4.302171803	0	0	0.147637447	0	0.130039676	0	0	0	0	0	0	0	0	0	0	0	0	0	27.0016																																																																																		0			2.2722	0.08013426	0.670429128	0	2.175362466	3.322287682	0.231768929	0.636099206	0.258812881	3.87263624	1.962233596	0	0	4.119569382	0	0	0.193798199	0	0	2.626436524	0	4.302171803	0	0	0.147637447	0	0.130039676	0	0	0	0	0	0	0	0	0	0	0	0	0	27.0016
H5928_012_0	2009	4																																					coin	coin																																																																										0		944.3188317	19.9330829	639.0679637	1543.934763	470.9327046	17.74046316	0.394085566	169.5264906	101.8709648	2095.916297	1061.983909	0	0	1918.965327	0	0	207.6797009	0	2902.435908	33666.00245	0	1297.959037	0	0	632.9005329	241.1111796	140.7580057	6.424716826	0	0											$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														0	0	11.1	0	50	0.2	0.2	38.55253964	27.5	20	20	0	0	20	0	0	10	0	0	1.269302323	0.2	43.84108405	0	0	5	0	10	0	0	0											0	0	11.1	0	50	0.2	0.2	38.55253964	27.5	20	20	0	0	20	0	0	10	0	0	1.269302323	0.2	43.84108405	0	0	5	0	10	0	0	0											0	0	0.591137866	0	1.962219602	3.548092633	0.078817113	0.544639729	0.233454294	3.493193829	1.769973182	0	0	3.198275545	0	0	0.173066417	0	0	3.561027926	0	4.741994268	0	0	0.263708555	0	0.117298338	0	0	0	0	0	0	0	0	0	0	0	0	0	24.2769			0	0	0.591137866	0	1.962219602	3.548092633	0.078817113	0.544639729	0.233454294	3.493193829	1.769973182	0	0	3.198275545	0	0	0.173066417	0	0	3.561027926	0	4.741994268	0	0	0.263708555	0	0.117298338	0	0	0	0	0	0	0	0	0	0	0	0	0	24.2769																																																																																		0			0	0	0.591137866	0	1.962219602	3.548092633	0.078817113	0.544639729	0.233454294	3.493193829	1.769973182	0	0	3.198275545	0	0	0.173066417	0	0	3.561027926	0	4.741994268	0	0	0.263708555	0	0.117298338	0	0	0	0	0	0	0	0	0	0	0	0	0	24.2769
H5932_001_0	2009	4																																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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2815.928206	132.458455	60.6915998	23.97465018	21.34564939	23.35006839	11.66198287	1616.40237	23.38206934	15.95667735	25.84256886	0.334339692	0.330153627	51.85431718	40.03216331	157.4166193	13.59938492	0.425537941	0.769038195	9.194322008	31.31272672	0.406244664	3.15	5.294933728	4.659076298	0	0	1.1518819	2.363450207	0											$185/day: PBP 1a	$185/day: 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																			185	185	0.123411874	9.80E-05	0.201405239	0.215180893	0.210682232	34.10376426	0.194558504	4.00E-06	0.208449975	0.168106072	0.197805814	0.271261499	0.268077233	0.21898353	0.263604077	0.195702872	0.207043525	0.000478047	0.200241967	0.054820421	0	0.010459346	0	0	0	0	0.001403743	0											185	185	0.123411874	9.80E-05	0.201405239	0.215180893	0.210682232	34.10376426	0.194558504	4.00E-06	0.208449975	0.168106072	0.197805814	0.271261499	0.268077233	0.21898353	0.263604077	0.195702872	0.207043525	0.000478047	0.200241967	0.054820421	0	0.010459346	0	0	0	0	0.001403743	0											43.4122	2.042067847	7.490064087	0.002349193	4.299125611	5.02448857	2.456972582	4.59378378	4.549180421	6.39E-05	5.386882838	0.056204532	0.065306307	14.0660798	10.73171155	34.47164697	3.584853308	0.083278997	0.159224379	0.004395316	6.270122003	0.022270504	0	0.055381545	0	0	0	0	0.003317676	0	0	0	0	0	0	0	0	0	0	0	148.831	135		43.4122	2.042067847	7.490064087	0.002349193	4.299125611	5.02448857	2.456972582	4.59378378	4.549180421	6.39E-05	5.386882838	0.056204532	0.065306307	14.0660798	10.73171155	34.47164697	3.584853308	0.083278997	0.159224379	0.004395316	6.270122003	0.022270504	0	0.055381545	0	0	0	0	0.003317676	0	0	0	0	0	0	0	0	0	0	0	148.831																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			43.4122	2.042067847	7.490064087	0.002349193	4.299125611	5.02448857	2.456972582	4.59378378	4.549180421	6.39E-05	5.386882838	0.056204532	0.065306307	14.0660798	10.73171155	34.47164697	3.584853308	0.083278997	0.159224379	0.004395316	6.270122003	0.022270504	0	0.055381545	0	0	0	0	0.003317676	0	0	0	0	0	0	0	0	0	0	0	148.831
H5938_001_0	2009	7																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	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		1105.975233	28.34684051	1546.656337	497.9413389	180.542239	6.032222314	6.795691286	234.3835869	222.4473493	785.4600128	245.7889546	0	34.7367426	210.8234678	4813.60691	6628.38053	79.28848233	296.6928441	2764.592941	6714.356739	743.9948099	0	0	0	0	125.272049	0	0	0	0											"$250 per admit, $100 per day for days 6-10"	"$250 per admit, $100 per day for days 6-10"	"$75 copay, days 7-100"	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$100 copay	$10 copay to 20% coinsurance	0% coinsurance to $100 copay		$0 copay	Varies	$15 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	0% coinsurance	Varies		Varies	$0 copay	$0 copay	$15 copay	$0 copay; and $150 credit covered every 2years	$25 copay	$0 credit	Varies	Varies											60.16363636	25.13580247	51.23965901	0	100	0.2	0.2	45	100	17.48126764	20.79364155	0	0	23.69849052	9.925181324	14.91463326	25	25	0	10.16475925	0	0	0	0	0	0	0	0	0	0											57.64406408	25.13580247	50.92471247	0	100	0.173894651	0.176827484	45	99.68505346	17.48126764	20.79364155	0	0	23.69849052	9.39519339	14.18483505	25	25	0	9.849812714	0	0	0	0	0	0	0	0	0	0											5.3127	0.059376715	6.56358577	0	1.504518659	1.048971195	1.201664989	0.878938451	1.847889659	1.144236392	0.425903952	0	0	0.416349829	3.768730652	7.83520704	0.165184338	0.618110092	0	5.511263031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.3027		6.2989	5.3127	0.059376715	6.56358577	0	1.504518659	1.048971195	1.201664989	0.878938451	1.847889659	1.144236392	0.425903952	0	0	0.416349829	3.768730652	7.83520704	0.165184338	0.618110092	0	5.511263031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.3027																																																																																		0			5.3127	0.059376715	6.56358577	0	1.504518659	1.048971195	1.201664989	0.878938451	1.847889659	1.144236392	0.425903952	0	0	0.416349829	3.768730652	7.83520704	0.165184338	0.618110092	0	5.511263031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.3027
H5938_006_0	2009	7																					3250											D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	O	T	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		1165.082755	29.86180348	1640.664253	528.2069037	190.1911029	6.354607215	7.158878873	247.6428241	235.0313455	829.8931598	259.6938286	0	36.70188391	222.7502599	5091.378298	7010.874258	83.86386045	313.8136403	2924.125041	7101.811764	783.756722	0	0	0	0	132.6139611	0	0	0	0											"$250 per admit, $100 per day for days 6-10"	"$250 per admit, $100 per day for days 6-10"	"$75 copay, days 7-100"	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$100 copay	$10 copay to 20% coinsurance	0% coinsurance to $100 copay		$0 copay	Varies	$15 copay	$25 copay	"$25 copay Group, $25 copay Individual"	$25 copay	0% coinsurance	Varies		Varies	$0 copay	$0 copay	$15 copay	$0 copay; and $150 credit covered every 2years	$25 copay	$0 credit	Varies	Varies											60.16363636	25.13580247	51.23965901	0	100	0.2	0.2	45	100	17.49002166	20.79364155	0	0	23.69849052	9.92521653	14.91472962	25	25	0	10.16475925	0	0	0	0	0	0	0	0	0	0											57.59476566	25.13580247	50.91855017	0	100	0.174734171	0.177572687	45	99.67889116	17.49002166	20.79364155	0	0	23.69849052	9.384858754	14.17065205	25	25	0	9.843650412	0	0	0	0	0	0	0	0	0	0											5.5919	0.062550033	6.961687088	0	1.584925858	1.110367024	1.271221356	0.92866059	1.952305326	1.209570778	0.449998365	0	0	0.439903743	3.981822182	8.279054972	0.174716376	0.653778417	0	5.825646024	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.4781		6.4222	5.5919	0.062550033	6.961687088	0	1.584925858	1.110367024	1.271221356	0.92866059	1.952305326	1.209570778	0.449998365	0	0	0.439903743	3.981822182	8.279054972	0.174716376	0.653778417	0	5.825646024	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.4781																																																																																		0			5.5919	0.062550033	6.961687088	0	1.584925858	1.110367024	1.271221356	0.92866059	1.952305326	1.209570778	0.449998365	0	0	0.439903743	3.981822182	8.279054972	0.174716376	0.653778417	0	5.825646024	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.4781
H5938_802_0	2009	4																					N/A											D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																			14.0172	0.1482	0	0	0.1592	0.012	0.0135	0.2477	0.6739	0.188	0.1803	0	0.0143	0.1885	1.136	2.4679	0.017	0.0666	0.6238	0.5177	0.6473	0																			21.319		918.6094282	23.69421933	1330.140866	509.0925076	5.134689359	0.387142533	0.436141276	7.989578461	21.73795883	6.062966987	5.816471022	0	0.460448436	6.079212631	36.64372777	79.60994088	0.549552592	2.149529452	20.12178076	16.70097156	20.88219637	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										13.18008659	5.40270604	75.04542946	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										13.18008659	5.40270604	75.04542946	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										1.0089	0.010667742	8.318416042	0	1.026937872	0.077428507	0.087228255	1.597915692	4.347591767	1.212593397	1.163294204	0	0.092089687	1.215842526	7.328745555	15.92198818	0.109910518	0.42990589	4.024356152	3.340194312	4.176439273	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.4905	Medicare Standard	0	15.0261	0.158873759	8.318416042	0	1.186113242	0.089429925	0.100748635	1.845592625	5.021468491	1.400545374	1.343604806	0	0.106363589	1.404298118	8.464701115	18.38989634	0.126946649	0.496541303	4.648131356	3.85792443	4.823787361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.8095																																																																																		0			15.0261	0.158873759	8.318416042	0	1.186113242	0.089429925	0.100748635	1.845592625	5.021468491	1.400545374	1.343604806	0	0.106363589	1.404298118	8.464701115	18.38989634	0.126946649	0.496541303	4.648131356	3.85792443	4.823787361	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.8095
H5938_803_0	2009	4																					N/A											D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																			13.9384	0.1474	0	0	0.1919	0.2325	0.2619	0.2023	0.6705	0.3811	0.3656	0	0.0289	0.3821	1.1295	2.4539	0.0235	0.092	0.8614	0.7149	0.6437	0.1912																			22.9128		1201.319654	30.98505005	1076.739681	2197.060439	6.191258345	7.499725054	8.448928694	6.526578887	21.62880294	12.29306492	11.79319465	0	0.933549121	12.32627287	36.43560633	79.15750625	0.758864717	2.968236493	27.78807891	23.06239754	1	6.166890485	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										10.02170517	4.108004021	74.81498949	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										10.02170517	4.108004021	74.81498949	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										1.0033	0.010607226	6.713022324	0	1.238251669	1.499945011	1.689785739	1.305315777	4.325760589	2.458612983	2.35863893	0	0.186709824	2.465254573	7.287121265	15.83150125	0.151772943	0.593647299	5.557615781	4.612479508	0.2	1.233378097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.7227	Medicare Covered	0	14.9417	0.157972499	6.713022324	0	1.430180678	1.732436487	1.951702528	1.507639723	4.99625348	2.839697996	2.724227964	0	0.215649847	2.847369032	8.416625061	18.28538394	0.17529775	0.68566263	6.419046227	5.327413831	0.84373073	1.424551702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.6355																																																																																		0			14.9417	0.157972499	6.713022324	0	1.430180678	1.732436487	1.951702528	1.507639723	4.99625348	2.839697996	2.724227964	0	0.215649847	2.847369032	8.416625061	18.28538394	0.17529775	0.68566263	6.419046227	5.327413831	0.84373073	1.424551702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.6355
H5938_804_0	2009	4																					N/A											D	D	D	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																			14.083	0.1489	0	0	0.1939	0.2349	0.2647	0.2044	0.6775	0.3851	0.3694	0	0.0292	0.3861	1.1413	2.4796	0.0238	0.093	0.8703	0.7224	0.6504	0.1932																			23.1511		1207.83093	31.15505285	1082.540351	2209.175307	6.255707148	7.578382742	8.537541702	6.592730094	21.85564748	12.421132	11.91618961	0	0.943340256	12.45424964	36.81714189	79.98686294	0.766823748	2.999367583	28.07567952	23.30362128	1	6.231229523	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										10.07113634	4.128324965	75.18507481	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										10.07113634	4.128324965	75.18507481	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										1.0137	0.010718182	6.782573109	0	1.25114143	1.515676548	1.70750834	1.318546019	4.371129496	2.4842264	2.383237922	0	0.188668051	2.490849929	7.363428379	15.99737259	0.15336475	0.599873517	5.615135903	4.660724256	0.2	1.246245905	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.3541	Medicare Standard	0	15.0967	0.159624958	6.782573109	0	1.445068351	1.750606413	1.972172133	1.522920652	5.048654568	2.869281492	2.7526398	0	0.217911599	2.876931668	8.504759778	18.47696534	0.177136286	0.692853912	6.485481968	5.383136516	0.850375299	1.43941402	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.5052																																																																																		0			15.0967	0.159624958	6.782573109	0	1.445068351	1.750606413	1.972172133	1.522920652	5.048654568	2.869281492	2.7526398	0	0.217911599	2.876931668	8.504759778	18.47696534	0.177136286	0.692853912	6.485481968	5.383136516	0.850375299	1.43941402	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.5052
H5948_001_0	2009	4																					0											A	A	D		T	Coin	Coin	V	V		V		Coin	V		V	V	V	P	P	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	214.2834383	1.944372013	302.3602964	0	153.4299528	9.007623179	5.23545804	302.9602552	190.9781855	0	85.05421636	0	0.43204154	432.9236994	0	3368.29652	160.044971	513.5919479	364.2088056	1718.03706	8.758816698	0.976669225	0	740.52	401.2774884	0	0	0	0	967.7641442											$200/Admit for IP Medical; $200/Admit for IP Surgical;	$750/Admit for IP Psych; $750/Admit for IP Substance Abuse;	$50/Days 21-100 for SNF	No cost sharing	$100/Run 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	$100/Case for OP Fac - CT/MRI/PET	No cost sharing	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/Visit for Prof - CORF; $10/Visit for Prof - CORF;	No cost sharing	$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/Visit for PT/ST (PCP); $10/Visit for Occ Therapy (PCP); $10/Visit for PT/ST (Specialist); $10/Visit for Occ Therapy (Specialist);	No cost sharing	$25/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	No cost sharing	$20/Procedure  for Dental: Prophylaxis;	$25/Exam for Vision (Refractions)	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$25/Service for Routine Chiropractor;											200	750	50	0	100	0.2	0.2	42.31840877	100	0	100	0	0.2	10	0	10	25	9.999999998	100	12.23210111	0.2	0.2	0	20	25	0	0	0	0	25											200	750	50	0	100	0.2	0.2	42.31840877	100	0	100	0	0.2	10	0	10	25	9.999999998	100	12.23210111	0.2	0.2	0	20	25	0	0	0	0	25											3.5714	0.121523251	1.259834568	0	1.27858294	1.801524636	1.047091608	1.06839966	1.591484879	0	0.708785136	0	0.086408308	0.36076975	0	2.806913767	0.333427023	0.42799329	3.03507338	1.75126692	1.75176334	0.195333845	0	1.2342	0.835994768	0	0	0	0	2.0161753	0	0	0	0	0	0	0	0	0	0	27.2839	0	0	3.5714	0.121523251	1.259834568	0	1.27858294	1.801524636	1.047091608	1.06839966	1.591484879	0	0.708785136	0	0.086408308	0.36076975	0	2.806913767	0.333427023	0.42799329	3.03507338	1.75126692	1.75176334	0.195333845	0	1.2342	0.835994768	0	0	0	0	2.0161753	0	0	0	0	0	0	0	0	0	0	27.2839	0																																																																																	0	0	0	3.5714	0.121523251	1.259834568	0	1.27858294	1.801524636	1.047091608	1.06839966	1.591484879	0	0.708785136	0	0.086408308	0.36076975	0	2.806913767	0.333427023	0.42799329	3.03507338	1.75126692	1.75176334	0.195333845	0	1.2342	0.835994768	0	0	0	0	2.0161753	0	0	0	0	0	0	0	0	0	0	27.2839
H5948_002_0	2009	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	253.8789076	6.26587573	31.9598754	0	12.93896158	23.25862542	14.31221265	27.56607587	29.25385635	6.3306904	17.37085782	0	4.014626829	35.51220458	88.92286811	177.421587	19.26790735	12.87297371	43.48327867	76.05053552	8.73254969	0.746185708	0	0	0	0	0	0	0	0											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	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing											0.060950544	0.060950544	0.169602974	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.230134951	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.060950544	0.060950544	0.169602974	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.230134951	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											15.4741	0.381908536	5.42048992	0	2.988900125	5.372742472	3.306121122	6.367763526	6.757640817	1.462389483	4.012668157	0	0.927378798	8.203319257	20.46425992	40.98438661	4.450886598	2.973656926	10.04463737	17.5676737	2.017218978	0.172368899	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	159.3505	0	0	15.4741	0.381908536	5.42048992	0	2.988900125	5.372742472	3.306121122	6.367763526	6.757640817	1.462389483	4.012668157	0	0.927378798	8.203319257	20.46425992	40.98438661	4.450886598	2.973656926	10.04463737	17.5676737	2.017218978	0.172368899	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	159.3505	0																																																																																	0	0	0	15.4741	0.381908536	5.42048992	0	2.988900125	5.372742472	3.306121122	6.367763526	6.757640817	1.462389483	4.012668157	0	0.927378798	8.203319257	20.46425992	40.98438661	4.450886598	2.973656926	10.04463737	17.5676737	2.017218978	0.172368899	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	159.3505
H5948_003_0	2009	4																					0											A	A	D		T	Coin	Coin	V	V		V		Coin	V		V	V	V	P	V	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	219.1272119	2.94311424	281.8777366	0	163.4003778	10.90819224	6.615896199	284.6037386	250.6504311	0	119.3382014	0	0.466238904	435.7993553	0	3582.724286	160.1539295	516.000659	405.5231376	1759.90696	7.210294517	0.803998188	0	740.52	401.7545657	0	0	0	0	938.0062417											$200/Admit for IP Medical; $200/Admit for IP Surgical;	$750/Admit for IP Psych; $750/Admit for IP Substance Abuse;	$50/Days 21-100 for SNF	No cost sharing	$100/Run 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	$100/Case for OP Fac - CT/MRI/PET	No cost sharing	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/Visit for Prof - CORF; $10/Visit for Prof - CORF;	No cost sharing	$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/Visit for PT/ST (PCP); $10/Visit for Occ Therapy (PCP); $10/Visit for PT/ST (Specialist); $10/Visit for Occ Therapy (Specialist);	No cost sharing	$25/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	No cost sharing	$20/Procedure  for Dental: Prophylaxis;	$25/Exam for Vision (Refractions)	No cost sharing	No cost sharing	No cost sharing	No cost sharing	$25/Service for Routine Chiropractor;											200	750	50	0	100	0.2	0.2	41.36794954	100	0	100	0	0.2	10	0	10	25	10	100	12.20536958	0.2	0.2	0	20	25	0	0	0	0	25											200	750	50	0	100	0.2	0.2	41.36794954	100	0	100	0	0.2	10	0	10	25	10	100	12.20536958	0.2	0.2	0	20	25	0	0	0	0	25											3.6521	0.18394464	1.174490569	0	1.361669815	2.181638447	1.32317924	0.981122758	2.088753592	0	0.994485011	0	0.093247781	0.36316613	0	2.985603572	0.33365402	0.430000549	3.37935948	1.790026239	1.442058903	0.160799638	0	1.2342	0.836988679	0	0	0	0	1.95417967	0	0	0	0	0	0	0	0	0	0	28.9447	0	0	3.6521	0.18394464	1.174490569	0	1.361669815	2.181638447	1.32317924	0.981122758	2.088753592	0	0.994485011	0	0.093247781	0.36316613	0	2.985603572	0.33365402	0.430000549	3.37935948	1.790026239	1.442058903	0.160799638	0	1.2342	0.836988679	0	0	0	0	1.95417967	0	0	0	0	0	0	0	0	0	0	28.9447	0																																																																																	0	0	0	3.6521	0.18394464	1.174490569	0	1.361669815	2.181638447	1.32317924	0.981122758	2.088753592	0	0.994485011	0	0.093247781	0.36316613	0	2.985603572	0.33365402	0.430000549	3.37935948	1.790026239	1.442058903	0.160799638	0	1.2342	0.836988679	0	0	0	0	1.95417967	0	0	0	0	0	0	0	0	0	0	28.9447
H5950_001_0	2009	5																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	10570.53335	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$225/day 1-10	$225/day 1-10	"$0/d 1-10, $75/d 11-100"	$20 per visit	$150 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$225 per procedure	$40 per visit	$40 X-ray; $175 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$25 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											184.420666	184.420666	47.56208437	20	150	0.2	0.2	47.5	225	40	64.3	35	25	35	25	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											157.606254	157.606254	40.64664831	20	150	0.170920383	0.170920383	40.59359089	192.2854305	34.18407654	54.95090303	29.91106697	21.36504784	29.91106697	25	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											25.6632	0	4.568337441	1.711889696	3.415189648	1.346970706	0	0.860648989	6.160978056	2.988818687	21.58814562	0	0.118977722	1.961693872	15.22237389	30.83072228	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.4369	0	11.1027	25.6632	0	4.568337441	1.711889696	3.415189648	1.346970706	0	0.860648989	6.160978056	2.988818687	21.58814562	0	0.118977722	1.961693872	15.22237389	30.83072228	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.4369																																																																					0	0	0											0			25.6632	0	4.568337441	1.711889696	3.415189648	1.346970706	0	0.860648989	6.160978056	2.988818687	21.58814562	0	0.118977722	1.961693872	15.22237389	30.83072228	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.4369
H5950_002_0	2009	4																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	10570.53335	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$200/day 1-10	$200/day 1-10	"$0/d 1-10, $75/d 11-100"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$200 per procedure	$30 per visit	$30 X-ray; $175 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$20 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											163.9294809	163.9294809	47.56208437	20	100	0.2	0.2	47.5	200	30	56.1	30	25	30	20	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											135.3137112	135.3137112	39.25957743	20	100	0.165087708	0.165087708	39.2083306	165.0877078	24.76315617	46.30710203	24.76315617	20.63596347	24.76315617	20	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											22.0333	0	4.412442476	1.711889696	2.276793099	1.301005198	0	0.831279257	5.289541398	2.165118716	18.1923209	0	0.114917595	1.624072179	12.17789911	26.42633338	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.2758	0	11.8351	22.0333	0	4.412442476	1.711889696	2.276793099	1.301005198	0	0.831279257	5.289541398	2.165118716	18.1923209	0	0.114917595	1.624072179	12.17789911	26.42633338	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.2758																																																																					0	0	0											0			22.0333	0	4.412442476	1.711889696	2.276793099	1.301005198	0	0.831279257	5.289541398	2.165118716	18.1923209	0	0.114917595	1.624072179	12.17789911	26.42633338	0	1.680146115	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.2758
H5950_003_0	2009	5																					2500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	10347.32211	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$150/day 1-10	$150/day 1-10	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$200 per procedure	$0 per visit	$20 X-ray; $175 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$20 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											122.9471107	122.9471107	47.56208437	0	100	0.2	0.2	47.5	200	0	47.9	25	25	25	10	25	25	25	20	25	45	0	0	0	0	0	0	0	0	0											102.6507993	102.6507993	39.71045719	0	100	0.166983671	0.166983671	39.65862181	166.9836708	0	39.99258915	0	20.87295885	20.87295885	10	25	25	25	20	25	45	0	0	0	0	0	0	0	0	0											16.7147	0	4.463117525	0	2.276793099	1.315946696	0	0.84082615	5.35028956	0	15.71158599	0	0.116237376	1.368936638	6.088949555	21.55692107	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2433	0	9.0718	16.7147	0	4.463117525	0	2.276793099	1.315946696	0	0.84082615	5.35028956	0	15.71158599	0	0.116237376	1.368936638	6.088949555	21.55692107	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2433																																																																					0	0	0											0			16.7147	0	4.463117525	0	2.276793099	1.315946696	0	0.84082615	5.35028956	0	15.71158599	0	0.116237376	1.368936638	6.088949555	21.55692107	0	1.400121763	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2433
H5950_004_0	2009	4																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	10570.53335	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	0	0	0											$250/day 1-10	$250/day 1-10	"$0/d 1-10, $75/d 11-100"	$20 per visit	$150 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$200 per procedure	$35 per visit	$35 X-ray; $150 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$25 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											204.9118511	204.9118511	47.56208437	20	150	0.2	0.2	47.5	200	35	55.7	35	25	35	25	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											175.5492608	175.5492608	40.7467343	20	150	0.171341247	0.171341247	40.69354623	171.3412473	29.98471828	47.71853737	29.98471828	21.41765591	29.98471828	25	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											28.5848	0	4.579586255	1.711889696	3.415189648	1.35028741	0	0.862768202	5.489909776	2.621655911	18.74682083	0	0.119270686	1.966524235	15.22237389	30.83072228	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.5008	0	10.7585	28.5848	0	4.579586255	1.711889696	3.415189648	1.35028741	0	0.862768202	5.489909776	2.621655911	18.74682083	0	0.119270686	1.966524235	15.22237389	30.83072228	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.5008																																																																					0	0	0											0			28.5848	0	4.579586255	1.711889696	3.415189648	1.35028741	0	0.862768202	5.489909776	2.621655911	18.74682083	0	0.119270686	1.966524235	15.22237389	30.83072228	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.5008
H5950_801_0	2009	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																																																			0		323.1901884	0	39.90760648	6.050471799	7.136071682	9.499909266	0	8.397109712	43.39729121	14.79265305	60.29591938	0	3.290280642	12.50680058	44.17602535	191.8894084	0	5.687157887	0	0	8.581992181	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.074499285	0.074499285	0.22494693	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											24.0774	0	8.97709358	0	1.648432559	2.194479041	0	1.939732343	10.02477427	3.417102855	13.92835738	0	0.760054828	2.889070934	10.20466186	44.32645334	0	1.313733472	0	0	1.982440194	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.6838			24.0774	0	8.97709358	0	1.648432559	2.194479041	0	1.939732343	10.02477427	3.417102855	13.92835738	0	0.760054828	2.889070934	10.20466186	44.32645334	0	1.313733472	0	0	1.982440194	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.6838																																																																																		0			24.0774	0	8.97709358	0	1.648432559	2.194479041	0	1.939732343	10.02477427	3.417102855	13.92835738	0	0.760054828	2.889070934	10.20466186	44.32645334	0	1.313733472	0	0	1.982440194	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.6838
H5950_802_0	2009	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																																																			0		323.200162	0	39.90883802	6.050658516	7.1362919	9.500202432	0	8.397368845	43.39863045	14.79310955	60.2977801	0	3.290382179	12.50718654	44.17738862	191.8953301	0	5.687333392	0	0	8.58225702	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.074499874	0.074499874	0.224990611	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											24.0784	0	8.979113832	0	1.648483429	2.194546762	0	1.939792203	10.02508363	3.417208306	13.9287872	0	0.760078283	2.88916009	10.20497677	44.32782124	0	1.313774014	0	0	1.982501372	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.6897			24.0784	0	8.979113832	0	1.648483429	2.194546762	0	1.939792203	10.02508363	3.417208306	13.9287872	0	0.760078283	2.88916009	10.20497677	44.32782124	0	1.313774014	0	0	1.982501372	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.6897																																																																																		0			24.0784	0	8.979113832	0	1.648483429	2.194546762	0	1.939792203	10.02508363	3.417208306	13.9287872	0	0.760078283	2.88916009	10.20497677	44.32782124	0	1.313774014	0	0	1.982501372	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.6897
H5952_001_0	2009	8																					3750											D	D	D	V	T	COIN	COIN	V	V	O	COIN	O	COIN	COIN	P	COIN	P	P	COIN	P	COIN	V	T	COIN	V	COIN	V	COIN	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	1775.400164	240.0408046	648.3052053	0	176.4078378	12.78527897	8.651532661	342.2552342	285.9873679	1480.838162	23.5703062	48.03123576	0.147724206	10.27454181	3482.840905	88.569548	511.7056652	659.1876237	15.33134263	1407.810632	17.12385633	0	0	1.269738914	18.31905915	0	3.651197656	0	0	0											1a:$180 1-9	1b:$180 1-9	2a:$80 4-34		10a:$150 (WIA)	11a:20%	11b:20%; 11c:20%	4a:$50	9a:$200; 9b:$200	8a:$5	8b:$15-200;20%	9a:$200	12:20%	3:20%; 7a:$15-$50; 7d:$40; 9a:$200; 9d:$30; 13a 20%	7a:$15-$50	7b:$40; 7d:$40; 7f:$40; 17a:$40; 17b 20%	5:$40; 7e:$40; 7h:$40 ;9c:$40;	7c:$30; 7i:$30	8b:$15-200;20%	7g:$40	15:20%			16a:50%	17a:$40		18a:$40														144.6575681	144.6575681	63.52228277	0	90	0.199999486	0.191620409	50	200	5	0.312779702	200	0.198263573	0.279812294	14.80673577	0.137489169	40	30	0.645214298	0.020270495	0.190146021	0	0	0.5	40	0	40	0	0	0											108.1817971	108.1817971	47.50497878	0	67.30627276	0.14956911	0.143302839	37.39237376	149.569495	3.739237376	0.233911511	149.569495	0.148270913	0.209256917	11.07317996	0.102820928	29.91389901	22.43542425	0.482521883	0.015159238	0.142200221	0	0	0.373923738	29.91389901	0	29.91389901	0	0	0											16.0055	2.164003801	2.566477085	0	0.98944617	1.912282802	1.23978919	1.06647797	3.564582184	0.461433784	5.51336593	0.598667307	0.021903203	2.150018947	3.213843677	9.106803119	1.275592632	1.2324295	7.397708324	0.001778445	2.435016162	0	0	0.47478552	0.045666207	0	0.009101796	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4467	0	21.3924	16.0055	2.164003801	2.566477085	0	0.98944617	1.912282802	1.23978919	1.06647797	3.564582184	0.461433784	5.51336593	0.598667307	0.021903203	2.150018947	3.213843677	9.106803119	1.275592632	1.2324295	7.397708324	0.001778445	2.435016162	0	0	0.47478552	0.045666207	0	0.009101796	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4467	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.0055	2.164003801	2.566477085	0	0.98944617	1.912282802	1.23978919	1.06647797	3.564582184	0.461433784	5.51336593	0.598667307	0.021903203	2.150018947	3.213843677	9.106803119	1.275592632	1.2324295	7.397708324	0.001778445	2.435016162	0	0	0.47478552	0.045666207	0	0.009101796	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4467
H5952_801_0	2009	6																					0											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	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	382.6441912	2.468023146	101.2399671	0	14.18741181	15.25125698	8.508349794	14.60260612	46.79577824	12.37565338	29.97808905	0.433580613	0.307254116	16.1072599	34.05378415	157.3692046	1.635252073	12.72222196	21.28343671	5.159458696	39.5277119	0	0	0	0	0	0	0	0	0											Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.073310123	0.073310123	0.176985905	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.073310123	0.073310123	0.176985905	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											28.0517	0.18093108	17.91804721	0	3.277292129	3.523040362	1.965428802	3.373202014	10.80982477	2.858775931	6.924938571	0.100157122	0.070975701	3.720777036	7.866424138	36.35228627	0.377743229	2.938833272	4.91647388	1.191834959	9.13090145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.5496	0	0	28.0517	0.18093108	17.91804721	0	3.277292129	3.523040362	1.965428802	3.373202014	10.80982477	2.858775931	6.924938571	0.100157122	0.070975701	3.720777036	7.866424138	36.35228627	0.377743229	2.938833272	4.91647388	1.191834959	9.13090145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.5496	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	28.0517	0.18093108	17.91804721	0	3.277292129	3.523040362	1.965428802	3.373202014	10.80982477	2.858775931	6.924938571	0.100157122	0.070975701	3.720777036	7.866424138	36.35228627	0.377743229	2.938833272	4.91647388	1.191834959	9.13090145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.5496
H5952_802_0	2009	6																					0											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	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	382.6441912	2.468023146	101.2399671	0	14.18741181	15.25125698	8.508349794	14.60260612	46.79577824	12.37565338	29.97808905	0.433580613	0.307254116	16.1072599	34.05378415	157.3692046	1.635252073	12.72222196	21.28343671	5.159458696	39.5277119	0	0	0	0	0	0	0	0	0											Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.073310123	0.073310123	0.176985905	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.073310123	0.073310123	0.176985905	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											28.0517	0.18093108	17.91804721	0	3.277292129	3.523040362	1.965428802	3.373202014	10.80982477	2.858775931	6.924938571	0.100157122	0.070975701	3.720777036	7.866424138	36.35228627	0.377743229	2.938833272	4.91647388	1.191834959	9.13090145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.5496	0	0	28.0517	0.18093108	17.91804721	0	3.277292129	3.523040362	1.965428802	3.373202014	10.80982477	2.858775931	6.924938571	0.100157122	0.070975701	3.720777036	7.866424138	36.35228627	0.377743229	2.938833272	4.91647388	1.191834959	9.13090145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.5496	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	28.0517	0.18093108	17.91804721	0	3.277292129	3.523040362	1.965428802	3.373202014	10.80982477	2.858775931	6.924938571	0.100157122	0.070975701	3.720777036	7.866424138	36.35228627	0.377743229	2.938833272	4.91647388	1.191834959	9.13090145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.5496
H5952_803_0	2009	6																					0											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	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	382.6441912	2.468023146	101.2399671	0	14.18741181	15.25125698	8.508349794	14.60260612	46.79577824	12.37565338	29.97808905	0.433580613	0.307254116	16.1072599	34.05378415	157.3692046	1.635252073	12.72222196	21.28343671	5.159458696	39.5277119	0	0	0	0	0	0	0	0	0											Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.073310123	0.073310123	0.176985905	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.073310123	0.073310123	0.176985905	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											28.0517	0.18093108	17.91804721	0	3.277292129	3.523040362	1.965428802	3.373202014	10.80982477	2.858775931	6.924938571	0.100157122	0.070975701	3.720777036	7.866424138	36.35228627	0.377743229	2.938833272	4.91647388	1.191834959	9.13090145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.5496	0	0	28.0517	0.18093108	17.91804721	0	3.277292129	3.523040362	1.965428802	3.373202014	10.80982477	2.858775931	6.924938571	0.100157122	0.070975701	3.720777036	7.866424138	36.35228627	0.377743229	2.938833272	4.91647388	1.191834959	9.13090145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.5496	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	28.0517	0.18093108	17.91804721	0	3.277292129	3.523040362	1.965428802	3.373202014	10.80982477	2.858775931	6.924938571	0.100157122	0.070975701	3.720777036	7.866424138	36.35228627	0.377743229	2.938833272	4.91647388	1.191834959	9.13090145	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.5496
H5969_001_0	2009	6																					3350											D	D	D		Coin	Coin	Coin	V	Coin		Coin		Coin	Coin	Coin	V	V	P	Coin	Coin	Coin	Coin			V	Coin	V	Coin		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	809.8733299	20.83025582	188.41989	0	6.852237787	4.311186335	2.728906717	266.0421041	24.78673279	0	20.56826181	0	0.622588687	26.88996022	32.32309611	9515.309118	81.59635801	270.8420428	17.19903808	28.29335117	15.27099173	0.521714974	0	0	254.1734786	5.585315933	159.2669396	3.781494642	0	389.3236488											$230/Days 1-10 for IP Medical; $230/Days 1-10 for IP Surgical;	$230/Days 1-10 for IP Psych; $230/Days 1-10 for IP Substance Abuse;	$150/Days 1-20 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; $50/Case for ER - Worldwide; $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;	$2/Visit for PCP - Office Visits; $2/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;	$15/Visit for OP Psych - Non-Physician; $15/Visit for OP Psych - Psychiatrist; $15/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 Vistion 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 Part B Rx	25% Coinsurance for Blood Products			$25/Exam for Vision (Refractions)	$100 Vision Benefit Maximum	$30/Exam for Routine Hearing Exams	$500 Hearing Benefit Maximum		$15/Service for Acupunture;											230	230	150	0	0.25	0.25	0.25	43.50429296	0.25	0	0.25	0	0.25	0.22145376	0.088182641	19.6783182	15	30	0.25	0.277330993	0.25	0.25	0	0	25	0.715099715	30	0.757591441	0	15											194.1585122	194.1585122	126.6251166	0	0.211041861	0.211041861	0.211041861	36.7249078	0.211041861	0	0.211041861	0	0.211041861	0.186944055	0.074440915	16.61179558	12.66251166	25.32502333	0.211041861	0.234113796	0.211041861	0.211041861	0	0	21.10418611	0.603663899	25.32502333	0.639534031	0	12.66251167											13.1037	0.337030957	1.988224213	0	1.446109015	0.909840787	0.575913552	0.814197645	5.231038217	0	4.340764251	0	0.131392275	5.026918195	2.406160838	13.17219749	0.086101236	0.571590088	3.629717005	6.623863832	3.222818514	0.110103699	0	0	0.447010366	3.371653592	0.336119914	2.41839451	0	0.410817937	0	0	0	0	0	0	0	0	0	0	70.7116	0	13.0533	13.1037	0.337030957	1.988224213	0	1.446109015	0.909840787	0.575913552	0.814197645	5.231038217	0	4.340764251	0	0.131392275	5.026918195	2.406160838	13.17219749	0.086101236	0.571590088	3.629717005	6.623863832	3.222818514	0.110103699	0	0	0.447010366	3.371653592	0.336119914	2.41839451	0	0.410817937	0	0	0	0	0	0	0	0	0	0	70.7116	0																																																																																	0	0	0	13.1037	0.337030957	1.988224213	0	1.446109015	0.909840787	0.575913552	0.814197645	5.231038217	0	4.340764251	0	0.131392275	5.026918195	2.406160838	13.17219749	0.086101236	0.571590088	3.629717005	6.623863832	3.222818514	0.110103699	0	0	0.447010366	3.371653592	0.336119914	2.41839451	0	0.410817937	0	0	0	0	0	0	0	0	0	0	70.7116
H5969_002_0	2009	6																					0											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	272.5228196	23.73674051	32.62875836	0	7.881209384	12.53794521	8.947905988	16.87409312	23.50094477	3.741749122	24.33552541	0	8.405637846	58.31750024	56.93497691	98.50375547	6.672982446	4.414517214	16.95717617	35.56818794	15.05037506	0.813646058	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																			0.071784136	0.071784136	0.163116486	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.071784136	0.071784136	0.163116486	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											19.5628	1.703921417	5.322288422	0	1.820559368	2.896265345	2.066966283	3.897915511	5.428718243	0.864344047	5.62150637	0	1.941702342	13.47134255	13.15197967	22.75436751	1.541458945	1.019753476	3.917107696	8.216251414	3.476636639	0.187952239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.8639	0	0	19.5628	1.703921417	5.322288422	0	1.820559368	2.896265345	2.066966283	3.897915511	5.428718243	0.864344047	5.62150637	0	1.941702342	13.47134255	13.15197967	22.75436751	1.541458945	1.019753476	3.917107696	8.216251414	3.476636639	0.187952239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.8639	0																																																																																	0	0	0	19.5628	1.703921417	5.322288422	0	1.820559368	2.896265345	2.066966283	3.897915511	5.428718243	0.864344047	5.62150637	0	1.941702342	13.47134255	13.15197967	22.75436751	1.541458945	1.019753476	3.917107696	8.216251414	3.476636639	0.187952239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.8639
H5980_005_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	624.2292414	41.79875002	439.3335705	6.457345455	62.4662977	10.80219469	52.36520971	21.35528684	18.9273888	11.69256713	14.56827963	1.138302863	1.787335198	156.7063609	104.3652518	139.4073724	9.902194977	1.14943126	27.4620874	46.80825814	2.899216327	6.924547732	16.25387467	0	0	0	0	0	0	46.41516808											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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0.06789054	0.067896087	0	0	0.230993543	0.231000165	0.23100674	0.231031144	0.231000035	0.230980271	0.23104282	0.231000183	0.231000012	0.231012964	0	0.23100001	0.231010911	0.231033119	0.231019221	0.229837072	0.231005343	0.2309935	0	0	0	0	0	0	0	0											0.06789054	0.067896087	0	0	0.230993543	0.231000165	0.23100674	0.231031144	0.231000035	0.230980271	0.23104282	0.231000183	0.231000012	0.231012964	0	0.23100001	0.231010911	0.231033119	0.231019221	0.229837072	0.231005343	0.2309935	0	0	0	0	0	0	0	0											42.3793	2.837971568	0	0	14.42931141	2.495308756	12.09671638	4.93373635	4.372227472	2.700752325	3.365896412	0.26294817	0.412874453	36.20120092	0	32.20310441	2.287515082	0.265556689	6.344270045	10.75827302	0.669734463	1.599525514	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	180.6162	0	0	42.3793	2.837971568	0	0	14.42931141	2.495308756	12.09671638	4.93373635	4.372227472	2.700752325	3.365896412	0.26294817	0.412874453	36.20120092	0	32.20310441	2.287515082	0.265556689	6.344270045	10.75827302	0.669734463	1.599525514	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	180.6162	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	42.3793	2.837971568	0	0	14.42931141	2.495308756	12.09671638	4.93373635	4.372227472	2.700752325	3.365896412	0.26294817	0.412874453	36.20120092	0	32.20310441	2.287515082	0.265556689	6.344270045	10.75827302	0.669734463	1.599525514	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	180.6162
H5980_006_0	2009	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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	2628.27	269.55	0	0	2505.76	0	0	354.49	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	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											25	25	0	0	50	0	0	49.65894666	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											17.19827888	17.19827888	0	0	34.39655777	0	0	34.16193655	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											3.7668	0.386316339	0	0	7.182459883	0	0	1.009172074	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.3448	0	5.6	3.7668	0.386316339	0	0	7.182459883	0	0	1.009172074	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.3448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.7668	0.386316339	0	0	7.182459883	0	0	1.009172074	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	12.3448
H5980_007_0	2009	7																					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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	2466.28	245.71	0	0	2367.74	0	0	337.08	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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											25	25	0	0	50	0	0	49.65468138	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											17.56373126	17.56373126	0	0	35.12746252	0	0	34.88485919	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											3.6098	0.359632034	0	0	6.931058177	0	0	0.979915695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.8804	0	5.03	3.6098	0.359632034	0	0	6.931058177	0	0	0.979915695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.8804	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.6098	0.359632034	0	0	6.931058177	0	0	0.979915695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	11.8804
H5985_001_0	2009	5																																D	Coin	D	V	T	Coin	Coin	V	V	Coin	Coin	V	P	V	Coin	V	V	V	V	Coin	Coin	P	T	P	P	P	P	P	O	P																																																			0		1172.560776	3.586526232	529.6444068		112.4601791	8.834627597	7.879822846	220.0554398	391.3516376	0.400177159	6.508283465	86.38086639	3.900314806	261.7577431	0.051503961	5182.785062	212.6902535			1.892153699	21.59874059	536.7677261			147.9890135					50											"(1a) $100 Days 1-3, $0 after day 3"	"(1b) $256 Days 61-90, $0 other days; $1024 deductible"	"(2) $75 Days 21-100, $0 other days; (2) 3-day hospital stay requirement waived"	(6) $0 copay	(10a) $100 copay	(11a) 20% coinsurance	(11b) 20% coinsurance; (11c) 20% coinsurance	(4a) $50 copay; (4b) $35 copay	(9a) $250 copay; (9b) $150 copay	(8a) 20% coinsurance in hospital setting; (8a) $0 copay in non-hospital setting	(8b) O/P Diagnostic Radiological Services - Hosp.: 20% coinsurance; (8b) O/P Diagnostic Radiological Services - Non-Hosp.: 0% coinsurance; (8b) X-rays - Hospital Setting: $150 copay; (8b) X-rays - Non-Hospital Setting: $0 copay; (8b) O/P Therapeutic Radiological Services: 20% coinsurance	(9a) $250 copay	(12) $30 copay	(3) $20 copay; (5) $35 copay; (9a) $250 copay; (9d) $20 copay	(14b) $0 copay; (14c) $0 copay:'[H5985001_2009 MA Bid Helper.xls]Cost Share_001'!$21:$21(14d) $0 copay; (14e) $0 copay; (14f) 20% coinsurance in hospital setting; (14f) $25 copay in non-hospital setting; (14g) $0 copay; (14h) $0 copay; (14h) $0 copay; (14i) 20% coinsurance	(7b) $30 copay; (7d) Physician Specialist Services Excluding Psychiatric Services (exclude Radiology) $30 copay; (7f) $10 copay in office setting; (7f) $30 copay in non-office setting; (7g) $30 copay; (14j) $5 copay	(7e) $35 copay; (7h) $35 copay; (9c) $35 copay	(7c) $30 copay; (7i) $30 copay	(7d) Physician Specialist Services Excluding Psychiatric Services (Radiology only) $0 copay	(8b) O/P Therapeutic Radiological Services: 20% coinsurance	(15) 20% coinsurance	(13a) 20% coinsurance; (16b) $0 copay; (17a) $30 copay; (17b) $0 copay; (18a) $30 copay	(10b) $0 copay	(16a) Not Covered	(17a) $10 copay	(17b) Not Covered	(18a) Not Covered	(18b) Not Covered	(14a) $0 copay	(13a) 0% coinsurance; (13c) $15 copay; (14c) $0 copay											44.83556206	0.0706	21.99031904		100	0.2	0.2	47	177.9798802	0.2	0.213248727	250	30	75.76630864	0.195005394	29.15892002	35			0.2	0.2	30.54753413			10					15											44.83556206	0.0706	21.99031904		100	0.2	0.2	47	177.9798802	0.2	0.213248727	250	30	75.76630864	0.195005394	29.15892002	35			0.2	0.2	30.54753413			10					15											4.381	0.253208752	0.970587457	0	0.937168159	1.766925519	1.575964569	0.861883806	5.804393133	0.080035432	1.387883163	1.799601383	0.009750787	1.652701496	0.01004355	12.59370126	0.620346573	0	0	0.37843074	4.319748119	1.366410869	0	0	0.123324178	0	0	0	0	0.0625	0	0	0	0	0	0	0	0	0	0	40.9556	0	0	4.381	0.253208752	0.970587457	0	0.937168159	1.766925519	1.575964569	0.861883806	5.804393133	0.080035432	1.387883163	1.799601383	0.009750787	1.652701496	0.01004355	12.59370126	0.620346573	0	0	0.37843074	4.319748119	1.366410869	0	0	0.123324178	0	0	0	0	0.0625	0	0	0	0	0	0	0	0	0	0	40.9556																																																																																		0	0	0	4.381	0.253208752	0.970587457	0	0.937168159	1.766925519	1.575964569	0.861883806	5.804393133	0.080035432	1.387883163	1.799601383	0.009750787	1.652701496	0.01004355	12.59370126	0.620346573	0	0	0.37843074	4.319748119	1.366410869	0	0	0.123324178	0	0	0	0	0.0625	0	0	0	0	0	0	0	0	0	0	40.9556
H5985_002_0	2009	5																																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																																																			0		370.9373075	13.44084885	29.82883212		20.73196044	9.873534734	4.916051823	32.39805304	34.31163617	4.264000876	8.751441268	5.425020715	49.60328829	6.22985294	37.85196465	88.10850525	4.490245905	3.584558702	36.55586741	64.543963	16.55255179	2.240250115																			Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing		Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Medicare FFS cost sharing	Not offered	Not offered	(17A) No copay	(17B) Frame allowance - $75	(18A) No copay. One per year.	(18B) $500 every two years	(14A) No copay	"(13C) No copay, (14C) No copay"											0.0706	0.0706	0.1444		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.0706	0.0706	0.1444		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			26.1882	0.948923929	4.307283358	0	4.789082863	2.280786523	1.135607971	7.483950252	7.925987955	0.984984202	2.021582933	1.253179785	11.4583596	1.439096029	8.743803835	20.35306471	1.037246804	0.82803306	8.444405372	14.90965545	3.823639463	0.517497777	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.8743	0	0	26.1882	0.948923929	4.307283358	0	4.789082863	2.280786523	1.135607971	7.483950252	7.925987955	0.984984202	2.021582933	1.253179785	11.4583596	1.439096029	8.743803835	20.35306471	1.037246804	0.82803306	8.444405372	14.90965545	3.823639463	0.517497777	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.8743																																																																																		0	0	0	26.1882	0.948923929	4.307283358	0	4.789082863	2.280786523	1.135607971	7.483950252	7.925987955	0.984984202	2.021582933	1.253179785	11.4583596	1.439096029	8.743803835	20.35306471	1.037246804	0.82803306	8.444405372	14.90965545	3.823639463	0.517497777	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.8743
H5989_002_0	2009	7																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	V																																																			0		773.7141189	32.66946136	476.5516642		41.06762698	15.57513832	15.13116946	11.65765824	14.39429643	51.92985709	10.58555151	1.680024006	8.74613957	18.13119958	215.2905325	129.6211628	23.44437526	33.65275487			26.48851462	9.308622434																			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	7a PCP: $0 copay	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																			0.0604	0.0604	0.1595		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	17.41367934	0.231	0.231	0.231			0.231	0.231																			0.0604	0.0604	0.1595		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	17.41367934	0.231	0.231	0.231			0.231	0.231																			46.7323	1.973235466	76.00999044	0	9.486621833	3.597856951	3.495300144	2.692919053	3.325082476	11.99579699	2.445262399	0.388085545	2.020358241	4.188307102	0.312416692	29.9424886	5.415650685	7.773786376	0	0	6.118846877	2.150291782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	220.0646	0	0	46.7323	1.973235466	76.00999044	0	9.486621833	3.597856951	3.495300144	2.692919053	3.325082476	11.99579699	2.445262399	0.388085545	2.020358241	4.188307102	0.312416692	29.9424886	5.415650685	7.773786376	0	0	6.118846877	2.150291782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	220.0646																																																																																		0	0	0	46.7323	1.973235466	76.00999044	0	9.486621833	3.597856951	3.495300144	2.692919053	3.325082476	11.99579699	2.445262399	0.388085545	2.020358241	4.188307102	0.312416692	29.9424886	5.415650685	7.773786376	0	0	6.118846877	2.150291782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	220.0646
H5989_003_0	2009	6																																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																																																			0		427.400179	7.431272745	5947.819207		362.838263		8.94084121	194.8719823	168.806167		761.3530815			1084.971583	7478.136168	3894.695426	749.5890664	1116.078501			851.7063276	712.0889152			147.9890135		0.003651643			38											PBP: 1A IP Acute: $300 per admit	1B IP Psych: $300 per admit	2 SNF: $0 1-10 Days; $50 21-100 Days	6 Home Health: $0	10A Ambulance: $50	11A DME: 0%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: $0 copay"	"4A ER: $50, 4B Urgent Care: $50"	9B ASC Services: $100	8A OP C/D/T: $0	8B OP X-Ray: General Radiology: $100    Radiology - CT/MRI/PET: $100	9A OP Observation: $0	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $0, 9A OP Clinic/Other $25, 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, 7B Chiropractic: $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	15 Part B Drugs: $40	"13A Blood: $0, 17A Medicare Covered Eye Exams: $25"	10B Transportation: 9 Round trips	"16A Preventive Dental Services: Capititaed, 16B Non Medicare Covered Comprehensive Dental: Capititaed"	17A1 Routine Eye Exams: $25	17B Eye Wear: Medicare Covered: $0	18A Routine Hearing Exams: $25	18B Hearing Aids: $1000 every three years	14A Health Education/Wellness Programs: $5	"13B Acupuncture: $25 , 13C OTHER: OTC Drug card - $200 allowance per year"											300	300	14.58198996		50		0.2	50	100		100			25	10	25	25	25			40	25			25		25			25											300	300	14.58198996		50		0.2	50	100		100			25	10	25	25	25			40	25			25		25			25											10.685	0.185781819	7.227586661	0	1.511826096	0	1.788168242	0.811966593	1.406718059	0	6.344609013	0	0	2.260357464	6.23178014	8.113948805	1.561643888	2.325163543	0	0	2.839021092	1.483518573	0	0	0.308310445	0	7.61E-06	0	0	0.079166667	0	0	0	0	0	0	0	0	0	0	55.1646	0	0	10.685	0.185781819	7.227586661	0	1.511826096	0	1.788168242	0.811966593	1.406718059	0	6.344609013	0	0	2.260357464	6.23178014	8.113948805	1.561643888	2.325163543	0	0	2.839021092	1.483518573	0	0	0.308310445	0	7.61E-06	0	0	0.079166667	0	0	0	0	0	0	0	0	0	0	55.1646																																																																																		0	0	0	10.685	0.185781819	7.227586661	0	1.511826096	0	1.788168242	0.811966593	1.406718059	0	6.344609013	0	0	2.260357464	6.23178014	8.113948805	1.561643888	2.325163543	0	0	2.839021092	1.483518573	0	0	0.308310445	0	7.61E-06	0	0	0.079166667	0	0	0	0	0	0	0	0	0	0	55.1646
H5989_004_0	2009	9																																A	A	D	V	T	O	Coin	V	V	P	P	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O																																																			0		302.3243218	16.26533968	781.7929456		242.1778311	1009.706832	5.640104848	229.6502292	192.350383		930.1987027		30.6454605	54.137041	4405.875421	6074.936465	1442.232564	2724.060968			923.5339	1038.354634			147.9890135		255.8976692			38											PBP: 1A IP Acute: $1000 per admit	1B IP Psych: $1000 per admit	2 SNF: $0 1-10 Days; $50 21-100 Days	6 Home Health: $0	10A Ambulance: $50	11A DME: 10%	"11B Prosthetic Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: 10%"	"4A ER: $50, 4B Urgent Care: $20"	9B ASC Services: $200	8A OP C/D/T: $0	8B OP X-Ray: 20%	9A OP Observation: $0	12 Renal Dialysis: 20%	"3 CORF: $20, 5 Partial Hosp: $0, 9C OP Substance Abuse: $20, 9D Cardiac Rehab: $20"	"7A PCP: $5, 14B Immunizations: $5, 14C Routine Physical Exams: $5, 14D Pap Smears: $5, 14D Pelvic Exams: $5, 14E Prostate Screening: $5, 14F Colorectal Screening: $5, 14G Bone Mass Measurement: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	"7D Physician Specialist: $20, 7B Chiropractic: $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	15 Part B Drugs: 20%	"13A Blood: $0, 17A Medicare Covered Eye Exams: $20"	10B Transportation: Not Covered	"16A Preventive Dental Services: Captitaed, 16B Non Medicare Covered Comprehensive Dental: Captitaed"	17A1 Routine Eye Exams: $20	17B Eye Wear: Medicare Covered: $0	18A Routine Hearing Exams: $20	18B Hearing Aids: $1000 every three years	14A Health Education/Wellness Programs: $0	13B Acupuncture: $20											1000	1000	14.58198996		50	10.11498059	0.1	47	200		39.03451713		165.3207298	20	5	20	20	20			46.04415538	20			20		20			20											1000	1000	14.58198996		50	10.11498059	0.1	47	200		39.03451713		165.3207298	20	5	20	20	20			46.04415538	20			20		20			20											25.1937	1.355444973	0.950008073	0	1.009074296	0.851097084	0.564010485	0.899463398	3.205839717	0	3.025821433	0	0.422194158	0.090228402	1.835781425	10.12489411	2.40372094	4.540101613	0	0	3.543611533	1.730591056	0	0	0.246648356	0	0.426496115	0	0	0.063333333	0	0	0	0	0	0	0	0	0	0	62.4821	0	0	25.1937	1.355444973	0.950008073	0	1.009074296	0.851097084	0.564010485	0.899463398	3.205839717	0	3.025821433	0	0.422194158	0.090228402	1.835781425	10.12489411	2.40372094	4.540101613	0	0	3.543611533	1.730591056	0	0	0.246648356	0	0.426496115	0	0	0.063333333	0	0	0	0	0	0	0	0	0	0	62.4821																																																																																		0	0	0	25.1937	1.355444973	0.950008073	0	1.009074296	0.851097084	0.564010485	0.899463398	3.205839717	0	3.025821433	0	0.422194158	0.090228402	1.835781425	10.12489411	2.40372094	4.540101613	0	0	3.543611533	1.730591056	0	0	0.246648356	0	0.426496115	0	0	0.063333333	0	0	0	0	0	0	0	0	0	0	62.4821
H5989_005_0	2009	11																																A	A	D	V	T	O	Coin	V	V	P	P	V	V	V	V	V	V	V	V	V	S	V	T	V	V	V	V	V	V	O																																																			0		302.3243218	16.26533968	781.7929456		242.1778311	1009.706832	5.640104848	229.6502292	192.350383		930.1987027		30.6454605	54.137041		6074.936465	1442.232564	2724.060968			923.5339	1038.354634			147.9890135		255.8976692			48											PBP: 1A IP Acute: $1000 per admit	1B IP Psych: $1000 per admit	2 SNF: $0 1-10 Days; $50 21-100 Days	6 Home Health: $0	10A Ambulance: $50	11A DME: 10%	"11B Prosthetic Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: 10%"	"4A ER: $50, 4B Urgent Care: $20"	9B ASC Services: $200	8A OP C/D/T: $0	8B OP X-Ray: 20%	9A OP Observation: $0	12 Renal Dialysis: 20%	"3 CORF: $20, 5 Partial Hosp: $0, 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, 7B Chiropractic: $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	15 Part B Drugs: 20%	"13A Blood: $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"	17A1 Routine Eye Exams: $20	17B Eye Wear: Medicare Covered: $0	18A Routine Hearing Exams: $20	18B Hearing Aids: $1000 every three years	14A Health Education/Wellness Programs: $0	13B Acupuncture: $20											1000	1000	14.58198996		50	10.11498059	0.1	47	200		39.03451713		165.3207298	20		20	20	20			46.04415538	20			20		20			20											1000	1000	14.58198996		50	10.11498059	0.1	47	200		39.03451713		165.3207298	20		20	20	20			46.04415538	20			20		20			20											25.1937	1.355444973	0.950008073	0	1.009074296	0.851097084	0.564010485	0.899463398	3.205839717	0	3.025821433	0	0.422194158	0.090228402	0	10.12489411	2.40372094	4.540101613	0	0	3.543611533	1.730591056	0	0	0.246648356	0	0.426496115	0	0	0.08	0	0	0	0	0	0	0	0	0	0	60.6629	0	0	25.1937	1.355444973	0.950008073	0	1.009074296	0.851097084	0.564010485	0.899463398	3.205839717	0	3.025821433	0	0.422194158	0.090228402	0	10.12489411	2.40372094	4.540101613	0	0	3.543611533	1.730591056	0	0	0.246648356	0	0.426496115	0	0	0.08	0	0	0	0	0	0	0	0	0	0	60.6629																																																																																		0	0	0	25.1937	1.355444973	0.950008073	0	1.009074296	0.851097084	0.564010485	0.899463398	3.205839717	0	3.025821433	0	0.422194158	0.090228402	0	10.12489411	2.40372094	4.540101613	0	0	3.543611533	1.730591056	0	0	0.246648356	0	0.426496115	0	0	0.08	0	0	0	0	0	0	0	0	0	0	60.6629
H5991_001_0	2009	7																																A	A	D	V	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin																																																											0									558.2775557						85.17908869		8088.959193	1874.533898	3534.411533																														4a ER $50 copay;4b UC $10 copay						5 Partial Hosp $20 copay; 9c OP SA $20 copay; 3 CORF $10 copay		7b Chiro $10 copay; 7d SPC $10 copay;7f Podiatry $10 copay	7e MH $20 copay; 7h Psych $20 copay	7c OT $10 copay; 7i PT/ST $10 copay		7g Prof Other $10 copay																												45.76901773						19.50942182		10	20	10																														45.76901773						19.50942182		10	20	10																							0	0	0	0	0	0	0	2.129317945	0	0	0	0	0	0.138482898	0	6.740799327	3.124223164	2.945342944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.0782	0	0	0	0	0	0	0	0	0	2.129317945	0	0	0	0	0	0.138482898	0	6.740799327	3.124223164	2.945342944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.0782																																																																																		0	0	0	0	0	0	0	0	0	0	2.129317945	0	0	0	0	0	0.138482898	0	6.740799327	3.124223164	2.945342944	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.0782
H5991_002_0	2009	7																																A	A	D	V	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin																																																											0		1116.151973	56.34706085						402.7305735																																	"1a IP Acute $100 per Admit, $300 max"	"1b IP Psych $100 per Admit, $300 max"						4a ER $25 copay																																	87.76	87.76						25																																	87.76	87.76						25																																	8.1628	0.412084838	0	0	0	0	0	0.839022028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.4139	0	0	8.1628	0.412084838	0	0	0	0	0	0.839022028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.4139																																																																																		0	0	0	8.1628	0.412084838	0	0	0	0	0	0.839022028	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.4139
H5992_001_0	2009	8																					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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	339.3661371	0	0	0	0	0	274.379632	0	5985.14431	812.6234106	977.7386893	0	1466.931309	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: $0, 9D Cardiac Rehab: $0, 7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $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, 14J Nutrition Therapy: $0"	7D Physician Specialist (excl. Radiology): $10	"7E Mental Health: $20, 7H Psychiatric: $20, 9C OP Substance Abuse: $20"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	7D Physician Specialist (Radiology): $0	"7B Chiropractic: $10, 7F Podiatry: $10, 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: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0	0	0	0	0	0	0	47.19466952	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	47.19466952	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	1.33468939	0	0	0	0	0	0.228649693	0	4.987620259	1.354372351	0.814782241	0	1.222442757	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.9426	0	0	0	0	0	0	0	0	0	1.33468939	0	0	0	0	0	0.228649693	0	4.987620259	1.354372351	0.814782241	0	1.222442757	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.9426	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	1.33468939	0	0	0	0	0	0.228649693	0	4.987620259	1.354372351	0.814782241	0	1.222442757	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	9.9426
H5992_002_0	2009	7																					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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	547.45	0	0	0	0	0	610.04	0	8937.19	1421.57	1358.51	0	2290.62	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: $0, 9D Cardiac Rehab: $0, 7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $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, 14J Nutrition Therapy: $0"	7D Physician Specialist (excl. Radiology): $10	"7E Mental Health: $20, 7H Psychiatric: $20, 9C OP Substance Abuse: $20"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	7D Physician Specialist (Radiology): $0	"7B Chiropractic: $10, 7F Podiatry: $10, 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: $0"	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0	0	0	0	0	0	0	47.43465157	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	47.43465157	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	2.164008333	0	0	0	0	0	0.508366667	0	7.447658333	2.369283333	1.132091667	0	1.90885	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.5303	0	0	0	0	0	0	0	0	0	2.164008333	0	0	0	0	0	0.508366667	0	7.447658333	2.369283333	1.132091667	0	1.90885	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.5303	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	2.164008333	0	0	0	0	0	0.508366667	0	7.447658333	2.369283333	1.132091667	0	1.90885	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.5303
H5992_003_0	2009	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	O	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	718.43	14.47	920.86	1786.23	186.37	10.49	7.41	228.87	258.08	0	895.39	0	0	253.69	5009.77	7740.98	176.05	798.81	0	1796.74	0	799.81	0	0	444.93	0	189.93	0	0	0											PBP: 1A IP Acute: $150 per days 1-4	1B IP Psych: $150 per days 1-4	2 SNF: $50 for Days 8 - 100	6 Home Health: $20	10A Ambulance: $100 Per Run	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $10"	9B ASC Services: $100	8A OP C/D/T: $0	8B OP X-Ray: $20	9A OP Hospital: $0	12 Renal Dialysis: $0	"3 CORF: $0, 5 Partial Hosp: $0, 9D Cardiac Rehab: $0,7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $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, 14J Nutrition Therapy: $0"	7D Physician Specialist (excl. Radiology): $10	"7E Mental Health: $20, 7H Psychiatric: $20, 9C OP Substance Abuse: $20"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	7D Physician Specialist (Radiology): $0	"7B Chiropractic: $10, 7F Podiatry: $10, 7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $10"	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: $0 copay, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $25	"17B Eye Wear: Medicare Covered: $0, Routine: $100 benefit maximum for hardware every two years"	18A Routine Hearing Exams: $25	18B Hearing Aids: $350 benefit maximum every year	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											150	150	50	20	100	0.199999996	0.199955656	46.96246778	100	0	20	0	0	10	5	10	20	10	0	10	0	10	0	0	25	0	25	0	0	0											150	150	50	20	100	0.199999996	0.199955656	46.96246778	100	0	20	0	0	10	5	10	20	10	0	10	0	10	0	0	25	0	25	0	0	0											8.9804	0.180875	3.836916667	2.97705	1.553083333	2.097999955	1.48167141	0.895691667	2.150666667	0	1.492316667	0	0	0.211408333	2.087404167	6.450816667	0.293416667	0.665675	0	1.497283333	0	0.666508333	0	0	0.9269375	0	0.3956875	0	0	0	0	0	0	0	0	0	0	0	0	0	38.8418	0	0	8.9804	0.180875	3.836916667	2.97705	1.553083333	2.097999955	1.48167141	0.895691667	2.150666667	0	1.492316667	0	0	0.211408333	2.087404167	6.450816667	0.293416667	0.665675	0	1.497283333	0	0.666508333	0	0	0.9269375	0	0.3956875	0	0	0	0	0	0	0	0	0	0	0	0	0	38.8418	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	8.9804	0.180875	3.836916667	2.97705	1.553083333	2.097999955	1.48167141	0.895691667	2.150666667	0	1.492316667	0	0	0.211408333	2.087404167	6.450816667	0.293416667	0.665675	0	1.497283333	0	0.666508333	0	0	0.9269375	0	0.3956875	0	0	0	0	0	0	0	0	0	0	0	0	0	38.8418
H5995_001_0	2009	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		232.3153676	8.858917562	45.6530628	0	26.27835837	27.39222875	4.323868834	44.6353368	30.62289036	9.453638295	14.46584701	0	3.331693584	21.1307031	91.84340497	190.0405628	38.13264	3.735299535	39.50942954	71.49580264	13.67863732	2.199996021	0	0	0	0	0	0	0	0											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	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing											0.0744	0.0744	0.1306	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0744	0.0744	0.1306	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											17.2843	0.659103467	5.962290002	0	6.070300784	6.32760484	0.998813701	10.3107628	7.073887673	2.183790446	3.34161066	0	0.769621218	4.881192416	21.21582655	43.89937	8.808639841	0.862854193	9.126678225	16.51553041	3.15976522	0.508199081	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	169.9601	0	0	17.2843	0.659103467	5.962290002	0	6.070300784	6.32760484	0.998813701	10.3107628	7.073887673	2.183790446	3.34161066	0	0.769621218	4.881192416	21.21582655	43.89937	8.808639841	0.862854193	9.126678225	16.51553041	3.15976522	0.508199081	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	169.9601																																																																																		0	0	0	17.2843	0.659103467	5.962290002	0	6.070300784	6.32760484	0.998813701	10.3107628	7.073887673	2.183790446	3.34161066	0	0.769621218	4.881192416	21.21582655	43.89937	8.808639841	0.862854193	9.126678225	16.51553041	3.15976522	0.508199081	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	169.9601
H5995_002_0	2009	4																					2250											D	D			T			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		533.6181502	10.08797433	0	0	142.0909603	0	0	273.0339002	245.8740524	0	0	0	0	261.9554812	3195.162322	2817.28135	126.5356665	400.6263815	0	1340.651893	5.864332005	0	0	0	265.3484563	0	0	0	0	0											$100/Days Custom for IP Medical; $100/Days Custom for IP Surgical;	$100/Days Custom for IP Psych; $100/Days Custom for IP Substance Abuse;	No Cost Sharing	No Cost Sharing	$50/Run for Ambulance	No Cost Sharing	No Cost Sharing	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $15/Visit for Urgent Care;	$100/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 - 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;	$10/Visit for PCP - Office Visits; $15/Consult for PCP - Consults; $10/Exam for PCP - Routine Physicals;	$10/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;	20% Coinsurance for Part B Rx	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											100	99.99999996	0	0	50	0	0	39.95088083	74.91862035	0	0	0	0	15	10.09130288	10.66111352	14.99999999	15	0	15	0.2	0	0	0	15	0	0	0	0	0											96.47919861	96.47919861	0	0	48.2395993	0	0	38.54428965	72.28088453	0	0	0	0	14.47187979	9.741625707	10.28575689	14.47187978	14.4718798	0	14.47187979	0.192958397	0	0	0	15	0	0	0	0	0											4.2903	0.08110664	0	0	0.571200916	0	0	0.876991478	1.480999499	0	0	0	0	0.315915686	2.593839618	2.414822588	0.152600746	0.483151403	0	1.616812753	1.131572104	0	0	0	0.33168557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.341	0	0.5827	4.2903	0.08110664	0	0	0.571200916	0	0	0.876991478	1.480999499	0	0	0	0	0.315915686	2.593839618	2.414822588	0.152600746	0.483151403	0	1.616812753	1.131572104	0	0	0	0.33168557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.341																																																																																		0	0	0	4.2903	0.08110664	0	0	0.571200916	0	0	0.876991478	1.480999499	0	0	0	0	0.315915686	2.593839618	2.414822588	0.152600746	0.483151403	0	1.616812753	1.131572104	0	0	0	0.33168557	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	16.341
H5995_003_0	2009	2																					2250											D	D			T			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		499.8041607	9.644392299	0	0	131.0372606	0	0	255.4137182	232.2815358	0	0	0	0	242.7553319	2899.641777	2560.440305	115.6472363	371.2175645	0	1244.740373	5.375764863	0	0	0	241.6761636	0	0	0	0	0											$100/Days Custom for IP Medical; $100/Days Custom for IP Surgical;	$100/Days Custom for IP Psych; $100/Days Custom for IP Substance Abuse;	No Cost Sharing	No Cost Sharing	$50/Run for Ambulance	No Cost Sharing	No Cost Sharing	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $15/Visit for Urgent Care;	$100/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 - 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;	$10/Visit for PCP - Office Visits; $15/Consult for PCP - Consults; $10/Exam for PCP - Routine Physicals;	$10/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;	20% Coinsurance for Part B Rx	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											100	99.99999997	0	0	50	0	0	40.27853217	74.91356507	0	0	0	0	15	10.09329557	10.67455845	14.99999999	15	0	15	0.2	0	0	0	15	0	0	0	0	0											96.96817602	96.96817598	0	0	48.48408801	0	0	39.05735798	72.64231764	0	0	0	0	14.5452264	9.792482718	10.35092462	14.5452264	14.54522641	0	14.5452264	0.193936352	0	0	0	15	0	0	0	0	0											4.0388	0.077933261	0	0	0.529435173	0	0	0.831315419	1.406122425	0	0	0	0	0.294244272	2.366224332	2.20857705	0.14017627	0.449953627	0	1.508752545	1.042556227	0	0	0	0.302095205	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.1961	0	0.4644	4.0388	0.077933261	0	0	0.529435173	0	0	0.831315419	1.406122425	0	0	0	0	0.294244272	2.366224332	2.20857705	0.14017627	0.449953627	0	1.508752545	1.042556227	0	0	0	0.302095205	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.1961																																																																																		0	0	0	4.0388	0.077933261	0	0	0.529435173	0	0	0.831315419	1.406122425	0	0	0	0	0.294244272	2.366224332	2.20857705	0.14017627	0.449953627	0	1.508752545	1.042556227	0	0	0	0.302095205	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.1961
H5996_001_0	2009	5																					3250											D	D	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	V											0	0	0	0	0	0	0	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	1088.573801	34.64365079	677.0074936	16.68431782	366.0706692	12.21977021	6.958603563	445.8596536	484.9889724	7.651996999	30.49259664	0	0.344878908	702.6515708	5113.569808	7604.189533	255.4598812	1092.787224	17.98332866	26.81623062	24.86637736	0	0	0	0	0	0	0	12000	0											1a:  Acute - $200/$0/day for 1-6/7-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $200/$0/day for 1-5/6-190	2:  Skilled Nursing Services - $0/$100/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $75/visit/9b:  Ambulatory Surgical Center Services - $75/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $20/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $10 to $50/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	200	100	0	100	0.3	0.261462646	49.99999978	75	0	0.249868517	0	0	20	10.0061896	20	50	20	0	50	0.2	0	0	0	0	0	0	0	0	0											163.4610925	163.4610925	81.73054625	0	81.73054625	0.245191639	0.213694849	40.86527294	61.29790969	0	0.204218904	0	0	16.34610925	8.17811342	16.34610925	40.86527312	16.34610925	0	40.86527312	0.163461092	0	0	0	0	0	0	0	0	0											14.8283	0.471907417	4.611016022	0	2.49326298	2.996185483	1.487017737	1.518348037	2.477400853	0	6.227164664	0	0	0.957134945	3.484946156	10.35824274	0.869953151	1.488568279	0	0.091321049	4.06468521	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.4254	0	13.06	14.8283	0.471907417	4.611016022	0	2.49326298	2.996185483	1.487017737	1.518348037	2.477400853	0	6.227164664	0	0	0.957134945	3.484946156	10.35824274	0.869953151	1.488568279	0	0.091321049	4.06468521	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.4254																																																																																		0			14.8283	0.471907417	4.611016022	0	2.49326298	2.996185483	1.487017737	1.518348037	2.477400853	0	6.227164664	0	0	0.957134945	3.484946156	10.35824274	0.869953151	1.488568279	0	0.091321049	4.06468521	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.4254
H5996_002_0	2009	6																					3350											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	V											0	0	0	0	0	0	0	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	486.1565868	11.7965097	526.5893889	40.63902611	577.6181607	19.38039659	11.0362553	455.5098356	623.2353341	6.05070825	30.76077975	0	0.429690968	649.2710812	6513.149088	9182.648807	313.4151096	1266.219523	37.03061002	32.89992863	30.45858496	0	0	1790.201423	367.5	0	0	0	12500	0											1a:  Acute - $400/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $1024/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$120/day for 1-17/18-100/2:  Non-Medicare Covered Stay - $0/$120/day for 1-17/18-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $115/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $125/visit/9b:  Ambulatory Surgical Center Services - $125/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $20/day	7a:  Primary Care - $5/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $20/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $20/visit/7h:  Psychiatric Services - Individual - $20/visit/7h:  Psychiatric Services - Group - $20/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $20/visit/9c:  Outpatient Substance Abuse Svcs - Group - $20/visit/7g:  Other Health Care Professional Services - $5 to $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		"16a:  Preventive Dental - Oral Exams - $50 ded, $500 annual max/16a:  Preventive Dental - Prophylaxis - $50 ded, $500 annual max/16a:  Preventive Dental - X-Rays - $50 ded, $500 annual max/16b:  Comprehensive Dental - Restorative Svcs - $50 ded, $500 annual max/visit"	17a:  Routine Eye Exams - $15/visit	17b:  Wear - $100 every other year (contact lenses and eyeglasses)			14b:  Other Immunizations - $0/visit/14a:  Membership in Health Club/Fitness Classes - $0/service/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												400	1024	120	0	115	0.3	0.261462648	49.99999972	125	0	0.23816101	0	0.2	20	5.00892032	20	20	20	0	20	0.2	0	0	28.60003113	8.571428571	0	0	0	0	0											321.6909133	823.5287381	96.50727399	0	92.48613758	0.241268185	0.210275395	40.21136394	100.5284104	0	0.191535582	0	0.160845457	16.08454567	4.028310381	16.08454567	16.08454567	16.08454567	0	16.08454567	0.160845457	0	0	28.60003113	8.571428571	0	0	0	0	0											13.0327	0.809563729	4.234975537	0	4.451806057	4.675873109	2.320652944	1.526389315	5.221071454	0	5.891783851	0	0.06911384	0.870269196	2.186415507	12.30822784	0.42009497	1.697213812	0	0.044098367	4.899125007	0	0	4.26665137	0.2625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1885	0	15.74	13.0327	0.809563729	4.234975537	0	4.451806057	4.675873109	2.320652944	1.526389315	5.221071454	0	5.891783851	0	0.06911384	0.870269196	2.186415507	12.30822784	0.42009497	1.697213812	0	0.044098367	4.899125007	0	0	4.26665137	0.2625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1885																																																																																		0			13.0327	0.809563729	4.234975537	0	4.451806057	4.675873109	2.320652944	1.526389315	5.221071454	0	5.891783851	0	0.06911384	0.870269196	2.186415507	12.30822784	0.42009497	1.697213812	0	0.044098367	4.899125007	0	0	4.26665137	0.2625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1885
H5996_003_0	2009	4																					3250											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	V											0	0	0	0	0	0	0	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	261.8926004	6.354780925	900.816629	16.8423906	379.9014264	13.38398575	7.621571775	497.8418757	838.4919936	12.23049235	25.77712057	0	0.505607969	698.5307313	5281.440335	8059.094116	301.8927198	1247.387975	37.37130739	31.69039601	29.25285848	0	0	0	0	0	0	0	12000	0											1a:  Acute - $200/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $200/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $75/visit/9b:  Ambulatory Surgical Center Services - $75/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	200	75	0	100	0.2	0.2	49.99999965	75	0	0.237896097	0	0.2	20	10.00618943	20	25	20	0	25	0.2	0	0	0	0	0	0	0	0	0											172.1353687	172.1353687	64.55076325	0	86.06768434	0.172135369	0.172135369	43.03384187	64.55076325	0	0.204751661	0	0.172135369	17.21353687	8.612095536	17.21353687	21.51692108	17.21353687	0	21.51692108	0.172135369	0	0	0	0	0	0	0	0	0											3.7567	0.09115688	4.845700079	0	2.724769671	2.303857322	1.311942067	1.78533738	4.510441514	0	5.277908265	0	0.087033014	1.002015375	3.790355728	11.56045947	0.541316819	1.789329908	0	0.056823312	5.035451579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4706	0	8.17	3.7567	0.09115688	4.845700079	0	2.724769671	2.303857322	1.311942067	1.78533738	4.510441514	0	5.277908265	0	0.087033014	1.002015375	3.790355728	11.56045947	0.541316819	1.789329908	0	0.056823312	5.035451579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4706																																																																																		0			3.7567	0.09115688	4.845700079	0	2.724769671	2.303857322	1.311942067	1.78533738	4.510441514	0	5.277908265	0	0.087033014	1.002015375	3.790355728	11.56045947	0.541316819	1.789329908	0	0.056823312	5.035451579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4706
H5996_005_0	2009	4																					3350											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	V											0	0	0	0	0	0	0	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	216.134546	5.244469243	362.8744573	15.18563967	365.3774104	14.90586035	8.488210213	427.5621062	492.630935	6.421110754	20.56390134	0	0.242987809	978.6993612	3736.53113	5198.534964	169.8588924	686.2421095	19.1639706	17.83049147	18.12771827	0	0	1790.201423	367.5	0	0	0	12500	0											1a:  Acute - $400/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $1024/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$120/day for 1-17/18-100/2:  Non-Medicare Covered Stay - $0/$120/day for 1-17/18-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $115/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $125/visit/9b:  Ambulatory Surgical Center Services - $125/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $20/day	7a:  Primary Care - $5/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $20/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $20/visit/7h:  Psychiatric Services - Individual - $20/visit/7h:  Psychiatric Services - Group - $20/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $20/visit/9c:  Outpatient Substance Abuse Svcs - Group - $20/visit/7g:  Other Health Care Professional Services - $5 to $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		"16a:  Preventive Dental - Oral Exams - $50 ded, $500 annual max/16a:  Preventive Dental - Prophylaxis - $50 ded, $500 annual max/16a:  Preventive Dental - X-Rays - $50 ded, $500 annual max/16b:  Comprehensive Dental - Restorative Svcs - $50 ded, $500 annual max/visit"	17a:  Routine Eye Exams - $15/visit	17b:  Wear - $100 every other year (contact lenses and eyeglasses)			14b:  Other Immunizations - $0/visit/14a:  Membership in Health Club/Fitness Classes - $0/service/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												400	1024	120	0	115	0.3	0.261462648	49.99999972	125	0	0.240920688	0	0.2	20	5.008920439	20	20	20	0	20	0.2	0	0	28.60003113	8.571428571	0	0	0	0	0											359.4646948	920.2296188	107.8394085	0	103.3460998	0.269598521	0.234966477	44.9330866	112.3327171	0	0.216506204	0	0.179732347	17.97323474	4.501325143	17.97323474	17.97323474	17.97323474	0	17.97323474	0.179732347	0	0	28.60003113	8.571428571	0	0	0	0	0											6.4744	0.402176328	3.261013901	0	3.146694193	4.018597908	1.994444854	1.600973762	4.611547623	0	4.452212226	0	0.043672769	1.465866113	1.401611793	7.786207435	0.254409479	1.027832544	0	0.026705967	3.258137359	0	0	4.26665137	0.2625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.7557	0	5.1	6.4744	0.402176328	3.261013901	0	3.146694193	4.018597908	1.994444854	1.600973762	4.611547623	0	4.452212226	0	0.043672769	1.465866113	1.401611793	7.786207435	0.254409479	1.027832544	0	0.026705967	3.258137359	0	0	4.26665137	0.2625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.7557																																																																																		0			6.4744	0.402176328	3.261013901	0	3.146694193	4.018597908	1.994444854	1.600973762	4.611547623	0	4.452212226	0	0.043672769	1.465866113	1.401611793	7.786207435	0.254409479	1.027832544	0	0.026705967	3.258137359	0	0	4.26665137	0.2625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.7557
H5996_006_0	2009	6																					2200											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	V											0	0	0	0	0	0	0	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	215.9575344	5.240174082	709.2601381	15.38860656	216.0909523	11.46412629	6.528299047	363.7882617	525.5486605	7.13331906	14.69630259	0	0.415665308	403.6796651	4095.955622	6317.802123	243.601886	1006.53657	33.4756496	25.5714687	19.83711025	0	0	0	0	0	0	0	12000	0											1a:  Acute - $200/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $200/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $75/visit/9b:  Ambulatory Surgical Center Services - $75/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	200	75	0	100	0.3	0.3	49.99999965	75	0	0.236302002	0	0.2	20	10.00618936	20	25	20	0	25	0.2	0	0	0	0	0	0	0	0	0											163.3691333	163.3691333	61.26342499	0	81.68456665	0.2450537	0.2450537	40.84228304	61.26342499	0	0.193022267	0	0.163369133	16.33691333	8.173512419	16.33691333	20.42114166	16.33691333	0	20.42114166	0.163369133	0	0	0	0	0	0	0	0	0											2.9401	0.071340225	3.620975439	0	1.470941316	2.809326565	1.599783836	1.238161929	2.683075912	0	2.836713639	0	0.067906881	0.549573309	2.789862012	8.601115478	0.414552385	1.370308393	0	0.043516549	3.24077151	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.348	0	8.15	2.9401	0.071340225	3.620975439	0	1.470941316	2.809326565	1.599783836	1.238161929	2.683075912	0	2.836713639	0	0.067906881	0.549573309	2.789862012	8.601115478	0.414552385	1.370308393	0	0.043516549	3.24077151	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.348																																																																																		0			2.9401	0.071340225	3.620975439	0	1.470941316	2.809326565	1.599783836	1.238161929	2.683075912	0	2.836713639	0	0.067906881	0.549573309	2.789862012	8.601115478	0.414552385	1.370308393	0	0.043516549	3.24077151	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.348
H5996_007_0	2009	3																					1500											coin	coin	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	361.1872675	7.822202444	1000.127357	34.92174512	493.2372388	17.34903905	9.879489463	467.4999896	55.15418376	6.257864306	24.61309754	0	0.503394354	852.7178532	5872.337749	9808.792205	389.3877514	1638.702546	40.00599565	40.87495733	31.02234751	0	0	1790.201423	367.5	0	0	0	12500	0											1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $0/admit for 1-190	2:  Skilled Nursing Services - $0/$75/day for 1-8/9-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-8/9-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - 25.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 25.0%/8b:  Outpatient Therapeutic Radiological Services - 25.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $5/visit/3:  Rehab Services (CORF) - $5/day/5:  Partial Hospitalization - $10/day	7a:  Primary Care - $5/visit/17a:  Vision Exams - $5/visit/18a:  Hearing Exams - $5/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $5/visit/7b:  Chiropractic Services - $5/visit/7f:  Podiatry Services - $5/visit/17a:  Vision Exams - $5/visit/18a:  Hearing Exams - $5/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $10/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $10/visit/7h:  Psychiatric Services - Individual - $10/visit/7h:  Psychiatric Services - Group - $10/visit	7c:  Occupational Therapy Services - $5/visit/7i:  Physical/Speech Therapy - $5/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $10/visit/9c:  Outpatient Substance Abuse Svcs - Group - $10/visit/7g:  Other Health Care Professional Services - $5 to $10/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		"16a:  Preventive Dental - Oral Exams - $50 ded, $500 annual max/16a:  Preventive Dental - Prophylaxis - $50 ded, $500 annual max/16a:  Preventive Dental - X-Rays - $50 ded, $500 annual max/16b:  Comprehensive Dental - Restorative Svcs - $50 ded, $500 annual max/visit"	17a:  Routine Eye Exams - $15/visit	17b:  Wear - $100 every other year (contact lenses and eyeglasses)			14b:  Other Immunizations - $0/visit/14a:  Membership in Health Club/Fitness Classes - $0/service/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												0	0	75	0	100	0.25	0.25	50	0	0	0.204573988	0	0.2	5	5	5	10	5	0	10	0.2	0	0	28.60003113	8.571428571	0	0	0	0	0											0	0	58.27556683	0	77.70075577	0.194251889	0.194251889	38.85037788	0	0	0.158955535	0	0.155401512	3.885037788	3.885037788	3.885037788	7.770075577	3.885037788	0	7.770075577	0.155401512	0	0	28.60003113	8.571428571	0	0	0	0	0											0	0	4.85691572	0	3.193742185	3.370083616	1.919109495	1.513545938	0	0	3.912388086	0	0.078228243	0.27607009	1.901187838	3.175627364	0.252131021	0.53053511	0	0.026466792	4.820919694	0	0	4.26665137	0.2625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.3561	0	8.56	0	0	4.85691572	0	3.193742185	3.370083616	1.919109495	1.513545938	0	0	3.912388086	0	0.078228243	0.27607009	1.901187838	3.175627364	0.252131021	0.53053511	0	0.026466792	4.820919694	0	0	4.26665137	0.2625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.3561																																																																																		0			0	0	4.85691572	0	3.193742185	3.370083616	1.919109495	1.513545938	0	0	3.912388086	0	0.078228243	0.27607009	1.901187838	3.175627364	0.252131021	0.53053511	0	0.026466792	4.820919694	0	0	4.26665137	0.2625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.3561
H5996_011_0	2009	6																					5000											D	D	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	V											0	0	0	0	0	0	0	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	1077.965046	39.03456597	472.9989843	16.4667013	377.5944842	13.10580585	7.463160961	428.5128318	583.410982	5.843994402	23.8633379	0	0.353272137	665.7031044	4713.777438	6868.249514	227.4552502	918.9355251	26.5012818	23.87651798	21.68379334	0	0	0	0	0	0	0	12000	0											1a:  Acute - $250/$0/day for 1-6/7-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/$0/day for 1-6/7-190	2:  Skilled Nursing Services - $0/$100/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $150/visit/9b:  Ambulatory Surgical Center Services - $150/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - $35/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $40/visit/3:  Rehab Services (CORF) - $40/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $40/visit/7b:  Chiropractic Services - $40/visit/7f:  Podiatry Services - $40/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $40/visit/7i:  Physical/Speech Therapy - $40/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $20 to $50/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												250	250	100	0	100	0.2	0.2	49.99999989	150	0	0.207936324	0	0	40	20.01245664	40	50	40	0	50	0.2	0	0	0	0	0	0	0	0	0											216.9617641	216.9617641	86.78470565	0	86.78470565	0.173569411	0.173569411	43.39235273	130.1770585	0	0.180456926	0	0	34.71388226	17.36905401	34.94905048	43.39235282	34.71388226	0	43.39235282	0.173569411	0	0	0	0	0	0	0	0	0											19.4898	0.705750691	3.420756469	0	2.730785514	2.274767005	1.295376454	1.549514996	6.328893793	0	4.306304611	0	0	1.925761599	6.822821241	20.00323324	0.822484872	2.658318302	0	0.086338191	3.763643245	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.1845	0	11.75	19.4898	0.705750691	3.420756469	0	2.730785514	2.274767005	1.295376454	1.549514996	6.328893793	0	4.306304611	0	0	1.925761599	6.822821241	20.00323324	0.822484872	2.658318302	0	0.086338191	3.763643245	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.1845																																																																																		0			19.4898	0.705750691	3.420756469	0	2.730785514	2.274767005	1.295376454	1.549514996	6.328893793	0	4.306304611	0	0	1.925761599	6.822821241	20.00323324	0.822484872	2.658318302	0	0.086338191	3.763643245	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.1845
H5996_012_0	2009	6																					5000											D	D	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	V											0	0	0	0	0	0	0	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	1103.556723	39.96127507	483.4902861	17.21393283	412.3484607	13.95900591	7.949019633	449.2478371	604.3476493	6.684635988	24.97496031	0	0.365370861	722.2605151	4789.45482	6994.594772	233.4108293	942.9964919	26.18362023	24.50168927	23.42346844	0	0	0	0	0	0	0	12000	0											1a:  Acute - $250/$0/day for 1-6/7-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/$0/day for 1-6/7-190	2:  Skilled Nursing Services - $0/$100/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $150/visit/9b:  Ambulatory Surgical Center Services - $150/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - $35/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $40/visit/3:  Rehab Services (CORF) - $40/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $40/visit/7b:  Chiropractic Services - $40/visit/7f:  Podiatry Services - $40/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $40/visit/7i:  Physical/Speech Therapy - $40/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $20 to $50/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												250	250	100	0	100	0.2	0.2	49.99999989	150	0	0.208130521	0	0	40	20.01245661	40	50	40	0	50	0.2	0	0	0	0	0	0	0	0	0											215.0876113	215.0876113	86.03504452	0	86.03504452	0.172070089	0.172070089	43.01752217	129.0525668	0	0.179065186	0	0	34.41401781	17.21908573	34.66094847	43.01752226	34.41401781	0	43.01752226	0.172070089	0	0	0	0	0	0	0	0	0											19.7801	0.7162646	3.466425691	0	2.956368181	2.40192739	1.367788516	1.610460733	6.499384615	0	4.472145918	0	0	2.071323852	6.872502762	20.20327408	0.836729629	2.704358172	0	0.087833497	4.030478301	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.0774	0	12.83	19.7801	0.7162646	3.466425691	0	2.956368181	2.40192739	1.367788516	1.610460733	6.499384615	0	4.472145918	0	0	2.071323852	6.872502762	20.20327408	0.836729629	2.704358172	0	0.087833497	4.030478301	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.0774																																																																																		0			19.7801	0.7162646	3.466425691	0	2.956368181	2.40192739	1.367788516	1.610460733	6.499384615	0	4.472145918	0	0	2.071323852	6.872502762	20.20327408	0.836729629	2.704358172	0	0.087833497	4.030478301	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.0774
H5996_013_0	2009	6																					4000											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	V											0	0	0	0	0	0	0	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	216.134546	5.244469244	362.8744572	15.18563968	363.6023732	14.90586035	8.488210217	427.5621061	485.090666	6.421110757	20.56390135	0	0.242987809	971.1891483	3479.744682	5089.699839	166.0842505	670.9922845	18.89190077	17.43425834	18.12771828	0	0	0	0	0	0	0	12000	0											1a:  Acute - $450/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $1024/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$120/day for 1-17/18-100/2:  Non-Medicare Covered Stay - $0/$120/day for 1-17/18-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - 25.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $225/visit/9b:  Ambulatory Surgical Center Services - $225/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 25.0%/8b:  Outpatient Therapeutic Radiological Services - 25.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $35/visit/3:  Rehab Services (CORF) - $35/day/5:  Partial Hospitalization - $35/day	7a:  Primary Care - $15/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $35/visit/7b:  Chiropractic Services - $35/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $35/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $35/visit/7h:  Psychiatric Services - Individual - $35/visit/7h:  Psychiatric Services - Group - $35/visit	7c:  Occupational Therapy Services - $35/visit/7i:  Physical/Speech Therapy - $35/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $35/visit/9c:  Outpatient Substance Abuse Svcs - Group - $35/visit/7g:  Other Health Care Professional Services - $15 to $35/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												450	1024	120	0	150	0.25	0.25	49.99999984	225	0	0.205540902	0	0.2	35	15.01248781	35	35	35	0	35	0.2	0	0	0	0	0	0	0	0	0											400.6959433	911.8058798	106.8522515	0	133.5653144	0.222608857	0.222608857	44.52177133	200.3479716	0	0.183020902	0	0.178087086	31.16524003	13.36843245	31.30066362	31.16524003	31.16524003	0	31.16524003	0.178087086	0	0	0	0	0	0	0	0	0											7.217	0.398494824	3.231162732	0	4.047055442	3.318176542	1.889550778	1.586318526	8.098910916	0	3.763623766	0	0.043272991	2.522278577	3.876560978	13.27591521	0.431337961	1.742636301	0	0.045278571	3.228312523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.7159	0	7.16	7.217	0.398494824	3.231162732	0	4.047055442	3.318176542	1.889550778	1.586318526	8.098910916	0	3.763623766	0	0.043272991	2.522278577	3.876560978	13.27591521	0.431337961	1.742636301	0	0.045278571	3.228312523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.7159																																																																																		0			7.217	0.398494824	3.231162732	0	4.047055442	3.318176542	1.889550778	1.586318526	8.098910916	0	3.763623766	0	0.043272991	2.522278577	3.876560978	13.27591521	0.431337961	1.742636301	0	0.045278571	3.228312523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.7159
H5996_014_0	2009	4																					3350											D	D	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	V											0	0	0	0	0	0	0	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	1256.389174	54.82839537	713.0851181	16.77640694	399.8447833	12.79085003	7.283807935	408.8817329	543.4737574	5.653522773	28.33244407	0	0.304568192	638.573215	5097.976421	7240.381775	205.1134952	857.920523	24.52501131	21.53125088	33.47959443	0	0	0	0	0	0	0	12000	0											1a:  Acute - $250/day for 1-12/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/day for 1-12	2:  Skilled Nursing Services - $0/$100/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $30/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $30/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - $15/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $30/visit/7f:  Podiatry Services - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $15 to $50/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												250	250	100	0	150	0.3	0.3	49.99999984	100	0	0.26307867	0	0	30	15.00936614	30	50	30	0	50	0.2	0	0	0	0	0	0	0	0	0											193.11122	193.11122	77.24448799	0	115.866732	0.231733464	0.231733464	38.62224387	77.24448799	0	0.203213771	0	0	23.1733464	11.59488648	23.32243864	38.62224399	23.1733464	0	38.62224399	0.154488976	0	0	0	0	0	0	0	0	0											20.2186	0.882331527	4.590157903	0	3.860725695	2.964067985	1.687902043	1.315994167	3.498362677	0	5.75754281	0	0	1.233156526	4.925871488	14.07194664	0.660161955	1.656740788	0	0.069298769	5.172228259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.5651	0	21.26	20.2186	0.882331527	4.590157903	0	3.860725695	2.964067985	1.687902043	1.315994167	3.498362677	0	5.75754281	0	0	1.233156526	4.925871488	14.07194664	0.660161955	1.656740788	0	0.069298769	5.172228259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.5651																																																																																		0			20.2186	0.882331527	4.590157903	0	3.860725695	2.964067985	1.687902043	1.315994167	3.498362677	0	5.75754281	0	0	1.233156526	4.925871488	14.07194664	0.660161955	1.656740788	0	0.069298769	5.172228259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.5651
H5996_015_0	2009	6																					5000											D	D	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	V											0	0	0	0	0	0	0	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	1109.538276	40.17787516	481.0255564	19.45165981	477.686769	14.73898326	8.393181295	498.896001	617.2874046	6.948142994	28.92936229	0	0.367556399	744.1798711	4930.27166	7170.824451	236.0577299	953.6901601	27.12133823	24.77954071	24.0106965	0	0	0	0	0	0	0	12000	0											1a:  Acute - $250/$0/day for 1-6/7-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/$0/day for 1-6/7-190	2:  Skilled Nursing Services - $0/$100/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $150/visit/9b:  Ambulatory Surgical Center Services - $150/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - $35/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $40/visit/3:  Rehab Services (CORF) - $40/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $40/visit/7b:  Chiropractic Services - $40/visit/7f:  Podiatry Services - $40/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $40/visit/7i:  Physical/Speech Therapy - $40/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $20 to $50/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												250	250	100	0	100	0.2	0.2	49.99999989	150	0	0.206067885	0	0	40	20.01245666	40	50	40	0	50	0.2	0	0	0	0	0	0	0	0	0											213.5036297	213.5036297	85.40145189	0	85.40145189	0.170802904	0.170802904	42.70072586	128.1021778	0	0.175984965	0	0	34.16058076	17.09236176	34.41780135	42.70072595	34.16058076	0	42.70072595	0.170802904	0	0	0	0	0	0	0	0	0											19.7409	0.714843515	3.423356743	0	3.399595302	2.51746114	1.433579737	1.775268447	6.589655073	0	5.091132818	0	0	2.118468049	7.0224989	20.56700096	0.839986369	2.714884144	0	0.088175365	4.101096685	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1379	0	13.86	19.7409	0.714843515	3.423356743	0	3.399595302	2.51746114	1.433579737	1.775268447	6.589655073	0	5.091132818	0	0	2.118468049	7.0224989	20.56700096	0.839986369	2.714884144	0	0.088175365	4.101096685	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1379																																																																																		0			19.7409	0.714843515	3.423356743	0	3.399595302	2.51746114	1.433579737	1.775268447	6.589655073	0	5.091132818	0	0	2.118468049	7.0224989	20.56700096	0.839986369	2.714884144	0	0.088175365	4.101096685	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.1379
H5996_016_0	2009	5																					3350											D	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	V											0	0	0	0	0	0	0	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	1337.02628	8.192600023	465.2195385	34.60738153	332.2022188	13.96062027	7.949938937	347.0022148	403.7948311	7.745395658	28.18893503	0	0.34624665	578.9356827	4278.35166	6121.481046	212.0900255	856.8589153	22.00415396	22.26359384	24.87528991	0	0	0	0	0	0	0	12000	0											1a:  Acute - $225/$0/day for 1-10/11-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $1024/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$120/day for 1-17/18-100/2:  Non-Medicare Covered Stay - $0/$120/day for 1-17/18-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $175/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $150/visit/9b:  Ambulatory Surgical Center Services - $150/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $25/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $40/visit/3:  Rehab Services (CORF) - $40/day/5:  Partial Hospitalization - $40/day	7a:  Primary Care - $15/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $40/visit/7b:  Chiropractic Services - $40/visit/7f:  Podiatry Services - $40/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $40/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $40/visit/7h:  Psychiatric Services - Individual - $40/visit/7h:  Psychiatric Services - Group - $40/visit	7c:  Occupational Therapy Services - $40/visit/7i:  Physical/Speech Therapy - $40/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $40/visit/9c:  Outpatient Substance Abuse Svcs - Group - $40/visit/7g:  Other Health Care Professional Services - $15 to $40/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												225	1024	120	0	175	0.3	0.3	50	150	0	0.25409474	0	0.2	40	15.01507767	40	40	40	0	40	0.2	0	0	0	0	0	0	0	0	0											174.5335076	794.3213855	93.08453737	0	135.7482837	0.232711343	0.232711343	38.7852239	116.3556717	0	0.197102427	0	0.155140896	31.02817912	11.64923632	31.40843248	31.02817912	31.02817912	0	31.02817912	0.155140896	0	0	0	0	0	0	0	0	0											19.4463	0.54229645	3.608728793	0	3.757990086	3.248794698	1.85004097	1.12154655	3.915318234	0	5.556107519	0	0.053717015	1.496943339	4.153294129	16.02217701	0.548397275	2.215564326	0	0.057566565	3.859174756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.454	0	20.41	19.4463	0.54229645	3.608728793	0	3.757990086	3.248794698	1.85004097	1.12154655	3.915318234	0	5.556107519	0	0.053717015	1.496943339	4.153294129	16.02217701	0.548397275	2.215564326	0	0.057566565	3.859174756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.454																																																																																		0			19.4463	0.54229645	3.608728793	0	3.757990086	3.248794698	1.85004097	1.12154655	3.915318234	0	5.556107519	0	0.053717015	1.496943339	4.153294129	16.02217701	0.548397275	2.215564326	0	0.057566565	3.859174756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.454
H5996_017_0	2009	5																					2200											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	V											0	0	0	0	0	0	0	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	214.4526626	5.203658621	676.3358973	16.48074293	269.1391165	11.51768433	6.558797915	394.5482303	584.6444338	8.923530266	28.90481633	0	0.583710108	491.3688693	4591.951051	7286.118351	301.5543446	1245.989844	33.20054083	31.65487595	18.57279645	0	0	0	0	0	0	0	12000	0											1a:  Acute - $200/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $200/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $75/visit/9b:  Ambulatory Surgical Center Services - $75/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	200	75	0	100	0.3	0.3	49.99999965	75	0	0.235869924	0	0.2	20	10.00618917	20	25	20	0	25	0.2	0	0	0	0	0	0	0	0	0											157.4644538	157.4644538	59.04917017	0	78.7322269	0.236196681	0.236196681	39.36611317	59.04917017	0	0.185705644	0	0.157464454	15.74644538	7.878095562	15.74644538	19.68305672	15.74644538	0	19.68305672	0.157464454	0	0	0	0	0	0	0	0	0											2.8141	0.068282605	3.328089458	0	1.765826832	2.720438808	1.549166297	1.29431919	2.876897389	0	5.367787534	0	0.091913593	0.644776088	3.014652433	9.560872054	0.494625939	1.634992586	0	0.05192206	2.924555249	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2032	0	10.86	2.8141	0.068282605	3.328089458	0	1.765826832	2.720438808	1.549166297	1.29431919	2.876897389	0	5.367787534	0	0.091913593	0.644776088	3.014652433	9.560872054	0.494625939	1.634992586	0	0.05192206	2.924555249	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2032																																																																																		0			2.8141	0.068282605	3.328089458	0	1.765826832	2.720438808	1.549166297	1.29431919	2.876897389	0	5.367787534	0	0.091913593	0.644776088	3.014652433	9.560872054	0.494625939	1.634992586	0	0.05192206	2.924555249	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.2032
H5996_018_0	2009	9																					2200											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	V											0	0	0	0	0	0	0	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	257.3812436	6.245313584	740.6242783	14.63242841	327.3999993	15.03871148	8.563862896	419.6640715	570.6086384	11.34657346	22.67536629	0	0.427942629	443.1200682	4977.468246	7385.877947	255.2085748	1054.49415	32.6858678	26.78985039	21.51348515	0	0	0	0	0	0	0	12000	0											1a:  Acute - $200/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $200/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $75/visit/9b:  Ambulatory Surgical Center Services - $75/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	200	75	0	100	0.3	0.3	49.99999965	75	0	0.237785136	0	0.2	20	10.00618961	20	25	20	0	25	0.2	0	0	0	0	0	0	0	0	0											155.003321	155.003321	58.12624538	0	77.50166051	0.232504982	0.232504982	38.75082998	58.12624538	0	0.184287429	0	0.155003321	15.5003321	7.754963105	15.5003321	19.37541513	15.5003321	0	19.37541513	0.155003321	0	0	0	0	0	0	0	0	0											3.3246	0.080670362	3.587475711	0	2.114503633	3.496575334	1.991140784	1.355194257	2.763944811	0	4.178784961	0	0.066332529	0.572375685	3.216673551	9.540296754	0.41206434	1.362084127	0	0.043255373	3.334661644	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.4406	0	12.03	3.3246	0.080670362	3.587475711	0	2.114503633	3.496575334	1.991140784	1.355194257	2.763944811	0	4.178784961	0	0.066332529	0.572375685	3.216673551	9.540296754	0.41206434	1.362084127	0	0.043255373	3.334661644	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.4406																																																																																		0			3.3246	0.080670362	3.587475711	0	2.114503633	3.496575334	1.991140784	1.355194257	2.763944811	0	4.178784961	0	0.066332529	0.572375685	3.216673551	9.540296754	0.41206434	1.362084127	0	0.043255373	3.334661644	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.4406
H5996_019_0	2009	6																					4500											D	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	V											0	0	0	0	0	0	0	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	985.4314908	6.422364233	452.5654731	17.65512452	401.365297	16.8894277	9.617761694	441.133665	546.1754747	8.282758104	24.20011323	0	0.315441496	810.8247468	3916.484263	5773.617597	198.5936276	802.3324996	26.13545964	20.84684488	16.13513585	0	0	0	0	0	0	0	12000	0											1a:  Acute - $225/$0/day for 1-8/9-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $1024/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$110/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$110/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $200/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - 25.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $200/visit/9b:  Ambulatory Surgical Center Services - $200/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 25.0%/8b:  Outpatient Therapeutic Radiological Services - 25.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $40/visit/3:  Rehab Services (CORF) - $40/day/5:  Partial Hospitalization - $40/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $40/visit/7b:  Chiropractic Services - $40/visit/7f:  Podiatry Services - $40/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $40/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $40/visit/7h:  Psychiatric Services - Individual - $40/visit/7h:  Psychiatric Services - Group - $40/visit	7c:  Occupational Therapy Services - $40/visit/7i:  Physical/Speech Therapy - $40/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $40/visit/9c:  Outpatient Substance Abuse Svcs - Group - $40/visit/7g:  Other Health Care Professional Services - $20 to $40/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												225	1024	110	0	200	0.25	0.25	49.99999984	200	0	0.204110328	0	0.2	40	20.01245649	40	40	40	0	40	0.2	0	0	0	0	0	0	0	0	0											193.880402	882.3712519	94.78597432	0	172.3381351	0.215422669	0.215422669	43.08453364	172.3381351	0	0.175879966	0	0.172338135	34.46762703	17.24586299	34.71281976	34.46762703	34.46762703	0	34.46762703	0.172338135	0	0	0	0	0	0	0	0	0											15.9213	0.472242464	3.574738276	0	5.764212233	3.638365591	2.071883893	1.583836519	7.84390523	0	4.256315093	0	0.054362599	2.328933746	5.628595918	16.70154558	0.570420924	2.304541446	0	0.05987844	2.780699223	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5558	0	11.99	15.9213	0.472242464	3.574738276	0	5.764212233	3.638365591	2.071883893	1.583836519	7.84390523	0	4.256315093	0	0.054362599	2.328933746	5.628595918	16.70154558	0.570420924	2.304541446	0	0.05987844	2.780699223	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5558																																																																																		0			15.9213	0.472242464	3.574738276	0	5.764212233	3.638365591	2.071883893	1.583836519	7.84390523	0	4.256315093	0	0.054362599	2.328933746	5.628595918	16.70154558	0.570420924	2.304541446	0	0.05987844	2.780699223	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.5558
H5996_020_0	2009	6																					4850											D	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	V											0	0	0	0	0	0	0	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	1503.979069	9.80190046	776.4456898	34.92188737	485.6904167	17.34928608	9.879630149	467.5079738	617.0994276	6.257990469	24.61298377	0	0.503403742	837.8560058	5295.221599	8338.423301	344.7762138	1392.920633	37.41289234	36.19197824	31.03868481	0	0	0	0	0	0	0	12000	0											1a:  Acute - $225/$0/day for 1-8/9-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $1024/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$110/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$110/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $200/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - 25.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $200/visit/9b:  Ambulatory Surgical Center Services - $200/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 25.0%/8b:  Outpatient Therapeutic Radiological Services - 25.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $40/visit/3:  Rehab Services (CORF) - $40/day/5:  Partial Hospitalization - $40/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $40/visit/7b:  Chiropractic Services - $40/visit/7f:  Podiatry Services - $40/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $40/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $40/visit/7h:  Psychiatric Services - Individual - $40/visit/7h:  Psychiatric Services - Group - $40/visit	7c:  Occupational Therapy Services - $40/visit/7i:  Physical/Speech Therapy - $40/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $40/visit/9c:  Outpatient Substance Abuse Svcs - Group - $40/visit/7g:  Other Health Care Professional Services - $20 to $40/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												225	1024	110	0	200	0.25	0.25	49.99999984	200	0	0.204574135	0	0.2	40	20.01245559	40	40	40	0	40	0.2	0	0	0	0	0	0	0	0	0											183.0561287	833.1087815	89.49410738	0	162.7165589	0.203395699	0.203395699	40.67913959	162.7165589	0	0.166437996	0	0.162716559	32.54331178	16.28379478	32.99285497	32.54331178	32.54331178	0	32.54331178	0.162716559	0	0	0	0	0	0	0	0	0											22.9427	0.680504112	5.790609495	0	6.585822774	3.528770162	2.009474276	1.584818511	8.367691278	0	4.096535703	0	0.081912125	2.272217435	7.185525154	22.92569922	0.935013318	3.777520869	0	0.098150569	5.050507985	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.9135	0	22.05	22.9427	0.680504112	5.790609495	0	6.585822774	3.528770162	2.009474276	1.584818511	8.367691278	0	4.096535703	0	0.081912125	2.272217435	7.185525154	22.92569922	0.935013318	3.777520869	0	0.098150569	5.050507985	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.9135																																																																																		0			22.9427	0.680504112	5.790609495	0	6.585822774	3.528770162	2.009474276	1.584818511	8.367691278	0	4.096535703	0	0.081912125	2.272217435	7.185525154	22.92569922	0.935013318	3.777520869	0	0.098150569	5.050507985	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.9135
H5996_022_0	2009	4																					4000											D	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	V											0	0	0	0	0	0	0	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	834.3677426	6.422364233	452.5654731	17.65512452	403.0289874	16.8894277	9.617761694	441.133665	554.6652489	8.282758104	24.20011323	0	0.315441496	815.1262043	4172.64657	6003.594671	205.6028144	830.6501172	26.36194431	21.58261588	16.13513585	0	0	0	0	0	0	0	12500	0											1a:  Acute - $200/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $1024/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$110/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$110/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $175/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - 25.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $150/visit/9b:  Ambulatory Surgical Center Services - $150/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 25.0%/8b:  Outpatient Therapeutic Radiological Services - 25.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $30/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $30/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $30/visit/7f:  Podiatry Services - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $30/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $30/visit/7h:  Psychiatric Services - Individual - $30/visit/7h:  Psychiatric Services - Group - $30/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $30/visit/9c:  Outpatient Substance Abuse Svcs - Group - $30/visit/7g:  Other Health Care Professional Services - $10 to $30/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Membership in Health Club/Fitness Classes - $0/service/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	1024	110	0	175	0.25	0.25	49.99999984	150	0	0.204110328	0	0.2	30	10.01210442	30	30	30	0	30	0.2	0	0	0	0	0	0	0	0	0											173.9102084	890.4202671	95.65061463	0	152.1714324	0.217387761	0.217387761	43.47755197	130.4326563	0	0.177484348	0	0.173910208	26.08653126	8.706452314	26.163202	26.08653126	26.08653126	0	26.08653126	0.173910208	0	0	0	0	0	0	0	0	0											12.0921	0.476550273	3.607347138	0	5.110791525	3.671554863	2.090783676	1.59828432	6.028871815	0	4.295141318	0	0.054858496	1.771984601	3.027412366	13.08943834	0.446955354	1.805731688	0	0.046917965	2.80606484	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.0208	0	9.26	12.0921	0.476550273	3.607347138	0	5.110791525	3.671554863	2.090783676	1.59828432	6.028871815	0	4.295141318	0	0.054858496	1.771984601	3.027412366	13.08943834	0.446955354	1.805731688	0	0.046917965	2.80606484	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.0208																																																																																		0			12.0921	0.476550273	3.607347138	0	5.110791525	3.671554863	2.090783676	1.59828432	6.028871815	0	4.295141318	0	0.054858496	1.771984601	3.027412366	13.08943834	0.446955354	1.805731688	0	0.046917965	2.80606484	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.0208
H5996_023_0	2009	4																					1500											coin	coin	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	215.0768434	4.657901214	529.9674943	15.18563968	366.2182176	14.90586035	8.488210217	427.5621015	41.89256939	6.421110757	20.56390135	0	0.242987809	985.8143003	3736.77803	5749.519404	181.1828187	762.4912324	20.143422	19.01919092	18.12771828	0	0	1790.201423	367.5	0	0	0	12500	0											1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $0/admit for 1-190	2:  Skilled Nursing Services - $0/$75/day for 1-8/9-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-8/9-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - 25.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 25.0%/8b:  Outpatient Therapeutic Radiological Services - 25.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $5/visit/3:  Rehab Services (CORF) - $5/day/5:  Partial Hospitalization - $10/day	7a:  Primary Care - $5/visit/17a:  Vision Exams - $5/visit/18a:  Hearing Exams - $5/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $5/visit/7b:  Chiropractic Services - $5/visit/7f:  Podiatry Services - $5/visit/17a:  Vision Exams - $5/visit/18a:  Hearing Exams - $5/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $10/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $10/visit/7h:  Psychiatric Services - Individual - $10/visit/7h:  Psychiatric Services - Group - $10/visit	7c:  Occupational Therapy Services - $5/visit/7i:  Physical/Speech Therapy - $5/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $10/visit/9c:  Outpatient Substance Abuse Svcs - Group - $10/visit/7g:  Other Health Care Professional Services - $5 to $10/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		"16a:  Preventive Dental - Oral Exams - $50 ded, $500 annual max/16a:  Preventive Dental - Prophylaxis - $50 ded, $500 annual max/16a:  Preventive Dental - X-Rays - $50 ded, $500 annual max/16b:  Comprehensive Dental - Restorative Svcs - $50 ded, $500 annual max/visit"	17a:  Routine Eye Exams - $15/visit	17b:  Wear - $100 every other year (contact lenses and eyeglasses)			14b:  Other Immunizations - $0/visit/14a:  Membership in Health Club/Fitness Classes - $0/service/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												0	0	75	0	100	0.25	0.25	50	0	0	0.205540902	0	0.2	5	5	5	10	5	0	10	0.2	0	0	28.60003113	8.571428571	0	0	0	0	0											0	0	62.77246709	0	83.69662278	0.209241557	0.209241557	41.84831139	0	0	0.172030794	0	0.167393246	4.184831139	4.184831139	4.184831139	8.369662278	4.184831139	0	8.369662278	0.167393246	0	0	28.60003113	8.571428571	0	0	0	0	0											0	0	2.772280591	0	2.554269001	3.118925428	1.776086322	1.491062663	0	0	3.53762427	0	0.040674518	0.343788865	1.303148755	2.005063986	0.126369917	0.265908088	0	0.01326535	3.034457598	0	0	4.26665137	0.2625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.9121	0	4.36	0	0	2.772280591	0	2.554269001	3.118925428	1.776086322	1.491062663	0	0	3.53762427	0	0.040674518	0.343788865	1.303148755	2.005063986	0.126369917	0.265908088	0	0.01326535	3.034457598	0	0	4.26665137	0.2625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.9121																																																																																		0			0	0	2.772280591	0	2.554269001	3.118925428	1.776086322	1.491062663	0	0	3.53762427	0	0.040674518	0.343788865	1.303148755	2.005063986	0.126369917	0.265908088	0	0.01326535	3.034457598	0	0	4.26665137	0.2625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.9121
H5996_024_0	2009	4																					1500											coin	coin	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	253.0629984	5.480564197	582.9546161	17.65512452	407.6041358	16.8894277	9.617761694	441.1336602	49.64761021	8.282758104	24.20011323	0	0.315441496	825.2180855	4343.358838	6784.068266	224.2939794	943.9205878	27.94733705	23.54467187	16.13513585	0	0	1790.201423	367.5	0	0	0	12500	0											1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $0/admit for 1-190	2:  Skilled Nursing Services - $0/$75/day for 1-8/9-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-8/9-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - 25.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 25.0%/8b:  Outpatient Therapeutic Radiological Services - 25.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $5/visit/3:  Rehab Services (CORF) - $5/day/5:  Partial Hospitalization - $10/day	7a:  Primary Care - $5/visit/17a:  Vision Exams - $5/visit/18a:  Hearing Exams - $5/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $5/visit/7b:  Chiropractic Services - $5/visit/7f:  Podiatry Services - $5/visit/17a:  Vision Exams - $5/visit/18a:  Hearing Exams - $5/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $10/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $10/visit/7h:  Psychiatric Services - Individual - $10/visit/7h:  Psychiatric Services - Group - $10/visit	7c:  Occupational Therapy Services - $5/visit/7i:  Physical/Speech Therapy - $5/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $10/visit/9c:  Outpatient Substance Abuse Svcs - Group - $10/visit/7g:  Other Health Care Professional Services - $5 to $10/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		"16a:  Preventive Dental - Oral Exams - $50 ded, $500 annual max/16a:  Preventive Dental - Prophylaxis - $50 ded, $500 annual max/16a:  Preventive Dental - X-Rays - $50 ded, $500 annual max/16b:  Comprehensive Dental - Restorative Svcs - $50 ded, $500 annual max/visit"	17a:  Routine Eye Exams - $15/visit	17b:  Wear - $100 every other year (contact lenses and eyeglasses)			14b:  Other Immunizations - $0/visit/14a:  Membership in Health Club/Fitness Classes - $0/service/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												0	0	75	0	100	0.25	0.25	50	0	0	0.204110328	0	0.2	5	5	5	10	5	0	10	0.2	0	0	28.60003113	8.571428571	0	0	0	0	0											0	0	60.69831692	0	80.93108923	0.202327723	0.202327723	40.46554461	0	0	0.165188711	0	0.161862178	4.046554461	4.046554461	4.046554461	8.093108923	4.046554461	0	8.093108923	0.161862178	0	0	28.60003113	8.571428571	0	0	0	0	0											0	0	2.948697003	0	2.748987224	3.41719945	1.945939824	1.487559484	0	0	3.997585517	0	0.051058048	0.27827416	1.464636507	2.287675142	0.151269634	0.318302172	0	0.015879133	2.611668239	0	0	4.26665137	0.2625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.2539	0	5.59	0	0	2.948697003	0	2.748987224	3.41719945	1.945939824	1.487559484	0	0	3.997585517	0	0.051058048	0.27827416	1.464636507	2.287675142	0.151269634	0.318302172	0	0.015879133	2.611668239	0	0	4.26665137	0.2625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.2539																																																																																		0			0	0	2.948697003	0	2.748987224	3.41719945	1.945939824	1.487559484	0	0	3.997585517	0	0.051058048	0.27827416	1.464636507	2.287675142	0.151269634	0.318302172	0	0.015879133	2.611668239	0	0	4.26665137	0.2625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.2539
H5996_025_0	2009	6																					2200											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	V											0	0	0	0	0	0	0	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	267.7079538	6.49588951	656.4258294	19.79786261	184.4460111	11.85492378	6.750840461	362.4282154	597.0806084	9.825500389	33.75056446	0	0.501897219	592.3298295	4925.697214	7411.959602	266.9585584	1103.043808	32.64608554	28.02327409	25.12169215	0	0	0	0	0	0	0	12000	0											1a:  Acute - $200/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $200/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $75/visit/9b:  Ambulatory Surgical Center Services - $75/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	200	75	0	100	0.3	0.3	49.99999965	75	0	0.235706872	0	0.2	20	10.00618952	20	25	20	0	25	0.2	0	0	0	0	0	0	0	0	0											154.2341354	154.2341354	57.83780078	0	77.11706771	0.231351203	0.231351203	38.55853358	57.83780078	0	0.181770228	0	0.154234135	15.42341354	7.716479951	15.42341354	19.27926693	15.42341354	0	19.27926693	0.154234135	0	0	0	0	0	0	0	0	0											3.4408	0.083490659	3.163852196	0	1.18532796	2.742650881	1.561815063	1.164558376	2.877819107	0	6.134847805	0	0.077409684	0.761312326	3.167420316	9.526476508	0.428897109	1.417725068	0	0.045022348	3.874622469	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6541	0	12.36	3.4408	0.083490659	3.163852196	0	1.18532796	2.742650881	1.561815063	1.164558376	2.877819107	0	6.134847805	0	0.077409684	0.761312326	3.167420316	9.526476508	0.428897109	1.417725068	0	0.045022348	3.874622469	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6541																																																																																		0			3.4408	0.083490659	3.163852196	0	1.18532796	2.742650881	1.561815063	1.164558376	2.877819107	0	6.134847805	0	0.077409684	0.761312326	3.167420316	9.526476508	0.428897109	1.417725068	0	0.045022348	3.874622469	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6541
H5996_026_0	2009	11																					2200											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	V											0	0	0	0	0	0	0	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	220.2689154	5.344789039	733.8562298	15.47350257	211.0681238	11.46189014	6.527025657	365.6109437	511.3238456	7.370907566	15.42073428	0	0.415636939	407.3432254	4186.190882	6425.726925	244.5929241	1010.631433	32.68290323	25.67550032	20.4694028	0	0	0	0	0	0	0	12000	0											1a:  Acute - $200/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $200/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $75/visit/9b:  Ambulatory Surgical Center Services - $75/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	200	75	0	100	0.3	0.3	49.99999965	75	0	0.236003347	0	0.2	20	10.00618939	20	25	20	0	25	0.2	0	0	0	0	0	0	0	0	0											162.714044	162.714044	61.0177665	0	81.35702201	0.244071066	0.244071066	40.67851072	61.0177665	0	0.192005295	0	0.162714044	16.2714044	8.140737708	16.2714044	20.3392555	16.2714044	0	20.3392555	0.162714044	0	0	0	0	0	0	0	0	0											2.9867	0.072472687	3.73152234	0	1.430989499	2.797515744	1.59305811	1.239375724	2.599986585	0	2.960862637	0	0.067629967	0.552337196	2.839890163	8.71296678	0.414569831	1.370366062	0	0.04351838	3.330659308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.7445	0	8.42	2.9867	0.072472687	3.73152234	0	1.430989499	2.797515744	1.59305811	1.239375724	2.599986585	0	2.960862637	0	0.067629967	0.552337196	2.839890163	8.71296678	0.414569831	1.370366062	0	0.04351838	3.330659308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.7445																																																																																		0			2.9867	0.072472687	3.73152234	0	1.430989499	2.797515744	1.59305811	1.239375724	2.599986585	0	2.960862637	0	0.067629967	0.552337196	2.839890163	8.71296678	0.414569831	1.370366062	0	0.04351838	3.330659308	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.7445
H5996_027_0	2009	9																					2200											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	V											0	0	0	0	0	0	0	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	221.341525	5.370815734	706.7635293	18.40538737	239.6772139	11.59421807	6.602380403	383.8505562	530.6220954	10.09294338	30.54766382	0	0.548520686	501.3114247	4422.10716	6948.051356	280.8017292	1160.242289	32.25839684	29.47642462	22.90575628	0	0	0	0	0	0	0	12000	0											1a:  Acute - $200/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $200/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $75/visit/9b:  Ambulatory Surgical Center Services - $75/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	200	75	0	100	0.3	0.3	49.99999965	75	0	0.234657592	0	0.2	20	10.00618924	20	25	20	0	25	0.2	0	0	0	0	0	0	0	0	0											157.1513157	157.1513157	58.9317434	0	78.57565787	0.235726974	0.235726974	39.28782866	58.9317434	0	0.184383747	0	0.157151316	15.71513157	7.862429021	15.71513157	19.64391447	15.71513157	0	19.64391447	0.157151316	0	0	0	0	0	0	0	0	0											2.8987	0.070335897	3.470900579	0	1.569399563	2.733069937	1.556359151	1.25672124	2.605873764	0	5.632492705	0	0.086200747	0.656514583	2.897375306	9.099128436	0.459670429	1.519446685	0	0.048252697	3.599669737	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.1601	0	10.95	2.8987	0.070335897	3.470900579	0	1.569399563	2.733069937	1.556359151	1.25672124	2.605873764	0	5.632492705	0	0.086200747	0.656514583	2.897375306	9.099128436	0.459670429	1.519446685	0	0.048252697	3.599669737	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.1601																																																																																		0			2.8987	0.070335897	3.470900579	0	1.569399563	2.733069937	1.556359151	1.25672124	2.605873764	0	5.632492705	0	0.086200747	0.656514583	2.897375306	9.099128436	0.459670429	1.519446685	0	0.048252697	3.599669737	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.1601
H5996_028_0	2009	7																					2200											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	V											0	0	0	0	0	0	0	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	262.3674347	6.366302691	764.1803047	14.6664678	315.0773423	15.00552545	8.544964958	399.364412	569.4603327	11.66314813	22.37118713	0	0.453553164	460.7308218	5055.615997	7544.852332	265.2365512	1095.928661	34.34945022	27.8425109	21.49150506	0	0	0	0	0	0	0	12000	0											1a:  Acute - $200/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $200/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $75/visit/9b:  Ambulatory Surgical Center Services - $75/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	200	75	0	100	0.3	0.3	49.99999965	75	0	0.237307164	0	0.2	20	10.00618958	20	25	20	0	25	0.2	0	0	0	0	0	0	0	0	0											154.5506893	154.5506893	57.95650847	0	77.27534463	0.231826034	0.231826034	38.63767204	57.95650847	0	0.183379929	0	0.154550689	15.45506893	7.732317481	15.45506893	19.31883616	15.45506893	0	19.31883616	0.154550689	0	0	0	0	0	0	0	0	0											3.3791	0.081993039	3.690768526	0	2.028975851	3.478671451	1.980945336	1.285875932	2.750327716	0	4.102426699	0	0.070096954	0.593385551	3.257635663	9.717184403	0.427005123	1.411471083	0	0.044823742	3.321526921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6222	0	12.24	3.3791	0.081993039	3.690768526	0	2.028975851	3.478671451	1.980945336	1.285875932	2.750327716	0	4.102426699	0	0.070096954	0.593385551	3.257635663	9.717184403	0.427005123	1.411471083	0	0.044823742	3.321526921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6222																																																																																		0			3.3791	0.081993039	3.690768526	0	2.028975851	3.478671451	1.980945336	1.285875932	2.750327716	0	4.102426699	0	0.070096954	0.593385551	3.257635663	9.717184403	0.427005123	1.411471083	0	0.044823742	3.321526921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.6222
H5996_029_0	2009	9																					2200											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	V											0	0	0	0	0	0	0	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	276.9060371	6.719079489	695.0431322	19.55999278	197.8303806	12.81993339	7.300369589	369.0752548	612.9608971	8.823037296	32.58467459	0	0.525557343	554.9328169	5073.917086	7711.429499	285.6911699	1180.444927	35.18504266	29.98968082	23.92300967	0	0	0	0	0	0	0	12000	0											1a:  Acute - $200/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $200/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $75/visit/9b:  Ambulatory Surgical Center Services - $75/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	200	75	0	100	0.3	0.3	49.99999965	75	0	0.235400546	0	0.2	20	10.00618946	20	25	20	0	25	0.2	0	0	0	0	0	0	0	0	0											153.1074821	153.1074821	57.41530579	0	76.55374105	0.229661223	0.229661223	38.27687026	57.41530579	0	0.180207925	0	0.153107482	15.31074821	7.660112368	15.31074821	19.13843526	15.31074821	0	19.13843526	0.153107482	0	0	0	0	0	0	0	0	0											3.533	0.085728445	3.325509497	0	1.262054644	2.944241584	1.676611809	1.177253803	2.932778112	0	5.87201658	0	0.080466761	0.708036386	3.238897919	9.838979616	0.455640163	1.506124588	0	0.04782963	3.662791775	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.348	0	12.97	3.533	0.085728445	3.325509497	0	1.262054644	2.944241584	1.676611809	1.177253803	2.932778112	0	5.87201658	0	0.080466761	0.708036386	3.238897919	9.838979616	0.455640163	1.506124588	0	0.04782963	3.662791775	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.348																																																																																		0			3.533	0.085728445	3.325509497	0	1.262054644	2.944241584	1.676611809	1.177253803	2.932778112	0	5.87201658	0	0.080466761	0.708036386	3.238897919	9.838979616	0.455640163	1.506124588	0	0.04782963	3.662791775	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.348
H5996_030_0	2009	4																					4000											D	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	V											0	0	0	0	0	0	0	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	1273.415186	9.801836444	776.4587124	34.92200121	487.7058323	17.34948374	9.879742711	467.5143581	626.6975803	6.258091412	24.61289275	0	0.503411253	842.3098242	5641.561232	8668.501486	356.9495974	1442.101976	37.73755626	37.46984725	31.03882875	0	0	0	0	0	0	0	12500	0											1a:  Acute - $200/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $1024/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$110/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$110/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $175/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - 25.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $150/visit/9b:  Ambulatory Surgical Center Services - $150/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 25.0%/8b:  Outpatient Therapeutic Radiological Services - 25.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $30/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $30/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $30/visit/7f:  Podiatry Services - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $30/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $30/visit/7h:  Psychiatric Services - Individual - $30/visit/7h:  Psychiatric Services - Group - $30/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $30/visit/9c:  Outpatient Substance Abuse Svcs - Group - $30/visit/7g:  Other Health Care Professional Services - $10 to $30/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Membership in Health Club/Fitness Classes - $0/service/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	1024	110	0	175	0.25	0.25	49.99999984	150	0	0.204574252	0	0.2	30	10.01210358	30	30	30	0	30	0.2	0	0	0	0	0	0	0	0	0											161.5298648	827.032908	88.84142567	0	141.3386317	0.201912331	0.201912331	40.38246608	121.1473986	0	0.165224257	0	0.161529865	24.22947973	8.087115212	24.41624099	24.22947973	24.22947973	0	24.22947973	0.161529865	0	0	0	0	0	0	0	0	0											17.1412	0.675536775	5.748474915	0	5.744306253	3.503074706	1.994841881	1.573281892	6.326898465	0	4.066646908	0	0.081315952	1.700727401	3.801996305	17.63768511	0.720725253	2.911781716	0	0.075656242	5.013697813	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7179	0	18.58	17.1412	0.675536775	5.748474915	0	5.744306253	3.503074706	1.994841881	1.573281892	6.326898465	0	4.066646908	0	0.081315952	1.700727401	3.801996305	17.63768511	0.720725253	2.911781716	0	0.075656242	5.013697813	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7179																																																																																		0			17.1412	0.675536775	5.748474915	0	5.744306253	3.503074706	1.994841881	1.573281892	6.326898465	0	4.066646908	0	0.081315952	1.700727401	3.801996305	17.63768511	0.720725253	2.911781716	0	0.075656242	5.013697813	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.7179
H5996_031_0	2009	6																					4000											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	V											0	0	0	0	0	0	0	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	486.1565868	11.79650969	526.5893888	40.63902611	574.8120382	19.38039659	11.0362553	455.5098353	613.6960182	6.05070825	30.76077977	0	0.429690968	644.2887912	6065.546145	8990.213545	306.4503297	1238.081312	36.5048885	32.16881914	30.45858497	0	0	0	0	0	0	0	12500	0											1a:  Acute - $450/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $1024/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$120/day for 1-17/18-100/2:  Non-Medicare Covered Stay - $0/$120/day for 1-17/18-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - 25.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $225/visit/9b:  Ambulatory Surgical Center Services - $225/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 25.0%/8b:  Outpatient Therapeutic Radiological Services - 25.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $35/visit/3:  Rehab Services (CORF) - $35/day/5:  Partial Hospitalization - $35/day	7a:  Primary Care - $15/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $35/visit/7b:  Chiropractic Services - $35/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $35/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $35/visit/7h:  Psychiatric Services - Individual - $35/visit/7h:  Psychiatric Services - Group - $35/visit	7c:  Occupational Therapy Services - $35/visit/7i:  Physical/Speech Therapy - $35/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $35/visit/9c:  Outpatient Substance Abuse Svcs - Group - $35/visit/7g:  Other Health Care Professional Services - $15 to $35/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Membership in Health Club/Fitness Classes - $0/service/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												450	1024	120	0	150	0.25	0.25	49.99999984	225	0	0.202781224	0	0.2	35	15.01248764	35	35	35	0	35	0.2	0	0	0	0	0	0	0	0	0											356.2355507	810.6337865	94.99614685	0	118.7451836	0.197908639	0.197908639	39.58172773	178.1177753	0	0.160528624	0	0.158326911	27.7072095	11.88601771	28.00218372	27.7072095	27.7072095	0	27.7072095	0.158326911	0	0	0	0	0	0	0	0	0											14.4322	0.796887443	4.168663576	0	5.688013416	3.835547917	2.184170269	1.502488857	9.109180793	0	4.937985658	0	0.068031644	1.487620376	6.007932408	20.97880095	0.707573624	2.858648191	0	0.074275684	4.822413685	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.6604	0	21.74	14.4322	0.796887443	4.168663576	0	5.688013416	3.835547917	2.184170269	1.502488857	9.109180793	0	4.937985658	0	0.068031644	1.487620376	6.007932408	20.97880095	0.707573624	2.858648191	0	0.074275684	4.822413685	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.6604																																																																																		0			14.4322	0.796887443	4.168663576	0	5.688013416	3.835547917	2.184170269	1.502488857	9.109180793	0	4.937985658	0	0.068031644	1.487620376	6.007932408	20.97880095	0.707573624	2.858648191	0	0.074275684	4.822413685	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.6604
H5996_032_0	2009	3																					1500											coin	coin	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	406.3638151	8.800587165	769.0683467	40.63902611	578.9473766	19.38039659	11.0362553	455.5098304	58.64993619	6.05070825	30.76077977	0	0.429690968	653.9911458	6513.579455	10158.62856	334.3094505	1406.910582	38.92320754	35.09325724	30.45858497	0	0	1790.201423	367.5	0	0	0	12500	0											1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $0/admit for 1-190	2:  Skilled Nursing Services - $0/$75/day for 1-8/9-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-8/9-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - 25.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 25.0%/8b:  Outpatient Therapeutic Radiological Services - 25.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $5/visit/3:  Rehab Services (CORF) - $5/day/5:  Partial Hospitalization - $10/day	7a:  Primary Care - $5/visit/17a:  Vision Exams - $5/visit/18a:  Hearing Exams - $5/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $5/visit/7b:  Chiropractic Services - $5/visit/7f:  Podiatry Services - $5/visit/17a:  Vision Exams - $5/visit/18a:  Hearing Exams - $5/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $10/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $10/visit/7h:  Psychiatric Services - Individual - $10/visit/7h:  Psychiatric Services - Group - $10/visit	7c:  Occupational Therapy Services - $5/visit/7i:  Physical/Speech Therapy - $5/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $10/visit/9c:  Outpatient Substance Abuse Svcs - Group - $10/visit/7g:  Other Health Care Professional Services - $5 to $10/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service		"16a:  Preventive Dental - Oral Exams - $50 ded, $500 annual max/16a:  Preventive Dental - Prophylaxis - $50 ded, $500 annual max/16a:  Preventive Dental - X-Rays - $50 ded, $500 annual max/16b:  Comprehensive Dental - Restorative Svcs - $50 ded, $500 annual max/visit"	17a:  Routine Eye Exams - $15/visit	17b:  Wear - $100 every other year (contact lenses and eyeglasses)			14b:  Other Immunizations - $0/visit/14a:  Membership in Health Club/Fitness Classes - $0/service/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												0	0	75	0	100	0.25	0.25	50	0	0	0.202781224	0	0.2	5	5	5	10	5	0	10	0.2	0	0	28.60003113	8.571428571	0	0	0	0	0											0	0	56.90334274	0	75.87112365	0.189677809	0.189677809	37.93556182	0	0	0.153852393	0	0.151742247	3.793556182	3.793556182	3.793556182	7.587112365	3.793556182	0	7.587112365	0.151742247	0	0	28.60003113	8.571428571	0	0	0	0	0											0	0	3.646879977	0	3.660449	3.676031165	2.093332726	1.440001778	0	0	4.732619579	0	0.065202273	0.206746013	2.059135801	3.211444016	0.21137028	0.444766195	0	0.02218804	4.621854133	0	0	4.26665137	0.2625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.6212	0	9.57	0	0	3.646879977	0	3.660449	3.676031165	2.093332726	1.440001778	0	0	4.732619579	0	0.065202273	0.206746013	2.059135801	3.211444016	0.21137028	0.444766195	0	0.02218804	4.621854133	0	0	4.26665137	0.2625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.6212																																																																																		0			0	0	3.646879977	0	3.660449	3.676031165	2.093332726	1.440001778	0	0	4.732619579	0	0.065202273	0.206746013	2.059135801	3.211444016	0.21137028	0.444766195	0	0.02218804	4.621854133	0	0	4.26665137	0.2625	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.6212
H5996_033_0	2009	4																					3250											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	V											0	0	0	0	0	0	0	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	181.1888389	4.396517402	667.8289441	12.80384368	395.9641892	10.45194249	5.951906357	445.1715986	627.0875985	4.78401879	23.31965945	0	0.38217531	563.0234786	3773.383982	5924.185055	238.9660083	987.3816274	27.03555717	25.0848296	15.2817592	0	0	0	0	0	0	0	12000	0											1a:  Acute - $200/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $200/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $75/visit/9b:  Ambulatory Surgical Center Services - $75/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	200	75	0	100	0.2	0.2	49.99999965	75	0	0.239114876	0	0.2	20	10.00618924	20	25	20	0	25	0.2	0	0	0	0	0	0	0	0	0											182.5558095	182.5558095	68.45842857	0	91.27790476	0.18255581	0.18255581	45.63895206	68.45842857	0	0.218259049	0	0.18255581	18.25558095	9.133439888	18.25558095	22.81947619	18.25558095	0	22.81947619	0.18255581	0	0	0	0	0	0	0	0	0											2.7564	0.066884149	3.809876672	0	3.011898462	1.908062822	1.086555083	1.693097104	3.577452631	0	5.089726688	0	0.069768323	0.856526724	2.871997981	9.01245332	0.454423261	1.502102102	0	0.047701889	2.789773922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6047	0	3.88	2.7564	0.066884149	3.809876672	0	3.011898462	1.908062822	1.086555083	1.693097104	3.577452631	0	5.089726688	0	0.069768323	0.856526724	2.871997981	9.01245332	0.454423261	1.502102102	0	0.047701889	2.789773922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6047																																																																																		0			2.7564	0.066884149	3.809876672	0	3.011898462	1.908062822	1.086555083	1.693097104	3.577452631	0	5.089726688	0	0.069768323	0.856526724	2.871997981	9.01245332	0.454423261	1.502102102	0	0.047701889	2.789773922	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6047
H5996_034_0	2009	4																					3250											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	V											0	0	0	0	0	0	0	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	199.7519191	4.846947495	547.1295426	9.396038885	377.4040659	12.20394884	6.949594372	552.0336644	755.4384825	7.382561785	27.25386335	0	0.416732527	478.5246916	4611.913923	7001.448545	258.5829965	1068.436895	26.43042717	27.14407146	26.55117028	0	0	0	0	0	0	0	12000	0											1a:  Acute - $200/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $200/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $75/visit/9b:  Ambulatory Surgical Center Services - $75/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	200	75	0	100	0.2	0.2	49.99999965	75	0	0.238817693	0	0.2	20	10.00618947	20	25	20	0	25	0.2	0	0	0	0	0	0	0	0	0											176.7394165	176.7394165	66.27728117	0	88.36970823	0.176739416	0.176739416	44.1848538	66.27728117	0	0.211042498	0	0.176739416	17.67394165	8.842440437	17.67394165	22.09242706	17.67394165	0	22.09242706	0.176739416	0	0	0	0	0	0	0	0	0											2.942	0.071387223	3.021854878	0	2.779257266	2.156918796	1.228267254	2.03262723	4.172367393	0	5.751723406	0	0.073653064	0.70478479	3.39838118	10.31193275	0.476060499	1.573624278	0	0.049973202	4.692638341	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4375	0	5.98	2.942	0.071387223	3.021854878	0	2.779257266	2.156918796	1.228267254	2.03262723	4.172367393	0	5.751723406	0	0.073653064	0.70478479	3.39838118	10.31193275	0.476060499	1.573624278	0	0.049973202	4.692638341	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4375																																																																																		0			2.942	0.071387223	3.021854878	0	2.779257266	2.156918796	1.228267254	2.03262723	4.172367393	0	5.751723406	0	0.073653064	0.70478479	3.39838118	10.31193275	0.476060499	1.573624278	0	0.049973202	4.692638341	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4375
H5996_035_0	2009	6																					3250											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	V											0	0	0	0	0	0	0	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	181.1987438	4.396757745	667.8521154	12.80895762	395.965277	10.4505456	5.951110896	445.1631334	627.157041	4.777742197	23.31269651	0	0.382283959	562.9257247	3774.291969	5925.610035	239.0234333	987.6189011	27.04325256	25.09085764	15.27325919	0	0	0	0	0	0	0	12000	0											1a:  Acute - $200/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $200/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $75/visit/9b:  Ambulatory Surgical Center Services - $75/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	200	75	0	100	0.2	0.2	49.99999965	75	0	0.239116596	0	0.2	20	10.00618924	20	25	20	0	25	0.2	0	0	0	0	0	0	0	0	0											182.5559966	182.5559966	68.45849871	0	91.27799828	0.182555997	0.182555997	45.63899882	68.45849871	0	0.218260842	0	0.182555997	18.25559966	9.133449245	18.25559966	22.81949957	18.25559966	0	22.81949957	0.182555997	0	0	0	0	0	0	0	0	0											2.7566	0.066887874	3.810012765	0	3.011909823	1.907809767	1.08641098	1.693066643	3.577852457	0	5.088248779	0	0.069788229	0.856378889	2.872692011	9.014630377	0.454532928	1.502464606	0	0.047713401	2.788225051	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6052	0	3.88	2.7566	0.066887874	3.810012765	0	3.011909823	1.907809767	1.08641098	1.693066643	3.577852457	0	5.088248779	0	0.069788229	0.856378889	2.872692011	9.014630377	0.454532928	1.502464606	0	0.047713401	2.788225051	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6052																																																																																		0			2.7566	0.066887874	3.810012765	0	3.011909823	1.907809767	1.08641098	1.693066643	3.577852457	0	5.088248779	0	0.069788229	0.856378889	2.872692011	9.014630377	0.454532928	1.502464606	0	0.047713401	2.788225051	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.6052
H5996_036_0	2009	6																					3250											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	V											0	0	0	0	0	0	0	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	261.2611822	6.339459655	898.9303053	16.77777844	380.0297135	13.37533856	7.616647595	497.5901154	836.5832805	12.21928782	25.81894483	0	0.504015133	698.2342395	5264.948253	8035.031751	301.1044638	1244.130986	37.23650575	31.6076509	29.2112537	0	0	0	0	0	0	0	12000	0											1a:  Acute - $200/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $200/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $75/visit/9b:  Ambulatory Surgical Center Services - $75/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	200	75	0	100	0.2	0.2	49.99999965	75	0	0.237898312	0	0.2	20	10.00618943	20	25	20	0	25	0.2	0	0	0	0	0	0	0	0	0											172.2256523	172.2256523	64.58461961	0	86.11282615	0.172225652	0.172225652	43.05641277	64.58461961	0	0.20486096	0	0.172225652	17.22256523	8.61661251	17.22256523	21.52820654	17.22256523	0	21.52820654	0.172225652	0	0	0	0	0	0	0	0	0											3.7497	0.090984798	4.838089319	0	2.727119388	2.303576408	1.3117821	1.78537045	4.502534412	0	5.289293811	0	0.086804335	1.002115395	3.780501582	11.5319882	0.540186591	1.785593922	0	0.05670467	5.030927222	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4132	0	8.13	3.7497	0.090984798	4.838089319	0	2.727119388	2.303576408	1.3117821	1.78537045	4.502534412	0	5.289293811	0	0.086804335	1.002115395	3.780501582	11.5319882	0.540186591	1.785593922	0	0.05670467	5.030927222	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4132																																																																																		0			3.7497	0.090984798	4.838089319	0	2.727119388	2.303576408	1.3117821	1.78537045	4.502534412	0	5.289293811	0	0.086804335	1.002115395	3.780501582	11.5319882	0.540186591	1.785593922	0	0.05670467	5.030927222	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.4132
H5996_037_0	2009	6																					3250											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	V											0	0	0	0	0	0	0	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	199.6605598	4.844730675	547.8728576	9.403863399	377.3069624	12.1992846	6.9469383	551.847459	755.8014678	7.403947999	27.19132196	0	0.416165125	478.6633095	4610.805257	6996.798803	258.1055605	1066.464181	26.44855713	27.09395386	26.55316794	0	0	0	0	0	0	0	12000	0											1a:  Acute - $200/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $200/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $75/visit/9b:  Ambulatory Surgical Center Services - $75/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	200	75	0	100	0.2	0.2	49.99999965	75	0	0.238821918	0	0.2	20	10.00618947	20	25	20	0	25	0.2	0	0	0	0	0	0	0	0	0											176.7280744	176.7280744	66.27302791	0	88.36403721	0.176728074	0.176728074	44.1820183	66.27302791	0	0.211032688	0	0.176728074	17.67280744	8.841872987	17.67280744	22.0910093	17.67280744	0	22.0910093	0.176728074	0	0	0	0	0	0	0	0	0											2.9405	0.071349994	3.025766099	0	2.778363872	2.155956077	1.227719029	2.031811211	4.174104314	0	5.73825777	0	0.073548061	0.704943708	3.397346204	10.30442316	0.475151028	1.57061801	0	0.049877732	4.69269024	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4124	0	5.98	2.9405	0.071349994	3.025766099	0	2.778363872	2.155956077	1.227719029	2.031811211	4.174104314	0	5.73825777	0	0.073548061	0.704943708	3.397346204	10.30442316	0.475151028	1.57061801	0	0.049877732	4.69269024	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4124																																																																																		0			2.9405	0.071349994	3.025766099	0	2.778363872	2.155956077	1.227719029	2.031811211	4.174104314	0	5.73825777	0	0.073548061	0.704943708	3.397346204	10.30442316	0.475151028	1.57061801	0	0.049877732	4.69269024	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4124
H5996_038_0	2009	4																					3250											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	V											0	0	0	0	0	0	0	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	203.7761987	4.944595976	283.7736554	16.74925319	288.1612697	12.24350769	6.972121338	407.4546918	636.8628987	8.211814785	17.20274976	0	0.31868018	983.7274764	4289.460719	6284.834299	208.7151265	862.3882648	23.11147893	21.90932267	13.85564175	0	0	0	0	0	0	0	12000	0											1a:  Acute - $200/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $200/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $75/visit/9b:  Ambulatory Surgical Center Services - $75/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	200	75	0	100	0.2	0.2	49.99999965	75	0	0.237058663	0	0.2	20	10.0061897	20	25	20	0	25	0.2	0	0	0	0	0	0	0	0	0											184.5071284	184.5071284	69.19017313	0	92.25356418	0.184507128	0.184507128	46.12678176	69.19017313	0	0.218695066	0	0.184507128	18.45071284	9.231066632	18.45071284	23.06339104	18.45071284	0	23.06339104	0.184507128	0	0	0	0	0	0	0	0	0											3.1332	0.0760261	1.636195696	0	2.215325349	2.259014444	1.286406087	1.566214471	3.672054519	0	3.762156494	0	0.058798765	1.512539431	3.299691476	9.663306072	0.401139882	1.325973186	0	0.042108606	2.556464671	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4666	0	3.23	3.1332	0.0760261	1.636195696	0	2.215325349	2.259014444	1.286406087	1.566214471	3.672054519	0	3.762156494	0	0.058798765	1.512539431	3.299691476	9.663306072	0.401139882	1.325973186	0	0.042108606	2.556464671	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4666																																																																																		0			3.1332	0.0760261	1.636195696	0	2.215325349	2.259014444	1.286406087	1.566214471	3.672054519	0	3.762156494	0	0.058798765	1.512539431	3.299691476	9.663306072	0.401139882	1.325973186	0	0.042108606	2.556464671	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4666
H5996_039_0	2009	4																					3250											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	V											0	0	0	0	0	0	0	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	208.7169551	5.064482619	547.6855772	11.26163758	354.1799136	13.82568809	7.87310119	543.3245701	567.9324772	11.58412151	37.45046299	0	0.277611986	573.7635335	3909.666588	5764.818692	195.3377294	807.1143108	16.73512329	20.50506551	29.03786308	0	0	0	0	0	0	0	12000	0											1a:  Acute - $200/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $200/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $75/visit/9b:  Ambulatory Surgical Center Services - $75/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	200	75	0	100	0.2	0.2	49.99999965	75	0	0.23594909	0	0.2	20	10.00618966	20	25	20	0	25	0.2	0	0	0	0	0	0	0	0	0											178.4564344	178.4564344	66.9211629	0	89.22821719	0.178456434	0.178456434	44.61410828	66.9211629	0	0.210533166	0	0.178456434	17.84564344	8.928344639	17.84564344	22.3070543	17.84564344	0	22.3070543	0.178456434	0	0	0	0	0	0	0	0	0											3.1039	0.075315793	3.054312977	0	2.633570188	2.467282999	1.405005566	2.0199951	3.167225152	0	7.88456455	0	0.049541645	0.853264953	2.908904227	8.573074906	0.363117445	1.200289517	0	0.038117301	5.181993507	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.9795	0	5.43	3.1039	0.075315793	3.054312977	0	2.633570188	2.467282999	1.405005566	2.0199951	3.167225152	0	7.88456455	0	0.049541645	0.853264953	2.908904227	8.573074906	0.363117445	1.200289517	0	0.038117301	5.181993507	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.9795																																																																																		0			3.1039	0.075315793	3.054312977	0	2.633570188	2.467282999	1.405005566	2.0199951	3.167225152	0	7.88456455	0	0.049541645	0.853264953	2.908904227	8.573074906	0.363117445	1.200289517	0	0.038117301	5.181993507	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.9795
H5996_040_0	2009	4																					3250											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	V											0	0	0	0	0	0	0	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	208.8632769	5.068033094	548.0695343	11.42936037	354.4282128	14.03159801	7.990357537	543.7054699	568.3306285	11.75664714	38.00822344	0	0.28174654	574.1657726	3912.407475	5768.860141	195.4746716	807.6801414	16.98436427	20.51944067	29.47033228	0	0	0	0	0	0	0	12000	0											1a:  Acute - $200/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $200/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $75/visit/9b:  Ambulatory Surgical Center Services - $75/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	200	75	0	100	0.2	0.2	49.99999965	75	0	0.235618084	0	0.2	20	10.00618966	20	25	20	0	25	0.2	0	0	0	0	0	0	0	0	0											177.6736632	177.6736632	66.62762371	0	88.83683161	0.177673663	0.177673663	44.41841549	66.62762371	0	0.209315641	0	0.177673663	17.76736632	8.889181855	17.76736632	22.2092079	17.76736632	0	22.2092079	0.177673663	0	0	0	0	0	0	0	0	0											3.0925	0.075038	3.043047558	0	2.623856621	2.49304542	1.419676094	2.012544622	3.155543271	0	7.955715636	0	0.05005894	0.850117801	2.898175128	8.541454281	0.361778135	1.195862412	0	0.03797671	5.236101892	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0425	0	5.66	3.0925	0.075038	3.043047558	0	2.623856621	2.49304542	1.419676094	2.012544622	3.155543271	0	7.955715636	0	0.05005894	0.850117801	2.898175128	8.541454281	0.361778135	1.195862412	0	0.03797671	5.236101892	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0425																																																																																		0			3.0925	0.075038	3.043047558	0	2.623856621	2.49304542	1.419676094	2.012544622	3.155543271	0	7.955715636	0	0.05005894	0.850117801	2.898175128	8.541454281	0.361778135	1.195862412	0	0.03797671	5.236101892	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.0425
H5996_041_0	2009	6																					3250											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	V											0	0	0	0	0	0	0	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	203.8013075	4.945205239	284.2737518	16.73969802	288.3036019	12.24753607	6.974415319	407.7328933	636.7886904	8.218265842	17.239054	0	0.318623233	983.0636466	4289.113768	6284.391916	208.7074783	862.3566632	23.10099326	21.90851982	13.88295565	0	0	0	0	0	0	0	12000	0											1a:  Acute - $200/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $200/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $75/visit/9b:  Ambulatory Surgical Center Services - $75/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	200	75	0	100	0.2	0.2	49.99999965	75	0	0.237056747	0	0.2	20	10.0061897	20	25	20	0	25	0.2	0	0	0	0	0	0	0	0	0											184.4660629	184.4660629	69.1747736	0	92.23303147	0.184466063	0.184466063	46.11651541	69.1747736	0	0.218644624	0	0.184466063	18.44660629	9.22901209	18.44660629	23.05825787	18.44660629	0	23.05825787	0.184466063	0	0	0	0	0	0	0	0	0											3.1329	0.076018545	1.638714369	0	2.215926265	2.259254759	1.286542935	1.566935022	3.670809458	0	3.769226479	0	0.058775173	1.511182338	3.298690235	9.660475289	0.401035904	1.325629488	0	0.042097692	2.560934172	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4751	0	3.24	3.1329	0.076018545	1.638714369	0	2.215926265	2.259254759	1.286542935	1.566935022	3.670809458	0	3.769226479	0	0.058775173	1.511182338	3.298690235	9.660475289	0.401035904	1.325629488	0	0.042097692	2.560934172	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4751																																																																																		0			3.1329	0.076018545	1.638714369	0	2.215926265	2.259254759	1.286542935	1.566935022	3.670809458	0	3.769226479	0	0.058775173	1.511182338	3.298690235	9.660475289	0.401035904	1.325629488	0	0.042097692	2.560934172	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.4751
H5996_042_0	2009	6																					3250											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	V											0	0	0	0	0	0	0	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	206.454523	5.009585075	541.7488221	11.13262241	350.3407045	13.66729873	7.782905649	537.435087	561.7762515	11.45141191	37.02142433	0	0.274431617	567.5441008	3867.286919	5702.329705	193.2203242	798.3654223	16.54340297	20.28279646	28.70520055	0	0	0	0	0	0	0	12000	0											1a:  Acute - $200/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $200/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $75/visit/9b:  Ambulatory Surgical Center Services - $75/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	200	75	0	100	0.2	0.2	49.99999965	75	0	0.23596385	0	0.2	20	10.00618966	20	25	20	0	25	0.2	0	0	0	0	0	0	0	0	0											178.9375997	178.9375997	67.1015999	0	89.46879987	0.1789376	0.1789376	44.73439962	67.1015999	0	0.211114025	0	0.1789376	17.89375997	8.952417797	17.89375997	22.36719997	17.89375997	0	22.36719997	0.1789376	0	0	0	0	0	0	0	0	0											3.0785	0.074700261	3.029351059	0	2.612046865	2.44559363	1.392654456	2.003486329	3.141340439	0	7.815741905	0	0.049106135	0.846291493	2.885130687	8.503009919	0.360149802	1.190479937	0	0.03780578	5.136439686	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.6019	0	5.25	3.0785	0.074700261	3.029351059	0	2.612046865	2.44559363	1.392654456	2.003486329	3.141340439	0	7.815741905	0	0.049106135	0.846291493	2.885130687	8.503009919	0.360149802	1.190479937	0	0.03780578	5.136439686	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.6019																																																																																		0			3.0785	0.074700261	3.029351059	0	2.612046865	2.44559363	1.392654456	2.003486329	3.141340439	0	7.815741905	0	0.049106135	0.846291493	2.885130687	8.503009919	0.360149802	1.190479937	0	0.03780578	5.136439686	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.6019
H5996_043_0	2009	6																					3250											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	V											0	0	0	0	0	0	0	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	208.4384325	5.057724314	546.9547175	11.41265795	353.7072777	14.01109279	7.978680742	542.5995299	567.174599	11.73946644	37.95267971	0	0.281334807	572.997874	3904.449328	5757.125822	195.0770607	806.037256	16.95954398	20.4777025	29.42726549	0	0	0	0	0	0	0	12000	0											1a:  Acute - $200/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $200/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $75/visit/9b:  Ambulatory Surgical Center Services - $75/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	200	75	0	100	0.2	0.2	49.99999965	75	0	0.235604698	0	0.2	20	10.00618966	20	25	20	0	25	0.2	0	0	0	0	0	0	0	0	0											177.7513752	177.7513752	66.6567657	0	88.8756876	0.177751375	0.177751375	44.43784349	66.6567657	0	0.209395295	0	0.177751375	17.77513752	8.893069859	17.77513752	22.2189219	17.77513752	0	22.2189219	0.177751375	0	0	0	0	0	0	0	0	0											3.0875	0.074918121	3.038186038	0	2.619664793	2.490491011	1.418221474	2.009329416	3.15050203	0	7.947112565	0	0.050007649	0.848759667	2.893545053	8.527808601	0.361200165	1.193951923	0	0.037916039	5.230736909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.9799	0	5.63	3.0875	0.074918121	3.038186038	0	2.619664793	2.490491011	1.418221474	2.009329416	3.15050203	0	7.947112565	0	0.050007649	0.848759667	2.893545053	8.527808601	0.361200165	1.193951923	0	0.037916039	5.230736909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.9799																																																																																		0			3.0875	0.074918121	3.038186038	0	2.619664793	2.490491011	1.418221474	2.009329416	3.15050203	0	7.947112565	0	0.050007649	0.848759667	2.893545053	8.527808601	0.361200165	1.193951923	0	0.037916039	5.230736909	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.9799
H5996_044_0	2009	5																					3250											D	D	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	V											0	0	0	0	0	0	0	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	1017.421437	32.37921897	654.71759	16.9331256	286.8707321	9.499556999	5.409566094	415.979012	498.3577697	6.762099524	23.60864208	0	0.366787637	792.0339508	4837.297215	7051.45919	222.4726524	951.6763828	27.19998061	23.35348285	22.75938364	0	0	0	0	0	0	0	12000	0											1a:  Acute - $200/$0/day for 1-6/7-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $200/$0/day for 1-5/6-190	2:  Skilled Nursing Services - $0/$100/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $75/visit/9b:  Ambulatory Surgical Center Services - $75/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $20/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $10 to $50/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	200	100	0	100	0.3	0.261462648	49.99999978	75	0	0.245693954	0	0	20	10.00618973	20	50	20	0	50	0.2	0	0	0	0	0	0	0	0	0											166.9582054	166.9582054	83.47910271	0	83.47910271	0.250437308	0.218266673	41.73955117	62.60932703	0	0.205103108	0	0	16.69582054	8.3530774	16.69582054	41.73955135	16.69582054	0	41.73955135	0.166958205	0	0	0	0	0	0	0	0	0											14.1556	0.450498024	4.554603078	0	1.995642609	2.379043483	1.180727991	1.446898105	2.600153715	0	4.842205862	0	0	1.101971392	3.36719317	9.810824766	0.773825725	1.324084842	0	0.081230325	3.799865849	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.8643	0	10.66	14.1556	0.450498024	4.554603078	0	1.995642609	2.379043483	1.180727991	1.446898105	2.600153715	0	4.842205862	0	0	1.101971392	3.36719317	9.810824766	0.773825725	1.324084842	0	0.081230325	3.799865849	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.8643																																																																																		0			14.1556	0.450498024	4.554603078	0	1.995642609	2.379043483	1.180727991	1.446898105	2.600153715	0	4.842205862	0	0	1.101971392	3.36719317	9.810824766	0.773825725	1.324084842	0	0.081230325	3.799865849	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.8643
H5996_045_0	2009	5																					3250											D	D	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	V											0	0	0	0	0	0	0	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	1171.586791	37.28549828	725.447824	21.14859618	405.6352998	13.08353595	7.450479267	532.4506517	543.3105182	8.228501131	32.51003046	0	0.37911355	840.6749545	5468.110021	7900.11957	241.8991292	1034.777469	25.43593468	25.39272627	27.81630772	0	0	0	0	0	0	0	12000	0											1a:  Acute - $200/$0/day for 1-6/7-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $200/$0/day for 1-5/6-190	2:  Skilled Nursing Services - $0/$100/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $75/visit/9b:  Ambulatory Surgical Center Services - $75/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $20/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $20/visit/18a:  Hearing Exams - $20/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $10 to $50/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	200	100	0	100	0.3	0.261462648	49.99999978	75	0	0.246210783	0	0	20	10.00618978	20	50	20	0	50	0.2	0	0	0	0	0	0	0	0	0											159.4487213	159.4487213	79.72436063	0	79.72436063	0.239173082	0.208449424	39.86218014	59.79327047	0	0.196289973	0	0	15.94487213	7.977370828	15.94487213	39.86218031	15.94487213	0	39.86218031	0.159448721	0	0	0	0	0	0	0	0	0											15.5673	0.495427085	4.819655328	0	2.69491791	3.129229615	1.553048115	1.768720316	2.707192731	0	6.381392998	0	0	1.117037887	3.635095114	10.49719969	0.803552225	1.374949535	0	0.084350786	4.435274695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.0644	0	15.53	15.5673	0.495427085	4.819655328	0	2.69491791	3.129229615	1.553048115	1.768720316	2.707192731	0	6.381392998	0	0	1.117037887	3.635095114	10.49719969	0.803552225	1.374949535	0	0.084350786	4.435274695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.0644																																																																																		0			15.5673	0.495427085	4.819655328	0	2.69491791	3.129229615	1.553048115	1.768720316	2.707192731	0	6.381392998	0	0	1.117037887	3.635095114	10.49719969	0.803552225	1.374949535	0	0.084350786	4.435274695	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.0644
H5996_046_0	2009	4																					2000											D	D	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	V											0	0	0	0	0	0	0	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	1038.651096	35.49917133	787.6407097	17.51854856	375.11109	12.83076783	7.306539309	456.8703822	499.4890993	8.034607397	32.01726383	0	0.362123503	721.7487166	5239.960916	8042.925659	277.1670227	1194.426295	19.04335674	29.09488084	26.12333794	0	0	0	0	0	0	0	12000	0											1a:  Acute - $100/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $100/$0/day for 1-5/6-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $50/visit/9b:  Ambulatory Surgical Center Services - $50/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $15/visit/3:  Rehab Services (CORF) - $10/day/5:  Partial Hospitalization - $20/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $15/visit/7b:  Chiropractic Services - $15/visit/7f:  Podiatry Services - $15/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $20/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $20/visit/7h:  Psychiatric Services - Individual - $20/visit/7h:  Psychiatric Services - Group - $20/visit	7c:  Occupational Therapy Services - $15/visit/7i:  Physical/Speech Therapy - $15/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $20/visit/9c:  Outpatient Substance Abuse Svcs - Group - $20/visit/7g:  Other Health Care Professional Services - $10 to $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												100	100	75	0	100	0.3	0.3	49.99999958	50	0	0.239791615	0	0	15	10.00319789	15	20	10	0	20	0.2	0	0	0	0	0	0	0	0	0											74.41759503	74.41759503	55.81319627	0	74.41759503	0.223252785	0.223252785	37.2087972	37.20879751	0	0.178447153	0	0	11.16263925	7.444139299	11.16263925	14.88351901	7.441759503	0	14.88351901	0.14883519	0	0	0	0	0	0	0	0	0											6.4412	0.220146913	3.66339546	0	2.326238766	2.864504653	1.63120525	1.416633116	1.548782397	0	5.713389585	0	0	0.671385046	3.250583249	7.481689807	0.343768388	0.740719436	0	0.036086184	3.888071967	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.2378	0	14.52	6.4412	0.220146913	3.66339546	0	2.326238766	2.864504653	1.63120525	1.416633116	1.548782397	0	5.713389585	0	0	0.671385046	3.250583249	7.481689807	0.343768388	0.740719436	0	0.036086184	3.888071967	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.2378																																																																																		0			6.4412	0.220146913	3.66339546	0	2.326238766	2.864504653	1.63120525	1.416633116	1.548782397	0	5.713389585	0	0	0.671385046	3.250583249	7.481689807	0.343768388	0.740719436	0	0.036086184	3.888071967	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.2378
H5996_047_0	2009	4																					2000											D	D	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	V											0	0	0	0	0	0	0	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	970.7618574	33.17884285	761.7080189	17.77979966	293.9551737	9.974544823	5.680050079	426.2518591	513.2572164	7.1002116	24.78909897	0	0.385127404	813.560401	4956.859389	7457.312597	241.3765542	1040.190498	28.80328712	25.33787033	23.91174036	0	0	0	0	0	0	0	12000	0											1a:  Acute - $100/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $100/$0/day for 1-5/6-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $50/visit/9b:  Ambulatory Surgical Center Services - $50/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $15/visit/3:  Rehab Services (CORF) - $10/day/5:  Partial Hospitalization - $20/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $15/visit/7b:  Chiropractic Services - $15/visit/7f:  Podiatry Services - $15/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $20/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $20/visit/7h:  Psychiatric Services - Individual - $20/visit/7h:  Psychiatric Services - Group - $20/visit	7c:  Occupational Therapy Services - $15/visit/7i:  Physical/Speech Therapy - $15/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $20/visit/9c:  Outpatient Substance Abuse Svcs - Group - $20/visit/7g:  Other Health Care Professional Services - $10 to $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												100	100	75	0	100	0.3	0.3	49.99999958	50	0	0.236736153	0	0	15	10.00319796	15	20	10	0	20	0.2	0	0	0	0	0	0	0	0	0											76.61016287	76.61016287	57.45762215	0	76.61016287	0.229830489	0.229830489	38.30508111	38.30508144	0	0.181363953	0	0	11.49152443	7.663466249	11.49152443	15.32203257	7.661016287	0	15.32203257	0.153220326	0	0	0	0	0	0	0	0	0											6.1975	0.211819713	3.647160962	0	1.876662811	2.29245451	1.305448685	1.360634336	1.638363289	0	4.495848973	0	0	0.779087435	3.165560386	7.141324157	0.308198285	0.664076362	0	0.032352306	3.663764646	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.7803	0	11.84	6.1975	0.211819713	3.647160962	0	1.876662811	2.29245451	1.305448685	1.360634336	1.638363289	0	4.495848973	0	0	0.779087435	3.165560386	7.141324157	0.308198285	0.664076362	0	0.032352306	3.663764646	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.7803																																																																																		0			6.1975	0.211819713	3.647160962	0	1.876662811	2.29245451	1.305448685	1.360634336	1.638363289	0	4.495848973	0	0	0.779087435	3.165560386	7.141324157	0.308198285	0.664076362	0	0.032352306	3.663764646	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	38.7803
H5996_048_0	2009	4																					2000											D	D	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	V											0	0	0	0	0	0	0	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	1041.951584	35.61197588	754.9462227	19.00569555	305.8354702	10.33747966	5.886724976	453.4982877	520.4644562	6.660981942	26.76980082	0	0.400256277	778.6142976	5213.190281	7849.929881	254.8207297	1098.12696	29.71379095	26.74913737	24.68121317	0	0	0	0	0	0	0	12000	0											1a:  Acute - $100/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $100/$0/day for 1-5/6-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $50/visit/9b:  Ambulatory Surgical Center Services - $50/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $15/visit/3:  Rehab Services (CORF) - $10/day/5:  Partial Hospitalization - $20/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $15/visit/7b:  Chiropractic Services - $15/visit/7f:  Podiatry Services - $15/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $20/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $20/visit/7h:  Psychiatric Services - Individual - $20/visit/7h:  Psychiatric Services - Group - $20/visit	7c:  Occupational Therapy Services - $15/visit/7i:  Physical/Speech Therapy - $15/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $20/visit/9c:  Outpatient Substance Abuse Svcs - Group - $20/visit/7g:  Other Health Care Professional Services - $10 to $20/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												100	100	75	0	100	0.3	0.3	49.99999958	50	0	0.235917963	0	0	15	10.00319796	15	20	10	0	20	0.2	0	0	0	0	0	0	0	0	0											75.46264058	75.46264058	56.59698043	0	75.46264058	0.226387922	0.226387922	37.73131997	37.73132029	0	0.178029924	0	0	11.31939609	7.54867732	11.31939609	15.09252812	7.546264058	0	15.09252812	0.150925281	0	0	0	0	0	0	0	0	0											6.5524	0.223947811	3.560639716	0	1.923262681	2.340280535	1.332683433	1.425924083	1.636484258	0	4.765825619	0	0	0.734453636	3.279390937	7.404705464	0.320490752	0.690563001	0	0.033642676	3.725019037	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.9497	0	12.99	6.5524	0.223947811	3.560639716	0	1.923262681	2.340280535	1.332683433	1.425924083	1.636484258	0	4.765825619	0	0	0.734453636	3.279390937	7.404705464	0.320490752	0.690563001	0	0.033642676	3.725019037	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.9497																																																																																		0			6.5524	0.223947811	3.560639716	0	1.923262681	2.340280535	1.332683433	1.425924083	1.636484258	0	4.765825619	0	0	0.734453636	3.279390937	7.404705464	0.320490752	0.690563001	0	0.033642676	3.725019037	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.9497
H5996_049_0	2009	7																					5500											D	D	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	V											0	0	0	0	0	0	0	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	1330.614452	55.73333726	672.6984917	16.50225355	344.7796183	12.04158244	6.857134082	424.3785118	493.9694999	6.735717152	29.34063158	0	0.349883965	681.872897	4821.733862	7361.287419	249.8725634	1009.503078	18.7511285	26.2297166	24.36221026	0	0	0	0	0	0	0	12000	0											1a:  Acute - $250/$0/day for 1-10/11-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/$0/day for 1-10/11-190	2:  Skilled Nursing Services - $0/$100/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $150/visit/9b:  Ambulatory Surgical Center Services - $150/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - $30/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $40/visit/3:  Rehab Services (CORF) - $40/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $35/visit/7b:  Chiropractic Services - $40/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $40/visit/7i:  Physical/Speech Therapy - $40/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $20 to $50/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												250	250	100	0	100	0.2	0.2	49.99999984	150	0	0.196545376	0	0	40	20.01245642	36.30475373	50	40	0	50	0.2	0	0	0	0	0	0	0	0	0											218.88011	218.88011	87.552044	0	87.552044	0.175104088	0.175104088	43.77602186	131.328066	0	0.172079494	0	0	35.0208176	17.52272594	32.04959036	43.776022	35.0208176	0	43.776022	0.175104088	0	0	0	0	0	0	0	0	0											24.2704	1.016576583	4.908010661	0	2.515513359	2.10853031	1.20071221	1.548133584	5.406004923	0	5.048921028	0	0	1.989978863	7.040826754	19.66052053	0.91153557	2.946135265	0	0.095686054	4.26592261	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.9334	0	11.89	24.2704	1.016576583	4.908010661	0	2.515513359	2.10853031	1.20071221	1.548133584	5.406004923	0	5.048921028	0	0	1.989978863	7.040826754	19.66052053	0.91153557	2.946135265	0	0.095686054	4.26592261	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.9334																																																																																		0			24.2704	1.016576583	4.908010661	0	2.515513359	2.10853031	1.20071221	1.548133584	5.406004923	0	5.048921028	0	0	1.989978863	7.040826754	19.66052053	0.91153557	2.946135265	0	0.095686054	4.26592261	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.9334
H5996_050_0	2009	7																					5500											D	D	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	V											0	0	0	0	0	0	0	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	1275.789397	53.43696712	714.8781863	18.50808497	406.4699824	13.60787994	7.749069344	490.3880551	494.270141	9.387544441	34.78280927	0	0.37424027	743.8928634	5012.683214	7753.398153	273.9123159	1106.625403	18.4520198	28.75322653	27.93579971	0	0	0	0	0	0	0	12000	0											1a:  Acute - $250/$0/day for 1-10/11-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/$0/day for 1-10/11-190	2:  Skilled Nursing Services - $0/$100/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $150/visit/9b:  Ambulatory Surgical Center Services - $150/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - $30/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $40/visit/3:  Rehab Services (CORF) - $40/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $35/visit/7b:  Chiropractic Services - $40/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $40/visit/7i:  Physical/Speech Therapy - $40/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $20 to $50/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												250	250	100	0	100	0.2	0.2	49.99999984	150	0	0.196549663	0	0	40	20.01245624	36.31715474	50	40	0	50	0.2	0	0	0	0	0	0	0	0	0											216.5366782	216.5366782	86.61467126	0	86.61467126	0.173229343	0.173229343	43.30733549	129.9220069	0	0.170240845	0	0	34.6458685	17.33528482	31.7598749	43.30733563	34.6458685	0	43.30733563	0.173229343	0	0	0	0	0	0	0	0	0											23.0213	0.964255279	5.159911592	0	2.933855325	2.357284095	1.342366188	1.769783335	5.351380722	0	5.921454832	0	0	2.147734527	7.241357602	20.52057962	0.988534383	3.194999849	0	0.103768803	4.839300216	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.8578	0	13.35	23.0213	0.964255279	5.159911592	0	2.933855325	2.357284095	1.342366188	1.769783335	5.351380722	0	5.921454832	0	0	2.147734527	7.241357602	20.52057962	0.988534383	3.194999849	0	0.103768803	4.839300216	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.8578																																																																																		0			23.0213	0.964255279	5.159911592	0	2.933855325	2.357284095	1.342366188	1.769783335	5.351380722	0	5.921454832	0	0	2.147734527	7.241357602	20.52057962	0.988534383	3.194999849	0	0.103768803	4.839300216	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.8578
H5996_051_0	2009	7																					5500											D	D	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	V											0	0	0	0	0	0	0	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	1293.395601	54.17441028	697.1776541	20.178194	380.3007309	12.38947134	7.055241004	500.5309212	520.4309683	8.268587082	30.86715097	0	0.357259291	814.0935235	4876.414178	7266.533047	227.6441356	919.6986355	23.87878487	23.89634572	26.92344821	0	0	0	0	0	0	0	12000	0											1a:  Acute - $250/$0/day for 1-10/11-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/$0/day for 1-10/11-190	2:  Skilled Nursing Services - $0/$100/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $150/visit/9b:  Ambulatory Surgical Center Services - $150/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - $30/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $40/visit/3:  Rehab Services (CORF) - $40/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $35/visit/7b:  Chiropractic Services - $40/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $40/visit/7i:  Physical/Speech Therapy - $40/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $20 to $50/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												250	250	100	0	100	0.2	0.2	49.99999984	150	0	0.192960901	0	0	40	20.01245674	36.28130841	50	40	0	50	0.2	0	0	0	0	0	0	0	0	0											217.2769169	217.2769169	86.91076675	0	86.91076675	0.173821533	0.173821533	43.45538323	130.3661501	0	0.167703799	0	0	34.7643067	17.39424901	31.74912077	43.45538337	34.7643067	0	43.45538337	0.173821533	0	0	0	0	0	0	0	0	0											23.4188	0.98090407	5.049353707	0	2.754352343	2.153556907	1.226352811	1.812563584	5.653881812	0	5.176538477	0	0	2.358449744	7.068463541	19.22550294	0.824363599	2.664390453	0	0.086535405	4.679875055	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.1338	0	12.67	23.4188	0.98090407	5.049353707	0	2.754352343	2.153556907	1.226352811	1.812563584	5.653881812	0	5.176538477	0	0	2.358449744	7.068463541	19.22550294	0.824363599	2.664390453	0	0.086535405	4.679875055	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.1338																																																																																		0			23.4188	0.98090407	5.049353707	0	2.754352343	2.153556907	1.226352811	1.812563584	5.653881812	0	5.176538477	0	0	2.358449744	7.068463541	19.22550294	0.824363599	2.664390453	0	0.086535405	4.679875055	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.1338
H5996_052_0	2009	4																					3350											D	D	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	V											0	0	0	0	0	0	0	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	1779.987628	76.94613358	497.3454928	18.46686417	377.2288477	13.07203802	7.443931717	438.2595896	606.2830618	5.292010315	25.15753466	0	0.388585138	665.6103407	5014.955926	7440.012415	244.9212768	1024.423038	29.49905456	25.70996828	20.01339941	0	0	0	0	0	0	0	12000	0											1a:  Acute - $250/$0/day for 1-/1-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/$0/day for 1-/1-190	2:  Skilled Nursing Services - $0/$100/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $125/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $125/visit/9b:  Ambulatory Surgical Center Services - $125/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $30/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $30/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - $15/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $15/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $30/visit/7f:  Podiatry Services - $30/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $15/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $15 to $50/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												250	250	100	0	125	0.3	0.3	49.99999978	125	0	0.269102276	0	0	30	15	29.06817886	50	30	0	50	0.2	0	0	0	0	0	0	0	0	0											190.039507	190.039507	76.01580281	0	95.01975351	0.228047408	0.228047408	38.00790124	95.01975351	0	0.204560256	0	0	22.80474084	11.40237042	22.23743322	38.00790141	22.80474084	0	38.00790141	0.152031606	0	0	0	0	0	0	0	0	0											28.189	1.218567108	3.150509742	0	2.987016011	2.981044393	1.697569337	1.3881106	4.800738925	0	5.146231722	0	0	1.26492261	4.765198759	13.7872316	0.775745312	1.946808491	0	0.081431828	3.042669246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.2228	0	24.25	28.189	1.218567108	3.150509742	0	2.987016011	2.981044393	1.697569337	1.3881106	4.800738925	0	5.146231722	0	0	1.26492261	4.765198759	13.7872316	0.775745312	1.946808491	0	0.081431828	3.042669246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.2228																																																																																		0			28.189	1.218567108	3.150509742	0	2.987016011	2.981044393	1.697569337	1.3881106	4.800738925	0	5.146231722	0	0	1.26492261	4.765198759	13.7872316	0.775745312	1.946808491	0	0.081431828	3.042669246	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.2228
H5996_053_0	2009	4																					3350											D	D	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	V											0	0	0	0	0	0	0	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	1791.943501	77.46296762	491.9540602	19.06038769	438.5716052	13.89218969	7.91097083	477.1056746	625.5750976	6.252385741	27.46924933	0	0.364415101	718.1446186	4995.391569	7353.573242	236.0240968	987.2091367	27.20766487	24.77601016	22.02302082	0	0	0	0	0	0	0	12000	0											1a:  Acute - $250/$0/day for 1-/1-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/$0/day for 1-/1-190	2:  Skilled Nursing Services - $0/$100/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $125/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $125/visit/9b:  Ambulatory Surgical Center Services - $125/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $30/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $30/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - $15/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $15/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $30/visit/7f:  Podiatry Services - $30/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $15/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $15 to $50/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												250	250	100	0	125	0.3	0.3	49.99999978	125	0	0.268432117	0	0	30	15	29.06089598	50	30	0	50	0.2	0	0	0	0	0	0	0	0	0											188.6875885	188.6875885	75.47503539	0	94.34379424	0.226425106	0.226425106	37.73751753	94.34379424	0	0.202599235	0	0	22.64251062	11.32125531	22.0916849	37.7375177	22.64251062	0	37.7375177	0.150950071	0	0	0	0	0	0	0	0	0											28.1765	1.218025046	3.094187509	0	3.44804244	3.145540525	1.79124241	1.500398647	4.918260691	0	5.565248899	0	0	1.355049763	4.712841944	13.53773525	0.742246961	1.862741113	0	0.077915427	3.324376551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.4703	0	25.37	28.1765	1.218025046	3.094187509	0	3.44804244	3.145540525	1.79124241	1.500398647	4.918260691	0	5.565248899	0	0	1.355049763	4.712841944	13.53773525	0.742246961	1.862741113	0	0.077915427	3.324376551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.4703																																																																																		0			28.1765	1.218025046	3.094187509	0	3.44804244	3.145540525	1.79124241	1.500398647	4.918260691	0	5.565248899	0	0	1.355049763	4.712841944	13.53773525	0.742246961	1.862741113	0	0.077915427	3.324376551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.4703
H5996_054_0	2009	4																					3350											D	D	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	V											0	0	0	0	0	0	0	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	1846.814797	79.83496955	487.779789	19.97323334	507.3476792	15.24499443	8.681331662	491.8571909	654.176271	7.058057894	29.52749143	0	0.375041999	721.6605929	5240.509295	7664.777584	240.7410361	1006.938502	28.53610952	25.27115848	25.44669074	0	0	0	0	0	0	0	12000	0											1a:  Acute - $250/$0/day for 1-/1-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/$0/day for 1-/1-190	2:  Skilled Nursing Services - $0/$100/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $125/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $125/visit/9b:  Ambulatory Surgical Center Services - $125/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $30/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $30/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - $15/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $15/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $30/visit/7f:  Podiatry Services - $30/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $15/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $15 to $50/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												250	250	100	0	125	0.3	0.3	49.99999978	125	0	0.266410115	0	0	30	15	29.0548094	50	30	0	50	0.2	0	0	0	0	0	0	0	0	0											185.6338087	185.6338087	74.25352349	0	92.81690437	0.22276057	0.22276057	37.12676158	92.81690437	0	0.197818897	0	0	22.27605705	11.13802852	21.73068003	37.12676175	22.27605705	0	37.12676175	0.148507047	0	0	0	0	0	0	0	0	0											28.5693	1.235005789	3.018280668	0	3.924203418	3.395983655	1.933858394	1.521755388	5.059884698	0	5.841095794	0	0	1.339646045	4.864078501	13.8800691	0.744827924	1.869218292	0	0.078186357	3.779012897	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.0544	0	27.97	28.5693	1.235005789	3.018280668	0	3.924203418	3.395983655	1.933858394	1.521755388	5.059884698	0	5.841095794	0	0	1.339646045	4.864078501	13.8800691	0.744827924	1.869218292	0	0.078186357	3.779012897	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.0544																																																																																		0			28.5693	1.235005789	3.018280668	0	3.924203418	3.395983655	1.933858394	1.521755388	5.059884698	0	5.841095794	0	0	1.339646045	4.864078501	13.8800691	0.744827924	1.869218292	0	0.078186357	3.779012897	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.0544
H5996_055_0	2009	4																					3250											D	D	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	V											0	0	0	0	0	0	0	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	1773.434997	76.66287338	538.7646461	17.50170129	405.6134759	14.00039467	7.97258865	450.2631728	581.3199377	6.405611506	26.16116624	0	0.36523734	705.7538702	5048.648389	7555.132197	239.7261021	990.5222523	27.77456193	25.16461845	23.96841424	0	0	0	0	0	0	0	12000	0											1a:  Acute - $100/$0/day for 1-/1-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $100/$0/day for 1-/1-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $50/visit/9b:  Ambulatory Surgical Center Services - $50/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $15/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $25/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $15 to $25/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												100	100	75	0	100	0.3	0.3	49.99999965	50	0	0.23975112	0	0	25	15	19.69074967	25	20	0	25	0.2	0	0	0	0	0	0	0	0	0											82.75906793	82.75906793	62.06930095	0	82.75906793	0.248277204	0.248277204	41.37953367	41.37953397	0	0.198415793	0	0	20.68976698	12.41386019	16.30469886	20.68976698	16.55181359	0	20.68976698	0.165518136	0	0	0	0	0	0	0	0	0											12.2307	0.528712329	2.786728747	0	2.797349434	3.475978841	1.979412017	1.55264001	2.004562342	0	5.190788537	0	0	1.216823593	5.222767937	10.26534628	0.413323099	1.366244973	0	0.043387508	3.967207244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.0419	0	11.46	12.2307	0.528712329	2.786728747	0	2.797349434	3.475978841	1.979412017	1.55264001	2.004562342	0	5.190788537	0	0	1.216823593	5.222767937	10.26534628	0.413323099	1.366244973	0	0.043387508	3.967207244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.0419																																																																																		0			12.2307	0.528712329	2.786728747	0	2.797349434	3.475978841	1.979412017	1.55264001	2.004562342	0	5.190788537	0	0	1.216823593	5.222767937	10.26534628	0.413323099	1.366244973	0	0.043387508	3.967207244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.0419
H5996_056_0	2009	4																					3250											D	D	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	V											0	0	0	0	0	0	0	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	1830.059741	79.11067418	585.1755245	20.22251306	404.5958156	13.92318267	7.928619924	460.0316788	646.8652689	5.605075949	27.33785296	0	0.417116628	682.2062575	5144.190596	7841.947578	264.61372	1093.35519	31.8173425	27.77713083	19.98226922	0	0	0	0	0	0	0	12000	0											1a:  Acute - $100/$0/day for 1-/1-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $100/$0/day for 1-/1-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $50/visit/9b:  Ambulatory Surgical Center Services - $50/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $15/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $25/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $15 to $25/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												100	100	75	0	100	0.3	0.3	49.99999965	50	0	0.240013137	0	0	25	15	19.7382262	25	20	0	25	0.2	0	0	0	0	0	0	0	0	0											82.19496925	82.19496925	61.64622694	0	82.19496925	0.246584908	0.246584908	41.09748434	41.09748463	0	0.197278724	0	0	20.54874231	12.32924539	16.22382896	20.54874231	16.43899385	0	20.54874231	0.164389939	0	0	0	0	0	0	0	0	0											12.5351	0.541874953	3.006155265	0	2.771311719	3.433246714	1.955078013	1.575512059	2.215377954	0	5.393176748	0	0	1.168206716	5.285332348	10.60220135	0.453123262	1.497804937	0	0.047565425	3.284884008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.766	0	12.08	12.5351	0.541874953	3.006155265	0	2.771311719	3.433246714	1.955078013	1.575512059	2.215377954	0	5.393176748	0	0	1.168206716	5.285332348	10.60220135	0.453123262	1.497804937	0	0.047565425	3.284884008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.766																																																																																		0			12.5351	0.541874953	3.006155265	0	2.771311719	3.433246714	1.955078013	1.575512059	2.215377954	0	5.393176748	0	0	1.168206716	5.285332348	10.60220135	0.453123262	1.497804937	0	0.047565425	3.284884008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.766
H5996_057_0	2009	4																					3250											D	D	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	V											0	0	0	0	0	0	0	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	1911.060728	82.61222256	568.3680454	20.15185807	530.9635139	15.79846814	8.996509797	528.5981002	667.5885208	7.768636139	30.75231735	0	0.364016938	785.5123617	5289.170602	7866.079221	244.2161021	1009.074445	27.93539285	25.63594441	26.91514217	0	0	0	0	0	0	0	12000	0											1a:  Acute - $100/$0/day for 1-/1-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $100/$0/day for 1-/1-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $50/visit/9b:  Ambulatory Surgical Center Services - $50/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $15/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $25/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $15 to $25/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												100	100	75	0	100	0.3	0.3	49.99999965	50	0	0.239366414	0	0	25	15	19.67463056	25	20	0	25	0.2	0	0	0	0	0	0	0	0	0											80.62366328	80.62366328	60.46774746	0	80.62366328	0.24187099	0.24187099	40.31183136	40.31183164	0	0.192985971	0	0	20.15591582	12.09354949	15.88238796	20.15591582	16.12473266	0	20.15591582	0.161247327	0	0	0	0	0	0	0	0	0											12.8397	0.555041668	2.863994619	0	3.567351963	3.821191128	2.17599473	1.775729789	2.242643004	0	5.934765837	0	0	1.31939342	5.33040387	10.41101016	0.410199933	1.355921305	0	0.043059661	4.339994719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.9864	0	14.16	12.8397	0.555041668	2.863994619	0	3.567351963	3.821191128	2.17599473	1.775729789	2.242643004	0	5.934765837	0	0	1.31939342	5.33040387	10.41101016	0.410199933	1.355921305	0	0.043059661	4.339994719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.9864																																																																																		0			12.8397	0.555041668	2.863994619	0	3.567351963	3.821191128	2.17599473	1.775729789	2.242643004	0	5.934765837	0	0	1.31939342	5.33040387	10.41101016	0.410199933	1.355921305	0	0.043059661	4.339994719	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.9864
H5996_058_0	2009	4																					3250											D	D	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	V											0	0	0	0	0	0	0	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	2000.394413	86.47398066	579.4584244	21.03528461	624.6894432	16.92295136	9.636851897	596.4971426	675.3122831	9.28615908	33.86786196	0	0.375384418	851.8251426	5471.402562	8107.237935	248.4059221	1026.386327	27.95264995	26.07575977	27.90386033	0	0	0	0	0	0	0	12000	0											1a:  Acute - $100/$0/day for 1-/1-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $100/$0/day for 1-/1-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $50/visit/9b:  Ambulatory Surgical Center Services - $50/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $15/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $25/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $15 to $25/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												100	100	75	0	100	0.3	0.3	49.99999965	50	0	0.239692408	0	0	25	15	19.66503874	25	20	0	25	0.2	0	0	0	0	0	0	0	0	0											79.37123101	79.37123101	59.52842326	0	79.37123101	0.238113693	0.238113693	39.68561522	39.6856155	0	0.190246815	0	0	19.84280775	11.90568465	15.62262636	19.84280775	15.8742462	0	19.84280775	0.158742462	0	0	0	0	0	0	0	0	0											13.2311	0.571962191	2.874520529	0	4.131864175	4.029586445	2.294666394	1.97269634	2.233348634	0	6.443252873	0	0	1.408550212	5.428399459	10.55469575	0.410755913	1.357759105	0	0.043118024	4.429527488	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.4159	0	15.95	13.2311	0.571962191	2.874520529	0	4.131864175	4.029586445	2.294666394	1.97269634	2.233348634	0	6.443252873	0	0	1.408550212	5.428399459	10.55469575	0.410755913	1.357759105	0	0.043118024	4.429527488	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.4159																																																																																		0			13.2311	0.571962191	2.874520529	0	4.131864175	4.029586445	2.294666394	1.97269634	2.233348634	0	6.443252873	0	0	1.408550212	5.428399459	10.55469575	0.410755913	1.357759105	0	0.043118024	4.429527488	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.4159
H5996_059_0	2009	4																					3350											D	D	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	V											0	0	0	0	0	0	0	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	1271.621815	55.49314263	638.9518019	16.27993157	381.1744218	12.4406373	7.084377698	421.0953569	448.262356	8.975210698	29.24476505	0	0.308847157	853.0797588	4898.624534	7057.600708	210.9730801	882.4291889	20.92056118	22.14634542	27.59764903	0	0	0	0	0	0	0	12000	0											1a:  Acute - $250/day for 1-12/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/day for 1-12	2:  Skilled Nursing Services - $0/$100/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $30/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $30/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - $15/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $30/visit/7f:  Podiatry Services - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $15 to $50/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												250	250	100	0	150	0.3	0.3	49.99999984	100	0	0.265042128	0	0	30	15.009366	30	50	30	0	50	0.2	0	0	0	0	0	0	0	0	0											194.0717078	194.0717078	77.62868311	0	116.4430247	0.232886049	0.232886049	38.81434143	77.62868311	0	0.205748714	0	0	23.28860493	11.65258067	23.45053044	38.81434156	23.28860493	0	38.81434156	0.155257366	0	0	0	0	0	0	0	0	0											20.5655	0.897470747	4.133415579	0	3.69875855	2.897250873	1.649852734	1.362044913	2.899834699	0	6.017072801	0	0	1.655586457	4.756801462	13.79204002	0.682398433	1.712545397	0	0.071632985	4.284738302	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.0769	0	20.36	20.5655	0.897470747	4.133415579	0	3.69875855	2.897250873	1.649852734	1.362044913	2.899834699	0	6.017072801	0	0	1.655586457	4.756801462	13.79204002	0.682398433	1.712545397	0	0.071632985	4.284738302	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.0769																																																																																		0			20.5655	0.897470747	4.133415579	0	3.69875855	2.897250873	1.649852734	1.362044913	2.899834699	0	6.017072801	0	0	1.655586457	4.756801462	13.79204002	0.682398433	1.712545397	0	0.071632985	4.284738302	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.0769
H5996_060_0	2009	4																					3350											D	D	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	V											0	0	0	0	0	0	0	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	1325.754833	57.8554891	624.5660062	15.55479938	442.897723	12.81590394	7.298074998	451.8790601	456.6553445	7.320032691	30.62379073	0	0.321192139	716.9045121	4940.46611	7168.835183	219.8229276	919.4451141	21.45828907	23.07533494	28.57659083	0	0	0	0	0	0	0	12000	0											1a:  Acute - $250/day for 1-12/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/day for 1-12	2:  Skilled Nursing Services - $0/$100/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $30/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $30/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - $15/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $30/visit/7f:  Podiatry Services - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $15 to $50/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												250	250	100	0	150	0.3	0.3	49.99999984	100	0	0.265166886	0	0	30	15.00936593	30	50	30	0	50	0.2	0	0	0	0	0	0	0	0	0											192.8264322	192.8264322	77.13057288	0	115.6958593	0.231391719	0.231391719	38.56528631	77.13057288	0	0.204524738	0	0	23.13917186	11.57784602	23.30997873	38.56528644	23.13917186	0	38.56528644	0.154261146	0	0	0	0	0	0	0	0	0											21.3034	0.929672295	4.014427821	0	4.270119387	2.965494039	1.688714117	1.452237111	2.935174027	0	6.263322775	0	0	1.382381393	4.766662992	13.92544964	0.706461181	1.772933209	0	0.074158908	4.408257642	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.8588	0	21.47	21.3034	0.929672295	4.014427821	0	4.270119387	2.965494039	1.688714117	1.452237111	2.935174027	0	6.263322775	0	0	1.382381393	4.766662992	13.92544964	0.706461181	1.772933209	0	0.074158908	4.408257642	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.8588																																																																																		0			21.3034	0.929672295	4.014427821	0	4.270119387	2.965494039	1.688714117	1.452237111	2.935174027	0	6.263322775	0	0	1.382381393	4.766662992	13.92544964	0.706461181	1.772933209	0	0.074158908	4.408257642	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.8588
H5996_061_0	2009	5																					2500											D	D	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	V											0	0	0	0	0	0	0	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	926.1048835	31.65255017	800.4081144	17.6780596	385.5970178	13.4264145	7.645733023	459.1350138	514.4498189	6.0307854	32.90004029	0	0.304197293	768.9823622	5209.926791	6338.164474	204.9872076	828.1630214	23.62090588	21.51799417	30.288239	3.318577586	0	0	0	0	0	0	12000	0											1a:  Acute - $100/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $100/$0/day for 1-5/6-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $50/visit/9b:  Ambulatory Surgical Center Services - $50/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $25/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - $5/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $15/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - $5/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $10 to $25/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												100	100	75	0	100	0.3	0.3	49.99999958	50	0	0.23818778	0	0	20	9.996561357	15.96434471	25	25	0	25	0.2	0	0	0	0	0	0	0	0	0											79.83091937	79.83091937	59.87318953	0	79.83091937	0.239492758	0.239492758	39.91545935	39.91545968	0	0.190147495	0	0	15.96618387	7.980346837	12.74448316	19.95772984	19.95772984	0	19.95772984	0.159661839	0	0	0	0	0	0	0	0	0											6.161	0.210571015	3.993582227	0	2.565213703	3.21552904	1.831097689	1.527215415	1.711208417	0	6.255860244	0	0	1.023142816	3.464751899	6.731385864	0.340923276	1.377354487	0	0.035787526	4.835875931	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.2805	0	11.44	6.161	0.210571015	3.993582227	0	2.565213703	3.21552904	1.831097689	1.527215415	1.711208417	0	6.255860244	0	0	1.023142816	3.464751899	6.731385864	0.340923276	1.377354487	0	0.035787526	4.835875931	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.2805																																																																																		0			6.161	0.210571015	3.993582227	0	2.565213703	3.21552904	1.831097689	1.527215415	1.711208417	0	6.255860244	0	0	1.023142816	3.464751899	6.731385864	0.340923276	1.377354487	0	0.035787526	4.835875931	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.2805
H5996_062_0	2009	5																					2500											D	D	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	V											0	0	0	0	0	0	0	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	1014.841875	34.68541625	785.469563	17.01748707	407.4220024	12.95018407	7.374541433	407.1881644	531.0398782	7.826711923	28.75876063	0	0.322397479	698.748408	5349.149578	6600.997766	223.5452246	903.1387411	24.78472041	23.4660733	34.08669402	3.737823432	0	0	0	0	0	0	12000	0											1a:  Acute - $100/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $100/$0/day for 1-5/6-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $50/visit/9b:  Ambulatory Surgical Center Services - $50/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $25/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - $5/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $15/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - $5/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $10 to $25/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												100	100	75	0	100	0.3	0.3	49.99999958	50	0	0.237197958	0	0	20	9.996561399	16.02107661	25	25	0	25	0.2	0	0	0	0	0	0	0	0	0											79.41790599	79.41790599	59.56342949	0	79.41790599	0.238253718	0.238253718	39.70895266	39.70895299	0	0.188377651	0	0	15.8835812	7.939059734	12.72360356	19.8544765	19.8544765	0	19.8544765	0.158835812	0	0	0	0	0	0	0	0	0											6.7164	0.229553594	3.898771745	0	2.696383524	3.085429504	1.757011915	1.347417962	1.75725313	0	5.417507787	0	0	0.92488559	3.538934836	6.999039891	0.369864451	1.494278909	0	0.03882555	5.414187723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.6857	0	11.84	6.7164	0.229553594	3.898771745	0	2.696383524	3.085429504	1.757011915	1.347417962	1.75725313	0	5.417507787	0	0	0.92488559	3.538934836	6.999039891	0.369864451	1.494278909	0	0.03882555	5.414187723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.6857																																																																																		0			6.7164	0.229553594	3.898771745	0	2.696383524	3.085429504	1.757011915	1.347417962	1.75725313	0	5.417507787	0	0	0.92488559	3.538934836	6.999039891	0.369864451	1.494278909	0	0.03882555	5.414187723	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.6857
H5996_063_0	2009	5																					2500											D	D	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	V											0	0	0	0	0	0	0	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	1033.453325	35.32152112	722.7474128	16.19147364	454.9121965	13.36288445	7.609555544	463.7641972	472.8302112	7.557536728	32.23941939	0	0.335164952	724.6262149	5215.060347	6537.260074	232.1793186	938.0211004	22.74523079	24.37241466	29.93096437	3.280493639	0	0	0	0	0	0	12000	0											1a:  Acute - $100/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $100/$0/day for 1-5/6-190	2:  Skilled Nursing Services - $0/$75/day for 1-11/12-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-11/12-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $50/visit/9b:  Ambulatory Surgical Center Services - $50/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $20/visit/3:  Rehab Services (CORF) - $25/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - $5/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $15/visit/7b:  Chiropractic Services - $20/visit/7f:  Podiatry Services - $20/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - $5/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $20/visit/7i:  Physical/Speech Therapy - $20/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $10 to $25/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												100	100	75	0	100	0.3	0.3	49.99999958	50	0	0.238092641	0	0	20	9.996561446	16.08254835	25	25	0	25	0.2	0	0	0	0	0	0	0	0	0											79.35135369	79.35135369	59.51351527	0	79.35135369	0.238054061	0.238054061	39.67567651	39.67567684	0	0.188929733	0	0	15.87027074	7.93240683	12.76171983	19.83783842	19.83783842	0	19.83783842	0.158702707	0	0	0	0	0	0	0	0	0											6.8338	0.233567543	3.584436599	0	3.008158217	3.18108891	1.8114856	1.533346522	1.563321555	0	6.090984912	0	0	0.958334518	3.447331693	6.952223458	0.383827984	1.550692586	0	0.040291335	4.75012508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.923	0	11.95	6.8338	0.233567543	3.584436599	0	3.008158217	3.18108891	1.8114856	1.533346522	1.563321555	0	6.090984912	0	0	0.958334518	3.447331693	6.952223458	0.383827984	1.550692586	0	0.040291335	4.75012508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.923																																																																																		0			6.8338	0.233567543	3.584436599	0	3.008158217	3.18108891	1.8114856	1.533346522	1.563321555	0	6.090984912	0	0	0.958334518	3.447331693	6.952223458	0.383827984	1.550692586	0	0.040291335	4.75012508	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.923
H5996_064_0	2009	4																					6000											D	D	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	V											0	0	0	0	0	0	0	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	1652.799173	75.15253298	1147.963192	27.39541948	243.9285033	12.2454209	6.973210824	501.3194347	627.086058	15.24466076	36.1490963	0	0.342325954	875.2199243	5198.959091	7562.365358	207.324953	886.8787207	28.43127025	21.76339286	27.76663654	0	0	0	0	0	0	0	12000	0											1a:  Acute - $250/day for 1-15/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/day for 1-15	2:  Skilled Nursing Services - $0/$100/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - $30/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $35/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $35/visit/7b:  Chiropractic Services - $35/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $35/visit/7i:  Physical/Speech Therapy - $35/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $20 to $50/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												250	250	100	0	100	0.2	0.2	49.99999984	100	0	0.200852269	0	0	35	20.00967241	35	50	20	0	50	0.2	0	0	0	0	0	0	0	0	0											216.3669688	216.3669688	86.54678751	0	86.54678751	0.173093575	0.173093575	43.27339362	86.54678751	0	0.173831187	0	0	30.29137563	17.31853526	30.40640325	43.27339376	17.3093575	0	43.27339376	0.173093575	0	0	0	0	0	0	0	0	0											29.8009	1.355043813	8.279377206	0	1.759269029	2.119603681	1.207017991	1.807816102	4.522690318	0	6.283840313	0	0	2.20930129	7.503196359	19.16202755	0.747637861	1.27927507	0	0.078481322	4.806226385	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.9217	0	14.36	29.8009	1.355043813	8.279377206	0	1.759269029	2.119603681	1.207017991	1.807816102	4.522690318	0	6.283840313	0	0	2.20930129	7.503196359	19.16202755	0.747637861	1.27927507	0	0.078481322	4.806226385	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.9217																																																																																		0			29.8009	1.355043813	8.279377206	0	1.759269029	2.119603681	1.207017991	1.807816102	4.522690318	0	6.283840313	0	0	2.20930129	7.503196359	19.16202755	0.747637861	1.27927507	0	0.078481322	4.806226385	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.9217
H5996_065_0	2009	4																					6000											D	D	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	V											0	0	0	0	0	0	0	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	1679.767859	76.37879512	1047.997293	29.54572436	199.4121839	12.46701642	7.099399405	526.4113344	693.7694533	16.0917422	40.79589587	0	0.333186656	1026.319369	5167.996785	7506.998517	204.6614297	875.4849059	28.82176725	21.48379649	36.46302116	0	0	0	0	0	0	0	12000	0											1a:  Acute - $250/day for 1-15/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/day for 1-15	2:  Skilled Nursing Services - $0/$100/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $100/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - $30/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $35/visit/3:  Rehab Services (CORF) - $20/day/5:  Partial Hospitalization - $50/day	7a:  Primary Care - $20/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $35/visit/7b:  Chiropractic Services - $35/visit/7f:  Podiatry Services - $35/visit/17a:  Vision Exams - $35/visit/18a:  Hearing Exams - $35/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $50/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $50/visit/7h:  Psychiatric Services - Individual - $50/visit/7h:  Psychiatric Services - Group - $50/visit	7c:  Occupational Therapy Services - $35/visit/7i:  Physical/Speech Therapy - $35/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $50/visit/9c:  Outpatient Substance Abuse Svcs - Group - $50/visit/7g:  Other Health Care Professional Services - $20 to $50/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												250	250	100	0	100	0.2	0.2	49.99999984	100	0	0.199702087	0	0	35	20.00967242	35	50	20	0	50	0.2	0	0	0	0	0	0	0	0	0											215.3024341	215.3024341	86.12097362	0	86.12097362	0.172241947	0.172241947	43.06048667	86.12097362	0	0.171985381	0	0	30.14234077	17.23338911	30.26488828	43.06048681	17.22419472	0	43.06048681	0.172241947	0	0	0	0	0	0	0	0	0											30.1382	1.370378375	7.52121227	0	1.431130953	2.147343184	1.222814378	1.888960687	4.979008399	0	7.016297714	0	0	2.577972347	7.421841626	18.93320595	0.734401733	1.256626875	0	0.077091895	6.280461767	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.9969	0	15.22	30.1382	1.370378375	7.52121227	0	1.431130953	2.147343184	1.222814378	1.888960687	4.979008399	0	7.016297714	0	0	2.577972347	7.421841626	18.93320595	0.734401733	1.256626875	0	0.077091895	6.280461767	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.9969																																																																																		0			30.1382	1.370378375	7.52121227	0	1.431130953	2.147343184	1.222814378	1.888960687	4.979008399	0	7.016297714	0	0	2.577972347	7.421841626	18.93320595	0.734401733	1.256626875	0	0.077091895	6.280461767	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.9969
H5996_066_0	2009	4																					3350											D	D	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	1235.036242	42.21125198	1176.312819	28.76521922	249.9524614	12.8577048	7.321878687	513.6998137	54.0589848	16.00690981	37.95658907	0	0.359442611	901.5791492	5675.67701	7850.015725	219.9430224	888.5855861	30.28278667	23.08794158	29.16953017	0	0	0	0	0	0	0	12000	0											1a:  Acute - $150/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $150/$0/day for 1-5/6-190	2:  Skilled Nursing Services - $0/$100/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $30/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - $25/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $25/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $10 to $25/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												150	150	100	0	100	0.3	0.3	49.99999972	0	0	0.270181889	0	0	25	10.00907879	21.78671743	25	25	0	25	0.2	0	0	0	0	0	0	0	0	0											120.0623196	120.0623196	80.0415464	0	80.0415464	0.240124639	0.240124639	40.02077297	0	0	0.216257762	0	0	20.0103866	8.011421446	17.43842555	20.0103866	20.0103866	0	20.0103866	0.160083093	0	0	0	0	0	0	0	0	0											12.3568	0.422331735	7.846158094	0	1.667215128	3.087451726	1.758163478	1.713221968	0	0	8.208406995	0	0	1.503412277	3.78918671	11.40765956	0.366762076	1.481745092	0	0.038499886	4.669548606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.3165	0	15.04	12.3568	0.422331735	7.846158094	0	1.667215128	3.087451726	1.758163478	1.713221968	0	0	8.208406995	0	0	1.503412277	3.78918671	11.40765956	0.366762076	1.481745092	0	0.038499886	4.669548606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.3165																																																																																		0			12.3568	0.422331735	7.846158094	0	1.667215128	3.087451726	1.758163478	1.713221968	0	0	8.208406995	0	0	1.503412277	3.78918671	11.40765956	0.366762076	1.481745092	0	0.038499886	4.669548606	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.3165
H5996_067_0	2009	4																					3350											D	D	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	1255.188299	42.900012	1073.878204	31.0230416	204.3367853	13.09038033	7.454376829	539.4113726	60.98983478	16.8963462	42.8357335	0	0.349846338	1057.229295	5641.875865	7792.680103	217.1173936	877.169843	30.69871382	22.79132861	38.30578496	0	0	0	0	0	0	0	12000	0											1a:  Acute - $150/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $150/$0/day for 1-5/6-190	2:  Skilled Nursing Services - $0/$100/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $30/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - $25/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $20/visit/7b:  Chiropractic Services - $25/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $10 to $25/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												150	150	100	0	100	0.3	0.3	49.99999972	0	0	0.269059426	0	0	25	10.0090788	21.78239259	25	25	0	25	0.2	0	0	0	0	0	0	0	0	0											119.2317741	119.2317741	79.4878494	0	79.4878494	0.238463548	0.238463548	39.74392448	0	0	0.213869551	0	0	19.87196235	7.956001487	17.31435541	19.87196235	19.87196235	0	19.87196235	0.158975699	0	0	0	0	0	0	0	0	0											12.4715	0.426253712	7.113355743	0	1.353524301	3.12157854	1.777597148	1.786527071	0	0	9.161259098	0	0	1.750768396	3.740564397	11.24376941	0.359545723	1.452590508	0	0.037742369	6.089688933	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8863	0	15.97	12.4715	0.426253712	7.113355743	0	1.353524301	3.12157854	1.777597148	1.786527071	0	0	9.161259098	0	0	1.750768396	3.740564397	11.24376941	0.359545723	1.452590508	0	0.037742369	6.089688933	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8863																																																																																		0			12.4715	0.426253712	7.113355743	0	1.353524301	3.12157854	1.777597148	1.786527071	0	0	9.161259098	0	0	1.750768396	3.740564397	11.24376941	0.359545723	1.452590508	0	0.037742369	6.089688933	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	61.8863
H5996_068_0	2009	5																					1200											A	A	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	226.4597833	5.49500943	406.6885984	7.193219685	112.1959072	6.902666321	3.930754844	296.8575613	40.57667268	2.727376983	29.01014186	0	0.245813855	445.8978293	4859.347113	6925.358221	161.0008301	677.5571891	18.72615331	16.90063963	28.44215201	0	0	0	0	0	0	0	12000	0											1a:  Acute - $200/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $200/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$75/day for 1-8/9-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-8/9-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $5/visit/3:  Rehab Services (CORF) - $5/day/5:  Partial Hospitalization - $10/day	7a:  Primary Care - $5/visit/17a:  Vision Exams - $5/visit/18a:  Hearing Exams - $5/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $5/visit/7b:  Chiropractic Services - $5/visit/7f:  Podiatry Services - $5/visit/17a:  Vision Exams - $5/visit/18a:  Hearing Exams - $5/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $10/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $10/visit/7h:  Psychiatric Services - Individual - $10/visit/7h:  Psychiatric Services - Group - $10/visit	7c:  Occupational Therapy Services - $5/visit/7i:  Physical/Speech Therapy - $5/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $10/visit/9c:  Outpatient Substance Abuse Svcs - Group - $10/visit/7g:  Other Health Care Professional Services - $5/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	200	75	0	100	0.3	0.3	49.99999942	0	0	0.236401073	0	0	5	5	5	10	5	0	10	0.2	0	0	0	0	0	0	0	0	0											152.1113896	152.1113896	57.04177112	0	76.05569482	0.228167084	0.228167084	38.02784697	0	0	0.179796479	0	0	3.802784741	3.802784741	3.802784741	7.605569482	3.802784741	0	7.605569482	0.15211139	0	0	0	0	0	0	0	0	0											2.8706	0.06965446	1.933186495	0	0.711094806	1.57496125	0.896868873	0.940737826	0	0	5.215921351	0	0	0.141304455	1.539920921	2.194637214	0.102041917	0.214717012	0	0.010711582	4.326375267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.7427	0	7.16	2.8706	0.06965446	1.933186495	0	0.711094806	1.57496125	0.896868873	0.940737826	0	0	5.215921351	0	0	0.141304455	1.539920921	2.194637214	0.102041917	0.214717012	0	0.010711582	4.326375267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.7427																																																																																		0			2.8706	0.06965446	1.933186495	0	0.711094806	1.57496125	0.896868873	0.940737826	0	0	5.215921351	0	0	0.141304455	1.539920921	2.194637214	0.102041917	0.214717012	0	0.010711582	4.326375267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.7427
H5996_069_0	2009	9																					1200											A	A	D	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	226.4597833	5.49500943	406.6885984	7.193219685	112.1959072	6.902666321	3.930754844	296.8575613	40.57667268	2.727376983	29.01014186	0	0.245813855	445.8978293	4859.347113	6925.358221	161.0008301	677.5571891	18.72615331	16.90063963	28.44215201	0	0	0	0	0	0	0	12000	0											1a:  Acute - $200/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $200/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$75/day for 1-8/9-100/2:  Non-Medicare Covered Stay - $0/$75/day for 1-8/9-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/:   - $0/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 30.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $5/visit/3:  Rehab Services (CORF) - $5/day/5:  Partial Hospitalization - $10/day	7a:  Primary Care - $5/visit/17a:  Vision Exams - $5/visit/18a:  Hearing Exams - $5/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $5/visit/7b:  Chiropractic Services - $5/visit/7f:  Podiatry Services - $5/visit/17a:  Vision Exams - $5/visit/18a:  Hearing Exams - $5/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $10/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $10/visit/7h:  Psychiatric Services - Individual - $10/visit/7h:  Psychiatric Services - Group - $10/visit	7c:  Occupational Therapy Services - $5/visit/7i:  Physical/Speech Therapy - $5/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $10/visit/9c:  Outpatient Substance Abuse Svcs - Group - $10/visit/7g:  Other Health Care Professional Services - $5/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $0/visit												200	200	75	0	100	0.3	0.3	49.99999942	0	0	0.236401073	0	0	5	5	5	10	5	0	10	0.2	0	0	0	0	0	0	0	0	0											152.1113896	152.1113896	57.04177112	0	76.05569482	0.228167084	0.228167084	38.02784697	0	0	0.179796479	0	0	3.802784741	3.802784741	3.802784741	7.605569482	3.802784741	0	7.605569482	0.15211139	0	0	0	0	0	0	0	0	0											2.8706	0.06965446	1.933186495	0	0.711094806	1.57496125	0.896868873	0.940737826	0	0	5.215921351	0	0	0.141304455	1.539920921	2.194637214	0.102041917	0.214717012	0	0.010711582	4.326375267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.7427	0	7.16	2.8706	0.06965446	1.933186495	0	0.711094806	1.57496125	0.896868873	0.940737826	0	0	5.215921351	0	0	0.141304455	1.539920921	2.194637214	0.102041917	0.214717012	0	0.010711582	4.326375267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.7427																																																																																		0			2.8706	0.06965446	1.933186495	0	0.711094806	1.57496125	0.896868873	0.940737826	0	0	5.215921351	0	0	0.141304455	1.539920921	2.194637214	0.102041917	0.214717012	0	0.010711582	4.326375267	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	22.7427
H5996_801_0	2009	3																					none											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	V											0	0	0	0	0	0	0	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	349.7426504	3.804322412	61.75717549	46.57272095	9.630862491	19.17496397	5.424331984	11.79370646	46.07116916	8.484342675	26.58260382	0	0.294205388	35.63305376	49.31707074	142.6785157	1.489125085	7.109107129	37.37891353	44.40331286	10.3072783	1.109758021	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											25.861	0.281302249	11.02606733	0	2.224729235	4.429416676	1.253020688	2.724346193	10.64244008	1.959883158	6.140581482	0	0.067961445	8.231235418	11.39224334	32.95873713	0.343987895	1.642203747	8.634529025	10.25716527	2.380981288	0.256354103	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.7081	0	0	25.861	0.281302249	11.02606733	0	2.224729235	4.429416676	1.253020688	2.724346193	10.64244008	1.959883158	6.140581482	0	0.067961445	8.231235418	11.39224334	32.95873713	0.343987895	1.642203747	8.634529025	10.25716527	2.380981288	0.256354103	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.7081	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	25.861	0.281302249	11.02606733	0	2.224729235	4.429416676	1.253020688	2.724346193	10.64244008	1.959883158	6.140581482	0	0.067961445	8.231235418	11.39224334	32.95873713	0.343987895	1.642203747	8.634529025	10.25716527	2.380981288	0.256354103	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.7081
H5996_802_0	2009	3																					none											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	V											0	0	0	0	0	0	0	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	349.7426505	3.804322416	61.75717549	46.57272099	9.630862491	19.17496396	5.424331982	11.79370645	46.07116912	8.484342663	26.58260376	0	0.294205372	35.63305376	49.31707073	142.6785157	1.489125085	7.109107123	37.37891353	44.40331286	10.30727824	1.109758014	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											25.861	0.28130225	11.02606733	0	2.224729235	4.429416674	1.253020688	2.724346191	10.64244007	1.959883155	6.140581469	0	0.067961441	8.231235418	11.39224334	32.95873712	0.343987895	1.642203745	8.634529026	10.25716527	2.380981273	0.256354101	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.7081	0	0	25.861	0.28130225	11.02606733	0	2.224729235	4.429416674	1.253020688	2.724346191	10.64244007	1.959883155	6.140581469	0	0.067961441	8.231235418	11.39224334	32.95873712	0.343987895	1.642203745	8.634529026	10.25716527	2.380981273	0.256354101	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.7081	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	25.861	0.28130225	11.02606733	0	2.224729235	4.429416674	1.253020688	2.724346191	10.64244007	1.959883155	6.140581469	0	0.067961441	8.231235418	11.39224334	32.95873712	0.343987895	1.642203745	8.634529026	10.25716527	2.380981273	0.256354101	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.7081
H5996_803_0	2009	3																					none											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	V											0	0	0	0	0	0	0	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	349.7426505	3.804322416	61.75717549	46.57272099	9.630862491	19.17496396	5.424331982	11.79370645	46.07116912	8.484342663	26.58260376	0	0.294205372	35.63305376	49.31707073	142.6785157	1.489125085	7.109107123	37.37891353	44.40331286	10.30727824	1.109758014	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											25.861	0.28130225	11.02606733	0	2.224729235	4.429416674	1.253020688	2.724346191	10.64244007	1.959883155	6.140581469	0	0.067961441	8.231235418	11.39224334	32.95873712	0.343987895	1.642203745	8.634529026	10.25716527	2.380981273	0.256354101	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.7081	0	0	25.861	0.28130225	11.02606733	0	2.224729235	4.429416674	1.253020688	2.724346191	10.64244007	1.959883155	6.140581469	0	0.067961441	8.231235418	11.39224334	32.95873712	0.343987895	1.642203745	8.634529026	10.25716527	2.380981273	0.256354101	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.7081	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	25.861	0.28130225	11.02606733	0	2.224729235	4.429416674	1.253020688	2.724346191	10.64244007	1.959883155	6.140581469	0	0.067961441	8.231235418	11.39224334	32.95873712	0.343987895	1.642203745	8.634529026	10.25716527	2.380981273	0.256354101	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.7081
H5996_804_0	2009	3																					none											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	V											0	0	0	0	0	0	0	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	349.7426505	3.804322416	61.75717549	46.57272099	9.630862491	19.17496396	5.424331982	11.79370645	46.07116912	8.484342663	26.58260376	0	0.294205372	35.63305376	49.31707073	142.6785157	1.489125085	7.109107123	37.37891353	44.40331286	10.30727824	1.109758014	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											25.861	0.28130225	11.02606733	0	2.224729235	4.429416674	1.253020688	2.724346191	10.64244007	1.959883155	6.140581469	0	0.067961441	8.231235418	11.39224334	32.95873712	0.343987895	1.642203745	8.634529026	10.25716527	2.380981273	0.256354101	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.7081	0	0	25.861	0.28130225	11.02606733	0	2.224729235	4.429416674	1.253020688	2.724346191	10.64244007	1.959883155	6.140581469	0	0.067961441	8.231235418	11.39224334	32.95873712	0.343987895	1.642203745	8.634529026	10.25716527	2.380981273	0.256354101	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.7081	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	25.861	0.28130225	11.02606733	0	2.224729235	4.429416674	1.253020688	2.724346191	10.64244007	1.959883155	6.140581469	0	0.067961441	8.231235418	11.39224334	32.95873712	0.343987895	1.642203745	8.634529026	10.25716527	2.380981273	0.256354101	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.7081
H5998_001_0	2009	8																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	Coin	T	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		1270.499124	244.6372764	624.1631651	289.680643	173.601869	13.56023676	5.04301445	1120.627577	2971.552663	2151.612523	687.7784539	0	0.638128847	132.2747837	4381.251886	5521.302922	532.3777091	126.2298661	1613.876436	0	11.98202901	0.287454141	5675.983032	930.8285577	545.0811839	449.0641824	14.34358729	1.072442739	4.924156209	8277.903816											$50/day - 1st 5 days	$50/day - 1st 5 days	$50/Day 6-100	Zero Cost Sharing	$75/Service	20% Coinsurance	20%/except 10% diabetic supplies	$50 visit ER / $30 visit Urgent Care	$100/visit	$0 Lab / $30 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$30/visit	$5/visit	$10/visit	$10/visit	$10/visit	$10/visit	$10/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											28.63574966	28.63574966	40.64438537	0	62.12421941	0.2	0.122529278	46.84373331	33	0	0	0	0	0	4.007087742	5	9.81369697	10	0.01121181	0	0.2	0	0	9.332565056	0	0	0	0	0	0											18.46304381	18.46304381	40.64438537	0	62.12421941	0.2	0.122529278	46.84373331	33	0	0	0	0	0	4.007087742	5	9.81369697	10	0.01121181	0	0.2	0	0	9.332565056	0	0	0	0	0	0											1.9548	0.376395729	2.114060684	0	0.89874005	2.712047353	0.61791692	4.374531613	8.171769823	0	0	0	0	0	1.463005061	2.300542884	0.435382793	0.105191555	0.001507873	0	2.396405802	0	0	0.723918173	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.6462	0	0	1.9548	0.376395729	2.114060684	0	0.89874005	2.712047353	0.61791692	4.374531613	8.171769823	0	0	0	0	0	1.463005061	2.300542884	0.435382793	0.105191555	0.001507873	0	2.396405802	0	0	0.723918173	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.6462		$50/day - 1st 5 days	$50/day - 1st 5 days	$50/Day 6-100	Zero Cost Sharing	$75/Service	20% Coinsurance	20%/except 10% diabetic supplies	$50 visit ER / $30 visit Urgent Care	$100/visit	$0 Lab / $30 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$30/visit	$5/visit	$10/visit	$10/visit	$10/visit	$10/visit	$10/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											0.308	0.0593	0.1413	0	0.573	0	0.0809	0.6554	0.5843	0	0	0	0	0	0.3718	0.5847	0.1107	0.0267	0.0004	0	0.8565	0	0	0.0558	0	0	0	0	0	0											4.4088	0	0	2.2628	0.435705954	2.255335778	0	1.471700879	2.71207248	0.698785686	5.029948729	8.756020034	0	0	0	0	0	1.834825206	2.885221785	0.546034558	0.131925803	0.001891096	0	3.252912744	0	0	0.779766317	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.0549
H5998_002_0	2009	6																																D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	Coin	T	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		1585.524001	356.724754	910.1411478	292.4042711	169.9703553	17.06698797	5.349488082	747.8733761	2612.923388	2550.913747	682.8472541	0	0.930505601	135.1837901	3619.44549	5964.326232	754.973074	185.6377286	1858.781926	0	16.81563315	0.419159374	7699.067093	1081.686001	673.1189476	1221.697184	16.93385719	1.563812669	3.198647715	11228.74129											$95/day - 1st 10 days	$95/day - 1st 10 days	$75/Day 6-100	Zero Cost Sharing	$150/Service	20% Coinsurance	20%/except 10% diabetic supplies	$50 visit ER / $30 visit Urgent Care	$100/visit	$0 Lab / $20 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$30/visit	$10/visit	$30/visit	$30/visit	$30/visit	$30/visit	$30/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											73.46495573	73.46495573	60.96657805	0	125.3164557	0.2	0.122529278	46.72576966	33	0	0	0	0	0	8.541691057	15	30	30	0	0	0.2	0	0	9.02200489	0	0	0	0	0	0											53.93677555	53.93677555	60.96657805	0	125.3164557	0.2	0.122529278	46.72576966	33	0	0	0	0	0	8.541691057	15	30	30	0	0	0.2	0	0	9.02200489	0	0	0	0	0	0											7.1265	1.603381916	4.624015943	0	1.775006875	3.413397595	0.655468913	2.912079925	7.185539316	0	0	0	0	0	2.576348764	7.45540779	1.887432685	0.464094322	0	0	3.363126629	0	0	0.813248033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8551	0	0	7.1265	1.603381916	4.624015943	0	1.775006875	3.413397595	0.655468913	2.912079925	7.185539316	0	0	0	0	0	2.576348764	7.45540779	1.887432685	0.464094322	0	0	3.363126629	0	0	0.813248033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8551		$95/day - 1st 10 days	$95/day - 1st 10 days	$75/Day 6-100	Zero Cost Sharing	$150/Service	20% Coinsurance	20%/except 10% diabetic supplies	$50 visit ER / $30 visit Urgent Care	$100/visit	$0 Lab / $20 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$30/visit	$10/visit	$30/visit	$30/visit	$30/visit	$30/visit	$30/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											1.123	0.2527	0.309	0	1.1316	0	0.0869	0.4363	0.5137	0	0	0	0	0	0.6548	1.8948	0.4797	0.1179	0	0	0.9207	0	0	0.0627	0	0	0	0	0	0											7.9839	0	0	8.2495	1.856033407	4.933022345	0	2.9066015	3.41342922	0.742401125	3.348384242	7.699277827	0	0	0	0	0	3.231123241	9.350186479	2.36712036	0.582043072	0	0	4.283853466	0	0	0.875987712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.8389
H5998_003_0	2009	6																																A	A	D	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	Coin	Coin	Coin	Coin	Coin	Coin	Coin											0	0	0	0	0.19	0.5462	0.2542	0.9461	1.5713	0.3379	0.3723	0	0.0173	0.0361	0.9925	2.2894	0.1382	0.0514	0.3233	0	0.4418	0.0175	0	0	0	0	0	0	0	0											8.5256		285.8808236	30.45883693	28.3329642	21.69655803	6.130429658	17.61908958	8.19891536	30.52012292	50.68750088	10.90004564	12.00889417	0	0.559143157	1.163887662	32.0175871	73.85248274	4.457711525	1.657240036	10.43029807	0	14.25093027	0.5641421	1.144546888	7.667980316	4.077434628	3.15709652	0.040058246	0.05604531	0.010492592	1.016586092											Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											760.4172725	760.4172725	2523.507194	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											760.4172725	760.4172725	2523.507194	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											18.1157	1.930118809	5.958203248	0	1.226085932	3.523817916	1.639783072	6.104024584	10.13750018	2.180009128	2.401778834	0	0.111828631	0.232777532	6.40351742	14.77049655	0.891542305	0.331448007	2.086059613	0	2.850186054	0.11282842	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.0077	135	0	18.1157	1.930118809	5.958203248	0	1.416129251	4.070009693	1.893949448	7.050148395	11.7088127	2.517910543	2.774054553	0	0.129162069	0.26885805	7.39606262	17.05992351	1.029731362	0.382822448	2.409398853	0	3.291964892	0.130316825	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.5333		Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											3.3885	0.361	0.4267	0	2.4906	0.5091	0.2369	1.2424	0.9016	0.6678	0.7357	0	0.0343	0.0713	2.5202	5.8132	0.3509	0.1304	0.821	0	0.85	0.0359	0	0	0	0	0	0	0	0											21.5875	135	0	21.5042	2.291143766	6.384882014	0	3.906731896	4.579120178	2.130860314	8.292591436	12.61040857	3.185690396	3.509766848	0	0.163417388	0.340162406	9.916263407	22.87307503	1.380611273	0.513268807	3.230399052	0	4.141962302	0.166188717	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.1208
H5998_004_0	2009	4																																D	D	D	V	P	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	Coin	T	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		1363.291709	354.636558	904.8133619	281.46802	165.6084987	16.8850835	5.276237615	732.2162309	2582.588862	2505.903223	667.5707589	0	0.925058606	123.1132083	3461.658689	5581.40931	744.0488834	155.279767	1698.292245	0	16.58587869	0.416705698	8227.886166	1075.354026	516.8249581	487.6170317	16.83472974	1.55465842	3.179923466	12000											$50/day - 1st 10 days	$50/day - 1st 10 days	$50/Day 6-100	Zero Cost Sharing	$150/Service	20% Coinsurance	20%/except 10% diabetic supplies	$50 visit ER / $30 visit Urgent Care	$100/visit	$0 Lab / $20 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$30/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	$20/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											38.66576617	38.66576617	40.64438537	0	125.3164557	0.2	0.122529278	46.72576966	33	0	0	0	0	0	4.270845528	10	20	20	0	0	0.2	0	0	9.02200489	0	0	0	0	0	0											28.38777661	28.38777661	40.64438537	0	125.3164557	0.2	0.122529278	46.72576966	33	0	0	0	0	0	4.270845528	10	20	20	0	0	0.2	0	0	9.02200489	0	0	0	0	0	0											3.2251	0.838945282	3.064631914	0	1.729455841	3.377016701	0.646493586	2.851113912	7.10211937	0	0	0	0	0	1.232017461	4.651174425	1.240081472	0.258799612	0	0	3.317175737	0	0	0.80848744	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.3426	0	0	3.2251	0.838945282	3.064631914	0	1.729455841	3.377016701	0.646493586	2.851113912	7.10211937	0	0	0	0	0	1.232017461	4.651174425	1.240081472	0.258799612	0	0	3.317175737	0	0	0.80848744	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	34.3426		$50/day - 1st 10 days	$50/day - 1st 10 days	$50/Day 6-100	Zero Cost Sharing	$150/Service	20% Coinsurance	20%/except 10% diabetic supplies	$50 visit ER / $30 visit Urgent Care	$100/visit	$0 Lab / $20 Radiation Therapy	$0 X-Ray	Zero Cost Sharing	20% Coinsurance	$30/visit	$5/visit	$20/visit	$20/visit	$20/visit	$20/visit	$20/visit	20% Coinsurance	10% Blood	Zero Cost Sharing	$10/visit	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing	Zero Cost Sharing											0.6032	0.1569	0.2195	0	3.0417	0.0293	0.0809	0.5024	0.5469	0	0	0	0	0	0.4198	1.5849	0.4226	0.0882	0	0	0.8565	0	0	0.0676	0	0	0	0	0	0											8.6203	0	0	3.8283	0.99586836	3.28409629	0	4.77111838	3.40631444	0.727362352	3.353563852	7.648993046	0	0	0	0	0	1.651826153	6.236057362	1.662637968	0.346985315	0	0	4.17368268	0	0	0.876073953	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.9629
H5998_801_0	2009	2																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																							0.2052	0.633	0.1978	0.8794	1.4131	0.4253	0.4234	0	0.0347	0.0425	0.8565	2.3392	0.2062	0.0538	0.2786	0	0.6218	0.0156																			8.6261		217.7919555	24.72978845	32.55076382	18.83862427	6.619573033	20.4197406	6.380744485	28.36617218	45.58494715	13.71905035	13.65930859	0	1.118706743	1.371855523	27.62885093	75.45676774	6.650586904	1.736134225	8.988442499	0	20.05790142	0.503937233																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			0.075008615	0.075008615	0.225251616	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																			0.075008615	0.075008615	0.225251616	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																			16.3363	1.854947188	7.332112162	0	1.323914607	4.08394812	1.276148897	5.673234436	9.116989431	2.74381007	2.731861717	0	0.223741349	0.274371105	5.525770185	15.09135355	1.330117381	0.347226845	1.7976885	0	4.011580285	0.100787447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.1759	135	0	16.3363	1.854947188	7.332112162	0	1.529121371	4.716960079	1.473951976	6.552585774	10.53012279	3.169100631	3.155300284	0	0.258421258	0.316898626	6.382264564	17.43051335	1.536285575	0.401047006	2.076330217	0	4.633375229	0.116409501	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.802		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			3.0557	0.347	0.5251	0	2.3284	0.5109	0.1596	0.9998	0.702	0.7277	0.7245	0	0.0593	0.0728	1.8829	5.1424	0.4532	0.1183	0.6126	0	1.0358	0.0277																			19.4857	135	0	19.3919	2.201911441	7.857179274	0	3.857542465	5.227814097	1.633583238	7.552376168	11.23214444	3.896791729	3.879822536	0	0.317760127	0.389665109	8.265165113	22.57287666	1.989521714	0.519364199	2.688890738	0	5.669179972	0.144152936	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.2877
H5998_802_0	2009	2																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																							0.2052	0.633	0.1978	0.8794	1.4131	0.4253	0.4234	0	0.0347	0.0425	0.8565	2.3392	0.2062	0.0538	0.2786	0	0.6218	0.0156																			8.6261		217.7919555	24.72978845	32.55076382	18.83862427	6.619573033	20.4197406	6.380744485	28.36617218	45.58494715	13.71905035	13.65930859	0	1.118706743	1.371855523	27.62885093	75.45676774	6.650586904	1.736134225	8.988442499	0	20.05790142	0.503937233																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			0.075008615	0.075008615	0.225251616	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																			0.075008615	0.075008615	0.225251616	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																			16.3363	1.854947188	7.332112162	0	1.323914607	4.08394812	1.276148897	5.673234436	9.116989431	2.74381007	2.731861717	0	0.223741349	0.274371105	5.525770185	15.09135355	1.330117381	0.347226845	1.7976885	0	4.011580285	0.100787447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.1759	135	0	16.3363	1.854947188	7.332112162	0	1.529121371	4.716960079	1.473951976	6.552585774	10.53012279	3.169100631	3.155300284	0	0.258421258	0.316898626	6.382264564	17.43051335	1.536285575	0.401047006	2.076330217	0	4.633375229	0.116409501	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.802		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			3.0557	0.347	0.5251	0	2.3284	0.5109	0.1596	0.9998	0.702	0.7277	0.7245	0	0.0593	0.0728	1.8829	5.1424	0.4532	0.1183	0.6126	0	1.0358	0.0277																			19.4857	135	0	19.3919	2.201911441	7.857179274	0	3.857542465	5.227814097	1.633583238	7.552376168	11.23214444	3.896791729	3.879822536	0	0.317760127	0.389665109	8.265165113	22.57287666	1.989521714	0.519364199	2.688890738	0	5.669179972	0.144152936	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.2877
H6013_801_0	2009	4																																D	D	D	V	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	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1388.740479	99.85725304	1327.41	1782.522	8.622126458	8.262511185	1.345741124	12.62792169	29.54669071	16.33760348	23.65174577	1.929550399	0.715191003	14.87923372	71.49053831	135.7124757	3.341933781	22.02693975	38.30284908	3.841698308	13.69239011	1.429137158	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.	0	0	0	0	0	0	0	0											220.6171855	92.70021663	135.3096521	0	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0	0	0	0	0	0	0	0											220.6171855	92.70021663	135.3096521	0	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0	0	0	0	0	0	0	0											25.5317	0.771399082	14.96761544	0	1.99173027	1.908658347	0.310869174	2.917077822	6.825350865	3.774022517	5.463605553	0.445730407	0.165210703	3.437135879	16.51447237	31.34988188	0.77199409	5.08827177	8.848042802	0.887440801	3.162972381	0.330133843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.4633	0	0	25.5317	0.771399082	14.96761544	0	1.99173027	1.908658347	0.310869174	2.917077822	6.825350865	3.774022517	5.463605553	0.445730407	0.165210703	3.437135879	16.51447237	31.34988188	0.77199409	5.08827177	8.848042802	0.887440801	3.162972381	0.330133843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.4633																																																																																		0	0	0	25.5317	0.771399082	14.96761544	0	1.99173027	1.908658347	0.310869174	2.917077822	6.825350865	3.774022517	5.463605553	0.445730407	0.165210703	3.437135879	16.51447237	31.34988188	0.77199409	5.08827177	8.848042802	0.887440801	3.162972381	0.330133843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.4633
H6013_802_0	2009	4																																D	D	D	V	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	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1388.740479	99.85725304	1327.41	1782.522	8.622126458	8.262511185	1.345741124	12.62792169	29.54669071	16.33760348	23.65174577	1.929550399	0.715191003	14.87923372	71.49053831	135.7124757	3.341933781	22.02693975	38.30284908	3.841698308	13.69239011	1.429137158	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.	0	0	0	0	0	0	0	0											220.6171855	92.70021663	135.3096521	0	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0	0	0	0	0	0	0	0											220.6171855	92.70021663	135.3096521	0	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0	0	0	0	0	0	0	0											25.5317	0.771399082	14.96761544	0	1.99173027	1.908658347	0.310869174	2.917077822	6.825350865	3.774022517	5.463605553	0.445730407	0.165210703	3.437135879	16.51447237	31.34988188	0.77199409	5.08827177	8.848042802	0.887440801	3.162972381	0.330133843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.4633	0	0	25.5317	0.771399082	14.96761544	0	1.99173027	1.908658347	0.310869174	2.917077822	6.825350865	3.774022517	5.463605553	0.445730407	0.165210703	3.437135879	16.51447237	31.34988188	0.77199409	5.08827177	8.848042802	0.887440801	3.162972381	0.330133843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.4633																																																																																		0	0	0	25.5317	0.771399082	14.96761544	0	1.99173027	1.908658347	0.310869174	2.917077822	6.825350865	3.774022517	5.463605553	0.445730407	0.165210703	3.437135879	16.51447237	31.34988188	0.77199409	5.08827177	8.848042802	0.887440801	3.162972381	0.330133843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.4633
H6013_803_0	2009	4																																D	D	D	V	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	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1388.740479	99.85725304	1327.41	1782.522	8.622126458	8.262511185	1.345741124	12.62792169	29.54669071	16.33760348	23.65174577	1.929550399	0.715191003	14.87923372	71.49053831	135.7124757	3.341933781	22.02693975	38.30284908	3.841698308	13.69239011	1.429137158	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.	0	0	0	0	0	0	0	0											220.6171855	92.70021663	135.3096521	0	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0	0	0	0	0	0	0	0											220.6171855	92.70021663	135.3096521	0	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0	0	0	0	0	0	0	0											25.5317	0.771399082	14.96761544	0	1.99173027	1.908658347	0.310869174	2.917077822	6.825350865	3.774022517	5.463605553	0.445730407	0.165210703	3.437135879	16.51447237	31.34988188	0.77199409	5.08827177	8.848042802	0.887440801	3.162972381	0.330133843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.4633	0	0	25.5317	0.771399082	14.96761544	0	1.99173027	1.908658347	0.310869174	2.917077822	6.825350865	3.774022517	5.463605553	0.445730407	0.165210703	3.437135879	16.51447237	31.34988188	0.77199409	5.08827177	8.848042802	0.887440801	3.162972381	0.330133843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.4633																																																																																		0	0	0	25.5317	0.771399082	14.96761544	0	1.99173027	1.908658347	0.310869174	2.917077822	6.825350865	3.774022517	5.463605553	0.445730407	0.165210703	3.437135879	16.51447237	31.34988188	0.77199409	5.08827177	8.848042802	0.887440801	3.162972381	0.330133843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.4633
H6013_804_0	2009	4																																D	D	D	V	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	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1388.740479	99.85725304	1327.41	1782.522	8.622126458	8.262511185	1.345741124	12.62792169	29.54669071	16.33760348	23.65174577	1.929550399	0.715191003	14.87923372	71.49053831	135.7124757	3.341933781	22.02693975	38.30284908	3.841698308	13.69239011	1.429137158	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.	0	0	0	0	0	0	0	0											220.6171855	92.70021663	135.3096521	0	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0	0	0	0	0	0	0	0											220.6171855	92.70021663	135.3096521	0	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0.23100221	0	0	0	0	0	0	0	0											25.5317	0.771399082	14.96761544	0	1.99173027	1.908658347	0.310869174	2.917077822	6.825350865	3.774022517	5.463605553	0.445730407	0.165210703	3.437135879	16.51447237	31.34988188	0.77199409	5.08827177	8.848042802	0.887440801	3.162972381	0.330133843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.4633	0	0	25.5317	0.771399082	14.96761544	0	1.99173027	1.908658347	0.310869174	2.917077822	6.825350865	3.774022517	5.463605553	0.445730407	0.165210703	3.437135879	16.51447237	31.34988188	0.77199409	5.08827177	8.848042802	0.887440801	3.162972381	0.330133843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.4633																																																																																		0	0	0	25.5317	0.771399082	14.96761544	0	1.99173027	1.908658347	0.310869174	2.917077822	6.825350865	3.774022517	5.463605553	0.445730407	0.165210703	3.437135879	16.51447237	31.34988188	0.77199409	5.08827177	8.848042802	0.887440801	3.162972381	0.330133843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.4633
H6120_001_0	2009	1																					3450											D	A	D		T	Coin	Coin	V	V		Coin			V		V	V	V	Coin	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	884.1692954	4.149744944	648.6843854	0	251.3462385	13.85225378	8.83716032	380.2979886	366.1723705	0	27.66992894	0	0	542.3902877	0	5177.996199	275.3670908	938.1844548	61.19607956	1117.592723	12.67442542	0	0	0	0	0	0	0	0	0											$50/Days 1-5 for IP Medical; $50/Days 1-5 for IP Surgical;	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	$75/Days Custom for SNF	No Cost Sharing	$100/Run 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;	$50/Case for OP Fac - Surgery; $50/Case for OP Fac - ASC	No Cost Sharing	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	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; $10/Visit for Prof - CORF; $10/Visit for Prof - CORF;	No Cost Sharing	$10/Visit for Speclst - Office Visits; $10/Consult for Speclst - Consults;	$10/Visit for OP Psych - Non-Physician; $10/Visit for OP Psych - Psychiatrist; $10/Visit for OP Substance Abuse;	$10/Visit for PT/ST (PCP); $10/Visit for Occ Therapy (PCP); $10/Visit for PT/ST (Specialist); $10/Visit for Occ Therapy (Specialist);	20% Coinsurance for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	$10/Service for Podiatrist;	20% Coinsurance for Part B Rx	No Cost Sharing	Not Covered	No Cost Sharing for Preventive Services	No Cost Sharing	Max Plan Benefit of $300 every two years	No Cost Sharing	Max Plan Benefit of $800 every three years	No Cost Sharing	No copay up to $100 every quarter											50	900	75	0	100	0.2	0.183125377	42.8808569	50	0	0.2	0	0	10	0	10	10	10	0.2	10	0.2	0	0	0	0	0	0	0	0	0											50	900	75	0	100	0.2	0.183125377	42.8808569	50	0	0.2	0	0	10	0	10	10	10	0.2	10	0.2	0	0	0	0	0	0	0	0	0											3.684	0.311230871	4.054277409	0	2.094551988	2.770450756	1.618308312	1.358958636	1.52571821	0	5.533985789	0	0	0.451991906	0	4.314996833	0.229472576	0.781820379	12.23921591	0.931327269	2.534885083	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.4352	0	0	3.684	0.311230871	4.054277409	0	2.094551988	2.770450756	1.618308312	1.358958636	1.52571821	0	5.533985789	0	0	0.451991906	0	4.314996833	0.229472576	0.781820379	12.23921591	0.931327269	2.534885083	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.4352	0																																																																																	0	0	0	3.684	0.311230871	4.054277409	0	2.094551988	2.770450756	1.618308312	1.358958636	1.52571821	0	5.533985789	0	0	0.451991906	0	4.314996833	0.229472576	0.781820379	12.23921591	0.931327269	2.534885083	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.4352
H6120_002_0	2009	6																					3450											D	A	D		T	Coin	Coin	V	Coin		Coin			V		V	V	V	Coin	P	Coin					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	844.7292644	3.951178988	635.1681138	0	243.0435961	13.31903849	8.545077031	372.185761	51.34098746	0	26.68944116	0	0	701.4399696	0	4800.159942	247.632456	828.1731423	57.1861406	1710.776985	12.39506679	0	0	0	0	793.6218602	0	0	0	0											$150/Days 1-5 for IP Medical; $150/Days 1-5 for IP Surgical;	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	$75/Days Custom for SNF	No Cost Sharing	$100/Run 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;	20% Coinsurance for OP Fac - Surgery; 20% Coinsurance for OP Fac - ASC	No Cost Sharing	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	No Cost Sharing	No Cost Sharing	$20/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/Visit for Prof - CORF; $25/Visit for Prof - CORF;	No Cost Sharing	$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/Visit for PT/ST (PCP); $25/Visit for Occ Therapy (PCP); $25/Visit for PT/ST (Specialist); $25/Visit 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/Service for Podiatrist;	20% Coinsurance for Part B Rx	No Cost Sharing	Not Covered	No Cost Sharing for Preventive Services	No Cost Sharing	Max Plan Benefit of $300 every two years	No Cost Sharing	Max Plan Benefit of $800 every three years	Not Covered	No copay up to $50 every quarter											150	899.9999999	75	0	100	0.2	0.183220335	42.85437426	0.2	0	0.2	0	0	23.62863953	0	25	25	25	0.2	25	0.2	0	0	0	0	5	0	0	0	0											150	899.9999999	75	0	100	0.2	0.183220335	42.85437426	0.2	0	0.2	0	0	23.62863953	0	25	25	25	0.2	25	0.2	0	0	0	0	5	0	0	0	0											10.5591	0.296338424	3.969800711	0	2.025363301	2.663807699	1.56563188	1.329148991	10.26819749	0	5.337888233	0	0	1.381172683	0	10.00033321	0.51590095	1.725360713	11.43722812	3.564118718	2.479013359	0	0	0	0	0.330675775	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4491	0	0	10.5591	0.296338424	3.969800711	0	2.025363301	2.663807699	1.56563188	1.329148991	10.26819749	0	5.337888233	0	0	1.381172683	0	10.00033321	0.51590095	1.725360713	11.43722812	3.564118718	2.479013359	0	0	0	0	0.330675775	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4491	0																																																																																	0	0	0	10.5591	0.296338424	3.969800711	0	2.025363301	2.663807699	1.56563188	1.329148991	10.26819749	0	5.337888233	0	0	1.381172683	0	10.00033321	0.51590095	1.725360713	11.43722812	3.564118718	2.479013359	0	0	0	0	0.330675775	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.4491
H6120_003_0	2009	6																					3450												A	D		T	Coin	Coin	V			Coin			V	V	V	V	V	Coin	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	4.028011309	607.616466	0	234.7098247	12.91752476	8.252195795	407.4288087	0	0	30.02417481	0	0	791.4801675	6292.993445	5270.408015	280.8652832	962.9123727	64.39688827	2046.16361	13.62481884	0	0	0	0	0	0	0	0	0											No Cost Sharing	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	$75/Days Custom for SNF	No Cost Sharing	$100/Run 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;	No Cost Sharing	No Cost Sharing	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	No Cost Sharing	No Cost Sharing	$20/Case for OP Fac - Cardiovascular; $25/Case for OP Fac - Occ Therapy; $25/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $20/Visit for Prof - CORF; $20/Visit for Prof - CORF;	$5/Visit for PCP - Office Visits; $5/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/Visit for PT/ST (PCP); $25/Visit for Occ Therapy (PCP); $25/Visit for PT/ST (Specialist); $25/Visit 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/Service for Podiatrist;	20% Coinsurance for Part B Rx	No Cost Sharing	Not Covered	No Cost Sharing for Preventive Services	No Cost Sharing	Max Plan Benefit of $300 every two years	No Cost Sharing	Max Plan Benefit of $400 every three years	Not Covered	No copay up to $100 every quarter											0	900.0000001	75	0	100	0.2	0.183148593	42.89965604	0	0	0.2	0	0	22.71643059	5	25	25	25	0.2	25	0.2	0	0	0	0	0	0	0	0	0											0	900.0000001	75	0	100	0.2	0.183148593	42.89965604	0	0	0.2	0	0	22.71643059	5	25	25	25	0.2	25	0.2	0	0	0	0	0	0	0	0	0											0	0.302100848	3.797602913	0	1.955915206	2.583504952	1.511378051	1.456546313	0	0	6.004834962	0	0	1.498300358	2.622080602	10.9800167	0.585136007	2.006067443	12.87937765	4.262840854	2.724963769	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1707	0	0	0	0.302100848	3.797602913	0	1.955915206	2.583504952	1.511378051	1.456546313	0	0	6.004834962	0	0	1.498300358	2.622080602	10.9800167	0.585136007	2.006067443	12.87937765	4.262840854	2.724963769	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1707	0																																																																																	0	0	0	0	0.302100848	3.797602913	0	1.955915206	2.583504952	1.511378051	1.456546313	0	0	6.004834962	0	0	1.498300358	2.622080602	10.9800167	0.585136007	2.006067443	12.87937765	4.262840854	2.724963769	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1707
H6178_001_0	2009	6																					0											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	385.3163684	39.60623555	97.62620377	0	16.98440532	29.23738323	21.61114082	29.37866845	36.3656594	12.1286936	28.56931747	0	4.430558703	49.70698978	68.56849764	126.2492113	10.93708915	5.613685797	25.42820458	38.17601054	10.80656269	0.778773601	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																			0.076442114	0.076442114	0.184415748	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.076442114	0.076442114	0.184415748	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											29.4544	3.027584377	18.00380944	0	3.92339763	6.753835525	4.992173529	6.786472413	8.400467321	2.801728221	6.599512335	0	1.02345906	11.48231464	15.83932296	29.16356781	2.526467593	1.296761419	5.873915258	8.818658436	2.49631598	0.179896702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	169.4441	0	0	29.4544	3.027584377	18.00380944	0	3.92339763	6.753835525	4.992173529	6.786472413	8.400467321	2.801728221	6.599512335	0	1.02345906	11.48231464	15.83932296	29.16356781	2.526467593	1.296761419	5.873915258	8.818658436	2.49631598	0.179896702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	169.4441	0																																																																																	0	0		29.4544	3.027584377	18.00380944	0	3.92339763	6.753835525	4.992173529	6.786472413	8.400467321	2.801728221	6.599512335	0	1.02345906	11.48231464	15.83932296	29.16356781	2.526467593	1.296761419	5.873915258	8.818658436	2.49631598	0.179896702	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	169.4441
H6181_007_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	572.76	32.37	187.58	83.4	16.15	19.66	18.04	17.23	24.8	7.76	16.61	1.52	2.99	50.91	94.72	155.43	8.85	10.22	40.28	62.43	6.44	6.26	7.96	8.14	2.82	2.77	0.6	1.65	3.03	17.91											PBP: 1A IP Acute: Standard Medicare	1B IP Psych: Standard Medicare	2 SNF: Standard Medicare	6 Home Health: Standard Medicare	10A Ambulance: Standard Medicare	11A DME: Standard Medicare	"11B Prosthetic Medical Supplies: Standard Medicare, 11C Diabetes Monitoring Supplies: $0"	"4A ER, 4B Urgent Care: Standard Medicare, 4A Worldwide Coverage: $0"	9B ASC Services: Standard Medicare	8A OP C/D/T: Standard Medicare	8B OP X-Ray: Standard Medicare	"9A OP Hospital, 5 Partial Hosp: Standard Medicare"	12 Renal Dialysis: Standard Medicare	"3 CORF, 9A OP Hospital, 9D Cardiac Rehab: Standard Medicare"	"7A PCP, 14B Immunizations, 14C Routine Physical Exams: Standard Medicare"	7D Physician Specialist (excl. Radiology): Standard Medicare	"7E Mental Health, 7H Psychiatric, 9C OP Substance Abuse,: Standard Medicare"	"7C Occupational Therapy, 7I Physical and Speech Therapy: Standard Medicare"	"8B Physician Specialist (Radiology), 14G Bone Mass Measurement, 14H Mammography: Standard Medicare"	"7B Chiropractic, 7F Podiatry - Medicare Covered, 7G Other Health Care, 14D Pap Smears/Pelvic Exams, 14E Prostate Screening, 14F Colorectal Screening, 14I Diabetes Monitoring, 14J Nutrition Therapy, 18A Medicare Covered Hearing Exams: Standard Medicare, 7F Podiatry - Routine: $0"	15 Part B Drugs: Standard Medicare	"13A Blood, 16B Medicare Covered Comprehensive Dental Services, 17A Medicare Covered Eye Exams, 17B Medicare Covered Eyewear: Standard Medicare"	10B Transportation: $0 for 24 one-way trips	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	17B Eye Wear - Non-Covered: $0	18A Hearing - Routine: $0	18B Hearing Aids: $0	"14A Medical Nutrition: $0, 14A Health Education/Wellness Programs: $0"	"6 Respite Care: $0, 13B Acupuncture: Not Covered, 13C Other: OTC Drugs: $0, 13D Other: Assistive Devices: $0 13E Other: PERS: $0"											0.059675646	0.05967331	0.159497404	0	0.231045291	0.231000082	0.182058354	0.229599989	0.231000011	0.231012934	0.231029549	0.231000016	0.231000006	0.230987719	0.228979573	0.230993815	0.23099034	0.23101115	0.230993184	0.222627004	0.230997758	0.231005436	0	0	0	0	0	0	0	0											0.059675646	0.05967331	0.159497404	0	0.231045291	0.231000082	0.182058354	0.229599989	0.231000011	0.231012934	0.231029549	0.231000016	0.231000006	0.230987719	0.228979573	0.230993815	0.23099034	0.23101115	0.230993184	0.222627004	0.230997758	0.231005436	0	0	0	0	0	0	0	0											34.1798	1.931625042	29.91852305	0	3.731381456	4.541461606	3.284332713	3.956007815	5.728800268	1.79266037	3.837400808	0.351120024	0.690690018	11.75958478	21.68894512	35.90336868	2.044264509	2.360933956	9.304405471	13.89860384	1.487625563	1.446094027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	193.8377	0	0	34.1798	1.931625042	29.91852305	0	3.731381456	4.541461606	3.284332713	3.956007815	5.728800268	1.79266037	3.837400808	0.351120024	0.690690018	11.75958478	21.68894512	35.90336868	2.044264509	2.360933956	9.304405471	13.89860384	1.487625563	1.446094027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	193.8377	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	34.1798	1.931625042	29.91852305	0	3.731381456	4.541461606	3.284332713	3.956007815	5.728800268	1.79266037	3.837400808	0.351120024	0.690690018	11.75958478	21.68894512	35.90336868	2.044264509	2.360933956	9.304405471	13.89860384	1.487625563	1.446094027	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	193.8377
H6181_008_0	2009	4																					0											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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	253.76	3.74	745.86	0	169.67	9.46	6.76	211.88	245.61	0	492.34	46.51	0.25	1065.19	0	8961.77	229.68	973.41	1856.64	2103.85	7.99	843.1	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $300 per admit	1B IP Psych: $300 per admit	2 SNF: $100 per day for days 21-100	6 Home Health: $0	10A Ambulance: $50	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50,4A Non Covered Foreign Travel: $50,  4B Urgent Care: $25"	9B ASC Services: $75	8A OP Lab Services: $0	8B OP X-Ray: $50	"9A OP Hospital: $75, 5 Partial Hosp: $75"	12 Renal Dialysis: 20%	"3 CORF: $75, 8A OP Diagnostic Procedures/Tests: $75, 9A OP Hospital: $75, 9D Cardiac Rehab: $75"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $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"	"8B Physician Specialist Services - Radiology: $50, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7B Chiropractic: $25, 7F Podiatry: $25, 7F Non Medicare Covered Podiatry: $0,  7G Other Health Care: $25, 14D Pap Smears & Pelvic Exams: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $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, 17B Medicare Covered Eyewear: $25"	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: $0	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: Over-the-Counter Drugs: $0, 13D Other: PERS: Not Covered, 13E Other: Assistive Devices: Not Covered"											300	300	100	0	50	0.200000298	0.200089374	47.71450821	75	0	50	75	0.2	61.00625241	0	25	25	25	50	25	0.199998637	25	0	0	0	0	0	0	0	0											300	300	100	0	50	0.200000298	0.200089374	47.71450821	75	0	50	75	0.2	61.00625241	0	25	25	25	50	25	0.199998637	25	0	0	0	0	0	0	0	0											6.344	0.0935	6.2155	0	0.706958333	1.892002815	1.352604165	0.842479167	1.5350625	0	2.051416667	0.2906875	0.05	5.415270833	0	18.67035417	0.4785	2.0279375	7.736	4.383020833	1.59798911	1.756458333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4397	0	0	6.344	0.0935	6.2155	0	0.706958333	1.892002815	1.352604165	0.842479167	1.5350625	0	2.051416667	0.2906875	0.05	5.415270833	0	18.67035417	0.4785	2.0279375	7.736	4.383020833	1.59798911	1.756458333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4397	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	6.344	0.0935	6.2155	0	0.706958333	1.892002815	1.352604165	0.842479167	1.5350625	0	2.051416667	0.2906875	0.05	5.415270833	0	18.67035417	0.4785	2.0279375	7.736	4.383020833	1.59798911	1.756458333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4397
H6181_009_0	2009	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	O	V											44.0385	0.4594	7.9092	5.3334	0	1.2083	0.8602	0	4.2675	0.7071	2.3329	0.1771	0.0299	2.6727	0	0	0	0	0	0	0.9308	0.073	0	0	0	0	0	0	0	0											71	0	0	0	0	0	171.2	0	0	228.98	0	0	0	0	0	301.33	0	9418.26	255.3	1099.11	0	2419.08	0	948.22	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, 4A Non Medicare Covered Foreign Travel: $50,  4B Urgent Care: $10"	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, 9A Outpatient Hospital Services $0,  9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $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"	"8B Physician Specialist Services - Radiology: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7G Other Health Care: $10, 18A Medicare Covered Hearing Exams: $10, 7B Chiropractic: $10, 7F Medicare Covered Podiatry: $10, 7F Non Medicare Covered Podiatry (Routine): $0, 14D Pap Smears & Pelvic Exams: $0, , 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $10"	15 Part B Drugs: 0%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $10, 17A Medicare Covered Eye Exams: $10, 17B Medicare Covered Eyewear: $10"	"10B Transportation: $0,  Number of Trips Covered - 8"	"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	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: Over-the-Counter Drugs: $0, 13D Other: PERS: $0, 13E Other: Assistive Devices: Not Covered"											0	0	0	0	50	0	0	46.45383876	0	0	0	0	0	10	0	10	10	10	0	10	0	10	0	0	0	0	0	0	0	0											0	0	0	0	50	0	0	46.45383876	0	0	0	0	0	10	0	10	10	10	0	10	0	10	0	0	0	0	0	0	0	0											0	0	0	0	0.713333333	0	0	0.886416667	0	0	0	0	0	0.251108333	0	7.84855	0.21275	0.915925	0	2.0159	0	0.790183333	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.6342	1200	0	44.0385	0.459407542	7.909227244	5.333434435	0.713333333	1.208337546	0.860192768	0.886416667	4.267465373	0.70705692	2.332928925	0.177063324	0.029909345	2.92380742	0	7.84855	0.21275	0.915925	0	2.0159	0.930778822	0.863162136	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.6342	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	44.0385	0.459407542	7.909227244	5.333434435	0.713333333	1.208337546	0.860192768	0.886416667	4.267465373	0.70705692	2.332928925	0.177063324	0.029909345	2.92380742	0	7.84855	0.21275	0.915925	0	2.0159	0.930778822	0.863162136	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	84.6342
H6181_013_0	2009	3																					0											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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	177.373	2.618	745.53	0	169.67	9.46	6.76	147.882	171.885	0	344.638	46.51	0.25	1064.38	6963.15	6155.59	159.208	674.051	1281.875	1456.301	7.99	584.091	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $350 per admit	1B IP Psych: $350 per admit	2 SNF: $100 per day for days 21-100	6 Home Health: $0	10A Ambulance: $50	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER/Worldwide Coverage: $50, 4B Urgent Care: $30"	9B ASC Services: $75	8A OP Lab Services: $0	8B OP X-Ray: $75	"9A OP Hospital: $75,  5 Partial Hosp: $75"	12 Renal Dialysis: 20%	"3 CORF: $75, 8A OP Diagnostic Procedures/Tests: $75, 9A OP Hospital: $75, 9D Cardiac Rehab: $75"	"7A PCP: $5, 14B Immunizations: $0, 14C Routine Physical Exams: $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"	"8B Physician Specialist Services - Radiology: $75, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7B Chiropractic: $30, 7F Podiatry - Medicare Covered: $30, 7F Podiatry - Routine: $0, 7G Other Health Care: $30, 14D Pap Smears/Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutritional Therapy: $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, 17B Medicare Covered Eyewear: $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	14A Health Education/Wellness Programs: $0	"13B Acupuncture: Not Covered, 13C Other: OTC drugs: $0, 13D Other: PERS: $0"											350	350	100	0	50	0.200000298	0.200089374	48.21925589	75	0	75	75	0.2	62.43028806	5	30	30	30	75	30	0.199998637	30	0	0	0	0	0	0	0	0											350	350	100	0	50	0.200000298	0.200089374	48.21925589	75	0	75	75	0.2	62.43028806	5	30	30	30	75	30	0.199998637	30	0	0	0	0	0	0	0	0											5.1734	0.076358333	6.21275	0	0.706958333	1.892002815	1.352604165	0.59423	1.07428125	0	2.1539875	0.2906875	0.05	5.5374625	2.9013125	15.388975	0.39802	1.6851275	8.01171875	3.6407525	1.59798911	1.4602275	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1988	0	0	5.1734	0.076358333	6.21275	0	0.706958333	1.892002815	1.352604165	0.59423	1.07428125	0	2.1539875	0.2906875	0.05	5.5374625	2.9013125	15.388975	0.39802	1.6851275	8.01171875	3.6407525	1.59798911	1.4602275	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.1988	0	PBP: 1A IP Acute: $450 per admit	1B IP Psych: $450 per admit	2 SNF: Not Covered	6 Home Health: Not Covered	10A Ambulance: Not Covered	11A DME: Not Covered	"11B Prosthetic Medical Supplies, 11C Diabetes Monitoring Supplies: Not Covered"	"4A ER/Worldwide Coverage: $50, 4B Urgent Care: $40"	9B ASC Services: $100	8A OP Lab Services: Not Covered	8B OP X-Ray: $125	"9A OP Hospital, 5 Partial Hosp: Not Covered"	12 Renal Dialysis: Not Covered	"3 CORF, 8A OP Diagnostic Procedures/Tests, 9A OP Hospital, 9D Cardiac Rehab: Not Covered"	"7A PCP, 14B Immunizations, 14C Routine Physical Exams, 14I Diabetes Monitoring: Not Covered"	7D Physician Specialist: $40	"7E Mental Health: $40,  7H Psychiatric: $40, 9C OP Substance Abuse: $40"	"7C Occupational Therapy: $40,  7I Physical and Speech Therapy: $40"	"7D Physician Specialist Services - Radiology: $125, 14H Mammography: $0, 14G Bone Mass Measurement:$0"	"7B Chiropractic: $40, 7F Podiatry: $40, 7G Other Health Care: $40, 14D Pap Smears:$0, 14D Pelvic Exams:$0, 14E Prostate Screening:$0, 14F Colorectal Screening:$0, 14I Diabetes Monitoring:$0, 14J Nutrition Therapy:$0, 18A Medicare Covered Hearing Exams: $40"	15 Part B Drugs: Not Covered	"13A Blood: Not Covered, 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: Not Covered	17B Eye Wear: Not Covered	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: OTC drugs: Not Covered, 13D Other: PERS: Not Covered"											3.3859	0.0547	0	0	0	0	0	0.2816	0.6589	0	1.6042	0	0	0	0	10.1077	0.2899	1.2349	6.9866	2.7764	0	1.0205	0	0	0	0	0	0	0	0											28.4013	0	0	8.5593	0.131033333	6.21275	0	0.706958333	1.892002815	1.352604165	0.8758375	1.73313125	0	3.758175	0.2906875	0.05	5.5374625	2.9013125	25.496685	0.68796	2.9200475	14.99834375	6.4171125	1.59798911	2.4806975	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.6001
H6184_001_0	2009	9	H.6	H.7	I.7	I.8	I.9	I.10	I.11	I.12	I.13		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional	0		CORF	Partial Hospitalization	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemo/Radiation	0	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	0	Coin	0	0	0	V	V	V	0	V	0	V	V	V	V	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1540.86654	55.12595621	468.3489416	436.5739266	233.3340886	10.43346786	1.419911897	354.5500508	456.5256802	4923.921192	1005.568381	139.3666936	0	192.7191606	4127.749881	3473.690117	23.29967675	1340.077804	2806.362534	0	31.0572228	0	0	0	366.8728457	343.1752547	185.934419	0	0	0	0	0.443372302	155.7146294	478.0789043	123.7843824	0.587233403	847.9740492	27.84784102	10.2101839	0	$240/day w/$2400 yrly max	$240/day w/$2400 yrly max	$100/day (for days 21-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$200 copay	$0 copay	$75/$125 copay for Lower/Higher Tier	$200 copay	20% coinsurance	$30 copay	$15 coapy	$30 copay	$35 copay	$30 copay	$75/$125 copay for Lower/Higher Tier	0	20% coinsurance	0	0	0	$30 copay	$30 Copay/ Covd up to $50/ 1 per yr	$30 copay	0	Silver Sneakers	0	$30 copay	$35 copay	$30 copay	$30 copay	$0 copay	20% coinsurance	$30 copay	$30 copay	20% coinsurance	0	240	240	75	0	100	0.2	0.2	50	200	0	90.43209877	200	0.2	30	15	30	35	30	80.21872402	0	0.2	0	0	0	30	30	30	0	0	0	30	35	30	30	0	0.2	30	30	0.2	0	143.5107934	118.808841	66.90171754	0	89.20229005	0.17840458	0.17840458	44.60114503	178.4045801	0	80.66750304	178.4045801	0	26.76068702	13.38034351	26.76068702	31.22080152	26.76068702	71.55693888	0	0.17840458	0	0	0	26.76068702	26.76068702	26.76068702	0	0	0	0	31.22080152	26.76068702	26.76068702	0	0.17840458	26.76068702	26.76068702	0.17840458	0	18.4276	0.545787581	2.611112383	0	1.734494587	1.861378453	0.253318786	1.317778186	6.787189357	0	6.759724201	2.071971371	0	0.429774761	4.602559277	7.746527835	0.060619549	2.988450223	16.73455936	0	5.540750794	0	0	0	0.81814745	0.765300465	0.414644399	0	0	0	0	0.001153537	0.347252538	1.066143327	0	0.104765129	1.891030677	0.06210228	1.821543571	0	87.7657		10.6238	18.4276	0.545787581	2.611112383	0	1.734494587	1.861378453	0.253318786	1.317778186	6.787189357	0	6.759724201	2.071971371	0	0.429774761	4.602559277	7.746527835	0.060619549	2.988450223	16.73455936	0	5.540750794	0	0	0	0.81814745	0.765300465	0.414644399	0	0	0	0	0.001153537	0.347252538	1.066143327	0	0.104765129	1.891030677	0.06210228	1.821543571	0	87.7657	3500																																																																																	0		0	18.4276	0.545787581	2.611112383	0	1.734494587	1.861378453	0.253318786	1.317778186	6.787189357	0	6.759724201	2.071971371	0	0.429774761	4.602559277	7.746527835	0.060619549	2.988450223	16.73455936	0	5.540750794	0	0	0	0.81814745	0.765300465	0.414644399	0	0	0	0	0.001153537	0.347252538	1.066143327	0	0.104765129	1.891030677	0.06210228	1.821543571	0	87.7657
H6184_803_0	2009	3																					none											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	V											0	0	0	0	0	0	0	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	294.9482719	3.208297074	58.83336188	20.26543692	6.19077903	12.17207833	3.436629652	9.355365871	40.06801342	7.012723248	27.09299746	0	0.205315046	46.86439222	35.31043395	112.8208382	1.046714586	4.960917846	24.37725769	31.65193119	12.94633322	1.375595377	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.073805067	0.073805067	0.164504946	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.073805067	0.073805067	0.164504946	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											21.7687	0.236788581	9.678379008	0	1.430069956	2.811750095	0.79386145	2.161089516	9.255711101	1.61993907	6.258482414	0	0.047427776	10.8256746	8.156710243	26.06161361	0.241791069	1.145972022	5.631146527	7.311596104	2.990602973	0.317762532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.745	0	0	21.7687	0.236788581	9.678379008	0	1.430069956	2.811750095	0.79386145	2.161089516	9.255711101	1.61993907	6.258482414	0	0.047427776	10.8256746	8.156710243	26.06161361	0.241791069	1.145972022	5.631146527	7.311596104	2.990602973	0.317762532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.745	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.7687	0.236788581	9.678379008	0	1.430069956	2.811750095	0.79386145	2.161089516	9.255711101	1.61993907	6.258482414	0	0.047427776	10.8256746	8.156710243	26.06161361	0.241791069	1.145972022	5.631146527	7.311596104	2.990602973	0.317762532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.745
H6184_804_0	2009	3																					none											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	V											0	0	0	0	0	0	0	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	294.9482719	3.208297074	58.83336188	20.26543692	6.19077903	12.17207833	3.436629652	9.355365871	40.06801342	7.012723248	27.09299746	0	0.205315046	46.86439222	35.31043395	112.8208382	1.046714586	4.960917846	24.37725769	31.65193119	12.94633322	1.375595377	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.073805067	0.073805067	0.164504946	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.073805067	0.073805067	0.164504946	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											21.7687	0.236788581	9.678379008	0	1.430069956	2.811750095	0.79386145	2.161089516	9.255711101	1.61993907	6.258482414	0	0.047427776	10.8256746	8.156710243	26.06161361	0.241791069	1.145972022	5.631146527	7.311596104	2.990602973	0.317762532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.745	0	0	21.7687	0.236788581	9.678379008	0	1.430069956	2.811750095	0.79386145	2.161089516	9.255711101	1.61993907	6.258482414	0	0.047427776	10.8256746	8.156710243	26.06161361	0.241791069	1.145972022	5.631146527	7.311596104	2.990602973	0.317762532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.745	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.7687	0.236788581	9.678379008	0	1.430069956	2.811750095	0.79386145	2.161089516	9.255711101	1.61993907	6.258482414	0	0.047427776	10.8256746	8.156710243	26.06161361	0.241791069	1.145972022	5.631146527	7.311596104	2.990602973	0.317762532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.745
H6184_805_0	2009	3																					none											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	V											0	0	0	0	0	0	0	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	294.9482719	3.208297074	58.83336188	20.26543692	6.19077903	12.17207833	3.436629652	9.355365871	40.06801342	7.012723248	27.09299746	0	0.205315046	46.86439222	35.31043395	112.8208382	1.046714586	4.960917846	24.37725769	31.65193119	12.94633322	1.375595377	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.073805067	0.073805067	0.164504946	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.073805067	0.073805067	0.164504946	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											21.7687	0.236788581	9.678379008	0	1.430069956	2.811750095	0.79386145	2.161089516	9.255711101	1.61993907	6.258482414	0	0.047427776	10.8256746	8.156710243	26.06161361	0.241791069	1.145972022	5.631146527	7.311596104	2.990602973	0.317762532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.745	0	0	21.7687	0.236788581	9.678379008	0	1.430069956	2.811750095	0.79386145	2.161089516	9.255711101	1.61993907	6.258482414	0	0.047427776	10.8256746	8.156710243	26.06161361	0.241791069	1.145972022	5.631146527	7.311596104	2.990602973	0.317762532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.745	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.7687	0.236788581	9.678379008	0	1.430069956	2.811750095	0.79386145	2.161089516	9.255711101	1.61993907	6.258482414	0	0.047427776	10.8256746	8.156710243	26.06161361	0.241791069	1.145972022	5.631146527	7.311596104	2.990602973	0.317762532	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.745
H6228_001_0	2009	4																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1860.888413	47.44818212	2575.062641	4872.33956	254.9216046	15.40267347	8.496712434	363.0917937	369.406577	6287.035224	462.2026663	0	7.360029247	1399.030691	6576.483069	5392.785554	226.133059	658.3527862	0	0	1360.509669	1602.923262	2759.542995	620.9054087	205.2567597	154.1150788	49.27524142	14.09480567	932.1	115.5175384											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b, 7d); $0 n/c (7b1); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0.2	0.2	49.97245876	50	8	16.62123034	0	0	46.77659972	1.305195376	17.53875559	20	0	0	0	0	0.001757725	0	20	20	0	20	0	0	20											0	0	0	0	0	0.164898617	0.164898617	41.20194667	41.22465424	6.595944678	13.70408948	0	0	38.566983	1.076124562	14.4605827	16.4898617	0	0	0	0	0.001449232	0	20	20	0	20	0	0	20											0	0	0	0	0	2.539879553	1.401096129	1.24667406	1.269054868	3.455744711	0.527838891	0	0	4.496366074	0.58975958	6.498568457	0.310741906	0	0	0	0	0.000193584	0	1.034842348	0.342094599	0	0.082125402	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	23.9875	0	4.7546	0	0	0	0	0	2.539879553	1.401096129	1.24667406	1.269054868	3.455744711	0.527838891	0	0	4.496366074	0.58975958	6.498568457	0.310741906	0	0	0	0	0.000193584	0	1.034842348	0.342094599	0	0.082125402	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	23.9875		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.7115	0.0215	0.5938	0.3703	0.0743	0.0943	0.052	0.0309	0.2598	0.0454	0.1102	0	0	0.2073	0.3287	1.0137	0.0129	0.033	0	0	0.1706	0.0747	0	0	0.0039	0.0039	0.0016	0.0006	0	0											5.2148	0	0	1.7115	0.021485962	0.593814084	0.370259398	0.074300203	2.634181635	1.453116817	1.277532206	1.528809711	3.501143161	0.637989801	0	0	4.703629863	0.918487083	7.512228046	0.323662878	0.033024479	0	0	0.170610963	0.074924214	0	1.034842348	0.346006016	0.003931507	0.083745916	0.000575298	0	0.192529231	0	0	0	0	0	0	0	0	0	0	29.2023
H6228_002_0	2009	2																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1860.888413	47.44818212	2575.062641	4872.33956	254.9216046	15.40267347	8.496712434	363.0917937	369.406577	6287.035224	462.2026663	0	7.360029247	1399.030691	6576.483069	5392.785554	226.133059	658.3527862	0	0	1360.509669	1602.923262	2759.542995	620.9054087	205.2567597	154.1150788	49.27524142	14.09480567	932.1	115.5175384											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b, 7d); $0 n/c (7b1); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0.2	0.2	49.97245876	50	8	16.62123034	0	0	46.77659972	1.305195376	17.53875559	20	0	0	0	0	0.001757725	0	20	20	0	20	0	0	20											0	0	0	0	0	0.164898617	0.164898617	41.20194667	41.22465424	6.595944678	13.70408948	0	0	38.566983	1.076124562	14.4605827	16.4898617	0	0	0	0	0.001449232	0	20	20	0	20	0	0	20											0	0	0	0	0	2.539879553	1.401096129	1.24667406	1.269054868	3.455744711	0.527838891	0	0	4.496366074	0.58975958	6.498568457	0.310741906	0	0	0	0	0.000193584	0	1.034842348	0.342094599	0	0.082125402	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	23.9875	0	4.7546	0	0	0	0	0	2.539879553	1.401096129	1.24667406	1.269054868	3.455744711	0.527838891	0	0	4.496366074	0.58975958	6.498568457	0.310741906	0	0	0	0	0.000193584	0	1.034842348	0.342094599	0	0.082125402	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	23.9875		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.7115	0.0215	0.5938	0.3703	0.0743	0.0943	0.052	0.0309	0.2598	0.0454	0.1102	0	0	0.2073	0.3287	1.0137	0.0129	0.033	0	0	0.1736	0.0747	0	0	0.0039	0.0039	0.0016	0.0006	0	0											5.2178	0	0	1.7115	0.021485962	0.593814084	0.370259398	0.074300203	2.634181635	1.453116817	1.277532206	1.528809711	3.501143161	0.637989801	0	0	4.703629863	0.918487083	7.512228046	0.323662878	0.033024479	0	0	0.173610963	0.074924214	0	1.034842348	0.346006016	0.003931507	0.083745916	0.000575298	0	0.192529231	0	0	0	0	0	0	0	0	0	0	29.2053
H6228_003_0	2009	3																					1500											D	D	D	V	T	P	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2739.419426	59.25428488	2516.144554	83940.8346	151.9035969	3078.150369	15.76865326	433.9976303	417.1123044	8060.65838	525.1589824	0	11.78092373	1606.78263	7357.855076	6001.904911	239.1785579	274.7148734	0	0	1793.688934	1607.052152	1418.390092	620.9054087	205.2567597	154.1150788	37.56409609	10.74492219	932.1	115.5175384											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	$0 (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b, 7d); $0 n/c (7b1); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0	0.2	49.9769584	50	3.2	16.87836848	0	0	45.70445279	1.385278156	17.93145706	20	0	0	0	0	0.001602202	0	20	0	0	20	0	0	20											0	0	0	0	0	0	0.160325316	40.06285823	40.08132899	2.565205055	13.5301488	0	0	36.63790417	1.110475791	14.3743326	16.0325316	0	0	0	0	0.001284368	0	20	0	0	20	0	0	20											0	0	0	0	0	0	2.528114316	1.448932128	1.393201291	1.723103469	0.592123265	0	0	4.905762334	0.680893328	7.189448117	0.319553149	0	0	0	0	0.000172004	0	1.034842348	0	0	0.062606827	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	22.0713	0	5.1426	0	0	0	0	0	0	2.528114316	1.448932128	1.393201291	1.723103469	0.592123265	0	0	4.905762334	0.680893328	7.189448117	0.319553149	0	0	0	0	0.000172004	0	1.034842348	0	0	0.062606827	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	22.0713		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a3); $0 (6a2)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.438	0.0269	0.5673	0.3639	0.0908	0.1497	0.0965	0.0369	0.307	0.0565	0.1275	0	0	0.2476	0.3944	1.1763	0.0141	0.0346	0	0	0.2159	0.0783	0	0	0.0039	0.0039	0.0009	0.0004	0	0											6.4314	0	0	2.438	0.026887578	0.567270685	0.363904886	0.09082629	0.149650152	2.624657091	1.485819681	1.700157968	1.779614515	0.719641479	0	0	5.153409654	1.075247765	8.365724963	0.333651925	0.034583233	0	0	0.215905071	0.078465466	0	1.034842348	0.003911416	0.003931507	0.063548589	0.000438568	0	0.192529231	0	0	0	0	0	0	0	0	0	0	28.5026
H6264_001_0	2009	2																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	P	P	P	Coin	Coin	P																																																			0		452.2678893	37.45542313	40.24065582		13.80728784	11.87198723	9.055167105	335.5205957	25.93459613	5.203624788	11.68113281	2.026014317	6.871851327	34.65032723	59.92123438	93.23393092	21.55852326	30.03268998	46.83439463	89.50750327	13.33850665	14.0761144																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	4a: $50; 4b: $50	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	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: $0; 16b3: $0	17a: $0	17b: $100 Allowance	18a: $0			14c: $0; $150/qtr Towards OTC Drugs;											0.0604	0.0604	0.1595		0.231	0.231	0.231	50	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.0604	0.0604	0.1595		0.231	0.231	0.231	50	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			27.317	2.262307557	6.418384604	0	3.189483491	2.742429051	2.091743601	1.398002482	5.990891706	1.202037326	2.698341678	0.468009307	1.587397657	8.004225591	13.84180514	21.53703804	4.980018873	6.937551386	10.81874516	20.67623326	3.081195036	3.251582427	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.4944	0	0	27.317	2.262307557	6.418384604	0	3.189483491	2.742429051	2.091743601	1.398002482	5.990891706	1.202037326	2.698341678	0.468009307	1.587397657	8.004225591	13.84180514	21.53703804	4.980018873	6.937551386	10.81874516	20.67623326	3.081195036	3.251582427	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.4944																																																																																		0	0	0	27.317	2.262307557	6.418384604	0	3.189483491	2.742429051	2.091743601	1.398002482	5.990891706	1.202037326	2.698341678	0.468009307	1.587397657	8.004225591	13.84180514	21.53703804	4.980018873	6.937551386	10.81874516	20.67623326	3.081195036	3.251582427	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.4944
H6328_001_0	2009	10																					3000											D	A	D		T	Coin	Coin	V	V	V	V		V	V	V	V	V	V	V		Coin			V	V		V																																																						0	5000	1851.454055	113.7413897	1304.858597		375.1005952	21.32449671	0.774101563	144.3307366	254.7780111	6671.972917	1753.843872		0	33845.99182	4498.649818	4878.244532	1003.96231	1274.663026	5557.381445		30.29415825			540.8	168		270														$100 days 1 to 5	$925 per admission	$100 days 21+		$50 waived if admitted	20%	0% to 20% varies by service	"$50 ER, $30 UC, waived if admitted"	"$100 Hosp, $50 ASC"		$100 for complex tests		$20 	$0 to $25 varies by service	$0 to $5 varies by service & location	$10 / $0 for preventive	$25 	$10 	$0 to $100 varies by service		20%			$10 	$10 		$10 														64.84414681	102.793597	10.4		40	0.2	0.18	38.7	75	0	15		20	1.25	3.5625	8.055555556	25	10	10		0.2			10	10		10														55.11752479	87.37455749	8.84		34	0.17	0.153	32.895	63.75	0	12.75		17	1.0625	3.028125	6.847222222	21.25	8.5	8.5		0.17			8.5	8.5		8.5														8.504	0.8281753	0.961245833	0	1.06278502	3.625164441	0.118437539	0.395646632	1.353508184	0	1.863459114	0	0	2.996780525	1.135206165	2.783535363	1.777849924	0.90288631	3.936478524	0	5.150006902	0	0	0.383066667	0.119	0	0.19125	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0884		6.7215	8.504	0.8281753	0.961245833	0	1.06278502	3.625164441	0.118437539	0.395646632	1.353508184	0	1.863459114	0	0	2.996780525	1.135206165	2.783535363	1.777849924	0.90288631	3.936478524	0	5.150006902	0	0	0.383066667	0.119	0	0.19125	0	0	0	0	0	0	0	0	0	0	0	0	0	38.0884		$175 days 1-5	"$1,024 per admission"	$125 days 11-100	$30 	$100 waived if admitted	30%	20%-30% varies by service	"$50 ER, $30 UC, waived if admitted"	"$150 Hosp, $100 ASC"	$10 	$200 for complex tests			$0 to $50 varies by service	$15 	$30 	$50 	$30 	$10 to $200 varies by service		30%																				1.5296	0.0942	0.4334	1.0354	0.2185	0.5589	0.0169	0.0346	0.2319	0.4858	0.3831			0.616	0.4913	1.0655	0.3655	0.2784	1.1734		0.794																				9.8063		2.665161816	10.0336	0.922409237	1.394687691	1.035412305	1.281260277	4.1840795	0.135345207	0.430212959	1.585373867	0.485756695	2.246527847	0	0	3.612824585	1.626496214	3.849025273	2.143320092	1.181293959	5.10984243	0	5.94401679	0	0	0.383066667	0.119	0	0.19125	0	0	0	0	0	0	0	0	0	0	0	0	0	47.8948
H6328_002_0	2009	7																					3350											D	D	D		T	Coin	Coin	V	V					V	V	V	V	V	V		Coin				V																																																								0	5000	1851.454055	113.7413897	1304.858597		375.1005952	21.32449671	0.774101563	144.3307366	254.7780111					33845.99182	4498.649818	4878.244532	1003.96231	1274.663026	5557.381445		30.29415825				168																$100 days 1 to 5	$925 per admission	$100 days 21+		$100 waived if admitted	20%	0% to 20% varies by service	"$50 ER / $30 UC, waived if admitted"	"$100 Hosp, $50 ASC"					$0 to $25 varies by service	$0 to $10 varies by service and location	$0 to $20 varies by service	$30 	$0 to $25 varies by service	$125 for complex tests		20%				$20 																64.84414681	102.793597	10.4		80	0.2	0.18	38.7	75					1.5	7.125	16.11111111	30	20	18.75		0.2				20																56.60245575	89.72853086	9.07816		69.832	0.17458	0.157122	33.78123	65.4675					1.30935	6.2194125	14.06338889	26.187	17.458	16.366875		0.17458				17.458																8.7331	0.850487317	0.987142927	0	2.182835397	3.722830636	0.121628386	0.406305817	1.389973287	0	0	0	0	3.693020782	2.331579909	5.717054162	2.190896751	1.854422259	7.579747287	0	5.288754147	0	0	0	0.244412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.2942		6.8863	8.7331	0.850487317	0.987142927	0	2.182835397	3.722830636	0.121628386	0.406305817	1.389973287	0	0	0	0	3.693020782	2.331579909	5.717054162	2.190896751	1.854422259	7.579747287	0	5.288754147	0	0	0	0.244412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.2942		20%	20%	20%	20%	20%	30%	20%-30% varies by service	"$50 ER, $30 UC, waived if admitted"	20%	$15 	20%	20%	20%	20%	20%	20%	$60 	$30 	20% / $200 for complex	20%	30%																				4.2533	0.1136	0.8466	0.6373	0.1648	0.5189	0.0157	0.033	0.3524	0.1638	0.1986	0.0201	0	0.7425	0.3804	0.3759	0.4072	0.2585	0.4602	1.8182	0.7372																				12.4979		4.622497077	12.9864	0.964068181	1.833707901	0.637276812	2.347636538	4.241726723	0.137325445	0.439261734	1.742361307	0.163842279	0.198589393	0.020056805	0	4.435558057	2.711954642	6.092920393	2.598059243	2.112895595	8.039920136	1.818154147	6.025911998	0	0	0	0.244412	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.792
H6411_002_0	2009	4	r.	s.	t.	u.							OP Facility - Other	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered								Renal Dialysis										A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin				V				O	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							0		251.973163	8.118531	489.519906	699.634853	139.158025	9.125634	3.295567	314.765011	341.195114	603.224763	895.315333	0	0	684.908755	3352.143559	4040.712807	27.564104	870.931215			20.625481				2.47				1.36	0.05	18.353736	0.06	1.23	2.7							$625/Admit:1a	$625/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$75/Visit:9b. $0 Surgery ASC -- Physician,9b. $50 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $75 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$100/Visit:14h. $50 DMAM -- OP,8b. $30 Radiology -- FSR,14h. $25 SMAM -- FSR,14h. $25 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$75/Visit:9a	20% Coins:12	"$15-$100/Visit:9d. $15 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $75 OP Other,5. $30 Partial Hospitalization,8b. $50 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$75/Visit:7h. $75 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			15% Coins:15				Vision Plan 8 PPO				$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	$0/Proc:12	$0: Nurse hotline 14a	$0 Health Education Materials 14a	$0 Corp Health 14a							624.999988	624.999769	43.132791	0	99.999982	0.2	0.199999	50.000004	63.65662	0	62.432439	0	0.2	52.707359	14.999998	29.999999	67.976669	39.708642			0.149999				0				0	0	0	0	0	0							624.999988	624.999769	43.132791	0	99.999982	0.2	0.199999	50.000004	63.65662	0	62.432439	0	0.2	52.707359	14.999998	29.999999	67.976669	39.708642			0.149999				0				0	0	0	0	0	0							13.1236	0.42284	1.759529983	0	1.15965	1.8251268	0.659110104	1.311520984	1.809943976	0	4.658059993	0	0	3.008310969	4.19017889	10.10178168	0.156142998	2.881957985	0	0	3.093801525	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.1616	0	0	13.1236	0.42284	1.759529983	0	1.15965	1.8251268	0.659110104	1.311520984	1.809943976	0	4.658059993	0	0	3.008310969	4.19017889	10.10178168	0.156142998	2.881957985	0	0	3.093801525	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.1616		$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		20% Coins	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			0%-15% Coins				Vision Plan 8 PPO				0	0		0	0	0							2.5696	0.0828	0.4815	0.7305	0.8963	2.0122	0.7267	0.2683	3.4774	0.448	1.8633		0	1.0525	2.1102	4.8179	0.0304	0.4068			0.558				0				0	0		0	0	0							22.5323	500	0	15.6932	0.505631	2.241006983	0.730451	2.055926	3.8373248	1.385781104	1.579840984	5.287299976	0.447965	6.521378993	0	0	4.060781969	6.30040889	14.91968368	0.186589998	3.288769985	0	0	3.651818525	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.6938
H6411_801_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		251.973163	8.118531	489.519906	699.634853	4.623846	9.125634	3.295567	20.288981	52.153053	603.224763	28.200073	0	0.355846	16.065489	30.265239	69.099086	0.436685	5.834567			20.625481																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000004	1023.999538	43.132791	0	0.199999	0.2	0.199999	0.199999	0.199999	0	0.199999	0	0.199999	0.199999	0.2	0.199999	0.500001	0.199999			0.199999																				1024.000004	1023.999538	43.132791	0	0.199999	0.2	0.199999	0.199999	0.199999	0	0.199999	0	0.199999	0.199999	0.2	0.199999	0.500001	0.199999			0.199999																				21.5017	0.692780999	1.759529983	0	0.924764576	1.8251268	0.659110104	4.057775911	10.43055845	0	5.6399864	0	0.071168844	3.213081735	6.0530478	13.8197481	0.218342937	1.166907565	0	0	4.125075575	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1587	0	0	21.5017	0.692780999	1.759529983	0	0.924764576	1.8251268	0.659110104	4.057775911	10.43055845	0	5.6399864	0	0.071168844	3.213081735	6.0530478	13.8197481	0.218342937	1.166907565	0	0	4.125075575	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1587		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3891	0.077	0.1955		0.5863	1.1571	0.4179	0.7643	1.9996		1.0715		0.0134	0.6052	1.2135	2.7705	0.0438	0.2339			0.827																				14.3656	0	0	23.8908	0.769756999	1.955032983	0	1.511056576	2.9822338	1.076980104	4.822102911	12.43019845	0	6.7114814	0	0.084573844	3.818301735	7.2665278	16.5902651	0.262114937	1.400844565	0	0	4.952051575	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.5243
H6411_802_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		251.973163	8.118531	489.519906	699.634853	4.623846	9.125634	3.295567	20.288981	52.153053	603.224763	28.200073	0	0.355846	16.065489	30.265239	69.099086	0.436685	5.834567			20.625481																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000004	1023.999538	43.132791	0	0.199999	0.2	0.199999	0.199999	0.199999	0	0.199999	0	0.199999	0.199999	0.2	0.199999	0.500001	0.199999			0.199999																				1024.000004	1023.999538	43.132791	0	0.199999	0.2	0.199999	0.199999	0.199999	0	0.199999	0	0.199999	0.199999	0.2	0.199999	0.500001	0.199999			0.199999																				21.5017	0.692780999	1.759529983	0	0.924764576	1.8251268	0.659110104	4.057775911	10.43055845	0	5.6399864	0	0.071168844	3.213081735	6.0530478	13.8197481	0.218342937	1.166907565	0	0	4.125075575	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1587	0	0	21.5017	0.692780999	1.759529983	0	0.924764576	1.8251268	0.659110104	4.057775911	10.43055845	0	5.6399864	0	0.071168844	3.213081735	6.0530478	13.8197481	0.218342937	1.166907565	0	0	4.125075575	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1587		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3891	0.077	0.1955		0.5863	1.1571	0.4179	0.7643	1.9996		1.0715		0.0134	0.6052	1.2135	2.7705	0.0438	0.2339			0.827																				14.3656	0	0	23.8908	0.769756999	1.955032983	0	1.511056576	2.9822338	1.076980104	4.822102911	12.43019845	0	6.7114814	0	0.084573844	3.818301735	7.2665278	16.5902651	0.262114937	1.400844565	0	0	4.952051575	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.5243
H6411_803_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		251.973163	8.118531	489.519906	699.634853	4.623846	9.125634	3.295567	20.288981	52.153053	603.224763	28.200073	0	0.355846	16.065489	30.265239	69.099086	0.436685	5.834567			20.625481																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000004	1023.999538	43.132791	0	0.199999	0.2	0.199999	0.199999	0.199999	0	0.199999	0	0.199999	0.199999	0.2	0.199999	0.500001	0.199999			0.199999																				1024.000004	1023.999538	43.132791	0	0.199999	0.2	0.199999	0.199999	0.199999	0	0.199999	0	0.199999	0.199999	0.2	0.199999	0.500001	0.199999			0.199999																				21.5017	0.692780999	1.759529983	0	0.924764576	1.8251268	0.659110104	4.057775911	10.43055845	0	5.6399864	0	0.071168844	3.213081735	6.0530478	13.8197481	0.218342937	1.166907565	0	0	4.125075575	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1587	0	0	21.5017	0.692780999	1.759529983	0	0.924764576	1.8251268	0.659110104	4.057775911	10.43055845	0	5.6399864	0	0.071168844	3.213081735	6.0530478	13.8197481	0.218342937	1.166907565	0	0	4.125075575	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1587		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3891	0.077	0.1955		0.5863	1.1571	0.4179	0.7643	1.9996		1.0715		0.0134	0.6052	1.2135	2.7705	0.0438	0.2339			0.827																				14.3656	0	0	23.8908	0.769756999	1.955032983	0	1.511056576	2.9822338	1.076980104	4.822102911	12.43019845	0	6.7114814	0	0.084573844	3.818301735	7.2665278	16.5902651	0.262114937	1.400844565	0	0	4.952051575	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.5243
H6411_804_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		251.973163	8.118531	489.519906	699.634853	4.623846	9.125634	3.295567	20.288981	52.153053	603.224763	28.200073	0	0.355846	16.065489	30.265239	69.099086	0.436685	5.834567			20.625481																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000004	1023.999538	43.132791	0	0.199999	0.2	0.199999	0.199999	0.199999	0	0.199999	0	0.199999	0.199999	0.2	0.199999	0.500001	0.199999			0.199999																				1024.000004	1023.999538	43.132791	0	0.199999	0.2	0.199999	0.199999	0.199999	0	0.199999	0	0.199999	0.199999	0.2	0.199999	0.500001	0.199999			0.199999																				21.5017	0.692780999	1.759529983	0	0.924764576	1.8251268	0.659110104	4.057775911	10.43055845	0	5.6399864	0	0.071168844	3.213081735	6.0530478	13.8197481	0.218342937	1.166907565	0	0	4.125075575	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1587	0	0	21.5017	0.692780999	1.759529983	0	0.924764576	1.8251268	0.659110104	4.057775911	10.43055845	0	5.6399864	0	0.071168844	3.213081735	6.0530478	13.8197481	0.218342937	1.166907565	0	0	4.125075575	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1587		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3891	0.077	0.1955		0.5863	1.1571	0.4179	0.7643	1.9996		1.0715		0.0134	0.6052	1.2135	2.7705	0.0438	0.2339			0.827																				14.3656	0	0	23.8908	0.769756999	1.955032983	0	1.511056576	2.9822338	1.076980104	4.822102911	12.43019845	0	6.7114814	0	0.084573844	3.818301735	7.2665278	16.5902651	0.262114937	1.400844565	0	0	4.952051575	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.5243
H6421_003_0	2009	3																					5000											D	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	V											0	0	0	0	0	0	0	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	950.5877121	3.509420875	937.5697713	31.64353485	223.1211705	13.03878946	3.694525201	171.7585954	433.810128	7.400649428	22.17763307	0	0.259059019	565.316087	3912.210741	6140.422861	167.6402477	770.7943234	39.79677942	18.1635191	7.442236542	10.29880656	0	0	0	0	0	0	324	0											1a:  Acute - $250/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - MC Cost Shares for 1-190	2:  Skilled Nursing Services - $0/$100/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $150/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $25/visit/7b:  Chiropractic Services - $25/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $25/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%/13a:  3-Pints Deductible Waived - $0/service							14a:  Written health education materials - $0/service/14c:  Routine Exams - $0/visit/												249.5423692	0.065624576	100	0	150	0.2	0.2	50	110.1315579	0	0.2	0	0.2	25	25	25	25	25	0	18.61663622	0.2	186.8467774	0	0	0	0	0	0	0	0											226.7558759	0.059632191	90.86868761	0	136.3030314	0.181737375	0.181737375	45.4343438	100.0751013	0	0.181737375	0	0.181737375	22.7171719	22.7171719	22.7171719	22.7171719	22.7171719	0	16.91669301	0.181737375	169.7852145	0	0	0	0	0	0	0	0											17.9626	0.209274456	7.099644555	0	2.534340993	2.369635372	0.671433313	0.65031159	3.617799375	0	4.030504822	0	0.047080706	1.070198561	7.406196994	11.62442014	0.31735936	1.459188929	0	0.025605556	1.352532535	0.145715423	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.5939	0	6.29	17.9626	0.209274456	7.099644555	0	2.534340993	2.369635372	0.671433313	0.65031159	3.617799375	0	4.030504822	0	0.047080706	1.070198561	7.406196994	11.62442014	0.31735936	1.459188929	0	0.025605556	1.352532535	0.145715423	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.5939	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	17.9626	0.209274456	7.099644555	0	2.534340993	2.369635372	0.671433313	0.65031159	3.617799375	0	4.030504822	0	0.047080706	1.070198561	7.406196994	11.62442014	0.31735936	1.459188929	0	0.025605556	1.352532535	0.145715423	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.5939
H6421_007_0	2009	3																					5000											D	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	V											0	0	0	0	0	0	0	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	1015.030737	3.627788585	1160.588517	41.02781322	203.4877938	12.04682301	3.373251586	193.7937003	339.7184274	5.574489274	19.18697965	0	0.294432322	595.9912671	3984.938006	6331.216783	171.8897061	781.4375371	42.08246086	18.38111252	7.771674227	10.62737934	0	0	0	0	0	0	324	0											1a:  Acute - $250/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - MC Cost Shares for 1-190	2:  Skilled Nursing Services - $0/$100/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $150/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $25/visit/7b:  Chiropractic Services - $25/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $25/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%/13a:  3-Pints Deductible Waived - $0/service							14a:  Written health education materials - $0/service/14c:  Routine Exams - $0/visit/												249.5397191	0.0667	100	0	150	0.2	0.2	50	110.1315579	0	0.2	0	0.2	25	25	25	25	25	0	20.88580271	0.2	189.2091448	0	0	0	0	0	0	0	0											225.6564132	0.060316181	90.42905634	0	135.6435845	0.180858113	0.180858113	45.21452817	99.59092854	0	0.180858113	0	0.180858113	22.60726409	22.60726409	22.60726409	22.60726409	22.60726409	0	18.8868343	0.180858113	171.1000441	0	0	0	0	0	0	0	0											19.0873	0.218814351	8.745910366	0	2.300151146	2.178765674	0.610079916	0.730190894	2.819406135	0	3.470120927	0	0.053250474	1.122810997	7.507378823	11.92762415	0.323829665	1.472180397	0	0.028930086	1.405570333	0.151528756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1539	0	6.79	19.0873	0.218814351	8.745910366	0	2.300151146	2.178765674	0.610079916	0.730190894	2.819406135	0	3.470120927	0	0.053250474	1.122810997	7.507378823	11.92762415	0.323829665	1.472180397	0	0.028930086	1.405570333	0.151528756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1539	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	19.0873	0.218814351	8.745910366	0	2.300151146	2.178765674	0.610079916	0.730190894	2.819406135	0	3.470120927	0	0.053250474	1.122810997	7.507378823	11.92762415	0.323829665	1.472180397	0	0.028930086	1.405570333	0.151528756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1539
H6421_009_0	2009	3																					5000											D	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	V											0	0	0	0	0	0	0	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	1015.030737	3.627788585	1160.588517	41.02781322	203.4877938	12.04682301	3.373251586	193.7937003	339.7184274	5.574489274	19.18697965	0	0.294432322	595.9912671	3984.938006	6331.216783	171.8897061	781.4375371	42.08246086	18.38111252	7.771674227	10.62737934	0	0	0	0	0	0	324	0											1a:  Acute - $250/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - MC Cost Shares for 1-190	2:  Skilled Nursing Services - $0/$100/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $150/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $25/visit/7b:  Chiropractic Services - $25/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $25/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%/13a:  3-Pints Deductible Waived - $0/service							14a:  Written health education materials - $0/service/14c:  Routine Exams - $0/visit/												249.5397191	0.0667	100	0	150	0.2	0.2	50	110.1315579	0	0.2	0	0.2	25	25	25	25	25	0	20.88580271	0.2	189.2091448	0	0	0	0	0	0	0	0											225.6564132	0.060316181	90.42905634	0	135.6435845	0.180858113	0.180858113	45.21452817	99.59092854	0	0.180858113	0	0.180858113	22.60726409	22.60726409	22.60726409	22.60726409	22.60726409	0	18.8868343	0.180858113	171.1000441	0	0	0	0	0	0	0	0											19.0873	0.218814351	8.745910366	0	2.300151146	2.178765674	0.610079916	0.730190894	2.819406135	0	3.470120927	0	0.053250474	1.122810997	7.507378823	11.92762415	0.323829665	1.472180397	0	0.028930086	1.405570333	0.151528756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1539	0	6.79	19.0873	0.218814351	8.745910366	0	2.300151146	2.178765674	0.610079916	0.730190894	2.819406135	0	3.470120927	0	0.053250474	1.122810997	7.507378823	11.92762415	0.323829665	1.472180397	0	0.028930086	1.405570333	0.151528756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1539	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	19.0873	0.218814351	8.745910366	0	2.300151146	2.178765674	0.610079916	0.730190894	2.819406135	0	3.470120927	0	0.053250474	1.122810997	7.507378823	11.92762415	0.323829665	1.472180397	0	0.028930086	1.405570333	0.151528756	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.1539
H6421_010_0	2009	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	V											0	0	0	0	0	0	0	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	330.5652345	3.595720252	54.86471214	34.17956372	6.407467584	12.60658641	3.55762728	9.025293587	56.44834796	7.073968217	21.25470076	0	0.269416521	26.23104996	47.97834223	136.7282256	1.374776551	6.564900639	39.32642363	40.17347059	7.639180289	0.812254583	0	1690.752593	0	0	0	0	324	1000											Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing		"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Emergency Svcs - $0/visit/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $0/visit		18a:  Routine Hearing Test - $0/visit/18a:  Fitting for Hearing Aid - $0/visit	18b:  Hearing Aids - $0/service	14a:  Written health education materials - $0/service/14a:  Smoking Cessation - $0/service/14c:  Routine Exams - $0/visit/												0.065014909	0.065014909	0.159891571	0	0.231	0.231	0.231	0.228200975	0.231	0.231	0.231	0	0.231	0.231	0.173644708	0.183090795	0.231	0.231	0.211657568	0.226727549	0.231	0.231	0	0	0	0	0	0	0	0											0.065014909	0.065014909	0.159891571	0	0.231	0.231	0.231	0.228200975	0.231	0.231	0.231	0	0.231	0.231	0.173644708	0.183090795	0.231	0.231	0.211657568	0.226727549	0.231	0.231	0	0	0	0	0	0	0	0											21.4917	0.233775424	8.772405023	0	1.480125012	2.91212146	0.821811902	2.059580795	13.03956838	1.634086658	4.909835875	0	0.062235216	6.059372541	8.331185237	25.03367948	0.317573383	1.516492048	8.32373517	9.10843251	1.764650647	0.187630809	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.06	135	0	21.4917	0.233775424	8.772405023	0	1.480125012	2.91212146	0.821811902	2.059580795	13.03956838	1.634086658	4.909835875	0	0.062235216	6.059372541	8.331185237	25.03367948	0.317573383	1.516492048	8.32373517	9.10843251	1.764650647	0.187630809	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.06	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	21.4917	0.233775424	8.772405023	0	1.480125012	2.91212146	0.821811902	2.059580795	13.03956838	1.634086658	4.909835875	0	0.062235216	6.059372541	8.331185237	25.03367948	0.317573383	1.516492048	8.32373517	9.10843251	1.764650647	0.187630809	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.06
H6421_011_0	2009	3																					1800											A	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	V											0	0	0	0	0	0	0	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	320.9595778	3.627788585	1160.588517	41.02781322	207.043079	12.04682301	3.373251586	193.7937003	343.1849419	5.574489274	19.18697965	0	0.294432322	600.3345233	4340.764161	6876.395294	187.516043	852.4773132	43.37983639	18.38111252	7.771674227	10.62737934	0	0	0	0	0	0	324	0											1a:  Acute - $200/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - 50.0% for 1-190	2:  Skilled Nursing Services - $0/$50/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$50/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $50/visit/9b:  Ambulatory Surgical Center Services - $50/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - $0/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $10/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $10/visit/7b:  Chiropractic Services - $10/visit/7f:  Podiatry Services - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $10/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $10/visit/7h:  Psychiatric Services - Individual - $10/visit/7h:  Psychiatric Services - Group - $10/visit	7c:  Occupational Therapy Services - $10/visit/7i:  Physical/Speech Therapy - $10/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $10/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%/13a:  3-Pints Deductible Waived - $0/service							14a:  Written health education materials - $0/service/14c:  Routine Exams - $0/visit/												206.2781957	0.5	50	0	50	0.3	0.3	50	50	0	0.141519144	0	0.2	10	10	10	10	10	0	20.88580271	0.2	189.2091448	0	0	0	0	0	0	0	0											170.2895936	0.412766829	41.27668294	0	41.27668294	0.247660098	0.247660098	41.27668294	41.27668294	0	0.116828817	0	0.165106732	8.255336588	8.255336588	8.255336588	8.255336588	8.255336588	0	17.24193312	0.165106732	156.1985176	0	0	0	0	0	0	0	0											4.5547	1.497430792	3.992103686	0	0.71217096	2.983517363	0.835419817	0.66659676	1.180461336	0	2.241592131	0	0.048612758	0.412996963	2.986205766	4.730579805	0.129000671	0.586457263	0	0.026410493	1.283155732	0.138331742	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.0057	0	6.13	4.5547	1.497430792	3.992103686	0	0.71217096	2.983517363	0.835419817	0.66659676	1.180461336	0	2.241592131	0	0.048612758	0.412996963	2.986205766	4.730579805	0.129000671	0.586457263	0	0.026410493	1.283155732	0.138331742	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.0057	1800																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.5547	1.497430792	3.992103686	0	0.71217096	2.983517363	0.835419817	0.66659676	1.180461336	0	2.241592131	0	0.048612758	0.412996963	2.986205766	4.730579805	0.129000671	0.586457263	0	0.026410493	1.283155732	0.138331742	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	29.0057
H6421_012_0	2009	3																					6000											D	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	V											0	0	0	0	0	0	0	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	950.5877121	3.509420875	937.5697713	31.64353485	223.1211705	13.03878946	3.694525201	171.7585954	433.810128	7.400649428	22.17763307	0	0.259059019	565.316087	3912.210741	6140.422861	167.6402477	770.7943234	39.79677942	18.1635191	7.442236542	10.29880656	0	0	0	0	0	0	324	0											1a:  Acute - $250/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - MC Cost Shares for 1-190	2:  Skilled Nursing Services - $0/$100/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $150/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $25/visit/7b:  Chiropractic Services - $25/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $25/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%/13a:  3-Pints Deductible Waived - $0/service							14a:  Written health education materials - $0/service/14c:  Routine Exams - $0/visit/												249.5423692	0.065624576	100	0	150	0.2	0.2	50	110.1315579	0	0.2	0	0.2	25	25	25	25	25	0	18.61663622	0.2	186.8467774	0	0	0	0	0	0	0	0											233.0955203	0.061299389	93.40919582	0	140.1137937	0.186818392	0.186818392	46.70459791	102.8730026	0	0.186818392	0	0.186818392	23.35229896	23.35229896	23.35229896	23.35229896	23.35229896	0	17.38965019	0.186818392	174.5320722	0	0	0	0	0	0	0	0											18.4648	0.215125354	7.29813653	0	2.605196139	2.435885675	0.690205256	0.668493011	3.718945868	0	4.14318974	0	0.048396989	1.100119189	7.613259567	11.94941586	0.326232099	1.499984956	0	0.026321437	1.390346661	0.149789338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3439	0	4.54	18.4648	0.215125354	7.29813653	0	2.605196139	2.435885675	0.690205256	0.668493011	3.718945868	0	4.14318974	0	0.048396989	1.100119189	7.613259567	11.94941586	0.326232099	1.499984956	0	0.026321437	1.390346661	0.149789338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3439	6000																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.4648	0.215125354	7.29813653	0	2.605196139	2.435885675	0.690205256	0.668493011	3.718945868	0	4.14318974	0	0.048396989	1.100119189	7.613259567	11.94941586	0.326232099	1.499984956	0	0.026321437	1.390346661	0.149789338	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3439
H6499_005_0	2009	6																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.9273	1.9189	0.3848	1.3747	1.128	0	0.9589	0.0741	0.0043	0.6691	1.7937	4.61	0.8203	0.5726	1.7815	0.1582	0	0	0	0	0	0	0	0	0	0											17.1762		517.7587333	53.50883863	2132.555776	2489.078326	21.12862115	43.72223338	8.767865897	31.32162732	25.7019267	15482.31611	21.84888813	1.687534918	0.097712839	15.2449015	45.91667791	115.6740751	18.68969819	13.04656513	40.59103888	7.317459579	28.97958884	0.000650361	0	684	2.76	158.976	116.4	31.04	0.07	6.8											Medicare FFS cost sharing	Medicare FFS cost sharing	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $0.00	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											706.7927472	752.8717406	67.38836966	3.273056465	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.178004496	0.180655289	0.5	0.2	0.2	0.034541287	0.2	0.2	0	0	0.2	10	0	0	0	0											706.7927472	752.8717406	67.38836966	3.273056465	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.178004496	0.180655289	0.5	0.2	0.2	0.034541287	0.2	0.2	0	0	0.2	10	0	0	0	0											30.4957	3.357107707	11.97578808	0.678907826	4.225724231	8.744446676	1.753573179	6.264325464	5.14038534	0	4.369777626	0.337506984	0.019542568	3.0489803	8.173375099	20.89713352	9.344849094	2.609313025	8.118207776	0.252754468	5.795917767	0.000130072	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.2879	135	0	30.4957	3.357107707	11.97578808	0.678907826	5.153028342	10.6633512	2.13838192	7.638985627	6.268405107	0	5.328693196	0.41157041	0.023831041	3.718056609	9.967035547	25.50712647	10.16511246	3.181907583	9.899688782	0.410934582	5.795917767	0.000158616	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	153.4641		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			30.4957	3.357107707	11.97578808	0.678907826	5.153028342	10.6633512	2.13838192	7.638985627	6.268405107	0	5.328693196	0.41157041	0.023831041	3.718056609	9.967035547	25.50712647	10.16511246	3.181907583	9.899688782	0.410934582	5.795917767	0.000158616	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	153.4641
H6499_014_0	2009	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		1902.205539	258.8032899	1581.45254	2640.023169	612.7953194	20.05322544	6.70407828	2217.831946	284.9287311	11663.68065	19.41075893	49.44086727	0.25752194	1161.059561	9128.123796	20503.19499	1018.398826	3076.002614	38.19401468	923.076011	30.69462771	0.000397482	0	275	1.785	285.6	116.4	31.04	1848	4558.153846											"$175 days 1 - 6, $0 days 7 - 90"	"$175 days 1 - 6, $0 days 7 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $50.00 and $100.00	$20.00 copayment	20% coinsurance	$175.00 copayment	20% coinsurance	"Copay between $20.00 and $100.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$20.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											111.9574782	57.45565374	66.7	12.13717495	56.2448232	0.2	0.2	25.04794637	68.62209686	5.72909759	0.2	79.82957573	0.2	38.22101826	7.632613268	16.1628398	23.31165282	11.78156291	0.176777646	0.319287088	0.2	0.2	0	20	0.2	10	0	0	0	0											95.61017951	49.06635497	56.96090226	10.36498405	48.03232199	0.170797308	0.170797308	21.39060907	58.60234711	4.892572231	0.170797308	68.17338321	0.170797308	32.64023516	6.518149	13.80284765	19.90783775	10.06129615	0.15096573	0.272666876	0.170797308	0.170797308	0	20	0.2	10	0	0	0	0											15.1559	1.058211174	7.506746961	2.280316503	2.452831841	3.425036924	1.145038524	3.953398011	1.3914577	4.755450006	3.315305374	0.280879266	0.043984054	3.158104759	4.958205916	23.58353973	1.689509883	2.579047772	5.765987307	0.020974354	5.242559786	6.79E-05	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.8158	0	16.0314	15.1559	1.058211174	7.506746961	2.280316503	2.452831841	3.425036924	1.145038524	3.953398011	1.3914577	4.755450006	3.315305374	0.280879266	0.043984054	3.158104759	4.958205916	23.58353973	1.689509883	2.579047772	5.765987307	0.020974354	5.242559786	6.79E-05	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.8158		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			15.1559	1.058211174	7.506746961	2.280316503	2.452831841	3.425036924	1.145038524	3.953398011	1.3914577	4.755450006	3.315305374	0.280879266	0.043984054	3.158104759	4.958205916	23.58353973	1.689509883	2.579047772	5.765987307	0.020974354	5.242559786	6.79E-05	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.8158
H6499_015_0	2009	8																					3750											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	V	V	V	V	V											0	0	0	0	0.5467	0.7438	0.2882	0.7904	0.9997	0	0.7799	0.0315	0.0313	0.5312	1.9361	7.479	0.7348	1.0542	3.2713	0.234	0	0.0004	0	0	0	0	0	0	0	0											19.4524		2742.723406	307.7459026	1722.607213	4090.450976	792.3740025	16.74017747	6.486493993	1866.306781	224.6250502	5804.597174	17.55187304	43.32544347	0.703417705	782.8306786	10246.6601	37456.73603	1917.689454	7614.51304	73.62571076	614.9897338	37.10849321	0.008069028	0	275	1.785	285.6	116.4	31.04	168	10472											"$250 days 1 - 5, $0 days 6 - 90"	"$250 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	20% coinsurance	$250.00 copayment	20% coinsurance	"Copay between $20.00 and $150.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$20.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											116.4265952	61.18531996	66.7	15.13983642	60.37614176	0.2	0.2	25.64752874	106.6650494	6.450429911	0.2	124.5837023	0.2	54.50647799	9.747124344	12.89306703	21.89603369	14.39157472	0.182901125	0.117789227	0.2	0.2	0	20	0.2	10	0	0	0	0											90.93984725	47.79134562	52.09881643	11.82560057	47.15930325	0.15621834	0.15621834	20.03307184	83.31518483	5.038377269	0.15621834	97.31129593	0.15621834	42.57455758	7.61339793	10.07066765	17.10281019	11.24113958	0.142862551	0.092004187	0.15621834	0.15621834	0	20	0.2	10	0	0	0	0											20.7852	1.225632566	7.478816414	4.031003283	3.113983822	2.615122738	1.013309325	3.115654819	1.559556465	2.437145871	2.741924472	0.351337921	0.109886746	2.77738915	6.500991735	31.43452831	2.733156561	7.132983657	10.51835684	0.004715136	5.797027213	0.00126053	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.5324	135	32.9246	20.7852	1.225632566	7.478816414	4.031003283	3.660650732	3.358924624	1.301518125	3.906013556	2.559252843	2.437145871	3.521791728	0.382814738	0.141141099	3.308591985	8.437116629	38.91352065	3.46796462	8.187213108	13.78970463	0.23872142	5.797027213	0.001619054	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.9848		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			20.7852	1.225632566	7.478816414	4.031003283	3.660650732	3.358924624	1.301518125	3.906013556	2.559252843	2.437145871	3.521791728	0.382814738	0.141141099	3.308591985	8.437116629	38.91352065	3.46796462	8.187213108	13.78970463	0.23872142	5.797027213	0.001619054	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.9848
H6499_017_0	2009	6																					3750											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		1787.577859	225.6862145	1451.806338	2388.724349	570.9453722	18.98128177	6.335888993	2109.548798	281.8680152	11369.29939	19.19629332	49.23916096	0.222336564	1116.997514	8913.354652	19450.12774	883.8608185	2990.479188	36.36614826	903.0712962	30.42142574	0.000280201	0	275	1.785	285.6	116.4	31.04	168	4080											"$250 days 1 - 5, $0 days 6 - 90"	"$250 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	20% coinsurance	$250.00 copayment	20% coinsurance	"Copay between $20.00 and $150.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$20.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											148.7197739	71.98307477	66.7	11.93781428	56.40025641	0.2	0.2	24.9979502	102.9375924	5.80733809	0.2	111.8197361	0.2	48.20305764	9.752009815	16.41254024	23.47878188	11.793356	0.176706734	0.31862766	0.2	0.2	0	20	0.2	10	0	0	0	0											125.8877042	60.93193785	56.45994239	10.10507206	47.74145769	0.16929518	0.16929518	21.16016234	87.13419093	4.915771725	0.16929518	94.65271149	0.16929518	40.8027265	8.254841265	13.89281974	19.87422297	9.982791611	0.149577991	0.269710634	0.16929518	0.16929518	0	20	0.2	10	0	0	0	0											18.7528	1.1459582	6.830741849	2.011519307	2.271480361	3.213439507	1.072635465	3.719866252	2.046695121	4.657406706	3.249839924	0.388385008	0.037640508	3.79804534	6.131527316	22.51809322	1.463837249	2.487777546	5.439575396	0.020297328	5.150200734	4.74E-05	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.4612	0	17.4854	18.7528	1.1459582	6.830741849	2.011519307	2.271480361	3.213439507	1.072635465	3.719866252	2.046695121	4.657406706	3.249839924	0.388385008	0.037640508	3.79804534	6.131527316	22.51809322	1.463837249	2.487777546	5.439575396	0.020297328	5.150200734	4.74E-05	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.4612		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			18.7528	1.1459582	6.830741849	2.011519307	2.271480361	3.213439507	1.072635465	3.719866252	2.046695121	4.657406706	3.249839924	0.388385008	0.037640508	3.79804534	6.131527316	22.51809322	1.463837249	2.487777546	5.439575396	0.020297328	5.150200734	4.74E-05	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	97.4612
H6499_021_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		1848.809397	252.2137951	1503.887786	2655.912146	593.0430907	19.59222825	6.48399336	2213.901771	285.7999026	11240.85705	18.80602524	49.63342998	0.245874151	1138.060592	9419.913412	21225.54183	1030.683752	3282.782803	38.41847996	905.7736296	31.02914908	0.000369332	0	474.9090909	2.76	158.976	116.4	31.04	1848	4080											"$125 days 1 - 6, $0 days 7 - 90"	"$125 days 1 - 6, $0 days 7 - 90"	"$0 days 1 - 20, $128 days 21 - 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	$10.00 copayment	20% coinsurance	$125.00 copayment	20% coinsurance	"Copay between $10.00 and $75.00, 20% coinsurance"	"Copay between $0.00 and $10.00, 20% coinsurance"	"Copay between $0.00 and $15.00, 20% coinsurance"	Copay between $10.00 and $20.00	$15.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $15.00	20% coinsurance	20% coinsurance		$15.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											80.42090408	40.92207554	66.7	5.029766255	56.45339293	0.2	0.2	20.8360329	52.90017258	2.856924913	0.2	56.23265632	0.2	30.75181002	5.077585571	7.532745239	13.29630589	5.140226139	0.176958143	0.138446319	0.2	0.2	0	15	0.2	10	0	0	0	0											72.54950923	36.91672621	60.17157256	4.537465445	50.9278775	0.180424505	0.180424505	18.79665465	47.72243738	2.577296322	0.180424505	50.72874603	0.180424505	27.74190057	4.580604328	6.795459172	11.99489707	4.637113795	0.159637927	0.124895544	0.180424505	0.180424505	0	15	0.2	10	0	0	0	0											11.1775	0.775908968	7.540941087	1.004259132	2.516868823	3.534918092	1.169871295	3.46782892	1.136588996	2.414251629	3.393067804	0.209820139	0.044361722	2.630996983	3.595741345	12.01977524	1.03024546	1.268553118	6.133046504	0.009427257	5.598418876	6.66E-05	0	0.593636364	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9506	0	7.6677	11.1775	0.775908968	7.540941087	1.004259132	2.516868823	3.534918092	1.169871295	3.46782892	1.136588996	2.414251629	3.393067804	0.209820139	0.044361722	2.630996983	3.595741345	12.01977524	1.03024546	1.268553118	6.133046504	0.009427257	5.598418876	6.66E-05	0	0.593636364	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9506		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			11.1775	0.775908968	7.540941087	1.004259132	2.516868823	3.534918092	1.169871295	3.46782892	1.136588996	2.414251629	3.393067804	0.209820139	0.044361722	2.630996983	3.595741345	12.01977524	1.03024546	1.268553118	6.133046504	0.009427257	5.598418876	6.66E-05	0	0.593636364	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.9506
H6499_022_0	2009	5																					4000											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		2605.429747	302.6378076	2087.607241	3383.238394	918.03493	19.98142282	6.524099848	3152.45996	221.7185405	10318.2068	22.6637696	46.7234561	0.012196431	1130.454434	8871.356794	24186.42339	1504.63756	5184.076334	46.82673288	848.6349469	27.65474713	0.001051197	0	275	0.75	0	58.2	31.04	168	4080											"$200 days 1 - 6, $0 days 7 - 90"	"$200 days 1 - 6, $0 days 7 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	20% coinsurance	$200.00 copayment	20% coinsurance	"Copay between $20.00 and $150.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$20.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											115.1682099	63.1319623	66.7	10.52339707	55.00777308	0.2	0.2	27.50817953	109.6564049	5.006505108	0.2	83.82598668	0.2	42.66461867	10.5165721	14.6462607	25.09731363	10.15142454	0.181523609	0.505090817	0.2	0.2	0	20	0.2	0	0	0	0	0											95.37623056	52.28255783	55.23741826	8.714921821	45.55453327	0.16562944	0.16562944	22.78082186	90.81164472	4.146123189	0.16562944	69.42025619	0.16562944	35.33258451	8.709269743	12.1292598	20.78427002	8.40687381	0.150328269	0.418289546	0.16562944	0.16562944	0	20	0.2	0	0	0	0	0											20.708	1.318556557	9.609502861	2.457054842	3.485054397	3.309511873	1.080583005	5.984635733	1.677885444	3.565046372	3.753787468	0.270296191	0.002020088	3.328489736	6.438586609	24.44695107	2.60606611	3.631822963	7.039381683	0.029581261	4.580440283	0.000174109	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.9318	0	22.6862	20.708	1.318556557	9.609502861	2.457054842	3.485054397	3.309511873	1.080583005	5.984635733	1.677885444	3.565046372	3.753787468	0.270296191	0.002020088	3.328489736	6.438586609	24.44695107	2.60606611	3.631822963	7.039381683	0.029581261	4.580440283	0.000174109	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.9318		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			20.708	1.318556557	9.609502861	2.457054842	3.485054397	3.309511873	1.080583005	5.984635733	1.677885444	3.565046372	3.753787468	0.270296191	0.002020088	3.328489736	6.438586609	24.44695107	2.60606611	3.631822963	7.039381683	0.029581261	4.580440283	0.000174109	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.9318
H6499_023_0	2009	7																					4000											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	V	V	V	V	V											0	0	0	0	0.5669	0.8127	0.291	0.8712	0.983	0	0.8044	0.0325	0.0333	0.5754	1.9842	7.163	0.7587	1.0384	3.1067	0.2208	0	0.0003	0	0	0	0	0	0	0	0											19.2426		2884.759361	392.972068	1751.648555	4254.177566	841.1610177	18.655633	6.680173803	2085.513928	245.007421	7132.986269	18.46594509	42.07045072	0.763807733	956.2721154	10526.50333	36001.75945	2044.824337	7767.812542	71.31424009	673.2210208	36.64546978	0.007476775	0	275	0.75	0	58.2	31.04	1848	0											"$200 days 1 - 6, $0 days 7 - 90"	"$200 days 1 - 6, $0 days 7 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	20% coinsurance	$200.00 copayment	20% coinsurance	"Copay between $20.00 and $150.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$20.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											101.008385	56.76039515	66.7	12.75013174	56.4810843	0.2	0.2	25.95076083	98.88972037	5.180161703	0.2	87.79268286	0.2	48.40769185	9.93466904	12.80896392	21.27136959	12.15358754	0.182959496	0.16221012	0.2	0.2	0	20	0.2	0	0	0	0	0											81.25709131	45.66140337	53.65740666	10.25695658	45.43670928	0.160891774	0.160891774	20.87631975	79.55271275	4.167227032	0.160891774	70.62560248	0.160891774	38.94199711	7.992032634	10.30428465	17.11194195	9.777061304	0.147183389	0.13049137	0.160891774	0.160891774	0	20	0.2	0	0	0	0	0											19.5339	1.495304676	7.832409901	3.636242881	3.184965718	3.001537891	1.074785014	3.628154633	1.624250415	2.477064433	2.971018665	0.247604244	0.122890381	3.103262163	7.010679842	30.91436477	2.915909612	6.328864952	10.49627156	0.007320794	5.895954644	0.001202952	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.1123	135	28.5619	19.5339	1.495304676	7.832409901	3.636242881	3.751888158	3.814241567	1.365796411	4.499388312	2.607289727	2.477064433	3.775458883	0.280145387	0.156164479	3.678651666	8.99483239	38.07734833	3.674649791	7.367228866	13.60296567	0.228117338	5.895954644	0.001528666	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.3549		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			19.5339	1.495304676	7.832409901	3.636242881	3.751888158	3.814241567	1.365796411	4.499388312	2.607289727	2.477064433	3.775458883	0.280145387	0.156164479	3.678651666	8.99483239	38.07734833	3.674649791	7.367228866	13.60296567	0.228117338	5.895954644	0.001528666	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.3549
H6499_028_0	2009	6																					None											A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.2197	0.5157	0.1609	0.6116	0.4525	0	0.469	0.0235	0.0209	0.2756	1.1632	3.6123	0.968	0.3999	1.389	0.0816	0	0	0	0	0	0	0	0	0	0											10.3636		404.1360227	78.81877908	2187.039398	2587.285484	9.633706078	22.6142165	7.056972882	26.81932082	19.84027886	7136.15409	20.5631425	1.03146333	0.915182827	12.08655894	54.54421973	178.7120863	42.44544519	17.53668203	60.90368423	7.008282711	38.64572014	0	0	684	2.76	158.976	116.4	31.04	0.07	6.8											Medicare FFS cost sharing	Medicare FFS cost sharing	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $0.00	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											716.8	716.8	66.7	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.186965452	0.17664794	0.5	0.2	0.2	0.000380232	0.2	0	0	0	0.2	10	0	0	0	0											716.8	716.8	66.7	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.186965452	0.17664794	0.5	0.2	0.2	0.000380232	0.2	0	0	0	0.2	10	0	0	0	0											24.1404	4.708108404	12.15629399	0	1.926741216	4.5228433	1.411394576	5.363864165	3.968055772	0	4.112628499	0.206292666	0.183036565	2.417311789	10.19788469	31.56912186	21.2227226	3.507336407	12.18073685	0.002664773	7.729144028	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	152.2111	135	0	24.1404	4.708108404	12.15629399	0	2.146446205	5.038580042	1.572334939	5.975501943	4.42053047	0	4.581588727	0.229816078	0.2039081	2.692956206	11.36112226	35.18147147	22.19072764	3.90727559	13.56969798	0.084310823	7.729144028	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	162.5747		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			24.1404	4.708108404	12.15629399	0	2.146446205	5.038580042	1.572334939	5.975501943	4.42053047	0	4.581588727	0.229816078	0.2039081	2.692956206	11.36112226	35.18147147	22.19072764	3.90727559	13.56969798	0.084310823	7.729144028	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	162.5747
H6499_030_0	2009	8																					3750											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	V	V	V	V	V											0	0	0	0	0.7572	0.9929	0.3425	1.2811	1.0346	0	1.1934	0.0514	0.0007	0.7044	1.8542	6.1657	0.618	0.8079	2.4584	0.2126	0	0	0	0	0	0	0	0	0	0											18.4751		2396.584441	242.3936096	1981.877298	3045.288719	845.1295319	18.410374	6.350423355	2838.480442	216.9574296	10046.2538	22.12692283	49.93614297	0.01276249	1109.556433	8467.261648	23578.88208	1375.042909	4865.591804	45.58268325	829.1764	27.15982936	0.000907417	0	275	0.75	0	58.2	31.04	168	10472											"$250 days 1 - 5, $0 days 6 - 90"	"$250 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	20% coinsurance	$250.00 copayment	20% coinsurance	"Copay between $20.00 and $150.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$20.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											133.0392624	73.55640496	66.7	10.75967449	55.11438811	0.2	0.2	27.42147658	110.1515756	5.060923152	0.2	99.84818709	0.2	42.39791434	10.46489742	14.63986663	24.24444228	10.14847295	0.181689834	0.521163177	0.2	0.2	0	20	0.2	0	0	0	0	0											108.9497166	60.23747673	54.62256754	8.811409991	45.13477342	0.16378581	0.16378581	22.45624372	90.20632501	4.144536982	0.16378581	81.76858086	0.16378581	34.72088365	8.570008491	11.98901205	19.85447805	8.310879297	0.148791083	0.426795665	0.16378581	0.16378581	0	20	0.2	0	0	0	0	0											21.7589	1.216764951	9.021268882	2.236107287	3.178727494	3.015358012	1.040109231	5.311800717	1.630911034	3.469755867	3.624075972	0.340267295	0.002090315	3.210398319	6.047042018	23.55729179	2.275063272	3.369778849	6.78229681	0.029490741	4.448394643	0.000148622	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.1744	135	23.3414	21.7589	1.216764951	9.021268882	2.236107287	3.93594272	4.008291015	1.382608788	6.592896455	2.665492805	3.469755867	4.817454875	0.391686632	0.002778639	3.914752078	7.901260507	29.72295019	2.893103571	4.177727506	9.240723269	0.242100775	4.448394643	0.000197562	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.6495		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			21.7589	1.216764951	9.021268882	2.236107287	3.93594272	4.008291015	1.382608788	6.592896455	2.665492805	3.469755867	4.817454875	0.391686632	0.002778639	3.914752078	7.901260507	29.72295019	2.893103571	4.177727506	9.240723269	0.242100775	4.448394643	0.000197562	0	0.458333333	0.15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.6495
H6499_032_0	2009	7																					3750											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	V	V	V	V	V											0	0	0	0	0.2019	0.537	0.2709	0.4982	0.886	0	0.7199	0.0256	0.0063	0.459	1.6817	6.4099	0.5074	0.8782	2.9354	0.192	0	0	0	0	0	0	0	0	0	0											16.2094		2308.982278	296.4298918	1667.144624	2168.086252	371.6458958	15.50761774	7.821376126	1302.468741	225.6713093	5670.963224	20.78922646	58.4616001	0.182408492	785.1923195	11333.99955	41038.55157	1880.624085	7242.943521	84.7629166	781.7145621	65.51499864	0	0	275	1.785	285.6	116.4	31.04	168	10472											"$250 days 1 - 5, $0 days 6 - 90"	"$250 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $75.00 and $150.00	$20.00 copayment	20% coinsurance	$250.00 copayment	20% coinsurance	"Copay between $20.00 and $150.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$20.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											135.2857819	72.71703585	66.7	14.08055451	54.74073131	0.2	0.2	20.08372874	109.7641352	4.494382482	0.2	142.9987363	0.2	50.44004845	10.28234365	12.64190223	23.20440624	11.58467887	0.183809812	0.026964981	0.2	0	0	20	0.2	10	0	0	0	0											105.1042266	56.49424283	51.81957643	10.93925593	42.52835847	0.155381039	0.155381039	15.60315317	85.27632671	3.491709093	0.155381039	111.0964609	0.155381039	39.18713562	7.988406186	9.821559505	18.02762373	9.00019718	0.142802797	0.020949234	0.155381039	0	0	20	0.2	10	0	0	0	0											20.2236	1.395548524	7.199227355	1.976437533	1.317124157	2.409589754	1.215293547	1.693551605	1.603701692	1.650112822	3.230251603	0.541239739	0.028342821	2.564119826	7.545049342	33.58854802	2.825265282	5.432326655	12.10438161	0.001364693	10.17978854	0	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.7782	135	34.0928	20.2236	1.395548524	7.199227355	1.976437533	1.519009173	2.946624529	1.486150815	2.191701637	2.489704201	1.650112822	3.950190522	0.566852812	0.034659697	3.02312072	9.226753627	39.99847492	3.332669704	6.310561612	15.03975406	0.193317158	10.17978854	0	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.9876		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			20.2236	1.395548524	7.199227355	1.976437533	1.519009173	2.946624529	1.486150815	2.191701637	2.489704201	1.650112822	3.950190522	0.566852812	0.034659697	3.02312072	9.226753627	39.99847492	3.332669704	6.310561612	15.03975406	0.193317158	10.17978854	0	0	0.458333333	0.357	0.238	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.9876
H6499_033_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		2073.033522	254.0576591	1738.187116	2985.441377	645.5127072	21.76936962	7.434397427	2367.965166	296.2992602	12692.80675	21.03267769	52.23253014	0.327338942	1252.566637	9913.416475	22770.02594	1099.151676	3485.08459	40.01752882	980.5989286	31.92166381	0.000418257	0	964.3636364	2.76	158.976	116.4	31.04	1848	4080											"$100 days 1 - 5, $0 days 6 - 90"	"$100 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 20, $128 days 21 - 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	$10.00 copayment	20% coinsurance	$100.00 copayment	20% coinsurance	"Copay between $10.00 and $75.00, 20% coinsurance"	"Copay between $0.00 and $10.00, 20% coinsurance"	"Copay between $0.00 and $10.00, 20% coinsurance"	Copay between $10.00 and $20.00	$10.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $10.00	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											58.10523705	29.40450686	66.7	3.543047731	56.05443406	0.2	0.2	20.82540178	53.86867853	2.889927584	0.2	47.03543753	0.2	31.03652947	2.878655599	5.495892653	13.26915551	3.352560873	0.176590684	0.093216565	0.2	0.2	0	0	0.2	10	0	0	0	0											52.85920644	26.74972132	60.67799132	3.22316371	50.99356017	0.181943002	0.181943002	18.94518063	49.00514556	2.629010508	0.181943002	42.78884363	0.181943002	28.23439679	2.618756214	4.999696053	12.07114997	3.049874956	0.160647196	0.084800509	0.181943002	0.181943002	0	0	0.2	10	0	0	0	0											9.1316	0.566330965	8.789141894	0.801880525	2.74308259	3.96078447	1.352636589	3.73846065	1.210015698	2.780793526	3.826748529	0.186247464	0.05955703	2.947121953	2.163401749	9.486934068	1.105668726	0.885756018	6.428703804	0.006929607	5.807923358	7.61E-05	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.6643	0	6.7467	9.1316	0.566330965	8.789141894	0.801880525	2.74308259	3.96078447	1.352636589	3.73846065	1.210015698	2.780793526	3.826748529	0.186247464	0.05955703	2.947121953	2.163401749	9.486934068	1.105668726	0.885756018	6.428703804	0.006929607	5.807923358	7.61E-05	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.6643		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			9.1316	0.566330965	8.789141894	0.801880525	2.74308259	3.96078447	1.352636589	3.73846065	1.210015698	2.780793526	3.826748529	0.186247464	0.05955703	2.947121953	2.163401749	9.486934068	1.105668726	0.885756018	6.428703804	0.006929607	5.807923358	7.61E-05	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.6643
H6499_034_0	2009	7																					3500											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		2606.122383	252.0507767	2158.4801	3430.037603	892.7102457	18.6205052	6.597823702	2893.441982	218.4287432	9635.722536	22.14948897	45.42334245	0.014799078	1051.888271	9116.720454	25892.91396	1515.615955	5367.890261	49.20223448	799.461085	28.51525134	0.001002446	0	964.3636364	2.76	158.976	116.4	31.04	1848	4080											"$100 days 1 - 5, $0 days 6 - 90"	"$100 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 20, $128 days 21 - 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 $90.00	$20.00 copayment	20% coinsurance	$100.00 copayment	20% coinsurance	"Copay between $20.00 and $90.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $25.00, 20% coinsurance"	Copay between $15.00 and $25.00	$25.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $25.00	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											51.96164672	28.71710839	66.7	8.69358378	57.55445291	0.2	0.2	22.04326145	67.60227595	5.831385437	0.2	45.79426508	0.2	33.92061324	5.685972608	10.67798828	17.6373942	8.243348901	0.181975911	0.410685703	0.2	0.2	0	0	0.2	10	0	0	0	0											44.36877067	24.52083175	56.95348764	7.423237127	49.14433017	0.170775075	0.170775075	18.82219818	57.72391885	4.979276437	0.170775075	39.10259535	0.170775075	28.96397642	4.855112004	9.117671267	15.06013662	7.038792649	0.155384749	0.350674409	0.170775075	0.170775075	0	0	0.2	10	0	0	0	0											9.6359	0.515041224	10.24441414	2.121831873	3.655970588	3.179918179	1.12674384	4.538411534	1.050713587	3.998243848	3.782580649	0.148014215	0.002527314	2.538905589	3.688558242	19.6735898	1.902115279	3.14862221	7.645276868	0.023362545	4.869694197	0.000171193	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.1751	0	14.9724	9.6359	0.515041224	10.24441414	2.121831873	3.655970588	3.179918179	1.12674384	4.538411534	1.050713587	3.998243848	3.782580649	0.148014215	0.002527314	2.538905589	3.688558242	19.6735898	1.902115279	3.14862221	7.645276868	0.023362545	4.869694197	0.000171193	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.1751		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			9.6359	0.515041224	10.24441414	2.121831873	3.655970588	3.179918179	1.12674384	4.538411534	1.050713587	3.998243848	3.782580649	0.148014215	0.002527314	2.538905589	3.688558242	19.6735898	1.902115279	3.14862221	7.645276868	0.023362545	4.869694197	0.000171193	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.1751
H6499_035_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	Coin	T	V	Coin	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		2884.116145	319.6748402	1844.351677	4441.062665	820.1123931	17.6463068	6.875013601	1926.985674	228.782327	5814.820587	18.04628907	45.14932955	0.734737025	777.2441147	10763.78755	39285.60987	2019.450463	8097.234915	76.77423289	624.2741253	38.3774216	0.008505177	0	964.3636364	2.76	158.976	116.4	31.04	1848	4080											"$125 days 1 - 5, $0 days 6 - 90"	"$125 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 20, $128 days 21 - 100"	Copay between $0.00 and $35.00	$100.00 copayment	20% coinsurance	20% coinsurance	Copay between $35.00 and $50.00	Copay between $55.00 and $105.00	$20.00 copayment	20% coinsurance	$125.00 copayment	20% coinsurance	"Copay between $20.00 and $105.00, 20% coinsurance"	"Copay between $0.00 and $20.00, 20% coinsurance"	"Copay between $0.00 and $35.00, 20% coinsurance"	Copay between $25.00 and $35.00	$35.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $35.00	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											58.36229445	30.67717707	66.7	12.39494632	54.84206291	0.2	0.2	25.10752756	73.59317495	4.529307033	0.2	53.87576397	0.2	39.90733529	7.307333475	12.16511772	20.05039305	11.53160909	0.182894833	0.095536775	0.2	0.2	0	0	0.2	10	0	0	0	0											46.50773103	24.44602142	53.15187981	9.877281815	43.70252978	0.159375951	0.159375951	20.00768047	58.64491139	3.609313089	0.159375951	42.93250571	0.159375951	31.80134766	5.823066126	9.694136054	15.97775234	9.189305856	0.14574519	0.076131322	0.159375951	0.159375951	0	0	0.2	10	0	0	0	0											11.1778	0.651231499	8.169229889	3.655468958	2.986748857	2.812396935	1.095711834	3.212876136	1.118076608	1.748959005	2.876144491	0.161531154	0.117099412	2.059784192	5.22318722	31.73667059	2.688856615	6.200664019	11.18947519	0.003960568	6.116438082	0.001355521	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.6882	0	26.7649	11.1778	0.651231499	8.169229889	3.655468958	2.986748857	2.812396935	1.095711834	3.212876136	1.118076608	1.748959005	2.876144491	0.161531154	0.117099412	2.059784192	5.22318722	31.73667059	2.688856615	6.200664019	11.18947519	0.003960568	6.116438082	0.001355521	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.6882		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			11.1778	0.651231499	8.169229889	3.655468958	2.986748857	2.812396935	1.095711834	3.212876136	1.118076608	1.748959005	2.876144491	0.161531154	0.117099412	2.059784192	5.22318722	31.73667059	2.688856615	6.200664019	11.18947519	0.003960568	6.116438082	0.001355521	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.6882
H6499_036_0	2009	5																					2500											D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	Coin	V	V	V	V	V	Coin	V	Coin	V	T	V	Coin	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		2126.801227	202.4437581	1904.959967	3017.182177	627.0608426	21.59428062	7.651994038	2264.762012	305.0148357	12875.48347	21.37570321	60.67658695	0.340341577	1386.759517	10598.96023	23200.61111	923.5650606	3512.598769	41.30599976	1009.492368	32.50596881	0.038160607	0	964.3636364	2.76	158.976	116.4	31.04	1848	3960											"$0 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 5, $0 days 6 - 90"	"$0 days 1 - 7, $0 days 8 - 100"	Copay between $0.00 and $15.00	$150.00 copayment	20% coinsurance	20% coinsurance	Copay between $25.00 and $50.00	$0.00 copayment	$0.00 copayment	20% coinsurance	$0.00 copayment	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	"Copay between $0.00 and $15.00, 20% coinsurance"	$15.00 copayment	$15.00 copayment	"$0.00 copayment, 20% coinsurance"	Copay between $0.00 and $15.00	20% coinsurance	$0.00 copayment		$0.00 copayment	20% coinsurance	$10.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											0	75.26038776	0	5.407428927	84.05464773	0.2	0.2	20.71761734	0	0	0.2	0	0.2	11.29330091	0.051035503	7.238408498	10.54535812	5.027438203	0.176677753	0.136455389	0.2	0	0	0	0.2	10	0	0	0	0											0	68.62914303	0	4.93097663	76.64853467	0.182377862	0.182377862	18.89217377	0	0	0.182377862	0	0.182377862	10.29824037	0.046538729	6.600627327	9.616199336	4.584467151	0.161110554	0.12443221	0.182377862	0	0	0	0.2	10	0	0	0	0											0	1.157795136	0	1.239804567	4.005274561	3.938318728	1.395554312	3.565523123	0	0	3.898455047	0	0.062070769	1.190098571	0.041105179	12.76154897	0.74009881	1.341949473	6.654832505	0.010467781	5.928369091	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.6157	0	4.6313	0	1.157795136	0	1.239804567	4.005274561	3.938318728	1.395554312	3.565523123	0	0	3.898455047	0	0.062070769	1.190098571	0.041105179	12.76154897	0.74009881	1.341949473	6.654832505	0.010467781	5.928369091	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.6157		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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	1.157795136	0	1.239804567	4.005274561	3.938318728	1.395554312	3.565523123	0	0	3.898455047	0	0.062070769	1.190098571	0.041105179	12.76154897	0.74009881	1.341949473	6.654832505	0.010467781	5.928369091	0	0	0	0.552	0.13248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.6157
H6499_801_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.3436	0.7469	0.3288	0.6945	0.9788	0	0.9956	0.054	0.0043	0.6676	1.3813	4.895	0.1462	0.5606	1.7388	0.3052	0	0.0003	0	0	0	0	0	0	0	0											13.8414		327.6041783	8.944189615	1201.16344	2540.773897	8.5859254	18.66371944	8.216061195	17.35388953	24.45830428	7813.312892	24.87751845	1.349482697	0.107609766	16.6831031	36.25450555	135.8676867	3.653017311	14.00755082	43.45001293	7.625248938	40.01868761	0.007142617	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											819.2	819.2	76.71	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199937572	0.197199066	0.5	0.2	0.2	0.195807763	0.2	0.2	0	0	0	0	0	0	0	0											819.2	819.2	76.71	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199937572	0.197199066	0.5	0.2	0.2	0.195807763	0.2	0.2	0	0	0	0	0	0	0	0											22.3644	0.610590011	7.678437292	0	1.71718508	3.732743888	1.643212239	3.470777907	4.891660855	0	4.975503691	0.269896539	0.021521953	3.336620619	7.248637807	26.79298088	1.826508656	2.801510164	8.690002586	1.493082937	8.003737523	0.001428523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.5705	135	0	22.3644	0.610590011	7.678437292	0	2.060786386	4.479649792	1.9720119	4.165265551	5.870461031	0	5.971080455	0.323901669	0.025828403	4.004263971	8.629913647	31.68798691	1.972699248	3.362080228	10.42883451	1.798238802	8.003737523	0.001714365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4119		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			22.3644	0.610590011	7.678437292	0	2.060786386	4.479649792	1.9720119	4.165265551	5.870461031	0	5.971080455	0.323901669	0.025828403	4.004263971	8.629913647	31.68798691	1.972699248	3.362080228	10.42883451	1.798238802	8.003737523	0.001714365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4119
H6499_802_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.3436	0.7469	0.3288	0.6945	0.9788	0	0.9956	0.054	0.0043	0.6676	1.3813	4.895	0.1462	0.5606	1.7388	0.3052	0	0.0003	0	0	0	0	0	0	0	0											13.8414		327.6041783	8.944189615	1201.16344	2540.773897	8.5859254	18.66371944	8.216061195	17.35388953	24.45830428	7813.312892	24.87751845	1.349482697	0.107609766	16.6831031	36.25450555	135.8676867	3.653017311	14.00755082	43.45001293	7.625248938	40.01868761	0.007142617	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											819.2	819.2	76.71	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199937572	0.197199066	0.5	0.2	0.2	0.195807763	0.2	0.2	0	0	0	0	0	0	0	0											819.2	819.2	76.71	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199937572	0.197199066	0.5	0.2	0.2	0.195807763	0.2	0.2	0	0	0	0	0	0	0	0											22.3644	0.610590011	7.678437292	0	1.71718508	3.732743888	1.643212239	3.470777907	4.891660855	0	4.975503691	0.269896539	0.021521953	3.336620619	7.248637807	26.79298088	1.826508656	2.801510164	8.690002586	1.493082937	8.003737523	0.001428523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.5705	135	0	22.3644	0.610590011	7.678437292	0	2.060786386	4.479649792	1.9720119	4.165265551	5.870461031	0	5.971080455	0.323901669	0.025828403	4.004263971	8.629913647	31.68798691	1.972699248	3.362080228	10.42883451	1.798238802	8.003737523	0.001714365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4119		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			22.3644	0.610590011	7.678437292	0	2.060786386	4.479649792	1.9720119	4.165265551	5.870461031	0	5.971080455	0.323901669	0.025828403	4.004263971	8.629913647	31.68798691	1.972699248	3.362080228	10.42883451	1.798238802	8.003737523	0.001714365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4119
H6499_803_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.3436	0.7469	0.3288	0.6945	0.9788	0	0.9956	0.054	0.0043	0.6676	1.3813	4.895	0.1462	0.5606	1.7388	0.3052	0	0.0003	0	0	0	0	0	0	0	0											13.8414		327.6041783	8.944189615	1201.16344	2540.773897	8.5859254	18.66371944	8.216061195	17.35388953	24.45830428	7813.312892	24.87751845	1.349482697	0.107609766	16.6831031	36.25450555	135.8676867	3.653017311	14.00755082	43.45001293	7.625248938	40.01868761	0.007142617	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											819.2	819.2	76.71	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199937572	0.197199066	0.5	0.2	0.2	0.195807763	0.2	0.2	0	0	0	0	0	0	0	0											819.2	819.2	76.71	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199937572	0.197199066	0.5	0.2	0.2	0.195807763	0.2	0.2	0	0	0	0	0	0	0	0											22.3644	0.610590011	7.678437292	0	1.71718508	3.732743888	1.643212239	3.470777907	4.891660855	0	4.975503691	0.269896539	0.021521953	3.336620619	7.248637807	26.79298088	1.826508656	2.801510164	8.690002586	1.493082937	8.003737523	0.001428523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.5705	135	0	22.3644	0.610590011	7.678437292	0	2.060786386	4.479649792	1.9720119	4.165265551	5.870461031	0	5.971080455	0.323901669	0.025828403	4.004263971	8.629913647	31.68798691	1.972699248	3.362080228	10.42883451	1.798238802	8.003737523	0.001714365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4119		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			22.3644	0.610590011	7.678437292	0	2.060786386	4.479649792	1.9720119	4.165265551	5.870461031	0	5.971080455	0.323901669	0.025828403	4.004263971	8.629913647	31.68798691	1.972699248	3.362080228	10.42883451	1.798238802	8.003737523	0.001714365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4119
H6499_804_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	V	Coin	V	V	V	Coin	Coin											0	0	0	0	0.3436	0.7469	0.3288	0.6945	0.9788	0	0.9956	0.054	0.0043	0.6676	1.3813	4.895	0.1462	0.5606	1.7388	0.3052	0	0.0003	0	0	0	0	0	0	0	0											13.8414		327.6041783	8.944189615	1201.16344	2540.773897	8.5859254	18.66371944	8.216061195	17.35388953	24.45830428	7813.312892	24.87751845	1.349482697	0.107609766	16.6831031	36.25450555	135.8676867	3.653017311	14.00755082	43.45001293	7.625248938	40.01868761	0.007142617	0	0	0	0	0	0	0	0											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	$0.00 copayment	20% coinsurance	20% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	"$0.00 copayment, 20% coinsurance"	50% coinsurance	20% coinsurance	20% coinsurance	"$0.00 copayment, 20% coinsurance"	20% coinsurance	20% coinsurance		$0.00 copayment	20% coinsurance	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment	$0.00 copayment											819.2	819.2	76.71	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199937572	0.197199066	0.5	0.2	0.2	0.195807763	0.2	0.2	0	0	0	0	0	0	0	0											819.2	819.2	76.71	0	0.2	0.2	0.2	0.2	0.2	0	0.2	0.2	0.2	0.2	0.199937572	0.197199066	0.5	0.2	0.2	0.195807763	0.2	0.2	0	0	0	0	0	0	0	0											22.3644	0.610590011	7.678437292	0	1.71718508	3.732743888	1.643212239	3.470777907	4.891660855	0	4.975503691	0.269896539	0.021521953	3.336620619	7.248637807	26.79298088	1.826508656	2.801510164	8.690002586	1.493082937	8.003737523	0.001428523	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.5705	135	0	22.3644	0.610590011	7.678437292	0	2.060786386	4.479649792	1.9720119	4.165265551	5.870461031	0	5.971080455	0.323901669	0.025828403	4.004263971	8.629913647	31.68798691	1.972699248	3.362080228	10.42883451	1.798238802	8.003737523	0.001714365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4119		N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	N/A	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			22.3644	0.610590011	7.678437292	0	2.060786386	4.479649792	1.9720119	4.165265551	5.870461031	0	5.971080455	0.323901669	0.025828403	4.004263971	8.629913647	31.68798691	1.972699248	3.362080228	10.42883451	1.798238802	8.003737523	0.001714365	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4119
H6504_801_0	2009	2																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	Coin	Coin	V	Coin	V	Coin	O																																																			0		1998.917394	76.94062332	1922.308848	198.3488815	20.15727457	10.93394442	10.93394442	12.17867449	1.540991927	0	0	0	0	99.58520311	99.58223699	133.0083909	1.493733555	2.489555925	3.485378295	8.896296844	11.24484319	0	0	0.183313335	8.164364832	0	0.799774514	0	0	0											2008 Mcare defined cost share	2008 Mcare defined cost share	$128/day (Days 21 - 100)	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	50% Days 1 - 999	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	0											148	148	45.34	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.5	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0	0.231	0	0.231	0											148	148	45.34	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.5	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0	0.231	0	0.231	0											24.6533	0.948934354	7.263123599	0	4.656330426	2.525741162	2.525741162	2.813273806	0.355969135	0	0	0	0	23.00418192	23.00349675	30.72493829	0.746866777	0.575087419	0.805122386	2.055044571	2.597558777	0	0	0.04234538	1.885968276	0	0.184747913	0	0	0	0	0	0	0	0	0	0	0	0	0	131.3678			24.6533	0.948934354	7.263123599	0	4.656330426	2.525741162	2.525741162	2.813273806	0.355969135	0	0	0	0	23.00418192	23.00349675	30.72493829	0.746866777	0.575087419	0.805122386	2.055044571	2.597558777	0	0	0.04234538	1.885968276	0	0.184747913	0	0	0	0	0	0	0	0	0	0	0	0	0	131.3678		2008 Mcare defined	2008 Mcare defined	$128/day (Days 21 - 100)	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	50% Days 1 - 999	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	0											1.2975	0.0499	0.3823	0	0.2451	0.1329	0.1329	0.1481	0.0187	0	0	0	0	1.2107	1.2107	1.6171	0.0393	0.0303	0.0424	0.1082	0.1367	0	0	0.0022	0.0993	0	0.0097	0	0	0											6.9141			25.9509	0.998878268	7.645393262	0	4.901400449	2.658674907	2.658674907	2.961340849	0.374704353	0	0	0	0	24.21492834	24.2142071	32.34204031	0.786175555	0.605355178	0.847497249	2.163204812	2.734272397	0	0	0.044574085	1.985229764	0	0.194471487	0	0	0	0	0	0	0	0	0	0	0	0	0	138.2819
H6504_803_0	2009	2																																D	D	D	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	Coin	Coin	V	Coin	V	Coin	O																																																			0		1998.917394	76.94062332	1922.308848	198.3488815	20.15727457	10.93394442	10.93394442	12.17867449	1.540991927	0	0	0	0	99.58520311	99.58223699	133.0083909	1.493733555	2.489555925	3.485378295	8.896296844	11.24484319	0	0	0.183313335	8.164364832	0	0.799774514	0	0	0											2008 Mcare defined cost share	2008 Mcare defined cost share	$128/day (Days 21 - 100)	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	50% Days 1 - 999	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	0											148	148	45.34	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.5	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0	0.231	0	0.231	0											148	148	45.34	0	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.5	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0	0.231	0	0.231	0											24.6533	0.948934354	7.263123599	0	4.656330426	2.525741162	2.525741162	2.813273806	0.355969135	0	0	0	0	23.00418192	23.00349675	30.72493829	0.746866777	0.575087419	0.805122386	2.055044571	2.597558777	0	0	0.04234538	1.885968276	0	0.184747913	0	0	0	0	0	0	0	0	0	0	0	0	0	131.3678			24.6533	0.948934354	7.263123599	0	4.656330426	2.525741162	2.525741162	2.813273806	0.355969135	0	0	0	0	23.00418192	23.00349675	30.72493829	0.746866777	0.575087419	0.805122386	2.055044571	2.597558777	0	0	0.04234538	1.885968276	0	0.184747913	0	0	0	0	0	0	0	0	0	0	0	0	0	131.3678		2008 Mcare defined	2008 Mcare defined	$128/day (Days 21 - 100)	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	50% Days 1 - 999	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	0	20% Coins. After Part B ded.	0											1.2975	0.0499	0.3823	0	0.2451	0.1329	0.1329	0.1481	0.0187	0	0	0	0	1.2107	1.2107	1.6171	0.0393	0.0303	0.0424	0.1082	0.1367	0	0	0.0022	0.0993	0	0.0097	0	0	0											6.9141			25.9509	0.998878268	7.645393262	0	4.901400449	2.658674907	2.658674907	2.961340849	0.374704353	0	0	0	0	24.21492834	24.2142071	32.34204031	0.786175555	0.605355178	0.847497249	2.163204812	2.734272397	0	0	0.044574085	1.985229764	0	0.194471487	0	0	0	0	0	0	0	0	0	0	0	0	0	138.2819
H6528_001_0	2009	8																					0											D	A	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	Coin	V	Coin	V	T	V	V	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	948.55	4.82	472.27	0	325.93	11.26	8.02	282.27	333.64	3.52	16	64.24	1.25	398.86	4877.82	6350.63	177.62	658.16	27.27	9074.98	6.73	590.56	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $165 per day	"1B IP Psych: $1,000 per admit"	2 SNF: $100	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $30"	"9B ASC Services: $100, 9A OP Hospital: $100"	8A OP C/D/T: 20%	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	"9A OP Hospital: $50 (Observation), 5 Partial Hosp: $50"	12 Renal Dialysis: $30	"3 CORF: $30, 9C OP Substance Abuse Individual: $30, Group: $15 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"	"7B Chiropractic: $30, 7D Physician Specialist: $30, 7F Podiatry: $30"	"7E Mental Health Individual: $30, Group: $15, 7H Psychiatric Individual: $30, Group: $15"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	"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: $10, 17A Medicare Covered Eye Exams: $30"	10B Transportation: $0	"16A Preventive Dental Services: $10, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $30	"17B Eye Wear: Medicare Covered: $0, Routine: $0 with a $150 allowance"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											165	1000	100	0	75	0.199999882	0.025120814	49.0824388	100	0.199741609	0.200018016	50	30	30	15	30	29.25	30	0.148885802	29.04573343	0.19999821	30	0	0	0	0	0	0	0	0											159.7083247	967.9292404	96.79292404	0	72.59469303	0.193585734	0.02431517	47.50832771	96.79292404	0.193335744	0.193603286	48.39646202	29.03787721	29.03787721	14.51893861	29.03787721	28.31193028	29.03787721	0.144110921	28.1142147	0.193584115	29.03787721	0	0	0	0	0	0	0	0											12.6243	0.388784912	3.809366186	0	1.971732358	2.179775361	0.195007665	1.117514638	2.691165931	0.68054182	3.097652577	0.259082393	0.003024779	0.965170642	5.901730759	15.36740118	0.419063755	1.592630772	3.929904826	21.26132801	1.302821097	1.429050731	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.187	0	2.69	12.6243	0.388784912	3.809366186	0	1.971732358	2.179775361	0.195007665	1.117514638	2.691165931	0.68054182	3.097652577	0.259082393	0.003024779	0.965170642	5.901730759	15.36740118	0.419063755	1.592630772	3.929904826	21.26132801	1.302821097	1.429050731	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.187	3350	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	12.6243	0.388784912	3.809366186	0	1.971732358	2.179775361	0.195007665	1.117514638	2.691165931	0.68054182	3.097652577	0.259082393	0.003024779	0.965170642	5.901730759	15.36740118	0.419063755	1.592630772	3.929904826	21.26132801	1.302821097	1.429050731	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.187
H6621_001_0	2009	5																					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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1896.4	62.1	2159.5	1489.9	364.1	17.1746353	0	392.8	421.5	11905	676.3	146.6	27.1	5543.9	4345.5	3593.7	186.5	173.8	50.3	0	24.68649105	0	0	0	357.4	1503	1.3	0	0	0											$50 / days 1-10	$50 / days 1-10	$25 / days 21-100	$0.00 	$50.00 	20%	20%	$50.00 	$100.00 	$0.00 	$50 Scans	$0.00 	$0.00 	"$25 Rad Ther, CORF"	"$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 	$25.00 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											40.54456999	40.54456999	7.139752391	$0.00 	$50.00 	20%	20%	$50.00 	$100.00 	$0.00 	5	$0.00 	$0.00 	2.5	15	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	0.18	$0.00 	$0.00 	$0.00 	$25.00 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											37.83178398	37.83178398	6.662040568	0	46.6545631	0.186618252	0.186618252	46.6545631	93.3091262	0	4.66545631	0	0	2.332728155	13.99636893	23.32728155	23.32728155	23.32728155	0	0	0.167956427	0	0	0	23.32728155	13.99636893	23.32728155	0	0	0											5.9787	0.195779482	1.198889717	0	1.415577202	3.205100426	0	1.527159365	3.277483058	0	0.262937342	0	0	1.077700968	5.068435099	6.985937642	0.362544834	0.337856794	0	0	4.146254836	0	0	0	0.694764202	1.753045208	0.002527122	0	0	0	0	0	0	0	0	0	0	0	0	0	37.4907		2.6883	5.9787	0.195779482	1.198889717	0	1.415577202	3.205100426	0	1.527159365	3.277483058	0	0.262937342	0	0	1.077700968	5.068435099	6.985937642	0.362544834	0.337856794	0	0	4.146254836	0	0	0	0.694764202	1.753045208	0.002527122	0	0	0	0	0	0	0	0	0	0	0	0	0	37.4907	0																																																																																	0		0	5.9787	0.195779482	1.198889717	0	1.415577202	3.205100426	0	1.527159365	3.277483058	0	0.262937342	0	0	1.077700968	5.068435099	6.985937642	0.362544834	0.337856794	0	0	4.146254836	0	0	0	0.694764202	1.753045208	0.002527122	0	0	0	0	0	0	0	0	0	0	0	0	0	37.4907
H6621_002_0	2009	3																					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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1896.4	62.1	2159.5	1489.9	364.1	17.1746353	0	392.8	421.5	11905	676.3	146.6	27.1	5543.9	4345.5	3593.7	186.5	173.8	50.3	0	24.68649105	0	0	0	357.4	1503	1.3	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	$0.00 	$0.00 	"$25 Rad Ther, CORF"	"$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 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											40.54456999	40.54456999	7.139752391	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	5	$0.00 	$0.00 	2.5	15	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	0.18	$0.00 	$0.00 	$0.00 	$15.00 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											37.83178398	37.83178398	6.662040568	0	23.32728155	0.186618252	0.186618252	46.6545631	93.3091262	0	4.66545631	0	0	2.332728155	13.99636893	23.32728155	23.32728155	23.32728155	0	0	0.167956427	0	0	0	13.99636893	13.99636893	23.32728155	0	0	0											5.9787	0.195779482	1.198889717	0	0.707788601	3.205100426	0	1.527159365	3.277483058	0	0.262937342	0	0	1.077700968	5.068435099	6.985937642	0.362544834	0.337856794	0	0	4.146254836	0	0	0	0.416858521	1.753045208	0.002527122	0	0	0	0	0	0	0	0	0	0	0	0	0	36.505		2.6176	5.9787	0.195779482	1.198889717	0	0.707788601	3.205100426	0	1.527159365	3.277483058	0	0.262937342	0	0	1.077700968	5.068435099	6.985937642	0.362544834	0.337856794	0	0	4.146254836	0	0	0	0.416858521	1.753045208	0.002527122	0	0	0	0	0	0	0	0	0	0	0	0	0	36.505	0																																																																																	0		0	5.9787	0.195779482	1.198889717	0	0.707788601	3.205100426	0	1.527159365	3.277483058	0	0.262937342	0	0	1.077700968	5.068435099	6.985937642	0.362544834	0.337856794	0	0	4.146254836	0	0	0	0.416858521	1.753045208	0.002527122	0	0	0	0	0	0	0	0	0	0	0	0	0	36.505
H6621_801_0	2009	3																					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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1896.4	62.1	2159.5	1489.9	364.1	17.1746353	0	392.8	421.5	11905	676.3	146.6	27.1	5543.9	4345.5	3593.7	186.5	173.8	50.3	0	24.68649105	0	0	0	357.4	1503	1.3	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	$0.00 	$0.00 	"$25 Rad Ther, CORF"	"$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 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											40.54456999	40.54456999	7.139752391	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	5	$0.00 	$0.00 	2.5	15	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	0.18	$0.00 	$0.00 	$0.00 	$15.00 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											37.83178398	37.83178398	6.662040568	0	23.32728155	0.186618252	0.186618252	46.6545631	93.3091262	0	4.66545631	0	0	2.332728155	13.99636893	23.32728155	23.32728155	23.32728155	0	0	0.167956427	0	0	0	13.99636893	13.99636893	23.32728155	0	0	0											5.9787	0.195779482	1.198889717	0	0.707788601	3.205100426	0	1.527159365	3.277483058	0	0.262937342	0	0	1.077700968	5.068435099	6.985937642	0.362544834	0.337856794	0	0	4.146254836	0	0	0	0.416858521	1.753045208	0.002527122	0	0	0	0	0	0	0	0	0	0	0	0	0	36.505		2.6176	5.9787	0.195779482	1.198889717	0	0.707788601	3.205100426	0	1.527159365	3.277483058	0	0.262937342	0	0	1.077700968	5.068435099	6.985937642	0.362544834	0.337856794	0	0	4.146254836	0	0	0	0.416858521	1.753045208	0.002527122	0	0	0	0	0	0	0	0	0	0	0	0	0	36.505	0																																																																																	0		0	5.9787	0.195779482	1.198889717	0	0.707788601	3.205100426	0	1.527159365	3.277483058	0	0.262937342	0	0	1.077700968	5.068435099	6.985937642	0.362544834	0.337856794	0	0	4.146254836	0	0	0	0.416858521	1.753045208	0.002527122	0	0	0	0	0	0	0	0	0	0	0	0	0	36.505
H6621_802_0	2009	3																					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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1896.4	62.1	2159.5	1489.9	364.1	17.1746353	0	392.8	421.5	11905	676.3	146.6	27.1	5543.9	4345.5	3593.7	186.5	173.8	50.3	0	24.68649105	0	0	0	357.4	1503	1.3	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	$0.00 	$0.00 	"$25 Rad Ther, CORF"	"$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 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											40.54456999	40.54456999	7.139752391	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	5	$0.00 	$0.00 	2.5	15	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	0.18	$0.00 	$0.00 	$0.00 	$15.00 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											37.83178398	37.83178398	6.662040568	0	23.32728155	0.186618252	0.186618252	46.6545631	93.3091262	0	4.66545631	0	0	2.332728155	13.99636893	23.32728155	23.32728155	23.32728155	0	0	0.167956427	0	0	0	13.99636893	13.99636893	23.32728155	0	0	0											5.9787	0.195779482	1.198889717	0	0.707788601	3.205100426	0	1.527159365	3.277483058	0	0.262937342	0	0	1.077700968	5.068435099	6.985937642	0.362544834	0.337856794	0	0	4.146254836	0	0	0	0.416858521	1.753045208	0.002527122	0	0	0	0	0	0	0	0	0	0	0	0	0	36.505		2.6176	5.9787	0.195779482	1.198889717	0	0.707788601	3.205100426	0	1.527159365	3.277483058	0	0.262937342	0	0	1.077700968	5.068435099	6.985937642	0.362544834	0.337856794	0	0	4.146254836	0	0	0	0.416858521	1.753045208	0.002527122	0	0	0	0	0	0	0	0	0	0	0	0	0	36.505	0																																																																																	0		0	5.9787	0.195779482	1.198889717	0	0.707788601	3.205100426	0	1.527159365	3.277483058	0	0.262937342	0	0	1.077700968	5.068435099	6.985937642	0.362544834	0.337856794	0	0	4.146254836	0	0	0	0.416858521	1.753045208	0.002527122	0	0	0	0	0	0	0	0	0	0	0	0	0	36.505
H6740_001_0	2009	2																					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																																																			0		245.0847296	7.091310691	896.6067132	1964.209375	132.6478442	6.398408324	5.610282782	190.3164329	211.9294176		4023.915935	30.09110124	13.77879305	54.63788003	2944.80233	4591.374281	621.9332546	1421.580534			16.6930733	1424.014452					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	21.12004438	100	0.2	0.2	48.54245484	47.5		11.76826343	50	50	17.92600003	10	24.17006807	28.0101517	15			0.2	15					15														150.937009	129.700309	53.09711795	17.25539513	81.7015098	0.16340302	0.16340302	39.6599185	38.80821716		9.614848899	40.8507549	40.8507549	14.64581267	8.17015098	19.74731053	22.88471684	12.25522647			0.16340302	12.25522647					12.25522647														3.0827	0.076645432	3.967269367	2.824434074	0.903127429	1.045519241	0.916737147	0.628994518	0.685383572	0	3.224111975	0.102437017	0.046906175	0.06668468	2.004956637	7.555607808	1.186063869	1.451815949	0	0	2.727698583	1.454301633	0	0	0	0	0.222139275	0	0	0	0	0	0	0	0	0	0	0	0	0	34.1735	0	7.6538	3.0827	0.076645432	3.967269367	2.824434074	0.903127429	1.045519241	0.916737147	0.628994518	0.685383572	0	3.224111975	0.102437017	0.046906175	0.06668468	2.004956637	7.555607808	1.186063869	1.451815949	0	0	2.727698583	1.454301633	0	0	0	0	0.222139275	0	0	0	0	0	0	0	0	0	0	0	0	0	34.1735		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										4.9908	0.1412	1.7228	1.4215	0.2416	0.3947	0.346	0.1943	1.4022	1.0166	2.3815	0.105	0.0159	1.0721	1.8259	3.2143	0.4536	0.8118			0.7429	0.8053					0.1174														23.4175	500	0	8.0735	0.217874429	5.690077308	4.245948642	1.144700994	1.440170203	1.262776879	0.82333841	2.087600112	1.016588136	5.605598869	0.207424019	0.062825086	1.138827422	3.830822597	10.7698991	1.639625762	2.263650532	0	0	3.470559371	2.259621501	0	0	0	0	0.339557302	0	0	0	0	0	0	0	0	0	0	0	0	0	57.591
H6740_002_0	2009	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																																																			0		245.0847296	7.091310691	896.6067132	1964.209375	132.6478442	6.398408324	5.610282782	190.3164329	211.9294176		4023.915935	30.09110124	13.77879305	54.63788003	2944.80233	4591.374281	621.9332546	1421.580534			16.6930733	1424.014452					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	21.12004438	100	0.2	0.2	48.54245484	47.5		11.76826343	50	50	17.92600003	10	24.17006807	28.0101517	15			0.2	15					15														150.937009	129.700309	53.09711795	17.25539513	81.7015098	0.16340302	0.16340302	39.6599185	38.80821716		9.614848899	40.8507549	40.8507549	14.64581267	8.17015098	19.74731053	22.88471684	12.25522647			0.16340302	12.25522647					12.25522647														3.0827	0.076645432	3.967269367	2.824434074	0.903127429	1.045519241	0.916737147	0.628994518	0.685383572	0	3.224111975	0.102437017	0.046906175	0.06668468	2.004956637	7.555607808	1.186063869	1.451815949	0	0	2.727698583	1.454301633	0	0	0	0	0.222139275	0	0	0	0	0	0	0	0	0	0	0	0	0	34.1735	0	7.6538	3.0827	0.076645432	3.967269367	2.824434074	0.903127429	1.045519241	0.916737147	0.628994518	0.685383572	0	3.224111975	0.102437017	0.046906175	0.06668468	2.004956637	7.555607808	1.186063869	1.451815949	0	0	2.727698583	1.454301633	0	0	0	0	0.222139275	0	0	0	0	0	0	0	0	0	0	0	0	0	34.1735		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										4.9908	0.1412	1.7228	1.4215	0.2416	0.3947	0.346	0.1943	1.4022	1.0166	2.3815	0.105	0.0159	1.0721	1.8259	3.2143	0.4536	0.8118			0.7429	0.8053					0.1174														23.4175	500	0	8.0735	0.217874429	5.690077308	4.245948642	1.144700994	1.440170203	1.262776879	0.82333841	2.087600112	1.016588136	5.605598869	0.207424019	0.062825086	1.138827422	3.830822597	10.7698991	1.639625762	2.263650532	0	0	3.470559371	2.259621501	0	0	0	0	0.339557302	0	0	0	0	0	0	0	0	0	0	0	0	0	57.591
H6740_003_0	2009	4																					3000											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																																																			0		296.2523917	22.27123669	906.30834		234.8615452	9.260315366	7.377380046	303.2382084	181.4974912			25.96568111	45.0313621	62.61332039	1.007015934	4222.9724	1305.060292	2258.802743			11.59480535	823.5540972					217.5130188														1a: $250 days 1-5	1b : $250 days 1-5	2a: $105 days 21 - 100  2a2: $105 days 21-100	6a: 0%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50  4b: $25	9a: $150 9b: $100	8a: 0%	8b1: 0% 8b2: 0% 8b3: 0%	9a: $150	12: $50	9a: $150 9c: 30% 9d: $25 3: $15 5: $25	"7a: $0, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $10, 14j: $10"	7b: $30 7d: $25 7f: $25	"7e: $35, 7h: $35"	7c: $25 7i: $25	8b1: 0% 8b2: 0% 8b3: 0%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $10 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $25 18a1: $25	18b: (n/c)		13c (: $											462.7102261	417.7604594	68.23860903		100	0.1	0.2	47.52134985	145			150	50	27.16303185	10	25.2477222	35	25			0.2	14.97589398					25														386.0519902	348.5491517	56.93336637		83.43277681	0.083432777	0.166865554	39.64838176	120.9775264			125.1491652	41.7163884	22.66287174	8.343277681	21.06487571	29.20147188	20.8581942			0.166865554	12.4948042					20.8581942														9.5307	0.646885055	4.299932064	0	1.63292924	0.772613825	1.231030606	1.001908688	1.829759794	0	0	0.27079861	0.156545483	0.118249804	0.000700151	7.413032394	3.175806784	3.92621219	0	0	1.934773614	0.857512266	0	0	0	0	0.378077399	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1775	0	7.7795	9.5307	0.646885055	4.299932064	0	1.63292924	0.772613825	1.231030606	1.001908688	1.829759794	0	0	0.27079861	0.156545483	0.118249804	0.000700151	7.413032394	3.175806784	3.92621219	0	0	1.934773614	0.857512266	0	0	0	0	0.378077399	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1775		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50  4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: 30% 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										5.7153	0.4272	1.748	2.1283	0.4148	0.5625	0.4482	0.2876	1.1602	0.9478	2.1767	0.0932	0.0637	1.2714	2.319	2.8918	0.9752	1.2632			0.5036	0.4931					0.1167														26.0074	500	0	15.246	1.074081485	6.047904005	2.128287654	2.047712208	1.335151682	1.67918549	1.289483072	2.989933972	0.947795266	2.176669392	0.364046668	0.220225706	1.389649396	2.319712944	10.30478564	4.151045917	5.189405681	0	0	2.438400339	1.350647516	0	0	0	0	0.494778138	0	0	0	0	0	0	0	0	0	0	0	0	0	65.1849
H6740_801_0	2009	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																																																			0		212.8064887	5.916354057	27.92280369		5.094835654	6.398408324	5.610282782	6.113066183	22.73389614	16.85299491	39.46208561	1.702136251	0.600438485	17.16771211	34.7148844	92.73428276	4.839012447	10.10007146			16.6930733	9.312882439																			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																			0.083346462	0.083346462	0.191200997		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.083346462	0.083346462	0.191200997		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			17.7367	0.49310718	5.338867906	0	1.176907036	1.478032323	1.295975323	1.412118288	5.251530009	3.893041825	9.115741777	0.393193474	0.13870129	3.965741497	8.019138295	21.42161932	1.117811875	2.333116507	0	0	3.856099932	2.151275843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.5887	0	0	17.7367	0.49310718	5.338867906	0	1.176907036	1.478032323	1.295975323	1.412118288	5.251530009	3.893041825	9.115741777	0.393193474	0.13870129	3.965741497	8.019138295	21.42161932	1.117811875	2.333116507	0	0	3.856099932	2.151275843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.5887		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																			3.2268	0.0897	0.9713		0.2141	0.2689	0.2358	0.2569	0.9554	0.6927	1.6226	0.0715	0.0251	0.7215	1.4169	3.7858	0.1985	0.4125			0.7015	0.3805																			16.248	0	0	20.9635	0.582817401	6.310159823	0	1.391019899	1.74692844	1.531750093	1.669022768	6.206932678	4.585695914	10.738372	0.46472655	0.163791935	4.68719281	9.436061999	25.20745132	1.316290328	2.745611567	0	0	4.557634183	2.531729971	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.8367
H6740_802_0	2009	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																																																			0		212.8064887	5.916354057	27.92280369		5.094835654	6.398408324	5.610282782	6.113066183	22.73389614	16.85299491	39.46208561	1.702136251	0.600438485	17.16771211	34.7148844	92.73428276	4.839012447	10.10007146			16.6930733	9.312882439																			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																			0.083346462	0.083346462	0.191200997		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.083346462	0.083346462	0.191200997		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			17.7367	0.49310718	5.338867906	0	1.176907036	1.478032323	1.295975323	1.412118288	5.251530009	3.893041825	9.115741777	0.393193474	0.13870129	3.965741497	8.019138295	21.42161932	1.117811875	2.333116507	0	0	3.856099932	2.151275843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.5887	0	0	17.7367	0.49310718	5.338867906	0	1.176907036	1.478032323	1.295975323	1.412118288	5.251530009	3.893041825	9.115741777	0.393193474	0.13870129	3.965741497	8.019138295	21.42161932	1.117811875	2.333116507	0	0	3.856099932	2.151275843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.5887		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																			3.2268	0.0897	0.9713		0.2141	0.2689	0.2358	0.2569	0.9554	0.6927	1.6226	0.0715	0.0251	0.7215	1.4169	3.7858	0.1985	0.4125			0.7015	0.3805																			16.248	0	0	20.9635	0.582817401	6.310159823	0	1.391019899	1.74692844	1.531750093	1.669022768	6.206932678	4.585695914	10.738372	0.46472655	0.163791935	4.68719281	9.436061999	25.20745132	1.316290328	2.745611567	0	0	4.557634183	2.531729971	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.8367
H6740_803_0	2009	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																																																			0		212.8064887	5.916354057	27.92280369		5.094835654	6.398408324	5.610282782	6.113066183	22.73389614	16.85299491	39.46208561	1.702136251	0.600438485	17.16771211	34.7148844	92.73428276	4.839012447	10.10007146			16.6930733	9.312882439																			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																			0.083346462	0.083346462	0.191200997		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.083346462	0.083346462	0.191200997		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			17.7367	0.49310718	5.338867906	0	1.176907036	1.478032323	1.295975323	1.412118288	5.251530009	3.893041825	9.115741777	0.393193474	0.13870129	3.965741497	8.019138295	21.42161932	1.117811875	2.333116507	0	0	3.856099932	2.151275843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.5887	0	0	17.7367	0.49310718	5.338867906	0	1.176907036	1.478032323	1.295975323	1.412118288	5.251530009	3.893041825	9.115741777	0.393193474	0.13870129	3.965741497	8.019138295	21.42161932	1.117811875	2.333116507	0	0	3.856099932	2.151275843	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.5887		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																			3.2268	0.0897	0.9713		0.2141	0.2689	0.2358	0.2569	0.9554	0.6927	1.6226	0.0715	0.0251	0.7215	1.4169	3.7858	0.1985	0.4125			0.7015	0.3805																			16.248	0	0	20.9635	0.582817401	6.310159823	0	1.391019899	1.74692844	1.531750093	1.669022768	6.206932678	4.585695914	10.738372	0.46472655	0.163791935	4.68719281	9.436061999	25.20745132	1.316290328	2.745611567	0	0	4.557634183	2.531729971	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.8367
H6793_001_0	2009	4																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1749.5714	44.60986584	2532.321323	4793.765604	250.6903734	14.89560462	8.216993578	357.0684553	363.2751052	6182.681967	454.5309496	0	7.237866257	1375.809347	6468.558441	5307.547731	222.3796648	647.4253371	0	0	1337.927703	1576.317675	2759.542995	446.5537466	205.2567597	154.1150788	49.27524142	14.09480567	932.1	115.5175384											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b, 7d); $0 n/c (7b1); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0.2	0.2	49.97199417	50	8	16.62123034	0	0	46.77659972	1.304946601	17.52463705	20	0	0	0	0	0.001757725	0	20	20	0	20	0	0	20											0	0	0	0	0	0.16542247	0.16542247	41.33245355	41.35561752	6.616898804	13.7476249	0	0	38.68950334	1.07933745	14.49484374	16.54224701	0	0	0	0	0.001453836	0	20	20	0	20	0	0	20											0	0	0	0	0	2.46406771	1.359275374	1.229876279	1.251955526	3.409181743	0.52072675	0	0	4.435781695	0.581813114	6.41100625	0.306554945	0	0	0	0	0.000190976	0	0.744256244	0.342094599	0	0.082125402	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	23.3314	0	4.5924	0	0	0	0	0	2.46406771	1.359275374	1.229876279	1.251955526	3.409181743	0.52072675	0	0	4.435781695	0.581813114	6.41100625	0.306554945	0	0	0	0	0.000190976	0	0.744256244	0.342094599	0	0.082125402	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	23.3314		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.5245	0.0191	0.5469	0.3581	0.0719	0.0912	0.0503	0.0303	0.2282	0.0399	0.0968	0	0	0.1821	0.3072	0.9475	0.0121	0.0309	0	0	0.1592	0.0698	0	0	0.0039	0.0039	0.0016	0.0006	0	0											4.7759	0	0	1.5245	0.019138143	0.546919266	0.35807015	0.071854178	2.555265289	1.409583498	1.260222236	1.480114923	3.449058124	0.617479384	0	0	4.617834821	0.888968206	7.358526211	0.318627992	0.030857281	0	0	0.159217918	0.070017483	0	0.744256244	0.346006016	0.003931507	0.083745916	0.000575298	0	0.192529231	0	0	0	0	0	0	0	0	0	0	28.1073
H6793_002_0	2009	2																					1500											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1749.5714	44.60986584	2532.321323	4793.765604	250.6903734	14.89560462	8.216993578	357.0684553	363.2751052	6182.681967	454.5309496	0	7.237866257	1375.809347	6468.558441	5307.547731	222.3796648	647.4253371	0	0	1337.927703	1576.317675	2759.542995	446.5537466	205.2567597	154.1150788	49.27524142	14.09480567	932.1	115.5175384											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b, 7d); $0 n/c (7b1); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0.2	0.2	49.97199417	50	8	16.62123034	0	0	46.77659972	1.304946601	17.52463705	20	0	0	0	0	0.001757725	0	20	20	0	20	0	0	20											0	0	0	0	0	0.16542247	0.16542247	41.33245355	41.35561752	6.616898804	13.7476249	0	0	38.68950334	1.07933745	14.49484374	16.54224701	0	0	0	0	0.001453836	0	20	20	0	20	0	0	20											0	0	0	0	0	2.46406771	1.359275374	1.229876279	1.251955526	3.409181743	0.52072675	0	0	4.435781695	0.581813114	6.41100625	0.306554945	0	0	0	0	0.000190976	0	0.744256244	0.342094599	0	0.082125402	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	23.3314	0	4.5924	0	0	0	0	0	2.46406771	1.359275374	1.229876279	1.251955526	3.409181743	0.52072675	0	0	4.435781695	0.581813114	6.41100625	0.306554945	0	0	0	0	0.000190976	0	0.744256244	0.342094599	0	0.082125402	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	23.3314		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.5245	0.0191	0.5469	0.3581	0.0719	0.0912	0.0503	0.0303	0.2282	0.0399	0.0968	0	0	0.1821	0.3072	0.9475	0.0121	0.0309	0	0	0.1622	0.0698	0	0	0.0039	0.0039	0.0016	0.0006	0	0											4.7789	0	0	1.5245	0.019138143	0.546919266	0.35807015	0.071854178	2.555265289	1.409583498	1.260222236	1.480114923	3.449058124	0.617479384	0	0	4.617834821	0.888968206	7.358526211	0.318627992	0.030857281	0	0	0.162217918	0.070017483	0	0.744256244	0.346006016	0.003931507	0.083745916	0.000575298	0	0.192529231	0	0	0	0	0	0	0	0	0	0	28.1103
H6793_003_0	2009	3																					1500											D	D	D	V	T	P	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		2693.950086	58.2707724	2474.381168	82550.61895	149.3822758	3027.058717	15.24953605	426.797385	410.1890049	7926.866231	516.4423063	0	11.585382	1580.112984	7236.961105	5904.768168	235.2086324	270.1551103	0	0	1763.916987	1580.378034	1418.390092	446.5537466	205.2567597	154.1150788	37.56409609	10.74492219	932.1	115.5175384											"$0 (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"$0 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$0 (10a)	$0 (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $20 (4b)	$50 (9b)	$0/$20 (8a1); $20/$0 (8a2)	"$0 (8b1); $20 (8b2, 8b3)"	Included in h.5.	$0 (12)	"$0 (3, 9d); $30 (5); $50 (9a); $20 (9c)"	"$0/$20 (7a); $20 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$20 (7b, 7d); $0 n/c (7b1); $0 (7f, 7f1)"	$0 (7e); $20 (7h)	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 18a); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a2, 16a3, 16a4, 16a5); $20 (16a1); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a7, 14a8, 14a9, 14a10); $0 (14a5, 14a6)"	"$20 Visits 1-6 (13b); $0 n/c (13d, 13e)"											0	0	0	0	0	0	0.2	49.97656968	50	3.2	16.87836848	0	0	45.70445279	1.385042152	17.9239141	20	0	0	0	0	0.001602202	0	20	0	0	20	0	0	20											0	0	0	0	0	0	0.161042702	40.24180916	40.26067557	2.576683236	13.59069035	0	0	36.80184291	1.115254655	14.43257781	16.10427023	0	0	0	0	0.001290115	0	20	0	0	20	0	0	20											0	0	0	0	0	0	2.455826493	1.431258243	1.376207204	1.702085278	0.584900622	0	0	4.845922486	0.67258788	7.101752168	0.315655281	0	0	0	0	0.000169906	0	0.744256244	0	0	0.062606827	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	21.4858	0	4.9558	0	0	0	0	0	0	2.455826493	1.431258243	1.376207204	1.702085278	0.584900622	0	0	4.845922486	0.67258788	7.101752168	0.315655281	0	0	0	0	0.000169906	0	0.744256244	0	0	0.062606827	0	0	0.192529231	0	0	0	0	0	0	0	0	0	0	21.4858		"30% (1a, 13c); $0 n/c (1a1, 1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a3); $0 (6a2)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $20 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14c1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"30% (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); 30% (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.2714	0.0251	0.5225	0.3519	0.0878	0.1447	0.0934	0.0363	0.2696	0.0496	0.112	0	0	0.2175	0.3685	1.0993	0.0132	0.0323	0	0	0.2015	0.0732	0	0	0.0039	0.0039	0.0009	0.0004	0	0											5.9791	0	0	2.2714	0.025050497	0.522472059	0.351924834	0.087836212	0.144723545	2.549191	1.467533531	1.645827011	1.751722567	0.696908078	0	0	5.063447067	1.041063204	8.20105839	0.32882884	0.032313743	0	0	0.201539646	0.073325438	0	0.744256244	0.003911416	0.003931507	0.063548589	0.000438568	0	0.192529231	0	0	0	0	0	0	0	0	0	0	27.4648
H6806_802_0	2009	7																					2500											A	A	D	V	T	O	O	V	V	V	V	V	P	V	V	V	V	V	V	V	S	V	T	P	P	P	P	P	O	O											7.3711	0.2895	1.6091	0.9847	0.269	0.3508	0.2781	0.3833	0.9478	0.1602	0.4082	0.0835	0.02	0.7893	0.9551	2.8432	0.1582	0.122	0.7364	0.322	0.6241	0.0399			0.0249		0.0031			0.0234											19.7971		355.5155702	18.8468629	2002.489521		233.3745264	1685.407899	947.7136235	401.2949477	391.6049993		724.8085371			334.5353435	5401.576012	13769.59812	733.8328813	653.8961129	4488.917228		1319.228689	0.109777812			145.7973624		2.82521045			234.38136											$250 per stay	$250 per stay	"$0(days 1-15), $65(days 16-100)"	$0 with 90 days max/year	20% Coinsurance	20% Coinsurance	20% Coinsurance	$50 per ER and Urgently Needed Care visit	$100 ASC	No cost sharing	20% Coinsurance	No cost sharing	No cost sharing	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	No cost sharing	20% Coinsurance	20% Coinsurance	Not covered	Not covered	$15 Copay per routine exam	No cost sharing	20% Coinsurance	Not covered	Not covered	50% Coinsurance											250	250	33.73420136		115.4140284	20.83987078	29.37947091	50	100		34.5044231			73.51730876	11.1506633	17.41570255	21.58807443	18.67291798	16.42383377		47.36373629	14.01733978			15		108.4314721			25											180.2080554	180.2080554	24.31669932		83.19415051	15.02205035	21.17766929	36.04161109	72.08322217		24.87189996			52.99364501	8.037757397	12.55379956	15.56137965	13.46004096	11.83882858		34.14130726	10.10415017			10.81248333		78.16089893			18.02080554											5.3389	0.283029709	4.057827963	0	1.617949623	2.109856861	1.672530475	1.20527637	2.352345847	0	1.502280452	0	0	1.477353936	3.618046462	14.40506457	0.951621006	0.733455705	4.428626798	0	3.753349336	9.24E-05	0	0	0.131369296	0	0.018401749	0	0	0.351978409	0	0	0	0	0	0	0	0	0	0	50.0094	250	19.3679	12.71	0.572553022	5.666928357	0.984729999	1.886984725	2.46068704	1.950641364	1.588558596	3.300142049	0.160248114	1.910528683	0.083531622	0.019960486	2.266682617	4.573170136	17.2482218	1.109857981	0.855415825	5.165025539	0.32202232	4.377461922	0.039942732	0	0	0.156272097	0	0.02146162	0	0	0.375389409	0	0	0	0	0	0	0	0	0	0	69.8064																																																																																		0	0	0	12.71	0.572553022	5.666928357	0.984729999	1.886984725	2.46068704	1.950641364	1.588558596	3.300142049	0.160248114	1.910528683	0.083531622	0.019960486	2.266682617	4.573170136	17.2482218	1.109857981	0.855415825	5.165025539	0.32202232	4.377461922	0.039942732	0	0	0.156272097	0	0.02146162	0	0	0.375389409	0	0	0	0	0	0	0	0	0	0	69.8064
H6864_001_0	2009	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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	306.145	0	0	0	0	0	306.229	0	11035.647	937.055	1093.141	0	1000.832	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: $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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0	0	0	0	0	0	0	46.97724934	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	46.97724934	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	1.1984875	0	0	0	0	0	0.255190833	0	9.1963725	1.561758333	0.910950833	0	0.834026667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.9568	0	0	0	0	0	0	0	0	0	1.1984875	0	0	0	0	0	0.255190833	0	9.1963725	1.561758333	0.910950833	0	0.834026667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.9568	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	14A Health Education/Wellness Programs: $0	13B Acupuncture: Not Covered											0	0	0	0	0	0	0	0.5906	0	0	0	0	0	0.1163	0	5.2911	0.7673	0.6019	0	0.5684	0	0	0	0	0	0	0	0	0	0											7.9355	0	0	0	0	0	0	0	0	0	1.7890525	0	0	0	0	0	0.371450833	0	14.4874275	2.329078333	1.512838333	0	1.402431667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	21.8923
H6900_001_0	2009	6	r.	s.	t.	u.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered							3700											A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			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		251.306201	8.097043	488.224167	697.782946	138.78968	9.077395	3.278146	313.93184	340.291984	601.62805	892.945468	0	18.59614	683.09583	3343.270571	4030.017207	27.491143	868.625894			20.516453			4.65	2.69				2.68	0.09	0.06	0.05	1.23	2.7							$650/Admit:1a	$650/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $50 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$50/Visit:9a	"$0-$100/Proc:12. $0 Dialysis -- Dialysis Center,12. $100 Dialysis -- OP Hosp"	"$30-$100/Visit:9d. $50 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $30 Partial Hospitalization,8b. $100 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			"Dental 749 16a, 16b"	VIS752				$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0: Health Education Materials 14a	$0 Corp Health 14a							649.999989	650.000253	43.132801	0	100.000028	0.2	0.199999	49.999987	127.31316	87.957394	83.490146	0	1.56484	71.766164	10	29.999999	89.074361	39.708648			0.2			0	0				0	0	0	0	0	0							554.78539	554.785616	36.814536	0	85.351624	0.170703	0.170703	42.675789	108.663819	75.073043	71.260175	0	1.335616	61.25357	8.53516	25.605479	76.026392	33.891966			0.170703			0	0				0	0	0	0	0	0							11.6184	0.374343582	1.497812181	0	0.987160382	1.549538559	0.559589357	1.116440747	3.081452213	3.763837372	5.30262086	0	0.002069775	3.486838187	2.377945771	8.59921008	0.174171035	2.453286606	0	0	3.502220076	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.447	0	8.6579	11.6184	0.374343582	1.497812181	0	0.987160382	1.549538559	0.559589357	1.116440747	3.081452213	3.763837372	5.30262086	0	0.002069775	3.486838187	2.377945771	8.59921008	0.174171035	2.453286606	0	0	3.502220076	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.447		$975/Admit	$975/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$100/Proc	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins			"Dental 749 16a, 16b"	VIS752				0	0	0	0	0	0							1.9364	0.0624	0.3526	0.5349	0.6581	1.9648	0.7095	0.197	2.5466	0.3281	1.3646		0.0004	0.7708	1.5454	3.5283	0.0223	0.2979			1.0532			0	0				0	0	0	0	0	0							17.8731	0	0	13.5548	0.436733582	1.850410181	0.534928	1.645267382	3.514315559	1.269135357	1.313459747	5.628007213	4.091892372	6.66717786	0	0.002434775	4.257589187	3.923319771	12.12748008	0.196468035	2.751206606	0	0	4.555379076	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.32
H6900_002_0	2009	6	r.	s.	t.	u.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered							3700											A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			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		254.219491	8.190908	493.883951	705.872061	140.398613	9.289068	3.354589	317.571124	344.23685	608.60248	903.297022	0	18.811719	691.014682	3382.027749	4076.735556	27.809837	878.695521			20.994871			4.65	2.69				2.68	0.09	0.06	0.05	1.23	2.7							$650/Admit:1a	$650/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $50 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$50/Visit:9a	"$0-$100/Proc:12. $0 Dialysis -- Dialysis Center,12. $100 Dialysis -- OP Hosp"	"$30-$100/Visit:9d. $50 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $30 Partial Hospitalization,8b. $100 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$100/Visit:7h. $100 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			"Dental 749 16a, 16b"	VIS752				$0: Membership in health club/fitness class 14a	$0: Nutritional benefit 14a	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0: Health Education Materials 14a	$0 Corp Health 14a							649.999979	649.999731	43.132788	0	99.999962	0.2	0.2	49.999999	127.313168	87.957393	83.490145	0	1.564769	71.766185	9.999998	30	89.074524	39.708648			0.199999			0	0				0	0	0	0	0	0							553.149982	553.149771	36.706003	0	85.099967	0.1702	0.1702	42.549999	108.343506	74.851742	71.050114	0	1.331618	61.073024	8.509998	25.53	75.80242	33.79206			0.170199			0	0				0	0	0	0	0	0							11.7185	0.377566574	1.510708816	0	0.995659778	1.580999374	0.570951048	1.126054251	3.107985602	3.796246318	5.348279699	0	0.002087502	3.516863022	2.398420782	8.673254895	0.175671079	2.474410981	0	0	3.573306049	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.9469	0	8.9202	11.7185	0.377566574	1.510708816	0	0.995659778	1.580999374	0.570951048	1.126054251	3.107985602	3.796246318	5.348279699	0	0.002087502	3.516863022	2.398420782	8.673254895	0.175671079	2.474410981	0	0	3.573306049	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.9469		$975/Admit	$975/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	40% Coins	40% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		$0-$100/Proc	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins			"Dental 749 16a, 16b"	VIS752				0	0	0	0	0	0							1.9531	0.0629	0.3598	0.5458	0.6638	2.0047	0.724	0.1987	2.5983	0.3347	1.3923		0.0004	0.7864	1.5767	3.5999	0.0228	0.304			1.0745			0	0				0	0	0	0	0	0							18.2026	0	0	13.6715	0.440494574	1.870464816	0.545788	1.659432778	3.585665374	1.294902048	1.324769251	5.706241602	4.130961318	6.740541699	0	0.002455502	4.303262022	3.975169782	12.2731579	0.198422079	2.778378981	0	0	4.647846049	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	69.1495
H6900_801_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		251.306201	8.097043	488.224167	697.782946	4.599404	9.077395	3.278146	20.181732	51.877367	601.62805	28.051005	0	0.353965	15.980565	30.105255	68.733824	0.434377	5.803725			20.516453																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000008	1024.00049	43.132801	0	0.2	0.2	0.199999	0.199999	0.199999	0	0.2	0	0.2	0.2	0.2	0.2	0.500001	0.2			0.2																				1024.000008	1024.00049	43.132801	0	0.2	0.2	0.199999	0.199999	0.199999	0	0.2	0	0.2	0.2	0.2	0.2	0.500001	0.2			0.2																				21.4448	0.690948	1.754872987	0	0.9198808	1.815479	0.655625922	4.036326218	10.37542152	0	5.610201	0	0.070793	3.196113	6.021051	13.7467648	0.217188934	1.160745	0	0	4.1032906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.8195	0	0	21.4448	0.690948	1.754872987	0	0.9198808	1.815479	0.655625922	4.036326218	10.37542152	0	5.610201	0	0.070793	3.196113	6.021051	13.7467648	0.217188934	1.160745	0	0	4.1032906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.8195		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3828	0.0768	0.195		0.5832	1.151	0.4157	0.7603	1.9891		1.0658		0.0133	0.602	1.2071	2.7559	0.0435	0.2327			0.8226																				14.2967	0	0	23.8276	0.76772	1.949858987	0	1.5030728	2.966469	1.071285922	4.796613218	12.36449152	0	6.676031	0	0.084128	3.798133	7.228116	16.5026358	0.260729934	1.393445	0	0	4.9258946	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.1162
H6900_802_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		251.306201	8.097043	488.224167	697.782946	4.599404	9.077395	3.278146	20.181732	51.877367	601.62805	28.051005	0	0.353965	15.980565	30.105255	68.733824	0.434377	5.803725			20.516453																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000008	1024.00049	43.132801	0	0.2	0.2	0.199999	0.199999	0.199999	0	0.2	0	0.2	0.2	0.2	0.2	0.500001	0.2			0.2																				1024.000008	1024.00049	43.132801	0	0.2	0.2	0.199999	0.199999	0.199999	0	0.2	0	0.2	0.2	0.2	0.2	0.500001	0.2			0.2																				21.4448	0.690948	1.754872987	0	0.9198808	1.815479	0.655625922	4.036326218	10.37542152	0	5.610201	0	0.070793	3.196113	6.021051	13.7467648	0.217188934	1.160745	0	0	4.1032906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.8195	0	0	21.4448	0.690948	1.754872987	0	0.9198808	1.815479	0.655625922	4.036326218	10.37542152	0	5.610201	0	0.070793	3.196113	6.021051	13.7467648	0.217188934	1.160745	0	0	4.1032906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.8195		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3828	0.0768	0.195		0.5832	1.151	0.4157	0.7603	1.9891		1.0658		0.0133	0.602	1.2071	2.7559	0.0435	0.2327			0.8226																				14.2967	0	0	23.8276	0.76772	1.949858987	0	1.5030728	2.966469	1.071285922	4.796613218	12.36449152	0	6.676031	0	0.084128	3.798133	7.228116	16.5026358	0.260729934	1.393445	0	0	4.9258946	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.1162
H6900_803_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		251.306201	8.097043	488.224167	697.782946	4.599404	9.077395	3.278146	20.181732	51.877367	601.62805	28.051005	0	0.353965	15.980565	30.105255	68.733824	0.434377	5.803725			20.516453																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000008	1024.00049	43.132801	0	0.2	0.2	0.199999	0.199999	0.199999	0	0.2	0	0.2	0.2	0.2	0.2	0.500001	0.2			0.2																				1024.000008	1024.00049	43.132801	0	0.2	0.2	0.199999	0.199999	0.199999	0	0.2	0	0.2	0.2	0.2	0.2	0.500001	0.2			0.2																				21.4448	0.690948	1.754872987	0	0.9198808	1.815479	0.655625922	4.036326218	10.37542152	0	5.610201	0	0.070793	3.196113	6.021051	13.7467648	0.217188934	1.160745	0	0	4.1032906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.8195	0	0	21.4448	0.690948	1.754872987	0	0.9198808	1.815479	0.655625922	4.036326218	10.37542152	0	5.610201	0	0.070793	3.196113	6.021051	13.7467648	0.217188934	1.160745	0	0	4.1032906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.8195		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3828	0.0768	0.195		0.5832	1.151	0.4157	0.7603	1.9891		1.0658		0.0133	0.602	1.2071	2.7559	0.0435	0.2327			0.8226																				14.2967	0	0	23.8276	0.76772	1.949858987	0	1.5030728	2.966469	1.071285922	4.796613218	12.36449152	0	6.676031	0	0.084128	3.798133	7.228116	16.5026358	0.260729934	1.393445	0	0	4.9258946	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.1162
H6900_804_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		251.306201	8.097043	488.224167	697.782946	4.599404	9.077395	3.278146	20.181732	51.877367	601.62805	28.051005	0	0.353965	15.980565	30.105255	68.733824	0.434377	5.803725			20.516453																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000008	1024.00049	43.132801	0	0.2	0.2	0.199999	0.199999	0.199999	0	0.2	0	0.2	0.2	0.2	0.2	0.500001	0.2			0.2																				1024.000008	1024.00049	43.132801	0	0.2	0.2	0.199999	0.199999	0.199999	0	0.2	0	0.2	0.2	0.2	0.2	0.500001	0.2			0.2																				21.4448	0.690948	1.754872987	0	0.9198808	1.815479	0.655625922	4.036326218	10.37542152	0	5.610201	0	0.070793	3.196113	6.021051	13.7467648	0.217188934	1.160745	0	0	4.1032906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.8195	0	0	21.4448	0.690948	1.754872987	0	0.9198808	1.815479	0.655625922	4.036326218	10.37542152	0	5.610201	0	0.070793	3.196113	6.021051	13.7467648	0.217188934	1.160745	0	0	4.1032906	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.8195		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3828	0.0768	0.195		0.5832	1.151	0.4157	0.7603	1.9891		1.0658		0.0133	0.602	1.2071	2.7559	0.0435	0.2327			0.8226																				14.2967	0	0	23.8276	0.76772	1.949858987	0	1.5030728	2.966469	1.071285922	4.796613218	12.36449152	0	6.676031	0	0.084128	3.798133	7.228116	16.5026358	0.260729934	1.393445	0	0	4.9258946	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.1162
H6923_001_0	2009	6																					5000											D	D	D	V	T	Coin	Coin	V	V	P	P	V	P	V	V	V	V	V	V	P	S	P	T	P	P	O	P	O	O	O																																																			0		1080.199161	41.32065061	794.9856905	2016.16149	129.717295	9.586093794	24.61379859	275.0444168	425.6073181	4382.879713	1022.089856		4.487619598	327.6641914	3471.892544	4581.544061	212.1641116	702.7890913			1215.430911	1059.913401																			$225/day 1-7	$225/day 1-7	"$0/day 1-8, $75/day 9-14, $100/day 15-100"	$20/visit	$100/trip	20% Coinsurance	20% Coinsurance	"$50/visit ER, $25/visit Urgent Care"	$225/visit	$35/proc	"$40/proc X-Rays and therapeutic radiology, $200/proc diag radiology"	No Cost Sharing	$25/proc	$35/proc	$25/visit	$35/visit	$35/visit	$35/visit	No Cost Sharing	No Cost Sharing	$45/script	"$35/visit, Opthalmology"	No Cost Sharing	No Cost Sharing	No Cost Sharing	$125 every 2 years	No Cost Sharing	$500 every 3 years	No Cost Sharing	No Cost Sharing											163.0846274	154.8303864	57.53177546	20	100	0.2	0.2	45	225	17.35153151	77.98531175		24.1616366	34.98875463	24.99552025	34.52116443	34.95874116	34.62689439			45	34.98078891																			94.06153521	89.30077638	33.18232508	20	83.6499842	0.115353037	0.115353037	25.9544333	129.7721665	17.35153151	44.97921271		24.1616366	20.18029551	24.99552025	34.52116443	34.49128572	34.62689439			45	34.98078891																			8.4671	0.307497182	2.198289468	3.360269151	0.904237473	1.105785031	2.839276416	0.594885164	4.602665312	6.337472955	3.831066418	0	0.009035686	0.551030018	7.231813366	13.18001966	0.609817749	2.027950304	0	0	4.557865917	3.089717244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8058	0	18.1615	8.4671	0.307497182	2.198289468	3.360269151	0.904237473	1.105785031	2.839276416	0.594885164	4.602665312	6.337472955	3.831066418	0	0.009035686	0.551030018	7.231813366	13.18001966	0.609817749	2.027950304	0	0	4.557865917	3.089717244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8058																																																																																		0	0	0	8.4671	0.307497182	2.198289468	3.360269151	0.904237473	1.105785031	2.839276416	0.594885164	4.602665312	6.337472955	3.831066418	0	0.009035686	0.551030018	7.231813366	13.18001966	0.609817749	2.027950304	0	0	4.557865917	3.089717244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.8058
H6923_002_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	V	P	P	V	P	V	V	V	V	V	V	P	S	P	T	P	P	O	P	O	O	O																																																			0		1063.265704	40.67289834	782.5233073	1984.555667	127.683816	9.433970867	24.22319913	270.7327556	418.9353974	4314.172656	1006.067334		4.417270614	322.5276503	3417.466338	4509.722695	208.8381769	691.7720037			1196.37753	1043.297948																			$150/day 1-7	$150/day 1-7	"$0/day 1-8, $75/day 9-14, $100/day 15-100"	No Cost Sharing	$100/trip	20% Coinsurance	20% Coinsurance	"$50/visit ER, $25/visit Urgent Care"	$150/visit	No Cost Sharing	"$25/proc X-Rays and therapeutic radiology, $125/proc diag radiology"	No Cost Sharing	$25/proc	No Cost Sharing	$10/visit	$25/visit	$25/visit	$25/visit	$25/visit	No Cost Sharing	$45/script	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$125 every 2 years	No Cost Sharing	$500 every 3 years	No Cost Sharing	No Cost Sharing											108.723085	103.2202576	57.53177546	20	100	0.2	0.2	45	150	17.34813128	41.10346093		24.1616366	25	9.9982081	25	25	25			45	24.98627779																			62.24377339	59.0934145	32.93683946	20	83.48514706	0.114499645	0.114499645	25.76242022	85.87473408	14.31245568	33.62635097		24.1616366	14.31245568	9.9982081	25	24.66273699	25			45	24.98627779																			5.5151	0.200291703	2.147820379	3.307592779	0.888308513	1.080186319	2.773547711	0.581227585	2.997997154	5.145533745	2.819197772	0	0.008894041	0.384680225	2.847378301	9.395255616	0.429210086	1.441191674	0	0	4.486415736	2.172344363	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.6222	0	13.6092	5.5151	0.200291703	2.147820379	3.307592779	0.888308513	1.080186319	2.773547711	0.581227585	2.997997154	5.145533745	2.819197772	0	0.008894041	0.384680225	2.847378301	9.395255616	0.429210086	1.441191674	0	0	4.486415736	2.172344363	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.6222																																																																																		0	0	0	5.5151	0.200291703	2.147820379	3.307592779	0.888308513	1.080186319	2.773547711	0.581227585	2.997997154	5.145533745	2.819197772	0	0.008894041	0.384680225	2.847378301	9.395255616	0.429210086	1.441191674	0	0	4.486415736	2.172344363	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.6222
H6923_003_0	2009	5																					2500											D	D	D	V	T	Coin	Coin	V	V	P	P	V	P	V	V	V	V	V	V	P	S	P	T	P	P	O	P	O	O	O																																																			0				844.8368337		137.8514734	10.18749663	26.15799465	292.2916185	452.2958631		1086.182013		4.769024621	348.2110198		4868.838803	225.46828	746.8588652			1291.6469	1125.958052																			No Cost Sharing	No Cost Sharing	"$0/day 1-8, $75/day 9-14, $100/day 15-100"	No Cost Sharing	$100/trip	20% Coinsurance	20% Coinsurance	"$50/visit ER, $25/visit Urgent Care"	$150/visit	No Cost Sharing	"$20/proc X-Rays and therapeutic radiology, $125/proc diag radiology"	No Cost Sharing	$20/proc	No Cost Sharing	No Cost Sharing	$20/visit	$20/visit	$20/visit	$20/visit	No Cost Sharing	$45/script	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$125 every 2 years	No Cost Sharing	$500 every 3 years	No Cost Sharing	No Cost Sharing													57.53177546		100	0.2	0.2	45	150		37.79577229		19.32930928	20		20	20	20			45	19.99646613																					33.41520436		83.80635651	0.116162604	0.116162604	26.13658598	87.12195328		32.19038525		19.32930928	11.61626044		20	19.73543733	20			45	19.99646613																			0	0	2.352532954	0	0.96273581	1.183406141	3.038580784	0.636625418	3.283741588	0	2.91371812	0	0.007681829	0.337075824	0	8.114731339	0.370809593	1.244764775	0	0	4.843675875	1.87626517	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.1663	0	8.5161	0	0	2.352532954	0	0.96273581	1.183406141	3.038580784	0.636625418	3.283741588	0	2.91371812	0	0.007681829	0.337075824	0	8.114731339	0.370809593	1.244764775	0	0	4.843675875	1.87626517	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.1663																																																																																		0	0	0	0	0	2.352532954	0	0.96273581	1.183406141	3.038580784	0.636625418	3.283741588	0	2.91371812	0	0.007681829	0.337075824	0	8.114731339	0.370809593	1.244764775	0	0	4.843675875	1.87626517	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.1663
H6923_004_0	2009	4																					5000											D	D	D	V	T	Coin	Coin	V	V	P	P	V	P	V	V	V	V	V	V	P	S	P	T	P	P	O	P	O	O	O																																																			0		1074.70265	41.11039363	790.9404664	2005.902406	129.0572384	9.5381719	24.49075161	273.6448742	423.4416477	4360.577763	1016.889029		0.149724483	325.9968971	3454.226083	4558.231223	211.0845307	699.2130025			1209.246284	1054.43336																			$100/day 1-5	$100/day 1-5	"$0/day 1-8, $75/day 9-14, $100/day 15-100"	No Cost Sharing	$100/trip	20% Coinsurance	20% Coinsurance	"$50/visit ER, $25/visit Urgent Care"	$150/visit	No Cost Sharing	"$25/proc X-Rays and therapeutic radiology, $125/proc diag radiology"	No Cost Sharing	$25/proc	No Cost Sharing	$10/visit	$25/visit	$25/visit	$25/visit	$25/visit	No Cost Sharing	$45/script	No Cost Sharing	No Cost Sharing	No Cost Sharing	No Cost Sharing	$125 every 2 years	No Cost Sharing	$500 every 3 years	No Cost Sharing	No Cost Sharing											144.9641133	137.6270102	57.53177546	20	100	0.2	0.2	47	200	17.35308925	47.73685696			35	24.99552025	35	32.96877319	34.62689439			45	34.9836669																			84.423113	80.15018593	33.50492389	20	83.86660082	0.1164745	0.1164745	27.37150748	116.4744999	17.35308925	38.0510972			20.38303749	24.99552025	35	32.50751094	34.62689439			45	34.9836669																			7.5608	0.274583808	2.208366677	3.343170677	0.901965991	1.110953802	2.852548047	0.624172727	4.110012847	6.305791259	3.224478607	0	0	0.553733915	7.195014834	13.29484107	0.571819391	2.017631233	0	0	4.534673563	3.073995453	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.7586	0	14.8393	7.5608	0.274583808	2.208366677	3.343170677	0.901965991	1.110953802	2.852548047	0.624172727	4.110012847	6.305791259	3.224478607	0	0	0.553733915	7.195014834	13.29484107	0.571819391	2.017631233	0	0	4.534673563	3.073995453	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.7586																																																																																		0	0	0	7.5608	0.274583808	2.208366677	3.343170677	0.901965991	1.110953802	2.852548047	0.624172727	4.110012847	6.305791259	3.224478607	0	0	0.553733915	7.195014834	13.29484107	0.571819391	2.017631233	0	0	4.534673563	3.073995453	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.7586
H6923_801_0	2009	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																																																			0		247.2068865	3.514526303	37.19975812		7.025675296	9.714690027	24.94398957	14.12275145	40.92235361	6.422489351	18.74066701	5.615474982	0.033293307	27.5281568	37.26035831	56.31513726	1.733589143	6.256055841	27.2587187	63.17450889	32.29680227	7.617832289																			Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing											0.072985663	0.072985663	0.158629117		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.072985663	0.072985663	0.158629117		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			18.0426	0.256510033	5.90096479	0	1.622930993	2.244093396	5.762061591	3.262355586	9.453063685	1.48359504	4.329094079	1.297174721	0.007690754	6.359004221	8.60714277	13.00879671	0.400459092	1.445148899	6.296764019	14.59331155	7.460561324	1.759719259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.593	0	0	18.0426	0.256510033	5.90096479	0	1.622930993	2.244093396	5.762061591	3.262355586	9.453063685	1.48359504	4.329094079	1.297174721	0.007690754	6.359004221	8.60714277	13.00879671	0.400459092	1.445148899	6.296764019	14.59331155	7.460561324	1.759719259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.593																																																																																		0	0	0	18.0426	0.256510033	5.90096479	0	1.622930993	2.244093396	5.762061591	3.262355586	9.453063685	1.48359504	4.329094079	1.297174721	0.007690754	6.359004221	8.60714277	13.00879671	0.400459092	1.445148899	6.296764019	14.59331155	7.460561324	1.759719259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.593
H6923_802_0	2009	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																																																			0		247.2068865	3.514526303	37.19975812		7.025675296	9.714690027	24.94398957	14.12275145	40.92235361	6.422489351	18.74066701	5.615474982	0.033293307	27.5281568	37.26035831	56.31513726	1.733589143	6.256055841	27.2587187	63.17450889	32.29680227	7.617832289																			Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing											0.072985663	0.072985663	0.158629117		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.072985663	0.072985663	0.158629117		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			18.0426	0.256510033	5.90096479	0	1.622930993	2.244093396	5.762061591	3.262355586	9.453063685	1.48359504	4.329094079	1.297174721	0.007690754	6.359004221	8.60714277	13.00879671	0.400459092	1.445148899	6.296764019	14.59331155	7.460561324	1.759719259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.593	0	0	18.0426	0.256510033	5.90096479	0	1.622930993	2.244093396	5.762061591	3.262355586	9.453063685	1.48359504	4.329094079	1.297174721	0.007690754	6.359004221	8.60714277	13.00879671	0.400459092	1.445148899	6.296764019	14.59331155	7.460561324	1.759719259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.593																																																																																		0	0	0	18.0426	0.256510033	5.90096479	0	1.622930993	2.244093396	5.762061591	3.262355586	9.453063685	1.48359504	4.329094079	1.297174721	0.007690754	6.359004221	8.60714277	13.00879671	0.400459092	1.445148899	6.296764019	14.59331155	7.460561324	1.759719259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.593
H6934_001_0	2009	6																																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																																																			0				1560.908754					407.3071763																																			"$0 Copay Days 1-20, $75 Copay Days 21-100"					$25 ER Copay																																			31.66902157					25																																			31.66902157					25																																	0	0	4.119371084	0	0	0	0	0.848556617	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.9679	0	0	0	0	4.119371084	0	0	0	0	0.848556617	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.9679																																																																																		0	0	0	0	0	4.119371084	0	0	0	0	0.848556617	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.9679
H6934_002_0	2009	9																					2250											D	D	D	V	T	Coin	Coin	V	V	P	P	O	O	V	V	V	V	V	V	V	Coin	V	T	V	V	P			O	O																																																			0		1606.646627	87.20013965	587.637059		180.4478465	13.27420072	10.53303862	288.2886454	393.2125531	3191.044987	958.1446247			333.5558921	3515.058235	4397.19973	287.0184628	316.1250482				897.9042464		203	0.443414796																$150 for Days 1-10; $0 for Days 11-90	$100 for Days 1-10; $0 for Days 11-90	$75 for Days 21-100; 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 & Partial Hospitalization	$15/Visit	$30/Visit	$30/Visit	$30/Visit	$20/Visit	$30/Visit	No Cost Sharing	$20 Eye Exam	No Cost Sharing	"$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	No Cost Sharing											94.23347724	67.29738379	31.66902157		100	0.2	0.2	46	150	13.31052122	26.63991051			30	15.00151873	29.97858754	29.92110411	29.3504433				29.98740219		30	20																92.07865151	65.75850252	31.66902157		100	0.2	0.2	46	150	13.31052122	26.63991051			30	15.00151873	29.97858754	29.92110411	29.3504433				29.98740219		30	20																12.3282	0.477845884	1.550824225	0	1.503732054	2.654840143	2.106607725	1.105106474	4.915156914	3.539539334	2.127073921	0	0	0.83388973	4.394267663	10.98515309	0.715659109	0.773200858	0	0	0	2.24381798	0	0.5075	0.000739025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.7631	0	0.2997	12.3282	0.477845884	1.550824225	0	1.503732054	2.654840143	2.106607725	1.105106474	4.915156914	3.539539334	2.127073921	0	0	0.83388973	4.394267663	10.98515309	0.715659109	0.773200858	0	0	0	2.24381798	0	0.5075	0.000739025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.7631																																																																																		0	0	0	12.3282	0.477845884	1.550824225	0	1.503732054	2.654840143	2.106607725	1.105106474	4.915156914	3.539539334	2.127073921	0	0	0.83388973	4.394267663	10.98515309	0.715659109	0.773200858	0	0	0	2.24381798	0	0.5075	0.000739025	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.7631
H6952_001_0	2009	5																																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																																																			0		2986.917178	354.9906553	1909.493761		18.27022542	32.04536405	25.39437474	764.4235718	43.12208959	22.75731717	52.35912281	3.096086364	4.056552331	47.69145394	81.95041697	132.3077919	8.439911389	10.69646638			22.91238932	6.324325318																			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 (10b)	"$0 n/c (16a, 16b1-16b3, 16b5-16b8)"	$0 (17a)	$0 (17b1-17b5)	$0 n/c (18a)	$0 n/c (18b)	$0 (14a)	$0 (13c)											123.9579285	52.99933278	75.27109356		0.22869	0.22869	0.22869	63.37134597	0.22869	0.22869	0.22869	0.22869	0.22869	0.22869	0.22608144	0.22869	0.22869	0.22869			0.22869	0.22869																			123.9579285	52.99933278	75.27109356		0.22869	0.22869	0.22869	63.37134597	0.22869	0.22869	0.22869	0.22869	0.22869	0.22869	0.22608144	0.22869	0.22869	0.22869			0.22869	0.22869																			30.8543	1.567855656	11.97747363	0	4.178217851	7.328454304	5.80743956	4.03687922	9.861590668	5.204370865	11.9740078	0.708043991	0.927692953	10.9065586	18.52746825	30.25746893	1.930123336	2.446174896	0	0	5.239834313	1.446309957	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	165.1803	135	0	30.8543	1.567855656	11.97747363	0	4.178217851	7.328454304	5.80743956	4.03687922	9.861590668	5.204370865	11.9740078	0.708043991	0.927692953	10.9065586	18.52746825	30.25746893	1.930123336	2.446174896	0	0	5.239834313	1.446309957	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	165.1803																																																																																		0	0	0	30.8543	1.567855656	11.97747363	0	4.178217851	7.328454304	5.80743956	4.03687922	9.861590668	5.204370865	11.9740078	0.708043991	0.927692953	10.9065586	18.52746825	30.25746893	1.930123336	2.446174896	0	0	5.239834313	1.446309957	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	165.1803
H7002_001_0	2009	5	r.	s.	t.	u.	v.						Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered	Other Non-Covered																	A	A	D	V	T	Coin	Coin	V	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						0		288.384325	9.291693	560.25755	800.73497	159.266935	11.953575	4.31683	360.249851	390.499214	690.393225	1024.692087	0	21.339845	783.880893	3836.542112	4624.612452	31.547232	996.784362			27.017107			6.43	2.47		0.77		2.73	0.09	0.06	0.65	0.05	1.23	2.7						$0/Admit:1a	$0/Admit:1b	"$0/Day(Days 1-20) $50(Days 21-100):2. $0 SNF 1,2. $50 SNF 2"	$0/Visit:6	$50/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0/Visit:9a, 9b"	"$0/Visit:8, 8a"	"$0-$50/Visit:14h. $0 DMAM -- OP,8b. $0 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $50 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $0 Radiology OP -- Facility"	$0/Visit:9a	"$0-$20/Proc:12. $0 Dialysis -- Dialysis Center,12. $20 Dialysis -- OP Hosp"	"$0-$50/Visit:9d. $5 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $0 OP Other,5. $20 Partial Hospitalization,8b. $5 Rad therapy,3. $5 Therapy (AT,PT,ST,OT) -- CORF"	$0/Visit:7a	"$20/Visit:7b, 7d, 7f"	"$0-$20/Visit:7h. $0 Psych -- OP,7e. $20 Psych -- Other Provider"	"$5-$20/Visit:9a. $5 Therapy (AT,PT,ST,OT) -- OP,7d. $20 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			DEN 750	VIS 743		HER 831		Silver Sneakers	Meals on Wheels	Other Added Benefit	Personal Health Coach	Other Added Benefit	Other Added Benefit	Other Added Benefit						0	0	16.848758	0	49.999982	0.2	0.2	49.999998	0	0	19.87249	0	0.313216	10.727303	0	19.999998	3.121795	16.763786			0.199999			0	0		0		0	0	0	0	0	0	0						0	0	16.848758	0	49.999982	0.2	0.2	49.999998	0	0	19.87249	0	0.313216	10.727303	0	19.999998	3.121795	16.763786			0.199999			0	0		0		0	0	0	0	0	0	0						0	0	0.78663699	0	0.66361199	2.390715	0.863366	1.501040986	0	0	1.696931938	0	0.000556998	0.700743988	0	7.707686649	0.008206999	1.392489978	0	0	5.403394383	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.1154	0	0	0	0	0.78663699	0	0.66361199	2.390715	0.863366	1.501040986	0	0	1.696931938	0	0.000556998	0.700743988	0	7.707686649	0.008206999	1.392489978	0	0	5.403394383	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.1154		30% Coins:1a	30% Coins:1b	"30% Coins(Days 1-20) 30%(Days 21-100):2. 30% SNF 1,2. 30% SNF 2"	30% Coins:6	$50/Trip:10a	40% Coins:11a	40% Coins:11b	$50/Visit:4a	"30% Coins:9a, 9b"	"30% Coins:8, 8a"	"30% Coins:14h. 30% DMAM -- OP,8b. 30% Radiology -- FSR,14h. 30% SMAM -- FSR,14h. 30% SMAM -- OP,8b. 30% Advanced Imaging -- FSR,8b. 30% Advanced Imaging -- Office,9a. 30% Advanced Imaging -- OP,8a. 30% Radiology OP -- Physician,8a. 30% Radiology OP -- Facility"		"$0-$20/Proc:12. $0 Dialysis -- Dialysis Center,12. $20 Dialysis -- OP Hosp"	"30% Coins:9d. 30% Cardiac Rehab,8b. 30% Nuclear Medicine,9a. 30% OP Other,5. 30% Partial Hospitalization,8b. 30% Rad therapy,3. 30% Therapy (AT,PT,ST,OT) -- CORF"	30% Coins:7a	"30% Coins:7b, 7d, 7f"	"30% Coins:7h. 30% Psych -- OP,7e. 30% Psych -- Other Provider"	"30% Coins:9a. 30% Therapy (AT,PT,ST,OT) -- OP,7d. 30% Therapy (AT,PT,ST,OT) - Specialist"			30% Coins:15			DEN 750	VIS 743		HER 831		Silver Sneakers	Meals on Wheels	Other Added Benefit	Personal Health Coach	Other Added Benefit	Other Added Benefit	Other Added Benefit						9.455	0.1353	0.5927	0.8992	0.482	3.3026	1.1927	0.2886	4.2806	0.5514	2.2937		0.0001	1.2956	2.5976	5.9307	0.0375	0.5008			1.7703			0	0		0		0	0	0	0	0	0	0						35.6064	500	0	9.455	0.135309	1.37932499	0.89917	1.14560899	5.693344	2.056055	1.789634986	4.280551	0.551434	3.990638938	0	0.000663998	1.996313988	2.597648	13.63842165	0.045686999	1.893266978	0	0	7.173667383	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.7218
H7015_001_0	2009	10																																D	D	D	V	T	Coin	Coin	V	Coin	Coin	P	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		1491.642743	42.57057528	1070.518843	0	120.6179003	9.233420927	0.469332812	222.6856499	37.03348372	4.578926483	334.3321687	0	9.921437953	508.8317969	4432.300629	4995.651566	1.703895818	594.5873343	545.6189186	2119.562673	1067.823516	0	0	4210.507032	0	0	80.41055759	0	0	0											"$150 copay, days 1-8"	"$150 copay, days 1-8"	"$50 copay, days 1-30"	$0 copay	$50 copay	10% coins	10% coins	$50 copay ER; $30 copay Urgent Care	20% coins	$0 copay	$30 copay Diagnositc Radiology	$0 copay	20% coins	20% coins Cardiovasular; $30 PT/OT/ST	$10 copay PCP; $0 copay Physical Exams; $0 copay Immunizations	$30 copay	50% coins	$30 copay	$30 copay Diagnositc Radiology	20% coins OP Surgery	"20% coins, up to $2,000"	$0 copay	$0 copay	$0 copay Preventive; $0-$150 copay Comprehensive	$0 copay	$0 copay	$30 copay	$0 copay	Not Covered	$0 copay											150	150	50	0	50	0.1	0.1	47.01136041	0.2	0	30	0	0.2	54.87848762	10	30	0.5	30	30	37.64039203	52.26127306	0	0	10.41645102	0	0	30	0	0	0											150	150	50	0	50	0.1	0.1	47.01136041	0.2	0	30	0	0.2	54.87848762	10	30	0.5	30	30	37.64039203	52.26127306	0	0	10.41645102	0	0	30	0	0	0											18.6455	0.532132191	4.460495178	0	0.502574584	0.923342093	0.046933281	0.872396279	7.406696744	0	0.835830422	0	1.984287591	2.326993289	3.693583858	12.48912891	0.851947909	1.486468336	1.364047297	6.64843083	4.650484694	0	0	3.654878354	0	0	0.201026394	0	0	0	0	0	0	0	0	0	0	0	0	0	73.5772	0	0	18.6455	0.532132191	4.460495178	0	0.502574584	0.923342093	0.046933281	0.872396279	7.406696744	0	0.835830422	0	1.984287591	2.326993289	3.693583858	12.48912891	0.851947909	1.486468336	1.364047297	6.64843083	4.650484694	0	0	3.654878354	0	0	0.201026394	0	0	0	0	0	0	0	0	0	0	0	0	0	73.5772																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.6455	0.532132191	4.460495178	0	0.502574584	0.923342093	0.046933281	0.872396279	7.406696744	0	0.835830422	0	1.984287591	2.326993289	3.693583858	12.48912891	0.851947909	1.486468336	1.364047297	6.64843083	4.650484694	0	0	3.654878354	0	0	0.201026394	0	0	0	0	0	0	0	0	0	0	0	0	0	73.5772
H7015_002_0	2009	8																																D	D	D	V	T	Coin	Coin	V	Coin	Coin	P	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		1536.616891	43.85411008	1084.62843	0	123.8994625	9.484681482	0.482104332	230.7122388	38.42250319	4.751453611	346.9253023	0	10.29757077	527.9035225	4552.768454	5131.456099	1.750222941	610.7617091	560.4221493	2177.10321	1098.50861	0	0	4093.548503	0	0	82.59607832	0	0	0											"$150 copay, days 1-8"	"$150 copay, days 1-8"	"$50 copay, days 1-30"	$0 copay	$50 copay	10% coins	10% coins	$50 copay ER; $30 copay Urgent Care	20% coins	$0 copay	$30 copay Diagnositc Radiology	$0 copay	20% coins	20% coins Cardiovasular; $30 PT/OT/ST	$10 copay PCP; $0 copay Physical Exams; $0 copay Immunizations	$30 copay	50% coins	$30 copay	$30 copay Diagnositc Radiology	20% coins OP Surgery	"20% coins, up to $2,000"	$0 copay	$0 copay	$0 copay Preventive; $0-$250 copay Comprehensive	$10 copay	$0 copay	$30 copay	$0 copay	Not Covered	$0 copay											150	150	50	0	50	0.1	0.1	47.03693283	0.2	0	30	0	0.2	54.88055777	10	30	0.5	30	30	37.6402696	52.30918715	0	0	16.93697848	0	0	30	0	0	0											150	150	50	0	50	0.1	0.1	47.03693283	0.2	0	30	0	0.2	54.88055777	10	30	0.5	30	30	37.6402696	52.30918715	0	0	16.93697848	0	0	30	0	0	0											19.2077	0.548176376	4.519285124	0	0.516247761	0.948468148	0.048210433	0.904333007	7.684500638	0	0.867313256	0	2.059514154	2.414303313	3.793973711	12.82864025	0.875111471	1.526904273	1.401055373	6.828895979	4.788507706	0	0	5.777695242	0	0	0.206490196	0	0	0	0	0	0	0	0	0	0	0	0	0	77.7453	0	0	19.2077	0.548176376	4.519285124	0	0.516247761	0.948468148	0.048210433	0.904333007	7.684500638	0	0.867313256	0	2.059514154	2.414303313	3.793973711	12.82864025	0.875111471	1.526904273	1.401055373	6.828895979	4.788507706	0	0	5.777695242	0	0	0.206490196	0	0	0	0	0	0	0	0	0	0	0	0	0	77.7453																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	19.2077	0.548176376	4.519285124	0	0.516247761	0.948468148	0.048210433	0.904333007	7.684500638	0	0.867313256	0	2.059514154	2.414303313	3.793973711	12.82864025	0.875111471	1.526904273	1.401055373	6.828895979	4.788507706	0	0	5.777695242	0	0	0.206490196	0	0	0	0	0	0	0	0	0	0	0	0	0	77.7453
H7015_003_0	2009	6																																D	D	D	V	T	Coin	Coin	V	Coin	Coin	P	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		1350.191409	38.53364038	969.4374358	0	109.1881372	8.358462272	0.424858851	201.5366253	33.51486677	4.143891068	302.5677977	0	8.978868857	460.4865103	4012.292904	4522.260869	1.54243387	538.2441399	493.9151489	1918.71007	966.5975907	0	0	4210.507032	0	0	72.79080022	0	0	0											"$150 copay, days 1-8"	"$150 copay, days 1-8"	"$50 copay, days 1-30"	$0 copay	$50 copay	10% coins	10% coins	$50 copay ER; $30 copay Urgent Care	20% coins	$0 copay	$30 copay Diagnositc Radiology	$0 copay	20% coins	20% coins Cardiovasular; $30 PT/OT/ST	$10 copay PCP; $0 copay Physical Exams; $0 copay Immunizations	$30 copay	50% coins	$30 copay	$30 copay Diagnositc Radiology	20% coins OP Surgery	"20% coins, up to $2,000"	$0 copay	$0 copay	$0 copay Preventive; $0-$150 copay Comprehensive	$0 copay	$0 copay	$30 copay	$0 copay	Not Covered	$0 copay											150	150	50	0	50	0.1	0.1	47.01066068	0.2	0	30	0	0.2	54.87853754	10	30	0.5	30	30	37.64038908	52.25998604	0	0	10.41645102	0	0	30	0	0	0											150	150	50	0	50	0.1	0.1	47.01066068	0.2	0	30	0	0.2	54.87853754	10	30	0.5	30	30	37.64038908	52.25998604	0	0	10.41645102	0	0	30	0	0	0											16.8774	0.481670505	4.039322649	0	0.454950572	0.835846227	0.042485885	0.789530826	6.702973355	0	0.756419494	0	1.795773771	2.105902187	3.34357742	11.30565217	0.771216935	1.34561035	1.234787872	6.018416131	4.209531383	0	0	3.654878354	0	0	0.181977001	0	0	0	0	0	0	0	0	0	0	0	0	0	66.9479	0	0	16.8774	0.481670505	4.039322649	0	0.454950572	0.835846227	0.042485885	0.789530826	6.702973355	0	0.756419494	0	1.795773771	2.105902187	3.34357742	11.30565217	0.771216935	1.34561035	1.234787872	6.018416131	4.209531383	0	0	3.654878354	0	0	0.181977001	0	0	0	0	0	0	0	0	0	0	0	0	0	66.9479																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.8774	0.481670505	4.039322649	0	0.454950572	0.835846227	0.042485885	0.789530826	6.702973355	0	0.756419494	0	1.795773771	2.105902187	3.34357742	11.30565217	0.771216935	1.34561035	1.234787872	6.018416131	4.209531383	0	0	3.654878354	0	0	0.181977001	0	0	0	0	0	0	0	0	0	0	0	0	0	66.9479
H7015_004_0	2009	8																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	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		403.7986978	29.63334268	75.53790059	28.79260637	10.18410548	24.21809389	1.989561561	17.00278797	33.7210962	6.237310564	15.25605561	0	27.56446795	20.63497611	569.4747469	63.89115487	9.138315572	9.855902291	36.69603861	114.3406781	30.13978155	31.83620763	0	4093.548503	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	$0 copay PCP;  $0 copay Physical Exams; Medicare FFS Cost Sharing Immunizations	Medicare FFS Cost Sharing	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 copay	$0 copay Preventive; $0-$250 copay Comprehensive	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	$0 copay											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	3.474273477	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	16.93697848	0	0	0	0	0	0											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	3.474273477	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	16.93697848	0	0	0	0	0	0											24.3894	1.789853898	12.04829514	0	2.352528366	5.594379688	0.459588721	3.927644021	7.789573221	1.44081874	3.524148847	0	6.367392096	4.766679481	0.164875917	14.75885677	2.110950897	2.276713429	8.476784919	26.41269664	6.962289539	7.354163963	0	5.777695242	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.7454	0	0	24.3894	1.789853898	12.04829514	0	2.352528366	5.594379688	0.459588721	3.927644021	7.789573221	1.44081874	3.524148847	0	6.367392096	4.766679481	0.164875917	14.75885677	2.110950897	2.276713429	8.476784919	26.41269664	6.962289539	7.354163963	0	5.777695242	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.7454																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.3894	1.789853898	12.04829514	0	2.352528366	5.594379688	0.459588721	3.927644021	7.789573221	1.44081874	3.524148847	0	6.367392096	4.766679481	0.164875917	14.75885677	2.110950897	2.276713429	8.476784919	26.41269664	6.962289539	7.354163963	0	5.777695242	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	148.7454
H7015_005_0	2009	8																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	P	Coin	Coin	Coin	Coin	Coin	Coin	Coin	T	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		403.7986978	29.63334268	75.53790059	28.79260637	10.18410548	24.21809389	1.989561561	17.00278797	33.7210962	6.237310564	15.25605561	0	27.56446795	20.63497611	569.4747469	63.89115487	9.138315572	9.855902291	36.69603861	114.3406781	30.13978155	31.83620763	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	$0 copay PCP;  $0 copay Physical Exams; Medicare FFS Cost Sharing Immunizations	Medicare FFS Cost Sharing	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 copay	$0 copay	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	$0 copay											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	3.474273477	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0604	0.0604	0.1595	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	3.474273477	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											24.3894	1.789853898	12.04829514	0	2.352528366	5.594379688	0.459588721	3.927644021	7.789573221	1.44081874	3.524148847	0	6.367392096	4.766679481	0.164875917	14.75885677	2.110950897	2.276713429	8.476784919	26.41269664	6.962289539	7.354163963	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.9677	0	0	24.3894	1.789853898	12.04829514	0	2.352528366	5.594379688	0.459588721	3.927644021	7.789573221	1.44081874	3.524148847	0	6.367392096	4.766679481	0.164875917	14.75885677	2.110950897	2.276713429	8.476784919	26.41269664	6.962289539	7.354163963	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.9677																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	24.3894	1.789853898	12.04829514	0	2.352528366	5.594379688	0.459588721	3.927644021	7.789573221	1.44081874	3.524148847	0	6.367392096	4.766679481	0.164875917	14.75885677	2.110950897	2.276713429	8.476784919	26.41269664	6.962289539	7.354163963	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	142.9677
H7086_001_0	2009	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	Coin	Coin	Coin	Coin	Coin	Coin	O											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	271.47	25.38	33.54	36.83	12.18	23.0068	17.57676	5.72	13.94	9.48776	20.14622	6.34	11.32	122.0542	48.34264204	97.1746697	8.86	5.11036	23.38346	32.2706	16.39	5.54	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											0.06710159	0.067105661	0.155198061	0	0.231060524	0.230999705	0.231039737	0.227454423	0.230999946	0.231090281	0.231035586	0.231000015	0.231000003	0.231011266	0.231003893	0.231002668	0.230999261	0.231022373	0.231001216	0.230990386	0.231002142	0.231006392	0	0	0	0	0	0	0	0											0.06710159	0.067105661	0.155198061	0	0.231060524	0.230999705	0.231039737	0.227454423	0.230999946	0.231090281	0.231035586	0.231000015	0.231000003	0.231011266	0.231003893	0.231002668	0.230999261	0.231022373	0.231001216	0.230990386	0.231002142	0.231006392	0	0	0	0	0	0	0	0											18.2161	1.703141664	5.205342964	0	2.814317188	5.314564006	4.06093001	1.301039298	3.220139244	2.192529123	4.65449374	1.464540093	2.614920035	28.19589525	11.16733852	22.44760799	2.046653451	1.180607493	5.401607695	7.454198352	3.786125105	1.279775411	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.7218	0	0	18.2161	1.703141664	5.205342964	0	2.814317188	5.314564006	4.06093001	1.301039298	3.220139244	2.192529123	4.65449374	1.464540093	2.614920035	28.19589525	11.16733852	22.44760799	2.046653451	1.180607493	5.401607695	7.454198352	3.786125105	1.279775411	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.7218	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.2161	1.703141664	5.205342964	0	2.814317188	5.314564006	4.06093001	1.301039298	3.220139244	2.192529123	4.65449374	1.464540093	2.614920035	28.19589525	11.16733852	22.44760799	2.046653451	1.180607493	5.401607695	7.454198352	3.786125105	1.279775411	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.7218
H7146_001_0	2009	3																					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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	47.41958373	0	0	0	0	0	0	0	0	110.2116801	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	4A - $50 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	7E & 7H & 9C- $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	0	0	0	0	0	0	50	0	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	50	0	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	0.197581599	0	0	0	0	0	0	0	0	0.1377646	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.3353			0	0	0	0	0	0	0	0.197581599	0	0	0	0	0	0	0	0	0.1377646	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.3353	0	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			0	0	0	0	0	0	0	0.197581599	0	0	0	0	0	0	0	0	0.1377646	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.3353
H7146_002_0	2009	4																					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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	180.3037597	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 copay	$0 copay	$0 copay	$0 copay	$0 copay	4A - $50 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 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	0	0	0	0	0	0	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	0	0	0	0											0	0	0	0	0	0	0	0.751265666	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7513			0	0	0	0	0	0	0	0.751265666	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7513	0	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			0	0	0	0	0	0	0	0.751265666	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.7513
H7149_001_0	2009	10																					3300											D	D	D	COIN	T	COIN	COIN	V	V	O	O	O	COIN	O	P	P	P	P	P	P	COIN	V	T	V	V	V	V	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	1400.490938	47.0314121	552.6190922	12.4003074	250.9985436	0	18.38781131	453.9919013	899.7543421	0	2860.423293	78.86566261	0.019772792	1051.313572	9071.19755	24873.99049	208.193672	2804.087047	0	28097.21332	5.31363244	0	0	0	173.1709557	0	0	0	0	0											1a $225 days 1-10	1b $225 days 1-10	2a $100 days 4-26	6a 20%	10a $150	11a 20%	11b 20%; 11c 20%	4a $50	9a $175; 9b $175	8a $0	8b $30 Therapeutic $150 Diagnostic	9a $175	12 20%	3 $30; 4b $50; 5 $100; 9d $35; 13a $0; 14b $0	7a $10; 14d - j $0	7b $25; 7d $30; 7f $25; 7g $30; 14c $10; 14d - j $0; 17a $30	7e $30; 7h $30; 9c $30	7c $30; 7i $30	14h $0	7g $30	15 20%			16a  50%; 16b $30	17a $30	17b $0	18a $30	18b $0	14a $0	14b $0											200.3704589	200.3704589	63.7755102	0.2	105.7377049	0	0.2	50	56.25342988	0	54.63258211	131.25	0.2	5.485975212	4.302378428	7.447584321	30	15	0	0.425022009	0.2	0	0	0	29.76284585	0	0	0	0	0											157.5678119	157.5678119	50.1519418	0.157276489	83.15027518	0	0.157276489	39.31912237	44.23670987	0	42.96210363	103.2126962	0.2	4.314074614	4.302378428	7.445519015	29.1962904	13.48776989	0	0.425022009	0.157276489	0	0	0	29.76284585	0	0	0	0	0											18.3894	0.617553058	2.309576712	1.950276816	1.739216498	0	2.891970412	1.487546927	3.316847648	0	10.24081683	0.67832814	0.003954558	0.377953766	3.252310387	15.4333141	0.506540242	3.15174007	0	0.995161171	0.835709457	0	0	0	0.429505038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.6077	0	12.5509	18.3894	0.617553058	2.309576712	1.950276816	1.739216498	0	2.891970412	1.487546927	3.316847648	0	10.24081683	0.67832814	0.003954558	0.377953766	3.252310387	15.4333141	0.506540242	3.15174007	0	0.995161171	0.835709457	0	0	0	0.429505038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.6077	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.3894	0.617553058	2.309576712	1.950276816	1.739216498	0	2.891970412	1.487546927	3.316847648	0	10.24081683	0.67832814	0.003954558	0.377953766	3.252310387	15.4333141	0.506540242	3.15174007	0	0.995161171	0.835709457	0	0	0	0.429505038	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.6077
H7149_002_0	2009	10																					3000											D	D	D	COIN	T	COIN	COIN	V	V	O	O	O	COIN	O	P	P	P	P	P	P	COIN	V	T	V	V	V	V	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	1451.817831	48.75507642	572.8721479	12.85476893	260.1974431	0	19.06171015	470.6303479	932.7296321	0	2965.255561	81.7560272	0.020497449	1089.843389	0	25785.60271	215.8238066	2906.854636	0	29126.95412	5.508372895	0	0	0	179.5175353	0	0	0	0	0											1a $225 days 1-10	1b $225 days 1-10	2a $100 days 4-26	6a 20%	10a $150	11a 20%	11b 20%; 11c 20%	4a $50;	9a $125; 9b $125	8a $0	8b $30 Therapeutic $100 Diagnostic	9a $125	12 20%	3 $30; 4b $50; 5 $100; 9d $35; 13a $0; 14b $0	7a $0; 14d - j $0	7b $20; 7d $25; 7f $20; 7g $25; 14c - j $0; 17a $25	7e $30; 7h $30; 9c $30	7c $30; 7i $30	14h $0	7g $25	15 20%			16a $50 ded; 16b $50 ded 50% - 80%	17a $25	17b $0	18a $25	18b $0	14a $0	14b $0											200.3704589	200.3704589	63.7755102	0.2	105.7377049	0	0.2	37.5	40.18102134	0	36.65667706	93.75	0.2	5.485975212	0	6.103975028	30	15	0	0.351535753	0.246042756	0	0	0	24.70355731	0	0	0	0	0											156.4970266	156.4970266	49.8111237	0.156207684	82.58520994	0	0.156207684	29.28894074	31.38292141	0	28.63027312	73.22235184	0.2	4.28475741	0	6.10228145	29.17618415	13.44993873	0	0.351535753	0.192168845	0	0	0	24.70355731	0	0	0	0	0											18.9338	0.635835374	2.377950452	2.008013682	1.790705039	0	2.977585595	1.148688697	2.439315062	0	7.074673047	0.498864049	0.00409949	0.389142878	0	13.11258376	0.524742927	3.258084728	0	0.853263812	1.058537657	0	0	0	0.369560143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.4554	0	11.9815	18.9338	0.635835374	2.377950452	2.008013682	1.790705039	0	2.977585595	1.148688697	2.439315062	0	7.074673047	0.498864049	0.00409949	0.389142878	0	13.11258376	0.524742927	3.258084728	0	0.853263812	1.058537657	0	0	0	0.369560143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.4554	0																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.9338	0.635835374	2.377950452	2.008013682	1.790705039	0	2.977585595	1.148688697	2.439315062	0	7.074673047	0.498864049	0.00409949	0.389142878	0	13.11258376	0.524742927	3.258084728	0	0.853263812	1.058537657	0	0	0	0.369560143	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.4554
H7149_801_0	2009	8																					0											COIN	COIN	COIN	COIN	COIN	O	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	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	211.3661753	4.049192162	16.31698597	0	6.382705397	0	18.38781131	7.726113308	46.94318467	20.76519867	28.93095276	1.862986915	0.019772792	9.0184303	38.26225773	114.8584677	2.041888659	7.184043723	44.22574699	37.68119695	6.536903836	0	0	0	0	0	0	0	0	0											FFS Medicare  8.0%	FFS Medicare  8.0%	FFS Medicare  16.2%		FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%																			0.079861243	0.079861243	0.162430756	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.079861243	0.079861243	0.162430756	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											16.88	0.32337352	2.650380363	0	1.474404947	0	4.247584412	1.784732174	10.84387566	4.796760893	6.683050087	0.430349977	0.004567515	2.083257399	8.838581536	26.53230604	0.47167628	1.6595141	10.21614756	8.704356496	1.510024786	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.1349	0	0	16.88	0.32337352	2.650380363	0	1.474404947	0	4.247584412	1.784732174	10.84387566	4.796760893	6.683050087	0.430349977	0.004567515	2.083257399	8.838581536	26.53230604	0.47167628	1.6595141	10.21614756	8.704356496	1.510024786	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.1349	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	16.88	0.32337352	2.650380363	0	1.474404947	0	4.247584412	1.784732174	10.84387566	4.796760893	6.683050087	0.430349977	0.004567515	2.083257399	8.838581536	26.53230604	0.47167628	1.6595141	10.21614756	8.704356496	1.510024786	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.1349
H7149_802_0	2009	8																					0											COIN	COIN	COIN	COIN	COIN	O	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	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	211.3661753	4.049192162	16.31698597	0	6.382705397	0	18.38781131	7.726113308	46.94318467	20.76519867	28.93095276	1.862986915	0.019772792	9.0184303	38.26225773	114.8584677	2.041888659	7.184043723	44.22574699	37.68119695	6.536903836	0	0	0	0	0	0	0	0	0											FFS Medicare  8.0%	FFS Medicare  8.0%	FFS Medicare  16.2%		FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%																			0.079861243	0.079861243	0.162430756	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.079861243	0.079861243	0.162430756	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											16.88	0.32337352	2.650380363	0	1.474404947	0	4.247584412	1.784732174	10.84387566	4.796760893	6.683050087	0.430349977	0.004567515	2.083257399	8.838581536	26.53230604	0.47167628	1.6595141	10.21614756	8.704356496	1.510024786	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.1349	0	0	16.88	0.32337352	2.650380363	0	1.474404947	0	4.247584412	1.784732174	10.84387566	4.796760893	6.683050087	0.430349977	0.004567515	2.083257399	8.838581536	26.53230604	0.47167628	1.6595141	10.21614756	8.704356496	1.510024786	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.1349	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	16.88	0.32337352	2.650380363	0	1.474404947	0	4.247584412	1.784732174	10.84387566	4.796760893	6.683050087	0.430349977	0.004567515	2.083257399	8.838581536	26.53230604	0.47167628	1.6595141	10.21614756	8.704356496	1.510024786	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.1349
H7149_803_0	2009	8																					0											COIN	COIN	COIN	COIN	COIN	O	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	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	211.3661753	4.049192162	16.31698597	0	6.382705397	0	18.38781131	7.726113308	46.94318467	20.76519867	28.93095276	1.862986915	0.019772792	9.0184303	38.26225773	114.8584677	2.041888659	7.184043723	44.22574699	37.68119695	6.536903836	0	0	0	0	0	0	0	0	0											FFS Medicare  8.0%	FFS Medicare  8.0%	FFS Medicare  16.2%		FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%																			0.079861243	0.079861243	0.162430756	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.079861243	0.079861243	0.162430756	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											16.88	0.32337352	2.650380363	0	1.474404947	0	4.247584412	1.784732174	10.84387566	4.796760893	6.683050087	0.430349977	0.004567515	2.083257399	8.838581536	26.53230604	0.47167628	1.6595141	10.21614756	8.704356496	1.510024786	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.1349	0	0	16.88	0.32337352	2.650380363	0	1.474404947	0	4.247584412	1.784732174	10.84387566	4.796760893	6.683050087	0.430349977	0.004567515	2.083257399	8.838581536	26.53230604	0.47167628	1.6595141	10.21614756	8.704356496	1.510024786	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.1349	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	16.88	0.32337352	2.650380363	0	1.474404947	0	4.247584412	1.784732174	10.84387566	4.796760893	6.683050087	0.430349977	0.004567515	2.083257399	8.838581536	26.53230604	0.47167628	1.6595141	10.21614756	8.704356496	1.510024786	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.1349
H7179_001_0	2009	8																					3800											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1724.752028	22.04656946	582.9143881	25.44018126	208.7548779	17.11672116	7.186808478	53.87515284	732.1648796	8.068383362	22.0529891	0.876209538	0.078891502	21.62828995	10801.42486	2644.55606	129.2002997	56.41968121	5241.011707	1741.542864	18.23539311	0	0	936	396.8751077	4.598512713	1.952496044	0	0	0											1a (IP Acute): 150 days 1-5	1b (IP Psych): 200 days 1-5	2a (SNF): 25 days 11-100		10a (Ambulance): 110 copay	11a (DME): 20% coin	11b (Medical Supplies): 10% coin	4a (ER): 50 copay	9b (OP Surg): 400 copay; 9b (OP ASC): 150 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 20% coin	9a (OP Other): 15% coin; 9c (OP SA): 50 copay; 3 (CORF): 35 copay; 5 (Partial Hosp): 50 copay; 9d (OP Cardiac Rehab): 35 copay		7b (Chiro): 15 copay; 7d (SPC w/Copay): 25 copay	7h (Psych): 50 copay; 7e (MH Non-Phys): 50 copay	7i (PT/ST): 20 copay; 7c (OT): 20 copay	7g (Prof. Other): 25 copay	7g (Prof. Other): 25 copay	15 (Part B Rx): 20% coin			16b (Comp. Dental): 25 copay	17a1 (Routine Eye Exam): $5 copay	17b1 (Non MCR Covered): 150 allowance	18a (Hearing Exam): 25 copay														85.64043363	101.6680289	14.25690077	0	110	0.2	0.1	50	399.3205662	0	0.150412614	0.15	0.2	0.148234433	0	23.98252587	50	20	25	20.21294291	0.2	0	0	25	5	0	25	0	0	0											75.44436714	89.56377	12.55952136	0	96.9037642	0.176188662	0.088094331	44.04716554	351.7787817	0	0.132504986	0.132141497	0.176188662	0.130586132	0	21.12724574	44.04716554	17.61886622	22.02358277	17.80645685	0.176188662	0	0	22.02358277	5	0	25	0	0	0											10.8436	0.164547823	0.610093809	0	1.685761122	3.015772201	0.633117085	0.197753981	21.46333912	0	2.922131023	0.11578364	0.013899788	2.824354735	0	4.656015479	0.474242249	0.082837568	9.618821261	2.584225655	3.212869517	0	0	1.717839456	0.165364628	0	0.0040677	0	0	0	0	0	0	0	0	0	0	0	0	0	67.0064		9.0328	10.8436	0.164547823	0.610093809	0	1.685761122	3.015772201	0.633117085	0.197753981	21.46333912	0	2.922131023	0.11578364	0.013899788	2.824354735	0	4.656015479	0.474242249	0.082837568	9.618821261	2.584225655	3.212869517	0	0	1.717839456	0.165364628	0	0.0040677	0	0	0	0	0	0	0	0	0	0	0	0	0	67.0064																																																																																		0			10.8436	0.164547823	0.610093809	0	1.685761122	3.015772201	0.633117085	0.197753981	21.46333912	0	2.922131023	0.11578364	0.013899788	2.824354735	0	4.656015479	0.474242249	0.082837568	9.618821261	2.584225655	3.212869517	0	0	1.717839456	0.165364628	0	0.0040677	0	0	0	0	0	0	0	0	0	0	0	0	0	67.0064
H7179_002_0	2009	7																					3000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1724.752028	22.04656946	582.9143881	25.44018126	208.7548779	17.32469412	7.274130218	53.87515284	732.1648796	8.166416484	22.32093911	0.88685573	0.079850056	21.89107974	10801.42486	2644.55606	129.2002997	56.41968121	5241.011707	1741.542864	18.45695826	0	0	936	394.485787	4.570828131	1.952496044	0	0	0											1a (IP Acute): 150 days 1-5	1b (IP Psych): 175 days 1-5	2a (SNF): 20 days 11-100		10a (Ambulance): 100 copay	11a (DME): 10% coin	11b (Medical Supplies): 10% coin	4a (ER): 50 copay	9b (OP Surg): 350 copay; 9b (OP ASC): 100 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 15% coin	9a (OP Other): 15% coin; 9c (OP SA): 25 copay; 3 (CORF): 35 copay; 5 (Partial Hosp): 50 copay; 9d (OP Cardiac Rehab): 25 copay		7b (Chiro): 8 copay; 7d (SPC w/Copay): 25 copay	7h (Psych): 25 copay; 7e (MH Non-Phys): 25 copay	7i (PT/ST): 10 copay; 7c (OT): 10 copay	7g (Prof. Other): 25 copay	7g (Prof. Other): 25 copay	15 (Part B Rx): 20% coin		10b (Transportation): 20 trips/year	16b (Comp. Dental): 25 copay	17a1 (Routine Eye Exam): 5 copay	17b1 (Non MCR Covered): 150 allowance	18a (Hearing Exam): 25 copay														86.15914043	89.49833516	11.47460155	0	100	0.1	0.1	50	349.3205662	0	0.150412614	0.15	0.15	0.147718598	0	23.27029398	25	10	25	20.40099953	0.2	0	0	25	5	0	25	0	0	0											74.44626446	77.33151346	9.914690619	0	86.40553293	0.086405533	0.086405533	43.20276647	301.8322969	0	0.129964821	0.129608299	0.129608299	0.127637042	0	20.10682152	21.60138323	8.640553293	21.60138323	17.62759237	0.172811066	0	0	21.60138323	5	0	25	0	0	0											10.7001	0.142074549	0.481617985	0	1.503131373	1.496949429	0.628525098	0.193962971	18.41591728	0	2.900936856	0.114943863	0.01034923	2.794112662	0	4.431134725	0.232575432	0.040624772	9.434425201	2.558267309	3.189566629	0	0	1.684907892	0.164369078	0	0.0040677	0	0	0	0	0	0	0	0	0	0	0	0	0	61.1226		9.5901	10.7001	0.142074549	0.481617985	0	1.503131373	1.496949429	0.628525098	0.193962971	18.41591728	0	2.900936856	0.114943863	0.01034923	2.794112662	0	4.431134725	0.232575432	0.040624772	9.434425201	2.558267309	3.189566629	0	0	1.684907892	0.164369078	0	0.0040677	0	0	0	0	0	0	0	0	0	0	0	0	0	61.1226																																																																																		0			10.7001	0.142074549	0.481617985	0	1.503131373	1.496949429	0.628525098	0.193962971	18.41591728	0	2.900936856	0.114943863	0.01034923	2.794112662	0	4.431134725	0.232575432	0.040624772	9.434425201	2.558267309	3.189566629	0	0	1.684907892	0.164369078	0	0.0040677	0	0	0	0	0	0	0	0	0	0	0	0	0	61.1226
H7179_003_0	2009	6																																D	D	Coin	V	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		2455.449627	34.43907312	12.08076608	60.55097428	15.38189222	21.72199181	10.8881118	14.83459133	35.04100197	1337.256425	25.38840407	0.230525961	0	28.58141829	12167.54327	2508.974047	246.4721054	70.2636451	5312.540975	1236.373598	14.11875534	0	0	2670.222222	441.1039213	2.841986966	12.81101101	0	0	0											1a (IP Acute): 250 days 1-4;1a1 (Add'l Days): 1a1 $0 coin	1b (IP Psych): $250 days 1-4;1a1 (Add'l Days): 1a1 $0 coin	2a (SNF): MC CS;2a2 (Waiver 3 Day): 0% coin		10a (Ambulance): MC CS	11a (DME): MC CS	11b (Medical Supplies): MC CS	4a (ER): MC CS	9b (OP Surg): MC CS; 9b (OP ASC): 100		8b (OP Therap Rad): MC CS; 8b (OP Diag): MC CS	9a (OP Observation): MC CS	12 (Renal Dialysis): MC CS	9a (OP Other): MC CS; 9c (OP SA): 8 copay; 3 (CORF): MC CS; 5 (Partial Hosp): MC CS; 9d (OP Cardiac Rehab): 8 copay		; 7d (SPC w/Copay): 8 copay	7h (Psych): 8 copay; 7e (MH Non-Phys): 8 copay	7i (PT/ST): 5; 7c (OT): 5	7g (Prof. Other): 8 copay	7g (Prof. Other): 8 copay	15 (Part B Rx): MC CS		10b (Transportation): 20 trips/year	16b (Comp. Dental): 8 copay	17a1 (Routine Eye Exam): $5 copay	17b1 (Non MCR Covered): 150 allowance	18a (Hearing Exam): 8 copay														147.3893897	124.4219938	0.2303	0	0.231	0.231	0.231	0.231	0.230861545	0	0.231	0.231	0	0.229497522	0	7.646763186	8	5	8	8	0.231	0	0	8	5	0	8	0	0	0											147.3893897	124.4219938	0.2303	0	0.231	0.231	0.231	0.231	0.230861545	0	0.231	0.231	0	0.229497522	0	7.646763186	8	5	8	8	0.231	0	0	8	5	0	8	0	0	0											30.1589	0.357081512	2.782200429	0	3.553217103	5.017780109	2.515153827	3.426790597	8.089619851	0	5.86472134	0.053251497	0	6.559364674	0	1.598794198	0.164314737	0.029276519	3.541693983	0.824249065	3.261432484	0	0	1.780148148	0.183793301	0	0.008540674	0	0	0	0	0	0	0	0	0	0	0	0	0	79.7704		0	30.1589	0.357081512	2.782200429	0	3.553217103	5.017780109	2.515153827	3.426790597	8.089619851	0	5.86472134	0.053251497	0	6.559364674	0	1.598794198	0.164314737	0.029276519	3.541693983	0.824249065	3.261432484	0	0	1.780148148	0.183793301	0	0.008540674	0	0	0	0	0	0	0	0	0	0	0	0	0	79.7704																																																																																		0			30.1589	0.357081512	2.782200429	0	3.553217103	5.017780109	2.515153827	3.426790597	8.089619851	0	5.86472134	0.053251497	0	6.559364674	0	1.598794198	0.164314737	0.029276519	3.541693983	0.824249065	3.261432484	0	0	1.780148148	0.183793301	0	0.008540674	0	0	0	0	0	0	0	0	0	0	0	0	0	79.7704
H7179_006_0	2009	5																					3000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1794.260799	22.93506238	606.4062654	26.46543922	215.8432694	17.91296404	7.521127478	55.84832673	758.9803697	8.465510945	23.13844202	0.919336762	0.082774559	22.69283908	11200.50641	2742.264792	133.9738788	58.504226	5434.652001	1805.887859	19.08367485	0	0	936	401.1273734	4.647782868	2.018794166	0	0	0											1a (IP Acute): 140 days 1-5	1b (IP Psych): 175 days 1-5	2a (SNF): 20 days 11-100		10a (Ambulance): 100 copay	11a (DME): 10% coin	11b (Medical Supplies): 10% coin	4a (ER): 50 copay	9b (OP Surg): 350 copay; 9b (OP ASC): 100 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 15% coin	9a (OP Other): 15% coin; 9c (OP SA): 25 copay; 3 (CORF): 35 copay; 5 (Partial Hosp): 50 copay; 9d (OP Cardiac Rehab): 25 copay		7b (Chiro): 8 copay; 7d (SPC w/Copay): 25 copay	7h (Psych): 25 copay; 7e (MH Non-Phys): 25 copay	7i (PT/ST): 10 copay; 7c (OT): 10 copay	7g (Prof. Other): 25 copay	7g (Prof. Other): 25 copay	15 (Part B Rx): 20% coin		10b (Transportation): 20 trips/year	16b (Comp. Dental): 25 copay	17a1 (Routine Eye Exam): 5 copay	17b1 (Non MCR Covered): 150 allowance	18a (Hearing Exam): 25 copay														77.29995294	86.03121415	11.03008119	0	100	0.1	0.1	50	349.3205662	0	0.150412614	0.15	0.15	0.147718598	0	23.27029398	25	10	25	20.40099953	0.2	0	0	25	5	0	25	0	0	0											66.9538404	74.51647721	9.553774191	0	86.61562893	0.086615629	0.086615629	43.30781446	302.5662054	0	0.130280832	0.129923443	0.129923443	0.127947393	0	20.15571148	21.65390723	8.661562893	21.65390723	17.67045405	0.173231258	0	0	21.65390723	5	0	25	0	0	0											10.0111	0.142420004	0.482789044	0	1.557950044	1.551542646	0.651447187	0.201555748	19.13681754	0	3.014495475	0.119443398	0.010754356	2.903489594	0	4.60602483	0.241754829	0.042228169	9.806787522	2.659238203	3.305888999	0	0	1.689004764	0.167136406	0	0.004205821	0	0	0	0	0	0	0	0	0	0	0	0	0	62.306		9.6014	10.0111	0.142420004	0.482789044	0	1.557950044	1.551542646	0.651447187	0.201555748	19.13681754	0	3.014495475	0.119443398	0.010754356	2.903489594	0	4.60602483	0.241754829	0.042228169	9.806787522	2.659238203	3.305888999	0	0	1.689004764	0.167136406	0	0.004205821	0	0	0	0	0	0	0	0	0	0	0	0	0	62.306																																																																																		0			10.0111	0.142420004	0.482789044	0	1.557950044	1.551542646	0.651447187	0.201555748	19.13681754	0	3.014495475	0.119443398	0.010754356	2.903489594	0	4.60602483	0.241754829	0.042228169	9.806787522	2.659238203	3.305888999	0	0	1.689004764	0.167136406	0	0.004205821	0	0	0	0	0	0	0	0	0	0	0	0	0	62.306
H7179_007_0	2009	7																					3300											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1724.752028	22.04656946	582.9143881	25.44018126	208.7548779	17.16982521	7.20910531	53.87515284	732.1648796	8.09341525	22.12140776	0.878927949	0.07913626	21.69539099	10801.42486	2644.55606	129.2002997	56.41968121	5241.011707	1741.542864	18.29196781	0	0	936	396.2608907	4.591395903	1.952496044	0	0	0											1a (IP Acute): 160 days 1-5	1b (IP Psych): 225 days 1-5	2a (SNF): 25 days 11-100		10a (Ambulance): 125 copay	11a (DME): 15% coin	11b (Medical Supplies): 10% coin	4a (ER): 50 copay	9b (OP Surg): 350 copay; 9b (OP ASC): 100 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 15% coin	9a (OP Other): 15% coin; 9c (OP SA): 30 copay; 3 (CORF): 35 copay; 5 (Partial Hosp): 50 copay; 9d (OP Cardiac Rehab): 25 copay		7b (Chiro): 8 copay; 7d (SPC w/Copay): 30 copay	7h (Psych): 30 copay; 7e (MH Non-Phys): 30 copay	7i (PT/ST): 15 copay; 7c (OT): 15 copay	7g (Prof. Other): 25 copay	7g (Prof. Other): 25 copay	15 (Part B Rx): 20% coin		10b (Transportation): 20 trips/year	16b (Comp. Dental): 30 copay	17a1 (Routine Eye Exam): $5 copay	17b1 (Non MCR Covered): 150 allowance	18a (Hearing Exam): 30 copay														91.49139097	114.5538198	14.27899942	0	125	0.15	0.1	50	349.3205662	0	0.150412614	0.15	0.15	0.147761813	0	27.76155691	30	15	25	20.2609615	0.2	0	0	30	5	0	30	0	0	0											79.41574354	99.43423833	12.3943613	0	108.5016616	0.130201994	0.086801329	43.40066464	303.214895	0	0.130560149	0.130201994	0.130201994	0.128259218	0	24.09740043	26.04039879	13.02019939	21.70033232	17.58678391	0.173602659	0	0	26.04039879	5	0	30	0	0	0											11.4144	0.182681987	0.602070961	0	1.887520927	2.235545478	0.625759924	0.194851453	18.50027476	0	2.888174286	0.114438171	0.010303699	2.782633878	0	5.310577193	0.280368944	0.061216292	9.477641312	2.552344835	3.175534242	0	0	2.031151105	0.165108704	0	0.00488124	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4975		9.7814	11.4144	0.182681987	0.602070961	0	1.887520927	2.235545478	0.625759924	0.194851453	18.50027476	0	2.888174286	0.114438171	0.010303699	2.782633878	0	5.310577193	0.280368944	0.061216292	9.477641312	2.552344835	3.175534242	0	0	2.031151105	0.165108704	0	0.00488124	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4975																																																																																		0			11.4144	0.182681987	0.602070961	0	1.887520927	2.235545478	0.625759924	0.194851453	18.50027476	0	2.888174286	0.114438171	0.010303699	2.782633878	0	5.310577193	0.280368944	0.061216292	9.477641312	2.552344835	3.175534242	0	0	2.031151105	0.165108704	0	0.00488124	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4975
H7179_008_0	2009	4																					3000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1794.260799	22.93506238	606.4062654	26.46543922	215.8432694	17.75283646	7.453894612	55.84832673	758.9803697	8.389836046	22.93160285	0.911118627	0.082034621	22.48998324	11200.50641	2742.264792	133.9738788	58.504226	5434.652001	1805.887859	18.91308206	0	0	936	402.9323628	4.66869692	2.018794166	0	0	0											1a (IP Acute): 150 days 1-5	1b (IP Psych): 175 days 1-5	2a (SNF): 20 days 11-100		10a (Ambulance): 100 copay	11a (DME): 10% coin	11b (Medical Supplies): 10% coin	4a (ER): 50 copay	9b (OP Surg): 350 copay; 9b (OP ASC): 100 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 15% coin	9a (OP Other): 15% coin; 9c (OP SA): 25 copay; 3 (CORF): 35 copay; 5 (Partial Hosp): 50 copay; 9d (OP Cardiac Rehab): 25 copay		7b (Chiro): 8 copay; 7d (SPC w/Copay): 25 copay	7h (Psych): 25 copay; 7e (MH Non-Phys): 25 copay	7i (PT/ST): 10 copay; 7c (OT): 10 copay	7g (Prof. Other): 25 copay	7g (Prof. Other): 25 copay	15 (Part B Rx): 20% coin		10b (Transportation): 20 trips/year	16b (Comp. Dental): 25 copay	17a1 (Routine Eye Exam): 5 copay	17b1 (Non MCR Covered): 150 allowance	18a (Hearing Exam): 25 copay														82.45036871	85.64582581	10.98067046	0	100	0.1	0.1	50	349.3205662	0	0.150412614	0.15	0.15	0.147727524	0	23.27029398	25	10	25	20.2609615	0.2	0	0	25	5	0	25	0	0	0											71.26226834	74.02411799	9.490648706	0	86.43050293	0.086430503	0.086430503	43.21525146	301.9195222	0	0.130002379	0.129645754	0.129645754	0.127681642	0	20.11263212	21.60762573	8.643050293	21.60762573	17.51165092	0.172861006	0	0	21.60762573	5	0	25	0	0	0											10.6553	0.14147898	0.47959907	0	1.554620194	1.534386584	0.64424386	0.201124957	19.09591588	0	2.981162926	0.118122662	0.01063544	2.871557979	0	4.596180244	0.241238119	0.042137914	9.785827201	2.635339816	3.269334388	0	0	1.685394807	0.167888485	0	0.004205821	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7157		9.8193	10.6553	0.14147898	0.47959907	0	1.554620194	1.534386584	0.64424386	0.201124957	19.09591588	0	2.981162926	0.118122662	0.01063544	2.871557979	0	4.596180244	0.241238119	0.042137914	9.785827201	2.635339816	3.269334388	0	0	1.685394807	0.167888485	0	0.004205821	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7157																																																																																		0			10.6553	0.14147898	0.47959907	0	1.554620194	1.534386584	0.64424386	0.201124957	19.09591588	0	2.981162926	0.118122662	0.01063544	2.871557979	0	4.596180244	0.241238119	0.042137914	9.785827201	2.635339816	3.269334388	0	0	1.685394807	0.167888485	0	0.004205821	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7157
H7179_009_0	2009	8																					3300											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	V	V	V	V	Coin	Coin	Coin																																																			0		1375.799448	17.58609795	464.978896	20.29311274	166.5195003	13.6804743	5.744029348	53.87515284	584.0329632	6.448624722	17.62576768	0.700307142	0.063053733	16.97100233	8724.217506	2109.508329	103.0604389	45.00482681	4180.647943	1389.193156	14.57456861	0	0	936	396.4859522	4.594003646	0	0	0	0											1a (IP Acute): 160 days 1-5	1b (IP Psych): 225 days 1-5	2a (SNF): 25 days 11-100		10a (Ambulance): 100 copay	11a (DME): 15% coin	11b (Medical Supplies): 10% coin	4a (ER): 50 copay	9b (OP Surg): 310 copay; 9b (OP ASC): 100 copay		8b (OP Therap Rad): 20% coin; 8b (OP Diag): 15% coin	9a (OP Observation): 15% coin	12 (Renal Dialysis): 15% coin	9a (OP Other): 15% coin; 9c (OP SA): 30 copay; 3 (CORF): 35 copay; 5 (Partial Hosp): 50 copay; 9d (OP Cardiac Rehab): 25 copay		7b (Chiro): 8 copay; 7d (SPC w/Copay): 30 copay	7h (Psych): 30 copay; 7e (MH Non-Phys): 30 copay	7i (PT/ST): 15 copay; 7c (OT): 15 copay	7g (Prof. Other): 25 copay	7g (Prof. Other): 25 copay	15 (Part B Rx): 20% coin			16b (Comp. Dental): 30 copay	17a1 (Routine Eye Exam): $5 copay	17b1 (Non MCR Covered): 150 allowance															91.43945674	114.4887944	14.27089408	0	100	0.15	0.1	50	309.4292756	0	0.150412614	0.15	0.15	0.147762986	0	27.76155691	30	15	25	20.24334061	0.2	0	0	30	5	0	0	0	0	0											82.25228627	102.9857944	12.83705861	0	89.95272851	0.134929093	0.089952729	50	278.3400762	0	0.135300251	0.134929093	0.134929093	0.132916838	0	24.97227792	26.98581855	13.49290928	22.48818213	18.20943722	0.179905457	0	0	30	5	0	0	0	0	0											9.4302	0.150926522	0.497413445	0	1.248240284	1.845893986	0.516691112	0.224479803	13.54664829	0	2.384770785	0.094491807	0.008507783	2.255731966	0	4.389935689	0.231764192	0.050603837	7.834597695	2.108035463	2.622044426	0	0	2.34	0.16520248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.9462		4.4107	9.4302	0.150926522	0.497413445	0	1.248240284	1.845893986	0.516691112	0.224479803	13.54664829	0	2.384770785	0.094491807	0.008507783	2.255731966	0	4.389935689	0.231764192	0.050603837	7.834597695	2.108035463	2.622044426	0	0	2.34	0.16520248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	51.9462		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.	20% coins.	20% coins.	20% coins.	20% coins.																				6.2576	0.0571	0.6009	0.1741	0.4196	0.694	0.2914	0.4396	1.3775	0.3271	0.8941	0.0355	0.0032	0.8609	3.9595	2.9782	0.0471	0.2106	2.2549	0.2973	0.7393																				22.9197			15.6878	0.208050742	1.098287393	0.174143439	1.667849573	2.539866758	0.808069897	0.664109147	14.92418363	0.327120967	3.278877422	0.130016459	0.011706325	3.116624161	3.95947447	7.368145719	0.278899891	0.261190641	10.08953155	2.405365863	3.36137214	0	0	2.34	0.16520248	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.8659
H7179_801_0	2009	9																					0											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		265.7474498	1.455078861	15.30557413	4.436719262	10.68836669	17.6770049	7.422055166	8.932672044	35.08883893	8.332486749	22.77485232	0.904890613	0.081473867	22.33625143	99.26977006	75.86152564	1.200649388	5.364106646	57.438099	7.573655821	18.83229449	0																			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																			0.079105229	0.079105229	0.181771175	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.079105229	0.079105229	0.181771175	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			21.022	0.115104347	2.782112194	0	2.469012705	4.083388132	1.714494743	2.063447242	8.105521792	1.924804439	5.260990885	0.209029732	0.018820463	5.15967408	22.93131688	17.52401242	0.277350009	1.239108635	13.26820087	1.749514495	4.350260026	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.2682		0	21.022	0.115104347	2.782112194	0	2.469012705	4.083388132	1.714494743	2.063447242	8.105521792	1.924804439	5.260990885	0.209029732	0.018820463	5.15967408	22.93131688	17.52401242	0.277350009	1.239108635	13.26820087	1.749514495	4.350260026	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.2682																																																																																		0			21.022	0.115104347	2.782112194	0	2.469012705	4.083388132	1.714494743	2.063447242	8.105521792	1.924804439	5.260990885	0.209029732	0.018820463	5.15967408	22.93131688	17.52401242	0.277350009	1.239108635	13.26820087	1.749514495	4.350260026	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.2682
H7187_001_0	2009	4																					800											D	D	D	V	T	P	P	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1656.373663	649.1186199	6052.456497	83.69522856	460.1501155	318.8058914	1192.242897	115.2979912	133.0094296	11339.7195	1652.442475	0	12.15490871	173.4217929	125.745175	7229.257376	4250.443019	28.8680573	0	0	1705.193999	455.5303138	1498.037626	3510.266383	182.0000636	141.3063859	46.85749586	13.66333203	0	0											"$75 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $800 (13c)"	"$75 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0 (11a)	"$0 (11b, 11c)"	$50 (4a); $0 n/c (4a1); $10 (4b)	$25 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$25 (3, 5, 9a); $0 (9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $10 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$0 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$0 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a9, 14a10); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											74.43800548	75	0	0	75	0	0	49.63855422	25	0	0	0	0	23.77608863	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											56.24343161	56.66806013	0	0	56.66806013	0	0	37.50560767	18.88935338	0	0	0	0	17.9645976	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											7.7633	3.065357749	0	0	2.172984535	0	0	0.360360102	0.209371843	0	0	0	0	0.25962106	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.831	0	4.4743	7.7633	3.065357749	0	0	2.172984535	0	0	0.360360102	0.209371843	0	0	0	0	0.25962106	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.831		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $10 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $10 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a9, 14a10); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.0164	0.3245	0.5963	0.0722	0.1982	0.1615	0.1823	0.0251	0.2573	0.6364	0.5954	0	0	0.0809	0.0148	2.0072	0.5516	0.0044	0	0	0.1459	0.0756	0.1107	0	0.0089	0	0.004	0	0	0											9.0696	0	0	10.7798	3.389807749	0.596313264	0.072222394	2.371155582	0.161453592	0.182340571	0.385461969	0.466720422	0.636381167	0.595410273	0	0	0.340504794	0.01482211	2.007181114	0.55155	0.004428145	0	0	0.145914838	0.0755746	0.110719388	0	0.008933819	0	0.003969466	0	0	0	0	0	0	0	0	0	0	0	0	0	22.9006
H7187_002_0	2009	3																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		334.8977521	22.5024	47.8598146	3248.650741	18.16996976	26.12971992	9.816564874	25.58457172	32.37462211	8.096549805	20.2513372	0	1.658123577	35.17487223	38.07687678	116.6457828	13.9175	3.523445256	0	0	16.04923749	5.662489892	352.9685741	0	196.3424327	214.3485762	0	0	20.2	0											"8% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"8% (1b); $0 n/c (1b1, 1b2)"	19.4% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.079204548	0.0802	0.1935	0	0.2	0.2	0.2	0.132170338	0.2	0.08	0.2	0	0.2	0.2	0	0.199681487	0.2	0.2	0	0	0.2	0.012006335	0	0	0	0	0	0	0	0											0.079204548	0.0802	0.1935	0	0.2	0.2	0.2	0.132170338	0.2	0.08	0.2	0	0.2	0.2	0	0.199681487	0.2	0.2	0	0	0.2	0.012006335	0	0	0	0	0	0	0	0											26.5254	1.80469248	9.260874126	0	3.633993952	5.225943985	1.963312975	3.381521482	6.474924422	0.647723984	4.05026744	0	0.331624715	7.034974445	0	23.29200337	2.7835	0.704689051	0	0	3.209847498	0.067985752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.3933	0	0	26.5254	1.80469248	9.260874126	0	3.633993952	5.225943985	1.963312975	3.381521482	6.474924422	0.647723984	4.05026744	0	0.331624715	7.034974445	0	23.29200337	2.7835	0.704689051	0	0	3.209847498	0.067985752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.3933		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											4.1862	0.2813	0.7557	0.6416	0.2869	0.4126	0.155	0.1781	0.5112	0.1278	0.3198	0	0.0175	0.5554	0.6012	1.8418	0.2198	0.0556	0	0	0.2534	0.0683	0.0261	0	0.0155	0	0	0	0.003	0											11.5136	0	0	30.7116	2.08597248	10.01655541	0.641602536	3.920888211	5.63851851	2.118311368	3.559605997	6.986102666	0.775564245	4.370025395	0	0.349078648	7.590367164	0.601213844	25.13377888	3.00325	0.760322397	0	0	3.463256511	0.13632502	0.0261	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	111.9069
H7187_003_0	2009	10																					3200											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	5000	1463.936881	150.6779323	623.698017	679.9328238	99.82375006	9.592741838	3.543309778	283.9111888	29.14146458	8840.444777	33.91361348	0	0.176516696	22.05042721	4157.781227	3267.947239	514.453263	185.0458589	0	0	13.64291624	709.2764743	0	0	103.5923094	0	12.88706159	0	775.2	0											"$195 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$195 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$24 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$5 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$24 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$24 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $24 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$24 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$24 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$0 n/c (13b, 13d, 13e)"											192.7155233	195	85.36789939	0	150	0.2	0.076056143	49.5169532	0.2	2.8	0.176076712	0	0.2	0.197146952	3.579317005	24	37.5	24	0	0	0.2	22.84596616	0	0	24	0	24	0	0	0											136.3757839	137.9735165	60.40261169	0	106.1334743	0.141511299	0.053814018	35.03604186	0.141511299	1.981158186	0.124584221	0	0.141511299	0.139776812	3.579317005	24	37.5	16.98135588	0	0	0.141511299	22.84596616	0	0	24	0	24	0	0	0											16.6371	1.732463682	3.139415761	0	0.882886784	1.357481359	0.190679736	0.828927025	4.123846509	1.459526628	4.225101127	0	0.024979107	3.082138419	1.240168088	6.535894478	1.607666447	0.261860799	0	0	1.930626799	1.350342194	0	0	0.207184619	0	0.025774123	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8441	0	16.4697	16.6371	1.732463682	3.139415761	0	0.882886784	1.357481359	0.190679736	0.828927025	4.123846509	1.459526628	4.225101127	0	0.024979107	3.082138419	1.240168088	6.535894478	1.607666447	0.261860799	0	0	1.930626799	1.350342194	0	0	0.207184619	0	0.025774123	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8441		"$250 Days 1-20 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$250 Days 1-20 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-34 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$10 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$10 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.9161	0.2974	3.6107	0.3785	0.2889	0.6664	0.2462	0.2713	2.0245	0.4777	2.0333	0	0.0082	1.509	1.2578	3.493	0.7809	0.1377	0	0	1.2186	0.7345	0	0	0.111	0	0.0138	0	0	0											22.4754	0	7.128378124	19.5533	2.029839981	6.750124706	0.378458244	1.171836322	2.023892304	0.436834637	1.100216713	6.148313683	1.937197777	6.258401578	0	0.033154222	4.591126354	2.498014193	10.02886211	2.388533007	0.399595052	0	0	3.149198384	2.084848741	0	0	0.318176379	0	0.039581689	0	0	0	0	0	0	0	0	0	0	0	0	0	73.3195
H7187_005_0	2009	3																																Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		346.3516031	22.6752	45.43241021	5097.426158	15.0184123	32.98900749	11.2181059	23.56547992	36.68336344	6.812400022	16.48116211	0	2.74728473	39.0533111	52.91468109	141.8881588	13.376	5.795988937	0	0	24.45464941	7.074825206	352.9685741	0	314.3760437	332.2285714	0	0	20.2	0											"6.7% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"6.7% (1b); $0 n/c (1b1, 1b2)"	15.5% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.0658996	0.0667	0.1553	0	0.2	0.2	0.2	0.116896282	0.2	0.08	0.2	0	0.2	0.2	0	0.199607951	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											0.0658996	0.0667	0.1553	0	0.2	0.2	0.2	0.116896282	0.2	0.08	0.2	0	0.2	0.2	0	0.199607951	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											22.8244	1.51243584	7.055653306	0	3.003682459	6.597801498	2.24362118	2.754716996	7.336672687	0.544992002	3.296232423	0	0.549456946	7.81066222	0	28.32200471	2.6752	1.159197787	0	0	4.890929882	0.105197549	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.6829	0	0	22.8244	1.51243584	7.055653306	0	3.003682459	6.597801498	2.24362118	2.754716996	7.336672687	0.544992002	3.296232423	0	0.549456946	7.81066222	0	28.32200471	2.6752	1.159197787	0	0	4.890929882	0.105197549	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.6829		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											4.3294	0.2834	0.7174	1.0624	0.2371	0.5209	0.1771	0.1451	0.5792	0.1076	0.2602	0	0.0289	0.6166	0.8355	2.2403	0.2112	0.0915	0	0	0.3861	0.0768	0.0261	0	0.0155	0	0	0	0.003	0											12.9514	0	0	27.1538	1.79587584	7.773007151	1.062399219	3.240815285	7.118680564	2.420749168	2.899811801	7.915883689	0.652556213	3.556461298	0	0.578375733	8.427293448	0.835494965	30.56234406	2.8864	1.250713402	0	0	5.277055926	0.181967436	0.0261	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	115.6343
H7187_006_0	2009	3																					3350											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1826.425846	269.6292713	41.22176034	49241.51043	85.30644879	20.59246453	9.104493986	348.611978	365.4904951	5788.166089	442.657682	0	0.799782599	1412.074029	5707.377335	4236.815183	1242.868229	252.6173035	0	0	26.52347355	1069.875664	769.983193	0	119.3840337	149.3972702	0	0	20.2	0											"$225 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$225 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	15.5% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$125 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$125 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5); $125 (9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											222.3	225	0.1553	0	125	0.14	0.2	49.97274907	125	4.4	64.79010385	0	0.2	115.5230067	3.251353121	25	20	20	0	0	0.2	13.6791576	0	0	0	0	0	0	0	0											157.7096809	159.6251831	0.1553	0	88.68065727	0.099322336	0.141889052	35.45292986	88.68065727	3.121559136	45.96503195	0	0.141889052	81.95724928	3.251353121	25	20	20	0	0	0.141889052	13.6791576	0	0	0	0	0	0	0	0											24.0038	3.58663515	6.401739381	0	0.630419329	2.045291684	1.291828017	1.029943001	2.700994778	1.505675228	1.695564541	0	0.113480395	9.644141936	1.546391593	8.826698298	2.071447048	0.421028839	0	0	3.763390508	1.219583152	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.498	0	21.3013	24.0038	3.58663515	6.401739381	0	0.630419329	2.045291684	1.291828017	1.029943001	2.700994778	1.505675228	1.695564541	0	0.113480395	9.644141936	1.546391593	8.826698298	2.071447048	0.421028839	0	0	3.763390508	1.219583152	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.498		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.6851	0.219	0.6509	0.5507	0.1417	0.3251	0.1438	0.0765	0.6434	0.1012	0.2729	0	0.0084	0.5127	0.6989	2.2043	0.1512	0.0757	0	0	0.4188	0.0869	0.0569	0	0.0059	0	0	0	0.003	0											11.0331	0	0	27.6889	3.80563515	7.052609281	0.550692704	0.772163653	2.370435861	1.435583185	1.106461029	3.344408799	1.606870238	1.96845296	0	0.121899159	10.1568818	2.245290616	11.03100587	2.222647048	0.496724958	0	0	4.182182196	1.306491795	0.056935837	0	0.005867124	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	83.5311
H7187_007_0	2009	4																					2400											D	D	D	V	T	Coin	Coin	V	V	V	V	V	O	V	V	V	V	V	V	V	S	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1726.155525	742.7501546	5734.038408	79.29204536	435.9417432	9.177785439	10.36510008	109.2321953	126.0118397	10743.13994	1565.507926	0	11.51544227	167.9494136	120.8276668	6861.805899	5719.660608	27.34931666	0	0	1615.484207	431.564988	1498.037626	0	182.0000636	141.3063859	0	0	0	0											"$175 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $35 (4b)	$35 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$35 (3, 5, 9a, 9d); $35/$25 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $35 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$15 (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"$35/$25 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"$0 (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											173.5179284	175	0	0	75	0.2	0.2	49.86445783	35	0	0	0	0	34.72692608	0	14.4649086	32.5	0	0	0	0	14.12060302	0	0	0	0	0	0	0	0											140.2482564	141.4461612	0	0	60.61978337	0.161652756	0.161652756	40.30363509	28.28923224	0	0	0	0	28.06851648	0	11.69146167	26.2685728	0	0	0	0	11.41317195	0	0	0	0	0	0	0	0											20.1742	8.754929842	0	0	2.202224503	1.483614307	1.675546991	0.366871212	0.29706485	0	0	0	0	0.392840907	0	6.68537839	12.52061009	0	0	0	0	0.410460451	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.9637	0	13.0385	20.1742	8.754929842	0	0	2.202224503	1.483614307	1.675546991	0.366871212	0.29706485	0	0	0	0	0.392840907	0	6.68537839	12.52061009	0	0	0	0	0.410460451	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	54.9637		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); $0 n/c (4a1); $35 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $35 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.9781	0.3713	0.5352	0.0648	0.1779	0.1449	0.1637	0.0239	0.231	0.5712	0.5344	0	0	0.073	0.0131	1.6679	0.7422	0.0037	0	0	0.1211	0.0627	0.1107	0	0.0089	0	0	0	0	0											8.5995	0	0	23.1523	9.126179842	0.535219973	0.064823089	2.380092595	1.628526709	1.839206466	0.390760704	0.528047636	0.571182853	0.534409495	0	0	0.465814805	0.013062526	8.353246786	13.26281009	0.003674232	0	0	0.121072118	0.473168103	0.110719388	0	0.008933819	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.5633
H7187_008_0	2009	3																					3350											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		1732.334229	270.8112079	37.08393563	46704.74532	80.91173342	18.52540073	8.190588324	330.6623922	346.6615939	5489.978287	419.8533742	0	0.719500725	1340.242804	5416.986903	4018.548017	1242.868229	239.6032681	0	0	23.81337699	1014.759092	769.983193	0	314.3760437	332.2285714	0	0	20.2	0											"$225 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$225 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	19.4% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$125 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$125 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5); $125 (9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											222.3	225	0.1935	0	125	0.14	0.2	49.97126979	125	4.4	64.79010385	0	0.2	115.45443	3.249171107	25	20	20	0	0	0.2	13.6791576	0	0	0	0	0	0	0	0											160.7416177	162.6939451	0.1935	0	90.38552504	0.101231788	0.14461684	36.13343566	90.38552504	3.181570481	46.84870043	0	0.14461684	83.48327417	3.249171107	25	20	20	0	0	0.14461684	13.6791576	0	0	0	0	0	0	0	0											23.2049	3.671611982	7.175741544	0	0.609437459	1.87535944	1.184497002	0.995664023	2.611099182	1.455562738	1.639132079	0	0.104051921	9.323988125	1.466726444	8.371975036	2.071447048	0.39933878	0	0	3.443815332	1.156754129	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.7611	0	19.1938	23.2049	3.671611982	7.175741544	0	0.609437459	1.87535944	1.184497002	0.995664023	2.611099182	1.455562738	1.639132079	0	0.104051921	9.323988125	1.466726444	8.371975036	2.071447048	0.39933878	0	0	3.443815332	1.156754129	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.7611		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											3.3152	0.22	0.5855	0.4954	0.1275	0.2925	0.1293	0.0726	0.5788	0.091	0.2455	0	0.0076	0.4614	0.6297	1.983	0.1512	0.0681	0	0	0.376	0.0782	0.0569	0	0.0155	0	0	0	0.003	0											9.9841	0	0	26.5201	3.891571982	7.76127737	0.495414378	0.736953542	2.167865767	1.31382208	1.068245739	3.189927546	1.546599832	1.884628061	0	0.111625613	9.785424981	2.096456254	10.35501504	2.222647048	0.467436551	0	0	3.819816021	1.234938916	0.056935837	0	0.01545	0	0	0	0.003	0	0	0	0	0	0	0	0	0	0	0	80.7451
H7187_009_0	2009	5																					3200											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1473.116063	151.6227135	627.6087303	684.0800466	100.4496653	9.713415863	3.58788363	285.6888867	29.50805611	8895.876163	34.34023731	0	0.178737227	22.32781545	4183.23578	3288.394435	517.6789895	186.2061341	0	0	13.81454033	713.7237819	0	0	103.5923094	0	12.88706159	0	775.2	0											"$195 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$195 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$24 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$5 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$24 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$24 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $24 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$24 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$24 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$0 n/c (13b, 13d, 13e)"											192.7155233	195	85.36789939	0	150	0.2	0.076056143	49.516949	0.2	2.8	0.175882124	0	0.2	0.197133185	3.579843717	24	37.5	24	0	0	0.2	22.8460745	0	0	24	0	24	0	0	0											135.9480829	137.5406022	60.21308866	0	105.8004632	0.141067284	0.053645168	34.92610761	0.141067284	1.97494198	0.124056068	0	0.141067284	0.139329794	3.579843717	24	37.5	16.92807411	0	0	0.141067284	22.8460745	0	0	24	0	24	0	0	0											16.6889	1.73785661	3.149188343	0	0.885635093	1.370245197	0.192472619	0.831500067	4.162621339	1.46406994	4.260114805	0	0.025213975	3.110929926	1.247944194	6.576788869	1.617746842	0.262675936	0	0	1.948779688	1.358815558	0	0	0.207184619	0	0.025774123	0	0	0	0	0	0	0	0	0	0	0	0	0	51.1245	0	16.7359	16.6889	1.73785661	3.149188343	0	0.885635093	1.370245197	0.192472619	0.831500067	4.162621339	1.46406994	4.260114805	0	0.025213975	3.110929926	1.247944194	6.576788869	1.617746842	0.262675936	0	0	1.948779688	1.358815558	0	0	0.207184619	0	0.025774123	0	0	0	0	0	0	0	0	0	0	0	0	0	51.1245		"$250 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$250 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$10 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$10 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											4.1971	0.429	5.224	0.5516	0.4185	0.9713	0.3588	0.393	2.9508	0.6919	2.9607	0	0.0119	2.1957	1.3532	3.5158	0.7858	0.1995	0	0	1.7762	0.7442	0	0	0.111	0	0.0138	0	0	0											29.8538	0	0	20.886	2.166897063	8.373154106	0.551629942	1.304175365	2.341586783	0.551260982	1.22445679	7.11342695	2.15597142	7.220825675	0	0.03712979	5.306662446	2.601169917	10.09257922	2.403509594	0.462182509	0	0	3.724934873	2.102993234	0	0	0.318176379	0	0.039581689	0	0	0	0	0	0	0	0	0	0	0	0	0	80.9783
H7187_801_0	2009	2																					4300											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	4300	1587.289554	163.3741939	676.2513876	717.1492569	108.2349914	10.74041518	3.967230514	307.8004412	32.62794245	9585.348815	37.9710301	0	0.197635111	24.68853505	4499.847349	3535.78573	557.8015698	200.6379938	0	0	15.27515148	769.0407647	0	0	0	0	0	0	0	0											"$425 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$425 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-29 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											419.9457376	425	150	0	150	0.2	0.076056143	49.51690084	0.3	2.8	0.24751409	0	0.2	0.29482937	17.92948549	29.9708072	37.5	30	0	0	0.2	28.55370192	0	0	0	0	0	0	0	0											259.4359162	262.5336704	92.65894248	0	92.65894248	0.123545257	0.046981879	30.58789111	0.185317885	1.729633593	0.152895959	0	0.123545257	0.182483617	17.92948549	29.9708072	37.5	18.5317885	0	0	0.123545257	28.55370192	0	0	0	0	0	0	0	0											34.3167	3.574268898	5.221728202	0	0.835744987	1.32692735	0.186387942	0.784580531	6.046541285	1.381595109	5.805617052	0	0.02441688	4.505253181	6.723328977	8.830862703	1.743129906	0.309848405	0	0	1.887172509	1.829913396	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.334	0	40.9518	34.3167	3.574268898	5.221728202	0	0.835744987	1.32692735	0.186387942	0.784580531	6.046541285	1.381595109	5.805617052	0	0.02441688	4.505253181	6.723328977	8.830862703	1.743129906	0.309848405	0	0	1.887172509	1.829913396	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.334		"$425 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$425 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-29 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											4.5934	0.4713	3.3665	0.3644	0.2694	0.6416	0.237	0.2529	1.9491	0.4454	1.9477	0	0.0079	1.4536	3.0979	3.7847	0.8467	0.1284	0	0	1.1732	0.795	0	0	0	0	0	0	0	0											25.8261	0	11.76167811	38.9101	4.045616542	8.588227652	0.364374976	1.105151487	1.96853967	0.423382875	1.037493918	7.995673557	1.826959076	7.753305873	0	0.032287782	5.958831411	9.821262711	12.61551815	2.589793002	0.438267033	0	0	3.06039835	2.624962898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.1601
H7187_803_0	2009	2																					4300											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	4300	1587.289554	163.3741939	676.2513876	717.1492569	108.2349914	10.74041518	3.967230514	307.8004412	32.62794245	9585.348815	37.9710301	0	0.197635111	24.68853505	4499.847349	3535.78573	557.8015698	200.6379938	0	0	15.27515148	769.0407647	0	0	0	0	0	0	0	0											"$425 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$425 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-29 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											419.9457376	425	150	0	150	0.2	0.076056143	49.51690084	0.3	2.8	0.24751409	0	0.2	0.29482937	17.92948549	29.9708072	37.5	30	0	0	0.2	28.55370192	0	0	0	0	0	0	0	0											259.4359162	262.5336703	92.65894248	0	92.65894248	0.123545257	0.046981879	30.58789111	0.185317885	1.729633593	0.152895959	0	0.123545257	0.182483617	17.92948549	29.9708072	37.5	18.5317885	0	0	0.123545257	28.55370192	0	0	0	0	0	0	0	0											34.3167	3.574268898	5.221728202	0	0.835744987	1.32692735	0.186387942	0.784580531	6.046541285	1.381595109	5.805617052	0	0.02441688	4.505253181	6.723328977	8.830862703	1.743129906	0.309848405	0	0	1.887172509	1.829913396	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.334	0	40.9518	34.3167	3.574268898	5.221728202	0	0.835744987	1.32692735	0.186387942	0.784580531	6.046541285	1.381595109	5.805617052	0	0.02441688	4.505253181	6.723328977	8.830862703	1.743129906	0.309848405	0	0	1.887172509	1.829913396	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.334		"$425 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$425 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-29 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											4.5934	0.4713	3.3665	0.3644	0.2694	0.6416	0.237	0.2529	1.9491	0.4454	1.9477	0	0.0079	1.4536	3.0979	3.7847	0.8467	0.1284	0	0	1.1732	0.795	0	0	0	0	0	0	0	0											25.8261	0	11.76167811	38.9101	4.045616542	8.588227652	0.364374976	1.105151487	1.96853967	0.423382875	1.037493918	7.995673557	1.826959076	7.753305873	0	0.032287782	5.958831411	9.821262711	12.61551815	2.589793003	0.438267033	0	0	3.06039835	2.624962898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.1601
H7187_804_0	2009	2																					4300											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	4300	1587.289554	163.3741939	676.2513876	717.1492569	108.2349914	10.74041518	3.967230514	307.8004412	32.62794245	9585.348815	37.9710301	0	0.197635111	24.68853505	4499.847349	3535.78573	557.8015698	200.6379938	0	0	15.27515148	769.0407647	0	0	0	0	0	0	0	0											"$425 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$425 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-29 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											419.9457376	425	150	0	150	0.2	0.076056143	49.51690084	0.3	2.8	0.24751409	0	0.2	0.29482937	17.92948549	29.9708072	37.5	30	0	0	0.2	28.55370192	0	0	0	0	0	0	0	0											259.4359162	262.5336703	92.65894248	0	92.65894248	0.123545257	0.046981879	30.58789111	0.185317885	1.729633593	0.152895959	0	0.123545257	0.182483617	17.92948549	29.9708072	37.5	18.5317885	0	0	0.123545257	28.55370192	0	0	0	0	0	0	0	0											34.3167	3.574268898	5.221728202	0	0.835744987	1.32692735	0.186387942	0.784580531	6.046541285	1.381595109	5.805617052	0	0.02441688	4.505253181	6.723328977	8.830862703	1.743129906	0.309848405	0	0	1.887172509	1.829913396	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.334	0	40.9518	34.3167	3.574268898	5.221728202	0	0.835744987	1.32692735	0.186387942	0.784580531	6.046541285	1.381595109	5.805617052	0	0.02441688	4.505253181	6.723328977	8.830862703	1.743129906	0.309848405	0	0	1.887172509	1.829913396	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.334		"$425 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$425 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-29 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											4.5934	0.4713	3.3665	0.3644	0.2694	0.6416	0.237	0.2529	1.9491	0.4454	1.9477	0	0.0079	1.4536	3.0979	3.7847	0.8467	0.1284	0	0	1.1732	0.795	0	0	0	0	0	0	0	0											25.8261	0	11.76167811	38.9101	4.045616542	8.588227652	0.364374976	1.105151487	1.96853967	0.423382875	1.037493918	7.995673557	1.826959076	7.753305873	0	0.032287782	5.958831411	9.821262711	12.61551815	2.589793003	0.438267033	0	0	3.06039835	2.624962898	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.1601
H7187_805_0	2009	2																					4300											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	4300	1587.289554	163.3741939	676.2513876	717.1492569	108.2349914	10.74041518	3.967230514	307.8645087	32.62794245	9585.348815	37.9710301	0	0.197635111	24.68853505	4561.348501	3535.78573	557.8015698	200.6379938	0	0	15.27515148	769.0407647	0	0	0	0	0	0	0	0											"$425 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$425 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-29 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$25 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$25 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											419.9457376	425	150	0	150	0.2	0.076056143	49.51700137	0.3	2.8	0.24751409	0	0.2	0.29482937	17.68774031	29.9708072	37.5	30	0	0	0.2	28.55370192	0	0	0	0	0	0	0	0											259.3871886	262.4843488	92.64153487	0	92.64153487	0.123522046	0.046973052	30.58220673	0.18528307	1.729308651	0.152867235	0	0.123522046	0.182449511	17.68774031	29.9708072	37.5	18.52830697	0	0	0.123522046	28.55370192	0	0	0	0	0	0	0	0											34.3102	3.573597409	5.220747209	0	0.835587977	1.326678063	0.186352926	0.784598004	6.045405336	1.381335552	5.804526365	0	0.024412293	4.504411155	6.723328977	8.830862703	1.743129906	0.309790195	0	0	1.886817971	1.829913396	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.3217	0	40.9643	34.3102	3.573597409	5.220747209	0	0.835587977	1.326678063	0.186352926	0.784598004	6.045405336	1.381335552	5.804526365	0	0.024412293	4.504411155	6.723328977	8.830862703	1.743129906	0.309790195	0	0	1.886817971	1.829913396	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.3217		"$425 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$425 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-29 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											4.5933	0.4713	3.3664	0.3644	0.2694	0.6416	0.237	0.253	1.9491	0.4454	1.9476	0	0.0079	1.4535	3.1307	3.7847	0.8467	0.1284	0	0	1.1732	0.795	0	0	0	0	0	0	0	0											25.8585	0	11.78430862	38.9035	4.044931945	8.587153044	0.364364843	1.104986986	1.968272541	0.423341268	1.037557513	7.994483407	1.826687135	7.752161025	0	0.032282976	5.957949209	9.854059027	12.61551815	2.589793003	0.438205252	0	0	3.060011186	2.624962598	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.1802
H7188_001_0	2009	3	r.	s.	t.	u.	v.						OP Facility - Other	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered							Renal Dialysis										A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin								O	O	P	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		255.280825	8.225104	495.945854	708.818987	140.984758	9.366786	3.382656	318.896943	345.673996	611.143316	907.068174	0	0	693.899578	3396.147279	4093.755403	27.925941	882.363963			21.170527								0.05	0.27	18.594665	1.87	1.23	0.06	2.7						$750/Admit:1a	$750/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1, 2. $128 SNF 2"	$5/Visit:6	$150/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician, 9b. $150 Surgery ASC -- Facility, 9a. $0 Surgery OP -- Physician, 9a. $150 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$75/Visit:14h. $25 DMAM -- OP, 8b. $25 Radiology -- FSR, 14h. $0 SMAM -- FSR, 14h. $0 SMAM -- OP, 8b. $75 Advanced Imaging -- FSR, 8b. $35 Advanced Imaging -- Office, 9a. $75 Advanced Imaging -- OP, 8a. $0 Radiology OP -- Physician, 8a. $25 Radiology OP -- Facility"	$75/Visit:9a	20% Coins:12	"$0-$75/Visit:9d. $0 Cardiac Rehab, 8b. $75 Nuclear Medicine, 9a. $75 OP Other, 5. $35 Partial Hospitalization, 8b. $25 Rad therapy, 3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$50/Visit:7h. $50 Psych -- OP, 7e. $35 Psych -- Other Provider"	"$35-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP, 7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15								SMC 001	MOW 001	$0/Proc:12	FTP 002	HAM 001	Other Added Benefit	Other Added Benefit						750.00002	750	43.132805	4.999995	149.999959	0.199999	0.199999	49.99999	150.000001	0	35.990401	0	0	48.657202	10	35	47.658913	43.629914			0.199999								0	0	0	0	0	0	0						750.00002	750	43.132805	4.999995	149.999959	0.199999	0.199999	49.99999	150.000001	0	35.990401	0	0	48.657202	10	35	47.658913	43.629914			0.199999								0	0	0	0	0	0	0						15.9551	0.514069	1.782627984	0.295340949	1.762308993	1.873347833	0.676527817	1.328736997	4.320924979	0	2.720478943	0	0	2.813600995	2.830122733	11.94011993	0.110909999	3.208121985	0	0	4.234084229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3664	0	0	15.9551	0.514069	1.782627984	0.295340949	1.762308993	1.873347833	0.676527817	1.328736997	4.320924979	0	2.720478943	0	0	2.813600995	2.830122733	11.94011993	0.110909999	3.208121985	0	0	4.234084229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.3664		30% Coins	30% Coins	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$150/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		20% Coins	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins								SMC 001	MOW 001	0	FTP 002	HAM 001	Other Added Benefit	Other Added Benefit						8.131	0.1164	0.5097	0.7733	1.4048	2.1301	0.7693	0.2804	3.6811	0.4742	1.9725		0.0004	1.1141	2.2339	5.1002	0.0322	0.4307			1.5224								0	0	0	0	0	0	0						30.6767	1000	0	24.0861	0.630431	2.292320984	1.068598949	3.167070993	4.003466833	1.445785817	1.609101997	8.002065979	0.474216	4.692994943	0	0.00039	3.927750995	5.064019733	17.04036793	0.143142999	3.638774985	0	0	5.756464229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.043
H7188_003_0	2009	3	r.	s.	t.	u.							Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered							3000											A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			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		232.479091	7.490436	451.647869	645.507132	128.391972	7.768228	2.805364	290.413004	314.798324	556.555871	826.04866	0	17.202972	631.920328	3092.802716	3728.100343	25.43159	803.551034			17.557513			3.07	2.69				0.05	0.09	1.23	1.87	0.06	2.7							$550/Admit:1a	$550/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$5/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$100/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $100 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$75/Visit:14h. $25 DMAM -- OP,8b. $25 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $75 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $25 Radiology OP -- Facility"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$0-$75/Visit:9d. $0 Cardiac Rehab,8b. $75 Nuclear Medicine,9a. $50 OP Other,5. $30 Partial Hospitalization,8b. $25 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$50/Visit:7h. $50 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			"DEN 767 16a, 16b"	VIS 752				$0 Additional Smoking Cessation 14a	$0: Nutritional benefit 14a	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0: Nurse hotline 14a	$0 Corp Health 14a							550.000016	550.00056	43.132797	4.999994	99.99999	0.2	0.199999	49.999992	99.999986	0	35.402723	0	0.782655	37.308601	10.000001	29.999997	46.878704	34.314953			0.2			0	0				0	0	0	0	0	0							463.747364	463.747822	36.368582	4.21588	84.317692	0.168635	0.168635	42.158843	84.317688	0	29.850761	0	0.659917	31.457755	8.431771	25.295307	39.527045	28.933579			0.168635			0	0				0	0	0	0	0	0							8.9843	0.289472782	1.368816047	0.226781717	0.902142896	1.309995129	0.473082558	1.020289687	2.211922239	0	2.054848427	0	0.000946044	1.656566238	2.173150354	7.858620225	0.083769634	1.937467277	0	0	2.960811205	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.513	0	6.6051	8.9843	0.289472782	1.368816047	0.226781717	0.902142896	1.309995129	0.473082558	1.020289687	2.211922239	0	2.054848427	0	0.000946044	1.656566238	2.173150354	7.858620225	0.083769634	1.937467277	0	0	2.960811205	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	35.513	5000	30% Coins	30% Coins	25% Coins(Days 1-20) 25%(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 767 16a, 16b"	VIS 752				0	0	0	0	0	0							5.9571	0.0853	0.3112	0.4721	0.7534	1.3005	0.4697	0.2256	2.2475	0.2895	1.2043		0.0002	0.6802	1.3639	3.1139	0.0197	0.2629			0.9295			0	0				0	0	0	0	0	0							19.6862	500	2.92282677	14.9414	0.374723782	1.680000047	0.698879717	1.655558896	2.610500129	0.942737558	1.245841687	4.459374239	0.289523	3.259134427	0	0.001155044	2.336789238	3.537014354	10.97248123	0.103448634	2.200395277	0	0	3.890272205	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1992
H7188_801_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		255.280825	8.225104	495.945854	708.818987	4.746035	9.366786	3.382656	20.825133	53.531239	611.143316	28.945284	0	0.36525	16.490034	31.065022	70.925085	0.448226	5.98875			21.170527																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000012	1024.000669	43.132805	0	0.2	0.199999	0.199999	0.2	0.199999	0	0.2	0	0.2	0.2	0.199999	0.2	0.5	0.2			0.199999																				1024.000012	1024.000669	43.132805	0	0.2	0.199999	0.199999	0.2	0.199999	0	0.2	0	0.2	0.2	0.199999	0.2	0.5	0.2			0.199999																				21.784	0.701876	1.782627984	0	0.949207	1.873347833	0.676527817	4.1650266	10.70619427	0	5.7890568	0	0.07305	3.2980068	6.212973335	14.185017	0.224113	1.19775	0	0	4.234084229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.8528	0	0	21.784	0.701876	1.782627984	0	0.949207	1.873347833	0.676527817	4.1650266	10.70619427	0	5.7890568	0	0.07305	3.2980068	6.212973335	14.185017	0.224113	1.19775	0	0	4.234084229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.8528		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4204	0.078	0.1981		0.6018	1.1877	0.4289	0.7845	2.0525		1.0998		0.0138	0.6212	1.2455	2.8437	0.0449	0.2401			0.8488																				14.7098	0	0	24.2044	0.779862	1.980697984	0	1.550992	3.061031833	1.105439817	4.9495516	12.75867727	0	6.8888668	0	0.08681	3.9192198	7.458520335	17.028747	0.269042	1.437868	0	0	5.082913229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.5626
H7188_802_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		255.280825	8.225104	495.945854	708.818987	4.746035	9.366786	3.382656	20.825133	53.531239	611.143316	28.945284	0	0.36525	16.490034	31.065022	70.925085	0.448226	5.98875			21.170527																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000012	1024.000669	43.132805	0	0.2	0.199999	0.199999	0.2	0.199999	0	0.2	0	0.2	0.2	0.199999	0.2	0.5	0.2			0.199999																				1024.000012	1024.000669	43.132805	0	0.2	0.199999	0.199999	0.2	0.199999	0	0.2	0	0.2	0.2	0.199999	0.2	0.5	0.2			0.199999																				21.784	0.701876	1.782627984	0	0.949207	1.873347833	0.676527817	4.1650266	10.70619427	0	5.7890568	0	0.07305	3.2980068	6.212973335	14.185017	0.224113	1.19775	0	0	4.234084229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.8528	0	0	21.784	0.701876	1.782627984	0	0.949207	1.873347833	0.676527817	4.1650266	10.70619427	0	5.7890568	0	0.07305	3.2980068	6.212973335	14.185017	0.224113	1.19775	0	0	4.234084229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.8528		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4204	0.078	0.1981		0.6018	1.1877	0.4289	0.7845	2.0525		1.0998		0.0138	0.6212	1.2455	2.8437	0.0449	0.2401			0.8488																				14.7098	0	0	24.2044	0.779862	1.980697984	0	1.550992	3.061031833	1.105439817	4.9495516	12.75867727	0	6.8888668	0	0.08681	3.9192198	7.458520335	17.028747	0.269042	1.437868	0	0	5.082913229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.5626
H7188_803_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		255.280825	8.225104	495.945854	708.818987	4.746035	9.366786	3.382656	20.825133	53.531239	611.143316	28.945284	0	0.36525	16.490034	31.065022	70.925085	0.448226	5.98875			21.170527																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000012	1024.000669	43.132805	0	0.2	0.199999	0.199999	0.2	0.199999	0	0.2	0	0.2	0.2	0.199999	0.2	0.5	0.2			0.199999																				1024.000012	1024.000669	43.132805	0	0.2	0.199999	0.199999	0.2	0.199999	0	0.2	0	0.2	0.2	0.199999	0.2	0.5	0.2			0.199999																				21.784	0.701876	1.782627984	0	0.949207	1.873347833	0.676527817	4.1650266	10.70619427	0	5.7890568	0	0.07305	3.2980068	6.212973335	14.185017	0.224113	1.19775	0	0	4.234084229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.8528	0	0	21.784	0.701876	1.782627984	0	0.949207	1.873347833	0.676527817	4.1650266	10.70619427	0	5.7890568	0	0.07305	3.2980068	6.212973335	14.185017	0.224113	1.19775	0	0	4.234084229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.8528		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4204	0.078	0.1981		0.6018	1.1877	0.4289	0.7845	2.0525		1.0998		0.0138	0.6212	1.2455	2.8437	0.0449	0.2401			0.8488																				14.7098	0	0	24.2044	0.779862	1.980697984	0	1.550992	3.061031833	1.105439817	4.9495516	12.75867727	0	6.8888668	0	0.08681	3.9192198	7.458520335	17.028747	0.269042	1.437868	0	0	5.082913229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.5626
H7188_804_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		255.280825	8.225104	495.945854	708.818987	4.746035	9.366786	3.382656	20.825133	53.531239	611.143316	28.945284	0	0.36525	16.490034	31.065022	70.925085	0.448226	5.98875			21.170527																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000012	1024.000669	43.132805	0	0.2	0.199999	0.199999	0.2	0.199999	0	0.2	0	0.2	0.2	0.199999	0.2	0.5	0.2			0.199999																				1024.000012	1024.000669	43.132805	0	0.2	0.199999	0.199999	0.2	0.199999	0	0.2	0	0.2	0.2	0.199999	0.2	0.5	0.2			0.199999																				21.784	0.701876	1.782627984	0	0.949207	1.873347833	0.676527817	4.1650266	10.70619427	0	5.7890568	0	0.07305	3.2980068	6.212973335	14.185017	0.224113	1.19775	0	0	4.234084229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.8528	0	0	21.784	0.701876	1.782627984	0	0.949207	1.873347833	0.676527817	4.1650266	10.70619427	0	5.7890568	0	0.07305	3.2980068	6.212973335	14.185017	0.224113	1.19775	0	0	4.234084229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	77.8528		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4204	0.078	0.1981		0.6018	1.1877	0.4289	0.7845	2.0525		1.0998		0.0138	0.6212	1.2455	2.8437	0.0449	0.2401			0.8488																				14.7098	0	0	24.2044	0.779862	1.980697984	0	1.550992	3.061031833	1.105439817	4.9495516	12.75867727	0	6.8888668	0	0.08681	3.9192198	7.458520335	17.028747	0.269042	1.437868	0	0	5.082913229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.5626
H7200_006_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	349.52	23.65	124.82	86.52	20.72	25.98	24.18	18.7	29.32	9.12	22.75	1.21	2.14	65.45	59.14	109	6.31	6.13	24.33	39.1	8.36	4.2	0	16.75	1.72	2.63	0.39	1.74	3.03	16.87											PBP: 1A IP Acute: Standard Medicare	1B IP Psych: Standard Medicare	2 SNF: Standard Medicare	6 Home Health: Standard Medicare	10A Ambulance: Standard Medicare	11A DME: Standard Medicare	"11B Prosthetic Medical Supplies: Standard Medicare, 11C Diabetes Monitoring Supplies: $0"	"4A ER, 4B Urgent Care: Standard Medicare, 4A Worldwide Coverage: $0"	9B ASC Services: Standard Medicare	8A OP C/D/T: Standard Medicare	8B OP X-Ray: Standard Medicare	"9A OP Hospital, 5 Partial Hosp: Standard Medicare"	12 Renal Dialysis: Standard Medicare	"3 CORF, 9A OP Hospital, 9D Cardiac Rehab: Standard Medicare"	"7A PCP, 14B Immunizations, 14C Routine Physical Exams: Standard Medicare"	7D Physician Specialist (excl. Radiology): Standard Medicare	"7E Mental Health, 7H Psychiatric, 9C OP Substance Abuse,: Standard Medicare"	"7C Occupational Therapy, 7I Physical and Speech Therapy: Standard Medicare"	"8B Physician Specialist (Radiology), 14G Bone Mass Measurement, 14H Mammography: Standard Medicare"	"7B Chiropractic, 7F Podiatry - Medicare Covered, 7G Other Health Care, 14D Pap Smears/Pelvic Exams, 14E Prostate Screening, 14F Colorectal Screening, 14I Diabetes Monitoring, 14J Nutrition Therapy, 18A Medicare Covered Hearing Exams: Standard Medicare, 7F Podiatry - Routine: $0"	15 Part B Drugs: Standard Medicare	"13A Blood, 16B Medicare Covered Comprehensive Dental Services, 17A Medicare Covered Eye Exams, 17B Medicare Covered Eyewear: Standard Medicare"	10B Transportation: Not Covered	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental: $0"	17A Routine Eye Exams: $0	17B Eye Wear - Non-Covered: $0	18A Hearing - Routine: $0	18B Hearing Aids: $0	"14A Medical Nutrition: $0, 14A Health Education/Wellness Programs: $0"	"6 Respite Care: Not Covered, 13B Acupuncture: Not Covered, 13C Other: OTC Drugs: $0, 13D Other: Assistive Devices: $0 13E Other: PERS: $0"											0.073112829	0.073130073	0.20120272	0	0.230977993	0.231000028	0.182416643	0.229603568	0.230999985	0.230944652	0.231048459	0.231000221	0.231000003	0.231017885	0.22876432	0.230998954	0.230992201	0.230992979	0.231005299	0.223076869	0.231001494	0.230999593	0	0	0	0	0	0	0	0											0.073112829	0.073130073	0.20120272	0	0.230977993	0.231000028	0.182416643	0.229603568	0.230999985	0.230944652	0.231048459	0.231000221	0.231000003	0.231017885	0.22876432	0.230998954	0.230992201	0.230992979	0.231005299	0.223076869	0.231001494	0.230999593	0	0	0	0	0	0	0	0											25.5544	1.729526217	25.11412351	0	4.785864013	6.001380735	4.410834422	4.293586727	6.772919563	2.10621523	5.256352439	0.279510267	0.494340007	15.1201206	13.52912188	25.17888599	1.457560788	1.41598696	5.620358932	8.72230559	1.931172491	0.97019829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.7448	0	0	25.5544	1.729526217	25.11412351	0	4.785864013	6.001380735	4.410834422	4.293586727	6.772919563	2.10621523	5.256352439	0.279510267	0.494340007	15.1201206	13.52912188	25.17888599	1.457560788	1.41598696	5.620358932	8.72230559	1.931172491	0.97019829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.7448	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	25.5544	1.729526217	25.11412351	0	4.785864013	6.001380735	4.410834422	4.293586727	6.772919563	2.10621523	5.256352439	0.279510267	0.494340007	15.1201206	13.52912188	25.17888599	1.457560788	1.41598696	5.620358932	8.72230559	1.931172491	0.97019829	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	160.7448
H7200_007_0	2009	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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	838.03	18.47	613.76	0	266.66	10.6	7.54	223.96	282.25	0	751.28	41.98	0.17	1376.68	5228.36	6507.45	165.71	671.52	1667.34	1445	8.17	647.95	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $200 per day for the first 8 days	1B IP Psych: $200 per day for the first 8 days	2 SNF: $125 per day for 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: $50,4A Non Covered Foreign Travel: $50,  4B Urgent Care: $35"	9B ASC Services: $200	8A OP Lab Services: $0	8B OP X-Ray: $50	"9A OP Hospital: $200, 5 Partial Hosp: $200"	12 Renal Dialysis: 20%	"3 CORF: $200, 8A OP Diagnostic Procedures/Tests: $200, 9A OP Hospital: $200, 9D Cardiac Rehab: $200"	"7A PCP: $15, 14B Immunizations: $0, 14C Routine Physical Exams: $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"	"8B Physician Specialist Services - Radiology: $50, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7B Chiropractic: $35, 7F Podiatry: $35, 7F Non Medicare Covered Podiatry: $0,  7G Other Health Care: $35, 14D Pap Smears & Pelvic Exams: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $35, 18A Medicare Covered Hearing Exams: $35"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $35, 17A Medicare Covered Eye Exams: $35, 17B Medicare Covered Eyewear: $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	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: Over-the-Counter Drugs: $0, 13D Other: PERS: $0, 13E Other: Assistive Devices: Not Covered"											200	200	125	0	100	0.199999619	0.200134523	49.03956064	200	0	50	200	0.199999986	120.5826336	15	35	35	35	50	35	0.199998264	35	0	0	0	0	0	0	0	0											200	200	125	0	100	0.199999619	0.200134523	49.03956064	200	0	50	200	0.199999986	120.5826336	15	35	35	35	50	35	0.199998264	35	0	0	0	0	0	0	0	0											13.9672	0.307833333	6.393333333	0	2.222166667	2.119995957	1.509014301	0.915241667	4.704166667	0	3.130333333	0.699666667	0.033999998	13.83364167	6.53545	18.9800625	0.483320833	1.9586	6.94725	4.214583333	1.633985815	1.889854167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.4797	0	0	13.9672	0.307833333	6.393333333	0	2.222166667	2.119995957	1.509014301	0.915241667	4.704166667	0	3.130333333	0.699666667	0.033999998	13.83364167	6.53545	18.9800625	0.483320833	1.9586	6.94725	4.214583333	1.633985815	1.889854167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.4797	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	13.9672	0.307833333	6.393333333	0	2.222166667	2.119995957	1.509014301	0.915241667	4.704166667	0	3.130333333	0.699666667	0.033999998	13.83364167	6.53545	18.9800625	0.483320833	1.9586	6.94725	4.214583333	1.633985815	1.889854167	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.4797
H7200_011_0	2009	4																					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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	599.571	13.398	626.19	0	266.66	10.6	7.54	160.433	203.161	0	525.896	41.98	0.17	1376.68	5228.36	4555.215	116.802	470.064	1167.138	1011.5	8.17	453.655	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $200 per day for the first 8 days	1B IP Psych: $200 per day for the first 8 days	2 SNF: $125 per day for 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/Worldwide Coverage: $50, 4B Urgent Care: $35"	9B ASC Services: $200	8A OP Lab Services: $0	8B OP X-Ray: $50	"9A OP Hospital: $200,  5 Partial Hosp: $200"	12 Renal Dialysis: 20%	"3 CORF: $200, 8A OP Diagnostic Procedures/Tests: $200, 9A OP Hospital: $200, 9D Cardiac Rehab: $200"	"7A PCP: $15, 14B Immunizations: $0, 14C Routine Physical Exams: $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"	"8B Physician Specialist Services - Radiology: $50, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7B Chiropractic: $35, 7F Podiatry - Medicare Covered: $35, 7F Podiatry - Routine: $0, 7G Other Health Care: $35, 14D Pap Smears/Pelvic Exams: $0, 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutritional Therapy: $35, 18A Medicare Covered Hearing Exams: $35"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $35, 17A Medicare Covered Eye Exams: $35, 17B Medicare Covered Eyewear: $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	14A Health Education/Wellness Programs: $0	"13B Acupuncture: Not Covered, 13C Other: OTC drugs: $0, 13D Other: PERS: $0"											200	200	125	0	100	0.199999619	0.200134523	49.06147738	200	0	50	200	0.199999986	120.5826336	15	35	35	35	50	35	0.199998264	35	0	0	0	0	0	0	0	0											200	200	125	0	100	0.199999619	0.200134523	49.06147738	200	0	50	200	0.199999986	120.5826336	15	35	35	35	50	35	0.199998264	35	0	0	0	0	0	0	0	0											9.9929	0.2233	6.5228125	0	2.222166667	2.119995957	1.509014301	0.655923333	3.386016667	0	2.191233333	0.699666667	0.033999998	13.83364167	6.53545	13.28604375	0.3406725	1.37102	4.863075	2.950208333	1.633985815	1.323160417	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.6942	0	0	9.9929	0.2233	6.5228125	0	2.222166667	2.119995957	1.509014301	0.655923333	3.386016667	0	2.191233333	0.699666667	0.033999998	13.83364167	6.53545	13.28604375	0.3406725	1.37102	4.863075	2.950208333	1.633985815	1.323160417	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.6942	0	PBP: 1A IP Acute: $250 per day for the first 8 days	1B IP Psych: $250 per day for the first 8 days	2 SNF: Not Covered	6 Home Health: Not Covered	10A Ambulance: Not Covered	11A DME: Not Covered	"11B Prosthetic Medical Supplies, 11C Diabetes Monitoring Supplies: Not Covered"	"4A ER/Worldwide Coverage: $50, 4B Urgent Care: $45"	9B ASC Services: $225	8A OP Lab Services: Not Covered	8B OP X-Ray: $100	"9A OP Hospital, 5 Partial Hosp: Not Covered"	12 Renal Dialysis: Not Covered	"3 CORF, 8A OP Diagnostic Procedures/Tests, 9A OP Hospital, 9D Cardiac Rehab: Not Covered"	"7A PCP, 14B Immunizations, 14C Routine Physical Exams, 14I Diabetes Monitoring: Not Covered"	7D Physician Specialist: $45	"7E Mental Health: $45,  7H Psychiatric: $45, 9C OP Substance Abuse: $45"	"7C Occupational Therapy: $45,  7I Physical and Speech Therapy: $45"	"7D Physician Specialist Services - Radiology: $100, 14H Mammography: $0, 14G Bone Mass Measurement:$0"	"7B Chiropractic: $45, 7F Podiatry: $45, 7G Other Health Care: $45, 14D Pap Smears:$0, 14D Pelvic Exams:$0, 14E Prostate Screening:$0, 14F Colorectal Screening:$0, 14I Diabetes Monitoring:$0, 14J Nutrition Therapy:$0, 18A Medicare Covered Hearing Exams: $45"	15 Part B Drugs: Not Covered	"13A Blood: Not Covered, 16B Medicare Covered Comprehensive Dental Services: $45, 17A Medicare Covered Eye Exams: $45"	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: Not Covered	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: OTC drugs: Not Covered, 13D Other: PERS: Not Covered"											6.4252	0.1583	0	0	0	0	0	0.3546	2.1335	0	2.065	0	0	0	0	8.2648	0.2307	0.9509	5.0663	2.1498	0	0.8727	0	0	0	0	0	0	0	0											28.6718	0	0	16.418	0.38155	6.5228125	0	2.222166667	2.119995957	1.509014301	1.010509583	5.519466667	0	4.256208333	0.699666667	0.033999998	13.83364167	6.53545	21.55089	0.57139875	2.32194875	9.9294	5.100015833	1.633985815	2.195867917	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.366
H7220_001_0	2009	5																																A	A	D	V	T	COIN	COIN	V	V	COIN	COIN			V	V	V	V		COIN	COIN	COIN	V			V		V																																																						0		326.1549808	12.43658542	2124.633767	2885.61008	378.8838003	17.49827795	0.71475568	407.7773879	197.7655116	24.78226084	43.39630656			2445.824582	8635.823846	1186.275741	242.1421253		25.20002916	151.5615034	16.72880536	116.1935566			0		0														"$750 per admit, combined annual max $1300 (acute & MH)"	"$750 per admit, combined annual max $1300 (acute & MH)"	"$0 days 1-20, $75 days 21-100"	$0 copay	$50 copay	20% coinsurance	20% coinsurance	Emergency care: $50 copay / Waived if admit / $35 UC if refered by PCP	$100 copay	10% coinsurance	10% coinsurance			Rehab: $15; 10% coinsurance on other services	$20 Primary; $25 specialists	"$25 Chiropractic, $25 Podiatry"	$25 Copay		10% coinsurance	10% coinsurance	20% coinsurance	10% coinsurance			Medicare covered exam only		Medicare covered exam only														750	750	57.77169211	0	50	0.2	0.2	39.4	100	0.1	0.1	0	0	20.55614943	21.86234728	25	25	0	0.1	0.09868362	0.2	13.69955844	0	0	0	0	0	0	0	0	0										750	750	57.77169211	0	50	0.2	0.2	39.4	100	0.1	0.1	0	0	20.55614943	21.86234728	25	25	0	0.1	0.09868362	0.2	13.69955844	0	0	0	0	0	0	0	0	0										20.3847	0.777286589	10.22864065	0	1.578682501	3.49965559	0.142951136	1.33886909	1.64804593	2.478226084	4.339630656	0	0	4.189727965	15.73328167	2.471407793	0.504462761	0	2.520002916	14.95663783	3.345761073	0.132650035	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.2706		0	20.3847	0.777286589	10.22864065	0	1.578682501	3.49965559	0.142951136	1.33886909	1.64804593	2.478226084	4.339630656	0	0	4.189727965	15.73328167	2.471407793	0.504462761	0	2.520002916	14.95663783	3.345761073	0.132650035	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.2706																																																																																		0			20.3847	0.777286589	10.22864065	0	1.578682501	3.49965559	0.142951136	1.33886909	1.64804593	2.478226084	4.339630656	0	0	4.189727965	15.73328167	2.471407793	0.504462761	0	2.520002916	14.95663783	3.345761073	0.132650035	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.2706
H7220_002_0	2009	6																					4000											A	A	D		T	COIN	COIN	V	V	V	V		V	V	V	V	V		V	V	COIN	V			V		V																																																						0		324.8352418	12.38626257	2116.036744	2947.624488	377.3507017	17.4274737	0.711863525	418.9524506	196.9652821	1638.47593	1491.222914	0	0	2435.927906	8864.965405	1181.475647	241.1623322	0	6206.837887	27573.08699	16.66111467	117.0646531	0	0	376	0	175	0	0	0											"$750 per admit, combined annual max $1300 (acute & MH)"	"$750 per admit, combined annual max $1300 (acute & MH)"	"$0 days 0-20, $75 days 21-100"	0	$50 copay	20% coinsurance	20% coinsurance	$50 copay / Waived if admit/ $35 UC if referred from PCP	$100 copay	$10 copay	"$25 radiation and x-rays, $35 for CT and MRI"			$15 copay for therapy; $25 copay for mental health	$10 PCP; $15 for specialists	$25 for podiatry; $25 for chiro	$25 copay		"$25 radiation and x-rays, $35 for CT and MRI"		20% coinsurance	$25 copay			$25 copay		$25 copay														734.6574934	1152.364056	57.77169211	0	50	0.2	0.2	39.4	100	10	27	0	0	5.633538875	12.20652556	25	25	0	0	0	0.2	25	0	0	25	0	25	0	0	0	0										733.5157037	1150.573075	57.68190453	0	49.92229102	0.199689164	0.199689164	39.33876532	99.84458204	9.984458204	26.95803715	0	0	5.624783344	12.18755443	24.96114551	24.96114551	0	0	0	0.199689164	24.96114551	0	0	24.96114551	0	24.96114551	0	0	0	0										19.856	1.187608352	10.17141912	0	1.569850962	3.480077655	0.142151432	1.373422678	1.638826355	1.363274537	3.350036893	0	0	1.141797226	9.003520698	2.457582129	0.501640672	0	0	0	3.327044061	0.243505653	0	0	0.782115893	0	0.364016705	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9539		0.0964	19.856	1.187608352	10.17141912	0	1.569850962	3.480077655	0.142151432	1.373422678	1.638826355	1.363274537	3.350036893	0	0	1.141797226	9.003520698	2.457582129	0.501640672	0	0	0	3.327044061	0.243505653	0	0	0.782115893	0	0.364016705	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9539																																																																																		0			19.856	1.187608352	10.17141912	0	1.569850962	3.480077655	0.142151432	1.373422678	1.638826355	1.363274537	3.350036893	0	0	1.141797226	9.003520698	2.457582129	0.501640672	0	0	0	3.327044061	0.243505653	0	0	0.782115893	0	0.364016705	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9539
H7220_003_0	2009	9																					4000											A	A	D		T	COIN	COIN	V	V	V	V		V	V	V	V	V			V	COIN	V			V		V																																																						0		324.8352418	12.38626257	2116.036744	2947.624488	377.3507017	17.4274737	0.711863525	418.9524506	196.9652821	1638.47593	1491.222914	0	0	2435.927906	8864.965405	1181.475647	241.1623322	0	6206.837887	27573.08699	16.66111467	117.0646531	0	0	376	0	175	0	0	0											"$750 per admit, combined annual max $1300 (acute and MH)"	"$750 per admit, combined annual max $1300 (acute and MH)"	"$0 days 0-20, $75 days 21-100"	0	$50 copay	20% coinsurance	20% coinsurance	$50 copay / Waived if admit/ $35 UC if referred from PCP	$100 copay	$10 copay	"$25 radiation and x-rays, $35 for CT and MRI"		0% coinsurance	$15 copay for therapy; $25 copay for mental health	$10 PCP; $15 for specialists	$25 for podiatry; $25 for chiro	$25 copay				20% coinsurance	$25 copay			$25 copay		$25 copay														734.6574934	1152.364056	57.77169211	0	50	0.2	0.2	39.4	100	10	27	0	0	5.633538875	12.20652556	25	25	0	0	0	0.2	25	0	0	25	0	25	0	0	0	0										733.5157037	1150.573075	57.68190453	0	49.92229102	0.199689164	0.199689164	39.33876532	99.84458204	9.984458204	26.95803715	0	0	5.624783344	12.18755443	24.96114551	24.96114551	0	0	0	0.199689164	24.96114551	0	0	24.96114551	0	24.96114551	0	0	0	0										19.856	1.187608352	10.17141912	0	1.569850962	3.480077655	0.142151432	1.373422678	1.638826355	1.363274537	3.350036893	0	0	1.141797226	9.003520698	2.457582129	0.501640672	0	0	0	3.327044061	0.243505653	0	0	0.782115893	0	0.364016705	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9539		0.0964	19.856	1.187608352	10.17141912	0	1.569850962	3.480077655	0.142151432	1.373422678	1.638826355	1.363274537	3.350036893	0	0	1.141797226	9.003520698	2.457582129	0.501640672	0	0	0	3.327044061	0.243505653	0	0	0.782115893	0	0.364016705	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9539																																																																																		0			19.856	1.187608352	10.17141912	0	1.569850962	3.480077655	0.142151432	1.373422678	1.638826355	1.363274537	3.350036893	0	0	1.141797226	9.003520698	2.457582129	0.501640672	0	0	0	3.327044061	0.243505653	0	0	0.782115893	0	0.364016705	0	0	0	0	0	0	0	0	0	0	0	0	0	61.9539
H7220_004_0	2009	11																																D	D	D	V	T	COIN	COIN	V	V	V	V		V	V	V	V	V		V	V	COIN	V		V	V	P	V			O																																																			0		1468.23774	87.81694323	1798.631232	2505.480815	320.7480965	14.81335264	0.605083996	356.109583	163.0146874	1547.44949	1267.539477		0	2070.53872	7535.220595	1004.2543	204.9879824		5275.812204	23437.12394	14.16194747	99.50495514		335.75	403.75	357	148.75			0.1275											$0 Copay	$0 Copay	$0  days 1-20; $75 days 21-130	0	$50 copay	20% coinsurance	20% coinsurance	$50 copay / waived if admit / $35 UC if refered by PCP for emergency care	$100 copay	$0 copay	$25 for radiation and x-rays / $35 for CT and MRI		$0 Copay	$15 for OP rehabilitation	"$10 for PCP; $10 copay for Medicare covered initial exam, then $10 copay for 1 exam per year"	Specialty: $15; Chiropractic: $25; Podiatry: $10 (nail trimming included 4x per year)	$25 copay		$0 copay	$0 copay	20% coinsurance	$10 copay for vision exam; $10 copay for hearing exam		Preventative services (1 visit every 6 months); $10 copay	$10 copay for exams	$40 copay for eye wear every 24 months	$10 copay for exam			$0 copay											0	0	57.77169211	0	50	0.2	0.2	39.42	100	0	27	0	0	5.633538875	12.20652556	11.87216378	25	0	0	0	0.2	5.417038832	0	10	10	40	10	0	0	0											0	0	57.68435637	0	49.92441303	0.199395761	0.199395761	39.36040724	99.84882607	0	26.95918304	0	0	5.625022433	12.18807248	11.85421617	24.96220652	0	0	0	0.199395761	5.408849682	0	9.984882607	9.984882607	39.93953043	9.984882607	0	0	0	0										0	0	8.646073748	0	1.334430037	2.953719728	0.120651184	1.168051517	1.356402097	0	2.847652397	0	0	0.970568896	7.653317894	0.992053964	0.426412696	0	0	0	2.823832298	0.044850612	0	0.279368695	0.335949696	1.18820103	0.123770941	0	0	0	0	0	0	0	0	0	0	0	0	0	33.2653		0.06	0	0	8.646073748	0	1.334430037	2.953719728	0.120651184	1.168051517	1.356402097	0	2.847652397	0	0	0.970568896	7.653317894	0.992053964	0.426412696	0	0	0	2.823832298	0.044850612	0	0.279368695	0.335949696	1.18820103	0.123770941	0	0	0	0	0	0	0	0	0	0	0	0	0	33.2653	4000	20%; limited to 100 days	20%; limited to 100 days	"20%, limited to 100 days"	0.2	0.2	0.2	0.2	"$50 copay / waived if admit / $35 UC if refered by PCP for emergency care; $50 copay, $35 UC if refered by PCP for urgently needed care"	0.2	0.2	0.2			0.2	0.2	"20% for specialty, chiropractic, and podiatry"	0.2		0.2	0.2	0.2	0.2																			6.853	0.1922	2.576	0.9054	0.0908	0.3829	0.0156	0.2064	0.3187	0.6026	0.9496	0	0	0.9318	0.8122	0.1122	0.0327	0	0.5656	3.4048	0.3661	0.011	0	0	0	0	0	0	0	0	0										19.3297		7.351364538	6.853	0.192209019	11.22205942	0.905354918	1.42518952	3.336633106	0.136292124	1.374490337	1.675135833	0.602564641	3.797290207	0	0	1.902360257	8.465562923	1.104257496	0.459157065	0	0.565589915	3.404778839	3.189907371	0.055884025	0	0.279368695	0.335949696	1.18820103	0.123770941	0	0	0	0	0	0	0	0	0	0	0	0	0	52.595
H7226_001_0	2009	5																					3350											D	D	D	V	T	P	P	V	V	P	P	V	V	V	P	P	V	V	P	P	S	P	P	P	P	P	P	P	P	P																																																			0		1801.584058	102.2797856	1369.123831		239.4152828			324.9799664	366.7181013					379.6200161	3429.122318	5908.579438	582.4774693	580.1959148		71.41200309							255.8976692														"1a (IP Acute), 1a1 (Add'l Days) - $50/days 1-5"	1b (IP Psych) - $50/days 1-5	2 (SNF) - $50 days 11-100; 2a2 (Waiver 3 Day) - $0	6 (Home Health)- $0	10a (Ambulance) - $150	11a (Medical Equip) - $0	"11b (Med Supp), 11c (Diab Supp) - $0"	4a (ER) $50 (WW Coverage)	"9a (OP Surgery), 9b (ASC) - $100"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $0	9a (OP Observation) - $0	12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - $15; 3 (CORF)- $0; 5 (Partial Hospitalization) - $0, 9a (OP Other excluding Surgery) - $0"	"7a (PCP) - $15, 14c (Routine Physical) - $15"	"7b (Chiro), 7d (Spec), 7f (Pod) - $15; 17a (MCR Eye Exam) - $15; 18a (MCR Hearing Exam) - $15, 16b (Comp Dental) - $0, 14j (Nutrition Therap) - $15; 14i (Diab Mon.) - $15; 14a (Smoking Cessation) - $15"	"7e (MH), 7h (Psychiatric) - $15"	"7c (OT), 7i (PT/ST) - $15"	"8b (Professional Radiology) - 0%, 14h (Mammography)"	"7g (Prof. Other - allergy visits)  - $5; 14b (Immun), 14d (Pap/Pelvic), 14e (Prostate), 14f (Colorectal), 14g (Bone Mass) - $0"	15 (Part B Rx) - $0	13a (Blood) - $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													30.95	30.95	27.55		150			50	100					15	15	15	15	15		5							15														29.48437361	29.46678609	26.22972397		142.8115643			47.6055248	95.2077095					14.28115643	14.30408984	14.28115643	14.28115643	14.28115643		4.760385475							15														4.4265	0.251154714	2.992645015	0	2.849272587	0	0	1.289236821	2.909532538	0	0	0	0	0.451784403	4.087539476	7.031778934	0.693204321	0.690489051	0	0.028329055	0	0	0	0	0	0	0.319872086	0	0	0	0	0	0	0	0	0	0	0	0	0	28.0214	0	1.3847	4.4265	0.251154714	2.992645015	0	2.849272587	0	0	1.289236821	2.909532538	0	0	0	0	0.451784403	4.087539476	7.031778934	0.693204321	0.690489051	0	0.028329055	0	0	0	0	0	0	0.319872086	0	0	0	0	0	0	0	0	0	0	0	0	0	28.0214																																																																																		0	0	0	4.4265	0.251154714	2.992645015	0	2.849272587	0	0	1.289236821	2.909532538	0	0	0	0	0.451784403	4.087539476	7.031778934	0.693204321	0.690489051	0	0.028329055	0	0	0	0	0	0	0.319872086	0	0	0	0	0	0	0	0	0	0	0	0	0	28.0214
H7226_002_0	2009	8																					3350											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																																																			0		1796.923346	102.015187	1365.581897		238.7959136	8.715635361	7.605701692	323.9133239	365.7693987		19.61370489			378.6379362	3311.13417	5893.293898	580.9705955	578.6949435	25.31273393	71.22725968																					"1a (IP Acute), 1a1 (Add'l Days) - $150 days 1-5"	1b (IP Psych) - $150 days 1-5	2 (SNF) - $100 days 11-100	6a (Home Health) - $0	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp) - 20%,11b1 (Prosthetics) - 30%, 11c (Diabetic Supplies) - 0%"	4a (ER) $50 (WW Coverage)	"9a (OP Surgery) - $100, 9b (ASC) - $100"	8a (OP Diag Proc/Test/Lab) - $0	"8b (OP Therap Rad, CT scans, PET, scans, & MRI) - 20%, 8b (OP x-rays) - 0%"	9a (OP Observation) - $0	12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - $25, 3 (CORF)- $0; 5 (Partial Hospitalization) - $0, 9a (OP Other excluding Surgery) - $0"	"7a (PCP) - $15, 14c (Routine Physical) - $0"	"7b (Chiro) - $25, 7d (Spec) - $15, 7f (Pod) - $25; 17a (MCR Eye Exam) - $25; 18a (MCR Hearing Exam) - $25, 16b (Comp Dental) - $0, 14j (Nutrition Therap) - $25; 14i (Diab Mon.) - $25; 14a (Smoking Cessation) - $25"	"7e (MH), 7h (Psychiatric) - $25"	"7c (OT), 7i (PT/ST) - $25"	"8b (OP Therap Rad, CT scans, PET, scans, & MRI) - 20%, 8b (OP x-rays) - 0%"	"7g (Prof. Other - allergy visits)  - $5; 14b (Immun), 14d (Pap/Pelvic), 14e (Prostate), 14f (Colorectal), 14g (Bone Mass) - $0"	15 (Part B Rx) - 0%	13a (Blood) - $0				17b1 (Non MCR Covered) - $100 limit															92.85	92.85	55.1		150	0.2	0.239402205	50	100		0.173202615			25	15	18.79336947	25	25	0.055503957	5																					83.93165169	83.82463151	49.74407319		135.419437	0.180559249	0.216131413	45.13981234	90.27962467		0.156366671			22.56990617	13.5419437	16.96658342	22.56990617	22.56990617	0.050108764	4.513981234																					12.5682	0.712615455	5.660800488	0	2.694800682	1.573688578	1.64383105	1.218448888	2.751793669	0	3.066929739	0	0	0.712151891	3.736599377	8.332421877	1.092704319	1.088424215	1.268389806	0.026793209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.1486	0	5.1664	12.5682	0.712615455	5.660800488	0	2.694800682	1.573688578	1.64383105	1.218448888	2.751793669	0	3.066929739	0	0	0.712151891	3.736599377	8.332421877	1.092704319	1.088424215	1.268389806	0.026793209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.1486																																																																																		0	0	0	12.5682	0.712615455	5.660800488	0	2.694800682	1.573688578	1.64383105	1.218448888	2.751793669	0	3.066929739	0	0	0.712151891	3.736599377	8.332421877	1.092704319	1.088424215	1.268389806	0.026793209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.1486
H7226_006_0	2009	3																					3350											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																																																			0		1798.833359	102.1236225	1367.033422		239.0497382	8.734173517	7.621879019	324.2576227	366.1581878		19.65542323			379.0404037	3314.653691	5899.558086	581.5881295	579.3100586	25.36657411	71.30296963																					"1a (IP Acute), 1a1 (Add'l Days) - $150 days 1-5"	1b (IP Psych) - $150 days 1-5	2 (SNF) - $100 days 11-100	6a (Home Health) - $0	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp) - 20%,11b1 (Prosthetics) - 30%, 11c (Diabetic Supplies) - 0%"	4a (ER) $50 (WW Coverage)	"9a (OP Surgery) - $100, 9b (ASC) - $100"	8a (OP Diag Proc/Test/Lab) - $0	"8b (OP Therap Rad, CT scans, PET, scans, & MRI) - 20%, 8b (OP x-rays) - 0%"	9a (OP Observation) - $0	12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - $25, 3 (CORF)- $0; 5 (Partial Hospitalization) - $0, 9a (OP Other excluding Surgery) - $0"	"7a (PCP) - $15, 14c (Routine Physical) - $0"	"7b (Chiro) - $25, 7d (Spec) - $15, 7f (Pod) - $25; 17a (MCR Eye Exam) - $25; 18a (MCR Hearing Exam) - $25, 16b (Comp Dental) - $0, 14j (Nutrition Therap) - $25; 14i (Diab Mon.) - $25; 14a (Smoking Cessation) - $25"	"7e (MH), 7h (Psychiatric) - $25"	"7c (OT), 7i (PT/ST) - $25"	"8b (OP Therap Rad, CT scans, PET, scans, & MRI) - 20%, 8b (OP x-rays) - 0%"	"7g (Prof. Other - allergy visits)  - $5; 14b (Immun), 14d (Pap/Pelvic), 14e (Prostate), 14f (Colorectal), 14g (Bone Mass) - $0"	15 (Part B Rx) - 0%	13a (Blood) - $0				17b1 (Non MCR Covered) - $100 limit															92.85	92.85	55.1		150	0.2	0.239402205	50	100		0.173202615			25	15	18.79336947	25	25	0.055503957	5																					83.91657002	83.80936886	49.73501588		135.3947801	0.180526373	0.21609206	45.13159336	90.26318671		0.1563382			22.56579668	13.53947801	16.96349417	22.56579668	22.56579668	0.05009964	4.513159336																					12.5793	0.713243029	5.665785747	0	2.697173894	1.57674867	1.647027536	1.219521931	2.754217073	0	3.072893489	0	0	0.712779057	3.739890063	8.339759934	1.093666623	1.08938275	1.270856233	0.026816805	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.1991	0	5.1815	12.5793	0.713243029	5.665785747	0	2.697173894	1.57674867	1.647027536	1.219521931	2.754217073	0	3.072893489	0	0	0.712779057	3.739890063	8.339759934	1.093666623	1.08938275	1.270856233	0.026816805	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.1991																																																																																		0	0	0	12.5793	0.713243029	5.665785747	0	2.697173894	1.57674867	1.647027536	1.219521931	2.754217073	0	3.072893489	0	0	0.712779057	3.739890063	8.339759934	1.093666623	1.08938275	1.270856233	0.026816805	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.1991
H7226_007_0	2009	6																					3350											D	D	D	V	T	P	P	V	V	P	P	V	V	V	P	P	V	V	P	P	S	P	P	P	P	P	P	P	P	P																																																			0		2531.212303	38.1731512	2018.646541		866.8131419			1572.183982	1706.176402					1642.508905	3389.179854	6826.308858	457.9315924	1607.782802		46.58714968							0.956614983														"1a (IP Acute), 1a1 (Add'l Days) - $50/days 1-5"	1b (IP Psych) - $50/days 1-5	2 (SNF) - $50 days 11-100; 2a2 (Waiver 3 Day) - $0	6 (Home Health)- $0	10a (Ambulance) - $150	11a (Medical Equip) - $0	"11b (Med Supp), 11c (Diab Supp) - $0"	4a (ER) $50 (WW Coverage)	"9a (OP Surgery), 9b (ASC) - $100"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $0	9a (OP Observation) - $0	12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - $15; 3 (CORF)- $0; 5 (Partial Hospitalization) - $0, 9a (OP Other excluding Surgery) - $0"	"7a (PCP) - $15, 14c (Routine Physical) - $15"	"7b (Chiro), 7d (Spec), 7f (Pod) - $15; 17a (MCR Eye Exam) - $15; 18a (MCR Hearing Exam) - $15, 16b (Comp Dental) - $0, 14j (Nutrition Therap) - $15; 14i (Diab Mon.) - $15; 14a (Smoking Cessation) - $15"	"7e (MH), 7h (Psychiatric) - $15"	"7c (OT), 7i (PT/ST) - $15"	"8b (Professional Radiology) - 0%, 14h (Mammography)"	"7g (Prof. Other - allergy visits)  - $5; 14b (Immun), 14d (Pap/Pelvic), 14e (Prostate), 14f (Colorectal), 14g (Bone Mass) - $0"	15 (Part B Rx) - $0	13a (Blood) - $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													20.86333333	20.86333333	11.43478261		57.01942414			8.30688384	25.06893523					15	15	15	15	15		5							15														19.64765153	19.6455679	10.76734933		53.69127504			7.822021912	23.60569432					14.12446965	14.23742973	14.12446965	14.12446965	14.12446965		4.708156549							15														4.1444	0.062494436	1.811289373	0	3.878358568	0	0	1.024804796	3.356289883	0	0	0	0	1.933297265	4.021100834	8.03483269	0.539003407	1.892423283	0	0.018278299	0	0	0	0	0	0	0.001195769	0	0	0	0	0	0	0	0	0	0	0	0	0	30.7177	0	1.8697	4.1444	0.062494436	1.811289373	0	3.878358568	0	0	1.024804796	3.356289883	0	0	0	0	1.933297265	4.021100834	8.03483269	0.539003407	1.892423283	0	0.018278299	0	0	0	0	0	0	0.001195769	0	0	0	0	0	0	0	0	0	0	0	0	0	30.7177																																																																																		0	0	0	4.1444	0.062494436	1.811289373	0	3.878358568	0	0	1.024804796	3.356289883	0	0	0	0	1.933297265	4.021100834	8.03483269	0.539003407	1.892423283	0	0.018278299	0	0	0	0	0	0	0.001195769	0	0	0	0	0	0	0	0	0	0	0	0	0	30.7177
H7226_008_0	2009	7																					3350											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																																																			0		2367.718879	68.56348934	2097.914298		1017.406212	7.993965578	2.61311659	1656.208903	1301.340028		23.96411039			973.8085293	2852.918037	5288.8473	477.545851	734.7656215	19.32751871	12.53686924																					"1a (IP Acute), 1a1 (Add'l Days) - $150 days 1-5"	1b (IP Psych) - $150 days 1-5	2 (SNF) - $100 days 11-100	6a (Home Health) - $0	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp) - 20%,11b1 (Prosthetics) - 30%, 11c (Diabetic Supplies) - 0%"	4a (ER) $50 (WW Coverage)	"9a (OP Surgery) - $100, 9b (ASC) - $100"	8a (OP Diag Proc/Test/Lab) - $0	"8b (OP Therap Rad, CT scans, PET, scans, & MRI) - 20%, 8b (OP x-rays) - 0%"	9a (OP Observation) - $0	12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - $25, 3 (CORF)- $0; 5 (Partial Hospitalization) - $0, 9a (OP Other excluding Surgery) - $0"	"7a (PCP) - $15, 14c (Routine Physical) - $0"	"7b (Chiro) - $25, 7d (Spec) - $15, 7f (Pod) - $25; 17a (MCR Eye Exam) - $25; 18a (MCR Hearing Exam) - $25, 16b (Comp Dental) - $0, 14j (Nutrition Therap) - $25; 14i (Diab Mon.) - $25; 14a (Smoking Cessation) - $25"	"7e (MH), 7h (Psychiatric) - $25"	"7c (OT), 7i (PT/ST) - $25"	"8b (OP Therap Rad, CT scans, PET, scans, & MRI) - 20%, 8b (OP x-rays) - 0%"	"7g (Prof. Other - allergy visits)  - $5; 14b (Immun), 14d (Pap/Pelvic), 14e (Prostate), 14f (Colorectal), 14g (Bone Mass) - $0"	15 (Part B Rx) - 0%	13a (Blood) - $0				17b1 (Non MCR Covered) - $100 limit															62.58795788	62.58795788	22.77723017		53.56969523	0.2	0.245718141	8.71584415	26.54263793		0.162443515			25	15	17.76358935	25	25	0.055503957	5																					56.92279003	56.92279003	20.71554233		48.72081813	0.18189694	0.22347689	7.926926892	24.14012307		0.147739892			22.73711747	13.64227048	16.16159997	22.73711747	22.73711747	0.050479999	4.547423494																					11.2314	0.325235426	3.621619369	0	4.130738586	1.454077875	0.583971168	1.094053908	2.617875702	0	3.54045507	0	0	1.845133244	3.243356628	7.123019529	0.904834676	1.392204354	0.975653132	0.004750871	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.0884	0	4.385	11.2314	0.325235426	3.621619369	0	4.130738586	1.454077875	0.583971168	1.094053908	2.617875702	0	3.54045507	0	0	1.845133244	3.243356628	7.123019529	0.904834676	1.392204354	0.975653132	0.004750871	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.0884																																																																																		0	0	0	11.2314	0.325235426	3.621619369	0	4.130738586	1.454077875	0.583971168	1.094053908	2.617875702	0	3.54045507	0	0	1.845133244	3.243356628	7.123019529	0.904834676	1.392204354	0.975653132	0.004750871	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	44.0884
H7226_009_0	2009	4																					3350											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																																																			0		3019.236974	131.3002988	2321.30449		1052.858987	7.304365218	2.48024095	1698.814451	956.674511		19.40017462			717.1940597	2600.342488	4758.516205	627.3428237	799.7666626	18.53814732	11.45250591																					"1a (IP Acute), 1a1 (Add'l Days) - $150 days 1-5"	1b (IP Psych) - $150 days 1-5	2 (SNF) - $100 days 11-100	6a (Home Health) - $0	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp) - 20%,11b1 (Prosthetics) - 30%, 11c (Diabetic Supplies) - 0%"	4a (ER) $50 (WW Coverage)	"9a (OP Surgery) - $100, 9b (ASC) - $100"	8a (OP Diag Proc/Test/Lab) - $0	"8b (OP Therap Rad, CT scans, PET, scans, & MRI) - 20%, 8b (OP x-rays) - 0%"	9a (OP Observation) - $0	12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - $25, 3 (CORF)- $0; 5 (Partial Hospitalization) - $0, 9a (OP Other excluding Surgery) - $0"	"7a (PCP) - $15, 14c (Routine Physical) - $0"	"7b (Chiro) - $25, 7d (Spec) - $15, 7f (Pod) - $25; 17a (MCR Eye Exam) - $25; 18a (MCR Hearing Exam) - $25, 16b (Comp Dental) - $0, 14j (Nutrition Therap) - $25; 14i (Diab Mon.) - $25; 14a (Smoking Cessation) - $25"	"7e (MH), 7h (Psychiatric) - $25"	"7c (OT), 7i (PT/ST) - $25"	"8b (OP Therap Rad, CT scans, PET, scans, & MRI) - 20%, 8b (OP x-rays) - 0%"	"7g (Prof. Other - allergy visits)  - $5; 14b (Immun), 14d (Pap/Pelvic), 14e (Prostate), 14f (Colorectal), 14g (Bone Mass) - $0"	15 (Part B Rx) - 0%	13a (Blood) - $0				17b1 (Non MCR Covered) - $100 limit															62.59	62.59	22.7826087		52.90786415	0.2	0.245512039	9.897673711	32.30627609		0.166233805			25	15	17.82254955	25	25	0.065502983	5																					56.70430653	56.70430653	20.6402305		47.93263694	0.181192863	0.222425146	8.966939192	29.26833331		0.150601895			22.6491079	13.58946474	16.16249721	22.6491079	22.6491079	0.059343365	4.529821579																					14.267	0.620441033	3.99268831	0	4.20552563	1.323498847	0.551667956	1.26943049	2.333355705	0	2.921703067	0	0	1.35365047	2.944771879	6.409125409	1.184062942	1.509500119	1.100116045	0.004323151	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9908	0	4.7667	14.267	0.620441033	3.99268831	0	4.20552563	1.323498847	0.551667956	1.26943049	2.333355705	0	2.921703067	0	0	1.35365047	2.944771879	6.409125409	1.184062942	1.509500119	1.100116045	0.004323151	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9908																																																																																		0	0	0	14.267	0.620441033	3.99268831	0	4.20552563	1.323498847	0.551667956	1.26943049	2.333355705	0	2.921703067	0	0	1.35365047	2.944771879	6.409125409	1.184062942	1.509500119	1.100116045	0.004323151	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.9908
H7226_011_0	2009	4																					3350											D	D	D	V	T	P	P	V	V	P	P	V	V	V	P	P	V	V	P	P	S	P	P	P	P	P	P	P	P	P																																																			0		1536.912971	67.27654781	1279.913391		235.5901587			331.7078271	360.9654904					432.5708194	3928.35041	5905.851405	663.7462944	584.6783188		97.57357114							255.8976692														"1a (IP Acute), 1a1 (Add'l Days) - $50/days 1-5"	1b (IP Psych) - $50/days 1-5	2 (SNF) - $50 days 11-100; 2a2 (Waiver 3 Day) - $0	6 (Home Health)- $0	10a (Ambulance) - $150	11a (Medical Equip) - $0	"11b (Med Supp), 11c (Diab Supp) - $0"	4a (ER) $50 (WW Coverage)	"9a (OP Surgery), 9b (ASC) - $100"	8a (OP Diag Proc/Test/Lab) - $0	8b (OP Diag & Therap Rad) - $0	9a (OP Observation) - $0	12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - $15; 3 (CORF)- $0; 5 (Partial Hospitalization) - $0, 9a (OP Other excluding Surgery) - $0"	"7a (PCP) - $15, 14c (Routine Physical) - $15"	"7b (Chiro), 7d (Spec), 7f (Pod) - $15; 17a (MCR Eye Exam) - $15; 18a (MCR Hearing Exam) - $15, 16b (Comp Dental) - $0, 14j (Nutrition Therap) - $15; 14i (Diab Mon.) - $15; 14a (Smoking Cessation) - $15"	"7e (MH), 7h (Psychiatric) - $15"	"7c (OT), 7i (PT/ST) - $15"	"8b (Professional Radiology) - 0%, 14h (Mammography)"	"7g (Prof. Other - allergy visits)  - $5; 14b (Immun), 14d (Pap/Pelvic), 14e (Prostate), 14f (Colorectal), 14g (Bone Mass) - $0"	15 (Part B Rx) - $0	13a (Blood) - $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													30.95	30.95	27.55		150			50	100					15	15	15	15	15		5							15														29.50395825	29.48660575	26.24736634		142.9076207			47.63774257	95.27174717					14.29076207	14.31051353	14.29076207	14.29076207	14.29076207		4.763587358							15														3.7788	0.165313087	2.799529639	0	2.805635755	0	0	1.316817673	2.865817745	0	0	0	0	0.515147222	4.684725973	7.033259774	0.790453364	0.696291562	0	0.038733353	0	0	0	0	0	0	0.319872086	0	0	0	0	0	0	0	0	0	0	0	0	0	27.8103	0	1.3552	3.7788	0.165313087	2.799529639	0	2.805635755	0	0	1.316817673	2.865817745	0	0	0	0	0.515147222	4.684725973	7.033259774	0.790453364	0.696291562	0	0.038733353	0	0	0	0	0	0	0.319872086	0	0	0	0	0	0	0	0	0	0	0	0	0	27.8103																																																																																		0	0	0	3.7788	0.165313087	2.799529639	0	2.805635755	0	0	1.316817673	2.865817745	0	0	0	0	0.515147222	4.684725973	7.033259774	0.790453364	0.696291562	0	0.038733353	0	0	0	0	0	0	0.319872086	0	0	0	0	0	0	0	0	0	0	0	0	0	27.8103
H7226_013_0	2009	7																					3350											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																																																			0		1530.8008	67.00899473	1274.823285		234.6532368	8.204686337	8.120834858	330.1274615	359.5299615		20.03235739			430.7924503	3803.76277	5882.364339	661.164704	582.3531031	22.74840289	97.18552939																					"1a (IP Acute), 1a1 (Add'l Days) - $150 days 1-5"	1b (IP Psych) - $150 days 1-5	2 (SNF) - $100 days 11-100	6a (Home Health) - $0	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp) - 20%,11b1 (Prosthetics) - 30%, 11c (Diabetic Supplies) - 0%"	4a (ER) $50 (WW Coverage)	"9a (OP Surgery) - $100, 9b (ASC) - $100"	8a (OP Diag Proc/Test/Lab) - $0	"8b (OP Therap Rad, CT scans, PET, scans, & MRI) - 20%, 8b (OP x-rays) - 0%"	9a (OP Observation) - $0	12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - $25, 3 (CORF)- $0; 5 (Partial Hospitalization) - $0, 9a (OP Other excluding Surgery) - $0"	"7a (PCP) - $15, 14c (Routine Physical) - $0"	"7b (Chiro) - $25, 7d (Spec) - $15, 7f (Pod) - $25; 17a (MCR Eye Exam) - $25; 18a (MCR Hearing Exam) - $25, 16b (Comp Dental) - $0, 14j (Nutrition Therap) - $25; 14i (Diab Mon.) - $25; 14a (Smoking Cessation) - $25"	"7e (MH), 7h (Psychiatric) - $25"	"7c (OT), 7i (PT/ST) - $25"	"8b (OP Therap Rad, CT scans, PET, scans, & MRI) - 20%, 8b (OP x-rays) - 0%"	"7g (Prof. Other - allergy visits)  - $5; 14b (Immun), 14d (Pap/Pelvic), 14e (Prostate), 14f (Colorectal), 14g (Bone Mass) - $0"	15 (Part B Rx) - 0%	13a (Blood) - $0				17b1 (Non MCR Covered) - $100 limit															92.85	92.85	55.1		150	0.2	0.239901063	50	100		0.178636761			25	15	19.11372113	25	25	0.055503957	5																					84.278435	84.17557622	49.95233441		135.9863913	0.181315188	0.217488532	45.3287971	90.6575942		0.16194779			22.66439855	13.59863913	17.32803974	22.66439855	22.66439855	0.050318552	4.53287971																					10.7511	0.470043395	5.30669992	0	2.65913724	1.487634249	1.766188452	1.247023393	2.71617678	0	3.244196008	0	0	0.813637649	4.310499771	8.494153583	1.248741697	1.099890235	1.14466669	0.03671086	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7965	0	4.808	10.7511	0.470043395	5.30669992	0	2.65913724	1.487634249	1.766188452	1.247023393	2.71617678	0	3.244196008	0	0	0.813637649	4.310499771	8.494153583	1.248741697	1.099890235	1.14466669	0.03671086	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7965																																																																																		0	0	0	10.7511	0.470043395	5.30669992	0	2.65913724	1.487634249	1.766188452	1.247023393	2.71617678	0	3.244196008	0	0	0.813637649	4.310499771	8.494153583	1.248741697	1.099890235	1.14466669	0.03671086	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7965
H7226_014_0	2009	3																					3350											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																																																			0		1610.402279	100.750694	1489.331052		261.2749014	9.014800778	8.26734902	369.2008894	404.0479942		25.31784704			457.212863	3449.385897	5822.277265	685.219554	602.1085086	23.30961054	69.87413564																					"1a (IP Acute), 1a1 (Add'l Days) - $150 days 1-5"	1b (IP Psych) - $150 days 1-5	2 (SNF) - $100 days 11-100	6a (Home Health) - $0	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp) - 20%,11b1 (Prosthetics) - 30%, 11c (Diabetic Supplies) - 0%"	4a (ER) $50 (WW Coverage)	"9a (OP Surgery) - $100, 9b (ASC) - $100"	8a (OP Diag Proc/Test/Lab) - $0	"8b (OP Therap Rad, CT scans, PET, scans, & MRI) - 20%, 8b (OP x-rays) - 0%"	9a (OP Observation) - $0	12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - $25, 3 (CORF)- $0; 5 (Partial Hospitalization) - $0, 9a (OP Other excluding Surgery) - $0"	"7a (PCP) - $15, 14c (Routine Physical) - $0"	"7b (Chiro) - $25, 7d (Spec) - $15, 7f (Pod) - $25; 17a (MCR Eye Exam) - $25; 18a (MCR Hearing Exam) - $25, 16b (Comp Dental) - $0, 14j (Nutrition Therap) - $25; 14i (Diab Mon.) - $25; 14a (Smoking Cessation) - $25"	"7e (MH), 7h (Psychiatric) - $25"	"7c (OT), 7i (PT/ST) - $25"	"8b (OP Therap Rad, CT scans, PET, scans, & MRI) - 20%, 8b (OP x-rays) - 0%"	"7g (Prof. Other - allergy visits)  - $5; 14b (Immun), 14d (Pap/Pelvic), 14e (Prostate), 14f (Colorectal), 14g (Bone Mass) - $0"	15 (Part B Rx) - 0%	13a (Blood) - $0				17b1 (Non MCR Covered) - $100 limit															92.85	92.85	55.1		150	0.2	0.229250518	50	100		0.171826779			25	15	19.22561313	25	25	0.055503957	5																					83.57351113	83.46219327	49.52899137		134.8339148	0.179778553	0.206071632	44.94463827	89.88927654		0.154453849			22.47231914	13.48339148	17.28176456	22.47231914	22.47231914	0.049892105	4.494463827																					11.2156	0.700739491	6.147088737	0	2.935726483	1.62066784	1.703666105	1.382800035	3.026631824	0	3.910438921	0	0	0.856219447	3.875785035	8.384935407	1.283206041	1.127564547	1.16296554	0.026170565	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3602	0	5.5354	11.2156	0.700739491	6.147088737	0	2.935726483	1.62066784	1.703666105	1.382800035	3.026631824	0	3.910438921	0	0	0.856219447	3.875785035	8.384935407	1.283206041	1.127564547	1.16296554	0.026170565	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3602																																																																																		0	0	0	11.2156	0.700739491	6.147088737	0	2.935726483	1.62066784	1.703666105	1.382800035	3.026631824	0	3.910438921	0	0	0.856219447	3.875785035	8.384935407	1.283206041	1.127564547	1.16296554	0.026170565	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.3602
H7226_015_0	2009	3																					3350											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																																																			0		1530.207534	66.98302523	1274.329224		234.5622964	8.198328076	8.114541579	329.9995198	359.3906248		20.01683322			430.6254956	3802.288612	5880.084614	660.908468	582.1274107	22.73077391	97.14786489																					"1a (IP Acute), 1a1 (Add'l Days) - $150 days 1-5"	1b (IP Psych) - $150 days 1-5	2 (SNF) - $100 days 11-100	6a (Home Health) - $0	10a (Ambulance) - $150	11a (Medical Equip) - 20%	"11b (Med Supp) - 20%,11b1 (Prosthetics) - 30%, 11c (Diabetic Supplies) - 0%"	4a (ER) $50 (WW Coverage)	"9a (OP Surgery) - $100, 9b (ASC) - $100"	8a (OP Diag Proc/Test/Lab) - $0	"8b (OP Therap Rad, CT scans, PET, scans, & MRI) - 20%, 8b (OP x-rays) - 0%"	9a (OP Observation) - $0	12 (Renal Dialysis) - $0	"7i, 7c (OP PT/ST/OT), 9c (OP SA), 9d (Cardiac Rehab) - $25, 3 (CORF)- $0; 5 (Partial Hospitalization) - $0, 9a (OP Other excluding Surgery) - $0"	"7a (PCP) - $15, 14c (Routine Physical) - $0"	"7b (Chiro) - $25, 7d (Spec) - $15, 7f (Pod) - $25; 17a (MCR Eye Exam) - $25; 18a (MCR Hearing Exam) - $25, 16b (Comp Dental) - $0, 14j (Nutrition Therap) - $25; 14i (Diab Mon.) - $25; 14a (Smoking Cessation) - $25"	"7e (MH), 7h (Psychiatric) - $25"	"7c (OT), 7i (PT/ST) - $25"	"8b (OP Therap Rad, CT scans, PET, scans, & MRI) - 20%, 8b (OP x-rays) - 0%"	"7g (Prof. Other - allergy visits)  - $5; 14b (Immun), 14d (Pap/Pelvic), 14e (Prostate), 14f (Colorectal), 14g (Bone Mass) - $0"	15 (Part B Rx) - 0%	13a (Blood) - $0				17b1 (Non MCR Covered) - $100 limit															92.85	92.85	55.1		150	0.2	0.239901063	50	100		0.178636761			25	15	19.11372113	25	25	0.055503957	5																					84.28316319	84.18036115	49.95517393		135.9941214	0.181325495	0.217500895	45.3313738	90.6627476		0.161956996			22.6656869	13.59941214	17.32902474	22.6656869	22.6656869	0.050321412	4.53313738																					10.7476	0.469887938	5.304944836	0	2.658257784	1.486565898	1.764920057	1.246610965	2.715278459	0	3.241866175	0	0	0.813368555	4.30907416	8.491344313	1.2483287	1.099526469	1.143844643	0.036698718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7781	0	4.8032	10.7476	0.469887938	5.304944836	0	2.658257784	1.486565898	1.764920057	1.246610965	2.715278459	0	3.241866175	0	0	0.813368555	4.30907416	8.491344313	1.2483287	1.099526469	1.143844643	0.036698718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7781																																																																																		0	0	0	10.7476	0.469887938	5.304944836	0	2.658257784	1.486565898	1.764920057	1.246610965	2.715278459	0	3.241866175	0	0	0.813368555	4.30907416	8.491344313	1.2483287	1.099526469	1.143844643	0.036698718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7781
H7226_807_0	2009	1																																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																																																			0		246.3442658	1.861340997	42.97453884		7.528397222	5.961802794	3.366121104	10.00377606	47.21239136	15.65402082	33.60734071	4.978760516	16.13979528	46.06041825	17.89031109	112.8292683	2.997926805	5.736820525	24.30472978	20.88959546	4.395469095	1.12205001																			Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share																			0.071576319	0.071576319	0.163155486		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.071576319	0.071576319	0.163155486		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			17.6324	0.133227936	7.011531756	0	1.739059758	1.377176445	0.777573975	2.310872271	10.9060624	3.61607881	7.763295704	1.150093679	3.72829271	10.63995662	4.132661861	26.06356098	0.692521092	1.325205541	5.614392579	4.825496552	1.015353361	0.259193552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.714	0	0	17.6324	0.133227936	7.011531756	0	1.739059758	1.377176445	0.777573975	2.310872271	10.9060624	3.61607881	7.763295704	1.150093679	3.72829271	10.63995662	4.132661861	26.06356098	0.692521092	1.325205541	5.614392579	4.825496552	1.015353361	0.259193552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.714																																																																																		0	0	0	17.6324	0.133227936	7.011531756	0	1.739059758	1.377176445	0.777573975	2.310872271	10.9060624	3.61607881	7.763295704	1.150093679	3.72829271	10.63995662	4.132661861	26.06356098	0.692521092	1.325205541	5.614392579	4.825496552	1.015353361	0.259193552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.714
H7252_001_0	2009	2																					3450											D	A	D		T	Coin	Coin	V	V		Coin			V		V	0	V	Coin	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	756.1582357	3.715141944	505.6817622	0	235.8967851	9.49451555	6.050706413	306.8468355	322.3642408	0	14.90884531	0	0	326.1065037	0	3663.497418	177.5778777	583.0083822	27.6946105	694.4966122	7.127962634	0	0	0	0	0	0	0	0	0											$50/Days 1-5 for IP Medical; $50/Days 1-5 for IP Surgical;	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	$75/Days Custom for SNF	No Cost Sharing	$100/Run 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;	$50/Case for OP Fac - Surgery; $50/Case for OP Fac - ASC	No Cost Sharing	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	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; $10/Visit for Prof - CORF; $10/Visit for Prof - CORF;	No Cost Sharing	$10/Visit for Speclst - Office Visits; $10/Consult for Speclst - Consults;	$10/Service for OP Psych - Non-Physician; $10/Service for OP Psych - Psychiatrist; $10/Service for OP Substance Abuse;	$10/Visit for PT/ST (PCP); $10/Visit for Occ Therapy (PCP); $10/Visit for PT/ST (Specialist); $10/Visit for Occ Therapy (Specialist);	20% Coinsurance for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	$10/Service for Podiatrist;	20% Coinsurance for Part B Rx	No Cost Sharing	Not Covered	No Cost Sharing for Preventive Services	No Cost Sharing	Max Plan Benefit of $300 every two years	No Cost Sharing	Max Plan Benefit of $800 every three years	No Cost Sharing	No copay up to $100 every quarter											50	899.9999997	75	0	100	0.2	0.183107532	43.64323285	50	0	0.2	0	0	10.00000001	0	10	10.00000001	10	0.2	10	0.2	0	0	0	0	0	0	0	0	0											50	899.9999997	75	0	100	0.2	0.183107532	43.64323285	50	0	0.2	0	0	10.00000001	0	10	10.00000001	10	0.2	10	0.2	0	0	0	0	0	0	0	0	0											3.1507	0.278635646	3.160511014	0	1.965806543	1.89890311	1.107929916	1.115982325	1.343184336	0	2.981769063	0	0	0.27175542	0	3.052914515	0.147981565	0.485840319	5.538922099	0.578747177	1.425592527	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.5051	0	0	3.1507	0.278635646	3.160511014	0	1.965806543	1.89890311	1.107929916	1.115982325	1.343184336	0	2.981769063	0	0	0.27175542	0	3.052914515	0.147981565	0.485840319	5.538922099	0.578747177	1.425592527	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.5051	0																																																																																	0	0	0	3.1507	0.278635646	3.160511014	0	1.965806543	1.89890311	1.107929916	1.115982325	1.343184336	0	2.981769063	0	0	0.27175542	0	3.052914515	0.147981565	0.485840319	5.538922099	0.578747177	1.425592527	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	28.5051
H7252_002_0	2009	6																					3450											D	A	D		T	Coin	Coin	V	Coin		Coin			V		V	V	V	Coin	V	Coin					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	659.6785681	3.168437413	480.0758966	0	202.1324323	7.993505398	5.184341671	287.1760243	32.48537396	0	13.76372385	0	0	464.4824072	0	3412.262899	157.8542739	492.0348193	24.84209073	929.6382538	6.803593042	0	0	0	0	718.2788694	0	0	0	0											$150/Days 1-5 for IP Medical; $150/Days 1-5 for IP Surgical;	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	$75/Days Custom for SNF	No Cost Sharing	$100/Run 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;	20% Coinsurance for OP Fac - Surgery; 20% Coinsurance for OP Fac - ASC	No Cost Sharing	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	No Cost Sharing	No Cost Sharing	$20/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/Case for Prof - CORF; $25/Case for Prof - CORF;	No Cost Sharing	$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/Visit for PT/ST (PCP); $25/Visit for Occ Therapy (PCP); $25/Visit for PT/ST (Specialist); $25/Visit 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/Visit for Podiatrist;	20% Coinsurance for Part B Rx	No Cost Sharing	Not Covered	No Cost Sharing for Preventive Services	No Cost Sharing	Max Plan Benefit of $300 every two years	No Cost Sharing	Max Plan Benefit of $800 every three years	Not Covered	No copay up to $50 every quarter											150	900.0000001	75	0	100	0.2	0.183401454	43.28058583	0.2	0	0.2	0	0	23.2382975	0	25	25	25	0.2	25	0.2	0	0	0	0	5	0	0	0	0											150	900.0000001	75	0	100	0.2	0.183401454	43.28058583	0.2	0	0.2	0	0	23.2382975	0	25	25	25	0.2	25	0.2	0	0	0	0	5	0	0	0	0											8.246	0.237632806	3.000474354	0	1.684436936	1.59870108	0.950815802	1.035762214	6.497074792	0	2.75274477	0	0	0.899481697	0	7.108881039	0.328863071	1.02507254	4.968418147	1.936746362	1.360718608	0	0	0	0	0.299282862	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.9311	0	0	8.246	0.237632806	3.000474354	0	1.684436936	1.59870108	0.950815802	1.035762214	6.497074792	0	2.75274477	0	0	0.899481697	0	7.108881039	0.328863071	1.02507254	4.968418147	1.936746362	1.360718608	0	0	0	0	0.299282862	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.9311	0																																																																																	0	0	0	8.246	0.237632806	3.000474354	0	1.684436936	1.59870108	0.950815802	1.035762214	6.497074792	0	2.75274477	0	0	0.899481697	0	7.108881039	0.328863071	1.02507254	4.968418147	1.936746362	1.360718608	0	0	0	0	0.299282862	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.9311
H7252_003_0	2009	6																					3450												A	D		T	Coin	Coin	V			Coin			V	V	V	V	V	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	0	3.52203399	489.9047519	0	221.3246595	8.86105673	5.676829889	308.5733789	0	0	14.97219105	0	0	497.5888224	4209.900022	3548.47494	169.2425533	548.3527905	27.04432306	1090.056203	7.204090707	0	0	0	0	0	0	0	0	0											No Cost Sharing	$900/Admit for IP Psych; $900/Admit for IP Substance Abuse;	$75/Days Custom for SNF	No Cost Sharing	$100/Run 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;	No Cost Sharing	No Cost Sharing	20% Coinsurance for OP Fac - Radiology; 20% Coinsurance for OP Fac - CT/MRI/PET	No Cost Sharing	No Cost Sharing	$20/Case for OP Fac - Cardiovascular; $25/Case for OP Fac - Occ Therapy; $25/Case for OP Fac - Physical/Speech Therapy; $20/Case for OP Fac - CORF; $20/Visit for Prof - CORF; $20/Visit for Prof - CORF;	$5/Visit for PCP - Office Visits; $5/Visit for PCP - Consults;	$25/Visit for Speclst - Office Visits; $25/Visit for Speclst - Consults;	$25/Visit for OP Psych - Non-Physician; $25/Visit for OP Psych - Psychiatrist; $25/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);	20% Coinsurance for Prof Radiology (Office); 20% Coinsurance for Prof Radiology (OP); 20% Coinsurance for Prof Radiology (IP);	$25/Visit for Chiropractor; $25/Visit for Podiatrist;	20% Coinsurance for Part B Rx	No Cost Sharing	Not Covered	No Cost Sharing for Preventive Services	No Cost Sharing	Max Plan Benefit of $300 every two years	No Cost Sharing	Max Plan Benefit of $400 every three years	Not Covered	No copay up to $100 every quarter											0	900.0000001	75	0	100	0.2	0.183196257	43.57397158	0	0	0.2	0	0	22.37584939	5	25	25	25	0.2	25	0.2	0	0	0	0	0	0	0	0	0											0	900.0000001	75	0	100	0.2	0.183196257	43.57397158	0	0	0.2	0	0	22.37584939	5	25	25	25	0.2	25	0.2	0	0	0	0	0	0	0	0	0											0	0.264152549	3.061904699	0	1.844372162	1.772211346	1.03997399	1.120480637	0	0	2.99443821	0	0	0.927831046	1.754125009	7.392656125	0.352588653	1.142401647	5.408864612	2.270950423	1.440818141	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7878	0	0	0	0.264152549	3.061904699	0	1.844372162	1.772211346	1.03997399	1.120480637	0	0	2.99443821	0	0	0.927831046	1.754125009	7.392656125	0.352588653	1.142401647	5.408864612	2.270950423	1.440818141	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7878	0																																																																																	0	0	0	0	0.264152549	3.061904699	0	1.844372162	1.772211346	1.03997399	1.120480637	0	0	2.99443821	0	0	0.927831046	1.754125009	7.392656125	0.352588653	1.142401647	5.408864612	2.270950423	1.440818141	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.7878
H7292_001_0	2009	5																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin			Coin		Coin	Coin	Coin	Coin	Coin	Coin																																																												0		415.9822766	30.34575809	112.3491426	35.04183048	28.20505411	31.22333167	7.805832917	13.41225701	14.03686845	9.38615102	19.58150862			113.4871729		140.092077	6.735446482	5.296585611	25.83325805	42.09647777	8.16060254																				Medicare Standard Cost Sharing	Medicare Standard Cost Sharing	Medicare Standard Cost Sharing	Medicare Standard Cost Sharing	Medicare Standard Cost Sharing	Medicare Standard Cost Sharing	Medicare Standard Cost Sharing	Medicare Standard Cost Sharing	Medicare Standard Cost Sharing	Medicare Standard Cost Sharing	Medicare Standard Cost Sharing			Medicare Standard Cost Sharing		Medicare Standard Cost Sharing	Medicare Standard Cost Sharing	Medicare Standard Cost Sharing	Medicare Standard Cost Sharing	Medicare Standard Cost Sharing	Medicare Standard Cost Sharing																				0.0539	0.0539	0.1261	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231		0.231	0.231	0.231	0.231	0.231	0.231																				0.0539	0.0539	0.1261	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231		0.231	0.231	0.231	0.231	0.231	0.231																				22.4214	1.635636361	14.16722688	0	6.5153675	7.212589616	1.803147404	3.09823137	3.242516611	2.168200886	4.523328491	0	0	26.21553695	0	32.36126979	1.555888137	1.223511276	5.96748261	9.724286366	1.885099187	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.7208			22.4214	1.635636361	14.16722688	0	6.5153675	7.212589616	1.803147404	3.09823137	3.242516611	2.168200886	4.523328491	0	0	26.21553695	0	32.36126979	1.555888137	1.223511276	5.96748261	9.724286366	1.885099187	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.7208																																																																																		0			22.4214	1.635636361	14.16722688	0	6.5153675	7.212589616	1.803147404	3.09823137	3.242516611	2.168200886	4.523328491	0	0	26.21553695	0	32.36126979	1.555888137	1.223511276	5.96748261	9.724286366	1.885099187	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	145.7208
H7301_001_0	2009	4																					1200											A	A	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	V	Coin	P																																																			0		314.9289493	4.537261013	940.9661417		127.081145	8.010466606	6.419636759	303.7919562	345.6860604	2250.564575	454.4937159	23.00167759		687.3476897	3524.903103	5813.303212	179.9276112	575.3222805	4142.083817	5479.196121	19.22958083				136.8		236.55														1a: $400 per admission;1a1: $400 per admission	1b: $400 per admission	"2: $0 days 1-20, $100 a day 21-100"	6: $0	10a: $25/trip	11a: 10%	11b: 10%;11c: 10%	4a: $50/visit;4a1: $50/visit;4b: $30/visit	9a: $100/visit;9b: $100/visit	8a: $10/visit	8b: $10/visit;8b: $50/visit;8b: 10%	9a: $75/visit	12a: $0/visit	5: $75/visit;9a: $100/visit;9c: $20/visit;9d: $20/visit; 7i: $20/visit; 7c: $20/visit; 7e: $20/visit	7a: $10/visit;14c: $10/visit;14d: $0/visit;14d1: $0/visit;14e: $0/visit;14e1: $0/visit;14f: $0/visit;14f1: $0/visit;14g: $0/visit;14g1: $0/visit	7b: $20/visit;7d: $20/visit;7f: $20/visit;16b: $20/visit;17a: $20/visit;18a: $20/visit	7e: $20/visit;7h: $20/visit	7c: $20/visit;7i: $20/visit	7a: $10/visit; 7d: $20/visit; 8b: $10/visit; 8b: $50/visit; 8b: 10%; 14h: $0/visit	14b: $0/visit;14i: $0/visit;17b: $0/visit; 7a: $10/visit; 7d: $20/visit; 8a: $10/visit; 12: $0/visit	15: 20%	13a: $0		16a: $500 allowance	17a1: $20/visit	17b1: $100/yr	18a1: $20/visit	18b: $500/3 yr	14a: $0/visit	14c1: $10/visit;13a1: 0											400	400	18.23124866		25	0.1	0.1	46	94.60835474	10	51.08683383	75		80.33195311	9.999545351	19.99922661	19.94679512	16.94130179	5.203434232	4.913442017	0.2				20		20														319.003875	319.003875	14.53959743		19.93774219	0.079750969	0.079750969	36.68544563	75.45107943	7.975096876	40.74224488	59.81322657		64.06551083	7.974734289	15.94957696	15.90776235	13.5108523	4.149789209	3.918517608	0.159501938				20		20														8.372	0.120616987	1.140105741	0	0.211142592	0.638842472	0.511972251	0.928728608	2.1735322	1.495705876	1.543091189	0.114650379	0	3.669606738	2.342513803	7.726643917	0.238520473	0.647757863	1.432397894	1.789193873	3.0671554	0	0	0	0.228	0	0.39425	0	0	0	0	0	0	0	0	0	0	0	0	0	38.7864	0	9.69	8.372	0.120616987	1.140105741	0	0.211142592	0.638842472	0.511972251	0.928728608	2.1735322	1.495705876	1.543091189	0.114650379	0	3.669606738	2.342513803	7.726643917	0.238520473	0.647757863	1.432397894	1.789193873	3.0671554	0	0	0	0.228	0	0.39425	0	0	0	0	0	0	0	0	0	0	0	0	0	38.7864		OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: $25/trip	OON: 20%	OON: 20%	OON: $50/visit	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%		OON: $500 allowance	OON: 20%	OON: 20%	OON: 20%	OON: 20%		OON: 20%											2.852	0.0234	0.3559	0.2056	0.0147	0.1109	0.0889	0.071	0.5172	0.1023	0.255	0.0156		0.3148	0.3295	1.1008	0.0138	0.0508	0.2687	0.1047	0.2131				0.0102	0.018	0.0136	0.0229		0.0096											7.083	0	0	11.224	0.144048517	1.496030112	0.205608503	0.225810314	0.749790763	0.600886887	0.999729418	2.690725279	1.598027617	1.798071081	0.130230395	0	3.98438725	2.672017695	8.827410258	0.252369627	0.69851542	1.701060326	1.893910754	3.280225548	0	0	0	0.2382264	0.018014492	0.407822575	0.022916667	0	0.0096	0	0	0	0	0	0	0	0	0	0	45.8694
H7301_002_0	2009	3																					2500											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	O	P																																																			0		1301.515747	27.306452	879.7948122		118.816568	7.489861686	6.002420804	284.0351938	323.2047628	2104.201681	424.9362368	21.50578979		663.2349084	3302.152188	5456.000493	168.2262248	537.906854	3872.708133	5122.862867	17.97983911				136.8		236.55														1a: $175 days 1-5;1a1: $175 days 1-5	1b: $175 days 1-5	"2: $0 days 1-20, $100 a day 21-100"	6: $0	10a: $100/trip	11a: 20%	11b: 20%;11c: 20%	4a: $50/visit;4a1: $50/visit;4b: $30/visit	9a: $150/visit;9b: $150/visit	8a: $30/visit	8b: $25/visit;8b: $100/visit;8b: 20%	9a: $75/visit	12a: $0/visit	5: $75/visit;9a: $150/visit;9c: $30/visit;9d: $30/visit; 7i: $30/visit; 7c: $30/visit; 7e: $30/visit	7a: $15/visit;14c: $15/visit;14d: $0/visit;14e: $0/visit;14f: $0/visit;14g: $0/visit	7b: $30/visit;7b1: $30/visit;7d: $30/visit;7f: $30/visit;7f1: $30/visit;16b: $30/visit;17a: $30/visit;18a: $30/visit	7e: $30/visit;7h: $30/visit	7c: $30/visit;7i: $30/visit	7a: $15; 7d: $30/visit; 8b: $25/visit; 8b: $100/visit; 8b: 20%; 14h: $0/visit	14b: $0/visit;14i: $0/visit; 7a: $15/visit; 7d: $30/visit; 8a: $30/visit; 12: $0/visit	15: 20%	13a: $0		16a: $500 allowance	17a1: $30/visit		18a1: $30/visit		14a: $0/visit	14c1: $15/visit;13a1: $0											130.3984293	102.1725037	18.23124866		100	0.2	0.2	46	141.9125321	30	100.0726207	75		98.28416444	14.99931937	29.99884433	29.92019268	25.41195269	7.805151348	7.370163025	0.2				30		30														116.6421859	91.39392423	16.30796251		89.45060653	0.178901213	0.178901213	41.147279	126.9416207	26.83518196	89.5155662	67.0879549		87.91578122	13.41698215	26.8341482	26.76379383	22.73114581	6.981755221	6.592655528	0.178901213				30		30														12.651	0.207970317	1.195638401	0	0.885684506	1.339945341	1.073840363	0.973939614	3.419011368	4.705552916	3.16986732	0.120231621	0	4.859067925	3.692076413	12.20059382	0.375197666	1.018936594	2.253191686	2.814439183	3.216615027	0	0	0	0.342	0	0.591375	0	0	0	0	0	0	0	0	0	0	0	0	0	61.1061	0	7.0965	12.651	0.207970317	1.195638401	0	0.885684506	1.339945341	1.073840363	0.973939614	3.419011368	4.705552916	3.16986732	0.120231621	0	4.859067925	3.692076413	12.20059382	0.375197666	1.018936594	2.253191686	2.814439183	3.216615027	0	0	0	0.342	0	0.591375	0	0	0	0	0	0	0	0	0	0	0	0	0	61.1061		OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: $100/trip	OON: 20%	OON: 20%	OON: $50/visit	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%			OON: $500 allowance	OON: 20%		OON: 20%			OON: 20%											2.6664	0.0219	0.3328	0.1922	0.0549	0.1037	0.0831	0.0664	0.4836	0.0957	0.2384	0.0146		0.2943	0.3088	1.0296	0.0129	0.0475	0.2512	0.0979	0.1992				0.0102		0.0136			0.0096											6.6285	0	0	15.3173	0.229879018	1.528437538	0.192245886	0.940539801	1.443683038	1.156976385	1.040379727	3.902591765	4.801224707	3.408275919	0.134799082	0	5.153390668	4.000842368	13.23018954	0.388146756	1.066395387	2.504393589	2.912350453	3.41583762	0	0	0	0.3522264	0	0.604947575	0	0	0.0096	0	0	0	0	0	0	0	0	0	0	67.7347
H7301_801_0	2009	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																																																			0		249.7759862	2.044326563	25.09966271		5.994863387	8.076628766	6.472659518	14.61254729	43.46476376	6.771497788	21.42428711	1.314742958	0.12181758	26.45228859	29.03585412	97.6625205	1.260209535	4.618704993	24.44704995	7.89747276	19.38840686																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.083079381	0.083079381	0.199951179		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.083079381	0.083079381	0.199951179		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				20.7512	0.169841386	5.018707163	0	1.384813442	1.865701245	1.495184349	3.375498424	10.04036043	1.564215989	4.949010322	0.303705623	0.028139861	6.110478664	6.707282302	22.56004224	0.291108403	1.066920853	5.647268538	1.824316208	4.478721986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.6326	0	0	20.7512	0.169841386	5.018707163	0	1.384813442	1.865701245	1.495184349	3.375498424	10.04036043	1.564215989	4.949010322	0.303705623	0.028139861	6.110478664	6.707282302	22.56004224	0.291108403	1.066920853	5.647268538	1.824316208	4.478721986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.6326		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				1.1889	0.0098	0.3587		0.0777	0.1292	0.1035	0.2026	0.6023	0.1192	0.2969	0.0181	0.0017	0.3666	0.3716	1.2753	0.0161	0.0591	0.3129	0.1219	0.2481																				5.8803	0	0	21.9401	0.179655164	5.377382878	0	1.462540244	1.994904932	1.598728971	3.578074058	10.64265229	1.683373717	5.245944523	0.32184917	0.029817444	6.477053061	7.07887689	23.83531946	0.307236292	1.126030042	5.960136601	1.946263171	4.726850627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.5128
H7301_802_0	2009	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																																																			0		249.7759862	2.044326563	25.09966271		5.994863387	8.076628766	6.472659518	14.61254729	43.46476376	6.771497788	21.42428711	1.314742958	0.12181758	26.45228859	29.03585412	97.6625205	1.260209535	4.618704993	24.44704995	7.89747276	19.38840686																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.083079381	0.083079381	0.199951179		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.083079381	0.083079381	0.199951179		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				20.7512	0.169841386	5.018707163	0	1.384813442	1.865701245	1.495184349	3.375498424	10.04036043	1.564215989	4.949010322	0.303705623	0.028139861	6.110478664	6.707282302	22.56004224	0.291108403	1.066920853	5.647268538	1.824316208	4.478721986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.6326	0	0	20.7512	0.169841386	5.018707163	0	1.384813442	1.865701245	1.495184349	3.375498424	10.04036043	1.564215989	4.949010322	0.303705623	0.028139861	6.110478664	6.707282302	22.56004224	0.291108403	1.066920853	5.647268538	1.824316208	4.478721986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.6326		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				1.1889	0.0098	0.3587		0.0777	0.1292	0.1035	0.2026	0.6023	0.1192	0.2969	0.0181	0.0017	0.3666	0.3716	1.2753	0.0161	0.0591	0.3129	0.1219	0.2481																				5.8803	0	0	21.9401	0.179655164	5.377382878	0	1.462540244	1.994904932	1.598728971	3.578074058	10.64265229	1.683373717	5.245944523	0.32184917	0.029817444	6.477053061	7.07887689	23.83531946	0.307236292	1.126030042	5.960136601	1.946263171	4.726850627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.5128
H7301_803_0	2009	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																																																			0		249.7759862	2.044326563	25.09966271		5.994863387	8.076628766	6.472659518	14.61254729	43.46476376	6.771497788	21.42428711	1.314742958	0.12181758	26.45228859	29.03585412	97.6625205	1.260209535	4.618704993	24.44704995	7.89747276	19.38840686																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.083079381	0.083079381	0.199951179		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.083079381	0.083079381	0.199951179		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				20.7512	0.169841386	5.018707163	0	1.384813442	1.865701245	1.495184349	3.375498424	10.04036043	1.564215989	4.949010322	0.303705623	0.028139861	6.110478664	6.707282302	22.56004224	0.291108403	1.066920853	5.647268538	1.824316208	4.478721986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.6326	0	0	20.7512	0.169841386	5.018707163	0	1.384813442	1.865701245	1.495184349	3.375498424	10.04036043	1.564215989	4.949010322	0.303705623	0.028139861	6.110478664	6.707282302	22.56004224	0.291108403	1.066920853	5.647268538	1.824316208	4.478721986	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.6326		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				1.1889	0.0098	0.3587		0.0777	0.1292	0.1035	0.2026	0.6023	0.1192	0.2969	0.0181	0.0017	0.3666	0.3716	1.2753	0.0161	0.0591	0.3129	0.1219	0.2481																				5.8803	0	0	21.9401	0.179655164	5.377382878	0	1.462540244	1.994904932	1.598728971	3.578074058	10.64265229	1.683373717	5.245944523	0.32184917	0.029817444	6.477053061	7.07887689	23.83531946	0.307236292	1.126030042	5.960136601	1.946263171	4.726850627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.5128
H7306_001_0	2009	9																					2000											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	O	P																																																			0	4000	1815.715303	79.98641219	621.6465556		137.7531175	13.85130145	9.328601623	252.358261	337.9107038		177.0527563	29.40596881	0.541944824	489.1785229		5199.607968	305.0786012	270.526427	289.6807278	411.8300955	27.99353603				105.4421721																1a: Days 1 - 7: $200/day then $0;1a1: Days 1 - 7: $200/day then $0	1b: Days 1 -7 : $200/day then $0	"2: Days 1 - 7: $0/day, then $100/day"	6: $0	10a: $100/trip	11a: 20%	11b: 20%;11c: 20%	4a: $50/visit;4a1: $50/visit;4b: $25/visit	9a: $250/visit;9b: $250/visit	8a: $0/visit	8b: $0/visit;8b: $100/visit;8b: 20%;8b: $30/visit	9a: $250/visit	12a: 20%	3: 20%;5: $30/visit;9a: $250/visit;9c: $30/visit;9d: $30/visit; 7i: $30/visit; 7c: $30/visit; 7e: $30/visit	7a: $0/visit;14c: $0/visit;14d: $0/visit;14e: $0/visit;14f: $0/visit;14g: $0/visit	7b: $30/visit;7d: $30/visit;7f: $30/visit;16b: $$30/visit;17a: $30/visit;18a: $30/visit	7e: $30/visit;7h: $30/visit	7c: $30/visit;7i: $30/visit	7a: $0; 7d: $30/visit; 8b: $0/visit; 8b: $100/visit; 8b: 20%; 14h: $0/visit	7g: $30/visit;14b: $10/visit;14i: 20%; 7a: $0/visit; 7d: $30/visit; 8a: $0/visit; 12: 20%	15: 20%	13a: $0		16a: $250 allowance	17a1: $30/visit	17b1: $100 per yr				14c1: $0/visit;13a1: $0 ;13c: OTC $10/month											148.1273968	127.9506577	54.792029		100	0.2	0.2	45	227.4899046		146.9263246	250	0.2	110.452067		29.99742796	29.98006947	30	30	12.48500492	0.2				30																107.7403247	93.06479227	39.85293149		72.73490727	0.145469815	0.145469815	32.73070827	165.4645712		106.866726	181.8372682	0.145469815	80.33720854		21.81860141	21.80597573	21.82047218	21.82047218	9.080956752	0.145469815				21.82047218																16.3021	0.62032657	2.064536466	0	0.834955019	2.014946252	1.357029948	0.688322052	4.659354142	0	1.576754033	0.445591753	0.078836613	3.274936417	0	9.454014479	0.554378048	0.491917865	0.526747522	0.311650941	4.072214495	0	0	0	0.191733165	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.5204	0	18.563	16.3021	0.62032657	2.064536466	0	0.834955019	2.014946252	1.357029948	0.688322052	4.659354142	0	1.576754033	0.445591753	0.078836613	3.274936417	0	9.454014479	0.554378048	0.491917865	0.526747522	0.311650941	4.072214495	0	0	0	0.191733165	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	49.5204		OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: $100/trip	OON: 40%	OON: 40%;OON: 20%	OON: $50/visit	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 40%;OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%		OON: $250 allowance		OON: $100 per yr				OON: 20%											2.1922	0.0394	0.162	0.476	0.04	0.1932	0.1301	0.0372	0.2759	0.0162	0.0893	0.0166	0.0033	0.1696	0.2187	0.7924	0.0149	0.0176	0.2753	0.1138	0.1952				0.005					0.0125											5.4863	0	3.2325	18.4944	0.65974616	2.226539558	0.475954992	0.874973952	2.208096774	1.487113339	0.725504843	4.935205261	0.016239393	1.666062293	0.462207209	0.082158376	3.444494477	0.218692652	10.24640386	0.569318192	0.509486327	0.801998618	0.425487088	4.267393486	0	0	0	0.196726043	0	0	0	0	0.012507196	0	0	0	0	0	0	0	0	0	0	55.0067
H7306_002_0	2009	9																					2000											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	O	P																																																			0	4000	1815.69618	79.98556979	621.6400118		137.7516668	13.85115557	9.328503376	252.3556032	337.907145		177.0508916	29.40565912	0.541939117	489.173371		5199.553207	305.0753882	270.5235779	289.677677	411.8257582	27.99324121				105.4421721																1a: Days 1 - 7: $200/day then $0;1a1: Days 1 - 7: $200/day then $0	1b: Days 1 - 7: $200/day then $0	"2: Days 1 - 7: $0/day, then $100/day"	6: $0	10a: $100/trip	11a: 20%	11b: 20%;11c: 20%	4a: $50/visit;4a1: $50/visit;4b: $25/visit	9a: $150/visit;9b: $150/visit	8a: $0/visit	8b: $0/visit;8b: $100/visit;8b: 20%	9a: $150/visit	12a: 20%	3: 20%;5: $20/visit;9a: $150/visit;9c: $20/visit;9d: $20/visit; 7i: $20/visit; 7c: $20/visit; 7e: $20/visit	14c: $0/visit;14d: $0/visit;14e: $0/visit;14f: $0/visit;14g: $0/visit	7b: $20/visit;7d: $20/visit;7f: $20/visit;16b: $20/visit;17a: $20/visit;18a: $20/visit	7e: $20/visit;7h: $20/visit	7c: $20/visit;7i: $20/visit	7a: $0; 7d: $20/visit; 8b: $0/visit; 8b: $100/visit; 8b: 20%; 14h: $0/visit	7g: $20/visit;14b: $10/visit;14i: 20%;17b: $0/visit; 7a: ; 7d: $20/visit; 8a: $0/visit; 12: 20%	15: 20%	13a: $0		16a: $250 allowance	17a1: $20/visit	17b1: $100 per yr				14c1: $0/visit											148.1273968	127.9506577	54.792029		100	0.2	0.2	45	136.4939428		146.9263246	150	0.2	102.5458628		19.99828531	19.98671298	20	20	8.323336614	0.2				20																106.0776933	91.62863133	39.23792745		71.61247386	0.143224948	0.143224948	32.22561324	97.74668909		105.2175758	107.4187108	0.143224948	73.43562922		14.32126684	14.31297961	14.32249477	14.32249477	5.960547257	0.143224948				14.32249477																16.0504	0.610747357	2.032655473	0	0.82206147	1.983831032	1.336074408	0.677692839	2.752442054	0	1.552405468	0.263226499	0.077619202	2.993562858	0	6.205349076	0.363878151	0.322881044	0.345742251	0.204558908	4.009330509	0	0	0	0.12584958	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.7303	0	16.9385	16.0504	0.610747357	2.032655473	0	0.82206147	1.983831032	1.336074408	0.677692839	2.752442054	0	1.552405468	0.263226499	0.077619202	2.993562858	0	6.205349076	0.363878151	0.322881044	0.345742251	0.204558908	4.009330509	0	0	0	0.12584958	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.7303		OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: $100/trip	OON: 40%	OON: 40%;OON: 20%	OON: $50/visit	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 40%;OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%		OON: $250 allowance		OON: $100 per yr				OON: 20%											2.192	0.0394	0.162	0.4759	0.04	0.1931	0.1301	0.0372	0.2758	0.0162	0.0893	0.0166	0.0033	0.1695	0.2187	0.7923	0.0149	0.0176	0.2752	0.1138	0.1952				0.005					0.0125											5.4857	0	3.233	18.2424	0.650162696	2.194641094	0.475903659	0.862076086	2.176960722	1.46614377	0.714871625	3.028263421	0.016237642	1.641704096	0.279840164	0.080940606	3.163102631	0.218669066	6.997652999	0.378816684	0.340447611	0.620963661	0.318382778	4.20448845	0	0	0	0.130841971	0	0	0	0	0.012505979	0	0	0	0	0	0	0	0	0	0	48.216
H7306_801_0	2009	8																																Coin	Coin	Coin	Coin	Coin	Coin	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		278.7431525	5.04445022	20.81239434		6.213431037	14.58784157	9.824648105	13.69901919	47.36343594	2.787726607	15.33063541	2.856236571	0.570762629	28.81183413	32.37318405	117.2978017	2.211597121	2.600668336	40.74555914	14.82432702	29.48208659																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.069139512	0.069139512	0.199569352		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.069139512	0.069139512	0.199569352		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				19.2722	0.348770827	4.153516055	0	1.43530257	3.369791402	2.269493712	3.164473432	10.9409537	0.643964846	3.54137678	0.659790648	0.131846167	6.655533684	7.478205515	27.09579219	0.510878935	0.600754386	9.41222416	3.424419541	6.810362001	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.9196	0	0	19.2722	0.348770827	4.153516055	0	1.43530257	3.369791402	2.269493712	3.164473432	10.9409537	0.643964846	3.54137678	0.659790648	0.131846167	6.655533684	7.478205515	27.09579219	0.510878935	0.600754386	9.41222416	3.424419541	6.810362001	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.9196		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				1.2556	0.0228	0.2705		0.0788	0.1867	0.1257	0.1543	0.5333	0.0314	0.1726	0.0321	0.0064	0.3246	0.4228	1.5318	0.0289	0.034	0.5321	0.2201	0.3773																				6.3416	0	0	20.5277	0.371578783	4.423968273	0	1.514072953	3.556483446	2.395227436	3.318740513	11.47420838	0.675357623	3.714020805	0.691910401	0.13826755	6.980173206	7.900965734	28.62757986	0.5397601	0.634716418	9.944318918	3.644479036	7.187667375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.2612
H7306_803_0	2009	8																																Coin	Coin	Coin	Coin	Coin	Coin	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		278.7431525	5.04445022	20.81239434		6.213431037	14.58784157	9.824648105	13.69901919	47.36343594	2.787726607	15.33063541	2.856236571	0.570762629	28.81183413	32.37318405	117.2978017	2.211597121	2.600668336	40.74555914	14.82432702	29.48208659																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.069139512	0.069139512	0.199569352		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.069139512	0.069139512	0.199569352		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				19.2722	0.348770827	4.153516055	0	1.43530257	3.369791402	2.269493712	3.164473432	10.9409537	0.643964846	3.54137678	0.659790648	0.131846167	6.655533684	7.478205515	27.09579219	0.510878935	0.600754386	9.41222416	3.424419541	6.810362001	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.9196	0	0	19.2722	0.348770827	4.153516055	0	1.43530257	3.369791402	2.269493712	3.164473432	10.9409537	0.643964846	3.54137678	0.659790648	0.131846167	6.655533684	7.478205515	27.09579219	0.510878935	0.600754386	9.41222416	3.424419541	6.810362001	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.9196		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				1.2556	0.0228	0.2705		0.0788	0.1867	0.1257	0.1543	0.5333	0.0314	0.1726	0.0321	0.0064	0.3246	0.4228	1.5318	0.0289	0.034	0.5321	0.2201	0.3773																				6.3416	0	0	20.5277	0.371578783	4.423968273	0	1.514072953	3.556483446	2.395227436	3.318740513	11.47420838	0.675357623	3.714020805	0.691910401	0.13826755	6.980173206	7.900965734	28.62757986	0.5397601	0.634716418	9.944318918	3.644479036	7.187667375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.2612
H7306_804_0	2009	8																																Coin	Coin	Coin	Coin	Coin	Coin	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		278.7431525	5.04445022	20.81239434		6.213431037	14.58784157	9.824648105	13.69901919	47.36343594	2.787726607	15.33063541	2.856236571	0.570762629	28.81183413	32.37318405	117.2978017	2.211597121	2.600668336	40.74555914	14.82432702	29.48208659																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.069139512	0.069139512	0.199569352		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.069139512	0.069139512	0.199569352		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				19.2722	0.348770827	4.153516055	0	1.43530257	3.369791402	2.269493712	3.164473432	10.9409537	0.643964846	3.54137678	0.659790648	0.131846167	6.655533684	7.478205515	27.09579219	0.510878935	0.600754386	9.41222416	3.424419541	6.810362001	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.9196	0	0	19.2722	0.348770827	4.153516055	0	1.43530257	3.369791402	2.269493712	3.164473432	10.9409537	0.643964846	3.54137678	0.659790648	0.131846167	6.655533684	7.478205515	27.09579219	0.510878935	0.600754386	9.41222416	3.424419541	6.810362001	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.9196		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				1.2556	0.0228	0.2705		0.0788	0.1867	0.1257	0.1543	0.5333	0.0314	0.1726	0.0321	0.0064	0.3246	0.4228	1.5318	0.0289	0.034	0.5321	0.2201	0.3773																				6.3416	0	0	20.5277	0.371578783	4.423968273	0	1.514072953	3.556483446	2.395227436	3.318740513	11.47420838	0.675357623	3.714020805	0.691910401	0.13826755	6.980173206	7.900965734	28.62757986	0.5397601	0.634716418	9.944318918	3.644479036	7.187667375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.2612
H7352_002_0	2009	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																																																			0		320.6794887	33.04663727	27.95404729		29.96320347	22.18300535	16.99774764	25.88720751	27.20390234	3.847683913	10.46786529	3.468830999	3.635088123	50.76121476	49.25147401	64.85145403	10.61571573	3.811320872	26.26585213	46.10396547	21.31830321	3.049898633																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	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) - $750 allowance for aids and exam													0.0714	0.0714	0.1721		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.0714	0.0714	0.1721		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			22.8965	2.359529901	4.810891538	0	6.921500001	5.124274236	3.926479705	5.979944935	6.284101441	0.888814984	2.418076882	0.801299961	0.839705357	11.72584061	11.3770905	14.98068588	2.452230334	0.880415121	6.067411843	10.65001602	4.924528042	0.704526584	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0139	0	0	22.8965	2.359529901	4.810891538	0	6.921500001	5.124274236	3.926479705	5.979944935	6.284101441	0.888814984	2.418076882	0.801299961	0.839705357	11.72584061	11.3770905	14.98068588	2.452230334	0.880415121	6.067411843	10.65001602	4.924528042	0.704526584	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0139																																																																																		0	0	0	22.8965	2.359529901	4.810891538	0	6.921500001	5.124274236	3.926479705	5.979944935	6.284101441	0.888814984	2.418076882	0.801299961	0.839705357	11.72584061	11.3770905	14.98068588	2.452230334	0.880415121	6.067411843	10.65001602	4.924528042	0.704526584	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.0139
H7352_003_0	2009	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																																																			0		324.9192972	31.96077915	28.78542405		29.84941789	21.17306581	17.64494954	24.50891279	27.37356593	3.818539473	10.36276732	3.467183436	4.091600145	52.17751298	48.25625993	63.85521259	9.947058673	3.653101356	25.83635618	46.74058628	21.17836884	3.188351164																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	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) - $1,600 allowance for aids and exam"													0.0706	0.0706	0.1444		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.0706	0.0706	0.1444		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			22.9393	2.256431008	4.156615233	0	6.895215532	4.890978201	4.075983344	5.661558853	6.323293729	0.882082618	2.393799251	0.800919374	0.945159633	12.0530055	11.14719604	14.75055411	2.297770554	0.843866413	5.968198277	10.79707543	4.892203203	0.736509119	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.7077	0	0	22.9393	2.256431008	4.156615233	0	6.895215532	4.890978201	4.075983344	5.661558853	6.323293729	0.882082618	2.393799251	0.800919374	0.945159633	12.0530055	11.14719604	14.75055411	2.297770554	0.843866413	5.968198277	10.79707543	4.892203203	0.736509119	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.7077																																																																																		0	0	0	22.9393	2.256431008	4.156615233	0	6.895215532	4.890978201	4.075983344	5.661558853	6.323293729	0.882082618	2.393799251	0.800919374	0.945159633	12.0530055	11.14719604	14.75055411	2.297770554	0.843866413	5.968198277	10.79707543	4.892203203	0.736509119	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.7077
H7357_001_0	2009	2																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		310.097846	38.8339373	412.8707588	20.78123278	178.4242967	22.35849299	1.271130047	757.5141131	1401.747006		15.54979747		4.232685203	2.402369459	3910.176937	3607.924114	1.05918068	588.2623445		44.13446316	1.281811413	617.9212396			94.77503051		20.84518003														1a: $350 per admit $600 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.63135167		0.1		50	0.259087199	10	25	0.5	15		30.55670103	0.2	15			15		15														284.684682	90.40772114	24.94651199	0.122007721	81.33848056	0.162676961	0.162676961	40.66924028	77.78508838		0.081338481		40.66924028	0.210737591	8.133848056	20.33462014	0.406692403	12.20077208		24.85435633	0.162676961	12.20077208			12.20077208		12.20077208														7.3567	0.292573981	0.858307111	2.535470847	1.209396766	3.637211696	0.206783573	2.567293623	9.08625123	0	1.264796899	0	0.014345008	0.506269552	2.650398757	6.113813862	0.430760736	0.598104566	0	0.091411139	0.208521185	0.628259684	0	0	0.096360712	0	0.021193941	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3742	0	9.2631	7.3567	0.292573981	0.858307111	2.535470847	1.209396766	3.637211696	0.206783573	2.567293623	9.08625123	0	1.264796899	0	0.014345008	0.506269552	2.650398757	6.113813862	0.430760736	0.598104566	0	0.091411139	0.208521185	0.628259684	0	0	0.096360712	0	0.021193941	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3742																																																																																		0	0	0	7.3567	0.292573981	0.858307111	2.535470847	1.209396766	3.637211696	0.206783573	2.567293623	9.08625123	0	1.264796899	0	0.014345008	0.506269552	2.650398757	6.113813862	0.430760736	0.598104566	0	0.091411139	0.208521185	0.628259684	0	0	0.096360712	0	0.021193941	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3742
H7357_002_0	2009	3																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		295.0678001	35.68137979	347.7564309	13.20765358	147.5819257	22.91787082	1.235329858	698.1519739	1397.58872		16.65680768		4.548786859	3.158871615	3962.397873	3419.861855	1.030660357	612.5182702		50.61216424	1.311613554	657.4210508			98.01911915		20.91712333														1a: $350 per admit $600 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.58622574		0.1		50	0.278802468	10	25	0.5	15		30.93964335	0.2	15			15		15														288.3170885	91.56126967	25.26481458	0.123564466	82.376311	0.164752622	0.164752622	41.1881555	78.74040659		0.082376311		41.1881555	0.229667188	8.2376311	20.59407775	0.411881555	12.35644665		25.48693682	0.164752622	12.35644665			12.35644665		12.35644665														7.0894	0.272252703	0.732166812	1.631996668	1.013104551	3.775779308	0.203523833	2.396299339	9.170558669	0	1.37212637	0	0.015613012	0.725489161	2.720064329	5.869075077	0.42450999	0.630712444	0	0.107495753	0.216091772	0.676949012	0	0	0.100930668	0	0.021538443	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1657	0	8.3792	7.0894	0.272252703	0.732166812	1.631996668	1.013104551	3.775779308	0.203523833	2.396299339	9.170558669	0	1.37212637	0	0.015613012	0.725489161	2.720064329	5.869075077	0.42450999	0.630712444	0	0.107495753	0.216091772	0.676949012	0	0	0.100930668	0	0.021538443	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1657																																																																																		0	0	0	7.0894	0.272252703	0.732166812	1.631996668	1.013104551	3.775779308	0.203523833	2.396299339	9.170558669	0	1.37212637	0	0.015613012	0.725489161	2.720064329	5.869075077	0.42450999	0.630712444	0	0.107495753	0.216091772	0.676949012	0	0	0.100930668	0	0.021538443	0	0	0	0	0	0	0	0	0	0	0	0	0	39.1657
H7357_003_0	2009	3																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		316.6413747	56.93778892	480.4005306	18.73237234	148.803136	20.81240754	1.149920255	682.9094393	1524.498352		15.57878456		17.39597195	2.701764859	3688.043597	3968.177923	1.684543961	638.5276527		47.47242762	1.945804247	695.6250589			99.41526125		21.5787025														1a: $350 per admit $600 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.82883577		0.1		50	0.23961455	10	25	0.5	15		30.89108911	0.2	15			15		15														282.0977681	89.58619122	24.71982442	0.120899043	80.59936232	0.161198725	0.161198725	40.29968116	77.23743056		0.080599362		40.29968116	0.193127799	8.059936232	20.14984058	0.402996812	12.08990435		24.89802084	0.161198725	12.08990435			12.08990435		12.08990435														7.4437	0.42506997	0.989618064	2.264725898	0.999453156	3.354933553	0.185365678	2.293419389	9.812361303	0	1.255640101	0	0.05842101	0.521785901	2.477116351	6.663179378	0.678865845	0.64331152	0	0.098497458	0.313661163	0.700836702	0	0	0.100160083	0	0.021740371	0	0	0	0	0	0	0	0	0	0	0	0	0	41.3018	0	9.9415	7.4437	0.42506997	0.989618064	2.264725898	0.999453156	3.354933553	0.185365678	2.293419389	9.812361303	0	1.255640101	0	0.05842101	0.521785901	2.477116351	6.663179378	0.678865845	0.64331152	0	0.098497458	0.313661163	0.700836702	0	0	0.100160083	0	0.021740371	0	0	0	0	0	0	0	0	0	0	0	0	0	41.3018																																																																																		0	0	0	7.4437	0.42506997	0.989618064	2.264725898	0.999453156	3.354933553	0.185365678	2.293419389	9.812361303	0	1.255640101	0	0.05842101	0.521785901	2.477116351	6.663179378	0.678865845	0.64331152	0	0.098497458	0.313661163	0.700836702	0	0	0.100160083	0	0.021740371	0	0	0	0	0	0	0	0	0	0	0	0	0	41.3018
H7357_004_0	2009	4																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		341.9764774	53.64413324	426.4355214	18.59544189	178.5061334	24.03469446	1.490823879	722.8385298	1621.152186		16.08733933		5.644494402	2.856021494	3755.580397	4232.553329	1.153352698	703.5255427		47.39227453	1.485193668	695.1062516			101.6619832		19.65573155														1a: $350 per admit $600 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.87832592		0.1		50	0.267081258	10	25	0.5	15		30.8004827	0.2	15			15		15														277.8125245	88.22532028	24.34431465	0.119062511	79.375007	0.158750014	0.158750014	39.6875035	76.10342792		0.079375007		39.6875035	0.211995767	7.9375007	19.84375175	0.396875035	11.90625105		24.4478853	0.158750014	11.90625105			11.90625105		11.90625105														7.9171	0.39439757	0.865106709	2.214019996	1.180743799	3.815508082	0.236668312	2.390638057	10.28126988	0	1.276932672	0	0.018667991	0.605464467	2.484160169	6.999144794	0.457736892	0.698029311	0	0.096553408	0.235774516	0.689675795	0	0	0.100867758	0	0.019502173	0	0	0	0	0	0	0	0	0	0	0	0	0	42.978	0	11.1675	7.9171	0.39439757	0.865106709	2.214019996	1.180743799	3.815508082	0.236668312	2.390638057	10.28126988	0	1.276932672	0	0.018667991	0.605464467	2.484160169	6.999144794	0.457736892	0.698029311	0	0.096553408	0.235774516	0.689675795	0	0	0.100867758	0	0.019502173	0	0	0	0	0	0	0	0	0	0	0	0	0	42.978																																																																																		0	0	0	7.9171	0.39439757	0.865106709	2.214019996	1.180743799	3.815508082	0.236668312	2.390638057	10.28126988	0	1.276932672	0	0.018667991	0.605464467	2.484160169	6.999144794	0.457736892	0.698029311	0	0.096553408	0.235774516	0.689675795	0	0	0.100867758	0	0.019502173	0	0	0	0	0	0	0	0	0	0	0	0	0	42.978
H7357_005_0	2009	3																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		367.1546524	46.67220158	328.6576127	21.36721975	168.6404255	24.65765648	2.180281502	713.9611861	1663.009805		14.56290383		12.83085896	2.331365764	3652.68267	4506.881242	1.342159293	620.4842771		33.04611427	1.599140049	720.6435507			109.0423899		21.6258992														1a: $350 per admit $600 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.80881391		0.1		50	0.256209975	10	25	0.5	15		30.52631579	0.2	15			15		15														275.7451471	87.56878029	24.16315332	0.118176492	78.78432775	0.157568656	0.157568656	39.39216388	75.48232997		0.078784328		39.39216388	0.201853306	7.878432775	19.69608194	0.393921639	11.81764916		24.04995268	0.157568656	11.81764916			11.81764916		11.81764916														8.4368	0.340585647	0.66178369	2.525103066	1.107185213	3.88527378	0.343544025	2.343706337	10.46065457	0	1.147328588	0	0.042119608	0.470593888	2.398117905	7.397325185	0.528705588	0.611055458	0	0.06622979	0.251974348	0.709692721	0	0	0.107385392	0	0.021297274	0	0	0	0	0	0	0	0	0	0	0	0	0	43.8564	0	11.81	8.4368	0.340585647	0.66178369	2.525103066	1.107185213	3.88527378	0.343544025	2.343706337	10.46065457	0	1.147328588	0	0.042119608	0.470593888	2.398117905	7.397325185	0.528705588	0.611055458	0	0.06622979	0.251974348	0.709692721	0	0	0.107385392	0	0.021297274	0	0	0	0	0	0	0	0	0	0	0	0	0	43.8564																																																																																		0	0	0	8.4368	0.340585647	0.66178369	2.525103066	1.107185213	3.88527378	0.343544025	2.343706337	10.46065457	0	1.147328588	0	0.042119608	0.470593888	2.398117905	7.397325185	0.528705588	0.611055458	0	0.06622979	0.251974348	0.709692721	0	0	0.107385392	0	0.021297274	0	0	0	0	0	0	0	0	0	0	0	0	0	43.8564
H7357_006_0	2009	3																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		380.7466031	50.85221215	441.8917308	25.59586884	178.6262131	23.14494801	2.911006303	726.5261673	1792.664786		15.66967818		0.531474885	2.212981857	3790.965363	4822.788031	1.236348632	853.5649412		32.41049574	1.269881084	785.7313947			117.0551417		24.39276879														1a: $350 per admit $600 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	96.09398162		0.1		50	0.223606243	10	25	0.5	15		29.50819672	0.2	15			15		15														271.0635026	86.08202375	23.7529075	0.116170073	77.44671502	0.15489343	0.15489343	38.72335751	74.4216321		0.077446715		38.72335751	0.17317569	7.744671502	19.36167876	0.387233575	11.61700725		22.85312902	0.15489343	11.61700725			11.61700725		11.61700725														8.6005	0.364788444	0.87468445	2.973473939	1.152834452	3.585000385	0.450895751	2.344461043	11.11775326	0	1.2135651	0	0.001715041	0.38323466	2.446648451	7.781439379	0.478755701	0.826322509	0	0.061723437	0.196696237	0.760653943	0	0	0.113319202	0	0.023614248	0	0	0	0	0	0	0	0	0	0	0	0	0	45.7521	0	13.3235	8.6005	0.364788444	0.87468445	2.973473939	1.152834452	3.585000385	0.450895751	2.344461043	11.11775326	0	1.2135651	0	0.001715041	0.38323466	2.446648451	7.781439379	0.478755701	0.826322509	0	0.061723437	0.196696237	0.760653943	0	0	0.113319202	0	0.023614248	0	0	0	0	0	0	0	0	0	0	0	0	0	45.7521																																																																																		0	0	0	8.6005	0.364788444	0.87468445	2.973473939	1.152834452	3.585000385	0.450895751	2.344461043	11.11775326	0	1.2135651	0	0.001715041	0.38323466	2.446648451	7.781439379	0.478755701	0.826322509	0	0.061723437	0.196696237	0.760653943	0	0	0.113319202	0	0.023614248	0	0	0	0	0	0	0	0	0	0	0	0	0	45.7521
H7357_007_0	2009	3																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		324.2932495	88.56081707	306.2680382	27.38207202	196.9426136	24.33158891	2.88059933	772.4456832	1056.047757		13.35449592		0.97040915	2.682592658	2826.946065	2490.555006	1.089786115	420.3069262		29.5888315	1.19039867	465.7137833			71.06502468		15.5419966														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	182.6786125		0.2		50	0.401998629	20	35	0.5	35		35	0.2	35			35		35														110.583369	137.9983932	25.17044734	0.16413725	123.1029378	0.16413725	0.16413725	41.03431259	149.9218257		0.16413725		41.03431259	0.329914748	16.41372504	28.72401881	0.410343126	28.72401881		28.72401881	0.16413725	28.72401881			28.72401881		28.72401881														2.9885	1.018437538	0.642408627	4.49441801	2.020351192	3.993720101	0.472813653	2.641398135	13.19371732	0	2.19197024	0	0.003318339	0.885026882	3.866726284	5.961562403	0.447186241	1.006075338	0	0.070825846	0.195388764	1.114764289	0	0	0.170106092	0	0.037202384	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4159	0	10.36	2.9885	1.018437538	0.642408627	4.49441801	2.020351192	3.993720101	0.472813653	2.641398135	13.19371732	0	2.19197024	0	0.003318339	0.885026882	3.866726284	5.961562403	0.447186241	1.006075338	0	0.070825846	0.195388764	1.114764289	0	0	0.170106092	0	0.037202384	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4159																																																																																		0	0	0	2.9885	1.018437538	0.642408627	4.49441801	2.020351192	3.993720101	0.472813653	2.641398135	13.19371732	0	2.19197024	0	0.003318339	0.885026882	3.866726284	5.961562403	0.447186241	1.006075338	0	0.070825846	0.195388764	1.114764289	0	0	0.170106092	0	0.037202384	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4159
H7357_008_0	2009	3																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		324.2932495	88.56081707	306.2680382	25.07629946	196.9426136	22.28268955	2.638031607	772.4456832	1056.047757		12.2299488		0.97040915	2.456698558	2826.946065	2490.555006	0.998018081	420.3069262		29.5888315	1.090158316	465.7137833			71.06502468		15.5419966														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	182.6786125		0.2		50	0.438962513	20	35	0.5	35		35	0.2	34.94786782			35		35														111.2854974	138.8745881	25.33026238	0.165179409	123.8845568	0.165179409	0.165179409	41.29485226	150.8737262		0.165179409		41.29485226	0.362537842	16.5179409	28.90639658	0.412948523	28.90639658		28.90639658	0.165179409	28.90639658			28.90639658		28.90639658														3.0074	1.024903916	0.64648748	4.142088326	2.033179033	3.680641492	0.435748502	2.658169197	13.27748835	0	2.020135715	0	0.003339409	0.890646194	3.891277337	5.999414225	0.412130092	1.012463224	0	0.071275541	0.180071706	1.121842276	0	0	0.171186149	0	0.037438593	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7174	0	9.8462	3.0074	1.024903916	0.64648748	4.142088326	2.033179033	3.680641492	0.435748502	2.658169197	13.27748835	0	2.020135715	0	0.003339409	0.890646194	3.891277337	5.999414225	0.412130092	1.012463224	0	0.071275541	0.180071706	1.121842276	0	0	0.171186149	0	0.037438593	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7174																																																																																		0	0	0	3.0074	1.024903916	0.64648748	4.142088326	2.033179033	3.680641492	0.435748502	2.658169197	13.27748835	0	2.020135715	0	0.003339409	0.890646194	3.891277337	5.999414225	0.412130092	1.012463224	0	0.071275541	0.180071706	1.121842276	0	0	0.171186149	0	0.037438593	0	0	0	0	0	0	0	0	0	0	0	0	0	46.7174
H7357_009_0	2009	3																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		324.2932495	88.56081707	306.2680382	27.31932378	196.9426136	24.27583111	2.873998204	772.4456832	1056.047757		13.32389301		0.97040915	2.67644528	2826.946065	2490.555006	1.087288782	420.3069262		29.5888315	1.187670775	465.7137833			71.06502468		15.5419966														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	182.6786125		0.2		50	0.402921958	20	35	0.5	35		35	0.2	35			35		35														110.6020549	138.0217116	25.17470054	0.164164986	123.1237392	0.164164986	0.164164986	41.04124639	149.9471589		0.164164986		41.04124639	0.330728387	16.41649856	28.72887247	0.410412464	28.72887247		28.72887247	0.164164986	28.72887247			28.72887247		28.72887247														2.989	1.018609629	0.642517179	4.484876395	2.020692583	3.985241464	0.471809874	2.641844467	13.19594674	0	2.187316704	0	0.0033189	0.88517643	3.867379667	5.962569762	0.446236868	1.00624534	0	0.070837814	0.194973956	1.114952657	0	0	0.170134836	0	0.03720867	0	0	0	0	0	0	0	0	0	0	0	0	0	47.3968	0	10.3461	2.989	1.018609629	0.642517179	4.484876395	2.020692583	3.985241464	0.471809874	2.641844467	13.19594674	0	2.187316704	0	0.0033189	0.88517643	3.867379667	5.962569762	0.446236868	1.00624534	0	0.070837814	0.194973956	1.114952657	0	0	0.170134836	0	0.03720867	0	0	0	0	0	0	0	0	0	0	0	0	0	47.3968																																																																																		0	0	0	2.989	1.018609629	0.642517179	4.484876395	2.020692583	3.985241464	0.471809874	2.641844467	13.19594674	0	2.187316704	0	0.0033189	0.88517643	3.867379667	5.962569762	0.446236868	1.00624534	0	0.070837814	0.194973956	1.114952657	0	0	0.170134836	0	0.03720867	0	0	0	0	0	0	0	0	0	0	0	0	0	47.3968
H7357_010_0	2009	4																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		328.3207965	54.08753005	321.6335252	28.27820866	175.7880411	20.90562462	3.944271085	795.7338676	1037.14671		13.26237789		2.785532792	2.712338552	2838.866249	2515.529439	0.765626135	311.2696944		31.25073473	0.522967709	395.3852012			63.91284547		12.42945745														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	183.3780961		0.2		50	0.392476374	20	35	0.5	35		35	0.2	34.98080852			35		35														111.6748672	139.3604878	25.41888885	0.165757345	124.3180087	0.165757345	0.165757345	41.43933624	151.9813317		0.165757345		41.43933624	0.325279209	16.5757345	29.00753537	0.414393362	29.00753537		29.00753537	0.165757345	29.00753537			29.00753537		29.00753537														3.0554	0.628138714	0.681297236	4.687320788	1.821134935	3.465260832	0.653791903	2.747890275	13.13557817	0	2.198336547	0	0.009619219	0.882267337	3.921357768	6.080775765	0.317270388	0.752430556	0	0.075542233	0.086685739	0.955762517	0	0	0.154496177	0	0.030045661	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3404	0	9.5725	3.0554	0.628138714	0.681297236	4.687320788	1.821134935	3.465260832	0.653791903	2.747890275	13.13557817	0	2.198336547	0	0.009619219	0.882267337	3.921357768	6.080775765	0.317270388	0.752430556	0	0.075542233	0.086685739	0.955762517	0	0	0.154496177	0	0.030045661	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3404																																																																																		0	0	0	3.0554	0.628138714	0.681297236	4.687320788	1.821134935	3.465260832	0.653791903	2.747890275	13.13557817	0	2.198336547	0	0.009619219	0.882267337	3.921357768	6.080775765	0.317270388	0.752430556	0	0.075542233	0.086685739	0.955762517	0	0	0.154496177	0	0.030045661	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3404
H7357_011_0	2009	3																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		324.2932495	88.56081707	306.2680382	30.39942866	196.9426136	27.01279878	3.198025839	772.4456832	1056.047757		14.82608934		0.97040915	2.9781999	2826.946065	2490.555006	1.209874667	420.3069262		29.5888315	1.321574183	465.7137833			71.06502468		15.5419966														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	182.6786125		0.2		50	0.362097444	20	35	0.5	35		35	0.2	35			35		35														109.7092983	136.9076293	24.97149563	0.16283988	122.1299102	0.16283988	0.16283988	40.70997005	148.7368169		0.16283988		40.70997005	0.294819522	16.28398802	28.49697904	0.407099701	28.49697904		28.49697904	0.16283988	28.49697904			28.49697904		28.49697904														2.9648	1.010387626	0.637330915	4.950239322	2.004381976	4.398760917	0.520766145	2.620520053	13.08943182	0	2.414278612	0	0.003292111	0.878031471	3.836162989	5.914441149	0.492539614	0.998123139	0	0.070266026	0.215204982	1.105952993	0	0	0.168761543	0	0.036908329	0	0	0	0	0	0	0	0	0	0	0	0	0	48.3306	0	11.0291	2.9648	1.010387626	0.637330915	4.950239322	2.004381976	4.398760917	0.520766145	2.620520053	13.08943182	0	2.414278612	0	0.003292111	0.878031471	3.836162989	5.914441149	0.492539614	0.998123139	0	0.070266026	0.215204982	1.105952993	0	0	0.168761543	0	0.036908329	0	0	0	0	0	0	0	0	0	0	0	0	0	48.3306																																																																																		0	0	0	2.9648	1.010387626	0.637330915	4.950239322	2.004381976	4.398760917	0.520766145	2.620520053	13.08943182	0	2.414278612	0	0.003292111	0.878031471	3.836162989	5.914441149	0.492539614	0.998123139	0	0.070266026	0.215204982	1.105952993	0	0	0.168761543	0	0.036908329	0	0	0	0	0	0	0	0	0	0	0	0	0	48.3306
H7357_012_0	2009	3																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		324.2932495	88.56081707	306.2680382	31.51290472	196.9426136	28.00222871	3.315163738	772.4456832	1056.047757		15.36914216		0.97040915	3.087285973	2826.946065	2490.555006	1.254190186	420.3069262		29.5888315	1.369981053	465.7137833			71.06502468		15.5419966														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	182.6786125		0.2		50	0.349303104	20	35	0.5	35		35	0.2	35			35		35														109.3984127	136.5196711	24.90073336	0.162378437	121.783828	0.162378437	0.162378437	40.59460932	148.3153381		0.162378437		40.59460932	0.283596461	16.23784373	28.41622652	0.405946093	28.41622652		28.41622652	0.162378437	28.41622652			28.41622652		28.41622652														2.9564	1.007524469	0.635524896	5.117016222	1.998702115	4.546958138	0.538311107	2.613094227	13.05234001	0	2.495617286	0	0.003282782	0.875543374	3.82529237	5.897681268	0.509133606	0.995294735	0	0.070066912	0.222455382	1.10281903	0	0	0.16828332	0	0.036803741	0	0	0	0	0	0	0	0	0	0	0	0	0	48.6682	0	11.276	2.9564	1.007524469	0.635524896	5.117016222	1.998702115	4.546958138	0.538311107	2.613094227	13.05234001	0	2.495617286	0	0.003282782	0.875543374	3.82529237	5.897681268	0.509133606	0.995294735	0	0.070066912	0.222455382	1.10281903	0	0	0.16828332	0	0.036803741	0	0	0	0	0	0	0	0	0	0	0	0	0	48.6682																																																																																		0	0	0	2.9564	1.007524469	0.635524896	5.117016222	1.998702115	4.546958138	0.538311107	2.613094227	13.05234001	0	2.495617286	0	0.003282782	0.875543374	3.82529237	5.897681268	0.509133606	0.995294735	0	0.070066912	0.222455382	1.10281903	0	0	0.16828332	0	0.036803741	0	0	0	0	0	0	0	0	0	0	0	0	0	48.6682
H7357_019_0	2009	7																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		345.2310167	37.76748976	436.4036434	20.41156168	171.5121876	22.82584086	1.09477053	714.741291	1678.148075		15.45544923		5.504058347	2.58189236	4033.001232	4557.993937	1.564020341	766.8057404		47.06560093	1.036894871	721.8277109			105.8478159		23.02492382														1a: $350 per admit $600 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.81381047		0.1		50	0.256738556	10	25	0.5	15		31.11691023	0.2	15			15		15														276.0882609	87.67774342	24.19321989	0.11832354	78.88236025	0.157764721	0.157764721	39.44118013	75.58019515		0.07888236		39.44118013	0.202521433	7.888236025	19.72059006	0.394411801	11.83235404		24.54575323	0.157764721	11.83235404			11.83235404		11.83235404														7.9429	0.275947356	0.879834109	2.415168242	1.127440514	3.601112403	0.172716167	2.349186667	10.56956325	0	1.219162314	0	0.018090546	0.522888539	2.651105467	7.490527496	0.61686808	0.756093083	0	0.096271719	0.16358543	0.711743419	0	0	0.104369069	0	0.022703254	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7072	0	11.7009	7.9429	0.275947356	0.879834109	2.415168242	1.127440514	3.601112403	0.172716167	2.349186667	10.56956325	0	1.219162314	0	0.018090546	0.522888539	2.651105467	7.490527496	0.61686808	0.756093083	0	0.096271719	0.16358543	0.711743419	0	0	0.104369069	0	0.022703254	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7072																																																																																		0	0	0	7.9429	0.275947356	0.879834109	2.415168242	1.127440514	3.601112403	0.172716167	2.349186667	10.56956325	0	1.219162314	0	0.018090546	0.522888539	2.651105467	7.490527496	0.61686808	0.756093083	0	0.096271719	0.16358543	0.711743419	0	0	0.104369069	0	0.022703254	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7072
H7357_020_0	2009	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		345.2310167	37.76748976	436.4036434	20.44783204	171.5121876	22.86640128	1.096715884	714.741291	1678.148075		15.48291282		5.504058347	2.586480259	4033.001232	4557.993937	1.56679953	766.8057404		47.06560093	1.038737384	721.8277109			105.8478159		23.02492382														1a: $350 per admit $600 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.81381047		0.1		50	0.256287921	10	25	0.5	15		31.11691023	0.2	15			15		15														276.0636366	87.66992344	24.19106209	0.118312987	78.87532473	0.157750649	0.157750649	39.43766237	75.57345415		0.078875325		39.43766237	0.20214793	7.887532473	19.71883118	0.394376624	11.83129871		24.54356399	0.157750649	11.83129871			11.83129871		11.83129871														7.9421	0.275922745	0.879755636	2.419244088	1.127339958	3.607189653	0.173007643	2.348977143	10.56862055	0	1.221219776	0	0.018088933	0.522851631	2.650869015	7.489859415	0.617909109	0.756025647	0	0.096263132	0.163861497	0.711679939	0	0	0.104359761	0	0.022701229	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7179	0	11.7087	7.9421	0.275922745	0.879755636	2.419244088	1.127339958	3.607189653	0.173007643	2.348977143	10.56862055	0	1.221219776	0	0.018088933	0.522851631	2.650869015	7.489859415	0.617909109	0.756025647	0	0.096263132	0.163861497	0.711679939	0	0	0.104359761	0	0.022701229	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7179																																																																																		0	0	0	7.9421	0.275922745	0.879755636	2.419244088	1.127339958	3.607189653	0.173007643	2.348977143	10.56862055	0	1.221219776	0	0.018088933	0.522851631	2.650869015	7.489859415	0.617909109	0.756025647	0	0.096263132	0.163861497	0.711679939	0	0	0.104359761	0	0.022701229	0	0	0	0	0	0	0	0	0	0	0	0	0	43.7179
H7357_021_0	2009	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		345.2310167	37.76748976	436.4036434	21.74111775	171.5121876	24.3126568	1.166081036	714.741291	1678.148075		16.46217702		5.504058347	2.750070117	4033.001232	4557.993937	1.665896561	766.8057404		47.06560093	1.104435508	721.8277109			105.8478159		23.02492382														1a: $350 per admit $600 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.81381047		0.1		50	0.241202358	10	25	0.5	15		31.11691023	0.2	15			15		15														275.1962044	87.39445176	24.11505025	0.11794123	78.62748697	0.157254974	0.157254974	39.31374348	75.33599134		0.078627487		39.31374348	0.189651352	7.862748697	19.65687174	0.393137435	11.79412304		24.46644454	0.157254974	11.79412304			11.79412304		11.79412304														7.9172	0.275055755	0.876991316	2.564174179	1.123797691	3.823286212	0.183372043	2.341596314	10.53541241	0	1.294379609	0	0.018032095	0.521554517	2.642539598	7.466325185	0.654926301	0.753650105	0	0.09596066	0.173677977	0.709443737	0	0	0.104031847	0	0.022629899	0	0	0	0	0	0	0	0	0	0	0	0	0	44.098	0	11.9867	7.9172	0.275055755	0.876991316	2.564174179	1.123797691	3.823286212	0.183372043	2.341596314	10.53541241	0	1.294379609	0	0.018032095	0.521554517	2.642539598	7.466325185	0.654926301	0.753650105	0	0.09596066	0.173677977	0.709443737	0	0	0.104031847	0	0.022629899	0	0	0	0	0	0	0	0	0	0	0	0	0	44.098																																																																																		0	0	0	7.9172	0.275055755	0.876991316	2.564174179	1.123797691	3.823286212	0.183372043	2.341596314	10.53541241	0	1.294379609	0	0.018032095	0.521554517	2.642539598	7.466325185	0.654926301	0.753650105	0	0.09596066	0.173677977	0.709443737	0	0	0.104031847	0	0.022629899	0	0	0	0	0	0	0	0	0	0	0	0	0	44.098
H7357_022_0	2009	6																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		345.2310167	37.76748976	436.4036434	22.60919492	171.5121876	25.28341013	1.212640203	714.741291	1678.148075		17.11947717		5.504058347	2.859874641	4033.001232	4557.993937	1.732412312	766.8057404		47.06560093	1.148533298	721.8277109			105.8478159		23.02492382														1a: $350 per admit $600 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.81381047		0.1		50	0.232044634	10	25	0.5	15		31.11691023	0.2	15			15		15														274.6252977	87.2131481	24.06502251	0.117696556	78.46437076	0.156928742	0.156928742	39.23218538	75.17970349		0.078464371		39.23218538	0.182072362	7.846437076	19.61609269	0.392321854	11.76965561		24.41568781	0.156928742	11.76965561			11.76965561		11.76965561														7.9008	0.27448514	0.875171959	2.661024379	1.121466323	3.967693733	0.190298101	2.336738569	10.51355623	0	1.343269004	0	0.017994686	0.52070413	2.637057533	7.450835963	0.67966321	0.752086624	0	0.095761585	0.180237885	0.707971964	0	0	0.103816028	0	0.022582952	0	0	0	0	0	0	0	0	0	0	0	0	0	44.3532	0	12.1733	7.9008	0.27448514	0.875171959	2.661024379	1.121466323	3.967693733	0.190298101	2.336738569	10.51355623	0	1.343269004	0	0.017994686	0.52070413	2.637057533	7.450835963	0.67966321	0.752086624	0	0.095761585	0.180237885	0.707971964	0	0	0.103816028	0	0.022582952	0	0	0	0	0	0	0	0	0	0	0	0	0	44.3532																																																																																		0	0	0	7.9008	0.27448514	0.875171959	2.661024379	1.121466323	3.967693733	0.190298101	2.336738569	10.51355623	0	1.343269004	0	0.017994686	0.52070413	2.637057533	7.450835963	0.67966321	0.752086624	0	0.095761585	0.180237885	0.707971964	0	0	0.103816028	0	0.022582952	0	0	0	0	0	0	0	0	0	0	0	0	0	44.3532
H7357_023_0	2009	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		345.2310167	37.76748976	436.4036434	23.17606936	171.5121876	25.91733446	1.243044414	714.741291	1678.148075		17.54870935		5.504058347	2.931579531	4033.001232	4557.993937	1.775848633	766.8057404		47.06560093	1.177330174	721.8277109			105.8478159		23.02492382														1a: $350 per admit $600 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.81381047		0.1		50	0.226434694	10	25	0.5	15		31.11691023	0.2	15			15		15														274.2572743	87.09627441	24.03277315	0.117538832	78.35922124	0.156718442	0.156718442	39.17961062	75.07895573		0.078359221		39.17961062	0.177432463	7.835922124	19.58980531	0.391796106	11.75388319		24.38296853	0.156718442	11.75388319			11.75388319		11.75388319														7.8902	0.274117304	0.873999147	2.724088119	1.119963455	4.06172429	0.194807984	2.333607123	10.49946709	0	1.375103198	0	0.017970572	0.520157376	2.633523632	7.440851153	0.69577058	0.751078758	0	0.095633256	0.184509351	0.707023216	0	0	0.103676905	0	0.022552689	0	0	0	0	0	0	0	0	0	0	0	0	0	44.5198	0	12.2952	7.8902	0.274117304	0.873999147	2.724088119	1.119963455	4.06172429	0.194807984	2.333607123	10.49946709	0	1.375103198	0	0.017970572	0.520157376	2.633523632	7.440851153	0.69577058	0.751078758	0	0.095633256	0.184509351	0.707023216	0	0	0.103676905	0	0.022552689	0	0	0	0	0	0	0	0	0	0	0	0	0	44.5198																																																																																		0	0	0	7.8902	0.274117304	0.873999147	2.724088119	1.119963455	4.06172429	0.194807984	2.333607123	10.49946709	0	1.375103198	0	0.017970572	0.520157376	2.633523632	7.440851153	0.69577058	0.751078758	0	0.095633256	0.184509351	0.707023216	0	0	0.103676905	0	0.022552689	0	0	0	0	0	0	0	0	0	0	0	0	0	44.5198
H7357_024_0	2009	5																					2500											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		345.2310167	37.76748976	436.4036434	23.87762441	171.5121876	26.70186943	1.280672196	714.741291	1678.148075		18.07992046		5.504058347	3.020320395	4033.001232	4557.993937	1.829604754	766.8057404		47.06560093	1.212968742	721.8277109			105.8478159		23.02492382														1a: $350 per admit $600 Max OOP	1b: $195 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $100; 9b: $75	8a: $0	8a: $0; 8b: 10%		12: $50	3: $15; 5: $175; 7c: $15; 7i: $15; 9c: 50%; 9d: $15	7a: $10; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $25; 7d: $25; 7f: $25; 13b: $0; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $15	7e: 50%; 7h: 50%	7i: $15		7g: $25	15: 20%	13a: $0; 17a: $15; 17b: $15; 18a: $15			17a: $15		18a: $15		14a2: Newsletters; 14a8: Nurseline												350	111.15	30.67	0.15	100	0.2	0.2	50	95.81381047		0.1		50	0.219860734	10	25	0.5	15		31.11691023	0.2	15			15		15														273.8069569	86.95326646	23.99331248	0.117345839	78.23055912	0.156461118	0.156461118	39.11527956	74.95567964		0.078230559		39.11527956	0.171998282	7.823055912	19.55763978	0.391152796	11.73458387		24.34293285	0.156461118	11.73458387			11.73458387		11.73458387														7.8772	0.273667217	0.872564082	2.801939861	1.118124528	4.17780435	0.200375404	2.329775451	10.48222746	0	1.414402287	0	0.017941065	0.519489918	2.629199511	7.428633628	0.715655014	0.749845523	0	0.09547623	0.189782446	0.705862318	0	0	0.103506673	0	0.022515658	0	0	0	0	0	0	0	0	0	0	0	0	0	44.726	0	12.446	7.8772	0.273667217	0.872564082	2.801939861	1.118124528	4.17780435	0.200375404	2.329775451	10.48222746	0	1.414402287	0	0.017941065	0.519489918	2.629199511	7.428633628	0.715655014	0.749845523	0	0.09547623	0.189782446	0.705862318	0	0	0.103506673	0	0.022515658	0	0	0	0	0	0	0	0	0	0	0	0	0	44.726																																																																																		0	0	0	7.8772	0.273667217	0.872564082	2.801939861	1.118124528	4.17780435	0.200375404	2.329775451	10.48222746	0	1.414402287	0	0.017941065	0.519489918	2.629199511	7.428633628	0.715655014	0.749845523	0	0.09547623	0.189782446	0.705862318	0	0	0.103506673	0	0.022515658	0	0	0	0	0	0	0	0	0	0	0	0	0	44.726
H7357_025_0	2009	5																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		287.0739877	38.51853295	308.5650658	12.30232625	150.004864	18.70779072	2.395371783	693.5290308	1183.409759		11.9566712		6.216009239	1.736818396	3197.350303	2751.703884	1.173282797	430.2588932		37.58107252	1.979466799	533.6537539			82.21527278		20.66104731														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	182.2911456		0.2		50	0.399067622	20	35	0.5	35		35	0.2	35			35		35														112.4612809	140.3418634	25.59788849	0.166924607	125.1934553	0.166924607	0.166924607	41.73115176	152.1443892		0.166924607		41.73115176	0.33307103	16.6924607	29.21180623	0.417311518	29.21180623		29.21180623	0.166924607	29.21180623			29.21180623		29.21180623														2.6904	0.450480224	0.658217846	2.053560975	1.564968936	3.122790615	0.399846494	2.411813769	15.00409625	0	1.995862641	0	0.021616769	0.578483893	4.447637025	6.698520056	0.489624424	1.047386618	0	0.091484251	0.330421718	1.299082505	0	0	0.200138051	0	0.050295543	0	0	0	0	0	0	0	0	0	0	0	0	0	45.6067	0	9.0368	2.6904	0.450480224	0.658217846	2.053560975	1.564968936	3.122790615	0.399846494	2.411813769	15.00409625	0	1.995862641	0	0.021616769	0.578483893	4.447637025	6.698520056	0.489624424	1.047386618	0	0.091484251	0.330421718	1.299082505	0	0	0.200138051	0	0.050295543	0	0	0	0	0	0	0	0	0	0	0	0	0	45.6067																																																																																		0	0	0	2.6904	0.450480224	0.658217846	2.053560975	1.564968936	3.122790615	0.399846494	2.411813769	15.00409625	0	1.995862641	0	0.021616769	0.578483893	4.447637025	6.698520056	0.489624424	1.047386618	0	0.091484251	0.330421718	1.299082505	0	0	0.200138051	0	0.050295543	0	0	0	0	0	0	0	0	0	0	0	0	0	45.6067
H7357_026_0	2009	6																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		287.0739877	38.51853295	308.5650658	11.97981628	150.004864	18.21735916	2.332576238	693.5290308	1183.409759		11.6432227		6.216009239	1.691287069	3197.350303	2751.703884	1.14252476	430.2588932		37.58107252	1.927574355	533.6537539			82.21527278		20.66104731														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	182.2911456		0.2		50	0.409810966	20	35	0.5	35		35	0.2	35			35		35														112.6291786	140.5513851	25.63610456	0.167173815	125.3803614	0.167173815	0.167173815	41.79345379	152.3715314		0.167173815		41.79345379	0.342548314	16.71738152	29.25541765	0.417934538	29.25541765		29.25541765	0.167173815	29.25541765			29.25541765		29.25541765														2.6944	0.451152763	0.659200524	2.002711593	1.567305339	3.045465434	0.389945669	2.415414459	15.02649644	0	1.946441959	0	0.021649041	0.579347534	4.454277072	6.708520534	0.477500558	1.048950302	0	0.091620831	0.322239959	1.301021955	0	0	0.200436845	0	0.050370631	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4545	0	8.9254	2.6944	0.451152763	0.659200524	2.002711593	1.567305339	3.045465434	0.389945669	2.415414459	15.02649644	0	1.946441959	0	0.021649041	0.579347534	4.454277072	6.708520534	0.477500558	1.048950302	0	0.091620831	0.322239959	1.301021955	0	0	0.200436845	0	0.050370631	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4545																																																																																		0	0	0	2.6944	0.451152763	0.659200524	2.002711593	1.567305339	3.045465434	0.389945669	2.415414459	15.02649644	0	1.946441959	0	0.021649041	0.579347534	4.454277072	6.708520534	0.477500558	1.048950302	0	0.091620831	0.322239959	1.301021955	0	0	0.200436845	0	0.050370631	0	0	0	0	0	0	0	0	0	0	0	0	0	45.4545
H7357_027_0	2009	5																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		287.0739877	38.51853295	308.5650658	12.81263971	150.004864	19.4838096	2.49473433	693.5290308	1183.409759		12.45264652		6.216009239	1.808863455	3197.350303	2751.703884	1.221951804	430.2588932		37.58107252	2.061577169	533.6537539			82.21527278		20.66104731														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	182.2911456		0.2		50	0.383173194	20	35	0.5	35		35	0.2	35			35		35														112.1988975	140.0144318	25.53816606	0.166535155	124.9013664	0.166535155	0.166535155	41.63378881	151.7894212		0.166535155		41.63378881	0.319059037	16.65351553	29.14365217	0.416337888	29.14365217		29.14365217	0.166535155	29.14365217			29.14365217		29.14365217														2.6841	0.449429209	0.656682158	2.133754944	1.561317708	3.244739258	0.415460969	2.406186767	14.96909019	0	2.073803422	0	0.021566335	0.577134232	4.437260243	6.68289174	0.508744834	1.044942961	0	0.091270809	0.343325074	1.296051615	0	0	0.199671109	0	0.050178198	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8476	0	9.213	2.6841	0.449429209	0.656682158	2.133754944	1.561317708	3.244739258	0.415460969	2.406186767	14.96909019	0	2.073803422	0	0.021566335	0.577134232	4.437260243	6.68289174	0.508744834	1.044942961	0	0.091270809	0.343325074	1.296051615	0	0	0.199671109	0	0.050178198	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8476																																																																																		0	0	0	2.6841	0.449429209	0.656682158	2.133754944	1.561317708	3.244739258	0.415460969	2.406186767	14.96909019	0	2.073803422	0	0.021566335	0.577134232	4.437260243	6.68289174	0.508744834	1.044942961	0	0.091270809	0.343325074	1.296051615	0	0	0.199671109	0	0.050178198	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8476
H7357_028_0	2009	6																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		287.0739877	38.51853295	308.5650658	13.7992525	150.004864	20.98412306	2.686836571	693.5290308	1183.409759		13.41153873		6.216009239	1.948151522	3197.350303	2751.703884	1.316045863	430.2588932		37.58107252	2.220324971	533.6537539			82.21527278		20.66104731														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	182.2911456		0.2		50	0.355777249	20	35	0.5	35		35	0.2	35			35		35														111.7027287	139.3952564	25.42523054	0.165798699	124.3490245	0.165798699	0.165798699	41.44967483	151.1181742		0.165798699		41.44967483	0.294937025	16.57986993	29.01477238	0.414496748	29.01477238		29.01477238	0.165798699	29.01477238			29.01477238		29.01477238														2.6722	0.447441732	0.653778161	2.287898116	1.554413209	3.479140309	0.445474009	2.395546067	14.9028935	0	2.223615676	0	0.021470963	0.574582015	4.417637679	6.653338488	0.545496731	1.040321988	0	0.090867189	0.368126992	1.290320183	0	0	0.198788119	0	0.049956299	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3134	0	9.5536	2.6722	0.447441732	0.653778161	2.287898116	1.554413209	3.479140309	0.445474009	2.395546067	14.9028935	0	2.223615676	0	0.021470963	0.574582015	4.417637679	6.653338488	0.545496731	1.040321988	0	0.090867189	0.368126992	1.290320183	0	0	0.198788119	0	0.049956299	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3134																																																																																		0	0	0	2.6722	0.447441732	0.653778161	2.287898116	1.554413209	3.479140309	0.445474009	2.395546067	14.9028935	0	2.223615676	0	0.021470963	0.574582015	4.417637679	6.653338488	0.545496731	1.040321988	0	0.090867189	0.368126992	1.290320183	0	0	0.198788119	0	0.049956299	0	0	0	0	0	0	0	0	0	0	0	0	0	46.3134
H7357_029_0	2009	6																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		287.0739877	38.51853295	308.5650658	14.07941052	150.004864	21.41015122	2.741385815	693.5290308	1183.409759		13.68382522		6.216009239	1.987703683	3197.350303	2751.703884	1.342764759	430.2588932		37.58107252	2.265402908	533.6537539			82.21527278		20.66104731														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	182.2911456		0.2		50	0.348697844	20	35	0.5	35		35	0.2	35			35		35														111.5644373	139.2226809	25.39375333	0.165593435	124.1950766	0.165593435	0.165593435	41.39835887	150.9310853		0.165593435		41.39835887	0.288710369	16.55934355	28.97885121	0.413983589	28.97885121		28.97885121	0.165593435	28.97885121			28.97885121		28.97885121														2.6689	0.446887785	0.652968764	2.331457957	1.552488798	3.545380495	0.453955495	2.392580309	14.88444327	0	2.265951628	0	0.021444382	0.573870665	4.412168509	6.645101453	0.555882574	1.039034037	0	0.090754692	0.37513585	1.288722728	0	0	0.198542013	0	0.049894451	0	0	0	0	0	0	0	0	0	0	0	0	0	46.4456	0	9.6503	2.6689	0.446887785	0.652968764	2.331457957	1.552488798	3.545380495	0.453955495	2.392580309	14.88444327	0	2.265951628	0	0.021444382	0.573870665	4.412168509	6.645101453	0.555882574	1.039034037	0	0.090754692	0.37513585	1.288722728	0	0	0.198542013	0	0.049894451	0	0	0	0	0	0	0	0	0	0	0	0	0	46.4456																																																																																		0	0	0	2.6689	0.446887785	0.652968764	2.331457957	1.552488798	3.545380495	0.453955495	2.392580309	14.88444327	0	2.265951628	0	0.021444382	0.573870665	4.412168509	6.645101453	0.555882574	1.039034037	0	0.090754692	0.37513585	1.288722728	0	0	0.198542013	0	0.049894451	0	0	0	0	0	0	0	0	0	0	0	0	0	46.4456
H7357_030_0	2009	5																					3000											A	D	D	Coin	T	Coin	Coin	V	V	V	Coin	V	V	Coin	P	P	Coin	V	Coin	P	Coin	P	P	P	P	P	P	P	P	P																																																			0		287.0739877	38.51853295	308.5650658	14.22426571	150.004864	21.63042832	2.769590404	693.5290308	1183.409759		13.82461046		6.216009239	2.008154057	3197.350303	2751.703884	1.356579717	430.2588932		37.58107252	2.288710375	533.6537539			82.21527278		20.66104731														1a: $195 Per Day (Days 1-5)	1b: $295 Per Day (Days 1-5)	2a: $100/ days 21-100; 2a2: $100/ days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4a1: $50 - $250 Ded; 4b: $35; 4b1: $35	9a: $200; 9b: $100	8a: $0	8a: $0; 8b: 20%		12: $50	3: $35; 5: $195; 7c: $35; 7i: $35; 9c: 50%; 9d: $35	7a: $20; 14b: $0; 14c: $0 - 1 exam per year; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0	7b: $35; 7d: $35; 7f: $35; 13b: ; 14b: $0; 14d: $0 - 1 per year; 14e: $0; 14f: $0; 14g: $0; 14h: $0; 14i: $0; 14j: $0; 18a: $35	7e: 50%; 7h: 50%	7i: $35		7g: $35	15: 20%	13a: $0; 17a: $35; 17b: $35; 18a: $35			17a: $35		18a: $35		14a2: Newsletters; 14a8: Nurseline												134.745	168.15	30.67	0.2	150	0.2	0.2	50	182.2911456		0.2		50	0.345146821	20	35	0.5	35		35	0.2	35			35		35														111.4933759	139.1340024	25.37757867	0.16548796	124.11597	0.16548796	0.16548796	41.37199	150.834949		0.16548796		41.37199	0.285588216	16.548796	28.960393	0.4137199	28.960393		28.960393	0.16548796	28.960393			28.960393		28.960393														2.6672	0.446603138	0.652552853	2.353944716	1.551499934	3.579575457	0.458333866	2.391056344	14.87496256	0	2.287806583	0	0.021430723	0.573505135	4.409358159	6.640868826	0.561244025	1.03837222	0	0.090696886	0.378754011	1.28790187	0	0	0.198415551	0	0.049862671	0	0	0	0	0	0	0	0	0	0	0	0	0	46.514	0	9.7004	2.6672	0.446603138	0.652552853	2.353944716	1.551499934	3.579575457	0.458333866	2.391056344	14.87496256	0	2.287806583	0	0.021430723	0.573505135	4.409358159	6.640868826	0.561244025	1.03837222	0	0.090696886	0.378754011	1.28790187	0	0	0.198415551	0	0.049862671	0	0	0	0	0	0	0	0	0	0	0	0	0	46.514																																																																																		0	0	0	2.6672	0.446603138	0.652552853	2.353944716	1.551499934	3.579575457	0.458333866	2.391056344	14.87496256	0	2.287806583	0	0.021430723	0.573505135	4.409358159	6.640868826	0.561244025	1.03837222	0	0.090696886	0.378754011	1.28790187	0	0	0.198415551	0	0.049862671	0	0	0	0	0	0	0	0	0	0	0	0	0	46.514
H7357_037_0	2009	2																					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																																																			0		393.2935073	20.16245475	1598.554501	6251.198235	329.324325	17.04766109	11.9693743	333.3512453	367.101958		6293.276043	48.92243201	31.48041988	58.12665193	3522.768204	4679.205652	899.4632159	364.8273013			28.22018051	1180.650107			147.9890135		255.8976692														"1a: $350 per admit, $875 Max OOP"	1b : $195 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4b: (n/c)	9a: $100 9b: $75	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $100	12: $50	9a: $100 9c: 50% 9d: $15 3: $15 5: $175	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $25 7d: $25 7f: $25	"7e, 7h: 50%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $15	10b: (n/c)	16a: (n/c)	17a1: $15	17b1: (n/c)	18a: $15 18a1: $15	18b: (n/c)		14a: (n/c)											331.5882178	325.8531583	64.98915146	26.70811646	100	0.2	0.2	50	97.5		10.25224249	100	50	16.34173672	10	25	80.24154984	15			0.2	15			15		15														231.4038224	227.4015249	45.35365629	18.63866056	69.78650324	0.139573006	0.139573006	34.89325162	68.04184066		7.154681535	69.78650324	34.89325162	11.40432662	6.978650324	17.44662581	55.99777178	10.46797549			0.139573006	10.46797549			10.46797549		10.46797549														7.5841	0.38208108	6.041690951	9.709496832	1.915199423	2.379393312	1.670601556	0.969309073	2.081524411	0	3.752198825	0.284510455	0.091537851	0.055241277	2.048680623	6.803029175	4.197327991	0.318250271	0	0	3.938775438	1.029918032	0	0	0.129095447	0	0.223227544	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6052	0	24.0738	7.5841	0.38208108	6.041690951	9.709496832	1.915199423	2.379393312	1.670601556	0.969309073	2.081524411	0	3.752198825	0.284510455	0.091537851	0.055241277	2.048680623	6.803029175	4.197327991	0.318250271	0	0	3.938775438	1.029918032	0	0	0.129095447	0	0.223227544	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6052																																																																																		0	0	0	7.5841	0.38208108	6.041690951	9.709496832	1.915199423	2.379393312	1.670601556	0.969309073	2.081524411	0	3.752198825	0.284510455	0.091537851	0.055241277	2.048680623	6.803029175	4.197327991	0.318250271	0	0	3.938775438	1.029918032	0	0	0.129095447	0	0.223227544	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6052
H7357_038_0	2009	2																					3000											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																																																			0		398.7192967	20.44061147	1620.598856	6337.43837	333.8676098	17.52127712	12.30190598	337.9500847	372.1664146		6380.096674	49.59735496	31.91471673	58.92855424	3571.367528	4743.758928	911.8720096	369.8603773			29.0041901	1196.938093			147.9890135		255.8976692														1a: $195 days 1-5	1b : $350 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: n/c 4b:n/c  4b1: n/c	9a: $50 9b: $50	8a: 0%	8b1: 20% 8b2: 20% 8b3: 20%	9a: $50	12: $50	"9a: $50 9c: 50% 9d: $35 3: $35 5: $195, $475 Max OOP"	"7a: $20, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 20% 8b2: 20% 8b3: 20%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $0 17a: $35 17b: (n/c)	10b: n/c	16a: (n/c)	17a: $35	17b1: $0	18a: $35 18a1: 35(n/c)	18b: (n/c)		14a: $0											360.9139764	325.8531583	64.98915146	36.10210089	150	0.2	0.2	50	190		20.78736027	200	50	35.30824337	20	35	81.34854435	35			0.2	35			35		35														240.8605081	217.4622276	43.37133241	24.09319376	100.1043977	0.13347253	0.13347253	33.36813255	126.7989037		13.87270786	133.4725302	33.36813255	23.5634029	13.34725302	23.35769279	54.28898022	23.35769279			0.13347253	23.35769279			23.35769279		23.35769279														8.003	0.370421742	5.857294307	12.72409422	2.785134665	2.338609189	1.641966518	0.939730268	3.932524448	0	7.375768106	0.551657038	0.088744542	0.115713106	3.972328836	9.233605309	4.125383457	0.719923756	0	0	3.871262639	2.329809355	0	0	0.288056826	0	0.498098262	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7631	0	35.7693	8.003	0.370421742	5.857294307	12.72409422	2.785134665	2.338609189	1.641966518	0.939730268	3.932524448	0	7.375768106	0.551657038	0.088744542	0.115713106	3.972328836	9.233605309	4.125383457	0.719923756	0	0	3.871262639	2.329809355	0	0	0.288056826	0	0.498098262	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7631																																																																																		0	0	0	8.003	0.370421742	5.857294307	12.72409422	2.785134665	2.338609189	1.641966518	0.939730268	3.932524448	0	7.375768106	0.551657038	0.088744542	0.115713106	3.972328836	9.233605309	4.125383457	0.719923756	0	0	3.871262639	2.329809355	0	0	0.288056826	0	0.498098262	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7631
H7357_040_0	2009	4																					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																																																			0		393.2935073	20.16245475	1598.554501	6251.198235	329.324325	17.04766109	11.9693743	333.3512453	367.101958		6293.276043	48.92243201	31.48041988	58.12665193	3522.768204	4679.205652	899.4632159	364.8273013			28.22018051	1180.650107			147.9890135		255.8976692														"1a: $350 per admit, $875 Max OOP"	1b : $195 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4b: (n/c)	9a: $100 9b: $75	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $100	12: $50	9a: $100 9c: 50% 9d: $15 3: $15 5: $175	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $25 7d: $25 7f: $25	"7e, 7h: 50%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $15	10b: (n/c)	16a: (n/c)	17a1: $15	17b1: (n/c)	18a: $15 18a1: $15	18b: (n/c)		14a: (n/c)											331.5882178	325.8531583	64.98915146	26.70811646	100	0.2	0.2	50	97.5		10.25224249	100	50	16.34173672	10	25	80.24154984	15			0.2	15			15		15														231.4038224	227.4015249	45.35365629	18.63866056	69.78650324	0.139573006	0.139573006	34.89325162	68.04184066		7.154681535	69.78650324	34.89325162	11.40432662	6.978650324	17.44662581	55.99777178	10.46797549			0.139573006	10.46797549			10.46797549		10.46797549														7.5841	0.38208108	6.041690951	9.709496832	1.915199423	2.379393312	1.670601556	0.969309073	2.081524411	0	3.752198825	0.284510455	0.091537851	0.055241277	2.048680623	6.803029175	4.197327991	0.318250271	0	0	3.938775438	1.029918032	0	0	0.129095447	0	0.223227544	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6052	0	24.0738	7.5841	0.38208108	6.041690951	9.709496832	1.915199423	2.379393312	1.670601556	0.969309073	2.081524411	0	3.752198825	0.284510455	0.091537851	0.055241277	2.048680623	6.803029175	4.197327991	0.318250271	0	0	3.938775438	1.029918032	0	0	0.129095447	0	0.223227544	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6052																																																																																		0	0	0	7.5841	0.38208108	6.041690951	9.709496832	1.915199423	2.379393312	1.670601556	0.969309073	2.081524411	0	3.752198825	0.284510455	0.091537851	0.055241277	2.048680623	6.803029175	4.197327991	0.318250271	0	0	3.938775438	1.029918032	0	0	0.129095447	0	0.223227544	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6052
H7357_041_0	2009	4																					3000											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																																																			0		398.7192967	20.44061147	1620.598856	6337.43837	333.8676098	17.52127712	12.30190598	337.9500847	372.1664146		6380.096674	49.59735496	31.91471673	58.92855424	3571.367528	4743.758928	911.8720096	369.8603773			29.0041901	1196.938093			147.9890135		255.8976692														1a: $195 days 1-5	1b : $350 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: n/c 4b:n/c  4b1: n/c	9a: $50 9b: $50	8a: 0%	8b1: 20% 8b2: 20% 8b3: 20%	9a: $50	12: $50	"9a: $50 9c: 50% 9d: $35 3: $35 5: $195, $475 Max OOP"	"7a: $20, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 20% 8b2: 20% 8b3: 20%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $0 17a: $35 17b: (n/c)	10b: n/c	16a: (n/c)	17a: $35	17b1: $0	18a: $35 18a1: 35(n/c)	18b: (n/c)		14a: $0											360.9139764	325.8531583	64.98915146	36.10210089	150	0.2	0.2	50	190		20.78736027	200	50	35.30824337	20	35	81.34854435	35			0.2	35			35		35														240.8605081	217.4622276	43.37133241	24.09319376	100.1043977	0.13347253	0.13347253	33.36813255	126.7989037		13.87270786	133.4725302	33.36813255	23.5634029	13.34725302	23.35769279	54.28898022	23.35769279			0.13347253	23.35769279			23.35769279		23.35769279														8.003	0.370421742	5.857294307	12.72409422	2.785134665	2.338609189	1.641966518	0.939730268	3.932524448	0	7.375768106	0.551657038	0.088744542	0.115713106	3.972328836	9.233605309	4.125383457	0.719923756	0	0	3.871262639	2.329809355	0	0	0.288056826	0	0.498098262	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7631	0	35.7693	8.003	0.370421742	5.857294307	12.72409422	2.785134665	2.338609189	1.641966518	0.939730268	3.932524448	0	7.375768106	0.551657038	0.088744542	0.115713106	3.972328836	9.233605309	4.125383457	0.719923756	0	0	3.871262639	2.329809355	0	0	0.288056826	0	0.498098262	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7631																																																																																		0	0	0	8.003	0.370421742	5.857294307	12.72409422	2.785134665	2.338609189	1.641966518	0.939730268	3.932524448	0	7.375768106	0.551657038	0.088744542	0.115713106	3.972328836	9.233605309	4.125383457	0.719923756	0	0	3.871262639	2.329809355	0	0	0.288056826	0	0.498098262	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7631
H7357_043_0	2009	4																					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																																																			0		362.8733128	18.23406786	2198.723761	7078.617111	220.2231693	19.46709079	12.29417006	379.0795667	419.4171235		6226.369033	25.91729113	32.87465131	117.8143773	3799.492262	4566.882111	865.4911513	343.4373049			34.9472772	1357.969299			147.9890135		255.8976692														"1a: $350 per admit, $875 Max OOP"	1b : $195 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4b: (n/c)	9a: $100 9b: $75	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $100	12: $50	9a: $100 9c: 50% 9d: $15 3: $15 5: $175	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $25 7d: $25 7f: $25	"7e, 7h: 50%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $15	10b: (n/c)	16a: (n/c)	17a1: $15	17b1: (n/c)	18a: $15 18a1: $15	18b: (n/c)		14a: (n/c)											331.5882178	325.8531583	64.98915146	29.09359045	100	0.2	0.2	50.03513021	97.5		10.25260011	100	50	15.65259679	10	25	47.03976497	15			0.2	15			15		15														226.2834929	222.3697553	44.35010475	19.85414112	68.24232008	0.13648464	0.13648464	34.14513371	66.53626207		6.99661218	68.24232008	34.12116004	10.6816952	6.824232008	17.06058002	32.10102697	10.23634801			0.13648464	10.23634801			10.23634801		10.23634801														6.8427	0.337892101	8.126135759	11.71165525	1.252378334	2.656958882	1.677965376	1.078643541	2.325537304	0	3.630290784	0.147388006	0.09347677	0.104871439	2.160718059	6.492804808	2.315262899	0.292961981	0	0	4.769766553	1.158387194	0	0	0.12623892	0	0.218288133	0	0	0	0	0	0	0	0	0	0	0	0	0	57.5203	0	26.768	6.8427	0.337892101	8.126135759	11.71165525	1.252378334	2.656958882	1.677965376	1.078643541	2.325537304	0	3.630290784	0.147388006	0.09347677	0.104871439	2.160718059	6.492804808	2.315262899	0.292961981	0	0	4.769766553	1.158387194	0	0	0.12623892	0	0.218288133	0	0	0	0	0	0	0	0	0	0	0	0	0	57.5203																																																																																		0	0	0	6.8427	0.337892101	8.126135759	11.71165525	1.252378334	2.656958882	1.677965376	1.078643541	2.325537304	0	3.630290784	0.147388006	0.09347677	0.104871439	2.160718059	6.492804808	2.315262899	0.292961981	0	0	4.769766553	1.158387194	0	0	0.12623892	0	0.218288133	0	0	0	0	0	0	0	0	0	0	0	0	0	57.5203
H7357_044_0	2009	4																					3000											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																																																			0		368.8227391	18.53302135	2234.76212	7194.673345	223.8337999	20.11066227	12.70060866	385.2867306	426.2936039		6328.452382	26.34221356	33.41364193	119.7459824	3861.786175	4641.757632	879.6811607	349.0680714			36.10261526	1380.233648			147.9890135		255.8976692														1a: $195 days 1-5	1b : $295 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20%/$250 Ded.	9a: $200 9b: $100	8a: 0%	8b1: 20% 8b2: 20% 8b3: 20%	9a: $0	12: $50	9a: $100 9c: 50% 9d: $35 3: $35 5: $195	"7a: $20, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 20% 8b2: 20% 8b3: 20%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $0 17a: $35 17b: $35	10b: (n/c)	16a: (n/c)	17a1: $35	17b1: (n/c)	18a: $35 18a1: $35	18b: (n/c)		14a: $0											360.9139764	325.8531583	64.98915146	39.42745247	150	0.2	0.2	50.03507713	190		20.84138965	200	50	35.23652713	20	35	47.81099724	35			0.2	35			35		35														235.043554	212.2103588	42.32388362	25.67694565	97.68680465	0.130249073	0.130249073	32.58511204	123.7366192		13.5728584	130.2490729	32.56226822	22.94762495	13.02490729	22.79358775	31.13669032	22.79358775			0.130249073	22.79358775			22.79358775		22.79358775														7.2241	0.327741593	7.881984326	15.3947697	1.822134057	2.619395116	1.654242503	1.046217607	4.395677445	0	7.157932337	0.285920741	0.090668664	0.228990491	4.191617241	8.816859158	2.28252999	0.66304281	0	0	4.702332166	2.621706398	0	0	0.281100047	0	0.486068831	0	0	0	0	0	0	0	0	0	0	0	0	0	74.175	0	39.7222	7.2241	0.327741593	7.881984326	15.3947697	1.822134057	2.619395116	1.654242503	1.046217607	4.395677445	0	7.157932337	0.285920741	0.090668664	0.228990491	4.191617241	8.816859158	2.28252999	0.66304281	0	0	4.702332166	2.621706398	0	0	0.281100047	0	0.486068831	0	0	0	0	0	0	0	0	0	0	0	0	0	74.175																																																																																		0	0	0	7.2241	0.327741593	7.881984326	15.3947697	1.822134057	2.619395116	1.654242503	1.046217607	4.395677445	0	7.157932337	0.285920741	0.090668664	0.228990491	4.191617241	8.816859158	2.28252999	0.66304281	0	0	4.702332166	2.621706398	0	0	0.281100047	0	0.486068831	0	0	0	0	0	0	0	0	0	0	0	0	0	74.175
H7357_046_0	2009	6																					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																																																			0		362.8733128	18.23406786	2198.723761	7078.617111	220.2231693	19.46709079	12.29417006	379.0795667	419.4171235		6226.369033	25.91729113	32.87465131	117.8143773	3799.492262	4566.882111	865.4911513	343.4373049			34.9472772	1357.969299			147.9890135		255.8976692														"1a: $350 per admit, $875 Max OOP"	1b : $195 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4b: (n/c)	9a: $100 9b: $75	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $100	12: $50	9a: $100 9c: 50% 9d: $15 3: $15 5: $175	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $25 7d: $25 7f: $25	"7e, 7h: 50%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $15	10b: (n/c)	16a: (n/c)	17a1: $15	17b1: (n/c)	18a: $15 18a1: $15	18b: (n/c)		14a: (n/c)											331.5882178	325.8531583	64.98915146	29.09359045	100	0.2	0.2	50.03513021	97.5		10.25260011	100	50	15.65259679	10	25	47.03976497	15			0.2	15			15		15														226.2834929	222.3697553	44.35010475	19.85414112	68.24232008	0.13648464	0.13648464	34.14513371	66.53626207		6.99661218	68.24232008	34.12116004	10.6816952	6.824232008	17.06058002	32.10102697	10.23634801			0.13648464	10.23634801			10.23634801		10.23634801														6.8427	0.337892101	8.126135759	11.71165525	1.252378334	2.656958882	1.677965376	1.078643541	2.325537304	0	3.630290784	0.147388006	0.09347677	0.104871439	2.160718059	6.492804808	2.315262899	0.292961981	0	0	4.769766553	1.158387194	0	0	0.12623892	0	0.218288133	0	0	0	0	0	0	0	0	0	0	0	0	0	57.5203	0	26.768	6.8427	0.337892101	8.126135759	11.71165525	1.252378334	2.656958882	1.677965376	1.078643541	2.325537304	0	3.630290784	0.147388006	0.09347677	0.104871439	2.160718059	6.492804808	2.315262899	0.292961981	0	0	4.769766553	1.158387194	0	0	0.12623892	0	0.218288133	0	0	0	0	0	0	0	0	0	0	0	0	0	57.5203																																																																																		0	0	0	6.8427	0.337892101	8.126135759	11.71165525	1.252378334	2.656958882	1.677965376	1.078643541	2.325537304	0	3.630290784	0.147388006	0.09347677	0.104871439	2.160718059	6.492804808	2.315262899	0.292961981	0	0	4.769766553	1.158387194	0	0	0.12623892	0	0.218288133	0	0	0	0	0	0	0	0	0	0	0	0	0	57.5203
H7357_047_0	2009	6																					3000											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																																																			0		368.8227391	18.53302135	2234.76212	7194.673345	223.8337999	20.11066227	12.70060866	385.2867306	426.2936039		6328.452382	26.34221356	33.41364193	119.7459824	3861.786175	4641.757632	879.6811607	349.0680714			36.10261526	1380.233648			147.9890135		255.8976692														1a: $195 days 1-5	1b : $295 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20%/$250 Ded.	9a: $200 9b: $100	8a: 0%	8b1: 20% 8b2: 20% 8b3: 20%	9a: $0	12: $50	9a: $100 9c: 50% 9d: $35 3: $35 5: $195	"7a: $20, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 20% 8b2: 20% 8b3: 20%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $0 17a: $35 17b: $35	10b: (n/c)	16a: (n/c)	17a1: $35	17b1: (n/c)	18a: $35 18a1: $35	18b: (n/c)		14a: $0											360.9139764	325.8531583	64.98915146	39.42745247	150	0.2	0.2	50.03507713	190		20.84138965	200	50	35.23652713	20	35	47.81099724	35			0.2	35			35		35														235.043554	212.2103588	42.32388362	25.67694565	97.68680465	0.130249073	0.130249073	32.58511204	123.7366192		13.5728584	130.2490729	32.56226822	22.94762495	13.02490729	22.79358775	31.13669032	22.79358775			0.130249073	22.79358775			22.79358775		22.79358775														7.2241	0.327741593	7.881984326	15.3947697	1.822134057	2.619395116	1.654242503	1.046217607	4.395677445	0	7.157932337	0.285920741	0.090668664	0.228990491	4.191617241	8.816859158	2.28252999	0.66304281	0	0	4.702332166	2.621706398	0	0	0.281100047	0	0.486068831	0	0	0	0	0	0	0	0	0	0	0	0	0	74.175	0	39.7222	7.2241	0.327741593	7.881984326	15.3947697	1.822134057	2.619395116	1.654242503	1.046217607	4.395677445	0	7.157932337	0.285920741	0.090668664	0.228990491	4.191617241	8.816859158	2.28252999	0.66304281	0	0	4.702332166	2.621706398	0	0	0.281100047	0	0.486068831	0	0	0	0	0	0	0	0	0	0	0	0	0	74.175																																																																																		0	0	0	7.2241	0.327741593	7.881984326	15.3947697	1.822134057	2.619395116	1.654242503	1.046217607	4.395677445	0	7.157932337	0.285920741	0.090668664	0.228990491	4.191617241	8.816859158	2.28252999	0.66304281	0	0	4.702332166	2.621706398	0	0	0.281100047	0	0.486068831	0	0	0	0	0	0	0	0	0	0	0	0	0	74.175
H7357_049_0	2009	2																					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																																																			0		367.2877399	21.1308484	2100.11672	1931.085609	252.67513	11.87657306	9.755219553	381.2144309	422.2873255		5798.171395	157.9474257	10.68390621	138.082647	3581.786205	4272.505178	710.5313031	533.3681869			27.18386165	1202.326731			147.9890135		255.8976692														"1a: $350 per admit, $875 Max OOP"	1b : $195 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: $20%/$250 Ded. 4b: (n/c)	9a: $100 9b: $75	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $100	12: $50	9a: $100 9c: 50% 9d: $15 3: $15 5: $175	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $25 7d: $25 7f: $25	"7e, 7h: 50%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $15	10b: (n/c)	16a: (n/c)	17a1: $15	17b1: (n/c)	18a: $15 18a1: $15	18b: (n/c)		14a: (n/c)											331.5882178	325.8531583	64.98915146	20.83931814	100	0.2	0.2	50.02773886	97.5		9.317667843	100	50	16.46937626	10	25	40.56380607	15			0.2	15			15		15														248.6106132	244.3107118	48.7260763	15.62442627	74.97570779	0.149951416	0.149951416	37.5086513	73.1013151		6.985987415	74.97570779	37.4878539	12.34803142	7.497570779	18.74392695	30.41300071	11.24635617			0.149951416	11.24635617			11.24635617		11.24635617														7.6093	0.430207718	8.527537293	2.51434206	1.578708059	1.780908943	1.462808981	1.19156993	2.572479903	0	3.375496033	0.98685167	0.033376393	0.142087405	2.237891299	6.673627078	1.800782419	0.499870717	0	0	4.076258536	1.126816221	0	0	0.138694763	0	0.239826361	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9994	0	16.3543	7.6093	0.430207718	8.527537293	2.51434206	1.578708059	1.780908943	1.462808981	1.19156993	2.572479903	0	3.375496033	0.98685167	0.033376393	0.142087405	2.237891299	6.673627078	1.800782419	0.499870717	0	0	4.076258536	1.126816221	0	0	0.138694763	0	0.239826361	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9994																																																																																		0	0	0	7.6093	0.430207718	8.527537293	2.51434206	1.578708059	1.780908943	1.462808981	1.19156993	2.572479903	0	3.375496033	0.98685167	0.033376393	0.142087405	2.237891299	6.673627078	1.800782419	0.499870717	0	0	4.076258536	1.126816221	0	0	0.138694763	0	0.239826361	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9994
H7357_050_0	2009	2																					3000											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																																																			0		367.2877399	21.1308484	2100.11672	1931.085609	252.67513	11.87657306	9.755219553	381.2144309	422.2873255		5798.171395	157.9474257	10.68390621	138.082647	3581.786205	4272.505178	710.5313031	533.3681869			27.18386165	1202.326731			147.9890135		255.8976692														1a: $195 days 1-5	1b : $295 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20%/$250 Ded.	9a: $200 9b: $100	8a: 0%	8b1: 20% 8b2: 20% 8b3: 20%	9a: $0	12: $50	9a: $100 9c: 50% 9d: $35 3: $35 5: $195	"7a: $20, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 20% 8b2: 20% 8b3: 20%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $0 17a: $35 17b: $35	10b: (n/c)	16a: (n/c)	17a1: $35	17b1: (n/c)	18a: $35 18a1: $35	18b: (n/c)		14a: $0											360.9139764	325.8531583	64.98915146	27.78575752	150	0.2	0.2	50.02773886	190		18.63533569	200	50	34.90450524	20	35	40.56380607	35			0.2	35			35		35														260.750643	235.4201448	46.95291438	20.07446265	108.3709665	0.144494622	0.144494622	36.14369609	137.2698909		13.46352893	144.494622	36.12365551	25.21756646	14.4494622	25.28655886	29.30625913	25.28655886			0.144494622	25.28655886			25.28655886		25.28655886														7.9809	0.414552282	8.217216711	3.230458828	2.281887338	1.716100936	1.409576762	1.148208211	4.830611259	0	6.505320694	1.901879465	0.032161812	0.290175694	4.312907033	9.00307947	1.735251208	1.123920504	0	0	3.927921815	2.533558805	0	0	0.311844408	0	0.539230956	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4467	0	24.3721	7.9809	0.414552282	8.217216711	3.230458828	2.281887338	1.716100936	1.409576762	1.148208211	4.830611259	0	6.505320694	1.901879465	0.032161812	0.290175694	4.312907033	9.00307947	1.735251208	1.123920504	0	0	3.927921815	2.533558805	0	0	0.311844408	0	0.539230956	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4467																																																																																		0	0	0	7.9809	0.414552282	8.217216711	3.230458828	2.281887338	1.716100936	1.409576762	1.148208211	4.830611259	0	6.505320694	1.901879465	0.032161812	0.290175694	4.312907033	9.00307947	1.735251208	1.123920504	0	0	3.927921815	2.533558805	0	0	0.311844408	0	0.539230956	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4467
H7357_052_0	2009	4																					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																																																			0		367.2877399	21.1308484	2100.11672	1931.085609	252.67513	11.87657306	9.755219553	381.2144309	422.2873255		5798.171395	157.9474257	10.68390621	138.082647	3581.786205	4272.505178	710.5313031	533.3681869			27.18386165	1202.326731			147.9890135		255.8976692														"1a: $350 per admit, $875 Max OOP"	1b : $195 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: $20%/$250 Ded. 4b: (n/c)	9a: $100 9b: $75	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $100	12: $50	9a: $100 9c: 50% 9d: $15 3: $15 5: $175	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $25 7d: $25 7f: $25	"7e, 7h: 50%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $15	10b: (n/c)	16a: (n/c)	17a1: $15	17b1: (n/c)	18a: $15 18a1: $15	18b: (n/c)		14a: (n/c)											331.5882178	325.8531583	64.98915146	20.83931814	100	0.2	0.2	50.02773886	97.5		9.317667843	100	50	16.46937626	10	25	40.56380607	15			0.2	15			15		15														248.6106132	244.3107118	48.7260763	15.62442627	74.97570779	0.149951416	0.149951416	37.5086513	73.1013151		6.985987415	74.97570779	37.4878539	12.34803142	7.497570779	18.74392695	30.41300071	11.24635617			0.149951416	11.24635617			11.24635617		11.24635617														7.6093	0.430207718	8.527537293	2.51434206	1.578708059	1.780908943	1.462808981	1.19156993	2.572479903	0	3.375496033	0.98685167	0.033376393	0.142087405	2.237891299	6.673627078	1.800782419	0.499870717	0	0	4.076258536	1.126816221	0	0	0.138694763	0	0.239826361	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9994	0	16.3543	7.6093	0.430207718	8.527537293	2.51434206	1.578708059	1.780908943	1.462808981	1.19156993	2.572479903	0	3.375496033	0.98685167	0.033376393	0.142087405	2.237891299	6.673627078	1.800782419	0.499870717	0	0	4.076258536	1.126816221	0	0	0.138694763	0	0.239826361	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9994																																																																																		0	0	0	7.6093	0.430207718	8.527537293	2.51434206	1.578708059	1.780908943	1.462808981	1.19156993	2.572479903	0	3.375496033	0.98685167	0.033376393	0.142087405	2.237891299	6.673627078	1.800782419	0.499870717	0	0	4.076258536	1.126816221	0	0	0.138694763	0	0.239826361	0	0	0	0	0	0	0	0	0	0	0	0	0	48.9994
H7357_053_0	2009	4																					3000											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																																																			0		367.2877399	21.1308484	2100.11672	1931.085609	252.67513	11.87657306	9.755219553	381.2144309	422.2873255		5798.171395	157.9474257	10.68390621	138.082647	3581.786205	4272.505178	710.5313031	533.3681869			27.18386165	1202.326731			147.9890135		255.8976692														1a: $195 days 1-5	1b : $295 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20%/$250 Ded.	9a: $200 9b: $100	8a: 0%	8b1: 20% 8b2: 20% 8b3: 20%	9a: $0	12: $50	9a: $100 9c: 50% 9d: $35 3: $35 5: $195	"7a: $20, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 20% 8b2: 20% 8b3: 20%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $0 17a: $35 17b: $35	10b: (n/c)	16a: (n/c)	17a1: $35	17b1: (n/c)	18a: $35 18a1: $35	18b: (n/c)		14a: $0											360.9139764	325.8531583	64.98915146	27.78575752	150	0.2	0.2	50.02773886	190		18.63533569	200	50	34.90450524	20	35	40.56380607	35			0.2	35			35		35														260.750643	235.4201448	46.95291438	20.07446265	108.3709665	0.144494622	0.144494622	36.14369609	137.2698909		13.46352893	144.494622	36.12365551	25.21756646	14.4494622	25.28655886	29.30625913	25.28655886			0.144494622	25.28655886			25.28655886		25.28655886														7.9809	0.414552282	8.217216711	3.230458828	2.281887338	1.716100936	1.409576762	1.148208211	4.830611259	0	6.505320694	1.901879465	0.032161812	0.290175694	4.312907033	9.00307947	1.735251208	1.123920504	0	0	3.927921815	2.533558805	0	0	0.311844408	0	0.539230956	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4467	0	24.3721	7.9809	0.414552282	8.217216711	3.230458828	2.281887338	1.716100936	1.409576762	1.148208211	4.830611259	0	6.505320694	1.901879465	0.032161812	0.290175694	4.312907033	9.00307947	1.735251208	1.123920504	0	0	3.927921815	2.533558805	0	0	0.311844408	0	0.539230956	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4467																																																																																		0	0	0	7.9809	0.414552282	8.217216711	3.230458828	2.281887338	1.716100936	1.409576762	1.148208211	4.830611259	0	6.505320694	1.901879465	0.032161812	0.290175694	4.312907033	9.00307947	1.735251208	1.123920504	0	0	3.927921815	2.533558805	0	0	0.311844408	0	0.539230956	0	0	0	0	0	0	0	0	0	0	0	0	0	63.4467
H7357_061_0	2009	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																																																			0		378.2398932	25.30762608	1410.294356	4799.738411	189.6269853	16.55933627	12.39914944	386.8754294	427.5898209		5607.343143	71.1729569	7.727191726	50.59873971	3651.77341	3745.219666	748.0186978	473.9791765			23.62981223	1200.026496			147.9890135		255.8976692														"1a: $350 per admit, $875 Max OOP"	1b : $195 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: $20%/$250 Ded 4b: (n/c)	9a: $100 9b: $75	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $100	12: $50	9a: $100 9c: 50% 9d: $15 3: $15 5: $175	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $25 7d: $25 7f: $25	"7e, 7h: 50%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $15	10b: (n/c)	16a: (n/c)	17a1: $15	17b1: (n/c)	18a: $15 18a1: $15	18b: (n/c)		14a: (n/c)											331.5882178	325.8531583	64.98915146	23.21480529	100	0.2	0.2	50.02815334	97.5		9.806878085	100	50	16.74385021	10	25	50.46713595	15			0.2	15			15		15														246.3930752	242.1315277	48.29145315	17.25021264	74.30694518	0.14861389	0.14861389	37.17439248	72.44927155		7.287191522	74.30694518	37.15347259	12.4418436	7.430694518	18.57673629	37.50058704	11.14604178			0.14861389	11.14604178			11.14604178		11.14604178														7.7663	0.510647847	5.675430319	6.899709018	1.174216833	2.460947384	1.842685836	1.198488254	2.581547587	0	3.405148618	0.440720417	0.023924334	0.0524618	2.261267721	5.797829842	2.337595024	0.440249309	0	0	3.511718324	1.114628789	0	0	0.137457644	0	0.237687176	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8707	0	17.2437	7.7663	0.510647847	5.675430319	6.899709018	1.174216833	2.460947384	1.842685836	1.198488254	2.581547587	0	3.405148618	0.440720417	0.023924334	0.0524618	2.261267721	5.797829842	2.337595024	0.440249309	0	0	3.511718324	1.114628789	0	0	0.137457644	0	0.237687176	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8707																																																																																		0	0	0	7.7663	0.510647847	5.675430319	6.899709018	1.174216833	2.460947384	1.842685836	1.198488254	2.581547587	0	3.405148618	0.440720417	0.023924334	0.0524618	2.261267721	5.797829842	2.337595024	0.440249309	0	0	3.511718324	1.114628789	0	0	0.137457644	0	0.237687176	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8707
H7357_062_0	2009	3																					3000											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																																																			0		378.2398932	25.30762608	1410.294356	4799.738411	189.6269853	16.55933627	12.39914944	386.8754294	427.5898209		5607.343143	71.1729569	7.727191726	50.59873971	3651.77341	3745.219666	748.0186978	473.9791765			23.62981223	1200.026496			147.9890135		255.8976692														1a: $195 days 1-5	1b : $295 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20%/$250 Ded.	9a: $200 9b: $100	8a: 0%	8b1: 20% 8b2: 20% 8b3: 20%	9a: $0	12: $50	9a: $100 9c: 50% 9d: $35 3: $35 5: $195	"7a: $20, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 20% 8b2: 20% 8b3: 20%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $0 17a: $35 17b: $35	10b: (n/c)	16a: (n/c)	17a1: $35	17b1: (n/c)	18a: $35 18a1: $35	18b: (n/c)		14a: $0											360.9139764	325.8531583	64.98915146	30.95307372	150	0.2	0.2	50.02815334	190		19.61375617	200	50	35.76032324	20	35	50.46713595	35			0.2	35			35		35														258.2338167	233.1478143	46.49971384	22.14691281	107.3249445	0.143099926	0.143099926	35.79512522	135.9449298		14.03363529	143.0999261	35.77498151	25.58649806	14.30999261	25.04248706	36.10921711	25.04248706			0.143099926	25.04248706			25.04248706		25.04248706														8.1395	0.491701476	5.464857	8.85828234	1.695975474	2.369639795	1.774317368	1.154021203	4.844055681	0	6.557617384	0.848737072	0.023036678	0.107887046	4.354737541	7.815801253	2.25086413	0.989134783	0	0	3.381424383	2.504304001	0	0	0.308834413	0	0.534026172	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4688	0	25.6344	8.1395	0.491701476	5.464857	8.85828234	1.695975474	2.369639795	1.774317368	1.154021203	4.844055681	0	6.557617384	0.848737072	0.023036678	0.107887046	4.354737541	7.815801253	2.25086413	0.989134783	0	0	3.381424383	2.504304001	0	0	0.308834413	0	0.534026172	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4688																																																																																		0	0	0	8.1395	0.491701476	5.464857	8.85828234	1.695975474	2.369639795	1.774317368	1.154021203	4.844055681	0	6.557617384	0.848737072	0.023036678	0.107887046	4.354737541	7.815801253	2.25086413	0.989134783	0	0	3.381424383	2.504304001	0	0	0.308834413	0	0.534026172	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4688
H7357_064_0	2009	4																					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																																																			0		378.2398932	25.30762608	1410.294356	4799.738411	189.6269853	16.55933627	12.39914944	386.8754294	427.5898209		5607.343143	71.1729569	7.727191726	50.59873971	3651.77341	3745.219666	748.0186978	473.9791765			23.62981223	1200.026496			147.9890135		255.8976692														"1a: $350 per admit, $875 Max OOP"	1b : $195 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: $20%/$250 Ded 4b: (n/c)	9a: $100 9b: $75	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $100	12: $50	9a: $100 9c: 50% 9d: $15 3: $15 5: $175	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $25 7d: $25 7f: $25	"7e, 7h: 50%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $15	10b: (n/c)	16a: (n/c)	17a1: $15	17b1: (n/c)	18a: $15 18a1: $15	18b: (n/c)		14a: (n/c)											331.5882178	325.8531583	64.98915146	23.21480529	100	0.2	0.2	50.02815334	97.5		9.806878085	100	50	16.74385021	10	25	50.46713595	15			0.2	15			15		15														246.3930752	242.1315277	48.29145315	17.25021264	74.30694518	0.14861389	0.14861389	37.17439248	72.44927155		7.287191522	74.30694518	37.15347259	12.4418436	7.430694518	18.57673629	37.50058704	11.14604178			0.14861389	11.14604178			11.14604178		11.14604178														7.7663	0.510647847	5.675430319	6.899709018	1.174216833	2.460947384	1.842685836	1.198488254	2.581547587	0	3.405148618	0.440720417	0.023924334	0.0524618	2.261267721	5.797829842	2.337595024	0.440249309	0	0	3.511718324	1.114628789	0	0	0.137457644	0	0.237687176	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8707	0	17.2437	7.7663	0.510647847	5.675430319	6.899709018	1.174216833	2.460947384	1.842685836	1.198488254	2.581547587	0	3.405148618	0.440720417	0.023924334	0.0524618	2.261267721	5.797829842	2.337595024	0.440249309	0	0	3.511718324	1.114628789	0	0	0.137457644	0	0.237687176	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8707																																																																																		0	0	0	7.7663	0.510647847	5.675430319	6.899709018	1.174216833	2.460947384	1.842685836	1.198488254	2.581547587	0	3.405148618	0.440720417	0.023924334	0.0524618	2.261267721	5.797829842	2.337595024	0.440249309	0	0	3.511718324	1.114628789	0	0	0.137457644	0	0.237687176	0	0	0	0	0	0	0	0	0	0	0	0	0	49.8707
H7357_065_0	2009	4																					3000											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																																																			0		378.2398932	25.30762608	1410.294356	4799.738411	189.6269853	16.55933627	12.39914944	386.8754294	427.5898209		5607.343143	71.1729569	7.727191726	50.59873971	3651.77341	3745.219666	748.0186978	473.9791765			23.62981223	1200.026496			147.9890135		255.8976692														1a: $195 days 1-5	1b : $295 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 20%	10a: $150	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20%/$250 Ded.	9a: $200 9b: $100	8a: 0%	8b1: 20% 8b2: 20% 8b3: 20%	9a: $0	12: $50	9a: $100 9c: 50% 9d: $35 3: $35 5: $195	"7a: $20, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 20% 8b2: 20% 8b3: 20%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $0 17a: $35 17b: $35	10b: (n/c)	16a: (n/c)	17a1: $35	17b1: (n/c)	18a: $35 18a1: $35	18b: (n/c)		14a: $0											360.9139764	325.8531583	64.98915146	30.95307372	150	0.2	0.2	50.02815334	190		19.61375617	200	50	35.76032324	20	35	50.46713595	35			0.2	35			35		35														258.2338167	233.1478143	46.49971384	22.14691281	107.3249445	0.143099926	0.143099926	35.79512522	135.9449298		14.03363529	143.0999261	35.77498151	25.58649806	14.30999261	25.04248706	36.10921711	25.04248706			0.143099926	25.04248706			25.04248706		25.04248706														8.1395	0.491701476	5.464857	8.85828234	1.695975474	2.369639795	1.774317368	1.154021203	4.844055681	0	6.557617384	0.848737072	0.023036678	0.107887046	4.354737541	7.815801253	2.25086413	0.989134783	0	0	3.381424383	2.504304001	0	0	0.308834413	0	0.534026172	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4688	0	25.6344	8.1395	0.491701476	5.464857	8.85828234	1.695975474	2.369639795	1.774317368	1.154021203	4.844055681	0	6.557617384	0.848737072	0.023036678	0.107887046	4.354737541	7.815801253	2.25086413	0.989134783	0	0	3.381424383	2.504304001	0	0	0.308834413	0	0.534026172	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4688																																																																																		0	0	0	8.1395	0.491701476	5.464857	8.85828234	1.695975474	2.369639795	1.774317368	1.154021203	4.844055681	0	6.557617384	0.848737072	0.023036678	0.107887046	4.354737541	7.815801253	2.25086413	0.989134783	0	0	3.381424383	2.504304001	0	0	0.308834413	0	0.534026172	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4688
H7406_001_0	2009	3																					5000											D	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	V											0	0	0	0	0	0	0	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	1101.699363	3.368038823	1035.970309	45.93996565	238.6942726	16.6630025	4.699153326	182.1457905	369.9339463	8.872015668	22.32329676	0	0.224699487	675.7596533	3822.147275	6071.037737	166.6691662	765.2325843	30.78740813	18.36840959	8.473511727	15.60353187	0	0	0	0	0	0	324	0											1a:  Acute - $250/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - MC Cost Shares for 1-190	2:  Skilled Nursing Services - $0/$100/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $150/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $25/visit/7b:  Chiropractic Services - $25/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $25/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%/13a:  3-Pints Deductible Waived - $0/service							14a:  Written health education materials - $0/service/14c:  Routine Exams - $0/visit/												249.5309145	0.073756007	100	0	150	0.2	0.2	50	110.1315579	0	0.2	0	0.2	25	25	25	25	25	0	16.01701768	0.2	138.5851537	0	0	0	0	0	0	0	0											225.2459258	0.066577883	90.26774346	0	135.4016152	0.180535487	0.180535487	45.13387173	99.41327215	0	0.180535487	0	0.180535487	22.56693586	22.56693726	22.56693586	22.56693586	22.56693586	0	14.45820043	0.180535487	125.097691	0	0	0	0	0	0	0	0											20.6794	0.224236896	7.792891838	0	2.693299171	3.00826327	0.848363934	0.685078729	3.06469534	0	4.030147249	0	0.040566231	1.27081873	7.187846479	11.41705994	0.313434365	1.439079554	0	0.022131179	1.529769566	0.162663817	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4098	0	7.16	20.6794	0.224236896	7.792891838	0	2.693299171	3.00826327	0.848363934	0.685078729	3.06469534	0	4.030147249	0	0.040566231	1.27081873	7.187846479	11.41705994	0.313434365	1.439079554	0	0.022131179	1.529769566	0.162663817	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4098	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	20.6794	0.224236896	7.792891838	0	2.693299171	3.00826327	0.848363934	0.685078729	3.06469534	0	4.030147249	0	0.040566231	1.27081873	7.187846479	11.41705994	0.313434365	1.439079554	0	0.022131179	1.529769566	0.162663817	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4098
H7406_003_0	2009	3																					5000											D	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	V											0	0	0	0	0	0	0	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	1101.699363	3.368038823	1035.970309	45.93996565	238.6942726	16.6630025	4.699153326	182.1457905	369.9339463	8.872015668	22.32329676	0	0.224699487	675.7596533	3822.147275	6071.037737	166.6691662	765.2325843	30.78740813	18.36840959	8.473511727	15.60353187	0	0	0	0	0	0	324	0											1a:  Acute - $250/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - MC Cost Shares for 1-190	2:  Skilled Nursing Services - $0/$100/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $150/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $25/visit/7b:  Chiropractic Services - $25/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $25/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%/13a:  3-Pints Deductible Waived - $0/service							14a:  Written health education materials - $0/service/14c:  Routine Exams - $0/visit/												249.5309145	0.073756007	100	0	150	0.2	0.2	50	110.1315579	0	0.2	0	0.2	25	25	25	25	25	0	16.01701768	0.2	138.5851537	0	0	0	0	0	0	0	0											225.2459258	0.066577883	90.26774346	0	135.4016152	0.180535487	0.180535487	45.13387173	99.41327215	0	0.180535487	0	0.180535487	22.56693586	22.56693726	22.56693586	22.56693586	22.56693586	0	14.45820043	0.180535487	125.097691	0	0	0	0	0	0	0	0											20.6794	0.224236896	7.792891838	0	2.693299171	3.00826327	0.848363934	0.685078729	3.06469534	0	4.030147249	0	0.040566231	1.27081873	7.187846479	11.41705994	0.313434365	1.439079554	0	0.022131179	1.529769566	0.162663817	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4098	0	7.16	20.6794	0.224236896	7.792891838	0	2.693299171	3.00826327	0.848363934	0.685078729	3.06469534	0	4.030147249	0	0.040566231	1.27081873	7.187846479	11.41705994	0.313434365	1.439079554	0	0.022131179	1.529769566	0.162663817	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4098	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	20.6794	0.224236896	7.792891838	0	2.693299171	3.00826327	0.848363934	0.685078729	3.06469534	0	4.030147249	0	0.040566231	1.27081873	7.187846479	11.41705994	0.313434365	1.439079554	0	0.022131179	1.529769566	0.162663817	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4098
H7406_004_0	2009	3																					6000											D	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	V											0	0	0	0	0	0	0	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	1089.584394	3.404187037	992.9534513	43.45646033	263.4672394	16.42767578	4.634345569	173.6239043	340.1508802	9.153767092	26.43482748	0	0.234444681	688.2926425	3924.24384	6241.131518	172.9375394	794.0887939	30.70842942	19.04826597	8.750585108	14.68169706	0	0	0	0	0	0	324	0											1a:  Acute - $250/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - MC Cost Shares for 1-190	2:  Skilled Nursing Services - $0/$100/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $150/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $25/visit/7b:  Chiropractic Services - $25/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $25/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%/13a:  3-Pints Deductible Waived - $0/service							14a:  Written health education materials - $0/service/14c:  Routine Exams - $0/visit/												249.5358656	0.074493697	100	0	150	0.2	0.2	50	110.1315579	0	0.2	0	0.2	25	25	25	25	25	0	16.10567462	0.2	152.6621037	0	0	0	0	0	0	0	0											231.2042618	0.069021181	92.65371986	0	138.9805798	0.18530744	0.18530744	46.32685993	102.0409851	0	0.18530744	0	0.18530744	23.16342996	23.16342996	23.16342996	23.16342996	23.16342996	0	14.92250664	0.18530744	141.4471178	0	0	0	0	0	0	0	0											20.993	0.23496101	7.666735909	0	3.051402474	3.04417054	0.858778712	0.670287524	2.892444242	0	4.8985702	0	0.043444344	1.328601535	7.574912279	12.04716773	0.333818882	1.532818347	0	0.023687323	1.621548522	0.173056978	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.9895	0	5.47	20.993	0.23496101	7.666735909	0	3.051402474	3.04417054	0.858778712	0.670287524	2.892444242	0	4.8985702	0	0.043444344	1.328601535	7.574912279	12.04716773	0.333818882	1.532818347	0	0.023687323	1.621548522	0.173056978	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.9895	6000																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.993	0.23496101	7.666735909	0	3.051402474	3.04417054	0.858778712	0.670287524	2.892444242	0	4.8985702	0	0.043444344	1.328601535	7.574912279	12.04716773	0.333818882	1.532818347	0	0.023687323	1.621548522	0.173056978	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.9895
H7406_006_0	2009	3																					5000											D	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	V											0	0	0	0	0	0	0	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	1089.584394	3.404187037	992.9534513	43.45646033	263.4672394	16.42767578	4.634345569	173.6239043	340.1508802	9.153767092	26.43482748	0	0.234444681	691.6365743	4143.405153	6582.145377	182.7635359	839.2074753	31.18444948	19.04826597	8.750585108	14.68169706	0	0	1000	0	0	0	324	1080											1a:  Acute - $250/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - MC Cost Shares for 1-190	2:  Skilled Nursing Services - $0/$100/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $150/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $15/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $15/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $15/visit/7b:  Chiropractic Services - $15/visit/7f:  Podiatry Services - $15/visit/17a:  Vision Exams - $15/visit/18a:  Hearing Exams - $15/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $15/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $15/visit/7h:  Psychiatric Services - Individual - $15/visit/7h:  Psychiatric Services - Group - $15/visit	7c:  Occupational Therapy Services - $15/visit/7i:  Physical/Speech Therapy - $15/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $15/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $0/visit				14a:  Written health education materials - $0/service/14c:  Routine Exams - $0/visit/												249.5358656	0.074493697	100	0	150	0.2	0.2	50	110.1315579	0	0.2	0	0.2	15	15	15	15	15	0	16.10567462	0.2	152.6621037	0	0	0	0	0	0	0	0											228.6591388	0.068261388	91.63377711	0	137.4506657	0.183267554	0.183267554	45.81688855	100.9177063	0	0.183267554	0	0.183267554	13.74506657	13.74506657	13.74506657	13.74506657	13.74506657	0	14.75823798	0.183267554	139.8900518	0	0	0	0	0	0	0	0											20.762	0.232374532	7.582339603	0	3.017812286	3.010659962	0.849325178	0.662908923	2.860603885	0	4.844646179	0	0.042966103	0.792215896	4.745948303	7.53933553	0.209341414	0.961246884	0	0.02342657	1.603698331	0.171151947	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.912	0	5.47	20.762	0.232374532	7.582339603	0	3.017812286	3.010659962	0.849325178	0.662908923	2.860603885	0	4.844646179	0	0.042966103	0.792215896	4.745948303	7.53933553	0.209341414	0.961246884	0	0.02342657	1.603698331	0.171151947	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.912	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	20.762	0.232374532	7.582339603	0	3.017812286	3.010659962	0.849325178	0.662908923	2.860603885	0	4.844646179	0	0.042966103	0.792215896	4.745948303	7.53933553	0.209341414	0.961246884	0	0.02342657	1.603698331	0.171151947	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.912
H7406_007_0	2009	3																					5000											D	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	V											0	0	0	0	0	0	0	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	1105.151579	3.350994683	1091.073955	50.15315038	280.2251196	16.38068464	4.62230115	186.8312809	350.7546914	8.733394816	23.36520442	0	0.255791802	654.5934519	3958.447033	6405.76563	185.3460044	851.1290965	33.13952688	20.37654827	8.708205015	15.77001465	0	0	0	0	0	0	324	0											1a:  Acute - $250/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - MC Cost Shares for 1-190	2:  Skilled Nursing Services - $0/$100/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $150/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $25/visit/7b:  Chiropractic Services - $25/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $25/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%/13a:  3-Pints Deductible Waived - $0/service							14a:  Written health education materials - $0/service/14c:  Routine Exams - $0/visit/												249.5301122	0.073975485	100	0	150	0.2	0.2	50	110.1315579	0	0.2	0	0.2	25	25	25	25	25	0	16.39553993	0.2	141.0063062	0	0	0	0	0	0	0	0											223.8912087	0.066374597	89.72512645	0	134.5876897	0.179450253	0.179450253	44.86256322	98.81567958	0	0.179450253	0	0.179450253	22.43128161	22.43128161	22.43128161	22.43128161	22.43128161	0	14.71091894	0.179450253	126.5180866	0	0	0	0	0	0	0	0											20.6195	0.222420922	8.158062384	0	3.142904286	2.939518001	0.82947311	0.698477513	2.8883386	0	4.192891842	0	0.045901903	1.223614172	7.399420013	11.97412773	0.346462368	1.590993038	0	0.024979812	1.562689592	0.166266007	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.026	0	7.79	20.6195	0.222420922	8.158062384	0	3.142904286	2.939518001	0.82947311	0.698477513	2.8883386	0	4.192891842	0	0.045901903	1.223614172	7.399420013	11.97412773	0.346462368	1.590993038	0	0.024979812	1.562689592	0.166266007	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.026	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	20.6195	0.222420922	8.158062384	0	3.142904286	2.939518001	0.82947311	0.698477513	2.8883386	0	4.192891842	0	0.045901903	1.223614172	7.399420013	11.97412773	0.346462368	1.590993038	0	0.024979812	1.562689592	0.166266007	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.026
H7406_008_0	2009	3																					5000											D	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	V											0	0	0	0	0	0	0	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	1105.151579	3.350994683	1091.073955	50.15315038	280.2251196	16.38068464	4.62230115	186.8312809	350.7546914	8.733394816	23.36520442	0	0.255791802	654.5934519	3958.447033	6405.76563	185.3460044	851.1290965	33.13952688	20.37654827	8.708205015	15.77001465	0	0	0	0	0	0	324	0											1a:  Acute - $250/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - MC Cost Shares for 1-190	2:  Skilled Nursing Services - $0/$100/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $150/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $150/visit/9b:  Ambulatory Surgical Center Services - $100/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - 20.0%		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $25/visit/7b:  Chiropractic Services - $25/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $25/visit/18a:  Hearing Exams - $25/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $25/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%/13a:  3-Pints Deductible Waived - $0/service							14a:  Written health education materials - $0/service/14c:  Routine Exams - $0/visit/												249.5301122	0.073975485	100	0	150	0.2	0.2	50	110.1315579	0	0.2	0	0.2	25	25	25	25	25	0	16.39553993	0.2	141.0063062	0	0	0	0	0	0	0	0											223.8912087	0.066374597	89.72512645	0	134.5876897	0.179450253	0.179450253	44.86256322	98.81567958	0	0.179450253	0	0.179450253	22.43128161	22.43128161	22.43128161	22.43128161	22.43128161	0	14.71091894	0.179450253	126.5180866	0	0	0	0	0	0	0	0											20.6195	0.222420922	8.158062384	0	3.142904286	2.939518001	0.82947311	0.698477513	2.8883386	0	4.192891842	0	0.045901903	1.223614172	7.399420013	11.97412773	0.346462368	1.590993038	0	0.024979812	1.562689592	0.166266007	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.026	0	7.79	20.6195	0.222420922	8.158062384	0	3.142904286	2.939518001	0.82947311	0.698477513	2.8883386	0	4.192891842	0	0.045901903	1.223614172	7.399420013	11.97412773	0.346462368	1.590993038	0	0.024979812	1.562689592	0.166266007	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.026	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	20.6195	0.222420922	8.158062384	0	3.142904286	2.939518001	0.82947311	0.698477513	2.8883386	0	4.192891842	0	0.045901903	1.223614172	7.399420013	11.97412773	0.346462368	1.590993038	0	0.024979812	1.562689592	0.166266007	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.026
H7406_009_0	2009	3																					1800											A	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	V											0	0	0	0	0	0	0	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	338.7945547	4.021494034	848.2104207	72.87987969	342.631819	20.39799561	5.804074152	180.4524716	367.7212699	3.973362751	21.69537121	0	0.284119229	541.5498092	4552.917032	7348.547711	220.0866288	1013.009966	43.52531725	22.13206935	9.706976742	15.02703072	0	0	0	0	0	0	324	0											1a:  Acute - $200/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - 50.0% for 1-190	2:  Skilled Nursing Services - $0/$50/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$50/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $50/visit/9b:  Ambulatory Surgical Center Services - $50/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - $0/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $10/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $10/visit/7b:  Chiropractic Services - $10/visit/7f:  Podiatry Services - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $10/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $10/visit/7h:  Psychiatric Services - Individual - $10/visit/7h:  Psychiatric Services - Group - $10/visit	7c:  Occupational Therapy Services - $10/visit/7i:  Physical/Speech Therapy - $10/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $10/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%/13a:  3-Pints Deductible Waived - $0/service							14a:  Written health education materials - $0/service/14c:  Routine Exams - $0/visit/												206.6168331	0.5	50	0	50	0.3	0.3	50	50	0	0.141519144	0	0.2	10	10	10	10	10	0	16.7242804	0.2	166.0671928	0	0	0	0	0	0	0	0											162.9537375	0.394338	39.43380001	0	39.43380001	0.2366028	0.2366028	39.43380001	39.43380001	0	0.111612753	0	0.1577352	7.886760002	7.886760002	7.886760002	7.886760002	7.886760002	0	13.19003857	0.1577352	130.9732094	0	0	0	0	0	0	0	0											4.6007	1.585827915	2.787346675	0	1.125939552	4.826222876	1.373260196	0.59299389	1.208387251	0	2.421480098	0	0.044815603	0.355922781	2.992313662	4.829686013	0.144647535	0.66578054	0	0.024326904	1.531131918	0.164011537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.2747	0	8.38	4.6007	1.585827915	2.787346675	0	1.125939552	4.826222876	1.373260196	0.59299389	1.208387251	0	2.421480098	0	0.044815603	0.355922781	2.992313662	4.829686013	0.144647535	0.66578054	0	0.024326904	1.531131918	0.164011537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.2747	1800																																									0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.6007	1.585827915	2.787346675	0	1.125939552	4.826222876	1.373260196	0.59299389	1.208387251	0	2.421480098	0	0.044815603	0.355922781	2.992313662	4.829686013	0.144647535	0.66578054	0	0.024326904	1.531131918	0.164011537	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.2747
H7406_010_0	2009	3																					1500											A	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	V											0	0	0	0	0	0	0	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	310.8532539	2.992825974	1155.558032	28.1375722	206.1314494	13.42129976	3.764707143	178.5392605	349.960442	11.49476873	25.05817962	0	0.208887327	769.7327876	4238.557051	6670.035364	177.754177	814.8619136	26.86571508	17.25580282	7.944409164	15.38209568	0	0	0	0	0	0	324	1000											1a:  Acute - $100/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - 50.0% for 1-190	2:  Skilled Nursing Services - $0/$50/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$50/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $50/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 30.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $50/visit/9b:  Ambulatory Surgical Center Services - $50/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 20.0%/8b:  Outpatient Therapeutic Radiological Services - 20.0%/8b:  Outpatient X-Ray Services - $0/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $5/visit/3:  Rehab Services (CORF) - 20.0%/5:  Partial Hospitalization - 20.0%	7a:  Primary Care - $5/visit/17a:  Vision Exams - $5/visit/18a:  Hearing Exams - $5/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $5/visit/7b:  Chiropractic Services - $5/visit/7f:  Podiatry Services - $5/visit/17a:  Vision Exams - $5/visit/18a:  Hearing Exams - $5/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $5/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $5/visit/7h:  Psychiatric Services - Individual - $5/visit/7h:  Psychiatric Services - Group - $5/visit	7c:  Occupational Therapy Services - $5/visit/7i:  Physical/Speech Therapy - $5/visit		9c:  Outpatient Substance Abuse Svcs - Individual - 20.0%/9c:  Outpatient Substance Abuse Svcs - Group - 20.0%/7g:  Other Health Care Professional Services - $5/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - 20.0%/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $0/visit				14a:  Written health education materials - $0/service/14c:  Routine Exams - $0/visit/												105.5136609	0.5	50	0	50	0.3	0.3	50	50	0	0.141519144	0	0.2	5	5	5	5	5	0	15.86931221	0.2	131.5688016	0	0	0	0	0	0	0	0											88.0850568	0.417410675	41.74106747	0	41.74106747	0.250446405	0.250446405	41.74106747	41.74106747	0	0.118143203	0	0.16696427	4.174106747	4.174106747	4.174106747	4.174106747	4.174106747	0	13.24804064	0.16696427	109.8364445	0	0	0	0	0	0	0	0											2.2818	1.249237509	4.019518814	0	0.717012228	3.361316272	0.942857369	0.621034943	1.217310202	0	2.960453598	0	0.03487672	0.267745569	1.474349132	2.320119968	0.061830409	0.283443384	0	0.019050465	1.326432476	0.140792892	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.2992	0	4.61	2.2818	1.249237509	4.019518814	0	0.717012228	3.361316272	0.942857369	0.621034943	1.217310202	0	2.960453598	0	0.03487672	0.267745569	1.474349132	2.320119968	0.061830409	0.283443384	0	0.019050465	1.326432476	0.140792892	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.2992	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	2.2818	1.249237509	4.019518814	0	0.717012228	3.361316272	0.942857369	0.621034943	1.217310202	0	2.960453598	0	0.03487672	0.267745569	1.474349132	2.320119968	0.061830409	0.283443384	0	0.019050465	1.326432476	0.140792892	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.2992
H7406_011_0	2009	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	V											0	0	0	0	0	0	0	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	352.6328857	3.835760922	47.56411866	65.58059833	9.63872806	19.51411833	5.539577941	7.591061976	41.38916738	5.31322447	22.06138337	0	0.278495788	27.87423237	47.08237747	135.8903075	1.418427389	6.741792667	38.57471952	42.55187602	9.321277703	1.003714341	0	2324.018776	0	0	0	0	324	3880											Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing	Medicare Cost Shares - Excluding IP Physician Cost Sharing		"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Emergency Svcs - $0/visit/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $0/visit		18a:  Routine Hearing Test - $0/visit/18a:  Fitting for Hearing Aid - $0/visit	18b:  Hearing Aids - $0/service	14a:  Written health education materials - $0/service/14a:  Smoking Cessation - $0/service/14c:  Routine Exams - $0/visit/												0.070603895	0.070603895	0.20047802	0	0.231	0.231	0.231	0.227632931	0.231	0.231	0.231	0	0.231	0.231	0.164143534	0.181120976	0.231	0.231	0.212251237	0.22664487	0.231	0.231	0	0	0	0	0	0	0	0											0.070603895	0.070603895	0.20047802	0	0.231	0.231	0.231	0.227632931	0.231	0.231	0.231	0	0.231	0.231	0.164143534	0.181120976	0.231	0.231	0.212251237	0.22664487	0.231	0.231	0	0	0	0	0	0	0	0											24.8973	0.270819663	9.535560317	0	2.226546182	4.507761334	1.279642504	1.727975687	9.560897664	1.227354853	5.096179559	0	0.064332527	6.438947678	7.728267826	24.61258518	0.327656727	1.557354106	8.187531932	9.644164392	2.153215149	0.231858013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.2759	135	0	24.8973	0.270819663	9.535560317	0	2.226546182	4.507761334	1.279642504	1.727975687	9.560897664	1.227354853	5.096179559	0	0.064332527	6.438947678	7.728267826	24.61258518	0.327656727	1.557354106	8.187531932	9.644164392	2.153215149	0.231858013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.2759	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	24.8973	0.270819663	9.535560317	0	2.226546182	4.507761334	1.279642504	1.727975687	9.560897664	1.227354853	5.096179559	0	0.064332527	6.438947678	7.728267826	24.61258518	0.327656727	1.557354106	8.187531932	9.644164392	2.153215149	0.231858013	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.2759
H7406_801_0	2009	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	V											0	0	0	0	0	0	0	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	344.2509765	3.744586783	60.78746168	45.84143414	9.300363528	18.50897487	5.235932886	11.62480551	45.34775766	8.351121153	26.16520258	0	0.283986966	35.08247478	47.67970432	137.8374681	1.441022304	6.872041954	36.13871547	42.92236851	10.14952446	1.092332546	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											25.4549	0.27688523	10.85293555	0	2.148383975	4.275573196	1.209500497	2.685330073	10.47533202	1.929108986	6.044161797	0	0.065600989	8.104051675	11.0140117	31.84045512	0.332876152	1.587441691	8.348043273	9.915067126	2.34454015	0.252328818	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1565	0	0	25.4549	0.27688523	10.85293555	0	2.148383975	4.275573196	1.209500497	2.685330073	10.47533202	1.929108986	6.044161797	0	0.065600989	8.104051675	11.0140117	31.84045512	0.332876152	1.587441691	8.348043273	9.915067126	2.34454015	0.252328818	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1565	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	25.4549	0.27688523	10.85293555	0	2.148383975	4.275573196	1.209500497	2.685330073	10.47533202	1.929108986	6.044161797	0	0.065600989	8.104051675	11.0140117	31.84045512	0.332876152	1.587441691	8.348043273	9.915067126	2.34454015	0.252328818	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1565
H7406_802_0	2009	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	V											0	0	0	0	0	0	0	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	344.2509765	3.744586783	60.78746168	45.84143414	9.300363528	18.50897487	5.235932886	11.62480551	45.34775766	8.351121153	26.16520258	0	0.283986966	35.08247478	47.67970432	137.8374681	1.441022304	6.872041954	36.13871547	42.92236851	10.14952446	1.092332546	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.0739428	0.0739428	0.178539048	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											25.4549	0.27688523	10.85293555	0	2.148383975	4.275573196	1.209500497	2.685330073	10.47533202	1.929108986	6.044161797	0	0.065600989	8.104051675	11.0140117	31.84045512	0.332876152	1.587441691	8.348043273	9.915067126	2.34454015	0.252328818	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1565	0	0	25.4549	0.27688523	10.85293555	0	2.148383975	4.275573196	1.209500497	2.685330073	10.47533202	1.929108986	6.044161797	0	0.065600989	8.104051675	11.0140117	31.84045512	0.332876152	1.587441691	8.348043273	9.915067126	2.34454015	0.252328818	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1565	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	25.4549	0.27688523	10.85293555	0	2.148383975	4.275573196	1.209500497	2.685330073	10.47533202	1.929108986	6.044161797	0	0.065600989	8.104051675	11.0140117	31.84045512	0.332876152	1.587441691	8.348043273	9.915067126	2.34454015	0.252328818	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1565
H7475_001_0	2009	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		401.4169378		377.9976291		58.70605898	25.18894441		24.39868528	15.72144752	171.950327					266.1520758						32.67140373	6.135218881																			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																			0.081464094		0.160642042		0.231	0.231		0.231	0.231	0.231					0.231						0.231	0.231																			0.081464094		0.160642042		0.231	0.231		0.231	0.231	0.231					0.231						0.231	0.231																			32.7011	0	60.72231089	0	13.56109963	5.818646158	0	5.636096299	3.631654377	39.72052553	0	0	0	0	61.48112951	0	0	0	0	0	7.547094262	1.417235562	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	232.2369	0	0	32.7011	0	60.72231089	0	13.56109963	5.818646158	0	5.636096299	3.631654377	39.72052553	0	0	0	0	61.48112951	0	0	0	0	0	7.547094262	1.417235562	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	232.2369																																																																																		0	0	0	32.7011	0	60.72231089	0	13.56109963	5.818646158	0	5.636096299	3.631654377	39.72052553	0	0	0	0	61.48112951	0	0	0	0	0	7.547094262	1.417235562	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	232.2369
H7526_001_0	2009	9																					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		683.4476435	18.48469038			619.2989083	49.94284323	39.34381264	491.4785114	337.1937164		435.6910807	83.6614935		1339.769938	10994.91883	7744.559303	381.8917372	1172.01572			49.18173882	0.039513542								5											$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 )											100	100			50	0.2	0.2	50	25		24.56162143	25		21.59413287	10	10	10	10			0.2	0.2								0.2											81.62084832	81.62084832			40.81042416	0.163241697	0.163241697	40.81042416	20.40521208		20.04740377	20.40521208		17.62531444	8.162084832	8.162084832	8.162084832	8.162084832			0.163241697	0.163241697								0.2											4.6486	0.125728009	0	0	2.106154261	8.152754464	6.422550728	1.671453877	0.573375775	0	0.727872918	0.142260876	0	1.967822202	7.478455016	5.267645835	0.25975273	0.797174311	0	0	8.028510489	0.006450258	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	49.3766	0	10.8933	4.6486	0.125728009	0	0	2.106154261	8.152754464	6.422550728	1.671453877	0.573375775	0	0.727872918	0.142260876	0	1.967822202	7.478455016	5.267645835	0.25975273	0.797174311	0	0	8.028510489	0.006450258	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	49.3766																																																																																		0	0	0	4.6486	0.125728009	0	0	2.106154261	8.152754464	6.422550728	1.671453877	0.573375775	0	0.727872918	0.142260876	0	1.967822202	7.478455016	5.267645835	0.25975273	0.797174311	0	0	8.028510489	0.006450258	0	0	0	0	0	0	0	1	0	0	0	0	0	0	0	0	0	0	49.3766
H7526_002_0	2009	8																																Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		250.1539974	63.19259954	21.65549525		15.53695136	26.72771714	18.45625612	29.08880457	27.9746701	6.804708613	12.37658793	2.588349881	1.346698579	32.69952235	45.86123963	63.74486415	30.85174765	4.178444914	22.63462236	47.74333576	29.087832	3.221335961																			FFS Medicare eff. coins	FFS Medicare eff. coins	FFS Medicare eff. coins		FFS Medicare eff. coins	FFS Medicare eff. coins	FFS Medicare eff. coins	FFS Medicare eff. coins	FFS Medicare eff. coins	FFS Medicare eff. coins	FFS Medicare eff. coins	FFS Medicare eff. coins	FFS Medicare eff. coins	FFS Medicare eff. coins	FFS Medicare eff. coins	FFS Medicare eff. coins	FFS Medicare eff. coins	FFS Medicare eff. coins	FFS Medicare eff. coins	FFS Medicare eff. coins	FFS Medicare eff. coins	FFS Medicare eff. coins																			0.076948513	0.076948513	0.134797134		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.076948513	0.076948513	0.134797134		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			19.249	4.862576594	2.919098702	0	3.589035764	6.17410266	4.263395165	6.719513856	6.462148792	1.57188769	2.858991812	0.597908823	0.311087372	7.553589664	10.59394635	14.72506362	7.126753707	0.965220775	5.228597766	11.02871056	6.719289192	0.744128607	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.264	0	0	19.249	4.862576594	2.919098702	0	3.589035764	6.17410266	4.263395165	6.719513856	6.462148792	1.57188769	2.858991812	0.597908823	0.311087372	7.553589664	10.59394635	14.72506362	7.126753707	0.965220775	5.228597766	11.02871056	6.719289192	0.744128607	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.264																																																																																		0	0	0	19.249	4.862576594	2.919098702	0	3.589035764	6.17410266	4.263395165	6.719513856	6.462148792	1.57188769	2.858991812	0.597908823	0.311087372	7.553589664	10.59394635	14.72506362	7.126753707	0.965220775	5.228597766	11.02871056	6.719289192	0.744128607	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.264
H7678_001_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		417.3056839	35.26274603	71.98588132	0	19.73315372	33.86754365	24.39903751	23.89700111	36.45132077	4.604005861	14.2802424	0	4.639992623	42.2119008	67.7311915	132.9858587	13.31333593	8.812472899	40.00684155	54.87475128	7.619097225	0.579694652	0	0	0	0	0	0	0	0											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	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing											0.069310293	0.069310293	0.197684663	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.069310293	0.069310293	0.197684663	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											28.9236	2.444071264	14.23050473	0	4.55835851	7.823402584	5.636177666	5.520207256	8.420255099	1.063525354	3.298735993	0	1.071838296	9.750949085	15.64590524	30.71973337	3.0753806	2.03568124	9.241580397	12.67606755	1.760011459	0.133909465	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	168.0299	0	0	28.9236	2.444071264	14.23050473	0	4.55835851	7.823402584	5.636177666	5.520207256	8.420255099	1.063525354	3.298735993	0	1.071838296	9.750949085	15.64590524	30.71973337	3.0753806	2.03568124	9.241580397	12.67606755	1.760011459	0.133909465	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	168.0299																																																																																		0	0	0	28.9236	2.444071264	14.23050473	0	4.55835851	7.823402584	5.636177666	5.520207256	8.420255099	1.063525354	3.298735993	0	1.071838296	9.750949085	15.64590524	30.71973337	3.0753806	2.03568124	9.241580397	12.67606755	1.760011459	0.133909465	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	168.0299
H7678_002_0	2009	6																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	V	Coin	Coin	Coin	V	V	V	V	V	P	Coin	Coin	Coin	Coin	V	Coin	V	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	820.5898907	16.92205282	276.114231	0	221.3538301	11.14534631	7.355754877	299.5865993	294.5285843	0	115.6105763	0	0.473538937	14.81320928	5542.184703	7493.032687	199.3953017	695.7929351	106.1557207	2292.975264	7.690434149	0	0	3.113041353	391.6127113	0	179.0124951	0	0	0											$150/Days 1-5 for IP Medical; $150/Days 1-5 for IP Surgical;	$150/Days 1-5 for IP Psych; $150/Days 1-5 for IP Substance Abuse;	$125/Days 21-100 for SNF	No Cost-Sharing	$100/Run 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;	$100/Case for OP Fac - Surgery; $50/Case for OP Fac - ASC	No Cost-Sharing	$100/Case for OP Fac - CT/MRI/PET	No Cost-Sharing	20% Coinsurance for Renal Dialysis - Fac; 20% Coinsurance for Renal Dialysis - Prof	20% Coinsurance 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/Visit for Prof - CORF; $20/Visit for Prof - CORF;	$5/Visit for PCP - Office Visits; $5/Consult for PCP - Consults; $5/Procedure for PCP - Surgery (Office); $5/Visit for PCP - Tx Injections; $5/Visit for PCP - Allergy Testing; $5/Visit for PCP - Allergy Tx;	$15/Visit for Speclst - Office Visits; $15/Procedure for Speclst - Surgery (Office); $15/Visit for Speclst - Tx Injections; $15/Visit for Speclst - Allergy Testing; $15/Visit for Speclst - Allergy Tx; $15/Consult for Speclst - Consults;	$20/Visit for OP Psych - Non-Physician; $20/Visit for OP Psych - Psychiatrist; $20/Visit for OP Substance Abuse;	$20/Visit for PT/ST (PCP); $20/Visit for Occ Therapy (PCP); $20/Visit for PT/ST (Specialist); $20/Visit for Occ Therapy (Specialist);	$100/Visit for Prof Radiology (Office);	$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/Service for Dental: Preventive Services;	$15/Service for Vision Exams (Refractions);	No Cost-Sharing	$15/Service for Hearing Exam;	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing											150	150	125	0	100	0.2	0.2	42.0197491	74.89730045	0	100	0	0.2	0.114970104	5	15	20.00000001	20	100	15	0.2	0	0	0.357541461	15	0	15	0	0	0											144.6944194	144.6944194	120.5786828	0	96.46294626	0.192925893	0.192925893	40.53348799	72.24814268	0	96.46294625	0	0.192925892	0.110903549	4.823147313	14.46944194	19.29258925	19.29258925	96.46294625	14.46944194	0.192925893	0	0	0.344895027	14.46944194	0	14.46944194	0	0	0											9.8946	0.204043884	2.774457523	0	1.779370218	2.150225884	1.419115575	1.011940819	1.773261932	0	0.929344734	0	0.091357922	1.642837488	2.227564438	9.035000117	0.320570971	1.118637275	0.853341131	2.76483937	1.483683872	0	0	1.073672482	0.472201449	0	0.215850909	0	0	0	0	0	0	0	0	0	0	0	0	0	43.2359	0	1.5854	9.8946	0.204043884	2.774457523	0	1.779370218	2.150225884	1.419115575	1.011940819	1.773261932	0	0.929344734	0	0.091357922	1.642837488	2.227564438	9.035000117	0.320570971	1.118637275	0.853341131	2.76483937	1.483683872	0	0	1.073672482	0.472201449	0	0.215850909	0	0	0	0	0	0	0	0	0	0	0	0	0	43.2359	0																																																																																	0	0	0	9.8946	0.204043884	2.774457523	0	1.779370218	2.150225884	1.419115575	1.011940819	1.773261932	0	0.929344734	0	0.091357922	1.642837488	2.227564438	9.035000117	0.320570971	1.118637275	0.853341131	2.76483937	1.483683872	0	0	1.073672482	0.472201449	0	0.215850909	0	0	0	0	0	0	0	0	0	0	0	0	0	43.2359
H7692_001_0	2009	9																					3350											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	O	P																																																			0	6000	1176.823004	49.14913172	527.3069302		107.8139464	7.813044764	6.983914139	215.0212123	341.9089017		171.5486749	82.57652174	0.083470968	255.6452482	3320.871907	5666.237453	211.6282782	1076.028407	4442.709513	1104.598356	20.85796129				105.4421721					103.93											"1a: Days 1 - 5, $125/day then $0;1a1: Days 1-5, $125/ day, then $0"	1b: Days 1 - 5: $150/day then $0	"2: Days 1 - 7: $0/day, then $100/day"	6: $0	10a: $100/trip	11a: 20%	11b: 20%;11c: 20%	4a: $50/visit;4a1: $50/visit;4b: $25/visit	9a: $250/visit;9b: $250/visit	8a: $0/visit	8b: $10/visit;8b: $200/visit;8b: 20%	9a: $250/visit	12a: 20%	3: 20%;5: $30/visit;9a: $250/visit;9c: $30/visit;9d: $30/visit; 7i: $30/visit; 7c: $30/visit; 7e: $30/visit	7a: $10/visit;14c: $10/visit;14d: $0/visit;14e: $0/visit;14f: $0/visit;14g: $0/visit	7b: $30/visit;7d: $30/visit;7f: $30/visit;16b: 20%;17a: $30/visit;18a: $30/visit	7e: $30/visit;7h: $30/visit	7c: $30/visit;7i: $30/visit	7a: $10; 7d: $30/visit; 8b: $10/visit; 8b: $200/visit; 8b: 20%; 14h: $0/visit	7g: $30/visit;14b: $10/visit;14i: 20%; 7a: $10/visit; 7d: $30/visit; 8a: $0/visit; 12: 20%	15: 20%	13a: $0		16a: $250 allowance	17a1: $30/visit	17b1: $100 per yr				14c1: $10/visit;13a1: $0											92.17794651	76.56333881	47.41650191		100	0.2	0.2	45	221.3905546		132.9527921	250	0.2	122.6748699	9.999710115	29.99823767	29.89275239	28.09576329	7.666195345	6.789869659	0.2				30					10											85.80634113	71.27106012	44.13893661		93.08771173	0.186175423	0.186175423	41.88947028	206.0874013		123.7627118	232.7192793	0.186175423	114.1952293	9.308501326	27.924673	27.82647917	26.15370314	7.136285824	6.320534295	0.186175423				27.92631352					9.308771173											8.4149	0.291909227	1.939563931	0	0.83634613	1.454596917	1.300233172	0.750593723	5.871926418	0	1.769277435	1.601429052	0.015540243	2.432788977	2.576028379	13.18565234	0.490739156	2.345177293	2.642037076	0.581804316	3.883239776	0	0	0	0.245384263	0	0	0	0	0.080621716	0	0	0	0	0	0	0	0	0	0	52.7098	0	3.914	8.4149	0.291909227	1.939563931	0	0.83634613	1.454596917	1.300233172	0.750593723	5.871926418	0	1.769277435	1.601429052	0.015540243	2.432788977	2.576028379	13.18565234	0.490739156	2.345177293	2.642037076	0.581804316	3.883239776	0	0	0	0.245384263	0	0	0	0	0.080621716	0	0	0	0	0	0	0	0	0	0	52.7098		OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: $100/trip	OON: 40%	OON: 40%;OON: 20%	OON: $50/visit	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 40%;OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%		OON: $250 allowance	OON: 20%	OON: 20%				OON: 20%											1.9825	0.0304	0.1685	0.1555	0.0413	0.1595	0.1425	0.042	0.2957	0.0181	0.074	0.0208	0.0008	0.138	0.3	1.0493	0.014	0.0854	0.3979	0.1512	0.1916				0.0066	0.0149				0.0165											5.4969	0	1.135	10.3974	0.32232854	2.108021904	0.155504271	0.877602961	1.614052584	1.442767193	0.792591377	6.167617582	0.018136135	1.843288322	1.622211917	0.016305752	2.570750624	2.876031957	14.2349203	0.504709338	2.430601699	3.039955161	0.733039099	4.074799418	0	0	0	0.251960959	0.01493143	0	0	0	0.097096389	0	0	0	0	0	0	0	0	0	0	58.2067
H7692_801_0	2009	8																																Coin	Coin	Coin	Coin	Coin	Coin	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		253.6149137	3.940189603	21.8149286		5.561015004	8.681160849	7.759904599	9.961402572	35.79861708	2.195623757	8.959754134	2.51632348	0.09274552	16.49300947	36.295415	126.9438732	1.690158366	10.33492434	48.14143255	17.4700018	23.17551255																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.0706	0.0706	0.1444		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.0706	0.0706	0.1444		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				17.9052	0.278177386	3.15007569	0	1.284594466	2.005348156	1.792537962	2.301083994	8.269480545	0.507189088	2.069703205	0.581270724	0.021424215	3.809885187	8.384240865	29.32403472	0.390426582	2.387367522	11.12067092	4.035570417	5.353543398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.9718	0	0	17.9052	0.278177386	3.15007569	0	1.284594466	2.005348156	1.792537962	2.301083994	8.269480545	0.507189088	2.069703205	0.581270724	0.021424215	3.809885187	8.384240865	29.32403472	0.390426582	2.387367522	11.12067092	4.035570417	5.353543398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.9718		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.9264	0.0144	0.163		0.0712	0.1234	0.1103	0.1274	0.4578	0.0281	0.1146	0.0322	0.0012	0.2109	0.4645	1.6246	0.0216	0.1323	0.6161	0.2342	0.2966																				5.7707	0	0	18.8316	0.292572073	3.313037474	0	1.35576062	2.128792179	1.902881943	2.428482341	8.727304437	0.535269588	2.184295579	0.613449203	0.022609467	4.020824618	8.848741744	30.94863498	0.412056864	2.519631651	11.73677457	4.269729923	5.6501386	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.7426
H7692_802_0	2009	8																																Coin	Coin	Coin	Coin	Coin	Coin	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		253.6149137	3.940189603	21.8149286		5.561015004	8.681160849	7.759904599	9.961402572	35.79861708	2.195623757	8.959754134	2.51632348	0.09274552	16.49300947	36.295415	126.9438732	1.690158366	10.33492434	48.14143255	17.4700018	23.17551255																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.0706	0.0706	0.1444		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.0706	0.0706	0.1444		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				17.9052	0.278177386	3.15007569	0	1.284594466	2.005348156	1.792537962	2.301083994	8.269480545	0.507189088	2.069703205	0.581270724	0.021424215	3.809885187	8.384240865	29.32403472	0.390426582	2.387367522	11.12067092	4.035570417	5.353543398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.9718	0	0	17.9052	0.278177386	3.15007569	0	1.284594466	2.005348156	1.792537962	2.301083994	8.269480545	0.507189088	2.069703205	0.581270724	0.021424215	3.809885187	8.384240865	29.32403472	0.390426582	2.387367522	11.12067092	4.035570417	5.353543398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.9718		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.9264	0.0144	0.163		0.0712	0.1234	0.1103	0.1274	0.4578	0.0281	0.1146	0.0322	0.0012	0.2109	0.4645	1.6246	0.0216	0.1323	0.6161	0.2342	0.2966																				5.7707	0	0	18.8316	0.292572073	3.313037474	0	1.35576062	2.128792179	1.902881943	2.428482341	8.727304437	0.535269588	2.184295579	0.613449203	0.022609467	4.020824618	8.848741744	30.94863498	0.412056864	2.519631651	11.73677457	4.269729923	5.6501386	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.7426
H7692_803_0	2009	8																																Coin	Coin	Coin	Coin	Coin	Coin	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		253.6149137	3.940189603	21.8149286		5.561015004	8.681160849	7.759904599	9.961402572	35.79861708	2.195623757	8.959754134	2.51632348	0.09274552	16.49300947	36.295415	126.9438732	1.690158366	10.33492434	48.14143255	17.4700018	23.17551255																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.0706	0.0706	0.1444		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.0706	0.0706	0.1444		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				17.9052	0.278177386	3.15007569	0	1.284594466	2.005348156	1.792537962	2.301083994	8.269480545	0.507189088	2.069703205	0.581270724	0.021424215	3.809885187	8.384240865	29.32403472	0.390426582	2.387367522	11.12067092	4.035570417	5.353543398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.9718	0	0	17.9052	0.278177386	3.15007569	0	1.284594466	2.005348156	1.792537962	2.301083994	8.269480545	0.507189088	2.069703205	0.581270724	0.021424215	3.809885187	8.384240865	29.32403472	0.390426582	2.387367522	11.12067092	4.035570417	5.353543398	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.9718		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.9264	0.0144	0.163		0.0712	0.1234	0.1103	0.1274	0.4578	0.0281	0.1146	0.0322	0.0012	0.2109	0.4645	1.6246	0.0216	0.1323	0.6161	0.2342	0.2966																				5.7707	0	0	18.8316	0.292572073	3.313037474	0	1.35576062	2.128792179	1.902881943	2.428482341	8.727304437	0.535269588	2.184295579	0.613449203	0.022609467	4.020824618	8.848741744	30.94863498	0.412056864	2.519631651	11.73677457	4.269729923	5.6501386	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.7426
H7731_001_0	2009	7																					Unlimited											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	P	P	P	P	P	P	S	P	T	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	1.986483709	0	0	168.6319432	7.6	1.2	176.3316746	0	0	0	0	0.12	0	48.53572254	0	8.753074274	0	0	0	0	0	0	1395.298698	0	0	0	0	0	5.366533452											$0 copay	1B - $250 per admit	$0 copay	$0 copay	10A - $50 copay	11A - 20% coin on items >$150	11B - 20% coin on items >$150	4A - $50 copay	$0 copay	$0 copay	$0 copay	$0 copay	12 - 20% coinsurance	$0 copay	4B- $25 copay	$0 copay	9C- $30 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	16A - $15 copay	$0 copay	17B - $160 max	$0 copay	$0 copay	$0 copay	"$0 copay, 52 hrs of homemaking"											0	250	0	0	50	0.12	0.2	50	0	0	0	0	0.2	0	25	0	30	0	0	0	0	0	0	15	0	0	0	0	0	50											0	250	0	0	50	0.12	0.2	50	0	0	0	0	0.2	0	25	0	30	0	0	0	0	0	0	15	0	0	0	0	0	50											0	0.041385077	0	0	0.702633097	0.912	0.24	0.734715311	0	0	0	0	0.024	0	0.101116089	0	0.021882686	0	0	0	0	0	0	1.744123372	0	0	0	0	0	0.022360556	0	0	0	0	0	0	0	0	0	0	4.5442			0	0.041385077	0	0	0.702633097	0.912	0.24	0.734715311	0	0	0	0	0.024	0	0.101116089	0	0.021882686	0	0	0	0	0	0	1.744123372	0	0	0	0	0	0.022360556	0	0	0	0	0	0	0	0	0	0	4.5442	0	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			0	0.041385077	0	0	0.702633097	0.912	0.24	0.734715311	0	0	0	0	0.024	0	0.101116089	0	0.021882686	0	0	0	0	0	0	1.744123372	0	0	0	0	0	0.022360556	0	0	0	0	0	0	0	0	0	0	4.5442
H7731_007_0	2009	4																					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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	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 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	$0 copay	17B - $200 max	$0 copay	$0 copay	$0 copay	"$0 copay, 52 hrs of homemaking"											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	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 benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit	HMO-no OON benefit											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0			0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H7787_001_0	2009	3																					3000											D	D	D	V	T	P	P	V	P	P	P	V	V	V	V	V	V	V	P	P	O	O	T	P	P	P	P	P	P	O																																																			0	9000	1458.168536	101.4808988	629.163068		49.33644731	1653.454459	774.9548212	289.8098291	1668.515034	2643.930069	266.8852322	39.1956461	14.71002983	947.7585084	2783.426528	3714.361185	304.0234146	298.8646306		8210.463263	1296.40441	934.3112895			133.1901121																"$75/day 1-5 (Acute), $500 per admit (Rehab)"	20%coins	$100/day for days 21-100	no cost sharing	$100 per trip	20% coins	20% coins	$50 per visit	$75 per procedure	20% coins	"$75 per MRI, CT, PET, Other imaging"	$100 per visit	20% coins	$75 for non-surgical service	$5 per visit	$25 per visit	$25 per visit	$25 per visit	no cost sharing	"20% Lab/Path,$25 Vision Exams"	20% coins	20% coins	no cost sharing	not covered	$25 for one routine eye exam	**$100 limit on eyewear per plan year	not covered	not covered	no cost sharing	no cost sharing											35.49734722	148.8155239	42.22536209		100	21.27618478	31.15723434	45	75	2.966447923	75	100	153.9937903	65.07101121	5.059134245	25.44808805	25	25		3.554347664	44.17612992	25			25																29.22132516	122.5045575	34.75980975		82.31974345	17.51450073	25.64855537	37.04388455	61.73980759	2.44197232	61.73980759	82.31974345	126.7672931	53.56628949	4.164667945	20.9488174	20.57993586	25		2.925929878	36.36567682	20.57993586			20.57993586																3.5508	1.035989383	1.822465712	0	0.338446974	2.413285777	1.656372637	0.894640154	8.584483094	0.53803367	1.373120241	0.268881294	0.155395889	4.230658886	0.966003936	6.484289518	0.521398531	0.622634647	0	2.001936648	3.92871865	1.602338868	0	0	0.22842033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.2183	0	9.1485	3.5508	1.035989383	1.822465712	0	0.338446974	2.413285777	1.656372637	0.894640154	8.584483094	0.53803367	1.373120241	0.268881294	0.155395889	4.230658886	0.966003936	6.484289518	0.521398531	0.622634647	0	2.001936648	3.92871865	1.602338868	0	0	0.22842033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.2183		20% coins	20% coins	20% coins	no cost sharing	$100 per trip	20% coins	20% coins	$50 per visit	20% coins	20% coins	"20% Coins MRI, CT, PET, Other imaging"	20% coins	20% coins	20% coins	$20 per visit	$40 per visit	$40 per visit	$40 per visit	20% Coins	"20% Lab/Path,$25 Vision Exams"	20% coins	20% coins	no cost sharing	not covered	$25 for one routine eye exam	**$100 limit on eyewear per plan year	not covered	not covered	no cost sharing	no cost sharing											7.4156	0.1847	0.6226	0.4401	0.1105	0.4303	0.2954	0.2434	0.9098	0.0959	0.2001	0.0769	0.0277	0.3294	0.7224	1.7699	0.1396	0.1315	0.1654	0.5838	1.2648	0.4185			0.0303	0.0067															16.6154	500	1.75498458	10.9664	1.220731725	2.445049711	0.440065736	0.448967385	2.843633879	1.951744544	1.138087291	9.494324653	0.633978283	1.573190176	0.345765819	0.183106791	4.560100692	1.68838698	8.254144409	0.661033596	0.754123871	0.165390343	2.585745075	5.193482851	2.020834327	0	0	0.258715222	0.006709288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8337
H7787_002_0	2009	3																					3000											D	D	D	V	T	P	P	V	P	P	P	V	V	V	V	V	V	V	P	P	O	O	T	P	P	P	P	P	P	O																																																			0	9000	1458.168536	101.4808988	629.163068		49.33644731	1653.454459	774.9548212	289.8098291	1668.515034	2643.930069	266.8852322	39.1956461	14.71002983	947.7585084	2783.426528	3714.361185	304.0234146	298.8646306		8210.463263	1296.40441	934.3112895			133.1901121																"$75/day 1-5 (Acute), $500 per admit (Rehab)"	20%coins	$100/day for days 21-100	no cost sharing	$100 per trip	20% coins	20% coins	$50 per visit	$75 per procedure	20% coins	"$75 per MRI, CT, PET, Other imaging"	$100 per visit	20% coins	$75 for non-surgical service	$5 per visit	$25 per visit	$25 per visit	$25 per visit	no cost sharing	"20% Lab/Path,$25 Vision Exams"	20% coins	20% coins	no cost sharing	not covered	$25 for one routine eye exam	**$100 limit on eyewear per plan year	not covered	not covered	no cost sharing	no cost sharing											35.49734722	148.8155239	42.22536209		100	21.27618478	31.15723434	45	75	2.966447923	75	100	153.9937903	65.07101121	5.059134245	25.44808805	25	25		3.554347664	44.17612992	25			25																29.22132516	122.5045575	34.75980975		82.31974345	17.51450073	25.64855537	37.04388455	61.73980759	2.44197232	61.73980759	82.31974345	126.7672931	53.56628949	4.164667945	20.9488174	20.57993586	25		2.925929878	36.36567682	20.57993586			20.57993586																3.5508	1.035989383	1.822465712	0	0.338446974	2.413285777	1.656372637	0.894640154	8.584483094	0.53803367	1.373120241	0.268881294	0.155395889	4.230658886	0.966003936	6.484289518	0.521398531	0.622634647	0	2.001936648	3.92871865	1.602338868	0	0	0.22842033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.2183	0	9.1485	3.5508	1.035989383	1.822465712	0	0.338446974	2.413285777	1.656372637	0.894640154	8.584483094	0.53803367	1.373120241	0.268881294	0.155395889	4.230658886	0.966003936	6.484289518	0.521398531	0.622634647	0	2.001936648	3.92871865	1.602338868	0	0	0.22842033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.2183		20% coins	20% coins	20% coins	no cost sharing	$100 per trip	20% coins	20% coins	$50 per visit	20% coins	20% coins	"20% Coin MRI, CT, PET, Other imaging"	20% coins	20% coins	20% coins	$20 per visit	$40 per visit	$40 per visit	$40 per visit	20% coins	"20% Lab/Path,$25 Vision Exams"	20% coins	20% coins	no cost sharing	not covered	$25 for one routine eye exam	**$100 limit on eyewear per plan year	not covered	not covered	no cost sharing	no cost sharing											7.4156	0.1847	0.6226	0.4401	0.1105	0.4303	0.2954	0.2434	0.9098	0.0959	0.2001	0.0769	0.0277	0.3294	0.7224	1.7699	0.1396	0.1315	0.1654	0.5838	1.2648	0.4185			0.0303	0.0067															16.6154	500	1.75498458	10.9664	1.220731725	2.445049711	0.440065736	0.448967385	2.843633879	1.951744544	1.138087291	9.494324653	0.633978283	1.573190176	0.345765819	0.183106791	4.560100692	1.68838698	8.254144409	0.661033596	0.754123871	0.165390343	2.585745075	5.193482851	2.020834327	0	0	0.258715222	0.006709288	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.8337
H7787_003_0	2009	4																					3000											D	D	D	V	T	P	P	V	P	P	P	V	V	V	V	V	V	V	P	P	O	O	T	P	P	P	P	P	P	O																																																			0	9000	1458.168536	101.4808988	629.163068		49.33644731	1653.454459	774.9548212	289.8098291	1668.515034	2643.930069	266.8852322	39.1956461	14.71002983	947.7585084	3.389544638	3714.361185	304.0234146	298.8646306		8210.429173	1296.40441	934.3112895																			"$75/day 1-5 (Acute), $500 per admit (Rehab)"	20%coins	$100/day for days 21-100	no cost sharing	$100 per trip	20% coins	20% coins	$50 per visit	$75 per procedure	20% coins	"$75 per MRI, CT, PET, Other imaging"	$100 per visit	20% coins	$75 for non-surgical service	$0 per visit	$25 per visit	$25 per visit	$25 per visit	no cost sharing	"20% Lab/Path,$0 Vision Exams"	20% coins	20% coins	no cost sharing	no cost sharing	$0 for one routine eye exam	**$150 limit on eyewear per plan year	no cost sharing	$500 every 2 years	no cost sharing	no cost sharing											35.49734722	148.8155239	42.22536209		100	21.27618478	31.15723434	45	75	2.966447923	75	100	153.9937903	65.07101121	53.59567525	25.44808805	25	25		3.55425862	44.17612992	25																			29.45925612	123.5020354	35.04283712		82.99002159	17.65711034	25.8573955	37.34550971	62.24251619	2.461855772	62.24251619	82.99002159	127.7994798	54.00244625	44.47906246	21.23407429	20.7475054	25		2.949679996	36.66177976	20.7475054																			3.5797	1.044424796	1.837304909	0	0.341202736	2.432935652	1.669859442	0.901924649	8.654381166	0.542414542	1.384300699	0.271070626	0.15666118	4.265106492	0.012563647	6.572585113	0.525643953	0.622634647	0	2.018178224	3.960707746	1.61538571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.409	0	8.5219	3.5797	1.044424796	1.837304909	0	0.341202736	2.432935652	1.669859442	0.901924649	8.654381166	0.542414542	1.384300699	0.271070626	0.15666118	4.265106492	0.012563647	6.572585113	0.525643953	0.622634647	0	2.018178224	3.960707746	1.61538571	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	42.409		20% coins	20% coins	20% coins	no cost sharing	$100 per trip	20% coins	20% coins	$50 per visit	20% coins	20% coins	"20% Coin MRI, CT, PET, Other imaging"	20% coins	20% coins	20% coins	$20 per visit	$40 per visit	$40 per visit	$40 per visit	20% coins	"20% Lab/Path,$25 Vision Exams"	20% coins	20% coins	no cost sharing	50% coins	$25 for one routine eye exam	**$150 limit on eyewear per plan year	$40 per visit	$500 every 2 years	no cost sharing	no cost sharing											7.4134	0.1847	0.6224	0.4401	0.1105	0.4302	0.2953	0.2434	0.9096	0.0959	0.2	0.0769	0.0277	0.3294	0.7122	1.7941	0.1396	0.1314	0.1654	0.5837	1.2644	0.4184	0.0144	0.1387	0.0303	0.011															16.7829	500	1.779128242	10.9931	1.229112975	2.459706393	0.440065736	0.451705453	2.863157585	1.965144752	1.145308907	9.563962419	0.638331025	1.584319259	0.347932611	0.184363958	4.594469337	0.72477062	8.366694009	0.665235403	0.754080996	0.165390343	2.601881988	5.225061152	2.03374228	0.01435202	0.138659908	0.030285427	0.01099043	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.1919
H7908_001_0	2009	5																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	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	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$35 X-ray; $165 Complex Radiology	$35 per visit	$20 per visit	$35 per visit	$10 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	Not Covered	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											91.92581111	91.92581111	40.33133874	0	100	0.2	0.2	47.5	150	0	87	35	20	35	10	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											91.92581111	91.92581111	40.33133874	0	100	0.2	0.2	47.5	150	0	87	35	20	35	10	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											14.9684	0	4.532899329	0	2.276793099	1.576138182	0	1.007075897	4.806119247	0	34.17903192	0	0.111376041	2.295447554	6.088949555	27.04289519	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.8841	0	0	14.9684	0	4.532899329	0	2.276793099	1.576138182	0	1.007075897	4.806119247	0	34.17903192	0	0.111376041	2.295447554	6.088949555	27.04289519	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.8841																																																																					0	0	0											0			14.9684	0	4.532899329	0	2.276793099	1.576138182	0	1.007075897	4.806119247	0	34.17903192	0	0.111376041	2.295447554	6.088949555	27.04289519	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	101.8841
H7908_002_0	2009	4																																D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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		1953.970832	0	1348.697902	1027.133818	273.2151718	7.88069091	0	254.4191741	384.4895397	1049.196816	4714.349231	0	66.82562435	787.0105899	7306.739466	9271.849779	0	672.0584461	0	0	277.02221	0	0	0	885.9916905	0	75.20029841	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	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$0 per visit	$35 X-ray; $150 Complex Radiology	$35 per visit	$20 per visit	$35 per visit	$10 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	Not Covered	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											91.92581111	91.92581111	40.33133874	0	100	0.2	0.2	47.5	150	0	81	35	20	35	10	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											91.92581111	91.92581111	40.33133874	0	100	0.2	0.2	47.5	150	0	81	35	20	35	10	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											14.9684	0	4.532899329	0	2.276793099	1.576138182	0	1.007075897	4.806119247	0	31.82185731	0	0.111376041	2.295447554	6.088949555	27.04289519	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.5269	0	0	14.9684	0	4.532899329	0	2.276793099	1.576138182	0	1.007075897	4.806119247	0	31.82185731	0	0.111376041	2.295447554	6.088949555	27.04289519	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.5269																																																																					0	0	0											0			14.9684	0	4.532899329	0	2.276793099	1.576138182	0	1.007075897	4.806119247	0	31.82185731	0	0.111376041	2.295447554	6.088949555	27.04289519	0	1.960170468	0	0	1.038833287	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.5269
H7908_801_0	2009	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																																																			0		347.8521472	0	42.95287141	6.512170488	7.680610198	10.22482722	0	9.03787537	46.70884659	15.92144908	64.89697329	0	3.541354989	13.46116804	47.54700429	206.5320827	0	6.121132861	0	0	9.236865828	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.0681	0.0681	0.1579	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.6887	0	6.782258395	0	1.774220956	2.361935088	0	2.08774921	10.78974356	3.677854737	14.99120083	0	0.818053002	3.109529818	10.98335799	47.70891111	0	1.413981691	0	0	2.133716006	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.3212			23.6887	0	6.782258395	0	1.774220956	2.361935088	0	2.08774921	10.78974356	3.677854737	14.99120083	0	0.818053002	3.109529818	10.98335799	47.70891111	0	1.413981691	0	0	2.133716006	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.3212																																																																																		0			23.6887	0	6.782258395	0	1.774220956	2.361935088	0	2.08774921	10.78974356	3.677854737	14.99120083	0	0.818053002	3.109529818	10.98335799	47.70891111	0	1.413981691	0	0	2.133716006	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.3212
H7908_802_0	2009	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																																																			0		347.852142	0	42.95287077	6.512170392	7.680610084	10.22482707	0	9.037875236	46.7088459	15.92144884	64.89697233	0	3.541354936	13.46116784	47.54700358	206.5320797	0	6.12113277	0	0	9.236865691	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.0681	0.0681	0.1579	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.6887	0	6.782258294	0	1.77422093	2.361935053	0	2.087749179	10.7897434	3.677854683	14.99120061	0	0.81805299	3.109529772	10.98335783	47.70891041	0	1.41398167	0	0	2.133715975	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.3212			23.6887	0	6.782258294	0	1.77422093	2.361935053	0	2.087749179	10.7897434	3.677854683	14.99120061	0	0.81805299	3.109529772	10.98335783	47.70891041	0	1.41398167	0	0	2.133715975	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.3212																																																																																		0			23.6887	0	6.782258294	0	1.77422093	2.361935053	0	2.087749179	10.7897434	3.677854683	14.99120061	0	0.81805299	3.109529772	10.98335783	47.70891041	0	1.41398167	0	0	2.133715975	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	132.3212
H7917_004_0	2009	7																					5000											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	V	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	858.8449052	41.77267189	170.3528934	8.609115159	134.7733875	17.13392424	3.912120651	172.5681619	457.056189	3.682265136	16.00437123	0	9.165184242	730.5997287	3411.066908	5146.133479	253.7715906	200.1965607	24.74467721	26.63900675	3.120846514	0	0	0	0	0	0	0	0	0											1a:  Acute - $250/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/$0/day for 1-5/6-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - $0/$150/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$150/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $200/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $250/visit/9b:  Ambulatory Surgical Center Services - $250/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 20.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 20.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $20/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $30/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $30/day	7a:  Primary Care - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $30/visit/7f:  Podiatry Services - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $30/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $30/visit/7h:  Psychiatric Services - Individual - $30/visit/7h:  Psychiatric Services - Group - $30/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $30/visit/9c:  Outpatient Substance Abuse Svcs - Group - $30/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service/15:  Medicare Chemo - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	$0 	$0 	$0 	$0 	/14c:  Routine Exams - $0/visit	$0 											250	250	150	0	200	0.2	0.052447212	51.49367151	250	0	0.148747907	0	20	30	29.99593171	29.77102341	30	30	0	30	0.04	0	0	0	0	0	0	0	0	0											227.4208763	227.4208763	136.4525258	0	181.9367011	0.181936701	0.047710363	46.8429436	227.4208763	0	0.135313518	0	18.19367011	27.29050516	27.28680431	27.08220893	27.29050516	27.29050516	0	27.29050516	0.03638734	0	0	0	0	0	0	0	0	0											16.2766	0.791664804	1.937090215	0	2.043352127	3.117289654	0.186648698	0.67363339	8.66200992	0	2.16560777	0	0.013895695	1.661536306	7.756426265	11.61405517	0.577129575	0.455288773	0	0.060582663	0.113559304	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.1064	0	5.769	16.2766	0.791664804	1.937090215	0	2.043352127	3.117289654	0.186648698	0.67363339	8.66200992	0	2.16560777	0	0.013895695	1.661536306	7.756426265	11.61405517	0.577129575	0.455288773	0	0.060582663	0.113559304	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.1064	10000	1a:  Acute - $250/$0/day for 1-/1-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/$0/day for 1-/1-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - $0/$150/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$150/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $200/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $300/visit/9b:  Ambulatory Surgical Center Services - $300/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 30.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 30.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $20/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $45/visit/3:  Rehab Services (CORF) - $45/day/5:  Partial Hospitalization - $45/day	7a:  Primary Care - $45/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $45/visit/7b:  Chiropractic Services - $45/visit/7f:  Podiatry Services - $45/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $45/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $45/visit/7h:  Psychiatric Services - Individual - $45/visit/7h:  Psychiatric Services - Group - $45/visit	7c:  Occupational Therapy Services - $45/visit/7i:  Physical/Speech Therapy - $45/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $45/visit/9c:  Outpatient Substance Abuse Svcs - Group - $45/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - 10.0%/15:  Medicare Chemo - 30.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							/14c:  Routine Exams - $0/visit												1.345	0.0517	0.2332	0	0.2087	0.5088	0.0305	0.0927	0.9994	0	0.3788	0	0.0013	0.3271	1.0545	1.4593	0.0756	0.0597	0	0.0079	0.0658	0	0	0	0	0	0	0	0	0											6.9	0	1.337	17.6216	0.843389134	2.170260773	0	2.252018757	3.62606608	0.217111847	0.766373638	9.661391995	0	2.544401235	0	0.015152644	1.988658254	8.810946678	13.07338961	0.652767249	0.514958187	0	0.068522529	0.17938397	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.0064
H7917_005_0	2009	7																					5000											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	V	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	705.7385417	34.32585368	217.9514708	11.25691356	115.9921187	16.15324178	3.688205332	223.7192504	476.5175316	9.672172146	20.22299967	0	8.380445377	1177.138044	3276.852809	4870.922811	232.0432298	183.0553862	23.67782969	24.35812909	5.669476416	0	0	0	0	0	0	0	0	0											1a:  Acute - $250/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/$0/day for 1-5/6-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - $0/$150/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$150/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $200/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $250/visit/9b:  Ambulatory Surgical Center Services - $250/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 20.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 20.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $20/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $30/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $30/day	7a:  Primary Care - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $30/visit/7f:  Podiatry Services - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $30/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $30/visit/7h:  Psychiatric Services - Individual - $30/visit/7h:  Psychiatric Services - Group - $30/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $30/visit/9c:  Outpatient Substance Abuse Svcs - Group - $30/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service/15:  Medicare Chemo - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	$0 	$0 	$0 	$0 	/14c:  Routine Exams - $0/visit	$0 											250	250	150	0	200	0.2	0.052447212	51.19317068	250	0	0.148747907	0	20	30	29.99634586	29.95744422	30	30	0	30	0.04	0	0	0	0	0	0	0	0	0											227.9799694	227.9799694	136.7879816	0	182.3839755	0.182383975	0.047827655	46.68406994	227.9799694	0	0.135646173	0	18.23839755	27.35759632	27.35426404	27.31878886	27.35759632	27.35759632	0	27.35759632	0.036476795	0	0	0	0	0	0	0	0	0											13.4079	0.652133922	2.484428481	0	1.762925311	2.946092454	0.176398212	0.870343761	9.053037687	0	2.74317252	0	0.012737158	2.683638952	7.469658081	11.08897599	0.529012084	0.417329613	0	0.055531655	0.20680433	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.5601	0	5.463	13.4079	0.652133922	2.484428481	0	1.762925311	2.946092454	0.176398212	0.870343761	9.053037687	0	2.74317252	0	0.012737158	2.683638952	7.469658081	11.08897599	0.529012084	0.417329613	0	0.055531655	0.20680433	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.5601	10000	1a:  Acute - $250/$0/day for 1-/1-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/$0/day for 1-/1-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - $0/$150/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$150/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $200/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $300/visit/9b:  Ambulatory Surgical Center Services - $300/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 30.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 30.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $20/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $45/visit/3:  Rehab Services (CORF) - $45/day/5:  Partial Hospitalization - $45/day	7a:  Primary Care - $45/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $45/visit/7b:  Chiropractic Services - $45/visit/7f:  Podiatry Services - $45/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $45/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $45/visit/7h:  Psychiatric Services - Individual - $45/visit/7h:  Psychiatric Services - Group - $45/visit	7c:  Occupational Therapy Services - $45/visit/7i:  Physical/Speech Therapy - $45/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $45/visit/9c:  Outpatient Substance Abuse Svcs - Group - $45/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - 10.0%/15:  Medicare Chemo - 30.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							/14c:  Routine Exams - $0/visit												1.3898	0.0534	0.2409	0	0.2156	0.5257	0.0315	0.0958	1.0326	0	0.3949	0	0.0013	0.338	1.0896	1.5079	0.0782	0.0617	0	0.0082	0.0686	0	0	0	0	0	0	0	0	0											7.1338	0	1.322	14.7976	0.705579609	2.725358823	0	1.978536249	3.471800671	0.207875157	0.966170353	10.08567863	0	3.138077861	0	0.014035937	3.021647333	8.559272335	12.59687625	0.607166937	0.478984792	0	0.063735756	0.275412165	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.6939
H7917_006_0	2009	7																					5000											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	V	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	697.918464	33.94549916	214.6005425	9.365762038	137.2473743	18.91571367	4.31894953	247.4016076	446.4436284	8.465888611	18.20735886	0	8.75577031	959.1577632	3249.552716	4906.674975	242.435471	191.2536678	21.49152969	25.44902734	6.169910167	0	0	0	0	0	0	0	0	0											1a:  Acute - $250/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/$0/day for 1-5/6-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - $0/$150/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$150/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $200/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $250/visit/9b:  Ambulatory Surgical Center Services - $250/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 20.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 20.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $20/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $30/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $30/day	7a:  Primary Care - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $30/visit/7f:  Podiatry Services - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $30/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $30/visit/7h:  Psychiatric Services - Individual - $30/visit/7h:  Psychiatric Services - Group - $30/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $30/visit/9c:  Outpatient Substance Abuse Svcs - Group - $30/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service/15:  Medicare Chemo - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	$0 	$0 	$0 	$0 	/14c:  Routine Exams - $0/visit	$0 											250	250	150	0	200	0.2	0.052447212	51.08633548	250	0	0.148747907	0	20	30	29.99611697	29.95121793	30	30	0	30	0.04	0	0	0	0	0	0	0	0	0											228.6955186	228.6955186	137.2173112	0	182.9564149	0.182956415	0.047977769	46.73286395	228.6955186	0	0.136071919	0	18.29564149	27.44346223	27.43991011	27.39883727	27.44346223	27.44346223	0	27.44346223	0.036591283	0	0	0	0	0	0	0	0	0											13.3009	0.646931961	2.453909119	0	2.092523963	3.460751158	0.207213564	0.963482139	8.50830476	0	2.477510264	0	0.01334937	2.193550821	7.430619535	11.2030991	0.554439058	0.437388567	0	0.058200785	0.225764929	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.2279	0	5.238	13.3009	0.646931961	2.453909119	0	2.092523963	3.460751158	0.207213564	0.963482139	8.50830476	0	2.477510264	0	0.01334937	2.193550821	7.430619535	11.2030991	0.554439058	0.437388567	0	0.058200785	0.225764929	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.2279	10000	1a:  Acute - $250/$0/day for 1-/1-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/$0/day for 1-/1-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - $0/$150/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$150/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $200/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $300/visit/9b:  Ambulatory Surgical Center Services - $300/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 30.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 30.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $20/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $45/visit/3:  Rehab Services (CORF) - $45/day/5:  Partial Hospitalization - $45/day	7a:  Primary Care - $45/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $45/visit/7b:  Chiropractic Services - $45/visit/7f:  Podiatry Services - $45/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $45/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $45/visit/7h:  Psychiatric Services - Individual - $45/visit/7h:  Psychiatric Services - Group - $45/visit	7c:  Occupational Therapy Services - $45/visit/7i:  Physical/Speech Therapy - $45/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $45/visit/9c:  Outpatient Substance Abuse Svcs - Group - $45/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - 10.0%/15:  Medicare Chemo - 30.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							/14c:  Routine Exams - $0/visit												1.3961	0.0537	0.242	0	0.2166	0.5318	0.0318	0.0963	1.0373	0	0.3984	0	0.0013	0.3395	1.0945	1.5147	0.0785	0.0619	0	0.0082	0.0692	0	0	0	0	0	0	0	0	0											7.1719	0	1.311	14.697	0.700619109	2.695927959	0	2.309109008	3.992510143	0.2390528	1.059741665	9.545611068	0	2.875883219	0	0.014654017	2.533086288	8.525156552	12.7178119	0.632947006	0.499322298	0	0.066441951	0.294967164	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	63.3998
H7917_007_0	2009	6																					5000											D	D	D	coin	T	coin	coin	V	V	coin	coin	O	V	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	595.34384	28.95645389	195.7317698	8.86361833	120.1802399	19.72013544	4.502619948	289.1397639	459.2852933	6.694729748	20.15950551	0	8.106823601	627.67023	2989.468393	4522.848832	224.4670118	177.0786227	16.68693301	23.5628355	3.214011965	0	0	0	0	0	0	0	0	0											1a:  Acute - $250/$0/day for 1-5/6-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/$0/day for 1-5/6-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - $0/$150/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$150/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $200/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $250/visit/9b:  Ambulatory Surgical Center Services - $250/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 20.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 20.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $20/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $30/visit/3:  Rehab Services (CORF) - $30/day/5:  Partial Hospitalization - $30/day	7a:  Primary Care - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $30/visit/7b:  Chiropractic Services - $30/visit/7f:  Podiatry Services - $30/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $30/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $30/visit/7h:  Psychiatric Services - Individual - $30/visit/7h:  Psychiatric Services - Group - $30/visit	7c:  Occupational Therapy Services - $30/visit/7i:  Physical/Speech Therapy - $30/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $30/visit/9c:  Outpatient Substance Abuse Svcs - Group - $30/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service/15:  Medicare Chemo - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	$0 	$0 	$0 	$0 	/14c:  Routine Exams - $0/visit	$0 											250	250	150	0	200	0.2	0.052447212	50.90970094	250	0	0.148747907	0	20	30	29.9960516	29.89814138	30	30	0	30	0.04	0	0	0	0	0	0	0	0	0											231.8246689	231.8246689	139.0948013	0	185.4597351	0.185459735	0.04863423	47.20849825	231.8246689	0	0.137933737	0	18.54597351	27.81896026	27.81529892	27.7245069	27.81896026	27.81896026	0	27.81896026	0.037091947	0	0	0	0	0	0	0	0	0											11.5013	0.559401694	2.268772636	0	1.857382955	3.657291095	0.218981454	1.137487836	8.872805086	0	2.780675939	0	0.012529078	1.455094432	6.929413082	10.44947947	0.520369907	0.410511931	0	0.054624465	0.119213962	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.8053	0	4.14	11.5013	0.559401694	2.268772636	0	1.857382955	3.657291095	0.218981454	1.137487836	8.872805086	0	2.780675939	0	0.012529078	1.455094432	6.929413082	10.44947947	0.520369907	0.410511931	0	0.054624465	0.119213962	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	52.8053	10000	1a:  Acute - $250/$0/day for 1-/1-90/1a:  Additional Days - $0/day for 91-999	1b:  Psych - $250/$0/day for 1-/1-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - $0/$150/day for 1-20/21-100/2:  Non-Medicare Covered Stay - $0/$150/day for 1-20/21-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $200/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $300/visit/9b:  Ambulatory Surgical Center Services - $300/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 30.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 30.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $20/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $45/visit/3:  Rehab Services (CORF) - $45/day/5:  Partial Hospitalization - $45/day	7a:  Primary Care - $45/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $45/visit/7b:  Chiropractic Services - $45/visit/7f:  Podiatry Services - $45/visit/17a:  Vision Exams - $30/visit/18a:  Hearing Exams - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $45/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $45/visit/7h:  Psychiatric Services - Individual - $45/visit/7h:  Psychiatric Services - Group - $45/visit	7c:  Occupational Therapy Services - $45/visit/7i:  Physical/Speech Therapy - $45/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $45/visit/9c:  Outpatient Substance Abuse Svcs - Group - $45/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - 10.0%/15:  Medicare Chemo - 30.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							/14c:  Routine Exams - $0/visit												1.3545	0.0521	0.2348	0	0.2101	0.5124	0.0307	0.0934	1.0064	0	0.3885	0	0.0013	0.3294	1.062	1.4696	0.0762	0.0601	0	0.008	0.0675	0	0	0	0	0	0	0	0	0											6.957	0	1.3	12.8558	0.61149148	2.503590649	0	2.067523908	4.169662255	0.249659839	1.230883337	9.879248246	0	3.169127879	0	0.013794908	1.784527644	7.991384156	11.91912477	0.596541995	0.470602936	0	0.06262043	0.186683527	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	59.7623
H7917_008_0	2009	7																					2500											coin	coin	coin	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	229.7754621	4.22175058	18.11046677	10.33093819	164.2419728	21.70297071	4.720462232	207.0817943	56.16366957	4.418718163	19.20524548	0	0.215161171	885.4388269	4460.261774	6715.8191	332.2100822	262.0754976	30.60915038	34.87288156	3.759720504	0	0	765.8731044	323.8717039	0	66.01256867	0	0	0											1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - 0/admit for 1-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - 0/day for 1-100/2:  Non-Medicare Covered Stay - $0/day for 1-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 10.0%	11b:  Prosthetics Devices - 10.0%/11b:  Medical Supplies - 10.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - $0/visit/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - $0/visit/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $10/visit/3:  Rehab Services (CORF) - $10/day/5:  Partial Hospitalization - $10/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $10/visit/7b:  Chiropractic Services - $10/visit/7f:  Podiatry Services - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $10/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $10/visit/7h:  Psychiatric Services - Individual - $10/visit/7h:  Psychiatric Services - Group - $10/visit	7c:  Occupational Therapy Services - $10/visit/7i:  Physical/Speech Therapy - $10/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $10/visit/9c:  Outpatient Substance Abuse Svcs - Group - $10/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service/15:  Medicare Chemo - 10.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $10/visit	$0 	18a:  Routine Hearing Test - $10/visit/18a:  Fitting for Hearing Aid - $10/visit	18b:  Hearing Aids - $0/service	/14c:  Routine Exams - $0/visit	$0 											0	0	0	0	100	0.1	0.026628671	51.49367151	0	0	0.012493726	0	0	10	10	10	10	10	0	10	0.02	0	0	0	10	0	10	0	0	0											0	0	0	0	96.91798508	0.096917985	0.025807972	49.90662887	1.24E-19	0	0.012108668	0	0	9.691798508	9.691798508	9.691798508	9.691798508	9.691798508	0	9.691798508	0.019383597	0	0	0	9.691798508	0	9.691798508	0	0	0											0	0	0	0	1.326500089	2.103408191	0.121825556	0.861229521	6.94E-18	0	0.23254994	0	0	0.715124558	3.602329867	5.424030461	0.268309432	0.211665243	0	0.028165078	0.072876907	0	0	0	0.261574941	0	0.053315043	0	0	0	0	0	0	0	0	0	0	0	0	0	15.2829	0	0.486	0	0	0	0	1.326500089	2.103408191	0.121825556	0.861229521	6.94E-18	0	0.23254994	0	0	0.715124558	3.602329867	5.424030461	0.268309432	0.211665243	0	0.028165078	0.072876907	0	0	0	0.261574941	0	0.053315043	0	0	0	0	0	0	0	0	0	0	0	0	0	15.2829	5000	1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - 0/admit for 1-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - 0/day for 1-100/2:  Non-Medicare Covered Stay - $0/day for 1-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $50/visit/9b:  Ambulatory Surgical Center Services - $50/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 10.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 10.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - $25/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $25/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $25/visit/7b:  Chiropractic Services - $25/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - 10.0%/15:  Medicare Chemo - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $10/visit		18a:  Routine Hearing Test - $10/visit/18a:  Fitting for Hearing Aid - $10/visit	18b:  Hearing Aids - $0/service	/14c:  Routine Exams - $0/visit												0	0	0	0	0.1388	0.4443	0.0266	0.1215	0.2238	0	0.1932	0	0	0.2406	0.8036	1.1321	0.057	0.045	0	0.006	0.0742	0	0	0	0.0254	0	0.0052	0	0	0											3.5372	0	0.331	0	0	0	0	1.465294916	2.547719361	0.148428827	0.982713712	0.22384103	0	0.425733466	0	0	0.955718363	4.405880612	6.556124807	0.325297104	0.256621954	0	0.03414721	0.147080342	0	0	0	0.287011491	0	0.058499602	0	0	0	0	0	0	0	0	0	0	0	0	0	18.8201
H7917_009_0	2009	7																					2500											coin	coin	coin	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	215.7397862	3.963867853	24.28126532	13.50829628	141.354126	20.46077293	4.45028043	268.4631005	56.79930679	11.60660658	24.2675996	0	0.217340325	1426.613901	4284.773129	6355.833827	303.7656826	239.636142	29.28731664	31.88700536	6.829277818	0	0	765.8731044	311.1416128	0	63.4178807	0	0	0											1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - 0/admit for 1-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - 0/day for 1-100/2:  Non-Medicare Covered Stay - $0/day for 1-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 10.0%	11b:  Prosthetics Devices - 10.0%/11b:  Medical Supplies - 10.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - $0/visit/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - $0/visit/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $10/visit/3:  Rehab Services (CORF) - $10/day/5:  Partial Hospitalization - $10/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $10/visit/7b:  Chiropractic Services - $10/visit/7f:  Podiatry Services - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $10/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $10/visit/7h:  Psychiatric Services - Individual - $10/visit/7h:  Psychiatric Services - Group - $10/visit	7c:  Occupational Therapy Services - $10/visit/7i:  Physical/Speech Therapy - $10/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $10/visit/9c:  Outpatient Substance Abuse Svcs - Group - $10/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service/15:  Medicare Chemo - 10.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $10/visit	$0 	18a:  Routine Hearing Test - $10/visit/18a:  Fitting for Hearing Aid - $10/visit	18b:  Hearing Aids - $0/service	/14c:  Routine Exams - $0/visit	$0 											0	0	0	0	100	0.1	0.026628671	51.19317068	0	0	0.012493726	0	0	10	10	10	10	10	0	10	0.02	0	0	0	10	0	10	0	0	0											0	0	0	0	96.91920699	0.096919207	0.025808297	49.61601506	-6.11E-20	0	0.012108821	0	0	9.691920699	9.691920699	9.691920699	9.691920699	9.691920699	0	9.691920699	0.019383841	0	0	0	9.691920699	0	9.691920699	0	0	0											0	0	0	0	1.141660816	1.983041886	0.114854159	1.11000577	-3.47E-18	0	0.29385201	0	0	1.152219066	3.460640115	5.133353119	0.245339409	0.19354454	0	0.025753861	0.132377638	0	0	0	0.251296653	0	0.051220089	0	0	0	0	0	0	0	0	0	0	0	0	0	15.2892	0	0.486	0	0	0	0	1.141660816	1.983041886	0.114854159	1.11000577	-3.47E-18	0	0.29385201	0	0	1.152219066	3.460640115	5.133353119	0.245339409	0.19354454	0	0.025753861	0.132377638	0	0	0	0.251296653	0	0.051220089	0	0	0	0	0	0	0	0	0	0	0	0	0	15.2892	5000	1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - 0/admit for 1-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - 0/day for 1-100/2:  Non-Medicare Covered Stay - $0/day for 1-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $50/visit/9b:  Ambulatory Surgical Center Services - $50/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 10.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 10.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - $25/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $25/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $25/visit/7b:  Chiropractic Services - $25/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - 10.0%/15:  Medicare Chemo - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $10/visit		18a:  Routine Hearing Test - $10/visit/18a:  Fitting for Hearing Aid - $10/visit	18b:  Hearing Aids - $0/service	/14c:  Routine Exams - $0/visit												0	0	0	0	0.1429	0.4573	0.0274	0.125	0.2304	0	0.2006	0	0	0.2476	0.8271	1.1653	0.0587	0.0463	0	0.0062	0.077	0	0	0	0.0262	0	0.0053	0	0	0											3.6433	0	0.328	0	0	0	0	1.284522958	2.440373379	0.142237026	1.235049996	0.230400583	0	0.494477777	0	0	1.399863356	4.287738524	6.298622941	0.303997077	0.239818686	0	0.031911295	0.209422393	0	0	0	0.277478609	0	0.056556579	0	0	0	0	0	0	0	0	0	0	0	0	0	18.9325
H7917_010_0	2009	7																					2500											coin	coin	coin	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	195.4287521	3.590685619	21.61885512	11.23891445	167.2569038	23.95990398	5.211352092	296.8819291	53.01734833	10.15906633	21.84883064	0	0.215174038	1162.436135	4249.067702	6403.368419	317.3700711	250.3684378	26.58199485	33.31509034	7.431979708	0	0	765.8731044	308.5355991	0	62.88671463	0	0	0											1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - 0/admit for 1-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - 0/day for 1-100/2:  Non-Medicare Covered Stay - $0/day for 1-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 10.0%	11b:  Prosthetics Devices - 10.0%/11b:  Medical Supplies - 10.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - $0/visit/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - $0/visit/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $10/visit/3:  Rehab Services (CORF) - $10/day/5:  Partial Hospitalization - $10/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $10/visit/7b:  Chiropractic Services - $10/visit/7f:  Podiatry Services - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $10/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $10/visit/7h:  Psychiatric Services - Individual - $10/visit/7h:  Psychiatric Services - Group - $10/visit	7c:  Occupational Therapy Services - $10/visit/7i:  Physical/Speech Therapy - $10/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $10/visit/9c:  Outpatient Substance Abuse Svcs - Group - $10/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service/15:  Medicare Chemo - 10.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $10/visit	$0 	18a:  Routine Hearing Test - $10/visit/18a:  Fitting for Hearing Aid - $10/visit	18b:  Hearing Aids - $0/service	/14c:  Routine Exams - $0/visit	$0 											0	0	0	0	100	0.1	0.026628671	51.08633548	0	0	0.012493726	0	0	10	10	10	10	10	0	10	0.02	0	0	0	10	0	10	0	0	0											0	0	0	0	96.73636261	0.096736363	0.025759608	49.41906274	1.31E-19	0	0.012085977	0	0	9.673636261	9.673636261	9.673636261	9.673636261	9.673636261	0	9.673636261	0.019347273	0	0	0	9.673636261	0	9.673636261	0	0	0											0	0	0	0	1.348318708	2.317793959	0.134242387	1.222635557	6.94E-18	0	0.264064454	0	0	0.937082029	3.42532795	5.161988077	0.255843552	0.2018311	0	0.026856505	0.143788537	0	0	0	0.248721763	0	0.050695267	0	0	0	0	0	0	0	0	0	0	0	0	0	15.7392	0	0.531	0	0	0	0	1.348318708	2.317793959	0.134242387	1.222635557	6.94E-18	0	0.264064454	0	0	0.937082029	3.42532795	5.161988077	0.255843552	0.2018311	0	0.026856505	0.143788537	0	0	0	0.248721763	0	0.050695267	0	0	0	0	0	0	0	0	0	0	0	0	0	15.7392	5000	1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - 0/admit for 1-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - 0/day for 1-100/2:  Non-Medicare Covered Stay - $0/day for 1-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $50/visit/9b:  Ambulatory Surgical Center Services - $50/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 10.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 10.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - $25/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $25/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $25/visit/7b:  Chiropractic Services - $25/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - 10.0%/15:  Medicare Chemo - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $10/visit		18a:  Routine Hearing Test - $10/visit/18a:  Fitting for Hearing Aid - $10/visit	18b:  Hearing Aids - $0/service	/14c:  Routine Exams - $0/visit												0	0	0	0	0.1433	0.462	0.0277	0.1255	0.2312	0	0.2021	0	0	0.2485	0.8298	1.1691	0.0588	0.0464	0	0.0062	0.0776	0	0	0	0.0263	0	0.0054	0	0	0											3.6597	0	0.326	0	0	0	0	1.491646428	2.779809452	0.16190571	1.348087294	0.231151444	0	0.466198239	0	0	1.185533375	4.255121819	6.331055437	0.314692382	0.248256049	0	0.033034007	0.221404068	0	0	0	0.274989044	0	0.056049148	0	0	0	0	0	0	0	0	0	0	0	0	0	19.3989
H7917_011_0	2009	7																					2500											coin	coin	coin	coin	T	coin	coin	V	coin	coin	coin	O	coin	P	V	V	V	V	coin	V	coin	O	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	166.6705729	3.062300827	18.81018046	10.72206457	148.2037715	24.99989484	5.437553273	344.3818335	51.06635379	8.15585461	24.08840657	0	0.194787691	771.4798726	3905.411738	5882.143718	291.1666452	229.6969523	20.76066663	30.56445446	3.968096967	0	0	765.8731044	283.5823058	0	57.80065441	0	0	0											1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - 0/admit for 1-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - 0/day for 1-100/2:  Non-Medicare Covered Stay - $0/day for 1-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 10.0%	11b:  Prosthetics Devices - 10.0%/11b:  Medical Supplies - 10.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - $0/visit/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - $0/visit/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $10/visit/3:  Rehab Services (CORF) - $10/day/5:  Partial Hospitalization - $10/day	7a:  Primary Care - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $10/visit/7b:  Chiropractic Services - $10/visit/7f:  Podiatry Services - $10/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $10/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $10/visit/7h:  Psychiatric Services - Individual - $10/visit/7h:  Psychiatric Services - Group - $10/visit	7c:  Occupational Therapy Services - $10/visit/7i:  Physical/Speech Therapy - $10/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $10/visit/9c:  Outpatient Substance Abuse Svcs - Group - $10/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service/15:  Medicare Chemo - 10.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service	$0 	"16a:  Preventive Dental - Oral Exams - $0/service/16a:  Preventive Dental - Prophylaxis - $0/service/16a:  Preventive Dental - Fluoride Treatment - $0/service/16a:  Preventive Dental - X-Rays - $0/service/16b:  Comprehensive Dental - Diagnostic Svcs - $0/visit/16b:  Comprehensive Dental - Restorative Svcs - $0/visit/16b:  Comprehensive Dental - Endodontics/Periodontics/Extractions - $0/visit/16b:  Comprehensive Dental - Prosthodontics, Other - $0/visit"	17a:  Routine Eye Exams - $10/visit	$0 	18a:  Routine Hearing Test - $10/visit/18a:  Fitting for Hearing Aid - $10/visit	18b:  Hearing Aids - $0/service	/14c:  Routine Exams - $0/visit	$0 											0	0	0	0	100	0.1	0.026628671	50.91492783	0	0	0.012493726	0	0	10	10	10	10	10	0	10	0.02	0	0	0	10	0	10	0	0	0											0	0	0	0	97.11094715	0.097110947	0.025859355	49.44396866	6.79E-20	0	0.012132776	0	0	9.711094715	9.711094715	9.711094715	9.711094715	9.711094715	0	9.711094715	0.019422189	0	0	0	9.711094715	0	9.711094715	0	0	0											0	0	0	0	1.199350718	2.427763467	0.14061162	1.418967049	3.47E-18	0	0.292259244	0	0	0.624326176	3.160485274	4.760171231	0.235628906	0.185884072	0	0.024734526	0.077069131	0	0	0	0.229491219	0	0.046775636	0	0	0	0	0	0	0	0	0	0	0	0	0	14.8235	0	0.441	0	0	0	0	1.199350718	2.427763467	0.14061162	1.418967049	3.47E-18	0	0.292259244	0	0	0.624326176	3.160485274	4.760171231	0.235628906	0.185884072	0	0.024734526	0.077069131	0	0	0	0.229491219	0	0.046775636	0	0	0	0	0	0	0	0	0	0	0	0	0	14.8235	5000	1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - 0/admit for 1-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - 0/day for 1-100/2:  Non-Medicare Covered Stay - $0/day for 1-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $100/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $50/visit/4a:  Worldwide Coverage - $50/visit + 20.0%	9a:  Outpatient Hospital Services (Hospital Surgery) - $50/visit/9b:  Ambulatory Surgical Center Services - $50/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services (Advanced Imaging) - 10.0%/8b:  Outpatient Therapeutic Radiological Services (Radiation Therapy) - 10.0%/8b:  Outpatient X-Ray Services - $0/visit	$0 	12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $25/visit/3:  Rehab Services (CORF) - $25/day/5:  Partial Hospitalization - $25/day	7a:  Primary Care - $25/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $25/visit/7b:  Chiropractic Services - $25/visit/7f:  Podiatry Services - $25/visit/17a:  Vision Exams - $10/visit/18a:  Hearing Exams - $10/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $25/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $25/visit/7h:  Psychiatric Services - Individual - $25/visit/7h:  Psychiatric Services - Group - $25/visit	7c:  Occupational Therapy Services - $25/visit/7i:  Physical/Speech Therapy - $25/visit	$0 	9c:  Outpatient Substance Abuse Svcs - Individual - $25/visit/9c:  Outpatient Substance Abuse Svcs - Group - $25/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - 10.0%/15:  Medicare Chemo - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $10/visit		18a:  Routine Hearing Test - $10/visit/18a:  Fitting for Hearing Aid - $10/visit	18b:  Hearing Aids - $0/service	/14c:  Routine Exams - $0/visit												0	0	0	0	0.1391	0.4454	0.0267	0.1218	0.2244	0	0.1971	0	0	0.2412	0.8055	1.1349	0.0571	0.0451	0	0.006	0.0757	0	0	0	0.0255	0	0.0052	0	0	0											3.5506	0	0.323	0	0	0	0	1.338484035	2.873158214	0.167279771	1.540747513	0.22438693	0	0.489352699	0	0	0.865506736	3.965995702	5.895026507	0.292755558	0.230950422	0	0.030731246	0.152740694	0	0	0	0.254989803	0	0.051972839	0	0	0	0	0	0	0	0	0	0	0	0	0	18.3741
H7917_801_0	2009	6																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	344.3744397	3.745929753	63.18814278	59.4064246	9.8740176	19.95410626	5.662742162	12.21451065	46.58384761	4.931193886	25.82007838	0	0.251291971	29.62192787	44.8449844	130.0852025	1.296401538	6.130554351	29.82525907	20609.0787	7.985270272	0.857955095	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0.078726127	0.078726127	0.217442637	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.339807578	0.231	0.231	0	0	0	0	0	0	0	0											0.078726127	0.078726127	0.217442637	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.339807578	0.231	0.231	0	0	0	0	0	0	0	0											27.1113	0.294902542	13.73979642	0	2.280898066	4.609398545	1.30809344	2.821551959	10.7608688	1.139105788	5.964438107	0	0.058048445	6.842665337	10.3591914	30.04968178	0.299468755	1.416158055	6.889634844	9.170709549	1.844597433	0.198187627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.1587	0	0	27.1113	0.294902542	13.73979642	0	2.280898066	4.609398545	1.30809344	2.821551959	10.7608688	1.139105788	5.964438107	0	0.058048445	6.842665337	10.3591914	30.04968178	0.299468755	1.416158055	6.889634844	9.170709549	1.844597433	0.198187627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.1587	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	27.1113	0.294902542	13.73979642	0	2.280898066	4.609398545	1.30809344	2.821551959	10.7608688	1.139105788	5.964438107	0	0.058048445	6.842665337	10.3591914	30.04968178	0.299468755	1.416158055	6.889634844	9.170709549	1.844597433	0.198187627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.1587
H7917_802_0	2009	8																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	344.3744397	3.745929753	63.18814278	59.4064246	9.8740176	19.95410626	5.662742162	12.21451065	46.58384761	4.931193886	25.82007838	0	0.251291971	29.62192787	44.8449844	130.0852025	1.296401538	6.130554351	29.82525907	20609.0787	7.985270272	0.857955095	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0.078726127	0.078726127	0.217442637	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.339807578	0.231	0.231	0	0	0	0	0	0	0	0											0.078726127	0.078726127	0.217442637	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.339807578	0.231	0.231	0	0	0	0	0	0	0	0											27.1113	0.294902542	13.73979642	0	2.280898066	4.609398545	1.30809344	2.821551959	10.7608688	1.139105788	5.964438107	0	0.058048445	6.842665337	10.3591914	30.04968178	0.299468755	1.416158055	6.889634844	9.170709549	1.844597433	0.198187627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.1587	0	0	27.1113	0.294902542	13.73979642	0	2.280898066	4.609398545	1.30809344	2.821551959	10.7608688	1.139105788	5.964438107	0	0.058048445	6.842665337	10.3591914	30.04968178	0.299468755	1.416158055	6.889634844	9.170709549	1.844597433	0.198187627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.1587	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	27.1113	0.294902542	13.73979642	0	2.280898066	4.609398545	1.30809344	2.821551959	10.7608688	1.139105788	5.964438107	0	0.058048445	6.842665337	10.3591914	30.04968178	0.299468755	1.416158055	6.889634844	9.170709549	1.844597433	0.198187627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.1587
H7917_803_0	2009	7																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	344.3744397	3.745929753	63.18814278	59.4064246	9.8740176	19.95410626	5.662742162	12.21451065	46.58384761	4.931193886	25.82007838	0	0.251291971	29.62192787	44.8449844	130.0852025	1.296401538	6.130554351	29.82525907	20609.0787	7.985270272	0.857955095	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0.078726127	0.078726127	0.217442637	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.339807578	0.231	0.231	0	0	0	0	0	0	0	0											0.078726127	0.078726127	0.217442637	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	5.339807578	0.231	0.231	0	0	0	0	0	0	0	0											27.1113	0.294902542	13.73979642	0	2.280898066	4.609398545	1.30809344	2.821551959	10.7608688	1.139105788	5.964438107	0	0.058048445	6.842665337	10.3591914	30.04968178	0.299468755	1.416158055	6.889634844	9.170709549	1.844597433	0.198187627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.1587	0	0	27.1113	0.294902542	13.73979642	0	2.280898066	4.609398545	1.30809344	2.821551959	10.7608688	1.139105788	5.964438107	0	0.058048445	6.842665337	10.3591914	30.04968178	0.299468755	1.416158055	6.889634844	9.170709549	1.844597433	0.198187627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.1587	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	27.1113	0.294902542	13.73979642	0	2.280898066	4.609398545	1.30809344	2.821551959	10.7608688	1.139105788	5.964438107	0	0.058048445	6.842665337	10.3591914	30.04968178	0.299468755	1.416158055	6.889634844	9.170709549	1.844597433	0.198187627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.1587
H7949_801_0	2009	2																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1135.29226	27.79611229	1459.64039	349.8733387	268.8147349	17.34231136	14.90019737	322.8052652	123.6507696	12474.92007	58.3389376	0	0.201501218	1303.57518	7600.424451	5962.755868	95.42635342	500.202363	0	0	34.1605685	1738.66396	0	0	0	0	0	0	0	0											"$390 Days 1-35 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$390 Days 1-35 (1b); $0 n/c (1b1, 1b2)"	"$200 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$300 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); $300 (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											376.0739287	370.8416673	199.7664663	0	150	0.2	0.066007868	49.99616252	300	2.8	0.258871052	0	0.2	152.8217144	13.79393243	40	37.5	35	0	0	0.2	39.13359274	0	0	0	0	0	0	0	0											376.0739287	370.8416673	199.7664663	0	150	0.2	0.066007868	49.99616252	300	2.8	0.258871052	0	0.2	152.8217144	13.79393243	40	37.5	35	0	0	0.2	39.13359274	0	0	0	0	0	0	0	0											35.5795	0.858996386	24.29893357	0	3.360184186	3.468462271	0.983530267	1.344918709	3.09126924	2.910814683	15.10226217	0	0.040300244	16.60121615	8.736645111	19.87585289	0.298207354	1.458923559	0	0	6.8321137	5.670013945	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.5121	0	0	35.5795	0.858996386	24.29893357	0	3.360184186	3.468462271	0.983530267	1.344918709	3.09126924	2.910814683	15.10226217	0	0.040300244	16.60121615	8.736645111	19.87585289	0.298207354	1.458923559	0	0	6.8321137	5.670013945	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.5121																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	35.5795	0.858996386	24.29893357	0	3.360184186	3.468462271	0.983530267	1.344918709	3.09126924	2.910814683	15.10226217	0	0.040300244	16.60121615	8.736645111	19.87585289	0.298207354	1.458923559	0	0	6.8321137	5.670013945	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.5121
H7949_802_0	2009	2																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1135.346566	27.79744192	1433.047504	349.8900749	268.8275936	17.24665425	14.83290243	322.6521935	123.6566844	12475.51681	58.00029468	0	0.200641772	1303.637537	7681.875371	6109.035675	97.76737641	512.4734515	0	0	34.78467053	1781.317296	0	0	0	0	0	0	0	0											"$420 Days 1-35 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$420 Days 1-35 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$300 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); $300 (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											405.0026925	399.3679494	174.795658	0	150	0.2	0.065969505	49.99616052	300	2.8	0.258980458	0	0.2	152.0627885	13.98248353	40	37.5	35	0	0	0.2	39.13359274	0	0	0	0	0	0	0	0											405.0026925	399.3679494	174.795658	0	150	0.2	0.065969505	49.99616052	300	2.8	0.258980458	0	0.2	152.0627885	13.98248353	40	37.5	35	0	0	0.2	39.13359274	0	0	0	0	0	0	0	0											38.3182	0.925117282	20.87420679	0	3.36034492	3.449330851	0.978519227	1.344280905	3.091417111	2.910953922	15.02094286	0	0.040128354	16.51956326	8.950974657	20.36345225	0.305523051	1.494714234	0	0	6.956934107	5.809112134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.7137	0	0	38.3182	0.925117282	20.87420679	0	3.36034492	3.449330851	0.978519227	1.344280905	3.091417111	2.910953922	15.02094286	0	0.040128354	16.51956326	8.950974657	20.36345225	0.305523051	1.494714234	0	0	6.956934107	5.809112134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.7137																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	38.3182	0.925117282	20.87420679	0	3.36034492	3.449330851	0.978519227	1.344280905	3.091417111	2.910953922	15.02094286	0	0.040128354	16.51956326	8.950974657	20.36345225	0.305523051	1.494714234	0	0	6.956934107	5.809112134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	150.7137
H7949_803_0	2009	2																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1140.366561	25.9644143	1428.607491	354.8002606	248.7720482	16.51282396	13.58834238	305.0896968	132.1930536	11902.42204	61.49820689	0	0.154952025	1201.720945	7331.64234	5753.463999	95.68360408	481.8274218	0	0	29.35566052	1706.060151	0	0	0	0	0	0	0	0											"$370 Days 1-35 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$370 Days 1-35 (1b); $0 n/c (1b1, 1b2)"	"$200 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$300 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); $300 (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											356.7884106	351.8241459	199.7664663	0	150	0.2	0.066885639	49.99670846	300	2.8	0.259714813	0	0.2	169.0907691	13.59955384	39.99975668	37.5	35	0	0	0.2	39.08689418	0	0	0	0	0	0	0	0											356.7884106	351.8241459	199.7664663	0	150	0.2	0.066885639	49.99670846	300	2.8	0.259714813	0	0.2	169.0907691	13.59955384	39.99975668	37.5	35	0	0	0.2	39.08689418	0	0	0	0	0	0	0	0											33.9058	0.761242324	23.78232252	0	3.109650603	3.302564793	0.908864958	1.271123386	3.30482634	2.777231809	15.97199532	0	0.030990405	16.93332657	8.308922064	19.17809667	0.299011263	1.40532998	0	0	5.871132103	5.557049382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	146.6795	0	0	33.9058	0.761242324	23.78232252	0	3.109650603	3.302564793	0.908864958	1.271123386	3.30482634	2.777231809	15.97199532	0	0.030990405	16.93332657	8.308922064	19.17809667	0.299011263	1.40532998	0	0	5.871132103	5.557049382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	146.6795																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	33.9058	0.761242324	23.78232252	0	3.109650603	3.302564793	0.908864958	1.271123386	3.30482634	2.777231809	15.97199532	0	0.030990405	16.93332657	8.308922064	19.17809667	0.299011263	1.40532998	0	0	5.871132103	5.557049382	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	146.6795
H7949_804_0	2009	2																																D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1140.366561	25.9644143	1402.212027	354.8002606	248.7720482	16.39784958	13.50731678	305.0896968	132.1930536	11902.42204	61.06207163	0	0.154056924	1201.720945	7507.710919	5894.327451	98.02624891	493.6241192	0	0	29.84044347	1747.830035	0	0	0	0	0	0	0	0											"$370 Days 1-35 (1a); $0 (1a1, 13c); $0 n/c (1a2, 1a3)"	"$370 Days 1-35 (1b); $0 n/c (1b1, 1b2)"	"$200 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$300 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); $300 (9a); $40/$30 (9c)"	"$20 (7a); $40 (7a1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $40 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											356.7884106	351.8241459	199.7664663	0	150	0.2	0.066845244	49.99670846	300	2.8	0.259842942	0	0.2	168.0249464	13.60577386	39.99970008	37.5	35	0	0	0.2	39.08665391	0	0	0	0	0	0	0	0											356.7884106	351.8241459	199.7664663	0	150	0.2	0.066845244	49.99670846	300	2.8	0.259842942	0	0.2	168.0249464	13.60577386	39.99970008	37.5	35	0	0	0.2	39.08665391	0	0	0	0	0	0	0	0											33.9058	0.761242324	23.34291181	0	3.109650603	3.279569916	0.902899883	1.271123386	3.30482634	2.777231809	15.86654836	0	0.030811385	16.82659145	8.512351414	19.64761085	0.306332028	1.439737014	0	0	5.968088693	5.693068972	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	146.9464	0	0	33.9058	0.761242324	23.34291181	0	3.109650603	3.279569916	0.902899883	1.271123386	3.30482634	2.777231809	15.86654836	0	0.030811385	16.82659145	8.512351414	19.64761085	0.306332028	1.439737014	0	0	5.968088693	5.693068972	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	146.9464																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	33.9058	0.761242324	23.34291181	0	3.109650603	3.279569916	0.902899883	1.271123386	3.30482634	2.777231809	15.86654836	0	0.030811385	16.82659145	8.512351414	19.64761085	0.306332028	1.439737014	0	0	5.968088693	5.693068972	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	146.9464
H7981_802_0	2009	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																																																					0		114.5614938		1.922829829		3.335817923	10.75742027	12.17858338	6.184697048	15.75089361	2.501991283	8.331134191		0.343385208	9.047856169	57.49458102	76.56119516	3.681364705	10.00994753	32.30994244	66.0696381	14.75037757	0.140026446																			Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share																			0.152022424		0.188757067		0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.152022424		0.188757067		0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			17.4159	0	0.362947718	0	0.77057394	2.484964082	2.813252761	1.428665018	3.638456424	0.577959986	1.924491998	0	0.079321983	2.090054775	13.28124822	17.68563608	0.850395247	2.31229788	7.463596703	15.2620864	3.407337218	0.032346109	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.8815	0	0	17.4159	0	0.362947718	0	0.77057394	2.484964082	2.813252761	1.428665018	3.638456424	0.577959986	1.924491998	0	0.079321983	2.090054775	13.28124822	17.68563608	0.850395247	2.31229788	7.463596703	15.2620864	3.407337218	0.032346109	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.8815																																																																																		0	0	0	17.4159	0	0.362947718	0	0.77057394	2.484964082	2.813252761	1.428665018	3.638456424	0.577959986	1.924491998	0	0.079321983	2.090054775	13.28124822	17.68563608	0.850395247	2.31229788	7.463596703	15.2620864	3.407337218	0.032346109	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.8815
H8031_001_0	2009	4																																D	D	D	V	P	O	O	V	V	V	V	V	V	V	P	P	P	P	P	P	S	O	T	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		2397.633267	132	3147.041621	0	464.1242118	107478.6661	105.8080667	819.7506344	254.7505157	2234.349626	908.2532031	0	1610.238262	710.445214	4873.974147	7057.019594	1123.013447	2353.924097	5091.250597	15467.19097	1503.31545	11374.57868	0	0	0	0	0	0	0	0											$165/day: PBP 1a	$165/day: 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																			165	165	71.85782056	0	84.93287851	0.972911171	84.06698555	48.48434198	324.9130055	13.3126385	66.3009091	0	46.49155667	81.29067879	14.46289082	15.88081125	16.65765351	6.290746995	11.54573908	13.95902496	47.75993837	4.37153782	0	0	0	0	0	0	0	0											165	165	71.85782056	0	84.93287851	0.972911171	84.06698555	48.48434198	324.9130055	13.3126385	66.3009091	0	46.49155667	81.29067879	14.46289082	15.88081125	16.65765351	6.290746995	11.54573908	13.95902496	47.75993837	4.37153782	0	0	0	0	0	0	0	0											32.9675	1.815	18.84496267	0	3.284950442	8.713932907	0.741247101	3.312089175	6.897646308	2.478757404	5.018167755	0	6.238540283	4.812714474	5.874312996	9.339266344	1.558897407	1.233995078	4.898520914	17.99224206	5.983187769	4.143700075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	146.1496	135	0	32.9675	1.815	18.84496267	0	3.284950442	8.713932907	0.741247101	3.312089175	6.897646308	2.478757404	5.018167755	0	6.238540283	4.812714474	5.874312996	9.339266344	1.558897407	1.233995078	4.898520914	17.99224206	5.983187769	4.143700075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	146.1496		PBP 1a	PBP 1b	PBP 2	PBP 6	PBP 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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	32.9675	1.815	18.84496267	0	3.284950442	8.713932907	0.741247101	3.312089175	6.897646308	2.478757404	5.018167755	0	6.238540283	4.812714474	5.874312996	9.339266344	1.558897407	1.233995078	4.898520914	17.99224206	5.983187769	4.143700075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	146.1496
H8172_001_0	2009	2																					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																																																			0		290.4799009	8.963337632	1041.960331	1494.935947	154.3748541	9.120941615	7.420775445	257.5234202	374.1602358		4827.606345	134.1553887	8.934659402	129.4633149	3072.960339	3710.663258	363.6457659	458.7674568			21.99502887	1084.751052					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	20.38003377	100	0.2	0.2	48.53900442	47.5		10.050154	50	50	15.26180006	10	24.15071967	25.48469857	15			0.2	15					15														150.6532824	129.4565025	52.99730769	16.61949566	81.54792992	0.16309586	0.16309586	39.58255331	38.73526671		8.195692544	40.77396496	40.77396496	12.44568202	8.154792992	19.69441196	20.78224413	12.23218949			0.16309586	12.23218949					12.23218949														3.6468	0.096696862	4.601757687	2.070423457	1.049079148	1.487587815	1.210297752	0.849452876	1.207766377	0	3.297131444	0.45583726	0.030358457	0.134271604	2.08827962	6.089944236	0.629781257	0.467644205	0	0	3.587298146	1.105740035	0	0	0	0	0.221721705	0	0	0	0	0	0	0	0	0	0	0	0	0	34.3279	0	7.7675	3.6468	0.096696862	4.601757687	2.070423457	1.049079148	1.487587815	1.210297752	0.849452876	1.207766377	0	3.297131444	0.45583726	0.030358457	0.134271604	2.08827962	6.089944236	0.629781257	0.467644205	0	0	3.587298146	1.105740035	0	0	0	0	0.221721705	0	0	0	0	0	0	0	0	0	0	0	0	0	34.3279		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										5.6862	0.1461	2.2214	1.0288	0.2728	0.5544	0.451	0.266	3.1779	0.8959	2.4567	0.3493	0.0079	1.8473	1.8375	2.582	0.2455	0.272			0.9562	0.6105					0.1167														25.9821	500	0	9.333	0.242780626	6.823163744	3.099219198	1.321908068	2.041975857	1.661346486	1.115470923	4.385695812	0.895927647	5.75378505	0.805154896	0.038220644	1.981525111	3.925770145	8.671954169	0.875321854	0.739612227	0	0	4.543537223	1.716205187	0	0	0	0	0.33844916	0	0	0	0	0	0	0	0	0	0	0	0	0	60.31
H8172_002_0	2009	2																					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																																																			0		260.9228261	7.832314999	1033.596745	1187.602747	141.9517805	8.05317683	6.760014998	279.3555166	322.9682587		4149.703413	59.25550294	7.569942209	134.3258052	2708.413897	3084.583873	287.6492331	336.3356385			19.02982093	1076.20789					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	19.42355855	100	0.2	0.2	48.54180315	47.5		9.612632774	50	50	15.53859307	10	23.86845431	23.95310402	15			0.2	15					15														156.7741963	134.7162094	55.15054292	16.48305564	84.86115248	0.169722305	0.169722305	41.19313359	40.30904743		8.157390956	42.43057624	42.43057624	13.18622916	8.486115248	20.2550454	20.32688012	12.72917287			0.169722305	12.72917287					12.72917287														3.4088	0.087928316	4.750285137	1.631276846	1.003849308	1.366803734	1.147325327	0.95896076	1.084878571	0	2.820896091	0.209520428	0.026766418	0.147604237	1.915326039	5.2065322	0.487250957	0.356772874	0	0	3.229785071	1.141603023	0	0	0	0	0.230730068	0	0	0	0	0	0	0	0	0	0	0	0	0	31.2129	0	5.5682	3.4088	0.087928316	4.750285137	1.631276846	1.003849308	1.366803734	1.147325327	0.95896076	1.084878571	0	2.820896091	0.209520428	0.026766418	0.147604237	1.915326039	5.2065322	0.487250957	0.356772874	0	0	3.229785071	1.141603023	0	0	0	0	0.230730068	0	0	0	0	0	0	0	0	0	0	0	0	0	31.2129		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										5.1811	0.1305	2.2162	0.794	0.2622	0.4989	0.4188	0.3223	2.3611	0.856	2.0595	0.1577	0.0067	1.7132	1.6508	2.2489	0.1842	0.2023			0.8529	0.6085					0.1176														22.8433	500	0	8.5899	0.218385968	6.966510293	2.425261323	1.266090497	1.865747682	1.566149928	1.281229141	3.446016046	0.855974749	4.880400318	0.367177322	0.033469765	1.86080144	3.566087825	7.455464034	0.671434519	0.559077904	0	0	4.082649651	1.750070106	0	0	0	0	0.348360891	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0563
H8172_003_0	2009	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																																																			0		290.4799009	8.963337632	1041.960331	1494.935947	154.3748541	9.120941615	7.420775445	257.5234202	374.1602358		4827.606345	134.1553887	8.934659402	129.4633149	3072.960339	3710.663258	363.6457659	458.7674568			21.99502887	1084.751052					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	20.38003377	100	0.2	0.2	48.53900442	47.5		10.050154	50	50	15.26180006	10	24.15071967	25.48469857	15			0.2	15					15														150.6532824	129.4565025	52.99730769	16.61949566	81.54792992	0.16309586	0.16309586	39.58255331	38.73526671		8.195692544	40.77396496	40.77396496	12.44568202	8.154792992	19.69441196	20.78224413	12.23218949			0.16309586	12.23218949					12.23218949														3.6468	0.096696862	4.601757687	2.070423457	1.049079148	1.487587815	1.210297752	0.849452876	1.207766377	0	3.297131444	0.45583726	0.030358457	0.134271604	2.08827962	6.089944236	0.629781257	0.467644205	0	0	3.587298146	1.105740035	0	0	0	0	0.221721705	0	0	0	0	0	0	0	0	0	0	0	0	0	34.3279	0	7.7675	3.6468	0.096696862	4.601757687	2.070423457	1.049079148	1.487587815	1.210297752	0.849452876	1.207766377	0	3.297131444	0.45583726	0.030358457	0.134271604	2.08827962	6.089944236	0.629781257	0.467644205	0	0	3.587298146	1.105740035	0	0	0	0	0.221721705	0	0	0	0	0	0	0	0	0	0	0	0	0	34.3279		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										5.6862	0.1461	2.2214	1.0288	0.2728	0.5544	0.451	0.266	3.1779	0.8959	2.4567	0.3493	0.0079	1.8473	1.8375	2.582	0.2455	0.272			0.9562	0.6105					0.1167														25.9821	500	0	9.333	0.242780626	6.823163744	3.099219198	1.321908068	2.041975857	1.661346486	1.115470923	4.385695812	0.895927647	5.75378505	0.805154896	0.038220644	1.981525111	3.925770145	8.671954169	0.875321854	0.739612227	0	0	4.543537223	1.716205187	0	0	0	0	0.33844916	0	0	0	0	0	0	0	0	0	0	0	0	0	60.31
H8172_004_0	2009	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																																																			0		260.9228261	7.832314999	1033.596745	1187.602747	141.9517805	8.05317683	6.760014998	279.3555166	322.9682587		4149.703413	59.25550294	7.569942209	134.3258052	2708.413897	3084.583873	287.6492331	336.3356385			19.02982093	1076.20789					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	19.42355855	100	0.2	0.2	48.54180315	47.5		9.612632774	50	50	15.53859307	10	23.86845431	23.95310402	15			0.2	15					15														156.7741963	134.7162094	55.15054292	16.48305564	84.86115248	0.169722305	0.169722305	41.19313359	40.30904743		8.157390956	42.43057624	42.43057624	13.18622916	8.486115248	20.2550454	20.32688012	12.72917287			0.169722305	12.72917287					12.72917287														3.4088	0.087928316	4.750285137	1.631276846	1.003849308	1.366803734	1.147325327	0.95896076	1.084878571	0	2.820896091	0.209520428	0.026766418	0.147604237	1.915326039	5.2065322	0.487250957	0.356772874	0	0	3.229785071	1.141603023	0	0	0	0	0.230730068	0	0	0	0	0	0	0	0	0	0	0	0	0	31.2129	0	5.5682	3.4088	0.087928316	4.750285137	1.631276846	1.003849308	1.366803734	1.147325327	0.95896076	1.084878571	0	2.820896091	0.209520428	0.026766418	0.147604237	1.915326039	5.2065322	0.487250957	0.356772874	0	0	3.229785071	1.141603023	0	0	0	0	0.230730068	0	0	0	0	0	0	0	0	0	0	0	0	0	31.2129		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										5.1811	0.1305	2.2162	0.794	0.2622	0.4989	0.4188	0.3223	2.3611	0.856	2.0595	0.1577	0.0067	1.7132	1.6508	2.2489	0.1842	0.2023			0.8529	0.6085					0.1176														22.8433	500	0	8.5899	0.218385968	6.966510293	2.425261323	1.266090497	1.865747682	1.566149928	1.281229141	3.446016046	0.855974749	4.880400318	0.367177322	0.033469765	1.86080144	3.566087825	7.455464034	0.671434519	0.559077904	0	0	4.082649651	1.750070106	0	0	0	0	0.348360891	0	0	0	0	0	0	0	0	0	0	0	0	0	54.0563
H8172_005_0	2009	4																					3000											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																																																			0		393.2736581	28.77552501	1258.467662		307.7143434	15.65954875	11.32015123	540.4714902	442.5879635			102.9729861	5.039318051	117.4750633	10.9007554	3739.696136	769.914843	447.6353427			19.58589545	679.569408					217.5130188														1a: $250 days 1-5	1b : $250 days 1-5	2a: $105 days 21 - 100  2a2: $105 days 21-100	6a: 0%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50  4b: $25	9a: $150 9b: $100	8a: 0%	8b1: 0% 8b2: 0% 8b3: 0%	9a: $150	12: $50	9a: $150 9c: 30% 9d: $25 3: $15 5: $25	"7a: $0, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $10, 14j: $10"	7b: $30 7d: $25 7f: $25	"7e: $35, 7h: $35"	7c: $25 7i: $25	8b1: 0% 8b2: 0% 8b3: 0%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $10 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $25 18a1: $25	18b: (n/c)		13c (: $											462.7102261	417.7604594	68.23860903		100	0.1	0.2	47.51643347	145			150	50	23.32785195	10	25.40999495	35	25			0.2	14.94892748					25														368.4131239	332.6238047	54.33205862		79.62070064	0.079620701	0.159241401	37.83291725	115.4500159			119.431051	39.81035032	18.57379917	7.962070064	20.23161601	27.86724522	19.90517516			0.159241401	11.9024408					19.90517516														12.0739	0.797618718	5.697928233	0	2.041702635	1.246824243	1.802636744	1.703967764	4.25806562	0	0	1.024847663	0.016718085	0.181829853	0.007232715	6.305008018	1.787950478	0.742521659	0	0	3.118885437	0.674044554	0	0	0	0	0.360802895	0	0	0	0	0	0	0	0	0	0	0	0	0	43.8425	0	11.2217	12.0739	0.797618718	5.697928233	0	2.041702635	1.246824243	1.802636744	1.703967764	4.25806562	0	0	1.024847663	0.016718085	0.181829853	0.007232715	6.305008018	1.787950478	0.742521659	0	0	3.118885437	0.674044554	0	0	0	0	0.360802895	0	0	0	0	0	0	0	0	0	0	0	0	0	43.8425		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50  4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: 30% 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										7.0193	0.4572	2.62	1.698	0.5317	0.9377	0.6779	0.5181	2.6098	0.9047	2.3076	0.2291	0.0042	2.1036	2.1254	2.5348	0.5064	0.2657			0.8314	0.3907					0.116														29.3895	500	0	19.0933	1.254789549	8.317965707	1.698031924	2.573404912	2.184566651	2.480522553	2.222019774	6.867910018	0.904722399	2.307580378	1.253950643	0.020882226	2.285461814	2.132617312	8.839813772	2.294385536	1.008264937	0	0	3.950268651	1.064792511	0	0	0	0	0.476838919	0	0	0	0	0	0	0	0	0	0	0	0	0	73.2321
H8172_006_0	2009	4																					3000											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																																																			0		336.6045168	25.04738325	1306.923967		257.9769754	13.11920528	10.31250509	512.1400695	316.2622974			60.59029526	12.4580968	119.1947057	9.452075623	2977.178818	695.055124	277.1979831			17.79383697	659.8932485					217.5130188														1a: $250 days 1-5	1b : $250 days 1-5	2a: $105 days 21 - 100  2a2: $105 days 21-100	6a: 0%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50  4b: $25	9a: $150 9b: $100	8a: 0%	8b1: 0% 8b2: 0% 8b3: 0%	9a: $150	12: $50	9a: $150 9c: 30% 9d: $25 3: $15 5: $25	"7a: $0, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $10, 14j: $10"	7b: $30 7d: $25 7f: $25	"7e: $35, 7h: $35"	7c: $25 7i: $25	8b1: 0% 8b2: 0% 8b3: 0%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $10 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $25 18a1: $25	18b: (n/c)		13c (: $											462.7102261	417.7604594	68.23860903		100	0.1	0.2	47.52057173	145			150	50	24.68509345	10	25.79042993	35	25			0.2	14.92809194					25														384.5419706	347.1858222	56.71067486		83.10643441	0.083106434	0.166212869	39.49265278	120.5043299			124.6596516	41.55321721	20.514901	8.310643441	21.43350674	29.08725205	20.7766086			0.166212869	12.40620494					20.7766086														10.7865	0.724674696	6.176378346	0	1.786628882	1.090290373	1.714071056	1.685480828	3.175914686	0	0	0.629430425	0.0431395	0.203772299	0.006546069	5.317615189	1.684770298	0.479936167	0	0	2.95756469	0.682230907	0	0	0	0	0.376598571	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5216	0	8.0338	10.7865	0.724674696	6.176378346	0	1.786628882	1.090290373	1.714071056	1.685480828	3.175914686	0	0	0.629430425	0.0431395	0.203772299	0.006546069	5.317615189	1.684770298	0.479936167	0	0	2.95756469	0.682230907	0	0	0	0	0.376598571	0	0	0	0	0	0	0	0	0	0	0	0	0	39.5216		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50  4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: 30% 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										6.1123	0.4005	2.8805	1.26	0.4605	0.8003	0.6291	0.5382	2.0256	0.8719	2.0626	0.1235	0.01	2.0067	1.8179	2.1058	0.438	0.1681			0.778	0.3798					0.1169														25.9862	500	0	16.8988	1.125182262	9.056841112	1.260037852	2.247139591	1.890548547	2.343123375	2.223654542	5.201541999	0.871868868	2.06260444	0.752936406	0.053145655	2.210512885	1.824398131	7.423461035	2.122771675	0.648064847	0	0	3.735570773	1.062050301	0	0	0	0	0.493493037	0	0	0	0	0	0	0	0	0	0	0	0	0	65.5078
H8172_801_0	2009	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																																																			0		234.6140178	4.420274543	40.66919829		5.80210422	8.080765613	6.783173633	13.86626496	43.33907992	15.6040542	37.47369397	2.893819107	0.139058953	30.77524647	31.30582401	74.45519358	2.139029238	3.639528552			19.09501378	7.475128438																			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																			0.077211483	0.077211483	0.163020865		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.077211483	0.077211483	0.163020865		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			18.1149	0.341295952	6.629927872	0	1.340286075	1.866656856	1.566913109	3.203107207	10.01132746	3.60453652	8.656423308	0.668472214	0.032122618	7.109081934	7.231645347	17.19914972	0.494115754	0.840731095	0	0	4.410948184	1.726754669	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.0484	0	0	18.1149	0.341295952	6.629927872	0	1.340286075	1.866656856	1.566913109	3.203107207	10.01132746	3.60453652	8.656423308	0.668472214	0.032122618	7.109081934	7.231645347	17.19914972	0.494115754	0.840731095	0	0	4.410948184	1.726754669	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.0484		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																			3.231	0.0609	1.1825		0.2645	0.3773	0.3167	0.5713	1.7856	0.6473	1.5575	0.1192	0.0058	1.268	1.281	3.1431	0.0897	0.1519			0.8916	0.3134																			17.2585	0	0	21.3459	0.402169913	7.812449877	0	1.604801961	2.243987937	1.883653176	3.774417307	11.79696001	4.251875521	10.21394286	0.787701731	0.037890842	8.377084793	8.512680795	20.34221554	0.583792092	0.9926663	0	0	5.302589216	2.040118032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.3069
H8172_802_0	2009	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																																																			0		234.6140178	4.420274543	40.66919829		5.80210422	8.080765613	6.783173633	13.86626496	43.33907992	15.6040542	37.47369397	2.893819107	0.139058953	30.77524647	31.30582401	74.45519358	2.139029238	3.639528552			19.09501378	7.475128438																			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																			0.077211483	0.077211483	0.163020865		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.077211483	0.077211483	0.163020865		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			18.1149	0.341295952	6.629927872	0	1.340286075	1.866656856	1.566913109	3.203107207	10.01132746	3.60453652	8.656423308	0.668472214	0.032122618	7.109081934	7.231645347	17.19914972	0.494115754	0.840731095	0	0	4.410948184	1.726754669	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.0484	0	0	18.1149	0.341295952	6.629927872	0	1.340286075	1.866656856	1.566913109	3.203107207	10.01132746	3.60453652	8.656423308	0.668472214	0.032122618	7.109081934	7.231645347	17.19914972	0.494115754	0.840731095	0	0	4.410948184	1.726754669	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.0484		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																			3.231	0.0609	1.1825		0.2645	0.3773	0.3167	0.5713	1.7856	0.6473	1.5575	0.1192	0.0058	1.268	1.281	3.1431	0.0897	0.1519			0.8916	0.3134																			17.2585	0	0	21.3459	0.402169913	7.812449877	0	1.604801961	2.243987937	1.883653176	3.774417307	11.79696001	4.251875521	10.21394286	0.787701731	0.037890842	8.377084793	8.512680795	20.34221554	0.583792092	0.9926663	0	0	5.302589216	2.040118032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.3069
H8172_803_0	2009	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																																																			0		234.6140178	4.420274543	40.66919829		5.80210422	8.080765613	6.783173633	13.86626496	43.33907992	15.6040542	37.47369397	2.893819107	0.139058953	30.77524647	31.30582401	74.45519358	2.139029238	3.639528552			19.09501378	7.475128438																			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																			0.077211483	0.077211483	0.163020865		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.077211483	0.077211483	0.163020865		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			18.1149	0.341295952	6.629927872	0	1.340286075	1.866656856	1.566913109	3.203107207	10.01132746	3.60453652	8.656423308	0.668472214	0.032122618	7.109081934	7.231645347	17.19914972	0.494115754	0.840731095	0	0	4.410948184	1.726754669	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.0484	0	0	18.1149	0.341295952	6.629927872	0	1.340286075	1.866656856	1.566913109	3.203107207	10.01132746	3.60453652	8.656423308	0.668472214	0.032122618	7.109081934	7.231645347	17.19914972	0.494115754	0.840731095	0	0	4.410948184	1.726754669	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.0484		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																			3.231	0.0609	1.1825		0.2645	0.3773	0.3167	0.5713	1.7856	0.6473	1.5575	0.1192	0.0058	1.268	1.281	3.1431	0.0897	0.1519			0.8916	0.3134																			17.2585	0	0	21.3459	0.402169913	7.812449877	0	1.604801961	2.243987937	1.883653176	3.774417307	11.79696001	4.251875521	10.21394286	0.787701731	0.037890842	8.377084793	8.512680795	20.34221554	0.583792092	0.9926663	0	0	5.302589216	2.040118032	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.3069
H8189_001_0	2009	6																																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		340.4599354	26.04587877	83.57770157	0	12.47690606	20.93767865	15.61369862	20.64328925	29.94424841	8.383995424	21.02179052	0	7.252608208	64.46527432	47.05000776	96.12904567	8.322188701	5.330901487	19.29751141	35.15293076	12.07070947	0.918393022	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											0.076686382	0.076686382	0.163055019	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.076686382	0.076686382	0.163055019	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											26.1086	1.997364219	13.62776368	0	2.882165299	4.836603767	3.606764382	4.768599817	6.917121382	1.936702943	4.856033611	0	1.675352496	14.89147837	10.86855179	22.20580955	1.92242559	1.231438243	4.457725135	8.120327006	2.788333888	0.212148788	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.9114	0		26.1086	1.997364219	13.62776368	0	2.882165299	4.836603767	3.606764382	4.768599817	6.917121382	1.936702943	4.856033611	0	1.675352496	14.89147837	10.86855179	22.20580955	1.92242559	1.231438243	4.457725135	8.120327006	2.788333888	0.212148788	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.9114																																																																																		0	0		26.1086	1.997364219	13.62776368	0	2.882165299	4.836603767	3.606764382	4.768599817	6.917121382	1.936702943	4.856033611	0	1.675352496	14.89147837	10.86855179	22.20580955	1.92242559	1.231438243	4.457725135	8.120327006	2.788333888	0.212148788	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.9114
H8201_001_0	2009	3																					1900											A	A	A		T	Coin	Coin	V	V	V	V			V		V	V								V		V																																																						0	1900	237.7738407	7.511830859	61.71437446		127.6670472	12.59901898	2.413616027	249.6167518	190.2015895	605.4303636	512.4272144			519.854969		9933.041851	268.6503771								248.8644452		109.6710574														$150 per admit	$150 per admit	$150 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		$15 per visit	$15 per visit								$15 per visit		$15 per visit														150	150	150		50	0.2	0.2	50	50	15	15			15		15	15								15		15														146.797745	146.797745	146.797745		48.93258167	0.195730327	0.195730327	48.93258167	48.93258167	14.6797745	14.6797745			14.6797745		14.6797745	14.6797745								14.6797745		14.6797745														2.9087	0.091893319	0.754960917	0	0.520589851	2.4660101	0.472417853	1.017866008	0.775587901	0.740631768	0.626859663	0	0	0.635946143	0	12.15123454	0.328643913	0	0	0	0	0	0	0	0.304439495	0	0.134162199	0	0	0	0	0	0	0	0	0	0	0	0	0	23.93		0.522	2.9087	0.091893319	0.754960917	0	0.520589851	2.4660101	0.472417853	1.017866008	0.775587901	0.740631768	0.626859663	0	0	0.635946143	0	12.15123454	0.328643913	0	0	0	0	0	0	0	0.304439495	0	0.134162199	0	0	0	0	0	0	0	0	0	0	0	0	0	23.93	1900																																																																																	0		0.01	2.9087	0.091893319	0.754960917	0	0.520589851	2.4660101	0.472417853	1.017866008	0.775587901	0.740631768	0.626859663	0	0	0.635946143	0	12.15123454	0.328643913	0	0	0	0	0	0	0	0.304439495	0	0.134162199	0	0	0	0	0	0	0	0	0	0	0	0	0	23.93
H8239_001_0	2009	11																					2500											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	O	P																																																			0	5000	1039.858497	31.00950058	447.3202463		87.0203701	8.526411345	14.68922796	273.795903	287.4283183		196.8156932	53.7291388		1245.506722	2748.916554	4034.013522	232.7092859	384.7864563	225.7331625	599.4698559	17.85787317				105.4421721					103.93											1a: Days 1 - 7: $200/day then $0;1a1: Days 1 - 7: $200/day then $0	1b: Days 1 - 7: $200/day then $0	"2: Days 1 - 7: $0/day, then $100/day"	6: $0	10a: $100/trip	11a: 20%	11b: 20%;11c: 20%	4a: $50/visit;4a1: $50/visit;4b: $25/visit	9a: $250/visit;9b: $250/visit	8a: $0/visit	8b: $0/visit;8b: $100/visit;8b: 20%	9a: $250/visit	12a: 20%	3: 20%;5: $30/visit;9a: $250/visit;9c: $30/visit;9d: $30/visit; 7i: $30/visit; 7c: $30/visit; 7e: $30/visit	7a: $10/visit;14c: $10/visit;14d: $0/visit;14e: $0/visit;14f: $0/visit;14g: $0/visit	7b: $30/visit;7d: $30/visit;7f: $30/visit;16b: $30/visit;17a: $30/visit;18a: $30/visit	7e: $30/visit;7h: $30/visit	7c: $30/visit;7i: $30/visit	7a: $10; 7d: $30/visit; 8b: $0/visit; 8b: $100/visit; 8b: 20%; 14h: $0/visit	7g: $30/visit;14b: $10/visit;14i: 20%; 7a: $10/visit; 7d: $30/visit; 8a: $0/visit; 12: 20%	15: 20%	13a: $0		16a: $250 allowance	17a1: $30/visit	17b1: $100 per yr				14c1: $10/visit;13a1: $0											159.697562	155.8224189	53.24203782		100	0.2	0.2	45	232.2215595		144.3285261	250		111.8779382	9.999766616	29.99952146	29.9502601	29.59914371	28.45689168	5.994847822	0.2				30					10											136.9935179	133.6693001	45.67267008		85.78309913	0.171566198	0.171566198	38.60239461	199.2068506		123.8094826	214.4577478		95.97236266	8.578109709	25.73451923	25.69226131	25.39106279	24.4112036	5.14256625	0.171566198				25.73492974					8.578309913											11.8712	0.345418187	1.702525836	0	0.622073086	1.462843979	2.520174996	0.880764791	4.771474171	0	2.030637429	0.960219175	0	9.961185238	1.965042315	8.651116546	0.498235649	0.814178089	0.459201516	0.256901121	3.063807409	0	0	0	0.226128908	0	0	0	0	0.074295312	0	0	0	0	0	0	0	0	0	0	53.1374	0	8.8065	11.8712	0.345418187	1.702525836	0	0.622073086	1.462843979	2.520174996	0.880764791	4.771474171	0	2.030637429	0.960219175	0	9.961185238	1.965042315	8.651116546	0.498235649	0.814178089	0.459201516	0.256901121	3.063807409	0	0	0	0.226128908	0	0	0	0	0.074295312	0	0	0	0	0	0	0	0	0	0	53.1374		OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: $100/trip	OON: 40%	OON: 40%;OON: 20%	OON: $50/visit	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 40%;OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%		OON: $250 allowance	OON: 20%	OON: 20%				OON: 20%											1.7227	0.0243	0.1345	0.2078	0.0331	0.1557	0.2683	0.053	0.2899	0.0527	0.1307	0.0334		0.2562	0.2313	0.7181	0.0161	0.0334	0.2198	0.0824	0.1631				0.0065	0.0148				0.0164											4.8644	0	1.037	13.5939	0.369690375	1.837050854	0.207763303	0.655188995	1.618592261	2.788496793	0.93376955	5.061376383	0.052721045	2.161364442	0.993593242	0	10.21736087	2.19631212	9.36921133	0.514341417	0.847550504	0.679044614	0.3393392	3.226908446	0	0	0	0.232669282	0.014848966	0	0	0	0.090679	0	0	0	0	0	0	0	0	0	0	58.0018
H8239_801_0	2009	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																																																			0		190.3782121	2.707754805	15.02213488		9.064407646	9.385244039	16.16881752	11.79618963	32.74035645	5.955977382	14.79414028	3.787112837		28.95405739	28.37119654	88.09858306	1.975787153	4.093985993	26.96941676	10.11315312	19.6566282																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.0761	0.0761	0.192		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.0761	0.0761	0.192		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				14.4878	0.206060141	2.884249896	0	2.093878166	2.167991373	3.734996847	2.724919805	7.56302234	1.375830775	3.417446405	0.874823065	0	6.688387257	6.553746401	20.35077269	0.456406832	0.945710764	6.229935272	2.336138371	4.540681115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.6328	0	0	14.4878	0.206060141	2.884249896	0	2.093878166	2.167991373	3.734996847	2.724919805	7.56302234	1.375830775	3.417446405	0.874823065	0	6.688387257	6.553746401	20.35077269	0.456406832	0.945710764	6.229935272	2.336138371	4.540681115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.6328		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.8658	0.0123	0.1723		0.1176	0.1201	0.2069	0.1611	0.4471	0.0813	0.2016	0.0515		0.3951	0.356	1.1054	0.0248	0.0514	0.3384	0.1269	0.2516																				5.0872	0	0	15.3535	0.218393139	3.056597005	0	2.211485047	2.288101698	3.94192188	2.886030209	8.010157275	1.457145853	3.619075135	0.926298048	0	7.083503504	6.909715463	21.45613213	0.481196732	0.99707738	6.568316418	2.463026556	4.792242396	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.72
H8239_802_0	2009	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																																																			0		190.3782121	2.707754805	15.02213488		9.064407646	9.385244039	16.16881752	11.79618963	32.74035645	5.955977382	14.79414028	3.787112837		28.95405739	28.37119654	88.09858306	1.975787153	4.093985993	26.96941676	10.11315312	19.6566282																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.0761	0.0761	0.192		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.0761	0.0761	0.192		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				14.4878	0.206060141	2.884249896	0	2.093878166	2.167991373	3.734996847	2.724919805	7.56302234	1.375830775	3.417446405	0.874823065	0	6.688387257	6.553746401	20.35077269	0.456406832	0.945710764	6.229935272	2.336138371	4.540681115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.6328	0	0	14.4878	0.206060141	2.884249896	0	2.093878166	2.167991373	3.734996847	2.724919805	7.56302234	1.375830775	3.417446405	0.874823065	0	6.688387257	6.553746401	20.35077269	0.456406832	0.945710764	6.229935272	2.336138371	4.540681115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.6328		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.8658	0.0123	0.1723		0.1176	0.1201	0.2069	0.1611	0.4471	0.0813	0.2016	0.0515		0.3951	0.356	1.1054	0.0248	0.0514	0.3384	0.1269	0.2516																				5.0872	0	0	15.3535	0.218393139	3.056597005	0	2.211485047	2.288101698	3.94192188	2.886030209	8.010157275	1.457145853	3.619075135	0.926298048	0	7.083503504	6.909715463	21.45613213	0.481196732	0.99707738	6.568316418	2.463026556	4.792242396	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.72
H8239_803_0	2009	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																																																			0		190.3782121	2.707754805	15.02213488		9.064407646	9.385244039	16.16881752	11.79618963	32.74035645	5.955977382	14.79414028	3.787112837		28.95405739	28.37119654	88.09858306	1.975787153	4.093985993	26.96941676	10.11315312	19.6566282																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.0761	0.0761	0.192		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.0761	0.0761	0.192		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				14.4878	0.206060141	2.884249896	0	2.093878166	2.167991373	3.734996847	2.724919805	7.56302234	1.375830775	3.417446405	0.874823065	0	6.688387257	6.553746401	20.35077269	0.456406832	0.945710764	6.229935272	2.336138371	4.540681115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.6328	0	0	14.4878	0.206060141	2.884249896	0	2.093878166	2.167991373	3.734996847	2.724919805	7.56302234	1.375830775	3.417446405	0.874823065	0	6.688387257	6.553746401	20.35077269	0.456406832	0.945710764	6.229935272	2.336138371	4.540681115	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.6328		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.8658	0.0123	0.1723		0.1176	0.1201	0.2069	0.1611	0.4471	0.0813	0.2016	0.0515		0.3951	0.356	1.1054	0.0248	0.0514	0.3384	0.1269	0.2516																				5.0872	0	0	15.3535	0.218393139	3.056597005	0	2.211485047	2.288101698	3.94192188	2.886030209	8.010157275	1.457145853	3.619075135	0.926298048	0	7.083503504	6.909715463	21.45613213	0.481196732	0.99707738	6.568316418	2.463026556	4.792242396	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.72
H8393_001_0	2009	10																					0											D	D	D	COIN	T	COIN	COIN	V	V	O	COIN	O	COIN	O	P	P	P	P	P	P	COIN	V	T	V	V	V	V	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	1399.024455	46.98216455	552.0404334	12.38732278	250.7357179	0	18.36855706	453.5165171	898.8121909	0	28.90065857	78.78308076	0.019752088	1050.21272	9061.698913	24847.94443	207.9756681	2801.150831	0	28067.79215	5.308068427	0	0	0	172.9896249	0	0	0	0	0											1a $180 days 1-10	1b $180 days 1-10	2 $100 days 7-26	6 20%	10a $150	11a 20%	11b 20%; 11c 20%	4a $50	9a $100; 9b $100	8a $0	8b 20% Therapeutic $100 Diagnostic	9a $100	12 20%	3 $30; 4b $50; 5 $100; 9d $35; 13a $0; 14b $0	7a $10; 14d - j $0	7b $10; 7d $10; 7f $10; 7g $10; 14c $10; 14d - j $0; 17a $10	7e $30; 7h $30; 9c $30	7c $30; 7i $30	14h $0	7g $10	15 20%			16a 50%; 16b $10	17a $10	17b $0	18a $10	18b $0	14a $0	14b $0											160.2963671	160.2963671	47.57653061	0.2	105.7377049	0	0.2	50	32.14481707	0	0.308846568	75	0.2	5.485975212	4.302378428	2.604900417	30	15	0	0.143793407	0.246042756	0	0	0	10	0	0	0	0	0											115.5430116	115.5430116	34.29357586	0.144161734	76.21665469	0	0.144161734	36.04043362	23.17026292	0	0.222619284	54.06065042	0.2	3.954338509	4.302378428	2.603820701	28.94957718	13.02356348	0	0.143793407	0.177349752	0	0	0	10	0	0	0	0	0											13.4706	0.452371732	1.57762004	1.785777938	1.592519803	0	2.648043045	1.362077661	1.735476231	0	6.433843927	0.354922049	0.003950418	0.346074717	3.248904827	5.391632675	0.501733971	3.040080471	0	0.336330288	0.941384619	0	0	0	0.144158021	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.3675	0	13.1478	13.4706	0.452371732	1.57762004	1.785777938	1.592519803	0	2.648043045	1.362077661	1.735476231	0	6.433843927	0.354922049	0.003950418	0.346074717	3.248904827	5.391632675	0.501733971	3.040080471	0	0.336330288	0.941384619	0	0	0	0.144158021	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.3675	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			0.5	0.2		0.2			0.2											4.5149	0.0865	0.3485	0.2649	0.2395	0	0.3928	0.202	1.0027	0.4436	0.618	0.0398	0.0004	0.1973	0.8417	2.4869	0.0449	0.1563	0.9447	0.8049	0.1135	0	0	0.0653	0.0093	0.057	0	0	0.0644	0.0001											13.94	0	0.48	17.9856	0.538865542	1.926163214	2.050657892	1.831972441	0	3.040820616	1.564111217	2.738218196	0.443560365	7.051830981	0.39471686	0.004389353	0.543356532	4.09056936	7.87856145	0.54659366	3.196428196	0.944695439	1.141229183	1.05488783	0	0	0.065333816	0.153504635	0.056995159	0	0	0.0643663	0.000115447	0	0	0	0	0	0	0	0	0	0	59.3075
H8393_801_0	2009	9																					0											COIN	COIN	COIN	COIN	COIN	O	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	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	199.1932542	3.815992613	15.37726426	0	6.015115034	0	17.32882741	7.281153903	44.23965047	19.56929717	27.26477223	1.755694475	0.018634045	8.499044261	36.05867221	108.2435821	1.924292977	6.770302985	41.67871444	35.51107566	6.160432934	0	0	0	0	0	0	0	0	0											FFS Medicare  8.0%	FFS Medicare  8.0%	FFS Medicare  16.2%		FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%																			0.079861243	0.079861243	0.162430756	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.079861243	0.079861243	0.162430756	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											15.9078	0.304749914	2.497740656	0	1.389491573	0	4.002959132	1.681946552	10.21935926	4.520507647	6.298162386	0.405565424	0.004304464	1.963279224	8.32955328	25.00426747	0.444511678	1.56393999	9.627783036	8.203058478	1.423060008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.7921	0	0	15.9078	0.304749914	2.497740656	0	1.389491573	0	4.002959132	1.681946552	10.21935926	4.520507647	6.298162386	0.405565424	0.004304464	1.963279224	8.32955328	25.00426747	0.444511678	1.56393999	9.627783036	8.203058478	1.423060008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.7921	0	FFS Medicare  8.0%	FFS Medicare  8.0%	FFS Medicare  16.2%		FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%																			1.7675	0.0339	0.2775	0	0.1544	0	0.4448	0.1869	1.1355	0.5023	0.6998	0.0451	0.0005	0.2181	0.9255	2.7783	0.0494	0.1738	1.0698	0.9115	0.1581	0	0	0	0	0	0	0	0	0											11.5325	0	0	17.6754	0.338611016	2.775267396	0	1.543879525	0	4.447732369	1.868829502	11.35484362	5.022786275	6.997958207	0.450628249	0.004782738	2.18142136	9.2550592	27.78251941	0.493901864	1.737711099	10.69753671	9.11450942	1.581177787	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.3245
H8393_802_0	2009	10																					0											COIN	COIN	COIN	COIN	COIN	O	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	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	199.1932542	3.815992613	15.37726426	0	6.015115034	0	17.32882741	7.281153903	44.23965047	19.56929717	27.26477223	1.755694475	0.018634045	8.499044261	36.05867221	108.2435821	1.924292977	6.770302985	41.67871444	35.51107566	6.160432934	0	0	0	0	0	0	0	0	0											FFS Medicare  8.0%	FFS Medicare  8.0%	FFS Medicare  16.2%		FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%																			0.079861243	0.079861243	0.162430756	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.079861243	0.079861243	0.162430756	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											15.9078	0.304749914	2.497740656	0	1.389491573	0	4.002959132	1.681946552	10.21935926	4.520507647	6.298162386	0.405565424	0.004304464	1.963279224	8.32955328	25.00426747	0.444511678	1.56393999	9.627783036	8.203058478	1.423060008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.7921	0	0	15.9078	0.304749914	2.497740656	0	1.389491573	0	4.002959132	1.681946552	10.21935926	4.520507647	6.298162386	0.405565424	0.004304464	1.963279224	8.32955328	25.00426747	0.444511678	1.56393999	9.627783036	8.203058478	1.423060008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.7921	0	FFS Medicare  8.0%	FFS Medicare  8.0%	FFS Medicare  16.2%		FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%																			1.7675	0.0339	0.2775	0	0.1544	0	0.4448	0.1869	1.1355	0.5023	0.6998	0.0451	0.0005	0.2181	0.9255	2.7783	0.0494	0.1738	1.0698	0.9115	0.1581	0	0	0	0	0	0	0	0	0											11.5325	0	0	17.6754	0.338611016	2.775267396	0	1.543879525	0	4.447732369	1.868829502	11.35484362	5.022786275	6.997958207	0.450628249	0.004782738	2.18142136	9.2550592	27.78251941	0.493901864	1.737711099	10.69753671	9.11450942	1.581177787	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.3245
H8393_803_0	2009	10																					0											COIN	COIN	COIN	COIN	COIN	O	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	V	T	V	V	V	V	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	199.1932542	3.815992613	15.37726426	0	6.015115034	0	17.32882741	7.281153903	44.23965047	19.56929717	27.26477223	1.755694475	0.018634045	8.499044261	36.05867221	108.2435821	1.924292977	6.770302985	41.67871444	35.51107566	6.160432934	0	0	0	0	0	0	0	0	0											FFS Medicare  8.0%	FFS Medicare  8.0%	FFS Medicare  16.2%		FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%																			0.079861243	0.079861243	0.162430756	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.079861243	0.079861243	0.162430756	0	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											15.9078	0.304749914	2.497740656	0	1.389491573	0	4.002959132	1.681946552	10.21935926	4.520507647	6.298162386	0.405565424	0.004304464	1.963279224	8.32955328	25.00426747	0.444511678	1.56393999	9.627783036	8.203058478	1.423060008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.7921	0	0	15.9078	0.304749914	2.497740656	0	1.389491573	0	4.002959132	1.681946552	10.21935926	4.520507647	6.298162386	0.405565424	0.004304464	1.963279224	8.32955328	25.00426747	0.444511678	1.56393999	9.627783036	8.203058478	1.423060008	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.7921	0	FFS Medicare  8.0%	FFS Medicare  8.0%	FFS Medicare  16.2%		FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%	FFS Medicare  23.1%																			1.7675	0.0339	0.2775	0	0.1544	0	0.4448	0.1869	1.1355	0.5023	0.6998	0.0451	0.0005	0.2181	0.9255	2.7783	0.0494	0.1738	1.0698	0.9115	0.1581	0	0	0	0	0	0	0	0	0											11.5325	0	0	17.6754	0.338611016	2.775267396	0	1.543879525	0	4.447732369	1.868829502	11.35484362	5.022786275	6.997958207	0.450628249	0.004782738	2.18142136	9.2550592	27.78251941	0.493901864	1.737711099	10.69753671	9.11450942	1.581177787	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.3245
H8578_001_0	2009	7																					3350											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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	236.5	3.51	1047.73	0	178.41	0	0	250.14	291.86	0	0	94.29	0	1659.33	5219.57	6106.72	155.16	602.83	0	1369.44	0	702.07	0	0	347.92	0	165.02	0	0	0											PBP: 1A IP Acute: $200 per admit	1B IP Psych: $200 per admit	2 SNF: $25 for Days 11 - 100	6 Home Health: $0	10A Ambulance: $50 Per Run	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50 per visit (waived if admitted), 4B Urgent Care: $10 per Visit"	9B ASC Services: $100 per Case	8A OP C/D/T: $0 general	"8B OP X-Ray: $0 general, $0 for CT/MRI/PET"	9A OP Hospital: $10	12 Renal Dialysis: $0	"3 CORF: $10, 5 Partial Hosp: $10, 9C OP Substance Abuse: $10, 9D Cardiac Rehab: $0"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $10"	"7B Chiropractic: $10, 7D Physician Specialist (excl. Radiology): $10, 7F Podiatry: $10"	"7E Mental Health: $10, 7H Psychiatric: $10"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	"8B OP X-Ray: $0 general and $0 for CT/MRI/PET, 14G Bone Mass Measurement: $0, 14H Mammogragy Screening $0,"	"7B Chiropractic Services: $10, 7F Podiatry Services: $10, 7G Other Health Care: $10, 14D Pap Smears and Pelvic Exams Screening: $0, 14E Prostate Cancer Screening: $0, 14F Colorectal Screening $0, 14I Diabetes Monitoring $0, 14J Nutrition Therapy: $0, 17A Vision Exams: $10, 18A Medicare Covered Hearing Exams: $10"	"15 Part B Drugs: $0, Home Infusion Drugs $0"	"13A Blood: Not Covered, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $10, 17B Eye Wear: Medicare Covered: $0"	10B Transportation: Not Covered	16A Preventive Dental Service and 16B Non Medicare Covered Comprehensive Dental: combined $150 Max Benefit	"17A Routine Eye Exams: $10, 17B Eye Wear: $100 limit every 2 years"	17B Routine: Not Covered	18A Routine Hearing Exams: $10	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Health Club Membership $150 Max Benefit	13B Acupuncture: Not Covered											200	200	25	0	50	0	0	47.61093787	100	0	0	10	0	10	10	10	10	10	0	10	0	10	0	0	10	0	10	0	0	0											197.5869751	197.5869751	24.69837188	0	49.39674377	0	0	47.03650598	98.79348754	0	0	9.879348754	0	9.879348754	9.879348754	9.879348754	9.879348754	9.879348754	0	9.879348754	0	9.879348754	0	0	9.879348754	0	9.879348754	0	0	0											3.8941	0.05779419	2.156435431	0	0.734406088	0	0	0.980475967	2.402822273	0	0	0.077626983	0	1.366091647	4.297162698	5.027534718	0.127739979	0.496297317	0	1.12743128	0	0.577999532	0	0	0.286435252	0	0.135857511	0	0	0	0	0	0	0	0	0	0	0	0	0	23.7462	0	0.29	3.8941	0.05779419	2.156435431	0	0.734406088	0	0	0.980475967	2.402822273	0	0	0.077626983	0	1.366091647	4.297162698	5.027534718	0.127739979	0.496297317	0	1.12743128	0	0.577999532	0	0	0.286435252	0	0.135857511	0	0	0	0	0	0	0	0	0	0	0	0	0	23.7462	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.8941	0.05779419	2.156435431	0	0.734406088	0	0	0.980475967	2.402822273	0	0	0.077626983	0	1.366091647	4.297162698	5.027534718	0.127739979	0.496297317	0	1.12743128	0	0.577999532	0	0	0.286435252	0	0.135857511	0	0	0	0	0	0	0	0	0	0	0	0	0	23.7462
H8578_002_0	2009	7																					3350											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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	236.5	3.51	1047.73	0	178.41	0	0	250.14	291.86	0	0	94.29	0	1659.33	5219.57	6106.72	155.16	602.83	0	1369.44	0	702.07	0	0	347.92	0	165.02	0	0	0											PBP: 1A IP Acute: $200 per admit	1B IP Psych: $200 per admit	2 SNF: $25 for Days 11 - 100	6 Home Health: $0	10A Ambulance: $50 Per Run	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50 per visit (waived if admitted), 4B Urgent Care: $10 per Visit"	9B ASC Services: $100 per Case	8A OP C/D/T: $0 general	"8B OP X-Ray: $0 general, $0 for CT/MRI/PET"	9A OP Hospital: $10	12 Renal Dialysis: $0	"3 CORF: $10, 5 Partial Hosp: $10, 9C OP Substance Abuse: $10, 9D Cardiac Rehab: $0"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $10"	"7B Chiropractic: $10, 7D Physician Specialist (excl. Radiology): $10, 7F Podiatry: $10"	"7E Mental Health: $10, 7H Psychiatric: $10"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	"8B OP X-Ray: $0 general and $0 for CT/MRI/PET, 14G Bone Mass Measurement: $0, 14H Mammogragy Screening $0,"	"7B Chiropractic Services: $10, 7F Podiatry Services: $10, 7G Other Health Care: $10, 14D Pap Smears and Pelvic Exams Screening: $0, 14E Prostate Cancer Screening: $0, 14F Colorectal Screening $0, 14I Diabetes Monitoring $0, 14J Nutrition Therapy: $0, 17A Vision Exams: $10, 18A Medicare Covered Hearing Exams: $10"	"15 Part B Drugs: $0, Home Infusion Drugs $0"	"13A Blood: Not Covered, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $10, 17B Eye Wear: Medicare Covered: $0"	10B Transportation: Not Covered	16A Preventive Dental Service and 16B Non Medicare Covered Comprehensive Dental: combined $150 Max Benefit	"17A Routine Eye Exams: $10, 17B Eye Wear: $100 limit every 2 years"	17B Routine: Not Covered	18A Routine Hearing Exams: $10	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Health Club Membership $150 Max Benefit	13B Acupuncture: Not Covered											200	200	25	0	50	0	0	47.61093787	100	0	0	10	0	10	10	10	10	10	0	10	0	10	0	0	10	0	10	0	0	0											197.5869751	197.5869751	24.69837188	0	49.39674377	0	0	47.03650598	98.79348754	0	0	9.879348754	0	9.879348754	9.879348754	9.879348754	9.879348754	9.879348754	0	9.879348754	0	9.879348754	0	0	9.879348754	0	9.879348754	0	0	0											3.8941	0.05779419	2.156435431	0	0.734406088	0	0	0.980475967	2.402822273	0	0	0.077626983	0	1.366091647	4.297162698	5.027534718	0.127739979	0.496297317	0	1.12743128	0	0.577999532	0	0	0.286435252	0	0.135857511	0	0	0	0	0	0	0	0	0	0	0	0	0	23.7462	0	0.29	3.8941	0.05779419	2.156435431	0	0.734406088	0	0	0.980475967	2.402822273	0	0	0.077626983	0	1.366091647	4.297162698	5.027534718	0.127739979	0.496297317	0	1.12743128	0	0.577999532	0	0	0.286435252	0	0.135857511	0	0	0	0	0	0	0	0	0	0	0	0	0	23.7462	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.8941	0.05779419	2.156435431	0	0.734406088	0	0	0.980475967	2.402822273	0	0	0.077626983	0	1.366091647	4.297162698	5.027534718	0.127739979	0.496297317	0	1.12743128	0	0.577999532	0	0	0.286435252	0	0.135857511	0	0	0	0	0	0	0	0	0	0	0	0	0	23.7462
H8578_003_0	2009	3																					3350											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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	236.5	3.51	1047.73	0	178.41	0	0	250.14	291.86	0	0	94.29	0	1659.33	5219.57	6106.72	155.16	602.83	0	1369.44	0	702.07	0	0	347.92	0	165.02	0	0	0											PBP: 1A IP Acute: $200 per admit	1B IP Psych: $200 per admit	2 SNF: $25 for Days 11 - 100	6 Home Health: $0	10A Ambulance: $50 Per Run	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50 per visit (waived if admitted), 4B Urgent Care: $10 per Visit"	9B ASC Services: $100 per Case	8A OP C/D/T: $0 general	"8B OP X-Ray: $0 general, $0 for CT/MRI/PET"	9A OP Hospital: $10	12 Renal Dialysis: $0	"3 CORF: $10, 5 Partial Hosp: $10, 9C OP Substance Abuse: $10, 9D Cardiac Rehab: $0"	"7A PCP: $10, 14B Immunizations: $0, 14C Routine Physical Exams: $10"	7D Physician Specialist (excl. Radiology): $10	"7E Mental Health: $10, 7H Psychiatric: $10"	"7C Occupational Therapy: $10, 7I Physical and Speech Therapy: $10"	"8B OP X-Ray: $0 general and $0 for CT/MRI/PET, 14G Bone Mass Measurement: $0, 14H Mammogragy Screening $0,"	"7B Chiropractic Services: $10, 7F Podiatry Services: $10, 7G Other Health Care: $10, 14D Pap Smears and Pelvic Exams Screening: $0, 14E Prostate Cancer Screening: $0, 14F Colorectal Screening $0, 14I Diabetes Monitoring $0, 14J Nutrition Therapy: $0, 17A Vision Exams: $10, 18A Medicare Covered Hearing Exams: $10"	"15 Part B Drugs: $0, Home Infusion Drugs $0"	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $10, 17B Eye Wear: Medicare Covered: $0"	10B Transportation: Not Covered	16A Preventive Dental Service and 16B Non Medicare Covered Comprehensive Dental: combined $150 Max Benefit	17A Routine Eye Exams: $10	17B Eye Wear: $100 limit every 2 years	18A Routine Hearing Exams: $10	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Health Club Membership $150 Max Benefit	13B Acupuncture: Not Covered											200	200	25	0	50	0	0	47.61093787	100	0	0	10	0	10	10	10	10	10	0	10	0	10	0	0	10	0	10	0	0	0											197.5869751	197.5869751	24.69837188	0	49.39674377	0	0	47.03650598	98.79348754	0	0	9.879348754	0	9.879348754	9.879348754	9.879348754	9.879348754	9.879348754	0	9.879348754	0	9.879348754	0	0	9.879348754	0	9.879348754	0	0	0											3.8941	0.05779419	2.156435431	0	0.734406088	0	0	0.980475967	2.402822273	0	0	0.077626983	0	1.366091647	4.297162698	5.027534718	0.127739979	0.496297317	0	1.12743128	0	0.577999532	0	0	0.286435252	0	0.135857511	0	0	0	0	0	0	0	0	0	0	0	0	0	23.7462	0	0.29	3.8941	0.05779419	2.156435431	0	0.734406088	0	0	0.980475967	2.402822273	0	0	0.077626983	0	1.366091647	4.297162698	5.027534718	0.127739979	0.496297317	0	1.12743128	0	0.577999532	0	0	0.286435252	0	0.135857511	0	0	0	0	0	0	0	0	0	0	0	0	0	23.7462	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	3.8941	0.05779419	2.156435431	0	0.734406088	0	0	0.980475967	2.402822273	0	0	0.077626983	0	1.366091647	4.297162698	5.027534718	0.127739979	0.496297317	0	1.12743128	0	0.577999532	0	0	0.286435252	0	0.135857511	0	0	0	0	0	0	0	0	0	0	0	0	0	23.7462
H8578_004_0	2009	7																					3350											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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	237.12	3.52	1018.53	0	176.59	7.65	5.39	247.14	285.73	0	268.66	93.14	0	1639.13	5016.68	5892.69	149.97	578.04	1579.03	1312.7	0	673.21	0	0	337.05	0	159.87	0	0	0											PBP: 1A IP Acute: $400 per admit	1B IP Psych: $400 per admit	2 SNF: $50 for Days 11 - 100	6 Home Health: $0	10A Ambulance: $50 Per Run	11A DME: 10%	"11B Prosthetic Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: 10%"	"4A ER: $50 per visit (waived if admitted), 4B Urgent Care: $15 per Visit"	9B ASC Services: $200 per Case	8A OP C/D/T: $0	"8B OP X-Ray: $0 general, $100 for CT/MRI/PET"	9A OP Hospital: $15	12 Renal Dialysis: $0	"3 CORF: $15, 5 Partial Hosp: $15, 9C OP Substance Abuse: $15, 9D Cardiac Rehab: $0"	"7A PCP: $15, 14B Immunizations: $0, 14C Routine Physical Exams: $15"	"7B Chiropractic: $15, 7D Physician Specialist (excl. Radiology): $15, 7F Podiatry: $15"	"7E Mental Health: $15, 7H Psychiatric: $15"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	"8B OP X-Ray: $0 general and $50 for CT/MRI/PET, 14G Bone Mass Measurement: $0, 14H Mammogragy Screening $0,"	"7B Chiropractic Services: $10, 7F Podiatry Services: $15, 7G Other Health Care: $15, 14D Pap Smears and Pelvic Exams Screening: $0, 14E Prostate Cancer Screening: $0, 14F Colorectal Screening $0, 14I Diabetes Monitoring $0, 14J Nutrition Therapy: $0, 17A Vision Exams: $15, 18A Medicare Covered Hearing Exams: $15"	"15 Part B Drugs: $0, Home Infusion Drugs $0"	"13A Blood: Not Covered, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $15"	10B Transportation: Not Covered	16A Preventive Dental Service and 16B Non Medicare Covered Comprehensive Dental: combined $150 Max Benefit	"17A Routine Eye Exams: $15, 17B Eye Wear: $100 limit every 2 years"	17B Routine: Not Covered	18A Routine Hearing Exams: $15	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Health Club Membership $150 Max Benefit	13B Acupuncture: Not Covered											400	400	50	0	50	0.099999978	0.099942896	47.97058347	200	0	50	15	0	15	15	15	15	15	9	15	0	15	0	0	15	0	15	0	0	0											390.5155064	390.5155064	48.8144383	0	48.8144383	0.097628855	0.097573127	46.83314175	195.2577532	0	48.8144383	14.64433149	0	14.64433149	14.64433149	14.64433149	14.64433149	14.64433149	8.786598894	14.64433149	0	14.64433149	0	0	14.64433149	0	14.64433149	0	0	0											7.7166	0.114551215	4.143247487	0	0.718345138	0.74686074	0.525919154	0.964528554	4.649249819	0	1.092873916	0.11366442	0	2.000330256	6.122160409	7.191208811	0.183017533	0.705417448	1.156191938	1.601967829	0	0.8215592	0	0	0.411322661	0	0.195099106	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1741	0	1	7.7166	0.114551215	4.143247487	0	0.718345138	0.74686074	0.525919154	0.964528554	4.649249819	0	1.092873916	0.11366442	0	2.000330256	6.122160409	7.191208811	0.183017533	0.705417448	1.156191938	1.601967829	0	0.8215592	0	0	0.411322661	0	0.195099106	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1741	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.7166	0.114551215	4.143247487	0	0.718345138	0.74686074	0.525919154	0.964528554	4.649249819	0	1.092873916	0.11366442	0	2.000330256	6.122160409	7.191208811	0.183017533	0.705417448	1.156191938	1.601967829	0	0.8215592	0	0	0.411322661	0	0.195099106	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1741
H8578_005_0	2009	7																					3350											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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	237.12	3.52	1018.53	0	176.59	7.65	5.39	247.14	285.73	0	268.66	93.14	0	1639.13	5016.68	5892.69	149.97	578.04	1579.03	1312.7	0	673.21	0	0	337.05	0	159.87	0	0	0											PBP: 1A IP Acute: $400 per admit	1B IP Psych: $400 per admit	2 SNF: $50 for Days 11 - 100	6 Home Health: $0	10A Ambulance: $50 Per Run	11A DME: 10%	"11B Prosthetic Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: 10%"	"4A ER: $50 per visit (waived if admitted), 4B Urgent Care: $15 per Visit"	9B ASC Services: $200 per Case	8A OP C/D/T: $0	"8B OP X-Ray: $0 general, $100 for CT/MRI/PET"	9A OP Hospital: $15	12 Renal Dialysis: $0	"3 CORF: $15, 5 Partial Hosp: $15, 9C OP Substance Abuse: $15, 9D Cardiac Rehab: $0"	"7A PCP: $15, 14B Immunizations: $0, 14C Routine Physical Exams: $15"	"7B Chiropractic: $15, 7D Physician Specialist (excl. Radiology): $15, 7F Podiatry: $15"	"7E Mental Health: $15, 7H Psychiatric: $15"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	"8B OP X-Ray: $0 general and $50 for CT/MRI/PET, 14G Bone Mass Measurement: $0, 14H Mammogragy Screening $0,"	"7B Chiropractic Services: $10, 7F Podiatry Services: $15, 7G Other Health Care: $15, 14D Pap Smears and Pelvic Exams Screening: $0, 14E Prostate Cancer Screening: $0, 14F Colorectal Screening $0, 14I Diabetes Monitoring $0, 14J Nutrition Therapy: $0, 17A Vision Exams: $15, 18A Medicare Covered Hearing Exams: $15"	"15 Part B Drugs: $0, Home Infusion Drugs $0"	"13A Blood: Not Covered, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $15"	10B Transportation: Not Covered	16A Preventive Dental Service and 16B Non Medicare Covered Comprehensive Dental: combined $150 Max Benefit	"17A Routine Eye Exams: $15, 17B Eye Wear: $100 limit every 2 years"	17B Routine: Not Covered	18A Routine Hearing Exams: $15	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Health Club Membership $150 Max Benefit	13B Acupuncture: Not Covered											400	400	50	0	50	0.099999978	0.099942896	47.97058347	200	0	50	15	0	15	15	15	15	15	9	15	0	15	0	0	15	0	15	0	0	0											390.5155064	390.5155064	48.8144383	0	48.8144383	0.097628855	0.097573127	46.83314175	195.2577532	0	48.8144383	14.64433149	0	14.64433149	14.64433149	14.64433149	14.64433149	14.64433149	8.786598894	14.64433149	0	14.64433149	0	0	14.64433149	0	14.64433149	0	0	0											7.7166	0.114551215	4.143247487	0	0.718345138	0.74686074	0.525919154	0.964528554	4.649249819	0	1.092873916	0.11366442	0	2.000330256	6.122160409	7.191208811	0.183017533	0.705417448	1.156191938	1.601967829	0	0.8215592	0	0	0.411322661	0	0.195099106	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1741	0	1	7.7166	0.114551215	4.143247487	0	0.718345138	0.74686074	0.525919154	0.964528554	4.649249819	0	1.092873916	0.11366442	0	2.000330256	6.122160409	7.191208811	0.183017533	0.705417448	1.156191938	1.601967829	0	0.8215592	0	0	0.411322661	0	0.195099106	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1741	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.7166	0.114551215	4.143247487	0	0.718345138	0.74686074	0.525919154	0.964528554	4.649249819	0	1.092873916	0.11366442	0	2.000330256	6.122160409	7.191208811	0.183017533	0.705417448	1.156191938	1.601967829	0	0.8215592	0	0	0.411322661	0	0.195099106	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1741
H8578_006_0	2009	3																					3350											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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	237.12	3.52	1018.53	0	176.59	7.65	5.39	247.14	285.73	0	268.66	93.14	0	1639.13	5016.68	5892.69	149.97	578.04	1579.03	1312.7	0	673.21	0	0	337.05	0	159.87	0	0	0											PBP: 1A IP Acute: $400 per admit	1B IP Psych: $400 per admit	2 SNF: $50 for Days 11 - 100	6 Home Health: $0	10A Ambulance: $50 Per Run	11A DME: 10%	"11B Prosthetic Medical Supplies: 10%, 11C Diabetes Monitoring Supplies: 10%"	"4A ER: $50 per visit (waived if admitted), 4B Urgent Care: $15 per Visit"	9B ASC Services: $200 per Case	8A OP C/D/T: $0	"8B OP X-Ray: $0 general, $50 for CT/MRI/PET"	9A OP Hospital: $15	12 Renal Dialysis: $0	"3 CORF: $15, 5 Partial Hosp: $15, 9C OP Substance Abuse: $15, 9D Cardiac Rehab: $0"	"7A PCP: $15, 14B Immunizations: $0, 14C Routine Physical Exams: $15"	7D Physician Specialist (excl. Radiology): $15	"7E Mental Health: $15, 7H Psychiatric: $15"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	"8B OP X-Ray: $0 general and $50 for CT/MRI/PET, 14G Bone Mass Measurement: $0, 14H Mammogragy Screening $0,"	"7B Chiropractic Services: $15, 7F Podiatry Services: $15, 7G Other Health Care: $15, 14D Pap Smears and Pelvic Exams Screening: $0, 14E Prostate Cancer Screening: $0, 14F Colorectal Screening $0, 14I Diabetes Monitoring $0, 14J Nutrition Therapy: $0, 17A Vision Exams: $15, 18A Medicare Covered Hearing Exams: $15"	"15 Part B Drugs: $0, Home Infusion Drugs $0"	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $15"	10B Transportation: Not Covered	16A Preventive Dental Service and 16B Non Medicare Covered Comprehensive Dental: combined $150 Max Benefit	17A Routine Eye Exams: $15	17B Eye Wear: $100 limit every 2 years	18A Routine Hearing Exams: $15	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Health Club Membership $150 Max Benefit	13B Acupuncture: Not Covered											400	400	50	0	50	0.099999978	0.099942896	47.97058347	200	0	50	15	0	15	15	15	15	15	9	15	0	15	0	0	15	0	15	0	0	0											390.5155064	390.5155064	48.8144383	0	48.8144383	0.097628855	0.097573127	46.83314175	195.2577532	0	48.8144383	14.64433149	0	14.64433149	14.64433149	14.64433149	14.64433149	14.64433149	8.786598894	14.64433149	0	14.64433149	0	0	14.64433149	0	14.64433149	0	0	0											7.7166	0.114551215	4.143247487	0	0.718345138	0.74686074	0.525919154	0.964528554	4.649249819	0	1.092873916	0.11366442	0	2.000330256	6.122160409	7.191208811	0.183017533	0.705417448	1.156191938	1.601967829	0	0.8215592	0	0	0.411322661	0	0.195099106	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1741	0	1	7.7166	0.114551215	4.143247487	0	0.718345138	0.74686074	0.525919154	0.964528554	4.649249819	0	1.092873916	0.11366442	0	2.000330256	6.122160409	7.191208811	0.183017533	0.705417448	1.156191938	1.601967829	0	0.8215592	0	0	0.411322661	0	0.195099106	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1741	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.7166	0.114551215	4.143247487	0	0.718345138	0.74686074	0.525919154	0.964528554	4.649249819	0	1.092873916	0.11366442	0	2.000330256	6.122160409	7.191208811	0.183017533	0.705417448	1.156191938	1.601967829	0	0.8215592	0	0	0.411322661	0	0.195099106	0	0	0	0	0	0	0	0	0	0	0	0	0	41.1741
H8578_007_0	2009	7																					3350											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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	236.95	3.52	989.78	0	173.91	7.18	5.07	243.87	282.82	0	265.92	91.72	0	1614.27	4729.59	5609.31	142.47	541.39	1505.37	1221.98	0	630.52	0	0	318.93	0	151.27	0	0	0											PBP: 1A IP Acute: $500 per admit	1B IP Psych: $500 per admit	2 SNF: $100 for Days 11 - 100	6 Home Health: $0	10A Ambulance: $75 Per Run	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50 per visit (waived if admitted), 4B Urgent Care: $25 per Visit"	9B ASC Services: $250 per Case	8A OP C/D/T: $0	"8B OP X-Ray: $0 general, $100 for CT/MRI/PET"	9A OP Hospital: $25	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $25, 9C OP Substance Abuse: $25, 9D Cardiac Rehab: $0"	"7A PCP: $25, 14B Immunizations: $0, 14C Routine Physical Exams: $25"	"7B Chiropractic: $25, 7D Physician Specialist (excl. Radiology): $25, 7F Podiatry: $25"	"7E Mental Health: $25, 7H Psychiatric: $25"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	"8B OP X-Ray: $0 general and $100 for CT/MRI/PET, 14G Bone Mass Measurement: $0, 14H Mammogragy Screening $0,"	"7B Chiropractic Services: $25, 7F Podiatry Services: $10, 7G Other Health Care: $25, 14D Pap Smears and Pelvic Exams Screening: $0, 14E Prostate Cancer Screening: $0, 14F Colorectal Screening $0, 14I Diabetes Monitoring $0, 14J Nutrition Therapy: $0, 17A Vision Exams: $25, 18A Medicare Covered Hearing Exams: $25"	"15 Part B Drugs: $0, Home Infusion Drugs $0"	"13A Blood: Not Covered, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $25"	10B Transportation: Not Covered	16A Preventive Dental Service and 16B Non Medicare Covered Comprehensive Dental: combined $150 Max Benefit	"17A Routine Eye Exams: $25, 17B Eye Wear: $100 limit every 2 years"	17B Routine: Not Covered	18A Routine Hearing Exams: $25	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Health Club Membership $150 Max Benefit	13B Acupuncture: Not Covered											500	500	100	0	75	0.200000027	0.199921377	48.62426703	250	0	100	25	0	25	25	25	25	25	18	25	0	25	0	0	25	0	25	0	0	0											487.1349307	487.1349307	97.42698614	0	73.07023961	0.194853998	0.194777372	47.3731579	243.5674654	0	97.42698614	24.35674654	0	24.35674654	24.35674654	24.35674654	24.35674654	24.35674654	17.53685751	24.35674654	0	24.35674654	0	0	24.35674654	0	24.35674654	0	0	0											9.6189	0.142892913	8.035940195	0	1.058970448	1.399051709	0.987521276	0.962741001	5.740479213	0	2.158982013	0.186166733	0	3.276530436	9.599785404	11.38537849	0.289175473	1.098874917	2.199954932	2.480288094	0	1.279784652	0	0	0.647341431	0	0.307037087	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8558	0	1.66	9.6189	0.142892913	8.035940195	0	1.058970448	1.399051709	0.987521276	0.962741001	5.740479213	0	2.158982013	0.186166733	0	3.276530436	9.599785404	11.38537849	0.289175473	1.098874917	2.199954932	2.480288094	0	1.279784652	0	0	0.647341431	0	0.307037087	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8558	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	9.6189	0.142892913	8.035940195	0	1.058970448	1.399051709	0.987521276	0.962741001	5.740479213	0	2.158982013	0.186166733	0	3.276530436	9.599785404	11.38537849	0.289175473	1.098874917	2.199954932	2.480288094	0	1.279784652	0	0	0.647341431	0	0.307037087	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8558
H8578_008_0	2009	6																					3350											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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	236.95	3.52	989.78	0	173.91	7.18	5.07	243.87	282.82	0	265.92	91.72	0	1614.27	4729.59	5609.31	142.47	541.39	1505.37	1221.98	0	630.52	0	0	318.93	0	151.27	0	0	0											PBP: 1A IP Acute: $500 per admit	1B IP Psych: $500 per admit	2 SNF: $100 for Days 11 - 100	6 Home Health: $0	10A Ambulance: $75 Per Run	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50 per visit (waived if admitted), 4B Urgent Care: $25 per Visit"	9B ASC Services: $250 per Case	8A OP C/D/T: $0	"8B OP X-Ray: $0 general, $100 for CT/MRI/PET"	9A OP Hospital: $25	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $25, 9C OP Substance Abuse: $25, 9D Cardiac Rehab: $0"	"7A PCP: $25, 14B Immunizations: $0, 14C Routine Physical Exams: $25"	"7B Chiropractic: $25, 7D Physician Specialist (excl. Radiology): $25, 7F Podiatry: $25"	"7E Mental Health: $25, 7H Psychiatric: $25"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	"8B OP X-Ray: $0 general and $100 for CT/MRI/PET, 14G Bone Mass Measurement: $0, 14H Mammogragy Screening $0,"	"7B Chiropractic Services: $25, 7F Podiatry Services: $10, 7G Other Health Care: $25, 14D Pap Smears and Pelvic Exams Screening: $0, 14E Prostate Cancer Screening: $0, 14F Colorectal Screening $0, 14I Diabetes Monitoring $0, 14J Nutrition Therapy: $0, 17A Vision Exams: $25, 18A Medicare Covered Hearing Exams: $25"	"15 Part B Drugs: $0, Home Infusion Drugs $0"	"13A Blood: Not Covered, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $25"	10B Transportation: Not Covered	16A Preventive Dental Service and 16B Non Medicare Covered Comprehensive Dental: combined $150 Max Benefit	"17A Routine Eye Exams: $25, 17B Eye Wear: $100 limit every 2 years"	17B Routine: Not Covered	18A Routine Hearing Exams: $25	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Health Club Membership $150 Max Benefit	13B Acupuncture: Not Covered											500	500	100	0	75	0.200000027	0.199921377	48.62426703	250	0	100	25	0	25	25	25	25	25	18	25	0	25	0	0	25	0	25	0	0	0											487.1349307	487.1349307	97.42698614	0	73.07023961	0.194853998	0.194777372	47.3731579	243.5674654	0	97.42698614	24.35674654	0	24.35674654	24.35674654	24.35674654	24.35674654	24.35674654	17.53685751	24.35674654	0	24.35674654	0	0	24.35674654	0	24.35674654	0	0	0											9.6189	0.142892913	8.035940195	0	1.058970448	1.399051709	0.987521276	0.962741001	5.740479213	0	2.158982013	0.186166733	0	3.276530436	9.599785404	11.38537849	0.289175473	1.098874917	2.199954932	2.480288094	0	1.279784652	0	0	0.647341431	0	0.307037087	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8558	0	1.66	9.6189	0.142892913	8.035940195	0	1.058970448	1.399051709	0.987521276	0.962741001	5.740479213	0	2.158982013	0.186166733	0	3.276530436	9.599785404	11.38537849	0.289175473	1.098874917	2.199954932	2.480288094	0	1.279784652	0	0	0.647341431	0	0.307037087	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8558	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	9.6189	0.142892913	8.035940195	0	1.058970448	1.399051709	0.987521276	0.962741001	5.740479213	0	2.158982013	0.186166733	0	3.276530436	9.599785404	11.38537849	0.289175473	1.098874917	2.199954932	2.480288094	0	1.279784652	0	0	0.647341431	0	0.307037087	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8558
H8578_009_0	2009	3																					3350											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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	236.95	3.52	989.78	0	173.91	7.18	5.07	243.87	282.82	0	265.92	91.72	0	1614.27	4729.59	5609.31	142.47	541.39	1505.37	1221.98	0	630.52	0	0	318.93	0	151.27	0	0	0											PBP: 1A IP Acute: $500 per admit	1B IP Psych: $500 per admit	2 SNF: $100 for Days 11 - 100	6 Home Health: $0	10A Ambulance: $75 Per Run	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies:20%"	"4A ER: $50 per visit (waived if admitted), 4B Urgent Care: $25 per Visit"	9B ASC Services: $250 per Case	8A OP C/D/T: $0	"8B OP X-Ray: $0 general, $100 for CT/MRI/PET"	9A OP Hospital: $25	12 Renal Dialysis: $0	"3 CORF: $25, 5 Partial Hosp: $25, 9C OP Substance Abuse: $25, 9D Cardiac Rehab: $0"	"7A PCP: $25, 14B Immunizations: $0, 14C Routine Physical Exams: $25"	7D Physician Specialist (excl. Radiology): $25	"7E Mental Health: $25, 7H Psychiatric: $25"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	"8B OP X-Ray: $0 general and $100 for CT/MRI/PET, 14G Bone Mass Measurement: $0, 14H Mammogragy Screening $0,"	"7B Chiropractic Services: $25, 7F Podiatry Services: $25, 7G Other Health Care: $25, 14D Pap Smears and Pelvic Exams Screening: $0, 14E Prostate Cancer Screening: $0, 14F Colorectal Screening $0, 14I Diabetes Monitoring $0, 14J Nutrition Therapy: $0, 17A Vision Exams: $25, 18A Medicare Covered Hearing Exams: $25"	"15 Part B Drugs: $0, Home Infusion 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 Service and 16B Non Medicare Covered Comprehensive Dental: combined $150 Max Benefit	17A Routine Eye Exams: $25	17B Eye Wear: $100 limit every 2 years	18A Routine Hearing Exams: $25	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Health Club Membership $150 Max Benefit	13B Acupuncture: Not Covered											500	500	100	0	75	0.200000027	0.199921377	48.62426703	250	0	100	25	0	25	25	25	25	25	18	25	0	25	0	0	25	0	25	0	0	0											487.1349307	487.1349307	97.42698614	0	73.07023961	0.194853998	0.194777372	47.3731579	243.5674654	0	97.42698614	24.35674654	0	24.35674654	24.35674654	24.35674654	24.35674654	24.35674654	17.53685751	24.35674654	0	24.35674654	0	0	24.35674654	0	24.35674654	0	0	0											9.6189	0.142892913	8.035940195	0	1.058970448	1.399051709	0.987521276	0.962741001	5.740479213	0	2.158982013	0.186166733	0	3.276530436	9.599785404	11.38537849	0.289175473	1.098874917	2.199954932	2.480288094	0	1.279784652	0	0	0.647341431	0	0.307037087	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8558	0	1.66	9.6189	0.142892913	8.035940195	0	1.058970448	1.399051709	0.987521276	0.962741001	5.740479213	0	2.158982013	0.186166733	0	3.276530436	9.599785404	11.38537849	0.289175473	1.098874917	2.199954932	2.480288094	0	1.279784652	0	0	0.647341431	0	0.307037087	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8558	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	9.6189	0.142892913	8.035940195	0	1.058970448	1.399051709	0.987521276	0.962741001	5.740479213	0	2.158982013	0.186166733	0	3.276530436	9.599785404	11.38537849	0.289175473	1.098874917	2.199954932	2.480288094	0	1.279784652	0	0	0.647341431	0	0.307037087	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8558
H8578_801_0	2009	1																					3350											Coin	Coin	Coin	Coin	Coin	Coin	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	257.21	2.72	65.49	34.48	5.05	10.88	7.64	11.42	31.81	13.98	27.45	1.57	0.27	32.56	42.83	101.06	1.24	4.63	28.32	35.24	8.74	6.81	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											0.073200844	0.073207683	0.184809855	0	0.231187545	0.231000144	0.231084169	0.230906785	0.230999971	0.230981284	0.231026033	0.23100019	0.231000017	0.231026707	0.231011896	0.231004107	0.231007337	0.231013512	0.231000921	0.231003258	0.231000389	0.230996345	0	0	0	0	0	0	0	0											0.073200844	0.073207683	0.184809855	0	0.231187545	0.231000144	0.231084169	0.230906785	0.230999971	0.230981284	0.231026033	0.23100019	0.231000017	0.231026707	0.231011896	0.231004107	0.231007337	0.231013512	0.231000921	0.231003258	0.231000389	0.230996345	0	0	0	0	0	0	0	0											18.828	0.199124899	12.10319739	0	1.1674971	2.513281571	1.765483052	2.636955487	7.348109087	3.229118351	6.341664601	0.362670298	0.062370005	7.522229577	9.894239521	23.3452751	0.286449098	1.069592563	6.541946088	8.140554824	2.018943397	1.573085112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.9498	0	0	18.828	0.199124899	12.10319739	0	1.1674971	2.513281571	1.765483052	2.636955487	7.348109087	3.229118351	6.341664601	0.362670298	0.062370005	7.522229577	9.894239521	23.3452751	0.286449098	1.069592563	6.541946088	8.140554824	2.018943397	1.573085112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.9498	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.828	0.199124899	12.10319739	0	1.1674971	2.513281571	1.765483052	2.636955487	7.348109087	3.229118351	6.341664601	0.362670298	0.062370005	7.522229577	9.894239521	23.3452751	0.286449098	1.069592563	6.541946088	8.140554824	2.018943397	1.573085112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.9498
H8578_802_0	2009	1																					3350											Coin	Coin	Coin	Coin	Coin	Coin	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	257.21	2.72	65.49	34.48	5.05	10.88	7.64	11.42	31.81	13.98	27.45	1.57	0.27	32.56	42.83	101.06	1.24	4.63	28.32	35.24	8.74	6.81	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											0.073200844	0.073207683	0.184809855	0	0.231187545	0.231000144	0.231084169	0.230906785	0.230999971	0.230981284	0.231026033	0.23100019	0.231000017	0.231026707	0.231011896	0.231004107	0.231007337	0.231013512	0.231000921	0.231003258	0.231000389	0.230996345	0	0	0	0	0	0	0	0											0.073200844	0.073207683	0.184809855	0	0.231187545	0.231000144	0.231084169	0.230906785	0.230999971	0.230981284	0.231026033	0.23100019	0.231000017	0.231026707	0.231011896	0.231004107	0.231007337	0.231013512	0.231000921	0.231003258	0.231000389	0.230996345	0	0	0	0	0	0	0	0											18.828	0.199124899	12.10319739	0	1.1674971	2.513281571	1.765483052	2.636955487	7.348109087	3.229118351	6.341664601	0.362670298	0.062370005	7.522229577	9.894239521	23.3452751	0.286449098	1.069592563	6.541946088	8.140554824	2.018943397	1.573085112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.9498	0	0	18.828	0.199124899	12.10319739	0	1.1674971	2.513281571	1.765483052	2.636955487	7.348109087	3.229118351	6.341664601	0.362670298	0.062370005	7.522229577	9.894239521	23.3452751	0.286449098	1.069592563	6.541946088	8.140554824	2.018943397	1.573085112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.9498	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.828	0.199124899	12.10319739	0	1.1674971	2.513281571	1.765483052	2.636955487	7.348109087	3.229118351	6.341664601	0.362670298	0.062370005	7.522229577	9.894239521	23.3452751	0.286449098	1.069592563	6.541946088	8.140554824	2.018943397	1.573085112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.9498
H8578_803_0	2009	1																					3350											Coin	Coin	Coin	Coin	Coin	Coin	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	257.21	2.72	65.49	34.48	5.05	10.88	7.64	11.42	31.81	13.98	27.45	1.57	0.27	32.56	42.83	101.06	1.24	4.63	28.32	35.24	8.74	6.81	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											0.073200844	0.073207683	0.184809855	0	0.231187545	0.231000144	0.231084169	0.230906785	0.230999971	0.230981284	0.231026033	0.23100019	0.231000017	0.231026707	0.231011896	0.231004107	0.231007337	0.231013512	0.231000921	0.231003258	0.231000389	0.230996345	0	0	0	0	0	0	0	0											0.073200844	0.073207683	0.184809855	0	0.231187545	0.231000144	0.231084169	0.230906785	0.230999971	0.230981284	0.231026033	0.23100019	0.231000017	0.231026707	0.231011896	0.231004107	0.231007337	0.231013512	0.231000921	0.231003258	0.231000389	0.230996345	0	0	0	0	0	0	0	0											18.828	0.199124899	12.10319739	0	1.1674971	2.513281571	1.765483052	2.636955487	7.348109087	3.229118351	6.341664601	0.362670298	0.062370005	7.522229577	9.894239521	23.3452751	0.286449098	1.069592563	6.541946088	8.140554824	2.018943397	1.573085112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.9498	0	0	18.828	0.199124899	12.10319739	0	1.1674971	2.513281571	1.765483052	2.636955487	7.348109087	3.229118351	6.341664601	0.362670298	0.062370005	7.522229577	9.894239521	23.3452751	0.286449098	1.069592563	6.541946088	8.140554824	2.018943397	1.573085112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.9498	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	18.828	0.199124899	12.10319739	0	1.1674971	2.513281571	1.765483052	2.636955487	7.348109087	3.229118351	6.341664601	0.362670298	0.062370005	7.522229577	9.894239521	23.3452751	0.286449098	1.069592563	6.541946088	8.140554824	2.018943397	1.573085112	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	116.9498
H8604_001_0	2009	7																					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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1648.25	60.99	1878.245	384.845	341.3	13.70240234	0	406.5	430.445	7706.305	653.6	163.21	47	4768.24	4225.315	3448.405	169.1	280.44	52.25	0	18.63319106	0	0	0	186.7	737.8	0.38	0	0	0											$50 / days 1-10	$50 / days 1-10	$25 / days 21-100	$0.00 	$50.00 	20%	20%	$50.00 	$100.00 	$0.00 	$50 Scans	$0.00 	$0.00 	"$25 Rad Ther, CORF"	"$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 	$25.00 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											40.54456999	40.54456999	7.139752391	$0.00 	$50.00 	20%	20%	$50.00 	$100.00 	$0.00 	5	$0.00 	$0.00 	2.5	15	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	0.18	$0.00 	$0.00 	$0.00 	$25.00 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											37.43424009	37.43424009	6.592034525	0	46.1643077	0.184657231	0.184657231	46.1643077	92.32861539	0	4.61643077	0	0	2.308215385	13.84929231	23.08215385	23.08215385	23.08215385	0	0	0.166191508	0	0	0	23.08215385	13.84929231	23.08215385	0	0	0											5.1417	0.190259525	1.031787991	0	1.312989851	2.530247671	0	1.563815923	3.311865904	0	0.251441596	0	0	0.917177077	4.876468544	6.633051229	0.325266018	0.539429935	0	0	3.096678115	0	0	0	0.359119844	0.851500655	0.000730935	0	0	0	0	0	0	0	0	0	0	0	0	0	32.9336		2.7364	5.1417	0.190259525	1.031787991	0	1.312989851	2.530247671	0	1.563815923	3.311865904	0	0.251441596	0	0	0.917177077	4.876468544	6.633051229	0.325266018	0.539429935	0	0	3.096678115	0	0	0	0.359119844	0.851500655	0.000730935	0	0	0	0	0	0	0	0	0	0	0	0	0	32.9336	3750	20%	20%	20%	20%	0	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											2.5231	0.0934	0.5372	0.0323	0	0.2178	0	0	0.4461	0.5634	0.0478	0.0119	0	0.3486	0.4278	0.4888	0.024	0.0397	0.0074	0	0.2056	0	0	0	0	0	0	0	0	0											6.0147	250	0.49974708	7.6648	0.283619987	1.568958914	0.032301905	1.312989851	2.748033542	0	1.563815923	3.757995783	0.56335222	0.299221565	0.011931103	0	1.265748616	5.304228943	7.121802372	0.349232988	0.579177404	0.007405524	0	3.302287759	0	0	0	0.359119844	0.851500655	0.000730935	0	0	0	0	0	0	0	0	0	0	0	0	0	38.9483
H8604_002_0	2009	5																					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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1648.25	60.99	1878.245	384.845	341.3	13.70240234	0	406.5	430.445	7706.305	653.6	163.21	47	4768.24	4225.315	3448.405	169.1	280.44	52.25	0	18.63319106	0	0	0	186.7	737.8	0.38	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	$0.00 	$0.00 	"$25 Rad Ther, CORF"	"$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 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											40.54456999	40.54456999	7.139752391	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	5	$0.00 	$0.00 	2.5	15	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	0.18	$0.00 	$0.00 	$0.00 	$15.00 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											37.43424009	37.43424009	6.592034525	0	23.08215385	0.184657231	0.184657231	46.1643077	92.32861539	0	4.61643077	0	0	2.308215385	13.84929231	23.08215385	23.08215385	23.08215385	0	0	0.166191508	0	0	0	13.84929231	13.84929231	23.08215385	0	0	0											5.1417	0.190259525	1.031787991	0	0.656494926	2.530247671	0	1.563815923	3.311865904	0	0.251441596	0	0	0.917177077	4.876468544	6.633051229	0.325266018	0.539429935	0	0	3.096678115	0	0	0	0.215471906	0.851500655	0.000730935	0	0	0	0	0	0	0	0	0	0	0	0	0	32.1334		2.6699	5.1417	0.190259525	1.031787991	0	0.656494926	2.530247671	0	1.563815923	3.311865904	0	0.251441596	0	0	0.917177077	4.876468544	6.633051229	0.325266018	0.539429935	0	0	3.096678115	0	0	0	0.215471906	0.851500655	0.000730935	0	0	0	0	0	0	0	0	0	0	0	0	0	32.1334	3750	20%	20%	20%	20%	0	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											2.5231	0.0934	0.5372	0.0323	0	0.2178	0	0	0.4461	0.5634	0.0478	0.0119	0	0.3486	0.4278	0.4888	0.024	0.0397	0.0074	0	0.2056	0	0	0	0	0	0	0	0	0											6.0147	250	0.49974708	7.6648	0.283619987	1.568958914	0.032301905	0.656494926	2.748033542	0	1.563815923	3.757995783	0.56335222	0.299221565	0.011931103	0	1.265748616	5.304228943	7.121802372	0.349232988	0.579177404	0.007405524	0	3.302287759	0	0	0	0.215471906	0.851500655	0.000730935	0	0	0	0	0	0	0	0	0	0	0	0	0	38.1481
H8604_003_0	2009	7																					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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1965.835	56.81	2237.06	2519.115	388.5	19.12186347	0	378.1	368.22	15169.6	630.61	113.62	5.7	5800.795	4024.295	3377.44	185.82	41.42	43.035	0	28.6154282	0	0	0	540.2	2322.5	2.09	0	0	0											$50 / days 1-10	$50 / days 1-10	$25 / days 21-100	$0.00 	$50.00 	20%	20%	$50.00 	$100.00 	$0.00 	$50 Scans	$0.00 	$0.00 	"$25 Rad Ther, CORF"	"$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 	$25.00 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											40.54456999	40.54456999	7.139752391	$0.00 	$50.00 	20%	20%	$50.00 	$100.00 	$0.00 	5	$0.00 	$0.00 	2.5	15	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	0.18	$0.00 	$0.00 	$0.00 	$25.00 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											37.43424009	37.43424009	6.592034525	0	46.1643077	0.184657231	0.184657231	46.1643077	92.32861539	0	4.61643077	0	0	2.308215385	13.84929231	23.08215385	23.08215385	23.08215385	0	0	0.166191508	0	0	0	23.08215385	13.84929231	23.08215385	0	0	0											6.1325	0.177219932	1.228898063	0	1.494569462	3.530990355	0	1.454560395	2.833103563	0	0.242597284	0	0	1.115790355	4.644469816	6.496549141	0.357427152	0.079671901	0	0	4.755641156	0	0	0	1.039081626	2.680415116	0.004020142	0	0	0	0	0	0	0	0	0	0	0	0	0	38.2675		3.1796	6.1325	0.177219932	1.228898063	0	1.494569462	3.530990355	0	1.454560395	2.833103563	0	0.242597284	0	0	1.115790355	4.644469816	6.496549141	0.357427152	0.079671901	0	0	4.755641156	0	0	0	1.039081626	2.680415116	0.004020142	0	0	0	0	0	0	0	0	0	0	0	0	0	38.2675	3750	20%	20%	20%	20%	0	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											2.5725	0.0743	0.7195	0.2025	0	0.3039	0	0	0.6286	0.8967	0.0373	0.0067	0	0.3429	0.4074	0.4787	0.0263	0.0059	0.0061	0	0.3158	0	0	0	0	0	0	0	0	0											7.0251	250	0.583696975	8.705	0.251562737	1.948359408	0.202538994	1.494569462	3.834913098	0	1.454560395	3.461674645	0.896651314	0.279871654	0.0067159	0	1.458666269	5.051879449	6.975242236	0.38376389	0.085542462	0.006099459	0	5.071400705	0	0	0	1.039081626	2.680415116	0.004021611	0	0	0	0	0	0	0	0	0	0	0	0	0	45.2925
H8604_004_0	2009	5																					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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1965.835	56.81	2237.06	2519.115	388.5	19.12186347	0	378.1	368.22	15169.6	630.61	113.62	5.7	5800.795	4024.295	3377.44	185.82	41.42	43.035	0	28.6154282	0	0	0	540.2	2322.5	2.09	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	$0.00 	$0.00 	"$25 Rad Ther, CORF"	"$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 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											40.54456999	40.54456999	7.139752391	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	5	$0.00 	$0.00 	2.5	15	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	0.18	$0.00 	$0.00 	$0.00 	$15.00 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											37.43424009	37.43424009	6.592034525	0	23.08215385	0.184657231	0.184657231	46.1643077	92.32861539	0	4.61643077	0	0	2.308215385	13.84929231	23.08215385	23.08215385	23.08215385	0	0	0.166191508	0	0	0	13.84929231	13.84929231	23.08215385	0	0	0											6.1325	0.177219932	1.228898063	0	0.747284731	3.530990355	0	1.454560395	2.833103563	0	0.242597284	0	0	1.115790355	4.644469816	6.496549141	0.357427152	0.079671901	0	0	4.755641156	0	0	0	0.623448975	2.680415116	0.004020142	0	0	0	0	0	0	0	0	0	0	0	0	0	37.1045		3.0829	6.1325	0.177219932	1.228898063	0	0.747284731	3.530990355	0	1.454560395	2.833103563	0	0.242597284	0	0	1.115790355	4.644469816	6.496549141	0.357427152	0.079671901	0	0	4.755641156	0	0	0	0.623448975	2.680415116	0.004020142	0	0	0	0	0	0	0	0	0	0	0	0	0	37.1045	3750	20%	20%	20%	20%	0	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											2.5725	0.0743	0.7195	0.2025	0	0.3039	0	0	0.6286	0.8967	0.0373	0.0067	0	0.3429	0.4074	0.4787	0.0263	0.0059	0.0061	0	0.3158	0	0	0	0	0	0	0	0	0											7.0251	250	0.583696975	8.705	0.251562737	1.948359408	0.202538994	0.747284731	3.834913098	0	1.454560395	3.461674645	0.896651314	0.279871654	0.0067159	0	1.458666269	5.051879449	6.975242236	0.38376389	0.085542462	0.006099459	0	5.071400705	0	0	0	0.623448975	2.680415116	0.004021611	0	0	0	0	0	0	0	0	0	0	0	0	0	44.1296
H8604_801_0	2009	5																					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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1801.58	58.995	2051.525	1415.405	364.1	16.31590354	0	392.8	400.425	11309.75	642.485	139.27	27.1	5266.705	4128.225	3414.015	177.175	165.11	47.785	0	23.4521665	0	0	0	357.4	1503	1.235	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	$0.00 	$0.00 	"$25 Rad Ther, CORF"	"$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 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											40.54456999	40.54456999	7.139752391	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	5	$0.00 	$0.00 	2.5	15	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	0.18	$0.00 	$0.00 	$0.00 	$15.00 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											37.43424009	37.43424009	6.592034525	0	23.08215385	0.184657231	0.184657231	46.1643077	92.32861539	0	4.61643077	0	0	2.308215385	13.84929231	23.08215385	23.08215385	23.08215385	0	0	0.166191508	0	0	0	13.84929231	13.84929231	23.08215385	0	0	0											5.6201	0.184036083	1.126976969	0	0.700351018	3.012849565	0	1.511111672	3.080890485	0	0.247165627	0	0	1.013057459	4.764416229	6.566901623	0.340798384	0.317591202	0	0	3.897550909	0	0	0	0.412478089	1.734623862	0.002375538	0	0	0	0	0	0	0	0	0	0	0	0	0	34.5332		2.8693	5.6201	0.184036083	1.126976969	0	0.700351018	3.012849565	0	1.511111672	3.080890485	0	0.247165627	0	0	1.013057459	4.764416229	6.566901623	0.340798384	0.317591202	0	0	3.897550909	0	0	0	0.412478089	1.734623862	0.002375538	0	0	0	0	0	0	0	0	0	0	0	0	0	34.5332	3750	20%	20%	20%	20%	0	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											2.5476	0.0834	0.6252	0.1145	0	0.2593	0	0	0.5341	0.7312	0.0415	0.009	0	0.3405	0.4179	0.4839	0.0251	0.0234	0.0068	0	0.2588	0	0	0	0	0	0	0	0	0											6.5023	250	0.540259073	8.1677	0.267461365	1.752207396	0.114456023	0.700351018	3.272174404	0	1.511111672	3.614988152	0.731184176	0.288702784	0.009003914	0	1.353554053	5.182347477	7.050778584	0.365909844	0.340992659	0.006772689	0	4.156335977	0	0	0	0.412478089	1.734623862	0.002377008	0	0	0	0	0	0	0	0	0	0	0	0	0	41.0355
H8604_802_0	2009	5																					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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	1801.58	58.995	2051.525	1415.405	364.1	16.31590354	0	392.8	400.425	11309.75	642.485	139.27	27.1	5266.705	4128.225	3414.015	177.175	165.11	47.785	0	23.4521665	0	0	0	357.4	1503	1.235	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	$0.00 	$0.00 	"$25 Rad Ther, CORF"	"$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 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											40.54456999	40.54456999	7.139752391	$0.00 	$25.00 	20%	20%	$50.00 	$100.00 	$0.00 	5	$0.00 	$0.00 	2.5	15	$25.00 	$25.00 	$25.00 	$0.00 	$0.00 	0.18	$0.00 	$0.00 	$0.00 	$15.00 	$15.00 	$25.00 	$0.00 	$0.00 	$0.00 											37.43424009	37.43424009	6.592034525	0	23.08215385	0.184657231	0.184657231	46.1643077	92.32861539	0	4.61643077	0	0	2.308215385	13.84929231	23.08215385	23.08215385	23.08215385	0	0	0.166191508	0	0	0	13.84929231	13.84929231	23.08215385	0	0	0											5.6201	0.184036083	1.126976969	0	0.700351018	3.012849565	0	1.511111672	3.080890485	0	0.247165627	0	0	1.013057459	4.764416229	6.566901623	0.340798384	0.317591202	0	0	3.897550909	0	0	0	0.412478089	1.734623862	0.002375538	0	0	0	0	0	0	0	0	0	0	0	0	0	34.5332		2.8693	5.6201	0.184036083	1.126976969	0	0.700351018	3.012849565	0	1.511111672	3.080890485	0	0.247165627	0	0	1.013057459	4.764416229	6.566901623	0.340798384	0.317591202	0	0	3.897550909	0	0	0	0.412478089	1.734623862	0.002375538	0	0	0	0	0	0	0	0	0	0	0	0	0	34.5332	3750	20%	20%	20%	20%	0	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											2.5476	0.0834	0.6252	0.1145	0	0.2593	0	0	0.5341	0.7312	0.0415	0.009	0	0.3405	0.4179	0.4839	0.0251	0.0234	0.0068	0	0.2588	0	0	0	0	0	0	0	0	0											6.5023	250	0.540259073	8.1677	0.267461365	1.752207396	0.114456023	0.700351018	3.272174404	0	1.511111672	3.614988152	0.731184176	0.288702784	0.009003914	0	1.353554053	5.182347477	7.050778584	0.365909844	0.340992659	0.006772689	0	4.156335977	0	0	0	0.412478089	1.734623862	0.002377008	0	0	0	0	0	0	0	0	0	0	0	0	0	41.0355
H8606_001_0	2009	1																					none											coin	coin	coin	coin	coin	coin	coin	V	coin	coin	coin	O	coin	P	V	V	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	145.5693453	1.575512048	3.427917294	22.38058285	14.03527749	26.70089352	7.53316138	246.3776248	7.778541515	0.866946801	5.248286671	0	0.141305456	0	0	0	0.863827955	3.70752196	19.14742746	0	1.378024626	0.148872467	0	0	0	0	0	0	0	0											1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - 0/admit for 1-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - 0/day for 1-100/2:  Non-Medicare Covered Stay - $0/day for 1-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $0/trip	11a:  Durable Medical Equipment - 20.0%	11b:  Prosthetics Devices - 20.0%/11b:  Medical Supplies - 20.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $25/visit/4b:  Urgently Needed Care / Urgent Care Centers - $0/visit/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $0/visit/8b:  Outpatient Therapeutic Radiological Services - $0/visit/8b:  Outpatient X-Ray Services - $0/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $0/visit/3:  Rehab Services (CORF) - $0/day/5:  Partial Hospitalization - $0/day	7a:  Primary Care - $0/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - $0/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $0/visit/7b:  Chiropractic Services - $0/visit/7f:  Podiatry Services - $0/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $0/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $0/visit/7h:  Psychiatric Services - Individual - $0/visit/7h:  Psychiatric Services - Group - $0/visit	7c:  Occupational Therapy Services - $0/visit/7i:  Physical/Speech Therapy - $0/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $0/visit/9c:  Outpatient Substance Abuse Svcs - Group - $0/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $0/visit		18a:  Routine Hearing Test - $0/visit/18a:  Fitting for Hearing Aid - $0/visit	18b:  Hearing Aids - $0/service	/14c:  Routine Exams - $0/visit												0	0	0	0	0	0.2	0.2	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	0.2	0.2	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	5.340178703	1.506632276	0.513286718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.3601	0	0	0	0	0	0	0	5.340178703	1.506632276	0.513286718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.3601	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	5.340178703	1.506632276	0.513286718	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	7.3601
H8606_002_0	2009	6																					none											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	P	V	V	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	154.1322479	1.668189228	3.629559488	23.69708772	14.86088205	31.4128159	8.758915682	12.19391777	8.23610278	0.917943672	5.557009416	0	0.149617542	0	0	0	0.914641364	3.925611487	20.27374672	0	1.459084898	0.15762967	0	2274.224346	1.8	0	0	0	0	864											1a:  Acute - 0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - 0/admit for 1-190/1b:  Non-Medicare Covered Stay - $0/day	2:  Skilled Nursing Services - 0/day for 1-100/2:  Non-Medicare Covered Stay - $0/day for 1-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $0/trip	11a:  Durable Medical Equipment - $0/service	11b:  Prosthetics Devices - $0/service/11b:  Medical Supplies - $0/service/11c:  Diabetes Monitoring Supplies - $0/service	4a:  Emergency Care / Post Stabilization Care - $0/visit/4b:  Urgently Needed Care / Urgent Care Centers - $0/visit/4a:  Worldwide Coverage - $0/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $0/visit/9b:  Ambulatory Surgical Center Services - $0/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - $0/visit/8b:  Outpatient Therapeutic Radiological Services - $0/visit/8b:  Outpatient X-Ray Services - $0/visit		12:  Renal Dialysis - $0/service/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $0/visit/3:  Rehab Services (CORF) - $0/day/5:  Partial Hospitalization - $0/day	7a:  Primary Care - $0/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - $0/visit/14c:  Physical Exams (Initial Exam) - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14b:  Immunizations (Hepatitis B) - $0/visit	7d:  Physician Specialist Services - $0/visit/7b:  Chiropractic Services - $0/visit/7f:  Podiatry Services - $0/visit/17a:  Vision Exams - $0/visit/18a:  Hearing Exams - $0/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $0/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $0/visit/7h:  Psychiatric Services - Individual - $0/visit/7h:  Psychiatric Services - Group - $0/visit	7c:  Occupational Therapy Services - $0/visit/7i:  Physical/Speech Therapy - $0/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $0/visit/9c:  Outpatient Substance Abuse Svcs - Group - $0/visit/7g:  Other Health Care Professional Services - $0/visit	15:  Medicare Part B Rx Drugs - $0/service	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service			17a:  Routine Eye Exams - $0/visit		18a:  Routine Hearing Test - $0/visit/18a:  Fitting for Hearing Aid - $0/visit	18b:  Hearing Aids - $0/service	/14c:  Routine Exams - $0/visit												0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0
H8644_001_0	2009	3	r.	s.	t.	u.	v.						OP Facility - Other	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered							Renal Dialysis										D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin	V		V		O	O	P	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		1444.98018	64.338207	504.318804	720.785829	143.364975	9.685729	3.497836	324.280814	351.509938	621.461121	922.382014	0	0	705.614541	3453.483725	4162.869419	28.397409	897.260729			21.891392			2.84	2.69		0.77		0.05	0.27	18.908595	1.42	1.23	0.06	2.7						$195/Day(Days 1-7):1a	$195/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$5/Visit:6	$150/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $150 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$150/Visit:14h. $25 DMAM -- OP,8b. $25 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $150 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $150 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $25 Radiology OP -- Facility"	$75/Visit:9a	20% Coins:12	"$0-$150/Visit:9d. $0 Cardiac Rehab,8b. $150 Nuclear Medicine,9a. $50 OP Other,5. $35 Partial Hospitalization,8b. $25 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$50/Visit:7h. $50 Psych -- OP,7e. $35 Psych -- Other Provider"	"$35-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			"DEN 767 16a, 16b"	VIS 752		HER  831		$0 Additional Smoking Cessation 14a	$0: Nutritional benefit 14a	$0/Proc:12	$0: Membership in health club/fitness class 14a	$0: Health Education Materials 14a	$0: Nurse hotline 14a	$0 Corp Health 14a						138.925016	99.659476	43.132811	4.999992	149.999984	0.2	0.199999	49.999997	149.999992	0	56.984029	0	0	42.847841	9.999999	34.999998	47.659136	38.236217			0.2			0	0		0		0	0	0	0	0	0	0						138.925016	99.659476	43.132811	4.999992	149.999984	0.2	0.199999	49.999997	149.999992	0	56.984029	0	0	42.847841	9.999999	34.999998	47.659136	38.236217			0.2			0	0		0		0	0	0	0	0	0	0						16.7287	0.534326	1.812723971	0.300326948	1.792061996	1.9371458	0.699563702	1.351169977	4.393873991	0	4.380086953	0	0	2.519504972	2.877902816	12.14170178	0.112782998	2.858987995	0	0	4.3782784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.8191	0	0	16.7287	0.534326	1.812723971	0.300326948	1.792061996	1.9371458	0.699563702	1.351169977	4.393873991	0	4.380086953	0	0	2.519504972	2.877902816	12.14170178	0.112782998	2.858987995	0	0	4.3782784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.8191		30% Coins	30% Coins	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$150/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		20% Coins	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins			"DEN 767 16a, 16b"	VIS 752		HER  831		0	0	0	0	0	0	0						8.3733	0.1198	0.5249	0.7963	1.4226	2.1936	0.7922	0.2839	3.7908	0.4883	2.0313		0.0003	1.1474	2.3005	5.2522	0.0332	0.4435			1.5677			0	0		0		0	0	0	0	0	0	0						31.5619	1000	0	25.102	0.654156	2.337606971	1.096629948	3.214669996	4.1307458	1.491745702	1.635096977	8.184718991	0.488349	6.411388953	0	0.000263	3.666858972	5.178373816	17.39394478	0.145976998	3.302474995	0	0	5.9460284	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.381
H8644_003_0	2009	3	r.	s.	t.	u.	v.						OP Facility - Other	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered							Renal Dialysis										D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin	V		V		O	O	P	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		1400.108114	62.340263	488.657944	698.402883	138.912986	9.135621	3.299174	314.210628	340.59413	602.162303	893.738386	0	0	683.702488	3346.333022	4033.686258	27.515552	869.39754			20.648047			2.84	2.69		0.77		0.05	0.27	18.321403	1.42	1.23	0.06	2.7						$195/Day(Days 1-7):1a	$195/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$5/Visit:6	$150/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $150 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0/Visit:8, 8a"	"$0-$100/Visit:14h. $25 DMAM -- OP,8b. $25 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $25 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$0-$100/Visit:9d. $0 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $50 OP Other,5. $35 Partial Hospitalization,8b. $25 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$50/Visit:7h. $50 Psych -- OP,7e. $35 Psych -- Other Provider"	"$35-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			"DEN 767 16a, 16b"	VIS 752		HER  831		$0 Additional Smoking Cessation 14a	$0: Nutritional benefit 14a	$0/Proc:12	$0: Membership in health club/fitness class 14a	$0: Health Education Materials 14a	$0: Nurse hotline 14a	$0 Corp Health 14a						138.925023	99.659444	43.132797	4.999996	149.999971	0.199999	0.2	50.000001	150.000013	0	42.988271	0	0	40.353359	10	34.999999	47.658865	38.236202			0.199999			0	0		0		0	0	0	0	0	0	0						138.925023	99.659444	43.132797	4.999996	149.999971	0.199999	0.2	50.000001	150.000013	0	42.988271	0	0	40.353359	10	34.999999	47.658865	38.236202			0.199999			0	0		0		0	0	0	0	0	0	0						16.2092	0.517732996	1.756431992	0.291000968	1.736411989	1.827115064	0.6598348	1.309210976	4.257426994	0	3.201688995	0	0	2.299140996	2.788610852	11.76491792	0.109279998	2.770204996	0	0	4.129588752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6278	0	0	16.2092	0.517732996	1.756431992	0.291000968	1.736411989	1.827115064	0.6598348	1.309210976	4.257426994	0	3.201688995	0	0	2.299140996	2.788610852	11.76491792	0.109279998	2.770204996	0	0	4.129588752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6278		30% Coins	30% Coins	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$150/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		20% Coins	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins			"DEN 767 16a, 16b"	VIS 752		HER  831		0	0	0	0	0	0	0						7.3783	0.1056	0.4625	0.7017	1.2878	1.9329	0.698	0.257	3.3403	0.4303	1.7899		0.0002	1.011	2.0271	4.6281	0.0292	0.3908			1.3814			0	0		0		0	0	0	0	0	0	0						27.8522	500	0	23.5874	0.623321996	2.218938992	0.992672968	3.024171989	3.760032064	1.3578748	1.566223976	7.597772994	0.430313	4.991593995	0	0.000238	3.310144996	4.815697852	16.39299592	0.138527998	3.160989996	0	0	5.511029752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.48
H8644_801_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		251.529411	8.104234	488.657944	698.402883	4.628907	9.135621	3.299174	20.311178	52.210105	602.162303	28.230924	0	0.356236	16.083065	30.298364	69.174715	0.437164	5.840952			20.648047																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999996	1023.999553	43.132797	0	0.199999	0.199999	0.2	0.2	0.2	0	0.2	0	0.199999	0.2	0.2	0.2	0.500002	0.2			0.199999																				1023.999996	1023.999553	43.132797	0	0.199999	0.199999	0.2	0.2	0.2	0	0.2	0	0.199999	0.2	0.2	0.2	0.500002	0.2			0.199999																				21.4638	0.691560999	1.756431992	0	0.925776771	1.827115064	0.6598348	4.0622356	10.442021	0	5.6461848	0	0.071246844	3.216613	6.0596728	13.834943	0.218582874	1.1681904	0	0	4.129588752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1738	0	0	21.4638	0.691560999	1.756431992	0	0.925776771	1.827115064	0.6598348	4.0622356	10.442021	0	5.6461848	0	0.071246844	3.216613	6.0596728	13.834943	0.218582874	1.1681904	0	0	4.129588752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1738		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3849	0.0768	0.1952		0.5869	1.1584	0.4183	0.7652	2.0018		1.0727		0.0134	0.6059	1.2148	2.7735	0.0438	0.2342			0.8279																				14.3737	0	0	23.8487	0.768400999	1.951590992	0	1.512709771	2.985488064	1.0781618	4.8273986	12.443849	0	6.7188518	0	0.084666844	3.822495	7.2744808	16.608492	0.262403874	1.4023824	0	0	4.957468752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.5476
H8644_802_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		251.529411	8.104234	488.657944	698.402883	4.628907	9.135621	3.299174	20.311178	52.210105	602.162303	28.230924	0	0.356236	16.083065	30.298364	69.174715	0.437164	5.840952			20.648047																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999996	1023.999553	43.132797	0	0.199999	0.199999	0.2	0.2	0.2	0	0.2	0	0.199999	0.2	0.2	0.2	0.500002	0.2			0.199999																				1023.999996	1023.999553	43.132797	0	0.199999	0.199999	0.2	0.2	0.2	0	0.2	0	0.199999	0.2	0.2	0.2	0.500002	0.2			0.199999																				21.4638	0.691560999	1.756431992	0	0.925776771	1.827115064	0.6598348	4.0622356	10.442021	0	5.6461848	0	0.071246844	3.216613	6.0596728	13.834943	0.218582874	1.1681904	0	0	4.129588752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1738	0	0	21.4638	0.691560999	1.756431992	0	0.925776771	1.827115064	0.6598348	4.0622356	10.442021	0	5.6461848	0	0.071246844	3.216613	6.0596728	13.834943	0.218582874	1.1681904	0	0	4.129588752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1738		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3849	0.0768	0.1952		0.5869	1.1584	0.4183	0.7652	2.0018		1.0727		0.0134	0.6059	1.2148	2.7735	0.0438	0.2342			0.8279																				14.3737	0	0	23.8487	0.768400999	1.951590992	0	1.512709771	2.985488064	1.0781618	4.8273986	12.443849	0	6.7188518	0	0.084666844	3.822495	7.2744808	16.608492	0.262403874	1.4023824	0	0	4.957468752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.5476
H8644_803_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		251.529411	8.104234	488.657944	698.402883	4.628907	9.135621	3.299174	20.311178	52.210105	602.162303	28.230924	0	0.356236	16.083065	30.298364	69.174715	0.437164	5.840952			20.648047																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999996	1023.999553	43.132797	0	0.199999	0.199999	0.2	0.2	0.2	0	0.2	0	0.199999	0.2	0.2	0.2	0.500002	0.2			0.199999																				1023.999996	1023.999553	43.132797	0	0.199999	0.199999	0.2	0.2	0.2	0	0.2	0	0.199999	0.2	0.2	0.2	0.500002	0.2			0.199999																				21.4638	0.691560999	1.756431992	0	0.925776771	1.827115064	0.6598348	4.0622356	10.442021	0	5.6461848	0	0.071246844	3.216613	6.0596728	13.834943	0.218582874	1.1681904	0	0	4.129588752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1738	0	0	21.4638	0.691560999	1.756431992	0	0.925776771	1.827115064	0.6598348	4.0622356	10.442021	0	5.6461848	0	0.071246844	3.216613	6.0596728	13.834943	0.218582874	1.1681904	0	0	4.129588752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1738		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3849	0.0768	0.1952		0.5869	1.1584	0.4183	0.7652	2.0018		1.0727		0.0134	0.6059	1.2148	2.7735	0.0438	0.2342			0.8279																				14.3737	0	0	23.8487	0.768400999	1.951590992	0	1.512709771	2.985488064	1.0781618	4.8273986	12.443849	0	6.7188518	0	0.084666844	3.822495	7.2744808	16.608492	0.262403874	1.4023824	0	0	4.957468752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.5476
H8644_804_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		251.529411	8.104234	488.657944	698.402883	4.628907	9.135621	3.299174	20.311178	52.210105	602.162303	28.230924	0	0.356236	16.083065	30.298364	69.174715	0.437164	5.840952			20.648047																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999996	1023.999553	43.132797	0	0.199999	0.199999	0.2	0.2	0.2	0	0.2	0	0.199999	0.2	0.2	0.2	0.500002	0.2			0.199999																				1023.999996	1023.999553	43.132797	0	0.199999	0.199999	0.2	0.2	0.2	0	0.2	0	0.199999	0.2	0.2	0.2	0.500002	0.2			0.199999																				21.4638	0.691560999	1.756431992	0	0.925776771	1.827115064	0.6598348	4.0622356	10.442021	0	5.6461848	0	0.071246844	3.216613	6.0596728	13.834943	0.218582874	1.1681904	0	0	4.129588752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1738	0	0	21.4638	0.691560999	1.756431992	0	0.925776771	1.827115064	0.6598348	4.0622356	10.442021	0	5.6461848	0	0.071246844	3.216613	6.0596728	13.834943	0.218582874	1.1681904	0	0	4.129588752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.1738		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.3849	0.0768	0.1952		0.5869	1.1584	0.4183	0.7652	2.0018		1.0727		0.0134	0.6059	1.2148	2.7735	0.0438	0.2342			0.8279																				14.3737	0	0	23.8487	0.768400999	1.951590992	0	1.512709771	2.985488064	1.0781618	4.8273986	12.443849	0	6.7188518	0	0.084666844	3.822495	7.2744808	16.608492	0.262403874	1.4023824	0	0	4.957468752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	90.5476
H8649_001_0	2009	4																					1000											D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	V	Coin	Coin	T	V	V	P	V	P	O	P																																																			0	3000	896.8827279	45.55696458			61.06151901	9.902331762	16.63477061	273.7922561	341.7492447		187.1602644	8.481737026		802.8198956	2746.345129	4072.577483	237.4371766	724.1848384			16.40889555				133.1901121		237.1062288			98.46											1a: $100/d (1-3) then $0;1a1: $100/d (1-3) then $0	1b: $100/d (1-3) then $0	2: $0;2: $0/visit	6: $0	10a: $50/trip	11a: 10%	11b: 10%;11c: $5/visit	4a: $50/visit;4a1: $50/visit;4b: $15/visit	9a: $50/visit;9b: $50/visit	8a: $0/visit	8b: $0/visit;8b: $50/visit	9a: $50/visit	12a: $0/visit	3: $0/visit;5: $5/visit;9a: $50/visit;9c: $5/visit;9d: $5/visit; 7i: $5/visit; 7c: $5/visit; 7e: $5/visit	7a: $5/visit;14b: $0/visit;14c: $5/visit;14d: $0/visit;14d1: $0/visit;14e: $0/visit;14e1: $0/visit;14f: $0/visit;14f1: $0/visit;14g: $0/visit;14g1: $0/visit	7b: $5/visit;7b1: $5/visit;7d: $5/visit;7f: $5/visit;7f1: $5/visit;16b: 10%;17a: $5/visit;18a: $5/visit	7e: $5/visit;7h: $5/visit	7c: $5/visit;7i: $5/visit	7a: $5; 7d: $5/visit; 8b: $0/visit; 8b: $50/visit; 8b: 0%; 14h: $0/visit	7g: $0/visit;14b: $0/visit;14i: $0/visit;17b: 10%; 7a: $5/visit; 7d: $5/visit; 8a: $0/visit; 12: $0/visit	15: 10%	13a: $0		"16a: $1,000 max"	17a1: $5/visit	17b1: $100/year	18a1: $5/visit			14c1: $5/visit											64.67405114	42.4307655			50	0.1	0.1	43	46.33052684		50	50		35.05523302	4.999452674	4.999203568	4.982403466	5			0.1				5		5			5											54.19696168	35.55705157			41.90008258	0.083800165	0.083800165	36.03407102	38.82505801		41.90008258	41.90008258		29.37634317	4.999452674	4.999203568	4.175262334	5			0.083800165				5		5			5											4.0507	0.134989278	0	0	0.213206891	0.829817037	1.393996525	0.822154134	1.105702854	0	0.653502545	0.029615457	0	1.965326063	1.144185208	1.69663699	0.082613542	0.301743683	0	0	1.375068157	0	0	0	0.05549588	0	0.098794262	0	0	0.041025	0	0	0	0	0	0	0	0	0	0	15.9946	0	2.4467	4.0507	0.134989278	0	0	0.213206891	0.829817037	1.393996525	0.822154134	1.105702854	0	0.653502545	0.029615457	0	1.965326063	1.144185208	1.69663699	0.082613542	0.301743683	0	0	1.375068157	0	0	0	0.05549588	0	0.098794262	0	0	0.041025	0	0	0	0	0	0	0	0	0	0	15.9946	3000	OON: 20%		OON: 20%	OON: 20%	OON: $50/trip	OON: 20%	OON: 20%	OON: $50/visit;OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%		OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%		"OON: $1,000 max"	OON: 20%	OON: $100/year	OON: 20%			OON: 20%											3.2401		0.4807	0.6024	0.0205	0.1598	0.2685	0.0927	0.7042	0.1006	0.2677	0.012	0.0008	0.4633	0.3611	1.3098		0.0803	0.293	0.1419	0.2648				0.0146		0.0204			0.0304											8.9298	250	5.543935851	7.2908	0.134989278	0.480674969	0.602350866	0.233739264	0.989644078	1.662487445	0.914850947	1.809894897	0.10057561	0.921224921	0.041637372	0.000823336	2.428669625	1.505254189	3.006440078	0.082613542	0.382011167	0.293046895	0.141939853	1.639913376	0	0	0	0.070095651	0	0.119238939	0	0	0.071467023	0	0	0	0	0	0	0	0	0	0	24.9243
H8649_002_0	2009	4																					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	O	P																																																			0	3000	891.4762084	45.28234159	748.5839397		60.69343266	9.842580506	16.53439542	272.1418027	339.6891382	1325.326509	398.5724592	8.430608071	0.049495363	799.4517499	2729.789823	4050.353128	236.0058761	719.8193631	2953.249267	4768.125547	16.30988331				133.1901121		237.1062288			98.46											1a: $125/d (1-5) then $0;1a1: $125/d (1-5) then $0	1b: $125/d (1-5) then $0	"2: $0 (1-6), $75/d (7-100)"	6: $0	10a: $100/trip	11a: 20%	11b: 20%;11c: 20%	4a: $50/visit;4a1: $50/visit;4b: $20/visit	9a: $50/visit;9b: $50/visit	8a: $15/visit	8b: $50/visit;8b: $15/visit	9a: $50/visit	12a: 10%	3: $15/visit;5: $40/day;9a: $50/visit;9c: $15/visit;9d: $15/visit; 7i: $15/visit; 7c: $15/visit; 7e: $15/visit	7a: $5/visit;14b: $0/visit;14c: $5/visit;14d: $0/visit;14d1: $0/visit;14e: $0/visit;14e1: $0/visit;14f: $0/visit;14f1: $0/visit;14g: $0/visit;14g1: $0/visit	7b: $15/visit;7b1: $15/visit;7d: $15/visit;7f: $15/visit;7f1: $15/visit;16b: 20%;17a: $15/visit;18a: $15/visit	7e: $15/visit;7h: $15/visit	7c: $15/visit;7i: $15/visit	7a: $5/visit; 7d: $15/visit; 8b: $50/visit; 8b: $50/visit; 8b: $15/visit; 14h: $0/visit	7g: $0/visit;14b: $0/visit;14i: $5/visit;17b: 20%; 7a: $5/visit; 7d: $15/visit; 8a: $15/visit; 12: 10%	15: 20%			"16a: $1,000 max"	17a1: $15/visit	17b1: $100/year	18a1: $15/visit			14c1: $5/visit											96.06788262	70.88151951	41.14375769		100	0.2	0.2	44	46.33052684	15	46.12870473	50	0.1	38.33326943	4.999452674	14.99761208	14.86631111	14.76810802	3.864361967	3.614263178	0.2				15		15			5											78.25542995	57.73900323	33.51507663		81.45847271	0.162916945	0.162916945	35.84172799	37.74013956	12.21877091	37.57573835	40.72923636	0.081458473	31.22569582	4.999452674	14.99761208	14.86631111	14.76810802	3.864361967	3.614263178	0.162916945				15		15			5											5.8136	0.217879772	2.090737342	0	0.411999527	1.603523151	2.693733197	0.812836039	1.06832629	1.349488416	1.248054537	0.028614352	0.004031817	2.080286431	1.137287919	5.062135416	0.292378065	0.885864176	0.951035346	1.436105049	2.657156368	0	0	0	0.16648764	0	0.296382786	0	0	0.041025	0	0	0	0	0	0	0	0	0	0	32.3489	0	5.0259	5.8136	0.217879772	2.090737342	0	0.411999527	1.603523151	2.693733197	0.812836039	1.06832629	1.349488416	1.248054537	0.028614352	0.004031817	2.080286431	1.137287919	5.062135416	0.292378065	0.885864176	0.951035346	1.436105049	2.657156368	0	0	0	0.16648764	0	0.296382786	0	0	0.041025	0	0	0	0	0	0	0	0	0	0	32.3489	3000	OON: 30%		OON: 30%	OON: 30%	OON: $100/trip	OON: 30%	OON: 30%	OON: $50/visit;OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%		OON: 30%	OON: 30%	OON: 30%;OON: 20%	OON: 30%	OON: 30%		"OON: $1,000 max"	OON: 30%	OON: $100/year	OON: 30%			OON: 30%											3.3232		0.493	0.6178	0.0281	0.1639	0.2754	0.0634	0.7223	0.1032	0.2746	0.0123	0.0008	0.4752	0.3703	1.3434		0.0823	0.3006	0.1456	0.2716				0.0151		0.0211			0.0314											9.1346	250	11.45082518	9.1367	0.217879772	2.583740754	0.617798962	0.4400783	1.767449171	2.969109927	0.876221807	1.790578282	1.452643422	1.522643012	0.040944586	0.004876268	2.555513059	1.507616998	6.405560935	0.292378065	0.968190228	1.251597822	1.58168514	2.928793898	0	0	0	0.181552745	0	0.31747909	0	0	0.072437294	0	0	0	0	0	0	0	0	0	0	41.4835
H8649_003_0	2009	4																					3000											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	O	P																																																			0	3000	848.8380465	43.11654535	712.7927336	2262.516627	57.79054374	9.371955858	15.74380052	259.1256099	323.442243	1261.937845	379.5092504	8.027382916	0.047128734	761.2149997	2599.227482	3875.082211	224.7180182	685.3913276	2811.999148	4540.072227	15.53002348				133.1901121		237.1062288			98.46											1a: $150/d (1-7) then $0;1a1: $150/d (1-7) then $0	1b: $150/d (1-7) then $0	2: $150/d (21-100)	6: $10/visit	10a: $150/trip	11a: 20%	11b: 20%;11c: $25/visit	4a: $50/visit;4a1: $50/visit;4b: $35/visit	9a: $200/visit;9b: $200/visit	8a: $30/visit	8b: $75/visit;8b: $30/visit	9a: $200/visit	12a: 20%	3: $25/visit;5: $60/day;9a: $200/visit;9c: $30/visit;9d: 25%; 7i: $30/visit; 7c: $30/visit; 7e: $30/visit	7a: $10/visit;14b: $0/visit;14c: $10/visit;14d: $0/visit;14d1: $0/visit;14e: $0/visit;14e1: $0/visit;14f: $0/visit;14f1: $0/visit;14g: $0/visit;14g1: $0/visit	7b: $25/visit;7b1: $25/visit;7d: $25/visit;7f: $25/visit;7f1: $25/visit;16b: 20%;17a: $25/visit;18a: $25/visit	7e: $30/visit;7h: $30/visit	7c: $30/visit;7i: $30/visit	7a: $10/visit; 7d: $25/visit; 8b: $75/visit; 8b: $75/visit; 8b: 30/visit; 14h: $0/visit	7g: $0/visit;14b: $0/visit;14i: 20%;17b: 20%; 7a: $10/visit; 7d: $25/visit; 8a: $30/visit; 12: 20%	15: 20%			"16a: $1,000 max"	17a1: $25/visit	17b1: $100/year	18a1: $25/visit			14c1: $10/visit											125.6457184	100.1811006	26.64080748	10	150	0.2	0.2	47	185.3221073	30	70.02262036	200	0.2	94.63172467	9.998905347	24.99603908	24.71123235	24.65216204	6.467740114	6.100625497	0.2				25		25			10											112.8230567	89.95720771	23.92200363	8.979458915	134.6918837	0.179589178	0.179589178	42.2034569	166.4092249	26.93837674	62.87652426	179.5891783	0.179589178	84.97416837	9.998905347	24.99603908	22.18934956	24.65216204	6.467740114	6.100625497	0.179589178				25		25			10											7.9807	0.323220336	1.42095253	1.693014592	0.648659766	1.683101851	2.827416198	0.911333042	4.485314413	2.832879757	1.988518549	0.120135925	0.008463811	5.390300962	2.165785798	8.071808866	0.415528888	1.408031506	1.515606641	2.308106699	2.789024156	0	0	0	0.2774794	0	0.49397131	0	0	0.08205	0	0	0	0	0	0	0	0	0	0	51.8414	0	4.0368	7.9807	0.323220336	1.42095253	1.693014592	0.648659766	1.683101851	2.827416198	0.911333042	4.485314413	2.832879757	1.988518549	0.120135925	0.008463811	5.390300962	2.165785798	8.071808866	0.415528888	1.408031506	1.515606641	2.308106699	2.789024156	0	0	0	0.2774794	0	0.49397131	0	0	0.08205	0	0	0	0	0	0	0	0	0	0	51.8414	3000	OON: 30%		OON: 30%	OON: 30%	OON: $150/trip	OON: 30%	OON: 30%	OON: $50/visit;OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%		OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	"OON: $1,000 max"	OON: 30%	OON: $100/year	OON: 30%			OON: 30%											3.0775		0.4566	0.5721	0.039	0.1518	0.255	0.0587	0.6689	0.0955	0.2543	0.0114	0.0008	0.4401	0.343	1.2443		0.0762	0.2783	0.1348	0.2516				0.0147		0.0205			0.0306											8.4756	250	11.22211679	11.0582	0.323220336	1.877514309	2.265138747	0.687663511	1.834908574	3.082433912	0.970051995	5.154169229	2.928408359	2.242806286	0.131554566	0.009245831	5.830393371	2.50873589	9.316150102	0.415528888	1.484271068	1.793948081	2.442923834	3.040579115	0	0	0	0.292131303	0	0.514488989	0	0	0.112600723	0	0	0	0	0	0	0	0	0	0	60.3171
H8649_004_0	2009	5																					1000											D	D	D	V	T	Coin	Coin	V	V	P	P	V	V	V	V	V	V	V	P	V	Coin	Coin	T	Coin	V	P	V	P	O	P																																																			0	3000	869.3749586	44.15971337			59.18873663	9.76108738	16.39749641	265.3949329	331.2676521		181.4199807	8.221598596		778.1970728	2662.113573	3959.502441	230.1548789	701.9737858		3.569337904	16.17484317				133.1901121		237.1062288			98.46											1a: $150/d (1-3) then $0;1a1: $150/d (1-3) then $0	1b: $150/d (1-3) then $0	2: $0	6: $0	10a: $50/trip	11a: 10%	11b: 10%;11c: $5/visit	4a: $50/visit;4a1: $50/visit;4b: $15/visit	9a: $50/visit;9b: $50/visit	8a: $0/visit	8b: $0/visit;8b: $50/visit	9a: $50/visit	12a: $0/visit	5: $5/visit;9a: $50/visit;9c: $5/visit;9d: $5/visit; 7i: $5/visit; 7c: $5/visit; 7e: $5/visit	7a: $5/visit;14b: $0/visit;14c: $5/visit;14d: $0/visit;14d1: $0/visit;14e: $0/visit;14e1: $0/visit;14f: $0/visit;14f1: $0/visit;14g: $0/visit;14g1: $0/visit	7b: $5/visit;7b1: $5/visit;7d: $5/visit;7f: $5/visit;7f1: $5/visit;16b: 10%;17a: $5/visit;18a: $5/visit	7e: $5/visit;7h: $5/visit	7c: $5/visit;7i: $5/visit	7a: $5/visit; 7d: $5/visit; 8b: $0/visit; 8b: $50/visit; 8b: 0%; 14h: $0/visit	7g: $0/visit;14b: $0/visit;14i: $5/visit;17b: 10%; 7a: $5/visit; 7d: $5/visit; 8a: $0/visit; 12: $0/visit	15: 10%	13a: $0		"16a: $1,000 max"	17a1: $5/visit	17b1: $100/year	18a1: $5/visit			14c1: $5/visit											97.01107671	63.64614825			50	0.1	0.1	43	46.33052684		50	50		35.05523302	4.999452674	4.999205948	4.982403466	5		5	0.1				5		5			5											76.25634016	50.02956874			39.30290372	0.078605807	0.078605807	33.8004972	36.41848472		39.30290372	39.30290372		27.55544897	4.999452674	4.999205948	3.916458475	5		5	0.078605807				5		5			5											5.5246	0.184107618	0	0	0.193857435	0.767278155	1.288938445	0.747540057	1.005355494	0	0.594194336	0.026927725	0	1.786964144	1.109092568	1.64953068	0.075116002	0.292489077	0	0.001487224	1.271436608	0	0	0	0.05549588	0	0.098794262	0	0	0.041025	0	0	0	0	0	0	0	0	0	0	16.7142	0	3.6651	5.5246	0.184107618	0	0	0.193857435	0.767278155	1.288938445	0.747540057	1.005355494	0	0.594194336	0.026927725	0	1.786964144	1.109092568	1.64953068	0.075116002	0.292489077	0	0.001487224	1.271436608	0	0	0	0.05549588	0	0.098794262	0	0	0.041025	0	0	0	0	0	0	0	0	0	0	16.7142	3000	OON: 20%		OON: 20%	OON: 20%	OON: $50/trip	OON: 20%	OON: 20%	OON: $50/visit;OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%		OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%		"OON: $1,000 max"	OON: 20%	OON: $100/year	OON: 20%			OON: 20%											3.0591		0.4533	0.6249	0.0209	0.1658	0.2785	0.0947	0.6534	0.0935	0.2484	0.0114	0.0007	0.4304	0.3748	1.3596		0.0833	0.3042	0.1473	0.2748				0.0154		0.0215			0.032											8.7482	250	4.829618923	8.5837	0.184107618	0.453343104	0.624895591	0.214803759	0.933087186	1.567478415	0.842223158	1.658797577	0.09347787	0.842602202	0.03832077	0.000729916	2.21739744	1.483883087	3.009180387	0.075116002	0.37580693	0.304183422	0.148821152	1.546194426	0	0	0	0.070861257	0	0.12031105	0	0	0.073063392	0	0	0	0	0	0	0	0	0	0	25.4624
H8649_005_0	2009	4																					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	O	P																																																			0	3000	867.3513636	44.0569253	728.3168868		59.05096635	9.738367048	16.35932888	264.7771881	330.4965791	1289.460946	387.7864184	8.202461645	0.041045249	777.8172417	2655.917122	3951.184133	229.6191604	700.3398411	2873.329378	4639.092054	16.1371939				133.1901121		237.1062288			98.46											1a: $125/d (1-5) then $0;1a1: $125/d (1-5) then $0	1b: $125/d (1-5) then $0	2: $75/d (7-100)	6: $0	10a: $100/trip	11a: 20%	11b: 20%;11c: 20%	4a: $50/visit;4a1: $50/visit;4b: $20/visit	9a: $50/visit;9b: $50/visit	8a: $15/visit	8b: $50/visit;8b: $15/visit	9a: $50/visit	12a: 10%	3: $15/visit;5: $40/day;9a: $50/visit;9c: $15/visit;9d: $15/visit; 7i: $15/visit; 7c: $15/visit; 7e: $15/visit	7a: $5/visit;14b: $0/visit;14c: $5/visit;14d: $0/visit;14d1: $0/visit;14e: $0/visit;14e1: $0/visit;14f: $0/visit;14f1: $0/visit;14g: $0/visit;14g1: $0/visit	7b: $15/visit;7b1: $15/visit;7d: $15/visit;7f: $15/visit;7f1: $15/visit;16b: 20%;17a: $15/visit;18a: $15/visit	7e: $15/visit;7h: $15/visit	7c: $15/visit;7i: $15/visit	7a: $5; 7d: $15/visit; 8b: $50/visit; 8b: $50/visit; 8b: $15/visit; 14h: $0/visit	7g: $0/visit;14b: $0/visit;14i: $5/visit;17b: 20%; 7a: $5/visit; 7d: $15/visit; 8a: $15/visit; 12: 10%	15: 20%			"16a: $1,000 max"	17a1: $15/visit	17b1: $100/year	18a1: $15/visit			14c1: $5/visit											96.06788262	70.88151951	41.14375769		100	0.2	0.2	44	46.33052684	15	46.12870473	50	0.1	38.33326943	4.999452674	14.99761839	14.86886744	14.76810802	3.864361967	3.614263178	0.2				15		15			5											78.93921789	58.24352073	33.80792794		82.17024851	0.164340497	0.164340497	36.15490934	38.06990904	12.32553728	37.90407131	41.08512425	0.082170249	31.49854275	4.999452674	14.99761839	14.86886744	14.76810802	3.864361967	3.614263178	0.164340497				15		15			5											5.7057	0.21383587	2.051907069	0	0.404352715	1.600408081	2.688500239	0.797749603	1.048497892	1.32444158	1.224890338	0.028083263	0.003372698	2.041675804	1.106510996	4.938195984	0.284514738	0.861891202	0.925298731	1.397241633	2.651994466	0	0	0	0.16648764	0	0.296382786	0	0	0.041025	0	0	0	0	0	0	0	0	0	0	31.8029	0	4.7271	5.7057	0.21383587	2.051907069	0	0.404352715	1.600408081	2.688500239	0.797749603	1.048497892	1.32444158	1.224890338	0.028083263	0.003372698	2.041675804	1.106510996	4.938195984	0.284514738	0.861891202	0.925298731	1.397241633	2.651994466	0	0	0	0.16648764	0	0.296382786	0	0	0.041025	0	0	0	0	0	0	0	0	0	0	31.8029	3000	OON: 30%		OON: 30%	OON: 30%	OON: $100/trip	OON: 30%	OON: 30%	OON: $50/visit;OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%		OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%		"OON: $1,000 max"	OON: 30%	OON: $100/year	OON: 30%			OON: 30%											3.2232		0.4777	0.6584	0.0294	0.1747	0.2935	0.0665	0.6885	0.0985	0.2617	0.012	0.0008	0.4535	0.3949	1.4326		0.0878	0.3205	0.1552	0.2895				0.0162		0.0227			0.0338											9.1916	250	10.12528961	8.9288	0.21383587	2.529559457	0.658403398	0.43377871	1.775108032	2.981975926	0.864257616	1.736978487	1.422931869	1.486618194	0.04008722	0.004141754	2.495189557	1.501398326	6.370764867	0.284514738	0.949676679	1.245792908	1.552475819	2.941485197	0	0	0	0.182714702	0	0.319106228	0	0	0.074860093	0	0	0	0	0	0	0	0	0	0	40.9945
H8649_006_0	2009	4																					3000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	Coin	T	Coin	V	P	V	P	O	P																																																			0	3000	866.0023003	43.98839992	727.1844599	2308.266709	58.95911949	9.72322016	16.33388386	264.3653582	329.9825304	1287.455341	387.1832621	8.189703678	0.040981407	776.6074382	2651.786154	3945.638595	229.2620147	699.2505446	2868.860251	4631.876491	16.11209439				133.1901121		237.1062288			98.46											1a: $150/d (1-7) then $0;1a1: $150/d (1-7) then $0	1b: $150/d (1-7) then $0	2: $150/d (21-100)	6: $0	10a: $150/trip	11a: 20%	11b: 20%;11c: $25/visit	4a: $50/visit;4a1: $50/visit;4b: $35/visit	9a: $200/visit;9b: $200/visit	8a: $30/visit	8b: $75/visit;8b: $30/visit	9a: $200/visit	12a: 20%	3: $25/visit;5: $60/day;9a: $200/visit;9c: $30/visit;9d: 25%; 7i: $30/visit; 7c: $30/visit; 7e: $30/visit	7a: $10/visit;14b: $0/visit;14c: $10/visit;14d: $0/visit;14d1: $0/visit;14e: $0/visit;14e1: $0/visit;14f: $0/visit;14f1: $0/visit;14g: $0/visit;14g1: $0/visit	7b: $25/visit;7b1: $25/visit;7d: $25/visit;7f: $25/visit;7f1: $25/visit;16b: 20%;17a: $25/visit;18a: $25/visit	7e: $30/visit;7h: $30/visit	7c: $30/visit;7i: $30/visit	7a: $10/visit; 7d: $25/visit; 8b: $75/visit; 8b: $75/visit; 8b: $30/visit; 14h: $0/visit	7g: $0/visit;14i: 20%;17b: 20%; 7a: $10/visit; 7d: $25/visit; 8a: $30/visit; 12: 20%	15: 20%			"16a: $1,000 max"	17a1: $25/visit	17b1: $100/year	18a1: $25/visit			14c1: $10/visit											125.6457184	100.1811006	26.64080748	10	150	0.2	0.2	47	185.3221073	30	70.02262036	200	0.2	85.33712447	9.998905347	24.99603125	24.708658	24.65216204	6.467740114	6.100625497	0.2				25		25			10											112.2885563	89.53103457	23.8086729	8.936918641	134.0537796	0.178738373	0.178738373	42.00351761	165.6208596	26.81075592	62.57864612	178.7383728	0.178738373	76.26509384	9.998905347	24.99603125	22.08192663	24.65216204	6.467740114	6.100625497	0.178738373				25		25			10											8.1035	0.328193913	1.442774746	1.719065981	0.658641068	1.73791255	2.919491824	0.925356248	4.554332528	2.876470909	2.019117029	0.121984526	0.00732495	4.935669929	2.209579896	8.218775467	0.421878916	1.436503144	1.546253544	2.354778651	2.879849534	0	0	0	0.2774794	0	0.49397131	0	0	0.08205	0	0	0	0	0	0	0	0	0	0	52.271	0	4.2409	8.1035	0.328193913	1.442774746	1.719065981	0.658641068	1.73791255	2.919491824	0.925356248	4.554332528	2.876470909	2.019117029	0.121984526	0.00732495	4.935669929	2.209579896	8.218775467	0.421878916	1.436503144	1.546253544	2.354778651	2.879849534	0	0	0	0.2774794	0	0.49397131	0	0	0.08205	0	0	0	0	0	0	0	0	0	0	52.271	3000	OON: 30%		OON: 30%	OON: 30%	OON: $150/trip	OON: 30%	OON: 30%	OON: $50/visit;OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%		OON: 30%	OON: 30%	OON: 30%	OON: 30%	OON: 30%		"OON: $1,000 max"	OON: 30%	OON: $100/year	OON: 30%			OON: 30%											3.0015		0.4448	0.6131	0.0411	0.1627	0.2733	0.0619	0.6411	0.0917	0.2437	0.0112	0.0007	0.4223	0.3677	1.3341		0.0817	0.2985	0.1446	0.2696				0.0151		0.0212			0.0316											8.5733	250	10.74460671	11.105	0.328193913	1.887578229	2.332189627	0.699744531	1.900598027	3.192784586	0.987291148	5.1954649	2.968187818	2.262845323	0.133162946	0.008041116	5.357994612	2.577310014	9.55283162	0.421878916	1.518251434	1.84470668	2.499337065	3.149431393	0	0	0	0.292614034	0	0.515164978	0	0	0.113607268	0	0	0	0	0	0	0	0	0	0	60.8442
H8649_801_0	2009	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																																																			0		187.9478527	0.755754851	28.17571506		5.073977897	10.49047098	17.62277638	13.64590607	46.16367939	6.598680463	17.54995753	0.796610943	0.052753408	30.4638896	23.69926663	87.82438027	0.314578163	5.2684684	19.23454211	9.316420417	17.38348569																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.07855788	0.07855788	0.177052718		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.07855788	0.07855788	0.177052718		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				14.7648	0.059370499	4.988586919	0	1.172088894	2.423298795	4.070861344	3.152204301	10.66380994	1.524295187	4.05404019	0.184017128	0.012186037	7.037158498	5.474530592	20.28743184	0.072667556	1.2170162	4.443179228	2.152093116	4.015585196	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.7692	0	0	14.7648	0.059370499	4.988586919	0	1.172088894	2.423298795	4.070861344	3.152204301	10.66380994	1.524295187	4.05404019	0.184017128	0.012186037	7.037158498	5.474530592	20.28743184	0.072667556	1.2170162	4.443179228	2.152093116	4.015585196	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.7692		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				1.9331		0.6531		0.1373	0.2834	0.4761	0.3689	1.2488	0.1784	0.4748	0.0213	0.0015	0.8217	0.6403	2.314		0.1423	0.5197	0.2517	0.4697																				10.936	0	0	16.6979	0.059370499	5.641723047	0	1.309348518	2.706725555	4.546985478	3.521148202	11.91257778	1.702649356	4.528801438	0.205336001	0.013646087	7.858821488	6.114826567	22.6013852	0.072667556	1.359357276	4.962849313	2.403799914	4.485244283	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.7052
H8649_802_0	2009	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																																																			0		187.9478527	0.755754851	28.17571506		5.073977897	10.49047098	17.62277638	13.64590607	46.16367939	6.598680463	17.54995753	0.796610943	0.052753408	30.4638896	23.69926663	87.82438027	0.314578163	5.2684684	19.23454211	9.316420417	17.38348569																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.07855788	0.07855788	0.177052718		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.07855788	0.07855788	0.177052718		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				14.7648	0.059370499	4.988586919	0	1.172088894	2.423298795	4.070861344	3.152204301	10.66380994	1.524295187	4.05404019	0.184017128	0.012186037	7.037158498	5.474530592	20.28743184	0.072667556	1.2170162	4.443179228	2.152093116	4.015585196	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.7692	0	0	14.7648	0.059370499	4.988586919	0	1.172088894	2.423298795	4.070861344	3.152204301	10.66380994	1.524295187	4.05404019	0.184017128	0.012186037	7.037158498	5.474530592	20.28743184	0.072667556	1.2170162	4.443179228	2.152093116	4.015585196	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.7692		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				1.9331		0.6531		0.1373	0.2834	0.4761	0.3689	1.2488	0.1784	0.4748	0.0213	0.0015	0.8217	0.6403	2.314		0.1423	0.5197	0.2517	0.4697																				10.936	0	0	16.6979	0.059370499	5.641723047	0	1.309348518	2.706725555	4.546985478	3.521148202	11.91257778	1.702649356	4.528801438	0.205336001	0.013646087	7.858821488	6.114826567	22.6013852	0.072667556	1.359357276	4.962849313	2.403799914	4.485244283	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.7052
H8649_803_0	2009	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																																																			0		187.9478527	0.755754851	28.17571506		5.073977897	10.49047098	17.62277638	13.64590607	46.16367939	6.598680463	17.54995753	0.796610943	0.052753408	30.4638896	23.69926663	87.82438027	0.314578163	5.2684684	19.23454211	9.316420417	17.38348569																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.07855788	0.07855788	0.177052718		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.07855788	0.07855788	0.177052718		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				14.7648	0.059370499	4.988586919	0	1.172088894	2.423298795	4.070861344	3.152204301	10.66380994	1.524295187	4.05404019	0.184017128	0.012186037	7.037158498	5.474530592	20.28743184	0.072667556	1.2170162	4.443179228	2.152093116	4.015585196	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.7692	0	0	14.7648	0.059370499	4.988586919	0	1.172088894	2.423298795	4.070861344	3.152204301	10.66380994	1.524295187	4.05404019	0.184017128	0.012186037	7.037158498	5.474530592	20.28743184	0.072667556	1.2170162	4.443179228	2.152093116	4.015585196	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.7692		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				1.9331		0.6531		0.1373	0.2834	0.4761	0.3689	1.2488	0.1784	0.4748	0.0213	0.0015	0.8217	0.6403	2.314		0.1423	0.5197	0.2517	0.4697																				10.936	0	0	16.6979	0.059370499	5.641723047	0	1.309348518	2.706725555	4.546985478	3.521148202	11.91257778	1.702649356	4.528801438	0.205336001	0.013646087	7.858821488	6.114826567	22.6013852	0.072667556	1.359357276	4.962849313	2.403799914	4.485244283	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	102.7052
H8707_001_0	2009	4	r.	s.	t.								Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered								4000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin				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		1451.40123	64.624107	506.559841	723.988782	144.002045	9.772017	3.528998	325.721819	353.071939	624.222705	926.4808	0	19.294534	708.750076	3468.82995	4181.367939	28.523597	901.24788			22.086417				2.47				1.71	0.05	0.06	1.23	2.7								$195/Day(Days 1-5):1a	$195/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$125/Visit:9b. $0 Surgery ASC -- Physician,9b. $125 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $125 Surgery OP -- Facility"	"$0-$75/Visit:8a. $0 Lab -- FSL,8. $75 Lab -- OP"	"$0-$100/Visit:14h. $75 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $75 Radiology OP -- Facility"	$50/Visit:9a	"$0-$75/Proc:12. $0 Dialysis -- Dialysis Center,12. $75 Dialysis -- OP Hosp"	"$35-$100/Visit:9d. $75 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $75 OP Other,5. $35 Partial Hospitalization,8b. $75 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$75/Visit:7h. $75 Psych -- OP,7e. $35 Psych -- Other Provider"	"$35-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15				Vision 743				Silver Sneakers	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit								119.554888	99.659404	43.132807	0	99.999996	0.199999	0.2	49.99999	124.999976	65.968052	68.319883	0	1.173596	61.86732	14.999998	34.999998	68.756545	43.629905			0.2				0				0	0	0	0	0								102.303835	85.27915	36.909001	0	85.570597	0.171141	0.171141	42.785292	106.963229	56.449258	58.461733	0	1.004253	52.940237	12.835588	29.949708	58.835388	37.334372			0.171141				0				0	0	0	0	0								12.3737	0.45925741	1.558051473	0	1.026861747	1.672392761	0.603956247	1.161341928	3.147142889	2.936409044	4.51363943	0	0.001614716	3.126783083	3.710372673	10.43589573	0.139849741	2.803960301	0	0	3.779891492	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4511	0	9.0132	12.3737	0.45925741	1.558051473	0	1.026861747	1.672392761	0.603956247	1.161341928	3.147142889	2.936409044	4.51363943	0	0.001614716	3.126783083	3.710372673	10.43589573	0.139849741	2.803960301	0	0	3.779891492	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.4511		$950/Admit:1a	$950/Admit:1b	"30% Coins(Days 1-20) 30%(Days 21-100):2. 30% SNF 1,2. 30% SNF 2"	30% Coins:6	$100/Trip:10a	40% Coins:11a	40% Coins:11b	$50/Visit:4a	"30% Coins:9b. 30% Surgery ASC -- Physician,9b. 30% Surgery ASC -- Facility,9a. 30% Surgery OP -- Physician,9a. 30% Surgery OP -- Facility"	"30% Coins:8a. 30% Lab -- FSL,8. 30% Lab -- OP"	"30% Coins:14h. 30% DMAM -- OP,8b. 30% Radiology -- FSR,14h. 30% SMAM -- FSR,14h. 30% SMAM -- OP,8b. 30% Advanced Imaging -- FSR,8b. 30% Advanced Imaging -- Office,9a. 30% Advanced Imaging -- OP,8a. 30% Radiology OP -- Physician,8a. 30% Radiology OP -- Facility"		"$0-$75/Proc:12. $0 Dialysis -- Dialysis Center,12. $75 Dialysis -- OP Hosp"	"30% Coins:9d. 30% Cardiac Rehab,8b. 30% Nuclear Medicine,9a. 30% OP Other,5. 30% Partial Hospitalization,8b. 30% Rad therapy,3. 30% Therapy (AT,PT,ST,OT) -- CORF"	30% Coins:7a	"30% Coins:7b, 7d, 7f"	"30% Coins:7h. 30% Psych -- OP,7e. 30% Psych -- Other Provider"	"30% Coins:9a. 30% Therapy (AT,PT,ST,OT) -- OP,7d. 30% Therapy (AT,PT,ST,OT) - Specialist"			30% Coins:15				Vision 743				Silver Sneakers	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit								1.9626	0.0632	0.3806	0.5773	0.6846	2.1206	0.7658	0.2049	2.7485	0.3541	1.4727		0.0003	0.8319	1.6679	3.808	0.0241	0.3215			1.1367				0				0	0	0	0	0								19.1252	0	0	14.3363	0.52249341	1.938604473	0.57734	1.711435747	3.792944761	1.369757247	1.366283928	5.895600889	3.290474044	5.98638243	0	0.001899716	3.958642083	5.378270673	14.24390373	0.163915741	3.125499301	0	0	4.916548492	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.5763
H8707_003_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered							4000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			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		1372.732518	61.121357	479.103333	684.74721	136.19686	8.741396	3.156807	308.067076	333.934767	590.388645	876.263775	0	18.248733	670.334471	3280.812757	3954.729829	26.977562	852.398529			19.757039				2.47				1.71	0.09	0.06	0.05	1.23	2.7							$175/Day(Days 1-5):1a	$175/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$175/Visit:9b. $0 Surgery ASC -- Physician,9b. $175 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $175 Surgery OP -- Facility"	"$0-$75/Visit:8a. $0 Lab -- FSL,8. $75 Lab -- OP"	"$0-$100/Visit:14h. $75 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $75 Radiology OP -- Facility"	$50/Visit:9a	"$0-$75/Proc:12. $0 Dialysis -- Dialysis Center,12. $75 Dialysis -- OP Hosp"	"$30-$100/Visit:9d. $75 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $75 OP Other,5. $30 Partial Hospitalization,8b. $75 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$5/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30-$75/Visit:7h. $75 Psych -- OP,7e. $30 Psych -- Other Provider"	"$30-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $30 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15				Vision 743				Silver Sneakers	Meals on Wheels	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit							107.292852	89.43787	43.132799	0	100.000014	0.199999	0.199999	50.000007	175.000035	65.968057	68.319893	0	1.17378	60.069827	4.999998	29.999998	67.97649	39.708651			0.2				0				0	0	0	0	0	0							91.368018	76.163143	36.730856	0	85.157612	0.170315	0.170315	42.578806	149.02583	56.176814	58.179581	0	0.999562	51.154023	4.257879	25.547278	57.887148	33.814934			0.170315				0				0	0	0	0	0	0							10.452	0.387932888	1.466489628	0	0.966516613	1.48879086	0.537651584	1.093094022	4.147075485	2.763846091	4.248388273	0	0.001520062	2.857525412	1.164108645	8.419381863	0.130137844	2.401983333	0	0	3.364920097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8914	0	7.9986	10.452	0.387932888	1.466489628	0	0.966516613	1.48879086	0.537651584	1.093094022	4.147075485	2.763846091	4.248388273	0	0.001520062	2.857525412	1.164108645	8.419381863	0.130137844	2.401983333	0	0	3.364920097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	45.8914	6000	$850/Admit:1a	$850/Admit:1b	"30% Coins(Days 1-20) 30%(Days 21-100):2. 30% SNF 1,2. 30% SNF 2"	30% Coins:6	$100/Trip:10a	40% Coins:11a	40% Coins:11b	$50/Visit:4a	"30% Coins:9b. 30% Surgery ASC -- Physician,9b. 30% Surgery ASC -- Facility,9a. 30% Surgery OP -- Physician,9a. 30% Surgery OP -- Facility"	"30% Coins:8a. 30% Lab -- FSL,8. 30% Lab -- OP"	"30% Coins:14h. 30% DMAM -- OP,8b. 30% Radiology -- FSR,14h. 30% SMAM -- FSR,14h. 30% SMAM -- OP,8b. 30% Advanced Imaging -- FSR,8b. 30% Advanced Imaging -- Office,9a. 30% Advanced Imaging -- OP,8a. 30% Radiology OP -- Physician,8a. 30% Radiology OP -- Facility"		"$0-$75/Proc:12. $0 Dialysis -- Dialysis Center,12. $75 Dialysis -- OP Hosp"	"30% Coins:9d. 30% Cardiac Rehab,8b. 30% Nuclear Medicine,9a. 30% OP Other,5. 30% Partial Hospitalization,8b. 30% Rad therapy,3. 30% Therapy (AT,PT,ST,OT) -- CORF"	30% Coins:7a	"30% Coins:7b, 7d, 7f"	"30% Coins:7h. 30% Psych -- OP,7e. 30% Psych -- Other Provider"	"30% Coins:9a. 30% Therapy (AT,PT,ST,OT) -- OP,7d. 30% Therapy (AT,PT,ST,OT) - Specialist"			20%-30% Coins:15				Vision 747				Silver Sneakers	Meals on Wheels	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit							1.6528	0.0533	0.3388	0.514	0.6443	1.8878	0.6817	0.1929	2.4467	0.3152	1.3111		0.0003	0.7405	1.4848	3.3899	0.0214	0.2862			0.9363				0				0	0	0	0	0	0							16.8981	0	2.945219436	12.1048	0.441186888	1.805263628	0.513957	1.610860613	3.37654086	1.219380584	1.285993022	6.593796485	3.079040091	5.559448273	0	0.001788062	3.598059412	2.648898645	11.80933086	0.151561844	2.688222333	0	0	4.301253097	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	62.7894
H8707_005_0	2009	4	r.	s.	t.	u.							Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered							5000											D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			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		1408.99776	62.736077	491.760423	702.837058	139.794946	9.209366	3.325806	316.205679	342.756752	605.9857	899.413163	0	0	688.043559	3367.486208	4059.207016	27.690264	874.917437			20.81473				2.47				1.71	0.09	0.06	0.05	1.23	2.7							$195/Day(Days 1-5):1a	$195/Day(Days 1-5):1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$125/Visit:9b. $0 Surgery ASC -- Physician,9b. $125 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $125 Surgery OP -- Facility"	"$0-$75/Visit:8a. $0 Lab -- FSL,8. $75 Lab -- OP"	"$0-$100/Visit:14h. $75 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $100 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $75 Radiology OP -- Facility"	$50/Visit:9a	20% Coins:12	"$35-$100/Visit:9d. $75 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $75 OP Other,5. $35 Partial Hospitalization,8b. $75 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35-$75/Visit:7h. $75 Psych -- OP,7e. $35 Psych -- Other Provider"	"$35-$75/Visit:9a. $75 Therapy (AT,PT,ST,OT) -- OP,7d. $35 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15				VIS743				Silver Sneakers	Meals on Wheels	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit							119.554887	99.659403	43.132808	0	100.00001	0.199999	0.199999	50.000012	124.99997	65.968051	68.319894	0	0	61.867333	15	35	68.756874	43.629917			0.2				0				0	0	0	0	0	0							106.818585	89.042587	38.537826	0	89.346908	0.178693	0.178693	44.673461	111.683598	58.940409	61.041707	0	0	55.276544	13.402035	31.271415	61.432135	38.981979			0.178693				0				0	0	0	0	0	0							12.5423	0.465515216	1.579281468	0	1.040853848	1.645649239	0.594298252	1.177166839	3.190025609	2.976420417	4.575142897	0	0	3.169389172	3.760930668	10.5780956	0.141756003	2.842167763	0	0	3.719446548	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.9984	0	6.4386	12.5423	0.465515216	1.579281468	0	1.040853848	1.645649239	0.594298252	1.177166839	3.190025609	2.976420417	4.575142897	0	0	3.169389172	3.760930668	10.5780956	0.141756003	2.842167763	0	0	3.719446548	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.9984		$950/Admit:1a	$950/Admit:1b	"30% Coins(Days 1-20) 30%(Days 21-100):2. 30% SNF 1,2. 30% SNF 2"	30% Coins:6	$100/Trip:10a	40% Coins:11a	40% Coins:11b	$50/Visit:4a	"30% Coins:9b. 30% Surgery ASC -- Physician,9b. 30% Surgery ASC -- Facility,9a. 30% Surgery OP -- Physician,9a. 30% Surgery OP -- Facility"	"30% Coins:8a. 30% Lab -- FSL,8. 30% Lab -- OP"	"30% Coins:14h. 30% DMAM -- OP,8b. 30% Radiology -- FSR,14h. 30% SMAM -- FSR,14h. 30% SMAM -- OP,8b. 30% Advanced Imaging -- FSR,8b. 30% Advanced Imaging -- Office,9a. 30% Advanced Imaging -- OP,8a. 30% Radiology OP -- Physician,8a. 30% Radiology OP -- Facility"		20% Coins:12	"30% Coins:9d. 30% Cardiac Rehab,8b. 30% Nuclear Medicine,9a. 30% OP Other,5. 30% Partial Hospitalization,8b. 30% Rad therapy,3. 30% Therapy (AT,PT,ST,OT) -- CORF"	30% Coins:7a	"30% Coins:7b, 7d, 7f"	"30% Coins:7h. 30% Psych -- OP,7e. 30% Psych -- Other Provider"	"30% Coins:9a. 30% Therapy (AT,PT,ST,OT) -- OP,7d. 30% Therapy (AT,PT,ST,OT) - Specialist"			30% Coins:15				VIS743				Silver Sneakers	Meals on Wheels	Other Added Benefit	Other Added Benefit	Other Added Benefit	Other Added Benefit							1.9894	0.0641	0.3745	0.5681	0.6939	2.0866	0.7536	0.2077	2.7045	0.3484	1.4492		0.0003	0.8186	1.6412	3.7471	0.0237	0.3164			1.1185				0				0	0	0	0	0	0							18.9058	0	0	14.5316	0.529612216	1.953750468	0.568109	1.734756848	3.732298239	1.347856252	1.384901839	5.894540609	3.324824417	6.024341897	0	0.000289	3.987950172	5.402162668	14.3252206	0.165437003	3.158566763	0	0	4.837931548	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.9042
H8707_801_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		260.74422	8.401134	506.559841	723.988782	4.95136	9.772017	3.528998	21.726081	55.847134	624.222705	30.197528	0	0.381051	17.203434	32.408973	73.993482	0.467617	6.247838			22.086417																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999979	1024.000331	43.132807	0	0.2	0.199999	0.2	0.199999	0.2	0	0.2	0	0.199999	0.2	0.2	0.199999	0.500001	0.2			0.2																				1023.999979	1024.000331	43.132807	0	0.2	0.199999	0.2	0.199999	0.2	0	0.2	0	0.199999	0.2	0.2	0.199999	0.500001	0.2			0.2																				22.2502	0.716897	1.820778988	0	0.990272	1.954393628	0.7057996	4.345194474	11.1694268	0	6.0395056	0	0.076209819	3.4406868	6.4817946	14.79862241	0.233808968	1.2495676	0	0	4.4172834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6904	0	0	22.2502	0.716897	1.820778988	0	0.990272	1.954393628	0.7057996	4.345194474	11.1694268	0	6.0395056	0	0.076209819	3.4406868	6.4817946	14.79862241	0.233808968	1.2495676	0	0	4.4172834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6904		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4722	0.0797	0.2023		0.6278	1.2391	0.4475	0.8185	2.1413		1.1474		0.0144	0.6481	1.2994	2.9668	0.0469	0.2505			0.8856																				15.2873	0	0	24.7224	0.796552	2.023087988	0	1.618092	3.193459628	1.1532676	5.163659474	13.3107058	0	7.1868976	0	0.090564819	4.0887748	7.7812276	17.76537941	0.280681968	1.5000736	0	0	5.3028344	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.9777
H8707_802_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		260.74422	8.401134	506.559841	723.988782	4.95136	9.772017	3.528998	21.726081	55.847134	624.222705	30.197528	0	0.381051	17.203434	32.408973	73.993482	0.467617	6.247838			22.086417																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999979	1024.000331	43.132807	0	0.2	0.199999	0.2	0.199999	0.2	0	0.2	0	0.199999	0.2	0.2	0.199999	0.500001	0.2			0.2																				1023.999979	1024.000331	43.132807	0	0.2	0.199999	0.2	0.199999	0.2	0	0.2	0	0.199999	0.2	0.2	0.199999	0.500001	0.2			0.2																				22.2502	0.716897	1.820778988	0	0.990272	1.954393628	0.7057996	4.345194474	11.1694268	0	6.0395056	0	0.076209819	3.4406868	6.4817946	14.79862241	0.233808968	1.2495676	0	0	4.4172834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6904	0	0	22.2502	0.716897	1.820778988	0	0.990272	1.954393628	0.7057996	4.345194474	11.1694268	0	6.0395056	0	0.076209819	3.4406868	6.4817946	14.79862241	0.233808968	1.2495676	0	0	4.4172834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6904		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4722	0.0797	0.2023		0.6278	1.2391	0.4475	0.8185	2.1413		1.1474		0.0144	0.6481	1.2994	2.9668	0.0469	0.2505			0.8856																				15.2873	0	0	24.7224	0.796552	2.023087988	0	1.618092	3.193459628	1.1532676	5.163659474	13.3107058	0	7.1868976	0	0.090564819	4.0887748	7.7812276	17.76537941	0.280681968	1.5000736	0	0	5.3028344	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.9777
H8707_803_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		260.74422	8.401134	506.559841	723.988782	4.95136	9.772017	3.528998	21.726081	55.847134	624.222705	30.197528	0	0.381051	17.203434	32.408973	73.993482	0.467617	6.247838			22.086417																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999979	1024.000331	43.132807	0	0.2	0.199999	0.2	0.199999	0.2	0	0.2	0	0.199999	0.2	0.2	0.199999	0.500001	0.2			0.2																				1023.999979	1024.000331	43.132807	0	0.2	0.199999	0.2	0.199999	0.2	0	0.2	0	0.199999	0.2	0.2	0.199999	0.500001	0.2			0.2																				22.2502	0.716897	1.820778988	0	0.990272	1.954393628	0.7057996	4.345194474	11.1694268	0	6.0395056	0	0.076209819	3.4406868	6.4817946	14.79862241	0.233808968	1.2495676	0	0	4.4172834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6904	0	0	22.2502	0.716897	1.820778988	0	0.990272	1.954393628	0.7057996	4.345194474	11.1694268	0	6.0395056	0	0.076209819	3.4406868	6.4817946	14.79862241	0.233808968	1.2495676	0	0	4.4172834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6904		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4722	0.0797	0.2023		0.6278	1.2391	0.4475	0.8185	2.1413		1.1474		0.0144	0.6481	1.2994	2.9668	0.0469	0.2505			0.8856																				15.2873	0	0	24.7224	0.796552	2.023087988	0	1.618092	3.193459628	1.1532676	5.163659474	13.3107058	0	7.1868976	0	0.090564819	4.0887748	7.7812276	17.76537941	0.280681968	1.5000736	0	0	5.3028344	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.9777
H8707_804_0	2009	2																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		260.74422	8.401134	506.559841	723.988782	4.95136	9.772017	3.528998	21.726081	55.847134	624.222705	30.197528	0	0.381051	17.203434	32.408973	73.993482	0.467617	6.247838			22.086417																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999979	1024.000331	43.132807	0	0.2	0.199999	0.2	0.199999	0.2	0	0.2	0	0.199999	0.2	0.2	0.199999	0.500001	0.2			0.2																				1023.999979	1024.000331	43.132807	0	0.2	0.199999	0.2	0.199999	0.2	0	0.2	0	0.199999	0.2	0.2	0.199999	0.500001	0.2			0.2																				22.2502	0.716897	1.820778988	0	0.990272	1.954393628	0.7057996	4.345194474	11.1694268	0	6.0395056	0	0.076209819	3.4406868	6.4817946	14.79862241	0.233808968	1.2495676	0	0	4.4172834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6904	0	0	22.2502	0.716897	1.820778988	0	0.990272	1.954393628	0.7057996	4.345194474	11.1694268	0	6.0395056	0	0.076209819	3.4406868	6.4817946	14.79862241	0.233808968	1.2495676	0	0	4.4172834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.6904		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.4722	0.0797	0.2023		0.6278	1.2391	0.4475	0.8185	2.1413		1.1474		0.0144	0.6481	1.2994	2.9668	0.0469	0.2505			0.8856																				15.2873	0	0	24.7224	0.796552	2.023087988	0	1.618092	3.193459628	1.1532676	5.163659474	13.3107058	0	7.1868976	0	0.090564819	4.0887748	7.7812276	17.76537941	0.280681968	1.5000736	0	0	5.3028344	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.9777
H8742_001_0	2009	6																					3250											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	Coin	V	Coin	V	T	V	V	V	V	V	V	V																																																			0		2386.552361	37.46971985	375.9002728		169.9563122	7.914889728	1.943748248	345.6971118	263.8992861	22.27949333	52.31732755	125.1174131	4.265321343	43.80072492	3930.109441	3255.260922	190.3592852	602.9463822			13.31801974	791.1521015		992	148																1a: $250 days 1-7	1b : $250 days 1-7	2a: $125 days 21 - 100 / 2a2: $125 days 21-100	6a: 0%	10a: $100	11a: 25%	11b: 25% 11c: 0%/25%	4a/4a1: $50 4b: $35	9b: $100	8a: 10%	8b1: 15% 8b2: 15% 8b3: 15%	9a: $200	12: $50	9a: $200 9c: $30 9d: $25 3: $25 5: $25	"7a: $7, 14b, 14c, 14d, 14d1, 14e, 14f, 14g, 14h: $0, 14i: $10"	7b: $35 7d: $30 7f: $30	"7e, 7h: $30"	7c: $25 7i: $25	8b1: 15% 8b2: 15% 8b3: 15%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $10 16b: $0 17a: $25 17b: $0	10b: (n/c)	16a: $15	17a: $25	17b1: $0	18a: $25 18a1: (n/c)	18b: (n/c)													115.722415	98.38787103	81.23643933		100	0.225	0.225	48.50045568	195	0.1	0.15	200	50	25.37924733	7.002146382	30.20417376	30	25			0.2	24.93795345		15	25																93.93922742	79.86767811	65.94477266		81.1763455	0.182646777	0.182646777	39.37089747	158.2938737	0.081176345	0.121764518	162.352691	40.58817275	20.60194549	5.684086539	24.51864445	24.35290365	20.29408637			0.162352691	20.24371925		12.17645182	20.29408637																18.6826	0.24938496	2.065721503	0	1.149702693	1.445629102	0.355019354	1.134200462	3.481136689	1.808567848	6.370394185	1.692762392	0.0144268	0.075198346	1.861590181	6.651215427	0.386316778	1.019687163	0	0	2.162216343	1.334655086	0	1.006586684	0.250293732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1973	0	12.3357	18.6826	0.24938496	2.065721503	0	1.149702693	1.445629102	0.355019354	1.134200462	3.481136689	1.808567848	6.370394185	1.692762392	0.0144268	0.075198346	1.861590181	6.651215427	0.386316778	1.019687163	0	0	2.162216343	1.334655086	0	1.006586684	0.250293732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1973																																																																																		0	0	0	18.6826	0.24938496	2.065721503	0	1.149702693	1.445629102	0.355019354	1.134200462	3.481136689	1.808567848	6.370394185	1.692762392	0.0144268	0.075198346	1.861590181	6.651215427	0.386316778	1.019687163	0	0	2.162216343	1.334655086	0	1.006586684	0.250293732	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1973
H8742_003_0	2009	5																					3250											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	Coin	V	Coin	V	T	V	V	V	V	V	V	V																																																			0		1715.330705	22.12287164	295.2751048		136.3845614	5.977216912	1.146989881	302.0184769	209.7994021	19.70921179	50.97436488	92.87788213	2.529217822	25.8466651	3385.002273	2703.664624	112.3303942	528.4850221			8.427438876	623.8752575		992	148																1a: $250 days 1-7	1b : $250 days 1-7	2a: $125 days 21 - 100 / 2a2: $125 days 21-100	6a: 0%	10a: $100	11a: 25%	11b: 25% 11c: 0%/25%	4a/4a1: $50 4b: $35	9b: $100	8a: 10%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $200	12: $50	9a: $200 9c: $30 9d: $25 3: $25 5: $25	"7a: $7, 14b, 14c, 14d, 14d1, 14e, 14f, 14g, 14h: $0, 14i: $10"	7b: $35 7d: $30 7f: $30	"7e, 7h: $30"	7c: $25 7i: $25	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $10 16b: $0 17a: $25 17b: $0	10b: (n/c)	16a: $15	17a: $25	17b1: $0	18a: $25 18a1: (n/c)	18b: (n/c)													115.722415	98.38787103	81.23643933		100	0.225	0.225	48.50034484	195	0.1	0.1	200	50	25.37924733	7.001470537	30.30759012	30	25			0.2	24.95356953		15	25																100.9856599	85.85859605	70.89132589		87.26542728	0.196347211	0.196347211	42.32403316	170.1675832	0.087265427	0.087265427	174.5308546	43.63271364	22.14730862	6.10986318	26.44804801	26.17962818	21.81635682			0.174530855	21.77583907		13.08981409	21.81635682																14.4353	0.158286558	1.744370307	0	0.991804752	1.173609872	0.225208265	1.065220003	2.975088101	1.719932788	4.448299732	1.350838011	0.009196386	0.047702839	1.723491729	5.95888765	0.245063996	0.960801485	0	0	1.470848109	1.132117267	0	1.082091298	0.269068401	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.1872	0	6.3023	14.4353	0.158286558	1.744370307	0	0.991804752	1.173609872	0.225208265	1.065220003	2.975088101	1.719932788	4.448299732	1.350838011	0.009196386	0.047702839	1.723491729	5.95888765	0.245063996	0.960801485	0	0	1.470848109	1.132117267	0	1.082091298	0.269068401	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.1872																																																																																		0	0	0	14.4353	0.158286558	1.744370307	0	0.991804752	1.173609872	0.225208265	1.065220003	2.975088101	1.719932788	4.448299732	1.350838011	0.009196386	0.047702839	1.723491729	5.95888765	0.245063996	0.960801485	0	0	1.470848109	1.132117267	0	1.082091298	0.269068401	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.1872
H8742_008_0	2009	7																					3000											D	D	D	Coin	T	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	Coin	V	Coin	V	T	V	V	V	V	V	V	V																																																			0		2383.428598	37.42067565	375.4082561		169.733856	7.894183654	1.938663225	345.2449032	263.5538677			124.9536466	4.259738455	43.74339405	3924.965312	3251.000103	190.1101235	602.1571844			13.28317858	790.1165607		992	148																1a: $175 days 1-7	1b : $175 days 1-7	2a: $50 days 21 - 100 / 2a2: $50 days 21-100	6a: 0%	10a: $75	11a: 10%	11b: 10% 11c: 0%/20%	4a/4a1: $50 4b: $30	9b: $75	8a: 0%	8b1: 0% 8b2: 0% 8b3: 0%	9a: $150	12: $50	9a: $150 9c: $25 9d: $25 3: $25 5: $25	"7a: $5, 14b, 14c, 14d, 14d1, 14e, 14f, 14g, 14h: $0, 14i: $10"	7b: $30 7d: $25 7f: $25	"7e, 7h: $25"	7c: $25 7i: $25	8b1: 0% 8b2: 0% 8b3: 0%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $10 16b: $0 17a: $10 17b: $0	10b: (n/c)	16a: $15	17a: $10	17b1: $0	18a: $25 18a1: (n/c)	18b: (n/c)													81.0056905	68.87150972	32.49457573		75	0.12	0.12	48.00060917	146.25			150	50	25	5.003577304	25.20417376	25	25			0.2	10		15	10																72.53782591	61.67208194	29.09778144		67.15993542	0.107455897	0.107455897	42.98290416	130.9618741			134.3198708	44.77329028	22.38664514	4.480532381	22.56947576	22.38664514	22.38664514			0.179093161	8.954658057		13.43198708	8.954658057																14.4074	0.192317581	0.910295615	0	0.949942901	0.848276583	0.208320795	1.236635716	2.87629237	0	0	1.398646473	0.015893542	0.081605653	1.465494515	6.114447337	0.354660656	1.1233566	0	0	2.378926442	0.589601969	0	1.110377599	0.110440783	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.3729	0	4.2461	14.4074	0.192317581	0.910295615	0	0.949942901	0.848276583	0.208320795	1.236635716	2.87629237	0	0	1.398646473	0.015893542	0.081605653	1.465494515	6.114447337	0.354660656	1.1233566	0	0	2.378926442	0.589601969	0	1.110377599	0.110440783	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.3729																																																																																		0	0	0	14.4074	0.192317581	0.910295615	0	0.949942901	0.848276583	0.208320795	1.236635716	2.87629237	0	0	1.398646473	0.015893542	0.081605653	1.465494515	6.114447337	0.354660656	1.1233566	0	0	2.378926442	0.589601969	0	1.110377599	0.110440783	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	36.3729
H8742_010_0	2009	7																					3150											Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	Coin	V	V																																																			0		317.9225188	3.803930716	13.74028	9.668479798	5.788360268	7.914889728	1.943748248	12.75905932	38.02166734	22.27949333	52.31732755	3.879199758	0.076922007	29.18209151	45.76656374	103.6324985	1.381674035	3.046309169			13.31801974	5.253593925		992	148																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	4a: Medicare FFS Ded/Coin  4b: $35	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	10b: n/c	16a: $15	17a: $10	17b1: n/c	18a1: n/c	18b: (n/c)		13c : $0											0.074493513	0.074493513	0.163205216	0.231	0.231	0.231	0.231	0.215800088	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.14096683		15	10																0.050264829	0.050264829	0.110123446	0.155868277	0.155868277	0.155868277	0.155868277	0.145612069	0.155868277	0.155868277	0.155868277	0.155868277	0.155868277	0.155868277	0.155868277	0.155868277	0.155868277	0.155868277			0.155868277	0.095117995		10.12131671	6.747544473																15.9803	0.191203927	1.513126976	1.50700929	0.902221743	1.233680227	0.302968691	1.85787303	5.926371788	3.472666245	8.154611719	0.604644184	0.011989701	4.548562333	7.133555448	16.15301902	0.215359152	0.474822962	0	0	2.075856794	0.499711322	0	0.836695515	0.083219715	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.6795	0	35.515	15.9803	0.191203927	1.513126976	1.50700929	0.902221743	1.233680227	0.302968691	1.85787303	5.926371788	3.472666245	8.154611719	0.604644184	0.011989701	4.548562333	7.133555448	16.15301902	0.215359152	0.474822962	0	0	2.075856794	0.499711322	0	0.836695515	0.083219715	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.6795																																																																																		0	0	0	15.9803	0.191203927	1.513126976	1.50700929	0.902221743	1.233680227	0.302968691	1.85787303	5.926371788	3.472666245	8.154611719	0.604644184	0.011989701	4.548562333	7.133555448	16.15301902	0.215359152	0.474822962	0	0	2.075856794	0.499711322	0	0.836695515	0.083219715	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	73.6795
H8742_801_0	2009	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																																																			0		331.005299	3.925930708	14.18095944		5.974005054	8.168736749	2.006088308	13.16826897	39.24110151	22.99404315	53.99525336	4.003613785	0.079389057	30.11802205	47.78259579	106.9562089	1.425987203	3.144010657			13.74515641	7.02624069																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS											0.074258476	0.074258476	0.163222081		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.074258476	0.074258476	0.163222081		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			24.5799	0.29153363	2.314645716	0	1.379995167	1.886978189	0.463406399	3.041870132	9.064694448	5.311623967	12.47290353	0.924834784	0.018338872	6.957263094	11.03777963	24.70688426	0.329403044	0.726266462	0	0	3.17513113	1.623061599	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.3066	0	0	24.5799	0.29153363	2.314645716	0	1.379995167	1.886978189	0.463406399	3.041870132	9.064694448	5.311623967	12.47290353	0.924834784	0.018338872	6.957263094	11.03777963	24.70688426	0.329403044	0.726266462	0	0	3.17513113	1.623061599	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.3066																																																																																		0	0	0	24.5799	0.29153363	2.314645716	0	1.379995167	1.886978189	0.463406399	3.041870132	9.064694448	5.311623967	12.47290353	0.924834784	0.018338872	6.957263094	11.03777963	24.70688426	0.329403044	0.726266462	0	0	3.17513113	1.623061599	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.3066
H8742_802_0	2009	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																																																			0		331.005299	3.925930708	14.18095944		5.974005054	8.168736749	2.006088308	13.16826897	39.24110151	22.99404315	53.99525336	4.003613785	0.079389057	30.11802205	47.78259579	106.9562089	1.425987203	3.144010657			13.74515641	7.02624069																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS											0.074258476	0.074258476	0.163222081		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.074258476	0.074258476	0.163222081		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			24.5799	0.29153363	2.314645716	0	1.379995167	1.886978189	0.463406399	3.041870132	9.064694448	5.311623967	12.47290353	0.924834784	0.018338872	6.957263094	11.03777963	24.70688426	0.329403044	0.726266462	0	0	3.17513113	1.623061599	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.3066	0	0	24.5799	0.29153363	2.314645716	0	1.379995167	1.886978189	0.463406399	3.041870132	9.064694448	5.311623967	12.47290353	0.924834784	0.018338872	6.957263094	11.03777963	24.70688426	0.329403044	0.726266462	0	0	3.17513113	1.623061599	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.3066																																																																																		0	0	0	24.5799	0.29153363	2.314645716	0	1.379995167	1.886978189	0.463406399	3.041870132	9.064694448	5.311623967	12.47290353	0.924834784	0.018338872	6.957263094	11.03777963	24.70688426	0.329403044	0.726266462	0	0	3.17513113	1.623061599	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.3066
H8742_803_0	2009	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																																																			0		331.005299	3.925930708	14.18095944		5.974005054	8.168736749	2.006088308	13.16826897	39.24110151	22.99404315	53.99525336	4.003613785	0.079389057	30.11802205	47.78259579	106.9562089	1.425987203	3.144010657			13.74515641	7.02624069																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS											0.074258476	0.074258476	0.163222081		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.074258476	0.074258476	0.163222081		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			24.5799	0.29153363	2.314645716	0	1.379995167	1.886978189	0.463406399	3.041870132	9.064694448	5.311623967	12.47290353	0.924834784	0.018338872	6.957263094	11.03777963	24.70688426	0.329403044	0.726266462	0	0	3.17513113	1.623061599	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.3066	0	0	24.5799	0.29153363	2.314645716	0	1.379995167	1.886978189	0.463406399	3.041870132	9.064694448	5.311623967	12.47290353	0.924834784	0.018338872	6.957263094	11.03777963	24.70688426	0.329403044	0.726266462	0	0	3.17513113	1.623061599	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.3066																																																																																		0	0	0	24.5799	0.29153363	2.314645716	0	1.379995167	1.886978189	0.463406399	3.041870132	9.064694448	5.311623967	12.47290353	0.924834784	0.018338872	6.957263094	11.03777963	24.70688426	0.329403044	0.726266462	0	0	3.17513113	1.623061599	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	110.3066
H8748_001_0	2009	6																					3400											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	3600	1574.087525	162.0153551	670.6267743	711.1844821	107.3347641	11.09061953	4.09658691	305.2436536	33.69181636	9505.624201	39.2091219	0	0.204079245	25.49353489	4463.237144	3513.314618	553.162144	198.9692192	0	0	15.77321644	762.6443905	0	0	103.5923094	0	12.88706159	11.22	453.6	0											"$240 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$240 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$15 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $30 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b2, 18b3, 18b4); $0 (18b1)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											237.1736087	240	85.36789939	0	150	0.2	0.076056143	49.51690605	0.2	2.8	0.173560039	0	0.2	0.197280088	10.75572315	30	37.5	30	0	0	0.2	28.5544382	0	0	30	0	30	0	0	0											159.4500814	161.3290745	57.38468416	0	100.8306715	0.134440895	0.05112528	33.28548593	0.134440895	1.882172536	0.116667835	0	0.134440895	0.132908828	10.75572315	30	37.5	20.16613431	0	0	0.134440895	28.5544382	0	0	30	0	30	0	0	0											20.9157	2.17814894	3.206975469	0	0.901886362	1.491032821	0.209439152	0.846681945	4.529557959	1.4909354	4.574443366	0	0.027436596	3.388315841	4.000445255	8.783286545	1.7286317	0.33437	0	0	2.120565342	1.814740176	0	0	0.258980774	0	0.032217654	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8338	0	22.5213	20.9157	2.17814894	3.206975469	0	0.901886362	1.491032821	0.209439152	0.846681945	4.529557959	1.4909354	4.574443366	0	0.027436596	3.388315841	4.000445255	8.783286545	1.7286317	0.33437	0	0	2.120565342	1.814740176	0	0	0.258980774	0	0.032217654	0	0	0	0	0	0	0	0	0	0	0	0	0	62.8338		"$325 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$325 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$190 Days 1-19 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											3.2466	0.3308	3.9136	0.3482	0.2473	0.6132	0.2265	0.2321	1.8627	0.4087	1.8466	0	0.0075	1.3903	2.4816	4.3648	0.8396	0.1375	0	0	1.1212	0.9176	0	0	0.1295	0	0.0161	0	0	0											24.6821	0	12.98785661	24.1623	2.508954864	7.120593143	0.348215475	1.149141643	2.104190567	0.435923704	1.078802743	6.392249049	1.899680523	6.421062287	0	0.034958435	4.778593878	6.482046655	13.14810103	2.568252811	0.471873047	0	0	3.241760322	2.732347826	0	0	0.38847116	0	0.048326481	0	0	0	0	0	0	0	0	0	0	0	0	0	87.5159
H8748_002_0	2009	4																					2800											D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1543.076149	158.823462	657.4146378	697.1733111	105.2201429	10.6579277	3.936761781	299.2377959	209.3475377	9318.352221	37.67940873	0	0.196117253	545.9816613	4377.240295	3444.234858	542.2641989	195.0492915	0	0	15.15783676	747.6193988	0	0	103.5923094	292.8	12.88706159	0	453.6	0											"$195 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$195 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-28 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$150 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); $150 (9a); $40/$30 (9c)"	"$5 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											192.7155233	195	100	0	150	0.2	0.076056143	49.51691864	150	2.8	0.17413628	0	0.2	52.82970021	3.583656836	20	37.5	20	0	0	0.2	19.0421189	0	0	20	30	20	0	0	0											131.0922175	132.625547	68.01310104	0	102.0196516	0.136026202	0.051728141	33.67799191	102.0196516	1.904366829	0.118435484	0	0.136026202	36.08991644	3.583656836	20	37.5	13.60262021	0	0	0.136026202	19.0421189	0	0	20	30	20	0	0	0											16.8571	1.755337377	3.726067349	0	0.894543527	1.449757427	0.20364137	0.839810673	1.779796905	1.478796739	4.46257901	0	0.026677085	1.642036045	1.307210592	5.74039143	1.694575622	0.221098453	0	0	2.061862966	1.18635479	0	0	0.172653849	0.732	0.021478436	0	0	0	0	0	0	0	0	0	0	0	0	0	48.2538	0	17.5745	16.8571	1.755337377	3.726067349	0	0.894543527	1.449757427	0.20364137	0.839810673	1.779796905	1.478796739	4.46257901	0	0.026677085	1.642036045	1.307210592	5.74039143	1.694575622	0.221098453	0	0	2.061862966	1.18635479	0	0	0.172653849	0.732	0.021478436	0	0	0	0	0	0	0	0	0	0	0	0	0	48.2538		"$275 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$275 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$10 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$10 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											4.8326	0.4944	5.4721	0.6053	0.4384	1.0658	0.3937	0.4116	3.2377	0.7248	3.2194	0	0.0131	2.4083	1.4282	3.6901	0.8231	0.209	0	0	1.9489	0.7804	0	0	0.111	0	0.0138	0	0	0											32.3215	0	0	21.6897	2.249695098	9.198125645	0.605269261	1.332960789	2.515550197	0.597317548	1.251403272	5.017532558	2.203557468	7.682027935	0	0.039751569	4.05030247	2.735399363	9.430523768	2.517655209	0.430079837	0	0	4.010727693	1.966709858	0	0	0.283645609	0.732	0.035286002	0	0	0	0	0	0	0	0	0	0	0	0	0	80.5752
H8748_003_0	2009	5																					3000											D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1587.339301	163.3793143	676.2725821	717.1717332	108.2383836	11.27814285	4.165853153	307.8100756	215.3526736	9585.64923	39.87208076	0	0.207529874	561.6431497	4499.985302	3542.833769	557.8190519	200.644282	0	0	16.03991442	769.0648673	0	0	103.5923094	292.8	12.88706159	0	453.6	0											"$200 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$200 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$150 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); $150 (9a); $40/$30 (9c)"	"$5 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											197.6553105	200	77.60718127	0	150	0.2	0.076056143	49.51690082	150	2.8	0.173320666	0	0.2	52.83019932	3.585899549	20	37.5	20	0	0	0.2	19.04264132	0	0	20	30	20	0	0	0											136.6375543	138.2384778	53.64149302	0	103.6788583	0.138238478	0.052569427	34.22570497	103.6788583	1.935338689	0.119797925	0	0.138238478	36.66913931	3.585899549	20	37.5	13.82384778	0	0	0.138238478	19.04264132	0	0	20	30	20	0	0	0											18.0742	1.882108976	3.023022583	0	0.935169337	1.559073299	0.218996514	0.877918069	1.860626611	1.545956485	4.776592543	0	0.028688614	1.716247575	1.344707939	5.904722948	1.743184537	0.231139668	0	0	2.217333354	1.220418868	0	0	0.172653849	0.732	0.021478436	0	0	0	0	0	0	0	0	0	0	0	0	0	50.0862	0	17.3864	18.0742	1.882108976	3.023022583	0	0.935169337	1.559073299	0.218996514	0.877918069	1.860626611	1.545956485	4.776592543	0	0.028688614	1.716247575	1.344707939	5.904722948	1.743184537	0.231139668	0	0	2.217333354	1.220418868	0	0	0.172653849	0.732	0.021478436	0	0	0	0	0	0	0	0	0	0	0	0	0	50.0862		"$275 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$275 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$10 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$10 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											4.9733	0.5085	5.629	0.6405	0.451	1.1278	0.4166	0.4234	3.4261	0.7456	3.3923	0	0.0138	2.5478	1.4762	3.7959	0.8467	0.215	0	0	2.0623	0.8033	0	0	0.111	0	0.0138	0	0	0											33.6199	0	0	23.0474	2.390647352	8.652046916	0.640491602	1.386162602	2.686887584	0.635581829	1.30130143	5.286775317	2.29150698	8.168936926	0	0.042523939	4.264052426	2.820904145	9.700616271	2.58987417	0.446115684	0	0	4.279608065	2.023702193	0	0	0.283645609	0.732	0.035286002	0	0	0	0	0	0	0	0	0	0	0	0	0	83.7061
H8748_004_0	2009	5																					3600											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	3900	1607.602483	165.4649331	684.9055404	726.3267897	109.6201008	11.567923	4.272890417	311.7343704	35.14180034	9708.014846	40.89655241	0	0.212862139	26.59069204	4556.176609	3587.97126	564.9398916	203.2056068	0	0	16.45204334	778.8823657	0	0	103.5923094	292.8	12.88706159	0	453.6	0											"$240 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$240 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$30 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											237.1736087	240	85.36789939	0	150	0.2	0.076056143	49.51689298	0.2	2.8	0.172962273	0	0.2	0.196996463	7.173771834	25	37.5	25	0	0	0.2	23.79885712	0	0	25	30	25	0	0	0											161.389509	163.2921424	58.08294659	0	102.057589	0.136076785	0.051747377	33.69049808	0.136076785	1.905074994	0.117680751	0	0.136076785	0.134316081	7.173771834	25	37.5	17.00959816	0	0	0.136076785	23.79885712	0	0	25	30	25	0	0	0											21.6208	2.251593618	3.315110994	0	0.932296933	1.574125774	0.221110872	0.875207184	4.781983221	1.541208027	4.812736991	0	0.028965596	3.571557548	2.723747619	7.474940124	1.765437161	0.288037143	0	0	2.23874117	1.544709178	0	0	0.215817311	0.732	0.026848045	0	0	0	0	0	0	0	0	0	0	0	0	0	62.537	0	22.5585	21.6208	2.251593618	3.315110994	0	0.932296933	1.574125774	0.221110872	0.875207184	4.781983221	1.541208027	4.812736991	0	0.028965596	3.571557548	2.723747619	7.474940124	1.765437161	0.288037143	0	0	2.23874117	1.544709178	0	0	0.215817311	0.732	0.026848045	0	0	0	0	0	0	0	0	0	0	0	0	0	62.537		"$295 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$295 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-23 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											3.1388	0.3192	3.8325	0.3781	0.2629	0.6658	0.2459	0.2468	2.0226	0.4346	1.9989	0	0.0082	1.5089	2.5453	4.4614	0.8575	0.1462	0	0	1.2174	0.9378	0	0	0.1295	0	0.0161	0	0	0											25.3745	0	12.21631783	24.7596	2.57084318	7.147602684	0.378108323	1.195180811	2.239920558	0.467038179	1.121993215	6.804578577	1.975789254	6.811626997	0	0.037133152	5.080444723	5.269078371	11.93638578	2.622935211	0.43423153	0	0	3.456186066	2.482531555	0	0	0.345307698	0.732	0.042956872	0	0	0	0	0	0	0	0	0	0	0	0	0	87.9115
H8748_801_0	2009	2																					4440											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	7500	1654.841225	170.3270526	705.0312101	747.6696059	112.8412427	11.67404644	4.31208966	320.8829216	35.46418913	9993.280898	41.27173495	0	0.214814923	26.83463347	4687.17315	3686.26126	581.5404197	209.1767206	0	0	16.60297341	801.769506	0	0	0	0	0	0	0	0											"$370 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$370 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-30 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											365.6080776	370	150	0	150	0.2	0.076056143	49.51687546	0.2	2.8	0.173524531	0	0.2	0.197516677	21.53456138	34.79716892	37.5	35	0	0	0.2	33.31043788	0	0	0	0	0	0	0	0											239.7023659	242.5595811	98.33496529	0	98.33496529	0.131113287	0.049859855	32.46160154	0.131113287	1.835586019	0.113756858	0	0.131113287	0.129796226	21.53456138	34.79716892	37.5	22.94482524	0	0	0.131113287	33.31043788	0	0	0	0	0	0	0	0											33.0558	3.442871543	5.777434965	0	0.92468664	1.530622602	0.215000163	0.868031128	4.64982641	1.528627225	4.694942896	0	0.028165091	3.483034153	8.411351492	10.68928798	1.817313811	0.399960275	0	0	2.176870419	2.225607777	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.9194	0	32.965	33.0558	3.442871543	5.777434965	0	0.92468664	1.530622602	0.215000163	0.868031128	4.64982641	1.528627225	4.694942896	0	0.028165091	3.483034153	8.411351492	10.68928798	1.817313811	0.399960275	0	0	2.176870419	2.225607777	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.9194		"$450 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$450 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	"$200 Days 1-38 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											5.9695	0.6141	5.523	0.4674	0.3315	0.8231	0.304	0.3112	2.5004	0.548	2.4783	0	0.0101	1.8652	5.1159	5.2089	0.8827	0.2107	0	0	1.505	1.1039	0	0	0	0	0	0	0	0											35.7729	0	9.915394074	39.0252	4.056953431	11.30048081	0.467423002	1.256175879	2.353687786	0.519019073	1.179210035	7.150188177	2.076622029	7.173271167	0	0.038261943	5.348221607	13.52728355	15.8981933	2.700009091	0.610642611	0	0	3.681893488	3.329480771	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.6923
H8748_802_0	2009	2																					4440											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	7500	1654.841225	170.3270526	705.0312101	747.6696059	112.8412427	11.67404644	4.31208966	320.8829216	35.46418913	9993.280898	41.27173495	0	0.214814923	26.83463347	4687.17315	3686.26126	581.5404197	209.1767206	0	0	16.60297341	801.769506	0	0	0	0	0	0	0	0											"$370 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$370 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-30 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											365.6080776	370	150	0	150	0.2	0.076056143	49.51687546	0.2	2.8	0.173524531	0	0.2	0.197516677	21.53456138	34.79716892	37.5	35	0	0	0.2	33.31043788	0	0	0	0	0	0	0	0											239.7023659	242.5595811	98.33496529	0	98.33496529	0.131113287	0.049859855	32.46160154	0.131113287	1.835586019	0.113756858	0	0.131113287	0.129796226	21.53456138	34.79716892	37.5	22.94482524	0	0	0.131113287	33.31043788	0	0	0	0	0	0	0	0											33.0558	3.442871543	5.777434965	0	0.92468664	1.530622602	0.215000163	0.868031128	4.64982641	1.528627225	4.694942896	0	0.028165091	3.483034153	8.411351492	10.68928798	1.817313811	0.399960275	0	0	2.176870419	2.225607777	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.9194	0	32.965	33.0558	3.442871543	5.777434965	0	0.92468664	1.530622602	0.215000163	0.868031128	4.64982641	1.528627225	4.694942896	0	0.028165091	3.483034153	8.411351492	10.68928798	1.817313811	0.399960275	0	0	2.176870419	2.225607777	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.9194		"$450 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$450 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	"$200 Days 1-38 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											5.9695	0.6141	5.523	0.4674	0.3315	0.8231	0.304	0.3112	2.5004	0.548	2.4783	0	0.0101	1.8652	5.1159	5.2089	0.8827	0.2107	0	0	1.505	1.1039	0	0	0	0	0	0	0	0											35.7729	0	9.915394074	39.0252	4.056953431	11.30048081	0.467423002	1.256175879	2.353687786	0.519019073	1.179210035	7.150188177	2.076622029	7.173271167	0	0.038261943	5.348221607	13.52728355	15.8981933	2.700009091	0.610642611	0	0	3.681893488	3.329480771	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.6923
H8748_803_0	2009	2																					4440											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	7500	1654.841225	170.3270526	705.0312101	747.6696059	112.8412427	11.67404644	4.31208966	320.8829216	35.46418913	9993.280898	41.27173495	0	0.214814923	26.83463347	4687.17315	3686.26126	581.5404197	209.1767206	0	0	16.60297341	801.769506	0	0	0	0	0	0	0	0											"$370 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$370 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-30 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											365.6080776	370	150	0	150	0.2	0.076056143	49.51687546	0.2	2.8	0.173524531	0	0.2	0.197516677	21.53456138	34.79716892	37.5	35	0	0	0.2	33.31043788	0	0	0	0	0	0	0	0											239.7023659	242.5595811	98.33496529	0	98.33496529	0.131113287	0.049859855	32.46160154	0.131113287	1.835586019	0.113756858	0	0.131113287	0.129796226	21.53456138	34.79716892	37.5	22.94482524	0	0	0.131113287	33.31043788	0	0	0	0	0	0	0	0											33.0558	3.442871543	5.777434965	0	0.92468664	1.530622602	0.215000163	0.868031128	4.64982641	1.528627225	4.694942896	0	0.028165091	3.483034153	8.411351492	10.68928798	1.817313811	0.399960275	0	0	2.176870419	2.225607777	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.9194	0	32.965	33.0558	3.442871543	5.777434965	0	0.92468664	1.530622602	0.215000163	0.868031128	4.64982641	1.528627225	4.694942896	0	0.028165091	3.483034153	8.411351492	10.68928798	1.817313811	0.399960275	0	0	2.176870419	2.225607777	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.9194		"$450 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$450 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	"$200 Days 1-38 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											5.9695	0.6141	5.523	0.4674	0.3315	0.8231	0.304	0.3112	2.5004	0.548	2.4783	0	0.0101	1.8652	5.1159	5.2089	0.8827	0.2107	0	0	1.505	1.1039	0	0	0	0	0	0	0	0											35.7729	0	9.915394074	39.0252	4.056953431	11.30048081	0.467423002	1.256175879	2.353687786	0.519019073	1.179210035	7.150188177	2.076622029	7.173271167	0	0.038261943	5.348221607	13.52728355	15.8981933	2.700009091	0.610642611	0	0	3.681893488	3.329480771	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.6923
H8748_804_0	2009	2																					4440											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	7500	1654.841225	170.3270526	705.0312101	747.6696059	112.8412427	11.67404644	4.31208966	320.8829216	35.46418913	9993.280898	41.27173495	0	0.214814923	26.83463347	4687.17315	3686.26126	581.5404197	209.1767206	0	0	16.60297341	801.769506	0	0	0	0	0	0	0	0											"$370 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$370 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-30 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											365.6080776	370	150	0	150	0.2	0.076056143	49.51687546	0.2	2.8	0.173524531	0	0.2	0.197516677	21.53456138	34.79716892	37.5	35	0	0	0.2	33.31043788	0	0	0	0	0	0	0	0											239.7023659	242.5595811	98.33496529	0	98.33496529	0.131113287	0.049859855	32.46160154	0.131113287	1.835586019	0.113756858	0	0.131113287	0.129796226	21.53456138	34.79716892	37.5	22.94482524	0	0	0.131113287	33.31043788	0	0	0	0	0	0	0	0											33.0558	3.442871543	5.777434965	0	0.92468664	1.530622602	0.215000163	0.868031128	4.64982641	1.528627225	4.694942896	0	0.028165091	3.483034153	8.411351492	10.68928798	1.817313811	0.399960275	0	0	2.176870419	2.225607777	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.9194	0	32.965	33.0558	3.442871543	5.777434965	0	0.92468664	1.530622602	0.215000163	0.868031128	4.64982641	1.528627225	4.694942896	0	0.028165091	3.483034153	8.411351492	10.68928798	1.817313811	0.399960275	0	0	2.176870419	2.225607777	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	85.9194		"$450 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$450 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	"$200 Days 1-38 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											5.9695	0.6141	5.523	0.4674	0.3315	0.8231	0.304	0.3112	2.5004	0.548	2.4783	0	0.0101	1.8652	5.1159	5.2089	0.8827	0.2107	0	0	1.505	1.1039	0	0	0	0	0	0	0	0											35.7729	0	9.915394074	39.0252	4.056953431	11.30048081	0.467423002	1.256175879	2.353687786	0.519019073	1.179210035	7.150188177	2.076622029	7.173271167	0	0.038261943	5.348221607	13.52728355	15.8981933	2.700009091	0.610642611	0	0	3.681893488	3.329480771	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	121.6923
H8778_001_0	2009	9																					1250											D	D	D	V	T	Coin	Coin	V	V	Coin	V	V	Coin	Coin	V	V	V	V	Coin	V	Coin	Coin	T	V	V	V	V	V	Coin	Coin																																																			0	0	1541.850082	5.832055423	1872.485984	1399.666863	225.288944	7.840036924	2.081615877	871.7937989	392.1605399	26.34826682	1044.313769	49.37991026	0	35.68728704	7889.253437	12622.39447	352.8320022	830.8273323	0	191.5525972	20.68618218	0	252.2910028	410.9141607	0	3.755519679	0	0	0.113026941	0											1a: $100 Days 1-10	1b: $150	2: $75 Days 21-35	6: none	10a: $75	11a: 20%	11b: 20%; 11c: 20%	4a: $50; 4b: $25	9b: $75	8a: 20%; 8a: $40; 8a: 20%; 8a: $40; 8a: 20%	8b: $15	5: $100	12: 20%	9a: 20%; 9a: $40; 9a: 20%; 9d: $25	14c: $5; 7a: $5	7d: $20	7e: $35; 7h: $35	7c: $25; 7i: $25		7b: $20; 7f: $20	15: 20%		10b: none	16a: $20	17a: $20	17b: $20	18a. $20	18b. $0	14a: none												59.80492268	150	13.85301775	0	75	0.200260338	0.173393055	14.6166357	53.35686444	0.108317703	5.664292499	31.95331773	0	0.171183309	3.233820124	5.696479896	35	22.87483547	0	19.80532883	0.196726328	0	0	19.61904762	0	17.8557338	0	0	0	0											54.58674535	150	7.624787155	0	53.80543762	0.15873811	0.149419136	13.52534014	52.17294507	0.10064147	5.299559513	26.84486442	0	0.081669675	3.229653146	5.687027128	35	20.42536686	0	19.80532883	0.077366249	0	0	19.61904762	0	17.8557338	0	0	0	0											7.0137	0.072900693	1.18977559	0	1.010147519	1.244512646	0.311033246	0.982608972	1.705014192	2.651728303	0.461200247	0.110466416	0	2.914569136	2.123296015	5.981991649	1.02909334	1.414162755	0	0.316146848	1.600412318	0	0	0.67181204	0	0.00558813	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.8102	0	8.6345	7.0137	0.072900693	1.18977559	0	1.010147519	1.244512646	0.311033246	0.982608972	1.705014192	2.651728303	0.461200247	0.110466416	0	2.914569136	2.123296015	5.981991649	1.02909334	1.414162755	0	0.316146848	1.600412318	0	0	0.67181204	0	0.00558813	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.8102	0																																																																																	0		0	7.0137	0.072900693	1.18977559	0	1.010147519	1.244512646	0.311033246	0.982608972	1.705014192	2.651728303	0.461200247	0.110466416	0	2.914569136	2.123296015	5.981991649	1.02909334	1.414162755	0	0.316146848	1.600412318	0	0	0.67181204	0	0.00558813	0	0	0	0	0	0	0	0	0	0	0	0	0	0	32.8102
H8778_801_0	2009	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																																																			0	0	225.5511046	0.685159437	52.83977349	7.433912482	7.131342504	7.840036924	2.07236588	10.48128095	31.45229752	26.34826682	2.530459631	2.806664609	0	35.65363408	71.59874837	98.12657513	5.249124946	4.498275673	0	1.155022675	20.67409109																				Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing											0.077569174	0.077569174	0.200738114	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.077569174	0.077569174	0.200738114	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				17.4958	0.053147252	10.6069565	0	1.647340119	1.811048529	0.478716518	2.421175899	7.265480727	6.086449634	0.584536175	0.648339525	0	8.235989473	16.53931087	22.66723885	1.212547862	1.03910168	0	0.266810238	4.775715042	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.8357	0	0	17.4958	0.053147252	10.6069565	0	1.647340119	1.811048529	0.478716518	2.421175899	7.265480727	6.086449634	0.584536175	0.648339525	0	8.235989473	16.53931087	22.66723885	1.212547862	1.03910168	0	0.266810238	4.775715042	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.8357	0																																																																																	0		0	17.4958	0.053147252	10.6069565	0	1.647340119	1.811048529	0.478716518	2.421175899	7.265480727	6.086449634	0.584536175	0.648339525	0	8.235989473	16.53931087	22.66723885	1.212547862	1.03910168	0	0.266810238	4.775715042	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.8357
H8778_802_0	2009	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																																																			0	0	225.5511046	0.685159437	52.83977349	7.433912482	7.131342504	7.840036924	2.07236588	10.48128095	31.45229752	26.34826682	2.530459631	2.806664609	0	35.65363408	71.59874837	98.12657513	5.249124946	4.498275673	0	1.155022675	20.67409109																				Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing	Medicare FFS Cost Sharing											0.077569174	0.077569174	0.200738114	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.077569174	0.077569174	0.200738114	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				17.4958	0.053147252	10.6069565	0	1.647340119	1.811048529	0.478716518	2.421175899	7.265480727	6.086449634	0.584536175	0.648339525	0	8.235989473	16.53931087	22.66723885	1.212547862	1.03910168	0	0.266810238	4.775715042	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.8357	0	0	17.4958	0.053147252	10.6069565	0	1.647340119	1.811048529	0.478716518	2.421175899	7.265480727	6.086449634	0.584536175	0.648339525	0	8.235989473	16.53931087	22.66723885	1.212547862	1.03910168	0	0.266810238	4.775715042	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.8357	0																																																																																	0		0	17.4958	0.053147252	10.6069565	0	1.647340119	1.811048529	0.478716518	2.421175899	7.265480727	6.086449634	0.584536175	0.648339525	0	8.235989473	16.53931087	22.66723885	1.212547862	1.03910168	0	0.266810238	4.775715042	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.8357
H8805_001_0	2009	9																																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																																																			0	3350	2197.777786	183.1503285						145.8521668								4402.851846					14.13222759																				1A: $250	1B: $250	2: $0	6: $0	10A: $0; 10B: $0	11A: $0	11B: $0; 11C: $0	4A: $50; 4B: $50	9A: $0; 9B: $0	8A: $0	8A: $0; 8B: $0		12: $0	3: $0; 5: $0; 7C: $0; 7I: $0; 9C: $0; 9D: $0; 13A: $0	7A: $0; 14C: $0; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0	7B: $0; 7D: $20; 7F: $0; 14B: $0; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0	7E: $0; 7H: $0	7I: $0			15: 20%	13A: $0; 16A: $0; 16B: $0; 17A: $0; 17B: $0; 18A: $0	10B: $0	16A: $0; 16B: $0	17A: $0	17B: $0	18A: $0	18B: $0	14A: $0	13B: $0											250	250						50								20					0.2																				250	250						50								20					0.2																				45.787	3.815631844	0	0	0	0	0	0.607717362	0	0	0	0	0	0	0	7.33808641	0	0	0	0	2.826445519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.3749	0	0	45.787	3.815631844	0	0	0	0	0	0.607717362	0	0	0	0	0	0	0	7.33808641	0	0	0	0	2.826445519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.3749		1A: 20%	1B: 20%	2: 20%	6: 20%	10A: 20%; 10B: 20%	11A: 20%	11B: 20%; 11C: 20%	4A: 20%; 4B: 20%	9A: 20%; 9B: 20%	8A: 20%	8A: 20%; 8B: 20%		12: 20%	3: 20%; 5: 20%; 7C: 20%; 7I: 20%; 9C: 20%; 9D: 20%; 13A: 20%	7A: 20%; 14C: 20%; 14D: 20%; 14E: 20%; 14F: 20%; 14G: 20%; 14H: 20%; 14I: 20%; 14J: 20%	7B: 20%; 7D: 20%; 7F: 20%; 14B: 20%; 14D: 20%; 14E: 20%; 14F: 20%; 14G: 20%; 14H: 20%; 14I: 20%; 14J: 20%	7E: 20%; 7H: 20%	7I: 20%			15: 20%	13A: 20%; 16A: 20%; 16B: 20%; 17A: 20%; 17B: 20%; 18A: 20%	10B: 20%	16A: 20%; 16B: 20%	17A: 20%	17B: 20%	18A: 20%	18B: 20%	14A: 20%	13B: 20%											16.1481	0.5837	1.6863	1.0284	0.2265	0.1978	0.1218	0.2477	1.0157	0.0362	0.4356	0	0.0278	0.3218	0.7954	1.6041	0.3854	0.5064	0	0	0.4635	0.4109																			26.2431	500	18.35887286	61.9351	4.399335272	1.686312819	1.028445495	0.226549716	0.197824941	0.121791737	0.855423726	1.015673571	0.036220965	0.435553833	0	0.027836505	0.321768651	0.795368013	8.942196118	0.385442048	0.506368126	0	0	3.289904279	0.410928747	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.6181
H8805_805_0	2009	4																																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																																																			0		2161.869047	183.1475872	977.7272117		144.6615178	6.032086634	281.0722713	181.8735477	177.4147831	704.929573	226.3606719	20.89279454	14.66735708	828.4709833	5307.806674	10615.58082	1087.29368	1853.283208	3117.910804	17694.8674	14.13180454	1511.736552																			1A: MC defined cost share	1B: MC defined cost share	2: MC defined cost share	6: $0	10A: MC defined cost share; 10B: MC defined cost share	11A: MC defined cost share	11B: MC defined cost share; 11C: MC defined cost share	4A: MC defined cost share; 4B: $0	9A: MC defined cost share; 9B: MC defined cost share	8A: MC defined cost share	8A: MC defined cost share; 8B: MC defined cost share	MC defined cost share	12: MC defined cost share	3: MC defined cost share; 5: MC defined cost share; 7C: MC defined cost share; 7I: MC defined cost share; 9C: MC defined cost share; 9D: MC defined cost share; 13A: MC defined cost share	7A: MC defined cost share; 14D: MC defined cost share; 14E: MC defined cost share; 14F: MC defined cost share; 14G: MC defined cost share; 14H: MC defined cost share; 14I: MC defined cost share; 14J: MC defined cost share	7B: MC defined cost share; 7D: MC defined cost share; 7F: MC defined cost share; 14B: $0; 14D: MC defined cost share; 14E: MC defined cost share; 14F: MC defined cost share; 14G: MC defined cost share; 14H: MC defined cost share; 14I: MC defined cost share; 14J: MC defined cost share	7E: MC defined cost share; 7H: MC defined cost share	7I: MC defined cost share	MC defined cost share	MC defined cost share	15: MC defined cost share	13A: MC defined cost share; 16A: MC defined cost share; 16B: MC defined cost share; 17A: MC defined cost share; 17B: MC defined cost share; 18A: MC defined cost share	10B: MC defined cost share	16A: MC defined cost share; 16B: MC defined cost share	17A: MC defined cost share	17B: MC defined cost share	18A: MC defined cost share	18B: $0 n/c	14A: $0	13B: $0											113.2683502	48.3290268	76.81805378		118.4364405	0.231	36.62516369	84.09470358	353.4804219	13.16368494	118.80696	289.2258795	117.2886273	70.28095754	13.4938911	15.94936075	21.97326254	16.95576021	26.38046542	8.721437113	0.231	17.23271556																			113.2683502	48.3290268	76.81805378		118.4364405	0.231	36.62516369	84.09470358	353.4804219	13.16368494	118.80696	289.2258795	117.2886273	70.28095754	13.4938911	15.94936075	21.97326254	16.95576021	26.38046542	8.721437113	0.231	17.23271556																			20.4059	0.737612054	6.258925128	0	1.427766271	1.393412012	0.857859829	1.274550173	5.226054365	0.773289233	2.241101941	0.503561406	0.143359515	4.8521445	5.968580435	14.10931067	1.990949124	2.61865214	6.854328179	12.86038943	3.264446849	2.170943834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.9332	0	0	20.4059	0.737612054	6.258925128	0	1.427766271	1.393412012	0.857859829	1.274550173	5.226054365	0.773289233	2.241101941	0.503561406	0.143359515	4.8521445	5.968580435	14.10931067	1.990949124	2.61865214	6.854328179	12.86038943	3.264446849	2.170943834	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	95.9332		1A: MC defined cost share	1B: MC defined cost share	2: MC defined cost share	6: $0	10A: MC defined cost share; 10B: MC defined cost share	11A: MC defined cost share	11B: MC defined cost share; 11C: MC defined cost share	4A: MC defined cost share; 4B: $0	9A: MC defined cost share; 9B: MC defined cost share	8A: MC defined cost share	8A: MC defined cost share; 8B: MC defined cost share	MC defined cost share	12: MC defined cost share	3: MC defined cost share; 5: MC defined cost share; 7C: MC defined cost share; 7I: MC defined cost share; 9C: MC defined cost share; 9D: MC defined cost share; 13A: MC defined cost share	7A: MC defined cost share; 14D: MC defined cost share; 14E: MC defined cost share; 14F: MC defined cost share; 14G: MC defined cost share; 14H: MC defined cost share; 14I: MC defined cost share; 14J: MC defined cost share	7B: MC defined cost share; 7D: MC defined cost share; 7F: MC defined cost share; 14B: $0; 14D: MC defined cost share; 14E: MC defined cost share; 14F: MC defined cost share; 14G: MC defined cost share; 14H: MC defined cost share; 14I: MC defined cost share; 14J: MC defined cost share	7E: MC defined cost share; 7H: MC defined cost share	7I: MC defined cost share	MC defined cost share	MC defined cost share	15: MC defined cost share	13A: MC defined cost share; 16A: MC defined cost share; 16B: MC defined cost share; 17A: MC defined cost share; 17B: MC defined cost share; 18A: MC defined cost share	10B: MC defined cost share	16A: MC defined cost share; 16B: MC defined cost share	17A: MC defined cost share	17B: MC defined cost share	18A: MC defined cost share	18B: $0 n/c	14A: $0	13B: $0											7.4351	0.2688	2.0503		0.3989	0.3484	0.2145	0.4362	1.7885	0.2646	0.767	0.1723	0.049	1.6606	2.0324	4.5109	0.6787	0.8917	2.334	4.3791	0.8161	0.7393																			32.2363	0	0	27.841	1.006366537	8.309262669	0	1.826701175	1.741765015	1.072324786	1.710740148	7.014569693	1.037932414	3.008075435	0.675895491	0.192377248	6.512696458	8.001023707	18.62019446	2.669679999	3.510323618	9.188280386	17.23945234	4.080558561	2.910266903	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.1695
H8822_001_0	2009	8																																Coin	Coin	Coin	Coin	Coin	Coin	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		334.8748043	1.265511195	47.31179499	9.188384275	3.860916824	13.41323293	3.592528872	5.640586951	40.63063266	9.678295675	40.44567516	0	0	50.04932177	56.31512899	0	4.421593437	0	35.19115425	143.2469071	38.15125086	5.56670247	2	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											0.0725	0.0725	0.2001	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0.231	0	0.231	0.231	0.231	0.231	0	0	0.231	0	0.231	0	0	0											0.0725	0.0725	0.2001	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0	0.231	0	0.231	0.231	0.231	0.231	0	0	0.231	0	0.231	0	0	0											24.2784	0.091749562	9.467090177	0	0.891871786	3.098456806	0.829874169	1.302975586	9.385676145	2.235686301	9.342950961	0	0	11.56139333	13.0087948	0	1.021388084	0	8.129156632	33.09003554	8.812938949	1.285908271	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.8344			24.2784	0.091749562	9.467090177	0	0.891871786	3.098456806	0.829874169	1.302975586	9.385676145	2.235686301	9.342950961	0	0	11.56139333	13.0087948	0	1.021388084	0	8.129156632	33.09003554	8.812938949	1.285908271	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.8344																																																																																		0			24.2784	0.091749562	9.467090177	0	0.891871786	3.098456806	0.829874169	1.302975586	9.385676145	2.235686301	9.342950961	0	0	11.56139333	13.0087948	0	1.021388084	0	8.129156632	33.09003554	8.812938949	1.285908271	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.8344
H8822_002_0	2009	5																					4000											D	D	D	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																																																			0	0	1918.556764	21.7165298	901.74149	575.8663279	831.6999961	13.78263713	3.691468125	262.9292038	474.4735892	6969.833521	2413.53757	0	0	19622.61738	7081.355946	0	1434.650755	0	4971.438622	47576.19526	39.20194702	754.3714177	0	0	385.11639	36.110664	0	0	0	70.66806009											$100 Copay for 1st 5 Days	$100 Copay for 1st 5 Days			$50 Copay	20% Coinsurance	20% Coinsurance	$40 Emergency Room Copy; $50 Urgent Care Copay	$100 Copay for 1st 5 Days						"$10 PCP copay, $25 Specialist Copay"		$25 MHSA Copay			"$25 Chiropractic, $25 Podiatry, $25 Physical Medicine"	20% Coinsurance	$25 Medicare Covered Vision Copay			$20 Non-Medicare Covered Vision Copay																59.11874534	59.67482669	0	0	50	0.2	0.2	42.01145488	100	0	0	0	0	0	17.2	0	4.935616213	0	0	1.587897216	0.2	19.83979085	0	0	20	0	0	0	0	0											59.11874534	59.67482669	0	0	50	0.2	0.2	42.01145488	100	0	0	0	0	0	17.2	0	4.935616213	0	0	1.587897216	0.2	19.83979085	0	0	20	0	0	0	0	0											9.4519	0.107994179	0	0	3.465416651	2.756527426	0.738293625	0.920503199	3.953946577	0	0	0	0	0	10.14994352	0	0.590073794	0	0	6.295508999	7.840389404	1.247214263	0	0	0.64186065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.1596		0	9.4519	0.107994179	0	0	3.465416651	2.756527426	0.738293625	0.920503199	3.953946577	0	0	0	0	0	10.14994352	0	0.590073794	0	0	6.295508999	7.840389404	1.247214263	0	0	0.64186065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.1596																																																																																		0			9.4519	0.107994179	0	0	3.465416651	2.756527426	0.738293625	0.920503199	3.953946577	0	0	0	0	0	10.14994352	0	0.590073794	0	0	6.295508999	7.840389404	1.247214263	0	0	0.64186065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.1596
H8822_003_0	2009	6																					4000											D	D	D	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																																																			0	0	2096.594719	23.75073298	986.1067622	629.8081469	909.6059414	12.88565551	3.451225345	287.3871969	518.9178764	7622.702911	2639.615395	0	0	21460.68227	7744.671723	0	1569.035538	0	5437.116904	51991.23937	36.6506627	825.0339387	0	0	385.11639	36.110664	0	0	0	70.66806009											$100 Copay for 1st 5 Days	$100 Copay for 1st 5 Days			$50 Copay	20% Coinsurance	20% Coinsurance	$40 Emergency Room Copy; $50 Urgent Care Copay	$100 Copay for 1st 5 Days						"$10 PCP copay, $25 Specialist Copay"		$25 MHSA Copay			"$25 Chiropractic, $25 Podiatry, $25 Physical Medicine"	20% Coinsurance	$25 Medicare Covered Vision Copay			$20 Non-Medicare Covered Vision Copay																59.16596648	59.67482669	0	0	49	0.2	0.2	42.03641982	100	0	0	0	0	0	17.2	0	4.935616213	0	0	1.589163252	0.2	19.83979085	0	0	20	0	0	0	0	0											59.16596648	59.67482669	0	0	49	0.2	0.2	42.03641982	100	0	0	0	0	0	17.2	0	4.935616213	0	0	1.589163252	0.2	19.83979085	0	0	20	0	0	0	0	0											10.3373	0.118110073	0	0	3.714224261	2.577131101	0.690245069	1.006727405	4.324315637	0	0	0	0	0	11.10069614	0	0.645346437	0	0	6.885213919	7.33013254	1.364041732	0	0	0.64186065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.7353		0	10.3373	0.118110073	0	0	3.714224261	2.577131101	0.690245069	1.006727405	4.324315637	0	0	0	0	0	11.10069614	0	0.645346437	0	0	6.885213919	7.33013254	1.364041732	0	0	0.64186065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.7353																																																																																		0			10.3373	0.118110073	0	0	3.714224261	2.577131101	0.690245069	1.006727405	4.324315637	0	0	0	0	0	11.10069614	0	0.645346437	0	0	6.885213919	7.33013254	1.364041732	0	0	0.64186065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.7353
H8822_004_0	2009	6																					4000											D	D	D	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																																																			0	0	2103.718087	23.83212225	989.4822499	631.9663803	912.7229889	12.92981221	3.463052041	288.3657708	520.6961098	7648.824472	2648.660857	0	0	21534.22396	7771.211248	0	1574.412326	0	5455.748875	52167.88702	36.77625759	827.8611739	0	0	385.11639	36.110664	0	0	0	70.66806009											$100 Copay for 1st 5 Days	$100 Copay for 1st 5 Days			$50 Copay	20% Coinsurance	20% Coinsurance	$40 Emergency Room Copy; $50 Urgent Care Copay	$100 Copay for 1st 5 Days						"$10 PCP copay, $25 Specialist Copay"		$25 MHSA Copay			"$25 Chiropractic, $25 Podiatry, $25 Physical Medicine"	20% Coinsurance	$25 Medicare Covered Vision Copay			$20 Non-Medicare Covered Vision Copay																59.16768952	59.67482669	0	0	49	0.2	0.2	42.03733057	100	0	0	0	0	0	17.2	0	4.935616213	0	0	1.589209448	0.2	19.83979085	0	0	20	0	0	0	0	0											59.16768952	59.67482669	0	0	49	0.2	0.2	42.03733057	100	0	0	0	0	0	17.2	0	4.935616213	0	0	1.589209448	0.2	19.83979085	0	0	20	0	0	0	0	0											10.3727	0.118514814	0	0	3.726952205	2.585962442	0.692610408	1.010177269	4.339134249	0	0	0	0	0	11.13873612	0	0.647557917	0	0	6.908808245	7.355251517	1.368716045	0	0	0.64186065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.907		0	10.3727	0.118514814	0	0	3.726952205	2.585962442	0.692610408	1.010177269	4.339134249	0	0	0	0	0	11.13873612	0	0.647557917	0	0	6.908808245	7.355251517	1.368716045	0	0	0.64186065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.907																																																																																		0			10.3727	0.118514814	0	0	3.726952205	2.585962442	0.692610408	1.010177269	4.339134249	0	0	0	0	0	11.13873612	0	0.647557917	0	0	6.908808245	7.355251517	1.368716045	0	0	0.64186065	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.907
H8836_001_0	2009	7																					3500											D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	V	V	Coin	Coin																																																											0		865.2286264	12.58583114	150.5544187	15.19736981	160.9955775	0.810792808	17.10786186	276.1977011	84.87639142	41.20114071	4.972551465	0.494290366	0.232871961	6.457494817	6181.09493	9978.209115	1.379713712	15.7157602	0	0	8.78143815	0.903464551																			$175 - days 1-5	$175 - days 1-5	$100 - days 11-100	15% Coinsurance	$150 Copay	20% Coinsurance	20% Coinsurance	$50 Copay	15% Coinsurance	15% Coinsurance	15% Coinsurance	50% Coinsurance	15% Coinsurance	50% Coinsurance	$20 Copay	$50 Copay	50% Coinsurance	15% Coinsurance	$50 Copay	$50 Copay	20% Coinsurance	15% Coinsurance																			175	175	100	0.15	150	0.2	0.2	50	0.15	0.15	0.15	0.5	0.15	0.5	20	50	0.5	0.15	50	50	0.2	0.15																			118.920879	118.920879	67.95478802	0.101932182	101.932182	0.135909576	0.135909576	33.97739401	0.101932182	0.101932182	0.101932182	0.33977394	0.101932182	0.33977394	13.5909576	33.97739401	0.33977394	0.101932182	33.98	33.98	0.135909576	0.101932182																			8.5745	0.124726509	0.852574467	1.549101065	1.367552542	0.110194507	2.325122252	0.782039843	8.65163578	4.199722174	0.506863021	0.167946985	0.023737147	2.194088457	7.000583262	28.25279522	0.468790764	1.601941729	0	0	1.193481536	0.092092113	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.0395		33.0283	8.5745	0.124726509	0.852574467	1.549101065	1.367552542	0.110194507	2.325122252	0.782039843	8.65163578	4.199722174	0.506863021	0.167946985	0.023737147	2.194088457	7.000583262	28.25279522	0.468790764	1.601941729	0	0	1.193481536	0.092092113	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.0395																																																																																		0			8.5745	0.124726509	0.852574467	1.549101065	1.367552542	0.110194507	2.325122252	0.782039843	8.65163578	4.199722174	0.506863021	0.167946985	0.023737147	2.194088457	7.000583262	28.25279522	0.468790764	1.601941729	0	0	1.193481536	0.092092113	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.0395
H8836_002_0	2009	5																					3500											D	D	D	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	Coin	V	Coin	Coin																																																											0		884.0912121	12.86021101	155.5151302	15.22686048	161.8226137	0.820596624	17.314724	275.3878182	84.21979858	40.88241399	4.934084447	0.501868939	0.231070493	4.302890514	6357.264413	10305.04898	1.412601612	16.09037296	0	0	8.713506075	0.899554494																			$125 day for 1st 5 days	$125 day for 1st 5 days	$100 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	$20 Per Visit	$50 Per Visit	50% Coinsurance	10% Coinsurance	$50 Per Visit	$50 Per Visit	20% Coinsurance	10% Coinsurance																			125	125	100	0.1	100	0.2	0.2	50	0.1	0.1	0.1	0.5	0.1	0.5	20	50	0.5	0.1	50	50	0.2	0.1																			88.38583228	88.38583228	70.70866582	0.070708666	70.70866582	0.141417332	0.141417332	35.35433291	0.070708666	0.070708666	0.070708666	0.353543329	0.070708666	0.353543329	14.14173316	35.35433291	0.353543329	0.070708666	35.35	35.35	0.141417332	0.070708666																			6.5118	0.094721704	0.916355615	1.076670989	0.953521759	0.116046585	2.448602066	0.81134605	5.955069594	2.890740949	0.348882528	0.177432416	0.016338686	1.521258237	7.491894749	30.36067768	0.499415877	1.137728804	0	0	1.232240778	0.063606298	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6243		26.7709	6.5118	0.094721704	0.916355615	1.076670989	0.953521759	0.116046585	2.448602066	0.81134605	5.955069594	2.890740949	0.348882528	0.177432416	0.016338686	1.521258237	7.491894749	30.36067768	0.499415877	1.137728804	0	0	1.232240778	0.063606298	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6243																																																																																		0			6.5118	0.094721704	0.916355615	1.076670989	0.953521759	0.116046585	2.448602066	0.81134605	5.955069594	2.890740949	0.348882528	0.177432416	0.016338686	1.521258237	7.491894749	30.36067768	0.499415877	1.137728804	0	0	1.232240778	0.063606298	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.6243
H8980_001_0	2009	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	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	3000	1916.814088	0	1128.064394	0	265.976564	10.72951918	7.312399127	123.2679145	0	0	996.4806053	0	0	362.3920458	6188.129557	16637.59704	170.9844787	1725.429789	5336.658149	1639.240037	1874.609667	0	0	0	234.1900858	0	256.8488024	0	0	420.0406105											"1a $300 per admit, with a max of 4/yr"	"1b $300 per admit, with a max of 4/yr"	2 $60 days 21-100	6 $0	10a $75	11a 20%	11b 20%	4a $50	"9a $0, 9b $0"	8a $0	8b $25	5 $0	12 $0	4b $50	7a $10	"16b $15, 17a $20, 18a $20, 7b $20, 7d $20, 7f $20"	"7e $25, 7h $25, 9c $25"	"7c $20, 7i $20"	8b $25	7g $20	"15 $50/$100, 11c DS $20/$40, Nebulizers $10/$30"		10b $0	16a $0	17a $20	17b $150 Allowance every two years	18a $20	"18b $750 Allowance every 3 yrs ($500 for 1st aid, $250 for 2nd aid)"		14a $0											37.29380316	0	18.14245954	0	75	0.198860702	0.2	45.88541521	0	0	18.65335686	0	0	0.005382131	5.599834889	4.148885669	22.62208296	3.00364583	21.74474747	0.657570378	8.123733131	0	0	0	7.816484892	0	19.86151922	0	0	2.775244209											27.57969293	0	13.41679906	0	55.46436122	0.147062424	0.147904963	33.93340325	0	0	13.7946203	0	0	0.00398022	4.141216867	3.068203912	22.62208296	2.22127063	16.08078037	0.486289613	8.123733131	0	0	0	5.780484553	0	14.68808635	0	0	2.052361963											4.4054	0	1.261251108	0	1.229351685	1.577909097	1.081540124	0.348574987	0	0	1.145505966	0	0	0.0001202	2.135532208	4.253961694	0.322335422	0.31938721	7.151468967	0.066428784	1.269069055	0	0	0	0.112811014	0	0.314384782	0	0	0.071839614	0	0	0	0	0	0	0	0	0	0	27.0669	0	8.973	4.4054	0	1.261251108	0	1.229351685	1.577909097	1.081540124	0.348574987	0	0	1.145505966	0	0	0.0001202	2.135532208	4.253961694	0.322335422	0.31938721	7.151468967	0.066428784	1.269069055	0	0	0	0.112811014	0	0.314384782	0	0	0.071839614	0	0	0	0	0	0	0	0	0	0	27.0669	4500	0.2	0.2	0.2	0.2	0.2	0.2	0.2	50	0.2	0.2	0.2	0.5	0.2	50	0.2	0.2	0.5	0.2	0.2	0.2	0.2		0	0	0.2	$150 Allowance every two years	$25 maximum benefit per year	$375 maximum benefit every three years		0.5											2.7657	0.0045	0.3606	0.1097	0.1034	0.1132	0.0776	0.0217	0.3938	0.0687	0.3387	0.0239	0.0014	0.0531	0.3688	1.0688	0.0015	0.1174	0.528	0.0675	0.4123	0	0	0	0.0029	0	0.0009	0	0	0.022											7.0261	300	0.010386768	7.1711	0.004530205	1.621805232	0.109652878	1.332772819	1.691124847	1.159141157	0.370323183	0.39376485	0.068675895	1.484227106	0.023876112	0.001382905	0.053259755	2.504333147	5.322749094	0.323876979	0.43675194	7.679516708	0.133943317	1.681325939	0	0	0	0.115690837	1.04E-05	0.315245103	0	0	0.093883658	0	0	0	0	0	0	0	0	0	0	34.093
H8980_002_0	2009	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	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	3350	1859.551198	0	1094.364606	0	260.6570328	10.5149288	7.166151145	120.8025562	598.0108453	0	976.5509931	0	0	355.1442049	6064.366966	16304.8451	167.5647891	1690.921193	5229.924986	1606.455237	1837.117473	0	0	0	229.506284	0	251.7118264	0	0	411.6397983											1a $175 days 1-5	1b $175 days 1-5	2 $75 days 11-100	6 $0	10a $75	11a 20%	11b 20%	4a $50	"9a $100, 9b $100"	8a $0	8b $25	5 $0	12 $0	4b $50	7a $15	"16b $15, 17a $25, 18a $25, 7b $30, 7d $30, 7f $30"	"7e $30, 7h $30, 9c $30"	"7c $30, 7i $30"	8b $25	7g $30	"15 $50/$100, 11c DS $20/$40, Nebulizers $10/$30"		10b $0	16a $0	17a $25	17b $150 Allowance every two years	18a $25	"18b $750 Allowance every 3 yrs ($500 for 1st aid, $250 for 2nd aid)"		14a $0											117.2944885	0	42.76620967	0	75	0.198860702	0.2	50	100	0	19.67508334	0	0	15.67814911	8.698809039	7.337918366	11.16334268	16.0282088	21.82069703	0.842585195	8.621286585	0	0	0	9.770606115	0	24.84300144	0	0	3.609572626											78.11983383	0	28.4829171	0	49.95108986	0.132444117	0.133202906	33.30072657	66.60145315	0	13.10389141	0	0	10.44187513	5.793533226	4.887160263	11.16334268	10.67501998	14.53290131	0.561173984	8.621286585	0	0	0	6.507365654	0	16.54579997	0	0	2.404027822											12.1057	0	2.59755803	0	1.085008572	1.39264046	0.954552159	0.335234408	3.319032608	0	1.066384848	0	0	0.309030953	2.927842626	6.640365923	0.15588193	1.504218126	6.333831972	0.075125074	1.319859686	0	0	0	0.124456776	0	0.347064461	0	0	0.082466127	0	0	0	0	0	0	0	0	0	0	42.6762	0	20.6607	12.1057	0	2.59755803	0	1.085008572	1.39264046	0.954552159	0.335234408	3.319032608	0	1.066384848	0	0	0.309030953	2.927842626	6.640365923	0.15588193	1.504218126	6.333831972	0.075125074	1.319859686	0	0	0	0.124456776	0	0.347064461	0	0	0.082466127	0	0	0	0	0	0	0	0	0	0	42.6762	5350	0.2	0.2	0.2	0.2	0.2	0.2	0.2	50	0.2	0.2	0.2	0.5	0.2	50	0.2	0.2	0.5	0.2	0.2	0.2	0.2		0	0	0.2	$150 Allowance every two years	$25 maximum benefit per year	$375 maximum benefit every three years		0.5											2.705	0.0044	0.3526	0.1072	0.1012	0.1107	0.0759	0.0221	0.3851	0.0672	0.3313	0.0234	0.0014	0.052	0.3607	1.0453	0.0015	0.1148	0.5165	0.066	0.404	0	0	0	0.0028	0	0.0008	0	0	0.0216											6.8734	300	0.02308243	14.8106	0.004439601	2.950197064	0.107245715	1.186159346	1.503370833	1.03044965	0.357295523	3.704153308	0.067168283	1.397670188	0.02335197	0.001352547	0.361003958	3.288547436	7.685692171	0.157392656	1.619006399	6.850287707	0.141157489	1.723871432	0	0	0	0.127273381	1.02E-05	0.347905895	0	0	0.104026247	0	0	0	0	0	0	0	0	0	0	49.5496
H8980_801_0	2009	2																					0											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	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	303.7853759	2.168067098	45.22277949	0	12.13112602	13.08020112	9.688701089	3.352248481	51.86651683	8.591168391	36.19539319	3.762951954	0.100012684	8.903069339	42.9118787	132.3610755	2.392694959	15.7050424	62.16217643	10.85077541	49.30741383	0	0	0	0	0	0	0	0	0											FFS 7.6%	FFS 7.6%	FFS 19.5%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%		FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%			FFS 23.1%											0.076336992	0.076336992	0.194636516	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.076336992	0.076336992	0.194636516	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											23.1901	0.165503721	8.802004265	0	2.80229011	3.021526459	2.238089951	0.774369399	11.98116539	1.984559898	8.361135827	0.869241901	0.02310293	2.056609017	9.912643979	30.57540844	0.552712536	3.627864793	14.35946276	2.506529121	11.39001259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1943	0	0	23.1901	0.165503721	8.802004265	0	2.80229011	3.021526459	2.238089951	0.774369399	11.98116539	1.984559898	8.361135827	0.869241901	0.02310293	2.056609017	9.912643979	30.57540844	0.552712536	3.627864793	14.35946276	2.506529121	11.39001259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1943	0	FFS 7.6%	FFS 7.6%	FFS 19.5%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%		FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%			FFS 23.1%											1.2423	0.0024	0.4715	0	0.1489	0.1606	0.1189	0.0412	0.6367	0.1011	0.4443	0.0462	0.0012	0.1093	0.5268	1.6048	0.0003	0.1928	0.7631	0.133	0.6263	0	0	0	0	0	0	0	0	0											7.3719	0	0	24.4324	0.167917584	9.273547451	0	2.951216934	3.18210453	2.357028474	0.815523017	12.61790064	2.08568796	8.805467899	0.915433426	0.024330728	2.165906855	10.43942031	32.18017308	0.553044954	3.820669148	15.12260106	2.639538036	12.01630784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	146.5662
H8980_802_0	2009	2																					0											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	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	303.7853759	2.168067098	45.22277949	0	12.13112602	13.08020112	9.688701089	3.352248481	51.86651683	8.591168391	36.19539319	3.762951954	0.100012684	8.903069339	42.9118787	132.3610755	2.392694959	15.7050424	62.16217643	10.85077541	49.30741383	0	0	0	0	0	0	0	0	0											FFS 7.6%	FFS 7.6%	FFS 19.5%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%		FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%			FFS 23.1%											0.076336992	0.076336992	0.194636516	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.076336992	0.076336992	0.194636516	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											23.1901	0.165503721	8.802004265	0	2.80229011	3.021526459	2.238089951	0.774369399	11.98116539	1.984559898	8.361135827	0.869241901	0.02310293	2.056609017	9.912643979	30.57540844	0.552712536	3.627864793	14.35946276	2.506529121	11.39001259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1943	0	0	23.1901	0.165503721	8.802004265	0	2.80229011	3.021526459	2.238089951	0.774369399	11.98116539	1.984559898	8.361135827	0.869241901	0.02310293	2.056609017	9.912643979	30.57540844	0.552712536	3.627864793	14.35946276	2.506529121	11.39001259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1943	0	FFS 7.6%	FFS 7.6%	FFS 19.5%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%		FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%			FFS 23.1%											1.2423	0.0024	0.4715	0	0.1489	0.1606	0.1189	0.0412	0.6367	0.1011	0.4443	0.0462	0.0012	0.1093	0.5268	1.6048	0.0003	0.1928	0.7631	0.133	0.6263	0	0	0	0	0	0	0	0	0											7.3719	0	0	24.4324	0.167917584	9.273547451	0	2.951216934	3.18210453	2.357028474	0.815523017	12.61790064	2.08568796	8.805467899	0.915433426	0.024330728	2.165906855	10.43942031	32.18017308	0.553044954	3.820669148	15.12260106	2.639538036	12.01630784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	146.5662
H8980_803_0	2009	2																					0											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	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	303.7853759	2.168067098	45.22277949	0	12.13112602	13.08020112	9.688701089	3.352248481	51.86651683	8.591168391	36.19539319	3.762951954	0.100012684	8.903069339	42.9118787	132.3610755	2.392694959	15.7050424	62.16217643	10.85077541	49.30741383	0	0	0	0	0	0	0	0	0											FFS 7.6%	FFS 7.6%	FFS 19.5%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%		FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%			FFS 23.1%											0.076336992	0.076336992	0.194636516	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											0.076336992	0.076336992	0.194636516	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0	0											23.1901	0.165503721	8.802004265	0	2.80229011	3.021526459	2.238089951	0.774369399	11.98116539	1.984559898	8.361135827	0.869241901	0.02310293	2.056609017	9.912643979	30.57540844	0.552712536	3.627864793	14.35946276	2.506529121	11.39001259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1943	0	0	23.1901	0.165503721	8.802004265	0	2.80229011	3.021526459	2.238089951	0.774369399	11.98116539	1.984559898	8.361135827	0.869241901	0.02310293	2.056609017	9.912643979	30.57540844	0.552712536	3.627864793	14.35946276	2.506529121	11.39001259	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.1943	0	FFS 7.6%	FFS 7.6%	FFS 19.5%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%		FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%	FFS 23.1%			FFS 23.1%											1.2423	0.0024	0.4715	0	0.1489	0.1606	0.1189	0.0412	0.6367	0.1011	0.4443	0.0462	0.0012	0.1093	0.5268	1.6048	0.0003	0.1928	0.7631	0.133	0.6263	0	0	0	0	0	0	0	0	0											7.3719	0	0	24.4324	0.167917584	9.273547451	0	2.951216934	3.18210453	2.357028474	0.815523017	12.61790064	2.08568796	8.805467899	0.915433426	0.024330728	2.165906855	10.43942031	32.18017308	0.553044954	3.820669148	15.12260106	2.639538036	12.01630784	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	146.5662
H8991_011_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	605.54	29.95	125.64	167.54	59.24	65.72	61.21	20.29	42.72	8.39	32.7	2.51	4.94	124.54	108.85	198.54	11.26	17.92	57.15	106.69	14.13	7.53	9.95	20.41	3.63	3.74	0.77	2.22	3.03	17.81											PBP: 1A IP Acute: Standard Medicare	1B IP Psych: Standard Medicare	2 SNF: Standard Medicare	6 Home Health: Standard Medicare	10A Ambulance: Standard Medicare	11A DME: Standard Medicare	"11B Prosthetic Medical Supplies: Standard Medicare, 11C Diabetes Monitoring Supplies: $0"	"4A ER, 4B Urgent Care: Standard Medicare, 4A Worldwide Coverage: $0"	9B ASC Services: Standard Medicare	8A OP C/D/T: Standard Medicare	8B OP X-Ray: Standard Medicare	"9A OP Hospital, 5 Partial Hosp: Standard Medicare"	12 Renal Dialysis: Standard Medicare	"3 CORF, 9A OP Hospital, 9D Cardiac Rehab: Standard Medicare"	"7A PCP, 14B Immunizations, 14C Routine Physical Exams: Standard Medicare"	7D Physician Specialist (excl. Radiology): Standard Medicare	"7E Mental Health, 7H Psychiatric, 9C OP Substance Abuse,: Standard Medicare"	"7C Occupational Therapy, 7I Physical and Speech Therapy: Standard Medicare"	"8B Physician Specialist (Radiology), 14G Bone Mass Measurement, 14H Mammography: Standard Medicare"	"7B Chiropractic, 7F Podiatry - Medicare Covered, 7G Other Health Care, 14D Pap Smears/Pelvic Exams, 14E Prostate Screening, 14F Colorectal Screening, 14I Diabetes Monitoring, 14J Nutrition Therapy, 18A Medicare Covered Hearing Exams: Standard Medicare, 7F Podiatry - Routine: $0"	15 Part B Drugs: Standard Medicare	"13A Blood, 16B Medicare Covered Comprehensive Dental Services, 17A Medicare Covered Eye Exams, 17B Medicare Covered Eyewear: Standard Medicare"	10B Transportation: $0 for 24 one-way trips	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental: $0"	17A Routine Eye Exams: $0	17B Eye Wear - Non-Covered: $0	18A Hearing - Routine: $0	18B Hearing Aids: $0	"14A Medical Nutrition: $0, 14A Health Education/Wellness Programs: $0"	"6 Respite Care: $0, 13B Acupuncture: Not Covered, 13C Other: OTC Drugs: $0, 13D Other: Assistive Devices: $0 13E Other: PERS: $0"											0.070938753	0.070922202	0.173693811	0	0.230992491	0.230999804	0.182784333	0.229382418	0.231000022	0.231018387	0.230997102	0.231000076	0.230999992	0.230997156	0.228721862	0.231008814	0.231011612	0.231028224	0.230999477	0.222467561	0.230999295	0.230990061	0	0	0	0	0	0	0	0											0.070938753	0.070922202	0.173693811	0	0.230992491	0.230999804	0.182784333	0.229382418	0.231000022	0.231018387	0.230997102	0.231000076	0.230999992	0.230997156	0.228721862	0.231008814	0.231011612	0.231028224	0.230999477	0.222467561	0.230999295	0.230990061	0	0	0	0	0	0	0	0											42.9563	2.124119942	21.82289039	0	13.68399516	15.18130712	11.188229	4.654169266	9.868320949	1.938244267	7.553605229	0.579810192	1.141139961	28.76838586	24.89637466	45.86448991	2.601190746	4.140025766	13.20162009	23.73506413	3.264020035	1.739355156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	280.9026	0	0	42.9563	2.124119942	21.82289039	0	13.68399516	15.18130712	11.188229	4.654169266	9.868320949	1.938244267	7.553605229	0.579810192	1.141139961	28.76838586	24.89637466	45.86448991	2.601190746	4.140025766	13.20162009	23.73506413	3.264020035	1.739355156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	280.9026	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	42.9563	2.124119942	21.82289039	0	13.68399516	15.18130712	11.188229	4.654169266	9.868320949	1.938244267	7.553605229	0.579810192	1.141139961	28.76838586	24.89637466	45.86448991	2.601190746	4.140025766	13.20162009	23.73506413	3.264020035	1.739355156	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	280.9026
H8991_012_0	2009	4																					0											A	A	D	V	T	O	O	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	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	0	0	606.98	0	413.08	0	0	153.59	0	0	545.71	0	0.31	0	0	0	0	0	2136.1	0	11.22	0	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $0 per admit	1B IP Psych: $0 per admit	2 SNF: $25 per day for days 11-100	6 Home Health: $0	10A Ambulance: $100	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50,4A Non Covered Foreign Travel: $50,  4B Urgent Care: $0"	9B ASC Services: $0	8A OP Lab Services: $0	8B OP X-Ray: $25	"9A OP Hospital: $0, 5 Partial Hosp: $0"	12 Renal Dialysis: 20%	"3 CORF: $0, 8A OP Diagnostic Procedures/Tests: $0, 9A OP Hospital: $0, 9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0"	7D Physician Specialist: $0	"7E Mental Health: $0, 7H Psychiatric: $0, 9C OP Substance Abuse: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	"8B Physician Specialist Services - Radiology: $25, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7B Chiropractic: $0, 7F Podiatry: $0, 7F Non Medicare Covered Podiatry: $0,  7G Other Health Care: $0, 14D Pap Smears & Pelvic Exams: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $0, 18A Medicare Covered Hearing Exams: $0"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0, 17B Medicare Covered Eyewear: $0"	"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	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: Over-the-Counter Drugs: $0, 13D Other: PERS: $0, 13E Other: Assistive Devices: $0"											0	0	25	0	100	0	0	50	0	0	25	0	0.200000001	0	0	0	0	0	25	0	0.200000972	0	0	0	0	0	0	0	0	0											0	0	25	0	100	0	0	50	0	0	25	0	0.200000001	0	0	0	0	0	25	0	0.200000972	0	0	0	0	0	0	0	0	0											0	0	1.264541667	0	3.442333333	0	0	0.639958333	0	0	1.136895833	0	0.062	0	0	0	0	0	4.450208333	0	2.244010908	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.2399	0	0	0	0	1.264541667	0	3.442333333	0	0	0.639958333	0	0	1.136895833	0	0.062	0	0	0	0	0	4.450208333	0	2.244010908	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.2399	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	1.264541667	0	3.442333333	0	0	0.639958333	0	0	1.136895833	0	0.062	0	0	0	0	0	4.450208333	0	2.244010908	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	13.2399
H8991_017_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	342.33	22.36	126.12	72.17	25.15	31.13	29.03	18.89	38.25	7.74	18.31	0.8	1.42	52.35	67.89	126.98	7.66	8.3	39.91	55.37	7.36	4.6	9.95	17.17	2.3	2.71	0.52	1.8	3.03	17.81											PBP: 1A IP Acute: Standard Medicare	1B IP Psych: Standard Medicare	2 SNF: Standard Medicare	6 Home Health: Standard Medicare	10A Ambulance: Standard Medicare	11A DME: Standard Medicare	"11B Prosthetic Medical Supplies: Standard Medicare, 11C Diabetes Monitoring Supplies: $0"	"4A ER, 4B Urgent Care: Standard Medicare, 4A Worldwide Coverage: $0"	9B ASC Services: Standard Medicare	8A OP C/D/T: Standard Medicare	8B OP X-Ray: Standard Medicare	"9A OP Hospital, 5 Partial Hosp: Standard Medicare"	12 Renal Dialysis: Standard Medicare	"3 CORF, 9A OP Hospital, 9D Cardiac Rehab: Standard Medicare"	"7A PCP, 14B Immunizations, 14C Routine Physical Exams: Standard Medicare"	7D Physician Specialist (excl. Radiology): Standard Medicare	"7E Mental Health, 7H Psychiatric, 9C OP Substance Abuse,: Standard Medicare"	"7C Occupational Therapy, 7I Physical and Speech Therapy: Standard Medicare"	"8B Physician Specialist (Radiology), 14G Bone Mass Measurement, 14H Mammography: Standard Medicare"	"7B Chiropractic, 7F Podiatry - Medicare Covered, 7G Other Health Care, 14D Pap Smears/Pelvic Exams, 14E Prostate Screening, 14F Colorectal Screening, 14I Diabetes Monitoring, 14J Nutrition Therapy, 18A Medicare Covered Hearing Exams: Standard Medicare, 7F Podiatry - Routine: $0"	15 Part B Drugs: Standard Medicare	"13A Blood, 16B Medicare Covered Comprehensive Dental Services, 17A Medicare Covered Eye Exams, 17B Medicare Covered Eyewear: Standard Medicare"	10B Transportation: $0 for 24 one-way trips	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental: $0"	17A Routine Eye Exams: $0	17B Eye Wear - Non-Covered: $0	18A Hearing - Routine: $0	18B Hearing Aids: $0	"14A Medical Nutrition: $0, 14A Health Education/Wellness Programs: $0"	"6 Respite Care: $0, 13B Acupuncture: Not Covered, 13C Other: OTC Drugs: $0, 13D Other: Assistive Devices: $0 13E Other: PERS: $0"											0.081435013	0.081469222	0.173696462	0	0.230972784	0.23100006	0.182520259	0.229683767	0.230999977	0.231088806	0.230969304	0.231000046	0.230999991	0.230996034	0.228421878	0.230995827	0.231015477	0.230956885	0.230995432	0.223398109	0.231003167	0.230990869	0	0	0	0	0	0	0	0											0.081435013	0.081469222	0.173696462	0	0.230972784	0.23100006	0.182520259	0.229683767	0.230999977	0.231088806	0.230969304	0.231000046	0.230999991	0.230996034	0.228421878	0.230995827	0.231015477	0.230956885	0.230995432	0.223398109	0.231003167	0.230990869	0	0	0	0	0	0	0	0											27.8776	1.821651806	21.90659775	0	5.808965526	7.191031871	5.298563122	4.338726358	8.835749123	1.788627355	4.22904796	0.184800037	0.328019988	12.09264237	15.50756127	29.33185011	1.769578554	1.916942143	9.219027706	12.3695533	1.700183308	1.062557997	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	174.5793	0	0	27.8776	1.821651806	21.90659775	0	5.808965526	7.191031871	5.298563122	4.338726358	8.835749123	1.788627355	4.22904796	0.184800037	0.328019988	12.09264237	15.50756127	29.33185011	1.769578554	1.916942143	9.219027706	12.3695533	1.700183308	1.062557997	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	174.5793	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	27.8776	1.821651806	21.90659775	0	5.808965526	7.191031871	5.298563122	4.338726358	8.835749123	1.788627355	4.22904796	0.184800037	0.328019988	12.09264237	15.50756127	29.33185011	1.769578554	1.916942143	9.219027706	12.3695533	1.700183308	1.062557997	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	174.5793
H8991_018_0	2009	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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	664.18	12.06	675.48	0	208.79	8.07	5.91	184.86	253.37	0	422.71	32.49	0.15	894.71	0	6859.72	187.6	650.64	1660.93	1263.13	6.79	646.75	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $50 per day for the first 5 days	1B IP Psych: $50 per day for the first 5 days	2 SNF: $100 per day for days 14-100	6 Home Health: $0	10A Ambulance: $100	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50,4A Non Covered Foreign Travel: $50,  4B Urgent Care: $15"	9B ASC Services: $75	8A OP Lab Services: $0	8B OP X-Ray: $50	"9A OP Hospital: $75, 5 Partial Hosp: $75"	12 Renal Dialysis: 20%	"3 CORF: $75, 8A OP Diagnostic Procedures/Tests: $75, 9A OP Hospital: $75, 9D Cardiac Rehab: $75"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $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"	"8B Physician Specialist Services - Radiology: $50, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7B Chiropractic: $15, 7F Podiatry: $15, 7F Non Medicare Covered Podiatry: $0,  7G Other Health Care: $15, 14D Pap Smears & Pelvic Exams: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $15, 18A Medicare Covered Hearing Exams: $15"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $15, 17A Medicare Covered Eye Exams: $15, 17B Medicare Covered Eyewear: $15"	"10B Transportation: $0, Number of Trips Covered - 12"	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	17B Eye Wear: $0	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: Over-the-Counter Drugs: $0, 13D Other: PERS: $0, 13E Other: Assistive Devices: $0"											50	50	100	0	100	0.199999939	0.20002059	47.2073461	75	0	50	75	0.199999987	50.93186619	0	15	15	15	50	15	0.2000017	15	0	0	0	0	0	0	0	0											50	50	100	0	100	0.199999939	0.20002059	47.2073461	75	0	50	75	0.199999987	50.93186619	0	15	15	15	50	15	0.2000017	15	0	0	0	0	0	0	0	0											2.7674	0.05025	5.629	0	1.739916667	1.613999508	1.182121688	0.727229167	1.5835625	0	1.761291667	0.2030625	0.029999998	3.7974375	0	8.57465	0.2345	0.8133	6.920541667	1.5789125	1.358011543	0.8084375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.3736	0	0	2.7674	0.05025	5.629	0	1.739916667	1.613999508	1.182121688	0.727229167	1.5835625	0	1.761291667	0.2030625	0.029999998	3.7974375	0	8.57465	0.2345	0.8133	6.920541667	1.5789125	1.358011543	0.8084375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.3736	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	2.7674	0.05025	5.629	0	1.739916667	1.613999508	1.182121688	0.727229167	1.5835625	0	1.761291667	0.2030625	0.029999998	3.7974375	0	8.57465	0.2345	0.8133	6.920541667	1.5789125	1.358011543	0.8084375	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	41.3736
H8991_019_0	2009	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	O	V											33.7674	0.3174	6.3454	7.046	0	1.5315	1.1073	0	5.6052	0.6626	2.5905	0.1477	0.0249	2.1868	0	0	0	0	0	0	1.138	0.0892	0	0	0	0	0	0	0	0											62.56	0	0	0	0	0	240.61	0	0	190.77	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: $100	11A DME: 0%	"11B Prosthetic Medical Supplies: 0%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4A Non Medicare Covered Foreign Travel: $50,  4B Urgent Care: $0"	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, 9A Outpatient Hospital Services $0,  9D Cardiac Rehab: $0"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $0"	7D Physician Specialist: $0	"7E Mental Health: $0, 7H Psychiatric: $0, 9C OP Substance Abuse: $0"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	"8B Physician Specialist Services - Radiology: $0, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $0, 7B Chiropractic: $0, 7F Medicare Covered Podiatry: $0, 7F Non Medicare Covered Podiatry (Routine): $0, 14D Pap Smears & Pelvic Exams: $0, , 14E Prostate Screening: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $0"	15 Part B Drugs: 0%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $0, 17B Medicare Covered Eyewear: $0"	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	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: Over-the-Counter Drugs: $0, 13D Other: PERS: $0, 13E Other: Assistive Devices: $0"											0	0	0	0	100	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	100	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	2.005083333	0	0	0.794875	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.8	1200	0	33.7674	0.31741495	6.345373518	7.046026795	2.005083333	1.531490566	1.107295471	0.794875	5.605226215	0.662621993	2.59051556	0.147736912	0.024866609	2.18679885	0	0	0	0	0	0	1.138013047	0.089227244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.36	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	33.7674	0.31741495	6.345373518	7.046026795	2.005083333	1.531490566	1.107295471	0.794875	5.605226215	0.662621993	2.59051556	0.147736912	0.024866609	2.18679885	0	0	0	0	0	0	1.138013047	0.089227244	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.36
H8991_022_0	2009	4																					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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	798.66	13.63	649.93	0	232.43	11.23	8.1	197.9	251.46	0	680.17	49.85	0.25	1321.71	0	9054.56	225.96	980.36	2203.33	2055.63	11.77	858.78	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $40 per day for the first 5 days	1B IP Psych: $40 per day for the first 5 days	2 SNF: $50 per day for days 11-100	6 Home Health: $0	10A Ambulance: $100	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50,4A Non Covered Foreign Travel: $50,  4B Urgent Care: $10"	9B ASC Services: $50	8A OP Lab Services: $0	8B OP X-Ray: $25	"9A OP Hospital: $100, 5 Partial Hosp: $100"	12 Renal Dialysis: 20%	"3 CORF: $100, 8A OP Diagnostic Procedures/Tests: $100, 9A OP Hospital: $100, 9D Cardiac Rehab: $100"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $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"	"8B Physician Specialist Services - Radiology: $25, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7B Chiropractic: $10, 7F Podiatry: $10, 7F Non Medicare Covered Podiatry: $0,  7G Other Health Care: $10, 14D Pap Smears & Pelvic Exams: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $10, 18A Medicare Covered Hearing Exams: $10"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $10, 17A Medicare Covered Eye Exams: $10, 17B Medicare Covered Eyewear: $10"	"10B Transportation: $0, Number of Trips Covered - 24"	"16A Preventive Dental Services: $0, 16B Non Medicare Covered Comprehensive Dental: Not Covered"	17A Routine Eye Exams: $0	17B Eye Wear: $0	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: Over-the-Counter Drugs: $0, 13D Other: PERS: $0, 13E Other: Assistive Devices: $0"											40	40	50	0	100	0.199999839	0.200014716	46.09095503	50	0	25	100	0.200000009	63.6645709	0	10	10	10	25	10	0.199999871	10	0	0	0	0	0	0	0	0											40	40	50	0	100	0.199999839	0.200014716	46.09095503	50	0	25	100	0.200000009	63.6645709	0	10	10	10	25	10	0.199999871	10	0	0	0	0	0	0	0	0											2.6622	0.045433333	2.708041667	0	1.936916667	2.245998195	1.620119198	0.760116667	1.04775	0	1.417020833	0.415416667	0.050000002	7.012175	0	7.545466667	0.1883	0.816966667	4.590270833	1.713025	2.353998477	0.71565	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.8449	0	0	2.6622	0.045433333	2.708041667	0	1.936916667	2.245998195	1.620119198	0.760116667	1.04775	0	1.417020833	0.415416667	0.050000002	7.012175	0	7.545466667	0.1883	0.816966667	4.590270833	1.713025	2.353998477	0.71565	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.8449	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	2.6622	0.045433333	2.708041667	0	1.936916667	2.245998195	1.620119198	0.760116667	1.04775	0	1.417020833	0.415416667	0.050000002	7.012175	0	7.545466667	0.1883	0.816966667	4.590270833	1.713025	2.353998477	0.71565	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	39.8449
H8991_027_0	2009	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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	692.02	12.85	632.78	0	213.63	9.7	6.97	194.09	276.01	0	696.33	31	0.14	1143.2	0	10270.82	280.51	1356.17	2262.7	2881.19	8.05	845.99	0	0	0	0	0	0	0	0											PBP: 1A IP Acute: $50 per day for the first 5 days	1B IP Psych: $50 per day for the first 5 days	2 SNF: $100 per day for days 14-100	6 Home Health: $0	10A Ambulance: $100	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50,4A Non Covered Foreign Travel: $50,  4B Urgent Care: $10"	9B ASC Services: $50	8A OP Lab Services: $0	8B OP X-Ray: $50	"9A OP Hospital: $100, 5 Partial Hosp: $100"	12 Renal Dialysis: 20%	"3 CORF: $100, 8A OP Diagnostic Procedures/Tests: $100, 9A OP Hospital: $100, 9D Cardiac Rehab: $100"	"7A PCP: $0, 14B Immunizations: $0, 14C Routine Physical Exams: $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"	"8B Physician Specialist Services - Radiology: $50, 14G Bone Mass Measurement: $0, 14H Mammography: $0"	"7B Chiropractic: $10, 7F Podiatry: $10, 7F Non Medicare Covered Podiatry: $0,  7G Other Health Care: $10, 14D Pap Smears & Pelvic Exams: $0, 14F Colorectal Screening: $0, 14I Diabetes Monitoring: $0, 14J Nutrition Therapy: $10, 18A Medicare Covered Hearing Exams: $10"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $10, 17A Medicare Covered Eye Exams: $10, 17B Medicare Covered Eyewear: $10"	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: $0	18A Routine Hearing Exams: $0	18B Hearing Aids: $0	14A Health Education/Wellness Programs: Not Covered	"13B Acupuncture: Not Covered, 13C Other: Over-the-Counter Drugs: $0, 13D Other: PERS: $0, 13E Other: Assistive Devices: $0"											50	50	100	0	100	0.199999652	0.199994663	46.08016899	50	0	50	100	0.2	51.98005598	0	10	10	10	50	10	0.200001945	10	0	0	0	0	0	0	0	0											50	50	100	0	100	0.199999652	0.199994663	46.08016899	50	0	50	100	0.2	51.98005598	0	10	10	10	50	10	0.200001945	10	0	0	0	0	0	0	0	0											2.8834	0.053541667	5.273166667	0	1.78025	1.939996624	1.3939628	0.745308333	1.150041667	0	2.901375	0.258333333	0.028	4.951966667	0	8.559016667	0.233758333	1.130141667	9.427916667	2.400991667	1.61001566	0.704991667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4262	0	0	2.8834	0.053541667	5.273166667	0	1.78025	1.939996624	1.3939628	0.745308333	1.150041667	0	2.901375	0.258333333	0.028	4.951966667	0	8.559016667	0.233758333	1.130141667	9.427916667	2.400991667	1.61001566	0.704991667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4262	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	2.8834	0.053541667	5.273166667	0	1.78025	1.939996624	1.3939628	0.745308333	1.150041667	0	2.901375	0.258333333	0.028	4.951966667	0	8.559016667	0.233758333	1.130141667	9.427916667	2.400991667	1.61001566	0.704991667	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	47.4262
H9001_001_0	2009	4																					3350											D	D	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	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	813.3394987	17.25919361	95.59770528	0	376.9867097	0	0	1120.574166	581.5907745	0	2236.571337	38.38837872	0	0	5024.810817	2649.737272	215.2954183	456.33158	0	1024.615121	78.43552216	212.8073924	0	384.4399233	59.02711151	0	0	0	3.75316894	0											"PBP: 1A IP Acute: $125 per day, days 1-5"	"1B IP Psych: $125 per day, days 1-5"	"2 SNF: $20 per day, days 1-20"	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: $0-75	8A OP C/D/T: $0	"8B OP X-Ray: $0-50, $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: $0; Nutrition Therapy: $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: $15-20; 18A Medicare Covered Hearing Exams: $15-20; 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-$51	17A Routine Eye Exams: $15-20	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $15	13B Acupuncture: Not Covered											125	125	252.6	0	50	0	0	48.82453073	75	0	50	75	0	0	14.0117801	18.84594045	19.29100707	15	0	15	12.38969044	12.2953886	0	10	15	0	0	0	15	0											124.375	124.375	251.337	0	49.75	0	0	48.58040808	74.625	0	49.75	74.625	0	0	13.9417212	18.75171075	19.19455204	14.925	0	14.925	12.32774199	12.23391166	0	9.95	14.925	0	0	0	14.925	0											8.4299	0.17888435	2.002270038	0	1.562924067	0	0	4.536495857	3.616767629	0	9.272452001	0.23872773	0	0	5.837875959	4.140592239	0.344374926	0.567562403	0	1.274365056	0.08057774	0.21695557	0	0.31876477	0.07341497	0	0	0	0.004668004	0	0	0	0	0	0	0	0	0	0	0	42.6976	0	0.2146	8.4299	0.17888435	2.002270038	0	1.562924067	0	0	4.536495857	3.616767629	0	9.272452001	0.23872773	0	0	5.837875959	4.140592239	0.344374926	0.567562403	0	1.274365056	0.08057774	0.21695557	0	0.31876477	0.07341497	0	0	0	0.004668004	0	0	0	0	0	0	0	0	0	0	0	42.6976	0																																																																																	0	0	0	8.4299	0.17888435	2.002270038	0	1.562924067	0	0	4.536495857	3.616767629	0	9.272452001	0.23872773	0	0	5.837875959	4.140592239	0.344374926	0.567562403	0	1.274365056	0.08057774	0.21695557	0	0.31876477	0.07341497	0	0	0	0.004668004	0	0	0	0	0	0	0	0	0	0	0	42.6976
H9001_006_0	2009	7																					3350											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	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	100.0797168	1.791708484	162.6050087	0	620.0403547	0	0	1605.326977	571.1350396	0	2913.287555	43.78434538	0	0	5523.787727	2910.52207	508.6084478	534.5821597	0	1233.114137	216.1627689	189.1320959	0	530.7142723	0	0	0	0	0.454520507	0											"PBP: 1A IP Acute: $100 per admit, $300 annual OOP Max"	"1B IP Psych: $100 per admit, $300 annual OOP Max"	"2 SNF: $20 per day, days 1-20"	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: $0-50	8A OP C/D/T: $0	"8B OP X-Ray: $0-50, $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: $0; Nutrition Therapy: $10	7B Chiropractic: $10; 7D Physician Specialist: $15; 7F Podiatry: $10	7E Mental Health: $10; 7H Psychiatric: $15; 9C OP Substance Abuse: $10	7C Occupational Therapy: $10; 7I Physical and Speech Therapy: $10	Included in i.2.	7G Other Health Care: $10-15; 18A Medicare Covered Hearing Exams: $10-15; 17A Medicare Covered Eye Exams: $10-15	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-$51	17A Routine Eye Exams: $10-15	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $10	13B Acupuncture: Not Covered											300	300	255.4	0	50	0	0	48.58996052	50	0	50	50	0	0	9.370884261	13.76551665	14.57690109	10	0	10	11.06246448	9.47303972	0	10	10	0	0	0	10	0											298.5	298.5	254.123	0	49.75	0	0	48.34701072	49.75	0	49.75	49.75	0	0	9.32402984	13.69668907	14.50401658	9.95	0	9.95	11.00715216	9.425674521	0	9.95	9.95	0	0	0	9.95	0											2.4895	0.044568749	3.44347272	0	2.570583971	0	0	6.467730046	2.367830685	0	12.07800465	0.181522599	0	0	4.2919968	3.322042984	0.61473878	0.443257707	0	1.022457138	0.198278041	0.148558131	0	0.440050584	0	0	0	0	0.000376873	0	0	0	0	0	0	0	0	0	0	0	40.125	0	0.2016	2.4895	0.044568749	3.44347272	0	2.570583971	0	0	6.467730046	2.367830685	0	12.07800465	0.181522599	0	0	4.2919968	3.322042984	0.61473878	0.443257707	0	1.022457138	0.198278041	0.148558131	0	0.440050584	0	0	0	0	0.000376873	0	0	0	0	0	0	0	0	0	0	0	40.125	0																																																																																	0	0	0	2.4895	0.044568749	3.44347272	0	2.570583971	0	0	6.467730046	2.367830685	0	12.07800465	0.181522599	0	0	4.2919968	3.322042984	0.61473878	0.443257707	0	1.022457138	0.198278041	0.148558131	0	0.440050584	0	0	0	0	0.000376873	0	0	0	0	0	0	0	0	0	0	0	40.125
H9001_010_0	2009	5																					3350											D	D	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	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	612.1873358	4.92638323	48.32258004	0	235.5207511	0	0	893.042068	510.5588731	0	1898.161836	33.77259657	0	0	4554.204387	2142.244609	215.157766	407.5804347	0	975.9471187	79.68901601	141.7000592	0	298.5211599	56.5451998	0	0	0	0.076279084	0											"PBP: 1A IP Acute: $175 per day, days 1-5"	"1B IP Psych: $175 per day, days 1-5"	"2 SNF: $20 per day, days 1-20"	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: $0-100	8A OP C/D/T: $0	"8B OP X-Ray: $0-50, $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: $0; Nutrition Therapy: $15	7B Chiropractic: $15; 7D Physician Specialist: $25; 7F Podiatry: $15	7E Mental Health: $15; 7H Psychiatric: $25; 9C OP Substance Abuse: $15	7C Occupational Therapy: $15; 7I Physical and Speech Therapy: $15	Included in i.2.	7G Other Health Care: $15-25; 18A Medicare Covered Hearing Exams: $15-25; 17A Medicare Covered Eye Exams: $15-$25	15 Part B Drugs: $5-$40	13A Blood: $0; 16B Medicare Covered Comprehensive Dental Services: $10-$25	10B Transportation: Not Covered	16A Preventive Dental Services: $10; 16B Non-Medicare Covered Comprehensive Dental Services: $10-$51	17A Routine Eye Exams: $15-25	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $15	13B Acupuncture: Not Covered											175	175	255.4	0	50	0	0	48.53872054	100	0	50	100	0	0	13.82987891	22.72675522	23.60672615	15	0	15	13.99724963	14.6900869	0	10	17.5	0	0	0	15	0											174.125	174.125	254.123	0	49.75	0	0	48.29602694	99.5	0	49.75	99.5	0	0	13.76072951	22.61312144	23.48869252	14.925	0	14.925	13.92726338	14.61663647	0	9.95	17.4125	0	0	0	14.925	0											8.8831	0.071483873	1.023323251	0	0.976429781	0	0	3.594198648	4.233383989	0	7.869462611	0.280031113	0	0	5.222431226	4.036903126	0.421147884	0.506928166	0	1.213834229	0.092487493	0.172598188	0	0.247523795	0.082049441	0	0	0	9.49E-05	0	0	0	0	0	0	0	0	0	0	0	38.9274	0	0.1956	8.8831	0.071483873	1.023323251	0	0.976429781	0	0	3.594198648	4.233383989	0	7.869462611	0.280031113	0	0	5.222431226	4.036903126	0.421147884	0.506928166	0	1.213834229	0.092487493	0.172598188	0	0.247523795	0.082049441	0	0	0	9.49E-05	0	0	0	0	0	0	0	0	0	0	0	38.9274	0																																																																																	0	0	0	8.8831	0.071483873	1.023323251	0	0.976429781	0	0	3.594198648	4.233383989	0	7.869462611	0.280031113	0	0	5.222431226	4.036903126	0.421147884	0.506928166	0	1.213834229	0.092487493	0.172598188	0	0.247523795	0.082049441	0	0	0	9.49E-05	0	0	0	0	0	0	0	0	0	0	0	38.9274
H9001_011_0	2009	7																					3350											D	D	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	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	743.8005871	17.0206084	91.06164091	0	387.6762642	0	0	1219.244174	568.4430799	0	2557.221172	42.89399685	0	0	4947.766172	2406.363234	380.2142461	442.8152132	0	1072.569445	162.2435028	214.4346845	0	359.5679295	55.89758203	0	0	0	0	0											"PBP: 1A IP Acute: $175 per day, days 1-5"	"1B IP Psych: $175 per day, days 1-5"	"2 SNF: $20 per day, days 1-20"	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: $0-100	8A OP C/D/T: $0	"8B OP X-Ray: $0-50, $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: $0; Nutrition Therapy: $15	7B Chiropractic: $15; 7D Physician Specialist: $25; 7F Podiatry: $15	7E Mental Health: $15; 7H Psychiatric: $25; 9C OP Substance Abuse: $15	7C Occupational Therapy: $15; 7I Physical and Speech Therapy: $15	Included in i.2.	7G Other Health Care: $15-25; 18A Medicare Covered Hearing Exams: $15-25; 17A Medicare Covered Eye Exams: $15-$25	15 Part B Drugs: $5-$40	13A Blood: $0; 16B Medicare Covered Comprehensive Dental Services: $10-$25	10B Transportation: Not Covered	16A Preventive Dental Services: $10; 16B Non-Medicare Covered Comprehensive Dental Services: $10-$51	17A Routine Eye Exams: $15-25	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $15	13B Acupuncture: Not Covered											175	175	255.4	0	50	0	0	48.53872054	100	0	50	100	0	0	13.82987891	22.72675522	23.60672615	15	0	15	13.99724963	14.6900869	0	10	17.5	0	0	0	15	0											174.125	174.125	254.123	0	49.75	0	0	48.29602694	99.5	0	49.75	99.5	0	0	13.76072951	22.61312144	23.48869252	14.925	0	14.925	13.92726338	14.61663647	0	9.95	17.4125	0	0	0	14.925	0											10.7929	0.24697612	1.928404781	0	1.607241179	0	0	4.907054124	4.713340538	0	10.60181277	0.355662724	0	0	5.673739331	4.534615338	0.74422796	0.550751421	0	1.334008248	0.188300666	0.261192819	0	0.298141742	0.081109721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.8194	0	0.2453	10.7929	0.24697612	1.928404781	0	1.607241179	0	0	4.907054124	4.713340538	0	10.60181277	0.355662724	0	0	5.673739331	4.534615338	0.74422796	0.550751421	0	1.334008248	0.188300666	0.261192819	0	0.298141742	0.081109721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.8194	0																																																																																	0	0	0	10.7929	0.24697612	1.928404781	0	1.607241179	0	0	4.907054124	4.713340538	0	10.60181277	0.355662724	0	0	5.673739331	4.534615338	0.74422796	0.550751421	0	1.334008248	0.188300666	0.261192819	0	0.298141742	0.081109721	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	48.8194
H9001_012_0	2009	5																					3350											D	D	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	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	1359.496153	31.80107961	0	0	973.0689672	0	0	2176.986636	0	0	1790.240735	0	0	0	4444.08606	2752.721126	2321.373677	613.4374211	0	917.5737087	304.3976549	312.5310196	0	576.4419558	60.36669136	0	0	0	0	0											"PBP: 1A IP Acute: $50 per day, days 1-3"	"1B IP Psych: $50 per day, days 1-3"	2 SNF: $0	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: $0-50, $100 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: $0; Nutrition Therapy: $5	7B Chiropractic: $5; 7D Physician Specialist: $10; 7F Podiatry: $5	7E Mental Health: $5; 7H Psychiatric: $10; 9C OP Substance Abuse: $5	7C Occupational Therapy: $5; 7I Physical and Speech Therapy: $5	Included in i.2.	7G Other Health Care: $10; 18A Medicare Covered Hearing Exams: $5-10; 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: $0-$51	17A Routine Eye Exams: $0-10	17B Eye Wear: $0	18A Routine Hearing Exams: $0-10	18B Hearing Aids: $0-10	14A Health Education/Wellness Programs: $5	13B Acupuncture: Not Covered											50	50	0	0	50	0	0	49.12644281	0	0	50	0	0	0	4.734502346	8.634370016	9.697399527	5	0	7.3534689	14.52287313	7.361125121	0	10	5	0	0	0	0	0											49.75	49.75	0	0	49.75	0	0	48.8808106	0	0	49.75	0	0	0	4.710829835	8.591198166	9.64891253	4.975	0	7.316701555	14.45025877	7.324319496	0	9.95	4.975	0	0	0	0	0											5.6362	0.131841976	0	0	4.03418176	0	0	8.867739287	0	0	7.422039712	0	0	0	1.7446111	1.970764391	1.866560963	0.254320931	0	0.559467748	0.366552073	0.19075642	0	0.477966455	0.025027024	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.5481	0	0.1686	5.6362	0.131841976	0	0	4.03418176	0	0	8.867739287	0	0	7.422039712	0	0	0	1.7446111	1.970764391	1.866560963	0.254320931	0	0.559467748	0.366552073	0.19075642	0	0.477966455	0.025027024	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.5481	0																																																																																	0	0	0	5.6362	0.131841976	0	0	4.03418176	0	0	8.867739287	0	0	7.422039712	0	0	0	1.7446111	1.970764391	1.866560963	0.254320931	0	0.559467748	0.366552073	0.19075642	0	0.477966455	0.025027024	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.5481
H9001_013_0	2009	6																					3350											D	D	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	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	671.6398981	20.18589858	70.12740331	0	280.7879006	0	0	1083.541587	704.1467961	0	2764.587676	53.09979203	0	0	5861.329199	2781.19265	388.4480616	626.0319145	0	1340.772342	197.5752263	168.7625382	0	352.1263077	69.81324609	0	0	0	0.596694411	0											"PBP: 1A IP Acute: $175 per day, days 1-5"	"1B IP Psych: $175 per day, days 1-5"	"2 SNF: $20 per day, days 1-20"	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: $0-100	8A OP C/D/T: $0	"8B OP X-Ray: $0-50, $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: $0; Nutrition Therapy: $15	7B Chiropractic: $15; 7D Physician Specialist: $25; 7F Podiatry: $15	7E Mental Health: $15; 7H Psychiatric: $25; 9C OP Substance Abuse: $15	7C Occupational Therapy: $15; 7I Physical and Speech Therapy: $15	Included in i.2.	7G Other Health Care: $15-25; 18A Medicare Covered Hearing Exams: $15-25; 17A Medicare Covered Eye Exams: $15-$25	15 Part B Drugs: $5-$40	13A Blood: $0; 16B Medicare Covered Comprehensive Dental Services: $10-$25	10B Transportation: Not Covered	16A Preventive Dental Services: $10; 16B Non-Medicare Covered Comprehensive Dental Services: $10-$51	17A Routine Eye Exams: $15-25	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $15	13B Acupuncture: Not Covered											175	175	255.4	0	50	0	0	48.53872054	100	0	50	100	0	0	13.82987891	22.72675522	23.60672615	15	0	15	13.99724963	14.6900869	0	10	17.5	0	0	0	15	0											174.125	174.125	254.123	0	49.75	0	0	48.29602694	99.5	0	49.75	99.5	0	0	13.76072951	22.61312144	23.48869252	14.925	0	14.925	13.92726338	14.61663647	0	9.95	17.4125	0	0	0	14.925	0											9.7458	0.292905799	1.485082176	0	1.164099838	0	0	4.360896138	5.838550518	0	11.46151974	0.440285776	0	0	6.721347141	5.240953928	0.760344756	0.778627194	0	1.6675856	0.229306851	0.205561722	0	0.291971397	0.101301929	0	0	0	0.000742139	0	0	0	0	0	0	0	0	0	0	0	50.7869	0	0.2552	9.7458	0.292905799	1.485082176	0	1.164099838	0	0	4.360896138	5.838550518	0	11.46151974	0.440285776	0	0	6.721347141	5.240953928	0.760344756	0.778627194	0	1.6675856	0.229306851	0.205561722	0	0.291971397	0.101301929	0	0	0	0.000742139	0	0	0	0	0	0	0	0	0	0	0	50.7869	0																																																																																	0	0	0	9.7458	0.292905799	1.485082176	0	1.164099838	0	0	4.360896138	5.838550518	0	11.46151974	0.440285776	0	0	6.721347141	5.240953928	0.760344756	0.778627194	0	1.6675856	0.229306851	0.205561722	0	0.291971397	0.101301929	0	0	0	0.000742139	0	0	0	0	0	0	0	0	0	0	0	50.7869
H9001_014_0	2009	7																					3350											D	D	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	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	1064.57239	13.84959744	142.5095388	0	535.4644564	0	0	1505.583987	595.0612527	0	3073.83425	55.71181599	0	0	5835.364937	3259.229903	387.2525852	494.5427793	0	1284.416946	235.9013582	320.6457627	0	477.2073663	80.89665619	0	0	0	0	0											"PBP: 1A IP Acute: $125 per day, days 1-5"	"1B IP Psych: $125 per day, days 1-5"	"2 SNF: $20 per day, days 1-20"	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: $0-75	8A OP C/D/T: $0	"8B OP X-Ray: $0-50, $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: $0; Nutrition Therapy: $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: $15-20; 18A Medicare Covered Hearing Exams: $15-20; 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-$51	17A Routine Eye Exams: $15-20	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $15	13B Acupuncture: Not Covered											125	125	252.6	0	50	0	0	48.82453073	75	0	50	75	0	0	14.0117801	18.84594045	19.29100707	15	0	15	12.38969044	12.2953886	0	10	15	0	0	0	15	0											124.375	124.375	251.337	0	49.75	0	0	48.58040808	74.625	0	49.75	74.625	0	0	13.9417212	18.75171075	19.19455204	14.925	0	14.925	12.32774199	12.23391166	0	9.95	14.925	0	0	0	14.925	0											11.0338	0.143545307	2.984826663	0	2.219946392	0	0	6.095157039	3.700537165	0	12.74360449	0.346457856	0	0	6.779585922	5.093011366	0.619428325	0.615087582	0	1.597493576	0.242344257	0.326895995	0	0.395684441	0.100615216	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.0381	0	0.2766	11.0338	0.143545307	2.984826663	0	2.219946392	0	0	6.095157039	3.700537165	0	12.74360449	0.346457856	0	0	6.779585922	5.093011366	0.619428325	0.615087582	0	1.597493576	0.242344257	0.326895995	0	0.395684441	0.100615216	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.0381	0																																																																																	0	0	0	11.0338	0.143545307	2.984826663	0	2.219946392	0	0	6.095157039	3.700537165	0	12.74360449	0.346457856	0	0	6.779585922	5.093011366	0.619428325	0.615087582	0	1.597493576	0.242344257	0.326895995	0	0.395684441	0.100615216	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	55.0381
H9001_015_0	2009	6																					3350											D	D	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	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	711.499371	11.85832285	80.75872209	0	322.2982011	0	0	1076.516338	613.2005684	0	2694.045085	47.91393852	0	0	5894.815283	3041.553648	379.584695	617.8715357	0	1254.279862	196.9737683	199.962962	0	399.9314799	58.13797206	0	0	0	1.125251072	0											"PBP: 1A IP Acute: $125 per day, days 1-5"	"1B IP Psych: $125 per day, days 1-5"	"2 SNF: $20 per day, days 1-20"	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: $0-75	8A OP C/D/T: $0	"8B OP X-Ray: $0-50, $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: $0; Nutrition Therapy: $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: $15-20; 18A Medicare Covered Hearing Exams: $15-20; 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-$51	17A Routine Eye Exams: $15-20	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $15	13B Acupuncture: Not Covered											125	125	252.6	0	50	0	0	48.82453073	75	0	50	75	0	0	14.0117801	18.84594045	19.29100707	15	0	15	12.38969044	12.2953886	0	10	15	0	0	0	15	0											124.375	124.375	251.337	0	49.75	0	0	48.58040808	74.625	0	49.75	74.625	0	0	13.9417212	18.75171075	19.19455204	14.925	0	14.925	12.32774199	12.23391166	0	9.95	14.925	0	0	0	14.925	0											7.3744	0.122906575	1.691471244	0	1.336194625	0	0	4.358133585	3.813341035	0	11.16906191	0.297964805	0	0	6.848655936	4.752861185	0.607163182	0.768477722	0	1.560010578	0.202353483	0.203860768	0	0.331609852	0.072309103	0	0	0	0.001399531	0	0	0	0	0	0	0	0	0	0	0	45.5122	0	0.2287	7.3744	0.122906575	1.691471244	0	1.336194625	0	0	4.358133585	3.813341035	0	11.16906191	0.297964805	0	0	6.848655936	4.752861185	0.607163182	0.768477722	0	1.560010578	0.202353483	0.203860768	0	0.331609852	0.072309103	0	0	0	0.001399531	0	0	0	0	0	0	0	0	0	0	0	45.5122	0																																																																																	0	0	0	7.3744	0.122906575	1.691471244	0	1.336194625	0	0	4.358133585	3.813341035	0	11.16906191	0.297964805	0	0	6.848655936	4.752861185	0.607163182	0.768477722	0	1.560010578	0.202353483	0.203860768	0	0.331609852	0.072309103	0	0	0	0.001399531	0	0	0	0	0	0	0	0	0	0	0	45.5122
H9001_016_0	2009	5																					3350											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	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	124.374827	1.2928315	170.6761928	0	628.9705137	0	0	1801.314436	712.3850341	0	3222.598551	65.02243327	0	0	6663.924398	3903.106268	458.1353808	746.609384	0	1417.18647	259.8086857	354.9764873	0	588.9504673	49.67149957	0	0	0	1.147878978	0											"PBP: 1A IP Acute: $100 per admit, $300 annual OOP Max"	"1B IP Psych: $100 per admit, $300 annual OOP Max"	"2 SNF: $20 per day, days 1-20"	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: $0-50	8A OP C/D/T: $0	"8B OP X-Ray: $0-50, $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: $0; Nutrition Therapy: $10	7B Chiropractic: $10; 7D Physician Specialist: $15; 7F Podiatry: $10	7E Mental Health: $10; 7H Psychiatric: $15; 9C OP Substance Abuse: $10	7C Occupational Therapy: $10; 7I Physical and Speech Therapy: $10	Included in i.2.	7G Other Health Care: $10-15; 18A Medicare Covered Hearing Exams: $10-15; 17A Medicare Covered Eye Exams: $10-15	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-$51	17A Routine Eye Exams: $10-15	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $10	13B Acupuncture: Not Covered											300	300	255.4	0	50	0	0	48.58996052	50	0	50	50	0	0	9.370884261	13.76551665	14.57690109	10	0	10	11.06246448	9.47303972	0	10	10	0	0	0	10	0											298.5	298.5	254.123	0	49.75	0	0	48.34701072	49.75	0	49.75	49.75	0	0	9.32402984	13.69668907	14.50401658	9.95	0	9.95	11.00715216	9.425674521	0	9.95	9.95	0	0	0	9.95	0											3.0938	0.032159184	3.614395512	0	2.607606921	0	0	7.257347362	2.953429621	0	13.36035649	0.269572171	0	0	5.177885828	4.454969413	0.553733597	0.619063614	0	1.175083781	0.238312811	0.278824403	0	0.488338096	0.041185952	0	0	0	0.000951783	0	0	0	0	0	0	0	0	0	0	0	46.217	0	0.2322	3.0938	0.032159184	3.614395512	0	2.607606921	0	0	7.257347362	2.953429621	0	13.36035649	0.269572171	0	0	5.177885828	4.454969413	0.553733597	0.619063614	0	1.175083781	0.238312811	0.278824403	0	0.488338096	0.041185952	0	0	0	0.000951783	0	0	0	0	0	0	0	0	0	0	0	46.217	0																																																																																	0	0	0	3.0938	0.032159184	3.614395512	0	2.607606921	0	0	7.257347362	2.953429621	0	13.36035649	0.269572171	0	0	5.177885828	4.454969413	0.553733597	0.619063614	0	1.175083781	0.238312811	0.278824403	0	0.488338096	0.041185952	0	0	0	0.000951783	0	0	0	0	0	0	0	0	0	0	0	46.217
H9001_017_0	2009	6																					3350											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	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	96.90428051	0.852842953	137.0502244	0	480.6354278	0	0	1455.41994	695.0083307	0	3208.23758	59.78445335	0	0	6155.079295	3850.474037	475.1568257	796.3083488	0	1320.216614	237.1540586	211.3688259	0	547.6069547	87.4591448	0	0	0	2.650277115	0											"PBP: 1A IP Acute: $100 per admit, $300 annual OOP Max"	"1B IP Psych: $100 per admit, $300 annual OOP Max"	"2 SNF: $20 per day, days 1-20"	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: $0-50	8A OP C/D/T: $0	"8B OP X-Ray: $0-50, $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: $0; Nutrition Therapy: $10	7B Chiropractic: $10; 7D Physician Specialist: $15; 7F Podiatry: $10	7E Mental Health: $10; 7H Psychiatric: $15; 9C OP Substance Abuse: $10	7C Occupational Therapy: $10; 7I Physical and Speech Therapy: $10	Included in i.2.	7G Other Health Care: $10-15; 18A Medicare Covered Hearing Exams: $10-15; 17A Medicare Covered Eye Exams: $10-15	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-$51	17A Routine Eye Exams: $10-15	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $10	13B Acupuncture: Not Covered											300	300	255.4	0	50	0	0	48.58996052	50	0	50	50	0	0	9.370884261	13.76551665	14.57690109	10	0	10	11.06246448	9.47303972	0	10	10	0	0	0	10	0											298.5	298.5	254.123	0	49.75	0	0	48.34701072	49.75	0	49.75	49.75	0	0	9.32402984	13.69668907	14.50401658	9.95	0	9.95	11.00715216	9.425674521	0	9.95	9.95	0	0	0	9.95	0											2.4105	0.021214468	2.902301182	0	1.992634378	0	0	5.863766952	2.881388705	0	13.3008183	0.24785638	0	0	4.782511917	4.394895471	0.574306873	0.660272339	0	1.094679609	0.217532567	0.16602448	0	0.454057433	0.072518208	0	0	0	0.002197521	0	0	0	0	0	0	0	0	0	0	0	42.0395	0	0.2113	2.4105	0.021214468	2.902301182	0	1.992634378	0	0	5.863766952	2.881388705	0	13.3008183	0.24785638	0	0	4.782511917	4.394895471	0.574306873	0.660272339	0	1.094679609	0.217532567	0.16602448	0	0.454057433	0.072518208	0	0	0	0.002197521	0	0	0	0	0	0	0	0	0	0	0	42.0395	0																																																																																	0	0	0	2.4105	0.021214468	2.902301182	0	1.992634378	0	0	5.863766952	2.881388705	0	13.3008183	0.24785638	0	0	4.782511917	4.394895471	0.574306873	0.660272339	0	1.094679609	0.217532567	0.16602448	0	0.454057433	0.072518208	0	0	0	0.002197521	0	0	0	0	0	0	0	0	0	0	0	42.0395
H9001_018_0	2009	7																					3350											D	D	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	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											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	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0																																																																																	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	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	2009	6																					3350											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	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	248.1370149	4.910744183	101.687287	0	463.7779234	0	0	1246.60254	628.1458612	0	3053.579048	43.33544314	0	0	5662.42995	3153.203167	381.4088517	707.4544872	0	1252.220613	220.1920873	0	0	0	58.7028262	0	0	0	0.478555648	0											PBP: 1A IP Acute: $450 per admit	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: $0-50	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: $0; Nutrition Therapy: $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: $20-25; 18A Medicare Covered Hearing Exams: $20-25; 17A Medicare Covered Eye Exams: $20-$25	15 Part B Drugs: $10-$60	13A Blood: $0; 16B Medicare Covered Comprehensive Dental Services: $20-$25	10B Transportation: Not Covered	16A Preventive Dental Services: Not Covered; 16B Non-Medicare Covered Comprehensive Dental Services: Not Covered	17A Routine Eye Exams: Not Covered	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $20	13B Acupuncture: Not Covered											450	450	450	0	50	0	0	48.72511987	225	0	50	225	0	0	19.64842099	23.8268326	24.5273944	20	0	20	14.07180057	0	0	0	20	0	0	0	20	0											447.75	447.75	447.75	0	49.75	0	0	48.48149427	223.875	0	49.75	223.875	0	0	19.55017889	23.70769844	24.40475742	19.9	0	19.9	14.00144157	0	0	0	19.9	0	0	0	19.9	0											9.2586	0.183232142	3.794206898	0	1.922745974	0	0	5.03642949	11.71884622	0	12.6596298	0.808476861	0	0	9.225126538	6.229599149	0.775682542	1.173195358	0	2.076599183	0.25691722	0	0	0	0.097348853	0	0	0	0.000793605	0	0	0	0	0	0	0	0	0	0	0	65.2174	0	0.3277	9.2586	0.183232142	3.794206898	0	1.922745974	0	0	5.03642949	11.71884622	0	12.6596298	0.808476861	0	0	9.225126538	6.229599149	0.775682542	1.173195358	0	2.076599183	0.25691722	0	0	0	0.097348853	0	0	0	0.000793605	0	0	0	0	0	0	0	0	0	0	0	65.2174	0																																																																																	0	0	0	9.2586	0.183232142	3.794206898	0	1.922745974	0	0	5.03642949	11.71884622	0	12.6596298	0.808476861	0	0	9.225126538	6.229599149	0.775682542	1.173195358	0	2.076599183	0.25691722	0	0	0	0.097348853	0	0	0	0.000793605	0	0	0	0	0	0	0	0	0	0	0	65.2174
H9001_803_0	2009	5																					3350											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	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	229.9986699	4.551778101	94.25413931	0	429.8766372	0	0	1155.478259	582.2295906	0	2830.368213	40.16770448	0	0	5248.517065	2922.709999	353.5285884	655.7409066	0	1160.685662	204.0964635	0	0	0	54.41176099	0	0	0	0.443574138	0											PBP: 1A IP Acute: $450 per admit	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: $0-50	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: $0; Nutrition Therapy: $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: $20-25; 18A Medicare Covered Hearing Exams: $20-25; 17A Medicare Covered Eye Exams: $20-$25	15 Part B Drugs: $10-$60	13A Blood: $0; 16B Medicare Covered Comprehensive Dental Services: $20-$25	10B Transportation: Not Covered	16A Preventive Dental Services: Not Covered; 16B Non-Medicare Covered Comprehensive Dental Services: Not Covered	17A Routine Eye Exams: Not Covered	17B Eye Wear: $0	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $20	13B Acupuncture: Not Covered											450	450	450	0	50	0	0	48.72511987	225	0	50	225	0	0	19.64842099	23.8268326	24.5273944	20	0	20	14.07180057	0	0	0	20	0	0	0	20	0											447.75	447.75	447.75	0	49.75	0	0	48.48149427	223.875	0	49.75	223.875	0	0	19.55017889	23.70769844	24.40475742	19.9	0	19.9	14.00144157	0	0	0	19.9	0	0	0	19.9	0											8.5818	0.16983822	3.516857573	0	1.782196892	0	0	4.668276051	10.8622208	0	11.73423488	0.749378737	0	0	8.550787293	5.774227272	0.71898162	1.087437003	0	1.924803723	0.238137059	0	0	0	0.090232837	0	0	0	0.000735594	0	0	0	0	0	0	0	0	0	0	0	60.4502	0	0.3038	8.5818	0.16983822	3.516857573	0	1.782196892	0	0	4.668276051	10.8622208	0	11.73423488	0.749378737	0	0	8.550787293	5.774227272	0.71898162	1.087437003	0	1.924803723	0.238137059	0	0	0	0.090232837	0	0	0	0.000735594	0	0	0	0	0	0	0	0	0	0	0	60.4502	0																																																																																	0	0	0	8.5818	0.16983822	3.516857573	0	1.782196892	0	0	4.668276051	10.8622208	0	11.73423488	0.749378737	0	0	8.550787293	5.774227272	0.71898162	1.087437003	0	1.924803723	0.238137059	0	0	0	0.090232837	0	0	0	0.000735594	0	0	0	0	0	0	0	0	0	0	0	60.4502
H9003_001_0	2009	7	q.										Other Non-Covered										3250	Residential Treatment Facility										D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	Coin			V	V	V		V	O	D										0	0	0	0	0	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	1029.561865	74.80301463	887.8167275	812.6263857	300.7923073	10.44312711	0.785662825	430.6121592	131.55068	0	55.48701259	6.442895939	13.08895518	285.7508493	4699.891531	4210.799786	355.2267214	393.5923201	2548.41577	5978.253442	836.4357799	0.126195949			481.6873929	153.4329341	51.91750878		18.40917857	0	18.70075366										$200/day $800max/admit	$200/day $800max/admit	$0 per day	$0 copay	$100 copay	0-20% Coinsurance	0-20% Coinsurance	$0-$50/copay waived if admitted	$150 per visit	$0 copay	$0 per visit	$0 to $100/day $400max/admit	$0 copay	$0-$20 per visit	$0-$20 per visit	$0-$150 per visit	$10 - $20 per visit	$20 per visit	$0-$50 per visit	$0 copay	$0 or $10 generic/$45 brand per script	0 - 20% coinsurance			$20 per visit	$0 copay	$20 per visit		$0-$165 per class	$0 copay	$100/day $400max/admit										117.8518617	117.8518617	0	0	100	0.18	0.2	48.31433109	150	0	0	20	0	19.8011545	18.05489846	19.29627497	18.50142455	20	6.355582149	0	14.20489753	0.063661713			20	0	20		15	0	58.92593084										115.9005489	115.9005489	0	0	94.53205688	0.18	0.2	45.67253095	141.7980853	0	0	18.90641138	0	18.71843864	17.06766688	18.24116563	17.48977718	18.90641138	6.008062533	0	14.20489753	0.060180727			18.90641138	0	18.90641138		15	0	57.95027446										9.9439	0.722475871	0	0	2.369542958	1.87976288	0.157132565	1.638928931	1.554469545	0	0	0.010151003	0	0.445734145	6.68468192	6.400824695	0.517736351	0.620118193	1.275920109	0	0.990123712	0.007594564	0	0	0.758915	0	0.081797815	0	0.023011473	0	0.090309484	0	0	0	0	0	0	0	0	0	36.1731	0	1.4748	9.9439	0.722475871	0	0	2.369542958	1.87976288	0.157132565	1.638928931	1.554469545	0	0	0.010151003	0	0.445734145	6.68468192	6.400824695	0.517736351	0.620118193	1.275920109	0	0.990123712	0.007594564	0	0	0.758915	0	0.081797815	0	0.023011473	0	0.090309484	0	0	0	0	0	0	0	0	0	36.1731	3250																																																																																	0	0	0	9.9439	0.722475871	0	0	2.369542958	1.87976288	0.157132565	1.638928931	1.554469545	0	0	0.010151003	0	0.445734145	6.68468192	6.400824695	0.517736351	0.620118193	1.275920109	0	0.990123712	0.007594564	0	0	0.758915	0	0.081797815	0	0.023011473	0	0.090309484	0	0	0	0	0	0	0	0	0	36.1731
H9003_006_0	2009	3	q.										Other Non-Covered										3250	Residential Treatment Facility										D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	Coin			V	V	V		V	O	D										0	0	0	0	0	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	655.3925312	39.61941132	578.6031317	518.4733252	181.9033838	6.076924841	0.520796554	266.9599648	85.49249988	0	36.56795318	3.916337593	7.679231272	182.6847474	2980.167713	2688.791717	212.0560207	245.6003776	1624.222194	3820.427354	528.9400864	0.083317812			308.8987632	0	33.06879153		11.31639975	0	9.90485283										$250/day $1000max/admit	$250/day $1000max/admit	$0 per day	$0 copay	$150 copay	0-20% Coinsurance	0-20% Coinsurance	$0-$50/copay waived if admitted	$200 per visit	$0 copay	$0 per visit	$0 to $125/day $500max/admit	$0 copay	$0-$30 per visit	$0-$30 per visit	$0-$200 per visit	$15 - $30 per visit	$30 per visit	$0-$100 copay	$0 copay	$0 or $10 generic/$45 brand per script	0 - 20% coinsurance			$30 per visit		$30 per visit		$0-$165 per class	$0 copay	$125/day $500max/admit										177.6717268	177.6717268	0	0	150	0.18	0.2	48.30462358	200	0	0	30	0	29.69026528	27.12138378	28.37840482	27.82242349	30	12.68594857	0	14.06916412	0.062904557			30	0	30		15	0	88.8358634										173.3260516	173.3260516	0	0	140.9057485	0.18	0.2	45.37599429	187.8743314	0	0	28.18114971	0	27.89019369	25.47705922	26.65786916	26.13559606	28.18114971	11.91682053	0	14.06916412	0.059090758			28.18114971	0	28.18114971		15	0	86.66302581										9.4664	0.572256344	0	0	2.135936038	1.093846471	0.104159311	1.009464487	1.338487188	0	0	0.009197241	0	0.424592749	6.32715911	5.973121483	0.461850875	0.576775084	1.612963699	0	0.620145407	0.004923313	0	0	0.725426858	0	0.077659714	0	0.0141455	0	0.071532043	0	0	0	0	0	0	0	0	0	32.62	0	1.588	9.4664	0.572256344	0	0	2.135936038	1.093846471	0.104159311	1.009464487	1.338487188	0	0	0.009197241	0	0.424592749	6.32715911	5.973121483	0.461850875	0.576775084	1.612963699	0	0.620145407	0.004923313	0	0	0.725426858	0	0.077659714	0	0.0141455	0	0.071532043	0	0	0	0	0	0	0	0	0	32.62	3250																																																																																	0	0	0	9.4664	0.572256344	0	0	2.135936038	1.093846471	0.104159311	1.009464487	1.338487188	0	0	0.009197241	0	0.424592749	6.32715911	5.973121483	0.461850875	0.576775084	1.612963699	0	0.620145407	0.004923313	0	0	0.725426858	0	0.077659714	0	0.0141455	0	0.071532043	0	0	0	0	0	0	0	0	0	32.62
H9003_801_0	2009	3	q.										Other Non-Covered											Residential Treatment Facility										A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	Coin			V	V	V		V	Coin	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		1024.422815	23.86252649	660.6570334	900.5040007	237.8345693	11.17159986	0.672688123	415.1339963	140.1463403	0	33.30462382	6.690261975	11.34538543	280.4610678	4683.363086	4425.137552	242.4387398	604.3930758	2371.35698	5907.658372	5.799044981	0.244798361			525.8422717	336.4991303	78.37059178	0	19.62858201	2.02116299	5.965631622										$900/admit	$900/admit	$0 per day	$0 copay	$100 copay	0-20% Coinsurance	0-20% Coinsurance	$0-$50/copay waived if admitted	$150 per visit	$0 copay	$0 per visit	$0 to $450/admit	$0 copay	$0-$30 per visit	$0-$30 per visit	$0-150 per visit	$15-$30 per visit	$30 per visit	$10-$100 per visit	$0 - $10 copay	0 or 40% Coin $150 max per Script	0 - 20% coinsurance			$30 per visit	$0 copay	$30 per visit		$0-$165 per class	0 - 20% coinsurance	$450/admit										179.0556576	179.0556576	0	0	100	0.19	0.2	48.21239716	150	0	0	20	0	29.94566066	27.5965407	27.92911311	27.69849684	30	20.94779207	10	0.334319248	0.036431904			30	0	30	0	15	0	89.52782881										171.9289511	171.9289511	0	0	89.20664163	0.19	0.2	43.00866035	133.8099624	0	0	17.84132833	0	26.71351819	24.61794717	24.91462385	24.70889881	26.76199249	18.6868218	8.920664163	0.334319248	0.032499678			26.76199249	0	26.76199249	0	15	0	85.96447555										14.6773	0.341888262	0	0	1.768035266	2.122603973	0.134537625	1.487863087	1.562748044	0	0	0.00994693	0	0.62434182	9.607898752	9.187553131	0.499199524	1.347896913	3.692760443	4.39168636	1.938732357	0.007955868	0	0	1.172715577	0	0.174779432	0	0.024535728	0	0.042736033	0	0	0	0	0	0	0	0	0	54.8177	0	4.9239	14.6773	0.341888262	0	0	1.768035266	2.122603973	0.134537625	1.487863087	1.562748044	0	0	0.00994693	0	0.62434182	9.607898752	9.187553131	0.499199524	1.347896913	3.692760443	4.39168636	1.938732357	0.007955868	0	0	1.172715577	0	0.174779432	0	0.024535728	0	0.042736033	0	0	0	0	0	0	0	0	0	54.8177																															20% Coinsurance																																								0.0204											0.0204	0	0	14.6773	0.341888262	0	0	1.768035266	2.122603973	0.134537625	1.487863087	1.562748044	0	0	0.00994693	0	0.62434182	9.607898752	9.187553131	0.499199524	1.347896913	3.692760443	4.39168636	1.938732357	0.007955868	0	0	1.172715577	0	0.174779432	0	0.024535728	0.020435209	0.042736033	0	0	0	0	0	0	0	0	0	54.8382
H9003_802_0	2009	3	q.										Other Non-Covered										3250	Residential Treatment Facility										A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	Coin	Coin			V	V	V		V	Coin	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	3250	1024.422815	23.86252649	660.6570334	900.5040007	237.8345693	11.17159986	0.672688123	415.1339963	140.1463403	0	33.30462382	6.690261975	11.34538543	280.4610678	4683.363086	4425.137552	242.4387398	604.3930758	2371.35698	5907.658372	5.799044981	0.244798361			525.8422717	336.4991303	78.37059178		19.62858201	2.02116299	5.965631622										$900/admit	$900/admit	$0 per day	$0 copay	$100 copay	0-20% Coinsurance	0-20% Coinsurance	$0-$50/copay waived if admitted	$150 per visit	$0 copay	$0 per visit	$0 to $451/admit	$0 copay	$0-$30 per visit	$0-$30 per visit	$0-150 per visit	$15-$30 per visit	$30 per visit	$10-$100 per visit	$0 - $10 copay	0 or 40% Coin $150 max per Script	0 - 20% coinsurance			$30 per visit	$0 copay	$30 per visit		$0-$165 per class	0 - 20% coinsurance	$450/admit										179.0556576	179.0556576	0	0	100	0.19	0.2	48.21239716	150	0	0	20	0	29.94566066	27.5965407	27.92911311	27.69849684	30	20.94779207	10	0.334319248	0.036431904			30	0	30		15	0	89.52782881										171.9289511	171.9289511	0	0	89.20664163	0.19	0.2	43.00866035	133.8099624	0	0	17.84132833	0	26.71351819	24.61794717	24.91462385	24.70889881	26.76199249	18.6868218	8.920664163	0.334319248	0.032499678			26.76199249	0	26.76199249		15	0	85.96447555										14.6773	0.341888262	0	0	1.768035266	2.122603973	0.134537625	1.487863087	1.562748044	0	0	0.00994693	0	0.62434182	9.607898752	9.187553131	0.499199524	1.347896913	3.692760443	4.39168636	1.938732357	0.007955868	0	0	1.172715577	0	0.174779432	0	0.024535728	0	0.042736033	0	0	0	0	0	0	0	0	0	54.8177	0	4.9239	14.6773	0.341888262	0	0	1.768035266	2.122603973	0.134537625	1.487863087	1.562748044	0	0	0.00994693	0	0.62434182	9.607898752	9.187553131	0.499199524	1.347896913	3.692760443	4.39168636	1.938732357	0.007955868	0	0	1.172715577	0	0.174779432	0	0.024535728	0	0.042736033	0	0	0	0	0	0	0	0	0	54.8177	3250																														20% Coinsurance																																								0.0204											0.0204	0	0	14.6773	0.341888262	0	0	1.768035266	2.122603973	0.134537625	1.487863087	1.562748044	0	0	0.00994693	0	0.62434182	9.607898752	9.187553131	0.499199524	1.347896913	3.692760443	4.39168636	1.938732357	0.007955868	0	0	1.172715577	0	0.174779432	0	0.024535728	0.020435209	0.042736033	0	0	0	0	0	0	0	0	0	54.8382
H9003_805_0	2009	5	q.										Other Non-Covered										750	Residential Treatment Facility										A	A	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	Coin			V	V	V		V	Coin	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	750	1024.422815	23.86252649	660.6570334	900.5040007	257.1184533	11.17159986	0.672688123	415.1339963	140.1463403	0	33.30462382	6.690261975	11.34538543	280.4610678	5125.372531	4842.776021	265.3197787	661.4348731	2595.16243	6465.215142	887.4035559	0.244798361			575.4705508	336.4991303	85.76710174		19.62858201	2.02116299	5.965631622										$100/admit	$100/admit	$0 per day	$0 copay	$75 copay	0-20% Coinsurance	0-20% Coinsurance	$0-$50/copay waived if admitted	$50 per visit	$0 copay	$0 per visit	$0 to $50/admit	$0 copay	$0-$5 per visit	$0-$5 per visit	$0-50 per visit	$2-$5 per visit	$5 per visit	$10 per visit	$0 - $10 copay	$0 or $20 generic/$40 brand per script	0 - 20% coinsurance			$5 per visit	$0 copay	$5 per visit		$0-$165 per class	0 - 20% coinsurance	$50/admit										19.89507307	19.89507307	0	0	75	0.19	0.2	48.21239716	50	0	0	20	0	4.990943443	4.428028907	7.163524256	4.539699368	5	10	10	20.29118634	0.036431904			5	0	5		15	0	9.947536534										19.8377898	19.8377898	0	0	67.19964707	0.19	0.2	43.19808098	44.79976472	0	0	17.91990589	0	4.471861839	3.967493063	6.418484024	4.067549272	4.479976472	8.959952943	8.959952943	20.29118634	0.032642814			4.479976472	0	4.479976472		15	0	9.918894898										1.6935	0.039448315	0	0	1.439855776	2.122603973	0.134537625	1.494415999	0.523210256	0	0	0.009990739	0	0.104515262	1.69457333	2.590273377	0.089933439	0.246934389	1.937711104	4.827335286	1.500539243	0.007990907	0	0	0.214841211	0	0.03201955	0	0.024535728	0	0.004931039	0	0	0	0	0	0	0	0	0	20.7337	0	1.771	1.6935	0.039448315	0	0	1.439855776	2.122603973	0.134537625	1.494415999	0.523210256	0	0	0.009990739	0	0.104515262	1.69457333	2.590273377	0.089933439	0.246934389	1.937711104	4.827335286	1.500539243	0.007990907	0	0	0.214841211	0	0.03201955	0	0.024535728	0	0.004931039	0	0	0	0	0	0	0	0	0	20.7337	750																														20% Coinsurance																																								0.0204											0.0204	0	0	1.6935	0.039448315	0	0	1.439855776	2.122603973	0.134537625	1.494415999	0.523210256	0	0	0.009990739	0	0.104515262	1.69457333	2.590273377	0.089933439	0.246934389	1.937711104	4.827335286	1.500539243	0.007990907	0	0	0.214841211	0	0.03201955	0	0.024535728	0.020435209	0.004931039	0	0	0	0	0	0	0	0	0	20.7542
H9005_007_0	2009	5																					3000																Coin		V									V				Coin							Coin																																																					0							24.0583728		371.306									485.781				31.906							5.952													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;	"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																0.1		30									9.05				0.038							0.5																		0.0949		28.47									8.588				0.03606							0.4745													0	0	0	0	0	2.283139579	0	0.880923485	0	0	0	0	0	0	0	0	0.347657269	0	0	0	1.15053036	0	0	0	0	0	0	2.824224	0	0	0	0	0	0	0	0	0	0	0	0	7.4865		0.415	0	0	0	0	0	2.283139579	0	0.880923485	0	0	0	0	0	0	0	0	0.347657269	0	0	0	1.15053036	0	0	0	0	0	0	2.824224	0	0	0	0	0	0	0	0	0	0	0	0	7.4865		"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% coins	"11a: 20% coins up to $100,000 of Medicare Allowable chgs"	"11b, 11c: 20% coins up to $100,000 of Medicare Allowable chgs"	4a: $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"	"15: 20% coins up to $100,000 of Medicare Allowable charges"								"14a: 20% coins up to $100,000 of Medicare Allowable chgs"												0	0	0.076	0	0.002	0.002	0	0.018	0.019	0.027					0.116						0.013																				0.273			0	0	0.076	0	0.002	2.285139579	0	0.898923485	0.019	0.027	0	0	0	0	0.116	0	0.347657269	0	0	0	1.16353036	0	0	0	0	0	0	2.824224	0	0	0	0	0	0	0	0	0	0	0	0	7.7595
H9005_804_0	2009	3																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin																																																											0							15.21204582		234.4553861							11623.70365		287.0491424				20.12008916																				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	"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, 14b (Immunizations), 14c (Phys Exam) - 0%"	"7d (Spec), 7f (Pod), 7b (Chiro), 17a (MCR Eye Exam), 18a (MCR Hearing Exam)  - $10"	"7e (MH) ,7h (SA) - $5/$10"	"7c (OT), 7i (PT/ST) - $10"	7d (Radiology) - $10	"7g (Other) $10, 14g (Bone Mass), 14d (Pap & Pelvic), 14e (Prostrate Screen), 14f (Colorectal Screen), 14h (Mamm) - $0"	15 (Part B Rx) - 20%	13a (Blood)-0%																								0.1		30							10		9.05				0.055																									0.0776		23.28							7.76		7.0228				0.04268																				0	0	0	0	0	1.180454755	0	0.454843449	0	0	0	0	0	0	7.516661695	0	0.167990726	0	0	0	0.858725405	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.1787		2.94	0	0	0	0	0	1.180454755	0	0.454843449	0	0	0	0	0	0	7.516661695	0	0.167990726	0	0	0	0.858725405	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.1787	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	"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), 14b (Immunizations), 14c (Phys Exam), 14j (Nutrition Therap), 14i (Diab Mon.) - 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), 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	0	0.0482	0	0	0.0012	0	0.0119	0.0121	0.0169	0	0	0	0	0	0	0	0	0	0	0.0084																				0.0987		0	0	0	0.04821675	0	0	1.181660174	0	0.46673884	0.012054188	0.016875863	0	0	0	0	7.516667823	0	0.167990726	0	0	0	0.867163337	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	10.2774
H9011_003_0	2009	5																					1950											D	D	D	V	T	Coin	Coin	V	V	O	O	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1477.198415	52.41833507	384.7221385	1216.488588	155.4396064	19.0088363	7.55779639	245.364219	318.276067	18313.23716	5487.409083	0	0.251439916	542.429052	5347.161578	8211.746918	193.1988351	698.7486048	0	0	36.12870512	2294.773534	626.4	985	206.7537167	409.2576691	18.67146683	0	788.4799283	0											"$0 (1a, 1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$150 (10a)	15% (11a)	15% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$0 (9b)	$0/$2 (8a1); $2 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"$0 (3, 9a, 9d); $60 (5); $0/$0 (9c)"	"$0 (7a, 7a1, 14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14e1, 14h1)"	"$0 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$0/$0 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 16b, 17a, 17b, 18a)"	$0 (10b)	"$0 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2); $0 n/c (17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a8, 14a9)"	"$0 n/c (13b, 13d, 13e)"											0.068683759	175	0	0	150	0.15	0.047140463	49.56072351	0	0.8	0	0	0.2	0.022294248	0	0	0	0	0	0	0.2	0	0	0	0	0	0	0	0	0											0.068683759	158.7984936	0	0	136.1129945	0.136112995	0.042776197	44.97238992	0	0.725935971	0	0	0.181483993	0.020230246	0	0	0	0	0	0	0.181483993	0	0	0	0	0	0	0	0	0											0.0085	0.693662721	0	0	1.763112525	2.587349632	0.323293791	0.919551277	0	1.107853133	0	0	0.04563232	0.000914456	0	0	0	0	0	0	6.556781655	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.0066	0	1.4282	0.0085	0.693662721	0	0	1.763112525	2.587349632	0.323293791	0.919551277	0	1.107853133	0	0	0.04563232	0.000914456	0	0	0	0	0	0	6.556781655	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.0066																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0.0085	0.693662721	0	0	1.763112525	2.587349632	0.323293791	0.919551277	0	1.107853133	0	0	0.04563232	0.000914456	0	0	0	0	0	0	6.556781655	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	14.0066
H9011_011_0	2009	5																					3350											Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		692.2739746	23.51	91.76439542	6013.14873	30.33419355	66.63120697	22.65833358	47.59084366	74.09306819	13.75968756	33.28865605	0	5.5489665	78.75963194	106.2504078	286.3167409	12.61	11.70674015	0	0	49.85291317	14.28973402	365.1399043	3624.360522	130.8881313	161.5719141	0	0	20.2	0											"7.2% (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"7.2% (1b); $0 n/c (1b1, 1b2)"	17.4% (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.0709384	0.0718	0.1737	0	0.2	0.2	0.2	0.068281741	0.2	0.08	0.2	0	0.2	0.2	0	0.199795489	0.2	0.2	0	0	0.2	0.014869279	0	0	0	0	0	0	0	0											0.0709384	0.0718	0.1737	0	0.11209525	0.11209525	0.11209525	0.038270294	0.11209525	0.0448381	0.11209525	0	0.11209525	0.11209525	0	0.111980627	0.11209525	0.11209525	0	0	0.11209525	0.008333878	0	0	0	0	0	0	0	0											49.1088	1.688018	15.93947549	0	3.400319021	7.46904183	2.539891576	1.821315598	8.305481031	0.616958249	3.731500236	0	0.622012789	8.828580664	0	32.0619282	1.413521107	1.312269968	0	0	5.588274784	0.119088896	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	144.5665	0	61.0342	49.1088	1.688018	15.93947549	0	3.400319021	7.46904183	2.539891576	1.821315598	8.305481031	0.616958249	3.731500236	0	0.622012789	8.828580664	0	32.0619282	1.413521107	1.312269968	0	0	5.588274784	0.119088896	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	144.5665																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	49.1088	1.688018	15.93947549	0	3.400319021	7.46904183	2.539891576	1.821315598	8.305481031	0.616958249	3.731500236	0	0.622012789	8.828580664	0	32.0619282	1.413521107	1.312269968	0	0	5.588274784	0.119088896	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	144.5665
H9011_016_0	2009	4																					1950											D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	7200	1403.338494	49.79741831	365.4860315	1156.58992	147.6676261	18.04905939	7.176194991	233.096008	302.3622636	17397.57531	75.08979221	0	0.23874444	515.3075994	5082.494985	7801.159572	183.5388933	663.8111746	0	0	34.30452732	2568.829643	0	985	196.4160309	0	17.73789349	0	788.4799283	0											"$175 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$175 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-20 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$175 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 10%/20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$20 (3, 9d); $60 (5); $175 (9a); $40/$30 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j); $20 (7a1); $0 n/c (14b1, 14e1, 14h1)"	"$20 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $20 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$20 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$20 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$0 n/c (13b, 13d, 13e)"											172.9606707	175	100	0	150	0.2	0.062853951	49.56072351	175	2.8	0.096969373	0	0.2	62.32093278	0.211823974	20	37.5	20	0	0	0.2	16.78169106	0	0	20	0	20	0	0	0											107.1388018	108.3755875	61.92890713	0	92.89336069	0.123857814	0.038924765	30.69241444	108.3755875	1.7340094	0.060052073	0	0.123857814	38.6454792	0.211823974	20	37.5	12.38578143	0	0	0.123857814	16.78169106	0	0	20	0	20	0	0	0											12.5293	0.449735372	1.886179209	0	1.143111838	2.235517045	0.279331703	0.59618994	2.730723996	2.513963259	4.509297682	0	0.029570365	1.65952576	0.089716191	13.00193262	0.573559042	0.685151676	0	0	4.248883772	3.59244212	0	0	0.327360051	0	0.029563156	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1111	0	21.8132	12.5293	0.449735372	1.886179209	0	1.143111838	2.235517045	0.279331703	0.59618994	2.730723996	2.513963259	4.509297682	0	0.029570365	1.65952576	0.089716191	13.00193262	0.573559042	0.685151676	0	0	4.248883772	3.59244212	0	0	0.327360051	0	0.029563156	0	0	0	0	0	0	0	0	0	0	0	0	0	53.1111		"$375 Days 1-20 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$375 Days 1-20 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-48 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$40 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$40 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											1.7816	0.063	0.1851	0.1625	0.0748	0.2193	0.0872	0.039	0.5257	0.1644	0.7208	0	0.0019	0.3351	0.7367	1.3533	0.0342	0.0896	0	0	0.4169	0.4013	0	0	0.0345	0	0.0031	0	0	0											7.4299	0	1.474380172	14.3109	0.512769215	2.07123289	0.16253034	1.217879231	2.45484438	0.366534903	0.635184872	3.256439931	2.678393784	5.230051769	0	0.03150447	1.994600906	0.826380308	14.35526063	0.607771335	0.774778961	0	0	4.6657432	3.993694959	0	0	0.361819004	0	0.032675067	0	0	0	0	0	0	0	0	0	0	0	0	0	60.541
H9011_801_0	2009	2																					7980											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1523.346463	54.05589696	396.7409542	1235.398351	160.2955786	19.60166385	7.793500973	307.2406577	46.98414374	18885.34727	81.54911752	0	0.259281559	30.2014962	5473.211078	8466.82472	199.234415	720.5776859	0	0	37.25544907	2366.462832	0	0	0	0	0	0	0	0											"$665 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$665 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-54 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											657.058234	665	150	0	150	0.2	0.062853951	47.87195192	0.2	2.8	0.160209312	0	0.2	0.198474487	26.69124877	34.72070137	37.5	35	0	0	0.2	34.60554049	0	0	0	0	0	0	0	0											498.9260647	504.9397791	113.8961908	0	113.8961908	0.151861588	0.047725504	36.34955313	0.151861588	2.126062228	0.121648202	0	0.151861588	0.150752831	26.69124877	34.72070137	37.5	26.57577785	0	0	0.151861588	34.60554049	0	0	0	0	0	0	0	0											63.3364	2.274581056	3.765606951	0	1.521421316	2.976739793	0.371948762	0.930671717	7.135086664	3.345951958	9.920303544	0	0.039374909	4.552961041	12.1739032	24.49784105	0.622607547	1.595826042	0	0	5.657671646	6.824393781	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.5433	0	34.0476	63.3364	2.274581056	3.765606951	0	1.521421316	2.976739793	0.371948762	0.930671717	7.135086664	3.345951958	9.920303544	0	0.039374909	4.552961041	12.1739032	24.49784105	0.622607547	1.595826042	0	0	5.657671646	6.824393781	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.5433																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	63.3364	2.274581056	3.765606951	0	1.521421316	2.976739793	0.371948762	0.930671717	7.135086664	3.345951958	9.920303544	0	0.039374909	4.552961041	12.1739032	24.49784105	0.622607547	1.595826042	0	0	5.657671646	6.824393781	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.5433
H9011_802_0	2009	2																					7980											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1523.346463	54.05589696	396.7409542	1235.398351	160.2955786	19.60166385	7.793500973	307.2406577	46.98414374	18885.34727	81.54911752	0	0.259281559	30.2014962	5473.211078	8466.82472	199.234415	720.5776859	0	0	37.25544907	2366.462832	0	0	0	0	0	0	0	0											"$665 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$665 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-54 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											657.058234	665	150	0	150	0.2	0.062853951	47.87195192	0.2	2.8	0.160209312	0	0.2	0.198474487	26.69124877	34.72070137	37.5	35	0	0	0.2	34.60554049	0	0	0	0	0	0	0	0											498.9260647	504.9397791	113.8961908	0	113.8961908	0.151861588	0.047725504	36.34955313	0.151861588	2.126062228	0.121648202	0	0.151861588	0.150752831	26.69124877	34.72070137	37.5	26.57577785	0	0	0.151861588	34.60554049	0	0	0	0	0	0	0	0											63.3364	2.274581056	3.765606951	0	1.521421316	2.976739793	0.371948762	0.930671717	7.135086664	3.345951958	9.920303544	0	0.039374909	4.552961041	12.1739032	24.49784105	0.622607547	1.595826042	0	0	5.657671646	6.824393781	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.5433	0	34.0476	63.3364	2.274581056	3.765606951	0	1.521421316	2.976739793	0.371948762	0.930671717	7.135086664	3.345951958	9.920303544	0	0.039374909	4.552961041	12.1739032	24.49784105	0.622607547	1.595826042	0	0	5.657671646	6.824393781	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.5433																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	63.3364	2.274581056	3.765606951	0	1.521421316	2.976739793	0.371948762	0.930671717	7.135086664	3.345951958	9.920303544	0	0.039374909	4.552961041	12.1739032	24.49784105	0.622607547	1.595826042	0	0	5.657671646	6.824393781	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.5433
H9011_803_0	2009	2																					7980											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1523.346463	54.05589696	396.7409542	1235.398351	160.2955786	19.60166385	7.793500973	307.2406577	46.98414374	18885.34727	81.54911752	0	0.259281559	30.2014962	5473.211078	8466.82472	199.234415	720.5776859	0	0	37.25544907	2366.462832	0	0	0	0	0	0	0	0											"$665 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$665 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-54 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											657.058234	665	150	0	150	0.2	0.062853951	47.87195192	0.2	2.8	0.160209312	0	0.2	0.198474487	26.69124877	34.72070137	37.5	35	0	0	0.2	34.60554049	0	0	0	0	0	0	0	0											498.9260647	504.9397791	113.8961908	0	113.8961908	0.151861588	0.047725504	36.34955313	0.151861588	2.126062228	0.121648202	0	0.151861588	0.150752831	26.69124877	34.72070137	37.5	26.57577785	0	0	0.151861588	34.60554049	0	0	0	0	0	0	0	0											63.3364	2.274581056	3.765606951	0	1.521421316	2.976739793	0.371948762	0.930671717	7.135086664	3.345951958	9.920303544	0	0.039374909	4.552961041	12.1739032	24.49784105	0.622607547	1.595826042	0	0	5.657671646	6.824393781	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.5433	0	34.0476	63.3364	2.274581056	3.765606951	0	1.521421316	2.976739793	0.371948762	0.930671717	7.135086664	3.345951958	9.920303544	0	0.039374909	4.552961041	12.1739032	24.49784105	0.622607547	1.595826042	0	0	5.657671646	6.824393781	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.5433																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	63.3364	2.274581056	3.765606951	0	1.521421316	2.976739793	0.371948762	0.930671717	7.135086664	3.345951958	9.920303544	0	0.039374909	4.552961041	12.1739032	24.49784105	0.622607547	1.595826042	0	0	5.657671646	6.824393781	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.5433
H9011_804_0	2009	3																					7980											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	1523.346463	54.05589696	396.7409542	1235.398351	160.2955786	19.60166385	7.793500973	307.2406577	46.98414374	18885.34727	81.54911752	0	0.259281559	30.2014962	5473.211078	8466.82472	199.234415	720.5776859	0	0	37.25544907	2366.462832	0	0	0	0	0	0	0	0											"$665 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$665 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-54 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$35 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$35 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											657.058234	665	150	0	150	0.2	0.062853951	47.87195192	0.2	2.8	0.160209312	0	0.2	0.198474487	26.69124877	34.72070137	37.5	35	0	0	0.2	34.60554049	0	0	0	0	0	0	0	0											498.9260647	504.9397791	113.8961908	0	113.8961908	0.151861588	0.047725504	36.34955313	0.151861588	2.126062228	0.121648202	0	0.151861588	0.150752831	26.69124877	34.72070137	37.5	26.57577785	0	0	0.151861588	34.60554049	0	0	0	0	0	0	0	0											63.3364	2.274581056	3.765606951	0	1.521421316	2.976739793	0.371948762	0.930671717	7.135086664	3.345951958	9.920303544	0	0.039374909	4.552961041	12.1739032	24.49784105	0.622607547	1.595826042	0	0	5.657671646	6.824393781	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.5433	0	34.0476	63.3364	2.274581056	3.765606951	0	1.521421316	2.976739793	0.371948762	0.930671717	7.135086664	3.345951958	9.920303544	0	0.039374909	4.552961041	12.1739032	24.49784105	0.622607547	1.595826042	0	0	5.657671646	6.824393781	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.5433																																										0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	63.3364	2.274581056	3.765606951	0	1.521421316	2.976739793	0.371948762	0.930671717	7.135086664	3.345951958	9.920303544	0	0.039374909	4.552961041	12.1739032	24.49784105	0.622607547	1.595826042	0	0	5.657671646	6.824393781	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	151.5433
H9047_001_0	2009	5																					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		239.3574316	0	0	0	321.4333722	20.58315606	0	503.3452891	380.7382801	0	27.80932734	0	0	117.9659895	12945.65818	0	0	0	24.92324255	0	40.90571461	0	0	0	160.4835869	0	0	0	0	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 per 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	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	250	0	0	0	50	0.1	0	44.13555926	50	0	0.1	0	0	15	15	0	0	0	0.1	0	0.1	0	0	0	15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	220	0	0	0	44	0.088	0	38.83929215	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	0	0	0	0	0	0	0	0	0	0	0	4.3882	0	0	0	1.178589031	1.811317733	0	1.629131228	1.39604036	0	2.447220806	0	0	0.129762588	14.240224	0	0	0	2.193245344	0	3.599702886	0	0	0	0.200604484	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.2141	0	4.5018	4.3882	0	0	0	1.178589031	1.811317733	0	1.629131228	1.39604036	0	2.447220806	0	0	0.129762588	14.240224	0	0	0	2.193245344	0	3.599702886	0	0	0	0.200604484	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.2141	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.3882	0	0	0	1.178589031	1.811317733	0	1.629131228	1.39604036	0	2.447220806	0	0	0.129762588	14.240224	0	0	0	2.193245344	0	3.599702886	0	0	0	0.200604484	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	33.2141
H9047_013_0	2009	6																					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		228.1725049	0	0	0	321.4333722	19.62132634	0	479.8244812	362.9467717	0	26.50982606	0	0	112.4535601	12340.72088	0	0	0	23.75860505	0	40.90571461	0	0	0	160.4835869	0	0	0	0	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 per 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	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	250	0	0	0	50	0.1	0	44.13555926	50	0	0.1	0	0	15	15	0	0	0	0.1	0	0.1	0	0	0	15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	220	0	0	0	44	0.088	0	38.83929215	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	0	0	0	0	0	0	0	0	0	0	0	4.1832	0	0	0	1.178589031	1.726676718	0	1.553003601	1.330804829	0	2.332864694	0	0	0.123698916	13.57479297	0	0	0	2.090757244	0	3.599702886	0	0	0	0.200604484	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.8947	0	4.5018	4.1832	0	0	0	1.178589031	1.726676718	0	1.553003601	1.330804829	0	2.332864694	0	0	0.123698916	13.57479297	0	0	0	2.090757244	0	3.599702886	0	0	0	0.200604484	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.8947	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	4.1832	0	0	0	1.178589031	1.726676718	0	1.553003601	1.330804829	0	2.332864694	0	0	0.123698916	13.57479297	0	0	0	2.090757244	0	3.599702886	0	0	0	0.200604484	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	31.8947
H9047_024_0	2009	6																																A		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		165.5945785	0	570.6066146	10.53573869	133.2013521	11.59604276	0	342.072601	403.7566089	0	24.82156298	0	0	99.92563076	13417.54892	0	0	0	23.11252329	0	23.79622765	0	0	0	216.6169992	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	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	350	0	12.13474026	0.1	50	0.1	0	44.13555926	100	0	0.1	0	0.1	20	20	0	0	0	0.1	0	0.1	0.1	0	0	20	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	308	0	10.67857143	0.088	44	0.088	0	38.83929215	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	0	0	0	0	0	0	0	0	0	0	0	4.2503	0	0.507771958	0.927145005	0.488404958	1.020451763	0	1.107154807	2.960881799	0	2.184297542	0	0	0.146557592	19.67907175	0	0	0	2.033902049	0	2.094068033	0	0	0	0.361028332	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.761	0	5.1	4.2503	0	0.507771958	0.927145005	0.488404958	1.020451763	0	1.107154807	2.960881799	0	2.184297542	0	0	0.146557592	19.67907175	0	0	0	2.033902049	0	2.094068033	0	0	0	0.361028332	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.761	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	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	0.8178	0	0.0987	0.0039	0	0.0987	0	0.331	0.0933	0	0	0	0	0	1.0634	0	0	0	0	0	0.0391	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	2.546	0	3.56	5.0681	0	0.606514436	0.931008794	0.488404958	1.119170416	0	1.438183533	3.054192571	0	2.184297542	0	0	0.146557592	20.74243882	0	0	0	2.033902049	0	2.133192678	0	0	0	0.361028332	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	40.307
H9047_033_0	2009	6																					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		184.3408641	0	0	0	189.3163813	12.55088033	0	332.2871764	396.8332801	0	26.40502895	0	0	47.3652561	7988.238804	0	0	0	21.78721261	0	28.20274481	0	0	0	181.4049506	0	0	0	0	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 per 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	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	250	0	0	0	50	0.1	0	44.13555926	50	0	0.1	0	0	15	15	0	0	0	0.1	0	0.1	0	0	0	15	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	220	0	0	0	44	0.088	0	38.83929215	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	0	0	0	0	0	0	0	0	0	0	0	3.3796	0	0	0	0.694160065	1.104477469	0	1.075483227	1.45505536	0	2.323642547	0	0	0.052101782	8.787062684	0	0	0	1.917274709	0	2.481841543	0	0	0	0.226756188	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.4974	0	3.1733	3.3796	0	0	0	0.694160065	1.104477469	0	1.075483227	1.45505536	0	2.323642547	0	0	0.052101782	8.787062684	0	0	0	1.917274709	0	2.481841543	0	0	0	0.226756188	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.4974	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	3.3796	0	0	0	0.694160065	1.104477469	0	1.075483227	1.45505536	0	2.323642547	0	0	0.052101782	8.787062684	0	0	0	1.917274709	0	2.481841543	0	0	0	0.226756188	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	23.4974
H9047_035_0	2009	6																																A		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		129.2328972	0	527.5292751	9.837822029	100.9724003	8.106215884	0	199.5792929	260.7612238	0	13.03423843	0	0	109.2150452	8692.264719	0	0	0	16.00939325	0	25.8441529	0	0	0	210.3203582	0	0	0	0	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	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	350	0	6.0546875	0.1	50	0.1	0	44.13555926	100	0	0.1	0	0.1	20	20	0	0	0	0.1	0	0.1	0.1	0	0	20	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	308	0	5.328125	0.088	44	0.088	0	38.83929215	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	0	0	0	0	0	0	0	0	0	0	0	3.317	0	0.234228493	0.865728339	0.370232134	0.713346998	0	0.645959872	1.912248975	0	1.147012982	0	0	0.160182066	12.74865492	0	0	0	1.408826606	0	2.274285455	0	0	0	0.35053393	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.1482	0	3.5179	3.317	0	0.234228493	0.865728339	0.370232134	0.713346998	0	0.645959872	1.912248975	0	1.147012982	0	0	0.160182066	12.74865492	0	0	0	1.408826606	0	2.274285455	0	0	0	0.35053393	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	26.1482	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	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	0.255	0	0	0	0	0.0443	0	0.3655	0	0	0	0	0	0.0573	0.6764	0	0	0	0	0	0.0001	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.3986	0	2.56	3.5719	0	0.234228493	0.865728339	0.370232134	0.757692847	0	1.011447204	1.912248975	0	1.147012982	0	0	0.217481607	13.42509278	0	0	0	1.408826606	0	2.274339529	0	0	0	0.35053393	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	27.5468
H9047_801_0	2009	5																					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	none	229.9428833	0	30.36074646	18.22850727	8.040740451	21.78403889	0	17.2568172	63.1994507	0	0	0	0	70.16510553	215.4453217	0	0	0	0	0	40.82277137	0.000550642	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	0.074183763	0	0.135890769	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0	0	0	0	0	0.231	0.231	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.074183763	0	0.135890769	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0	0	0	0	0	0.231	0.231	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.058	0	4.125745183	0	1.857411044	5.032112984	0	3.986324774	14.59907311	0	0	0	0	16.20813938	49.76786931	0	0	0	0	0	9.430060185	0.000127198	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.0649	0	0	17.058	0	4.125745183	0	1.857411044	5.032112984	0	3.986324774	14.59907311	0	0	0	0	16.20813938	49.76786931	0	0	0	0	0	9.430060185	0.000127198	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.0649	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.058	0	4.125745183	0	1.857411044	5.032112984	0	3.986324774	14.59907311	0	0	0	0	16.20813938	49.76786931	0	0	0	0	0	9.430060185	0.000127198	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.0649
H9047_804_0	2009	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	none	275.8400361	0	24.33256827	18.82503946	6.582836712	18.99683504	0	16.53277939	69.11085594	0	0	0	0	88.7779644	218.4152689	0	0	0	0	0	39.67088639	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	0.073964335	0	0.140758442	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0	0	0	0	0	0.231	0.231	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.073964335	0	0.140758442	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0	0	0	0	0	0.231	0.231	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.4023	0	3.425014398	0	1.520635281	4.388268895	0	3.819072039	15.96460772	0	0	0	0	20.50770978	50.45392711	0	0	0	0	0	9.163974757	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.6455	0	0	20.4023	0	3.425014398	0	1.520635281	4.388268895	0	3.819072039	15.96460772	0	0	0	0	20.50770978	50.45392711	0	0	0	0	0	9.163974757	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.6455	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.4023	0	3.425014398	0	1.520635281	4.388268895	0	3.819072039	15.96460772	0	0	0	0	20.50770978	50.45392711	0	0	0	0	0	9.163974757	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.6455
H9047_805_0	2009	5																					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	none	234.7035989	0	29.73546928	18.29038301	7.889518323	21.49493414	0	17.18171585	63.81261552	0	0	0	0	72.09573789	215.7533816	0	0	0	0	0	40.70329126	0.000493526	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	0.074161827	0	0.136398904	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0	0	0	0	0	0.231	0.231	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.074161827	0	0.136398904	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0	0	0	0	0	0.231	0.231	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.406	0	4.055885411	0	1.822478733	4.965329787	0	3.968976362	14.74071418	0	0	0	0	16.65411545	49.83903115	0	0	0	0	0	9.40246028	0.000114005	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.8552	0	0	17.406	0	4.055885411	0	1.822478733	4.965329787	0	3.968976362	14.74071418	0	0	0	0	16.65411545	49.83903115	0	0	0	0	0	9.40246028	0.000114005	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.8552	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	20% coins.	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	1.0259	0	0.1502	0.0067	0	0	0	0.3222	0.1133	0	0	0	0	0	0	0	0	0	0	0	0.0672	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.6855	0	0	18.4319	0	4.206125312	0.006732809	1.822478733	4.965329787	0	4.291194041	14.85398993	0	0	0	0	16.65411545	49.83903115	0	0	0	0	0	9.469633611	0.000114005	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.5407
H9047_806_0	2009	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	none	234.7035989	0	29.73546928	18.29038301	7.889518323	21.49493414	0	17.18171585	63.81261552	0	0	0	0	72.09573789	215.7533816	0	0	0	0	0	40.70329126	0.000493526	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	0.074161827	0	0.136398904	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0	0	0	0	0	0.231	0.231	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0.074161827	0	0.136398904	0	0.231	0.231	0	0.231	0.231	0	0	0	0	0.231	0.231	0	0	0	0	0	0.231	0.231	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	17.406	0	4.055885411	0	1.822478733	4.965329787	0	3.968976362	14.74071418	0	0	0	0	16.65411545	49.83903115	0	0	0	0	0	9.40246028	0.000114005	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.8552	0	0	17.406	0	4.055885411	0	1.822478733	4.965329787	0	3.968976362	14.74071418	0	0	0	0	16.65411545	49.83903115	0	0	0	0	0	9.40246028	0.000114005	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.8552	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	20% coins.	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	1.0259	0	0.1502	0.0067	0	0	0	0.3222	0.1133	0	0	0	0	0	0	0	0	0	0	0	0.0672	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	1.6855	0	0	18.4319	0	4.206125312	0.006732809	1.822478733	4.965329787	0	4.291194041	14.85398993	0	0	0	0	16.65411545	49.83903115	0	0	0	0	0	9.469633611	0.000114005	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.5407
H9082_001_0	2009	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											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0		248.4936872	19.99265796	57.1283656	0	16.58796009	28.15778537	20.63236338	16.97571123	23.17924088	5.933110773	14.10061043	0	9.692364996	68.02919317	41.49404195	83.16319386	6.84089398	4.387739302	20.89171868	30.20499382	10.38774855	0.790345903	0	8.190154297	0	0	0	0	0	0											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	No Cost-Sharing	$5/Service for Dental: Preventative	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing											0.073120786	0.073120786	0.185248965	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.132870128	0	0	0	0	0	0											0.073120786	0.073120786	0.185248965	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.132870128	0	0	0	0	0	0											18.1701	1.461878872	10.5829706	0	3.83181878	6.504448421	4.766075941	3.921389295	5.354404644	1.370548589	3.257241009	0	2.238936314	15.71474362	9.585123691	19.21069778	1.580246509	1.013567779	4.825987015	6.977353572	2.399569914	0.182569904	0	1.088226848	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.0379	0	0	18.1701	1.461878872	10.5829706	0	3.83181878	6.504448421	4.766075941	3.921389295	5.354404644	1.370548589	3.257241009	0	2.238936314	15.71474362	9.585123691	19.21069778	1.580246509	1.013567779	4.825987015	6.977353572	2.399569914	0.182569904	0	1.088226848	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.0379																																																																																		0	0	0	18.1701	1.461878872	10.5829706	0	3.83181878	6.504448421	4.766075941	3.921389295	5.354404644	1.370548589	3.257241009	0	2.238936314	15.71474362	9.585123691	19.21069778	1.580246509	1.013567779	4.825987015	6.977353572	2.399569914	0.182569904	0	1.088226848	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.0379
H9082_002_0	2009	5																					2800											D	D	D	Coin	T	Coin	Coin	V	V	Coin	V	Coin	Coin	Coin	V	V	V	V	V	V	Coin	Coin	Coin	Coin	V	Coin	V	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	521.2703412	8.883127326	224.3668394	0	141.520179	10.75701443	7.270879042	258.6173087	237.6079397	0	111.427946	0	0.57170948	10.058191	4405.974652	5802.901565	130.0980421	400.5906605	73.18920508	1349.093234	7.08443215	0	0	8.18974367	353.4600539	0	166.1153518	0	0	0											$150/Days 1-5 for IP Medical; $150/Days 1-5 for IP Surgical;	$150/Days 1-5 for IP Psych; $150/Days 1-5 for IP Substance Abuse;	$125/Days 21-100 for SNF	No Cost-Sharing	$125/Run 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;	$100/Case for OP Fac - Surgery; $75/Case for OP Fac - ASC	No Cost-Sharing	$100/Case for OP Fac - CT/MRI/PET	No Cost-Sharing	20% Coinsurance for Renal Dialysis - Fac; 20% Coinsurance for Renal Dialysis - Prof	20% Coinsurance 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/Visit for Prof - CORF; $20/Visit for Prof - CORF;	$5/Visit for PCP - Office Visits; $5/Consult for PCP - Consults; $5/Procedure for PCP - Surgery (Office); $5/Visit for PCP - Tx Injections; $5/Visit for PCP - Allergy Testing; $5/Visit for PCP - Allergy Tx;	$20/Visit for Speclst - Office Visits; $20/Procedure for Speclst - Surgery (Office); $20/Visit for Speclst - Tx Injections; $20/Visit for Speclst - Allergy Testing; $20/Visit for Speclst - Allergy Tx; $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/Visit for PT/ST (PCP); $20/Visit for Occ Therapy (PCP); $20/Visit for PT/ST (Specialist); $20/Visit for Occ Therapy (Specialist);	$100/Visit for Prof Radiology (Office);	$15/Visit for Chiropractor; $20/Exam for Vistion Exams; $15/Service for Podiatrist; $20/Exam for Hearing/Speech Exams;	20% Coinsurance for Part B Rx	No Cost-Sharing	No Cost-Sharing	$5/Service for Dental: Preventive Services;	$15/Service for Vision Exams (Refractions);	No Cost-Sharing	$15/Service for Hearing Exam;	No Cost-Sharing	No Cost-Sharing	No Cost-Sharing											150	150	125	0	125	0.2	0.2	43.76274871	87.48238958	0	100	0	0.2	0.130220885	5	20	20.00000001	20	100	17.18338408	0.2	0	0	0.132886953	15	0	15	0	0	0											145.0111756	145.0111756	120.8426463	0	120.8426464	0.193348234	0.193348234	42.30725092	84.57282773	0	96.67411708	0	0.193348234	0.125889891	4.833705854	19.33482342	19.33482342	19.33482341	96.67411709	16.61188485	0.193348234	0	0	0.128467288	14.50111756	0	14.50111756	0	0	0											6.2992	0.107346061	2.259423552	0	1.425139412	2.079849744	1.405811624	0.911782281	1.674597946	0	0.897683191	0	0.110539018	1.266224566	1.774765456	9.349839755	0.209618556	0.645445807	0.589625149	1.867581788	1.369762446	0	0	1.05211416	0.427130483	0	0.200738187	0	0	0	0	0	0	0	0	0	0	0	0	0	35.9242	0	1.2359	6.2992	0.107346061	2.259423552	0	1.425139412	2.079849744	1.405811624	0.911782281	1.674597946	0	0.897683191	0	0.110539018	1.266224566	1.774765456	9.349839755	0.209618556	0.645445807	0.589625149	1.867581788	1.369762446	0	0	1.05211416	0.427130483	0	0.200738187	0	0	0	0	0	0	0	0	0	0	0	0	0	35.9242	0																																																																																	0	0	0	6.2992	0.107346061	2.259423552	0	1.425139412	2.079849744	1.405811624	0.911782281	1.674597946	0	0.897683191	0	0.110539018	1.266224566	1.774765456	9.349839755	0.209618556	0.645445807	0.589625149	1.867581788	1.369762446	0	0	1.05211416	0.427130483	0	0.200738187	0	0	0	0	0	0	0	0	0	0	0	0	0	35.9242
H9086_001_0	2009	5																																D	D	D	P	T	COIN	COIN	V	V	V	V	V	V	V	V	V	V	V	P		COIN																																																												0		242.1383048	5.88468029	179.3519096		237.3270461	9.709747008	3.461458947	364.73625	274.7604		287.8601		8.3729		3803.66	4538.5562	236.9864	204.7775			72.54657754																				$200/D first 1 Days; $200 OP max/admit	$200/D first 1 Days; $200 OP max/admit	$0/(D1-20); $50/(D21-100); 2K OP max/admit		$125 CP/Trip	20% Coins	20% Coins	$50 CP / Visit	$75 CP / Surg		"$75 CP / (MRI, CT, Test)"		$5 CP / Visit		$0 CP / Visit	$5 CP / Visit	$5 CP / Visit	$5 CP / Visit			5% Coins																				200	200	50		125	0.2	0.2	50	75		75		5		0	5	5	5			0.05																				200	200	47.37284069		125	0.2	0.2	50	75		75		5		0	5	5	5			0.05																				4.0356	0.098078005	0.70803412	0	2.47215673	1.941949402	0.692291789	1.519734375	1.7172525	0	1.799125625	0	0.003488708	0	0	1.891065083	0.098744333	0.085323958	0	0	3.627328877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.6902			4.0356	0.098078005	0.70803412	0	2.47215673	1.941949402	0.692291789	1.519734375	1.7172525	0	1.799125625	0	0.003488708	0	0	1.891065083	0.098744333	0.085323958	0	0	3.627328877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.6902																																																																																		0			4.0356	0.098078005	0.70803412	0	2.47215673	1.941949402	0.692291789	1.519734375	1.7172525	0	1.799125625	0	0.003488708	0	0	1.891065083	0.098744333	0.085323958	0	0	3.627328877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.6902
H9086_002_0	2009	5																																D	D	D	P	T	COIN	COIN	V	V	V	V	V	V	V	V	V	V	V	P		COIN																																																												0		242.1383048	5.88468029	179.3519096		237.3270461	9.709747008	3.461458947	364.73625	274.7604		287.8601		8.3729		3803.66	4538.5562	236.9864	204.7775			72.54657754																				$200/D first 1 Days; $200 OP max/admit	$200/D first 1 Days; $200 OP max/admit	$0/(D1-20); $50/(D21-100); 2K OP max/admit		$125 CP/Trip	20% Coins	20% Coins	$50 CP / Visit	$75 CP / Surg		"$75 CP / (MRI, CT, Test)"		$5 CP / Visit		$0 CP / Visit	$5 CP / Visit	$5 CP / Visit	$5 CP / Visit			5% Coins																				200	200	50		125	0.2	0.2	50	75		75		5		0	5	5	5			0.05																				200	200	47.37284069		125	0.2	0.2	50	75		75		5		0	5	5	5			0.05																				4.0356	0.098078005	0.70803412	0	2.47215673	1.941949402	0.692291789	1.519734375	1.7172525	0	1.799125625	0	0.003488708	0	0	1.891065083	0.098744333	0.085323958	0	0	3.627328877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.6902			4.0356	0.098078005	0.70803412	0	2.47215673	1.941949402	0.692291789	1.519734375	1.7172525	0	1.799125625	0	0.003488708	0	0	1.891065083	0.098744333	0.085323958	0	0	3.627328877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.6902																																																																																		0			4.0356	0.098078005	0.70803412	0	2.47215673	1.941949402	0.692291789	1.519734375	1.7172525	0	1.799125625	0	0.003488708	0	0	1.891065083	0.098744333	0.085323958	0	0	3.627328877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.6902
H9086_003_0	2009	4																																D	D	D	P	T	COIN	COIN	V	V	V	V	V	V	V	V	V	V	V	P		COIN																																																												0		242.1383048	5.88468029	179.3519096		237.3270461	9.709747008	3.461458947	364.73625	274.7604		287.8601		8.3729		3803.66	4538.5562	236.9864	204.7775			72.54657754																				$200/D first 1 Days; $200 OP max/admit	$200/D first 1 Days; $200 OP max/admit	$0/(D1-20); $50/(D21-100); 2K OP max/admit		$125 CP/Trip	20% Coins	20% Coins	$50 CP / Visit	$50 CP / Surg		"$50 CP / (MRI, CT, Test)"		$5 CP / Visit		$0 CP / Visit	$5 CP / Visit	$5 CP / Visit	$5 CP / Visit			5% Coins																				200	200	50		125	0.2	0.2	50	50		50		5		0	5	5	5			0.05																				200	200	47.37284069		125	0.2	0.2	50	50		50		5		0	5	5	5			0.05																				4.0356	0.098078005	0.70803412	0	2.47215673	1.941949402	0.692291789	1.519734375	1.144835	0	1.199417083	0	0.003488708	0	0	1.891065083	0.098744333	0.085323958	0	0	3.627328877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.5181			4.0356	0.098078005	0.70803412	0	2.47215673	1.941949402	0.692291789	1.519734375	1.144835	0	1.199417083	0	0.003488708	0	0	1.891065083	0.098744333	0.085323958	0	0	3.627328877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.5181																																																																																		0			4.0356	0.098078005	0.70803412	0	2.47215673	1.941949402	0.692291789	1.519734375	1.144835	0	1.199417083	0	0.003488708	0	0	1.891065083	0.098744333	0.085323958	0	0	3.627328877	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.5181
H9086_801_0	2009	3																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																			14.9012		4.8063		0.221	0.4083		0.6222	1.5996	1.5981					7.807						2.2489	0																			34.2127		1421.508206		412.4483486		7.12898737	13.17120595		20.07168283	51.60094144	51.5521057					251.8397955						72.54657754	0																			Standard Medicare benefits	Std Med benefit included in a.1	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Std Med benefit included in e.1	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Std Med benefit included in h.1	Std Med benefit included in h.1	Std Med benefit included in h.1	Std Med benefit included in h.1	Standard Medicare benefits	Std Med benefit included in i.1	Std Med benefit included in i.1	Std Med benefit included in i.1	Std Med benefit included in i.1	Std Med benefit included in i.1	Standard Medicare benefits	Standard Medicare benefits																			3.890472227		4.324863998		0.2	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																			3.890472227		4.324863998		0.2	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																			0.4609	0	0.148648584	0	1.425797474	2.634241191	0	4.014336566	10.32018829	10.31042114	0	0	0	0	50.3679591	0	0	0	0	0	14.50931551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.1918	34.21274345		15.3621	0	4.954952816	0	1.646796083	3.042548576	0	4.636558734	11.91981747	11.90853642	0	0	0	0	58.17499276	0	0	0	0	0	16.75825941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4045																																																																																		0			15.3621	0	4.954952816	0	1.646796083	3.042548576	0	4.636558734	11.91981747	11.90853642	0	0	0	0	58.17499276	0	0	0	0	0	16.75825941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4045
H9086_802_0	2009	3																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																			14.9012		4.8063		0.221	0.4083		0.6222	1.5996	1.5981					7.807						2.2489	0																			34.2127		1421.508206		412.4483486		7.12898737	13.17120595		20.07168283	51.60094144	51.5521057					251.8397955						72.54657754	0																			Standard Medicare benefits	Std Med benefit included in a.1	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Std Med benefit included in e.1	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Std Med benefit included in h.1	Std Med benefit included in h.1	Std Med benefit included in h.1	Std Med benefit included in h.1	Standard Medicare benefits	Std Med benefit included in i.1	Std Med benefit included in i.1	Std Med benefit included in i.1	Std Med benefit included in i.1	Std Med benefit included in i.1	Standard Medicare benefits	Standard Medicare benefits																			3.890472227		4.324863998		0.2	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																			3.890472227		4.324863998		0.2	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																			0.4609	0	0.148648584	0	1.425797474	2.634241191	0	4.014336566	10.32018829	10.31042114	0	0	0	0	50.3679591	0	0	0	0	0	14.50931551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.1918	34.21274345		15.3621	0	4.954952816	0	1.646796083	3.042548576	0	4.636558734	11.91981747	11.90853642	0	0	0	0	58.17499276	0	0	0	0	0	16.75825941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4045																																																																																		0			15.3621	0	4.954952816	0	1.646796083	3.042548576	0	4.636558734	11.91981747	11.90853642	0	0	0	0	58.17499276	0	0	0	0	0	16.75825941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4045
H9086_803_0	2009	3																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																			14.9012		4.8063		0.221	0.4083		0.6222	1.5996	1.5981					7.807						2.2489	0																			34.2127		1421.508206		412.4483486		7.12898737	13.17120595		20.07168283	51.60094144	51.5521057					251.8397955						72.54657754	0																			Standard Medicare benefits	Std Med benefit included in a.1	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Std Med benefit included in e.1	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Std Med benefit included in h.1	Std Med benefit included in h.1	Std Med benefit included in h.1	Std Med benefit included in h.1	Standard Medicare benefits	Std Med benefit included in i.1	Std Med benefit included in i.1	Std Med benefit included in i.1	Std Med benefit included in i.1	Std Med benefit included in i.1	Standard Medicare benefits	Standard Medicare benefits																			3.890472227		4.324863998		0.2	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																			3.890472227		4.324863998		0.2	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																			0.4609	0	0.148648584	0	1.425797474	2.634241191	0	4.014336566	10.32018829	10.31042114	0	0	0	0	50.3679591	0	0	0	0	0	14.50931551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.1918	34.21274345		15.3621	0	4.954952816	0	1.646796083	3.042548576	0	4.636558734	11.91981747	11.90853642	0	0	0	0	58.17499276	0	0	0	0	0	16.75825941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4045																																																																																		0			15.3621	0	4.954952816	0	1.646796083	3.042548576	0	4.636558734	11.91981747	11.90853642	0	0	0	0	58.17499276	0	0	0	0	0	16.75825941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4045
H9086_804_0	2009	3																																D	D	D	V	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN	COIN																			14.9012		4.8063		0.221	0.4083		0.6222	1.5996	1.5981					7.807						2.2489	0																			34.2127		1421.508206		412.4483486		7.12898737	13.17120595		20.07168283	51.60094144	51.5521057					251.8397955						72.54657754	0																			Standard Medicare benefits	Std Med benefit included in a.1	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Std Med benefit included in e.1	Standard Medicare benefits	Standard Medicare benefits	Standard Medicare benefits	Std Med benefit included in h.1	Std Med benefit included in h.1	Std Med benefit included in h.1	Std Med benefit included in h.1	Standard Medicare benefits	Std Med benefit included in i.1	Std Med benefit included in i.1	Std Med benefit included in i.1	Std Med benefit included in i.1	Std Med benefit included in i.1	Standard Medicare benefits	Standard Medicare benefits																			3.890472227		4.324863998		0.2	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																			3.890472227		4.324863998		0.2	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																			0.4609	0	0.148648584	0	1.425797474	2.634241191	0	4.014336566	10.32018829	10.31042114	0	0	0	0	50.3679591	0	0	0	0	0	14.50931551	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	94.1918	34.21274345		15.3621	0	4.954952816	0	1.646796083	3.042548576	0	4.636558734	11.91981747	11.90853642	0	0	0	0	58.17499276	0	0	0	0	0	16.75825941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4045																																																																																		0			15.3621	0	4.954952816	0	1.646796083	3.042548576	0	4.636558734	11.91981747	11.90853642	0	0	0	0	58.17499276	0	0	0	0	0	16.75825941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	128.4045
H9101_007_0	2009	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																																																			0		2692.341805		1550.696877		652.0420224	10.37462814		237.9568362	171.7588136		286.418536				19110.44522		294.8430247	3321.839832		63.17584756	5.911262398					78.96980945															"1A: $200/day day 1, $85/day days 2-7; 1B: $200/day day 1, $85/day days 2-7"	"1A: $200/day day 1, $85/day days 2-7; 1B: $200/day day 1, $85/day days 2-7"	"2: $0/day days 1-7, $100/day days 8-39, $0/day days 40-100"	6: $0	10A: $50	11A: 20%; 11B: 20%; 11C: $0	11A: 20%; 11B: 20%; 11C: $0	4A: $50; $4B: $50	9A: $200; 9B: $200	8A: $0	"8B: $45 Diag Rad, $0 x-rays, 20% Ther Rad"			9C: $20; 9D: $0; 12: 20%	7A: $0; 7D: $20; 7F: $20; 7G: $20; 8A: $0; 11A: 20%; 11B: 20%; 11C: $0; 14B: $0; 17A: $0 routine; $20 MC Benefits	14C: $0	5: $20/day; 7E: $20; 7H: $20; 9C: $20	3: $25; 7C: $25; 7I: $25	"8B: $45 Diag Rad, $0 x-rays, 20% Ther Rad"	7B: $20; 8A: $0	15: 20%		10B: n/a	16A: $0; 16B: $0	17A: $0 routine; $20 MC Benefits	17B: $0 contact lenses and glasses; $10 MC Benefits	"18A: $0 routine hearing test, hearing aid eval, MC benefits"	18B: $0													65.57640574		45.14077426		50	0.176		50	192.7030825		97.92841951				1.246372827		8.242534762	9.978338516		18.53544681	0.17877033					1.996844695															65.57640574		45.14077426		50	0.176		50	192.7030825		97.92841951				1.246372827		8.242534762	9.978338516		18.53544681	0.17877033					1.996844695															14.7128	0	5.833304806	0	2.71684176	1.825934552	0	0.991486817	2.758204403	0	2.337376212	0	0	0	1.984894969	0	0.202521157	2.762203528	0	0.097582714	1.056758329	0	0	0	0	0.01314087	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.2931	0	0	14.7128	0	5.833304806	0	2.71684176	1.825934552	0	0.991486817	2.758204403	0	2.337376212	0	0	0	1.984894969	0	0.202521157	2.762203528	0	0.097582714	1.056758329	0	0	0	0	0.01314087	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.2931																																																																																		0	0	0	14.7128	0	5.833304806	0	2.71684176	1.825934552	0	0.991486817	2.758204403	0	2.337376212	0	0	0	1.984894969	0	0.202521157	2.762203528	0	0.097582714	1.056758329	0	0	0	0	0.01314087	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.2931
H9103_001_0	2009	4	q.	q.									Other Non-Covered	Other Non-Covered									3250	Residential Treatment Facility	Expanded Care									D	D	D	V	T	Coin	Coin	V	V	V	V	V	V	V	V	V	V	V	V	V	S	Coin			V	V	V	V	V	Coin	D	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	3250	1863.636287	53.41085279	1558.56461	3049.385455	1116.163079	25.1984886	0.754157095	688.107681	145.9541157	0	22.45327502	11.29139457	23.56946307	371.0775075	6325.299035	5804.834009	394.6497738	490.7831286	3338.919214	8822.782092	1192.327991	0.476430223	0	0	522.8098933	376.8501183	99.07040791	43.79941236	12.48328856	5.122278807	13.3527132	75.86057824									$150/day $600max/admit	$150/day $600max/admit	$0 per day	$0 copay	$100 copay	0-20% Coinsurance	0-20% Coinsurance	$0-$50/copay waived if admitted	$100 per visit	$0 copay	$0 per visit	$0 to $75/day $300max/admit	$0 copay	$0-$15 per visit	$0-$15 per visit	$0-$100 per visit	$7 - $15 per visit	$15 per visit	$0-$25 copay	$0 copay	$0 or $10 generic/$40 brand per script	0 - 20% coinsurance			$15 per visit	$0 copay	$15 per visit	$0 Copay	$0-$165 per class	0 - 20% coinsurance	$75/day $300max/admit	20% Coinsurance									88.38889626	88.38889626	0	0	100	0.19	0.2	47.92125904	100	0	0	11	0	15	13.40213213	12.92913255	14.23309234	15	3.470271031	0	13.99806339	0.017011967	0	0	15	0	15	0	15	0	44.19444813	0.2									87.8644131	87.8644131	0	0	96.97349431	0.19	0.2	46.47091941	96.97349431	0	0	10.66708437	0	14.54602415	12.99651584	12.53783162	13.80232699	14.54602415	3.365243081	0	13.99806339	0.016497099	0	0	14.54602415	0	14.54602415	0	15	0	43.93220655	0.2									13.6456	0.391076103	0	0	9.01985283	4.787712834	0.150831419	2.664749716	1.179473384	0	0	0.010037188	0	0.449808532	6.850570759	6.065002613	0.453923769	0.594911937	0.936356232	0	1.390856901	0.007859717	0	0	0.633733778	0	0.120090045	0	0.015604111	0	0.048884513	15.17211565	0	0	0	0	0	0	0	0	64.5891	0	0.9887	13.6456	0.391076103	0	0	9.01985283	4.787712834	0.150831419	2.664749716	1.179473384	0	0	0.010037188	0	0.449808532	6.850570759	6.065002613	0.453923769	0.594911937	0.936356232	0	1.390856901	0.007859717	0	0	0.633733778	0	0.120090045	0	0.015604111	0	0.048884513	15.17211565	0	0	0	0	0	0	0	0	64.5891	3250																														20% Coinsurance																																								0.0184											0.0184	0	0	13.6456	0.391076103	0	0	9.01985283	4.787712834	0.150831419	2.664749716	1.179473384	0	0	0.010037188	0	0.449808532	6.850570759	6.065002613	0.453923769	0.594911937	0.936356232	0	1.390856901	0.007859717	0	0	0.633733778	0	0.120090045	0	0.015604111	0.018441856	0.048884513	15.17211565	0	0	0	0	0	0	0	0	64.6075
H9104_006_0	2009	11																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	V	Coin	O	T	P	V	P	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	0	140	175.8449056	94.98480436	0	0	10083.81836											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, 0% specialized"	"$10 hearing, podiatry, & chiro"	20% coinsurance	0	0	0	$10/visit	$25/service	$0-$10/visit	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	14.11											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	14.11											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	0.116666667	0.366343553	0.039577002	0	0	11.85688975	0	0	0	0	0	0	0	0	0	0	42.2576			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	0.116666667	0.366343553	0.039577002	0	0	11.85688975	0	0	0	0	0	0	0	0	0	0	42.2576																																																																																		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	0.116666667	0.366343553	0.039577002	0	0	11.85688975	0	0	0	0	0	0	0	0	0	0	42.2576
H9104_007_0	2009	10																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	V	Coin	O	T	P	V	P	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	4018.750505	0.000778737	0	0	0	199.4006425	137.0268638	19.00217978	0	0	10083.81836											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, 10% specialized"	"$10 hearing, podiatry, & chiro"	20% coinsurance	0	0	0	$10/visit	$25/service	$0-$10/visit	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	14.11											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	14.11											2.8995	0.051063797	0.580777664	0	0.988741032	0.096191992	0.055132892	2.370077871	0.775122451	0	0	0	0	0	1.902820479	3.448624138	0.180581897	1.707641231	3.097292444	3.348958754	0.000155747	0	0	0	0.166167202	0.285472633	0.007917575	0	0	11.85688975	0	0	0	0	0	0	0	0	0	0	33.8192			2.8995	0.051063797	0.580777664	0	0.988741032	0.096191992	0.055132892	2.370077871	0.775122451	0	0	0	0	0	1.902820479	3.448624138	0.180581897	1.707641231	3.097292444	3.348958754	0.000155747	0	0	0	0.166167202	0.285472633	0.007917575	0	0	11.85688975	0	0	0	0	0	0	0	0	0	0	33.8192																																																																																		0			2.8995	0.051063797	0.580777664	0	0.988741032	0.096191992	0.055132892	2.370077871	0.775122451	0	0	0	0	0	1.902820479	3.448624138	0.180581897	1.707641231	3.097292444	3.348958754	0.000155747	0	0	0	0.166167202	0.285472633	0.007917575	0	0	11.85688975	0	0	0	0	0	0	0	0	0	0	33.8192
H9104_008_0	2009	10																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	V	Coin	O	T	P	V	P	V	P	V	V																																																			0		692.4837627	13.90894481	352.6940718	0	210.2522006	3.57194443	2.234292662	954.3560597	217.7720587	0	0	0	0	0	5143.432957	4656.319475	247.4096831	2009.828647	36.07577775	11180.1192	0.018987697	0	0	0	204.4719861	146.6034138	14.66122999	0	0	10083.81836											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, 10% specialized"	"$10 hearing, podiatry, & chiro, 10% lab"	20% coinsurance	0	0	0	$10/visit	$25/service	$0-$10/visit	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	14.11											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	14.11											2.8853	0.057953937	0.587823453	0	1.314076253	0.178597222	0.102090363	3.439009892	0.907383578	0	0	0	0	0	4.286194131	3.880266229	0.206174736	1.842342926	3.174668442	2.922806613	0.003797539	0	0	0	0.170393322	0.305423779	0.006108846	0	0	11.85688975	0	0	0	0	0	0	0	0	0	0	38.1274			2.8853	0.057953937	0.587823453	0	1.314076253	0.178597222	0.102090363	3.439009892	0.907383578	0	0	0	0	0	4.286194131	3.880266229	0.206174736	1.842342926	3.174668442	2.922806613	0.003797539	0	0	0	0.170393322	0.305423779	0.006108846	0	0	11.85688975	0	0	0	0	0	0	0	0	0	0	38.1274																																																																																		0			2.8853	0.057953937	0.587823453	0	1.314076253	0.178597222	0.102090363	3.439009892	0.907383578	0	0	0	0	0	4.286194131	3.880266229	0.206174736	1.842342926	3.174668442	2.922806613	0.003797539	0	0	0	0.170393322	0.305423779	0.006108846	0	0	11.85688975	0	0	0	0	0	0	0	0	0	0	38.1274
H9104_009_0	2009	10																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	V	Coin	O	T	P	V	P	V	P	V	V																																																			0		789.2460829	13.86658736	420.7387325	0	293.0792381	5.059453473	3.164746817	1829.874033	158.2943048	0	0	0	0	0	4791.274717	4337.512701	241.3424731	1960.541763	33.60575772	10905.94994	0.006350469	0	0	0	198.1224227	142.05087	24.71651933	0	0	10083.81836											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, 10% specialized"	"$10 hearing, podiatry, & chiro, 10% lab"	20% coinsurance	0	0	0	$10/visit	$25/service	$0-$10/visit	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	14.11											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	14.11											3.2885	0.057777447	0.701231221	0	1.831745238	0.252972674	0.144605116	6.593927745	0.659559603	0	0	0	0	0	3.992728931	3.614593918	0.201118728	1.797163282	2.95730668	2.851130835	0.001270094	0	0	0	0.165102019	0.295939312	0.01029855	0	0	11.85688975	0	0	0	0	0	0	0	0	0	0	41.2739			3.2885	0.057777447	0.701231221	0	1.831745238	0.252972674	0.144605116	6.593927745	0.659559603	0	0	0	0	0	3.992728931	3.614593918	0.201118728	1.797163282	2.95730668	2.851130835	0.001270094	0	0	0	0.165102019	0.295939312	0.01029855	0	0	11.85688975	0	0	0	0	0	0	0	0	0	0	41.2739																																																																																		0			3.2885	0.057777447	0.701231221	0	1.831745238	0.252972674	0.144605116	6.593927745	0.659559603	0	0	0	0	0	3.992728931	3.614593918	0.201118728	1.797163282	2.95730668	2.851130835	0.001270094	0	0	0	0.165102019	0.295939312	0.01029855	0	0	11.85688975	0	0	0	0	0	0	0	0	0	0	41.2739
H9104_013_0	2009	10																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	V	Coin	O	T	P	V	P	V	P	V	V																																																			0		816.0147219	14.64066725	483.8978293	0	328.5249198	3.344246959	2.098455201	1272.036133	208.8038575	0	15.35250243	0	0	142.2063166	8947.099795	8108.573875	405.8521917	3484.682209	63.91289732	3561.794126	0.000299218	0	0	0	164.0389662	206.0386895	555.5728101	0	0	6550.178292											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, 0% specialized"	"$10 hearing, podiatry, & chiro"	20% coinsurance	0	0	0	$10/visit	$25/service	$0-$10/visit	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	14.11											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	14.11											3.4001	0.06100278	0.806496382	0	1.368853833	0.167212348	0.095904715	4.505257774	0.870016073	0	0.690862609	0	0	0.118505264	3.727958248	6.757144896	0.33821016	3.194292025	5.624334964	2.968161772	5.98E-05	0	0	0	0.136699138	0.42924727	0.231488671	0	0	7.701917975	0	0	0	0	0	0	0	0	0	0	43.1937			3.4001	0.06100278	0.806496382	0	1.368853833	0.167212348	0.095904715	4.505257774	0.870016073	0	0.690862609	0	0	0.118505264	3.727958248	6.757144896	0.33821016	3.194292025	5.624334964	2.968161772	5.98E-05	0	0	0	0.136699138	0.42924727	0.231488671	0	0	7.701917975	0	0	0	0	0	0	0	0	0	0	43.1937																																																																																		0			3.4001	0.06100278	0.806496382	0	1.368853833	0.167212348	0.095904715	4.505257774	0.870016073	0	0.690862609	0	0	0.118505264	3.727958248	6.757144896	0.33821016	3.194292025	5.624334964	2.968161772	5.98E-05	0	0	0	0.136699138	0.42924727	0.231488671	0	0	7.701917975	0	0	0	0	0	0	0	0	0	0	43.1937
H9104_014_0	2009	10																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	V	Coin	O	T	P	V	P	V	P	V	V																																																			0		790.8220372	15.88412705	512.9967529	0	267.6473941	5.582720915	3.492056671	1653.87292	301.5908923	0	0	0	0	0	6296.944757	5700.586894	302.8959684	2460.570608	44.16645097	13687.47169	0	0	0	0	251.452998	180.2881099	236.066074	0	0	12791.66247											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, 10% specialized"	"$10 hearing, podiatry, & chiro, 10% lab"	20% coinsurance	0	0	0	$10/visit	$25/service	$0-$10/visit	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	14.11											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	14.11											3.2951	0.066183863	0.854994588	0	1.672796213	0.279136046	0.159560714	5.95970998	1.256628718	0	0	0	0	0	5.247453964	4.750489079	0.252413307	2.255523058	3.886647686	3.578301094	0	0	0	0	0.209544165	0.375600229	0.098360864	0	0	15.04086312	0	0	0	0	0	0	0	0	0	0	49.2393			3.2951	0.066183863	0.854994588	0	1.672796213	0.279136046	0.159560714	5.95970998	1.256628718	0	0	0	0	0	5.247453964	4.750489079	0.252413307	2.255523058	3.886647686	3.578301094	0	0	0	0	0.209544165	0.375600229	0.098360864	0	0	15.04086312	0	0	0	0	0	0	0	0	0	0	49.2393																																																																																		0			3.2951	0.066183863	0.854994588	0	1.672796213	0.279136046	0.159560714	5.95970998	1.256628718	0	0	0	0	0	5.247453964	4.750489079	0.252413307	2.255523058	3.886647686	3.578301094	0	0	0	0	0.209544165	0.375600229	0.098360864	0	0	15.04086312	0	0	0	0	0	0	0	0	0	0	49.2393
H9104_015_0	2009	10																																D	D	D	V	T	Coin	Coin	V	V	P	Coin	V	V	V	V	V	V	V	Coin	V	Coin	O	T	P	V	P	V	P	V	V																																																			0		955.55933	16.78861285	278.3868078	0	393.5614983	4.979535808	3.114757392	3394.027836	158.1520163	0	0	0	0	0	5495.177	4974.75128	276.7989075	2248.571547	38.54289261	12508.17972	0	0	0	0	228.4207463	163.7743234	125.1010787	0	0	565.3671719											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, 10% specialized"	"$10 hearing, podiatry, & chiro, 10% lab"	20% coinsurance	0	0	0	$10/visit	$25/service	$0-$10/visit	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	14.11											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	14.11											3.9815	0.069952554	0.463978013	0	2.459759364	0.24897679	0.142320976	12.23033603	0.658966734	0	0	0	0	0	4.579314167	4.145626066	0.230665756	2.061190584	3.39177455	3.270000055	0	0	0	0	0.190350622	0.341196507	0.052125449	0	0	0.664777566	0	0	0	0	0	0	0	0	0	0	39.1828			3.9815	0.069952554	0.463978013	0	2.459759364	0.24897679	0.142320976	12.23033603	0.658966734	0	0	0	0	0	4.579314167	4.145626066	0.230665756	2.061190584	3.39177455	3.270000055	0	0	0	0	0.190350622	0.341196507	0.052125449	0	0	0.664777566	0	0	0	0	0	0	0	0	0	0	39.1828																																																																																		0			3.9815	0.069952554	0.463978013	0	2.459759364	0.24897679	0.142320976	12.23033603	0.658966734	0	0	0	0	0	4.579314167	4.145626066	0.230665756	2.061190584	3.39177455	3.270000055	0	0	0	0	0.190350622	0.341196507	0.052125449	0	0	0.664777566	0	0	0	0	0	0	0	0	0	0	39.1828
H9104_801_0	2009	4																																D	D	D	V	T	P	P	V	V	P	P	V	V	V	V	V	V	V	P	V	Coin	O	T	P	V	P	V	P	V	V																																																			0		251.6797233	3.265448277	447.4920287	0	0	0	0	1148.153817	205.560824	1068.484077	538.011619	0	0	279.6	12132.2841	10992.77853	553.1346954	4749.153016	11263.64357	19587.53835	0.124476517	800.6220047	0	90	177.5802267	122.6904854	564.9743662	0	0	10083.81836											copay/admit	copay/admit	copay/days 21-100	0	0	0	0	"$50 ER, $25 urgent care"	$15/OP hospital and ASC visits	$0 copay	$0 copay	0	0	0	$15/visit	$30/visit	$15/visit	$15/visit	0	"$15 hearing, pod, chiro"	20% coinsurance	0	0	$8/visit	$15/visit	$20/service	$0-$15/visit	0	0	ILP Services											100	100	50	0	0	0	0	39.27857074	15	0	0	0	0	15	15	30	15	15	0	14.3838103	0.2	0	0	8	15	20	7.5	0	0	15											100	100	50	0	0	0	0	39.27857074	15	0	0	0	0	15	15	30	15	15	0	14.3838103	0.2	0	0	8	15	20	7.5	0	0	15											2.0973	0.027212069	1.864550119	0	0	0	0	3.758153411	0.25695103	0	0	0	0	0.3495	15.16535512	27.48194634	0.691418369	5.93644127	0	23.47861965	0.024895303	0	0	0.06	0.221975283	0.204484142	0.353108979	0	0	12.60477295	0	0	0	0	0	0	0	0	0	0	94.5767			2.0973	0.027212069	1.864550119	0	0	0	0	3.758153411	0.25695103	0	0	0	0	0.3495	15.16535512	27.48194634	0.691418369	5.93644127	0	23.47861965	0.024895303	0	0	0.06	0.221975283	0.204484142	0.353108979	0	0	12.60477295	0	0	0	0	0	0	0	0	0	0	94.5767																																																																																		0			2.0973	0.027212069	1.864550119	0	0	0	0	3.758153411	0.25695103	0	0	0	0	0.3495	15.16535512	27.48194634	0.691418369	5.93644127	0	23.47861965	0.024895303	0	0	0.06	0.221975283	0.204484142	0.353108979	0	0	12.60477295	0	0	0	0	0	0	0	0	0	0	94.5767
H9104_802_0	2009	4																																D	D	D	V	T	P	P	V	V	P	P	V	V	V	V	V	V	V	P	V	Coin	O	T	P	V	P	V	P	V	V																																																			0		251.6797233	3.265448277	447.4920287	0	0	0	0	1148.153817	205.560824	1068.484077	538.011619	0	0	279.6	12132.2841	10992.77853	553.1346954	4749.153016	11263.64357	19587.53835	0.124476517	800.6220047	0	90	177.5802267	122.6904854	564.9743662	0	0	10083.81836											copay/admit	copay/admit	copay/days 21-100	0	0	0	0	"$50 ER, $25 urgent care"	$15/OP hospital and ASC visits	$0 copay	$0 copay	0	0	0	$15/visit	$30/visit	$15/visit	$15/visit	0	"$15 hearing, pod, chiro"	20% coinsurance	0	0	$8/visit	$15/visit	$20/service	$0-$15/visit	0	0	ILP Services											100	100	50	0	0	0	0	39.27857074	15	0	0	0	0	15	15	30	15	15	0	14.3838103	0.2	0	0	8	15	20	7.5	0	0	15											100	100	50	0	0	0	0	39.27857074	15	0	0	0	0	15	15	30	15	15	0	14.3838103	0.2	0	0	8	15	20	7.5	0	0	15											2.0973	0.027212069	1.864550119	0	0	0	0	3.758153411	0.25695103	0	0	0	0	0.3495	15.16535512	27.48194634	0.691418369	5.93644127	0	23.47861965	0.024895303	0	0	0.06	0.221975283	0.204484142	0.353108979	0	0	12.60477295	0	0	0	0	0	0	0	0	0	0	94.5767			2.0973	0.027212069	1.864550119	0	0	0	0	3.758153411	0.25695103	0	0	0	0	0.3495	15.16535512	27.48194634	0.691418369	5.93644127	0	23.47861965	0.024895303	0	0	0.06	0.221975283	0.204484142	0.353108979	0	0	12.60477295	0	0	0	0	0	0	0	0	0	0	94.5767																																																																																		0			2.0973	0.027212069	1.864550119	0	0	0	0	3.758153411	0.25695103	0	0	0	0	0.3495	15.16535512	27.48194634	0.691418369	5.93644127	0	23.47861965	0.024895303	0	0	0.06	0.221975283	0.204484142	0.353108979	0	0	12.60477295	0	0	0	0	0	0	0	0	0	0	94.5767
H9104_803_0	2009	4																																D	D	D	V	T	P	P	V	V	P	P	V	V	V	V	V	V	V	P	V	Coin	O	T	P	V	P	V	P	V	V																																																			0		251.6797233	3.265448277	447.4920287	0	0	0	0	1148.153817	205.560824	1068.484077	538.011619	0	0	279.6	12132.2841	10992.77853	553.1346954	4749.153016	11263.64357	19587.53835	0.124476517	800.6220047	0	90	177.5802267	122.6904854	564.9743662	0	0	10083.81836											copay/admit	copay/admit	copay/days 21-100	0	0	0	0	"$50 ER, $25 urgent care"	$15/OP hospital and ASC visits	$0 copay	$0 copay	0	0	0	$15/visit	$30/visit	$15/visit	$15/visit	0	"$15 hearing, pod, chiro"	20% coinsurance	0	0	$8/visit	$15/visit	$20/service	$0-$15/visit	0	0	ILP Services											100	100	50	0	0	0	0	39.27857074	15	0	0	0	0	15	15	30	15	15	0	14.3838103	0.2	0	0	8	15	20	7.5	0	0	15											100	100	50	0	0	0	0	39.27857074	15	0	0	0	0	15	15	30	15	15	0	14.3838103	0.2	0	0	8	15	20	7.5	0	0	15											2.0973	0.027212069	1.864550119	0	0	0	0	3.758153411	0.25695103	0	0	0	0	0.3495	15.16535512	27.48194634	0.691418369	5.93644127	0	23.47861965	0.024895303	0	0	0.06	0.221975283	0.204484142	0.353108979	0	0	12.60477295	0	0	0	0	0	0	0	0	0	0	94.5767			2.0973	0.027212069	1.864550119	0	0	0	0	3.758153411	0.25695103	0	0	0	0	0.3495	15.16535512	27.48194634	0.691418369	5.93644127	0	23.47861965	0.024895303	0	0	0.06	0.221975283	0.204484142	0.353108979	0	0	12.60477295	0	0	0	0	0	0	0	0	0	0	94.5767																																																																																		0			2.0973	0.027212069	1.864550119	0	0	0	0	3.758153411	0.25695103	0	0	0	0	0.3495	15.16535512	27.48194634	0.691418369	5.93644127	0	23.47861965	0.024895303	0	0	0.06	0.221975283	0.204484142	0.353108979	0	0	12.60477295	0	0	0	0	0	0	0	0	0	0	94.5767
H9104_804_0	2009	4																																D	D	D	V	T	P	P	V	V	P	P	V	V	V	V	V	V	V	P	V	Coin	O	T	P	V	P	V	P	V	V																																																			0		251.6797233	3.265448277	447.4920287	0	0	0	0	1148.153817	205.560824	1068.484077	538.011619	0	0	279.6	12132.2841	10992.77853	553.1346954	4749.153016	11263.64357	19587.53835	0.124476517	800.6220047	0	90	177.5802267	122.6904854	564.9743662	0	0	10083.81836											copay/admit	copay/admit	copay/days 21-100	0	0	0	0	"$50 ER, $25 urgent care"	$15/OP hospital and ASC visits	$0 copay	$0 copay	0	0	0	$15/visit	$30/visit	$15/visit	$15/visit	0	"$15 hearing, pod, chiro"	20% coinsurance	0	0	$8/visit	$15/visit	$20/service	$0-$15/visit	0	0	ILP Services											100	100	50	0	0	0	0	39.27857074	15	0	0	0	0	15	15	30	15	15	0	14.3838103	0.2	0	0	8	15	20	7.5	0	0	15											100	100	50	0	0	0	0	39.27857074	15	0	0	0	0	15	15	30	15	15	0	14.3838103	0.2	0	0	8	15	20	7.5	0	0	15											2.0973	0.027212069	1.864550119	0	0	0	0	3.758153411	0.25695103	0	0	0	0	0.3495	15.16535512	27.48194634	0.691418369	5.93644127	0	23.47861965	0.024895303	0	0	0.06	0.221975283	0.204484142	0.353108979	0	0	12.60477295	0	0	0	0	0	0	0	0	0	0	94.5767			2.0973	0.027212069	1.864550119	0	0	0	0	3.758153411	0.25695103	0	0	0	0	0.3495	15.16535512	27.48194634	0.691418369	5.93644127	0	23.47861965	0.024895303	0	0	0.06	0.221975283	0.204484142	0.353108979	0	0	12.60477295	0	0	0	0	0	0	0	0	0	0	94.5767																																																																																		0			2.0973	0.027212069	1.864550119	0	0	0	0	3.758153411	0.25695103	0	0	0	0	0.3495	15.16535512	27.48194634	0.691418369	5.93644127	0	23.47861965	0.024895303	0	0	0.06	0.221975283	0.204484142	0.353108979	0	0	12.60477295	0	0	0	0	0	0	0	0	0	0	94.5767
H9149_002_0	2009	4																					3350											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1661.275599	170.9893203	707.772521	750.5767039	113.2799934	12.35325553	4.562971864	322.1290428	37.52753536	10032.13689	43.6729707	0	0.227313096	28.39590249	4705.016146	3707.531448	583.8015722	209.990044	0	0	17.56895299	804.8869559	0	0	103.5923094	0	12.88706159	0	98.4	0											"$200 Days 1-17 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$200 Days 1-17 (1b); $0 n/c (1b1, 1b2)"	"$100 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$15 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$5 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$15 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$15 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$15 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$15 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											197.6553105	200	77.60718127	0	150	0.2	0.076056143	49.51687316	0.2	2.8	0.172055214	0	0.2	0.196475537	3.589384754	15	37.5	15	0	0	0.2	14.28753732	0	0	15	0	15	0	0	0											133.3705767	134.9316779	52.35833591	0	101.1987584	0.134931678	0.051311915	33.40697388	0.134931678	1.88904349	0.116078493	0	0.134931678	0.132832488	3.589384754	15	37.5	10.11987584	0	0	0.134931678	14.28753732	0	0	15	0	15	0	0	0											18.4638	1.922656323	3.088149283	0	0.955316223	1.666845495	0.234134824	0.89677971	5.063653311	1.579261907	5.069492633	0	0.030671737	3.77189838	1.407342768	4.634414311	1.824379913	0.177089431	0	0	2.370608305	0.958321035	0	0	0.129490387	0	0.016108827	0	0	0	0	0	0	0	0	0	0	0	0	0	54.2604	0	21.8244	18.4638	1.922656323	3.088149283	0	0.955316223	1.666845495	0.234134824	0.89677971	5.063653311	1.579261907	5.069492633	0	0.030671737	3.77189838	1.407342768	4.634414311	1.824379913	0.177089431	0	0	2.370608305	0.958321035	0	0	0.129490387	0	0.016108827	0	0	0	0	0	0	0	0	0	0	0	0	0	54.2604		"$300 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$300 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$15 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$15 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											5.6747	0.5806	5.8912	0.7015	0.472	1.2353	0.4563	0.4431	3.7528	0.7803	3.6912	0	0.0152	2.7918	2.1781	4.6165	0.8861	0.2625	0	0	2.2589	0.9784	0	0	0.1295	0	0.0161	0	0	0											37.812	0	0	24.1385	2.50326592	8.979366595	0.701547811	1.427316196	2.902171048	0.690432011	1.339858125	8.816406847	2.359539221	8.760656684	0	0.045825944	6.563699702	3.585408636	9.250946571	2.710507299	0.439576986	0	0	4.62947369	1.936686032	0	0	0.258980774	0	0.032217654	0	0	0	0	0	0	0	0	0	0	0	0	0	92.0724
H9149_801_0	2009	1																					5700											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1744.339379	179.5387863	743.1611471	788.1055391	118.9439931	12.97091831	4.791120458	338.2156954	39.40391213	10533.74374	45.85661923	0	0.238678751	29.81569761	4935.358175	3885.623937	612.9916508	220.4895463	0	0	18.44740064	845.1313037	0	0	0	0	0	0	0	0											"$380 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$380 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-38 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$15 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											375.4876521	380	150	0	150	0.2	0.076056143	49.51684487	0.2	2.8	0.172055214	0	0.2	0.196929942	10.77886442	25	37.5	25	0	0	0.2	23.7994906	0	0	0	0	0	0	0	0											262.5285802	265.6640318	104.867381	0	104.867381	0.139823175	0.053172057	34.61801224	0.139823175	1.957524445	0.120286531	0	0.139823175	0.137934522	10.77886442	25	37.5	17.47789683	0	0	0.139823175	23.7994906	0	0	0	0	0	0	0	0											38.1616	3.974749819	6.494446927	0	1.039445419	1.813634975	0.254753729	0.975696257	5.509580086	1.718338405	5.515933643	0	0.033372821	4.112614009	4.433129721	8.095049869	1.915598909	0.321141128	0	0	2.579374121	1.67614121	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.6246	0	31.1894	38.1616	3.974749819	6.494446927	0	1.039445419	1.813634975	0.254753729	0.975696257	5.509580086	1.718338405	5.515933643	0	0.033372821	4.112614009	4.433129721	8.095049869	1.915598909	0.321141128	0	0	2.579374121	1.67614121	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.6246		"$400 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$400 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$200 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											7.9168	0.8129	8.2477	0.7366	0.4956	1.2971	0.4791	0.4652	3.9404	0.8193	3.8757	0	0.0159	2.9336	3.586	5.5013	0.9304	0.315	0	0	2.3718	1.1708	0	0	0	0	0	0	0	0											45.9113	0	0	46.0784	4.787603255	14.74215116	0.736625201	1.53504539	3.110726806	0.733865775	1.440901094	9.449971299	2.537629585	9.391655897	0	0.049284737	7.046263467	8.01914037	13.59630692	2.846032664	0.636126194	0	0	4.951182775	2.846975341	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.5358
H9149_802_0	2009	1																					5700											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1744.339379	179.5387863	743.1611471	788.1055391	118.9439931	12.97091831	4.791120458	338.2156954	39.40391213	10533.74374	45.85661923	0	0.238678751	29.81569761	4935.358175	3885.623937	612.9916508	220.4895463	0	0	18.44740064	845.1313037	0	0	0	0	0	0	0	0											"$380 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$380 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-38 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$15 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											375.4876521	380	150	0	150	0.2	0.076056143	49.51684487	0.2	2.8	0.172055214	0	0.2	0.196929942	10.77886442	25	37.5	25	0	0	0.2	23.7994906	0	0	0	0	0	0	0	0											262.5285802	265.6640318	104.867381	0	104.867381	0.139823175	0.053172057	34.61801224	0.139823175	1.957524445	0.120286531	0	0.139823175	0.137934522	10.77886442	25	37.5	17.47789683	0	0	0.139823175	23.7994906	0	0	0	0	0	0	0	0											38.1616	3.974749819	6.494446927	0	1.039445419	1.813634975	0.254753729	0.975696257	5.509580086	1.718338405	5.515933643	0	0.033372821	4.112614009	4.433129721	8.095049869	1.915598909	0.321141128	0	0	2.579374121	1.67614121	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.6246	0	31.1894	38.1616	3.974749819	6.494446927	0	1.039445419	1.813634975	0.254753729	0.975696257	5.509580086	1.718338405	5.515933643	0	0.033372821	4.112614009	4.433129721	8.095049869	1.915598909	0.321141128	0	0	2.579374121	1.67614121	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.6246		"$400 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$400 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$200 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											7.9168	0.8129	8.2477	0.7366	0.4956	1.2971	0.4791	0.4652	3.9404	0.8193	3.8757	0	0.0159	2.9336	3.586	5.5013	0.9304	0.315	0	0	2.3718	1.1708	0	0	0	0	0	0	0	0											45.9113	0	0	46.0784	4.787603255	14.74215116	0.736625201	1.53504539	3.110726806	0.733865775	1.440901094	9.449971299	2.537629585	9.391655897	0	0.049284737	7.046263467	8.01914037	13.59630692	2.846032664	0.636126194	0	0	4.951182775	2.846975341	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.5358
H9149_803_0	2009	1																					5700											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1744.339379	179.5387863	743.1611471	788.1055391	118.9439931	12.97091831	4.791120458	338.2156954	39.40391213	10533.74374	45.85661923	0	0.238678751	29.81569761	4935.358175	3885.623937	612.9916508	220.4895463	0	0	18.44740064	845.1313037	0	0	0	0	0	0	0	0											"$380 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$380 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-38 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$15 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											375.4876521	380	150	0	150	0.2	0.076056143	49.51684487	0.2	2.8	0.172055214	0	0.2	0.196929942	10.77886442	25	37.5	25	0	0	0.2	23.7994906	0	0	0	0	0	0	0	0											262.5285802	265.6640318	104.867381	0	104.867381	0.139823175	0.053172057	34.61801224	0.139823175	1.957524445	0.120286531	0	0.139823175	0.137934522	10.77886442	25	37.5	17.47789683	0	0	0.139823175	23.7994906	0	0	0	0	0	0	0	0											38.1616	3.974749819	6.494446927	0	1.039445419	1.813634975	0.254753729	0.975696257	5.509580086	1.718338405	5.515933643	0	0.033372821	4.112614009	4.433129721	8.095049869	1.915598909	0.321141128	0	0	2.579374121	1.67614121	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.6246	0	31.1894	38.1616	3.974749819	6.494446927	0	1.039445419	1.813634975	0.254753729	0.975696257	5.509580086	1.718338405	5.515933643	0	0.033372821	4.112614009	4.433129721	8.095049869	1.915598909	0.321141128	0	0	2.579374121	1.67614121	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.6246		"$400 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$400 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$200 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											7.9168	0.8129	8.2477	0.7366	0.4956	1.2971	0.4791	0.4652	3.9404	0.8193	3.8757	0	0.0159	2.9336	3.586	5.5013	0.9304	0.315	0	0	2.3718	1.1708	0	0	0	0	0	0	0	0											45.9113	0	0	46.0784	4.787603255	14.74215116	0.736625201	1.53504539	3.110726806	0.733865775	1.440901094	9.449971299	2.537629585	9.391655897	0	0.049284737	7.046263467	8.01914037	13.59630692	2.846032664	0.636126194	0	0	4.951182775	2.846975341	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.5358
H9149_804_0	2009	1																					5700											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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		1744.339379	179.5387863	743.1611471	788.1055391	118.9439931	12.97091831	4.791120458	338.2156954	39.40391213	10533.74374	45.85661923	0	0.238678751	29.81569761	4935.358175	3885.623937	612.9916508	220.4895463	0	0	18.44740064	845.1313037	0	0	0	0	0	0	0	0											"$380 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$380 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-38 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$15 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											375.4876521	380	150	0	150	0.2	0.076056143	49.51684487	0.2	2.8	0.172055214	0	0.2	0.196929942	10.77886442	25	37.5	25	0	0	0.2	23.7994906	0	0	0	0	0	0	0	0											262.5285802	265.6640318	104.867381	0	104.867381	0.139823175	0.053172057	34.61801224	0.139823175	1.957524445	0.120286531	0	0.139823175	0.137934522	10.77886442	25	37.5	17.47789683	0	0	0.139823175	23.7994906	0	0	0	0	0	0	0	0											38.1616	3.974749819	6.494446927	0	1.039445419	1.813634975	0.254753729	0.975696257	5.509580086	1.718338405	5.515933643	0	0.033372821	4.112614009	4.433129721	8.095049869	1.915598909	0.321141128	0	0	2.579374121	1.67614121	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.6246	0	31.1894	38.1616	3.974749819	6.494446927	0	1.039445419	1.813634975	0.254753729	0.975696257	5.509580086	1.718338405	5.515933643	0	0.033372821	4.112614009	4.433129721	8.095049869	1.915598909	0.321141128	0	0	2.579374121	1.67614121	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.6246		"$400 Days 1-999 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$400 Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"$200 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											7.9168	0.8129	8.2477	0.7366	0.4956	1.2971	0.4791	0.4652	3.9404	0.8193	3.8757	0	0.0159	2.9336	3.586	5.5013	0.9304	0.315	0	0	2.3718	1.1708	0	0	0	0	0	0	0	0											45.9113	0	0	46.0784	4.787603255	14.74215116	0.736625201	1.53504539	3.110726806	0.733865775	1.440901094	9.449971299	2.537629585	9.391655897	0	0.049284737	7.046263467	8.01914037	13.59630692	2.846032664	0.636126194	0	0	4.951182775	2.846975341	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	134.5358
H9302_001_0	2009	5																					1500											D	D	D		T	Coin	Coin	V	V		V		P	V	V	V	V	V	P	P	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	0	0	0											0		700.269659	14.82188668	719.6849035	0	251.394947	12.35384293	7.026148365	398.5740007	452.5052521	0	170.1694441	0	44.21983409	1122.870575	4387.81666	3766.797764	210.9089855	264.2700449	216.7580434	2428.585252	7.839891751	0	0	0	407.6987688	0	131.0460328	0	0	215.9280677											$100/Days 1-5 for IP Medical; $100/Days 1-5 for IP Surgical;	$100/Days 1-5 for IP Psych; $100/Days 1-5 for IP Substance Abuse;	$100/Days 10-100 for SNF	No cost sharing	$50/Run 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	No cost sharing	$50/Case for OP Fac - CT/MRI/PET	No cost sharing	$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/Visit for Prof - CORF; $15/Visit for Prof - CORF;	$5/Visit for PCP - Office Visits; $5/Consult for PCP - Consults; $5/Exam for PCP - Routine Physicals;	$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);	$50/Procedure for Prof Radiology (Office);	$15/Visit for Chiropractor; $15/Exam for Vistion Exams; $14/Service for Podiatrist; $15/Exam for Hearing/Speech Exams;	10% Coinsurance for Part B Rx	No cost sharing	No cost sharing	No cost sharing	$15/Exam for Vision (Refractions)	No cost sharing	$15/Exam for Routine Hearing Exams	No cost sharing	No cost sharing	$15/Visit for Acupunture;											100	99.99999999	100	0	50	0.2	0.2	40.86551294	50	0	50	0	14.69177311	15	5	15	14.99999999	15	50	14.6281673	0.1	0	0	0	15	0	15	0	0	15											95.16931236	95.16931237	95.16931236	0	47.58465618	0.190338625	0.190338625	38.89142766	47.58465618	0	47.58465619	0	13.98205946	14.27539686	4.758465618	14.27539685	14.27539685	14.27539685	47.58465618	13.92152623	0.095169312	0	0	0	14.27539686	0	14.27539685	0	0	14.27539686											5.5537	0.117549064	5.707659782	0	0.99687851	2.351413474	1.337347417	1.291759326	1.794358904	0	0.674787874	0	0.051523696	1.335785256	1.73993956	4.481044413	0.250900789	0.314379981	0.859529748	2.817467774	0.746117107	0	0	0	0.485005144	0	0.15589451	0	0	0.256871572	0	0	0	0	0	0	0	0	0	0	33.3199	0	1.6913	5.5537	0.117549064	5.707659782	0	0.99687851	2.351413474	1.337347417	1.291759326	1.794358904	0	0.674787874	0	0.051523696	1.335785256	1.73993956	4.481044413	0.250900789	0.314379981	0.859529748	2.817467774	0.746117107	0	0	0	0.485005144	0	0.15589451	0	0	0.256871572	0	0	0	0	0	0	0	0	0	0	33.3199																																																																																		0	0	0	5.5537	0.117549064	5.707659782	0	0.99687851	2.351413474	1.337347417	1.291759326	1.794358904	0	0.674787874	0	0.051523696	1.335785256	1.73993956	4.481044413	0.250900789	0.314379981	0.859529748	2.817467774	0.746117107	0	0	0	0.485005144	0	0.15589451	0	0	0.256871572	0	0	0	0	0	0	0	0	0	0	33.3199
H9302_002_0	2009	2																					1500											D	D	D		T	Coin	Coin	V	V		V		P	V	V	V	V	V	P	P	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	0	0	0											0		649.287249	13.7928812	646.8443557	0	225.2571326	11.15994889	6.347357357	357.8403465	407.2290367	0	152.5243178	0	39.69483866	1005.382336	3946.162186	3387.656359	189.6628731	237.6574836	194.9266484	2184.115783	7.023515873	0	0	0	366.6853452	0	117.8631467	0	0	194.2185214											$100/Days 1-5 for IP Medical; $100/Days 1-5 for IP Surgical;	$100/Days 1-5 for IP Psych; $100/Days 1-5 for IP Substance Abuse;	$100/Days 10-100 for SNF	No cost sharing	$50/Run 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	No cost sharing	$50/Case for OP Fac - CT/MRI/PET	No cost sharing	$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/Visit for Prof - CORF; $15/Visit for Prof - CORF;	$5/Visit for PCP - Office Visits; $5/Consult for PCP - Consults; $5/Exam for PCP - Routine Physicals;	$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);	$50/Procedure for Prof Radiology (Office);	$15/Visit for Chiropractor; $15/Exam for Vistion Exams; $14/Service for Podiatrist; $15/Exam for Hearing/Speech Exams;	10% Coinsurance for Part B Rx	No cost sharing	No cost sharing	No cost sharing	$15/Exam for Vision (Refractions)	No cost sharing	$15/Exam for Routine Hearing Exams	No cost sharing	No cost sharing	$15/Visit for Acupunture;											100	100	100	0	50	0.2	0.2	40.84993237	50	0	50	0	14.69123234	15	5	15	15	15	50	14.62818312	0.1	0	0	0	15	0	15	0	0	15											95.70432813	95.70432818	95.70432813	0	47.85216407	0.191408656	0.191408656	39.09515332	47.85216407	0	47.85216407	0	14.06014523	14.35564922	4.785216407	14.35564922	14.35564922	14.35564922	47.85216407	13.99980438	0.095704328	0	0	0	14.35564922	0	14.35564922	0	0	14.35564922											5.1783	0.110003202	5.158817039	0	0.898253439	2.13611082	1.214939143	1.165818601	1.623899223	0	0.608218224	0	0.0465096	1.202743012	1.573603337	4.052667198	0.226894473	0.284310622	0.777305164	2.548099474	0.672180868	0	0	0	0.438667183	0	0.141000166	0	0	0.232344414	0	0	0	0	0	0	0	0	0	0	30.2907	0	1.3596	5.1783	0.110003202	5.158817039	0	0.898253439	2.13611082	1.214939143	1.165818601	1.623899223	0	0.608218224	0	0.0465096	1.202743012	1.573603337	4.052667198	0.226894473	0.284310622	0.777305164	2.548099474	0.672180868	0	0	0	0.438667183	0	0.141000166	0	0	0.232344414	0	0	0	0	0	0	0	0	0	0	30.2907																																																																																		0	0	0	5.1783	0.110003202	5.158817039	0	0.898253439	2.13611082	1.214939143	1.165818601	1.623899223	0	0.608218224	0	0.0465096	1.202743012	1.573603337	4.052667198	0.226894473	0.284310622	0.777305164	2.548099474	0.672180868	0	0	0	0.438667183	0	0.141000166	0	0	0.232344414	0	0	0	0	0	0	0	0	0	0	30.2907
H9302_003_0	2009	5																					2750											D	D	D		T	Coin	Coin	V	V		V		P	V	V	V	V	V	P	P	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	0	0	0											0		698.8841595	17.46654776	1046.536047	0	193.5011643	9.081817558	5.199169134	313.2821091	349.5991749	0	143.1159198	0	38.33359536	1121.280252	3475.892832	2910.939673	154.2180491	189.4856724	171.0809264	1761.117188	7.809862935	0	0	0	333.3365093	0	107.143878	0	0	158.1320663											$250/Days 1-10 for IP Medical; $250/Days 1-10 for IP Surgical;	$250/Days 1-10 for IP Psych; $250/Days 1-10 for IP Substance Abuse;	$150/Day for SNF	No cost sharing	$150/Run 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	No cost sharing	$100/Case for OP Fac - CT/MRI/PET	No cost sharing	$30/Case for Renal Dialysis - Fac; $29/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/Visit for Prof - CORF; $30/Visit 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; $30/Consult for Speclst - Consults;	$30/Visit for OP Psych - Non-Physician; $30/Visit for OP Psych - Psychiatrist; $30/Visit for OP Substance Abuse;	$30/Visit for PT/ST (PCP); $30/Visit for Occ Therapy (PCP); $30/Visit for PT/ST (Specialist); $30/Visit for Occ Therapy (Specialist);	$100/Procedure for Prof Radiology (Office);	$25/Visit for Chiropractor; $30/Exam for Vistion Exams; $28/Service for Podiatrist; $30/Exam for Hearing/Speech Exams;	10% Coinsurance for Part B Rx	No cost sharing	No cost sharing	No cost sharing	$30/Exam for Vision (Refractions)	No cost sharing	$30/Exam for Routine Hearing Exams	No cost sharing	No cost sharing	$25/Visit for Acupunture;											250	250	150	0	150	0.2	0.2	44.86874652	200	0	100	0	29.45446875	30	10	30	30	30	100	27.71972008	0.1	0	0	0	30	0	30	0	0	25											238.1571579	238.157158	142.8942947	0	142.8942947	0.190525726	0.190525726	42.7432526	190.5257263	0	95.26286316	0	28.05917025	28.57885895	9.526286316	28.57885895	28.57885896	28.57885895	95.26286316	26.40659901	0.095262863	0	0	0	28.57885895	0	28.57885895	0	0	23.81571579											13.8704	0.346648615	12.46200253	0	2.304184366	1.730319887	0.990575476	1.115891361	5.550636393	0	1.136136024	0	0.089634073	2.67040918	2.759362527	6.932611194	0.367281323	0.451273692	1.35813824	3.875426282	0.743989904	0	0	0	0.793864757	0	0.255170815	0	0	0.313835696	0	0	0	0	0	0	0	0	0	0	60.1177	0	2.9895	13.8704	0.346648615	12.46200253	0	2.304184366	1.730319887	0.990575476	1.115891361	5.550636393	0	1.136136024	0	0.089634073	2.67040918	2.759362527	6.932611194	0.367281323	0.451273692	1.35813824	3.875426282	0.743989904	0	0	0	0.793864757	0	0.255170815	0	0	0.313835696	0	0	0	0	0	0	0	0	0	0	60.1177																																																																																		0	0	0	13.8704	0.346648615	12.46200253	0	2.304184366	1.730319887	0.990575476	1.115891361	5.550636393	0	1.136136024	0	0.089634073	2.67040918	2.759362527	6.932611194	0.367281323	0.451273692	1.35813824	3.875426282	0.743989904	0	0	0	0.793864757	0	0.255170815	0	0	0.313835696	0	0	0	0	0	0	0	0	0	0	60.1177
H9302_004_0	2009	2																					2750											D	D	D		T	Coin	Coin	V	V		V		P	V	V	V	V	V	P	P	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	0	0	0											0		621.94441	15.41805312	903.5460791	0	161.6644597	7.81049468	4.473838106	267.2539471	300.2661905	0	123.7218607	0	33.59625213	1009.332228	2986.44633	2501.05875	131.3492617	161.3167778	147.76126	1503.287926	7.026895592	0	0	0	286.1278062	0	91.96965198	0	0	134.3068995											$250/Days 1-10 for IP Medical; $250/Days 1-10 for IP Surgical;	$250/Days 1-10 for IP Psych; $250/Days 1-10 for IP Substance Abuse;	$150/Day for SNF	No cost sharing	$150/Run 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	No cost sharing	$100/Case for OP Fac - CT/MRI/PET	No cost sharing	$30/Case for Renal Dialysis - Fac; $29/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/Visit for Prof - CORF; $30/Visit 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; $30/Consult for Speclst - Consults;	$30/Visit for OP Psych - Non-Physician; $30/Visit for OP Psych - Psychiatrist; $30/Visit for OP Substance Abuse;	$30/Visit for PT/ST (PCP); $30/Visit for Occ Therapy (PCP); $30/Visit for PT/ST (Specialist); $30/Visit for Occ Therapy (Specialist);	$100/Procedure for Prof Radiology (Office);	$25/Visit for Chiropractor; $30/Exam for Vistion Exams; $28/Service for Podiatrist; $30/Exam for Hearing/Speech Exams;	10% Coinsurance for Part B Rx	No cost sharing	No cost sharing	No cost sharing	$30/Exam for Vision (Refractions)	No cost sharing	$30/Exam for Routine Hearing Exams	No cost sharing	No cost sharing	$25/Visit for Acupunture;											250	250	150	0	150	0.2	0.2	44.83209937	200	0	100	0	29.46975788	30	10	30	30	30	100	27.72735573	0.1	0	0	0	30	0	29.99999999	0	0	25											239.9551974	239.9551974	143.9731184	0	143.9731184	0.191964158	0.191964158	43.03078101	191.9641579	0	95.98207895	0	28.28568627	28.79462369	9.598207896	28.79462369	28.79462368	28.79462368	95.98207896	26.61329247	0.095982079	0	0	0	28.79462369	0	28.79462368	0	0	23.99551974											12.4366	0.308303498	10.84052889	0	1.939611366	1.499335034	0.858816565	0.958345506	4.803362201	0	0.989590117	0	0.079191087	2.42194514	2.388711062	6.00142046	0.31517938	0.387087992	1.181869411	3.333953436	0.674456048	0	0	0	0.686578542	0	0.22068596	0	0	0.268563655	0	0	0	0	0	0	0	0	0	0	52.5941	0	2.2017	12.4366	0.308303498	10.84052889	0	1.939611366	1.499335034	0.858816565	0.958345506	4.803362201	0	0.989590117	0	0.079191087	2.42194514	2.388711062	6.00142046	0.31517938	0.387087992	1.181869411	3.333953436	0.674456048	0	0	0	0.686578542	0	0.22068596	0	0	0.268563655	0	0	0	0	0	0	0	0	0	0	52.5941																																																																																		0	0	0	12.4366	0.308303498	10.84052889	0	1.939611366	1.499335034	0.858816565	0.958345506	4.803362201	0	0.989590117	0	0.079191087	2.42194514	2.388711062	6.00142046	0.31517938	0.387087992	1.181869411	3.333953436	0.674456048	0	0	0	0.686578542	0	0.22068596	0	0	0.268563655	0	0	0	0	0	0	0	0	0	0	52.5941
H9302_005_0	2009	5																					1500											D	D	D		T	Coin	Coin	V	V		V		V	V	V	V	V	V	P	P	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	0	0	0											0		680.5461122	13.8781895	733.4132503	0	216.0672071	10.44770506	6.0070574	383.8633893	420.3442398	0	185.2971109	0	52.86031545	1728.805663	4423.634484	3794.054741	193.5093146	236.3962484	220.2364312	2216.051282	12.12769537	0	0	0	409.7946505	0	131.7197091	0	0	179.4591168											$100/Days 1-5 for IP Medical; $100/Days 1-5 for IP Surgical;	$100/Days 1-5 for IP Psych; $100/Days 1-5 for IP Substance Abuse;	$100/Days 10-100 for SNF	No cost sharing	$50/Run 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	No cost sharing	$50/Case for OP Fac - CT/MRI/PET	No cost sharing	$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/Visit for Prof - CORF; $15/Visit for Prof - CORF;	$5/Visit for PCP - Office Visits; $5/Consult for PCP - Consults; $5/Exam for PCP - Routine Physicals;	$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);	$50/Procedure for Prof Radiology (Office);	$15/Visit for Chiropractor; $15/Exam for Vistion Exams; $14/Service for Podiatrist; $15/Exam for Hearing/Speech Exams;	10% Coinsurance for Part B Rx	No cost sharing	No cost sharing	No cost sharing	$15/Exam for Vision (Refractions)	No cost sharing	$15/Exam for Routine Hearing Exams	No cost sharing	No cost sharing	$15/Visit for Acupunture;											100	99.99999996	100	0	50	0.2	0.2	40.37805118	50	0	50	0	14.76014043	15	5	15	15	14.99999999	50	14.63564221	0.1	0	0	0	15	0	15	0	0	15											95.17284045	95.17284045	95.17284045	0	47.58642023	0.190345681	0.190345681	38.42893823	47.58642022	0	47.58642022	0	14.04764491	14.27592607	4.758642023	14.27592607	14.27592607	14.27592606	47.58642022	13.92915641	0.09517284	0	0	0	14.27592607	0	14.27592608	0	0	14.27592606											5.3975	0.110068893	5.816751854	0	0.856822076	1.988675534	1.143417431	1.229288539	1.666889803	0	0.734802182	0	0.061880245	2.05669182	1.754207746	4.513637081	0.230210389	0.28123128	0.87335528	2.572310409	1.154227217	0	0	0	0.487516511	0	0.156701736	0	0	0.213495424	0	0	0	0	0	0	0	0	0	0	33.2996	0	1.689	5.3975	0.110068893	5.816751854	0	0.856822076	1.988675534	1.143417431	1.229288539	1.666889803	0	0.734802182	0	0.061880245	2.05669182	1.754207746	4.513637081	0.230210389	0.28123128	0.87335528	2.572310409	1.154227217	0	0	0	0.487516511	0	0.156701736	0	0	0.213495424	0	0	0	0	0	0	0	0	0	0	33.2996																																																																																		0	0	0	5.3975	0.110068893	5.816751854	0	0.856822076	1.988675534	1.143417431	1.229288539	1.666889803	0	0.734802182	0	0.061880245	2.05669182	1.754207746	4.513637081	0.230210389	0.28123128	0.87335528	2.572310409	1.154227217	0	0	0	0.487516511	0	0.156701736	0	0	0.213495424	0	0	0	0	0	0	0	0	0	0	33.2996
H9302_006_0	2009	2																					1500											D	D	D		T	Coin	Coin	V	V		V		V	V	V	V	V	V	P	P	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	0	0	0											0		617.8950831	12.69306358	641.2166886	0	188.9056395	9.134335712	5.251916914	335.6083507	367.5032343	0	162.0036178	0	46.21530415	1511.479432	3867.544327	3317.108351	169.1834745	206.6791397	192.5507551	1937.473947	10.60313631	0	0	0	358.279822	0	115.1613714	0	0	156.8995114											$100/Days 1-5 for IP Medical; $100/Days 1-5 for IP Surgical;	$100/Days 1-5 for IP Psych; $100/Days 1-5 for IP Substance Abuse;	$100/Days 10-100 for SNF	No cost sharing	$50/Run 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	No cost sharing	$50/Case for OP Fac - CT/MRI/PET	No cost sharing	$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/Visit for Prof - CORF; $15/Visit for Prof - CORF;	$5/Visit for PCP - Office Visits; $5/Consult for PCP - Consults; $5/Exam for PCP - Routine Physicals;	$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);	$50/Procedure for Prof Radiology (Office);	$15/Visit for Chiropractor; $15/Exam for Vistion Exams; $14/Service for Podiatrist; $15/Exam for Hearing/Speech Exams;	10% Coinsurance for Part B Rx	No cost sharing	No cost sharing	No cost sharing	$15/Exam for Vision (Refractions)	No cost sharing	$15/Exam for Routine Hearing Exams	No cost sharing	No cost sharing	$15/Visit for Acupunture;											100	100	100	0	50	0.2	0.2	40.37805118	50	0	50	0	14.76014044	15	5	15	15	15	50	14.63564221	0.1	0	0	0	15	0	15	0	0	15											95.83666516	95.83666514	95.83666517	0	47.91833258	0.19167333	0.19167333	38.69697771	47.91833258	0	47.91833258	0	14.14562637	14.37549978	4.791833258	14.37549978	14.37549978	14.37549978	47.91833259	14.02631142	0.095836665	0	0	0	14.37549977	0	14.37549977	0	0	14.37549978											4.9348	0.10137174	5.121005757	0	0.754336938	1.750808546	1.006652406	1.082252406	1.46751185	0	0.646911936	0	0.054478702	1.810689352	1.544385628	3.973757529	0.20267475	0.247592994	0.768892593	2.264634412	1.016169225	0	0	0	0.429204292	0	0.137958522	0	0	0.187959074	0	0	0	0	0	0	0	0	0	0	29.504	0	1.2817	4.9348	0.10137174	5.121005757	0	0.754336938	1.750808546	1.006652406	1.082252406	1.46751185	0	0.646911936	0	0.054478702	1.810689352	1.544385628	3.973757529	0.20267475	0.247592994	0.768892593	2.264634412	1.016169225	0	0	0	0.429204292	0	0.137958522	0	0	0.187959074	0	0	0	0	0	0	0	0	0	0	29.504																																																																																		0	0	0	4.9348	0.10137174	5.121005757	0	0.754336938	1.750808546	1.006652406	1.082252406	1.46751185	0	0.646911936	0	0.054478702	1.810689352	1.544385628	3.973757529	0.20267475	0.247592994	0.768892593	2.264634412	1.016169225	0	0	0	0.429204292	0	0.137958522	0	0	0.187959074	0	0	0	0	0	0	0	0	0	0	29.504
H9302_007_0	2009	5																					3350											D	D	D		T	Coin	Coin	V	V		V		P	V	V	V	V	V	P	P	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	0	0	0											0		699.7307104	17.96112583	1054.273973	0	213.4044598	9.520533459	5.414508271	323.2840687	364.919631	0	143.9094581	0	35.79732774	959.920735	3371.287449	2815.876261	155.5935921	192.0300759	168.357933	1809.125557	6.683575035	0	0	0	332.2181241	0	106.784397	0	0	174.9326863											$300/Days 1-10 for IP Medical; $300/Days 1-10 for IP Surgical;	$300/Days 1-10 for IP Psych; $300/Days 1-10 for IP Substance Abuse;	$200/Day for SNF	No cost sharing	$150/Run for Ambulance	25% Coinsurance for DME	25% Coinsurance for Prosthetics/Supplies; 25% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $40/Visit for Urgent Care; $40/Visit for Urgent Care - Worldwide;	$250/Case for OP Fac - Surgery; $250/Case for OP Fac - ASC	No cost sharing	$100/Case for OP Fac - CT/MRI/PET	No cost sharing	$40/Case for Renal Dialysis - Fac; $39/Procedure for Renal Dialysis - Prof	$40/Case for OP Fac - Cardiovascular; $40/Case for OP Fac - Occ Therapy; $40/Case for OP Fac - Physical/Speech Therapy; $40/Case for OP Fac - CORF; $40/Case for OP Fac - Other; $40/Visit for Prof - CORF; $40/Visit for Prof - CORF;	$15/Visit for PCP - Office Visits; $15/Consult for PCP - Consults; $15/Exam for PCP - Routine Physicals;	$40/Visit for Speclst - Office Visits; $40/Consult for Speclst - Consults;	$40/Visit for OP Psych - Non-Physician; $40/Visit for OP Psych - Psychiatrist; $40/Visit for OP Substance Abuse;	$40/Visit for PT/ST (PCP); $40/Visit for Occ Therapy (PCP); $40/Visit for PT/ST (Specialist); $40/Visit for Occ Therapy (Specialist);	$100/Procedure for Prof Radiology (Office);	$25/Visit for Chiropractor; $40/Exam for Vistion Exams; $38/Service for Podiatrist; $40/Exam for Hearing/Speech Exams;	15% Coinsurance for Part B Rx	No cost sharing	No cost sharing	No cost sharing	$40/Exam for Vision (Refractions)	No cost sharing	$40/Exam for Routine Hearing Exams	No cost sharing	No cost sharing	$25/Visit for Acupunture;											300	300	200	0	150	0.25	0.25	47.6121811	250	0	100	0	39.25909758	40	15	40	40	39.99999999	100	34.13328647	0.15	0	0	0	40	0	40	0	0	25											285.2472697	285.2472697	190.1648465	0	142.6236349	0.237706058	0.237706058	45.27081554	237.7060581	0	95.08242324	0	37.32850134	38.03296929	14.26236349	38.0329693	38.03296931	38.03296928	95.08242324	32.45475591	0.142623635	0	0	0	38.03296929	0	38.0329693	0	0	23.77060581											16.633	0.426946842	16.70715401	0	2.536376646	2.26308848	1.287061418	1.21961112	7.228633917	0	1.140271667	0	0.11135505	3.04238632	4.006877252	8.924677949	0.493140526	0.608622831	1.33399002	4.892894029	0.953235765	0	0	0	1.052936809	0	0.338443975	0	0	0.346521328	0	0	0	0	0	0	0	0	0	0	75.5472	0	3.9072	16.633	0.426946842	16.70715401	0	2.536376646	2.26308848	1.287061418	1.21961112	7.228633917	0	1.140271667	0	0.11135505	3.04238632	4.006877252	8.924677949	0.493140526	0.608622831	1.33399002	4.892894029	0.953235765	0	0	0	1.052936809	0	0.338443975	0	0	0.346521328	0	0	0	0	0	0	0	0	0	0	75.5472																																																																																		0	0	0	16.633	0.426946842	16.70715401	0	2.536376646	2.26308848	1.287061418	1.21961112	7.228633917	0	1.140271667	0	0.11135505	3.04238632	4.006877252	8.924677949	0.493140526	0.608622831	1.33399002	4.892894029	0.953235765	0	0	0	1.052936809	0	0.338443975	0	0	0.346521328	0	0	0	0	0	0	0	0	0	0	75.5472
H9302_008_0	2009	7																					1000											D	D	D		T	Coin	Coin	V			V		P	V		V	V	V	P	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	0	0	0											0	1000	672.7555517	13.50880681	814.9541587	0	259.8801256	12.77306848	7.242546687	424.0075931	0	0	196.0697451	0	50.41690772	1499.373984	0	3812.382201	210.4361225	265.9622435	226.9123456	2417.177849	10.26540842	0	0	0	431.179131	0	138.5932921	0	0	232.2138067											$100/Days 1-4 for IP Medical; $100/Days 1-4 for IP Surgical;	$100/Days 1-4 for IP Psych; $100/Days 1-4 for IP Substance Abuse;	$50/Days 10-100 for SNF	No cost sharing	$50/Run for Ambulance	10% Coinsurance for DME	10% Coinsurance for Prosthetics/Supplies; 10% Coinsurance for Prosthetics;	$50/Case for ER - Facility; $50/Case for ER - Worldwide; $15/Visit for Urgent Care; $15/Visit for Urgent Care - Worldwide;	No cost sharing	No cost sharing	$50/Case for OP Fac - CT/MRI/PET	No cost sharing	$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/Visit for Prof - CORF; $15/Visit for Prof - CORF;	No cost sharing	$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	$25/Visit for Chiropractor; $15/Exam for Vistion Exams; $14/Service for Podiatrist; $15/Exam for Hearing/Speech Exams;	10% Coinsurance for Part B Rx	No cost sharing	No cost sharing	No cost sharing	$15/Exam for Vision (Refractions)	No cost sharing	$15/Exam for Routine Hearing Exams	No cost sharing	No cost sharing	$25/Visit for Acupunture;											100	100	50	0	50	0.1	0.1	41.33861208	0	0	50	0	14.73156211	15	0	15	15	15	50	17.5522649	0.1	0	0	0	15	0	15	0	0	25											81.95562625	81.95562631	40.97781312	0	40.97781312	0.081955626	0.081955626	33.87931841	0	0	40.97781312	0	12.07334397	12.29334394	0	12.29334394	12.29334393	12.29334394	40.97781312	14.38506862	0.081955626	0	0	0	12.29334394	0	12.29334394	0	0	20.48890656											4.5947	0.092260227	2.782919935	0	0.887443268	1.046824826	0.593567449	1.197090688	0	0	0.669542448	0	0.050725056	1.536026673	0	3.905577134	0.215580302	0.272463778	0.774864308	2.897605769	0.841307976	0	0	0	0.441719446	0	0.141981251	0	0	0.396483916	0	0	0	0	0	0	0	0	0	0	23.3387	0	4.7153	4.5947	0.092260227	2.782919935	0	0.887443268	1.046824826	0.593567449	1.197090688	0	0	0.669542448	0	0.050725056	1.536026673	0	3.905577134	0.215580302	0.272463778	0.774864308	2.897605769	0.841307976	0	0	0	0.441719446	0	0.141981251	0	0	0.396483916	0	0	0	0	0	0	0	0	0	0	23.3387	1000								$50/Visit for Urgent Care; $50/Visit for Urgent Care - Worldwide;					$50/Procedure for Renal Dialysis - Prof	$50/Visit for Prof - CORF; $50/Visit for Prof - CORF;	$50/Visit for PCP - Office Visits; $50/Consult for PCP - Consults;	$50/Visit for Speclst - Office Visits; $50/Consult for Speclst - Consults;	$50/Visit for OP Psych - Non-Physician; $50/Visit for OP Psych - Psychiatrist; $50/Visit for OP Substance Abuse;	$50/Visit for PT/ST (PCP); $50/Visit for Occ Therapy (PCP); $50/Visit for PT/ST (Specialist); $50/Visit for Occ Therapy (Specialist);		$50/Visit for Chiropractor; $50/Exam for Vistion Exams; $50/Service for Podiatrist; $50/Exam for Hearing/Speech Exams;																					0	0	0	0	0	0	0	0.023	0	0	0	0	0.006	0.0201	0.9048	0.8378	0.0484	0.1794	0.1033	0.591	0	0	0	0	0	0	0	0	0	0											2.7138	0	0.890162462	4.5947	0.092260227	2.782919935	0	0.887443268	1.046824826	0.593567449	1.220110819	0	0	0.669542448	0	0.056724493	1.556091184	0.904818803	4.743334219	0.263994037	0.45188681	0.878137612	3.488613523	0.841307976	0	0	0	0.441719446	0	0.141981251	0	0	0.396483916	0	0	0	0	0	0	0	0	0	0	26.0524
H9302_801_0	2009	3																																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		260.6160225	3.118949055	55.47937017	0	6.936099912	12.00540284	7.381436025	16.47054788	55.029884	8.837057528	21.75329911	0	0.67200557	30.65723476	41.16134929	116.4819308	1.799730021	6.355971746	38.75995488	56.33144218	9.017424459	1.005505796	0	0	0	0	0	0	0	0											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	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing	No cost sharing											0.068795161	0.068795161	0.154754289	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.068795161	0.068795161	0.154754289	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											17.9291	0.214568603	8.585670471	0	1.60223908	2.773248055	1.705111722	3.804696559	12.7119032	2.041360289	5.025012093	0	0.155233287	7.081821231	9.508271685	26.90732602	0.415737635	1.468229473	8.953549577	13.01256314	2.08302505	0.232271839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.211	0	0	17.9291	0.214568603	8.585670471	0	1.60223908	2.773248055	1.705111722	3.804696559	12.7119032	2.041360289	5.025012093	0	0.155233287	7.081821231	9.508271685	26.90732602	0.415737635	1.468229473	8.953549577	13.01256314	2.08302505	0.232271839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.211																																																																																		0	0	0	17.9291	0.214568603	8.585670471	0	1.60223908	2.773248055	1.705111722	3.804696559	12.7119032	2.041360289	5.025012093	0	0.155233287	7.081821231	9.508271685	26.90732602	0.415737635	1.468229473	8.953549577	13.01256314	2.08302505	0.232271839	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.211
H9313_007_0	2009	4																					1500											D	D	D	V	T	Coin	Coin	V	V	Coin	V	V	Coin	V	V	V	V	V	V	V	Coin	P	T	P	P	P	P	P	O	O											18.2382	0.2951	3.0836	1.4967	0.444	0.6285	0.6216	0.9854	2.765	0.523	1.3886	0.3279	0.0124	1.4844	2.3833	7.2211	0.0978	0.688	1.5519	0.1402	1.4037																				45.7805	1500	1423.406037	56.36521988	1141.715611		107.03789	8.048284229	7.96049205	273.8434651	258.3918862		1289.957773	60.26837832		129.7341156	3480.552485	4785.855872	196.0358333	362.0658027																							1a: $100 per Admit	1b: $100 per Admit	2: $100 per Admit	6: $0	10a: $50	11a: 20%	"11b, 11c:20%"	"4a: $50, 4b: $25"	"9a: $100, 9b: $100"	8a: 0%	8b: $20	9a: $100	12: 0%	"3, 9c, 9d: $20; 5, 13a: $0"	"7a: $15, 14: $0"	"7b, 7d, 7f, 7g, 17a, 18a: $20; 14: $0"	"7e,7h: $20"	"7c, 7i: $20"					10b: n/c	16: n/c	17a: n/c	17b: n/c	18a: n/c	18b: n/c	14a: n/c												17.54385965	14.70588235	4.494382022		50	0.2	0.2	45.00352394	100		20	100		20	15	20	20	20																							13.58688662	11.3890079	3.480685561		38.72262687	0.154890507	0.154890507	34.8530933	77.44525373		15.48905075	77.44525373		15.48905075	11.61678806	15.48905075	15.48905075	15.48905075																							1.6116	0.053495328	0.331162753	0	0.345399023	1.246602828	1.233004653	0.795357653	1.667602099	0	1.665018451	0.388958321	0	0.167454858	3.369403379	6.177363706	0.253034081	0.467337966	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	19.7728	500	5.7585	19.8498	0.348626353	3.414795097	1.496680609	0.789359558	1.875086672	1.854632878	1.780720448	4.432613185	0.523044571	3.053654389	0.716862265	0.012402469	1.651860649	5.752741324	13.39844788	0.350849336	1.155309743	1.551935675	0.140239147	1.403656519	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.5533		0.2	0.2	0.2	0.2	0.2	0.2	0.2	4a: $50	0.2	0.2	0.2	0.2	12: 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											3.4367	0.0556	0.5813	0.3175	0.093	0.1333	0.1319	0.1233	0.5213	0.0986	0.2618	0.0618	0.001	0.2793	0.4834	1.4658	0.0198	0.1321	0.3148	0.0284	0.2978																				8.8385	500	9.111237654	23.2865	0.404265124	3.996123258	1.814168641	0.882375141	2.008405763	1.9864977	1.903976106	4.95387935	0.62165012	3.315443188	0.778679461	0.013401047	1.931204403	6.236110662	14.86425201	0.370687435	1.287453218	1.866686725	0.168681317	1.701411526	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.3918
H9313_008_0	2009	2																					1500											D	D	D	V	T	Coin	Coin	V	V	Coin	V	V	Coin	V	V	V	V	V	V	V	Coin	P	T	P	P	P	P	P	O	O											3.9563	0.064	0.6689	0.3247	0.0963	0.1363	0.1348	0.2137	0.5998	0.1135	0.3012	0.0711	0.0027	0.3221	0.517	1.5664	0.0212	0.1492	0.3366	0.0304	0.3045																				9.931	1500	1494.788408	59.19187855	1198.974277		112.4057317	8.451897529	8.359702661	287.5785269	271.3499775		1354.647849	63.29077643		136.2401501	3655.098665	5025.861695	205.8668317	380.2230359																							1a: $100 per Admit	1b: $100 per Admit	2: $100 per Admit	6: $0	10a: $75	11a: 20%	"11b, 11c: 20%"	"4a: $50, 4b: $50"	"9a: $25, 9b: $25"	8a: 0%	8b: $20	9a: $25	12: 0%	"3, 9c, 9d: $20; 5, 13a: $0"	"7a: $15, 14: $0"	"7b, 7d, 7f, 7g, 17a, 18a: $20; 14: $0"	"7e,7h: $20"	"7c, 7i: $20"					10b: n/c	16: n/c	17a: n/c	17b: n/c	18a: n/c	18b: n/c	14a: n/c												17.54385965	14.70588235	4.494382022		75	0.2	0.2	50	25		20	25		20	15	20	20	20																							14.45177602	12.11398872	3.702252733		61.78134247	0.164750247	0.164750247	41.18756165	20.59378082		16.47502466	20.59378082		16.47502466	12.35626849	16.47502466	16.47502466	16.47502466																							1.8002	0.059754146	0.369908816	0	0.578714751	1.392452202	1.377263075	0.987054859	0.46567683	0	1.859821393	0.108616365	0	0.187046653	3.76361504	6.900099614	0.282638427	0.522015324	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	20.6549	100	4.4193	5.7565	0.123774615	1.038818662	0.324663241	0.675019644	1.528784296	1.512108033	1.200803471	1.0654691	0.113459976	2.161047346	0.179746008	0.002690371	0.509196306	4.280613935	8.466513032	0.303856727	0.671251671	0.336649291	0.030420983	0.304484251	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	30.5858		0.2	0.2	0.2	0.2	0.2	0.2	0.2	4a: $50	0.2	0.2	0.2	0.2	12: 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											2.596	0.042	0.4391	0.2398	0.0703	0.1007	0.0996	0.0734	0.3938	0.0745	0.1978	0.0467	0.0002	0.2111	0.3651	1.1073	0.015	0.0998	0.2378	0.0215	0.2249																				6.6564	100	8.748333849	8.3525	0.165803729	1.477950615	0.564491342	0.745282924	1.629492547	1.61171774	1.274192056	1.459229689	0.187945875	2.35880066	0.226442258	0.002901084	0.720304489	4.645747543	9.573770585	0.31884228	0.771071871	0.574409896	0.051905988	0.529406172	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.2422
H9313_009_0	2009	2																					2000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	V	V	Coin	P	T	P	P	P	P	P	O	O																																																			0	2000	1518.899873	60.14666447	1218.314155		114.2188759	8.588229623	8.494547619	292.2172702	275.7269486			64.31167902		138.4377518	3714.056698	5466.97562	209.1875364	386.3561678							133.1901121		230.3079022														1a: $250 per Admit	1b: $250 per Admit	2: $100 per Admit	6: $0	10a: $50	11a: 20%	"11b, 11c:20%"	"4a: $50, 4b: $30"	"9a: $100, 9b: $75"	8a: 0%	8b: 0%	9a: $100	12: 0%	"3, 9c, 9d: $20; 5, 13a: $0"	"7a: $10, 14: $0"	"7b, 7d, 7f, 7g, 17a, 18a: $20; 14: $0"	"7e,7h: $20"	"7c, 7i: $20"					10b: n/c	16: n/c	17a: $20	17b: $40 Max. Benefit	18a: $20	18b: $250 every 3 years Max. Benefit	14a: n/c												43.85964912	36.76470588	5.617977528		50	0.2	0.2	46.00284819	93.72534138			100		20	10	20	20	20							20		20														38.80558956	32.52821478	4.970603606		44.2383721	0.176953488	0.176953488	46.00284819	82.92513054			88.47674419		17.69534884	8.847674419	17.69534884	17.69534884	17.69534884							17.69534884		17.69534884														4.9118	0.163038635	0.504646395	0	0.421071428	1.519717191	1.503139833	1.12023556	1.9053911	0	0	0.474173998	0	0.204142026	2.738397037	8.061670058	0.308470536	0.569725597	0	0	0	0	0	0	0.196403791	0	0.339614889	0	0	0	0	0	0	0	0	0	0	0	0	0	24.9417	0	3.1025	4.9118	0.163038635	0.504646395	0	0.421071428	1.519717191	1.503139833	1.12023556	1.9053911	0	0	0.474173998	0	0.204142026	2.738397037	8.061670058	0.308470536	0.569725597	0	0	0	0	0	0	0.196403791	0	0.339614889	0	0	0	0	0	0	0	0	0	0	0	0	0	24.9417		0.2	0.2	0.2	0.2	0.2	0.2	0.2	4a: $50	0.2	0.2	0.2	0.2	12: 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											2.7533	0.0446	0.4657	0.2544	0.0745	0.1068	0.1056	0.0626	0.4176	0.079	0.2097	0.0495		0.2239	0.3968	1.184	0.0159	0.1059	0.2522	0.0228	0.2385				0.0101	0.0047	0.0134	0.0022													7.0937	0	7.75952624	7.6651	0.207613077	0.970372646	0.254352345	0.495589927	1.626524441	1.60878201	1.182807249	2.322998249	0.078996845	0.209729465	0.523698223	0	0.428035145	3.135221432	9.245694762	0.32436363	0.675591015	0.25215964	0.022786159	0.238543431	0	0	0	0.20647578	0.004711831	0.352982528	0.002232714	0	0	0	0	0	0	0	0	0	0	0	0	32.0353
H9313_010_1	2009	4																					4000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	V	V	Coin	P	T	P	P	P	P	P	O	O																																																			0		1726.136875	68.357274	1384.617977		145.7853766	9.778211771	9.671549221	332.1017839	317.7506251			73.09085389		32.66085617	4221.06186	6254.676823	237.7436866	1145.251132							147.9890135		255.8976692														1a: $200 days 1-8	1b: $200 days 1-8	2: $100 per Admit	6: $0	10a: $75	11a: 20%	"11b, 11c:20%"	"4a: $50, 4b: $30"	"9a: $250, 9b: $150"	8a: 0%	8b: 0%	9a: $250	12: 0%	"3, 9c, 9d: $30; 5, 13a: $0"	"7a: $20, 14: $0"	"7b, 7d, 7f, 7g, 17a, 18a: $30; 14: $0"	"7e,7h: $30"	"7c, 7i: $30"					10b: n/c	16: n/c	17a: $30	17b: n/c	18a: $30	18b: n/c	14a: n/c												152.45	146.04	5.61		75	0.2	0.2	46.00277586	223.8678951			250		30	20	30	30	30							30		30														132.3333305	126.7691675	4.869727675		65.10331116	0.17360883	0.17360883	39.93244042	194.3272164			217.0110372		26.04132446	17.36088298	26.04132446	26.04132446	26.04132446							26.04132446		26.04132446														19.0355	0.722132893	0.561892707	0	0.790925895	1.697583903	1.679066342	1.105136225	5.145632875	0	0	1.321793501	0	0.070877663	6.106780082	13.57333905	0.51593004	2.485321361	0	0	0	0	0	0	0.321152493	0	0.555326186	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6883	0	8.4655	19.0355	0.722132893	0.561892707	0	0.790925895	1.697583903	1.679066342	1.105136225	5.145632875	0	0	1.321793501	0	0.070877663	6.106780082	13.57333905	0.51593004	2.485321361	0	0	0	0	0	0	0.321152493	0	0.555326186	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6883																																																																																		0	0	0	19.0355	0.722132893	0.561892707	0	0.790925895	1.697583903	1.679066342	1.105136225	5.145632875	0	0	1.321793501	0	0.070877663	6.106780082	13.57333905	0.51593004	2.485321361	0	0	0	0	0	0	0.321152493	0	0.555326186	0	0	0	0	0	0	0	0	0	0	0	0	0	55.6883
H9313_010_2	2009	4																					4000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	V	V	Coin	P	T	P	P	P	P	P	O	O																																																			0		1703.845207	67.47449485	1366.746471		143.9026758	9.549115651	9.444952124	327.8202506	313.6471316			72.14694436		32.23906751	4166.550245	6179.069032	234.6734183	1130.461136							147.9890135		255.8976692														1a: $200 days 1-8	1b: $200 days 1-8	2: $100 per Admit	6: $0	10a: $75	11a: 20%	"11b, 11c:20%"	"4a: $50, 4b: $30"	"9a: $250, 9b: $150"	8a: 0%	8b: 0%	9a: $250	12: 0%	"3, 9c, 9d: $30; 5, 13a: $0"	"7a: $20, 14: $0"	"7b, 7d, 7f, 7g, 17a, 18a: $30; 14: $0"	"7e,7h: $30"	"7c, 7i: $30"					10b: n/c	16: n/c	17a: $30	17b: n/c	18a: $30	18b: n/c	14a: n/c												152.45	146.04	5.61		75	0.2	0.2	46.0028648	223.8678951			250		30	20	30	30	30							30		30														132.7432547	127.1618558	4.884812457		65.30497938	0.174146612	0.174146612	40.05621516	194.929177			217.6832646		26.12199175	17.41466117	26.12199175	26.12199175	26.12199175							26.12199175		26.12199175														18.8478	0.715015166	0.556358349	0	0.783130106	1.662946135	1.64480641	1.094269874	5.094914769	0	0	1.308765198	0	0.070179055	6.046588396	13.45079919	0.510844758	2.460824706	0	0	0	0	0	0	0.322147316	0	0.5570464	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1265	0	8.1839	18.8478	0.715015166	0.556358349	0	0.783130106	1.662946135	1.64480641	1.094269874	5.094914769	0	0	1.308765198	0	0.070179055	6.046588396	13.45079919	0.510844758	2.460824706	0	0	0	0	0	0	0.322147316	0	0.5570464	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1265																																																																																		0	0	0	18.8478	0.715015166	0.556358349	0	0.783130106	1.662946135	1.64480641	1.094269874	5.094914769	0	0	1.308765198	0	0.070179055	6.046588396	13.45079919	0.510844758	2.460824706	0	0	0	0	0	0	0.322147316	0	0.5570464	0	0	0	0	0	0	0	0	0	0	0	0	0	55.1265
H9313_011_1	2009	4																					3000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	V	V	Coin	P	T	P	P	P	P	P	O	O																																																			0		1571.391633	62.14297637	1258.771536		118.0098841	8.889283428	8.792317474	301.9316642	284.8785282			66.44623081		143.0326023	3837.328964	5676.483393	216.1306241	399.1796123							147.9890135		255.8976692														1a: $750 per Admit	1b: $750 per Admit	2: $100 per Admit	6: $0	10a: $50	11a: 20%	"11b, 11c:20%"	"4a: $50, 4b: $30"	"9a: $150, 9b: $100"	8a: 0%	8b: 0%	9a: $150	12: 0%	"3, 9c, 9d: $25; 5, 13a: $0"	"7a: $15, 14: $0"	"7b, 7d, 7f, 7g, 17a, 18a: $25; 14: $0"	"7e,7h: $25"	"7c, 7i: $25"					10b: n/c	16: n/c	17a: $25	17b: $40 Max. Benefit	18a: $25	18b: $250 every 3 years Max. Benefit	14a: n/c												131.5789474	110.2941176	5.617977528		50	0.2	0.2	46.00305324	137.4506828			150		25	15	25	25	25							25		25														113.107688	94.81085612	4.829317016		42.98092144	0.171923686	0.171923686	46.00305324	118.15514			128.9427643		21.49046072	12.89427643	21.49046072	21.49046072	21.49046072							21.49046072		21.49046072														14.8114	0.490985733	0.5065839	0	0.42268113	1.528278371	1.511607627	1.157481535	2.804988531	0	0	0.713980057	0	0.256153044	4.123298368	10.16585362	0.387062224	0.714879482	0	0	0	0	0	0	0.26502934	0	0.458279901	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3185	0	6.3953	14.8114	0.490985733	0.5065839	0	0.42268113	1.528278371	1.511607627	1.157481535	2.804988531	0	0	0.713980057	0	0.256153044	4.123298368	10.16585362	0.387062224	0.714879482	0	0	0	0	0	0	0.26502934	0	0.458279901	0	0	0	0	0	0	0	0	0	0	0	0	0	40.3185		0.2	0.2	0.2	0.2	0.2	0.2	0.2	4a: $50	0.2	0.2	0.2	0.2	12: 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											5.9011	0.0966	1.0095	0.5515	0.1616	0.2316	0.229	0.1353	0.9054	0.1713	0.4547	0.1074		0.4642	0.8396	2.546	0.0345	0.2295	0.5467	0.0494	0.5172																				15.1821	0	0	20.7125	0.587628022	1.516108924	0.55146384	0.584245426	1.759848227	1.740651476	1.292747179	3.710406728	0.171273842	0.454716531	0.82135402	0	0.720398732	4.962891312	12.71189597	0.421520199	0.944407342	0.546709813	0.049402897	0.517188377	0	0	0	0.26502934	0	0.458279901	0	0	0	0	0	0	0	0	0	0	0	0	0	55.5006
H9313_011_2	2009	4																					3000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	V	V	Coin	P	T	P	P	P	P	P	O	O																																																			0		1551.098375	61.34044987	1242.525235		116.4858815	8.681014228	8.586320113	298.0397537	281.1995514			65.58813124		141.1854515	3787.77295	5608.342504	213.3394712	394.024529							147.9890135		255.8976692														1a: $750 per Admit	1b: $750 per Admit	2: $100 per Admit	6: $0	10a: $50	11a: 20%	"11b, 11c:20%"	"4a: $50, 4b: $30"	"9a: $150, 9b: $100"	8a: 0%	8b: 0%	9a: $150	12: 0%	"3, 9c, 9d: $25; 5, 13a: $0"	"7a: $15, 14: $0"	"7b, 7d, 7f, 7g, 17a, 18a: $25; 14: $0"	"7e,7h: $25"	"7c, 7i: $25"					10b: n/c	16: n/c	17a: $25	17b: $40 Max. Benefit	18a: $25	18b: $250 every 3 years Max. Benefit	14a: n/c												131.5789474	110.2941176	5.617977528		50	0.2	0.2	46.00315105	137.4506828			150		25	15	25	25	25							25		25														113.4510604	95.09868298	4.84397786		43.11140295	0.172445612	0.172445612	46.00315105	118.5138354			129.3342089		21.55570148	12.93342089	21.55570148	21.55570148	21.55570148							21.55570148		21.55570148														14.6645	0.486116333	0.501563727	0	0.418489148	1.49700281	1.480673225	1.142563984	2.777169779	0	0	0.706899089	0	0.25361262	4.082405148	10.07431307	0.383223496	0.707789594	0	0	0	0	0	0	0.265833916	0	0.459671147	0	0	0	0	0	0	0	0	0	0	0	0	0	39.9018	0	6.1932	14.6645	0.486116333	0.501563727	0	0.418489148	1.49700281	1.480673225	1.142563984	2.777169779	0	0	0.706899089	0	0.25361262	4.082405148	10.07431307	0.383223496	0.707789594	0	0	0	0	0	0	0.265833916	0	0.459671147	0	0	0	0	0	0	0	0	0	0	0	0	0	39.9018		0.2	0.2	0.2	0.2	0.2	0.2	0.2	4a: $50	0.2	0.2	0.2	0.2	12: 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											5.7497	0.0942	0.9836	0.5373	0.1574	0.2256	0.2232	0.1335	0.8822	0.1669	0.443	0.1046		0.4523	0.818	2.4807	0.0336	0.2236	0.5327	0.0481	0.5039																				14.7942	0	0	20.4141	0.580278625	1.485182711	0.537312389	0.575907443	1.72263021	1.70383944	1.276082781	3.659353485	0.166878679	0.443047771	0.811517663	0	0.705945016	4.900452783	12.55501986	0.416797223	0.931427399	0.532680357	0.048135139	0.503916489	0	0	0	0.265833916	0	0.459671147	0	0	0	0	0	0	0	0	0	0	0	0	0	54.696
H9313_012_1	2009	5																					3000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	V	V	Coin	P	T	P	P	P	P	P	O	O																																																			0		1587.105549	62.76440613	1271.35618		119.189983	8.978176262	8.880240649	304.9486762	287.7273134			67.11069311		144.4629284	3875.702253	5729.247726	218.2919304	403.1714084							147.9890135		255.8976692														1a: $250 per Admit	1b: $250 per Admit	2: $100 per Admit	6: $0	10a: $50	11a: 20%	"11b, 11c:20%"	"4a: $50, 4b: $30"	"9a: $100, 9b: $75"	8a: 0%	8b: 0%	9a: $100	12: 0%	"3, 9c, 9d: $20; 5, 13a: $0"	"7a: $10, 14: $0"	"7b, 7d, 7f, 7g, 17a, 18a: $20; 14: $0"	"7e,7h: $20"	"7c, 7i: $20"					10b: n/c	16: n/c	17a: $20	17b: $40 Max. Benefit	18a: $20	18b: $250 every 3 years Max. Benefit	14a: n/c												46.8164794	36.76470588	5.617977528		50	0.2	0.2	46.00302303	93.72534138			100		20	10	20	20	20							20		20														43.83641107	34.42447575	5.260369328		46.81728702	0.187269148	0.187269148	46.00302303	87.75932417			93.63457404		18.72691481	9.363457404	18.72691481	18.72691481	18.72691481							18.72691481		18.72691481														5.7978	0.180052648	0.557316921	0	0.465012637	1.68133542	1.662995101	1.169046748	2.104229548	0	0	0.523656764	0	0.225445413	3.024164413	8.94092784	0.340661199	0.629179718	0	0	0	0	0	0	0.230948137	0	0.399347821	0	0	0	0	0	0	0	0	0	0	0	0	0	27.9321	0	1.8194	5.7978	0.180052648	0.557316921	0	0.465012637	1.68133542	1.662995101	1.169046748	2.104229548	0	0	0.523656764	0	0.225445413	3.024164413	8.94092784	0.340661199	0.629179718	0	0	0	0	0	0	0.230948137	0	0.399347821	0	0	0	0	0	0	0	0	0	0	0	0	0	27.9321		0.2	0.2	0.2	0.2	0.2	0.2	0.2	4a: $50	0.2	0.2	0.2	0.2	12: 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											5.9601	0.0976	1.0196	0.557	0.1632	0.2339	0.2313	0.1366	0.9145	0.173	0.4593	0.1084		0.4689	0.848	2.5715	0.0348	0.2318	0.5522	0.0499	0.5224																				15.3339	0	0	11.7578	0.27766136	1.576937196	0.556978479	0.628192576	1.915220975	1.894329389	1.305665048	3.018701927	0.172986581	0.459263696	0.632104466	0	0.694333559	3.872153287	11.51243062	0.375463753	0.861002857	0.552176911	0.049896926	0.52236026	0	0	0	0.230948137	0	0.399347821	0	0	0	0	0	0	0	0	0	0	0	0	0	43.266
H9313_012_2	2009	5																					3000											D	D	D	V	T	Coin	Coin	V	V	Coin	Coin	V	Coin	V	V	V	V	V	V	V	Coin	P	T	P	P	P	P	P	O	O																																																			0		1564.537325	61.95385436	1254.916071		117.6507403	8.76782437	8.672183314	300.9943249	284.0115469			66.24401255		142.597306	3825.650679	5620.420429	215.4728659	397.9647743							133.1901121		230.3079022														1a: $250 per Admit	1b: $250 per Admit	2: $100 per Admit	6: $0	10a: $50	11a: 20%	"11b, 11c:20%"	"4a: $50, 4b: $30"	"9a: $100, 9b: $75"	8a: 0%	8b: 0%	9a: $100	12: 0%	"3, 9c, 9d: $20; 5, 13a: $0"	"7a: $10, 14: $0"	"7b, 7d, 7f, 7g, 17a, 18a: $20; 14: $0"	"7e,7h: $20"	"7c, 7i: $20"					10b: n/c	16: n/c	17a: $20	17b: $40 Max. Benefit	18a: $20	18b: $250 every 3 years Max. Benefit	14a: n/c												46.8164794	36.76470588	5.617977528		50	0.2	0.2	46.00280811	93.72534138			100		20	10	20	20	20							20		20														43.9176826	34.4882978	5.270121911		46.90408501	0.18761634	0.18761634	46.00280811	87.9220276			93.80817002		18.761634	9.380817002	18.761634	18.761634	18.761634							18.761634		18.761634														5.7259	0.178056915	0.551130057	0	0.45985836	1.644987119	1.627043294	1.153882014	2.080905922	0	0	0.517852466	0	0.222946539	2.990644078	8.78735592	0.336885254	0.622205787	0	0	0	0	0	0	0.208238678	0	0.360079381	0	0	0	0	0	0	0	0	0	0	0	0	0	27.468	0	1.7369	5.7259	0.178056915	0.551130057	0	0.45985836	1.644987119	1.627043294	1.153882014	2.080905922	0	0	0.517852466	0	0.222946539	2.990644078	8.78735592	0.336885254	0.622205787	0	0	0	0	0	0	0.208238678	0	0.360079381	0	0	0	0	0	0	0	0	0	0	0	0	0	27.468		0.2	0.2	0.2	0.2	0.2	0.2	0.2	4a: $50	0.2	0.2	0.2	0.2	12: 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											5.8741	0.0951	0.9937	0.5427	0.159	0.2279	0.2254	0.135	0.891	0.1685	0.4475	0.1057		0.4773	0.8463	2.5258	0.0339	0.2259	0.538	0.0486	0.509				0.0211	0.0099	0.028	0.0047													15.1339	0	0	11.6	0.27316083	1.544798349	0.542685512	0.618850839	1.872870793	1.85244117	1.288833826	2.971911465	0.168547466	0.447478249	0.623517226	0	0.700256191	3.836927033	11.31320217	0.370794719	0.84807997	0.538007161	0.04861649	0.508955653	0	0	0	0.229328057	0.009865934	0.388069405	0.004675	0	0	0	0	0	0	0	0	0	0	0	0	42.6018
H9313_801_0	2009	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																																																			0		294.2337384	3.699037879	30.19847565		5.056984415	11.72484002	11.76630499	6.615542686	20.22849958	38.25230604	20.01883453	2.307821708	0.265684283	48.3981701	38.8042329	76.50752884	1.427479716	3.105781085	28.6386618	74.95198396	12.2656416	4.835196969																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing											0.07851528	0.07851528	0.181348065		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.07851528	0.07851528	0.181348065		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			23.1018	0.290430993	5.476435117	0	1.1681634	2.708438044	2.718016453	1.52819036	4.672783403	8.836282694	4.624350777	0.533106815	0.061373069	11.17997729	8.9637778	17.67323916	0.329747814	0.717435431	6.615530877	17.3139083	2.833363209	1.1169305	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.4633	0	0	23.1018	0.290430993	5.476435117	0	1.1681634	2.708438044	2.718016453	1.52819036	4.672783403	8.836282694	4.624350777	0.533106815	0.061373069	11.17997729	8.9637778	17.67323916	0.329747814	0.717435431	6.615530877	17.3139083	2.833363209	1.1169305	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.4633		Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing											2.4599	0.0199	0.8973		0.7797	0.2478	0.3215	0.1773	0.9414	0.6806	0.4412	0.0621	0.2808	1.1288	1.1782	2.9267	0.0661	0.0728	1.3585	2.774	0.3726	0.1772																			17.3643	0	0	25.5617	0.310308063	6.373750663	0	1.947875268	2.956251627	3.039508488	1.705522196	5.614195759	9.516868087	5.065511637	0.595193406	0.342144309	12.30879697	10.14196246	20.59992224	0.395843239	0.79018841	7.974018326	20.08787577	3.206009287	1.294120921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.8276
H9313_802_0	2009	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																																																			0		294.2337384	3.699037879	30.19847565		5.056984415	11.72484002	11.76630499	6.615542686	20.22849958	38.25230604	20.01883453	2.307821708	0.265684283	48.3981701	38.8042329	76.50752884	1.427479716	3.105781085	28.6386618	74.95198396	12.2656416	4.835196969																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing											0.07851528	0.07851528	0.181348065		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.07851528	0.07851528	0.181348065		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			23.1018	0.290430993	5.476435117	0	1.1681634	2.708438044	2.718016453	1.52819036	4.672783403	8.836282694	4.624350777	0.533106815	0.061373069	11.17997729	8.9637778	17.67323916	0.329747814	0.717435431	6.615530877	17.3139083	2.833363209	1.1169305	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.4633	0	0	23.1018	0.290430993	5.476435117	0	1.1681634	2.708438044	2.718016453	1.52819036	4.672783403	8.836282694	4.624350777	0.533106815	0.061373069	11.17997729	8.9637778	17.67323916	0.329747814	0.717435431	6.615530877	17.3139083	2.833363209	1.1169305	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.4633		Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing											2.4599	0.0199	0.8973		0.7797	0.2478	0.3215	0.1773	0.9414	0.6806	0.4412	0.0621	0.2808	1.1288	1.1782	2.9267	0.0661	0.0728	1.3585	2.774	0.3726	0.1772																			17.3643	0	0	25.5617	0.310308063	6.373750663	0	1.947875268	2.956251627	3.039508488	1.705522196	5.614195759	9.516868087	5.065511637	0.595193406	0.342144309	12.30879697	10.14196246	20.59992224	0.395843239	0.79018841	7.974018326	20.08787577	3.206009287	1.294120921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.8276
H9313_803_0	2009	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																																																			0		294.2337384	3.699037879	30.19847565		5.056984415	11.72484002	11.76630499	6.615542686	20.22849958	38.25230604	20.01883453	2.307821708	0.265684283	48.3981701	38.8042329	76.50752884	1.427479716	3.105781085	28.6386618	74.95198396	12.2656416	4.835196969																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing											0.07851528	0.07851528	0.181348065		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.07851528	0.07851528	0.181348065		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			23.1018	0.290430993	5.476435117	0	1.1681634	2.708438044	2.718016453	1.52819036	4.672783403	8.836282694	4.624350777	0.533106815	0.061373069	11.17997729	8.9637778	17.67323916	0.329747814	0.717435431	6.615530877	17.3139083	2.833363209	1.1169305	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.4633	0	0	23.1018	0.290430993	5.476435117	0	1.1681634	2.708438044	2.718016453	1.52819036	4.672783403	8.836282694	4.624350777	0.533106815	0.061373069	11.17997729	8.9637778	17.67323916	0.329747814	0.717435431	6.615530877	17.3139083	2.833363209	1.1169305	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.4633		Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing											2.4599	0.0199	0.8973		0.7797	0.2478	0.3215	0.1773	0.9414	0.6806	0.4412	0.0621	0.2808	1.1288	1.1782	2.9267	0.0661	0.0728	1.3585	2.774	0.3726	0.1772																			17.3643	0	0	25.5617	0.310308063	6.373750663	0	1.947875268	2.956251627	3.039508488	1.705522196	5.614195759	9.516868087	5.065511637	0.595193406	0.342144309	12.30879697	10.14196246	20.59992224	0.395843239	0.79018841	7.974018326	20.08787577	3.206009287	1.294120921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.8276
H9313_804_0	2009	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																																																			0		294.2337384	3.699037879	30.19847565		5.056984415	11.72484002	11.76630499	6.615542686	20.22849958	38.25230604	20.01883453	2.307821708	0.265684283	48.3981701	38.8042329	76.50752884	1.427479716	3.105781085	28.6386618	74.95198396	12.2656416	4.835196969																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing											0.07851528	0.07851528	0.181348065		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.07851528	0.07851528	0.181348065		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			23.1018	0.290430993	5.476435117	0	1.1681634	2.708438044	2.718016453	1.52819036	4.672783403	8.836282694	4.624350777	0.533106815	0.061373069	11.17997729	8.9637778	17.67323916	0.329747814	0.717435431	6.615530877	17.3139083	2.833363209	1.1169305	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.4633	0	0	23.1018	0.290430993	5.476435117	0	1.1681634	2.708438044	2.718016453	1.52819036	4.672783403	8.836282694	4.624350777	0.533106815	0.061373069	11.17997729	8.9637778	17.67323916	0.329747814	0.717435431	6.615530877	17.3139083	2.833363209	1.1169305	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	122.4633		Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing											2.4599	0.0199	0.8973		0.7797	0.2478	0.3215	0.1773	0.9414	0.6806	0.4412	0.0621	0.2808	1.1288	1.1782	2.9267	0.0661	0.0728	1.3585	2.774	0.3726	0.1772																			17.3643	0	0	25.5617	0.310308063	6.373750663	0	1.947875268	2.956251627	3.039508488	1.705522196	5.614195759	9.516868087	5.065511637	0.595193406	0.342144309	12.30879697	10.14196246	20.59992224	0.395843239	0.79018841	7.974018326	20.08787577	3.206009287	1.294120921	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	139.8276
H9313_805_0	2009	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																																																			0		312.0971679	3.77884766	33.73407022		7.606352702	12.09693702	12.50295292	7.021728829	22.91878953	39.31278099	21.00992988	2.441132546	0.27264192	50.73989375	42.12827349	90.14426058	1.598327987	3.321044463	41.00383143	83.89672253	12.85363532	5.238901783																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing											0.077154954	0.077154954	0.182478327		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.077154954	0.077154954	0.182478327		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			24.0798	0.291556818	6.155736701	0	1.757067474	2.794392452	2.888182124	1.62201936	5.294240381	9.081252408	4.853293803	0.563901618	0.062980283	11.72091546	9.731631175	20.82332419	0.369213765	0.767161271	9.47188506	19.3801429	2.969189758	1.210186312	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.8881	0	0	24.0798	0.291556818	6.155736701	0	1.757067474	2.794392452	2.888182124	1.62201936	5.294240381	9.081252408	4.853293803	0.563901618	0.062980283	11.72091546	9.731631175	20.82332419	0.369213765	0.767161271	9.47188506	19.3801429	2.969189758	1.210186312	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.8881		Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	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	24.0798	0.291556818	6.155736701	0	1.757067474	2.794392452	2.888182124	1.62201936	5.294240381	9.081252408	4.853293803	0.563901618	0.062980283	11.72091546	9.731631175	20.82332419	0.369213765	0.767161271	9.47188506	19.3801429	2.969189758	1.210186312	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.8881
H9313_806_0	2009	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																																																			0		312.0971679	3.77884766	33.73407022		7.606352702	12.09693702	12.50295292	7.021728829	22.91878953	39.31278099	21.00992988	2.441132546	0.27264192	50.73989375	42.12827349	90.14426058	1.598327987	3.321044463	41.00383143	83.89672253	12.85363532	5.238901783																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing											0.077154954	0.077154954	0.182478327		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.077154954	0.077154954	0.182478327		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			24.0798	0.291556818	6.155736701	0	1.757067474	2.794392452	2.888182124	1.62201936	5.294240381	9.081252408	4.853293803	0.563901618	0.062980283	11.72091546	9.731631175	20.82332419	0.369213765	0.767161271	9.47188506	19.3801429	2.969189758	1.210186312	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.8881	0	0	24.0798	0.291556818	6.155736701	0	1.757067474	2.794392452	2.888182124	1.62201936	5.294240381	9.081252408	4.853293803	0.563901618	0.062980283	11.72091546	9.731631175	20.82332419	0.369213765	0.767161271	9.47188506	19.3801429	2.969189758	1.210186312	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.8881		Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	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	24.0798	0.291556818	6.155736701	0	1.757067474	2.794392452	2.888182124	1.62201936	5.294240381	9.081252408	4.853293803	0.563901618	0.062980283	11.72091546	9.731631175	20.82332419	0.369213765	0.767161271	9.47188506	19.3801429	2.969189758	1.210186312	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.8881
H9313_807_0	2009	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																																																			0		312.0971679	3.77884766	33.73407022		7.606352702	12.09693702	12.50295292	7.021728829	22.91878953	39.31278099	21.00992988	2.441132546	0.27264192	50.73989375	42.12827349	90.14426058	1.598327987	3.321044463	41.00383143	83.89672253	12.85363532	5.238901783																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing											0.077154954	0.077154954	0.182478327		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.077154954	0.077154954	0.182478327		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			24.0798	0.291556818	6.155736701	0	1.757067474	2.794392452	2.888182124	1.62201936	5.294240381	9.081252408	4.853293803	0.563901618	0.062980283	11.72091546	9.731631175	20.82332419	0.369213765	0.767161271	9.47188506	19.3801429	2.969189758	1.210186312	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.8881	0	0	24.0798	0.291556818	6.155736701	0	1.757067474	2.794392452	2.888182124	1.62201936	5.294240381	9.081252408	4.853293803	0.563901618	0.062980283	11.72091546	9.731631175	20.82332419	0.369213765	0.767161271	9.47188506	19.3801429	2.969189758	1.210186312	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.8881		Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	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	24.0798	0.291556818	6.155736701	0	1.757067474	2.794392452	2.888182124	1.62201936	5.294240381	9.081252408	4.853293803	0.563901618	0.062980283	11.72091546	9.731631175	20.82332419	0.369213765	0.767161271	9.47188506	19.3801429	2.969189758	1.210186312	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.8881
H9313_808_0	2009	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																																																			0		312.0971679	3.77884766	33.73407022		7.606352702	12.09693702	12.50295292	7.021728829	22.91878953	39.31278099	21.00992988	2.441132546	0.27264192	50.73989375	42.12827349	90.14426058	1.598327987	3.321044463	41.00383143	83.89672253	12.85363532	5.238901783																			Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing											0.077154954	0.077154954	0.182478327		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.077154954	0.077154954	0.182478327		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			24.0798	0.291556818	6.155736701	0	1.757067474	2.794392452	2.888182124	1.62201936	5.294240381	9.081252408	4.853293803	0.563901618	0.062980283	11.72091546	9.731631175	20.82332419	0.369213765	0.767161271	9.47188506	19.3801429	2.969189758	1.210186312	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.8881	0	0	24.0798	0.291556818	6.155736701	0	1.757067474	2.794392452	2.888182124	1.62201936	5.294240381	9.081252408	4.853293803	0.563901618	0.062980283	11.72091546	9.731631175	20.82332419	0.369213765	0.767161271	9.47188506	19.3801429	2.969189758	1.210186312	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.8881		Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	Medicare Cost Sharing	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	24.0798	0.291556818	6.155736701	0	1.757067474	2.794392452	2.888182124	1.62201936	5.294240381	9.081252408	4.853293803	0.563901618	0.062980283	11.72091546	9.731631175	20.82332419	0.369213765	0.767161271	9.47188506	19.3801429	2.969189758	1.210186312	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.8881
H9385_001_0	2009	8																					0											Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin		Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	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	435.284025	12.99143963	169.1828468	50.97281081	30.430352	29.96299039	21.86794821	40.65751841	19.75749836	4.69452252	11.40755489	0	3.360879474	54.36502456	45.93040024	169.1217082	3.851682639	6.868674433	22.17202782	54.15945267	9.673623088	0.605597241	0	0	707.9999969	0	0	0	0	0.901412004											Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing		Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing		Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing	Medicare FFS Cost-Sharing			$25 copay for vision exams					20% coins for non-Medicare immunizations											0.0706	0.0706	0.1444	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	25	0	0	0	0	0.2											0.0706	0.0706	0.1444	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	25	0	0	0	0	0.2											30.7311	0.917195638	24.43000308	0	7.029411311	6.92145078	5.051496036	9.391886753	4.563982121	1.084434702	2.63514518	0	0.776363158	12.55832067	10.60992245	39.0671146	0.88973869	1.586663794	5.121738425	12.51083357	2.234606933	0.139892963	0	0	1.474999994	0	0	0	0	0.180282401	0	0	0	0	0	0	0	0	0	0	179.9065	0	0	30.7311	0.917195638	24.43000308	0	7.029411311	6.92145078	5.051496036	9.391886753	4.563982121	1.084434702	2.63514518	0	0.776363158	12.55832067	10.60992245	39.0671146	0.88973869	1.586663794	5.121738425	12.51083357	2.234606933	0.139892963	0	0	1.474999994	0	0	0	0	0.180282401	0	0	0	0	0	0	0	0	0	0	179.9065	0																																																																																	0	0		30.7311	0.917195638	24.43000308	0	7.029411311	6.92145078	5.051496036	9.391886753	4.563982121	1.084434702	2.63514518	0	0.776363158	12.55832067	10.60992245	39.0671146	0.88973869	1.586663794	5.121738425	12.51083357	2.234606933	0.139892963	0	0	1.474999994	0	0	0	0	0.180282401	0	0	0	0	0	0	0	0	0	0	179.9065
H9385_002_0	2009	7																					0											D	D	D		T	Coin	Coin	V	V		Coin		P	V	V	V	V	V	Coin	V	Coin				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	607.1735677	12.7925838	231.9634153	0	158.8537426	9.03423847	5.593158535	278.4633717	265.7432952	0	5.042786994	0	35.24309263	418.6482065	3897.600758	3338.591485	161.9655669	510.3353528	10.91127415	1687.701569	6.512639227	0	0	0	398.6116872	290.0179474	164.9206542	0	0	210											$150/Days 1-5 for IP Medical; $150/Days 1-5 for IP Surgical;	$150/Days Custom for IP Psych; $150/Days Custom for IP Substance Abuse;	$100/Days 21-100 for SNF		$100/Run 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;	$150/Case for OP Fac - Surgery; $150/Case for OP Fac - ASC		20% Coinsurance 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/Visit for Prof - CORF; $30/Visit for Prof - CORF;	$10/Visit for PCP - Office Visits; $10/Consult for PCP - Consults;	$30/Visit for Speclst - Office Visits; $30/Consult for Speclst - Consults;	$30/Visit for OP Psych - Non-Physician; $30/Visit for OP Psych - Psychiatrist; $30/Visit for OP Substance Abuse;	$30/Visit for PT/ST (PCP); $30/Visit for Occ Therapy (PCP); $30/Visit for PT/ST (Specialist); $30/Visit for Occ Therapy (Specialist);		$30/Visit for Chiropractor; $10/Exam for Vistion Exams; $30/Visit for Podiatrist; $10/Exam for Hearing/Speech Exams;	20% Coinsurance for Part B Rx				$10/Exam for Vision (Refractions)	$25/Service for Vision Hardware	$10/Exam for Routine Hearing Exams			$15/Service  for IHRB;											150	150	100	0	100	0.2	0.2	43.22728164	150	0	0.2	0	29.99999997	30	10	30	30	30	0.2	21.59371588	0.2	0	0	0	10	25	10	0	0	15											150	150	100	0	100	0.2	0.2	43.22728164	150	0	0.2	0	29.99999997	30	10	30	30	30	0.2	21.59371588	0.2	0	0	0	10	25	10	0	0	15											7.5897	0.159907298	1.933028461	0	1.323781188	1.806847694	1.118631707	1.003101216	3.32179119	0	1.008557399	0	0.088107732	1.046620516	3.248000632	8.346478712	0.404913917	1.275838382	2.182254831	3.036979013	1.302527845	0	0	0	0.332176406	0.604204057	0.137433879	0	0	0.2625	0	0	0	0	0	0	0	0	0	0	41.5334	0	0	7.5897	0.159907298	1.933028461	0	1.323781188	1.806847694	1.118631707	1.003101216	3.32179119	0	1.008557399	0	0.088107732	1.046620516	3.248000632	8.346478712	0.404913917	1.275838382	2.182254831	3.036979013	1.302527845	0	0	0	0.332176406	0.604204057	0.137433879	0	0	0.2625	0	0	0	0	0	0	0	0	0	0	41.5334	0																																																																																	0	0		7.5897	0.159907298	1.933028461	0	1.323781188	1.806847694	1.118631707	1.003101216	3.32179119	0	1.008557399	0	0.088107732	1.046620516	3.248000632	8.346478712	0.404913917	1.275838382	2.182254831	3.036979013	1.302527845	0	0	0	0.332176406	0.604204057	0.137433879	0	0	0.2625	0	0	0	0	0	0	0	0	0	0	41.5334
H9385_805_0	2009	4																					0											A	A	D					V	V					V	V	V	V	V		V	Coin			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	219.676188	3.017751569	233.2551925	0	0	0	0	279.1086067	269.4647705	0	0	0	0	421.9878226	3842.29616	3338.591485	167.6525545	529.8998292	0	1720.893583	6.512639227	0	0	818	392.9024939	305.2820499	166.4740872	0	0	210											$100/Admit for IP Medical/Surgical	$100/Admit for IP Psych/Substance Abuse;	$50/Days 21-100 for SNF					$50/Case for ER; $25/Visit for Urgent Care;	$15/Case for OP Fac - Surgery/ASC					$15/Case for Cardio/PT/OT/ST/CORF	$15/Visit for PCP - Office Visits & Consults	$30/Visit for Speclst - Office Visits & Consults	$15/Visit for OP Psych/Substance Abuse	$15/Visit for PT/ST/OT		"$15/Visit for Chiropractor, vision, hearing/speech"	20% Coinsurance for Part B Rx			$8/Procedure for Dental - Preventive	$15/Exam  for Vision (Refractions)	$20/Service for Vision Hardware	$15/Exam for Routine Hearing Exams			$15/Service  for IHRB;											100	99.99999983	50	0	0	0	0	41.49587899	15	0	0	0	0	15	15	30	14.99999999	15	0	15	0.2	0	0	8	15	20	15	0	0	15											100	99.99999983	50	0	0	0	0	41.49587899	15	0	0	0	0	15	15	30	14.99999999	15	0	15	0.2	0	0	8	15	20	15	0	0	15											1.8306	0.02514793	0.971896635	0	0	0	0	0.965154748	0.336830963	0	0	0	0	0.527484778	4.8028702	8.346478712	0.209565693	0.662374787	0	2.151116979	1.302527845	0	0	0.545333333	0.491128117	0.508803416	0.208092609	0	0	0.2625	0	0	0	0	0	0	0	0	0	0	24.1479	0	0	1.8306	0.02514793	0.971896635	0	0	0	0	0.965154748	0.336830963	0	0	0	0	0.527484778	4.8028702	8.346478712	0.209565693	0.662374787	0	2.151116979	1.302527845	0	0	0.545333333	0.491128117	0.508803416	0.208092609	0	0	0.2625	0	0	0	0	0	0	0	0	0	0	24.1479	0																																																																																	0	0		1.8306	0.02514793	0.971896635	0	0	0	0	0.965154748	0.336830963	0	0	0	0	0.527484778	4.8028702	8.346478712	0.209565693	0.662374787	0	2.151116979	1.302527845	0	0	0.545333333	0.491128117	0.508803416	0.208092609	0	0	0.2625	0	0	0	0	0	0	0	0	0	0	24.1479
H9385_806_0	2009	4																					0											A	A	D					V	V					V	V	V	V	V		V	Coin			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	219.676188	3.017751569	233.2551925	0	0	0	0	279.1086067	269.4647705	0	0	0	0	421.9878226	3842.29616	3338.591485	167.6525545	529.8998292	0	1720.893583	6.512639227	0	0	818	392.9024939	305.2820499	166.4740872	0	0	210											$100/Admit for IP Medical/Surgical	$100/Admit for IP Psych/Substance Abuse;	$50/Days 21-100 for SNF					$50/Case for ER; $25/Visit for Urgent Care;	$15/Case for OP Fac - Surgery/ASC					$15/Case for Cardio/PT/OT/ST/CORF	$15/Visit for PCP - Office Visits & Consults	$30/Visit for Speclst - Office Visits & Consults	$15/Visit for OP Psych/Substance Abuse	$15/Visit for PT/ST/OT		"$15/Visit for Chiropractor, vision, hearing/speech"	20% Coinsurance for Part B Rx			$8/Procedure for Dental - Preventive	$15/Exam  for Vision (Refractions)	$20/Service for Vision Hardware	$15/Exam for Routine Hearing Exams			$15/Service  for IHRB;											100	99.99999983	50	0	0	0	0	41.49587899	15	0	0	0	0	15	15	30	14.99999999	15	0	15	0.2	0	0	8	15	20	15	0	0	15											100	99.99999983	50	0	0	0	0	41.49587899	15	0	0	0	0	15	15	30	14.99999999	15	0	15	0.2	0	0	8	15	20	15	0	0	15											1.8306	0.02514793	0.971896635	0	0	0	0	0.965154748	0.336830963	0	0	0	0	0.527484778	4.8028702	8.346478712	0.209565693	0.662374787	0	2.151116979	1.302527845	0	0	0.545333333	0.491128117	0.508803416	0.208092609	0	0	0.2625	0	0	0	0	0	0	0	0	0	0	24.1479	0	0	1.8306	0.02514793	0.971896635	0	0	0	0	0.965154748	0.336830963	0	0	0	0	0.527484778	4.8028702	8.346478712	0.209565693	0.662374787	0	2.151116979	1.302527845	0	0	0.545333333	0.491128117	0.508803416	0.208092609	0	0	0.2625	0	0	0	0	0	0	0	0	0	0	24.1479	0																																																																																	0	0		1.8306	0.02514793	0.971896635	0	0	0	0	0.965154748	0.336830963	0	0	0	0	0.527484778	4.8028702	8.346478712	0.209565693	0.662374787	0	2.151116979	1.302527845	0	0	0.545333333	0.491128117	0.508803416	0.208092609	0	0	0.2625	0	0	0	0	0	0	0	0	0	0	24.1479
H9385_807_0	2009	5																					0											A	A	D					V	V					V	V	V	V	V		V	Coin			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	219.676188	3.017751569	233.2551925	0	0	0	0	279.1086067	269.4647705	0	0	0	0	421.9878226	3842.29616	3338.591485	167.6525545	529.8998292	0	1720.893583	6.512639227	0	0	818	392.9024939	305.2820499	166.4740872	0	0	210											$100/Admit for IP Medical/Surgical	$100/Admit for IP Psych/Substance Abuse;	$50/Days 21-100 for SNF					$50/Case for ER; $25/Visit for Urgent Care;	$15/Case for OP Fac - Surgery/ASC					$15/Case for Cardio/PT/OT/ST/CORF	$15/Visit for PCP - Office Visits & Consults	$30/Visit for Speclst - Office Visits & Consults	$15/Visit for OP Psych/Substance Abuse	$15/Visit for PT/ST/OT		"$15/Visit for Chiropractor, vision, hearing/speech"	20% Coinsurance for Part B Rx			$8/Procedure for Dental - Preventive	$15/Exam  for Vision (Refractions)	$20/Service for Vision Hardware	$15/Exam for Routine Hearing Exams			$15/Service  for IHRB;											100	99.99999983	50	0	0	0	0	41.49587899	15	0	0	0	0	15	15	30	14.99999999	15	0	15	0.2	0	0	8	15	20	15	0	0	15											100	99.99999983	50	0	0	0	0	41.49587899	15	0	0	0	0	15	15	30	14.99999999	15	0	15	0.2	0	0	8	15	20	15	0	0	15											1.8306	0.02514793	0.971896635	0	0	0	0	0.965154748	0.336830963	0	0	0	0	0.527484778	4.8028702	8.346478712	0.209565693	0.662374787	0	2.151116979	1.302527845	0	0	0.545333333	0.491128117	0.508803416	0.208092609	0	0	0.2625	0	0	0	0	0	0	0	0	0	0	24.1479	0	0	1.8306	0.02514793	0.971896635	0	0	0	0	0.965154748	0.336830963	0	0	0	0	0.527484778	4.8028702	8.346478712	0.209565693	0.662374787	0	2.151116979	1.302527845	0	0	0.545333333	0.491128117	0.508803416	0.208092609	0	0	0.2625	0	0	0	0	0	0	0	0	0	0	24.1479	0																																																																																	0	0		1.8306	0.02514793	0.971896635	0	0	0	0	0.965154748	0.336830963	0	0	0	0	0.527484778	4.8028702	8.346478712	0.209565693	0.662374787	0	2.151116979	1.302527845	0	0	0.545333333	0.491128117	0.508803416	0.208092609	0	0	0.2625	0	0	0	0	0	0	0	0	0	0	24.1479
H9385_808_0	2009	5																					0											A	A	D					V	V					V	V	V	V	V		V	Coin			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	219.676188	3.017751569	233.2551925	0	0	0	0	279.1086067	269.4647705	0	0	0	0	421.9878226	3842.29616	3338.591485	167.6525545	529.8998292	0	1720.893583	6.512639227	0	0	818	392.9024939	305.2820499	166.4740872	0	0	210											$100/Admit for IP Medical/Surgical	$100/Admit for IP Psych/Substance Abuse;	$50/Days 21-100 for SNF					$50/Case for ER; $25/Visit for Urgent Care;	$15/Case for OP Fac - Surgery/ASC					$15/Case for Cardio/PT/OT/ST/CORF	$15/Visit for PCP - Office Visits & Consults	$30/Visit for Speclst - Office Visits & Consults	$15/Visit for OP Psych/Substance Abuse	$15/Visit for PT/ST/OT		"$15/Visit for Chiropractor, vision, hearing/speech"	20% Coinsurance for Part B Rx			$8/Procedure for Dental - Preventive	$15/Exam  for Vision (Refractions)	$20/Service for Vision Hardware	$15/Exam for Routine Hearing Exams			$15/Service  for IHRB;											100	99.99999983	50	0	0	0	0	41.49587899	15	0	0	0	0	15	15	30	14.99999999	15	0	15	0.2	0	0	8	15	20	15	0	0	15											100	99.99999983	50	0	0	0	0	41.49587899	15	0	0	0	0	15	15	30	14.99999999	15	0	15	0.2	0	0	8	15	20	15	0	0	15											1.8306	0.02514793	0.971896635	0	0	0	0	0.965154748	0.336830963	0	0	0	0	0.527484778	4.8028702	8.346478712	0.209565693	0.662374787	0	2.151116979	1.302527845	0	0	0.545333333	0.491128117	0.508803416	0.208092609	0	0	0.2625	0	0	0	0	0	0	0	0	0	0	24.1479	0	0	1.8306	0.02514793	0.971896635	0	0	0	0	0.965154748	0.336830963	0	0	0	0	0.527484778	4.8028702	8.346478712	0.209565693	0.662374787	0	2.151116979	1.302527845	0	0	0.545333333	0.491128117	0.508803416	0.208092609	0	0	0.2625	0	0	0	0	0	0	0	0	0	0	24.1479	0																																																																																	0	0		1.8306	0.02514793	0.971896635	0	0	0	0	0.965154748	0.336830963	0	0	0	0	0.527484778	4.8028702	8.346478712	0.209565693	0.662374787	0	2.151116979	1.302527845	0	0	0.545333333	0.491128117	0.508803416	0.208092609	0	0	0.2625	0	0	0	0	0	0	0	0	0	0	24.1479
H9452_001_0	2009	7	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Ambulatory Surgical Center	Urgent Care	Radiology	Chiropractic	Podiatric	Vision Exam Diagnostic	Hearing Exam Diagnostic	Radiation-Chemotherapy	Radiology	Diabetes Supplies	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	Coin	V	V	0	Coin	0	0	0	V	V	V	0	0	0	V	V	V	V	V	V	V	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	0	0	0	0	0	0	0	0	0		1431.687762	41.72930722	555.4540048	60.63330427	121.5116906	11.88443332	0.484274427	516.9434421	479.9850659	5137.377686	542.4156386	165.7571737	0.362144318	1288.804915	2987.632135	2447.193491	0.385459907	1478.400405	223.3024439	0	49.64698754	0	0	0	465.3336841	351.2071332	190.2861391	0	0	0	102.3135951	22.43317886	1001.96086	1870.972866	280.4229052	746.4873094	0.588196969	20.45393602	2060.274257	2.046308153	$200/day (days 1-5); $1000 yrly max	$200/day (days 1-5); $1000 yrly max	$125/day (for days 21-100)	$0 copay	$100 copay	30% coinsurance	30% coinsurance	$50 copay	$175 copay	$15 copay	$100 copay/Higher Tier	$175 copay	20% coinsurance	$25 copay	$15 copay	$25 copay	50% coinsurance	$25 copay	$100 copay/Higher Tier	0	20% coinsurance	0	0	0	$25 copay	Covd up to $50/ Every 2 yrs.	$25 copay	0	0	0	$100 copay	$25 copay	$15 copay/Lower Tier	$25 copay	$25 copay	$25 copay	$25 copay	20% coinsurance	$15 copay/Lower Tier	20% coinsurance	200	200	125	0	100	0.3	0.3	50	175	15	100	175	0.2	25	15	25	0.5	25	100	0	0.2	0	0	0	25	0	25	0	0	0	100	25	15	25	25	25	25	0.2	15	0.2	93.05439977	47.34829788	117.1778612	0	93.74228897	0.281226867	0.281226867	46.87114449	164.0490057	14.06134335	93.74228897	164.0490057	0.187484578	23.43557224	14.06134335	23.43557224	0.468711445	23.43557224	93.74228897	0	0.187484578	0	0	0	23.43557224	0	23.43557224	0	0	0	93.74228897	23.43557224	14.06134335	23.43557224	23.43557224	23.43557224	23.43557224	0.187484578	14.06134335	0.187484578	11.1021	0.164650972	5.423909357	0	0.949232001	3.342221948	0.13619098	2.019144231	6.561756067	6.019869295	4.237273629	2.266024962	0.067896475	2.516990058	3.500843436	4.779281655	0.18066947	2.887263291	1.744406852	0	9.308044505	0	0	0	0.908780098	0	0.371622047	0	0	0	0.799259216	0.043811199	1.174076306	3.653943313	0.547655938	1.457863106	0.001148728	3.834797563	2.41418531	0.38365122	82.7985		5.5272	11.1021	0.164650972	5.423909357	0	0.949232001	3.342221948	0.13619098	2.019144231	6.561756067	6.019869295	4.237273629	2.266024962	0.067896475	2.516990058	3.500843436	4.779281655	0.18066947	2.887263291	1.744406852	0	9.308044505	0	0	0	0.908780098	0	0.371622047	0	0	0	0.799259216	0.043811199	1.174076306	3.653943313	0.547655938	1.457863106	0.001148728	3.834797563	2.41418531	0.38365122	82.7985	4000																																																																																	0		0	11.1021	0.164650972	5.423909357	0	0.949232001	3.342221948	0.13619098	2.019144231	6.561756067	6.019869295	4.237273629	2.266024962	0.067896475	2.516990058	3.500843436	4.779281655	0.18066947	2.887263291	1.744406852	0	9.308044505	0	0	0	0.908780098	0	0.371622047	0	0	0	0.799259216	0.043811199	1.174076306	3.653943313	0.547655938	1.457863106	0.001148728	3.834797563	2.41418531	0.38365122	82.7985
H9452_002_0	2009	9	H.6	H.7	H.8	I.7	I.8	I.9	I.10	I.11	I.12	I.13	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional		Ambulatory Surgical Center	Urgent Care	Radiology	Chiropractic	Podiatric	Vision Exam Diagnostic	Hearing Exam Diagnostic	Radiation-Chemotherapy	Radiology	Diabetes Supplies	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	Coin	V	V	0	Coin	0	0	0	V	V	V	0	0	0	V	V	V	V	V	V	V	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	0	0	0	0	0	0	0	0	0		1286.660946	64.62302239	373.502993	33.14001148	100.3991711	12.31961076	0.434917	303.2311051	277.9995054	4162.91267	305.4906513	86.6159391	0.252443547	646.1549057	3083.376796	2360.020727	0.361830723	875.8001216	223.6197593	0	34.89647041	0	0	0	457.8133097	364.7200047	197.6074942	0	0	0	65.90343192	11.97559506	582.4357018	901.7849034	200.5723877	667.6959132	0.602545663	12.32775592	1937.410262	1.749417115	$275/day (days 1-5); $1375 yrly max	$275/day (days 1-5); $1375 yrly max	$125/day (for days 21-100)	$0 copay	$150 copay	30% coinsurance	30% coinsurance	$50 copay	$200 copay	$20 copay	$100 copay/Higher Tier	$200 copay	20% coinsurance	$30 copay	$20 copay	$30 copay	50% coinsurance	$30 copay	$100 copay/Higher Tier	0	20% coinsurance	0	0	0	$30 copay	Covd up to $50/ Every 2 yrs.	$30 copay	0	0	0	$100 copay	$30 copay	$30 copay/Lower Tier	$30 copay	$30 copay	$30 copay	$30 copay	20% coinsurance	$30 copay/Lower Tier	20% coinsurance	275	275	125	0	150	0.3	0.3	50	200	20	100	200	0.2	30	20	30	0.5	30	100	0	0.2	0	0	0	30	0	30	0	0	0	100	30	30	30	30	30	30	0.2	30	0.2	125.8265237	70.6306473	119.7650106	0	143.7180128	0.287436026	0.287436026	47.90600426	191.624017	19.1624017	95.81200851	191.624017	0.191624017	28.74360255	19.1624017	28.74360255	0.479060043	28.74360255	95.81200851	0	0.191624017	0	0	0	28.74360255	0	28.74360255	0	0	0	95.81200851	28.74360255	28.74360255	28.74360255	28.74360255	28.74360255	28.74360255	0.191624017	28.74360255	0.191624017	13.4913	0.380363825	3.727715828	0	1.20243078	3.541099952	0.125010814	1.210549217	4.43928183	6.647617069	2.439139407	1.383141182	0.048374247	1.547734983	4.923742063	5.652958149	0.173338642	2.097804218	1.785454857	0	6.687001841	0	0	0	1.096600318	0	0.473329273	0	0	0	0.526195015	0.028685145	1.39510836	2.160045571	0.480431083	1.599332163	0.001443278	2.36229411	4.640679213	0.335230335	76.6035		3.3484	13.4913	0.380363825	3.727715828	0	1.20243078	3.541099952	0.125010814	1.210549217	4.43928183	6.647617069	2.439139407	1.383141182	0.048374247	1.547734983	4.923742063	5.652958149	0.173338642	2.097804218	1.785454857	0	6.687001841	0	0	0	1.096600318	0	0.473329273	0	0	0	0.526195015	0.028685145	1.39510836	2.160045571	0.480431083	1.599332163	0.001443278	2.36229411	4.640679213	0.335230335	76.6035	4000																																																																																	0		0	13.4913	0.380363825	3.727715828	0	1.20243078	3.541099952	0.125010814	1.210549217	4.43928183	6.647617069	2.439139407	1.383141182	0.048374247	1.547734983	4.923742063	5.652958149	0.173338642	2.097804218	1.785454857	0	6.687001841	0	0	0	1.096600318	0	0.473329273	0	0	0	0.526195015	0.028685145	1.39510836	2.160045571	0.480431083	1.599332163	0.001443278	2.36229411	4.640679213	0.335230335	76.6035
H9452_801_0	2009	3																					none											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	V											0	0	0	0	0	0	0	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	328.6194609	3.574555118	35.36158745	42.2043499	10.77454004	23.1762968	6.657628911	10.90949334	51.9838224	4.103656212	14.46351277	0	0.345739438	21.05057852	53.70605461	150.5489379	1.702869016	8.188517074	56.67811439	52.99809583	5.854553113	0.622499721	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.068925297	0.068925297	0.159945164	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.068925297	0.068925297	0.159945164	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											22.6502	0.246377274	5.655914904	0	2.488918749	5.353724562	1.537912279	2.520092961	12.00826297	0.947944585	3.341071451	0	0.07986581	4.862683638	12.40609862	34.77680466	0.393362743	1.891547444	13.09264442	12.24256014	1.352401769	0.143797436	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.9922	0	0	22.6502	0.246377274	5.655914904	0	2.488918749	5.353724562	1.537912279	2.520092961	12.00826297	0.947944585	3.341071451	0	0.07986581	4.862683638	12.40609862	34.77680466	0.393362743	1.891547444	13.09264442	12.24256014	1.352401769	0.143797436	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.9922	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.6502	0.246377274	5.655914904	0	2.488918749	5.353724562	1.537912279	2.520092961	12.00826297	0.947944585	3.341071451	0	0.07986581	4.862683638	12.40609862	34.77680466	0.393362743	1.891547444	13.09264442	12.24256014	1.352401769	0.143797436	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.9922
H9452_802_0	2009	3																					none											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	V											0	0	0	0	0	0	0	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	328.6194609	3.574555118	35.36158745	42.2043499	10.77454004	23.1762968	6.657628911	10.90949334	51.9838224	4.103656212	14.46351277	0	0.345739438	21.05057852	53.70605461	150.5489379	1.702869016	8.188517074	56.67811439	52.99809583	5.854553113	0.622499721	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.068925297	0.068925297	0.159945164	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.068925297	0.068925297	0.159945164	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											22.6502	0.246377274	5.655914904	0	2.488918749	5.353724562	1.537912279	2.520092961	12.00826297	0.947944585	3.341071451	0	0.07986581	4.862683638	12.40609862	34.77680466	0.393362743	1.891547444	13.09264442	12.24256014	1.352401769	0.143797436	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.9922	0	0	22.6502	0.246377274	5.655914904	0	2.488918749	5.353724562	1.537912279	2.520092961	12.00826297	0.947944585	3.341071451	0	0.07986581	4.862683638	12.40609862	34.77680466	0.393362743	1.891547444	13.09264442	12.24256014	1.352401769	0.143797436	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.9922	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.6502	0.246377274	5.655914904	0	2.488918749	5.353724562	1.537912279	2.520092961	12.00826297	0.947944585	3.341071451	0	0.07986581	4.862683638	12.40609862	34.77680466	0.393362743	1.891547444	13.09264442	12.24256014	1.352401769	0.143797436	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.9922
H9452_803_0	2009	3																					none											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	V											0	0	0	0	0	0	0	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	328.6194609	3.574555118	35.36158745	42.2043499	10.77454004	23.1762968	6.657628911	10.90949334	51.9838224	4.103656212	14.46351277	0	0.345739438	21.05057852	53.70605461	150.5489379	1.702869016	8.188517074	56.67811439	52.99809583	5.854553113	0.622499721	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.068925297	0.068925297	0.159945164	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.068925297	0.068925297	0.159945164	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											22.6502	0.246377274	5.655914904	0	2.488918749	5.353724562	1.537912279	2.520092961	12.00826297	0.947944585	3.341071451	0	0.07986581	4.862683638	12.40609862	34.77680466	0.393362743	1.891547444	13.09264442	12.24256014	1.352401769	0.143797436	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.9922	0	0	22.6502	0.246377274	5.655914904	0	2.488918749	5.353724562	1.537912279	2.520092961	12.00826297	0.947944585	3.341071451	0	0.07986581	4.862683638	12.40609862	34.77680466	0.393362743	1.891547444	13.09264442	12.24256014	1.352401769	0.143797436	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.9922	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	22.6502	0.246377274	5.655914904	0	2.488918749	5.353724562	1.537912279	2.520092961	12.00826297	0.947944585	3.341071451	0	0.07986581	4.862683638	12.40609862	34.77680466	0.393362743	1.891547444	13.09264442	12.24256014	1.352401769	0.143797436	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.9922
H9466_001_0	2009	8	H.6	H.7	I.7	I.8	I.9	I.10	I.11	I.12	I.13		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional	0		CORF	Partial Hospitalization	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemo/Radiation	0	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	0	Coin	0	0	0	V	V	V	0	V	0	V	V	V	V	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1540.86654	55.12595621	468.3489416	436.5739266	233.3340886	10.43346786	1.419911897	354.5500508	456.5256802	4923.921192	1005.568381	139.3666936	0	192.7191606	4127.749881	3473.690117	23.29967675	1340.077804	2806.362534	0	31.0572228	0	0	0	366.8728457	343.1752547	185.934419	0	0	0	0	0.443372302	155.7146294	478.0789043	123.7843824	0.587233403	847.9740492	27.84784102	10.2101839	0	$240/day w/$2400 yrly max	$240/day w/$2400 yrly max	$100/day (for days 21-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$200 copay	$0 copay	$75/$125 copay for Lower/Higher Tier	$200 copay	20% coinsurance	$30 copay	$15 coapy	$30 copay	$35 copay	$30 copay	$75/$125 copay for Lower/Higher Tier	0	20% coinsurance	0	0	0	$30 copay	$30 Copay/ Covd up to $50/ 1 per yr	$30 copay	0	Forever Fit	0	$30 copay	$35 copay	$30 copay	$30 copay	$0 copay	20% coinsurance	$30 copay	$30 copay	20% coinsurance	0	240	240	75	0	100	0.2	0.2	50	200	0	90.43209877	200	0.2	30	15	30	35	30	80.21872402	0	0.2	0	0	0	30	30	30	0	0	0	30	35	30	30	0	0.2	30	30	0.2	0	143.4745591	118.7788436	66.88482587	0	89.17976783	0.178359536	0.178359536	44.58988391	178.3595357	0	80.64713572	178.3595357	0	26.75393035	13.37696517	26.75393035	31.21291874	26.75393035	71.53887184	0	0.178359536	0	0	0	26.75393035	26.75393035	26.75393035	0	0	0	0	31.21291874	26.75393035	26.75393035	0	0.178359536	26.75393035	26.75393035	0.178359536	0	18.4229	0.545649777	2.610453117	0	1.734056654	1.860908483	0.253254827	1.317445467	6.785475695	0	6.758017473	2.071448229	0	0.42966625	4.6013972	7.744571954	0.060604243	2.987695685	16.73033414	0	5.539351838	0	0	0	0.81794088	0.765107239	0.414539708	0	0	0	0	0.001153245	0.347164862	1.065874142	0	0.104738677	1.890553221	0.0620866	1.821083659	0	87.7435		10.646	18.4229	0.545649777	2.610453117	0	1.734056654	1.860908483	0.253254827	1.317445467	6.785475695	0	6.758017473	2.071448229	0	0.42966625	4.6013972	7.744571954	0.060604243	2.987695685	16.73033414	0	5.539351838	0	0	0	0.81794088	0.765107239	0.414539708	0	0	0	0	0.001153245	0.347164862	1.065874142	0	0.104738677	1.890553221	0.0620866	1.821083659	0	87.7435	3500																																																																																	0		0	18.4229	0.545649777	2.610453117	0	1.734056654	1.860908483	0.253254827	1.317445467	6.785475695	0	6.758017473	2.071448229	0	0.42966625	4.6013972	7.744571954	0.060604243	2.987695685	16.73033414	0	5.539351838	0	0	0	0.81794088	0.765107239	0.414539708	0	0	0	0	0.001153245	0.347164862	1.065874142	0	0.104738677	1.890553221	0.0620866	1.821083659	0	87.7435
H9466_803_0	2009	3																					none											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	V											0	0	0	0	0	0	0	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	294.095127	3.199016998	55.39154237	35.57230656	6.99581093	13.95848448	3.954380006	9.734893548	29.26197074	6.280847405	26.16088186	0	0.224363371	32.96273011	37.22291811	111.4751563	1.137314919	5.389561529	24.37471373	36.57971739	11.66578611	1.249640444	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.080021396	0.080021396	0.195948689	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.080021396	0.080021396	0.195948689	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.5339	0.255989805	10.85390011	0	1.616032325	3.224409914	0.913461781	2.24876041	6.75951524	1.450875751	6.04316371	0	0.051827939	7.614390656	8.598494083	25.7507611	0.262719746	1.244988713	5.630558871	8.449914718	2.694796592	0.288666943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.4871	0	0	23.5339	0.255989805	10.85390011	0	1.616032325	3.224409914	0.913461781	2.24876041	6.75951524	1.450875751	6.04316371	0	0.051827939	7.614390656	8.598494083	25.7507611	0.262719746	1.244988713	5.630558871	8.449914718	2.694796592	0.288666943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.4871	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.5339	0.255989805	10.85390011	0	1.616032325	3.224409914	0.913461781	2.24876041	6.75951524	1.450875751	6.04316371	0	0.051827939	7.614390656	8.598494083	25.7507611	0.262719746	1.244988713	5.630558871	8.449914718	2.694796592	0.288666943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.4871
H9466_804_0	2009	3																					none											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	V											0	0	0	0	0	0	0	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	294.095127	3.199016998	55.39154237	35.57230656	6.99581093	13.95848448	3.954380006	9.734893548	29.26197074	6.280847405	26.16088186	0	0.224363371	32.96273011	37.22291811	111.4751563	1.137314919	5.389561529	24.37471373	36.57971739	11.66578611	1.249640444	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.080021396	0.080021396	0.195948689	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.080021396	0.080021396	0.195948689	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.5339	0.255989805	10.85390011	0	1.616032325	3.224409914	0.913461781	2.24876041	6.75951524	1.450875751	6.04316371	0	0.051827939	7.614390656	8.598494083	25.7507611	0.262719746	1.244988713	5.630558871	8.449914718	2.694796592	0.288666943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.4871	0	0	23.5339	0.255989805	10.85390011	0	1.616032325	3.224409914	0.913461781	2.24876041	6.75951524	1.450875751	6.04316371	0	0.051827939	7.614390656	8.598494083	25.7507611	0.262719746	1.244988713	5.630558871	8.449914718	2.694796592	0.288666943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.4871	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.5339	0.255989805	10.85390011	0	1.616032325	3.224409914	0.913461781	2.24876041	6.75951524	1.450875751	6.04316371	0	0.051827939	7.614390656	8.598494083	25.7507611	0.262719746	1.244988713	5.630558871	8.449914718	2.694796592	0.288666943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.4871
H9466_805_0	2009	3																					none											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	V											0	0	0	0	0	0	0	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	294.095127	3.199016998	55.39154237	35.57230656	6.99581093	13.95848448	3.954380006	9.734893548	29.26197074	6.280847405	26.16088186	0	0.224363371	32.96273011	37.22291811	111.4751563	1.137314919	5.389561529	24.37471373	36.57971739	11.66578611	1.249640444	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.080021396	0.080021396	0.195948689	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.080021396	0.080021396	0.195948689	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.5339	0.255989805	10.85390011	0	1.616032325	3.224409914	0.913461781	2.24876041	6.75951524	1.450875751	6.04316371	0	0.051827939	7.614390656	8.598494083	25.7507611	0.262719746	1.244988713	5.630558871	8.449914718	2.694796592	0.288666943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.4871	0	0	23.5339	0.255989805	10.85390011	0	1.616032325	3.224409914	0.913461781	2.24876041	6.75951524	1.450875751	6.04316371	0	0.051827939	7.614390656	8.598494083	25.7507611	0.262719746	1.244988713	5.630558871	8.449914718	2.694796592	0.288666943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.4871	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	Similar to FFS Medicare	Similar to FFS Medicare	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	23.5339	0.255989805	10.85390011	0	1.616032325	3.224409914	0.913461781	2.24876041	6.75951524	1.450875751	6.04316371	0	0.051827939	7.614390656	8.598494083	25.7507611	0.262719746	1.244988713	5.630558871	8.449914718	2.694796592	0.288666943	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	117.4871
H9503_001_0	2009	7	r.	s.	t.	u.	v.						OP Facility - Other	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Health & Education (Non-Covered)	Other Non-Covered						5000	Renal Dialysis										A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin	V				O	O	P	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		277.194621	8.931163	538.518797	769.665367	153.087161	11.043946	3.988333	346.271669	375.347315	663.605031	984.932642	0	0	753.465249	3687.679073	4445.171215	30.323157	958.107775			24.961191			5.02	0.35				0.05	0.09	20.190867	1.23	1.52	0.06	2.7						$550/Admit:1a	$550/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $150 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$150/Visit:8a. $0 Lab -- FSL,8. $150 Lab -- OP"	"$0-$150/Visit:14h. $150 DMAM -- OP,8b. $25 Radiology -- FSR,14h. $25 SMAM -- FSR,14h. $25 SMAM -- OP,8b. $100 Advanced Imaging -- FSR,8b. $25 Advanced Imaging -- Office,9a. $150 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $150 Radiology OP -- Facility"	$100/Visit:9a	20% Coins:12	"$15-$150/Visit:9d. $15 Cardiac Rehab,8b. $150 Nuclear Medicine,9a. $150 OP Other,5. $40 Partial Hospitalization,8b. $100 Rad therapy,3. $50 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$25/Visit:7b, 7d, 7f"	"$25-$150/Visit:7h. $150 Psych -- OP,7e. $25 Psych -- Other Provider"	"$25-$50/Visit:9a. $50 Therapy (AT,PT,ST,OT) -- OP,7d. $25 Therapy (AT,PT,ST,OT) - Specialist"			20% Coins:15			"DEN 749 16a, 16b"	VIS738				$0 Additional Smoking Cessation 14a	$0: Nutritional benefit 14a	$0/Proc:12	$0: Health Education Materials 14a	$0: Membership in health club/fitness class 14a	$0: Nurse hotline 14a	$0 Corp Health 14a						549.999979	550.000039	43.1328	0	99.999973	0.199999	0.199999	50.000013	149.999986	131.936106	88.761578	0	0	94.809564	10	25.000001	130.489579	30.393695			0.199999			0	0				0	0	0	0	0	0	0						482.036482	482.036534	37.80288	0	87.642976	0.175285	0.175285	43.821511	131.464487	115.632761	77.79331	0	0	83.158985	8.7643	21.910751	114.364981	26.637946			0.175285			0	0				0	0	0	0	0	0	0						11.1348	0.358762238	1.696463455	0	1.118084531	1.935838075	0.69909495	1.264512313	4.112070184	6.394540162	6.385097529	0	0	5.221450445	2.693327142	8.11641997	0.288992273	2.126835264	0	0	4.375322364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.9216	0	8.2234	11.1348	0.358762238	1.696463455	0	1.118084531	1.935838075	0.69909495	1.264512313	4.112070184	6.394540162	6.385097529	0	0	5.221450445	2.693327142	8.11641997	0.288992273	2.126835264	0	0	4.375322364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.9216		$800/Admit	$800/Admit	40% Coins(Days 1-20) 40%(Days 21-100)	40% Coins	$100/Trip	50% Coins	50% Coins	$50/Visit	30% Coins	30% Coins	30% Coins		20% Coins	30% Coins	30% Coins	30% Coins	30% Coins	30% Coins			30% Coins			"DEN 749 16a, 16b"	VIS738				0	0	0	0	0	0	0						1.7996	0.058	0.5873	0.8911	0.7454	3.0683	1.108	0.2231	3.1814	0.4098	1.7047		0.0004	0.9629	1.9306	4.4079	0.0279	0.3722			1.3157			0	0				0	0	0	0	0	0	0						22.7944	0	0	12.9344	0.416744238	2.283799455	0.891051	1.863474531	5.004096075	1.80714395	1.487662313	7.293494184	6.804381162	8.089844529	0	0.000414	6.184354445	4.623972142	12.52430697	0.316849273	2.499027264	0	0	5.691038364	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.716
H9503_801_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		277.194621	8.931163	538.518797	769.665367	5.595831	11.043946	3.988333	24.553954	63.116214	663.605031	34.128047	0	0.430649	19.442638	36.627335	83.624496	0.528482	7.061059			24.961191																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024	1024.000121	43.1328	0	0.199999	0.199999	0.199999	0.2	0.199999	0	0.199999	0	0.2	0.2	0.2	0.199999	0.5	0.2			0.199999																				1024	1024.000121	43.1328	0	0.199999	0.199999	0.199999	0.2	0.199999	0	0.199999	0	0.2	0.2	0.2	0.199999	0.5	0.2			0.199999																				23.6539	0.762125999	1.935651964	0	1.119160604	2.208778156	0.797662612	4.9107908	12.62317968	0	6.825575272	0	0.0861298	3.8885276	7.325467	16.72481558	0.264241	1.4122118	0	0	4.992213239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.5305	0	0	23.6539	0.762125999	1.935651964	0	1.119160604	2.208778156	0.797662612	4.9107908	12.62317968	0	6.825575272	0	0.0861298	3.8885276	7.325467	16.72481558	0.264241	1.4122118	0	0	4.992213239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.5305		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.6282	0.0847	0.2151		0.7095	1.4003	0.5057	0.925	2.42		1.2967		0.0162	0.7324	1.4686	3.3529	0.053	0.2831			1.0008																				17.0923	0	0	26.2822	0.846806999	2.150723964	0	1.828697604	3.609121156	1.303372612	5.8357878	15.04316668	0	8.122310272	0	0.1023528	4.6209706	8.794034	20.07772658	0.317215	1.6953248	0	0	5.993028239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.6228
H9503_802_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		277.194621	8.931163	538.518797	769.665367	5.595831	11.043946	3.988333	24.553954	63.116214	663.605031	34.128047	0	0.430649	19.442638	36.627335	83.624496	0.528482	7.061059			24.961191																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024	1024.000121	43.1328	0	0.199999	0.199999	0.199999	0.2	0.199999	0	0.199999	0	0.2	0.2	0.2	0.199999	0.5	0.2			0.199999																				1024	1024.000121	43.1328	0	0.199999	0.199999	0.199999	0.2	0.199999	0	0.199999	0	0.2	0.2	0.2	0.199999	0.5	0.2			0.199999																				23.6539	0.762125999	1.935651964	0	1.119160604	2.208778156	0.797662612	4.9107908	12.62317968	0	6.825575272	0	0.0861298	3.8885276	7.325467	16.72481558	0.264241	1.4122118	0	0	4.992213239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.5305	0	0	23.6539	0.762125999	1.935651964	0	1.119160604	2.208778156	0.797662612	4.9107908	12.62317968	0	6.825575272	0	0.0861298	3.8885276	7.325467	16.72481558	0.264241	1.4122118	0	0	4.992213239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.5305		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.6282	0.0847	0.2151		0.7095	1.4003	0.5057	0.925	2.42		1.2967		0.0162	0.7324	1.4686	3.3529	0.053	0.2831			1.0008																				17.0923	0	0	26.2822	0.846806999	2.150723964	0	1.828697604	3.609121156	1.303372612	5.8357878	15.04316668	0	8.122310272	0	0.1023528	4.6209706	8.794034	20.07772658	0.317215	1.6953248	0	0	5.993028239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.6228
H9503_803_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		277.194621	8.931163	538.518797	769.665367	5.595831	11.043946	3.988333	24.553954	63.116214	663.605031	34.128047	0	0.430649	19.442638	36.627335	83.624496	0.528482	7.061059			24.961191																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024	1024.000121	43.1328	0	0.199999	0.199999	0.199999	0.2	0.199999	0	0.199999	0	0.2	0.2	0.2	0.199999	0.5	0.2			0.199999																				1024	1024.000121	43.1328	0	0.199999	0.199999	0.199999	0.2	0.199999	0	0.199999	0	0.2	0.2	0.2	0.199999	0.5	0.2			0.199999																				23.6539	0.762125999	1.935651964	0	1.119160604	2.208778156	0.797662612	4.9107908	12.62317968	0	6.825575272	0	0.0861298	3.8885276	7.325467	16.72481558	0.264241	1.4122118	0	0	4.992213239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.5305	0	0	23.6539	0.762125999	1.935651964	0	1.119160604	2.208778156	0.797662612	4.9107908	12.62317968	0	6.825575272	0	0.0861298	3.8885276	7.325467	16.72481558	0.264241	1.4122118	0	0	4.992213239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.5305		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.6282	0.0847	0.2151		0.7095	1.4003	0.5057	0.925	2.42		1.2967		0.0162	0.7324	1.4686	3.3529	0.053	0.2831			1.0008																				17.0923	0	0	26.2822	0.846806999	2.150723964	0	1.828697604	3.609121156	1.303372612	5.8357878	15.04316668	0	8.122310272	0	0.1023528	4.6209706	8.794034	20.07772658	0.317215	1.6953248	0	0	5.993028239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.6228
H9503_804_0	2009	3																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		277.194621	8.931163	538.518797	769.665367	5.595831	11.043946	3.988333	24.553954	63.116214	663.605031	34.128047	0	0.430649	19.442638	36.627335	83.624496	0.528482	7.061059			24.961191																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024	1024.000121	43.1328	0	0.199999	0.199999	0.199999	0.2	0.199999	0	0.199999	0	0.2	0.2	0.2	0.199999	0.5	0.2			0.199999																				1024	1024.000121	43.1328	0	0.199999	0.199999	0.199999	0.2	0.199999	0	0.199999	0	0.2	0.2	0.2	0.199999	0.5	0.2			0.199999																				23.6539	0.762125999	1.935651964	0	1.119160604	2.208778156	0.797662612	4.9107908	12.62317968	0	6.825575272	0	0.0861298	3.8885276	7.325467	16.72481558	0.264241	1.4122118	0	0	4.992213239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.5305	0	0	23.6539	0.762125999	1.935651964	0	1.119160604	2.208778156	0.797662612	4.9107908	12.62317968	0	6.825575272	0	0.0861298	3.8885276	7.325467	16.72481558	0.264241	1.4122118	0	0	4.992213239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.5305		$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)		20% Coins	20% Coins	20% Coins	20% Coins	20% Coins		20% Coins		20% Coins	20% Coins	20% Coins	20% Coins	50% Coins	20% Coins			20% Coins																				2.6282	0.0847	0.2151		0.7095	1.4003	0.5057	0.925	2.42		1.2967		0.0162	0.7324	1.4686	3.3529	0.053	0.2831			1.0008																				17.0923	0	0	26.2822	0.846806999	2.150723964	0	1.828697604	3.609121156	1.303372612	5.8357878	15.04316668	0	8.122310272	0	0.1023528	4.6209706	8.794034	20.07772658	0.317215	1.6953248	0	0	5.993028239	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.6228
H9519_001_0	2009	10																					0											A	A	D	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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	188.26	3.88	91.05	1389.56	349.63	6.76	5.6	282.66	495	0	602.89	40.21	0	935.32	6986.56	3375.73	1.7	884.22	1084.37	1499.74	22.7	691.88	0	0	471.97	471.97	26.35	0	0	0											PBP: 1A IP Acute: $300 per admit	1B IP Psych: $300 per admit	2 SNF: $300	6 Home Health: $5	10A Ambulance: $100	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $5"	9B ASC Services: $50	8A OP C/D/T: $0	8B OP X-Ray: $5	9A OP Hospital: $50	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: Various Cost Sharing	18A Routine Hearing Exams: $5	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											300	300	300	5	100	0.156014028	0.16699109	47.55306729	50	0	5	5	0	5	5	5	0.500518333	5	5	5	0.200005842	5	0	0	5	27.3471	5	0	0	0											300	300	300	5	100	0.156014028	0.16699109	47.55306729	50	0	5	5	0	5	5	5	0.500518333	5	5	5	0.200005842	5	0	0	5	27.3471	5	0	0	0											4.7065	0.097	2.27625	0.578983333	2.913583333	1.054654831	0.935150102	1.1201125	2.0625	0	0.251204167	0.016754167	0	0.389716667	2.911066667	1.406554167	0.850881167	0.368425	0.451820833	0.624891667	4.540132617	0.288283333	0	0	0.196654167	1.075584232	0.010979167	0	0	0	0	0	0	0	0	0	0	0	0	0	29.1277	0	0	4.7065	0.097	2.27625	0.578983333	2.913583333	1.054654831	0.935150102	1.1201125	2.0625	0	0.251204167	0.016754167	0	0.389716667	2.911066667	1.406554167	0.850881167	0.368425	0.451820833	0.624891667	4.540132617	0.288283333	0	0	0.196654167	1.075584232	0.010979167	0	0	0	0	0	0	0	0	0	0	0	0	0	29.1277	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.7065	0.097	2.27625	0.578983333	2.913583333	1.054654831	0.935150102	1.1201125	2.0625	0	0.251204167	0.016754167	0	0.389716667	2.911066667	1.406554167	0.850881167	0.368425	0.451820833	0.624891667	4.540132617	0.288283333	0	0	0.196654167	1.075584232	0.010979167	0	0	0	0	0	0	0	0	0	0	0	0	0	29.1277
H9519_002_0	2009	7																					0											A	A	D	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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	188.26	3.88	91.05	1389.56	351.41	6.76	5.6	282.66	495	0	602.89	40.21	0	935.32	6986.56	3375.73	1.7	884.22	1084.37	1499.74	22.7	691.88	0	0	471.97	471.97	26.35	0	0	0											PBP: 1A IP Acute: $300 per admit	1B IP Psych: $300 per admit	2 SNF: $300	6 Home Health: $5	10A Ambulance: $75	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $5"	9B ASC Services: $50	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: Various Cost Sharing	18A Routine Hearing Exams: $5	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											300	300	300	5	75	0.156014028	0.16699109	47.55306729	50	0	5	5	0	5	5	5	0.500518333	5	5	5	0.200005842	5	0	0	5	27.3471	5	0	0	0											300	300	300	5	75	0.156014028	0.16699109	47.55306729	50	0	5	5	0	5	5	5	0.500518333	5	5	5	0.200005842	5	0	0	5	27.3471	5	0	0	0											4.7065	0.097	2.27625	0.578983333	2.1963125	1.054654831	0.935150102	1.1201125	2.0625	0	0.251204167	0.016754167	0	0.389716667	2.911066667	1.406554167	0.850881167	0.368425	0.451820833	0.624891667	4.540132617	0.288283333	0	0	0.196654167	1.075584232	0.010979167	0	0	0	0	0	0	0	0	0	0	0	0	0	28.4104	0	0	4.7065	0.097	2.27625	0.578983333	2.1963125	1.054654831	0.935150102	1.1201125	2.0625	0	0.251204167	0.016754167	0	0.389716667	2.911066667	1.406554167	0.850881167	0.368425	0.451820833	0.624891667	4.540132617	0.288283333	0	0	0.196654167	1.075584232	0.010979167	0	0	0	0	0	0	0	0	0	0	0	0	0	28.4104	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	4.7065	0.097	2.27625	0.578983333	2.1963125	1.054654831	0.935150102	1.1201125	2.0625	0	0.251204167	0.016754167	0	0.389716667	2.911066667	1.406554167	0.850881167	0.368425	0.451820833	0.624891667	4.540132617	0.288283333	0	0	0.196654167	1.075584232	0.010979167	0	0	0	0	0	0	0	0	0	0	0	0	0	28.4104
H9519_003_0	2009	10																					0											A	A	D	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	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	187.88	3.87	91.05	1389.56	349.63	6.76	5.6	280.81	69.55	0	602.89	39.61	0	921.25	6313.44	3052.93	1.7	760.42	960.82	1301.46	22.7	595.09	0	0	471.97	471.97	22.66	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: $100	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: $50, 4B Urgent Care: $35"	9B ASC Services: $0.2	8A OP C/D/T: $0	8B OP X-Ray: $35	9A OP Hospital: $0.2	12 Renal Dialysis: $0	"3 CORF: $35, 5 Partial Hosp: $35, 9C OP Substance Abuse: $35, 9D Cardiac Rehab: $35"	"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: $35, 14J Nutrition therapy $35"	7D Physician Specialist: $35	"7E Mental Health: 50%, 7H Psychiatric: 50%"	"7C Occupational Therapy: $35, 7I Physical and Speech Therapy: $35"	Included in i.2.	"7B Chiropractic: $35, 7F Podiatry: $35, 7G Other Health Care: $35, 18A Medicare Covered Hearing Exams: $35"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $35, 17A Medicare Covered Eye Exams: $35"	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: Various Cost Sharing	18A Routine Hearing Exams: $35	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											500	500	500	5	100	0.156014028	0.16699109	49.2778035	0.199999986	0	35	35	0	35	20	35	0.500518333	35	35	33.19347202	0.200005842	35	0	0	5	27.3471	35	0	0	0											500	500	500	5	100	0.156014028	0.16699109	49.2778035	0.199999986	0	35	35	0	35	20	35	0.500518333	35	35	33.19347202	0.200005842	35	0	0	5	27.3471	35	0	0	0											7.8283	0.16125	3.79375	0.578983333	2.913583333	1.054654831	0.935150102	1.153141667	13.90999903	0	1.758429167	0.115529167	0	2.686979167	10.5224	8.904379167	0.850881167	2.217891667	2.802391667	3.599998008	4.540132617	1.735679167	0	0	0.196654167	1.075584232	0.066091667	0	0	0	0	0	0	0	0	0	0	0	0	0	73.4019	0	0	7.8283	0.16125	3.79375	0.578983333	2.913583333	1.054654831	0.935150102	1.153141667	13.90999903	0	1.758429167	0.115529167	0	2.686979167	10.5224	8.904379167	0.850881167	2.217891667	2.802391667	3.599998008	4.540132617	1.735679167	0	0	0.196654167	1.075584232	0.066091667	0	0	0	0	0	0	0	0	0	0	0	0	0	73.4019	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.8283	0.16125	3.79375	0.578983333	2.913583333	1.054654831	0.935150102	1.153141667	13.90999903	0	1.758429167	0.115529167	0	2.686979167	10.5224	8.904379167	0.850881167	2.217891667	2.802391667	3.599998008	4.540132617	1.735679167	0	0	0.196654167	1.075584232	0.066091667	0	0	0	0	0	0	0	0	0	0	0	0	0	73.4019
H9519_801_0	2009	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	V	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	233.37	3.26	37.11	14.13	12.16	6.87	5.63	12.53	63.67	9.65	16.68	1.89	0.33	20.01	59.85	98.18	1.81	3.03	41.46	41.7	20.78	4.09	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: $13.1374"	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: $35, 14J Nutrition therapy $35"	7D Physician Specialist: $0	"7E Mental Health: 0%, 7H Psychiatric: 0%"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"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: $5	17B Eye Wear: Medicare Covered: Various Cost Sharing	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											0.087265221	0.08700945	0.18531416	0	0.230905375	0.230999984	0.230962218	0.230994336	0.230999981	0.230957114	0.230973723	0.231000162	0.231	0.231025056	0.230992832	0.230998289	0.231012975	0.230997468	0.231008538	0.231019347	0.231015237	0.230989253	0	0	0	0	0	0	0	0											0.087265221	0.08700945	0.18531416	0	0.230905375	0.230999984	0.230962218	0.230994336	0.230999981	0.230957114	0.230973723	0.231000162	0.231	0.231025056	0.230992832	0.230998289	0.231012975	0.230997468	0.231008538	0.231019347	0.231015237	0.230989253	0	0	0	0	0	0	0	0											20.3651	0.283650806	6.877008477	0	2.807809355	1.586969892	1.30031729	2.894359025	14.70776876	2.228736149	3.852641694	0.436590306	0.07623	4.622811367	13.82492097	22.67941198	0.418133485	0.699922329	9.577613968	9.633506788	4.800496617	0.944746043	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.6187	0	0	20.3651	0.283650806	6.877008477	0	2.807809355	1.586969892	1.30031729	2.894359025	14.70776876	2.228736149	3.852641694	0.436590306	0.07623	4.622811367	13.82492097	22.67941198	0.418133485	0.699922329	9.577613968	9.633506788	4.800496617	0.944746043	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.6187	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.3651	0.283650806	6.877008477	0	2.807809355	1.586969892	1.30031729	2.894359025	14.70776876	2.228736149	3.852641694	0.436590306	0.07623	4.622811367	13.82492097	22.67941198	0.418133485	0.699922329	9.577613968	9.633506788	4.800496617	0.944746043	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.6187
H9519_803_0	2009	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	V	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	233.37	3.26	37.11	14.13	12.16	6.87	5.63	12.53	63.67	9.65	16.68	1.89	0.33	20.01	59.85	98.18	1.81	3.03	41.46	41.7	20.78	4.09	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: $13.1374"	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: $35, 14J Nutrition therapy $35"	7D Physician Specialist: $0	"7E Mental Health: 0%, 7H Psychiatric: 0%"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"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: $5	17B Eye Wear: Medicare Covered: Various Cost Sharing	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											0.087265221	0.08700945	0.18531416	0	0.230905375	0.230999984	0.230962218	0.230994336	0.230999981	0.230957114	0.230973723	0.231000162	0.231	0.231025056	0.230992832	0.230998289	0.231012975	0.230997468	0.231008538	0.231019347	0.231015237	0.230989253	0	0	0	0	0	0	0	0											0.087265221	0.08700945	0.18531416	0	0.230905375	0.230999984	0.230962218	0.230994336	0.230999981	0.230957114	0.230973723	0.231000162	0.231	0.231025056	0.230992832	0.230998289	0.231012975	0.230997468	0.231008538	0.231019347	0.231015237	0.230989253	0	0	0	0	0	0	0	0											20.3651	0.283650806	6.877008477	0	2.807809355	1.586969892	1.30031729	2.894359025	14.70776876	2.228736149	3.852641694	0.436590306	0.07623	4.622811367	13.82492097	22.67941198	0.418133485	0.699922329	9.577613968	9.633506788	4.800496617	0.944746043	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.6187	0	0	20.3651	0.283650806	6.877008477	0	2.807809355	1.586969892	1.30031729	2.894359025	14.70776876	2.228736149	3.852641694	0.436590306	0.07623	4.622811367	13.82492097	22.67941198	0.418133485	0.699922329	9.577613968	9.633506788	4.800496617	0.944746043	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.6187	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.3651	0.283650806	6.877008477	0	2.807809355	1.586969892	1.30031729	2.894359025	14.70776876	2.228736149	3.852641694	0.436590306	0.07623	4.622811367	13.82492097	22.67941198	0.418133485	0.699922329	9.577613968	9.633506788	4.800496617	0.944746043	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.6187
H9519_804_0	2009	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	V	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	233.37	3.26	37.11	14.13	12.16	6.87	5.63	12.53	63.67	9.65	16.68	1.89	0.33	20.01	59.85	98.18	1.81	3.03	41.46	41.7	20.78	4.09	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: $13.1374"	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: $35, 14J Nutrition therapy $35"	7D Physician Specialist: $0	"7E Mental Health: 0%, 7H Psychiatric: 0%"	"7C Occupational Therapy: $0, 7I Physical and Speech Therapy: $0"	Included in i.2.	"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: $5	17B Eye Wear: Medicare Covered: Various Cost Sharing	18A Routine Hearing Exams: $0	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: Not Covered	13B Acupuncture: Not Covered											0.087265221	0.08700945	0.18531416	0	0.230905375	0.230999984	0.230962218	0.230994336	0.230999981	0.230957114	0.230973723	0.231000162	0.231	0.231025056	0.230992832	0.230998289	0.231012975	0.230997468	0.231008538	0.231019347	0.231015237	0.230989253	0	0	0	0	0	0	0	0											0.087265221	0.08700945	0.18531416	0	0.230905375	0.230999984	0.230962218	0.230994336	0.230999981	0.230957114	0.230973723	0.231000162	0.231	0.231025056	0.230992832	0.230998289	0.231012975	0.230997468	0.231008538	0.231019347	0.231015237	0.230989253	0	0	0	0	0	0	0	0											20.3651	0.283650806	6.877008477	0	2.807809355	1.586969892	1.30031729	2.894359025	14.70776876	2.228736149	3.852641694	0.436590306	0.07623	4.622811367	13.82492097	22.67941198	0.418133485	0.699922329	9.577613968	9.633506788	4.800496617	0.944746043	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.6187	0	0	20.3651	0.283650806	6.877008477	0	2.807809355	1.586969892	1.30031729	2.894359025	14.70776876	2.228736149	3.852641694	0.436590306	0.07623	4.622811367	13.82492097	22.67941198	0.418133485	0.699922329	9.577613968	9.633506788	4.800496617	0.944746043	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.6187	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	20.3651	0.283650806	6.877008477	0	2.807809355	1.586969892	1.30031729	2.894359025	14.70776876	2.228736149	3.852641694	0.436590306	0.07623	4.622811367	13.82492097	22.67941198	0.418133485	0.699922329	9.577613968	9.633506788	4.800496617	0.944746043	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	124.6187
H9615_001_0	2009	4																																A	A	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	P	P	P	P	P	O	O																																																			0	3000			849.9235669	1929.861682	128.8725384	1161.035808	727.463465	247.1123107			496.3222436			168.5029803	3139.328812	5185.092039	580.5752893	1043.334185		15.0512	1062.933684	1200.691333			1.803753916		233.6616			312.8											No cost sharing	No cost sharing (190 day limit)	"$0(day 1-15), $65(days 16-100)"	"$0(day 1-20), $15(days 21+)"	$35 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER visit, $20 per Urgently Needed Care"	No cost sharing	No cost sharing	$15 Copay per visit	No cost sharing	No cost sharing	"PT/OT/ST/Partial Hospital $15 copay,Cardiac Rehab $50 copay"	$10 Copay per visit	$15 Copay per visit	$15 Copay per visit	$15 Copay per visit	No cost sharing	$15 Copay per visit	20% Coinsurance	$15 Copay per visit	No cost sharing	$300 for any services	$10 Copay per routine exam	$100 allowance per year	$15 Copay for 1 exam per year	$600 every 3 years	No cost sharing	50% Coinsurance													33.73420136	3.97447	35	18.85323267	26.9699133	44			15			23.93667569	10	15	15	15		15	52.15977049	14.99910569			10		15			26.47058824													33.73420136	3.97447	35	18.85323267	26.9699133	44			15			23.93667569	10	15	15	15		15	52.15977049	14.99910569			10		15			26.47058824											0	0	2.389291063	0.639181447	0.375878237	1.824106518	1.634968882	0.906078473	0	0	0.620402805	0	0	0.336116766	2.616107344	6.481365049	0.725719112	1.304167731	0	0.018814	4.620198086	1.500774683	0	0	0.001503128	0	0.292077	0	0	0.69	0	0	0	0	0	0	0	0	0	0	26.9768	0	0	0	0	2.389291063	0.639181447	0.375878237	1.824106518	1.634968882	0.906078473	0	0	0.620402805	0	0	0.336116766	2.616107344	6.481365049	0.725719112	1.304167731	0	0.018814	4.620198086	1.500774683	0	0	0.001503128	0	0.292077	0	0	0.69	0	0	0	0	0	0	0	0	0	0	26.9768		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$35 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER visit, $20 per Urgently needed Care"	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	"PT/OT/ST $25 copay,Cardiac Rehab/Partial Hospital50%coinsurance"	$25 Copay per visit	$25 Copay per visit	"50% Coinsurance for MH, $25 Copay per visit for Substance Abuse"	$25 Copay per visit	20% Coinsurance	20% Coinsurance	20% Coinsurance	"Ophthalmology Service $25 copay, others $0"	No cost sharing	$300 for any services	$25 Copay per visit	$100 Allowance	$25 copay for 1 exam every year	$600 every 3 years	No cost sharing	50% Coinsurance											2.5955	0.0767	0.3197	0.2556	0.0202	0.1093	0.098	0.0486	0.369	0.0722	0.0913		0.0083	0.0187	0.4539	0.6638	0.1493	0.1165	0.3898	0.6459	0.2769	0.1341			0.0002		0.0243			0.0344											6.972	0	5.186840956	2.5955	0.07666842	2.708975946	0.894774527	0.396030868	1.933445888	1.732971091	0.954657675	0.368995747	0.072189306	0.711677442	0	0.008257948	0.354768387	3.070015122	7.145124753	0.874997915	1.420705519	0.38981435	0.664745557	4.897138902	1.634888866	0	0	0.001693238	0	0.316349451	0	0	0.724404608	0	0	0	0	0	0	0	0	0	0	33.9488
H9615_002_0	2009	4																																A	A	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	P	P	P	P	P	O	O																																																			0	3000			849.9235669	1929.861682	128.8725384	1161.035808	727.463465	247.1123107			496.3222436			168.5029803	3139.328812	5185.092039	580.5752893	1043.334185		15.0512	1062.933684	1200.691333			1.803753916		235.4258556			312.8											No cost sharing	No cost sharing (190 day limit)	"$0(day 1-15), $65(days 16-100)"	"$0(day 1-20), $15(days 21+)"	$35 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER visit, $20 per Urgently Needed Care"	No cost sharing	No cost sharing	$15 Copay per visit	No cost sharing	No cost sharing	"PT/OT/ST/Partial Hospital $15 copay,Cardiac Rehab $50 copay"	$10 Copay per visit	$15 Copay per visit	$15 Copay per visit	$15 Copay per visit	No cost sharing	$15 Copay per visit	20% Coinsurance	$15 Copay per visit	No cost sharing	$300 for any services	$10 Copay per routine exam	$100 allowance per year	$15 Copay for 1 exam per year	$600 every 3 years	No cost sharing	50% Coinsurance													33.73420136	3.97447	35	18.85323267	26.9699133	44			15			23.93667569	10	15	15	15		15	52.15977049	14.99910569			10		15			26.47058824													33.73420136	3.97447	35	18.85323267	26.9699133	44			15			23.93667569	10	15	15	15		15	52.15977049	14.99910569			10		15			26.47058824											0	0	2.389291063	0.639181447	0.375878237	1.824106518	1.634968882	0.906078473	0	0	0.620402805	0	0	0.336116766	2.616107344	6.481365049	0.725719112	1.304167731	0	0.018814	4.620198086	1.500774683	0	0	0.001503128	0	0.29428232	0	0	0.69	0	0	0	0	0	0	0	0	0	0	26.979	0	0	0	0	2.389291063	0.639181447	0.375878237	1.824106518	1.634968882	0.906078473	0	0	0.620402805	0	0	0.336116766	2.616107344	6.481365049	0.725719112	1.304167731	0	0.018814	4.620198086	1.500774683	0	0	0.001503128	0	0.29428232	0	0	0.69	0	0	0	0	0	0	0	0	0	0	26.979		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$35 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER visit, $20 per Urgently needed Care"	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	"PT/OT/ST $25 copay,Cardiac Rehab/Partial Hospital50%coinsurance"	$25 Copay per visit	$25 Copay per visit	"50% Coinsurance for MH, $25 Copay per visit for Substance Abuse"	$25 Copay per visit	20% Coinsurance	20% Coinsurance	20% Coinsurance	"Ophthalmology Service $25 copay, others $0"	No cost sharing	$300 for any services	$25 Copay per visit	$100 Allowance	$25 copay for 1 exam every year	$600 every 3 years	No cost sharing	50% Coinsurance											2.5955	0.0767	0.3197	0.2556	0.0202	0.1093	0.098	0.0493	0.369	0.0722	0.0913		0.0083	0.0187	0.4539	0.6638	0.1493	0.1165	0.3898	0.6459	0.2769	0.1341			0.0002		0.0245			0.0344											6.9729	0	5.187517522	2.5955	0.07666842	2.708975946	0.894774527	0.396030868	1.933445888	1.732971091	0.955383828	0.368995747	0.072189306	0.711677442	0	0.008257948	0.354768387	3.070015122	7.145124753	0.874997915	1.420705519	0.38981435	0.664745557	4.897138902	1.634888866	0	0	0.001693238	0	0.318738039	0	0	0.724404608	0	0	0	0	0	0	0	0	0	0	33.9519
H9615_003_0	2009	4																																A	A	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	P	P	P	P	P	O	O																																																			0	3000			901.8968857	2047.873842	136.7531688	1232.03382	771.9482776	262.2233717			526.6726365			178.8070352	3325.145905	5502.163423	616.0778048	1107.134675		15.0512	1127.932695	1274.114303			1.825166031		235.4258556			312.8											No cost sharing	No cost sharing (190 day limit)	"$0(day 1-15), $65(days 16-100)"	"$0(day 1-20), $15(days 21+)"	$35 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER visit, $20 per Urgently Needed Care"	No cost sharing	No cost sharing	$15 Copay per visit	No cost sharing	No cost sharing	"PT/OT/ST/Partial Hospital $15 copay,Cardiac Rehab $50 copay"	$10 Copay per visit	$15 Copay per visit	$15 Copay per visit	$15 Copay per visit	No cost sharing	$15 Copay per visit	20% Coinsurance	$15 Copay per visit	No cost sharing	$300 for any services	$10 Copay per routine exam	$100 allowance per year	$15 Copay for 1 exam per year	$600 every 3 years	No cost sharing	50% Coinsurance													33.73420136	3.97447	35	20.6729894	29.57311044	44			15			25.31464782	10	15	15	15		15	57.19434971	14.99910569			10		15			26.47058824													33.73420136	3.97447	35	20.6729894	29.57311044	44			15			25.31464782	10	15	15	15		15	57.19434971	14.99910569			10		15			26.47058824											0	0	2.535397596	0.678267763	0.398863409	2.122485175	1.902409305	0.961485696	0	0	0.658340796	0	0	0.377203094	2.770954921	6.877704279	0.770097256	1.383918344	0	0.018814	5.375948086	1.592547925	0	0	0.001520972	0	0.29428232	0	0	0.69	0	0	0	0	0	0	0	0	0	0	29.4102	0	0	0	0	2.535397596	0.678267763	0.398863409	2.122485175	1.902409305	0.961485696	0	0	0.658340796	0	0	0.377203094	2.770954921	6.877704279	0.770097256	1.383918344	0	0.018814	5.375948086	1.592547925	0	0	0.001520972	0	0.29428232	0	0	0.69	0	0	0	0	0	0	0	0	0	0	29.4102		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$35 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER visit, $20 per Urgently needed Care"	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	"PT/OT/ST $25 copay,Cardiac Rehab/Partial Hospital50%coinsurance"	$25 Copay per visit	$25 Copay per visit	"50% Coinsurance for MH, $25 Copay per visit for Substance Abuse"	$25 Copay per visit	20% Coinsurance	20% Coinsurance	20% Coinsurance	"Ophthalmology Service $25 copay, others $0"	No cost sharing	$300 for any services	$25 Copay per visit	$100 Allowance	$25 copay for 1 exam every year	$600 every 3 years	No cost sharing	50% Coinsurance											2.8821	0.0851	0.355	0.2838	0.0204	0.1214	0.1088	0.0492	0.4097	0.0802	0.1014		0.0092	0.0196	0.4689	0.6804	0.1656	0.118	0.4329	0.717	0.3075	0.1358			0.0002		0.0226			0.0318											7.6066	0	6.757192471	2.8821	0.085134883	2.890385154	0.962085885	0.419271638	2.243898848	2.011233859	1.010681035	0.4097438	0.080161142	0.759694855	0	0.00916987	0.396791463	3.23985718	7.558151693	0.935743942	1.501934195	0.432861393	0.73578332	5.683471366	1.728363095	0	0	0.001700032	0	0.316868176	0	0	0.721774061	0	0	0	0	0	0	0	0	0	0	37.0168
H9615_004_0	2009	5																																A	A	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	P	P	P	P	P	O	O																																																			0	3000			901.8968857	2047.873842	136.7531688	1232.03382	771.9482776	262.2233717			526.6726365			178.8070352	3325.145905	5502.163423	616.0778048	1107.134675		15.0512	1127.932695	1274.114303			1.825166031		235.4258556			312.8											No cost sharing	No cost sharing (190 day limit)	"$0(day 1-15), $65(days 16-100)"	"$0(day 1-20), $15(days 21+)"	$35 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER visit, $20 per Urgently Needed Care"	No cost sharing	No cost sharing	$15 Copay per visit	No cost sharing	No cost sharing	"PT/OT/ST/Partial Hospital $15 copay,Cardiac Rehab $50 copay"	$10 Copay per visit	$15 Copay per visit	$15 Copay per visit	$15 Copay per visit	No cost sharing	$15 Copay per visit	20% Coinsurance	$15 Copay per visit	No cost sharing	$300 for any services	$10 Copay per routine exam	$100 allowance per year	$15 Copay for 1 exam per year	$600 every 3 years	No cost sharing	50% Coinsurance													33.73420136	3.97447	35	20.6729894	29.57311044	44			15			25.31464782	10	15	15	15		15	57.19434971	14.99910569			10		15			26.47058824													33.73420136	3.97447	35	20.6729894	29.57311044	44			15			25.31464782	10	15	15	15		15	57.19434971	14.99910569			10		15			26.47058824											0	0	2.535397596	0.678267763	0.398863409	2.122485175	1.902409305	0.961485696	0	0	0.658340796	0	0	0.377203094	2.770954921	6.877704279	0.770097256	1.383918344	0	0.018814	5.375948086	1.592547925	0	0	0.001520972	0	0.29428232	0	0	0.69	0	0	0	0	0	0	0	0	0	0	29.4102	0	0	0	0	2.535397596	0.678267763	0.398863409	2.122485175	1.902409305	0.961485696	0	0	0.658340796	0	0	0.377203094	2.770954921	6.877704279	0.770097256	1.383918344	0	0.018814	5.375948086	1.592547925	0	0	0.001520972	0	0.29428232	0	0	0.69	0	0	0	0	0	0	0	0	0	0	29.4102		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$35 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER visit, $20 per Urgently needed Care"	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	"PT/OT/ST $25 copay,Cardiac Rehab/Partial Hospital50%coinsurance"	$25 Copay per visit	$25 Copay per visit	"50% Coinsurance for MH, $25 Copay per visit for Substance Abuse"	$25 Copay per visit	20% Coinsurance	20% Coinsurance	20% Coinsurance	"Ophthalmology Service $25 copay, others $0"	No cost sharing	$300 for any services	$25 Copay per visit	$100 Allowance	$25 copay for 1 exam every year	$600 every 3 years	No cost sharing	50% Coinsurance											2.8821	0.0851	0.355	0.2838	0.0204	0.1214	0.1088	0.0498	0.4097	0.0802	0.1014		0.0092	0.0196	0.4689	0.6804	0.1656	0.118	0.4329	0.717	0.3075	0.1358			0.0002		0.0226			0.0318											7.6072	0	6.757735775	2.8821	0.085134883	2.890385154	0.962085885	0.419271638	2.243898848	2.011233859	1.011292635	0.4097438	0.080161142	0.759694855	0	0.00916987	0.396791463	3.23985718	7.558151693	0.935743942	1.501934195	0.432861393	0.73578332	5.683471366	1.728363095	0	0	0.001700032	0	0.316868176	0	0	0.721774061	0	0	0	0	0	0	0	0	0	0	37.0175
H9615_802_0	2009	7																																A	A	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	P	P	P	P	P	O	O																																																			0	3000				1929.842375	128.8712491	1161.024192	727.4561872	247.1098385			496.3172782			168.5012945	3139.298412	5185.040166	580.569481	1043.323747		15.0512	1062.92305	1200.67932			1.803750413		235.4258556			312.8											No cost sharing	No cost sharing (190 day limit)	$0(day 1-100)	"$0(day 1-20), $15(days 21+)"	$35 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER visit, $20 per Urgently Needed Care"	No cost sharing	No cost sharing	$15 Copay per visit	No cost sharing	No cost sharing	"PT/OT/ST/Partial Hospital $15 copay,Cardiac Rehab $50 copay"	$10 Copay per visit	$15 Copay per visit	$15 Copay per visit	$15 Copay per visit	No cost sharing	$15 Copay per visit	20% Coinsurance	$15 Copay per visit	No cost sharing	$300 for any services	$10 Copay per routine exam	$100 allowance per year	$15 Copay for 1 exam per year	$600 every 3 years	No cost sharing	50% Coinsurance														3.97447	35	18.85304405	26.96964348	44			15			23.93653287	10	15	15	15		15	52.15924866	14.99910569			10		15			26.47058824														3.97447	35	18.85304405	26.96964348	44			15			23.93653287	10	15	15	15		15	52.15924866	14.99910569			10		15			26.47058824											0	0	0	0.639175052	0.375874476	1.82407002	1.634936168	0.906069408	0	0	0.620396598	0	0	0.336111398	2.61608201	6.481300207	0.725711851	1.304154684	0	0.018814	4.620105641	1.500759669	0	0	0.001503125	0	0.29428232	0	0	0.69	0	0	0	0	0	0	0	0	0	0	24.5893	0	0	0	0	0	0.639175052	0.375874476	1.82407002	1.634936168	0.906069408	0	0	0.620396598	0	0	0.336111398	2.61608201	6.481300207	0.725711851	1.304154684	0	0.018814	4.620105641	1.500759669	0	0	0.001503125	0	0.29428232	0	0	0.69	0	0	0	0	0	0	0	0	0	0	24.5893		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$35 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER visit, $20 per Urgently needed Care"	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	"PT/OT/ST $25 copay,Cardiac Rehab/Partial Hospital50%coinsurance"	$25 Copay per visit	$25 Copay per visit	"50% Coinsurance for MH, $25 Copay per visit for Substance Abuse"	$25 Copay per visit	20% Coinsurance	20% Coinsurance	20% Coinsurance	"Ophthalmology Service $25 copay, others $0"	No cost sharing	$300 for any services	$25 Copay per visit	$100 Allowance	$25 copay for 1 exam every year	$600 every 3 years	No cost sharing	50% Coinsurance											2.5954	0.0767	0.3197	0.2556	0.0202	0.1093	0.098	0.0486	0.369	0.0722	0.0913		0.0083	0.0187	0.4539	0.6638	0.1493	0.1165	0.3898	0.6459	0.2769	0.1341			0.0002		0.0245			0.0344											6.9721	0	5.186824837	2.5954	0.076667535	0.319681194	0.894765183	0.396027076	1.933408128	1.732937246	0.954648536	0.368991489	0.072188473	0.711670182	0	0.008257853	0.354762919	3.069988154	7.145058044	0.874988943	1.420692292	0.389809851	0.664738134	4.897043262	1.634873645	0	0	0.001693236	0	0.318738246	0	0	0.724404899	0	0	0	0	0	0	0	0	0	0	31.5615
H9615_804_0	2009	7																																A	A	D	V	T	O	O	V	V	V	V	V	V	V	V	V	V	V	V	V	S	V	T	P	P	P	P	P	O	O																																																			0	3000				2046.877587	136.6866407	1231.434457	771.5727381	262.0958046			526.4164194			178.7200487	3323.577243	5499.486716	615.7780936	1106.596073		15.0512	1127.383976	1273.494469			1.824985271		235.4258556			312.8											No cost sharing	No cost sharing (190 day limit)	$0(day 1-100)	"$0(day 1-20), $15(days 21+)"	$35 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER visit, $20 per Urgently Needed Care"	No cost sharing	No cost sharing	$15 Copay per visit	No cost sharing	No cost sharing	"PT/OT/ST/Partial Hospital $15 copay,Cardiac Rehab $50 copay"	$10 Copay per visit	$15 Copay per visit	$15 Copay per visit	$15 Copay per visit	No cost sharing	$15 Copay per visit	20% Coinsurance	$15 Copay per visit	No cost sharing	$300 for any services	$10 Copay per routine exam	$100 allowance per year	$15 Copay for 1 exam per year	$600 every 3 years	No cost sharing	50% Coinsurance														3.97447	35	20.66293235	29.55872363	44			15			25.30703233	10	15	15	15		15	57.16652565	14.99910569			10		15			26.47058824														3.97447	35	20.66293235	29.55872363	44			15			25.30703233	10	15	15	15		15	57.16652565	14.99910569			10		15			26.47058824											0	0	0	0.677937797	0.398669369	2.120420573	1.900558777	0.96101795	0	0	0.658020524	0	0	0.376906171	2.769647702	6.874358395	0.769722617	1.383245091	0	0.018814	5.370718747	1.591773178	0	0	0.001520821	0	0.29428232	0	0	0.69	0	0	0	0	0	0	0	0	0	0	26.8576	0	0	0	0	0	0.677937797	0.398669369	2.120420573	1.900558777	0.96101795	0	0	0.658020524	0	0	0.376906171	2.769647702	6.874358395	0.769722617	1.383245091	0	0.018814	5.370718747	1.591773178	0	0	0.001520821	0	0.29428232	0	0	0.69	0	0	0	0	0	0	0	0	0	0	26.8576		20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	$35 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER visit, $20 per Urgently needed Care"	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	20% Coinsurance	"PT/OT/ST $25 copay,Cardiac Rehab/Partial Hospital50%coinsurance"	$25 Copay per visit	$25 Copay per visit	"50% Coinsurance for MH, $25 Copay per visit for Substance Abuse"	$25 Copay per visit	20% Coinsurance	20% Coinsurance	20% Coinsurance	"Ophthalmology Service $25 copay, others $0"	No cost sharing	$300 for any services	$25 Copay per visit	$100 Allowance	$25 copay for 1 exam every year	$600 every 3 years	No cost sharing	50% Coinsurance											2.8806	0.0851	0.3548	0.2837	0.0204	0.1213	0.1088	0.0492	0.4095	0.0801	0.1013		0.0092	0.0196	0.4688	0.6804	0.1656	0.118	0.4326	0.7166	0.3074	0.1358			0.0002		0.0226			0.0318											7.6033	0	6.747819291	2.8806	0.085090165	0.354801098	0.961606841	0.419076806	2.241770473	2.00932617	1.010211381	0.409528579	0.080119037	0.759321346	0	0.009165053	0.39648991	3.23848027	7.554733713	0.935282885	1.501256365	0.432634028	0.735408131	5.678080498	1.727583079	0	0	0.001699942	0	0.316878292	0	0	0.721788293	0	0	0	0	0	0	0	0	0	0	34.4609
H9663_001_0	2009	6																					5000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	5000	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$175/day 1-10	$175/day 1-10	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$200 per procedure	$0 per visit	$30 X-ray; $175 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$20 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											143.4382958	143.4382958	47.56208437	0	100	0.2	0.2	47.5	200	0	56.1	30	25	30	20	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											116.48495	116.48495	38.62474097	0	100	0.162418201	0.162418201	38.57432281	162.4182013	0	45.55830547	0	20.30227516	24.3627302	20	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											16.6913	0	3.820161188	0	2.003577927	1.126371526	0	0.719696806	4.579527294	0	15.75036924	0	0.099492229	1.406073289	10.71655122	20.39806951	0	1.478528581	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.7039	0	10.2258	16.6913	0	3.820161188	0	2.003577927	1.126371526	0	0.719696806	4.579527294	0	15.75036924	0	0.099492229	1.406073289	10.71655122	20.39806951	0	1.478528581	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.7039		$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP	$100 copay	$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP	$50 copay	$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP	$25 copay	$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP	$0 ded; 35% coinsurance; $5000 max OOP		Not Covered		$0 ded; 35% coinsurance; $5000 max OOP	0	$0 ded; 35% coinsurance; $5000 max OOP	0	Not Covered												5.2416	0	0.6472	0.0981	0.1272	0.1541	0	0.0592	0.7038	0.2399	0.9779	0	0.0078	0.2028	0.7165	3.1121	0	0.0922	0	0	0.1392	0	0	0	0.0649	0	0.0041	0	0	0											12.5888	0	11.20993845	21.9329	0	4.467397173	0.098128738	2.130757586	1.280444487	0	0.778911936	5.283360247	0.239912593	16.72827025	0	0.107268939	1.608913101	11.43301396	23.51020129	0	1.570764963	0	0	1.053359144	0	0	0	0.064914967	0	0.004143689	0	0	0	0	0	0	0	0	0	0	0	0	0	92.2926
H9663_002_0	2009	5																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	3500	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$150/day 1-10	$150/day 1-10	"$0/d 1-10, $75/d 11-100"	$0 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$200 per procedure	$0 per visit	$25 X-ray; $175 Complex Radiology	$25 per visit	$25 per visit	$25 per visit	$10 PCP visit; $25 if no PCP selected	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$25 per visit	$45 per script	0	Not Covered	0	$0 per visit	$125 Every 2 Years	$0 per visit	$500 Every 3 Yrs	Fitness/Coaching	0											122.9471107	122.9471107	47.56208437	0	100	0.2	0.2	47.5	200	0	52	25	25	25	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											95.8028002	95.8028002	37.06130906	0	100	0.155843923	0.155843923	37.0129317	155.8439229	0	40.51941997	0	19.48049037	19.48049037	10	25	25	25	25	25	45	0	0	0	0	0	0	0	0	0											13.7277	0	3.665530717	0	2.003577927	1.080778852	0	0.690565298	4.394159601	0	14.00833107	0	0.095465035	1.124299163	5.358275608	16.99839126	0	1.232107151	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.2934	0	10.9897	13.7277	0	3.665530717	0	2.003577927	1.080778852	0	0.690565298	4.394159601	0	14.00833107	0	0.095465035	1.124299163	5.358275608	16.99839126	0	1.232107151	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.2934		$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP	$100 copay	$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP	$50 copay	$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP	$25 copay	$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP	$0 ded; 35% coinsurance; $3500 max OOP		Not Covered		$0 ded; 35% coinsurance; $3500 max OOP	0	$0 ded; 35% coinsurance; $3500 max OOP	0	Not Covered												4.3557	0	0.5378	0.0815	0.1057	0.128	0	0.0492	0.5849	0.1994	0.8126	0	0.0065	0.1686	0.5954	2.5861	0	0.0766	0	0	0.1157	0	0	0	0.0539	0	0.0034	0	0	0											10.4611	0	13.33763049	18.0834	0	4.203374196	0.081543522	2.109262333	1.208811193	0	0.73977219	4.97903432	0.199363798	14.82095227	0	0.101927365	1.29285603	5.953645496	19.58452649	0	1.308754213	0	0	1.029834665	0	0	0	0.053943373	0	0.003443344	0	0	0	0	0	0	0	0	0	0	0	0	0	75.7544
H9663_801_0	2009	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																																																			0	Unlimited	304.5298033	0	37.60341739	5.701129096	6.724048512	8.951402622	0	7.912276611	40.89161438	13.93855348	56.81454799	0	3.100306112	11.78468177	41.6253859	180.8100799	0	5.358792237	0	0	8.086484319	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.074262624	0.074262624	0.211074881	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											22.6152	0	7.937136852	0	1.553255206	2.067774006	0	1.827735897	9.445962922	3.219805853	13.12416059	0	0.716170712	2.722261488	9.615464142	41.76712846	0	1.237881007	0	0	1.867977878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.7179			22.6152	0	7.937136852	0	1.553255206	2.067774006	0	1.827735897	9.445962922	3.219805853	13.12416059	0	0.716170712	2.722261488	9.615464142	41.76712846	0	1.237881007	0	0	1.867977878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.7179		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.0839	0	1.0823	0	0.2118	0.282	0	0.2492	1.2881	0.4391	1.7897	0	0.0977	0.3712	1.3112	5.6955	0	0.1688	0	0	0.2547	0	0	0	0	0	0	0	0	0											16.3252		0	25.6991	0	9.019473696	0	1.765062734	2.349743188	0	2.07697261	10.73404877	3.658870288	14.91381885	0	0.813830354	3.093478963	10.9266638	47.46264597	0	1.406682962	0	0	2.122702134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.0431
H9663_802_0	2009	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																																																			0	Unlimited	304.5298033	0	37.60341739	5.701129096	6.724048512	8.951402622	0	7.912276611	40.89161438	13.93855348	56.81454799	0	3.100306112	11.78468177	41.6253859	180.8100799	0	5.358792237	0	0	8.086484319	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.074262624	0.074262624	0.211074881	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											22.6152	0	7.937136852	0	1.553255206	2.067774006	0	1.827735897	9.445962922	3.219805853	13.12416059	0	0.716170712	2.722261488	9.615464142	41.76712846	0	1.237881007	0	0	1.867977878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.7179			22.6152	0	7.937136852	0	1.553255206	2.067774006	0	1.827735897	9.445962922	3.219805853	13.12416059	0	0.716170712	2.722261488	9.615464142	41.76712846	0	1.237881007	0	0	1.867977878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	119.7179		Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											3.0839	0	1.0823	0	0.2118	0.282	0	0.2492	1.2881	0.4391	1.7897	0	0.0977	0.3712	1.3112	5.6955	0	0.1688	0	0	0.2547	0	0	0	0	0	0	0	0	0											16.3252		0	25.6991	0	9.019473696	0	1.765062734	2.349743188	0	2.07697261	10.73404877	3.658870288	14.91381885	0	0.813830354	3.093478963	10.9266638	47.46264597	0	1.406682962	0	0	2.122702134	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	136.0431
H9670_001_0	2009	6																					3100											A	A	D	V	T	O	O	V	V	P	P	P	P	P	P	P	P	P	P	P	S	P	T	P	P	P	P	P	P	P																																																			0		404.2709582	10.02709025	1396.441109		140.1469449	1395.865241	265.6504194	370.7014699	468.668613		1183.027111			228.3134624		8271.696091	302.4071782	383.540051			1115.479298	1038.360062					233.4443507														1A: $100/stay - $200 annual max	1B: $100/stay - $200 annual max	"2: $0/day days 1-15, $60/day days 16-50, $0/day days 51-100 - $2100 annual max"	6: $0	10A: $100; 10B: $0	11A: 20%	"11B: 20% prosthetics, $0 medical supplies; 11C: $0 training/ $15/45/37.50 for R30/R90/MO90"	4A: $50; 4B: $50	9A: $60 - $120 max; 9B: $60 - $120 max	"8A: $0 labs, $15 x-rays, $50 advanced imaging, $0 ther rad - $200 max"	"8A: $0 labs, $15 x-rays, $50 advanced imaging, $0 ther rad - $200 max; 8B: $0 labs, $15 x-rays, $50 advanced imaging, $0 ther rad - $200 max"		12: $0	3: $0; 5: $0; 7C: $15; 7I: $15; 9C: $25; 9D: $0	7A: $0; 14B: $0; 14C: $0; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0	7B: $25; 7D: $25; 7F: $25; 13B: n/a; 14B: $0; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0; 18A: $25; 7A: $0	7E: $25; 7H: $25	7C: $15; 7I: $15			15: $25/75/62.50 for R30/R90/MO	13A: $0; 16A: $0 n/c on routine exams; 16B: $25; 17A: $25 n/c on routine exams; 17B: $0; 18A: $25	10B: $0	16A: $0 n/c on routine exams; 16B: $25	17A: $25 n/c on routine exams	17B: $0	18A: $25	18B: $0	14A: $0	13B: n/a											86.34920635	86.34920635	20.1012119		100	19.6856161	31.07606003	50	57.21518987		29.9327449			15.00404281		24.95750043	25	15			27.5	25					25														76.92028922	76.92028922	17.90625645		89.080482	17.53604171	27.68270406	44.540241	50.96756692		26.66423343			13.36567366		22.2701205	22.2701205	13.3620723			24.49713255	22.2701205					22.2701205														2.5914	0.06427389	2.083752717	0	1.040363117	2.039829257	0.612826828	1.375927734	1.990574908	0	2.628709254	0	0	0.254296936	0	15.35097239	0.561220358	0.427074158	0	0	2.277170351	1.927033643	0	0	0	0	0.433236152	0	0	0	0	0	0	0	0	0	0	0	0	0	35.6586	0	4.3418	2.5914	0.06427389	2.083752717	0	1.040363117	2.039829257	0.612826828	1.375927734	1.990574908	0	2.628709254	0	0	0.254296936	0	15.35097239	0.561220358	0.427074158	0	0	2.277170351	1.927033643	0	0	0	0	0.433236152	0	0	0	0	0	0	0	0	0	0	0	0	0	35.6586		1A: 20%	1B: 20%	2: 20%	6: 20%	10A: 20%; 10B: $0	11A: 50%	11B: 50%; 11C: 20%	4A: $50; 4B: $50	9A: 20%; 9B: 20%	8A: 20%	8A: 20%; 8B: 20%		12: 20%	3: 20%; 5: 20%; 7C: 20%; 7I: 20%; 9C: 20%; 9D: $0	7A: 20%; 14B: $0; 14C: $0; 14D: 20%; 14E: 20%; 14F: 20%; 14G: 20%; 14H: 20%; 14I: 20%; 14J: 20%	7B: 20%; 7D: 20%; 7F: 20%; 13B: n/a; 14B: $0; 14D: 20%; 14E: 20%; 14F: 20%; 14G: 20%; 14H: 20%; 14I: 20%; 14J: 20%; 18A: 20%; 7A: 20%	7E: 20%; 7H: 20%	7C: 20%; 7I: 20%			15: 20%	13A: 20%; 16A: no routine exams; 16B: 20%; 17A: 50%; 17B: 50%; 18A: 20%	10B: $0	16A: no routine exams; 16B: 20%	17A: 50%	17B: 50%	18A: 20%	18B: 50%	14A: 50%	13B: n/a											9.9428	0.1747	1.5155	0.7543	0.2075	0.6869	0.6459	0.2733	1.3987	0.2664	0.5665	0	0.0067	0.3735	0.757	1.2993	0.0572	0.0761	0	0	0.6685	0.3854			0.0546	0.1141	0.0322	0.0505	0.2063												20.5139	500	0	12.5342	0.238985876	3.599229845	0.754291481	1.247853072	2.726712005	1.258715651	1.64924091	3.38922571	0.26638769	3.195190312	0	0.006717216	0.627792156	0.757025317	16.65029651	0.618459402	0.503124229	0	0	2.945719765	2.312473881	0	0	0.054607552	0.114148012	0.465451679	0.050484199	0.206256298	0	0	0	0	0	0	0	0	0	0	0	56.1726
H9670_002_0	2009	6																					3100											A	A	D	V	T	O	O	V	V	P	P	P	P	P	P	P	P	P	P	P	S	P	T	P	P	P	P	P	P	P																																																			0		431.2994395	8.336628252	859.3465326		178.921087	1853.980008	240.0072256	433.1786299	384.7528211		1198.566636			106.8669627		7038.743441	254.7294475	550.1342327			937.6872617	919.0394075					233.4443507														1A: $100/stay - $200 annual max	1B: $100/stay - $200 annual max	"2: $0/day days 1-15, $60/day days 16-50, $0/day days 51-100 - $2100 annual max"	6: $0	10A: $100; 10B: $0	11A: 20%	"11B: 20% prosthetics, $0 medical supplies; 11C: $0 training/ $15/45/37.50 for R30/R90/MO90"	4A: $50; 4B: $50	9A: $60 - $120 max; 9B: $60 - $120 max	"8A: $0 labs, $15 x-rays, $50 advanced imaging, $0 ther rad - $200 max"	"8A: $0 labs, $15 x-rays, $50 advanced imaging, $0 ther rad - $200 max; 8B: $0 labs, $15 x-rays, $50 advanced imaging, $0 ther rad - $200 max"		12: $0	3: $0; 5: $0; 7C: $15; 7I: $15; 9C: $25; 9D: $0	7A: $0; 14B: $0; 14C: $0; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0	7B: $25; 7D: $25; 7F: $25; 13B: n/a; 14B: $0; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0; 18A: $25; 7A: $0	7E: $25; 7H: $25	7C: $15; 7I: $15			15: $25/75/62.50 for R30/R90/MO	13A: $0; 16A: $0 n/c on routine exams; 16B: $25; 17A: $25 n/c on routine exams; 17B: $0; 18A: $25	10B: $0	16A: $0 n/c on routine exams; 16B: $25	17A: $25 n/c on routine exams	17B: $0	18A: $25	18B: $0	14A: $0	13B: n/a											86.34920635	86.34920635	20.1012119		100	17.48863966	28.27876435	50	57.21518987		29.06694371			15		25	25	15			27.5	25					25														78.1977525	78.1977525	18.20363683		90.5598972	15.8376941	25.60921993	45.2799486	51.81401713		26.32299434			13.58398458		22.6399743	22.6399743	13.58398458			24.90397173	22.6399743					22.6399743														2.8106	0.054325466	1.303602683	0	1.35025627	2.446897353	0.512199819	1.634525508	1.661299105	0	2.629155232	0	0	0.120973264	0	13.27974755	0.480589012	0.622751245	0	0	1.946011421	1.733919047	0	0	0	0	0.440431175	0	0	0	0	0	0	0	0	0	0	0	0	0	33.0272	0	3.4428	2.8106	0.054325466	1.303602683	0	1.35025627	2.446897353	0.512199819	1.634525508	1.661299105	0	2.629155232	0	0	0.120973264	0	13.27974755	0.480589012	0.622751245	0	0	1.946011421	1.733919047	0	0	0	0	0.440431175	0	0	0	0	0	0	0	0	0	0	0	0	0	33.0272		1A: 20%	1B: 20%	2: 20%	6: 20%	10A: 20%; 10B: $0	11A: 50%	11B: 50%; 11C: 20%	4A: $50; 4B: $50	9A: 20%; 9B: 20%	8A: 20%	8A: 20%; 8B: 20%		12: 20%	3: 20%; 5: 20%; 7C: 20%; 7I: 20%; 9C: 20%; 9D: $0	7A: 20%; 14B: $0; 14C: $0; 14D: 20%; 14E: 20%; 14F: 20%; 14G: 20%; 14H: 20%; 14I: 20%; 14J: 20%	7B: 20%; 7D: 20%; 7F: 20%; 13B: n/a; 14B: $0; 14D: 20%; 14E: 20%; 14F: 20%; 14G: 20%; 14H: 20%; 14I: 20%; 14J: 20%; 18A: 20%; 7A: 20%	7E: 20%; 7H: 20%	7C: 20%; 7I: 20%			15: 20%	13A: 20%; 16A: no routine exams; 16B: 20%; 17A: 50%; 17B: 50%; 18A: 20%	10B: $0	16A: no routine exams; 16B: 20%	17A: 50%	17B: 50%	18A: 20%	18B: 50%	14A: 50%	13B: n/a											10.1821	0.1389	0.8904	0.5739	0.285	0.8155	0.7096	0.3253	1.2716	0.256	0.5537	0	0.0023	0.2685	0.616	1.0617	0.0436	0.0964	0	0	0.413	0.3272			0.0549	0.1149	0.0327	0.0508	0.2075												19.2913	500	0	12.9927	0.193186666	2.19396957	0.573857206	1.635233077	3.262383154	1.221796736	1.959800939	2.932882585	0.255964374	3.18287824	0	0.00229214	0.389506575	0.616004596	14.34145926	0.524152358	0.719198337	0	0	2.359051627	2.061098556	0	0	0.054923579	0.114850681	0.473094851	0.050794968	0.207525965	0	0	0	0	0	0	0	0	0	0	0	52.3186
H9670_801_0	2009	4																					3100											A	A	D	V	T	O	O	V	V	P	P	P	P	P	P	P	P	P	P	P	S	P	T	P	P	P	P	P	P	P																																																			0		401.8278516	9.54578532	1275.572113		144.5461447	1452.471193	256.3058705	375.1899619	445.2801133		677.7275657			202.5532363	4575.010896	7870.390941	288.4748751	406.3483503			1063.742695	998.4255595		469.8	0.058663213		233.4443507														1A: $100/stay	1B: $100/stay	"2: $0/day days 1-20, $30/day days 21-100"	6: $0	10A: $75; 10B: $0	11A: 15%	"11B: 15% prosthetics, $0 medical supplies; 11C: $0 training/ $15/45 for R30/R90"	4A: $50; 4B: $50	9A: $100; 9B: $100		"8A: $0 labs, $0 x-rays, $30 advanced imaging, $0 ther rad; 8B: $0 labs, $0 x-rays, $30 advanced imaging, $0 ther rad"		12: $0	3: $0; 5: $0; 7C: $20; 7I: $20; 9C: $20; 9D: $0	7A: $10; 14B: $0; 14C: $10; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0	"7A: $30, 7B: $20; 7D: $20; 7F: $20; 13B: n/a; 14B: $0; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0; 18A: $20"	7E: $20; 7H: $20	"7I, 7C: $20"			15: $15/45 for R30/R90	"13A: $0; 16A: $0;  $25 bitewing x-ray,16B: 20% restorative; 17A: $20; 17B: $0; 18A: $20"	10B: $0	"16A: $0;  $25 bitewing x-ray,16B: 20% restorative"	17A: $20	17B: $0	18A: $20	18B: $0	14A: $0	13B: n/a											100	100	8.752481557		75	14.13615319	22.53562014	50	100		30			20	10	20	20	20			16.5	20		27.24137931	20		20														90.49592154	90.49592154	7.920638843		67.87194116	12.7926421	20.39381712	45.24796077	90.49592154		27.14877646			18.09918431	9.049592154	18.09918431	18.09918431	18.09918431			14.93182705	18.09918431		24.65233725	18.09918431		18.09918431														3.0303	0.071987887	0.841945502	0	0.817552285	1.54841201	0.435587921	1.414715056	3.35800285	0	1.533289515	0	0	0.30550403	3.450165226	11.87063802	0.435096661	0.61288114	0	0	1.323635163	1.505890685	0	0.965139003	8.85E-05	0	0.352096027	0	0	0	0	0	0	0	0	0	0	0	0	0	33.8729	0	3.5574	3.0303	0.071987887	0.841945502	0	0.817552285	1.54841201	0.435587921	1.414715056	3.35800285	0	1.533289515	0	0	0.30550403	3.450165226	11.87063802	0.435096661	0.61288114	0	0	1.323635163	1.505890685	0	0.965139003	8.85E-05	0	0.352096027	0	0	0	0	0	0	0	0	0	0	0	0	0	33.8729		1A: 20%	1B: 20%	2: 20%	6: 20%	10A: 20%; 10B: $0	11A: 50%	11B: 50%; 11C: 20%	4A: $50; 4B: $50	9A: 20%; 9B: 20%	8A: 20%	8A: 20%; 8B: 20%		12: 20%	3: 20%; 5: $0; 7C: 20%; 7I: 20%; 9C: 20%; 9D: 20%	7A: 20%; 14B: $0; 14C: 20%; 14D: 20%; 14E: 20%; 14F: 20%; 14G: 20%; 14H: 20%; 14I: 20%; 14J: 20%	7B: 20%; 7D: 20%; 7F: 20%; 13B: n/a; 14B: $0; 14D: 20%; 14E: 20%; 14F: 20%; 14G: 20%; 14H: 20%; 14I: 20%; 14J: 20%; 18A: 20%	7E: 20%; 7H: 20%	"7I, 7C: 20%"			15: 20%	"13A: 20%; 16A: $0 MC services, 50% routine services; 16B: 20%; 17A: 50% MC services, 50% routine services; 17B: 50%; 18A: 20%"	10B: $0	"16A:50% routine, 16B:20% Medicare, 50% Routine"	"17A: 50% MC services, 50% routine services"	17B: 50%	18A: 20%	18B: 50%	14A: 50%	13B: n/a											9.6861	0.1631	1.3597	0.6998	0.2149	0.6868	0.6357	0.2789	1.3342	0.2565	0.6443	0	0.0057	0.3468	0.7127	1.2096	0.0532	0.0773	0	0	0.6034	0.3626		0.2361	0.0548	0.1146	0.0325	0.0507	0.207												20.0272	500		12.7165	0.235136224	2.201695272	0.699806279	1.032468387	2.235250933	1.071334224	1.693614985	4.692247319	0.256545687	2.177542748	0	0.005736378	0.652305314	4.162825603	13.08022764	0.48825417	0.690172521	0	0	1.927063167	1.86849572	0	1.201205429	0.054891781	0.11456597	0.384577919	0.050669049	0.207011516	0	0	0	0	0	0	0	0	0	0	0	53.9001
H9670_802_0	2009	4																					3100											A	A	D	V	T	O	O	V	V	P	P	P	P	P	P	P	P	P	P	P	S	P	T	P	P	P	P	P	P	P																																																			0		401.8278516	9.54578532	1275.572113		144.5461447	1452.471193	256.3058705	375.1899619	445.2801133		677.7275657			202.5532363	4575.010896	7870.390941	288.4748751	406.3483503			1063.742695	998.4255595		469.8	0.058663213		233.4443507														1A: $100/stay	1B: $100/stay	"2: $0/day days 1-20, $30/day days 21-100"	6: $0	10A: $75; 10B: $0	11A: 15%	"11B: 15% prosthetics, $0 medical supplies; 11C: $0 training/ $15/45 for R30/R90"	4A: $50; 4B: $50	9A: $100; 9B: $100		"8A: $0 labs, $0 x-rays, $30 advanced imaging, $0 ther rad; 8B: $0 labs, $0 x-rays, $30 advanced imaging, $0 ther rad"		12: $0	3: $0; 5: $0; 7C: $20; 7I: $20; 9C: $20; 9D: $0	7A: $10; 14B: $0; 14C: $10; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0	"7A: $30, 7B: $20; 7D: $20; 7F: $20; 13B: n/a; 14B: $0; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0; 18A: $20"	7E: $20; 7H: $20	"7I, 7C: $20"			15: $15/45 for R30/R90	"13A: $0; 16A: $0;  $25 bitewing x-ray,16B: 20% restorative; 17A: $20; 17B: $0; 18A: $20"	10B: $0	"16A: $0;  $25 bitewing x-ray,16B: 20% restorative"	17A: $20	17B: $0	18A: $20	18B: $0	14A: $0	13B: n/a											100	100	8.752481557		75	14.13615319	22.53562014	50	100		30			20	10	20	20	20			16.5	20		27.24137931	20		20														90.49592154	90.49592154	7.920638843		67.87194116	12.7926421	20.39381712	45.24796077	90.49592154		27.14877646			18.09918431	9.049592154	18.09918431	18.09918431	18.09918431			14.93182705	18.09918431		24.65233725	18.09918431		18.09918431														3.0303	0.071987887	0.841945502	0	0.817552285	1.54841201	0.435587921	1.414715056	3.35800285	0	1.533289515	0	0	0.30550403	3.450165226	11.87063802	0.435096661	0.61288114	0	0	1.323635163	1.505890685	0	0.965139003	8.85E-05	0	0.352096027	0	0	0	0	0	0	0	0	0	0	0	0	0	33.8729	0	3.5574	3.0303	0.071987887	0.841945502	0	0.817552285	1.54841201	0.435587921	1.414715056	3.35800285	0	1.533289515	0	0	0.30550403	3.450165226	11.87063802	0.435096661	0.61288114	0	0	1.323635163	1.505890685	0	0.965139003	8.85E-05	0	0.352096027	0	0	0	0	0	0	0	0	0	0	0	0	0	33.8729		1A: 20%	1B: 20%	2: 20%	6: 20%	10A: 20%; 10B: $0	11A: 50%	11B: 50%; 11C: 20%	4A: $50; 4B: $50	9A: 20%; 9B: 20%	8A: 20%	8A: 20%; 8B: 20%		12: 20%	3: 20%; 5: $0; 7C: 20%; 7I: 20%; 9C: 20%; 9D: 20%	7A: 20%; 14B: $0; 14C: 20%; 14D: 20%; 14E: 20%; 14F: 20%; 14G: 20%; 14H: 20%; 14I: 20%; 14J: 20%	7B: 20%; 7D: 20%; 7F: 20%; 13B: n/a; 14B: $0; 14D: 20%; 14E: 20%; 14F: 20%; 14G: 20%; 14H: 20%; 14I: 20%; 14J: 20%; 18A: 20%	7E: 20%; 7H: 20%	"7I, 7C: 20%"			15: 20%	"13A: 20%; 16A: $0 MC services, 50% routine services; 16B: 20%; 17A: 50% MC services, 50% routine services; 17B: 50%; 18A: 20%"	10B: $0	"16A:50% routine, 16B:20% Medicare, 50% Routine"	"17A: 50% MC services, 50% routine services"	17B: 50%	18A: 20%	18B: 50%	14A: 50%	13B: n/a											9.6861	0.1631	1.3597	0.6998	0.2149	0.6868	0.6357	0.2789	1.3342	0.2565	0.6443	0	0.0057	0.3468	0.7127	1.2096	0.0532	0.0773	0	0	0.6034	0.3626		0.2361	0.0548	0.1146	0.0325	0.0507	0.207												20.0272	500		12.7165	0.235136224	2.201695272	0.699806279	1.032468387	2.235250933	1.071334224	1.693614985	4.692247319	0.256545687	2.177542748	0	0.005736378	0.652305314	4.162825603	13.08022764	0.48825417	0.690172521	0	0	1.927063167	1.86849572	0	1.201205429	0.054891781	0.11456597	0.384577919	0.050669049	0.207011516	0	0	0	0	0	0	0	0	0	0	0	53.9001
H9670_803_0	2009	4																					3100											A	A	D	V	T	O	O	V	V	P	P	P	P	P	P	P	P	P	P	P	S	P	T	P	P	P	P	P	P	P																																																			0		401.8278516	9.54578532	1275.572113		144.5461447	1452.471193	256.3058705	375.1899619	445.2801133		677.7275657			202.5532363	4575.010896	7870.390941	288.4748751	406.3483503			1063.742695	998.4255595		469.8	0.058663213		233.4443507														1A: $100/stay	1B: $100/stay	"2: $0/day days 1-20, $30/day days 21-100"	6: $0	10A: $75; 10B: $0	11A: 15%	"11B: 15% prosthetics, $0 medical supplies; 11C: $0 training/ $15/45 for R30/R90"	4A: $50; 4B: $50	9A: $100; 9B: $100		"8A: $0 labs, $0 x-rays, $30 advanced imaging, $0 ther rad; 8B: $0 labs, $0 x-rays, $30 advanced imaging, $0 ther rad"		12: $0	3: $0; 5: $0; 7C: $20; 7I: $20; 9C: $20; 9D: $0	7A: $10; 14B: $0; 14C: $10; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0	"7A: $30, 7B: $20; 7D: $20; 7F: $20; 13B: n/a; 14B: $0; 14D: $0; 14E: $0; 14F: $0; 14G: $0; 14H: $0; 14I: $0; 14J: $0; 18A: $20"	7E: $20; 7H: $20	"7I, 7C: $20"			15: $15/45 for R30/R90	"13A: $0; 16A: $0;  $25 bitewing x-ray,16B: 20% restorative; 17A: $20; 17B: $0; 18A: $20"	10B: $0	"16A: $0;  $25 bitewing x-ray,16B: 20% restorative"	17A: $20	17B: $0	18A: $20	18B: $0	14A: $0	13B: n/a											100	100	8.752481557		75	14.13615319	22.53562014	50	100		30			20	10	20	20	20			16.5	20		27.24137931	20		20														90.49592154	90.49592154	7.920638843		67.87194116	12.7926421	20.39381712	45.24796077	90.49592154		27.14877646			18.09918431	9.049592154	18.09918431	18.09918431	18.09918431			14.93182705	18.09918431		24.65233725	18.09918431		18.09918431														3.0303	0.071987887	0.841945502	0	0.817552285	1.54841201	0.435587921	1.414715056	3.35800285	0	1.533289515	0	0	0.30550403	3.450165226	11.87063802	0.435096661	0.61288114	0	0	1.323635163	1.505890685	0	0.965139003	8.85E-05	0	0.352096027	0	0	0	0	0	0	0	0	0	0	0	0	0	33.8729	0	3.5574	3.0303	0.071987887	0.841945502	0	0.817552285	1.54841201	0.435587921	1.414715056	3.35800285	0	1.533289515	0	0	0.30550403	3.450165226	11.87063802	0.435096661	0.61288114	0	0	1.323635163	1.505890685	0	0.965139003	8.85E-05	0	0.352096027	0	0	0	0	0	0	0	0	0	0	0	0	0	33.8729		1A: 20%	1B: 20%	2: 20%	6: 20%	10A: 20%; 10B: $0	11A: 50%	11B: 50%; 11C: 20%	4A: $50; 4B: $50	9A: 20%; 9B: 20%	8A: 20%	8A: 20%; 8B: 20%		12: 20%	3: 20%; 5: $0; 7C: 20%; 7I: 20%; 9C: 20%; 9D: 20%	7A: 20%; 14B: $0; 14C: 20%; 14D: 20%; 14E: 20%; 14F: 20%; 14G: 20%; 14H: 20%; 14I: 20%; 14J: 20%	7B: 20%; 7D: 20%; 7F: 20%; 13B: n/a; 14B: $0; 14D: 20%; 14E: 20%; 14F: 20%; 14G: 20%; 14H: 20%; 14I: 20%; 14J: 20%; 18A: 20%	7E: 20%; 7H: 20%	"7I, 7C: 20%"			15: 20%	"13A: 20%; 16A: $0 MC services, 50% routine services; 16B: 20%; 17A: 50% MC services, 50% routine services; 17B: 50%; 18A: 20%"	10B: $0	"16A:50% routine, 16B:20% Medicare, 50% Routine"	"17A: 50% MC services, 50% routine services"	17B: 50%	18A: 20%	18B: 50%	14A: 50%	13B: n/a											9.6861	0.1631	1.3597	0.6998	0.2149	0.6868	0.6357	0.2789	1.3342	0.2565	0.6443	0	0.0057	0.3468	0.7127	1.2096	0.0532	0.0773	0	0	0.6034	0.3626		0.2361	0.0548	0.1146	0.0325	0.0507	0.207												20.0272	500		12.7165	0.235136224	2.201695272	0.699806279	1.032468387	2.235250933	1.071334224	1.693614985	4.692247319	0.256545687	2.177542748	0	0.005736378	0.652305314	4.162825603	13.08022764	0.48825417	0.690172521	0	0	1.927063167	1.86849572	0	1.201205429	0.054891781	0.11456597	0.384577919	0.050669049	0.207011516	0	0	0	0	0	0	0	0	0	0	0	53.9001
H9720_008_0	2009	9	X1	X2		X4	X5		X7				OP Facility - Other	OP Facility - Other		OP Facility - Other	OP Facility - Other		Professional				3350	Non-facility lab	Diabetic supplies		Ambulatory surgical center	MRI/PET/CAT		Podiatry				D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	V	V	V	V	V	V	V	V	Coin	O	T	P	V	V	V	V	O	O	V	Coin		V	Coin		V																																												0		1942.427129	120.7076977	942.1730921	2100.803652	385.7012993	22.35625673	2.331016958	347.1605057	265.1830228	2552.809907	12.12834153	69.92150805	0	2425.730939	4724.651472	4972.680762	809.7947414	1619.666786	4555.791443	5623.599932	18.23447227	0	0	0	0	0	0	0	0	0	6272.984186	4.844920626		2.863358256	7.976866264		419.7736158				$350 for 1st 7 days	$300 for 1st 7 days	$100 for days 10-100	$25 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$250 Copay	$15 Copay	20% Coinsurance	$350 Copay	$25 Copay	$15 Copay	$15 per Visit	$30 per Visit	$30 per Visit	$30 per Visit	$30 per Visit	$30 per Visit	20% Coinsurance			$0 per Procedure	$0 - 1 / Year ($3.85 Cap)	$0 - up to $100 ($3.85 Cap)	$0 (1 / 3 Years)	"$1,000 allowable/hearing aid"			$0 / 1 per year	20% Coinsurance		$100 Copay	20% Coinsurance		$30 Copay				262.9246013	157.6419886	40.74391478	25	100	0.3	0.3	32.05	250	15	0.2	350	25	15	15	30	30	30	30	30	0.2	0	0	0	0	0	0	0	0	0	15	0.2		100	0.2		30				182.6122889	109.4890483	28.29837717	17.3635605	69.45424201	0.208362726	0.208362726	22.26008456	173.635605	10.4181363	0.138908484	243.089847	17.3635605	10.4181363	10.4181363	20.8362726	20.8362726	20.8362726	20.8362726	20.8362726	0.138908484	0	0	0	0	0	0	0	0	0	10.4181363	0.138908484		69.45424201	0.138908484		20.8362726				29.5593	1.101347578	2.221830794	3.039785943	2.232382616	4.658210595	0.485697048	0.643985184	3.837101217	2.216293464	1.684729536	1.416434058	0	2.105966296	4.101838585	8.634344327	1.406091999	2.812318223	7.910476036	9.764571766	2.5329229	0	0	0	0	0	0	0	0	0	5.446067023	0.673000579	0	0.016572698	1.1080544	0	0.728876458	0	0	0	100.3382		44.1284	29.5593	1.101347578	2.221830794	3.039785943	2.232382616	4.658210595	0.485697048	0.643985184	3.837101217	2.216293464	1.684729536	1.416434058	0	2.105966296	4.101838585	8.634344327	1.406091999	2.812318223	7.910476036	9.764571766	2.5329229	0	0	0	0	0	0	0	0	0	5.446067023	0.673000579	0	0.016572698	1.1080544	0	0.728876458	0	0	0	100.3382																																																																																		0			29.5593	1.101347578	2.221830794	3.039785943	2.232382616	4.658210595	0.485697048	0.643985184	3.837101217	2.216293464	1.684729536	1.416434058	0	2.105966296	4.101838585	8.634344327	1.406091999	2.812318223	7.910476036	9.764571766	2.5329229	0	0	0	0	0	0	0	0	0	5.446067023	0.673000579	0	0.016572698	1.1080544	0	0.728876458	0	0	0	100.3382
H9720_009_0	2009	11	X1	X2		X4	X5		X7	X8			OP Facility - Other	OP Facility - Other		OP Facility - Other	OP Facility - Other		Professional	Other Non-Covered			3350	Non-facility lab	Diabetic supplies		Ambulatory surgical center	MRI/PET/CAT		Podiatry	Gym Membership			D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	V	V	V	V	V	V	V	V	Coin	O	T								V	Coin		V	Coin		V																																												0		1942.427129	120.7076977	942.1730921	2100.803652	385.7012993	22.35625673	2.331016958	347.1605057	265.1830228	2552.809907	12.12834153	69.92150805	0	2425.730939	4724.651472	4972.680762	809.7947414	1619.666786	4555.791443	5623.599932	18.23447227	0	0								6272.984186	4.844920626		2.863358256	7.976866264		419.7736158	12000			$350 for 1st 7 days	$300 for 1st 7 days	$100 for days 10-100	$25 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$250 Copay	$15 Copay	20% Coinsurance	$350 Copay	$25 Copay	$15 Copay	$15 per Visit	$30 per Visit	$30 per Visit	$30 per Visit	$30 per Visit	$30 per Visit	20% Coinsurance													$100 Copay	20% Coinsurance		$30 Copay	$0 Copay			262.9246013	157.6419886	40.74391478	25	100	0.3	0.3	32.05	250	15	0.2	350	25	15	15	30	30	30	30	30	0.2	0	0	0	0	0	0	0	0	0	15	0.2		100	0.2		30	0			182.6122889	109.4890483	28.29837717	17.3635605	69.45424201	0.208362726	0.208362726	22.26008456	173.635605	10.4181363	0.138908484	243.089847	17.3635605	10.4181363	10.4181363	20.8362726	20.8362726	20.8362726	20.8362726	20.8362726	0.138908484	0	0	0	0	0	0	0	0	0	10.4181363	0.138908484		69.45424201	0.138908484		20.8362726	0			29.5593	1.101347578	2.221830794	3.039785943	2.232382616	4.658210595	0.485697048	0.643985184	3.837101217	2.216293464	1.684729536	1.416434058	0	2.105966296	4.101838585	8.634344327	1.406091999	2.812318223	7.910476036	9.764571766	2.5329229	0	0	0	0	0	0	0	0	0	5.446067023	0.673000579	0	0.016572698	1.1080544	0	0.728876458	0	0	0	100.3382		44.1284	29.5593	1.101347578	2.221830794	3.039785943	2.232382616	4.658210595	0.485697048	0.643985184	3.837101217	2.216293464	1.684729536	1.416434058	0	2.105966296	4.101838585	8.634344327	1.406091999	2.812318223	7.910476036	9.764571766	2.5329229	0	0	0	0	0	0	0	0	0	5.446067023	0.673000579	0	0.016572698	1.1080544	0	0.728876458	0	0	0	100.3382																																																																																		0			29.5593	1.101347578	2.221830794	3.039785943	2.232382616	4.658210595	0.485697048	0.643985184	3.837101217	2.216293464	1.684729536	1.416434058	0	2.105966296	4.101838585	8.634344327	1.406091999	2.812318223	7.910476036	9.764571766	2.5329229	0	0	0	0	0	0	0	0	0	5.446067023	0.673000579	0	0.016572698	1.1080544	0	0.728876458	0	0	0	100.3382
H9720_010_0	2009	8	X1	X2		X4	X5		X7				OP Facility - Other	OP Facility - Other		OP Facility - Other	OP Facility - Other		Professional				3350	Non-facility lab	Diabetic supplies		Ambulatory surgical center	MRI/PET/CAT		Podiatry				D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	V	V	V	V	V	V	V	V	Coin	Coin	T	P	V	V	V	V	O	O	V	Coin		V	Coin		V																																												0		2217.969555	137.8306525	1075.824778	2398.812533	440.4148431	25.52759691	2.661682679	396.4068566	302.8004821	1482.370701	13.84880383	79.84020289	0	2769.832285	5394.86551	5678.078921	924.667935	1849.424139	5202.051891	6421.334037	20.82111795	0	0	0	0	0	0	0	0	0	7162.836503	5.532195409		3.269539095	9.108422269		479.320478				$150 for 1st 7 days	$150 for 1st 7 days	$100 for days 10-100	$0 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$150 Copay	$15 Copay	20% Coinsurance	$150 Copay	$25 Copay	$15 Copay	$10 per Visit	$25 per Visit	$25 per Visit	$30 per Visit	$25 per Visit	$25 per Visit	20% Coinsurance			$0 per Procedure	$0 - 1 / Year ($3.85 Cap)	$0 - up to $100 ($3.85 Cap)	$0 (1 / 3 Years)	"$1,000 allowable/hearing aid"			$15 Copay	20% Coinsurance		$75 Copay	20% Coinsurance		$25 Copay				112.681972	78.82099431	40.74391478	0	100	0.3	0.3	0.56	150	15	0.2	150	25	15	10	25	25	30	25	25	0.2	0	0	0	0	0	0	0	0	0	15	0.2		75	0.2		25				83.4881275	58.39991178	30.18790932	0	74.09182324	0.22227547	0.22227547	0.41491421	111.1377349	11.11377349	0.148183646	111.1377349	18.52295581	11.11377349	7.409182324	18.52295581	18.52295581	22.22754697	18.52295581	18.52295581	0.148183646	0	0	0	0	0	0	0	0	0	11.11377349	0.148183646		55.56886743	0.148183646		18.52295581				15.4312	0.670774829	2.706408402	0	2.719261559	5.674158595	0.591626768	0.013706236	2.804379975	1.372894349	2.052166251	0.739438275	0	2.56527405	3.330961848	8.764567079	1.427298608	3.425680159	8.029781442	9.911840552	3.085349181	0	0	0	0	0	0	0	0	0	6.633845201	0.819780889	0	0.015140382	1.349719226	0	0.739869336	0	0	0	84.8751		29.6788	15.4312	0.670774829	2.706408402	0	2.719261559	5.674158595	0.591626768	0.013706236	2.804379975	1.372894349	2.052166251	0.739438275	0	2.56527405	3.330961848	8.764567079	1.427298608	3.425680159	8.029781442	9.911840552	3.085349181	0	0	0	0	0	0	0	0	0	6.633845201	0.819780889	0	0.015140382	1.349719226	0	0.739869336	0	0	0	84.8751																																																																																		0			15.4312	0.670774829	2.706408402	0	2.719261559	5.674158595	0.591626768	0.013706236	2.804379975	1.372894349	2.052166251	0.739438275	0	2.56527405	3.330961848	8.764567079	1.427298608	3.425680159	8.029781442	9.911840552	3.085349181	0	0	0	0	0	0	0	0	0	6.633845201	0.819780889	0	0.015140382	1.349719226	0	0.739869336	0	0	0	84.8751
H9720_011_0	2009	9	X1	X2		X4	X5		X7				OP Facility - Other	OP Facility - Other		OP Facility - Other	OP Facility - Other		Professional				3350	Non-facility lab	Diabetic supplies		Ambulatory surgical center	MRI/PET/CAT		Podiatry				D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	V	V	V	V	V	V	V	V	Coin	Coin	T								V	Coin		V	Coin		V																																												0		2217.969555	137.8306525	1075.824778	2398.812533	440.4148431	25.52759691	2.661682679	396.4068566	302.8004821	1482.370701	13.84880383	79.84020289	0	2769.832285	5394.86551	5678.078921	924.667935	1849.424139	5202.051891	6421.334037	20.82111795	0	0								7162.836503	5.532195409		3.269539095	9.108422269		479.320478				$150 for 1st 7 days	$150 for 1st 7 days	$100 for days 10-100	$0 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$150 Copay	$15 Copay	20% Coinsurance	$150 Copay	$25 Copay	$15 Copay	$10 per Visit	$25 per Visit	$25 per Visit	$30 per Visit	$25 per Visit	$25 per Visit	20% Coinsurance										$15 Copay	20% Coinsurance		$75 Copay	20% Coinsurance		$25 Copay				112.681972	78.82099431	40.74391478	0	100	0.3	0.3	0.56	150	15	0.2	150	25	15	10	25	25	30	25	25	0.2	0	0								15	0.2		75	0.2		25				83.4881275	58.39991178	30.18790932	0	74.09182324	0.22227547	0.22227547	0.41491421	111.1377349	11.11377349	0.148183646	111.1377349	18.52295581	11.11377349	7.409182324	18.52295581	18.52295581	22.22754697	18.52295581	18.52295581	0.148183646	0	0								11.11377349	0.148183646		55.56886743	0.148183646		18.52295581				15.4312	0.670774829	2.706408402	0	2.719261559	5.674158595	0.591626768	0.013706236	2.804379975	1.372894349	2.052166251	0.739438275	0	2.56527405	3.330961848	8.764567079	1.427298608	3.425680159	8.029781442	9.911840552	3.085349181	0	0	0	0	0	0	0	0	0	6.633845201	0.819780889	0	0.015140382	1.349719226	0	0.739869336	0	0	0	84.8751		29.6788	15.4312	0.670774829	2.706408402	0	2.719261559	5.674158595	0.591626768	0.013706236	2.804379975	1.372894349	2.052166251	0.739438275	0	2.56527405	3.330961848	8.764567079	1.427298608	3.425680159	8.029781442	9.911840552	3.085349181	0	0	0	0	0	0	0	0	0	6.633845201	0.819780889	0	0.015140382	1.349719226	0	0.739869336	0	0	0	84.8751																																																																																		0			15.4312	0.670774829	2.706408402	0	2.719261559	5.674158595	0.591626768	0.013706236	2.804379975	1.372894349	2.052166251	0.739438275	0	2.56527405	3.330961848	8.764567079	1.427298608	3.425680159	8.029781442	9.911840552	3.085349181	0	0	0	0	0	0	0	0	0	6.633845201	0.819780889	0	0.015140382	1.349719226	0	0.739869336	0	0	0	84.8751
H9720_024_0	2009	5																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin																																																											0		276.9615286	13.10432792	70.06445987	19.02535464	8.897748893	23.58462248	7.570219869	7.202531832	19.69198158	15.51915724	12.79473392	0.824788784	0	27.83111141	24.58983478	24.90994003	2.640137171	4.184174548	25.41211006	107.2620191	19.23636635	0																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																			0.077682476	0.077682476	0.204823935	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.077682476	0.077682476	0.204823935	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											21.5151	1.017976636	14.35087841	0	2.055379994	5.448047793	1.74872079	1.663784853	4.548847746	3.584925322	2.955583536	0.190526209	0	6.428986735	5.680251834	5.754196146	0.609871686	0.96654432	5.870197424	24.7775264	4.443600628	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.6109			21.5151	1.017976636	14.35087841	0	2.055379994	5.448047793	1.74872079	1.663784853	4.548847746	3.584925322	2.955583536	0.190526209	0	6.428986735	5.680251834	5.754196146	0.609871686	0.96654432	5.870197424	24.7775264	4.443600628	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.6109	0																																																																																	0			21.5151	1.017976636	14.35087841	0	2.055379994	5.448047793	1.74872079	1.663784853	4.548847746	3.584925322	2.955583536	0.190526209	0	6.428986735	5.680251834	5.754196146	0.609871686	0.96654432	5.870197424	24.7775264	4.443600628	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.6109
H9720_025_0	2009	8	X1	X2	X3	X4	X5	X6	X7	X8			OP Facility - Other	OP Facility - Other	Professional	OP Facility - Other	OP Facility - Other	Professional	Professional	Other Non-Covered			3350	Non-facility lab	Diabetic supplies	Biannual Physical	Ambulatory surgical center	MRI/PET/CAT	Chiropractic	Podiatry	Gym Membership			D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	V	V	V	V	V	V	V	V	Coin	O	T	P	V	V	V	V	O	O	V	Coin	V	V	Coin	V	V	V																																											0		2258.126309	101.618428	811.3385753	3391.072206	757.3652061	27.10946368	1.756790119	405.6700987	561.2997123	1419.813352	12.76890863	58.65527792	0	3374.729388	4635.242447	5128.301748	581.871534	1564.030789	5046.919568	4290.5887	33.59677056	0	0	0	0	0	0	0	0	0	6384.129814	5.903051745	711.1472413	4.495097785	10.07403128	0	374.6427501	12000			$250 for 1st 7 days	$250 for 1st 7 days	$100 for days 10-100	$0 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$100 Copay	$15 Copay	20% Coinsurance	$250 Copay	$25 Copay	$35 Copay	$10 per Visit	$35 per Visit	$35 per Visit	$30 per Visit	$35 per Visit	$22.75 per Visit	20% Coinsurance			$0 per Procedure	$0 - 1 / Year ($3.85 Cap)	$0 - up to $100 ($3.85 Cap)	$0 (1 / 3 Years)	"$1,000 allowable/hearing aid"			$15 Copay	20% Coinsurance	$0 Copay	$75 Copay	20% Coinsurance	$35 Copay	$35 Copay	$0 Copay			187.8032866	131.3683238	40.74391478	0	100	0.3	0.25	30.7	112.5	15	0.2	250	25	28.33333333	9	22.75	35	30	35	22.75	0.2	0	0	0	0	0	0	0	0	0	15	0.2	0	75	0.2	35	35	0			133.5802291	93.43931681	28.98022483	0	71.1277377	0.213383213	0.177819344	21.83621548	80.01870492	10.66916066	0.142255475	177.8193443	17.78193443	20.15285902	6.401496393	16.18156033	24.8947082	21.33832131	24.8947082	16.18156033	0.142255475	0	0	0	0	0	0	0	0	0	10.66916066	0.142255475	0	53.34580328	0.142255475	24.8947082	24.8947082	0			25.1368	0.791263041	1.959397861	0	4.489139477	5.784704465	0.312391267	0.738191641	3.742873004	1.262351396	1.816447168	0.869170255	0	5.667537132	2.472707317	6.915327009	1.207126837	2.781149293	10.47013249	5.785701657	4.779324568	0	0	0	0	0	0	0	0	0	5.676108886	0.839741432	0	0.019982884	1.433086109	0	0.777218495	0	0	0	95.7278		38.858	25.1368	0.791263041	1.959397861	0	4.489139477	5.784704465	0.312391267	0.738191641	3.742873004	1.262351396	1.816447168	0.869170255	0	5.667537132	2.472707317	6.915327009	1.207126837	2.781149293	10.47013249	5.785701657	4.779324568	0	0	0	0	0	0	0	0	0	5.676108886	0.839741432	0	0.019982884	1.433086109	0	0.777218495	0	0	0	95.7278																																																																																		0			25.1368	0.791263041	1.959397861	0	4.489139477	5.784704465	0.312391267	0.738191641	3.742873004	1.262351396	1.816447168	0.869170255	0	5.667537132	2.472707317	6.915327009	1.207126837	2.781149293	10.47013249	5.785701657	4.779324568	0	0	0	0	0	0	0	0	0	5.676108886	0.839741432	0	0.019982884	1.433086109	0	0.777218495	0	0	0	95.7278
H9720_026_0	2009	11	X1	X2	X3	X4	X5	X6	X7	X8			OP Facility - Other	OP Facility - Other	Professional	OP Facility - Other	OP Facility - Other	Professional	Professional	Other Non-Covered			3350	Non-facility lab	Diabetic supplies	Biannual Physical	Ambulatory surgical center	MRI/PET/CAT	Chiropractic	Podiatry	Gym Membership			D	D	D	V	T	Coin	Coin	V	V	V	Coin	V	V	V	V	V	V	V	V	V	Coin	O	T								V	Coin	V	V	Coin	V	V	V																																											0		2258.126309	101.618428	811.3385753	3391.072206	757.3652061	27.10946368	1.756790119	405.6700987	561.2997123	1419.813352	12.76890863	58.65527792	0	3374.729388	4635.242447	5128.301748	581.871534	1564.030789	5046.919568	4290.5887	33.59677056	0	0								6384.129814	5.903051745	711.1472413	4.495097785	10.07403128	0	374.6427501	12000			$250 for 1st 7 days	$250 for 1st 7 days	$100 for days 10-100	$0 Copay	$100 Copay	30% Coinsurance	30% Coinsurance	$50 Copay	$100 Copay	$15 Copay	20% Coinsurance	$250 Copay	$25 Copay	$35 Copay	$10 per Visit	$35 per Visit	$35 per Visit	$30 per Visit	$35 per Visit	$22.75 per Visit	20% Coinsurance										$15 Copay	20% Coinsurance	$0 Copay	$75 Copay	20% Coinsurance	$35 Copay	$35 Copay	$0 Copay			187.8032866	131.3683238	40.74391478	0	100	0.3	0.25	30.7	112.5	15	0.2	250	25	28.33333333	9	22.75	35	30	35	22.75	0.2	0	0								15	0.2	0	75	0.2	35	35	0			133.5802291	93.43931681	28.98022483	0	71.1277377	0.213383213	0.177819344	21.83621548	80.01870492	10.66916066	0.142255475	177.8193443	17.78193443	20.15285902	6.401496393	16.18156033	24.8947082	21.33832131	24.8947082	16.18156033	0.142255475	0	0								10.66916066	0.142255475	0	53.34580328	0.142255475	24.8947082	24.8947082	0			25.1368	0.791263041	1.959397861	0	4.489139477	5.784704465	0.312391267	0.738191641	3.742873004	1.262351396	1.816447168	0.869170255	0	5.667537132	2.472707317	6.915327009	1.207126837	2.781149293	10.47013249	5.785701657	4.779324568	0	0	0	0	0	0	0	0	0	5.676108886	0.839741432	0	0.019982884	1.433086109	0	0.777218495	0	0	0	95.7278		38.858	25.1368	0.791263041	1.959397861	0	4.489139477	5.784704465	0.312391267	0.738191641	3.742873004	1.262351396	1.816447168	0.869170255	0	5.667537132	2.472707317	6.915327009	1.207126837	2.781149293	10.47013249	5.785701657	4.779324568	0	0	0	0	0	0	0	0	0	5.676108886	0.839741432	0	0.019982884	1.433086109	0	0.777218495	0	0	0	95.7278																																																																																		0			25.1368	0.791263041	1.959397861	0	4.489139477	5.784704465	0.312391267	0.738191641	3.742873004	1.262351396	1.816447168	0.869170255	0	5.667537132	2.472707317	6.915327009	1.207126837	2.781149293	10.47013249	5.785701657	4.779324568	0	0	0	0	0	0	0	0	0	5.676108886	0.839741432	0	0.019982884	1.433086109	0	0.777218495	0	0	0	95.7278
H9720_027_0	2009	5																																Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	Coin	O																																																											0		304.995746	9.807518728	53.7150086	28.80350955	11.14261993	26.82327729	7.578979238	6.966822686	19.22036428	11.98427776	12.63411114	0.399024151	0	31.83301844	23.98506013	23.07587107	2.557902057	3.968053107	16.39000754	113.893828	33.24209964	0																			Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.077669215	0.077669215	0.206136615	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.077669215	0.077669215	0.206136615	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											23.6888	0.761742278	11.07263003	0	2.573945204	6.196177055	1.750744204	1.60933604	4.439904149	2.768368164	2.918479673	0.092174579	0	7.353427259	5.540548891	5.330526218	0.590875375	0.916620268	3.786091742	26.30947427	7.678925017	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.3788			23.6888	0.761742278	11.07263003	0	2.573945204	6.196177055	1.750744204	1.60933604	4.439904149	2.768368164	2.918479673	0.092174579	0	7.353427259	5.540548891	5.330526218	0.590875375	0.916620268	3.786091742	26.30947427	7.678925017	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.3788																																																																																		0			23.6888	0.761742278	11.07263003	0	2.573945204	6.196177055	1.750744204	1.60933604	4.439904149	2.768368164	2.918479673	0.092174579	0	7.353427259	5.540548891	5.330526218	0.590875375	0.916620268	3.786091742	26.30947427	7.678925017	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.3788
H9793_001_0	2009	9																					5000											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		912.0907066	0	912.2173911	0	198.2329282	16.7368717	0.879479128	284.9997996	73.15465561	2815.491398	1020.860515	0	0	440.459881	3676.289302	5243.675982	114.2378374	534.5574607	979.6329529	2312.094269	1137.679288	0	0	0	320.2101118	0	142.984469	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											150	0	50	0	50	0.2	0.2	50	100	23	34	0	0	25	25	25	25	25	34	23	2.1	0	0	0	25	0	25	0	0	0											143.4417395	0	47.80298274	0	47.80298274	0.191211931	0.191211931	47.81391317	95.60596548	21.98937206	32.50602826	0	0	23.90149137	23.91217263	23.90149137	23.90149137	23.90149137	32.50602826	21.98937206	2.007725275	0	0	0	25	0	25	0	0	0											10.9027	0	3.633892684	0	0.789677104	3.200289557	0.168166902	1.135579639	0.582835123	5.159240658	2.765343396	0	0	0.877304004	7.325672037	10.44430635	0.22753789	1.064726711	2.653664704	4.23679176	0.190345622	0	0	0	0.6671044	0	0.297884311	0	0	0	0	0	0	0	0	0	0	0	0	0	56.323	0	2.5379	10.9027	0	3.633892684	0	0.789677104	3.200289557	0.168166902	1.135579639	0.582835123	5.159240658	2.765343396	0	0	0.877304004	7.325672037	10.44430635	0.22753789	1.064726711	2.653664704	4.23679176	0.190345622	0	0	0	0.6671044	0	0.297884311	0	0	0	0	0	0	0	0	0	0	0	0	0	56.323																																																																																		0	0	0	10.9027	0	3.633892684	0	0.789677104	3.200289557	0.168166902	1.135579639	0.582835123	5.159240658	2.765343396	0	0	0.877304004	7.325672037	10.44430635	0.22753789	1.064726711	2.653664704	4.23679176	0.190345622	0	0	0	0.6671044	0	0.297884311	0	0	0	0	0	0	0	0	0	0	0	0	0	56.323
H9793_002_0	2009	4																					4000											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		913.9333141	0	923.6201085	0	198.2329282	16.7368717	0.879479128	284.9997996	73.52789365	2872.818091	1036.201605	0	0	440.7200334	3759.841331	5355.492819	116.8341519	546.7064939	994.3544913	2359.171208	1146.038519	0	0	0	309.0068598	0	146.2341161	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											125	0	35	0	50	0.2	0.2	50	75	19	30	0	0	20	20	20	20	20	30	19	2.1	0	0	0	20	0	20	0	0	0											118.9992461	0	33.31138785	0	47.58769693	0.190350788	0.190350788	47.59969844	71.3815454	18.08332483	28.55261816	0	0	19.03507877	19.04446111	19.03507877	19.03507877	19.03507877	28.55261816	18.08332483	1.998683271	0	0	0	20	0	20	0	0	0											9.0631	0	2.563922305	0	0.786120709	3.185876713	0.167409545	1.130492043	0.43737789	4.329175227	2.465522397	0	0	0.699095046	5.967012668	8.495185639	0.18532894	0.867216765	2.365952009	3.555138274	0.190880668	0	0	0	0.515011433	0	0.243723527	0	0	0	0	0	0	0	0	0	0	0	0	0	47.2136	0	2.3491	9.0631	0	2.563922305	0	0.786120709	3.185876713	0.167409545	1.130492043	0.43737789	4.329175227	2.465522397	0	0	0.699095046	5.967012668	8.495185639	0.18532894	0.867216765	2.365952009	3.555138274	0.190880668	0	0	0	0.515011433	0	0.243723527	0	0	0	0	0	0	0	0	0	0	0	0	0	47.2136																																																																																		0	0	0	9.0631	0	2.563922305	0	0.786120709	3.185876713	0.167409545	1.130492043	0.43737789	4.329175227	2.465522397	0	0	0.699095046	5.967012668	8.495185639	0.18532894	0.867216765	2.365952009	3.555138274	0.190880668	0	0	0	0.515011433	0	0.243723527	0	0	0	0	0	0	0	0	0	0	0	0	0	47.2136
H9793_003_0	2009	9																					3000											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		915.7759216	0	931.2219201	0	199.2341046	16.7368717	0.879479128	284.9997996	73.90113169	2942.89561	1061.096975	0	0	440.9801858	3885.169376	5525.476642	120.7286236	564.9300437	1018.244459	2416.719183	1154.397751	0	0	0	298.5610478	0	151.1085866	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											100	0	25	0	25	0.2	0.2	50	50	15	25	0	0	15	15	15	15	15	25	15	2.1	0	0	0	15	0	15	0	0	0											94.6311418	0	23.65107438	0	23.65107438	0.189208595	0.189208595	47.3155709	47.30214875	14.19064463	23.65107438	0	0	14.19064463	14.19851433	14.19064463	14.19064463	14.19064463	23.65107438	14.19064463	1.986690248	0	0	0	15	0	15	0	0	0											7.2217	0	1.835366575	0	0.392675052	3.16675998	0.16640501	1.123744019	0.29130686	3.480132148	2.09134029	0	0	0.521482759	4.596969422	6.534172951	0.142768083	0.668060124	2.006881286	2.857900258	0.191119229	0	0	0	0.37320131	0	0.188885733	0	0	0	0	0	0	0	0	0	0	0	0	0	37.8509	0	2.1216	7.2217	0	1.835366575	0	0.392675052	3.16675998	0.16640501	1.123744019	0.29130686	3.480132148	2.09134029	0	0	0.521482759	4.596969422	6.534172951	0.142768083	0.668060124	2.006881286	2.857900258	0.191119229	0	0	0	0.37320131	0	0.188885733	0	0	0	0	0	0	0	0	0	0	0	0	0	37.8509																																																																																		0	0	0	7.2217	0	1.835366575	0	0.392675052	3.16675998	0.16640501	1.123744019	0.29130686	3.480132148	2.09134029	0	0	0.521482759	4.596969422	6.534172951	0.142768083	0.668060124	2.006881286	2.857900258	0.191119229	0	0	0	0.37320131	0	0.188885733	0	0	0	0	0	0	0	0	0	0	0	0	0	37.8509
H9793_004_0	2009	8																					5000											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		1072.735413	0	1086.25064	0	222.9770826	19.54473315	1.027024953	325.6947321	72.95744504	3102.743255	1180.364041	0	0	493.3532107	3724.137038	5313.462079	115.9050261	542.3588005	1004.211143	2232.834526	1200.134623	0	0	0	324.9164312	0	144.8454442	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											150	0	50	0	50	0.2	0.2	50	100	23	34	0	0	25	25	25	25	25	34	23	2.1	0	0	0	25	0	25	0	0	0											142.4580332	0	47.47344113	0	47.47344113	0.189893765	0.189893765	47.48601107	94.94688226	21.83778292	32.28193997	0	0	23.73672056	23.74900396	23.73672056	23.73672056	23.73672056	32.28193997	21.83778292	1.993884527	0	0	0	25	0	25	0	0	0											12.735	0	4.297337984	0	0.882124117	3.711422955	0.195025635	1.288828638	0.577256829	5.646419472	3.175370091	0	0	0.975882275	7.370378773	10.51034705	0.229267101	1.072818274	2.701490319	4.063346307	0.199410821	0	0	0	0.676909232	0	0.301761342	0	0	0	0	0	0	0	0	0	0	0	0	0	60.6104	0	3.1657	12.735	0	4.297337984	0	0.882124117	3.711422955	0.195025635	1.288828638	0.577256829	5.646419472	3.175370091	0	0	0.975882275	7.370378773	10.51034705	0.229267101	1.072818274	2.701490319	4.063346307	0.199410821	0	0	0	0.676909232	0	0.301761342	0	0	0	0	0	0	0	0	0	0	0	0	0	60.6104																																																																																		0	0	0	12.735	0	4.297337984	0	0.882124117	3.711422955	0.195025635	1.288828638	0.577256829	5.646419472	3.175370091	0	0	0.975882275	7.370378773	10.51034705	0.229267101	1.072818274	2.701490319	4.063346307	0.199410821	0	0	0	0.676909232	0	0.301761342	0	0	0	0	0	0	0	0	0	0	0	0	0	60.6104
H9793_005_0	2009	4																					4000											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		1074.902556	0	1099.828773	0	222.9770826	19.54473315	1.027024953	325.6947321	73.3296769	3165.918731	1198.102087	0	0	493.644604	3808.776516	5426.769797	118.5392313	554.6851369	1019.302033	2278.297644	1208.615849	0	0	0	313.3873659	0	148.1373861	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											125	0	35	0	50	0.2	0.2	50	75	19	30	0	0	20	20	20	20	20	30	19	2.1	0	0	0	20	0	20	0	0	0											118.2143065	0	33.09050586	0	47.27215122	0.189088605	0.189088605	47.28572261	70.90822684	17.96341746	28.36329073	0	0	18.90886049	18.9194701	18.90886049	18.90886049	18.90886049	28.36329073	17.96341746	1.985430351	0	0	0	20	0	20	0	0	0											10.5891	0	3.032824205	0	0.878383864	3.695686325	0.194198716	1.283392563	0.433306447	4.739226652	2.831843152	0	0	0.777854746	6.005002785	8.551169417	0.186786816	0.874038656	2.409229991	3.410500975	0.199968549	0	0	0	0.522312277	0	0.246895644	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8617	0	2.8834	10.5891	0	3.032824205	0	0.878383864	3.695686325	0.194198716	1.283392563	0.433306447	4.739226652	2.831843152	0	0	0.777854746	6.005002785	8.551169417	0.186786816	0.874038656	2.409229991	3.410500975	0.199968549	0	0	0	0.522312277	0	0.246895644	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8617																																																																																		0	0	0	10.5891	0	3.032824205	0	0.878383864	3.695686325	0.194198716	1.283392563	0.433306447	4.739226652	2.831843152	0	0	0.777854746	6.005002785	8.551169417	0.186786816	0.874038656	2.409229991	3.410500975	0.199968549	0	0	0	0.522312277	0	0.246895644	0	0	0	0	0	0	0	0	0	0	0	0	0	50.8617
H9793_006_0	2009	8																					3000											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		1077.069698	0	1108.880862	0	224.1032295	19.54473315	1.027024953	325.6947321	73.70190876	3243.145943	1226.887214	0	0	493.9359972	3935.735733	5599.028071	122.490539	573.1746415	1043.79138	2333.872847	1217.097075	0	0	0	302.6484396	0	153.075299	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											100	0	25	0	25	0.2	0.2	50	50	15	25	0	0	15	15	15	15	15	25	15	2.1	0	0	0	15	0	15	0	0	0											93.78620002	0	23.43878276	0	23.43878276	0.187510262	0.187510262	46.89310001	46.87756551	14.06326965	23.43878276	0	0	14.06326965	14.07237788	14.06326965	14.06326965	14.06326965	23.43878276	14.06326965	1.968857751	0	0	0	15	0	15	0	0	0											8.4179	0	2.165901468	0	0.437725576	3.664838035	0.192577718	1.272736304	0.287913838	3.80076966	2.396395239	0	0	0.578862927	4.615430039	6.56172013	0.143551457	0.671725795	2.038766617	2.735156932	0.199690917	0	0	0	0.37831055	0	0.191344124	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7513	0	2.6698	8.4179	0	2.165901468	0	0.437725576	3.664838035	0.192577718	1.272736304	0.287913838	3.80076966	2.396395239	0	0	0.578862927	4.615430039	6.56172013	0.143551457	0.671725795	2.038766617	2.735156932	0.199690917	0	0	0	0.37831055	0	0.191344124	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7513																																																																																		0	0	0	8.4179	0	2.165901468	0	0.437725576	3.664838035	0.192577718	1.272736304	0.287913838	3.80076966	2.396395239	0	0	0.578862927	4.615430039	6.56172013	0.143551457	0.671725795	2.038766617	2.735156932	0.199690917	0	0	0	0.37831055	0	0.191344124	0	0	0	0	0	0	0	0	0	0	0	0	0	40.7513
H9793_801_0	2009	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		285.2440062	0	48.77206863	0	8.107546504	21.58649295	1.074613383	14.80709066	38.79772758	9.769339518	26.49376643	0	0	30.60472353	23.41727841	43.98770418	1.501748067	5.892901326	31.73219387	99.10327411	26.0003195	23.30448858	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.077070555	0	0.189906514	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.077070555	0	0.189906514	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											21.9839	0	9.262133555	0	1.872843242	4.986479872	0.248235691	3.420437942	8.96227507	2.256717429	6.120060046	0	0	7.069691136	5.409391314	10.16115967	0.346903803	1.361260206	7.330136783	22.89285632	6.006073804	5.383336863	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0739	0	0	21.9839	0	9.262133555	0	1.872843242	4.986479872	0.248235691	3.420437942	8.96227507	2.256717429	6.120060046	0	0	7.069691136	5.409391314	10.16115967	0.346903803	1.361260206	7.330136783	22.89285632	6.006073804	5.383336863	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0739																																																																																		0	0	0	21.9839	0	9.262133555	0	1.872843242	4.986479872	0.248235691	3.420437942	8.96227507	2.256717429	6.120060046	0	0	7.069691136	5.409391314	10.16115967	0.346903803	1.361260206	7.330136783	22.89285632	6.006073804	5.383336863	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0739
H9793_802_0	2009	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		285.2440062	0	48.77206863	0	8.107546504	21.58649295	1.074613383	14.80709066	38.79772758	9.769339518	26.49376643	0	0	30.60472353	23.41727841	43.98770418	1.501748067	5.892901326	31.73219387	99.10327411	26.0003195	23.30448858	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.077070555	0	0.189906514	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.077070555	0	0.189906514	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											21.9839	0	9.262133555	0	1.872843242	4.986479872	0.248235691	3.420437942	8.96227507	2.256717429	6.120060046	0	0	7.069691136	5.409391314	10.16115967	0.346903803	1.361260206	7.330136783	22.89285632	6.006073804	5.383336863	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0739	0	0	21.9839	0	9.262133555	0	1.872843242	4.986479872	0.248235691	3.420437942	8.96227507	2.256717429	6.120060046	0	0	7.069691136	5.409391314	10.16115967	0.346903803	1.361260206	7.330136783	22.89285632	6.006073804	5.383336863	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0739																																																																																		0	0	0	21.9839	0	9.262133555	0	1.872843242	4.986479872	0.248235691	3.420437942	8.96227507	2.256717429	6.120060046	0	0	7.069691136	5.409391314	10.16115967	0.346903803	1.361260206	7.330136783	22.89285632	6.006073804	5.383336863	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0739
H9793_804_0	2009	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		285.2440062	0	48.77206863	0	8.107546504	21.58649295	1.074613383	14.80709066	38.79772758	9.769339518	26.49376643	0	0	30.60472353	23.41727841	43.98770418	1.501748067	5.892901326	31.73219387	99.10327411	26.0003195	23.30448858	0	0	0	0	0	0	0	0											"PBP 1a, 1b"		PBP 2	PBP 6	PBP 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"	"PBP 4b, 7a, 14b-j"	"PBP 4b, 7b, 7d, 7f, 7g, 14d-j, 17a, 18a"	"PBP 7e, 7h"	"PBP 7c, 7i"	PBP 7d	"PBP 7d, 7g"	PBP 15	PBP 7g	PBP 10b	"PBP 16a, 16b"	PBP 17a	PBP 17b	PBP 18a	PBP 18b	PBP 14a	PBP 13b-e											0.077070555	0	0.189906514	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.077070555	0	0.189906514	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											21.9839	0	9.262133555	0	1.872843242	4.986479872	0.248235691	3.420437942	8.96227507	2.256717429	6.120060046	0	0	7.069691136	5.409391314	10.16115967	0.346903803	1.361260206	7.330136783	22.89285632	6.006073804	5.383336863	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0739	0	0	21.9839	0	9.262133555	0	1.872843242	4.986479872	0.248235691	3.420437942	8.96227507	2.256717429	6.120060046	0	0	7.069691136	5.409391314	10.16115967	0.346903803	1.361260206	7.330136783	22.89285632	6.006073804	5.383336863	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0739																																																																																		0	0	0	21.9839	0	9.262133555	0	1.872843242	4.986479872	0.248235691	3.420437942	8.96227507	2.256717429	6.120060046	0	0	7.069691136	5.409391314	10.16115967	0.346903803	1.361260206	7.330136783	22.89285632	6.006073804	5.383336863	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.0739
H9847_001_0	2009	5																					2250											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	O	P																																																			0		1247.847729	59.50266318	748.9847411		112.64847	9.581198303	7.045389686	219.6357719	268.3652942	884.760381	333.0430061	30.25131885	0.333945995	488.1061701	3327.943781	5040.985178	356.1741961	506.5310028	3612.433603	10191.43058	18.06885183				105.4421721					103.93											1a: Days 1 - 10: $175/day then $0 ;1a1: Days 1 - 10: $175/day then $0	1b: Days 1 - 10: $175/day then $0	"2: Days 1 - 7: $0/day, then $100/day"	6: $0	10a: $100/trip	11a: 20%	11b: 20%;11c: 20%	4a: $50/visit;4a1: $50/visit;4b: $25/visit	9a: $250/visit;9b: $250/visit	8a: $10/visit	8b: $30/visit;8b: 20%;8b: $50/visit	9a: $250/visit	12a: 20%	3: 20%;5: $175/day;9a: $250/visit;9c: $30/visit;9d: $30/visit; 7i: $30/visit; 7c: $30/visit; 7e: $30/visit	7a: $10/visit;14c: $10/visit;14d: $0/visit;14e: $0/visit;14f: $0/visit;14g: $0/visit;14j: $10/visit	7b: $30/visit;7d: $30/visit;7f: $30/visit;16b: $30/visit;17a: $30/visit;18a: $30/visit	7e: $30/visit;7h: $30/visit	7c: $30/visit;7i: $30/visit	7a: $10/visit; 7d: $30/visit; 8b: $30/visit; 8b: 20%; 8b: $50/visit; 14h: $0/visit	7g: $30/visit;14b: $10/visit;14i: 20%;17b: $100 per yr; 7a: $10/visit; 7d: $30/visit; 8a: $10/visit; 12: 20%	15: 20%	13a: $0		16a: $150 allowance	17a1: $30/visit	17b1: $100 per yr			14a: $0/visit	14c1: $10/visit;13a1: 0;13c: OTC $10/month											148.4356177	132.0455681	53.52827658		100	0.2	0.2	45	237.2990098	10	69.88943365	250	0.2	104.3809022	10	29.93297164	29.90873953	29.90413216	7.316677069	7.18680601	0.2				30					10											121.937827	108.4736257	43.97274609		82.14863041	0.164297261	0.164297261	36.96688369	194.9378865	8.214863041	57.41321255	205.371576	0.164297261	85.74748154	8.214863041	24.58952625	24.5696199	24.56583501	6.010550004	5.903862707	0.164297261				24.64458912					8.214863041											12.68	0.537872468	2.744576321	0	0.771159794	1.574164637	1.157538227	0.67660417	4.359546939	0.605682113	1.593422408	0.517730086	0.054866412	3.487822901	2.278216864	10.32961978	0.729255385	1.03694642	1.809392734	5.014067244	2.968662862	0	0	0	0.216548251	0	0	0	0	0.07114756	0	0	0	0	0	0	0	0	0	0	55.2148	0	11.9985	12.68	0.537872468	2.744576321	0	0.771159794	1.574164637	1.157538227	0.67660417	4.359546939	0.605682113	1.593422408	0.517730086	0.054866412	3.487822901	2.278216864	10.32961978	0.729255385	1.03694642	1.809392734	5.014067244	2.968662862	0	0	0	0.216548251	0	0	0	0	0.07114756	0	0	0	0	0	0	0	0	0	0	55.2148		OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: $100/trip	OON: 40%	OON: 40%;OON: 20%	OON: $50/visit	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 40%;OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%	OON: 20%			OON: 20%					OON: 20%											2.4872	0.0487	0.2966	0.2452	0.052	0.2235	0.1643	0.0517	0.386	0.0388	0.193	0.022	0.0038	0.316	0.2993	0.9903	0.0273	0.0468	0.2653	0.147	0.2107				0.0079					0.02											6.5434	0	0	15.1672	0.586622103	3.041142024	0.245231434	0.823167398	1.797665399	1.321886142	0.728256496	4.745555055	0.644525104	1.78638487	0.539739205	0.058662114	3.8037743	2.577467556	11.31995451	0.756516144	1.083796309	2.074730861	5.161025743	3.179409056	0	0	0	0.224482912	0	0	0	0	0.091106498	0	0	0	0	0	0	0	0	0	0	61.7583
H9847_801_0	2009	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																																																			0		226.517764	4.499270125	27.33313179		5.492053269	10.5592674	7.764598046	10.96527051	37.32835321	3.760072697	18.66804357	2.143966663	0.368035912	30.51162455	30.6572756	101.456624	2.792777506	4.799621144	27.18304187	15.05542788	19.91335864																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.079046485	0.079046485	0.201095665		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.079046485	0.079046485	0.201095665		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				17.9054	0.355651488	5.496574303	0	1.268664305	2.439190769	1.793622149	2.532977488	8.622849593	0.868576793	4.312318065	0.495256299	0.085016296	7.04818527	7.081830664	23.43648014	0.645131604	1.108712484	6.279282672	3.477803841	4.599985846	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.8535	0	0	17.9054	0.355651488	5.496574303	0	1.268664305	2.439190769	1.793622149	2.532977488	8.622849593	0.868576793	4.312318065	0.495256299	0.085016296	7.04818527	7.081830664	23.43648014	0.645131604	1.108712484	6.279282672	3.477803841	4.599985846	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.8535		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				1.0715	0.0212	0.3285		0.0735	0.1422	0.1046	0.1446	0.4914	0.0494	0.2456	0.028	0.0048	0.4015	0.3809	1.2606	0.0347	0.0596	0.3378	0.1871	0.2683																				5.636	0	0	18.9769	0.376885785	5.825089959	0	1.342194779	2.581438372	1.898221778	2.677614686	9.114201198	0.918020225	4.55794092	0.523271814	0.089847863	7.449689638	7.462748324	24.69708204	0.679831956	1.168347935	6.617032863	3.664868029	4.8682457	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.4895
H9847_802_0	2009	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																																																			0		226.517764	4.499270125	27.33313179		5.492053269	10.5592674	7.764598046	10.96527051	37.32835321	3.760072697	18.66804357	2.143966663	0.368035912	30.51162455	30.6572756	101.456624	2.792777506	4.799621144	27.18304187	15.05542788	19.91335864																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.079046485	0.079046485	0.201095665		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.079046485	0.079046485	0.201095665		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				17.9054	0.355651488	5.496574303	0	1.268664305	2.439190769	1.793622149	2.532977488	8.622849593	0.868576793	4.312318065	0.495256299	0.085016296	7.04818527	7.081830664	23.43648014	0.645131604	1.108712484	6.279282672	3.477803841	4.599985846	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.8535	0	0	17.9054	0.355651488	5.496574303	0	1.268664305	2.439190769	1.793622149	2.532977488	8.622849593	0.868576793	4.312318065	0.495256299	0.085016296	7.04818527	7.081830664	23.43648014	0.645131604	1.108712484	6.279282672	3.477803841	4.599985846	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.8535		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				1.0715	0.0212	0.3285		0.0735	0.1422	0.1046	0.1446	0.4914	0.0494	0.2456	0.028	0.0048	0.4015	0.3809	1.2606	0.0347	0.0596	0.3378	0.1871	0.2683																				5.636	0	0	18.9769	0.376885785	5.825089959	0	1.342194779	2.581438372	1.898221778	2.677614686	9.114201198	0.918020225	4.55794092	0.523271814	0.089847863	7.449689638	7.462748324	24.69708204	0.679831956	1.168347935	6.617032863	3.664868029	4.8682457	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.4895
H9847_803_0	2009	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																																																			0		226.517764	4.499270125	27.33313179		5.492053269	10.5592674	7.764598046	10.96527051	37.32835321	3.760072697	18.66804357	2.143966663	0.368035912	30.51162455	30.6572756	101.456624	2.792777506	4.799621144	27.18304187	15.05542788	19.91335864																				Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				0.079046485	0.079046485	0.201095665		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				0.079046485	0.079046485	0.201095665		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																				17.9054	0.355651488	5.496574303	0	1.268664305	2.439190769	1.793622149	2.532977488	8.622849593	0.868576793	4.312318065	0.495256299	0.085016296	7.04818527	7.081830664	23.43648014	0.645131604	1.108712484	6.279282672	3.477803841	4.599985846	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.8535	0	0	17.9054	0.355651488	5.496574303	0	1.268664305	2.439190769	1.793622149	2.532977488	8.622849593	0.868576793	4.312318065	0.495256299	0.085016296	7.04818527	7.081830664	23.43648014	0.645131604	1.108712484	6.279282672	3.477803841	4.599985846	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	99.8535		Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS	Medicare FFS																				1.0715	0.0212	0.3285		0.0735	0.1422	0.1046	0.1446	0.4914	0.0494	0.2456	0.028	0.0048	0.4015	0.3809	1.2606	0.0347	0.0596	0.3378	0.1871	0.2683																				5.636	0	0	18.9769	0.376885785	5.825089959	0	1.342194779	2.581438372	1.898221778	2.677614686	9.114201198	0.918020225	4.55794092	0.523271814	0.089847863	7.449689638	7.462748324	24.69708204	0.679831956	1.168347935	6.617032863	3.664868029	4.8682457	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.4895
H9859_001_0	2009	5																																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	V																																																			0		276.4116226	8.717556468	923.2198084	2096.290304	139.9863291	1261.161942	790.1989154	269.0311997	288.797813		473.2963882			183.034446	3300.732473	5632.247257	630.6433051	1133.309892			1154.599626	1304.237304			1.960350709		2.84			159.4											$100 per stay/$300 max per year	$100 per stay/$300 max per year	$0(day 1-15) $65(days 16-100)	$0 days 1-20 $20 days 21+	$50 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER visit, $20 per Urgently Needed Care"	$50 ASC	No cost sharing	$15 copay per visit	No cost sharing	No cost sharing	"PT/OT/ST/Chemotherapy/Cardiac Rehab $15 copay,Others no cost sharing"	$10 Copay per visit	$15 copay per visit	$15 copay per visit	$15 copay per visit	No cost sharing	No cost sharing	20% Coinsurance	"20% Coinsurance for Eyewear, others $15 copay"	No cost sharing	No cost sharing	$10 Copay per visit	$100 allowance per year	$15 copay per visit	$600 every 3 years	No cost sharing	"Acupuncture 50% Coin, Rouine Physical Exam $10 copay"											93.56	93.56	33.734	5.95	50	18.8407808	26.95210067	43.97965157	50		15			14.99945275	10	15	15	15			52.12532088	15			10		15			22.67252196											93.56	93.56	33.734	5.95	50	18.8407808	26.95210067	43.97965157	50		15			14.99945275	10	15	15	15			52.12532088	15			10		15			22.67252196											2.1551	0.067967882	2.595324751	1.039410609	0.583276371	1.980106308	1.774793393	0.985991535	1.203324221	0	0.591620485	0	0	0.22878471	2.750610394	7.040309072	0.788304131	1.416637366	0	0	5.015322999	1.630296631	0	0	0.001633626	0	0.00355	0	0	0.301166667	0	0	0	0	0	0	0	0	0	0	32.1535	0	0	2.1551	0.067967882	2.595324751	1.039410609	0.583276371	1.980106308	1.774793393	0.985991535	1.203324221	0	0.591620485	0	0	0.22878471	2.750610394	7.040309072	0.788304131	1.416637366	0	0	5.015322999	1.630296631	0	0	0.001633626	0	0.00355	0	0	0.301166667	0	0	0	0	0	0	0	0	0	0	32.1535																															"30% Coinsurance,$5k/yr max benefit"																																								0.369											0.369	0	0	2.1551	0.067967882	2.595324751	1.039410609	0.583276371	1.980106308	1.774793393	0.985991535	1.203324221	0	0.591620485	0	0	0.22878471	2.750610394	7.040309072	0.788304131	1.416637366	0	0	5.015322999	1.630296631	0	0	0.001633626	0	0.00355	0	0	0.670166667	0	0	0	0	0	0	0	0	0	0	32.5225
H9859_002_0	2009	5																																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	V																																																			0		276.4116226	8.717556468	923.2198084	2096.290304	139.9863291	1261.161942	790.1989154	269.0311997	288.797813		473.2963882			183.034446	3300.732473	5632.247257	630.6433051	1133.309892			1154.599626	1304.237304			1.960350709		2.84			159.4											$100 per stay/$300 max per year	$100 per stay/$300 max per year	$0(day 1-15) $65(days 16-100)	$0 days 1-20 $20 days 21+	$50 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER visit, $20 per Urgently Needed Care"	$50 ASC	No cost sharing	$15 copay per visit	No cost sharing	No cost sharing	"PT/OT/ST/Chemotherapy/Cardiac Rehab $15 copay,Others no cost sharing"	$10 Copay per visit	$15 copay per visit	$15 copay per visit	$15 copay per visit	No cost sharing	No cost sharing	20% Coinsurance	"20% Coinsurance for Eyewear, others $15 copay"	No cost sharing	No cost sharing	$10 routine	$100 allowance per year	$15 copay per visit	$600 every 3 years	No cost sharing	"Acupuncture 50% Coin, Rouine Physical Exam $10 copay"											93.56	93.56	33.734	5.95	50	18.8407808	26.95210067	43.97965157	50		15			14.99945275	10	15	15	15			52.12532088	15			10		15			22.67252196											93.56	93.56	33.734	5.95	50	18.8407808	26.95210067	43.97965157	50		15			14.99945275	10	15	15	15			52.12532088	15			10		15			22.67252196											2.1551	0.067967882	2.595324751	1.039410609	0.583276371	1.980106308	1.774793393	0.985991535	1.203324221	0	0.591620485	0	0	0.22878471	2.750610394	7.040309072	0.788304131	1.416637366	0	0	5.015322999	1.630296631	0	0	0.001633626	0	0.00355	0	0	0.301166667	0	0	0	0	0	0	0	0	0	0	32.1535	0	0	2.1551	0.067967882	2.595324751	1.039410609	0.583276371	1.980106308	1.774793393	0.985991535	1.203324221	0	0.591620485	0	0	0.22878471	2.750610394	7.040309072	0.788304131	1.416637366	0	0	5.015322999	1.630296631	0	0	0.001633626	0	0.00355	0	0	0.301166667	0	0	0	0	0	0	0	0	0	0	32.1535																															"30% Coinsurance,$5k/yr max benefit"																																								0.369											0.369	0	0	2.1551	0.067967882	2.595324751	1.039410609	0.583276371	1.980106308	1.774793393	0.985991535	1.203324221	0	0.591620485	0	0	0.22878471	2.750610394	7.040309072	0.788304131	1.416637366	0	0	5.015322999	1.630296631	0	0	0.001633626	0	0.00355	0	0	0.670166667	0	0	0	0	0	0	0	0	0	0	32.5225
H9859_003_0	2009	5																																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	V																																																			0		293.438777	9.254564204	980.0908112	2225.423291	148.6095875	1338.850422	838.8757358	285.5124673	306.5879656		805.9811787			238.3371237	3504.059963	5979.197731	669.4913854	1203.122595			1225.723792	1384.579258			1.983780586		2.84			159.4											$500 per stay	$500 per stay	$0(day1-15) $65(days 16-100)	"$0 days 1-20, $20 days 21+"	$100 per trip	25% Coinsurance	25% Coinsurance	"$50 per ER visit, $30 per Urgently needed care"	$100 ASC	No cost sharing	$30 copay per visit	No cost sharing	No cost sharing	"PT/OT/ST/Chemotherapy/Cardiac Rehab $30 copay,Others no cost sharing"	$15 copay per visit	$30 copay per visit	$30 copay per visit	$30 copay per visit	No cost sharing	No cost sharing	20% Coinsurance	"20% Coinsurance for Eyewear, others $30 copay"	No cost sharing	No cost sharing	$15 routine	$100 allowance	$30 copay per visit	$600 every 3 years	No cost sharing	"Acupuncture 50% Coin, Rouine Physical Exam $15 copay"											500	500	33.734	5.95	100	25.83512413	36.95764383	45.98834759	100		30			29.99910768	15	30	30	30			57.18082066	30			15		30			26.10414053											500	500	33.734	5.95	100	25.83512413	36.95764383	45.98834759	100		30			29.99910768	15	30	30	30			57.18082066	30			15		30			26.10414053											12.2266	0.385606842	2.755198619	1.103439048	1.238413229	2.882447238	2.583572555	1.094187216	2.554899713	0	2.014952947	0	0	0.595825086	4.380074953	14.94799433	1.673728463	3.007806488	0	0	5.840657693	3.461448146	0	0	0.002479726	0	0.0071	0	0	0.34675	0	0	0	0	0	0	0	0	0	0	63.1032	0	0	12.2266	0.385606842	2.755198619	1.103439048	1.238413229	2.882447238	2.583572555	1.094187216	2.554899713	0	2.014952947	0	0	0.595825086	4.380074953	14.94799433	1.673728463	3.007806488	0	0	5.840657693	3.461448146	0	0	0.002479726	0	0.0071	0	0	0.34675	0	0	0	0	0	0	0	0	0	0	63.1032																															"30% Coinsurance,$5k/yr max benefit"																																								0.369											0.369	0	0	12.2266	0.385606842	2.755198619	1.103439048	1.238413229	2.882447238	2.583572555	1.094187216	2.554899713	0	2.014952947	0	0	0.595825086	4.380074953	14.94799433	1.673728463	3.007806488	0	0	5.840657693	3.461448146	0	0	0.002479726	0	0.0071	0	0	0.71575	0	0	0	0	0	0	0	0	0	0	63.4722
H9859_004_0	2009	5																																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	V																																																			0		293.438777	9.254564204	980.0908112	2225.423291	148.6095875	1338.850422	838.8757358	285.5124673	306.5879656		805.9811787			238.3371237	3504.059963	5979.197731	669.4913854	1203.122595			1225.723792	1384.579258			1.983780586		2.84			159.4											$500 per stay	$500 per stay	$0(day1-15) $65(days 16-100)	"$0 days 1-20, $20 days 21+"	$100 per trip	25% Coinsurance	25% Coinsurance	"$50 per ER visit, $30 per Urgently needed care"	$100 ASC	No cost sharing	$30 copay per visit	No cost sharing	No cost sharing	"PT/OT/ST/Chemotherapy/Cardiac Rehab $30 copay,Others no cost sharing"	$15 copay per visit	$30 copay per visit	$30 copay per visit	$30 copay per visit	No cost sharing	No cost sharing	20% Coinsurance	"20% Coinsurance for Eyewear, others $30 copay"	No cost sharing	No cost sharing	$15 routine	$100 allowance	$30 copay per visit	$600 every 3 years	No cost sharing	"Acupuncture 50% Coin, Rouine Physical Exam $15 copay"											500	500	33.734	5.95	100	25.83512413	36.95764383	45.98834759	100		30			29.99910768	15	30	30	30			57.18082066	30			15		30			26.10414053											500	500	33.734	5.95	100	25.83512413	36.95764383	45.98834759	100		30			29.99910768	15	30	30	30			57.18082066	30			15		30			26.10414053											12.2266	0.385606842	2.755198619	1.103439048	1.238413229	2.882447238	2.583572555	1.094187216	2.554899713	0	2.014952947	0	0	0.595825086	4.380074953	14.94799433	1.673728463	3.007806488	0	0	5.840657693	3.461448146	0	0	0.002479726	0	0.0071	0	0	0.34675	0	0	0	0	0	0	0	0	0	0	63.1032	0	0	12.2266	0.385606842	2.755198619	1.103439048	1.238413229	2.882447238	2.583572555	1.094187216	2.554899713	0	2.014952947	0	0	0.595825086	4.380074953	14.94799433	1.673728463	3.007806488	0	0	5.840657693	3.461448146	0	0	0.002479726	0	0.0071	0	0	0.34675	0	0	0	0	0	0	0	0	0	0	63.1032																															"30% Coinsurance,$5k/yr max benefit"																																								0.369											0.369	0	0	12.2266	0.385606842	2.755198619	1.103439048	1.238413229	2.882447238	2.583572555	1.094187216	2.554899713	0	2.014952947	0	0	0.595825086	4.380074953	14.94799433	1.673728463	3.007806488	0	0	5.840657693	3.461448146	0	0	0.002479726	0	0.0071	0	0	0.71575	0	0	0	0	0	0	0	0	0	0	63.4722
H9859_801_0	2009	9																																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	V																																																			0					2096.737655	140.0162024	1261.431075	790.3675451	269.0883518			759.3751237			224.5552223	3301.436855	5633.449188	630.7778854	1133.551743			1154.846019	1304.515631			1.960431877		2.84			159.4											No cost sharing	No cost sharing	$0(day 1-15) $65(days 16-100)	$0 days 1-20 $20 days 21+	$50 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER visit, $20 per Urgently Needed Care"	No cost sharing	No cost sharing	$10 copay per visit	No cost sharing	No cost sharing	"PT/OT/ST/Chemotherapy/Cardiac Rehab $10 copay,Others no cost sharing"	$5 Copay per visit	$10 copay per visit	$10 copay per visit	$10 copay per visit	No cost sharing	No cost sharing	20% Coinsurance	"20% Coinsurance for Eyewear, others $10 copay"	No cost sharing	Not covered	$5 routine	$100 allowance per year	$10 copay per exam	"$600 every 3 yrs, or 1 per ear/3yrs"	No cost sharing	"Acupuncture 50% Coin, Rouine Physical Exam $5 copay"														5.95	50	18.84480145	26.95785229	43.97966023			10			9.999702561	5	10	10	10			52.1364445	10			5		10			19.24090339														5.95	50	18.84480145	26.95785229	43.97966023			10			9.999702561	5	10	10	10			52.1364445	10			5		10			19.24090339											0	0	0	1.039632421	0.583400843	1.980951514	1.775550961	0.98620119	0	0	0.632812603	0	0	0.187123786	1.375598689	4.69454099	0.525648238	0.944626452	0	0	5.017463783	1.087096359	0	0	0.000816847	0	0.002366667	0	0	0.255583333	0	0	0	0	0	0	0	0	0	0	21.0894	0	0	0	0	0	1.039632421	0.583400843	1.980951514	1.775550961	0.98620119	0	0	0.632812603	0	0	0.187123786	1.375598689	4.69454099	0.525648238	0.944626452	0	0	5.017463783	1.087096359	0	0	0.000816847	0	0.002366667	0	0	0.255583333	0	0	0	0	0	0	0	0	0	0	21.0894																															"30% Coinsurance,$5k/yr max benefit"																																								0.369											0.369	0	0	0	0	0	1.039632421	0.583400843	1.980951514	1.775550961	0.98620119	0	0	0.632812603	0	0	0.187123786	1.375598689	4.69454099	0.525648238	0.944626452	0	0	5.017463783	1.087096359	0	0	0.000816847	0	0.002366667	0	0	0.624583333	0	0	0	0	0	0	0	0	0	0	21.4584
H9859_802_0	2009	8																																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	V																																																			0					2096.347454	139.9901455	1261.196324	790.2204583	269.0385011			759.2338046			224.5134328	3300.82246	5632.400807	630.6604981	1133.340789			1154.631103	1304.272861			1.960361079		2.84			159.4											No cost sharing	No cost sharing	$0(day 1-15) $65(days 16-100)	$0 days 1-20 $20 days 21+	$50 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER visit, $20 per Urgently Needed Care"	No cost sharing	No cost sharing	$10 copay per visit	No cost sharing	No cost sharing	"PT/OT/ST/Chemotherapy/Cardiac Rehab $10 copay,Others no cost sharing"	$5 Copay per visit	$10 copay per visit	$10 copay per visit	$10 copay per visit	No cost sharing	No cost sharing	20% Coinsurance	"20% Coinsurance for Eyewear, others $10 copay"	No cost sharing	Not covered	$5 routine	$100 allowance per year	$10 copay per exam	"$600 every 3 yrs, or 1 per ear/3yrs"	No cost sharing	"Acupuncture 50% Coin, Rouine Physical Exam $5 copay"														5.95	50	18.84129445	26.95283545	43.97965267			10			9.999702561	5	10	10	10			52.12674195	10			5		10			19.24090339														5.95	50	18.84129445	26.95283545	43.97965267			10			9.999702561	5	10	10	10			52.12674195	10			5		10			19.24090339											0	0	0	1.039438946	0.583292273	1.980214275	1.774890165	0.986018319	0	0	0.632694837	0	0	0.187088962	1.375342692	4.693667339	0.525550415	0.944450658	0	0	5.015596465	1.086894051	0	0	0.000816817	0	0.002366667	0	0	0.255583333	0	0	0	0	0	0	0	0	0	0	21.0839	0	0	0	0	0	1.039438946	0.583292273	1.980214275	1.774890165	0.986018319	0	0	0.632694837	0	0	0.187088962	1.375342692	4.693667339	0.525550415	0.944450658	0	0	5.015596465	1.086894051	0	0	0.000816817	0	0.002366667	0	0	0.255583333	0	0	0	0	0	0	0	0	0	0	21.0839																															"30% Coinsurance,$5k/yr max benefit"																																								0.369											0.369	0	0	0	0	0	1.039438946	0.583292273	1.980214275	1.774890165	0.986018319	0	0	0.632694837	0	0	0.187088962	1.375342692	4.693667339	0.525550415	0.944450658	0	0	5.015596465	1.086894051	0	0	0.000816817	0	0.002366667	0	0	0.624583333	0	0	0	0	0	0	0	0	0	0	21.4529
H9859_803_0	2009	7																																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	V																																																			0		292.9763622	9.239980421	978.5463375	2221.916363	148.3754014	1336.740598	837.5537955	285.0642921			804.7110752			237.9615407	3498.538098	5969.775427	668.436369	1201.226657			1223.792238	1382.397373			1.98314429		2.84			159.4											$100 per stay/$300 max per year	$100 per stay/$300 max per year	$0(day 1-15) $65(days 16-100)	$0 days 1-20 $20 days 21+	$50 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER visit, $20 per Urgently Needed Care"	No cost sharing	No cost sharing	$20 copay per visit	No cost sharing	No cost sharing	"PT/OT/ST/Chemotherapy/Cardiac Rehab $20 copay,Others no cost sharing"	$15 Copay per visit	$20 copay per visit	$20 copay per visit	$20 copay per visit	No cost sharing	No cost sharing	20% Coinsurance	"20% Coinsurance for Eyewear, others $20 copay"	No cost sharing	Not covered	$15 routine	$100 allowance per yr with rider	$20 copay per exam	$600 every 3 yrs or 1 per ear/3yrs	No cost sharing	"Acupuncture 50% Coin, Rouine Physical Exam $15 copay"											93.56	93.56	33.734	5.95	50	20.63552953	29.51952337	43.98246628			20			19.99940512	15	20	20	20			57.09071241	20			15		20			26.10414053											93.56	93.56	33.734	5.95	50	20.63552953	29.51952337	43.98246628			20			19.99940512	15	20	20	20			57.09071241	20			15		20			26.10414053											2.2842	0.072041047	2.750856846	1.101700197	0.618230839	2.29869584	2.06034907	1.044819218	0	0	1.341185125	0	0	0.396590771	4.373172623	9.949625711	1.114060615	2.002044429	0	0	5.822264224	2.303995621	0	0	0.00247893	0	0.004733333	0	0	0.34675	0	0	0	0	0	0	0	0	0	0	39.8878	0	0	2.2842	0.072041047	2.750856846	1.101700197	0.618230839	2.29869584	2.06034907	1.044819218	0	0	1.341185125	0	0	0.396590771	4.373172623	9.949625711	1.114060615	2.002044429	0	0	5.822264224	2.303995621	0	0	0.00247893	0	0.004733333	0	0	0.34675	0	0	0	0	0	0	0	0	0	0	39.8878																															"30% Coinsurance,$5k/yr max benefit"																																								0.369											0.369	0	0	2.2842	0.072041047	2.750856846	1.101700197	0.618230839	2.29869584	2.06034907	1.044819218	0	0	1.341185125	0	0	0.396590771	4.373172623	9.949625711	1.114060615	2.002044429	0	0	5.822264224	2.303995621	0	0	0.00247893	0	0.004733333	0	0	0.71575	0	0	0	0	0	0	0	0	0	0	40.2568
H9859_804_0	2009	9																																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	V																																																			0		293.3869081	9.252928347	979.9175683	2225.02992	148.5833189	1338.613764	838.7274543	285.4621955			805.8387118			238.2949947	3503.440578	5978.140836	669.3730447	1202.909929			1225.50713	1384.334517			1.983709213		2.84			159.4											$100 per stay/$300 max per year	$100 per stay/$300 max per year	$0(day 1-15) $65(days 16-100)	$0 days 1-20 $20 days 21+	$50 per trip	20% Coinsurance	20% Coinsurance	"$50 per ER visit, $20 per Urgently Needed Care"	No cost sharing	No cost sharing	$20 copay per visit	No cost sharing	No cost sharing	"PT/OT/ST/Chemotherapy/Cardiac Rehab $20 copay,Others no cost sharing"	$15 Copay per visit	$20 copay per visit	$20 copay per visit	$20 copay per visit	No cost sharing	No cost sharing	20% Coinsurance	"20% Coinsurance for Eyewear, others $20 copay"	No cost sharing	Not covered	$15 routine	$100 allowance per yr with rider	$20 copay per exam	$600 every 3 yrs or 1 per ear/3yrs	No cost sharing	"Acupuncture 50% Coin, Rouine Physical Exam $15 copay"											93.56	93.56	33.734	5.95	50	20.66444597	29.56088889	43.98251522			20			19.99940512	15	20	20	20			57.17071326	20			15		20			26.10414053											93.56	93.56	33.734	5.95	50	20.66444597	29.56088889	43.98251522			20			19.99940512	15	20	20	20			57.17071326	20			15		20			26.10414053											2.2874	0.072141998	2.754711604	1.103244002	0.619097162	2.30514265	2.066127424	1.04627878	0	0	1.34306452	0	0	0.397146511	4.379300722	9.963568059	1.115621741	2.004849881	0	0	5.838593061	2.307224196	0	0	0.002479637	0	0.004733333	0	0	0.34675	0	0	0	0	0	0	0	0	0	0	39.9575	0	0	2.2874	0.072141998	2.754711604	1.103244002	0.619097162	2.30514265	2.066127424	1.04627878	0	0	1.34306452	0	0	0.397146511	4.379300722	9.963568059	1.115621741	2.004849881	0	0	5.838593061	2.307224196	0	0	0.002479637	0	0.004733333	0	0	0.34675	0	0	0	0	0	0	0	0	0	0	39.9575																															"30% Coinsurance,$5k/yr max benefit"																																								0.369											0.369	0	0	2.2874	0.072141998	2.754711604	1.103244002	0.619097162	2.30514265	2.066127424	1.04627878	0	0	1.34306452	0	0	0.397146511	4.379300722	9.963568059	1.115621741	2.004849881	0	0	5.838593061	2.307224196	0	0	0.002479637	0	0.004733333	0	0	0.71575	0	0	0	0	0	0	0	0	0	0	40.3265
H9882_001_0	2009	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		2664.937495	649.4661952	3002.304733	0	504.7753361	117140.6753	116.1114216	916.6637945	202.2968016	1513.115493	1036.970635	0	1026.482988	548.3790583	5916.956786	10592.41411	2226.90615	4412.84758	5436.628351	21928.64795	2586.176916	21922.98212																			$150 per day	$150 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																			150	150	70.42232484	0	89.68854649	0.970450102	83.84964892	48.21769587	344.2913204	14.16683274	70.02481181	0	49.44703214	85.4370343	11.10337646	12.25872861	13.76161485	5.201679307	10.18964146	10.02492348	36.90239348	3.54448981																			150	150	70.42232484	0	89.68854649	0.970450102	83.84964892	48.21769587	344.2913204	14.16683274	70.02481181	0	49.44703214	85.4370343	11.10337646	12.25872861	13.76161485	5.201679307	10.18964146	10.02492348	36.90239348	3.54448981																			33.3117	8.11832744	17.6191066	0	3.77271385	9.473265023	0.811325161	3.683284672	5.804086077	1.786337842	6.051139467	0	4.229711442	3.904323368	5.474849894	10.82079416	2.553818729	1.912851495	4.616441138	18.31941814	7.953009849	6.475482228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	156.692	135	0	33.3117	8.11832744	17.6191066	0	3.77271385	9.473265023	0.811325161	3.683284672	5.804086077	1.786337842	6.051139467	0	4.229711442	3.904323368	5.474849894	10.82079416	2.553818729	1.912851495	4.616441138	18.31941814	7.953009849	6.475482228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	156.692																																																																																		0	0	0	33.3117	8.11832744	17.6191066	0	3.77271385	9.473265023	0.811325161	3.683284672	5.804086077	1.786337842	6.051139467	0	4.229711442	3.904323368	5.474849894	10.82079416	2.553818729	1.912851495	4.616441138	18.31941814	7.953009849	6.475482228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	156.692
H9882_002_0	2009	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		2664.937495	649.4661952	3002.304733	0	504.7753361	117140.6753	116.1114216	916.6637945	202.2968016	1513.115493	1036.970635	0	1026.482988	548.3790583	5916.956786	10592.41411	2226.90615	4412.84758	5436.628351	21928.64795	2586.176916	21922.98212																			$150 per day	$150 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																			150	150	70.42232484	0	89.68854649	0.970450102	83.84964892	48.21769587	344.2913204	14.16683274	70.02481181	0	49.44703214	85.4370343	11.10337646	12.25872861	13.76161485	5.201679307	10.18964146	10.02492348	36.90239348	3.54448981																			150	150	70.42232484	0	89.68854649	0.970450102	83.84964892	48.21769587	344.2913204	14.16683274	70.02481181	0	49.44703214	85.4370343	11.10337646	12.25872861	13.76161485	5.201679307	10.18964146	10.02492348	36.90239348	3.54448981																			33.3117	8.11832744	17.6191066	0	3.77271385	9.473265023	0.811325161	3.683284672	5.804086077	1.786337842	6.051139467	0	4.229711442	3.904323368	5.474849894	10.82079416	2.553818729	1.912851495	4.616441138	18.31941814	7.953009849	6.475482228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	156.692	135	0	33.3117	8.11832744	17.6191066	0	3.77271385	9.473265023	0.811325161	3.683284672	5.804086077	1.786337842	6.051139467	0	4.229711442	3.904323368	5.474849894	10.82079416	2.553818729	1.912851495	4.616441138	18.31941814	7.953009849	6.475482228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	156.692																																																																																		0	0	0	33.3117	8.11832744	17.6191066	0	3.77271385	9.473265023	0.811325161	3.683284672	5.804086077	1.786337842	6.051139467	0	4.229711442	3.904323368	5.474849894	10.82079416	2.553818729	1.912851495	4.616441138	18.31941814	7.953009849	6.475482228	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	156.692
H9930_001_0	2009	2																					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																																																			0		300.6890651	7.276013596	1374.484601	1822.634939	180.2738737	12.11717618	11.27923445	323.5024064	411.4812487		4901.910664	75.49171347	15.61111457	105.5627993	3412.157714	3662.105189	226.1823145	240.1739904			28.833468	1213.336209					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	22.74736459	100	0.2	0.2	48.54094142	47.5		10.96870143	50	50	15.22764185	10	24.24549602	28.19822438	15			0.2	15					15														144.9213716	124.5310663	50.98091722	17.84423224	78.44527291	0.156890546	0.156890546	38.07807397	37.26150463		8.604427774	39.22263645	39.22263645	11.94536521	7.844527291	19.01944552	22.12017407	11.76679094			0.156890546	11.76679094					11.76679094														3.6314	0.075507478	5.839373806	2.710293428	1.178469435	1.901070384	1.76960525	1.026529047	1.277700871	0	3.514844689	0.246748669	0.051025756	0.105082183	2.230563692	5.80426751	0.416932681	0.235506428	0	0	4.523698533	1.189756126	0	0	0	0	0.213285851	0	0	0	0	0	0	0	0	0	0	0	0	0	37.9416	0	10.4254	3.6314	0.075507478	5.839373806	2.710293428	1.178469435	1.901070384	1.76960525	1.026529047	1.277700871	0	3.514844689	0.246748669	0.051025756	0.105082183	2.230563692	5.80426751	0.416932681	0.235506428	0	0	4.523698533	1.189756126	0	0	0	0	0.213285851	0	0	0	0	0	0	0	0	0	0	0	0	0	37.9416		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										5.6925	0.119	2.8826	1.3842	0.3176	0.7282	0.6778	0.3642	2.8908	0.9803	2.6733	0.2987	0.0191	1.4723	2.0252	2.5914	0.1666	0.1427			1.2346	0.678					0.1164														27.4556	500	0	9.3239	0.194460547	8.721985701	4.094482625	1.496026873	2.629250143	2.447429035	1.390753861	4.168519312	0.98029273	6.188101897	0.545463064	0.07011142	1.577409583	4.255749234	8.395710496	0.583572924	0.378206241	0	0	5.758328653	1.867784318	0	0	0	0	0.329715916	0	0	0	0	0	0	0	0	0	0	0	0	0	65.3972
H9930_003_0	2009	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																																																			0		300.6890651	7.276013596	1374.484601	1822.634939	180.2738737	12.11717618	11.27923445	323.5024064	411.4812487		4901.910664	75.49171347	15.61111457	105.5627993	3412.157714	3662.105189	226.1823145	240.1739904			28.833468	1213.336209					217.5130188														"1a: $195 per admit, $600 Max OOP"	1b : $95 days 1-5	2a: $100 days 21 - 100  2a2: $100 days 21-100	6a: 15%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: $50 9b: $25	8a: 0%	8b1: 10% 8b2: 10% 8b3: 10%	9a: $50	12: $50	9a: $50 9c: 30% 9d: $15 3: $15 5: $95	"7a: $10, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $20 7d: $25 7f: $20	"7e, 7h: 30%"	7c: $15 7i: $15	8b1: 10% 8b2: 10% 8b3: 10%	7g: $25	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $15 17b: $	10b: n/c	16a: $	17a: $15		18a: $15 18a1: 15	18b: (n/c)		14a: $0											184.742007	158.7489746	64.98915146	22.74736459	100	0.2	0.2	48.54094142	47.5		10.96870143	50	50	15.22764185	10	24.24549602	28.19822438	15			0.2	15					15														144.9213716	124.5310663	50.98091722	17.84423224	78.44527291	0.156890546	0.156890546	38.07807397	37.26150463		8.604427774	39.22263645	39.22263645	11.94536521	7.844527291	19.01944552	22.12017407	11.76679094			0.156890546	11.76679094					11.76679094														3.6314	0.075507478	5.839373806	2.710293428	1.178469435	1.901070384	1.76960525	1.026529047	1.277700871	0	3.514844689	0.246748669	0.051025756	0.105082183	2.230563692	5.80426751	0.416932681	0.235506428	0	0	4.523698533	1.189756126	0	0	0	0	0.213285851	0	0	0	0	0	0	0	0	0	0	0	0	0	37.9416	0	10.4254	3.6314	0.075507478	5.839373806	2.710293428	1.178469435	1.901070384	1.76960525	1.026529047	1.277700871	0	3.514844689	0.246748669	0.051025756	0.105082183	2.230563692	5.80426751	0.416932681	0.235506428	0	0	4.523698533	1.189756126	0	0	0	0	0.213285851	0	0	0	0	0	0	0	0	0	0	0	0	0	37.9416		1a: $800	1b : $800	2a / 2a2: 30%	6a: 30%	10a: $100	11a: 20%	11b: 20% 11c: 20%	4a: $50 4a1: 20% / $250 Ded 4b: $35	9a: 30% 9b: 30%	8a: 30%	8b1: 30% 8b2: 30% 8b3: 30%	9a: 30%	12: $50	9a: $50 9c: 50% 9d: $35 3: $15 5: 30%	"7a: $35, 14b, 14c, 14d, 14e, 14f, 14g, 14h: $0, 14i: $0"	7b: $35 7d: $35 7f: $35	"7e, 7h: 50%"	7c: $35 7i: $35	8b1: 30% 8b2: 30% 8b3: 30%	7g: $35	15: 20%	13a: $0 14a: $0 14j: $0 16b: $ 17a: $35 17b: $	10b: n/c	16a: 0%	17a: $35		18a: $35 18a1: 35	18b: (n/c)		14a: $0	13b: (n/c)										5.6925	0.119	2.8826	1.3842	0.3176	0.7282	0.6778	0.3642	2.8908	0.9803	2.6733	0.2987	0.0191	1.4723	2.0252	2.5914	0.1666	0.1427			1.2346	0.678					0.1164														27.4556	500	0	9.3239	0.194460547	8.721985701	4.094482625	1.496026873	2.629250143	2.447429035	1.390753861	4.168519312	0.98029273	6.188101897	0.545463064	0.07011142	1.577409583	4.255749234	8.395710496	0.583572924	0.378206241	0	0	5.758328653	1.867784318	0	0	0	0	0.329715916	0	0	0	0	0	0	0	0	0	0	0	0	0	65.3972
H9930_009_0	2009	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	V																																																			0		351.9085873	13.7450386	81.86838		14.2222039	23.15988043	19.4970584	653.5682687	46.47177555	17.30767475	46.24015843	6.184973842	4.83692017	33.45986904	44.83573583	95.15727233	5.262177864	2.409751585			34.70766302	5.595390341																			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	4a: Medicare FFS Ded/Coin  4b: $35	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																			0.0725	0.0725	0.2001		0.231	0.231	0.231	119.922319	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.21557232																			0.0725	0.0725	0.2001		0.231	0.231	0.231	119.922319	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.21557232																			25.5134	0.996515299	16.38186284	0	3.2853291	5.349932379	4.50382049	6.531451868	10.73498015	3.998072868	10.6814766	1.428728958	1.117328559	7.729229747	10.35705498	21.98132991	1.215563087	0.556652616	0	0	8.017470158	1.206211279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.5864	0	0	25.5134	0.996515299	16.38186284	0	3.2853291	5.349932379	4.50382049	6.531451868	10.73498015	3.998072868	10.6814766	1.428728958	1.117328559	7.729229747	10.35705498	21.98132991	1.215563087	0.556652616	0	0	8.017470158	1.206211279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	141.5864		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	4a: Medicare FFS Ded/Coin  4b: $35	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														4.573	0.1786	2.9363		0.5932	0.9685	0.8153	1.1712	1.9241	0.7184	1.9196	0.2561	0.2004	1.3889	1.8647	3.9599	0.4733	0.1			1.4513	0.2186																			25.7114	0	0	30.0864	1.175130545	19.31814036	0	3.87854571	6.318394926	5.31911705	7.702660792	12.65911632	4.716483208	12.60108218	1.684814113	1.317702441	9.118158339	12.2217728	25.94119173	1.688832879	0.656693007	0	0	9.468819263	1.424786849	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	167.2978
H9930_801_0	2009	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																																																			0		270.3541168	4.295478293	49.03615148		6.398131545	10.93178533	10.1758172	16.93707554	49.18480694	16.51963106	45.02706279	5.082370309	0.961478384	24.70029334	36.18386886	89.11832367	1.774015433	2.574990292			26.01276717	7.726432974																			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																			0.071822104	0.071822104	0.195188152		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.071822104	0.071822104	0.195188152		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			19.4174	0.308510287	9.571275787	0	1.477968387	2.525242412	2.350613774	3.91246445	11.3616904	3.816034774	10.4012515	1.174027541	0.222101507	5.705767761	8.358473706	20.58633277	0.409797565	0.594822758	0	0	6.008949217	1.784806017	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.9875	0	0	19.4174	0.308510287	9.571275787	0	1.477968387	2.525242412	2.350613774	3.91246445	11.3616904	3.816034774	10.4012515	1.174027541	0.222101507	5.705767761	8.358473706	20.58633277	0.409797565	0.594822758	0	0	6.008949217	1.784806017	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.9875		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																			3.4633	0.055	1.7071		0.2891	0.5105	0.4752	0.6978	2.0265	0.6872	1.874	0.2094	0.0397	1.0177	1.4798	3.755	0.0742	0.1074			1.2147	0.3241																			20.0075	0	0	22.8807	0.363536558	11.27842019	0	1.767021273	3.035701764	2.825773219	4.610296371	13.38817533	4.503227167	12.27522441	1.383428522	0.261803525	6.723473681	9.838252893	24.34130451	0.483969246	0.702217355	0	0	7.223614513	2.108892878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.995
H9930_802_0	2009	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																																																			0		270.3541168	4.295478293	49.03615148		6.398131545	10.93178533	10.1758172	16.93707554	49.18480694	16.51963106	45.02706279	5.082370309	0.961478384	24.70029334	36.18386886	89.11832367	1.774015433	2.574990292			26.01276717	7.726432974																			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																			0.071822104	0.071822104	0.195188152		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.071822104	0.071822104	0.195188152		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			19.4174	0.308510287	9.571275787	0	1.477968387	2.525242412	2.350613774	3.91246445	11.3616904	3.816034774	10.4012515	1.174027541	0.222101507	5.705767761	8.358473706	20.58633277	0.409797565	0.594822758	0	0	6.008949217	1.784806017	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.9875	0	0	19.4174	0.308510287	9.571275787	0	1.477968387	2.525242412	2.350613774	3.91246445	11.3616904	3.816034774	10.4012515	1.174027541	0.222101507	5.705767761	8.358473706	20.58633277	0.409797565	0.594822758	0	0	6.008949217	1.784806017	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.9875		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																			3.4633	0.055	1.7071		0.2891	0.5105	0.4752	0.6978	2.0265	0.6872	1.874	0.2094	0.0397	1.0177	1.4798	3.755	0.0742	0.1074			1.2147	0.3241																			20.0075	0	0	22.8807	0.363536558	11.27842019	0	1.767021273	3.035701764	2.825773219	4.610296371	13.38817533	4.503227167	12.27522441	1.383428522	0.261803525	6.723473681	9.838252893	24.34130451	0.483969246	0.702217355	0	0	7.223614513	2.108892878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.995
H9930_803_0	2009	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																																																			0		270.3541168	4.295478293	49.03615148		6.398131545	10.93178533	10.1758172	16.93707554	49.18480694	16.51963106	45.02706279	5.082370309	0.961478384	24.70029334	36.18386886	89.11832367	1.774015433	2.574990292			26.01276717	7.726432974																			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																			0.071822104	0.071822104	0.195188152		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			0.071822104	0.071822104	0.195188152		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231			0.231	0.231																			19.4174	0.308510287	9.571275787	0	1.477968387	2.525242412	2.350613774	3.91246445	11.3616904	3.816034774	10.4012515	1.174027541	0.222101507	5.705767761	8.358473706	20.58633277	0.409797565	0.594822758	0	0	6.008949217	1.784806017	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.9875	0	0	19.4174	0.308510287	9.571275787	0	1.477968387	2.525242412	2.350613774	3.91246445	11.3616904	3.816034774	10.4012515	1.174027541	0.222101507	5.705767761	8.358473706	20.58633277	0.409797565	0.594822758	0	0	6.008949217	1.784806017	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.9875		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																			3.4633	0.055	1.7071		0.2891	0.5105	0.4752	0.6978	2.0265	0.6872	1.874	0.2094	0.0397	1.0177	1.4798	3.755	0.0742	0.1074			1.2147	0.3241																			20.0075	0	0	22.8807	0.363536558	11.27842019	0	1.767021273	3.035701764	2.825773219	4.610296371	13.38817533	4.503227167	12.27522441	1.383428522	0.261803525	6.723473681	9.838252893	24.34130451	0.483969246	0.702217355	0	0	7.223614513	2.108892878	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	129.995
H9931_001_0	2009	6																					3350											D	D	D	V	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	P	P	Coin	Coin	Coin	Coin	Coin	Coin	T	P	P	P	P	P	P	P																																																			0		1207.031138	63.88497756	1051.550374		8.387100438	9.635775299	7.924604661	280.7970604	41.70527028	9.419184675	19.62548868	3.84863683	0.178563315	43.28298267	3393.98355	4205.397814	1.630804542	1.92997393		9.725439347	17.61017986																				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) - $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%"	8b (Professional Radiology) - 0%	8a (Professional Labs) - 20%	15 (Part B Rx) - 20%	13a (Blood); 13a1 (Add'l Blood) - 0%; 17b (MCR Eyewear) - $0																			122.7	122.7	65.9		0.2	0.3	0.3	50.05281245	0.2	0.2	0.2	0.2	0.2	0.205569702	15.00002528	24.88736924	0.5	0.2		0.2	0.2																				105.9205519	105.9205519	56.88805515		0.172649636	0.258974454	0.258974454	43.20799932	0.172649636	0.172649636	0.172649636	0.172649636	0.172649636	0.177457671	12.94881844	21.48397623	0.431624091	0.172649636		0.172649636	0.172649636																				10.6541	0.56389434	4.985054641	0	1.44802984	2.495419651	2.052270168	1.0110566	7.200399744	1.626218808	3.388333482	0.664465749	0.030828891	7.680897301	3.662339731	7.529055557	0.703894528	0.333209297	0	1.679093566	3.040391147	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.749	0	9.6235	10.6541	0.56389434	4.985054641	0	1.44802984	2.495419651	2.052270168	1.0110566	7.200399744	1.626218808	3.388333482	0.664465749	0.030828891	7.680897301	3.662339731	7.529055557	0.703894528	0.333209297	0	1.679093566	3.040391147	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.749																																																																																		0	0	0	10.6541	0.56389434	4.985054641	0	1.44802984	2.495419651	2.052270168	1.0110566	7.200399744	1.626218808	3.388333482	0.664465749	0.030828891	7.680897301	3.662339731	7.529055557	0.703894528	0.333209297	0	1.679093566	3.040391147	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	60.749
H9931_801_0	2009	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	P	P	P	P	P	P																																																			0		273.1108096	5.808698428	32.44669136		7.696009812	11.80628085	9.897728362	10.60807846	41.97650434	6.260188881	17.86935916	3.470031027	0.353350962	28.17170232	36.23580514	70.79144313	3.331889718	5.327047776	30.99562397	63.74475759	25.99866044	0.69737978																			Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share	Medicare Cost Share																			0.074699416	0.074699416	0.173405118		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.074699416	0.074699416	0.173405118		0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			20.4012	0.433906382	5.626422339	0	1.777778267	2.727250876	2.286375252	2.450466124	9.696572502	1.446103632	4.127821966	0.801577167	0.081624072	6.507663237	8.370470988	16.35282336	0.769666525	1.230548036	7.159989138	14.725039	6.005690563	0.161094729	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.1401	0	0	20.4012	0.433906382	5.626422339	0	1.777778267	2.727250876	2.286375252	2.450466124	9.696572502	1.446103632	4.127821966	0.801577167	0.081624072	6.507663237	8.370470988	16.35282336	0.769666525	1.230548036	7.159989138	14.725039	6.005690563	0.161094729	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.1401																																																																																		0	0	0	20.4012	0.433906382	5.626422339	0	1.777778267	2.727250876	2.286375252	2.450466124	9.696572502	1.446103632	4.127821966	0.801577167	0.081624072	6.507663237	8.370470988	16.35282336	0.769666525	1.230548036	7.159989138	14.725039	6.005690563	0.161094729	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	113.1401
H9951_001_0	2009	3																																Coin		Coin	Coin	Coin	Coin		V	Coin					Coin						Coin	Coin	Coin																																																											0		267.1995159		28.70307341	8.966427324	6.861390771	32.82557862		946.3208292	38.48238189					97.89688678						164.0872294	28.21337688	3.574487931																			traditional Medicare	included in a.1	traditional Medicare	traditional Medicare	traditional Medicare	traditional Medicare	included in e.1	$50 Copay (max for MA)	traditional Medicare	included in h.5	included in h.5	included in h.5	included in h.5	traditional Medicare	included in i.6	included in i.6	included in i.6	included in i.6	included in i.6	traditional Medicare	traditional Medicare	traditional Medicare								no cost share											0.0793		0.1517	0	0.231	0.231		50	0.231					0.231						0.231	0.231	0.231																			0.0793		0.1517	0	0.231	0.231		50	0.231					0.231						0.231	0.231	0.231																			21.1889	0	4.354256237	0	1.584981268	7.582708661	0	3.943003455	8.889430216	0	0	0	0	22.61418085	0	0	0	0	0	37.90415	6.517290058	0.825706712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.4046			21.1889	0	4.354256237	0	1.584981268	7.582708661	0	3.943003455	8.889430216	0	0	0	0	22.61418085	0	0	0	0	0	37.90415	6.517290058	0.825706712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.4046																																																																																		0			21.1889	0	4.354256237	0	1.584981268	7.582708661	0	3.943003455	8.889430216	0	0	0	0	22.61418085	0	0	0	0	0	37.90415	6.517290058	0.825706712	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	115.4046
R3175_001_0	2009	6																					3050											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	4050	1269.584093	127.6135536	222.6134012	29.97835359	64.01484606	4.171849238	3.179153539	229.2471534	26.01590094	11605.32908	33.91493039	0	0.090028378	18.95528175	6129.352087	5033.063905	519.6745123	410.0394081	0	0	12.06868779	1154.429328	0	488.4949815	116.1713756	0	14.45191907	0	377.232	549.5											"$275 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$275 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$5 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $10 (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$25 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$10 (13b); $0 n/c (13d, 13e)"											222.2332289	185.0678054	85.36789939	0	150	0.2	0.064573342	49.97728087	0.2	2.8	0.179727765	0	0.2	0.200181086	3.679350257	23.0600514	37.5	25	0	0	0.2	24.08271025	0	25	25	0	25	0	0	10											160.4443275	133.6122403	61.63252578	0	108.2945572	0.144392743	0.04661961	36.08178336	0.144392743	2.021498402	0.129756925	0	0.144392743	0.14452348	2.65635738	17.00810444	27.07363931	18.04909287	0	0	0.144392743	17.38684296	0	25	25	0	25	0	0	10											16.9748	1.420894399	1.143352183	0	0.577704951	0.602384755	0.148210898	0.689303844	3.756507298	1.955012849	4.400697065	0	0.012999444	2.739483292	1.356812471	7.133573047	1.172456692	0.616736613	0	0	1.742630935	1.672656786	0	1.017697878	0.242023699	0	0.030108165	0	0	0.457916667	0	0	0	0	0	0	0	0	0	0	49.864	0	18.3212	16.9748	1.420894399	1.143352183	0	0.577704951	0.602384755	0.148210898	0.689303844	3.756507298	1.955012849	4.400697065	0	0.012999444	2.739483292	1.356812471	7.133573047	1.172456692	0.616736613	0	0	1.742630935	1.672656786	0	1.017697878	0.242023699	0	0.030108165	0	0	0.457916667	0	0	0	0	0	0	0	0	0	0	49.864		"$375 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$375 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-27 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); 50% (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"50% (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a7, 14a8, 14a9, 14a10); $0 (14a6)"	"50% (13b); $0 n/c (13d, 13e)"											1.2333	0.1239	0.1171	0.0136	0.0894	0.1399	0.1066	0.1067	0.8724	0.3027	1.002	0	0.002	0.635	1.8865	2.4528	0.3322	0.2159	0	0	0.6536	0.5948	0	0.3623	0.0928	0	0.0115	0	0	0.2257											11.5726	0	5.627442462	18.208	1.544748047	1.260420008	0.013598772	0.667147762	0.742280525	0.25481833	0.796024885	4.628905675	2.257696504	5.402723928	0	0.015012075	3.374435035	3.243263198	9.586405109	1.504703442	0.832627364	0	0	2.396217245	2.26741231	0	1.379972878	0.334825143	0	0.041652824	0	0	0.683666667	0	0	0	0	0	0	0	0	0	0	61.4366
R3175_002_0	2009	4																					2750											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	3750	1268.675794	127.522255	222.4541369	29.95690617	63.96904791	4.165882041	3.174606242	229.0834661	25.97868914	11597.02628	33.86642023	0	0.089899606	18.92816909	6125.045731	5029.934357	519.3027215	409.7460536	0	0	12.05142537	1153.603415	0	488.4949815	116.1713756	0	14.45191907	0	377.232	549.5											"$275 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$275 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$25 Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$15 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$5 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$15 (7b, 7d, 7f, 7f1); $10 (7b1)"	"$40/$30 (7e, 7h)"	"$15 (7c, 7i)"	Included in h.2.	$5 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $15 (16b, 17a, 18a)"	$0 n/c (10b)	"$25 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$15 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$15 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$10 (13b); $0 n/c (13d, 13e)"											271.7627564	275	24.97080829	0	150	0.2	0.064573342	49.9772809	0.2	2.8	0.1797504	0	0.2	0.199560702	3.679302941	14.35294813	37.5	15	0	0	0.2	14.44962615	0	25	15	0	15	0	0	10											189.1602051	191.4134854	17.38090708	0	104.4073557	0.139209808	0.044946213	34.78663828	0.139209808	1.948937306	0.125115093	0	0.139209808	0.138904034	2.560975272	10.38369981	26.10183891	10.44073557	0	0	0.139209808	10.05764838	0	25	15	0	15	0	0	10											19.9986	2.034123274	0.322204557	0	0.556569928	0.579931637	0.142686528	0.664086972	3.616488316	1.883489763	4.237200317	0	0.012514907	2.629199052	1.307174221	4.352444036	1.129562999	0.356504183	0	0	1.677676606	0.966878126	0	1.017697878	0.145214219	0	0.018064899	0	0	0.457916667	0	0	0	0	0	0	0	0	0	0	48.1062	0	20.0545	19.9986	2.034123274	0.322204557	0	0.556569928	0.579931637	0.142686528	0.664086972	3.616488316	1.883489763	4.237200317	0	0.012514907	2.629199052	1.307174221	4.352444036	1.129562999	0.356504183	0	0	1.677676606	0.966878126	0	1.017697878	0.145214219	0	0.018064899	0	0	0.457916667	0	0	0	0	0	0	0	0	0	0	48.1062		"$375 Days 1-10 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$375 Days 1-10 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-25 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$20 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f, 7f1); 50% (7b1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"50% (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$35 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$35 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a7, 14a8, 14a9, 14a10); $0 (14a6)"	"50% (13b); $0 n/c (13d, 13e)"											1.2108	0.1216	0.1149	0.0133	0.0878	0.1373	0.1046	0.1048	0.8559	0.2972	0.9832	0	0.002	0.623	1.5109	2.4083	0.3262	0.212	0	0	0.6412	0.5839	0	0.3623	0.0928	0	0.0115	0	0	0.2257											11.0313	0	5.626406999	21.2094	2.155725962	0.43714475	0.013342071	0.644387174	0.717186626	0.247281554	0.768868575	4.472418619	2.180672338	5.220424391	0	0.014489546	3.252170103	2.818039026	6.760737227	1.455771378	0.568471258	0	0	2.31892531	1.550817864	0	1.379972878	0.238015663	0	0.029609558	0	0	0.683666667	0	0	0	0	0	0	0	0	0	0	59.1375
R3175_003_0	2009	5																					2900											D	D	D	V	T	P	P	V	V	V	V	V	O	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	6000	1922.739872	133.7154306	1137.93956	4283.427652	259.0921968	2695.336875	787.2128953	555.7371264	279.8221363	5036.313811	395.4326805	0	31.74610817	1657.649647	5091.913524	3703.519084	599.440958	695.9978323	0	0	18.73577203	849.8408334	314.7167888	3436.366038	121.7259621	0	37.12850305	10.19671187	20.2	0											"$200 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$200 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	"$0 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0 (11a)	"$0 (11b, 11c)"	$50 (4a); $0 (4a1); $10 (4b)	$25 (9b)	$0 (8a1); $0/$0 (8a2)	"$0 (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"$25 (3, 5, 9a, 9d); $0 (9c)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $10 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$10 (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"$0 (7e, 7h)"	"$0 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $10 (16b, 17a, 18a)"	$0 (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	$0 (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											197.6	200	0	0	75	0	0	49.98380529	25	0	0	0	0	24.90893499	0	9.800308713	0	0	0	0	0.2	5.445807732	0	0	0	0	0	0	0	0											149.2392635	151.0518861	0	0	56.6444573	0	0	37.75074033	18.88148577	0	0	0	0	18.81270806	0	7.40177558	0	0	0	0	0.151051886	4.112997647	0	0	0	0	0	0	0	0											23.9124	1.683164	0	0	1.223011407	0	0	1.748290663	0.44028814	0	0	0	0	2.598739907	0	2.28438476	0	0	0	0	2.830073704	0.291282779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.0116	0	11.9935	23.9124	1.683164	0	0	1.223011407	0	0	1.748290663	0.44028814	0	0	0	0	2.598739907	0	2.28438476	0	0	0	0	2.830073704	0.291282779	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	37.0116		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $10 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	$0 (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $10 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	30% (18a1); $0 n/c (18a2)	"$0 n/c (18b); $0 (18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											5.1864	0.4349	0.4557	1.1247	0.251	0.5514	0.1875	0.1733	0.6132	0.1139	0.2755	0	0	0.6529	0.6259	1.6631	0.1604	0.0678	0	0	0.2846	0.0599	0.0528	0	0.0086	0	0.0034	0	0.0042	0											12.9513	0	6.205577057	29.0988	2.118052531	0.455667337	1.124736942	1.474058324	0.551442355	0.187521214	1.921557438	1.053485138	0.113875688	0.27549816	0	0	3.251665615	0.625904517	3.947534529	0.16036338	0.067819793	0	0	3.11471505	0.351160586	0.0528	0	0.008555215	0	0.003433103	0	0.0042	0	0	0	0	0	0	0	0	0	0	0	49.9629
R3175_004_0	2009	4																					2900											D	D	Coin	V	T	Coin	Coin	V	Coin	V	V	V	Coin	Coin	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	6000	1514.205647	254.8858443	31.20010805	40800.25975	70.68274792	14.92287655	6.59781347	288.8735653	29.53024748	4795.926807	366.7748663	0	0.579583711	23.55607376	4895.282592	3627.534244	1219.168569	216.2893305	0	0	19.75233324	916.0207471	729.4577618	0	310.7455386	325.2342857	0	0	20.2	0											"$225 Days 1-13 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$225 Days 1-13 (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	20% (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5); 20% (9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											222.3	225	0.161516735	0	75	0.14	0.2	49.9688445	0.2	4.4	64.79010385	0	0.2	0.205686176	3.245599736	25	20	20	0	0	0.2	13.6791576	0	0	0	0	0	0	0	0											158.1720652	160.0931834	0.161516735	0	53.36439446	0.099613536	0.142305052	35.55409505	0.142305052	3.130711142	46.09979545	0	0.142305052	0.146350909	3.245599736	25	20	20	0	0	0.142305052	13.6791576	0	0	0	0	0	0	0	0											19.9588	3.400457184	5.039339592	0	0.314328503	1.486520506	0.938902188	0.855886516	4.202303399	1.251221791	1.409020526	0	0.08247769	3.447452819	1.324010658	7.557363009	2.031947615	0.360482217	0	0	2.810856806	1.044199347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.5155	0	16.2814	19.9588	3.400457184	5.039339592	0	0.314328503	1.486520506	0.938902188	0.855886516	4.202303399	1.251221791	1.409020526	0	0.08247769	3.447452819	1.324010658	7.557363009	2.031947615	0.360482217	0	0	2.810856806	1.044199347	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	57.5155		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											4.6964	0.3623	0.4405	0.6212	0.1599	0.3668	0.1622	0.0988	0.7258	0.1141	0.3078	0	0.0095	0.5789	0.7284	2.3606	0.2121	0.0811	0	0	0.3289	0.0901	0.1139	0	0.0218	0	0	0	0.0042	0											12.5851	0	3.196040583	24.6552	3.762771235	5.479844523	0.621175986	0.474214716	1.853279958	1.101056612	0.95465064	4.928068124	1.365368773	1.716835994	0	0.091973974	4.02639031	2.05237398	9.917980077	2.244047615	0.441546019	0	0	3.139712052	1.134273249	0.113871675	0	0.02184	0	0	0	0.0042	0	0	0	0	0	0	0	0	0	0	0	70.1006
R3175_801_0	2009	3																					5520											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	5520	1332.114846	133.8988967	233.5777664	31.45487573	67.16776563	4.374210701	3.333362889	240.5160162	27.2778391	12176.9257	35.56002218	0	0.094395332	19.87473457	6425.818122	4589.808657	545.2700115	430.2350558	0	0	12.65409661	1175.464064	0	0	0	0	0	0	0	0											"$460 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$460 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-35 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 25% (9a); $40/$30 (9c)"	"$15 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											454.5332789	460	160	0	150	0.2	0.064573342	49.97727877	0.25	2.8	0.21677811	0	0.2	0.249545176	11.04736552	25	37.5	25	0	0	0.2	24.81667261	0	0	0	0	0	0	0	0											339.9184423	344.0066783	119.6544968	0	112.1760907	0.149568121	0.048290567	37.37503839	0.186960151	2.093953694	0.162115473	0	0.149568121	0.186620016	8.261668513	18.69601512	28.04402269	18.69601512	0	0	0.149568121	18.55891546	0	0	0	0	0	0	0	0											37.7342	3.838509556	2.329052509	0	0.627884781	0.654242475	0.160969985	0.749107945	5.099868924	2.124826545	5.764829813	0	0.014118532	3.709023274	4.423998271	7.150927672	1.274297048	0.670306759	0	0	1.892649452	1.81794485	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.0368	0	26.9871	37.7342	3.838509556	2.329052509	0	0.627884781	0.654242475	0.160969985	0.749107945	5.099868924	2.124826545	5.764829813	0	0.014118532	3.709023274	4.423998271	7.150927672	1.274297048	0.670306759	0	0	1.892649452	1.81794485	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.0368		"40% (1a, 13c); $0 (1a1); $0 n/c (1a2, 1a3)"	"40% (1b); $0 n/c (1b1, 1b2)"	"40% (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 40% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.5475	0.1182	0.1934	0.0197	0.0974	0.1522	0.116	0.1162	1.2659	0.3296	1.3962	0	0.0022	0.9187	2.1062	2.5038	0.3618	0.2351	0	0	0.7113	0.6378	0	0	0	0	0	0	0	0											13.8295	0	6.385535883	40.2817	3.956757458	2.522425122	0.019732796	0.725295053	0.806491596	0.276991275	0.865324822	6.365781733	2.454472902	7.160993664	0	0.016308887	4.62769516	6.530229182	9.654750824	1.636139945	0.905428802	0	0	2.60395002	2.455789663	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.8663
R3175_802_0	2009	3																					5520											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	5520	1332.114846	133.8988967	233.5777664	31.45487573	67.16776563	4.374210701	3.333362889	240.5160162	27.2778391	12176.9257	35.56002218	0	0.094395332	19.87473457	6425.818122	4589.808657	545.2700115	430.2350558	0	0	12.65409661	1175.464064	0	0	0	0	0	0	0	0											"$460 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$460 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-35 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 25% (9a); $40/$30 (9c)"	"$15 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											454.5332789	460	160	0	150	0.2	0.064573342	49.97727877	0.25	2.8	0.21677811	0	0.2	0.249545176	11.04736552	25	37.5	25	0	0	0.2	24.81667261	0	0	0	0	0	0	0	0											339.9184423	344.0066783	119.6544968	0	112.1760907	0.149568121	0.048290567	37.37503839	0.186960151	2.093953694	0.162115473	0	0.149568121	0.186620016	8.261668513	18.69601512	28.04402269	18.69601512	0	0	0.149568121	18.55891546	0	0	0	0	0	0	0	0											37.7342	3.838509556	2.329052509	0	0.627884781	0.654242475	0.160969985	0.749107945	5.099868924	2.124826545	5.764829813	0	0.014118532	3.709023274	4.423998271	7.150927672	1.274297048	0.670306759	0	0	1.892649452	1.81794485	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.0368	0	26.9871	37.7342	3.838509556	2.329052509	0	0.627884781	0.654242475	0.160969985	0.749107945	5.099868924	2.124826545	5.764829813	0	0.014118532	3.709023274	4.423998271	7.150927672	1.274297048	0.670306759	0	0	1.892649452	1.81794485	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.0368		"40% (1a, 13c); $0 (1a1); $0 n/c (1a2, 1a3)"	"40% (1b); $0 n/c (1b1, 1b2)"	"40% (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 40% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.5475	0.1182	0.1934	0.0197	0.0974	0.1522	0.116	0.1162	1.2659	0.3296	1.3962	0	0.0022	0.9187	2.1062	2.5038	0.3618	0.2351	0	0	0.7113	0.6378	0	0	0	0	0	0	0	0											13.8295	0	6.385535883	40.2817	3.956757458	2.522425122	0.019732796	0.725295053	0.806491596	0.276991275	0.865324822	6.365781733	2.454472902	7.160993664	0	0.016308887	4.62769516	6.530229182	9.654750824	1.636139945	0.905428802	0	0	2.60395002	2.455789663	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.8663
R3175_803_0	2009	3																					5520											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	5520	1332.114846	133.8988967	233.5777664	31.45487573	67.16776563	4.374210701	3.333362889	240.5160162	27.2778391	12176.9257	35.56002218	0	0.094395332	19.87473457	6425.818122	4589.808657	545.2700115	430.2350558	0	0	12.65409661	1175.464064	0	0	0	0	0	0	0	0											"$460 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$460 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-35 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 25% (9a); $40/$30 (9c)"	"$15 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											454.5332789	460	160	0	150	0.2	0.064573342	49.97727877	0.25	2.8	0.21677811	0	0.2	0.249545176	11.04736552	25	37.5	25	0	0	0.2	24.81667261	0	0	0	0	0	0	0	0											339.9184423	344.0066783	119.6544968	0	112.1760907	0.149568121	0.048290567	37.37503839	0.186960151	2.093953694	0.162115473	0	0.149568121	0.186620016	8.261668513	18.69601512	28.04402269	18.69601512	0	0	0.149568121	18.55891546	0	0	0	0	0	0	0	0											37.7342	3.838509556	2.329052509	0	0.627884781	0.654242475	0.160969985	0.749107945	5.099868924	2.124826545	5.764829813	0	0.014118532	3.709023274	4.423998271	7.150927672	1.274297048	0.670306759	0	0	1.892649452	1.81794485	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.0368	0	26.9871	37.7342	3.838509556	2.329052509	0	0.627884781	0.654242475	0.160969985	0.749107945	5.099868924	2.124826545	5.764829813	0	0.014118532	3.709023274	4.423998271	7.150927672	1.274297048	0.670306759	0	0	1.892649452	1.81794485	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.0368		"40% (1a, 13c); $0 (1a1); $0 n/c (1a2, 1a3)"	"40% (1b); $0 n/c (1b1, 1b2)"	"40% (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 40% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.5475	0.1182	0.1934	0.0197	0.0974	0.1522	0.116	0.1162	1.2659	0.3296	1.3962	0	0.0022	0.9187	2.1062	2.5038	0.3618	0.2351	0	0	0.7113	0.6378	0	0	0	0	0	0	0	0											13.8295	0	6.385535883	40.2817	3.956757458	2.522425122	0.019732796	0.725295053	0.806491596	0.276991275	0.865324822	6.365781733	2.454472902	7.160993664	0	0.016308887	4.62769516	6.530229182	9.654750824	1.636139945	0.905428802	0	0	2.60395002	2.455789663	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.8663
R3175_804_0	2009	3																					5520											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	5520	1332.114846	133.8988967	233.5777664	31.45487573	67.16776563	4.374210701	3.333362889	240.5160162	27.2778391	12176.9257	35.56002218	0	0.094395332	19.87473457	6425.818122	4589.808657	545.2700115	430.2350558	0	0	12.65409661	1175.464064	0	0	0	0	0	0	0	0											"$460 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$460 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$160 Days 1-35 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	25% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 25% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 25% (9a); $40/$30 (9c)"	"$15 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$15 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											454.5332789	460	160	0	150	0.2	0.064573342	49.97727877	0.25	2.8	0.21677811	0	0.2	0.249545176	11.04736552	25	37.5	25	0	0	0.2	24.81667261	0	0	0	0	0	0	0	0											339.9184423	344.0066783	119.6544968	0	112.1760907	0.149568121	0.048290567	37.37503839	0.186960151	2.093953694	0.162115473	0	0.149568121	0.186620016	8.261668513	18.69601512	28.04402269	18.69601512	0	0	0.149568121	18.55891546	0	0	0	0	0	0	0	0											37.7342	3.838509556	2.329052509	0	0.627884781	0.654242475	0.160969985	0.749107945	5.099868924	2.124826545	5.764829813	0	0.014118532	3.709023274	4.423998271	7.150927672	1.274297048	0.670306759	0	0	1.892649452	1.81794485	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.0368	0	26.9871	37.7342	3.838509556	2.329052509	0	0.627884781	0.654242475	0.160969985	0.749107945	5.099868924	2.124826545	5.764829813	0	0.014118532	3.709023274	4.423998271	7.150927672	1.274297048	0.670306759	0	0	1.892649452	1.81794485	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.0368		"40% (1a, 13c); $0 (1a1); $0 n/c (1a2, 1a3)"	"40% (1b); $0 n/c (1b1, 1b2)"	"40% (2a, 2a2); $0 n/c (2a1)"	"40% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	40% (9b)	40%/$7 (8a1); $7 (8a2)	"$20 (8b1); 40% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $75 (5); 40% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 40% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $35 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.5475	0.1182	0.1934	0.0197	0.0974	0.1522	0.116	0.1162	1.2659	0.3296	1.3962	0	0.0022	0.9187	2.1062	2.5038	0.3618	0.2351	0	0	0.7113	0.6378	0	0	0	0	0	0	0	0											13.8295	0	6.385535883	40.2817	3.956757458	2.522425122	0.019732796	0.725295053	0.806491596	0.276991275	0.865324822	6.365781733	2.454472902	7.160993664	0	0.016308887	4.62769516	6.530229182	9.654750824	1.636139945	0.905428802	0	0	2.60395002	2.455789663	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.8663
R3444_001_0	2009	11																					0											A	A	D	V	T	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	S	Coin	T	V	V	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	460.462254	26.3200446	278.8223185	749.0240533	1081.527124	48.6498313	34.42233649	36.81131579	36.28133528	8.679863849	19.57629935	106.8271204	0.405316643	31.06770646	49.28762154	100.6568694	1.76551896	1.347895318	26.75472822	36.03845357	1388.398327	11.29014131	330	300	175.4782086	0	0	0	0	11520											PBP: 1A IP Acute: $1064 per admit	1B IP Psych: $1064 per admit	"2 SNF: $133, days 21 - 100"	6 Home Health: $0	10A Ambulance: 20%	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: 20%, 4B Urgent Care: 20%"	9B ASC Services: 20%	8A OP C/D/T: 20%	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	9A OP Hospital: $0	12 Renal Dialysis: 20%	"3 CORF: 20%, 5 Partial Hosp: 50%, 9D Cardiac Rehab: 20%"	"7A PCP: 20%, 14B Immunizations: 20%, 14C Routine Physical Exams: $0, 14D Pap Smears: 20%, 14D Pelvic Exams: 20%, 14E Prostate Screening: 20%, 14F Colorectal Screening: 20%, 14G Bone Mass Measurement: 20%, 14H Mammography: 20%, 14I Diabetes Monitoring: 20%"	7D Physician Specialist: 20%	"7E Mental Health Individual: 50%, Group: 50%, 7H Psychiatric Individual: 50%, Group: 50%, 9C Outpatient Sub Abuse: 50%"	"7C Occupational Therapy: 20%, 7I Physical and Speech Therapy: 20%"	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	"7G Other Health Care: 20%, 18A Medicare Covered Hearing Exams: 20%, 7B Chiropractic: 20%, 7F Podiatry: 20%"	15 Part B Drugs: 20%	"13A Blood: 20%, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: 20%"	"10B Transportation: $0, 24 one-way trips"	16A Preventive Dental Services: $15	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: 20%, Routine: $0 with a $200 allowance"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	OTC Drug Card: $34											917.0842547	462.8928735	334.2826546	0	51.68589611	0.231	0.231	0.231	0.231	0.231	0.231	18.02891369	25.11369228	0.231	0.230338246	0.231	0.231	0.231	0.231	0.211859359	12.85434419	0.231	0	15	39.59465995	0	0	0	0	0											917.0842547	462.8928735	334.2826546	0	51.68589611	0.231	0.231	0.231	0.231	0.231	0.231	18.02891369	25.11369228	0.231	0.230338246	0.231	0.231	0.231	0.231	0.211859359	12.85434419	0.231	0	15	39.59465995	0	0	0	0	0											35.1902	1.01528009	7.767122066	0	4.658308213	11.23811103	7.95155973	8.503413948	8.380988449	2.005048549	4.52212515	0.160498078	0.00084825	7.176640193	11.3528243	23.25173683	0.40783488	0.311363818	6.180342218	7.635083681	1.487245831	2.608022642	0	0.375	0.579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	152.7586	0	0	35.1902	1.01528009	7.767122066	0	4.658308213	11.23811103	7.95155973	8.503413948	8.380988449	2.005048549	4.52212515	0.160498078	0.00084825	7.176640193	11.3528243	23.25173683	0.40783488	0.311363818	6.180342218	7.635083681	1.487245831	2.608022642	0	0.375	0.579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	152.7586	90000	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	35.1902	1.01528009	7.767122066	0	4.658308213	11.23811103	7.95155973	8.503413948	8.380988449	2.005048549	4.52212515	0.160498078	0.00084825	7.176640193	11.3528243	23.25173683	0.40783488	0.311363818	6.180342218	7.635083681	1.487245831	2.608022642	0	0.375	0.579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	152.7586
R3444_002_0	2009	9																					0											D	A	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	Coin	V	S	V	T	V	V	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	2210.844831	14.48397288	212.873184	402.2271437	735.8051922	33.82837837	23.50285553	598.7568423	291.9298557	6.53924614	16.98683953	131.6704028	0.276901173	838.2439502	9269.992142	9952.600692	158.1675427	357.7861104	26.70922057	12649.32693	1048.430416	536.4651706	210	300	133.1190447	0	0	0	0	0											"PBP: 1A IP Acute: $160 per day, days 1 - 10"	1B IP Psych: $1000 per admit	"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: 0%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $100	8A OP C/D/T: 20%	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $30	"3 CORF: $30, 5 Partial Hosp: $30, 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 Individual: $30, Group: $15, 7H Psychiatric Individual: $30, Group: $15,  9C Outpatient Sub Abuse Individual: $30, Group: $15"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $30, 7B Chiropractic: $30, 7F Podiatry: $30, 8A OP C/D/T: 20%"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $30"	"10B Transportation: $0, 12 one-way trips"	16A Preventive Dental Services: $10	17A Routine Eye Exams: $30	"17B Eye Wear: Medicare Covered: $30, Routine: $0 with a $150 allowance"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	OTC Drug Card: Not Covered											176.4502001	1127.646795	105.93364	0	101.5807215	0.20377247	0.026211585	71.88702312	176.3019313	0.242228423	0.245756141	3.821857344	6.676464747	24.30147517	6.55469388	9.606683611	29.18472753	30.2084168	0.173610592	5.140395408	16.51199854	41.16469993	0	10	20	0	0	0	0	0											165.1879805	1087.70797	96.6683761	0	100.8029762	0.199227069	0.025740459	71.88316339	170.032078	0.237902554	0.241450411	3.821857344	6.676464747	23.24459775	6.431571705	9.517804792	28.92106654	30.16649657	0.168893007	4.97287193	16.23522702	40.95296078	0	10	20	0	0	0	0	0											30.4337	1.312861061	1.714842084	0	6.180946104	6.739528681	0.604974278	3.586711327	4.136453333	1.555703361	4.101479392	0.041935458	0.00015406	1.623720287	4.968384931	7.893909213	0.381197836	0.899429456	4.511000582	5.241956903	1.418458818	1.830819757	0	0.25	0.221865074	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.6501	0	3.3378	30.4337	1.312861061	1.714842084	0	6.180946104	6.739528681	0.604974278	3.586711327	4.136453333	1.555703361	4.101479392	0.041935458	0.00015406	1.623720287	4.968384931	7.893909213	0.381197836	0.899429456	4.511000582	5.241956903	1.418458818	1.830819757	0	0.25	0.221865074	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.6501	3350	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	30.4337	1.312861061	1.714842084	0	6.180946104	6.739528681	0.604974278	3.586711327	4.136453333	1.555703361	4.101479392	0.041935458	0.00015406	1.623720287	4.968384931	7.893909213	0.381197836	0.899429456	4.511000582	5.241956903	1.418458818	1.830819757	0	0.25	0.221865074	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	89.6501
R3444_003_0	2009	8																					0											D	A	D	V	T	Coin	Coin	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	S	V	T	V	V	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	2634.256292	11.32348486	430.3762521	472.3048107	761.6859479	51.23119973	34.30361537	663.20982	469.4440957	6127.906864	29.64136468	265.155945	0.503777028	1581.75347	14289.32697	16055.56406	172.7338007	1329.167921	39.21667342	24051.81135	1941.834709	891.0769499	210	300	163.2179037	0	0	0	0	0											"PBP: 1A IP Acute: $125 per day, days 1 - 10"	1B IP Psych: $1000 per admit	"2 SNF: $50, days 21 - 100"	6 Home Health: $0	10A Ambulance: $75	"11A DME: 10% For DME less than $1,000 and 20% for DME > $1,000"	"11B Prosthetic Medical Supplies: 12%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $100	8A OP C/D/T: 0%	"8B All Radiation Therapy: 10%, Radiation Therapy and Chemo: 20%, X-Ray: 0%"	9A OP Hospital: $0	12 Renal Dialysis: $15	"3 CORF: $15, 5 Partial Hosp: $15, 9D Cardiac Rehab: $25"	"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: $15	"7E Mental Health Individual: $15, Group: $5, 7H Psychiatric Individual: $15, Group: $5,  9C Outpatient Sub Abuse Individual: $15, Group: $5"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	"8B All Radiation Therapy: 10%, Radiation Therapy and Chemo: 20%, X-Ray: 0%"	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $25, 7B Chiropractic: $25, 7F Podiatry: $15, 8A OP C/D/T: 0%"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $10"	"10B Transportation: $0, 12 one-way trips"	16A Preventive Dental Services: $10	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $10, Routine: $0 with a $150 allowance"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	OTC Drug Card: Not Covered											145.6274241	1118.477182	55.15720752	0	76.76710041	0.124149717	0.013691358	75.6743247	185.5353626	1.256611751	0.161307393	2.845821911	6.300399429	23.4170659	2.408869053	5.270921607	14.43377663	15.20110973	0.102929697	2.883993803	22.49655426	19.22602633	0	10	20	0	0	0	0	0											141.5220168	1106.145973	52.53345312	0	76.42367619	0.122559034	0.013579612	75.6722301	183.2773096	1.256611751	0.159784194	2.845821911	6.300399429	23.07043107	2.358301599	5.235280192	14.32111117	15.16290863	0.101300475	2.858503919	22.37658869	19.13255644	0	10	20	0	0	0	0	0											31.0671	1.043785598	1.884095888	0	4.850903353	6.278846331	0.465829798	4.182213842	7.169870903	0.641699981	4.736221568	0.062882217	0.0002645	3.040977866	2.808211886	7.004614707	0.206144997	1.679504312	3.972667641	5.729349751	3.620969714	1.420715003	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.3889	0	1.5485	31.0671	1.043785598	1.884095888	0	4.850903353	6.278846331	0.465829798	4.182213842	7.169870903	0.641699981	4.736221568	0.062882217	0.0002645	3.040977866	2.808211886	7.004614707	0.206144997	1.679504312	3.972667641	5.729349751	3.620969714	1.420715003	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.3889	3350	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	31.0671	1.043785598	1.884095888	0	4.850903353	6.278846331	0.465829798	4.182213842	7.169870903	0.641699981	4.736221568	0.062882217	0.0002645	3.040977866	2.808211886	7.004614707	0.206144997	1.679504312	3.972667641	5.729349751	3.620969714	1.420715003	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.3889
R3444_004_0	2009	8																					0											D	A	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	Coin	V	S	V	T	V	V	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	2210.844831	14.48397288	212.873184	402.2271437	735.8051922	33.82837837	23.50285553	598.7568423	291.9298557	6.53924614	16.98683953	131.6704028	0.276901173	838.2439502	9269.992142	9952.600692	158.1675427	357.7861104	26.70922057	12649.32693	1048.430416	536.4651706	210	300	133.1190447	0	0	0	0	0											"PBP: 1A IP Acute: $130 per day, days 1 - 10"	1B IP Psych: $1000 per admit	"2 SNF: $100, days 21 - 100"	6 Home Health: $0	10A Ambulance: $75	11A DME: 20%	"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 All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $30	"3 CORF: $30, 5 Partial Hosp: $30, 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 Individual: $30, Group: $15, 7H Psychiatric Individual: $30, Group: $15,  9C Outpatient Sub Abuse Individual: $30, Group: $15"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $30, 7B Chiropractic: $30, 7F Podiatry: $30, 8A OP C/D/T: 20%"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $30"	"10B Transportation: $0, 12 one-way trips"	16A Preventive Dental Services: $10	17A Routine Eye Exams: $30	"17B Eye Wear: Medicare Covered: $30, Routine: $0 with a $150 allowance"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	OTC Drug Card: Not Covered											146.4502001	1127.646795	105.93364	0	76.58072147	0.20377247	0.026211585	71.88702312	176.3019313	0.242228423	0.245756141	3.821857344	6.676464747	24.30147517	6.55469388	9.606683611	29.18472753	30.2084168	0.173610592	5.140395408	16.51199854	41.16469993	0	10	20	0	0	0	0	0											135.7322494	1090.207418	97.24821399	0	75.71786367	0.199511529	0.025769943	71.88340494	170.4244574	0.238173276	0.241719872	3.821857344	6.676464747	23.31073916	6.439276926	9.523366998	28.93756694	30.16912001	0.169188243	4.983355869	16.25254791	40.96621182	0	10	20	0	0	0	0	0											25.0069	1.315877889	1.725128079	0	4.642799769	6.749151496	0.605667236	3.58672338	4.145998937	1.557473672	4.106056679	0.041935458	0.00015406	1.628340506	4.974337208	7.898522414	0.381415321	0.899507675	4.518886091	5.253008134	1.419972131	1.831412151	0	0.25	0.221865074	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.7611	0	3.1667	25.0069	1.315877889	1.725128079	0	4.642799769	6.749151496	0.605667236	3.58672338	4.145998937	1.557473672	4.106056679	0.041935458	0.00015406	1.628340506	4.974337208	7.898522414	0.381415321	0.899507675	4.518886091	5.253008134	1.419972131	1.831412151	0	0.25	0.221865074	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.7611	3350	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	25.0069	1.315877889	1.725128079	0	4.642799769	6.749151496	0.605667236	3.58672338	4.145998937	1.557473672	4.106056679	0.041935458	0.00015406	1.628340506	4.974337208	7.898522414	0.381415321	0.899507675	4.518886091	5.253008134	1.419972131	1.831412151	0	0.25	0.221865074	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.7611
R3444_005_0	2009	8																					0											D	A	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	Coin	V	S	V	T	V	V	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	2293.981425	16.08748304	209.4480018	426.6509962	754.1814655	36.28900485	25.9762556	621.1238295	318.0829642	7.25350102	17.39645419	136.5478883	0.311719341	941.4954225	9938.96528	10691.7528	164.5199134	381.1043463	27.74186883	13939.96557	1231.509722	572.8110575	210	300	133.1190447	0	0	0	0	0											"PBP: 1A IP Acute: $225 per day, days 1 - 10"	1B IP Psych: $1000 per admit	"2 SNF: $100, days 21 - 100"	6 Home Health: $0	10A Ambulance: $150	11A DME: 35%	"11B Prosthetic Medical Supplies: 35%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $225	8A OP C/D/T: 20%	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $40	"3 CORF: $40, 5 Partial Hosp: $30, 9D Cardiac Rehab: $30"	"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: $0, 14H Mammography: $0, 14I Diabetes Monitoring: $0"	7D Physician Specialist: $40	"7E Mental Health Individual: $30, Group: $15, 7H Psychiatric Individual: $30, Group: $15,  9C Outpatient Sub Abuse Individual: $30, Group: $15"	"7C Occupational Therapy: $40, 7I Physical and Speech Therapy: $40"	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $30, 7B Chiropractic: $30, 7F Podiatry: $40, 8A OP C/D/T: 20%"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $30"	"10B Transportation: $0, 12 one-way trips"	16A Preventive Dental Services: $10	17A Routine Eye Exams: $30	"17B Eye Wear: Medicare Covered: $30, Routine: $0 with a $150 allowance"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	OTC Drug Card: Not Covered											241.9591231	1121.363121	105.9775116	0	151.6319762	0.353065132	0.050999807	71.82757901	300.1820235	0.242228423	0.245756141	3.775932021	6.45955093	24.19048317	11.03694871	12.74149022	29.18521027	37.23453348	0.173610592	5.589747094	18.19135843	39.76476412	0	10	20	0	0	0	0	0											225.0523801	1062.413917	91.78906922	0	150.8179987	0.347457101	0.050272096	71.82142344	291.8972893	0.23565959	0.239217889	3.775932021	6.45955093	22.60243661	10.88551636	12.63170376	28.78967729	37.23453348	0.166446938	5.354074087	17.72833629	39.43941666	0	10	20	0	0	0	0	0											43.0222	1.424297155	1.602086428	0	9.478678274	12.60887241	1.305880807	3.717499797	7.737296253	1.709357079	4.161543052	0.042966295	0.000167797	1.773340884	9.01589743	11.25458783	0.394706268	1.182520212	4.617549119	6.219634037	1.819384874	1.882611164	0	0.25	0.221865074	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4429	0	5.1023	43.0222	1.424297155	1.602086428	0	9.478678274	12.60887241	1.305880807	3.717499797	7.737296253	1.709357079	4.161543052	0.042966295	0.000167797	1.773340884	9.01589743	11.25458783	0.394706268	1.182520212	4.617549119	6.219634037	1.819384874	1.882611164	0	0.25	0.221865074	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4429	3350	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	43.0222	1.424297155	1.602086428	0	9.478678274	12.60887241	1.305880807	3.717499797	7.737296253	1.709357079	4.161543052	0.042966295	0.000167797	1.773340884	9.01589743	11.25458783	0.394706268	1.182520212	4.617549119	6.219634037	1.819384874	1.882611164	0	0.25	0.221865074	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	125.4429
R3444_006_0	2009	8																					0											D	A	D	V	T	Coin	Coin	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	S	V	T	V	V	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	2634.256292	11.32348486	430.3762521	472.3048107	761.6859479	51.23119973	34.30361537	663.20982	469.4440957	6127.906864	29.64136468	265.155945	0.503777028	1581.75347	14289.32697	16055.56406	172.7338007	1329.167921	39.21667342	24051.81135	1941.834709	891.0769499	210	300	163.2179037	0	0	0	0	0											"PBP: 1A IP Acute: $125 per day, days 1 - 10"	1B IP Psych: $1000 per admit	"2 SNF: $50, days 21 - 100"	6 Home Health: $0	10A Ambulance: $75	"11A DME: 10% For DME less than $1,000 and 20% for DME > $1,000"	"11B Prosthetic Medical Supplies: 12%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $100	8A OP C/D/T: 0%	"8B All Radiation Therapy: 10%, Radiation Therapy and Chemo: 20%, X-Ray: 0%"	9A OP Hospital: $0	12 Renal Dialysis: $15	"3 CORF: $15, 5 Partial Hosp: $15, 9D Cardiac Rehab: $25"	"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: $15	"7E Mental Health Individual: $15, Group: $5, 7H Psychiatric Individual: $15, Group: $5,  9C Outpatient Sub Abuse Individual: $15, Group: $5"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	"8B All Radiation Therapy: 10%, Radiation Therapy and Chemo: 20%, X-Ray: 0%"	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $25, 7B Chiropractic: $25, 7F Podiatry: $15, 8A OP C/D/T: 0%"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $10"	"10B Transportation: $0, 12 one-way trips"	16A Preventive Dental Services: $10	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $10, Routine: $0 with a $150 allowance"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	OTC Drug Card: Not Covered											145.6274241	1118.477182	55.15720752	0	76.76710041	0.124149717	0.013691358	75.6743247	185.5353626	1.256611751	0.161307393	2.845821911	6.300399429	23.4170659	2.408869053	5.270921607	14.43377663	15.20110973	0.102929697	2.883993803	22.49655426	19.22602633	0	10	20	0	0	0	0	0											141.5220168	1106.145973	52.53345312	0	76.42367619	0.122559034	0.013579612	75.6722301	183.2773096	1.256611751	0.159784194	2.845821911	6.300399429	23.07043107	2.358301599	5.235280192	14.32111117	15.16290863	0.101300475	2.858503919	22.37658869	19.13255644	0	10	20	0	0	0	0	0											31.0671	1.043785598	1.884095888	0	4.850903353	6.278846331	0.465829798	4.182213842	7.169870903	0.641699981	4.736221568	0.062882217	0.0002645	3.040977866	2.808211886	7.004614707	0.206144997	1.679504312	3.972667641	5.729349751	3.620969714	1.420715003	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.3889	0	1.5485	31.0671	1.043785598	1.884095888	0	4.850903353	6.278846331	0.465829798	4.182213842	7.169870903	0.641699981	4.736221568	0.062882217	0.0002645	3.040977866	2.808211886	7.004614707	0.206144997	1.679504312	3.972667641	5.729349751	3.620969714	1.420715003	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.3889	3350	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	31.0671	1.043785598	1.884095888	0	4.850903353	6.278846331	0.465829798	4.182213842	7.169870903	0.641699981	4.736221568	0.062882217	0.0002645	3.040977866	2.808211886	7.004614707	0.206144997	1.679504312	3.972667641	5.729349751	3.620969714	1.420715003	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.3889
R3444_007_0	2009	8																					0											D	A	D	V	T	Coin	Coin	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	S	V	T	V	V	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	2634.256292	11.32348486	430.3762521	472.3048107	761.6859479	51.23119973	34.30361537	663.20982	469.4440957	6127.906864	29.64136468	265.155945	0.503777028	1581.75347	14289.32697	16055.56406	172.7338007	1329.167921	39.21667342	24051.81135	1941.834709	891.0769499	210	300	163.2179037	0	0	0	0	0											"PBP: 1A IP Acute: $60 per day, days 1 - 10"	1B IP Psych: $1000 per admit	"2 SNF: $25, days 21 - 100"	6 Home Health: $0	10A Ambulance: $50	"11A DME: 10% For DME less than $1,000 and 20% for DME > $1,000"	"11B Prosthetic Medical Supplies: 12%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $50	8A OP C/D/T: 0%	"8B All Radiation Therapy: 10%, Radiation Therapy and Chemo: 20%, X-Ray: 0%"	9A OP Hospital: $0	12 Renal Dialysis: $15	"3 CORF: $15, 5 Partial Hosp: $15, 9D Cardiac Rehab: $25"	"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: $15	"7E Mental Health Individual: $15, Group: $5, 7H Psychiatric Individual: $15, Group: $5,  9C Outpatient Sub Abuse Individual: $15, Group: $5"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	"8B All Radiation Therapy: 10%, Radiation Therapy and Chemo: 20%, X-Ray: 0%"	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $25, 7B Chiropractic: $15, 7F Podiatry: $15, 8A OP C/D/T: 0%"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $10"	"10B Transportation: $0, 12 one-way trips"	16A Preventive Dental Services: $10	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $10, Routine: $0 with a $150 allowance"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	OTC Drug Card: Not Covered											80.62742413	1118.477182	30.15720752	0	51.76710041	0.124149717	0.013691358	75.6743247	135.5353626	1.256611751	0.161307393	2.845821911	6.300399429	23.4170659	2.408869053	5.270921607	14.43377663	15.20110973	0.102929697	2.277123716	22.49655426	19.22602633	0	10	20	0	0	0	0	0											77.16270597	1108.361261	27.96756048	0	51.44812477	0.122844798	0.013599687	75.67260639	133.6084719	1.256611751	0.160057835	2.845821911	6.300399429	23.13270363	2.367385986	5.241683133	14.34135139	15.16977142	0.101593163	2.255308893	22.39814037	19.1493482	0	10	20	0	0	0	0	0											16.9389	1.045875996	1.003047822	0	3.265609473	6.29348639	0.466518441	4.182234639	5.226809021	0.641699981	4.744332662	0.062882217	0.0002645	3.049186186	2.819029368	7.01318161	0.206436344	1.680264461	3.984145891	4.520355336	3.624457198	1.421961899	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.7127	0	1.3	16.9389	1.045875996	1.003047822	0	3.265609473	6.29348639	0.466518441	4.182234639	5.226809021	0.641699981	4.744332662	0.062882217	0.0002645	3.049186186	2.819029368	7.01318161	0.206436344	1.680264461	3.984145891	4.520355336	3.624457198	1.421961899	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.7127	3350	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	16.9389	1.045875996	1.003047822	0	3.265609473	6.29348639	0.466518441	4.182234639	5.226809021	0.641699981	4.744332662	0.062882217	0.0002645	3.049186186	2.819029368	7.01318161	0.206436344	1.680264461	3.984145891	4.520355336	3.624457198	1.421961899	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.7127
R5287_001_0	2009	6																					3350											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	7500	1255.913947	100.0235625	792.1984936	947.8378191	102.8934055	10.71425958	4.78936272	286.5924177	39.75846819	10331.11577	57.4009656	0	0.285729202	13.41586771	5050.315467	5289.065348	440.5593576	508.7301425	0	0	34.45860066	1232.470875	0	274.2730406	145.0268695	0	14.48873935	0	386.5391231	0											"$250 Days 1-14/$325 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$250 Days 1-14/$325 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20%/30% (9b)	$0/$14 (8a1); $14 (8a2)	"$15 (8b1); 20%/30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20%/30% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											265.5847559	268.75	85.36789939	0	150	0.2	0.080219842	47.94478873	0.235	5.6	0.17559028	0	0.2	0.231606692	7.632321879	24.9981558	37.5	25	0	0	0.2	24.2330572	0	0	25	0	25	0	0	0											171.9169434	173.9658527	55.25990478	0	97.09722011	0.12946296	0.051927491	31.03537136	0.152118978	3.624962884	0.113662187	0	0.12946296	0.14992244	4.940514916	16.18167624	24.27430503	16.18287002	0	0	0.12946296	15.68641659	0	0	25	0	25	0	0	0											17.9927	1.450057028	3.648067777	0	0.832555303	1.38709976	0.248699589	0.741208509	6.048017555	3.120825933	6.524319274	0	0.036991348	2.011339621	2.079263241	7.132161922	0.891189352	0.686059481	0	0	4.461112444	1.611087632	0	0	0.302139311	0	0.030184874	0	0	0	0	0	0	0	0	0	0	0	0	0	61.2351	0	33.1825	17.9927	1.450057028	3.648067777	0	0.832555303	1.38709976	0.248699589	0.741208509	6.048017555	3.120825933	6.524319274	0	0.036991348	2.011339621	2.079263241	7.132161922	0.891189352	0.686059481	0	0	4.461112444	1.611087632	0	0	0.302139311	0	0.030184874	0	0	0	0	0	0	0	0	0	0	0	0	0	61.2351		"$375 Days 1-20 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$375 Days 1-20 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-50 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$14 (8a1); $14 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$40 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$40 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$40 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a7, 14a8, 14a9, 14a10); $0 (14a6)"	"$0 n/c (13b, 13d, 13e)"											3.1924	0.2543	0.8055	0.3149	0.1727	0.4317	0.193	0.1538	1.6018	0.6475	1.8406	0	0.0077	0.5336	2.9407	3.7452	0.3316	0.3604	0	0	2.1973	0.8555	0	0.2654	0.1196	0	0.014	0	0	0											20.9791	0	7.530179789	21.1851	1.704325291	4.453601712	0.314911589	1.005280171	1.818758693	0.441654705	0.894982248	7.649817272	3.768283519	8.364960228	0	0.044665704	2.544906241	5.019962218	10.8773791	1.222835727	1.046496473	0	0	6.658375391	2.466557674	0	0.265425523	0.42171817	0	0.044206234	0	0	0	0	0	0	0	0	0	0	0	0	0	82.2142
R5287_002_0	2009	5																					2500											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	7500	1249.75232	95.96284454	715.4134157	841.5519188	92.1868699	8.558117985	3.289532713	252.0913041	37.11455033	8860.415959	52.34027074	0	0.179970181	12.71907115	4515.148763	5024.330884	451.10853	502.9053447	0	0	41.54082118	1190.455229	0	274.3426062	130.7853737	0	14.49241422	0	386.5673425	0											"$250 Days 1-10/$325 Days 1-8 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$250 Days 1-10/$325 Days 1-8 (1b); $0 n/c (1b1, 1b2)"	"$125 Days 1-20 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20%/30% (9b)	$0/$13 (8a1); $13 (8a2)	"$15 (8b1); 20%/30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20%/30% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											265.5850658	268.75	125	0	150	0.2	0.082476441	48.10945909	0.235	5.2	0.175946426	0	0.2	0.232622119	7.573382221	24.99947412	37.5	25	0	0	0.2	24.26201857	0	0	25	0	25	0	0	0											153.3590106	155.1865651	72.17979774	0	86.61575729	0.115487676	0.047625063	27.78024821	0.13569802	3.002679586	0.10159822	0	0.115487676	0.13432494	4.373161575	14.43565589	21.65393932	14.43595955	0	0	0.115487676	14.00982074	0	0	25	0	25	0	0	0											15.9717	1.241012019	4.303199637	0	0.665402962	0.98835716	0.156664201	0.583596583	5.036370984	2.21708251	5.317678323	0	0.020784338	1.70848847	1.645456257	6.044125975	0.814023061	0.604993434	0	0	4.797452913	1.389838697	0	0	0.272469528	0	0.03019253	0	0	0	0	0	0	0	0	0	0	0	0	0	53.8089	0	39.1552	15.9717	1.241012019	4.303199637	0	0.665402962	0.98835716	0.156664201	0.583596583	5.036370984	2.21708251	5.317678323	0	0.020784338	1.70848847	1.645456257	6.044125975	0.814023061	0.604993434	0	0	4.797452913	1.389838697	0	0	0.272469528	0	0.03019253	0	0	0	0	0	0	0	0	0	0	0	0	0	53.8089		"$375 Days 1-20 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$375 Days 1-20 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-50 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$13 (8a1); $13 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$40 (16a); $0 n/c (16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$40 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$40 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a7, 14a8, 14a9, 14a10); $0 (14a6)"	"$0 n/c (13b, 13d, 13e)"											3.2201	0.2473	0.7373	0.2649	0.1569	0.3495	0.1343	0.1376	1.5156	0.5226	1.7045	0	0.0049	0.5146	2.651	3.607	0.3442	0.3612	0	0	2.6849	0.8374	0	0.2655	0.1039	0	0.014	0	0	0											20.3791	0	6.950074053	19.1919	1.488273363	5.040543694	0.264854853	0.822258434	1.33783538	0.290995141	0.721167833	6.551976048	2.739715474	7.022147704	0	0.025683831	2.22304338	4.296420514	9.651150136	1.158226448	0.966146589	0	0	7.482319738	2.227276963	0	0.265492845	0.376392923	0	0.044217447	0	0	0	0	0	0	0	0	0	0	0	0	0	74.188
R5287_003_0	2009	6																					3900											Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	7500	375.8314141	21.8764	47.45880545	1707.676056	12.82425187	28.79594075	13.04406432	33.20585992	45.30579285	21.19800843	66.04150354	0	0.169674729	24.30500895	34.54727193	188.6163001	12.0156	5.92461249	0	0	84.74936308	7.017549557	414.1227115	503.5969897	124.1006403	109.0134545	0	0	20.2	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14c, 14c1); 20% (7a1, 14b, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1); $0/20% (14d)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 (16a, 16a1, 16a2, 16a3, 16a4, 16a5); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.079672968	0.0807519	0.173390256	0	0.2	0.2	0.2	0.075250813	0.2	0.08	0.2	0	0.2	0.2	0.020819627	0.199979331	0.2	0.2	0	0	0.2	0.004733683	0	0	0	0	0	0	0	0											0.079579983	0.0807519	0.173390256	0	0.127540226	0.127540226	0.127540226	0.047987529	0.127540226	0.05101609	0.127540226	0	0.127540226	0.127540226	0.0132767	0.127527046	0.127540226	0.127540226	0	0	0.127540226	0.003018675	0	0	0	0	0	0	0	0											29.9087	1.766560856	8.228894447	0	1.635607982	3.672640791	1.663642911	1.593467155	5.77831106	1.081439514	8.422948287	0	0.021640353	3.099866334	0.458673753	24.05367952	1.53247234	0.755626416	0	0	10.80895292	0.0211837	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.5043	0	36.7364	29.9087	1.766560856	8.228894447	0	1.635607982	3.672640791	1.663642911	1.593467155	5.77831106	1.081439514	8.422948287	0	0.021640353	3.099866334	0.458673753	24.05367952	1.53247234	0.755626416	0	0	10.80895292	0.0211837	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	104.5043		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$40 (16a, 16a1, 16a2, 16a3, 16a4, 16a5); $0 n/c (16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											7.7453	0.4484	0.6279	0.3068	0.2953	0.6631	0.3004	0.192	1.0433	0.4882	1.5209	0	0.0026	0.5597	0.544	2.9426	0.1874	0.0924	0	0	1.3221	0.1104	0.0528	0	0.0218	0	0	0	0.0042	0											19.4717	0	8.608579721	37.6539	2.214990609	8.856746975	0.306816894	1.930937582	4.335782294	1.964034571	1.785500251	6.821657823	1.569608291	9.943817576	0	0.024245312	3.659586202	1.002648638	26.99628366	1.719919127	0.848052061	0	0	12.13106716	0.131534669	0.0528	0	0.02184	0	0	0	0.0042	0	0	0	0	0	0	0	0	0	0	0	123.976
R5287_801_0	2009	4																					6550											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	10200	1315.463828	104.7662372	829.7610403	992.7800938	107.7721554	11.1946603	5.004105819	300.1255794	41.54113891	10820.97155	59.97468198	0	0.298540588	14.01740182	5277.667876	5533.929869	461.4487327	532.8518745	0	0	36.00363851	1290.909189	0	0	0	0	0	0	0	0											"$575 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$575 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-44 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											568.1448928	575	150	0	150	0.2	0.080219842	47.94440674	0.2	2.8	0.161674357	0	0.2	0.198513165	22.94950963	35	37.5	35	0	0	0.2	33.92628008	0	0	0	0	0	0	0	0											400.3899982	405.2210129	105.7098295	0	105.7098295	0.140946439	0.056533505	33.78796707	0.140946439	1.97325015	0.113937125	0	0.140946439	0.139898619	16.17325833	24.66562687	26.42745736	24.66562687	0	0	0.140946439	23.90894188	0	0	0	0	0	0	0	0											43.8915	3.537790062	7.309491505	0	0.949381347	1.577847508	0.282899643	0.845052766	5.855075614	1.779373645	6.833342828	0	0.042078233	1.961015156	7.113090494	11.37482077	1.016243059	1.09526046	0	0	5.07458465	2.572022731	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.1109	0	43.2013	43.8915	3.537790062	7.309491505	0	0.949381347	1.577847508	0.282899643	0.845052766	5.855075614	1.779373645	6.833342828	0	0.042078233	1.961015156	7.113090494	11.37482077	1.016243059	1.09526046	0	0	5.07458465	2.572022731	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.1109		"$575 Days 1-18 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$575 Days 1-18 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-59 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											5.4035	0.4322	1.0418	0.3482	0.1915	0.4773	0.2134	0.1704	1.7713	0.3589	2.036	0	0.0085	0.59	3.2504	4.1486	0.3676	0.3996	0	0	2.4297	0.9483	0	0	0	0	0	0	0	0											24.587	0	7.145154461	49.2951	3.969976911	8.351265339	0.348225994	1.140850001	2.055171513	0.496267424	1.015480715	7.626329254	2.138232893	8.869319369	0	0.050564457	2.551052077	10.36347806	15.52339096	1.383879091	1.494811413	0	0	7.504295402	3.520302126	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.698
R5287_802_0	2009	5																					6550											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	10200	1315.470491	104.7667678	829.7652429	992.7851222	107.7727013	11.1947737	5.00415651	300.1270972	41.54155972	10821.02636	59.97528951	0	0.298543612	14.01754381	5277.694057	5533.957897	461.4510698	532.8545733	0	0	36.00400322	1290.915728	0	0	0	0	0	0	0	0											"$575 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$575 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-44 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											568.1448928	575	150	0	150	0.2	0.080219842	47.94440673	0.2	2.8	0.161674246	0	0.2	0.198513143	22.94951202	35	37.5	35	0	0	0.2	33.92628008	0	0	0	0	0	0	0	0											400.3891519	405.2201565	105.709606	0	105.709606	0.140946141	0.056533386	33.78789565	0.140946141	1.97324598	0.113936806	0	0.140946141	0.139898308	16.17322583	24.66557474	26.42740151	24.66557474	0	0	0.140946141	23.90889135	0	0	0	0	0	0	0	0											43.8917	3.537800504	7.309513078	0	0.949384149	1.577860156	0.282901911	0.845055254	5.85512255	1.779378897	6.833392902	0	0.04207857	1.961030657	7.113111487	11.37485435	1.016246058	1.095263692	0	0	5.074625329	2.572030322	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.1113	0	43.2018	43.8917	3.537800504	7.309513078	0	0.949384149	1.577860156	0.282901911	0.845055254	5.85512255	1.779378897	6.833392902	0	0.04207857	1.961030657	7.113111487	11.37485435	1.016246058	1.095263692	0	0	5.074625329	2.572030322	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.1113		"$575 Days 1-18 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$575 Days 1-18 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-59 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											5.4035	0.4322	1.0418	0.3482	0.1915	0.4773	0.2134	0.1704	1.7713	0.3589	2.036	0	0.0085	0.59	3.2504	4.1486	0.3676	0.3996	0	0	2.4297	0.9483	0	0	0	0	0	0	0	0											24.5871	0	7.145252724	49.2952	3.969988656	8.351290053	0.348228808	1.14085338	2.055188018	0.496271416	1.015483715	7.626390501	2.138239227	8.869384628	0	0.050564863	2.551072295	10.36350915	15.52343804	1.383883198	1.49481585	0	0	7.504355712	3.520312627	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.6985
R5287_805_0	2009	5																					6550											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	10200	1315.470483	104.7667672	829.7652379	992.7851162	107.7727006	11.19477356	5.00415645	300.1270954	41.54155922	10821.0263	59.97528879	0	0.298543609	14.01754364	5277.694026	5533.957864	461.4510671	532.8545701	0	0	36.00400279	1290.91572	0	0	0	0	0	0	0	0											"$575 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$575 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-44 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											568.1448928	575	150	0	150	0.2	0.080219842	47.94440673	0.2	2.8	0.161674246	0	0.2	0.198513143	22.94951202	35	37.5	35	0	0	0.2	33.92628008	0	0	0	0	0	0	0	0											400.3891529	405.2201575	105.7096063	0	105.7096063	0.140946142	0.056533386	33.78789573	0.140946142	1.973245984	0.113936806	0	0.140946142	0.139898308	16.17322587	24.66557481	26.42740158	24.66557481	0	0	0.140946142	23.90889141	0	0	0	0	0	0	0	0											43.8917	3.537800491	7.309513053	0	0.949384146	1.577860141	0.282901908	0.845055251	5.855122494	1.779378891	6.833392843	0	0.04207857	1.961030639	7.113111462	11.37485431	1.016246055	1.095263688	0	0	5.074625281	2.572030313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.1113	0	43.2018	43.8917	3.537800491	7.309513053	0	0.949384146	1.577860141	0.282901908	0.845055251	5.855122494	1.779378891	6.833392843	0	0.04207857	1.961030639	7.113111462	11.37485431	1.016246055	1.095263688	0	0	5.074625281	2.572030313	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.1113		"$575 Days 1-18 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$575 Days 1-18 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-59 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											5.4035	0.4322	1.0418	0.3482	0.1915	0.4773	0.2134	0.1704	1.7713	0.3589	2.036	0	0.0085	0.59	3.2504	4.1486	0.3676	0.3996	0	0	2.4297	0.9483	0	0	0	0	0	0	0	0											24.5871	0	7.145252608	49.2952	3.969988642	8.351290024	0.348228804	1.140853376	2.055187998	0.496271411	1.015483711	7.626390428	2.138239219	8.869384551	0	0.050564862	2.551072271	10.36350912	15.52343798	1.383883194	1.494815845	0	0	7.504355641	3.520312615	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.6985
R5287_806_0	2009	5																					6550											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	10200	1315.470525	104.7667705	829.7652646	992.7851482	107.7727041	11.19477428	5.004156772	300.1271051	41.54156189	10821.02665	59.97529265	0	0.298543628	14.01754454	5277.694192	5533.958042	461.4510819	532.8545873	0	0	36.00400511	1290.915761	0	0	0	0	0	0	0	0											"$575 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$575 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-44 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$30 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$30 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											568.1448928	575	150	0	150	0.2	0.080219842	47.94440673	0.2	2.8	0.161674245	0	0.2	0.198513143	22.94951203	35	37.5	35	0	0	0.2	33.92628008	0	0	0	0	0	0	0	0											400.3891476	405.2201521	105.7096049	0	105.7096049	0.14094614	0.056533385	33.78789528	0.14094614	1.973245958	0.113936804	0	0.14094614	0.139898306	16.17322566	24.66557447	26.42740122	24.66557447	0	0	0.14094614	23.90889109	0	0	0	0	0	0	0	0											43.8917	3.537800558	7.30951319	0	0.949384164	1.577860222	0.282901923	0.845055266	5.855122792	1.779378924	6.833393161	0	0.042078572	1.961030737	7.113111596	11.37485452	1.016246074	1.095263709	0	0	5.074625539	2.572030362	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.1113	0	43.2018	43.8917	3.537800558	7.30951319	0	0.949384164	1.577860222	0.282901923	0.845055266	5.855122792	1.779378924	6.833393161	0	0.042078572	1.961030737	7.113111596	11.37485452	1.016246074	1.095263709	0	0	5.074625539	2.572030362	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.1113		"$575 Days 1-18 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$575 Days 1-18 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-59 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$40 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$40 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											5.4035	0.4322	1.0418	0.3482	0.1915	0.4773	0.2134	0.1704	1.7713	0.3589	2.036	0	0.0085	0.59	3.2504	4.1486	0.3676	0.3996	0	0	2.4297	0.9483	0	0	0	0	0	0	0	0											24.5871	0	7.145253232	49.2952	3.969988716	8.351290181	0.348228822	1.140853398	2.055188103	0.496271437	1.01548373	7.626390817	2.138239259	8.869384965	0	0.050564865	2.551072399	10.36350931	15.52343828	1.38388322	1.494815873	0	0	7.504356024	3.520312681	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.6985
R5342_001_0	2009	5																					2800											D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2800	1375.054309	99.71145032	653.9992745	97.91441508	71.14796774	5.355266804	3.178672017	193.1310262	142.6662223	6787.674816	30.48347095	0	0.014038546	500.0368258	3561.16264	4414.680199	416.2821046	644.035291	0	0	15.0061409	656.8416374	0	0	83.31010285	0	11.15982598	0	327.4249527	0											"$150 Days 1-19 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$150 Days 1-19 (1b); $0 n/c (1b1, 1b2)"	"$95 Days 1-30 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$125 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); $125 (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											148.2509855	150	95	0	150	0.2	0.056149763	49.40838127	125	2.8	0.168127018	0	0.2	44.55829552	6.955386921	25	37.5	25	0	0	0.2	24.08602961	0	0	25	0	25	0	0	0											101.3917133	102.5878981	64.97233546	0	102.5878981	0.136783864	0.038401907	33.79134655	85.48991508	1.914974098	0.114985316	0	0.136783864	30.4742792	4.756923497	17.09798302	25.64697452	17.09798302	0	0	0.136783864	16.47290101	0	0	25	0	25	0	0	0											11.6183	0.852432342	3.540988354	0	0.608243372	0.732514087	0.122067069	0.543846453	1.016376936	1.083185121	3.50515154	0	0.001920247	1.269855153	1.41168152	6.290177255	0.889698044	0.917642039	0	0	2.052597938	0.901673939	0	0	0.173562714	0	0.023249637	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5551	0	17.2655	11.6183	0.852432342	3.540988354	0	0.608243372	0.732514087	0.122067069	0.543846453	1.016376936	1.083185121	3.50515154	0	0.001920247	1.269855153	1.41168152	6.290177255	0.889698044	0.917642039	0	0	2.052597938	0.901673939	0	0	0.173562714	0	0.023249637	0	0	0	0	0	0	0	0	0	0	0	0	0	37.5551		"$200 Days 1-14 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$200 Days 1-14 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-19 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$15 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$15 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a7, 14a8, 14a9, 14a10); $0 (14a6)"	"$0 n/c (13b, 13d, 13e)"											3.4158	0.2465	3.1045	0.0769	0.3593	0.6491	0.3853	0.3213	2.1647	0.6399	3.0504	0	0.0011	1.1908	1.363	3.8547	0.5149	0.5623	0	0	1.5723	0.5613	0	0	0.1304	0	0.0175	0	0	0											24.1819	0	19.04462934	15.0341	1.098894588	6.645474689	0.076866285	0.967544206	1.381578921	0.507325974	0.865106812	3.18103812	1.723043006	6.555562107	0	0.003054572	2.460674776	2.774702805	10.14486574	1.404624796	1.479982981	0	0	3.624915639	1.46302253	0	0	0.303946412	0	0.040715219	0	0	0	0	0	0	0	0	0	0	0	0	0	61.737
R5342_002_0	2009	5																					1700											D	D	D	V	T	Coin	Coin	V	V	O	Coin	V	Coin	O	V	V	V	V	V	V	Coin	O	T	V	P	P	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	2400	1460.345441	97.90786329	668.2334459	119.1895035	73.62939363	6.525906641	3.286676432	181.969265	134.3211932	6524.59815	31.53432408	0	0.016127402	521.2369398	3447.786477	4447.428223	419.3019452	640.8845345	0	0	15.08181675	685.0669937	0	0	75.76933079	0	11.35151587	0	329.296826	0											"$150 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$150 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$95 Days 1-18 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	$125 (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); $125 (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a9, 14a10); $0 (14a1, 14a4, 14a6, 14a7)"	"$0 n/c (13b, 13d, 13e)"											148.2488323	150	95	0	150	0.2	0.073140425	49.27239508	125	2.8	0.167438568	0	0.2	44.58896124	6.890439748	25	37.5	25	0	0	0.2	23.9228795	0	0	25	0	25	0	0	0											81.59284692	82.55665052	52.28587866	0	82.55665052	0.110075534	0.040254857	27.11842601	68.79720876	1.541057476	0.092154449	0	0.110075534	24.5407686	3.792344175	13.75944175	20.63916263	13.75944175	0	0	0.110075534	13.16661868	0	0	25	0	25	0	0	0											9.9295	0.673578771	2.911597739	0	0.506549677	0.718342658	0.132304688	0.411226671	0.770076931	0.837898397	2.906028253	0	0.001775232	1.065962927	1.089599413	5.099510799	0.721170086	0.734851119	0	0	1.660139033	0.75166799	0	0	0.157852772	0	0.023648991	0	0	0	0	0	0	0	0	0	0	0	0	0	31.1033	0	25.261	9.9295	0.673578771	2.911597739	0	0.506549677	0.718342658	0.132304688	0.411226671	0.770076931	0.837898397	2.906028253	0	0.001775232	1.065962927	1.089599413	5.099510799	0.721170086	0.734851119	0	0	1.660139033	0.75166799	0	0	0.157852772	0	0.023648991	0	0	0	0	0	0	0	0	0	0	0	0	0	31.1033		"$200 Days 1-12 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$200 Days 1-12 (1b); $0 n/c (1b1, 1b2)"	"$150 Days 1-16 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$15 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$15 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a7, 14a8, 14a9, 14a10); $0 (14a6)"	"$0 n/c (13b, 13d, 13e)"											3.3659	0.2246	2.9444	0.0813	0.3451	0.7342	0.3698	0.2802	1.8941	0.5709	2.9189	0	0.0012	1.0716	1.2105	3.6046	0.4814	0.5194	0	0	1.4668	0.5405	0	0	0.1186	0	0.0178	0	0	0											22.7618	0	21.06391344	13.2953	0.898215055	5.856003503	0.0812859	0.851696526	1.452526442	0.5020655	0.691423454	2.664157984	1.408815732	5.824945903	0	0.002984819	2.137518767	2.30005269	8.704101433	1.202609404	1.254280837	0	0	3.126976208	1.292188696	0	0	0.276434855	0	0.041414575	0	0	0	0	0	0	0	0	0	0	0	0	0	53.865
R5342_003_0	2009	6																					3350											Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	7500	353.6049211	20.3616	44.66679498	250.9360865	23.29375569	27.49594929	11.44009461	22.31539154	24.71222942	20.42584441	40.52666539	0	0.86329228	33.41365053	29.61754546	131.3489874	11.4488	3.779828622	0	0	28.63053665	6.132170008	55.06313398	0	153.0727774	169.988676	0	0	20.2	0											"FFS (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"FFS (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	20% (10a)	20% (11a)	"20% (11b, 11c)"	$50 (4a); $0 (4a1); 20% (4b)	20% (9b)	$0/20% (8a1); 20%/$0 (8a2)	"20% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"20% (3, 5, 9a, 9c, 9d)"	"$0 (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"20% (7b, 7d, 7f); $0 n/c (7b1); $0 (7f1)"	"20% (7e, 7h)"	"20% (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"20% (13a, 16b, 18a); $0 (13a1, 17b); $0 n/c (17a)"	$0 (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a9, 14a10); $0 (14a4, 14a7, 14a8)"	"$0 n/c (13b, 13d, 13e)"											0.075952568	0.076974488	0.182984904	0	0.2	0.2	0.2	0.128520688	0.2	0.08	0.2	0	0.2	0.2	0	0.199888231	0.2	0.2	0	0	0.2	0.005624766	0	0	0	0	0	0	0	0											0.075866357	0.076974488	0.182984904	0	0.128697241	0.128697241	0.128697241	0.082701289	0.128697241	0.051478896	0.128697241	0	0.128697241	0.128697241	0	0.128625319	0.128697241	0.128697241	0	0	0.128697241	0.003619459	0	0	0	0	0	0	0	0											26.8267	1.56732374	8.173349182	0	2.997842082	3.538652803	1.472308609	1.845511653	3.180395737	1.051499925	5.215670009	0	0.111103334	4.300244623	0	16.89480536	1.473428969	0.486453514	0	0	3.684671065	0.02219514	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.8422	0	25.6683	26.8267	1.56732374	8.173349182	0	2.997842082	3.538652803	1.472308609	1.845511653	3.180395737	1.051499925	5.215670009	0	0.111103334	4.300244623	0	16.89480536	1.473428969	0.486453514	0	0	3.684671065	0.02219514	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.8422		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); 20% (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); 20% (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	30% (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a9, 14a10); 30% (14a4); $0 (14a8)"	"$0 n/c (13b, 13d, 13e)"											14.8451	0.8511	1.0891	0.0776	1.1221	1.3245	0.5511	0.4609	1.1904	0.9839	1.9522	0	0.0277	1.6095	0.8983	3.9312	0.3426	0.1131	0	0	0.8567	0.1848	0.0977	0	0.0378	0	0	0	0.0076	0											32.5548	0	11.78989984	41.6719	2.418400449	9.262425687	0.077565927	4.11989742	4.863126928	2.023375573	2.306408082	4.370778658	2.035408577	7.167831002	0	0.138826407	5.909773178	0.898255267	20.8260539	1.816018943	0.599559812	0	0	4.54140145	0.206958109	0.09774	0	0.0378	0	0	0	0.00756	0	0	0	0	0	0	0	0	0	0	0	115.397
R5342_004_0	2009	5																					2900											D	D	Coin	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	T	V	V	P	V	P	O	V											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	6000	1564.819659	228.9447998	37.44155096	41617.48285	72.09851279	17.04146653	7.53450027	294.6400542	308.9018651	4891.988504	374.121312	0	0.727391602	1193.762858	5178.024653	3842.844249	1159.167614	229.1270471	0	0	22.33877029	970.3905802	0	0	296.8660852	307.7485714	0	0	20.2	0											"$200 Days 1-15 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$200 Days 1-15 (1b); $0 n/c (1b1, 1b2)"	FFS (2a); $0 n/c (2a1); $0 (2a2)	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$75 (10a)	$0/20% (11a)	20% (11b); $0 (11c)	$50 (4a); $0 (4a1); $25 (4b)	$75 (9b)	$0/$20 (8a1); $20/$5 (8a2)	"$15 (8b1); $75 (8b2, 8b3)"	Included in h.5.	20% (12)	"$75 (3, 5, 9a); $15 (9c); $25 (9d)"	"$5 (7a); $25 (7a1); $0 (14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"$25 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$20 (7e, 7h)"	"$20 (7c, 7i)"	Included in h.2.	$0 (7g)	"20% (15, 15a1, 15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a8, 14a9, 14a10); $0 (14a4, 14a7)"	"$0 n/c (13b, 13d, 13e)"											197.6	200	0.189246539	0	75	0.14	0.2	49.97216943	75	4.4	64.79010385	0	0.2	70.30053442	3.25049779	25	20	20	0	0	0.2	13.6791576	0	0	0	0	0	0	0	0											139.5590297	141.2540787	0.189246539	0	52.97027949	0.098877855	0.141254079	35.29386376	52.97027949	3.10758973	45.75933212	0	0.141254079	49.65118609	3.25049779	25	20	20	0	0	0.141254079	13.6791576	0	0	0	0	0	0	0	0											18.1987	2.694948896	7.085683924	0	0.318256531	1.685023658	1.064278894	0.866582161	1.363551511	1.26685777	1.426628448	0	0.102747031	4.93931182	1.402596474	8.005925519	1.931946024	0.381878412	0	0	3.155442416	1.10617714	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.9966	0	15.4221	18.1987	2.694948896	7.085683924	0	0.318256531	1.685023658	1.064278894	0.866582161	1.363551511	1.26685777	1.426628448	0	0.102747031	4.93931182	1.402596474	8.005925519	1.931946024	0.381878412	0	0	3.155442416	1.10617714	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	56.9966		"30% (1a, 1a1, 13c); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	30% (10a)	30% (11a)	"30% (11b, 11c)"	$50 (4a); 30% (4a1); $25 (4b)	30% (9b)	"30% (8a1, 8a2)"	"30% (8b1, 8b2, 8b3)"	Included in h.5.	20% (12)	"30% (3, 5, 9a, 9c, 9d)"	"30% (7a, 14b, 14c, 14c1, 14d, 14e, 14f, 14g, 14h, 14i, 14j); $25 (7a1); $0 n/c (14b1, 14d1, 14d2, 14e1, 14f1, 14h1)"	"30% (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"30% (7e, 7h)"	"30% (7c, 7i)"	Included in h.2.	$0 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"30% (13a, 13a1, 16b, 17a, 18a); $0 (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	30% (17a1)	"$0 (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); 30% (14a4)"	"$0 n/c (13b, 13d, 13e)"											9.7903	0.5723	0.8403	1.2797	0.3294	0.7555	0.334	0.1817	1.6431	0.2584	0.6969	0	0.0215	1.3092	1.4706	4.8185	0.3654	0.1655	0	0	0.6153	0.1824	0	0	0.0378	0	0	0	0.0076	0											25.6755	0	9.023081102	27.989	3.267265028	7.925934395	1.279665332	0.647633145	2.440573401	1.398328181	1.048308719	3.006694261	1.525288333	2.123527507	0	0.124246766	6.24852588	2.873238505	12.8244651	2.297346024	0.547347492	0	0	3.770697597	1.288545732	0	0	0.0378	0	0	0	0.00756	0	0	0	0	0	0	0	0	0	0	0	82.672
R5342_801_0	2009	3																					5195											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	5195	1432.334514	103.8650989	681.2427167	101.9932051	74.11175627	5.53402383	3.284775033	201.1498935	18.45622495	7070.426853	31.50099908	0	0.014507148	10.20501821	3695.71449	4594.864773	433.6230374	670.8636667	0	0	15.50704089	684.203483	0	0	0	0	0	0	0	0											"$480 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$480 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$180 Days 1-29 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											474.2785224	480	180	0	150	0.2	0.056149763	49.40830382	0.3	2.52	0.238904719	0	0.2	0.081140795	13.96269629	35	37.5	35	0	0	0.2	33.70843731	0	0	0	0	0	0	0	0											308.8114166	312.5367753	117.2012907	0	97.66774228	0.130223656	0.036560137	32.17064989	0.195335485	1.64081807	0.15555523	0	0.130223656	0.052832255	9.091366817	22.78913986	24.41693557	22.78913986	0	0	0.130223656	21.94817978	0	0	0	0	0	0	0	0											36.8601	2.705138589	6.653543808	0	0.603193993	0.720660818	0.120091825	0.539260233	3.605155643	0.966773679	4.900145166	0	0.001889174	0.539154124	2.799924674	8.726084665	0.882312147	1.274033828	0	0	2.019383564	1.251418421	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1683	0	40.2766	36.8601	2.705138589	6.653543808	0	0.603193993	0.720660818	0.120091825	0.539260233	3.605155643	0.966773679	4.900145166	0	0.001889174	0.539154124	2.799924674	8.726084665	0.882312147	1.274033828	0	0	2.019383564	1.251418421	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1683		"30% (1a, 13c); $0 (1a1); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$30 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$30 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											10.3953	0.3175	1.8588	0.0918	0.4326	0.7753	0.4602	0.3867	2.5856	0.7704	3.6478	0	0.0014	1.4254	2.9773	6.1409	0.62	0.9027	0	0	1.878	0.8973	0	0	0	0	0	0	0	0											36.5649	0	20.13681439	47.2554	3.022600142	8.512328791	0.09181205	1.035794187	1.495928842	0.580259892	0.926008253	6.190710295	1.737166117	8.547915246	0	0.003244056	1.96455985	5.777253028	14.86702081	1.502286809	2.176782641	0	0	3.897420356	2.148683697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.7332
R5342_802_0	2009	3																					5195											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	5195	1432.334514	103.8650989	681.2427167	101.9932051	74.11175627	5.53402383	3.284775033	201.1498935	18.45622495	7070.426853	31.50099908	0	0.014507148	10.20501821	3695.71449	4594.864773	433.6230374	670.8636667	0	0	15.50704089	684.203483	0	0	0	0	0	0	0	0											"$480 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$480 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$180 Days 1-29 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											474.2785224	480	180	0	150	0.2	0.056149763	49.40830382	0.3	2.52	0.238904719	0	0.2	0.081140795	13.96269629	35	37.5	35	0	0	0.2	33.70843731	0	0	0	0	0	0	0	0											308.8114166	312.5367753	117.2012907	0	97.66774228	0.130223656	0.036560137	32.17064989	0.195335485	1.64081807	0.15555523	0	0.130223656	0.052832255	9.091366817	22.78913986	24.41693557	22.78913986	0	0	0.130223656	21.94817978	0	0	0	0	0	0	0	0											36.8601	2.705138589	6.653543808	0	0.603193993	0.720660818	0.120091825	0.539260233	3.605155643	0.966773679	4.900145166	0	0.001889174	0.539154124	2.799924674	8.726084665	0.882312147	1.274033828	0	0	2.019383564	1.251418421	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1683	0	40.2766	36.8601	2.705138589	6.653543808	0	0.603193993	0.720660818	0.120091825	0.539260233	3.605155643	0.966773679	4.900145166	0	0.001889174	0.539154124	2.799924674	8.726084665	0.882312147	1.274033828	0	0	2.019383564	1.251418421	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1683		"30% (1a, 13c); $0 (1a1); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$30 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$30 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											10.3953	0.3175	1.8588	0.0918	0.4326	0.7753	0.4602	0.3867	2.5856	0.7704	3.6478	0	0.0014	1.4254	2.9773	6.1409	0.62	0.9027	0	0	1.878	0.8973	0	0	0	0	0	0	0	0											36.5649	0	20.13681439	47.2554	3.022600142	8.512328791	0.09181205	1.035794187	1.495928842	0.580259892	0.926008253	6.190710295	1.737166117	8.547915246	0	0.003244056	1.96455985	5.777253028	14.86702081	1.502286809	2.176782641	0	0	3.897420356	2.148683697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.7332
R5342_803_0	2009	3																					5195											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	5195	1432.334514	103.8650989	681.2427167	101.9932051	74.11175627	5.53402383	3.284775033	201.1498935	18.45622495	7070.426853	31.50099908	0	0.014507148	10.20501821	3695.71449	4594.864773	433.6230374	670.8636667	0	0	15.50704089	684.203483	0	0	0	0	0	0	0	0											"$480 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$480 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$180 Days 1-29 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											474.2785224	480	180	0	150	0.2	0.056149763	49.40830382	0.3	2.52	0.238904719	0	0.2	0.081140795	13.96269629	35	37.5	35	0	0	0.2	33.70843731	0	0	0	0	0	0	0	0											308.8114166	312.5367753	117.2012907	0	97.66774228	0.130223656	0.036560137	32.17064989	0.195335485	1.64081807	0.15555523	0	0.130223656	0.052832255	9.091366817	22.78913986	24.41693557	22.78913986	0	0	0.130223656	21.94817978	0	0	0	0	0	0	0	0											36.8601	2.705138589	6.653543808	0	0.603193993	0.720660818	0.120091825	0.539260233	3.605155643	0.966773679	4.900145166	0	0.001889174	0.539154124	2.799924674	8.726084665	0.882312147	1.274033828	0	0	2.019383564	1.251418421	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1683	0	40.2766	36.8601	2.705138589	6.653543808	0	0.603193993	0.720660818	0.120091825	0.539260233	3.605155643	0.966773679	4.900145166	0	0.001889174	0.539154124	2.799924674	8.726084665	0.882312147	1.274033828	0	0	2.019383564	1.251418421	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1683		"30% (1a, 13c); $0 (1a1); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$30 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$30 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											10.3953	0.3175	1.8588	0.0918	0.4326	0.7753	0.4602	0.3867	2.5856	0.7704	3.6478	0	0.0014	1.4254	2.9773	6.1409	0.62	0.9027	0	0	1.878	0.8973	0	0	0	0	0	0	0	0											36.5649	0	20.13681439	47.2554	3.022600142	8.512328791	0.09181205	1.035794187	1.495928842	0.580259892	0.926008253	6.190710295	1.737166117	8.547915246	0	0.003244056	1.96455985	5.777253028	14.86702081	1.502286809	2.176782641	0	0	3.897420356	2.148683697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.7332
R5342_804_0	2009	3																					5195											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	5195	1432.334514	103.8650989	681.2427167	101.9932051	74.11175627	5.53402383	3.284775033	201.1498935	18.45622495	7070.426853	31.50099908	0	0.014507148	10.20501821	3695.71449	4594.864773	433.6230374	670.8636667	0	0	15.50704089	684.203483	0	0	0	0	0	0	0	0											"$480 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$480 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$180 Days 1-29 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											474.2785224	480	180	0	150	0.2	0.056149763	49.40830382	0.3	2.52	0.238904719	0	0.2	0.081140795	13.96269629	35	37.5	35	0	0	0.2	33.70843731	0	0	0	0	0	0	0	0											308.8114166	312.5367753	117.2012907	0	97.66774228	0.130223656	0.036560137	32.17064989	0.195335485	1.64081807	0.15555523	0	0.130223656	0.052832255	9.091366817	22.78913986	24.41693557	22.78913986	0	0	0.130223656	21.94817978	0	0	0	0	0	0	0	0											36.8601	2.705138589	6.653543808	0	0.603193993	0.720660818	0.120091825	0.539260233	3.605155643	0.966773679	4.900145166	0	0.001889174	0.539154124	2.799924674	8.726084665	0.882312147	1.274033828	0	0	2.019383564	1.251418421	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1683	0	40.2766	36.8601	2.705138589	6.653543808	0	0.603193993	0.720660818	0.120091825	0.539260233	3.605155643	0.966773679	4.900145166	0	0.001889174	0.539154124	2.799924674	8.726084665	0.882312147	1.274033828	0	0	2.019383564	1.251418421	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.1683		"30% (1a, 13c); $0 (1a1); $0 n/c (1a2, 1a3)"	"30% (1b); $0 n/c (1b1, 1b2)"	"30% (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$30 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$30 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											10.3953	0.3175	1.8588	0.0918	0.4326	0.7753	0.4602	0.3867	2.5856	0.7704	3.6478	0	0.0014	1.4254	2.9773	6.1409	0.62	0.9027	0	0	1.878	0.8973	0	0	0	0	0	0	0	0											36.5649	0	20.13681439	47.2554	3.022600142	8.512328791	0.09181205	1.035794187	1.495928842	0.580259892	0.926008253	6.190710295	1.737166117	8.547915246	0	0.003244056	1.96455985	5.777253028	14.86702081	1.502286809	2.176782641	0	0	3.897420356	2.148683697	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.7332
R5566_005_0	2009	6																					3350											A	A	D	V	Coin	Coin	Coin	V	V	V	Coin	V	V	V	P	P	V	V	P	P	Coin	O	T	P	P	P	P	V	V	V																																																			0		219.8402381		855.5024446		2.838680022	4.447025617	1.925255518	190.9101939	298.9251721		27.41729602			620.6674616	4807.937553	2477.102656	153.6492131	312.0670968			10.27903511	45.02538804			384.8169831																"$225 / Day, Days 1-3 (1a, 1b)"	(included in a.1 above)	$0 Days 1-20; $125 Days 21+ (2)	$0 (6)	20% (10a)	20% (11a)	"20% (11b, 11c)"	"$50 (4a), $35 (4b)"	"$150 (9a, 9b)"	$0 (8a)	20% (8b)	$0 (9a)	$0 (12)	"$125 (5) $35 (3) $35 (9a, 9c, 9d)"	"$25 (7a, 14c) $0 (14b, 14d, 14e, 14f, 14g, 14h) $35 (14i)"	"20% (7b) $35 (7d, 7f)"	"$35 (7e, 7h)"	"$35 (7c, 7i)"	$0 (8b)	$35 (7g)	20% (15)	"$35 (14a, 14j, 16b, 17a) 20% (17b) $0 (13a)"	$0 n/c (10b)	$0 n/c (16a)	$35 (17a)	$0 n/c (17b)	$35 (18a)	$0 n/c (18b)	$0 (14a)	$0 n/c (13b)											575.8963406		30.42840891		0.2	0.2	0.2	48.65465159	150		0.2			35	25.01914582	18.16293312	35	35			0.2	11.6837704			35																558.6121036		29.51516846		0.193997449	0.193997449	0.193997449	47.19439134	145.4980864		0.193997449			33.9495535	24.26825227	17.63114406	33.9495535	33.9495535			0.193997449	11.33310824			33.9495535																10.2338	0	2.104191564	0	0.550696682	0.862711623	0.373494658	0.7508242	3.624420043	0	5.318885473	0	0	1.755948599	9.723353452	3.639512814	0.434693515	0.882878216	0	0	1.994106585	0.042523133	0	0	1.088697063	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.3807	0	1.3394	10.2338	0	2.104191564	0	0.550696682	0.862711623	0.373494658	0.7508242	3.624420043	0	5.318885473	0	0	1.755948599	9.723353452	3.639512814	0.434693515	0.882878216	0	0	1.994106585	0.042523133	0	0	1.088697063	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	43.3807	8350	"OON: 40%; OOA: $225 / Day, Days 1-3 (1a, 1b)"	(included in a.1 above)	OON: 40%; OOA: $0 Days 1-20; $125 Days 21+ (2)	OON: 40%; OOA: $0 (6)	OON: 40%; OOA: 20% (10a)	OON: 40%; OOA: 20% (11a)	"OON: 40%; OOA: 20% (11b, 11c)"	"OON: 40%; OOA: $50 (4a), $35 (4b)"	"OON: 40%; OOA: $150 (9a, 9b)"	OON: 40%; OOA: $0 (8a)	OON: 40%; OOA: 20% (8b)	OON: 40%; OOA: $0 (9a)	OON: 40%; OOA: $0 (12)	"OON: 40%; OOA: $125 (5) $35 (3) $35 (9a, 9c, 9d)"	"OON: 40%; OOA: $25 (7a, 14c) $0 (14b, 14d, 14e, 14f, 14g, 14h) $35 (14i)"	"OON: 40%; OOA: 20% (7b) $35 (7d, 7f)"	"OON: 40%; OOA: $35 (7e, 7h)"	"OON: 40%; OOA: $35 (7c, 7i)"	OON: 40%; OOA: $0 (8b)	OON: 40%; OOA: $35 (7g)	OON: 40%; OOA: 20% (15)	"OON: 40%; OOA: $35 (14a, 14j, 16b, 17a) 20% (17b) $0 (13a)"	OON: 40%; OOA: $0 n/c (10b)	OON: 40%; OOA: $0 n/c (16a)	OON: 40%; OOA: $35 (17a)	OON: 40%; OOA: $0 n/c (17b)	OON: 40%; OOA: $35 (18a)	OON: 40%; OOA: $0 n/c (18b)	OON: 40%; OOA: $0 (14a)	OON: 40%; OOA: $0 n/c (13b)											4.5462		1.6686	0.4017	0.5521	0.4361	0.3716	0.0835	1.0292	0.6727	0.5014	0.0722	0.0031	0.3672	2.5276	0.8329	0.1132	0.1157	0.705		0.5317	0.0223			0.0156																15.5696	0	4.534366265	14.78	0	3.772818882	0.401683576	1.102813764	1.298790708	0.745045042	0.834293946	4.65360433	0.672739441	5.820304556	0.072179853	0.003128685	2.123145937	12.25092942	4.472385727	0.547908033	0.998582385	0.705042022	0	2.525793929	0.064817885	0	0	1.104291851	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.9503
R5566_804_0	2009	4																					3350											A	A	D	V	Coin	Coin	Coin	V	V	V	Coin	V	V	V	P	P	V	V	P	P	Coin	O	T	P	P	P	P	V	V	V																																																			0		323.0160007		2021.087273		6.404134186	10.18306811	10.49986111	309.1485097	356.3401645		25.59339928	82.33121014	3.114063589	2791.144105	12803.40826	6832.860869	217.9247116	868.4513731	3667.218014	218.5416832	23.51357746	822.2655956																			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																			763.9233868		41.80755139		0.231	0.231	0.231	49.9680564	348.1060684		0.231	164.0734689	78.42722948	30.24294736	13.21652466	21.41178427	18.63016993	10.92955677	20.39430373	10.97212612	0.231	17.74106937																			510.8990787		27.96018535		0.154488905	0.154488905	0.154488905	33.41779348	232.8074683		0.154488905	109.7295692	52.45080851	20.22597319	8.837462777	14.31984024	12.45954348	7.309503257	13.63936641	7.337972919	0.154488905	11.86492802																			13.7524	0	4.709164563	0	0.989367675	1.573171037	1.62211204	0.860921755	6.913220962	0	3.953896219	0.752847352	0.013611263	4.704467153	9.429136995	8.153789669	0.226270202	0.528995678	4.168210851	0.133637746	3.632586823	0.813010175	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.9308	0	33.1501	13.7524	0	4.709164563	0	0.989367675	1.573171037	1.62211204	0.860921755	6.913220962	0	3.953896219	0.752847352	0.013611263	4.704467153	9.429136995	8.153789669	0.226270202	0.528995678	4.168210851	0.133637746	3.632586823	0.813010175	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.9308	8350	0.5	0.5	0.5	0.5	0.5	0.5	0.5	"$50 (4a, 4b)"	0.5	$0 (8a)	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																			13.8588		3.0591		0.6544	0.5818	1.5918	0.1417	1.3869	1.1809	0.8051	0.5066	0.0048	1.5181	3.0545	2.8026	0.1026	0.2957	1.0011	0.047	0.9073	0.2837																			33.7842	0	21.1880333	27.6112	0	7.768228593	0	1.643788159	2.15498937	3.213890054	1.002604076	8.300144892	1.180875798	4.758962039	1.259455643	0.018393932	6.222567552	12.48368199	10.95634337	0.328845469	0.824679308	5.169266823	0.180594825	4.539844449	1.096664891	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.715
R5566_805_0	2009	5																					3350											A	A	D	V	Coin	Coin	Coin	V	V	V	Coin	V	V	V	P	P	V	V	P	P	Coin	O	T	P	P	P	P	V	V	V																																																			0		322.9898467		2020.958131		6.403503733	10.18228989	10.49909055	309.1230295	356.3110509		25.59186268	82.32457412	3.113622804	2790.830386	12802.67222	6832.069578	217.9021084	868.4209561	3666.925444	218.5107493	23.51181918	822.1536687																			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																			763.9216254		41.80633361		0.231	0.231	0.231	49.96805377	348.1085442		0.231	164.0712525	78.42722948	30.24312684	13.21666024	21.41168951	18.63001753	10.92900496	20.39458716	10.97212612	0.231	17.74107342																			510.8848509		27.95865675		0.154484958	0.154484958	0.154484958	33.41693814	232.8031774		0.154484958	109.7252841	52.44946877	20.22557659	8.83732751	14.3194111	12.45912331	7.308947519	13.63920757	7.337785486	0.154484958	11.86462766																			13.7509	0	4.708606223	0	0.989245008	1.57301063	1.621951568	0.860828763	6.912528733	0	3.953557843	0.752757274	0.013608988	4.703846144	9.428450618	8.152601078	0.226239103	0.528936933	4.167829774	0.133615417	3.632222409	0.81287893	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.9236	0	33.1491	13.7509	0	4.708606223	0	0.989245008	1.57301063	1.621951568	0.860828763	6.912528733	0	3.953557843	0.752757274	0.013608988	4.703846144	9.428450618	8.152601078	0.226239103	0.528936933	4.167829774	0.133615417	3.632222409	0.81287893	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.9236	8350	0.5	0.5	0.5	0.5	0.5	0.5	0.5	"$50 (4a, 4b)"	0.5	$0 (8a)	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																			13.8669		3.0609		0.6547	0.5821	1.5922	0.1418	1.3881	1.1815	0.8056	0.5068	0.0048	1.5193	3.0558	2.8049	0.1026	0.2958	1.0017	0.047	0.9079	0.2839																			33.8045	0	21.19299503	27.6178	0	7.769525094	0	1.643947458	2.155145033	3.214186286	1.002596393	8.300651418	1.181484349	4.759199096	1.259575	0.01839608	6.223135087	12.48426688	10.95745726	0.32887811	0.824750348	5.169561291	0.180615915	4.540136508	1.096788573	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	100.7281
R5595_001_0	2009	8																					3500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	7500	1383.063649	0	1002.651336	966.4811453	226.6537451	12.30975157	0	205.0863258	315.3546727	1727.048276	4418.033419	0	87.87128957	704.7044487	5713.027356	6792.165624	0	1051.103763	0	0	220.3748164	0	0	0	786.3320634	0	46.50916953	0	0	0											$200/day 1-10	$200/day 1-10	"$0 1-10, $75 11-100"	$20 per visit	$150 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$200 per procedure	$35 per visit	$35 X-ray; $165 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$20 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											163.9294809	163.9294809	47.56208437	20	150	0.2	0.2	47.5	200	35	87	35	25	35	20	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											134.1650243	0	38.92630034	16.36862676	122.7647007	0.163686268	0	38.87548855	163.6862676	28.64509682	71.20352639	0	20.46078345	28.64509682	16.36862676	28.64509682	0	28.64509682	0	0	36.8294102	0	0	0	0	0	0	0	0	0											15.4632	0	3.25245892	1.318330761	2.318756597	2.014937288	0	0.664402593	4.301602445	4.122622091	26.21496326	0	0.149826286	1.682193931	7.792867704	16.21352016	0	2.509080756	0	0	0.676356209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.6951	0	20.4052	15.4632	0	3.25245892	1.318330761	2.318756597	2.014937288	0	0.664402593	4.301602445	4.122622091	26.21496326	0	0.149826286	1.682193931	7.792867704	16.21352016	0	2.509080756	0	0	0.676356209	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.6951	7500	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$100 copay	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$50 copay	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$25 copay	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP		0	0	$500 ded; 30% coinsurance; $7500 max OOP	0	$500 ded; 30% coinsurance; $7500 max OOP	0	Not Covered												7.1834	0	0.8852	0.134	0.1937	0.2116	0	0.1079	0.9499	0.3301	1.3437	0	0.0225	0.2944	0.9849	4.2788	0	0.1262	0	0	0.1914	0	0	0	0.0892	0	0.0057	0	0	0											17.3324	500	6.193906626	22.6466	0	4.137674706	1.452357475	2.512488396	2.226510759	0	0.772339987	5.251492677	4.452684549	27.55861923	0	0.172286888	1.976565657	8.777795962	20.49230652	0	2.635280389	0	0	0.867735834	0	0	0	0.089154894	0	0.005667276	0	0	0	0	0	0	0	0	0	0	0	0	0	106.0275
R5595_003_0	2009	9																					10000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	10000	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$800 per stay	$800 per stay	"0 1-15, $75 16-20, $100 21+"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$35 per visit	$35 X-ray; $150 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$25 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											135.2615432	135.2615432	47.8866492	20	100	0.2	0.2	48.5	250	35	81	35	25	35	25	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											122.1195597	122.1195597	43.23399228	20	100	0.180568041	0.180568041	43.78775004	225.7100518	31.59940725	73.13005677	31.59940725	22.57100518	31.59940725	25	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											17.4987	0	4.276036944	1.506462933	2.003577927	1.252240812	0	0.816965835	6.364097954	2.431293147	25.28244597	0	0.110610244	1.823731664	13.39568902	23.79774777	0	1.724950012	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.1987	0	6.4415	17.4987	0	4.276036944	1.506462933	2.003577927	1.252240812	0	0.816965835	6.364097954	2.431293147	25.28244597	0	0.110610244	1.823731664	13.39568902	23.79774777	0	1.724950012	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.1987	10000	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP	$100 copay	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP	$50 copay	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP	$25 copay	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP		0	0	$500 ded; 30% coinsurance; $10000 max OOP	0	$500 ded; 30% coinsurance; $10000 max OOP	0	Not Covered												7.7761	0	0.9602	0.1456	0.2127	0.2286	0	0.1176	1.0442	0.3559	1.4507	0	0.0235	0.3009	1.0629	4.6169	0	0.1368	0	0	0.2065	0	0	0	0.0963	0	0.0061	0	0	0											18.7416	500	4.57737946	25.2747	0	5.236227808	1.652039384	2.216327625	1.480811926	0	0.93460586	7.408251844	2.787209514	26.73318672	0	0.134070615	2.124649627	14.45857952	28.41467354	0	1.861785004	0	0	1.120659004	0	0	0	0.096302987	0	0.006147267	0	0	0	0	0	0	0	0	0	0	0	0	0	121.9403
R5595_004_0	2009	8																					7500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	7500	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$500 per stay	$500 per stay	"0 1-15, $75 16-20, $100 21+"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$30 per visit	$30 X-ray; $125 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$10 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											84.53846451	84.53846451	47.8866492	20	100	0.2	0.2	48.5	250	30	68	30	25	30	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											76.41634344	76.41634344	43.28588948	20	100	0.180784792	0.180784792	43.84031196	225.9809895	27.11771874	61.46682914	27.11771874	22.59809895	27.11771874	10	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											10.9498	0	4.281169811	1.506462933	2.003577927	1.253743976	0	0.817946504	6.371737286	2.086467104	21.25024724	0	0.110743019	1.565075	5.358275608	20.39806951	0	1.478528581	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.346	0	5.1748	10.9498	0	4.281169811	1.506462933	2.003577927	1.253743976	0	0.817946504	6.371737286	2.086467104	21.25024724	0	0.110743019	1.565075	5.358275608	20.39806951	0	1.478528581	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.346	7500	$150 ded; 20% coinsurance; $7500 max OOP	$150 ded; 20% coinsurance; $7500 max OOP	$150 ded; 20% coinsurance; $7500 max OOP	$150 ded; 20% coinsurance; $7500 max OOP	$100 copay	$150 ded; 20% coinsurance; $7500 max OOP	$150 ded; 20% coinsurance; $7500 max OOP	$50 copay	$150 ded; 20% coinsurance; $7500 max OOP	$150 ded; 20% coinsurance; $7500 max OOP	$150 ded; 20% coinsurance; $7500 max OOP	$150 ded; 20% coinsurance; $7500 max OOP	$25 copay	$150 ded; 20% coinsurance; $7500 max OOP	$150 ded; 20% coinsurance; $7500 max OOP	$150 ded; 20% coinsurance; $7500 max OOP	$150 ded; 20% coinsurance; $7500 max OOP	$150 ded; 20% coinsurance; $7500 max OOP	$150 ded; 20% coinsurance; $7500 max OOP	$150 ded; 20% coinsurance; $7500 max OOP	$150 ded; 20% coinsurance; $7500 max OOP		0	0	$150 ded; 20% coinsurance; $7500 max OOP	0	$150 ded; 20% coinsurance; $7500 max OOP	0	Not Covered												4.9682	0	0.6135	0.093	0.202	0.146	0	0.101	0.6671	0.2274	0.9269	0	0.0162	0.1923	0.6791	2.9498	0	0.0874	0	0	0.1319	0	0	0	0.0615	0	0.0039	0	0	0											12.0671	150	2.756525583	15.9179	0	4.894638362	1.599472123	2.205554741	1.399778682	0	0.918902446	7.038850043	2.313863038	22.17712944	0	0.12698244	1.757332304	6.037359239	23.34783593	0	1.56595283	0	0	1.046097574	0	0	0	0.06152824	0	0.003927506	0	0	0	0	0	0	0	0	0	0	0	0	0	92.4131
R5595_005_0	2009	10																					10000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	10000	1719.494333	0	1186.854154	903.8777596	240.4293512	6.935008	0	223.8888732	338.350795	923.2931978	4148.627323	0	58.80654943	692.5693191	6429.93073	8159.227805	0	591.4114325	0	0	243.7795448	0	0	0	779.6726876	0	66.1762626	0	0	0											$800 per stay	$800 per stay	"0 1-15, $75 16-20, $100 21+"	$20 per visit	$100 per trip	0.2	0.2	$50 Emer Rm; $35 Urgent Care Ctr	$250 per procedure	$35 per visit	$35 X-ray; $150 Complex Radiology	$35 per visit	$25 per visit	$35 per visit	$25 PCP visit; $35 if no PCP selected	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$35 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											135.2615432	135.2615432	47.8866492	20	100	0.2	0.2	48.5	250	35	81	35	25	35	25	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											122.1195597	122.1195597	43.23399228	20	100	0.180568041	0.180568041	43.78775004	225.7100518	31.59940725	73.13005677	31.59940725	22.57100518	31.59940725	25	35	35	35	35	35	45	0	0	0	0	0	0	0	0	0											17.4987	0	4.276036944	1.506462933	2.003577927	1.252240812	0	0.816965835	6.364097954	2.431293147	25.28244597	0	0.110610244	1.823731664	13.39568902	23.79774777	0	1.724950012	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.1987	0	6.4152	17.4987	0	4.276036944	1.506462933	2.003577927	1.252240812	0	0.816965835	6.364097954	2.431293147	25.28244597	0	0.110610244	1.823731664	13.39568902	23.79774777	0	1.724950012	0	0	0.914173293	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.1987	10000	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP	$100 copay	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP	$50 copay	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP	$25 copay	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP	$500 ded; 30% coinsurance; $10000 max OOP		0	0	$500 ded; 30% coinsurance; $10000 max OOP	0	$500 ded; 30% coinsurance; $10000 max OOP	0	Not Covered												7.7761	0	0.9602	0.1456	0.2127	0.2286	0	0.1176	1.0442	0.3559	1.4507	0	0.0235	0.3009	1.0629	4.6169	0	0.1368	0	0	0.2065	0	0	0	0.0963	0	0.0061	0	0	0											18.7416	500	4.57737946	25.2747	0	5.236227808	1.652039384	2.216327625	1.480811926	0	0.93460586	7.408251844	2.787209514	26.73318672	0	0.134070615	2.124649627	14.45857952	28.41467354	0	1.861785004	0	0	1.120659004	0	0	0	0.096302987	0	0.006147267	0	0	0	0	0	0	0	0	0	0	0	0	0	121.9403
R5595_006_0	2009	10																					1000											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	1000	2539.067164	0	1840.695536	1774.293282	416.0973229	22.5985883	0	376.5032478	578.9369818	3170.563822	8110.750068	0	161.316586	1293.716256	10488.13638	12469.24878	0	1929.645865	0	0	404.5702891	0	0	3445.512067	1443.570528	0	85.38284213	0	0	0											$0 	$0 	$0/d 1-100	$0 per visit	$50 per trip	0.15	0.15	$35 Emer Rm; $0 Urgent Care Ctr	$0 per procedure	$0 per visit	$0 X-ray; $25 Complex Radiology	$0 per visit	$0 per visit	$0 per visit	$0 PCP visit; $0 if no PCP selected	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$0 per visit	$45 per script	0	$0 per Trip/30 One Way Trips	$5 per visit	$0 per visit	$150 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Coaching Only	0											0	0	0	0	50	0.15	0.15	31.5	0	0	10	0	0	0	0	0	0	0	0	0	45	0	0	5	0	0	0	0	0	0											0	0	0	0	49.51261333	0.14853784	0	31.1929464	0	0	9.902522666	0	0	0	0	0	0	0	0	0	44.561352	0	0	4.951261333	0	0	0	0	0	0											0	0	0	0	1.716838821	3.356745493	0	0.978687136	0	0	6.693073865	0	0	0	0	0	0	0	0	0	1.502349921	0	0	1.421635889	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.6693	0	0.1542	0	0	0	0	1.716838821	3.356745493	0	0.978687136	0	0	6.693073865	0	0	0	0	0	0	0	0	0	1.502349921	0	0	1.421635889	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	15.6693	1000	$0 ded; 20% coinsurance; $1000 max OOP	$0 ded; 20% coinsurance; $1000 max OOP	$0 ded; 20% coinsurance; $1000 max OOP	$0 ded; 20% coinsurance; $1000 max OOP	$50 copay	$0 ded; 20% coinsurance; $1000 max OOP	$0 ded; 20% coinsurance; $1000 max OOP	$35 copay	$0 ded; 20% coinsurance; $1000 max OOP	$0 ded; 20% coinsurance; $1000 max OOP	$0 ded; 20% coinsurance; $1000 max OOP	$0 ded; 20% coinsurance; $1000 max OOP	$0 ded; 0% coinsurance; $1000 max OOP	$0 ded; 20% coinsurance; $1000 max OOP	$0 ded; 20% coinsurance; $1000 max OOP	$0 ded; 20% coinsurance; $1000 max OOP	$0 ded; 20% coinsurance; $1000 max OOP	$0 ded; 20% coinsurance; $1000 max OOP	$0 ded; 20% coinsurance; $1000 max OOP	$0 ded; 20% coinsurance; $1000 max OOP	$0 ded; 20% coinsurance; $1000 max OOP		0	0	$0 ded; 20% coinsurance; $1000 max OOP	0	$0 ded; 20% coinsurance; $1000 max OOP	0	Not Covered												1.6786	0	0.2069	0.0313	0.0351	0.0494	0	0.0229	0.222	0.0771	0.314	0	0	0.0688	0.2302	0.9999	0	0.0295	0	0	0.0447	0	0	0	0.0208	0	0.0013	0	0	0											4.0326	0	9.775743724	1.6786	0	0.206861186	0.031319962	1.75194727	3.406186929	0	1.001573178	0.2219746	0.077130472	7.007065405	0	0	0.068790102	0.230162442	0.999885941	0	0.029490895	0	0	1.547072369	0	0	1.421635889	0.020834115	0	0.001324354	0	0	0	0	0	0	0	0	0	0	0	0	0	19.7019
R5595_007_0	2009	8																					2500											D	D	D	V	T	Coin	Coin	V	P	V	V	V	V	V	V	V	V	V	V	V	S	V	T	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	7500	1366.66918	0	990.7661735	955.0247345	223.9670518	12.16383504	0	202.655287	311.6165422	1706.576305	4365.663224	0	86.82968664	696.3510694	5645.306648	6711.653097	0	1038.644258	0	0	217.7625519	0	0	0	777.011092	0	45.95786219	0	0	0											$200/day 1-10	$200/day 1-10	"$0 1-10, $75 11-100"	$20 per visit	$150 per trip	0.2	0.2	$50 Emer Rm; $25 Urgent Care Ctr	$150 per procedure	$30 per visit	$30 X-ray; $165 Complex Radiology	$30 per visit	$25 per visit	$30 per visit	$15 PCP visit; $30 if no PCP selected	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$30 per visit	$45 per script	0	Not Covered	0	$0 per visit	$100 Every 2 Years	$0 per visit	$800 Every 3 Yrs	Fitness/Coaching	0											163.9294809	163.9294809	47.56208437	20	150	0.2	0.2	47.5	150	30	84	30	25	30	15	30	30	30	30	30	45	0	0	0	0	0	0	0	0	0											124.2597858	0	36.05241953	15.1601512	113.701134	0.151601512	0	36.00535911	113.701134	22.7402268	63.67263505	0	18.950189	22.7402268	11.3701134	22.7402268	0	22.7402268	0	0	34.11034021	0	0	0	0	0	0	0	0	0											14.1518	0	2.976626478	1.206526615	2.122108981	1.844055784	0	0.608056365	2.952596186	3.233994352	23.1644401	0	0.137119914	1.319598438	5.348981398	12.71870947	0	1.968250501	0	0	0.618996227	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.3719	0	23.7431	14.1518	0	2.976626478	1.206526615	2.122108981	1.844055784	0	0.608056365	2.952596186	3.233994352	23.1644401	0	0.137119914	1.319598438	5.348981398	12.71870947	0	1.968250501	0	0	0.618996227	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.3719	7500	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$100 copay	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$50 copay	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$25 per visit	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP	$500 ded; 30% coinsurance; $7500 max OOP		0	0	$500 ded; 30% coinsurance; $7500 max OOP	0	$500 ded; 30% coinsurance; $7500 max OOP	0	Not Covered												7.1834	0	0.8852	0.134	0.1937	0.2116	0	0.1079	0.9499	0.3301	1.3437	0	0.0225	0.2944	0.9849	4.2788	0	0.1262	0	0	0.1914	0	0	0	0.0892	0	0.0057	0	0	0											17.3324	500	6.193906626	21.3352	0	3.861842264	1.340553328	2.31584078	2.055629255	0	0.71599376	3.902486418	3.564056811	24.50809607	0	0.159580517	1.613970164	6.333909656	16.99749583	0	2.094450134	0	0	0.810375853	0	0	0	0.089154894	0	0.005667276	0	0	0	0	0	0	0	0	0	0	0	0	0	91.7043
R5595_801_0	2009	6																					10000											COIN	COIN	COIN	COIN	COIN	COIN	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	10000	332.1142541	0	36.09401542	4.357730894	8.912177406	7.882147444	0	7.614879635	37.52812996	25.43819338	70.23781002	0	13.20941603	17.35095105	31.05649423	135.4042515	0	8.301512601	0	0	7.855965427	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.063670581	0.063670581	0.158653508	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											21.1459	0	5.726442165	0	2.058712981	1.820776059	0	1.759037196	8.668998022	5.876222671	16.22493411	0	3.051375102	4.008069693	7.174050167	31.27838209	0	1.917649411	0	0	1.814728014	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.5253	0	0	21.1459	0	5.726442165	0	2.058712981	1.820776059	0	1.759037196	8.668998022	5.876222671	16.22493411	0	3.051375102	4.008069693	7.174050167	31.27838209	0	1.917649411	0	0	1.814728014	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.5253	10000	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											2.8835	0	0.7809	0	0.2807	0.2483	0	0.2399	1.1821	0.8013	2.2125	0	0.4161	0.5466	0.9783	4.2652	0	0.2615	0	0	0.2475	0	0	0	0	0	0	0	0	0											15.3444	135	0	24.0294	0	6.507320642	0	2.339446569	2.069063704	0	1.998905904	9.851134116	6.677525763	18.43742513	0	3.467471707	4.554624652	8.152329736	35.54361601	0	2.179147058	0	0	2.062190925	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	127.8696
R5595_802_0	2009	6																					10000											COIN	COIN	COIN	COIN	COIN	COIN	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	10000	327.8141029	0	35.62667709	4.301307837	8.796784256	7.780090922	0	7.516283646	37.04222299	25.10882457	69.32838443	0	13.03838306	17.12629429	30.65438075	133.6510634	0	8.194026221	0	0	7.754247906	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.06368868	0.06368868	0.158422569	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.878	0	5.644069692	0	2.032057163	1.797201003	0	1.736261522	8.556753511	5.800138476	16.0148568	0	3.011866487	3.956173982	7.081161953	30.87339564	0	1.892820057	0	0	1.791231266	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.066	0	0	20.878	0	5.644069692	0	2.032057163	1.797201003	0	1.736261522	8.556753511	5.800138476	16.0148568	0	3.011866487	3.956173982	7.081161953	30.87339564	0	1.892820057	0	0	1.791231266	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.066	10000	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											2.847	0	0.7696	0	0.2771	0.2451	0	0.2368	1.1668	0.7909	2.1838	0	0.4107	0.5395	0.9656	4.21	0	0.2581	0	0	0.2443	0	0	0	0	0	0	0	0	0											15.1454	135	0	23.7251	0	6.413715559	0	2.309155867	2.042273867	0	1.973024457	9.723583535	6.59106645	18.19870091	0	3.422575554	4.495652252	8.046774946	35.08340414	0	2.150931883	0	0	2.035490075	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	126.2114
R5595_803_0	2009	6																					10000											COIN	COIN	COIN	COIN	COIN	COIN	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	10000	320.3442986	0	39.55619528	5.997193647	7.07323415	9.41625668	0	8.323167959	43.01515118	14.66239458	59.76497646	0	3.261307682	12.39667045	43.78702809	190.1997033	0	5.637078939	0	0	8.506422424	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.063222441	0.063222441	0.166209018	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.2529	0	6.574596383	0	1.633917089	2.175155293	0	1.922651799	9.936499923	3.387013148	13.80570956	0	0.753362075	2.863630875	10.11480349	43.93613146	0	1.302165235	0	0	1.96498358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.6236		0	20.2529	0	6.574596383	0	1.633917089	2.175155293	0	1.922651799	9.936499923	3.387013148	13.80570956	0	0.753362075	2.863630875	10.11480349	43.93613146	0	1.302165235	0	0	1.96498358	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	120.6236	10000	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											2.7618	0	0.8965	0	0.2228	0.2966	0	0.2622	1.355	0.4619	1.8826	0	0.1027	0.3905	1.3793	5.9913	0	0.1776	0	0	0.268	0	0	0	0	0	0	0	0	0											16.4487		0	23.0147	0	7.471132253	0	1.856723964	2.471767379	0	2.184831589	11.29147719	3.848878577	15.68830632	0	0.856093267	3.254125994	11.49409487	49.92742211	0	1.479733222	0	0	2.232935886	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	137.0722
R5595_804_0	2009	6																					10000											COIN	COIN	COIN	COIN	COIN	COIN	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	10000	314.0843659	0	38.78321721	5.8800009	6.935014211	9.232251119	0	8.160522733	42.17458074	14.37587285	58.59709325	0	3.197577607	12.15442384	42.93137419	186.4829606	0	5.526923289	0	0	8.340196174	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	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered																																																			0.065735747	0.065735747	0.163393896	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											20.6466	0	6.336940971	0	1.601988283	2.132650008	0	1.885080751	9.74232815	3.320826628	13.53592854	0	0.738640427	2.807671906	9.917147438	43.0775639	0	1.27671928	0	0	1.926585316	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.9466		0	20.6466	0	6.336940971	0	1.601988283	2.132650008	0	1.885080751	9.74232815	3.320826628	13.53592854	0	0.738640427	2.807671906	9.917147438	43.0775639	0	1.27671928	0	0	1.926585316	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	118.9466	10000	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Medicare FFS cost Sharing	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered	Not Covered											2.8154	0	0.8641	0	0.2185	0.2908	0	0.2571	1.3285	0.4528	1.8458	0	0.1007	0.3829	1.3523	5.8742	0	0.1741	0	0	0.2627	0	0	0	0	0	0	0	0	0											16.22		0	23.462	0	7.201069285	0	1.82044123	2.423465919	0	2.142137217	11.07082744	3.773666623	15.38173698	0	0.839364122	3.190536257	11.26948573	48.95177715	0	1.450817363	0	0	2.189301496	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	135.1666
R5674_001_0	2009	12																					3350											A	A	D		Coin	Coin	Coin	V	V		Coin					V	V	V	V	V	Coin																																																												0		263.0487091	10.82092687	1996.060881		7.237025884	14.15301895	4.303716461	91.23666446	260.8806368		20.6890215				34.41840486	6657.586695	102.4868629	579.2397953	2360.859344		3.473691413																				$450/Stay	$450/Stay	$50/Day > 10	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																				450	450	50	0	0.4	0.2	0.2	50	50	0	0.2	0	0	0	10	25	25	25	25	0	0.2																				441.7190875	441.7190875	49.07989861	0	0.392639189	0.196319594	0.196319594	49.07989861	49.07989861	0	0.196319594	0	0	0	9.815979722	24.5399493	24.5399493	24.5399493	24.5399493	0	0.196319594																				9.6828	0.398317495	8.163872138	0	2.841539973	2.778514941	0.84490387	0.373157187	1.0669996	0	4.06166031	0	0	0	0.028154197	13.61473667	0.209585202	1.184542934	4.827947385	0	0.681953689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.7587	0	0.9516	9.6828	0.398317495	8.163872138	0	2.841539973	2.778514941	0.84490387	0.373157187	1.0669996	0	4.06166031	0	0	0	0.028154197	13.61473667	0.209585202	1.184542934	4.827947385	0	0.681953689	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	50.7587	7500	$750/Admit	$750/Admit	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																				0.1126	0.0131	0.1318	0.0641	2.3013	0.6148	0.0291	0.078	0.0708	0	0.3456	0	0	0	0.0118	2.9308	0.3199	0.5497	0.6144	0	0.0045																				8.1924	0	0.153582833	9.7954	0.411417246	8.295667221	0.064145634	5.142814502	3.393292632	0.874041936	0.451148821	1.137797209	0	4.407285304	0	0	0	0.039966652	16.54549337	0.529504891	1.734215484	5.442356028	0	0.686487568	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	58.9511
R5674_801_0	2009	7	h.1.	h.2.									OP Facility - Other	OP Facility - Other									2500	Complex diag	PET scans									A	A	D		Coin	Coin	Coin	V	V		Coin					V	V	V	V	V	Coin										P	V																																																	0		279.4198845	1.875814968	556.9403344		6.681913314	18.02209996	5.474770913	91.23666446	260.8806368		20.6890215				6743.887993	12021.83284	150.8594748	1280.893448	2001.674287		12.08062922										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									100	100	50	0	0.4	0.2	0.2	50	50	0	0.2	0	0	0	10	25	25	25	25	0	0.2										50	200									91.17196298	91.17196298	45.58598149	0	0.364687852	0.182343926	0.182343926	45.58598149	45.58598149	0	0.182343926	0	0	0	9.117196298	22.79299074	22.79299074	22.79299074	22.79299074	0	0.182343926										45.58598149	182.343926									2.1229	0.014251811	2.115722648	0	2.436812613	3.286220461	0.998291222	0.346592741	0.991041656	0	3.772517404	0	0	0	5.12377922	22.83446039	0.286544884	2.432949376	3.802011958	0	2.20282936	0	0	0	0	0	0	0	0	0	0.17204247	0.057780596	0	0	0	0	0	0	0	0	52.9968	0	5.1316	2.1229	0.014251811	2.115722648	0	2.436812613	3.286220461	0.998291222	0.346592741	0.991041656	0	3.772517404	0	0	0	5.12377922	22.83446039	0.286544884	2.432949376	3.802011958	0	2.20282936	0	0	0	0	0	0	0	0	0	0.17204247	0.057780596	0	0	0	0	0	0	0	0	52.9968	7500	"$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	$35/visit	$35/visit	$35/visit	$35/visit	None	25 % Coins																				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																				5.6503	0		2.9382	0.078301135	2.43224451	0.180602235	2.579617491	3.383267457	1.143861716	0.401793726	1.060212941	0	3.998902088	0	0	0	6.788291867	24.03142604	0.305864714	2.542188321	4.209392707	0	2.343094876	0	0	0	0	0	0	0	0	0	0.17204247	0.057780596	0	0	0	0	0	0	0	0	58.6471
R5674_802_0	2009	7	h.1.	h.2.									OP Facility - Other	OP Facility - Other									2500	Complex diag	PET scans									A	A	D		Coin	Coin	Coin	V	V		Coin					V	V	V	V	V	Coin										P	V																																																	0		279.4198845	1.875814968	556.9403344		6.681913314	18.02209996	5.474770913	91.23666446	260.8806368		20.6890215				6743.887993	12021.83284	150.8594748	1280.893448	2001.674287		12.08062922										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									100	100	50	0	0.4	0.2	0.2	50	50	0	0.2	0	0	0	10	25	25	25	25	0	0.2										50	200									91.17196298	91.17196298	45.58598149	0	0.364687852	0.182343926	0.182343926	45.58598149	45.58598149	0	0.182343926	0	0	0	9.117196298	22.79299074	22.79299074	22.79299074	22.79299074	0	0.182343926										45.58598149	182.343926									2.1229	0.014251811	2.115722648	0	2.436812613	3.286220461	0.998291222	0.346592741	0.991041656	0	3.772517404	0	0	0	5.12377922	22.83446039	0.286544884	2.432949376	3.802011958	0	2.20282936	0	0	0	0	0	0	0	0	0	0.17204247	0.057780596	0	0	0	0	0	0	0	0	52.9968	0	5.1316	2.1229	0.014251811	2.115722648	0	2.436812613	3.286220461	0.998291222	0.346592741	0.991041656	0	3.772517404	0	0	0	5.12377922	22.83446039	0.286544884	2.432949376	3.802011958	0	2.20282936	0	0	0	0	0	0	0	0	0	0.17204247	0.057780596	0	0	0	0	0	0	0	0	52.9968	7500	"$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	$35/visit	$35/visit	$35/visit	$35/visit	None	25 % Coins																				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																				5.6503	0		2.9382	0.078301135	2.43224451	0.180602235	2.579617491	3.383267457	1.143861716	0.401793726	1.060212941	0	3.998902088	0	0	0	6.788291867	24.03142604	0.305864714	2.542188321	4.209392707	0	2.343094876	0	0	0	0	0	0	0	0	0	0.17204247	0.057780596	0	0	0	0	0	0	0	0	58.6471
R5674_803_0	2009	7	h.1.	h.2.									OP Facility - Other	OP Facility - Other									2500	Complex diag	PET scans									A	A	D		Coin	Coin	Coin	V	V		Coin					V	V	V	V	V	Coin										P	V																																																	0		279.4198845	1.875814968	556.9403344		6.681913314	18.02209996	5.474770913	91.23666446	260.8806368		20.6890215				6743.887993	12021.83284	150.8594748	1280.893448	2001.674287		12.08062922										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									100	100	50	0	0.4	0.2	0.2	50	50	0	0.2	0	0	0	10	25	25	25	25	0	0.2										50	200									91.17196298	91.17196298	45.58598149	0	0.364687852	0.182343926	0.182343926	45.58598149	45.58598149	0	0.182343926	0	0	0	9.117196298	22.79299074	22.79299074	22.79299074	22.79299074	0	0.182343926										45.58598149	182.343926									2.1229	0.014251811	2.115722648	0	2.436812613	3.286220461	0.998291222	0.346592741	0.991041656	0	3.772517404	0	0	0	5.12377922	22.83446039	0.286544884	2.432949376	3.802011958	0	2.20282936	0	0	0	0	0	0	0	0	0	0.17204247	0.057780596	0	0	0	0	0	0	0	0	52.9968	0	5.1316	2.1229	0.014251811	2.115722648	0	2.436812613	3.286220461	0.998291222	0.346592741	0.991041656	0	3.772517404	0	0	0	5.12377922	22.83446039	0.286544884	2.432949376	3.802011958	0	2.20282936	0	0	0	0	0	0	0	0	0	0.17204247	0.057780596	0	0	0	0	0	0	0	0	52.9968	7500	"$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	$35/visit	$35/visit	$35/visit	$35/visit	None	25 % Coins																				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																				5.6503	0	0	2.9382	0.078301135	2.43224451	0.180602235	2.579617491	3.383267457	1.143861716	0.401793726	1.060212941	0	3.998902088	0	0	0	6.788291867	24.03142604	0.305864714	2.542188321	4.209392707	0	2.343094876	0	0	0	0	0	0	0	0	0	0.17204247	0.057780596	0	0	0	0	0	0	0	0	58.6471
R5826_001_0	2009	5	r.	s.	t.	u.	v.	w.	x.				OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered				5000	Radiology	Renal Dialysis	Mental Health (MH)	Therapy (PT/OT/ST)							A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin					O	O	V	P	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	0	0	0				0		269.5968	9.814223	532.605893	726.858817	140.235434	8.133548	3.759203	354.380226	319.739199	766.450677	118.829193	0	0.019112	575.220408	3660.147385	4336.381436	1.793714	241.878132			22.820453			2.79					2.07	0.05	803.861911	17.275689	20.58436	657.225361	0.06	1.23	2.7				$800/Admit:1a	$800/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$35/Visit:14h, 8a, 8b, 9a"	$100/Visit:9a	20% Coins:12	"$35-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $35 Partial Hospitalization,8b. $100 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35/Visit:7e, 7h"	"$100/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $75 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$0/Proc:12	"$100/Visit:7e, 7h"	"$35/Visit:7d, 9a"	$0: Nurse hotline 14a	$0 Health Education Materials 14a	$0 Corp Health 14a				799.999999	800.00056	43.132808	0	100.000032	0.2	0.2	49.99999	129.807906	90.485775	34.999985	0	0.199975	79.193476	14.999999	34.999999	35.002234	99.999994			0.2			0					0	0	75.926757	0	99.999805	34.999994	0	0	0				661.823999	661.824463	35.682909	0	82.728027	0.165456	0.165456	41.363992	107.387484	74.857072	28.954787	0	0.165435	65.515179	12.409199	28.954799	28.956648	82.727995			0.165456			0					0	0	62.812687	0	82.727838	28.954795	0	0	0				14.8688	0.541274406	1.583743968	0	0.966783398	1.345744318	0.621982692	1.221548403	2.861332343	4.781187793	0.286722831	0	0.003161794	3.140472333	3.784958106	10.46325441	0.004328329	1.667507741	0	0	3.775780872	0	0	0	0	0	0	0	0	0	4.207727217	0	0.1419083	1.5858188	0	0	0	0	0	0	57.854	0	12.0788	14.8688	0.541274406	1.583743968	0	0.966783398	1.345744318	0.621982692	1.221548403	2.861332343	4.781187793	0.286722831	0	0.003161794	3.140472333	3.784958106	10.46325441	0.004328329	1.667507741	0	0	3.775780872	0	0	0	0	0	0	0	0	0	4.207727217	0	0.1419083	1.5858188	0	0	0	0	0	0	57.854	7500	$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$40/Visit	30% Coins	20% Coins	30% Coins	$40/Visit	$40/Visit	$40/Visit	30% Coins			30% Coins			Coin:  50%					0	0	30% Coins	20% Coins	30% Coins	$40/Visit	0	0	0				2.4407	0.0888	0.5648	0.8096	0.8018	1.8486	0.8544	0.3799	3.8118	0.6775	0.0719	0	0.0009	1.2304	2.2159	2.6253	0.0011	0.1455			1.6797			1.4					0	0	1.7841	0	0.0277	0.3979	0	0	0				23.8584	500	3.768944019	17.3095	0.630124406	2.148592968	0.809646	1.768622398	3.194360318	1.476385692	1.601475403	6.673108343	5.458668793	0.358663831	0	0.004025794	4.370870333	6.000865106	13.08856341	0.005414329	1.812964741	0	0	5.455452872	0	0	1.4	0	0	0	0	0	0	5.991801217	0	0.1696143	1.9837128	0	0	0	0	0	0	81.7124
R5826_002_0	2009	6	r.	s.	t.	u.	v.	w.	x.				OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered				5000	Radiology	Renal Dialysis	Mental Health (MH)	Therapy (PT/OT/ST)							A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin					O	O	V	P	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	0	0	0				0		263.031442	9.575222	519.635605	709.157982	136.820349	7.734017	3.574546	345.75018	311.952748	747.78568	115.935404	0	0.018174	561.212347	3571.013617	4230.779672	1.750033	235.987792			21.699481			3.42					2.07	0.05	784.285856	16.854982	20.083078	641.220275	0.06	1.23	2.7				$800/Admit:1a	$800/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$35/Visit:14h, 8a, 8b, 9a"	$100/Visit:9a	20% Coins:12	"$35-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $35 Partial Hospitalization,8b. $100 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35/Visit:7e, 7h"	"$100/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $75 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$0/Proc:12	"$100/Visit:7e, 7h"	"$35/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a				799.999979	799.999862	43.132794	0	100.000037	0.199999	0.199999	50.000008	129.807928	90.485776	35.000007	0	0.200013	79.193467	14.999999	34.999997	34.998189	100.000003			0.199999			0					0	0	75.92676	0	100.000007	35.000003	0	0	0				666.670382	666.670285	35.944197	0	83.333831	0.166667	0.166667	41.666907	108.173879	75.405236	29.166836	0	0.166678	65.994926	12.500069	29.166827	29.165321	83.333802			0.166667			0					0	0	63.272654	0	83.333806	29.166833	0	0	0				14.6129	0.531959665	1.55649038	0	0.950146987	1.289005411	0.595758858	1.200528383	2.812094901	4.698912973	0.281789076	0	0.003029206	3.086430609	3.719826384	10.28320156	0.004253356	1.638813328	0	0	3.6165874	0	0	0	0	0	0	0	0	0	4.135320634	0	0.13946661	1.55853039	0	0	0	0	0	0	56.7151	0	11.3426	14.6129	0.531959665	1.55649038	0	0.950146987	1.289005411	0.595758858	1.200528383	2.812094901	4.698912973	0.281789076	0	0.003029206	3.086430609	3.719826384	10.28320156	0.004253356	1.638813328	0	0	3.6165874	0	0	0	0	0	0	0	0	0	4.135320634	0	0.13946661	1.55853039	0	0	0	0	0	0	56.7151	7500	$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$40/Visit	30% Coins	20% Coins	30% Coins	$40/Visit	$40/Visit	$40/Visit	30% Coins			30% Coins			50% Coins					0	0	30% Coins		30% Coins	$40/Visit	0	0	0				2.4105	0.0878	0.5437	0.7793	0.7919	1.7794	0.8224	0.3752	3.6691	0.6521	0.0711	0	0.0008	1.1843	2.1885	2.5928	0.0011	0.14			1.6168			1.71					0	0	1.7173		0.0267	0.393	0	0	0				23.5538	500	3.494301157	17.0235	0.619711665	2.10019238	0.779334	1.742070987	3.068411411	1.418173858	1.575757383	6.481162901	5.351030973	0.352840076	0	0.003860206	4.270762609	5.908332384	12.87604656	0.005325356	1.778824328	0	0	5.2333754	0	0	1.71	0	0	0	0	0	0	5.852602634	0	0.16613461	1.95150339	0	0	0	0	0	0	80.2689
R5826_003_0	2009	5	r.	s.	t.	u.	v.	w.	x.				OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered				5000	Radiology	Renal Dialysis	Mental Health (MH)	Therapy (PT/OT/ST)							A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin					O	O	V	P	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	0	0	0				0		246.138591	8.960266	486.262687	663.613238	128.033241	6.771531	3.129699	323.544827	291.91799	699.760121	108.489604	0	0.015912	525.169219	3341.669935	3959.063379	1.63764	220.831785			18.999015			3.14					2.07	0.05	733.916124	15.772492	18.793269	600.038741	0.06	1.23	2.7				$800/Admit:1a	$800/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$35/Visit:14h, 8a, 8b, 9a"	$100/Visit:9a	20% Coins:12	"$35-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $35 Partial Hospitalization,8b. $100 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35/Visit:7e, 7h"	"$100/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $75 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$0/Proc:12	"$100/Visit:7e, 7h"	"$35/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a				799.999981	799.999951	43.132809	0	100.00003	0.199999	0.2	49.999983	129.80795	90.485773	34.999998	0	0.199973	79.193468	14.999998	35.000002	34.996702	100.000006			0.199999			0					0	0	75.926774	0	100.000271	35	0	0	0				679.040784	679.040758	36.611172	0	84.880125	0.16976	0.16976	42.440035	110.181118	76.804415	29.708033	0	0.169737	67.219495	12.732013	29.708037	29.705236	84.880105			0.16976			0					0	0	64.446722	0	84.88033	29.708035	0	0	0				13.9282	0.507032151	1.483553906	0	0.905623125	1.149535103	0.531297702	1.144271148	2.680320875	4.478722228	0.268584395	0	0.002700855	2.941800808	3.545515421	9.801333446	0.004053874	1.562018758	0	0	3.225272786	0	0	0	0	0	0	0	0	0	3.941540701	0	0.132931573	1.48549766	0	0	0	0	0	0	53.7198	0	9.5692	13.9282	0.507032151	1.483553906	0	0.905623125	1.149535103	0.531297702	1.144271148	2.680320875	4.478722228	0.268584395	0	0.002700855	2.941800808	3.545515421	9.801333446	0.004053874	1.562018758	0	0	3.225272786	0	0	0	0	0	0	0	0	0	3.941540701	0	0.132931573	1.48549766	0	0	0	0	0	0	53.7198	7500	$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$40/Visit	30% Coins	20% Coins	30% Coins	$40/Visit	$40/Visit	$40/Visit	30% Coins			30% Coins			50% Coins					0	0	30% Coins		30% Coins	$40/Visit	0	0	0				2.3288	0.0848	0.4915	0.7045	0.7651	1.6084	0.7434	0.3625	3.3165	0.5895	0.0686	0	0.0008	1.0705	2.1143	2.5049	0.001	0.1266			1.4614			1.57					0	0	1.5523		0.0241	0.3796	0	0	0				21.8691	500	2.853475458	16.257	0.591808151	1.975014906	0.704453	1.670695125	2.757970103	1.274691702	1.506777148	5.996854875	5.068183228	0.337226395	0	0.003452855	4.012339808	5.659815421	12.30626345	0.005089874	1.688576758	0	0	4.686713786	0	0	1.57	0	0	0	0	0	0	5.493819701	0	0.157037573	1.86514666	0	0	0	0	0	0	75.5889
R5826_004_0	2009	5	r.	s.	t.	u.	v.	w.					OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered					5000	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)								A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin					O	O	V	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	0	0					0		255.374575	9.296487	504.508969	688.514336	132.837497	7.288267	3.368528	335.685364	302.871779	726.017577	112.560515	0	17.247515	544.875411	3467.061117	4107.621329	1.699089	229.118168			20.448833			2.86					2.07	0.05	761.455233	19.498459	622.554301	0.06	1.23	2.7					$550/Admit:1a	$550/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$95/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $95 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$30/Visit:14h, 8a, 8b, 9a"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$30-$50/Visit:9d. $50 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $30 Partial Hospitalization,8b. $50 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30/Visit:7e, 7h"	"$50/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	"$50/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a					549.999999	550.00004	43.132799	0	99.999987	0.199999	0.2	49.999999	86.923199	45.242888	29.999969	0	2.560368	43.598018	10.000001	29.999999	30.001953	49.999998			0.2			0					0	0	42.11406	50.000259	30.000004	0	0	0					482.869749	482.869785	37.868225	0	87.794488	0.175588	0.175589	43.897249	76.313788	39.720767	26.338323	0	2.247863	38.276661	8.779451	26.338349	26.340065	43.897248			0.175589			0					0	0	36.973829	43.897477	26.338354	0	0	0					10.2761	0.374082723	1.592071596	0	0.97186667	1.279732226	0.591476463	1.227972001	1.926107728	2.403164584	0.2470546	0	0.003230838	1.73800095	2.536574433	9.015663677	0.00372951	0.838138087	0	0	3.590590138	0	0	0	0	0	0	0	0	0	2.346159631	0.071327763	1.366421297	0	0	0	0	0	0	0	42.3994	0	5.8945	10.2761	0.374082723	1.592071596	0	0.97186667	1.279732226	0.591476463	1.227972001	1.926107728	2.403164584	0.2470546	0	0.003230838	1.73800095	2.536574433	9.015663677	0.00372951	0.838138087	0	0	3.590590138	0	0	0	0	0	0	0	0	0	2.346159631	0.071327763	1.366421297	0	0	0	0	0	0	0	42.3994	7500	$800/Admit	$800/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$35/Visit		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			50% Coins					0	0	30% Coins	30% Coins	$35/Visit	0	0	0					2.0914	0.0761	0.5437	0.7793	0.8159	1.7794	0.8224	0.3866	3.6691	0.6521	0.0641		0.001	1.1843	1.9729	2.3374	0.001	0.14			1.6168			1.43					0	0	1.7173	0.0267	0.3543	0	0	0					22.462	500	2.321904016	12.3674	0.450216723	2.135780596	0.779343	1.78777167	3.059159226	1.413900463	1.614563001	5.595220728	3.055289584	0.3111076	0	0.004247838	2.92234795	4.509506433	11.35310568	0.00469651	0.978150087	0	0	5.207398138	0	0	1.43	0	0	0	0	0	0	4.063460631	0.097996763	1.720685297	0	0	0	0	0	0	0	64.8614
R5826_005_0	2009	5	r.	s.	t.	u.	v.	w.	x.				OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered				5000	Radiology	Renal Dialysis	Mental Health (MH)	Therapy (PT/OT/ST)							A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin					O	O	V	P	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	0	0	0				0		254.933251	7.330779	487.380431	662.313937	133.256274	7.819618	3.48732	327.267766	353.640219	461.669198	143.327459	0	0	432.595179	4114.48701	5330.279367	0.44526	221.127117			28.591704			1.76					2.07	0.05	913.777581	26.143287	6.155407	855.016188	0.06	1.23	2.7				$800/Admit:1a	$800/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$35/Visit:14h, 8a, 8b, 9a"	$100/Visit:9a	20% Coins:12	"$35-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $35 Partial Hospitalization,8b. $100 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35/Visit:7e, 7h"	"$100/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $75 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$0/Proc:12	"$100/Visit:7e, 7h"	"$35/Visit:7d, 9a"	$0: Nurse hotline 14a	$0 Health Education Materials 14a	$0 Corp Health 14a				799.999996	800.000654	43.132794	0	100.000004	0.2	0.2	50.000011	122.477257	85.582967	34.999964	0	0	77.838149	15	35.000001	35.008758	100.000001			0.2			0					0	0	71.899465	0	99.999886	34.999996	0	0	0				656.024797	656.025336	35.370228	0	82.003103	0.164006	0.164006	41.001559	100.435147	70.180686	28.701056	0	0	63.829695	12.300465	28.701086	28.708267	82.003101			0.164006			0					0	0	58.95979	0	82.003006	28.701082	0	0	0				13.9369	0.40076473	1.436563081	0	0.910618997	1.28246427	0.571941404	1.118207385	2.959825615	2.700021752	0.342804119	0	0	2.301034861	4.217508622	12.74873388	0.00106522	1.511092442	0	0	4.689211006	0	0	0	0	0	0	0	0	0	4.489677857	0	0.04206349	2.04499081	0	0	0	0	0	0	57.7055	0	12.6644	13.9369	0.40076473	1.436563081	0	0.910618997	1.28246427	0.571941404	1.118207385	2.959825615	2.700021752	0.342804119	0	0	2.301034861	4.217508622	12.74873388	0.00106522	1.511092442	0	0	4.689211006	0	0	0	0	0	0	0	0	0	4.489677857	0	0.04206349	2.04499081	0	0	0	0	0	0	57.7055	7500	$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$40/Visit	30% Coins	20% Coins	30% Coins	$40/Visit	$40/Visit	$40/Visit	30% Coins			30% Coins			50% Coins					0	0	30% Coins		30% Coins	$40/Visit	0	0	0				2.2687	0.0652	0.4893	0.621	0.749	1.747	0.7791	0.3449	4.1126	0.7444	0.0853	0	0	1.2006	2.4486	3.1721	0.0003	0.1448			2.0686			0.88					0	0	2.1173		0.0093	0.5088	0	0	0				24.5568	500	4.211885595	16.2055	0.46600173	1.925842081	0.620999	1.659579997	3.02946727	1.351054404	1.463093385	7.072409615	3.444412752	0.428099119	0	0	3.501667861	6.666065622	15.92081788	0.00133022	1.655896442	0	0	6.757836006	0	0	0.88	0	0	0	0	0	0	6.606970857	0	0.05133649	2.55381681	0	0	0	0	0	0	82.2622
R5826_006_0	2009	5	r.	s.	t.	u.	v.	w.	x.				OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered				5000	Radiology	Renal Dialysis	Mental Health (MH)	Therapy (PT/OT/ST)							A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin					O	O	V	P	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	0	0	0				0		272.465091	11.308179	639.484776	583.699271	144.010635	6.507935	3.287407	343.897702	270.430503	1127.603089	72.129134	0	0.063985	769.553088	3213.719425	3714.653957	0.556333	264.768169			20.422299			3.95					2.07	0.05	727.954479	13.999571	29.750121	625.922153	0.06	1.23	2.7				$800/Admit:1a	$800/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$35/Visit:14h, 8a, 8b, 9a"	$100/Visit:9a	20% Coins:12	"$35-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $35 Partial Hospitalization,8b. $100 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35/Visit:7e, 7h"	"$100/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $75 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$0/Proc:12	"$100/Visit:7e, 7h"	"$35/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a				799.999981	800.000432	43.132798	0	100.000031	0.199999	0.199999	49.999996	137.982215	94.721425	35.000059	0	0.200001	78.7531	14.999998	35.000002	35.007793	99.999981			0.199999			0					0	0	78.502578	0	100.000129	34.999994	0	0	0				665.064784	665.065159	35.857632	0	83.133126	0.166266	0.166266	41.566547	114.708893	78.744857	29.096634	0	0.166267	65.469894	12.469964	29.096586	29.103064	83.133084			0.166266			0					0	0	65.261627	0	83.133207	29.09658	0	0	0				15.1006	0.626722989	1.910867481	0	0.997671189	1.082048321	0.546584012	1.191219999	2.585065303	7.399412	0.174892918	0	0.010638594	4.198546592	3.339580461	9.006979027	0.00134925	1.834249536	0	0	3.395533966	0	0	0	0	0	0	0	0	0	3.958957807	0	0.206101914	1.517682833	0	0	0	0	0	0	59.0847	0	11.9877	15.1006	0.626722989	1.910867481	0	0.997671189	1.082048321	0.546584012	1.191219999	2.585065303	7.399412	0.174892918	0	0.010638594	4.198546592	3.339580461	9.006979027	0.00134925	1.834249536	0	0	3.395533966	0	0	0	0	0	0	0	0	0	3.958957807	0	0.206101914	1.517682833	0	0	0	0	0	0	59.0847	7500	$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$40/Visit	30% Coins	20% Coins	30% Coins	$40/Visit	$40/Visit	$40/Visit	30% Coins			30% Coins			50% Coins					0	0	30% Coins		30% Coins	$40/Visit	0	0	0				2.4996	0.1037	0.7245	0.6528	0.8344	1.4989	0.7571	0.3736	3.4306	0.7698	0.0442	0	0.0029	1.3856	1.9716	2.2789	0.0003	0.1492			1.5232			1.97					0	0	1.6794		0.0241	0.384	0	0	0				23.0585	500	3.410586357	17.6001	0.730461989	2.635381481	0.65279	1.832070189	2.580903321	1.303714012	1.564822999	6.015655303	8.169251	0.219142918	0	0.013568594	5.584154592	5.311144461	11.28585803	0.00169025	1.983405536	0	0	4.918725966	0	0	1.97	0	0	0	0	0	0	5.638385807	0	0.230243914	1.901675833	0	0	0	0	0	0	82.1432
R5826_007_0	2009	5	r.	s.	t.	u.	v.	w.	x.				OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered				5000	Radiology	Renal Dialysis	Mental Health (MH)	Therapy (PT/OT/ST)							A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin					O	O	V	P	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	0	0	0				0		311.566493	10.848239	893.045542	813.529735	187.727512	9.590972	7.565013	482.037324	324.216031	1843.943562	63.853024	0	0.010045	874.956843	3272.100327	3438.043575	8.339142	302.749047			13.709557			3.03					2.07	0.05	816.337048	8.159043	37.660172	509.24154	0.06	1.23	2.7				$800/Admit:1a	$800/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$35/Visit:14h, 8a, 8b, 9a"	$100/Visit:9a	20% Coins:12	"$35-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $35 Partial Hospitalization,8b. $100 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35/Visit:7e, 7h"	"$100/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $75 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$0/Proc:12	"$100/Visit:7e, 7h"	"$35/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a				800.000017	800.000073	43.132801	0	100.000004	0.199999	0.199999	50.000003	138.551989	93.090656	35.000002	0	0.2	86.306268	14.999998	34.999999	34.999284	100.00001			0.2			0					0	0	81.655051	0	100.000074	35.000004	0	0	0				644.136014	644.136059	34.729237	0	80.517003	0.161033	0.161033	40.258503	111.557905	74.953803	28.180952	0	0.161034	69.491218	12.077548	28.180949	28.180373	80.517008			0.161034			0					0	0	65.746198	0	80.517059	28.180953	0	0	0				16.7243	0.582311826	2.584565857	0	1.259604721	1.544462994	1.218216738	1.617175088	3.014071765	11.51754854	0.14995325	0	0.001617587	5.06681806	3.29324573	8.073944221	0.019583344	2.03137062	0	0	2.207704802	0	0	0	0	0	0	0	0	0	4.472588099	0	0.252690524	1.195909325	0	0	0	0	0	0	66.8276	0	16.1705	16.7243	0.582311826	2.584565857	0	1.259604721	1.544462994	1.218216738	1.617175088	3.014071765	11.51754854	0.14995325	0	0.001617587	5.06681806	3.29324573	8.073944221	0.019583344	2.03137062	0	0	2.207704802	0	0	0	0	0	0	0	0	0	4.472588099	0	0.252690524	1.195909325	0	0	0	0	0	0	66.8276	7500	$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$40/Visit	30% Coins	20% Coins	30% Coins	$40/Visit	$40/Visit	$40/Visit	30% Coins			30% Coins			50% Coins					0	0	30% Coins		30% Coins	$40/Visit	0	0	0				2.7526	0.0958	0.8373	0.892	1.0475	2.1273	1.6779	0.5043	3.2503	0.9454	0.0377	0	0.0004	1.4234	1.9332	2.0312	0.0049	0.125			0.9847			1.52					0	0	1.4618		0.0213	0.3009	0	0	0				23.975	500	4.355883085	19.4769	0.678152826	3.421869857	0.891981	2.307092721	3.671722994	2.896123738	2.121491088	6.264337765	12.46293554	0.18767825	0	0.002060587	6.49025406	5.22641973	10.10515822	0.024509344	2.15641462	0	0	3.192429802	0	0	1.52	0	0	0	0	0	0	5.934402099	0	0.274005524	1.496772325	0	0	0	0	0	0	90.8027
R5826_008_0	2009	5	r.	s.	t.	u.	v.	w.	x.				OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered				5000	Radiology	Renal Dialysis	Mental Health (MH)	Therapy (PT/OT/ST)							A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin					O	O	V	P	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	0	0	0				0		261.63919	9.52454	516.885123	705.40434	136.096145	7.650122	3.53577	343.920091	310.301552	743.827577	115.321746	0	0.017977	558.241795	3552.111891	4208.385739	1.74077	234.738686			21.464094			3.13					2.07	0.05	780.134556	16.765768	19.976777	637.826233	0.06	1.23	2.7				$800/Admit:1a	$800/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$35/Visit:14h, 8a, 8b, 9a"	$100/Visit:9a	20% Coins:12	"$35-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $35 Partial Hospitalization,8b. $100 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35/Visit:7e, 7h"	"$100/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $75 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$0/Proc:12	"$100/Visit:7e, 7h"	"$35/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a				800.000014	799.999557	43.132802	0	100.00004	0.199999	0.199999	49.999986	129.807949	90.485776	34.99999	0	0.199981	79.19349	15	34.999998	34.998309	100.000014			0.2			0					0	0	75.926779	0	99.999914	35.000009	0	0	0				667.732811	667.732431	36.001483	0	83.466633	0.166933	0.166933	41.733288	108.346281	75.525401	29.213301	0	0.166917	66.100113	12.51999	29.213309	29.211899	83.466611			0.166933			0					0	0	63.3735	0	83.466528	29.213317	0	0	0				14.5588	0.529987021	1.550719247	0	0.946623916	1.277057816	0.590236693	1.196076351	2.801668262	4.681489669	0.280744073	0	0.003000667	3.074987144	3.70603378	10.24507275	0.0042376	1.632736883	0	0	3.583065604	0	0	0	0	0	0	0	0	0	4.119988107	0	0.138949351	1.552751661	0	0	0	0	0	0	56.4742	0	11.1866	14.5588	0.529987021	1.550719247	0	0.946623916	1.277057816	0.590236693	1.196076351	2.801668262	4.681489669	0.280744073	0	0.003000667	3.074987144	3.70603378	10.24507275	0.0042376	1.632736883	0	0	3.583065604	0	0	0	0	0	0	0	0	0	4.119988107	0	0.138949351	1.552751661	0	0	0	0	0	0	56.4742	7500	$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$40/Visit	30% Coins	20% Coins	30% Coins	$40/Visit	$40/Visit	$40/Visit	30% Coins			30% Coins			50% Coins					0	0	30% Coins		30% Coins	$40/Visit	0	0	0				2.4041	0.0875	0.5392	0.7729	0.7898	1.7648	0.8157	0.3742	3.6389	0.6468	0.0709	0	0.0008	1.1746	2.1827	2.586	0.0011	0.1389			1.6035			1.57					0	0	1.7032		0.0265	0.3919	0	0	0				23.284	500	3.436710396	16.9629	0.617506021	2.089953247	0.77293	1.736450916	3.041840816	1.405892693	1.570311351	6.440584262	5.328248669	0.351607073	0	0.003824667	4.249587144	5.88874478	12.83105175	0.0053076	1.771596883	0	0	5.186565604	0	0	1.57	0	0	0	0	0	0	5.823156107	0	0.165399351	1.944684661	0	0	0	0	0	0	79.7581
R5826_009_0	2009	8	r.	s.	t.	u.	v.	w.	x.				OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered				5000	Radiology	Renal Dialysis	Mental Health (MH)	Therapy (PT/OT/ST)							A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin	V				O	O	V	P	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	0	0	0	0				0		282.554411	12.139483	693.215459	560.512351	150.021218	6.480951	3.37504	352.40038	264.794357	1274.16569	60.559102	0	0.081358	853.931241	3188.613088	3653.913264	0.203882	280.604637			21.121125			2.18	0.35				2.07	0.05	729.833706	13.490696	33.508122	637.729675	0.06	1.23	2.7				$650/Admit:1a	$650/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$35/Visit:14h, 8a, 8b, 9a"	$50/Visit:9a	20% Coins:12	"$35-$50/Visit:9d. $50 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $35 Partial Hospitalization,8b. $50 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35/Visit:7e, 7h"	"$50/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 767 16a, 16b"	"$0/exam 17a, 17b. Vision 738"				$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $50 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$0/Proc:12	"$50/Visit:7e, 7h"	"$35/Visit:7d, 9a"	$0: Nurse hotline 14a	$0 Health Education Materials 14a	$0 Corp Health 14a				650.000017	649.999674	43.132806	0	100.000014	0.199999	0.2	50.000002	140.943955	47.742977	35.000056	0	0.200004	45.076331	10.000001	34.999999	35.020256	50			0.2			0	0				0	0	50.000003	0	49.999937	35.000002	0	0	0				567.065214	567.064916	37.629405	0	87.240812	0.174481	0.174481	43.620402	122.960634	41.651355	30.534329	0	0.174485	39.324952	8.724081	30.534279	30.551952	43.6204			0.174481			0	0				0	0	43.620403	0	43.620345	30.534281	0	0	0				13.3522	0.573656242	2.173773772	0	1.090664406	1.130802811	0.588880354	1.280987187	2.713273501	4.422560624	0.154094295	0	0.014195751	2.798400422	2.318143238	9.297467254	0.000519083	1.020007209	0	0	3.685235011	0	0	0	0	0	0	0	0	0	2.652970032	0	0.121802987	1.622718092	0	0	0	0	0	0	51.0124	0	7.46	13.3522	0.573656242	2.173773772	0	1.090664406	1.130802811	0.588880354	1.280987187	2.713273501	4.422560624	0.154094295	0	0.014195751	2.798400422	2.318143238	9.297467254	0.000519083	1.020007209	0	0	3.685235011	0	0	0	0	0	0	0	0	0	2.652970032	0	0.121802987	1.622718092	0	0	0	0	0	0	51.0124	10000	$1200/Admit	$1200/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$40/Visit		20% Coins	30% Coins	$40/Visit	$40/Visit	$40/Visit	30% Coins			30% Coins			50% Coins	$35/exam				0	0	30% Coins	20% Coins	30% Coins	$40/Visit	0	0	0				2.8078	0.1206	0.7015	0.5563	0.7454	1.28	0.6666	0.3283	3.0353	0.7259	0.0319		0.0032	1.3038	1.6775	1.9223	0.0001	0.1371			1.3509			1.09	0				0	0	1.5066	0.0244	0.0211	0.3355	0	0	0				20.3722	0	2.277762111	16.16	0.694289242	2.875299772	0.556335	1.836063406	2.410808811	1.255460354	1.609289187	5.748581501	5.148504624	0.185954295	0	0.017390751	4.102230422	3.995639238	11.21975225	0.000626083	1.157083209	0	0	5.036137011	0	0	1.09	0	0	0	0	0	0	4.159532032	0.024358	0.142940987	1.958221092	0	0	0	0	0	0	71.3845
R5826_010_0	2009	5	r.	s.	t.	u.	v.	w.	x.				OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered				5000	Radiology	Renal Dialysis	Mental Health (MH)	Therapy (PT/OT/ST)							A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin					O	O	V	P	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	0	0	0				0		257.310238	9.366951	508.332996	693.733067	133.844365	7.399751	3.420053	338.229759	305.167455	731.520573	113.41369	0	0.017388	549.005402	3493.340402	4138.755869	1.711968	230.854816			20.761623			2.82					2.07	0.05	767.226835	16.488369	19.646252	627.273075	0.06	1.23	2.7				$800/Admit:1a	$800/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$35/Visit:14h, 8a, 8b, 9a"	$100/Visit:9a	20% Coins:12	"$35-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $35 Partial Hospitalization,8b. $100 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35/Visit:7e, 7h"	"$100/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $75 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$0/Proc:12	"$100/Visit:7e, 7h"	"$35/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a				800.000005	799.999461	43.132797	0	100.000025	0.199999	0.2	50.000012	129.807957	90.485772	35.000007	0	0.200018	79.193493	15.000001	34.999999	34.998327	99.999992			0.199999			0					0	0	75.926781	0	100.000143	34.999991	0	0	0				671.047204	671.046748	36.180178	0	83.880921	0.167761	0.167761	41.94046	108.884082	75.90028	29.358321	0	0.167777	66.428215	12.582136	29.358314	29.356912	83.880894			0.167761			0					0	0	63.688067	0	83.88102	29.358307	0	0	0				14.3889	0.523805167	1.532631523	0	0.935582384	1.241389628	0.573751511	1.182125973	2.768989849	4.626884693	0.277469626	0	0.002917306	3.03912074	3.662807003	10.12557453	0.004188174	1.613692363	0	0	3.482990636	0	0	0	0	0	0	0	0	0	4.071932839	0	0.137328971	1.534639626	0	0	0	0	0	0	55.7268	0	10.7088	14.3889	0.523805167	1.532631523	0	0.935582384	1.241389628	0.573751511	1.182125973	2.768989849	4.626884693	0.277469626	0	0.002917306	3.03912074	3.662807003	10.12557453	0.004188174	1.613692363	0	0	3.482990636	0	0	0	0	0	0	0	0	0	4.071932839	0	0.137328971	1.534639626	0	0	0	0	0	0	55.7268	7500	$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$40/Visit	30% Coins	20% Coins	30% Coins	$40/Visit	$40/Visit	$40/Visit	30% Coins			30% Coins			50% Coins					0	0	30% Coins	20% Coins	30% Coins	$40/Visit	0	0	0				2.3839	0.0868	0.5259	0.7538	0.7832	1.7211	0.7955	0.3711	3.5489	0.6308	0.0703	0	0.0008	1.1455	2.1643	2.5642	0.0011	0.1354			1.5638			1.41					0	0	1.661	0	0.0258	0.3886	0	0	0				22.7317	500	3.263129004	16.7728	0.610586167	2.058522523	0.753804	1.718752384	2.962504628	1.369225511	1.553206973	6.317864849	5.257639693	0.347735626	0	0.003721306	4.18465774	5.827120003	12.68975853	0.005249174	1.749116363	0	0	5.046813636	0	0	1.41	0	0	0	0	0	0	5.732957839	0	0.163123971	1.923268626	0	0	0	0	0	0	78.4585
R5826_011_0	2009	5	r.	s.	t.	u.	v.	w.	x.				OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered				5000	Radiology	Renal Dialysis	Mental Health (MH)	Therapy (PT/OT/ST)							A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin					O	O	V	P	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	0	0	0				0		281.129291	10.234045	555.389075	757.95152	146.234258	8.834934	4.083373	369.539484	333.416623	799.236991	123.912326	0	0.020761	599.8265	3816.716816	4521.878005	1.870444	252.224907			24.788345			2.76					2.07	0.05	838.248558	18.014688	21.464893	685.339366	0.06	1.23	2.7				$800/Admit:1a	$800/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$35/Visit:14h, 8a, 8b, 9a"	$100/Visit:9a	20% Coins:12	"$35-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $35 Partial Hospitalization,8b. $100 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35/Visit:7e, 7h"	"$100/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $75 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$0/Proc:12	"$100/Visit:7e, 7h"	"$35/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a				800.000011	800.000419	43.132789	0	100.000015	0.2	0.199999	50.000004	129.807937	90.485766	35.000004	0	0.199991	79.19348	14.999999	35	34.997042	99.999989			0.2			0					0	0	75.926782	0	99.99994	34.999991	0	0	0				653.976009	653.976342	35.259761	0	81.747012	0.163494	0.163493	40.873504	106.114094	73.969399	28.611453	0	0.163487	64.738294	12.262049	28.61145	28.609032	81.746991			0.163494			0					0	0	62.067866	0	81.746951	28.611443	0	0	0				15.321	0.557735276	1.631907171	0	0.99618447	1.444458699	0.667602902	1.258697798	2.94835024	4.92658999	0.295442641	0	0.003394154	3.235978692	3.900064051	10.7814572	0.004459299	1.718218934	0	0	4.052745677	0	0	0	0	0	0	0	0	0	4.335691598	0	0.14622413	1.634045684	0	0	0	0	0	0	59.8602	0	13.366	15.321	0.557735276	1.631907171	0	0.99618447	1.444458699	0.667602902	1.258697798	2.94835024	4.92658999	0.295442641	0	0.003394154	3.235978692	3.900064051	10.7814572	0.004459299	1.718218934	0	0	4.052745677	0	0	0	0	0	0	0	0	0	4.335691598	0	0.14622413	1.634045684	0	0	0	0	0	0	59.8602	7500	$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$40/Visit	30% Coins	20% Coins	30% Coins	$40/Visit	$40/Visit	$40/Visit	30% Coins			30% Coins			50% Coins					0	0	30% Coins	20% Coins	30% Coins	$40/Visit	0	0	0				2.4947	0.0908	0.6014	0.862	0.8196	1.9682	0.9097	0.3883	4.0584	0.7213	0.0735	0	0.0009	1.31	2.2649	2.6834	0.0011	0.1549			1.7884			1.38					0	0	1.8995	0	0.0295	0.4067	0	0	0				24.9074	500	4.25693363	17.8157	0.648550276	2.233309171	0.86204	1.81575747	3.412701699	1.577294902	1.647026798	7.00679324	5.64791099	0.368974641	0	0.004313154	4.545997692	6.164978051	13.4648272	0.005569299	1.873087934	0	0	5.841110677	0	0	1.38	0	0	0	0	0	0	6.235216598	0	0.17572313	2.040739684	0	0	0	0	0	0	84.7676
R5826_012_0	2009	5	r.	s.	t.	u.	v.	w.	x.				OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered				5000	Radiology	Renal Dialysis	Mental Health (MH)	Therapy (PT/OT/ST)							A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin					O	O	V	P	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	0	0	0				0		289.139097	9.007279	410.072837	963.872504	139.936273	9.524766	3.329325	355.252981	301.385302	478.447784	138.714353	0	0.010119	464.989045	3527.934645	3818.963275	0	212.16812			23.397813			2.77					2.07	0.05	723.422736	10.614503	16.425666	459.42686	0.06	1.23	2.7				$800/Admit:1a	$800/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$35/Visit:14h, 8a, 8b, 9a"	$100/Visit:9a	20% Coins:12	"$35-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $35 Partial Hospitalization,8b. $100 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35/Visit:7e, 7h"	"$100/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $75 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$0/Proc:12	"$100/Visit:7e, 7h"	"$35/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a				800.000008	799.999644	43.132805	0	100.000033	0.199999	0.2	50.000008	132.250868	86.73907	35.00004	0	0.200019	78.828437	14.999998	35.000003	0	100.000018			0.2			0					0	0	78.168419	0	100.000328	34.999999	0	0	0				671.497606	671.497301	36.204469	0	83.937228	0.167874	0.167874	41.968606	111.007676	72.806346	29.378054	0	0.16789	66.166383	12.590579	29.378022	0	83.937215			0.167874			0					0	0	65.612382	0	83.937475	29.378019	0	0	0				16.1797	0.504030295	1.237205776	0	0.978821904	1.598960567	0.558907105	1.242456032	2.78800683	2.902836242	0.339596479	0	0.001698879	2.563886937	3.701561655	9.349465593	0	1.484066759	0	0	3.92788446	0	0	0	0	0	0	0	0	0	3.955457408	0	0.114894077	1.124754252	0	0	0	0	0	0	54.5542	0	10.4399	16.1797	0.504030295	1.237205776	0	0.978821904	1.598960567	0.558907105	1.242456032	2.78800683	2.902836242	0.339596479	0	0.001698879	2.563886937	3.701561655	9.349465593	0	1.484066759	0	0	3.92788446	0	0	0	0	0	0	0	0	0	3.955457408	0	0.114894077	1.124754252	0	0	0	0	0	0	54.5542	7500	$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$40/Visit	30% Coins	20% Coins	30% Coins	$40/Visit	$40/Visit		30% Coins			30% Coins			50% Coins					0	0	30% Coins	20% Coins	30% Coins	$40/Visit	0	0	0				2.6483	0.0825	0.4838	1.2754	0.8095	2.1902	0.7656	0.3853	4.2181	0.4954	0.085	0	0.0005	0.9664	2.1609	2.3392		0.1588			1.7424			1.38					0	0	1.6369	0	0.0163	0.2814	0	0	0				24.1221	500	3.508192621	18.828	0.586532295	1.721021776	1.275432	1.788338904	3.789176567	1.324484105	1.627787032	7.00611083	3.398281242	0.424561479	0	0.002160879	3.530317937	5.862486655	11.68865059	0	1.642869759	0	0	5.67025746	0	0	1.38	0	0	0	0	0	0	5.592374408	0	0.131219077	1.406161252	0	0	0	0	0	0	78.6763
R5826_013_0	2009	5	r.	s.	t.	u.	v.	w.	x.				OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered				5000	Radiology	Renal Dialysis	Mental Health (MH)	Therapy (PT/OT/ST)							A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin					O	O	V	P	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	0	0	0				0		266.800079	9.712413	527.080789	719.318586	138.780669	7.974889	3.685873	350.703986	316.422314	758.49973	117.596493	0	0.018739	569.253233	3622.178033	4291.39702	1.775107	239.368955			22.3753			2.82					2.07	0.05	795.522869	17.096475	20.370824	650.407487	0.06	1.23	2.7				$800/Admit:1a	$800/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$35/Visit:14h, 8a, 8b, 9a"	$100/Visit:9a	20% Coins:12	"$35-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $35 Partial Hospitalization,8b. $100 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35/Visit:7e, 7h"	"$100/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $75 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$0/Proc:12	"$100/Visit:7e, 7h"	"$35/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a				800.000004	799.999782	43.132795	0	100.000036	0.2	0.199999	50.000013	129.807937	90.485775	35.000023	0	0.200005	79.193479	15.000001	35	34.997333	99.999985			0.2			0					0	0	75.926787	0	100.00008	35.000002	0	0	0				663.802403	663.802219	35.789566	0	82.97533	0.16595	0.16595	41.487661	107.708525	75.080843	29.041374	0	0.165955	65.711026	12.446296	29.041355	29.039142	82.975287			0.16595			0					0	0	63.000479	0	82.975367	29.041357	0	0	0				14.7585	0.537260108	1.57199939	0	0.959614317	1.32343283	0.611670624	1.212490674	2.84011506	4.745733262	0.284596978	0	0.003109831	3.1171845	3.756891664	10.38566536	0.004295632	1.655142312	0	0	3.713181035	0	0	0	0	0	0	0	0	0	4.176526817	0	0.140856383	1.574059669	0	0	0	0	0	0	57.3724	0	11.7715	14.7585	0.537260108	1.57199939	0	0.959614317	1.32343283	0.611670624	1.212490674	2.84011506	4.745733262	0.284596978	0	0.003109831	3.1171845	3.756891664	10.38566536	0.004295632	1.655142312	0	0	3.713181035	0	0	0	0	0	0	0	0	0	4.176526817	0	0.140856383	1.574059669	0	0	0	0	0	0	57.3724	7500	$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$40/Visit	30% Coins	20% Coins	30% Coins	$40/Visit	$40/Visit	$40/Visit	30% Coins			30% Coins			50% Coins					0	0	30% Coins	20% Coins	30% Coins	$40/Visit	0	0	0				2.4273	0.0884	0.5566	0.7978	0.7974	1.8215	0.8419	0.3778	3.7559	0.6676	0.0715	0	0.0009	1.2124	2.2038	2.6109	0.0011	0.1433			1.6551			1.41					0	0	1.7579	0	0.0273	0.3957	0	0	0				23.6221	500	3.656145067	17.1859	0.625623108	2.12857039	0.797781	1.757062317	3.14495683	1.453551624	1.590337674	6.59603006	5.413287262	0.356143978	0	0.003960831	4.3295505	5.960663664	12.99659636	0.005375632	1.798467312	0	0	5.368238035	0	0	1.41	0	0	0	0	0	0	5.934455817	0	0.168156383	1.969774669	0	0	0	0	0	0	80.9945
R5826_014_0	2009	6	r.	s.	t.	u.	v.	w.	x.				OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered				5000	Radiology	Renal Dialysis	Mental Health (MH)	Therapy (PT/OT/ST)							A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin					O	O	V	P	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	0	0	0				0		255.305168	9.293961	504.371851	688.327207	132.801395	7.285437	3.367219	335.594129	302.789462	725.820256	112.529922	0	0.01712	544.727323	3466.118818	4106.504936	1.698628	229.055897			20.440892			3.21					2.07	0.05	761.248277	16.359885	19.49316	622.385099	0.06	1.23	2.7				$800/Admit:1a	$800/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$35/Visit:14h, 8a, 8b, 9a"	$100/Visit:9a	20% Coins:12	"$35-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $35 Partial Hospitalization,8b. $100 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35/Visit:7e, 7h"	"$100/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $75 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$0/Proc:12	"$100/Visit:7e, 7h"	"$35/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a				800.000021	799.999482	43.132795	0	99.999973	0.199999	0.2	50.000004	129.807939	90.485774	34.99997	0	0.200003	79.193494	15.000001	35.000002	34.997666	99.999992			0.199999			0					0	0	75.926776	0	99.999999	35.000002	0	0	0				672.494418	672.493965	36.258204	0	84.061777	0.168123	0.168123	42.030903	109.11889	76.06397	29.421605	0	0.168126	66.571476	12.609271	29.421632	29.419668	84.061793			0.168123			0					0	0	63.825415	0	84.061799	29.421632	0	0	0				14.3076	0.52084439	1.523968122	0	0.930293438	1.224849525	0.56610696	1.17544369	2.7533375	4.600730848	0.27590091	0	0.002878317	3.021941826	3.642102625	10.06833975	0.004164423	1.604570783	0	0	3.436584086	0	0	0	0	0	0	0	0	0	4.0489156	0	0.136552508	1.525965445	0	0	0	0	0	0	55.3711	0	10.4984	14.3076	0.52084439	1.523968122	0	0.930293438	1.224849525	0.56610696	1.17544369	2.7533375	4.600730848	0.27590091	0	0.002878317	3.021941826	3.642102625	10.06833975	0.004164423	1.604570783	0	0	3.436584086	0	0	0	0	0	0	0	0	0	4.0489156	0	0.136552508	1.525965445	0	0	0	0	0	0	55.3711	7500	$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$40/Visit	30% Coins	20% Coins	30% Coins	$40/Visit	$40/Visit	$40/Visit	30% Coins			30% Coins			50% Coins					0	0	30% Coins	20% Coins	30% Coins	$40/Visit	0	0	0				2.3741	0.0864	0.5197	0.7449	0.78	1.7009	0.7861	0.3696	3.5071	0.6233	0.07	0	0.0008	1.1321	2.1555	2.5537	0.0011	0.1338			1.5454			1.61					0	0	1.6415	0	0.0255	0.387	0	0	0				22.7485	500	3.186874329	16.6818	0.60727039	2.043671122	0.744933	1.710265438	2.925709525	1.35221896	1.54500869	6.2604485	5.224063848	0.34587991	0	0.003673317	4.153997826	5.797577625	12.62205275	0.005220423	1.738400783	0	0	4.982003086	0	0	1.61	0	0	0	0	0	0	5.6903946	0	0.162044508	1.913008445	0	0	0	0	0	0	78.1196
R5826_018_0	2009	2	r.	s.	t.	u.	v.	w.					OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered					3000	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)								A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin					O	O	V	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	0	0					0		227.064623	6.529399	434.101295	589.911536	118.68905	6.203431	2.766548	291.491721	314.981208	411.200745	127.659282	0	23.767083	385.305021	3664.702204	4747.587368	0.396586	196.954085			22.682266			2.82					2.07	0.05	813.885837	5.482513	761.548086	0.06	1.23	2.7					$550/Admit:1a	$550/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$95/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $95 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$30/Visit:14h, 8a, 8b, 9a"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$30-$50/Visit:9d. $50 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $30 Partial Hospitalization,8b. $50 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30/Visit:7e, 7h"	"$50/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 750 16a, 16b"					$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	"$50/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0 Health Education Materials 14a	$0 Corp Health 14a					550.000023	549.999777	43.132808	0	99.999957	0.199999	0.2	50.000006	83.990877	42.791478	29.99998	0	1.013334	43.180937	10.000001	30.000001	29.985929	49.999998			0.2			0					0	0	42.216967	50.000428	29.999996	0	0	0					446.607169	446.606969	35.024401	0	81.201265	0.162402	0.162402	40.600655	68.201684	34.747237	24.360374	0	0.82284	35.063482	8.120131	24.360391	24.348964	40.600648			0.162402			0					0	0	34.280726	40.600998	24.360387	0	0	0					8.4507	0.243006258	1.267011486	0	0.80314175	1.007449601	0.449292928	0.986229567	1.790187401	1.190674145	0.259152321	0	0.001629709	1.125844639	2.479821831	9.637757049	0.000804705	0.666371956	0	0	3.683645363	0	0	0	0	0	0	0	0	0	2.325049781	0.018549625	1.545967175	0	0	0	0	0	0	0	37.9323	0	8.7816	8.4507	0.243006258	1.267011486	0	0.80314175	1.007449601	0.449292928	0.986229567	1.790187401	1.190674145	0.259152321	0	0.001629709	1.125844639	2.479821831	9.637757049	0.000804705	0.666371956	0	0	3.683645363	0	0	0	0	0	0	0	0	0	2.325049781	0.018549625	1.545967175	0	0	0	0	0	0	0	37.9323	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$35/Visit	30% Coins	$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			50% Coins					0	0	30% Coins	30% Coins	$35/Visit	0	0	0					1.7593	0.0506	0.4013	0.5094	0.6897	1.4329	0.639	0.3176	3.3732	0.6106	0.0687		0.0005	0.9848	1.973	2.556	0.0002	0.1188			1.6967			1.41					0	0	1.7367	0.0076	0.41	0	0	0					20.7467	500	3.475210584	10.21	0.293596258	1.668329486	0.509357	1.49285275	2.440380601	1.088338928	1.303831567	5.163420401	1.801241145	0.327881321	0	0.002154709	2.110630639	4.452819831	12.19375805	0.001017705	0.785142956	0	0	5.380377363	0	0	1.41	0	0	0	0	0	0	4.061700781	0.026154625	1.955968175	0	0	0	0	0	0	0	58.679
R5826_021_0	2009	2	r.	s.	t.	u.	v.	w.					OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered					2800	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)								A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin	V				O	O	V	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	0	0	0					0		293.238726	10.210096	840.512513	765.67419	176.68452	8.508687	6.711346	453.681682	305.144159	1735.474356	60.096898	0	8.008441	823.48787	3079.620398	3235.802101	7.848597	284.939961			12.162514			3.9	2.69				2.07	0.05	768.316363	35.444829	479.285621	0.06	1.23	2.7					$550/Admit:1a	$550/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$95/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $95 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$30/Visit:14h, 8a, 8b, 9a"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$30-$50/Visit:9d. $50 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $30 Partial Hospitalization,8b. $50 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30/Visit:7e, 7h"	"$50/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 750 16a, 16b"	0% Coin Vision 752				$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	"$50/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0 Health Education Materials 14a	$0 Corp Health 14a					549.999988	550.000314	43.132797	0	100	0.199999	0.199999	49.99999	90.420816	46.545323	29.999951	0	2.05583	45.786554	9.999998	30.000002	29.999247	50.000006			0.2			0	0				0	0	41.897085	50.000071	29.999998	0	0	0					428.111741	428.111994	33.573922	0	77.8385	0.155676	0.155676	38.919242	70.382207	36.230181	23.351511	0	1.600227	35.639566	7.783848	23.351552	23.350964	38.919255			0.155677			0	0				0	0	32.612062	38.919305	23.351548	0	0	0					10.4616	0.36425538	2.351608463	0	1.146071501	1.324598357	1.0447955	1.471412264	1.789726614	5.239712503	0.116946115	0	0.001067944	2.445729191	1.99760809	6.296750085	0.015272692	0.924137583	0	0	1.893423692	0	0	0	0	0	0	0	0	0	2.088031739	0.114957343	0.932671765	0	0	0	0	0	0	0	42.0204	0	11.9637	10.4616	0.36425538	2.351608463	0	1.146071501	1.324598357	1.0447955	1.471412264	1.789726614	5.239712503	0.116946115	0	0.001067944	2.445729191	1.99760809	6.296750085	0.015272692	0.924137583	0	0	1.893423692	0	0	0	0	0	0	0	0	0	2.088031739	0.114957343	0.932671765	0	0	0	0	0	0	0	42.0204	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$35/Visit		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			50% Coins	0				0	0	30% Coins	30% Coins	$35/Visit	0	0	0					2.1806	0.0759	0.7425	0.791	0.9854	1.8863	1.4879	0.4744	2.8821	0.8383	0.0311		0.0003	1.2622	1.5913	1.672	0.0041	0.1109			0.8732			1.95	0				0	0	1.2962	0.0189	0.2477	0	0	0					21.4022	500	4.294170473	12.6422	0.44018038	3.094077463	0.790953	2.131475501	3.210919357	2.5326575	1.945838264	4.671858614	6.078023503	0.147998115	0	0.001411944	3.707943191	3.58888109	7.968724085	0.019328692	1.035018583	0	0	2.766616692	0	0	1.95	0	0	0	0	0	0	3.384276739	0.133857343	1.180323765	0	0	0	0	0	0	0	63.4225
R5826_023_0	2009	2	r.	s.	t.	u.	v.	w.					OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered					3000	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)								A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin	V				O	O	V	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	0	0	0					0		243.979239	10.482164	598.575614	483.989531	129.539872	4.838647	2.51979	304.289629	228.643839	1100.212787	52.291393	0	15.342266	737.349998	2753.294107	3155.070112	0.176047	242.295655			15.768933			3.51	0.35				2.07	0.05	630.194628	28.933492	550.664915	0.06	1.23	2.7					$550/Admit:1a	$550/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$95/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $95 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$30/Visit:14h, 8a, 8b, 9a"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$30-$50/Visit:9d. $50 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $30 Partial Hospitalization,8b. $50 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30/Visit:7e, 7h"	"$50/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"	0% Coin Vision 738				$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	"$50/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0 Health Education Materials 14a	$0 Corp Health 14a					550.00001	550.000548	43.132796	0	100.000005	0.199999	0.2	49.999982	91.377594	47.742975	29.999889	0	12.036553	43.435117	10.000001	29.999998	29.992041	49.999988			0.2			0	0				0	0	41.146716	49.99991	29.999993	0	0	0					458.808909	458.809357	35.981292	0	83.419804	0.166839	0.166839	41.709885	76.227006	39.827094	25.025847	0	10.040868	36.233488	8.34198	25.025939	25.019301	41.70989			0.166839			0	0				0	0	34.324508	41.709825	25.025934	0	0	0					9.3283	0.400776244	1.794793663	0	0.900515894	0.807275027	0.420399244	1.057657119	1.452402941	3.651523174	0.109053033	0	0.012837472	2.226396859	1.913993698	6.57988268	0.000367048	0.842177093	0	0	2.630873013	0	0	0	0	0	0	0	0	0	1.802593379	0.100567574	1.148408652	0	0	0	0	0	0	0	37.1808	0	7.3899	9.3283	0.400776244	1.794793663	0	0.900515894	0.807275027	0.420399244	1.057657119	1.452402941	3.651523174	0.109053033	0	0.012837472	2.226396859	1.913993698	6.57988268	0.000367048	0.842177093	0	0	2.630873013	0	0	0	0	0	0	0	0	0	1.802593379	0.100567574	1.148408652	0	0	0	0	0	0	0	37.1808	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$35/Visit	30% Coins	$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			0% Coins	0				0	0	30% Coins	30% Coins	$35/Visit	0	0	0					1.9785	0.085	0.6411	0.5084	0.7879	1.1698	0.6092	0.347	2.7739	0.6634	0.0295		0.0042	1.1916	1.5514	1.7778	0.0001	0.1253			1.2346			1.76	0				0	0	1.3768	0.0193	0.3103	0	0	0					18.9451	500	2.602701765	11.3068	0.485779244	2.435909663	0.508428	1.688372894	1.977057027	1.029579244	1.404659119	4.226332941	4.314954174	0.138518033	0	0.017049472	3.417949859	3.465408698	8.35768868	0.000467048	0.967448093	0	0	3.865446013	0	0	1.76	0	0	0	0	0	0	3.179419379	0.119885574	1.458694652	0	0	0	0	0	0	0	56.1259
R5826_026_0	2009	2	r.	s.	t.	u.	v.	w.					OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered					3000	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)								A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin					O	O	V	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	0	0					0		264.412152	8.236984	375.003737	881.442898	127.969034	7.965328	2.784233	324.87203	275.611074	437.531313	126.851611	0	9.9266	425.223555	3226.228497	3492.368593	0	194.023673			19.567015			2.77					2.07	0.05	661.556205	15.020955	420.137041	0.06	1.23	2.7					$550/Admit:1a	$550/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$95/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $95 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$30/Visit:14h, 8a, 8b, 9a"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$30-$50/Visit:9d. $50 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $30 Partial Hospitalization,8b. $50 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30/Visit:7e, 7h"	"$50/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	"$50/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a					549.999986	549.999368	43.132786	0	100.000035	0.2	0.199999	49.999983	87.900343	43.369531	29.999997	0	1.107327	43.485681	10	29.999998	0	50.000001			0.2			0					0	0	42.841983	49.99975	30.000011	0	0	0					454.930288	454.929777	35.677111	0	82.714629	0.165429	0.165429	41.357285	72.706417	35.872934	24.814377	0	0.915921	35.969007	8.27146	24.814378	0	41.357301			0.165429			0					0	0	35.436575	41.357093	24.814389	0	0	0					10.0241	0.312270775	1.114920829	0	0.882075931	1.317696246	0.460592881	1.119652094	1.66989114	1.307960993	0.262311975	0	0.000757665	1.274572419	2.223801664	7.221746199	0	0.668691287	0	0	3.236951724	0	0	0	0	0	0	0	0	0	1.953607173	0.051768586	0.868786997	0	0	0	0	0	0	0	35.9721	0	7.5173	10.0241	0.312270775	1.114920829	0	0.882075931	1.317696246	0.460592881	1.119652094	1.66989114	1.307960993	0.262311975	0	0.000757665	1.274572419	2.223801664	7.221746199	0	0.668691287	0	0	3.236951724	0	0	0	0	0	0	0	0	0	1.953607173	0.051768586	0.868786997	0	0	0	0	0	0	0	35.9721	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$35/Visit	30% Coins	$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			50% Coins					0	0	30% Coins	30% Coins	$35/Visit	0	0	0					2.0863	0.065	0.4139	1.0911	0.7573	1.8737	0.6549	0.3605	3.6085	0.4238	0.0695		0.0002	0.8268	1.7688	1.9147		0.1359			1.4906			1.38					0	0	1.4004	0.014	0.2303	0	0	0					20.5663	500	3.113435531	12.1104	0.377263775	1.528818829	1.091114	1.639368931	3.191395246	1.115533881	1.480125094	5.27841914	1.731806993	0.331859975	0	0.001001665	2.101339419	3.992630664	9.136491199	0	0.804545287	0	0	4.727528724	0	0	1.38	0	0	0	0	0	0	3.353967173	0.065735586	1.099133997	0	0	0	0	0	0	0	56.5385
R5826_049_0	2009	5	r.	s.	t.	u.	v.	w.	x.	y.			OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered			5000	Radiology	Renal Dialysis	Mental Health (MH)	Therapy (PT/OT/ST)							A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin					O	O	V	P	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	0	0	0			0		246.165243	8.961236	486.31534	663.685097	128.047104	6.771489	3.12968	323.579861	291.9496	699.835893	108.501352	0	0.015912	525.226086	3342.031782	3959.492074	1.637816	220.855697			18.998899			3.14					2.07	17.145	733.995594	15.7742	18.795304	600.103715	0.06	0.05	1.23	2.7			$800/Admit:1a	$800/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$35/Visit:14h, 8a, 8b, 9a"	$100/Visit:9a	20% Coins:12	"$35-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $35 Partial Hospitalization,8b. $100 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35/Visit:7e, 7h"	"$100/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$35/visit;  Acupuncture 13b; Other-Chiropractic 7b	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $75 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$0/Proc:12	"$100/Visit:7e, 7h"	"$35/Visit:7d, 9a"	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0 Health Education Materials 14a	$0 Corp Health 14a			799.99999	800.000357	43.132803	0	99.999981	0.2	0.2	49.999984	129.807953	90.485767	34.999969	0	0.199974	79.193484	15	34.999998	35.000268	99.999992			0.199999			0					0	34.995625	75.926777	0	100.000297	35.000009	0	0	0	0			679.027991	679.028303	36.610476	0	84.878484	0.169757	0.169757	42.439236	110.179043	76.802962	29.707449	0	0.169735	67.218241	12.731775	29.707473	29.707703	84.878493			0.169756			0					0	34.995625	64.445509	0	84.878752	29.707483	0	0	0	0			13.9294	0.507077739	1.48368634	0	0.905703672	1.149507658	0.531285088	1.144373507	2.680560628	4.479122458	0.268608198	0	0.002700823	2.942064469	3.545833058	9.802208657	0.004054646	1.562158228	0	0	3.225177099	0	0	0	0	0	0	0	0	0.049999999	3.941893305	0	0.132943496	1.485630909	0	0	0	0	0	0	53.774	0	9.5712	13.9294	0.507077739	1.48368634	0	0.905703672	1.149507658	0.531285088	1.144373507	2.680560628	4.479122458	0.268608198	0	0.002700823	2.942064469	3.545833058	9.802208657	0.004054646	1.562158228	0	0	3.225177099	0	0	0	0	0	0	0	0	0.049999999	3.941893305	0	0.132943496	1.485630909	0	0	0	0	0	0	53.774	7500	$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$40/Visit	30% Coins	20% Coins	30% Coins	$40/Visit	$40/Visit	$40/Visit	30% Coins			30% Coins			50% Coins					0	$40/visit	30% Coins	20% Coins	30% Coins	$40/Visit	0	0	0	0			2.329	0.0848	0.4914	0.7044	0.7651	1.6084	0.7434	0.3625	3.3164	0.5894	0.0686	0	0.0008	1.0705	2.1145	2.5051	0.001	0.1266			1.4614			1.57					0	0.05	1.5522	0	0.0241	0.3797	0	0	0	0			21.9195	500	2.853898085	16.2584	0.591861739	1.97513334	0.704433	1.670840672	2.757895658	1.274658088	1.506909507	5.996994628	5.068565458	0.337256198	0	0.003452823	4.012572469	5.660313058	12.30735166	0.005090646	1.688713228	0	0	4.686576099	0	0	1.57	0	0	0	0	0	0.099999999	5.494126305	0	0.157049496	1.865311909	0	0	0	0	0	0	75.6935
R5826_051_0	2009	5	r.	s.	t.	u.	v.	w.	x.	y.			OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered			5000	Radiology	Renal Dialysis	Mental Health (MH)	Therapy (PT/OT/ST)							A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin					O	O	V	P	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	0	0	0			0		254.933251	7.330779	487.380431	662.313937	133.256274	7.819618	3.48732	327.267766	353.640219	461.669198	143.327459	0	0	432.595179	4114.48701	5330.279367	0.44526	221.127117			28.591704			1.76					2.07	17.145	913.777581	26.143287	6.155407	855.016188	0.06	0.05	1.23	2.7			$800/Admit:1a	$800/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$35/Visit:14h, 8a, 8b, 9a"	$100/Visit:9a	20% Coins:12	"$35-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $35 Partial Hospitalization,8b. $100 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35/Visit:7e, 7h"	"$100/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 762 16a, 16b"					$0: Membership in health club/fitness class 14a	$35/visit; Acupuncture 13b; Other-Chiropractic 7b	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $75 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$0/Proc:12	"$100/Visit:7e, 7h"	"$35/Visit:7d, 9a"	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0 Health Education Materials 14a	$0 Corp Health 14a			799.999996	800.000654	43.132794	0	100.000004	0.2	0.2	50.000011	122.477257	85.582967	34.999964	0	0	77.838149	15	35.000001	35.008758	100.000001			0.2			0					0	34.995625	71.899465	0	99.999886	34.999996	0	0	0	0			656.024797	656.025336	35.370228	0	82.003103	0.164006	0.164006	41.001559	100.435147	70.180686	28.701056	0	0	63.829695	12.300465	28.701086	28.708267	82.003101			0.164006			0					0	34.995625	58.95979	0	82.003006	28.701082	0	0	0	0			13.9369	0.40076473	1.436563081	0	0.910618997	1.28246427	0.571941404	1.118207385	2.959825615	2.700021752	0.342804119	0	0	2.301034861	4.217508622	12.74873388	0.00106522	1.511092442	0	0	4.689211006	0	0	0	0	0	0	0	0	0.049999999	4.489677857	0	0.04206349	2.04499081	0	0	0	0	0	0	57.7555	0	12.6644	13.9369	0.40076473	1.436563081	0	0.910618997	1.28246427	0.571941404	1.118207385	2.959825615	2.700021752	0.342804119	0	0	2.301034861	4.217508622	12.74873388	0.00106522	1.511092442	0	0	4.689211006	0	0	0	0	0	0	0	0	0.049999999	4.489677857	0	0.04206349	2.04499081	0	0	0	0	0	0	57.7555	7500	$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$40/Visit	30% Coins	20% Coins	30% Coins	$40/Visit	$40/Visit	$40/Visit	30% Coins			30% Coins			50% Coins					0	$40/visit	30% Coins		30% Coins	$40/Visit	0	0	0	0			2.2687	0.0652	0.4893	0.621	0.749	1.747	0.7791	0.3449	4.1126	0.7444	0.0853	0	0	1.2006	2.4486	3.1721	0.0003	0.1448			2.0686			0.88					0	0.05	2.1173		0.0093	0.5088	0	0	0	0			24.6068	500	4.211885595	16.2055	0.46600173	1.925842081	0.620999	1.659579997	3.02946727	1.351054404	1.463093385	7.072409615	3.444412752	0.428099119	0	0	3.501667861	6.666065622	15.92081788	0.00133022	1.655896442	0	0	6.757836006	0	0	0.88	0	0	0	0	0	0.099999999	6.606970857	0	0.05133649	2.55381681	0	0	0	0	0	0	82.3622
R5826_053_0	2009	2	r.	s.	t.	u.	v.	w.					OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered					3000	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)								A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin					O	O	V	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	0	0					0		280.415664	12.047595	687.968283	556.26965	148.885658	6.383207	3.32414	349.732947	262.790041	1264.521114	60.10071	0	17.633516	847.467551	3164.477427	3626.255596	0.202338	278.480649			20.802584			3.95					2.07	0.05	724.309353	33.254487	632.902489	0.06	1.23	2.7					$550/Admit:1a	$550/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$95/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $95 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$30/Visit:14h, 8a, 8b, 9a"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$30-$50/Visit:9d. $50 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $30 Partial Hospitalization,8b. $50 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30/Visit:7e, 7h"	"$50/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	"$50/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a					550.000017	549.999564	43.132796	0	100.000014	0.199999	0.2	50.000013	91.377572	47.742975	30.000044	0	12.036397	43.435121	10.000001	30	30.009192	49.999998			0.199999			0					0	0	41.146728	49.999869	29.999995	0	0	0					439.776163	439.775801	34.488682	0	79.959311	0.159918	0.159918	39.97966	73.064867	38.174948	23.987825	0	9.624218	34.730419	7.995931	23.98779	23.99514	39.979648			0.159918			0					0	0	32.900635	39.979545	23.987786	0	0	0					10.2767	0.441520062	1.977259945	0	0.992066219	1.020789697	0.531589821	1.165183693	1.60005995	4.022752314	0.120140443	0	0.0141424	2.452741928	2.108578596	7.248821477	0.000404594	0.927796527	0	0	3.326707628	0	0	0	0	0	0	0	0	0	1.985853138	0.110791605	1.265160789	0	0	0	0	0	0	0	41.589	0	10.4237	10.2767	0.441520062	1.977259945	0	0.992066219	1.020789697	0.531589821	1.165183693	1.60005995	4.022752314	0.120140443	0	0.0141424	2.452741928	2.108578596	7.248821477	0.000404594	0.927796527	0	0	3.326707628	0	0	0	0	0	0	0	0	0	1.985853138	0.110791605	1.265160789	0	0	0	0	0	0	0	41.589	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$35/Visit	30% Coins	$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			50% Coins					0	0	30% Coins	30% Coins	$35/Visit	0	0	0					2.1131	0.0908	0.7859	0.6233	0.8414	1.434	0.7468	0.3706	3.4005	0.8133	0.0315		0.0045	1.4607	1.6569	1.8987	0.0001	0.1536			1.5134			1.97					0	0	1.6878	0.0237	0.3314	0	0	0					21.952	500	3.936451811	12.3898	0.532305062	2.763186945	0.62327	1.833515219	2.454795697	1.278367821	1.535789693	5.00055195	4.836035314	0.151609443	0	0.0186404	3.913437928	3.765524596	9.147558477	0.000510594	1.081364527	0	0	4.840138628	0	0	1.97	0	0	0	0	0	0	3.673672138	0.134472605	1.596553789	0	0	0	0	0	0	0	63.5411
R5826_054_0	2009	5	r.	s.	t.	u.	v.	w.	x.	y.			OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered			5000	Radiology	Renal Dialysis	Mental Health (MH)	Therapy (PT/OT/ST)							A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin					O	O	V	P	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	0	0	0			0		311.566493	10.848239	893.045542	813.529735	187.727512	9.590972	7.565013	482.037324	324.216031	1843.943562	63.853024	0	0.010045	874.956843	3272.100327	3438.043575	8.339142	302.749047			13.709557			3.03					2.07	17.145	816.337048	8.159043	37.660172	509.24154	0.06	0.05	1.23	2.7			$800/Admit:1a	$800/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$35/Visit:14h, 8a, 8b, 9a"	$100/Visit:9a	20% Coins:12	"$35-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $35 Partial Hospitalization,8b. $100 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35/Visit:7e, 7h"	"$100/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$35/visit; Acupuncture 13b; Other-Chiropractic 7b	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $75 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$0/Proc:12	"$100/Visit:7e, 7h"	"$35/Visit:7d, 9a"	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0 Health Education Materials 14a	$0 Corp Health 14a			800.000017	800.000073	43.132801	0	100.000004	0.199999	0.199999	50.000003	138.551989	93.090656	35.000002	0	0.2	86.306268	14.999998	34.999999	34.999284	100.00001			0.2			0					0	34.995625	81.655051	0	100.000074	35.000004	0	0	0	0			644.136014	644.136059	34.729237	0	80.517003	0.161033	0.161033	40.258503	111.557905	74.953803	28.180952	0	0.161034	69.491218	12.077548	28.180949	28.180373	80.517008			0.161034			0					0	34.995625	65.746198	0	80.517059	28.180953	0	0	0	0			16.7243	0.582311826	2.584565857	0	1.259604721	1.544462994	1.218216738	1.617175088	3.014071765	11.51754854	0.14995325	0	0.001617587	5.06681806	3.29324573	8.073944221	0.019583344	2.03137062	0	0	2.207704802	0	0	0	0	0	0	0	0	0.049999999	4.472588099	0	0.252690524	1.195909325	0	0	0	0	0	0	66.8776	0	16.1705	16.7243	0.582311826	2.584565857	0	1.259604721	1.544462994	1.218216738	1.617175088	3.014071765	11.51754854	0.14995325	0	0.001617587	5.06681806	3.29324573	8.073944221	0.019583344	2.03137062	0	0	2.207704802	0	0	0	0	0	0	0	0	0.049999999	4.472588099	0	0.252690524	1.195909325	0	0	0	0	0	0	66.8776	7500	$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$40/Visit	30% Coins	20% Coins	30% Coins	$40/Visit	$40/Visit	$40/Visit	30% Coins			30% Coins			50% Coins					0	$40/visit	30% Coins		30% Coins	$40/Visit	0	0	0	0			2.7526	0.0958	0.8373	0.892	1.0475	2.1273	1.6779	0.5043	3.2503	0.9454	0.0377	0	0.0004	1.4234	1.9332	2.0312	0.0049	0.125			0.9847			1.52					0	0.05	1.4618		0.0213	0.3009	0	0	0	0			24.025	500	4.355883085	19.4769	0.678152826	3.421869857	0.891981	2.307092721	3.671722994	2.896123738	2.121491088	6.264337765	12.46293554	0.18767825	0	0.002060587	6.49025406	5.22641973	10.10515822	0.024509344	2.15641462	0	0	3.192429802	0	0	1.52	0	0	0	0	0	0.099999999	5.934402099	0	0.274005524	1.496772325	0	0	0	0	0	0	90.9027
R5826_059_0	2009	5	r.	s.	t.	u.	v.	w.	x.	y.			OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered	Other Non-Covered			5000	Radiology	Renal Dialysis	Mental Health (MH)	Therapy (PT/OT/ST)							A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin					O	O	V	P	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	0	0	0			0		289.139097	9.007279	410.072837	963.872504	139.936273	9.524766	3.329325	355.252981	301.385302	478.447784	138.714353	0	0.010119	464.989045	3527.934645	3818.963275	0	212.16812			23.397813			2.77					2.07	17.145	723.422736	10.614503	16.425666	459.42686	0.06	0.05	1.23	2.7			$800/Admit:1a	$800/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$35/Visit:14h, 8a, 8b, 9a"	$100/Visit:9a	20% Coins:12	"$35-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $35 Partial Hospitalization,8b. $100 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35/Visit:7e, 7h"	"$100/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$35/visit; Acupuncture 13b; Other-Chiropractic 7b	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $75 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$0/Proc:12	"$100/Visit:7e, 7h"	"$35/Visit:7d, 9a"	$0: Nurse hotline 14a	$0 Additional Smoking Cessation 14a	$0 Health Education Materials 14a	$0 Corp Health 14a			800.000008	799.999644	43.132805	0	100.000033	0.199999	0.2	50.000008	132.250868	86.73907	35.00004	0	0.200019	78.828437	14.999998	35.000003	0	100.000018			0.2			0					0	34.995625	78.168419	0	100.000328	34.999999	0	0	0	0			671.497606	671.497301	36.204469	0	83.937228	0.167874	0.167874	41.968606	111.007676	72.806346	29.378054	0	0.16789	66.166383	12.590579	29.378022	0	83.937215			0.167874			0					0	34.995625	65.612382	0	83.937475	29.378019	0	0	0	0			16.1797	0.504030295	1.237205776	0	0.978821904	1.598960567	0.558907105	1.242456032	2.78800683	2.902836242	0.339596479	0	0.001698879	2.563886937	3.701561655	9.349465593	0	1.484066759	0	0	3.92788446	0	0	0	0	0	0	0	0	0.049999999	3.955457408	0	0.114894077	1.124754252	0	0	0	0	0	0	54.6042	0	10.4399	16.1797	0.504030295	1.237205776	0	0.978821904	1.598960567	0.558907105	1.242456032	2.78800683	2.902836242	0.339596479	0	0.001698879	2.563886937	3.701561655	9.349465593	0	1.484066759	0	0	3.92788446	0	0	0	0	0	0	0	0	0.049999999	3.955457408	0	0.114894077	1.124754252	0	0	0	0	0	0	54.6042	7500	$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$40/Visit		20% Coins	30% Coins	$40/Visit	$40/Visit		30% Coins			30% Coins			50% Coins					0	$40/visit	30% Coins		30% Coins	$40/Visit	0	0	0	0			2.6483	0.0825	0.4838	1.2754	0.8095	2.1902	0.7656	0.3853	4.2181	0.4954	0.085		0.0005	0.9664	2.1609	2.3392		0.1588			1.7424			1.38					0	0.05	1.6369		0.0163	0.2814	0	0	0	0			24.1721	500	3.508192621	18.828	0.586532295	1.721021776	1.275432	1.788338904	3.789176567	1.324484105	1.627787032	7.00611083	3.398281242	0.424561479	0	0.002160879	3.530317937	5.862486655	11.68865059	0	1.642869759	0	0	5.67025746	0	0	1.38	0	0	0	0	0	0.099999999	5.592374408	0	0.131219077	1.406161252	0	0	0	0	0	0	78.7763
R5826_062_0	2009	3	r.	s.	t.	u.	v.	w.					OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered					3000	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)								A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin					O		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		268.165045	9.762103	529.777368	722.998667	139.49068	8.035908	3.714075	352.49821	318.04115	762.380265	118.198124	0	18.111359	572.165569	3640.709335	4313.35209	1.784188	240.593583			22.546502			3.42					2.07		799.592817	20.475042	653.735016		1.23	2.7					$550/Admit:1a	$550/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$95/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $95 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$30/Visit:14h, 8a, 8b, 9a"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$30-$50/Visit:9d. $50 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $30 Partial Hospitalization,8b. $50 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30/Visit:7e, 7h"	"$50/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a		"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	"$50/Visit:7e, 7h"	"$30/Visit:7d, 9a"		$0: Health Education Materials 14a	$0 Corp Health 14a					550.000004	550.000343	43.132805	0	99.999971	0.2	0.2	50.000015	86.923167	45.242886	29.999968	0	2.560161	43.598002	9.999998	29.999999	29.996838	49.999986			0.2			0					0		42.11406	50.00019	30.000008		0	0					437.568453	437.568723	34.315554	0	79.557877	0.159115	0.159115	39.778962	69.154246	35.99429	23.867344	0	2.03681	34.685655	7.955788	23.867369	23.864855	39.778939			0.159115			0					0		33.505061	39.779101	23.867376		0	0					9.7784	0.355965912	1.51496699	0	0.92479853	1.278633501	0.590965044	1.168501075	1.83282466	2.286778029	0.235089607	0	0.003074116	1.653828127	2.41372597	8.579030497	0.003548282	0.797546455	0	0	3.587486666	0	0	0	0	0	0	0	0	0	2.232533842	0.06787323	1.300244953	0	0	0	0	0	0	0	40.6058	0	10.4335	9.7784	0.355965912	1.51496699	0	0.92479853	1.278633501	0.590965044	1.168501075	1.83282466	2.286778029	0.235089607	0	0.003074116	1.653828127	2.41372597	8.579030497	0.003548282	0.797546455	0	0	3.587486666	0	0	0	0	0	0	0	0	0	2.232533842	0.06787323	1.300244953	0	0	0	0	0	0	0	40.6058	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$35/Visit	30% Coins	$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			50% Coins					0		30% Coins	30% Coins	$35/Visit		0	0					2.0046	0.073	0.5472	0.7844	0.7821	1.7909	0.8277	0.3706	3.6927	0.6563	0.0614		0.001	1.192	1.8911	2.2405	0.0009	0.1409			1.6272			1.71					0		1.7283	0.0268	0.3396		0	0					22.4891	500	4.209075202	11.783	0.428940912	2.06217299	0.784356	1.70685453	3.069506501	1.418679044	1.539055075	5.52553666	2.943098029	0.296484607	0	0.004049116	2.845794127	4.30480797	10.8195015	0.004474282	0.938459455	0	0	5.214692666	0	0	1.71	0	0	0	0	0	0	3.960880842	0.09471423	1.639811953	0	0	0	0	0	0	0	63.0949
R5826_063_0	2009	3	r.	s.	t.	u.	v.	w.					OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered					3000	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)								A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin					O	O	V	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	0	0					0		250.689435	9.125931	495.253175	675.882752	130.400441	7.022684	3.245778	329.526833	297.315247	712.697953	110.495464	0	16.931088	534.879048	3403.453914	4032.262316	1.667918	224.914734			19.703679			3.14					2.07	0.05	747.485465	19.140737	611.132829	0.06	1.23	2.7					$550/Admit:1a	$550/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$95/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $95 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$30/Visit:14h, 8a, 8b, 9a"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$30-$50/Visit:9d. $50 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $30 Partial Hospitalization,8b. $50 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30/Visit:7e, 7h"	"$50/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	"$50/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a					549.999979	550.000213	43.132799	0	99.999968	0.2	0.2	49.999982	86.92317	45.242891	30.000036	0	2.560024	43.597983	10.000001	30	30.001474	50.000014			0.2			0					0	0	42.114092	49.999955	29.999998	0	0	0					447.357332	447.357523	35.083227	0	81.337674	0.162675	0.162675	40.668836	70.701307	36.799527	24.40134	0	2.082265	35.461597	8.133771	24.40131	24.402509	40.668861			0.162675			0					0	0	34.254634	40.668813	24.401308	0	0	0					9.3456	0.340212824	1.447923297	0	0.88387238	1.14241512	0.528006936	1.116789394	1.751714713	2.185578964	0.224686449	0	0.002937918	1.58063877	2.306909562	8.199373565	0.003391782	0.762252171	0	0	3.205295981	0	0	0	0	0	0	0	0	0	2.133736752	0.064869254	1.242703366	0	0	0	0	0	0	0	38.469	0	8.8264	9.3456	0.340212824	1.447923297	0	0.88387238	1.14241512	0.528006936	1.116789394	1.751714713	2.185578964	0.224686449	0	0.002937918	1.58063877	2.306909562	8.199373565	0.003391782	0.762252171	0	0	3.205295981	0	0	0	0	0	0	0	0	0	2.133736752	0.064869254	1.242703366	0	0	0	0	0	0	0	38.469	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$35/Visit	30% Coins	$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			50% Coins					0	0	30% Coins	30% Coins	$35/Visit	0	0	0					1.9434	0.0707	0.4959	0.7109	0.7582	1.623	0.7501	0.3592	3.3467	0.5948	0.0595		0.0009	1.0803	1.8333	2.1721	0.0009	0.1277			1.4747			1.57					0	0	1.5664	0.0243	0.3292	0	0	0					20.8923	500	3.445581445	11.2891	0.410959824	1.943848297	0.710851	1.64204638	2.76545712	1.278152936	1.476026394	5.098366713	2.780391964	0.284207449	0	0.003882918	2.66089977	4.140241562	10.37142456	0.004289782	0.889960171	0	0	4.680009981	0	0	1.57	0	0	0	0	0	0	3.700114752	0.089194254	1.571901366	0	0	0	0	0	0	0	59.3613
R5826_064_0	2009	2	r.	s.	t.	u.	v.	w.					OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered					3000	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)								A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin					O	O	V	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	0	0					0		252.724559	9.200017	499.273692	681.369639	131.459046	7.137164	3.29869	332.201966	299.728885	718.483712	111.392477	0	17.068538	539.221252	3431.083509	4064.996643	1.681458	226.740614			20.02488			2.86					2.07	0.05	753.553633	19.296124	616.094069	0.06	1.23	2.7					$550/Admit:1a	$550/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$95/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $95 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$30/Visit:14h, 8a, 8b, 9a"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$30-$50/Visit:9d. $50 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $30 Partial Hospitalization,8b. $50 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30/Visit:7e, 7h"	"$50/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	"$50/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a					550.000002	549.999418	43.132791	0	99.999995	0.2	0.2	50.000005	86.923153	45.242879	29.999979	0	2.5605	43.597984	9.999999	30.000001	30.002533	50.000023			0.2			0					0	0	42.114072	50.0003	29.999996	0	0	0					446.279351	446.278878	34.99868	0	81.141696	0.162283	0.162283	40.570854	70.530924	36.710841	24.342493	0	2.077633	35.376146	8.114169	24.34251	24.344565	40.570868			0.162283			0					0	0	34.172074	40.571093	24.342507	0	0	0					9.3988	0.342147772	1.456160015	0	0.888900829	1.158240385	0.535321309	1.123143122	1.761679601	2.198011776	0.225964216	0	0.00295518	1.589630811	2.32003262	8.246018453	0.003411197	0.766588627	0	0	3.249697601	0	0	0	0	0	0	0	0	0	2.145874209	0.065238737	1.249772849	0	0	0	0	0	0	0	38.7276	0	9.0008	9.3988	0.342147772	1.456160015	0	0.888900829	1.158240385	0.535321309	1.123143122	1.761679601	2.198011776	0.225964216	0	0.00295518	1.589630811	2.32003262	8.246018453	0.003411197	0.766588627	0	0	3.249697601	0	0	0	0	0	0	0	0	0	2.145874209	0.065238737	1.249772849	0	0	0	0	0	0	0	38.7276	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$35/Visit		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			50% Coins					0	0	30% Coins	30% Coins	$35/Visit	0	0	0					1.951	0.071	0.5019	0.7194	0.7611	1.6426	0.7592	0.3606	3.3869	0.602	0.0598		0.0009	1.0933	1.8405	2.1805	0.0009	0.1292			1.4925			1.43					0	0	1.5852	0.0246	0.3305	0	0	0					20.9235	500	3.527426345	11.3498	0.413168772	1.958054015	0.719407	1.650020829	2.800817385	1.294495309	1.483777122	5.148611601	2.799983776	0.285715216	0	0.00390318	2.682893811	4.16048962	10.42651145	0.004312197	0.895833627	0	0	4.742159601	0	0	1.43	0	0	0	0	0	0	3.731102209	0.089856737	1.580249849	0	0	0	0	0	0	0	59.6511
R5826_065_0	2009	2	r.	s.	t.	u.	v.	w.					OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered					3000	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)								A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin					O	O	V	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	0	0					0		261.375478	9.514939	516.364141	704.693345	135.95897	7.634147	3.528387	343.573445	309.98879	743.077856	115.205512	0	17.652804	557.67913	3548.531629	4204.144004	1.739015	234.502087			21.419273			2.79					2.07	0.05	779.348236	19.956642	637.183352	0.06	1.23	2.7					$550/Admit:1a	$550/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$95/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $95 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$30/Visit:14h, 8a, 8b, 9a"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$30-$50/Visit:9d. $50 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $30 Partial Hospitalization,8b. $50 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30/Visit:7e, 7h"	"$50/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	"$50/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a					549.999981	549.999532	43.132793	0	99.999963	0.199999	0.2	49.999999	86.923169	45.242882	30.000022	0	2.560046	43.597995	10.000001	29.999999	30.003191	49.999998			0.2			0					0	0	42.114051	50.000195	29.999992	0	0	0					441.343634	441.343274	34.611608	0	80.24427	0.160488	0.160488	40.122149	69.750888	36.304834	24.073308	0	2.054291	34.984906	8.02443	24.073289	24.07585	40.122148			0.160488			0					0	0	33.794126	40.122306	24.073284	0	0	0					9.613	0.349946194	1.489349436	0	0.909160691	1.225188984	0.566263773	1.148742079	1.801832781	2.248109851	0.231114814	0	0.003022	1.625862662	2.372911972	8.433964467	0.003489022	0.78406062	0	0	3.437536285	0	0	0	0	0	0	0	0	0	2.194782707	0.066725541	1.278257983	0	0	0	0	0	0	0	39.7834	0	9.7944	9.613	0.349946194	1.489349436	0	0.909160691	1.225188984	0.566263773	1.148742079	1.801832781	2.248109851	0.231114814	0	0.003022	1.625862662	2.372911972	8.433964467	0.003489022	0.78406062	0	0	3.437536285	0	0	0	0	0	0	0	0	0	2.194782707	0.066725541	1.278257983	0	0	0	0	0	0	0	39.7834	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$35/Visit		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			Coin:  50%					0	0	30% Coins	30% Coins	$35/Visit	0	0	0					1.9813	0.0721	0.5271	0.7556	0.773	1.7252	0.7974	0.3662	3.5573	0.6323	0.0607		0.001	1.1483	1.8691	2.2144	0.0009	0.1357			1.5675			1.4					0	0	1.665	0.0259	0.3356	0	0	0					21.6115	500	3.901883903	11.5943	0.422072194	2.016492436	0.755599	1.682113691	2.950400984	1.363631773	1.514982079	5.359155781	2.880365851	0.291795814	0	0.003986	2.774127662	4.241979972	10.64835347	0.004405022	0.91980662	0	0	5.005082285	0	0	1.4	0	0	0	0	0	0	3.859761707	0.092582541	1.613872983	0	0	0	0	0	0	0	61.3949
R5826_066_0	2009	2	r.	s.	t.	u.	v.	w.					OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered					3000	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)								A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin					O	O	V	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	0	0					0		258.564478	9.41261	510.810829	697.114619	134.496781	7.470832	3.452905	339.878434	306.654972	735.086318	113.966517	0	17.462955	551.681488	3510.368437	4158.929932	1.720313	231.9801			20.961058			3.13					2.07	0.05	770.966625	19.742015	630.330672	0.06	1.23	2.7					$550/Admit:1a	$550/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$95/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $95 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$30/Visit:14h, 8a, 8b, 9a"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$30-$50/Visit:9d. $50 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $30 Partial Hospitalization,8b. $50 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30/Visit:7e, 7h"	"$50/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	"$50/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a					550.000004	549.999628	43.132789	0	100.000043	0.199999	0.2	49.999994	86.923201	45.242882	29.999969	0	2.560391	43.598004	9.999999	30	30.001517	50.000012			0.2			0					0	0	42.114072	49.999759	30.000006	0	0	0					442.967803	442.9675	34.738976	0	80.539635	0.161079	0.161079	40.269795	70.007598	36.438436	24.161855	0	2.062129	35.113658	8.053959	24.16188	24.163101	40.26981			0.161079			0					0	0	33.918505	40.269606	24.161884	0	0	0					9.5446	0.347456693	1.478753761	0	0.902693471	1.203394148	0.556190484	1.140569572	1.789014834	2.232116313	0.229470205	0	0.003000905	1.614296258	2.356030289	8.373963829	0.003464008	0.778482879	0	0	3.376386262	0	0	0	0	0	0	0	0	0	2.17916961	0.066250264	1.269164715	0	0	0	0	0	0	0	39.4445	0	9.5308	9.5446	0.347456693	1.478753761	0	0.902693471	1.203394148	0.556190484	1.140569572	1.789014834	2.232116313	0.229470205	0	0.003000905	1.614296258	2.356030289	8.373963829	0.003464008	0.778482879	0	0	3.376386262	0	0	0	0	0	0	0	0	0	2.17916961	0.066250264	1.269164715	0	0	0	0	0	0	0	39.4445	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$35/Visit	30% Coins	$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			50% Coins					0	0	30% Coins	30% Coins	$35/Visit	0	0	0					1.9716	0.0718	0.5189	0.7438	0.7692	1.6983	0.7849	0.3645	3.5019	0.6224	0.0604		0.001	1.1304	1.8599	2.2036	0.0009	0.1336			1.5431			1.57					0	0	1.639	0.0255	0.334	0	0	0					21.5487	500	3.77686081	11.5163	0.419229693	1.997682761	0.743823	1.671871471	2.901721148	1.341131484	1.505021572	5.290898834	2.854520313	0.289854205	0	0.003958905	2.744665258	4.215972289	10.57754183	0.004375008	0.912113879	0	0	4.919504262	0	0	1.57	0	0	0	0	0	0	3.81820161	0.091703264	1.603140715	0	0	0	0	0	0	0	60.9932
R5826_067_0	2009	2	r.	s.	t.	u.	v.	w.					OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered					3000	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)								A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin					O	O	V	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	0	0					0		254.829885	9.276658	503.432897	687.045796	132.554166	7.256578	3.35388	334.969378	302.22578	724.469048	112.320434	0	17.210727	543.713239	3459.666191	4098.860148	1.695465	228.629481			20.35992			2.82					2.07	0.05	759.831118	19.456871	621.226448	0.06	1.23	2.7					$550/Admit:1a	$550/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$95/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $95 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$30/Visit:14h, 8a, 8b, 9a"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$30-$50/Visit:9d. $50 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $30 Partial Hospitalization,8b. $50 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30/Visit:7e, 7h"	"$50/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	"$50/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a					549.999997	549.999795	43.132795	0	99.999995	0.2	0.2	50.000009	86.923173	45.242893	29.99999	0	2.560263	43.597981	9.999999	30.000001	30.002388	50.000008			0.2			0					0	0	42.114074	49.999817	29.999997	0	0	0					445.130947	445.130784	34.908621	0	80.932896	0.161865	0.161865	40.466457	70.349445	36.616385	24.279862	0	2.072095	35.285111	8.093289	24.279871	24.281803	40.466456			0.161865			0					0	0	34.084141	40.466302	24.279868	0	0	0					9.4527	0.344110504	1.46451235	0	0.893999378	1.174585998	0.542875786	1.129585328	1.771784657	2.210619799	0.227260386	0	0.002971855	1.598748499	2.333339861	8.293316303	0.003430746	0.770985403	0	0	3.295558451	0	0	0	0	0	0	0	0	0	2.15818258	0.065612301	1.256941346	0	0	0	0	0	0	0	38.9911	0	9.186	9.4527	0.344110504	1.46451235	0	0.893999378	1.174585998	0.542875786	1.129585328	1.771784657	2.210619799	0.227260386	0	0.002971855	1.598748499	2.333339861	8.293316303	0.003430746	0.770985403	0	0	3.295558451	0	0	0	0	0	0	0	0	0	2.15818258	0.065612301	1.256941346	0	0	0	0	0	0	0	38.9911	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$35/Visit		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			50% Coins					0	0	30% Coins	30% Coins	$35/Visit	0	0	0					1.9586	0.0713	0.5081	0.7282	0.7641	1.6628	0.7685	0.362	3.4285	0.6094	0.06		0.001	1.1067	1.8477	2.189	0.0009	0.1308			1.5108			1.41					0	0	1.6047	0.0249	0.3318	0	0	0					21.0799	500	3.614539469	11.4113	0.415410504	1.97257235	0.728246	1.658105378	2.837344998	1.311378786	1.491633328	5.200331657	2.819988799	0.287246386	0	0.003924855	2.705444499	4.181017861	10.4823643	0.004336746	0.901818403	0	0	4.806359451	0	0	1.41	0	0	0	0	0	0	3.76289058	0.090532301	1.588715346	0	0	0	0	0	0	0	60.071
R5826_068_0	2009	3	r.	s.	t.	u.	v.	w.					OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered					3000	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)								A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin					O	O	V	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	0	0					0		272.746476	9.928882	538.828282	735.350644	141.873792	8.312836	3.842067	358.520421	323.474684	775.405053	120.217464	0	18.420779	581.940653	3702.908562	4387.042996	1.81467	244.703973			23.323484			2.76					2.07	0.05	813.253359	20.824845	664.903666	0.06	1.23	2.7					$550/Admit:1a	$550/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$95/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $95 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$30/Visit:14h, 8a, 8b, 9a"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$30-$50/Visit:9d. $50 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $30 Partial Hospitalization,8b. $50 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30/Visit:7e, 7h"	"$50/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	"$50/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a					549.999993	550.000292	43.132791	0	100.000033	0.199999	0.2	49.999997	86.923191	45.242877	30.000033	0	2.560152	43.597992	9.999999	30.000001	30.002149	50.000005			0.199999			0					0	0	42.114063	49.999891	29.999997	0	0	0					435.118194	435.118431	34.123386	0	79.112426	0.158224	0.158224	39.556197	68.767023	35.792726	23.733746	0	2.025397	34.491417	7.911239	23.733721	23.73542	39.556204			0.158224			0					0	0	33.317446	39.556114	23.733717	0	0	0					9.8897	0.360019963	1.532220455	0	0.935331656	1.315290163	0.607907209	1.1818087	1.853699253	2.312821717	0.237767563	0	0.003109116	1.672663144	2.441216219	8.676737874	0.00358933	0.806630023	0	0	3.690334932	0	0	0	0	0	0	0	0	0	2.257960406	0.068645829	1.315052953	0	0	0	0	0	0	0	41.1626	0	10.8679	9.8897	0.360019963	1.532220455	0	0.935331656	1.315290163	0.607907209	1.1818087	1.853699253	2.312821717	0.237767563	0	0.003109116	1.672663144	2.441216219	8.676737874	0.00358933	0.806630023	0	0	3.690334932	0	0	0	0	0	0	0	0	0	2.257960406	0.068645829	1.315052953	0	0	0	0	0	0	0	41.1626	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$35/Visit	30% Coins	$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			50% Coins					0	0	30% Coins	30% Coins	$35/Visit	0	0	0					2.0204	0.0735	0.5609	0.804	0.7882	1.8358	0.8485	0.3735	3.7853	0.6728	0.0619		0.001	1.2218	1.9059	2.2581	0.0009	0.1444			1.668			1.38					0	0	1.7717	0.0275	0.3422	0	0	0					22.5463	500	4.421090095	11.9101	0.433567963	2.093145455	0.804021	1.723528656	3.151061163	1.456373209	1.5552717	5.638992253	2.985595717	0.299645563	0	0.004092116	2.894512144	4.347146219	10.93479887	0.00452333	0.951076023	0	0	5.358335932	0	0	1.38	0	0	0	0	0	0	4.029638406	0.096158829	1.657286953	0	0	0	0	0	0	0	63.7089
R5826_069_0	2009	2	r.	s.	t.	u.	v.	w.					OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered					3000	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)								A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin					O	O	V	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	0	0					0		258.514265	9.410781	510.711628	696.979238	134.47066	7.46793	3.451564	339.812431	306.595419	734.943562	113.944385	0	17.459563	551.574354	3509.686714	4158.12226	1.719978	231.935049			20.952916			2.82					2.07	0.05	770.8169	19.738182	630.20826	0.06	1.23	2.7					$550/Admit:1a	$550/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$95/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $95 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$30/Visit:14h, 8a, 8b, 9a"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$30-$50/Visit:9d. $50 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $30 Partial Hospitalization,8b. $50 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30/Visit:7e, 7h"	"$50/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	"$50/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a					549.999977	549.99941	43.132802	0	100.000014	0.2	0.2	49.999995	86.923177	45.242886	30.000003	0	2.560201	43.597987	10	29.999998	30.000383	49.999998			0.199999			0					0	0	42.114063	49.999741	30.000006	0	0	0					442.996932	442.996474	34.741272	0	80.544911	0.161089	0.161089	40.272446	70.012186	36.440837	24.163473	0	2.062111	35.115955	8.05449	24.163468	24.163779	40.272448			0.161089			0					0	0	33.92073	40.272241	24.163475	0	0	0					9.5434	0.3474119	1.478564298	0	0.902577278	1.203001376	0.556008993	1.140423148	1.788784625	2.231829879	0.229441006	0	0.003000296	1.61408835	2.355728045	8.372887847	0.003463431	0.778382683	0	0	3.375284286	0	0	0	0	0	0	0	0	0	2.178889329	0.066241735	1.269001795	0	0	0	0	0	0	0	39.4384	0	9.5261	9.5434	0.3474119	1.478564298	0	0.902577278	1.203001376	0.556008993	1.140423148	1.788784625	2.231829879	0.229441006	0	0.003000296	1.61408835	2.355728045	8.372887847	0.003463431	0.778382683	0	0	3.375284286	0	0	0	0	0	0	0	0	0	2.178889329	0.066241735	1.269001795	0	0	0	0	0	0	0	39.4384	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$35/Visit		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			50% Coins					0	0	30% Coins	30% Coins	$35/Visit	0	0	0					1.9714	0.0718	0.5188	0.7436	0.7691	1.6978	0.7847	0.3644	3.5009	0.6222	0.0604		0.001	1.13	1.8598	2.2034	0.0009	0.1336			1.5427			1.41					0	0	1.6386	0.0254	0.3339	0	0	0					21.3845	500	3.774646207	11.5149	0.4191799	1.997346298	0.743614	1.671688278	2.900849376	1.340727993	1.504843148	5.289683625	2.854057879	0.289820006	0	0.003958296	2.74413735	4.215507045	10.57627285	0.004374431	0.911975683	0	0	4.917967286	0	0	1.41	0	0	0	0	0	0	3.817462329	0.091688735	1.602948795	0	0	0	0	0	0	0	60.823
R5826_070_0	2009	4	r.	s.	t.	u.	v.	w.					OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered					2800	Radiology	Mental Health (MH)	Therapy (PT/OT/ST)								A	A	D	V	T	Coin	Coin	V	V	V	V	V	P	V	V	V	V	V			Coin			Coin	V				O	O	V	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	0	0	0					0		249.884384	9.096625	493.662744	673.712257	129.981679	6.97765	3.224964	328.468606	296.360464	710.409233	110.140624	0	16.876718	533.161366	3392.524237	4019.313318	1.662563	224.192454			19.577327			4.14	1.5				2.07	0.05	745.085026	19.07927	609.170268	0.06	1.23	2.7					$550/Admit:1a	$550/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$95/Visit:9b. $0 Surgery ASC -- Physician,9b. $75 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $95 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$30/Visit:14h, 8a, 8b, 9a"	$50/Visit:9a	"$0-$50/Proc:12. $0 Dialysis -- Dialysis Center,12. $50 Dialysis -- OP Hosp"	"$30-$50/Visit:9d. $50 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $30 Partial Hospitalization,8b. $50 Rad therapy,3. $30 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$30/Visit:7b, 7d, 7f"	"$30/Visit:7e, 7h"	"$50/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 750 16a, 16b"	0% Coins VIS 742				$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $30 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	"$50/Visit:7e, 7h"	"$30/Visit:7d, 9a"	$0: Nurse hotline 14a	$0 Health Education Materials 14a	$0 Corp Health 14a					549.999987	550.000467	43.132791	0	100.000031	0.2	0.2	49.999992	86.923173	45.242891	30.000047	0	2.56045	43.597997	10.000001	30.000002	29.997058	49.999987			0.199999			0	0				0	0	42.114066	50.000026	30.000006	0	0	0					438.275739	438.276122	34.371011	0	79.686525	0.159373	0.159373	39.843244	69.266034	36.052476	23.905988	0	2.040333	34.741718	7.968651	23.905951	23.903606	39.84324			0.159372			0	0				0	0	33.559225	39.84327	23.905955	0	0	0					9.1265	0.332236127	1.413973967	0	0.863149026	1.112049013	0.513972188	1.090604568	1.710642831	2.134334319	0.21941837	0	0.00286951	1.543578486	2.252820138	8.007125603	0.003311771	0.744379479	0	0	3.120077759	0	0	0	0	0	0	0	0	0	2.083706336	0.063348376	1.213566418	0	0	0	0	0	0	0	37.5517	0	9.5726	9.1265	0.332236127	1.413973967	0	0.863149026	1.112049013	0.513972188	1.090604568	1.710642831	2.134334319	0.21941837	0	0.00286951	1.543578486	2.252820138	8.007125603	0.003311771	0.744379479	0	0	3.120077759	0	0	0	0	0	0	0	0	0	2.083706336	0.063348376	1.213566418	0	0	0	0	0	0	0	37.5517	5000	$800/Admit	$800/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$35/Visit		$0-$50/Proc	30% Coins	$35/Visit	$35/Visit	$35/Visit	30% Coins			30% Coins			50% Coins	0				0	0	30% Coins	30% Coins	$35/Visit	0	0	0					1.9084	0.0695	0.4854	0.6958	0.7445	1.5887	0.7343	0.3528	3.2758	0.5822	0.0584		0.0009	1.0574	1.8003	2.1329	0.0009	0.125			1.4435			2.07	0				0	0	1.5332	0.0238	0.3233	0	0	0					21.0071	500	3.731066268	11.0349	0.401708127	1.899402967	0.695807	1.607668026	2.700743013	1.248242188	1.443372568	4.986468831	2.716559319	0.27786637	0	0.00379751	2.600979486	4.053134138	10.1400596	0.004194771	0.869384479	0	0	4.563582759	0	0	2.07	0	0	0	0	0	0	3.616933336	0.087158376	1.536836418	0	0	0	0	0	0	0	58.5588
R5826_071_0	2009	9	r.	s.	t.	u.	v.	w.	x.				OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered				5000	Radiology	Renal Dialysis	Mental Health (MH)	Therapy (PT/OT/ST)							A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin	V				O	O	V	P	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	0	0	0	0				0		282.554411	12.139483	693.215459	560.512351	150.021218	6.480951	3.37504	352.40038	264.794357	1274.16569	60.559102	0	0.081358	853.931241	3188.613088	3653.913264	0.203882	280.604637			21.121125			2.18	0.35				2.07	0.05	729.833706	13.490696	33.508122	637.729675	0.06	1.23	2.7				$650/Admit:1a	$650/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$50/Visit:8a. $0 Lab -- FSL,8. $50 Lab -- OP"	"$35/Visit:14h, 8a, 8b, 9a"	$50/Visit:9a	20% Coins:12	"$35-$50/Visit:9d. $50 Cardiac Rehab,8b. $50 Nuclear Medicine,9a. $50 OP Other,5. $35 Partial Hospitalization,8b. $50 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$10/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35/Visit:7e, 7h"	"$50/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 767 16a, 16b"	"$0/exam 17a, 17b. Vision 738"				$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$50/Visit:14h. $50 DMAM -- OP,8b. $50 Radiology -- FSR,14h. $50 SMAM -- FSR,14h. $50 SMAM -- OP,8b. $50 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $50 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $50 Radiology OP -- Facility"	$0/Proc:12	"$50/Visit:7e, 7h"	"$35/Visit:7d, 9a"	$0: Nurse hotline 14a	$0 Health Education Materials 14a	$0 Corp Health 14a				650.000017	649.999674	43.132806	0	100.000014	0.199999	0.2	50.000002	140.943955	47.742977	35.000056	0	0.200004	45.076331	10.000001	34.999999	35.020256	50			0.2			0	0				0	0	50.000003	0	49.999937	35.000002	0	0	0				581.328815	581.328508	38.575911	0	89.435213	0.17887	0.17887	44.717602	126.053508	42.699027	31.30237	0	0.178874	40.314107	8.943521	31.302319	31.320436	44.7176			0.17887			0	0				0	0	44.717603	0	44.717543	31.302321	0	0	0				13.6881	0.588085628	2.228451488	0	1.118098299	1.159247705	0.603693405	1.313208328	2.781521467	4.533802933	0.157970285	0	0.014552831	2.868789618	2.376452343	9.531329882	0.000532139	1.045663826	0	0	3.777935629	0	0	0	0	0	0	0	0	0	2.71970116	0	0.124866741	1.663534917	0	0	0	0	0	0	52.2955	0	6.1776	13.6881	0.588085628	2.228451488	0	1.118098299	1.159247705	0.603693405	1.313208328	2.781521467	4.533802933	0.157970285	0	0.014552831	2.868789618	2.376452343	9.531329882	0.000532139	1.045663826	0	0	3.777935629	0	0	0	0	0	0	0	0	0	2.71970116	0	0.124866741	1.663534917	0	0	0	0	0	0	52.2955	10000	$1200/Admit	$1200/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$40/Visit	30% Coins	20% Coins	30% Coins	$40/Visit	$40/Visit	$40/Visit	30% Coins			30% Coins			50% Coins	$35/exam				0	0	30% Coins	20% Coins	30% Coins	$40/Visit	0	0	0				2.8078	0.1206	0.7015	0.5563	0.7454	1.28	0.6666	0.3283	3.0353	0.7259	0.0319	0	0.0032	1.3038	1.6775	1.9223	0.0001	0.1371			1.3509			1.09	0				0	0	1.5066	0.0244	0.0211	0.3355	0	0	0				20.3722	0	2.277762111	16.4959	0.708718628	2.929977488	0.556335	1.863497299	2.439253705	1.270273405	1.641510328	5.816829467	5.259746933	0.189830285	0	0.017747831	4.172619618	4.053948343	11.45361488	0.000639139	1.182739826	0	0	5.128837629	0	0	1.09	0	0	0	0	0	0	4.22626316	0.024358	0.146004741	1.999037917	0	0	0	0	0	0	72.6677
R5826_072_0	2009	5	r.	s.	t.	u.	v.	w.	x.				OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered				5000	Radiology	Renal Dialysis	Mental Health (MH)	Therapy (PT/OT/ST)							A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin					O	O	V	P	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	0	0	0				0		274.292377	11.784517	672.94549	544.122688	145.634523	6.107483	3.180552	342.096018	257.051637	1236.908448	58.788324	0	0.07667	828.961859	3095.376437	3547.071001	0.197919	272.399618			19.904009			3.95					2.07	0.05	708.493003	13.096223	32.528327	619.082138	0.06	1.23	2.7				$800/Admit:1a	$800/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$35/Visit:14h, 8a, 8b, 9a"	$100/Visit:9a	20% Coins:12	"$35-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $35 Partial Hospitalization,8b. $100 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35/Visit:7e, 7h"	"$100/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $75 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$0/Proc:12	"$100/Visit:7e, 7h"	"$35/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a				799.999979	799.999524	43.132795	0	99.999997	0.2	0.2	49.999997	140.943992	95.485954	35.000011	0	0.2	78.664096	15.000001	35	34.984008	100.000008			0.199999			0					0	0	79.353862	0	99.999855	34.999995	0	0	0				665.254383	665.254004	35.867852	0	83.156798	0.166313	0.166313	41.578397	117.204513	79.403064	29.104889	0	0.166313	65.414545	12.473521	29.10488	29.091582	83.156806			0.166313			0					0	0	65.988132	0	83.156679	29.104876	0	0	0				15.2062	0.653308093	2.01142577	0	1.009208384	1.01575382	0.528967145	1.185317004	2.510634328	8.184526722	0.142585637	0	0.012751218	4.518846902	3.217520249	8.603089653	0.000479815	1.887656849	0	0	3.310295449	0	0	0	0	0	0	0	0	0	3.896010817	0	0.225412304	1.501525738	0	0	0	0	0	0	59.6215	0	12.0762	15.2062	0.653308093	2.01142577	0	1.009208384	1.01575382	0.528967145	1.185317004	2.510634328	8.184526722	0.142585637	0	0.012751218	4.518846902	3.217520249	8.603089653	0.000479815	1.887656849	0	0	3.310295449	0	0	0	0	0	0	0	0	0	3.896010817	0	0.225412304	1.501525738	0	0	0	0	0	0	59.6215	7500	$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$40/Visit	30% Coins	20% Coins	30% Coins	$40/Visit	$40/Visit	$40/Visit	30% Coins			30% Coins			50% Coins					0	0	30% Coins		30% Coins	$40/Visit	0	0	0				2.5217	0.1083	0.7726	0.6127	0.8456	1.4097	0.7341	0.3724	3.3427	0.7995	0.0361	0	0.0035	1.4359	1.903	2.1808	0.0001	0.151			1.4877			1.97					0	0	1.6592		0.0233	0.3806	0	0	0				22.7506	500	3.348860357	17.7279	0.761650093	2.78400577	0.612684	1.854831384	2.42540582	1.263062145	1.557762004	5.853375328	8.983998722	0.178728637	0	0.016269218	5.954732902	5.120567249	10.78383965	0.000600815	2.038615849	0	0	4.798023449	0	0	1.97	0	0	0	0	0	0	5.555166817	0	0.248691304	1.882139738	0	0	0	0	0	0	82.3721
R5826_073_0	2009	5	r.	s.	t.	u.	v.	w.	x.				OP Facility - Other	OP Facility - Other	Professional	Professional	Health & Education (Non-Covered)	Other Non-Covered	Other Non-Covered				5000	Radiology	Renal Dialysis	Mental Health (MH)	Therapy (PT/OT/ST)							A	A	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V			Coin			Coin					O	O	V	P	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	0	0	0				0		266.705979	9.708987	526.894889	719.064885	138.731722	7.969131	3.683212	350.580294	316.310713	758.232209	117.555017	0	0.018	569.052459	3620.900504	4289.88346	1.774481	239.28453			22.359146			2.82					2.07	0.05	795.242291	17.112335	20.363639	650.178091	0.06	1.23	2.7				$800/Admit:1a	$800/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	$100/Trip:10a	20% Coins:11a	20% Coins:11b	$50/Visit:4a	"$0-$150/Visit:9b. $0 Surgery ASC -- Physician,9b. $100 Surgery ASC -- Facility,9a. $0 Surgery OP -- Physician,9a. $150 Surgery OP -- Facility"	"$0-$100/Visit:8a. $0 Lab -- FSL,8. $100 Lab -- OP"	"$35/Visit:14h, 8a, 8b, 9a"	$100/Visit:9a	20% Coins:12	"$35-$100/Visit:9d. $100 Cardiac Rehab,8b. $100 Nuclear Medicine,9a. $100 OP Other,5. $35 Partial Hospitalization,8b. $100 Rad therapy,3. $35 Therapy (AT,PT,ST,OT) -- CORF"	$15/Visit:7a	"$35/Visit:7b, 7d, 7f"	"$35/Visit:7e, 7h"	"$100/Visit:7d, 9a"			20% Coins:15			"0% CoinDental 814 16a, 16b"					$0: Membership in health club/fitness class 14a	$0 Additional Smoking Cessation 14a	"$0-$100/Visit:14h. $100 DMAM -- OP,8b. $75 Radiology -- FSR,14h. $0 SMAM -- FSR,14h. $0 SMAM -- OP,8b. $75 Advanced Imaging -- FSR,8b. $35 Advanced Imaging -- Office,9a. $100 Advanced Imaging -- OP,8a. $0 Radiology OP -- Physician,8a. $100 Radiology OP -- Facility"	$0/Proc:12	"$100/Visit:7e, 7h"	"$35/Visit:7d, 9a"	$0: Nurse hotline 14a	$0: Health Education Materials 14a	$0 Corp Health 14a				800.000008	800.000246	43.13281	0	99.999969	0.2	0.199999	49.999997	129.807936	90.485769	35.000007	0	0.199989	79.193505	14.999998	34.999999	34.998674	100.000019			0.199999			0					0	0	75.926772	0	99.999803	35.000009	0	0	0				663.711207	663.711404	35.784661	0	82.963874	0.165927	0.165927	41.481947	107.693726	75.070523	29.03737	0	0.165918	65.70202	12.444583	29.037364	29.036265	82.963915			0.165927			0					0	0	62.991811	0	82.963737	29.037372	0	0	0				14.7513	0.536997116	1.571229582	0	0.959143425	1.322293999	0.611144318	1.211896098	2.838723271	4.743407374	0.284457377	0	0.002986524	3.115658004	3.755049738	10.38057563	0.004293692	1.654331784	0	0	3.709986018	0	0	0	0	0	0	0	0	0	4.174479341	0	0.140786966	1.573288591	0	0	0	0	0	0	57.342	0	11.7884	14.7513	0.536997116	1.571229582	0	0.959143425	1.322293999	0.611144318	1.211896098	2.838723271	4.743407374	0.284457377	0	0.002986524	3.115658004	3.755049738	10.38057563	0.004293692	1.654331784	0	0	3.709986018	0	0	0	0	0	0	0	0	0	4.174479341	0	0.140786966	1.573288591	0	0	0	0	0	0	57.342	7500	$950/Admit	$950/Admit	30% Coins(Days 1-20) 30%(Days 21-100)	30% Coins	$100/Trip	30% Coins	30% Coins	$50/Visit	30% Coins	30% Coins	$40/Visit	30% Coins	20% Coins	30% Coins	$40/Visit	$40/Visit	$40/Visit	30% Coins			30% Coins			50% Coins					0	0	30% Coins		30% Coins	$40/Visit	0	0	0				2.4293	0.0884	0.5561	0.7971	0.7981	1.82	0.8412	0.3782	3.7527	0.667	0.0716	0	0.0008	1.2113	2.2055	2.613	0.0011	0.1432			1.6537			1.41					0	0	1.7564		0.0273	0.396	0	0	0				23.6181	500	3.658378793	17.1806	0.625432116	2.127329582	0.797104	1.757234425	3.142272999	1.452311318	1.590048098	6.591453271	5.410394374	0.356062377	0	0.003836524	4.326996004	5.960598738	12.99361363	0.005374692	1.797534784	0	0	5.363639018	0	0	1.41	0	0	0	0	0	0	5.930918341	0	0.168062966	1.969322591	0	0	0	0	0	0	80.9602
R5826_801_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		261.375205	9.51493	516.363601	704.692608	4.471427	7.634143	3.528386	22.154454	51.492944	743.077079	29.863775	0	0.475379	17.038991	32.697072	70.685604	0.362301	5.892989			21.419262																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999977	1024.000386	43.132792	0	0.199999	0.2	0.199999	0.2	0.2	0	0.2	0	0.2	0.199999	0.199999	0.2	0.500001	0.2			0.199999																				890.295276	890.295632	37.5009	0	0.173885	0.173885	0.173885	0.173885	0.173885	0	0.173885	0	0.173886	0.173885	0.173885	0.173885	0.434715	0.173885			0.173885																				19.3918	0.705925051	1.61367498	0	0.777514084	1.327462956	0.6135334	3.852327234	8.953850567	0	5.192862516	0	0.082661753	2.96282495	5.685530365	12.29116625	0.157497679	1.024702392	0	0	3.724488373	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.3578	0	10.266	19.3918	0.705925051	1.61367498	0	0.777514084	1.327462956	0.6135334	3.852327234	8.953850567	0	5.192862516	0	0.082661753	2.96282495	5.685530365	12.29116625	0.157497679	1.024702392	0	0	3.724488373	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.3578	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.1546	0.0784	0.1793	0	0.5723	0.9772	0.4516	0.8456	2.0149	0	1.1693	0	0.0181	0.6504	1.3553	2.93	0.0375	0.2443			0.8879																				14.5669	0	2.187654823	21.5464	0.784361051	1.79297198	0	1.349853084	2.304627956	1.0651644	4.697964234	10.96872757	0	6.362126516	0	0.100807753	3.61320395	7.040875365	15.22119625	0.195042679	1.268976392	0	0	4.612351373	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9246
R5826_802_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		268.164097	9.762067	529.775497	722.996112	4.706716	8.035857	3.714051	23.320237	54.202539	762.377572	31.435226	0	0.500394	17.935594	34.417615	74.405131	0.381366	6.203082			22.54636																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999987	1024.000347	43.132798	0	0.199999	0.199999	0.199999	0.199999	0.2	0	0.199999	0	0.2	0.2	0.2	0.199999	0.500002	0.2			0.2																				883.902453	883.902763	37.231628	0	0.172637	0.172637	0.172637	0.172637	0.172637	0	0.172637	0	0.172637	0.172637	0.172637	0.172637	0.431595	0.172637			0.172637																				19.7526	0.719059833	1.643700352	0	0.81255333	1.387286245	0.641182622	4.025935755	9.357363725	0	5.426883111	0	0.086386519	3.096347141	5.941753801	12.8450786	0.164595659	1.070881467	0	0	3.892335951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.8639	0	11.2319	19.7526	0.719059833	1.643700352	0	0.81255333	1.387286245	0.641182622	4.025935755	9.357363725	0	5.426883111	0	0.086386519	3.096347141	5.941753801	12.8450786	0.164595659	1.070881467	0	0	3.892335951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.8639	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.1947	0.0799	0.1826	0	0.5981	1.0212	0.472	0.8837	2.1057	0	1.222	0	0.019	0.6797	1.4164	3.0621	0.0392	0.2553			0.9279																				15.1595	0	2.402757978	21.9473	0.798955833	1.826334352	0	1.41068333	2.408484245	1.113164622	4.909678755	11.46303473	0	6.648838111	0	0.105349519	3.776034141	7.358173801	15.9071416	0.203833659	1.326163467	0	0	4.820206951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.0234
R5826_803_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		250.689435	9.125931	495.253175	675.882752	4.113286	7.022684	3.245778	20.379985	47.368597	712.697953	27.471825	0	0.437303	15.674247	30.078188	65.024016	0.333282	5.420988			19.703679																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999994	1023.999852	43.132799	0	0.199999	0.2	0.2	0.2	0.199999	0	0.199999	0	0.199998	0.2	0.2	0.199999	0.500003	0.2			0.2																				900.470778	900.470654	37.929517	0	0.175873	0.175873	0.175873	0.175873	0.175873	0	0.175873	0	0.175871	0.175873	0.175873	0.175873	0.439685	0.175873			0.175873																				18.8115	0.684802755	1.56539281	0	0.723415949	1.235100503	0.570844714	3.584289102	8.33085726	0	4.831552278	0	0.076908916	2.756676843	5.289941158	11.43596877	0.146539096	0.953405423	0	0	3.465345137	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4626	0	8.8432	18.8115	0.684802755	1.56539281	0	0.723415949	1.235100503	0.570844714	3.584289102	8.33085726	0	4.831552278	0	0.076908916	2.756676843	5.289941158	11.43596877	0.146539096	0.953405423	0	0	3.465345137	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4626	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.0902	0.0761	0.1739	0	0.5325	0.9092	0.4202	0.7868	1.8747	0	1.0879	0	0.0169	0.6051	1.261	2.7262	0.0349	0.2273			0.8261																				13.649	0	1.872403501	20.9017	0.760891755	1.73932481	0	1.255930949	2.144272503	0.991049714	4.371085102	10.20553626	0	5.919455278	0	0.093790916	3.361800843	6.550979158	14.16212277	0.181472096	1.180682423	0	0	4.291428137	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.1115
R5826_804_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		252.724559	9.200017	499.273692	681.369639	4.180339	7.137164	3.29869	20.71221	48.140779	718.483712	27.919657	0	0.444432	15.929761	30.568508	66.084006	0.338715	5.509358			20.02488																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999998	1023.999846	43.132791	0	0.2	0.2	0.2	0.2	0.199999	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				898.551806	898.551673	37.848679	0	0.175498	0.175498	0.175498	0.175498	0.175498	0	0.175498	0	0.175497	0.175498	0.175498	0.175498	0.438747	0.175498			0.175498																				18.9238	0.688890889	1.574737475	0	0.733641134	1.252558008	0.578913498	3.634951431	8.448610433	0	4.899843964	0	0.077996483	2.795641196	5.364712017	11.59761088	0.14861019	0.96688131	0	0	3.51432639	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.2018	0	9.1029	18.9238	0.688890889	1.574737475	0	0.733641134	1.252558008	0.578913498	3.634951431	8.448610433	0	4.899843964	0	0.077996483	2.795641196	5.364712017	11.59761088	0.14861019	0.96688131	0	0	3.51432639	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.2018	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.1026	0.0765	0.175	0	0.54	0.922	0.4261	0.7979	1.9012	0	1.1033	0	0.0171	0.6137	1.2789	2.7647	0.0354	0.2305			0.8378																				13.8228	0	1.929820378	21.0265	0.765434889	1.749708475	0	1.273684134	2.174582008	1.005059498	4.432869431	10.34978943	0	6.003126964	0	0.095117483	3.409319196	6.643576017	14.36230088	0.18403619	1.19737131	0	0	4.35208739	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.0246
R5826_805_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		252.466318	7.259842	482.66416	655.904873	4.291594	7.670083	3.420633	24.167934	58.923276	457.20173	38.758191	0	0.79545	17.676704	39.76775	97.565453	0.125719	7.42815			28.044945																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000023	1024.000798	43.132798	0	0.2	0.2	0.2	0.2	0.199999	0	0.199999	0	0.2	0.2	0.199999	0.199999	0.499997	0.2			0.199999																				866.977812	866.978468	36.518729	0	0.169331	0.169331	0.169331	0.169331	0.169331	0	0.169331	0	0.169331	0.169331	0.169331	0.169331	0.423327	0.169331			0.169331																				18.2402	0.524510558	1.468856805	0	0.726699904	1.298782824	0.579219207	4.092380432	9.977537248	0	6.56296324	0	0.134694344	2.993213965	6.733912875	16.52085572	0.053220247	1.257816068	0	0	4.748878582	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.9138	0	13.7491	18.2402	0.524510558	1.468856805	0	0.726699904	1.298782824	0.579219207	4.092380432	9.977537248	0	6.56296324	0	0.134694344	2.993213965	6.733912875	16.52085572	0.053220247	1.257816068	0	0	4.748878582	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.9138	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.0267	0.0583	0.1632	0	0.5349	0.9561	0.4264	0.8983	2.2506	0	1.4756	0	0.0296	0.657	1.6053	3.9383	0.0127	0.2998			1.1321																				16.4649	0	2.982025926	20.2669	0.582789558	1.632062805	0	1.261633904	2.254834824	1.005590207	4.990710432	12.22815925	0	8.03855824	0	0.164261344	3.650262965	8.339174875	20.45917472	0.065906247	1.557661068	0	0	5.880938582	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.3786
R5826_806_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		256.150682	9.324739	506.04222	690.606796	4.294449	7.331986	3.388733	21.277586	49.454866	728.224012	28.681775	0	0.456564	16.364591	31.40293	67.887885	0.347962	5.659746			20.571493																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000021	1023.999921	43.132796	0	0.2	0.199999	0.2	0.199999	0.199999	0	0.2	0	0.2	0.2	0.2	0.2	0.5	0.199999			0.199999																				895.372307	895.372218	37.714756	0	0.174877	0.174877	0.174877	0.174877	0.174877	0	0.174877	0	0.174877	0.174877	0.174877	0.174877	0.437193	0.174877			0.174877																				19.1125	0.695759353	1.590438238	0	0.751000358	1.282195716	0.592611461	3.720960407	8.648518601	0	5.015782767	0	0.079842543	2.86179058	5.49165019	11.87202967	0.152126551	0.989759401	0	0	3.597480981	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4545	0	9.5468	19.1125	0.695759353	1.590438238	0	0.751000358	1.282195716	0.592611461	3.720960407	8.648518601	0	5.015782767	0	0.079842543	2.86179058	5.49165019	11.87202967	0.152126551	0.989759401	0	0	3.597480981	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4545	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.1236	0.0773	0.1767	0	0.5528	0.9438	0.4362	0.8168	1.9462	0	1.1294	0	0.0175	0.6282	1.3091	2.8301	0.0363	0.2359			0.8576																				14.1176	0	2.028114839	21.2361	0.773065353	1.767153238	0	1.303821358	2.226035716	1.028840461	4.537758407	10.5946816	0	6.145170767	0	0.097368543	3.48999058	6.80077419	14.70213667	0.188391551	1.225703401	0	0	4.455064981	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.5721
R5826_807_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		311.189288	10.835106	891.964356	812.544816	6.185001	9.56776	7.546705	27.074755	47.856722	1841.711149	24.284386	0	0.200405	21.469032	26.319215	49.308497	0.326167	4.992006			13.676378																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.99999	1024.000318	43.132804	0	0.199999	0.2	0.2	0.2	0.199999	0	0.199999	0	0.2	0.199999	0.2	0.199999	0.500001	0.2			0.2																				894.223351	894.223638	37.666368	0	0.174652	0.174653	0.174653	0.174653	0.174652	0	0.174652	0	0.174653	0.174652	0.174653	0.174652	0.436633	0.174653			0.174653																				23.1894	0.807417325	2.799754806	0	1.080222795	1.671037987	1.318054668	4.728687185	8.358272211	0	4.241316584	0	0.035001334	3.749609377	4.596729857	8.611827618	0.142415276	0.871868824	0	0	2.388620447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5902	0	9.9544	23.1894	0.807417325	2.799754806	0	1.080222795	1.671037987	1.318054668	4.728687185	8.358272211	0	4.241316584	0	0.035001334	3.749609377	4.596729857	8.611827618	0.142415276	0.871868824	0	0	2.388620447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5902	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.5766	0.0897	0.3111	0	0.7952	1.2301	0.9702	1.038	1.8794	0	0.9533	0	0.0077	0.8231	1.0958	2.0529	0.034	0.2078			0.5694																				14.6343	0	2.123844267	25.766	0.897130325	3.110838806	0	1.875391795	2.901107987	2.288288668	5.766692185	10.23771021	0	5.194621584	0	0.042684334	4.572699377	5.692515857	10.66475962	0.176365276	1.079707824	0	0	2.958029447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.2245
R5826_808_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		258.564478	9.41261	510.810829	697.114619	4.375773	7.470832	3.452905	21.680521	50.391395	735.086318	29.224922	0	0.465209	16.674487	31.997608	69.173482	0.35455	5.766924			20.961058																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000009	1023.999507	43.132789	0	0.2	0.199999	0.2	0.199999	0.2	0	0.2	0	0.2	0.199999	0.2	0.199999	0.500002	0.2			0.2																				893.021192	893.020754	37.615717	0	0.174418	0.174418	0.174418	0.174418	0.174418	0	0.174418	0	0.174418	0.174418	0.174418	0.174418	0.436047	0.174418			0.174418																				19.242	0.70047134	1.601209632	0	0.763213575	1.303047576	0.602248784	3.781473112	8.789166333	0	5.097352445	0	0.081140823	2.908330674	5.580958792	12.06510038	0.154600464	1.00585535	0	0	3.655985814	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3321	0	9.8756	19.242	0.70047134	1.601209632	0	0.763213575	1.303047576	0.602248784	3.781473112	8.789166333	0	5.097352445	0	0.081140823	2.908330674	5.580958792	12.06510038	0.154600464	1.00585535	0	0	3.655985814	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3321	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.138	0.0778	0.1779	0	0.5618	0.9592	0.4433	0.8301	1.9778	0	1.1478	0	0.0178	0.6384	1.3304	2.8761	0.0369	0.2398			0.8715																				14.3246	0	2.100984629	21.38	0.77830234	1.779121632	0	1.325024575	2.262235576	1.045570784	4.611554112	10.76697833	0	6.245106445	0	0.098952823	3.546744674	6.911370792	14.94122838	0.191455464	1.24563535	0	0	4.527514814	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.6568
R5826_809_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		270.521019	9.847868	534.431749	729.350601	4.789818	8.177739	3.779627	23.731981	55.159542	769.078187	31.990251	0	0.509229	18.252267	35.025295	75.718833	0.388099	6.312604			22.944439																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999987	1023.999509	43.132789	0	0.2	0.2	0.199999	0.199999	0.199999	0	0.2	0	0.2	0.199999	0.2	0.2	0.500001	0.2			0.2																				881.77458	881.774169	37.141989	0	0.172221	0.172221	0.172221	0.172221	0.172221	0	0.172221	0	0.172221	0.172221	0.172221	0.172221	0.430555	0.172221			0.172221																				19.8782	0.723632969	1.654154845	0	0.824907246	1.408378388	0.650931142	4.0871455	9.499631483	0	5.509393017	0	0.087699928	3.143423675	6.03209133	13.04037314	0.167097965	1.087162973	0	0	3.951514229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7458	0	11.5722	19.8782	0.723632969	1.654154845	0	0.824907246	1.408378388	0.650931142	4.0871455	9.499631483	0	5.509393017	0	0.087699928	3.143423675	6.03209133	13.04037314	0.167097965	1.087162973	0	0	3.951514229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7458	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.2087	0.0804	0.1838	0	0.6072	1.0367	0.4792	0.8972	2.1377	0	1.2405	0	0.0193	0.69	1.438	3.1086	0.0398	0.2592			0.942																				15.3682	0	2.478813996	22.0869	0.804035969	1.837949845	0	1.432133246	2.445105388	1.130090142	4.9843275	11.63732348	0	6.749928017	0	0.106951928	3.833446675	7.47004933	16.14900014	0.206931965	1.346325973	0	0	4.893495229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.114
R5826_810_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		254.829885	9.276658	503.432897	687.045796	4.250281	7.256578	3.35388	21.058751	48.946234	724.469048	28.386789	0	0.451868	16.196285	31.079957	67.189673	0.344383	5.601536			20.35992																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000022	1023.999806	43.132795	0	0.199999	0.2	0.2	0.199999	0.2	0	0.2	0	0.199998	0.199999	0.199999	0.2	0.500001	0.199999			0.2																				896.585747	896.585558	37.765867	0	0.175114	0.175114	0.175114	0.175114	0.175114	0	0.175114	0	0.175113	0.175114	0.175114	0.175114	0.437787	0.175114			0.175114																				19.0397	0.693109799	1.584381653	0	0.744283707	1.2707284	0.587311342	3.687682123	8.571170821	0	4.970924169	0	0.079127961	2.836196251	5.44253559	11.7658524	0.1507664	0.980907375	0	0	3.565307031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.97	0	9.375	19.0397	0.693109799	1.584381653	0	0.744283707	1.2707284	0.587311342	3.687682123	8.571170821	0	4.970924169	0	0.079127961	2.836196251	5.44253559	11.7658524	0.1507664	0.980907375	0	0	3.565307031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.97	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.1155	0.077	0.176	0	0.5479	0.9354	0.4323	0.8095	1.9288	0	1.1193	0	0.0174	0.6226	1.2974	2.8048	0.0359	0.2338			0.8499																				14.0036	0	1.990055394	21.1553	0.770121799	1.760424653	0	1.292160707	2.2061284	1.019639342	4.497175123	10.49992982	0	6.090211169	0	0.096497961	3.458777251	6.73995159	14.5706484	0.1867064	1.214740375	0	0	4.415220031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.9736
R5826_811_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		272.746476	9.928882	538.828282	735.350644	4.868947	8.312836	3.842067	24.124035	56.070782	775.405053	32.518733	0	0.517642	18.553796	35.603915	76.969714	0.39451	6.416889			23.323484																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000002	1024.000486	43.132791	0	0.199999	0.199999	0.2	0.2	0.2	0	0.2	0	0.200001	0.2	0.2	0.2	0.500002	0.2			0.199999																				879.809537	879.809954	37.05922	0	0.171837	0.171837	0.171837	0.171837	0.171837	0	0.171837	0	0.171838	0.171837	0.171837	0.171837	0.429596	0.171837			0.171837																				19.9971	0.727960768	1.66404632	0	0.836665246	1.4284528	0.660209267	4.145401802	9.635034967	0	5.587921523	0	0.088950566	3.188228643	6.118069942	13.22624474	0.169479918	1.102658955	0	0	4.00783752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.5842	0	11.8957	19.9971	0.727960768	1.66404632	0	0.836665246	1.4284528	0.660209267	4.145401802	9.635034967	0	5.587921523	0	0.088950566	3.188228643	6.118069942	13.22624474	0.169479918	1.102658955	0	0	4.00783752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.5842	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.2219	0.0809	0.1849	0	0.6159	1.0515	0.486	0.91	2.1682	0	1.2582	0	0.0195	0.6999	1.4585	3.1529	0.0404	0.2629			0.9554																				15.5668	0	2.551223836	22.219	0.808845768	1.84894032	0	1.452546246	2.4799578	1.146198267	5.055372802	11.80319797	0	6.846139523	0	0.108476566	3.888086643	7.576525942	16.37918274	0.209881918	1.365516955	0	0	4.96324552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.1511
R5826_812_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		290.734642	9.056983	412.335726	969.191403	5.700536	9.630174	3.36617	25.179083	60.797618	481.087982	29.659743	0	0.184162	14.249592	36.531781	73.121171	0.221656	5.346609			23.65675																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999995	1024.000597	43.132813	0	0.199999	0.2	0.2	0.2	0.199999	0	0.199999	0	0.199997	0.2	0.199999	0.199999	0.5	0.2			0.2																				880.105467	880.105985	37.071704	0	0.171895	0.171895	0.171895	0.171895	0.171895	0	0.171895	0	0.171893	0.171895	0.171895	0.171895	0.429739	0.171895			0.171895																				21.3231	0.664258745	1.273832332	0	0.979893636	1.65537876	0.578627792	4.328158472	10.45080655	0	5.098361523	0	0.031656159	2.449433617	6.279630495	12.56916369	0.095254228	0.919055354	0	0	4.066477041	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.7631	0	11.8966	21.3231	0.664258745	1.273832332	0	0.979893636	1.65537876	0.578627792	4.328158472	10.45080655	0	5.098361523	0	0.031656159	2.449433617	6.279630495	12.56916369	0.095254228	0.919055354	0	0	4.066477041	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.7631	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.3692	0.0738	0.1415	0	0.7213	1.2185	0.4259	0.9501	2.3468	0	1.1514	0	0.0069	0.5377	1.497	2.9963	0.0227	0.2191			0.9694																				15.6477	0	2.558346483	23.6923	0.738065745	1.415369332	0	1.701206636	2.87392576	1.004563792	5.278245472	12.79758855	0	6.249713523	0	0.038605159	2.987116617	7.776598495	15.56546169	0.117961228	1.138144354	0	0	5.035863041	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.4108
R5826_813_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		258.514265	9.410781	510.711628	696.979238	4.374073	7.46793	3.451564	21.6721	50.371824	734.943562	29.213572	0	0.465029	16.668013	31.985181	69.146616	0.354413	5.764684			20.952916																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000002	1023.999602	43.132802	0	0.2	0.2	0.2	0.2	0.199999	0	0.199999	0	0.2	0.2	0.199999	0.199999	0.500001	0.2			0.199999																				893.071362	893.071013	37.617842	0	0.174428	0.174428	0.174428	0.174428	0.174427	0	0.174427	0	0.174428	0.174428	0.174427	0.174427	0.436071	0.174428			0.174427																				19.2393	0.700374643	1.600989111	0	0.762960805	1.302616094	0.602049405	3.780221059	8.786206145	0	5.095635723	0	0.081114078	2.907368172	5.579079166	12.06103679	0.154549231	1.005522301	0	0	3.654754279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3138	0	9.8686	19.2393	0.700374643	1.600989111	0	0.762960805	1.302616094	0.602049405	3.780221059	8.786206145	0	5.095635723	0	0.081114078	2.907368172	5.579079166	12.06103679	0.154549231	1.005522301	0	0	3.654754279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3138	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.1377	0.0778	0.1779	0	0.5616	0.9589	0.4432	0.8298	1.9772	0	1.1474	0	0.0178	0.6382	1.33	2.8752	0.0368	0.2397			0.8712																				14.3203	0	2.099432815	21.377	0.778193643	1.778877111	0	1.324584805	2.261486094	1.045224405	4.610026059	10.76336014	0	6.243008723	0	0.098920078	3.545570172	6.909050166	14.93620979	0.191392231	1.245223301	0	0	4.525994279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.6341
R5826_814_0	2009	10																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		251.020482	9.137984	495.907177	676.775283	4.124151	7.041233	3.254351	20.433815	47.493713	713.6391	27.544387	0	0.438459	15.715646	30.157634	65.195764	0.334163	5.435306			19.755723																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999977	1024.000479	43.132805	0	0.199999	0.2	0.199999	0.2	0.199999	0	0.199999	0	0.2	0.2	0.2	0.2	0.500001	0.199999			0.199999																				900.156396	900.156837	37.916281	0	0.175811	0.175811	0.175811	0.175811	0.175811	0	0.175811	0	0.175812	0.175811	0.175811	0.175811	0.43953	0.175811			0.175811																				18.8298	0.685468231	1.566912989	0	0.725071111	1.237926215	0.572150704	3.592489449	8.349917176	0	4.842606223	0	0.077086354	2.762983439	5.302043791	11.46213246	0.146874663	0.955586583	0	0	3.473273416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5823	0	8.8853	18.8298	0.685468231	1.566912989	0	0.725071111	1.237926215	0.572150704	3.592489449	8.349917176	0	4.842606223	0	0.077086354	2.762983439	5.302043791	11.46213246	0.146874663	0.955586583	0	0	3.473273416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5823	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.0922	0.0762	0.1741	0	0.5337	0.9113	0.4212	0.7886	1.879	0	1.0904	0	0.0169	0.6065	1.2639	2.7324	0.035	0.2278			0.828																				13.6771	0	1.881702031	20.922	0.761631231	1.741013989	0	1.258807111	2.149181215	0.993319704	4.381088449	10.22889118	0	5.933003223	0	0.094007354	3.369495439	6.565971791	14.19453246	0.181887663	1.183384583	0	0	4.301249416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2595
R5826_815_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		261.375205	9.51493	516.363601	704.692608	4.471427	7.634143	3.528386	22.154454	51.492944	743.077079	29.863775	0	0.475379	17.038991	32.697072	70.685604	0.362301	5.892989			21.419262																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999977	1024.000386	43.132792	0	0.199999	0.2	0.199999	0.2	0.2	0	0.2	0	0.2	0.199999	0.199999	0.2	0.500001	0.2			0.199999																				890.295276	890.295632	37.5009	0	0.173885	0.173885	0.173885	0.173885	0.173885	0	0.173885	0	0.173886	0.173885	0.173885	0.173885	0.434715	0.173885			0.173885																				19.3918	0.705925051	1.61367498	0	0.777514084	1.327462956	0.6135334	3.852327234	8.953850567	0	5.192862516	0	0.082661753	2.96282495	5.685530365	12.29116625	0.157497679	1.024702392	0	0	3.724488373	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.3578	0	10.266	19.3918	0.705925051	1.61367498	0	0.777514084	1.327462956	0.6135334	3.852327234	8.953850567	0	5.192862516	0	0.082661753	2.96282495	5.685530365	12.29116625	0.157497679	1.024702392	0	0	3.724488373	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.3578	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.1546	0.0784	0.1793	0	0.5723	0.9772	0.4516	0.8456	2.0149	0	1.1693	0	0.0181	0.6504	1.3553	2.93	0.0375	0.2443			0.8879																				14.5669	0	2.187654823	21.5464	0.784361051	1.79297198	0	1.349853084	2.304627956	1.0651644	4.697964234	10.96872757	0	6.362126516	0	0.100807753	3.61320395	7.040875365	15.22119625	0.195042679	1.268976392	0	0	4.612351373	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9246
R5826_816_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		268.164097	9.762067	529.775497	722.996112	4.706716	8.035857	3.714051	23.320237	54.202539	762.377572	31.435226	0	0.500394	17.935594	34.417615	74.405131	0.381366	6.203082			22.54636																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999987	1024.000347	43.132798	0	0.199999	0.199999	0.199999	0.199999	0.2	0	0.199999	0	0.2	0.2	0.2	0.199999	0.500002	0.2			0.2																				883.902453	883.902763	37.231628	0	0.172637	0.172637	0.172637	0.172637	0.172637	0	0.172637	0	0.172637	0.172637	0.172637	0.172637	0.431595	0.172637			0.172637																				19.7526	0.719059833	1.643700352	0	0.81255333	1.387286245	0.641182622	4.025935755	9.357363725	0	5.426883111	0	0.086386519	3.096347141	5.941753801	12.8450786	0.164595659	1.070881467	0	0	3.892335951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.8639	0	11.2319	19.7526	0.719059833	1.643700352	0	0.81255333	1.387286245	0.641182622	4.025935755	9.357363725	0	5.426883111	0	0.086386519	3.096347141	5.941753801	12.8450786	0.164595659	1.070881467	0	0	3.892335951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.8639	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.1947	0.0799	0.1826	0	0.5981	1.0212	0.472	0.8837	2.1057	0	1.222	0	0.019	0.6797	1.4164	3.0621	0.0392	0.2553			0.9279																				15.1595	0	2.402757978	21.9473	0.798955833	1.826334352	0	1.41068333	2.408484245	1.113164622	4.909678755	11.46303473	0	6.648838111	0	0.105349519	3.776034141	7.358173801	15.9071416	0.203833659	1.326163467	0	0	4.820206951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.0234
R5826_817_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		250.689435	9.125931	495.253175	675.882752	4.113286	7.022684	3.245778	20.379985	47.368597	712.697953	27.471825	0	0.437303	15.674247	30.078188	65.024016	0.333282	5.420988			19.703679																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999994	1023.999852	43.132799	0	0.199999	0.2	0.2	0.2	0.199999	0	0.199999	0	0.199998	0.2	0.2	0.199999	0.500003	0.2			0.2																				900.470778	900.470654	37.929517	0	0.175873	0.175873	0.175873	0.175873	0.175873	0	0.175873	0	0.175871	0.175873	0.175873	0.175873	0.439685	0.175873			0.175873																				18.8115	0.684802755	1.56539281	0	0.723415949	1.235100503	0.570844714	3.584289102	8.33085726	0	4.831552278	0	0.076908916	2.756676843	5.289941158	11.43596877	0.146539096	0.953405423	0	0	3.465345137	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4626	0	8.8432	18.8115	0.684802755	1.56539281	0	0.723415949	1.235100503	0.570844714	3.584289102	8.33085726	0	4.831552278	0	0.076908916	2.756676843	5.289941158	11.43596877	0.146539096	0.953405423	0	0	3.465345137	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4626	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.0902	0.0761	0.1739	0	0.5325	0.9092	0.4202	0.7868	1.8747	0	1.0879	0	0.0169	0.6051	1.261	2.7262	0.0349	0.2273			0.8261																				13.649	0	1.872403501	20.9017	0.760891755	1.73932481	0	1.255930949	2.144272503	0.991049714	4.371085102	10.20553626	0	5.919455278	0	0.093790916	3.361800843	6.550979158	14.16212277	0.181472096	1.180682423	0	0	4.291428137	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.1115
R5826_818_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		252.724559	9.200017	499.273692	681.369639	4.180339	7.137164	3.29869	20.71221	48.140779	718.483712	27.919657	0	0.444432	15.929761	30.568508	66.084006	0.338715	5.509358			20.02488																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999998	1023.999846	43.132791	0	0.2	0.2	0.2	0.2	0.199999	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				898.551806	898.551673	37.848679	0	0.175498	0.175498	0.175498	0.175498	0.175498	0	0.175498	0	0.175497	0.175498	0.175498	0.175498	0.438747	0.175498			0.175498																				18.9238	0.688890889	1.574737475	0	0.733641134	1.252558008	0.578913498	3.634951431	8.448610433	0	4.899843964	0	0.077996483	2.795641196	5.364712017	11.59761088	0.14861019	0.96688131	0	0	3.51432639	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.2018	0	9.1029	18.9238	0.688890889	1.574737475	0	0.733641134	1.252558008	0.578913498	3.634951431	8.448610433	0	4.899843964	0	0.077996483	2.795641196	5.364712017	11.59761088	0.14861019	0.96688131	0	0	3.51432639	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.2018	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.1026	0.0765	0.175	0	0.54	0.922	0.4261	0.7979	1.9012	0	1.1033	0	0.0171	0.6137	1.2789	2.7647	0.0354	0.2305			0.8378																				13.8228	0	1.929820378	21.0265	0.765434889	1.749708475	0	1.273684134	2.174582008	1.005059498	4.432869431	10.34978943	0	6.003126964	0	0.095117483	3.409319196	6.643576017	14.36230088	0.18403619	1.19737131	0	0	4.35208739	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.0246
R5826_819_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		252.466318	7.259842	482.66416	655.904873	4.291594	7.670083	3.420633	24.167934	58.923276	457.20173	38.758191	0	0.79545	17.676704	39.76775	97.565453	0.125719	7.42815			28.044945																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000023	1024.000798	43.132798	0	0.2	0.2	0.2	0.2	0.199999	0	0.199999	0	0.2	0.2	0.199999	0.199999	0.499997	0.2			0.199999																				866.977812	866.978468	36.518729	0	0.169331	0.169331	0.169331	0.169331	0.169331	0	0.169331	0	0.169331	0.169331	0.169331	0.169331	0.423327	0.169331			0.169331																				18.2402	0.524510558	1.468856805	0	0.726699904	1.298782824	0.579219207	4.092380432	9.977537248	0	6.56296324	0	0.134694344	2.993213965	6.733912875	16.52085572	0.053220247	1.257816068	0	0	4.748878582	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.9138	0	13.7491	18.2402	0.524510558	1.468856805	0	0.726699904	1.298782824	0.579219207	4.092380432	9.977537248	0	6.56296324	0	0.134694344	2.993213965	6.733912875	16.52085572	0.053220247	1.257816068	0	0	4.748878582	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.9138	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.0267	0.0583	0.1632	0	0.5349	0.9561	0.4264	0.8983	2.2506	0	1.4756	0	0.0296	0.657	1.6053	3.9383	0.0127	0.2998			1.1321																				16.4649	0	2.982025926	20.2669	0.582789558	1.632062805	0	1.261633904	2.254834824	1.005590207	4.990710432	12.22815925	0	8.03855824	0	0.164261344	3.650262965	8.339174875	20.45917472	0.065906247	1.557661068	0	0	5.880938582	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.3786
R5826_820_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		256.150682	9.324739	506.04222	690.606796	4.294449	7.331986	3.388733	21.277586	49.454866	728.224012	28.681775	0	0.456564	16.364591	31.40293	67.887885	0.347962	5.659746			20.571493																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000021	1023.999921	43.132796	0	0.2	0.199999	0.2	0.199999	0.199999	0	0.2	0	0.2	0.2	0.2	0.2	0.5	0.199999			0.199999																				895.372307	895.372218	37.714756	0	0.174877	0.174877	0.174877	0.174877	0.174877	0	0.174877	0	0.174877	0.174877	0.174877	0.174877	0.437193	0.174877			0.174877																				19.1125	0.695759353	1.590438238	0	0.751000358	1.282195716	0.592611461	3.720960407	8.648518601	0	5.015782767	0	0.079842543	2.86179058	5.49165019	11.87202967	0.152126551	0.989759401	0	0	3.597480981	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4545	0	9.5468	19.1125	0.695759353	1.590438238	0	0.751000358	1.282195716	0.592611461	3.720960407	8.648518601	0	5.015782767	0	0.079842543	2.86179058	5.49165019	11.87202967	0.152126551	0.989759401	0	0	3.597480981	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4545	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.1236	0.0773	0.1767	0	0.5528	0.9438	0.4362	0.8168	1.9462	0	1.1294	0	0.0175	0.6282	1.3091	2.8301	0.0363	0.2359			0.8576																				14.1176	0	2.028114839	21.2361	0.773065353	1.767153238	0	1.303821358	2.226035716	1.028840461	4.537758407	10.5946816	0	6.145170767	0	0.097368543	3.48999058	6.80077419	14.70213667	0.188391551	1.225703401	0	0	4.455064981	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.5721
R5826_821_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		311.189288	10.835106	891.964356	812.544816	6.185001	9.56776	7.546705	27.074755	47.856722	1841.711149	24.284386	0	0.200405	21.469032	26.319215	49.308497	0.326167	4.992006			13.676378																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.99999	1024.000318	43.132804	0	0.199999	0.2	0.2	0.2	0.199999	0	0.199999	0	0.2	0.199999	0.2	0.199999	0.500001	0.2			0.2																				894.223351	894.223638	37.666368	0	0.174652	0.174653	0.174653	0.174653	0.174652	0	0.174652	0	0.174653	0.174652	0.174653	0.174652	0.436633	0.174653			0.174653																				23.1894	0.807417325	2.799754806	0	1.080222795	1.671037987	1.318054668	4.728687185	8.358272211	0	4.241316584	0	0.035001334	3.749609377	4.596729857	8.611827618	0.142415276	0.871868824	0	0	2.388620447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5902	0	9.9544	23.1894	0.807417325	2.799754806	0	1.080222795	1.671037987	1.318054668	4.728687185	8.358272211	0	4.241316584	0	0.035001334	3.749609377	4.596729857	8.611827618	0.142415276	0.871868824	0	0	2.388620447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5902	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.5766	0.0897	0.3111	0	0.7952	1.2301	0.9702	1.038	1.8794	0	0.9533	0	0.0077	0.8231	1.0958	2.0529	0.034	0.2078			0.5694																				14.6343	0	2.123844267	25.766	0.897130325	3.110838806	0	1.875391795	2.901107987	2.288288668	5.766692185	10.23771021	0	5.194621584	0	0.042684334	4.572699377	5.692515857	10.66475962	0.176365276	1.079707824	0	0	2.958029447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.2245
R5826_822_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		258.564478	9.41261	510.810829	697.114619	4.375773	7.470832	3.452905	21.680521	50.391395	735.086318	29.224922	0	0.465209	16.674487	31.997608	69.173482	0.35455	5.766924			20.961058																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000009	1023.999507	43.132789	0	0.2	0.199999	0.2	0.199999	0.2	0	0.2	0	0.2	0.199999	0.2	0.199999	0.500002	0.2			0.2																				893.021192	893.020754	37.615717	0	0.174418	0.174418	0.174418	0.174418	0.174418	0	0.174418	0	0.174418	0.174418	0.174418	0.174418	0.436047	0.174418			0.174418																				19.242	0.70047134	1.601209632	0	0.763213575	1.303047576	0.602248784	3.781473112	8.789166333	0	5.097352445	0	0.081140823	2.908330674	5.580958792	12.06510038	0.154600464	1.00585535	0	0	3.655985814	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3321	0	9.8756	19.242	0.70047134	1.601209632	0	0.763213575	1.303047576	0.602248784	3.781473112	8.789166333	0	5.097352445	0	0.081140823	2.908330674	5.580958792	12.06510038	0.154600464	1.00585535	0	0	3.655985814	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3321	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.138	0.0778	0.1779	0	0.5618	0.9592	0.4433	0.8301	1.9778	0	1.1478	0	0.0178	0.6384	1.3304	2.8761	0.0369	0.2398			0.8715																				14.3246	0	2.100984629	21.38	0.77830234	1.779121632	0	1.325024575	2.262235576	1.045570784	4.611554112	10.76697833	0	6.245106445	0	0.098952823	3.546744674	6.911370792	14.94122838	0.191455464	1.24563535	0	0	4.527514814	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.6568
R5826_823_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		270.521019	9.847868	534.431749	729.350601	4.789818	8.177739	3.779627	23.731981	55.159542	769.078187	31.990251	0	0.509229	18.252267	35.025295	75.718833	0.388099	6.312604			22.944439																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999987	1023.999509	43.132789	0	0.2	0.2	0.199999	0.199999	0.199999	0	0.2	0	0.2	0.199999	0.2	0.2	0.500001	0.2			0.2																				881.77458	881.774169	37.141989	0	0.172221	0.172221	0.172221	0.172221	0.172221	0	0.172221	0	0.172221	0.172221	0.172221	0.172221	0.430555	0.172221			0.172221																				19.8782	0.723632969	1.654154845	0	0.824907246	1.408378388	0.650931142	4.0871455	9.499631483	0	5.509393017	0	0.087699928	3.143423675	6.03209133	13.04037314	0.167097965	1.087162973	0	0	3.951514229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7458	0	11.5722	19.8782	0.723632969	1.654154845	0	0.824907246	1.408378388	0.650931142	4.0871455	9.499631483	0	5.509393017	0	0.087699928	3.143423675	6.03209133	13.04037314	0.167097965	1.087162973	0	0	3.951514229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7458	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.2087	0.0804	0.1838	0	0.6072	1.0367	0.4792	0.8972	2.1377	0	1.2405	0	0.0193	0.69	1.438	3.1086	0.0398	0.2592			0.942																				15.3682	0	2.478813996	22.0869	0.804035969	1.837949845	0	1.432133246	2.445105388	1.130090142	4.9843275	11.63732348	0	6.749928017	0	0.106951928	3.833446675	7.47004933	16.14900014	0.206931965	1.346325973	0	0	4.893495229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.114
R5826_824_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		254.829885	9.276658	503.432897	687.045796	4.250281	7.256578	3.35388	21.058751	48.946234	724.469048	28.386789	0	0.451868	16.196285	31.079957	67.189673	0.344383	5.601536			20.35992																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000022	1023.999806	43.132795	0	0.199999	0.2	0.2	0.199999	0.2	0	0.2	0	0.199998	0.199999	0.199999	0.2	0.500001	0.199999			0.2																				896.585747	896.585558	37.765867	0	0.175114	0.175114	0.175114	0.175114	0.175114	0	0.175114	0	0.175113	0.175114	0.175114	0.175114	0.437787	0.175114			0.175114																				19.0397	0.693109799	1.584381653	0	0.744283707	1.2707284	0.587311342	3.687682123	8.571170821	0	4.970924169	0	0.079127961	2.836196251	5.44253559	11.7658524	0.1507664	0.980907375	0	0	3.565307031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.97	0	9.375	19.0397	0.693109799	1.584381653	0	0.744283707	1.2707284	0.587311342	3.687682123	8.571170821	0	4.970924169	0	0.079127961	2.836196251	5.44253559	11.7658524	0.1507664	0.980907375	0	0	3.565307031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.97	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.1155	0.077	0.176	0	0.5479	0.9354	0.4323	0.8095	1.9288	0	1.1193	0	0.0174	0.6226	1.2974	2.8048	0.0359	0.2338			0.8499																				14.0036	0	1.990055394	21.1553	0.770121799	1.760424653	0	1.292160707	2.2061284	1.019639342	4.497175123	10.49992982	0	6.090211169	0	0.096497961	3.458777251	6.73995159	14.5706484	0.1867064	1.214740375	0	0	4.415220031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.9736
R5826_825_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		272.746476	9.928882	538.828282	735.350644	4.868947	8.312836	3.842067	24.124035	56.070782	775.405053	32.518733	0	0.517642	18.553796	35.603915	76.969714	0.39451	6.416889			23.323484																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000002	1024.000486	43.132791	0	0.199999	0.199999	0.2	0.2	0.2	0	0.2	0	0.200001	0.2	0.2	0.2	0.500002	0.2			0.199999																				879.809537	879.809954	37.05922	0	0.171837	0.171837	0.171837	0.171837	0.171837	0	0.171837	0	0.171838	0.171837	0.171837	0.171837	0.429596	0.171837			0.171837																				19.9971	0.727960768	1.66404632	0	0.836665246	1.4284528	0.660209267	4.145401802	9.635034967	0	5.587921523	0	0.088950566	3.188228643	6.118069942	13.22624474	0.169479918	1.102658955	0	0	4.00783752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.5842	0	11.8957	19.9971	0.727960768	1.66404632	0	0.836665246	1.4284528	0.660209267	4.145401802	9.635034967	0	5.587921523	0	0.088950566	3.188228643	6.118069942	13.22624474	0.169479918	1.102658955	0	0	4.00783752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.5842	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.2219	0.0809	0.1849	0	0.6159	1.0515	0.486	0.91	2.1682	0	1.2582	0	0.0195	0.6999	1.4585	3.1529	0.0404	0.2629			0.9554																				15.5668	0	2.551223836	22.219	0.808845768	1.84894032	0	1.452546246	2.4799578	1.146198267	5.055372802	11.80319797	0	6.846139523	0	0.108476566	3.888086643	7.576525942	16.37918274	0.209881918	1.365516955	0	0	4.96324552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.1511
R5826_826_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		290.734642	9.056983	412.335726	969.191403	5.700536	9.630174	3.36617	25.179083	60.797618	481.087982	29.659743	0	0.184162	14.249592	36.531781	73.121171	0.221656	5.346609			23.65675																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999995	1024.000597	43.132813	0	0.199999	0.2	0.2	0.2	0.199999	0	0.199999	0	0.199997	0.2	0.199999	0.199999	0.5	0.2			0.2																				880.105467	880.105985	37.071704	0	0.171895	0.171895	0.171895	0.171895	0.171895	0	0.171895	0	0.171893	0.171895	0.171895	0.171895	0.429739	0.171895			0.171895																				21.3231	0.664258745	1.273832332	0	0.979893636	1.65537876	0.578627792	4.328158472	10.45080655	0	5.098361523	0	0.031656159	2.449433617	6.279630495	12.56916369	0.095254228	0.919055354	0	0	4.066477041	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.7631	0	11.8966	21.3231	0.664258745	1.273832332	0	0.979893636	1.65537876	0.578627792	4.328158472	10.45080655	0	5.098361523	0	0.031656159	2.449433617	6.279630495	12.56916369	0.095254228	0.919055354	0	0	4.066477041	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.7631	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.3692	0.0738	0.1415	0	0.7213	1.2185	0.4259	0.9501	2.3468	0	1.1514	0	0.0069	0.5377	1.497	2.9963	0.0227	0.2191			0.9694																				15.6477	0	2.558346483	23.6923	0.738065745	1.415369332	0	1.701206636	2.87392576	1.004563792	5.278245472	12.79758855	0	6.249713523	0	0.038605159	2.987116617	7.776598495	15.56546169	0.117961228	1.138144354	0	0	5.035863041	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.4108
R5826_827_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		258.514265	9.410781	510.711628	696.979238	4.374073	7.46793	3.451564	21.6721	50.371824	734.943562	29.213572	0	0.465029	16.668013	31.985181	69.146616	0.354413	5.764684			20.952916																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000002	1023.999602	43.132802	0	0.2	0.2	0.2	0.2	0.199999	0	0.199999	0	0.2	0.2	0.199999	0.199999	0.500001	0.2			0.199999																				893.071362	893.071013	37.617842	0	0.174428	0.174428	0.174428	0.174428	0.174427	0	0.174427	0	0.174428	0.174428	0.174427	0.174427	0.436071	0.174428			0.174427																				19.2393	0.700374643	1.600989111	0	0.762960805	1.302616094	0.602049405	3.780221059	8.786206145	0	5.095635723	0	0.081114078	2.907368172	5.579079166	12.06103679	0.154549231	1.005522301	0	0	3.654754279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3138	0	9.8686	19.2393	0.700374643	1.600989111	0	0.762960805	1.302616094	0.602049405	3.780221059	8.786206145	0	5.095635723	0	0.081114078	2.907368172	5.579079166	12.06103679	0.154549231	1.005522301	0	0	3.654754279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3138	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.1377	0.0778	0.1779	0	0.5616	0.9589	0.4432	0.8298	1.9772	0	1.1474	0	0.0178	0.6382	1.33	2.8752	0.0368	0.2397			0.8712																				14.3203	0	2.099432815	21.377	0.778193643	1.778877111	0	1.324584805	2.261486094	1.045224405	4.610026059	10.76336014	0	6.243008723	0	0.098920078	3.545570172	6.909050166	14.93620979	0.191392231	1.245223301	0	0	4.525994279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.6341
R5826_828_0	2009	10																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		251.020482	9.137984	495.907177	676.775283	4.124151	7.041233	3.254351	20.433815	47.493713	713.6391	27.544387	0	0.438459	15.715646	30.157634	65.195764	0.334163	5.435306			19.755723																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999977	1024.000479	43.132805	0	0.199999	0.2	0.199999	0.2	0.199999	0	0.199999	0	0.2	0.2	0.2	0.2	0.500001	0.199999			0.199999																				900.156396	900.156837	37.916281	0	0.175811	0.175811	0.175811	0.175811	0.175811	0	0.175811	0	0.175812	0.175811	0.175811	0.175811	0.43953	0.175811			0.175811																				18.8298	0.685468231	1.566912989	0	0.725071111	1.237926215	0.572150704	3.592489449	8.349917176	0	4.842606223	0	0.077086354	2.762983439	5.302043791	11.46213246	0.146874663	0.955586583	0	0	3.473273416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5823	0	8.8853	18.8298	0.685468231	1.566912989	0	0.725071111	1.237926215	0.572150704	3.592489449	8.349917176	0	4.842606223	0	0.077086354	2.762983439	5.302043791	11.46213246	0.146874663	0.955586583	0	0	3.473273416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5823	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.0922	0.0762	0.1741	0	0.5337	0.9113	0.4212	0.7886	1.879	0	1.0904	0	0.0169	0.6065	1.2639	2.7324	0.035	0.2278			0.828																				13.6771	0	1.881702031	20.922	0.761631231	1.741013989	0	1.258807111	2.149181215	0.993319704	4.381088449	10.22889118	0	5.933003223	0	0.094007354	3.369495439	6.565971791	14.19453246	0.181887663	1.183384583	0	0	4.301249416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2595
R5826_831_0	2009	7																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		268.164097	9.762067	529.775497	722.996112	4.706716	8.035857	3.714051	23.320237	54.202539	762.377572	31.435226	0	0.500394	17.935594	34.417615	74.405131	0.381366	6.203082			22.54636																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999987	1024.000347	43.132798	0	0.199999	0.199999	0.199999	0.199999	0.2	0	0.199999	0	0.2	0.2	0.2	0.199999	0.500002	0.2			0.2																				883.902453	883.902763	37.231628	0	0.172637	0.172637	0.172637	0.172637	0.172637	0	0.172637	0	0.172637	0.172637	0.172637	0.172637	0.431595	0.172637			0.172637																				19.7526	0.719059833	1.643700352	0	0.81255333	1.387286245	0.641182622	4.025935755	9.357363725	0	5.426883111	0	0.086386519	3.096347141	5.941753801	12.8450786	0.164595659	1.070881467	0	0	3.892335951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.8639	0	11.2319	19.7526	0.719059833	1.643700352	0	0.81255333	1.387286245	0.641182622	4.025935755	9.357363725	0	5.426883111	0	0.086386519	3.096347141	5.941753801	12.8450786	0.164595659	1.070881467	0	0	3.892335951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.8639	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.1947	0.0799	0.1826	0	0.5981	1.0212	0.472	0.8837	2.1057	0	1.222	0	0.019	0.6797	1.4164	3.0621	0.0392	0.2553			0.9279																				15.1595	0	2.402757978	21.9473	0.798955833	1.826334352	0	1.41068333	2.408484245	1.113164622	4.909678755	11.46303473	0	6.648838111	0	0.105349519	3.776034141	7.358173801	15.9071416	0.203833659	1.326163467	0	0	4.820206951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.0234
R5826_832_0	2009	7																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		250.689435	9.125931	495.253175	675.882752	4.113286	7.022684	3.245778	20.379985	47.368597	712.697953	27.471825	0	0.437303	15.674247	30.078188	65.024016	0.333282	5.420988			19.703679																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999994	1023.999852	43.132799	0	0.199999	0.2	0.2	0.2	0.199999	0	0.199999	0	0.199998	0.2	0.2	0.199999	0.500003	0.2			0.2																				900.470778	900.470654	37.929517	0	0.175873	0.175873	0.175873	0.175873	0.175873	0	0.175873	0	0.175871	0.175873	0.175873	0.175873	0.439685	0.175873			0.175873																				18.8115	0.684802755	1.56539281	0	0.723415949	1.235100503	0.570844714	3.584289102	8.33085726	0	4.831552278	0	0.076908916	2.756676843	5.289941158	11.43596877	0.146539096	0.953405423	0	0	3.465345137	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4626	0	8.8432	18.8115	0.684802755	1.56539281	0	0.723415949	1.235100503	0.570844714	3.584289102	8.33085726	0	4.831552278	0	0.076908916	2.756676843	5.289941158	11.43596877	0.146539096	0.953405423	0	0	3.465345137	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4626	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.0902	0.0761	0.1739	0	0.5325	0.9092	0.4202	0.7868	1.8747	0	1.0879	0	0.0169	0.6051	1.261	2.7262	0.0349	0.2273			0.8261																				13.649	0	1.872403501	20.9017	0.760891755	1.73932481	0	1.255930949	2.144272503	0.991049714	4.371085102	10.20553626	0	5.919455278	0	0.093790916	3.361800843	6.550979158	14.16212277	0.181472096	1.180682423	0	0	4.291428137	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.1115
R5826_833_0	2009	7																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		252.724559	9.200017	499.273692	681.369639	4.180339	7.137164	3.29869	20.71221	48.140779	718.483712	27.919657	0	0.444432	15.929761	30.568508	66.084006	0.338715	5.509358			20.02488																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999998	1023.999846	43.132791	0	0.2	0.2	0.2	0.2	0.199999	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				898.551806	898.551673	37.848679	0	0.175498	0.175498	0.175498	0.175498	0.175498	0	0.175498	0	0.175497	0.175498	0.175498	0.175498	0.438747	0.175498			0.175498																				18.9238	0.688890889	1.574737475	0	0.733641134	1.252558008	0.578913498	3.634951431	8.448610433	0	4.899843964	0	0.077996483	2.795641196	5.364712017	11.59761088	0.14861019	0.96688131	0	0	3.51432639	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.2018	0	9.1029	18.9238	0.688890889	1.574737475	0	0.733641134	1.252558008	0.578913498	3.634951431	8.448610433	0	4.899843964	0	0.077996483	2.795641196	5.364712017	11.59761088	0.14861019	0.96688131	0	0	3.51432639	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.2018	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.1026	0.0765	0.175	0	0.54	0.922	0.4261	0.7979	1.9012	0	1.1033	0	0.0171	0.6137	1.2789	2.7647	0.0354	0.2305			0.8378																				13.8228	0	1.929820378	21.0265	0.765434889	1.749708475	0	1.273684134	2.174582008	1.005059498	4.432869431	10.34978943	0	6.003126964	0	0.095117483	3.409319196	6.643576017	14.36230088	0.18403619	1.19737131	0	0	4.35208739	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.0246
R5826_834_0	2009	7																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		252.466318	7.259842	482.66416	655.904873	4.291594	7.670083	3.420633	24.167934	58.923276	457.20173	38.758191	0	0.79545	17.676704	39.76775	97.565453	0.125719	7.42815			28.044945																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000023	1024.000798	43.132798	0	0.2	0.2	0.2	0.2	0.199999	0	0.199999	0	0.2	0.2	0.199999	0.199999	0.499997	0.2			0.199999																				866.977812	866.978468	36.518729	0	0.169331	0.169331	0.169331	0.169331	0.169331	0	0.169331	0	0.169331	0.169331	0.169331	0.169331	0.423327	0.169331			0.169331																				18.2402	0.524510558	1.468856805	0	0.726699904	1.298782824	0.579219207	4.092380432	9.977537248	0	6.56296324	0	0.134694344	2.993213965	6.733912875	16.52085572	0.053220247	1.257816068	0	0	4.748878582	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.9138	0	13.7491	18.2402	0.524510558	1.468856805	0	0.726699904	1.298782824	0.579219207	4.092380432	9.977537248	0	6.56296324	0	0.134694344	2.993213965	6.733912875	16.52085572	0.053220247	1.257816068	0	0	4.748878582	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.9138	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.0267	0.0583	0.1632	0	0.5349	0.9561	0.4264	0.8983	2.2506	0	1.4756	0	0.0296	0.657	1.6053	3.9383	0.0127	0.2998			1.1321																				16.4649	0	2.982025926	20.2669	0.582789558	1.632062805	0	1.261633904	2.254834824	1.005590207	4.990710432	12.22815925	0	8.03855824	0	0.164261344	3.650262965	8.339174875	20.45917472	0.065906247	1.557661068	0	0	5.880938582	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.3786
R5826_835_0	2009	7																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		261.375205	9.51493	516.363601	704.692608	4.471427	7.634143	3.528386	22.154454	51.492944	743.077079	29.863775	0	0.475379	17.038991	32.697072	70.685604	0.362301	5.892989			21.419262																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999977	1024.000386	43.132792	0	0.199999	0.2	0.199999	0.2	0.2	0	0.2	0	0.2	0.199999	0.199999	0.2	0.500001	0.2			0.199999																				890.295276	890.295632	37.5009	0	0.173885	0.173885	0.173885	0.173885	0.173885	0	0.173885	0	0.173886	0.173885	0.173885	0.173885	0.434715	0.173885			0.173885																				19.3918	0.705925051	1.61367498	0	0.777514084	1.327462956	0.6135334	3.852327234	8.953850567	0	5.192862516	0	0.082661753	2.96282495	5.685530365	12.29116625	0.157497679	1.024702392	0	0	3.724488373	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.3578	0	10.266	19.3918	0.705925051	1.61367498	0	0.777514084	1.327462956	0.6135334	3.852327234	8.953850567	0	5.192862516	0	0.082661753	2.96282495	5.685530365	12.29116625	0.157497679	1.024702392	0	0	3.724488373	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.3578	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.1546	0.0784	0.1793	0	0.5723	0.9772	0.4516	0.8456	2.0149	0	1.1693	0	0.0181	0.6504	1.3553	2.93	0.0375	0.2443			0.8879																				14.5669	0	2.187654823	21.5464	0.784361051	1.79297198	0	1.349853084	2.304627956	1.0651644	4.697964234	10.96872757	0	6.362126516	0	0.100807753	3.61320395	7.040875365	15.22119625	0.195042679	1.268976392	0	0	4.612351373	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9246
R5826_836_0	2009	7																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		256.150682	9.324739	506.04222	690.606796	4.294449	7.331986	3.388733	21.277586	49.454866	728.224012	28.681775	0	0.456564	16.364591	31.40293	67.887885	0.347962	5.659746			20.571493																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000021	1023.999921	43.132796	0	0.2	0.199999	0.2	0.199999	0.199999	0	0.2	0	0.2	0.2	0.2	0.2	0.5	0.199999			0.199999																				895.372307	895.372218	37.714756	0	0.174877	0.174877	0.174877	0.174877	0.174877	0	0.174877	0	0.174877	0.174877	0.174877	0.174877	0.437193	0.174877			0.174877																				19.1125	0.695759353	1.590438238	0	0.751000358	1.282195716	0.592611461	3.720960407	8.648518601	0	5.015782767	0	0.079842543	2.86179058	5.49165019	11.87202967	0.152126551	0.989759401	0	0	3.597480981	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4545	0	9.5468	19.1125	0.695759353	1.590438238	0	0.751000358	1.282195716	0.592611461	3.720960407	8.648518601	0	5.015782767	0	0.079842543	2.86179058	5.49165019	11.87202967	0.152126551	0.989759401	0	0	3.597480981	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4545	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.1236	0.0773	0.1767	0	0.5528	0.9438	0.4362	0.8168	1.9462	0	1.1294	0	0.0175	0.6282	1.3091	2.8301	0.0363	0.2359			0.8576																				14.1176	0	2.028114839	21.2361	0.773065353	1.767153238	0	1.303821358	2.226035716	1.028840461	4.537758407	10.5946816	0	6.145170767	0	0.097368543	3.48999058	6.80077419	14.70213667	0.188391551	1.225703401	0	0	4.455064981	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.5721
R5826_837_0	2009	7																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		311.189288	10.835106	891.964356	812.544816	6.185001	9.56776	7.546705	27.074755	47.856722	1841.711149	24.284386	0	0.200405	21.469032	26.319215	49.308497	0.326167	4.992006			13.676378																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.99999	1024.000318	43.132804	0	0.199999	0.2	0.2	0.2	0.199999	0	0.199999	0	0.2	0.199999	0.2	0.199999	0.500001	0.2			0.2																				894.223351	894.223638	37.666368	0	0.174652	0.174653	0.174653	0.174653	0.174652	0	0.174652	0	0.174653	0.174652	0.174653	0.174652	0.436633	0.174653			0.174653																				23.1894	0.807417325	2.799754806	0	1.080222795	1.671037987	1.318054668	4.728687185	8.358272211	0	4.241316584	0	0.035001334	3.749609377	4.596729857	8.611827618	0.142415276	0.871868824	0	0	2.388620447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5902	0	9.9544	23.1894	0.807417325	2.799754806	0	1.080222795	1.671037987	1.318054668	4.728687185	8.358272211	0	4.241316584	0	0.035001334	3.749609377	4.596729857	8.611827618	0.142415276	0.871868824	0	0	2.388620447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5902	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.5766	0.0897	0.3111	0	0.7952	1.2301	0.9702	1.038	1.8794	0	0.9533	0	0.0077	0.8231	1.0958	2.0529	0.034	0.2078			0.5694																				14.6343	0	2.123844267	25.766	0.897130325	3.110838806	0	1.875391795	2.901107987	2.288288668	5.766692185	10.23771021	0	5.194621584	0	0.042684334	4.572699377	5.692515857	10.66475962	0.176365276	1.079707824	0	0	2.958029447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.2245
R5826_838_0	2009	7																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		258.564478	9.41261	510.810829	697.114619	4.375773	7.470832	3.452905	21.680521	50.391395	735.086318	29.224922	0	0.465209	16.674487	31.997608	69.173482	0.35455	5.766924			20.961058																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000009	1023.999507	43.132789	0	0.2	0.199999	0.2	0.199999	0.2	0	0.2	0	0.2	0.199999	0.2	0.199999	0.500002	0.2			0.2																				893.021192	893.020754	37.615717	0	0.174418	0.174418	0.174418	0.174418	0.174418	0	0.174418	0	0.174418	0.174418	0.174418	0.174418	0.436047	0.174418			0.174418																				19.242	0.70047134	1.601209632	0	0.763213575	1.303047576	0.602248784	3.781473112	8.789166333	0	5.097352445	0	0.081140823	2.908330674	5.580958792	12.06510038	0.154600464	1.00585535	0	0	3.655985814	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3321	0	9.8756	19.242	0.70047134	1.601209632	0	0.763213575	1.303047576	0.602248784	3.781473112	8.789166333	0	5.097352445	0	0.081140823	2.908330674	5.580958792	12.06510038	0.154600464	1.00585535	0	0	3.655985814	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3321	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.138	0.0778	0.1779	0	0.5618	0.9592	0.4433	0.8301	1.9778	0	1.1478	0	0.0178	0.6384	1.3304	2.8761	0.0369	0.2398			0.8715																				14.3246	0	2.100984629	21.38	0.77830234	1.779121632	0	1.325024575	2.262235576	1.045570784	4.611554112	10.76697833	0	6.245106445	0	0.098952823	3.546744674	6.911370792	14.94122838	0.191455464	1.24563535	0	0	4.527514814	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.6568
R5826_839_0	2009	7																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		270.521019	9.847868	534.431749	729.350601	4.789818	8.177739	3.779627	23.731981	55.159542	769.078187	31.990251	0	0.509229	18.252267	35.025295	75.718833	0.388099	6.312604			22.944439																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999987	1023.999509	43.132789	0	0.2	0.2	0.199999	0.199999	0.199999	0	0.2	0	0.2	0.199999	0.2	0.2	0.500001	0.2			0.2																				881.77458	881.774169	37.141989	0	0.172221	0.172221	0.172221	0.172221	0.172221	0	0.172221	0	0.172221	0.172221	0.172221	0.172221	0.430555	0.172221			0.172221																				19.8782	0.723632969	1.654154845	0	0.824907246	1.408378388	0.650931142	4.0871455	9.499631483	0	5.509393017	0	0.087699928	3.143423675	6.03209133	13.04037314	0.167097965	1.087162973	0	0	3.951514229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7458	0	11.5722	19.8782	0.723632969	1.654154845	0	0.824907246	1.408378388	0.650931142	4.0871455	9.499631483	0	5.509393017	0	0.087699928	3.143423675	6.03209133	13.04037314	0.167097965	1.087162973	0	0	3.951514229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7458	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.2087	0.0804	0.1838	0	0.6072	1.0367	0.4792	0.8972	2.1377	0	1.2405	0	0.0193	0.69	1.438	3.1086	0.0398	0.2592			0.942																				15.3682	0	2.478813996	22.0869	0.804035969	1.837949845	0	1.432133246	2.445105388	1.130090142	4.9843275	11.63732348	0	6.749928017	0	0.106951928	3.833446675	7.47004933	16.14900014	0.206931965	1.346325973	0	0	4.893495229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.114
R5826_840_0	2009	7																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		254.829885	9.276658	503.432897	687.045796	4.250281	7.256578	3.35388	21.058751	48.946234	724.469048	28.386789	0	0.451868	16.196285	31.079957	67.189673	0.344383	5.601536			20.35992																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000022	1023.999806	43.132795	0	0.199999	0.2	0.2	0.199999	0.2	0	0.2	0	0.199998	0.199999	0.199999	0.2	0.500001	0.199999			0.2																				896.585747	896.585558	37.765867	0	0.175114	0.175114	0.175114	0.175114	0.175114	0	0.175114	0	0.175113	0.175114	0.175114	0.175114	0.437787	0.175114			0.175114																				19.0397	0.693109799	1.584381653	0	0.744283707	1.2707284	0.587311342	3.687682123	8.571170821	0	4.970924169	0	0.079127961	2.836196251	5.44253559	11.7658524	0.1507664	0.980907375	0	0	3.565307031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.97	0	9.375	19.0397	0.693109799	1.584381653	0	0.744283707	1.2707284	0.587311342	3.687682123	8.571170821	0	4.970924169	0	0.079127961	2.836196251	5.44253559	11.7658524	0.1507664	0.980907375	0	0	3.565307031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.97	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.1155	0.077	0.176	0	0.5479	0.9354	0.4323	0.8095	1.9288	0	1.1193	0	0.0174	0.6226	1.2974	2.8048	0.0359	0.2338			0.8499																				14.0036	0	1.990055394	21.1553	0.770121799	1.760424653	0	1.292160707	2.2061284	1.019639342	4.497175123	10.49992982	0	6.090211169	0	0.096497961	3.458777251	6.73995159	14.5706484	0.1867064	1.214740375	0	0	4.415220031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.9736
R5826_841_0	2009	7																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		272.746476	9.928882	538.828282	735.350644	4.868947	8.312836	3.842067	24.124035	56.070782	775.405053	32.518733	0	0.517642	18.553796	35.603915	76.969714	0.39451	6.416889			23.323484																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000002	1024.000486	43.132791	0	0.199999	0.199999	0.2	0.2	0.2	0	0.2	0	0.200001	0.2	0.2	0.2	0.500002	0.2			0.199999																				879.809537	879.809954	37.05922	0	0.171837	0.171837	0.171837	0.171837	0.171837	0	0.171837	0	0.171838	0.171837	0.171837	0.171837	0.429596	0.171837			0.171837																				19.9971	0.727960768	1.66404632	0	0.836665246	1.4284528	0.660209267	4.145401802	9.635034967	0	5.587921523	0	0.088950566	3.188228643	6.118069942	13.22624474	0.169479918	1.102658955	0	0	4.00783752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.5842	0	11.8957	19.9971	0.727960768	1.66404632	0	0.836665246	1.4284528	0.660209267	4.145401802	9.635034967	0	5.587921523	0	0.088950566	3.188228643	6.118069942	13.22624474	0.169479918	1.102658955	0	0	4.00783752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.5842	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.2219	0.0809	0.1849	0	0.6159	1.0515	0.486	0.91	2.1682	0	1.2582	0	0.0195	0.6999	1.4585	3.1529	0.0404	0.2629			0.9554																				15.5668	0	2.551223836	22.219	0.808845768	1.84894032	0	1.452546246	2.4799578	1.146198267	5.055372802	11.80319797	0	6.846139523	0	0.108476566	3.888086643	7.576525942	16.37918274	0.209881918	1.365516955	0	0	4.96324552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.1511
R5826_842_0	2009	7																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		290.734642	9.056983	412.335726	969.191403	5.700536	9.630174	3.36617	25.179083	60.797618	481.087982	29.659743	0	0.184162	14.249592	36.531781	73.121171	0.221656	5.346609			23.65675																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999995	1024.000597	43.132813	0	0.199999	0.2	0.2	0.2	0.199999	0	0.199999	0	0.199997	0.2	0.199999	0.199999	0.5	0.2			0.2																				880.105467	880.105985	37.071704	0	0.171895	0.171895	0.171895	0.171895	0.171895	0	0.171895	0	0.171893	0.171895	0.171895	0.171895	0.429739	0.171895			0.171895																				21.3231	0.664258745	1.273832332	0	0.979893636	1.65537876	0.578627792	4.328158472	10.45080655	0	5.098361523	0	0.031656159	2.449433617	6.279630495	12.56916369	0.095254228	0.919055354	0	0	4.066477041	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.7631	0	11.8966	21.3231	0.664258745	1.273832332	0	0.979893636	1.65537876	0.578627792	4.328158472	10.45080655	0	5.098361523	0	0.031656159	2.449433617	6.279630495	12.56916369	0.095254228	0.919055354	0	0	4.066477041	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.7631	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.3692	0.0738	0.1415	0	0.7213	1.2185	0.4259	0.9501	2.3468	0	1.1514	0	0.0069	0.5377	1.497	2.9963	0.0227	0.2191			0.9694																				15.6477	0	2.558346483	23.6923	0.738065745	1.415369332	0	1.701206636	2.87392576	1.004563792	5.278245472	12.79758855	0	6.249713523	0	0.038605159	2.987116617	7.776598495	15.56546169	0.117961228	1.138144354	0	0	5.035863041	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.4108
R5826_843_0	2009	7																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		258.514265	9.410781	510.711628	696.979238	4.374073	7.46793	3.451564	21.6721	50.371824	734.943562	29.213572	0	0.465029	16.668013	31.985181	69.146616	0.354413	5.764684			20.952916																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000002	1023.999602	43.132802	0	0.2	0.2	0.2	0.2	0.199999	0	0.199999	0	0.2	0.2	0.199999	0.199999	0.500001	0.2			0.199999																				893.071362	893.071013	37.617842	0	0.174428	0.174428	0.174428	0.174428	0.174427	0	0.174427	0	0.174428	0.174428	0.174427	0.174427	0.436071	0.174428			0.174427																				19.2393	0.700374643	1.600989111	0	0.762960805	1.302616094	0.602049405	3.780221059	8.786206145	0	5.095635723	0	0.081114078	2.907368172	5.579079166	12.06103679	0.154549231	1.005522301	0	0	3.654754279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3138	0	9.8686	19.2393	0.700374643	1.600989111	0	0.762960805	1.302616094	0.602049405	3.780221059	8.786206145	0	5.095635723	0	0.081114078	2.907368172	5.579079166	12.06103679	0.154549231	1.005522301	0	0	3.654754279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3138	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.1377	0.0778	0.1779	0	0.5616	0.9589	0.4432	0.8298	1.9772	0	1.1474	0	0.0178	0.6382	1.33	2.8752	0.0368	0.2397			0.8712																				14.3203	0	2.099432815	21.377	0.778193643	1.778877111	0	1.324584805	2.261486094	1.045224405	4.610026059	10.76336014	0	6.243008723	0	0.098920078	3.545570172	6.909050166	14.93620979	0.191392231	1.245223301	0	0	4.525994279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.6341
R5826_844_0	2009	8																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		251.020482	9.137984	495.907177	676.775283	4.124151	7.041233	3.254351	20.433815	47.493713	713.6391	27.544387	0	0.438459	15.715646	30.157634	65.195764	0.334163	5.435306			19.755723																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999977	1024.000479	43.132805	0	0.199999	0.2	0.199999	0.2	0.199999	0	0.199999	0	0.2	0.2	0.2	0.2	0.500001	0.199999			0.199999																				900.156396	900.156837	37.916281	0	0.175811	0.175811	0.175811	0.175811	0.175811	0	0.175811	0	0.175812	0.175811	0.175811	0.175811	0.43953	0.175811			0.175811																				18.8298	0.685468231	1.566912989	0	0.725071111	1.237926215	0.572150704	3.592489449	8.349917176	0	4.842606223	0	0.077086354	2.762983439	5.302043791	11.46213246	0.146874663	0.955586583	0	0	3.473273416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5823	0	8.8853	18.8298	0.685468231	1.566912989	0	0.725071111	1.237926215	0.572150704	3.592489449	8.349917176	0	4.842606223	0	0.077086354	2.762983439	5.302043791	11.46213246	0.146874663	0.955586583	0	0	3.473273416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5823	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.0922	0.0762	0.1741	0	0.5337	0.9113	0.4212	0.7886	1.879	0	1.0904	0	0.0169	0.6065	1.2639	2.7324	0.035	0.2278			0.828																				13.6771	0	1.881702031	20.922	0.761631231	1.741013989	0	1.258807111	2.149181215	0.993319704	4.381088449	10.22889118	0	5.933003223	0	0.094007354	3.369495439	6.565971791	14.19453246	0.181887663	1.183384583	0	0	4.301249416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2595
R5826_845_0	2009	7																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		268.164097	9.762067	529.775497	722.996112	4.706716	8.035857	3.714051	23.320237	54.202539	762.377572	31.435226	0	0.500394	17.935594	34.417615	74.405131	0.381366	6.203082			22.54636																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999987	1024.000347	43.132798	0	0.199999	0.199999	0.199999	0.199999	0.2	0	0.199999	0	0.2	0.2	0.2	0.199999	0.500002	0.2			0.2																				883.902453	883.902763	37.231628	0	0.172637	0.172637	0.172637	0.172637	0.172637	0	0.172637	0	0.172637	0.172637	0.172637	0.172637	0.431595	0.172637			0.172637																				19.7526	0.719059833	1.643700352	0	0.81255333	1.387286245	0.641182622	4.025935755	9.357363725	0	5.426883111	0	0.086386519	3.096347141	5.941753801	12.8450786	0.164595659	1.070881467	0	0	3.892335951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.8639	0	11.2319	19.7526	0.719059833	1.643700352	0	0.81255333	1.387286245	0.641182622	4.025935755	9.357363725	0	5.426883111	0	0.086386519	3.096347141	5.941753801	12.8450786	0.164595659	1.070881467	0	0	3.892335951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	70.8639	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.1947	0.0799	0.1826	0	0.5981	1.0212	0.472	0.8837	2.1057	0	1.222	0	0.019	0.6797	1.4164	3.0621	0.0392	0.2553			0.9279																				15.1595	0	2.402757978	21.9473	0.798955833	1.826334352	0	1.41068333	2.408484245	1.113164622	4.909678755	11.46303473	0	6.648838111	0	0.105349519	3.776034141	7.358173801	15.9071416	0.203833659	1.326163467	0	0	4.820206951	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	86.0234
R5826_846_0	2009	6																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		250.689435	9.125931	495.253175	675.882752	4.113286	7.022684	3.245778	20.379985	47.368597	712.697953	27.471825	0	0.437303	15.674247	30.078188	65.024016	0.333282	5.420988			19.703679																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999994	1023.999852	43.132799	0	0.199999	0.2	0.2	0.2	0.199999	0	0.199999	0	0.199998	0.2	0.2	0.199999	0.500003	0.2			0.2																				900.470778	900.470654	37.929517	0	0.175873	0.175873	0.175873	0.175873	0.175873	0	0.175873	0	0.175871	0.175873	0.175873	0.175873	0.439685	0.175873			0.175873																				18.8115	0.684802755	1.56539281	0	0.723415949	1.235100503	0.570844714	3.584289102	8.33085726	0	4.831552278	0	0.076908916	2.756676843	5.289941158	11.43596877	0.146539096	0.953405423	0	0	3.465345137	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4626	0	8.8432	18.8115	0.684802755	1.56539281	0	0.723415949	1.235100503	0.570844714	3.584289102	8.33085726	0	4.831552278	0	0.076908916	2.756676843	5.289941158	11.43596877	0.146539096	0.953405423	0	0	3.465345137	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.4626	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.0902	0.0761	0.1739	0	0.5325	0.9092	0.4202	0.7868	1.8747	0	1.0879	0	0.0169	0.6051	1.261	2.7262	0.0349	0.2273			0.8261																				13.649	0	1.872403501	20.9017	0.760891755	1.73932481	0	1.255930949	2.144272503	0.991049714	4.371085102	10.20553626	0	5.919455278	0	0.093790916	3.361800843	6.550979158	14.16212277	0.181472096	1.180682423	0	0	4.291428137	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.1115
R5826_847_0	2009	6																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		252.724559	9.200017	499.273692	681.369639	4.180339	7.137164	3.29869	20.71221	48.140779	718.483712	27.919657	0	0.444432	15.929761	30.568508	66.084006	0.338715	5.509358			20.02488																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999998	1023.999846	43.132791	0	0.2	0.2	0.2	0.2	0.199999	0	0.2	0	0.199999	0.199999	0.2	0.199999	0.500001	0.2			0.2																				898.551806	898.551673	37.848679	0	0.175498	0.175498	0.175498	0.175498	0.175498	0	0.175498	0	0.175497	0.175498	0.175498	0.175498	0.438747	0.175498			0.175498																				18.9238	0.688890889	1.574737475	0	0.733641134	1.252558008	0.578913498	3.634951431	8.448610433	0	4.899843964	0	0.077996483	2.795641196	5.364712017	11.59761088	0.14861019	0.96688131	0	0	3.51432639	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.2018	0	9.1029	18.9238	0.688890889	1.574737475	0	0.733641134	1.252558008	0.578913498	3.634951431	8.448610433	0	4.899843964	0	0.077996483	2.795641196	5.364712017	11.59761088	0.14861019	0.96688131	0	0	3.51432639	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.2018	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.1026	0.0765	0.175	0	0.54	0.922	0.4261	0.7979	1.9012	0	1.1033	0	0.0171	0.6137	1.2789	2.7647	0.0354	0.2305			0.8378																				13.8228	0	1.929820378	21.0265	0.765434889	1.749708475	0	1.273684134	2.174582008	1.005059498	4.432869431	10.34978943	0	6.003126964	0	0.095117483	3.409319196	6.643576017	14.36230088	0.18403619	1.19737131	0	0	4.35208739	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.0246
R5826_848_0	2009	6																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		252.466318	7.259842	482.66416	655.904873	4.291594	7.670083	3.420633	24.167934	58.923276	457.20173	38.758191	0	0.79545	17.676704	39.76775	97.565453	0.125719	7.42815			28.044945																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000023	1024.000798	43.132798	0	0.2	0.2	0.2	0.2	0.199999	0	0.199999	0	0.2	0.2	0.199999	0.199999	0.499997	0.2			0.199999																				866.977812	866.978468	36.518729	0	0.169331	0.169331	0.169331	0.169331	0.169331	0	0.169331	0	0.169331	0.169331	0.169331	0.169331	0.423327	0.169331			0.169331																				18.2402	0.524510558	1.468856805	0	0.726699904	1.298782824	0.579219207	4.092380432	9.977537248	0	6.56296324	0	0.134694344	2.993213965	6.733912875	16.52085572	0.053220247	1.257816068	0	0	4.748878582	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.9138	0	13.7491	18.2402	0.524510558	1.468856805	0	0.726699904	1.298782824	0.579219207	4.092380432	9.977537248	0	6.56296324	0	0.134694344	2.993213965	6.733912875	16.52085572	0.053220247	1.257816068	0	0	4.748878582	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	75.9138	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.0267	0.0583	0.1632	0	0.5349	0.9561	0.4264	0.8983	2.2506	0	1.4756	0	0.0296	0.657	1.6053	3.9383	0.0127	0.2998			1.1321																				16.4649	0	2.982025926	20.2669	0.582789558	1.632062805	0	1.261633904	2.254834824	1.005590207	4.990710432	12.22815925	0	8.03855824	0	0.164261344	3.650262965	8.339174875	20.45917472	0.065906247	1.557661068	0	0	5.880938582	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	92.3786
R5826_849_0	2009	6																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		261.375205	9.51493	516.363601	704.692608	4.471427	7.634143	3.528386	22.154454	51.492944	743.077079	29.863775	0	0.475379	17.038991	32.697072	70.685604	0.362301	5.892989			21.419262																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999977	1024.000386	43.132792	0	0.199999	0.2	0.199999	0.2	0.2	0	0.2	0	0.2	0.199999	0.199999	0.2	0.500001	0.2			0.199999																				890.295276	890.295632	37.5009	0	0.173885	0.173885	0.173885	0.173885	0.173885	0	0.173885	0	0.173886	0.173885	0.173885	0.173885	0.434715	0.173885			0.173885																				19.3918	0.705925051	1.61367498	0	0.777514084	1.327462956	0.6135334	3.852327234	8.953850567	0	5.192862516	0	0.082661753	2.96282495	5.685530365	12.29116625	0.157497679	1.024702392	0	0	3.724488373	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.3578	0	10.266	19.3918	0.705925051	1.61367498	0	0.777514084	1.327462956	0.6135334	3.852327234	8.953850567	0	5.192862516	0	0.082661753	2.96282495	5.685530365	12.29116625	0.157497679	1.024702392	0	0	3.724488373	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.3578	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.1546	0.0784	0.1793	0	0.5723	0.9772	0.4516	0.8456	2.0149	0	1.1693	0	0.0181	0.6504	1.3553	2.93	0.0375	0.2443			0.8879																				14.5669	0	2.187654823	21.5464	0.784361051	1.79297198	0	1.349853084	2.304627956	1.0651644	4.697964234	10.96872757	0	6.362126516	0	0.100807753	3.61320395	7.040875365	15.22119625	0.195042679	1.268976392	0	0	4.612351373	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	82.9246
R5826_850_0	2009	6																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		256.150682	9.324739	506.04222	690.606796	4.294449	7.331986	3.388733	21.277586	49.454866	728.224012	28.681775	0	0.456564	16.364591	31.40293	67.887885	0.347962	5.659746			20.571493																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000021	1023.999921	43.132796	0	0.2	0.199999	0.2	0.199999	0.199999	0	0.2	0	0.2	0.2	0.2	0.2	0.5	0.199999			0.199999																				895.372307	895.372218	37.714756	0	0.174877	0.174877	0.174877	0.174877	0.174877	0	0.174877	0	0.174877	0.174877	0.174877	0.174877	0.437193	0.174877			0.174877																				19.1125	0.695759353	1.590438238	0	0.751000358	1.282195716	0.592611461	3.720960407	8.648518601	0	5.015782767	0	0.079842543	2.86179058	5.49165019	11.87202967	0.152126551	0.989759401	0	0	3.597480981	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4545	0	9.5468	19.1125	0.695759353	1.590438238	0	0.751000358	1.282195716	0.592611461	3.720960407	8.648518601	0	5.015782767	0	0.079842543	2.86179058	5.49165019	11.87202967	0.152126551	0.989759401	0	0	3.597480981	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	66.4545	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.1236	0.0773	0.1767	0	0.5528	0.9438	0.4362	0.8168	1.9462	0	1.1294	0	0.0175	0.6282	1.3091	2.8301	0.0363	0.2359			0.8576																				14.1176	0	2.028114839	21.2361	0.773065353	1.767153238	0	1.303821358	2.226035716	1.028840461	4.537758407	10.5946816	0	6.145170767	0	0.097368543	3.48999058	6.80077419	14.70213667	0.188391551	1.225703401	0	0	4.455064981	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	80.5721
R5826_851_0	2009	6																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		311.189288	10.835106	891.964356	812.544816	6.185001	9.56776	7.546705	27.074755	47.856722	1841.711149	24.284386	0	0.200405	21.469032	26.319215	49.308497	0.326167	4.992006			13.676378																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.99999	1024.000318	43.132804	0	0.199999	0.2	0.2	0.2	0.199999	0	0.199999	0	0.2	0.199999	0.2	0.199999	0.500001	0.2			0.2																				894.223351	894.223638	37.666368	0	0.174652	0.174653	0.174653	0.174653	0.174652	0	0.174652	0	0.174653	0.174652	0.174653	0.174652	0.436633	0.174653			0.174653																				23.1894	0.807417325	2.799754806	0	1.080222795	1.671037987	1.318054668	4.728687185	8.358272211	0	4.241316584	0	0.035001334	3.749609377	4.596729857	8.611827618	0.142415276	0.871868824	0	0	2.388620447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5902	0	9.9544	23.1894	0.807417325	2.799754806	0	1.080222795	1.671037987	1.318054668	4.728687185	8.358272211	0	4.241316584	0	0.035001334	3.749609377	4.596729857	8.611827618	0.142415276	0.871868824	0	0	2.388620447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	68.5902	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.5766	0.0897	0.3111	0	0.7952	1.2301	0.9702	1.038	1.8794	0	0.9533	0	0.0077	0.8231	1.0958	2.0529	0.034	0.2078			0.5694																				14.6343	0	2.123844267	25.766	0.897130325	3.110838806	0	1.875391795	2.901107987	2.288288668	5.766692185	10.23771021	0	5.194621584	0	0.042684334	4.572699377	5.692515857	10.66475962	0.176365276	1.079707824	0	0	2.958029447	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	83.2245
R5826_852_0	2009	6																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		258.564478	9.41261	510.810829	697.114619	4.375773	7.470832	3.452905	21.680521	50.391395	735.086318	29.224922	0	0.465209	16.674487	31.997608	69.173482	0.35455	5.766924			20.961058																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000009	1023.999507	43.132789	0	0.2	0.199999	0.2	0.199999	0.2	0	0.2	0	0.2	0.199999	0.2	0.199999	0.500002	0.2			0.2																				893.021192	893.020754	37.615717	0	0.174418	0.174418	0.174418	0.174418	0.174418	0	0.174418	0	0.174418	0.174418	0.174418	0.174418	0.436047	0.174418			0.174418																				19.242	0.70047134	1.601209632	0	0.763213575	1.303047576	0.602248784	3.781473112	8.789166333	0	5.097352445	0	0.081140823	2.908330674	5.580958792	12.06510038	0.154600464	1.00585535	0	0	3.655985814	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3321	0	9.8756	19.242	0.70047134	1.601209632	0	0.763213575	1.303047576	0.602248784	3.781473112	8.789166333	0	5.097352445	0	0.081140823	2.908330674	5.580958792	12.06510038	0.154600464	1.00585535	0	0	3.655985814	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3321	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.138	0.0778	0.1779	0	0.5618	0.9592	0.4433	0.8301	1.9778	0	1.1478	0	0.0178	0.6384	1.3304	2.8761	0.0369	0.2398			0.8715																				14.3246	0	2.100984629	21.38	0.77830234	1.779121632	0	1.325024575	2.262235576	1.045570784	4.611554112	10.76697833	0	6.245106445	0	0.098952823	3.546744674	6.911370792	14.94122838	0.191455464	1.24563535	0	0	4.527514814	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.6568
R5826_853_0	2009	6																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		270.521019	9.847868	534.431749	729.350601	4.789818	8.177739	3.779627	23.731981	55.159542	769.078187	31.990251	0	0.509229	18.252267	35.025295	75.718833	0.388099	6.312604			22.944439																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999987	1023.999509	43.132789	0	0.2	0.2	0.199999	0.199999	0.199999	0	0.2	0	0.2	0.199999	0.2	0.2	0.500001	0.2			0.2																				881.77458	881.774169	37.141989	0	0.172221	0.172221	0.172221	0.172221	0.172221	0	0.172221	0	0.172221	0.172221	0.172221	0.172221	0.430555	0.172221			0.172221																				19.8782	0.723632969	1.654154845	0	0.824907246	1.408378388	0.650931142	4.0871455	9.499631483	0	5.509393017	0	0.087699928	3.143423675	6.03209133	13.04037314	0.167097965	1.087162973	0	0	3.951514229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7458	0	11.5722	19.8782	0.723632969	1.654154845	0	0.824907246	1.408378388	0.650931142	4.0871455	9.499631483	0	5.509393017	0	0.087699928	3.143423675	6.03209133	13.04037314	0.167097965	1.087162973	0	0	3.951514229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	71.7458	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.2087	0.0804	0.1838	0	0.6072	1.0367	0.4792	0.8972	2.1377	0	1.2405	0	0.0193	0.69	1.438	3.1086	0.0398	0.2592			0.942																				15.3682	0	2.478813996	22.0869	0.804035969	1.837949845	0	1.432133246	2.445105388	1.130090142	4.9843275	11.63732348	0	6.749928017	0	0.106951928	3.833446675	7.47004933	16.14900014	0.206931965	1.346325973	0	0	4.893495229	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	87.114
R5826_854_0	2009	6																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		254.829885	9.276658	503.432897	687.045796	4.250281	7.256578	3.35388	21.058751	48.946234	724.469048	28.386789	0	0.451868	16.196285	31.079957	67.189673	0.344383	5.601536			20.35992																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000022	1023.999806	43.132795	0	0.199999	0.2	0.2	0.199999	0.2	0	0.2	0	0.199998	0.199999	0.199999	0.2	0.500001	0.199999			0.2																				896.585747	896.585558	37.765867	0	0.175114	0.175114	0.175114	0.175114	0.175114	0	0.175114	0	0.175113	0.175114	0.175114	0.175114	0.437787	0.175114			0.175114																				19.0397	0.693109799	1.584381653	0	0.744283707	1.2707284	0.587311342	3.687682123	8.571170821	0	4.970924169	0	0.079127961	2.836196251	5.44253559	11.7658524	0.1507664	0.980907375	0	0	3.565307031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.97	0	9.375	19.0397	0.693109799	1.584381653	0	0.744283707	1.2707284	0.587311342	3.687682123	8.571170821	0	4.970924169	0	0.079127961	2.836196251	5.44253559	11.7658524	0.1507664	0.980907375	0	0	3.565307031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	65.97	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.1155	0.077	0.176	0	0.5479	0.9354	0.4323	0.8095	1.9288	0	1.1193	0	0.0174	0.6226	1.2974	2.8048	0.0359	0.2338			0.8499																				14.0036	0	1.990055394	21.1553	0.770121799	1.760424653	0	1.292160707	2.2061284	1.019639342	4.497175123	10.49992982	0	6.090211169	0	0.096497961	3.458777251	6.73995159	14.5706484	0.1867064	1.214740375	0	0	4.415220031	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	79.9736
R5826_855_0	2009	6																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		272.746476	9.928882	538.828282	735.350644	4.868947	8.312836	3.842067	24.124035	56.070782	775.405053	32.518733	0	0.517642	18.553796	35.603915	76.969714	0.39451	6.416889			23.323484																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000002	1024.000486	43.132791	0	0.199999	0.199999	0.2	0.2	0.2	0	0.2	0	0.200001	0.2	0.2	0.2	0.500002	0.2			0.199999																				879.809537	879.809954	37.05922	0	0.171837	0.171837	0.171837	0.171837	0.171837	0	0.171837	0	0.171838	0.171837	0.171837	0.171837	0.429596	0.171837			0.171837																				19.9971	0.727960768	1.66404632	0	0.836665246	1.4284528	0.660209267	4.145401802	9.635034967	0	5.587921523	0	0.088950566	3.188228643	6.118069942	13.22624474	0.169479918	1.102658955	0	0	4.00783752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.5842	0	11.8957	19.9971	0.727960768	1.66404632	0	0.836665246	1.4284528	0.660209267	4.145401802	9.635034967	0	5.587921523	0	0.088950566	3.188228643	6.118069942	13.22624474	0.169479918	1.102658955	0	0	4.00783752	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.5842	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.2219	0.0809	0.1849	0	0.6159	1.0515	0.486	0.91	2.1682	0	1.2582	0	0.0195	0.6999	1.4585	3.1529	0.0404	0.2629			0.9554																				15.5668	0	2.551223836	22.219	0.808845768	1.84894032	0	1.452546246	2.4799578	1.146198267	5.055372802	11.80319797	0	6.846139523	0	0.108476566	3.888086643	7.576525942	16.37918274	0.209881918	1.365516955	0	0	4.96324552	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.1511
R5826_856_0	2009	6																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		290.734642	9.056983	412.335726	969.191403	5.700536	9.630174	3.36617	25.179083	60.797618	481.087982	29.659743	0	0.184162	14.249592	36.531781	73.121171	0.221656	5.346609			23.65675																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999995	1024.000597	43.132813	0	0.199999	0.2	0.2	0.2	0.199999	0	0.199999	0	0.199997	0.2	0.199999	0.199999	0.5	0.2			0.2																				880.105467	880.105985	37.071704	0	0.171895	0.171895	0.171895	0.171895	0.171895	0	0.171895	0	0.171893	0.171895	0.171895	0.171895	0.429739	0.171895			0.171895																				21.3231	0.664258745	1.273832332	0	0.979893636	1.65537876	0.578627792	4.328158472	10.45080655	0	5.098361523	0	0.031656159	2.449433617	6.279630495	12.56916369	0.095254228	0.919055354	0	0	4.066477041	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.7631	0	11.8966	21.3231	0.664258745	1.273832332	0	0.979893636	1.65537876	0.578627792	4.328158472	10.45080655	0	5.098361523	0	0.031656159	2.449433617	6.279630495	12.56916369	0.095254228	0.919055354	0	0	4.066477041	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	72.7631	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.3692	0.0738	0.1415	0	0.7213	1.2185	0.4259	0.9501	2.3468	0	1.1514	0	0.0069	0.5377	1.497	2.9963	0.0227	0.2191			0.9694																				15.6477	0	2.558346483	23.6923	0.738065745	1.415369332	0	1.701206636	2.87392576	1.004563792	5.278245472	12.79758855	0	6.249713523	0	0.038605159	2.987116617	7.776598495	15.56546169	0.117961228	1.138144354	0	0	5.035863041	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.4108
R5826_857_0	2009	6																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		258.514265	9.410781	510.711628	696.979238	4.374073	7.46793	3.451564	21.6721	50.371824	734.943562	29.213572	0	0.465029	16.668013	31.985181	69.146616	0.354413	5.764684			20.952916																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1024.000002	1023.999602	43.132802	0	0.2	0.2	0.2	0.2	0.199999	0	0.199999	0	0.2	0.2	0.199999	0.199999	0.500001	0.2			0.199999																				893.071362	893.071013	37.617842	0	0.174428	0.174428	0.174428	0.174428	0.174427	0	0.174427	0	0.174428	0.174428	0.174427	0.174427	0.436071	0.174428			0.174427																				19.2393	0.700374643	1.600989111	0	0.762960805	1.302616094	0.602049405	3.780221059	8.786206145	0	5.095635723	0	0.081114078	2.907368172	5.579079166	12.06103679	0.154549231	1.005522301	0	0	3.654754279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3138	0	9.8686	19.2393	0.700374643	1.600989111	0	0.762960805	1.302616094	0.602049405	3.780221059	8.786206145	0	5.095635723	0	0.081114078	2.907368172	5.579079166	12.06103679	0.154549231	1.005522301	0	0	3.654754279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	67.3138	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.1377	0.0778	0.1779	0	0.5616	0.9589	0.4432	0.8298	1.9772	0	1.1474	0	0.0178	0.6382	1.33	2.8752	0.0368	0.2397			0.8712																				14.3203	0	2.099432815	21.377	0.778193643	1.778877111	0	1.324584805	2.261486094	1.045224405	4.610026059	10.76336014	0	6.243008723	0	0.098920078	3.545570172	6.909050166	14.93620979	0.191392231	1.245223301	0	0	4.525994279	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	81.6341
R5826_858_0	2009	7																																A	A	D	V	Coin	Coin	Coin	Coin	Coin	V	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		251.020482	9.137984	495.907177	676.775283	4.124151	7.041233	3.254351	20.433815	47.493713	713.6391	27.544387	0	0.438459	15.715646	30.157634	65.195764	0.334163	5.435306			19.755723																				$1024/Admit:1a	$1024/Admit:1b	"$0/Day(Days 1-20) $128(Days 21-100):2. $0 SNF 1,2. $128 SNF 2"	$0/Visit:6	20% Coins:10a	20% Coins:11a	20% Coins:11b	20% Coins:4a	"20% Coins:9a, 9b"	"$0/Visit:8, 8a"	"20% Coins:14h, 8a, 8b, 9a"	20% Coins:9a	20% Coins:12	"20% Coins:3, 5, 8b, 9a, 9d"	20% Coins:7a	"20% Coins:7b, 7d, 7f"	"50% Coins:7e, 7h"	"20% Coins:7d, 9a"			20% Coins:15																				1023.999977	1024.000479	43.132805	0	0.199999	0.2	0.199999	0.2	0.199999	0	0.199999	0	0.2	0.2	0.2	0.2	0.500001	0.199999			0.199999																				900.156396	900.156837	37.916281	0	0.175811	0.175811	0.175811	0.175811	0.175811	0	0.175811	0	0.175812	0.175811	0.175811	0.175811	0.43953	0.175811			0.175811																				18.8298	0.685468231	1.566912989	0	0.725071111	1.237926215	0.572150704	3.592489449	8.349917176	0	4.842606223	0	0.077086354	2.762983439	5.302043791	11.46213246	0.146874663	0.955586583	0	0	3.473273416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5823	0	8.8853	18.8298	0.685468231	1.566912989	0	0.725071111	1.237926215	0.572150704	3.592489449	8.349917176	0	4.842606223	0	0.077086354	2.762983439	5.302043791	11.46213246	0.146874663	0.955586583	0	0	3.473273416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	64.5823	10000	$1024/Admit	$1024/Admit	$0/Day(Days 1-20) $128(Days 21-100)	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	50% Coins	20% Coins			20% Coins																				2.0922	0.0762	0.1741	0	0.5337	0.9113	0.4212	0.7886	1.879	0	1.0904	0	0.0169	0.6065	1.2639	2.7324	0.035	0.2278			0.828																				13.6771	0	1.881702031	20.922	0.761631231	1.741013989	0	1.258807111	2.149181215	0.993319704	4.381088449	10.22889118	0	5.933003223	0	0.094007354	3.369495439	6.565971791	14.19453246	0.181887663	1.183384583	0	0	4.301249416	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	78.2595
R5863_001_0	2009	11																					4250											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	V											0	0	0	0	0	0	0	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	192.8682157	2.757960497	198.7280582	10.72008317	222.5830155	7.69047428	3.762693028	361.0603698	375.6745951	6.050633324	20.62133639	0	0.05496444	750.2915482	3654.822406	5320.372209	153.8533631	573.3226915	32.00366137	16.15035303	32.89378345	0	0	0	0	0	0	0	191.5496588	450											1a:  Acute - $500/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $1024/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$100/day for 1-14/15-100/2:  Non-Medicare Covered Stay - $0/$100/day for 1-14/15-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $200/trip	11a:  Durable Medical Equipment - 25.0%	11b:  Prosthetics Devices - 25.0%/11b:  Medical Supplies - 25.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $35 to $40/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $225/visit/9b:  Ambulatory Surgical Center Services - $225/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - $0/visit	8b:  Outpatient Diagnostic Radiological Services - 25.0%/8b:  Outpatient Therapeutic Radiological Services - 25.0%/8b:  Outpatient X-Ray Services - $15/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $40/visit/3:  Rehab Services (CORF) - $40/day/5:  Partial Hospitalization - $40/day	7a:  Primary Care - $15/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14c:  Physical Exams (Initial Exam) - $15/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $40/visit/7b:  Chiropractic Services - $40/visit/7f:  Podiatry Services - $40/visit/17a:  Vision Exams - $40/visit/18a:  Hearing Exams - $40/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $40/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $40/visit/7h:  Psychiatric Services - Individual - $40/visit/7h:  Psychiatric Services - Group - $40/visit	7c:  Occupational Therapy Services - $40/visit/7i:  Physical/Speech Therapy - $40/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $40/visit/9c:  Outpatient Substance Abuse Svcs - Group - $40/visit/7g:  Other Health Care Professional Services - $15 to $40/visit	15:  Medicare Part B Rx Drugs - 20.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Written health education materials - $0/service/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $15/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												500	1024	100	0	200	0.25	0.227573304	44.66744915	225	0	0.214982515	0	0.2	40	15.0110639	40	40	40	0	40	0.2	0	0	0	0	0	0	0	15	0											438.2965067	897.6312457	87.65930134	0	175.3186027	0.219148253	0.199489169	39.15517385	197.233428	-9.32E-19	0.188452171	0	0.175318603	35.06372054	13.15894357	35.1177056	35.06372054	35.06372054	0	35.06372054	0.175318603	0	0	0	0	0	0	0	13.1488952	0											7.0445	0.206302626	1.451696895	0	3.251911938	1.685354006	0.750616504	1.178115129	6.174632351	-5.64E-18	3.886135608	0	0.009636289	2.192334431	4.007800151	15.56993874	0.449555944	1.675235553	0	0.047190955	5.766892152	0	0	0	0	0	0	0	0.209888866	0	0	0	0	0	0	0	0	0	0	0	55.5577	0	7.871	7.0445	0.206302626	1.451696895	0	3.251911938	1.685354006	0.750616504	1.178115129	6.174632351	-5.64E-18	3.886135608	0	0.009636289	2.192334431	4.007800151	15.56993874	0.449555944	1.675235553	0	0.047190955	5.766892152	0	0	0	0	0	0	0	0.209888866	0	0	0	0	0	0	0	0	0	0	0	55.5577	10000	1a:  Acute - $1000/$0/admit for 1-90/1a:  Additional Days - $0/admit for 91-999	1b:  Psych - $1500/$0/admit for 1-190	2:  Skilled Nursing Services - $0/$120/day for 1-10/11-100/2:  Non-Medicare Covered Stay - $0/$120/day for 1-10/11-100	6:  Home Health Services - $0/visit	10a:  Ambulance - $200/trip	11a:  Durable Medical Equipment - 30.0%	11b:  Prosthetics Devices - 30.0%/11b:  Medical Supplies - 30.0%/11c:  Diabetes Monitoring Supplies - 20.0%	4a:  Emergency Care / Post Stabilization Care - $50/visit/4b:  Urgently Needed Care / Urgent Care Centers - $40 to $25/visit/4a:  Worldwide Coverage - $50/visit	9a:  Outpatient Hospital Services (Hospital Surgery) - $450/visit/9b:  Ambulatory Surgical Center Services - $450/visit	8a:  Outpatient Diagnostic Procedures/Tests - $0/visit/8a:  Outpatient Lab Services - 30.0%	8b:  Outpatient Diagnostic Radiological Services - 30.0%/8b:  Outpatient Therapeutic Radiological Services - 25.0%/8b:  Outpatient X-Ray Services - $20/visit		12:  Renal Dialysis - 20.0%/14i:  Diabetes Monitoring - $0/visit/14j:  Nutrition Therapy for Diabetes & Renal Dialysis - $0/visit	9d:  Cardiac Rehabilitation Services - $45/visit/3:  Rehab Services (CORF) - $45/day/5:  Partial Hospitalization - $45/day	7a:  Primary Care - $30/visit/17a:  Vision Exams - 30.0%/18a:  Hearing Exams - 30.0%/14c:  Physical Exams (Initial Exam) - $30/visit/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7d:  Physician Specialist Services - $45/visit/7b:  Chiropractic Services - $45/visit/7f:  Podiatry Services - $45/visit/17a:  Vision Exams - 30.0%/18a:  Hearing Exams - 30.0%/14d:  Pap Smears and Pelvic Exams Screening - $0/visit/14e:  Prostate Cancer Screening - $0/visit/14f:  Colorectal Screening - $0/visit/14g:  Bone Mass Measurement - $0/visit/14b:  Immunizations - $0/visit	7e:  Mental Hlth Spec-Non-Physician - Individual - $45/visit/7e:  Mental Hlth Spec-Non-Physician - Group - $45/visit/7h:  Psychiatric Services - Individual - $45/visit/7h:  Psychiatric Services - Group - $45/visit	7c:  Occupational Therapy Services - $45/visit/7i:  Physical/Speech Therapy - $45/visit		9c:  Outpatient Substance Abuse Svcs - Individual - $45/visit/9c:  Outpatient Substance Abuse Svcs - Group - $45/visit/7g:  Other Health Care Professional Services - $30 to $45/visit	15:  Medicare Part B Rx Drugs - 25.0%	13a:  Blood - $0/service/13a:  3-Pints Deductible Waived - $0/service							14b:  Other Immunizations - $0/visit/14a:  Written health education materials - $0/service/14a:  Nursing Hotline - $0/service/14c:  Routine Exams - $30/visit/14d:  Additional Pap - $0/visit/14d:  Addition Pelvic - $0/visit												1.7533	0.0376	0.258	0	0.4101	0.2532	0.1054	0.1509	1.576	0.1942	0.5602	0	0.0012	0.3094	0.9491	2.0626	0.0635	0.2365	0	0.0067	0.8904	0	0	0	0	0	0	0	0.0497	0											9.8682	0	0.077	8.7978	0.243910344	1.709743677	0	3.662018564	1.938559846	0.855979456	1.329034676	7.750669462	0.194246428	4.446339187	0	0.010848198	2.50177848	4.956903475	17.63250729	0.513030732	1.911769455	0	0.053854055	6.657326812	0	0	0	0	0	0	0	0.259587647	0	0	0	0	0	0	0	0	0	0	0	65.4259
R5863_801_0	2009	4																					10000											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	207.1924969	2.253734451	11.28628758	10.72008317	14.90195443	7.719979867	3.777798806	15.15999466	37.82853233	5.873542503	20.64205812	0	0.05496444	27.06483138	35.17159201	99.12022887	1.259834031	2.646600949	30.96440478	10981.81391	32.91105427	3.476147935	0	0	0	0	0	0	0	0											Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits											0.069858192	0.069858192	0.154230137	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	6.887194704	0.231	0.231	0	0	0	0	0	0	0	0											0.066704774	0.066704774	0.147268146	0	0.220572598	0.220572598	0.220572598	0.220572598	0.220572598	0.220572598	0.220572598	0	0.220572598	0.220572598	0.220572598	0.220572598	0.220572598	0.220572598	0.220572598	6.576304874	0.220572598	0.220572598	0	0	0	0	0	0	0	0											13.8207	0.150334848	1.662110653	0	3.286962797	1.702816012	0.833278896	3.3438794	8.343937639	1.295542527	4.553072378	0	0.012123649	5.969760161	7.75788941	21.86320635	0.277884865	0.583767646	6.829899194	6.018313029	7.259276728	0.766742979	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.3315	0	4.627	13.8207	0.150334848	1.662110653	0	3.286962797	1.702816012	0.833278896	3.3438794	8.343937639	1.295542527	4.553072378	0	0.012123649	5.969760161	7.75788941	21.86320635	0.277884865	0.583767646	6.829899194	6.018313029	7.259276728	0.766742979	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.3315	10000	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits											1.5959	0.0174	0.192	0	0.3783	0.196	0.0959	0.3797	0.974	0.1454	0.527	0	0.0014	0.6624	0.8922	2.5202	0.0321	0.0675	0.7827	0.6902	0.8282	0.0875	0	0	0	0	0	0	0	0											11.0658	0	0.073	15.4166	0.167693906	1.854083569	0	3.66530876	1.898775253	0.929172227	3.723620076	9.317979596	1.440914708	5.080055911	0	0.01352514	6.63212692	8.650095071	24.38339477	0.310001837	0.651243289	7.612562832	6.70853601	8.087431505	0.854225119	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.3973
R5863_803_0	2009	4																					10000											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	207.1924969	2.253734451	11.28628758	10.72008317	14.90195443	7.719979867	3.777798806	15.15999466	37.82853233	5.873542503	20.64205812	0	0.05496444	27.06483138	35.17159201	99.12022887	1.259834031	2.646600949	30.96440478	10981.81391	32.91105427	3.476147935	0	0	0	0	0	0	0	0											Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits											0.069858192	0.069858192	0.154230137	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	6.887194704	0.231	0.231	0	0	0	0	0	0	0	0											0.066704774	0.066704774	0.147268146	0	0.220572598	0.220572598	0.220572598	0.220572598	0.220572598	0.220572598	0.220572598	0	0.220572598	0.220572598	0.220572598	0.220572598	0.220572598	0.220572598	0.220572598	6.576304874	0.220572598	0.220572598	0	0	0	0	0	0	0	0											13.8207	0.150334848	1.662110653	0	3.286962797	1.702816012	0.833278896	3.3438794	8.343937639	1.295542527	4.553072378	0	0.012123649	5.969760161	7.75788941	21.86320635	0.277884865	0.583767646	6.829899194	6.018313029	7.259276728	0.766742979	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.3315	0	4.627	13.8207	0.150334848	1.662110653	0	3.286962797	1.702816012	0.833278896	3.3438794	8.343937639	1.295542527	4.553072378	0	0.012123649	5.969760161	7.75788941	21.86320635	0.277884865	0.583767646	6.829899194	6.018313029	7.259276728	0.766742979	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.3315	10000	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits											1.5959	0.0174	0.192	0	0.3783	0.196	0.0959	0.3797	0.974	0.1454	0.527	0	0.0014	0.6624	0.8922	2.5202	0.0321	0.0675	0.7827	0.6902	0.8282	0.0875	0	0	0	0	0	0	0	0											11.0658	0	0.073	15.4166	0.167693906	1.854083569	0	3.66530876	1.898775253	0.929172227	3.723620076	9.317979596	1.440914708	5.080055911	0	0.01352514	6.63212692	8.650095071	24.38339477	0.310001837	0.651243289	7.612562832	6.70853601	8.087431505	0.854225119	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.3973
R5863_804_0	2009	4																					10000											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	207.1924969	2.253734451	11.28628758	10.72008317	14.90195443	7.719979867	3.777798806	15.15999466	37.82853233	5.873542503	20.64205812	0	0.05496444	27.06483138	35.17159201	99.12022887	1.259834031	2.646600949	30.96440478	10981.81391	32.91105427	3.476147935	0	0	0	0	0	0	0	0											Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits											0.069858192	0.069858192	0.154230137	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	6.887194704	0.231	0.231	0	0	0	0	0	0	0	0											0.066704774	0.066704774	0.147268146	0	0.220572598	0.220572598	0.220572598	0.220572598	0.220572598	0.220572598	0.220572598	0	0.220572598	0.220572598	0.220572598	0.220572598	0.220572598	0.220572598	0.220572598	6.576304874	0.220572598	0.220572598	0	0	0	0	0	0	0	0											13.8207	0.150334848	1.662110653	0	3.286962797	1.702816012	0.833278896	3.3438794	8.343937639	1.295542527	4.553072378	0	0.012123649	5.969760161	7.75788941	21.86320635	0.277884865	0.583767646	6.829899194	6.018313029	7.259276728	0.766742979	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.3315	0	4.627	13.8207	0.150334848	1.662110653	0	3.286962797	1.702816012	0.833278896	3.3438794	8.343937639	1.295542527	4.553072378	0	0.012123649	5.969760161	7.75788941	21.86320635	0.277884865	0.583767646	6.829899194	6.018313029	7.259276728	0.766742979	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.3315	10000	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits											1.5959	0.0174	0.192	0	0.3783	0.196	0.0959	0.3797	0.974	0.1454	0.527	0	0.0014	0.6624	0.8922	2.5202	0.0321	0.0675	0.7827	0.6902	0.8282	0.0875	0	0	0	0	0	0	0	0											11.0658	0	0.073	15.4166	0.167693906	1.854083569	0	3.66530876	1.898775253	0.929172227	3.723620076	9.317979596	1.440914708	5.080055911	0	0.01352514	6.63212692	8.650095071	24.38339477	0.310001837	0.651243289	7.612562832	6.70853601	8.087431505	0.854225119	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.3973
R5863_806_0	2009	4																					10000											coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	coin	O	coin	coin	coin	coin	coin	coin	coin	V	coin	coin	T	P	V	P	V	P	O	V											0	0	0	0	0	0	0	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	207.1924969	2.253734451	11.28628758	10.72008317	14.90195443	7.719979867	3.777798806	15.15999466	37.82853233	5.873542503	20.64205812	0	0.05496444	27.06483138	35.17159201	99.12022887	1.259834031	2.646600949	30.96440478	10981.81391	32.91105427	3.476147935	0	0	0	0	0	0	0	0											Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits											0.069858192	0.069858192	0.154230137	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	6.887194704	0.231	0.231	0	0	0	0	0	0	0	0											0.066704774	0.066704774	0.147268146	0	0.220572598	0.220572598	0.220572598	0.220572598	0.220572598	0.220572598	0.220572598	0	0.220572598	0.220572598	0.220572598	0.220572598	0.220572598	0.220572598	0.220572598	6.576304874	0.220572598	0.220572598	0	0	0	0	0	0	0	0											13.8207	0.150334848	1.662110653	0	3.286962797	1.702816012	0.833278896	3.3438794	8.343937639	1.295542527	4.553072378	0	0.012123649	5.969760161	7.75788941	21.86320635	0.277884865	0.583767646	6.829899194	6.018313029	7.259276728	0.766742979	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.3315	0	4.627	13.8207	0.150334848	1.662110653	0	3.286962797	1.702816012	0.833278896	3.3438794	8.343937639	1.295542527	4.553072378	0	0.012123649	5.969760161	7.75788941	21.86320635	0.277884865	0.583767646	6.829899194	6.018313029	7.259276728	0.766742979	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	96.3315	10000	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits	Medicare Defined Benefits											1.5959	0.0174	0.192	0	0.3783	0.196	0.0959	0.3797	0.974	0.1454	0.527	0	0.0014	0.6624	0.8922	2.5202	0.0321	0.0675	0.7827	0.6902	0.8282	0.0875	0	0	0	0	0	0	0	0											11.0658	0	0.073	15.4166	0.167693906	1.854083569	0	3.66530876	1.898775253	0.929172227	3.723620076	9.317979596	1.440914708	5.080055911	0	0.01352514	6.63212692	8.650095071	24.38339477	0.310001837	0.651243289	7.612562832	6.70853601	8.087431505	0.854225119	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	107.3973
R5941_001_0	2009	10	H.6	H.7	I.7	I.8	I.9	I.10	I.11	I.12	I.13		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional	0		CORF	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemotherapy/Radiation	0	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	0	Coin	0	0	V	V	V	V	0	V	0	V	V	V	V	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		790.1512737	79.38150355	273.5608738	306.5347291	53.83691269	6.056321668	3.104618754	235.0913759	335.8448227	3281.429729	634.4414014	71.44335319	0	75.10711489	2689.747862	2217.159999	13.34159773	862.6671973	1738.597574	0	15.55553427	0	0	317.1784093	267.4787475	228.0466376	123.5570411	0	0	0	0	0.00487334	214.4867798	218.6689732	74.08457017	0.166258361	569.9732253	20.91096739	7.179735502	0	$200/day (days 1-10) w/$2000 yrly max	$200/day (days 1-10) w/$2000 yrly max	$100/day (for days 21-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$200 copay	$0 copay	$75/$125 copay for Lower/Higher Tier	$200 copay	20% coinsurance	$0 copay	$15 copay	$30 copay	$35 copay	$30 copay	$75/$125 copay for Lower/Higher Tier	0	20% coinsurance	0	0	$10/$20 copay; Exam/Cleaning 1/yr	$30 copay/ $50 limit	$30 copay / Covd up to $75	$30 copay	0	Silver Sneakers	0	$30 copay	$0 copay	$30 copay	$30 copay	$0 copay	20% coinsurance	$30 copay	$30 copay	20% coinsurance	0	200	200	100	0	100	0.2	0.2	50	200	0	70.24870082	200	0.2	0	15	30	35	30	81.20274914	0	0.2	0	0	19.47935514	30	30	30	0	0	0	30	0	30	30	0	0.2	30	30	0.2	0	135.2016698	53.02847174	93.15812603	0	93.15812603	0.186316252	0.186316252	46.57906302	186.3162521	0	65.44237324	186.3162521	0	0	13.9737189	27.94743781	32.60534411	27.94743781	75.64695939	0	0.186316252	0	0	19.47935514	27.94743781	27.94743781	27.94743781	0	0	0	0	0	27.94743781	27.94743781	0	0.186316252	27.94743781	27.94743781	0.186316252	0	8.9025	0.350789985	2.12370153	0	0.417945491	1.128391154	0.57844093	0.912528001	5.21444572	0	3.459945916	1.109254817	0	0	3.132148379	5.163661766	0.036250615	2.009111487	10.95996834	0	2.898248844	0	0	0.51486924	0.622945472	0.531109935	0.28775856	0	0	0	0	0	0.499529662	0.509269794	0	0.030976635	1.327440939	0.048700663	1.33770141	0	54.1076		3.936	8.9025	0.350789985	2.12370153	0	0.417945491	1.128391154	0.57844093	0.912528001	5.21444572	0	3.459945916	1.109254817	0	0	3.132148379	5.163661766	0.036250615	2.009111487	10.95996834	0	2.898248844	0	0	0.51486924	0.622945472	0.531109935	0.28775856	0	0	0	0	0	0.499529662	0.509269794	0	0.030976635	1.327440939	0.048700663	1.33770141	0	54.1076	4500	$225/day (days 1-10)	$225/day (days 1-10)	25% Coinsurance	$0 copay	$100 copay	30% Coinsurance	30% Coinsurance	$50 copay	$275 copay	0% Coinsurance	25% Coinsurance	$275 copay	20% coinsurance	$0 copay	$20 copay	$40 copay	$45 copay	$40 copay	25% Coinsurance		20% Coinsurance			50% Coinsurance	$40 copay	$40 copay / Covd up to $75	$40 copay		Silver Sneakers		$40 copay	$40 copay	$40 copay	$40 copay	$0 copay	30% Coinsurance	$40 copay	$40 copay	20% coinsurance		7.1782	0.1067	0.511		0.886	1.291	0.0922	0.5001	1.8251		2.7085	0.5345			1.7773	1.7402	0.0231	0.6548	3.885		0.6836			0.488	0.4224	0.3575	0.1937					0	0.9239	0.3173		0.234	0.3321	0.039	0.5572		28.2625		2.039858582	16.0806	0.457449102	2.6347491	0	1.303935996	2.419397743	0.670689863	1.41264075	7.039501722	0	6.16848218	1.643735503	0	0	4.909490685	6.903898804	0.059347533	2.663904451	14.84495895	0	3.581822282	0	0	1.00286924	1.045385231	0.888615476	0.481457214	0	0	0	0	3.29E-06	1.423450818	0.82651983	0	0.265011169	1.659533082	0.087661194	1.894932518	0	82.3701
R5941_002_0	2009	10	H.6	H.7	I.7	I.8	I.9	I.10	I.11	I.12	I.13		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional	0		CORF	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemo-Radiation	0	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	0	Coin	0	0	V	V	V	V	0	V	0	V	V	V	V	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		929.4252292	182.5399656	216.4399623	176.7872764	58.83349135	11.12124444	3.913098209	297.0507448	316.871782	3486.629862	745.261509	139.5157455	0	124.4999373	3094.78842	2501.768356	27.64018183	967.0356174	1839.855804	0	36.87225782	0	0	309.5344328	258.6172697	222.5507302	123.5570411	0	0	0	0	0.00449318	379.552301	415.9081415	64.89541461	0.295063566	624.1012071	22.20347715	13.48498513	0	$200/day (days 1-10); w/$2000 yrly max	$200/day (days 1-10); w/$2000 yrly max	$100/day (for days 21-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$175 copay	$0 copay	$75/$125 copay for Lower/Higher Tier	$175 copay	20% coinsurance	$0 copay	$10 coapy	$25 copay	$30 copay	$25 copay	$75/$125 copay for Lower/Higher Tier	0	20% coinsurance	0	0	$10/$20 copay; Exam/Cleaning 1/yr	$25 copay/ $50 limit	$25 copay / Covd up to $75	$25 copay	0	Silver Sneakers	0	$25 copay	$0 copay	$25 copay	$25 copay	$0 copay	20% coinsurance	$25 copay	$25 copay	20% coinsurance	0	200	200	100	0	100	0.2	0.2	50	175	0	91.98829006	175	0.2	0	10	25	30	25	80.3251997	0	0.2	0	0	19.47935514	25	25	25	0	0	0	25	0	25	25	0	0.2	25	25	0.2	0	134.4847245	87.65037281	90.68801385	0	90.68801385	0.181376028	0.181376028	45.34400692	158.7040242	0	83.42235323	158.7040242	0	0	9.068801385	22.67200346	27.20640415	22.67200346	72.84532822	0	0.181376028	0	0	19.47935514	22.67200346	22.67200346	22.67200346	0	0	0	0	0	22.67200346	22.67200346	0	0.181376028	22.67200346	22.67200346	0.181376028	0	10.4161	1.333308003	1.635709192	0	0.444624373	2.01712714	0.709742209	1.122455919	4.19073558	0	5.180955737	1.845142521	0	0	2.338835126	4.726675069	0.06266583	1.827052905	11.16874166	0	6.687743655	0	0	0.502460929	0.488614303	0.420472577	0.233440472	0	0	0	0	0	0.717100924	0.785789235	0	0.053517458	1.179135394	0.041949776	2.445853036	0	62.576		6.3738	10.4161	1.333308003	1.635709192	0	0.444624373	2.01712714	0.709742209	1.122455919	4.19073558	0	5.180955737	1.845142521	0	0	2.338835126	4.726675069	0.06266583	1.827052905	11.16874166	0	6.687743655	0	0	0.502460929	0.488614303	0.420472577	0.233440472	0	0	0	0	0	0.717100924	0.785789235	0	0.053517458	1.179135394	0.041949776	2.445853036	0	62.576	3750	$225/day (days 1-10)	$225/day (days 1-10)	25% Coinsurance	$0 copay	$100 copay	30% Coinsurance	30% Coinsurance	$50 copay	$275 copay	0% Coinsurance	25% Coinsurance	$275 copay	20% Coinsurance	$0 copay	$15 copay	$40 copay	$45 copay	$40 copay	25% Coinsurance		20% Coinsurance			50% Coinsurance	$40 copay	$40 copay / Covd up to $75	$40 copay		Silver Sneakers		$40 copay	$40 copay	$40 copay	$40 copay	$0 copay	30% Coinsurance	$40 copay	$40 copay	20% coinsurance		9.2277	0.781	2.3188		1.3561	1.0888	0.0047	0.6954	3.0506		3.5374	0.6651			1.516	2.9912	0.0593	1.0928	5.6199		2.9996			0.488	0.4143	0.3396	0.1886					0	2.0843	0.3806		0.3843	0.4366	0.0402	0.3932		42.1543		4.278355636	19.6438	2.114294019	3.954557834	0	1.800700828	3.105956144	0.714491511	1.817829861	7.241361778	0	8.718385095	2.510234443	0	0	3.854853385	7.717846446	0.121932086	2.919860985	16.78860358	0	9.687374223	0	0	0.990460929	0.902960031	0.760111359	0.422003156	0	0	0	0	3.56E-06	2.801435337	1.166365309	0	0.437850578	1.615727341	0.082183997	2.839056493	0	104.7302
R5941_003_0	2009	7	H.6	H.7	I.7	I.8	I.9	I.10	I.11	I.12	I.13		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional	0		CORF	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemotherapy/Radiation	0	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	0	Coin	0	0	V	V	V	V	0	V	0	V	V	V	V	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		886.3424247	33.57047521	154.3423068	275.5235343	22.8811462	7.549426648	1.354505909	212.8859404	227.2148017	2888.963117	538.7651875	61.81880191	0	51.99329697	2384.373689	1892.709039	28.60937933	555.5451301	1307.907914	0	24.98955225	0	0	309.5344328	219.5593062	192.8127753	107.046946	0	0	0	1.637584157	0.002519245	268.6167844	177.8786742	56.36155744	0.356036198	454.0902784	17.58800374	5.382065435	0	$200/day (days 1-10) w/$2000 yrly max	$200/day (days 1-10) w/$2000 yrly max	$100/day (for days 21-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$200 copay	$0 copay	$75/$125 copay for Lower/Higher Tier	$200 copay	20% coinsurance	$0 copay	$15 copay	$30 copay	$35 copay	$30 copay	$75/$125 copay for Lower/Higher Tier	0	20% coinsurance	0	0	$10/$20 copay; Exam/Cleaning 1/yr	$30 copay/ $50 limit	$30 copay / Covd up to $75	$30 copay	0	Silver Sneakers	0	$30 copay	$0 copay	$30 copay	$30 copay	$0 copay	20% coinsurance	$30 copay	$30 copay	20% coinsurance	0	200	200	100	0	100	0.2	0.2	50	200	0	71.78965718	200	0.2	0	15	30	35	30	81.05134474	0	0.2	0	0	19.47935514	30	30	30	0	0	0	30	0	30	30	0	0.2	30	30	0.2	0	123.2329362	160.3912014	93.94341794	0	93.94341794	0.187886836	0.187886836	46.97170897	187.8868359	0	67.44165768	187.8868359	0	0	14.09151269	28.18302538	32.88019628	28.18302538	76.14240354	0	0.187886836	0	0	19.47935514	28.18302538	28.18302538	28.18302538	0	0	0	28.18302538	0	28.18302538	28.18302538	0	0.187886836	28.18302538	28.18302538	0.187886836	0	9.1022	0.448700737	1.208286986	0	0.179127757	1.418437886	0.254493829	0.833301369	3.557555847	0	3.027934779	0.967911591	0	0	2.799952675	4.445188907	0.078390167	1.304745209	8.298937684	0	4.695207902	0	0	0.502460929	0.515653792	0.452837278	0.2514089	0	0	0	0.003846006	0	0.630869471	0.417763266	0	0.066894515	1.06646982	0.04130693	1.011219245	0	47.5811		3.0352	9.1022	0.448700737	1.208286986	0	0.179127757	1.418437886	0.254493829	0.833301369	3.557555847	0	3.027934779	0.967911591	0	0	2.799952675	4.445188907	0.078390167	1.304745209	8.298937684	0	4.695207902	0	0	0.502460929	0.515653792	0.452837278	0.2514089	0	0	0	0.003846006	0	0.630869471	0.417763266	0	0.066894515	1.06646982	0.04130693	1.011219245	0	47.5811	4500	$275/day (days 1-10)	$275/day (days 1-10)	25% Coinsurance	$0 copay	$100 copay	30% Coinsurance	30% Coinsurance	$50 copay	$275 copay	0% Coinsurance	25% Coinsurance	$275 copay	20% Coinsurance	$0 copay	$20 copay	$40 copay	$45 copay	$40 copay	25% Coinsurance		20% Coinsurance			50% Coinsurance	$40 copay	$40 copay / Covd up to $75	$40 copay		Silver Sneakers		$40 copay	$40 copay	$40 copay	$40 copay	$0 copay	30% Coinsurance	$40 copay	$40 copay	20% coinsurance		10.6999	0.379	1.5263		0.9741	1.4359	0.0217	0.5913	3.6753		3.0452	0.5288			2.25	3.272	0.037	1.092	5.5298		2.8602			0.4742	0.5148	0.445	0.247					0	0.9476	0.2441		0.571	0.5633	0.0325	0.8499		42.8078		2.729269147	19.8021	0.82769261	2.734573297	0	1.153252363	2.854366271	0.276152975	1.424624841	7.232895637	0	6.073132238	1.49673746	0	0	5.049928615	7.717198425	0.115343744	2.396721099	13.82875792	0	7.55538726	0	0	0.976650705	1.03042658	0.897790823	0.498440861	0	0	0	0.003846006	5.78E-06	1.578425403	0.661849668	0	0.637851677	1.629746133	0.073851783	1.861124708	0	90.3889
R5941_004_0	2009	8	H.6	H.7	I.7	I.8	I.9	I.10	I.11	I.12	I.13		OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional	Professional	0		Rehab Services	Bone Mass Measurement	Chiropractic	Podiatric	Physical Exam	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Chemo-Radiation	0	D	D	D	V	T	Coin	Coin	V	V	V	V	V	Coin	V	V	V	V	V	V	0	Coin	0	0	V	V	V	V	0	V	0	V	V	V	V	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	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0		1035.596711	113.1473147	313.9148061	235.2636239	47.49106632	12.41787263	3.893099049	265.6202205	298.7365078	3476.460424	714.0699435	106.9380109	0	103.4883976	3018.247323	2464.755911	29.49336591	885.0995348	1649.013391	0	24.28904497	0	0	309.5344328	228.859594	192.8127753	107.046946	0	0	0	31.73644193	0.003901408	335.0611837	314.8361626	60.00089608	0.294153598	510.3447004	23.59585801	9.663405264	0	$200/day (days 1-10); w/$2000 yrly max	$200/day (days 1-10); w/$2000 yrly max	$100/day (for days 21-100)	$0 copay	$100 copay	20% coinsurance	20% coinsurance	$50 copay	$175 copay	$0 copay	$75/$125 copay for Lower/Higher Tier	$175 copay	20% coinsurance	$0 copay	$10 coapy	$25 copay	$30 copay	$25 copay	$75/$125 copay for Lower/Higher Tier	0	20% coinsurance	0	0	$10/$20 copay; Exam/Cleaning 1/yr	$25 copay/ $50 limit	$25 copay / Covd up to $75	$25 copay	0	Silver Sneakers	0	$25 copay	$0 copay	$25 copay	$25 copay	$0 copay	20% coinsurance	$25 copay	$25 copay	20% coinsurance	0	200	200	100	0	100	0.2	0.2	50	175	0	92.01674876	175	0.2	0	10	25	30	25	80.53445967	0	0.2	0	0	19.47935514	25	25	25	0	0	0	25	0	25	25	0	0.2	25	25	0.2	0	119.2958175	118.0285438	89.19573089	0	89.19573089	0.178391462	0.178391462	44.59786544	156.092529	0	82.07501159	156.092529	0	0	8.919573089	22.29893272	26.75871927	22.29893272	71.83329992	0	0.178391462	0	0	19.47935514	22.29893272	22.29893272	22.29893272	0	0	0	22.29893272	0	22.29893272	22.29893272	0	0.178391462	22.29893272	22.29893272	0.178391462	0	10.2952	1.112884399	2.333321714	0	0.353000031	2.21524245	0.69449563	0.987174571	3.885878085	0	4.883941574	1.391018714	0	0	2.243456467	4.580118853	0.065767058	1.644731248	9.871172792	0	4.332958238	0	0	0.502460929	0.425277057	0.358293259	0.198919387	0	0	0	0.058974065	0	0.622625566	0.585042534	0	0.05247449	0.948345178	0.043846871	1.723868991	0	56.4105		6.7721	10.2952	1.112884399	2.333321714	0	0.353000031	2.21524245	0.69449563	0.987174571	3.885878085	0	4.883941574	1.391018714	0	0	2.243456467	4.580118853	0.065767058	1.644731248	9.871172792	0	4.332958238	0	0	0.502460929	0.425277057	0.358293259	0.198919387	0	0	0	0.058974065	0	0.622625566	0.585042534	0	0.05247449	0.948345178	0.043846871	1.723868991	0	56.4105	4500	$275/day (days 1-10)	$275/day (days 1-10)	20% Coinsurance	$0 copay	$100 copay	30% Coinsurance	30% Coinsurance	$50 copay	$275 copay	20% Coinsurance	20% Coinsurance	$275 copay	20% Coinsurance	$0 copay	$15 copay	$40 copay	$45 copay	$40 copay	20% Coinsurance	0	20% Coinsurance	0	0	50% Coinsurance	$40 copay	$40 copay / Covd up to $75	$40 copay	0	Silver Sneakers	0	$40 copay	$40 copay	$40 copay	$40 copay	$0 copay	20% Coinsurance	$40 copay	$40 copay	20% coinsurance	0	14.7514	1.1883	2.7531	0	1.5217	1.2609	0.0127	0.7691	4.3245	1.5868	3.1695	0.5295	0	0	1.6487	3.7173	0.0515	1.0072	5.6688	0	5.9353	0	0	0.4742	0.4799	0.4225	0.2345	0	0	0	0	0	1.1075	0.1648	0	0.2684	0.5862	0.0601	0.8379	0	54.5324		6.548070797	25.0466	2.301160551	5.086423131	0	1.874737652	3.476151495	0.707173247	1.756308359	8.210356589	1.586779477	8.053485731	1.920549161	0	0	3.892172813	8.297436054	0.117289064	2.651926358	15.53996865	0	10.26829842	0	0	0.976650705	0.90518176	0.780759862	0.433466914	0	0	0	0.058974065	3.55E-06	1.730136035	0.749861016	0	0.320850603	1.534562502	0.103964572	2.561742664	0	110.9429
R5941_801_0	2009	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	V																																																			0		243.1016312	2.910730077	22.81193579	5.388048599	8.674817607	16.75379201	0.330654234	14.10552597	47.21050875	10.66751501	28.81523503	0	0.241717617	28.35532428	43.3238128	117.4249723	1.335926058	4.495803384	29.19626314	38.66136897	54.05483238	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.077173928	0.077173928	0.183565292	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.057586571	0.057586571	0.13697496	0	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362																			13.9994	0.167618964	3.124663997	0	1.495281452	2.887857196	0.05699499	2.43137462	8.13769249	1.838763425	4.966892498	0	0.041664953	4.887617515	7.467741302	20.24058501	0.230274058	0.774943257	5.032570452	6.66407417	9.317451033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.7635		31.89	13.9994	0.167618964	3.124663997	0	1.495281452	2.887857196	0.05699499	2.43137462	8.13769249	1.838763425	4.966892498	0	0.041664953	4.887617515	7.467741302	20.24058501	0.230274058	0.774943257	5.032570452	6.66407417	9.317451033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.7635	6000																																																																																	0			13.9994	0.167618964	3.124663997	0	1.495281452	2.887857196	0.05699499	2.43137462	8.13769249	1.838763425	4.966892498	0	0.041664953	4.887617515	7.467741302	20.24058501	0.230274058	0.774943257	5.032570452	6.66407417	9.317451033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.7635
R5941_802_0	2009	6																																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	V																																																			0		236.9884372	2.837534939	20.13147652	2.88422746	7.048453858	15.75778357	0.179637296	15.40830238	38.46165587	7.688826041	20.76916033	0	0.174222835	20.4376704	32.4599824	87.97961881	1.000930747	3.368440802	21.87504115	28.96668772	38.48728719	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.074429411	0.074429411	0.197627781	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.055538635	0.055538635	0.147468278	0	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362																			13.162	0.157592816	2.968754178	0	1.214944544	2.716174861	0.030964146	2.655934662	6.629649552	1.325325729	3.579987688	0	0.030030853	3.522848649	5.595138922	15.16507876	0.172530795	0.580619361	3.770608765	4.992998453	6.634067631	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.9053		25.47	13.162	0.157592816	2.968754178	0	1.214944544	2.716174861	0.030964146	2.655934662	6.629649552	1.325325729	3.579987688	0	0.030030853	3.522848649	5.595138922	15.16507876	0.172530795	0.580619361	3.770608765	4.992998453	6.634067631	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.9053	6000																																																																																	0			13.162	0.157592816	2.968754178	0	1.214944544	2.716174861	0.030964146	2.655934662	6.629649552	1.325325729	3.579987688	0	0.030030853	3.522848649	5.595138922	15.16507876	0.172530795	0.580619361	3.770608765	4.992998453	6.634067631	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.9053
R5941_805_0	2009	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	V																																																			0		243.1016312	2.910730077	22.81193579	5.388048599	8.674817607	16.75379201	0.330654234	14.10552597	47.21050875	10.66751501	28.81523503	0	0.241717617	28.35532428	43.3238128	117.4249723	1.335926058	4.495803384	29.19626314	38.66136897	54.05483238	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.077173928	0.077173928	0.183565292	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.057586571	0.057586571	0.13697496	0	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362																			13.9994	0.167618964	3.124663997	0	1.495281452	2.887857196	0.05699499	2.43137462	8.13769249	1.838763425	4.966892498	0	0.041664953	4.887617515	7.467741302	20.24058501	0.230274058	0.774943257	5.032570452	6.66407417	9.317451033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.7635		31.89	13.9994	0.167618964	3.124663997	0	1.495281452	2.887857196	0.05699499	2.43137462	8.13769249	1.838763425	4.966892498	0	0.041664953	4.887617515	7.467741302	20.24058501	0.230274058	0.774943257	5.032570452	6.66407417	9.317451033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.7635	6000																																																																																	0			13.9994	0.167618964	3.124663997	0	1.495281452	2.887857196	0.05699499	2.43137462	8.13769249	1.838763425	4.966892498	0	0.041664953	4.887617515	7.467741302	20.24058501	0.230274058	0.774943257	5.032570452	6.66407417	9.317451033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.7635
R5941_806_0	2009	6																																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	V																																																			0		236.9884372	2.837534939	20.13147652	2.88422746	7.048453858	15.75778357	0.179637296	15.40830238	38.46165587	7.688826041	20.76916033	0	0.174222835	20.4376704	32.4599824	87.97961881	1.000930747	3.368440802	21.87504115	28.96668772	38.48728719	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.074429411	0.074429411	0.197627781	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.055538635	0.055538635	0.147468278	0	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362																			13.162	0.157592816	2.968754178	0	1.214944544	2.716174861	0.030964146	2.655934662	6.629649552	1.325325729	3.579987688	0	0.030030853	3.522848649	5.595138922	15.16507876	0.172530795	0.580619361	3.770608765	4.992998453	6.634067631	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.9053		25.47	13.162	0.157592816	2.968754178	0	1.214944544	2.716174861	0.030964146	2.655934662	6.629649552	1.325325729	3.579987688	0	0.030030853	3.522848649	5.595138922	15.16507876	0.172530795	0.580619361	3.770608765	4.992998453	6.634067631	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.9053																																																																																		0			13.162	0.157592816	2.968754178	0	1.214944544	2.716174861	0.030964146	2.655934662	6.629649552	1.325325729	3.579987688	0	0.030030853	3.522848649	5.595138922	15.16507876	0.172530795	0.580619361	3.770608765	4.992998453	6.634067631	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.9053
R5941_807_0	2009	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	V																																																			0		243.1016312	2.910730077	22.81193579	5.388048599	8.674817607	16.75379201	0.330654234	14.10552597	47.21050875	10.66751501	28.81523503	0	0.241717617	28.35532428	43.3238128	117.4249723	1.335926058	4.495803384	29.19626314	38.66136897	54.05483238	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.077173928	0.077173928	0.183565292	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.057586571	0.057586571	0.13697496	0	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362																			13.9994	0.167618964	3.124663997	0	1.495281452	2.887857196	0.05699499	2.43137462	8.13769249	1.838763425	4.966892498	0	0.041664953	4.887617515	7.467741302	20.24058501	0.230274058	0.774943257	5.032570452	6.66407417	9.317451033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.7635		31.89	13.9994	0.167618964	3.124663997	0	1.495281452	2.887857196	0.05699499	2.43137462	8.13769249	1.838763425	4.966892498	0	0.041664953	4.887617515	7.467741302	20.24058501	0.230274058	0.774943257	5.032570452	6.66407417	9.317451033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.7635																																																																																		0			13.9994	0.167618964	3.124663997	0	1.495281452	2.887857196	0.05699499	2.43137462	8.13769249	1.838763425	4.966892498	0	0.041664953	4.887617515	7.467741302	20.24058501	0.230274058	0.774943257	5.032570452	6.66407417	9.317451033	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.7635
R5941_808_0	2009	6																																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	V																																																			0		236.9884372	2.837534939	20.13147652	2.88422746	7.048453858	15.75778357	0.179637296	15.40830238	38.46165587	7.688826041	20.76916033	0	0.174222835	20.4376704	32.4599824	87.97961881	1.000930747	3.368440802	21.87504115	28.96668772	38.48728719	0																			Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare	Similar to 2009 FFS Medicare																			0.074429411	0.074429411	0.197627781	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231																			0.055538635	0.055538635	0.147468278	0	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362	0.172370362																			13.162	0.157592816	2.968754178	0	1.214944544	2.716174861	0.030964146	2.655934662	6.629649552	1.325325729	3.579987688	0	0.030030853	3.522848649	5.595138922	15.16507876	0.172530795	0.580619361	3.770608765	4.992998453	6.634067631	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.9053		25.47	13.162	0.157592816	2.968754178	0	1.214944544	2.716174861	0.030964146	2.655934662	6.629649552	1.325325729	3.579987688	0	0.030030853	3.522848649	5.595138922	15.16507876	0.172530795	0.580619361	3.770608765	4.992998453	6.634067631	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.9053	6000																																																																																	0			13.162	0.157592816	2.968754178	0	1.214944544	2.716174861	0.030964146	2.655934662	6.629649552	1.325325729	3.579987688	0	0.030030853	3.522848649	5.595138922	15.16507876	0.172530795	0.580619361	3.770608765	4.992998453	6.634067631	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	74.9053
R6801_001_0	2009	11																					0											A	A	D	V	T	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	S	Coin	T	V	V	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	503.1141937	14.7479035	294.9140827	1711.648431	1230.405566	44.85356852	35.59037095	27.3729064	32.98268585	7.72735232	15.52389864	115.6284749	0.288586757	33.47253506	74.7007426	135.7544184	1.724106778	1.874876171	45.12725487	44.92243481	970.7701918	9.022765688	330	300	175.4782086	0	0	0	0	10800											PBP: 1A IP Acute: $1064 per admit	1B IP Psych: $1064 per admit	"2 SNF: $133, days 21 - 100"	6 Home Health: $0	10A Ambulance: 20%	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: 20%, 4B Urgent Care: 20%"	9B ASC Services: 20%	8A OP C/D/T: 20%	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	9A OP Hospital: $0	12 Renal Dialysis: 20%	"3 CORF: 20%, 5 Partial Hosp: 50%, 9D Cardiac Rehab: 20%"	"7A PCP: 20%, 14B Immunizations: 20%, 14C Routine Physical Exams: $0, 14D Pap Smears: 20%, 14D Pelvic Exams: 20%, 14E Prostate Screening: 20%, 14F Colorectal Screening: 20%, 14G Bone Mass Measurement: 20%, 14H Mammography: 20%, 14I Diabetes Monitoring: 20%"	7D Physician Specialist: 20%	"7E Mental Health Individual: 50%, Group: 50%, 7H Psychiatric Individual: 50%, Group: 50%, 9C Outpatient Sub Abuse: 50%"	"7C Occupational Therapy: 20%, 7I Physical and Speech Therapy: 20%"	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	"7G Other Health Care: 20%, 18A Medicare Covered Hearing Exams: 20%, 7B Chiropractic: 20%, 7F Podiatry: 20%"	15 Part B Drugs: 20%	"13A Blood: 20%, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: 20%"	"10B Transportation: $0, 24 one-way trips"	16A Preventive Dental Services: $15	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: 20%, Routine: $0 with a $200 allowance"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	OTC Drug Card: $56											982.6366402	498.8076626	337.7774572	0	45.46345198	0.231	0.231	0.231	0.231	0.231	0.231	19.91697863	33.31574566	0.231	0.230272424	0.231	0.231	0.231	0.231	0.203490716	17.15110592	0.231	0	15	39.59465995	0	0	0	0	0											982.6366402	498.8076626	337.7774572	0	45.46345198	0.231	0.231	0.231	0.231	0.231	0.231	19.91697863	33.31574566	0.231	0.230272424	0.231	0.231	0.231	0.231	0.203490716	17.15110592	0.231	0	15	39.59465995	0	0	0	0	0											41.1982	0.613030606	8.301277412	0	4.661540365	10.36117433	8.22137569	6.323141379	7.619000431	1.785018386	3.586020585	0.191914155	0.000801207	7.732155598	17.20152104	31.35927064	0.398268666	0.433096396	10.42439587	9.141298403	1.387481865	2.084258874	0	0.375	0.579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	173.9782	0	0	41.1982	0.613030606	8.301277412	0	4.661540365	10.36117433	8.22137569	6.323141379	7.619000431	1.785018386	3.586020585	0.191914155	0.000801207	7.732155598	17.20152104	31.35927064	0.398268666	0.433096396	10.42439587	9.141298403	1.387481865	2.084258874	0	0.375	0.579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	173.9782	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	41.1982	0.613030606	8.301277412	0	4.661540365	10.36117433	8.22137569	6.323141379	7.619000431	1.785018386	3.586020585	0.191914155	0.000801207	7.732155598	17.20152104	31.35927064	0.398268666	0.433096396	10.42439587	9.141298403	1.387481865	2.084258874	0	0.375	0.579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	173.9782
R6801_002_0	2009	8																					0											D	A	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	Coin	V	S	V	T	V	V	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	2532.165065	6.973365491	185.7183547	781.9175178	778.7146634	27.82332417	23.17064005	522.7371781	231.6111871	6.589593967	14.8285429	196.2638741	0.255092599	747.7275034	11424.5284	12681.6476	86.65804901	670.0079685	49.60933561	16523.60653	857.4416241	671.8263382	210	300	163.2179037	0	0	0	0	0											"PBP: 1A IP Acute: $199 per day, days 1 - 10"	1B IP Psych: $1000 per admit	"2 SNF: $130, days 21 - 100"	6 Home Health: $0	10A Ambulance: $150	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $50"	9B ASC Services: $175	8A OP C/D/T: 20%	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $25	"3 CORF: $25, 5 Partial Hosp: $30, 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 Individual: $30, Group: $10, 7H Psychiatric Individual: $30, Group: $10,  9C Outpatient Sub Abuse Individual: $30, Group: $10"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $25, 7B Chiropractic: $30, 7F Podiatry: $30, 8A OP C/D/T: 20%"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $10"	"10B Transportation: $0, 12 one-way trips"	16A Preventive Dental Services: $10	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $10, Routine: $0 with a $150 allowance"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	OTC Drug Card: Not Covered											213.6000065	975.0409358	127.6064771	0	152.9991191	0.210006705	0.06459264	78.96482103	316.9124171	0.247950742	0.251576334	5.8368214	9.770315417	36.14122634	5.043492427	8.998238122	29.8202031	25.37625478	0.180574068	4.811287636	18.68577599	15.26652967	0	10	20	0	0	0	0	0											202.6106701	942.7485262	119.2379811	0	152.7400948	0.205818484	0.063544669	78.96199592	307.1472358	0.243963685	0.247608498	5.8368214	9.770315417	34.48547095	4.903029089	8.900296013	29.55241072	25.33114178	0.176229808	4.658077168	18.40220483	14.91812707	0	10	20	0	0	0	0	0											42.7536	0.54784417	1.845390139	0	9.911745962	5.726554411	1.472370647	3.439697577	5.92822799	1.607621625	3.671673243	0.095463098	0.000207695	2.148811258	4.667899591	9.405868133	0.213412855	1.414338903	8.742643679	6.414019526	1.314901366	0.835199224	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.6796	0	3.7096	42.7536	0.54784417	1.845390139	0	9.911745962	5.726554411	1.472370647	3.439697577	5.92822799	1.607621625	3.671673243	0.095463098	0.000207695	2.148811258	4.667899591	9.405868133	0.213412855	1.414338903	8.742643679	6.414019526	1.314901366	0.835199224	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.6796	3350	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	42.7536	0.54784417	1.845390139	0	9.911745962	5.726554411	1.472370647	3.439697577	5.92822799	1.607621625	3.671673243	0.095463098	0.000207695	2.148811258	4.667899591	9.405868133	0.213412855	1.414338903	8.742643679	6.414019526	1.314901366	0.835199224	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	112.6796
R6801_003_0	2009	9																					0											D	A	D	V	T	Coin	Coin	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	S	V	T	V	V	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	3691.666926	10.24956706	358.6509031	928.9977805	1013.847477	46.35421755	34.49339354	626.0313293	418.8845856	4340.714807	25.53222165	165.740198	0.276058259	881.459056	18508.37917	21212.60452	211.8956962	2163.450391	65.73927027	28751.09901	1438.346938	1164.901835	210	300	163.2179037	0	0	0	0	0											"PBP: 1A IP Acute: $125 per day, days 1 - 10"	1B IP Psych: $1000 per admit	"2 SNF: $50, days 21 - 100"	6 Home Health: $0	10A Ambulance: $75	"11A DME: 10% For DME less than $1,000 and 20% for DME > $1,000"	"11B Prosthetic Medical Supplies: 12%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $100	8A OP C/D/T: 0%	"8B All Radiation Therapy: 10%, Radiation Therapy and Chemo: 20%, X-Ray: 0%"	9A OP Hospital: $0	12 Renal Dialysis: $15	"3 CORF: $15, 5 Partial Hosp: $15, 9D Cardiac Rehab: $25"	"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: $15	"7E Mental Health Individual: $15, Group: $5, 7H Psychiatric Individual: $15, Group: $5,  9C Outpatient Sub Abuse Individual: $15, Group: $5"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	"8B All Radiation Therapy: 10%, Radiation Therapy and Chemo: 20%, X-Ray: 0%"	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $25, 7B Chiropractic: $25, 7F Podiatry: $15, 8A OP C/D/T: 0%"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $10"	"10B Transportation: $0, 12 one-way trips"	16A Preventive Dental Services: $10	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $10, Routine: $0 with a $150 allowance"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	OTC Drug Card: Not Covered											139.2609952	952.9381315	47.59781741	0	78.0803133	0.131007376	0.03345299	83.88370671	229.3858348	1.537983477	0.167779243	5.885977125	10.32045256	42.73631859	2.952056997	6.091713422	15.35610233	15.41483425	0.110488758	2.502527376	25.46867507	16.49499976	0	10	20	0	0	0	0	0											135.8986517	941.1379053	44.99790788	0	77.87873928	0.129652034	0.0332332	83.88090902	226.6737248	1.537983477	0.166481253	5.885977125	10.32045256	42.12749681	2.905130445	6.05842035	15.24927768	15.38060693	0.109101414	2.468136269	25.35496896	16.39468943	0	10	20	0	0	0	0	0											41.8077	0.803854673	1.344878358	0	6.579763613	6.009918591	1.146325841	4.376006414	7.912510775	0.556328971	4.250636256	0.081295251	0.000237421	3.094471964	4.480771317	10.70957291	0.269271359	2.772931673	7.172247344	5.913469188	3.039103496	1.591516984	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.4349	0	1.7185	41.8077	0.803854673	1.344878358	0	6.579763613	6.009918591	1.146325841	4.376006414	7.912510775	0.556328971	4.250636256	0.081295251	0.000237421	3.094471964	4.480771317	10.70957291	0.269271359	2.772931673	7.172247344	5.913469188	3.039103496	1.591516984	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.4349	3350	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	41.8077	0.803854673	1.344878358	0	6.579763613	6.009918591	1.146325841	4.376006414	7.912510775	0.556328971	4.250636256	0.081295251	0.000237421	3.094471964	4.480771317	10.70957291	0.269271359	2.772931673	7.172247344	5.913469188	3.039103496	1.591516984	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.4349
R6801_004_0	2009	9																					0											D	A	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	Coin	V	S	V	T	V	V	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	2532.165065	6.973365491	185.7183547	781.9175178	778.7146634	27.82332417	23.17064005	522.7371781	231.6111871	6.589593967	14.8285429	196.2638741	0.255092599	747.7275034	11424.5284	12681.6476	86.65804901	670.0079685	49.60933561	16523.60653	857.4416241	671.8263382	210	300	163.2179037	0	0	0	0	0											"PBP: 1A IP Acute: $160 per day, days 1 - 10"	1B IP Psych: $1000 per admit	"2 SNF: $100, days 21 - 100"	6 Home Health: $0	10A Ambulance: $150	11A DME: 30%	"11B Prosthetic Medical Supplies: 30%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $100	8A OP C/D/T: 20%	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $25	"3 CORF: $25, 5 Partial Hosp: $25, 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 Individual: $25, Group: $10, 7H Psychiatric Individual: $25, Group: $10,  9C Outpatient Sub Abuse Individual: $25, Group: $10"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $25, 7B Chiropractic: $25, 7F Podiatry: $25, 8A OP C/D/T: 20%"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $10"	"10B Transportation: $0, 12 one-way trips"	16A Preventive Dental Services: $10	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $10, Routine: $0 with a $150 allowance"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	OTC Drug Card: Not Covered											174.6000065	975.0409358	97.60647714	0	152.9991191	0.308755867	0.08930153	78.22208596	241.9124171	0.247950742	0.251576334	5.8368214	9.770315417	36.14122634	5.043492427	8.998238122	25.0702031	25.37625478	0.180574068	4.591639949	18.68577599	15.26652967	0	10	20	0	0	0	0	0											162.4881062	940.1071196	88.38141002	0	152.7189076	0.304791415	0.08830955	78.21477	230.9183348	0.243637557	0.247283943	5.8368214	9.770315417	34.35003593	4.891539678	8.89228469	24.75326384	25.32745169	0.175874462	4.424637667	18.3790097	14.88962896	0	10	20	0	0	0	0	0											34.2872	0.546309212	1.367837505	0	9.910371058	8.480310336	2.046188789	3.407147347	4.456939136	1.605472578	3.666860563	0.095463098	0.000207695	2.140372217	4.656961166	9.397401735	0.178755796	1.414132871	8.725015231	6.092580987	1.313243994	0.833603742	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.1444	0	4.0543	34.2872	0.546309212	1.367837505	0	9.910371058	8.480310336	2.046188789	3.407147347	4.456939136	1.605472578	3.666860563	0.095463098	0.000207695	2.140372217	4.656961166	9.397401735	0.178755796	1.414132871	8.725015231	6.092580987	1.313243994	0.833603742	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.1444	3350	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	34.2872	0.546309212	1.367837505	0	9.910371058	8.480310336	2.046188789	3.407147347	4.456939136	1.605472578	3.666860563	0.095463098	0.000207695	2.140372217	4.656961166	9.397401735	0.178755796	1.414132871	8.725015231	6.092580987	1.313243994	0.833603742	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	105.1444
R6801_005_0	2009	8																					0											D	A	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	Coin	V	S	V	T	V	V	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	2724.964178	7.674978837	193.7126442	810.3714347	826.989258	31.07161534	26.3270356	554.2907233	251.5171495	6.959450102	15.45829581	203.7357508	0.27399205	797.4186013	12208.33117	13534.63772	93.48855858	732.3308585	52.11795344	17861.15236	995.4643114	710.3108565	210	300	163.2179037	0	0	0	0	0											"PBP: 1A IP Acute: $225 per day, days 1 - 10"	1B IP Psych: $1000 per admit	"2 SNF: $100, days 21 - 100"	6 Home Health: $0	10A Ambulance: $150	11A DME: 35%	"11B Prosthetic Medical Supplies: 35%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $225	8A OP C/D/T: 20%	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $35	"3 CORF: $35, 5 Partial Hosp: $25, 9D Cardiac Rehab: $25"	"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"	7D Physician Specialist: $35	"7E Mental Health Individual: $25, Group: $10, 7H Psychiatric Individual: $25, Group: $10,  9C Outpatient Sub Abuse Individual: $25, Group: $10"	"7C Occupational Therapy: $35, 7I Physical and Speech Therapy: $35"	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $25, 7B Chiropractic: $25, 7F Podiatry: $35, 8A OP C/D/T: 20%"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $10"	"10B Transportation: $0, 12 one-way trips"	16A Preventive Dental Services: $10	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $10, Routine: $0 with a $150 allowance"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	OTC Drug Card: Not Covered											239.5445293	954.8102892	97.48808289	0	153.0099581	0.358130448	0.106169867	78.44641727	365.262961	0.247950742	0.251576334	5.596566081	9.691582904	35.65117332	9.526925588	12.03602185	25.06634734	34.2514717	0.180574068	4.983654955	20.55313558	15.11560806	0	10	20	0	0	0	0	0											224.861293	905.9476796	85.25193589	0	152.6521291	0.353497619	0.10495195	78.43705789	352.4985019	0.242522668	0.246174429	5.596566081	9.691582904	33.46172571	9.366346915	11.92275059	24.6701822	34.2514717	0.174659689	4.780354609	20.12849422	14.63946353	0	10	20	0	0	0	0	0											51.0616	0.579427439	1.37619816	0	10.52013925	10.98374205	2.763073728	3.623077796	7.388284867	1.687824406	3.805437142	0.095018383	0.000221285	2.223583543	9.528955418	13.44750916	0.192198314	2.090284139	9.102905551	7.115220167	1.66976647	0.86654749	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.643	0	5.2669	51.0616	0.579427439	1.37619816	0	10.52013925	10.98374205	2.763073728	3.623077796	7.388284867	1.687824406	3.805437142	0.095018383	0.000221285	2.223583543	9.528955418	13.44750916	0.192198314	2.090284139	9.102905551	7.115220167	1.66976647	0.86654749	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.643	3350	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	51.0616	0.579427439	1.37619816	0	10.52013925	10.98374205	2.763073728	3.623077796	7.388284867	1.687824406	3.805437142	0.095018383	0.000221285	2.223583543	9.528955418	13.44750916	0.192198314	2.090284139	9.102905551	7.115220167	1.66976647	0.86654749	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	140.643
R6801_006_0	2009	8																					0											D	A	D	V	T	Coin	Coin	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	S	V	T	V	V	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	3691.666926	10.24956706	358.6509031	928.9977805	1013.847477	46.35421755	34.49339354	626.0313293	418.8845856	4340.714807	25.53222165	165.740198	0.276058259	881.459056	18508.37917	21212.60452	211.8956962	2163.450391	65.73927027	28751.09901	1438.346938	1164.901835	210	300	163.2179037	0	0	0	0	0											"PBP: 1A IP Acute: $125 per day, days 1 - 10"	1B IP Psych: $1000 per admit	"2 SNF: $50, days 21 - 100"	6 Home Health: $0	10A Ambulance: $75	"11A DME: 10% For DME less than $1,000 and 20% for DME > $1,000"	"11B Prosthetic Medical Supplies: 12%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $100	8A OP C/D/T: 0%	"8B All Radiation Therapy: 10%, Radiation Therapy and Chemo: 20%, X-Ray: 0%"	9A OP Hospital: $0	12 Renal Dialysis: $15	"3 CORF: $15, 5 Partial Hosp: $15, 9D Cardiac Rehab: $25"	"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: $15	"7E Mental Health Individual: $15, Group: $5, 7H Psychiatric Individual: $15, Group: $5,  9C Outpatient Sub Abuse Individual: $15, Group: $5"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	"8B All Radiation Therapy: 10%, Radiation Therapy and Chemo: 20%, X-Ray: 0%"	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $25, 7B Chiropractic: $25, 7F Podiatry: $15, 8A OP C/D/T: 0%"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $10"	"10B Transportation: $0, 12 one-way trips"	16A Preventive Dental Services: $10	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $10, Routine: $0 with a $150 allowance"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	OTC Drug Card: Not Covered											139.2609952	952.9381315	47.59781741	0	78.0803133	0.131007376	0.03345299	83.88370671	229.3858348	1.537983477	0.167779243	5.885977125	10.32045256	42.73631859	2.952056997	6.091713422	15.35610233	15.41483425	0.110488758	2.502527376	25.46867507	16.49499976	0	10	20	0	0	0	0	0											135.8986517	941.1379053	44.99790788	0	77.87873928	0.129652034	0.0332332	83.88090902	226.6737248	1.537983477	0.166481253	5.885977125	10.32045256	42.12749681	2.905130445	6.05842035	15.24927768	15.38060693	0.109101414	2.468136269	25.35496896	16.39468943	0	10	20	0	0	0	0	0											41.8077	0.803854673	1.344878358	0	6.579763613	6.009918591	1.146325841	4.376006414	7.912510775	0.556328971	4.250636256	0.081295251	0.000237421	3.094471964	4.480771317	10.70957291	0.269271359	2.772931673	7.172247344	5.913469188	3.039103496	1.591516984	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.4349	0	1.7185	41.8077	0.803854673	1.344878358	0	6.579763613	6.009918591	1.146325841	4.376006414	7.912510775	0.556328971	4.250636256	0.081295251	0.000237421	3.094471964	4.480771317	10.70957291	0.269271359	2.772931673	7.172247344	5.913469188	3.039103496	1.591516984	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.4349	3350	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	41.8077	0.803854673	1.344878358	0	6.579763613	6.009918591	1.146325841	4.376006414	7.912510775	0.556328971	4.250636256	0.081295251	0.000237421	3.094471964	4.480771317	10.70957291	0.269271359	2.772931673	7.172247344	5.913469188	3.039103496	1.591516984	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	114.4349
R6801_007_0	2009	8																					0											D	A	D	V	T	Coin	Coin	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	S	V	T	V	V	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	3691.666926	10.24956706	358.6509031	928.9977805	1013.847477	46.35421755	34.49339354	626.0313293	418.8845856	4340.714807	25.53222165	165.740198	0.276058259	881.459056	18508.37917	21212.60452	211.8956962	2163.450391	65.73927027	28751.09901	1438.346938	1164.901835	210	300	163.2179037	0	0	0	0	0											"PBP: 1A IP Acute: $60 per day, days 1 - 10"	1B IP Psych: $1000 per admit	"2 SNF: $25, days 21 - 100"	6 Home Health: $0	10A Ambulance: $75	"11A DME: 10% For DME less than $1,000 and 20% for DME > $1,000"	"11B Prosthetic Medical Supplies: 12%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $50	8A OP C/D/T: 0%	"8B All Radiation Therapy: 10%, Radiation Therapy and Chemo: 20%, X-Ray: 0%"	9A OP Hospital: $0	12 Renal Dialysis: $15	"3 CORF: $15, 5 Partial Hosp: $15, 9D Cardiac Rehab: $25"	"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: $15	"7E Mental Health Individual: $15, Group: $5, 7H Psychiatric Individual: $15, Group: $5,  9C Outpatient Sub Abuse Individual: $15, Group: $5"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	"8B All Radiation Therapy: 10%, Radiation Therapy and Chemo: 20%, X-Ray: 0%"	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $25, 7B Chiropractic: $15, 7F Podiatry: $15, 8A OP C/D/T: 0%"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $10"	"10B Transportation: $0, 12 one-way trips"	16A Preventive Dental Services: $10	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $10, Routine: $0 with a $150 allowance"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	OTC Drug Card: Not Covered											74.26099521	952.9381315	22.59781741	0	78.0803133	0.131007376	0.03345299	83.88370671	179.3858348	1.537983477	0.167779243	5.885977125	10.32045256	42.73631859	2.952056997	6.091713422	15.35610233	15.41483425	0.110488758	2.301676542	25.46867507	16.49499976	0	10	20	0	0	0	0	0											71.43361124	943.305785	20.44372215	0	77.91577147	0.129901031	0.033273579	83.88142299	177.1083236	1.537983477	0.166719713	5.885977125	10.32045256	42.23934657	2.913751561	6.06453679	15.26890298	15.38689501	0.10935629	2.273347891	25.37585849	16.41311796	0	10	20	0	0	0	0	0											21.9758	0.805706325	0.611013284	0	6.582892362	6.02146064	1.14771864	4.376033228	6.182328896	0.556328971	4.256724678	0.081295251	0.000237421	3.102687879	4.494068225	10.72038505	0.269617902	2.774065334	7.189002709	5.446770858	3.041607362	1.593305935	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.751	0	1.4321	21.9758	0.805706325	0.611013284	0	6.582892362	6.02146064	1.14771864	4.376033228	6.182328896	0.556328971	4.256724678	0.081295251	0.000237421	3.102687879	4.494068225	10.72038505	0.269617902	2.774065334	7.189002709	5.446770858	3.041607362	1.593305935	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.751	3350	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	21.9758	0.805706325	0.611013284	0	6.582892362	6.02146064	1.14771864	4.376033228	6.182328896	0.556328971	4.256724678	0.081295251	0.000237421	3.102687879	4.494068225	10.72038505	0.269617902	2.774065334	7.189002709	5.446770858	3.041607362	1.593305935	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	91.751
R7444_001_0	2009	5																					3450											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	6000	1906.329985	139.6710408	1189.369182	2195.106225	288.3888712	7.690520476	4.126554898	354.4134586	29.24641895	11103.66685	49.79404236	0	0.063522731	33.25197492	4360.127346	5230.369439	583.4766639	699.8621685	0	0	10.15892095	1359.865549	0	0	118.3912108	0	14.72807038	0	775.2	0											"$225 Days 1-16 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$225 Days 1-16 (1b); $0 n/c (1b1, 1b2)"	"$110 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a, 6a2); $0 n/c (6a1, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	20% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 20% (8b2, 8b3)"	Included in h.5.	20% (12)	"$25 (3, 9d); $60 (5); 20% (9a); $40/$30 (9c)"	"$10 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$25 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$40/$30 (7e, 7h)"	"$25 (7c, 7i)"	Included in h.2.	$10 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $25 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$25 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$25 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a2, 14a3, 14a5, 14a8, 14a10); $0 (14a1, 14a4, 14a6, 14a7, 14a9)"	"$0 n/c (13b, 13d, 13e)"											222.3433474	225	85.36789939	0	150	0.2	0.073510203	48.47407899	0.2	2.8	0.172447458	0	0.2	0.197383244	7.529484953	25	37.5	25	0	0	0.2	23.20675105	0	0	25	0	25	0	0	0											144.5832932	146.3108358	55.51221648	0	97.54055717	0.130054076	0.047801508	31.52125782	0.130054076	1.820757067	0.112137474	0	0.130054076	0.128352477	4.89620105	16.25675953	24.38513929	16.25675953	0	0	0.130054076	15.09066285	0	0	25	0	25	0	0	0											22.9686	1.702948893	5.50204329	0	2.344134265	1.000183536	0.197255545	0.930963167	3.803615999	1.684756658	5.583778147	0	0.00826139	4.267973363	1.779005008	7.085738185	1.185679977	0.948124248	0	0	1.32120908	1.710106044	0	0	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3017	0	34.4337	22.9686	1.702948893	5.50204329	0	2.344134265	1.000183536	0.197255545	0.930963167	3.803615999	1.684756658	5.583778147	0	0.00826139	4.267973363	1.779005008	7.085738185	1.185679977	0.948124248	0	0	1.32120908	1.710106044	0	0	0.246648356	0	0.03068348	0	0	0	0	0	0	0	0	0	0	0	0	0	64.3017		"$325 Days 1-19 (1a); $0 (1a1); $0 n/c (1a2, 1a3); 30% (13c)"	"$325 Days 1-19 (1b); $0 n/c (1b1, 1b2)"	"$175 Days 1-35 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$30 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$25 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$30 (7b, 7d, 7f, 7f1); $0 n/c (7b1)"	"$45/$35 (7e, 7h)"	"$30 (7c, 7i)"	Included in h.2.	$25 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $30 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$30 (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	$30 (18a1); $0 n/c (18a2)	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											2.1256	0.156	4.8039	0.5948	0.4111	0.2631	0.1412	0.1633	1.0006	0.2955	1.4427	0	0.0014	1.1209	1.236	2.1126	0.3339	0.2827	0	0	0.4924	0.5307	0	0	0.074	0	0.0092	0	0	0											17.5917	0	9.584035665	25.0942	1.858987093	10.3059631	0.594839919	2.75524602	1.263300211	0.33843785	1.094234489	4.804227145	1.980227475	7.026504276	0	0.009710264	5.388858328	3.015039359	9.198309771	1.519544471	1.230801972	0	0	1.813597574	2.240815307	0	0	0.320642863	0	0.039888524	0	0	0	0	0	0	0	0	0	0	0	0	0	81.8934
R7444_801_0	2009	3																					5280											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	7400	2001.648229	146.6547206	1248.838729	2285.422542	302.8085786	8.075060572	4.332890194	372.1120159	30.70879341	11658.86036	52.28383559	0	0.066698984	34.91463451	4572.527568	5483.568022	612.6510309	734.8559172	0	0	10.66688559	1427.860071	0	0	0	0	0	0	0	0											"$490 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$490 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$205 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											484.1543379	490	205	0	150	0.2	0.073510203	48.47398697	0.3	2.52	0.244835557	0	0.2	0.295627225	15.07744609	34.81287489	37.5	35	0	0	0.2	32.48945148	0	0	0	0	0	0	0	0											291.5976836	295.1184235	123.4679119	0	90.34237454	0.120456499	0.044273908	29.19503391	0.180684749	1.517751892	0.14746017	0	0.120456499	0.178051103	9.080881877	20.96718521	22.58559364	21.07988739	0	0	0.120456499	19.56782796	0	0	0	0	0	0	0	0											48.6397	3.606709163	12.84929251	0	2.279703836	0.972693529	0.191833984	0.905318577	5.548610632	1.474604781	7.709783302	0	0.008034326	6.21658919	3.460215227	9.581248862	1.153090602	1.290889999	0	0	1.284895698	2.328343351	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.5015	0	72.3094	48.6397	3.606709163	12.84929251	0	2.279703836	0.972693529	0.191833984	0.905318577	5.548610632	1.474604781	7.709783302	0	0.008034326	6.21658919	3.460215227	9.581248862	1.153090602	1.290889999	0	0	1.284895698	2.328343351	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.5015		"30% Days 1-999 (1a); 30% (1a1, 13c); $0 n/c (1a2, 1a3)"	"30% Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"30% Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$30 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$30 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											4.0856	0.1385	3.7188	0.6452	0.4459	0.2854	0.1531	0.1771	1.0854	0.3205	1.5649	0	0.0016	1.217	1.5863	3.0215	0.3621	0.4088	0	0	0.5341	0.76	0	0	0	0	0	0	0	0											20.512	0	10.21303489	52.7253	3.745258832	16.56809223	0.645217871	2.725632919	1.258093979	0.344973245	1.082406441	6.633965148	1.795099218	9.274696034	0	0.009605907	7.433602334	5.046498784	12.60279294	1.515230302	1.699713851	0	0	1.818985366	3.088344885	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.0135
R7444_802_0	2009	4																					5280											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	7400	2001.648229	146.6547206	1248.838729	2285.422542	302.8085786	8.075060572	4.332890194	372.1120159	30.70879341	11658.86036	52.28383559	0	0.066698984	34.91463451	4572.527568	5483.568022	612.6510309	734.8559172	0	0	10.66688559	1427.860071	0	0	0	0	0	0	0	0											"$490 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$490 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$205 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											484.1543379	490	205	0	150	0.2	0.073510203	48.47398697	0.3	2.52	0.244835557	0	0.2	0.295627225	15.07744609	34.81287489	37.5	35	0	0	0.2	32.48945148	0	0	0	0	0	0	0	0											291.5976836	295.1184235	123.4679119	0	90.34237454	0.120456499	0.044273908	29.19503391	0.180684749	1.517751892	0.14746017	0	0.120456499	0.178051103	9.080881877	20.96718521	22.58559364	21.07988739	0	0	0.120456499	19.56782796	0	0	0	0	0	0	0	0											48.6397	3.606709163	12.84929251	0	2.279703836	0.972693529	0.191833984	0.905318577	5.548610632	1.474604781	7.709783302	0	0.008034326	6.21658919	3.460215227	9.581248862	1.153090602	1.290889999	0	0	1.284895698	2.328343351	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.5015	0	72.3094	48.6397	3.606709163	12.84929251	0	2.279703836	0.972693529	0.191833984	0.905318577	5.548610632	1.474604781	7.709783302	0	0.008034326	6.21658919	3.460215227	9.581248862	1.153090602	1.290889999	0	0	1.284895698	2.328343351	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.5015		"30% Days 1-999 (1a); 30% (1a1, 13c); $0 n/c (1a2, 1a3)"	"30% Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"30% Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$30 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$30 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											4.0856	0.1385	3.7188	0.6452	0.4459	0.2854	0.1531	0.1771	1.0854	0.3205	1.5649	0	0.0016	1.217	1.5863	3.0215	0.3621	0.4088	0	0	0.5341	0.76	0	0	0	0	0	0	0	0											20.512	0	10.21303489	52.7253	3.745258832	16.56809223	0.645217871	2.725632919	1.258093979	0.344973245	1.082406441	6.633965148	1.795099218	9.274696034	0	0.009605907	7.433602334	5.046498784	12.60279294	1.515230302	1.699713851	0	0	1.818985366	3.088344885	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.0135
R7444_803_0	2009	3																					5280											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	7400	2001.648229	146.6547206	1248.838729	2285.422542	302.8085786	8.075060572	4.332890194	372.1120159	30.70879341	11658.86036	52.28383559	0	0.066698984	34.91463451	4572.527568	5483.568022	612.6510309	734.8559172	0	0	10.66688559	1427.860071	0	0	0	0	0	0	0	0											"$490 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$490 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$205 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											484.1543379	490	205	0	150	0.2	0.073510203	48.47398697	0.3	2.52	0.244835557	0	0.2	0.295627225	15.07744609	34.81287489	37.5	35	0	0	0.2	32.48945148	0	0	0	0	0	0	0	0											291.5976836	295.1184235	123.4679119	0	90.34237454	0.120456499	0.044273908	29.19503391	0.180684749	1.517751892	0.14746017	0	0.120456499	0.178051103	9.080881877	20.96718521	22.58559364	21.07988739	0	0	0.120456499	19.56782796	0	0	0	0	0	0	0	0											48.6397	3.606709163	12.84929251	0	2.279703836	0.972693529	0.191833984	0.905318577	5.548610632	1.474604781	7.709783302	0	0.008034326	6.21658919	3.460215227	9.581248862	1.153090602	1.290889999	0	0	1.284895698	2.328343351	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.5015	0	72.3094	48.6397	3.606709163	12.84929251	0	2.279703836	0.972693529	0.191833984	0.905318577	5.548610632	1.474604781	7.709783302	0	0.008034326	6.21658919	3.460215227	9.581248862	1.153090602	1.290889999	0	0	1.284895698	2.328343351	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.5015		"30% Days 1-999 (1a); 30% (1a1, 13c); $0 n/c (1a2, 1a3)"	"30% Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"30% Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$30 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$30 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											4.0856	0.1385	3.7188	0.6452	0.4459	0.2854	0.1531	0.1771	1.0854	0.3205	1.5649	0	0.0016	1.217	1.5863	3.0215	0.3621	0.4088	0	0	0.5341	0.76	0	0	0	0	0	0	0	0											20.512	0	10.21303489	52.7253	3.745258832	16.56809223	0.645217871	2.725632919	1.258093979	0.344973245	1.082406441	6.633965148	1.795099218	9.274696034	0	0.009605907	7.433602334	5.046498784	12.60279294	1.515230302	1.699713851	0	0	1.818985366	3.088344885	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.0135
R7444_804_0	2009	3																					5280											D	D	D	V	T	Coin	Coin	V	Coin	O	Coin	V	Coin	Coin	V	V	V	V	V	V	Coin	O	T	V	P	P	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	7400	2001.648229	146.6547206	1248.838729	2285.422542	302.8085786	8.075060572	4.332890194	372.1120159	30.70879341	11658.86036	52.28383559	0	0.066698984	34.91463451	4572.527568	5483.568022	612.6510309	734.8559172	0	0	10.66688559	1427.860071	0	0	0	0	0	0	0	0											"$490 Days 1-11 (1a); $0 (1a1); $0 n/c (1a2, 1a3); $1500 (13c)"	"$490 Days 1-11 (1b); $0 n/c (1b1, 1b2)"	"$205 Days 1-26 (2a, 2a2); $0 n/c (2a1)"	"$0 (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	20% (11a)	20% (11b); $0 (11c)	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	$0/$7 (8a1); $7 (8a2)	"$15 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$35 (3, 9d); $60 (5); 30% (9a); $40/$30 (9c)"	"$20 (7a); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b, 14c, 14c1, 14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$35 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$40/$30 (7e, 7h)"	"$35 (7c, 7i)"	Included in h.2.	$20 (7g)	"20% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1, 17b); $35 (16b, 17a, 18a)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10); $0 (14a4)"	"$0 n/c (13b, 13d, 13e)"											484.1543379	490	205	0	150	0.2	0.073510203	48.47398697	0.3	2.52	0.244835557	0	0.2	0.295627225	15.07744609	34.81287489	37.5	35	0	0	0.2	32.48945148	0	0	0	0	0	0	0	0											291.5976836	295.1184235	123.4679119	0	90.34237454	0.120456499	0.044273908	29.19503391	0.180684749	1.517751892	0.14746017	0	0.120456499	0.178051103	9.080881877	20.96718521	22.58559364	21.07988739	0	0	0.120456499	19.56782796	0	0	0	0	0	0	0	0											48.6397	3.606709163	12.84929251	0	2.279703836	0.972693529	0.191833984	0.905318577	5.548610632	1.474604781	7.709783302	0	0.008034326	6.21658919	3.460215227	9.581248862	1.153090602	1.290889999	0	0	1.284895698	2.328343351	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.5015	0	72.3094	48.6397	3.606709163	12.84929251	0	2.279703836	0.972693529	0.191833984	0.905318577	5.548610632	1.474604781	7.709783302	0	0.008034326	6.21658919	3.460215227	9.581248862	1.153090602	1.290889999	0	0	1.284895698	2.328343351	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	109.5015		"30% Days 1-999 (1a); 30% (1a1, 13c); $0 n/c (1a2, 1a3)"	"30% Days 1-90 (1b); $0 n/c (1b1, 1b2)"	"30% Days 1-100 (2a, 2a2); $0 n/c (2a1)"	"30% (6a); $0 n/c (6a1, 6a2, 6a3)"	$150 (10a)	30% (11a)	"30% (11b, 11c)"	"$50 (4a, 4a1); $40 (4b)"	30% (9b)	30%/$7 (8a1); $7 (8a2)	"$20 (8b1); 30% (8b2, 8b3)"	Included in h.5.	20% (12)	"$40 (3, 9d); $75 (5); 30% (9a); $45/$35 (9c)"	"$30 (7a, 14c, 14c1); $0 n/c (7a1, 14b1, 14e1, 14h1); $0 (14b); 30% (14d, 14d1, 14d2, 14e, 14f, 14f1, 14g, 14h, 14i, 14j)"	"$40 (7b, 7d, 7f); $0 n/c (7b1, 7f1)"	"$45/$35 (7e, 7h)"	"$40 (7c, 7i)"	Included in h.2.	$30 (7g)	"30% (15, 15a1); $0 n/c (15a2)"	"$0 (13a, 13a1); $40 (16b, 17a, 18a); 30% (17b)"	$0 n/c (10b)	"$0 n/c (16a, 16a1, 16a2, 16a3, 16a4, 16a5, 16b1, 16b2, 16b3, 16b4, 16b5)"	$0 n/c (17a1)	"$0 n/c (17b1, 17b2, 17b3, 17b4, 17b5)"	"$0 n/c (18a1, 18a2)"	"$0 n/c (18b, 18b1, 18b2, 18b3, 18b4)"	"$0 n/c (14a, 14a1, 14a2, 14a3, 14a4, 14a5, 14a6, 14a7, 14a8, 14a9, 14a10)"	"$0 n/c (13b, 13d, 13e)"											4.0856	0.1385	3.7188	0.6452	0.4459	0.2854	0.1531	0.1771	1.0854	0.3205	1.5649	0	0.0016	1.217	1.5863	3.0215	0.3621	0.4088	0	0	0.5341	0.76	0	0	0	0	0	0	0	0											20.512	0	10.21303489	52.7253	3.745258832	16.56809223	0.645217871	2.725632919	1.258093979	0.344973245	1.082406441	6.633965148	1.795099218	9.274696034	0	0.009605907	7.433602334	5.046498784	12.60279294	1.515230302	1.699713851	0	0	1.818985366	3.088344885	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.0135
R9896_001_0	2009	11																					0											A	A	D	V	T	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	Coin	Coin	Coin	Coin	Coin	S	Coin	T	V	V	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	444.4096254	15.58406649	319.5628141	655.889325	1096.660468	44.67359373	38.01564346	40.30096567	37.48036732	8.664288944	17.73180328	107.1558469	0.365862937	32.54455118	57.91172919	110.723059	0.983250462	2.311036201	30.16913042	34.7826952	1189.302373	12.62421881	330	300	175.4782086	0	0	0	0	11280											PBP: 1A IP Acute: $1064 per admit	1B IP Psych: $1064 per admit	"2 SNF: $133, days 21 - 100"	6 Home Health: $0	10A Ambulance: 20%	11A DME: 20%	"11B Prosthetic Medical Supplies: 20%, 11C Diabetes Monitoring Supplies: 20%"	"4A ER: 20%, 4B Urgent Care: 20%"	9B ASC Services: 20%	8A OP C/D/T: 20%	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	9A OP Hospital: $0	12 Renal Dialysis: 20%	"3 CORF: 20%, 5 Partial Hosp: 50%, 9D Cardiac Rehab: 20%"	"7A PCP: 20%, 14B Immunizations: 20%, 14C Routine Physical Exams: $0, 14D Pap Smears: 20%, 14D Pelvic Exams: 20%, 14E Prostate Screening: 20%, 14F Colorectal Screening: 20%, 14G Bone Mass Measurement: 20%, 14H Mammography: 20%, 14I Diabetes Monitoring: 20%"	7D Physician Specialist: 20%	"7E Mental Health Individual: 50%, Group: 50%, 7H Psychiatric Individual: 50%, Group: 50%, 9C Outpatient Sub Abuse: 50%"	"7C Occupational Therapy: 20%, 7I Physical and Speech Therapy: 20%"	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	"7G Other Health Care: 20%, 18A Medicare Covered Hearing Exams: 20%, 7B Chiropractic: 20%, 7F Podiatry: 20%"	15 Part B Drugs: 20%	"13A Blood: 20%, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: 20%"	"10B Transportation: $0, 24 one-way trips"	16A Preventive Dental Services: $15	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: 20%, Routine: $0 with a $200 allowance"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	OTC Drug Card: $40											906.7781853	488.2485528	348.4161489	0	45.45365333	0.231	0.231	0.231	0.231	0.231	0.231	15.41150209	34.59252896	0.231	0.230245758	0.231	0.231	0.231	0.231	0.197960828	15.69161987	0.231	0	15	39.59465995	0	0	0	0	0											906.7781853	488.2485528	348.4161489	0	45.45365333	0.231	0.231	0.231	0.231	0.231	0.231	15.41150209	34.59252896	0.231	0.230245758	0.231	0.231	0.231	0.231	0.197960828	15.69161987	0.231	0	15	39.59465995	0	0	0	0	0											33.5817	0.634074826	9.278403752	0	4.153935394	10.31960015	8.781613638	9.309523069	8.65796485	2.001450746	4.096046558	0.13761938	0.001054677	7.517791322	13.33393	25.57702663	0.227130857	0.533849363	6.969069127	6.885611145	1.555173395	2.916194544	0	0.375	0.579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	157.4228	0	0	33.5817	0.634074826	9.278403752	0	4.153935394	10.31960015	8.781613638	9.309523069	8.65796485	2.001450746	4.096046558	0.13761938	0.001054677	7.517791322	13.33393	25.57702663	0.227130857	0.533849363	6.969069127	6.885611145	1.555173395	2.916194544	0	0.375	0.579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	157.4228	90000	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	33.5817	0.634074826	9.278403752	0	4.153935394	10.31960015	8.781613638	9.309523069	8.65796485	2.001450746	4.096046558	0.13761938	0.001054677	7.517791322	13.33393	25.57702663	0.227130857	0.533849363	6.969069127	6.885611145	1.555173395	2.916194544	0	0.375	0.579	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	157.4228
R9896_002_0	2009	8																					0											D	A	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	Coin	V	S	V	T	V	V	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	2317.116073	10.26161185	198.0547568	444.7155871	698.8431591	30.36403695	26.68359649	645.0151467	254.8707924	7.268064016	18.40702812	65.83305122	0.244570956	752.3262727	9690.521026	10522.45716	130.0835772	434.4370367	32.59175485	13899.09789	917.8531226	534.1022785	210	300	138.5915645	0	0	0	0	0											"PBP: 1A IP Acute: $195 per day, days 1 - 10"	1B IP Psych: $1000 per admit	"2 SNF: $100, days 21 - 100"	6 Home Health: $0	10A Ambulance: $150	11A DME: 35%	"11B Prosthetic Medical Supplies: 35%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $185	8A OP C/D/T: 20%	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $30	"3 CORF: $30, 5 Partial Hosp: $30, 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 Individual: $30, Group: $15, 7H Psychiatric Individual: $30, Group: $15,  9C Outpatient Sub Abuse Individual: $30, Group: $15"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $30, 7B Chiropractic: $30, 7F Podiatry: $30, 8A OP C/D/T: 20%"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $30"	"10B Transportation: $0, 12 one-way trips"	16A Preventive Dental Services: $10	17A Routine Eye Exams: $25	"17B Eye Wear: Medicare Covered: $30, Routine: $0 with a $150 allowance"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	OTC Drug Card: Not Covered											205.3934757	979.3060622	103.2127133	0	152.5890017	0.357216799	0.114074897	76.40709552	285.4604288	0.245872428	0.250721755	5.289973522	8.858267037	31.76646052	7.65964676	11.11079333	29.58000679	30.56345432	0.179232561	4.932038163	19.13405313	39.32649733	0	10	20	0	0	0	0	0											190.0787546	936.2594434	90.33793677	0	152.1252109	0.352080337	0.112590012	76.40056146	275.2536569	0.239846216	0.244734294	5.289973522	8.858267037	29.8245397	7.453484569	10.96687741	29.29169905	30.46367689	0.172673832	4.721980268	18.69143079	38.97602925	0	10	20	0	0	0	0	0											36.7029	0.800627584	1.490988175	0	8.859305247	10.69058037	3.004306441	4.106626613	5.846176469	1.743217653	4.504831038	0.029021258	0.00018054	1.869815399	6.019012411	9.616541471	0.317530749	1.102879126	5.62774321	5.469272166	1.429665676	1.734765503	0	0.25	0.230985941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.447	0	4.7279	36.7029	0.800627584	1.490988175	0	8.859305247	10.69058037	3.004306441	4.106626613	5.846176469	1.743217653	4.504831038	0.029021258	0.00018054	1.869815399	6.019012411	9.616541471	0.317530749	1.102879126	5.62774321	5.469272166	1.429665676	1.734765503	0	0.25	0.230985941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.447	3350	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	36.7029	0.800627584	1.490988175	0	8.859305247	10.69058037	3.004306441	4.106626613	5.846176469	1.743217653	4.504831038	0.029021258	0.00018054	1.869815399	6.019012411	9.616541471	0.317530749	1.102879126	5.62774321	5.469272166	1.429665676	1.734765503	0	0.25	0.230985941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	111.447
R9896_003_0	2009	8																					0											D	A	D	V	T	Coin	Coin	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	S	V	T	V	V	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	2539.951553	11.18030625	310.7298663	717.5861452	777.1267705	46.51425203	36.95434448	628.7207302	457.8625292	5306.306041	25.35723688	111.2501228	0.310293419	1037.914733	15506.37119	17488.35566	261.4783909	1848.968271	47.47652906	24732.85121	1498.924845	864.4215749	210	300	163.2179037	0	0	0	0	0											"PBP: 1A IP Acute: $125 per day, days 1 - 10"	1B IP Psych: $1000 per admit	"2 SNF: $50, days 21 - 100"	6 Home Health: $0	10A Ambulance: $75	"11A DME: 10% For DME less than $1,000 and 20% for DME > $1,000"	"11B Prosthetic Medical Supplies: 12%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $100	8A OP C/D/T: 0%	"8B All Radiation Therapy: 10%, Radiation Therapy and Chemo: 20%, X-Ray: 0%"	9A OP Hospital: $0	12 Renal Dialysis: $15	"3 CORF: $15, 5 Partial Hosp: $15, 9D Cardiac Rehab: $25"	"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: $15	"7E Mental Health Individual: $15, Group: $5, 7H Psychiatric Individual: $15, Group: $5,  9C Outpatient Sub Abuse Individual: $15, Group: $5"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	"8B All Radiation Therapy: 10%, Radiation Therapy and Chemo: 20%, X-Ray: 0%"	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $25, 7B Chiropractic: $25, 7F Podiatry: $15, 8A OP C/D/T: 0%"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $10"	"10B Transportation: $0, 12 one-way trips"	16A Preventive Dental Services: $10	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $10, Routine: $0 with a $150 allowance"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	OTC Drug Card: Not Covered											139.976536	978.571705	53.45579564	0	77.6035991	0.129770436	0.038747012	76.39301753	199.8676201	1.153238807	0.166828981	5.84904055	12.01808975	34.75044964	2.987159244	6.257087458	14.87745715	15.51273581	0.109032512	2.621229586	23.32928696	24.23460095	0	10	20	0	0	0	0	0											135.9670987	968.7129316	50.18049611	0	77.35897606	0.128184306	0.038406453	76.38998797	197.4003637	1.153238807	0.165310396	5.84904055	12.01808975	34.28006808	2.926708539	6.216310959	14.76769199	15.46960822	0.107408584	2.586384039	23.206194	24.11985029	0	10	20	0	0	0	0	0											28.7792	0.90254227	1.299381571	0	5.009810936	5.962397121	1.419285294	4.002330752	7.531852484	0.509953171	4.191814878	0.05422554	0.000310761	2.964982308	3.781885747	9.059421411	0.321786028	2.383567898	5.099386766	5.330720968	2.898695063	1.737476581	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.763	0	1.5375	28.7792	0.90254227	1.299381571	0	5.009810936	5.962397121	1.419285294	4.002330752	7.531852484	0.509953171	4.191814878	0.05422554	0.000310761	2.964982308	3.781885747	9.059421411	0.321786028	2.383567898	5.099386766	5.330720968	2.898695063	1.737476581	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.763	3350	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	28.7792	0.90254227	1.299381571	0	5.009810936	5.962397121	1.419285294	4.002330752	7.531852484	0.509953171	4.191814878	0.05422554	0.000310761	2.964982308	3.781885747	9.059421411	0.321786028	2.383567898	5.099386766	5.330720968	2.898695063	1.737476581	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.763
R9896_004_0	2009	8																					0											D	A	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	Coin	V	S	V	T	V	V	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	2317.116073	10.26161185	198.0547568	444.7155871	698.8431591	30.36403695	26.68359649	645.0151467	254.8707924	7.268064016	18.40702812	65.83305122	0.244570956	752.3262727	9690.521026	10522.45716	130.0835772	434.4370367	32.59175485	13899.09789	917.8531226	534.1022785	210	300	138.5915645	0	0	0	0	0											"PBP: 1A IP Acute: $175 per day, days 1 - 10"	1B IP Psych: $1000 per admit	"2 SNF: $100, days 21 - 100"	6 Home Health: $0	10A Ambulance: $150	11A DME: 35%	"11B Prosthetic Medical Supplies: 35%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $165	8A OP C/D/T: 20%	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $25	"3 CORF: $25, 5 Partial Hosp: $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: $0"	7D Physician Specialist: $25	"7E Mental Health Individual: $30, Group: $15, 7H Psychiatric Individual: $30, Group: $15,  9C Outpatient Sub Abuse Individual: $30, Group: $15"	"7C Occupational Therapy: $25, 7I Physical and Speech Therapy: $25"	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $30, 7B Chiropractic: $30, 7F Podiatry: $25, 8A OP C/D/T: 20%"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $30"	"10B Transportation: $0, 12 one-way trips"	16A Preventive Dental Services: $10	17A Routine Eye Exams: $25	"17B Eye Wear: Medicare Covered: $30, Routine: $0 with a $150 allowance"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	OTC Drug Card: Not Covered											185.3934757	979.3060622	103.2127133	0	152.5890017	0.357216799	0.114074897	76.40709552	265.4604288	0.245872428	0.250721755	5.289973522	8.858267037	31.66417738	5.249734029	9.474945105	29.58000679	25.56345432	0.179232561	4.72062639	19.13405313	39.32649733	0	10	20	0	0	0	0	0											170.7617163	938.6038672	91.03912846	0	152.1504701	0.352360081	0.112670882	76.40091732	255.6584272	0.240174418	0.245060386	5.289973522	8.858267037	29.82724548	5.036591202	9.326507113	29.30740099	25.43133219	0.173031037	4.520411383	18.71553708	38.9951166	0	10	20	0	0	0	0	0											32.9729	0.802632381	1.502561037	0	8.860776264	10.69907453	3.006464356	4.106645741	5.429988828	1.745603047	4.510833417	0.029021258	0.00018054	1.869985035	4.067266079	8.178147626	0.317700963	0.920692717	5.639385127	5.23580336	1.431509512	1.735615052	0	0.25	0.230985941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.5438	0	4.5316	32.9729	0.802632381	1.502561037	0	8.860776264	10.69907453	3.006464356	4.106645741	5.429988828	1.745603047	4.510833417	0.029021258	0.00018054	1.869985035	4.067266079	8.178147626	0.317700963	0.920692717	5.639385127	5.23580336	1.431509512	1.735615052	0	0.25	0.230985941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.5438	3350	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	32.9729	0.802632381	1.502561037	0	8.860776264	10.69907453	3.006464356	4.106645741	5.429988828	1.745603047	4.510833417	0.029021258	0.00018054	1.869985035	4.067266079	8.178147626	0.317700963	0.920692717	5.639385127	5.23580336	1.431509512	1.735615052	0	0.25	0.230985941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	103.5438
R9896_005_0	2009	9																					0											A	A	D	V	T	Coin	Coin	V	V	Coin	Coin	V	V	V	V	V	V	V	Coin	V	S	V	T	V	V	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	396.0932181	11.97006543	204.8943267	485.2158145	707.940852	33.06482264	28.25973079	664.9932863	271.5859454	7.70137198	18.76026753	78.9221976	0.25604378	791.3906225	10306.5403	11175.26535	135.2905221	460.8327045	34.18342138	15115.44023	1056.486839	569.2996584	210	300	138.5915645	0	0	0	0	0											"PBP: 1A IP Acute: $250 per day, days 1 - 10"	1B IP Psych: $1000 per admit	"2 SNF: $100, days 21 - 100"	6 Home Health: $0	10A Ambulance: $150	11A DME: 35%	"11B Prosthetic Medical Supplies: 35%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $30"	9B ASC Services: $250	8A OP C/D/T: 20%	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	9A OP Hospital: $0	12 Renal Dialysis: $30	"3 CORF: $30, 5 Partial Hosp: $30, 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 Individual: $30, Group: $15, 7H Psychiatric Individual: $30, Group: $15,  9C Outpatient Sub Abuse Individual: $30, Group: $15"	"7C Occupational Therapy: $30, 7I Physical and Speech Therapy: $30"	"8B All Radiation Therapy: 20%, Radiation Therapy and Chemo: 20%, X-Ray: 20%"	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $30, 7B Chiropractic: $30, 7F Podiatry: $30, 8A OP C/D/T: 20%"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $30"	"10B Transportation: $0, 12 one-way trips"	16A Preventive Dental Services: $10	17A Routine Eye Exams: $25	"17B Eye Wear: Medicare Covered: $30, Routine: $0 with a $150 allowance"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	OTC Drug Card: Not Covered											317.1605579	969.2284196	103.1670827	0	152.6027691	0.357216799	0.10703212	76.368873	351.6643563	0.245872428	0.250721755	5.279024211	8.751364638	32.26943743	7.705044213	11.14047014	29.58408296	30.56753906	0.179232561	4.994351441	19.58879689	39.14984271	0	10	20	0	0	0	0	0											237.7614862	935.211831	93.11457542	0	152.2282766	0.353146888	0.105936032	76.36345788	343.8775525	0.241097517	0.245977549	5.279024211	8.751364638	30.68244286	7.539870917	11.02578958	29.35053107	30.48652955	0.174035707	4.831160512	19.22974686	38.87066631	0	10	20	0	0	0	0	0											7.848	0.9328789	1.589887353	0	8.980717988	11.67673922	2.993723744	4.231765568	7.782692516	1.856781664	4.614604628	0.034719349	0.000186728	2.023483129	6.475831955	10.26801035	0.330904056	1.170765822	5.949135905	6.085426497	1.692997872	1.844088088	0	0.25	0.230985941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.8643	0	4.1034	7.848	0.9328789	1.589887353	0	8.980717988	11.67673922	2.993723744	4.231765568	7.782692516	1.856781664	4.614604628	0.034719349	0.000186728	2.023483129	6.475831955	10.26801035	0.330904056	1.170765822	5.949135905	6.085426497	1.692997872	1.844088088	0	0.25	0.230985941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.8643	3350	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	7.848	0.9328789	1.589887353	0	8.980717988	11.67673922	2.993723744	4.231765568	7.782692516	1.856781664	4.614604628	0.034719349	0.000186728	2.023483129	6.475831955	10.26801035	0.330904056	1.170765822	5.949135905	6.085426497	1.692997872	1.844088088	0	0.25	0.230985941	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	88.8643
R9896_006_0	2009	8																					0											D	A	D	V	T	Coin	Coin	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	S	V	T	V	V	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	2539.951553	11.18030625	310.7298663	717.5861452	777.1267705	46.51425203	36.95434448	628.7207302	457.8625292	5306.306041	25.35723688	111.2501228	0.310293419	1037.914733	15506.37119	17488.35566	261.4783909	1848.968271	47.47652906	24732.85121	1498.924845	864.4215749	210	300	163.2179037	0	0	0	0	0											"PBP: 1A IP Acute: $125 per day, days 1 - 10"	1B IP Psych: $1000 per admit	"2 SNF: $50, days 21 - 100"	6 Home Health: $0	10A Ambulance: $75	"11A DME: 10% For DME less than $1,000 and 20% for DME > $1,000"	"11B Prosthetic Medical Supplies: 12%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $100	8A OP C/D/T: 0%	"8B All Radiation Therapy: 10%, Radiation Therapy and Chemo: 20%, X-Ray: 0%"	9A OP Hospital: $0	12 Renal Dialysis: $15	"3 CORF: $15, 5 Partial Hosp: $15, 9D Cardiac Rehab: $25"	"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: $15	"7E Mental Health Individual: $15, Group: $5, 7H Psychiatric Individual: $15, Group: $5,  9C Outpatient Sub Abuse Individual: $15, Group: $5"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	"8B All Radiation Therapy: 10%, Radiation Therapy and Chemo: 20%, X-Ray: 0%"	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $25, 7B Chiropractic: $25, 7F Podiatry: $15, 8A OP C/D/T: 0%"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $10"	"10B Transportation: $0, 12 one-way trips"	16A Preventive Dental Services: $10	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $10, Routine: $0 with a $150 allowance"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	OTC Drug Card: Not Covered											139.976536	978.571705	53.45579564	0	77.6035991	0.129770436	0.038747012	76.39301753	199.8676201	1.153238807	0.166828981	5.84904055	12.01808975	34.75044964	2.987159244	6.257087458	14.87745715	15.51273581	0.109032512	2.621229586	23.32928696	24.23460095	0	10	20	0	0	0	0	0											135.9670987	968.7129316	50.18049611	0	77.35897606	0.128184306	0.038406453	76.38998797	197.4003637	1.153238807	0.165310396	5.84904055	12.01808975	34.28006808	2.926708539	6.216310959	14.76769199	15.46960822	0.107408584	2.586384039	23.206194	24.11985029	0	10	20	0	0	0	0	0											28.7792	0.90254227	1.299381571	0	5.009810936	5.962397121	1.419285294	4.002330752	7.531852484	0.509953171	4.191814878	0.05422554	0.000310761	2.964982308	3.781885747	9.059421411	0.321786028	2.383567898	5.099386766	5.330720968	2.898695063	1.737476581	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.763	0	1.5375	28.7792	0.90254227	1.299381571	0	5.009810936	5.962397121	1.419285294	4.002330752	7.531852484	0.509953171	4.191814878	0.05422554	0.000310761	2.964982308	3.781885747	9.059421411	0.321786028	2.383567898	5.099386766	5.330720968	2.898695063	1.737476581	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.763	3350	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	28.7792	0.90254227	1.299381571	0	5.009810936	5.962397121	1.419285294	4.002330752	7.531852484	0.509953171	4.191814878	0.05422554	0.000310761	2.964982308	3.781885747	9.059421411	0.321786028	2.383567898	5.099386766	5.330720968	2.898695063	1.737476581	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	93.763
R9896_007_0	2009	8																					0											D	A	D	V	T	Coin	Coin	V	V	V	Coin	V	V	V	V	V	V	V	Coin	V	S	V	T	V	V	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	2539.951553	11.18030625	310.7298663	717.5861452	777.1267705	46.51425203	36.95434448	628.7207302	457.8625292	5306.306041	25.35723688	111.2501228	0.310293419	1037.914733	15506.37119	17488.35566	261.4783909	1848.968271	47.47652906	24732.85121	1498.924845	864.4215749	210	300	163.2179037	0	0	0	0	0											"PBP: 1A IP Acute: $60 per day, days 1 - 10"	1B IP Psych: $1000 per admit	"2 SNF: $25, days 21 - 100"	6 Home Health: $0	10A Ambulance: $75	"11A DME: 10% For DME less than $1,000 and 20% for DME > $1,000"	"11B Prosthetic Medical Supplies: 12%, 11C Diabetes Monitoring Supplies: 0%"	"4A ER: $50, 4B Urgent Care: $25"	9B ASC Services: $50	8A OP C/D/T: 0%	"8B All Radiation Therapy: 10%, Radiation Therapy and Chemo: 20%, X-Ray: 0%"	9A OP Hospital: $0	12 Renal Dialysis: $15	"3 CORF: $15, 5 Partial Hosp: $15, 9D Cardiac Rehab: $25"	"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: $15	"7E Mental Health Individual: $15, Group: $5, 7H Psychiatric Individual: $15, Group: $5,  9C Outpatient Sub Abuse Individual: $15, Group: $5"	"7C Occupational Therapy: $15, 7I Physical and Speech Therapy: $15"	"8B All Radiation Therapy: 10%, Radiation Therapy and Chemo: 20%, X-Ray: 0%"	"7G Other Health Care: $0, 18A Medicare Covered Hearing Exams: $25, 7B Chiropractic: $15, 7F Podiatry: $15, 8A OP C/D/T: 0%"	15 Part B Drugs: 20%	"13A Blood: $0, 16B Medicare Covered Comprehensive Dental Services: $0, 17A Medicare Covered Eye Exams: $10"	"10B Transportation: $0, 12 one-way trips"	16A Preventive Dental Services: $10	17A Routine Eye Exams: $10	"17B Eye Wear: Medicare Covered: $10, Routine: $0 with a $150 allowance"	18A Routine Hearing Exams: Not Covered	18B Hearing Aids: Not Covered	14A Health Education/Wellness Programs: $0	OTC Drug Card: Not Covered											74.976536	978.571705	28.45579564	0	77.6035991	0.129770436	0.038747012	76.39301753	149.8676201	1.153238807	0.166828981	5.84904055	12.01808975	34.75044964	2.987159244	6.257087458	14.87745715	15.51273581	0.109032512	2.263682184	23.32928696	24.23460095	0	10	20	0	0	0	0	0											71.49001707	970.2447792	25.65092294	0	77.39698538	0.128430758	0.038459369	76.3904587	147.7067512	1.153238807	0.165546353	5.84904055	12.01808975	34.35315556	2.936101316	6.222646776	14.78474721	15.47630935	0.107660909	2.233700479	23.22532008	24.13768015	0	10	20	0	0	0	0	0											15.1318	0.903969481	0.664208988	0	5.012272441	5.973860628	1.42124076	4.002355415	5.635782222	0.509953171	4.197798081	0.05422554	0.000310761	2.971303855	3.794023072	9.068654996	0.322157659	2.384600412	5.11136626	4.603815135	2.901084109	1.738760957	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9255	0	1.3248	15.1318	0.903969481	0.664208988	0	5.012272441	5.973860628	1.42124076	4.002355415	5.635782222	0.509953171	4.197798081	0.05422554	0.000310761	2.971303855	3.794023072	9.068654996	0.322157659	2.384600412	5.11136626	4.603815135	2.901084109	1.738760957	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9255	3350	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0											0	0	0	15.1318	0.903969481	0.664208988	0	5.012272441	5.973860628	1.42124076	4.002355415	5.635782222	0.509953171	4.197798081	0.05422554	0.000310761	2.971303855	3.794023072	9.068654996	0.322157659	2.384600412	5.11136626	4.603815135	2.901084109	1.738760957	0	0.25	0.27202984	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	76.9255
R9943_001_0	2009	14	H.6	H.7	H.8	H.9	I.7	I.8	I.9	I.10	I.11	I.12	OP Facility - Other	OP Facility - Other	OP Facility - Other	OP Facility - Other	Professional	Professional	Professional	Professional	Professional	Professional		Cardiac Rehab Services	ASC	Urgent Care	Office Visit (Clinic)	Chiropractic	Podiatric	Diabetes Supplies	Vision Exam Diagnostic	Hearing Exam Diagnostic	Radiation/Chemo	Coin	Coin	Coin	Coin	T	Coin	Coin	V	Coin	Coin	Coin	Coin	Coin	Coin	V	V	Coin	Coin	V	Coin	Coin	0	0	0	V	V	0	V	V	0	Coin	V	V	V	Coin	Coin	Coin	V	V	Coin	14.3248	0.2364	0.7472	0.2319	0.534	0.5146	0.1328	0.4267	1.6433	1.2175	2.5718	0.1274	0.013	0.0032	1.6447	2.1331	0.0481	0.7521	2.7879	0.1618	3.9637	0	0	0	0.2232	0	0	0	0	0	0.0179	0.5738	0.0091	0.0999	0.1219	0.1736	0.0274	0.6497	0.0022	1.5129	37.6275		216.6278683	3.574341819	11.29999691	3.506638077	96.91074805	3.890769662	1.003762862	154.8653848	24.85160622	18.41125776	38.89242668	1.926207473	0.197347913	0.048267832	2984.732299	1935.474789	0.727657825	11.37317138	505.9270815	2.44705268	29.97040138	0	0	0	202.5639532	173.0614352	131.6241901	11.37493001	0	0	0.270860641	104.1265342	4.703961852	90.60835256	1.84372753	2.624718767	0.414239123	589.502326	1.963789899	11.43970075	10% Coinsurance	10% Coinsurance	10% Coinsurance (days 11-100)	10% Coinsurance	$100 copay	20% Coinsurance	20% Coinsurance	$50 copay	10% Coinsurance	10% Coinsurance	10% Coinsurance Tier 1	10% Coinsurance	10% Coinsurance	10% Coinsurance	$10 copay	$20 copay	10% Coinsurance	10% Coinsurance	$100 copay - Tier 2	10% Coinsurance	20% Coinsurance	0	0	0	$20 copay	"$0 copay / Covd up to $100/$80, glasses/lenses, /2yrs"	0	$100 max / 2 yrs	Forever Fit	0	10% Coinsurance	$100 copay	$35 copay	$20 copay	10% Coinsurance	10% Coinsurance	10% Coinsurance	$20 copay	$20 copay	20% Coinsurance	0.1	0.1	0.1	0.1	100	0.2	0.2	50	0.1	0.1	0.1	0.1	0.1	0.1	10	20	0.1	0.1	100	0.1	0.2	0	0	0	20	0	0	0	0	0	0.1	100	35	20	0.1	0.1	0.1	20	20	0.2	0.090812685	0.090812685	0.090812685	0.090812685	90.81268492	0.18162537	0.18162537	45.40634246	0.090812685	0.090812685	0.090812685	0.090812685	0.090812685	0.090812685	9.081268492	18.16253698	0.090812685	0.090812685	90.81268492	0.090812685	0.18162537	0	0	0	18.16253698	0	0	0	0	0	0.090812685	90.81268492	31.78443972	18.16253698	0.090812685	0.090812685	0.090812685	18.16253698	18.16253698	0.18162537	19.6726	0.324595577	1.026183059	0.318447219	0.733393769	0.706662479	0.182308801	0.585989225	2.256841085	1.67197575	3.53192569	0.174924072	0.017921694	0.004383331	2.258762949	2.929427703	0.066080561	1.032828229	3.828716387	0.222223424	5.443385236	0	0	0	0.306589608	0	0	0	0	0	0.024597582	0.788000845	0.012459399	0.137139796	0.167433847	0.238357758	0.037618167	0.89223815	0.002972284	2.07773988	51.6747		5.2278	33.9973	0.560953445	1.773409629	0.550328091	1.267422571	1.221226596	0.315058975	1.012683775	3.900184938	2.889443426	6.103736532	0.302296975	0.030971574	0.007575103	3.903506228	5.062522957	0.114197854	1.784893553	6.616638665	0.384037874	9.407046533	0	0	0	0.529836229	0	0	0	0	0	0.042508584	1.361792395	0.021531849	0.236999659	0.289352659	0.411920602	0.065010252	1.541931249	0.005136585	3.590669205	89.3022	4000	10% Coinsurance	10% Coinsurance	20% Coinsurance (days 1-100)	20% Coinsurance	$100 copay	30% Coinsurance	30% Coinsurance	$50 copay	10% Coinsurance	20% Coinsurance	20% Coinsurance Tier 1	10% Coinsurance	10% Coinsurance	10% Coinsurance	$25 copay	$35 copay	20% Coinsurance	20% Coinsurance	$150 copay - Tier 2	20% Coinsurance	30% Coinsurance				Covd up to $40	"$0 copay, covd up to $50 frame, $25/$35/$45/$45 sin/bif/trif/cont lenses /2yrs"	20% Coinsurance		Forever Fit		20% Coinsurance	20% Coinsurance	$35 copay	20% Coinsurance	20% Coinsurance	20% Coinsurance	15% Coinsurance	20% Coinsurance	20% Coinsurance	30% Coinsurance	12.4458	0.2404	2.165	0.4717	0.5432	0.7851	0.2025	0.434	1.4479	2.0294	4.7845	0.1296	0.0133	0.0032	4.1823	3.7969	0.0979	1.5299	4.2536	1.056	5.3857				0.0019		0.118				0.0364	1.3161	0.0092	0.1542	0.248	0.3531	0.0418	1.5933	0.0036	2.3083	52.1818		3.054759889	46.4432	0.801362064	3.938433952	1.022037884	1.810603673	2.006300836	0.517596888	1.446691107	5.348062327	4.918848336	10.88824982	0.431852821	0.044245106	0.010821575	8.085834329	8.859415175	0.212081728	3.314802313	10.87019209	1.440017631	14.7927915	0	0	0	0.531780101	0	0.117980505	0	0	0	0.078944513	2.677892806	0.030759784	0.391160075	0.537369224	0.764995404	0.106802557	3.135187423	0.008768943	5.898956552	141.484
R9943_805_0	2009	6																					none											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	V											0	0	0	0	0	0	0	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	258.1301803	2.807808626	45.04259034	33.49823254	5.91551152	11.67542585	3.301337817	7.724060607	35.07645993	5.863891427	17.47805891	0	0.313992455	18.50271099	42.5425055	122.8983411	1.533101565	7.335557868	33.43664198	41.37907386	5.971468945	0.634931083	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.061069197	0.061069197	0.153470375	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.061069197	0.061069197	0.153470375	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											15.7638	0.171470617	6.912703222	0	1.366483161	2.697023372	0.762609036	1.784258	8.102662244	1.35455892	4.037431609	0	0.072532257	4.274126239	9.827318769	28.3895168	0.354146461	1.694513868	7.723864297	9.558566063	1.379409326	0.14666908	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.3737	0	0	15.7638	0.171470617	6.912703222	0	1.366483161	2.697023372	0.762609036	1.784258	8.102662244	1.35455892	4.037431609	0	0.072532257	4.274126239	9.827318769	28.3895168	0.354146461	1.694513868	7.723864297	9.558566063	1.379409326	0.14666908	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.3737	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											3.7469	0.0408	1.7327	0	0.3722	0.7288	0.2061	0.487	1.8874	0.3476	1.0796	0	0.0122	1.4559	2.0262	5.7921	0.0608	0.29	1.532	1.8296	0.4209	0.0453	0	0	0	0	0	0	0	0											24.0941	0	0	19.5107	0.212227393	8.645409408	0	1.7386774	3.425826683	0.968685111	2.271274273	9.990070117	1.702149612	5.117011494	0	0.084751637	5.730042144	11.85348676	34.18162162	0.414971532	1.984560834	9.255886802	11.38811747	1.800338988	0.191958939	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.4678
R9943_806_0	2009	6																					none											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	V											0	0	0	0	0	0	0	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	258.1301803	2.807808626	45.04259034	33.49823254	5.91551152	11.67542585	3.301337817	7.724060607	35.07645993	5.863891427	17.47805891	0	0.313992455	18.50271099	42.5425055	122.8983411	1.533101565	7.335557868	33.43664198	41.37907386	5.971468945	0.634931083	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.061069197	0.061069197	0.153470375	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.061069197	0.061069197	0.153470375	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											15.7638	0.171470617	6.912703222	0	1.366483161	2.697023372	0.762609036	1.784258	8.102662244	1.35455892	4.037431609	0	0.072532257	4.274126239	9.827318769	28.3895168	0.354146461	1.694513868	7.723864297	9.558566063	1.379409326	0.14666908	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.3737	0	0	15.7638	0.171470617	6.912703222	0	1.366483161	2.697023372	0.762609036	1.784258	8.102662244	1.35455892	4.037431609	0	0.072532257	4.274126239	9.827318769	28.3895168	0.354146461	1.694513868	7.723864297	9.558566063	1.379409326	0.14666908	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.3737	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											3.7469	0.0408	1.7327	0	0.3722	0.7288	0.2061	0.487	1.8874	0.3476	1.0796	0	0.0122	1.4559	2.0262	5.7921	0.0608	0.29	1.532	1.8296	0.4209	0.0453	0	0	0	0	0	0	0	0											24.0941	0	0	19.5107	0.212227393	8.645409408	0	1.7386774	3.425826683	0.968685111	2.271274273	9.990070117	1.702149612	5.117011494	0	0.084751637	5.730042144	11.85348676	34.18162162	0.414971532	1.984560834	9.255886802	11.38811747	1.800338988	0.191958939	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.4678
R9943_807_0	2009	6																					none											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	V											0	0	0	0	0	0	0	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	258.1301803	2.807808626	45.04259034	33.49823254	5.91551152	11.67542585	3.301337817	7.724060607	35.07645993	5.863891427	17.47805891	0	0.313992455	18.50271099	42.5425055	122.8983411	1.533101565	7.335557868	33.43664198	41.37907386	5.971468945	0.634931083	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											0.061069197	0.061069197	0.153470375	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											0.061069197	0.061069197	0.153470375	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0.231	0	0	0	0	0	0	0	0											15.7638	0.171470617	6.912703222	0	1.366483161	2.697023372	0.762609036	1.784258	8.102662244	1.35455892	4.037431609	0	0.072532257	4.274126239	9.827318769	28.3895168	0.354146461	1.694513868	7.723864297	9.558566063	1.379409326	0.14666908	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.3737	0	0	15.7638	0.171470617	6.912703222	0	1.366483161	2.697023372	0.762609036	1.784258	8.102662244	1.35455892	4.037431609	0	0.072532257	4.274126239	9.827318769	28.3895168	0.354146461	1.694513868	7.723864297	9.558566063	1.379409326	0.14666908	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	106.3737	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	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare	Similar to FFS Medicare											3.7469	0.0408	1.7327	0	0.3722	0.7288	0.2061	0.487	1.8874	0.3476	1.0796	0	0.0122	1.4559	2.0262	5.7921	0.0608	0.29	1.532	1.8296	0.4209	0.0453	0	0	0	0	0	0	0	0											24.0941	0	0	19.5107	0.212227393	8.645409408	0	1.7386774	3.425826683	0.968685111	2.271274273	9.990070117	1.702149612	5.117011494	0	0.084751637	5.730042144	11.85348676	34.18162162	0.414971532	1.984560834	9.255886802	11.38811747	1.800338988	0.191958939	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	0	130.4678
